PMID- 1733543
TI  - Intrapleural epidural catheter for the treatment of pneumothorax.

PMID- 1733544
TI  - Obstetrical anaesthesia for patients with HELLP syndrome.

PMID- 1733545
TI  - SIADH following minor surgery.

PMID- 1733546
TI  - Fibreoptic bronchoscopic intubation after induction of general anaesthesia:
      another approach.

PMID- 1733547
TI  - Hyperthermia after cardiopulmonary bypass in a child.

PMID- 1733548
TI  - Pharmacokinetics of ara-C and ara-U in plasma and CSF after high-dose
      administration of cytosine arabinoside.
AB  - Cytosine arabinoside (ara-C) and uracil arabinoside (ara-U) levels were measured
      in the plasma, cerebrospinal fluid (CSF), and urine of 10 patients exhibiting
      primary central nervous system lymphoma who received 31 infusions of high-dose
      ara-C (3 g/m2) as part of their treatment regimen. Peak plasma and CSF ara-C
      levels were 10.8 and 1.5 micrograms/ml, respectively. Ara-C was cleared more
      rapidly from plasma than from CSF. Ara-U appeared rapidly in both plasma and CSF,
      reaching a peak that was 10 times higher than the corresponding ara-C
      concentration (104 and 11.2 micrograms/ml, respectively). Only 4%-6% of the dose
      was excreted unchanged in the urine, but 63%-73% of it appeared as ara-U within
      the first 24 h. The presence of leptomeningeal lymphoma did not affect the CSF
      level of ara-C or ara-U.

PMID- 1733549
TI  - 5-Fluorouracil, leucovorin, hydroxyurea, and escalating doses of continuous
      infusion cisplatin with concomitant radiotherapy: a clinical and pharmacologic
      study.
AB  - Cisplatin (CDDP), 5-fluorouracil (5-FU), and hydroxyurea (HU) have individually
      demonstrated activity against several solid tumors, act synergistically with each
      other in vitro, and may act as radiation sensitizers. Therefore, we designed a
      phase I study to determine the maximally tolerated dose of cisplatin as given in
      addition to our previously described combination of 5-FU, HU, and concomitant
      radiotherapy (XRT). Patients exhibiting advanced solid tumors requiring
      palliative XRT were eligible. The regimen consisted of 1 g HU given p.o.b.i.d. on
      days 1-5, 600 mg/m2 5-FU given i.v. daily by continuous infusion (c.i.) on days 1
      5, escalating doses of cisplatin starting at 10 mg/m2 daily given by c.i. on days
      1-5, and involved-field XRT carried out on days 1-5. The cycle was repeated every
      14 days until the target XRT dose had been reached. In all, 19 patients were
      entered at the first dose level, and cumulative grade 3-4 myelosuppression was
      seen in 16 subjects. As no dose escalation was feasible, the chemotherapy was
      subsequently altered by using the above regimen for cycles 1, 3, 5, and 7 and
      substituting the less myelosuppressive regimen of 1 g HU given p.o.b.i.d. on days
      1-5, 400 mg/m2 5-FU given i.v. daily by c.i., and 100 mg leucovorin given p.o.4 h
      on days 1-5 for cycles 2, 4, and 6. On this alternating program, 28 patients were
      treated with escalating doses of CDDP. The dose-limiting toxicity was again
      myelosuppression, which was prohibitive at a CDDP dose of 20 mg/m2 daily. In the
      final phase of the protocol, 30 subjects were treated with the above alternating
      cycle regimen at a CDDP dose of 20 mg/m2 daily and a decreased HU dose of 500 mg
      p.o.b.i.d. in an attempt to circumvent the myelosuppression associated with this
      dose of CDDP. Although severe acute toxicity (cycles 1 and 2) was observed less
      frequently, cumulative toxicity (all cycles) remained pronounced. The other major
      toxicity encountered was mucositis, which was particularly pronounced in patients
      receiving radiation to the head and neck and following leucovorin-containing
      cycles. Plasma concentrations of free platinum did not correlate with the CDDP
      dose, possibly due to the narrow range of doses given. Pharmacodynamic modeling
      demonstrated that the CDDP dose and the HU dose were associated with leukopenia.
      Antitumor activity was demonstrated in a number of solid tumors particularly non
      small-cell lung cancer and head and neck cancer.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1733550
TI  - In vitro succinate dehydrogenase chemosensitivity of gastric carcinoma-
      relationship to DNA content.
AB  - Relationships between in vitro chemosensitivity and cell nuclear DNA content were
      investigated in malignant cells from 41 patients exhibiting advanced gastric
      carcinoma. The chemosensitivity was evaluated by measuring the succinate
      dehydrogenase (SD) activity in drug-exposed cancer cells and the DNA content was
      microspectrophotometrically determined. Following exposure of malignant tissue to
      carboquone (CQ) and cisplatin (DDP), the mean SD activity in cells displaying a
      relatively regular DNA distribution (type II) was significantly higher than that
      in those exhibiting a widely scattered DNA distribution (type IV; P less than
      0.01 in CQ, P less than 0.05 in DDP). A similar tendency was recognized in cells
      that were treated with aclacinomycin A (ACR), Adriamycin (ADM), and mitomycin C
      (MMC). Such a decrease in SD activity in cells exhibiting a type IV pattern was
      remarkable, especially in cases undifferentiated adenocarcinoma. Mitotic counting
      analysis revealed a significantly higher value for DNA pattern type IV as
      compared with the findings for type II (P less than 0.01). These results
      demonstrate that gastric carcinoma displaying a high malignant potentially shows
      a better response to antitumor drugs. Adjuvant chemotherapy prescribed following
      drug-sensitivity testing should be effective against such tumors.

PMID- 1733551
TI  - Antitumor drug cross-resistance in vivo in a murine P388 leukemia resistant to
      ethyl 5-amino-1,2-dihydro-2-methyl-3-phenylpyrido[3,4-b]pyrazin-7 - ylcarbamate 2
      hydroxyethanesulfonate hydrate (NSC 370,147) 370147.
AB  - Ethyl 5-amino-1,2-dihydro-2-methyl-3-phenylpyrido[3,4-b]pyrazin-7- ylcarbamate 2
      hydroxyethane-sulfonate hydrate (NSC 370147) is a potent mitotic inhibitor, which
      has provided the basis for a candidate for clinical trial. As observed with
      clinically useful drugs, the development of clinical resistance to NSC 370147
      will probably be encountered. Information concerning resistance to NSC 370147
      should aid in the design of strategies for the optimal clinical use of the drug.
      A P388 leukemia resistant to NSC 370147 (P388/NSC 370147) was isolated and its in
      vivo cross-resistance profile was determined. The P388/NSC 370147 line was cross
      resistant to vincristine but was not cross-resistant to doxorubicin, etoposide,
      cisplatin, melphalan, methotrexate, or 5-fluorouracil. This information plus
      other in vivo cross-resistance data [Waud et al. (1990) Cancer Res 50: 3239]
      suggests that NSC 370147 may be useful in non-cross-resistant combinations with
      doxorubicin, melphalan, cisplatin, or methotrexate. The lack of cross-resistance
      of P388/NSC 370147 to doxorubicin and etoposide shows that resistance to NSC
      370147 does not involve multidrug resistance and suggests that the mdr1 gene is
      not involved in resistance to NSC 370147.

PMID- 1733552
TI  - A clinical and pharmacological study of high-dose mitozolomide given in
      conjunction with autologous bone marrow rescue.
AB  - In conjunction with autologous bone marrow rescue, high-dose mitozolomide was
      given i.v. to 16 patients with refractory malignancies at doses ranging from 100
      to 400 mg/m2 over 1 h. Neutropaenia occurred consistently at 300 mg/m2, and three
      trivial infective episodes were recorded. Thrombocytopaenia occurred consistently
      at 150 mg/m2, and three patients experienced episodes of minor bleeding. The
      death of one subject was attributable to pulmonary thromboembolism during the
      bone marrow reinfusion. Transient emesis and mild alopecia were the only other
      toxicities. Three of six evaluable patients receiving greater than or equal to
      300 mg/m2 exhibited measurable reductions in tumour dimensions, although these
      failed to fulfil the criteria for a partial response. Mitozolomide was
      undetectable in plasma at 12 h after drug administration. The plasma
      pharmacokinetic data fitted mono- or biexponential models in all patients. Model
      independent pharmacokinetic parameters were: peak plasma drug concentration, 3.4
      46 mg/l; AUC, 8-82 mg h l-1; clearance, 7.6-45 l/h; steady-state volume of
      distribution, 11-85 l; and plasma elimination half-life, 1.4-2.8 h. Dose
      dependent pharmacokinetics were not observed, and only a small percentage of the
      delivered dose was eliminated unchanged in the urine. The maximally tolerated
      dose of mitozolomide given with autologous bone marrow rescue was greater than
      400 mg/m2. At this dose myelosuppression was the only major toxicity, and the
      plasma drug levels and AUC values were comparable to those obtained after
      therapeutic doses in experimental models.

PMID- 1733553
TI  - Beta-carotene and/or vitamin E as modulators of alkylating agents in SCC-25 human
      squamous carcinoma cells.
AB  - Dietary levels of beta-carotene and vitamin E have been associated with cancer
      prevention and to a lesser extent, with therapeutic enhancement of cancer
      treatment. We report on the cytotoxicity of beta-carotene, vitamin E, and the
      combination of beta-carotene and vitamin E in human SCC-25 squamous carcinoma
      cells under various environmental conditions found in solid tumor masses. Beta
      Carotene was selectively cytotoxic toward normally oxygenated cells and was
      generally more cytotoxic at normal pH than at acidic pH (6.45). Vitamin E was
      selectively cytotoxic toward normally oxygenated cells following 6 h exposure at
      normal pH and was generally equally cytotoxic toward normally oxygenated and
      hypoxic cells under the other conditions tested. Beta-Carotene was an effective
      modulator of cisplatin (CDDP) cytotoxicity toward SCC-25 cells, whereas vitamin E
      was not. Both beta-carotene and vitamin E were effective modulators of melphalan
      cytotoxicity toward SCC-25 cells. Treatment of SCC-25 cells with beta-carotene
      (70 microM, 2h) resulted in a reduction in superoxide dismutase activity, in
      glutathione-S-transferase activity, and in nonprotein sulfhydryl levels in the
      cells. Exposure to vitamin E or to a combination of beta-carotene and vitamin E
      increased the glutathione-S-transferase activity in SCC-25 cells by 40%-45% over
      the control value. Treatment with beta-carotene, vitamin E, or canthaxanthin
      reduced the incorporation of [3H]-thymidine into SCC-25 cells but not that into
      normal human keratinocytes. The most marked reduction in [3H]-thymidine
      incorporation into SCC-25 cells occurred following treatment with the combination
      of beta-carotene and melphalan. We hope to continue to explore the mechanisms of
      this effect and to study these combinations in vivo.

PMID- 1733554
TI  - Phase I trial of piroxicam in 62 dogs bearing naturally occurring tumors.
AB  - Piroxicam, a nonsteroidal antiinflammatory drug, was given to 62 dogs bearing
      naturally occurring tumors in a phase I clinical trial. Dose escalation was
      performed, with oral doses ranging from 0.5 mg/kg every 48 h (q48h) to 1.5 mg/kg
      q48h being tested. Dose-limiting gastrointestinal irritation/ulceration occurred
      in all four animals that received 1.5 mg/kg q48h. The maximum tolerated dose was
      1 mg/kg q48h. Subclinical renal papillary necrosis occurred in two dogs (initial
      dosages, 1 and 1.5 mg/kg q48h, respectively). Following dose escalation, an
      additional group of dogs was treated with 0.3 mg/kg piroxicam q24h per os, the
      accepted canine dosage prior to this trial. Inclusion of this treatment group
      enabled evaluation of the toxicity of and tumor response to a daily dosage
      regimen. No complete remissions occurred in this trial. Partial remission was
      documented in three of ten dogs exhibiting transitional-cell carcinoma, in three
      of five animals bearing squamous-cell carcinoma, in one of three dogs displaying
      mammary adenocarcinoma, and in the one dog that exhibited a transmissible
      venereal tumor. The results of this study support the additional evaluation of
      piroxicam in a phase II clinical trial in dogs bearing naturally occurring
      tumors.

PMID- 1733556
TI  - Effects of carboplatin on the testis. A histological study.
AB  - In the present study, the influence of carboplatin [diammine(cyclobutane-1,1
      dicarboxylato)platinum(II)], the main and most active representative of second
      generation antitumour platinum complexes, on the morphology of the testes of male
      CF1 mice was investigated histologically by examining semithick sections.
      Carboplatin was administered in doses of 30, 60, or 120 mg/kg and applied as a
      single intraperitoneal injection. For comparison purposes, the parent compound
      cisplatin [cis-diamminedichloroplatinum(II)] was administered at equitoxic doses
      (3, 6 or 12 mg/kg). At various intervals between days 1 and 28 after treatment,
      the testes were removed and embedded in Epon. Both compounds effected severe
      structural alterations of Sertoli cells, disrupted the blood/testis barrier, and
      impaired the processes both of spermatogenesis and spermiohistogenesis. The
      structural damage in the testes following treatment with carboplatin was at least
      as pronounced as that occurring under the influence of equitoxic doses of
      cisplatin. Within a few days, the intercellular spaces around Sertoli cells
      widened, the tight contacts with neighbouring cells were disrupted, the cytoplasm
      of Sertoli cells disintegrated and their nuclei shrank. Numerous necroses,
      abnormal mitotic figures of spermatogenic cells and malformed spermatozoa
      appeared. Severe damage was evident on days 10-21 after treatment with
      carboplatin, the strength of the symptoms being clearly dependent on the dose
      applied. The first indications of ongoing recovery processes were detected on day
      21 in the case of the low dose (30 mg/kg) or on day 28 following treatment with
      60 mg/kg or 120 mg/kg. These results confirm that carboplatin is at least as
      toxic to the testes as cisplatin and that its substitution for cisplatin in
      clinical therapy does not diminish the problem of drug-induced infertility
      following platinum-based chemotherapy.

PMID- 1733555
TI  - Experimental basis for increasing the therapeutic index of cis
      diamminedicarboxylatocyclobutaneplatinum(II) in brain tumor therapy by a high
      zinc diet.
AB  - Metallothionein (MT), a ubiquitous intracellular protein, confers resistance to
      the toxic effects of platinum compounds. Since a high-zinc diet has been shown to
      induce MT synthesis in extracerebral tissues but not in brain, we investigated
      whether it could provide an experimental basis for decreasing the hematotoxicity
      of carboplatin without impairing its activity against brain tumors. After 2 weeks
      on either a high-zinc diet or a control diet (zinc content, 180 vs 10 ppm), mice
      and rats received various doses of carboplatin or Hanks' balanced salt solution
      by i.p. injection. The hematotoxicity of carboplatin was evaluated with an assay
      of colony-forming units of granulocytes and mononuclear cells in mice. The high
      zinc diet enabled a 50% increase in the carboplatin dose without increasing
      hematotoxicity. The antitumor activity was evaluated with an assay of the colony
      forming efficiency of gliosarcoma cells from 9L brain tumors in rats. The high
      zinc diet did not alter the efficacy of carboplatin against this brain tumor.
      Northern blot analysis confirmed that the high-zinc diet induced MT mRNA in the
      kidney but not in the brain of mice and rats; it also showed MT mRNA induction in
      bone marrow cells of mice but not in rat 9L brain tumors. These results suggest
      that increasing the dietary intake of zinc might increase the therapeutic index
      of carboplatin in the treatment of brain tumors.

PMID- 1733557
TI  - Modulation of the cellular pharmacokinetics of ara-CTP in human leukemic blasts
      by dipyridamole.
AB  - The effect of dipyridamole (DP) on the cellular retention of 1-beta-D
      arabinofuranosylcytosine (ara-C) and its metabolites was examined in leukemic
      blasts that had been isolated directly from bone marrow aspirates from patients
      afflicted with acute myeloid leukemia (AML). When AML cells were loaded for 2 h
      with 1 microM [3H]-ara-C and then transferred to ara-C-free medium, total
      intracellular concentrations of radiolabel and [3H]-ara-C 5'-triphosphate [3H]
      ara-C-CTP rapidly declined. After 8 h, total intracellular levels of tritium were
      4.4 times higher if 10 microM was included in the washout medium; however, the
      majority of this intracellular radiolabel corresponded to [3H]-uridine
      arabinoside ([3H]-ara-U) and [3H]-ara-C. DP significantly increased the mean t1/2
      for [3H]-ara-CTP from 102 to 136 min (P less than 0.01), but this effect was much
      less pronounced than that obtained for total tritium and the increase was quite
      variable (0-70%; median, 19%). The presence of DP in the washout medium also
      increased the incorporation of ara-C into DNA and the formation of ara-CDP
      choline. The level of ara-CDP-choline continued to increase in both DP-containing
      and DP-free media for the first 4 h following drug removal and the formation of
      ara-CDP-choline continued during the first few hours in ara-C-free medium. At the
      end of the 8-h wash in DP-containing medium, the cellular concentration of ara
      CDP-choline was equivalent to that found at the beginning of the washout period.
      Although statistically significant, the effect of DP on ara-CTP retention in AML
      blasts was much less pronounced than that previously observed in L5178Y leukemia.
      The former cells exhibited only 10% as many nucleoside transport carriers as did
      the L5178Y cells as measured by their capacity to bind [3H]
      nitrobenzylmercaptopurine riboside (NBMPR). The effect of DP in prolonging ara
      CTP retention was proportional to the number of [3H]-NBMPR binding sites. This
      suggests that in patients cells that exhibit extremely low transport capacity,
      most of the net catabolism occurs via deamination, and further inhibition of
      transport by DP in an effort to improve cellular retention of ara-C has little
      effect on ara-CTP catabolism.

PMID- 1733558
TI  - Assembly of prednimustine low-density-lipoprotein complexes and their cytotoxic
      activity in tissue culture.
AB  - The lipophilic anticancer drug prednimustine was incorporated into model low
      density-lipoprotein (m-LDL) using a novel modified method. The major steps of
      this procedure involve the preparation of a microemulsion containing the drug and
      the complexing of this emulsion with apolipoprotein B (apo B) that has been
      delipidated by heptane extraction. The resulting particles contained on average
      338 mol prednimustine/mol apoB and exhibited a diameter that was ca. 2.5 times
      that of native LDL. The cellular binding, uptake, and metabolism of the complexes
      were found to be similar to those of native LDL. The cytotoxic activity of the
      complexes was monitored in vitro against T-47D breast cancer cells and normal 3T3
      fibroblasts. The activity of prednimustine in m-LDL against T-47D cells after 24
      h treatment was nearly 50% higher than that of the free drug, whereas in 3T3
      cells the difference was relatively small. The results indicate that it is
      possible to target drug/m-LDL complexes to cancer cells exhibiting high LDL
      receptor activity.

PMID- 1733559
TI  - Suitability of cisplatin solutions for 14-day continuous infusion by ambulatory
      pump.
AB  - The stability of cisplatin (DDP) solutions (1 and 1.6 mg/ml in saline-mannitol)
      in plastic infusion bags was studied for up to 14 days at 25 degrees C, 37
      degrees C and 60 degrees C. Small changes in the solution were observed, but no
      evidence of any decomposition product was seen. Some precipitation of DDP was
      seen in the 1.6-mg/ml solution at the lower temperatures. Fluid loss from the
      bags was significant at the higher temperatures.

PMID- 1733560
TI  - Highly purified human alpha-thrombin promotes morphological transformation of
      BALB/c 3T3 cells.
AB  - Purified human alpha-thrombin stimulates phosphoinositide turnover as a necessary
      step in its stimulation of fibroblast cell proliferation. Since phosphoinositide
      turnover releases diacylglycerol, which activates protein kinase C, we postulated
      that long-term exposure to thrombin might promote cellular transformation in a
      manner similar to long-term exposure to phorbol esters, which also activate
      protein kinase C. The present studies show that chronic exposure of BALB/c 3T3
      cells (subclone A31-1-13) to thrombin (5 micrograms/ml) led to a 4- to 20-fold
      increase in the frequency of morphological transformation over controls as
      determined by induced foci in monolayer cultures. The foci appeared to represent
      true transformants as cells from randomly selected foci grew in soft agar and had
      saturation densities 2- to 3-fold higher than control cells. Acute thrombin
      treatment for 24 h resulted in small but statistically significant (P less than
      0.05) increases in morphological transformation with or without promotion by
      phorbol myristate acetate, indicating that thrombin can act as a weak initiator
      or complete carcinogen in this test system. Initiation of cells with low levels
      of 3-methylcholanthrene followed by promotion with thrombin caused a greater
      enhancement of morphological transformation (P less than 0.005). Thus, it appears
      that most of the stimulation of in vitro cell transformation by thrombin may be
      due to its promotional activity. These results raise the possibility that
      thrombin released locally following tissue injury or chronic irritation may play
      a role in cellular transformation and tumor development, especially in tissues
      sensitized by exposure to initiating carcinogens.

PMID- 1733562
TI  - Reaction product inactivation of aryl sulfotransferase IV following electrophilic
      substitution by the sulfuric acid ester of N-hydroxy-2-acetylaminofluorene.
AB  - Rat liver N-hydroxy-2-acetylaminofluorene (N-OH-2AAF) sulfotransferase activity
      is mediated by aryl sulfotransferase IV (AST IV) and causes the bioactivation of
      N-OH-2AAF to a highly reactive sulfuric acid ester form putatively capable of
      inducing liver cancer. Dietary administration of 2-acetylaminofluorene (2AAF) to
      induce hepatocarcinogenesis in rats has been shown to cause a rapid loss in N-OH
      2AAF sulfotransferase activity. A possible mechanism for the in vivo loss in
      sulfotransferase activity may be the PAPS-dependent, sulfotransferase-catalyzed,
      reaction product inactivation of the enzyme by covalent reaction with the N-OH
      2AAF sulfuric acid ester. In vitro studies to evaluate this possibility utilized
      a highly purified form of AST IV and measured the extent of PAPS-dependent
      interaction between the enzyme and N-OH-2[9-14C]AAF. The results showed the
      presence of a adenosine-3'-phospho-5'-phosphosulfate (PAPS)-dependent 14C
      labeling of AST IV. The labeling could be blocked if the sulfotransferase
      inhibitor pentachlorophenol was present. Analysis of 14C-labeled AST IV following
      alkaline digestion and chromatography of digestion products indicated that AST IV
      cysteine and methionine residues were primary sites of 2[9-14C]AAF adduction.
      Studies involving the pretreatment of AST IV with PAPS and N-OH-2AAF prior to the
      measurement of N-OH-2AAF sulfotransferase activity showed a close parallel
      between formation of the AST IV cysteine-2AAF adduct and loss of activity.
      Similar studies showed that enzyme inactivation and cysteine-2AAF adduct
      formation could be blocked when excessive amounts of a competing nucleophile,
      methionine, were present during the pretreatment step, suggesting that
      inactivation does not proceed by a mechanism-based process. Finally, experiments
      involving prior reaction of AST IV with the thiol-blocking agent, N
      ethylmaleimide, before measurement of enzyme activity showed essentially full
      loss of sulfotransferase activity and suggested that formation of AST IV cysteine
      2AAF adducts could be a mechanism for enzyme inactivation. These results indicate
      that the in vitro inactivation of AST IV by the reactive N-OH-2AAF sulfuric acid
      ester is accompanied by covalent binding to AST IV, possibly through the
      formation of cysteine-2AAF adducts, and suggests that this mechanism merits
      further consideration as a basis for the loss of N-OH-2AAF sulfotransferase
      activity in vivo.

PMID- 1733561
TI  - Molecular dosimetry of urinary aflatoxin-N7-guanine and serum aflatoxin-albumin
      adducts predicts chemoprotection by 1,2-dithiole-3-thione in rats.
AB  - Hepatocellular carcinoma has one of the poorest 5 year survival rates of any
      human cancer. Preventive measures offer the best possibility of ameliorating this
      disease and chemoprotective agents are being developed for this purpose. The
      dithiolethiones, including oltipraz and the unsubstituted molecule 1,2-dithiole-3
      thione, have been shown to be potent inhibitors of aflatoxin-induced hepatic
      tumorigenesis in rats. However, subsequent evaluation of dithiolethiones or other
      chemoprotective agents in human clinical trials will require the development of
      intermediate, non-invasive biomarkers to evaluate the efficacy of these
      interventions. In this study, levels of molecular dosimetry biomarkers for
      determining genotoxic damage caused by aflatoxin B1 have been measured in a
      chronic exposure model with male F344 rats wherein half the animals were fed a
      diet supplemented with 0.03% 1,2-dithiole-3-thione to lower their risk for tumors
      and the other half were fed unsupplemented AIN-76A diet and were at high risk for
      tumor development. Levels of hepatic aflatoxin-DNA adducts, serum aflatoxin
      albumin adducts and excreted aflatoxin-N7-guanine adducts in urine were
      determined following multiple administrations of 250 micrograms aflatoxin B1/kg
      body wt on days 0-4 and 7-11 to assess the use of the serum and urinary
      biomarkers as indices of chemoprotective efficacy. In the rats fed 1,2-dithiole-3
      thione, the overall diminutions in the levels of hepatic DNA adducts, urinary
      aflatoxin-N7-guanine and serum aflatoxin-albumin adducts over the 2 week exposure
      period were 76, 62 and 66% respectively. This parallelism in reductions of levels
      of biomarkers relative to target organ DNA adduct burden suggests that these
      biomarkers are predictive short-term, non-invasive measures for assessing the
      efficacy of chemoprotective interventions in experimental studies and can be
      applied to human clinical trials directed at populations at high risk for
      aflatoxin exposure and primary hepatocellular carcinoma.

PMID- 1733563
TI  - Protection by chlorophyllin against the covalent binding of 2-amino-3
      methylimidazo[4,5-f]quinoline (IQ) to rat liver DNA.
AB  - Chlorophyllin (CHL), a sodium/copper salt of chlorophyll used in the treatment of
      geriatric patients, exhibits potent antimutagenic activity in a range of assays
      in vitro and in vivo. The protective effects of CHL were studied in Sprague
      Dawley rats using inhibition of carcinogen-DNA binding as an end-point. Animals
      were administered CHL (150 mg/kg body wt) and [2-14C]2-amino-3-methylimidazo[4,5
      f]quinoline (IQ, 50 mg/kg body wt) by single oral gavage. Covalent IQ-DNA binding
      in liver was determined 8, 24 and 48 h after dosing; CHL inhibited binding at
      these times by 58, 56 and 46% respectively, compared with rats given IQ alone.
      The total liver burden of IQ-derived radioactivity was reduced in CHL-treated
      rats, as was the total amount of radiolabel eliminated in the urine and bile.
      However, elimination via the feces was increased in rats given CHL, both in terms
      of total radiolabel eliminated and amount of unmetabolized IQ in dichloromethane
      extracts of feces. Finally, pretreatment with CHL in the drinking water, or
      injection of CHL into isolated loops of intestine in situ, reduced the absorption
      of IQ from the gut. Collectively, these findings indicate that, when administered
      simultaneously with the carcinogen, CHL attenuates IQ-DNA binding in rat liver by
      interacting with IQ in the gut and reducing carcinogen uptake, distribution and
      metabolism. The results suggest that further studies should be conducted with
      respect to the protective mechanisms and possible anti-carcinogenic properties of
      CHL.

PMID- 1733564
TI  - Molecular dosimetry of DNA adducts in C3H mice treated with glycidaldehyde.
AB  - The formation of DNA adducts in the skin of male C3H mice treated cutaneously
      with glycidaldehyde (2 or 10 mg/animal) in acetone has been investigated by HPLC
      coupled with fluorescence detection and 32P-postlabelling analysis. Following a
      24 h exposure period, epidermal DNA was isolated from treated dorsal skin and
      enzymically digested to nucleoside-3'-monophosphates. HPLC-32P-postlabelling
      analysis of the DNA hydrolysate indicated that a single major cyclic adduct was
      formed from the reaction of glycidaldehyde with deoxyadenosine residues in mouse
      skin DNA. This adduct was identified as 3-beta-D-deoxyribofuranosyl-7
      (hydroxymethyl)-3H- imidazo[2,1-i]purine-3'-monophosphate by comparison with a
      synthetic standard. This adduct was stable, strongly fluorescent and readily
      detected by HPLC with fluorescence detection. There was no evidence for the
      formation of deoxyguanosine adducts in epidermal DNA of treated animals.
      Glycidaldehyde also reacted with calf thymus DNA in vitro at pH 7.0 to give the
      same deoxyadenosine adduct observed in vivo. At pH 10, however, this was a
      relatively minor product and the major adduct was 5,9-dihydro-7-(hydroxymethyl)-9
      oxo-3-beta-D-deoxyribofuranosyl-3H-imidazo[1,2-a]purine-3'- monophosphate formed
      by the initial reaction of glycidaldehyde with deoxyguanosine residues.

PMID- 1733565
TI  - Effects of phenobarbital on I-compounds in liver DNA as a function of age in male
      rats fed two different diets.
AB  - The age-dependent effects of diet and of phenobarbital (PB), a known promoter of
      hepatocarcinogenesis, on indigenous DNA adducts (I-compounds) were studied by the
      32P-post-labeling technique. Late-gestation female Sprague-Dawley rats were fed
      either AIN-76A semisynthetic or Teklad cereal-based diet. At 21 days after birth,
      the male pups were weaned and continued on the diets, with half of each dietary
      group receiving 0.05% PB mixed into the diet for 2, 4 and 8 months. Age-dependent
      increases in I-compound levels were observed. In addition, both the levels of
      individual I-compounds and the overall number of I-compounds were greater in rats
      fed the Teklad cereal-based diet than in those fed the AIN-76A diet. Independent
      of the parent diet, PB administration reduced the levels of the majority of I
      compounds in a time-dependent manner. This effect of PB was detected earlier in
      the Teklad-fed than in the AIN-76A-fed group. In contrast to the I-compounds, a
      second group of spots, termed reverse I-compounds, declined between 2 and 4
      months and, especially in AIN-76A-fed animals, tended to increase when PB was
      administered. It is hypothesized that alterations of DNA modification patterns
      may play a role in diet-modified hepatocarcinogenesis promoted by PB.

PMID- 1733566
TI  - Status of ornithine decarboxylase activity and DNA synthesis in mancozeb-exposed
      mouse skin.
AB  - The effect of mancozeb, a fungicide, on mouse skin ornithine decarboxylase (ODC)
      activity and DNA synthesis was studied. ODC activity was induced after topical
      application of mancozeb and exhibited a peak level at 5 h. This ODC induction was
      dependent on the dose of mancozeb applied. Cycloheximide, an inhibitor of protein
      synthesis, inhibited the mancozeb-caused ODC induction, indicating the effect on
      enzyme protein synthesis. The rate of DNA synthesis was also increased by
      mancozeb, as indicated by increased [3H]thymidine incorporation into skin DNA.
      Induction of ODC activity and DNA synthesis are among the events probably
      involved in the tumorigenic action of mancozeb on mouse skin.

PMID- 1733567
TI  - Mutations recovered in the Chinese hamster aprt gene after exposure to
      carboplatin: a comparison with cisplatin.
AB  - Platinum-based compounds such as cisplatin and carboplatin are currently used for
      the treatment of a variety of solid tumors. Their primary mode of action involves
      the production of cross-links in DNA. These compounds induce mutations in
      bacterial as well as in mammalian cells. Previously we determined the sequence
      specificity and mutational outcome in the Chinese hamster aprt gene in mutants
      isolated after exposure to cisplatin. The second-generation platinum drug,
      carboplatin, is of clinical relevance because it displays different and less
      toxic effects. Here we report the mutagenic specificity of this related compound.
      Mutations recovered after exposure to carboplatin display the same preference for
      sequences that contain 5'-AGG-3', 5'-AGA-3' and 5'-GAG-3' as was found for
      cisplatin. We thus conclude that the mutagenic outcome of exposure to carboplatin
      and cisplatin respectively, is similar, if not identical.

PMID- 1733568
TI  - Transplacental and transgeneration carcinogenic effect of 7,12
      dimethylbenz[a]anthracene: relationship with ras oncogene activation.
AB  - Transgeneration transmission of the carcinogenic action of 7,12
      dimethylbenz[a]anthracene (DMBA) was studied in two generations of mice using
      transplacental DMBA initiation followed by postnatal skin tumor promotion with 12
      O-tetradecanoylphorbol-13-acetate (TPA) in the first generation (F0) and only
      promotion in the second generation (F1). Local application of TPA resulted in
      increased skin tumor yield in both the in utero DMBA-exposed mice and their
      progeny (P = 0.0002 and P = 0.0941 respectively compared to control). Similarly,
      lung tumor incidence was increased in the two generations of mice (P less than
      0.0001 and P = 0.0080 respectively). The results suggest transgeneration transfer
      of the effect of DMBA. A to T mutation at the second base of codon 61 of the Ha
      ras oncogene was found in skin tumors of DMBA-exposed mice, but not in tumors
      induced by TPA without initiation. Analysis of Ki-ras codon 61 in seven lung
      tumors from DMBA-treated mice revealed three types of mutation: two cases with
      CA[C or G or T], one case with CCA and one case with CTA (the remaining cases
      having only the wild type). Six of these mice also had skin tumors, which
      contained A to T mutation at the second base of codon 61 of the Ha-ras gene in
      five cases. Thus mutations of different ras genes were found in skin and lung
      tumors from the same animals. In the progeny (F1) of DMBA-exposed F0 mice, only
      skin tumor samples were available for oncogene analysis and none contained the Ha
      ras mutation. The results confirm our previous finding that initiation of skin
      and lung tumorigenesis can be transmitted transgenerationally. On the other hand,
      our data from a limited number of skin tumors suggests that ras gene mutation may
      not be critically involved in this transmission.

PMID- 1733569
TI  - Development of a quantitative in vitro transformation assay for kidney epithelial
      cells.
AB  - A quantitative in vitro transformation assay has been developed for the first
      time using primary rat kidney epithelial (RKE) cells. RKE cells were grown in a
      50:50 mixture of 3T3 conditioned medium and DF8 medium composed of Ham's F
      12/DMEM supplemented with ferrous sulfate, vasopressin, transferrin, sodium
      selenite and 10% fetal bovine serum. Colony forming efficiency of cells plated in
      this medium was high, ranging from 2.4 to 16%. Normal RKE cells treated with N
      methyl-N'-nitro-N-nitrosoguanidine (MNNG) became transformed to a preneoplastic
      state of enhanced in vitro growth potential and formed large colonies of
      morphologically altered cells, whereas RKE cells treated with vehicle alone
      ceased proliferating and/or sloughed off the dish within 4-6 weeks. Relative
      survival and percent transformation frequency (Tf) of RKE cells exposed to MNNG
      were inversely proportional and both were dose dependent. MNNG concentration of
      0.5, 1.0 and 2.0 micrograms/ml resulted in transformation frequencies of 0.13,
      0.37 and 1.1% respectively (n = 4). Morphologically transformed colonies gave
      rise to cell lines with indefinite growth capacity and neoplastic potential. One
      of six transformed RKE cell (TRKE) lines injected into nude mice produced
      adenocarcinomas. This assay represents the first in vitro model for studying
      mechanisms of chemical transformation of normal kidney epithelial cells and may
      also be useful as a screen for identifying potential renal carcinogens.

PMID- 1733570
TI  - Relationship between the depletion of O6-methylguanine-DNA methyltransferase by
      O6-methylguanine and the stimulation of DNA synthesis and growth of cultured
      chick hepatocytes.
AB  - O6-Methylguanine-DNA methyltransferase (O6-MT) has been described as a DNA repair
      enzyme that reverses alkylation damage at the O6 position of guanine in DNA. We
      demonstrate that the concentration of this protein decreases immediately prior to
      DNA synthesis in cultured chick hepatocytes. If intracellular levels are
      experimentally depleted by treatment of cultures with O6-methylguanine, DNA
      synthesis occurs as an associated resultant. This effect is dose dependent and
      can be followed by discernible morphological changes of organoids in culture.
      Increased and altered growth caused by O6-methylguanine was quantified and was
      also found to be dose dependent. Therefore, O6-MT may play a role in the
      regulation of DNA synthesis.

PMID- 1733571
TI  - Diet-induced increase of colonic bile acids stimulates lytic activity of fecal
      water and proliferation of colonic cells.
AB  - The proposed intermediate steps in the relationship between a diet-dependent
      increase in colonic bile acids and proliferation of colonic cells were studied in
      rats. Male Wistar rats were fed diets supplemented with increasing amounts of
      steroids to increase the bile acid concentration of the colon. After 2 weeks, in
      vivo colonic proliferation was measured using tritiated thymidine incorporation
      into DNA. Luminal lytic activity was measured as lysis of erythrocytes by fecal
      water. To quantify hemolysis in the presence of fecal water, a method was
      developed which measures Fe-release using atomic absorption spectrophotometry.
      This method proved to be superior to the cell-counter method published earlier.
      Our results showed that steroid supplementation increased, in a dose-dependent
      manner, the total fecal and the soluble bile acid concentration as well as lytic
      activity of fecal water and colonic proliferation. A highly significant
      correlation between lytic activity of fecal water and colonic proliferation (r =
      0.85, n = 24, P less than 0.001) was observed. These results indicate that the
      increase in colonic proliferation is mediated by diet-dependent increases in
      soluble colonic bile acid concentration and luminal lytic activity. This sequence
      of effects illustrates how diet could influence the risk for colon cancer.

PMID- 1733572
TI  - K-ras oncogene mutations in rat colon tumors induced by N-methyl-N-nitrosourea.
AB  - We have been studying a rat model of colon cancer in which tumors are induced by
      direct application of N-methyl-N-nitrosourea (MNU) to discrete areas of the
      colonic mucosa for a limited period of time. Activation of the ras genes by point
      mutation has been observed in many experimental tumors, including tumors induced
      by MNU. To detect potential activating point mutations in the H-ras and K-ras
      oncogenes in MNU-induced rat colon tumors, DNA samples from 40 adenomas, nine
      carcinomas, and 14 histologically normal tissue samples from 14 rats--as well as
      from 16 foci induced on NIH3T3 cells by tumor DNAs--were amplified by the
      polymerase chain reaction and hybridized with allele-specific oligonucleotide
      probes. No H-ras point mutations were observed in any of these samples. We did
      detect K-ras point mutations, however, in four primary tumours--one adenoma
      (2.5%) and three carcinomas (33%); these mutations were all G----A transitions at
      the second nucleotide of codons 12 and 13. The absence of detectable ras
      mutations from the majority of tumors suggests that, in contrast to other animal
      models utilizing MNU, tumorigenesis in MNU-induced rat colon tumors may
      predominantly involve activation of genes other than ras.

PMID- 1733573
TI  - Induction of ornithine decarboxylase in specific subpopulations of murine
      epidermal cells following multiple exposures to 12-O-tetradecanoylphorbol-13
      acetate, mezerein and ethyl phenylpropriolate.
AB  - Single applications of 12-O-tetradecanoylphorbol-13-acetate (TPA), mezerein or
      ethyl phenylpropriolate (EPP) to mouse skin at appropriate doses cause similar
      degrees of hyperplasia and comparable levels of induction of epidermal ornithine
      decarboxylase (ODC) activity. Multiple (n = 5) treatments with these agents, in
      contrast, resulted in large differences in induced ODC activity (TPA much greater
      than mezerein greater than EPP) with no differences in the degree of hyperplasia
      or [3H]thymidine pulse-labeling among the multiple treatment groups. To attempt
      to explain the cellular basis for the greater ODC-inducing ability of TPA
      relative to mezerein and EPP in chronic exposure protocols, immunocytochemical
      and flow cytometric analyses were performed. Immunocytochemistry using an ODC
      specific polyclonal antibody revealed substantially different pattern of ODC
      positive cells in chronically exposed epidermis than observed with single
      exposures. TPA treatment resulted in very pronounced immunostaining of the
      perifollicular cells, with little evidence of specific staining in the
      interfollicular epidermis mezerein treatment yielded staining in both
      interfollicular and some perifollicular areas, while EPP treatment produced the
      least amount of specifically stained cells, all of which were in the
      interfollicular epidermis. Flow cytometric analysis of keratinocytes isolated
      from chronically treated skin identified three distinct subpopulations that bound
      varying amounts of ODC antibody. Chronic treatment of CD-1 murine epidermis with
      TPA appeared to cause the expansion of an intermediate sized cell subpopulation
      that was not apparent with EPP or mezerein. Our results suggest that chronic
      treatment of murine epidermis with the potent complete tumor promoter TPA leads
      to the selective expansion of a keratinocyte subpopulation that is hyperinducible
      for ODC and may be identical to the cells in the perifollicular region previously
      identified. These observations also suggest that the weaker tumor promoters
      mezerein and EPP are less capable of causing expansion of this specific
      subpopulation, which may be an important target cell population for neoplastic
      transformation in mouse epidermis.

PMID- 1733574
TI  - Investigations of the frequency of DNA strand breakage and cross-linking and of
      sister chromatid exchange frequency in the lymphocytes of female workers exposed
      to benzene and toluene.
AB  - Peripheral lymphocyte DNA damage as measured by the method of alkaline filter
      elution and the frequency of sister chromatid exchange (SCE) in lymphocytes was
      investigated for a group of 20 female workers of a shoemaking plant who were
      exposed to benzene and toluene, primarily below the German threshold limit value
      of 5 and 100 p.p.m. respectively; the results were compared with those from a
      control group. In the female workers significantly raised (P less than 0.05) SCE
      values were found. The relative DNA elution rate through polycarbonate filters
      was significantly increased (P less than 0.001). The elution rate through
      polyvinylidene fluoride (HVLP) filters showed a tendency to increase (P = 0.052),
      which must be interpreted as indicating increased DNA strand breakage. The SCE
      rates of the female workers were significantly correlated (P less than 0.01) with
      the relative DNA elution rate through HVLP filters. There was no correlation with
      the actual benzene and toluene uptake measured by personal air monitoring. Four
      months after cessation of work, DNA strand breakage decreased significantly (P
      less than 0.05) in blood samples of six reinvestigated female workers.

PMID- 1733575
TI  - The role of macrophage-derived TNFa in the induction of sublethal tumor cell DNA
      damage.
AB  - In previous studies we showed that tumor-associated macrophages isolated from
      murine mammary tumors are mutagenic to bacteria and mammalian cells and thus may
      contribute to tumor progression. We reported previously, and confirm here, that
      inflammatory macrophages induce DNA strand breaks in cultured mammary tumor cells
      co-incubated at a 1:1 ratio for 1 h. This activity is prevented by inhibitors of
      arachidonate metabolism or the removal of H2O2 with catalase. In the present
      study, we show that two antibodies to recombinant murine tumor necrosis factor
      alpha (rMuTNFa)--a hamster monoclonal antibody (TN3-19.12) and a rabbit
      polyclonal antibody (Genzyme)--partially protect tumor cells from DNA strand
      breaks induced by elicited but not resident peritoneal macrophages. Antibody
      protection was reversed upon the addition of excess exogenous rMuTNFa. Purified
      rMuTNFa alone was unable to induce DNA strand breaks in the absence of
      macrophages, indicating that TNFa is necessary but not sufficient to mediate
      damage. Tumor target cells were completely resistant to the cytotoxic effects of
      rMuTNFa in the absence of actinomycin D and relatively resistant (in comparison
      to WEHI 164 clone 13 cells) in its presence. The incomplete protection seen with
      either catalase or anti-TNF suggests that macrophage-released TNFa, in the
      presence of other factors, induces non-cytotoxic DNA effects in tumor cells.

PMID- 1733576
TI  - Stimulation of TGF-beta 1 mRNA concentration in mouse skin treated with
      benzo[a]pyrene.
AB  - Topical application of benzo[a]pyrene (B[a]P) at dose rates of 32 or 64
      micrograms/week to the dorsal skin of female Swiss (ICR) mice resulted in a
      marked and rapid increase in concentration of RNA for transforming growth factor
      beta 1 (TGF-beta 1) in epidermis. Two RNA species 1.9 and 2.5 kb, detected by a
      mouse TGF-beta 1 cDNA probe, were coordinately expressed. The concentration of
      these species appeared to be maximal 6-12 h after application, and returned to
      control levels after 48 h. A second, less intense maximum was observed 72-96 h
      after treatment. Similar effects were observed in CD-1 and HRS (both hr/hr and
      hr/+) mice, which are also sensitive to B[a[] tumorigenesis. In comparison with
      32 and 64 micrograms/week a dose rate of 16 micrograms/week was essentially
      without activity in increasing TGF-beta 1 RNA concentration. All three dose rates
      induced an increase in epidermal RNA for ornithine decarboxylase, however, and
      with kinetics similar to those observed with the potent tumor-promoting phorbol
      ester 12-O-tetradecanoylphorbol-13-acetate. The results obtained support other
      findings made in this laboratory, that at high dose rates above 16 micrograms
      tumorigenesis by B[a]P involves a strong tumor-promoting component. The latter
      further appears to be mediated by increased TGF-beta 1 expression.

PMID- 1733577
TI  - Prevalence of tumor prevention rather than tumor enhancement when repetitive UV
      radiation treatments precede initiation and promotion.
AB  - UV irradiation can act as a tumor initiator in mouse skin, yet repetitive UV
      irradiation can systemically prevent chemically induced two-stage skin
      tumorigenesis. The present study addressed the question of whether repetitive
      dorsal UV irradiation would enhance or inhibit subsequent initiation and
      promotion applied dorsally. Approximately 4.25 x 10(5) J/m2 was applied
      intermittently to 30 shaved CDF1 mice over an 8 week period. Mice were then
      initiated dorsally with 100 micrograms of 7,12-dimethylbenz[a]anthracene and
      subsequently promoted with 7.5 micrograms 12-O-tetradecanoylphorbol-13-acetate
      (TPA) applied twice weekly for 19 weeks. Initiated and promoted mice that had
      been treated repetitively with 1.06 x 10(4) J/m2 showed a decrease in tumor
      incidence from 92 to 28%, and a reduction in tumor yield per mouse from 5.35 to
      0.58, at 19 weeks after the first TPA treatment. Histological analysis revealed
      that the UVB radiation treatments used in these experiments did not produce
      permanent loss of epidermal cells or sebaceous gland atrophy. When the same dose
      of UVB irradiation was applied after initiation and promotion, no increased
      conversion of papillomas to carcinomas was found, within a 48 weeks experimental
      duration. Thus, repetitive UV irradiation prevented rather than enhanced
      subsequent two-stage tumorigenesis. Repetitive UVB irradiation at late stages of
      promotion failed to enhance conversion of papillomas to carcinomas within the
      time frame in which chemical initiators mediate conversion to malignancy.

PMID- 1733578
TI  - High-performance liquid-chromatographic measurement of plasma creatinine in
      newborns.
AB  - This HPLC method for measuring plasma creatinine is based on cation-exchange
      chromatography and is particularly suitable for use with specimens from babies. A
      short chromatographic run is performed after simple protein precipitation with
      zinc sulfate and addition of an internal standard, N-methylnicotinamide. The
      standard curve for the method is linear up to 200 mumol/L, and analytical
      recovery of added creatinine is between 101% and 103%. Between-batch precision
      (CV) is less than 3% for mean creatinine values of 103 and 164 mumol/L. The
      method is free of interference from other metabolic components and drugs commonly
      used in neonates in routine clinical practice. Using specimens from neonates, I
      compared this method with a routinely used automated alkaline picrate method
      (from Randox Labs., performed on a Cobas MIRA analyzer). Linear-regression
      analysis yielded a correlation coefficient of 0.90, a slope of 1.00, and an
      intercept of +0.8 mumol/L. This HPLC method for creatinine should be of use in
      those circumstances where the alkaline picrate method is known to produce dubious
      results; however, the latter method is probably more suitable for routine use.

PMID- 1733579
TI  - Severe unexplained hypophosphatemia.

PMID- 1733580
TI  - Monitoring cyclosporine in liver-transplant recipients: effects of clinical
      status on the performance of two monoclonal antibody-based methods.
AB  - The characteristics of the Abbott selective fluorescence polarization immunoassay
      for cyclosporine in whole blood (TDXSP) were compared with the Incstar
      radioimmunoassay by using kit standards (INCSP) or TDXSP standards (INCTDX) with
      samples from adult (48) and pediatric (24) liver-transplant recipients and a
      further 32 control specimens. The TDXSP assay was faster, less labor intensive,
      and more precise at higher concentrations; it gave results a median of 5
      micrograms/L lower than INCSP values, irrespective of biliary T-tube status,
      patient's age, or severity of cholestasis in nine patients, comparisons being
      made for serum bilirubin more than eight times normal or less than 50 mumol/L.
      However, both assays overestimated INCTDX values by approximately 10%. There was
      a progressive increase in the ratio of TDXSP to both INCSP and INCTDX results in
      57 samples stratified in relation to serum bilirubin concentrations. Cross
      reactivity of TDXSP with cyclosporine metabolites M1 (23%) or M17 (12%) was
      greater than for INCSP (15% and 5%, respectively) or INCTDX (22% and 4%,
      respectively), but the converse was true with M21 (2% for TDXSP vs 4% and 8%,
      respectively). Some overestimation of cyclosporine whole-blood concentrations
      (relative to INCTDX results) may be detected with either the TDXSP (because of
      cross-reactivity with metabolites) or the INCSP assays (probably because of
      matrix effects). The similar magnitude of these overestimations suggests that
      alternative factors such as speed, precision, and cost may influence which method
      one selects for use in routine monitoring.

PMID- 1733581
TI  - One-step, labeled-antibody assay for measuring free thyroxin. I. Assay
      development and validation.
AB  - We describe a one-step, labeled-antibody radioassay for measuring free thyroxin
      (FT4) in serum or plasma, based on a novel principle. FT4 in the sample competes
      with a gross molar excess (over antibody) of a cross-reactant (L
      triiodothyronine, T3), chemically coupled to magnetizable polymer particles, for
      binding to avid 125l-labeled monoclonal anti-thyroxin antibodies. As in
      conventional immunoassays, 125I counts bound to the solid phase (T3-magnetizable
      particles) are inversely proportional to sample FT4 concentration. We demonstrate
      here the development and technical validity of this new method.

PMID- 1733582
TI  - Ektachem slides for direct potentiometric determination of sodium in plasma:
      effect of natremia, blood pH, and type of electrolyte reference fluid on
      concordance with flame photometry and other potentiometric methods.
AB  - With electrolyte reference fluid (ERF)00, results from Kodak Ektachem slides for
      the direct potentiometric assay of sodium in plasma were significantly correlated
      with results from flame photometry, but also appeared to be systematically
      higher, especially in hypernatremic patients. Indirect potentiometry with the
      Technicon RA-1000 yielded intermediate values. In 23 hypernatremic patients with
      greater than or equal to 6 mmol/L difference in sodium between Ektachem ERF00 and
      flame photometry, a clinical survey disclosed the frequent association of large
      between-method differences with renal failure, diabetes mellitus, and
      gastrointestinal disease. However, there was no correlation between differences
      in sodium on the one hand and anion gaps or (lipo)protein concentrations on the
      other, nor did in vitro addition studies implicate metabolites that often
      accumulate in the above-mentioned disorders. Unlike indirect methods, sodium
      measurements by direct potentiometry on Ektachem and Corning were influenced by
      in vitro changes of pH between 7.0 and 7.9. However, in a group of patients that
      included many acidotic individuals, between-method differences in sodium appeared
      not significantly correlated with in vivo blood pH. Use of the equitransferant
      ERF04 on Ektachem strongly diminishes the systematic differences with flame
      photometry, reduces the pH-dependency of the results to that of the direct
      Corning method, and brings the mean analytical recovery of sodium to below 95%
      (instead of 115% previously) without affecting the ability of Ektachem slides to
      avoid spuriously low results in the presence of increased (monoclonal) protein
      concentrations.

PMID- 1733583
TI  - Elimination of matrix effects in electrothermal atomic absorption
      spectrophotometric determinations of bismuth in serum and urine.
AB  - A sensitive and precise electrothermal atomic absorption spectrophotometric
      method for determining bismuth concentration is described. Protein precipitation
      and the use of a palladium modifier reduce the problems of foaming and permit the
      use of a higher ashing temperature. The detection limit of the assay is 0.9
      nmol/L. Total CVs (intra- and interassay) for serum ranged from 3.5% to 15.1% and
      for urine from 4.8% to 14.5% at concentrations of 60.0 and 6.0 nmol/L,
      respectively. Analytical recoveries of bismuth added to serum and urine were 102%
      and 103% over the same range. The method is robust and reproducible and can be
      accurately calibrated with aqueous standards.

PMID- 1733584
TI  - Monoclonal fluorescence polarization immunoassay evaluated for monitoring
      cyclosporine in whole blood after kidney, heart, and liver transplantation.
AB  - In a prospective study we evaluated a novel fluorescence polarization immunoassay
      (FPIA) for determining cyclosporine (CsA) in whole blood. FPIA uses a monoclonal
      antibody and is performed on the TDx (Abbott). The within-series (CV less than
      2%) and between-days (CV less than 3.3%) precision of the assay was excellent.
      The results obtained by the monoclonal FPIA in samples from transplant patients
      (n = 100) averaged 31.9% and 20.2% higher than those by HPLC and a specific
      radioimmunoassay (INCStar), respectively. Results by all three methods correlated
      well. Follow-up studies during the early course after liver transplantation,
      however, suggested that high metabolite concentrations affect FPIA results. This
      is explained by previously described cross-reactions of the monoclonal antibody
      with some CsA metabolites. The FPIA results in samples of such patients should be
      interpreted cautiously.

PMID- 1733585
TI  - Methods for measuring plasma hemoglobin in micromolar concentration compared.
AB  - Of eight methods examined for measuring plasma hemoglobin in micromolar
      concentration, all exhibited acceptable linearity, reproducibility, and
      concurrence except when specimens were icteric or lipemic or contained
      methemoglobin or methemalbumin. Measurement of absorbance at 578 nm with an Allen
      correction permits precise assay of plasma oxyhemoglobin concentration as low as
      0.01 g/L (1 mg/dL, 0.16 mumol/L), unaffected by hyperlipidemia or
      hyperbilirubinemia. Discrepancies between methods occurred in 11.6% of a
      consecutive series of 50 nonicteric patients' plasma specimens. Examination of
      absorption spectra is helpful when discrepancies are observed between methods.
      The presence of methemalbumin or methemoglobin in plasma is not recognized by
      methods that measure only oxyhemoglobin. Increased ceruloplasmin or beta-carotene
      does not significantly affect results.

PMID- 1733586
TI  - Association between magnesium, calcium, phosphorus, copper, and zinc in umbilical
      cord plasma and erythrocytes, and the gestational age and growth variables of
      full-term newborns.
AB  - We determined reference values in umbilical cord plasma and erythrocytes for
      magnesium, total calcium, phosphorus, copper, and zinc, and then calculated
      correlations and stepwise-regression equations in 66 white full-term newborn
      infants (35 boys, 31 girls). Only infants meeting certain optimal criteria and
      benefiting from excellent maternal conditions and uncomplicated pregnancies were
      included. There were no significant sex-related differences at birth among the
      variables studied. Gestational age was positively correlated with erythrocyte
      zinc (P less than 0.001), and plasma calcium was positively correlated with
      erythrocyte copper (P less than 0.001). Plasma copper proved to be the most
      significant variable in the stepwise-regression equation for birth height as the
      dependent variable. The most significant regressors accounting for birth weight
      were erythrocyte zinc followed by plasma zinc.

PMID- 1733587
TI  - Simple quantitative measurement of serum choriogonadotropin compared with
      immunoradiometric, immunoenzymometric, and chemiluminescent assays.
AB  - We evaluated a new simplified quantitative method (Tandem Icon QSR; Hybritech)
      for choriogonadotropin (hCG), which could theoretically be performed in a ward or
      with outpatients. The method was compared with immunoradiometric (Bioclone
      Australia), chemiluminescent (Amerlite; Amersham), and immunoenzymometric assays
      (Stratus; Dade). We analyzed by each of the methods 104 serum samples from
      pregnant and nonpregnant patients. For quantitative hCG values indicative of
      pregnancy (greater than 25 int. units/L), excellent correlation was observed
      between the Tandem Icon method and the other standard laboratory assays (r =
      0.995, 0.990, and 0.992, respectively). Occasional problems arose because of the
      instability of Tandem Icon QSR reagents at room temperature but this was resolved
      by storing the reagents at 4 degrees C. We conclude that this simplified
      quantitative method for hCG is reliable and suitable for use outside of the
      routine immunoassay laboratory.

PMID- 1733588
TI  - Effect of precipitation and centrifugation conditions on high-density lipoprotein
      cholesterol measured with phosphotungstate-magnesium reagent.

PMID- 1733589
TI  - Measurement of low-density-lipoprotein cholesterol in serum: a status report.
AB  - Current recommendations of the Adult Treatment Panel and the Children and
      Adolescents Treatment Panel of the National Cholesterol Education Program make
      the concentration of low-density lipoproteins cholesterol (LDL-C) in serum the
      basis for the classification and treatment of hypercholesterolemia. Numerous
      methodologies for the determination of serum LDL-C concentrations, in research
      and clinical laboratories, have been described. Here, we review the principles,
      performance, and limitations of major current methodologies for determining LDL-C
      concentrations. These methods include sequential and density-gradient
      ultracentrifugation, chromatographic and electrophoretic techniques, and
      precipitation methods. In addition, the advantages and disadvantages of
      estimating LDL-C concentration by the Friedewald equation, the most commonly used
      approach in clinical laboratories, are addressed.

PMID- 1733590
TI  - Heparinized plasma is an unacceptable specimen for ammonia determination.

PMID- 1733591
TI  - Ouabain as endogenous digitalis-like factor in animals?

PMID- 1733593
TI  - Inefficiency of diagnostic efficiency.

PMID- 1733592
TI  - Adenosine deaminase, acquired immunodeficiency syndrome (AIDS), and hepatitis B
      infection.

PMID- 1733594
TI  - Reflotron method for high-density lipoprotein evaluated for venous and capillary
      blood.

PMID- 1733595
TI  - Improved stability of the Hitachi 717 electrolyte unit.

PMID- 1733596
TI  - Thermal effects on serum analyte concentrations.

PMID- 1733597
TI  - Improvement of apolipoprotein E phenotyping by isoelectric
      focusing/immunofixation.

PMID- 1733598
TI  - New enzymatic CO2 slide on the Ektachem 700 XR analyzer eliminates interference
      from nitrate/nitrite ions.

PMID- 1733599
TI  - Oligoclonal banding in sera of hospitalized patients.

PMID- 1733600
TI  - Development of an immunoradiometric assay kit for ventricular myosin light chain
      I with monoclonal antibodies.

PMID- 1733601
TI  - Interlaboratory survey of methods for measuring human anti-mouse antibodies. HAMA
      Survey Group.

PMID- 1733602
TI  - One-step, labeled-antibody assay for measuring free thyroxin. II. Performance in
      a multicenter trial.
AB  - The technical and diagnostic performance of a labeled antibody radioassay for
      free thyroxin (Amerlex-MAB* FT4) was examined in a multicenter trial. The overall
      mean within-assay precision (CV) in eight centers was 6.2% at 30 pmol/L and 3.6%
      at 13 pmol/L concentrations of FT4. Between-assay precision was 5.4% at 18 pmol/L
      and 6.8% at 50 pmol/L. The euthyroid central 95% reference range for FT4 was 11.3
      to 24.3 pmol/L. Results of the method correlated well with those of an analog
      radioimmunoassay: [Amerlex-MAB* FT4] = 1.09 [Amerlex-M FT4] + 1.50 pmol/L (r =
      0.96, n = 732). Clinical performance of the assay was better than that of first
      generation analog tracer assays for sera from patients with nonthyroidal illness
      or binding-protein abnormalities.

PMID- 1733603
TI  - Application of neural networks to the interpretation of laboratory data in cancer
      diagnosis.
AB  - Neural networks are a relatively new method of multivariate analysis. The purpose
      of this study was to investigate the ability of neural networks to differentiate
      benign from malignant breast conditions on the basis of the pattern of nine
      variables: patient age, total cholesterol, high-density lipoprotein cholesterol,
      triglycerides, apolipoprotein A-I, apolipoprotein B, albumin, the tumor marker
      CA15-3, and the Fossel index (measurement of methylene and methyl line-widths in
      proton NMR spectra). The laboratory analyses were made with blood plasma or serum
      specimens. The neural network was "trained" with 57 patients: 23 patients with
      breast malignancies and 34 patients with benign breast conditions. A neural
      network with nine input neurons, 15 hidden neurons, and two output neurons
      correctly classified all 57 patients. The ability of the network to predict the
      diagnoses of patients that it had no encountered in training was tested with a
      separate group (cross-validation group) of 20 patients. The network correctly
      predicted the diagnoses for 80% of these patients. For comparison we analyzed the
      same sets of 57 training patients and 20 cross-validation patients by quadratic
      discriminant function analysis. The quadratic discriminant function, calculated
      from the same 57 patients used to train the neural network, correctly classified
      84% of the 57 patients, and correctly diagnosed 75% of the 20 cross-validation
      patients. The results suggest that neural networks are a potentially useful
      multivariate method for optimizing the diagnostic utility of laboratory data.

PMID- 1733604
TI  - Screening for defined cystic fibrosis mutations by solid-phase minisequencing.
AB  - We have developed a rapid method for the quantitative detection of point
      mutations and deletions. In this minisequencing method, enzymatically amplified
      DNA, 5'-biotinylated in one strand, is bound to a solid phase and denatured. A
      detection primer, constructed to end immediately before the mutation, is annealed
      to the immobilized single-stranded template and elongated with a single, labeled
      deoxynucleoside residue. We have applied the solid-phase minisequencing method to
      the detection of the major mutation, delta F508, causing cystic fibrosis (CF). In
      the presence of the allele with the delta F508 mutation, [3H]dTTP is
      incorporated; with the nonmutated allele, [3H]dCTP is incorporated. Thus, samples
      from heterozygous individuals allow the incorporation of both labels. The method
      was evaluated by analyzing 59 coded DNA specimens collected from 20 Finnish CF
      patients and their parents. The ratio of [3H]C to [3H]T gave unambiguously the
      allele combination. The solid-phase minisequencing method was also applicable to
      the analysis of three CF mutations simultaneously, i.e., delta F508, G542X, and
      G551D. We conclude that the microtiter-plate-based minisequencing test is an
      accurate method for the screening of defined sequence alterations in the CF gene.

PMID- 1733605
TI  - New enzymatic method with tryptophanase for determining potassium in serum.
AB  - We established a simple and rapid enzymatic method for measuring potassium ion in
      serum by using tryptophanase (EC 4.1.99.1) purified from Escherichia coli K12
      strain (E. coli K12 IFO 3301). The presence of pyridoxal 5-phosphate promotes
      this enzymatic reaction, and potassium and (or) ammonium ions further accelerate
      it, with ammonium and potassium ions providing equivalent acceleration. We
      eliminated endogenous ammonium ion by using glutamate dehydrogenase (GLDH; EC
      1.4.1.4), then produced ammonium ion in the presence of tryptophanase,
      tryptophan, and pyridoxal 5-phosphate. The concentration of formed ammonium ion,
      which was proportional to that of potassium ion in sample, was determined by
      adding GLDH to produce NADP+ in the presence of 2-oxoglutarate and NADPH; we then
      read the change of absorbance at 340 nm. The standard curve was linear for
      potassium ion concentrations up to 7.00 mmol/L. The within-assay variation (CV)
      was 0.89% at 5.51 mmol/L and 1.32% at 3.37 mmol/L. The day-to-day CVs were 0.99%
      at 6.85 mmol/L and 1.71% at 3.52 mmol/L. Analytical recoveries ranged from 98.7%
      to 108.9%. The correlation coefficient between values obtained with this
      enzymatic assay (y) and by flame photometry (x) was 0.995: y = 0.984x + 0.091
      mmol/L (Sy.x = 0.105, n = 100). The presence of hemoglobin, bilirubin, or other
      cations little affects this system.

PMID- 1733606
TI  - Biological variation data applied to the selection of serum lipid ratios used as
      risk markers of coronary heart disease.
AB  - The biological variation of several relative lipid quantities, calculated as the
      ratios between the concentrations of various serum lipids and apolipoproteins,
      has been estimated over a one-year period. The medians of the within-subject
      biological coefficient of variation, separated by sex when significant
      differences exist, were 15.4% for [apolipoprotein A-I]/[apolipoprotein B], 6.8%
      for [high-density lipoprotein (HDL)-cholesterol]/[cholesterol], 10.5% and 17.6%
      (women and men, respectively) for [HDL2-cholesterol]/[HDL-cholesterol], 13.6% for
      [HDL2-cholesterol]/[HDL3-cholesterol], 10.6% for [low-density lipoprotein (LDL)
      cholesterol]/[apolipoprotein B], 10.6% and 8.7% (women and men, respectively) for
      [LDL-cholesterol]/[cholesterol], and 6.3% for [LDL-cholesterol]/[HDL
      cholesterol]. From these data, we have calculated the critical difference for
      significant change detection, the index of individuality, and the goal for the
      between-day imprecision. Concerning within-subject biological variation, the best
      ratios for the detection of risk of coronary heart disease and the monitoring of
      intervention are [LDL-cholesterol]/[HDL-cholesterol] and [HDL
      cholesterol]/[cholesterol]. The index of individuality obtained in this study
      indicates that the use of population-based reference values is inadequate for
      interpreting the ratios studied.

PMID- 1733607
TI  - Ion-trap detection of volatile organic compounds in alveolar breath.
AB  - We describe a method for the collection and microanalysis of the volatile organic
      compounds in human breath. A transportable apparatus supplies subjects with
      purified air and samples their alveolar breath; the volatile organic compounds
      are captured in an adsorptive trap containing activated carbon and molecular
      sieve. The sample is thermally desorbed from the trap in an automated
      microprocessor-controlled device, concentrated by two-stage cryofocusing, and
      assayed by gas chromatography with ion-trap detection. Compounds are identified
      by reference to a computer-based library of mass spectra with subtraction of the
      background components present in the inspired air. We used this device to study
      10 normal subjects and determined the relative abundance of the volatile organic
      compounds in their alveolar breath. The breath-collecting apparatus was
      convenient to operate and was well tolerated by human volunteers.

PMID- 1733608
TI  - Age-correlated modifications of copper-zinc superoxide dismutase and glutathione
      related enzyme activities in human erythrocytes.
AB  - To obtain a comprehensive profile of the erythrocyte antioxidant defense
      potential during aging, we investigated copper-zinc superoxide dismutase (CuZn
      SOD), seleno-dependent glutathione peroxidase (GSH-Px), glutathione reductase
      (GSSG-RD), and glutathione-S-transferase (GSH-S-T) activities in human
      erythrocytes from 167 apparently healthy subjects, ages one month to 63 years
      (102 females, 65 males). We found a negative correlation between age and
      activities of CuZn-SOD (r = 0.362, P less than 0.001), GSSG-RD (r = 0.549, P less
      than 0.001), and GSH-S-T (r = 0.575, P less than 0.001). In contrast, we found a
      positive correlation between age and GSH-Px activity (r = 0.401, P less than
      0.001). To evaluate aging changes, we divided the subjects into five groups:
      Group 1 (newborn-age one year), Group 2 (1-11 years), Group 3 (11-25 years),
      Group 4 (25-40 years), and Group 5 (40-63 years). Significant age-related
      modifications in erythrocyte enzyme activities appeared in Group 3 for CuZn-SOD,
      GSSG-RD, and GSH-Px activity, whereas for GSH-S-T activity age-related
      modifications appeared in Group 2. We found no sex-related differences in
      erythrocyte CuZn-SOD, GSSG-RD, GSH-Px, and GSH-S-T activities.

PMID- 1733609
TI  - Automation and the single-gene disorder: cystic fibrosis as a model.

PMID- 1733610
TI  - Development of time-resolved immunofluorometric assay of vascular permeability
      factor.
AB  - We describe a two-site time-resolved immunofluorometric assay for guinea pig
      vascular permeability factor (VPF) for quantifying VPF in different biological
      fluids. Antibody against the carboxy terminus (C-IgG) is immobilized on
      microtiter wells, and antibody against the amino terminus (N-IgG) is labeled with
      Eu(3+)-chelate. Line 10 tumor culture medium, known to be rich in VPF, is assayed
      in a two-step incubation. Bound Eu3+ is then quantified by dissociation into a
      fluorescent enhancement solution, with measurement of the time-resolved
      fluorescence. The analytical sensitivity is 0.35 VPF unit, and the intra-assay CV
      is about 20%. The assay is specific for VPF, because pre-treatment with the
      appropriate C- or N-peptide, or pre-extraction of VPF, greatly decreases
      fluorescence. The VPF immunoassay is highly correlated (r2 = 0.94) with the Miles
      permeability assay, the classical bioassay of VPF. In addition, the
      immunofluorometric assay is about 30-fold more sensitive than the Miles assay.

PMID- 1733611
TI  - VALAB: expert system for validation of biochemical data.
AB  - In large laboratories that use "high-throughput" equipment, it is now possible to
      use artificial intelligence techniques to aid decision making and validation of
      data. This paper describes an artificial intelligence project, VALAB, that has
      been carried out in our laboratory. VALAB, an expert system that permits real
      time validation of data, is designed to be equivalent to validation by the
      laboratory director. The decision produced by the expert system is based on
      several factors, including correlation between repeated laboratory results,
      physiological association between different variables, the hospital department
      from which the test was ordered, and the patient's age and sex. In 200 abnormal
      chemistry profiles randomly selected, VALAB's ability to detect abnormal cases
      (i.e., sensitivity = 0.75) was exceeded by only one of seven laboratory experts.
      However, all seven experts outperformed VALAB's measured specificity of 0.63. The
      VALAB system incorporates greater than 4000 rules. Operational since November
      1988, it has validated greater than 50,000 medical patients' reports in real
      time.

PMID- 1733612
TI  - Prevalence of anti-thyroid peroxidase antibodies in serum in the elderly:
      comparison with other tests for anti-thyroid antibodies.
AB  - Autoimmune thyroid disease, especially chronic thyroiditis, is prevalent in
      elderly women and is probably the major cause of hypothyroidism in this
      population. The reported prevalence of chronic thyroiditis is variable, depending
      on the area of residence and the method(s) used to detect the presence of anti
      thyroid antibodies. The recent finding that thyroid peroxidase (TPO) is the
      antigen for the thyroid anti-microsomal antibody (AbM) has resulted in the
      development of sensitive radioimmunoassays (RIA) to detect the presence of AbTPO.
      We have determined the prevalence of AbTPO (by RIA) in sera from 342 elderly
      subjects, 248 women and 94 men (mean age 80 years) residing in Reggio Emilia,
      Italy, and compared the results with other methods for detecting anti-thyroid
      antibodies, including anti-thyroglobulin (AbTg) and AbM measured by passive
      hemagglutination (PH) of tanned erythrocytes, and AbM measured by RIA. The
      prevalence of positive AbTPO was 2.3% in the men and 10.2% in the women, only
      slightly higher than the prevalence of AbM. However, in the antibody-positive
      sera, the mean value for AbTPO was approximately 20-fold greater than the upper
      limit of the normal range, whereas the mean value for AbM was only threefold
      greater. The prevalence of positive titers for AbM and AbTg measured by PH was
      far lower, 1.2% and 3.2%, respectively, and those sera weakly positive for AbM
      and AbTg by PH were strongly positive for AbTPO by RIA. AbTPO RIA may be more
      useful than AbM and AbTg hemagglutination and AbM RIA for detecting the presence
      of autoimmune thyroid disease.

PMID- 1733613
TI  - Neural networks and diagnosis in the clinical laboratory: state of the art.

PMID- 1733614
TI  - Denaturing gradient gel electrophoresis for rapid detection of latent carriers of
      a subtype of acute intermittent porphyria with normal erythrocyte porphobilinogen
      deaminase activity.
AB  - Acute intermittent porphyria is an autosomal dominant disorder defined by a
      partial deficiency of porphobilinogen deaminase (EC 4.3.1.8). Clinical
      manifestations of the disease are characterized by acute attacks of neurological
      dysfunction often linked to environmental factors. Early diagnosis of gene
      carriers is important in the prevention of attacks and is usually achieved by
      determining the porphobilinogen deaminase activity in erythrocytes. However, in a
      subtype of acute intermittent porphyria, the enzymatic defect is restricted to
      nonerythropoietic cells. Different mutations have already been described that
      account for this phenotype in two unrelated families. We previously detected
      asymptomatic carriers by using mutation-specific probes after in vitro
      amplification of the target DNA sequence. In this study, we investigated the DNA
      of eight unrelated subjects with the same subtype of acute intermittent porphyria
      by using the polymerase chain reaction, with subsequent analysis of the amplified
      products by denaturing gradient gel electrophoresis. Five of these patients
      shared the same single-base change. This technique was quite simple and efficient
      for detecting asymptomatic carriers. Importantly, it is potentially useful for
      studying families with the same phenotypic subtype of the disease and possibly
      different mutations in the same DNA region.

PMID- 1733616
TI  - Alpha rhythm power and the effect of photic stimulation in migraine with brain
      mapping.
AB  - The topographic maps of 50 patients suffering from migraine with or without aura
      were compared to the brain maps of 20 normal controls and 20 patients with
      tension-type headaches. Only the migraine group showed a significant decrement of
      alpha rhythm power, during rest with eyes closed, at the posterior areas of the
      brain, and a significant increment of alpha power at the same regions during IPS
      at 20 c/sec.

PMID- 1733615
TI  - Fecal coproporphyrin isomers in hereditary coproporphyria.
AB  - To see whether the fecal coproporphyrin III:coproporphyrin I (CIII:CI) ratio
      (determined by HPLC) would be suitable for screening patients at risk of
      hereditary coproporphyria (HC), we compared such ratios with the lymphocyte
      coproporphyrinogen oxidase (EC 1.3.3.3) activities (COOX) in 38 subjects from one
      large family and two smaller families with HC. The CIII:CI ratio was normal (less
      than 1.3) in adults with normal COOX (greater than 180 nmol/g of protein per
      hour) and high (greater than 2) in those with low COOX. Results were difficult to
      interpret in six of 10 children, who had borderline or low COOX but normal fecal
      CIII:CI ratios. Five subjects with low COOX and abnormal fecal CIII:CI ratios had
      normal fecal total porphyrin, indicating that the latter investigation alone is
      inadequate for family studies. The sample for determining the fecal CIII:CI ratio
      is easier to obtain and the assay is technically less demanding than COOX. We
      found the fecal CIII:CI ratio suitable for investigation of adults in a family
      study, but its usefulness in children needs to be established.

PMID- 1733617
TI  - The Rolandic mu rhythm: a clinical study of the atypical group.
AB  - We studied 241 patients whose electroencephalograms (EEGs) showed 7-13 Hz arch
      shaped wave patterns (mu rhythm) that are known to appear in the Rolandic area.
      The patients were then classified into two groups depending on the conditions of
      appearance of the mu rhythm. Group I (typical group) consisted of 171 cases. In
      this group, the presence of the wave patterns was not affected by the opening of
      the eyes, and it was blocked by spontaneous movements, or when sensorimotor
      stimulation was applied. The characteristic symptoms for this group were observed
      in patients diagnosed as having well-controlled epilepsy, psychiatric disorders,
      collagen diseases, etc. In Group I, the peak lay between the ages 6 through 15.
      Group II (atypical group) consisted of 70 cases. In contrast to Group I, the
      presence of the wave patterns in this group was reinforced by drowsiness, photic
      stimulation and hyperventilation. The characteristic symptoms for this group were
      observed in patients diagnosed as having intractable epilepsy or organic brain
      disorders. In Group II the peak lay between ages 11 through 15. However, in Group
      II the cases were almost equally distributed among the various age groups.
      Paroxysmal abnormal EEG patterns were found to be jointly present with more
      frequency in the Group II sample of epileptic patients than the Group I sample.
      Therefore, when the mu rhythm associated with conditions indicating Group II type
      patients is observed, care must be exercised in the observation of further
      progression of the illness, and in searching for the possibility of organic brain
      disorders.

PMID- 1733618
TI  - Auditory evoked potentials in Gilles de la Tourette syndrome.
AB  - Gilles de la Tourette syndrome (TS) has been increasingly studied
      neurophysiologically as well as clinically. Obsessive-compulsive disorder (OCD)
      and attention deficit disorder (ADD) have been recognized to be part of the
      continuum of TS. We recorded brainstem auditory evoked potentials (BAEPs) and
      long-latency auditory event-related potentials (ERPs) in 20 patients with TS, 10
      of whom had ADD and 6 OCD. TS patients with and without OCD and ADD did not
      differ in BAEP latencies, and no differences were found from normal controls. AEP
      latencies did not differ between TS patients and controls. TS patients with ADD
      had longer N100 and N200 latencies than TS patients without ADD, and TS patients
      with OCD had shorter N200 and P300 latencies. These findings suggest that TS is
      neurophysiologically heterogenous, and that TS patients with OCD or ADD may
      differ from those without.

PMID- 1733619
TI  - Effects of anesthesia and stimulus intensity on posterior tibial nerve
      somatosensory evoked potentials.
AB  - Under anesthesia peak latencies occurring up to 75 milliseconds after stimulus
      onset upon somatosensory evoked potential testing of the somatosensory evoked
      potential testing of the posterior tibial nerve were not affected by stimulus
      intensity (between 5 and 19 ma) or by length of time under isoflurane and nitrous
      oxide up to over 2 hours. When pre- and postoperative tests on patients who were
      not under anesthesia were compared with results under anesthesia, no significant
      latency differences were found in relation to stimulus intensity for peaks N30,
      P40 and N50. For peaks P60 and N75, however, significantly increased latencies
      were seen during anesthesia, more pronounced and consistent for N75. Amplitudes,
      however, were affected by both stimulus intensity and anesthesia duration. A
      curvilinear relationship was found during early anesthesia. Maximum amplitudes
      were found at 7 or 11 ma stimulus intensity levels, depending upon which peak was
      analyzed, with lesser amplitudes occurring at both lower and higher stimulus
      intensity levels. Stimulus intensity and anesthesia interacted such that maximum
      amplitude occurred, in general, at 11 ma after short duration anesthesia (6') and
      at 7 ma after long duration anesthesia (125'). Under long duration anesthesia
      amplitudes were significantly diminished, mostly at the 11 ma intensity level. At
      15 and 19 ma intensity levels peak amplitudes remained relatively constant
      regardless of anesthesia duration and therefore are the intensities to use to
      monitor changes during prolonged surgeries. When preoperative during prolonged
      surgeries. When preoperative and postoperative tests were compared to tests under
      anesthesia, there was a decrease in amplitude under anesthesia, greater for long
      than short duration anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1733620
TI  - Changes in reactivity during the 6/second spike and wave complex.
AB  - This study on a patient with the WHAM form of the 6/sec spike and wave complex
      shows significant delays in reaction time and increased variability when stimuli
      were presented during the complex and within 1 second after it, especially when
      the pattern was high in amplitude and short in duration, and also during theta
      bursts without the spike component. The similarities and differences between this
      pattern and the 3/sec spike and wave complex are discussed.

PMID- 1733621
TI  - Pain and tooth pulp evoked potentials.
AB  - The purpose of this study was to verify whether the late components (N 140) of
      TPEPs were a reliable index of pain intensity. In the group with acute pain,
      except for higher amplitudes of the second negative wave, the plateau phenomenon
      has been noted. Analgesic and placebo effects indicated that the method used
      offers more objective than subjective components, because the real value of
      amplitudes is about 10% of control values for analgesic and between 60 and 70%
      for placebo. Shorter latency periods were observed in all parts of evoked
      potentials in the patients suffering from trigeminal neuralgia, as occurrence of
      a greater number of waves; while amplitudes on the affected side were
      significantly higher than on the healthy side.

PMID- 1733622
TI  - A simultaneous comparison of acupuncture needle and insulated needle sphenoidal
      electrodes for detection of anterior temporal spikes.
AB  - Uninsulated acupuncture needles have been used as sphenoidal electrodes, but the
      issue of insulation has not been adequately addressed. In this report,
      acupuncture needles and insulated needle sphenoidal electrodes were
      simultaneously used to compare the rate of spike detection, spike amplitude and
      distribution of maximal spikes from eight spike foci in seven patients with
      temporal lobe epilepsy. When compared to the insulated needle electrode, the
      acupuncture needle electrode was equally effective in spike detection, but spike
      amplitudes tended to be smaller and maximal spikes were less frequently
      encountered. Thus, insulation has an influence on the spikes recorded by the
      acupuncture needle sphenoidal electrode. However, the overall effect appears to
      be not sufficiently different from the insulated needle electrode for the purpose
      of detecting anterior temporal spikes in outpatient EEG recordings for the
      diagnosis of temporal lobe epilepsy.

PMID- 1733623
TI  - EEG characteristics of healthy adults living at higher elevations.
AB  - EEG data from 400 healthy adult volunteers in the Xining area (with an altitude
      of 2260 meters) are summarized to show changes in indices of waves, frequencies
      and amplitude. Analysis and observations were made for tests of eyes open-close,
      acoustic stimulation and hyperventilation. Differences in EEGs were compared
      between males and females of various age groups, and between adults living at the
      higher elevations in Xining and those living on the plains in the Beijing area
      (altitude 40 meters). Comparisons showed that EEG characteristics of healthy
      adults at the higher altitude were: an increase in the incidence of abnormality,
      a decrease of alpha indices, an increase in the number of slow waves, the
      appearance of spikes and sharp waves, and a reduction in the level of sensitivity
      to activation tests.

PMID- 1733624
TI  - Tuberous sclerosis, agenesis of the corpus callosum and Lennox-Gastaut syndrome:
      mere chance or a new syndrome?
AB  - The relationship between tuberous sclerosis (TS) and epilepsy on one hand and
      between agenesis of the corpus callosum (ACC) and epilepsy on the other has been
      recognized for a long time. Until now, a syndrome characterized by TS, ACC and
      Lennox-Gastaut syndrome (LGS) has not been described in the literature. Three
      cases of children, all young male patients, who suffer from TS, ACC and LGS, were
      presented. The ACC was total in two cases and partial in the third. None of the
      subjects previously had West syndrome. Two cases showed a slight degree of mental
      deficiency, while in the third it was very pronounced. In all subjects tonic and
      astatic seizures were frequent. Antiepileptic therapy improved the clinical
      picture in one case, while in the other two it remained unchanged.

PMID- 1733625
TI  - Molecular heterogeneity of human IgA antibodies during an immune response.
AB  - Human IgA occurs in multiple molecular forms (polymeric and monomeric) and two
      subclasses which show differential distribution between the mucosal and
      circulatory compartments of the immune system. However, the molecular form and
      subclass of specific IgA antibodies are influenced, especially during an immune
      response, by the type of antigen and duration of the response as well as by the
      route of exposure. These considerations question previously held notions that
      polymeric IgA and an increased representation of the IgA2 subclass among
      circulating antibodies or antibody-secreting cells signify their mucosal origin.
      Although the functional properties of different molecular forms and subclasses of
      IgA antibodies are incompletely understood, it appears that there is
      physiological benefit in the diversity of the IgA immune system.

PMID- 1733626
TI  - IL-1-like production in adriamycin-induced nephrotic syndrome in the rat.
AB  - Rats receiving a single dose of adriamycin (7.5 mg/kg) develop heavy proteinuria
      and morphological abnormalities similar to those observed in minimal change
      nephrotic syndrome in humans. A concomitance between enhanced I-a display by
      resident glomerular macrophages, IL-1-like cytokine secreted by whole isolated
      rat glomeruli and proteinuria was observed in adriamycin-injected rats during the
      experimental protocol. In addition, in vitro studies have shown that after
      stimulation with adriamycin or lipopolysaccharide (LPS) this cytokine is mainly
      produced by resident glomerular macrophages in culture. Although the precise
      mechanism of proteinuria in this model needs to be further studied, our results
      indicate that IL-1-like cytokine could be an important mediator implicated in the
      structural and functional disturbances occurring at the glomerular capillary wall
      level in adriamycin nephrosis.

PMID- 1733627
TI  - Primary structure of a monoclonal kappa chain in myeloma with light chain
      deposition disease.
AB  - Previous data suggest that structural abnormalities of immunoglobulin light
      chains may be responsible for non-amyloid light chain deposition disease (LCDD).
      We report on the complete primary sequence deduced from complementary (c)DNA
      analysis of a normal-sized kappa chain in a case of myeloma-associated LCDD. The
      patient's urine contained a kappa type Bence-Jones protein made of monomers and
      dimers of an unglycosylated kappa chain. The bone marrow myeloma cells contained
      intracellular kappa and gamma chains by immunofluorescence. Biosynthesis
      experiments showed the production of normal-sized gamma chains and of kappa
      chains with the same apparent molecular mass (Mr) in SDS gels as the urinary
      kappa chain (26,000-27,000). These kappa chains were secreted as assembled IgG
      molecules and as a large excess of free monomers and dimers. The complete
      sequence of two identical cDNA clones derived from a normal-sized kappa messenger
      RNA indicated that this kappa chain belonged to the rare V kappa IV subgroup. The
      kappa mRNA had an overall normal structure made up of the V kappa IV sequence
      rearranged to J kappa 1 and followed by a normal constant exon of the Km(3)
      allotype. The variable region differed from the V kappa IV-J kappa 1 germline
      sequence by 17 amino acid substitutions. The peculiar sequence of the variable
      region of this kappa chain of a rare subgroup might relate to its tissue
      deposition.

PMID- 1733628
TI  - In vivo activation of complement by IgA in a rat model.
AB  - In this study we investigated the capacity of rat IgA to activate complement (C)
      in vivo in a rat model. Rat monomeric (m-), dimeric (d-) and polymeric (p-) IgA
      MoAbs were injected intravenously and assessed for deposition of C3 and C4 on
      IgA. By ELISA it was shown that both d- and p-IgA bound C3 whereas no binding of
      C3 by m-IgA was observed. Polymeric IgA was more efficient in binding of C3 as
      compared with d-IgA. However, in haemolytic assays no consistent decrease of
      plasma complement levels was observed except for dimeric IgA which induced a
      marginal consumption of AP50. When rats were pre-treated with cobra venom factor
      (CVF) to deplete C3, no C3 deposition was found on m-, d- or p-IgA. Neither m-
      nor d- or p-IgA was able to bind C4 in vivo. In agreement with the results
      described above, large sized polymeric IgA was shown to be taken up by Kupffer
      cells (KC) together with C3. No C3 was detected when rats were depleted of C
      using CVF. Taken together, the experimental data suggest that d- and p-IgA are
      able to activate C via the alternative pathway in vivo.

PMID- 1733629
TI  - HIV-induced deletion of antigen-specific T cell function is MHC restricted.
AB  - When antigen-specific T cells are pulsed by antigen-presenting cells (APC) in the
      presence of HIV they are functionally deleted following subsequent exposure to
      syngeneic APC in the absence of HIV. Recombinant soluble HIV envelope (gp120) is
      able to induce a similar effect which, unlike that induced by HIV, is reversible.
      Neither HIV nor gp120 affect the ability to respond to IL-2. Thus it is only
      antigen-specific responses involving the T cell receptor pathways and CD4/MHC
      class II interaction that appear to be inhibited by HIV-1 and gp120. Furthermore,
      the functional impairment caused by HIV-1 is specific to the T cells that respond
      to the antigen in co-culture with HIV, as there is no apparent effect on
      'bystander'-activated T cells specific for another antigen. Antigen-specific T
      cell lines may be deleted by a signalling mechanism which involves molecules
      other than gp120/CD4 but still requires MHC class II restriction.

PMID- 1733630
TI  - Regulation of IL-2 beta receptor expression and beta-chain mRNA by human
      thymocytes.
AB  - The high affinity form of the human IL-2 receptor (IL-2R) has two known
      components, the IL-2R alpha (p55) and the IL-2R beta chain (p75). We have
      previously shown that recombinant IL-2 (rIL-2) could induce the expression of the
      alpha-chain (p55) on T cells and thymocytes, and increase this expression
      following suboptimal activation with concanavalin A (Con A) in combination with
      IL-2. An increase in the accumulation of IL-2R alpha-specific mRNA induced by rIL
      2 in T cells and thymocytes had also been documented. We report here that the
      expression of IL-2R beta on the cell surface can be demonstrated on human
      thymocytes by the binding of Mik beta1, a MoAb directed against an epitope of the
      beta-chain. The IL-2R beta chain is constitutively expressed on freshly isolated
      thymocytes; this expression can be increased in thymocytes activated with Con A
      in combination with IL-2 or tetradecanoylphorbol 13-acetate (TPA). Blocking the
      formation of high affinity receptors with a MoAb directed against the alpha-chain
      of the receptor results in an increase in the display of IL-2R beta as evidenced
      by binding of MoAb Mik beta1. The accumulation of IL-2R-beta-specific mRNA is
      observed in freshly isolated thymocytes and it is increased in thymocytes
      cultured with rIL-2 alone, with Con A, and further enhanced by the addition of
      rIL-2 in combination with Con A or with TPA. Cyclosporine (CsA), which inhibits
      the accumulation of lymphokine-specific mRNA of thymocytes, does not inhibit the
      induction of the accumulation of IL-2R beta-specific mRNA. This is analogous to
      its effect on the expression of the alpha-chain (p55), and the accumulation of
      alpha-chain-specific mRNA.

PMID- 1733631
TI  - Inhibition of the reactive proliferation of lymphocytes by activated macrophages:
      the role of nitric oxide.
AB  - The effects of nitric oxide synthesis by activated macrophages on concanavalin A
      (Con A) stimulated lymphocyte proliferation and the modulation of these events by
      extraneous L-arginine concentration were investigated. In 1 mM or 5 mM exogenous
      L-arginine, inhibition of proliferation of a fixed number of lymphocytes was
      progressively inhibited in the presence of increasing numbers of macrophages.
      This inhibition was related to increased nitric oxide synthesis by the
      macrophages and was suppressed in the presence of NG-monomethyl-L-arginine
      (NMMA), a specific inhibitor of nitric oxide synthesis. Inhibition of nitric
      oxide synthesis by 500 microM NMMA was less effective at high concentrations of
      macrophages, and in 5 mM as compared with 1 mM L-arginine. In the absence of
      exogenous L-arginine, NMMA inhibited lymphocyte proliferation in the presence of
      low numbers of macrophages but appeared to promote proliferation at high
      macrophage concentrations. Membrane separation of lymphocytes and macrophages led
      to loss of the nitric oxide mediated inhibitory effect on lymphocyte division
      except at the highest concentrations of macrophages used. Inhibition of
      lymphocyte proliferation could not be associated with L-arginine depletion of the
      media by macrophages or by the action of nitrite ions, a product of nitric oxide
      oxidation.

PMID- 1733632
TI  - The expression of HLA-DR by monocytes from black and from white donors: different
      requirements for protein synthesis.
AB  - Epidemiologic data indicates that blacks may be more susceptible than whites to
      infection by Mycobacterium tuberculosis. Resistance to the in vivo growth of
      Mycobacteria in mice correlates with the persistence of MHC class II expression
      by peritoneal macrophages. The expression of HLA-DR by human monocytes from
      different groups of individuals also differs. The increase in the expression of
      HLA-DR by monocytes that occurs upon in vitro culture was prevented by the
      protein synthesis inhibitor cycloheximide (CHX) in a majority of black donors. In
      contrast, the increase in HLA-DR expression by monocytes from the majority of
      white donors was unaffected.

PMID- 1733633
TI  - HLA-associated susceptibility to HIV-1 infection.
AB  - We studied HLA antigen distribution of 50 heterosexual partners of HIV+ drug
      abusers with more than 1 year of sexual exposure to HIV, 36 children born to
      seropositive mothers and 61 haemophiliac patients exposed to presumably
      infectious clotting factor concentrates. B52 and B44 antigens were associated
      with HIV resistance while B51 was associated with HIV susceptibility. Forty-nine
      HIV+ drug abusers, spouses of heterosexual partners studied and 25 HIV+ mothers
      of the children were also typed. DR11 phenotype was associated with
      infectiousness of HIV+ subjects. Our data suggest that the HLA region controls
      susceptibility to infection with HIV and infectiousness of HIV+ subjects in
      different risk groups.

PMID- 1733634
TI  - Anti-neutrophil cytoplasmic autoantibodies in patients with symptomatic HIV
      infection.
AB  - Antibodies against cytoplasmic antigens of neutrophils, producing perinuclear (p
      ANCA) as well as cytoplasmic staining with central accentuation (c-ANCA), have
      been described in non-HIV-infected patients with specific pathology such as
      glomerulonephritis and vasculitis. Here, we report on a patient with a vasculitis
      like syndrome and a positive ANCA-test who appeared to be infected by HIV.
      Further analysis revealed that ANCA, p-ANCA as well as c-ANCA without central
      accentuation can be demonstrated in the serum of HIV+ individuals. In a cross
      sectional study on individuals in different stages of HIV infection, we found
      that the occurrence of ANCA was limited to the symptomatic stages of HIV
      infection: p-ANCA was found in one out of 10 ARC patients and in two out of 11
      AIDS patients with malignancies (AIDS-MAL), but not in AIDS patients with
      opportunistic infections (AIDS-OI). c-ANCA was found in four of the ARC patients,
      in two of the 14 AIDS-OI patients and in two AIDS-MAL patients. The presence of
      ANCA was not related to the degree of hypergammaglobulinaemia nor to specific
      symptomatology. ANCA containing sera from HIV+ individuals did not react with
      HEp2 cells nor with cytoplasmic antigens of lymphocytes, natural killer (NK)
      cells or eosinophils. Five out of the 11 (two p-ANCA and three c-ANCA) sera
      reacted weakly with cytoplasmic antigens of monocytes. All sera reacted with
      karyoplasts but not with cytoplasts prepared from neutrophils. These results
      suggest that HIV-ANCA might be directed against myeloid cell-specific granule
      constituents. However, sandwich-ELISAs with MoAbs against granule antigens that
      are frequently the target antigens of ANCA in HIV- individuals were negative.
      Also immunoprecipitation and immunoblotting, using lysates of neutrophil
      granules, did not allow further identification of the target antigens of HIV
      ANCA.

PMID- 1733635
TI  - Frequencies of HIV-reactive B cells in seropositive and seronegative individuals.
AB  - Peripheral blood mononuclear cells (PBMC) from HIV-infected seropositive (HIV+)
      but not from normal, seronegative (HIV-) individuals are known to produce anti
      HIV antibodies in vitro, in the absence or presence of pokeweed mitogen (PWM).
      Previous studies showed that up to 20-40% of spontaneously immunoglobulin
      secreting B cells from HIV+ individuals are HIV-specific. To analyse the
      frequency of anti-HIV B cells among 'total' peripheral blood B cells in the
      present study, we used a limiting dilution assay in which EL-4 thymoma cells
      induce clones of immunoglobulin-secreting cells in activated as well as resting B
      cells. Anti-HIV B cells were detected not only in 11/12 HIV+ individuals (with
      frequencies from 1/910 to 1/21,500 B cells cultured; one negative test was from a
      person undergoing seroconversion), but also in 4/9 HIV- normal blood donors
      (1/16,200 to 1/49,000 B cells cultured) and in 3/6 newborns from HIV- mothers
      (1/11,800 to 1/26,600 B cells cultured). The mean frequency was nine times higher
      in the HIV+ individuals than in the normal donors. As in previous studies, only
      the cells from HIV+ individuals generated anti-HIV antibodies in PBMC bulk
      cultures with or without PWM. The relative proportion of specific anti-HIV
      antibody/total immunoglobulin in PBMC bulk cultures was 800 times higher by the
      mean than in EL-4 B cell cultures from HIV+ individuals (whereby the total
      immunoglobulin secretion for equal numbers of B cells cultured was 500 times
      lower for PBMC). These different results obtained with different assays suggest
      that in seropositives most anti-HIV B cells belong to an activated B compartment
      which is quite small, even in a disease with B cell hyperactivity. Therefore, the
      specific B cells are strongly diluted among the EL-4 cell-responsive, total B
      cells. On the other hand, the EL-4 assay can detect HIV-reactive B cells in the B
      cell repertoire of normal, non-infected individuals.

PMID- 1733636
TI  - LFA-1-dependent OKT3-driven T cell clusters in common variable immunodeficiency.
AB  - The triggering of the TCR/CD3 complex by anti-CD3 (OKT3) antibody leads to the
      formation of T cell clusters. In cultures of T lymphocytes from most normal
      individuals, the peak of cluster formation occurs at 24 h, but with cells from
      patients with common variable immunodeficiency (CVI) it was seen earlier at 4-9
      h; in addition, the clusters were larger than normal, particularly at 9 h.
      Cluster formation by CVI and normal cells was dependent on temperature and
      divalent cations, but did not require Fc receptors. Since OKT3 clustering is
      known to be dependent on the LFA-1/ICAM-1 adhesion system, the effect of
      monoclonal antibodies directed against these molecules was tested. A potent
      inhibitor was the antibody against the common beta chain of the integrin family
      (CD18), but of four MoAbs against the alpha chains (CD11), three inhibited and
      one stimulated T cell aggregate formation. Increased expression of LFA-1 or ICAM
      1 on CVI patients' T cells could not be demonstrated. The accelerated clustering
      was therefore probably due to an increase in the proportion of cells carrying the
      activated form of LFA-1. The formation of large numbers of homotypic lymphocyte
      clusters might reduce the effective interaction between B and T cells, thus
      contributing to the depression of immunoglobulin synthesis observed in this
      disease.

PMID- 1733637
TI  - Hyper-response of serum IgG1 to Staphylococcus aureus peptidoglycan in patients
      with hyper-IgE syndrome.
AB  - The hyper-IgE (HIE) syndrome is characterized by high IgE serum levels, chronic
      dermatitis and recurrent infections. To determine whether an impairment of the
      antibody response to Staphylococcus aureus contributes to infections in this
      syndrome we measured total serum IgG subclass, specific IgG1 and IgG2 levels
      against peptidoglycan (PG), the immunodominant cell wall component of S. aureus
      and serum opsonic activity to PG. Of the 14 patients with HIE syndrome, nine had
      increased level of serum IgG1 and six had IgG2 subclass deficiency. In regard to
      specific response of IgG1 and IgG2 antibodies to PG, patients were divided into
      five groups related to ages and compared with 10 control subjects for each age
      cohort. Patients with HIE syndrome had significant high levels of serum-specific
      IgG1 to PG and significant decreased levels of serum-specific IgG2 to PG in all
      five groups. Additionally, serum opsonic activity in patients was significantly
      higher than that in normal control subjects. It is concluded that IgG2 deficiency
      or poor IgG2 antibody response to S. aureus is not the explanation of the
      abnormal susceptibility to S. aureus infections of HIE patients.

PMID- 1733638
TI  - Contribution of non-Leishmania-specific immunity to resistance to Leishmania
      infection in humans.
AB  - Lymphocytes of individuals from a country non-endemic for Leishmania (Sweden),
      responded with a vigorous interferon-gamma (IFN-gamma) and IL-6 response when
      exposed to live or dead promastigotes of Leishmania aethiopica. This response was
      sometimes as strong as when the same cells were exposed to the mitogen
      (phytohaemagglutinin (PHA)). Furthermore, supernatants of cells exposed to
      Leishmania promastigotes were able to inhibit the amastigote form of the same
      parasite. In some few instances there was no such reactivity to Leishmania
      parasites. It is proposed that most individuals have such a first line cytokine
      response which is enough to prevent further spread and growth of the parasites.
      In exposed individuals who display disease symptoms, this non-Leishmania-specific
      response is overcome (by dose) or is weak (for genetic reasons). In the latter
      instances curbing of parasite growth would depend on acquired immunity.

PMID- 1733639
TI  - Enhancement of HIV-specific cytotoxic T lymphocyte responses by zidovudine (AZT)
      treatment.
AB  - Zidovudine or 3'-azido-2'-3'-dideoxy-thymidine (AZT) is an antiviral drug widely
      used to treat HIV-infected patients. Because cytotoxic T lymphocytes (CTL) are
      thought to contribute actively to resistance against HIV-induced disease, we
      studied sequentially 10 HIV-infected individuals under zidovudine treatment for a
      period of 6-12 months. For a given patient all lymphocyte suspensions
      corresponding to the complete zidovudine therapy period were tested on the same
      day and on the same target cells. Patients were selected for expression of HLA-A2
      and/or HLA-A3 class I transplantation antigen. HLA-restricted cytotoxicity
      specific for env, gag and nef HIV proteins was quantified for each patient at 6
      week intervals. The data clearly indicated that zidovudine has a beneficial
      effect on the CTL response during the first 6-12 weeks of treatment, inducing
      cytotoxicity levels up to 100-fold stronger than base line. This effect was
      usually short lived. However, patients who maintained strong levels of
      cytotoxicity had better clinical and survival outlook than patients who had lost
      all detectable cytotoxic lymphocytes. It is proposed that AZT, among other
      effects, delays the onset of disease in HIV-infected patients by contributing to
      the stimulation of the HIV-specific CTL response.

PMID- 1733640
TI  - Cell-mediated immunity in patients with chronic fatigue syndrome, healthy control
      subjects and patients with major depression.
AB  - The chronic fatigue syndrome (CFS) is characterized by severe persistent fatigue
      and neuropsychiatric symptoms. It has been proposed that the abnormalities in
      cell-mediated immunity which have been documented in patients with CFS may be
      attributable to a clinical depression, prevalent in patients with this disorder.
      Cell-mediated immune status was evaluated in patients with carefully defined CFS
      and compared with that of matched subjects with major depression (non
      melancholic, non-psychotic) as well as healthy control subjects. Patients with
      CFS demonstrated impaired lymphocyte responses to phytohaemagglutinin (PHA)
      stimulation, and reduced or absent delayed-type hypersensitivity (DTH) skin
      responses when compared either with subjects with major depression or with
      healthy control subjects (P less than 0.05 for each analysis). Although
      depression is common in patients with CFS, the disturbances of cell-mediated
      immunity in this disorder differ in prevalence and magnitude from those
      associated with major depression. These observations strengthen the likelihood of
      a direct relationship between abnormal cell-mediated immunity and the etiology of
      CFS.

PMID- 1733641
TI  - Immunization of mice with mycobacterial culture filtrate proteins.
AB  - Culture filtrate proteins were obtained from Mycobacterium tuberculosis cultures
      after 7 days growth in Proskauer and Beck medium. The protein yield increased
      substantially to peak about the time the number of viable organisms reached its
      maximum level (day 8). Examination of the protein concentrate by SDS-PAGE
      revealed the presence of at least 12 separate protein bands varying from 10 to 90
      kD. Mice were injected subcutaneously with 20 micrograms of M. tuberculosis
      culture filtrate (MTCF) protein suspended in saline or Freund's complete or
      incomplete adjuvant. The vaccinated mice were subjected to an aerogenic challenge
      with 10(3) colony-forming unit (CFU) M. tuberculosis Erdman and a significant
      reduction in the number of viable organisms was observed in the spleens and lungs
      determined over a 21-day period compared with age-matched normal controls. Mice
      immunized with the same culture filtrate proteins bound to nitrocellulose
      particles also showed some resistance to the virulent challenge, suggesting that
      individual antigens present in the culture filtrate were able to induce a
      protective T cell-mediated immune response in appropriately immunized mice.

PMID- 1733642
TI  - Rate of metastasis from C3H mouse mammary tumours.
AB  - Transplants from the same C3H mouse mammary tumour have been used for
      radiobiological experiments with curative intent for more than 8 years. During
      that time, the rate of metastasis to the lungs has varied between 0 and 63% and
      an explanation has been sought for this change. The results of immunological
      assays showed no obvious pattern. An inverse relationship was found between
      tumour latency and metastasis.

PMID- 1733643
TI  - Metastatic mode of gastric carcinoma by flow cytometric and clinicopathologic
      parameters.
AB  - We used flow cytometric and conventional clinicopathologic parameters to analyse
      the metastatic mode of cancer in 113 stomach cancer patients. Liver metastasis
      was frequent in cases with intestinal-type cancer, cancer located in the distal
      stomach, positive venous invasion and aneuploid cancer. Lung and pleural
      metastasis (excluding nodular lung metastasis), however, were frequent in cases
      with serosal invasion and diploid cancer. Peritoneal metastasis was frequently
      seen with tumors located in the proximal or whole stomach, diffuse-type cancer
      and cancer with serosal invasion. All cases developing bone metastasis were
      positive for lymph node metastasis. DNA ploidy was partially related to the
      metastatic mode of stomach cancer, but this was not the sole parameter for
      predicting metastasis. However, prediction may be possible if based on both DNA
      ploidy and clinicopathologic parameters, suggesting the possibility of the
      prophylaxis of recurrence by appropriate postoperative adjuvant therapy.

PMID- 1733644
TI  - Metastatic potential of human colon cancer cell lines: relationship to cellular
      differentiation and carcinoembryonic antigen production.
AB  - The relationship between cellular differentiation and carcinoembryonic antigen
      (CEA) production by human colorectal tumor cells and their ability to form
      hepatic metastases was studied. Eight human colon cancer cell lines were injected
      into athymic mice using different routes of administration to characterize their
      metastatic potential. The four poorly differentiated, non or low CEA producing
      cell lines were poorly metastatic to the liver after intrasplenic injection.
      After intraperitoneal implantation the same cell lines were highly tumorigenic,
      and subsequently metastatic to the liver. In contrast, the four moderate to well
      differentiated cell lines that produced moderate to high levels of CEA were
      highly metastatic to the liver following intrasplenic injection. After
      intraperitoneal implantation they were less tumorigenic, and metastatic to the
      liver. We conclude that in this system poorly differentiated non or low CEA
      producing colorectal cell lines have a lower metastatic capacity compared to the
      well-differentiated high CEA producing colorectal cell lines. These data
      correlate directly with the pattern of metastatic spread and clinical course
      observed in patients with these tumors, suggesting that degree of differentiation
      and level of CEA production may play a role in development of site-specific
      metastases.

PMID- 1733645
TI  - Myeloma affects both the growth and function of human osteoblast-like cells.
AB  - Myeloma behaves differently to other osteolytic tumours which metastasize to
      bone, in that the latter usually provoke reactive bone formation in the host
      bone. A previous study showed that a myeloma cell line (GM1500) secreted an
      osteoblast-inhibiting factor(s). The present study was undertaken to determine
      whether other myeloma cells also secreted a factor(s) which inhibited both cell
      proliferation and DNA synthesis of osteoblast-like cells and whether the myeloma
      also affected the function of osteoblasts. The results showed that a second cell
      line (Karpas 707) as well as myeloma tissue taken from two patients had a similar
      effect. The myeloma cells did not affect total collagen or protein synthesis, and
      did not affect the overall degree of mineralization. A biphasic effect was seen
      on alkaline phosphatase activity. Thus, although the proliferation of the pre
      osteoblast was affected, the synthetic functions of the osteoblasts were not.

PMID- 1733646
TI  - Inhibition of tumor implantation at sites of trauma by Arg-Gly-Asp containing
      proteins and peptides.
AB  - We report on the inhibition of wound implantation by TA3Ha mammary carcinoma
      cells by Arg-Gly-Asp containing proteins and peptides using a hepatic wedge
      resection model. Intravenously injected TA3Ha cells rarely form tumor in the
      liver of syngeneic mice, but after hepatic wedge resection, 45% (107/240) of the
      mice develop tumors in the hepatic wound. Hepatic wound implantation is
      significantly (P = 0.01) inhibited by pretreating the cells with whole mouse
      plasma, but not with fibrinogen-depleted plasma or serum. Tumor inhibition is
      also achieved by pretreatment of cells with fibrinogen (P = 0.05-0.0004),
      fibronectin (P = 0.007) and laminin, but not by albumin. The active domain
      appears to be the RGDS sequence since the deca- and tetrapeptides containing RGDS
      inhibit wound implantation (P less than 0.05). However, the tetrapeptide Arg-Gly
      Glu-Ser has no such activity. None of these agents affects ascites tumor
      formation by the intraperitoneally injected cells, suggesting that anchorage
      independent growth of cells is not affected. We propose that proteins and
      peptides containing RGD occupy the binding sites and prevent the cells from
      interacting with cell adhesion proteins in healing wounds. Proteins and/or
      peptides containing RGD may be useful for preventing local recurrence in
      postsurgical cancer patients.

PMID- 1733648
TI  - Retinoic acid-induced inhibition of metastatic melanoma cell lung colonization
      and adhesion to endothelium and subendothelial extracellular matrix.
AB  - The effect of pretreatment of metastatic B16 melanoma cells with 10(-6) M all
      trans-retinoic acid resulted in a significant inhibition of lung colonization
      following injection of 10(5) cells into the tail vein of syngeneic C57BL mice.
      Adhesion of melanoma cells to vascular endothelial cell monolayers, and
      subendothelial extracellular matrix was also inhibited by pretreatment with
      retinoic acid, as was tumour cell aggregation following seeding of pretreated
      cells on to 0.5% agar. Release of 35SO4 from radiolabelled subendothelial
      extracellular matrix by melanoma cells was essentially unaltered by retinoic acid
      pretreatment, as was the release of radiolabel from [3H]proline-labelled matrix,
      while plasminogen activator activity was enhanced in retinoic-acid-treated cells.
      These observed changes in adhesive properties may be responsible, at least in
      part, for the retinoic-acid-induced inhibition of lung colonization.

PMID- 1733647
TI  - Inhibition of tumor invasion and extracellular matrix degradation by ubenimex
      (bestatin).
AB  - We have investigated the effect of the immunomodulator ubenimex (hereafter
      referred to as bestatin) on the enzymatic degradation of the extracellular matrix
      by human renal cell carcinoma SN12M cells during the invasive process. The
      invasion of SN12M cells into reconstituted basement membrane (Matrigel) was
      inhibited by the presence of bestatin in a concentration-dependent manner.
      However, bestatin did not have any effect on tumor cell adhesion and migration to
      the extracellular matrices which may be involved in tumor cell invasion. Bestatin
      inhibited the degradation of type IV collagen by tumor cells, but not by tumor
      conditioned medium (TCM), in a concentration-dependent manner. We also found that
      bestatin inhibited hydrolysing activities towards substrates of aminopeptidases
      in SN12M cells. Since bestatin was found to inhibit aminopeptidase activity, the
      inhibition of tumor invasion by bestatin is likely to be associated with its
      action as an enzyme inhibitor. Bestatin only slightly inhibited tumor cell
      plasmin activity, which can lead to the conversion of the latent collagenase to
      the active form, but this slight effect was not significant. The zymography of
      TCM from SN12M cells showed that the treatment of tumor cells with bestatin
      resulted in the disappearance of the 68 kDa type IV collagenase-enzyme level
      (active form) and slight reduction of the 72 kDa type IV collagenase-enzyme level
      (latent form). These results indicated that bestatin may inhibit tumor cell
      invasion through a mechanism involving its inhibitory action on aminopeptidases
      in tumor cells, suggesting that the aminopeptidase may partly be associated with
      the conversion of a latent form of type IV procollagenase to an active form or
      the secretion of the collagenases from tumor cells.

PMID- 1733649
TI  - Effects of size and growth time of a murine sarcoma on its metastatic spread.
AB  - The effects of the size of an implanted tumor and of its time of growth on
      metastasis were examined in the same tumor grown under two different conditions.
      Tumors were implanted either in the untreated legs of mice or in legs that had
      been irradiated one day earlier. The radiation slowed the growth of tumors. When
      the tumors grew to predetermined diameters, the legs were excised and 20 days
      later the mice were examined for the presence of lung metastases. Equal changes
      in the time to excision of the tumors grown under the two conditions led to
      nearly equal changes in the proportions of animals with metastases. Tumor volume
      effects were not apparent in this consideration of changes in metastasis rates
      with time. This work reanalyses the data of that study using the variability in
      growth rates within a tumor growth condition to investigate the effect of tumor
      size on metastatic intensity. This intensity increased at least linearly with
      tumor volume for both irradiated and control animals. The finding of equal effect
      at equal growth times of the implanted tumors under the two growth conditions was
      confirmed but is due to: (1) metastatic intensity changing five times as rapidly
      with tumor size in the irradiated group as compared to the control group and (2)
      non-exponential retarded growth of the tumors in the control treatment group.

PMID- 1733650
TI  - Policy on HIV infected physicians adopted by CMS Board.

PMID- 1733651
TI  - Occupational health and environmental illnesses in Colorado.

PMID- 1733652
TI  - Death certificates--fill them out carefully (and correctly).

PMID- 1733653
TI  - Assistance for AIDS Specific Drugs (AASD) Program.

PMID- 1733654
TI  - Iatrogenic (intraoperative) rubber glove allergy and anaphylaxis: Part I.

PMID- 1733655
TI  - A dermatologic diary. Portrait of a practice.

PMID- 1733656
TI  - Chronic varicella zoster in a child infected with human immunodeficiency virus:
      case report and review of the literature.
AB  - Chronic zoster represents an infrequent presentation of varicella zoster virus
      infection. It is observed with increased frequency in patients infected with
      human immunodeficiency virus, especially when their lymphocyte counts are
      depressed. We report a child infected with human immunodeficiency virus who
      showed a long-standing cutaneous zoster lesion and was treated for a prolonged
      period of time with acyclovir. The occurrence of resistance to acyclovir by
      varicella zoster virus was suspected based on the clinical picture. The clinical
      and laboratory features of this case and a review of the literature are
      presented.

PMID- 1733657
TI  - Skin reactions to radiotherapy--a spectrum resembling erythema multiforme: case
      report and review of the literature.
AB  - Eruptions resembling erythema multiforme associated with radiotherapy are rare.
      Although several case reports are cited in the older literature, only recently
      has this phenomenon been described in patients receiving external beam radiation
      therapy both with and without contributory concurrent medications. The eruption
      typically begins within the radiation port and then generalizes; it is usually
      self-limited, but serious and fatal outcomes are reported. We review the
      literature and report a case of an eruption resembling erythema multiforme
      associated with external beam irradiation and 5-fluorouracil.

PMID- 1733658
TI  - Basal cell carcinoma and melanocytic nevus in the same lesion.
AB  - We report a case of basal cell carcinoma and intradermal melanocytic nevus in the
      same lesion. A review of the literature indicates that the simultaneous
      occurrence of two or more neoplasms in one specimen is a relatively infrequent
      finding. The pathogenesis of simultaneously occurring neoplasms remains the
      subject of speculation. Based on currently available evidence, we believe that
      the coexistence of lesions in this particular patient is most likely
      coincidental.

PMID- 1733659
TI  - Dermatology days, 1991: Ocean City, Maryland.

PMID- 1733660
TI  - Secondary syphilis presenting as cutaneous nodules in a patient previously
      treated for laryngeal carcinoma.
AB  - A person who had previously been treated for laryngeal carcinoma presented with
      the new onset of asymptomatic nodular skin lesions. The preliminary differential
      diagnosis included cutaneous metastasis. Examination of a biopsy specimen of the
      lesions and results of subsequent laboratory investigation ruled out the
      possibility of recurrent metastatic disease and established a diagnosis of
      secondary syphilis. The differential diagnosis of nodular lesions that resemble a
      lymphoid neoplasm or a cutaneous metastasis in a patient treated for cancer
      should also include secondary syphilis.

PMID- 1733661
TI  - Delayed reaction to suture material simulating melanoma.
AB  - A twenty-one-year-old woman who had been involved in an accident sustained severe
      trauma to the left side of her face and scalp. Because of deterioration in her
      neurologic condition, a number of exploratory burr holes were drilled in her
      skull. Fifteen years later, a 6 mm black tender nodule was noted on the left
      temple, close to one of the burr holes. Nodular melanoma was suspected, but
      results of microscopic examination proved the lesion to be a granuloma with
      transepidermal elimination of exogenous filamentous material. The relationship
      between foreign bodies and cutaneous neoplasia, genuine or simulated, is noted
      briefly.

PMID- 1733662
TI  - Mobile encapsulated lipomas.
AB  - Mobile encapsulated lipomas are a benign neoplastic process with pronounced
      mobility in the subcutaneous plane. Characteristic clinical and histologic
      features differentiate this distinctive entity from similar reactive adipose
      processes.

PMID- 1733663
TI  - Microtubule-associated proteins during mouse spermatogenesis: localization of a
      protein immunologically related to brain MAP1B protein in the synaptonemal
      complex.
AB  - Monospecific polyclonal antibodies against MAP1A protein and an immunologically
      related brain MAP1B polypeptide were used to visualize mouse synaptonemal
      complexes (SCs) with immunofluorescence microscopy. Anti-MAP1A antibody
      recognized SCs uniformly. However, when anti-MAP1B antibody was used, a dashed
      pattern of staining was observed along the SCs in both autosomes and pachytene XY
      bivalents. After purification of SCs, immunoblots of the electrophoresed proteins
      revealed a polypeptide of 220 kDal, which was recognized by anti-MAP1B antibody,
      and two proteins of 180 kDal and 160 kDal, which were recognized by anti-MAP1A
      antibody. High-molecular-weight polypeptides immunologically related to
      microtubule-associated proteins were localized in the cell nucleus. The function
      of these nuclear proteins is unknown. The distribution of fluorescent signal
      corresponding to the 220-kDal protein during meiosis and spermiogenesis and its
      localization in the nuclear matrix suggest the participation of preexisting
      nucleoskeletal proteins in the molecular organization of the SC and its dynamics
      during meiotic prophase.

PMID- 1733664
TI  - Detection of structural chromosome aberrations in immunophenotyped mitoses.
AB  - The recently developed MAC (morphology-antibody-chromosome) method allows
      simultaneous immunophenotype and karyotype analysis in the same cell. To date,
      application of this new method has been hampered by the poor quality of
      chromosome banding. In this paper, we describe a modified simultaneous
      immunofluorescence and Q-banding technique, as well as a new combination of
      immunohistochemical and fluorescent R-banding methods. By further modifying the
      MAC method, we were able not only to achieve unequivocal results with weakly
      expressed antigens but also to improve the quality of the banding techniques, so
      that even structural chromosome abnormalities were well defined.

PMID- 1733665
TI  - Isolation and comparative mapping of a human chromosome 20-specific alpha
      satellite DNA clone.
AB  - We have isolated and characterized a human genomic DNA clone (PZ20, locus D20Z2)
      that identifies, under high-stringency hybridization conditions, an alphoid DNA
      subset specific for chromosome 20. The specificity was determined using
      fluorescence in situ hybridization. Sequence analysis confirmed our previously
      reported data on the great similarity between the chromosome 20 and chromosome 2
      alphoid subsets. Comparative mapping of pZ20 on chimpanzee and gorilla
      chromosomes, also performed under high-stringency conditions, indicates that the
      alphoid subset has ancestral sequences on chimpanzee chromosome 11 and gorilla
      chromosome 19. However, no hybridization was observed to chromosomes 21 in the
      great apes, the homolog of human chromosome 20.

PMID- 1733666
TI  - The polymorphic DNA sequence D20S14 is assigned to human chromosome 20p12---
      p11.2 by in situ hybridization.
AB  - The polymorphic DNA marker D20S14 was previously mapped to human chromosome 20
      and shown to be linked to two other DNA markers, D20S5 and D20S6, located at
      20p12. This segment has been implicated in several human diseases. Because of its
      importance, we mapped the D20S14 locus to 20p12----p11.2 by radioactive in situ
      hybridization.

PMID- 1733667
TI  - Regional localization of the human platelet-derived endothelial cell growth
      factor (ECGF1) gene to chromosome 22q13.
AB  - Using in situ hybridization and a panel of human X rodent somatic cell hybrids,
      which discriminates between four different regions of human chromosome 22, we
      have localized the gene for human platelet-derived endothelial cell growth factor
      (ECGF1) to 22q13, placing ECGF1 distal to the PDGFB locus at 22q12.3----q13.1.

PMID- 1733668
TI  - Chromosomal mapping of human kininogen gene (KNG) to 3q26----qter.
AB  - The structural gene for human kininogen (KNG) was localized to chromosome 3q26---
      qter by in situ hybridization. The assignment substantiates the evolutionary
      relationship of kininogen to two other members of the cystatin superfamily, alpha
      2-HS-glycoprotein and histidine-rich glycoprotein, which also map to chromosome
      3.

PMID- 1733669
TI  - A physical and genetic linkage map of the distal long arm of human chromosome 5.
AB  - By in situ hybridization of probes for three cloned genes and eight genetically
      linked polymorphic DNA markers, we have prepared a physical map of the distal
      long arm of chromosome 5. These results, together with the localizations of 11
      genes and the genetic linkage map reported previously by us and by other
      investigators, represent a map that spans 55 cM.

PMID- 1733670
TI  - Cytogenetics and karyosystematics of South American oryzomyine rodents
      (Cricetidae: Sigmodontinae). IV. Karyotypes of Venezuelan, Trinidadian, and
      Argentinian water rats of the genus Nectomys.
AB  - Bone marrow chromosomes were studied in South American water rats of the genus
      Nectomys from Venezuela, Trinidad, and Argentina. Specimens of N. squamipes from
      western and southern Venezuela showed a 2n = 52-53 karyotype, whereas a 2n = 56
      57 karyotype was found in specimens from northeastern Argentina. In both cases,
      odd karyotypes can be explained by the presence of a supernumerary chromosome. In
      contrast, water rats from northeastern Venezuela and Trinidad showed a strikingly
      reduced 2n = 16-17 polymorphic chromosome complement. Six different karyomorphs
      were found among the latter, which may have resulted from a combination of
      pericentric inversions in two pairs of autosomes and a centromeric fusion in
      another autosomal pair. It is proposed that the new 2n = 16-17 cytotypes belong
      to a species of its own, for which the name N. palmipes is suggested.

PMID- 1733671
TI  - Defective repair of radiation-induced chromosomal damage in scid/scid mice.
AB  - The murine severe combined immunodeficiency (scid) mutation interferes with
      normal recombination of immunoglobulin and T-cell receptor genes. This
      immunologic defect results in a lack of fully differentiated B and T cells in
      scid/scid mice. Animals homozygous for the scid mutation also display increased
      sensitivity to the damaging effects of ionizing radiation. We report here our
      observations of high frequencies of radiation-induced chromatid interchanges and
      intrachanges in bone marrow cells and fibroblasts from scid/scid mice. The
      presence of these aberrant chromosome structures suggests that a delay in strand
      rejoining underlies the increased sensitivity of scid/scid mice to ionizing
      radiation. The scid mutation may provide important clues for understanding the
      relationship between mitotic recombination and DNA repair in higher eukaryotic
      cells.

PMID- 1733672
TI  - Assignment of two markers carried by human chromosome 1 to different cattle
      synteny groups: FH to U1 and PEPC to U17 (chromosome 8).
AB  - Two loci located on human chromosome 1 were mapped in cattle by means of
      interspecific (hamster x cattle) somatic cell hybridization. FH is assigned to
      the U1 synteny group together with PGD, ENO1, AT3, and REN, while PEPC is found
      to belong to the U17 group (chromosome 8), like FN1, CRYG, and VIL1.

PMID- 1733673
TI  - Localization of the pig luteinizing hormone/choriogonadotropin receptor gene
      (LHCGR) by radioactive and nonradioactive in situ hybridization.
AB  - The porcine gene for luteinizing hormone/choriogonadotropin receptor (LHCGR) was
      localized to chromosome 3q2.2----q2.3 using radioactive and nonradioactive in
      situ hybridization. A computer-assisted image-analysis system was developed which
      facilitated detection of the position of silver grains and fluorescent spots on
      the chromosomes after in situ hybridization. Compared with autoradiographic
      visualization, the nonisotopic procedure proved to be more rapid, precise, and
      highly specific; however, nonradiographic in situ hybridization was much less
      efficient than the autoradiographic technique for the detection of unique DNA
      sequences with small probes. From these results and published gene-mapping data,
      it was concluded that the synteny between LHCGR and MDH1 observed in man is
      conserved in the pig genome.

PMID- 1733674
TI  - Equalization of Z and W axes in chicken and quail oocytes.
AB  - The different morphological types of ZW pairs have been classified in three main
      types according to the relative extension of the free segment of the Z axis: 1,
      "long asynaptic segment;" 2, "medium asynaptic segment;" and 3, "equalized." Pre-
      and post-pairing types have also been defined. Frequencies of each type were
      determined at day 20 and day 21 of incubation, and one and three days after
      hatching. The changing frequencies and the morphological transitions observed
      show a definite sequence of ZW types that can be used as a timetable for
      pachytene substaging. Measurements made on each ZW type show that the Z axis of
      the chicken shortens from 20.6 microns to 13.1 microns. This shortening occurs
      both in the free segment (at a higher rate) and in the paired segment (at a lower
      rate). The synaptonemal complex becomes elongated while adjustment occurs. The
      equalized Z axis makes many twists around the W axis. However, a segment 1 micron
      long from the synaptic terminus is free from twists and is assumed to be the
      homologously paired region. The ZW pair of the quail shows a similar behavior but
      equalization of the Z and W axes ends earlier and forms a straighter synaptonemal
      complex as compared with the chicken. In both species a recombination nodule is
      strictly localized near the synaptic terminus. In the ZW pair of the quail the
      average location of this nodule is 0.14 microns from the synaptic terminus. The
      meiotic behavior of ZW pairs in birds may be conserved.

PMID- 1733675
TI  - Mapping of five human chromosome 19 DNA markers to owl monkey chromosomes.
AB  - Hybridization of DNA from three panels of karyotypically distinct owl monkey x
      rodent somatic cell hybrids with human DNA probes resulted in the syntenic
      assignments of INSR-LDLR-TGFB1-APOE-D19S8 to owl monkey chromosome 25 of
      karyotype VI (2n = 49/50), INSR-LDLR-TGFB1-D19S8 to chromosome 2 of karyotype II
      (2n = 54), and INSR-APOE to chromosome 2 of karyotype V (2n = 46). The APOE and
      D19S8 loci are on adjacent regions proximal to the centromere of chromosomes 25q
      (K-VI) and 2p (K-II), as determined by in situ chromosomal hybridization
      analysis. These findings support our previous proposals on (1) the homology of
      these chromosomes of three owl monkey karyotypes, (2) the evolutionary derivation
      of chromosome 2 of karyotypes II and V as the result of two separate centric
      fusion events, and (3) the likelihood that owl monkey chromosome 25 (K-VI) (and
      its homologs) is a conserved genetic homoeolog of human chromosome 19.

PMID- 1733676
TI  - Telomeric signals in robertsonian fusion and fission chromosomes: implications
      for the origin of pseudoaneuploidy.
AB  - In situ hybridization with synthetic plant telomeric sequences resulted in
      labeling of all broad bean (Vicia faba) chromosomes at their ends only.
      Telocentric chromosomes derived by fission of the metacentric satellite
      chromosome of V. faba also showed signals at both of their ends, whereas the
      ancestral metacentric did not display signals at its primary constriction, the
      point of fission. As in V. faba, all acrocentric mouse chromosomes were labeled
      by in situ hybridization with a vertebrate telomeric probe at both ends of each
      chromatid exclusively. However, different metacentric Robertsonian chromosomes
      derived by fusion of defined acrocentrics did not show signals at their primary
      constrictions. The mechanism of Robertsonian rearrangement leading to a
      pseudoaneuploid increase or decrease in chromosome number therefore cannot
      consist solely of a simple fission or fusion of chromosomes without a concomitant
      gain or loss of chromatin material. The additional assumption of a subdetectable
      deletion of telomeric sequences after fusion and amplification of these sequences
      following fission is necessary to explain the present observations.

PMID- 1733677
TI  - Mapping of the porcine lipoprotein lipase (LPL) gene to chromosome 14q12----q14
      by in situ hybridization.

PMID- 1733679
TI  - TNM staging system.

PMID- 1733678
TI  - Outpatient protocol for biofeedback therapy of pelvic floor outlet obstruction.
AB  - Pelvic floor outlet obstruction is a rare cause of severe constipation. Anal
      myectomy, subtotal colectomy, and medical therapy have limited success. The
      purpose of this study was to develop a short outpatient treatment using
      biofeedback techniques. Nine patients with severe constipation and straining
      resulting from pelvic floor outlet obstruction underwent complete investigation
      of the pelvic floor musculature and anal sphincter mechanism. Patients were
      unable to expel a 60-cc rectal balloon and had nonrelaxing puborectalis on
      defecography. The treatment protocol utilized anal surface electromyography to
      document improper straining and retrain pelvic floor muscles to relax during
      defecation. Sensory retraining with a rectal balloon, behavioral relaxation
      techniques, and defecation of simulated stool using a 120-cc Metamucil (Procter &
      Gamble, Cincinnati, OH) slurry in the rectum allowed re-establishment of normal
      defecation in all nine patients. Repeat training was required in three patients
      during follow-up. Treatment of pelvic floor outlet obstruction with outpatient
      retraining techniques is possible.

PMID- 1733680
TI  - Preoperative radiation therapy for locally advanced carcinoma of the rectum.
      Clinicopathologic correlative review.
AB  - During a three-year period, 27 patients with the diagnosis of adenocarcinoma of
      the rectum were referred to the Department of Radiation Oncology and accepted for
      preoperative radiation therapy. The referral was based solely on endoluminal
      ultrasound staging (ELUS) of an unfavorable lesion (n = 12) or ultrasound staging
      with the clinical impression of a fixed (n = 9) or tethered (n = 6) lesion. High
      dose (4,500-5,600 cGy) preoperative radiation was followed by definitive surgery
      in four to seven weeks. The gross and microscopic pathology observed in 23
      specimens of this group of patients formed the basis of this report. The
      microscopic findings that persist after radiation allow an accurate determination
      of the tumor stage existing prior to radiation. Correlations are made between the
      original evaluation of the tumor, including ELUS, and the microscopic findings.
      ELUS accurately predicted the depth of tumor penetration in 20 to 23 of 23
      specimens and the lymph node status in 16 of 23 specimens. In the context of the
      pathologic findings as described, downstaging was not demonstrated. Following
      this radiation protocol, a marked reduction in tumor mass was demonstrated, as
      well as evidence of tumor destruction in the remaining mass, varying from minimal
      to total elimination of viable tumor. The concept that radiation fibrosis exists
      only as it approximates or replaces neoplasm is offered. In the context of this
      pathologic finding, improved resectability occurred for certain tumors. It is
      recommended that ELUS be added to the clinical evaluation of rectal
      adenocarcinoma. It is also recommended that the pathologic findings described be
      used when reporting the stage of rectal tumors that have received high-dose
      preoperative radiation therapy.

PMID- 1733681
TI  - Gallstones and colorectal cancer--there is a relationship, but it is hardly due
      to cholecystectomy.
AB  - The prevalence of gallstone disease in 145 consecutive patients with colorectal
      cancer was compared with gallstone prevalence in 4,159 subjects randomly selected
      from a population. The group of patients had a significantly higher prevalence of
      gallstone disease than the population (odds ratio = 1.59; 95 percent confidence
      limits 1.04-2.45), whereas cholecystectomies occurred with equal frequency in the
      two groups. There was a nonsignificant trend toward more right-sided cancers in
      patients with gallstones than in patients without. These results, together with
      available literature, give substantial evidence for an association between
      gallstones and colorectal cancer, an association which is not due to
      cholecystectomy being a predisposing factor to colorectal cancer. Sporadic
      findings of an association between cholecystectomy and colorectal cancer can be
      explained by the above relationship.

PMID- 1733682
TI  - Colectomy-proctomucosectomy with S-pouch: operative procedures, complications,
      and functional outcome in 69 consecutive patients.
AB  - Sixty-nine patients were operated upon in a three-stage procedure. Early
      complications occurred in 29 percent after colectomy-ileostomy, in 25 percent
      after proctomucosectomy with ileoanal anastomosis and loop ileostomy, and in 9
      percent after closure of loop ileostomy. Only three of these were considered
      serious. Seventy-one percent of the patients were readmitted into the hospital
      between the three operations or after the last one. Total hospital stay was 49
      days (median); the range was 20 to 345 days. Reconstruction of the reservoir was
      performed in four patients owing to defecation problems, with satisfying
      functional results in two patients, while two emptied by catheter. There was no
      postoperative mortality or pelvic sepsis, and no pouches were excised. Ileostomy
      was re-established in two patients. At histopathologic re-evaluation of colectomy
      specimens, the diagnosis was changed from ulcerative colitis to Crohn's disease
      in three patients and to indeterminate colitis in five. Median follow-up was 4.3
      years. Continent anal defecation without ileostomy was achieved in 67 patients
      (97 percent), with 4.1 bowel movements per day and 0.6 per night. Perfect
      continence was achieved in 55 percent in the daytime and in 43 percent at night.
      The low rate of reservoir-threatening complications is attributed to the three
      stage procedure and the technical details in the surgical procedures.

PMID- 1733683
TI  - Abdominal rectopexy for complete prolapse: prospective study evaluating changes
      in symptoms and anorectal function.
AB  - The effect of abdominal rectopexy on bowel function is difficult to assess in
      retrospective studies because preoperative bowel habit cannot be determined
      accurately. This study examined bowel symptoms and physiologic tests of anorectal
      function prospectively in 23 patients before and at three months after rectopexy.
      Rectopexy eliminated complete prolapse in all and stopped bleeding in 16 of 18
      patients. Incontinence improved significantly. Constipation (less than 3 bowel
      actions per week or straining for more than 25 percent of defecation time) was
      relieved in 4 of 11 affected patients but developed in 5 of the 12 who were not
      constipated preoperatively. Since the median bowel frequency was 21 motions per
      week before surgery and 17 afterward, the main determinant of constipation was
      straining. Abdominal pain was relieved after rectopexy in 6 of 12 patients but
      developed in 3 of 13 who were pain-free before surgery. Three patients (13
      percent) had a first-degree relative with rectal prolapse. Perineal descent
      decreased significantly. Maximal anal resting pressure increased significantly,
      but this did not correlate significantly with improved continence. Twenty-one
      patients (91 percent) could expel a 50-ml balloon preoperatively; 18 of those 21
      could still do so postoperatively. The two patients who could not expel the
      balloon preoperatively were able to do so postoperative. This study shows that
      rectal prolapse is associated with profoundly abnormal defecation and abdominal
      pain. While abdominal rectopexy improved continence, it may improve or worsen
      other bowel symptoms, including constipation.

PMID- 1733684
TI  - Is anorectal surgery on chronic dialysis patients risky?
AB  - Patients on chronic hemodialysis for end-stage renal disease (ESRD) may develop
      anorectal problems necessitating surgery. From January 1984 to December 1987, 18
      ESRD patients underwent anorectal surgery. During this period, a mean of 215
      patients underwent dialysis. Patients with ESRD present with characteristic
      problems: chronic constipation, need for dialysis pre- and postoperatively with
      heparin infusion, anemia, anticoagulation secondary to the consequences of
      uremia, and significant medical problems including coronary artery disease,
      diabetes mellitus, hypertension, and chronic obstructive pulmonary disease
      (COPD). Two patients had concomitant anal fissure, two had fistula-in-ano, and
      one had an acute perianal abscess. In two patients, the postoperative course was
      complicated by hemorrhage and, in one patient, by abscess formation. There was no
      delay in wound healing compared with a cohort group. The essentials of
      perioperative management are discussed with respect to timing of dialysis,
      methods of anesthesia and pain management, coagulation screening, and
      complications. Patients on well-managed chronic dialysis will tolerate anorectal
      surgery without undue jeopardy.

PMID- 1733685
TI  - Anal sphincter imaging in fecal incontinence using endosonography.
AB  - Clinical anal examination, manometry (resting and squeeze pressures), and single
      fiber electromyography were compared with endosonography of the anal sphincters
      in 14 patients with fecal incontinence. Technical aspects of the procedure and
      normal imaging of the puborectal muscle and both sphincters were defined. Defects
      in both sphincters were seen in nine patients. The defect is visualized as a
      clear discontinuity in the muscular ring. Compared with the conventional studies,
      anal endosonography gave significant information in six patients (four male
      patients after perianal surgery and two women), showing sphincter defects in five
      patients and integrity of the sphincters in another one. This information
      obtained by endosonography was important in understanding the type and extension
      of the lesion and deciding upon the surgical repair. Anal endosonography is an
      imaging technique of the sphincters that can assess their integrity in fecal
      incontinence.

PMID- 1733686
TI  - Volvulus of the sigmoid colon in Jordan.
AB  - This report discusses 27 patients with sigmoid volvulus treated at Jordan
      University Hospital (JUH) during a 15-year period. These patients represented 4.7
      percent of adult patients treated for intestinal obstruction in the same period.
      The average age was 54.5 years, and none of the patients was institutionalized.
      Twenty-five patients presented with acute symptoms, and two had chronic symptoms.
      Sigmoidoscopic detorsion was achieved in 15 patients. Emergency resection was
      required in two of these patients: for the development of gangrene a few hours
      after detorsion in one patient and for recurrence within 24 hours in the other
      despite the presence of a rectal tube. Early recurrence occurred in two other
      patients and was managed endoscopically. Emergency surgery was performed in 10
      other patients: for a failed endoscopic detorsion in three patients, for
      ulcerated and bleeding mucosa forecasting gangrene in another, and as a primary
      treatment in six patients who were either misdiagnosed or suspected to have
      gangrenous bowel. Elective resection was performed in 13 patients. The mortality
      rate was 15 percent (4/27) for the whole series and 33.3 percent (1/3) for those
      with gangrenous bowel.

PMID- 1733687
TI  - Straight ileoanal anastomosis after longitudinal strip myectomy in the swine
      model.
AB  - In an attempt to improve the function of the straight ileoanal anastomosis, an
      experimental study was performed using the swine model. The terminal ileum was
      altered by completely removing two longitudinal strips of muscle prior to
      performing a straight ileoanal anastomosis. The intent of the study was to
      determine whether muscle stripping was technically possible and whether bowel
      thus treated would remain viable to passively form a pelvic reservoir. The length
      of time required for formation of the reservoir was noted. All animals survived
      the procedure to allow evaluation. The muscle stripping was not difficult to
      perform. Viability was not a problem since the myectomy animals thrived well and
      demonstrated continence, weight gain, and reservoir formation. The results are
      encouraging. It appears that strips of muscularis propria can be removed from the
      terminal ileum without jeopardizing its viability. This seems to disrupt
      sufficiently the tonus of the bowel to allow better function of the straight
      ileoanal anastomosis through formation of a passive pelvic reservoir within a
      month's time in the swine model, and it may have application in the human.

PMID- 1733688
TI  - Massive lower gastrointestinal hemorrhage caused by pseudocyst of the pancreas
      ruptured into the colon. Report of two cases.
AB  - We report two cases of massive lower gastrointestinal (LGI) bleeding occurring in
      young adult men, as the first manifestation of pseudocyst of the pancreas.
      Despite the rarity of such a complication, pancreatic pseudocyst should be kept
      in mind as a possible source of massive LGI bleeding requiring immediate surgical
      treatment.

PMID- 1733689
TI  - Split notochord syndrome in an adult presenting with colonic duplication. Report
      of a case.
AB  - A case of tubular colonic duplication, sigmoid colon diverticulum, and lumbar
      anterior spina bifida in a 28-year-old man was diagnosed as split notochord
      syndrome. After subtotal colectomy, including the duplicated colon, the patient
      recovered. Histologic study of the duplicated colon revealed multifocal, ectopic
      gastric fundic mucosa in a mosaic pattern. Since bleeding and perforation occur
      most frequently in conjunction with ectopic gastric mucosa within the
      duplication, we believe that complete resection of the duplicated bowel is the
      best procedure. Split notochord syndrome is a rare congenital anomaly. It is
      usually discovered in the first year of life, and the majority of reported cases
      have involved the cervical or thoracic region. Our patient is exceptional in
      having reached the age of 28 years without complaints and in that his case
      involved lumbar anterior spina bifida and tubular colonic duplication.

PMID- 1733690
TI  - Anorectal pressure gradient in patients with anal incontinence.
AB  - Anorectal pressures in patients with fecal incontinence have been investigated.
      With anal manometry, 34 percent of patients with fecal incontinence had maximal
      resting pressure and 39 percent had maximal squeeze pressure within the normal
      range. When a pressure gradient was calculated as the pressure difference between
      maximal resting pressure and rectal pressuring during filling of a rectal
      balloon, patients with fecal incontinence could be better distinguished from
      controls: 20 percent of patients with fecal incontinence had values within the
      normal range when the rectal pressure at the earliest defecation urge was used (P
      less than 0.05), and 12 percent had values within the normal range when the
      rectal pressure at maximal tolerable volume was used (P less than 0.01).
      Anorectal pressure gradient measurements seem to distinguish patients with fecal
      incontinence from controls better than maximal resting pressure or maximal
      squeeze pressure alone.

PMID- 1733691
TI  - Technique for revision of continent ileostomy.
AB  - A technique is described for revising an incompetent nipple valve of a continent
      ileostomy. The procedure involves preserving the incompetent valve and using it
      as a collar around the base of the new valve to improve function.

PMID- 1733692
TI  - Hemorrhoidectomy with self-retaining retraction.
AB  - Hemorrhoidectomy is facilitated by good exposure. Appropriate application of
      towel clips helps to maintain good exposure during hemorrhoidectomy.

PMID- 1733693
TI  - Intersphincteric surgical access to the rectum for the treatment of villous
      adenomas.
AB  - Intersphincteric surgical access is proposed to treat villous adenomas of the
      posterior rectal wall, not accessible to an endoanal approach, in which anterior
      resection is not suitable because of the poor general condition of the patient.

PMID- 1733694
TI  - Flow cytometric analysis of DNA content in colorectal carcinoma.
AB  - Over the past decade, flow cytometric DNA analysis has been employed by a number
      of investigators in an attempt to further define patient prognosis beyond classic
      pathologic staging. The results of these studies taken independently have been
      confusing; however, their cumulative effect suggests that flow cytometry is a
      useful prognostic indicator and can be used to further delineate prognosis within
      a specific pathologic stage. DNA nondiploid tumors are more likely to recur than
      diploid tumors, and patients with DNA nondiploid tumors have a poorer five-year
      survival than patients with DNA diploid tumors. There appears to be a weak
      relationship between advanced pathologic stage and DNA aneuploid tumors, although
      there is no clear and consistent relationship between tumor ploidy and histology.
      Therefore, all patients with colorectal tumors should undergo DNA ploidy
      analysis. Patients with DNA nondiploid tumors should be treated for biologically
      more aggressive disease independent of other prognostic variables. Ploidy status
      should be employed as a variable by which to randomize patients to both primary
      treatment schemes and adjuvant therapies in clinical trials.

PMID- 1733695
TI  - [The long-term toxicity of polychemotherapy in successfully treated testicular
      carcinoma].
AB  - Of 55 patients with testicular cancer, treated by combination chemotherapy
      including cisplatin, 21 (mean age 35 [21-51] years) were reexamined for late
      sequelae of the chemotherapy 1-9 years later. No patient had a recurrence or
      second malignancy. They all had normal renal function (renal sequence
      scintigraphy; creatinine clearance). Seven of 20 patients had a polyneuropathy,
      nine of 18 had high-tone hearing loss. Two patients became fathers after
      treatment. In nine of 20 patients the serum concentration of follicle-stimulating
      hormone was raised to above 20 mU/ml, evidence of germ-cell damage. Six of 13
      patients had an abnormal ejaculation following retroperitoneal lymphadenectomy or
      excision of a residual tumour. There was no evidence of any life-limiting
      toxicity of the chemotherapy.

PMID- 1733696
TI  - [The percutaneous implantable heart-lung machine in the coronary angioplasty of
      high-risk and emergency patients].
AB  - Using a recently developed, percutaneously introduced cardiopulmonary support
      system (PCPS) seven high-risk patients (four men, three women; mean age 61 [41
      77] years) underwent percutaneous transluminal coronary angioplasty. In one
      patient, with unstable angina and in incipient cardiogenic shock, perfusion with
      PCPS was begun immediately before coronary angioplasty. In six patients it was
      undertaken with the PCPS on stand-by, but eventually not needed. Coronary
      angioplasty was successful in six patients, partially successful in one. Angina
      was considerably improved long-term in all patients, but one of them died 2.5
      months afterwards at home. In two other patients (men, aged 41 and 71 years) with
      acute myocardial infarction, the PCPS was employed under circumstances of
      emergency resuscitation. In both cases recanalization of the occluded coronary
      artery was achieved mechanically during perfusion with PCPS; one patient
      survived. Availability of PCPS, also in an emergency, makes it possible to extend
      the indications for coronary angioplasty to include even high-risk patients.

PMID- 1733697
TI  - [Taenia crassiceps infection in AIDS].
AB  - A 33-year-old patient with AIDS, and a history of episodes of Pneumocystis
      carinii pneumonia and cerebral toxoplasmosis, developed a subcutaneous
      paravertebral infiltrate, which at first resembled a haematoma. Over a period of
      several weeks, the lesion spread to cover almost the entire back. Initially,
      numerous investigations failed to reveal the aetiology. His general condition
      worsened progressively, and intermittent bleeding into the soft tissue of the
      back occurred, requiring transfusion. This was associated with the development of
      an isolated deficiency of clotting factor V and a fall in Quick values to 10%. On
      the 22nd day after admission, the infiltrate ruptured spontaneously, releasing
      blood and a large number of whitish spherical masses 2-3 mm in diameter. These
      were identified as Cysticerci longicolles, the larval form of Taenia crassiceps,
      a tapeworm occurring in Canidae. The blood clotting values returned to normal
      within two days of incision of the infiltrate and commencement of therapy with
      mebendazole (6 g/day) and praziquantel (3.6 g/day). The infiltrate subsequently
      regressed almost completely. After combination treatment for 2 weeks, treatment
      was continued with praziquantel alone, which, however, the patient stopped
      himself after 10 weeks. A recurrence at the same site 4 months later was
      successfully treated with a further course of mebendazole and praziquantel.

PMID- 1733698
TI  - [The diagnosis of corrosive esophageal burns].

PMID- 1733699
TI  - [Nonpharmacological factors in the treatment of arterial hypertension. The roll
      of obesity, alcohol consumption and table salt intake].

PMID- 1733700
TI  - [The history of massage].

PMID- 1733701
TI  - [The safekeeping of medical data on employment medical exams].

PMID- 1733702
TI  - [The x-ray diagnosis of diverticulosis].

PMID- 1733703
TI  - [Mechanical heart valves or bioprostheses. A 12-year comparison].

PMID- 1733704
TI  - Effects of stage of the cycle and estradiol-17 beta on oxytocin synthesis by
      ovine granulosa and luteal cells.
AB  - Individual ovine follicles or corpora lutea (CL) were obtained at different
      stages of the estrous cycle to compare the pattern of oxytocin synthesis with
      time in vitro. Granulosa cells from follicles in the early follicular phase
      produced minimal amounts of oxytocin whereas output from preovulatory (post LH
      surge) follicles increased to a peak of 540 pg/10(4) cells.24 h on days 4-7 in
      vitro declining to 180 pg/10(4) cells.24 h by day 11. Production from day 1 CL
      was also high, peaking at 1639 pg/10(4) cells.24 h. In contrast the capacity for
      oxytocin synthesis by day 2 CL had already declined, with peak output reaching
      only 185 pg/10(4) cells.24 h on days 3-4. Day 9 CL produced small amounts of
      oxytocin (50 pg/10(4) cells in the first 24 h) followed by a low output
      thereafter. The effect of estradiol-17 beta (E2 beta) on oxytocin synthesis was
      examined. The results were dependent on the stage of the cycle at which the cells
      were obtained. Oxytocin production was significantly stimulated in three and
      inhibited in four out of nine preovulatory follicles by the addition of 50 or 500
      ng/ml E2 beta, whereas in days 1 and 2 CL E2 beta consistently inhibited oxytocin
      synthesis and in day 9 CL no response was found. These data indicate that the
      ovarian capacity to synthesize oxytocin varies markedly at different stages of
      the cycle, and that cells obtained close to ovulation do not experience the rapid
      down-regulation in oxytocin synthesis which occurs in vivo in the early luteal
      phase. E2 beta may switch from having a stimulatory to an inhibitory action on
      oxytocin synthesis shortly before ovulation.

PMID- 1733705
TI  - Subgroups of luteinizing hormone-releasing hormone perikarya defined by computer
      analyses in the basal forebrain of intact female rats.
AB  - The hypothesis that the basal forebrain population of LHRH perikarya is composed
      of heterogeneous subgroups was examined in this study. We used three-dimensional
      computerized reconstruction to examine populations of LHRH-immunopositive neurons
      detected in noncolchicine treated cycling female rats. Perikarya were detected
      with two antisera capable of detecting LHRH decapeptide within larger mol wt
      species, i.e. Millar's (RM) 1076 and Arimura's (AA) 419. No immunopositive
      perikarya were detected with antiserum AA 422, which requires the fully processed
      decapeptide for binding. A more broadly distributed population of LHRH neurons
      was detected in females killed on proestrus than in females killed on estrus or
      the other days of the cycle. These relationships were observed with both
      antisera, RM 1076 and AA 419. Subgroups of cells were clearly defined when the
      population of LHRH neurons detected on proestrus was simultaneously displayed
      with the population detected on estrus. Strikingly similar subgroups were
      revealed by simultaneous displays of populations of LHRH neurons detected by the
      antisera RM 1076 and AA 419 in proestrous females. This study revealed a three
      dimensional onion skin-like laminar organization of LHRH subgroups expanding from
      the ventricle outward laterally and from the diagonal band of Broca to the
      hypothalamus caudally. We propose that these subgroups vary in their metabolic
      activity of biosynthesis, processing, transport, or release of LHRH in relation
      to the proestrous preovulatory release of LH.

PMID- 1733706
TI  - Additive and/or synergistic effects of 5 alpha-dihydrotestosterone,
      dexamethasone, and triiodo-L-thyronine on induction of proteinases and epidermal
      growth factor in the submandibular gland of hypophysectomized mice.
AB  - The effects of androgen, glucocorticoid, and thyroid hormones on levels of
      proteinase isozymes and epidermal growth factor (EGF) in the submandibular glands
      of hypophysectomized (Hypox) mice were investigated. Total proteinase activity in
      males was decreased by hypophysectomy and increased by single or combined
      injection of the three hormones into these mice. 5 alpha-Dihydrotestosterone
      (DHT) had the strongest effect, and dexamethasone (Dex) the least. By isoelectric
      focusing, proteinases extracted from the submandibular gland of untreated male
      and female mice were fractionated into four isozymes with pI values of 4.8
      (proteinase-F), 5.8 (proteinase-D), 6.2 (proteinase-A), and 10.0 (proteinase-P).
      In Hypox mice (both sexes), there was only a single isozyme, proteinase-F.
      Proteinase-D, -A, and -P were induced in the submandibular gland of Hypox males
      by injections of DHT, Dex, and/or T3; the percent ratio of activity of each of
      these isozymes induced by these hormones, given either singly or in combination,
      was almost parallel among the three isozymes. Synergistic effects were observed
      between T3 and Dex, and additive effects between T3 and DHT. The increase in
      proteinase isozyme activities by concomitant injections of T3 and Dex was about 2
      times more than the additive values. The changes in proteinase-F upon hormone
      injection were complicated. In females, the enzyme activity was decreased by
      hypophysectomy and increased by DHT administration. In males, on the other hand,
      it was increased by hypophysectomy and suppressed by T3 or T3 plus steroid
      hormones. The EGF level in the submandibular gland was decreased to about 1/800th
      (males) or 1/90th (females) of its normal level by hypophysectomy. Its level in
      the Hypox animal was greatly increased by all three hormones, given singly or in
      combination. Synergism was also observed between T3 and steroid hormones; DHT
      plus T3 and T3 plus Dex induced EGF 6 times and 9 times, respectively, more than
      the additive values. These values were much greater than those for the induction
      of proteinase-D, -A, and -P by combined injections of T3 and steroids. The
      present results suggest that the genes coding for proteinase-A, -D, and -P are
      located close to each other and that the onset of their expression may be
      controlled by the same regulatory mechanism. By contrast, the gene for proteinase
      F may be mapped to a different locus or regulated differently. The mechanism of
      induction of EGF by T3, DHT, and Dex appears to be similar to but not completely
      the same as that for proteinase-D, -A, and -P.

PMID- 1733707
TI  - A mouse growth hormone-binding protein RIA: concentrations in maternal serum
      during pregnancy.
AB  - A RIA for mouse growth hormone-binding protein (mGHBP) was developed. A 28-amino
      acid synthetic peptide corresponding to the carboxyl-terminal 27 amino acids of
      mGHBP plus an additional cysteine residue at the amino-terminus was coupled to
      keyhole limpet hemocyanin and used as the antigen for antiserum production. The
      ability of the antiserum to recognize mGHBP was demonstrated by incubating mouse
      serum with 125I-iodomouse GH (mGH) in the presence of increasing concentrations
      of antiserum and subsequent immunoprecipitation. The antiserum precipitated mGHBP
      in a dose-dependent manner. The uncoupled synthetic peptide was used as the
      standard and radioligand in the RIA. Serial dilutions of sera from non-pregnant
      or 17-days-pregnant mice yielded displacement curves parallel to the synthetic
      peptide, with serum from 17-days-pregnant mice being 32 times more effective than
      serum from non-pregnant mice for a given dilution. The relative concentration of
      mGHBP in maternal serum on days 5, 11, and 15 of pregnancy was 1, 17, and 39,
      respectively.

PMID- 1733708
TI  - Expression of thyroid hormone receptor beta 2 in rat hypothalamus.
AB  - A polymerase chain reaction based assay was used to evaluate expression of
      thyroid hormone receptor beta 2 mRNA in rat hypothalamus. Expression was detected
      in the arcuate, ventromedial and paraventricular nuclei, as well as the median
      eminence. Trace expression was found in the dorsomedial nucleus, but no
      expression of thyroid hormone receptor beta 2 was detected in the lateral
      hypothalamus or the preoptic region. The results indicate that, contrary to
      previous belief, expression of thyroid hormone receptor beta 2 is not confined to
      the anterior pituitary.

PMID- 1733709
TI  - A failed assay opened a new door in growth hormone research.

PMID- 1733710
TI  - Steroidogenesis-inducing protein promotes deoxyribonucleic acid synthesis in
      Leydig cells from immature rats.
AB  - A protein [steroidogenesis-inducing protein (SIP)] has been isolated from human
      ovarian follicular fluid and shown previously to stimulate steroidogenesis in
      Leydig cells, adrenal cells, and early luteal cells. Since proteins and peptides
      known to regulate steroidogenesis, such as gonadotropins and growth factors, also
      influence the growth of gonadal cells, the present study was designed to assess
      the effects of SIP on the synthesis of DNA by Leydig cells in vitro. Leydig cells
      were isolated from 10- and 20-day-old rats and cultured in serum-free medium for
      48 h. The cells were then treated with the test materials for 18 h. Incorporation
      of [3H]thymidine into DNA was measured during the final 4 h of the culture. SIP
      significantly stimulated DNA synthesis in Leydig cells in a dose- and time
      dependent manner, and the response to SIP was higher than that obtained with
      maximal concentrations of LH/hCG. The stimulatory effects of SIP were
      significantly enhanced when the cell cultures were preincubated in the presence
      of low levels of ovine LH (2 ng/ml). Cultures treated with SIP, followed by
      incubation with [3H]thymidine, contained 22 times as many labeled cells as
      control cultures, as assessed by autoradiography. The cells that were labeled
      were identified morphologically as Leydig cells. Insulin/insulin-like growth
      factor-I and/or transforming growth factor-alpha alone stimulated DNA synthesis
      and enhanced the effects of SIP on DNA synthesis. Dramatic changes in the
      morphology of cultured Leydig cells treated with SIP were observed; cells became
      flattened and developed extended projections which connected adjacent cells.
      LH/hCG, insulin, and transforming growth factor-alpha did not induce effects
      comparable to those of SIP on the morphology of Leydig cells. The effects of SIP
      on the synthesis of DNA and the morphology of Leydig cells were blocked in the
      presence of cycloheximide. It is concluded that SIP not only stimulates steroid
      production in Leydig cells, as shown previously, but also stimulates DNA
      synthesis and induces morphological changes in these cells. The latter properties
      of SIP combined with the magnitude of the responses elicited identify SIP as a
      unique gonadal protein.

PMID- 1733711
TI  - The regulation of p33 gene expression by insulin and calcium ionophores.
AB  - We have previously shown that insulin induces p33 transcription and mRNA levels
      in serum-deprived rat H4 hepatoma cells. In the current study, the effects of the
      calcium ionophores A23187 and ionomycin on the regulation of p33 gene expression
      were examined. When H4 cells were incubated with A23187 or ionomycin (1 microM)
      for 90-300 min, 700-900% and 400-600% increases in p33 mRNA levels were observed.
      The effects of ionophore and insulin together on p33 mRNA levels were not
      additive. Insulin-induced increases in p33 mRNA levels were diminished at low
      concentrations of extracellular calcium, but were unchanged by the calcium
      channel blocker verapamil. The chelation of intracellular calcium using 20 and 60
      microM quin2-AM resulted in 50% and 90% reductions in insulin-induced p33 mRNA
      levels. When transcription assays were performed, A23187 treatment for 15-180 min
      increased p33 transcription 300-400%. The lesser effect of A23187 on
      transcription compared to that on mRNA levels was also true for insulin
      treatment. Similar results were obtained using ionomycin. Insulin- and A23187
      induced p33 transcription was reduced by quin2-AM to below basal levels. These
      studies show that calcium ionophores stimulate p33 gene expression and suggest
      that changes in intracellular calcium can alter insulin's induction of this gene.

PMID- 1733712
TI  - Tissue-specific regulation of fatty acid synthesis by thyroid hormone.
AB  - It is generally agreed that thyroid hormone stimulates the hepatic synthesis of
      long chain fatty acids in the rat. However, there are conflicting data about its
      effects in white adipose tissue, while in brown adipose tissue, lipogenic rates
      are highest in hypothyroid animals. We have systematically examined the effect of
      thyroid state on lipogenesis in different rat tissues. Fatty acid synthesis was
      assessed in vivo, using the incorporation of tritiated water. Hepatic lipogenesis
      was induced 16-fold between hypothyroid (4.1 +/- 0.6 microns H incorporated/g.h)
      and hyperthyroid rats (66.5 +/- 13.2 microns H/g.h). Kidney and heart were much
      less lipogenically active, but also responded positively to thyroid hormone. Both
      hyper- and hypothyroidism diminished fatty acid synthesis in retroperitoneal fat
      and had similar, although not significant, effects in epididymal fat. However,
      epididymal adipocytes, taken from hyperthyroid rats and cultured in vitro, were 3
      times more lipogenically active than cells from either hypo- or euthyroid
      animals. Lipogenesis in sc fat from hyperthyroid rats was enhanced when
      calculated per g tissue, but was not different when expressed per whole tissue.
      In brown adipose tissue, lipogenesis was inversely related to thyroid hormone
      status. Fatty acid synthesis in brain, lung, skin, and bone and muscle did not
      respond to changes in thyroid state. TLC confirmed that greater than 90% of the
      incorporated tritium was in fatty acids. Thus, in hypothyroid animals,
      lipogenesis primarily occurs in skin, bone, muscle, and other nonresponsive
      organs, whereas in hyperthyroid rats, the liver alone constitutes almost half of
      all fatty acid synthesis. The fatty acid synthetic pathway provides an excellent
      model for examining the tissue-specific regulation of gene expression by thyroid
      hormone.

PMID- 1733713
TI  - Effects of hypothyroidism on hypothalamic release of thyrotropin-releasing
      hormone in rats.
AB  - The aim of this study was to investigate whether the severity and duration of
      primary hypothyroidism influence hypothalamic TRH release. Hypothyroidism was
      induced in male Wistar rats by treatment with different thyrostatic drugs or by
      thyroidectomy. Serum TSH in rats treated for up to 3 weeks with methimazole (MMI;
      0.05% in drinking water) increased 20-fold, but TRH release into hypophyseal
      portal blood (HPB) did not change. Treatment with propylthiouracil (PTU; 0.1% in
      drinking water), which inhibits thyroidal T4 production and peripheral conversion
      of T4 to T3, resulted in a more rapid reduction in serum T3 levels and increase
      in serum TSH than those in rats treated with 0.1% MMI. Although these differences
      were no longer observed after 3 weeks of treatment, TRH release into HPB of rats
      treated with PTU was 34-49% higher than that in MMI-treated rats. Combined
      treatment with MMI (0.05-0.1% in drinking water) and iopanoic acid (IOP; 4 mg/100
      g BW.day, ip), an inhibitor of both peripheral and central T4 to T3 conversion,
      also tended to produce a more rapid decrease in serum T3 and increase in serum
      TSH. After 3 weeks of treatment, serum T4, T3, and TSH were not different in the
      two groups, but TRH release into HPB was 48-65% increased by MMI plus IOP vs. MMI
      alone. Three to 10 weeks after thyroidectomy, TRH release into HPB was 58-72%
      higher than that in untreated controls. In vitro incubation of hypothalami
      isolated from rats treated for 3 weeks with MMI, MMI plus IOP, or PTU, as
      described above, showed that basal and 56 mM K(+)-induced TRH release were not
      influenced by the different drugs. Also, the total hypothalamic TRH content was
      not changed by any of these treatments. However, in rats treated for 1 or 2 weeks
      with MMI or PTU, the TRH content of the median eminence was decreased by 17-25%.
      These findings indicate that, depending on severity and duration, experimental
      hypothyroidism may cause a significant increase in hypothalamic TRH release in
      rats. The magnitude of these changes compared with the much larger increases in
      serum TSH suggests that the feedback of thyroid hormone on TSH secretion is
      mainly exerted at the pituitary level.

PMID- 1733714
TI  - Characterization of the insulinotropic potency of polyunsaturated fatty acids.
AB  - In this study we have assessed the individual abilities of the essential fatty
      acids, linoleic and linolenic acids, to release insulin and compared their
      insulinotropic potencies with those of the more established nutrient insulin
      secretagogues, glucose and arginine. In each experiment, a total of six islets
      microdissected from three mice were preperifused at the rate of 1 ml/min with
      Krebs-Ringer bicarbonate buffer, pH 7.4, containing 2% bovine albumin and 5.5 mM
      glucose (basal) with a continuous supply of 95% O2-5% CO2 at 37 C for 1 h. After
      collecting basal samples, the effects of 27.7 mM glucose, 20 mM arginine, 10 mM
      linoleic acid (18:2, omega 6), and 5 mM linolenic acid (18:3, omega 3) were
      tested using a sandwich protocol that entails 20-min alternating periods of
      stimulation with a secretagogue and a washout with basal perifusion. These
      nutrient concentrations were selected from initial experiments performed to
      characterize their dose-response effects on insulin secretion. Effluent samples
      were collected throughout each experiment for measurement of insulin by RIA. In
      one series of experiments, islets were challenged three times with 27.7 mM
      glucose, 10 mM linoleic acid, and 5 mM linolenic acid. In another set of
      experiments, islets were perifused with 20 mM arginine, 27.7 mM glucose, and 10
      mM linoleic acid. All of these nutrients stimulated insulin release in a dose
      dependent manner. In comparing the insulinotropic potencies of these
      secretagogues, we assessed insulin secretion as the integrated areas under the
      curve during 20 min of perifusion with a given nutrient. Thus, the mean
      integrated area under the curve per 20 min above basal in the presence of 27.7 mM
      glucose was 6,516 +/- 1,435 pg, which was not significantly different from the
      value of 4,772 +/- 866 pg obtained during arginine perifusion. However, the area
      under the curve during 20 min above basal obtained in the presence of linoleate
      and linolenic acid (8,712 +/- 1,949 and 10,506 +/- 1,490 pg, respectively) were
      significantly different (P less than 0.05) from those calculated during arginine
      and glucose perifusions. There was no statistically significant difference
      between the effects of these two fatty acids at the concentrations tested. In
      conclusion, our data suggest that linoleic acid and linolenic acid may be, at
      least in this murine islet preparation, as effective in stimulating insulin
      release as glucose and arginine, hitherto used to assess the abilities of
      nutrients to stimulate insulin secretion. However, it remains to be seen whether
      the efficacy of these polyunsaturated fatty acids in insulin release by murine
      islets will be obtained in experiments performed on human islets.

PMID- 1733715
TI  - Luteinizing hormone differentially regulates the secretion of testicular oxytocin
      and testosterone by purified adult rat Leydig cells in vitro.
AB  - The aims of the present study were to determine whether Leydig cells in vitro
      synthesize oxytocin, and whether LH modulates the secretion of oxytocin by Leydig
      cells. Highly purified adult Leydig cells were prepared from adult rats and
      cultured for 3 days in the presence or absence of 0.1 ng/ml ovine LH, and media
      were changed daily. The total amount of oxytocin present in the culture was
      estimated by RIA of cell extracts before culture (day 0) and at the end of day 3
      of culture and in media on days 1-3. The content of immunoreactive oxytocin in
      cell extracts on day 0 (3.4 +/- 1.2 pg/10(6) cells) was significantly lower than
      the total amount that had been released into the medium and was present in the
      cell extracts at the end of day 3 (+LH, 27.8 +/- 3.3; -LH, 16.5 +/- 2.7 pg/10(6)
      cells), suggesting that Leydig cells are able to synthesize and secrete oxytocin.
      This hypothesis was supported by the observation that oxytocin release into the
      medium was significantly reduced during a 3-h treatment of Leydig cells with the
      protein synthesis inhibitor cycloheximide (5 micrograms/ml for 3 h). The role of
      LH in regulating testosterone production by Leydig cells is well defined, but
      whether LH also regulates oxytocin is unknown. Therefore, the effects of LH on
      oxytocin and testosterone production by Leydig cells were compared. The
      production of both hormones was stimulated by increasing doses of LH (0.001-100
      ng/ml), but no further rise in oxytocin release could be elicited with amounts of
      LH greater than 0.1 ng/ml. Testosterone production, however, continued to
      increase with doses of LH up to 100 ng/ml. Furthermore, the two hormones differed
      in the rate of their responses to both 3- and 12-h exposures to LH; testosterone
      secretion increased more rapidly than that of oxytocin. These data provide direct
      evidence that adult Leydig cells produce immunoreactive oxytocin, and that their
      production of this peptide is regulated by LH.

PMID- 1733716
TI  - Prostatic involution in rats induced by a novel 5 alpha-reductase inhibitor, SK&F
      105657: role for testosterone in the androgenic response.
AB  - Within the prostate, androgen stimulates glandular cell secretion and
      proliferation while inhibiting glandular cell death. Due to its predominant
      nuclear localization, higher affinity for the androgen receptor, and more than 10
      fold higher intracellular concentration than testosterone, dihydrotestosterone
      (DHT), not testosterone, appears to be the active intracellular androgen within
      the prostate of intact male hosts. The issue has remained unanswered, however,
      whether testosterone itself, without irreversible conversion to DHT by the 5
      alpha-reductase enzyme, is capable of androgenic effects in the prostate. To
      address this issue, a novel dead end (i.e. product) inhibitor of the 5 alpha
      reductase enzyme, SK&F 105657, was administered to intact or castrated male rats
      treated with either exogeneous testosterone or DHT. When administered twice a day
      orally at 25 mg/kg.dose, SK&F 105657 reduced the prostatic DHT content of either
      intact or castrated rats maintained with exogeneous testosterone to the same low
      level as that produced by surgical castration. Unlike castration, however, such
      SK&F 105657 treatment increased the prostatic testosterone content by more than 5
      fold. The decrease in prostatic DHT coupled with a raise in testosterone are
      specifically due to the in vivo inhibition of the 5 alpha-reductase activity,
      since they were not observed in castrated rats maintained with exogeneous DHT.
      Treatment of intact or castrated male rats with exogeneous testosterone and oral
      SK&F 105657 (25 mg/kg, twice daily) resulted in a substantial inhibition of
      prostatic secretion, an inhibition of prostatic glandular cell proliferation, and
      an increase in prostatic glandular cell death. The magnitude of the changes,
      however, was not as great as that observed after surgical castration. The results
      are, however, specific for 5 alpha-reductase inhibition, since they were not
      observed in castrated rats given exogeneous DHT. These results demonstrate that
      if the prostatic testosterone content is elevated to sufficient levels,
      androgenic effects are induced without a requirement for an elevation in
      prostatic DHT content. Thus, the conversion of testosterone to DHT appears to
      function as a means of amplifying androgenic stimulation in the prostate.

PMID- 1733717
TI  - Dose-dependent effects of human prolactin on the immature hypophysectomized rat
      testis.
AB  - We have studied dose-dependent effects of highly purified human PRL (39 IU/mg) on
      the testis of immature (22-day-old) hypophysectomized rats daily supplemented for
      7 days with 2, 10, or 30 micrograms hormone. Dose-dependent stimulation was
      observed for all parameters: testis weight (1.6- and 2-fold above control for 10
      and 30 micrograms PRL), basal and hCG-stimulated testosterone (14- and 21-fold),
      intratesticular testosterone (7- and 21-fold) and estradiol (1.2- and 1.5-fold),
      LH receptor concentration (1.8- and 2.5-fold), in vitro pregnenolone production
      by cholesterol side-chain cleavage enzyme (3-, 5- and 7-fold), and aromatase
      activity (2.1- and 2.4-fold). The number of Leydig cells exhibiting
      immunoreactivity toward anti-P450scc, anti-P450(17 alpha), and anti-3 beta
      hydroxysteroid dehydrogenase antibodies also underwent a dose-dependent increase
      (under conditions revealing many immunopositive cells in hypox control animals).
      The respective increases were 8- to 14-fold for anti-P450scc and P450(17 alpha)
      and 1.5- to 2-fold for anti-3 beta-hydroxysteroid dehydrogenase. The number of
      germ cells and the percentage of tubular sections containing late pachytene
      spermatocytes as most advanced stages of spermatogenesis were subject to similar
      dose-dependent effects. These results suggest that during puberty PRL stimulates
      testicular function by promoting multiplication and differentiation of Leydig
      cells (acting at various steps of steroidogenesis and on tissue responsiveness to
      LH) and germ cells.

PMID- 1733718
TI  - Melatonin inhibits gonadotropin-releasing hormone-induced elevation of
      intracellular Ca2+ in neonatal rat pituitary cells.
AB  - GnRH stimulates LH release by increasing intracellular Ca2+ ([Ca2+]i). Melatonin
      is known to inhibit GnRH-stimulated LH release from neonatal rat pituitary cells.
      In the present report, the issue of whether melatonin acts through [Ca2+]i was
      addressed. [Ca2+]i was studied in cells in suspension, using Fluo-3 as a
      fluorescent indicator. In neonatal rat pituitary cells, melatonin inhibited the
      GnRH-induced [Ca2+]i increase in a dose-dependent manner; the GnRH-induced
      increase in [Ca2+]i was inhibited 40% by 100 nM melatonin. The relative potencies
      of several indoles as inhibitors of the GnRH stimulation of [Ca2+]i in neonatal
      pituitary cells (2-iodo-melatonin greater than melatonin greater than 6
      hydroxymelatonin) correlate with their known potencies to inhibit LH release and
      with their binding affinity to high affinity melatonin receptors, which indicates
      that these receptors probably mediate the effects of melatonin. Further support
      for this interpretation comes from the observation that melatonin does not
      inhibit the GnRH effect on [Ca2+]i in cells obtained from adolescent rat
      pituitary glands, which lack melatonin receptors and are insensitive to melatonin
      as an inhibitor of GnRH-stimulated LH release. The possible involvement of an
      inhibitory G-protein was also investigated by studying the effects of pertussis
      toxin. Pretreatment with pertussis toxin antagonized the effects of melatonin on
      [Ca2+]i and LH release. This indicates that melatonin may inhibit the GnRH
      induced increase in [Ca2+]i through a mechanism involving a pertussis toxin
      sensitive G-protein. To examine the role of extracellular Ca2+ in this effect,
      the effects of melatonin were examined in a low Ca2+ medium. Under these
      conditions, the effect of melatonin was markedly reduced, which indicates that
      melatonin may act by inhibiting Ca2+ influx. These observations indicate that
      melatonin inhibits GnRH stimulation of [Ca2+]i in neonatal rat gonadotrophs, and
      this probably explains the inhibitory action of melatonin on GnRH stimulation of
      LH release.

PMID- 1733719
TI  - The hormonal regulation of platelet-activating factor-acetylhydrolase in the rat.
AB  - Platelet-activating factor-acetylhydrolase (PAF-AH), the enzyme that inactivates
      PAF, is decreased in the plasma of both rabbits and humans during the latter
      stages of pregnancy. The activity of the enzyme was decreased in rats by the
      administration of 1,3,5(10)-estratrien-17 alpha-ethynyl-3,17 beta-diol (17 alpha
      ethynylestradiol) and increased by dexamethasone treatment. In the present study,
      we have further defined the hormonal regulation of PAF-AH levels in plasma of
      adult and juvenile rats. Estrone (E1), 17 beta-estradiol (E2), estriol (E3), and
      various progestins [4-pregnen-6 alpha-methyl-17 alpha-ol-3,20-dione
      (medroxyprogesterone), 4-estren-17 alpha-ethynyl-17 beta-ol-3-one
      (norethindrone), and 5(10)-estren-17 alpha-ethynyl-17 beta-ol-3-one
      (norethynodrel)] were administered to adult rats, and the plasma PAF-AH
      activities were assayed. E1, E2, and E3 administration to adult female rats
      lowered the plasma PAF-AH activity, E3 being the most effective. After
      administration of these estrogens the activity returned to the preinjection level
      within 4 days. The administration of medroxyprogesterone resulted in a 2-fold
      increase in plasma PAF-AH activity in adult female rats, and the activity
      remained elevated for up to 30 days. When adult male rats were treated with
      similar doses only a 20% increase was observed and the PAF-AH activity returned
      to control values by day 10. In contrast, norethindrone and norethynodrel
      administration resulted in a reduction of the enzyme activity in adult female
      rats. The plasma PAF-AH activity in juvenile male and female rats (3 weeks of
      age, 45-60 g body wt) was two times higher than that in adult rats of both sexes
      and spontaneously decreased up to the time of puberty. When juvenile male or
      female rats were injected with either 17 alpha-ethynylestradiol or
      medroxyprogesterone, a minimal change in PAF-AH activity was observed. In
      contrast, when dexamethasone was administered to juvenile male and female rats
      the plasma PAF-AH activity increased in a manner similar to adult animals. It is
      suggested that estrogens cause a decrease and medroxyprogesterone an increase in
      plasma PAF-AH activity. It is suggested that the different responsiveness to
      medroxyprogesterone between adult female and male rats and juvenile animals may
      depend on the concentration of the hormone receptor in the tissue responsible for
      the synthesis of PAF-AH. The decrease in PAF-AH activity after the administration
      of norethindrone and norethynodrel may be due to the known estrogenic activity of
      these steroids.

PMID- 1733720
TI  - pH homeostasis in pituitary GH4C1 cells: basal intracellular pH is regulated by
      cytosolic free Ca2+ concentration.
AB  - In GH4C1 cells, membrane depolarization induces a rapid and sustained increase in
      the cytosolic free calcium concentration ([Ca2+]i). In the present study we have
      investigated the role of [Ca2+]i in the regulation of basal intracellular pH
      (pHi). Depolarizing GH4C1 cells in buffer containing 0.4 mM extracellular Ca2+
      decreased basal pHi from 7.02 +/- 0.04 to 6.85 +/- 0.03 (P less than 0.05). If
      the depolarization-induced influx of Ca2+ was inhibited by chelating
      extracellular Ca2+ or blocking influx through voltage-operated Ca2+ channels with
      nimodipine, no acidification was observed. Addition of TRH induced a rapid
      activation of Na+/H+ exchange in acidified cells, increasing pHi by 0.14 +/- 0.03
      U. The action of TRH was blunted if extracellular Ca2+ was chelated; however, if
      influx of Ca2+ via voltage-operated channels was blocked by nimodipine, TRH still
      increased pHi. To deplete ATP, we incubated cells with 2-deoxy-D-glucose for 15
      20 min and observed a decrease in basal pHi to 6.75 +/- 0.03 (P less than 0.05).
      No additional acidification was obtained when 2-deoxy-D-glucose-treated cells
      were depolarized, and no TRH-induced activation of Na+/H+ exchange was observed.
      Addition of ionomycin or 12-O-tetradecanoyl-phorbol-13-acetate separately to
      acidified cells had only modest effects on pHi; however, addition of 12-O
      tetradecanoyl-phorbol-13-acetate and ionomycin together increased pHi markedly.
      We conclude that in GH4C1 cells, increasing [Ca2+]i reduces basal pHi through a
      mechanism dependent on influx of extracellular Ca2+ and independent of Na+/H+
      exchange. In addition, elevation of [Ca2+]i and activation of protein kinase C
      act synergistically to enhance Na+/H+ exchange and increase pHi in acidified
      cells. Finally, normal cellular ATP is necessary for the activation of Na+/H+
      exchange.

PMID- 1733721
TI  - Treatment of insulin-resistant mice with the oral antidiabetic agent
      pioglitazone: evaluation of liver GLUT2 and phosphoenolpyruvate carboxykinase
      expression.
AB  - Obese KKAy insulin-resistant mice represent a model for the human syndrome of
      noninsulin-dependent diabetes mellitus. As such, the animals are hyperglycemic
      and hyperinsulinenic. Treatment of KKAy mice with pioglitazone, a new
      antihyperglycemic agent, lowered elevated blood glucose and insulin levels to
      near normal. Since hepatic glucose overproduction is a key abnormality in
      noninsulin-dependent diabetes mellitus, the aim of the present study was to
      define the specific effects of pioglitazone on hepatic glucose metabolism and
      release. To do so, we evaluated the expression of the major liver glucose
      transporter, GLUT2, and examined the activity and expression of the major rate
      limiting enzyme for gluconeogenesis, phosphoenolpyruvate carboxykinase. Our
      results showed that GLUT2 mRNA abundance was unchanged in diabetic KKAy mice
      compared to nondiabetic animals, and that no changes were elicited by
      pioglitazone treatment. Such unaltered GLUT2 levels were consistent with a role
      for liver GLUT2 in bidirectional transport of glucose during physiological states
      of uptake or release. In contrast, phosphoenolpyruvate carboxykinase activity and
      mRNA abundance were concordantly elevated 2-fold in diabetic animals and were
      returned to normal levels after treatment with pioglitazone. Given that
      pioglitazone therapy led to decreased hepatic gluconeogenesis while insulin
      levels were concomitantly lowered, it appeared that pioglitazone acted to restore
      sensitivity to insulin's normal inhibitory actions.

PMID- 1733722
TI  - Concentrations of parathyroid hormone-related protein in rat milk change with
      duration of lactation and interval from previous suckling, but not with milk
      calcium.
AB  - PTH-related protein (PTHrP) is found in high concentrations in the milk of
      various mammals. However, little is known about the regulation of PTHrP
      production or the physiological role(s) of PTHrP in the mammary glands. To
      address these questions, we examined in lactating rats 1) the longitudinal
      changes in PTHrP concentrations in milk and PTHrP mRNA levels in the mammary
      glands throughout lactation, 2) the effects of the nonsuckling interval on milk
      PTHrP concentration, and 3) the correlation between PTHrP and calcium
      concentrations in milk. PTHrP concentrations in milk, measured by RIA and in
      vitro bioassay, increased with the duration of lactation. The maximal
      concentrations of PTHrP (observed between days 19-21 of lactation in rats milked
      serially) were 4.8- to 8.0-fold higher than the concentrations on day 7. PTHrP
      mRNA levels in the mammary glands also increased during the late stages of
      lactation. The longitudinal changes in calcium concentrations in milk were small
      and did not parallel the changes in PTHrP. When pups were removed from the mother
      for 4-24 h, milk PTHrP decreased while calcium increased in a time-dependent
      manner. As a whole, calcium concentrations in milk did not correlate with PTHrP
      throughout lactation. These data suggest that the production and secretion of
      PTHrP into milk are regulated independently of the other major milk proteins by a
      factor(s) that changes with progression of lactation and in relation to suckling
      status.

PMID- 1733723
TI  - Altered glucose regulation of insulin biosynthesis in insulinoma cells: mouse
      beta TC3 cells secrete insulin-related peptides predominantly via a constitutive
      pathway.
AB  - The effects of glucose on insulin gene expression and proinsulin biosynthesis,
      processing, and secretion were studied in mouse beta TC3 cells, an established
      insulinoma cell line derived from transgenic mice carrying a hybrid insulin
      promotor-simian virus-40 tumor antigen. The level of insulin mRNA was maintained
      at high levels by culture in 11 mM glucose, but essentially disappeared after 48
      h of culture without glucose. The rate of insulin biosynthesis in beta TC3 cells
      was also dependent on glucose concentration over periods of 24 or 48 h (but not
      during 3 h) of stimulation. Insulin biosynthesis decreased about 50% after 24 h
      and about 85% after 48 h of incubation without glucose. When beta TC3 cells were
      incubated without glucose for 48 h, the rate of conversion of proinsulin to
      insulin was decreased compared to that at 11 mM glucose. Insulin secretion was
      sustained by medium glucose and also exhibited a much lower threshold for maximal
      stimulation; 2-deoxyglucose uptake decreased about 50% after 48 h of incubation
      without glucose. Studies on the secretion of newly synthesized proinsulin/insulin
      revealed that up to 80% of the total cellular pool of labeled proinsulin was
      released during a 60-min chase compared to only 10% of labeled insulin. The
      release of immunoreactive insulin (IRI) during the chase period was stimulated by
      forskolin and phorbol-12-myristate-13-acetate 1.6- and 10-fold, respectively.
      However, the release of newly synthesized proinsulin was insensitive to these
      secretagogues. It is concluded that 1) as in normal islets, glucose influences
      the steady state levels of proinsulin mRNA in beta TC3 cells; 2) the rate of
      proinsulin biosynthesis reflects only the level of insulin mRNA; translational
      control is absent; 3) cellular conversion of proinsulin to insulin is up
      regulated by glucose as in normal rat islets; 4) newly synthesized proinsulin is
      released predominantly via a constitutive, rather than a regulated pathway, in
      contrast to normal beta-cells.

PMID- 1733724
TI  - Thyroid hormones and 5'-deiodinase activity in neonatal undernourished rats.
AB  - Undernutrition was induced in rats submitted to food restriction from the fetal
      stage, and malnutrition was continued after birth until 70 days of life. Body
      weight was decreased to less than 50%. Plasma T4 and T3 and pituitary TSH content
      were determined between 8-70 days of life. In control rats, plasma T4 and T3
      reached a maximum at 14 and 35 days of life, respectively, and TSH pituitary
      content at 45 days of life. In undernourished rats, after 8 days of life, plasma
      T4 and T3 and pituitary TSH content were decreased to about 50% or less, and the
      pattern of sequential changes observed in control rats was absent or modified. T4
      and T3 concentrations were measured in heart, liver, and brain in the fetus (22
      days old) and 8, 14, and 23 days after birth, as well as liver and brain 5'
      deiodinases (5'D). Hepatic 5'D type I was always decreased in undernourished rats
      from 8-70 days after birth. Liver and heart T4 and T3 concentrations were
      decreased in 14-day-old undernourished rats as well as brain T3. Brain 5'D type
      II was decreased at 8 and 14 days, and total brain 5'D activities at 8 days.
      These changes occurred during the critical period for brain development (7th to
      20th day) during which most processes of myelination take place and T3 brain
      normal levels are required.

PMID- 1733725
TI  - Purification and characterization of high molecular weight forms of inhibin from
      bovine follicular fluid.
AB  - High molecular mass forms [95 kilodaltons (kDa)] of bovine inhibin-A as well as
      the known forms of intermediate (55 kDa) and low (32 kDa) mass were purified from
      bovine follicular fluid by ion exchange chromatography on DEAE-Sepharose,
      immunoaffinity chromatography using a monoclonal antibody directed against bovine
      32-kDa inhibin-A, gel permeation HPLC on TSK-gel, and reverse phase HPLC. The 95
      kDa inhibin-A had similar suppressive activity on FSH secretion from cultured rat
      anterior pituitary cells as the 55- and 32-kDa inhibins. There is, however, a
      possibility that the inhibin activity detected with larger forms may be due to
      that of the 32-kDa form that results from proteolytic processing during
      incubation with rat pituitary cells. Both sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis (SDS-PAGE) and immunoblotting analysis using monoclonal
      antibodies specific for 32-kDa inhibin alpha- or beta A-subunits revealed that
      the 95-kDa inhibin preparation contained two forms of inhibin (105 and 95 kDa),
      which were composed of either a 50- or a 40-kDa alpha-subunit linked by a
      disulfide bond(s) to a 55-kDa beta A-subunit. Amino-terminal sequence analysis
      showed that the 50-kDa alpha-subunit and the 55-kDa beta A-subunit were generated
      by removal of a signal peptide from each corresponding primary translation
      product [the first NH2-terminal 17 residues of the inhibin alpha-subunit
      (residues 1-360) and the first 20 residues of the inhibin beta A-subunit
      (residues 1-425)] and suggested that the 40-kDa alpha-subunit was formed by
      proteolytic processing of the 50-kDa alpha-subunit. On the basis of our findings,
      we propose that in bovine follicular fluid, the larger 105-kDa form of inhibin is
      processed successively to form the lowest molecular mass form, 32 kDa inhibin,
      through the smaller 95- and 55-kDa forms.

PMID- 1733726
TI  - Glucocorticoid regulation of plasminogen activator inhibitor-1 messenger
      ribonucleic acid and protein in normal and malignant rat osteoblasts.
AB  - Glucocorticoids exert potent inhibitory effects on bone formation. We have
      previously shown that glucocorticoids suppress plasminogen activator (PA)
      activity in normal and malignant rat osteoblasts. To clarify the mechanism of
      this suppression, we investigated the effects of dexamethasone on PA inhibitor-1
      (PAI-1), tissue-type PA (tPA), and urokinase-type PA (uPA) expression and also on
      PAI-1 protein and PA activity in both normal rat calvarial osteoblasts and a
      clonal osteogenic sarcoma cell line, UMR 106-01. Dexamethasone increased PAI-1
      mRNA and protein in both cell types. The increase in PAI-1 protein and the
      decrease in PA activity were obtained over the same concentration range, with a
      half-maximally effective concentration of dexamethasone of about 10(-9) M. The
      increase in PAI-1 mRNA caused by dexamethasone was retained with cycloheximide
      treatment, but abolished with actinomycin-D. Dexamethasone had no effect on tPA
      or uPA mRNA in either cell type. The glucocorticoid antagonist RU 486 prevented
      the effects of dexamethasone on PA activity and PAI-1 protein.
      Dihydrotestosterone, progesterone, and 17 beta-estradiol did not influence PA
      activity or PAI-1 formation. Although tPA and uPA protein could not be measured,
      these results suggest that glucocorticoids suppress PA activity predominantly by
      increasing PAI-1 synthesis in rat osteoblasts. Suppression of PA activity through
      actions on PAI-1 formation by glucocorticoids could contribute to the mechanisms
      by which glucocorticoids inhibit bone formation.

PMID- 1733727
TI  - Differential contributions of ovarian and extraovarian factors to age-related
      reductions in plasma estradiol and progesterone during the estrous cycle of
      C57BL/6J mice.
AB  - The relative contributions of ovarian and extra-ovarian factors to the altered
      ovarian steroidal profiles of middle-aged mice were assessed by reciprocal,
      heterochronic ovarian grafting. Ovaries from cycling, young (2 months), and
      middle-aged (12 months) mice were exchanged by grafting under the renal capsules.
      Blood samples were obtained daily at midday throughout the estrous cycle for
      measurement of estradiol (E2) and 3-4 h after lights-out on proestrus to measure
      the preovulatory elevation of progesterone (P4). Middle-aged intact mice had
      lower mean concentrations of E2 during the cycle, no detectable midday
      preovulatory elevation of E2, and an attenuated preovulatory increase of P4
      compared to young mice. Ovarian grafts from young donors failed to increase mean
      E2 levels of middle-aged mice, but did restore the preovulatory elevation of E2
      and preovulatory P4 to levels of young controls. Reciprocal grafting confirmed
      these findings: ovaries from middle-aged donors in young hosts produced mean E2
      levels equivalent to those of young mice but were unable to support a
      preovulatory increase of E2 or a preovulatory P4 level equivalent to that of
      young controls. These results reveal differential contributions of ovarian and
      extra-ovarian factors to age changes in E2 and P4. They indicate that ovarian
      aging plays an important role in attenuating the preovulatory increase of E2 and
      P4, but extra-ovarian, presumably neuroendocrine, age changes underlie the mean
      reduction of E2 levels across the estrous cycle.

PMID- 1733728
TI  - Prolactin variants in ram adenohypophyses vary with season.
AB  - Secretion of PRL in sheep is affected by photoperiod being highest during the
      spring and summer, lowest in fall and winter. The objectives of this study were
      to determine if 1) the production of variant forms of PRL, and 2) immuno- and
      bioactivities of PRL (iPRL and bPRL) differ during times of the year selected to
      represent periods of low, transitional and high PRL secretion. Twelve mature rams
      were maintained on pasture and killed in October, December, and April (n =
      4/month). Individual pituitary glands were dispersed, cells obtained, and fixed
      for immunocytochemical flow cytometry, extracted with 0.01 N NaHCO3 or cultured
      in serum-free, defined media. The Mr of PRL extracted from cells immediately
      following dispersion ranged from 14-140K, with significantly more bands greater
      than 40K being detected from rams sacrificed in December than from those killed
      in October and April (P less than 0.01). No bands of PRL greater than 25K were
      observed when samples were reduced with beta-mercaptoethanol prior to
      electrophoresis, indicating that the high Mr forms were disulfide-linked
      aggregates. Culture media from October and April contained variants of PRL that
      ranged from 22-40K but those greater than 25K were generally not observed from
      cells harvested during December. Extracts of cells after 24 h in culture
      contained fewer high Mr species during December than had been present in initial
      extracts from that month. In contrast, during April more high Mr intracellular
      forms were present after culture than had been detected prior to culture during
      that month. The percentage of lactotrophs averaged 50.0 +/- 2.5, 47.4 +/- 5.7,
      and 59.4 +/- 5.5 for October, December, and April, respectively. Initial
      lactotroph content (pg/lactotroph) of iPRL was higher (P = 0.06) in April (46.0
      +/- 17.0) when compared to October and December (8.0 +/- 2.0 and 20.0 +/- 10.0,
      respectively). In contrast, the bPRL content of initial extracts was higher (P =
      0.05) in December (267.0 +/- 68.0) than in October (101.0 +/- 35.0), but not than
      in April (190.0 +/- 70.0). Although iPRL and bPRL concentrations in culture media
      were similar for the 3 months, the intracellular iPRL (P less than 0.001) and
      bPRL (P less than 0.0001) content after culture was greatest during April. In
      summary, in addition to the well-documented seasonal changes in blood
      concentrations of PRL, different molecular forms of PRL were found within the
      pituitary at different times of the year and seasonal variations in iPRL and bPRL
      did not occur in parallel.

PMID- 1733729
TI  - Dehydration attenuates plasma prolactin response to suckling through a
      dopaminergic mechanism.
AB  - The tuberoinfundibular dopaminergic neurons projecting to the median eminence are
      well accepted as a major physiological regulator of adenohypophyseal PRL
      secretion. However, recent evidence has shown that dopamine (DA) in the
      neurointermediate lobe also has an inhibitory effect on PRL secretion by anterior
      pituitary. Since the neurointermediate is innervated by the tuberohypophyseal
      dopaminergic (THDA) neurons, which is known to be selectively activated by
      dehydration of the animal, the aim of this study was to investigate the
      physiological role of the THDA system in PRL release during lactation. On the day
      of the experiments, the litters were separated from the mothers for 4 h before
      initiation of the suckling stimulus. The suckling-induced PRL surge was detected
      on three consecutive days. On the first day the normal response was tested; then
      immediately after taking the last blood samples, drinking solutions were changed
      to the high salt (2.5% saline) containing bottles or were taken away. Suckling
      induced PRL response was significantly decreased after 24 h and almost completely
      blocked 48 h later in dehydrated mothers. This effect could be prevented by
      haloperidol (a DA receptor antagonist) pretreatment (0.1 mg/kg BW sc), and it was
      only transient because rehydration of the mothers reestablished basal as well as
      suckling-induced PRL response. In addition, the effect of an acute osmotic
      stimulus on the plasma PRL levels (injecting 0.5 ml 10% saline solution iv) was
      also tested. There was a marked and immediate decrease in PRL concentration
      within 15 min of injection. Domperidone, another DA receptor blocker (20
      micrograms/rat iv) completely abolished the depletion of plasma PRL in response
      to 10% saline injection. These results support our assumption that the
      dopaminergic regulation of PRL secretion during lactation involves the THDA
      system. Furthermore, these data underline the importance of an interaction
      between regulation of PRL secretion and water and sodium homeostasis.

PMID- 1733730
TI  - Nerve growth factor enhances [3H]nicotine binding to a nicotinic cholinergic
      receptor on PC 12 cells.
AB  - Although nicotinic cholinergic agonists have functional effects on PC 12 cells,
      radioligand-binding sites have not been detected. We, therefore, studied PC 12
      cells incubated in the presence of nerve growth factor (NGF) and determined that
      specific [3H]nicotine-binding sites were induced approximately 2.5-fold in the
      presence of NGF (50 or 100 ng/ml). Specific binding was maximal between the first
      (100 ng/ml NGF) and seventh (50 ng/ml NGF) days of treatment and was stable for 2
      weeks with addition of NGF every 3 days. Using intact cells, average association
      and dissociation rates for [3H]nicotine were 0.00021 min-1 nM-1 (n = 2) and 0.048
      min-1 (n = 2), respectively, at 4 C, yielding an average apparent Kd of 229 nM.
      At 22 C, stable equilibrium was not attained during association studies. A
      similar Kd value for broken cell preparations was obtained by kinetic analysis
      (i.e. an average association rate of 0.00042 min-1 nM-1 and dissociation rate of
      0.087 min-1), yielding an average Kd value of 207 nM (n = 2) at 4 C. By
      saturation binding analysis of intact cells, an average Kd of 292 nM (n = 2) and
      a binding capacity (Bmax) of 15,118 molecules/cell were obtained. [3H]Nicotine
      binding was inhibited on an equimolar basis by L-(-)nicotine and N
      methylcarbamylcholine. D-(+) Nicotine was 7-fold less potent, whereas alpha
      bungarotoxin, mecamylamine, and atropine showed no significant inhibition.
      [3H]Nicotine binding was also inhibited quantitatively by mono-specific
      polyclonal antibodies raised against the predicted alpha 3-subunit sequence
      (amino acids 130-139) of the rat neuronal nicotinic cholinergic receptor. This
      study represents the first biochemical characterization of NGF-stimulated
      nicotine-binding sites on PC 12 cells and confirms previous evidence of the
      presence of functional nicotinic cholinergic receptors on these cells.

PMID- 1733731
TI  - Tumor necrosis factor-alpha alters bovine luteal cell synthetic capacity and
      viability.
AB  - Tumor necrosis factor-alpha (TNF-alpha) is a macrophage-derived cytokine that is
      also reportedly produced by granulosal cells and is localized in luteal cells.
      The present study employed serum-free culture of midcycle bovine luteal cells to
      investigate the effects of TNF-alpha, alone and with other cytokines, on luteal
      function. TNF-alpha (1-1000 ng/ml) produced a dose-dependent increase in
      prostaglandin (PG)F2 alpha and 6-keto-PGF1 alpha synthesis on all days of
      culture, but had no effect on basal progesterone (P4) production. TNF-alpha, in
      combination with other known stimulators of luteal PG synthesis, interleukin-1
      beta (2.5 ng/ml) or interferon-gamma (IFN-gamma, 100 U/ml), had synergistic
      effects on PGF2 alpha production (greater than 50-fold above control, P less than
      0.05) whereas interferon-alpha (1000 U/ml) significantly suppressed TNF-alpha
      stimulated PGF2 alpha production. By day 7 of culture, TNF-alpha inhibited LH
      stimulated P4 production (P less than 0.05). Luteal cell numbers were
      significantly reduced by IFN-gamma but not by TNF-alpha alone. However, the
      combination of TNF-alpha + IFN-gamma was extremely cytotoxic (only 20% of cells
      maintained as compared to control). Finally, TNF-alpha (100 ng/ml) enhanced the
      expression of Class I major histocompatibility complex antigens on cultured
      bovine luteal cells but did not alter IFN-gamma induction of Class II major
      histocompatibility complex antigens. In light of these findings, it appears that
      TNF-alpha, in conjunction with other cytokines, is a modulator of luteal cell
      function in vitro. The stimulation of PG synthesis, as well as cytotoxic effects
      of TNF-alpha, may suggest a role in luteolysis.

PMID- 1733732
TI  - The expression of 15-lipoxygenase gene and the presence of functional enzyme in
      cytoplasm and nuclei of pregnancy human myometria.
AB  - The expression of the 15-lipoxygenase (15-LO) gene in pregnancy human myometria,
      from messenger RNA (mRNA) to the product of the enzyme reaction, was
      investigated. In situ hybridization with antisense riboprobe synthesized from
      human reticulocyte 15-LO complementary DNA has revealed the presence of mRNA in
      myometrial smooth muscle as well as in myometrial blood vessels. Immunoblot
      analysis with a polyclonal antibody to recombinant human 15-LO enzyme showed a
      single 110-kilodalton immunoreactive protein in myometria. Light microscope
      immunocytochemistry using polyclonal antibodies has demonstrated the presence of
      immunoreactive 15-LO protein and 15-hydroxyeicosatetraenoic acid (15-HETE), the
      primary product of the 15-LO pathway. While myometrial blood vessels did not show
      any obvious change, myometrial smooth muscle showed lower 15-LO mRNA, 15-LO
      immunoreactive protein, and 15-HETE at term pregnancy and during labor.
      Immunogold electron microscopy showed the presence of immunoreactive 15-LO in
      rough endoplasmic reticulum and 15-HETE in myofilaments. Quite unexpectedly, both
      are also present in nuclear chromatin. In summary, the present study demonstrates
      for the first time the expression of 15-LO gene in pregnancy human myometria and
      the mRNA and catalytically active enzyme are lower at term pregnancy and during
      labor. Quite unexpectedly, catalytically active 15-LO is also present in nuclear
      chromatin. These findings suggest that 15-LO/15-HETE may have genomic as well as
      nongenomic actions, both of which may either initiate and/or facilitate the
      progression of labor in women.

PMID- 1733733
TI  - Immunocytochemical localization of progestin receptors in monkey hypothalamus:
      effect of estrogen and progestin.
AB  - The increase in PRL secretion which follows progesterone (P) administration to
      estradiol (E)-primed women and monkeys cannot be due to an action of P at the
      pituitary level because lactotropes do not contain progestin receptors (PR). To
      further the hypothesis that P increases PRL secretion by an action in the
      hypothalamus, PR-expressing neurons were studied in free-ranging and steroid
      manipulated monkeys using immunocytochemistry with a monoclonal antibody to human
      PR. Specific PR immunoreactivity is localized in the nucleus of individual
      hypothalamic neurons. Male and female adult and juvenile macaque hypothalami
      contain significant populations of PR-positive neurons throughout the anterior
      and medial basal hypothalamus. Ovariectomy decreases, but does not abolish, the
      number of neurons expressing PR. PR expression was not altered in the supraoptic
      nucleus (SON) by ovariectomy. Estrogen treatment for 28 days caused a significant
      increase in the number of PR-positive neurons in the medial preoptic area, the
      ventro-medial nucleus, the arcuate nucleus, and the median eminence, but not in
      the SON. P treatment added to the E treatment from day 14 to day 28 did not alter
      the number of PR-positive neurons in any area. These data suggest that PR may be
      constitutively expressed in the magnocellular neurons of the SON and in certain
      other cells throughout the hypothalamus. E induces PR in a large proportion of
      neurons in the medial basal hypothalamus and this action is not blocked by
      subsequent P treatment. The inability of P to down-regulate PR in the
      hypothalamus differs from the reproductive tract and pituitary. Indeed, this
      observation is consistent with the fact that PRL secretion remains elevated
      during chronic P administration.

PMID- 1733734
TI  - The stimulatory and inhibitory effects of dopamine on prolactin secretion involve
      different G-proteins.
AB  - The reverse hemolytic plaque assay (RHPA) was used in this study to further
      characterize the mechanism whereby low concentrations of dopamine (DA) stimulate
      PRL secretion in vitro. Female Sprague-Dawley rats were used as a source of
      anterior pituitary cells for the RHPA. Pituitary cells were infused into
      Cunningham chambers along with a suspension of protein-A-coated ovine red blood
      cells. Excess cells were rinsed from the chambers leaving a monolayer of cells
      attached to the glass. The cells were then incubated with solutions containing
      PRL antiserum (1:40) and various concentrations of DA. After 4 h, a solution
      containing guinea pig complement (1:60) was infused into the chambers. Thirty
      minutes later, the cells were fixed and plaques (zones of hemolysis) surrounding
      PRL-producing cells (lactotrophs) were measured and used as an index of the
      amount of PRL secreted. Control cells that received no DA had a mean plaque area
      of 8,000 microns 2 and two distinct subpopulations of plaque sizes. This biphasic
      population of cells consisted of a small and a large plaque producing population.
      The mean plaque area surrounding lactotrophs was significantly (P less than 0.05)
      decreased if 1 microM or 10 microM DA was present (4,500 microns 2 and 3,500
      microns 2, respectively). These cells which received inhibitory concentrations of
      DA demonstrated a monophasic distribution of plaque-forming cells. On the other
      hand, mean plaque area was significantly (P less than 0.05) increased if 0.1 nM
      or 1 nM DA was presented to the cells (15,000 microns 2 and 14,500 microns 2,
      respectively). These cells receiving stimulatory doses of DA exhibited a
      multiphasic distribution of plaque-forming cells. The possibility that the two
      physiological opposing actions of DA on PRL secretion might be mediated by
      different GTP binding proteins was also examined using cholera toxin (CTX) and
      pertussis toxin (PTX). Anterior pituitary cells were pretreated with either CTX
      (50 micrograms/ml) or PTX (5 micrograms/ml) for 1 h before initiation of the
      RHPA. In the RHPA, cells received no DA, a stimulatory dose of DA (0.1 nM), or a
      inhibitory dose of DA (10 microM). The effects of toxin pretreatment on mean
      plaque area of DA-treated cells was determined. PTX pretreatment significantly
      attenuated the inhibitory effects of DA while having no effect on the stimulatory
      effects of DA on PRL secretion. CTX significantly (P less than 0.05) potentiated
      the stimulatory effects of DA on PRL secretion and had no effect on
      inhibition.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1733735
TI  - Role of transthyretin in the transport of thyroxine from the blood to the choroid
      plexus, the cerebrospinal fluid, and the brain.
AB  - T4 is bound to transthyretin (TTR; 75%) and albumin (Alb; 25%) in rat serum and
      only to TTR in cerebrospinal fluid (CSF). In addition to the liver, TTR is
      synthesized in large amounts in the choroid plexus and then secreted into the
      CSF, suggesting that serum T4 could be transported to the CSF and brain via the
      choroid plexus. We determined whether serum T4 bound to TTR is transported into
      the choroid plexus and CSF. N-Bromoacetyl-L-[125I]T4, a derivative of T4 that
      binds covalently to TTR, was used as the affinity label for the T4-binding site
      on TTR. Rats were injected with [125I]T4, acetyl-[125I]T4 covalently bound to
      human TTR ([125I]T4Ac.human hTTR), or acetyl-[125I]T4 covalently bound to human
      Alb ([125I]T4Ac.hAlb). The quantities of [125I]T4Ac.hTTR and [125I]T4Ac.hAlb
      present in the choroid plexus, CSF, and brain 90 min later were barely
      detectable. In contrast, [125I]T4 injected as the unbound form accumulated in the
      choroid plexus and CSF to levels 6-11 times higher than with [125I]T4Ac.hTTR (P
      less than 0.005). We then used a synthetic flavonoid (EMD) that competitively
      inhibits binding of T4 to serum TTR and transiently increases serum free T4 to
      determine the role of choroid plexus TTR and CSF TTR in the transport of T4 from
      serum to brain. Rats were given 110 microCi [125I]T4 15 min after the injection
      of vehicle, a low (0.3 mumol/100 g BW) or high dose of EMD (2.0 mumol/100 g BW).
      Rats were killed 60 min later. In serum, the percentage of [125I]T4 bound to TTR
      decreased and free T4 increased similarly in the low and high dose EMD-treated
      rats. In contrast, the percentage of [125I]T4 bound to TTR in choroid plexus and,
      subsequently, CSF was significantly decreased in rats given the high dose of EMD,
      but was not affected by the low dose of EMD, suggesting that in high doses, EMD
      crossed from serum to choroid plexus and CSF and occupied TTR-binding sites for
      T4. There was a significant decrease (P less than 0.05) in the percentage of
      injected [125I]T4 in the high dose vs. the low dose EMD-treated rats in total
      choroid plexus (61%), 1 ml CSF (94%), and 1 g cerebral cortex (46%) and
      cerebellum (46%).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1733736
TI  - Calcium signalling in single growth hormone-releasing factor-responsive pituitary
      cells.
AB  - The release of pituitary GH appears to be critically dependent on alterations in
      the free intracellular Ca2+ concentration ([Ca2+]i). However, little is known
      about the nature of Ca2+ signalling within normal pituitary cells. We, therefore,
      examined [Ca2+]i patterns in individual cultured pituicytes of adult male rats
      under basal conditions and in response to GH regulatory agents, using the calcium
      sensitive dye fura-2 together with digital imaging microscopy. Perfusion of
      cultured anterior pituitary cells with GH-releasing factor (GHRF) resulted in a
      marked increase in [Ca2+]i in specific pituitary cells. These cells did not
      respond to other hypothalamic secretagogues (GnRH, TRH, or CRF), and there was no
      evidence of desensitization on repetitive administration of GHRF. Somatotrophs (n
      = 134) exhibited spontaneous oscillations of [Ca2+]i in the basal state, with
      considerable heterogeneity of oscillatory patterns among cells. After application
      of a near-maximal stimulatory dose of GHRF (1 nM), there was a striking 2.2-fold
      increase in the amplitude of [Ca2+]i oscillations and only a modest increase in
      their frequency. Forskolin (1 microM) augmented somatotroph [Ca2+]i in patterns
      similar to those of GHRF. Somatostatin (10 nM) abolished the [Ca2+]i response to
      GHRF (n = 26); this reflected a marked reduction in the amplitude of [Ca2+]i
      oscillations and a slight reduction in their frequency. Ca(2+)-free medium or the
      Ca2+ channel antagonist nimodipine (0.1-1 microM) suppressed the Ca2+ stimulatory
      effect of GHRF. Conversely, the Ca2+ channel agonist BAY K8644 (1 microM)
      strikingly augmented the GHRF-induced rise in [Ca2+]i, with a major stimulatory
      effect on the amplitude of [Ca2+]i oscillations and no observed effect on their
      frequency. In summary, GHRF and other hypothalamic secretagogues increase [Ca2+]i
      in pituitary cells in a highly specific manner, consistent with the known
      specificity of their effects on hormone release. Somatotrophs exhibit spontaneous
      rhythmic oscillation of [Ca2+]i in the basal state. Known regulators of GH
      release markedly alter the [Ca2+]i oscillatory pattern in characteristic manners,
      exerting predominant effects on the amplitude of [Ca2+]i pulses and lesser
      effects on their frequency. These striking effects of GH regulatory agents on
      pituitary Ca2+ signalling are consistent with the concept that modulation of
      [Ca2+]i is a critical mediator of somatotroph function.

PMID- 1733737
TI  - Isolation, characterization, and culture of cell subpopulations forming the
      pregnant rat corpus luteum.
AB  - The aim of this investigation was to isolate, characterize, and culture the small
      and large luteal cell subpopulations forming the corpus luteum of the pregnant
      rat. Since the large luteal cells are extremely fragile and do not survive
      standard cell dispersion, a method which allows the survival and the long-term
      culture in serum-free media of small and large cells was developed. The two
      luteal cell populations differed not only by their size but also by their
      morphology in culture. The small luteal cells (12-20 mu in diameter) are
      characterized by a large oval nucleus, contain few lipid droplets and have a
      stellate shape. In contrast, the large luteal cells have a smaller spherical
      nucleus, high lipid content, and do not flatten out completely in culture, most
      probably due to the abundance of lipid droplets. Both luteal cell types express 3
      beta HSD and the cytochrome P450 enzymes involved in steroidogenesis. However, it
      is the lipid filled large luteal cells that secrete the most progesterone,
      androgen, and estradiol; express greater amounts of P450scc and P450AROM; and
      possess more PRL and LH receptors. Despite the greater expression of LH receptor
      in the large luteal cells, small and large luteal cells responded to LH with
      equal increase in steroidogenic output. In serum free culture, luteal cells
      produced progesterone for up to 20 days; however, an exogenous source of
      cholesterol was a prerequisite for maximal progesterone secretion. The pattern of
      progesterone secretion by cultures of small and large luteal cells differed
      remarkably from that of mixed cell population. When nonsteroidogenic corpus
      luteum cells were cocultured with the large luteal cells, a severalfold increase
      in progesterone secretion was observed. This stimulation occurred even when cells
      were cocultured in the absence of exogenous source of cholesterol. In summary, a
      successful method was developed to disperse, isolate, and independently culture
      the two luteal cell populations forming the rat corpus lutem. The results
      indicate that the marked difference in the steroidogenic capacity of these two
      cell populations is due, in large part, to the difference in their size rather
      than to their origin in the follicle. In addition, the results have revealed an
      important effect of the nonsteroidogenic cells forming the corpus luteum on
      luteal cell steroidogenesis.

PMID- 1733738
TI  - Characterization of monoclonal antibodies to the human thyrotropin receptor.
AB  - We have produced four monoclonal antibodies (mAbs), 34A, 49G, 11E7, and 12E3,
      which bind the human TSH receptor (hTSH-R) when expressed on a human thyroid cell
      line (GEJ), freshly dissociated human and murine thyroid cells, or Chinese
      hamster ovary cells stably transfected with the hTSH-R gene. These mAbs were
      obtained after immunization of DBA/1 mice with affinity-purified TSH-binding
      sites from GEJ cells. Biochemical studies, including sodium dodecyl sulfate
      polyacrylamide-gel electrophoresis, Western blot, and immunoprecipitation of
      solubilized GEJ cell membranes or human thyroid cells showed that most of the
      mAbs recognized two bands: one located at 46-48 kilodaltons and the other at 86
      88 kilodaltons. Inhibition of [125I]hTSH binding to solubilized porcine membranes
      (TSH-receptor auto-antikorper assay) or Chinese hamster ovary cell membranes
      previously transfected with hTSH-R gene showed that mAb 34A recognizes the hTSH
      binding site of both receptors. In contrast, mAbs 49G, 11E7, and 12E3 recognize a
      structure located near the hTSH-binding site. Lastly, the ability of these mAbs
      to stimulate murine thyroid function was investigated by measuring cAMP
      production and iodide accumulation. The 34A mAb, which fully competes with
      [125I]TSH for binding to hTSH-R, was able to induce both functions. Conversely,
      the 12E3 mAb, which was the least potent inhibitor of [125I]TSH binding to hTSH-R
      transfected cells had no effect. A relationship was, therefore, established
      between the capacity of mAb to hTSH-R to inhibit [125I]hTSH binding and their
      ability to induce thyroid functions.

PMID- 1733739
TI  - Distribution and characterization of peptidylglycine alpha-amidating
      monooxygenase activity in the ovine brain and hypothalamo-pituitary axis.
AB  - The production of alpha-amidated peptide hormones from their glycine-extended
      precursors is catalyzed by the specific enzyme peptidylglycine alpha-amidating
      monooxygenase (PAM). In the present study, the distribution and subcellular
      localization of PAM activity in the sheep brain was examined and compared with
      known sites of amidated peptide synthesis and release. Of the brain regions
      assayed, the preoptic anterior and medial basal areas of the hypothalamus
      contained the greatest concentration of amidating activity. Lower concentrations
      (greater than 3-fold less) were found in the anterior and neurointermediate
      pituitary, median eminence, cerebral cortex, hippocampus, pons-medulla, and
      brainstem. Very low amounts of activity were present in the cerebellum and pineal
      gland. In most tissues tested, PAM activity was 40-75% higher in the membrane
      associated fraction than in the soluble fraction. In the hypothalamus, affinity
      constants were identical for both membrane-associated and soluble fractions, and
      ranged from 12.3-13.3 microM. Maximal velocity was higher in the membrane
      fraction (4.7-4.8 pmol/microgram.h) than in the soluble fraction (2.6-2.9
      pmol/microgram/h). Levels of amidating activity in hypophysial-portal and jugular
      plasma were similar and were 20- to 25-fold lower than in hypothalamic extracts.
      Insulin-induced hypoglycemia did not significantly alter PAM levels in portal or
      peripheral plasma, suggesting that amidating activity is not released during this
      stress. These results indicate that the hypothalamus is the richest source of
      amidating activity in the sheep brain, and suggest that amidation of
      neurohypophysial and hypothalamic releasing peptides may occur before axonal
      transport, given the much lower levels in median eminence, neurointermediate
      pituitary, and portal plasma.

PMID- 1733740
TI  - Severe burns as a consequence of seizures in patients with epilepsy.
AB  - We report 10 seizure-related thermal injuries severe enough to require
      hospitalization in patients with epilepsy. Eight of the ten incidents were with
      patients who had had seizures with impaired consciousness two or more times a
      month. This suggests that seizure frequency is a risk factor and implies the
      importance of striving for optimal seizure control. Two burns each occurred from
      an electric iron, a hand-held hair dryer, and stove-top cooking. Minimizing these
      activities, especially in patients with frequent consciousness-altering seizures,
      may be useful. Three burns occurred while showering; these resulted in the most
      severe injuries, with hospital stays of 29, 30, and 41 days. Simple plumbing
      devices may have prevented these injuries.

PMID- 1733741
TI  - Acute intermittent porphyria and epilepsy: safety of clonazepam.
AB  - A young woman with acute intermittent porphyria (AIP) and juvenile myoclonic
      epilepsy began to have generalized tonic-clonic seizures (GTCs) at age 13.
      Subsequently, she had myoclonic seizures, which were often precipitated by visual
      stimulation, tended to occur in the morning, and sometimes evolved into GTCs.
      Valproate (VPA) resulted in a worsening of latent AIP, and treatment with a
      combination of phenytoin (PHT), carbamazepine (CBZ), and clonazepam (CZP) led to
      severe neuropathy of AIP and an electrolyte imbalance. These conditions were
      improved by water restriction, infusion of high doses of carbohydrates, and
      discontinuation of all antiepileptic drugs (AEDs) except for CZP. CZP appeared to
      be effective both in improving GTCs and myoclonic seizures and did not induce any
      symptoms of AIP. CZP may be porphyrogenic but can be used safely at a low dose
      for treatment of epilepsy in patients with AIP.

PMID- 1733742
TI  - Analysis of B10.D2 recombinant congenic mouse strains shows that audiogenic and
      beta-CCM-induced seizures depend on different genetic mechanisms.
AB  - The rate of occurrence of audiogenic seizures and seizures induced by the
      benzodiazepine receptor inverse agonist methyl-beta-carboline-3-carboxylate (beta
      CCM) were analyzed in several recombinant congenic strains of mice bred from
      B10.D2 and DBA/2J. Although both types of seizures have similar behavioral
      patterns and might involve GABAergic mechanisms, no correlation was observed
      between the occurrence of the two types of seizures across the strains,
      suggesting that these two types of seizures depend on different genetic
      mechanisms.

PMID- 1733744
TI  - Carbamazepine-induced eosinophilic colitis.
AB  - Severe watery diarrhea and eosinophilic colitis induced by carbamazepine (CBZ)
      has not been described previously. We report the first known case of CBZ-induced
      watery diarrhea and eosinophilic colitis in a 57-year-old man receiving CBZ for
      secondarily generalized tonic-clonic seizures that developed after a cerebral
      infarction.

PMID- 1733743
TI  - Pharmacokinetic and dose tolerability study of ADD 94057 in comedicated patients
      with partial seizures.
AB  - ADD 94057, a metabolite of fluzinamide, manufactured by the A. H. Robins Company,
      blocks chemically- and electrically-induced seizures in animals. The primary
      objective of this open add-on study was to evaluate patient tolerability of ADD
      94057 at ascending target plasma concentrations. Nine subjects with medically
      refractory seizures were receiving phenytoin (PHT, 3), carbamazepine (CBZ, 3), or
      both (3). A pharmacokinetic profile after a single oral 400-mg dose of ADD 94057
      was used to calculate ADD 94057 dosages. After a 4-week baseline period, patients
      were treated for 4 weeks with weekly ADD 94057 dosage escalations. Two patients
      completed the study at their assigned highest dosage level; the other patients
      finished the study at lower dosages. The patients receiving PHT (but not CBZ)
      tolerated higher plasma concentrations of ADD 94057 than did patients receiving
      CBZ, alone or in combination with PHT. Adverse experiences included headache,
      ataxia, blurred vision, diplopia, dizziness, lightheadedness, and mild confusion.
      Eight of nine patients had reductions in seizure frequency from baseline.

PMID- 1733745
TI  - Effect of vigabatrin on the electroencephalogram in rats.
AB  - Vigabatrin (gamma-vinyl GABA; GVG) is a new antiepileptic drug (AED) that
      increases the level of the inhibitory transmitter, gamma-aminobutyric acid (GABA)
      in the brain. We evaluated the effect of GVG on the EEG of normal rats. GVG was
      administered intraperitoneally (i.p.) at a dose of 100 mg/kg once a day for 12
      days. EEG was recorded at baseline, on the fourth day, at the end of the 12-day
      GVG period and 10 days after discontinuation of GVG. GVG increased the amplitude
      of delta (1-4 Hz) and theta (4-8 Hz) frequency bands and resulted in slowing of
      the peak frequency (Fp) and mean frequency (Fm) in both the frontal and occipital
      cortex, especially during waking-immobility. EEG changes normalized within 10
      days after the last GVG injections. The results suggest that a relationship may
      exist between the EEG changes and increase in GABA levels with GVG.

PMID- 1733746
TI  - Effects of vigabatrin on cognitive function and mood when used as add-on therapy
      in patients with intractable epilepsy.
AB  - Cognitive function and mood of patients with epilepsy who received 2 g/day
      vigabatrin (GVG) in addition to their usual antiepileptic drugs (AEDs) was
      assessed on two occasions: before start of treatment (baseline) and 4 weeks after
      start of treatment. A battery of selected psychological tasks measuring
      attention, mental speed, motor speed, central cognitive processing, and
      perceptuomotor performance was used, along with standardized, objective mood
      assessments. A comparison group (n = 15) of patients receiving stable medication
      was also tested to evaluate practice effects of the psychometric tests.
      Administration of 2 g/day GVG significantly decreased response time on a test of
      central cognitive processing ability (arithmetic). No adverse effect was noted on
      any other test of cognitive function or mood.

PMID- 1733747
TI  - Preliminary assessment of the efficacy of Org 6370 in photosensitive epileptic
      patients: paradoxical enhancement of photosensitivity and provocation of
      myoclonic seizures.
AB  - Photosensitivity has proved to be a useful model to study the acute effects of
      experimental antiepileptic drugs (AEDs). The photosensitivity range is usually
      diminished or even abolished after administration of a known or experimental AED.
      An increase in photosensitivity, an unexpected reaction, was found in four
      photosensitive epileptic patients after oral ingestion of 500, 100, or 50 mg of
      Org 6370. Moreover, the three patients receiving doses of 100 and 500 mg reported
      nausea, dizziness, restlessness, and an increase in spontaneous epileptic
      seizures (myoclonus and in one patient a generalized tonic-clonic convulsion).
      The side effects coincided with peak Org 6370 serum levels. Our findings indicate
      that in the photosensitivity model experimental drugs with proven anticonvulsant
      properties in animals may increase rather than decrease the degree of patient
      photosensitivity. Photosensitive patients may represent a special subgroup of
      epileptic patients and therefore need to be classified as such.

PMID- 1733748
TI  - Effects of seizures, kindling, and carbamazepine on sleep organization in cats.
AB  - We studied the relationships between epilepsy, sleep, and anticonvulsant drugs in
      kindled cats. No sleep alteration was present at midkindling. When the animals
      became fully kindled, a reduction in REM sleep percentage and the number of
      entries into REM sleep were observed compared to baseline. In addition, with
      further seizures, an increase in the percentage of wakefulness appeared,
      accompanied by a further reduction in the number of entries into REM sleep. It
      therefore seems that there is a progressive disruption of sleep, dependent on the
      increasing number of tonic-clonic generalized seizures. After a seizure-free
      interval, REM sleep and wakefulness returned to baseline values. A reduction in
      the percentage of stage II compared to baseline was found and remained as a long
      term effect of the kindling process. Acute administration of carbamazepine (CBZ)
      reduced the REM sleep percentage. This effect, paralleled by a reduction in the
      number of entries into REM sleep, was evident both at baseline and when the
      animals were fully kindled. After a large number of seizures, however, CBZ
      administration did not cause a further reduction in the already low percentage of
      REM sleep. Results are discussed with reference to previous literature. We
      propose a hypothesis of competition between seizure and REM sleep in the
      elimination of epileptogenic and hypnogenic factors.

PMID- 1733750
TI  - Effects of antiepileptic drugs on sperm motility of normal controls and epileptic
      patients with long-term therapy.
AB  - The in vitro effects of four antiepileptic drugs (AEDs) on human sperm motility
      were studied with a transmembrane migration method. Sperm motility of epileptic
      patients receiving chronic AED therapy was also investigated. Sperm motility was
      measured immediately after semen had been mixed with AED and after a 2-h
      preincubation at 37 degrees C. Both in vitro and in vivo studies demonstrated
      that AEDs inhibited sperm motility. When the drug effect was evaluated after the
      semen-AED mixture had been preincubated for 2 h, sperm motility was inhibited to
      50% of control at concentrations of 1.59, 4.23, and 5.00 mM for phenytoin,
      carbamazepine, and valproate, respectively. Both with and without preincubation,
      phenobarbital, even up to 12.92 mM, did not inhibit the motility to less than 50%
      of the control. In the in vivo study, poor sperm motility was noted in epileptic
      patients with long-term AED therapy despite serum levels within the therapeutic
      range. Shorter duration of activity of spermatozoa was also observed in these
      patients. Interference with sperm membrane function by AEDs may be the underlying
      mechanism.

PMID- 1733749
TI  - Thyroid function with antiepileptic drugs.
AB  - Serum thyroid hormone balance was assessed in 108 patients receiving chronic
      antiepileptic drug (AED) therapy. Forty-five patients were receiving
      carbamazepine (CBZ), 26 phenytoin (PHT), 16 CBZ-PHT, 11 valproate (VPA), and 10
      CBZ-VPA. Serum thyroxine (T4) and free thyroxine (FT4) concentrations were low in
      patient groups receiving CBZ and/or PHT. Serum T4 concentrations were below the
      normal range in 24 (53.3%) CBZ patients, 11 (42.3%) PHT patients, 12 (75%) CBZ
      PHT patients, and in all 10 patients (100%) receiving CBZ-VPA. Furthermore, serum
      levels of FT4 were below the normal range in 13 (28.9%) CBZ patients, 6 PHT
      (23.1%) patients, 5 (31.3%) CBZ-PHT patients, and 5 (50%) CBZ-VPA patients.
      Despite the decreased serum T4 and FT4 levels in these patients, serum basal and
      stimulated thyrotropin (TSH) concentrations were normal, except for the slightly
      increased basal TSH in the CBZ-VPA group. In the VPA group, the findings were
      different from those in other patients: T4 serum levels were unchanged and FT4,
      T3, and basal TSH levels increased, but stimulated TSH levels did not differ from
      those of the control group. The decrease in serum thyroid hormone levels during
      CBZ and/or PHT medication probably is caused by an accelerated hepatic plasma
      clearance of these hormones due to induction of hepatic microsomal enzyme systems
      by these AEDs. VPA, an AED with no liver enzyme-inducing properties, does not
      cause similar changes. The feedback mechanism is not activated, possibly because
      of a hypothalamic interference by CBZ and PHT.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1733751
TI  - Treatment of intractable childhood epilepsy with high-dose valproate.
AB  - Forty-six children with refractory epilepsy (12 with symptomatic generalized
      epilepsy, 14 with symptomatic partial epilepsy, and 20 with undetermined
      epilepsy) were treated by high-dose (serum level above 100 micrograms/ml)
      valproate (VPA) therapy. Monotherapy was used with 34 patients and two drugs with
      12. Serum VPA concentrations ranged from 105.1 to 198.4 micrograms/ml. Assessment
      of initial response to treatment, after the serum level had reached the
      appropriate level, showed seizures to be completely controlled in 15 (32.6%) of
      46 patients and improved in 12 (26.1%) (50% or more). Follow-up of more than 6
      months after the time of initial response showed control of seizures in 14
      (30.4%) and improvement in 11 (23.9%). The initial effect on EEG was the
      disappearance of epileptic discharges in 3 (6.5%) of 46 patients and marked
      improvement in 15 (32.6%). Follow-up revealed the disappearance of epileptic
      discharges in 7 (15.2%) and marked improvement in 9 patients (19.6%). High-dose
      VPA therapy was especially effective for West syndrome and for epilepsy with
      continuous spike-waves during slow-wave sleep. Control of atypical absences and
      myoclonic seizures was relatively good. Hypofibrinogenemia and thrombocytopenia
      were sometimes encountered but these side effects were reversible with reduction
      of dosage.

PMID- 1733752
TI  - Valproate metabolites in serum and urine during antiepileptic therapy in children
      with infantile spasms: abnormal metabolite pattern associated with reversible
      hepatotoxicity.
AB  - The purpose of this study was to identify abnormal metabolite patterns of
      valproate (VPA) as possible early indicators of VPA-induced liver toxicity. In a
      prospective study, we determined serum and urine levels of VPA metabolites by gas
      chromatography-mass spectrometry (GC-MS) during the course of therapy in 25
      children treated for infantile spasms with high VPA doses (less than or equal to
      100 mg/kg body weight/day). Most patients had similar metabolite profiles: The
      main metabolites in serum were the beta-oxidation products (2-en-VPA and 3-keto
      VPA) and the major diunsaturated metabolite 2,3'-dien-VPA. Glucuronide conjugates
      and the oxidation products represent the most abundant metabolites in urine.
      Other metabolites, including the potential hepatotoxin 4-en-VPA, were detected
      only in low concentrations. Two children had transiently aberrant metabolite
      profiles, indicating altered beta-oxidation, (levels of 2-en-VPA, 2,3'-dien-VPA,
      and 3-en-VPA were markedly increased) in connection with hepatomegaly and
      increased liver enzyme activities at a time when both had febrile infections and
      were receiving dexamethasone comedication. At no time were increased levels of 4
      en-VPA or its derivatives detected. Establishing the VPA metabolite profile may
      aid in evaluation of patients who show signs and symptoms of liver dysfunction
      during VPA therapy. The present study shows that initial stages of hepatotoxicity
      reactions to VPA may be accompanied by characteristic changes in VPA metabolism;
      early detection of such abnormal metabolite patterns might decrease the risk of
      severe hepatic injury.

PMID- 1733753
TI  - Associations between risk factors for valproate hepatotoxicity and altered
      valproate metabolism.
AB  - The effects of three risk factors for valproate (VPA) hepatotoxicity (i.e., young
      age, polypharmacy, and high VPA serum level) on the metabolism of VPA to its
      monounsaturated metabolites [2-en-VPA (2-en), 3-en-VPA (3-en) and 4-en-VPA (4
      en)] were investigated in 106 patients treated with VPA (56 cases of monotherapy
      and 50 cases of polytherapy). In the monotherapy group, there was a significant
      negative correlation between age and 4-en/VPA ratio. In the same group, the 4
      en/VPA ratio showed a significant positive correlation with serum VPA level,
      while 3-en/VPA and 2-en/VPA ratios showed significant negative correlations. In
      patients greater than 10 years, the 4-en/VPA ratio was significantly higher,
      while the 2-en/VPA ratio was significantly lower in the polytherapy group than in
      the monotherapy group. Our results indicate that all three risk factors clearly
      increase the metabolic conversion of VPA to 4-en, the most toxic VPA metabolite,
      and that polytherapy and high VPA serum level result in the inhibited beta
      oxidative metabolism of VPA to 2-en. These altered VPA metabolic profiles are
      strikingly similar to the abnormal VPA metabolism previously reported in cases
      with fatal hepatic failure. Although VPA-induced fatal hepatotoxicity has been
      regarded as an idiosyncratic reaction, it is possible that these three factors
      enhance susceptibility to VPA hepatotoxicity by altering the metabolism of VPA.

PMID- 1733754
TI  - Valproate therapy induces von Willebrand disease type I.
AB  - To investigate the increased tendency of hemorrhage in patients receiving
      valproate (VPA) therapy, we studied coagulation parameters in 30 randomized
      children of a group of 83 children receiving antiepileptic drug (AED) therapy.
      Besides a reduction in fibrinogen concentration and platelet count, we observed a
      significant decrease in factor VIII-complex. A decrease in factor VIII:C was
      noted in 33%, a decrease in von Willebrand factor (vWF:Ag) was noted in 83% and a
      decrease in ristocetin-cofactor activity (vWF:Rcof) was noted in 66% of the
      children. We classified a von Willebrand syndrome type I in 67% of our patients
      receiving VPA therapy. Sixty-three percent of patients had a history of bleeding,
      and 23% had a prolonged bleeding time. We compared our results with those of a
      control group and of a group of patients with congenital von Willebrand disease
      (vWD), from which patients with multimer types II and III were excluded. Because
      coagulation parameters in patients with congenital vWD are similar to those
      receiving AED therapy, we designated the increased tendency to hemorrhage as VPA
      induced vWD. The decrease in coagulation parameters were not dependent on either
      VPA dose or period of administration. In patients receiving VPA therapy, this
      result must be considered, especially during surgical intervention and after
      traumatic events.

PMID- 1733755
TI  - Intractable diarrhea from carbamazepine.
AB  - Diarrhea has been reported as an early, mild, and uncommon complication of
      carbamazepine (CBZ) therapy. We report three cases of intractable diarrhea
      induced by CBZ necessitating discontinuation of the drug.

PMID- 1733756
TI  - The developmental profile of seizure genesis in the inferior collicular cortex of
      the rat: relevance to human neonatal seizures.
AB  - The ontogeny of seizure genesis within the inferior collicular cortex was
      characterized in rats ranging in age from 3 days old to adult. Brief electrical
      stimulation of the right inferior collicular cortex in 30-day-old rats evoked
      poststimulus wild running behavior that coincided with afterdischarge activity in
      the inferior collicular cortex but not in the adjacent occipital cortex. Similar
      electrical stimulation in 16-day-old rats produced poststimulus wild running and
      jumping behaviors, which also coincided with afterdischarge in the inferior
      collicular cortex. In 10- and 5-day-old rats, electrical stimulation of the
      inferior collicular cortex produced poststimulus locomotion and coincident
      afterdischarge activity, but unlike older rats the locomotor behaviors consisted
      of forelimb paddling, hindlimb treading, and rolling/curling movements of the
      torso. Identical behaviors can be electrically elicited in 3-day-old rats.
      Although many of the seizure characteristics appear to be similar among the
      different age groups, 5-day-old rats were more sensitive to low frequency
      stimulation than 16-day-old rats, who in turn were more sensitive than adult
      rats. Thus, the inferior collicular cortex is capable of generating seizure
      activity in rats as young as 3 days of age, providing a focal model of neonatal
      seizure genesis.

PMID- 1733757
TI  - Hippocampal pyramidal cell loss in human status epilepticus.
AB  - A pilot case-control quantitative study of the hippocampus in patients with
      severe status epilepticus was performed to identify specific patterns of
      pyramidal cell loss. Pyramidal cell densities from five patients who died
      following status epilepticus were compared with five normal controls and five
      controls matched for age, hypoxia/ischemia, previous epilepsy, and alcohol abuse.
      Neuronal densities were greatest in the normal control group and least in
      patients with status epilepticus. Significant reductions were identified in
      Sommer's sector (prosubiculum and CA1) as well as in CA3 when compared to normal
      controls.

PMID- 1733758
TI  - High signal intensity on T2-weighted MRI correlates with hypoperfusion in
      temporal lobe epilepsy.
AB  - Single-photon emission computed tomography (SPECT) and [99mTc]HMPAO were used to
      assess the functional significance of nonspecific magnetic resonance imaging
      (MRI) abnormalities observed in patients with temporal lobe epilepsy and no focal
      lesion on CT scan. We studied 18 patients whose MRI was normal or showed high
      signal intensity on T2-weighted images (T2WIs) at the site of the EEG focus in 11
      and 7 cases, respectively. EEG was monitored during regional cerebral blood flow
      (rCBF) study. Lateralized hypoperfusion was present in 7 of 17 interictal (41%)
      and in one postictal cases; it was located in the temporal lobe on the side of
      the EEG focus in all, and was significantly more frequent in patients with high
      signal intensity on T2WI (86%) than in patients with a normal MRI (18%). The
      degree of temporal perfusion asymmetry measured in each individual was higher in
      patients whose MRI was abnormal.

PMID- 1733759
TI  - Prognosis of epilepsy in newly referred patients: a multicenter prospective study
      of the effects of monotherapy on the long-term course of epilepsy. Collaborative
      Group for the Study of Epilepsy.
AB  - A cohort of 280 previously untreated epilepsy subjects (159 men and 121 women
      aged 2-81 years) recruited in 14 Italian centers were treated with antiepileptic
      drug (AED) monotherapy and followed for a median period of 48 months to
      investigate the rates of seizure remission (i.e., complete control), in general
      and with reference to various prognostic factors. The cumulative probability of
      achieving 1-year remission was 62% by 1 year after onset of treatment, 81% by 2
      years, 92% by 3 years, and 98% by 5 years. The corresponding figures for 2- and 3
      year remission at 5 years were 92 and 78%, respectively. Sixty-two patients
      (22.1%) had no remission period with monotherapy. Remission rates were
      significantly lower among patients with two or more seizure types and were
      inversely correlated to the number of seizures before treatment. The rate of
      seizure relapses during the first year of follow-up appear to correlate to the
      risk of developing refractory epilepsy (i.e., with no remission).

PMID- 1733760
TI  - Febrile seizures: clinical characteristics and initial EEG.
AB  - We examined the relationship between clinical characteristics and EEG
      classification in all children with febrile seizures examined at the University
      Pediatric Clinic, Skopje, Yugoslavia between 1982 and 1984. This is the only
      facility in Macedonia providing EEG or neurologic consultation for children. EEGs
      were classified as paroxysmally abnormal if they contained spikes, sharp waves,
      or spike-wave complexes considered abnormal for age. In all, 22% of the 676
      children had an abnormal initial EEG. The most common basis for classification as
      abnormal was spike-wave complexes greater than 3 Hz; the next most common basis
      was the presence of spikes. Birth weight, gender, accompanying illness, and
      family history of seizures, and whether the index seizure was single or multiple
      were not associated with differences in rate of abnormal EEG. Clinically focal
      index seizures and longer duration were associated with EEG abnormality. Number
      of previous febrile seizures was associated with an increasing rate of EEG
      abnormality, from 18% in children with no previous seizures to 63% in those with
      four or more previous seizures. Age at EEG was linearly related to likelihood of
      paroxysmal EEG abnormality, both for the total cohort and for the 376 children
      with no previous seizures. In the total cohort, logistic regression identified
      leading predictors of abnormal initial EEG to be older age, number of previous
      febrile seizures, preexisting motor abnormality, and focal seizures. For children
      with a first febrile seizure, leading predictors were focal seizure, older age,
      and preexisting motor abnormality.

PMID- 1733761
TI  - Kufs' disease presenting as progressive dementia with late-onset generalized
      seizures: a clinicopathological and electrophysiological study.
AB  - A 32-year-old woman presented with increasing motor difficulties and memory
      disturbances. Neurological examination only showed mild cerebellar and
      extrapyramidal symptoms, whereas neuropsychological evaluation disclosed severe
      cognitive changes consistent with dementia. Her motor and mental status
      progressively deteriorated until death, which occurred 5 years after the first
      admission. One year before death, while she was almost bedridden, symptoms of
      myoclonic epilepsy first appeared, with frequent generalized seizures and
      generalized myoclonus, occurring especially upon sensory stimulation or passive
      joint movements. Pathological examination showed neuronal inclusions typical of
      Kufs' disease. This case, with primary progressive dementia and late-onset
      myoclonic epilepsy, differs from previously reported cases. Three special
      electrophysiological features were abnormal, "giant", evoked potentials;
      unusually marked photosensitivity; and seizure induction by any sensory
      stimulation.

PMID- 1733762
TI  - A study of unilateral brief focal atonia in childhood partial epilepsy.
AB  - We studied unilateral brief focal atonia (BFA) in seven patients with childhood
      partial epilepsy. BFA was observed as a transient dropping of one arm lasting
      from 100 to 150 ms when patients were asked to keep both arms outstretched in
      front of the body. Close examination using simultaneous video-polygraphic
      recordings showed dropping of the arm to correspond exactly with a single sharp
      and slow wave complex arising from the contralateral centrotemporoparietal
      region. The BFA occasionally would progress to atonic seizures or atonic absence
      seizures, when the localized epileptic discharge evolved into generalized
      discharges. In one patient we found a positive correlation between the intensity
      of BFA and the amplitude of the contralateral epileptic discharges. A higher
      amplitude corresponded to more pronounced BFA and a lower amplitude to less
      pronounced BFA. These results led us to conclude that the apparently interictal
      single sharp and slow wave complex in the rolandic region may inhibit
      contralateral motor control, thus producing BFA that corresponds with the spike
      amplitude.

PMID- 1733763
TI  - Pattern-sensitive epilepsy: genetic aspects in two families.
AB  - We report two families in which five members (three in one and two in the other)
      suffer from pattern-sensitive epilepsy. In all affected members seizures were
      induced by environmental visual patterned stimuli. Diagnosis was confirmed by
      neurophysiological studies, including EEG with pattern and intermittent light
      stimulation and visual evoked potentials. The role of genetic aspects and the
      relationship between this form of reflex seizures and photosensitive epilepsy are
      emphasized.

PMID- 1733764
TI  - Game-playing epilepsy.
AB  - A 25-year-old woman with documented generalized seizures evoked by playing
      checkers was given a battery of psychological tests as well as a series of
      cognitive and non-game-related tasks during a session of intensive EEG-video
      monitoring. Generalized epileptiform discharges during each task, as well as
      during intervals of checkers playing, were quantified to determine possible
      triggering factors. Previous reports have discussed the roles of attention,
      concentration, stress, thinking, and spatial processing in similar cases. Our
      analysis showed significant activation of the EEG only with tasks involving
      strategic thinking, i.e., considering a sequence of moves based on evaluating the
      consequences of previous moves.

PMID- 1733765
TI  - Effects of a broad-spectrum behavioral medicine treatment program on children
      with refractory epileptic seizures: an 8-year follow-up.
AB  - We present an 8 year follow-up on a group of children with refractory epileptic
      seizures who participated in the early 1980s in a controlled group study on the
      effects of a broad-spectrum behavior modification treatment program on children
      with refractory epileptic seizures. In the original study, 18 children were
      divided into three groups: behavior modification group, attention control group,
      and control group. The purpose was to investigate the effects of a learning-based
      treatment program superimposed on a regular medical treatment program. Also, the
      effects of professional attention were evaluated. At the 10 week and 1 year
      follow-ups, only the group receiving the behavior modification intervention had a
      significantly reduced rate of seizure index. The present study investigates these
      same children 8 years later using the same methods of investigation for an
      additional 10 week period. The results indicate that a significant reduction in
      seizures was obtained only for the behavior modification group at the 8 year
      follow-up.

PMID- 1733766
TI  - Time-varying and static magnetic fields act in combination to alter calcium
      signal transduction in the lymphocyte.
AB  - We have tested the hypothesis that extremely low frequency (ELF) time-varying
      magnetic fields act in combination with static magnetic fields to alter calcium
      signalling in the lymphocyte. Results indicate that a 60-min exposure of thymic
      lymphocytes at 37 +/- 0.05 degrees C to a 16 Hz, 421 mG (42.1 microT) magnetic
      field simultaneously with a colinear static magnetic field of 234 mG (23.4
      microT) (a.c./d.c. field intensity ratio = 1.8) inhibits calcium influx triggered
      by the mitogen Concanavalin A. Significantly, resting lymphocytes do not respond
      to the fields, thus, only mitogen-activated cells undergoing calcium signalling
      exhibit a field response. These results indicate that signal transduction
      involving calcium is an important biological constraint which operates to mediate
      this field interaction. Additional split field exposures show that the presence
      of the a.c. field or the d.c. field alone does not produce an effect. This is
      consistent with a proposed parametric resonance theory of interaction of low
      intensity magnetic fields with biological systems (L.L. Lednev (1991)
      Bioelectromagnetics 12, 71-75), which predicts the occurrence of biological
      effects at specific values for the frequency and field intensity of the ELF and
      static magnetic fields.

PMID- 1733767
TI  - Retroviral-mediated transfer of a dystrophin minigene into mdx mouse myoblasts in
      vitro.
AB  - We have demonstrated expression of a 6.3 kb Becker muscular dystrophy (BMD) human
      dystrophin cDNA following retroviral-mediated transduction of cultured myoblasts
      from the dystrophin-deficient mdx mouse. The truncated dystrophin protein was
      localised to the sarcolemma of differentiated myotubes by antibodies against the
      C-terminus of the molecule, and produced an identical immunostaining pattern to
      that observed in control myotubes expressing normal endogenous dystrophin. These
      results indicate that retroviral-mediated gene transfer may be useful for
      experimental in vivo studies on the complementation of dystrophin gene mutations.

PMID- 1733768
TI  - Resonance effects in strongly exothermic long-range electron transfer and their
      possible implications for the behaviour of site-directed mutant proteins.
AB  - Long-range electron transfer investigations of hemoproteins, blue copper and iron
      sulphur proteins frequently rest on electronically excited metal centres. When
      the excitation energy approaches the oxidation or reduction potentials of
      intermediate residues the superexchange view normally used, however, fails and a
      variety of new dynamic features arise. These all involve population of the
      intermediate cation or anion residue states which can be partially or wholly
      vibrationally relaxed. We discuss suitable views and a new theoretical formalism
      for these phenomena. We also note some important implications for site-directed
      mutagenesis in long-range, strongly exothermic electron transfer processes.

PMID- 1733769
TI  - Specific inhibition of binding of antistasin and [A103,106,108] antistasin 93-119
      to sulfatide (Gal(3-SO4)beta 1-1Cer) by glycosaminoglycans.
AB  - Leech-derived antistasin is a potent anticoagulant and antimetastatic protein
      that binds sulfatide (Gal(3-SO4)beta 1-1Cer) and sulfated polysaccharides. In
      this study, the synthetic fragment [A103,106,108] antistasin 93-119, which
      corresponds to the carboxyl terminus, showed specific and saturable binding to
      sulfatide. Binding was competitively blocked by glycosaminoglycans (GAGs) in the
      order: dextran sulfate 5000 congruent to dextran sulfate 500,000 greater than
      heparin greater than dermatan sulfate much greater than chondroitin sulfates A
      and C. This rank order of inhibitory potency was identical to that observed with
      whole antistasin. We suggest that residues 93-119 of antistasin represent a
      critical domain for binding GAGs and sulfated glycolipids.

PMID- 1733770
TI  - Low resolution solution structure of the Bacillus subtilis glucose permease IIA
      domain derived from heteronuclear three-dimensional NMR spectroscopy.
AB  - A low resolution solution structure of the IIA domain of the Bacillus subtilis
      phosphoenolpyruvate-sugar phosphotransferase system (PTS) glucose permease has
      been determined using 945 inter-residue and 724 intra-residue distance
      constraints derived from three-dimensional 15N and 13C edited NOESY spectra. A
      total of 15 structures was generated using distance geometry calculations. The
      protein is comprised of 13 beta-strands forming an antiparallel beta-barrel. The
      average backbone atomic RMS deviation about the average distance geometry
      structure for the beta-sheet residues is 1.1 A. The conformations of the loop
      regions between the beta-strands are less well determined. Backbone distance
      constraints obtained during the process of sequential assignment were
      insufficient to correctly calculate the polypeptide fold.

PMID- 1733771
TI  - A study of D52S hen lysozyme-GlcNAc oligosaccharide complexes by NMR spectroscopy
      and electrospray mass spectrometry.
AB  - The production of a mutant hen lysozyme is described in which Asp-52, one of the
      catalytically important residues, is replaced by Ser. The mutant enzyme has very
      low catalytic activity but NMR studies show that its structure is closely similar
      to that of the wild-type protein. NMR experiments also show that well defined
      complexes are formed with GlcNAc4 and GlcNAc6 bound in the active site of the
      mutant enzyme. These complexes have been examined using electrospray mass
      spectrometry (ESMS). The most intense peaks arise from the uncomplexed protein
      indicating that dissociation takes place in the mass spectrometer under the
      conditions used here. Peaks from minor species corresponding to complexes between
      the protein and the oligosaccharides are, however, also observed. The possibility
      that the latter arise from novel covalent enzyme-saccharide complexes is
      discussed.

PMID- 1733772
TI  - Anhydrosubtilisin-catalyzed peptide synthesis.
AB  - Anhydrosubtilisin was found to be a good catalyst for the peptide synthesis
      though its hydrolytic activity was fully inhibited. Amino acid (peptide) p
      chlorophenyl ester (acyl donor) was coupled with amino acid (peptide) amide in
      the presence of the modified enzyme. The method did not afford by-products
      resulting from the hydrolysis of the acyl donor. This is the most advantageous
      characteristic of the method, since the hydrolysis of the acyl donor is
      unavoidable for the methods using catalytically active proteases.
      Anhydrosubtilisin was further shown to be useful for the fragment condensation of
      peptides.

PMID- 1733773
TI  - Oleoylamine and sphingosine stimulation of phosphatidylserine synthesis by LA-N-2
      cells is protein kinase C independent.
AB  - The presence of sphingosine and oleoylamine in the culture medium of LA-N-2 cells
      stimulated the incorporation of [3H]serine into its corresponding phospholipid,
      phosphatidylserine (PtdSer). The optimum stimulation for sphingosine and
      oleoylamine were 50 microM and 100 microM, respectively. Oleoylamine increased
      the incorporation of [3H]serine over 6-fold while sphingosine increased the
      incorporation of [3H]serine over 2.5-fold. The amount of radioactivity found in
      water-soluble components and in protein was similar to that found with control LA
      N-2 cells. The incorporation of [3H]choline and [3H]ethanolamine into their
      corresponding phospholipids were decreased in the presence of either oleoylamine
      or sphingosine. A protein kinase C (PKC) activator, DiC8, and a PKC inhibitor,
      H7, did not influence the enhanced phosphatidylserine formation by sphingosine
      and oleoylamine. In addition, there were no differences in the stimulatory effect
      of sphingosine and oleoylamine discernable between PKC down-regulated cells or
      controls. These observations indicate that this oleoylamine and sphingosine
      mediated enhanced phosphatidylserine synthesis is PKC-independent.

PMID- 1733774
TI  - The precursor form of the rat liver non-specific lipid-transfer protein,
      expressed in Escherichia coli, has lipid transfer activity.
AB  - The cDNA encoding the precursor form of non-specific lipid-transfer protein (pre
      nsL-TP) from rat liver was cloned into the expression vector pET3d. The resulting
      plasmid was transformed to the Escherichia coli strain BL21(DE3). After induction
      of the bacteria with isopropyl-beta-D-thiogalactopyranoside (IPTG) pre-nsL-TP was
      purified from the bacterial lysate by anion exchange chromatography followed by
      gelfiltration. From 11 of culture, 6-7 mg of pre-nsL-TP was obtained, equal to
      approximately 7% of the cytoplasmic protein. By use of a fluorescence lipid
      transfer assay, pre-nsL-TP was found to have lipid transfer activity identical to
      mature nsL-TP.

PMID- 1733775
TI  - Alteration of the proximal bond energy in the unliganded form of the homodimeric
      myoglobin from Nassa mutabilis. Kinetic and spectroscopic evidence.
AB  - CO binding kinetics to the homodimeric myoglobin (Mb) from Nassa mutabilis has
      been investigated between pH 1.9 and 7.0. Protonation of the proximal imidazole
      at low pH (less than or equal to 3.0) and the consequent cleavage of the HisF8NE2
      Fe proximal bond brings about a approximately 20-fold increase of the second
      order rate constant for CO binding. This process displays a pKa = 4.0 +/- 0.2,
      significantly higher than that observed in all other deoxygenated hemoproteins
      investigated up to now. Such a feature underlies a decreased energy for the
      HisF8NE2-Fe proximal bond in the unliganded form and it also appears supported by
      resonance Raman spectroscopy in the low frequency region of the Fe(II)
      deoxygenated hemoprotein. Further, the pH-rate profile of N. mutabilis Mb, like
      that of the homodimeric hemoglobin (Hb) from Scapharca inaequivalvis (Coletta,
      M., Boffi, A., Ascenzi, P., Brunori, M. and Chiancone, E. (1990) J. Biol. Chem.
      265, 4828-4830), can be described only by assuming a concerted proton-linked
      transition with n = 1.8 +/- 0.1. Such a characteristic suggests, also on the
      basis of the amino acid sequence homology between N. mutabilis Mb and S.
      inaequivalvis Hb in the region forming the subunit interface, that the
      interaction mechanism is similar for the two homodimeric proteins, and
      drastically different Hb in the region forming the subunit interface, that the
      interaction mechanism is similar for the two homodimeric proteins, and
      drastically different from that operative in other hemoproteins.

PMID- 1733776
TI  - Glycinebetaine stabilizes the association of extrinsic proteins with the
      photosynthetic oxygen-evolving complex.
AB  - The photosynthetic oxygen-evolving activity of the photosystem 2 complex,
      prepared from spinach, was labile when the complex was exposed to high-salt
      conditions under which the extrinsic proteins were dissociated from the complex.
      Glycinebetaine prevented the dissociation of the 18-kDa and the 23-kDa extrinsic
      proteins from the photosystem 2 complex in the presence of 1 M NaCl. It also
      prevented the dissociation of the 33-kDa extrinsic protein from the complex in
      the presence of 1 M MgCl2 or 1 M CaCl2. The oxygen-evolving activity of the
      photosystem 2 complex was stabilized by glycinebetaine when the complex was
      subjected to treatment with NaCl and MgCl2.

PMID- 1733777
TI  - Shortened cecropin A-melittin hybrids. Significant size reduction retains potent
      antibiotic activity.
AB  - We have earlier reported two 26-residue antibacterial peptides made up from
      different segments of cecropin A (CA) and melittin (M). We now report a
      substantial reduction in size at the C-terminal section of the highly active
      hybrid CA(1-8)M(1-18), leading to a series of 20-, 18- and 15-residue analogs
      with antibiotic properties similar to the larger molecule. In particular, the 15
      residue hybrids CA(1-7)M(2-9), CA(1-7)M(4-11) and CA(1-7)M(5-12) are the shortest
      cecropin-based peptide antibiotics described so far, with antibacterial activity
      and spectra similar or better than cecropin A and a 60% reduction in size. Their
      reduced size and highly alpha-helical structure require an alternative mechanism
      for their interaction with bacterial membranes.

PMID- 1733778
TI  - Molecular cloning of a human gene (S31) encoding a novel serotonin receptor
      mediating inhibition of adenylyl cyclase.
AB  - We report the molecular cloning of human gene (S31) containing an open reading
      frame of 1095 nucleotides, which encodes a protein of 365 amino acids. The
      encoded protein contains seven hydrophobic putative transmembrane domains
      considered the hallmark of G protein-coupled receptors. The amino acid sequence
      shows highest homology to receptors for serotonin (5-hydroxytryptamine).
      Expression of this receptor in murine Ltk- cells conferred upon these cells the
      ability to respond to serotonin by inhibition of adenylyl cyclase. No response
      was observed to isoproterenol, epinephrine, histamine, dopamine or melatonin in
      the transfected cells. We propose that the human gene S31 encodes a novel
      serotonin receptor.

PMID- 1733779
TI  - Puromycin reaction for the A site-bound peptidyl-tRNA.
AB  - AcPhe2-tRNA(Phe) synthesized in 70S ribosomes after consecutive binding of AcPhe
      tRNA(Phe) at the P sites and EF-Tu-directed binding of Phe-tRNA(Phe) at the A
      sites is able to react quantitatively with puromycin in the absence of EF-G. A
      detailed study of the kinetics of the puromycin reaction, its comparison with
      that of spontaneous translocation, the use of antibiotic viomycin as an effective
      inhibitor of spontaneous translocation revealed that, besides spontaneous
      translocation, this peptidyl-tRNA could react with puromycin being located at the
      A site. This leads to the conclusion that the transpeptidation reaction per se
      triggers conformational changes in the ribosomal complex bringing the 3'-end of a
      newly synthesized peptidyl-tRNA nearer to the peptidyl-site of the
      peptidyltransferase center. This is detected functionally as the ability of such
      an A site bound peptidyl-tRNA to react with puromycin. This reaction is highly
      pronounced at elevated (25 degrees C) temperature but can be hardly detected at 0
      degrees C.

PMID- 1733780
TI  - Glucose has to be phosphorylated to activate glycogen synthase, but not to
      inactivate glycogen phosphorylase in hepatocytes.
AB  - 2-Deoxyglucose and 5-thioglucose, in the same fashion as glucose, cause the
      inactivation of the rat hepatocyte glycogen phosphorylase and the activation of
      glycogen synthase. However, 6-deoxyglucose and 1,5-anhydroglucitol inactivate
      phosphorylase without increasing the activation state of glycogen synthase. With
      3-O-methylglucose no changes in the activity of these enzymes occurred. These
      results prove that while glucose is the molecule that triggers the inactivation
      of phosphorylase, glucose 6-phosphate is the signal for glucose synthase
      activation and that a metabolite control of the activation state of glycogen
      synthase is operative in hepatocytes.

PMID- 1733781
TI  - Nitrendipine is a potent inhibitor of the Ca(2+)-activated K+ channel of human
      erythrocytes.
AB  - Nitrendipine, a classical blocker of L-type Ca2+ channels, is shown to be a
      potent inhibitor of the Ca(2+)-activated K+ channel of human erythrocytes. In
      erythrocytes suspended in a solution with physiological Na+ and K+ concentrations
      and in which the channel was activated using the Ca2+ ionophore ionomycin,
      nitrendipine inhibited K+(86Rb+) influx with an I50 of around 130 nM. Similar
      results were obtained for K+(86Rb+) efflux, and for K+(86Rb+) influx into cells
      suspended in a high-K+ medium.

PMID- 1733782
TI  - A plant homologue to mammalian brain 14-3-3 protein and protein kinase C
      inhibitor.
AB  - We have isolated cDNA clones of Spinacea oleracea L. and Oenothera hookeri of 930
      and 1017 base pairs, respectively. The open reading frame deduced from the
      Oenothera sequence codes for a protein of a calculated molecular mass of 29,200.
      The primary amino acid sequence exhibits a very high degree (88%) of homology to
      the 14-3-3 protein from bovine brain, and protein kinase C inhibitor from sheep
      brain. Subsequently the plant protein was partially purified from leaf extract.
      The partially purified plant protein inhibited protein kinase C from sheep brain
      in a heterologous assay system. The active fraction consisted of 5-6 different
      polypeptides of similar molecular size. One of these proteins crossreacted with a
      peptide-specific antibody against protein kinase C inhibitor protein from sheep
      brain.

PMID- 1733783
TI  - Okadaic acid inhibits angiotensin II stimulation of Ins(1,4,5)P3 and calcium
      signalling in rat hepatocytes.
AB  - OKA2 and CL-A significantly inhibit the ability of angiotensin II, ATP and
      vasopressin to raise [Ca2+]i in rat hepatocytes, with a partial inhibition of the
      initial spike, and a complete inhibition of the following plateau. In contrast,
      the [Ca2+]i response to thapsigargin, which releases intracellular calcium stores
      through a mechanism independent of inositol phosphates, is much less affected.
      The ability of angiotensin II to stimulate Ins(1,4,5)P3 production is also
      reduced by OKA, with kinetics consistent with the inhibited [Ca2+]i response.
      Since OKA and CL-A are potent and selective inhibitors of phosphoprotein
      phosphatases, these results provide further evidence that agonist-stimulated
      Ins(1,4,5)P3 signalling can be inhibited by protein phosphorylation.

PMID- 1733784
TI  - Kinetic interpretations of active site topologies and residue exchanges in
      Drosophila alcohol dehydrogenases.
AB  - 1. A comparison of full and partly sequenced Adhs from various Drosophila species
      reveal that 127 of their 253-255 positions are identical (50% identity). 2. Fifty
      six of the 115 C-terminal amino acids building up the alcohol binding region
      differ. In spite of the large differences in primary structure of the alcohol
      binding region in the Adh enzyme in distantly related Drosophila species, the
      substrate specificity and stereospecificity have been retained. The topology of
      the alcohol binding region has been largely conserved during evolution. 3. The
      primary structures of the alcohol dehydrogenases (Adh) in the Sophophora subgenus
      is distinguished by few amino acid exchanges, and kinetic and activity parameters
      show that those at positions 14, 82, 192 and 214 are directly or indirectly
      involved in coenzyme binding. 4. In these non-metallo Adhs, a tyrosine has been
      tentatively identified as a nucleophilic catalyst of the hydride transfer step.
      The three tyrosines at positions 63, 152 and 178 are conserved among the
      Drosophila alcohol dehydrogenases.

PMID- 1733785
TI  - Insulin: signal transmission and short-term effects on the cytoskeleton and
      protein synthesis.

PMID- 1733786
TI  - The role of cellular oncogenes in myogenesis and muscle cell hypertrophy.

PMID- 1733787
TI  - Selective chemical modification of amino acid residues in the flavin adenine
      dinucleotide binding site of NADPH-ferredoxin reductase.
AB  - 1. An apo-NADPH-ferredoxin reductase was prepared from holo-NADPH-ferredoxin
      reductase (EC 1.18.1.2) from bovine adrenocortical mitochondria. 2. Amino acid
      residues of the apo-reductase were modified selectively, to identify the FAD
      binding site of the reductase, with chemical reagents such as
      diethylpyrocarbonate, 5,5'-dithiobis(2-nitrobenzoate), tetranitromethane,
      pyridoxal 5'-phosphate, p-nitrophenylglyoxal, diisopropylfluorophosphate and N
      bromosuccinimide. The binding of FAD to the apo-reductase was measured as
      quenching of the fluorescence of FAD caused by the binding between apo-reductase
      and FAD. The quenching was blocked when the apo-reductase was modified with
      diethylpyrocarbonate and restored on the addition of hydroxylamine. 3. The
      blocking of the quenching occurred in a competitive manner as to FAD in the
      presence of diethylpyrocarbonate. However, when the apo-reductase was modified
      with 5,5'-dithiobis(2-nitrobenzoate), the blocking of the quenching occurred in a
      non-competitive manner. 4. These results suggested that a histidyl residue of the
      apo-reductase is essential for the binding of FAD to the reductase. This was
      confirmed by amino acid sequencing of the modified apo-reductase.

PMID- 1733788
TI  - Bovine brain cathepsin D: inhibition by pepstatin and binding to concanavalin A.
AB  - 1. Cathepsin D from bovine brain has been purified 1100-fold in 46% recovery.
      Three isozymes are present with pI (+/- 0.05) = 6.10, 6.30 and 6.40. 2. The
      isozymes are single polypeptide chains with apparent Mr = 42,000 and are similar
      with respect to substrate binding and cleavage; the pH-optimum is 3.5 with
      virtually no activity at neutral pH. 3. Pepstatin inhibits the enzyme and kinetic
      data are consistent with a "tight binding" mechanism. 4. The dissociation
      constant for the concanavalin A-enzyme complex is Kd = 19 nM at pH 5.0. 5. Under
      conditions where 90% of the enzyme is bound to soluble concanavalin A, full
      enzymatic activity is observed.

PMID- 1733789
TI  - Isolation, biochemical characterization and crystallization of the p15gag
      proteinase of myeloblastosis associated virus expressed in E. coli.
AB  - 1. The p15gag proteinase responsible for the processing of the polyprotein
      precursor of the myeloblastosis associated virus was obtained by a recombinant
      technique in an E. coli expression system. The massive expression of the
      intentionally truncated precursor (Pr25lac-delta gag) was accompanied by its
      structurally correct processing. 2. Three procedures for the purification of the
      recombinant proteinase from both the cytoplasmic fraction and the inclusion
      bodies were developed. 3. The purified proteinase was compared with the authentic
      proteinase isolated from MAV virions by N-terminal sequence analysis and amino
      acid analysis, molecular weight determination, reverse-phase HPLC and FPLC
      elution profiles, electrophoretic mobility and isoelectric point determination,
      and activity assays with proteins and synthetic substrates. The identity of both
      enzymes was shown. 3. Contrary to reported data, the amino acid sequence of the
      p15gag proteinase differs from the sequence of the homologous Rous sarcoma virus
      proteinase in one residue only, as follows from cDNA sequencing. 4.
      Crystallization of the proteinase from a citrate-phosphate buffer at pH 5.6
      afforded hexagonal crystals which diffracted well as 2.3 A without deterioration.

PMID- 1733790
TI  - Influence of dietary sorbose on lipogenesis in gold thioglucose-injected obese
      mice.
AB  - 1. The influence of dietary sorbose on food intake and fatty acid synthesis of
      the liver and epididymal white adipose tissue (EWAT) was investigated in gold
      thioglucose (GTG)-injected obese mice from 12 to 14 weeks of age. 2. Sorbose was
      supplemented to a semi-purified diet at a level of 200 g/kg diet at the expense
      of sucrose. 3. On the last day of the experiment, fatty acids synthesis in the
      liver and EWAT was measured using an i.p. injection [1-14C]sodium acetate. 4. The
      decreases in body weight and food intake by dietary sorbose in GTG-injected obese
      mice were greater than those in control mice. 5. Lipid content and fatty acid
      synthesis in the liver and EWAT of control mice were not influenced by dietary
      sorbose. 6. In GTG-injected obese mice, the reduction of food intake by dietary
      sorbose suppressed fatty acid synthesis and lipid deposition in both liver and
      EWAT.

PMID- 1733791
TI  - Rat pulmonary lipoxygenase: dioxygenase activity and role in xenobiotic
      metabolism.
AB  - 1. Dioxygenase activity and the ability of pregnant rat lung lipoxygenase to
      oxidize xenobiotics were examined in vitro under a variety of experimental
      conditions. 2. More than 90% of the dioxygenase activity towards linoleic acid in
      the lung homogenate was found to be associated with the cytosolic fraction. The
      cytosolic enzyme exhibited pH optima at 6.5 and 9.5, the activity being two-fold
      greater at pH 9.5. To observe maximal dioxygenase activity (about 0.7 mumol of 13
      hydroperoxylinoleic acid formed/min per mg protein) at pH 9.5, the presence of
      6.0 mM linoleic acid was required. 3. Benzidine oxidation occurred at maximal
      rate of pH 6.5 when the reaction medium contained 1.0 mM benzidine and 13.5 mM
      linoleic acid. All eight xenobiotics tested were oxidized at significant rates by
      the lung cytosolic lipoxygenase. 4. Both dioxygenase activity and benzidine
      oxidation were inhibited by the inhibitors of lipoxygenase, viz.
      nordihydroguaiaretic acid, BHT, caffeic acid, esculetin, and gossypol, in a
      concentration-dependent manner. 5. The results suggest that oxidation of
      xenobiotics by lipoxygenase may be an important pathway of metabolism in the
      mammalian lung.

PMID- 1733792
TI  - Behaviour of butyrylcholinesterase in the intestinal epithelial cells of starved
      and refed rats.
AB  - 1. The activity and the molecular characteristics of butyrylcholinesterase were
      studied in the epithelial cells of the following intestinal segments: duodenum,
      jejunum, ileum, caecum and colon of starved and refed rats. 2. After starvation,
      the specific activity of the enzyme is found to increase in the jejunum. The same
      level of activity was maintained after refeeding. No notable changes were
      observed in the other intestinal segments after either starvation or refeeding.
      3. The behaviour of aminopeptidase, a well-characterized intestinal enzyme, is
      comparable to that of butyrylcholinesterase, except in the duodenum where the
      aminopeptidase activity is increased after refeeding. 4. In this cell type, BuChE
      is found only in its globular forms (G1, G2 and G4). Starvation resulted in a
      higher value of the sedimentation coefficient of the ileal G2 form, suggesting
      the existence of a complex between the enzyme and non-cholinesterase components.
      5. After refeeding, the sedimentation profile was similar to that of control.

PMID- 1733793
TI  - Changes of malic enzyme activity in the developing rat brain are due to both the
      increase of mitochondrial protein content and the increase of specific activity.
AB  - 1. The pattern of NADP-linked malic enzyme activity estimated in the whole brain
      homogenate did not parallel that found in liver of developing rat. 2. Studies on
      intracellular distribution of malic enzyme in brain showed that the mitochondrial
      enzyme increased about three-fold between 10th and 40th day of life. Thereafter,
      a slow gradual increase to the adult level was observed. 3. The
      extramitochondrial malic enzyme from brain, like the liver enzyme, increased at
      the time of weaning, although to a lesser extent. At day 5 the brain malic enzyme
      was equally distributed between mitochondria and cytosol. 4. During the postnatal
      development, the contribution of the mitochondrial malic enzyme in the total
      activity was increasing, reaching the value approx. 80% at day 150 after birth.
      5. The increase with age of the malic enzyme specific activity was observed in
      both synaptosomal and non-synaptosomal mitochondria, the changes in the last
      fraction being more pronounced. 6. The activity of citrate synthase developed
      markedly between 10-40 postnatal days, increasing about five-fold, while the
      specific activity of the enzyme did change neither in the synaptosomal nor in non
      synaptosomal mitochondria at this period. 7. We conclude that the changes in
      malic enzyme activity in the developing rat brain are mainly due both to the
      increase of mitochondrial protein content and to the increase of specific
      activity of the mitochondrial malic enzyme.

PMID- 1733794
TI  - Determination of the amino acid sequence of adreno-ferredoxin from sheep
      adrenocortical mitochondria.
AB  - 1. An adreno-ferredoxin was purified from sheep adrenocortical mitochondria. 2.
      Its amino acid composition and amino acid sequence were determined chemically. 3.
      It was found to be composed of 127 amino acid residues, including two tyrosyl
      residues. 4. The amino acid sequences of various ferredoxins of the two iron and
      two sulfur type were compared with respect to amino acid homology.

PMID- 1733795
TI  - Molecular cloning and nucleotide sequences of bovine hepato-ferredoxin cDNA;
      identical primary structures of hepato- and adreno-ferredoxins.
AB  - 1. The ferredoxin from bovine liver mitochondria, so-called hepatoredoxin, was
      purified and characterized as to its molecular weight, optical absorption
      spectrum and amino acid composition. 2. These properties were found to be very
      similar to those of adreno-ferredoxin. 3. To clarify the molecular basis of
      tissue specificity, the ferredoxin clones were obtained from a bovine liver
      library and the cDNA sequence of hepato-ferredoxin was determined. 4. The
      nucleotide sequence of hepato-ferredoxin clone was found to be identical to that
      of adreno-ferredoxin clone except for a single nucleotide in the 3' non
      translated region. 5. Identical amino acid sequence of the two ferredoxins was
      confirmed by determining the partial amino acid sequence of the purified hepato
      ferredoxin. 6. The results indicated that the organ specific activity of purified
      ferredoxin could not be explained by the different primary structure nor
      different RNA processing. 7. Other factors may be involved in the tissue specific
      properties of ferredoxins.

PMID- 1733796
TI  - Inhibition of aspartic proteinases by synthetic peptides derived from the propart
      region of human prorenin.
AB  - 1. Five synthetic peptides which together spanned the propart segment of human
      prorenin were tested for their ability to interact with human renin, pepsin,
      gastricsin, cathepsin D, cathepsin E, calf chymosin and the aspartic proteinase
      from Endothia parasitica. 2. While two peptides showed no significant effect with
      any of the enzymes, a further two were cleaved by several enzymes. 3. Only one
      (corresponding to the 32P-43P residues in the propart sequence) acted as a weak
      competitive inhibitor of most of the enzymes.

PMID- 1733797
TI  - Strong ionic interactions between mucins and two basic proteins, mucus proteinase
      inhibitor and lysozyme, in human bronchial secretions.
AB  - 1. Mucins were isolated from sputum from a patient with chronic bronchitis and
      subjected to two different preparation procedures. 2. In the first procedure,
      CsBr density-gradient centrifugation gave rise to two well-separated fractions.
      Mucins recovered in the high-density fraction still contained mucus proteinase
      inhibitor (MPI) and lysozyme (LSZ). 3. Mucins were purified after a second step
      of CsBr density-gradient centrifugation or after gel-filtration chromatography
      with a buffer of high ionic strength, containing 0.5 M NaCl. 4. In the second
      procedure, trichloroacetic acid treatment of whole sputum followed by cation
      exchange chromatography allowed the obtention of a non-retained fraction composed
      of mucins. 5. Gel-filtration in buffer containing 0.5 M NaCl, allowed the release
      of MPI and LSZ from mucins, thus confirming that interactions still occurred
      between those components. 6. The chemical compositions of the mucins isolated by
      the two above procedures were quite similar. 7. These data support the hypothesis
      of the existence of ionic interactions between basic amino acid residues of MPI
      and LSZ and acid residues of the carbohydrate chains of mucins in the secretions
      of the large airways. 8. These interactions could play a role in the protection
      of mucins against proteolysis and consequently in the maintenance of rheological
      properties of the mucus gel in disease.

PMID- 1733798
TI  - Bacterial lipopolysaccharide stimulates phospholipid synthesis and
      phosphatidylcholine breakdown in cultured human leukemia monocytic THP-1 cells.
AB  - 1. De novo synthesis of phospholipid and its catabolism in human leukemia
      monocytic THP-1 cells were investigated. 2. Radiolabelled precursors: [methyl
      3H]chloride, [1,2-14C]ethanolamine and myo-[2-3H]inositol were readily
      incorporated into CHCl3-MEOH extractable lipid fraction as a function of time. 3.
      The radiolabels derived from choline, ethanolamine and inositol were
      preferentially incorporated into PC, PE and PI fraction, respectively. The data
      indicate that de novo PL synthesis takes place, and the CDP-choline pathway is
      operative as a major pathway for PC synthesized in THP-1 cells. 4. Bacterial
      endotoxin dose-dependently stimulated the incorporation of radiolabelled
      precursors. Approximately 50% stimulation in PC and PE synthesis was obtained in
      20 hr, while the incorporation of [3H]inositol was rapidly stimulated by 170%
      within 4 hr, and the stimulation declined drastically thereafter. 5. LPS did not
      alter the radiolabel distribution into PL in any of the three cases. 6. In pulse
      chase studies, the cells prelabelled with radioactive PL were exposed to LPS (1
      micrograms/ml). The breakdown of PC was enhanced about 30% within the first 2 hr
      followed by a stimulated PC synthesis observed in the next 4 hr. In contrast, LPS
      did not induce the hydrolysis of PE and PI. 7. The data indicate that LPS
      produces a broad spectrum of stimulatory effects on PL synthesis and selectively
      stimulates the hydrolysis of PC via phospholipase C/D reaction in THP-1 cells.

PMID- 1733799
TI  - A comparative study of the biological properties of venoms of some old world
      vipers (subfamily viperinae).
AB  - 1. The hemorrhagic, procoagulant, anticoagulant, phosphodiesterase,
      hyaluronidase, alkaline phosphomonoesterase, 5'-nucleotidase, arginine ester
      hydrolase, phospholipase A, L-amino acid oxidase and protease activities of 30
      samples of venoms from nine species (12 taxa) of the old world vipers (Subfamily
      Viperinae) including snakes from the genera Bitis, Causus, Cerastes, Echis,
      Eristicophis and Pseudocerastes, were determined and the Sephadex G-75 gel
      filtration patterns for some of the venoms were also examined. 2. Examination of
      the biological properties of the venoms of the Viperinae tested indicates the
      presence of common venom biological characteristics at the various phylogenic
      levels. 3. Venoms of most species of the Viperinae examined exhibited
      characteristic biological properties at the species level, and this allows the
      differentiation of the Viperinae species by differences in their biological
      properties. 4. Particularly useful for this purpose, are the effects of venom on
      kaolin-cephalin clotting time of platelet poor rabbit plasma and the Sephadex G
      75 gel filtration pattern and arginine ester hydrolase activity of the venom.

PMID- 1733800
TI  - HLA and insulin-dependent diabetes. A protective perspective.
AB  - This article presents a model for the HLA effect in insulin-dependent diabetes
      mellitus (IDDM) that is almost the mirror image of a model suggested by Nepom. In
      the Nepom model, the products of certain HLA alleles are associated with IDDM
      because they bind and present a specific peptide or peptides so as to induce an
      immune response to pancreatic beta-cells; certain other alleles can protect
      against IDDM if they compete strongly for binding of the diabetogenic peptide. My
      model focuses instead on the failure of the immune system to maintain tolerance
      to pancreatic beta-cells. I suggest that the HLA alleles negatively associated
      with IDDM (e.g., DR2 and DQw1) produce products with high affinity for certain
      beta-cell peptide or peptides needed to establish and maintain tolerance to beta
      cells, whereas the alleles that are common in IDDM (e.g., DR3, DR4, and DQw8)
      produce products that have low affinity for the tolerogenic peptide or peptides
      or that bind the peptide or peptides in the wrong orientation or configuration
      for establishing tolerance. I also discuss the multiplicity of HLA loci, alleles,
      and amino acids contributing to IDDM and the fact that the associations of
      specific loci, alleles, and even genotypes with IDDM depend not only on their
      intrinsic properties but also on various population parameters.

PMID- 1733801
TI  - Influence of STZ-induced diabetes on zero-stress states of rat pulmonary and
      systemic arteries.
AB  - Zero-stress states of the main pulmonary arteries and aorta and small systemic
      arteries were determined in 22 nondiabetic and 29 streptozocin (STZ)-induced
      diabetic rats. The zero-stress state of each vessel was obtained by cutting the
      vessel transversely into a series of short rings, then cutting each ring
      radially, which caused the ring to spring open into a sector. Each sector can be
      characterized by its opening angle. The opening angle has strong regional
      dependence. In some regions of rat arteries, the opening angle can be greater
      than 360 degrees. Rats were studied 5, 10, 20, 30, and 40 days after an injection
      of 75 mg/kg body wt i.v. STZ. During diabetes development, the opening angles in
      general increased and reached a plateau in approximately 30 days. The maximum
      change of opening angle over normal lies in the range of 18-105 degrees,
      depending on location. The pulmonary arteries were affected by diabetes as much
      as the systemic arteries. The course of change of the opening angle during
      diabetogenesis was different from those of the serum glucose level and blood
      pressure. Blood pressure in carotid, external iliac, and pulmonary arteries did
      not change significantly in diabetogenesis. To clarify the physiological meaning
      of the opening angle, we measured the circumferential strain in the blood vessel
      wall in homeostatic condition and the residual strain at the no-load state, with
      both strains referred to the zero-stress state. We calculated the corresponding
      stresses in the vessel wall. The circumferential stress in the vessel wall was
      greatly increased by diabetes; great errors will result if the opening angle is
      ignored.

PMID- 1733802
TI  - Effects of streptozocin-induced diabetes and food restriction on quantities and
      source of T4 and T3 in rat tissues.
AB  - Diabetes mellitus and fasting are both associated with low plasma thyroid hormone
      concentrations and loss of body weight. To discriminate between the separate
      effects of energy shortage and insulin, we studied control rats, diabetic rats
      (DM), DM rats treated with insulin (DMI), and rats after modified fasting (MF1
      and MF2; 70 and 30% of normal daily food intake, respectively). In double
      isotopic equilibrium experiments, we determined the tissue thyroxine (T4) and
      triiodothyronine (T3) concentrations and the contribution of local T4-to-T3
      conversion to total T3 in rat tissues; thyroidal T4 and T3 secretion and
      extrathyroidal T3 production were calculated. In DM and DMI rats, plasma T4 and
      T3 decreased; in MF1 and MF2 rats, only plasma T4 decreased. Thyroidal T4
      secretion decreased, whereas that of T3 remained normal. The decrease in tissue
      T4 in MF and DM rats paralleled the decrease in plasma T4. Although plasma T3 did
      not differ in DM and DMI rats, total T3 concentrations in all tissues were not
      the same due to changed uptake of T3 from plasma and local T4-to-T3 conversion;
      these changes were not found in several tissues of MF1 and MF2 rats. Our results
      suggest that the decrease in tissue T4 during diabetes mellitus is due to the
      decrease in plasma T4 caused by the decreased thyroidal secretion, possibly due
      to intracellular energy shortage. The changes in tissue T3 during diabetes
      mellitus are only partly attributable to the same phenomenon; in several tissues,
      the decrease in T3 seems more related to the lack of insulin.

PMID- 1733803
TI  - Chromatographic quantitation of plasma and erythrocyte pentosidine in diabetic
      and uremic subjects.
AB  - Pentosidine is a fluorescent advanced Maillard/glycosylation product and protein
      cross-link present in elevated amounts in skin from diabetic and uremic subjects.
      A high-performance liquid chromatographic (HPLC) assay was developed to
      quantitate pentosidine in plasma and erythrocytes and other tissue proteins with
      low levels of pentosidine. High protein content and presence of basic amino acids
      and O2 during acid hydrolysis led to the formation of fluorescent artifacts that
      could be separated from true pentosidine through combined reverse-phase ion
      exchange HPLC. No true pentosidine was formed during acid hydrolysis of ribated
      protein, suggesting that Amadori products do not generate artifactual pentosidine
      during hydrolysis. With the combined reverse-phase ion-exchange chromatographic
      assay, we found a 2.5-fold (P less than 0.001) and a 23-fold (P less than 0.001)
      elevation of mean +/- SD plasma protein pentosidine in diabetic (2.4 +/- 1.2
      pmol/mg) and uremic (21.5 +/- 10.8 pmol/mg) subjects compared with healthy (0.95
      +/- 0.33 pmol/mg) subjects. Pentosidine in hemolysate was normal in diabetes but
      dramatically elevated in uremia (0.6 +/- 0.4 pmol/mg hemoglobin, P less than
      0.001). Although the precise nature of the pentosidine precursor sugar is
      unknown, plasma pentosidine may be a useful marker for monitoring the biochemical
      efficacy of trials with aminoguanidine or other treatment modalities.
      Furthermore, pentosidine in plasma proteins may act as a signal for advanced
      glycosylation end product-mediated receptor uptake by macrophages and other cells
      and contribute to accelerated atherosclerosis in diabetes and uremia.

PMID- 1733804
TI  - Alterations in cardiac parasympathetic indices in STZ-induced diabetic rats.
AB  - Autonomic neuropathy involving parasympathetic innervation is a complication of
      diabetes mellitus. Biochemical and morphological indices of the parasympathetic
      innervation of the heart were investigated in rats after diabetes mellitus was
      induced with streptozocin (STZ). Choline acetyltransferase (CAT) activity was
      used as a biochemical marker for parasympathetic innervation. Total CAT activity
      within the hearts of diabetic rats was unchanged after 1 and 2 wk of diabetes and
      was significantly reduced after 4, 8, and 12 wk. Morphological changes within the
      cardiac portion of the parasympathetic innervation were assessed at 8 wk when CAT
      activity was decreased. In diabetic rats, there was a reduction in both cardiac
      ganglion cell size and number. In contrast, in insulin-treated STZ-induced
      diabetic rats, ganglion cells were similar in size and number to those in a
      control group given 3-O-methylglucose to prevent induction of diabetes mellitus
      by STZ. Thus, diabetes mellitus is associated with alterations in cardiac
      parasympathetic innervation in rats, and supplemental insulin protects against
      these changes. These alterations may contribute to impaired parasympathetic
      neural control of the heart in diabetes mellitus.

PMID- 1733805
TI  - Effect of vitamin C on glycosylation of proteins.
AB  - Twelve nondiabetic subjects consumed 1 g/day vitamin C for 3 mo. A fasting blood
      sample was taken at the start of the study and at the end of each month for the
      measurement of plasma and intraerythrocyte glucose, vitamin C, glycosylated
      hemoglobin (affinity chromatography and electrophoresis), and glycosylated
      albumin (affinity chromatography). Although there were no significant changes in
      fasting glycemia, glycosylated hemoglobin (affinity chromatography) decreased
      18%, from 6.18 +/- 0.48% (mean +/- SD) at the start to 5.05 +/- 0.50% (P less
      than 0.0001) after 3 mo, whereas, HbA1 measured by electrophoresis increased 16%,
      from 6.17 +/- 0.61 to 7.16 +/- 0.59% (P less than 0.0001) in this period.
      Glycosylated albumin decreased 33%, from 1.56 +/- 0.24 to 1.04 +/- 1.01% (P less
      than 0.0001) after 3 mo. This discrepancy between glycosylated hemoglobin
      measured by electrophoresis and affinity chromatography was due to methodological
      differences between the two techniques, with affinity chromatography measuring
      "true" glycosylated hemoglobin. The greater decrease found with glycosylated
      albumin was probably due to the different distribution of vitamin C between
      plasma and within the erythrocyte, levels after 1 mo of supplementation being 109
      +/- 19 and 59 +/- 9 microM, respectively (P less than 0.001). This indicates that
      administration of oral vitamin C may inhibit the glycosylation of proteins in
      vivo by a competitive mechanism.

PMID- 1733806
TI  - Effect of acute hyperglycemia on glucose metabolism in skeletal muscles in IDDM
      patients.
AB  - The effect of acute hyperglycemia on glucose metabolism in skeletal muscles was
      assessed during replacement insulin infusion in 11 patients with insulin
      dependent diabetes mellitus (IDDM). With a primed continuous [3-3H]glucose
      infusion and indirect calorimetry, glucose metabolism was assessed during a basal
      period (plasma glucose [PG] 5 mM) and during a hyperglycemic period (4-h i.v.
      glucose infusion, PG 12.1 mM). Biopsies were taken from the vastus lateralis
      muscle during both periods. On a control day, glucose metabolism was assessed in
      10 patients during a basal period (PG 5.2 mM) and after 4 h with no glucose
      infusion (PG 4.2 mM). Nonoxidative glucose disposal increased during
      hyperglycemia (32 +/- 7 vs. 51 +/- 9 mg.m-2.min-1, P less than 0.05), whereas
      glucose oxidation remained constant. On the control day, nonoxidative glucose
      disposal decreased from the basal to the second (control) period (33 +/- 7 vs. 22
      +/- 6 mg.m-2.min-1, P less than 0.05), and glucose oxidation remained constant.
      The activity of glycogen synthase in muscle biopsies (fractional velocities [0.1
      and 10 mM glucose 6-phosphate (G6P)]) decreased slightly during hyperglycemia (18
      +/- 2 vs. 12 +/- 2%, P less than 0.05) and on the control day (26 +/- 4 vs. 20 +/
      3%, P less than 0.05). Hyperglycemia increased the intracellular concentration
      of free glucose, corrected for estimated extracellular glucose (0.56 +/- 0.11 vs.
      1.43 +/- 0.19 mM, P less than 0.01), G6P (0.14 +/- 0.04 vs. 0.23 +/- 0.08 mM, P
      less than 0.02), and lactate (2.88 +/- 0.33 vs. 4.46 +/- 0.61 mM, P less than
      0.05), whereas these substrate concentrations remained constant on the control
      day.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1733807
TI  - Cloning and expression of IDDM-specific human autoantigens.
AB  - A DNA cloning approach was taken to identify islet cell protein antigens that are
      recognized specifically by insulin-dependent diabetes mellitus (IDDM) sera. A
      human islet cDNA library was generated and screened with diabetic sera. In this
      article, identification of two clones is described. Proteins expressed by these
      lambda phages appeared to react specifically with newly diagnosed diabetic sera.
      Islet cell antibody 12 (ICA12) was tested by Western blotting. ICA512 was not
      reactive with sera in the Western format but was specifically immunoprecipitated
      by diabetic sera from an Escherichia coli extract.

PMID- 1733808
TI  - Glucose transporter levels in tissues of spontaneously diabetic Zucker fa/fa rat
      (ZDF/drt) and viable yellow mouse (Avy/a).
AB  - We used antibodies to the fat/muscle glucose transporter (GLUT4) and the liver
      glucose transporter (GLUT2) to measure levels of these proteins in various
      tissues of two rodent models of non-insulin-dependent (type II) diabetes
      mellitus: the obese spontaneously diabetic male Zucker fa/fa rat (ZDF/drt) and
      the male viable yellow Avy/a obese diabetic mouse. The ZDF/drt strain generally
      develops overt diabetes associated with decreased plasma insulin levels.
      Depending on the age of the animals, the ZDF/drt rats can be arbitrarily
      segregated into age-matched obese, mildly diabetic (blood glucose less than 11
      mM) and obese, and severely diabetic (blood glucose greater than 20 mM) groups.
      Avy/a mice are comparably hyperglycemic but unlike the ZDF/drt rats are severely
      hyperinsulinemic. In both groups of diabetic animals, GLUT4 in adipose tissue,
      heart, and skeletal muscle was reduced 25-55%, and GLUT2 in liver was increased
      30-40%, relative to lean, age-matched controls. However, when the mildly diabetic
      ZDF/drt rats were compared to the lean controls, the only significant difference
      was a 25% reduction of GLUT4 in heart. Within all of the ZDF/drt rats (excluding
      the lean controls), GLUT2 in liver and GLUT4 in adipose tissue, heart, and
      skeletal muscle correlated significantly with glycemia. These data suggest that,
      in these two models of type II diabetes, glucose transporter levels in muscle,
      adipose tissue, and liver are regulated in a tissue-selective manner in response
      to changes in insulin and glucose. Furthermore, at least in the ZDF/drt rat,
      alterations in GLUT2 and/or GLUT4 protein levels appear not to be associated with
      obesity per se but appear to be secondary to the severely diabetic
      state.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1733809
TI  - Insulin stimulates accumulation and efflux of macromolecules in isolated nuclei
      from H35 hepatoma cells.
AB  - This study used 10-nm gold particles with 5-7 insulin molecules attached (Au10
      Ins) to investigate the site of interaction of insulin with the nuclear envelope
      during insulin uptake into intact isolated nuclei. Despite its size, and in the
      absence of ATP, Au10-Ins entered nuclei through the nuclear pore and associated
      with the heterochromatin. Because Au10-Ins is essentially gold-bovine serum
      albumin (Au-BSA) with a few insulin molecules attached, the effect of insulin and
      other growth factors on the nuclear accumulation of BSA coupled to 10-, 15-, and
      24-nm-diam colloidal gold particles (Au10-BSA, Au15-BSA, and Au24-BSA) was
      determined. The Au-BSA complexes were excluded from nuclei in the absence of
      insulin. Insulin (0.5-100 ng/ml) caused a dose-dependent accumulation of Au10-BSA
      in the nucleus. The nuclear membrane was shown to be intact by several criteria,
      therefore, accumulation of Au-BSA occurred via the nuclear pore and was not due
      to leakage across or through the membrane. Uptake of 15- and 24-nm Au-BSA
      molecules was not affected by insulin, suggesting the hormone had a limited
      effect in increasing the functional diameter of the nuclear pores. Glucagon,
      epidermal growth factor, platelet-derived growth factor, insulinlike growth
      factor I, and insulin A or B chains did not stimulate the accumulation of Au10
      BSA. The insulin-stimulated accumulation of Au10-BSA was blocked by concanavalin
      A, mimicked by wheat-germ agglutinin, and did not require ATP. The Au10-BSA in
      the nucleus was associated with heterochromatin, suggesting it bound to a nuclear
      element.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1733810
TI  - Association of HbA1c with prevalent cardiovascular disease in the original cohort
      of the Framingham Heart Study.
AB  - We studied the cross-sectional relationship between HbA1c and cardiovascular
      disease (CVD) in the survivors of the original cohort of the Framingham Heart
      Study (n = 1045). HbA1c was significantly related to prevalent CVD among women
      but not men. HbA1c was also related to hypertension and to the ratio of total to
      high-density lipoprotein cholesterol levels. In regression analyses that
      controlled for these and other potential risk factors, HbA1c remained
      significantly related to CVD among women. The relative odds of CVD increased 1.39
      fold (95% confidence interval 1.06-1.83) for increases in HbA1c of 1% (e.g., for
      HbA1c from 5 to 6%). The relationship was not weakened when known diabetic
      subjects or subjects taking beta-blocker or thiazide medications were excluded
      from analysis. In contrast, there was no significant relationship between
      "casual" blood glucose and prevalent CVD. Our results reveal a strong,
      significant, independent association between hyperglycemia, measured by HbA1c,
      and CVD among older women.

PMID- 1733811
TI  - Exaggerated sensitivity to NE-induced vasoconstriction in IDDM patients with
      microalbuminuria. Possible etiology and diagnostic implications.
AB  - Increased urinary albumin excretion rate (AER) in the microalbuminuric phase of
      diabetic nephropathy has been attributed to intraglomerular hypertension. This
      could be caused by constriction of efferent glomerular arterioles, which carry
      alpha-adrenoceptors. We tested the hypothesis that insulin-dependent diabetes
      mellitus (IDDM) patients with microalbuminuria are hypersensitive to
      vasoconstriction induced by norepinephrine (NE). We studied 15 IDDM patients with
      microalbuminuria (AER 32-295 mg/24 h), 13 IDDM patients with normal AER (5-24
      mg/24 h), and 9 nondiabetic subjects (AER 8-22 mg/24 h). All were normotensive.
      NE-induced vasoconstriction was measured in dorsal hand veins, which carry alpha
      receptors similar to those of glomerular efferent arterioles. Vein diameter was
      measured with a linear displacement probe during a stepped NE infusion (1-32
      ng/min) into the vein, and venoconstriction was expressed as a percentage of the
      maximum passively distended venous diameter. Microalbuminuric IDDM patients
      exhibited significantly greater vasoconstriction (P less than 0.005) at all NE
      infusion rates than both other groups. The NE infusion rate producing 50% of
      maximal venoconstriction (ED50) in the microalbuminuric IDDM group (median 1.1
      ng/min, range 0.2-25.2 ng/min) was significantly less than in both the
      normoalbuminuric IDDM group (median 12.5 ng/min, range 4.9-40.5 ng/min, P =
      0.00007) and the nondiabetic group (median 17.7 ng/min, range 5.9-42.2 ng/min, P
      = 0.0003). Dose-response curves and ED50 did not differ significantly between
      normalbuminuric IDDM and nondiabetic groups. IDDM patients with microalbuminuria
      are hypersensitive to NE-induced vasoconstriction.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1733812
TI  - Subcellular localization of GLUT4 in nonstimulated and insulin-stimulated soleus
      muscle of rat.
AB  - Soleus muscles of fed rats were fixed by vascular perfusion with
      paraformaldehyde; individual fibers were teased and immunostained with a
      polyclonal antibody against the COOH-terminal of GLUT4. The binding sites were
      visualized by a horseradish peroxidase-coupled secondary antibody and
      diaminobenzidine. The fibers were embedded in epoxy resin and studied by electron
      microscopy. Strong immunoreactivity was found in subsarcolemmal clusters of
      vesicles and cisternae, Golgilike structures, and triadic junctions. Clusters of
      vesicles between myofibrils were occasionally stained. The plasma membrane was
      unlabeled. However, the plasma membrane was labeled when the rats had been
      injected with insulin (40 U/kg body wt) 15 min before perfusion fixation. In non
      insulin-injected rats, the plasma membrane might show spotty staining close to
      clusters of intensely labeled subsarcolemmal vesicles. This may have been due to
      diffusion but may also indicate that there are domains of GLUT4 in the plasma
      membrane of nonstimulated fibers or that the endogenous insulin activity to some
      extent had translocated GLUT4 from the intracellular pool into the plasma
      membrane. Coated vesicles that were also labeled were found adjacent to
      subsarcolemmal vesicles and cisternae; it is possible that coated vesicles play a
      role during insulin- or contraction-induced translocation of GLUT4 between
      subsarcolemmal pool and plasma membrane. It has been proposed that glucose uptake
      into skeletal muscle fibers takes place across the t-tubule membrane rather than
      across the plasma membrane. This would explain the presence of GLUT4 at triadic
      junctions. Alternatively, we suggest that GLUT4 in t-tubules represents a second
      intracellular pool.

PMID- 1733813
TI  - Tissue-specific regulation of basic fibroblast growth factor mRNA levels by
      diabetes.
AB  - Because basic fibroblast growth factor (bFGF) is recognized as an angiogenic
      factor and diabetes is characterized by multiple vascular complications,
      including diabetic microangiopathy, we examined the regulation of tissue bFGF
      mRNA levels by diabetes. Diabetes was induced in male Sprague-Dawley rats by
      injection of 125 mg/kg body wt i.v. streptozocin (STZ), with intensive insulin
      therapy initiated in half of the diabetic rats. Rats were killed 96 h
      postinjection of STZ. Tissue bFGF and insulinlike growth factor I (IGF-I) mRNA
      levels were measured simultaneously with a solution hybridization-RNase
      protection assay. bFGF mRNA levels increased from 1.7- to 2.7-fold in eye, heart,
      lung, and brain from diabetic compared with buffer-injected control rats. In
      skeletal muscle, bFGF mRNA levels decreased to 23% of control levels, whereas
      bFGF mRNA levels were unchanged in kidneys from diabetic versus control rats.
      Changes in tissue bFGF mRNA levels were partially reversed by insulin treatment
      in all tissues. In contrast, IGF-I mRNA levels were significantly decreased from
      15 to 50% of control levels in all tissues studied except those in brain, which
      decreased to only 85% of control levels. These data demonstrate that bFGF mRNA
      levels are altered by diabetes in a tissue-specific fashion and are consistent
      with the hypothesis that increased production of bFGF may contribute to the
      development of diabetic microangiopathy in some tissues.

PMID- 1733814
TI  - Insulin-stimulated glucose transport in circulating mononuclear cells from
      nondiabetic and IDDM subjects.
AB  - The objectives of this study were 1) to evaluate glucose transport and its
      regulation by insulin in easily accessible human cells, 2) to investigate the
      glucose transporter isoforms involved, and 3) to establish whether a defect in
      glucose transport is associated with peripheral insulin resistance, which is
      common in insulin-dependent diabetes mellitus (IDDM) patients. We measured 2
      deoxyglucose (2-DG) uptake in circulating mononuclear cells from 23 nondiabetic
      adults, 16 adults with IDDM, and 10 children with IDDM. Circulating mononuclear
      cells were separated from whole blood by Ficoll gradients and incubated with +/-
      1 nM insulin. 2-DG uptake was measured after incubation with [3H]2-DG and cell
      separation through corn oil-phthalate. Cytochalasin B-inhibitable 2-DG uptake
      (basal and insulin stimulated) was higher in control than in IDDM subjects (P
      less than 0.001). Insulin significantly increased 2-DG uptake or 3-O
      methylglucose uptake in both groups. Basal and insulin-stimulated 2-DG uptake was
      similar for adults and children with IDDM and did not correlate with age or body
      mass index in any group or disease duration, insulin dosage, or HbA1c in IDDM. In
      separated monocytes and lymphocytes, 2-DG uptake increased in response to insulin
      only in the monocyte population. Insulin dose-response curves indicated maximal
      stimulation of hexose uptake at 1-2 nM insulin for both control and diabetic
      subjects and demonstrated a significant decrease in maximal insulin response in
      the latter. Immunoblotting with specific antibodies revealed that circulating
      mononuclear cells and separated monocytes express the GLUT1 but not the GLUT4
      isoform of the glucose transporter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1733815
TI  - Duration of obesity increases the incidence of NIDDM.
AB  - The effect of duration of obesity on incidence of non-insulin-dependent diabetes
      mellitus (NIDDM) was determined among Pima Indians. Duration of obesity was
      defined as the time since body mass index (BMI) was first known to be at least 30
      kg/m2. Among 1057 participants eligible for study, there were 224 incident cases
      of NIDDM in 5975 person-yr of follow-up. The association of duration of obesity
      with incidence of diabetes adjusted for age, sex, and current BMI was highly
      significant (P less than 0.0001). This adjusted incidence of diabetes in
      cases/1000 person-yr of obesity was 24.8 for people with less less than 5 yr of
      obesity, 35.2 for people with 5-10 yr of obesity, and 59.8 for people with at
      least 10 yr of obesity. There was no apparent excess risk of diabetes for people
      who had a BMI of at least 30 kg/m2 and then lost weight. They had a slightly
      nonsignificantly higher rate than people who had not attained a BMI of at least
      30 kg/m2 and a lower rate than people whose BMI remained 30-35 kg/m2. The
      relationship of duration of obesity with serum insulin concentrations among
      nondiabetic people was determined controlling for sex and age, BMI, and plasma
      glucose concentrations at the time of a glucose tolerance test. Duration of
      obesity was inversely associated with fasting serum insulin concentration through
      most of the range of fasting plasma glucose concentrations (P less than 0.001)
      and tended to be inversely associated with 2-h postload serum insulin
      concentration through the entire range of postload plasma glucose concentrations
      (P = 0.058).

PMID- 1733816
TI  - Dose-response relationship between lymph insulin and glucose uptake reveals
      enhanced insulin sensitivity of peripheral tissues.
AB  - To examine the role of transcapillary insulin transport to peripheral insulin
      sensitivity in vivo, we performed dose-response experiments in which both plasma
      and thoracic duct lymph insulin and glucose utilization (Rd) were measured in
      conscious dogs. Euglycemic clamps (n = 22) consisted of a 3-h activation period
      in which insulin was infused (rates: "physiological" 3.6, 5.4, 7.2 pmol.min-1.kg
      1; "pharmacological" 108 pmol.min-1.kg-1), followed by a 3-h deactivation period.
      [14C]inulin was also infused as a diffusionary marker. Insulin sensitivity was
      estimated as the ED50. When based on plasma insulin, ED50 was 480 pM. However,
      when calculated from lymph (i.e., interstitial) insulin measurements, ED50 was
      240 pM. Thus, interstitial insulin measurements reveal that insulin sensitivity
      of peripheral tissues is approximately twice that estimated from plasma insulin
      and is similar to sensitivity reported for suppression of hepatic glucose
      production. Furthermore, although [14C]inulin achieved equilibrium between plasma
      and lymph within 180 min, within the physiological range, steady state plasma
      insulin was higher than insulin in lymph (306 +/- 18, 474 +/- 42, and 780 +/- 60
      pM vs. 180 +/- 18, 318 +/- 12, and 504 +/- 36 pM; P less than 0.0001); plasma
      insulin achieved steady state faster than lymph insulin (6 +/- 1, 6 +/- 2, and 11
      +/- 3 min vs. 29 +/- 4, 16 +/- 6, and 44 +/- 8 min; P less than 0.01) and
      disappeared faster (5 +/- 2, 7 +/- 2, and 15 +/- 6 min vs. 37 +/- 8, 32 +/- 4,
      and 43 +/- 9 min; P less than 0.01). The time course of lymph insulin at each
      dose was similar to that of Rd, and at each dose, unlike plasma insulin, lymph
      insulin was strongly correlated with Rd (r = 0.93 or better). At pharmacological
      hyperinsulinemia (plasma 35232 +/- 5250 pM, lymph 27366 +/- 4380 pM), Rd rose
      faster than lymph insulin and disappeared more slowly than insulin. Thus, lymph
      insulin data indicate that the periphery is more sensitive to insulin than
      previously realized from estimates based solely on plasma hormone. Furthermore,
      lymph insulin is proportional to Rd within the physiological but not
      pharmacological range of insulin, indicating that transcapillary insulin
      transport is rate limiting for insulin action in this range. Finally, based on in
      vivo lymph (i.e., interstitial) insulin measurements, peripheral tissue is almost
      twice as sensitive to insulin than previously realized.

PMID- 1733817
TI  - Visually impaired children's visual characteristics and intelligence.
AB  - The results are presented of the mentally normal, visually impaired, Braille
      educated population of Dutch and Dutch-speaking Belgian children on verbal and
      non-verbal tests of intelligence and school achievement. The children were aged
      between six and 15 years old. Their visual characteristics were strongly inter
      related and correlated similarly with the test scores. Colour perception did not
      contribute to the intelligence test score variation after controlling for near
      visual acuity. Congenital blindness had a positive influence on verbal memory and
      a negative influence on spatial ability.

PMID- 1733818
TI  - Herpes simplex virus encephalitis: problems in diagnosis.
AB  - Six children aged 13 days to nine years with herpes simplex encephalitis (HSE)
      are presented. Institution of appropriate antiviral treatment was later than six
      days in three cases; original diagnosis in these cases were post-traumatic
      epilepsy, bacterial meningitis and febrile convulsion. Initially pyrexia was
      absent in two cases and cranial CT was normal in two cases. Encephalitic changes
      were observed on the EEGs of five children. Diagnosis was confirmed by paired
      serological titres, brain biopsy, vesicle culture and CSF titres. The outcome for
      all six children was poor. HSE should always be considered in children presenting
      with focal seizures, even when apyrexial and with normal CT findings. In such
      situations, saving CSF for antibody titres or antigen identification should be
      routine practice. Treatment with acyclovir is justified before precise
      virological diagnosis has been established.

PMID- 1733819
TI  - Oral-motor dysfunction and feeding disorders of infants with Turner syndrome.
AB  - The oral-motor function of 10 infants with Turner syndrome and their age- and sex
      matched controls were assessed during feeding. In addition to well-recognised
      dysmorphic features, including oral anomalies and high-arched palates, index
      infants had marked hypotonia of the cheeks and lips, dysfunctional tongue
      movements and poorly developed chewing skills. Their meal-times were
      significantly shorter than those of the controls and they weighed significantly
      less at six, 12 and 15 months. All mothers of infants with Turner syndrome
      complained of difficulties feeding their children and these problems often had
      been present since birth.

PMID- 1733820
TI  - Isosorbide in the medical management of hydrocephalus in children with
      myelodysplasia.
AB  - Fourteen children with hydrocephalus associated with myelodysplasia were given
      isosorbide (8 to 12 g/kg/day) and compared with 17 children managed without it.
      Three of the treated and three of the untreated children did not require
      shunting. The mean interval between back closure and shunt placement was 33 days
      for the controls and 115 days for the treated children. Two of the treated
      children developed gastro-intestinal symptoms that necessitated withdrawal of the
      isosorbide. Although isosorbide did extend the interval between back closure and
      shunt placement, its side-effects and the availability of alternative treatments
      render it unsuitable for the management of hydrocephalus in children with
      myelodysplasia.

PMID- 1733821
TI  - The effect of pethidine on the neonatal EEG.
AB  - Thirty-two preterm infants were monitored with an on-line cotside EEG system for
      periods of up to nine days. Changes in the normal pattern of discontinuity of the
      EEG were seen in association with pethidine administration. The duration of the
      EEG suppression after pethidine administration was greatest after the first dose
      and progressively less with subsequent doses. It was not related to the
      gestational maturity or postnatal age at which the dose was given. This system of
      EEG analysis allowed recognition of this previously undescribed effect of
      pethidine on the neonatal EEG, and should have application to monitoring the
      effects of brain function of other drugs in routine neonatal practice.

PMID- 1733822
TI  - Positional asphyxia in individuals with severe cerebral palsy.
AB  - The authors report the accidental death by positional asphyxia of three
      individuals with cerebral palsy occurring after they had been placed in bed for
      the night. During the five-year period between 1984 and 1989, 12 per cent of
      deaths from positional asphyxia in King County, Washington, involved individuals
      with cerebral palsy. Such accidents are similar to those occurring among healthy
      young children, perhaps because both groups have limited motor skills. Further
      research into accidents among disabled persons may clarify their special risks
      and possibly lead to modifications in bed design.

PMID- 1733823
TI  - Chiari malformation type I in a child with velopharyngeal insufficiency.
AB  - A five-year-old girl was referred for chronic and stable velopharyngeal
      insufficiency. Pharyngoplasty was performed, without significant improvement, and
      further neurological investigation was undertaken. Clinical examination and
      electromyography led to a suspicion of denervation of the IX, X and XI cranial
      nerves. Magnetic resonance imaging revealed a type 1 Chiari malformation.

PMID- 1733824
TI  - Holoprosencephaly with retroprosencephalic extracerebral cyst.
AB  - The authors report holoprosencephaly combined with an enormous extracerebral glio
      ependymal cyst in the superior cistern of a 10-week-old boy. The cyst had
      compressed the holosphere at the floor of the anterior fossa and had caused
      herniation of the cerebellar vermis and tonsils at the foramen magnum, along with
      ascending cervical roots. This uncommon combination of lesions clinically may
      mimic hydranencephaly or hydrocephalus.

PMID- 1733825
TI  - Carrier detection and prenatal diagnosis of alpha-thalassemia of Southeast Asian
      deletion by polymerase chain reaction.
AB  - Alpha-thalassemia of Southeast Asian deletion (-- SEA/) is very common in
      Southeast Asia. Homozygosity of this genotype is the major cause of Hb Bart's
      hydrops fetalis in Taiwan. With polymerase chain reaction using three
      oligonucleotide primers bridging the common deletion breakpoint, a DNA fragment
      of 194 basepairs (bp) was amplified in chromosomes with the -- SEA determinant
      and a DNA fragment of 287 bp was amplified in chromosomes without this deletion.
      In our pilot study including 8 normal subjects, 20 obligate carriers, and 11
      homozygotes of the deletion, all the genotypes were determined and then confirmed
      by Southern blotting and DNA hybridization with phi zeta globin gene probe. For
      prenatal diagnosis, 55 at-risk pregnancies were collected. Chorionic villus
      sampling was done in 51 cases and early amniocentesis was done in 4 cases.
      Fourteen cases (25.5%) were diagnosed as normal, 25 (45.5%) as heterozygotes, and
      16 (29%) as homozygotes of -- SEA. All of the diagnoses were also confirmed as
      aforementioned. With polymerase chain reaction, the determination of the -- SEA
      deletion is straightforward and is much quicker and easier than with conventional
      Southern blotting and DNA hybridization. In areas with a high prevalence of --
      SEA deletion, this method provides a rapid tool for carrier detection and
      prenatal diagnosis.

PMID- 1733826
TI  - Parental origin and germline mosaicism of deletions and duplications of the
      dystrophin gene: a European study.
AB  - Knowledge about the parental origin of new mutations and the occurrence of
      germline mosaicism is important for estimating recurrence risks in Duchenne (DMD)
      and Becker muscular dystrophy (BMD). However, there are problems in resolving
      these issues partly because not all mutations can as yet be directly detected,
      and additionally because genetic ratios are very sensitive to ascertainment bias.
      In the present study, therefore, analysis was restricted to currently detectable
      mutations (deletions and duplications) in particular types of families which tend
      to be rare. In order to obtain sufficient data we pooled results from 25 European
      centers. In mothers of affected patients who were the first in their family with
      a dystrophin gene deletion or duplication, the ratio between the paternal and the
      maternal origin of this new mutation was 32:49 (binomial test P = 0.075) for DMD.
      In five BMD families the ratio between paternal and maternal origin of new
      mutations was 3:2. Recurrence risk because of maternal germline mosaicism was
      studied in sisters or subsequent sibs of isolated cases with an apparently new
      detectable mutation. In 12 out of 59 (0.20; 95% CI 0.10-0.31) transmissions of
      the risk haplotype the DMD mutation was transmitted as well. No recurrences were
      found in nine BMD families.

PMID- 1733827
TI  - Birth and population prevalence of Duchenne muscular dystrophy in The
      Netherlands.
AB  - Mutations causing Duchenne muscular dystrophy (DMD) have a short survival.
      Therefore, birth and population prevalence are maintained by new mutations. The
      present inventory was made to estimate the birth and population prevalence rates
      of DMD in the Netherlands. Seven methods of case identification were used. Data
      on 496 definite, probable or possible DMD patients born since 1961, or alive on
      January 1, 1983, were obtained. Several methods gave an estimated ascertainment
      of more than 95%. The prevalence rate at birth of DMD was estimated at 23.7 x 10(
      5) (1:4215) male live births (MLB) yearly. The prevalence rate in the male
      population on January 1, 1983 was 5.4 x 10(-5) (1:18496). About 1% of the males
      in this study may have autosomal recessive Duchenne-like muscular dystrophy.
      Until now there has been no convincing evidence for geographic differences in DMD
      prevalence at birth. A list of frequency studies of Duchenne muscular dystrophy
      is included. The DMD mutation rate calculated by the indirect method is 7.9 x 10(
      5) genes per generation. However, this may well be an over-estimate, as this
      method does not account for germline mosaicism. Using a modified sex ratio method
      the proportion of sporadic DMD among all cases was estimated to be 0.106 (range 0
      0.332). High frequency of germline mosaicism in DMD is a likely cause for the
      apparent lack of sporadic cases as found in previous studies, if mutation rates
      in male and female gametes are equal. Therefore, methods for estimating the
      proportion of new mutants in DMD should take germline mosaicism into account. The
      modified sex ratio method allows incorporation of data on germline mosaicism if
      available.

PMID- 1733828
TI  - Heterozygote deficiency, population substructure and their implications in DNA
      fingerprinting.
AB  - Substructured populations exhibit an overall deficiency of heterozygosity whose
      proportional magnitude depends on the nature of substructuring, i.e., the number
      of subpopulations (s), their time of divergence (t) from the ancestral
      population, and the rate of gene flow amongst them (m). Since apparent
      heterozygote deficiency could be caused by many factors other than population
      substructuring, one must examine the nature of substructuring that could produce
      the observed extent of heterozygote deficiency, in order to infer the
      substructuring from an observed heterozygote deficiency. Using the equivalence of
      proportional heterozygote deficiency and the coefficient of gene differentiation
      (GST), we can generate isolines of GST as functions of s, t (in units of 2Ne
      generations, Ne being the effective population size) and m. Analytical results
      suggest that large GST values cannot be reached by substructuring alone, unless
      the number of subpopulations are large and they remain isolated over a long
      period of time. Application of the theory to population data on six variable
      number of tandem repeats (VNTR) loci in US Caucasians and US Blacks demonstrates
      that the observed heterozygote deficiencies at these loci cannot be explained by
      substructuring within these populations alone. This is so because such large
      values of GST (3%-10%) would require an absence of gene exchange between the
      subpopulations and a divergence time from each other of at least 25,000 years
      ago, neither of which is compatible with the demography and ethnohistory of US
      Caucasians and Blacks. In contrast, the inability to detect extreme-sized alleles
      and/or incomplete resolution of nearly similar-sized alleles following Southern
      gel electrophoresis could easily explain the observed heterozygote deficiencies.
      The implications of these results are discussed in the context of the forensic
      use of DNA-typing data, and justify the employment of population genetic
      principles in forensic genetics.

PMID- 1733829
TI  - Ewing's tumor X mouse hybrids expressing the MIC2 antigen: analyses using
      fluorescence CDD-banding and non-isotopic ISH.
AB  - We present a highly sensitive method that has been applied to map the chromosomal
      origin of the prominent cell surface antigen of Ewing's tumor cells recognized by
      monoclonal antibody HBA-71. The technique allows an unambiguous identification of
      human chromosomal material in interspecific cell hybrids. This is achieved by
      fluorescent in situ hybridization of biotinylated total human DNA, followed by
      high resolution fluorescence banding with the chromomycin/distamycin/DAPI triple
      stain. An advantage of this method is that all signals can be visualized in one
      single operation by simply switching the appropriate filter blocks. The protocol
      has proved extremely useful in gene mapping by means of interspecific cell
      hybrids, a technique that depends on the accurate and unambiguous recognition of
      the relevant (e.g., human) genetic material in the clonal genome. Our studies
      confirm that this antigen is the product of the MIC2 gene, which is so far the
      only well-studied pseudoautosomal gene in man, and which is located on the short
      arms of chromosomes X and Y. Furthermore, no influence of the Ewing's tumor
      specific translocation t(11;22) on MIC2 expression could be discerned.

PMID- 1733830
TI  - Mosaicism in 45,X Turner syndrome: does survival in early pregnancy depend on the
      presence of two sex chromosomes?
AB  - Cytogenetic and molecular genetic findings in 91 patients with Turner syndrome
      are reported. In 87 patients, chromosome studies were carried out both in
      lymphocyte and fibroblast cultures. Mosaicism was demonstrated in 58 of these
      patients (66.7%), whereas only 18 (20.7%) were apparent non-mosaic 45,X, and 11
      patients (12.6%) showed non-mosaic structural aberrations of the X chromosome.
      Among the mosaic cases 16 (18.4% of all patients) displayed a second cell line
      containing small marker chromosomes. The association of Y-specific chromosomal
      material with the presence of marker chromosomes was demonstrated in 6 out of 7
      mixoploid fibroblast cell lines by polymerase chain reaction amplification and by
      Southern-blot analysis. The observation of ring formation and morphological
      variability in vivo and in vitro, and the continuous reduction in the percentage
      of cells containing marker chromosomes in longterm cultivation experiments
      indicated an increased instability of marker chromosomes. The findings suggest
      that in vivo selection of structurally altered sex chromosomes exists. Thus, the
      observation of apparent non-mosaic 45,X chromosomal complements in liveborn
      individuals with Turner syndrome does not contradict the hypothesis that some
      degree of mosaicism is necessary for survival in early pregnancy.

PMID- 1733831
TI  - Chromosomal localization of the human glycoasparaginase gene to 4q32-q33.
AB  - Glycoasparaginase cleaves the N-glycosidic linkage between asparagine and N
      acetylglucosamine in the degradation of glycoproteins. In humans, a deficient
      activity of glycoasparaginase results in accumulation of glycoasparagines,
      causing the lysosomal storage disease aspartylglycosaminuria. Recombinant plasmid
      containing the cDNA insert encoding human glycoasparaginase was used to localize
      the enzyme to chromosome 4q32-q33 by in situ hybridization to metaphase
      chromosomes prepared from normal human lymphocytes.

PMID- 1733832
TI  - Exclusion map of Salla disease: attempts to localize the disease gene using a
      computer program.
AB  - Salla disease is a lysosomal storage disorder due to impaired transport of free
      sialic acid across the lysosomal membrane. The clinical presentation of this
      autosomal recessive trait is severe psychomotor retardation from early infancy
      on. In order to determine the gene locus for the disease we have initiated a
      genetic linkage study using polymorphic gene markers in representative family
      material comprising about 60% of all families known to be affected with Salla
      disease. Here we present an exclusion map based on combined linkage data from 64
      informative loci on 19 autosomes. Theoretically, at least 55% of the genome has
      been excluded as a locus for the disease gene, while some chromosome areas,
      particularly the long arm of chromosome 2, are highlighted as possible sites for
      the gene locus.

PMID- 1733833
TI  - Apolipoprotein E phenotypes and hyperlipidemia in patients under maintenance
      hemodialysis.
AB  - Apolipoprotein E phenotypes and gene frequencies were determined in 560 patients
      receiving long-term hemodialysis. In addition, fasting plasma lipid- and
      apolipoprotein-concentrations were evaluated in 245 of these individuals. The
      distribution of the three major apolipoprotein E alleles (epsilon 4, epsilon 3,
      and epsilon 2) and that of the six common apolipoprotein E phenotypes (E4/4,
      E3/3, E2/2, E4/2, E4/3, and E3/2) in the dialysis group was nearly identical to
      that of healthy controls. Patients with the apolipoprotein E phenotypes E2/2,
      E4/4 and E4/3 (comprising 24% of the whole group) had higher mean plasma
      cholesterol- and triglyceride-concentrations than those with the apolipoprotein E
      phenotypes E3/3 and E3/2 (72% of the whole group). Thus, the genetic polymorphism
      of apolipoprotein E may contribute to the individual risk of accelerated
      atherosclerosis in patients under maintenance hemodialysis.

PMID- 1733834
TI  - Heterogeneity of mutations in the uroporphyrinogen III synthase gene in
      congenital erythropoietic porphyria.
AB  - Congenital erythropoietic porphyria (CEP) or Gunther's disease is an inborn error
      of heme biosynthesis transmitted as an autosomal recessive trait and
      characterized by a profound deficiency of uroporphyrinogen III synthase (UROIIIS)
      activity. We have previously described two missense mutations in the UROIIIS
      gene, confirming that the primary defect responsible for CEP is a structural
      alteration of this gene. We have extended our work to 5 additional unrelated
      families. Two new point mutations, a deletion and an insertion have been found in
      the messenger RNA. Our study shows that a molecular heterogeneity of the
      mutations exists in Gunther's disease. One mutation (C73R), however, appears to
      be more frequent than the others. Finally, the different normal and mutated
      proteins have been expressed in Escherichia coli to determine the consequence of
      the mutations on the enzyme activity.

PMID- 1733835
TI  - A family with RP3 type of X-linked retinitis pigmentosa: an association with
      ciliary abnormalities.
AB  - The results of linkage analysis in a family with X-linked retinitis pigmentosa
      (XLRP) are presented. Probe M27B (DXS255), localized to Xp11.22, was only loosely
      linked to XLRP, whereas pHOC3 (OTC), in the more distal Xp21.1 region, was
      tightly linked. In this family, the conditional probability of an RP3 locus (in
      Xp21.1-p11.4) was found to be 0.978 compared with 0.021 for an RP2 locus (in
      Xp11.4-p11.2). Risk assessment showed that 2 out of 4 "at risk" females showing
      no clinical abnormality have a high probability of being genetic carriers of
      XLRP. Some affected males have recurrent respiratory infections as a result of a
      condition indistinguishable from the immotile cilia syndrome; indeed, there is an
      association between XLRP and susceptibility to respiratory infections in the
      majority of affected males. The possibility that previously observed ciliary
      abnormalities in XLRP patients might be associated specifically with an RP3 locus
      abnormality is discussed.

PMID- 1733836
TI  - Distribution of ADH2 and ALDH2 genotypes in different populations.
AB  - The distribution of the human liver alcohol dehydrogenase, ADH2, and aldehyde
      dehydrogenase, ALDH2, genotypes in 21 different populations comprising
      Mongoloids, Caucasoids, and Negroids was determined by hybridization of the
      amplified genomic DNA with allele-specific oligonucleotide probes. Whereas the
      frequency of the ADH1(2) allele was found to be relatively high in the
      Caucasoids, Mexican Mestizos, Brazilian Indios, Swedish Lapps, Papua New Guineans
      and Negroids, the frequency of the ADH2(2) gene was considerably higher in the
      Mongoloids and Australian Aborigines. The atypical ALDH2 gene (ALDH2(2)) was
      found to be extremely rare in Caucasoids, Negroids, Papua New Guineans,
      Australian Aborigines and Aurocanians (South Chile). In contrast, this mutant
      gene was found to be widely prevalent among the Mongoloids. Individuals
      possessing the abnormal ALDH2 gene show alcohol-related sensitivity responses
      (e.g. facial flushing), have the tendency not to be habitual drinkers, and
      apparently suffer less from alcoholism and alcohol-related liver disease.

PMID- 1733837
TI  - Molecular abnormality of a Japanese glucose-6-phosphate dehydrogenase variant
      (G6PD Tokyo) associated with hereditary non-spherocytic hemolytic anemia.
AB  - The entire coding sequence of a Japanese class 1 variant (G6PD Tokyo) was
      amplified by the polymerase chain reaction from genomic DNA. Nucleotide analysis
      by a direct sequencing technique revealed a unique nucleotide substitution (1246
      G to A) in exon 10, which predicts a Glu to Lys substitution at the 416th amino
      acid. This is another member of a conspicuous mutation cluster surrounding the
      putative NADP-binding domain.

PMID- 1733838
TI  - Localisation of the gene for Norrie disease to between DXS7 and DXS426 on Xp.
AB  - A highly informative microsatellite marker, DXS426, which maps proximal to DXS7
      in the interval Xp11.4-Xp11.23, has been used to refine further the localisation
      of the gene for Norrie disease (NDP). The results from a multiply informative
      crossover localize the NDP gene proximal to DXS7. In conjunction with information
      from 2 NDP patients who have a deletion for DXS7 but not for DSX426, our data
      indicate that the NDP gene lies between DXS7 and DXS426 on proximal Xp.

PMID- 1733839
TI  - Familial synovial chondromatosis combined with dwarfism.
AB  - In a family with synovial chondromatosis affecting at least three, presumably
      five members, the articular disorder was combined with dwarfism. The persons with
      joint disorders were below the third percentile in body height, but family
      members with normal articular function had normal height. We believe this to be
      the first description of a combination of synovial chondromatosis with
      genetically caused dwarfism.

PMID- 1733840
TI  - A possible example of gene conversion with a common beta-thalassemia mutation and
      Chi sequence present in the beta-globin gene.

PMID- 1733841
TI  - Germinal "mosaicism"--germline mutation or chimerism?

PMID- 1733842
TI  - Prader-Willi or Angelman syndrome in familial 15q11----q13 deletion of maternal
      origin?

PMID- 1733843
TI  - Triple trisomy in a spontaneous abortion.

PMID- 1733844
TI  - High population incidence of the 15p marker D15Z1 mapping to the short arm of one
      homologue 14.

PMID- 1733845
TI  - Chromosome 15p marker D15Z1 frequently maps to the short arm of other D-group
      chromosomes.

PMID- 1733846
TI  - Delineation of genetic predisposition to multifactorial disease: a general
      approach on the threshold of feasibility.

PMID- 1733847
TI  - Rapid physical mapping of cloned DNA on banded mouse chromosomes by fluorescence
      in situ hybridization.
AB  - Physical mapping of DNA clones by nonisotopic in situ hybridization has greatly
      facilitated the human genome mapping effort. Here we combine a variety of in situ
      hybridization techniques that make the physical mapping of DNA clones to mouse
      chromosomes much easier. Hybridization of probes containing the mouse long
      interspersed repetitive element to metaphase chromosomes produces a Giemsa-like
      banding pattern which can be used to identify individual Mus musculus, Mus
      spretus, and Mus castaneus chromosomes. The DNA binding fluorophore, DAPI, gives
      quinacrine-like bands that can complement the hybridization banding data.
      Simultaneous hybridization of a differentially labeled clone of interest with the
      banding probe allows the assignment of a mouse clone to a specific cytogenetic
      band. These methods were validated by first mapping four known genes, Cpa, Ly-2,
      Cck, and Igh-6, on banded chromosomes. Twenty-seven additional clones, including
      twenty anonymous cosmids, were then mapped in a similar fashion. Known marker
      clones and fractional length measurements can also provide information about
      chromosome assignment and clone order without the necessity of recognizing
      banding patterns. Clones hybridizing to each murine chromosome have been
      identified, thus providing a panel of marker probes to assist in chromosome
      identification.

PMID- 1733848
TI  - Human minisatellite alleles detectable only after PCR amplification.
AB  - We present evidence that a proportion of alleles at two human minisatellite loci
      is undetected by standard Southern blot hybridization. In each case the missing
      allele(s) can be identified after PCR amplification and correspond to tandem
      arrays too short to detect by hybridization. At one locus, there is only one
      undetected allele (population frequency 0.3), which contains just three repeat
      units. At the second locus, there are at least five undetected alleles (total
      population frequency 0.9) containing 60-120 repeats; they are not detected
      because these tandem repeats give very poor signals when used as a probe in
      standard Southern blot hybridization, and also cross-hybridize with other
      sequences in the genome. Under these circumstances only signals from the longest
      tandemly repeated alleles are detectable above the nonspecific background. The
      structures of these loci have been compared in human and primate DNA, and at one
      locus the short human allele containing three repeat units is shown to be an
      intermediate state in the expansion of a monomeric precursor allele in primates
      to high copy number in the longer human arrays. We discuss the implications of
      such loci for studies of human populations, minisatellite isolation by cloning,
      and the evolution of highly variable tandem arrays.

PMID- 1733849
TI  - Regional localization of the human G protein alpha i2 (GNAI2) gene: assignment to
      3p21 and a related sequence (GNAI2L) to 12p12-p13.
AB  - Gi alpha proteins, members of the G protein signal transduction family, include a
      small number of polypeptides: Gi alpha 1 (GNAI1), Gi alpha 2 (GNAI2), and Gi
      alpha 3 (GNAI3). A cDNA for the human GNAI2 gene has been isolated from a human T
      cell library and is mapped by chromosomal in situ hybridization to the short arm
      of chromosome 3 at 3p21. A related sequence, GNAI2L, is mapped by in situ
      hybridization to the short arm of chromosome 12 at p12-p13. These mapping results
      are further supported by amplification of GNAI2-specific sequences in a
      monochromosomal human/rodent somatic cell hybrid containing only human chromosome
      3. Of note, these assignments are to chromosome regions in which other G proteins
      reside. Localization of GNAI2 to 3p21 is of great interest as this region of the
      short arm of chromosome 3 is frequently involved in rearrangements in various
      human tumors.

PMID- 1733850
TI  - Long-range mapping of the gene for the human alpha 5(IV) collagen chain at Xq22
      q23.
AB  - The X-linked kidney disorder known as Alport syndrome (AS) has been shown to be
      due to mutations in the gene for an alpha 5 chain of type IV collagen that maps
      to Xq22-23. Using overlapping cDNA clones that represent approximately 90% of
      this gene and pulsed-field gel electrophoresis, we have constructed a 2.4-Mb long
      range restriction map around the locus. All of the cDNA clones lie within a 360
      kb segment of DNA bounded by CpG islands that contain sites for the rare-cutting
      enzymes BssHII, MluI, NotI, NruI, SalI, and SfiI. High-resolution PFGE mapping
      with XhoI shows that the gene is at least 110 kb in size and is one of the
      largest collagen genes characterized to date. This map will prove useful in the
      characterization of mutations in individuals affected with AS and will also
      provide information as to the location of other genes in the region.

PMID- 1733851
TI  - Cloning and polymerase chain reaction-single-strand conformation polymorphism
      analysis of anonymous Alu repeats on chromosome 11.
AB  - We have shown that many of the Alu repeats found in the GenBank database are
      polymorphic and that this polymorphism can be detected by a simple technique,
      single-strand conformation polymorphism (SSCP) analysis, after polymerase chain
      reaction (PCR) amplification of each repeat from DNA of individuals. Here, we
      describe a method for collecting many anonymous Alu repeats and their flanks in a
      chromosome-specific phage library and cloning them into plasmids. The flanking
      single-copy sequences of each repeat in the plasmid were then determined, and
      20mer to 30mer segments of these sequences were used as primers for the PCR-SSCP
      analysis. Many new polymorphic DNA markers on chromosome 11 were obtained with
      this method. These markers can also serve as sequence-tagged sites for physical
      mapping of the genome.

PMID- 1733852
TI  - Assignment of tyrosine-specific T-cell phosphatase to conserved syntenic groups
      on human chromosome 18 and mouse chromosome 18.
AB  - Phosphorylation of proteins on tyrosine is crucially involved in signal
      transduction and mitogenesis and is regulated by both kinases and phosphatases.
      Recently, a number of soluble and transmembrane receptor-linked protein tyrosine
      phosphatases (PTPase) have been characterized. Among these is a 48.4-kDa PTPase
      encoded by a cDNA isolated from a T-lymphocyte library by low-stringency
      screening with probes derived from placental PTPase 1B. A human T-cell PTPase
      (PTPT) cDNA and somatic cell hybrids were used to assign a PTPT gene to conserved
      syntentic groups on human chromosome 18 and on mouse chromosome 18. Two unlinked
      sequences, one on human chromosome 1, were also detected.

PMID- 1733853
TI  - Clinical and genetic heterogeneity of Charcot-Marie-Tooth disease.
AB  - The autosomal dominant forms of hereditary motor and sensory neuropathies include
      the hypertrophic form (CMT1) and the neuronal form of Charcot-Marie-Tooth disease
      (CMT2). While at least two distinct loci have been shown to be linked to the CMT1
      phenotype (CMT1A and CMT1B, on chromosomes 17 and 1, respectively), whether the
      CMT2 phenotype results from mutations allelic to either of the CMT1 genes remains
      unknown. Studying one CMT1 and two CMT2 pedigrees, we were able to exclude the
      CMT2 disease locus from the region of chromosome 17 (Z = -2.80 at theta = 0.05
      for D17S58) where the CMT1A gene maps (Z = +3.67 at theta = 0.00). Similarly,
      negative lod score values were obtained in CMT2 for the region of chromosome 1
      where the CMT1B gene has been located (Z = -3.09 at theta = 0.05 for D1S61). The
      present study therefore provides evidence for genetic heterogeneity between the
      hypertrophic and the neuronal forms of Charcot-Marie-Tooth disease and
      demonstrates that the CMT2 gene is not allelic to either of the CMT1 genes mapped
      to date.

PMID- 1733854
TI  - Unique sequence homology in the pericentromeric regions of the long arms of
      chromosomes 13 and 21.
AB  - We previously isolated two polymorphic chromosome 21q probes, pVC1.21c (D21S190)
      and pVC1.34a (D21S149), localized in 21qcen-21q21.2. In addition, pVC1.21c
      recognized a sequence in 21q22.1-q22.2 and both probes cross-hybridized with non
      chromosome-21 sequences. In this study we refined the proximal 21q locations of
      probes pVC1.21c and pVC1.34a to 21q11.1 and demonstrated that they recognize
      sequences on chromosome 13 but not on chromosomes 14, 15, and 22. Furthermore,
      the polymorphisms associated with the two loci were assigned to pericentromeric
      13q for pVC1.34a and distal 21q for pVC1.21c. Our results are indicative of a
      region of unique sequence homology in the pericentromeric region of the long arms
      of chromosomes 13 and 21.

PMID- 1733855
TI  - An A to T transversion at position -5 of the factor IX promoter results in
      hemophilia B.
AB  - The molecular pathology that results in hemophilia B has been determined by many
      studies to be highly variable. Several point mutations have been identified in a
      40-bp region within the Factor IX promoter. These include mutations at
      nucleotides -20, -6, +8, and +13. Here we report an A to T transversion at
      position -5 of the Factor IX gene. There is strong circumstantial evidence to
      support an important role for this region of the Factor IX promoter in the
      developmental regulation of the gene through the binding of specific
      transcription factors.

PMID- 1733856
TI  - Assignment of the gene encoding DNA ligase I to human chromosome 19q13.2-13.3.
AB  - The gene encoding DNA ligase I has been mapped on human chromosome 19 by analysis
      of rodent-human somatic cell hybrids informative for this chromosome and by two
      color fluorescence in situ hybridization. The DNA ligase I gene (LIG1) is
      localized to 19q13.2-13.3 and is distal to ERCC1, the most telomeric of three DNA
      repair genes on this chromosome.

PMID- 1733857
TI  - Mapping of the human gene for the human immunodeficiency virus type 1 enhancer
      binding protein HIV-EP2 to chromosome 6q23-q24.
AB  - The human gene encoding the human immunodeficiency virus type 1 enhancer binding
      protein HIV-EP2 has been isolated. Using Southern analysis of human-rodent
      somatic cell hybrid DNA with a human HIV-EP2-specific cDNA probe, the HIV-EP2
      gene was assigned to chromosome 6. The gene was further localized to the region
      6q23-24 by fluorescence in situ hybridization.

PMID- 1733858
TI  - Assignment of the human heterogeneous nuclear ribonucleoprotein A1 gene (HNRPA1)
      to chromosome 12q13.1 by cDNA competitive in situ hybridization.
AB  - Heterogeneous nuclear ribonucleoprotein (HNRP) core protein A1 is a major
      component of mammalian HNRP particles. The human HNRP A1 protein was shown to be
      encoded by a 4.6-kb gene, split into 10 exons, belonging to a multigene family of
      about 30 A1-specific sequences per haploid genome, many of which correspond to
      pseudogenes of the processed type. Here we report the mapping of the human HNRPA1
      gene to band 12q13.1. Localization was performed by nonisotopic in situ
      hybridization using a phage genomic clone that contains the active HNRPA1 gene as
      well as 13.5-kb flanking sequences. To suppress hybridization to pseudogene
      sequences, unlabeled HNRPA1 cDNA was added in excess over the probe to the
      hybridization mixture.

PMID- 1733859
TI  - Highly polymorphic (GT)n repeat sequence in intron II of the human MAOB gene.

PMID- 1733860
TI  - Assignment of the interleukin-2 receptor beta chain gene (Il-2rb) to band E on
      mouse chromosome 15.

PMID- 1733861
TI  - A structural analysis of the Sxr region of the mouse Y chromosome.
AB  - Three genetic functions have been mapped to the minute Sxr (sex-reversed) region
      of the mouse Y chromosome. These are Tdy, the primary testis determinant; Hya,
      the locus (either structural or regulatory) controlling the expression of the
      male-specific minor histocompatibility antigen H-Y; and Spy, a spermatogenic
      gene. Hya and Spy map to DNA deleted from the Sxr region in the deletion variant
      Sxrb (the delta Sxrb DNA). With the object of cloning Hya and Spy, we initiated
      chromosome walking in the delta Sxrb DNA. From three independent loci--Sx1, Zf2,
      and T5--we have isolated approximately 270 kb of delta Sxrb DNA lying in three
      contigs of 145, 60, and 65 kb, respectively. Within 17 kb of the 3' end of the
      Zfy-2 gene, lowcopy repeat elements were found in a region that extends for
      approximately 35 kb. Probes isolated from this region detect multiple Sxr loci,
      some of which map to the delta Sxrb DNA present in the T5 contig DNA. Three of
      these multicopy probes detect delta Sxrb loci not represented in our three
      contigs, which means that six distinct delta Sxrb loci have now been identified.
      Here we present a preliminary model of the molecular structure of the DNA in this
      unique region.

PMID- 1733862
TI  - Walking, cloning, and mapping with yeast artificial chromosomes: a contig
      encompassing D21S13 and D21S16.
AB  - Chromosome 21 has often been used as a model system for the development of genome
      mapping and cloning strategies in humans. In this report methods for systematic
      chromosome walking, cloning, and mapping are exemplified in the construction of a
      1.5-Mb yeast artificial chromosome (YAC) contig encompassing and extending 400 kb
      beyond each of the genetic loci D21S13 and D21S16. Isolation of insert-terminal
      sequences from YACs in this contig provides a set of closely spaced physical
      markers. These have been used to generate a long-range genomic restriction map.

PMID- 1733863
TI  - The iduronate sulfatase gene: isolation of a 1.2-Mb YAC contig spanning the
      entire gene and identification of heterogeneous deletions in patients with Hunter
      syndrome.
AB  - A recently isolated cDNA clone from the iduronate sulfatase (IDS) gene has been
      used both to seed a contig of overlapping yeast artificial chromosomes (YACs) and
      to investigate the molecular defect in patients with Hunter syndrome (MPS II).
      Six YAC clones were found to span the IDS gene, and those and 14 other YACs were
      assembled into a 1.2-Mb contig around the gene in Xq27-q28. The physical map of
      the region identifies several putative CpG islands, suggesting the presence of
      other genes in the vicinity. DNA from a patient with a translocation breakpoint
      in the gene also permitted the orientation of the contig in the chromosome.
      Southern analysis of DNA from 25 unrelated Italian Hunter syndrome patients
      revealed 4 with deletions or rearrangements in the IDS gene.

PMID- 1733864
TI  - Assignment of the gene (RLBP1) for cellular retinaldehyde-binding protein
      (CRALBP) to human chromosome 15q26 and mouse chromosome 7.
AB  - Cellular retinaldehyde-binding protein (CRALBP) has properties that suggest that
      it is involved in the visual process and, therefore, potentially with retinal
      diseases. A human cDNA probe has been used to map this gene to human chromosome
      15q26 (somatic cell hybrids and in situ hybridization) and to mouse chromosome 7
      by somatic cell hybrids.

PMID- 1733865
TI  - Allele frequency distribution of the (TG)n(AG)m microsatellite in the
      apolipoprotein C-II gene.
AB  - The dinucleotide (TG)n interspersed repetitive sequences are the most abundant
      microsatellites in the human genome. Using the polymerase chain reaction to
      amplify a (TG)n(AG)m microsatellite in the first intron of the apo C-II gene, we
      have detected 15 different alleles in 242 unrelated individuals of French
      ancestry. The heterozygosity index was 0.85 and codominant Mendelian inheritance
      of the alleles was observed in individuals from 121 nuclear families. We report
      that polymorphism at this locus is attributable to length variation at both (TG)n
      and (AG)m motifs, although the (AG)m motif contains only two alleles differing by
      one repeat unit. A quadrimodal allele frequency distribution was observed at the
      (TG)n(AG)m locus. Each of the first three modes comprises one frequent allele and
      one very rare allele adjacent in size. No alleles of intermediate size were found
      between the three first modes. The fourth mode encompasses nine alleles that span
      from 27 to 35 repeat units. We suggest that this distribution reflects the
      molecular mechanisms by which alleles give rise to one another.

PMID- 1733866
TI  - Isolation and characterization of a yeast artificial chromosome (YAC) contig
      around the human steroid sulfatase gene.
AB  - The region surrounding the steroid sulfatase (STS) locus on Xp22.3 is of
      particular interest since it represents a deletion hot spot, shares homology with
      the proximal long arm of the Y chromosome (Yq11.2), and contains genes for
      several well-described X-linked disorders. Here we describe yeast artificial
      chromosomes (YACs) covering 450 kb around the STS gene. Eight YAC clones were
      isolated from a human YAC library. Their STS exon content was determined and the
      overlap of the clones characterized. Two of the YAC clones were found to contain
      the entire STS gene. The most proximal and the most distal ends of the YAC contig
      were cloned but neither of them crossed the breakpoints in any of the previously
      described patients with entire STS gene deletions. This is consistent with
      deletions larger than 500 kb in all these patients. One of the YAC clones was
      found to contain sequences from the STS pseudogene on Yq11.2. Two anonymous DNA
      sequences, GMGXY19 and GMGXY3, previously mapped in the vicinity of the STS
      locus, were found within the YAC contig and their assignment with respect to the
      STS locus was thus possible. This contig is useful for the overlap cloning of the
      Xp22.3 region and for reverse genetic strategies for the isolation of disease
      genes in the region. Furthermore, it may provide insight into the molecular
      mechanisms of deletion and translocation events on Xp22.3 and in the evolution of
      sex chromosomes.

PMID- 1733867
TI  - Long-range physical map of the Ly-6 complex: mapping the Ly-6 multigene family by
      field-inversion and two-dimensional gel electrophoresis.
AB  - The Ly-6 proteins are encoded by a recently identified multigene family. Much
      attention has been focused on these proteins because they may be involved in
      lymphocyte activation, and expression of some of them occurs at critical times in
      the differentiation of lymphocytes. These features make it important to
      investigate and to characterize further this family of molecules and the genes
      that encode them. To aid our investigation of these issues, we have constructed a
      physical map of the entire Ly-6 complex in the C57BL/6 murine genome using the
      combined techniques of field-inversion gel electrophoresis (FIGE), phage and
      cosmid genomic library screening, and two-dimensional DNA electrophoresis. This
      map spans approximately 1600 kb, and comparison of the FIGE map and cosmids
      indicates that most of the Ly-6 complex has been isolated in the cosmid clones.

PMID- 1733868
TI  - Differential diagnosis between Hodgkin's disease and non-Hodgkin's lymphoma.

PMID- 1733869
TI  - The nature and function of the Hodgkin's cell lectin and its role in lymphocyte
      agglutination.

PMID- 1733870
TI  - Role of T cells in the pathogenesis of Hodgkin's disease.

PMID- 1733871
TI  - Diagnosis and grading of nodular sclerosing Hodgkin's disease: a study of 2190
      patients.

PMID- 1733872
TI  - Lymphocyte-predominance Hodgkin's disease.

PMID- 1733873
TI  - Immunophenotype of Reed-Sternberg cells.

PMID- 1733874
TI  - The consensus of committees.

PMID- 1733875
TI  - X-ray contrast media.

PMID- 1733876
TI  - Comparative safety of high-osmolality and low-osmolality radiographic contrast
      agents. Report of a multidisciplinary working group.

PMID- 1733877
TI  - Quantitative assessment of tumor enhancement by ultrastable lipid-coated
      microbubbles as a sonographic contrast agent.
AB  - We have previously reported that ultrastable lipid-coated microbubbles make a
      suitable ultrasonic contrast agent in the brain, causing increased intensity of
      echoes that persists for many hours. We showed that intravenously administered
      lipid-coated microbubbles accumulate selectively in rat brain gliomas with
      echogenicity enhancement for up to 1 hour, allowing visualization of the growing
      lesions 40% (2 days) earlier than can be seen without contrast. This work is a
      detailed evaluation of the accumulation of the lipid-coated microbubbles in tumor
      and the effect of the bubbles on the echogenicity of insonified tumors. Using a
      lipid-specific stain, we measured and characterized the distribution of the
      bubbles in the brain and tumor. We showed that on the scan, the enhancement of
      the tumor is accompanied by a change in the signal-to-noise ratio of the echoes
      from the tumor. We identified characteristic textural changes associated with
      contrast-enhanced tumor using spectral analysis.

PMID- 1733878
TI  - Effects of intracoronary administration of contrast media on myocardial high
      energy phosphate. A comparison of sodium meglumine diatrizoate and iohexol.
AB  - Myocardial ATP, ADP, and AMP were measured from cardiac biopsy in 11 dogs after
      intracoronary injection of 6 mL of sodium-meglumine diatrizoate (SMD), iohexol
      (IOH), or 0.9% sodium chloride (NaCl), and in three of the dogs at baseline
      before any injection. The ATP at baseline and after SMD, IOH, and 0.9% NaCl were
      5.39 +/- 0.41, 3.72 +/- 0.70, 5.52 +/- 0.82, and 5.44 +/- 1.40 mumol/g wet
      weight, respectively. There were significant differences between SMD and IOH (P
      less than .02), and between SMD and 0.9% NaCl (P less than .05). The energy
      charge of SMD was 0.82 +/- 0.08, which differed from 0.89 +/- 0.02 for NaCl or
      0.9 +/- 0.05 for baseline (P less than .05), but not from 0.85 +/- 0.04 for IOH.
      In conclusion, diatrizoate caused significant depletions in ATP stores in
      comparison with iohexol, but there was no significant difference with respect to
      energy charge. Nonionic contrast media would be preferable for coronary
      arteriography in patients whose high-energy stores might be depleted from severe
      ischemia.

PMID- 1733879
TI  - Quality of urography and renal clearance of ionic and nonionic contrast media.
AB  - The authors evaluated whether urographic quality correlated with patient
      hydration and the level of their renal function, depending on whether they
      received ionic or nonionic contrast media. One hundred patients with normal serum
      creatinine levels were randomly assigned to receive intravenous urography with
      either an ionic high-osmolar or a nonionic low-osmolar contrast medium. Patient
      hydration was evaluated by measuring urine osmolality in a sample voided just
      before the examination. The plasma concentration of iodine was determined in a
      single blood sample drawn approximately 3 hours later. From these determinations
      the plasma clearance of contrast medium was calculated. The urograms were
      assessed blindly with regard to nephrographic and pyelographic opacification, as
      well as overall diagnostic quality. The clearance varied between 42 and 115 mL x
      minutes-1 x 1.73 m-2. No systematic correlation of practical significance was
      found between the clearances and the urogram quality. A high urinary osmolality
      before the examination tended to improve quality with both media. It is not
      possible to assess glomerular filtration rate from nephrographic and pyelographic
      opacification, or from overall quality of routine urograms in patients with
      normal serum creatinine levels.

PMID- 1733880
TI  - Incompatibility of water-soluble contrast media and intravascular pharmacologic
      agents. An in vitro study.
AB  - In vitro incompatibilities between nine water-soluble contrast media and 21
      intravascular pharmacologic agents were investigated using naked-eye observation
      and a centrifuge. Most of the previously reported incompatibilities were
      verified, and a few new incompatibilities were discovered: phentolamine mesylate
      with diatrizoate sodium, diatrizoate meglumine, ioxaglate, and iothalamate;
      diatrizoate meglumine with diazepam and meperidine hydrochloride; and diatrizoate
      sodium with meperidine hydrochloride. There were no incompatibilities when the
      pharmacologic agents investigated were mixed with ioxithalamate, iopromide,
      iopamidol, and iohexol.

PMID- 1733881
TI  - Effect of flow rate on adherence of unlabeled and indium-111 oxine-labeled
      leukocytes.
AB  - Uptake of radioactively labeled leukocytes has been observed in ischemic
      noninfected regions. Since this may be a flow-related phenomenon, the authors
      investigated the effect of flow rate on adherence of indium-111 oxine-labeled
      leukocytes with a model based on the elution patterns of radioactivity and
      granulocytes from nylon fiber columns. Relative radioactivity adherence (%RA) and
      relative granulocyte adherence (%GA) agreed closely, indicating that
      radioactivity retained by the columns is predominantly in the form of viable
      labeled granulocytes, and that labeled and unlabeled granulocytes have the same
      adherence characteristics. When other conditions were held constant, but passage
      speed was varied, %GA and %RA were related to the flow rate in an inverse linear
      fashion. Decrease in flow rate can lead to increased accumulation of leukocytes.

PMID- 1733882
TI  - Diagnostic performance of teleradiology in cervical spine fracture detection.
AB  - This study was done to assess the diagnostic accuracy of high-resolution (5
      lp/mm) teleradiology for detecting cervical spine fractures. Single radiographs
      from 25 patients with and 25 patients without cervical spine fractures were
      transmitted between two units of our teleradiology system (Dupont DTR 2000)
      located 5 miles apart. Each image was examined by four readers. Fracture
      detection accuracy was assessed by generating receiver operating characteristic
      (ROC) curves and comparing the areas under each reader's curves for original and
      transmitted images. Two readers had statistically significant better fracture
      detection using nontransmitted images, whereas two had no significant differences
      in accuracy. The authors conclude that high resolution in and of itself is not
      adequate for fracture detection, and that issues concerning image contrast
      manipulation also will have to be addressed before teleradiology systems can be
      used for clinical cervical spine fracture screening.

PMID- 1733883
TI  - Ultrafast computed tomography in experimental pulmonary embolism.
AB  - Computed tomography (CT) has proven useful in the diagnosis of central pulmonary
      embolism; however, its ability to detect peripheral emboli has not been
      established. The authors evaluate the usefulness of ultrafast CT (UFCT) in
      detecting experimental peripheral pulmonary emboli. Three Gelfoam emboli
      measuring 0.7 x 1.5 cm were introduced into the pulmonary arteries of each of
      seven dogs, and contiguous, 3-mm, axial UFCT images from the lung apex to the
      base were obtained after the administration of a contrast bolus. After scanning,
      the dogs were killed, and the locations of the emboli were determined by a
      pulmonary pathologist blinded to the imaging results. Concomitantly, the
      locations of the emboli on the UFCT images were determined by consensus of three
      chest radiologists blinded to the autopsy results. All 21 emboli were identified
      on UFCT images; the locations of the emboli corresponded exactly with the autopsy
      findings. The authors conclude that UFCT can reliably detect Gelfoam emboli in
      second- to fourth-division pulmonary vessels. Further studies are needed to
      determine if in vivo blood clots can be similarly visualized.

PMID- 1733884
TI  - A fully automated adaptive unsharp masking technique in digital chest radiograph.
AB  - The authors are developing a fully automated adaptive unsharp masking technique
      with parameters that depend on regional image features of a digital chest
      radiograph. A chest radiograph includes various regions such as lung fields,
      retrocardiac area, and spine. These areas have very different texture patterns
      and optical densities. Therefore, for best evaluation, it is necessary to enhance
      the image contrast of each region by an optimal parameter. In the current study,
      a chest radiograph was automatically divided into three segments (lung field,
      retrocardiac area, and spine) by using a histogram analysis of pixel values. The
      lung fields and retrocardiac area were selectively enhanced with a small mask
      size and mild weighting factors that had been previously determined to be
      optimal. The spine was enhanced with a large mask size and adequate weighting
      factors. An observer performance test indicated that this technique provides
      excellent diagnostic accuracy for simulated nodules in chest radiographs.

PMID- 1733885
TI  - Computer-aided detection of diffuse liver disease in ultrasound images.
AB  - The authors are developing an automated method of determining measures of texture
      in liver ultrasound images to improve the accuracy of diagnosis of diffuse liver
      abnormalities. In each digitized image, the background trend of pixel values is
      estimated to isolate the underlying pattern of liver texture. After correcting
      for background trend, the root mean square (RMS) variation and the first moment
      of the power spectrum are calculated; these measures have been applied
      successfully to texture analysis of digital chest radiographs. Background trend
      corrected measurements detected statistically significant differences in
      digitized ultrasound images of 11 normal and 11 abnormal livers. Without
      correction for background trend, the measures are unable to distinguish normal
      from abnormal liver texture. The authors also investigated the effect on the
      texture measures of varying several ultrasound imaging parameters in normal
      patients and in an ultrasound phantom.

PMID- 1733886
TI  - Computer-assisted fusion of single-photon emission tomographic and computed
      tomographic images. Evaluation in complicated inflammatory disease.
AB  - Fusion of single-photon emission computed tomographic (SPECT) and x-ray computed
      tomographic (CT) images can facilitate the direct comparison of function and
      anatomy by simultaneously displaying comparable cross-sectional images. A
      computer-assisted fusion method was used to prospectively evaluate 10 patients
      with suspected inflammatory disease complicated by an associated condition. CT
      images were transferred to the nuclear computer. Image fusion was accomplished
      with standard scaling, rotation, translation, and stretching transformations,
      using anatomic or external landmarks. SPECT-CT fusion correctly localized the
      inflammatory process in all 10 cases and facilitated percutaneous drainage or
      preoperative surgical planning in 6.

PMID- 1733887
TI  - Magnetic resonance imaging in assessing cartilage changes in experimental
      osteoarthrosis of the knee.
AB  - Cartilage degeneration in osteoarthrosis (OA) of the knee generally is believed
      to precede osseous abnormalities. Because cartilage abnormalities are not readily
      detected by routine radiography, we investigated the role of magnetic resonance
      imaging (MRI) in assessing cartilage damage in a goat model for OA. Four goats
      had the anterior cruciate ligament of one knee severed surgically to create
      instability and accelerate OA. Two goats each were killed at 4 and 6 weeks,
      respectively, after walking on the unstable knees. MRI of the knees was performed
      with Hybrid fat suppression sequences. The images were correlated with gross
      anatomic sections and histologic analysis of the knees. On gross examination, the
      unstable knees showed rapid development of thinning, surface irregularity, and
      focal defects of the cartilage. These findings correlated well with abnormalities
      detected on the MRIs. In addition, areas of decreased signal intensity in
      cartilage correlated with histologic evidence of degenerative changes in the
      cartilage substance, including fragmentation, fibrillary and eosinophilic
      changes, and chondrocyte proliferation, indicating attempted cartilage repair.
      Precise correlation of pathologic and MRI data, however, was lacking, related in
      part to inability to match perfectly the level and orientation of the gross
      section with that on the MRI examination.

PMID- 1733888
TI  - Efficient method for selecting cardiac magnetic resonance image locations.
AB  - Selecting locations for long- and short-axis cardiac magnetic resonance images
      (MRIs) conventionally requires two preliminary image sets, one to find the plane
      of the left ventricular (LV) axis and a second to find the axis within that
      plane. By specifying the LV axis from landmarks on the initial image set, it is
      possible to go directly to short-axis images without the second set of
      preliminary images, thus improving efficiency and shortening the duration of the
      examination.

PMID- 1733889
TI  - The dark age all around us.

PMID- 1733890
TI  - Coal worker's pneumoconiosis CT assessment in exposed workers in correlation with
      radiographic findings.

PMID- 1733891
TI  - Kidney transplantation in Jerusalem, 1972-89. Kidney Transplant Group.
AB  - The results of a small transplant program over 18 years are presented. Two
      hundred and fifty-six transplantations including 36 living donor transplants were
      performed in 203 patients. Graft survival at 1, 3, 5 and 10 years without and
      with cyclosporin A treatment was 57%, 49%, 44%, 38%, and 71%, 69%, 58%, -%
      (respectively). Patient survival was 83%, 67%, 62%, 54%, and 92%, 90%, 68%, -%
      (respectively). Recent results with cyclosporin A treatment have shown further
      improvement. Analysis using the COX model shows that age under 30 years, lack of
      systemic disease, and the use of cyclosporin A and living donors all improved
      patient survival. More than 10- and 5-year survival was achieved in 78 and 103
      patients, respectively, of whom 53 and 81 have good graft function. Local
      transplant policy and patient material are discussed.

PMID- 1733892
TI  - Hereditary ovarian cancer: a dilemma in prognosis.
AB  - Five women in three generations developed ovarian cancer. We closely monitored 36
      descendent women in this family who were at high risk for developing this
      disease. Prophylactic oophorectomy is considered the optimal way to prevent the
      development of ovarian cancer. In the light of the young age of the women at risk
      and their strong objection to oophorectomy, we closely monitored the examinees
      for early signs of cancer for more than 5 years. None of them developed cancer.
      The dilemma in treatment of women at risk is discussed.

PMID- 1733893
TI  - Clinical characteristics of patients with fibromyalgia.
AB  - Fibromyalgia, also known as fibrositis and muscle rheumatism, is a common,
      noninflammatory, painful musculoskeletal disorder. It is common between the ages
      of 30 and 60 years and has a female to male ratio of 5 to 1. Essential symptoms
      of fibrositis are pain, fatigue, disturbed sleep, morning stiffness and local
      tenderness. Subjective swelling, paresthesia and numbness sometimes occur.
      Multiple host and environmental factors seem to contribute to the onset and
      course of fibromyalgia. Modest improvement follows treatment by antidepressive
      agents, physical measures and reduction in stress. In this study 60 patients with
      fibromyalgia were investigated and the clinical characteristics of these patients
      are described and compared with those in other studies.

PMID- 1733894
TI  - Autonomous hyperparathyroidism not associated with increased aluminum absorption.
AB  - A single 6-g dose of aluminum hydroxide was given to eight patients on regular
      hemodialysis before and 3 days after parathyroidectomy (PTX). Serum aluminum
      levels were measured before and after 5 h after ingestion of aluminum hydroxide
      to examine indirectly the effects on absorption of aluminum from the
      gastrointestinal tract of both high and low parathyroid hormone (PTH). Plasma PTH
      levels fell significantly from 2,724 +/- 1,830 ng/l (mean +/- 1 SD) before PTX to
      352 +/- 63 ng/l after PTX. However, no significant change was detected in serum
      aluminum levels before or after PTX (1.45 +/- 0.96 to 1.92 +/- 0.88 mumol/l
      before PTX; 2.02 +/- 1.41 to 2.89 +/- 1.19 mol/l after). These findings indicate
      that in patients with chronic renal failure, high plasma levels of PTH are not
      associated with significant increases in serum aluminum concentrations after
      ingestion of a large quantity of aluminum hydroxide. Parathyroid hormone may not
      enhance intestinal absorption of aluminum in humans.

PMID- 1733895
TI  - Combined carotid endarterectomy and coronary artery revascularization: a sobering
      review.
AB  - The clinical outcome of 99 patients who underwent combined single-stage carotid
      thromboendarterectomy and coronary artery bypass grafts in three different
      hospitals over a 15-year period was analyzed. Coronary revascularization was
      elective in 16 patients, urgent in 46 and emergent in 37 patients. Asymptomatic
      carotid artery stenosis of greater than or equal to 80% was detected in 79% of
      patients. Sequential reconstruction of the carotid artery circulation followed by
      restoration of the coronary circulation was performed in all patients by two
      separate surgical teams. The population included 79 men and 20 women, with a mean
      age of 67 +/- 6 years, of whom 53% had a previous myocardial infarction, 59% had
      hypertension and 49% had a history of smoking. Three or more coronary arteries
      were revascularized in 90% of patients. The overall major neurological
      complication rate was 25%, with an 11% stroke rate ipsilateral to the operated
      carotid. Other major complications included respiratory failure (5%), multisystem
      failure (8%), and myocardial infarction (8%). The overall mortality was 12%. Ten
      of the 12 deaths were directly related to the cardiac operation, and 2 died as a
      result of stroke. We conclude that a combined carotid and coronary artery
      operation results in a high morbidity and mortality in institutions with
      excellent records for each operation when performed separately. Whenever
      possible, these high risk patients should be carefully assessed regarding the
      need for both procedures, since prophylactic carotid endarterectomy has not been
      shown to significantly reduce the neurologic risk of coronary bypass.

PMID- 1733896
TI  - Cigarette smoking and educational level among young Israelis upon release from
      military service in 1988--a public health challenge.
AB  - The prevalence of cigarette smoking was determined in a representative sample of
      Israeli men and women mostly aged 20-22, upon release from military service. In
      this sample, 47.5% of the men and 30% of the women reported themselves to be
      current smokers, and 46% and 26% respectively to be current regular smokers. Of
      the current smokers 80% of the men and 74% of the women took up smoking before
      entering military service. Educational level at recruitment was strongly
      associated with age at uptake of smoking, the prevalence of smoking and the
      number of cigarettes currently smoked per day. Ethnic differences in smoking
      prevalence after controlling for education were relatively small. Men and women
      with less than or equal to 11 years of schooling reported twice the smoking
      prevalence of those with greater than or equal to 12 years, 71 vs. 35% current
      smokers in men and 56% vs. 26% current smokers in women respectively. Heavy
      smoking of greater than or equal to 20 cigarettes per day was reported by 51% and
      30% of less educated men and women, respectively, compared with 17% and 9%
      respectively of those with greater than or equal to 12 years of schooling. We
      conclude that intervention programs directed toward the prevention of uptake of
      smoking in adolescents should receive high public health priority in Israel, with
      special emphasis on adolescents prior to military service and focusing on the
      more susceptible segments of the young population.

PMID- 1733897
TI  - The relationship between the lupus anticoagulant, anticardiolipin antibodies and
      antiphospholipid antibodies.

PMID- 1733898
TI  - Studying tenderness--a clue to understanding fibromyalgia.

PMID- 1733899
TI  - Medicine and the Ethiopian Jews: report and analysis from Addis Ababa.

PMID- 1733900
TI  - Severe gastrointestinal bleeding induced by a probable hydroxycoumarin
      bezafibrate interaction.

PMID- 1733901
TI  - Considerations in health services planning in an atmosphere of uncertainty: the
      case of coronary artery bypass surgery in Israel.

PMID- 1733903
TI  - Annual meeting of the Israel Society of Microbiology. 25-26 March 1991, Ramat
      Gan, Israel. Abstracts.

PMID- 1733902
TI  - Acute surgical abdominal disease in schizophrenics.

PMID- 1733904
TI  - Association of lupus anticoagulant and anticardiolipin antibodies with thrombosis
      in patients with systemic lupus erythematosus, primary antiphospholipid syndrome
      and other disorders.
AB  - Lupus anticoagulant (LA) and anticardiolipin antibodies (ACA) have been
      associated with thrombotic events and recurrent fetal loss. In order to assess
      the role of LA with the thrombotic tendency in various disease states we
      evaluated 38 patients with confirmed LA [tissue thromboplastin index (TTI)
      greater than 1.3; circulating anticoagulant index (CAI) greater than 15],
      subgrouped as follows: a) LA associated with systemic lupus erythematosus (SLE)
      (n = 13); b) primary antiphospholipid syndrome (PAPS) (n = 16); and c) LA
      associated with other disorders (n = 9). Male/female ratio differed between the
      groups: 0/13, 6/10 and 4/5, respectively. Venous and arterial thrombotic events
      were more common in the PAPS group (87%) compared with the SLE group (61%) and
      the other disorders group (22%). Serum ACA antiphospholipid IgG levels by ELISA
      were increased in the SLE and PAPS patients, but did not differ between the
      groups (167 +/- 24 vs. 190 +/- 28 mu respectively). Antiphospholipid IgM levels
      were higher in the SLE group compared with the PAPS group (127 +/- 15 vs. 67 +/-
      16 mu). Mean TTI and CAI levels did not differ between the SLE, PAPS and other
      disorders groups (1.8 +/- 0.19, 2.8 +/- 0.9, 2.0 +/- 0.3 for TTI; 25 +/- 4, 33 +/
      4, 32 +/- 5 for CAI). Likewise TTI, CAI and ACA levels did not differ in
      patients with or without thrombosis. We conclude that the prevalence of
      thrombotic manifestations varies among patients with similar serum intensities of
      LA and levels of ACA, suggesting that other factors may be involved in the
      pathogenesis of thrombosis in these patients.

PMID- 1733905
TI  - Primary and secondary prevention of cancer in Israel.

PMID- 1733906
TI  - Screening for colorectal neoplasia: a multicenter study in Israel.
AB  - We report the design and results of the first Israeli multicenter screening
      program for colorectal neoplasia. The screening protocol comprised a risk
      questionnaire, fecal occult blood testing, flexible sigmoidoscopy and
      colonoscopy. A total of 5,601 individuals were screened in five medical centers,
      55% being asymptomatic with low or average risk. Colorectal tumors were found in
      12.3% of screenees, the majority being adenomas. The risk for large bowel
      neoplasia was greatest in persons with a personal history of colorectal neoplasia
      (neoplasia rate 473.2/10(3)) and was increased in those with inflammatory bowel
      disease, a family history of colorectal tumor, or past history of cured breast
      cancer. European-born Jews had a 50% greater risk than non-European-born Jews.
      Persons at high risk were more likely to return for repeat screening than those
      at low or average risk. However, approximately 15% of persons at high risk
      actually thought that they were of average risk. Fecal occult blood testing was
      markedly less reliable than flexible sigmoidoscopy and had a false-negative rate
      of 84.4%. The results demonstrate that existing medical facilities in Israel can
      be used to screen at least those individuals with increased risk for colorectal
      neoplasia.

PMID- 1733907
TI  - Colon cancer screening in Israel.

PMID- 1733908
TI  - Screening for colorectal neoplasia in the Tel Aviv area: cumulative data 1979-89
      and initial conclusions.
AB  - We present an analysis comprising the initial 10 years experience with a
      screening program for colorectal neoplasia in the Tel Aviv area that involved
      5,625 screenees. It demonstrated that selective screening, based on pre
      established epidemiologic criteria and selective screening methodology, resulted
      in a colorectal neoplasia yield that related directly to the screenee's risk of
      neoplasia. We have no evidence that the program is life-saving or cost-effective.
      Medically, however, it yielded early-stage neoplasms that were mainly adenomas,
      and most cancers were early-stage and noninvasive. Among the screenees 1% had
      cancer, of which 2/3 were Duke's A or B; 10% had adenomas and 7.3% of these (0.7%
      of all screenees) had severe dysplasia. Removal of these adenomas has been shown
      to reduce large bowel cancer incidence. Presently we cannot generally recommend
      mass screening by the available screening tests, fecal occult blood and
      endoscopy. However, an outreach case-finding program, based on existing health
      services, is possible and medically rewarding especially in groups at high risk
      for neoplasia.

PMID- 1733909
TI  - Cellular and subcellular localization of tritiated gentamicin in the guinea pig
      cochlea following combined treatment with ethacrynic acid.
AB  - Guinea pigs (GPs) receiving one intra-muscular injection of gentamicin (GM) (150
      mg/kg) in which 2 mg of tritiated GM (2 mCi) were incorporated, followed 1.5 h
      later by an intra-cardiac injection of ethacrynic acid (EA) (30 mg/kg) were
      sacrificed 25 min, 1, 4 and 24 h after the EA injection. Other GPs were treated
      with one injection of GM or EA alone and sacrificed 24 h later. Cochlear function
      was monitored by recording VIIIth nerve compound action potential (CAP) responses
      to clicks at 70 dB peak-equivalent Sound Pressure Level (pe SPL) and CAP
      audiograms. At 24 h thresholds were significantly elevated for high frequencies
      only in GPs treated with the GM/EA combination. GM was revealed in the cochlea
      and kidney by autoradiography using light and electron microscopy. In the kidney
      GM was already detected in the proximal tubule cells at 25 min and at 24 h. In
      the cochlea GM was systematically not observed at 25 min. At 1 h a weak labelling
      was detected in vessels of the stria vascularis and in sensory cells at the base
      of the cochlea. At 4 h the labelling disappeared in stria vascularis but
      increased in the hair cells. At 24 h GM labelling was found exclusively in hair
      cells, particularly outer hair cells, with a gradient from base to apex and from
      first to 3rd row, this distribution pattern correlating well with the pattern of
      threshold changes prominent at high frequencies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1733910
TI  - Ongoing production of sensory cells in the vestibular epithelium of the chick.
AB  - Recent studies have shown that the vestibular and auditory systems of some
      species of birds have the capacity to generate sensory hair cells postnatally. We
      used a traditional technique, 3H-thymidine autoradiography, and a newer method,
      bromodeoxyuridine immunocytochemistry, to determine whether ongoing proliferation
      of hair cells occurs in the intact chick vestibular epithelium. A ten-day course
      of 3H-thymidine, bromodeoxyuridine, or both was administered to twelve-day-old
      chicks. Both autoradiographic and immunocytochemical labeling demonstrated
      ongoing production of supporting cells and Type II hair cells in all chick
      vestibular organs. No evidence for production of Type I hair cells was seen in
      this investigation. New sensory cells were distributed throughout the epithelium;
      there was no peripheral growth zone analogous to that found in other vertebrates.
      Labeled Type II hair cells were frequently seen immediately above labeled
      supporting cells. This observation suggests that supporting cells are precursors
      for new hair cells. The ongoing, postnatal regeneration of vestibular epithelial
      cells also suggests that this epithelium may retain the potential for repair
      after trauma or ototoxic damage.

PMID- 1733911
TI  - Ionic coupling among cells in the organ of Corti.
AB  - Gap junctions have been demonstrated morphologically among the supporting cells
      of the mammalian organ of Corti but, in contradistinction to reptiles, evidence
      for their existence between the supporting cells and hair cells is equivocal. The
      literature is ambiguous with respect to electrical coupling and dye coupling
      among the supporting cells, and no coupling of either kind has been demonstrated
      for the hair cells. We found strong coupling of both kinds among the supporting
      cells in the cochleas of live Mongolian gerbils and a less stable coupling
      between the supporting cells and the outer hair cells. The electrical coupling
      was established by recording alternating receptor potentials in the hair cells
      and following their decrement in the population of Hensen's cells; the dye
      coupling, by injecting Lucifer yellow electrophoretically into the hair cells or
      the supporting cells and investigating its spread to the neighboring cells. The
      electrical recordings were made by means of microelectrodes filled with either
      1.5 or 3 M KCl or 1 M LiCl with 6% Lucifer yellow, the latter used for dye
      injection. The electrode resistances ranged from about 20 to 60 M omega in the
      first instance, and from about 50 to 110 M omega, in the second. The electrodes
      were inserted into the organ of Corti through scala media according to the method
      of Dallos, Santos-Sacchi and Flock (1982) modified by us. The alternating
      potential in Hensen's cells was usually larger than in the outer tunnel of Corti
      and remained practically constant up to the outer margin of the Hensen's-cell
      population. Its phase was the same as in the outer hair cells. When the dye was
      injected into a Hensen's cell, it always spread to neighboring Hensen's cells and
      often to Deiter's cells. Dye injected into outer hair cells (identified according
      to anatomical and physiological criteria) also spread to Deiter's and Hensen's
      cells and, usually, to other outer hair cells. Stained cells were identified in
      surface preparations and, on two occasions, in serial sections from plastic
      embedded cochleas.

PMID- 1733912
TI  - Age-dependent disruption of basal lamina and extracellular matrix formation in L
      proline analog treated otic explants.
AB  - L-azetidine-2-carboxylic acid, LACA, a naturally occurring vegetable imino acid,
      can be incorporated into mammal proteins instead of proline. This incorporation
      has an especially inhibitive effect on collagen secretion. Exposure of embryonic
      mouse inner ear explants to LACA causes dysmorphogenesis and retarded
      differentiation, reduces the number of collagen fibrils in the perilymphatic
      spaces and capsules, and gives rise to a dose-dependent derangement of the basal
      lamina. In control specimens, both in vivo and in vitro, the inner ear epithelia
      had a dense contiguous basal lamina overlying a well-developed network of
      collagen fibrils. When the inner ears were exposed to LACA at a concentration of
      150 micrograms per ml of medium, there was a loss of the collagen network and
      gaps appeared in the basal lamina. At exposure to 300 micrograms LACA/ml,
      scarcely any collagen fibrils were present and the basal lamina was disrupted in
      many areas, especially beneath the sensory epithelia.

PMID- 1733913
TI  - Actin-binding and microtubule-associated proteins in the organ of Corti.
AB  - Actin-binding and microtubule-associated proteins regulate microfilament and
      microtubule number, length, organization and location in cells. In freeze-dried
      preparations of the guinea pig cochlea, both actin and tubulin are found in the
      sensory and supporting cells of the organ of Corti. Fodrin (brain spectrin) co
      localized with actin in the cuticular plates of both inner and outer hair cells
      and along the lateral wall of the outer hair cells. Alpha-actinin co-localized
      with actin in the cuticular plates of the hair cells and in the head and foot
      plates of the supporting cells. It was also found in the junctional regions
      between hair cells and supporting cells. Profilin co-localized with actin in the
      cuticular plates of the sensory hair cells. Myosin was detected only in the
      cuticular plates of the outer hair cells and in the supporting cells in the
      region facing endolymph. Gelsolin was found in the region of the nerve fibers.
      Tubulin is found in microtubules in all cells of the organ of Corti. In
      supporting cells, microtubules are bundled together with actin microfilaments and
      tropomyosin, as well as being present as individual microtubules arranged in
      networks. An intensely stained network of microtubules is found in both outer and
      inner sensory hair cells. The microtubules in the outer hair cells appear to
      course throughout the entire length of the cells, and based on their staining
      with antibodies to the tyrosinated form of tubulin they appear to be more dynamic
      structures than the microtubules in the supporting cells. The microtubule
      associated protein MAP-2 is present only in outer hair cells within the organ of
      Corti and co-localizes with tubulin in these cells. No other MAPs (1,3,4,5) are
      present. Tau is found in the nerve fibers below both inner and outer hair cells
      and in the osseous spiral lamina. It is clear that the actin-binding and
      microtubule-associated proteins present in the cochlea co-localize with actin and
      tubulin and that they modulate microfilament and microtubule structure and
      function in a manner similar to that seen in other cell types. The location of
      some of these proteins in outer hair cells suggests a role for microfilaments and
      microtubules in outer hair cell motility.

PMID- 1733914
TI  - Setting complex tasks to single units in the avian auditory forebrain. I:
      Processing of complex artificial stimuli.
AB  - In the auditory forebrain (field L) of the European starling (Sturnus vulgaris),
      single unit responses were recorded for a wide range of complex stimuli,
      comprising different forms of amplitude and frequency modulation. About two-third
      of the units locked to sinusoidal modulation regardless of whether frequency
      (SFM) or amplitude (SAM) was modulated. On average, however, frequency led to
      stronger synchronization. Both the proportion of phase locking and its mean
      strength showed a low-pass dependence on modulation frequency. The lower
      efficiency of amplitude modulation is also visible in unit responses when SAM is
      combined with (random) frequency modulation. For the assessment of response
      strength and its comparison across the tested repertoire of complex stimuli, a
      new index (REX) is introduced which primarily weighs similarity of the spike
      trains in identically repeated stimulus runs. Applied to a set of 311 field L
      neurons, also this approach discloses the two stimulus classes lacking frequency
      modulation (pure tone and SAM) as the least effective. A new measure for response
      latency, the Effective Response Delay (ERD), based on the spike-triggered
      analysis of responses to randomly frequency-modulated sounds (RFM), reflects
      physiological delays better than conventional latency. So, ERD correction of SAM
      and SFM Period Histograms allowed to disclose response effective stimulus ranges
      independent of modulation frequency.

PMID- 1733915
TI  - Setting complex tasks to single units in the avian auditory forebrain. II. Do we
      really need natural stimuli to describe neuronal response characteristics?
AB  - The response characteristic of auditory forebrain neurons in the European
      starling was established both with artificial stimuli (AS) and a conspecific
      territorial song as a natural stimulus (NS1). Applying experimenter-centred
      statistical methods for response detection and for scaling response strength, and
      spike-triggered analyses for the delimitation of the key sound parameters
      (spectrotemporal receptive field STRF, Aertsen et al. 1980) the study aimed at
      disclosing differences in the processing of the two stimulus classes, AS and NS.
      With the STRF as reference, we find congruence (1) in the best frequency with
      those determined under sweep and bandpass noise stimulation, (2) in response
      latency, and (3) in response-intensity dependence, further similarity in the
      overall frequency characteristic. Partitioning the song into 42 acoustically
      defined segments allowed to further delimit the response criteria under natural
      stimulation. They are easily understood from the AS response characteristics: (1)
      In the neuronal sample as a whole, long segments are more effective than short
      and, among the short, loud segments are more effective than faint; (2) Units
      showing their best excitatory response to AS in a certain frequency band are most
      probably excited by segments with a high proportion of their power concentrated
      upon or near this band; (3) Units with a slow (build-up) AS response react to a
      lower number of song segments than those dynamically following AS transients. Our
      data give no hint towards adaptive, feature detection properties of single
      neurons in field L. Instead, these neurons appear to base their response solely
      on the short-time spectrotemporal structure of the stimulus, irrespective of its
      natural or artificial origin.

PMID- 1733916
TI  - Middle-ear transmission: acoustic versus ossicular coupling in cat and human.
AB  - Otologic surgeons consider the action of sound pressure on the cochlear windows
      to be of major importance in certain cases of middle-ear pathology, yet
      previously published network models of mammalian middle ears do not include such
      a mechanism. A unified middle-ear model is developed in which it is assumed that
      the difference of acoustic pressures acting on the windows adds to the ossicular
      chain pressure to produce cochlear input. From a network model of the cat middle
      ear cavities we estimate the contributions of pressures on the cochlear windows
      for both normal and abnormal cat ears. For the human ear we use the model of
      Kringlebotn (1988) and measurements of Bekesy (1947). We determine that the
      pressure difference across the cochlear windows is negligibly small in normal cat
      and human ears. Thus, it is a reasonable approximation to ignore this mechanism
      in normal ears. For ears with a drastically altered tympanic membrane and/or
      ossicular chain, acoustic coupling to the cochlear windows can--to a considerable
      extent--explain residual hearing in human. The model predicts hearing levels for
      type IV tympanoplastic reconstructions that agree with the best results obtained
      surgically.

PMID- 1733917
TI  - Analysis of possible interactions of an attentional task with cochlear
      micromechanics.
AB  - Several contradictory studies have been published regarding the effect of
      selective attention on cochlear mechanics, possibly modulated through efferent
      pathways. Click-evoked otoacoustic emissions have been proposed as a highly
      sensitive tool for testing the hypothesis of such a modulation. In this study,
      two other types of evoked otoacoustic emissions (i.e. distortion products and
      stimulus frequency emissions between 1 and 4 kHz) were measured on 20 normal
      subjects in absence and presence of a visual selective attention task. The
      duration of measurements at a given frequency was short enough to eliminate
      possible artefacts due to long-time averaging. No significant change was observed
      in these signals, considered as probes of cochlear micromechanics. It is
      concluded that in this set of experimental conditions, selective attention has a
      negligible effect on peripheral sensitivity.

PMID- 1733918
TI  - Triple fluorochrome labeling of cochlear bone growth.
AB  - A new technique is described which measures the extent and time course of
      intracochlear bone formation after cochlear implantation in an experimental
      animal model. A series of fluorescent histochemical markers is used to delineate
      the amount of intracochlear bone deposition during specified time periods.

PMID- 1733919
TI  - The structure of human lymphotoxin (tumor necrosis factor-beta) at 1.9-A
      resolution.
AB  - The three-dimensional structure of recombinant human lymphotoxin (residues 24-171
      of the mature protein) has been determined by x-ray crystallography at 1.9-A
      resolution (Rcryst = 0.215 for I greater than 3 sigma (I)). Phases were derived
      by molecular replacement using tumor necrosis factor (TNF-alpha) as a search
      model. Like TNF-alpha, lymphotoxin (LT) folds to form a "jellyroll" beta-sheet
      sandwich. Three-fold related LT subunits form a trimer stabilized primarily by
      hydrophobic interactions. A cluster of 6 basic residues around the 3-fold axis
      may account for the acid lability of the trimer. Although the structural cores of
      TNF-alpha and LT are similar, insertions and deletions relative to TNF-alpha
      occur in loops at the "top" of the LT trimer and significantly alter the local
      structure and the overall shape trimer is highly conserved. The sites of two
      mutations (Asp-50 and Tyr-108) that abolish the cytotoxicity of LT are contained
      within poorly ordered loops of polypeptide chain that flank the cleft between
      neighboring subunits at the base of the molecule, suggesting that the receptor
      recognizes an intersubunit binding site.

PMID- 1733920
TI  - Smooth muscle myosin is composed of homodimeric heavy chains.
AB  - Vertebrate smooth muscle myosin heavy chains (MHCs) exist as two isoforms with
      molecular masses of 204 and 200 kDa (MHC204 and MHC200) that are generated from a
      single gene by alternative splicing of mRNA (Nagai, R., Kuro-o, M., Babij, P.,
      and Periasamy, M. (1989) J. Biol. Chem. 264, 9734-9737). A dimer of two MHCs
      associated with two pairs of myosin light chains forms a functional myosin
      molecule. To investigate the isoform composition of the MHCs in native myosin,
      antibodies specific for MHC204 were generated and used to immunoprecipitate
      purified bovine aortic smooth muscle myosin from a solution containing equal
      amounts of each isoform. MHC204 quantitatively removed from this mixture was
      completely free of MHC200. Immunoprecipitation of the supernatant with an
      antiserum that recognizes both isoforms equally well revealed that only MHC200
      remained. We conclude that only homodimers of MHC204 and MHC200 exist under these
      conditions. A method is described for the purification of enzymatically active
      MHC204 and myosin on a protein G-agarose high performance liquid chromatography
      column containing immobilized MHC204 antibodies. We show, using an in vitro
      motility assay, that the movement of actin filaments by myosin containing 204-kDa
      heavy chains (0.435 +/- 0.115 microns/s) was not significantly different from
      that of myosin containing 200-kDa heavy chains (0.361 +/- 0.078 microns/s) or
      from myosin containing equal amounts of each heavy chain isoform (0.347 +/- 0.082
      microns/s).

PMID- 1733921
TI  - Cloning and expression of an intron-less gene for AKAP 75, an anchor protein for
      the regulatory subunit of cAMP-dependent protein kinase II beta.
AB  - The A-Kinase Anchor Protein AKAP 75 (formerly designated bovine brain P75) is a
      particulate brain protein that avidly binds the regulatory subunit (RII beta) of
      cAMP-dependent protein kinase II beta (Bregman, D. B., Hirsch, A.H. and Rubin,
      C.S. (1991) J. Biol. Chem. 266, 7207-7213). The formation of stable AKAP 75.RII
      beta complexes provides a potential mechanism for targeting physiological signals
      carried by cAMP to specific effector sites within neurons and other brain cells.
      We have now cloned and characterized the AKAP 75 gene. Its coding sequence is
      novel and unexpectedly short (1284 base pairs) and contains no introns. When the
      AKAP 75 gene was transfected into HEK 293 cells, a new RII beta-binding protein
      with an apparent Mr of 75,000 accumulated. A high proportion (approximately 65%)
      of the AKAP 75 gene product was excluded from the cytoplasm and was recovered in
      the 40,000 x g pellet derived from disrupted transfected cells. In contrast,
      cells transfected with a construct encoding 249 amino acids from the central and
      C-terminal regions of AKAP 75 produced an RII beta-binding protein (apparent Mr =
      45,000) that was exclusively cytosolic. AKAP 75 is a novel protein composed of
      only 428 amino acid residues (Mr = 47,878). A highly acidic C-terminal region
      mediates the binding of RII beta (and cAMP-dependent protein kinase II beta),
      whereas a positively charged N-terminal segment contains structural features that
      are essential for the association of AKAP 75 with the cytoskeleton and/or
      intracellular membranes.

PMID- 1733922
TI  - Charge polarity reversal inverses the specificity of neutral endopeptidase-24.11.
AB  - Attempts to change enzyme specificity by charge polarity reversal have so far met
      with little success, probably due to a destabilization of the resulting ion pair
      in an environment naturally optimized for the inverted pair. In the zinc
      metallopeptidase neutral endopeptidase-24.11 (EC 3.4.24.11), Arg102, involved in
      substrate binding, is probably located at the edge of the active site (Bateman,
      R.C., Jr., Kim, Y.-A., Slaughter, C., and Hersh, L.B. (1990) J. Biol. Chem. 265,
      8365-8368; Beaumont, A., Le Moual, H., Boileau, G., Crine, P., and Roques, B.P.
      (1991) J. Biol. Chem. 266, 214-220). This environment may be favorable for
      polarity reversal, as in water the energies of reverse ion pairs would be
      identical. We show here that, while mutating Arg102 to Glu reduces the
      specificity of a C-terminally negatively charged substrate 16-fold, it increases
      that of a substrate with an optimally positioned positive charge 29-fold. The
      concept of charge polarity reversal can be extended to other zinc
      metallopeptidases, and the mutated enzyme could also have applications in the
      enantiomeric separation of unnatural amino acids.

PMID- 1733923
TI  - A single amino acid deletion at the amino terminus of influenza virus
      hemagglutinin causes malfolding and blocks exocytosis of the molecule in
      mammalian cells.
AB  - I am investigating the role of protein folding in the transport of influenza
      virus hemagglutinin (HA), a membrane-bound protein, along the exocytotic pathway.
      From a previous work (Gething, M.-J., McCammon, K., and Sambrook, J. (1986) Cell
      46, 939-950), it has been shown that a subset of alterations of the COOH-terminal
      sequences of the HA molecule inhibit folding and impede its transport to the cell
      surface. Current studies establish that the integrity of the NH2-terminal
      sequences of the HA is essential for assembly and transport of the molecule.
      Mutants lacking just 1 or 2 amino acids immediately COOH-terminal to the signal
      cleavage site are translocated and core glycosylated, but also incorrectly
      folded. The mutant molecules are not terminally glycosylated and are thus
      confined inside the cells. A hypothesis will be presented to explain why
      sequences at opposite ends of the HA molecule are essential for the assembly of
      native structures and why correct folding is necessary for transport along the
      exocytotic pathway of mammalian cells.

PMID- 1733924
TI  - Wortmannin, a microbial product inhibitor of myosin light chain kinase.
AB  - We have found that a fungal strain, Talaromyces wortmannin KY12420, produces a
      potent inhibitor of smooth muscle myosin light chain kinase (MLCK). This active
      product, designated as MS-54, was isolated and purified from the culture broth of
      the fungus and identified as wortmannin. The inhibition of MLCK by wortmannin was
      prevented by a high concentration of ATP. The activity of the catalytic domain,
      which was disclosed by partial tryptic digestion, was also inhibited by
      wortmannin. These results suggest that wortmannin acts at or near to the
      catalytic site of the enzyme. It was shown clearly by kinetic analyses,
      preincubation studies, and dialysis experiments that the inhibitory action of
      wortmannin on MLCK was irreversible. Under the condition of preincubation for 3
      min, 0.3 microM wortmannin inhibited the activity of MLCK, while 10 microM
      wortmannin had no effect on the activities of cAMP-dependent protein kinase, cGMP
      dependent protein kinase, and calmodulin-dependent protein kinase II, and had
      little effect on protein kinase C activity. These data expressed clearly the
      marked selectivity of the compound for MLCK. Furthermore, wortmannin also
      inhibited both the phosphorylation of myosin light chain and the contraction in
      rat thoracic aorta stimulated with KCl, which indicates the effectiveness of the
      compound in the cellular level as an MLCK inhibitor.

PMID- 1733925
TI  - The active site of creatine kinase. Affinity labeling of cysteine 282 with N-(2,3
      epoxypropyl)-N-amidinoglycine.
AB  - Epoxycreatine (N-(2,3-epoxypropyl)-N-amidinoglycine) is an affinity label of
      creatine kinase that irreversibly and completely inactivates the enzyme
      (Marletta, M. A., and Kenyon, G. L. (1979) J. Biol. Chem. 254, 1879-1886). To
      identify active site residues of rabbit muscle creatine kinase, the site of
      modification of it by epoxycreatine has been determined. Separation by high
      performance liquid chromatography of a tryptic digest of [14C]epoxycreatine
      modified creatine kinase yielded two radiolabeled peptides. The larger of these
      consisted of amino acids Ala-266 through Arg-291 and was labeled with
      epoxycreatine at Cys-282. Attempts to purify completely the other labeled peptide
      were not successful; however, it was possible to obtain, by tandem mass
      spectrometry, a collision-induced dissociation spectrum of it from a mixture of
      several peptides. This peptide was a fragment (amino acids Val-279 through Arg
      291) of the previously identified peptide and was also labeled at Cys-282. Model
      studies with cysteine and epoxycreatine have demonstrated that opening of the
      oxirane ring occurs by attack of the cysteine thiolate at the terminal carbon of
      the epoxide. These results are consistent with previous studies on the base
      lability of the label; however, a carboxyl group in the active site is not
      labeled, as had been previously suggested. These results provide evidence that
      Cys-282 is located in or near the creatine-binding site and will also be
      important in identifying and delineating the boundaries of the active site of
      creatine kinase.

PMID- 1733926
TI  - The predominant form of secreted colony stimulating factor-1 is a proteoglycan.
AB  - Colony stimulating factor-1 (CSF-1) is a homodimeric glycoprotein that humorally
      regulates the proliferation and differentiation of mononuclear phagocytic cells
      and locally regulates cells of the female reproductive tract. Alternative
      splicing of the human CSF-1 mRNA leads to alternative expression of the CSF-1
      homodimer as a secreted glycoprotein or as a membrane-spanning molecule with cell
      surface biological activity. In the present study, analysis of immunoaffinity
      purified CSF-1 from mouse L929 cell medium by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis (SDS-PAGE) indicated that CSF-1 is
      predominantly secreted as highly sulfated species of 375- and 250-kDa with a
      smaller amount of a 100-kDa species. Analysis by gel filtration in 4 M guanidine
      HCI buffer, indicated that, in contrast to the 100-kDa species, the highly
      sulfated species exhibit anomalously high molecular weights and self-association
      on SDS-PAGE similar to the dermatan sulfate proteoglycan, biglycan. The three
      predominant CSF-1 species were shown to be an 80-kDa homodimer, an 80-kDa/50-kDa
      heterodimer, and a 50-kDa homodimer. The 80-kDa subunit contained a single 18-kDa
      chondroitin sulfate chain that was absent from the 50-kDa subunit. Furthermore,
      treatment of the 80- and 50-kDa subunits, synthesized in the presence of
      tunicamycin, with chondroitinase ABC, neuraminidase, and endo-alpha-N-acetyl
      galactosaminidase reduced their apparent molecular masses to 60 and 25 kDa,
      respectively. These results are consistent with intracellular proteolytic
      cleavage of the 80-kDa chondroitin sulfate containing subunits from the membrane
      spanning CSF-1 precursor at a point carboxyl-terminal to the single consensus
      sequence for glycosaminoglycan addition and cleavage of the 50-kDa glycoprotein
      subunit at a position aminoterminal to this site. The predominance of the
      proteoglycan form of secreted CSF-1, which represents only 3-4% of the total
      trichloroacetic acid-precipitable counts released from 35SO4(2-)-labeled L cells,
      has important implications for regulation by this growth factor.

PMID- 1733927
TI  - IciA protein, a specific inhibitor of initiation of Escherichia coli chromosomal
      replication.
AB  - Specific binding of IciA protein to the 13-mers in the origin of a minichromosome
      (oriC) inhibits initiation of replication in vitro by blocking the opening of
      this region effected by the initiator DnaA protein (Hwang, D.S., and Kornberg, A.
      (1990) Cell 63, 325-331). Isolation of the iciA gene (Thony, B., Hwang, D.S.,
      Fradkin, L., and Kornberg, A. (1991) Proc. Natl. Acad. Sci. U.S.A. 88, 4066-4070)
      has made possible the construction of an IciA-overproducing strain, which in turn
      has simplified the isolation of a large quantity of the protein,
      indistinguishable from that of the wild-type strain. Based on sedimentation and
      gel filtration, the IciA protein is an elongated dimer of a 33.4-kDa subunit. The
      specific binding of IciA protein to the 13-mers was stable for 2 h at 30 degrees
      C. The amounts of IciA protein, detected by immunoassays, increased 4-fold
      compared with levels (about 100 dimers) in log-phase cells whereas levels of DnaA
      protein decreased upon entry of cells into the stationary phase.

PMID- 1733928
TI  - Activation by G protein beta gamma subunits of agonist- or light-dependent
      phosphorylation of muscarinic acetylcholine receptors and rhodopsin.
AB  - We have partially purified a protein kinase that phosphorylates muscarinic
      receptors (mAChR) in the presence of agonists and have shown that the
      phosphorylation is stimulated by the beta gamma subunits of the GTP binding
      protein Go (Haga, K., and Haga, T. (1990) FEBS Lett. 268, 43-47). We report here
      that rhodopsin is also phosphorylated in a light-dependent manner by the same
      kinase preparation and that beta gamma subunits derived from Gs, Gi, and Go
      stimulate the phosphorylation of both rhodopsin and mAChRs. The rhodopsin- and
      mAChR-phosphorylating activities were eluted in the same fractions using a
      purification procedure that is essentially the same as that used for the
      purification of beta-adrenergic receptor kinase (Benovic, J.L., Strasser, R.H.,
      Caron, M.G., and Lefkowitz, R.J. (1986) Proc. Natl. Acad. Sci. U. S. A. 83, 2797
      2801) and were inhibited by low concentrations of heparin, an inhibitor of beta
      adrenergic receptor kinase, (IC50 = 15 nM), suggesting that both mAChR and
      rhodopsin are phosphorylated by the same or very similar kinase(s) belonging to
      the beta-adrenergic receptor kinase family. G protein beta gamma subunits
      increased the Vmax of the phosphorylation of rhodopsin 12-fold. Kinetic data were
      consistent with the assumptions that the protein kinase (mAChR kinase) binds
      rhodopsin and beta gamma subunits in a random order and that the reaction rate is
      proportional to concentration of the ternary complex. By contrast, the light
      dependent phosphorylation of rhodopsin by the rhodopsin kinase was not stimulated
      by the beta gamma subunits. These results indicate that beta gamma subunits may
      interact with and activate the mAChR kinase but not rhodopsin kinase and suggest
      that the beta gamma subunit of G proteins may take part in the desensitization of
      G protein-linked receptors.

PMID- 1733929
TI  - Isolation and characterization of a novel class of plant antimicrobial peptides
      form Mirabilis jalapa L. seeds.
AB  - We have isolated from seeds of Mirabilis jalapa L. two antimicrobial peptides,
      designated Mj-AMP1 and Mj-AMP2, respectively. These peptides are highly basic and
      consist of 37 and 36 residues for Mj-AMP1 and Mj-AMP2, respectively. Both
      peptides contain three disulfide bridges and differ from one another only by 4
      amino acids. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis
      of the reduced and unreduced peptides suggests that the peptides associate into
      dimers in their native form. The Mj-AMPs exhibit a broad spectrum of antifungal
      activity since they are active against all 13 tested plant pathogenic fungi.
      Concentrations required for 50% inhibition of fungal growth vary from 6 to 300
      micrograms/ml for Mj-AMP1 and from 0.5 to 20 micrograms/ml for Mj-AMP2. These
      peptides were also active on two tested Gram-positive bacteria but were
      apparently nontoxic for Gram-negative bacteria and cultured human cells. Although
      the Mj-AMPs show sequence similarity to mu-agatoxins, a class of insecticidal
      neurotoxic peptides isolated from the venom of spiders, they do not affect pulse
      transmission in insect nerves.

PMID- 1733930
TI  - Protein L from Peptostreptococcus magnus binds to the kappa light chain variable
      domain.
AB  - Protein L is an immunoglobulin light chain-binding protein expressed by some
      strains of the anaerobic bacterial species Peptostreptococcus magnus. The major
      variable region subgroups of human kappa and lambda light chains were tested for
      protein L binding; V kappa I, V kappa III, and V kappa IV bound protein L,
      whereas no binding occurred with proteins of the V kappa II subgroup or with any
      lambda light chain subgroups. Studies of the protein L binding capacity of
      naturally occurring VL fragments, and VL- and CL-related trypsin- and pepsin
      derived peptides prepared from a kappa I light chain, localized the site of
      interaction to the VL domain. The affinity constant for the binding to an
      isolated V kappa I fragment was comparable to that for the native protein (Ka 0.9
      x 10(9) M-1 and Ka 1.5 x 10(9) M-1, respectively). No binding occurred with CL
      related fragments. Extensive reduction and alkylation of the V kappa fragment or
      the native kappa chain resulted in complete loss of protein L binding. Although
      it is possible, from comparative amino acid sequence data, to identify certain VL
      framework region residues that account for the selective binding of protein L by
      kappa I, kappa III, and kappa IV proteins, our studies indicate that this
      interaction is essentially dependent upon the tertiary structural integrity of
      the kappa chain VL domain.

PMID- 1733931
TI  - Insertional mutagenesis of Bordetella pertussis adenylate cyclase.
AB  - We developed an improved method of linker insertion mutagenesis for introducing 2
      or 16 codons into the Bordetella pertussis cyaA gene which encodes a calmodulin
      dependent adenylate cyclase. A recombinant kanamycin resistance cassette,
      containing oligonucleotide linkers, was cloned in plasmids which carried a
      truncated cyaA gene, fused at its 3' end to the 5' end of the Escherichia coli
      lacZ gene, specifying the alpha-peptide. This construction permitted a double
      selection for in-frame insertions by using screening for kanamycin resistance and
      for lactose-positive phenotype, resulting from alpha-complementation. We showed
      that most of the two-amino acid insertions within the N-terminal moiety of the
      catalytic domain of adenylate cyclase abolished enzymatic activity and/or altered
      the stability of the protein. All two-amino acid insertions within the C-terminal
      part of adenylate cyclase resulted in fully stable and active enzymes. These
      results confirm the modular structure of the catalytic domain of adenylate
      cyclase, previously proposed on the basis of proteolytic studies. Two-amino acid
      insertions between residues 247-248 and 335-336 were shown to affect the
      calmodulin responsiveness of adenylate cyclase, suggesting that the corresponding
      region in the enzyme is involved in the binding of calmodulin or in the process
      of calmodulin activation. In addition, we have identified within the primary
      structure of adenylate cyclase several permissive sites which tolerate 16-amino
      acid insertions without interfering with the catalytic activity or calmodulin
      binding. By inserting foreign antigenic determinants into these permissive sites
      the resulting recombinant adenylate cyclase toxin could be used to deliver
      specific epitopes into antigen-presenting cells.

PMID- 1733932
TI  - The human blood fluke Schistosoma mansoni synthesizes a novel type of
      glycosphingolipid.
AB  - Previous studies have shown that the glycoprotein oligosaccharides synthesized by
      adult Schistosoma mansoni, the organism responsible for human schistosomiasis,
      are unusual in that they contain terminal beta-GalNAc residues and lack sialic
      acid. These observations and other studies indicating that schistosome
      glycoproteins and glycolipids are antigenic in infected animals led us to
      investigate the structures of the glycosphingolipids synthesized by these
      organisms and to determine whether they are structurally related to those
      synthesized by their vertebrate hosts. For our studies, adult schistosomes were
      metabolically radiolabeled with either [3H]galactose or [3H]glucosamine, and the
      newly synthesized glycosphingolipids were isolated and characterized. The major
      glycosphingolipids synthesized by adult schistosomes were found to be
      galactosylceramide and glucosylceramide. The adult worms synthesized no
      lactosylceramide (Gal beta 1-4Glc-ceramide), a common constituent of vertebrate
      cells; however, another disaccharide-containing glycosphingolipid cleavable by
      ceramide glycanase was found. The results of compositional and methylation
      analyses and exoglycosidase treatments demonstrated that this ceramide
      disaccharide has the structure GalNAc beta 1-4Glc-ceramide. We also found that
      extracts of adult schistosomes are unable to transfer Gal from UDP-Gal to
      glucosylceramide, whereas extracts of Chinese hamster ovary cells, as a control,
      are able to do so, confirming that schistosomes are unable to synthesize
      lactosylceramide. Low levels of higher molecular weight glycosphingolipids were
      also found to be synthesized by adult schistosomes, and although their levels
      were too small to allow definitive characterization, compositional analyses
      indicated that they also contained GalNAc. We have tentatively designated the new
      disaccharide structure GalNAc beta 1, 4Glc- the "schistocore", which may
      represent a new type of glycosphingolipid core series.

PMID- 1733933
TI  - Cooperative cyanide dissociation from ferrous hemoglobin.
AB  - Rapid reduction of cyano-met hemoglobin (Hb+CN-) leads to the formation of an
      intermediate species, the cyanide derivative of ferrous hemoglobin, which
      dissociates to unliganded hemoglobin because of the extremely low affinity of the
      ligand for the ferrous heme iron. The properties of the intermediate were studied
      by transient spectroscopy in human hemoglobin and its isolated alpha and beta
      chains, in the presence and absence of CO. When mixing with dithionite, the time
      courses of reduction of the heme iron and dissociation of cyanide overlap
      considerably; addition to the reaction mixture of the redox indicator methyl
      viologen considerably increases the rate of reduction and allows unequivocal
      determination of the spectroscopic and kinetic properties of the intermediate.
      The results show that (i) the dissociation of cyanide from the isolated alpha and
      beta chains (as well as the (alpha CO)2(beta + CN-)2 hybrid) is a simple process;
      (ii) the two chains display similar rate parameters, but show spectroscopic
      inequivalence, both in the Soret and the visible regions; (iii) cooperative
      effects are shown to control the rate of dissociation of cyanide from hemoglobin,
      similarly to what happens for oxygen; and (iv) allosteric effectors (typically
      inositol hexaphosphate) increase the overall rate of dissociation by
      stabilization of the T state. We have, therefore, shown for the first time that
      the dissociation of cyanide from ferrous hemoglobin is controlled by the
      quaternary state, thereby adding one more ligand to the analysis of the structure
      function relationships in hemoglobin.

PMID- 1733934
TI  - The disulfide structure of bovine pituitary basic fibroblast growth factor.
AB  - Basic fibroblast growth factor has 4 cysteine residues in its amino acid
      sequence, two of which are perfectly conserved within the fibroblast growth
      factor family of proteins suggesting a disulfide bond at this position.
      Furthermore, thiol titration of bovine pituitary basic fibroblast growth factor
      (bFGF) indicates the presence of two free thiols, which is consistent with an
      intramolecular disulfide. Direct analysis of natural and recombinant fibroblast
      growth factor proteins have not confirmed the existence of such a disulfide.
      Instead, the two nonconserved cysteines of bFGF purified from bovine pituitaries
      are S-thiolated with glutathione. Inclusion of 75 mM N-ethylmaleimide during the
      homogenization of the pituitaries effectively blocks the S-thiolation,
      demonstrating that this modification is an artifact of the purification
      procedure. Analysis of the N-ethylmaleimide purified bovine pituitary bFGF
      suggests that the natural protein is in the correct redox state when all 4
      cysteines are in the reduced form.

PMID- 1733935
TI  - Critical functional requirement for the guanidinium group of the arginine 41 side
      chain of human epidermal growth factor as revealed by mutagenic inactivation and
      chemical reactivation.
AB  - In a preliminary study we demonstrated that the formation of the epidermal growth
      factor (EGF) receptor-ligand complex requires the participation of the highly
      conserved arginine 41 side chain of the growth factor peptide (Engler, D.A.,
      Montelione, G.T., and Niyogi, S.K. (1990) FEBS Lett. 271, 47-50). In an attempt
      to gain further insight into the nature of this interaction(s), we used both site
      directed mutagenesis and chemical modification reagents to produce human EGF
      (hEGF) analogues with altered chemical properties of the residue 41 side chain.
      Eight mutant analogues of hEGF were generated, substituting arginine 41 with
      lysine, glutamine, isoleucine, tyrosine, glycine, alanine, aspartate, or
      glutamate. Although each of the mutant analogues was able to displace wild-type
      hEGF fully in receptor competition binding assays, affinity of the receptor for
      the mutants was substantially reduced, varying from 0.4 to less than 0.01% of
      that observed for wild-type growth factor. At sufficiently high concentrations
      these mutants were able to stimulate DNA synthesis in mouse keratinocytes.
      Substitution of lysine for arginine 41 reduced the receptor affinity 250-fold
      from that observed for wild type, despite retention of the positive electrostatic
      charge. The lysine substitution leaves a reactive amine at position 41 and made
      it possible, using amine-specific chemical modification reagents, to produce
      selected arginine homologues that were tested for their effects on receptor
      binding, receptor tyrosine kinase activation, and stimulation of DNA synthesis in
      mouse keratinocytes. The reaction of lysine 41 with methyl acetimidate resulted
      in a lysineacetamidine product which only partially restored activity of the
      lysine hEGF mutant. However, reaction with O-methylisourea resulted in generation
      of an arginine 41 homologue (homoarginine) which restored full activity. The
      results indicate that the chemical properties inherent in the guanidinium group
      of the arginine 41 side chain of hEGF are responsible for optimal receptor-ligand
      association.

PMID- 1733936
TI  - Purification and characterization of transforming growth factor-beta 2.3 and 
      beta 1.2 heterodimers from bovine bone.
AB  - A unique form of transforming growth factor-beta (TGF-beta), TGF-beta 2.3
      heterodimer, has been purified from bovine bone extract. TGF-beta 2.3 migrated as
      a single 25-kDa band by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, whereas under reducing conditions it migrated as a 12.5 kDa
      band. The TGF-beta 2.3 reacted positively with anti-TGF-beta 2 and anti-TGF-beta
      3 antibodies on immunoblots. Equal levels of TGF-beta 2 and TGF-beta 3 sequences
      were detected by N-terminal sequencing. TGF-beta 2.3 eluted as a single sharp
      peak by reverse-phase high performance liquid chromatography. However, prior
      reduction of the protein with dithiothreitol resulted in the protein eluting in
      two peaks, one containing predominantly TGF-beta 3 and the other containing
      predominantly TGF-beta 2. TGF-beta 2.3 inhibited proliferation of mink lung
      epithelial cells and promoted the formation of colonies of normal rat kidney
      fibroblasts in culture with specific biological activity similar to those of TGF
      beta 1 and TGF-beta 2. These results demonstrate that the protein is TGF-beta 2.3
      heterodimer, consisting of one polypeptide chain each of TGF-beta 2 and TGF-beta
      3 linked by one or more disulfide bonds. In addition, TGF-beta 1.2 heterodimer,
      previously found only in porcine platelets, has also been purified from bovine
      bone extract.

PMID- 1733937
TI  - Topology of the hydrophobic membrane-bound components of the histidine
      periplasmic permease. Comparison with other members of the family.
AB  - The membrane-bound complex of periplasmic permeases comprises two hydrophobic
      proteins which have been hypothesized to be integral membrane-spaninning
      proteins. We have investigated the topological organization of the hydrophobic
      components of the Salmonella typhimurium histidine permease, HisQ and HisM. Both
      proteins are digested by trypsin and proteinase K when either inside-out or right
      side-out membrane vesicles are used. Therefore, these proteins are exposed to
      both surfaces of the membrane. Digestion with carboxypeptidase and binding
      studies with antibodies directed against the carboxyl terminus of HisQ and HisM
      have localized their carboxyl termini to the inside surface of the cytoplasmic
      membrane. Aminopeptidase digestion suggests periplasmic localization of their
      amino termini. Alkaline phosphatase fusions to HisQ and HisM indicate the
      existence of five spanners in both proteins. The periodicity and orientation of
      spanners and loops in HisQ and HisM match those of the five carboxyl-terminal
      spanners of MalF, the only other hydrophobic component of the periplasmic
      permeases for which topological information is available. An alignment of the
      sequences of all known hydrophobic components of periplasmic permeases is
      presented which indicates clear conservation of secondary structure and some
      conservation of primary sequence. The structural conservation of the components
      is discussed, and a role for a hydrophilic loop containing a conserved sequence
      (the EAA loop) is proposed.

PMID- 1733938
TI  - Identification of the protein responsible for hepatic system N amino acid
      transport activity.
AB  - In the liver, glutamine utilization may be limited by the rate of transport
      across the plasma membrane by the System N carrier. System N-mediated transport
      activity has been solubilized from rat liver plasma membrane, partially purified,
      and then reconstituted into proteoliposomes. To identify the System N carrier
      protein, monoclonal antibodies were generated against the protein fraction
      enriched for System N activity. Two antibodies , 3E1-2 and 1E7-3, inhibited
      System N activity in hepatocytes. These antibodies also immunoprecipitated System
      N activity from a mixture of solubilized proteins and were specific for antigen
      recognition in that neither immunoprecipitated System A activity. The antibody
      recognized a single protein of molecular size 100 kDa by immunoblot analysis.
      Recognition of this protein by the antibody increased in parallel with the
      enrichment of System N activity in solubilized membrane fractions. These data
      suggest that a 100-kDa plasma membrane protein mediates System N transport
      activity in rat hepatocytes.

PMID- 1733939
TI  - Search for the heparin antithrombin III-binding site precursor.
AB  - The last step of heparin biosynthesis is thought to involve the action of 3-O
      sulfotransferase resulting in the formation of an antithrombin III (ATIII)
      binding site required for heparin's anticoagulant activity. The isolation of a
      significant fraction of heparin chains without antithrombin III-binding sites and
      having low affinity for ATIII suggests the presence of a precursor site, lacking
      the 3-O-sulfate group. Porcine mucosal heparin was depolymerized into a mixture
      of oligosaccharides using heparin lyase. One of these oligosaccharides was
      derived from heparin's ATIII-binding site. In an effort to find the ATIII-binding
      site precursor, the structures of several minor oligosaccharides were determined.
      A greater than 90% recovery of oligosaccharides (on a mole and weight basis) was
      obtained for both unfractionated and affinity-fractionated heparins. An
      oligosaccharide arising from the ATIII-binding site precursor was found that
      comprised only 0.8 mol % of the oligosaccharide product mixture. This
      oligosaccharide was only slightly enriched in heparin having a low affinity for
      ATIII and only slightly disenriched in high affinity heparin. The small number of
      these ATIII-binding site precursors, found in unfractionated and fractionated
      heparins, suggests the existence of a low ATIII affinity heparin may not simply
      be the result of the incomplete action of 3-O-sulfotransferase in the final step
      in heparin biosynthesis. Rather these data suggest that some earlier step,
      involved in the formation of placement of these precursor sites, may be primarily
      responsible for high and low ATIII affinity heparins.

PMID- 1733940
TI  - Site-directed mutagenesis of the phosphate-binding consensus sequence in
      Escherichia coli adenylosuccinate synthetase.
AB  - Adenylosuccinate synthetases from different sources contain an N-terminal glycine
      rich sequence GDEGKGK, which is homologous to the conserved sequence GXXXXGK
      found in many other guanine nucleotide-binding proteins or enzymes. To determine
      the role of this sequence in the structure and function of Escherichia coli
      adenylosuccinate synthetase, site-directed mutagenesis was performed to generate
      five mutant enzymes: G12V (Gly12----Val), G15V (Gly15----Val), G17V (Gly17---
      Val), K18R (Lys18----Arg), and I19T (Ile19----Thr). Comparison of the kinetic
      properties of the wild-type enzyme and those of the mutant enzymes revealed that
      the sequence is critical for enzyme activity. Replacement of Gly12, Gly15, or
      Gly17 with Val, or replacement of Lys18 with Arg, resulted in significant
      decreases in the kcat/Km values of the enzyme. Because the consensus sequence
      GXXXXGK(T/S) has been found in many GTP-binding proteins, isoleucine at position
      19 in the E. coli adenylosuccinate synthetase was changed to threonine to produce
      the sequence GDEGKGKT. This mutation, which more closely resembles the consensus
      sequence, resulted in a 160-fold increase in the Km value for substrate GTP;
      however, there were no great changes for the other two substrates, IMP and
      aspartate. Based on these data, we suggest that the N-terminal glycinerich
      sequence in E. coli adenylosuccinate synthetase plays a more important role in
      enzyme catalysis than in substrate binding. In addition, a hydrophobic amino acid
      residue such as isoleucine, leucine, or valine, rather than threonine, may play a
      critical role in GTP binding in adenosuccinate synthetase. These findings suggest
      that the glycine-rich sequence in adenylosuccinate synthetase functions
      differently relative to those in other GTP binding proteins or enzymes.

PMID- 1733941
TI  - Tolerance of T4 lysozyme to proline substitutions within the long interdomain
      alpha-helix illustrates the adaptability of proteins to potentially destabilizing
      lesions.
AB  - To investigate the ability of a protein to accommodate potentially destabilizing
      amino acid substitutions, and also to investigate the steric requirements for
      catalysis, proline was substituted at different sites within the long alpha-helix
      that connects the amino-terminal and carboxyl-terminal domains of T4 lysozyme. Of
      the four substitutions attempted, three yielded folded, functional proteins. The
      catalytic activities of these three mutant proteins (Q69P, D72P, and A74P) were
      60-90% that of wild-type. Their melting temperatures were 7-12 degrees C less
      than that of wild-type at pH 6.5. Mutant D72P formed crystals isomorphous with
      wild-type allowing the structure to be determined at high resolution. In the
      crystal structure of wild-type lysozyme the interdomain alpha-helix has an
      overall bend angle of 8.5 degrees. In the mutant structure the introduction of
      the proline causes this bend angle to increase to 14 degrees and also causes a
      corresponding rotation of 5.5 degrees of carboxyl-terminal domain relative to the
      amino-terminal one. Except for the immediate location of the proline substitution
      there is very little change in the geometry of the interdomain alpha-helix. The
      results support the view that protein structures are adaptable and can compensate
      for potentially destabilizing amino acid substitutions. The results also suggest
      that the precise shape of the active site cleft of T4 lysozyme is not critical
      for catalysis.

PMID- 1733942
TI  - Comparison of the enzymatic and biochemical properties of human insulin-degrading
      enzyme and Escherichia coli protease III.
AB  - The enzymatic and biochemical properties of human insulin-degrading enzyme and
      Escherichia coli protease III have been compared. Both enzymes were found to
      degrade insulin in such a way that its receptor binding activity was rapidly lost
      but its precipitability in trichloracetic acid was only slightly decreased. Both
      enzymes were also found to be inhibited by chelating agents. The bacterial
      enzyme, which could be purified in large amounts, was found to contain 0.6 mol of
      zinc per mol of enzyme but no detectable manganese. The mammalian enzyme but not
      the bacterial one was inhibited by a sulfhydryl alkylating agent. The two enzymes
      also differed in substrate specificity. The mammalian enzyme degraded insulin
      much better than insulin-like growth factor II, whereas the bacterial enzyme
      degraded them equally. The mammalian enzyme could be labeled by cross-linking to
      insulin = bombyxin II much greater than insulin-like growth factor I and II much
      greater than relaxin, while the bacterial enzyme was labeled by insulin-like
      growth factor II greater than insulin = insulin-like growth factor I much greater
      than relaxin much greater than bombyxin. Finally, sucrose gradient centrifugation
      and cross-linking studies both in vitro and in vivo indicated that active human
      enzyme partially existed as a homo- or heterodimer, whereas the bacterial enzyme
      was active as a monomer.

PMID- 1733943
TI  - Sequence complementarity between the 5'-terminal regions of mRNAs for rat
      mitochondrial cytochrome P-450c27/25 and a growth hormone-inducible serine
      protease inhibitor. A possible gene overlap.
AB  - Recently we reported that a P-450c27/25 cDNA probe hybridizes to two RNA species
      of about 1.9 and 2.3-2.4 kilobase pairs (kb) in some rat tissues. To understand
      the molecular relationship between the two mRNAs, we have isolated and
      characterized a cDNA for the larger, previously uncharacterized 2.3-kb mRNA
      species. The 2.3-kb cDNA is identical to the previously reported 1.9-kb P
      450c27/25 cDNA excepting a 400-nucleotide-long 5' extension. The terminal 291
      nucleotides of this extension exhibit 100% complementarity with the 5'-translated
      region of the mRNA belonging to a family of growth hormone-inducible serine
      protease inhibitors (SPI). Northern blot analysis, using strand-specific probes,
      and S1 nuclease protection revealed the presence of the 2.3-kb mRNA exhibiting
      the sequence characteristics of the larger cDNA. These results were further
      confirmed by polymerase chain reaction amplification of reverse transcribed RNA.
      Expression of the 2.3-kb cDNA in COS cells resulted in the correct mitochondrial
      targeting of a 52-kDa protein exhibiting the properties of P-450c27/25.
      Furthermore, both the 1.9- and 2.3-kb mRNAs appear to direct the synthesis of a
      similarly sized 55-kDa precursor protein in a reticulocyte lysate system.
      Restriction mapping, polymerase chain reaction amplification and partial
      sequencing of a 25-kb genomic DNA clone suggest the proximal location of the SPI
      and the P-450c27/25 protein coding regions in the rat genome on either side of a
      common overlap region. The results also show that the P-450c27/25 mRNAs are
      regulated by growth hormone in parallel to the SPI mRNAs. These results
      collectively suggest that a growth hormone-inducible SPI family mRNA and the P
      450c27/25 mRNA are encoded by two closely linked, possibly overlapping genes.

PMID- 1733944
TI  - Long range effects of amino acid substitutions in the catalytic chain of
      aspartate transcarbamoylase. Localized replacements in the carboxyl-terminal
      alpha-helix cause marked alterations in allosteric properties and intersubunit
      interactions.
AB  - A single alpha-helical polypeptide segment of 21 amino acids near the carboxyl
      terminus of the catalytic chain of aspartate transcarbamoylase from Escherichia
      coli has been shown recently to be important for the in vivo folding of the
      chains and assembly of the enzyme (Peterson, C. B., and Schachman, H. K. (1991)
      Proc. Natl. Acad. Sci. U.S.A. 88, 458-462). Calorimetric measurements on purified
      mutant enzymes showed that single amino acid replacements within this secondary
      structural element affect the overall thermal stability of the oligomeric enzyme
      and the energetics of the interactions between polypeptide chains within the
      holoenzyme. Studies presented here demonstrate that marked changes in
      cooperativity occur due to single amino acid substitutions. Replacement of Gln288
      by either Ala or Glu leads to a striking increase in the Hill coefficient of the
      holoenzymes and a substantial increase in the aspartate concentration
      corresponding to one-half Vmax. In contrast, the isolated catalytic trimers
      harboring these same substitutions were similar in activity to the wild-type
      subunit, with the same affinity for aspartate as indicated by the values of Km.
      Substituting Ala for the only charged residue in the helix, Arg296, caused a
      marked reduction in enzyme activity, as well as a greatly reduced stability of
      the holoenzyme due to a substantial weakening of the interactions between the
      catalytic and regulatory subunits. A subunit exchange method was used to
      demonstrate the changes in interchain interactions resulting from the amino acid
      substitutions and to show the additional weakening upon the binding of the
      bisubstrate ligand, N-(phosphonacetyl)-L-aspartate, at the active sites. Taken
      together, the results on this series of mutant enzymes illustrate how the effects
      of single amino acid replacements in one element of secondary structure are
      propagated throughout the molecule to positions remote from the site of the
      substitution.

PMID- 1733945
TI  - Effects of Ca2+ on the kinetics of phosphate release in skeletal muscle.
AB  - The process of phosphate dissociation during the muscle cross-bridge cycle has
      been investigated by photoliberation of inorganic phosphate (Pi) within skinned
      fibers of rabbit psoas muscle. This permitted a test of the idea that Ca2+
      controls muscle contraction by regulating the Pi release step of the cycle.
      Photoliberation of Pi from structurally distinct "caged" Pi precursors initiated
      a rapid tension decline of up to 12% of active tension, and this was followed by
      a slower tension decline. The apparent rate constant of the fast phase, kPi,
      depended on both [Pi] and [Ca2+], whereas the slow phase generally occurred at 2
      4 s-1. At maximal Ca2+, kPi increased in a nonlinear manner from 43 +/- 2 s-1 to
      118 +/- 7 s-1, as Pi was raised from 0.9 to 12 mM. This was analyzed in terms of
      a three-state kinetic model in which a force-generating transition is coupled to
      Pi dissociation from the cross-bridge. As Ca(2+)-activated tension was reduced
      from maximal (Pmax) to 0.1 Pmax, (i) kPi decreased by up to 2.5-fold, (ii) the
      relative amplitude of the rapid phase increased 2-fold, and (iii) the relative
      amplitude of the slow phase increased about 6-fold. Changes in the rapid phase
      are compatible with Ca2+ influencing an apparent equilibrium constant for the
      force-generating transition. By comparison, kPi was faster than the rate constant
      of tension redevelopment, ktr, and was influenced less by Ca2+. Ca2+ effects on
      the caged Pi transient cannot account for the large effects of Ca2+ on actomyosin
      ATPase rates or cross-bridge cycling kinetics but may be a manifestation of
      reciprocal interactions between the thin filament and force-generating cross
      bridges, and may represent Ca2+ regulation of the distribution of cross-bridges
      between non-force-and force-generating states.

PMID- 1733946
TI  - Cyclohexadienyl dehydratase from Pseudomonas aeruginosa. Molecular cloning of the
      gene and characterization of the gene product.
AB  - The gene encoding cyclohexadienyl dehydratase (denoted pheC) was cloned from
      Pseudomonas aeruginosa by functional complementation of a pheA auxotroph of
      Escherichia coli. The gene was highly expressed in E. coli due to the use of the
      high-copy number vector pUC18. The P. aeruginosa cyclohexadienyl dehydratase
      expressed in E. coli was purified to electrophoretic homogeneity. The latter
      enzyme exhibited identical physical and biochemical properties as those obtained
      for cyclohexadienyl dehydratase purified from P. aeruginosa. The activity ratios
      of prephenate dehydratase to arogenate dehydratase remained constant (about 3.3
      fold) throughout purification, thus demonstrating a single protein having broad
      substrate specificity. The cyclohexadienyl dehydratase exhibited Km values of
      0.42 mM for prephenate and 0.22 mM for L-arogenate, respectively. The pheC gene
      was 807 base pairs in length, encoding a protein with a calculated molecular mass
      of 30,480 daltons. This compares with a molecular mass value of 29.5 kDa
      determined for the purified enzyme by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. Since the native molecular mass determined by gel filtration was
      72 kDa, the enzyme probably is a homodimer. Comparison of the deduced amino acid
      sequence of pheC from P. aeruginosa with those of the prephenate dehydratases of
      Corynebacterium glutamicum, Bacillus subtilis, E. coli, and Pseudomonas stutzeri
      by standard pairwise alignments did not establish obvious homology. However, a
      more detailed analysis revealed a conserved motif (containing a threonine residue
      known to be essential for catalysis) that was shared by all of the dehydratase
      proteins.

PMID- 1733947
TI  - Sulfhydryl groups on yeast ribosomal proteins L7 and L26 are significantly more
      reactive in the 80 S particles than in the 60 S subunits.
AB  - The sulfhydryl-directed fluorescent reagent, 5-iodoacetamidofluorescein (IAF),
      reacts differently with proteins from the 60 S ribosomal subunit of Saccharomyces
      cerevisiae when this subunit is free as opposed to being contained within the 80
      S ribosome. When the 80 S ribosomes and the free 60 S subunits were labeled with
      IAF, the specific fluorescence intensity (fluorescence intensity unit/A260 60 S
      subunit) of the subsequently derived 60 S was 16.3 and 5.4, respectively. Gel
      analysis showed that proteins L7 and L26 were selectively labeled and contained
      greater than 90% of the total fluorescent label, when 80 S ribosomes were
      labeled. When free 60 S subunits were labeled, six additional proteins were
      labeled. Both types of modified 60 S subunits were equally capable to support
      protein synthesis in vitro. Reassociation of the IAF-labeled derived and free 60
      S subunits with unmodified 40 S subunits resulted in a maximum of 5-7% decrease
      and a 3-fold increase, respectively, in the fluorescence intensity without a
      shift in the emission maxima. The data suggest that ribosomal proteins L7 and L26
      contain SH groups that respond to ribosomal subunit association and become more
      reactive in the intact ribosome than in the subunit. The environments of some or
      all of the additionally labeled proteins are also sensitive to subunit
      reassociation.

PMID- 1733948
TI  - Tissue-specific alternative splicing of the beta-galactoside alpha 2,6
      sialyltransferase gene.
AB  - The rat alpha 2,6-sialyltransferase gene produces three different sized mRNAs
      (4.7, 4.3, and 3.6 kilobases (kb)) which exhibit striking tissue-specific
      expression. Recently, we characterized the cDNA and genomic organization of the
      4.3-kb mRNA which is unique to rat liver. In this report cDNAs of the 4.7-kb mRNA
      found in most tissues and the 3.6-kb mRNA(s) unique to kidney have been cloned
      and characterized as well as the corresponding genomic sequences which differed
      from those of the previously characterized 4.3-kb mRNA. The 4.7-kb mRNA was found
      to be identical to the 4.3-kb mRNA with the exception of two additional exons at
      the 5'-untranslated end of the transcript. The constitutively expressed 4.7-kb
      mRNA therefore codes for the same sialyltransferase as the liver-restricted 4.3
      kb mRNA. The additional 5'-exons of the 4.7-kb mRNA are located at least 15-40 kb
      upstream of the promoter responsible for the production of the 4.3-kb liver
      message. The 3.6-kb mRNA of rat kidney was found to be comprised of three
      transcripts of similar size. They were only expressed in kidney and were found to
      be generated from the alpha 2,6-sialyltransferase gene by alternative splicing
      and alternative promoter utilization. The results reveal the complexity of the
      alpha 2,6-sialyltransferase gene which produces at least five transcripts via
      alternative splicing in a tissue-specific fashion.

PMID- 1733949
TI  - Identification, purification, and partial sequence analysis of autotaxin, a novel
      motility-stimulating protein.
AB  - Autotaxin (ATX) is a potent human motility-stimulating protein that has been
      identified in the conditioned medium from A2058 melanoma cells. This protein has
      been purified to homogeneity utilizing a strategy involving five column steps.
      Homogeneity of ATX was verified by two-dimensional gel electrophoresis. The
      molecular size of ATX is 125 kDa, and it has an isoelectric point of 7.7 +/- 0.2.
      Purified ATX was digested with cyanogen bromide and trypsin, and the resulting
      ATX peptides were purified by reverse-phase high performance liquid
      chromatography. Eleven peptides were subjected to amino acid sequence analysis,
      and 114 residues were identified. The partial amino acid sequences and the amino
      acid composition obtained for ATX show that it does not exhibit any significant
      homology to known growth factors or previously described motility factors. At
      picomolar concentrations, ATX stimulates both random and directed migration of
      human A2058 melanoma cells. Pretreatment of the melanoma cells with pertussis
      toxin abolishes the response to purified ATX, indicating that ATX stimulates
      motility through a receptor acting via a pertussis toxin-sensitive G protein.

PMID- 1733950
TI  - Inhibition of interleukin 3 and granulocyte-macrophage colony-stimulating factor
      stimulated increase of active ras.GTP by herbimycin A, a specific inhibitor of
      tyrosine kinases.
AB  - Interleukin 3 (IL-3) and granulocyte-macrophage colony-stimulating factor (GM
      CSF) stimulate the proliferation of several kinds of cultured hematopoietic cell
      lines. Growth signals from IL-3 and GM-CSF cause accumulation of active Ras.GTP
      complexes in PT18 mouse mast cell line (Satoh, T., Nakafuku, M., Miyajima, A.,
      and Kaziro, Y. (1991) Proc. Natl. Acad. Sci. U. S. A. 88, 3314-3318). In this
      paper we describe the effect of herbimycin A, a tyrosine kinase-specific
      inhibitor, on the activation of Ras. The increase of Ras.GTP induced by IL-3 and
      GM-CSF diminished in cells treated with 0.5 approximately 1 micrograms/ml of
      herbimycin A for 24 h prior to the addition of the growth factors. Under this
      condition, the extent of phosphorylation on tyrosine residues of proteins
      decreased. However, the activity of cAMP-dependent protein kinase and protein
      kinase C did not change. Growth of cells in the presence of IL-3 or GM-CSF was
      also completely inhibited. These observations suggest that tyrosine kinases are
      involved in the pathways between IL-3 and GM-CSF receptors and Ras and that they
      are essential for the growth stimulated by these growth factors.

PMID- 1733951
TI  - Lymphotoxin is expressed as a heteromeric complex with a distinct 33-kDa
      glycoprotein on the surface of an activated human T cell hybridoma.
AB  - We characterized the membrane-associated form of lymphotoxin (surface LT) on the
      activated II-23.D7 T cell hybridoma. Antibodies to rLT precipitated both surface
      LT and a distinct 33-kDa glycoprotein (p33). Because p33 and surface LT were
      antigenically unrelated, their coprecipitation suggested a physical association
      of p33 and surface LT on the membrane. Pulse-chase analysis indicated that LT and
      p33 associate with each other early in the LT biosynthetic pathway, precluding
      the possibility that LT is secreted and bound to p33 or a surface receptor.
      Furthermore, no p33 was associated with the secreted form of LT. Isoelectric
      focusing of surface LT and p33 under nondenaturing and denaturing conditions
      confirmed that surface LT and p33 existed as a complex. Treatment of cells with a
      high concentration of salt or with acid indicated that surface LT is a peripheral
      membrane protein. Although secreted LT is a homologous trimer, protein cross
      linking studies revealed that surface LT existed as a monomer associated with a
      dimer of p33. Together the results demonstrate a novel mechanism for stable
      membrane expression of LT by activated T cells.

PMID- 1733952
TI  - New insights into the import mechanism of the ferredoxin precursor into
      chloroplasts.
AB  - We have investigated the import pathway of the nuclear-encoded chloroplast
      protein ferredoxin. By using purified precursor protein and washed intact
      chloroplasts in a defined in vitro uptake system, we show that preferredoxin is
      fully import-competent by itself. In addition, we show also that the in vitro, in
      a wheat germ lysate, synthesized preferredoxin is not stably associated with
      another protein. Import is dependent only on ATP and does not require the
      presence of cytosolic proteins. Translocation could be largely stimulated by the
      thiol reducing agent dithiothreitol (DTT). To determine whether DTT acts on the
      precursor or on the chloroplast, we modified the 5 cysteines in the precursor by
      a reaction with iodoacetamide, thereby preventing the formation of disulfide
      bridges in the precursor. The import of this modified precursor was still
      stimulated by the addition of DTT, indicating that DTT had a stimulating effect
      on the chloroplast import machinery. In the case of the modified precursor, the
      import must have taken place without iron-sulfur cluster attachment in the
      stroma. The modified precursor could be imported with a similar efficiency as the
      parent precursor showing that import takes place independently from cofactor
      assembly.

PMID- 1733953
TI  - The 5'-flanking region of the human calreticulin gene shares homology with the
      human GRP78, GRP94, and protein disulfide isomerase promoters.
AB  - Calreticulin (CR) is a calcium binding protein that resides in the endoplasmic
      and sarcoplasmic reticulum and is reactive with human Ro/SS-A autoimmune sera. We
      have used human CR cDNA to isolate a human 6-kilobase genomic clone that contains
      529 base pairs upstream of the presumed transcription start site, 9 exons, 8
      introns, and several hundred base pairs 3' of a polyadenylation sequence.
      Analysis of the human CR promoter region reveals a number of potential regulatory
      sites also found in the human GRP78, GRP94, and protein disulfide isomerase
      promoters, including multiple Sp1 and CCAAT consensus sequences, an AP-2
      recognition sequence (absent in protein disulfide isomerase), and multiple GC
      rich areas. DNA footprint and gel shift analysis on the CR 5'-flanking region
      demonstrates an area that is bound by protein found in human but not murine
      nuclear extracts. This sequence is homologous with previously determined
      regulatory sequences of the human GRP78 and GRP94 promoters. These data indicate
      that CR, GRP78, GRP94, and protein disulfide isomerase may in part have similar
      transcriptional regulation and suggest that their gene products while
      structurally distinct may have similar functions or co-functions. These
      observations are of additional interest as all four of these genes encode acidic
      proteins that localize to the endoplasmic reticulum.

PMID- 1733954
TI  - Neither amino nor carboxyl termini are required for function of the sodium- and
      chloride-coupled gamma-aminobutyric acid transporter from rat brain.
AB  - Antibodies were raised against synthetic peptides corresponding to several
      regions of the rat brain gamma-aminobutyric acid (GABA) transporter. According to
      our model, this glycoprotein has 12 transmembrane alpha-helices with both amino
      and carboxyl termini located in the cytoplasm. The antibodies recognized the
      intact transporter on Western blots. Upon papain treatment, a reconstitutively
      active transporter can be isolated upon lectin chromatography (Kanner, B. I.,
      Keynan, S., and Radian, R. (1989) Biochemistry 28, 3722-3728). The papainized
      transporter runs on sodium dodecyl sulfate-polyacrylamide gels as a broad band
      with an apparent molecular mass between about 58 and 68 kDa as compared to 80 kDa
      for the untreated transporter. The transporter fragment was recognized by all the
      antibodies, except for that raised against the amino terminus. Pronase cleaves
      the transporter to a relatively sharp 60-kDa band, which reacts with the
      antibodies against the internal loops but not with either the amino- or the
      carboxyl-terminal. This pronase-treated transporter, upon isolation by lectin
      chromatography, was reconstituted. It exhibits full GABA transport activity. This
      activity exhibits the same features as the intact system including an absolute
      dependence on sodium and chloride as well as electrogenicity. We conclude that
      the amino- and carboxyl-terminal parts of the transporter, possibly including
      transmembrane alpha-helices 1, 2, and 12, are not required for the transport
      function.

PMID- 1733955
TI  - Tissue-specific expression of an 11 beta-hydroxysteroid dehydrogenase with a
      truncated N-terminal domain. A potential mechanism for differential intracellular
      localization within mineralocorticoid target cells.
AB  - The enzyme 11 beta-hydroxysteroid dehydrogenase (11-HSD) is thought to confer
      specificity on the nonselective Type I adrenocorticoid receptor by converting
      glucocorticoids to receptor-inactive metabolites in mineralocorticoid target
      tissues. S1 nuclease analyses using a rat liver 11-HSD probe demonstrated tissue
      specific expression of the 5' region of the 11-HSD gene in the liver, lung, and
      kidney not evident in previous studies. Renal tissue contained a unique protected
      species which mapped to a position within the coding region, consistent with a
      divergence in liver and kidney protein sequences. Screening of a rat kidney cDNA
      library resulted in the isolation of several clones (11-HSD1B) noncolinear in
      their 5' regions with the liver sequence (11-HSD1A). Nucleic acid sequence
      analysis showed that the divergent clones code for a protein lacking a 26-amino
      acid NH2-terminal putative membrane-spanning signal peptide. The deletion of the
      leader sequence from the microsomal 11-HSD1A protein may result in a nuclear
      localization of the 11-HSD1B isoform. The renal 11-HSD1A and 11-HSD1B species
      increased coordinately during ontogeny and in parallel with the developmental
      surge in glucocorticoids. At least three alternate sites of polyadenylation were
      found to be utilized by the 11-HSD gene. Southern blot analysis showed the
      presence of a single gene in the rat. This study shows the expression of a kidney
      specific 11-HSD isoform which may protect the Type I adrenocorticoid receptor
      from occupation by glucocorticoids in the nucleus of a mineralocorticoid target
      cell.

PMID- 1733956
TI  - A heparin-binding growth factor secreted from breast cancer cells homologous to a
      developmentally regulated cytokine.
AB  - We report purification of an 18-kDa heparin-binding growth factor secreted from
      human cancer cells which is homologous to a developmentally regulated,
      neurotrophic factor, heparin-binding growth-associated molecule/pleiotrophin (HB
      GAM/PTN; Merenmies, J., and Rauvala, H. (1990) J. Biol. Chem. 265, 16721-16724;
      Li, Y. S., Milner, P. G., Chauhan, A. K., Watson, M. A., Hoffman, R. M., Kodner,
      C. M., Milbrandt, J., and Deuel, T. F. (1990) Science 250, 1690-1694). We have
      purified the protein from tissue culture supernatants of human breast cancer
      cells (MDA-MB 231) and have used soft agar cloning of an epithelial cell line (SW
      13) to detect its growth stimulating activity. A 32,000-fold purification was
      achieved by isoelectric focusing, heparin affinity chromatography, and reversed
      phase high pressure liquid chromatography. The molecular mass of the protein was
      confirmed by gel filtration chromatography in the presence of detergent and
      bioassay of the fractions. The N-terminal sequence was homologous to HB-GAM/PTN,
      and polymerase chain reaction amplification and DNA sequencing confirmed that the
      respective transcript was present in the cancer cells. We conclude that HB
      GAM/PTN can function as a tumor growth factor in addition to its role during
      neuronal development.

PMID- 1733957
TI  - The bacteriophage phi 29 DNA polymerase, a proofreading enzyme.
AB  - The bacteriophage phi 29 DNA polymerase, involved both in the protein-primed
      initiation and elongation steps of the viral DNA replication, displays a very
      processive 3',5'-exonuclease activity acting preferentially on single-stranded
      DNA. This exonucleolytic activity showed a marked preference for excision of a
      mismatched versus a correctly paired 3' terminus. These characteristics enable
      the phi 29 DNA polymerase to act as a proofreading enzyme. A comparative analysis
      of the wild-type phi 29 DNA polymerase and a mutant lacking 3',5'-exonuclease
      activity indicated that a productive coupling between the exonuclease and
      polymerase activities is necessary to prevent fixation of polymerization errors.
      Based on these data, the phi 29 DNA polymerase, a model enzyme for protein-primed
      DNA replication, appears to share the same mechanism for the editing function as
      that first proposed for T4 DNA polymerase and Escherichia coli DNA polymerase I
      on the basis of functional and structural studies.

PMID- 1733958
TI  - Epidermal cell differentiation inhibitor ADP-ribosylates small GTP-binding
      proteins and induces hyperplasia of epidermis.
AB  - Epidermal cell differentiation inhibitor (EDIN) is a recently discovered protein
      which inhibits terminal differentiation of cultured keratinocytes (Sugai, M.,
      Enomoto, T., Hashimoto, K., Matsumoto, K., Matsuo, Y., Ohgai, H., Hong, Y.-M.,
      Inoue, S., Yoshikawa, K., and Suginaka, H. (1990) Biochem. Biophys. Res. Commun.
      173, 92-98). The amino acid sequenced deduced from the EDIN gene has revealed
      that EDIN shares high amino acid sequence homology with the exoenzyme C3 of
      Clostridium botulinum (Inoue, S., Sugai, M., Murooka, Y., Paik, S.-Y., Hong, Y.
      M., Ohgai, H., and Suginaka, H. (1991) Biochem. Biophys. Res. Commun. 174, 459
      464), which has been shown to ADP-ribosylate the rho/rac proteins (members of the
      small GTP-binding protein family). We show here that EDIN ADP-ribosylates rhoB
      p21 in time- and dose-dependent manners in a cell-free system. Kinetic studies of
      the ADP-ribosylation and peptide mapping of the reaction products of rhoB p21 by
      EDIN and C3 suggest that the mode of action of the ADP-ribosylation by EDIN is
      quite similar to that by C3 and that the ADP-ribosylation site of rhoB p21 by
      EDIN is presumably the same as that by C3. Proteins in epidermal membranes and
      keratinocyte homogenate with Mr values of about 22,000 are ADP-ribosylated by
      EDIN or C3. Treatment of cultured human keratinocytes by EDIN or C3 results in an
      inhibition of terminal differentiation and a stimulation of growth of the cells.
      Moreover, EDIN and C3 injected into adult mouse skin induce hyperplasia of
      epidermis. These results suggest that EDIN and C3 affect growth and
      differentiation of keratinocytes by ADP-ribosylation of protein(s) with a Mr of
      about 22,000, which may be the rho/rac proteins or related proteins.

PMID- 1733959
TI  - Organization of the regulatory elements and nuclear activities participating in
      the transcription of the human apolipoprotein B gene.
AB  - The human apolipoprotein B (apoB) promoter region (-150 to +124) is
      transcriptionally active in HepG2 and CaCo-2 but not in HeLa cells. In the
      present study, we demonstrate that transcription of the human apoB gene in
      hepatic cells is achieved through the interaction of proteins that bind to five
      regulatory elements, I (-118 to -98), II (-112 to -94), III (-86 to -62), IV (-72
      to -53), and V (-53 to -33). Elements I, IV, and V can bind to bacterially
      expressed enhancer-binding protein (C/EBP) although with different affinities. In
      addition, elements I, IV, and V interact with at least two other heat-stable
      nuclear factors, designated NF-BA2 and NF-BA3, that are distinct from C/EBP.
      These activities have been separated by ion exchange chromatography and shown to
      produce footprints in elements I, IV, and V that are similar to those obtained
      with C/EBP. Element II is recognized by three activities designated NF-BCB1, NF
      BCB2, and NF-BCB3, which have been separated by heparin-Sepharose chromatography.
      Saturation mutagenesis of the region established that they belong to a family of
      proteins recognizing the same motif, 5'-AAAAGCAAACAG-3'. Substitution mutations
      in element II that abolish binding of all three activities in vitro also reduce
      hepatic transcription in vivo to 10% of control, indicating that the binding of
      NF-BCB1, NF-BCB2, and NF-BCB3 activities is required for efficient transcription
      of the apoB gene. Furthermore, element III is recognized by the previously
      characterized nuclear factor NF-BA1, the binding of which is essential for the
      transcriptional activation of the apoB gene in hepatic and intestinal cells.

PMID- 1733960
TI  - Initiation of transcription by T7 RNA polymerase as its natural promoters.
AB  - A kinetic assay has been developed to measure the strength of natural T7
      promoters. By determining the rate of appearance of initiation products in the
      presence of constant concentrations of T7 RNA polymerase, an incomplete mixture
      of ribonucleoside triphosphates, and increasing promoter concentrations, a
      maximum rate of product formation (Vmax) and a promoter concentration giving half
      of the maximal activity ([P]Vmax/2) can be determined for any cloned T7 promoter.
      On supercoiled plasmids, it was found that the [P]Vmax/2 measured for the six
      promoters phi 1.1B, phi 1.3, phi 3.8, phi 6.5, phi 10, and phi 13 ranged from 3.4
      +/- 1.1 to 12.0 +/- 2.4 nM while the Vmax values showed no significant trends. On
      plasmids that had been linearized by cleavage at a single site with a restriction
      endonuclease, the cloned T7 promoters assayed fell into two broad classes that
      appear to be characterized by the T7 class II and III promoters. Generally, the
      class II promoters required higher promoter concentrations to produce half of the
      maximum rates of initiation ([P]Vmax/2 values) than the class III promoters. The
      [P]Vmax/2 values for the class II promoters ranged from 20 +/- 2.7 to 23 +/- 3.6
      nM, while the [P]Vmax/2 values for the class III promoters phi 10 and phi 13 were
      13 +/- 1.6 nM and 7.8 +/- 1.4 nM. The one exception is the class III promoter phi
      6.5 whose [P] Vmax/2 (17 +/- 5 nM) falls between the [P]Vmax/2 values of the
      class II promoters and the strong class III promoters. The Vmax values measured
      on linear templates are variable, but it appears that phi 10 is more active than
      the other five promoters.

PMID- 1733961
TI  - Temperature-induced post-translational over-modification of type I procollagen.
      Effects of over-modification of the protein on the rate of cleavage by
      procollagen N-proteinase and on self-assembly of collagen into fibrils.
AB  - Previous observations suggested that incubating fibroblasts at elevated
      temperature caused over-modification of type I procollagen by post-translational
      enzymes because of a delay in folding of the collagen triple helix. Here, human
      skin fibroblasts were incubated at 40.5 instead of 37 degrees C, and the type I
      procollagen secreted into the medium was isolated. Analysis of the protein
      indicated that there was an increase of about 5 residues of hydroxylysine/alpha
      chain and about 1 residue of glycosylated hydroxylysine/alpha chain. Assays with
      procollagen N-proteinase indicated that the N-propeptide of the over-modified
      collagen was cleaved at a decreased rate, apparently because the over
      modification altered the conformation-dependent cleavage site for the enzyme.
      Assays in a system for assembly of collagen into fibrils demonstrated that the
      over-modified protein had a higher critical concentration for self-assembly.
      Also, the fibrils formed from the over-modified collagen at 31 and 29 degrees C
      had smaller diameters than fibrils formed from normal type I collagen. The
      results provide direct evidence for earlier suggestions that post-translational
      over-modification of a fibrillar collagen can alter the morphology of the fibrils
      formed. The results also indicate that some of the biological consequences of the
      mutations in type I procollagen causing heritable disorders must be ascribed to
      the effects of post-translational over-modifications that frequently occur as
      secondary consequences of changes in the primary structure of the protein.

PMID- 1733962
TI  - Complement receptor-mediated phagocytosis is associated with accumulation of
      phosphatidylcholine-derived diglyceride in human neutrophils. Involvement of
      phospholipase D and direct evidence for a positive feedback signal of protein
      kinase.
AB  - Complement receptor (CR)-mediated phagocytosis is associated with an increased
      accumulation of diglyceride (sn-1,2-diacylglycerol and/or 1-O-alkyl-2-acyl
      glycerol) in human neutrophils. The C3bi-mediated increase in diglyceride (5-20
      min) was only partially impaired when phosphoinositide-specific phospholipase C
      (PLC) activity was abolished by reduction of cytosolic free Ca2+. At an early
      time point (1 min), however, diglyceride production was barely detectable in
      control cells, whereas production was considerable in cells with a reduced
      cytosolic free Ca2+ concentration. C3bi stimulation of 32P-labeled neutrophils
      caused a rapid and significant breakdown of [32P]phosphatidylcholine (PC) which
      was not affected by inhibition of Ca(2+)-dependent phosphoinositide-specific PLC.
      Thus, PC hydrolysis could be involved in C3bi-induced diglyceride formation.
      Stimulation of cells labeled with [3H]1-O-alkyl-lyso-PC ([3H]alkyl-lyso-PC),
      resulted in an increased formation of [3H]1-O-alkyl-phosphatidic acid ([3H]alkyl
      PA) and a later and slower formation of [3H]1-O-alkyl-diglyceride ([3H]alkyl
      diglyceride); this suggests activation of phospholipase D (PLD). When these
      labeled cells were stimulated in the presence of 0.5% ethanol a marked
      accumulation of [3H]1-O-alkyl-phosphatidylethanol ([3H]alkyl-PEt) was observed in
      both controls and calcium-reduced cells, further strengthening the suggested
      involvement of PLD activity. In parallel with the sustained increase in
      diglyceride formation, CR-mediated phagocytosis was also associated with
      phosphorylation of a cellular protein kinase C substrate (MARCKS). Therefore it
      seems reasonable to suggest a causal relationship between C3bi-induced PLD
      activation, which results in diglyceride formation, and activation of protein
      kinase C. In electropermeabilized cells which were incapable of ingesting
      particles, C3bi particles were still able to activate PLD and induce formation of
      diglyceride. This signaling event must therefore be triggered by binding of
      particles to the cell and not by the engulfment process. Most importantly,
      introduction of the protein kinase C inhibitor peptides, PKC(19-36) and PKC(19
      31), into these permeabilized cells resulted in a clear reduction of the C3bi
      induced production of diglyceride, indicating that CR-mediated activation of
      protein kinase C directly triggers a positive feedback mechanism for additional
      diglyceride formation. Taken together, these data further clarify the mechanisms
      of CR-mediated diglyceride formation and give added support to the concept that
      protein kinase C plays an important role in the phagocytic process.

PMID- 1733963
TI  - Synthetic model proteins. Positional effects of interchain hydrophobic
      interactions on stability of two-stranded alpha-helical coiled-coils.
AB  - We have designed a model protein that consists of two identical 35-residue
      polypeptide chains, parallel and in-register arranged in a two-stranded alpha
      helical coiled-coil structure. This structure is stabilized by interchain
      hydrophobic interactions between leucine residues at positions "a" and "d" of a
      repeating heptad sequence. To determine the positional effects of interchain
      hydrophobic interactions on the stability of the coiled-coil, a single leucine
      residue in each chain at position "a" (9, 16, 23, 30) and "d" (5, 12, 19, 26, 33)
      was systematically replaced by an alanine. All these proteins formed two-stranded
      alpha-helical coiled-coils in benign conditions (0.05 M phosphate, 0.1 M KCl, pH
      7). The stability of each mutant protein was determined by guanidine
      hydrochloride denaturation experiments, where the decrease in ellipticity at 220
      nm was monitored by circular dichroism. The single alanine replacements of a
      leucine residue at hydrophobic positions a and/or d are all shown to destabilize
      the coiled-coil structure. The non-equivalent hydrophobic positions a and d make
      an equivalent contribution to protein stability along the majority of the coiled
      coil structure (positions 9-30). The small decrease in coiled-coil stability
      caused by Leu----Ala substitution at either ends of the coiled-coil suggested
      that the Leu-Leu hydrophobic interactions are less important at the ends of the
      coiled-coil and the ends of the coiled-coil are more flexible. Analysis of the
      difference between the ellipticity in benign buffer and in 50% trifluoroethanol
      (delta theta 220) and the slope term from a plot of the free energy of unfolding
      versus guanidine hydrochloride concentration also supported the conclusion that
      the leucine residues at the ends of the coiled-coil are much less buried than in
      the middle section of the coiled-coil.

PMID- 1733964
TI  - Amino-terminal processing of actins mutagenized at the Cys-1 residue.
AB  - Most actins examined to date undergo a unique posttranslational modification
      termed processing, catalyzed by the actin N-acetylaminopeptidase. Processing is
      the removal of acetylmethionine from the amino terminus in class I actins with
      Met-Asp(Glu) amino termini. For class II actins with Met-X-Asp(Glu) amino
      termini, processing is the removal of the second residue as an N-acetylamino
      acid. Other cytosolic proteins with these amino termini are not processed
      suggesting that the reaction may be specific for actins. In actin, X is usually
      cysteine. However, there are some class II actins in which this residue is other
      than cysteine, suggesting a broader substrate specificity for actin N
      acetylaminopeptidase than acetylmethionine or acetylcysteine. We constructed
      mutant actins in which this cysteine was replaced with serine, asparagine,
      glycine, aspartic acid, histidine, phenylalanine, and tyrosine and used these to
      determine the substrate specificity of rat liver actin N-acetylaminopeptidase in
      vitro. Amino-terminal acetylmethinonine was cleaved from adjacent aspartic acid,
      asparagine, or histidine, but not serine, glycine, phenylalanine, or tyrosine. Of
      the acetylated actin amino termini tested, only acetylmethionine and
      acetylcysteine were cleaved. Histidine was never N-acetylated and was not
      cleaved. When phenylalanine and tyrosine were adjacent to the initiator
      methionine, no initiator methionine was cleaved even though it was acetylated.
      These results suggest a narrow substrate specificity for the rat liver actin N
      acetylaminopeptidase. They also demonstrate that the adjacent residue can effect
      actin N-acetylaminopeptidase specificity.

PMID- 1733965
TI  - Protein-specific energy requirements for protein transport across or into
      thylakoid membranes. Two lumenal proteins are transported in the absence of ATP.
AB  - Cytosolically synthesized thylakoid proteins must be translocated across the
      chloroplast envelope membranes, traverse the stroma, and then be translocated
      into or across the thylakoid membrane. Protein transport across the envelope
      requires ATP hydrolysis but not electrical or proton gradients. The energy
      requirements for the thylakoid translocation step were studied here for the light
      harvesting chlorophyll a/b protein (LHCP), an integral membrane protein, and for
      several thylakoid lumen-resident proteins: plastocyanin and OE33, OE23, and OE17
      (the 33-, 23-, and 17-kDa subunits of the oxygen-evolving complex, respectively).
      Dissipation of the thylakoid protonmotive force during an in organello protein
      import assay partially inhibited the thylakoid localization of LHCP and OE33,
      totally inhibited localization of OE23 and OE17, and had no effect on
      localization of plastocyanin. We used reconstitution assays for LHCP insertion
      and for OE23 and OE17 transport into isolated thylakoids to investigate the
      energy requirements in detail. The results indicated that LHCP insertion
      absolutely requires ATP hydrolysis and is enhanced by a transthylakoid delta pH
      and that transport of OE23 and OE17 is absolutely dependent upon a delta pH.
      Surprisingly, OE23 and OE17 transport occurred maximally in the complete absence
      of ATP. These results establish the thylakoid membrane as the only membrane
      system in which a delta pH can provide all of the energy required to translocate
      proteins across the bilayer. They also demonstrate that the energy requirements
      for integration into or translocation across the thylakoid membranes are protein
      specific.

PMID- 1733966
TI  - Interaction of two cis sites with the RNA replicase of the yeast L-A virus.
AB  - L-A is a 4.6-kilobase double-stranded RNA virus of Saccharomyces cerevisiae. The
      in vitro L-A replication reaction ((-)-strand synthesis) requires an internal
      site 400 bases from the 3' end in addition to the 3'-terminal 30 nucleotides of
      the L-A (+)-single-stranded RNA. Elimination of the internal site reduces the
      template activity 5-10-fold. Here we investigate how the internal site can
      stimulate the replication reaction which starts at the 3' end of the template.
      When these two sites are split into two distinct RNA molecules, the internal site
      can no longer stimulate replication (no trans-activation). However, establishment
      of an intermolecular hydrogen bonding between these RNAs restored the replication
      enhancing activity of the internal site. This result is consistent with a model
      wherein L-A's RNA polymerase interacts first with the internal site and then with
      the 3' end site by either looping or by a local dissociation-reassociation
      mechanism. These results, however, clearly eliminate anchored tracking and
      sliding models which require continuity of the RNA molecule between these two cis
      sites.

PMID- 1733967
TI  - EGF-R antisense RNA blocks expression of the epidermal growth factor receptor and
      suppresses the transforming phenotype of a human carcinoma cell line.
AB  - We have used an antisense approach to investigate the role of overexpression of
      the normal human epidermal growth factor (EGF) receptor in the transformed
      phenotype of KB cells, which are a tumor derived human cell line. Initial
      experiments performed in vitro, showed that antisense RNA complementary to the
      entire coding region (AS-FL) or to parts of the EGF-R mRNA (AS-3', AS-5', and AS
      K) effectively blocked translation of EGF-R mRNA. In addition, upon
      microinjection into KB cells, the in vitro synthesized antisense RNAs were able
      to inhibit transiently the synthesis of EGF-R. Inhibition was concentration
      dependent, both in vitro and in cells, and the most effective constructs were
      those complementary to the entire coding region (AS-FL) or to the 3'-coding end
      of the mRNA (AS-3'). Transfection of the same EGF-R antisense RNA constructs into
      the human epidermoid carcinoma KB cell line gave rise to several clones stably
      expressing elevated levels of antisense RNA and resulting in low residual levels
      of EGF receptor. The most reduced clones exhibited a totally restored serum
      dependent growth and were severely impaired in colony formation and growth in
      agar. In addition the severity of the phenotype was directly proportional to the
      residual amount of EGF-R expressed. We conclude that over-expression of normal
      EGF-R plays a direct primary role in the development of the transformed phenotype
      of this human cancer cell line.

PMID- 1733968
TI  - Choice of 3' cleavage/polyadenylation site in beta-tropomyosin RNA processing is
      differentiation-dependent in mouse BC3H1 muscle cells.
AB  - The rodent beta-tropomyosin (TM) gene produces either a 1.2-kilobase (kb)
      skeletal muscle beta-TM mRNA or a 1.1-kb fibroblast/smooth muscle TM-1 mRNA
      through tissue-specific alternative exon splicing and 3' cleavage/polyadenylation
      at two alternative poly(A) sites. beta-TM mRNA contains exon 6b, 9a, and the
      poly(A) site immediately following exon 9a, whereas TM-1 mRNA contains exon 6a,
      9b, and the poly(A) site following exon 9b. We isolated a novel 2.1-kb beta-TM
      cDNA clone, pUTM, from a cDNA library of 2-day differentiated mouse BC3H1 muscle
      like cells. This cDNA contains the entire sequence of mature beta-TM mRNA with a
      normal but unused poly(A) site associated with exon 9a. Instead, 3'
      cleavage/polyadenylation of this cDNA occurred at the exon 9b-associated distal
      poly(A) site, resulting in the retention of a 1-kb intron and the TM-1 exon 9b.
      We identified a 2.3-kb functional mRNA, UTM RNA, corresponding to pUTM. UTM RNA
      appeared early during BC3H1 cell differentiation and gradually decreased as the
      beta-TM mRNA increased. UTM RNA was also detected in mouse C2C12 muscle cells and
      in skeletal muscle tissue isolated from mouse leg. Thus, in the processing of
      beta-TM gene transcripts, selection of alternative terminal exons and alternative
      poly(A) sites are not necessarily linked as they appear to be in other gene
      systems.

PMID- 1733969
TI  - Purification of the secretor-type beta-galactoside alpha 1----2
      fucosyltransferase from human serum.
AB  - The secretor-type beta-galactoside alpha 1----2-fucosyltransferase from human
      serum was purified by hydrophobic chromatography on phenyl-Sepharose, ion
      exchange chromatography on sulfopropyl-Sepharose, and affinity chromatography on
      GDP-hexanolamine-Sepharose. Final purification of the enzyme was achieved by high
      pressure liquid chromatography gel filtration and resulted in a homogeneous
      protein as determined by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis of the radiolabeled protein. The native enzyme appears as a
      molecule of apparent Mr 150,000 as determined by gel filtration high pressure
      liquid chromatography. The apparent Mr of the enzyme resolved in the presence of
      beta-mercaptoethanol by sodium dodecyl sulfate-polyacrylamide gel electrophoresis
      was determined to be 50,000, indicating a multisubunit structure of the enzyme.
      Secretor-type alpha 1----2-fucosyltransferase is a glycoprotein as determined by
      WGA binding properties. A comparison of the Mr of the native blood group H gene
      encoded with the secretor-type beta-galactoside alpha 1----2-fucosyltransferases
      as well as comparison of subunit Mr for both enzymes suggests structural
      similarity. The alpha 1----2 linkage formed between alpha-L-fucose and terminal
      beta-D-galactose by the purified H- and secretor-type alpha 1----2
      fucosyltransferases was determined by 1H NMR homonuclear cross-irradiation
      analysis of the oligosaccharide products. The substrate specificity and Km values
      calculated from the initial rate using various oligosaccharide acceptors showed
      that purified enzymes differ primarily in affinity for phenyl-beta-D
      galactopyranoside and GDP-fucose as well as type 1 (Gal beta 1----3GlcNAc), 2
      (Gal beta 1----4GlcNAc), and 3 (Gal beta 1----3GalNAc) oligosaccharide acceptors.
      The secretor-type alpha 1----2-fucosyltransferase shows significantly lower
      affinity than the H enzyme for phenyl-beta-D-galactopyranoside and GDP-fucose as
      well as for type 2 oligosaccharide acceptors. On the contrary, type 1 and 3
      oligosaccharide acceptors are preferentially utilized by the secretor-type enzyme
      as compared with the H enzyme. The enzymes also differ in several physicochemical
      properties, implying nonidentity of the two enzymes (Sarnesto, A., Kohlin, T.,
      Thurin, J., and Blaszczyk-Thurin, M. (1990) J. Biol. Chem. 265, 15067-15075).

PMID- 1733970
TI  - Purification of the beta-N-acetylglucosaminide alpha 1----3-fucosyltransferase
      from human serum.
AB  - A beta-N-Acetylglucosaminide alpha 1----3-fucosyltransferase was purified from
      human serum by ammonium sulfate precipitation, hydrophobic chromatography on
      phenyl-Sepharose, ion-exchange chromatography on sulfopropyl-Sepharose, affinity
      chromatography on GDP-hexanolamine-Sepharose, and finally high pressure liquid
      chromatography gel filtration. Gel filtration chromatography of the native enzyme
      revealed a Mr of 45,000. Upon sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, the purified protein also appeared as a single molecular species
      of Mr 45,000. In contrast to the multisubunit beta-galactoside alpha 1----2
      fucosyltransferases with an apparent Mr of 150,000, present in human serum, the
      native beta-N-acetylglucosaminide alpha 1----3-fucosyltransferase is a monomer
      with a Mr of 45,000. The enzyme is glycosylated, as revealed by wheat germ
      agglutinin binding properties. The alpha 1----3 linkage formed by the enzyme
      between alpha-L-fucose and the penultimate beta-N-acetylglucosamine by the
      purified enzyme was confirmed by 1H NMR homonuclear cross-irradiation analysis of
      the oligosaccharide product. The specificity of the purified enzyme is restricted
      to type 2 structures, as revealed by its reactivity with different substrates and
      from the Km values calculated from the initial rate data using various
      oligosaccharide acceptors. The enzyme has the ability to utilize the N-acetyl
      beta-lactosamine determinant (Gal beta 1----4GlcNAc) and the sialylated (NeuAc
      alpha 2----3Gal beta 1----4GlcNAc) and fucosylated (Fuc alpha 1----2Gal beta 1---
      4GlcNAc) derivatives of N-acetyl-beta-lactosamine and thus is distinct from both
      the human Lewis gene-encoded enzyme and the alpha 1----3-fucosyltransferase of
      the myeloid cell type.

PMID- 1733971
TI  - Characterization of an abnormal fibrinogen Osaka V with the replacement of gamma
      arginine 375 by glycine. The lack of high affinity calcium binding to D-domains
      and the lack of protective effect of calcium on fibrinolysis.
AB  - Prolonged thrombin time was completely corrected by the addition of millimolar
      concentrations of calcium in a new abnormal fibrinogen, Osaka V. Analysis of
      lysyl endopeptidase digests of A alpha-, B beta-, or gamma-chains by high
      performance liquid chromatography, and the following amino acid sequence analysis
      of relevant peptides revealed that about 50% of the gamma-chain has a replacement
      of gamma-arginine 375 by glycine. When fibrinogen was digested with plasmin in
      the presence of millimolar concentration of calcium, the amount of fragment D1
      was about 50% of the normal control, and the rest was further cleaved to fragment
      D2, D3, or D62 with an apparent Mr of 62,000. Plasmic digestion of cross-linked
      fibrin in the presence of calcium resulted in the appearance of an abnormal
      fragment with an apparent Mr of 123,000 as well as fragments D2, D3, and D62,
      concomitant with the decrease of D dimer. The gamma-remnant of the abnormal
      fragment proved to be a cross-linked complex of the normal D1 gamma-remnant and
      residues 374-406/411 of the abnormal gamma-chain. The number of high affinity
      Ca(2+)-binding sites for the normal fibrinogen and fibrinogen Osaka V obtained by
      equilibrium dialysis was 2.88 (about 3) and 1.85, respectively, and that for the
      abnormal molecules was calculated as 0.9 (about 1) from their relative amounts in
      the samples, suggesting the lack of two Ca(2+)-binding sites in the D-domains.
      These data suggest that the normal structure of the COOH-terminal portion of the
      gamma-chain including residue 375 is required for the full expression of high
      affinity calcium binding to D-domains, the ability to be protected by calcium
      against plasmic digestion, and fibrin polymerization. During these studies, we
      found that the NH2-terminal amino acid of the gamma-remnant in fragments D or D
      dimer which were obtained after prolonged digestion with plasmin is gamma-Met89.

PMID- 1733972
TI  - Accumulation of Golgi-processed secretory proteins in an organelle of high
      density upon reduction of ATP concentration in rat hepatocytes.
AB  - We have previously shown that when rat hepatocytes are incubated with 4 mM azide,
      which reduces the intracellular ATP concentration to about 30% of its normal
      level, secretory proteins are reversibly arrested within the cell. Analysis of
      haptoglobin after 150 min of azide incubation shows that its carbohydrates have
      been processed by Golgi enzymes (Persson, R., Ahlstrom, E., and Fries, E. (1988)
      J. Cell Biol. 107, 2503-2510). Here, we have further characterized the site of
      arrest. Subcellular fractionation by density gradient centrifugation showed that
      albumin and haptoglobin fractionated like a marker for the endoplasmic reticulum.
      Localization of albumin by immunoelectron microscopy showed, however, that it
      occurred in flattened cisternae and that the endoplasmic reticulum was devoid of
      the protein. A possible explanation for these results is that the azide treatment
      blocks transport through the Golgi complex, leading to an accumulation of
      secretory proteins in a pre- or early Golgi compartment of high density. This
      compartment could contain sufficient amounts of Golgi enzymes to carry out the
      observed carbohydrate processing upon prolonged incubation or possibly acquire
      them as an effect of the azide treatment.

PMID- 1733973
TI  - Factors involved in specific transcription by mammalian RNA polymerase II.
      Identification and characterization of factor IIH.
AB  - Two new factors required for transcription of class II genes have been
      identified. These factors, TFIIH and TFIIJ, were required together with the
      previously described general factors (TFIIA, TFIIB, TFIID, TFIIE, and TFIIF) and
      RNA polymerase II for transcription of different class II genes. TFIIH was
      extensively purified, and the activity appeared to coelute with polypeptides of
      33 and 95 kDa. The role of TFIIH and TFIIJ in preinitiation complex assembly was
      analyzed using mobility shift assays. It was found that TFIIH and TFIIJ
      association with the preinitiation complex was ordered and required the previous
      assembly of a preinitiation complex intermediate containing factors IID, IIB,
      IIF, IIE, and RNA polymerase II. A model for the ordered assembly of the general
      factors and RNA polymerase II is presented.

PMID- 1733974
TI  - Expression and polarized apical secretion in Madin-Darby canine kidney cells of a
      recombinant soluble form of neutral endopeptidase lacking the cytosolic and
      transmembrane domains.
AB  - Neutral endopeptidase-24.11 (NEP; EC 3.4.24.11) is an abundant
      metalloendopeptidase of the brush border membrane of kidney proximal tubules. We
      have recently shown that NEP is delivered directly to the apical domain of the
      plasma membrane when expressed in polarized Madin-Darby canine kidney (MDCK)
      cells in culture (Jalal, F., Lemay, G., Zollinger, M., Berteloot, A., Boileau,
      G., and Crine, P. (1991) J. Biol. Chem. 266, 19826-19832). Here, a soluble form
      of NEP consisting of the signal peptide of pro-opiomelanocortin fused in-frame
      with the ectodomain of NEP has been expressed in MDCK cells. Enzymatic assays
      performed on apical and basolateral culture media of MDCK cells grown on semi
      permeable supports indicated that the recombinant enzyme was predominantly
      released at the apical surface. In contrast, when the chimeric protein was
      expressed in NIH 3T3 cells or when pro-opiomelanocortin was expressed in MDCK
      cells, non-polarized secretion was observed into both the apical and basolateral
      compartments of the culture chamber. Our results suggest that the ectodomain of
      NEP is sufficient for directing the targeting of this protein to the apical
      membrane of polarized MDCK epithelial cells.

PMID- 1733975
TI  - Oxidative stress causes rapid membrane translocation and in vivo degradation of
      ribulose-1,5-bisphosphate carboxylase/oxygenase.
AB  - We have studied the turnover of an abundant chloroplast protein, ribulose-1,5
      bisphosphate carboxylase/oxygenase (Rbu-P2 carboxylase/oxygenase), in plants
      (Spirodela oligorrhiza and Triticum aestivum L.) and algae (Chlamydomonas
      reinhardtii and C. moewusii) induced to senesce under oxidative conditions. Rbu
      P2 carboxylase/oxygenase activity and stability in vivo were found to be highly
      susceptible to oxidative stress, resulting in intermolecular cross-linking of
      large subunits by disulfide bonds within the holoenzyme, rapid and specific
      translocation of the soluble enzyme complex to the chloroplast membranes, and
      finally protein degradation. The redox state of Cys-247 in Rbu-P2
      carboxylase/oxygenase large subunit seems involved in the sensitivity of the
      holoenzyme to oxidative inactivation and cross-linking. However, this process did
      not drive membrane attachment or degradation of Rbu-P2 carboxylase/oxygenase in
      vivo. Translocation of oxidized Rbu-P2 carboxylase/oxygenase to chloroplast
      membranes may be a necessary step in its turnover, particularly during leaf
      senescence. Thus, processes that regulate the redox state of plant cells seem
      closely intertwined with cellular switches shifting the leaf from growth and
      maturation to senescence and death.

PMID- 1733976
TI  - Similar mechanisms for transcription initiation mediated through a TATA box or an
      initiator element.
AB  - Previous studies have identified several biochemical parameters that resolve
      promoter-specific transcription initiation by RNA polymerase II into distinct
      steps. We have employed these parameters to compare the mechanisms of initiation
      mediated through either a TATA box or a transcriptional initiator element. Time
      course experiments revealed that initiator-mediated transcription in a cell-free
      extract does not display the lag period typically found with TATA-mediated
      transcription. Titration experiments with increasing amounts of extract revealed
      further differences between TATA- and initiator-mediated transcription, again
      suggesting that different steps are rate-limiting. In contrast, experiments with
      the detergent Sarkosyl, which is believed to define later steps in the initiation
      process, revealed a striking degree of similarity between TATA- and initiator
      mediated transcription. Additional similarities were found using dinucleotide
      priming experiments, which are believed to measure the flexibility of initiation
      after RNA polymerase II is positioned over the transcription start site region.
      Taken together, these results suggest that the location of a preinitiation
      complex can be determined by core promoter recognition through either a TATA box
      or an initiator element. However, following these distinct template recognition
      events, the steps leading to initiation may be very similar and may proceed in a
      DNA sequence-independent manner.

PMID- 1733977
TI  - On Wolff's law of trabecular architecture.
AB  - Several studies suggest that the yield strain in cancellous bone may be uniformly
      distributed and isotropic. Yield strain was reported to be independent of
      textural anisotropy in bovine cancellous bone [Turner, J. biomech. Engng 111, 1-5
      (1989)] and it is plausible that yield strain is isotropic in human cancellous
      bone as well. In this paper, it is hypothesized that uniform, isotropic strain
      represents a goal of cancellous bone adaptation, i.e. cancellous bone alters its
      structure to maintain uniform, isotropic peak strains. Therefore, textural
      anisotropy must exactly cancel the anisotropy of the peak principal stresses
      imposed upon cancellous bone. When evaluating the relationships between
      mechanical properties of cancellous bone and trabecular architecture, it was
      found that over 90% of the variance of yield strength can be explained by one
      term--rho 2H3 (where rho is apparent density and H is the normalized anisotropy
      (fabric) constant). Furthermore, this single term explains 70-78% of the variance
      in Young's modulus of cancellous bone. Based upon these findings, it was
      postulated that fabric adaptation goes as Hi/Hj = [ sigma i/sigma j[, where Hi
      and Hj are fabric eigenvalues in the i- and the j-direction and sigma i and sigma
      j are peak principal stresses.

PMID- 1733978
TI  - Micromechanics of the fibrosa and the ventricularis in aortic valve leaflets.
AB  - The elastic response of aortic valve cusps is a summation of its fibrous
      components. To investigate the micromechanical function of valve leaflet
      constituents, we separated the fibrosa and the ventricularis from fresh and
      glutaraldehyde-fixed leaflets and tested them individually. The ventricularis was
      stiffer circumferentially than radially (7.41 kPa vs 3.68 kPa, p less than
      0.00001) and was more extensible radially (62.7% vs 21.8% strain to high modulus
      phase, p less than 0.00001). The fibrosa was also stiffer circumferentially than
      radially (13.02 kPa vs 4.65 kPa, p less than 0.0008), but had uniform
      extensibility. Glutaraldehyde fixation did not affect the circumferential elastic
      modulus of the fibrosa, but reduced its radial modulus from 4.65 kPa to 2.32 kPa
      (p less than 0.0078). The elastic modulus of the ventricularis remained
      unchanged. Fixation also reduced the extensibility of the ventricularis
      circumferentially (from 21.8% to 15.2% strain, p less than 0.018), but not
      radially, and increased the radial extensibility of the fibrosa from 27.7% to
      46.1% (p less than 0.0048). These data show that while the ventricularis contains
      a large amount of elastin, the amount of radially oriented collagen is similar to
      that of the fibrosa. The fibrosa, by itself, has the same extensibility in both
      directions (about 23% strain), but can extend much more radially when connected
      to the rest of the leaflet because it is attached to the ventricularis in a
      highly folded configuration. The two layers therefore complement each other
      during aortic valve function, and become detrimentally altered by fixation in
      glutaraldehyde.

PMID- 1733979
TI  - Creep fracture in bones with different stiffnesses.
AB  - Creep fracture experiments were used to examine the differences in time to
      fracture of bones with very different Young's moduli (bovine bone and red deer
      antler) and the implications of these differences for the 'cumulative-damage'
      model of Caler and Carter [J. Biomechanics 22, 625-635 (1989)] for bone fracture.
      Using normalised stress as the explanatory variable, the slopes of the
      distributions agreed quite well with that of Caler and Carter for human bone.
      However, antler took far longer to fracture at any given normalised stress than
      did bovine bone. Using stress alone as the explanatory variable, the
      relationships within each bone type almost disappeared. Within any bone type
      strain is the important determinant of time to fracture, but less mineralised
      bone takes much longer to fracture at any given strain, or normalised stress,
      which seems not to be in accord with the cumulative-damage model. The rate of
      damage accumulation in lightly mineralised bone at high strains (greater than 1%)
      is much less than that occurring in more heavily mineralised bone.

PMID- 1733980
TI  - A new technique to study the mechanical properties of collagen lattices.
AB  - A new technique to study the mechanical properties of collagen lattices or dermal
      equivalents is described. With the help of the load-extension curve obtained with
      a uniaxial traction apparatus, a stiffness modulus varying from 0.06 to 1 MPa is
      calculated from the studied parameters (duration of culture, collagen and
      fibroblast concentration). The technique is presented as a new tool for testing
      the effect of pharmacological agents on the mechanical properties of the skin.

PMID- 1733981
TI  - Lumbar posterior ligament involvement during extremely heavy lifts estimated from
      fluoroscopic measurements.
AB  - The mechanical role of the lumbar posterior ligaments during lifting tasks
      remains controversial. This study was designed to assess the ligament and disc
      contribution in resisting trunk flexion moment during extremely heavy lifts
      performed by national class powerlifters. Direct measurements of lumbar vertebrae
      kinematics in sagittal plane were obtained from videofluoroscopy utilizing
      multiple digitizing, correction for optical distortions and digital filtering.
      Four experienced powerlifters executed three trials, resulting in about 72 mA s
      of total radiation exposure. In the first trial, joint angles were measured when
      subjects fully flexed their spines to a point where the passive tissues resisted
      the flexor moment creating myoelectric silence in the extensor musculature. Next,
      two conventional deadlift style lifts were executed with the barbell load ranging
      from 183.7 to 210.9 kg. Four vertebral corners were digitized at a sampling rate
      of 30 Hz. The relative intervertebral joint angles, distance between the ligament
      attachment points, shearing and compressive displacements were calculated from a
      rigid body motion approach. Analysis revealed that except for one trial of one
      subject, they accomplished their lifts with an amount of lumbar flexion between
      1.5 and 13 degrees less than they demonstrated during full flexion. Resultant
      ligament lengths at the beginning of the lifts ranged from 56.1 to 99.8% of their
      lengths when the trunk was fully flexed. It was concluded that ligaments did not
      strain sufficiently to contribute substantial resistance to the trunk flexion
      moment, relegating this responsibility to the musculature.

PMID- 1733982
TI  - Human plantarflexor stiffness to multiple single-stretch trials.
AB  - The purpose of this investigation was to determine the influence of different
      stretch velocities, different rates of pre-stretch force development, and
      different pre-stretch muscle lengths on the intrinsic stiffness exhibited by the
      quasi-statically contracting active human plantarflexors during multiple single
      stretch trials at 20-60% of maximum isometric contraction. Subjects were
      positioned prone, with the knee flexed 1.57 rad(90 degrees), shank stabilized,
      and foot secured in a hard plastic orthotic. Slowly increasing isometric
      plantarflexion force was produced until the plantarflexors were stretched by a
      rapid 0.2 rad (12 degrees) dorsiflexion movement. Plantarflexion forces and ankle
      positions were determined during these stretches as well as during resting
      stretches when the muscle was inactive. Resting forces were subtracted from the
      active trials, forces converted to torques, and stiffnesses determined for the
      first 62 ms of the stretch. The slope of the stiffness vs pre-stretch torque
      relationship averaged 4.30 +/- 0.34 Nm rad-1 Nm-1. Little difference was found
      between stiffness determined through the single-stretch method and the results of
      previous studies employing different mechanical inputs. Differences in
      stiffnesses with different stretching velocities were caused by computational
      artifact rather than by differences in intrinsic muscular reaction. Faster rates
      of pre-stretch force increase prior to the stretch resulted in slightly lower
      stiffnesses. Different pre-stretch muscle lengths apparently did not result in
      different stiffnesses. The shape of the torque vs displacement curve was
      remarkably insensitive to the planned manipulations of the testing conditions,
      responding in a stereotypical manner.

PMID- 1733983
TI  - Three-dimensional knee joint loading during seated cycling.
AB  - The hypothesis which motivated the work reported in this article was that
      neglecting pure moments developed between the foot and pedal during cycling leads
      to a substantial error in computing axial and varus/valgus moments at the knee.
      To test this hypothesis, a mathematical procedure was developed for computing the
      three-dimensional knee loads using three-dimensional pedal forces and moments. In
      addition to data from a six-load-component pedal dynamometer, the model used
      pedal position and orientation and knee position in the frontal plane to
      determine the knee joint loads. Experimental data were collected from the right
      leg of 11 male subjects during steady-state cycling at 90 rpm and 225 W. The mean
      peak varus knee moment calculated was 15.3 N m and the mean peak valgus knee
      moment was 11.2 N m. Neglecting the pedal moment about the anterior/posterior
      axis resulted in an average absolute error of 2.6 N m and a maximum absolute
      error of 4.0 N m in the varus/valgus knee moment. The mean peak internal and
      external axial knee moments were 2.8 N m and 2.3 N m, respectively. The average
      and maximum absolute errors in the axial knee moment for not including the moment
      about an axis normal to the pedal were found to be 2.6 N m and 5.0 N m,
      respectively. The results strongly support the use of three-dimensional pedal
      loads in the computation of knee joint moments out of the sagittal plane.

PMID- 1733984
TI  - Visualization and quantification of the human blood flow by magnetic resonance
      imaging.
AB  - Magnetic Resonance Imaging (MRI) offers new possibilities for the visualization
      and the noninvasive quantification of the blood flow in human vessels. By the
      application of conventional gradient echo sequences with electrocardiographic
      gating on a 1.5 Tesla whole body MRI system the flow induced phase shifts in the
      ascending and the abdominal aorta are analyzed. The instantaneous two-dimensional
      velocity profiles and the instantaneous flow rates are determined in a series of
      subsequent images with high temporal resolution throughout the cardiac cycle. For
      the flow analysis in further vessels and for the analysis of more complex flow
      patterns, as they occur in bifurcations or stenoses, a new MR flow imaging
      technique called FAcE with extremely short echo times is introduced and the first
      results of flow examinations in a bifurcation phantom and in the carotid artery
      are presented.

PMID- 1733985
TI  - A new transducer for facet force measurement in the lumbar spine: benchmark and
      in vitro test results.
AB  - A new transducer capable of direct measurement of time-dependent loads in human
      lumbar facet joints was developed and tested. The transducer was comprised of a
      force-sensitive resistor (FSR) in series with a pressure-sensitive film. A wide
      range of experiments revealed the performance attributes and limitations of the
      FSR. The output signal of the FSR is actually sensitive to both force and area of
      contact independently. Therefore, a pressure-sensitive film was used to quantify
      the contact area. At least two transformation equations were calculated for each
      FSR corresponding to known contact areas. Each equation was a linearization of
      the log of the FSR output vs the log of the applied ramp loads. Coefficients of
      determination (CD) were calculated for small (21 mm2) and large (32 mm2) contact
      areas, and were found to exceed 0.900 for all data. The average of nine cycles
      was nearly linear for some FSRs (CD of 0.999). FSR output signal and contact area
      were recorded in cadaveric lumbar facets under ramp load. The appropriate
      transformation equation was determined by a linear interpolation between
      benchmark equations based on the contact area measured in vitro. Facet force
      measurements compared well with those of other researchers. The transducer was
      found to be quite easy to use.

PMID- 1733986
TI  - A theoretical model of the knee and ACL: theory and experimental verification.
AB  - A three-dimensional mathematical model of the human knee joint was developed to
      examine the role of single ligaments, such as an anterior cruciate ligament (ACL)
      graft in ACL reconstruction, on joint motion and tissue forces. The model is
      linear and valid for small motions about an equilibrium position. The knee joint
      is modeled as two rigid bodies (the femur and the tibia) interconnected by
      deformable structures, including the ACL or ACL graft, the cartilage layer, and
      the remainder of the knee tissues (modeled as a single element). The model was
      demonstrated for the equilibrium condition of the knee in extension with an
      anterior tibial force, causing anterior drawer and hyperextension. The knee
      stiffness matrix for this condition was measured for a human right knee in vitro.
      Predicted model response was compared with experimental observations. Qualitative
      agreement was found between model and experiment, validating the model and its
      assumptions. The model was then used to predict the change in graft and cartilage
      forces and joint motion of the knee due to an increment of load in the normal
      joint both after ACL removal and with various altered states simulating ACL
      reconstructions. Results illustrate the interdependence between loads in the ACL
      graft, other knee structures, and contact force. Stiffer grafts and smaller
      maximum unloaded length of the ligament lead to higher graft and contact forces.
      Changes in cartilage stiffness alter load sharing between ACL graft and other
      joint tissues.

PMID- 1733987
TI  - A model of pulsatile flow in a uniform deformable vessel.
AB  - Simulations of blood flow in natural and artificial conduits usually require
      large computers for numerical solution of the Navier-Stokes equations. Often,
      physical insight into the fluid dynamics is lost when the solution is purely
      numerical. An alternative to solving the most general form of the Navier-Stokes
      equations is described here, wherein a functional form of the solution is assumed
      in order to simplify the required computations. The assumed forms for the axial
      pressure gradient and velocity profile are chosen such that conservation of mass
      is satisfied for fully established pulsatile flow in a straight, deformable
      vessel. The resulting equations are cast in finite-difference form and solved
      explicitly. Results for the limiting cases of rigid wall and zero applied
      pressure are found to be in good agreement with analytical solutions. Comparison
      with the experimental results of Klanchar et al. [Circ. Res. 66, 1624-1635
      (1990]) also shows good agreement. Application of the model to realistic
      physiological parameter values provides insight as to the influence of the
      pulsatile nature of the flow field on wall shear development in the presence of a
      moving wall boundary. Specifically, the model illustrates the dependence of flow
      rate and shear rate on the amplitude of the vessel wall motion and the phase
      difference between the applied pressure difference and the oscillations of the
      vessel radius. The present model can serve as a useful tool for experimentalists
      interested in quantifying the magnitude and character of velocity profiles and
      shearing forces in natural and artificial biologic conduits.

PMID- 1733988
TI  - Heel-off perturbation during gait initiation: biomechanical analysis using
      triaxial accelerometry and a force plate.
AB  - This study analyzes the movements of the hips, shoulders and of the body center
      of gravity before and at heel-off, when step execution begins to initiate gait
      from an upright posture. The heel-off movement was considered as a dynamic
      perturbation induced by the stepping movement. The experimental paradigm used for
      studying this perturbation was the single-step movement, in which the initial
      posture and voluntary movements are identical to those of gait initiation. Data
      were collected from accelerometer recordings of the triaxial accelerations at the
      joints of the upper part of the body, and by calculating the triaxial
      accelerations of the center of gravity using force plate measurements. The
      resultant vectors were used to establish and compare the magnitude and direction
      of the accelerations at different joints, and from them, the roles of the pelvis
      and the scapular girdles with respect to the objectives of the gait movement.

PMID- 1733989
TI  - Geometry parameters for musculoskeletal modelling of the shoulder system.
AB  - A dynamical finite-element model of the shoulder mechanism consisting of thorax,
      clavicula, scapula and humerus is outlined. The parameters needed for the model
      are obtained in a cadaver experiment consisting of both shoulders of seven
      cadavers. In this paper, in particular, the derivation of geometry parameters
      from the measurement data is described. The results for one cadaver are presented
      as a typical example. Morphological structures are modelled as geometrical forms.
      Parameters describing this form are estimated from 3-D position coordinates of a
      large number of datapoints on the morphological structure, using a least-squares
      criterion. Muscle and ligament attachments are represented as a plane or as a
      (curved) line. Muscle paths are determined by a geometrical form of the bony
      contour around which the muscle is wrapped. Muscle architecture is determined by
      the distribution of muscle bundles over the attachment area, mapping the
      distribution of the origin to the insertion. Joint rotation centers are derived
      from articular surfaces. Hence, muscle moment arms can be calculated. The result
      of this study is a set of parameters for each cadaver, describing very precisely
      the geometry of the shoulder mechanism. This set allows positioning of muscle
      force vectors a posteriori, and recalculation of position coordinates and moment
      arms for any position of the shoulder.

PMID- 1733990
TI  - Mass, center of mass, and moment of inertia estimates for infant limb segments.
AB  - To quantify limb dynamics, accurate estimates are needed of anthropometric
      inertia parameters (mass, center-of-mass location, and moments of inertia). These
      estimates, however, are not available for human infants; therefore, the movement
      dynamics of infants have not been studied extensively. Here, regression equations
      for the masses, center-of-mass locations, and transverse moments of inertia of
      upper and lower limb segments (upper arm, forearm, and hand; thigh, leg, and
      foot) of 0.04 to 1.50 yr old infants are provided. A mathematical model of the
      human body was used to determine the anthropometric inertia parameters for upper
      limbs in 44 infants and for lower limbs in 70 infants. Stepwise linear
      regressions were used to fit the distributions of the anthropometric inertia
      parameters. The regression equations accounted for significant amounts of the
      variance (64-98%), and the R2-values compared favorably when our equations were
      cross-validated. Consequently, these regression equations can provide, for
      infants of similar ages, reasonable estimates of upper and lower limb
      anthropometric inertia parameters, suitable for equations of motion in the
      analysis of limb dynamics in human infants.

PMID- 1733991
TI  - A kinematic model of the human hand to evaluate its prehensile capabilities.
AB  - A kinematic model has been developed for simulation and prediction of the
      prehensile capabilities of the human hand. The kinematic skeleton of the hand is
      characterized by ideal joints and simple segments. Finger-joint angulation is
      characterized by yaw (abduction-adduction), pitch (flexion-extension) and roll
      (axial rotation) angles. The model is based on an algorithm that determines
      contact between two ellipsoids, which are used to approximate the geometry of the
      cutaneous surface of the hand segments. The model predicts the hand posture
      (joint angles) for power grasp of ellipsoidal objects by 'wrapping' the fingers
      around the object. Algorithms for two grip types are included: (1) a transverse
      volar grasp, which has the thumb abducted for added power; and (2) a diagonal
      volar grasp, which has the thumb adducted for an element of precision.
      Coefficients for estimating anthropometric parameters from hand length and
      breadth are incorporated in the model. Graphics procedures are included for
      visual display of the model. In an effort to validate the predictive capabilities
      of the model, joint angles were measured on six subjects grasping circular
      cylinders of various diameters and these measured joint angles were compared with
      angles predicted by the model. Sensitivity of the model to the various input
      parameters was also determined. On an average, the model predicted joint flexion
      angles that were 5.3% or 2.8 degrees +/- 12.2 degrees larger than the measured
      angles. Good agreement was found for the MCP and PIP joints, but results for DIP
      were more variable because of its dependence on the predictions for the proximal
      joints.

PMID- 1733992
TI  - Mechanical properties of the canine patellar tendon: some correlations with age
      and the content of collagen.
AB  - Portions of the patellar tendon (PT) are currently used for autogenous and
      allogeneic reconstruction of a torn or damaged anterior cruciate ligament (ACL).
      Age-related changes in the mechanical properties of the PT may influence its use
      in this reconstruction procedure. Age-dependent changes in the PT were determined
      in the dog, which is often used to experimentally study this reconstruction.
      Tensile failure experiments were performed at 100% s-1 on patella-patellar tendon
      tibia preparations from dogs aged 0.5-15 yr. The contents of collagen soluble and
      insoluble in pepsin were also measured at each age. Fifty-nine percent (16/27) of
      the preparations failed by avulsion at the patella, but neither the failure load
      nor the mode of failure were a function of age. Failure load and energy were
      higher for tendon substance failures compared to avulsions of bone from the
      patella. While a positive, linear correlation was measured between tensile
      modulus of the PT and age, the slope of regression was not significantly
      different from zero. The content of total collagen in the PT decreased
      significantly with age. The content of collagen insoluble in pepsin, however,
      increased with age and positively correlated with tensile modulus of the tendon.
      These results are different from those reported for the canine CCL, by others,
      which degenerates with age. Age-related changes in the mechanical properties of
      the canine PT are qualitatively similar to earlier, limited data on human
      patellar tendons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1733993
TI  - Application and validation of a three-dimensional mathematical model of the human
      masticatory system in vivo.
AB  - A previously described three-dimensional mathematical model of the human
      masticatory system, predicting maximum possible bite forces in all directions and
      the recruitment patterns of the masticatory muscles necessary to generate these
      forces, was validated in in vivo experiments. The morphological input parameters
      to the model for individual subjects were collected using MRI scanning of the jaw
      system. Experimental measurements included recording of maximum voluntary bite
      force (magnitude and direction) and surface EMG from the temporalis and masseter
      muscles. For bite forces with an angle of 0, 10 and 20 degrees relative to the
      normal to the occlusal plane the predicted maximum possible bite forces were
      between 0.9 and 1.2 times the measured ones and the average ratio of measured to
      predicted maximum bite force was close to unity. The average measured and
      predicted muscle recruitment patterns showed no striking differences.
      Nevertheless, some systematic differences, dependent on the bite force direction,
      were found between the predicted and the measured maximum possible bite forces.
      In a second series of simulations the influence of the direction of the joint
      reaction forces on these errors was studied. The results suggest that they were
      caused primarily by an improper determination of the joint force directions.

PMID- 1733994
TI  - Towards a model for force predictions in the human shoulder.
AB  - In this paper the concept of a three-dimensional biomechanical model of the human
      shoulder is introduced. This model is used to analyze static load sharing between
      the muscles, the bones and the ligaments. The model consists of all shoulder
      structures, which means that different positions and different load situations
      may be analyzed using the same model. Solutions can be found for the complete
      range of shoulder motion. However, this article focuses only on elevation in the
      scapular plane and on forces in structures attached to the humerus. The intention
      is to expand the model in future studies to also involve the forces acting on the
      other shoulder bones: the scapula and the clavicle. The musculoskeletal forces in
      the shoulder complex are predicted utilizing the optimization technique with the
      sum of squared muscle stresses as an objective function. Numerical results
      predict that among the muscles crossing the glenohumeral joint parts of the
      deltoideus, the infraspinatus, the supraspinatus, the subscapularis, the
      pectoralis major, the coracobrachialis and the biceps are the muscles most
      activated during this sort of abduction. Muscle-force levels reached values of
      150 N when the hand load was 1 kg. The results from the model seem to be
      qualitatively accurate, but it is concluded that in the future development of the
      model the direction of the contact force in the glenohumeral joint must be
      constrained.

PMID- 1733995
TI  - Knee muscle moment arms from MRI and from tendon travel.
AB  - We tested magnetic resonance imaging (MRI) as a means to collect geometric data
      for moment arm estimation. A knee specimen in five successive flexion postures
      was scanned by MRI, while simultaneously tendon positions of loaded muscles were
      measured (long head of biceps femoris, lateral and medial gastrocnemius,
      gracilis, rectus femoris, sartorius, semimembranosus, semitendinosus, and tensor
      fasciae latae). Discrete rotation centres were derived from MRI pictures. Moment
      arms were estimated as the distances from these centres to the tendons. The ratio
      of tendon travel over the increment of joint angulation was the alternative, more
      reliable estimate of the moment arm. An important principal shortcoming of MRI is
      the impossibility of accounting for force distribution in taut tissue. As a
      consequence, for some muscles, considerable inaccuracies in moment arm estimation
      are found in a relatively small range of joint angulation (up to about 30% for
      the rectus femoris and semimembranosus). For the tensor fasciae latae, the moment
      arm cannot be estimated by MRI, while the estimate by tendon travel is unreliable
      owing to the deformability and attachments of the fascia lata.

PMID- 1733996
TI  - On the role of biarticular muscles in human jumping.

PMID- 1733997
TI  - Evaluation of the lymph flow with lymphoscintigraphy after rotationplasty for the
      treatment of bone tumors.
AB  - We studied the cases of eleven patients in whom a rotationplasty had been done
      after wide resection of the distal part of the femur. All patients had had a
      malignant tumor of bone, but none had the complication of edema or leakage of
      lymph after the rotationplasty. We made lymphoscintiscans soon after the
      operation in four patients and weeks or months later in all eleven patients.
      There was a delay in the flow of lymph in three of the four patients who were
      examined lymphoscintigraphically soon after the operation and there was
      obstruction of flow in the fourth patient, but there was evidence of a decreased
      rate of flow in only two of the eleven patients at the time of the later
      examination.

PMID- 1733998
TI  - Intramedullary nailing of femoral shaft fractures. Part III: Long-term effects of
      static interlocking fixation.
AB  - The results of treatment of fractures of the femoral shaft with static
      interlocking nailing were reviewed retrospectively to determine the clinical
      importance of any stress-riser or stress-shielding properties of the nail. These
      properties, if relevant, would have been manifested by refracture of the femur,
      either through a hole used for a locking screw or through the original site of
      fracture after extraction of the device. Two hundred and fourteen fractures that
      had been treated with static interlocking nailing and that had healed without
      conversion to dynamic intramedullary fixation were divided into two groups. In
      Group I, which comprised 111 fractures, the static interlocking-fixation device
      was retained and in Group II, which comprised 103 fractures, the static
      interlocking-fixation device was removed during one operative procedure at an
      average of fourteen months after the injury. The average duration of follow-up
      was thirty months from the time of the original fixation in both groups. All
      patients in Group II were followed for a minimum of six months after removal of
      the nail. No femur in Group I, in which the static interlocked nail remained in
      situ, refractured. No femur in either group fractured through the proximal or the
      distal holes used for the locking screws. No locking screws or nails broke. One
      patient (1 per cent) in Group II had a refracture of the femoral shaft through
      the site of the original fracture six weeks after removal of the nail.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1733999
TI  - Survival of cells after intra-articular transplantation of fresh allografts of
      the patellar and anterior cruciate ligaments. DNA-probe analysis in a goat model.
AB  - The fate of donor cells in fresh allografts of the patellar and anterior cruciate
      ligaments was assessed after transplantation of the allografts as substitutes for
      the anterior cruciate ligament in goats. DNA-probe analysis was used to
      distinguish between the DNA of individual goats. Donor DNA was completely
      replaced by recipient DNA in both the transplanted patellar and anterior cruciate
      ligaments within a four-week period. Simultaneous full-thickness skin transplants
      in the same animals were not rejected during the interval of rapid loss of donor
      DNA from the allografts. The absence of rejection of the skin grafts at the one
      week interval suggests that no pre-existing antibody associated with an immune
      reaction was responsible for the rapid loss of DNA in the allografts.

PMID- 1734000
TI  - The weight-bearing abduction brace for the treatment of Legg-Perthes disease.
AB  - We reviewed the cases of thirty-one patients (thirty-four hips) who had had
      severe Legg-Perthes disease (Catterall group III, five hips and group IV, twenty
      nine hips) and had been treated with a weight-bearing abduction orthosis, to
      determine the effectiveness of the brace. The mean age of the patients when they
      were first seen was six years (range, three to twelve years). The mean duration
      of follow-up was seven years (range, two to thirteen years). At the most recent
      follow-up, all hips were rated with the method of Mose and the classification of
      Stulberg et al. According to the criteria of Mose, no hip had a good result,
      twelve (35 per cent) had a fair result, and twenty-two (65 per cent) had a poor
      result. On the basis of the classification of Stulberg et al., there were
      fourteen (41 per cent) class-II results, eighteen (53 per cent) class-III and IV
      results, and two (6 per cent) class-V results. Although containment is the most
      widely accepted principle of treatment for patients who have Legg-Perthes
      disease, and the Atlanta Scottish Rite-type orthosis is the most commonly used
      orthosis for this condition, there are few clinical data supporting the
      effectiveness of this device. On the basis of our results, we do not recommend
      the use of a weight-bearing abduction brace for the treatment of severely
      involved hips.

PMID- 1734001
TI  - Repair of hallux valgus with a distal soft-tissue procedure and proximal
      metatarsal osteotomy. A long-term follow-up.
AB  - We retrospectively reviewed the results for seventy-five patients (109 feet) in
      whom a hallux valgus deformity had been corrected with the release of the distal
      soft tissues, excision of the medial eminence, plication of the medial part of
      the capsule, and proximal crescentic osteotomy of the first metatarsal. The
      patients were followed for an average of thirty-four months (range, twenty-four
      to fifty-six months). The preoperative hallux valgus angle averaged 31 degrees,
      and the postoperative angle averaged 9 degrees. The preoperative intermetatarsal
      angle averaged 14 degrees and the postoperative angle, 6 degrees. Ninety-three
      per cent of the patients were satisfied with the result of the procedure. They
      stated that, given the same circumstances, they would have the operation again.
      The most common complication was hallux varus, which occurred in thirteen feet
      (nine patients). The other complications included recurrence of the hallux valgus
      in two feet, pain under a fibular sesamoid in one foot, and a tailor's bunion
      that was unrelated to the operation in one foot. Only five of forty-eight feet
      that had had a symptomatic plantar keratosis beneath the second metatarsal head
      preoperatively remained symptomatic postoperatively.

PMID- 1734002
TI  - Isolated avulsion of the popliteus tendon: operative repair. A report of two
      cases.

PMID- 1734003
TI  - Fracture of the middle third of the clavicle and dislocation of the
      acromioclavicular joint. A report of four cases.

PMID- 1734004
TI  - Hypoglossal nerve palsy after arthroscopy of the shoulder and open operation with
      the patient in the beach-chair position. A case report.

PMID- 1734005
TI  - The treatment of injuries of the anterior cruciate ligament.

PMID- 1734006
TI  - Osteoarticular allografts for reconstruction in the proximal part of the humerus
      after excision of a musculoskeletal tumor.

PMID- 1734007
TI  - Evidence for a humoral mechanism for enhanced osteogenesis after head injury.

PMID- 1734008
TI  - Use of a knee-brace for control of tibial translation and rotation. A comparison,
      in cadavera, of available models.

PMID- 1734009
TI  - The Scottish Rite abduction orthosis for the treatment of Legg-Perthes disease. A
      radiographic analysis.
AB  - We evaluated a consecutive series of thirty-four patients who had had Legg
      Perthes disease to determine the results of treatment with the Scottish Rite
      weight-bearing abduction orthosis. All patients had been older than six years at
      the time of the onset of the symptoms, had been in the fragmentation phase of the
      disease when they were first seen, and had had Catterall group-III or IV
      involvement. Although comparison of this series with those reported previously is
      difficult due to the variability of the presentation of data in the literature,
      this orthosis does not appear to offer an advantage compared with other methods
      of management, or with no treatment, for patients such as those whom we studied.

PMID- 1734010
TI  - Cervical stability after foraminotomy. A biomechanical in vitro analysis.
AB  - Laminectomy or facetectomy of the cervical spine, or both, may be needed for
      decompression of the spinal cord or of the nerve-roots. Acute stability of the
      cervical spine was tested after laminectomy and progressive staged foraminotomies
      in an in vitro model. Twelve cervical spines from human cadavera were used in the
      experiment. Biomechanical testing included the application of an axial load, the
      application of a flexion and extension moment, and the application of a torsional
      moment. Each specimen was tested intact, after laminectomy of the fifth cervical
      vertebra, and after progressive foraminotomy of the sixth cervical root.
      Foraminotomy was performed by resection of 25, 50, 75, and 100 per cent of the
      facet joint and capsule. Torsional stiffness decreased dramatically when more
      than 50 per cent of the facet had been resected. Statistically equivalent subsets
      were the intact specimen, laminectomy, 25 per cent facetectomy, and 50 per cent
      facetectomy in one subset, and 75 and 100 per cent facetectomy in the least-stiff
      subset. Flexion-moment testing showed that the posterior strain did not differ
      among three groups: the intact specimens, those that had been treated with
      laminectomy, and those that had been treated with a 25 per cent facetectomy. The
      50 per cent facetectomy resulted in a 2.5 per cent increase in posterior strain,
      and the 75 or 100 per cent facetectomy, in a 25 per cent increase in posterior
      strain compared with the intact specimen. Segmental hypermobility of the cervical
      spine results if a foraminotomy involves resection of more than 50 per cent of
      the facet.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734011
TI  - Epithelioid sarcoma in the upper extremity.
AB  - Eighteen patients who had epithelioid sarcoma in the upper extremity were divided
      into two groups on the basis of treatment: marginal resection of the tumor or
      wide or radical resection of the tumor. Historical, demographic, histological,
      and staging data were recorded and were correlated with the type of treatment and
      the outcome. Marginal resection (excision through the reactive zone or
      pseudocapsule surrounding the tumor, with confirmation of a negative margin by a
      pathologist), with or without adjuvant therapy, led to a dismal outcome in
      patients who had been treated in this manner initially or secondarily (fifteen
      failures after seventeen procedures). Disease-free survival at ten years was
      significantly improved when wide resection (intracompartmental en bloc excision
      with a cuff of normal tissue of more than three centimeters) or radical resection
      was either the initial or the secondary treatment; success then was noted in nine
      of thirteen operations. Of twelve patients in whom a marginal resection had been
      done initially, three had had a recurrence, three had had a metastasis, and five
      had died, at a mean follow-up of seven years (range, twenty-seven months to
      sixteen years). At a mean follow-up of six years (range, two to fifteen years),
      only one of five patients in whom a secondary lesion had been treated with
      marginal resection was free of disease. Of the six patients who had been treated
      with wide or radical resection initially, none had died, one had had a
      recurrence, and one had had a metastasis, at a mean follow-up of seven years
      (range, twenty-two months to fourteen years).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734012
TI  - Anatomy and relationships of the suprascapular nerve: anatomical constraints to
      mobilization of the supraspinatus and infraspinatus muscles in the management of
      massive rotator-cuff tears.
AB  - Thirty-one shoulders in eighteen cadavera were dissected to allow study of the
      neurovascular anatomy of the rotator cuff and to help determine the limits of
      mobilization of the cuff for the repair of chronic massive retracted tears. The
      dissection demonstrated the diameter, length, and relationships of the
      suprascapular nerve and its branches and made clear the dangers of extensive
      mobilization and advancement of the supraspinatus and infraspinatus muscles. The
      suprascapular nerve ran an oblique course across the supraspinatus fossa, was
      relatively fixed on the floor of the fossa, and was tethered underneath the
      transverse scapular ligament. In twenty-six (84 per cent) of the thirty-one
      shoulders, there were no more than two motor branches to the supraspinatus
      muscle, and the first was always the larger of the two. In twenty-six (84 per
      cent) of the thirty-one shoulders, the first motor branch originated underneath
      the transverse scapular ligament or just distal to it. In one shoulder (3 per
      cent), the first motor branch passed over the ligament. The average distance from
      the origin of the long tendon of the biceps to the motor branches of the
      supraspinatus was three centimeters. In fifteen (48 per cent) of the thirty-one
      shoulders, the infraspinatus muscle had three or four motor branches of the same
      size. The average distance from the posterior rim of the glenoid to the motor
      branches of the infraspinatus muscle was two centimeters. The motor branches to
      the supraspinatus muscle were fewer, usually smaller, and significantly shorter
      than those to the infraspinatus muscle. The standard anterosuperior approach
      allowed only one centimeter of lateral advancement of either tendon and limited
      the ability of the surgeon to dissect safely beyond the neurovascular pedicle.
      The advancement technique of Debeyre et al., or a modification of that technique,
      permitted lateral advancement of each muscle of as much as three centimeters and
      was limited by tension in the motor branches of the suprascapular nerve. In some
      situations, the safe limit of advancement may be even less. We concluded that
      lateral advancement of the rotator cuff is limited anatomically and may place the
      neurovascular structures at risk.

PMID- 1734013
TI  - Anatomy, histology, and vascularity of the glenoid labrum. An anatomical study.
AB  - We studied the gross, histological, and vascular anatomy of the glenoid labrum in
      twenty-three fresh-frozen shoulders from cadavera to demonstrate its cross
      sectional anatomy, its microvascularity, and its attachments. The superior and
      anterosuperior portions of the labrum are loosely attached to the glenoid, and
      the macro-anatomy of those portions is similar to that of the meniscus of the
      knee. The superior portion of the labrum also consistently inserts directly into
      the biceps tendon, while its inferior portion is firmly attached to the glenoid
      rim and appears as a fibrous, immobile extension of the articular cartilage. The
      arteries supplying the periphery of the glenoid labrum come from the
      suprascapular, circumflex scapular, and posterior circumflex humeral arteries. In
      general, the superior and anterosuperior parts of the labrum have less
      vascularity than do the posterosuperior and inferior parts, and the vascularity
      is limited to the periphery of the labrum. Vessels supplying the labrum originate
      from either capsular or periosteal vessels and not from the underlying bone.

PMID- 1734014
TI  - The role of the rotator interval capsule in passive motion and stability of the
      shoulder.
AB  - The purpose of this study was to characterize the role of the capsule in the
      interval between the supraspinatus and subscapularis tendons with respect to
      glenohumeral motion, translation, and stability. We used a six-degrees-of-freedom
      position-sensor and a six-degrees-of-freedom force and torque-transducer to
      determine the glenohumoral rotations and translations that resulted from applied
      loads in eight cadaver shoulders. The range of motion of each specimen was
      measured with the capsule in the rotator interval in a normal state, after the
      capsule had been sectioned, and after it had been imbricated. Operative
      alteration of this capsular interval was found to affect flexion, extension,
      external rotation, and adduction of the humerus with respect to the scapula.
      Modification of this portion of the capsule also affected obligate anterior
      translation of the humeral head on the glenoid during flexion. Limitation of
      motion and obligate translation were increased by operative imbrication and
      diminished by sectioning of the rotator interval capsule. Passive stability of
      the glenohumeral joint was evaluated with the use of anterior, posterior, and
      inferior stress tests. Instability and occasional frank dislocation of the
      glenohumeral joint occurred inferiorly and posteriorly after section of the
      rotator interval capsule. Imbrication of this part of the capsule increased the
      resistance to inferior and posterior translation.

PMID- 1734015
TI  - Medial instability of the elbow in throwing athletes. Treatment by repair or
      reconstruction of the ulnar collateral ligament.
AB  - From September 1974 to December 1987, seventy-one patients were operated on for
      valgus instability of the elbow. The average length of follow-up of sixty-eight
      patients (seventy operations) was 6.3 years (range, two to fifteen years). At the
      operation, a torn or incompetent ulnar collateral ligament was found. Fourteen
      patients had a direct repair of the ligament, and fifty-six had a reconstruction
      of the ligament using a free tendon graft. The result was excellent or good in
      ten patients in the repair group and in forty-five (80 per cent) in the
      reconstruction group. Seven of the fourteen patients who had a direct repair
      returned to the previous level of participation in their sport. Of the fifty-six
      who had a reconstruction, thirty-eight (68 per cent) returned to the previous
      level of participation. Twelve of the sixteen major-league baseball players who
      had a reconstruction as the primary operation (no previous operation on the
      elbow) were able to return to playing major-league baseball, and two of the seven
      major-league players who had a direct repair returned to playing major-league
      baseball. Previous operations on the elbow decreased the chance of returning to
      the previous level of sports participation (p = 0.04). Fifteen patients had
      postoperative ulnar neuropathy. This was transient in six patients, only one of
      whom was unable to return to the previous level of sport. The other nine patients
      had an additional operation for the neuropathy; four were able to return to the
      previous level of sport.

PMID- 1734016
TI  - Arthroscopy of the elbow. Diagnostic and therapeutic benefits and hazards.
AB  - We analyzed the results of seventy-one arthroscopies of the elbow in seventy
      patients who had been followed for an average of thirty-four months, in order to
      evaluate the risks and benefits of the procedure. Thirty-four arthroscopies were
      done for diagnostic purposes, fifteen were done for treatment, and twenty-two
      were done for both diagnosis and treatment. Overall, fifty-one (73 per cent) of
      the seventy patients benefited in some way. There were diagnostic benefits in
      thirty-six (64 per cent) of the fifty-six elbows in which diagnosis was an
      indication for the procedure, and there were therapeutic benefits in thirty (70
      per cent) of the forty-three elbows in which treatment was intended or was
      performed although not planned. The procedure was of benefit in only eighteen (75
      per cent) of the twenty-four elbows that had loose bodies, but it was successful
      in all elbows in which the loose bodies were not secondary to some other
      condition, including arthrosis. The procedure was also successful in all four
      elbows in which the loose bodies had been due to osteochondritis dissecans. In
      twelve (80 per cent) of the fifteen patients who had debridement (removal of
      flaps or loose fragments of articular cartilage) and in one of the two in whom a
      synovectomy had been performed, the treatment was successful. Seven (10 per cent)
      of the seventy patients had complications, none of which were major. Three
      patients (4 per cent) had a transient radial-nerve palsy after intra-articular
      injection of local anesthetic; four others had persistent drainage and negative
      cultures, but the drainage resolved with antibiotic therapy. In one of the four
      patients, a permanent flexion contracture of 15 degrees developed, and 10 degrees
      of flexion was lost.

PMID- 1734017
TI  - Capitellocondylar total elbow replacement. A long-term follow-up study.
AB  - Fifty-one capitellocondylar elbow replacements were inserted in forty-one
      patients between 1976 and 1986. Thirty-nine patients had rheumatoid arthritis and
      two had traumatic osteoarthrosis. The average age of the patients at the time of
      the operation was fifty-six years (range, twenty-one to seventy-seven years).
      Thirty-one patients who had thirty-nine retained elbow prostheses had an average
      length of follow-up of 6.5 years (range, two to thirteen years). Flexion improved
      an average of 20 degrees; extension, 4 degrees; pronation, 22 degrees; and
      supination, 36 degrees. Relief of pain was complete in 85 per cent of the thirty
      nine elbows, and in 15 per cent there was only mild pain. Noteworthy
      postoperative complications in the original fifty-one elbows included infection
      in four elbows (8 per cent), dislocation in three (6 per cent), and ulnar
      neuropathy in sixteen (31 per cent). Three elbows were revised: one for a humeral
      fracture, one for recurrent dislocation, and one for aseptic loosening. Aseptic
      loosening was evident on radiographs of two elbows; one patient was completely
      asymptomatic, and one had mild pain with deformity. The Souter zonal radiographic
      assessment system for identification of radiolucencies at the bone-cement
      interface was utilized; there was no significant difference in radiolucencies
      between ulnar components backed with metal and those that were not backed with
      metal. Kaplan-Meier cumulative survivorship analysis demonstrated that a
      functional prosthesis was retained in 88 per cent of the elbows at 1.4 years
      postoperatively and in 83 per cent at 5.5 years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734018
TI  - Induction of proliferation or hypertrophy of chondrocytes in serum-free culture:
      the role of insulin-like growth factor-I, insulin, or thyroxine.
AB  - In bone forming cartilage in vivo, cells undergo terminal differentiation,
      whereas most of the cells in normal articular cartilage do not. Chondrocyte
      hypertrophy can be induced also in vitro by diffusible signals. We have
      identified growth factors or hormones acting individually on 17-d chick embryo
      sternal chondrocytes cultured in agarose gels under strictly serum-free
      conditions. Insulin-like growth factor I or insulin triggered the first steps of
      chondrocyte maturation, i.e., cell proliferation and increased matrix deposition
      while the chondrocytic phenotype was maintained. However, cells did not progress
      to the hypertrophic stage. Proliferation and stimulated collagen production was
      preceded by a lag period, indicating that synthesis of other components was
      required before cells became responsive to insulin-like growth factor I or
      insulin. Very small amounts of FBS exerted effects similar to those of insulin
      like growth factor I or insulin. However, FBS could act directly and elicited
      hypertrophy when constituting greater than 1% of the culture media. Basic FGF has
      been claimed to be the most potent chondrocyte mitogen, but had negligible
      effects under serum-free conditions. The same is true for PDGF, a major serum
      mitogen. Under the direction of thyroxine, cells did not proliferate but became
      typical hypertrophic chondrocytes, extensively synthesizing collagen X and
      alkaline phosphatase.

PMID- 1734019
TI  - Hepatocytes in collagen sandwich: evidence for transcriptional and translational
      regulation.
AB  - The influence of extracellular matrix configuration on the tissue-specific
      function of cultured hepatocytes was investigated. Adult rat hepatocytes
      sandwiched between two layers of collagen gel were compared to cells cultured on
      a single layer of collagen gel for differences in the total RNA content, the
      level of albumin-specific mRNA, the rate of albumin gene transcription, and the
      rate of albumin mRNA translation. Adult hepatocytes in the sandwich system
      maintained the level of albumin mRNA similar to that found in the normal liver
      for at least six weeks, whereas the level of albumin mRNA declined rapidly in the
      single gel system. After one week of culture, hepatocytes in the single gel
      system could be induced to recover the high level of albumin mRNA and albumin
      production when a second layer of collagen gel was overlaid at that time.
      Furthermore, sandwiched hepatocytes maintained significantly higher
      transcriptional activity compared to cells in the single gel system. In addition
      to transcriptional control, the ultimate rate of albumin production was shown to
      depend on the rate of translation, which increased with culture time and reached
      a plateau in one to two weeks. This increase in translational activity over time
      in culture was observed in both the sandwich and the single gel systems and,
      thus, appeared to be independent of the configuration of extracellular matrix.

PMID- 1734020
TI  - Deletion of the regulatory domain of protein kinase C alpha exposes regions in
      the hinge and catalytic domains that mediate nuclear targeting.
AB  - Members of the protein kinase C (PKC) family are characterized by an NH2-terminal
      regulatory domain containing binding sites for calcium, phosphatidylserine, and
      diacylglycerol (or tumor-promoting phorbol esters), a small central hinge region
      and a COOH-terminal catalytic domain. We have constructed fusion proteins in
      which the regulatory domain of PKC alpha was removed and replaced by a 19-amino
      acid leader sequence containing a myristoylation consensus or by the same
      sequence in which the amino-terminal glycine was changed to alanine to prevent
      myristoylation. The goal was to generate constitutively active mutants of PKC
      that were either membrane bound, due to their myristoylation, or cytoplasmic.
      Western blotting of fractions from COS cells transfected with plasmids encoding
      wild-type and mutant proteins revealed that PKC alpha resided entirely in a
      Triton X-100 soluble (TS) fraction, whereas both the myristoylated and
      nonmyristoylated mutants were associated primarily with the nuclear envelope
      fraction. A similar mutant that lacked the 19 amino acid leader sequence was also
      found almost entirely in the nuclear envelope, as was a truncation mutant
      containing only the regulatory domain, hinge region, and a small portion of the
      catalytic domain. However, an additional truncation mutant consisting of only the
      regulatory domain plus the first one-third of the hinge region was almost
      entirely in the TS fraction. A nonmyristoylated fusion protein containing only
      the catalytic domain was also found in the nuclear envelope. Immunostaining of
      cells transfected with these constructs revealed that both the myristoylated and
      nonmyristoylated mutants were localized in nuclei, whereas wild-type PKC alpha
      was primarily cytoplasmic and perinuclear. Phorbol dibutyrate treatment of PKC
      alpha-transfected cells resulted in increased perinuclear and nuclear staining.
      The results are consistent with a model in which activation of PKC, by phorbol
      esters or by deletion of the regulatory domain, exposes regions in the hinge and
      catalytic domains that interact with a PKC "receptor" present in the nuclear
      envelope, and may explain the ability of wild-type PKC to be translocated to the
      nucleus under certain conditions.

PMID- 1734021
TI  - Fc receptor endocytosis is controlled by a cytoplasmic domain determinant that
      actively prevents coated pit localization.
AB  - Macrophages and B-lymphocytes express two major isoforms of Fc receptor (FcRII-B2
      and FcRII-B1) that exhibit distinct capacities for endocytosis. This difference
      in function reflects the presence of an in-frame insertion of 47 amino acids in
      the cytoplasmic domain of the lymphocyte isoform (FcRII-B1) due to alternative
      mRNA splicing. By expressing wild type and mutant FcRII cDNAs in fibroblasts, we
      have now examined the mechanism by which the insertion acts to prevent coated pit
      localization and endocytosis. We first identified the region of the FcRII-B2
      cytoplasmic domain that is required for rapid internalization. Using a
      biochemical assay for endocytosis and an immuno-EM assay to determine coated pit
      localization directly, we found that the distal half of the cytoplasmic domain,
      particularly a region including residues 18-31, as needed for coated pit-mediated
      endocytosis. Elimination of the tyrosine residues at position 26 and 43,
      separately or together, had little effect on coated pit localization and a
      partial effect on endocytosis of ligand. Since the FcRII-B1 insertion occurs in
      the membrane-proximal region of the cytoplasmic domain (residue 6) not required
      for internalization, it is unlikely to act by physically disrupting the coated
      pit localization determinant. In fact, the insertion was found to prevent
      endocytosis irrespective of its position in the cytoplasmic tail and appeared to
      selectively exclude the receptor from coated regions. Moreover, receptors bearing
      the insertion exhibited a temperature- and ligand-dependent association with a
      detergent-insoluble fraction and with actin filaments, perhaps in part explaining
      the inability of FcRII-B1 to enter coated pits.

PMID- 1734022
TI  - Remodeling the cell surface distribution of membrane proteins during the
      development of epithelial cell polarity.
AB  - The development of polarized epithelial cells from unpolarized precursor cells
      follows induction of cell-cell contacts and requires resorting of proteins into
      different membrane domains. We show that in MDCK cells the distributions of two
      membrane proteins, Dg-1 and E-cadherin, become restricted to the basal-lateral
      membrane domain within 8 h of cell-cell contact. During this time, however, 60
      80% of newly synthesized Dg-1 and E-cadherin is delivered directly to the forming
      apical membrane and then rapidly removed, while the remainder is delivered to the
      basal-lateral membrane and has a longer residence time. Direct delivery of
      greater than 95% of these proteins from the Golgi complex to the basal-lateral
      membrane occurs greater than 48 h later. In contrast, we show that two apical
      proteins are efficiently delivered and restricted to the apical cell surface
      within 2 h after cell-cell contact. These results provide insight into mechanisms
      involved in the development of epithelial cell surface polarity, and the
      establishment of protein sorting pathways in polarized cells.

PMID- 1734024
TI  - Direct proof that the primary site of action of cytochalasin on cell motility
      processes is actin.
AB  - We have previously described the isolation of a mutant KB cell (Cyt 1 mutant)
      resistant to the cytotoxic effect of cytochalasin B (CB). The Cyt 1 mutant
      carries an altered form of beta-actin (beta'-actin) and lacks normal beta-actin
      (Toyama, S., and S. Toyama. 1984. Cell. 37:609-614). Increased resistance of the
      Cyt 1 mutant to CB in vivo is reflected in altered properties of beta'-actin in
      vitro (Toyama, S., and S. Toyama. 1988. J. Cell Biol. 107:1499-1504). Here, we
      show that the mutation in beta-actin is solely responsible for the cytochalasin
      resistant phenotype of the Cyt mutant. We have isolated a cDNA clone encoding
      beta'-actin from Cyt 1 cells. Sequence analysis reveals two mutations in the
      coding region that substitute two amino acid residues (Val139----Met and Ala295--
      -Asp). Expression of the beta'-actin cDNA confers cytochalasin resistance upon
      transformed cytochalasin-sensitive KB cells. Levels of resistance to CB in the
      transformed cell clones correlate well with amounts of beta'-actin polypeptide.
      Both of the two mutations in beta'-actin are necessary for the high level
      expression of cytochalasin resistance. Overall, we conclude that the primary site
      of action of cytochalasin on cell motility processes in vivo is actin.

PMID- 1734023
TI  - Perturbations of Drosophila alpha-actinin cause muscle paralysis, weakness, and
      atrophy but do not confer obvious nonmuscle phenotypes.
AB  - We have investigated accumulation of alpha-actinin, the principal cross-linker of
      actin filaments, in four Drosophila fliA mutants. A single gene is variably
      spliced to generate one nonmuscle and two muscle isoforms whose primary sequence
      differences are confined to a peptide spanning the actin binding domain and first
      central repeat. In fliA3 the synthesis of an adult muscle-specific isoform is
      blocked in flight and leg muscles, while in fliA4 the synthesis of nonmuscle and
      both muscle-specific isoforms is severely reduced. Affected muscles are weak or
      paralyzed, and, in the case of fliA3, atrophic. Their myofibrils, while
      structurally irregular, are remarkably normal considering that they are nearly
      devoid of a major contractile protein. Also surprising is that no obvious
      nonmuscle cell abnormalities can be discerned despite the fact that both the
      fliA1- and fliA4-associated mutations perturb the nonmuscle isoform. Our
      observations suggest that alpha-actinin stabilizes and anchors thin filament
      arrays, rather than orchestrating their assembly, and further imply that alpha
      actinin function is redundant in both muscle and nonmuscle cells.

PMID- 1734025
TI  - Evidence that the stalk of Drosophila kinesin heavy chain is an alpha-helical
      coiled coil.
AB  - Kinesin is a mechanochemical enzyme composed of three distinct domains: a
      globular head domain, a rodlike stalk domain, and a small globular tail domain.
      The stalk domain has sequence features characteristic of alpha-helical coiled
      coils. To gain insight into the structure of the kinesin stalk, we expressed it
      from a segment of the Drosophila melanogaster kinesin heavy chain gene and
      purified it from Escherichia coli. When observed by EM, this protein formed a
      rodlike structure 40-55 nm long that was occasionally bent at a hingelike region
      near the middle of the molecule. An additional EM study and a chemical cross
      linking study showed that this protein forms a parallel dimer and that the two
      chains are in register. Finally, using circular dichroism spectroscopy, we showed
      that this protein is approximately 55-60% alpha-helical in physiological aqueous
      solution at 25 degrees C, and approximately 85-90% alpha-helical at 4 degrees C.
      From these results, we conclude that the stalk of kinesin heavy chain forms an
      alpha-helical coiled coil structure. The temperature dependence of the circular
      dichroism signal has two major transitions, at 25-30 degrees C and at 45-50
      degrees C, which suggests that a portion of the alpha-helical structure in the
      stalk is less stable than the rest. By producing the amino-terminal (coil 1) and
      carboxy-terminal (coil 2) halves of the stalk separately in E. coli, we showed
      that the region that melts below 30 degrees C lies within coil 1, while the
      majority of coil 2 melts above 45 degrees C. We suggest that this difference in
      stability may play a role in the force-generating mechanism or regulation of
      kinesin.

PMID- 1734026
TI  - A normally masked nuclear matrix antigen that appears at mitosis on cytoskeleton
      filaments adjoining chromosomes, centrioles, and midbodies.
AB  - mAbs were generated against HeLa nuclear matrix proteins and one, HIB2, which
      selectively stained mitotic cells, was selected for further study. Western blot
      analysis showed H1B2 antibody detected a protein of 240 kD in the nuclear matrix
      fractions. The H1B2 antigen was completely masked in immunofluorescently stained
      interphase cells. However, removing chromatin with DNase I digestion and 0.25 M
      ammonium sulfate extraction exposed the protein epitope. The resulting
      fluorescence pattern was bright, highly punctate, and entirely nuclear. Further
      extraction of the nuclear matrix with 2 M NaCl uncovers an underlying,
      anastomosing network of 9-13 nm core filaments. Most of the H1B2 antigen was
      retained in the fibrogranular masses enmeshed in the core filament network and
      not in the filaments themselves. The H1B2 antigen showed remarkable behavior at
      mitosis. As cells approached prophase the antigen became unmasked to
      immunofluorescent staining without the removal of chromatin. First appearing as a
      bright spot, the antibody staining spread through the nucleus finally
      concentrating in the region around the condensed chromosomes. The antibody also
      brightly stained the spindle poles and, more weakly, in a punctate pattern in the
      cytoskeleton around the spindle. As the chromosomes separated at anaphase, H1B2
      remained with the separating daughter sets of chromosomes. The H1B2 antigen
      returned to the reforming nucleus at telophase, but left a bright staining region
      in the midbody. Immunoelectron microscopy of resinless sections showed that, in
      the mitotic cell, the H1B2 antibody did not stain chromosomes and centrioles
      themselves, but decorated a fibrogranular network surrounding and connected to
      the chromosomes and a fibrogranular structure surrounding the centriole.

PMID- 1734027
TI  - Molecular organization of the uvomorulin-catenin complex.
AB  - The Ca(2+)-dependent cell adhesion molecule uvomorulin is a member of the
      cadherin gene family. Its cytoplasmic region complexes with structurally defined
      proteins termed alpha-, beta-, and gamma-catenins. Here we show that A-CAM (N
      cadherin), another member of this gene family, also associates with catenins
      suggesting that this complex formation may be a general property of the
      cadherins. For uvomorulin it has been found that this association with catenins
      is of crucial importance for the adhesive function, but little is known about the
      molecular organization of the uvomorulin-catenin complex. Using a combination of
      biochemical analyses we show that a single complex is composed of one molecule of
      uvomorulin, one or two molecules of beta-catenin, and one molecule of alpha
      catenin. Furthermore, beta-catenin seems to interact more directly with
      uvomorulin. In pulse-chase experiments beta-catenin is already associated with
      the 135-kD uvomorulin precursor molecule but the assembly of the newly
      synthesized alpha-catenin into the complex is only detected around the time of
      endoproteolytic processing.

PMID- 1734028
TI  - Degradation of collagen in the bone-resorbing compartment underlying the
      osteoclast involves both cysteine-proteinases and matrix metalloproteinases.
AB  - The site of action of cysteine-proteinases (CPs) and matrix metalloproteinases
      (MMPs) in the degradation of bone collagen by osteoclasts was investigated by
      evaluating the effects of the CP-inhibitor trans-epoxy-succinyl-L-leucylamido (4
      guanidino)-butane (E-64) and the MMP-inhibitor N-(3-N-benzyloxycarbonyl amino-1-R
      carboxypropyl)-L-leucyl-O-methyl-L-tyrosine N-methylamide (Cl-1) in an in vitro
      model system of PTH-stimulated mouse calvaria. In the presence of each of the two
      inhibitors a large area of collagen free of mineral crystallites was seen
      adjacent to the ruffled border of the osteoclasts. Following a culture period of
      24 h this area proved to be about 10 times larger in inhibitor-treated explants
      than in controls. Moreover the percentage of osteoclasts in close contact with
      such demineralized bone areas appeared to be significantly higher in inhibitor
      treated explants than in control specimens (60% and 5%, respectively). These
      effects were not apparent when the osteoclastic activity was inhibited with
      calcitonin. No significant differences were found between the effects of the two
      inhibitors, E-64 and Cl-1. Our observations indicate that under the influence of
      inhibitors of MMPs and CPs demineralization of bone by osteoclasts proceeded up
      to a certain point whereas matrix degradation was strongly inhibited. It is
      concluded that within the osteoclastic resorption lacuna both CPs and MMPs
      participate in the degradation of the collagenous bone matrix.

PMID- 1734029
TI  - Growth and function of primary rabbit kidney proximal tubule cells in glucose
      free serum-free medium.
AB  - The properties of primary rabbit kidney proximal tubule cells in glucose-free
      serum-free medium have been examined. Primary rabbit kidney proximal tubule cells
      were observed to grow at the same rate, 1.0 doublings/day, both in glucose-free
      and in glucose-supplemented medium. Growth in glucose-free medium was dependent
      upon the presence of an additional nutritional supplement, such as glutamine,
      pyruvate, palmitate, lactate, or beta hydroxybutyrate. Lactate, pyruvate, and
      glutamate are utilized for renal gluconeogenesis in vivo. The growth of the
      primary rabbit kidney proximal tubule cells in glucose-free medium was also
      dependent upon the presence of the three growth supplements insulin, transferrin,
      and hydrocortisone. Insulin was growth stimulatory to the primary proximal tubule
      cells in glucose-free medium, although insulin causes a reduction in the
      phosphoenolpyruvate carboxykinase (PEPCK) activity in these cells. PEPCK is a key
      regulatory enzyme in the gluconeogenic pathway. In order to evaluate whether or
      not the primary cells have gluconeogenic capacity, their glucose content was
      determined. The cells contained 5 pmoles D-glucose/mg protein. However, no
      significant glucose was detected in the medium. Presumably, the primary cells
      were either utilizing or storing the glucose made by the gluconeogenic pathway.
      Consistent with this latter possibility, cellular glycogen levels were observed
      to increase with time in culture. The effect of glucose on the expression of the
      alpha I(IV) collagen and laminin B1 chain genes was examined. Northern analysis
      indicated that the level of alpha I(IV) collagen mRNA was significantly elevated
      in glucose containing, as compared with glucose deficient, medium. In contrast,
      laminin B1 chain mRNA levels were not significantly affected by the glucose
      content of the medium.

PMID- 1734030
TI  - Entactin promotes adhesion and long-term maintenance of cultured regenerated
      skeletal myotubes.
AB  - The basal lamina protein, laminin, has been shown to promote migration and
      proliferation of cultured skeletal myoblasts, resulting in increased myotube
      formation. However, skeletal myotubes adhere poorly to a laminin substrate, and
      long-term cultures of skeletal myotubes on laminin have not been achieved. We
      have found that cultured satellite cells from bupivacaine-damaged rat skeletal
      muscle actively proliferate and differentiate on a diluted Matrigel substrate
      composed of laminin, type IV collagen, heparan sulfate proteoglycan, and
      entactin. Myotubes cultured on diluted Matrigel are contractile and have never
      been observed to detach from the culture dish; rather, myotubes generally atrophy
      after 2-3 weeks in culture. Antibodies directed against the various protein
      components of Matrigel were used to determine the role of each component in
      enhancing muscle differentiation. Anti-laminin impaired satellite cell adhesion,
      whereas antibodies against either type IV collagen or heparan sulfate
      proteoglycan had no effect. Anti-entactin did not inhibit attachment,
      proliferation, or fusion of cultured satellite cells; however, myotubes exposed
      to anti-entactin failed to adhere to the culture dish after spontaneous myotube
      contractions began. We conclude that entactin is responsible for long-term
      maintenance and maturation of contractile skeletal myotubes on a diluted Matrigel
      substrate. This is the first study to assign a biological function for entactin
      in myogenesis.

PMID- 1734031
TI  - Urokinase-type plasminogen activator mediates basic fibroblast growth factor
      induced bovine endothelial cell migration independent of its proteolytic
      activity.
AB  - The dependence of urokinase-type plasminogen activator (uPA) induction on
      endogenous basic fibroblast growth factor (bFGF) activity during endothelial cell
      migration was investigated utilizing a combination of wounded endothelial cell
      monolayers and substrate overlay techniques. Purified polyclonal rabbit
      immunoglobulin G (IgG) against bFGF blocked the appearance of uPA-dependent lytic
      activity normally observed at the edge of a wounded bovine aortic endothelial
      (BAE) cell monolayer. Additionally, the migration of cells into the denuded area
      was inhibited 30-50% by antibodies either to bFGF or to bovine uPA. Incubation of
      wounded monolayers with either purified bovine uPA or agents able to induce PA
      activity, such as phorbol myristate acetate (PMA), vanadate, or bFGF, resulted in
      enhanced migration of cells (28-50%). Anti-bovine uPA IgG blocked a significant
      fraction (25%) of BAE cell migration induced by exposure to exogenous bFGF. The
      role of uPA in migration of wounded BAE cells was not dependent on plasmin
      generation. Furthermore, the amino terminal fragment (ATF) of human recombinant
      (hr) uPA, which is enzymatically inactive, stimulated endothelial cell movement
      in the presence of anti-bFGF IgG. These results suggest that BAE cell migration
      from the edge of a wounded monolayer is dependent upon local increases of uPA
      mediated by endogenous bFGF. Moreover, the data support the conclusion that
      migration is stimulated via a signalling mechanism dependent upon occupancy of
      the uPA receptor but independent of uPA-mediated proteolysis.

PMID- 1734032
TI  - Modulation of nuclear statin expression in rat thyroid follicle cell following
      administration of thyroid stimulating hormone.
AB  - This study was designed to examine the state of proliferation in the rat
      thyrocyte following the administration of thyroid stimulating hormone (TSH). An
      immunohistochemical technique involving the use of a monoclonal antibody to
      statin, a nonproliferation-specific nuclear antigen, was developed to measure the
      subpopulation of cells that have ceased to divide. Following the random
      assignment of young male Sprague-Dawley rats into various groups, the rats in the
      control group received a single intraperitoneal (i-p) injection of normal saline,
      whereas the experimental groups received single i-p injections of TSH at doses of
      0.25, 0.50, and 1.0 IU, respectively. All rats were subsequently sacrificed in
      groups of three at 1, 2, 4, and 24 hours. The statin antibody label was readily
      identified within the follicle cell nucleus. Results revealed a statistically
      significant transient decrease in the mean percent statin-positive nuclei in the
      TSH-treated groups. The time- and dose-dependent effect of TSH was maximal at 2
      hours and no longer discernible at 24 hours. A second experiment involving the
      chronic administration of TSH (i-p 0.25 IU twice daily) resulted in a cumulative
      response with a statistically significant progressive decrease in the mean
      percent of statin-positive nuclei at 5 and 10 days, returning to near normal
      values 5 days following the cessation of treatment. Determination of the nuclear
      optical density of the statin reaction product by image analysis techniques
      revealed that a single injection of TSH resulted in a rapid disappearance of the
      statin nuclear protein. This result suggests that the disappearance of statin in
      the nucleus appears to reflect the event of cells leaving the nondividing
      quiescent state to resume the cell cycle traverse following the administration of
      TSH. The disappearance of statin appears as an early nuclear event that parallels
      the earliest known cytoplasmic pinocytotic response to TSH in the rat thyroid
      follicle cell.

PMID- 1734033
TI  - Polarity in the transcytotic processing of apical and basal membrane-bound
      peroxidase-polylysine conjugates in MDCK cells.
AB  - A conjugate of horseradish peroxidase (HRP) to poly(L-lysine) (PLL) was used to
      characterize a non-lysosomal proteolytic compartment in the MDCK Strain I
      epithelial cell line. This compartment is expressed in a polar fashion, and is
      capable of degradation of the PLL moiety in the conjugate followed by release of
      HRP via a basal-to-apical, but not apical-to-basal, transcytotic pathway. This
      uptake, cleavage, and transport process appears to require approximately 2 hr, as
      there is a 2 hr lag-time between conjugate administration to the basal surface
      and HRP release to the apical medium. Monensin (10 microM) failed to inhibit this
      process, indicating that participation of the trans-Golgi network (TGN) in the
      trafficking of internalized conjugate is not the rate-determining step.
      Inhibition of HRP transport was found to be elicited by 50 micrograms/ml
      leupeptin, but only when applied to the basal surface. Brief trypsinization of
      either the basal or apical surfaces of cells preloaded with HRP conjugate showed
      no appreciable inhibitory effect on the apical release of HRP, indicating that an
      intracellular compartment rather than surface-bound enzymes is responsible for
      the degradation of the PLL moiety in the conjugate. Our results demonstrate the
      presence of an intracellular proteolytic compartment which is accessible in the
      basal-to-apical, but not apical-to-basal, transport pathway; and this compartment
      can be exploited for the transcytosis of membrane-bound molecules.

PMID- 1734034
TI  - Parathyroid hormone-related protein production by primary cultures of mammary
      epithelial cells.
AB  - Parathyroid hormone-related protein (PTHrP) plays a major role in the
      pathogenesis of malignant hypercalcemia, but has also been found in fetal and
      adult non-neoplastic tissues. Among them, lactating mammary gland was shown to
      produce PTHrP, and high levels of PTHrP were measured in milk. However, the
      regulation of PTHrP production by breast cells is still unknown. Primary cultures
      of mammary cells isolated from rat lactating glands were grown on collagen gels
      in an insulin/epidermal growth factor (EGF)-supplemented medium. Under these
      conditions, mammary cells displayed an epithelial phenotype and their number
      increased more than twofold after 1 week in culture. At that time, the cells were
      capable of producing immunoreactive PTHrP (range: 25 to 150 pg/10(5) cells x 24
      h) and PTH-like bioactivity, as indicated by a 60% increase in cyclic adenosine
      monophosphate (cAMP) production induced by mammary epithelial cell conditioned
      medium in the PTH-responsive osteoblast-like UMR-106 cell line. When cell
      proliferation was hindered by lowering plating density, by removing medium
      supplements, or by adding transforming growth factor (TGF)-beta, a well-known
      autocrine inhibitor of mammary epithelial cell growth. PTHrP production was
      increased. In contrast, the omission of EGF or addition of specified anti-EGF
      antibodies decreased PTHrP production. In conclusion, primary cultures of mammary
      epithelial cells isolated from lactating rat were shown for the first time to
      produce PTHrP in vitro. This production was higher in the presence of EGF and
      could be modulated by cell growth rate.

PMID- 1734035
TI  - Enhanced wound healing in animal models by interferon and an interferon inducer.
AB  - Healing of wounds is a significant biological process that involves the
      interactions of different cell types, growth factors, cytokines, and
      extracellular matrix molecules. Mice and rats were treated in vivo with
      interferon (IFN) alpha/beta or polyinosinic-polycytidylic acid (Poly I:C), a ds
      RNA, a potent inducer of IFN. We observed faster and enhanced closure of wounds
      as compared to untreated controls on day 7 (wound area measured on Macintosh II
      CX using NIH image 1.30u program), increased migration of dermal fibroblasts in
      the wound bed, complete re-epithelialization evidenced by routine histology and
      scanning electron microscopic procedures, and increased collagen synthesis, which
      correlates to greater tensile strength. In addition, classical immunofluorescence
      procedures using frozen sections showed that dermal fibroblasts synthesized much
      more laminin following Poly I:C treatment, whereas no effect was observed on
      fibronectin synthesis. These results suggest that Poly I:C and IFN treatment
      result in a faster restoration of tissue integrity in both full skin punch biopsy
      and skin incision models.

PMID- 1734036
TI  - Inhibition of heme synthesis decreases transferrin receptor expression in mouse
      erythroleukemia cells.
AB  - The coordination of transferrin receptor (TfR) expression and heme synthesis was
      investigated in mouse erythroleukemia (MEL) cells of line 707 treated with heme
      synthesis inhibitors or in a variant line Fw genetically deficient in heme
      synthesis. Cells of line 707 were induced for differentiation by 5 mM
      hexamethylene bisacetamide (HMBA). TfR expression increased in the course of
      induction, as judged by increased TfR mRNA synthesis, increased cytoplasmic TfR
      mRNA level, and by the increased number of cellular 125I-Tf binding sites.
      Addition of 0.1 mM succinylacetone (SA) decreased cellular TfR to the level
      comparable with the uninduced cells. The decrease was reverted by the iron
      chelator desferrioxamine (DFO) but not by exogenous hemin. In short-term (1-2
      hours) incubation, SA inhibited 59Fe incorporation from transferrin into heme,
      whereas total cellular 59Fe uptake was increased. A decrease in TfR mRNA
      synthesis was apparent after 2 hours of SA treatment. Conversely, glutathione
      peroxidase mRNA synthesis, previously shown to be inducible by iron, was
      increased by SA treatment. Cells of heme deficient line Fw did not increase the
      number of Tf binding sites after the induction of differentiation by 5 mM sodium
      butyrate. SA had no effect on TfR expression in Fw cells. The results suggest
      that the depletion of cellular non-heme iron due to the increase in heme
      synthesis maintains a high level of transferrin receptor expression in
      differentiating erythroid cells even after the cessation of cell division.

PMID- 1734037
TI  - Expression of exogenous c-myc oncogene does not initiate DNA synthesis in primary
      rat hepatocyte cultures.
AB  - Cultured hepatocytes from adult rats stimulated with combinations of growth
      factors enter into S phase but do not undergo multiple rounds of DNA synthesis
      nor mitosis. We have examined the potential of an introduced oncogene to induce
      alterations in the DNA synthetic activity of the cultured hepatocytes in response
      to epidermal growth factor (EGF). Overexpression of c-myc did not initiate
      significant DNA synthesis in rat hepatocyte cultures alone, although it
      cooperated with added EGF to super-induce thymidine incorporation into DNA. From
      our results, it is suggested that EGF is also necessary to initiate hepatocyte
      DNA synthesis probably by inducing a battery of cell cycle-related genes if
      incubated with c-myc transfected cultures for only 5 hours. Hepatocyte
      polypeptides reacting with anti-MYC antisera were found to migrate between 55-67
      KDa in SDS-PAGE; only the 64-67 KDa species were found to be phosphorylated, and
      the observed size heterogeneity may be due to proteolytic degradation or may
      reflect presently unknown posttranslational modifications.

PMID- 1734038
TI  - Abnormal extracellular matrix and excessive growth of human adult polycystic
      kidney disease epithelia.
AB  - Human autosomal dominant polycystic kidney disease (ADPKD) epithelia were grown
      in primary monolayer cultures and their properties compared with intact kidney
      epithelial cultures derived from individually microdissected normal human kidney
      proximal convoluted tubules (PCT), proximal straight tubules (PST), and cortical
      collecting tubules (CCT). In vivo, ADPKD cyst epithelia exhibited a thickened
      basement membrane, and immunofluorescence demonstrated the presence of laminin,
      fibronectin, type IV collagen, and heparan sulfate proteoglycan in basement
      membranes and type I collagen in the interstitium. ADPKD epithelia grown in
      culture synthesized and secreted basally a unique, extracellular matrix that took
      the form of proteinaceous spheroids when the cells were grown on dried, type I
      collagen. Incorporation of H2[S35O4] into basement membrane extracts was
      increased more than ten-fold in ADPKD epithelia by comparison to normal PST and
      CCT. In addition to incorporation into the normal tubular basement membrane 220
      kD band, radioactivity was also seen at 175 kD and 150 kD in ADPKD extracts.
      Growth in culture of cyst-lining ADPKD epithelia was more rapid than normal
      tubules, and was abnormal since there was no absolute requirement for added
      extracellular matrix. However, when ADPKD epithelia were grown on different,
      exogenous matrix protein components, a profound influence on both structure and
      epithelial cell proliferation was seen. Growth on a complete basement membrane
      three-dimensional gel derived from the Engelbreth-Holm-Swarm (EHS) sarcoma led to
      a reduction in the numbers of spheroids and increase in amorphous filaments.
      Incorporation of [3H]-thymidine into ADPKD epithelia was greater than into normal
      PCT, PST, and CCT and was also greatly modified by the type of extracellular
      matrix components provided. In studies using single matrix components, the
      strongest proliferative response was seen when ADPKD epithelia were plated on
      type I collagen greater than type IV collagen greater than fibronectin greater
      than laminin. These findings suggest that the excessive growth of cyst-lining
      epithelia may be, at least in part, a result of abnormal basement membrane and
      extracellular matrix production by ADPKD cells.

PMID- 1734039
TI  - Differential regulation of the expression of transforming growth factor-beta
      mRNAs by growth factors and retinoic acid in chicken embryo chondrocytes,
      myocytes, and fibroblasts.
AB  - Transforming growth factor-beta (TGF-beta) autoregulates its expression in
      several mammalian cell types. We now report that addition of TGF-beta s 1, 2, and
      3 to primary chicken embryo cells differentially affects expression of the
      messenger RNAs for the different TGF-beta isoforms depending on the cell type. In
      cultured sternal chondrocytes, addition of TGF-beta s 1, 2, or 3 results in an
      increase in the steady-state levels of the messenger RNAs for TGF-beta s 2 and 3,
      but does not change expression of TGF-beta 4 mRNA. In contrast, in cultured
      cardiac myocytes, addition of TGF-beta s 1, 2, or 3 results in an increase in
      expression of TGF-beta s 3 and 4 mRNAs, but does not change expression of TGF
      beta 2 mRNA. Moreover, expression of TGF-beta s 2, 3, and 4 mRNAs is not affected
      by addition of any of the TGF-beta s to fibroblasts. Addition of platelet-derived
      growth factor (PDGF), epidermal growth factor (EGF), or interleukin-1 (IL-1) to
      these chicken cells also has differential effects on expression of the different
      TGF-beta mRNAs depending on the cell type. Retinoic acid also has contrasting
      effects on chondrocytes and myocytes either increasing or decreasing,
      respectively, expression of TGF-beta s 2 and 3 mRNAs and TGF-beta 2 protein. Our
      results indicate a complex pattern of regulation of the different TGF-beta genes
      by themselves as well as by PDGF, EGF, IL-1, dexamethasone, TPA, and retinoic
      acid in chicken embryo cells.

PMID- 1734040
TI  - Increased peptidylarginine deiminase expression during induction of prolactin
      biosynthesis in a growth-hormone-producing rat pituitary cell line, MtT/S.
AB  - Insulin and type I insulin-like growth factor (IGF-I) suppressed growth hormone
      (GH) expression followed by the induction of prolactin (PRL) biosynthesis in
      MtT/S cells cultured with normal sera. Insulin also increased the
      peptidylarginine deiminase activity in a dose-dependent manner. The increase was
      detectable at 1 ng/ml and reached a maximum (about 16-fold higher than the
      control) at 1 micrograms/ml. IGF-I showed similar but less prominent effects. The
      enzyme activity started to increase by 15 hr after the addition of insulin (500
      ng/ml), and reached a plateau level at 48 hr. There were concurrent increases in
      the enzyme mRNA level, enzyme biosynthesis, and enzyme protein contents detected
      by Northern blot hybridization, [35S]-amino-acid incorporation, and Western
      immunoblot analysis, respectively. Two-color immunofluorescence staining at 1 day
      after the insulin addition detected a small number of peptidylarginine-deiminase
      positive cells (about 1% of the total cells) which were also GH-positive. The
      enzyme-positive cells increased to 12% on day 2 and to 24-26% on days 4-6. PRL
      positive cells first appeared in the enzyme-positive cell population on day 2,
      and PRL-positive, enzyme-negative cells appeared later. These results suggest
      that peptidylarginine deiminase expression increases in association with the
      hormone switching in MtT/S cells. When the cells were cultured in a steroid
      depleted medium, insulin failed to increase the enzyme activity. The insulin
      action could be specifically restored by estrogen, indicating estrogen-insulin
      synergism in regulation of the enzyme expression.

PMID- 1734041
TI  - Rapid and biologically safe diagnosis of African swine fever virus infection by
      using polymerase chain reaction.
AB  - In order to circumvent the need for infectious virus for the diagnosis of African
      swine fever (ASF), we established the polymerase chain reaction (PCR) technique
      for the detection of ASF virus (ASFV) DNA. A 740-bp fragment that originated from
      the conserved region of the viral genome was partially sequenced. From this
      sequence, four PCR primers and one oligonucleotide probe were designed and
      synthesized. A specific 640-bp PCR product was amplified by using
      oligonucleotides 1 and 5 as primers and extracts of the following samples as
      templates: organs and plasma obtained from ASFV-infected pigs, ASFV-infected cell
      cultures, and cloned DNA fragments containing the same conserved genomic region
      as that in the original 740-bp clone. No specific reaction products were observed
      in the corresponding controls. The identities of the PCR products were confirmed
      either by a second amplification with nested primers or by hybridization with a
      specific, biotinylated oligonucleotide probe. PCR proved to be a quicker and more
      sensitive method than virus isolation followed by the hemadsorption test when
      spleen and plasma samples from experimentally ASFV-infected pigs were tested.
      Furthermore, cloned virus DNA could be used as a positive control in the place of
      a live virus control. This is advantageous whenever the use of live virus is
      undesirable.

PMID- 1734042
TI  - Evaluation of a Treponema pallidum western immunoblot assay as a confirmatory
      test for syphilis.
AB  - Tests for the detection of antibodies to Treponema pallidum are recommended for
      the confirmation of reactive nontreponemal test results and the accurate
      diagnosis of syphilis. The present-day use of Western blot (immunoblot)
      technology for the diagnosis of retroviruses prompted the development and
      evaluation of a Western blot assay with whole-cell T. pallidum as the antigen.
      The assay detected antibodies in syphilitic serum or plasma from dilutions of
      specimens incubated overnight with test strips. A test was considered positive
      when at least three of four major antigens having molecular masses of 15.5, 17,
      44.5, and 47 kDa were detected. The Western blot assay had 93.8% sensitivity and
      100% specificity for clinically defined samples. The Western blot assay was
      compared with double-staining fluorescent treponemal antibody absorption [FTA-ABS
      (DS)], which had a sensitivity and a specificity of 91.7 and 92.0%, respectively.
      Dilution series studies of syphilis-positive specimens indicated that the Western
      blot assay has an endpoint of reactivity at least 3 to 4 serial dilutions greater
      than that for FTA-ABS (DS). Overall, the greater than 95% agreement between the
      Western blot assay and FTA-ABS (DS) for clinically defined specimens indicates
      that the sensitivity of the Western blot assay is equal to or greater than that
      of FTA-ABS (DS). The Western blot assay demonstrated no false-positive or
      equivocal reactivities for nonsyphilitic specimens, including normal specimens
      (both plasma and serum), biological false-positives, and specimens with elevated
      gamma globulin or antinuclear antibody. We conclude that the high sensitivity and
      specificity of the T. pallidum Western blot assay, together with its simplicity
      and objectivity, make it a good confirmatory test for syphilis.

PMID- 1734043
TI  - Reevaluation of the API 20E identification system versus conventional
      biochemicals for identification of members of the family Enterobacteriaceae: a
      new look at an old product.
AB  - The API 20E bacterial identification system has been used for 19 years, often as
      the standard with which other identification systems are compared. Because the
      accuracy of this system compared with conventional biochemical tests has not been
      determined in many years, we evaluated the API 20E linear strip by using 291
      typical and atypical strains of the family Enterobacteriaceae taken from a
      culture collection. At 24 h, the API 20E correctly identified by genus and
      species 229 of 291 (78.7%) of the strains, using Salmonella and Shigella
      serotyping where indicated. At 48 h, 95.2% were correctly identified by using
      additional biochemical tests as recommended by the manufacturer. The API 20E
      misidentified eight (2.7%) strains; these strains were not limited to any
      particular genus. When 81 of these Enterobacteriaceae strains were arranged into
      a weighted assortment correlating to the frequency with which they might be found
      in a clinical laboratory, the API 20E correctly identified 71 (87.7%) at 24 h and
      78 (96.3%) at 48 h. This evaluation concluded that the accuracy of the
      identification of Enterobacteriaceae strains at 24 h (78.7%) may be significantly
      lower than that of earlier evaluations. However, there is no significant
      difference in the ability of the API 20E to correctly identify "challenge" type
      organisms (229 of 291) versus routine hospital isolates (71 of 81) (P greater
      than 0.05), but the system is not as accurate as the conventional biochemical
      method of identification.

PMID- 1734044
TI  - Characterization of Neisseria meningitidis serogroup C by multilocus enzyme
      electrophoresis and ribosomal DNA restriction profiles (ribotyping).
AB  - We compared multilocus enzyme electrophoresis (MEE) and ribosomal DNA
      fingerprinting (ribotyping) for subtyping 44 strains of Neisseria meningitidis
      serogroup C that were isolated in Los Angeles County, California, between
      December 1985 and July 1986. The isolates were divided into six enzyme types
      (ETs) by MEE, but 36 of the isolates were clustered in one ET, 3. The same
      isolates were divided into 17 ribotypes by use of restriction endonucleases ClaI,
      EcoRI, and XhoI. Twenty of the 36 ET 3 isolates were divided into 17 ribotypes by
      use of restriction endonucleases ClaI, EcoRI, and XhoI. Twenty of the 36 ET 3
      isolates were grouped in a single ribotype, J. The rate of infection with
      ribotype J strains was higher in the southern part of the study area than in the
      northern part. Isolates from each of eight pairs (each isolate pair was cultured
      from the same patient from the same or different sites) were found identical by
      MEE, but ribotyping revealed a difference in one pair. In this study, ribotyping
      showed a greater discriminating capacity than MEE for subtyping N. meningitidis
      serogroup C, but the epidemiologic relevance of this increased sensitivity needs
      further assessment.

PMID- 1734045
TI  - Rapid detection of group A streptococci: comparative performance by nurses and
      laboratory technologists in pediatric satellite laboratories using three test
      kits.
AB  - Rapid tests for detecting group A streptococci in throat swabs are often
      performed outside hospitals or commercial laboratories by individuals with little
      or no technical training. We compared the abilities of nurses and technologists
      to perform and interpret three commercial kits (Directigen 1-2-3, ICON Strep A,
      and Culturette Brand 10-Minute Strep A ID) in three hospital satellite locations
      (the emergency department, a walk-in emergency clinic, and a general pediatric
      clinic). When the three tests were compared with culture, the sensitivities of
      the tests as performed by nurses and technologists, respectively, were 39 versus
      44% for Directigen, 55 versus 51% for Culturette, and 72 versus 39% for ICON. A
      significant difference in sensitivity was found only with ICON tests. This result
      was largely explained by the tendency of technologists to test moist swabs, while
      nurses generally processed dry swabs; ICON test sensitivity was significantly
      greater with dry swabs. The specificities of Directigen and ICON tests performed
      by nurses and technologists were high (97 to 100%). The difference in the
      specificities of the Culturette test as determined from results obtained by
      nurses and technologists (80 versus 98%) was due to the tendency of one nurse to
      overinterpret the latex agglutination reaction. Analysis of the accuracies of the
      tests during practice periods compared with the accuracies of the tests during
      the study periods revealed statistically significant improvement in test
      performance. We conclude that these tests are specific but not sensitive when
      performed by nurses and technologists in satellite laboratories. With one
      exception, nurses and technologists performed the tests with comparable accuracy
      after brief training periods.

PMID- 1734046
TI  - Analyses of Ehrlichia canis and a canine granulocytic Ehrlichia infection.
AB  - Ehrlichia canis and canine granulocytic Ehrlichia sp. (CGE) infect canine
      monocytes and granulocytes, respectively. E. canis has been cultured in vitro and
      used to develop an immunofluorescence assay. CGE has not been cultured, and a
      serologic assay is not available. The sera of dogs infected with CGE were
      reported to react with E. canis by immunofluorescence. In this study, the
      temporal response of immunoglobulin G (IgG) was determined by an enzyme-linked
      immunosorbent assay (ELISA) with purified E. canis antigen in four dogs
      experimentally infected with E. canis, in two dogs experimentally infected with
      CGE, and in one dog infected with E. canis and subsequently infected with CGE. E.
      canis-infected dogs developed an IgG ELISA result of 1.5 or greater for the
      optical density signal/noise ratio by 2 months postinfection. CGE challenge of a
      dog with a previous E. canis infection induced an anamnestic increase in the IgG
      ELISA result; however, CGE infection alone did not induce a significant IgG ELISA
      response. Western immunoblot analysis showed that dogs infected with E. canis
      developed antibodies initially that reacted with low-molecular-mass proteins (30,
      24, and 21 kDa) and subsequently with higher-molecular-mass proteins (160, 100,
      78, 64, 47, and 40 kDa). In contrast, CGE-infected dogs showed reactions with the
      same higher-molecular-mass proteins of E. canis but, unlike E. canis-infected
      dogs, not with the low-molecular-mass proteins of E. canis. Of 10 serum samples
      collected in the field of Indonesia from dogs with tropical canine pancytopenia,
      all had an optical density signal minus noise value of 2.54 or greater in the IgG
      ELISA and reacted with E. canis antigen in a pattern similar to that of serum
      samples from dogs experimentally infected with E. canis in Western
      immunoblotting. This study suggests that the IgG ELISA and Western immunoblotting
      with purified E. canis as the antigen are useful in distinguishing between E.
      canis and CGE infections in dogs.

PMID- 1734047
TI  - Serotype prevalence of Candida albicans from blood culture isolates.
AB  - Blood culture isolates of Candida albicans were collected from 102 patients in
      Seattle, Wash., hospitals (n = 77) and Hong Kong (n = 25). The patients were
      classified by immune status into two groups. Group I patients were severely
      immunosppression, and group II patients had underlying risk factors for
      candidemia but no underlying immunosuppression. Serotyping by Hasenclever tube
      agglutination was done. In the Seattle area, the odds of fungemia with type B C.
      albicans were 3.62 times greater than the odds of type B fungemia in group II
      patients. Although the odds ratio could not be computed for Hong Kong patients,
      the direction of the relationship in this population was consistent with the data
      on Seattle patients. Despite the magnitude of the odds ratios, the relative
      prevalence of type B over type A in group I compared with group II was not
      significant when analyzed separately by region, probably because of relatively
      low numbers of isolates in group II. Accepting that the effect of immune status
      on serotype is equivalent across regions but presupposing that a regional effect
      on type B prevalence exists, the pooled odds for fungemia with serotype B in
      group I patients are increased 5.4-fold over those of group II patients. Logistic
      regression analysis controlling for region gave similar results.

PMID- 1734049
TI  - Mycobacterium paratuberculosis cultured from milk and supramammary lymph nodes of
      infected asymptomatic cows.
AB  - Milk and supramammary lymph node samples were obtained from asymptomatic cows
      infected with Mycobacterium paratuberculosis at the time of slaughter. Of 81
      supramammary lymph node samples, 22 (27%) were culture positive for M.
      paratuberculosis. Of 77 milk samples, 9 (11.6%) were culture positive. The
      prevalence of supramammary lymph node or milk infection was highest with heavy
      fecal shedding of M. paratuberculosis and lowest with light shedding. The
      serologic status of the cow was not useful for predicting the risk of
      supramammary lymph node or milk infection. Shedding of M. paratuberculosis occurs
      in the milk of asymptomatic infected cows but, apparently, less frequently than
      previously reported for symptomatic cows.

PMID- 1734048
TI  - Multicenter comparison of levels of antibody to the Neisseria meningitidis group
      A capsular polysaccharide measured by using an enzyme-linked immunosorbent assay.
AB  - There is no standard immunoassay for evaluating immune responses to meningococcal
      vaccines. We developed an enzyme-linked immunosorbent assay to measure total
      levels of antibody to Neisseria meningitidis group A capsular polysaccharide.
      Five laboratories measured the antibody levels in six paired pre- and
      postvaccination serum samples by using the enzyme-linked immunosorbent assay.
      Methylated human serum albumin was used to bind native group A polysaccharide to
      microtiter plate surfaces. The between-laboratory coefficients of variation for
      pre- and postvaccination sera had ranges of 31 to 91 and 17 to 31, respectively.
      The mean laboratory coefficients of variation for pre- and postvaccination sera,
      respectively, were 17 and 11 (Molecular Biology Laboratory, Centers for Disease
      Control), 12 and 15 (Immunodiagnostic Methods Laboratory, Centers for Disease
      Control), 22 and 19 (Dana-Farber Cancer Institute), 38 and 38 (Bacterial
      Polysaccharide Laboratory, U.S. Food and Drug Administration), and 11 and 10
      (Praxis Biologics, Inc.). Standardization of this enzyme-linked immunosorbent
      assay should allow interlaboratory comparison of meningococcal vaccine
      immunogenicity, thus providing a laboratory-based assessment tool for evaluating
      meningococcal vaccines.

PMID- 1734050
TI  - Evaluation of a commercially available second-generation immunoglobulin G enzyme
      immunoassay for detection of Helicobacter pylori infection.
AB  - We evaluated a commercially available second-generation anti-H. pylori
      immunoglobulin G enzyme immunoassay (EIA) (Cobas Core Anti-Helicobacter pylori
      EIA; Roche S. A., Basel, Switzerland) for serodiagnosis of H. pylori infection.
      The results of the assay were assessed in relation to the results of bacterial
      culture, urease testing, and histological Giemsa stain of gastric biopsy
      specimens from 1,134 patients with a variety of symptoms relating to the upper
      gastrointestinal tract. H. pylori was detected in biopsy specimens from 660
      (58.2%) patients: 6 had a normal mucosa, 123 had chronic gastritis only, and 531
      were found to have chronic active gastritis by histology; endoscopy showed
      duodenal and gastric ulcers in 137 and 64 patients of the last two groups,
      respectively. The test was evaluated with different age and ethnic groups. The
      prevalence, sensitivity, specificity, and positive and negative predictive values
      were, respectively, (i) for Belgian patients between 18 and 40 years old, 34, 93,
      95, 91, and 96%; (ii) for Belgian patients more than 40 years old, 53, 96, 91,
      93, and 95%; and (iii) the Mediterranean patients more than 17 years old, 87, 94,
      70, 95, and 64%. All sera showing discordant immunoassay results compared with
      the results of histology and culture of biopsy specimens, as well as those with
      borderline immunoassay results, were tested further by immunoblotting. Among the
      EIA results considered false negative, we demonstrated an absence of
      seroconversion in 14 of 19 patients tested by immunoblotting. Among the EIA
      results considered false positive, immunoblotting showed the presence of specific
      antibodies in 28 of 37 patients tested. Among the borderline results obtained in
      the first assay with 22 patients' sera, a second assay showed positive results in
      10 patients (8 were positive by immunoblotting) and negative reactions in 10
      patients (9 were negative by immunoblotting), whereas 2 remained borderline.
      These data indicate that sera showing borderline immunoassay results must be
      tested again. In conclusion, this commercially available second-generation EIA,
      which is easy and quick to perform, was found highly reliable for the
      serodiagnosis of H. pylori infection.

PMID- 1734051
TI  - 15NH4+ excretion test: a new method for detection of Helicobacter pylori
      infection.
AB  - A noninvasive test for the detection of Helicobacter pylori infection that uses
      [15N]urea as a tracer has been established. The principle the test is based on is
      the strong urease activity of H. pylori. After oral ingestion, [15N]urea is
      broken down into ammonia and carbon dioxide by H. pylori urease in the stomach.
      The ammonia is absorbed into the blood and excreted in the urine. The amount of
      [15N]urea, reflecting the magnitude of H. pylori infection, is evaluated by
      measuring the abundance and excretion rate of 15N in ammonia in the urine. Thirty
      six patients were examined in our study. The 15N excretion rates in urine ammonia
      of patients who were H. pylori positive were significantly higher than those of
      H. pylori-negative patients (P less than 0.05). Twenty-three patients were H.
      pylori positive by Gram stain and culture. The sensitivity of the 15NH4 excretion
      test compared with these techniques was 96%, and no false positives were
      obtained. The 15NH4+ excretion rates of 13 H. pylori-negative subjects were all
      in the normal range (less than 0.3%). This method is a simple, precise, highly
      sensitive, noninvasive, nonradioactive test. It could be used for diagnosis as
      well as for the followup of patients receiving H. pylori eradication therapy,
      especially children and pregnant women. It could also be used in epidemiological
      investigation of H. pylori infection in a general population.

PMID- 1734052
TI  - Sensitive detection of Helicobacter pylori by using polymerase chain reaction.
AB  - A polymerase chain reaction (PCR) for the specific detection of Helicobacter
      pylori was developed with a single primer pair derived from the nucleotide
      sequence of the urease A gene of H. pylori. We achieved specific amplification of
      a 411-bp DNA fragment in H. pylori. After 35 cycles of amplification, the product
      could be detected by agarose gel electrophoresis and contained conserved single
      HinfI and AluI restriction sites. This fragment was amplified in all 50 strains
      of H. pylori tested, but it was not detected in other bacterial species, showing
      the PCR assay to be 100% specific. PCR DNA amplification was able to detect as
      few as 10 H. pylori cells. PCR detected H. pylori in 15 of 23 clinical human
      gastric biopsy samples, whereas culturing and microscopy detected H. pylori in
      only 7 of the samples found to be positive by PCR. Additional primer pairs based
      on the urease genes enabled the detection of H. pylori in paraffin-embedded human
      gastric biopsy samples. The detection of H. pylori by PCR will enable both
      retrospective and prospective analyses of clinical samples, elucidating the role
      of this organism in gastroduodenal disease.

PMID- 1734053
TI  - Capnocytophaga canimorsus septicemia caused by a dog bite in a hairy cell
      leukemia patient.
AB  - Fatal septicemia developed in a splenectomized patient with hairy cell leukemia
      following a dog bite. Capnocytophaga canimorsus, a slowly growing gram-negative
      bacillus, was isolated from the patient's blood. Although a rare complication of
      dog bites in the normal population, this bacterium should be suspected and
      promptly treated in immunologically compromised dog bite victims. Furthermore,
      immunocompromised patients should be made aware of the dangers of dog ownership.

PMID- 1734054
TI  - Comparison of the E test and microdilution for detection of beta-lactam-resistant
      mutants that are stably derepressed for type I beta-lactamase.
AB  - The activities of cefotaxime, ceftazidime, piperacillin, and aztreonam were
      compared in the E test and broth microdilution test against 30 gram-negative
      bacterial mutants derepressed for type I beta-lactamases. The results
      demonstrated complete agreement between 24-h MICs of 80 to 83% and essential
      agreement between 24-h MICs of 90 to 97%. When sufficient growth was present for
      the E test to be read at 6 h, the essential agreement between 6- and 24-h E-test
      MICs was 100% for ceftazidime, piperacillin, and aztreonam and 85% for
      cefotaxime.

PMID- 1734055
TI  - Detection of human immunodeficiency virus type 1 antibody by using commercially
      available whole-cell viral lysate, synthetic peptide, and recombinant protein
      enzyme immunoassay systems.
AB  - A total of 575 serum specimens received for human immunodeficiency virus type 1
      (HIV-1) antibody determination were tested prospectively by enzyme immunoassay
      with a whole-cell viral lysate (VL) (Genetic Systems Corp.), a synthetic peptide
      (SP) (United Biomedical, Inc.), and a recombinant protein (RCP) (Syva Co.).
      Concordance of all three antigens was noted for 559 of 575 (97.2%) specimens
      tested. Of the specimens tested, 90 (15.7%) were positive and 469 (84.3%) were
      negative. Retrospective testing by SP and RCP of 86 specimens indeterminate for
      HIV-1 antibody by VL, Western blot (immunoblot), and immunofluorescence was also
      performed. The results of both phases of this study indicate that the specificity
      of the three antigens is RCP greater than SP greater than VL. As noted from the
      prospective phase, the sensitivities of the antigens appear to be equivalent,
      indicating that the RCP and SP systems could be used in place of, or to confirm,
      a VL enzyme immunoassay screening test.

PMID- 1734057
TI  - Rapid diagnosis of Brucella melitensis in blood: some operational characteristics
      of the BACT/ALERT.
AB  - A clinical isolate of Brucella melitensis was detected in a blood culture with
      the BACT/ALERT after an incubation period of 2.8 days. Dilution studies revealed
      an inverse linear relationship between the log of the initial concentration of
      the organism and the time to detection of a positive result. Reproducibility
      studies demonstrated a mean detection time of 48 +/- 1 h in 8 of 10 replicates
      seeded with a stock containing 10(2) CFU/ml.

PMID- 1734056
TI  - Occurrence of resistance to vibriostatic compound 0/129 in Vibrio cholerae 01
      isolated from clinical and environmental samples in Bangladesh.
AB  - Fifty-one Vibrio cholerae 01 strains isolated from 734 natural water and plankton
      samples and 31 rectal swabs were examined. Of these strains, 32 (62.7%) were
      found to be resistant to vibriostatic compound 0/129. When antibiograms using the
      antibiotics ampicillin, tetracycline, chloramphenicol, trimethoprim
      sulfamethoxazole, furoxan, and gentamicin were done, it was observed that there
      was a correlation of sensitivity to 0/129 with selected antibiotics. Only the
      Ogawa E1 Tor (72% of strains resistant) and Inaba classical (28% of strains
      resistant) biotypes of V. cholerae 01 showed resistance to 0/129. On the other
      hand, all Inaba E1 Tor and Ogawa classical strains were susceptible to 0/129. The
      32 0/129-resistant and 19 0/129-sensitive isolates of V. cholerae 01 were tested
      for the presence of plasmid DNA. Only two strains isolated from the environment
      were found to carry a plasmid, and they were also found to be resistant to 0/129
      and gentamicin. Thus, 0/129 resistance, although more common than previously
      suspected, is concluded not to be plasmid mediated in the strains tested in this
      study.

PMID- 1734058
TI  - Clinical demonstration of isolation of Nocardia asteroides on buffered charcoal
      yeast extract media.
AB  - Nocardia asteroides was isolated only from sputum samples, obtained from three
      patients with pulmonary nocardiosis, that had been cultured onto buffered
      charcoal-yeast extract (BCYE) and selective BCYE media as part of laboratory
      workups for Legionella species. A decontamination procedure with low-pH
      pretreatment (KCl-HCl solution) had been performed on the sputa prior to culture
      onto the BCYE media because direct cultures on the media were overgrown with
      commensal microflora. Chalky white colonies, 0.5 to 1.0 mm in diameter, that were
      subsequently identified as N. asteroides grew well on the BCYE media. Thus, the
      techniques and the selective media used for Legionella species were useful for
      isolating Nocardia species from sputum.

PMID- 1734059
TI  - Ovalbumin blocking improves sensitivity and specificity of immunoglobulin M
      immunoblotting for serodiagnosis of patients with erythema migrans.
AB  - To improve the serodiagnosis of erythema migrans, we evaluated how sensitivity
      and specificity of immunoblotting are influenced by antigen concentration and
      blocking conditions. We found that an antigen concentration of 0.5 micrograms per
      lane in concert with ovalbumin blocking of the nitrocellulose provided the best
      results. In this case, 81% of the erythema migrans had positive immunoglobulin M
      tests, whereas only 33% were positive in a flagellum enzyme-linked immunosorbent
      assay (ELISA) and 28% were positive in a sonicate ELISA.

PMID- 1734060
TI  - Recovery of Histoplasma capsulatum from blood in a commercial radiometric
      Mycobacterium medium.
AB  - We report the recovery of Histoplasma capsulatum from blood specimens cultured
      for Mycobacterium sp. in BACTEC 13A radiometric medium. H. capsulatum was
      recovered from six of eight blood specimens submitted for mycobacterial cultures
      from five human immunodeficiency virus-positive individuals. Initial positive
      metabolic signals occurred at a mean of 11 days, but no organisms were detected
      with acid-fast stains. The bottles remained positive, and after an additional
      incubation (mean, 8 days), yeast cells morphologically compatible with H.
      capsulatum were detected when aliquots were stained with acridine orange.
      Therefore, when radiometric mycobacterial blood cultures with persistent positive
      metabolic signals and negative acid-fast stains are encountered, acridine orange
      staining and subculturing for a variety of microorganisms, including fungi, e.g.,
      H. capsulatum, should be considered.

PMID- 1734061
TI  - Isolation of Yersinia enterocolitica serovar O8 from free-living small rodents in
      Japan.
AB  - Yersinia species were isolated from 65 of 223 free-living small mammals trapped
      in 10 regions on Honshu Island in Japan. Of the 65 strains isolated, 1 was
      Yersinia enterocolitica serovar O3, 8 were Y. enterocolitica O5, 6 were Y.
      enterocolitica O8, 3 were Y. enterocolitica O9, and 1 was Yersinia
      pseudotuberculosis 4b. Of the six Y. enterocolitica O8 strains, five were
      positive for autoagglutination, Ca2+ dependence, and the 45-MDa virulence plasmid
      and showed high pathogenicity for mice.

PMID- 1734062
TI  - Streptococcus intermedius, Streptococcus constellatus, and Streptococcus
      anginosus (the Streptococcus milleri group): association with different body
      sites and clinical infections.
AB  - The associations of Streptococcus intermedius, S. constellatus, and S. anginosus
      (the three species of the S. milleri group) with clinical infections and sites of
      isolation were investigated by using a simple biochemical scheme to identify a
      collection of 153 clinical isolates. S. intermedius was associated with abscesses
      of the brain and liver, while both S. anginosus and S. constellatus were isolated
      from a wider range of sites and infections. S. anginosus strains predominated in
      both genitourinary and gastrointestinal sources and exhibited a wider range of
      phenotypes, particularly in the ability to ferment mannitol and/or raffinose.

PMID- 1734063
TI  - Comparison of six different culture media for isolation of Treponema
      hyodysenteriae.
AB  - Fecal material from pigs experimentally infected with Treponema hyodysenteriae
      was collected and inoculated on six different selective media to compare their
      abilities for recovery of T. hyodysenteriae. Additionally, various types of
      samples were compared to find the most appropriate for submitting material to
      laboratories. Isolation rates for T. hyodysenteriae were 89.7% on BJ medium,
      88.3% on TSA-BJ medium, 76.6% on SVC medium, 76.6% on BA2-BJ medium, 75.2% on BA2
      SVC medium, and 52.4% on TSA-S400 medium. BJ medium was the most useful, yielding
      good growth of T. hyodysenteriae and inhibition of the normal fecal flora. Also,
      undiluted fecal material kept at refrigeration temperature allowed better
      recovery of T. hyodysenteriae during storage than swabs.

PMID- 1734064
TI  - Phage pattern-specific oxacillin-resistant and borderline oxacillin-resistant
      Staphylococcus aureus in U.S. hospitals: epidemiological significance.
AB  - For a 13-year period (1978 through 1990), oxacillin-resistant (MIC, greater than
      4 micrograms/ml) Staphylococcus aureus (ORSA) strains were collected from
      Clinical Center (National Institutes of Health) patients and patients from five
      other U.S. hospitals. From Clinical Center patients, 251 of 253 isolates (99%)
      were bacteriophage typed as phage group III. Five other hospitals contributed 203
      ORSA strains, of which 188 (93%) were group III. The group III ORSA strains
      predominantly included a characteristic core pattern of phages, 7/47/53/54/75/77.
      For the low-level (borderline) oxacillin-resistant strains (MIC, 2 to 4
      micrograms/ml), amoxicillin-clavulanic acid combination (Augmentin) testing
      disclosed 62 hyper-beta-lactamase producers, of which 59 (95%) were of a
      separate, distinct S. aureus strain, with the phage pattern 92/94/96/292/D-11
      (group V). Thus, ORSA and hyper-beta-lactamase producing S. aureus are distinct
      epidemic strains.

PMID- 1734065
TI  - Use of polymerase chain reaction for rapid diagnosis of tuberculosis.
AB  - A DNA amplification assay using the polymerase chain reaction technique designed
      for the rapid identification of Mycobacterium bovis organisms was used to test
      211 human mycobacterial isolates and 177 clinical specimens previously submitted
      for routine mycobacterial culture. The procedures described could be used by
      routine or specialist laboratories for identification of M. tuberculosis complex
      organisms in 4 h and/or as a rapid screening method for the direct detection of
      M. tuberculosis complex organisms in specimens.

PMID- 1734066
TI  - Immune reactivity to fractionated Leishmania aethiopica antigens during
      coinfection with human immunodeficiency virus type 1.

PMID- 1734067
TI  - Detection of human immunodeficiency virus type 1 infection in young pediatric
      patients by using polymerase chain reaction and biotinylated probes.
AB  - Polymerase chain reaction (PCR) testing using up to four primer pairs and
      biotinylated probes was 97.9% sensitive (188 of 192 specimens positive) and 100%
      specific (267 of 267 specimens negative) for detecting the presence or absence of
      human immunodeficiency virus (HIV) DNA in peripheral blood mononuclear cells from
      pediatric patients whose HIV status has been confirmed. SK38/39 and SK145/150
      were the most sensitive primer pairs, respectively detecting HIV DNA in 95.6 and
      95.9% of peripheral blood mononuclear cell specimens from HIV-infected children
      and collectively detecting all adequately tested PCR-positive specimens. Primer
      pairs SK29/30 and SK68/69 respectively detected HIV DNA in only 76.4 and 76.6% of
      HIV-positive specimens. Among infants born to HIV-seropositive mothers, 30 who
      subsequently were confirmed to be infected were sampled when they were less than
      or equal to 6 months of age; in all but one infant, HIV DNA was found in the
      first specimen collected. Among the nine youngest infected infants tested, all
      were PCR positive by 38 days of age. PCR methods thus have reliably detected
      vertically transmitted HIV infection early in life.

PMID- 1734068
TI  - Optimization and standardization of an enzyme-linked immunosorbent assay protocol
      for serodiagnosis of Actinobacillus pleuropneumoniae serotype 5.
AB  - An indirect enzyme-linked immunosorbent assay protocol has been optimized with
      special emphasis given to assay standardization and quality control. Technical
      aspects such as choice of a microplate, antigen immobilization, buffer
      composition, optimal screening dilution of sera, and kinetics of the enzymatic
      reaction were studied and evaluated in order to design a standard protocol
      offering maximal analytical sensitivity and specificity, as well as to obtain
      minimal within- and between-plate variability. Among the 27 plates tested, the
      Nunc 475-094 and 269-620 immunoplates were found to be the best in terms of high
      positive-to-negative ratio and low variability. No significant differences in
      antigen immobilization were found by using buffers of various compositions or
      pHs; however, the presence of magnesium ions (Mg2+; 0.02 M) resulted in a twofold
      increase in nonspecific background. An optimal screening dilution of sera was
      established at 1:200. A 1-h incubation period for test serum was found to be
      optimal. Maximum enzymatic activity for peroxidase was obtained by adjusting both
      substrate (H2O2) and hydrogen donor [2,2' -azinobis(3-ethylbenz-thiazoline
      sulfonic acid)] concentrations to 4 and 1 mM, respectively. To control between
      plate variability, a timing protocol was adopted. Within-plate variability was
      also controlled by using a sample placement configuration pattern. Sliding scales
      were determined by repeated testing of a cross section of samples to set
      acceptance limits for both within- and between-plate variability. These limits
      were used in a quality control program to monitor assay performance. The results
      obtained suggest that this standardized protocol might be useful in the
      serodiagnosis of Actinobacillus pleuropneumoniae serotype 5.

PMID- 1734069
TI  - Controlled evaluation of BACTEC PLUS 27 and Roche Septi-Chek anaerobic blood
      culture bottles.
AB  - Becton Dickinson Diagnostic Instrument Systems (Sparks, Md.) recently introduced
      BACTEC high-volume aerobic and anaerobic bottles that accept up to 10 ml of blood
      for use on their nonradiometric blood culture instruments. Both bottles contain
      25 ml of tryptic soy broth, 0.05% sodium polyanetholesulfonate, and mixed resins.
      We compared the anaerobic bottle, designated BACTEC PLUS 27 (BP27), with the
      Roche Septi-Chek (RSC) Columbia broth anaerobic bottle in a collaborative
      evaluation at three university hospitals. A total of 5,152 adequately filled
      blood cultures were obtained from adult patients with suspected bacteremia or
      fungemia. Staphylococcus aureus was recovered significantly more often (P less
      than 0.03) from BP27 bottles alone; there were no other significant differences
      in yield. When microorganisms were recovered from both anaerobic bottles, growth
      was detected earlier in BP27 than it was in RSC (P less than 0.001), especially
      for S. aureus (P less than 0.001) and Staphylococcus epidermidis (P less than
      0.02). We conclude that the yield from BP27 bottles is equivalent to or better
      (S. aureus) than that from RSC anaerobic bottles with Columbia broth and that
      speed of detection is superior with BP27 bottles.

PMID- 1734070
TI  - Differentiation of Giardia duodenalis from other Giardia spp. by using polymerase
      chain reaction and gene probes.
AB  - Giardia spp. are waterborne organisms that are the most commonly identified
      pathogenic intestinal protozoans in the United States. Current detection
      techniques for Giardia species in water include microscopy and immunofluorescence
      techniques. Species of the genus Giardia are classified on the basis of taxonomic
      criteria, such as cell morphology, and on host specificity. We have developed a
      polymerase chain reaction- and gene probe-based detection system specific for
      Giardia spp., which can discriminate between the relevant species of the G.
      duodenalis type pathogenic to humans and other Giardia species that are not human
      pathogens. This method can detect a single Giardia cyst and is therefore
      sensitive enough for environmental monitoring.

PMID- 1734071
TI  - Evaluation of MicroScan Rapid Pos Combo panels for identification of
      staphylococci.
AB  - MicroScan Rapid Pos Combo panels (Baxter Diagnostics, Inc., MicroScan, West
      Sacramento, Calif.) contain substrates conjugated with fluorophores and
      substrates with a fluorescent pH indicator. AutoSCAn W/A, an automated panel
      processor equipped with a fluorometer, reads the panels after 2 h of incubation
      and can identify staphylococci to the species level. We tested 239 strains
      belonging to 17 species of staphylococci. All the strains were identified by
      conventional methods (W.E. Kloos and K.H. Schleifer, J. Clin. Microbiol. 1:82-88,
      1975) and by the MicroScan Rapid ID system. The system correctly identified 219
      (91.6%) strains; nine (3.8%) identification results were probably correct, and
      six (2.5%) results were incorrect. The system designated five (2.1%) strains as
      rare biotypes. The automated MicroScan Rapid ID system is useful and reliable in
      identifying most human isolates of staphylococci encountered in the clinical
      laboratory.

PMID- 1734072
TI  - Diagnosis of Helicobacter pylori infection in adult and pediatric patients by
      using Pyloriset, a rapid latex agglutination test.
AB  - Pyloriset (Orion Diagnostica, Espoo, Finland) is a rapid antibody test using
      latex particles coated with acid-extracted antigen of Helicobacter pylori. We
      evaluated its ability to predict infection in 100 adult patients and 50 pediatric
      patients referred for gastric endoscopy. Sixty of 65 H. pylori-infected adults
      were correctly identified by the test. There were 12 false-positive and 5 false
      negative reactions seen. Pyloriset had a sensitivity of 92% and a specificity of
      66%. The positive predictive value was 83% and the negative predictive value 82%.
      In contrast, sensitivity dropped to 36% in the pediatric patients and the
      positive predictive value was only 40%. Pyloriset could become an important
      alternative to other more time-consuming diagnostic tests for H. pylori-infected
      adult patients but is inadequate for diagnosis of pediatric H. pylori infection.

PMID- 1734073
TI  - Polymerase chain reaction primers and probes derived from flagellin gene
      sequences for specific detection of the agents of Lyme disease and North American
      relapsing fever.
AB  - By cloning and sequencing the flagellin gene of Borrelia hermsii and comparing
      this sequence with that of the corresponding gene from B. burgdorferi, I
      identified a central region within the two genes which showed a reduced level of
      sequence similarity. Oligonucleotide sequences selected from this region produced
      species-specific amplimers when used in polymerase chain reaction experiments.
      Thus, primers derived from the B. burgdorferi sequence amplified a 276-bp
      fragment from 22 strains of B. burgdorferi of diverse geographic origin but not
      from 5 strains of B. hermsii, 5 other Borrelia species, 16 Treponema, Leptospira,
      and Spirochaeta species, or representatives of 10 other bacterial genera.
      However, when the amplified fragments were tested for hybridization with an
      oligonucleotide probe derived from the nonhomologous region, seven strains from
      either Germany or Switzerland did not hybridize. Cloning and sequencing of the
      amplified fragments from these strains revealed that the 22 strains of B.
      burgdorferi tested could be divided into three groups based on the nucleic acid
      sequence of the central region of the flagellin gene. With this information,
      oligonucleotide probes that hybridized to the amplified fragments and were able
      to differentiate the three groups of B. burgdorferi were designed. The
      corresponding primers, derived from the B. hermsii gene sequence, were tested for
      their ability to amplify DNA from this collection of strains. Although no
      amplification was obtained with representatives of the three groups of B.
      burgdorferi or various Treponema, Leptospira, and Spirochaeta species,
      amplification was obtained with the five other Borrelia species (B. parkeri, B.
      turicatae, B. crocidurae, B. anserina, and B. coriaceae) in addition to the five
      strains of B. hermsii. Sequencing of the amplified fragments from one strain of
      B. hermsii as well as B. parkeri and B. turicatae allowed the design of
      oligonucleotide probes that were able to differentiate the three species of North
      American relapsing fever spirochetes into two separate groups. These studies
      suggest that there is sufficient diversity within the flagellin gene sequences of
      closely related Borrelia species to differentiate them into groups and to pursue
      taxonomic studies both within and between species.

PMID- 1734074
TI  - Di-n-pentyl phthalate-induced inflammatory changes in the rat testis are
      accompanied by local production of a novel lymphocyte activating factor.
AB  - Phthalate esters (PAE) are plasticizers in polyvinyl chloride plastics used, for
      example, in package material for medical solutions. PAE exposure is associated
      with testicular damage that primarily affects Sertoli cells, and is concomitant
      with leukocyte infiltration into the testicular interstitium. We have
      demonstrated that the rat testis constitutively produces a lymphocyte activating
      factor (LAF) resembling interleukin-1 alpha, and originating from Sertoli cells.
      The testicular interleukin-1-like factor (tIL-1) has a relative molecular mass
      (Mr) of 17,000 (17 k) and an isoelectric point (pI) of 5.7. In the present study
      we have measured testicular LAF activity after exposure to di-n-pentyl phthalate
      (DPP) in 40-day-old rats. We found a large increase in LAF bioactivity which was
      evident already 3 h after a single oral dose of DPP. The increase was maximal 9
      12 h after exposure, and had decreased toward the control level at 24 h. The
      increased activity was found to be at least partly due to the induction of a
      novel LAF with Mr 38,000 and pI 4.5. Morphological examination confirmed earlier
      results with an interstitial leukocyte infiltration 6 h after DPP exposure. The
      identity of the novel LAF and its functional relation to testicular inflammation
      remain to be established.

PMID- 1734075
TI  - Preferential mammary storage and secretion of immunoglobulin gamma (IgG)
      subclasses in swine.
AB  - Levels of three immunoglobulin gamma (IgG) subclasses, IgGA, IgGB and IgGC, were
      measured in sow sera, mammary glands, colostrum and milk samples by the single
      radial immunodiffusion. Serum IgGA and IgGB levels, but not IgGC, showed time
      dependent variations during gestation and lactation periods. The IgGA level
      started to decline at day 106 of gestation, reached its minimum at farrowing, and
      returned to the pre-gestation level 1-3 weeks after weaning. The serum IgGB level
      started to decrease at day 111 of gestation, reached its minimum at farrowing,
      and returned to the initial gestation level 1 week after farrowing. A notable
      decrease (P less than 0.1) in serum IgGC level was observed only on the day of
      farrowing. IgGA and IgGB were preferentially stored in mammary glands of full
      term pregnant sows and secreted into colostrum after farrowing. In contrast,
      relatively small amounts of IgGC were stored in the mammary glands and secreted
      into colostrum. These data are interpreted as an indication that the preferential
      storage of IgGA and IgGB in the mammary gland of sows occurs at the time of
      significant decreases of these two IgG subclasses in the sera during late
      gestation and early lactation.

PMID- 1734076
TI  - The cellular immune response to immunization with zona pellucida antigens.
AB  - The cellular immune response of mice to porcine and rat zona pellucida and
      cynomolgus macaques to porcine zona pellucida antigens was evaluated. Mice
      mounted a vigorous cellular response to both antigens, as determined by the T
      cell proliferation response in vitro. There was poor cross-reactivity to murine
      zonae by T cells or serum antibodies from mice immunized with rat zona pellucida.
      Nevertheless, ovaries from the mice immunized with rat zona had significantly
      fewer antral follicles than adjuvant-treated controls, suggesting that the immune
      response to the zona antigen disrupted follicular development. T cells from two
      macaques that had been immunized with porcine zona pelludica proteins
      proliferated in vitro in response to this antigen. Both macaques also had strong
      antibody responses. The patterns of urinary steroid metabolites in these animals
      provided clear evidence of ovarian malfunction following immunization. The data
      indicate that a significant cellular immune response is generated upon
      immunization of animals with zona pellucida antigens regardless of whether the
      antigens are cross reactive with the host zona antigens. Whether impaired ovarian
      function and follicular development are related to the cellular response must be
      determined in future studies.

PMID- 1734077
TI  - Pregnancy-associated major basic protein in amniotic fluid.
AB  - The pregnancy-associated major basic protein, a protein elevated in the sera of
      all pregnant women, is virtually identical to the eosinophil granule major basic
      protein. To determine whether pregnancy-associated major basic protein is present
      in amniotic fluid, we examined samples from both early and late gestation by a
      double antibody radioimmunoassay. A total of 112 amniotic fluids were tested and
      all but three contained levels of pregnancy-associated major basic protein
      greater than 400 ng/ml. Amniotic fluid pregnancy-associated major basic protein
      antigenic activity was immunochemically identical to that of the eosinophil
      granule major basic protein and also had identical physicochemical properties
      such as heat stability and the need for reduction and alkylation. Although the
      majority of amniotic fluid samples (90 of 112) were obtained from healthy women
      with normal gestations, the remaining 21 amniotic fluid samples were from women
      with Rh sensitization and from one gestation complicated by intrauterine growth
      retardation.

PMID- 1734078
TI  - Bovine early pregnancy factor (EPF) activity dependent on a 67-kDa polypeptide.
AB  - Maternal bovine EPF activity can be reduced to one single polypeptide enriched
      and identified from serum of cows in early pregnancy. The relative molecular
      weight of this active polypeptide was estimated at 67 kDa. This bovine EPF was
      labelled by 125I and peroxidase. In parallel investigations of non-pregnant
      animals a 67-kDa polypeptide was additionally identified in the last purification
      step, but without EPF activity in the rosette inhibition test. This indicated
      occurrence of an inactive pre-compound (or carrier protein) of the EPF in the non
      pregnant state. On pre-incubation of lymphocytes with EPF analogues (inactive
      polypeptide from nonpregnancy serum) EPF retained its optimal activity, its
      lymphocyte receptors being unaffected. Monoclonal antibodies produced against
      HPLC-enriched EPF were reactive to the 67-kDa polypeptide in pregnancy material
      as well as in nonpregnancy material and were not able to differentiate between
      'pregnant' and 'nonpregnant'. A mouse anti-EPF serum produced against highly
      purified EPF isolated from SDS PAGE showed reactivity only against the 67-kDa
      polypeptide of pregnancy serum but not against that of non-pregnancy serum. This
      is the first evidence for a difference in antigenic determinants of the two 67
      kDa proteins found in pregnancy and non-pregnancy serum. Furthermore, a second
      higher molecular weight protein could be identified by this antiserum in
      pregnancy and non-pregnancy serum.

PMID- 1734079
TI  - Isolation and characterisation of a subpopulation of human chorionic
      cytotrophoblast using a monoclonal anti-trophoblast antibody (NDOG2) in flow
      cytometry.
AB  - Human cytotrophoblast cells, isolated from term amniochorion by enzymic digestion
      and Percoll gradient centrifugation, were characterised by flow cytometry. A
      panel of 12 anti-trophoblast monoclonal antibodies was screened for labelling of
      these cells in flow cytometry and the results compared with immunoperoxidase
      labelling of cytospin preparations and tissue sections. All 12 antibodies were
      positive for trophoblast on tissue sections, 11/12 were positive on cytospins but
      only two (NDOG2 and GB25) gave consistent results in flow cytometry. Two-colour
      labelling with NDOG2 and W6/32, an antibody to HLA-A, -B, -C, demonstrated that
      88% of the NDOG2-positive cells also express Class I major histocompatibility
      complex (MHC) antigens. The NDOG2-positive cytotrophoblast subpopulation was
      isolated by flow cytometry in sufficient purity (greater than 95%) and yield (3.1
      x 10(6)) for use in functional studies in vitro.

PMID- 1734080
TI  - PGE2-independent immunosuppressive activity of horse trophoblast tissue.
AB  - It has been proposed that PGE2 is an important immunosuppressant acting at the
      fetal-maternal interface during pregnancy. We have previously shown that horse
      conceptus-conditioned medium suppresses lymphocyte proliferation. This experiment
      was designed to determine if horse conceptus-derived immunosuppressive activity
      could be attributed to PGE2 production by the trophoblast tissue. Trophoblast
      tissue from 21-day-old conceptuses was cut into equal sections and cultured in
      the presence or absence of the prostaglandin inhibitor, indomethacin. Following
      culture, immunosuppressive activity and the concentration of PGE2 were determined
      for each sample of both horse-trophoblast conditioned medium (HTCM) and
      indomethacin-treated HTCM (I-HTCM). Suppressive activity was identified in
      lymphocyte proliferation assays via reduced [3H]thymidine uptake by pokeweed
      mitogen stimulated horse lymphocytes. A radioimmunoassay was used to quantify
      PGE2. While PGE2 production was greatly reduced in cultures containing
      indomethacin, trophoblast-derived immunosuppressive activity was not affected.
      These data indicate that PGE2 is not the primary immunosuppressant produced by
      horse trophoblast tissue.

PMID- 1734081
TI  - Active cancer therapy combining 13-cis-retinoic acid with interferon-alpha.

PMID- 1734082
TI  - Anti-metastasis drug ready for human trials.

PMID- 1734083
TI  - Consensus on early melanoma: less surgery, fewer tests.

PMID- 1734084
TI  - 13-cis-retinoic acid and interferon alpha-2a: effective combination therapy for
      advanced squamous cell carcinoma of the skin.
AB  - BACKGROUND: Retinoids (vitamin A derivatives) and interferon-alpha (IFN-alpha)
      are potent regulators of malignant cell differentiation and proliferation, and
      both have immunomodulatory and antiangiogenesis activity. A large body of
      preclinical and clinical data supports the use of combination therapy with 13-cis
      retinoic acid (13-cRA) and IFN-alpha in patients with squamous cell carcinoma of
      the skin. This carcinoma is an extremely common and frequently severely
      disfiguring cancer, for which about 10% of patients remain uncured following
      standard local therapy. PURPOSE: Our purpose was to test whether a 20% or greater
      complete response rate could be achieved using a combination of these two agents
      in patients with advanced squamous cell carcinoma of the skin in whom local
      therapy had failed or was unfeasible or who had regional and/or distant
      metastases. METHODS: Thirty-two patients with heavily pretreated, advanced
      inoperable cutaneous squamous cell carcinoma of the skin were given a combination
      of oral 13-cRA (1 mg/kg per day) and subcutaneous recombinant human IFN alpha-2a
      (3 million units per day) for at least 2 months, unless disease progressed
      earlier, in a phase II trial. RESULTS: Nineteen (68%) of the 28 assessable
      patients responded, seven (25%) of whom had complete responses. Response rates
      were 93% (13 of 14) in patients with advanced local disease (six complete
      responses), 67% (four of six) in patients with regional disease (no complete
      responses), and 25% (two of eight) in patients with distant metastases (one
      complete response). The relationship between decreased response rate and
      increased extent of disease was highly statistically significant (P less than
      .005, chi-square test). The median response duration was greater than 5 months.
      No life-threatening toxic effects occurred in assessable patients treated with
      this combination, although dose reductions were required in 18 patients. The
      major limiting side effect in this elderly patient population (median age, 67
      years) was cumulative fatigue. CONCLUSION: These results indicate that combined
      systemic therapy with 13-cRA and IFN alpha-2a is highly effective in patients
      with advanced squamous cell carcinoma of the skin.

PMID- 1734085
TI  - 13-cis-retinoic acid plus interferon alpha-2a: highly active systemic therapy for
      squamous cell carcinoma of the cervix.
AB  - BACKGROUND: Chemotherapeutic study of cervical squamous cell carcinoma has shown
      some positive results. Complete plus partial (overall) response rates of 15%-35%
      (complete response rate, less than 5%) were achieved with the use of a small
      number of cytotoxic single agents in patients with advanced disease. In addition,
      overall response rates of 60%-70% (complete response rates, 10%-20%) were
      achieved with cisplatin-based, multiagent regimens in patients with primary,
      locally advanced disease. However, the lack of clear evidence that existing
      chemotherapy can achieve a survival benefit, coupled with the worldwide annual
      deaths of hundreds of thousands of women from cervical cancer, indicates the
      urgent need for effective systemic therapy for this disease. PURPOSE: In view of
      the preclinical and clinical evidence that supports testing of the novel
      combination of 13-cis-retinoic acid (13-cRA) plus interferon-alpha (IFN-alpha) in
      cervical squamous cell carcinoma, we conducted a phase II study of this regimen
      in locally advanced disease. METHODS: Twenty-six patients with untreated, locally
      advanced squamous cell carcinoma of the cervix were treated daily for at least 2
      months with oral 13-cRA (1 mg/kg) and subcutaneous recombinant human IFN alpha-2a
      (6 million units). In 21 patients (81%), the disease was stage II or higher.
      RESULTS: Thirteen patients (50%) experienced major responses (tumor regression
      greater than or equal to 50%) in association with resolution of symptoms; one
      achieved complete response, and 12 experienced partial response. Seven with
      partial response are improving further, four are being maintained in partial
      response, and one responder has relapsed during therapy. The response rate is 58%
      (11 of 19) in patients with stage IIB or higher disease and 66% (10 of 15) in
      patients with bulky disease (at least one dimension greater than or equal to 10
      cm). Of the 13 non-responders, nine have stable disease and four have had disease
      progression during therapy. Toxicity was minimal. CONCLUSION: These preliminary
      results indicate that systemic 13-cRA plus IFN alpha-2a is a highly active, well
      tolerated therapy for locally advanced cervical cancer.

PMID- 1734086
TI  - Pattern of p53 gene mutations in breast cancers of women of the midwestern United
      States.
AB  - BACKGROUND: Mutation in the p53 gene is the most common genetic lesion in human
      cancers. The pattern of mutation in the p53 gene differs among cancers and may be
      a useful epidemiological tool for identification of factors contributing to
      carcinogenesis. PURPOSE: Our purpose was to determine if the pattern of p53
      mutation in breast carcinomas in our population of women residing in the
      midwestern region of the United States is similar to the pattern of p53 mutation
      in breast cancers in patients from other regions of the United States and Europe
      and in other epithelial tumors. METHODS: With a technique we recently developed
      for the analysis of p53 mutations in genomic DNA from tumor cell clusters in
      touch preparations of solid tumors, we sequenced exons 5-9 and adjacent splice
      junctions of the gene in 44 breast cancers. Cells from each tumor were also
      stained with three monoclonal antibodies which recognize different epitopes of
      the p53 protein. RESULTS: We detected p53 mutations in 14 (32.6%) of 44 breast
      carcinomas. Only half of the mutations were missense changes. The other half
      included five microdeletions (three producing frame-shifts), one single-base
      substitution generating a stop codon, and one single-base substitution generating
      a splice junction abnormality. Nuclear expression of p53 antigen was present in
      eight of 44 cancers, including six with hemizygous missense mutations in the p53
      gene. CONCLUSIONS: The pattern of p53 mutations in our breast cancer population
      differs from that reported in breast cancer populations by other investigators in
      which most p53 mutations were missense. Among 14 mutations in our population, at
      least five drastically altered the structure of p53, suggesting that a recessive
      mechanism of inactivation of the p53 gene may be more common than in other
      populations. IMPLICATIONS: Differences in the pattern of p53 mutation in breast
      cancers in Midwestern women and in breast cancers in other populations may
      reflect selection bias or small sample sizes currently available. However, our
      data are compatible with the possibility that an endogenous or exogenous factor
      influences p53 carcinogenesis in some women with breast cancer in the Midwest to
      a greater extent than in other regions of the United States and Europe.

PMID- 1734087
TI  - Unexpected acute neurologic toxicity in the treatment of children with acute
      lymphoblastic leukemia.
AB  - BACKGROUND: Our current protocol for treatment of childhood acute lymphoblastic
      leukemia (ALL) was designed to assess the efficacy of methotrexate (MTX) plus L
      asparaginase and of etopisode (VP-16) plus cytarabine (ARA-C) during intensive
      consolidation and continuation therapies and to determine the feasibility of
      intensifying MTX therapy by the use of divided oral doses of MTX. The protocol
      was associated with unexpected acute neurotoxicity. There are few reports of such
      toxic effects during therapy for ALL. PURPOSE: This report describes these toxic
      effects and outlines our successful approach to the problem. METHODS: The
      standard four-drug induction regimen consisted of vincristine, L-asparaginase,
      daunorubicin, and prednisone. In consolidation therapy, oral MTX was given in
      divided doses (dMTX) of 25 mg/m2 every 6 hours four times daily in four weekly
      courses concomitant with weekly triple intrathecal therapy--MTX, ARA-C, and
      hydrocortisone--plus one dose of leucovorin 24 hours after triple intrathecal
      therapy. Consolidation treatment ended with three daily doses of intravenous VP
      16 and ARA-C. The first 16 months of continuation therapy included 6-week cycles
      of dMTX and L-asparaginase, both given every other week for 5 weeks, with 6
      mercaptopurine nightly, and then two doses of VP-16 plus ARA-C and one dose of
      triple intrathecal therapy. RESULTS: Twenty-five of the 138 patients evaluated
      had acute neurotoxicity. Ten of the first 72 experienced a seizure or episode of
      transient neurological deficit 9-11 days following the administration of
      intravenous ARA-C, VP-16, and triple intrathecal therapy. Despite discontinuation
      of intrathecal ARA-C, which eliminated simultaneous intravenous and intrathecal
      treatment with ARA-C, acute neurotoxicity was observed in six previously
      unaffected patients and six of 42 patients treated after the elimination of
      intrathecal ARA-C. Therefore, as a second amendment, oral leucovorin was given 24
      and 36 hours after dMTX and intrathecal MTX in continuation therapy. No acute
      neurotoxicity has been seen in 24 patients subsequently entered in the study.
      CONCLUSION: These findings suggest that folate replacement due to administration
      of leucovorin modulated MTX toxicity and/or modified an interaction among VP-16,
      ARA-C, intrathecal therapy, and the central nervous system.

PMID- 1734088
TI  - Depletion of glutathione in normal and malignant human cells in vivo by
      buthionine sulfoximine: clinical and biochemical results.

PMID- 1734089
TI  - Canine malignant lymphoma and 2,4-dichlorophenoxyacetic acid herbicides.

PMID- 1734090
TI  - Antimicrobial treatment of the umbilical cord.

PMID- 1734091
TI  - Persistent tympanic membrane perforation from ventilation tubes.

PMID- 1734092
TI  - New forms and new needs may make macrolides antibiotics of the decade.

PMID- 1734093
TI  - From the Centers for Disease Control. Surgeon General's Conference on
      Agriculture.

PMID- 1734094
TI  - From the Centers for Disease Control. Hysterectomy prevalence, cervical cancer
      deaths.

PMID- 1734095
TI  - A piece of my mind. Keeping up with the literature.

PMID- 1734096
TI  - Radiation dosage estimation and health risk.

PMID- 1734097
TI  - Reporting negative studies in the mass media.

PMID- 1734098
TI  - Reporting negative studies in the mass media.

PMID- 1734099
TI  - Tuberculous pericarditis.

PMID- 1734100
TI  - Tuberculosis screening and indications for preventive therapy.

PMID- 1734101
TI  - CABG surgical mortality in different centers.

PMID- 1734102
TI  - Free clinics and malpractice claims.

PMID- 1734103
TI  - A modest proposal: a vow of chastity for single physicians in remote areas?

PMID- 1734104
TI  - Glove tears and sharp injuries in surgical personnel.

PMID- 1734105
TI  - Improving growth status of Asian refugee children in the United States.
AB  - OBJECTIVE: To analyze the trend and pattern of the nutrition status of Southeast
      Asian refugee children and other low-income children in the United States.
      DESIGN: Descriptive analysis of the growth data from the Pediatric Nutrition
      Surveillance System of the Centers for Disease Control, Atlanta, Ga, from 1980
      through 1989. SUBJECTS: Children under 5 years of age from low-income families
      enrolled in public health clinics in 12 selected states. MEASUREMENTS AND MAIN
      RESULTS: Asian refugee children experienced a progressive and significant decline
      in the prevalence of low birth weight, low height-for-age, and low weight-for
      age, while these nutritional indexes remained stable for low-income white, black,
      and Hispanic children. By 1989, the growth status of Asian children was near that
      of other ethnic groups. CONCLUSIONS: The marked improvement of growth status
      among Asian refugee children over a short period suggests that the poor growth
      status often observed among recently immigrated Asian children is primarily
      related to nutritional and health factors, rather than genetic factors. In
      assessing the growth of Asian or immigrant children, it would be helpful to take
      their family and early childhood background into account.

PMID- 1734106
TI  - A prospective study of benign breast disease and the risk of breast cancer.
AB  - OBJECTIVE: To examine the relation between proliferative benign breast disease
      with and without atypical hyperplasia and the subsequent risk of breast cancer.
      DESIGN: Case-control study nested within a prospective cohort study. Median
      follow-up after breast biopsy was 8 years (25th to 75th percentile, 5 to 14
      years). PARTICIPANTS: Selected from a prospective cohort of 121,700 US registered
      nurses followed up from 1976 to 1986. Cases were women with breast cancer who had
      a prior biopsy for benign breast disease. Controls were randomly selected and
      matched on year of biopsy and year of birth from among women in the cohort who
      had a benign breast biopsy but who did not develop breast cancer. Included in the
      analysis were 121 cases and 488 controls. MAIN OUTCOME MEASURE: Development of
      breast cancer. RESULTS: Slides from the first benign breast biopsy were reviewed
      by two breast pathologists blinded to the outcome. The multiply adjusted relative
      risks (RRs) for breast cancer, relative to women with no proliferative disease,
      were 1.6 for proliferative disease without atypia (95% confidence interval [Cl],
      1.0 to 2.5) and 3.7 for atypical hyperplasia (95% Cl, 2.1 to 6.8). Breast cancer
      risk was more strongly associated with atypical hyperplasia among premenopausal
      women (RR = 5.9; 95% Cl, 2.9 to 13.2) than postmenopausal women (RR = 2.3; 95%
      Cl, 0.9 to 5.9), but the association of breast cancer risk with proliferative
      disease without atypia did not differ across menopausal status. CONCLUSION: These
      results confirm the marked increase in breast cancer risk among women with
      atypical hyperplasia, particularly in premenopausal women, and suggest that these
      women should be encouraged to undergo frequent breast cancer screening.

PMID- 1734107
TI  - Reducing the number of uninsured by subsidizing employment-based health
      insurance. Results from a pilot study.
AB  - OBJECTIVE: To evaluate whether employers who do not provide health insurance
      would offer such benefits after a 50% reduction in the price of health insurance.
      DESIGN: Using a survey of 530 firms at two sites in New York State, we estimate
      the number of firms that added insurance during 1988 as a percentage of firms
      that were eligible for the subsidy. We use this proportion as an estimate for the
      number of firms that would have added insurance in the absence of the subsidy
      program. We then estimate the number of firms adding insurance during the initial
      year of the program, 1989. SETTING: The subsidized health insurance pilot
      projects were available in Brooklyn and in the Albany-Plattsburgh-Poughkeepsie
      region of New York State. INTERVENTION: New York State subsidized the price of
      health insurance, reducing it by 50%. Eligible employers were responsible for
      paying the remaining portion of the premium. RESULTS: The subsidized health
      insurance products increased the number of small firms (under 20 employees)
      offering insurance by a small amount, approximately a 3.5 percentage point
      increase. When fully implemented and assuming all eligible employers were aware
      of the program, the subsidy would increase the proportion of firms offering
      insurance by 16.5 percentage points. We view this as an upper boundary.
      CONCLUSIONS: Increased program visibility and allowing the employee to share in
      the premium payment may increase the number of employers offering insurance. Even
      under ideal conditions, however, the results highlight the limitations of
      voluntary programs to increase the number of employers offering health insurance.

PMID- 1734108
TI  - The challenge of minority recruitment in clinical trials for AIDS.

PMID- 1734109
TI  - The reliability of peer assessments of quality of care.
AB  - OBJECTIVE: To critically examine the literature regarding the interreviewer
      reliability of the standard practice of peer assessment of quality of care. DATA
      SOURCES: Computerized searches of the English-language literature from 1966
      through 1990 using MEDLINE, HEALTHLINE, and SCISEARCH databases were performed to
      identify studies reporting data on interreviewer agreement of implicit
      evaluations of patient care episodes. STUDY SELECTION: Seventeen studies were
      identified. Five studies were excluded from this review because of deficiencies
      in the methods or lack of data on chance-corrected indexes of agreement. DATA
      EXTRACTION SYNTHESIS: The degree of agreement beyond chance was compared with
      accepted standards in the 12 remaining studies. Most of these studies found
      agreement corrected for chance to be in the range regarded as poor, indicating
      that physician agreement regarding quality of care is only slightly better than
      the level expected by chance. CONCLUSIONS: Given the magnitude of the resources
      devoted to quality assurance and the centrality of peer assessment to these
      efforts, there is a need for a global reexamination of the peer review process. A
      number of proposals appear to have potential for improving the peer review
      process including more objective assessment procedures, multiple reviewers,
      higher standards for reviewers, elimination of systematic reviewer bias, use of
      outcome judgements, and adoption of practice guidelines.

PMID- 1734111
TI  - An investigator's journey in cardiology.

PMID- 1734110
TI  - Secondary dyslipidemia. Inadvertent effects of drugs in clinical practice.
AB  - OBJECTIVE: To examine the available literature on commonly prescribed drugs and
      their effects on blood lipid and lipoprotein levels. DATA SOURCES: The review was
      based on searches of English-language articles from 1975 to 1990 by Medlars II
      and MEDLINE programs, the Index Medicus for 1980 to 1990, and references from
      identified articles. Relevant journals published within the last 6 months were
      also examined. STUDY SELECTION: More than 500 articles were identified for
      inclusion. Articles were selected on the basis of appropriateness of design to
      demonstrate significant results, determined by consensus when necessary. DATA
      EXTRACTION: Studies were classified according to type (observational or
      interventional), length of follow-up, and type of controls. Quanitative analysis
      of lipid, lipoprotein, and apoprotein changes induced by drugs was computed as
      the percentage of change observed during the course of the study (interventional)
      or compared with the controls at a given time (observational). DATA SYNTHESIS:
      Steroid hormones that have strong progestogenic and androgenic properties,
      retinoids, cyclosporine A, and phenothiazines are potentially atherogenic.
      Steroid hormones with dominant estrogenic properties, several anticonvulsants,
      biguanides, high-dose ketoconazole, and aminosalicylic acid are potentially
      antiatherogenic. Corticosteroids appear to elevate all the lipoprotein
      cholesterol levels. Oral estrogens, retinoids, and corticosteroids also can
      elevate triglyceride levels. Other drugs with questionable effects on lipoprotein
      metabolism are reviewed. CONCLUSION: Although the long-term implications of drug
      induced lipoprotein changes are still undefined, physicians need to consider
      these effects in clinical practice.

PMID- 1734112
TI  - On the utility of growth curves.

PMID- 1734113
TI  - Public opinion and AIDS. Lessons for the second decade.

PMID- 1734114
TI  - Dr Mudd, the grandson, fights to clear name of famed ancestor.

PMID- 1734115
TI  - Clinical and metabolic characteristics of diabetic ketoacidosis.

PMID- 1734116
TI  - Management of complex perineal injury.

PMID- 1734117
TI  - An unusual cause of hypertension.

PMID- 1734118
TI  - False sense of security.

PMID- 1734119
TI  - Medical education: behind the lectern.

PMID- 1734120
TI  - Patient relations guidelines: keeping your schedule running smoothly to minimize
      the waiting game. TMA Communications and Public Service Committee.

PMID- 1734121
TI  - On the other end...

PMID- 1734122
TI  - Organ transplantation in Tennessee 1989-1990. Report of the Tennessee Transplant
      Society and the TMA Committee on Organ Procurement.

PMID- 1734123
TI  - [Sweden and Great Britain. Internal market is introduced into health care.
      Independence of the medical profession is challenged].

PMID- 1734124
TI  - [Coronary vessel radiography--further decentralization is necessary, safe and
      feasible].

PMID- 1734125
TI  - [Studies of prescriptions--a starting-point for scientific work].

PMID- 1734126
TI  - [Drug companies have to find new indications for ACE inhibitors].

PMID- 1734127
TI  - [Organizational change at a surgery department increased productivity].

PMID- 1734128
TI  - [A regional center for adverse effects in Umea will stimulate increased
      reporting].

PMID- 1734129
TI  - [Complications of coronary vessel radiography--a Swedish study compared with
      international results].

PMID- 1734130
TI  - [The number of psychiatric commitments is decreasing but more and more patients
      appeal].

PMID- 1734131
TI  - [Fish-scale and algae become biosensors. Hunting for a biocompatible blood
      glucose sensor].

PMID- 1734132
TI  - [Drug control within the EEC I: coordination during the 1990's].

PMID- 1734133
TI  - [Insult to psychiatry].

PMID- 1734134
TI  - [Gene therapy soon in clinical use but major problems remain unsolved].

PMID- 1734135
TI  - [Exposure to gasoline and leukemia: a small risk for many].

PMID- 1734136
TI  - [Should active euthanasia reduce confidence of the public in health care
      services?].

PMID- 1734137
TI  - [The patient insurance's injury registry: feedback of experiences to the health
      care services has a preventive effect].

PMID- 1734138
TI  - [Cephalosporins--a common cause of nosocomial Clostridium difficile diarrhea].

PMID- 1734139
TI  - [Strongly increased risk of acute myeloid leukemia among gasoline service station
      workers].

PMID- 1734140
TI  - [Autoantibodies as serological markers in the diagnosis of glomerulonephritis].
AB  - Autoimmunity is now regarded as the unequivocally predominant pathogenic process
      underlying most forms of primary and secondary glomerulonephritis in humans, and
      a number of autoantibodies occurring in conjunction with glomerulonephritis have
      been discovered. However, apart from the anti-NC1 antibodies occurring in classic
      Goodpasture's syndrome, the exact pathogenic role of these autoantibodies in
      human glomerulonephritis remains to be established, though this in no way
      diminishes the importance of their study. They have been of enormous value in
      subclassifying glomerulonephritis, previously thought to be a homogeneous entity.
      Autoantibody analysis has become a vital aid in the early diagnosis of rapidly
      progressive glomerulonephritis, which in turn has enabled treatment to be started
      early, thus contributing to a decline in the morbidity and mortality resulting
      from these disorders. Moreover, investigation of these autoantibodies will be of
      immense value in future studies focused on the pathogenic mechanisms involved in
      glomerulonephritis.

PMID- 1734141
TI  - [What happens with the ear in temporal bone fractures?].

PMID- 1734142
TI  - [Medical technology facing the 21st century--industrial methods headed for
      clinical practice].

PMID- 1734143
TI  - [Warning against wrongly labelled implants. Neglected follow-up in Sweden].

PMID- 1734144
TI  - [Acanthamoeba keratitis--a new diagnosis in Sweden].

PMID- 1734145
TI  - [50 obstetric malpractice cases: difficult to draw limits, inconsistent
      decisions].

PMID- 1734146
TI  - [Comments on the rules for physicians III].

PMID- 1734147
TI  - [Drug control within the EEC II: good possibilities for Sweden].

PMID- 1734148
TI  - [Is screening for ovarian cancer beneficial?].

PMID- 1734149
TI  - [Advantages and disadvantages of parenteral nutrition].

PMID- 1734150
TI  - [Debatable questions on Clostridium difficile diarrhea].

PMID- 1734151
TI  - [Wrong conclusions on sick-listing after changing the amalgam fillings].

PMID- 1734152
TI  - [Infant-friendly hospitals save millions of lives].

PMID- 1734153
TI  - [A study in Fagersta: extensive anticoagulant therapy. High incidence of
      hemorrhagic complications].

PMID- 1734154
TI  - [The woman behind the syndrome. Lucja Frey. Famous for her description of
      gustatory facial sweating].

PMID- 1734155
TI  - [Iatrogenic superior vena cava syndrome. Successful thrombolysis with recombinant
      tissue plasminogen activator (r-tPA)].

PMID- 1734156
TI  - [The dynamic view in psychiatry should get more space in Swedish education and
      care].

PMID- 1734157
TI  - MK801 antagonism of the prolonged depletion of striatal dopamine by amphetamine
      in iprindole-treated rats.
AB  - The administration of amphetamine to rats pretreated with iprindole to inhibit
      the metabolism of amphetamine results in a long-lasting depletion of striatal
      dopamine and its metabolites, DOPAC and HVA. Pretreatment with MK801, a
      noncompetitive antagonist of the NMDA (N-methyl-D-aspartate) subclass of
      excitatory amino acid receptors, antagonized the depletion of striatal dopamine,
      DOPAC and HVA 3 days after a single dose of amphetamine in iprindole-treated
      rats. MK801 pretreatment was effective up to 4 hours but not at 8 or 24 hours in
      preventing amphetamine effects on striatal dopamine, DOPAC and HVA.

PMID- 1734158
TI  - Nitric oxide control of steroidogenesis: endocrine effects of NG-nitro-L-arginine
      and comparisons to alcohol.
AB  - Recent studies suggest that nitric oxide (NO) may regulate hormone biosynthesis
      and secretion. This was tested by treating male rats with NG-nitro-L-arginine
      methyl ester (NAME), a NO synthase inhibitor, and measuring serum and testicular
      interstitial fluid testosterone and serum corticosterone, luteinizing hormone
      (LH), and prolactin (PRL). The effect of NG-nitro-L-arginine (NA), a less-soluble
      form of the same NO synthase inhibitor, on the reproductive suppressant actions
      of alcohol was also examined. NAME increased testosterone and corticosterone
      secretion dose-dependently without affecting LH and PRL secretion. The alcohol
      induced suppression of testosterone or LH secretion was not altered by treatment
      with NA. Although effects of NAME and NA on other systems may be involved, these
      results indicate that testicular and adrenal steroidogenesis are negatively
      regulated by endogenous NO and that NO does not regulate LH and PRL secretion or
      inhibit the testicular steroidogenic pathway in the same way as alcohol.

PMID- 1734159
TI  - Immunohistochemical labeling of androgen receptors in the brain of rat and
      monkey.
AB  - Androgen receptor antibodies have recently been developed using fusion proteins
      containing fragments of human prostatic androgen receptor. We have used a
      polyclonal antibody raised in rabbits to label androgen receptors in brain
      sections from male and female rats and monkeys. Free-floating frozen sections
      were incubated in primary antibody, and processed by the peroxidase-avidin-biotin
      complex method using biotinylated anti-rabbit IgG. Nickel intensified
      diaminobenzidine was used as the chromagen, and neurons were labeled in the
      amygdala, hippocampus, bed nucleus of stria terminalis, septum, preoptic area, in
      several hypothalamic nuclei including the supraoptic and paraventricular nuclei,
      in several brain stem motor nuclei and in cerebral cortex. Staining was most
      intense in cell nuclei but also occurred in cytoplasm and in some neuronal
      processes. Labeling was more restricted in monkey than in rat brain. Omitting the
      primary antibody or pre-incubating the primary antibody with rat prostatic
      cytosol for control purposes demonstrated the specificity of staining.

PMID- 1734160
TI  - Stimulation of muscarinic cholinoceptive neurons in the hippocampus evokes a
      pressor response with bradycardia.
AB  - The injection of neostigmine into the hippocampus of anesthetized rats increased
      the mean arterial blood pressure (17% of baseline after 60 min injection) and
      decreased the heart rate (24% of baseline after 60 min injection). These changes
      were blocked by the co-administration of methylatropine into the hippocampus.
      Intrahippocampal injection of neostigmine stimulated the secretion of epinephrine
      and norepinephrine. Adrenodemedullation did not suppress the increase in blood
      pressure and the decrease in heart rate. It is concluded that the stimulation of
      muscarinic cholinoceptive neurons in the hippocampus evokes a hypertensive
      response via an increase in sympathetic drive to the heart and peripheral
      vasculature, with bradycardia possibly mediated via the parasympathetic system.

PMID- 1734161
TI  - 'Normal' cigarette smoking increases free cortisol in habitual smokers.
AB  - In habitual smokers salivary cortisol responses to cigarette smoking were
      investigated. In the first study, 31 adults assigned to two experimental groups
      smoked either one or two cigarettes of their preferred brand. Mean salivary
      cortisol levels were significantly elevated after smoking of two cigarettes. In
      the second study, 10 smokers and 10 nonsmokers provided saliva samples at 20 min
      intervals over a 12-hr period. While environmental stimuli were paralleled in
      both groups overall cortisol output was significantly elevated in the smokers.
      These data suggest that 'normal' cigarette smoking can increase free cortisol
      levels.

PMID- 1734162
TI  - Binding of 3H-gossypol in organelles of cultured bovine luteal cells.
AB  - Gossypol is an antifertility agent which inhibits steroidogenesis in both sexes.
      The present study investigated the binding of gossypol in organelles of cultured
      bovine luteal cell to elucidate its inhibitory site of action in steroid
      biosynthesis. Cultured bovine luteal cells were incubated with 3H-gossypol (4.3
      or 2.15 microM) for 3 hours. At the end of treatment, cultured bovine luteal
      cells were harvested, homogenized and centrifuged for organelle preparation. The
      radioactivity of gossypol was measured in each subcellular fraction. The cell
      membrane fraction has the highest binding capacity for gossypol, and the majority
      of gossypol was located in the particulate fractions. Results of the present
      study provide information in understanding the regulatory mechanism of gossypol
      on antisteroidogenic and/or toxic effects in cultured bovine luteal cells.

PMID- 1734163
TI  - Chronopharmacological study of furosemide; (IX). Influence of continuous
      norepinephrine infusion.
AB  - Our previous studies have suggested that the adrenergic nervous system is
      involved in the mechanisms responsible for the time-dependent changes in the
      effects of furosemide in rats. To examine this hypothesis further, norepinephrine
      (150 micrograms/kg/hr) or its vehicle alone was infused subcutaneously by osmotic
      minipumps. Furosemide (30 mg/kg) was given orally at 12 am or 12 pm. Urine was
      collected for 8 hours after the agent, and urinary excretions of sodium and
      furosemide were determined. Urine volume and urinary excretion of sodium and
      furosemide were significantly greater at 12 am than at 12 pm in the vehicle
      infused group of rats. However these administration-time-dependent changes in the
      effects of furosemide and its urinary amount disappeared in the norepinephrine
      infused group of animals. Since chronic norepinephrine infusion is considered to
      disturb the axis of adrenergic nervous system, these data support the hypothesis
      concerning the mechanisms of this chronopharmacological phenomenon of furosemide.

PMID- 1734164
TI  - Legislative preview: an overview of legislative issues affecting Maryland
      medicine in 1992.

PMID- 1734165
TI  - Providers with HIV/AIDS--a new dilemma.
AB  - Recently, a great deal of attention has been focused on health care providers who
      have or may have the human immunodeficiency virus or, as it is known in its later
      stages, acquired immunodeficiency syndrome. This article explores some of the
      duties physicians have, or soon may have, to their patients and employers in the
      areas of testing, disclosure, and practice restraints.

PMID- 1734166
TI  - Diagnosis and management of asymptomatic primary hyperparathyroidism: a
      commentary.

PMID- 1734167
TI  - Imaging case of the month. Crohn's disease involving the terminal ileum.

PMID- 1734168
TI  - Are hypoglycemic reactions dangerous?

PMID- 1734169
TI  - A safe treatment for hyperemesis gravidarum?

PMID- 1734170
TI  - Current challenges in medical practice and research.

PMID- 1734171
TI  - Inhomogeneity correction for in vivo spectroscopy by high-resolution water
      referencing.
AB  - One of the most common sources of distortion in in vivo spectroscopy is the
      inhomogeneity of the main magnetic field. This effect is particularly problematic
      when performing spectroscopic imaging, as the shim cannot be simultaneously
      optimized for all voxels. In this paper we present a technique to measure
      inhomogeneity rapidly, then show how to use the measurement to improve the
      analysis of the spectrum. This technique can be applied in conjunction with any
      spectroscopic localization method and any spectral quantitation algorithm. We
      present results from spectroscopic imaging of phantoms, then show application to
      a single-voxel water-suppressed proton brain study. We find that the quantitation
      of the in vivo spectrum is made immune to inhomogeneous line broadening.

PMID- 1734172
TI  - Fast angiography using selective inversion recovery.
AB  - We have developed an enhancement of selective inversion recovery that allows us
      to obtain high-resolution angiograms in reduced scan time. By applying several
      read pulses following each tagging inversion pulse, we can obtain several phase
      encodes in each cardiac cycle, thereby reducing the total scan time required for
      a complete image. Using this technique, high-resolution angiograms can be
      obtained in as little as 15 s. Because the phase encodes are collected in short
      bursts separated by long pauses, care must be taken to maintain uniform signal
      weighting across phase-encoding views and avoid ghosting. We use an increasing
      flip-angle sequence to equalize signal level weighting across the readouts. The
      phase encodes are collected in a special order to minimize ghosting. A
      postprocessing technique is used to further reduce signal nonuniformity between
      phase encodes. This fast angiography technique can significantly reduce artifacts
      due to patient motion during scanning and is especially useful for imaging
      vasculature in regions of the body where respiratory motion is a problem.

PMID- 1734173
TI  - Spin-lattice relaxation in murine tumors after in vivo treatment with interferon
      alpha/beta or tumor necrosis factor alpha.
AB  - 1H NMR spin-lattice relaxation times (T1) were measured in vitro and in vivo in
      Friend leukemia cell tumors during subcutaneous tumor growth in syngeneic mice
      and after in vivo administration of either purified murine interferon alpha/beta
      (IFN) or recombinant tumor necrosis factor alpha (TNF). Untreated tumors
      exhibited monoexponential T1 relaxation independently of tumor age at least until
      Day 16 after implantation. Histological examinations showed that under these
      conditions tumors were highly homogeneous and substantially free of necrotic
      areas. Peritumoral administrations of either IFN or TNF did not significantly
      alter the tumor relaxation properties at early stages of inhibition of tumor
      growth. The longitudinal relaxation decay became instead clearly biexponential at
      later stages (more than 7 days of IFN treatment or 2 days after TNF
      administration). While the T1 relaxation behavior could be unequivocally
      correlated with the presence of necrotic areas in these tumors, it could not be
      considered as an early marker of the altered growth capability, induced by
      administration of either IFN or TNF.

PMID- 1734174
TI  - On the precision of diffusion/perfusion imaging by gradient sensitization.
AB  - Computer simulation is used to assess the precision and accuracy of diffusion and
      perfusion parameters derived from a set of gradient-sensitized images. Under
      ideal experimental conditions, a moderate signal-to-noise level (ca. 40) suffices
      to estimate diffusion coefficients to within 20% relative precision. However,
      estimation of a typical cerebral perfusion fraction of 5% to within 20% relative
      precision requires signal-to-noise levels of ca. 400. Simulations also show that
      systematic errors in perfusion fraction estimation, as well as underestimation of
      the uncertainties in perfusion parameters (by chi-squared analysis), will be
      found at moderate signal-to-noise levels.

PMID- 1734175
TI  - Contrast-to-noise ratios in maximum intensity projection images.
AB  - We present a statistical analysis of the maximum intensity projection (MIP)
      algorithm, which is commonly used for MR angiography (MRA). The analysis explains
      why MIP projection images display as much as a twofold increase in signal- and
      contrast-to-noise ratios over those of the source image set. This behavior is
      demonstrated with simulations and in phantom and MRA image sets.

PMID- 1734176
TI  - "One-shot" velocity microscopy: NMR imaging of motion using a single phase
      encoding step.
AB  - The use of the pulsed gradient spin-echo sequence in NMR microscopy enables the
      measurement of molecular translational motion and simultaneous construction of
      velocity and self-diffusion images, a technique that has been termed dynamic NMR
      microscopy. In this method the PGSE contrast gradient is stepped in a fourth
      dimension (q space) and so is inherently inefficient. Provided that one is
      prepared to sacrifice some of the additional information provided by the multiple
      PGSE gradient approach, it is possible to construct a velocity image alone by
      means of a single PGSE phase-encoding step. We illustrate applications of this
      method in which a signal from the stationary spins is nulled by the use of both
      gradient phase cycling and a final "z-storage" rf pulse. The limits to velocity
      resolution are around 10 microns s-1 in free water but can be considerably
      smaller for molecules with a low self-diffusion coefficient. We demonstrate this
      method in a study of water capillary flow at 12 microns transverse pixel
      resolution, extending the velocity range by employing a four-quadrant analysis
      method. This method is also used to measure vascular transport in a living plant
      and find a flow rate of around 45 microns s-1.

PMID- 1734177
TI  - Formulation of radiographically detectable gastrointestinal contrast agents for
      magnetic resonance imaging: effects of a barium sulfate additive on MR contrast
      agent effectiveness.
AB  - Complete and homogeneous distribution of gastrointestinal (GI) contrast media are
      important factors for their effective use in computed tomography as well as in
      magnetic resonance (MR) imaging. A radiographic method (using fluoroscopy or spot
      films) could be effective for monitoring intestinal filling with GI contrast
      agents for MR imaging (GICMR), but it would require the addition of a radiopaque
      agent to most GICMR. This study was conducted to determine the minimum amount of
      barium additive necessary to be radiographically visible and to evaluate whether
      this additive influences the signal characteristics of the GICMR. A variety of
      barium sulfate preparations (3-12% wt/vol) were tested in dogs to determine the
      minimum quantity needed to make the administered agent visible during fluoroscopy
      and on abdominal radiographs. Solutions of 10 different potential GI contrast
      agents (Gd-DTPA, ferric ammonium citrate, Mn-DPDP, chromium-EDTA, gadolinium
      oxalate, ferrite particles, water, mineral oil, lipid emulsion, and
      methylcellulose) were prepared without ("nondoped") and with ("doped") the barium
      sulfate additive. MR images of the solutions in tubes were obtained at 0.38 T
      using 10 different spin-echo pulse sequences. Region of interest (ROI)
      measurements of contrast agent signal intensity (SI) were made. In addition, for
      the paramagnetic contrast media, the longitudinal and transverse relaxivity (R1
      and R2) were measured. A 6% wt/vol suspension of barium was the smallest
      concentration yielding adequate radiopacity in the GI tract. Except for
      gadolinium-oxalate, there was no statistically significant difference in SI for
      doped and non-doped solutions with most pulse sequences used. In addition, the
      doped and nondoped solutions yielded R1 and R2 values which were comparable. We
      conclude that barium sulfate 6% wt/vol added to MR contrast agents produces a
      suspension with sufficient radiodensity to be viewed radiographically, and it
      does not cause significant alteration in the MR signal appearance of most GICMR.
      These formulations can be useful for achieving optimal filling of the
      gastrointestinal tract prior to MRI.

PMID- 1734178
TI  - Diffusion imaging of the human brain in vivo using high-speed STEAM MRI.
AB  - This paper describes a new method for diffusion imaging of the human brain in
      vivo that is based on a combination of diffusion-encoding gradients with high
      speed STEAM MR imaging. The single-shot sequence 90 degrees-TE/2-90 degrees-TM
      (alpha-TE/2-STE)n generates n = 32-64 differently phase-encoded stimulated echoes
      STE yielding image acquisition times of 576 ms for a 48 x 128 data matrix.
      Diffusion encoding is performed during the first TE/2-interval as well as during
      each readout period. Phantom studies reveal a quantitative agreement of
      calculated diffusion coefficients with literature values. EKG triggering
      completely eliminates motion artifacts from diffusion-weighted single-shot STEAM
      images of human brain in vivo. While signal attenuation of the cerebrospinal
      fluid (CSF) is predominantly due to flow, that observed for gray and white matter
      results from diffusion. Evaluated diffusion coefficients yield (1.0 +/- 0.1) x
      10(-5) cm2 s-1 for gray matter, (0.5 +/- 0.1) x 10(-5) cm2 s-1 for white matter
      with the diffusion encoding parallel to the main orientation of the myelin sheath
      of the neurofibrils, and (0.3 +/- 0.1) x 10(-5) cm2 s-1 for white matter and a
      perpendicular orientation. All studies were performed at 2.0 T using a
      conventional 10 mT m-1 gradient system.

PMID- 1734179
TI  - Reduction of susceptibility artifact in gradient-echo imaging.
AB  - A new technique with which susceptibility artifact in gradient-echo imaging can
      be reduced substantially by use of a tailored RF pulse is described. The proposed
      technique can ideally be applied to the case where high local magnetic field
      inhomogeneity is dominated by the susceptibility. The signal loss and void
      phenomena due to susceptibility in a voxel are studied and a correction method is
      also proposed. The description of the tailored RF pulse and its proposed
      application are given and experimental results obtained using a human volunteer
      with a 2.0-T KAIS NMR system are presented.

PMID- 1734180
TI  - Hypercarbia-induced changes in cerebral blood volume in the cat: a 1H MRI and
      intravascular contrast agent study.
AB  - Cerebral blood volume changes with arterial carbon dioxide were monitored by
      proton T1-weighted MR images following administration of the intravascular
      contrast agent Gd-DTPA labeled with human serum albumin. Without MR contrast, no
      significant image intensity changes were observed with PaCO2. Following contrast,
      regional brain image intensities increased significantly over control (0%
      inspired CO2) in cortical gray, white, and basal ganglia regions with increasing
      PaCO2 and returned to control intensities upon return to 0% inspired CO2. Imaging
      of through-plane and in-plane phantoms was performed to assess flow effects.
      Signal losses of 2 and 6% (relative to no flow) were observed for bulk velocities
      of 5 mm/s at TE values of 15 ms. An intravascular contrast agent may be useful
      for MRI monitoring of local cerebral blood volume changes during cerebral
      perturbations.

PMID- 1734181
TI  - In vivo 1H and 31P NMR spectroscopy of the developing rat brain.
AB  - The biochemical changes associated with brain maturation during the first 28 days
      postnatal were investigated utilizing proton and phosphorus-31 nuclear magnetic
      resonance spectroscopy in rat pups in vivo. Phosphocreatine was found to increase
      linearly during this period of development. Phosphomonoester was high at birth,
      peaked around the 10th day postnatal, and declined thereafter. N-Acetyl-aspartate
      was low at birth, increased in an approximately linear fashion, and reached adult
      levels by about Day 28 postnatal. Choline was high at birth and declined
      thereafter. Taurine, a sulfur amino acid abundant in fetal brain, was also
      present in high levels on the first day postnatal.

PMID- 1734182
TI  - Perfusion imaging.
AB  - Measurement of tissue perfusion is important for the functional assessment of
      organs in vivo. Here we report the use of 1H NMR imaging to generate perfusion
      maps in the rat brain at 4.7 T. Blood water flowing to the brain is saturated in
      the neck region with a slice-selective saturation imaging sequence, creating an
      endogenous tracer in the form of proximally saturated spins. Because proton T1
      times are relatively long, particularly at high field strengths, saturated spins
      exchange with bulk water in the brain and a steady state is created where the
      regional concentration of saturated spins is determined by the regional blood
      flow and regional T1. Distal saturation applied equidistantly outside the brain
      serves as a control for effects of the saturation pulses. Average cerebral blood
      flow in normocapnic rat brain under halothane anesthesia was determined to be 105
      +/- 16 cc.100 g-1.min-1 (mean +/- SEM, n = 3), in good agreement with values
      reported in the literature, and was sensitive to increases in arterial pCO2. This
      technique allows regional perfusion maps to be measured noninvasively, with the
      resolution of 1H MRI, and should be readily applicable to human studies.

PMID- 1734183
TI  - In vivo phosphorus NMR spectroscopy of skin using a crossover surface coil.
AB  - A modified crossover surface coil with minimal B1 field penetration was used for
      collection of skin phosphorus NMR spectra. Projection imaging experiments show
      that the coil-sensitive volume is uniform at the phosphorus frequency, but
      strikingly nonuniform at the proton frequency. Experiments with an in vitro
      phosphorus phantom, designed to simulate skin and underlying tissue, demonstrated
      that 45.1% (+/- 1.2%) of total signal was derived from Sprague-Dawley rat skin
      and 19.3% (+/- 1.4%) of total signal was derived from Fischer-344 rat skin. 31P
      MR spectra of rat skin in vivo permitted resolution of four phosphorus compounds:
      nucleoside triphosphates, phosphocreatine (PCr), inorganic phosphate (Pi), and
      phosphomonoester. Spectra collected after skin flap surgery in Fischer-344 rats
      showed a 50.1% (+/- 7.6%) reduction in the ratio of PCr/Pi within 30 min of
      surgery, compared to presurgical PCr/Pi levels (P less than 0.01). Skin
      phosphorus spectra are potentially useful for assessment of skin flap and skin
      graft viability.

PMID- 1734184
TI  - Multispectral analysis of uterine corpus tumors in magnetic resonance imaging.
AB  - The goal of this prospective study was to evaluate multispectral analysis
      techniques for automatic recognition of uterine cancer in magnetic resonance (MR)
      imaging. The first part of this study was an open training phase in which the
      statistical parameters of the various normal and pathological tissue types were
      estimated. This was followed by a test phase that was done as a blind experiment.
      Results from an extensive pathological examination of the surgically removed
      organs served as the reference for the diagnosis and various geometric
      measurements of the lesions. A radiological examination of the MR images was also
      performed. All malignant test tumors were correctly or close to correctly
      classified. However, parts of normal endometrium and other mucosal linings were
      also classified as adenocarcinomas. In addition, parts of some of the malignant
      tumors were classified as normal endometrium. The geometrical extension of the
      tumor and its relationship to the surroundings were slightly better predicted
      than those obtained by the radiologist. The results indicate that it is possible
      to differentiate and determine the local extension of some types of uterine
      malignancies based on the information present in MR images.

PMID- 1734185
TI  - NMR relaxation times in acute myocardial infarction: relative influence of
      changes in tissue water and fat content.
AB  - Tissue changes known to occur with acute myocardial infarction include increases
      in tissue water and lipid content. We sought to evaluate the relative
      contribution of alterations in tissue water and fat content to the changes of T1
      and T2 relaxation times with infarction. Nine mongrel dogs underwent coronary
      artery occlusion for 6-12 h. T1 and T2 at 20 MHz and tissue water and fat content
      of normal and infarcted tissue were measured. Tissue water content, T1, and T2
      were significantly greater in infarcted myocardium compared to normal (P less
      than 0.05). Tissue fat content, while not significantly different, increased
      linearly in infarcted samples as a function of duration of ischemia (r = 0.77).
      Despite this increase in fat content, only tissue water content was significantly
      linearly related to T1 (r = 0.97) and T2 (r = 0.91). Increases in T1 and T2 of
      infarcted tissue appeared to be most significantly influenced by changes in
      tissue water content. While total tissue fat content increased with duration of
      ischemia, it did not appear to significantly alter T1 or T2.

PMID- 1734186
TI  - Spatially localized in vivo 1H magnetic resonance spectroscopy of an
      intracerebral rat glioma.
AB  - Surface coil MRI combined with spatially localized spectroscopy was used to
      noninvasively detect 1H signals from metabolites within an intracerebral
      malignant glioma in rats. The MRS pulse sequence was based upon two-dimensional
      ISIS, which restricted 1H signals to a column-shaped volume, combined with one
      dimensional spectroscopic imaging, which further resolved the signals into 8 or
      16 slices along the major axis of the column. All experiments were executed with
      adiabatic pulses which induced uniform spin excitation despite the inhomogeneous
      radiofrequency field distribution produced by the surface coil transmitter.
      Surface coil MRI and MRS experiments were performed on phantom samples, normal
      rat brains, and rat brains harboring malignant gliomas. Spatially resolved in
      vivo 1H spectra of intracerebral gliomas revealed significantly decreased
      concentrations of N-acetyl-aspartate and creatine and increased lactic acid (or
      lipids) as compared to the contralateral hemisphere. These results demonstrate
      that metabolic abnormalities in intracerebral rat gliomas can be spatially
      resolved in a noninvasive manner using localized in vivo 1H MRS.

PMID- 1734187
TI  - General practitioner databases in Australia.
AB  - OBJECTIVE: General practitioner-based research has been hampered by the poorly
      defined database and the cost of continuous updating of lists of practitioners.
      Little is known about the general practitioner workforce. Fresh awareness by
      health planners of the serious maldistribution of general practitioners has
      heightened the need for workforce planning. Integral to this is the availability
      of an accurate listing of general practitioners. DATA SOURCES: A CD-ROM Medline
      review of all surveys involving general practitioners which were conducted in
      Australia in the period 1983-1990 was performed. All general practitioner
      listings still existing at the end of the decade were identified. STUDY
      SELECTION: Nine listings considered for use as general practitioner databases.
      DATA EXTRACTION: Each listing was assessed in six ways--quality of information
      provided, availability for research purposes, cost, potential to provide the
      correct postal address, ability to identify general practitioners in active
      practice and comparative advantage over other lists. DATA SYNTHESIS: Each listing
      has limitations and advantages, with individual peculiarities and variable
      information relating to identifying characteristics of general practitioners.
      None was specifically created for research or workforce planning purposes. The
      Medical Provider File (formerly called the Central Register of Medical
      Practitioners) was the most used list. CONCLUSIONS: We propose a framework for
      the ideal database and avenues for its development.

PMID- 1734188
TI  - Resistance to ciprofloxacin of respiratory pathogens in patients with cystic
      fibrosis.
AB  - OBJECTIVE: To determine the incidence of resistance to ciprofloxacin in
      respiratory pathogens isolated from patients with cystic fibrosis (CF) compared
      with that of isolates from patients without CF. The hypothesis was that repeated
      exposure of these respiratory pathogens to ciprofloxacin would reduce their
      sensitivity. DESIGN: Isolates of Pseudomonas aeruginosa and Staphylococcus aureus
      were obtained prospectively from sputa of patients with CF, as part of their
      routine care. The sensitivities of these isolates to ciprofloxacin were
      determined by standard agar dilution techniques. SETTING AND PATIENTS: The study
      was carried out in patients who attended the outpatient clinic or were treated as
      inpatients of a tertiary referral hospital. Sputa were obtained from 71 patients
      with CF (age range, 2-31 years) and isolates of P. aeruginosa and S. aureus were
      compared with those from 54 hospital patients who did not have CF. OUTCOME
      MEASURES: Sensitivities to ciprofloxacin, expressed as the minimal concentrations
      required to inhibit growth of the organisms (MIC), were used to make comparisons
      between different isolates and the same isolates within patients at different
      times. RESULTS: A higher incidence of ciprofloxacin resistance was displayed by
      isolates of P. aeruginosa from CF patients who had been previously prescribed
      ciprofloxacin (MIC50 of 2.0 mg/L and 4.0 mg/L for mucoid and non-mucoid strains
      respectively). The MIC of individual organisms tended to rise after a course of
      ciprofloxacin had been given to their host. A much lower incidence of resistance
      was displayed by isolates of P. aeruginosa from patients without CF (MIC50, 0.25
      mg/L). Similarly, S. aureus isolates from patients with CF exhibited greater
      resistance to ciprofloxacin (MIC50, 32 mg/L) than isolates from other patients
      (MIC50, 0.75 mg/L). CONCLUSION: The resistance of P. aeruginosa appears to be
      related to ciprofloxacin exposure, so further development of resistance may be
      diminished by restricting the frequency of ciprofloxacin administration to
      individual patients.

PMID- 1734190
TI  - Recent developments in radiotherapy.

PMID- 1734189
TI  - Strongyloidiasis in North Queensland: re-emergence of a forgotten risk group?
AB  - OBJECTIVE: To describe the clinical presentation, diagnosis and management of
      strongyloidiasis in northern Queensland, and to identify predisposing factors for
      this infection. DESIGN: A five-year retrospective study of medical records of all
      cases diagnosed in a regional hospital microbiology laboratory, with follow-up by
      interview where possible. SETTING: The Townsville General Hospital. PATIENTS: A
      total of 14 cases of strongyloidiasis were identified, with patients ranging in
      age from 7 months to 59 years. RESULTS: Infected patients included nine
      Aborigines and two Vietnamese refugees, both high-risk groups. Of three
      Caucasians diagnosed, one was a war veteran, but the other two did not have
      significant travel histories; all three had lived or worked under insanitary
      conditions. In only one case was strongyloidiasis suspected; in most, it was
      diagnosed because of diarrhoea or blood eosinophilia which could not be related
      to the presenting illness. Thiabendazole treatment was effective in most cases.
      CONCLUSION: In northern Australia, strongyloidiasis can be acquired locally by
      Caucasians who live in unhygienic circumstances. It should be suspected in any
      person with unexplained abdominal pain, diarrhoea, cutaneous symptoms or blood
      eosinophilia, and the laboratory must be informed of the provisional diagnosis.

PMID- 1734191
TI  - Meta-analysis. Part 1: An assessment of its aims, validity and reliability.

PMID- 1734192
TI  - General practice financing: report of a "think tank".

PMID- 1734193
TI  - Sodium and blood pressure revisited.

PMID- 1734194
TI  - Drug and alcohol related health problems in primary care--what do GPs think?
AB  - OBJECTIVE: To examine knowledge, attitudes and beliefs of general practitioners
      (GPs) in the field of drug and alcohol related health problems. DESIGN: A cross
      sectional survey in which self-completion postal questionnaires were sent to all
      identifiable GPs in the Adelaide metropolitan area. Non-responders received a
      reminder letter and second questionnaire. SETTING, PARTICIPANTS: The target
      population was doctors whose principal activity was general practice, or who were
      in training for general practice. MAIN OUTCOME MEASURES: Demographic and
      "practice characteristic" information on participants. Measures of knowledge,
      attitudes and beliefs regarding alcohol consumption, smoking and over the counter
      medication. RESULTS: The response rate was 59.8%. More responders than non
      responders were affiliated with the Royal Australian College of General
      Practitioners. Alcohol consumption was perceived to be a more difficult issue
      than smoking to raise during consultations. GPs indicated that significant
      proportions of their patients were participating in hazardous drinking (mean
      estimate was 13.8% of patients), but only a third of respondents believed their
      effort in changing alcohol related behaviour would be effective. Sixty-one per
      cent of respondents identified hazardous daily levels of alcohol consumption for
      men consistent with National Health and Medical Research Council guidelines. In
      the case of women this figure was 42%. Longer reported appointment times were
      associated with greater reported levels of enquiry about alcohol consumption.
      CONCLUSIONS: New developments in medical training and systems of payment in
      general practice need to address both the pessimistic attitude of GPs in dealing
      with drug and alcohol related health problems, and apparent inconsistencies in
      defining hazardous alcohol consumption.

PMID- 1734195
TI  - The role of corticosteroids in the management of childhood asthma. The Thoracic
      Society of Australia and New Zealand.
AB  - OBJECTIVE: To formulate recommendations for the role of corticosteroid therapy in
      the management of childhood asthma. DATA SOURCES: The recommendations are based
      on a review of the available literature and a variety of review articles on the
      efficacy and safety of corticosteroid therapy supplemented by personal experience
      in managing children with asthma. DATA SYNTHESIS: 1. Preventive therapy. Sodium
      cromoglycate should be considered first-line treatment. Inhaled corticosteroids
      are indicated in children who fail to achieve control on this therapy or those
      with severe disease. An initial dosage of 400-600 micrograms/day is recommended
      with subsequent variation in dosage related to clinical response. Large volume
      spacers can be used to improve aerosol delivery and minimise side effects.
      Indications for specialist assessment include: use of inhaled corticosteroids in
      children under 3 years of age; the requirement for high dose therapy (greater
      than 600 micrograms/day); or the need for regular oral corticosteroids. 2. Acute
      severe asthma. Systemic corticosteroid therapy is a valuable adjunct in the
      treatment of acute severe asthma and can be used safely in the short term. The
      efficacy of high dose inhaled corticosteroids in the management of acute severe
      asthma requires further evaluation. The need for systemic corticosteroid therapy
      signals the need for reassessment of that child's usual maintenance therapy.
      CONCLUSION: These recommendations are presented as a guide to the use of
      corticosteroid therapy in childhood asthma. In the individual child, the benefits
      of therapy need to be weighted against the possible risks, with the aim of
      maintaining good asthma control with the minimum dose of corticosteroid.

PMID- 1734196
TI  - Unexplained severe renal failure.

PMID- 1734197
TI  - The billion dollar question: can incontinence be reduced in nursing homes?

PMID- 1734198
TI  - Supply of organs for transplantation.

PMID- 1734200
TI  - Mammography is fallible.

PMID- 1734199
TI  - Illness associated with blue-green algae.

PMID- 1734201
TI  - Sodium valproate and oedema.

PMID- 1734202
TI  - Imipramine in primary nocturnal enuresis and the value of blood level
      measurements.

PMID- 1734203
TI  - Community acquired Flavobacterium meningosepticum pneumonia and septicaemia.

PMID- 1734204
TI  - Renal calculi and lithotripsy.

PMID- 1734205
TI  - Drug availability revisited: notification of clinical trials.

PMID- 1734206
TI  - Treatment of bipolar disorder.

PMID- 1734207
TI  - Smoking--another cause of palmar erythema?

PMID- 1734208
TI  - The physician as patient.

PMID- 1734209
TI  - The physician as parent of patient.

PMID- 1734210
TI  - Accuracy of mortality rates for livebirths 500-999 g birthweight.

PMID- 1734211
TI  - Paracetamol syrup induced diarrhoea.

PMID- 1734212
TI  - The first five years' clinical experience of the Australian National Liver
      Transplantation Unit.
AB  - OBJECTIVE: To report the first five years' clinical experience of the Australian
      National Liver Transplant Unit. PATIENTS: Three hundred and seventy patients were
      referred--292 adults (79%) and 78 children (21%). The major causes of liver
      failure in the adults were chronic active hepatitis (25%), primary biliary
      cirrhosis (12%), primary sclerosing cholangitis (12%), alcoholic cirrhosis (9%)
      and malignancy (9%). Ten per cent of patients were referred in fulminant hepatic
      failure. In children, the major causes were biliary atresia (40%) and inborn
      errors in metabolism (27%). RESULTS: Two hundred and sixty-three patients (71%)
      were accepted for transplantation. Of 158 (43%) accepted for early
      transplantation, 22 (14%) died before a donor became available. Four hundred and
      forty-three suitable organ donors were referred. One hundred and twenty-six
      patients, including 32 children (25%), received 137 grafts. Three patients with
      renal failure due to hyperoxaluria type 1 received concurrent renal grafts.
      Ninety-two patients survived (73%). For all recipients, one-year survival was
      75%. Two, three and four-year survivals were 69%. One to four-year survivals for
      adults with benign conditions were 77%, contrasting with results for those with
      hepatic malignancy (40% one-year survival). Children weighing more than 8 kg had
      good outcomes whether they received whole grafts or reduced-size grafts (83% one
      to five-year survival in both cases). Infants weighing less than 8 kg who
      received reduced adult grafts did significantly worse (37% one to-five year
      survival, P less than 0.05). Thirteen (87%) of 15 patients with fulminant hepatic
      failure who received grafts survived. Five of these patients were given ABO
      incompatible grafts and two subsequently required retransplantation. All three
      patients with concurrent renal and hepatic grafts survived. Rehabilitation of
      survivors was excellent with 95% of adults and 100% of children pursuing normal
      activities. Only three grafts (2%) failed with primary non-function, all in
      infants because of graft infarction. Graft survival was significantly worse (P
      less than 0.01) in patients with a positive result to a direct cross match test
      against the donor. CONCLUSIONS: The need for liver transplantation in Australia
      is approximately eight per million of population per year. More donor offers are
      required to prevent deaths of patients on the waiting list. Reduced-size livers
      are successful for children and have alleviated considerably the critical
      shortage of paediatric donor livers. Successful treatment by liver
      transplantation can now be achieved in more than 80% of patients with non
      malignant liver disorders including those with fulminant hepatic failure not
      responding to conservative therapy.

PMID- 1734213
TI  - Survival in Hodgkin's disease by stage and age.
AB  - Patterns of care for Hodgkin's disease in the United States were surveyed through
      voluntary audits of hospitals with cancer programs nonapproved and approved by
      the Cancer Commission of the American College of Surgeons. Four hundred and
      seventy-three hospitals reported 6,345 patients diagnosed immediately preceding
      December 31, 1975. The survival rates varied with age, being better at younger
      ages and worse in the elderly. By pathologic stage, the younger patients faired
      better than the elderly in each stage grouping. Histologic type was not a factor
      in this poor prognosis. Hodgkin's disease in elderly patients has a different
      biologic behavior than in younger patients.

PMID- 1734214
TI  - Results of the LMT81 protocol, a modified LSA2L2 protocol with high dose
      methotrexate, on 84 children with non-B-cell (lymphoblastic) lymphoma.
AB  - From May 1981 to June 1989, 84 children with non-B-cell lymphoma (82
      lymphoblastic, 1 T-cell immunoblastic, 1 unclassified diffuse lymphoma) were
      treated in the pediatric department of the Institut Gustave Roussy according to a
      protocol called LMT81, which was derived from the LSA2L2 protocol of Wollner and
      modified by the adjunction of 10 courses of high dose methotrexate to improve the
      CNS prophylaxis. No planned irradiation was performed except in cases of initial
      tests (2 patients) or CNS (5 patients) involvement and residual mass (2
      patients). Sixty patients had mediastinal involvement; for the others, primaries
      were in the head and neck (7), nodes (2), (sub)cutaneous (4), bone (7), and
      elsewhere (2). According to Murphy's staging system, there were 2 stage I, 6
      stage II, 33 stage III, and 43 stage IV. Among the stage IV patients, 41 had bone
      marrow involvement, 24 of them with more than 25% blast cells in bone marrow and
      19 with blast cells in blood; 7 had CNS involvement. Three patients did not
      achieve complete remission, 4 died in remission (two measles, one post
      transfusion AIDS, one unexplained definitive aplasia) and 13 relapsed at 2 to 29
      months (median-13 months). Among the 77 patients without initial CNS involvement,
      there was only one isolated CNS relapse. With a median follow-up of 57 months (10
      106 months), the event-free survival is 75% (SE 2.5) for the 84 patients with a
      plateau at 29 months, 73% (SE 8) for stage I and II patients, 79% (SE 4) for
      stage III, and 72% (SE 4) for stage IV patients. Survival was similar in each
      stage group. Reasons for failure of treatment, however, were different, being
      toxic deaths in stage II; initial therapy resistance, early relapses, and toxic
      deaths in stage III; and tumor failures in stage IV. In conclusion, this protocol
      is efficacious on T and non-T, non-B childhood lymphoma with a low incidence of
      CNS relapse. A future study will seek to diminish toxicity and long-term
      sequellae while at least maintaining the same cure rate of patients.

PMID- 1734215
TI  - Soft-tissue sarcomas other than rhabdomyosarcoma in children.
AB  - Forty-seven children with nonrhabdomyosarcomatous soft-tissue sarcomas (NRSTS)
      were treated by the Hematology-Oncology Service at Texas Children's Hospital,
      Houston, Texas, between 1958 and 1990. The male:female ratio was 1:1, and the
      median age was 11 years (3 weeks-16 years). A preexisting condition was found in
      9/47 (19%) patients including neurofibromatosis (3), Down's syndrome (1), spina
      bifida (1), congenital facial asymmetry (1), giant pigmented nevus (1), juvenile
      onset diabetes mellitus (1), and acquired immune deficiency syndrome (1). The
      site of primary tumor was head and neck (3), trunk (33), and extremities (11).
      Twenty-four patients (51%) have survived free of disease with a median follow-up
      of 5 years (4 months-22 years). No patient whose disease recurred achieved a
      second remission. Of the 19 patients with group I disease, 16 (84%) survived free
      of disease. Wide excision of the primary tumor, with no microscopic residual
      disease, was associated with the greatest chance of disease-free survival.

PMID- 1734216
TI  - High-dose methylprednisolone sodium succinate as a single agent in relapsed
      childhood acute lymphoblastic leukaemia.
AB  - Twenty children received methylprednisolone (1 g/m2), daily for 5 to 8 days, as
      initial single agent therapy for relapsed acute lymphoblastic leukaemia. Bone
      marrow blasts were reduced to less than 5% in 2 and 5-10% in 3 of 12 patients
      with bone marrow relapses. In 3/9 with central nervous system relapses the
      cerebrospinal fluid (CSF) blasts completely cleared and were reduced in 4 others.
      In two patients with testicular relapses there was shrinkage of tumour and one
      patient with a navicular bone relapse became pain free. Toxicity was minimal.
      These results indicate high-dose methylprednisolone is an effective agent,
      particularly in the treatment of established central nervous system (CNS) disease
      and could contribute to early CNS directed therapy in acute lymphoblastic
      leukaemia.

PMID- 1734217
TI  - Determination of the maximum tolerated dose of idarubicin when used in a
      combination chemotherapy program of reinduction of childhood ALL at first marrow
      relapse and a preliminary assessment of toxicity compared to that of
      daunorubicin: a report from the Childrens Cancer Study Group.
AB  - An escalating-dose trial of idarubicin, used weekly for 3 doses in combination
      with vincristine, prednisone, and L-asparaginase (VPLI), to reinduce remission of
      childhood ALL at first bone marrow relapse was conducted by the Childrens Cancer
      Study Group (CCSG). The maximum tolerated dose (MTD) of idarubicin, used in the
      manner, was determined to be 12.5 mg/m2/dose. Twelve of 16 (75%) evaluable
      patients in first marrow relapse of ALL treated at a dose of 10 or 12.5 mg/m2
      entered a second complete remission, compared to 41 of 69 evaluable patients
      (59%) treated in a comparable way with daunorubicin (30 mg/m2) (VPLD). Prolonged
      myelosuppression was observed in both groups, but the frequency of documented
      bacterial sepsis and the duration of required hospitalization were greater among
      patients treated with idarubicin. No additional toxicity, specifically
      attributable to idarubicin, was observed at these doses.

PMID- 1734218
TI  - Value of cytogenetics in the differential diagnosis of the small round cell
      tumors of childhood.
AB  - Small round cell tumors are among the most common problems in the differential
      diagnosis of cancer, even when more sophisticated histological techniques are
      utilized (Ezinger and Weiss: In Soft Tissue Tumors. St. Louis: CV Mosby, 1988, pp
      668-683). Six cases of small round cell tumors are described the diagnosis of
      which was particularly difficult. Cytogenetic analysis provided useful
      information in all of them in making the definitive diagnosis. The reported cases
      stress the value of cytogenetic methods in approaching difficult diagnostic
      problems.

PMID- 1734219
TI  - Seizures and cortical dysfunction following high-dose cisplatin administration in
      children.
AB  - Four of eight children with advanced neuroblastoma treated with a rapid delivery
      high dose intensity cisplatin based regimen developed acute neurological
      toxicity. Three had seizures and one developed transient blindness. In the
      absence of other causes it seems probable that high dose cisplatin (200 mg/m2) as
      a continuous infusion over five days followed 10 days later by 80 mg/m2 infused
      over 48 hours was responsible. Other risk factors included an associated
      deterioration in renal function and neutropenia related fever.

PMID- 1734220
TI  - Neuroblastoma with intracranial involvement: an ENSG Study.
AB  - We report the experience of the European Neuroblastoma Study Group (ENSG) with
      central nervous system (CNS) involvement of neuroblastoma. Among this series of
      intensively treated patients, CNS neuroblastoma was diagnosed by computerised
      tomography (CT) scanning, rather than by autopsy. Cranial disease occurred in 5%
      of ENSG patients. Of 11 patients with intracranial disease, 4 had disease in the
      posterior fossa, a site rarely reported previously. Furthermore, 5 cases had CNS
      metastases at a time when there was no detectable disease elsewhere, rather than
      as part of extensive relapse. The pattern of disease we observed, at least for
      those with parenchymal disease, is in keeping with arterial spread. Although CT
      scanning is the optimal modality for identifying CNS disease, 2 cases had normal
      head CT scans prior to the onset of CNS disease. As most patients had symptoms of
      raised intracranial pressure (RICP) at the time the CNS disease was diagnosed,
      there does not seem to be any indication for routine CT scanning of the head at
      diagnosis, but this should be performed as soon as any symptoms or signs appear.
      With patients living longer with their disease, vigilance must be maintained
      during follow-up.

PMID- 1734221
TI  - Neuroblastoma diagnosed antenatally: a treatment dilemma with implications for
      screening.

PMID- 1734222
TI  - The unique association of malignant histiocytosis and a primary gonadal germ cell
      tumor.
AB  - Previous reports of the association between hematologic malignancies and germ
      cell tumors have been limited to patients with nonseminomatous tumors,
      exclusively of mediastinal origin. Among the various hematologic disorders, a
      large proportion have involved histiocytic tumors, either acute monocytic
      leukemia or malignant histiocytosis. We now report the first case of
      simultaneously occurring malignant histiocytosis and testicular embryonal
      carcinoma. The patient, an 18-year-old male, presented with hepatosplenomegaly
      due to malignant histiocytosis and was found on further evaluation to have a
      stage I testicular cancer consisting of teratocarcinoma with endodermal sinus
      elements. Despite aggressive chemotherapy, the patient died of malignant
      histiocytosis 6 months after the original diagnosis. The autopsy revealed
      widespread organ involvement with malignant histiocytosis and no evidence of
      residual germ cell tumor. This case demonstrates that germ cell tumors associated
      with hematologic malignancy do not arise solely in extragonadal sites.

PMID- 1734223
TI  - Isolated breast relapse after allogeneic bone marrow transplantation for
      childhood acute lymphoblastic leukemia.
AB  - Unusual sites of relapses following bone marrow transplantation (BMT) for
      childhood acute lymphoblastic leukemia (ALL) are rarely reported. We report the
      case of a 16-year-old girl who presented with an isolated right breast relapse 8
      months after allogeneic BMT for ALL in second remission. Biopsy showed an ALL
      infiltrate. Bone marrow and CSF were normal. The girl never showed before
      extramedullary involvement. She was treated with local radiotherapy and mild
      systemic chemotherapy. Nine months after breast relapse, she presented an
      isolated central nervous system relapse. The treatment of isolated extramedullary
      relapses following BMT is still controversial.

PMID- 1734224
TI  - Benign cystic mesothelioma of the peritoneum: the occurrence of an adult entity
      in a child.
AB  - Benign cystic mesothelioma of the peritoneum is considered a disease of adulthood
      occurring predominantly in women. We report a case of benign cystic mesothelioma
      of the peritoneum in an 11-year-old boy. The innumerable cystic lesions that
      varied in size occupied the entire peritoneal cavity. He underwent two
      laparotomies in a period of 15 months during which a partial removal of the tumor
      was performed. Four years after the second operation the child is well and
      active, despite significant tumor tissue left behind after the first two
      operations. The management of this disease is discussed, and the importance of a
      conservative approach minimizing the number of laparotomies and avoiding radical
      surgical intervention especially in childhood is emphasized.

PMID- 1734225
TI  - Decrease in childhood neuroblastoma death in Japan. Response to Dr. Cole et al.

PMID- 1734226
TI  - Cigarette smoking bans in county jails--Wisconsin, 1991.
AB  - In the United States, an increasing number of prisons and jails are adopting
      restrictions on cigarette smoking (1,2); these restrictions could affect
      approximately 10 million inmates (3). Although the importance of smoking
      restrictions in the workplace and some public places (e.g., health-care
      facilities, schools, and public transportation) has been well described (4),
      information about smoking restrictions in jails is limited. This report
      summarizes preliminary findings from a survey of sheriffs in Wisconsin to assess
      the development of policies and to characterize smoking restrictions among county
      jails in the state.

PMID- 1734227
TI  - Retrospective assessment of vaccination coverage among school-aged children-
      selected U.S. cities, 1991.
AB  - Preschool-aged children are at increased risk for vaccine-preventable diseases;
      outbreaks of these diseases in this age group occur predominantly among
      unvaccinated children (1). In the United States, vaccination rates of individual
      antigens required for children at the time they enter school are greater than
      95%; however, vaccination rates for children at their second birthday are
      substantially lower (2) despite recommendations by the Immunization Practices
      Advisory Committee (ACIP) and the American Academy of Pediatrics that all
      children complete a schedule of vaccination by age 15-18 months.* To
      retrospectively assess vaccination levels among school-aged children at their
      second birthday, CDC, in collaboration with state and local health departments,
      is conducting surveys of vaccination levels among children entering school who
      reside in the 60 largest U.S. cities. This report presents findings from surveys
      completed in nine cities during 1991.

PMID- 1734228
TI  - Public health assessment--Russian Federation, 1992.
AB  - On December 25, 1991, the Russian Federation became an independent republic, and
      on January 2, 1992, restrictions on retail prices of most commodities were
      removed. From January 16 through February 6, a multidisciplinary team from the
      U.S. Food and Humanitarian Assistance Bureau (FHA) conducted an assessment of the
      needs for humanitarian and technical assistance, focusing on three regions in the
      southern Ural Mountains-Yekaterinburg, Perm, and Cheliabinsk-and three regions in
      south-central Siberia-Kusbas, Tomsk, and Novosibirsk. The FHA assessment included
      observations of health facilities, vaccine- and drug-storage centers, and disease
      control programs; review of health data at central, regional, and district
      epidemiology stations; and collection of food-price and income data through
      interviews with administrative authorities and surveys of markets and private
      homes. This report summarizes findings from the assessment.

PMID- 1734229
TI  - Physical fighting among high school students--United States, 1990.
AB  - During 1986, interpersonal violence caused an estimated 2.2 million injuries and
      more than 20,000 deaths in the United States. Physical fighting, a common form of
      interpersonal violence among adolescents, is a prominent cause of injuries and
      homicides in this age group. This article presents self-reported data about the
      prevalence and incidence of physical fighting among high school students in the
      United States during 1990.

PMID- 1734230
TI  - Street outreach for STD/HIV prevention--Colorado Springs, Colorado, 1987-1991.
AB  - Strategies to identify and influence persons at increased risk for infection with
      human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs)
      require outreach to provide prevention messages directly to persons at risk,
      assist them to obtain prevention services, and encourage them to reduce risks.
      Street outreach programs complement CDC's information and education campaign
      "America Responds to AIDS" by providing persons with specific risk-reduction
      messages and materials. This report describes efforts to implement such
      approaches in Colorado Springs, Colorado, and presents preliminary results
      regarding the prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis
      infections among female street prostitutes in that community.

PMID- 1734231
TI  - Lactic acidosis, ketoacidosis, and energy turnover: "figure" you made the correct
      diagnosis only when you have "counted" on it--quantitative analysis based on
      principles of metabolism.
AB  - Three cases are presented to illustrate that quantitative analysis based on
      physiologic principles can help resolve certain controversies in clinical
      medicine. For example, in case 1, a patient with severe hypoxia, the rate of
      production of lactic acid is so high that only restoration of delivery of oxygen
      is rational therapy. If the degree of hypoxia exceeds 5.6% of demand,
      dichloroacetate will not lessen the degree of acidosis. Further, even when
      delivery of oxygen is returned to normal, the rate of fall in lactate and rise in
      bicarbonate in plasma will be relatively slow. In case 2, a patient with diabetic
      ketoacidosis, our discussion stresses that the rate of production of ketoacids is
      not that rapid and that the degree of ketoacidosis is influenced to a major
      degree by decreasing the rate of oxidation of ketoacids in brain and kidneys.
      Case 3, a patient with severe hyperglycemia, illustrates that insulin will only
      promote the oxidation of glucose at a rapid rate once the levels of fatty acids
      and ketoacids decline to low levels. Accelerated transport of glucose by insulin
      is only a permissive action for the oxidation of glucose.

PMID- 1734232
TI  - Why kidneys fail.

PMID- 1734233
TI  - Environmental hazards and public health: lessons for the practice of medicine and
      for public policy.
AB  - The separation of occupational and environmental disease from the mainstream of
      medical practice has deep roots in the culture of the profession. Medical
      practice centered on individual patient care as nineteenth-century science
      yielded the therapeutic triumphs of the twentieth century. Social issues seemed
      remote to medical practitioners as the rewards of scientifically based therapies
      upstaged the unglamorous aspects of preventive medicine. Public health was left
      to politicians and bureaucrats. Victorian ambivalence toward the less successful
      members of society reinforced the isolation of medicine from public policy. As a
      consequence, physicians are largely ignored in contemporary debates about
      environmental hazards, to the detriment of both society and the profession.

PMID- 1734234
TI  - Diminished ratio of estrogen receptors to progesterone receptors in breast
      carcinomas of women who have had multiple miscarriages.
AB  - We examined the relationship of a history of miscarriage to the ratio of tumor
      estrogen receptors to progesterone receptors in 74 women with breast carcinoma
      evaluated between 1988 and 1990. Only women who had been pregnant and whose tumor
      contained both estrogen and progesterone receptors were included. Women with
      breast carcinoma and a history of two to four miscarriages had significantly
      lower ratios (less than 1) of tumor estrogen receptors to progesterone receptors
      than women with a history of zero or one miscarriage (greater than 1). This
      finding may be the result of a genetic anomaly in breast cancer patients that
      also affects the uterine environment during the reproductive years.

PMID- 1734235
TI  - The correlation between lupus anticoagulant and autoantibodies.
AB  - The presence of a positive lupus anticoagulant (LA) has recently been associated
      with reproductive failure. LA positivity and reproductive failure have also been
      associated with autoantibody abnormalities, especially antiphospholipid
      autoantibodies. Because the correlation between LA and autoantibody positivity
      has remained controversial, we retroactively investigated 326 sera of patients
      with reproductive failure for correlation between lupus anticoagulant and 15
      autoantibodies separately for IgG, IgM, and IgA isotypes. LA by TTI and APTT
      correlated significantly (p less than 0.0001). Among 18 antiphospholipid
      isotypes, 6 (33%) correlated significantly with TTI, 5 (28%) with APTT, and 3
      (17%) both with TTI and APTT. Among 15 isotypes to histone subfractions, 4 (27%)
      correlated significantly to TTI, 3 (20%) to APTT, and 2 (13%) to both LA assay
      methods. Of 12 isotypes to antipolynucleotide antibodies, 2 (17%) correlated
      significantly to TTI, 1 (8%) to APTT, and none to both assay methods. The
      correlation between LA and autoantibodies was less striking among LA-positive
      than LA-negative sera. LA by both TTI and APTT was primarily found to correlate
      with IgG and IgA autoantibodies. This occurs in decreasing frequency to
      phospholipids, histones, and polynucleotides. At abnormal levels of LA (by either
      method) the correlation with autoantibody levels is less pronounced and appears
      closer with IgM autoantibodies to histones and polynucleotides than antibodies to
      phospholipids. We conclude that the correlation between LA and autoantibodies,
      especially antiphospholipid antibodies, is less pronounced than often reported in
      the literature. Patients suspected to suffer from reproductive failure due to
      abnormal autoimmunity have to be screened not only with LA and/or selected
      antiphospholipid autoantibodies, but with a more comprehensive autoantibody
      profile.

PMID- 1734236
TI  - Intravenous fat emulsions and the pancreas: a review.
AB  - There is conflicting evidence of the effect of intravenous fat emulsions on
      pancreatic secretion. Intralipid is a safe component of intravenous nutritional
      support in patients with pancreatic fistulas, though it may minimally increase
      the volume, as well as the bicarbonate and amylase concentrations, of the output.
      Intravenous fat emulsions may rarely cause pancreatitis; this may be more likely
      in patients with Crohn's disease, given that three of the four reported cases
      occurred in patients with Crohn's disease. It is unclear whether
      hypertriglyceridemia secondary to the intravenous fat emulsion is a prerequisite
      for this complication to occur. Intravenous fat emulsions appear to be a safe
      component of intravenous nutritional support for the patient with pancreatitis,
      based on multiple studies proving their safety in a total of nearly 100 patients.
      It seems prudent to avoid hypertriglyceridemia secondary to intravenous fat
      emulsions, as this alone is a cause of pancreatitis, albeit uncommon, in patients
      with abnormalities of triglyceride metabolism. However, hypertriglyceridemia
      resulting from parenteral nutrition may be caused by glucose intolerance and not
      intravenous fat emulsion administration.

PMID- 1734237
TI  - Synthetic antiproteases in acute pancreatitis: an experimental study.
AB  - Acute pancreatitis was induced in 19 anesthetized dogs by retrograde injection of
      bile mixed with trypsin into the pancreatic duct. Two groups, of six animals
      each, were treated with intravenous infusion of synthetic antiproteases: gabexate
      mesilate and nafamostat mesilate in doses of 1 mg/kg per hr. One group of seven
      animals remained untreated. Two untreated dogs died during the experiment. All
      the treated dogs survived. Hemodynamic data were monitored hourly during a 6-hr
      observation period. In the untreated animals, cardiac output, mean arterial
      pressure, and left ventricular stroke volume decreased rapidly; an increase of
      pulmonary vascular resistance and systemic vascular resistance was observed.
      Synthetic antiproteases, given as a therapy, improved the hemodynamic parameters
      significantly and prevented the animals from developing shock. Gabexate mesilate
      and nafamostat mesilate seem to be of value in the treatment of experimentally
      produced acute pancreatitis in dogs.

PMID- 1734238
TI  - Carcinoma of the gallbladder: review of the literature and report on 56 cases at
      the Beth Israel Medical Center.
AB  - Fifty-six patients with carcinoma of the gallbladder were treated at the Beth
      Israel Medical Center, New York City, during the 17-year period 1969-1987. The
      disease was most common among elderly women with cholelithiasis. Of the 56, 42
      patients (75%) had liver metastases at operation; therefore, the majority
      underwent only exploratory laparotomy and biopsy. In 50 patients (89%), the
      tissue diagnosis was adenocarcinoma. Cholecystectomy was performed in 19
      patients. Long-term survival occurred in patients with an incidental diagnosis of
      carcinoma of the gallbladder. The average survival in 44 patients for whom data
      were available, including long-term survivors, was 20 months. Of this group, 5
      patients (11.3%) were still alive 5 years after diagnosis. Excluding those with
      an incidental diagnosis of gallbladder cancer, 1 patient (2.2%) survived longer
      than 5 years after diagnosis. Survival data in 3 of 4 patients who underwent
      extensive surgical treatment, such as liver wedge resection or hepatic lobectomy,
      averaged 23 months. Although no defined protocols were used, the addition of
      adjuvant chemotherapy or radiation therapy in patients treated surgically
      appeared to improve survival. Five patients survived more than 5 years after
      diagnosis, and 2 patients were alive after 17 years.

PMID- 1734239
TI  - An outbreak of bacteremic Campylobacter jejuni infection.
AB  - During September 1980, an outbreak of bacteremic Campylobacter jejuni infection
      occurred in metropolitan Los Angeles. The outbreak was recognized when blood
      cultures obtained from 11 previously healthy persons with acute febrile illnesses
      (characterized in over 80% by fever, diarrhea, and headaches) were positive for
      C. jejuni. All recovered after an illness that lasted a mean of 8 days. A
      surveillance system failed to reveal a concomitant outbreak of gastroenteritis.
      Isolates had identical biochemical characteristics, susceptibility patterns to
      antimicrobial agents, and serotypes. Isolates from 2 patients were found to be
      susceptible to bactericidal activity of normal human serum. When bacteremic case
      patients were matched with healthy controls, a significant association (p less
      than 0.05, odds ratio 10) between illness and consumption of processed turkey was
      established. Although turkey was not available for culture, and processing of
      turkey theoretically destroys Campylobacter, turkey carcasses are known to be
      heavily contaminated with the pathogen.

PMID- 1734240
TI  - Acute myocardial infarction in a long-term care institution for the aged.
AB  - We reviewed the clinical characteristics and outcome of cases of acute myocardial
      infarction occurring from January 1, 1985, through December 31, 1987, in the
      population of a long-term care institution for the elderly. The total number of
      patients in the series was 43. Comparisons were made between those patients
      transferred to a general acute-care hospital and those who remained at the
      facility. The most common initial symptoms of acute myocardial infarction in 32
      of 48 patients were, in order, dyspnea, dizziness or syncope, precordial pain,
      and abdominal pain. Nine (of 43) patients were asymptomatic. In the 14 (of 43)
      patients transferred to an acute-care hospital, cardiac failure, arrhythmias, and
      cardiogenic shock were much more frequent than among those retained in the long
      term care facility. We concluded that a high index of suspicion for the diagnosis
      of acute myocardial infarction in the institutionalized elderly is indicated.
      Patients with mild infarction can be retained in long-term care institutions;
      resulting mortality from cardiac disorders should be low in adequately staffed
      and equipped long-term care institutions.

PMID- 1734241
TI  - HIV-1 seroprevalence in pregnant women testing positive on serologic screening
      for syphilis.
AB  - Epidemic increases in active syphilis have been reported in the geographic areas
      hit hard by acquired immunodeficiency syndrome. Although both epidemics have been
      associated with illicit substance abuse, the extent to which recent increases in
      syphilis are linked to the human immunodeficiency virus (HIV-1) epidemic is
      uncertain. In order to define the frequency of syphilis and HIV-1 coinfection in
      the pregnant patients seen at City Hospital Center at Elmhurst, we saved syphilis
      positive serologic specimens from obstetrical patients for anonymous HIV-1
      antibody testing. Of 120 women who tested positive for syphilis, 7/120 (5.8%) had
      antibodies to HIV-1; of the 44 women with VDRL titers greater than or equal to
      1:16 (suggestive of a recent infection), 1/44 (2.3%) had antibodies to HIV-1.

PMID- 1734242
TI  - Phycomycosis (mucormycosis) in differential diagnosis of cerebral mass lesions in
      intravenous drug users.

PMID- 1734243
TI  - Cortical blindness in postpartum preeclampsia progressing to eclampsia: case
      report.
AB  - A 23-year-old woman who had an uneventful prenatal course and normal delivery
      developed severe, generalized headache and blurred vision on postpartum day four.
      The patient was noted to have generalized hyperreflexia and sustained ankle
      clonus. The blood pressure was 170/100 mm Hg, there was no edema, and the urine
      showed trace proteinuria. The visual disturbance rapidly progressed to complete
      blindness with preserved pupillary reactions. The patient then had a generalized
      tonic-clonic seizure lasting about one minute. Treatment was initiated with
      intravenous diazepam and phenytoin, and there was no recurrence of seizure
      activity. Vision returned to normal and the patient made a complete recovery.
      This case is presented to demonstrate progressive postpartum pre-eclampsia and
      the importance of early recognition and treatment. Pathophysiologic mechanisms
      and treatment options are discussed.

PMID- 1734244
TI  - Duodenocolic fistula: an unusual presentation of esophageal squamous cell
      carcinoma.
AB  - Duodenocolic fistula, one of the less common forms of entero-enteric fistulas, is
      usually associated with colonic malignancies at the hepatic flexure or Crohn's
      disease of the colon or duodenum. We report an unusual case of duodenocolic
      fistula caused by metastatic esophageal squamous cell carcinoma in which the
      primary esophageal tumor remained asymptomatic. In several collected series of
      clinical and autopsy studies of over 2800 patients, no similar complication of
      metastatic esophageal squamous cell carcinoma has been reported.

PMID- 1734245
TI  - Hyperthyroidism in patients treated with lithium: report of nine cases.
AB  - Nine cases of hyperthyroidism which developed in patients on lithium therapy are
      presented and analyzed and the literature is briefly reviewed. The findings
      strongly suggest that lithium therapy does not cause hyperthyroidism.

PMID- 1734246
TI  - Ovarian pregnancy with ipsilateral mature cystic teratoma of the ovary: case
      report.
AB  - Ovarian pregnancy is a rare form of ectopic gestation. Mature cystic teratoma is
      the most common form of germ cell tumor, and usually occurs in the reproductive
      age group. The concomitant occurrence of an ovarian pregnancy with a mature
      cystic teratoma in the same ovary is exceedingly rare. We were able to find two
      other such cases in the literature. We present a case, and discuss the entity.

PMID- 1734247
TI  - A randomized, controlled trial of corticosteroids in the treatment of acute optic
      neuritis. The Optic Neuritis Study Group.
AB  - BACKGROUND AND METHODS: The use of corticosteroids to treat optic neuritis is
      controversial. At 15 clinical centers, we randomly assigned 457 patients with
      acute optic neuritis to receive oral prednisone (1 mg per kilogram of body weight
      per day) for 14 days; intravenous methylprednisolone (1 g per day) for 3 days,
      followed by oral prednisone (1 mg per kilogram per day) for 11 days; or oral
      placebo for 14 days. Visual function was assessed over a six-month follow-up
      period. RESULTS: Visual function recovered faster in the group receiving
      intravenous methylprednisolone than in the placebo group; this was particularly
      true for the reversal of visual-field defects (P = 0.0001). Although the
      differences between the groups decreased with time, at six months the group that
      received intravenous methylprednisolone still had slightly better visual fields
      (P = 0.054), contrast sensitivity (P = 0.026), and color vision (P = 0.033) but
      not better visual acuity (P = 0.66). The outcome in the oral-prednisone group did
      not differ from that in the placebo group. In addition, the rate of new episodes
      of optic neuritis in either eye was higher in the group receiving oral
      prednisone, but not the group receiving intravenous methylprednisolone, than in
      the placebo group (relative risk for oral prednisone vs. placebo, 1.79; 95
      percent confidence interval, 1.08 to 2.95). CONCLUSIONS: Intravenous
      methylprednisolone followed by oral prednisone speeds the recovery of visual loss
      due to optic neuritis and results in slightly better vision at six months. Oral
      prednisone alone, as prescribed in this study, is an ineffective treatment and
      increases the risk of new episodes of optic neuritis.

PMID- 1734248
TI  - Biliary sludge as a cause of acute pancreatitis.
AB  - BACKGROUND: In about 20 to 40 percent of cases of acute pancreatitis, no cause
      can be found, and these are labeled idiopathic. In this study, we sought to
      determine the frequency with which patients with acute idiopathic pancreatitis
      have biliary sludge, a suspension of cholesterol monohydrate crystals or calcium
      bilirubinate granules that is found predominantly in the gallbladder. METHODS:
      Between 1980 and 1988, we prospectively studied 86 patients who had acute
      pancreatitis. In patients with no known cause of pancreatitis and no
      ultrasonographic evidence of gallstones or dilatation of the biliary ducts, we
      determined how often biliary sludge was present and its subsequent fate by
      repeated microscopical examinations of bile samples and abdominal
      ultrasonography. The outcome of patients treated by cholecystectomy or
      papillotomy was compared with that of untreated patients. RESULTS: The
      pancreatitis was considered idiopathic in 31 of the 86 patients (36 percent), of
      whom 23 had microscopical evidence of biliary sludge. Biliary sludge was detected
      by ultrasonography in only 11 of the 23 patients (48 percent). The sludge
      detected by ultrasonography was composed of calcium bilirubinate granules in 10
      and cholesterol monohydrate crystals in 1 (P = 0.003). Calcium bilirubinate
      granules were found more frequently in men (nine men vs. four women, P less than
      0.001). Of the 21 patients in whom biliary sludge was the only finding (2
      patients also had dilasted bile ducts when restudied), the 6 treated by
      cholecystectomy and the 4 treated by papillotomy had fewer recurrences of acute
      pancreatitis during follow-up (up to seven years) than the 11 untreated patients
      (P = 0.011). The presence of biliary sludge appeared to increase the likelihood
      of recurrent attacks of pancreatitis (P = 0.020). CONCLUSIONS: Biliary sludge is
      an underestimated cause of acute idiopathic pancreatitis.

PMID- 1734249
TI  - A controlled trial in intensive care units of selective decontamination of the
      digestive tract with nonabsorbable antibiotics. The French Study Group on
      Selective Decontamination of the Digestive Tract.
AB  - BACKGROUND: Selective decontamination of the digestive tract with topical
      nonabsorbable antibiotics has been reported to prevent nosocomial infections in
      patients receiving mechanical ventilation, and the procedure is used widely in
      Europe. However, it is unclear whether selective decontamination improves
      survival. METHODS: We conducted a randomized, double-blind multicenter study in
      which 445 patients receiving mechanical ventilation in 15 intensive care units
      were given either prophylactic nonabsorbable antibiotics (n = 220) or a placebo
      (n = 225). Topical antibiotics (tobramycin, colistin sulfate, and amphotericin B)
      or a placebo was administered through a nasogastric tube and applied to the
      oropharynx throughout the period of ventilation. The main end points were the
      mortality rate in the intensive care unit and within 60 days of randomization.
      RESULTS: A total of 142 patients died in the intensive care unit; 75 (34 percent)
      in the treatment group and 67 (30 percent) in the placebo group (P = 0.37).
      Mortality within 60 days of randomization was similar in the two groups (P =
      0.40), even after adjustment for factors that were either unbalanced or
      individually predictive of survival in the two groups (P = 0.70). Pneumonia
      developed in 59 patients (13 percent) in the intensive care unit within 30 days
      of enrollment in the study (33 in the placebo group and 26 in the treatment
      group, P = 0.42). Pneumonia acquired in the intensive care unit and due to gram
      negative bacilli was less frequent (P = 0.01) in the treatment group than in the
      placebo group. The total charges for antibiotics were 2.2 times higher in the
      treatment group. CONCLUSIONS: Selective decontamination of the digestive tract
      does not improve survival among patients receiving mechanical ventilation in the
      intensive care unit, although it substantially increases the cost of their care.

PMID- 1734250
TI  - Osteopenia in men with a history of delayed puberty.
AB  - BACKGROUND AND METHODS: The effect of delayed puberty on peak bone mineral
      density in men is unknown. To determine whether such a delay reduces normal peak
      bone density and leads to osteopenia during adulthood, we measured radial bone
      mineral density by single-photon absorptiometry and spinal bone mineral density
      by dual-energy x-ray absorptiometry in 23 men who had a history of
      constitutionally delayed puberty and 21 men who underwent normal puberty. Their
      mean ages were 26 and 24 years, respectively. The groups were matched for other
      factors known to affect bone mass. RESULTS: The mean (+/- SD) radial bone mineral
      density was significantly lower in the men with a history of delayed puberty than
      in the normal men (0.73 +/- 0.07 vs. 0.80 +/- 0.05 g per square centimeter; P
      less than 0.0002). Spinal bone mineral density was also significantly lower in
      the men with delayed puberty than in the normal men (1.03 +/- 0.10 vs. 1.13 +/-
      0.11 g per square centimeter; P less than 0.003). Radial bone density was at
      least 1 SD below the mean value for the normal men in 15 of the 23 men with a
      history of delayed puberty, and spinal bone density was similarly decreased in 10
      of the 23. CONCLUSIONS: Adult men with a history of constitutionally delayed
      puberty have decreased radial and spinal bone mineral density. These findings
      suggest that the timing of puberty is an important determinant of peak bone
      density in men. Because the peak bone mineral density achieved during young
      adulthood is a major determinant of bone density in later life, men in whom
      puberty was delayed may be at increased risk for osteoporotic fractures when they
      are older.

PMID- 1734251
TI  - The use of transcranial ultrasonography to predict stroke in sickle cell disease.
AB  - BACKGROUND: Stroke, especially cerebral infarction, is a major cause of morbidity
      and mortality in children with sickle cell disease. Primary prevention of stroke
      by transfusion therapy may be feasible if there is a way to identify the patients
      at greatest risk. Transcranial Doppler ultrasonography can measure flow velocity
      in the large intracranial arteries. The narrowing of these arteries, which leads
      to cerebral infarction, is characterized by an increased velocity of flow.
      METHODS: Using transcranial Doppler ultrasonography, we prospectively measured
      the velocity of cerebral blood flow in children and young adults being followed
      because of sickle cell disease. The results were classified as either normal or
      abnormal on the basis of the highest velocity of flow in the middle cerebral
      artery. Abnormal velocity was defined as a flow greater than or equal to 170 cm
      per second, a definition determined by post hoc analysis to maximize the
      predictive success of the test. The end point was a clinically apparent first
      cerebral infarction. RESULTS: Two hundred eighty-three transcranial ultrasound
      examinations were performed in 190 patients with sickle cell disease (age at
      entry, 3 to 18 years). After an average follow-up of 29 months, cerebral
      infarction was diagnosed in seven patients. In 23 patients the results of the
      ultrasound examinations were abnormal, and in 167 patients they were normal. The
      clinical and hematologic characteristics of the two groups were similar, but six
      of the seven strokes occurred among the 23 patients with abnormal ultrasound
      results (P less than 0.00001 by Fisher's exact test). In this group, the relative
      risk of stroke was 44 (95 percent confidence interval, 5.5 to 346). CONCLUSIONS:
      Transcranial ultrasonography can identify the children with sickle cell disease
      who are at highest risk for cerebral infarction. Periodic ultrasound examinations
      and the selective use of transfusion therapy could make the primary prevention of
      stroke an achievable goal.

PMID- 1734252
TI  - Androgen resistance--the clinical and molecular spectrum.

PMID- 1734253
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 9-1992. Wide-complex tachycardia in a 65-year-old woman without
      previous evidence of cardiac disease.

PMID- 1734254
TI  - Corticosteroid treatment of acute optic neuritis.

PMID- 1734255
TI  - Acute pancreatitis--never leave a stone unturned.

PMID- 1734256
TI  - Sickle cell anemia, stroke, and transcranial Doppler studies.

PMID- 1734257
TI  - Systemic mastocytosis.

PMID- 1734258
TI  - Postnatal transmission of HIV infection.

PMID- 1734259
TI  - Postnatal transmission of HIV infection.

PMID- 1734260
TI  - Postnatal transmission of HIV infection.

PMID- 1734261
TI  - Psychological stress and the common cold.

PMID- 1734262
TI  - Emergency balloon valvuloplasty as initial treatment of patients with aortic
      stenosis and cardiogenic shock.

PMID- 1734263
TI  - Insulin resistance.

PMID- 1734264
TI  - Correction: platelet calcium metabolism in the prediction of preeclampsia.

PMID- 1734265
TI  - Herpes gladiatorum.

PMID- 1734266
TI  - Roche cuts controversial PCR fees, testing limits.

PMID- 1734267
TI  - Drug development. Orphan drug windfalls?

PMID- 1734268
TI  - Epidemiology. Leukaemia linked to radiation.

PMID- 1734269
TI  - EC biotechnology policy. Progress on animal patents.

PMID- 1734270
TI  - Genetic resources. A gene library that goes "moo".

PMID- 1734271
TI  - International collaboration. A lifeline from abroad.

PMID- 1734272
TI  - Research plans. Monopoly threatens variety.

PMID- 1734273
TI  - Biotechnology. Entrepreneurs look for customers.

PMID- 1734274
TI  - Universities. Democracy a mixed blessing.

PMID- 1734275
TI  - Gene expression. Dialogue with the cell cycle.

PMID- 1734276
TI  - Palaeoanthropology. A remote sense for fossils.

PMID- 1734277
TI  - Maintenance of MHC polymorphism.

PMID- 1734278
TI  - Language gap.

PMID- 1734279
TI  - Language gap.

PMID- 1734280
TI  - Molecular dissection of the secretory pathway.
AB  - A combination of biochemistry in animal cell-free systems and genetics in yeast
      is revealing the molecular machinery of the secretory pathway of eukaryotes.
      Transporting vesicles have a simple coat structure and employ a general mechanism
      for fusion that is conserved in evolution.

PMID- 1734281
TI  - Control of DNA synthesis genes in fission yeast by the cell-cycle gene cdc10+.
AB  - In the budding yeast Saccharomyces cerevisiae, cell-cycle control over DNA
      synthesis occurs partly through the coordinate expression in late G1 phase of
      many, if not all, of the genes required for DNA synthesis. A cis-acting hexamer
      element ACGCGT (an MluI restriction site) is responsible for coordinating
      transcriptional regulation of these genes at the G1/S phase boundary and we have
      identified a binding activity, DSC1, that recognizes these sequences in a cell
      cycle-dependent manner. In the distantly related fission yeast
      Schizosaccharomyces pombe, only one of the known DNA synthesis genes, cdc22+,
      which encodes a subunit of ribonucleotide reductase, is periodically expressed in
      late G1 (ref. 6). The promoter region of cdc22+ has two MluI sites and five
      related sequences, suggesting that similar controls over DNA synthesis genes
      could occur in fission yeast. We report here a binding activity in fission yeast
      that is very similar to DSC1 in budding yeast. We also show that the fission
      yeast cdc10+ gene product, which is required for Start and entry into S phase, is
      a component of this binding activity.

PMID- 1734282
TI  - A transcriptional hierarchy involved in mammalian cell-type specification.
AB  - Although transcriptional hierarchies have been extensively studied in
      invertebrates, their involvement in mammalian cell-type specification is poorly
      understood. Here we report a hepatocyte transcriptional cascade suggested by the
      expression patterns of hepatic transcription factors in dedifferentiated
      hepatomas and hepatocyte: fibroblast hybrids in which the liver phenotype was
      extinguished. These results indicated that the homeoprotein hepatocyte nuclear
      factor-1 alpha (HNF-1 alpha), and HNF-4, a member of the steroid hormone receptor
      superfamily, were regulated coordinately or in a hierarchy by a higher-order
      locus, independently of other hepatic transactivators. HNF-4 was implicated as an
      essential positive regulator of HNF-1 alpha, as deletion of an HNF-4 binding site
      in the HNF-1 alpha promoter abolished promoter activity, and HNF-4 potently
      transactivated the HNF-1 alpha promoter in cotransfection assays. Moreover,
      genetic complementation of dedifferentiated hepatomas with HNF-4 complementary
      DNA rescued expression of endogenous HNF-1 alpha messenger RNA and DNA-binding
      activity. Our studies therefore define an HNF-4----HNF-1 alpha (4----1 alpha)
      transcriptional hierarchy operative in differentiated hepatocytes but selectively
      inhibited by an extinguishing locus and somatic mutations which antagonize the
      liver phenotype.

PMID- 1734283
TI  - Characterization of cDNA for the large subunit of the transcription initiation
      factor TFIIF.
AB  - At least six chromatographically resolvable general transcription factors may
      participate in accurate initiation by RNA polymerase II in HeLa cell-derived
      systems. TFIIF (also termed FC, RAP30/74 and beta/gamma) can bind directly to RNA
      polymerase II in solution and decrease the affinity of RNA polymerase II for
      nonspecific DNA. From studies on the kinetics of transcription initiation, on the
      composition of transcription initiation complexes fractionated by acrylamide gel
      electrophoresis, and on template competition experiments, TFIIF is known to act
      at an intermediate stage in initiation complex formation. It acts after TFIID
      firmly associates with DNA, but coincidentally with or immediately after RNA
      polymerase II binding to DNA, and before the recruitment of factor TFIIE. TFIIF
      may or may not have DNA helicase activity. The small subunit (RAP30) of TFIIF has
      been cloned and shows some amino-acid sequence homology to bacterial sigma
      factors. We have partially sequenced the RAP74 protein from purified HeLa cells,
      cloned its complementary DNA and shown that its translation product can interact
      with RAP30 in vitro as well as in vivo. The cDNA predicts an amino-acid sequence
      that lacks obvious DNA or RNA helicase motifs. It has regions rich in charged
      amino acids, including segments containing a higher content of acidic amino acids
      than are found in strong transcriptional activators such as VP16.

PMID- 1734284
TI  - A cDNA encoding RAP74, a general initiation factor for transcription by RNA
      polymerase II.
AB  - RAP30/74 (also known as TFIIF, beta gamma and FC is one of several general
      factors required for initiation by RNA polymerase II. The small RAP30 subunit of
      RAP30/74 binds directly to polymerase and appears structurally and functionally
      homologous to bacterial sigma factors in their RNA polymerase-binding region.
      RAP30/74 or recombinant RAP30 suppresses nonspecific binding of RNA polymerase II
      to DNA and is required for RNA polymerase II to assemble stably into a
      preinitiation complex containing promoter DNA and the general factors TFIID,
      TFIIA and TFIIB; both RAP30 and RAP74 are physical components of the
      preinitiation complex. A complementary DNA encoding human RAP30 has been
      isolated, and here we report the isolation of a cDNA encoding human RAP74. RAP30
      and RAP74 produced in Escherichia coli can be used in place of natural human
      RAP30/74 to direct accurate transcription initiation by RNA polymerase II in
      vitro.

PMID- 1734285
TI  - Type III restriction enzymes need two inversely oriented recognition sites for
      DNA cleavage.
AB  - Type III restriction/modification enzyme recognize short, non-palindromic
      sequences that can be methylated on only one strand, with the paradoxical
      consequence that during replication of what is in effect hemimethylated DNA
      totally unmodified sites arise. Why the unmodified sites are not subject to
      suicidal restriction was not clear. Here we show that restriction requires two
      unmodified recognition sites that can be separated by different distances but
      which must be in inverse orientation. All of the unmodified sites in newly
      replicated DNA are of course in the same orientation, which explains why they are
      not restricted. This result may be of relevance to other manifestations of
      anisotropy in double-stranded DNA, such as genetic imprinting.

PMID- 1734286
TI  - Novel NADPH-binding domain revealed by the crystal structure of aldose reductase.
AB  - Aldose reductase is the first enzyme in the polyol pathway and catalyses the
      NADPH-dependent reduction of D-glucose to D-sorbitol. Under normal physiological
      conditions aldose reductase participates in osmoregulation, but under
      hyperglycaemic conditions it contributes to the onset and development of severe
      complications in diabetes. Here we present the crystal structure of pig lens
      aldose reductase refined to an R-factor of 0.232 at 2.5-A resolution. It exhibits
      a single domain folded in an eight-stranded parallel alpha/beta barrel, similar
      to that in triose phosphate isomerase and a score of other enzymes. Hence, aldose
      reductase does not possess the expected canonical dinucleotide-binding domain.
      Crystallographic analysis of the binding of 2'-monophospho-adenosine-5'
      diphosphoribose, which competitively inhibits NADPH binding reveals that it binds
      into a cleft located at the C-terminal end of the strands of the alpha/beta
      barrel. This represents a new type of binding for nicotinamide adenine
      dinucleotide coenzymes.

PMID- 1734287
TI  - Assessment: magnetoencephalography (MEG). Report of the Therapeutics and
      Technology Assessment Subcommittee of the American Academy of Neurology.

PMID- 1734288
TI  - Clinical and EEG features of status epilepticus in comatose patients.
AB  - We retrospectively evaluated the clinical and EEG features of status epilepticus
      (SE) in 47 comatose adult patients in whom SE was suspected clinically or because
      the EEG revealed repetitive electrographic seizures or continuous spike-and-wave
      activity. Three groups of patients were identified. Group-1 patients (n = 33) had
      SE both clinically and on EEG. They usually had subtle, clonic movements
      restricted to the eyes, face, and upper extremities, and the EEG most commonly
      showed repetitive electrographic seizures or continuous spike-and-wave activity.
      Group-2 patients (n = 9) also had subtle motor manifestations of seizures, but
      the EEG was not that of SE, consisting of either irregular slowing with frequent
      spikes and sharp waves, an irregular mixed-frequency background with episodic
      accentuation, or diffuse slowing; one patient also had an intermittent burst
      suppression pattern. The five patients in Group 3 lacked any clinical signs of
      seizures, but the EEG showed repetitive electrographic seizures or continuous
      spike-and-wave activity. There were no significant differences between groups in
      etiology of SE, response to therapy, or outcome, and there was no obvious
      relationship between the EEG findings and duration of SE. We conclude that
      recognition of SE in comatose patients may require both clinical and EEG
      evaluation since either approach by itself may fail to establish the diagnosis.
      Furthermore, the EEG findings in established SE do not necessarily progress
      through the series of defined stages suggested by some authors.

PMID- 1734289
TI  - 'De novo' absence status of late onset: report of 11 cases.
AB  - Absence status (AS) is a heterogenous epileptic syndrome that can occur at any
      age, usually in a context of prior epilepsy. Eleven cases of AS occurring in
      middle-aged patients who had no history of epilepsy were retrospectively
      collected over a 10-year period (10 women and one man; mean age, 58.6 years).
      Eight patients were receiving high doses of psychotropic drugs. Clinical and EEG
      presentation was similar to AS occurring in patients with prior epilepsy.
      Evaluation of precipitating factors revealed that AS coincided with
      benzodiazepine withdrawal in eight cases. Cofactors included excessive use of
      other psychotropic drugs, nonpsychotropic treatment, hypocalcemia, hyponatremia,
      and chronic alcoholism. CT demonstrated mild cerebral atrophy in six cases. There
      was no recurrence, even without chronic antiepileptic treatment. These data
      indicate that (1) most cases of "de novo" AS of middle age or late onset result
      from the addition of various epileptogenic factors; (2) AS can be considered a
      new and uncommon complication of benzodiazepine withdrawal, and (3) long-term
      administration of anticonvulsant medication may not be required.

PMID- 1734290
TI  - Prevention of stroke with ticlopidine: who benefits most? TASS Baseline and
      Angiographic Data Subgroup.
AB  - We examined the baseline characteristics of patients in the Ticlopidine Aspirin
      Stroke Study (TASS) to determine if the effects of the two treatments in
      preventing stroke differed in various subgroups. Patients with the following
      characteristics did less well on aspirin: elevated creatinine, hypertension or
      diabetes requiring treatment, or treatment with anticoagulant or antiplatelet
      drugs prior to their qualifying TIA or stroke. Women and patients with
      vertebrobasilar symptoms did particularly well on ticlopidine. We performed
      arteriography in 1,188 patients with carotid qualifying events. The frequency of
      stroke in patients with abnormal arteriograms ipsilateral to their symptoms was
      slightly higher than in those with normal carotid arteries. Ticlopidine was more
      effective in patients without carotid stenosis. Ticlopidine is more effective
      than aspirin in preventing strokes in patients having warning TIAs. The patients
      who benefit most from ticlopidine may be women, those who have vertebrobasilar
      symptoms, those with cerebral ischemic symptoms while on aspirin or anticoagulant
      therapy, and patients with diffuse atherosclerotic disease rather than high-grade
      carotid stenosis.

PMID- 1734291
TI  - Prevalence of dementia and probable senile dementia of the Alzheimer type in the
      Framingham Study.
AB  - We determined the prevalence of dementia and probable senile dementia of the
      Alzheimer type (SDAT) for biennial Exam 17 of the Framingham cohort (1982/1983).
      The prevalence of dementia was 30.5/1,000 for men and 48.2/1,000 for women and
      increased with advancing age. Cases of probable SDAT constituted 55.6% of all
      dementia cases. THe prevalence of SDAT was 11.7/1,000 for men and 30.1/1,000 for
      women and also increased with advancing age. Prevalence of dementia and probable
      SDAT were greater for women than men. The female:male ratio of prevalence for
      cohort members 75 years of age and older was 1.8 for all cases of dementia and
      2.8 for cases of probable SDAT.

PMID- 1734292
TI  - Familial presenile dementia with psychosis associated with cortical
      neurofibrillary tangles and degeneration of the amygdala.
AB  - We report a family in which 13 members in three generations had the presenile
      (age 42 to 66 years) onset of dementia with an autosomal dominant pattern of
      inheritance. An early symptom in eight individuals was prominent antisocial
      psychotic or belligerent behavior, often leading to the initial clinical
      diagnosis of paranoid schizophrenia. Duration of illness was longer than is usual
      in Alzheimer's disease (AD), ranging from 14 to 26 years in six members. Three
      affected siblings and a cousin have come to autopsy, and all had neurofibrillary
      tangles without senile plaques in several regions of the neocortex, amygdala, and
      parahippocampal gyrus. The hippocampus was free of both neurofibrillary tangles
      and senile plaques in all four, but in three there was neuronal loss with gliosis
      in the CA1 region of Ammon's horn bilaterally. There also was neuronal loss and
      neurofibrillary tangles in the nucleus basalis. The neurofibrillary tangles were
      tau-2 and Alz-50 positive and were composed of paired helical filaments
      ultrastructurally. The disease in this kindred appears to be a unique hereditary
      disorder that is distinct from familial AD.

PMID- 1734293
TI  - Cardioskeletal mitochondrial myopathy associated with chronic magnesium
      deficiency.
AB  - A 3-year-old boy presenting with convulsions and carpopedal spasm had
      hypomagnesemia and hypermagnesuria due to congenital magnesium-losing
      nephropathy. Despite chronic oral and intermittent intravenous magnesium
      supplementation, he remained chronically hypomagnesemic. At age 4, he developed a
      progressive proximal myopathy and dilated hypertrophic cardiomyopathy that
      ultimately contributed to his death at age 14 years. Skeletal and cardiac muscle
      specimens showed a mitochondrial myopathy with increased numbers of enlarged,
      structurally abnormal mitochondria. Muscle magnesium content was markedly
      decreased. Chronic oral and intermittent intravenous magnesium supplementation
      may be inadequate to prevent the progressive cardioskeletal myopathy associated
      with the chronic magnesium deficiency of congenital magnesium-losing nephropathy.

PMID- 1734294
TI  - Symptomatic and asymptomatic high-grade carotid stenoses in Doppler color-flow
      imaging.
AB  - We examined 63 patients with 31 symptomatic and 44 asymptomatic carotid stenoses
      with Doppler color-flow imaging (DCFI); conventional Doppler duplex had shown a
      hemodynamic obstruction (greater than or equal to 80% stenosis) in all patients.
      Analysis of plaque surface morphology demonstrated more ulcerated plaques in
      symptomatic (43%) than asymptomatic (23%) stenoses. Although the frequency of
      homogeneous and heterogeneous plaques was not different, calcific lesions were
      more frequent in asymptomatic (46% versus 29%), and echolucent plaques, probably
      indicating mural thrombi, were more frequent in symptomatic (29% versus 11%)
      stenosis. Color-coded hemodynamic patterns, such as jet flow, poststenotic
      turbulence, or reversed flow, were not different in symptomatic and asymptomatic
      stenoses. Comparison of DCFI with 30 angiograms showed agreement in plaque
      surface analysis in 70%. DCFI measurements of area reduction in cross sections
      correlated with angiography in 85%, while DCFI tended to underestimate the degree
      of stenosis from diameter reduction in longitudinal cuts. The advanced DCFI
      technique identified distinct morphologic features but no hemodynamic patterns,
      separating symptomatic from asymptomatic high-grade carotid stenoses.

PMID- 1734295
TI  - A quantitative MRI study of vascular dementia.
AB  - We studied the MRI and clinical factors associated with dementia following stroke
      by quantifying ventricle-to-brain ratio (VBR), anatomic region of infarction, and
      cortical, subcortical, and white matter areas of infarction in 24 stroke patients
      with dementia and 29 nondemented stroke patients. The factors that most strongly
      correlated with dementia were total white matter lesion (WML) area, left WML,
      VBR, right WML, age, left cortical infarction area, left parietal infarction
      area, and total infarction area. Using discriminant analysis, these factors
      correctly classified 28 of 29 nondemented patients and 18 of 24 demented
      patients. Both cortical and white matter total infarction area measurements were
      strongly associated with dementia in stroke patients, suggesting that these
      factors strongly influenced the development of dementia following stroke. There
      was a strong association between dementia and left- but not right-hemisphere
      infarction area. The only demographic factor that strongly associated with
      dementia was age.

PMID- 1734296
TI  - Japanese crossed Wernicke's aphasia.
AB  - A right-handed Japanese man with no personal or family history of left-handedness
      developed severe Wernicke's aphasia, a mild constructional disorder, and slight
      left hemiparesis. MRI revealed infarction in the territory of the righ middle
      cerebral artery, including areas homologous to Broca's and Wernicke's areas. The
      cerebral blood flow in these areas remained diminished even after language
      activation. The most likely explanation is that language production occurred in
      the left Broca's area, while language comprehension occurred in the right
      Wernicke's area (a dissociated aphasia).

PMID- 1734297
TI  - 'Spectacular shrinking deficit': rapid recovery from a major hemispheric syndrome
      by migration of an embolus.
AB  - We studied the clinical features of a major hemispheric stroke syndrome with
      rapid recovery ("spectacular shrinking deficit" [SSD]) compared with stroke
      patients with the same major initial manifestations but without rapid recovery
      (non-SSD). There were 118 patients with an initial major hemispheric syndrome; 14
      patients (12%) had SSD. All but one SSD patient met criteria for cardiogenic
      brain embolism. Angiographic examination within 24 hours after stroke onset
      demonstrated that the occlusion sites in SSD differed from those in non-SSD and
      suggested that rapid embolus migration had occurred in all SSD patients but in
      only five of 39 non-SSD. Infarcts in SSD were smaller and often scattered over
      the cortices and deeper structures. Hemorrhagic transformation was less frequent
      in SSD. In patients with a potential cardiac source of emboli, SSD was more
      likely to occur in nondiabetic men less than 60 years of age.

PMID- 1734298
TI  - Memory in a case of bilateral thalamic infarction.
AB  - The role of individual structures within the diencephalon for memory functioning
      is unknown. We present anatomic localization of lesions and a longitudinal
      neuropsychological profile of a young man who had a bilateral diencephalic stroke
      in the interpeduncular profundus arterial territory. MRI localized the lesions to
      the mamillothalamic tracts and inferior thalamic peduncle. The amnesia was
      characterized by severe impairment in explicit recall of new facts and events,
      while word-completion priming and remote memory were intact. We suggest that the
      memory deficit results from a disconnection of the diencephalon from the medial
      temporal region.

PMID- 1734299
TI  - Olfactory dysgenesis or hypoplasia: a variant in the arhinencephaly spectrum?
AB  - Postmortem examination of a 65-year-old anosmic woman revealed rudimentary
      olfactory bulbs, an imperforate cribriform plate, and sulcal abnormalities of the
      orbitofrontal surface of the brain. The remainder of the brain, skull, and body
      was normal. This abnormality most likely resulted from a local insult to the area
      of the cribriform plate during early fetal life, occurring after the induction of
      olfactory bulb differentiation, but before migration and complete differentiation
      of the olfactory bulbs. Such a lesion can be dated to approximately 11 to 12
      weeks gestational age. The malformation may represent another variant in the
      arhinencephaly spectrum, but is termed "olfactory dysgenesis" or "olfactory
      hypoplasia" to separate it from true olfactory aplasia and arhinencephaly.

PMID- 1734300
TI  - MR-based hippocampal volumetry in the diagnosis of Alzheimer's disease.
AB  - We evaluated a new magnetic resonance (MR)-based technique for performing
      volumetric measurements of temporal lobe structures. The technique was designed
      to assist in making the clinical diagnosis of dementia of the Alzheimer type
      (DAT). We chose specific anatomic regions of interest because of their known
      involvement in memory function and in the neuropathology of DAT and used a
      regression model to assess the effects of age on the volumes of the anterior
      temporal lobe (ATL) and the hippocampal formation (HF). These measurements were
      normalized by total intracranial volume (TIV). The volumetric measurements of
      both the normalized ATL and HF were significantly smaller (p less than 0.001) in
      DAT patients (N = 20) than in controls (N = 22), but the HF volumes provided much
      better separation between the two groups. Eighty-five percent of the DAT patients
      fell below the range of the HF/TIV measurement for the control subjects. This
      separation held up over the entire age range studied. Normalized volumes of both
      the HF and ATL decreased with age significantly for both the DAT patients and the
      controls. These results support the contention that MR-based HF volumetric
      measurements are accurate in differentiating DAT patients from cognitively normal
      elderly individuals. This technique may be a useful adjunct in making the
      clinical diagnosis of DAT.

PMID- 1734301
TI  - Contrast sensitivity is increased in a case of nonparkinsonian freezing gait.
AB  - We measured spatiotemporal contrast sensitivity and gait variables in a 60-year
      old man who had spontaneous episodes of freezing gait without any sign of
      rigidity or tremor. One major factor triggering freezing was the characteristics
      of visual space, as freezing episodes occurred during spontaneous walking and
      passing through apertures and never during walking with eyes closed. Initiation
      and maintenance of locomotion were greatly facilitated when transverse stripes
      with optimal intervals were placed on the ground in front of the patient. On the
      other hand, contrast sensitivity to low-to-intermediate spatiotemporal
      frequencies was increased in this patient when compared with that of elderly
      controls. These data suggest that hypersensitivity to visual stimulation and to
      modifications of the visual environment, associated with abnormal ocular motor
      behavior, can be one factor leading to the freezing gait phenomenon, which could
      be called "hypersensitivity braking" and be considered as a sensorimotor
      disorder.

PMID- 1734302
TI  - Two alien hand syndromes.
AB  - Review of the clinical characteristics and neuroanatomy of 20 reported cases of
      alien hand syndrome (AHS) and a patient of our own confirm that AHS is actually
      two distinct syndromes. Frontal AHS occurs in the dominant hand; is associated
      with reflexive grasping, groping, and compulsive manipulation of tools; and
      results from damage to the supplementary motor area, anterior cingulate gyrus,
      and medial prefrontal cortex of the dominant hemisphere and anterior corpus
      callosum. Callosal AHS is characterized primarily by intermanual conflict and
      requires only an anterior callosal lesion. the occurrence of frontal AHS in the
      dominant limb can be explained by an increased tendency for dominant limb
      exploratory reflexes coupled with release from an asymmetrically distributed,
      predominant nondominant-hemisphere inhibition. Callosal AHS is best explained by
      hemispheric disconnection manifested during behaviors requiring dominant
      hemisphere control.

PMID- 1734303
TI  - Hypoprebetalipoproteinemia, acanthocytosis, retinitis pigmentosa, and pallidal
      degeneration (HARP syndrome).
AB  - We describe the clinical and laboratory studies of an 11-year-old girl with
      prominent orofacial dyskinesia, dystonia, and progressive dementia.
      Investigations revealed hypoprebetalipoproteinemia, acanthocytosis, atypical
      retinitis pigmentosa, and evidence of iron deposition in the pallidal nuclei.
      Electroneuromyography and skin and sural nerve biopsies were normal. The "eye-of
      the-tiger" sign, used to describe the pallidal nuclei in Hallervorden-Spatz
      syndrome, was present on T2-weighted MRIs (GE Signa, 1.5 T). Phase-contrast
      microscopy of whole blood showed 80 to 90% acanthocytes whose morphology was
      confirmed by electron microscopy. High-resolution lipoprotein electrophoresis
      demonstrated an absence of the pre-beta fraction. This case differs
      phenotypically from the previous reports of Hallervorden-Spatz disease with
      acanthocytosis by the presence of prominent orofacial dyskinesia and abnormal
      serum lipoproteins.

PMID- 1734304
TI  - [18F]-6-fluorodopa PET scanning in Parkinson's disease after selective COMT
      inhibition with nitecapone (OR-462).
AB  - PET studies were performed to investigate the effects of a new cathechol-O
      methyltransferase (COMT) inhibitor, nitecapone (OR-462 [3-(3,4-dihydroxy-5
      nitrobenzylidene)- 2,4-pentadione]), on the accumulation of dopamine in the
      striatum and whether it is able to improve [18F]6-fluorodopa imaging of the
      brain. Altogether, three patients with Parkinson's disease (PD) and three normal
      volunteers were examined, first without nitecapone and then with an oral dose of
      100 mg of nitecapone 1 hour before the IV injection of 3 mCi of [18F]6
      fluorodopa. High-pressure liquid chromatography analysis of arterial plasma
      samples showed a significant reduction in the metabolic conversion rate from
      [18F]6-fluorodopa to [18F]3-O-methylfluorodopa after the administration of
      nitecapone. PET studies showed that nitecapone significantly (p less than 0.05)
      increased the [18F]6-fluorodopa accumulation in the striatum both in PD patients
      and normal controls; the magnitude of this increase was 20.0 +/- 5.5% (mean +/-
      SEM). The ratio of radioactivity in the striatum and arterial plasma was
      increased 39.0 +/- 5.0% (mean +/- SEM) after the administration of nitecapone.
      Consequently, the quality of PET images after OR-462 was better, which has
      implications for future [18F]6-fluorodopa studies. In addition, COMT inhibition
      may have clinical advantages by improving levodopa treatment in PD.

PMID- 1734305
TI  - Myotonic dystrophy: clinical assessment of muscular disability in an isolated
      population with presumed homogeneous mutation.
AB  - We evaluated the muscular disability of 295 patients affected by the adult form
      of myotonic dystrophy (DM) and living in the Saguenay-Lac-Saint-Jean region
      (Quebec, Canada). The patients are known to have a common ancestral couple, and a
      homogeneous DM mutation is presumed. Using a five-point muscular disability
      rating scale (MDRS), we confirmed, in each age group, the wide expressivity of
      the muscular involvement usually observed in DM. Based on the duration of the
      disease and the MDRS, we also found a great variation in the rate of disease
      progression. There were no significant relationships between the rate of disease
      progression and the sex of the patient, the sex of the affected parent, or the
      age at onset of the disease. Furthermore, there was an absence of association
      between the age at onset and the sex of the patient or the sex of the affected
      parent. The variable severity of the muscular involvement, and the absence of
      relationship between age at onset and rate of disease progression, suggest a
      multiallelic influence at the DM locus or at other loci.

PMID- 1734306
TI  - Mitochondrial myopathy of childhood associated with depletion of mitochondrial
      DNA.
AB  - We have studied five children with mitochondrial myopathy manifesting within or
      soon after the first year of life. Muscle biopsies showed ragged-red fibers and
      decreased respiratory chain activity. All five patients had a severe decrease (2
      to 34% of normal) in the amount of muscle mitochondrial DNA (mtDNA). The
      depletion of mtDNA correlated with absence of mtDNA-encoded translation products
      and with loss of cytochrome c oxidase enzyme activity in individual muscle
      fibers. This mitochondrial myopathy of childhood illustrates one phenotypic
      expression of a novel pathogenetic mechanism in mitochondrial diseases, the
      specific depletion of mtDNA in affected tissues.

PMID- 1734307
TI  - Muscle acetylcholine receptors complexed with autologous IgG reflect
      seropositivity but not necessarily in vivo binding.
AB  - The diagnosis of acquired myasthenia gravis (MG) in apparently seronegative
      individuals is aided by finding immunoglobulin complexed to acetylcholine
      receptors (AChR) and a reduction in the number of binding sites for alpha
      bungarotoxin (alpha-BTx) in nerve-muscle biopsies. In this study, we found that
      anti-AChR antibodies in extracellular fluids can complex with cytoplasmic
      epitopes of AChR in the process of muscle extraction. When normal muscle was
      briefly exposed to antibodies (greater than or equal to 0.3 nmol/l) in the
      initial step of tissue homogenization (before detergent extraction), membranous
      AChR became complexed with IgG. This was so even with a nonmyasthenogenic
      monoclonal antibody specific for the alpha-subunit's presumptive cytoplasmic
      segment 366-389. We also found that antibodies reactive with AChR's alpha-BTx
      binding region can significantly lower apparent yields of alpha-BTx binding sites
      extracted from muscle. Thus, the finding of IgG complexed to AChR extracted from
      biopsied muscle does not necessarily reflect in vivo binding but, nevertheless,
      is a sensitive indicator of AChR seropositivity in patients suspected to have MG.

PMID- 1734308
TI  - Advanced cerebrovascular disease and the death of Vladimir Ilyich Lenin.

PMID- 1734309
TI  - The changing 19th-century view of epilepsy as reflected in the West Riding
      Lunatic Asylum Medical Reports, 1871-1876, vols 1-6.
AB  - The West Riding Lunatic Asylum Medical Reports (WRLAMR) were published from 1871
      to 1876. Organized by Sir James Crichton-Browne at a little-known mental asylum
      in northern England, the WRLAMR contains many historically important works in
      neurology by such landmark figures as Sir David Ferrier and John Hughlings
      Jackson. The writings on epilepsy in the WRLAMR are particularly important and
      reveal the 19th-century shift in understanding the etiology of seizures.

PMID- 1734310
TI  - Endothelins and the nervous system.

PMID- 1734311
TI  - Contralateral disappearance of parkinsonian signs after subthalamic hematoma.
AB  - A man with Parkinson's disease (PD) suddenly developed a left hemiballismus, and
      the CT showed a hematoma of the right subthalamic nucleus. After the ballistic
      movements had disappeared, akinesia and the other parkinsonian signs did not
      reappear on the left. This clinical case confirms the involvement of the
      subthalamic nucleus in the akinesia of PD, as suggested by recent experimental
      data.

PMID- 1734312
TI  - Cerebral infarction complicating intravenous immunoglobulin therapy for
      polyneuritis cranialis.

PMID- 1734313
TI  - Propranolol therapy for shuddering attacks.

PMID- 1734314
TI  - Ocular tilt reaction following lateral pontomedullary infarction.

PMID- 1734315
TI  - Short-term memory impairment in an alert patient as a presentation of herpes
      simplex encephalitis.

PMID- 1734316
TI  - Acute and persistent parkinsonism after use of diquat.

PMID- 1734317
TI  - Nonconvulsive status epilepticus following electroconvulsive therapy.

PMID- 1734318
TI  - HIV nomenclature.

PMID- 1734319
TI  - Pupils in neurosyphilis.

PMID- 1734320
TI  - Toluene and visual loss.

PMID- 1734321
TI  - PCR detection of Borrelia burgdorferi DNA in cerebrospinal fluid of Lyme
      neuroborreliosis patients.
AB  - We used the polymerase chain reaction (PCR), a method useful in the detection of
      Borrelia burgdorferi in vitro, to evaluate CSF in patients thought to have
      neuroborreliosis. Nested pairs of oligonucleotide primers were designed to
      recognize the C-terminal region of B burgdorferi OspA. CSF samples were obtained
      from (1) patients with immunologic evidence of systemic B burgdorferi infection
      and clinical manifestations suggestive of CNS dysfunction, (2) seronegative
      patients with clinical disorders consistent with Lyme borreliosis, and (3)
      patient and contamination controls; all were analyzed in a blinded fashion. PCR
      detected B burgdorferi OspA DNA in CSF of (1) 10 of 11 patients with Lyme
      encephalopathy, (2) 28 of 37 patients with inflammatory CNS disease, (3) seven of
      seven seronegative patients with Lyme-compatible disorders, and (4) zero of 23
      patient controls. Zero of 83 additional contamination controls were PCR-positive.
      In eight patients from whom we obtained CSF before and after parenteral
      antimicrobial therapy, PCR results invariably predicted clinical outcome
      accurately.

PMID- 1734322
TI  - Surgical treatment of cervical spondylotic myelopathy: time for a controlled
      trial.
AB  - Surgical procedures on the cervical spine are accepted therapies for the
      myelopathy of cervical spondylosis. However, reported improvement rates vary
      widely, and many reports indicate improvement in about one-half of the cases. It
      has not been proven that outcome after surgery is better than the natural history
      or conservative therapy. Radiographic or imaging evidence of cord impingement or
      compression may be seen in asymptomatic people. There are no clear guides to the
      selection of patients who may benefit from the operation and there has been no
      standardization of preoperative evaluation, trials of conservative therapy,
      ascertainment of progressive disability, or assessment of outcome. A multicenter
      controlled trial might answer these questions.

PMID- 1734323
TI  - Cardiac rhythm during temporal lobe seizures.
AB  - We studied the neuroanatomic correlates of ictal tachycardia in 27 seizures from
      five patients with unilateral temporal lobe epilepsy being evaluated with
      bilateral temporal lobe depth electrodes and orbitofrontal subdural electrodes.
      There were 11 complex partial seizures, three simple partial seizures, and 13
      subclinical seizures. For all seizures, heart rate (HR) increased in a graded
      fashion as new cortical regions anywhere in the brain were recruited into the
      seizure. HR plateaued at the new level despite EEG frequency changes until the
      next region became involved. Increases in HR did not correlate with increased
      duration of seizures but rather with volume of brain involved. Restricted
      amygdaloid seizure activity was generally insufficient to alter HR. We conclude
      that the amygdala has a limited role in modulating HR during seizures, and ictal
      tachycardia depends principally on the volume of cerebral structures recruited
      into a seizure.

PMID- 1734325
TI  - Serial gadolinium-enhanced MRI in relapsing/remitting multiple sclerosis of
      varying disease duration.
AB  - In the planning of MRI protocols to monitor disease activity in multiple
      sclerosis (MS), the clinical subtype needs to be considered. In this serial
      gadolinium-enhanced MRI study, we demonstrated differences between patients with
      early relapsing/remitting MS and benign MS in both the production of new lesions
      and the occurrence of enhancement.

PMID- 1734324
TI  - Shunting normal-pressure hydrocephalus: do the benefits outweigh the risks? A
      multicenter study and literature review.
AB  - We performed a multicenter retrospective study in 166 consecutive patients
      shunted for presumed normal-pressure hydrocephalus (NPH) in the four
      neurosurgical departments of Amsterdam. Overall improvement occurred in 36%,
      substantial improvement in 21%. In the subgroup of idiopathic NPH (N = 127),
      marked improvement was only 15%. The incidence of shunt-responsive NPH in our
      area was 2.2/million/year. The rate of severe and moderate shunt-related
      complications was 28%, leading to death or severe residual morbidity in 7%. The
      substantial benefit/serious harm ration in the whole group was only three
      (21%/7%), decreasing to 1.7 in idiopathic NPH. By excluding patients at high
      surgical risk, this ratio might have risen to 10 in the whole group and to six in
      idiopathic NPH. Our experience is much less favorable than that encountered in
      the literature, reporting overall improvement in 74% and marked improvement in
      55% of the shunted patients. We conclude that NPH is probably a very rare and
      still overdiagnosed syndrome and that the overall morbidity rate for each patient
      demonstrating meaningful improvement is high.

PMID- 1734326
TI  - Symptomatic retrochiasmal lesions in multiple sclerosis: clinical features,
      visual evoked potentials, and magnetic resonance imaging.
AB  - We have studied 18 patients with relapsing-remitting multiple sclerosis (MS) who
      had symptomatic visual field defects due to retrochiasmal lesions. In 17, the
      lesion responsible was identified by magnetic resonance imaging (MRI), computed x
      ray tomography (CT), or both. The lesion responsible involved the posterior optic
      radiations in eight cases, the optic tract and lateral geniculate nucleus in six,
      and the posterior limb of the internal capsule in three. The prognosis for
      recovery of the field defect was good; complete recovery occurred in 14 patients,
      and only two showed no recovery at all. The striking characteristic of the
      lesions was that most were unusually large; indeed, many were detectable on CT as
      well as MRI. Half-field asymmetries of either amplitude or latency of the visual
      evoked potentials (VEPs), consistent with a postchiasmal lesion, were present in
      only five out of 13 patients acutely. In only three of these did the abnormality
      persist at follow-up. We conclude that only large postchiasmal lesions are likely
      to cause symptomatic homonymous field defects in MS, usually characterized by
      rapid recovery. Hemifield VEPs have a low sensitivity for the detection of
      postchiasmal as compared with prechiasmal abnormalities.

PMID- 1734327
TI  - Frequent involvement of the optic radiation in patients with acute isolated optic
      neuritis.
AB  - Magnetic resonance imaging revealed asymptomatic lesions in white matter regions
      corresponding with the optic radiations in 20 of 28 patients (71%) with
      clinically isolated optic neuritis. In contrast to the findings with symptomatic
      lesions, there was no relationship between the latency of the visual evoked
      potential and the presence of these asymptomatic posterior visual pathway
      lesions.

PMID- 1734328
TI  - Brain MRI and electrophysiologic abnormalities in preclinical and clinical
      adrenomyeloneuropathy.
AB  - We describe the neurophysiologic abnormalities in 17 patients with clinical
      adrenomyeloneuropathy (AMN), an adult phenotype of X-linked adrenoleukodystrophy
      (ALD). These abnormalities also allowed the early recognition of the AMN
      phenotype in three asymptomatic boys with biochemically proven ALD. In 14/16
      adult AMN patients, there were cerebral white matter abnormalities on MRI which
      were severe and comparable with cerebral ALD in four of the patients.

PMID- 1734329
TI  - Decreased cerebral glucose utilization in myotonic dystrophy.
AB  - To test the hypothesis that cerebral metabolism is altered in myotonic dystrophy
      (MyD), we investigated cerebral glucose kinetics and utilization in 11 adult
      patients with MyD and 14 healthy controls, using 18F-labeled 2-fluoro-2-deoxy-D
      glucose (FDG) and dynamic positron emission tomography. Estimation of rate
      constants in MyD revealed a reduction of FDG delivery to the brain. Cortical
      glucose utilization rate was reduced by about 20% in MyD. These findings may be
      related to the presence of neurologic impairment in MyD and prompt further
      investigations on the metabolic and clinical features of brain dysfunction in
      this disease.

PMID- 1734330
TI  - Psychogenic seizures: ictal characteristics and diagnostic pitfalls.
AB  - We analyzed ictal features of psychogenic seizures using video-EEG recordings in
      47 patients and reviewed the medical records to determine if patients received
      antiepileptic drug therapy and whether they were treated pharmacologically for
      status epilepticus. Unresponsive behavior in the absence of motor manifestations
      was the single most common ictal presentation. Motor characteristics previously
      considered to distinguish psychogenic seizures (out-of-phase limb movements, side
      to-side head movements, pelvic thrusting) were infrequent. Most patients (74%)
      received anticonvulsants, and six were treated as status epilepticus. Slow,
      subtle writhing or in-phase limb movements were most likely to be mistaken for
      status epilepticus. Physicians, assuming that the spells constituted a neurologic
      emergency, omitted the neurologic examination and chart review and proceeded with
      aggressive pharmacotherapy based merely on observation.

PMID- 1734331
TI  - Fetal drug therapy: an overview of selected conditions.
AB  - Fetal drug therapy may be defined as the administration of any drug for the
      primary or sole purpose of treating a fetal disorder or in the hope of improving
      the capacity for later intrauterine or postnatal adaptation. In several
      intrauterine conditions, the drug exposure has been directed at the fetus rather
      than the mother. Progress in clinical investigation has been slowed by often
      unfounded fears of malformations and potential litigation. Since 1975, federal
      regulations have required that the fetus be protected and subjected to no more
      than minimal additional risk. Although no large-scale trials have been reported,
      drug administration has been proven to aid the fetus in many circumstances. Such
      treatment has been administered primarily during the second or third trimester
      and is generally short-term, preventive, and without apparent risk to the
      consenting mother. The published reports have made obstetricians aware of both
      the limits of our knowledge in this area and new applications for innovative
      fetal monitoring by the latest technology. Whether such therapy has a role in the
      care of the unborn infant will depend on accumulation of a larger body of
      information and the continued cooperation of basic scientists and clinical
      investigators.

PMID- 1734332
TI  - Exercise in pregnancy.

PMID- 1734333
TI  - Estrogen and bone metabolism.

PMID- 1734334
TI  - [Liver specific gene expressions in human fetal hepatocyte culture].
AB  - The authors studied the function of human fetal liver cell--on level of DNA and
      gene regulation--by methods of molecular biology. Experiments were done under
      strict observation of the ethical guidelines of the 1975 Declaration of Helsinki
      Human Research Committee. They conclude that human fetal liver culture may serve
      as a suitable in vitro modell for study of the liver specific gene expressions.
      They found that cultured human fetal liver cells from second trimester express
      albumin and AFP. They demonstrate that fetal hepatocytes--like adult hepatocytes-
      respond to the inflammatory mediators, IL-1, IL-6 and TNF, by induction of CRP
      and alpha-1-Ach expression and regression of albumin synthesis proving the
      ability of fetal hepatocytes to produce an acute phase response.

PMID- 1734335
TI  - [Five-year follow-up pulmonary function studies in patients with anti-trypsin
      deficient pulmonary emphysema].
AB  - Five-year follow-up study was carried out in pulmonary emphysematous patients
      with intermediate antitrypsin deficiency. The examinations showed no
      deterioration in the clinical state of the patients but in some parts of the
      controlled functional parameters a statistically significant worsening was found
      in this period of study.

PMID- 1734336
TI  - [The role of imitation in suicidal behavior].
AB  - The authors analyse the modelling effect of the suicide of the first Hungarian
      beauty queen. After the publication of a book, a film and the newspapers about
      her suicide increased significantly the number of suicides committed by young
      females by the same method (Lidocain pill). During this period the consumption of
      Lidocain pills decreased in Hungary. The monthly and seasonal fluctuation of
      suicides committed by other methods is different from these changes. The suicide
      of celebrities mediated by the mass media can become modell through
      identification for a people in crisis situation.

PMID- 1734337
TI  - [Connection between microalbuminuria and subclinical cardiovascular autonomic
      neuropathy in diabetic children].
AB  - Cardiovascular tests were investigated in 16 microalbuminuric, in 20
      normoalbuminuric diabetic children and a control group of 20 healthy children.
      Comparing to the control group, in both of two diabetic groups a similar increase
      in resting heart rate (74.5 +/- 2.5/min vs. 87.8 +/- 3.5/min, p less than 0.01,
      and 83.6 +/- 3.2/min, p less than 0.05) and a decrease in hyperventilatory
      arrhythmia (32.3 +/- 1.2/min vs. 20.1 +/- 0.8/min, p less than 0.01, and 17.2 +/-
      0.8/min, p less than 0.01) was observed. In the diabetic group with
      microalbuminuria in comparison with both the control group and the
      normoalbuminuric group there was a lower standing/lying heart rate ratio (1.02 +/
      0.03 vs. 1.30 +/- 0.05, p less than 0.01, and 1.22 +/- 0.05, p less than 0.05),
      a pronounced orthostatic decrease in blood pressure (15.1 +/- 0.3 mmHg vs. 2.0 +/
      0.1 mmHg, p less than 0.001, and 5.0 +/- 0.2 mmHg, p less than 0.01) and a
      diminished increase in blood pressure during sustained handgrip (6.3 +/- 0.2 mmHg
      vs. 14.0 +/- 0.3 mmHg, p less than 0.01, and 12.2 +/- 0.3 mmHg, p less than
      0.05). The occurrence of cases with distinct autonomic dysfunction (3 or more
      abnormal cardiovascular tests) proved to be more frequent in the group with
      microalbuminuria than in the diabetic group with normal albumin excretion (6/16
      vs. 1/20, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734338
TI  - [Delayed diagnosis of infectious endocarditis].
AB  - Three cases are presented to show examples of mistakes in the diagnosis and
      treatment of infective endocarditis which led to serious complications. The role
      of echocardiography in the early diagnosis and in the recognition of
      complications, the importance of bacteriologic diagnosis in the choice of
      antibiotic treatment and the need of timely surgical treatment are emphasized.

PMID- 1734339
TI  - [Carcinoid tumor of the breast].
AB  - Two cases of carcinoid breast tumour are presented by the authors. Discussing the
      diagnostic and therapeutic possibilities, it is emphasized that this type of
      tumour represent a bad prognosis, in spite of the relative benign behaviour of
      the carcinoid tumour of other organs. In case of carcinoid tumour of the breast,
      radical operation and careful follow-up is recommended.

PMID- 1734340
TI  - [A new method for the termination of cervical pregnancy].
AB  - The authors described a 7 weeks old cervical pregnant case, whome was
      administered 250 mg methotrexate in infusion to eliminate the throphoblastic
      tissue. 3 days later the HCG was negative in the urine. After the dilatation of
      cervix by laminaria, the collapsed amniotic sac came from the cervix with minimal
      hemorrhage. They suggest the method is suitable to prevent the serious
      complications of cervical pregnancy.

PMID- 1734341
TI  - [The role of different committees and individuals in the ethical position on the
      new methods of human reproduction].
AB  - Due to the research on assisted human reproduction and the application of its
      results we face new type ethical dilemma which had never existed before. The
      traditional system of ethical values does not provide a safe basis for judgement
      of our actions. One of the challenging questions is who has the right to
      authorize or prohibit performing different procedures. There might be necessary
      and justifiable taking into account the opinions of various bodies (professional
      committees, national and institutional ethical committees, religious bodies,
      parliamentary representatives and private organizations or persons). The authors
      introduce the activities of the role and importance of these bodies and
      investigate the position of the research and clinical professionals in obtaining
      permission for the application of ethically sound or less criticizable
      procedures. The importance of the provision of continuous and many-sided
      information for wide range of the society is underlined.

PMID- 1734342
TI  - [Experience with the surgical management of constrictive pericarditis].
AB  - 61 patients were operated on for constrictive pericarditis at the Cardiovascular
      Surgical Clinic of Semmelweis Medical University in the last 33 years. The
      average hospital mortality of the surgical pericardiectomy was 4.9%. The final
      conclusions of this retrospective and follow up study are as follows:
      pericardiectomy is the method of choice in the treatment of constrictive
      pericarditis, since it does not has any therapeutic alternative, its hospital
      mortality is low and it results excellent early and late postoperative functional
      effects.

PMID- 1734343
TI  - [Cases of familial leukemia-lymphoma in Szabolcs-Szatmar-Bereg County].
AB  - Nine cases of familial malignant haematologic diseases were found by authors.
      Demonstrating the clinical pictures and the developments of nine pairs of cases
      (Hodgkin's disease--non-Hodgkin's lymphoma, Hodgkin's disease--chronic
      lymphocytic leukaemia, non-Hodgkin's lymphoma--acute lymphoblastic leukaemia,
      hairy cell leukaemia--acute lymphoblastic leukaemia, chronic lymphocytic
      leukaemia--acute myelogenous leukaemia, non-Hodgkin's lymphoma--chronic
      lymphocytic leukaemia, and three times chronic lymphocytic leukaemia--chronic
      lymphocytic leukaemia) authors want to give data about occurrences of familial
      leukaemia/lymphoma in their county.

PMID- 1734345
TI  - [Differential diagnosis in patients with fever at the department for infectious
      diseases of a county hospital].
AB  - Between the 1st of January 1985 and the 31st of december 1989 101 patients were
      admitted for fever. Their data were analysed retrospectively. The patients were
      divided into three groups according to the diagnostic procedures. 32 patients
      belonged to the first group. The causes of their fever were diagnosed within 24
      hours by simple clinical and laboratory means. The second group held 42 patients
      whose diagnosis were made within one week after detailed laboratory and clinical
      examinations. The third group (21 patients) fulfilled the criteria of FUO (Fever
      of Unknown Origin), and the authors analyse this group of patients. Most of the
      FUO group, 11 patients were diagnosed as infectious origin, 1 tumor, 4
      autoimmune. In three cases the diagnosis remained unknown. Authors conclude that
      patients coming to hospital with fever should deserve more attention of
      specialist infectologists.

PMID- 1734344
TI  - [Relationship between congenital heart disease and various factors affecting
      pregnancy].
AB  - In a prospective epidemiological study data of 24,732 pregnancies were analysed
      by computer programmes for the incidence of congenital heart disease (CHD) and
      its relationship to various factors affecting pregnancy (age and weight of
      mother, smoking, alcohol-, and coffee-consumption, usage of oral contraception).
      Frequency of CHD was 0.9%. Data showed that CHD could be associated with alcohol
      consumption, smoking, maternal age. Other factors like coffee consumption or
      taking oral contraceptive tablets did not influence the frequency of CHD. Authors
      conclude that in the prevention of CHD, reduction or even omission of both
      alcohol consumption and smoking are highly justified.

PMID- 1734347
TI  - [Trace element deficiency in healthy subjects?].

PMID- 1734346
TI  - [Alkaptonuria-ochronosis].
AB  - The authors describe the case of a 40-year old female patient. Since her
      childhood she realised of her urine the black discoloration of the underwear. For
      about a year, without subjective complaints, blue-black color of the skin
      involved the axillae and pinnae. For a year appeared the increased pain of
      thoracal and lumbal spine column and the limitation of motion of these parts. The
      examination of urine, histological and electron microscopical findings, the X-ray
      photograph of the spinal column confirmed the diagnosis of alkaptonuria or rather
      congenital ochronosis.

PMID- 1734348
TI  - Skull base surgery.

PMID- 1734349
TI  - The posterior ethmoid artery in severe epistaxis.

PMID- 1734350
TI  - Cervical "tropical" pyomyositis.

PMID- 1734351
TI  - Verrucous carcinoma.

PMID- 1734352
TI  - Stereophotography of computer-aided three-dimensional reconstructions of the
      temporal bone structures.

PMID- 1734354
TI  - Otitis media.

PMID- 1734353
TI  - Hearing.

PMID- 1734355
TI  - Equilibrium.

PMID- 1734356
TI  - Chemical senses.

PMID- 1734357
TI  - Hearing and equilibrium.

PMID- 1734358
TI  - Otitis media.

PMID- 1734360
TI  - Voice.

PMID- 1734359
TI  - Airways, allergy, sinus.

PMID- 1734361
TI  - Head and neck cancer.

PMID- 1734362
TI  - The Robert Wood Johnson Clinical Scholars Program: a research training plan.

PMID- 1734363
TI  - The importance of the eosinophil in head and neck cancer.
AB  - In a previous study, we found tumor-associated tissue eosinophilia (TATE) to be a
      favorable prognostic indicator for squamous cell carcinoma of the head and neck
      (p less than 0.05). The present expanded study was undertaken to confirm this
      finding. The pathology of 120 head and neck tumors was examined for histologic
      features suggestive of poor prognosis. Ten descriptive histopathologic variables,
      including two malignancy grading scales, were correlated with DNA flow cytometric
      data and clinical outcome. No correlation was found between the malignancy
      grading scales and DNA flow cytometric data or clinical outcome. The present
      expanded study confirmed with greater statistical significance (p less than
      0.001) that high-grade TATE is a favorable prognostic indicator for head and neck
      cancer. Furthermore, high-grade TATE was associated with the absence of distant
      metastasis (p less than 0.05). Using a stepwise logistic regression analysis of
      the clinicopathologic variables in the study, high-grade TATE was the most
      influential variable affecting clinical outcome, followed by border, stage, and
      perineural invasion. We conclude that the grade of TATE is a significant
      prognostic indicator for head and neck cancer. The significance and possible role
      of the eosinophil in the tumor-host interaction are discussed.

PMID- 1734364
TI  - Post-tympanostomy otorrhea: a randomized clinical trial of topical prophylaxis.
AB  - Myringotomy with the insertion of tympanostomy tubes has become the most
      frequently performed otolaryngologic procedure, and otorrhea is the most common
      post-tympanostomy complication. Many otolaryngologists routinely use prophylactic
      topical antibiotic solutions when performing tympanostomy tube placement.
      Relatively little has been written regarding early post-tympanostomy otorrhea and
      scarcely any examining the efficacy of such prophylaxis. The current study is a
      randomized clinical trial to critically evaluate the efficacy of prophylactic
      otic drops after tympanostomy tube placement. The ototoxic potential of these
      solutions, combined with constant pressures to decrease medication expenses and
      eliminate unnecessary use of antibiotics, makes determination of the shortest
      effective course of application paramount. Subjects were randomized at the time
      of surgery into one of three groups: one group received no prophylaxis, a second
      group received gentamicin otic drops immediately after tympanostomy tube
      placement in the operating room only, and the third group received an additional
      48 hours of drops (4 drops in each ear, three times a day). All patients were
      seen within 2 weeks postoperatively. An overall early post-tympanostomy otorrhea
      incidence of 8.7% is documented with 12%, 8.8%, and 5.6% for each study group,
      respectively. While these findings may suggest possible efficacy of topical
      prophylaxis, a statistically significant difference between the treatment groups
      was not proved (p = 0.62). Further analysis by subdivision of the patients, on
      the basis of middle ear cavity finding at the time of surgery, reveals a highly
      significant statistical association of the occurrence of post-tympanostomy
      otorrhea in ears having mucoid effusions (p less than 0.001) as compared to ears
      without effusion or with serous effusions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734365
TI  - Sinus, nasal airway, allergy.

PMID- 1734366
TI  - An animal model of chronic tympanic membrane perforation.
AB  - Previous investigations into the healing and reconstruction of tympanic membrane
      (TM) perforations have involved animal models with acute TM perforations. A
      problem with the acute TM perforation model is that most acute TM perforations
      will heal spontaneously, both in animals and human beings. A second inadequacy of
      acute perforation models is that they are not analogous to the salient problem in
      human beings: long-standing TM perforation. The ideal animal model must have a TM
      perforation that is permanent, well-epithelialized, and free from infection. The
      perforation must also be subtotal to preserve a rim of membrane for experimental
      manipulations. In the chinchilla, we have identified a hardy animal with a short,
      wide ear canal and relatively large tympanic membranes. Thermal myringectomy,
      followed by medial infolding of TM microflaps, has resulted in permanent,
      subtotal chronic TM perforations in the chinchilla animal model. Of the 19
      chinchillas (38 TMs) perforated, chronic subtotal perforations were created in 32
      ears, 6 to 8 weeks after the initial procedure (84% success). Persistent
      infection or TM regeneration despite reperforation was recorded in 6 ears (16%)
      failure). This model is currently being used to assess various biomembrane
      scaffolds impregnated with growth-promoting substances in the regeneration of a
      physiologically sound TM, initially in our animal model and then in human beings.
      We envision the development of a biomembrane disc impregnated with biorecombinant
      growth factors that may provide a simple office technique for the repair of
      chronic, non-infected TM perforations.

PMID- 1734367
TI  - Voice.

PMID- 1734368
TI  - Videolaryngoscopy in the office--a critical evaluation.
AB  - In view of the growing popularity of office videolaryngoscopy, surprisingly
      little objective data exist as to its influence on clinical practice. We reviewed
      150 consecutive laryngeal recordings in an attempt to determine what effect
      videolaryngoscopy has had on our practice and the patient care provided.

PMID- 1734369
TI  - Chemical senses.

PMID- 1734370
TI  - Transfusion, recurrence, and infection in head and neck cancer surgery.
AB  - The detrimental effects of transfusion have been documented--particularly by
      surgical oncologists, who believe transfusion-induced immunosuppression increases
      the incidence of recurrence and infectious complications. We examined this
      relation in surgical oncology of the head and neck. After meeting strict
      inclusion criteria, 104 patients were entered into the study, in which 31
      variables of a clinical, surgical, pathologic, laboratory, and treatment nature
      were studied. Multivariate analysis showed transfusion did not significantly
      affect recurrence or infectious complications. However, by univariate analysis,
      infectious complications were related to transfusion (p = 0.029). The variables
      age (p = 0.024), postoperative hemoglobin level (p = 0.049), and spread to
      regional lymph node (p = 0.0015) were found to significantly affect the incidence
      of recurrence. In the three previous otolaryngologic studies, transfusions had
      been shown to affect recurrence; however, two studies used univariate analysis
      only. Since this is one of the first otolaryngologic studies to examine the
      relation of transfusion with infectious complications, prospective studies using
      multivariate analysis are warranted. Meanwhile, the decision to transfuse should
      continue to depend on the clinical status of the patient.

PMID- 1734371
TI  - Bone conduction implants: transcutaneous vs. percutaneous.
AB  - Clinical experience with transcutaneous bone conduction implants has demonstrated
      that they are most beneficial for patients with purely conductive hearing loss in
      at least one ear. Percutaneous bone conduction implants, however, have been
      reported to provide adequate benefit for patients with mixed hearing loss with
      bone conduction pure-tone averages up to 45 dB HL (Tjellstrom, 1989). The results
      of 24 Xomed Audiant osseointegrated bone conduction hearing devices (including a
      clinical trial on two patients using a new, larger magnet [Neodynium Iron
      Boron]), plus the results of eleven patients implanted and fitted with the
      percutaneous bone-anchored hearing aid are reported. Aided results with these
      devices will be presented. In addition, general comparisons of benefit obtained
      with the two devices will be made for patients who exhibit similar hearing
      losses. Finally, a direct comparison will be made on two patients who have
      undergone both implant procedures.

PMID- 1734372
TI  - Head and neck oncology.

PMID- 1734373
TI  - Absence of sensorineural hearing loss in treated infants and children with
      congenital toxoplasmosis.
AB  - Educationally significant hearing loss has been reported in 10% to 15% of
      children with congenital toxoplasmosis. As part of a pilot study to assess
      feasibility and safety of prolonged therapy for congenital toxoplasmosis, 30
      congenitally infected infants and children were evaluated for auditory function.
      Serial testing, beginning within 2 months of birth, was performed. Availability
      of auditory brainstem response (ABR) testing made evaluation at an earlier age
      than previously possible. Six (20%) of the 30 infants had mild to moderate
      conductive type hearing loss associated with otitis media. No infant or child had
      sensorineural hearing loss. The better outcome we observed compared to previous
      reports of a 15% to 26% incidence of sensorineural hearing loss and 10% to 15%
      incidence of educationally significant, bilateral hearing impairment may be
      related to early initiation and/or prolonged institution of antimicrobial
      therapy. Continued followup to exclude progressive hearing impairment and study
      of larger numbers of children are needed to verify these preliminary findings.

PMID- 1734374
TI  - Facial nerve disorders.

PMID- 1734375
TI  - Postoperative risk following uvulopalatopharyngoplasty for obstructive sleep
      apnea.
AB  - A study was conducted to assess oxygenation and respiratory changes on the first
      and second postoperative nights after uvulopalatopharyngoplasty (UPPP) for
      obstructive sleep apnea (OSA). Twelve patients were postoperatively evaluated
      with 8-hour nocturnal polysomnography on four occasions: (1) PREOP--night before
      UPPP, (2) POPN1--first postoperative night, (3) POPN2--second postoperative
      night, and (4) 3MOS--3-month follow-up study. Results demonstrate that apnea
      index (AI) and respiratory disturbance index (RDI) were significantly improved at
      3MOS from PREOP levels: AI (p less than 0.01) and RDI (p less than 0.05). There
      were no statistical differences from PREOP to POPN1 or POPN2 for AI, RDI, lowest
      oxyhemoglobin saturation (LSAT), or number of desaturations (#DESAT). One of
      twelve patients dropped LSAT greater than 10% from PREOP to POPN1 or POPN2 (82%
      PREOP to 71% POPN2). Patients were grouped by PREOP LSAT greater than or equal to
      80% or less than 80%, and the postoperative change in LSAT was evaluated by
      comparing PREOP to a value averaging POPN1 and POPN2. Patients with LSAT greater
      than or equal to 80% decreased by 2.6%; patients with LSAT less than 80% improved
      by 6.2%. This change in LSAT between groups was statistically different (p =
      0.02). These data suggest that in the majority of patients, preoperative indices
      remain unchanged for at least 2 days after surgery, even for patients who
      demonstrated improvement at 3 months. However, worsening does occur in some
      patients. On the basis of the results of this study and clinical experience with
      the postoperative course, a selective management protocol is outlined.

PMID- 1734376
TI  - The effect of pentoxifylline on cochlear blood flow.
AB  - Pentoxifylline, a phosphodiesterase inhibitor and hemorrheologic agent has been
      found to increase oxygen delivery to ischemic tissue. Intravenous pentoxifylline
      was administered to normal guinea pigs in order to assess the effect of
      pentoxifylline on cochlear blood flow and to elucidate its mechanism of action.
      Intravenous pentoxifylline was found to acutely increase cochlear blood flow in a
      dose-dependent manner. In normal animals, the effect appeared strongly related to
      the rheologic properties of this agent rather than a vasodilative action.
      Normovolemic hemodilution with 75% dextran resulted in no increase in cochlear
      blood flow during infusion of pentoxifylline, whereas the application of
      nitroprusside over the round window failed to abolish the effect of
      pentoxifylline.

PMID- 1734377
TI  - Facial plastic and reconstructive surgery.

PMID- 1734378
TI  - Laser surgery.

PMID- 1734379
TI  - Sudden bilateral profound hearing loss resulting from meningeal carcinomatosis.
AB  - SBPHL is a rare manifestation of hearing loss. Patients with SBPHL should have a
      thorough evaluation for meningeal carcinomatosis as the cause, including a
      complete neurologic evaluation, CT scan, and, probably, MRI. If MC is highly
      suspected, an LP is necessary. Because the diagnosis of MC can be confirmed only
      by the presence of malignant cells in the CSF, multiple LPs may be necessary to
      find them. Although MC should be strongly considered in the differential
      diagnosis of SBPHL, MC should also be considered with other patterns of eighth
      cranial nerve involvement, especially in patients with a history of malignancy.
      These patterns include unilateral hearing loss associated with tinnitus,
      unilateral hearing loss rapidly progressing to severe bilateral involvement,
      audiologic and caloric studies that show eighth cranial nerve impairment, and
      facial nerve palsy associated with hearing loss. The prognosis for MC is poor,
      although intraventricular chemotherapy and whole brain radiotherapy can provide
      significant palliation.

PMID- 1734380
TI  - Salmonella parotitis with abscess formation.

PMID- 1734381
TI  - Suppression of bilirubin production in the Crigler-Najjar type I syndrome:
      studies with the heme oxygenase inhibitor tin-mesoporphyrin.
AB  - The heme oxygenase inhibitor tin-mesoporphyrin was used to moderate
      hyperbilirubinemia in two 17-year-old boys with Crigler-Najjar type I syndrome.
      Both patients had histories of recent, progressive neurological deterioration and
      plasma bilirubin concentrations on admission to the hospital were 34.5 and 28.5
      mg/dL. Throughout hospitalization lasting more than 400 days, both patients
      underwent 10 hours of phototherapy nightly and consumed constant weight
      maintaining diets. They were treated with intermittent plasmapheresis and two
      periods of tin-mesoporphyrin therapy comprising, in the first study period, 40
      doses of 0.5 mumol/kg body weight and in the second study period, 70 doses of 1.0
      mumol/kg body weight. Plasma bilirubin concentrations were decreased in both
      patients to varying degrees as was the rebound hyperbilirubinemia which occurs
      after plasmapheresis. The prolonged treatments with the inhibitor were well
      tolerated and no progression of the preexisting neurological impairments occurred
      during the clinical trials. The results of this study suggest that the clinical
      application of an effective heme oxygenase inhibitor can provide a potentially
      useful, pharmacological adjunct to presently available therapeutic modalities for
      controlling episodes of acute, severe jaundice in this but lethal disorder.

PMID- 1734382
TI  - Vaccine storage practices in pediatric offices.
AB  - Fifty pediatric offices and clinics in the metropolitan Los Angeles area were
      visited to assess vaccine storage practices. Questionnaires were administered to
      the personnel responsible for vaccine storage and the vaccine refrigerators were
      inspected. Only 16% of vaccine storage coordinators could cite appropriate
      storage temperatures for vaccines and 18% were unaware that heat can harm certain
      vaccines. Refrigerator thermometers were checked at least weekly in only 20% of
      offices, and 22% of the refrigerators had inappropriately high temperatures.
      Vaccines were routinely stored outside of the refrigerator uninsulated during the
      practice day in 16% of the offices visited. It is concluded that vaccine storage
      errors occur in pediatric offices at an unacceptably high frequency.
      Pediatricians should familiarize themselves with the guidelines for optimal
      vaccine storage in order to minimize the potential for vaccine failure in primary
      care practice.

PMID- 1734383
TI  - Determinants of condom use among junior high school students in a minority, inner
      city school district.
AB  - Condoms reduce the risk of human immunodeficiency virus (HIV) transmission;
      however, their use among adolescents has been inconsistent. Little is known about
      factors which motivate consistent condom use, particularly among younger
      adolescents. In a study designed to identify such factors, 1899 inner-city junior
      high school students were surveyed. In June 1988, students completed an anonymous
      self-report questionnaire assessing HIV-related knowledge, attitudes, and
      behaviors. Among sexually active students (N = 403), logistic regression analysis
      evaluated the influence of demographic, psychosocial, and behavioral factors on
      frequency of condom use. Respondents who believe condoms are effective in
      preventing HIV transmission were 2.2 times more likely to report using condoms
      consistently during sexual intercourse; those with low perceived costs associated
      with condom use were 1.9 times more likely to be consistent users. Number of
      lifetime sexual partners was inversely related to frequency of condom use.
      Respondents with a history of three or more sex partners were half as likely to
      use condoms consistently. Factors not associated with consistent condom use
      include age, age at sexual debut, ethnicity, HIV knowledge, perceived efficacy to
      avoid HIV infection, and alcohol and drug use. School- and community-based HIV
      prevention programs will have to go beyond the didactic transfer of factual
      information and include more interactive teaching strategies to improve
      adolescents' attitudes toward condoms are self-efficacy to increase condom use
      and to counter negative peer influences and adolescents' perceptions of
      invulnerability. Physicians are an underutilized source of HIV prevention
      information. They have an important role in counseling adolescents about
      effective HIV-prevention methods and dispelling misperceptions which hinder
      consistent condom use.

PMID- 1734384
TI  - Intratracheal suctioning, systemic infection, and the meconium aspiration
      syndrome.
AB  - A retrospective analysis was performed to determine: (1) the proportion of
      neonates with the meconium aspiration syndrome (MAS) who were not depressed at
      birth; (2) to evaluate the clinical course of neonates with MAS, particularly
      relating to whether or not delivery room intubation and intratracheal suctioning
      had taken place; and (3) to examine the incidence of culture-proven bacteremia
      among meconium-stained neonates and those with MAS. The medical records of all
      meconium-stained neonates and those with MAS admitted to our facility from 1985
      through 1989 were reviewed. Of 5697 liveborn neonates, 741 (13%) were meconium
      stained, of whom 608 (82%) were intubated and suctioned in the delivery room. No
      complications of the intubation/suctioning procedure were noted in these
      neonates. Forty-five neonates had culture-proven bacteremia. Five bacteremic
      neonates had been meconium-stained (0.7% of all such neonates), while 40 were not
      stained (0.8% incidence). Of 36 neonates with MAS, 1 (2.8%) was bacteremic.
      Twenty (56%) of 36 newborns with MAS did not require positive pressure
      ventilation in the delivery room. Twelve (33%) of the babies with MAS had not
      been intubated and suctioned in the delivery room. Nine (75%) of 12 nonsuctioned
      neonates, as well as 6 (25%) of 24 suctioned neonates, required mechanical
      ventilation for more than 6 hours (P = .010). Pneumothoraces occurred in 6 (50%)
      of 12 nonsuctioned and 5 (21%) of 24 suctioned babies (P = .125). Four of 12
      nonsuctioned newborns either died (n = 1) or required extracorporeal membrane
      oxygenation (n = 3), while only 1 of the suctioned newborns required
      extracorporeal membrane oxygenation (P = .034).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734385
TI  - Localization of human immunodeficiency virus core antigen in term human
      placentas.
AB  - Evidence of human immunodeficiency virus (HIV) replication was sought in human
      placentas obtained at term from pregnancies complicated by maternal HIV
      infection. Placentas were obtained from the pregnancies of 19 HIV-seropositive
      women, 4 women who were seronegative, and 4 untested women with no risk factors
      for HIV infection. These placentas were each examined by immunoperoxidase
      immunocytochemistry using monoclonal anti-p24/55 antibodies. In addition, minced
      placental tissue from 11 of the seropositive pregnancies and the 3 seronegative
      pregnancies were co-cultivated with stimulated human peripheral blood mononuclear
      cells. The clinical status of the infants born to the HIV-seropositive women was
      assessed when the infants were 8 to 28 months of age. P24/55 antigen was detected
      in 5 of the 19 placentas of the HIV-seropositive pregnancies and in none of the 8
      placentas of seronegative or low-risk pregnancies. This HIV core viral antigen
      was located exclusively in the cytoplasm of villous cells with morphological
      characteristics of macrophages. The HIV antigen-containing cells were very
      sparsely distributed. Staining of the trophoblast was not observed in any
      placental specimen. Human immunodeficiency virus was isolated in culture from 3
      of the 11 placentas from seropositive pregnancies. Clinical follow-up has not
      revealed a relationship between infection of the infant and either p24/55 antigen
      identification or isolation of virus from the placenta. Virological and
      histological evidence of HIV replication is found in approximately one fourth of
      placentas obtained at term from pregnancies complicated by maternal HIV
      infection. Replicating virus appears localized to sparse macrophages located
      within the chorionic villi, but specifically not within the trophoblastic
      layer.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734386
TI  - Cost-effectiveness of erythromycin versus mupirocin for the treatment of impetigo
      in children.
AB  - A new topical antibiotic, mupirocin, has been found to be as effective as
      erythromycin for the treatment of impetigo, but concerns about its expense have
      been raised. This controlled clinical trial sought to compare the cost
      effectiveness of erythromycin (E) and mupirocin (M). Ninety-three children, aged
      3 months to 16 years, were randomly assigned to receive 10 days of oral
      erythromycin (n = 46) or topical mupirocin (n = 47). Costs and effects were
      measured through structured interviews. Cost per case differed significantly by
      group (E = $56.85; M = $62.30; P less than .05) due chiefly to extra visits and
      medication changes needed by those treated with mupirocin. Erythromycin and
      mupirocin were equally effective. The likelihood of side effects (E = 43%, M =
      22%) approached significance (P less than .07); those treated with erythromycin
      were willing to pay more for a different medicine to avoid the side effects
      experienced (P less than .05). Working parents and school-age children were more
      likely to alter their daily activities when the patient was taking erythromycin
      (P less than .04). Compliance and parental satisfaction did not differ by
      treatment group; however, parents of children treated with erythromycin were more
      likely to prefer the alternate drug regimen. It is concluded that the type of
      medication prescribed can be based on parental preference because the increased
      cost of mupirocin is offset by increased side effects and number of schooldays
      and workdays lost with erythromycin.

PMID- 1734387
TI  - Adaptation of feeding to a low fat yield in breast milk.
AB  - The effect of a low milk fat yield was assessed in a blinded prospective study of
      healthy term infants and mothers encouraged to breast-feed. Fat yield index was
      calculated as milk volume collected by Egnell pump multiplied by the
      "creamatocrit." Two weeks after delivery mothers who had a relatively low fat
      yield index (less than or equal to 30th percentile) were matched with mothers
      with a higher fat yield index and with formula-feeding mothers. Between 2 and 6
      weeks the low fat yield group had a marginally lower weight gain but similar
      growth in length and head circumference to that of the higher fat yield group.
      The low fat yield group spent more time per feeding and had more complete breast
      emptying, resulting in a fat yield index comparable with the higher fat yield
      group for the mean milk volume ingested by the infant at 6 weeks. A low fat yield
      had no adverse effect on maternal satisfaction or maternal-infant interaction
      during feeding. Formula feeders spent the least time in feeding and en face
      gazing. Adaptation of breast-feeding to a low fat yield sustains infant intake
      and growth, maternal-infant interaction, and maternal satisfaction. However,
      there is little reserve if milk production diminishes. Further study is needed to
      define the limits of adaptation and effective interventions if fat yield is
      inadequate.

PMID- 1734388
TI  - Nutrient adequacy of low fat intakes for children: the Bogalusa Heart Study.
AB  - Nutritional adequacy is important when diets and dietary alterations are
      recommended for children. Concern is expressed that low fat intakes may have
      deleterious effects on growth and development and may be deficient in total
      calories and essential nutrients. In a study of the effect of variation in
      percent fat in the diet, a sample of 871 ten-year-olds was stratified according
      to four different fat intakes: less than 30% of total kilocalories (kcal), 30% to
      35% kcal, 35% to 40% kcal, and greater than 40% kcal. The race/sex distribution
      was similar within each fat intake group. Fourteen percent of the sample had fat
      intakes less than 30% of total calories. The amount of calories from breakfast,
      dinner, and snacks was higher in the children with fat intakes greater than 40%
      of total calories than those with lower fat intakes. The energy intake of all
      race/sex groups fell within the recommended range. The low fat intake group was
      eating 25% less calories than the high fat intake group (1800 kcal vs 2400 kcal).
      The percentage of calories from carbohydrate, specifically sugar, was greater in
      the low fat intake group compared with the high fat intake group. Percentage of
      calories from protein was approximately 13% for all groups. Fiber and starch were
      the same across all fat intakes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734389
TI  - Symmetric cerebral blood flow in newborns who have undergone successful
      extracorporeal membrane oxygenation.
AB  - Cerebral blood flow (CBF) was measured with positron emission tomography in 23
      newborns following extracorporeal membrane oxygenation. In 9 newborns the common
      carotid artery was reanastomosed after extracorporeal membrane oxygenation and in
      14 newborns the common carotid artery remained ligated. The ratio of right/left
      hemispheric CBF was not significantly different in the newborns with
      reanastomosed or occluded common carotid arteries (right/left CBF ratio was 0.98
      in both groups). The maximum asymmetry was 8% and was observed in 2 newborns. All
      9 newborns with reanastomosis of the carotid artery are normal at follow-up at 1
      year or longer. Three newborns with ligation of the common carotid artery were
      lost to follow-up and 1 newborn died. Eight of 10 remaining newborns are normal
      at follow-up; the 2 other infants have developmental quotients of 60 and 64,
      respectively, and no other deficits. The data indicate (1) that hemispheric CBF
      is symmetric in newborns who have undergone extracorporeal membrane oxygenation
      and have no evidence of brain injury, and (2) that reanastomosis of the common
      carotid artery does not alter hemispheric CBF in the newborn period.

PMID- 1734390
TI  - Lupus nephritis: prognostic factors in children.
AB  - As newer treatment modalities become available for patients with severe lupus
      nephritis, it becomes increasingly important to identify patients at risk for
      renal failure. In this study, the records of 90 children presenting with systemic
      lupus erythematosus over a 13-year period were reviewed. Nineteen were lost to
      follow-up prior to completion of the study. Of the 71 remaining children, 16
      (22%) progressed to chronic renal failure. Persistent hypertension lasting
      greater than 4 months, anemia, abnormalities of the urinalysis, and elevated
      serum creatinine level were significantly associated with progression to renal
      failure. Sex, race, age, abnormalities of creatinine clearance, and 24-hour urine
      protein collection were not associated with progression to renal failure. Renal
      biopsies were obtained in 45 children. Biopsies were initially classified
      according to World Health Organization criteria. Diffuse proliferative
      glomerulonephritis was significantly associated with progression to renal
      failure. The 45 biopsies available were reviewed by one of the authors and
      categorized by activity and chronicity indices. Both the active lesions of
      fibrinoid necrosis, synechiae, tubular casts, and vasculitic lesions and the
      chronic lesion of glomerular sclerosis correlated with progression to renal
      failure. Of the 16 children who progressed to renal failure, 2 had cadaver kidney
      transplants and are well 5 years posttransplant; 4 had fulminant lupus and died
      within 1 month of commencing dialysis; 10 began chronic dialysis. Five of the 10
      children on chronic dialysis died from sepsis. These data suggest that children
      with systemic lupus erythematosus who undergo dialysis do poorly.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1734391
TI  - Cerebrospinal fluid isoniazid concentrations in children with tuberculous
      meningitis: the influence of dosage and acetylation status.
AB  - Cerebrospinal fluid (CSF) and plasma isoniazid (INH) concentrations were
      determined on 96 occasions in 38 children (median age 1.5 years) with tuberculous
      meningitis, and the effects of INH elimination status and test dosages of 10
      mg/kg body weight and 20 mg/kg body weight was studied. Maximum cerebrospinal
      fluid INH concentrations were reached during the period 2 to 4 hours after dosing
      and cerebrospinal fluid and plasma INH concentrations did not differ
      significantly during this period. Cerebrospinal fluid INH concentrations
      following a dosage of 10 mg/kg (4.6 +/- 2.4 micrograms/mL) were, however,
      significantly lower than those following a dosage of 20 mg/kg (11.6 +/- 2.7
      micrograms/mL). Cerebrospinal fluid INH concentrations in faster acetylators at a
      dosage of 10 mg/kg (3.2 +/- 1.1 micrograms/mL) were significantly lower than in
      slower acetylators (7.7 +/- 1.3 micrograms/mL), as was the case with a dosage of
      20 mg/kg, where faster acetylators had cerebrospinal fluid INH concentrations of
      10.5 +/- 2.5 micrograms/mL compared with 14.1 +/- 1.4 microgram/mL in slower
      acetylators. Following dosages of both 10 mg/kg and 20 mg/kg, INH concentrations
      in excess of the minimal inhibitory concentration for Mycobacterium tuberculosis
      persisted in the CSF 12 to 14 hours later. Despite the patients' being young and
      frequently malnourished, suffering from advanced forms of tuberculous meningitis,
      and receiving high dosages of INH, rifampicin, and pyrazinamide, none developed
      any clinical signs of hepatotoxicity and in only one child did the serum
      bilirubin level rise to 19 micrograms/mL.

PMID- 1734392
TI  - Rapid improvement in the renal tubular dysfunction associated with tyrosinemia
      following hepatic replacement.
AB  - The postoperative management of patients with hereditary tyrosinemia type I
      (McKusick 27670) following liver transplantation is often complicated by the
      renal tubular dysfunction associated with this disease. To characterize better
      the temporal course of the improvement in renal excretory activity following
      hepatic replacement, renal tubular function and metabolite excretion were studied
      in a 4-year-old girl with hereditary tyrosinemia during the immediate post
      transplantation course. Tubular reabsorption of bicarbonate and phosphate were
      normal 5 days following transplantation, in contrast to glucosuria,
      hyperaminoaciduria, and tyrosyluria, which persisted for approximately 3 weeks.
      After hepatic replacement, serum amino acid concentrations returned to normal and
      succinylacetone was no longer detected in the urine. This is the third
      tyrosinemia patient reported to achieve complete resolution of urinary
      abnormalities following transplantation, and the only patient in whom renal
      tubular function was formally assessed within the first postoperative week.

PMID- 1734393
TI  - Heart rate monitoring of physical activity in children and adolescents: the
      Muscatine Study.
AB  - To assess the usefulness of whole-day heart rate monitoring as a quantitative
      measure of physical activity in children, the activity of 76 children and
      adolescents (ages 6 to 17 years), randomly selected from a school population, was
      measured during a typical summer day using a light-weight, nonrestrictive heart
      rate telemetry unit. A 12-hour recall and a simple self-rating of usual activity
      questionnaire were also administered on the same day. An additional 12-hour
      recall questionnaire was administered on another day. Within 1 month of the heart
      rate monitoring, the skinfold measures, peak aerobic capacity, and sexual
      maturation were assessed. Data analysis indicated that activity as measured by
      telemetry was related to questionnaire recall on the monitored day (r = .50),
      nonmonitored day (r = .32), and self-rating (r = .35); level of activity as
      measured by telemetry was related to peak aerobic capacity in girls (r = .36) but
      not in boys (r = -.06); body fat was related inversely to activity (r = -.32);
      and prepubescent children were more active than post- and pubescent children (P
      less than .003). No difference was found in activity level between boys and girls
      (P greater than .05). This study suggests that for children whole-day heart rate
      monitoring is an objective, nonobtrusive method for measuring physical activity;
      and maturation, but not gender, is an influential mediating factor for activity.

PMID- 1734394
TI  - Increased familial cardiovascular mortality in obese schoolchildren: the
      Muscatine Ponderosity Family Study.
AB  - Total and cause-specific mortality was investigated in 387 first- and second
      degree deceased adult relatives of three groups of children selected from those
      who participated in three biennial school surveys in Muscatine, Iowa: the lean
      group (students in the first quintile of relative weight on all three surveys);
      the random group (a random sample of all eligible students); and the heavy group
      (students in the fifth quintile of relative weight on all three surveys). A
      greater proportion of death certificates for heavy group relatives listed a
      cardiovascular cause of death (60%) compared with lean (48%) and random (43%)
      group relatives. The relative risk of dying of cardiovascular disease for heavy
      group vs random group relatives was 1.41 (95% confidence interval 1.01, 1.98). In
      a subset of heavy group families identified by children with elevated systolic
      blood pressure, the proportion of death certificates listing a cardiovascular
      cause was even higher (76%) and the estimate of relative risk vs random group
      relatives was 2.20 (95% confidence interval 1.43, 3.37). These results indicate
      that persistent obesity in children, particularly when accompanied by persistent
      blood pressure elevation, identifies families whose members are at increased risk
      of dying of cardiovascular disease.

PMID- 1734395
TI  - Horizontal transmission of hepatitis B virus infection to United States-born
      children of Hmong refugees.
AB  - There is evidence that hepatitis B virus (HBV) transmission continues among
      Southeast Asian refugees after resettlement. To determine the prevalence of HBV
      infection (hepatitis B surface antigen [HBsAg] positive or core antibody
      positive) and modes of transmission in Hmong refugee households in Wisconsin,
      results of serologic tests were reviewed for 429 US-born children not previously
      vaccinated with hepatitis B vaccine and 754 of their Asian-born household
      members. The prevalence of HBV infection was 14% (62/429) among all US-born
      children, 30% (21/69) among children whose mothers were HBsAg-positive, and 11%
      (41/360) among children whose mothers were HBsAg-negative. Among children whose
      mothers were HBsAg-negative, the prevalence of HBV infection increased with
      increasing age (chi 2 test for trend = 5.6, P = .02) and was related to the
      household presence of HBsAg-positive sibling(s) (relative risk = 4.0; 95%
      confidence interval = 1.5, 9.3; P less than .001). Of the 62 infected children,
      13 (21%) lived in households with no HBsAg-positive household members. US-born
      children of Hmong refugees apparently acquire HBV infection through both
      horizontal and perinatal transmission. These findings emphasize the importance of
      routinely integrating hepatitis B vaccine doses into the childhood vaccination
      schedule for all infants whose parents are from areas where HBV infection is
      highly endemic. In addition, the findings support the need for pediatricians to
      consider vaccinating older children (up to age 7 years) whose parents are from
      HBV-endemic areas.

PMID- 1734396
TI  - Markers for occult liver injury in cases of physical abuse in children.
AB  - Children suffering physical abuse are at risk for abdominal trauma. When the
      abdominal trauma is not evident clinically and remains occult, the child's
      condition can rapidly deteriorate before the diagnosis is made, and delay may
      occur in the activation of child protective services. The use of markers for
      abdominal trauma in the evaluation of cases of child physical abuse was examined.
      Children younger than 12 years presenting to the Emergency Department at the
      Children's Hospital of Buffalo from August 1989 through April 1990 for the
      evaluation of suspected physical abuse were prospectively entered in the project.
      All patients had a complete history and physical examination performed. Those
      patients who did not show any signs of abdominal injury had the following
      laboratory tests done: (1) levels of liver transaminases, lactate dehydrogenase,
      and alkaline phosphatase; (2) amylase level; and (3) uranlysis. Of 49 patients
      without clinical signs of abdominal trauma, 4 children had elevated transaminase
      levels. Three of these 4 patients had liver lacerations documented by subsequent
      abdominal computed tomographic scans. A new finding of transaminase levels as
      markers of occult liver injury in children suffering physical abuse is reported.

PMID- 1734397
TI  - Parasitology screening of Latin American children in a primary care clinic.
AB  - A screening program based in a Massachusetts community hospital primary care
      clinic, which included 124 children from 12 different Latin American countries,
      demonstrated that nearly 35% were carriers of pathogenic parasites. The large
      majority (83.7%) of these children were asymptomatic at the time of the
      examination. Although there may be considerable variation based on country of
      origin, the present results, as well as a review of the literature, suggest this
      is likely to be a common finding among children born in most regions of Latin
      America. Compliance with the screening process was significantly higher in groups
      with higher infection rates and the successive yield in those patients who
      submitted two or more stool samples revealed that most pathogens were identified
      in the first sample. School-age children were found to have the highest risk for
      both roundworm infections and multiple parasitic infections. For those children
      with identified pathogens, nearly 90% received treatment. Current trends in
      immigration, international adoptions, and special circumstances including day
      care, family shelters, and increasing numbers of human immunodeficiency virus
      infected children have made an appreciation of the extent of parasitosis, and
      awareness of possible management approaches, an important consideration for
      primary care physicians in the United States.

PMID- 1734398
TI  - Estimating infant mortality from human immunodeficiency virus and other causes in
      breast-feeding and bottle-feeding populations.
AB  - This paper discusses the literature dealing with breast-feeding in women with
      human immunodeficiency virus (HIV) infection. This review is used to develop a
      background for a quantitative assessment of factors determining whether breast
      feeding or bottle-feeding will result in a lower overall mortality in areas of
      different HIV prevalence. An algebraic formula is presented that enables
      calculation of the mortality that would result in any population if the following
      variables are known or capable of estimation: portion of childbearing women
      infected with HIV, portion of newborns infected with HIV at birth, relative
      mortality of breast-fed and bottle-fed infants that are not HIV infected, and
      transmissibility of HIV during breast-feeding. The information available for
      estimating these variables is incomplete. Nevertheless, boundaries can be set for
      each variable, based on information obtained locally or from the literature, to
      aid in objective evaluation of the risks of promoting bottle-feeding or breast
      feeding in populations with different risk characteristics. Consideration of
      these factors indicates that the benefits of breast-feeding over bottle-feeding
      can substantially outweigh any putative risk of HIV transmission during breast
      feeding unless the prevalence of HIV infection is quite high or the difference in
      mortality of breast-fed and bottle-fed infants is very low.

PMID- 1734399
TI  - Thymic abnormalities in fetuses aborted from human immunodeficiency virus type 1
      seropositive women.
AB  - Pathological abnormalities of the thymus were found in 3 of 37 fetuses aborted
      from human immunodeficiency virus (HIV)-infected mothers. These lesions were
      located predominantly in the thymic cortex, which contains mostly immature
      lymphocytes. Areas of focal lymphocyte depletion were infiltrated with CD4+
      macrophages and were associated with abnormalities of the epithelial stromal
      network. No evidence of extensive HIV infection in any of the 37 thymuses was
      detected by either immunofluorescence or in situ hybridization techniques,
      although rare cells that expressed HIV antigens were found in 3 fetuses. Although
      less extensive, this thymic fetopathy was similar to that described in postnatal
      acquired immunodeficiency syndrome thymuses, strongly suggesting that the lesions
      were related to HIV infection. Thymic fetopathy might represent the initial
      injury to the lymphoid system in HIV-infected infants in whom early and severe
      immunosuppression develops.

PMID- 1734400
TI  - Prospective randomized double-blind study comparing L-epinephrine and racemic
      epinephrine aerosols in the treatment of laryngotracheitis (croup).
AB  - Aerosolized racemic epinephrine, but not L-epinephrine, is commonly used in
      treating croup. The efficacy and adverse effects of nebulized racemic and L
      epinephrine in the treatment of laryngotracheitis were compared. Children 6
      months to 6 years of age with a croup score of 6 or above were assigned in a
      randomized double-blind fashion to receive either racemic (n = 16) or L
      epinephrine (n = 15) aerosols. Croup score, heart rate, blood pressure,
      respiratory rate, fraction of inspired oxygen, and oxygen saturation were
      recorded before treatment and at 5, 15, 30, 60, 90, and 120 minutes after the
      aerosol. Patients in both groups showed significant transient reduction of the
      croup score and respiratory rate following the aerosol (P less than .001), but
      there were no differences between treatment groups when croup score, heart rate,
      blood pressure, and respiratory rate were assessed over time. It is concluded
      that L-epinephrine is at least as effective as racemic epinephrine in the
      treatment of laryngotracheitis and does not carry the risk of additional adverse
      effects. L-Epinephrine is also more readily available worldwide, is less
      expensive, and can be recommended for this purpose.

PMID- 1734401
TI  - Genital injuries resulting from sexual abuse: a longitudinal study.
AB  - Three children who incurred genital injuries as a result of sexual assaults were
      followed up on a longitudinal basis to document the anatomical changes which
      ensued. The subjects, who were 4 months, 4 years 5 months, and 9 years of age,
      were followed up for periods ranging from 14 months to 3 years. A multi-method
      examination approach and a 35-mm camera mounted on a colposcope were used to
      examine and record their injuries. Signs of the acute damage disappeared rapidly,
      and the wounds healed without complications. Following the resolution of the
      acute injuries, the changes created by the trauma remained relatively stable
      throughout the prepubertal years. The most persistent findings were irregular
      hymenal edges and narrow rims at the point of the injury. Over time the jagged,
      angular margins smoothed off. Disruption of the hymen exposed underlying
      longitudinal intravaginal ridges whose hymenal attachments created mounds or
      projections. There was little apparent scar formation. Even the injuries to the
      posterior fourchettes healed with minimal scar tissue and left only the slightest
      evidence of the trauma. With the onset of puberty, the hymenal changes in the
      oldest subject were obscured by the hypertrophy of this membrane. An examination
      technique which used a Q-tip to separate the redundant tissues demonstrated that
      the signs of trauma had survived.

PMID- 1734402
TI  - The ricochet of magic bullets: summary of the Institute of Medicine Report,
      Adverse Effects of Pertussis and Rubella Vaccines.

PMID- 1734403
TI  - Finger intubation of the trachea in newborns.

PMID- 1734404
TI  - Intraventricular hemorrhage in the full-term neonate associated with abdominal
      compression.

PMID- 1734405
TI  - Idiopathic neonatal hepatitis in one DNA fingerprint identical twin.

PMID- 1734406
TI  - Not all severe hyperglycemia is diabetes.

PMID- 1734407
TI  - Magnetic resonance imaging evaluation of neonates with retinal hemorrhages.

PMID- 1734408
TI  - How safe are pertussis and rubella vaccines? A commentary on the Institute of
      Medicine Report.

PMID- 1734409
TI  - American Academy of Pediatrics, Committee on Communications: The
      commercialization of children's television.

PMID- 1734410
TI  - The other view of disposable diapers.

PMID- 1734411
TI  - Mental retardation and ADHD!

PMID- 1734412
TI  - Fire hydrant injuries.

PMID- 1734413
TI  - Fire hydrant injuries.

PMID- 1734414
TI  - Developmental toxicants risk assessment.

PMID- 1734415
TI  - Life, death, and parents' opinions in the intensive care unit.

PMID- 1734416
TI  - Risks with translocation in "typus edinburgensis".

PMID- 1734417
TI  - Publish or perish.

PMID- 1734418
TI  - More on dog-bite injuries.

PMID- 1734419
TI  - Very low birth weight outcomes.

PMID- 1734420
TI  - Very low birth weight outcomes.

PMID- 1734421
TI  - Iron syrup concentration error.

PMID- 1734422
TI  - Pediatricians do matter.

PMID- 1734423
TI  - [Fever is children].
AB  - Fever is a common symptom in childhood, and is often a sign of innocuous
      infection. Although most children with serious infections are diagnosed at
      clinical examination, there are important exceptions that should be borne in mind
      by all physicians. The article provides advice as to when parents ought to
      consult a physician in cases of childhood fever, and on the use of antipyretics.

PMID- 1734424
TI  - [Prediction of cancer mortality in Scandinavia in 2005. Effect of various
      interventions].
AB  - Approximate estimates have been made of the effect by the year 2005 of various
      preventive measures to reduce cancer mortality in Scandinavia. Figures have been
      calculated for changes in smoking, diet and exposure to sunlight (primary
      prevention), for earlier diagnosis (secondary prevention), and improved survival
      as a result of improved treatment (tertiary prevention). The calculations have
      been performed with the American program CAN TROL, the effect being expressed as
      the percentage reduction in cancer mortality by the year 2005. The results give
      promise of a substantial overall reduction in cancer mortality in Scandinavia.

PMID- 1734425
TI  - [fever!].

PMID- 1734426
TI  - [Swedish public health report 1991. Increasing social consequences of illness?].
AB  - According to the Swedish Public Health Report of 1991, health has improved in the
      45-64-year-old age group of the gainfully employed population during the 1980s.
      Cardiopulmonary and gastrointestinal diseases have become less common, whereas
      certain types of cancer, allergy, and locomotor pain are on the increase. The
      prevalence of locomotor pain among young working women has doubled. The number of
      those on early pensions is increasing, which may be due to increasing demands in
      the working environment as well as to organisational re-structuring. The report
      points out that the chronically ill and those on disability pensions are finding
      it harder to compete in the housing market. A medical class distinction is made:
      those with long-term mental illness have a much worse standard of living than
      those with somatic diseases.

PMID- 1734427
TI  - [Unemployment and ill health].

PMID- 1734429
TI  - [Education proposal for physicians in sparsely populated areas].

PMID- 1734428
TI  - [Unemployment and ill health--or the other way around?].
AB  - In response to a recent article in Nord Med (No 11/91) this paper raises a
      critique of the reanalysis of two Nordic studies on the effects of unemployment
      on health: The model based on varying relationships between vocational ability
      and job requirement does not invalidate earlier findings. However, the
      interpretation of measurements of health in individual based follow-up studies
      warrants a discussion, as well as the external validity of their findings.
      Unemployment has been shown to affect health related behaviour, like consultation
      rates, referrals, sick leave and disability pension, in well controlled studies.
      These effects are of importance to the individuals and the health- and social
      services, regardless of their relation to disease in a biomedical sense.

PMID- 1734430
TI  - [A glimpse of Estonia's health services].

PMID- 1734431
TI  - [Fever--friend or foe?].
AB  - Since the turn of the century intensive research has been carried out to
      ascertain whether fever is associated with the organism's defence against
      microbial agents, and evidence is now available concerning the beneficial impact
      of fever under certain circumstances. However, fever also often gives rise to
      risks and inimical sequelae. Antipyretics should be used in the correct manner,
      and when the fever constitutes a hazard to the patient or causes suffering.

PMID- 1734432
TI  - [Temperature measurement--where, when and how?].
AB  - The mercury thermometer may no longer be sold in Sweden, and is soon to be
      proscribed in the other Scandinavian countries. How reliable are other
      thermometers, and should body temperature be measured orally, rectally or in some
      other way?

PMID- 1734433
TI  - [How do people perceive fever and what is done for it?].
AB  - The perception of fever has changed throughout history. Fever is a common
      symptom, and nowadays antipyretics are widely used. However, our knowledge of
      layman's perception of fever and self-care is rather limited. Unfounded parental
      concern of fever in children ("fever phobia") has not been found in Nordic
      studies. However, the findings indicate a need for more definite and consistent
      information on fever and fever management, including self-medication. This is a
      joint challenge to primary health care workers and local pharmacists.

PMID- 1734434
TI  - Infancy problem behaviors.
AB  - The goal of pediatric health supervision is to promote the optimal growth and
      development of children. Parent-infant interaction and parental attitudes toward
      their infant are important determinants of child development. Anticipatory
      guidance during child health supervision enables the pediatric provider to
      discuss developmental stages and demystify common stage-related behaviors, such
      as fussing, night-waking, repetitive movements, and clinging. Anticipating the
      emergence of such behaviors and issues may lessen parental anxiety and concern.
      When behavioral problems such as colic or sleep difficulties do arise, a
      consideration of developmental stage is helpful in suggesting specific management
      strategies. The successful implementation of developmentally-oriented approaches
      has benefits for the family and pediatric provider, including increased parental
      self-confidence, enhanced family functioning, and increased parental confidence
      in the pediatrician. Furthermore, by encouraging developmentally-oriented
      approaches, parents will be less inclined to adopt inappropriate or ineffectual
      behavioral management strategies.

PMID- 1734435
TI  - Otitis media.

PMID- 1734436
TI  - Left upper quadrant masses in children.

PMID- 1734437
TI  - Pickles, pizza, and PREP.

PMID- 1734438
TI  - Case 1 presentation. Sickle cell sequestration crisis.

PMID- 1734439
TI  - Case 2 presentation. Salicylate toxicity.

PMID- 1734440
TI  - Case 3 presentation. Congestive heart failure in an infant.

PMID- 1734441
TI  - Screening for vision problems in pediatric practice.

PMID- 1734442
TI  - Amblyopia: etiology, detection, and treatment.
AB  - Amblyopia is a preventable cause of visual loss in children that may be permanent
      unless it is detected and treated early. It may be caused by strabismus,
      refractive errors, or cataracts. Primary strabismus may lead to loss of vision
      from amblyopia and the loss of binocularity. Secondary strabismus may be a sign
      of primary visual loss in one or both eyes. The most serious disorder that may
      present as secondary strabismus is retinoblastoma. It is imperative to detect
      retinoblastoma early because of its morbidity and mortality. Amblyopia is
      detected by assessing the visual acuity of each eye. Strabismus is detected by
      using the corneal light reflex test and the cover test. Focusing problems are
      detected by assessing the visual acuity and the red reflex. Cataracts and
      retinoblastoma may be detected by examining the red reflex of the eye. Treatment
      of amblyopia consists of correcting the amblyogenic factor with appropriate
      glasses and surgery. The preferred eye is patched with an adhesive patch to
      stimulate visual development in the amblyopic eye. The pediatrician plays a
      crucial role in the early detection of amblyopia, strabismus, and cataracts. The
      key to successful visual outcome is early recognition by the pediatrician,
      referral to the pediatric ophthalmologist, and prompt treatment.

PMID- 1734443
TI  - Vascular response to radiation injury in the rat lung.
AB  - Changes in relative left-to-right lung blood flow ratios were followed as an
      index of vascular radiation injury in left-hemithorax-irradiated Sprague-Dawley
      rats. Single doses of 11 to 21 Gy gamma radiation resulted in a dose-dependent
      decrease in relative blood flow to the irradiated lung from 3 to 5 weeks after
      exposure during the development of pneumonitis. Blood flow returned to near
      normal by 5 weeks after lower doses (11-13.5 Gy). After a single dose of 15 Gy
      the left-to-right blood flow ratio recovered to 75% of normal at 12 weeks and
      leveled off. Following 18 Gy irradiation a second period of reduced flow began 16
      weeks after exposure. After 21 Gy irradiation flow to the irradiated side
      remained low for 1 year after exposure. Rats that received a single dose of 18 Gy
      to the left hemithorax were also treated with one or two of the following drugs:
      captopril, cyproheptadine, dexamethasone, diethylcarbamazine, penicillamine, or
      theophylline. Dexamethasone was most effective at preventing the decrease in
      blood flow to the irradiated lung when treatment was continued through the
      pneumonitis period and dose was not tapered until 8 weeks after radiation
      exposure. All other drugs and drug combinations were, for the most part,
      virtually ineffective after the pneumonitis period. There was a relatively poor
      correlation with earlier vascular permeability surface area product studies. This
      suggests that endothelial damage, as well as damage to other cell types,
      contributes to the development of post-irradiation fibrosis in the lung.

PMID- 1734444
TI  - Effects of v-src oncogene activation on radiation sensitivity in drug-sensitive
      and in multidrug-resistant rat fibroblasts.
AB  - Recent work has implicated the activated ras oncogene, whose gene product is a G
      protein located in the plasma membrane, as well as the activated raf oncogene,
      whose gene product is a membrane-associated protein kinase, in contributing to
      radioresistance. Another transforming oncogene whose gene product is localized to
      the plasma membrane is v-src. We have examined a rat fibroblast line (RAT-1)
      infected with an avian sarcoma virus carrying a temperature-sensitive mutation in
      the v-src tyrosine kinase domain (LA-24). At 40 degrees C, LA-24 cells have a
      flat morphology and grow as a contact-inhibited monolayer, while at 35 degrees C,
      LA-24 cells have a transformed morphology, lose contact inhibition, grow in soft
      agar, and exhibit 3.5-fold higher tyrosine kinase activity. The parental RAT-1
      line, not infected by the virus, grows at both temperatures as a contact
      inhibited monolayer. This well-characterized system represents a good model for
      examining the effect of v-src transformation on radiosensitivity. RAT-1 and LA-24
      cells grown at 35 and 40 degrees C were irradiated with graded doses of
      radiation, and clonogenic survival was assayed. For LA-24 cells grown at 35 and
      40 degrees C, and for RAT-1 cells grown at 35 and 40 degrees C, calculated D0, n,
      alpha, and beta values did not differ significantly. To determine whether there
      might be differences in radiation damage repair capacity too subtle to detect by
      comparing radiation survival curves, sublethal damage repair capacity was
      assessed. There was no difference in sublethal damage repair capacity for LA-24
      cells grown at 35 or 40 degrees C. Other studies have associated multidrug
      resistance with radioresistance. We have examined the radiation sensitivity of
      two colchicine-resistant LA-24 clones with four- to fivefold amplification of the
      P-glycoprotein gene, which are four-to fivefold more resistant to colchicine than
      the parental LA-24 line. In these multidrug-resistant clones, v-src activation
      does appear to increase radiation resistance. This did not appear to be due to
      alteration in cell cycle kinetics. We conclude that oncogene activation, or even
      protein kinase activity per se, does not necessarily lead to radiation
      resistance. Rather, radiation resistance following oncogene activation depends
      upon the oncogene and cell line studied, and perhaps upon specific protein
      phosphorylation.

PMID- 1734445
TI  - Differences in effects of oncogenes on resistance of gamma rays, ultraviolet
      light, and heat shock.
AB  - The effects of viral or activated cellular oncogenes on sensitivity to gamma
      rays, ultraviolet light, and heat shock were examined in SHOK (Syrian hamster
      Osaka-Kanazawa) cells and their transfectants. Resistance to gamma rays was
      conferred by the introduction of v-mos or c-cot genes, which coded
      serine/threonine kinase. Cells transfected with v-mos and c-cot genes increased
      their resistance to ultraviolet light and heat shock compared to their parent
      cells (SHOK cells). Of the activated ras genes, the N-ras gene developed a SHOK
      cell phenotype resistant to gamma rays and ultraviolet light. The Ha-ras gene
      produced SHOK cells resistant to ultraviolet light and heat shock, while
      introduction of the Ki-ras gene did not affect sensitivity. The v-erbB gene was
      found to be involved in the development of resistance to heat shock. Transfection
      with neo, c-myc, and v-fgr genes had little or no effect on cell survival. The
      karyotypes of SHOK cells and oncogene-containing cells were compared. No
      alterations were seen after the introduction of a foreign gene. Using cell cycle
      analysis, we found no apparent difference between SHOK cells and their
      transfectants. These results suggest that activation of serine/threonine kinase
      may be involved in common processes occurring after gamma-ray, ultraviolet-light,
      and heat-shock treatment, and that each oncogene may have a different effect on
      the development of a resistant phenotype.

PMID- 1734446
TI  - Leptomycin B-induced fixation of X-ray-related potentially lethal damage.
AB  - Effects of an antifungal antibiotic, Leptomycin B (LMB), on X-ray cell killing
      were studied using cultured mammalian cells (BHK21). LMB at concentrations from
      0.05 to 2 ng/ml inhibited cell proliferation but enhanced cell killing without
      significant cytotoxic effect when added to cell cultures pre- and
      postirradiation. The degree of enhanced cell killing decreased as the interval
      between irradiation and LMB treatment was prolonged. Enhancement of cell killing
      was probably due to fixation of potentially lethal damage (PLD) to LMB.
      Radioresistant S-phase cells were more sensitive to LMB-induced PLD fixation than
      G1-phase cells. Furthermore, a preliminary study showed that LMB not only
      inhibited the repair of PLD which was induced by conditioned medium but also
      inhibited splitdose repair of sublethal damage. Although the target molecule of
      LMB has not been identified, we suggest that LMB inhibits repair processes by
      altering the structure of the nuclear scaffold, which is supposed to be a
      radiosensitive site.

PMID- 1734447
TI  - Charged-particle mutagenesis. 1. Cytotoxic and mutagenic effects of high-LET
      charged iron particles on human skin fibroblasts.
AB  - Cytotoxic and mutagenic effects of high-LET charged iron (56Fe) particles were
      measured quantitatively using primary cultures of human skin fibroblasts. Argon
      and lanthanum particles and gamma rays were used in comparative studies. The span
      of LETs selected was from 150 keV/microns (330 MeV/u) to 920 keV/microns (600
      MeV/u). Mutations were scored at the hypoxanthine guanine phosphoribosyl
      transferase (HPRT) locus using 6-thio-guanine (6-TG) for selection. Exposure to
      these high-LET charged particles resulted in exponential survival curves.
      Mutation induction, however, was fitted by the linear model. The relative
      biological effectiveness (RBE) for cell killing ranged from 3.7 to 1.3, while
      that for mutation induction ranged from 5.7 to 0.5. Both the RBE for cell killing
      and the RBE for mutagenesis decreased with increasing LET over the range of 1.50
      to 920 keV/microns. The inactivation cross section (sigma i) and the action cross
      section for mutation induction (sigma m) ranged from 32.9 to 92.0 microns2 and
      1.45 to 5.56 X 10(-3) microns2; the maximum values were obtained by 56Fe with an
      LET of 200 keV/microns. The mutagenicity (sigma m/sigma i) ranged from 2.05 to
      7.99 X 10(-5) with an inverse relationship to LET.

PMID- 1734448
TI  - Protein synthesis in irradiated cells. I. Ultraviolet radiation.
AB  - Excision-deficient haploid yeast cells (Saccharomyces cerevisiae) were exposed to
      254-nm UV radiation and protein synthesis inhibition was measured for a large
      number of different proteins resolved by two-dimensional gel electrophoresis. The
      derived UV-radiation sensitivities exhibited an overall increase with protein
      molar mass. Quantitatively, this behavior is compatible with a well known
      mechanism of transcription inactivation--termination of RNA chains at UV
      radiation-induced pyrimidine dimers--if the respective target sizes are inferred
      from protein molar mass. The observed deviations from the predicted response
      suggest that (i) UV-radiation damage may also interfere with recognition/binding
      of RNA polymerase to regulatory sequences and (ii) the frequency of photolesions
      for a specific protein encoding gene may differ markedly from the mean induction
      rate for the total yeast genome.

PMID- 1734449
TI  - Chromatin compaction and the efficiency of formation of DNA-protein crosslinks in
      gamma-irradiated mammalian cells.
AB  - Chromatin has been prepared from Chinese hamster V79 cell nuclei by successive
      suspension and sedimentation in buffers of decreasing ionic strength. For buffer
      concentrations from 50 to 1 mM, the resultant chromatin maintained a normal
      histone content, nucleosomal organization, and attachment to the nuclear matrix;
      however, as the buffer concentration was reduced from 50 to 10 and 1 mM, the
      higher-order chromatin structures became increasingly relaxed. Fully expanded
      chromatin is 5- to 10-fold more susceptible to the induction of DNA-protein
      crosslinks (DPCs) by gamma radiation than is chromatin residing in living
      interphase cells. As much as 60-70% of expanded chromatin can be induced to form
      DPCs as compared to a maximum of about 20% of cellular DNA. For expanded
      chromatin, the maximum level of induced DPCs is two to three times higher than
      would be expected if only matrix-associated DNA were induced to form DPCs.
      Therefore, DNA in distal regions of chromatin loops must also be induced to form
      DPCs with histones or other nonhistone chromosomal proteins. The hypersensitivity
      of isolated chromatin to radiation-induced production of DPCs appears to be
      related to the expansion of chromatin conformation rather than to the removal of
      intracellular radical scavengers for the following reasons: (a) there is an
      inverse relationship between the buffer concentration in which the chromatin is
      suspended and DPC formation, and (b) the induction of a more compact 30-nm
      chromatin fiber from the expanded 10-nm chromatin fiber in the presence of a low
      concentration of MgCl2 results in a marked reduction in DPC formation. The
      formation of radiation-induced DPC seems to occur at maximum efficiency in fully
      expanded chromatin, since DPC formation cannot be further stimulated by the
      addition of Cu2+, which can catalyze the production of OH by Fenton chemistry. It
      is concluded that radiation-induced DNA damage production is greatly influenced
      by chromatin conformation, and that chromatin as it exists in the cell is a
      relatively poor substrate for DNA-protein crosslinking in comparison to
      completely expanded chromatin.

PMID- 1734450
TI  - Chronic exposure to ionizing radiation as a tumor promoter in mouse skin.
AB  - We have tested chronic exposure to 90Y beta radiation for its action as a
      complete tumor promoter, a stage I tumor promoter, or a stage II tumor promoter
      in SENCAR mouse skin. In skin initiated with a single application of
      7,12,dimethylbenz[a]anthracene (DMBA, 10 nmol), chronic exposure to beta
      radiation as a complete promoter (0.5 Gy, twice/week, 13 weeks) produced no
      tumors and, when added to a complete chemical promoter (TPA), reduced tumor
      frequency about 30%. A similar result was observed when beta radiation was tested
      as a stage II promoter. DMBA-initiated mice that received chemical (12-O
      tetradecanoylphorbol-13-acetate, TPA) stage I promotion followed by 13 weeks of
      beta-radiation exposure (0.5 Gy, twice/week) as stage II promotion produced
      essentially no tumors, and combining the same chronic beta-radiation exposure
      with chemical (mezerein) stage II promotion reduced tumor frequency about 20%
      when compared to a similar group that was not irradiated. Chronic beta-radiation
      exposure was tested two ways as a stage I tumor promoter in initiated skin that
      was subsequently treated with mezerein as a stage II promoter. Stage I promotion
      was shown to proceed with the passage of time, indicating this process occurs
      naturally in the absence of chemical or physical stimulation. Hyperthermia,
      previously shown to be a potent inhibitor of chemically stimulated stage I
      promotion, had no effect on the natural process, indicating at least some
      differences in mechanism between the two processes. The natural process was, in
      fact, inhibited by chemical tumor promoters, but not by radiation. In addition to
      the increase resulting from this natural process, tumor frequency was further
      increased slightly but significantly (12-15%, P less than or equal to 0.05) when
      chronic radiation exposure was given as a stage I promoter (0.5 Gy, twice/week,
      13 weeks) subsequent to initiation, in spite of the expected 20% reduction
      resulting from this dose. Exposure of initiated animals to radiation (0.5 or 1.0
      Gy, twice/week, 2 weeks) in addition to TPA as stage I promotion produced a
      similar increase in tumor frequency (P less than 0.02). At higher radiation
      doses, however, tumor frequency was reduced compared to unirradiated controls. In
      a third test as a stage I promoter, beta radiation (0.5 Gy twice/week, 4 weeks)
      was given prior to initiation with N-methyl-N'-nitro-N-nitrosoguanidine in
      animals subsequently promoted by TPA (twice/week, 13 weeks), and again the
      radiation slightly but significantly (P less than 0.03) increased tumor frequency
      compared to the unirradiated control group.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1734451
TI  - Mechanism of radiosensitization by halogenated pyrimidines: effect of BrdU on
      repair of DNA breaks, interphase chromatin breaks, and potentially lethal damage
      in plateau-phase CHO cells.
AB  - There is evidence suggesting that radiosensitization induced in mammalian cells
      by substitution in the DNA of thymidine with BrdU has a component that relies on
      inhibition of repair and/or fixation of radiation damage. Here, experiments
      designed to study the mechanism of this phenomenon are described. The effect of
      BrdU incorporation into DNA was studied on cellular repair capability, rejoining
      of interphase chromosome breaks, as well as induction and rejoining of DNA double
      and single-stranded breaks (DSBs and SSBs) in plateau-phase CHO cells exposed to
      X rays. Repair of potentially lethal damage (PLD), as measured by delayed plating
      of plateau-phase cells, was used to assay cellular repair capacity. Rejoining of
      interphase chromosome breaks was assayed by means of premature chromosome
      condensation (PCC); induction and rejoining of DNA DSBs were assayed by pulsed
      field gel electrophoresis and induction and rejoining of DNA SSBs by DNA
      unwinding. A decrease was observed in the rate of repair of PLD in cells grown in
      the presence of BrdU, the magnitude of which depended upon the degree of
      thymidine replacement. The relative increase in survival caused by PLD repair was
      larger in cells substituted with BrdU and led to a partial loss of the
      radiosensitizing effect compared to cells tested immediately after irradiation. A
      decrease was also observed in the rate of rejoining of interphase chromosome
      breaks as well as in the rate of rejoining of the slow component of DNA DSBs in
      cells substituted with BrdU. The time constants measured for the rejoining of the
      slow component of DNA DSBs and of interphase chromosome breaks were similar both
      in the presence and in the absence of BrdU, suggesting a correlation between this
      subset of DNA lesions and interphase chromosome breaks. It is proposed that a
      larger proportion of radiation-induced potentially lethal lesions becomes lethal
      in cells grown in the presence of BrdU. Potentially lethal lesions are fixed via
      interaction with processes associated with cell cycle progression in cells plated
      immediately after irradiation, but can be partly repaired in cells kept in the
      plateau-phase. It is hypothesized that fixation of PLD is caused by alterations
      in chromatin conformation that occur during normal progression of cells
      throughout the cell cycle.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1734452
TI  - Neutron RBE for primate spinal cord treated with clinical regimens.
AB  - The RBEs of high-energy neutrons given in 9 or 12 fractions for cervical spinal
      cord injury in rhesus monkeys was determined using photons at 2.2 Gy per fraction
      as the reference radiation. Because the dose-response functions were not
      parallel, the RBE was not constant but rather increased with dose or,
      equivalently, with the probability of myelopathy. This required the development
      of a novel method of determining the RBE versus level of response. The RBE is
      presented as a function of probability of myelopathy from 0.1 to 99%. At a 50%
      incidence of myelopathy, the RBE (+/- 1 SE) was 5.22 +/- 0.15. A difference in
      the histopathology of lesions induced by photon and neutron treatments was
      observed.

PMID- 1734453
TI  - Hyperthermia-induced enhancement of melphalan activity against a melphalan
      resistant human rhabdomyosarcoma xenograft.
AB  - The effects of regional hyperthermia (42 degrees C for 70 min) on the antitumor
      activity of melphalan were examined in athymic mice bearing melphalan-resistant
      human rhabdomyosarcoma (TE-671 MR) xenografts growing in the right hind limb, and
      results were compared with similar studies of melphalan-sensitive (TE-671) parent
      xenografts. Melphalan alone at a dose of 36 mg/m2 (0.5 of the 10% lethal dose)
      produced growth delays of 4.1 to 10.2 days in TE-671 MR xenografts and 21.8 to
      28.7 days in TE-671, respectively. Hyperthermia alone produced growth delays of
      0.9 days in TE-671 MR xenografts and 0.8 days in TE-671. Combination therapy with
      melphalan and hyperthermia produced growth delays of 7.2 to 13.3 days in TE-671
      MR xenografts and 34.3 to 42.8 days in TE-671, respectively, representing a mean
      thermal enhancement ratio of 1.7 in TE-671 MR and 1.5 in TE-671. Measurement of
      glutathione levels in TE-671 MR xenografts following treatment with melphalan,
      hyperthermia, or melphalan plus hyperthermia revealed significant reductions in
      glutathione content with the nadir (60% of control values) seen 6 h following
      treatment. Glutathione levels in TE-671 xenografts following identical therapy
      revealed no differences from control values. Hyperthermia plus melphalan did not
      result in a higher tumor-to-plasma melphalan ratio compared with treatment with
      melphalan alone in either TE-671 MR or TE-671 xenografts. These studies suggest
      that heat-induced alterations in tumor glutathione or melphalan levels are not
      responsible for the increase in melphalan activity produced by hyperthermia.
      Combination therapy with melphalan plus regional hyperthermia offers promise for
      treatment of melphalan-resistant neoplasms.

PMID- 1734454
TI  - Reduction of radiation-induced G2 arrest by caffeine.
AB  - A large number of studies have been undertaken in an attempt to define the
      mechanism by which caffeine (1,3,7-trimethylxanthine) reduces the duration of
      radiation-induced arrest of cells in the G2 phase of the cell cycle. These
      studies are summarized and those agents which mimic the action of caffeine are
      listed in the order of their potency. This ranking does not match any activities
      of these agents described previously, but provides a comparison for future
      studies, which might profitably include measurement of the ability of these
      agents to inhibit protein kinases.

PMID- 1734455
TI  - Contributions of the direct and indirect effects of ionizing radiation to
      reproductive cell death.

PMID- 1734456
TI  - Laser alignment system for high-quality portable radiography.
AB  - In portable radiography, image quality is degraded by scattered radiation. Use of
      an accurately aligned, antiscatter grid can provide consistently high image
      quality, but the necessary precision for grid alignment is difficult to achieve
      with conventional techniques. The authors developed a simple laser alignment
      method for bedside radiography. A compact laser device is mounted on the
      collimator housing of a mobile radiography machine, so that the laser beam is
      precisely parallel to the central x-ray beam. A small reflector device, which
      attaches to the edge of the grid cassette, indicates beam centering and alignment
      in a clear, intuitive way. In clinical use, the laser alignment technique
      provided uniformly high image quality, equivalent to that of fixed equipment. The
      system has the advantages of being simple to use and inexpensive to implement
      with existing equipment.

PMID- 1734457
TI  - The videodisc in medical education.

PMID- 1734458
TI  - Picture archiving and communication systems: an overview.
AB  - Organizational techniques that enable small departments to function efficiently
      often fail as departments become larger. With the recent growth in imaging
      technology, the capacity of film-based systems to meet the increasing needs of
      radiology departments has decreased. Electronic picture archiving and
      communication systems (PACS) have been developed in an attempt to provide
      economical storage, rapid retrieval of images, access to images acquired with
      multiple modalities, and simultaneous access at multiple sites. Input to a PACS
      may come from digital or analog sources (when the latter have been digitized). A
      PACS consists primarily of an image acquisition device (an electronic gateway to
      the system), data management system (a specialized computer system that controls
      the flow of information on the network), image storage devices (both short- and
      long-term archives), transmission network (which serves local or wide areas),
      display stations (which include a computer, text monitor, image monitors, and a
      user interface), and devices to produce hard-copy images (currently, a
      multiformat or laser camera). The goals of PACS are to improve operational
      efficiency while maintaining or improving diagnostic ability.

PMID- 1734459
TI  - Three methods of implementing a picture archiving and communication system.
AB  - A picture archiving and communication system (PACS) is a system integration of
      many components, including radiologic image acquisition devices, computers,
      communication networks, image display workstations, and data base management
      systems. The author describes three general approaches to implementing a PACS. In
      the first approach, the department or institution acts as a systems integrator,
      designing and implementing the PACS. In the second approach, the PACS is planned
      on the basis of the department's operations and environment and then a
      manufacturer is contracted to design and build the system. The third approach is
      to purchase a turnkey system, with some modifications provided by the
      manufacturer for a specific clinical application. The author provides examples of
      each approach in the clinical environment and presents the disadvantages and
      advantages of each.

PMID- 1734460
TI  - Evaluation of requirements and planning for picture archiving and communication
      systems.
AB  - Successful implementation of a picture archiving and communication system (PACS)
      requires extensive planning and the input of the users in the planning and
      evaluation stages. System design is conducted in nine stages: systems analysis,
      stages 1-4; system design, stages 5 and 6; and system implementation, stages 7-9.
      Users of the PACS are actively involved in systems analysis. At stage 1, problems
      are identified, project scope is defined, and whether the problems can be
      successfully addressed with a PACS is determined. If the project is feasible,
      current systems are studied at stage 2. Data are collected on the volume of image
      data to be transmitted, stored, retrieved, and displayed; distribution of imaging
      through the day; radiologists' reading patterns and volumes; job functions of
      technologists; characteristics of images to be included; types of equipment to be
      interfaced; physical placement of cables, connections, and equipment; and
      operational restrictions. All these data and more are used in stage 3 to specify
      requirements of the PACS. Rigorous specifications are needed to ensure that the
      final system performs at the desired level. At stage 4, users evaluate
      alternative solutions to problems. Although consultants and equipment
      manufacturers do much of the design, implementation, and installation, users must
      understand project scope and limitations of the technology and must ultimately be
      responsible for planning a system that meets their needs.

PMID- 1734461
TI  - Thymoma: radiologic-pathologic correlation.
AB  - Thymoma is the most common primary neoplasm of the thymus. The majority of
      thymomas are encapsulated masses and exhibit a benign behavior. Less frequently,
      thymomas may be locally invasive, or rarely they may metastasize to distant
      sites. The usual clinical presentation is that of an anterior mediastinal mass
      found incidentally in an asymptomatic patient. The variable gross features of
      thymoma and the potential for local invasion result in a variety of radiologic
      appearances. The most common radiologic manifestation is a rounded, soft-tissue
      mass of the anterior superior mediastinum. Computed tomography and magnetic
      resonance imaging typically show a prevascular mediastinal mass of variable size
      and may be helpful in the evaluation of adjacent structures in cases of invasive
      thymoma. The treatment of choice is complete surgical excision. Radiation therapy
      and chemotherapy may be used adjunctively to surgery in the treatment of invasive
      tumors. The prognosis of encapsulated thymoma is generally favorable. Invasive
      tumors are associated with a worse prognosis but may respond to radical
      resection.

PMID- 1734462
TI  - Image interpretation session. Primary carcinoma of the male breast with
      lymphangitic spread to the lungs.

PMID- 1734463
TI  - Image interpretation session. Multiple benign pheochromocytomas.

PMID- 1734465
TI  - Image interpretation session. Mycetoma of the right foot.

PMID- 1734464
TI  - Image interpretation session. Gonadotropin insufficiency secondary to pituitary
      siderosis in a patient with thalassemia major and repeated blood transfusions.

PMID- 1734466
TI  - Image interpretation session. Cystic fibrosis with distal intestinal obstruction
      syndrome or meconium ileus equivalent.

PMID- 1734468
TI  - Image interpretation session. Focal xanthogranulomatous pyelonephritis.

PMID- 1734467
TI  - Image interpretation session. Mediastinal parathyroid adenoma with
      hyperparathyroidism.

PMID- 1734469
TI  - Image interpretation session. Rhinocerebral mucormycosis.

PMID- 1734470
TI  - Image interpretation session. Tuberculosis dactylitis, psoas abscess, and lumbar
      vertebral tuberculosis osteomyelitis.

PMID- 1734471
TI  - Image interpretation session. Ischemic small bowel, arterial embolus, and left
      atrial myxoma.

PMID- 1734472
TI  - Pediatric case of the day. Right ovarian torsion, amputation, and calcification.

PMID- 1734473
TI  - Proper terminology for the left periaortic area.

PMID- 1734474
TI  - Ultrasound case of the day. Right adnexal torsion.

PMID- 1734475
TI  - General case of the day. Cystic rheumatoid arthritis.

PMID- 1734476
TI  - Communicating risk information in medical practice.
AB  - The public's preceptions about the risks of radiation are adversely influenced by
      the many negative reports by the media on the hazards of all radiation. As a
      result, patients express concern about the risks of radiation from radiologic
      examinations. Radiologists are well positioned to dispel these fears because of
      their training and their access to and ability to interpret information from
      scientific organizations specifically concerned with the determination of
      radiation risk. To do this, radiologists must be willing to communicate with
      patients and be accessible. Pamphlets and handouts can be given to anxious
      patients before examinations. In direct interaction with patients, the
      radiologist must listen to them and be prepared to address their concerns,
      especially those about repeat examinations, exposure during pregnancy,
      inadvertent exposure of the fetus, exposure of children, use of radiation in
      research, and misadministration of radionuclides. In addition, radiologists can
      help patients by educating referring physicians, other medical staff, and nurses.
      They can also reach the public by being a spokesperson at meetings of local
      organizations or by accepting opportunities to speak to the media. All these
      efforts help counteract negative perceptions aroused by the media.

PMID- 1734477
TI  - Gd-DOTA-enhanced MR imaging and color Doppler US of renal allograft necrosis.
AB  - In 21 recipients of renal transplants suspected of allograft necrosis, the
      authors correlated the results of imaging to pathologic and histologic data in
      order to describe the magnetic resonance (MR) imaging and color Doppler
      ultrasonographic (US) characteristics of infarction. All patients underwent MR
      imaging performed with and without gadolinium tetraazacyclododecanetetraacetic
      acid (DOTA) and color Doppler US. Nonenhanced T1-weighted images showed no
      obvious changes, whereas nonenhanced T2-weighted images demonstrated a slight
      increase in signal intensity in areas of ischemic necrosis and low or
      heterogeneous signal intensity in areas of hemorrhagic necrosis. Gd-DOTA-enhanced
      MR images showed no contrast material uptake in infarcted areas. Color Doppler US
      characteristics of infarction included absence of Doppler signal and alteration
      of the cortical echogenic structure, particularly in cases of ischemic necrosis.
      Color Doppler US allows measurement of vascular resistance and assessment of
      intrarenal vasculature and the renal pedicle. Gd-DOTA-enhanced MR imaging is
      useful in confirming the diagnosis of infarction and provides an accurate
      evaluation of the extent of the infarct.

PMID- 1734478
TI  - Color Doppler sonography in the evaluation of erectile dysfunction.
AB  - Color Doppler sonography can be useful in the evaluation of erectile dysfunction,
      which can result from psychogenic, endocrinologic, neurogenic, pharmacologic, and
      vasogenic causes. It is used to determine the integrity of the vascular
      mechanism. After an intracavernosal injection of a vasodilatory agent, color
      Doppler sonography is performed to evaluate cavernosal arteries and dorsal
      vessels. Color flow imaging allows direct visualization of intrapenile anatomy,
      vascular variants, and disease. It is also helpful in demonstrating transitions
      in cavernosal and dorsal blood flow. Color Doppler sonography is combined with
      spectral interrogation of the cavernosal arteries and dorsal veins to help
      determine peak systolic and end-diastolic velocities. Cavernosal artery size and
      systolic velocities help diagnose arterial insufficiency. Recent work on
      cavernosal artery diastolic flow and dorsal vein flow has indicated that color
      Doppler sonography, when correlated with cavernosographic findings, may be
      helpful in diagnosing venous incompetence. Temporal variations in transitions in
      cavernosal artery and dorsal vein flow during various stages of erection are
      important in the accurate diagnosis of vasogenic impotence.

PMID- 1734479
TI  - Sexual harassment in radiology departments.

PMID- 1734480
TI  - Spectral and color Doppler artifacts.
AB  - Artifacts in spectral and color Doppler imaging can be confusing and lead to
      misinterpretation of flow information. The authors review these artifacts by
      considering three main causes: inappropriate equipment settings, anatomic
      factors, and physical and technical limitations of the modality. Incorrect gain,
      wall-filter, or velocity scale settings can cause loss of clinically important
      information or distortion of the tracing. Reflection of the Doppler signal from
      highly reflective surfaces can create a color Doppler mirror image. Vascular
      motion can introduce artifactual variation in velocity as the sample volume
      passes through different velocities in a laminar flow state. Unintentional motion
      can cause a generalized Doppler shift. Increasing the angle of Doppler
      interrogation degrades the quality of the tracing and gives the impression of
      spectral broadening. As angulation approaches 90 degrees, directional ambiguity
      can occur, suggesting bidirectional flow. Grating and side lobes can interrogate
      areas unrelated to the sample volume and introduce extraneous Doppler information
      to the apparent area of interrogation. Recognition of these artifacts is
      essential to proper interpretation of Doppler information and rendering a correct
      diagnosis.

PMID- 1734481
TI  - High-resolution CT of parenchymal lung disease: precise correlation with
      histologic findings.
AB  - To provide a precise correlation between high-resolution computed tomographic
      (CT) findings and histologic studies of various parenchymal lung diseases, 20
      fixed and inflated lungs were studied as follows: (a) Every lung was cut at the
      corresponding CT level into 1.5-mm-thick sections, (b) selected slices were cut
      into small blocks to prepare histologic slides, (c) each slide was photographed,
      and (d) the image of the entire lung section was reconstituted with the enlarged
      photographs (assembled as in a jigsaw puzzle). Results obtained in cases of
      normal lungs, pulmonary edema, alveolitis, hypersensitivity pneumonitis,
      emphysema, Pneumocystis carinii pneumonia, silicosis-asbestosis, and idiopathic
      pulmonary fibrosis demonstrated the method to be accurate in correlating high
      resolution CT findings and the corresponding histologic data.

PMID- 1734482
TI  - Appendices epiploicae of the colon: radiologic and pathologic features.
AB  - Appendices epiploicae are adipose structures protruding from the serosal surface
      of the colon. They can be seen with abdominal radiography and cross-sectional
      imaging if the colonic wall is surrounded by intraperitoneal contrast material,
      ascites, or blood. Normal appendices epiploicae appear as lobulated masses of
      pericolic fat, usually 2-5 cm long and 1-2 cm thick. Their enlargement,
      deformity, or altered radiopacity may result from various pathologic processes
      that can originate locally or extend from adjacent viscera. In a series of 22
      cases, appendices epiploicae were affected by spontaneous torsion and hemorrhagic
      infarct, calcification due to aseptic fat necrosis, primary or secondary
      inflammation, enlargement by lipomas or metastases, and incarceration in hernias.
      Disorders of appendices epiploicae are often manifested by nonspecific clinical
      signs and symptoms (eg, torsion is often mistaken for appendicitis or
      diverticulitis). These entities should be included in the differential diagnosis
      of any unexplained abdominal pain or pericolic lesions in adults.

PMID- 1734483
TI  - Radiographic caricature as a medical illustration.

PMID- 1734484
TI  - US-guided percutaneous pancreatography: an essential tool for imaging
      pancreatitis.
AB  - The pancreatic duct can be opacified when contrast material is injected through a
      fine needle percutaneously placed under ultrasound (US) guidance. Percutaneous
      pancreatography was performed in 63 patients with chronic pancreatitis diagnosed
      at US or computed tomography (CT). In 52 of these patients, endoscopic retrograde
      pancreatography (ERP) was unsuccessful or did not enable complete visualization
      of the duct. The percutaneous pancreatograms and other relevant images of these
      patients were retrospectively reviewed. Percutaneous pancreatography was
      successful in 54 patients (86%), in whom it clearly mapped the full ductal
      anatomy, depicted the relationship between cavities seen at US or CT and the
      duct, and allowed assessment of duct drainage after antegrade injection of
      contrast material. This information was not provided by other modalities.
      Percutaneous pancreatography is a valuable complement to CT, US, and ERP for
      imaging chronic pancreatitis.

PMID- 1734485
TI  - MR imaging in high-risk obstetric patients: a valuable complement to US.
AB  - The accuracy of prenatal diagnosis has become increasingly critical in the field
      of high-risk obstetrics. Although ultrasound (US) provides adequate information
      in most cases and continues to be the initial prenatal examination of choice,
      there are instances in which the results of the US study may be equivocal. The
      role of magnetic resonance (MR) imaging was explored in 27 selected patients with
      various indications to determine its effectiveness as a complement to US. MR
      imaging was most helpful in the diagnosis of extrauterine gestation, evaluation
      of placental position, determination of extent or nature of masses associated
      with pregnancy, and differentiation between diaphragmatic hernia and a thoracic
      mass. Although MR imaging did not add information that affected the accuracy of
      the diagnosis of oligohydramnios, in all other cases it provided an extra
      dimension in diagnosis by showing clearer anatomic relationships in the pelvis.
      It has proved to be a valuable complement to an equivocal US study.

PMID- 1734486
TI  - [Blood pressure measurement using the fingers].
AB  - An increasing number of devices for self-assessment of blood pressure has been
      developed over the past years. Accepted international standards for evaluation of
      such devices are still lacking. A new apparatus (T88, Marshall Electronics)
      measuring blood pressure on digital arteries by oscillometry was tested for
      accuracy. Comparative measurements in 36 patients indicated position-dependent
      results with a reasonable correlation with the measurements taken on the upper
      arm only if the device was used at the level of the heart. Significant
      differences for systolic values were noted on different phalanges. In a last
      series of measurements, comparing values obtained about the basal phalanges of
      the index positioned at the level of the heart, significant differences were
      found for systolic and diastolic values compared to the traditional measurement.
      The use of this device for evaluation of hypertension, monitoring of treatment or
      use in studies is thus not recommended.

PMID- 1734487
TI  - [Self measurement of blood pressure: automation and management problems].
AB  - In the Federal Republic of Germany, the introduction of clinical testing of
      devices designed for the self-measurement of blood pressure resulted in an
      improvement of quality of these devices during the last ten years. Further
      progress seems to be possible by more restrictive administrative prescriptions.
      Now, electronic devices have the same accuracy as stethoscope devices. They
      facilitate self-measurement especially in handicapped persons. Devices working by
      the oscillometric method do not measure blood pressure more accurately than
      Korotkow devices, but they are a bit less sensitive for wrong placing of the
      bladder. In most devices automation of the prescribed deflation rate (2 to 3
      mmHg/s) was successful.

PMID- 1734488
TI  - [Self measurement of blood pressure: normal and pathological values].
AB  - To date, the normal range for self-recorded blood-pressure values has yet to be
      defined. In this paper possible definitions of the normal range of self-recorded
      blood pressure are discussed. In large epidemiologic studies self-recorded and
      casual blood-pressure values should be compared to each other, and in prospective
      interventional studies blood-pressure values for the initiation of therapy should
      be defined. Before the termination of these studies we recommend the start of an
      antihypertensive therapy above 140/90 mmHg. Although definite normal values for
      self-recorded blood pressure are still missing, a broader use of this method
      seems to be justified because of the well-known pitfalls of the causal clinical
      blood-pressure measurement.

PMID- 1734489
TI  - [Technique and interpretation of 24-hour blood pressure measurements].
AB  - Development of ambulatory repetitive recording of blood pressure during day and
      night under normal daily activity demonstrates a marked fall in blood pressure of
      normo- and hypertensive individuals during the night hours. Although no general
      consensus exists on normal values for such measurements, the upper normal limit
      appears to be 140/90 mmHg during the day and 120/80 mmHg during the night. This
      method also avoids the excessive rise in blood pressure induced by the physician
      (white-coat effect). Furthermore, it permits an exact assessment of efficacy of
      antihypertensive treatment. It may also provide means for better characterization
      of hypertension as risk factor in general, although there is still a lack of
      experience to estimate its cardio-vascular risk potency.

PMID- 1734490
TI  - [What is your diagnosis? Carbon monoxide poisoning--attempted suicide].

PMID- 1734491
TI  - [Are mercury sphygmomanometers obsolete?].
AB  - The measurement of blood pressure during medical visits is limited in its
      diagnostic, prognostic and therapeutic value by physiologic variability of
      hypertension and measurement errors. Repeated measurements reduce the effect of
      spontaneous variations of blood pressure. They allow a more secure assessment of
      real tension. Regular training for proper technique and elimination of arbitrary
      preference for rounded last digits or automated recording minimize erroneous
      measurements. By the multitude of recorded parameters the ambulatory measurement
      over 24 hours and the self-assessment of blood pressure provide a representative
      diurnal profile superior to individual measurements at the doctors office. Each
      of the two methods has its own field of application, although prognostic and
      therapeutic aims seem similar. The continuous recording over 24 hours is suited
      for initial assessment and identification of hypertensive patients. Self
      assessment of blood pressure has its use for long-term follow up and optimization
      of therapy. Both methods are complementary and only limited from wider use by
      lacking internationally accepted normal values and standardization of available
      devices.

PMID- 1734492
TI  - The Nobel lectures in immunology. The Nobel Prize for Physiology or Medicine,
      1977 awarded to Rosalyn S. Yalow.

PMID- 1734493
TI  - T-independent polyclonal activation of B cells in vitro by immunoglobulin binding
      substance (IBS) from the granary weevil.
AB  - Experiments are described for T-independent polyclonal activation of B cells in
      vitro by the immunoglobulin binding substance (IBS) from the granary weevil. The
      affinity-chromatographically purified IBS was used. IBS is a heat-, alkali- and
      acid-stable glucopeptide which is characterized by non-specific immunoglobulin
      binding to the Fab fragment. The purified IBS consists of three polymer
      homologues whose molecular weights are 12-14,000, 25-30,000 and more than 150,000
      Da. IBS did not stimulate DNA synthesis by murine T cells, macrophages or plasma
      cells whereas it did stimulate that by mature B cells without any help from T
      cells or macrophages. IBS also stimulated both in vitro IgG production by spleen
      cells and in vitro sensitization of spleen cells by sheep red cells (SRBC). IBS
      was found to stimulate DNA synthesis by B cells mediated by binding to surface
      immunoglobulins of B cells. IBS is thought to be a useful amplifier for inducing
      human hybridomas and a valuable tool for examining mature B cells, both
      diagnostically and experimentally.

PMID- 1734494
TI  - Production of heterohybridomas secreting autoreactive and polyreactive human
      monoclonal antibodies.
AB  - Peripheral blood lymphocytes from two polytransfused renal dialysis patients were
      transformed by Epstein-Barr virus, fused to a heteromyeloma and cloned. Eight
      human monoclonal antibodies from the resulting clones were tested for their
      binding to a variety of antigens by ELISA, indirect immunofluorescence and
      immunoblotting. Antigens tested included B-cell lines, T and B lymphocytes, red
      blood cells, chronic lymphocytic leukaemic B cells, IgG, ssDNA, dsDNA, histones,
      nucleoprotamine, sperm nuclei, thymus and spleen extracts, MOLT4 cell lysates,
      affinity purified autoantigens, tetanus toxoid, bacterial lipopolysaccharide,
      insulin, and a tissue section screen. These human monoclonal antibodies reacted
      with more than one antigen to varying degrees and were autoreactive and
      polyreactive. One of these heterohybridoma cell lines exhibited cytoplasmic
      staining with an anti-CD5 monoclonal. Our findings support the concept that in
      adult individuals a subset of B cells produce heterogeneous IgM antibodies which
      can bind to a variety of different autoantigens and also to foreign antigens.
      These monoclonals were different from the autoantibodies usually seen in renal
      dialysis patients in the sense that they were not lymphocytotoxic.

PMID- 1734495
TI  - Clustering of IgA-producing immunocytes related to HLA-DR-positive ducts in
      normal and inflamed salivary glands.
AB  - Ig-producing immunocytes and epithelial expression of secretory component (SC)
      and HLA-DR were evaluated by two-colour immunofluorescence staining in 10 normal
      and 20 inflamed salivary glands; the latter included specimens from 10 patients
      with obstructive sialadenitis and 10 with Sjogren's syndrome (SS). Epithelium
      adjacent to T-cell infiltrates showed extensive co-expression of SC and HLA-DR,
      suggesting that leucocyte-derived cytokines were responsible for this concurrent
      up-regulation. Clusters (greater than 2 positive cells) of IgA-producing cells
      were spatially related to DR-positive ducts. The possibility is discussed that DR
      expressing epithelium contributes to local terminal differentiation of IgA
      producing plasma cells. A cytokine-mediated up-regulation of SC that
      simultaneously increases the transport capacity for polymeric IgA would
      constitute an efficient enhancement of secretory immunity in diseased glandular
      tissue.

PMID- 1734496
TI  - Regulation of the immune response to hepatitis B virus and human serum albumin.
      III. Induction of anti-albumin antibody secretion in vitro by C-gene-derived
      proteins in peripheral B cells from chronic carriers of HBsAg.
AB  - The circulatory pool of B cells from the majority (11/13) of chronic hepatitis B
      surface antigen (HBsAg) carriers contained sensitized B cells with the capacity
      to secrete IgG antibodies with specificity for human serum albumin (HSA), when
      stimulated with E. coli-derived core protein at low concentrations in vitro. The
      IgG anti-HSA secretion was dependent upon and regulated by T cells, and optimal
      secretion was obtained at T/B-cell ratios of 1.0-4.0, varying for different
      individuals. The level of anti-HSA secretion was higher for patients with on
      going viral replication as assessed by hepatitis B virus (HBV)-DNA in serum.
      Culture supernatants containing anti-HSA antibodies also contained anti-HBc
      antibodies, as detected by enzyme-linked immunosorbent assay (ELISA) where the
      solid phase was charged with E. coli-derived core protein, or the synthetic
      peptides corresponding to the 75-84 and 132-147 sequences in the C region of HBV.
      In contrast, IgG anti-HBc (E. coli-derived), but no anti-HSA or anti-HBc 75-84,
      132-147 antibodies, were detected at similar T/B-cell ratios in cell cultures
      from 5/6 individuals with naturally acquired immunity to hepatitis B. These data
      indicate that peripheral B cells from the majority of HB-immune donors are
      sensitized to unique (e.g. non-albumin associated) structures in the nucleocapsid
      of HBV, while B cells in the majority of chronic HBsAg carriers are sensitized to
      linear C-gene-derived structures in association with the host 'self'-component
      HSA.

PMID- 1734497
TI  - Amino acid sequence analyses of non-AA proteins from amyloid fibrils of bovine
      kidney.
AB  - The elution pattern obtained when amyloid fibrils from amyloid-laden bovine
      kidneys were subjected to gel filtration under dissociating conditions revealed a
      larger amount of non-AA material (eluting between the void volume and protein AA)
      than usually seen in other species. SDS-PAGE of this non-AA fraction yielded
      several Coomassie blue stained bands. The most distinctive ones gave estimated
      molecular masses of 15 kDa, 18 kDa, 33 kDa and 43 kDa. These molecular species
      were electroblotted onto PVDF membranes, and were further characterized by amino
      acid composition analyses, cyanogen bromide cleavage and N-terminal analyses. The
      results revealed that the intermediate 'non-AA' fraction consisted of histones
      H2B, H3 and H4 in addition to protein AA also found in this fraction.

PMID- 1734498
TI  - Secretory component is bound to the paraproteins in sera of IgA and IgM
      gammopathies.
AB  - Secretory immunoglobulins A (SIgA) and M (SIgM) were investigated in 20 sera
      containing high levels of monoclonal polymeric IgM or IgA. In the sera of
      patients suffering from Waldenstrom's macroglobulinemia (WM), the level of SIgA
      was found to be low, whereas that of SIgM was extremely high. Reciprocally, in
      the multiple myeloma (MM) patients, SIgA were increased and SIgM were
      dramatically decreased. Electrophoretic analysis showed these SIgA and SIgM to
      have the same monoclonal pattern as the corresponding paraprotein. Hence these
      molecules must originate from the malignant clone. The most likely mechanism
      involved is an intravascular formation of the secretory-like immunoglobulins.
      Free secretory component (SC) could diffuse passively from the digestive lumen
      and bind the circulating myeloma polymeric immunoglobulins. Such a possibility of
      in vivo binding of free SC to IgM and IgA polymers leads to a reconsideration of
      the secretory origin of SIgM and SIgA in normal human serum.

PMID- 1734499
TI  - Generation of iC3 at the interface between blood and gas.
AB  - Earlier studies have shown that C3 can be denatured when blood comes in contact
      with a polystyrene surface. This study was undertaken to see if similar
      denaturation of C3 occurs at the gas-plasma interface which is found in all kinds
      of oxygenator used during cardio-pulmonary operations. An in vitro system
      consisting of gas bubbling through human blood, serum or plasma was used. The
      generation of C3a, as an indicator of complement activation, and iC3 and iC3
      fragments were monitored. Both C3a and iC3/iC3 fragments levels were increased
      during bubbling. In contrast to the C3a level, no reduction in iC3/iC3 fragments
      formation was seen in the presence of EDTA, indicating that it was independent of
      complement activation. The rate of iC3/iC3 fragments generation was unaffected by
      the composition of the gas (pure oxygen, pure nitrogen or air), suggesting that
      the denaturation of C3 indeed occurred at the serum-gas interface. C3 and iC3/iC3
      fragments were isolated from bubbled EDTA-chelated serum by PEG precipitation and
      chromatography on FPLC, using a Mono S column and detected by two ELISAs,
      specific for native C3 and iC3/iC3 fragments. After 240 min approximately 20% of
      the total amount of C3 consisted of intact iC3 and it was confirmed that this
      population bound to human erythrocytes.

PMID- 1734500
TI  - [Mild and severe organic brain disorders in childhood].
AB  - An outline of the classification of minor brain dysfunction and severe brain
      syndrome is followed by a short historical sketch of the development of the
      concept of minor brain dysfunction and a description of the clinical and
      diagnostic relevance of this concept. After evaluation of specific therapeutic
      approaches, selected empirical studies are reported to elucidate the course of
      the disorder. The issue concerning the existence of a behavioral syndrome that
      characterizes severe brain disorders is discussed. The presentation of selected
      research findings on psychopathological and neuropsychological sequelae of severe
      brain traumas provides the argument for the final discussion. The necessity of
      qualifying a highly specific, narrowly defined psychopathological syndrome in
      childhood is emphasized.

PMID- 1734501
TI  - [Role of the parents with the chronically ill child].
AB  - The term "chronic illness" subsumes a multitude of conditions and complaints, all
      of varying development. It is often impossible to establish a prognosis and only
      seldom is causal therapy available. A chronic illness or handicap must be seen as
      fate, not only for the affected child but also for his or her family. Both
      require concerned and competent support towards mastering their situation in a
      justifiably realistic way. A highly developed network must be available to
      families of chronically ill children to help them prevent and overcome crisis.
      The organization of this network requires much planning and effort. In many
      families with chronically ill or handicapped children the ability to develop and
      to make decisions can only be regained when the hopelessness and helplessness
      involved in having a severely chronically ill child has been recognized and
      accepted by all concerned.

PMID- 1734502
TI  - [Psychosocial aspects of cystic fibrosis].
AB  - Psychosocial stress and coping in families with cystic fibrosis (CF) are
      described. The illness does not lead to specific psychopathological disturbances,
      but with additional intra- or extra-familial stress, patients and family members
      are more vulnerable to psychoreactive disorders. Interdisciplinary and family
      oriented bio-psycho-social care is required. The role of the child psychiatrist
      is discussed.

PMID- 1734503
TI  - [Psychosomatic aspects of growth retardation].
AB  - Emotional deprivation is one of the possible causes of failure to thrive.
      Deprivation dwarfism is also associated with growth hormone deficiency, which
      disappears when the child is removed from his harmful environment. This
      phenomenon may constitute a pertinent model for etiopathogenic studies in child
      psychosomatics with particular emphasis on exploration of the linkage between
      biological, environmental and psychic factors.

PMID- 1734504
TI  - [The adolescent with a chronic somatic disorder].
AB  - Adolescence, a period of psychic reorganization which allows for new adjustments
      in order to face future life and reorganize the experience of the past, is one of
      the critical phases of existence. It is described as a "new birth", a successful
      achievement of individuation and separation processes. For the adolescent with an
      infirmity or chronic illness, and for his family, there exist specific problems
      in addition to those encountered by a healthy adolescent. The painful realization
      of social, professional and relational barriers is reactivated. The feeling of
      failure and helplessness, the impairment of self-esteem, and anger at being the
      victim of the unfairness of destiny, represent a supplementary affective burden
      for the adolescent and his family. This results in a risk of deterioration,
      either towards affective and social withdrawal expressed by overadaptation and
      weakening of psychic functions, or towards autoaggressive acting-out or various
      forms of marginalization. Preventive and therapeutic action by the individual and
      the family are discussed in the light of the case history of an adolescent
      suffering from a facial malformation.

PMID- 1734505
TI  - [The role of liaison psychiatry in the framework of chronic disease].
AB  - Liaison psychiatry in paediatrics should not be confined to psychiatric cases.
      Due to their special skills, psychiatrists can be helpful in the long term care
      of chronically ill children. The case of cystic fibrosis is cited to show how
      this disease affects the family; how educating patients (and their parents) about
      the disease and treatments is essential; how compliance is affected by factors
      such as family characteristics and psychological characteristics of young
      patients. Poor compliance is seen as a symptom that can, to a certain extent, be
      treated by psychological analysis of all the factors involved.

PMID- 1734506
TI  - [Chronic disease and adolescence].
AB  - Chronic disease is not a strictly defined term and includes a large number of
      illnesses ranging from physical to mental impairment. It is estimated that
      between 10% and 20% of adolescents have a chronic disease. Independence and new
      relations, acceptance of a new body image and sexuality, career plans and
      cognitive maturation are core topics in development to adulthood. Chronic disease
      may interfere with these developmental tasks. Most often there is no specific
      psychopathology, but the type of impairment, its influence on family life and
      functioning, age at onset, gender, and other factors will interact with
      psychosocial maturation. Because of the important role of the family, not only
      the adolescent patient him/herself, but also parents and siblings need to be
      included in all major decisions. As hospitalizations may be disruptive they must
      be planned, taking in account the patient's plans and opinions. Chronic disease
      may lead to death during the period of adolescence. It is believed that the
      concept of one's own mortality develops at age 14 to 17 years, a fact that will
      influence care during the terminal stage of a disease. Whatever the problems and
      questions raised by the family, the developmental stage of the adolescent has
      always to be considered when dealing with specific issues of chronic disease.
      Periodic reassessment of psychosocial development is therefore one of the main
      tasks of the primary care physician. Counselling will address not only the
      disease but also the developmental tasks of any teenager.

PMID- 1734507
TI  - [The therapeutic challenge of anorexia nervosa].
AB  - Anorexia nervosa represents a typical paradox of adolescence. This paradox drives
      the adolescent to refuse what he fears he would need too much: this need seems
      threatening because it would make him dependent on the object of satisfaction
      which seems alienating to him. Thus, he becomes alienated to his refusal, which
      worsens the underlying need and increases the refusal. The life of the anorectic
      is centered on a passion for food and fear of bulimia. In fact, food focuses a
      greater "appetite" for recognition and to be the centre of attention. Beyond, and
      with, curing of the symptom, the treatment, by means of the weight contract,
      tends to resolve this paradox in which the anorectic tries to enclose us. To take
      up the challenge, the treatment must create the conditions for the emergence of
      pleasure in desiring what they need, without anxiety about their autonomy.

PMID- 1734508
TI  - Growing strong. Biotechnology's new wave hopes that being first will pay off.

PMID- 1734509
TI  - Under construction. Temporary scaffolding guides nerves in the developing brain.

PMID- 1734510
TI  - Turing test. A computerized therapist for human passes (almost)

PMID- 1734511
TI  - Inside job. Antibodies can destroy some viruses inside neurons.

PMID- 1734512
TI  - Profile: David Baltimore. A troubled homecoming.

PMID- 1734513
TI  - How cells absorb glucose.

PMID- 1734514
TI  - Air pollution and mortality.

PMID- 1734516
TI  - Coping with an "embarrassment of riches".

PMID- 1734515
TI  - The case of the Florida dentist.

PMID- 1734517
TI  - Stanford and MIT in the dock?

PMID- 1734518
TI  - Information processing in the primate visual system: an integrated systems
      perspective.
AB  - The primate visual system contains dozens of distinct areas in the cerebral
      cortex and several major subcortical structures. These subdivisions are
      extensively interconnected in a distributed hierarchical network that contains
      several intertwined processing streams. A number of strategies are used for
      efficient information processing within this hierarchy. These include linear and
      nonlinear filtering, passage through information bottlenecks, and coordinated use
      of multiple types of information. In addition, dynamic regulation of information
      flow within and between visual areas may provide the computational flexibility
      needed for the visual system to perform a broad spectrum of tasks accurately and
      at high resolution.

PMID- 1734519
TI  - Addictive drugs: the cigarette experience.
AB  - Cigarettes are among the most addictive substances of abuse and by far the most
      deadly. In this country smokers know it and try to stop. Their success has been
      dramatic but partial and excruciatingly slow, and until recently quite uncoerced
      by government. Cigarettes and nicotine have characteristics distinct among
      addictive drugs, and some of these help explain why efforts to quit smoking are
      so often frustrated. Nicotine itself is the most interesting chemical in the
      treatment of addiction and, in some forms, can pose a dilemma: compromise by
      settling for pure nicotine indefinitely, or stay with cigarettes and keep trying
      to quit. Nicotine is not alone among addictive drugs in becoming increasingly
      identified with the poorer classes.

PMID- 1734520
TI  - Widespread dispersion of neuronal clones across functional regions of the
      cerebral cortex.
AB  - The cerebral cortex of the mammalian brain has expanded rapidly during the course
      of evolution and acquired structurally distinguishable areas devoted to separate
      functions. In some brain regions, topographic restrictions to cell intermixing
      occur during embryonic development. As a means of examining experimentally
      whether such restrictions occur during formation of functional subdivisions in
      the rat neocortex, clonally related neocortical cells were marked by retroviral
      mediated transfer of a histochemical marker gene. Clonal boundaries were
      determined by infection of the developing brain with a library of genetically
      distinct viruses and amplification of single viral genomes by the polymerase
      chain reaction. Many clonally related neurons in the cerebral cortex became
      widely dispersed across functional areas of the cortex. Specification of cortical
      areas therefore occurs after neurogenesis.

PMID- 1734521
TI  - Sporogonic development of a malaria parasite in vitro.
AB  - The sporogonic cycle of the avian malaria parasite Plasmodium gallinaceum was
      completed in vitro. Ookinetes (motile zygotes) were seeded onto a murine basement
      membrane-like gel (Matrigel) in coculture with Drosophila melanogaster cells
      (Schneider's L2). Transformation into oocysts as well as subsequent growth and
      differentiation were observed in parasites attached to Matrigel and depended on
      the presence of L2 cells. Sporozoites were first observed on day 10 in culture.
      Specific circumsporozoite protein antigenicity was identified in mature oocysts
      and in sporozoites. It is now possible to follow the entire life cycle of
      Plasmodium in vitro.

PMID- 1734522
TI  - DNA binding activity of recombinant SRY from normal males and XY females.
AB  - The protein encoded by the human testis determining gene, SRY, contains a high
      mobility group (HMG) box related to that present in the T cell-specific, DNA
      binding protein TCF-1. Recombinant SRY protein was able to bind to the same core
      sequence AACAAAG recognized by TCF-1 in a sequence dependent manner. In five XY
      females point mutations were found in the region encoding the HMG box. In four
      cases DNA binding activity of mutant SRY protein was negligible; in the fifth
      case DNA binding was reduced. These results imply that the DNA binding activity
      of SRY is required for sex determination.

PMID- 1734523
TI  - GnRH-induced Ca2+ oscillations and rhythmic hyperpolarizations of pituitary
      gonadotropes.
AB  - Secretion of gonadotropic hormones from pituitary gonadotropes in response to
      gonadotropin-releasing hormone (GnRH) is essential for regulation of reproductive
      potential. Gonadotropes from male rats exhibited an unusual form of cellular
      excitation that resulted from periodic membrane hyperpolarization. GnRH induced
      an oscillatory release of intracellular Ca2+ via a guanosine triphosphate (GTP)
      binding protein-coupled phosphoinositide pathway and hyperpolarized the
      gonadotrope periodically by opening apamin-sensitive Ca(2+)-activated K+ (SK)
      channels. Each hyperpolarization was terminated by firing of a few action
      potentials that may result from removal of inactivation from voltage-gated Na+
      and Ca2+ channels.

PMID- 1734524
TI  - Predicted structural similarities of the DNA binding domains of c-Myc and
      endonuclease Eco RI.
AB  - The c-Myc oncoprotein belongs to a family of proteins whose DNA binding domains
      contain a basic region-helix-loop-helix (bHLH) motif. Systematic mutagenesis of c
      Myc revealed that dimerized bHLH motifs formed a parallel four-helix bundle with
      the amino termini of helices 1 and 2 directed toward the inner and outer
      nucleotides of the DNA binding site, respectively. Both the basic region and the
      carboxyl-terminal end of the loop contributed to DNA binding specificity. The DNA
      binding domain of c-Myc may therefore be structurally similar to that of
      restriction endonuclease Eco RI.

PMID- 1734525
TI  - Aromatase enzyme activity and sex determination in chickens.
AB  - During development, the genotype of the zygote determines the nature of the
      gonad, which then determines the male or female phenotype. The molecular events
      underlying this process are just beginning to be defined. A single treatment of
      chicken embryos with an aromatase inhibitor (which blocks the synthesis of
      estrogen from testosterone) at a stage when their gonads were bipotential caused
      genetic females to develop a permanent male phenotype. These sex-reversed females
      developed bilateral testes that were capable of complete spermatogenesis and had
      the physical appearance and behavior of normal males. This result identifies
      aromatase as a key developmental switch in the sex determination of chickens.

PMID- 1734526
TI  - Axon guidance by gradients of a target-derived component.
AB  - Spatial gradients of axon guiding molecules have long been suspected to provide
      positional and directional cues for retinal ganglion cell axons growing within
      the optic tectum. With the identification of a guiding activity from tectal cell
      membranes, it has become possible to investigate the potential physiological
      significance of molecular gradients for retinal growth cone behavior in vitro. A
      subset of retinal growth cones, those from the temporal half, were highly
      sensitive to small concentration changes of the guiding component. The degree of
      response was correlated with the strength of the gradient. These findings
      demonstrate that the neural growth cone can read gradients of surface-associated
      information.

PMID- 1734527
TI  - Oral ofloxacin therapy for lower respiratory tract infection.
AB  - We made an open, noncomparative evaluation of ofloxacin, 400 mg orally bid for 10
      days, in 98 subjects with community-acquired pneumonia or pathogen-confirmed
      bronchitis. Thirty-nine (40%) of the subjects were treated in the hospital and 59
      (60%) were treated as outpatients. The mean age of those treated was 56.2 years;
      73 (74%) of the subjects either were more than 60 years old or had a history of
      chronic obstructive pulmonary disease, or both. There were 95 organisms initially
      isolated in sputum, aspirate, or lavage fluid; all were susceptible to ofloxacin,
      and none acquired resistance during therapy. Haemophilus influenzae was the most
      common pathogen (19 isolates), followed by Streptococcus pneumoniae (18) and
      Staphylococcus aureus (10). Clinical responses included cure in 70 patients
      (71%), improvement in 26 (27%), and failure in two (2%). After 10 days of
      therapy, pathogens persisted in two cases; in one case, Streptococcus salivarius
      was isolated, though it remained susceptible to ofloxacin, and in the other,
      Klebsiella pneumoniae was accompanied by superinfection due to a resistant strain
      of Serratia marcescens. We included in this study three confirmed cases of
      atypical pneumonia successfully treated with ofloxacin, two of them due to
      Mycoplasma pneumonia and one to Legionella pneumophila. Ofloxacin was well
      tolerated. Our data indicate that ofloxacin is effective and safe as specific and
      empiric treatment for many lower respiratory tract infections.

PMID- 1734529
TI  - Too smart for our own good.

PMID- 1734528
TI  - Appendicitis complicating pregnancy.
AB  - In this series, nine pregnant patients had appendectomy. Seven patients had acute
      appendicitis; pyuria and symptoms suggesting urinary tract infection delayed
      diagnosis in one whose appendix perforated. Abdominal pain and nausea with or
      without vomiting were presenting symptoms in all of the patients. Tenderness in
      the right lower quadrant was present in six. Eight patients, including two with a
      normal appendix, had leukocytosis with a left shift. There was no fetal or
      maternal loss. In addition, I reviewed more than 900 other cases of appendectomy
      during pregnancy, as reported in the literature since 1960. Among 713 previously
      reported cases of confirmed appendicitis, rupture had occurred in 25%. There were
      five maternal deaths, all in the group of patients with perforation. Perinatal
      mortality was 4.8% among patients with acute inflammation only and 19.4% in those
      with perforative appendicitis. The diagnosis rests on clinical acumen, and prompt
      surgical intervention is the key to good outcome.

PMID- 1734530
TI  - Effects of dietary stearic acid on plasma cholesterol levels.
AB  - Dietary advice based on saturated versus unsaturated fatty acids for the purpose
      of controlling the plasma cholesterol level has for many years plagued the
      American public with unpalatable diets that are difficult to adhere to. Stearic
      acid, an 18-carbon saturated fatty acid, does not share the hypercholesterolemic
      effect of other saturated fatty acids and may be the key to more palatable diets
      for the cholesterol-conscious dieter in the future.

PMID- 1734531
TI  - Infection due to Strongyloides stercoralis in patients with pulmonary disease.

PMID- 1734532
TI  - Contarini's condition.

PMID- 1734533
TI  - Pediatric journal club: unlikely abstracts of the pediatric literature.

PMID- 1734534
TI  - Gastrointestinal Kaposi's sarcoma as the first manifestation of acquired
      immunodeficiency syndrome.
AB  - Gastrointestinal Kaposi's sarcoma can occur in HIV-infected patients without
      previously diagnosed AIDS. Gastrointestinal symptoms in such patients should be
      thoroughly investigated because of the possibility of gastrointestinal Kaposi's
      sarcoma, despite the absence of the cutaneous form. The discovery of
      gastrointestinal Kaposi's sarcoma establishes the diagnosis of AIDS, as it did in
      our two patients.

PMID- 1734535
TI  - Atypical Kawasaki disease: coronary aneurysms and thrombocytopenia.
AB  - The patient we have described had coronary artery aneurysms pathognomonic for
      Kawasaki disease after a nonspecific febrile illness not meeting the classic
      clinical criteria. The child had significant thrombocytopenia, which in the past
      has been thought to militate against the diagnosis of Kawasaki disease.
      Echocardiography should be considered in febrile infants with thrombocytopenia of
      uncertain etiology.

PMID- 1734536
TI  - Group G streptococcal infection in an elderly patient.
AB  - It is only recently that GGS infections have been reported in the literature.
      These infections are rare, but they are serious when they occur. The organism is
      not very virulent, and serious infections occur only in patients who are
      immunocompromised, have some serious underlying disease such as cancer or
      intravenous drug abuse, or are at the extremes of age. I have described a fatal
      case of GGS meningitis and endocarditis in a previously healthy 84-year-old who
      had obtundation, irritability, and cellulitis. Many of the separately reported
      characteristics of serious GGS infections were present together in this case.

PMID- 1734538
TI  - Traumatic pseudoaneurysm of the posterior auricular artery.

PMID- 1734537
TI  - Gastroenteritis due to Salmonella sp: clinical and radiologic signs mimicking
      surgical peritonitis.
AB  - Salmonella infections most often are self-limited illnesses confined to the
      gastrointestinal system. They can, however, produce clinical and radiographic
      findings consistent with peritonitis. Careful attention to evaluation and
      treatment is required to avoid unnecessary surgery for what may initially appear
      to be a surgical condition.

PMID- 1734539
TI  - Stroke involving the midbrain and thalamus and causing 'nonfocal' coma.
AB  - We have described two patients who had coma without focal findings and who were
      found to have an ischemic stroke involving the midbrain and the thalamus. In both
      cases metabolic encephalopathy or drug overdose was initially suspected, but
      recognition of abnormal vertical eye movements led to the proper diagnosis.
      Examination of vertical eye movements in drowsy or comatose patients may be
      helpful in arriving at the correct diagnosis early and may prevent unnecessary
      investigations.

PMID- 1734540
TI  - Compliance with therapy for cervical dysplasia among women of low socioeconomic
      status.
AB  - This paper reports results of a project designed to examine factors related to
      compliance with referral for follow-up and treatment of cervical dysplasia. Women
      studied had cervical dysplasia diagnosed by Pap smear between May 1989 and April
      1990. These women had regular follow-up at the gynecology clinic of the Reynolds
      Health Center in Winston-Salem or at one of 14 county health departments in
      northwestern North Carolina. Data were collected by chart review, and included
      age, race, place of residence, marital status, parity/gravidity, education,
      previous papillomavirus infections, method of payment, and previous Pap smear
      results. Patients were traced through the treatment protocol, and compliance was
      assessed at each appointment. In these women of low socioeconomic status,
      approximately one third of those referred for treatment of dysplasia were
      noncompliant with referral.

PMID- 1734541
TI  - Pneumocystis carinii pneumonia due to corticosteroids.
AB  - A patient receiving long-term corticosteroid therapy for asthma had two episodes
      of Pneumocystis carinii pneumonia (PCP) 8 years apart. She had no other causes of
      immunosuppression. Experimental evidence indicates that corticosteroid
      administration causes a reduction in T lymphocytes mediated by suppression of
      cytokines. Corticosteroid therapy is a rare but possible independent
      predisposition to PCP.

PMID- 1734543
TI  - Environmental illness and the public health.

PMID- 1734542
TI  - Asymptomatic heterotopic ovarian pregnancy.
AB  - An unruptured heterotopic ovarian pregnancy was diagnosed and managed surgically.
      We believe this is the first such case in a woman who was asymptomatic at
      presentation for an unrelated complaint.

PMID- 1734544
TI  - Consecutive orbital cellulitis associated with elevated serum immunoglobulin E.

PMID- 1734545
TI  - Positional headache due to spontaneous intracranial hypotension.

PMID- 1734547
TI  - The continuing problem of community-acquired bacterial pneumonia.

PMID- 1734546
TI  - Community-wide outbreak of hepatitis A among an Indian population in Oklahoma.
AB  - Between September 1983 and September 1984, 118 cases of hepatitis A were reported
      from Caddo County, Oklahoma. No common source was identified, and the epidemic
      curve suggested person-to-person transmission. In July 1984, enhanced control
      measures were implemented; these consisted of improvements in surveillance,
      standardization of case investigation, an expanded, although targeted, use of
      immune globulin, and a public awareness campaign. Control measures resulted in a
      decrease in the delay between onset of symptoms and case report (from 12 days to
      4 days), an increase in the percentage of patients with confirmed cases
      interviewed (from 77% to 100%), an increase in the percentage of patients
      reporting contact with a previous case (from 39% to 72%), and an increase in the
      average number of household-like contacts per case (from seven to 27). Within two
      incubation periods of the implementation of enhanced controls, the outbreak
      ended. These data indicate that community-wide outbreaks of hepatitis A can be
      stopped with an intensive epidemiologic approach, coupled with the expanded and
      targeted use of immune globulin.

PMID- 1734549
TI  - Nutritional requirements in pregnancy.

PMID- 1734548
TI  - [Salpingoscopy].

PMID- 1734550
TI  - The first 6 years of the Tygerberg Hospital lipid clinic.
AB  - The Tygerberg Hospital Lipid Clinic was established in July 1983. The demographic
      characteristics, lipid abnormalities, coronary risk factor profile, treatment
      status and 6-month follow-up lipid changes of patients seen during its first 6
      years are summarised. During this period 329 patients were seen and complete
      lipograms were available for 312 of them. This patient population, consisting of
      87.2% whites and 12.8% coloureds, represented a wide age range (2-69 years),
      various occupations and the whole spectrum of educational qualifications. The
      plasma cholesterol levels of 78.8% of the patients could be described as high
      risk, according to the cholesterol action limits of the Heart Foundation of
      Southern Africa, and 33.2% had low high-density lipoprotein cholesterol (less
      than 1 mmol/l) levels. Approximately 20% of the patients had familial
      hypercholesterolaemia and 31.1% were already on lipid-lowering medication before
      registration. The Lipid Clinic succeeded in improving the mean overall plasma
      cholesterol levels by 8% during the 6 months after registration and provided
      essential information for the planning of treatment strategies for patients with
      hypercholesterolaemia.

PMID- 1734551
TI  - Cardiac glycoside poisoning involved in deaths from traditional medicines.
AB  - Autopsy cases (from all areas of South Africa except the Cape Province) are
      referred for chemical investigation to the Johannesburg Forensic Chemistry
      Laboratory of the State Health Department. Over a 1-year period in 41 autopsies
      where death was presumed to have been caused by a herbal medicine, the presence
      of cardiac glycosides was sought and was found in 44%. Most of the cases were
      from the Transvaal, followed by Natal. Clinical histories of the patients
      revealed that gastrointestinal irritation was the most common syndrome
      experienced after traditional medicine administration (54%). It is concluded that
      in patients presenting with gastro-intestinal symptoms, presumably due to
      poisoning by traditional medicines, cardiac glycoside poisoning should be
      suspected.

PMID- 1734552
TI  - Cardiovascular causes of death at Tshepong Hospital in 1 year, 1989-1990. A
      necropsy study.
AB  - Cardiovascular disease is the third most common cause of death in Tshepong
      Hospital in the western Transvaal, and the most common cause of death in patients
      older than 35 years. A prospective study was undertaken which included limited
      necropsies in 90 of the 167 cardiovascular disease deaths over 1 year. A reliable
      mortality pattern for cardiovascular deaths is described. Additionally, attention
      is paid to co-existing conditions. Conditions relating to cardiovascular disease,
      such as hypertension, benign hypertensive nephrosclerosis, atherosclerosis and
      obesity, were also evaluated. Cerebrovascular conditions were found in 32% of
      cardiovascular deaths. Intracerebral haemorrhage was found in 50% and cerebral
      infarction in 29% of cases. Fifty-seven per cent of cardiovascular deaths were
      due to cardiac conditions, the most common being pulmonary hypertension (31%),
      dilated cardiomyopathy and chronic rheumatic valvular disease (17% each) and
      hypertensive heart disease (14%). Forty-nine per cent of subjects were
      hypertensive, while 40% exhibited benign nephrosclerosis and only 3% of the
      examined vessels had signs of severe atherosclerosis. Tuberculosis was present in
      13% of cases. The clinical diagnosis was the same as the final necropsy diagnosis
      in 38% of cases. These results emphasise the importance of performing necropsies
      to obtain reliable mortality statistics.

PMID- 1734553
TI  - Urinary C-peptide in gestational diabetes.
AB  - Urinary C-peptide excretion was measured during the last trimester of pregnancy
      in 12 non-diabetic control women and in 32 women with gestational diabetes. The
      urine was sampled in two 12-hour periods between 06h00 and 18h00 and 18h00 and
      06h00. At the end of the sampling period a fasting plasma sample was analysed for
      insulin, C-peptide, glycerol, free fatty acids and 3-hydroxybutyrate. The women
      with gestational diabetes had a significantly lower excretion of C-peptide during
      the daytime period. In this group women with diabetic heredity had lower C
      peptide excretion during the day-time and the 24-hour period compared with women
      without diabetic heredity. In the non-diabetic group there was significant
      correlation between body mass index and urinary C-peptide during the night-time
      and the total 24-hour period. The gestational diabetic women had fasting plasma
      concentrations of glycerol, free fatty acids and 3-hydroxybutyrate acid that were
      significantly above the levels found in the control group.

PMID- 1734554
TI  - Vaginal absorption of low-dose tranexamic acid from impregnated tampons.
AB  - Tranexamic acid (TA), an antifibrinolytic drug, is usually administered orally to
      women with menorrhagia. This route of administration is associated with adverse
      side-effects, therefore tampons impregnated with TA were used to assess the
      absorption of the drug across the vaginal epithelium. Blood levels of TA in group
      A (9 patients), who had one tampon inserted, and group B (10 patients), who had a
      tampon inserted at 2-hourly intervals so that a total of 3 tampons were
      administered over a 6-hour period, demonstrated absorption of the drug into the
      blood stream in low concentrations.

PMID- 1734555
TI  - Salivary calcium, magnesium, phosphate, chloride, sodium and potassium in
      pregnancy and labour.
AB  - Pregnancy and labour produce significant changes in salivary calcium, magnesium,
      phosphate and chloride when pregnant patients in labour are compared with non
      pregnant patients. There is a decrease in concentration of these constituents in
      the 3rd trimester of pregnancy followed by a marked increase when labour occurs.
      Magnesium and chloride are the constituents most significantly affected and show
      the largest increase during labour. Changes in saliva flow rate were accounted
      for and are not responsible for these changes noted. Sodium and potassium follow
      a similar pattern. When their levels are corrected for saliva flow rate changes,
      both show a significant increase with the onset of labour.

PMID- 1734556
TI  - The prevalence of potential pathogenic micro-organisms in the endocervix of
      pregnant women at Tygerberg Hospital.
AB  - The prevalence of potential pathogenic organisms cultured from the endocervix in
      206 pregnant patients was: Ureaplasma urealyticum 63%, Mycoplasma hominis 39%,
      Candida albicans 20%, Chlamydia trachomatis 11%, Neisseria gonorrhoeae 7%, group
      B beta-haemolytic streptococcus 6% and Listeria monocytogenes 1%. The most common
      complications of pregnancy found were: preterm labour 14%, urinary tract
      infection 8% and premature rupture of membranes 4%. Significantly more patients
      in whom C. trachomatis or C. albicans were found delivered prematurely. Other
      organisms were not associated with preterm labour.

PMID- 1734557
TI  - Surgical glove powder and intraperitoneal adhesion formation. An appeal for the
      use of powder-free surgical gloves.
AB  - Intraperitoneal adhesion formation is a major cause of infertility and/or
      intestinal obstruction. Among the many well-known aetiological factors
      responsible for peritoneal inflammatory reaction is surgical glove powder; for
      example, cornstarch powder. A study was undertaken on 30 rats to determine
      whether cornstarch powder caused intraperitoneal adhesions. The rats were
      randomised into two groups under laboratory conditions. Laparotomies were
      performed on all the rats and trauma inflicted to the right uterine horn. The
      study group received cornstarch powder suspended in normal physiological salt
      solution intraperitoneally, and the control group received only normal
      physiological salt solution. Peritoneal adhesions were evaluated after 2 weeks
      and statistically analysed with a t-test and 95% confidence intervals. The study
      group showed a statistically significantly higher incidence of intraperitoneal
      adhesions (P = 0.0003). It is concluded that cornstarch, as used on surgical
      gloves, caused peritoneal adhesions and should therefore be removed before
      surgery. Powder-free gloves are more suitable for preventing adhesion formation.

PMID- 1734558
TI  - Feeding intervals and fat absorption in preterm babies.
AB  - Fat absorption studies were conducted on 18 preterm babies to determine whether
      continuous nasogastric feeding is as effective as intermittent feeding. The
      infants ranged from 1 290 g to 1 960 g in birth weight and were assessed at a
      mean postnatal age of 34 days. Each served as a control by receiving an
      evaporated milk 1-hourly, 2-hourly, 3-hourly or continuously in random order.
      Equivalent volumes of milk were ingested over each 3-day period irrespective of
      the method of feeding and the daily weight gain was similar for the various
      regimens. Stool transit times did not vary and fat absorption and retention
      showed no significant differences. Continuous feeding appears to be suitable for
      preterm babies, especially when there is a need to avoid abdominal distension.

PMID- 1734559
TI  - Nutritional recommendations for individuals with diabetes mellitus.
AB  - The diabetic diet is fundamentally a healthy diet, high in complex carbohydrates,
      high in dietary fibre, low in fat. A nutritionally adequate, mixed diet is
      satisfactory for most people with diabetes and special foods or food supplements
      are not required. The dietary recommendations directed towards the diabetic
      population are essentially similar to those recommended by most authorities for
      the population as a whole. Education of diabetic patients and their families and
      also individualised diet and meal planning are essential components in the
      management of diabetes mellitus. Weight loss and subsequent maintenance of a
      desirable body weight should be achieved when necessary. The amount of
      carbohydrate should be liberalised, including a wide variety of fibre-rich
      complex carbohydrates. In some individuals modest amounts of sucrose taken at
      meal times are acceptable. Foods with lower glycaemic indices should be offered
      on trial to people with diabetes. Total fat intake, especially saturated fat,
      should be restricted. More research is needed before recommendations regarding
      eicosapentaenoic acid supplementation can be made. Protein intake should be
      restricted to the Recommended Daily Allowance except in groups at risk of
      negative nitrogen balance. A restriction in salt intake is advised. Alcoholic
      beverages and nutritive and non-nutritive sweeteners may be used, but in moderate
      amounts.

PMID- 1734560
TI  - Erotomania in men. A report of 3 cases.
AB  - Erotomania is an uncommon psychiatric syndrome, rare in men. Three cases
      presenting in a forensic context are described. They support the contention that
      erotomania occurs secondary to another major psychosis.

PMID- 1734561
TI  - Confidentiality and AIDS.

PMID- 1734562
TI  - Guidelines on HIV infection.

PMID- 1734563
TI  - Guidelines on HIV infection.

PMID- 1734564
TI  - Guidelines on HIV infection.

PMID- 1734566
TI  - Unacceptable trends in the diagnosis of chronic fatigue syndrome.

PMID- 1734565
TI  - Infant mortality in South Africa.

PMID- 1734567
TI  - Hemoaccess site infection.
AB  - Infectious complications involving a hemoaccess graft or fistula are a
      significant cause of morbidity in patients on chronic hemodialysis. A review of
      274 consecutive hemoaccess procedures identified 28 infections (an incidence of
      10 per cent). Infections occurred in 27 polytetrafluoroethylene (PTFE) grafts.
      The predominant organism was Staphylococcus aureus. Partial excision resolved 14
      of the 27 graft infections. The remaining 13 required complete removal. Surgical
      management required six arterial ligations and seven autogenous reconstructions.
      No limb ischemia or mortality was directly attributable to these procedures. One
      infection occurred in 48 autogenous fistulas (an incidence of 2 per cent).
      Although partial removal of an infected prosthesis was often sufficient, brachial
      artery ligation was well tolerated when required to control anastomotic
      infection.

PMID- 1734568
TI  - Aggressive axillary evaluation and adjuvant therapy for nonpalpable carcinoma of
      the breast.
AB  - While quadrantectomy or lumpectomy with axillary node sampling and dissection, or
      both, has been shown to be an equivalent alternative to modified radical
      mastectomy, some surgeons have begun to omit axillary dissection altogether in
      patients with extremely small tumors, believing that the axilla is unlikely to be
      involved. In reviewing the incidence of axillary involvement with 69 nonpalpable
      primary tumors in one community for nine years, 20 per cent of patients with
      invasive carcinoma had axillary involvement. In a four year review of the
      Connecticut Tumor Registry, we identified 137 instances of quite small invasive
      carcinoma of the breast that were 1 millimeter or less. Sixteen per cent of these
      patients had axillary involvement. The survival of patients with nonpalpable
      primary tumors and axillary involvement was no different than patients with
      palpable primary tumors and axillary involvement. Regardless of how small the
      primary tumor, the incidence of axillary disease is significant and failure to
      evaluate the axilla will result in understaging and inappropriate decisions about
      adjuvant therapy.

PMID- 1734569
TI  - Obscure bleeding in the gastrointestinal tract originating in the small
      intestine.
AB  - In the past 12 years, we operated upon 49 patients with bleeding lesions of the
      small intestine. After endoscopic examination and barium studies of the upper and
      lower gastrointestinal tract excluded esophagogastroduodenal and lesions of the
      colon and rectum, preoperative examinations consisted of technetium-99m
      pertechnetate scan, technetium-99m labeled erythrocyte scan, barium studies of
      the small intestine and selective visceral angiogram. In one patient, diagnostic
      laparotomy had to be done before any procedure because of severe bleeding and
      angiosarcoma of the ileum. The results of gross examination at operation revealed
      bleeding lesions in 40 patients. Special intraoperative localization procedures
      consisting of methylene blue injection through superselectively prepositioned
      angiographic catheter was done on eight patients, and intraoperative enteroscopy
      was done on 17 patients. These two procedures were complementary, having their
      own indications and limitations. Our regimen of preoperative and intraoperative
      localization procedures was effective in the management of bleeding small
      intestinal lesions.

PMID- 1734570
TI  - Effects of thromboxane synthetase inhibition on postburn mesenteric vascular
      resistance and the rate of bacterial translocation in a chronic porcine model.
AB  - It is known that thromboxane (TX)B2, the metabolite of the potent vasoconstrictor
      TXA2, is elevated markedly in the serum of the patients immediately postburn. We
      had shown that extensive thermal injury causes a reduction in mesenteric blood
      flow that can lead to bacterial translocation from the intestine. In this study,
      we tested the hypothesis that the TX synthetase inhibitor, OKY-046, prevents
      increased mesenteric vascular resistance (MVR) and decreases the rate of
      translocation of bacteria seen after extensive thermal injury. Pigs in groups 1
      (n = 6) and 2 (n = 6) had third degree burns of 40 per cent total body surface
      area under general anesthesia and were resuscitated according to the Parkland
      formula. Pigs in group 2 received 10 milligrams per kilogram of OKY-046 as a
      bolus just before the burn and 10 grams per kilogram per minute for 16 hours as a
      continuous infusion. Pigs in group 3 (control, n = 6) underwent general
      anesthesia only and received daily maintenance fluids of lactated Ringer's
      solution, 2 milliliters per kilogram per hour. OKY-046 prevented the significant
      increase in MVR seen during the first eight hours after burn. The total
      peripheral resistance (TPR) showed an early increase and a late decrease in the
      burn group, while the cardiac index (CI) and temperature (T) significantly
      increased after 24 hours. Administration of OKY-046 kept TPR, Cl, and T
      remarkably stable. OKY-046 reduced the rate of translocation of bacteria seen in
      the burn group from 67 to 17 per cent. Our results show that the blockade of
      thromboxane synthesis by OKY-046 prevented the early mesenteric vasoconstriction
      and the late hyperdynamic response seen after thermal injury and was useful in
      reducing the incidence of postburn translocation of bacteria.

PMID- 1734571
TI  - Effect of deoxyribonucleic acid ploidy status on survival of patients with
      carcinoma of the endometrium.
AB  - This retrospective study was performed to determine the clinical usefulness of
      deoxyribonucleic acid (DNA) ploidy and the amount of DNA in the nucleus of the
      tumor cell on the prognosis of patients with carcinoma of the endometrium. Five
      year follow-up study was obtained for 121 patients. Flow cytometric analysis was
      used to determine tumor cell ploidy from paraffin-embedded specimens. Patients
      were grouped according to ploidy, clinical stage and grade and whether or not
      they received postoperative radiation. The data were subjected to a Cox
      proportional hazards regression analysis, and only ploidy status and clinical
      stage were significantly associated with survival time. Of the 121 patients
      observed, 44.6 per cent were aneuploid and 55.4 per cent, euploid. Preliminary
      chi-square analysis indicated a strong survival advantage to those patients with
      euploid endometrial carcinoma. The over-all five year survival rate for patients
      with aneuploid tumors was 53.7 per cent, as opposed to 80.6 per cent for patients
      with euploid tumors (p less than 0.01). Eighty-seven patients were Stage I, 39
      aneuploid, 48 euploid. The five year survival rate for patients with Stage I
      aneuploid was 71.8 versus 85.4 per cent for those who were euploid. Twenty-one
      patients were Stage II; seven aneuploid and 14 euploid. The five year survival
      rate for aneuploid patients was 14.3 versus 85.7 per cent for euploid patients.
      The over-all five year survival rate for those with Stage I and II was 85.5 per
      cent euploid and 63.0 per cent aneuploid, p less than 0.05. Patients with Stage
      III or IV had poor outcome regardless of ploidy status. These data show that
      patients with euploid Stage I and II carcinoma of the endometrium have a
      significant survival advantage over patients with aneuploid tumors. We,
      therefore, believe that ploidy status may be used to facilitate the determination
      of prognosis in carcinoma of the endometrium.

PMID- 1734572
TI  - Epidural analgesia.
AB  - The most frequently used postoperative analgesia techniques are intramuscular
      injection (IM) and patient controlled analgesia (PCA). Recently, the use of
      epidural catheter injection (EPI) has been done with success. This study was done
      to prospectively compare these three techniques for postoperative analgesia after
      extensive operations upon the colon and rectum. Patients were randomized to one
      of three analgesia groups--IM, intramuscular morphine sulfate; PCA, patient
      controlled morphine sulfate, and EPI, epidural morphine sulfate. Data collected
      included age, time to first bowel movement, amount of narcotic, number achieving
      75 per cent of preoperative forced vital capacity, postoperative pruritus,
      headache, nausea and vomiting, respiratory depression, atelectasis or
      pneumonitis. A visual analog pain scale was used to evaluate postoperative pain
      severity (0, no; 1, partial; 2, marked, and 3, total relief). Sixty-eight
      patients were eligible for study (IM, 19; PCA, 22; EPI, 23, and excluded, four).
      The EPI group required significantly less daily narcotic compared with either the
      IM or PCA groups (17.0 +/- 6.12 milligrams; 67.8 +/- 26.8 milligrams; 40.5 +/-
      20.6 milligrams, respectively, less than 0.05 ANOVA) and total narcotic (81.3 +/-
      31.3 milligrams; 355.4 +/- 147.7 milligrams; 215.3 +/- 105.4 milligrams,
      respectively, p less than 0.05 ANOVA). EPI achieves excellent pain control in
      more patients with a significantly lower dose of narcotics and significantly
      fewer pulmonary complications. Therefore, epidural analgesia is the optimal
      method of postoperative analgesia after extensive abdominal operations.

PMID- 1734573
TI  - Failure of percutaneous drainage of pancreatic abscesses complicating severe
      acute pancreatitis.
AB  - From 1981 to 1990, 14 of 70 patients hospitalized at our institution for severe
      acute pancreatitis were selected to undergo percutaneous drainage of pancreatic
      abscess, under computed tomographic (CT) scan guidance. Pancreatic abscess was
      defined, on contrast-enhanced CT scan, as an infected fluid collection without
      pancreatic necrosis. There were nine men and five women, ranging in age from 28
      to 46 years. The main cause of pancreatitis was alcohol abuse (eight patients).
      Other causes were gallstones (two patients), hyperlipidemia (two patients),
      postoperative (one patient) and one unknown. Ranson criteria were available in
      ten patients and ranged from three to six. Percutaneous drainage was performed as
      the primary treatment in 13 patients and for removal of a residual collection
      postoperatively in one patient. In two critically ill patients, percutaneous
      drainage was performed as a temporizing measure. In 12 patients with well-limited
      hypodense collections, percutaneous drainage was expected to result in the
      definitive cure of the abscess. Pigtail drains (No. 14F), were inserted using
      local anesthesia and CT scan guidance. Two patients had two drains and 12
      patients had only one drain. Two patients were definitively cured by percutaneous
      drainage and all other patients were operated upon for removal of infected
      necrosis. In this study, the lack of accuracy of contrast-enhanced CT scan in the
      diagnosis of peripancreatic necrosis is highlighted and that percutaneous
      drainage has a better efficiency in the treatment of residual collections
      postoperatively than as a primary treatment of infected fluid collections is
      illustrated.

PMID- 1734574
TI  - A prospective randomized study of abdominal rectopexy with and without
      sigmoidectomy in rectal prolapse.
AB  - Eighteen patients with full-thickness prolapse of the rectum were randomized to
      rectopexy alone (group 1) or with sigmoidectomy (group 2). Three months
      postoperatively, seven patients in group 1 and two in group 2 complained of
      severe constipation. One patient in group 1 and three patients in group 2
      remained incontinent. The results of colonic marker studies showed a significant
      increase in the number of markers at day 5 for those in group 1 (preoperative,
      7.7 +/- 2.6; postoperative, 14.6 +/- 2.2; t test, p less than 00.1) but no
      significant increase in group 2 (preoperative, 4.6 +/- 2.2; postoperative 6.8 +/-
      2.3; t test, p less than 0.01). No significant changes or differences between the
      groups were seen in the anorectal angle on videoproctogram. The results of
      anorectal physiologic studies done postoperatively showed no differences between
      the groups in maximum resting pressure, sphincter length or saline solution
      infusion test; however, the patients in group 1 had a significantly greater
      rectal compliance (group 1, 0.24 +/- 0.02 millimeters mercury per milliliter;
      group 2, 0.1 +/- 0.02 millimeters mercury per milliliter; p less than 00.1). This
      may occur because the redundant loop of sigmoid colon causes hold-up of
      intestinal content and kinking at the junction between the sigmoid colon and the
      rectum.

PMID- 1734575
TI  - A modified technique for hemostasis during myomectomy.
AB  - By using a rubber shod Bainbridge type vascular clamp during myomectomy, the
      uterine blood supply coming from the ovarian artery can be interrupted medial to
      the ovary, allowing for adnexal perfusion. The gap in its clamp jaws provides a
      space for the fallopian tube to pass through undamaged. When used in conjunction
      with a tourniquet on the uterine arteries, excellent hemostasis is obtained. This
      simple and effective technique should prove to be a useful addition to the
      armamentarium of the gynecologic surgeon.

PMID- 1734576
TI  - The posterior intrahepatic approach for hepatectomy or removal of segments of the
      liver.
AB  - We have described herein an anterior and posterior perihilar intrahepatic
      approach to the hepatic sheaths of the segments of the liver. This approach
      allows early delineation of the anatomy of the liver and we believe it is a
      useful addition to the techniques available for operating on the liver.

PMID- 1734577
TI  - A simple method of removing residual intrathoracic air post-thoracotomy in
      children.
AB  - A simple and effective method of aspirating residual intrathoracic air is
      described. This method can be used when air leaks or persistent fluid
      accumulations are not expected. This technique may be easily adapted for use in
      older children or adults when similar circumstances are present. Standard
      postoperative monitoring, including serial roentgenogram of the chest, should be
      used to verify appropriate pulmonary re-expansion.

PMID- 1734578
TI  - A new and quick method for treating postmastectomy seromas.
AB  - The Seroma-Cath wound drainage system has proved to be a quick and effective
      method for treating postmastectomy seromas. It has been well received by the
      patients we studied, has eliminated frequent office visits, bulky dressings and
      the risk of wound infections.

PMID- 1734579
TI  - A method to prevent kinking of femorofemoral bypass grafts when using
      polytetrafluoroethylene.

PMID- 1734580
TI  - A double balloon occlusion technique for embolectomy in the trifurcation vessels.

PMID- 1734581
TI  - Gastric ulcer in diaphragmatic hernia.

PMID- 1734582
TI  - Improving the yield of biopsy for nonpalpable lesions of the breast.
AB  - Our early experience and frustration with needle localization biopsy of
      nonpalpable lesions of the breast led us to develop a protocol to improve
      diagnostic accuracy and management of patients with mammograms read as suspicious
      for malignancy. In this context and as part of the program, surgical and
      radiologic consultation is required prior to the decision to proceed with biopsy.
      In this article, our experience with that protocol is summarized and mammographic
      description with pathological findings is correlated. In a series of 200
      consecutive patients who underwent biopsies, we have achieved a positive rate of
      37 per cent. Only 2 per cent of those lesions with round, oval or lobulated
      borders were malignant, while irregular or spiculated lesions were malignant in
      69 per cent of instances. We conclude that careful adherence to this protocol and
      to radiologic principles of contour analysis can substantially increase the yield
      of needle localization biopsy.

PMID- 1734583
TI  - Critical review of the treatment of pyogenic hepatic abscess.
AB  - A retrospective review of 29 consecutive patients with pyogenic hepatic abscesses
      was undertaken to ascertain the efficacy of various treatments. Percutaneous
      routes were used 25 times (aspiration alone in 16 and with concomitant drainage
      in nine), as a primary step 22 times and for recurrent abscesses, three times. An
      operation was required in nine patients; initially in five and after percutaneous
      treatment in four. Antibiotics alone were used twice. There were seven deaths,
      two after antibiotics alone and five after initial percutaneous aspirations.
      There were six recurrent abscesses, all but one after percutaneous aspiration.
      Our results suggest that antibiotics alone and percutaneous aspiration alone are
      inadequate in the treatment of pyogenic hepatic abscesses; percutaneous
      management is valid provided concomitant drainage is used, and that once the
      abscess has been successfully handled percutaneously, surgical treatment is a
      safe alternative as a first step, for abscesses recurring after percutaneous
      management, or for removal of the primary cause of the disease.

PMID- 1734584
TI  - [The potentials and limits of the radiotherapy of laryngeal carcinoma].
AB  - Early stage glottic carcinoma can be treated with primary radiotherapy reaching
      equally good results compared to primary surgery; for supraglottic carcinoma
      surgery offers only slight advantages over primary radiotherapy. Tumor control
      for recurrences is considerably improved by salvage surgery. The use of primary
      radiotherapy allows improved or at least preserved voice and reduced rates of
      acute complications and late treatment sequelae. However, treatment duration is
      longer and probably more expensive compared to function preservation
      microlaryngoscopic surgery. Which treatment approach is chosen, depends on
      individual patient factors and specific conditions in the clinical setting. In
      any case, primary radiotherapy deserves a stronger say in the early stage tumor
      situation. In our institution early stage supraglottic carcinomas undergo primary
      surgery. Advanced carcinomas (T2b and more) are rarely suited for primary
      radiotherapy with the exception of some very confined T3 tumors. Surgical
      approaches should be favoured, since they provide a detailed pathohistological
      tumor staging including R-classification, which would be lacking using primary
      radiotherapy. There are clear reasons to treat the lymph nodes for glottic
      carcinomas stage T2b and more and for all supraglottic carcinomas with
      radiotherapy. Specific risk factors are: tumor at the margins of the incision
      (R1), infiltration of the cartilage and pre-epiglottic space, paratracheal and
      subglottic extension of more than 1 cm, perineural invasion, grade III and IV as
      well as emergency tracheostomy. Postoperative radiotherapy should be given to the
      lymph nodes for all positive neck-dissections. New therapeutic approaches are on
      the horizon, which may improve the results of radiotherapy even for advanced
      larynx carcinomas, like hyperfractionation radiotherapy and simultaneous radio
      chemotherapy combined enoral resection and postoperative radiotherapy may yield
      larynx preservation even for advanced stages. New imaging techniques allow an
      improved staging and predictive radiobiological assays may play a major role in
      tumor prognosis.

PMID- 1734585
TI  - [High-dose-rate brachytherapy of prostatic carcinoma with iridium 192].
AB  - In the therapy of localized prostatic cancer the radical prostatectomy shows good
      results within a five-year interval with no evidence of disease in nearly 90%. An
      important alternative is the radiotherapy by external beam or interstitial
      technique with iodine, gold or iridium. We use the high dose rate technique with
      Ir-192. In this technique five to seven hollow needles are placed in the prostate
      from perineal punctures under transrectal sonographic control. The three
      dimensional brachytherapy planning is done according the actual needle position.
      A computer program calculates the radiation dose and distribution for each needle
      by adjustment of time and stops of the Ir-implants. The Ir-192 is temporary
      loaded twice with 9 Gy supplemented with external beam radiation (18 x 2 Gy).
      Since 1985 29 patients with localized tumor (T1-T3, N0, M0) have been irradiated.
      21/29 had a pelvic lymphadenectomy before. In 85% of the patients were seen no
      side effects. Only one patient had a serious complication through a recto-vesical
      fistula. Out of the 21 followed-up patients 16 were in full remission, three had
      an androgen deprivation because of progression. A local tumor control could be
      demonstrated by cytology in 70% of the patients. This rational technique seems to
      be an alternative for patients not eligible for a radical prostatectomy.

PMID- 1734586
TI  - Irradiated volume and arytenoid edema after radiotherapy for T1 glottic
      carcinoma.
AB  - From May 1982 through December 1986, 116 T1 glottic carcinomas were treated with
      radiotherapy in a prospective randomized study to determine the effect of
      radiation field size. Patients were treated with a total dose of 60 Gy over six
      weeks using 4 MV X-ray, wedge filter and shell. Local control rates treated with
      a field size of 5 x 5 cm2 and 6 x 6 cm2 were 93% and 95%, respectively.
      Persistent laryngeal edema occurred in 4% of cases treated with 5 x 5 cm2 and 21%
      with 6 x 6 cm2 (p less than 0.02). The rate of late laryngeal edema was dependent
      upon the treatment volume. A larger treatment field yielded a higher minor
      complication rate without improvement of local control rate.

PMID- 1734587
TI  - [The sensitometric recording of verification films in high-volt therapy].
AB  - Film sensitometric determinations under high voltage conditions, i.e. under
      radiation at an energy of at least 1 MeV, are very time-consuming and material
      intensive, because, with increased dose of radiation, several films have to be
      exposed and densitometrically measured. These results then form the basis of the
      preparation of the density curve. This paper describes, how, by applying a
      special technique (so-called sensitometric double exposure method), film
      sensitometry under high voltage radiation conditions may be considerably
      simplified and shows how the necessary resources (i.e. step-wedge = stepped
      photometric absorption wedge) can be made quite simply. The method described uses
      film DOT-I and DOT-II by Dupont, whereby the exposure of the step wedge takes
      place on a linear accelerator with a photo energy of 10 MeV. The results show
      that with a target volume dose up to 1.5 Gy the DOT-II film yields the better
      results, while with doses above 1.5 Gy, usage of DOT-I film is recommended.

PMID- 1734588
TI  - [3-D visualization of dose distributions in CT image volumes].
AB  - The 3D-visualization of the entire spatial radiation dosage in cooperation with
      the 3D-radiation volume requires several data volumes. The structure of the
      interface between the 3D-treatment planning program "ProPlan" and the 3D-imaging
      system "VOXEL-MAN" is explained. The first results in the radiological
      application point out the possibilities of the complex registration of dose
      distributions and the critical examination of the irradiation technique.

PMID- 1734589
TI  - [The prevention of mucosal lesions during oropharyngeal irradiation with a dental
      filling shield].
AB  - In patients with metallic dental fillings radiation therapy to the oral cavity
      can cause mucous membrane lesions, which are more severe than expected. They
      appear as circumscribed erosions, opposite to metallic fillings and are caused by
      an increase in radiation dose through secondary radiation due to the higher
      density and atomic number of the filling material. This dose increase can be
      directly measured with 0.1 mm thin sheets of graphite-loaded TLD's (LiF, Vinten).
      For Co-60 gamma rays a commercial amalgam filling caused a dose increase by a
      factor of 1.7. The half value layer for this additional radiation was measured to
      be approximately 0.4 mm tissue. In order to avoid painful mucous membrane
      ulcerations which are even more a problem if hyperfractionated treatment
      schedules are used, we constructed individual dental shields for each patient. As
      shielding material we used a dental impression material (Optosil P+1 Bayer). This
      method was tested in 35 patients, in all of them circumscribed mucous membrane
      ulcerations could be avoided. The method proved to be fast and simple and was
      very well tolerated by all patients.

PMID- 1734590
TI  - [The print-out of CT images and radiation treatment planning data on a laser
      printer].
AB  - We introduce a program for the digital output of CT images with overlaid isodose
      maps to a laser printer. The high quality prints permit the additional output of
      treatment planning data on the same sheet.

PMID- 1734591
TI  - RBE and OER measurements on the p(66) + Be neutron beam at Faure, South Africa.
AB  - Results reported are for single dose exposures and refer to 60Co-gamma
      irradiation. The RBE determined by V79 cell survival and based on the Do ratio
      was found to be 1.70 +/- 0.4 ranging from 1.5 to 1.8. In the case of the
      regeneration of mouse jejunal crypts the RBE was calculated at ten cell survival
      and was found to be 1.68. The maximum acute mouse skin reaction at a skin score
      of 2.0 was found to be 2.1 while the average skin reaction was 1.7. Growth
      retardation of Vicia faba bean roots measured at the level of 50% indicated an
      average RBE of 3.0 and a range of 2.7 to 3.7. The OER obtained for V79 cell
      survival was found to be 1.7 to 1.8. Comparison is made with the RBE and OER
      measurements for the neutron facilities at Clatterbridge, Fermilab and Louvain-la
      Neuve which produce neutrons by the same nuclear reaction and whose physical
      specifications closely resemble those of the Faure neutrons. This comparison
      indicates that the Faure beam shows no unusual biological features and that its
      biological effectiveness is in line with that expected from its physical
      characteristics.

PMID- 1734592
TI  - [The experimental brachytherapy of rhabdomyosarcoma R1H in the rat with iodine
      125 seeds].
AB  - Rhabdomyosarcoma R1H of the rat with a volume of 1.2 cm3 were treated by
      implanting three to eight iodine-125 seeds (20.4 MBq). While implantation of
      inactive seeds had no influence on tumour growth, implantation of three or four
      seeds caused a reduction in tumour growth rate. Local tumour control was achieved
      in 71 and 80% of the tumours after implantation of seven and eight seeds,
      respectively.

PMID- 1734593
TI  - [The psychosocial care of cancer radiology patients--the requirement, subjective
      need and acceptance].
AB  - The topic of the investigation was the discrepancy between the documented
      objective need for psychosocial support of cancer patients on the one hand, and
      of the patient's little subjective needs on the other, the latter resulting in
      only low acceptance of care offered. In an empiric study the attitude of 38 radio
      oncological patients (29 female, nine male) toward psychosocial support was
      investigated. The study revealed a tendency, independent of sex, that may be
      described as a social retreat (e.g. emphasis on personal independence, desire not
      to burden anybody, to hold back own interests and feelings, to be of help rather
      to others). We interpret this attitude as a specific reaction of coping with the
      problem, attempting at self-stabilisation.

PMID- 1734594
TI  - Indoor radon and lung cancer. Estimating the risks.
AB  - Radon is ubiquitous in indoor environments. Epidemiologic studies of underground
      miners with exposure to radon and experimental evidence have established that
      radon causes lung cancer. The finding that this naturally occurring carcinogen is
      present in the air of homes and other buildings has raised concern about the lung
      cancer risk to the general population from radon. I review current approaches for
      assessing the risk of indoor radon, emphasizing the extrapolation of the risks
      for miners to the general population. Although uncertainties are inherent in this
      risk assessment, the present evidence warrants identifying homes that have
      unacceptably high concentrations.

PMID- 1734595
TI  - Primary care physicians' refusal to care for patients infected with the human
      immunodeficiency virus.
AB  - We conducted a telephone survey of a random sample of office-based primary care
      physicians in Los Angeles County to determine their practice experiences with
      patients infected with the human immunodeficiency virus (HIV). Telephone
      interviews included questions related to the physicians' experiences evaluating
      patients for HIV infection during the past 6 months and the presence of HIV
      infected patients in their practices. Those without HIV-infected patients were
      asked if this was because they had not encountered such patients, because those
      patients had died, or because the physicians had chosen to refer these patients
      elsewhere or the patients had gone elsewhere for care. Of physicians who
      participated in the survey, 78% had evaluated a patient for HIV infection in the
      past 6 months; 34% were currently providing primary care for infected patients;
      and 36% had elected to refer HIV-infected patients elsewhere, or their patients
      had elected to find other physicians. In all, 48% of physicians in the sample had
      elected not to care for, or said they would not provide care for, patients with
      HIV infection. Among Los Angeles County primary care physicians, 36% have refused
      to provide continuing care for HIV-infected patients and another 12% indicated
      their unwillingness to do so should such patients present themselves for care. As
      of 1991, the reservoir of primary care physicians in Los Angeles not yet involved
      with but willing to care for HIV-infected patients is relatively small (15%).

PMID- 1734596
TI  - Home oxygen therapy under Medicare. A primer.
AB  - Medicare recently implemented a new, strict, and complex home oxygen policy and a
      new oxygen prescription form. Unfortunately, the lack of instructions for the
      form has led to confusion, frustration, and suboptimal treatment. Long-term
      oxygen therapy prolongs survival, ameliorates hypoxic organ dysfunction, and
      improves exercise endurance. Indications for therapy include hypoxemia caused by
      cardiopulmonary diseases, hypoxemia that occurs with sleep or exercise, and
      hypoxemic organ dysfunction. Patients should be stable and have an arterial blood
      oxygen tension (PaO2) of 55 mm of mercury (7.3 kPa) or less or arterial blood
      oxygen saturation (SaO2) of 88% or less. There should be evidence of hypoxic
      organ dysfunction when the (PaO2) is 56 to 59 mm of mercury (7.4 to 7.8 kPa) or
      the SaO2 is 89%. A medical review by the insurance carrier is required if oxygen
      is to be prescribed when hypoxemia is less severe--if the PaO2 is 60 mm of
      mercury (8.0 kPa) or more or if the SaO2 is 90% or more. The instructions for
      oxygen flow, duration, and equipment must be explicit to ensure adequate therapy.
      An oxygen concentrator with a small oxygen cylinder portable system fulfills most
      needs. Oxygen cylinders may be used at low flows for patients who require therapy
      only during sleep or where electrical power is unreliable. A liquid oxygen system
      may be prescribed for active patients. Portable equipment should be provided in
      addition to stationary equipment when patients have resting hypoxemia. Portable
      equipment alone is sufficient when there is exercise-related hypoxemia with
      normal oxygenation at rest. Newly developed oxygen-conserving devices may offer
      longer ambulatory times and possibly lower operating costs. When home oxygen
      therapy is started in the hospital, the Certificate of Medical Necessity should
      be completed and patients should be trained to use the equipment before
      discharge.

PMID- 1734597
TI  - Screening persons aged 65 and older for coronary heart disease risk factors.
AB  - Because of limited clinical investigations addressing the effectiveness of
      intervention to reduce known risk factors, it is difficult for primary care
      physicians to decide on which coronary heart disease risk factors to continue to
      screen for among older patients. The recently published report of the United
      States Preventive Services Task Force, using explicit screening criteria, has
      recommended that several risk factors be investigated for use among older adults.
      Recent longitudinal studies have found that a number of risk factors persist with
      advancing age-hypertension, left ventricular hypertrophy, impaired glucose
      metabolism, elevated cholesterol levels, obesity, smoking, physical inactivity,
      decline in vital capacity, and increased heart rate. Screening to identify many
      of these risks and treatment and counseling to modify them appear to improve
      survival. Evidence is less clear that diabetes mellitus and elevated cholesterol
      levels have the same significance for men and women as they age. Left ventricular
      hypertrophy and diabetes seem particularly important as risk factors for older
      women, whereas a high heart rate may be a greater risk for men.

PMID- 1734598
TI  - Health behavior and experiences of physicians. Results of a survey of Palo Alto
      Medical Clinic physicians.
AB  - The results of a health practice questionnaire submitted to the 152 physician
      members of the Palo Alto Medical Clinic, 126 of whom responded, indicate a
      generally favorable profile of preventive medicine strategies. Physicians
      generally smoke less, drink about the same, exercise more, and use their seat
      belts more than the population at large. They also can expect to live longer.
      These results are compared with those of other physician surveys and surveys of
      the general public.

PMID- 1734599
TI  - Current issues concerning the epidemiology of acquired immunodeficiency syndrome
      and human immunodeficiency virus.
AB  - This discussion was selected from the weekly staff conferences in the Department
      of Medicine, University of California, San Francisco. Taken from a transcription,
      it has been edited by Nathan M. Bass, MD, PhD, Associate Professor of Medicine,
      under the direction of Lloyd H. Smith Jr, MD, Professor of Medicine and Associate
      Dean in the School of Medicine.

PMID- 1734600
TI  - Pulse oximetry and capnography in intensive and transitional care units.

PMID- 1734601
TI  - Ventilator management of severe asthma.
AB  - The Scientific Board of the California Medical Association presents the following
      inventory of items of progress in internal medicine. Each item, in the judgment
      of a panel of knowledgeable physicians, has recently become reasonably firmly
      established, both as to scientific fact and important clinical significance. The
      items are presented in simple epitome, and an authoritative reference, both to
      the item itself and to the subject as a whole, is generally given for those who
      may be unfamiliar with a particular item. The purpose is to assist busy
      practitioners, students, researchers, or scholars to stay abreast of these items
      of progress in internal medicine that have recently achieved a substantial degree
      of authoritative acceptance, whether in their own field of special interest or
      another.The items of progress listed below were selected by the Advisory Panel to
      the Section on Internal Medicine of the California Medical Association, and the
      summaries were prepared under its direction.

PMID- 1734602
TI  - Recent advances in diagnostic tests for syncope.

PMID- 1734603
TI  - Primary human immunodeficiency virus infection--will you miss the diagnosis?

PMID- 1734604
TI  - Pressure support mechanical ventilation.

PMID- 1734605
TI  - Cardiovascular risk factors in people older than 65.

PMID- 1734606
TI  - Benefits of dual-chamber pacemakers.

PMID- 1734607
TI  - Diabetic nephropathy revisited.

PMID- 1734608
TI  - Treatment of chronic hepatitis C with recombinant interferon alfa.

PMID- 1734609
TI  - Transesophageal echocardiography.

PMID- 1734610
TI  - Advance medical directives.

PMID- 1734611
TI  - Clinical use of erythropoietin.

PMID- 1734612
TI  - Cognitive decline with nortriptyline use in a patient with dementia of the
      Alzheimer's type.

PMID- 1734613
TI  - The physician as erotomanic object.

PMID- 1734614
TI  - Occult Enterobacter aerogenes pneumonia diagnosed by indium 111-labeled leukocyte
      scan.

PMID- 1734615
TI  - Communicating bad news.

PMID- 1734616
TI  - Indoor radon--what is to be done?

PMID- 1734617
TI  - A medical practice opinion program.

PMID- 1734618
TI  - Nervous about ticks--assessing Lyme disease risk in San Diego County.

PMID- 1734619
TI  - A medical practice opinion program.

PMID- 1734620
TI  - Mistreatment of gay medical students.

PMID- 1734621
TI  - HIV incidence in Nevada?

PMID- 1734623
TI  - Durable power of attorney for health care.

PMID- 1734622
TI  - Thyroid dysfunction and false pregnancy.

PMID- 1734624
TI  - Secretin and the endocrine pancreas. Structure-activity relationship between
      secretin and the release of glucose-regulated hormones from isolated pancreatic
      islets.

PMID- 1734625
TI  - Do forehead lifts lift or unfurl?
AB  - Forehead lifts are becoming increasingly more popular as an adjunct to facial
      rejuvenation. Considerable confusion exists as to how much the eyebrow should be
      elevated and how much scalp should be removed to achieve this goal. In an effort
      to evaluate this question, we have reviewed our recent forehead lift experience.
      These were done with forehead flap dissection down to glabella and supraorbital
      ridge, partial resection of corrugator supercilii, procerus, and frontalis
      muscles, and limited skin resection. We suggest that a natural-appearing,
      rejuvenating forehead lift should unfurl facial wrinkles without excessive
      eyebrow elevation. Technical maneuvers to obtain this goal are discussed.

PMID- 1734626
TI  - Perioral dermabrasion: clinical and experimental studies.
AB  - From 1985 through 1989, 54 patients with wrinkles around the lips and in the chin
      area were treated by dermabrasion. Significant improvement, lasting longer than
      three years, was achieved using both types of abrading tool: the wire brush and
      the diamond fraise. The side effects of dermabrasion were permanent but very
      slight bleaching in 66% of the patients and formation of milia in less than 20%.
      The surgical technique is described in detail. Dermabrading tools were tested at
      different speeds on excess cheek skin at facelift. Histological examination
      showed that the diamond fraise left a smooth abraded surface and the wire brush
      left an uneven surface. EMLA cream, usually used for skin surface analgesia, was
      tested as an adjunct to anesthesia in dermabrasion. EMLA's analgesic performance
      alone was insufficient in the sensitive perioral region, but it elevated pain
      threshold and decreased the required amount of local anesthetic solution. Five
      types of dressing were used and the speed of epithelialization and postoperative
      comfort were compared. At present Vigilon is the most suitable dressing for
      dermabrasion. The main advantage of dermabrasion over the chemical peel is the
      absence of severe depigmentation.

PMID- 1734627
TI  - Secondary rhinoplasty via transcolumellar incision.
AB  - The transcolumellar rhinoplasty was used in 90 patients with severe nasal
      sequelae caused by one or more previous surgical interventions. In each case the
      deformity was located mainly on the nasal tip making it extremely difficult to
      correct with conventional surgical procedures. We chose the transcolumellar
      rhinoplasty procedure to avoid another failure for these patients who sought
      complete resolution of their problem. At the same time, the technique provides a
      more secure surgical field to make a definitive diagnosis and to treat the
      sequelae properly.

PMID- 1734628
TI  - Suction lipectomy: the gold triangle at the neck.
AB  - Cervical suction lipectomy is a simple procedure that poses no technical
      problems. Evaluation of the amount of fat to remove is easy since the deposit is
      superficial and the skin considerably more supple than over the body. Although
      postoperative changes may be slow to develop, the skin usually exhibits
      outstanding adaptability in this area and this adaptability improves over time.
      On the basis of these favorable features occurring in the same location, a
      cervical gold triangle can be defined. In this area, where excellent results can
      be expected, indications of suction-assisted lipectomy can be very broad.

PMID- 1734629
TI  - Cornerstones in reconstructive plastic surgery: Argentinian development of
      muscular, myocutaneous, and fasciocutaneous flaps.
AB  - This article pays tribute to two Argentinian surgeons whose work has been
      published in their local journals but is unknown internationally. Goldtraj's
      pioneering work on the treatment of vascular ulcers of the leg using a muscular
      flap, presented in 1954, and Spadafora's work on the treatment of tissue defects
      with myocutaneous and fasciocutaneous flaps, presented in 1964, are discussed.
      Both papers deserve a place among the pioneering contributions on the subject of
      muscular as well as myocutaneous and fasciocutaneous flaps.

PMID- 1734630
TI  - Bury-and-knot suturing method.
AB  - An innovative bury-and-knot suturing method for firm fixation of a graft through
      a small skin incision is described and two clinical cases presented.

PMID- 1734631
TI  - Twenty years of experience with particulate silicone in plastic surgery.
AB  - The use of particulate silicone in plastic surgery involves the introduction of
      solid silicone into the body. The silicone is in small pieces in order for it to
      adapt to the shape of the defect. This way large quantities can be introduced
      through small incisions. It is also possible to distribute the silicone particles
      from outside the skin to make the corrections more regular. This method has been
      very useful for correcting post-traumatic depressions in the face and all areas
      where the depression has a rigid back support. We consider it the treatment of
      choice for correcting the funnel chest deformity.

PMID- 1734632
TI  - Bioplastique: a new biphasic polymer for minimally invasive injection
      implantation.
AB  - The search for prosthetic materials that are biocompatible, nontoxic, and
      permanent led the authors to develop a micronized, inert, biphasic polymer
      particle for permanent soft tissue augmentation which neither migrates nor is
      absorbed by the body. Placed in a bioexcretable gel carrier, these textured
      microparticles are easily implanted using a specially designed blunt-tipped
      cannula with local anesthesia on an outpatient basis. Research using this implant
      material, Bioplastique (Bioplasty, St. Paul, MN), in rabbits has shown that when
      the textured particle size is maintained within a critical range, neither
      particle migration nor storage disease occurs. The gel carrier is rapidly
      phagocytized and replaced by fibrin matrix within a few days. Host collagen then
      gradually forms a fibrotic capsule around each textured particle, making use of
      the naturally occurring foreign body reaction to create a stable inplant. After
      being followed for over two years, Bioplastique has proven to be useful in many
      clinical applications with few complications.

PMID- 1734633
TI  - Bioplastique: specific technical advice on its use and possible complications.

PMID- 1734634
TI  - Twelve months of experience with Bioplastique.
AB  - Over a 12-month period, 40 patients were treated for various facial defects using
      a new, injectable microimplant material--Bioplastique. Areas treated included
      cheeks, chins, lips, nasolabial lines, nasoglabellar lines, infraoral lines,
      noses, and miscellaneous depressions. Patients were observed for overcorrection,
      inflammation, morbidity, allergic reaction, or other complications. Both patient
      and physician satisfaction were recorded. Use of Bioplastique was found to offer
      permanent results by means of a quick, simple procedure administered under local
      anesthesia without scarring. With proper training and a good "eye," subtle
      corrections are possible. The author anticipates wide application of Bioplastique
      for the treatment of numerous soft tissue deficiencies.

PMID- 1734635
TI  - Utilization of injectable microimplants in aesthetic facial surgery.
AB  - The authors present a series of 74 patients that underwent injections of a
      biphasic copolymer (Bioplastique) to improve the facial contours or to fill deep
      creases and folds. The followup period was ten months. This preliminary report
      could be useful in defining the possibilities of the new product.

PMID- 1734636
TI  - Mammalian response to subdermal implantation of textured microimplants.
AB  - The development of small, textured implant particles suspended in a hydrogel has
      allowed for subdermal injection therapy to fill tissue defects. The microimplant
      particles were placed subdermally into the ears of white New Zealand rabbits in
      order to characterize the foreign body response and the permanence of the
      implant. Serial micrometer readings were performed on the implant sites to
      determine any change in thickness of the augmentation following baseline
      measurement. An initial increase in the thickness was noted approximately 20-30
      days postimplantation, as expected. A stable thickness was noted for the
      remainder of the experiment. Serial histological sections were performed at
      irregular intervals from one week to one year. Histology demonstrated a mild
      foreign body response with collagen surrounding each individual microimplant
      particle. The response was stable after 30-40 days and has remained stable for
      over one year. It was determined that the histology demonstrated a Boros 1A type,
      or nonimmunogenic, low-turnover foreign body reaction.

PMID- 1734637
TI  - Enhancement of the efficacy of isosorbide dinitrate by captopril in stable angina
      pectoris.
AB  - This study was designed to assess whether the angiotensin-converting enzyme
      inhibitor captopril could potentiate the efficacy of a single dose of oral
      isosorbide dinitrate (ISDN) in patients with coronary artery disease. Fourteen
      men (mean age 53 years) with stable angina pectoris were studied. In each patient
      the efficacy of placebo, captopril (50 to 100 mg), ISDN (10 mg), and a
      combination of captopril (50 to 100 mg) and ISDN (10 mg) was assessed by repeated
      exercise treadmill tests performed before and 1, 2, 3 and 6 hours after
      administration of a single dose. A single-blind, randomized technique was
      applied. According to the mean data in the whole group of 14 patients, captopril
      alone produced no improvement in exercise duration to the onset of angina and to
      angina of moderate severity compared with placebo. The magnitude of ST-segment
      depression did not significantly change after captopril administration. ISDN
      alone significantly increased exercise duration to onset of angina and to angina
      of moderate severity (antianginal effect) and decreased the magnitude of ST
      segment depression (antiischemic effect) 1 to 3 hours after administration.
      Combined administration of ISDN and captopril resulted in more expressed
      antianginal and antiischemic effects; at 2, 3 and 6 hours these effects with ISDN
      plus captopril were significantly more pronounced than those with ISDN alone.
      According to individual data, the most marked potentiation of ISDN efficacy was
      observed in patients who had poor response to ISDN alone. In all 6 patients in
      whom ISDN alone was ineffective, after the addition of captopril the desired
      antianginal effect was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734638
TI  - Identifying coronary artery disease in women by heart rate adjustment of ST
      segment depression and improved performance of linear regression over simple
      averaging method with comparison to standard criteria.
AB  - Performance of exercise electrocardiography for the detection of coronary artery
      disease (CAD) in women has been limited by relatively poor sensitivity and
      specificity of standard test criteria. Recent studies suggest that diagnostic
      methods incorporating heart rate (HR) adjustment of ST-segment depression during
      exercise may improve the accuracy of exercise testing in women, but the relative
      performance of different rate-adjusted methods for this purpose is unknown. To
      assess the effect of gender on relative test performance of the ST-segment/HR
      (ST/HR) slope, the simple ST/HR index, the HR-recovery loop, and standard ST
      depression criteria for the identification of CAD, the exercise
      electrocardiograms of 254 patients with known or suspected CAD (67 women and 187
      men) and of 150 clinically normal subjects (29 women and 121 men) were analyzed.
      Specificity of each method was comparable in men and women: ST/HR slope 98% (118
      of 121) vs 97% (28 of 29), ST/HR index 97% (117 of 121) vs 97% (28 of 29), and HR
      recovery loop 96% (116 of 121) vs 93% (27 of 29). In contrast, although there was
      no difference in sensitivity of the ST/HR slope (95% [177 of 187] vs 93% [62 of
      67]; p = not significant [NS]) or HR-recovery loop (90% [168 of 187] vs 87% [58
      of 67]; p = NS) between men and women, the ST/HR index was less sensitive for CAD
      in women than in men (82% [55 of 67] vs 93% [173 of 187]; p less than
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734639
TI  - Usefulness of exercise-induced ST-segment depression in the inferior leads during
      exercise testing as a marker for coronary artery disease.
AB  - Multiple lead systems are shown to have a higher sensitivity than that of single
      leads for detecting coronary artery disease (CAD) during exercise testing, but
      the value of ST-segment depression isolated to the inferior leads is
      questionable. To ascertain the diagnostic accuracy of inferior limb lead II
      compared with that of precordial lead V5, a retrospective analysis of 173 men was
      performed (108 in a training population and 65 in a validation cohort). All
      patients had a standard exercise test and underwent diagnostic coronary
      angiography within 15 days of the exercise test (range 1 to 65). Sixty-three
      patients had greater than or equal to 1 coronary stenoses greater than or equal
      to 70%, or left main lesion greater than or equal to 50%, whereas 45 patients in
      the training population did not. Exclusion criteria were female sex, left
      ventricular hypertrophy, left bundle branch block or resting ST-segment
      depression on the baseline electrocardiogram, previous myocardial infarction or
      revascularization procedures, and any significant valvular or congenital heart
      disease. Lead V5 had a better combination of sensitivity (65%) and specificity
      (84%) (chi-square = 24.11; p less than 0.001) than that of lead II (sensitivity
      71%, specificity 44%) (chi-square = 2.25; p = 0.13) at a single cut point, and
      this improved specificity was substantial (95% confidence interval for observed
      difference 22 to 58%). Receiver-operating characteristic curve analysis also
      revealed that lead V5 (area = 0.759) was markedly superior to lead II (area =
      0.582) over multiple cut points (z = 3.032; 2p = 0.002).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1734640
TI  - Comparison of one-, six- and 24-hour ambulatory electrocardiographic monitoring
      for ventricular arrhythmia as a predictor of mortality in survivors of acute
      myocardial infarction. CAMIAT Pilot Study Group. Canadian Amiodarone Myocardial
      Infarction Arrhythmia Trial.
AB  - To compare 1-, 6- and 24-hour ambulatory electrocardiograms for prediction of
      mortality after acute myocardial infarction (AMI), all patients with AMI
      hospitalized in Hamilton, Ontario during 1 year were identified. There were 683
      patients discharged alive after AMI. One-, 6- and 24-hour ambulatory
      electrocardiographic results were available in 565 patients, and follow-up
      mortality data at 1 year was available in 560. Mean age of the patients was 64
      years; 160 (29%) had previous AMI and 105 (19%) had had congestive heart failure.
      One hundred and fifty-two patients (27%) were receiving beta blockers, and 31
      (6%) were receiving antiarrhythmic drugs. Regression modeling of survival times
      up to 1 year showed that all 3 durations of recording were univariate predictors
      of mortality. Using greater than 10 ventricular premature complexes/hour as the
      criterion of a positive test, neither the 6- nor 24-hour data contained
      statistically significant residual explanatory power after the 1-hour data were
      accounted for by the model. The longer durations of recording increased
      sensitivity at a cost of decreased specificity. The positive and negative
      predictive values of the 3 durations of recording were virtually identical. The
      presence of ventricular tachycardia was not a significant predictor of mortality
      in this population. There appears to be no benefit to ambulatory
      electrocardiographic recordings greater than 1 hour when they are to be used for
      prediction of 1-year mortality after AMI.

PMID- 1734641
TI  - Clinical angiographic and histologic correlates of ectasia after directional
      coronary atherectomy.
AB  - Directional coronary atherectomy can cause ectasia (final area stenosis less than
      0%), presumably due to an excision deeper than the angiographically "normal"
      arterial lumen. In a multicenter series in which quantitative coronary
      arteriography was performed after directional atherectomy in 382 lesions (372
      patients), ectasia after atherectomy occurred in 50 (13%) lesions. By univariate
      analysis, ectasia was seen more often within the circumflex coronary artery (p =
      0.008), in complex, probably thrombus-containing lesions (p = 0.015), and with
      higher device:artery ratios (p less than 0.001). Ectasia occurred less often in
      lesions within the right coronary artery (p = 0.008). Histologic analysis
      demonstrated adventitia or media, or both, in all patients with angiographic
      ectasia. Repeat angiography was performed in 188 of 271 eligible patients (69%)
      6.1 +/- 2.4 months after atherectomy. Restenosis, defined as a follow-up area
      stenosis greater than or equal to 75%, was present in 50% of patients without
      procedural ectasia and in 70% of patients with marked ectasia (residual area
      stenosis less than -20%; p = 0.12). It is concluded that excision beyond the
      normal arterial lumen may occur after directional coronary atherectomy, related,
      in part, to angiographic and procedural features noted at the time of
      atherectomy. Restenosis tends to occur more often in patients with marked ectasia
      after coronary atherectomy.

PMID- 1734642
TI  - Pulmonary thallium-201 uptake following dipyridamole-exercise combination
      compared with single modality stress testing.
AB  - Angiographic and clinical determinants of pulmonary uptake of thallium-201 were
      assessed in a laboratory setting where supine bicycle exercise is used for stress
      testing in the absence of limiting pharmacologic or physical factors, and where
      symptom-limited exercise is added to intravenous dipyridamole infusion in other
      cases. Angiographic correlation was available in 400 patients, including 130
      tested with exercise, 94 in whom only handgrip or abbreviated bicycle exercise
      could be used after dipyridamole, and 176 in whom intravenous dipyridamole was
      combined with a significant level of exercise. For each test mode,
      lung/myocardial ratios on the immediate image were highly correlated (p less than
      or equal to 0.001) with a score based on the number of critical coronary artery
      stenoses, with grading by contrast ventriculography, and with the number of
      stenosed (greater than or equal to 50%) arteries; relationships (p less than
      0.05) to history of myocardial infarction and to gender were also present.
      Multiple regression analysis showed the critical stenosis score and ventricular
      dysfunction to be the only significant determinants. When dipyridamole based
      tests were compared with exercise, curves of receiver-operating characteristics
      showed a tendency to better diagnostic performance. When dipyridamole is
      incorporated in stress testing, the value of increased lung uptake as an
      ancillary diagnostic sign is similar to that established for exercise.

PMID- 1734643
TI  - Survey of practicing cardiologists in Maryland on their choice of thrombolytic
      therapy for acute myocardial infarction.
AB  - In November 1990, we surveyed 160 practicing community cardiologists in the state
      of Maryland and 20 academic cardiologists at the University of Maryland Medical
      Center to determine each individual's preference for aggressive versus
      nonaggressive therapy for various presentations of acute myocardial infarction.
      The survey was repeated in April 1991 following a report of the results of the
      Third International Study of Infarct Survival. All 100 responding cardiologists
      chose aggressive therapy to manage an early (less than 2 hours) acute anterior
      myocardial infarction in a 50-year-old patient. However, less aggressive therapy
      was chosen by many community cardiologists for management of early inferior acute
      myocardial infarction or for elderly patients. Most community cardiologists chose
      tissue plasminogen activator as their thrombolytic drug of choice, whereas
      university cardiologists favored streptokinase. Although there were substantial
      shifts in choice of thrombolytic agent on the repeat survey, most community
      physicians still chose tissue plasminogen activator over the less expensive
      streptokinase.

PMID- 1734644
TI  - Survey of cardiac pacing in the United States in 1989.
AB  - A survey of physicians who implant permanent cardiac pacemakers was conducted to
      identify practice patterns related to pacemaker-implantation frequency, hospital
      and implantation-facility characteristics, indications for pacing and pulse
      generator replacement, preferences regarding device types, pacing modes, follow
      up methods and frequency, and type and frequency of pacing-related complications.
      Questionnaires were sent to 11,414 potential physician respondents and 6
      pacemaker manufacturers. Implanters' opinions were solicited regarding such
      issues as the importance of various device features and capabilities, the
      appropriateness of practice guidelines, and the efficacy of quality-assurance
      measures. In 1989, 89,445 primary pacemaker implantations and 21,055 pulse
      generator replacements were performed by approximately 7,919 physicians at about
      3,400 U.S. centers. Typically, a pacemaker manufacturer's sales representative
      played an active role in 80% of cases. Since the last survey, which examined
      pacing practices in 1985, primary implantations of dual-chamber pacemakers
      increased from 22 to 32%, and the proportion of adaptive-rate pacemakers
      increased from 1 to 40% of primary implants. The "typical" implanter used bipolar
      electrode systems in 90% of cases, single-chamber pacemakers in 70%, and the
      introducer method in 95% of lead placements. Significant differences in practice
      patterns were found among subsets of the survey respondents. Surgeons tended to
      work alone, use simpler, single-chamber pacemakers, and leave follow-up to
      others. Electrode stability tended to be better among implanters in nonacademic
      environments. The quadrennial survey continues to provide useful information on
      an easily identifiable and traceable patient population, but the process would be
      greatly simplified by the adoption of a "universal" reporting system such as that
      used in Europe.

PMID- 1734645
TI  - Role of sympathovagal interaction in diurnal variation of QT interval.
AB  - To elucidate the role of sympathovagal interaction in diurnal variation of QT
      interval, 24-hour ambulatory electrocardiographic recordings from 56 subjects (23
      control subjects, 18 patients with atherosclerotic coronary artery disease, and
      15 patients with diabetes mellitus) were studied. The QT interval at a heart rate
      of 60 beats/min (QT60) was determined for each of the day and night periods by
      regression analysis. Sympathetic and parasympathetic activities were assessed by
      spectral analysis of heart rate variability and represented by the low- and high
      frequency components, respectively. The proportion of high-frequency component to
      the sum of low- and high-frequency components was used as an index of
      sympathovagal balance. The relative increase in QT60 at night (delta QT60 [%])
      was larger in control subjects (4.2 +/- 2.1%) than in patients with coronary
      artery disease (2.2 +/- 1.8%; p less than 0.01) and diabetes mellitus (-1.5 +/-
      4.0%; p less than 0.001). When the data from the 3 subject groups were pooled and
      analyzed, delta QT60 was correlated with the change in the sympathovagal balance
      (r = 0.554; p less than 0.001). Low-frequency component in the day alone was also
      related with delta QT60 (r = 0.554; p less than 0.001), but the ratio or
      difference of the high-frequency component value between day and night was not.
      These results indicate that although change in sympathovagal balance was
      responsible for the diurnal variation in QT interval, the enhanced sympathetic
      activity in the day was a major determinant of this phenomenon.

PMID- 1734646
TI  - Circadian variation in ventricular arrhythmias in hypertensive men.
AB  - Circadian patterns have been observed for various cardiovascular functions and
      events including sudden cardiac death. This study examined whether ventricular
      arrhythmias could be a pathophysiologic explanation for the increase in
      prevalence of sudden cardiac death observed between 6 A.M. and noon. Hypertensive
      men 35 to 70 years of age and without a history of symptomatic cardiac disease
      were withdrawn from diuretic treatment and received 1 month of oral electrolyte
      repletion with both 40 mmol of potassium chloride and 400 mg of magnesium oxide
      daily. Then continuous 24-hour Holter monitoring was performed and ventricular
      arrhythmias were classified by 6-hour time intervals. The interval from 6 A.M. to
      noon revealed a higher prevalence of complex or frequent ventricular arrhythmias
      than the interval from midnight to 6 A.M., as well as a higher mean number of
      ventricular premature complexes per hour. The differences were statistically
      significant (p less than 0.01) and amounted to increases of about one third.
      Ventricular arrhythmias during the other two 6-hour periods were intermediary in
      frequency. It is concluded that the increase in sudden cardiac death noted in the
      morning might be related, at least in part, to an increase in frequency of
      ventricular arrhythmias; the implications of this observation for preventive
      cardiology deserve further investigation.

PMID- 1734647
TI  - Effects of a single oral dose of captopril on left ventricular performance in
      severe mitral regurgitation.
AB  - For comparable decreases in systemic resistance, angiotensin-converting enzyme
      inhibitors produce a lesser increase in cardiac output than do previously used
      vasodilators. Although the reason for this is not yet clear, the possibility of a
      negative inotropic effect of angiotensin-converting enzyme inhibitors was
      demonstrated by intracoronary injection. The effects of an oral dose of captopril
      on systolic performance were assessed by examining left ventricular (LV) pressure
      volume loops obtained with simultaneous cineangiography and micromanometer
      pressure recordings before and 90 minutes after administration of oral captopril
      (25 to 50 mg) in 18 patients with chronic, severe mitral regurgitation. Group 1
      (n = 9) was given captopril alone, and group 2 (n = 9) was given captopril plus
      atropine (0.04 mg/kg intravenous) to assess the role of parasympathetic activity
      in mediating the effects of captopril. Captopril reduced heart rate (90 to 81
      beats/min; p less than 0.002) and LV end-diastolic pressure (13 to 10 mm Hg; p =
      0.03), despite a slight increase in end-diastolic volume (257 to 264 ml; p = not
      significant) that suggests improved diastolic properties. Despite a decrease in
      end-systolic pressure (103 to 90 mm Hg; p less than 0.001), ejection fraction did
      not increase (0.60 to 0.58; p = not significant) owing to an increase in end
      systolic volume (107 to 114 ml; p = 0.008). Contractile performance, estimated
      from the end-systolic pressure/volume quotient, was consistently depressed by
      captopril, as was the relation of preload-corrected ejection fraction to end
      systolic stress.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734648
TI  - Comparison of results of percutaneous mitral valvuloplasty in patients with large
      (greater than 6 cm) versus those with smaller left atria.
AB  - To determine whether the presence of an aneurysmatic (severely enlarged) left
      atrium (greater than 60 mm on echocardiography) influences results of
      percutaneous mitral valvuloplasty (PMV), the clinical, echocardiographic and
      hemodynamic characteristics and the results of this technique were compared in 46
      consecutive patients with aneurysmatic left atrium (group I) and 125 consecutive
      patients without such echocardiographic finding (group II). Left atrial size was
      70.5 +/- 8 vs 50.1 +/- 6 mm (p less than 0.005) in groups I and II, respectively.
      Patients in group I were older (57 +/- 12 vs 48 +/- 12 years, p less than 0.025),
      more symptomatic (New York Heart Association functional class greater than or
      equal to III or IV: 67 vs 42%, p less than 0.05), and had atrial fibrillation
      more frequently (91 vs 44%, p less than 0.001). The echocardiographic score (8.9
      +/- 1.9 vs 7.5 +/- 2, p less than 0.005) and the incidence of mild mitral
      regurgitation on angiography before PMV (54 vs 30%, p less than 0.01) was also
      higher in group I patients. Hemodynamic parameters before PMV were similar in
      both groups, but after the procedure, final mitral valve area (1.61 +/- 0.5 vs
      1.95 +/- 0.4 cm2, p less than 0.05) and the absolute increase in mitral area
      (0.81 +/- 0.3 vs 1.02 +/- 0.3 cm2, p less than 0.05) were lower and mean
      pulmonary artery pressure (35 +/- 10 vs 28 +/- 9 mm Hg, p less than 0.025) was
      higher in group I.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734649
TI  - Hemodynamic effects of nitroprusside on valvular aortic stenosis.
AB  - The effects of acute reduction of left ventricular (LV) loading in valvular
      aortic stenosis (AS) were examined. Thirty-five consecutive patients with AS
      (peak-to-peak aortic valve gradient 66 +/- 26 mm Hg, aortic valve area 0.65 +/-
      0.22 cm2) were given intravenous sodium nitroprusside (1 to 3 micrograms/kg/min)
      to reduce systolic aortic pressures by greater than 10 mm Hg (mean aortic
      pressure 99 +/- 15 to 80 +/- 15 mm Hg; p less than 0.001). Overall, nitroprusside
      infusion resulted in little change in cardiac index (2.72 +/- 0.61 to 2.67 +/-
      0.58 liters/min/m2; p = not significant). Individual patients had a range of
      responses. Fourteen patients (group 1) had an increase in cardiac index (2.42 +/-
      0.59 to 2.74 +/- 0.67 liters/min/m2; p less than 0.001), whereas 21 (group 2) had
      a decrease or no change (2.93 +/- 0.56 to 2.61 +/- 0.52 liters/min/m2; p less
      than 0.001). Comparison of these subgroups showed that a cardiac index increase
      with nitroprusside was significantly predicted by a higher LV end-diastolic
      pressure (26 +/- 12 vs 15 +/- 6 mm Hg), lower LV ejection fraction (44 +/- 18 vs
      62 +/- 12%). smaller aortic valve area (0.52 +/- 0.12 vs 0.74 +/- 0.22 cm2) and
      lower cardiac index (2.42 +/- 0.59 vs 2.93 +/- 0.56 liters/min/m2) (all values
      groups 1 and 2, respectively). It is concluded that there is a disparate response
      to acute vasodilatation in AS. Potentially beneficial effects are seen in a
      subgroup of patients, especially those with increased filling pressures and
      impaired LV function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734650
TI  - Value of exercise Doppler echocardiography in patients with prosthetic or
      bioprosthetic cardiac valves.
AB  - Doppler echocardiographic evaluation of the prosthetic valve function is usually
      performed at rest, although this situation is not representative for patients'
      daily activities. Therefore, a symptom-limited Master 2-step test was performed
      in 61 asymptomatic patients with normal left ventricular function. No adequate
      Doppler signals were obtained in 5 of 61 patients (8%) within 60 second after
      termination of exercise. In patients with aortic valve prostheses (n = 24), heart
      rate increased from 74 +/- 10 to 105 +/- 18 beats/min, the maximal instantaneous
      gradient from 44 (range 22 to 90) to 68 (range 28 to 165) mm Hg (r = 0.89) and
      the mean gradient from 24 (range 12 to 50) to 39 (range 18 to 100) mm Hg (r =
      0.90). In 6 of 11 patients with a maximal flow velocity ratio between the left
      ventricular outflow tract and the aortic valve prosthesis less than or equal to
      0.25, the mean gradient increased to a value greater than or equal to 50 mm Hg
      after exercise, whereas in patients with a ratio of greater than or equal to
      0.25, this never occurred. In patients with mitral valve prostheses (n = 39),
      heart rate increased from 80 +/- 12 to 116 +/- 14 beats/min and mean gradient
      from 6 (range 3 to 10) to 14 (range 6 to 25) mm Hg (r = 0.59). The correlation of
      the mean diastolic pressure gradient after exercise with pressure half-time was
      0.66. Systolic pulmonary artery pressure at rest and after exercise could be
      determined in 22 of 39 patients (56%) and increased from 34 (range 20 to 70) to
      57 (range 35 to 110) mm Hg. It is concluded that the response to exercise can, to
      a large extent, be inferred from Doppler parameters at rest, particularly in
      patients with aortic valve prostheses. The clinical implication of the high
      gradients found in some asymptomatic patients in the present study should be
      elucidated by follow-up studies.

PMID- 1734651
TI  - Influence of mitral regurgitation on the response to captopril therapy for
      congestive heart failure caused by idiopathic dilated cardiomyopathy.
AB  - To assess the influence of mitral regurgitation (MR) on the response to captopril
      therapy for congestive heart failure (CHF), 30 patients with idiopathic dilated
      cardiomyopathy in New York Heart Association functional class III were studied.
      Left ventricular end-diastolic diameter and stroke volume were measured by
      Doppler echocardiography, and exercise tolerance by exercise testing before and
      at 1, 3 and 12 months after treatment. Patients were classified into 2 groups:
      those with (n = 14) and those without (n = 16) MR. No significant differences
      were observed between the 2 groups in pretreatment studies. Exercise tolerance
      increased significantly in the group with MR (p less than 0.001) during the year
      of follow-up, from 514 +/- 193 seconds at baseline study to 671 +/- 178 seconds
      (p less than 0.0005) at 1 month, 688 +/- 127 seconds (p less than 0.0005) at 3
      months and 690 +/- 108 seconds (p less than 0.01) at 12 months. The group without
      MR had no significant changes. Stroke volume increased significantly only in the
      MR group during follow-up (p less than 0.01), changing from 43 +/- 9 ml at
      baseline study to 52 +/- 11 ml (p less than 0.01) at 1 and 49 +/- 11 ml (p less
      than 0.01) at 3 months. At 12 months the increase was not statistically
      significant. Left ventricular end-diastolic diameter decreased more in the group
      with than without MR, although the differences were not significant. Thus, the
      presence of dynamic MR appears to be an important factor in the therapeutic
      response to captopril therapy for CHF.

PMID- 1734652
TI  - Predictors of long-term survival with Ebstein's anomaly of the tricuspid valve.
AB  - In patients with Ebstein's anomaly of the tricuspid valve, predictors of death
      and indications for surgery are poorly defined. We retrospectively reviewed 48
      patients with Ebstein's anomaly, 17 (35%) of whom presented in the first week of
      life. Duration of follow-up extended to 32 years (greater than 10 years in 35%).
      Twenty of the 48 patients (42%) died, 6 in the first week of life and 1 at age 5
      months. Thirteen of the 41 patients surviving to age 6 months subsequently died,
      50% probability of survival being reached at 47 years. Significant (p less than
      or equal to 0.05) predictors of death in this group were: male sex,
      cardiothoracic ratio greater than or equal to 0.65, New York Heart Association
      class III or IV, breathlessness and the absence of Wolff-Parkinson-White
      syndrome. Eight patients died suddenly. A cardiothoracic ratio greater than or
      equal to 0.65 was a better predictor of sudden death than functional status. All
      who developed atrial fibrillation died within 5 years. Other atrial arrhythmias
      were not helpful in predicting sudden death. In view of these findings, tricuspid
      valve surgery is recommended before the cardiothoracic ratio reaches 0.65,
      regardless of the symptomatic state.

PMID- 1734653
TI  - Differences in circadian blood pressure between upper and lower extremity in
      aortic coarctation patients with and without postoperative pressure gradients.
AB  - The purpose of this study was to investigate possible circulatory differences
      between pre- and poststenotic vascular beds in postoperative coarctation patients
      with and without a residual pressure gradient during a physiologic decrease in
      circulatory activity. Simultaneous diurnal variations in blood pressure in the
      brachial and femoral arteries were recorded in 5 long-term postoperative
      coarctation patients with and in 5 without a pressure gradient. The patients were
      studied 6.5 to 8.5 years postoperatively with intraarterial blood pressure
      telemetry. Both groups of patients had a normal pressure decrease during the
      hours of sleep. A significant (p less than 0.05) increase, however, in brachial
      to femoral pressure gradients developed during the hours of sleep in patients
      with a positive gradient in contrast to patients without a gradient who had
      identical pressure profiles in both vascular beds. A significant positive
      correlation was found between changes in mean pressure gradient and upper
      extremity systolic pressure (r = 0.79, p less than 0.01). There was no difference
      between the 2 groups regarding pre- and postoperative pressures, preoperative
      gradients or age at surgery. Results suggest that normalization of prestenotic
      circadian vascular reactivity depends on complete relief of the gradient, and
      that upper extremity vascular abnormality may not be fully irreversible, even in
      older patients with coarctation.

PMID- 1734654
TI  - Systemic venous flow during cardiac surgery examined by intraoperative
      transesophageal echocardiography.
AB  - Patterns of systemic venous return change after cardiac surgery. However, the
      exact timing and underlying mechanisms are not well understood. To analyze these
      changes transesophageal echocardiography was used to evaluate 21 patients (mean
      age 56 +/- 17 years) during cardiac surgery. Eleven patients underwent coronary
      bypass grafting, 2 had ablation of accessory bundles, 4 had mitral and 4 had
      aortic valve replacements. All were in sinus rhythm and were undergoing their
      first cardiac operation. Hepatic and pulmonary venous flow, tricuspid annular
      motion, and signs of tricuspid regurgitation were recorded sequentially 5 times:
      (A) with chest closed, (B) with chest open and pericardium closed, (C) with both
      chest and pericardium open, (D) after cardiopulmonary bypass with chest open, and
      (E) after cardiopulmonary bypass with chest closed. The hepatic venous Doppler
      flow velocity integrals (cm) changed, from stage A to stage E: systolic flow
      decreased from 5.9 +/- 5.2 to 2.2 +/- 1.4 (p less than 0.01); diastolic flow
      increased from 3.1 +/- 1.5 to 4.8 +/- 3.3 (p less than 0.001); and systolic to
      diastolic ratio decreased from 2.0 +/- 1.2 to 0.7 +/- 0.6 (p less than 0.001).
      Reversed flow at the end of ventricular systole was present in 9 patients (43%)
      at stage A and in all patients at stage E. Decreased tricuspid annular motion was
      noted in all but 1 patient after cardiopulmonary bypass. No patient presented
      significant tricuspid regurgitation at any stage. In conclusion, the significant
      change in the pattern of systemic venous return after open heart surgery is not
      due to opening of the chest wall or parietal pericardium, or to tricuspid
      regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734655
TI  - Relation of plain chest radiographic findings to pulmonary arterial pressure and
      arterial blood oxygen levels in patients with acute pulmonary embolism.
AB  - Abnormalities of the plain chest radiograph of 123 patients with acute pulmonary
      embolism (PE) and no prior cardiac or pulmonary disease were related to the
      pulmonary arterial mean pressure, the partial pressure of oxygen in arterial
      blood, and the alveolar-arterial oxygen gradient. Patients with either a
      prominent central pulmonary artery or cardiomegaly had higher pulmonary arterial
      mean pressures than did patients with atelectasis, a pulmonary parenchymal
      abnormality or pleural effusion (p less than 0.001). These radiographic findings
      give clues to the severity of pulmonary hypertension in acute PE and suggest that
      pulmonary infarction or hemorrhage is associated with less severe PE.

PMID- 1734656
TI  - Rate-corrected mean velocity of fiber shortening-stress at peak systole as a load
      independent measure of contractility.
AB  - The relation of mean velocity of fiber shortening-stress at end-systole is a good
      load-independent index of left ventricular contractility, but involves
      simultaneous M-mode echocardiography, carotid tracing and blood pressure
      determination, which may be impractical in children. As stress at peak systole
      and end-systole are closely related, this study examined whether the relation of
      mean velocity of fiber shortening-stress at peak systole could be used as a
      simpler method of assessing left ventricular contractility in a normal population
      of children. In addition, the cross-sectional normal range for a pediatric
      population was obtained. In 25 normal children aged 4 to 17 years (mean age 11),
      rate-corrected mean velocity of fiber shortening (MVCFc), stress at peak systole
      (sigma PS), and end-systolic stress (sigma ES) were determined using
      echocardiography, carotid pulse tracing and blood pressure measurement. Six
      patients with cardiomyopathy (mean age 8 years) were also studied. The relation
      of stress at peak systole and end-systolic stress was sigma PS = 1.004 sigma ES +
      12.0 (r = 0.91, SEE = 4.98; p less than 0.001) for the normal group, and sigma PS
      = 1.083 sigma ES + 7.7 (r = 0.99, SEE = 4.07; p less than .001) for the
      cardiomyopathic group. This slope of the regression line was slightly higher and
      the difference was statistically significant. The slope of MVCFc = 0.0066 sigma
      PS + 1.55 (SEE = 0.131, r = -0.52) was nearly identical to that of MVCFc = 0.0065
      sigma ES + 1.46, (SEE = 0.135, r = -0.46), with no difference in the regression
      coefficients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734657
TI  - Consequences of a media campaign focusing on delay in acute myocardial
      infarction.

PMID- 1734658
TI  - Interobserver variability in grading of coronary arterial narrowings using the
      American College of Cardiology/American Heart Association grading criteria.

PMID- 1734659
TI  - Lack of correlation between the signal-averaged electrocardiogram and regional
      wall motion abnormalities in coronary artery disease.

PMID- 1734660
TI  - Efficacy and safety of a new selective class III antiarrhythmic agent dofetilide
      in paroxysmal atrial fibrillation or atrial flutter.

PMID- 1734661
TI  - Usefulness of transesophageal echocardiography for diagnosis of mitral valve
      prolapse.

PMID- 1734662
TI  - Efficiency of disopyramide in hypertrophic cardiomyopathy during stress states.

PMID- 1734663
TI  - Assessment of relative sensitivities of noninvasive tests for cardiac amyloidosis
      in documented cardiac amyloidosis.

PMID- 1734664
TI  - Simultaneous mechanical clot fragmentation and pharmacologic thrombolysis in
      acute massive pulmonary embolism.

PMID- 1734665
TI  - Patency of ductus arteriosus in pulmonary atresia and ventricular septal defect.

PMID- 1734666
TI  - The bedside Valsalva maneuver in the diagnosis of congestive heart failure.

PMID- 1734667
TI  - Doctors, save your money because there will be less in the future.

PMID- 1734668
TI  - Rayon balls and disposable-diaper material selectively adsorb creatinine.
AB  - One method for the collection of urine samples from infants involves absorption
      of the urine on cotton balls placed in the diaper. Such samples are not timed and
      excretions are often expressed per mg of urinary creatinine. An assumption in
      this method is that the creatinine concentration is not changed by the absorption
      process. The concentration of creatinine in urine samples was measured before and
      after absorption of the urine by cotton balls, rayon balls, or diaper material
      over a range of wetness. For urine from both adults and infants, absorption on
      rayon balls and diaper material caused an important artifactual decrease in the
      concentration of creatinine. The effect was particularly striking in lightly
      wetted samples; the mean percent decrease was only 3 +/- 2% for cotton but was 9
      +/- 5% for rayon (n = 10) and 13 +/- 4% for diaper material (n = 7). These data
      provide evidence that rayon balls and diaper material (and to a lesser extent
      cotton balls) selectively adsorb creatinine from human urine.

PMID- 1734669
TI  - Caloric, but not macronutrient, compensation by humans for required-eating
      occasions with meals and snack varying in fat and carbohydrate.
AB  - Six subjects participated in a residential study assessing the effects of covert
      macronutrient and energy manipulations during three required-eating occasions
      (breakfast, lunch, and afternoon snack) on total macronutrient and energy
      intakes. Overall, energy content of the occasions varied between approximately
      3000 and approximately 7000 kJ (approximately 700 and approximately 1700 kcal)
      with the majority of the differential derived from either fat or carbohydrate
      (CHO). Each condition (high, medium, and low fat; high, medium, and low CHO; and
      no required eating) was examined for 2 d. Subjects compensated for the energy
      content of the required occasions such that only under the low-CHO condition
      (11,297 +/- 3314 kJ) was total daily energy intake lower than that observed in
      the absence of required occasions (13,297 +/- 1356 kJ). Only total energy intake
      under the high-fat condition (12,326 +/- 2548 kJ) was significantly different
      from its matched CHO condition (high-CHO condition: 14,665 +/- 2686 kJ). In
      contrast to the clear evidence for caloric compensation, there were no
      differential effects of condition on macronutrient intake, ie, there was no
      macronutrient compensation.

PMID- 1734670
TI  - Food intake measured by an automated food-selection system: relationship to
      energy expenditure.
AB  - Measuring food intake in a laboratory usually involves limited food choices. An
      automated food-selection system with two vending machines containing a large
      variety of foods was used to measure food intake in 10 male volunteers (31 +/- 6
      y, 69.2 +/- 7.1 kg, 18 +/- 7% fat, mean +/- SD) on a metabolic ward. The effect
      of carbohydrate, fat, and protein intakes on 24-h energy expenditure (24EE) and
      substrate oxidations was measured in a respiratory chamber during day 4 of weight
      maintenance and day 7 of ad libitum intake. Ad libitum intake resulted in a 7-d
      overfeeding of 6468 +/- 3824 kJ/d above weight-maintenance requirements, leading
      to a 2.3 +/- 1.2-kg gain. The 10,975 +/- 3774 kJ excess energy intake on day 7 of
      ad libitum intake caused a 1205 +/- 920 kJ/d increase in 24EE (delta 24EE = 0.17
      x delta intake - 695; r = 0.71, P less than 0.02). Of the excess carbohydrate
      intake, 74% was oxidized (r = 0.86, P less than 0.001), whereas excess fat intake
      was not. Carbohydrate and protein stores are regulated whereas excess fat intake
      is channeled to fat stores.

PMID- 1734671
TI  - Energy intake required to maintain body weight is not affected by wide variation
      in diet composition.
AB  - Diets rich in fat may promote obesity by leading to a greater deposition of
      adipose-tissue triglycerides than do isoenergetic diets with less fat. This
      possibility was examined by a retrospective analysis of the energy needs of 16
      human subjects (13 adults, 3 children) fed liquid diets of precisely known
      composition with widely varied fat content, for 15-56 d (33 +/- 2 d, mean +/-
      SE). Subjects lived in a metabolic ward and received fluid formulas with
      different fat and carbohydrate content, physical activity was kept constant, and
      precise data were available on energy intake and daily body weight. Isoenergetic
      formulas contained various percentages of carbohydrate as cerelose (low, 15%;
      intermediate, 40% or 45%; high, 75%, 80%, or 85%), a constant 15% of energy as
      protein (as milk protein), and the balance of energy as fat (as corn oil). Even
      with extreme changes in the fat-carbohydrate ratio (fat energy varied from 0% to
      70% of total intake), there was no detectable evidence of significant variation
      in energy need as a function of percentage fat intake.

PMID- 1734672
TI  - Effects of weight loss on substrate oxidation, energy expenditure, and insulin
      sensitivity in obese individuals.
AB  - To evaluate the effect of weight loss on substrate oxidation, energy expenditure,
      and insulin sensitivity we studied 12 obese subjects (body mass index 33.4 +/-
      1.1) before and after 6 wk of a very-low-calorie diet (VLCD) with euglycemic
      insulin clamp in combination with indirect calorimetry. Body weight decreased
      from 105.3 +/- 4.6 to 94.1 +/- 4.0 kg (P less than 0.001) and fat mass from 47.2
      +/- 3.6 to 37.7 +/- 3.0 kg (P less than 0.001). Total glucose disposal during
      insulin clamp increased from 30.4 +/- 4.3 to 38.4 +/- 4.4 mumol.kg lean body mass
      (LBM)-1.min-1 (P less than 0.05), insulin-stimulated glucose oxidation from 14.3
      +/- 4.6 to 19.1 +/- 1.4 mumol.kg LBM-1.min-1 (P less than 0.05), and non
      oxidative glucose metabolism from 16.0 +/- 3.8 to 19.3 +/- 3.6 mumol.kg LBM-1.min
      1 (NS). Lipid oxidation decreased in the basal state (P less than 0.05) and
      during the insulin clamp (P less than 0.01). The basal rate of energy expenditure
      decreased from 99.1 +/- 4.6 to 88.5 +/- 2.7 kJ.kg LBM-1.min-1 (P less than 0.05)
      after weight reduction. A reduction in fat mass achieved by VLCD is associated
      with reduced lipid oxidation and, because of substrate competition, enhanced
      glucose oxidation. The physiological consequence is improved insulin sensitivity.

PMID- 1734673
TI  - Relationship of perceived macronutrient and caloric content to affective
      cognitions about food in eating-disordered, restrained, and unrestrained
      subjects.
AB  - Cognitive sets concerning food were examined in eating-disorder patients and in
      restrained and unrestrained control subjects. Subjects rated 38 common foods for
      preference, presence or absence of guilt and danger, preferred monthly frequency,
      and caloric, fat, and carbohydrate content. Cognitive ratings were examined based
      upon the individual's perceived amounts of calories and macronutrients. Hedonic
      ratings of foods perceived as high in fat or calories were different in patients
      with current or past anorexia and did not change with treatment. The fat-calorie
      aversions seen in these patients, therefore, appear to be stable trait
      characteristics of the disorder. Guilt and danger were perceived as separate
      constructs by unrestrained and restrained control subjects but not by patients.
      Perceived high amounts of calories or fat triggered stronger feelings of guilt
      and danger for restrained control subjects and patients (especially bulimic
      patients) as compared with unrestrained control subjects. The patients'
      expressions of guilt and danger improved with treatment.

PMID- 1734674
TI  - Laboratory assessment of feeding behavior in bulimia nervosa and healthy women:
      methods for developing a human-feeding laboratory.
AB  - We have designed a human-feeding laboratory to be used to study feeding behavior
      in patients with eating disorders. Twenty-one normal-weight bulimic subjects
      consumed 29.711 +/- 39.940 MJ (range 0.862-178.632 MJ; 7101 +/- 9546 kcal, range
      206 to 42,694 kcal) in 24 h. In comparison, 11 healthy volunteer women, when
      instructed to eat ad lib for 48 h, ate 7.715 +/- 2.590 MJ (1844 +/- 619 kcal)
      during the first 24 h and 7665 +/- 1828 MJ (1832 +/- 437 kcal) during the second
      24 h. Bulimics and control subjects had a similar number of eating intervals (6.6
      +/- 2.6 vs 5.0 +/- 1.7); 72% of the bulimic subjects' meals were similar in size
      to the meals of the controls [167-4100 kJ (40-980 kcal)] but these meals were
      higher in carbohydrate and lower in fat in bulemic patients. Excessive caloric
      intake by bulimic subjects was because 28% of their meals were very large [range
      4.427-28.150 MJ (1058-6728 kcal)]. Data gathered in a laboratory setting appears
      to be a reasonable replication of naturalistic feeding and suggest that such a
      laboratory may prove useful for future studies of feeding behaviors in humans.

PMID- 1734675
TI  - Insulin-like growth factor I and low-density-lipoprotein cholesterol in women
      during high- and low-fat feeding.
AB  - In vitro studies suggest that insulin-like growth factor I (IGF-I) may modulate
      hepatic production and peripheral utilization of lipoproteins. We measured blood
      concentrations of IGF-I; total, high-density-lipoprotein, and low-density
      lipoprotein (LDL) cholesterol; and apolipoproteins in 18 women with above average
      cholesterol after high- and low-fat diet periods. Total cholesterol fell 6% (P
      less than 0.02) during the low-fat diet because of reduced concentrations of LDL
      cholesterol (P less than 0.01). Serum concentrations of IGF-I were inversely
      correlated with total and LDL cholesterol and apolipoprotein B during both high
      fat (r = -0.676, P less than 0.005; r = -0.745, P less than 0.001; and r = 
      0.504, P less than 0.04, respectively) and low-fat (r = -0.656, P less than
      0.005; r = -0.757, P less than 0.001; and r = -0.695, P less than 0.001,
      respectively) diets. IGF-I increased with reduced fat intake in obese subjects
      only. Thus, IGF-I may contribute to the regulation of LDL cholesterol in mildly
      hypercholesterolemic women but may not mediate the beneficial response to reduced
      fat intake.

PMID- 1734676
TI  - Differential reduction of plasma cholesterol by the American Heart Association
      Phase 3 Diet in moderately hypercholesterolemic, premenopausal women with
      different body mass indexes.
AB  - The ability of a low-fat, low-cholesterol diet to improve the risk-factor
      profiles of moderately hypercholesterolemic, premenopausal women was evaluated.
      Nineteen women were fed a typical American diet for 1 mo, after which a low-fat
      diet consisting of 21% of total energy (en%) as fat, 59 en% carbohydrates, 19 en%
      protein, and 96 mg cholesterol/d (P:S 1.8) was given. After 5 months, total and
      low-density lipoprotein (LDL) cholesterol was decreased by 7% and 11%,
      respectively, and total triglycerides increased by approximately 30%. High
      density-lipoprotein (HDL) cholesterol was decreased by 12% at month 2 and 5% at
      month 5 (P less than 0.05). Although HDL2 cholesterol decreased progressively
      throughout the diet period to -35% by month 5, HDL3 cholesterol, which decreased
      to -5% at month 1, increased to +7% by month 5. Of the plasma apolipoproteins
      only apo A-II was altered (+15%) by the diet. Body mass index correlated to
      baseline values and affected response to diet; only the leanest women had
      significant decreases in total, LDL, and HDL2 cholesterol in response to the low
      fat diet.

PMID- 1734677
TI  - Egg intake does not change plasma lipoprotein and coagulation profiles.
AB  - The effect of the intake of 3-14 eggs/wk on biochemical risk markers of coronary
      heart disease (CHD) was examined in 70 young men who followed a high-fat diet.
      The study consisted of a run-in phase during which all subjects ate 3 eggs/wk for
      2 mo and an experimental phase during which a reference group continued eating 3
      eggs/wk and two experimental groups ate either 7 or 14 eggs/wk for 5 mo. The mean
      coefficients of variation in total plasma cholesterol (5.4-7.4%) were similar in
      all three groups and were larger than the mean changes of 0.2-5.6% in plasma
      cholesterol from baseline to end in the experimental groups. Except for increased
      lecithin-cholesterol acyltransferase activities and total serum protein
      concentrations, no significant differences in lipoproteins or coagulation factors
      occurred between groups. It seems that egg intake in this range did not influence
      CHD risk markers in these subjects. Recommendations to lower risk should probably
      concentrate on a reduction in fat and not cholesterol intake.

PMID- 1734678
TI  - Egg yolk as a source of long-chain polyunsaturated fatty acids in infant feeding.
AB  - In this paper we compare the fatty acid content of egg yolks from hens fed four
      different feeds as a source of docosahexaenoic acid to supplement infant formula.
      Greek eggs contain more docosahexaenoic acid (DHA, 22:6 omega 3) and less
      linoleic acid (LA, 18:2 omega 6) and alpha-linolenic acid (LNA, 18:3 omega 3)
      than do fish-meal or flax eggs. Two to three grams of Greek egg yolk may provide
      an adequate amount of DHA and arachidonic acid for a preterm neonate. Mean intake
      of breast milk at age 1 mo provides 250 mg long-chain omega 3 fatty acids. This
      amount can be obtained from less than 1 yolk of a Greek egg (0.94), greater than
      1 yolk of flax eggs (1.6) and fish-meal eggs (1.4), or 8.3 yolks of supermarket
      eggs. With proper manipulation of the hens' diets, eggs could be produced with
      fatty acid composition similar to that of Greek eggs.

PMID- 1734679
TI  - Mycoprotein reduces blood lipids in free-living subjects.
AB  - Mycoprotein is a food produced by continuous fermentation of Fusarium graminearum
      (Schwabe). A previous metabolic study showed that mycoprotein decreased total and
      low-density-lipoprotein (LDL) cholesterol and increased high-density-lipoprotein
      (HDL) cholesterol. This study was undertaken to determine the effects of
      mycoprotein under free-living conditions. Two groups of subjects with slightly
      raised cholesterol concentrations participated in the 8-wk study. The
      experimental group was fed cookies containing mycoprotein and the control group
      was fed a nutrient-balanced cookie without mycoprotein. After 8 wk of treatment
      total cholesterol was reduced by 0.46 mmol/L in the control group and 0.95 mmol/L
      in the mycoprotein group, and LDL was reduced by 0.34 mmol/L in the control group
      and 0.84 mmol/L in the mycoprotein group. All analysis of variance differences
      were statistically significant. This study confirms the metabolic-study results
      and we are now relatively confident that mycoprotein exerts a beneficial effect
      on blood lipids.

PMID- 1734680
TI  - Bioavailability of starch in various wheat-based bread products: evaluation of
      metabolic responses in healthy subjects and rate and extent of in vitro starch
      digestion.
AB  - Glucose and insulin responses to bread products were evaluated in healthy
      subjects. Also studied were the rate of in vitro starch digestion and the content
      of in vitro resistant starch (RS). Three white-wheat-bread (WWB) products varying
      in crust-crumb ratio and monoglyceride addition, three bread products with a high
      soluble fiber content (HSFB), and two coarse-wheat breads (CB) were included. The
      metabolic responses to WWBs were in general higher than those to CB and HSFB
      products. The most prominent reduction in metabolic responses was noted with the
      CBs with intact kernels and the HSFBs with oat bran. The starch in these products
      was also more slowly released from a dialysis tubing after enzyme incubation of
      chewed samples. The RS content ranged from 0 to 1.7 g/100 g starch. HSFBs and the
      CB with intact kernels showed a higher satiety score than did the WWBs
      immediately after the test meal.

PMID- 1734681
TI  - 13C appearance in plasma glucose and breath CO2 during feeding with naturally 13C
      enriched starchy food in normal humans.
AB  - We have used a recently developed technique (isotope-ratio mass spectrometer) to
      measure 13C appearance in plasma glucose and breath CO2 in eight normal subjects
      during feeding with naturally 13C-enriched starch. 13C in CO2 and plasma glucose,
      metabolites and insulin concentrations, carbohydrates, and lipid oxidation were
      measured after ingestion of 76 g glucose equivalent of crackers, pasta, or
      polenta. 13C in plasma glucose displays a very different pattern from plasma
      glucose concentration. It increases steadily for 90 min before reaching a plateau
      for approximately 2 h and slowly declines during the last 2 h of the study. No
      significant difference was observed with the three different starchy foods tested
      although plasma glucose tended to be higher during feeding with polenta. In
      summary measurement of 13C in plasma glucose during feeding with naturally 13C
      labeled carbohydrates yields new insight in the study of carbohydrate
      bioavailability in humans.

PMID- 1734682
TI  - Effects of timing and dose of vitamin A on tissue retinol concentrations and
      antibody production in the previously vitamin A-depleted rats.
AB  - The effect of retinol repletion in previously vitamin A-depleted Lewis rats on
      antibody production to pneumococcal polysaccharide (SSS-III) was studied. When
      vitamin A-depleted rats were given either 0.35 mumol (0.1 mg) or 5.2 mumol (1.5
      mg) retinol, plasma retinol became normal within 8 h. Liver and lymphoid-organ
      retinol concentrations were normalized by 1 d after repletion with 5.2 mumol but
      not 0.35 mumol retinol. Antibody production to SSS-III was compared after
      administering 5.2 mumol retinol either as a divided dose (half given 4 d before
      and half given on the day of immunization) or as a single dose concurrent with
      immunization. Vitamin A-depleted rats produced very little SSS-III-specific
      antibody. The divided dose of retinol consistently restored anti-SSS-III
      production whereas the single concurrent dose was less effective despite equal
      effects on tissue retinol concentrations. Interestingly, normalization of plasma
      retinol was not always a good predictor of the immune response to pneumococcal
      polysaccharide.

PMID- 1734683
TI  - Extrinsic vs intrinsic labeling of the calcium in whole-wheat flour.
AB  - Fractional absorption of calcium from bread made either from intrinsically or
      extrinsically labeled whole-wheat flour was compared in 11 healthy adult women.
      The intrinsic label was provided by 45Ca injected individually into stems of
      wheat plants during growth. The extrinsic tag was introduced by adding 45Ca to
      unlabeled flour via the water used in dough making. The two labeled breads were
      tested in a randomized crossover design using a standardized breakfast
      administered after an overnight fast. Approximately 80 g labeled bread was
      consumed by each subject, providing a total calcium load of 13.3 mg. Fractional
      absorption from the intrinsically labeled bread averaged 0.812 +/- 0.130 (mean +/
      SE) and from the extrinsically labeled bread 0.792 +/- 0.113. The mean
      difference, within subject, was only 0.025 +/- 0.016 and was not significantly
      different from zero. Extrinsic labeling of the calcium of whole-wheat flour
      results in a degree of labeling homogeneity equivalent to that of intrinsic
      labeling, at least for a leavened bread product.

PMID- 1734684
TI  - Resting energy expenditure, caloric intake, and short-term weight change in human
      immunodeficiency virus infection and the acquired immunodeficiency syndrome.
AB  - To assess the causes of short-term weight loss in patients with acquired
      immunodeficiency syndrome (AIDS), we measured resting energy expenditure (REE),
      caloric intake, and the 28-d weight trend in control subjects, human
      immunodeficiency virus (HIV)+ subjects, AIDS patients, and AIDS patients during
      secondary infection (AIDS-SI). REE was increased in HIV+ (11%), AIDS (25%), and
      AIDS-SI (29%). Caloric intake was similar in control subjects, HIV+, and AIDS but
      reduced 36% in AIDS-SI, who consumed 17% fewer calories than their REE. Average
      short-term weight was stable for HIV+ and AIDS but decreased 5% in AIDS-SI.
      Weight trend correlated with caloric intake but not with REE. Thus HIV+ and AIDS
      are able to partially compensate for increased REE because they do not show short
      term weight loss. Decreased caloric intake is critical for short-term weight loss
      and is seen during secondary infection. Inability of decreased caloric intake to
      decrease REE during infection accelerates short-term weight loss. Rapid weight
      loss with anorexia may be a harbinger of secondary infection in AIDS.

PMID- 1734685
TI  - Metabolic advantages of spreading the nutrient load: effects of increased meal
      frequency in non-insulin-dependent diabetes.
AB  - The acute effect of increasing meal frequency as a model of slow absorption was
      studied for 1 d in 11 patients with non-insulin-dependent diabetes. On 1 d they
      took 13 snacks (the nibbling diet) and on another day the same diet was taken as
      three meals and one snack (the three-meal diet). The nibbling diet reduced mean
      blood glucose, serum insulin, and C peptide concentrations over the 9.5 h of
      observation and 24-h urinary C peptide output by 12.7 +/- 3.7% (mean +/- SE) (P =
      0.0062), 20.1 +/- 5.8% (P = 0.0108), 9.2 +/- 2.6% (P = 0.0073), and 20.37 +/-
      8.12% (P = 0.039), respectively, compared with the three-meal diet. Serum
      triglyceride concentrations were lower by 8.5 +/- 3.2% (P = 0.037). Despite lower
      insulin concentrations on the nibbling diet, the concentrations of free fatty
      acids, 3-hydroxybutyrate, and the insulin-sensitive branched-chain amino acids
      responded similarly on both treatments. Metabolic benefits seen with increased
      meal frequency may explain the success of similar agents that prolong absorption,
      including fiber and enzyme inhibitors.

PMID- 1734686
TI  - Fat elimination in acute renal failure: long-chain vs medium-chain triglycerides.
AB  - Elimination and hydrolysis of fat emulsions containing long-chain (LCT;
      Intralipid) or long- and medium-chain triglycerides (MCT; Lipofundin MCT) were
      compared in seven patients with acute renal failure (ARF) and six healthy control
      subjects. In control subjects, clearance of MCT was slightly higher than that of
      LCT (1.93 +/- 0.34 vs 1.55 +/- 0.3 mL.kg body wt-1.min-1, P less than 0.05). The
      rise in plasma triglycerides was similar and the release of free fatty acids was
      higher during MCT (P less than 0.02). In ARF, clearance of both LCT and MCT was
      equally reduced (0.53 +/- 0.12 vs 0.59 +/- 0.14 mL.kg body wt-1.min-1, P less
      than 0.01 vs control subjects). Again, the rise in triglycerides was comparable.
      Free fatty acid release was higher during MCT but lower than in control subjects.
      Plasma concentrations of glucose and lactate were not affected in control
      subjects but increased during both LCT and MCT in ARF. Thus elimination of both
      LCT and MCT is profoundly decreased in ARF. The impaired lipolysis in ARF cannot
      be circumvented by the use of MCT.

PMID- 1734687
TI  - The analysis of stable isotopes in urine to determine the fractional absorption
      of zinc.
AB  - We measured isotopic enrichment in urine after oral and intravenous
      administration of stable isotopes of zinc to determine fractional absorption
      (FA). 68Zn and 70Zn were administered orally and intravenously to four normal
      adults. Subsequently, urine and fecal samples were collected for 7 and 14 d,
      respectively, ashed, and passed through ion-exchange columns to separate zinc
      from other elements. Samples were analyzed by fast-atom-bombardment mass
      spectrometry. From 32 h onwards the enrichment of 68Zn and 70Zn in urine declined
      proportionately so that FA could be determined as follows: FA = enrichment
      (oral/iv) x dose (iv/oral). FA determinations from urine and feces (cumulative
      excretion) were, respectively, for subject ZK1, urine 0.79 +/- 0.03 and feces
      0.70 +/- 0.01; ZK2, 0.79 +/- 0.05 and 0.69 +/- 0.02; ZK3, 0.26 +/- 0.01 and 0.25
      +/- 0.01; and ZK4, 0.41 +/- 0.02 and 0.37 +/- 0.02. ZK1 and ZK2 received the oral
      isotope while fasting whereas ZK3 and ZK4 received the oral isotope with meals.
      FA of zinc can be determined by measurement of isotope enrichment in urine.

PMID- 1734688
TI  - Phytate and colon-cancer risk.

PMID- 1734689
TI  - The case of the missing calories revisited.

PMID- 1734690
TI  - Urea kinetics and total parenteral nutrition.

PMID- 1734691
TI  - New weight guidelines for Americans.

PMID- 1734692
TI  - Aluminum and TPN-related bone disease.

PMID- 1734693
TI  - Management of perforation of the colon at colonoscopy.
AB  - We propose guidelines for the management of perforation of the colon at
      colonoscopy based upon a comprehensive literature review. Conservative management
      is advocated for silent perforations and in patients with mild or localized
      symptoms and signs diagnosed within 4-8 h of injury. Perforations diagnosed late
      may be managed by nonoperative methods, if the infection is confined as
      determined clinically or by imaging techniques. A suspected large perforation,
      generalized peritonitis, or failure to improve on conservative management will
      mandate surgical exploration. In an intermediate group of patients, decisions
      regarding management will depend on crucial information regarding the
      circumstances surrounding the procedure. These include the endoscopist's
      assessment of the size, mechanism, and timing of the perforation, the adequacy of
      bowel preparation, delay time to diagnosis, overall condition of the patient, and
      the presence or absence of associated colonic pathology. Antibiotic therapy
      should be given to all patients immediately upon diagnosis. Single-agent therapy
      with cefoxitin can be used in the immunocompetent patient. Under other
      circumstances, combination antibiotic treatment is indicated.

PMID- 1734694
TI  - Prospective randomized comparison of sodium tetradecyl sulfate and polidocanol as
      variceal sclerosing agents.
AB  - A prospective randomized controlled study was designed to evaluate differences in
      efficacy and complication rate between the two most commonly used sclerosing
      agents, sodium tetradecyl sulfate (STD) and polidocanol. Of 52 patients with
      esophageal variceal bleeding, 26 were randomized to receive sclerotherapy with
      1.5% STD and 26 to receive 1% polidocanol at weekly intervals. Eradication of
      varices was achieved in 88% patients each of the STD and polidocanol group. There
      was no significant difference between patients injected with STD and polidocanol
      with regard to re-bleeding (27% vs. 15%) and mortality (11.5% in both). The use
      of STD, in contrast to polidocanol, was associated with a higher incidence of
      complications in terms of severe retrosternal pain (27% vs. 4%), deep ulceration
      (53% vs. 23%), dysphagia (88% vs. 46%), and stricture formation (27% vs. 8%). It
      was concluded that these two agents were similar in efficacy. However,
      polidocanol was superior due to a lower incidence of complications.

PMID- 1734695
TI  - Manometric characteristics in idiopathic and reflux-associated esophageal spasm.
AB  - Ancillary manometric findings, e.g., high amplitude contractions, repetitiveness,
      or elevated lower esophageal sphincter (LES) pressure, have been reported in
      diffuse esophageal spasm (DES). However, two recent changes in DES have been
      noted: 1) it has been redefined as increased simultaneous contractions, with
      intermittent peristalsis, and 2) there has been more attention to reflux
      associated DES. Therefore, our aims were to characterize the ancillary findings
      in currently defined DES and to determine whether these occurred in both
      idiopathic and reflux-associated DES. Records of 31 patients with DES (greater
      than 25% simultaneous contractions) were reviewed. Independent of manometry, some
      patients could be subclassified as idiopathic (N = 7; no heartburn; normal
      endoscopy or acid perfusion test) or reflux-associated (N = 10; heartburn;
      positive endoscopy). Both low and high LES pressures and contraction amplitudes
      were seen. Repetitive contractions were seen in nearly all patients, and
      segmental aperistalsis, dropped waves, or distally nonpropagated waves were seen
      in more than half. These findings were generally observed in both types of DES.
      This study of DES 1) confirms the high prevalence of repetitive contractions, 2)
      deemphasizes high LES pressure and contraction amplitude, 3) extends the findings
      to include other types of peristaltic dysfunction, and 4) indicates that
      manometric findings per se do not allow clear differentiation of idiopathic from
      reflux-associated DES.

PMID- 1734696
TI  - Reversal of negative pressure ventilation-induced lower esophageal sphincter
      dysfunction with metoclopramide.
AB  - We have previously demonstrated that lower esophageal sphincter (LES) dysfunction
      is induced in healthy volunteers placed in negative pressure body ventilators.
      This is important, because regurgitation of gastric contents and peptic
      esophagitis are frequent complications of the use of such ventilators. The
      present study was conducted to determine whether LES dysfunction during the use
      of these ventilators also occurs in patients with chronic respiratory failure,
      and whether this dysfunction can be pharmacologically reversed. Seven patients
      with documented chronic respiratory failure due to COPD were studied. After an
      overnight fast, esophageal, LES, and gastric pressures were simultaneously
      recorded in the unassisted state and during mechanically assisted ventilation,
      after which 10 mg iv metoclopramide were administered to each patient, and
      pressure recordings were continued for 1 h more. In all seven patients, baseline
      LES pressures were in the normal range. During the inspiratory cycle of
      mechanical ventilation, five of the seven patients demonstrated a significant
      reduction in LES pressure, whereas it was unchanged in the other two. Within 15
      min of metoclopramide administration, there was an increase in LES pressure to
      baseline levels in the five patients in which a significant decrease in LES
      pressure had occurred. Metoclopramide did not have any effect on the LES pressure
      of the other two patients. Thus, we conclude that in patients with chronic
      respiratory failure, as in normals, there is a subset of individuals in whom
      negative pressure mechanical ventilatory assistance induces dysfunction of the
      LES, and that this dysfunction is reversible with metoclopramide.

PMID- 1734697
TI  - Gastrin release from antral G cells stimulated with secretin.
AB  - Recently, gastrinoma cells were demonstrated to release gastrin when directly
      stimulated by secretin both in vivo and in vitro. In this study, the reaction of
      antral G cells was investigated. Secretin was injected into the right
      gastroepiploic artery in canines, and into the common hepatic artery during a
      selective arteriography in patients without gastrinomas. G cells obtained from
      the antrum of rats were attached to 0.45-microns filters and irrigated with
      medium containing secretin. The serum gastrin concentration increased rapidly in
      significant amounts and very quickly after an intraarterial injection of
      secretin, both in humans and in dogs. The rate of gastrin release from the rat
      antral G cells in vitro increased significantly when the medium contained
      secretin. In conclusion, secretin stimulated gastrin release from antral G cells
      both in vivo and in vitro.

PMID- 1734698
TI  - Changing epidemiology of gastrointestinal angiodysplasia with increasing
      recognition of clinically milder cases: angiodysplasia tend to produce mild
      chronic gastrointestinal bleeding in a study of 47 consecutive patients admitted
      from 1980-1989.
AB  - It is important to recognize patients with gastrointestinal bleeding who are at
      high risk of having angiodysplasia, because these patients should be evaluated by
      endoscopy rather than barium studies. Sixty-two clinical and epidemiologic
      parameters were compared between 47 consecutive patients bleeding from
      angiodysplasia and 47 consecutive controls bleeding from other lesions admitted
      to two university teaching hospitals from 1980 through 1989. This study
      demonstrated statistically significant differences between these two groups. The
      patients with angiodysplasia generally presented with symptoms and clinical
      findings compatible with hemodynamically well-compensated, chronic bleeding: they
      were more likely than other gastrointestinal bleeders to experience weakness or
      fatigue, less likely to experience dizziness or syncope, and less likely to be
      orthostatic or hypotensive. They had more prior admissions for gastrointestinal
      bleeding, particularly for gastrointestinal bleeding of undetermined etiology.
      They were more likely than other gastrointestinal bleeders to be smokers.
      Patients with angiodysplasia had a milder hospital course: they had fewer
      transfusions of packed erythrocytes, shorter hospitalizations, and a lower
      mortality. The in-hospital mortality of patients bleeding from angiodysplasia was
      2.1%. Despite the futility of diagnosing angiodysplasia by barium studies,
      patients ultimately diagnosed as having angiodysplasia were more often initially
      evaluated by barium studies than the other gastrointestinal bleeders. The
      currently identified risk factors for bleeding from angiodysplasia should help to
      select which gastrointestinal bleeders should be evaluated initially by
      endoscopy.

PMID- 1734699
TI  - Vincristine-induced paralytic ileus: role of fiberoptic colonoscopy and
      prostaglandin F2 alpha.
AB  - Two cases of vincristine-induced paralytic ileus are described, with therapeutic
      correlation. Both patients had a roentgenographic picture of paralytic ileus
      showing fecal mass in the ascending colon and dilated bowel loops. One patient
      was successfully treated with glycerin and saline enema through a fiberoptic
      colonoscope placed in the ascending colon. The second patient was successfully
      treated with intravenous prostaglandin F2 alpha (PGF2 alpha). Enema through a
      fiberoptic colonoscope or the intravenous administration of PGF2 alpha may,
      therefore, prove useful in the treatment of vincristine-induced gastrointestinal
      toxicity.

PMID- 1734700
TI  - Periampullary cysts: endoscopic management.
AB  - Periampullary cysts are a rare but remediable cause of recurrent pancreatitis.
      Hitherto, the management of such cysts was mainly surgical. We report on two
      cases of periampullary cysts. The first patient, who had a cyst of the minor
      papilla (Santorini cyst), presented with upper gastrointestinal hemorrhage and a
      history of recurrent pancreatitis. The second patient presented with cholangitis.
      Both were successfully and safely treated by endoscopic methods alone. Details of
      the cases and the endoscopic techniques used are fully described.

PMID- 1734701
TI  - Spontaneous regression of hepatic pseudotumor.
AB  - Inflammatory pseudotumor of the liver is a rare benign lesion that usually has
      been discovered at laparotomy and treated by hepatic resection. We report a case
      of hepatic pseudotumor that was treated without surgery and that subsequently
      spontaneously resolved. Hepatic pseudotumor occur in all age groups, but most
      commonly in middle-aged adults, with a 3.5:1 male predominance. Presenting
      symptoms are 1 or 2 months of fever (66%), abdominal pain (51%), and weight loss
      (21%). Most often, the lesions are solitary encapsulated tumors composed of
      whorled laminated fibrous stroma and chronic inflammatory infiltrate. Our report
      provides documentation of spontaneous resolution of a hepatic pseudotumor.

PMID- 1734702
TI  - Bile-duct hamartomas presenting as multiple focal lesions on hepatic
      ultrasonography.
AB  - Multiple bile-duct hamartomas are usually diagnosed at autopsy as an incidental
      finding. We report a case of a 50-yr-old male in whom multiple bile-duct
      hamartomas were suspected in an abdominal ultrasonography and confirmed by an
      echo-guided needle liver biopsy. The ultrasonography disclosed multiple scattered
      hyperechoic lesions with a diameter of up to 1 cm, associated with some anechoic
      lesions of a larger size and a cystic appearance. Computed tomography
      demonstrated multiple hypodense lesions that were not modified by the
      administration of contrast. Bile-duct hamartomas should be included in the
      differential diagnosis of multiple focal hepatic lesions at ultrasonography or
      computed tomography.

PMID- 1734703
TI  - Gastrointestinal hemorrhage due to gastrointestinal Mycobacterium avium
      intracellulare or esophageal candidiasis in patients with the acquired
      immunodeficiency syndrome.
AB  - A 33-yr-old black intravenous drug abuser with the acquired immunodeficiency
      syndrome (AIDS) had a massive fatal upper gastrointestinal hemorrhage due to
      profound and diffuse esophageal ulceration from Candida, as demonstrated by
      postmortem examination. A 2-yr-old white male with congenitally acquired AIDS had
      a massive fatal esophageal bleed as a result of esophagitis from Candida
      albicans, as proven by pathologic examination and culture of endoscopic biopsies.
      A 27-yr-old black human immunodeficiency virus-seropositive female died from
      massive lower gastrointestinal bleeding due to extensive small and large
      intestinal ulceration caused by Mycobacterium avium intracellulare, as proven by
      microscopic examination and mycobacterial culture of intestinal tissue. These
      reports extend the clinical spectrum of these infections in AIDS patients by
      demonstrating that these infections can produce gastrointestinal bleeding.

PMID- 1734704
TI  - Mesenteritis ossificans.
AB  - A unique finding of an extraskeletal pseudomalignant osseous lesion of the
      mesentery and omentum was detected in a 63-yr-old insulin-dependent diabetic man,
      following aortic bifemoral bypass and two subsequent laparotomies at 2-wk
      intervals for intractable intestinal obstruction. An analogy is made to myositis
      ossificans and fasciitis ossificans. The histogenesis of new bone formation from
      connective tissue following chemical or physical stimuli supports a metaplastic
      mechanism. Our review of the literature reveals no prior report of a similar
      case.

PMID- 1734705
TI  - Hyperplastic polyp of the common bile duct.
AB  - We describe a hyperplastic polyp of the common bile duct, found in a 45-yr-old
      Japanese woman. Endoscopic retrograde sphincterotomy and intraductal biopsy
      yielded a histological diagnosis of adenocarcinoma, preoperatively. However,
      final diagnosis after pancreatoduodenectomy proved to be hyperplasia. The wrong
      diagnosis seemed attributable to tortuosity of the specimens caused by the biopsy
      procedure and/or a lack of experience of pathologists due to the rarity of this
      condition. One should be aware of this entity in diagnosing polypoid lesions in
      the biliary tract.

PMID- 1734706
TI  - Diplopia and diarrhea: ileal carcinoid metastatic to the central nervous system.
AB  - The case of a patient with metastatic ileal carcinoid is reported. The
      peculiarities of this case were as follows: 1) The patient presented with
      symptoms attributable to a mass lesion in the brain which was proven to be a
      carcinoid tumor by biopsy. 2) The patient had symptoms attributable to carcinoid
      syndrome without radiologic evidence of hepatic metastasis. 3) No bony or
      pulmonary metastasis was evident, which suggests that the metastatic spread from
      the ileum occurred through the spinous venous plexus of Batson. The patient's
      symptoms were managed with cyproheptadine with good effect. A review of the
      carcinoid syndrome and the determinants of its metastatic spread is presented.

PMID- 1734707
TI  - Gastric perforation after endoscopic treatment of a Dieulafoy's lesion.
AB  - Dieulafoy's vascular malformation is an underdiagnosed cause of massive, often
      recurrent upper gastrointestinal hemorrhage. Attempted endoscopic treatment of
      Dieulafoy's lesion has been recommended prior to surgery in many instances, but
      may occasionally be employed as primary therapy in patients that are not
      considered good "operative risks." Although generally considered safe and
      effective therapy for nonvariceal hemorrhage, combination therapy by injection
      and thermocoagulation techniques may result in perforation. We present a patient
      with a Dieulafoy's lesion of the stomach that illustrates both the efficacy and
      risks of combination endoscopic therapy for nonvariceal gastrointestinal
      hemorrhage.

PMID- 1734708
TI  - Closure of a controlled biliary fistula complicating partial cholecystectomy with
      endoscopic biliary stenting.
AB  - An elderly woman presented 2 months after partial cholecystectomy performed for
      gangrenous cholecystitis with choledocholithiasis and a controlled biliary
      fistula. Despite ductal clearance of stones via endoscopic retrograde
      sphincterotomy and stone extraction, bilious drainage via the fistulous tract
      persisted. Endoscopic insertion of a 10F Amsterdam endoprosthesis resulted in
      complete closure of the fistula within 6 wk. This case represents the first
      example of closure of a biliary fistula after partial cholecystectomy.

PMID- 1734709
TI  - Simvastatin-induced protein-losing enteropathy.

PMID- 1734710
TI  - Biliary ectasia in a patient with Marfan's syndrome.

PMID- 1734711
TI  - Debates, divisions, and decisions: recombinant DNA advisory committee (RAC)
      authorization of the first human gene transfer experiments.
AB  - Possibly the most far-reaching, controversial research currently being conducted
      in the international biological science community involves human gene therapy
      experimentation. In this paper, I report the dynamics of the political process
      which ultimately found the Recombinant DNA Advisory Committee (RAC) of the
      National Institutes of Health approving for the first time protocols of this
      genre. A full appreciation of the policy-making dialogue shows that significant
      participants perceived the process from very different vantage points regarding
      the way in which the American political system works and the way in which it
      ought to work. I argue that, if we are to understand how the RAC should proceed
      in orchestrating a human gene therapy policy agenda, then we must flesh out and
      critically analyze these competing vantage points. To that end, I postulate seven
      possible "action models" for characterizing how protocol assessments of the type
      at issue might be developed given the nature of our politics, reaching the
      conclusion that one of these models holds out the most promise for synthesizing
      efficaciously the key factors involved. In conclusion, I discuss how the RAC
      might profitably employ this preferred strategy in these and other cases.

PMID- 1734712
TI  - Examination of X chromosome markers in Rett syndrome: exclusion mapping with a
      novel variation on multilocus linkage analysis.
AB  - Rett syndrome is a neurologic disorder characterized by early normal development
      followed by regression, acquired deceleration of head growth, autism, ataxia, and
      stereotypic hand movements. The exclusive occurrence of the syndrome in females
      and the occurrence of a few familial cases with inheritance through maternal
      lines suggest that this disorder is most likely secondary to a mutation on the X
      chromosome. To address this hypothesis and to identify candidate regions for the
      Rett syndrome gene locus, genotypic analysis was performed in two families with
      maternally related affected half-sisters by using 63 DNA markers from the X
      chromosome. Maternal and paternal X chromosomes from the affected sisters were
      separated in somatic cell hybrids and were examined for concordance/discordance
      of maternal alleles at the tested loci. Thirty-six markers were informative in at
      least one of the two families, and 25 markers were informative in both families.
      Twenty loci were excluded as candidates for the Rett syndrome gene, on the basis
      of discordance for maternal alleles in the half-sisters. Nineteen of the loci
      studied were chosen for multipoint linkage analysis because they have been
      previously genetically mapped using a large number of meioses from reference
      families. Using the exclusion criterion of a lod score less than -2, we were able
      to exclude the region between the Duchenne muscular dystrophy locus and the
      DXS456 locus. This region extends from Xp21.2 to Xq21-q23. The use of the
      multipoint linkage analysis approach outlined in this study should allow the
      exclusion of additional regions of the X chromosome as new markers are analyzed.
      This in turn will result in a defined region of the X chromosome that should be
      searched for candidate sequences for the Rett syndrome gene in both familial and
      sporadic cases.

PMID- 1734713
TI  - The human enamel protein gene amelogenin is expressed from both the X and the Y
      chromosomes.
AB  - Amelogenins, a family of extracellular matrix proteins of the dental enamel, are
      transiently but abundantly expressed by ameloblasts during tooth development.
      Amelogenins seem to regulate the formation of crystallites during the secretory
      stage of enamel development, while they are specifically degraded during tooth
      bud maturation. In this paper we report the characterization of the AMGX and AMGY
      genes on the short arms of the human X and Y chromosomes which encode the
      amelogenins. Our studies on the expression of the amelogenin genes in male
      developing tooth buds showed that both the AMGX and AMGY genes are
      transcriptionally active and encode potentially functional proteins. We have
      isolated genomic and cDNA clones from both the AMGX and AMGY loci and have
      studied the sequence organization of these two genes. Reverse transcriptase
      (RT)PCR amplification of the 5' portion of the amelogenin transcripts revealed
      several alternatively spliced products. The splicing pattern observed in the Y
      derived mRNA varies from that of the X-derived mRNA. The promoter regions from
      both genes and the predicted amelogenin protein sequences are presented. This
      information will be useful for studying the molecular basis of X-linked
      amelogenesis imperfecta, for understanding the evolution and regulation of gene
      expression on the mammalian sex chromosomes, and for investigating the role of
      amelogenin genes during tooth development.

PMID- 1734714
TI  - Fine mapping of the McLeod locus (XK) to a 150-380-kb region in Xp21.
AB  - McLeod syndrome, characterized by acanthocytosis and the absence of a red-blood
      cell Kell antigen (Kx), is a multisystem disorder involving a late-onset
      myopathy, splenomegaly, and neurological defects. The locus for this syndrome has
      been mapped, by deletion analysis, to a region between the loci for Duchenne
      muscular dystrophy (DMD) and chronic granulomatous disease (CGD). In this study,
      we describe a new marker, 3BH/R 0.3 (DXS 709), isolated by cloning the deletion
      breakpoint of a DMD patient. A long-range restriction map of Xp21, encompassing
      the gene loci for McLeod and CGD, was constructed, and multiple CpG islands were
      found clustered in a 700-kb region. Using the new marker, we have limited the
      McLeod syndrome critical region to 150-380-kb. Within this interval, two CpG-rich
      islands which may represent candidate sites for the McLeod gene were identified.

PMID- 1734715
TI  - A multiple-tubes approach for accurate genotyping of very small DNA samples by
      using PCR: statistical considerations.
AB  - A multiple-tubes procedure is described for using PCR to determine the genotype
      of a very small DNA sample. The procedure involves dividing the sample among
      several tubes, then amplifying and typing the contents of each tube separately.
      The results are analyzed by a statistical procedure which determines whether a
      genotype can be conclusively assigned to the DNA sample. Simulation studies show
      that this procedure usually gives correct results even when the number of double
      stranded fragments in the sample is as small as 30. The procedure remains
      effective even in the presence of small amounts of laboratory contamination. We
      find that the multiple-tubes procedure is superior to the standard one-tube
      procedure, either when the sample is small or when laboratory contamination is a
      potential problem; and we recommend its use in these situations. Because the
      procedure is statistical, it allows the degree of certainty in the result to be
      quantified and may be useful in other PCR applications as well.

PMID- 1734716
TI  - Lack of transmission of deleted mtDNA from a woman with Kearns-Sayre syndrome to
      her child.
AB  - We have investigated the daughter of a woman with Kearns-Sayre syndrome. The
      woman had a high percentage of deleted mtDNA in muscle, but no deleted mtDNA was
      detected in fibroblasts, bone marrow, and peripheral blood cells by Southern blot
      analysis. With PCR, analytical sensitivity was significantly increased, and
      deleted mtDNA was detected in all examined tissues from this patient. The patient
      had healthy parents and nine healthy siblings. No deleted mtDNA was detected in
      blood from the mother of the patient. The patient had an uneventful pregnancy and
      delivered at term. Deleted mtDNA could not be detected in placenta by Southern
      blot analysis. With PCR, deleted mtDNA was detected in the majority of placental
      specimens. This finding may, however, be due to contamination with maternal DNA.
      The patient's daughter was healthy at age 5 mo, and morphologic examination of
      muscle was normal. No transmission of deleted mtDNA to the daughter could be
      detected by Southern blot and PCR analysis of peripheral blood cells, bone
      marrow, fibroblasts, and muscle. The presence of deleted mtDNA was excluded at a
      fractional level of less than 1:100,000 in all examined tissues from the
      daughter.

PMID- 1734717
TI  - Amplification and characterization of the retinoblastoma gene VNTR by PCR.
AB  - VNTR regions are informative genetic markers for linkage mapping and individual
      identification. Using PCR, we have developed a procedure for the enzymatic
      amplification of the VNTR located in the 16th intron of the human retinoblastoma
      (RB1) gene. We have also prepared a nonisotopically labeled oligonucleotide probe
      which facilitates detection of the amplification products. In examining 250
      individuals from four different populations, we have detected 11 alleles ranging
      from 650 to 1,800 bp in size. The core repeat is approximately 50 bp in length.
      On the basis of the observed allele frequencies for Caucasian, African-American,
      and Hispanic populations from the United States and for the Mexican Hispanic
      population, the heterozygosities have been calculated to be 62%, 75%, 61%, and
      50%, respectively. The observed genotype frequencies do not deviate from the
      values expected under Hardy-Weinberg equilibrium. The effect of varying primer
      sequences, annealing temperature, and cycle number on the amplification are also
      discussed. Amplification of this marker may also prove useful for detecting the
      heterozygosity loss that is associated with tumor formation in retinoblastoma.

PMID- 1734718
TI  - The origin of glucose-6-phosphate-dehydrogenase (G6PD) polymorphisms in African
      Americans.
AB  - DNA samples from 54 male Afro-Americans were examined for glucose-6-phosphate
      dehydrogenase (G6PD) genotypes G6PD A(+)376G, G6PD A(-)202A/376G, and G6PD B and
      for polymorphisms in intron 5 (PvuII), at nucleotide 1311, and at nucleotide 1116
      (PstI). In the G6PD B subjects, the nucleotide 1311 mutation and the PstI site
      appeared to be in linkage equilibrium. No PvuII+ G6PD men were encountered. The
      G6PD A(+) mutation was in disequilibrium with respect to both the nucleotide 1311
      mutation and the PstI site. The G6PD A- nucleotide 202 mutation was in
      disequilibrium with all three polymorphic sites. No conclusion could be drawn
      with respect to the PvuII site, except that it preceded the nucleotide 202 (A-)
      mutation. We conclude from these and our previous studies that G6PD B is the most
      ancient genotype. The nucleotide 1311 mutation, with its worldwide distribution,
      probably occurred next. The PstI mutation, limited to Africans, probably arose
      next and is more ancient than the A(+) mutation, which occurred in a gene without
      either the PstI or the 1311 mutation. G6PD A-202A/376G is the most recent of
      these mutations and is still in linkage disequilibrium with all of the sites.
      Presumably it occurred in an individual with both the A(+) and PvuII mutations.

PMID- 1734719
TI  - Fine-scale mapping of the gene responsible for multiple endocrine neoplasia type
      1 (MEN 1).
AB  - We have constructed a high-resolution genetic linkage map in the vicinity of the
      gene responsible for multiple endocrine neoplasia type 1 (MEN1). The mutation
      causing this disease, inherited as an autosomal dominant, predisposes carriers to
      development of neoplastic tumors in the parathyroid, the endocrine pancreas, and
      the anterior lobe of the pituitary. The 12 markers on the genetic linkage map
      reported here span nearly 20 cM, and linkage analysis of MEN1 pedigrees has
      placed the MEN1 locus within the 8-cM region between D11S480 and D11S546. The
      markers on this map will be useful for prenatal or presymptomatic diagnosis of
      individuals in families that segregate a mutant allele of the MEN1 gene.

PMID- 1734720
TI  - Interethnic genetic differentiation in Africa: HLA class I antigens in The
      Gambia.
AB  - A total of 752 individuals from The Gambia, west Africa who are representative of
      the major ethnic groups in the capital, Banjul, were serologically typed for HLA
      A, -B, and -C antigens. Although all were typically "African" in their antigenic
      profiles, some marked frequency differences were found between the ethnic groups.
      Genetic distance comparisons with several other African populations showed that,
      although these west African populations clustered closely together, the positions
      of the various ethnic groups in The Gambia were consistent with historical and
      linguistic evidence of their affinities with one another and with other African
      populations. Despite the potential confounding effects both of selection by
      infectious diseases and of genetic drift caused by local differences in
      population structure, HLA frequencies appear to be of value in measuring inter-
      and intraregional population affinities in sub-Saharan Africa.

PMID- 1734721
TI  - Molecular characterization of beta-thalassemia in the Sardinian population.
AB  - This study reports the molecular characterization of beta-thalassemia in the
      Sardinian population. Three thousand beta-thalassemia chromosomes from
      prospective parents presenting at the genetic service were initially analyzed by
      dot blot analysis with oligonucleotide probes complementary to the most common
      beta-thalassemia mutations in the Mediterranean at-risk populations. the
      mutations which remained uncharacterized by this approach were defined by
      denaturing gradient gel electrophoresis (DGGE) followed by direct sequence
      analysis on amplified DNA. We reconfirmed that the predominant mutation in the
      Sardinian population is the codon 39 nonsense mutation, which accounts for 95.7%
      of the beta-thalassemia chromosomes. The other two relatively common mutations
      are frameshifts at codon 6 (2.1%) and at codon 76 (0.7%), relatively uncommon in
      other Mediterranean-origin populations. In this study we have detected a novel
      beta-thalassemia mutation, i.e., a frameshift at codon 1, in three beta
      thalassemia chromosomes. The DGGE procedure followed by direct sequencing on
      amplified DNA is a powerful approach for the characterization of unknown
      mutations in this genetic system. The results herein presented allowed an
      expansion of the applicability of prenatal diagnosis by DNA analysis, to all
      couples at risk for beta-thalassemia in our population.

PMID- 1734722
TI  - A nonsense mutation in the LDL receptor gene leads to familial
      hypercholesterolemia in the Druze sect.
AB  - Familial hypercholesterolemia (FH) is an autosomal dominant disease caused by
      mutations in the LDL receptor gene. Here we characterize an LDL receptor mutation
      that is associated with a distinct haplotype and causes FH in the Druze, a small
      Middle Eastern Islamic sect with a high degree of inbreeding. The mutation was
      found in FH families from two distinct Druze villages from the Golan Heights
      (northern Israel). It was not found neither in another Druze FH family residing
      in a different geographical area nor in eight Arab and four Jewish FH
      heterozygote index cases whose hypercholesterolemia cosegregates with an
      identical LDL receptor gene haplotype. The mutation, a single-base substitution,
      results in a termination codon in exon 4 of the LDL receptor gene that encodes
      for the fourth repeat of the binding domain of the mature receptor. It can be
      diagnosed by allele-specific oligonucleotide hybridization of PCR-amplified DNA
      from FH patients.

PMID- 1734723
TI  - General population screening for cystic fibrosis is premature.

PMID- 1734724
TI  - Advantages of a two-step laboratory approach for cystic fibrosis carrier
      screening.

PMID- 1734725
TI  - Population genetic issues in DNA fingerprinting.

PMID- 1734726
TI  - Molecular genetic analysis of a sporadic case of Leber hereditary optic
      neuropathy.

PMID- 1734727
TI  - Leber optic neuropathy.

PMID- 1734728
TI  - Informative microsatellite markers allow carrier detection in a Duchenne muscular
      dystrophy deletion pedigree in the absence of DNA from an affected boy.

PMID- 1734729
TI  - Chest pain and breathlessness: relationship to psychiatric illness.
AB  - Chest pain and breathlessness are common somatic symptoms of emotional disorder
      in ambulatory care. Chronic chest pain has a prevalence of 12% and is associated
      with high utilization of health care. Of patients with chest pain and
      breathlessness who are referred to a cardiac clinic but subsequently shown not to
      have heart disease, the majority continue to report symptoms. Those patients with
      the worst outcome, in terms of continuing limitation of activity and use of
      medical resources, are those with chest pain but normal coronary arteries. A
      number of studies that fail to support a unitary theory of causation of
      noncardiac chest pain are described. A multifactorial, interactive model is
      proposed, with contributions from physical factors, such as palpitations and
      intercostal muscle pain; psychologic factors, which include enhanced awareness of
      and selective attention to bodily sensation; and environmental factors, such as
      previous exposure to cardiorespiratory disease in first-degree relatives or
      significant others. Although there have been few controlled intervention studies
      in patients with unexplained cardiorespiratory symptoms, there is evidence for
      the efficacy of both drug treatments and psychologic treatment. The results of
      intervention studies in patients with chest pain and normal coronary arteries are
      eagerly awaited. Atypical chest pain and breathlessness are common causes of
      office consultations and/or functional disability. The diagnoses should be
      established on the basis of positive evidence of psychiatric illness rather than
      by exclusion. The etiology is multifactorial, and management is aimed at treating
      the underlying psychosocial problems and/or psychiatric illness. Cognitive
      behavioral treatments are probably as effective as drug treatments in the short
      term, and the care of these patients would be improved by a more detailed
      explanation of noncardiac causes and a greater opportunity for patients to
      discuss their fears.

PMID- 1734730
TI  - Medically unexplained syncope: relationship to psychiatric illness.
AB  - The purpose of this article is to review the literature and present new data
      concerning the relationship between psychiatric disorders and unexplained
      syncope. Several case series are presented of patients with syncope in whom
      psychiatric structured interviews were undertaken, tilt-table (physiologic)
      testing was performed, and health-related quality of life was measured. Patients
      seen in a syncope specialty clinic underwent structured psychiatric interviews in
      addition to in-depth medical evaluations. Tilt-table testing was performed on a
      separate series of patients to determine susceptibility to syncope during the
      orthostatic challenge of head-up tilt; in some cases, tilt studies included
      simultaneous electroencephalographic (EEG) monitoring and cerebral blood flow
      measurements. Formal functional status assessment was carried out using the
      Sickness Impact Profile, the Symptom Check List 90, and the Medical Outcomes
      Study Short-Form 36. Psychiatric disorders (in particular, panic disorders and
      major depression) were a common cause of syncope (24-31% of syncope patients).
      Tilt table studies showed several physiologic profiles in syncope: (a) a typical
      vasovagal (hypotension-bradycardia) response, (b) a "psychosomatic" response
      (fainting with normal vital signs), and (c) a gradual decline in blood pressure
      (dysautonomic response). EEG and cerebral blood flow measurements in three
      patients with the psychosomatic response to tilt were normal during fainting.
      Functional status measurements showed serious impairment in two series of syncope
      patients. Conclusions were as follows: (a) Psychiatric disorders are common in
      syncope. (b) Tilt-table methodology may elucidate underlying mechanisms of
      syncope in these subjects. (c) Syncope can seriously disrupt a patient's life and
      result in important psychosocial sequelae. (d) There is an intimate relationship
      between unexplained syncope and psychiatric illness, mandating a combined medical
      and psychiatric approach to such patients.

PMID- 1734731
TI  - Symptoms in medical patients: an untended field.
AB  - Somatic symptoms are one of the leading reasons for medical outpatient clinic
      visits, with the most common symptoms having a prevalence of 10% or more.
      However, the usual diagnostic workups are often unproductive, with less than 1 in
      5 symptoms having an organic explanation after the initial physical examination
      and laboratory testing. Therapy appears more effective for some symptoms than for
      others. Of patients with unspecified pain or gastrointestinal complaints, greater
      than 70% state that some type of treatment has been helpful, whereas less than
      50% of individuals with fatigue, dizziness, numbness, insomnia, sexual
      dysfunction, anxiety, or depression report any relief. Future educational efforts
      and research need to focus on that majority of symptoms that are either
      psychiatric or unexplained, in order to improve our current evaluation and
      management strategies.

PMID- 1734732
TI  - Palpitations, cardiac awareness, and panic disorder.
AB  - This article reviews and appraises a variety of studies on panic disorder,
      visceral sensitivity, and cardiac disease. The literature reviewed includes
      descriptive surveys, small-scale experimental manipulations, and clinical
      interventions. Instruments have included structured diagnostic interviews,
      clinical observation, self-report inventories, direct measures of perceptual
      sensitivity, and cognitive tests. The subjects in these studies have ranged from
      community residents to carefully defined samples of designated patients with
      psychiatric or cardiac disease. We then outline a prospective investigation to
      examine the prominence of palpitations in panic anxiety and speculate on the
      importance of sensitivity to cardiac sensation in several other clinical
      conditions characterized by marked discrepancies between cardiac activity and
      cardiac symptoms.

PMID- 1734733
TI  - Physician consultation for headache pain and history of panic: results from a
      population-based study.
AB  - In a population-based telephone interview survey of 10,169 respondents aged 12-29
      years in Washington County, Maryland, data were collected on history of panic
      attacks, on the most recent headache and associated symptoms in the 2 weeks
      before the interview, and on physician consultation for headache-related
      problems. Of those who had a headache in the previous 12 months, 14.2% of females
      and 5.8% of males consulted a physician for headache. The proportion who recently
      consulted a physician increased with age among females but not among males. An
      unexpectedly high proportion of those who recently sought physician care for
      their headache problem had a history of panic. In particular, among those who
      sought care, 15% of females and 12.8% of males ages 24-29 had a history of panic
      disorder. Overall, females with panic disorder who had recently seen a physician
      for headache exhibited the most frequent, severe, and complex headaches. In
      particular, headaches were of considerably longer duration, more severe, and
      greater than 50% of these females had five or more headaches in a 4-week period.
      A very high proportion experienced disability (up to 46.7%) from their headache.
      Males with a history of panic who did or did not seek physician care differed
      only in that a considerably higher proportion of the former group (up to 45%) had
      frequent headaches. Overall, 11.8% of the total population had a migraine
      headache in the 2 weeks before the interview. In contrast, 21.8% of those who
      sought physician care and 36% of those with panic disorder who sought physician
      care had a migraine headache.

PMID- 1734734
TI  - Panic disorder: relationship to high medical utilization.
AB  - The purpose of this review is to describe the relationship between panic
      disorder, somatization, functional disability, and high medical utilization. Data
      from community, primary-care, and specialty studies were reviewed to determine
      the prevalence of anxiety and panic disorder in these populations. Data from the
      Epidemiologic Catchment Area Study were reviewed to emphasize the effect of panic
      disorder on health-care utilization and health perception in a community
      population. Data on the prevalence of panic disorder in primary care and mode of
      presentation of primary-care patients with panic disorder were also reviewed.
      Finally, the epidemiologic psychiatric findings from our recent study of
      distressed high utilizers of primary care were presented. Panic disorder was
      found to occur in 1-3% of people in the study community and 1.4-8% of primary
      care patients. Of people with or without psychiatric disorder, people with panic
      disorder in the community had the highest risk of having multiple medically
      unexplained symptoms and of being high utilizers of medical ambulatory services.
      People with panic disorder in the community compared to both community
      psychiatric and nonpsychiatric controls tend to perceive themselves as having
      poor physical health and to be high users of emergency and hospital inpatient
      services, as well as ambulatory services. Most patients with panic disorder
      present to their primary-care physician with somatic complaints, especially
      cardiac (tachycardia, chest pain), gastrointestinal (epigastric pain or irritable
      bowel syndrome), or neurologic complaints (headaches, dizziness, or presyncope).
      Patients who were distressed high utilizers of primary care had an extremely high
      prevalence of current panic disorder (12%) and lifetime panic disorder (30%),
      which supported the association between panic disorder and high medical
      utilization found in the Epidemiologic Catchment Area (ECA) Study.

PMID- 1734735
TI  - Is sleep deprivation useful in the treatment of depression?
AB  - OBJECTIVE: The authors critically reviewed the literature on clinical
      applications of sleep deprivation in the treatment of depression. DATA
      COLLECTION: They included all studies using sleep deprivation for clinical
      purposes, with the exception of treatment studies that did not provide follow-up
      beyond a night of recovery sleep. They focused on six uses of sleep deprivation:
      1) to potentiate response to antidepressant medication (13 studies), 2) to hasten
      the onset of action of antidepressant medication or lithium (five studies), 3) to
      prevent recurrent mood cycles (four studies), 4) as an alternative to
      antidepressant medication (five studies), 5) as a diagnostic probe (two studies),
      and 6) to predict response to antidepressant medication (nine studies). FINDINGS:
      Although the literature appears to demonstrate the efficacy of sleep deprivation
      as a potentiation strategy, these treatment studies have substantial
      methodological shortcomings. Well-designed pilot studies indicate that sleep
      deprivation may hasten the onset of action of thymoleptic medications. Sleep
      deprivation may prevent premenstrual mood swings, and response to sleep
      deprivation may differentiate depressive pseudodementia from primary degenerative
      dementia with depression. Studies attempting to use sleep deprivation to predict
      response to antidepressant medication have yielded inconsistent results.
      CONCLUSIONS: Given the noninvasive nature of sleep deprivation, it would be
      useful to determine if even a small subset of refractory patients respond to it.
      The authors suggest future research directions to determine the usefulness of
      this potential treatment.

PMID- 1734736
TI  - Community mental health and mental retardation services in the United States: a
      comparative study of resource allocation.
AB  - OBJECTIVE: Preliminary studies suggest that during the 1980s, spending for
      community mental retardation services in the United States may have grown much
      more rapidly than spending for community mental health. The primary objective of
      this study was to test empirically the validity of this thesis on a national
      basis. An additional objective was to determine why such a distinction in
      community spending patterns might have evolved nationally. METHOD: The study used
      states as the units of analysis and employed a five-factor hierarchical
      regression to predict variance in mental health and mental retardation spending.
      Factors were state size, state wealth, degree of federal assistance, state civil
      rights activity, and strength of consumer advocacy groups. Strong roles for the
      civil rights and consumer advocacy factors were hypothesized. A collateral
      opinion survey in the 10 states exhibiting the greatest within-state difference
      in community mental health and mental retardation spending was also completed.
      RESULTS: Community mental retardation spending grew nearly four times more
      rapidly than community mental health spending in the 1980s. The consumer advocacy
      and civil rights factors were strongly associated with spending for community
      mental retardation services in the states, but these factors did not predict
      spending for community mental health services. CONCLUSIONS: Study recommendations
      included strengthening mental health family and consumer advocacy groups in the
      states and promoting systematic exchange between the mental health and mental
      retardation fields through joint state planning initiatives, studies, and
      conferences. The need for Medicaid reform is a unifying theme in both the mental
      health and mental retardation fields.

PMID- 1734737
TI  - Cognitive deficits of patients with Alzheimer's disease with and without
      delusions.
AB  - OBJECTIVE: The goal of this investigation was to study the prevalence of
      delusions in Alzheimer's disease and to compare the performance of the delusional
      and nondelusional groups on a neuropsychological test battery. METHOD: The
      authors studied 107 patients with Alzheimer's disease and 51 age- and education
      comparable normal subjects using a standardized psychiatric interview and a
      neuropsychological test battery. RESULTS: Thirty-seven patients with Alzheimer's
      disease had delusions with or without hallucinations. Patients with delusions
      were significantly more impaired than those without delusions (and the normal
      comparison group) on the Mini-Mental State examination; Blessed Information
      Memory-Concentration Test; Dementia Rating Scale, especially its
      conceptualization and memory subtests; and a test of verbal fluency. The
      delusional group also tended to be somewhat more impaired than the nondelusional
      group on the modified Wisconsin Card Sorting Test and the similarities subtest of
      the Wechsler Adult Intelligence Scale-revised. CONCLUSIONS: Approximately one
      third of patients with Alzheimer's disease had developed psychotic symptoms
      sometime after the onset of dementia. The presence of psychotic symptoms in
      Alzheimer's disease was associated with greater cognitive impairment, especially
      frontal/temporal dysfunction, and possibly with a more rapidly progressive
      dementia.

PMID- 1734738
TI  - An empirical evaluation of the Global Deterioration Scale for staging Alzheimer's
      disease.
AB  - OBJECTIVE: Although the Global Deterioration Scale has been widely used since its
      publication in 1982, its stages are based on implicit assumptions about the
      linearity, temporality, and interdependence of cognitive, functional, and
      behavioral impairment in Alzheimer's disease. The authors evaluated the validity
      of these assumptions and tested the hypothesis that psychopathology and
      functional impairment would occur in earlier stages than the Global Deterioration
      Scale predicts. METHOD: The analyses were based on data on 324 patients with
      Alzheimer's disease who were selected from a registry of such patients. Data
      analyses included 1) descriptive statistics on the frequency of psychiatric
      symptoms and difficulties with activities of daily living and 2) logistic
      regression, with symptoms and functional impairment as independent variables, to
      test for significant changes in patients' status between stages of the Global
      Deterioration Scale. RESULTS: More than 50% of the patients at stage 2 displayed
      psychopathology, and 32% had two or more symptoms. The significant increase in
      psychiatric symptoms occurred between stages 3 and 4, not between stages 5 and 6
      as predicted by the Global Deterioration Scale. Impairment in functional status
      was observed at all stages, and significant increases occurred between stages 3
      and 4 as well as between stages 5 and 6. CONCLUSIONS: Psychiatric symptoms and
      functional impairment occur earlier than predicted by the Global Deterioration
      Scale, and the rate of change is also different from that specified in the scale.
      Separate scales to describe cognitive, clinical, and functional status may be the
      best way to describe the illness until better multidimensional instruments are
      developed.

PMID- 1734739
TI  - Treatment of imipramine-resistant recurrent depression, IV: A double-blind
      crossover study of tranylcypromine for anergic bipolar depression.
AB  - OBJECTIVE: Few trials of monoamine oxidase inhibitors (MAOIs) in tricyclic
      resistant depression have had double-blind conditions. In the authors' previous
      double-blind comparison of tranylcypromine and imipramine in anergic bipolar
      depression, tranylcypromine was significantly more effective. This investigation
      was a crossover study of nonresponders in the initial study. METHOD: The subjects
      were 16 outpatients with anergic bipolar depression. Fourteen had not responded
      to 4 weeks of treatment with at least 30 mg/day of tranylcypromine or 150 mg/day
      of imipramine, and two patients were crossed over because of intolerable side
      effects from the initial drug. The crossover medication was prescribed as in the
      initial double-blind study. RESULTS: Twelve patients were crossed over from
      imipramine to tranylcypromine; nine of them responded to tranylcypromine. Highly
      significant improvements were documented on the Hamilton, Beck, and Pittsburgh
      Reversed Vegetative Symptom Scales. Four patients were switched from
      tranylcypromine to imipramine, but only one responded. CONCLUSIONS: The high
      rates of response to tranylcypromine in both the initial and crossover double
      blind studies document the efficacy of MAOI treatment for anergic bipolar
      depression. Moreover, the results further illustrate the utility of MAOIs in
      tricyclic-resistant depressions.

PMID- 1734740
TI  - Controlled investigation of the amobarbital interview for catatonic mutism.
AB  - OBJECTIVE: Clinical reports over the last 60 years suggest that the amobarbital
      interview is effective in relieving catatonic symptoms. This has never been
      substantiated with methodologically sound trials. The authors postulated that a
      randomized blind comparison of intravenous amobarbital and saline would
      demonstrate the superiority of amobarbital in relieving catatonic mutism. METHOD:
      The subjects were 20 inpatients with catatonic mutism. They were randomly
      assigned to either saline (N = 10) or a 5% amobarbital solution (N = 10), and the
      infusions were administered intravenously at a rate of 1 cc/min or less over 10
      minutes by a blinded physician. A second blinded physician administered a
      semistructured interview during the infusion to control for the effect of
      suggestion. A third blinded physician rated patient responsiveness, reactivity,
      and arousal. Any patient who was unresponsive to the initial infusion was crossed
      over to the other infusion. Interviews were videotaped for determination of
      interrater reliability. RESULTS: In the initial infusions, six of 10 patients
      responded to amobarbital and zero of 10 responded to saline. Four of the saline
      nonresponders responded when given amobarbital. Response was evident by the 4th
      minute of the amobarbital infusion. Interrater reliability was high. The
      responders and nonresponders differed significantly in the variance of the weight
      adjusted amobarbital dose, and the responders tended to be older and female.
      CONCLUSIONS: Intravenous amobarbital is superior to saline in relieving catatonic
      mutism, although only 50% of these patients responded. The nonresponders were
      distinguished from the responders by a greater variance in the weight-adjusted
      dose of amobarbital.

PMID- 1734741
TI  - The role of violence in decisions about hospitalization from the psychiatric
      emergency room.
AB  - OBJECTIVE: The authors evaluated the relationship between violent behavior and
      decision making about hospitalization from the psychiatric emergency room.
      METHOD: The medical charts of 321 patients evaluated in an urban psychiatric
      emergency room during a 4-week period were reviewed retrospectively. Violent
      behavior was defined as physical attacks on persons or fear-inducing behavior
      before or during the evaluation in the emergency room; and its value in
      predicting hospitalization decisions was assessed with logistic regression
      analyses that also included 12 demographic, clinical, and contextual variables.
      RESULTS: A model predicting hospitalization decisions was developed and cross
      validated. Although violent patients were more likely to be hospitalized than
      nonviolent patients, clinical variables such as diagnosis and overall severity of
      psychiatric impairment were more important than violent behavior in predicting
      hospitalization decisions. CONCLUSIONS: Despite legal pressures to focus on overt
      behaviors such as violence as a basis for liability prevention and civil
      commitment, clinicians in this study did not allocate inpatient resources to
      preventively detain persons unlikely to benefit from treatment. Rather, they
      hospitalized the most severely disturbed patients, with diagnoses such as
      schizophrenic and manic disorders for which a widely accepted therapeutic
      armamentarium exists. The results are consistent with clinical recommendations
      that in the evaluation of the violent patient, attention needs to be given to the
      underlying disorder, since violent behavior itself can result from diverse causes
      only some of which require inpatient psychiatric treatment.

PMID- 1734742
TI  - Diagnosis of DSM-III-R personality disorders by two structured interviews:
      patterns of comorbidity.
AB  - OBJECTIVE: The purpose of this study was to examine patterns of co-occurrence of
      axis II disorders in a group of consecutive patients evaluated with two
      contrasting structured interviews. METHOD: One hundred of 106 consecutive
      applicants for long-term, inpatient treatment of severe personality
      psychopathology were assessed, face-to-face, by psychiatrists using the
      Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and
      the Personality Disorder Examination (PDE). The percent of co-occurrence of pairs
      of disorders diagnosed by each structured interview separately was calculated,
      and significance levels were determined by using chi-square tests of
      independence. Finally, odds ratios were computed for the odds of each pair of
      disorders occurring together compared with the odds for the occurrence of each
      disorder alone. RESULTS: The two interview methods revealed different comorbidity
      patterns. Significant covariation was found for 29 pairs of disorders diagnosed
      with the PDE, compared with 12 pairs diagnosed with the SCID-II. Six pairs of
      disorders covaried significantly and were associated with odds ratios greater
      than 4: histrionic with borderline, histrionic with narcissistic, narcissistic
      with antisocial, narcissistic with passive-aggressive, avoidant with schizotypal,
      and avoidant with dependent. CONCLUSIONS: Substantial overlap occurred among
      personality disorders. In this group of patients, consistent patterns of
      comorbidity involving narcissistic, avoidant, and histrionic personality
      disorders suggest that categorical distinctions between them and certain other
      DSM-III-R personality disorders may be illusory. The question of which of two
      overlapping disorders is more valid, however, is left unanswered. For clinical
      purposes, a two-level diagnostic convention is proposed.

PMID- 1734743
TI  - Self-mutilation in personality disorders: psychological and biological
      correlates.
AB  - OBJECTIVE: The goal of this study was to determine whether self-mutilators with
      personality disorders differ from nonmutilators with personality disorders in
      impulsivity, aggression, and other psychopathology and whether serotonergic
      dysfunction contributes to self-mutilation. METHOD: Twenty-six self-mutilators
      with personality disorders were matched to 26 control subjects with personality
      disorders for gender, age, education, axis I diagnosis of affective disorder, and
      axis II diagnosis of personality disorder. Numerous indexes of psychopathology as
      well as CSF 5-hydroxyindoleacetic acid (5-HIAA) levels and platelet imipramine
      binding sites (Bmax) and affinity (Kd) were determined. RESULTS: Self-mutilators
      had significantly more severe character pathology, had greater lifetime
      aggression, and were more antisocial than the control subjects. The self
      mutilators scored higher on the Hamilton Rating Scale for Depression but not on
      the Beck Depression Inventory or the Beck Hopelessness Scale. The two groups did
      not differ on the Buss-Durkee Hostility and Guilt Inventory or on the Sensation
      Seeking Scale. The degree of self-mutilation was significantly correlated with
      impulsivity, chronic anger, and somatic anxiety. Both self-mutilation and
      impulsivity showed significant negative correlations with Bmax, although the two
      groups did not differ in CSF 5-HIAA levels or in platelet imipramine binding.
      CONCLUSIONS: The results demonstrate the contribution of severe character
      pathology, aggression, impulsivity, anxiety, and anger to self-mutilation and
      provide preliminary support for the hypothesis of underlying serotonergic
      dysfunction facilitating self-mutilation.

PMID- 1734744
TI  - Prevalence of mental disorder in 88 morbidly obese bariatric clinic patients.
AB  - OBJECTIVE: The authors sought to determine the association between mental
      disorder and morbid obesity, defined as weight at least 100% or 100 lb over ideal
      body weight. METHOD: Eighty-eight morbidly obese subjects who had come to a
      tertiary care center surgery clinic requesting vertical banded gastroplasty were
      systematically interviewed with the National Institute of Mental Health
      Diagnostic Interview Schedule (DIS) and the Structured Interview for DSM-III
      Personality Disorders. A comparison group of 76 psychiatrically normal subjects
      who were matched in age (within 5 years) and gender to the morbidly obese
      subjects were also interviewed. RESULTS: Most of the morbidly obese subjects were
      women, were of low socioeconomic status as indicated by method of payment for
      medical care, weighed more than 300 lb, and had been obese for more than 14
      years. The morbidly obese subjects were more likely than the comparison group to
      have a lifetime history of mood disorders, anxiety disorders, bulimia, and
      tobacco dependence. The morbidly obese subjects were also more likely to meet
      diagnostic criteria for one or more personality disorders. CONCLUSIONS:
      Substantial psychopathology exists in morbidly obese individuals requesting
      gastroplasty, a finding that has important clinical implications.

PMID- 1734745
TI  - Patients who use drugs during inpatient substance abuse treatment.
AB  - OBJECTIVE: Drug use by patients during inpatient substance abuse treatment is
      frequently a cause of premature hospital discharge. The authors examined the
      histories of patients who used drugs while in inpatient substance abuse
      treatment, the methods used to detect drug use, and the temporal relationship of
      drug use episodes. METHOD: The authors reviewed the charts of patients admitted
      consecutively to an inpatient substance abuse treatment unit between 1981 and
      1988. Of 729 patients, 42 were found to have used drugs while receiving inpatient
      treatment. The diagnoses and clinical histories of these 42 patients were
      compared with those of all other patients. Methods of detection and circumstances
      of drug use were recorded, and drug use episodes were plotted on a time line that
      was examined for temporal clustering. RESULTS: Significantly more of the patients
      who used drugs during inpatient substance abuse treatment had primarily used
      heroin or methadone before treatment. Random urine screens, self-report, and
      staff observation together detected approximately 85% of the patients who used
      drugs during treatment. Episodes of drug use did cluster in time, but within
      clusters the hospital stays of the patients who used drugs did not necessarily
      overlap. CONCLUSIONS: Temporal clustering of drug use episodes may occur because
      drug use by one patient heralds drug availability and stimulates craving in other
      inpatients. Clinicians should be aware that one episode of drug use may be
      followed by others. Multiple detection methods, including random comprehensive
      urine screens, should be used to test for drug use on inpatient units.

PMID- 1734746
TI  - Now is the time to retire the term "organic mental disorders".
AB  - The organic/nonorganic distinction in contemporary classifications of mental
      disorders such as DSM-III and DSM-III-R has important prognostic and treatment
      implications, because it directs the clinician to pay special attention to the
      possibility of an underlying "physical" disorder as the cause of the mental
      disturbance. However, the term "organic" raises serious and intractable problems,
      since the connotative meaning of the term always returns to its historical roots,
      which imply an outmoded functional/structural, psychological/biological, and
      mind/body dualism. The authors present a proposal being considered for DSM-IV
      that would eliminate the term "organic" and reorganize the classification of
      organic mental disorders. Disorders previously referred to as "organic mental
      disorders" would be renamed as either "secondary disorders" (if they are due to
      "physical" disorders) or "substance-induced disorders." The entire classification
      of mental disorders would be reorganized to distribute the secondary and
      substance-induced disorders into the major groups with which they share
      phenomenology. The traditional organic mental disorders--delirium, dementia, and
      amnestic disorder--would be grouped together under the rubric of "cognitive
      impairment disorders." While acknowledging problems with the suggested new
      terminology and reorganization of the classification, the authors argue that the
      potential benefits of the proposal for clarity and for facilitating differential
      diagnosis justify putting to rest the familiar but now anachronistic term
      "organic mental disorders."

PMID- 1734747
TI  - Magnetic resonance imaging of the posterior fossa in autistic adults.
AB  - Magnetic resonance imaging measurements were obtained for 12 adults with DSM-III
      defined autism and a matched group of 12 normal subjects. No significant
      differences were found for mean midsagittal areas of pons, fourth ventricle,
      cerebellar vermis, or vermis lobules. No significant brain abnormalities were
      observed in either group.

PMID- 1734748
TI  - High-intensity signals in Alzheimer's disease without cerebrovascular risk
      factors: a magnetic resonance imaging evaluation.
AB  - The authors examined the relationship between Alzheimer's disease, without
      cerebrovascular risk factors, and high-intensity signals on magnetic resonance
      imaging (MRI) with a 1.5-tesla scanner. There were no significant differences in
      MRI high-intensity signals between subjects with Alzheimer's disease (N = 16) and
      healthy control subjects (N = 23).

PMID- 1734749
TI  - Glutamate and other CSF amino acids in Alzheimer's disease.
AB  - The authors compared CSF amino acid levels of 10 patients with mild to moderate
      dementia and probable Alzheimer's disease who had never received antidepressant
      or neuroleptic medication with those of 10 normal subjects of similar age. The
      Alzheimer's patients had significantly higher levels of CSF glutamate. This
      finding was not related to age, sex, or severity of dementia. Elevated CSF
      glutamate may reflect greater glutamatergic activity early in the course of
      Alzheimer's disease. The authors speculate that the excitotoxic effects of
      glutamate may contribute to progressive neuronal loss in Alzheimer's disease.

PMID- 1734750
TI  - Modified activity of the human auditory cortex during auditory hallucinations.
AB  - Previous reports have shown abnormalities in brain metabolism and evoked
      responses of schizophrenic patients with hallucinations. The authors recorded
      electric and magnetic auditory responses during transitory auditory
      hallucinations in two patients. Small but replicable response delays occurred
      during hallucinations. The results suggest that the effect of hallucinations on
      auditory cortex activity is similar to the effect of real sounds.

PMID- 1734751
TI  - Brief anabolic steroid use and sustained behavioral reaction.

PMID- 1734752
TI  - Development of transient obsessive-compulsive symptoms during treatment with
      clozapine.

PMID- 1734753
TI  - Clozapine-induced priapism.

PMID- 1734754
TI  - Control of depression with fluoxetine and antiseizure medication in a brain
      injured patient.

PMID- 1734755
TI  - Automobile driving by psychiatric patients.

PMID- 1734756
TI  - "Pseudohypermnesia": a conscious effort to avoid telling the truth.

PMID- 1734757
TI  - Sequelae of denied abortion.

PMID- 1734758
TI  - Meaning of refractory depression.

PMID- 1734759
TI  - Meaning of refractory depression.

PMID- 1734760
TI  - Performance anxiety.

PMID- 1734761
TI  - Factors in homelessness among psychiatric patients.

PMID- 1734762
TI  - The mind-body problem.

PMID- 1734763
TI  - The mind-body problem.

PMID- 1734764
TI  - When a patient commits suicide.

PMID- 1734765
TI  - When a patient commits suicide.

PMID- 1734766
TI  - Further comments on trichotillomania.

PMID- 1734767
TI  - Further comments on trichotillomania.

PMID- 1734768
TI  - Lectures in anesthesia training.

PMID- 1734769
TI  - Is resting membrane potential a possible indicator of viability of muscle bundles
      used in the in vitro caffeine contracture test?
AB  - In 22 patients susceptible to and 34 patients not susceptible to malignant
      hyperthermia, we examined which muscle conditions may influence the degree of
      sensitivity of skeletal muscle to the in vitro caffeine contracture test: predrug
      resting membrane potential, predrug twitch tension, and maximum contracture
      induced by 32 mM caffeine in two caffeine tests performed respectively at 30 and
      75 min after biopsy. No differences in the measured variables were observed
      between the first and the second caffeine tests in the 34 patients susceptible to
      malignant hyperthermia. The first caffeine test was found to be positive in all
      of the 22 patients susceptible to malignant hyperthermia. However, in eight
      patients, the second caffeine test was negative and the muscle fibers were found
      to be significantly depolarized. Resting membrane potential was -73.4 +/- 7.9 mV
      before the first caffeine test and -65.8 +/- 8.8 mV before the second test. We
      suggest that when time-induced partial depolarization of malignant hyperthermia
      susceptible fibers occurs, fibers may become less sensitive to caffeine.

PMID- 1734770
TI  - Lecture practices in United States anesthesiology residencies.
AB  - We obtained data on lecture practices from 100 of the 110 university-affiliated
      anesthesiology residency programs certified in the United States in 1988. Of
      these residency programs, 36% had a majority of their lectures before the
      operating room schedule began, 57% had no lectures at all in this early time
      slot, and 78% had morning lectures at least once a week in conjunction with a
      delayed operating room start. Seventy-one percent of programs had one or more
      afternoon lectures each week. An attendance of more than 80% was reported in 66%
      of the programs for morning lectures and in 50% of the programs for afternoon
      lectures, which is a significant difference. Aggregate pass rates on the American
      Board of Anesthesiology written examinations in 1987 and 1988 correlated
      significantly with morning-lecture attendance, but not with afternoon-lecture
      attendance, number of lecture days per week, or mandatory lecture attendance.
      These findings suggest the need for further study and definition of the role of
      lectures in resident education in anesthesiology.

PMID- 1734771
TI  - Anesthesiology journals, 1992.

PMID- 1734772
TI  - Anesthetic management for magnetic resonance imaging: problems and solutions.

PMID- 1734773
TI  - Clinical use of magnesium infusions in anesthesia.

PMID- 1734774
TI  - Succinylcholine-induced prolonged apnea in a 3-week-old newborn: treatment with
      human plasma cholinesterase.

PMID- 1734775
TI  - Intravenous regional block using ketorolac: preliminary results in the treatment
      of reflex sympathetic dystrophy.

PMID- 1734776
TI  - Influence of anesthesia on the threshold of pacing-induced ischemia.
AB  - Increased myocardial oxygen demand, induced by increased heart rate, may cause
      myocardial ischemia in the presence of significant coronary artery disease.
      Alterations in anesthetic depth or technique might put at risk or protect
      myocardium with compromised blood flow. In 20 dogs with critical left anterior
      descending coronary artery (LAD) stenosis, atrial pacing rates from 100 to 160
      beats/min were achieved, with end-tidal halothane 0.7% (LowH) and 1.1% (HighH),
      end-tidal isoflurane 1.1% (LowI) and 1.5% (HighI), as well as with continuous
      fentanyl plus midazolam (FM) infusion anesthesia. Despite significantly different
      mean arterial and coronary perfusion pressures, rate-pressure product, and left
      ventricular dP/dtmax, the pacing rate at which systolic shortening decreased
      below the lower limit of the physiologic response, indicating regional
      dysfunction, was the same in all investigated anesthesia conditions (LowH: 127 +/
      4 beats/min; HighH: 128 +/- 5 beats/min; LowI: 125 +/- 4 beats/min; HighI: 122
      +/- 5 beats/min; FM: 124 +/- 4 beats/min [mean +/- SEM], P greater than 0.05).
      None of the investigated anesthesia conditions either increased ischemia
      tolerance or showed a detrimental effect on myocardium with compromised coronary
      blood flow.

PMID- 1734777
TI  - Continuous epidural infusion of bupivacaine and fentanyl for erythromelalgia in
      an adolescent.

PMID- 1734778
TI  - Acute and long-term benefits of iliac crest donor site perfusion with local
      anesthetics.

PMID- 1734779
TI  - Massive intraoperative pulmonary embolism: diagnosis with transesophageal two
      dimensional echocardiography.

PMID- 1734780
TI  - Venous air embolism during radical retropubic prostatectomy.

PMID- 1734781
TI  - An unusual complication of pulmonary artery catheterization.

PMID- 1734782
TI  - Bronchial obstruction by transesophageal echocardiography probe in a pediatric
      cardiac patient.

PMID- 1734783
TI  - Difficult endotracheal intubation in a patient with tumoral calcinosis.

PMID- 1734784
TI  - Anesthetic care of patients with Crigler-Najjar syndrome.

PMID- 1734785
TI  - End-systolic pressure-volume relationship and arterial elastance: the optimal
      method to evaluate myocardial contractile effects of anesthetic agents?

PMID- 1734786
TI  - Sacrococcygeal teratoma and venous shunting through a tumor: biological evidence.

PMID- 1734787
TI  - Anaphylactic reactions during anesthesia.

PMID- 1734788
TI  - Bleeding diathesis after perioperative ketorolac.

PMID- 1734789
TI  - Bleeding diathesis after perioperative ketorolac.

PMID- 1734790
TI  - A potential complication of lightwand-guided intubation.

PMID- 1734791
TI  - Ophthalmic surgery and vomiting--an ancient problem.

PMID- 1734792
TI  - Is the cardiovascular response to electroconvulsive therapy due to the
      electricity or the subsequent convulsion?

PMID- 1734793
TI  - Electrocardiographic R-wave changes during cardiac surgery.
AB  - The diagnostic accuracy of exercise electrocardiography has been improved by
      incorporation of R-wave gain factor to correct the measured ST-segment changes.
      If marked changes in R-wave amplitude occur in individual patients during cardiac
      operations, a similar gain factor correction may improve the intraoperative
      diagnosis of myocardial ischemia. This investigation was designed to determine
      the frequency and magnitude of intraoperative V5 R-wave amplitude changes during
      cardiac operations. Electrocardiograms were recorded from 83 patients while
      patients were awake, anesthetized (baseline), after placement of the Favaloro and
      Canadian sternal retractors, and at end-operation. Compared with baseline values,
      placement of the Canadian sternal retractor was associated with a reduction in V5
      R-wave amplitude from 15 +/- 1 to 10 +/- 1 mm (mean +/- SEM), in V5 S-wave
      amplitude from 3.5 +/- 0.4 to 1.7 +/- 0.3 mm, and in absolute ST-segment
      deviation from 0.50 +/- 0.04 to 0.39 +/- 0.05 mm. Changes in V5 R-wave amplitude
      were correlated with changes in ST-segment deviation in patients with baseline ST
      segment deviations greater than or equal to 0.5 mm (r = 0.55, P = 0.0004, n =
      37). Changes associated with the Favaloro retractor and the respiratory cycle
      were less marked. However, the V5 R-wave amplitude was decreased from 15 +/- 1 to
      9 +/- 1 mm at end-operation. In conclusion, sternal spreading with the Canadian
      retractor was associated with marked reductions in V5 R- and S-wave amplitudes
      and ST-segment deviations. Marked changes in V5 R-wave amplitude persisted after
      sternal closure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734794
TI  - A randomized, blinded, placebo-controlled evaluation of calcium chloride and
      epinephrine for inotropic support after emergence from cardiopulmonary bypass.
AB  - Forty hemodynamically stable patients were randomized to receive an intravenous
      bolus of either calcium chloride (5 mg/kg) (n = 20) or placebo (n = 20) (phase
      I). Six minutes later, they received either an epinephrine (30 ng.kg-1.min-1) (n
      = 20) or placebo (n = 20) infusion (phase II). Hemodynamic and ionized calcium
      measurements were obtained in phase I at baseline and at 3 and 6 min after the
      bolus, and in phase II, at 3 and 6 min (study times 9 and 12 min) after
      initiation of the infusion. Compared with placebo, calcium did not significantly
      increase cardiac index but significantly increased mean arterial pressure.
      Calcium improved cardiac index from 2.46 +/- 0.12 (mean +/- SEM) to 2.74 +/- 0.12
      L.min-1.m-2; likewise, placebo improved cardiac index from 2.51 +/- 0.15 to 2.74
      +/- 0.15 L.min-1.m-2. Mean arterial blood pressure increased with calcium from 74
      +/- 2 to 82 +/- 3 mm Hg compared with a placebo change of 74 +/- 2 to 76 +/- 2 mm
      Hg. Patients who received the epinephrine infusion (n = 20) demonstrated a
      significant increase in cardiac index at time 12 min compared with patients
      receiving only placebo (n = 20). Cardiac index of the epinephrine group increased
      from 2.56 +/- 0.15 to 2.92 +/- 0.22 L.min-1.m-2, whereas in the placebo group it
      decreased from 2.86 +/- 0.13 to 2.78 +/- 0.12 L.min-1.m-2. Prior administration
      of calcium did not alter the subsequent response to epinephrine (n = 10) compared
      with patients receiving epinephrine alone (n = 10). We conclude that cardiac
      index improves with time without drug therapy after bypass. Calcium chloride
      increases mean arterial blood pressure but not cardiac index immediately after
      cardiopulmonary bypass, whereas low-dose epinephrine significantly increases both
      cardiac index and mean arterial blood pressure without causing tachycardia in
      these patients. Calcium chloride (5 mg/kg) did not augment or inhibit the
      hemodynamic response to an epinephrine infusion.

PMID- 1734795
TI  - Effect of alpha-stat versus pH-stat strategy on oxyhemoglobin dissociation and
      whole-body oxygen consumption during hypothermic cardiopulmonary bypass.
AB  - To determine whether alpha-stat or pH-stat strategy should be used, 20 patients
      undergoing coronary artery bypass grafting during moderate hypothermic
      hemodilutional cardiopulmonary bypass were studied. The carbon dioxide management
      during bypass was randomly done according to alpha-stat strategy in 10 patients
      (i.e., temperature-uncorrected PaCO2 was kept near 40 mm Hg and uncorrected pHa
      was kept at about 7.4) and according to pH-stat strategy in the other 10 patients
      (i.e., temperature-corrected PaCO2 was kept near 40 mm Hg and uncorrected pHa was
      kept at about 7.4). In both groups, when the central venous temperature was
      stable at 26.5 +/- 2.5 degrees C, the perfusion flow was altered sequentially
      from 2.4 to 1.8 and 1.2 L.min-1.m-2. The mixed venous oxyhemoglobin saturation at
      the different perfusion flows was monitored by the Oxy-Stat meter and was
      correlated with the corresponding mixed venous oxygen tension to construct an
      oxyhemoglobin dissociation curve. Also, the whole-body oxygen consumption at the
      different perfusion flows was computed. The whole-body oxygen consumption and the
      oxyhemoglobin dissociation were not significantly different between the alpha
      stat and the pH-stat groups. In both groups, the dissociation curve is shifted to
      the left, but the oxygen consumption per unit time does not significantly change
      despite decreasing the perfusion flow from 2.4 to 1.2 L.min-1.m-2. The results
      suggest that oxygen delivery is not impaired during moderate hypothermic
      cardiopulmonary bypass independent of whether alpha-stat or pH-stat strategy is
      used.

PMID- 1734796
TI  - Comparison of thromboxane synthetase inhibitor and methylprednisolone effects on
      protamine responses in dogs.
AB  - Neutralization of heparin anticoagulation by protamine produces catastrophic
      hemodynamic reactions in some patients. Using a canine model, we tested effects
      of thromboxane synthetase inhibition (CGS-13080) and glucocorticoid pretreatment
      on the cardiorespiratory effects of protamine. In control dogs, protamine
      decreased mean arterial pressure and cardiac output and increased mean pulmonary
      artery pressure, systemic and pulmonary vascular resistances (SVR, PVR), and
      airway pressure. Both CGS-13080 and methylprednisolone ameliorated some effects
      of protamine. CGS-13080 infusion decreased mean pulmonary artery pressure, SVR,
      and airway pressure after protamine injection relative to controls. Cardiac
      output and PVR were unaffected by the drug, whereas the decrease in mean arterial
      pressure was prolonged. Plasma thromboxane A2 metabolite (TXB2) concentrations
      were lower and prostacyclin metabolite (6-keto PGF1 alpha) concentrations were
      higher compared with that of controls. These experiments support a role for TXA2
      in the response to protamine. Methylprednisolone pretreatment produced larger
      cardiac output and lower airway pressure after protamine injection compared with
      controls. Mean arterial pressure was improved, but not significantly. Mean
      pulmonary artery pressure, SVR, and PVR were not different from that of controls;
      TXB2 and 6-keto PGF1 alpha were unaffected. The effects of methylprednisolone
      appear unrelated to arachidonic acid metabolism, as TXB2 and 6-keto PGF1 alpha
      levels were unaffected.

PMID- 1734797
TI  - Transcatheter closure of atrial septal defects: hemodynamic complications and
      anesthetic management.
AB  - Transcatheter closure of atrial septal defects using a double-umbrella
      (clamshell) device can now be performed during an overnight hospital stay with
      little morbidity and no mortality. The initial 2-yr experience with anesthetic
      care for the procedure was collected and subsequently analyzed. Primary
      anesthetic care was given in 118 cases and urgent anesthetic intervention was
      required in another four cases. Anesthesia with spontaneous ventilation in
      patients with unprotected airways using intravenous ketamine and midazolam
      (average cumulative doses 1.4 and 0.17 mg.kg-1.h-1, respectively) was used in 93
      cases (77%); mean maximum PaCO2 value was 41 +/- 6 mm Hg. In 29 patients (23%)
      tracheal intubation and muscle paralysis were used to facilitate control of
      airway and ventilation. Anesthetic-related complications occurred in three
      patients: ventilatory compromise developed in two patients in the spontaneous
      ventilation group and one patient experienced awareness during endotracheal
      anesthesia with paralysis. Procedural complications that altered anesthetic
      management were more frequent, including embolization of the clamshell device
      requiring surgical retrieval in two of six embolizations, intracardiac air
      embolization (four cases), tricuspid regurgitation (one case), device
      malplacement requiring late operation (one case), and transient brachial plexus
      injury (three cases). Anesthesia for transcatheter atrial septal defect closure
      allows precise device placement, prompt control of hemodynamic complications, and
      transesophageal echocardiographic monitoring of device placement. Although
      general anesthesia with spontaneous ventilation using ketamine and midazolam was
      usually safe and effective, tracheal intubation for control of airway and
      ventilation was sometimes necessary for safety and for optimal operating
      conditions. Familiarity with transcatheter closure techniques and close
      communication with the catheterization team is essential to minimize and treat
      associated complications.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734798
TI  - Electrocardiographic changes during cesarean section under regional anesthesia.
AB  - To determine electrocardiographic changes and whether myocardial ischemia occurs
      during cesarean section, electrocardiograms were recorded continuously using
      Holter monitoring in 25 patients undergoing elective cesarean section under
      either spinal or epidural anesthesia. In addition, in 13 of the patients, two
      dimensional precordial echocardiography was carried out before and during
      cesarean section. ST segment depression suggestive of myocardial ischemia
      occurred in 16 patients including 8 of the 13 with echocardiograms. Wall motion
      remained entirely normal during episodes of ST segment depression. Patients in
      whom ST depression developed had significantly more rapid heart rates at delivery
      than those who did not experience ST depression. We conclude that ST segment
      depression is a common feature of the electrocardiogram during cesarean section
      under regional anesthesia and is not the result of myocardial ischemia.

PMID- 1734799
TI  - Pregnancy does not alter the threshold for lidocaine-induced seizures in the rat.
AB  - Although altered effects of various anesthetics have been demonstrated during
      pregnancy, published studies have incompletely defined potential pregnancy
      induced changes in the central nervous system toxicity of lidocaine. Accordingly,
      the seizure threshold for lidocaine was measured in three groups of mechanically
      ventilated rats breathing 70% N2O-30% O2: male (n = 21), nonpregnant female (n =
      19), and pregnant female (n = 23). Lidocaine was administered intravenously at a
      constant rate of 2.3 mg.kg-1.min-1 while the electroencephalogram was monitored
      continuously. Total doses of lidocaine and the durations of lidocaine infusion
      necessary to induce seizure activity were similar among groups. Plasma lidocaine
      concentrations at the onset of electroencephalographic seizure activity were also
      similar among groups (male = 10.7 +/- 5.5, nonpregnant female = 12.1 +/- 4.9,
      pregnant female = 10.8 +/- 4.1 micrograms/mL). In a subset of each group, brain
      lidocaine concentrations at the onset of seizure activity were also measured, and
      again no differences among groups were observed (male = 17.4 +/- 6.3, nonpregnant
      female = 16.8 +/- 4.5, pregnant female = 16.7 +/- 4.2 micrograms/100 g wet wt).
      The authors conclude that there are no pregnancy-specific alterations in either
      plasma or brain concentration thresholds for central nervous system toxicity of
      lidocaine in rats.

PMID- 1734800
TI  - Effect of ropivacaine and bupivacaine on uterine blood flow in pregnant ewes.
AB  - The effects of ropivacaine, a new amide local anesthetic, on uterine blood flow
      and fetal well-being were compared with those of bupivacaine in 10 chronically
      instrumented pregnant ewes. In random sequence, animals received two intravenous
      infusions of each drug. The low infusion rate regimens were chosen to result in
      clinically relevant maternal plasma concentrations of local anesthetics, whereas
      the more rapid rates of infusions were given to assess the safety of higher
      maternal drug concentrations. An epinephrine infusion was given to demonstrate
      the appropriateness of the animal model for the measurement of uterine blood
      flow. Maternal and fetal heart rates, arterial blood pressure, and the ewe's
      central venous pressure, intraamniotic pressure, and uterine blood flow were
      recorded continuously. Arterial blood samples were taken from mother and fetus at
      frequent intervals to determine acid-base status and local anesthetic
      concentrations. A total of 39 studies were performed. None of the infusions of
      either local anesthetic resulted in a significant decrease in uterine blood flow
      or deterioration in fetal condition. The mean maternal plasma concentrations at
      the end of infusions were as follows: ropivacaine low dose, 1.60 +/- 0.35
      micrograms/mL; bupivacaine low dose, 1.55 +/- 0.15 micrograms/mL; ropivacaine
      high dose, 2.50 +/- 0.37 micrograms/mL; and bupivacaine high dose, 1.83 +/- 0.19
      micrograms/mL. Epinephrine infusion resulted in a 25% decrease in uterine blood
      flow without adverse fetal effects. We conclude that neither ropivacaine nor
      bupivacaine, as administered in this study, led to any ill effects on uterine
      artery blood flow or fetal well-being.

PMID- 1734801
TI  - Attenuation of gastric effects of famotidine by preoperative administration of
      intravenous fluids.
AB  - Effects of preoperative administration of intravenous crystalloids on the gastric
      effects of famotidine were studied in 89 patients scheduled for elective surgery
      in the afternoon. Patients were randomly assigned to one of six groups. Groups
      P1, P2, and P3 received 2.0 mL of intramuscular saline (placebo) and groups F1,
      F2, and F3 received 20 mg of intramuscular famotidine 1 h before anesthesia. All
      patients fasted for 14-18 h before surgery. No fluid was administered to groups
      P1 and F1 preoperatively, whereas 500 mL of intravenous fluid was given to the
      other groups over a period of 4-5 h before anesthesia: a maintenance fluid with
      10% glucose to groups P2 and F2, and lactated Ringer's solution without glucose
      to groups P3 and F3. After anesthetic induction, the stomach was aspirated using
      a nasogastric tube and volume and pH of the contents were measured. The gastric
      volume was significantly less in F2 (4.2 +/- 1.2 mL, mean +/- SEM) than in P1
      (30.7 +/- 5.5 mL) (P less than 0.01) and in F3 (12.7 +/- 2.1 mL) than in P3 (26.8
      +/- 4.4 mL) (P less than 0.05). There was no significant difference between P2
      (23.4 +/- 4.6 mL) and F2 (17.5 +/- 3.5 mL). Mean pH values were significantly
      higher in F1 (6.82 +/- 0.48) than in P1 (3.21 +/- 0.72) (P less than 0.01). No
      significance was observed between P2 (3.65 +/- 0.62) and F2 (4.53 +/- 0.77), or
      P3 (3.17 +/- 0.81) and F3 (5.03 +/- 0.80).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734802
TI  - Systemic and regional hemodynamics of isoflurane and sevoflurane in rats.
AB  - The authors studied the effects of sevoflurane and isoflurane on systemic
      hemodynamics and regional blood flow distribution (microsphere technique) in 15
      rats during general anesthesia with intravenous chloralose and controlled
      ventilation. Inhaled anesthetics were applied to reduce mean arterial blood
      pressure (MAP) to 70 mm Hg (1.66 vol% sevoflurane and 0.96 vol% isoflurane) and
      50 mm Hg (MAP 50; 3.95 vol% sevoflurane and 2.43 vol% isoflurane). Control
      recordings were obtained with intravenous chloralose only. At a MAP of 70 mm Hg,
      both anesthetics reduced heart rate, cardiac output, and systemic vascular
      resistance to a similar degree. Isoflurane decreased systemic vascular resistance
      markedly at a MAP of 50 mm Hg and thereby maintained cardiac output at higher
      levels than sevoflurane. The left ventricular rate-pressure product decreased
      comparably with both anesthetics. Cerebral blood flow increased dose-dependently
      with both inhaled anesthetics but to a greater degree with isoflurane. Total
      hepatic blood flow remained unchanged from control at a MAP of 70 mm Hg but
      decreased at a MAP of 50 mm Hg. This was due to reductions of hepatic arterial
      and portal venous tributaries. Renal blood flow was reduced with only the high
      concentrations of the anesthetics. Myocardial blood flow was reduced at all
      concentrations of volatile anesthetic; however, the decrease was less with
      isoflurane. This would indicate a more pronounced coronary vasodilation by
      isoflurane as the rate-pressure product, as a measure of the actual left
      ventricular oxygen demand, decreased by comparable degrees with both anesthetics.
      Our results indicate that sevoflurane and isoflurane (each approximately 0.7 MAC)
      have no dissimilar systemic and regional hemodynamic effects at a MAP of 70 mm Hg
      in this animal model. At higher concentrations (approximately 1.7 MAC), cerebral
      blood flow was more with isoflurane than with sevoflurane and was associated with
      a more pronounced vasodilation in the myocardium.

PMID- 1734803
TI  - Halothane- and enflurane-induced inhibition of phasic responses to carbachol in
      isolated guinea pig trachea.
AB  - Volatile anesthetics produce bronchodilatation by a combination of effects on the
      autonomic nervous system as well as direct effects on the airway smooth muscle.
      We sought to further explain the direct effects on airway smooth muscle by
      studying the effect of volatile anesthetics on the phasic and tonic components of
      the contractile response. The effects of 1.2%, 2.3%, and 4.3% halothane and 1.6%,
      3.2%, 4.9%, and 8.7% enflurane on the phasic and tonic components of the
      contractile response to 10 microM carbachol and 40 mM KCl in isolated guinea pig
      trachea were determined using steady-state and kinetic analyses. No direct effect
      of either anesthetic on resting tension was observed. The peak tensions of the
      phasic responses to 10 microM carbachol were significantly inhibited by all
      concentrations of halothane and enflurane. The inhibition by enflurane was
      concentration-dependent and eliminated the phasic response at 8.7%. The peak
      tensions of the tonic responses to 10 microM carbachol were unaffected. The peak
      tensions of the responses to 40 mM KCl were unaffected by halothane but were
      significantly inhibited by 4.9% enflurane. The decay rate of the phasic response
      was unaffected by the anesthetics. The onset rate of the tonic response was
      significantly inhibited only by 8.7% enflurane, whereas halothane was without
      effect. The EC50 concentration for carbachol, as determined by cumulative
      concentration response curves, was increased by both 8.7% enflurane and 4.3%
      halothane. The results support the hypothesis that halothane and enflurane
      inhibit that portion of the contractile response to carbachol dependent on the
      release of intracellular Ca2+.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734804
TI  - Differential sensitivity of diabetic rat papillary muscles to negative inotropic
      effects of oxybarbiturates versus thiobarbiturates.
AB  - The negative inotropic effects of oxybarbiturates and thiobarbiturates were
      examined in papillary muscles isolated from streptozotocin-induced diabetic rats
      and in papillary muscles from age-matched control rats. The muscles from diabetic
      rats exhibited less negative inotropic responses to pentobarbital and
      secobarbital than the muscles from control rats. Conversely, the negative
      inotropic responses to thiopental and thiamylal were significantly enhanced in
      diabetic muscles. Differences in sensitivity to pentobarbital between control and
      diabetic muscles became less marked by treatment with ouabain or by lowering
      [Na+]o. Enhancement of the negative inotropic effect of thiamylal observed in
      diabetic muscles remained unchanged with these treatments. In both control and
      diabetic muscles, the negative inotropic effect of pentobarbital was completely
      reversed by increasing [Ca2+]o, but the effect of thiamylal was only partially
      reversed. These results suggest a difference in mechanism of action involved in
      establishment of the negative inotropic effects of oxybarbiturates vs
      thiobarbiturates. Oxybarbiturates appear to exclusively reduce the influx of
      extracellular Ca2+, whereas thiobarbiturates appear to affect Ca2+ movements at
      the Ca2+ storage sites in addition to the Ca2+ influx inhibition.

PMID- 1734805
TI  - The role of leukocyte-endothelial interactions in the accumulation of leukocytes
      in allergic inflammation.

PMID- 1734806
TI  - Fibroblasts and other structural cells in airway inflammation.

PMID- 1734807
TI  - Cellular inflammation in asthma: neutral proteases of mast cells.

PMID- 1734808
TI  - New insights into airway inflammation by endobronchial biopsy.

PMID- 1734809
TI  - The role of macrophages in the mechanisms of airway inflammation in asthma.

PMID- 1734810
TI  - Mechanisms of hyperresponsiveness: platelet-activating factor.

PMID- 1734811
TI  - Mechanism of aspirin sensitivity.

PMID- 1734812
TI  - Biologic effects of mast cell enzymes.

PMID- 1734813
TI  - Microvasculature and airway responses.

PMID- 1734814
TI  - Mechanisms of bronchial reactivity: the role of immunoglobulin E.

PMID- 1734815
TI  - Regulation of neurogenic inflammation by neutral endopeptidase.

PMID- 1734816
TI  - Persistent and latent viral infections in the pathology of asthma.

PMID- 1734817
TI  - Physical growth and socioeconomic background of Stockholm schoolchildren born in
      1933-63.
AB  - Height, weight and body mass index (BMI) at aged 7, 10 and 13 years for samples
      of Stockholm schoolchildren born in 1933, 1943, 1953 and 1963 were analysed in
      relation to their socioeconomic background. In height there were significant
      socioeconomic differences for boys and girls born in 1933 and 1943 at the ages of
      7 and 10 years; children from the lowest socioeconomic group were smaller. For
      the cohort born in 1953 there were, however, no socioeconomic differences in
      height--either for boys or for girls. For children born in 1963, socioeconomic
      differences in height appeared again, but mainly for the boys; boys in the lowest
      socioeconomic group were smaller. Significant weight differences between
      socioeconomic groups were for the boys found only in cohorts born in 1943 and in
      1963 and for the girls born in 1933, 1943 and 1953. Socioeconomic differences in
      BMI were found for boys born in 1943, when the middle socioeconomic group had the
      lowest index, and for boys born in 1963 when the highest socioeconomic group had
      the highest index. For girls socioeconomic differences in BMI were only found for
      girls born in 1953 when the lowest group had the highest BMI. The main
      conclusions from the study were: socioeconomic differences in height formerly
      present in Stockholm schoolchildren born in 1933 and 1943 were levelled out for
      the children born in 1953, but reappeared again for children born in 1963--mainly
      for the boys; these socioeconomic height differences for the 1963 cohort were of
      about the same magnitudes as those for the cohort born in 1943 during the Second
      World War. The influence of socioeconomic background on the BMI of Stockholm
      schoolchildren born 1933-63 was not so marked.

PMID- 1734818
TI  - Prepubertal growth of boys and girls using data from the Edinburgh Longitudinal
      Growth Study.

PMID- 1734819
TI  - Population and sex differences in arm circumference and skinfold thicknesses
      among Indo-Pakistani children living in the East Midlands of Britain.
AB  - Arm circumference, triceps and subscapular skinfold thicknesses of 2224 Indo
      Pakistani children aged 3-10.9 years living in Nottingham and Leicestershire were
      measured. The children were classified into populations according to country of
      origin, and religion, prior to analysis. Significant between-population
      differences were shown for all three variables, the effect being stronger in
      males than in females. Sex differences in arm circumference and triceps skinfold
      thickness were greater than those found in the British reference populations,
      whilst the patterns of fat distribution differed from the British standards for
      all the Indo-Pakistani populations, male and female.

PMID- 1734820
TI  - Urban-rural differences in the growth of South African black children.
AB  - Urbanization is a major migratory process characteristic of developing countries.
      The majority of comparisons of the growth of urban and rural children from
      developed countries reflect greater heights and weights, and by implication
      health, of urban children. Urban-rural comparisons of South African black
      children are few in number and have concentrated on 'average' children, thereby
      omitting the factor of socioeconomic status. The present study compares two
      groups of urban children of high (n = 307) and average (n = 867) socioeconomic
      status and two groups of rural children. The rural children came from farm
      labourer's families (n = 392) and traditional subsistence farming environments (n
      = 420). The children ranged in age from 5 to 19 years. In general the well-off
      urban children were consistently, but not significantly, larger than all other
      groups and 'average' urban children were consistently and at times significantly
      smaller and lighter. The growth of the two rural groups fell between these
      extremes but were also consistently different in that the children of farm
      labourers were significantly lighter at all ages than children living in a
      traditional subsistence economy. It is concluded that the average urban
      environment in South Africa is not conducive to improved growth and health unless
      it is accompanied by an improved socioeconomic status.

PMID- 1734821
TI  - Serum protein polymorphisms (HP, TF, GC and PI) in four Iranian population
      samples.
AB  - A total of 960 individuals from four Iranian population samples (Tabriz, Tehran,
      Yazd, Mashhad) was typed for HP and for TF, GC and PI subtype polymorphism.
      Statistically significant intergroup heterogeneity in the distribution of allele
      frequencies was found only in the HP polymorphism. Comparisons with other Iranian
      populations suggest considerable ethnic differences with regard to the TF and GC
      subtype polymorphisms. Some rare alleles were observed in all four samples
      (Tabriz: GC*1C1; Tehran: PI*S: Yazd: PI*S; Mashhad: PI*Z).

PMID- 1734822
TI  - Physical growth of Chinese school children 7-18 years, in 1985.
AB  - Physical development in Chinese school children was analysed based on a national
      survey in 1985. Close to half a million children and adolescents, aged 7-18, from
      Han ethnic group and 27 minority ethnic groups were assessed for height, weight,
      sitting-height, chest circumference, biacromial and biiliac diameters. Growth in
      Han children was greater than that in minority ethnic group children. The growth
      differences among minority ethnic groups were large. Growth in urban children was
      greater than that in rural children except in a few age groups of girls. A
      significant difference in children's growth was found between northern and
      southern divisions of China, it being greater in the north. The growth curves of
      physical characteristics demonstrated systematic regularity. Finally, the results
      of this study were compared with research reports from other world literature.

PMID- 1734823
TI  - Body composition and body hydration in old age estimated by means of skinfold
      thickness and deuterium dilution.
AB  - In this study a group of 30 women and 30 men aged 60-90 years was examined. Body
      density was predicted from the sum of four skinfold thickness (SFT) as described
      by Durnin and Womersley (1974). Body composition, expressed as a percentage of
      total body weight as fat mass (FM) and fat free mass (FFM) was calculated by
      means of Siri's formula (Siri 1961). Total body water (TBW) was measured from the
      dilution of an oral deuterium dose and FFM calculated assuming a hydration of
      73.2%. The FM% predicted from SFT showed a slight but not significant decreasing
      age trend from 28.3% to 25.4% in men, and from 40.3% to 37.8% in women. Body
      hydration (about 50% of body weight in men and 44% in women) remained constant
      throughout the age range. FFM obtained from TBW assuming a constant hydration of
      FFM, was found to be unchanged with age. FM% predicted from SFT was correlated
      with values obtained from TBW on an individual basis (R2 = 0.38; p less than
      0.0001 in men and R2 = 0.31; p less than 0.002 in women), but the scatter was
      large. The Bland and Altman statistical analysis (Bland and Altman 1986) suggests
      that the discrepancy between the two estimates tends to be significantly more
      positive with increasing fatness of the subject. The assumption of a constant
      hydration of FFM between individuals and with advancing age was tested. The
      hydration of FFM was calculated as the ratio between TBW (from deuterium
      dilution) and FFM (estimated from SFT). The wide range of values (50% to 90%)
      suggests large inter-individual differences. The mean values were lower than
      commonly reported, and differed with age and sex. In men, FFM hydration steadily
      decreases with age from the 7th decade (70.2 +/- 7.7%) to the 10th decade (65.9
      +/- 8.2%). Women showed higher average figures than those of men and a lower age
      associated decline (72.5% and 68.5% respectively). Our results suggest that FFM
      hydration decreases with age, and this indicates the need to develop age-related
      correction factors in order to derive FFM from TBW in an elderly population.

PMID- 1734824
TI  - Salivary testosterone concentration of Aymara men native to 3600 m.
AB  - This paper explores the possibility that variation in the normal physiological
      range of testosterone concentration modulates men's adaptation to hypobaric high
      altitude hypoxia through stimulating haemoglobin production and/or causing
      respiratory disturbances and exacerbated hypoxaemia during sleep. These effects
      of testosterone are observed clinically at sea level and have potentially
      opposing consequences at high altitude, the former perhaps enhancing and the
      latter diminishing the effectiveness of adaptations to hypoxia. Seventeen young
      (average age 27 years) and 22 older (average age 57 years) healthy adult high
      altitude native Aymara men tested at 3600 m have average morning salivary
      testosterone concentrations of 282 and 241 pmol/l, respectively. The 31 urban men
      of both age groups have higher testosterone concentrations than the eight rural
      men and have mean haemoglobin concentrations significantly 0.7-1.0 g/dl higher
      within the normal high-altitude range, consistent with known effects of
      testosterone at sea level. Older urban men have slightly more frequent
      respiratory disturbances during sleep, associated with significantly greater
      hypoxaemia. There appear to be modest benefits to testosterone concentrations in
      the upper end of the observed range; however, the direction of these responses
      towards more haemoglobin production and more hypoxaemia during sleep of older men
      suggests the hypothesis that very high testosterone concentrations such as those
      in the upper ranges of sea level values could compromise adaptation to high
      altitude, particularly among older men.

PMID- 1734825
TI  - The anthropometric history of Pittsburgh and Allegheny County, Pennsylvania, 1890
      1945.
AB  - A positive relationship has been found between the height and socioeconomic
      status of Pittsburgh and Allegheny County residents born between 1890 and 1945.
      Generally, the higher their socioeconomic status, the higher was their stature.
      However, the relationship gradually became weaker and by World War II was nearly
      negligible, because the growing economy was able to meet the nutritional and
      medical needs of the population better. Inequality still existed, but it
      manifested itself less in necessities than in the area of education, amenities
      and luxury. The Great Depression did not seem to have an adverse effect on the
      biological well-being of the population as a whole, as most people were able to
      maintain the rising standard of necessities while sacrificing amenities and
      luxury.

PMID- 1734826
TI  - Further observations on diurnal variation in standing height.
AB  - A total of 328 daily assessments of standing height were made on one boy between
      the ages of 12.83 and 13.95 years; 292 of these were replicates to establish
      reliability of measurement. On 300 days, measurements were taken in the morning
      within 1/2 h of rising (which varied between 0700 and 1100 h) and repeated before
      bed on the same day, between 2100 and 2300 h. The standard error of measurement
      from 292 duplicate measurements was 0.12 cm. A mean of 0.98 +/- 0.2 cm decrease
      in stature occurred during the course of the day. A similar decrease was found on
      three occasions after 2-3 h naps.

PMID- 1734827
TI  - Primary squamous cell carcinoma originating in congenital cysts of the liver.
      Report of a case and review of the literature.
AB  - An 82-year-old woman developed a well-differentiated squamous cell carcinoma that
      apparently arose in two discrete congenital cysts of the liver. Both cysts were
      lined predominantly by stratified squamous epithelium with extensive areas of
      dysplasia and foci of transition to in situ carcinoma and overt exophytic and
      infiltrating squamous cell carcinoma. A third intrahepatic cyst was lined
      entirely by bile duct-type epithelium and contained no tumor. The liver was
      massively infiltrated by the carcinoma, and there were metastases to the lymph
      nodes, lung, and bone marrow. Since a search for an alternative primary tumor
      site was unrevealing, the authors interpret this as a unique case of primary
      squamous cell carcinoma originating in congenital cysts of the liver.

PMID- 1734828
TI  - A clinical laboratory management elective for pathology residents.
AB  - Many practicing pathologists, particularly those in private settings, function as
      managers. Their responsibilities may not only involve directing the successful
      activities of laboratory personnel, but often require a level of accountability
      to hospital administrators or business managers. Traditional training programs
      focus on technical competency and devote little time, if any, to preparing their
      graduates for the management aspects of their careers. In response to this need,
      a 1-month elective was designed for senior pathology residents at the University
      of Utah, Salt Lake City. The cumulative experiences of a large academic pathology
      department and its successful commercial laboratory venture provided a real-world
      supplement to a curriculum founded in basic business management principles.

PMID- 1734829
TI  - The new HLA.
AB  - The application of molecular genetics and biochemical techniques to the study of
      the HLA system over the past few years has resulted in tremendous advances in our
      knowledge of this area of the human genome. In this article, we describe the "new
      HLA" that has been pieced together recently through the combined efforts of
      molecular geneticists, biochemists, and HLA serologists, as well as developments
      in attempts to elucidate the associations of HLA antigens and disease.

PMID- 1734830
TI  - Pathologic correlation in mammographically directed breast biopsies.
AB  - In a series of 1137 diagnostic breast biopsy specimens in a 2-year period, nearly
      half (n = 534) underwent specimen mammography. Calcifications were found in 48%
      of the specimen mammograms. In a quarter of the cases, calcification was a marker
      either for carcinoma or a significant precursor lesion. Moreover, in the majority
      of these malignancies, calcifications were markers of preinvasive carcinoma. In
      another quarter of cases, some form of proliferative ductal hyperplasia accounted
      for calcifications, and in the remainder, cysts and miscellaneous other
      conditions accounted for calcifications. The yield of malignancy was much lower
      in noncalcified specimens (12%). A nodular or asymmetric density proved to be a
      fibroadenoma in 30% of cases. However, the majority of cases had less well
      defined changes, probably representing some form of lobular fibrosis. We found
      submission of a duplicate specimen mammogram with the breast biopsy specimen to
      pathology to be a significant adjunct to correlation. The abnormal area is marked
      on the mammogram by the radiologist for the pathologist. This is particularly
      helpful for localizing noncalcified stromal abnormalities. Calcifications are
      most easily and reliably isolated by serial slicing and performing another
      radiograph of the slices.

PMID- 1734831
TI  - Pulmonary metastases of colonic carcinoma. Distinction from pulmonary
      adenocarcinoma.
AB  - Pulmonary metastases may develop in patients with colonic carcinoma.
      Histopathologic separation of a solitary colonic metastasis from a primary
      pulmonary adenocarcinoma may be problematic. With the use of a polyclonal
      antibody to carcinoembryonic antigen, a monoclonal antibody to cytokeratin (CAM
      5.2), and a monoclonal carcinoembryonic antigen antibody (D-14), we compared 23
      colonic carcinomas metastatic to the lung with 24 primary pulmonary
      adenocarcinomas. Both carcinomas manifested similar histologic features. However,
      foci of "dirty necrosis" were common in all but one of the colonic neoplasms, and
      foci were observed in only four of the primary lung carcinomas. The polyclonal
      carcinoembryonic antigen antibody did not distinguish metastatic colonic
      carcinoma from primary pulmonary adenocarcinoma. All colonic tumors stained with
      D-14, while three primary pulmonary adenocarcinomas stained diffusely, and eight
      stained focally. Staining with D-14 will not absolutely distinguish colonic from
      pulmonary adenocarcinoma. However, positive D-14 staining and the presence of
      dirty necrosis should identify most colonic carcinomas. True-negative D-14
      staining practically excludes a colonic origin.

PMID- 1734832
TI  - Measurement of glomerular basement membrane thickness and its application to the
      diagnosis of thin-membrane nephropathy.
AB  - Morphometry is a valuable diagnostic aid when the glomerular basement membrane is
      suspected of being abnormally thin. Determination of overall width by the
      harmonic mean method has been described in detail. Results were given of
      measurements in 20 control subjects with histologically normal basement membranes
      and 41 allograft kidneys. Mean +/- 1.5 SDs of a series was found to be the most
      useful empiric guide to basement membrane widths. It was confirmed that the
      membrane was thinner in females than in males. The lower end of the respective
      mean +/- 1.5 SDs range overlapped with thicknesses that occurred in "thin
      membrane nephropathy" in women but not in men, although the threshold width below
      which hematuria was liable to occur was similar, at approximately 340 nm, in both
      sexes. It is suggested that the higher incidence of symptomatic thin-membrane
      nephropathy in females is related to their normally thinner glomerular basement
      membranes, in the context of the common threshold level. Other histologic
      findings, and the clinical picture, remain relevant to the diagnosis of thin
      membrane diseases.

PMID- 1734834
TI  - Prolonged storage of tissues at low temperatures does not preclude their use for
      ultrastructural studies.
AB  - A cost-effective method for electron microscopic study of snap-frozen surgical
      specimens is described. The method is available to any surgical pathology
      laboratory equipped with a deep freezer and allows the performance of
      ultrastructural observations on archival material.

PMID- 1734833
TI  - Renal microvascular features of hypertension in Japan, Guatemala, and the United
      States.
AB  - The finding of benign arteriolar nephrosclerosis at autopsy usually implies the
      prior existence of essential hypertension. It was found in this study that minor
      degrees of incipient nephrosclerosis in young people can be shown to correlate
      with seemingly trivial blood pressure elevations. In this study, autopsy tissues
      were used to assess the magnitude of early nephrosclerosis in five population
      groupings. A comparison of males in Tokyo, Japan, Guatemala, and New Orleans, La
      (blacks and whites); and females in Tokyo revealed significant differences among
      these populations. Blacks exceeded whites in New Orleans in the magnitude of
      incipient nephrosclerosis in all 10-year age groups from 15 through 24 years to
      45 through 54 years. Guatemalan males were, on average, less affected than New
      Orleans whites in all age groups. The data for all males (age range, 15 through
      54 years) in Tokyo revealed little difference in nephrosclerosis from those in
      New Orleans whites. Blood pressure data were obtained from reports of cross
      sectional surveys in these five populations. Blood pressure in males varied
      across age x race subgroups in close parallel with nephrosclerosis (r = .90),
      implying that variation in blood pressure among groups of subjects is strongly
      nephrosclerosis linked, even at very young ages; findings for Tokyo females were
      aberrant in this correlation. The results suggest that the lifelong progression
      toward the hypertensive state begins in childhood, and that these beginnings are
      measurably in the population averages of both nephrosclerosis and blood pressure
      elevations. Moreover, population differences in these two commensurate measures
      of the early precursors of hypertension were found to be well established by the
      ages of 15 through 24 years and were sustained at least into the ages of 45
      through 54 years. The years of adolescence are here brought under suspicion of
      special importance in setting the lifelong course toward the hypertensive state.

PMID- 1734835
TI  - Lectin histochemistry of human fetal notochord, ecchordosis physaliphora, and
      chordomas.
AB  - Lectin histochemical studies of human fetal notochord, ecchordosis physaliphora,
      and eight chordomas were performed. Ecchordosis physaliphora and eight chordomas
      were stained with Ricinus communis type I, Canavalia ensiformis, Triticum
      vulgaris, and Limax flavus. Ricinus communis type I, T vulgaris, and L flavus
      reacted with both tumor cells and the extracellular mucinous matrix, while C
      ensiformis mainly reacted with the cytoplasm of tumor cells. Thus, tumor cells
      were most recognizable with the C ensiformis stain. After neuraminidase
      treatment, ecchordosis physaliphora and chordomas invariably showed positivities
      for Arachis hypogaea. The lectin-binding patterns of chordomas closely reflected
      those of the human fetal notochord. Chordomas were completely sialylated
      regardless of either the clinical course or histopathological findings. Among the
      eight lectins, C ensiformis heavily labeled chordoma cells but not extracellular
      space. This was probably because asparagine-linked N-glycosylation was active in
      the chordomas, while the high-mannose-type oligosaccharides were apt to remain in
      the cytoplasm.

PMID- 1734836
TI  - Predicting the effect of hemolysis on measured creatine kinase: a caveat.

PMID- 1734837
TI  - Proteinaceous lymphadenopathy and the kidney.

PMID- 1734838
TI  - Automated measurement of red blood cell microcytosis and hypochromia in iron
      deficiency and beta-thalassemia trait.
AB  - Some routine red blood cell (RBC) measurements and indexes (count, mean volume,
      volume dispersion, and mean hemoglobin [HGB] concentration) can be used to
      differentiate iron deficiency from heterozygous beta-thalassemia. A number of
      formulas that incorporate two or more of these measurements have been described
      to amplify such differences. The H*1 hematology analyzer directly measures volume
      and HGB concentration of individual RBCs. We have assessed the diagnostic
      usefulness of conventional and new RBC measurements provided by the H*1 on a
      learning data set that comprised 119 patients with iron deficiency and 172
      patients with beta-thalassemia trait, both untreated and uncomplicated. The most
      striking finding was the inverse behavior of percentages of microcytes (volume,
      less than 60 fL) and hypochromic RBCs (HGB concentration, less than 280 g/L) in
      the two conditions. In 162 of 172 patients with beta-thalassemia trait, the
      percentage of microcytes (mean, 33.1%; central 95th percentile range, 9.2% to
      54.5%) was higher than the percentage of hypochromic RBCs (mean, 13.9%; central
      95th percentile range, 1.7% to 24.7%). In 105 of 119 patients with iron
      deficiency, on the contrary, the percentage of hypochromic cells (mean, 34.6%;
      central 95th percentile range, 9.7% to 73.1%) was higher than the percentage of
      microcytes (mean, 12.8%; central 95th percentile range, 1.7% to 29.6%). The ratio
      between the percentage of microcytes and the percentage of hypochromic cells
      provided by the H*1 (microcytic-hypochromic ratio) was useful in differentiating
      the two types of microcytic anemia: with the use of a discriminant value of 0.9,
      the discriminant efficiency of the microcytic-hypochromic ratio was 92.4% (95%
      confidence interval, 88.8% to 95.2%), higher than that of the five previously
      described discriminant formulas and simple RBC measurements. When assessed on a
      test data set that comprised 149 unselected cases of microcytic anemia, a
      microcytic-hypochromic ratio lower than 0.9 demonstrated high sensitivity
      (94.0%), specificity (92.3%), and predictive value (94.0%) for the presence of
      iron-deficient erythropoiesis in patients with isolated iron deficiency,
      polycythemia vera treated by phlebotomy, and iron deficiency complicating
      heterozygous thalassemia. In conclusion, our results showed that iron-deficient
      erythropoiesis is characterized by the production of RBCs with a severely
      decreased HGB concentration, while microcytes of beta-thalassemia trait are
      generally smaller, with a more preserved HGB concentration. Such properties, as
      assessed by the H*1 hematology analyzer, are very useful in distinguishing these
      two common types of microcytic anemia.

PMID- 1734839
TI  - Pseudopolycythemia, pseudothrombocytopenia, and pseudoleukopenia due to
      overfilling of blood collection vacuum tubes.
AB  - A patient blood sample with an unexpectedly high hemoglobin level, high
      hematocrit, low white blood cell count, and low platelet count was recognized as
      being spurious based on previously available data. Repeated testing of the
      original sample showed a gradual return of all parameters to expected levels. We
      provide evidence that the overfilling of blood collection vacuum tubes can lead
      to inadequate sample mixing and that, in combination with the settling of the
      cellular contents in the collection tubes, can result in spuriously abnormal
      hematological parameters as estimated by an automated method.

PMID- 1734840
TI  - Fatal neonatal pneumonia caused by adenovirus type 35. Report of one case and
      review of the literature.
AB  - A 3680-g term male neonate developed bilateral bronchopneumonia at 9 days of age.
      The labor, delivery, and immediate postnatal period had been unremarkable.
      Despite standard antibiotic therapy, the patient progressed to respiratory
      failure and died 4 days later. Adenovirus particles were found in oropharyngeal
      secretions 1 day prior to death. Autopsy revealed an extensive necrotizing
      bronchiolitis and alveolitis with frequent "smudge cells." Adenovirus was
      identified by culture, electron microscopy, and in situ DNA hybridization. The
      adenovirus was serotyped as type 35, which, to our knowledge, has not been
      previously described in neonatal adenovirus pneumonia.

PMID- 1734841
TI  - Pheochromocytoma producing multiple vasoactive peptides.
AB  - Pheochromocytomas may produce several vasoactive peptides. We studied a 39-year
      old man who presented with paroxysmal flushing and abdominal pain with normal
      blood pressure. Laboratory and radiologic studies established the diagnosis of
      right adrenal pheochromocytoma, and histologic and ultrastructural examination
      showed the tumor to be a typical pheochromocytoma. Tissue culture yielded large
      quantities of norepinephrine and epinephrine. However, immunohistochemical
      studies, tissue assays, and in vitro cultures documented production of several
      peptides, including calcitonin gene-related peptide and vasoactive intestinal
      polypeptide in tumor cells. The patient has been asymptomatic after tumor
      resection. Production of multiple peptides by this tumor may account for the
      flushing and lack of hypertension, despite elevated catecholamine levels in this
      patient.

PMID- 1734842
TI  - History and current status of trauma scoring systems.

PMID- 1734844
TI  - Molecular biology: the message, its language, and the surgeon.

PMID- 1734843
TI  - Unnecessary operation?

PMID- 1734845
TI  - The making of a surgeon revisited.

PMID- 1734846
TI  - Catheter sepsis in short-bowel syndrome.
AB  - Catheter sepsis with catheter removal is an important problem in patients with
      short-bowel syndrome. We determined the incidence of catheter sepsis and the
      catheter salvage rate in 20 pediatric patients with short-bowel syndrome. To
      evaluate the intestine as a source and translocation as the pathophysiologic
      mechanism for catheter sepsis, we identified the sepsis organisms, compared them
      with the fecal flora, and used mesenteric lymph node cultures to document
      translocation. The incidence of catheter sepsis was significantly higher in
      patients with short-bowel syndrome than in patients without short-bowel syndrome
      (7.8 vs 1.3 per 1000 catheter days). Overall catheter salvage was 42% and was
      highest in gram-negative sepsis (71%). Enteric organisms were responsible for 62%
      of cases of catheter sepsis in patients with short-bowel syndrome vs 12% in
      patients without short-bowel syndrome. Anaerobes were strikingly absent in 25 of
      28 stool cultures. The sepsis organism was identified in the fecal flora in 19 of
      28 cases. The dominant fecal organism or yeast was the septic organism in 12 of
      these 19 cases and was isolated in three of four mesenteric lymph node cultures.
      Our findings support translocation as a mechanism in catheter sepsis in patients
      with short-bowel syndrome.

PMID- 1734847
TI  - Alterations in intestinal permeability after thermal injury.
AB  - Alterations in intestinal permeability have been postulated to occur after
      thermal injury. We evaluated the status of intestinal permeability during the
      first 2 postburn weeks in 15 subjects by measuring the differential excretion of
      enterally administered lactulose and mannitol. The mean age and burn size of the
      patients were 32.7 +/- 3.6 years and 53.3% +/- 5.1% of the total body surface
      area, respectively. Ten healthy volunteers were also studied. The lactulose
      mannitol excretion ratio was 0.159 +/- 0.017 for the patients and 0.017 +/- 0.003
      for controls. The increased ratio did not correlate with burn size or postburn
      day. Patients who developed significant clinical infections during their first 2
      postburn weeks had lactulose-mannitol ratios on postburn day 2 that were
      significantly higher than those of controls and patients who did not develop
      infections. This suggests a relationship between susceptibility to infection and
      early alterations in intestinal permeability.

PMID- 1734848
TI  - Liver nonparenchymal cells are stimulated to provide interleukin 6 for induction
      of the hepatic acute-phase response in endotoxemia but not in remote localized
      inflammation.
AB  - It has been postulated that Kupffer cells provide signals that regulate
      hepatocyte responses in sepsis and inflammation. Although in vitro data support
      such a hypothesis, to our knowledge, no in vivo evidence has been reported. We
      injected rats with lipopolysaccharide intraperitoneally to simulate sepsis or
      turpentine intramuscularly to mimic localized inflammation. Both treatments are
      known to induce the hepatic acute-phase response. Liver nonparenchymal cells and
      hepatocytes were isolated and placed in culture. Hepatocyte fibrinogen synthesis
      was measured as an indication of interleukin 6 exposure, while nonparenchymal
      interleukin 6 production was measured directly. Both lipopolysaccharide and
      turpentine stimulated a sharp increase in hepatocyte fibrinogen synthesis
      (turpentine greater than lipopolysaccharide). However, only lipopolysaccharide
      injection was associated with increased nonparenchymal cell interleukin 6
      synthesis. Increased circulating levels of interleukin 6 could be found only
      after lipopolysaccharide injection. In addition, tumor necrosis factor synthesis
      was enhanced by lipopolysaccharide but not turpentine. Our data show that
      nonparenchymal cells are stimulated to provide the interleukin 6 signal to
      hepatocytes in endotoxemia but not in remote localized inflammation, even though
      both treatments stimulate the hepatic acute-phase response. Our findings support
      paracrine functions for liver sinusoidal cells in certain septic states.

PMID- 1734849
TI  - Analysis of infectious complications occurring after solid-organ transplantation.
AB  - To improve our understanding of posttransplant infections, we analyzed bacterial,
      viral, fungal, parasitic, and other infections in 604 consecutive recipients of
      kidney (n = 518), kidney-pancreas (n = 82), kidney-liver (n = 3), or kidney-islet
      (n = 1) allografts (355 cadaveric, 14 living-unrelated, 235 living-related
      donors) who also received cyclosporine, azathioprine, and prednisone
      immunosuppression. Recipients of cadaveric grafts received additional induction
      immunosuppression (antilymphocyte globulin or murine monoclonal antibody OKT3).
      Rejection episodes were treated with high-dose steroids, and either
      antilymphocyte globulin or OKT3 was administered when clinically indicated.
      Perioperative antibiotics and posttransplant prophylactic acyclovir sodium or
      ganciclovir sodium, trimethoprim-sulfamethoxazole, and clotrimazole or nystatin
      (Mycostatin) were administered to all recipients. Two hundred thirteen patients
      (35.3%) were found to have had no identifiable infections, while 391 (64.7%) had
      either isolated bacterial (97 [16.1%]), viral (53 [8.8%]), or fungal (34 [5.6%])
      infections or combination (concurrent or sequential) infections with bacterial
      plus viral (46 [7.6%]), bacterial plus fungal (66 [10.9%]), viral plus fungal (20
      [3.3%]), bacterial plus viral plus fungal (64 [10.6%]), or bacterial plus viral
      plus fungal plus parasitic (11 [1.8%]) pathogens in the posttransplantation
      period. Renal allograft survival (percentage, actuarial method) was diminished in
      patients with infections at both 1 year (91% vs 83%) and 3 years (81% vs 76%)
      after transplantation, as was actuarial patient survival (1 year, 97% vs 92%; 3
      years, 93% vs 88%). We conclude that infection remains a major cause of both
      patient demise and allograft loss following successful solid-organ
      transplantation.

PMID- 1734850
TI  - Ibuprofen improves survival but does not ameliorate increased gut mucosal
      permeability in endotoxic pigs.
AB  - Intravenous lipopolysaccharide (LPS) decreases superior mesenteric arterial blood
      flow and increases ileal mucosal permeability in pigs. We tested the hypothesis
      that these phenomena can be ameliorated by pretreatment and posttreatment with
      ibuprofen. Pentobarbital-anesthetized immature swine were mechanically ventilated
      (fraction of inspired oxygen, 0.5) and infused with Ringer's lactate (RL)
      solution (0.8 mL/kg per minute). Animals in group RL (n = 10) received no other
      interventions. Animals in group RL + LPS (n = 15) were infused with LPS (50
      micrograms/kg) from a time range equal to 0 through 60 minutes. Animals in group
      RL + LPS + ibuprofen (n = 10) were similarly infused with LPS, but in addition,
      they received ibuprofen (10 mg/kg at -30 minutes and 10 mg/kg per hour from -30
      through 210 minutes). Intestinal permeability was assessed by measuring plasma-to
      lumen clearances of two hydrophilic probes (chromium 51-labeled edetic acid
      monohydrate [EDTA] and urea) and by expressing the results as a clearance ratio
      (CEDTA/CUREA). Survival was 100%, 67%, and 100% in groups RL, RL + LPS, and RL +
      LPS + ibuprofen, respectively. Among survivors only, CEDTA/CUREA increased
      significantly over time in both endotoxic groups, but not in nonendotoxic
      controls. Treatment with ibuprofen transiently blocked LPS-induced mesenteric
      hypoperfusion. These data indicate that mediators other than cyclooxygenase
      derived metabolites of arachidonic acid are responsible for the adverse effect of
      LPS on mesenteric permeability to hydrophilic solutes in this porcine model.

PMID- 1734851
TI  - Inhibitory effects of interleukin 6 on immunity. Possible implications in burn
      patients.
AB  - Certain disease states are associated with abnormal increases in the monokine
      interleukin 6. Increased levels of interleukin 6 have been demonstrated in serum
      from patients with burns and are associated with systemic increases in endotoxin
      levels. Using a murine in vitro experimental model, we have studied the effects
      of interleukin 6 on various measures of immunity. Our data indicate that levels
      equivalent to the concentrations found in serum of burn victims inhibit T-cell
      proliferation. The inhibitory effect is dose and time dependent, is specific for
      T cells, is not due to impairment of interleukin 2 production or of interleukin 2
      receptor expression, and is dependent on macrophages. These data suggest that
      extraordinary increases in interleukin 6 levels may be related to impaired T-cell
      responses and to an increased susceptibility to infection in the patient with
      burns.

PMID- 1734852
TI  - Chloroquine attenuates hemorrhagic shock-induced immunosuppression and decreases
      susceptibility to sepsis.
AB  - Hemorrhagic shock causes a severe suppression of cellular immunity and an
      increased susceptibility to sepsis that may be due to increased release of
      prostaglandin E2 by macrophages. Since chloroquine inhibits the secretion of
      prostaglandin E2 by macrophages in vitro, the effects of chloroquine
      administration in vivo following hemorrhagic shock on macrophage prostaglandin E2
      secretion and on depressed cellular immunity were examined. Inbred C3H/HeN male
      mice, aged 6 to 8 weeks, were bled to a mean blood pressure of 35 mm Hg, which
      was maintained for 60 minutes, and adequately, resuscitated. Mice then received
      intramuscular injections of either saline (vehicle) or chloroquine (10 mg/kg of
      body weight). Prostaglandin E2 in macrophage supernatants (radioimmunoassay)
      concanavalin A-dependent splenocyte proliferation, and interleukin 2 in
      splenocyte supernatants (CTLL 20 interleukin 2-dependent proliferation) were
      determined 2 or 24 hours later. Hemorrhage caused a significant decrease of
      splenocyte proliferation (47%) and interleukin 2 release (49%) at 24 hours, while
      prostaglandin E2 secretion from macrophages was elevated at 2 hours. Chloroquine
      treatment attenuated depression of splenocyte functions and reduced prostaglandin
      E2 release. Furthermore, chloroquine treatment decreased the mortality of septic
      mice after hemorrhage to levels comparable with those of sham-operated mice.
      Thus, chloroquine may be a useful adjunct in the clinical setting for the
      treatment of shock-induced immunodepression and increased susceptibility to
      sepsis following hemorrhage.

PMID- 1734853
TI  - The necessity and efficiency of wound surveillance after discharge.
AB  - A surgical wound surveillance program followed up 16,453 consecutive patients
      from 1983 through 1988. Patients were followed up for 30 days after operation,
      and 516 (35%) of the surgical wound infections first became manifest after
      discharge. In-hospital surveillance alone would have estimated the surgical wound
      infection rate to be 5.8% when the true rate was 8.9%. Infections that occurred
      after discharge were more likely in clean operations, in shorter operations, in
      obese patients, and in nonalcoholic patients. The probability that infections
      would begin after discharge was inversely associated with the duration of
      postoperative stay in the hospital. Postdischarge follow-up of patients who
      previously have undergone surgery is necessary to avoid underestimated of the
      infection rates and biases related to known risk factors. The most efficient time
      to survey patients appears to be at 21 days after the operation, at which time
      90% of surgical wound infections have occurred.

PMID- 1734854
TI  - Guidelines for clinical care: anti-infective agents for intra-abdominal
      infection. A Surgical Infection Society policy statement.
AB  - Several antibiotics have been marketed for therapeutic use in intra-abdominal
      infection. Often, these agents do not provide a sufficient spectrum activity
      against both facultative and obligate anaerobic gram-negative organisms, or have
      certain toxic effects that would not otherwise support their use. Guidelines have
      been developed for selection of antibiotic therapy for intra-abdominal infections
      and are presented as a statement of the Surgical Infection Society endorsed by
      the Executive Council. These guidelines are restricted to infections derived from
      the gastrointestinal tract and deal with those microorganisms commonly seen in
      such infections. The recommendations are based on in vitro activity against
      enteric bacteria, experience in animal models, and documented efficacy in
      clinical trials. Other concerns regarding pharmacokinetics, mechanisms of action,
      microbial resistance, and safety were also used in the formation of these
      guidelines. For community-acquired infections of mild to moderate severity,
      single-agent therapy with cefoxitin, cefotetan, or cefmetazole or ticarcillin
      clavulanic acid is recommended. For more severe infections, single-agent therapy
      with carbapenems (imipenem/cilastatin) or combination therapy with either a third
      generation cephalosporin, a monobactam (aztreonam), or an aminoglycoside plus
      clindamycin or metronidazole is recommended. Regimens with little or no activity
      against facultative gram-negative rods or anaerobic gram-negative rods are not
      considered acceptable.

PMID- 1734855
TI  - Chronic pancreatitis beginning in childhood and adolescence.
AB  - We identified 10 patients with symptoms beginning before the age of 20 years in a
      group of 69 patients with proven chronic pancreatitis. Six of the 10 patients
      were women. There was a family history of pancreatitis in three patients and
      alcohol exposure in seven patients. Three patients were dependent on narcotics at
      the time of presentation. Six of the 10 patients had pancreatic duct dilatation
      to 10 mm or more in diameter during observation. These six patients underwent
      pancreaticojejunostomy, with clinical improvement in five patients. The median
      time of follow-up was 19 years from presentation. No patient developed diabetes
      and one developed malabsorption. Only three patients were free of pain, but four
      other patients had only mild episodes that rarely required hospital admission.
      One patient died of metastatic abdominal carcinoma of unknown origin 51 years
      after developing familial pancreatitis. Chronic pancreatitis beginning at a young
      age is sufficiently common to merit special awareness. It is compatible with
      prolonged survival, and pancreaticojejunostomy may help if the pancreatic duct
      reaches sufficient size. The disease does not seem to burn out with time.

PMID- 1734856
TI  - Hypertonic saline treatment of uncontrolled hemorrhagic shock at different
      periods from bleeding.
AB  - Hypertonic saline has been recently recommended for treatment of patients in
      hemorrhagic shock. Infusion of hypertonic saline at different periods in cases of
      uncontrolled hemorrhagic shock was studied in rats. The animals were divided into
      six groups: in group 1 uncontrolled hemorrhagic shock was induced by tail
      resection and no hypertonic saline was administered; in group 2 hypertonic saline
      was administered 5 minutes after shock was induced; in group 3 hypertonic saline
      was administered 15 minutes after shock was induced; in group 4 hypertonic saline
      was administered 30 minutes after shock was induced; in group 5 hypertonic saline
      was administered 60 minutes after shock was induced; and in group 6 hypertonic
      saline was administered 120 minutes after shock was induced. Tail resection in
      rats in group 1 was followed by a mean +/- SEM bleeding of 2.7 +/- .03 mL in 5
      minutes. Infusion of hypertonic saline after 5 and 15 minutes resulted in
      additional bleeding of 6.3 +/- 1.0 mL and 3.8 +/- 0.5 mL, respectively, and a
      drop in mean arterial pressure to 36 +/- 8 mm Hg and 56 +/- 9 mm Hg,
      respectively. Mortality was 80% in group 2 and 53% in group 3. Infusion of
      hypertonic saline 30 and 60 minutes after shock was induced did not alter
      bleeding, mean arterial pressure, or survival. Infusion of hypertonic saline
      within 15 minutes of hemorrhagic shock resulted in increased bleeding,
      hypotension, and early death. Infusion 30 minutes or later did not alter these
      variables. This potential danger of early hypertonic saline therapy should be
      considered in the treatment of patients in trauma.

PMID- 1734857
TI  - Immunoaffinity purification and cDNA cloning of human platelet prostaglandin
      endoperoxide synthase (cyclooxygenase).
AB  - The cDNA for prostaglandin endoperoxide synthase (cyclooxygenase) was cloned from
      human platelets by the polymerase chain reaction amplification method, and the
      primary structure of the enzyme was deduced from the nucleotide sequence. The
      enzyme was composed of 599 amino acids including 23-amino acid signal sequence,
      and the calculated molecular weight of the mature protein was 65,995. The enzyme
      was immunoaffinity-purified from human platelets. The N-terminal amino acid
      sequence determined by Edman degradation was Ala-Asp-Pro-Gly-Ala-Pro-Thr-Pro-,
      and the result confirmed the primary structure of the enzyme, which was deduced
      from the cDNA sequence.

PMID- 1734858
TI  - Leupeptin and ammonium chloride inhibit intrinsic factor mediated transcytosis of
      [57Co]cobalamin across polarized renal epithelial cells.
AB  - The [125I] intrinsic factor (IF) mediated transcytosis of [57Co]Cyanocobalamin
      (Cbl) by polarized opossum kidney cells was inhibited (greater than 80%) by
      preincubation of the cells with lysosomotropic agents leupeptin or ammonium
      chloride. Inhibition of Cbl transcytosis resulted in the intracellular
      accumulation of both [125I]IF (48 kDa) and [57Co]Cbl. Intracellular degradation
      of [125I]IF occurred during normal cellular transcytosis of [57Co]Cbl and in one
      h following internalization the major intracellular degradation products of IF
      were two polypeptides of Mr 29 kDa and 19 kDa. The size of the major degradation
      product of IF in the basolateral media was 10 kDa. Based on these results, we
      suggest that IF is internalized by the renal epithelial cells and is degraded by
      leupeptin-sensitive acid proteases during Cbl transcytosis.

PMID- 1734859
TI  - Avian species-specific tandem repeats contain nuclear protein binding sites.
AB  - Three avian highly repetitive tandem repeats were identified and examined. These
      repeats had similar unit lengths (about 42 bp long) but completely different
      sequences each containing particular protein binding sites. Each of these repeats
      was found within only one of the five closely related genera studied.

PMID- 1734860
TI  - PRS3 encoding an essential subunit of yeast proteasomes homologous to mammalian
      proteasome subunit C5.
AB  - We found by computer analysis that a putative yeast proteasome subunit gene named
      PRS3 that encodes a protein very similar to subunit C5 of rat and human
      proteasomes is located immediately 3' to the ERD2 gene of Saccharomyces
      cerevisiae. The similarity of the primary structures of the two suggests that
      this subunit may have a common function in proteasomes of all eukaryotes. The
      protein, deduced from the open reading frame of PRS3, consists of 242 amino acid
      residues with a calculated molecular weight of 27,077. Chromosomal disruption of
      the PRS3 gene created a recessive lethal mutation. Physical mapping by
      hybridization to intact S. cerevisiae chromosomal DNA showed that the PRS3 gene
      is located on chromosome II, unlike two other subunit genes, PRS1 and PRS2, which
      are located on chromosomes XV and VII, respectively. These findings indicate that
      the PRS3 protein is a subunit of yeast proteasomes that is essential for cell
      viability.

PMID- 1734861
TI  - Purification and characterization of a calpain activator from human platelets.
AB  - A calpain (Ca(2+)-activated neutral protease) activator was purified from human
      platelets by ammonium sulfate fractionation, gel-filtration, ion-exchange
      chromatography, followed by heat-treatment. The purified calpain activator with a
      Mr of 47.5 kDa was a heat-stable protein as demonstrated in other cells. The
      calpain activator did not change the Ca2+ sensitivity of calpain but activated
      calpain activity about 2-fold. This calpain activator may play an important role
      in the activation of the protease system leading to the Ca(2+)-mediated
      physiological process of platelets.

PMID- 1734862
TI  - Binding site mapping of a photoaffinity-labeled juvenile hormone binding protein.
AB  - The juvenile hormone binding protein (JHBP) of larval Manduca sexta was labeled
      by a photoaffinity analog of JH II and purified by preparative IEF and ion
      exchange HPLC. The purified [3H]EHDA-labeled JHBP was selectively cleaved by CNBr
      and by endoproteinases Lys-C and Glu-C. The radioactive peptides were separated
      by tricine SDS-PAGE and sequenced after blotting to a PVDF membrane. The sequence
      revealed that Ala184-Asn226 contained a primary binding site of [3H]EHDA.
      Furthermore, peptide mapping indicated that Asp1-Glu34 also contained a second
      covalent attachment site of [3H]EHDA. Labeling of the N-terminal region increased
      when the photolysis was performed at lower temperature. Since Ala184-Asn226 is
      predicted to be a hydrophobic beta-sheet region, it may participate in the
      recognition of lipophilic backbone of JH. Five out of six cysteines are located
      in these two regions, consistent with a model in which the two binding regions
      connected by disulfide bridges provide a two-sided binding pocket for juvenile
      hormone.

PMID- 1734863
TI  - Alkaline phosphatase activity during differentiation of the human promyelocytic
      leukemia cell line, HL-60.
AB  - The differentiation of HL-60 promyelocytic cells toward mature myelocytic cells
      induced by retinoic acid (RA) was accompanied by a quantitative similar increase
      in alkaline phosphatase (ALP) activity. The potentiation of RA-induced
      differentiation and the enhancement of ALP activity by sphinganine seemed to
      correlate with each other. The combination of RA and sphinganine increased in
      parallel the percentage of mature cells and the ALP activities. Short exposures
      (4-8h) of HL-60 cells to RA promoted differentiation and ALP activity to a
      fraction (about 50%) of their maximums which were achieved in cells after 24h or
      longer RA exposure. Our results indicate that the key step for the induction of
      ALP activity and the differentiation by RA probably takes place within 24h of
      incubation.

PMID- 1734864
TI  - Partial deletion of a dystrophin gene leads to exon skipping and to loss of an
      intra-exon hairpin structure from the predicted mRNA precursor.
AB  - In dystrophin Kobe exon 19 of the dystrophin gene is skipped during the process
      of mRNA precursor splicing even though the splice sites are unchanged (Matsuo et
      al. J. Clin. Invest. 87:2127-2131,1991). In the predicted secondary structure of
      the mRNA precursor, exon 19 of dystrophin Kobe is paired with intron sequences,
      whereas a large part of exon sequence from wild type is paired with itself and
      folded into a large hairpin structure. As all of 22 additional dystrophin exons
      analyzed also form intra-exon hairpin structures, these structures may be
      considered essential components of exons. We suggest that the abolishment of a
      hairpin structure in the truncated exon of dystrophin Kobe might prevent the
      splicing machinery from recognizing the splice sites and induce exon skipping.

PMID- 1734865
TI  - A novel primer extension method to detect the number of CAG repeats in the
      androgen receptor gene in families with X-linked spinal and bulbar muscular
      atrophy.
AB  - X-linked spinal and bulbar muscular atrophy (SBMA), an adult-onset form of motor
      neuron disease, was recently reported to be caused by amplification of the CAG
      repeats in the androgen receptor gene. We report here a simple and rapid strategy
      to detect the precise number of the CAGs. After the DNA fragment containing the
      CAG repeats is amplified by the polymerase chain reaction, a primer extension is
      carried out; the extension of the end-labelled reverse primer adjacent to 3' end
      of CAG repeats stops at the first T after CAG repeats with the incorporation of
      dideoxy ATP in the reaction mixture. The resultant primer products are analysed
      by denaturing polyacrylamide gel electrophoresis and autoradiography. This method
      could be quite useful to detect not only CAG repeats in SBMA but also other
      polymorphic dinucleotide and trinucleotide repeats.

PMID- 1734866
TI  - A novel transthyretin mutation associated with familial amyloidotic
      polyneuropathy.
AB  - We characterized the mutation associated with familial amyloidotic polyneuropathy
      in a Japanese patient. Sequence analysis of polymerase chain reaction-amplified
      exons of the transthyretin gene revealed a novel point mutation resulting in a
      substitution of arginine for glycine at position 47. The mutation was confirmed
      using allele-specific olgonucleotide hybridization procedures. This most likely
      represents a de novo mutation since neither parent carries the mutant allele.

PMID- 1734867
TI  - Isolation and primary structure of a novel pheromonotropic neuropeptide
      structurally related to leucopyrokinin from the armyworm larvae, Pseudaletia
      separata.
AB  - A novel pheromonotropic neuropeptide has been isolated from a head extract of the
      armyworm larvae, Pseudaletia separata, by a seven step purification procedure
      using an in vivo assay with decapitated female moths of Bombyx mori. Amino acid
      sequence analysis and comparison with synthetic peptides established the primary
      structure of the peptide, termed Pseudaletia pheromonotropin (Pss PT), as H-Lys
      Leu-Ser-Tyr-Asp-Asp-Lys-Val-Phe-Glu-Asn-Val-Glu-Phe-Thr-Pro-Arg-Le u-NH2. Pss PT
      is structurally related to leucopyrokinin, an insect myotropic neuropeptide, and
      possesses the C-terminal pentapeptide, Phe-Thr-Pro-Arg-Leu-NH2, responsible for
      the biological activity.

PMID- 1734868
TI  - P2 protamines from human sperm are zinc -finger proteins with one CYS2/HIS2
      motif.
AB  - P1 (HP1) and P2 (HP2, HP3, HP4) protamines were isolated from human sperm nuclei
      in the reduced form and their interaction with zinc and cobalt was studied. One
      zinc atom per molecule of P2 protamines but not of P1 protamine was found.
      Absorption spectra of P2 protamines with cobalt were characteristic of a
      tetrahedral complex involving two histidine and two cysteine residues and with
      one cobalt per molecule. A tetrahedral complex was found neither in P1 protamines
      nor in P2 protamines alkylated at cysteine or at histidine residues. The zinc
      finger motif Cys2/His2 of P2 protamines may play a role in stabilization of human
      sperm chromatin and in inhibition of transcription.

PMID- 1734869
TI  - Oxidized low density lipoproteins exert arrhythmogenic effects in rabbit Purkinje
      fibers.
AB  - The electrophysiological effects of oxidized low density lipoproteins (ox-LDLs)
      have been studied in rabbit Purkinje fibers using standard microelectrode
      techniques, in comparison with native LDLs (n-LDLs) and lysophosphatidylcholine
      (LPC). At the concentration of 100 micrograms protein/ml, ox-LDL but never n-LDL
      induced the abrupt occurrence of abnormal electrical activities during the basic
      stimulation of 1 Hz (6/13 fibers) and the development of either early
      afterdepolarizations (6/13 fibers) or abnormal automaticity (4/13 fibers) at low
      frequencies (0.1 and 0.03 Hz). Short trains of rapid stimulation (2, 3, 4 and 5
      Hz) did not trigger delayed afterdepolarizations. However, early
      afterhyperpolarizations were commonly seen after each action potential. 30 microM
      LPC caused quite similar electrophysiological derangements. The results suggest
      that ox-LDLs may exert arrhythmogenic effects partly explained by their LPC
      content.

PMID- 1734870
TI  - Synthesis and characterization of a d(ApG) platinated nonanucleotide duplex.
AB  - The nonamer 5'd(CTCAGCCTC) 3' 1 has been reacted with cis
      diamminediaquaplatinum(II) in water at pH 4.2. The major reaction product was
      shown by enzymatic digestion and 1H NMR to be the d(ApG)cis-Pt(NH3)2 chelate [cis
      Pt(NH3)2[d(CTCAGCCTC)-N7(4),N7(5)]] 1-Pt. When mixed with its complementary
      strand 2, 1-Pt forms a B DNA type duplex 3-Pt with a Tm of 35 degrees C (versus
      58 degrees C for the unplatinated duplex). The NMR study of the exchangeable
      protons of 3-Pt revealed that the helix distortion is localized on the CA*G*-CTG
      moiety (the asterisks indicating the platinum chelation sites) with a strong
      perturbation of the A*(4)T(15) base pair related to a large tilt of A*(4).

PMID- 1734871
TI  - The complex CD44 transcriptional unit; alternative splicing of three internal
      exons generates the epithelial form of CD44.
AB  - We have utilized the polymerase chain reaction (PCR) to isolate a 3.5 kilobase
      pair (kb) genomic fragment that encodes the additional extracellular domain
      unique to the epithelial isoform of CD44 (CD44E). Nucleotide sequence was
      determined for this complete region and sequence comparison to our previously
      determined CD44R1 and CD44R2 cDNA sequences revealed the R region to be comprised
      of three exons of 102 bp, 90 bp, and 204 bp. Northern blot analysis of CD44
      expressing cell lines confirmed the presence of CD44R1 transcripts and indicates
      that the epithelial domain may be inserted through alternative splicing into all
      CD44 transcript classes. Southern blot analysis of the CD44E genomic fragments is
      consistent with a single copy per human haploid genome. The data presented here
      further supports our model of the human CD44 transcriptional unit as a single
      gene complex that utilizes an invariant 5' initiation site, alternative internal
      and 3' end splicing, and multiple poly (A) sites to generate through RNA
      processing a diverse number of human CD44 isoforms.

PMID- 1734872
TI  - Differential requirement of ATP and extra-ribosomal proteins for ribosome
      inactivation by eight RNA N-glycosidases.
AB  - The requirement of ATP and extra-ribosomal proteins for the inactivation of
      ribosomes by eight plant RNA N-glycosidases [ribosome-inactivating proteins
      (RIPs)] was investigated. Tritin, pokeweed antiviral protein and barley RIP
      depend, as gelonin [Sperti, S., Brigotti, M., Zamboni, M., Carnicelli, D. and
      Montanaro, L. (1991) Biochem. J., 277, 281-284], on the presence of ATP and extra
      ribosomal proteins for full inactivation of ribosomes, while bryodin, lychnin,
      momordin, momorcochin and saporin inactivate isolated Artemia salina ribosomes
      suspended in buffer saline.

PMID- 1734873
TI  - Stereochemistry of NADPH oxidation by dihydropyrimidine dehydrogenase from pig
      liver.
AB  - Dihydropyrimidine dehydrogenase reduces uracil to 5,6-dihydrouracil in a strictly
      NADPH-dependent reaction. Either by analysing the 1H-NMR spectra of the NADP+
      products formed or by determination of the kinetic isotope effects of
      stereospecifically deuterated coenzymes dihydropyrimidine dehydrogenase was found
      to abstract specifically the pro-S hydrogen of NADPH, making it a member of the B
      side stereospecific class of dehydrogenases.

PMID- 1734874
TI  - Tissue specificity of S14 and fatty acid synthase in vitro transcription.
AB  - Hepatic nuclear extracts support in vitro transcription from S14 and fatty acid
      synthase (FAS) promoters. Renal nuclear extracts support in vitro transcription
      from S14 promoter constructs at rates comparable to hepatic nuclear extracts, but
      lack the apparent positive and negative control observed with liver. In contrast,
      renal nuclear extracts do not support in vitro transcription from the FAS
      promoter. NF-1 or a related protein in both hepatic and renal extracts
      contributes to in vitro transcriptional activity from the S14 promoter, but not
      the FAS promoter. These studies indicate that different mechanisms regulate
      tissue-specific expression of S14 and FAS.

PMID- 1734875
TI  - Effect of extracellular phosphatidylinositol on c-myc gene-expressed human renal
      cancer cell line.
AB  - Effect of exogenously added soybean phosphatidylinositol on c-myc gene expressed
      and unexpressed human cancer cell lines was investigated. When
      phosphatidylinositol liposomes were introduced into culture media, viability of c
      myc unexpressed cells was reduced, while that of c-myc expressed cells was not.
      Death of c-myc unexpressed cells by phosphatidylinositol liposomes was found to
      be caused by abnormally accumulated intracellular Ca2+, and it seemed to be
      related to reduction of protein kinase C activity.

PMID- 1734876
TI  - Role of the metF and metJ genes on the vitamin B12 regulation of methionine gene
      expression: involvement of N5-methyltetrahydrofolic acid.
AB  - The repression of MetE synthesis in Escherichia coli by vitamin B12 is known to
      require the MetH holoenzyme (B12-dependent methyltransferase) and the metF gene
      product. Experiments using trimethoprim, an inhibitor of dihydrofolate reductase,
      show that the MetF protein is not directly involved in the repression, but that
      N5-methyltetrahydrofolic acid (N5-methyl-H4-folate), the product of the MetF
      enzymatic reaction is required. Since the methyl group from N5-methyl-H4-folate
      is normally transferred to the MetH holoenzyme to form a methyl-B12 enzyme, the
      present results suggest that a methyl-B12 enzyme is involved in the vitamin B12
      repression of metE expression. Other results argue against the possibility that a
      methyl-B12 enzyme functions in this repression solely by decreasing the cellular
      level of homocysteine, which is required for MetR activation of metE expression.
      Experiments with metJ mutants show that the MetJ protein mediates about 50% of
      the repression of metE expression by B12 but is totally responsible for the
      regulation of metF expression by vitamin B12.

PMID- 1734877
TI  - Expression of mouse-GLUT3 and human-GLUT3 glucose transporter proteins in brain.
AB  - Polyclonal anti-peptide antisera were raised to the C-terminal sequence of mouse-
      and human-GLUT3 glucose transporter isoforms. GLUT3 protein and mRNA expression
      were investigated by Western blot and Northern blot assays, in a range of tissues
      and cell lines. Mouse-GLUT3 protein was detected only in rat brain, where it was
      present in most regions except adenohypophysis and pineal gland. Mouse-GLUT3 was
      also detected in primary cultured rat cerebellar neurons and the neuronal cell
      lines PC12 and NG108-15, but not in cultured astroglia. Human-GLUT3 protein was
      detected in CHO cells transfected with the human-GLUT3 cDNA and in human brain,
      but not in human placenta or fat. The expression of GLUT3 in rat brain and
      neurons indicates it is a major neuronal glucose transporter.

PMID- 1734878
TI  - Decreased fidelity of DNA polymerases and decreased DNA excision repair in aging
      mice: effects of caloric restriction.
AB  - Hepatic DNA polymerases from calorie restricted and ad libitum 26 month old
      C57BL/6 mice showed a decline in fidelity of nucleotide incorporation compared
      with weanling animals. Both alpha and beta polymerases from calorie restricted
      aged mice exhibited a higher level of fidelity than polymerases from ad libitum
      aged mice. UV-initiated unscheduled DNA synthesis was significantly higher in
      hepatocytes from weanling and 18 month old calorie restricted animals compared
      with cells from 18 month old ad libitum animals, while MMS-initiated unscheduled
      DNA synthesis did not differ significantly between cells from young and old or ad
      libitum and calorie restricted animals. These data suggest that calorie
      restriction could play a significant role in decreasing the age-related decline
      of cellular mechanisms expected to reduce the rate at which mutations accumulate
      during aging, and could potentially prolong the onset age of mutation-associated
      diseases of the elderly.

PMID- 1734879
TI  - The effect of interleukin-4 on the macrophage respiratory burst is species
      dependent.
AB  - Preexposure of human monocytes to recombinant human interleukin-4 (IL-4)
      suppressed the respiratory burst response to a number of different stimuli,
      including phorbol myristate acetate, zymosan, platelet-activating factor and the
      chemotactic peptide, f-met-leu-phe. Under similar conditions, the respiratory
      burst of murine macrophages was enhanced by preexposure to recombinant murine IL
      4. By conducting our studies on cells from different species under similar
      conditions we have demonstrated that there is a significant disparity in the
      effects of IL-4 on human and murine macrophages thus providing an explanation for
      some apparent inconsistencies in the literature and highlighting the need for
      caution when extrapolating data across species barriers.

PMID- 1734880
TI  - Interleukin-1 impairs both vascular contraction and relaxation in rabbit isolated
      aorta.
AB  - Incubation of rabbit aortic rings with interleukin-1 (100 U/ml) in vitro led to a
      depressed contractile response to norepinephrine, whether the endothelium was
      present or not. In both cases norepinephrine-induced contraction was restored in
      the presence of NG-methyl-L-arginine (300 microM), an inhibitor of nitric oxide
      synthesis. In interleukin-1-treated rings precontracted with norepinephrine (1
      microM), the relaxing response to acetylcholine was totally suppressed
      independently on the presence of endothelium. High concentrations of
      acetylcholine (greater than 1 microM) induced a slight contraction which was of
      lower amplitude than that obtained in control endothelium-denuded rings and was
      increased in the presence of NG-methyl-L-arginine. These results show that
      interleukin-1 (i) affects not only vascular contraction but also relaxation and
      (ii) involves both endothelial and non-endothelial factors. These observations
      suggest an impairment of the whole vascular reactivity during septic shock.

PMID- 1734881
TI  - Coordinate regulation of oestrogen and prolactin receptor expression by sodium
      butyrate in human breast cancer cells.
AB  - Prolactin receptor and oestrogen receptor are co-ordinately expressed in human
      breast cancer cell lines and in human breast tumour biopsies, leading to the
      suggestion that the expression of these receptors may be coupled. To examine this
      hypothesis, T-47D and MCF-7 human breast cancer cells were treated with sodium
      butyrate, a known modulator of oestrogen receptor levels, and the changes in
      oestrogen and prolactin receptor mRNA and binding activity were measured. In both
      cell lines treatment with 0.3-10 mM sodium butyrate resulted in a parallel
      decrease in prolactin and oestrogen receptor mRNA levels and binding activity. In
      T-47D cells, where the effect was transient, mRNA levels of both receptors
      recovered in parallel. These data indicated that oestrogen receptor and prolactin
      receptor gene expression is modulated in parallel by sodium butyrate and
      supported the hypothesis that the expression of these two receptors is coupled.

PMID- 1734882
TI  - Enhanced intracellular activation of carboplatin in hemoglobin-synthesizing
      versus undifferentiated erythroleukemic cells.
AB  - The formation of DNA interstrand cross-links following exposure of target cells
      to the antineoplastic drugs Cisplatin and Carboplatin was measured in murine
      erythroleukemic cells either native or induced to differentiate and to synthesize
      hemoglobin by treatment with hexamethylene bisacetamide. The uptake of both drugs
      was identical in the uninduced and the induced cells, thus excluding differences
      in permeability due to differentiation. Both cell types formed comparable levels
      of DNA interstrand cross-links when submitted to treatment with Cisplatin.
      Conversely, significant differences were observed after exposure to Carboplatin.
      Specifically, the induced, hemoglobin containing cells showed significantly
      enhanced intracellular activation of the drug and subsequent binding to DNA,
      compared to the uninduced cells. These data suggest that, in agreement with
      previous results obtained with erythrocytes, the hemoglobin present in the
      committed cells enhances the aquation process that mediates the activation of
      Carboplatin.

PMID- 1734883
TI  - Production of monoclonal antibodies against human 6-pyruvoyl tetrahydropterin
      synthase and immunocytochemical localization of the enzyme.
AB  - Monoclonal antibodies were produced against human pituitary gland 6-pyruvoyl
      tetrahydropterin synthase, one of the key enzymes in the biosynthesis of
      tetrahydrobiopterin, by in vitro immunization with the antigen directly blotted
      from SDS-PAGE to polyvinylidene difluoride membranes. The antibodies produced
      show crossreactivity in the enzyme linked immunosorbent assay, not only with the
      human 6-pyruvoyl tetrahydropterin synthase but some also with the same enzyme
      isolated from salmon liver. 6-Pyruvoyl tetrahydropterin synthase was localized
      immuno-enzymatically in peripheral blood smears and in skin fibroblasts by the
      use of these monoclonal antibodies and the alkaline phosphatase monoclonal anti
      alkaline phosphatase labeling technique.

PMID- 1734884
TI  - The role of 5'-methylthioadenosine on rat calvaria cell differentiation.
AB  - The role of 5'-methylthioadenosine (MTA), formed during the process of polyamine
      biosynthesis, on differentiation of osteoprogenitor cells was assessed by its
      effects on alkaline phosphatase (ALP) activity, bone nodule formation and
      osteopontin contents of cultured rat calvaria (RC) cells. These three markers
      were stimulated by exogenous MTA and were depressed by 5'
      difluoromethylthioadenosine (DFMTA), a synthetic inhibitor of MTA phosphorylase,
      which cleaves MTA to adenine and 5-methylthioribose-1-phosphate. 5
      Methylthioribose and 2-keto-4-methylthiobutyrate, metabolites of 5
      methylthioribose-1-phosphate, had no effects on ALP activity and bone nodule
      formation in the presence or absence of DFMTA. On the other hand, adenine
      enhanced ALP activity, bone nodule formation and osteopontin contents in
      mineralized nodules and also partially reversed DFMTA-induced inhibition of these
      three markers. MTA, its metabolites and DFMTA did not affect the growth of RC
      cells under these culture conditions. These results suggest that adenine formed
      from MTA is important in the differentiation of RC cells.

PMID- 1734885
TI  - Translocation and induction of alpha B crystallin by heat shock in rat glioma (GA
      1) cells.
AB  - Response to heat shock of alpha B crystallin expressed in rat astrocytoma GA-1
      cells was analysed quantitatively using an immunoassay method. GA-1 cells
      contained a considerable amount of alpha B crystallin at growing phase. When the
      growing cells were heated at 45 degrees C, concentrations of alpha B crystallin
      in cell extracts were decreased to less than one-fifth of the original level
      within 15 min, with an increase in the insoluble fraction which was detected by
      immunoblotting. The low level of alpha B crystallin in the cytoplasm, that was
      observed for a few hours after heat shock, gradually recovered to the control
      level within several hours. At 10 h following heat shock (45 degrees C for 15
      min), the concentration of alpha B crystallin in the soluble extract was about
      twice that of the control level, with little detectable amounts in the insoluble
      fraction. These results are additional evidence that suggest that alpha B
      crystallin is a small heat shock protein.

PMID- 1734886
TI  - The role of calcium in neutrophil migration: the effect of calcium and calcium
      antagonists in electroporated neutrophils.
AB  - Chemotaxis by electroporated rabbit peritoneal neutrophils in the absence of Ca2+
      is only slightly different from that in the presence of Ca2+. Pretreatment of
      neutrophils with quin2-AM causes inhibition of chemotaxis. Calcium antagonists as
      nitrendipine and verapamil are inhibitory in nanomolar concentrations, while
      10(5) times higher concentrations are required for inhibition of chemotaxis by
      neutrophils which were not electroporated. The results support the hypothesis
      that Ca2+ from Ca(2+)-storing organelles is of importance for chemotaxis, but
      that chemotaxis is not dependent on changes in cytoplasmic Ca2+ concentrations.

PMID- 1734887
TI  - Presence of islet amyloid polypeptide in rat islet B and D cells determines
      parallelism and dissociation between rat pancreatic islet amyloid polypeptide and
      insulin content.
AB  - The islet amyloid polypeptide (IAPP) immunoreactivity of the adult rat pancreas
      is located in insulin-containing B cells as well as in somatostatin-containing D
      cells. In both cell types, the IAPP immunoreactivity is identical to rat
      synthetic IAPP in terms of its elution position after reversed phase HPLC and its
      binding to IAPP antibodies. The IAPP content per 10(6) B-cells is more than 100
      fold lower than the corresponding insulin content, but comparable to the IAPP
      content of D cells. After induction of diabetes by streptozotocin, pancreatic
      IAPP seems predominantly located in somatostatin-containing cells. In normal
      rats, pancreatic insulin and IAPP content increase 20 fold from birth to 12 weeks
      of age; beyond week 12, the further rise in pancreatic insulin was not paralleled
      by an increase in IAPP content.

PMID- 1734888
TI  - Isoflavonoids, genistein, psi-tectorigenin, and orobol, increase cytoplasmic free
      calcium in isolated rat hepatocytes.
AB  - Isoflavonoid compounds, genistein, psi-tectorigenin and orobol have been
      implicated as inhibitors of tyrosine-specific protein kinase and
      phosphatidylinositol turnover. These compounds have been frequently used as a
      pharmacological tool to assess signal transduction pathways in various cell
      systems. In the course of analyzing signaling pathways in rat hepatocytes, we
      obtained an unexpected finding that these compounds transiently increase
      cytoplasmic free calcium. Since the Ca2+ mobilizing effect was observed in 1
      microM calcium containing buffer, the source of the Ca2+ may be intracellular
      stores. Thus, when interpreting data obtained using these compounds, caution is
      needed.

PMID- 1734889
TI  - Carbon 13 NMR study of glycogen metabolism in the baboon liver in vivo.
AB  - In vivo glycogen metabolism was investigated at 2 Tesla by 13C NMR in the baboon
      liver. Two concentric surface coils were used for 13C observation and proton
      decoupling, respectively. Spectra were acquired in 2 to 10 minutes with a 60 ms
      repetition time. After 3 hours of glucose infusion in the 48 hr fasted animal, 3
      g of 99%-enriched [1-13C]glucose were injected. The distribution of the label on
      C-1 and also C-2, C-5 and C-6 of glycogen indicated 65% and 35% contributions of
      the direct and indirect pathways to glycogen synthesis from glucose,
      respectively. The results show that hepatic metabolic pathways and rates can be
      followed in vivo in large animals by 13C NMR at 2 Tesla.

PMID- 1734890
TI  - Both stimulatory and inhibitory GDP/GTP exchange proteins, smg GDS and rho GDI,
      are active on multiple small GTP-binding proteins.
AB  - Six peaks of small GTP-binding proteins (G proteins) were separated by column
      chromatographies from the cytosol fraction of the differentiated HL-60 cells: two
      peaks of rho p21, one peak of smg/rap1 p21, two peaks of rac1 p21, and one peak
      of an unidentified small G protein with a Mr of about 20,000 (20 KG). smg GDS,
      previously thought to be a stimulatory GDP/GTP exchange protein for smg p21, Ki
      ras p21, and rho p21, but not for Ha-ras p21 or smg p25A, was also active on rac1
      p21. rho GDI, previously thought to be an inhibitory GDP/GTP exchange protein
      specific for rho p21, was also active on rac1 p21. These results indicate that
      both smg GDS and rho GDI are active on multiple small G proteins.

PMID- 1734891
TI  - Pyruvate/malate antiporter in rat liver mitochondria.
AB  - To gain some insight into the process by which both acetylCoA and NADPH, needed
      for fatty acid synthesis, are obtained, in the cytosol, from the effluxed
      intramitochondrial citrate, via citrate lyase and malate dehydrogenase plus malic
      enzyme respectively, the capability of externally added pyruvate to cause efflux
      of malate from rat liver mitochondria was tested. The occurrence of a
      pyruvate/malate translocator is here shown: pyruvate/malate exchange shows
      saturation features (Km and Vmax values, measured at 20 degrees C and at pH 7.20,
      were found to be about 0.25 mM and 2.7 nmoles/min x mg mitochondrial protein,
      respectively) and is inhibited by certain impermeable compounds. This carrier,
      together with the previously reported tricarboxylate and oxodicarboxylate
      translocators proved to allow for citrate and oxaloacetate efflux due to
      externally added pyruvate.

PMID- 1734892
TI  - Calpain activation is essential for membrane fusion of erythrocytes in the
      presence of exogenous Ca2+.
AB  - The membrane mobility agent, 2-(methoxyethoxy)ethyl-cis-8-(2
      octylcyclopropyl)octanoate (A2C) promotes the fusion of rat, rabbit, and human
      erythrocytes in the presence of exogenous Ca2+. Under these conditions, the high
      sensitivity form of calcium-activated neutral protease (mu-calpain) in
      erythrocytes is activated autolytically. mu-Calpain is activated in accordance
      with fusion; that is, both erythrocyte fusion and autolytic activation of mu
      calpain are induced in rat erythrocytes at 30 min, in rabbit erythrocytes at 150
      min, and in human erythrocytes at 240 min after the addition of A2C and Ca2+.
      When erythrocytes are preincubated with the Ca2+ ionophore A23187, both fusion
      and autolytic activation start earlier. A leupeptin analogue, Cbz-Leu-Leu-Leu
      aldehyde (ZLLLal), inhibits both the autolytic activation of mu-calpain and
      fusion induced by A2C and Ca2+. These results indicate that treatment of
      erythrocytes with A2C and Ca2+, results in first an influx of Ca2+ into the
      cells, followed by autolytic activation of mu-calpain, proteolysis of membrane
      proteins, exposure of fusion-sites, and, finally, fusion of erythrocytes.

PMID- 1734893
TI  - 6-pyruvoyl tetrahydropterin synthase from salmon liver: amino acid sequence
      analysis by tandem mass spectrometry.
AB  - The most frequent variant of atypical phenylketonuria, an inborn error of
      metabolism, is characterized by a low activity of the 6-pyruvoyl tetrahydropterin
      synthase. We purified and characterized this enzyme from salmon liver known to
      contain high levels. After digestion, peptides were sequenced by tandem mass
      spectrometry and/or automated Edman microsequence analysis. Both a free amine
      terminus and an N-acetylated amine terminus were found, indicating the presence
      of two isoforms. The peptide sequences determined here have a high degree of
      homology with the protein sequence deduced from cDNA for rat 6-pyruvoyl
      tetrahydropterin synthase (1), however, the amine termini of these proteins
      differ significantly.

PMID- 1734894
TI  - A 1H-NMR study of the solution conformation of cyclo(GRGDSPA): conformational
      effects on the physiological activity.
AB  - Solution conformations of cyclo(GRGDSPA) have been analyzed by the use of two
      dimensional proton nuclear magnetic resonance spectroscopy and the dynamical
      simulated annealing calculation. It has been shown that the RGDS segment in
      cyclo(GRGDSPA) takes a beta-turn conformation. We have concluded that this beta
      turn conformation is essential for the physiological activity of cyclo(GRGDSPA).

PMID- 1734895
TI  - Membrane transport in disease and treatment. Proceedings of the Fifth Biochemical
      Pharmacology Symposium. Oxford, 25-26 July 1991.

PMID- 1734896
TI  - Potassium channels in nervous tissue.
AB  - There is a multiplicity of potassium channels in nervous tissue. These have been
      characterized on the basis of their electrophysiological actions but more
      information is required on their structures and on the functions of the different
      subtypes of channel in different parts of the nervous system. We currently also
      lack drugs which are specific in opening or closing individual subtypes of
      channel. However, when more is known about the structure and function of these
      channels and when more specific modulators of their activity are available, it is
      likely that the use of such compounds may be of great value in the treatment of a
      variety of conditions affecting the nervous system, including epilepsy, the
      damage due to cerebral anoxia, neurodegenerative disorders and demyelinating
      disorders.

PMID- 1734897
TI  - Effects of isozyme selective phosphodiesterase inhibitors on bovine tracheal
      smooth muscle tone.

PMID- 1734898
TI  - Recent progress in potassium channel opener pharmacology.
AB  - Potassium (K) channel openers comprise a diverse group of molecules capable of
      opening K channels in excitable cells. These agents exhibit their greatest
      potency in the smooth muscle system but K channels in cardiac muscle, neurones
      and in secretory cells are also affected. The development of tissue selectivity
      is currently one major focus of research and evidence is starting to emerge that
      this can be achieved. The profound effects of the K channel openers in vivo has
      led to the suggestion that an endogenous K channel opener might exist and exert
      an important role in blood pressure homeostasis. The discovery of such a
      substance--endothelium-derived hyperpolarizing factor--has many implications and
      its role in cardiovascular regulation is currently under investigation. In vivo,
      initial studies with the K channel openers emphasized their antihypertensive
      properties. However, later studies have concentrated on the improvement to
      coronary blood flow produced by these substances together with their protective
      effect on the ischaemic myocardium, the basis of which is not fully understood.
      In spite of great efforts, the K channel which forms the target of these agents
      in smooth muscle is a matter of controversy. The ability of glibenclamide to
      antagonize the actions of the K channel openers initially led to the suggestion
      that an ATP-dependent K channel was their site of action in smooth muscle
      although the most recent data have implicated a smaller conductance K channel.

PMID- 1734899
TI  - Quinoline-containing antimalarials--mode of action, drug resistance and its
      reversal. An update with unresolved puzzles.
AB  - Malaria constitutes one of the major health threats in the tropical and sub
      tropical areas of the world. Yet, few advances were made in recent years in
      revealing the mode of action of the common and most economically affordable
      antimalarial drugs, the schizontocidal 4-aminoquinolines. Data presented
      indubitably repudiate the previous notions that these drugs act by either halting
      the feeding of the parasite on its host erythrocyte cytosol or repressing nucleic
      acid synthesis due to intercalation into the parasite's DNA. A novel target for
      drugs is outlined, i.e. they are shown to inhibit in vitro the release of iron
      from acidified host cell cytosol, consisting mostly of hemoglobin, a process that
      could provide this trace element to the parasite. Resistance to quinoline
      containing drugs is the principal reason for the present resurgence of malaria.
      Drug-resistant parasites accumulate less of these weak base-like drugs in the
      acidic digestive vacuoles. A kinetic model is presented, indicating that
      diminishing drug accumulation is due to decreased vacuolar proton pump activity
      and is not a result of a putative multidrug resistance (MDR) efflux pump.
      Findings to date on the molecular biology of parasite mdr genes are reviewed.
      These indicate no correlation between gene expression or mutations and phenotypic
      drug resistance. Reversal of parasite drug resistance by relevant compounds in
      MDR cancer cells seems to involve mechanism(s) different from the inhibition of
      the MDR pump in cancer cells.

PMID- 1734900
TI  - Single or multiple localization of ADP/ATP transporter in human malarial
      Plasmodium falciparum.

PMID- 1734901
TI  - Long-term prospective study of methotrexate in the treatment of rheumatoid
      arthritis. 84-month update.
AB  - OBJECTIVE: To determine the long-term efficacy and safety of low-dose
      methotrexate (MTX) in rheumatoid arthritis (RA). METHODS: Eighty-four-month open
      prospective trial at a single academic rheumatology center. RESULTS: Twenty-six
      patients were enrolled in a prospective study of the long-term efficacy of MTX in
      RA; a significant improvement had been demonstrated after 36 months of therapy.
      Twelve patients remained in the study at the 84-month visit; the mean weekly
      dosage of MTX was 10.2 mg. A significant improvement was still noted at 84 months
      in the number of painful joints, number of swollen joints, joint pain index,
      joint swelling index, and physician and patient global assessments. A 50%
      improvement in the joint pain index and joint swelling index was observed in more
      than 80% of the 12 patients still enrolled. A significant reduction in prednisone
      dosage was achieved; of 14 patients taking prednisone at entry, 7 had
      discontinued prednisone completely. Fourteen patients withdrew from the study: 10
      between 0 and 36 months, and 4 between 36 and 84 months. Toxicity in 3 patients
      and visit noncompliance in 1 patient were the reasons for withdrawal between 36
      and 84 months. At 84 months, 46% of the patients remained in the study; 11.5% had
      discontinued due to MTX toxicity. CONCLUSION: The effectiveness of MTX in the
      treatment of RA continues to be demonstrated in this prospective study, after 84
      months of treatment.

PMID- 1734902
TI  - Long-term prospective study of the use of methotrexate in the treatment of
      rheumatoid arthritis. Update after a mean of 90 months.
AB  - OBJECTIVE: To determine and describe the clinical, radiographic, and toxicity
      profile in a cohort of rheumatoid arthritis patients receiving weekly oral
      methotrexate (MTX) over a mean period of 90 months, and to compare and contrast
      these data with our previous data on this cohort, reported after 53 months.
      METHODS: Prospective, open observational study over a mean treatment period of 90
      months (range 79-107 months). Standard clinical and laboratory measures of
      disease activity were assessed by the same investigator at baseline, 1 month, 3
      months, and every 3 months thereafter. RESULTS: A significant improvement from
      baseline was maintained in all clinical parameters but the number of tender
      joints. Toxic reactions were as common in months 54-90 as during the first 53
      months. The mean dosage of MTX decreased from 14.6 mg/week at the time of the
      last report to 11.7 mg/week, while the mean prednisone dosage increased from 1.9
      mg/day to 2.1 mg/day. Radiographic scores for erosive disease became
      statistically significantly different from baseline at year 8, and scores for
      joint space narrowing differed significantly from baseline at years 5 and 8.
      Since study entry, 2 patients (6.9%) have experienced MTX pneumonitis.
      CONCLUSION: We conclude that a majority of rheumatoid arthritis patients are able
      to continue MTX treatment with generally sustained efficacy, for intervals that
      meaningfully exceed those reported previously.

PMID- 1734903
TI  - The effect of local heat and cold therapy on the intraarticular and skin surface
      temperature of the knee.
AB  - OBJECTIVE: To evaluate the effects of local application of ice chips, ligno
      paraffin, short-wave diathermy, and nitrogen-cold air on skin and intraarticular
      temperature. METHODS: Forty-two healthy subjects were divided into 4 treatment
      groups. A temperature probe was inserted into the knee joint cavity and another
      placed on the overlying skin, and changes in temperature over 3 hours, by
      treatment group, were recorded. RESULTS: The mean skin surface temperature
      dropped from 27.9 degrees C to 11.5 degrees C after application of ice chips, and
      from 28.8 degrees C to 13.8 degrees C after application of cold air. The mean
      intraarticular temperature decreased from 31.9 degrees C to 22.5 degrees C and
      from 32.9 degrees C to 28.8 degrees C, respectively, after these 2 treatments.
      Shortwave diathermy increased skin temperature by 2.4 degrees C; intraarticular
      temperature was increased only 1.4 degrees C by short-wave diathermy. Treatment
      with ligno-paraffin increased the skin surface temperature 8.9 degrees C; the
      temperature in the joint cavity was increased 3.5 degrees C. CONCLUSION: The use
      of short-wave diathermy and superficial heat packs in the treatment of patients
      with arthritis may potentially cause harm by increasing intraarticular
      temperature. This may have major implications regarding treatment policy for
      patients with arthritis.

PMID- 1734904
TI  - Timing of pregnancy in relation to the onset of rheumatoid arthritis.
AB  - The interval between the onset of rheumatoid arthritis (RA) and the most recent
      pregnancy prior to RA onset in 88 women was determined. These data were compared
      with data obtained from a group of 144 age-matched normal women (controls) who
      had been assigned a "dummy date for RA onset" for the purposes of analysis. The
      frequency of disease onset during 3 time intervals within the period from
      conception to 1 year postpartum was compared with the frequency of disease onset
      outside this period. There was a reduction in the incidence of disease onset
      during pregnancy (adjusted odds ratio [OR] 0.30, 95% confidence interval [CI]
      0.04-2.6) and a numerically greater increased risk of RA onset during the first 3
      months postpartum (OR 5.6, 95% CI 1.8-17.6), which persisted for the subsequent 9
      months (OR 2.6, 95% CI 0.8-7.9). A reduction in the incidence of disease onset
      was seen during all pregnancies; in contrast, the postpartum increase was greater
      in those with RA onset after the first pregnancy. The reduced incidence of RA
      onset during pregnancy, with the increased risk postpartum, mirrors the
      previously described suppression of disease activity during pregnancy and the
      subsequent flare postpartum in women with established RA. In addition, the
      increased postpartum risk after the first pregnancy might suggest that in
      susceptible women, either the hormonal changes or the exposure to the fetus's
      paternal HLA might represent a risk factor for disease causation.

PMID- 1734905
TI  - The rapid assessment of disease activity in rheumatology (radar) questionnaire.
      Validity and sensitivity to change of a patient self-report measure of joint
      count and clinical status.
AB  - OBJECTIVE: This study documents the measurement properties of a brief, self
      administered questionnaire of disease signs and symptoms in patients with
      rheumatoid arthritis. METHODS: The Rapid Assessment of Disease Activity in
      Rheumatology (RADAR) questionnaire assesses joint pain/tenderness and clinical
      status. One hundred ninety-three pairs of RADAR forms were completed by 45
      subjects and their assigned clinician evaluators. RESULTS: Subject-clinician
      agreement (intraclass correlation coefficients [ICC]) for joint pain/tenderness
      and clinical status ranged from 0.52 to 0.87 (P = 0.0001), with 83% greater than
      or equal to 0.65. The ICC for change in joint scores over 6 months was 0.83 (P =
      0.0001). CONCLUSION: The 2-page RADAR questionnaire produces valid estimates of
      joint count and clinical status that are sensitive to change.

PMID- 1734906
TI  - Regulation of B cell function by lobenzarit, a novel disease-modifying
      antirheumatic drug.
AB  - OBJECTIVE: Lobenzarit (disodium 4-chloro-2,2'-iminodibenzoate [CCA]) is a novel
      disease-modifying drug for the treatment of rheumatoid arthritis (RA). Although
      its clinical efficacy has been demonstrated, its mechanism of action remains
      unclear. We therefore examined the effects of CCA on in vitro IgM and IgM
      rheumatoid factor (IgM-RF) production by human B cells. METHODS: IgM and IgM-RF
      production was induced from highly purified B cells from 8 healthy donors by
      stimulation with Staphylococcus aureus Cowan 1 (SAC) plus factors generated from
      mitogen-activated T cells (TCF) or with immobilized anti-CD3-activated CD4+ T
      cells. RESULTS: CCA suppressed the production of IgM-RF as well as IgM at
      concentrations of 25-50 micrograms/ml (therapeutic serum concentrations of the
      drug), although the IgM-RF production induced by SAC plus TCF was suppressed at
      lower concentrations of CCA (1-3 micrograms/ml). Whereas CCA suppressed
      interleukin-2 (IL-2) production by anti-CD3-activated CD4+ T cells, its
      suppressive effects on B cells were not overcome by addition of IL-2 or TCF. CCA
      did not inhibit the initial stages of B cell activation in either culture system,
      but rather, suppressed the maturation of previously activated B cells. Cell cycle
      analysis by acridine orange staining indicated that CCA-mediated inhibition of B
      cell responsiveness induced by anti-CD3-activated CD4+ T cells was the result of
      a block at the G1-S interphase. CONCLUSION: These results indicate that CCA
      suppresses the production of IgM and IgM-RF by directly inhibiting activated B
      cells. Thus, one of the actions of CCA in RA may be the suppression of the
      function of activated B cells.

PMID- 1734907
TI  - Anti-Ro/SS-A antibodies in the pathophysiology of congenital heart block in
      neonatal lupus syndrome, an experimental model. In vitro electrophysiologic and
      immunocytochemical studies.
AB  - OBJECTIVE: To determine whether anti-Ro/SS-A antibodies selectively bind to
      neonatal cardiac cells and alter membrane repolarization. METHODS: An in vitro
      electrophysiologic and immunocytochemical experimental model contrasting neonatal
      and rabbit cardiac tissue was employed. RESULTS: Sera and IgG-enriched fractions
      from anti-Ro/SS-A antibody-positive mothers of infants with neonatal lupus
      erythematosus and congenital heart block bind to neonatal, rather than adult,
      rabbit cardiac tissue and alter the transmembrane action potential (i.e., inhibit
      repolarization). The additional presence of anti-La/SS-B antibodies was not
      additive or synergistic for these immunocytochemical and electrophysiologic
      features. Sera containing other antibody specificities (i.e., anti-native DNA,
      cardiolipin, Sm, and nuclear RNP) failed to stain the neonatal cardiac tissue or
      produced alterations in membrane repolarization. CONCLUSION: Anti-Ro/SS-A
      antibodies may play a pathophysiologic role in the development of congenital
      heart block in neonatal lupus.

PMID- 1734908
TI  - Antibiotic treatment of venereal disease and Reiter's syndrome in a Greenland
      population.
AB  - OBJECTIVE: To assess the effects of antibiotic treatment of urethritis or
      cervicitis on the incidence of recurrences of articular symptoms in Reiter's
      syndrome patients. METHODS: Retrospective evaluation of the medical charts of 109
      patients living in Greenland. RESULTS: Thirty-seven percent of the episodes of
      genitourinary tract inflammation that were not treated or were treated with
      penicillin were followed by arthritis, compared with 10% of those treated with
      tetracycline or erythromycin. CONCLUSION: Antibiotics active against Chlamydia
      trachomatis reduced the risk of postvenereal arthritis in the population studied.

PMID- 1734909
TI  - P-31 magnetic resonance spectroscopy in polymyositis and dermatomyositis. Altered
      energy utilization during exercise.
AB  - OBJECTIVE: To explore alterations in energy utilization as a potential etiology
      for weakness in polymyositis and dermatomyositis (PM/DM). METHODS: P-31 magnetic
      resonance spectroscopy studies were performed in patients with acute and treated
      PM/DM and in normal controls, at rest and with exercise. RESULTS: Patients with
      acute and treated PM/DM showed increased ratios of inorganic phosphate to
      phosphocreatine (PCr) during exercise, with loss of ATP disproportional to loss
      of PCr. CONCLUSION: This study demonstrates changes in energy utilization in
      PM/DM, thus supporting the notion of a metabolic etiology for the weakness
      associated with these diseases.

PMID- 1734910
TI  - Racial differences in the frequencies of scleroderma-related autoantibodies.
AB  - OBJECTIVE: To determine demographic differences in scleroderma-related
      autoantibodies. METHODS: One hundred fifty-six patients with systemic sclerosis
      were prospectively examined for anticentromere antibodies (ACA), anti
      topoisomerase I (anti-topo I, or Scl-70), antinucleolar, and anti-U1 RNP
      autoantibodies. RESULTS: ACA was found in 36% of Caucasians and 4% of American
      blacks (P = 0.002, odds ratio [OR] 15). Anti-topo I was found in 37% of American
      blacks, compared with 17% of Caucasians (P = 0.04, OR 3). No significant
      differences in the frequencies of antinucleolar and anti-U1 RNP autoantibodies
      were found. CONCLUSION: These data suggest important demographic differences in
      scleroderma-associated autoantibodies.

PMID- 1734911
TI  - Serologic evaluation of patients receiving procainamide.
AB  - This controlled study examined the characteristics of serologic abnormalities in
      52 patients receiving procainamide for cardiac arrhythmias, who had no symptoms
      of a connective tissue disease. Antinuclear antibodies occurred in 43 patients
      (83%). Significant elevation of antibody binding to single-stranded DNA (mean +/-
      SEM 30 +/- 2.6%), double-stranded DNA (13 +/- 1.1%), Z-DNA (optical density 0.54
      +/- 0.06), and poly A (7.2 +/- 0.6%) was seen (P less than 0.001). Thirty-four
      patients (65.4%) had antibodies to total histones, most frequently, the H2A/2B
      dimer. IgG antibodies to H2A/2B correlated with the cumulative procainamide dose.
      One patient subsequently developed drug-related lupus.

PMID- 1734912
TI  - Articular cartilage vesicles generate calcium pyrophosphate dihydrate-like
      crystals in vitro.
AB  - OBJECTIVE: To identify the morphology of a mineral-forming of adult porcine
      hyaline articular cartilage digest and characterize the mineral it forms.
      METHODS: Electron microscopy, Fourier transform infrared (FTIR) spectroscopy, x
      ray microanalysis, compensated polarized light microscopy, and biochemical
      studies including 14C-labeled UDPG pyrophosphohydrolase radiometric assay.
      RESULTS: This fraction of articular cartilage digest contained membrane-limited
      vesicles resembling growth plate cartilage matrix vesicles and formed mineral
      after only 24 hours in physiologic salt solution containing 1 mM ATP: The mineral
      contained inorganic pyrophosphate, 95% of which derived from ATP, and phosphate,
      93% of which derived from inorganic phosphate in the medium. The FTIR spectrum of
      this mineral closely resembled the spectrum of standard calcium pyrophosphate
      dihydrate (CPPD) crystals. Compensated polarized light microscopy showed
      positively birefringent, rod-shaped crystals morphologically identical to CPPD.
      Ca:P ratios, defined by energy-dispersive microanalysis, were also consistent
      with CPPD. CONCLUSION: The articular cartilage vesicle fraction of porcine
      hyaline cartilage is capable of generating mineral that strongly resembles CPPD.

PMID- 1734913
TI  - Bone marrow changes in adjuvant-induced and collagen-induced arthritis.
      Interleukin-1 and interleukin-6 activity and abnormal myelopoiesis.
AB  - OBJECTIVE: To investigate the role of bone marrow in arthritis. METHODS: Bone
      marrow changes over time were investigated in rats with adjuvant-induced and
      collagen-induced arthritis, using bioassay techniques and histologic analysis.
      RESULTS: In both animal models, bone marrow interleukin-1 and interleukin-6
      activity began to rise before the onset of arthritis and increased in relation to
      the progression of arthritis. Enhanced myelopoiesis in the bone marrow was noted
      in conjunction with the increased cytokine activity. CONCLUSION: Bone marrow
      changes such as those demonstrated in this study may be common to various models
      of induced arthritis and may have an important role in the pathogenesis of this
      disease.

PMID- 1734914
TI  - Failure of multitarget detection of Borrelia burgdorferi-associated DNA sequences
      in synovial fluids of patients with juvenile rheumatoid arthritis: a cautionary
      note.

PMID- 1734915
TI  - Volatiles from interactions of Maillard reactions and lipids.
AB  - This article provides current information on the production of volatile compounds
      from interactions of Maillard reactions and lipids. It includes a brief
      introduction outlining the Maillard reactions, the Strecker degradation of amino
      acids, and the oxidation of lipids. It highlights those compounds derived from
      these reactions that could interact to form volatile flavor components during the
      processing or cooking of food. The article discusses results obtained from model
      systems involving interactions between (1) Maillard reaction products and
      carbonyl compounds, (2) amino acids and carbonyl compounds, (3) amino acids and
      derivatives of fatty acids, and (4) Maillard reaction products, triglycerides and
      phospholipids. The qualitative and quantitative effects that triglycerides and
      phospholipids have on the formation of volatile Maillard products are also
      discussed. Particular attention is given to those long-chain alkyl heterocyclic
      compounds formed during these reactions, proposed methods for their formation,
      and their aromas. The role that such compounds play in food flavors is discussed
      with reference to those volatile compounds identified in certain cooked foods,
      such as meat (beef, lamb, and pork), chicken, potatoes (baked, French-fried, and
      crisps), and beverages (coffee, tea, and cocoa).

PMID- 1734916
TI  - Carotenoids and retinoids in human nutrition.
AB  - Since the discovery of vitamin A as a fat-soluble growth factor in the early part
      of the century, research into carotenoids and retinoids has attracted the
      attention of many scientists. These two groups of compounds are still being
      actively studied all over the world since many gaps in knowledge exist and new
      frontiers are being pursued. Recent developments in studies into the possible
      roles of carotenoids and retinoids beyond their classical functions in vision
      have created a great deal of excitement in the biomedical community. This review
      covers a wide range of topics pertaining to these two closely related compounds.
      Particular emphasis is given to the functions of these compounds and their roles
      in human nutrition. Various aspects of vitamin A deficiency and studies on
      carotenoids and retinoids in cancer development and prevention are reviewed in
      some detail.

PMID- 1734917
TI  - A review of sweet taste potentiation brought about by divalent oxygen and sulfur
      incorporation.
AB  - The plethora of high-potency sweetener research has allowed the construction of
      important structure-taste relationships. In light of new structure-taste
      relationships, it is instructive to review sweet taste potentiation brought about
      by divalent oxygen and sulfur incorporation. The taste of sulfur-containing
      organic compounds was reviewed in Japanese by Yasuo Ariyoshi in 1977. Several new
      representative examples of sweet taste potentiation and taste dichotomy (sweet
      and bitter) found within similar classes of oxygen- and sulfur-containing organic
      compound: amides, dipeptides, ureas, sulfamates, sulfonamides, oximes, sugars,
      dihydroisocoumarins, and others are reviewed. Special attention is given to the
      thioethers and thioureas in sulfamates, dipeptides, aryl ureas, and hybrid
      dipeptide ureas. The most notable contributions have arisen from the work of
      Nofre and Tinti at Universite Claude Bernard in Lyons, France. A common trend
      emerges with certain sweeteners when a carbon atom is strategically replaced by
      sulfur or oxygen atoms. The net result is an increase in the sweetness two- to
      tenfold. With saccharins, the usual bitter, metallic taste is removed. Sweet
      taste receptor models that have been published are mainly based on the original
      Shallenberger and Acree model of the glucophores AH-B with contributions from
      Kier (AH-B-X). AH is a proton donor group, B is a proton acceptor group, and X is
      some hydrophobic group. All of the models have overlooked the contributions of
      divalent sulfur (often in place of oxygen) in bringing about sweetness
      potentiation. There is no precedence for localizing the energy-minimized
      structures of sulfur-containing sweeteners in a binding mode that includes
      sulfur. These sulfur potentiation loci are analyzed and illustrated in a computer
      generated sweetener model to show the specific region in which sulfur is being
      "recognized" as a potentiating feature.

PMID- 1734918
TI  - Dual asymmetric PCR: one-step construction of synthetic genes.
AB  - We have developed a one-step process for constructing synthetic genes. Four
      adjacent oligonucleotides 17-100 bases in length having short overlaps of 15-17
      bases are used as primers in a PCR mixture. The quantity of the two internal
      primers is highly limited, and the resultant reaction causes an asymmetric single
      stranded amplification of the two halves of the total sequence due to an excess
      of the two flanking primers. In subsequent PCR cycles, these dual asymmetrically
      amplified fragments, which overlap each other, yield a double-stranded, full
      length product.

PMID- 1734919
TI  - An efficient method for blunt-end ligation of PCR products.
AB  - This report presents data demonstrating a simple method that can potentially be
      extended to a wide range of cloning strategies to increase the yield of insert
      containing recombinants. The method requires that the ligation of an insert to a
      vector does not regenerate the original restriction enzyme recognition sequence.
      In the example presented, PCR products were blunt-end ligated to a SmaI-cut
      vector, in the presence of SmaI endonuclease. The addition of the restriction
      enzyme to the ligation reaction dramatically favored the ligation of insert to
      vector rather than vector self-ligation.

PMID- 1734920
TI  - A rapid PCR method of screening for small mutations.
AB  - We report a modified method of screening for point mutations using a PCR approach
      based upon the sensitivity of PCR to the 3' terminus of the primer. This method
      provides a sensitive screen when using either plasmid DNA or bacterial cell
      lysates. We have optimized the technique for general use to allow rapid screening
      of mutants with good discrimination. Unlike previous similar methods, this
      technique has no inherent limitation in primer design on the 3'-terminal base
      chosen.

PMID- 1734921
TI  - Using PCR to extend the limit of oligonucleotide synthesis.
AB  - A method has been developed to allow one to extend the practical limit of
      oligonucleotide synthesis by coupling the synthesis reaction to a subsequent PCR.
      Given that DNA synthesizers are capable of producing reasonable yields of
      oligonucleotides that are 125-150 bases in length, this method could be used to
      recover the minute amount of full-length product present in mixtures extended
      well beyond the established limits. This technology could be applied to gene
      synthesis and mutagenesis.

PMID- 1734922
TI  - Dideoxy linear PCR on a commercial fluorescent automated DNA sequencer.
AB  - The use of automated fluorescent DNA sequencer systems and PCR-based DNA
      sequencing methods play an important role in the actual effort to improve the
      efficiency of large-scale DNA analysis. Here we show the application of the
      linear PCR using a single fluorescent primer and dideoxynucleotide terminators in
      four separate sequencing reactions on the EMBL/Pharmacia's fluorescent automated
      DNA sequencer. We have used dideoxy/deoxynucleoside triphosphate ratios and
      linear amplification cycle conditions to obtain an accurate sequencing response
      of up to, and over, 500 bases from just 400 ng of double-stranded DNA template
      without chemical denaturation. The sequencing protocol described in this paper is
      effectively suited for enhancement of sensitivity and performance of the
      automated DNA sequencing system.

PMID- 1734923
TI  - Recovery of plasmid DNA from nonviable bacterial colonies and cultures.

PMID- 1734924
TI  - Reverse fluorescent sequencing of large M13 clones.

PMID- 1734925
TI  - Nearly complete loss of nucleic acids by commercially available highly purified
      ethanol.

PMID- 1734926
TI  - EGTA inhibition of DNase activity in commercial lysostaphin preparations.

PMID- 1734927
TI  - Rapid removal of cesium chloride from DNA obtained from ultracentrifuge
      gradients.

PMID- 1734928
TI  - A simple and rapid procedure for pouring sequencing gels.

PMID- 1734929
TI  - PCR amplification of specific alleles (PASA) is a general method for rapidly
      detecting known single-base changes.
AB  - Previous data suggested that PCR amplification of specific alleles (also known as
      allele-specific amplification and amplification refractory mutation system) is
      not a general method for rapidly and accurately detecting known single-base
      changes. Herein we present our experience with the use of PCR amplification of
      specific alleles to detect 69 polymorphic or mutant alleles. Our results indicate
      that with proper optimization, all alleles were reliably distinguished.

PMID- 1734930
TI  - Gene conversion of immunoglobulin variable regions in mutagenesis cassettes by
      replacement PCR mutagenesis.
AB  - A technique, Replacement PCR Mutagenesis, was developed to replace one
      immunoglobulin variable region (V) in a M13 phage cassette with a different,
      homologous V. This allows the use of the same mutagenesis and subsequent
      expression vectors for many V regions or V segments. The method combines PCR of V
      fragments and in vitro mutagenesis. Primers homologous to 3' and 5' ends of both
      V regions initiate PCR synthesis of the V DNA fragment (donor) that will replace
      the V region (recipient) in M13. Donor V PCR DNA may originate from mRNA, cloned
      V genes or genomic templates. The donor V PCR DNA is denatured and annealed to
      the M13 cassette containing the recipient V to be supplanted. The second strand
      is synthesized, transfected into bacteria and mutant plaques selected by
      hybridization. Since restriction sites in primers are not required, altered
      primer-encoded amino acids are avoided. Further, the PCR donor piece can be of
      any length if it shares homology with the recipient gene. This allows
      construction and expression of complete gene replacements and chimeras. This
      method is also applicable to V "humanization" and studying sets of homologous
      genes containing polymorphic or evolutionary disparities. The potential uses of
      the technique are discussed.

PMID- 1734931
TI  - PCR amplification and simultaneous digoxigenin incorporation of long DNA probes
      for fluorescence in situ hybridization.
AB  - Nonradioactive in situ hybridization has found widespread applications in
      cytogenetics. Basic requirements are DNA probes in sufficient amounts and of high
      specificity as well as a labeling protocol of good reproducibility. The PCR has
      been of fundamental importance for the amplification of DNA sequences and thus
      for the production of DNA probes. Meanwhile, PCR protocols for amplification of
      DNA have reached a high degree of automation. So far, incorporation of labeled
      nucleotides into these DNA probes has normally been done by nick translation.
      Here we show that in using the PCR, amplification of a DNA probe larger than one
      kilobase accompanied by simultaneous incorporation of digoxigenin-11-dUTP can be
      performed for in situ hybridization experiments. As an example, the DNA probe pUC
      1.77 specific for the subcentromeric region q12 of chromosome number 1 was used
      and hybridized against metaphase chromosomes from human lymphocytes. The labeled
      chromosome region was detected by anti-digoxigenin-fluorescein, Fab fragments.
      The experiments were evaluated by digital image analysis of microphotographs.

PMID- 1734932
TI  - The effect of oxidation/reduction on the charge heterogeneity of the human
      glucocorticoid receptor.
AB  - In order to investigate the molecular basis for the charge heterogeneity which
      has been reported for the glucocorticoid receptor, we have analyzed the
      [3H]dexamethasone mesylate ([3H]DM)1 affinity labeled receptor from HeLa S3 cells
      by high resolution two-dimensional gel analysis. The [3H]DM labeled
      glucocorticoid receptor from HeLa cells exists as a population of 5-6 isoforms
      which range over approx. 0.6 pI units but have similar molecular weights. This
      heterogeneity is apparently the result of modification(s) of a single gene
      product since the affinity labeled receptor from Chinese hamster ovary (CHO)
      cells transfected with the human glucocorticoid receptor cDNA displays the same
      pattern of heterogeneity on two-dimensional gels. Since previous one-dimensional
      gel studies from our laboratory showed that the structure of the [3H]DM labeled
      glucocorticoid receptor from HeLa cells is highly susceptible to sulfhydryl group
      modification, we investigated the potential role of the same modifications in the
      apparent charge heterogeneity of the glucocorticoid receptor. Treatment of the
      affinity labeled receptor with iodoacetamide which alkylates free sulfhydryl
      groups and irreversibly prevents the formation of intra- or intermolecular
      disulfide bonds, reproducibly resulted in the appearance of 5-6 discrete isoforms
      of the receptor protein. Treatment with dithiothreitol, a reversible reducing
      reagent, resulted in detection of 3 to 4 isoforms of the glucocorticoid receptor.
      In marked contrast, treatment with sodium tetrathionate, which induces
      intramolecular disulfide bond formation, resulted in only one detectable isoform
      of the [3H]DM labeled glucocorticoid receptor. These data demonstrate that the
      oxidation/reduction state of sulfhydryl groups within the receptor protein can
      account for much of the charge heterogeneity of this ligand dependent
      transcription factor.

PMID- 1734933
TI  - Tissue localization of 11 beta-hydroxysteroid dehydrogenase and its relationship
      to the glucocorticoid receptor.
AB  - 11 beta-Hydroxysteroid dehydrogenase (11 beta-HSD) dictates specificity for the
      mineralocorticoid receptor (MR) by converting the active steroid cortisol to
      cortisone in man (corticosterone to 11-dehydrocorticosterone in rodents), leaving
      aldosterone to occupy the MR. However cortisol is the principal circulating
      glucocorticoid in man and 11 beta-HSD, distributed in a tissue specific fashion,
      may represent a powerful mechanism in regulating exposure of active steroid to
      the glucocorticoid receptor (GR). A detailed localization study of 11 beta-HSD
      gene expression and activity in numerous rat tissues has been performed and
      compared with the presence of GR mRNA. 11 beta-HSD mRNA (1.4 kB) measured by
      hybridization to a cDNA derived from hepatic 11 beta-HSD, and enzyme activity,
      measured by percentage conversion of [3H]corticosterone to [3H]11
      dehydrocorticosterone by tissue homogenate, was widespread, present in all
      tissues studied except spleen, brain cortex and heart. There was a close
      correlation between tissue 11 beta-HSD mRNA levels and activity (r = 0.91, P less
      than 0.001) suggesting pretranslational regulation of the enzyme at a tissue
      level. There was also close co-localization of GR mRNA (7 kB), measured by
      hybridization to a rat GR cRNA probe, and enzyme mRNA/activity in every tissue
      studied except heart and brain cortex in which GR mRNA was found. In the
      mineralocorticoid target tissues kidney and colon, additional 11 beta-HSD mRNA
      bands were seen (kidney 1.8 kB, colon 3.4 kB), suggesting the presence of
      multiple dehydrogenase species. 11 beta-HSD is widely distributed and suitably
      placed to modulate ligand occupancy of the GR. The possibility of multiple
      dehydrogenase species in mineralocorticoid target tissues is consistent with the
      hypothesis that the ubiquitous 'native' 1.4 kB hepatic enzyme regulates the GR,
      and these separate dehydrogenases regulate the MR.

PMID- 1734934
TI  - Kinetic mechanism of reduction of testosterone by hepatic 5 beta-reductase of
      chicken and inhibition of the reductase activity by a secosteroid, an azasteroid
      and glycyrrhetinic acid.
AB  - The present studies on initial velocity of testosterone reduction by hepatic 5
      beta-reductase (4-en-3-oxosteroid 5 beta-reductase) of chicken and mode of
      inhibition of the 5 beta-reduction by 5 beta-dihydrotestosterone and NADP+
      indicated that the reduction of testosterone occurred after the 5 beta-reductase
      bound firstly to NADPH and then to testosterone, forming a ternary complex. After
      5 beta-reduction, 5 beta-dihydrotestosterone and then NADP+ were liberated from
      the complex, following a mechanism of "ordered Bi-Bi". Effect of (4R)-5,10-seco
      19-norpregna-4,5-diene-3,10,20-trione (a steroidal 5 alpha-reductase-inhibitor or
      Secosteroid), diethyl-4-methyl-3-oxo-4-aza-5 alpha-androstane-17 beta-carboxamide
      (the other steroidal 5 alpha-reductase-inhibitor or 4-MA), and glycyrrhetinic
      acid (3 beta-hydroxy-11-oxoolean-12-en-30-oic acid, a 5 beta-reductase-inhibitor)
      was examined upon the 5 beta-reductase activity by double reciprocal plots. The
      mode of inhibition against testosterone by 4-MA and glycyrrhetinic acid was found
      to be competitive, while that by Secosteroid was non-competitive.

PMID- 1734935
TI  - Isoelectric focusing and 2D electrophoresis of the human androgen receptor.
AB  - Nuclear androgen receptors from cultured genital skin fibroblasts were analyzed
      by non-denaturing isoelectric focusing (IEF) in ultrathin polyacrylamide gels
      before and after photoaffinity labeling with [3H]methyltrienolone. Both
      reversibly and covalently labeled receptors focused at pH 5.28 +/- 0.20 when
      extracted from nuclei with high salt. Lowering of the salt concentration yielded,
      in both cases, a second species which focused at pH 7.16. This species became
      predominant when nuclei were sonicated in IEF sample buffer containing no salt,
      even after extensive nucleic acid digestion. Low salt cytosols from both prostate
      and foreskin focused as a single peak of pI: 4.93 +/- 0.31 which remained
      unchanged when KCl was added to the cytosol up to a concentration of 0.6 M. SDS
      polyacrylamide gel electrophoresis of photoaffinity labeled receptors revealed
      labeled proteins with Mw 90-95 kDa. Two-dimensional electrophoresis of
      photoaffinity labeled nuclear receptors, extracted in low or high salt, showed
      that the two isoforms (pI 5.28 and 7.16) contain the same steroid-binding subunit
      with Mw 90-95 kDa. Nuclear receptors from 4 patients with the receptor positive
      form of the Complete Androgen Insensitivity Syndrome (CAIS, Rc+) were analyzed by
      non-denaturing IEF: a single species was observed, focusing at pH 6.0 whether in
      high or low salt conditions. These results indicate that the nuclear androgen
      receptor is an acidic protein with pI 5.28 and Mw 90-95 kDa under maximum protein
      dissociation conditions. When extracted under low salt conditions, it can be
      isolated in a neutral form (pI 7.16) suggesting its association with a nuclear
      protein. Receptors of (CAIS, Rc+) patients have an abnormal charge and show no pI
      shift upon lowering of the salt concentration suggesting that this shift could be
      a significant step in the mechanism of action of androgens.

PMID- 1734936
TI  - Intrinsic estrogenicity of some progestagenic drugs.
AB  - The intrinsic estrogenic activity of some progestins cannot be properly evaluated
      by using hormone responsive systems when the chosen end-points are also sensitive
      to progestagenic activity, usually antagonistic of estrogenic actions. We have
      therefore applied to the evaluation of some drugs commonly used in contraceptive
      and hormone replacement formulations a recently developed in vitro method to
      estimate estrogenic activities, which is based on measurements of the estrogen
      stimulated alkaline phosphatase activity in cells of the Ishikawa-Var I human
      endometrial adenocarcinoma line, a response not influenced by progestins. Whereas
      progesterone, medroxyprogesterone acetate and danazol were found to be devoid of
      estrogenic activity in this assay, Org OD-14, norethynodrel, gestrinone (R 2323),
      norethindrone and dl-norgestrel provoked half maximal increases in alkaline
      phosphatase activity at concentrations (EC-50) of 7, 14, 140, 200 and 2900 nM,
      respectively, under conditions in which the corresponding value for estradiol was
      8 pM. This intrinsic estrogenic activity can be inhibited by antiestrogens, as
      verified by reversing the effect of R 2323 with 4-hydroxytamoxifen. Since
      prostaglandin F2 alpha output by secretory endometrium is increased by estrogens
      and diminished by progestins, this end-point can serve to evaluate the net effect
      of drugs with intrinsic estrogenic and progestagenic activities. For instance, R
      2323 showed estrogenic activity in this assay whereas Org OD-14 did not. The same
      in vitro system can be used to evaluate estrogen antagonistic activities of test
      compounds, using estradiol as the agonist. These in vitro systems are useful in
      establishing a profile of activities of a drug on a relevant human target tissue,
      in the screening of synthetic or natural compounds under investigation, and in
      studies on structure/action relationships.

PMID- 1734937
TI  - Pituitary progestin-metabolizing enzyme activities in the aged female rat.
AB  - Progesterone 5 alpha-reductase activity and 5 alpha-dihydroprogesterone 3 alpha
      hydroxysteroid oxidoreductase (3 alpha-HSOR) enzymic activities (NADH-linked and
      NADPH-linked) were measured in anterior pituitaries (AP) from aged female rats
      during three stages of reproductive senescence (constant estrus: CE; repeated
      pseudopregnancies: PSP; and anestrus: AN). To assess ovarian influence on these
      enzymes during these stages of reproductive aging, we also determined enzyme
      levels from ovariectomized rats from each stage treated with estrogen or vehicle.
      Progesterone 5 alpha-reductase and NADH-linked 3 alpha-HSOR activities were 2
      fold higher in pituitaries of CE rats as compared to those of PSP and AN rats.
      NADPH-linked 3 alpha-HSOR levels did not differ among the three stages. All three
      enzyme levels were elevated 2- to 5-fold as compared to the corresponding enzyme
      levels from young cycling rats. After ovariectomy (10 days), 5 alpha-reductase
      activity in PSP and AN rats was elevated 3- to 4-fold relative to mean levels in
      intact PSP and AN rats. Ovariectomy had no effect on 5 alpha-reductase levels in
      CE rats. Under similar conditions, young cycling rats exhibit a 10-12-fold
      increase. Treatment of ovariectomized PSP and AN rats for 3 days with estradiol
      benzoate (10 micrograms/day) restored 5 alpha-reductase levels. Ovariectomy had
      no effect on the NADPH-linked 3 alpha-HSOR levels in CE, PSP or AN animals which
      is similar to that observed with young rats. Ovariectomy also had no effect on
      the NADH-linked 3 alpha-HSOR levels except for the CE group. The ovariectomized
      CE rats exhibited reduced pituitary NADH-linked 3 alpha-HSOR levels (30%). In
      contrast, young rats exhibit elevated pituitary NADH-linked 3 alpha-HSOR levels
      after ovariectomy (4- to 5-fold). These changes suggest the possibility that
      altered processing of progesterone and its 5 alpha- and 3 alpha-reduced products
      may be one means by which the effectiveness of progesterone is reduced during
      aging. The results also suggest an altered ovarian role in the regulation of
      these enzymes.

PMID- 1734938
TI  - Aromatase inhibition by 7-substituted steroids in human choriocarcinoma cell
      culture.
AB  - Androstenedione analogs containing 7 alpha-substituents have proven to be potent
      inhibitors of aromatase both in vitro and in vivo. Several of these agents have
      exhibited higher affinity for the enzyme complex than the substrate. In order to
      examine further the interaction(s) of 7-substituted steroids with aromatase, 7
      substituted 4,6-androstadiene-3,17-diones were synthesized and demonstrated
      competitive inhibition of aromatase activity in human placental microsomes. 7
      Substituted 1,4,6-androstatriene-3,17-diones demonstrated mechanism-based
      inhibition of placental aromatase activity. These agents were evaluated for
      inhibition of aromatase activity in the JAr human choriocarcinoma line. The 7
      substituted 4,6-androstadiene-3,17-diones produced dose dependent inhibition of
      aromatase activity in the cell cultures, with IC50 values ranging from 490 nM to
      4.5 microM. However, these agents are less effective when compared to other
      steroidal inhibitors, such as 7 alpha-thiosubstituted androstenediones. These
      results on the 7-substituted 4,6-androstadiene-3,17-diones are consistent with
      the data from biochemical enzyme inhibition studies using human placental
      aromatase. On the other hand, 7-phenethyl-1,4,6-androstatriene-3,17-dione
      exhibits greater inhibitory activity, with an IC50 value of 80 nM. Other
      mechanism-based inhibitors, 7 alpha-(4'-amino)phenylthio-1,4-androstadiene-3,17
      dione and 4-hydroxyandrostenedione, also exhibited potent inhibition of aromatase
      activity in JAr cells. In summary, the most effective B-ring modified steroidal
      aromatase inhibitors are those derivatives that can project the 7-aryl
      substituent into the 7 alpha-position.

PMID- 1734939
TI  - A conspicuous down-regulating effect of morphine on essential steroid
      hydroxylation reactions and certain drug N-demethylations.
AB  - This study was conducted to explore the potency of morphine to induce reductions
      of specific cytochrome P450 isoenzyme functions. Male Sprague-Dawley rats were
      treated with escalating doses (20-125 mg/kg per day) of morphine for 2 weeks in
      order to study the effects on the following cytochrome P450 catalyzed reactions:
      16 alpha-hydroxylation of dehydroepienderosterone (DHA) and progesterone; 17
      alpha- and 21-hydroxylation of progesterone; N-demethylation of ethymorphine,
      codeine and morphine as well as O-dealkylation of ethylmorphine and codeine. 16
      alpha-Hydroxylation of DHA and progesterone and 17 alpha-hydroxylation of
      progesterone decreased to 18, 12 and 10% of control activities, respectively. The
      N-demethylation of ethylmorphine and codeine decreased to 34 and 43% of control
      activities, respectively. Morphine treatment had no effect on the 21
      hydroxylation reactions or the O-dealkylation of ethylmorphine or codeine. A
      monoclonal antibody (Mab) against rat liver cytochrome P450 2 c/RLM 5 exerted a
      66-73% inhibition of the N-demethylation of ethylmorphine and codeine,
      respectively, whereas the O-dealkylation reactions were not affected. This Mab
      inhibited the 16 alpha- and 17 alpha-hydroxylation of DHA and progesterone,
      whereas the 21-hydroxylation reactions were unaffected. The steroid hydroxylation
      reactions in rat adrenals were not altered upon morphine treatment. Our data
      suggest that a major part of the 16 alpha- and 17 alpha-steroid hydroxylations
      are catalyzed by the same (or closely related) cytochrome(s) P450 as the opioid N
      demethylation reactions.

PMID- 1734940
TI  - Phospholipases modulate immature pig testicular androgen and 16-androstene
      biosynthetic pathways in vitro.
AB  - The role of membrane phospholipids in porcine testicular androgen and 16
      androstene biosynthesis was examined by monitoring the effects of phospholipase
      treatments on the activities of the steroid transforming enzymes. Untreated
      (control) microsomes from immature pig testes converted pregnenolone to 17
      hydroxypregnenolone and DHA to 5,16-androstadien-3 beta-ol (andien-beta) and 4,16
      androstadien-3-one (dienone) in the 16-androstene pathway, these metabolites
      accounting for most (65%) of the pregnenolone converted. The 4-ene steroids in
      the androgen pathway (progesterone, 17-hydroxyprogesterone, androstenedione and
      testosterone) totalled less than 10% of the pregnenolone metabolites. No
      estrogens or 5 alpha-reduced metabolites were detected. Treatment with
      phospholipase A2 or C, decreased the conversion of pregnenolone to 4-ene-3-oxo
      steroids but did not decrease the quantities of 5-ene-3 beta-hydroxysteroids.
      Confirmation of these findings was obtained by measuring the individual enzymatic
      steps. Phospholipases A2 and C significantly reduced the conversion of DHA to
      androstenedione and andien-beta to dienone but did not affect 17-hydroxylase or
      'andien-beta-synthetase'. However, when the C-17, 20 lyase step was measured
      alone, phospholipase C decreased the quantity of androstenedione produced
      indicating that the side-chain cleavage reaction may involve a lipid component.
      The different effects of phospholipases on these enzymes suggests that
      pregnenolone metabolism may be regulated by alterations in the membrane
      microenvironment.

PMID- 1734941
TI  - Automation in cervical cytology: an overview.
AB  - Cancer of the uterine cervix is one of the more common female cancers and a major
      source of premature female mortality. UK deaths in 1987 exceeded 2000. To reduce
      these rates, national screening programmes have been introduced using the
      Papanicolaou method. In screening for cancer, the examination of specimens is an
      intensive and expensive task. Its high cost has led to a number of attempts to
      automate the process, either fully or partially. Over the last 30 years, various
      experimental prescreening systems have been developed for the diagnosis of
      cytological samples including the use of image processing techniques. This paper
      presents a historical overview of automation in cervical cytology and the status
      of current developments for automated cytological diagnosis.

PMID- 1734942
TI  - An image analysis and statistical evaluation program for the assessment of tumour
      cell invasion in vitro.
AB  - Tumour cell invasion is a complex process, which is essential for the formation
      of metastasis and is therefore of critical clinical importance. For detailed
      investigations of the invasive process, quantifiable in vitro models of invasion
      are necessary. In this study we describe an image analysis procedure and a
      statistical program which facilitate an objective analysis of experiments carried
      out using the embryonic chick heart invasion model of Mareel. Tumour
      multicellular spheroids are confronted with embryonic chick heart fragments in
      culture and are sampled after different time intervals for up to 7 days.
      Immunohistological sections are then evaluated by an image analysis procedure
      which provides 9 parameters indicating invasion, proliferation and destruction
      taking place in the confrontation cultures. The data obtained by image analysis
      are further evaluated by a statistical program which describes the change with
      time of each parameter by means of linear regression analysis. Thus the data
      obtained at various time intervals serve as the source data for a single
      statistic, namely the slope of the regression line. Confidence intervals and
      statistical differences between various experiments can be calculated. In order
      to make the procedure more comprehensible in biological terms, the program
      provides a full text interpretation of the experimental results. The image
      analysis procedure in conjunction with statistical evaluation and text
      interpretation provides a comprehensive tool for the quantitative assessment of
      experimental invasion in vitro.

PMID- 1734943
TI  - Characterization of a human renal cell carcinoma specific cytotoxic CD8+ T cell
      line.
AB  - Human renal cell carcinoma (RCC) is one of the tumors most sensitive to
      immunotherapy and in that regard it is similar to malignant melanoma. Clinical
      studies reporting responses to therapy suggested that a host immune response may
      be involved in the antitumor activity induced by immunotherapy in these tumors.
      Although detection of a specific T cell response to melanoma has been well
      documented, this has not been the case for RCC. The lytic response of interleukin
      2 (IL-2) cultured tumor-infiltrating lymphocytes (TILs) from RCC has been
      nonspecific. However, in this report we describe a CD8+ TIL line derived from a
      primary RCC tumor that displays specificity for the autologous tumor. This line
      is lytic for autologous RCC but does not lyse autologous lymphoblasts, allogeneic
      RCC, or tumor cell lines of other histologic types. It also proliferates
      specifically to the autologous tumor in the absence of exogenous IL-2. However,
      the addition of low dose IL-2 to the cultures can significantly augment its
      proliferative response. When stimulated with autologous RCC but not allogeneic
      RCC the CD8+ line will produce interferon-gamma (IFN-gamma). It appears that
      recognition of RCC by this TIL line is through the TCR/CD3 complex because anti
      CD3 antibody blocks the lytic activity, proliferation and IFN-gamma production of
      the line in response to the autologous tumor. Additional studies illustrate that
      cytotoxic T lymphocytes with apparent specificity for the autologous tumor are
      present in unseparated cultured TILs that can be detected by clonal analysis.
      Collectively these results suggest that there is a specific T cell response to
      human RCC.

PMID- 1734944
TI  - Combined antitumor therapy with the chemotherapeutic drug doxorubicin and an anti
      transferrin receptor immunotoxin: in vitro and in vivo studies.
AB  - We have determined the in vitro and in vivo efficacy of the combination of
      doxorubicin and an anti-transferrin receptor-monoclonal antibody (MAb)-ricin A
      chain immunotoxin. These agents both possess antineoplastic activity and their
      differing mechanisms of action and toxicities suggest that they may work well in
      combination. In vitro cytotoxicity was assayed by the inhibition of both 3H
      leucine and 3H-thymidine incorporation into H-MESO-1 human malignant mesothelioma
      cells. In vivo, tumoricidal activity was determined by the effect of treatment on
      the survival of nude mice bearing H-MESO-1 as an intraperitoneal xenograft. The
      effect of doxorubicin on the antitumor activity of immunotoxin was directly
      compared to that of monensin, a well-described immunotoxin potentiator. The
      coincubation of doxorubicin (1 microM) with immunotoxin in vitro produced no
      increase in cytotoxicity or rate of cell kill when compared to immunotoxin alone.
      The addition of monensin to immunotoxin produced a significant increase in both
      cytotoxicity and the rate of cell kill. In animal trials, all treated groups
      demonstrated a significant increase in median survival when compared to controls.
      Treatment with doxorubicin or immunotoxin produced a mean survival time (MST) of
      22 and 23 days, respectively, vs. control MST of 10 days. The combination of
      immunotoxin and doxorubicin increased the MST to 31 days (p = 0.004 vs
      immunotoxin or doxorubicin alone). Immunotoxin combined with monensin emulsion
      produced an increase in survival equivalent to doxorubicin/immunotoxin. The use
      of all three agents produced an additional improvement in survival. Combinations
      of standard chemotherapeutic drugs and ricin A chain immunotoxins may have
      additive antitumor effects in the therapy of solid tumors.

PMID- 1734945
TI  - The persistence of human peripheral lymphocytes, tumor infiltrating lymphocytes,
      and colon adenocarcinomas in immunodeficient mice.
AB  - The reconstitution of severely immunodeficient mice with human peripheral blood
      mononuclear cells (PBMCs) may represent a unique model system to evaluate human
      antitumor responses. To evaluate this possibility, we studied human PBMC
      reconstitution, human tumor infiltrating lymphocyte (TIL) persistence, and human
      colon adenocarcinoma propagation in beige/nude/xid (BNX) and in severe combined
      immunodeficient (SCID) mice. To evaluate human PBMC reconstitution, 75 mice
      received 1 x 10(7)-1 x 10(9) human PBMCs i.p. or i.v. and were studied at
      intervals ranging from 1 to 8 weeks by fluorescence-activated cell sorting (FACS)
      analysis and by measurement of circulating human immunoglobulin levels. By FACS
      analyses, only one of 75 mice had evidence of human PBMC persistence at 2 weeks
      in the spleen. Moreover, liver and peritoneum showed evidence of human cells in
      only 13 of 56 and 16 of 55 mice, respectively. In these mice, human cells
      comprised 1-77% of total cells recovered. Human immunoglobulin levels in mouse
      serum ranged from 0 to 34,000 micrograms/ml and correlated only weakly with
      evidence of human PBMC reconstitution in peripheral organs, but were generally
      higher in SCID mice than in BNX mice. Human TIL persistence was evaluated in BNX
      and SCID mice that were given 3 x 10(7) TILs i.v. (in divided doses) or 1 x 10(8)
      i.p. TILs along with interleukin-2 administration. At 1, 2, 7, and 14 days
      following TIL delivery, evidence of human TIL persistence in liver, lung,
      peritoneum, and spleen was evaluated by FACS analysis. Fresh organ suspensions
      did not contain human TILs. In mice given cyclophosphamide followed by human TILs
      i.p., the TILs were demonstrated at 7 days in the SCID peritoneum (leu 4 = 4%)
      and at 2 days in the SCID spleen (leu 4 = 2%). In BNX mice, 12 of 14 fresh human
      colon adenocarcinomas were propagated successfully at subcutaneous sites with
      latency periods ranging from 1 to 13 weeks. Enzymatic disaggregation of tumors
      greater than 1 cm following one passage yielded 6.5-47 x 10(6) cells with
      viabilities ranging from 13 to 85%. We conclude that limitations and variability
      exist in the use of BNX and SCID mice for human PBMC reconstitution, TIL
      persistence, and propagation of human colon adenocarcinomas.

PMID- 1734946
TI  - Influence of estradiol and tamoxifen on susceptibility of human breast cancer
      cell lines to lysis by lymphokine-activated killer cells.
AB  - The design of combination hormonal and immunotherapeutic protocols for breast
      cancer patients may be facilitated by analysis of preclinical in vitro model
      systems. Estrogen receptor positive (ER+: MCF-7) and negative (ER-: MDA-MB-231)
      human breast cancer cell lines were utilized to evaluate the effects of tamoxifen
      (TAM) and estradiol (E2) on modulation of breast cancer target susceptibility to
      lysis by lymphokine-activated killer (LAK) cells. E2-stimulated ER+ cells were
      more susceptible to lysis by LAK cells than corresponding TAM-treated or control
      cells, while treatment of ER- cells with either E2 or TAM alone did not alter
      from control their susceptibility to this immune-mediated lysis. All ER+ and ER-
      cells tested remained sensitive after treatment with TAM to lysis by LAK cells.
      In addition, an adenocarcinoma reactive human-mouse chimeric monoclonal antibody
      (ING-1) was able to significantly boost in vivo generated LAK cell-mediated lysis
      of control, E2-treated, and TAM-treated ER+ and ER- cells. These in vitro results
      provide a preclinical rationale for in vivo testing of TAM, interleukin-2 (IL-2),
      and breast cancer reactive antibody-dependent cellular cytotoxicity facilitating
      antibody in patients with refractory or high risk breast cancer.

PMID- 1734947
TI  - Cytokine and natural killing regulation of growth of a hairy cell leukemia-like
      cell line: the role of interferon-alpha and interleukin-2.
AB  - Hairy cell leukemia (HCL) is a lymphoproliferative disorder of B-lymphocytes,
      with pathological manifestations usually including splenomegaly and pancytopenia.
      Naturally occurring and recombinant interferons (IFNs), specifically of the alpha
      subtype, have shown a significant anti-tumor effect in HCL patients, with
      improvement of hematologic parameters within the first few months of treatment.
      The mechanisms responsible for the beneficial action of IFN-alpha in HCL patients
      are unclear, but several hypotheses have been suggested. Recently, a continuous
      line of cells (Eskol) from a patient diagnosed with hairy cell leukemia was
      established and shown to have several properties of a leukemic hairy cell. In the
      present study, we investigated the direct effect of IFN-alpha and interleukin (IL
      2) on the Eskol cell line, and lymphokine regulation of natural killing (NK)
      activity against these cells. It was found that IFN-alpha has a direct
      antiproliferative effect on Eskol cells. Furthermore, Eskol cells were found to
      be completely resistant to NK-cell mediated cytotoxicity (CMC) but were somewhat
      sensitive to either IFN-alpha-primed NK or lymphokine-activated killer (LAK)
      cells-CMC. The resistance of Eskol cells to NK-CMC is due to a low binding
      ability to effector cells. Moreover, it was found that like IFN, IL-2 can protect
      Eskol cells from activated NK-CMC. Both cytokines reduced the ability of Eskol
      cells to induce NK-cytotoxic factor (NKCF) release from NK cells following
      conjugate formation between Eskol cells and effector cells. Moreover,
      cycloheximide treatment abolished the protective effect against NK-CMC induced by
      IFN-alpha or by IL-2. Therefore, it seems that the protective effect against NK
      CMC induced by both cytokines is mediated via the same mechanism.

PMID- 1734948
TI  - Phase I trial of interleukin-2 plus gamma-interferon.
AB  - Interleukin-2 (IL-2) and gamma interferon (gamma-IFN) may be synergistic in
      inducing cell-mediated antitumor cytotoxicity. In order to determine the dose
      limiting toxicities and define a maximum tolerated dose of these two agents in
      combination, we performed a Phase I clinical trial of intravenous IL-2 plus
      intramuscular gamma-IFN. Patients received both agents on a thrice-weekly
      schedule consisting of 4 weeks of treatment followed by 2 weeks of rest. Twenty
      five patients were treated and received gamma-IFN doses between 0.05-0.25 mg/m2
      (1-4 x 10(6) U/m2) with IL-2 doses from 0.33 mg/m2 to 2.33 mg/m2 (6-42 x 10(6)
      IU/m2). Two patients had partial responses of melanoma and adenocarcinoma of the
      lung lasting greater than 11 and 8 months, respectively. The toxicities of the
      combination were those expected from each agent, with no unusual effects, no
      irreversible organ toxicities, and no patient deaths. The doses recommended for
      outpatient administration on this schedule are IL-2, 2.0 mg/m2 plus gamma-IFN,
      0.25 mg/m2, a dose combination that is unassociated with significant organ
      toxicity.

PMID- 1734949
TI  - Human antibody response to the intravenous and intraperitoneal administration of
      the F(ab')2 fragment of the OC125 murine monoclonal antibody.
AB  - We have characterized the human immune response against murine monoclonal
      antibodies (HAMA) in 18 patients following administration of the F(ab')2 fragment
      of the murine monoclonal antibody OC125. OC125 is directed against the CA125
      antigen, present on the surface of many human ovarian cancers. An affinity matrix
      was used to separate serum into immunoglobulin-containing and immunoglobulin-free
      fractions. HAMA titer was determined on the immunoglobulin fraction with an OC125
      sandwich enzyme-linked immunosorbent assay (ELISA). All patients developed an
      HAMA response, despite the use of F(ab')2 fragments and small amounts (1-4 mg) of
      antibody. It may be that the intraperitoneal (i.p.) route provides a more marked
      HAMA response. Enzyme-linked sandwich immunoassays were also used to determine
      anti-isotype and anti-idiotype titers. Anti-isotype titers were analyzed with
      antigen irrelevant, isotype-matched murine antibodies and OC125-HRPO. Anti
      idiotypes titers were assessed in a sandwich assay that utilized F(ab')2 and
      F(ab') fragments of OC125. The anti-isotype response tended to be of low titer
      and short duration, while the anti-idiotype response was of high titer and
      remarkably persistent. HAMA interfered in an unpredictable manner with the
      correct measurement of serum levels of CA125 in an enzyme immunoassay using
      OC125. Corrected values of CA125 could be obtained by measurement of antigen in
      the immunoglobulin-free fraction of serum. The response of one patient, who
      developed a markedly elevated anti-idiotype titer after serial i.v./i.p.
      injections, was further characterized and found to contain an antibody consistent
      with an anti-anti-idiotype to the CA125 antigen.

PMID- 1734950
TI  - A phase II study of recombinant tumor necrosis factor in renal cell carcinoma: a
      study of the National Cancer Institute of Canada Clinical Trials Group.
AB  - The National Cancer Institute (NCI) Canada Clinical Trials Group conducted a
      phase II study of recombinant tumor necrosis factor (rTNF) given intravenously
      daily for 5 days every other week, in measurable metastatic renal cell carcinoma.
      Two of 26 patients responded with responses lasting greater than 200 days.
      Toxicity was severe including rigors, fever, headache, fatigue, hypotension, and
      localized pain. We conclude that rTNF, given as described, has only modest
      antitumor activity in renal cell carcinoma and produces considerable toxicity. We
      plan no further studies of rTNF in this disease.

PMID- 1734951
TI  - Hypoprothrombinemia associated with interleukin-2 therapy: correction with
      vitamin K.
AB  - We noted that patients treated with high-dose interleukin (IL)-2 (600,000 IU/kg
      every 8 h by intravenous bolus) at our institution frequently developed
      prolongation of their prothrombin time (PT). We therefore performed a prospective
      study of coagulation function during IL-2 treatment. Since IL-2 treated
      individuals are known to develop cholestatic liver dysfunction, we hypothesized
      that the hypoprothrombinemia was due to deficiency of liver-synthesized clotting
      factors and could be prevented by vitamin K replacement. Alternating patients
      served as controls or received prophylactic subcutaneous subcutaneous vitamin K.
      While the nine control patients did not exhibit a significant increase (mean +/-
      SD) in PT (13.6 +/- 0.6 s pretreatment, 15.0 +/- 2.2 on day 4, and 15.0 +/- 2.5
      on day 7, p = 0.77 by repeated measures analysis), three patients developed
      marked increases in PT (greater than 18 s). Changes in partial thromboplastin
      time (PTT) over this interval were also not statistically significant. Factor VII
      levels decreased in all patients from 106 +/- 22 to 59 +/- 16 and 52 +/- 26% on
      days 4 and 7 (p = 0.0002). Factor VII levels in four patients dropped below the
      lower limit of normal. Prophylactic treatment of seven patients with vitamin K on
      days 1-8 of the IL-2 therapy protocol resulted in diminished changes in PT and
      factor VII compared to control patients (p = 0.02 and 0.003 respectively). No
      vitamin K-treated patient developed PT or Factor VII levels significantly outside
      the normal range. Prophylactic vitamin K can prevent hypoprothrombinemia in
      patients treated with IL-2. This may be of importance in patients with decreased
      hepatic vitamin K stores, who may be at risk for bleeding complications.

PMID- 1734952
TI  - Three-dimensional solution structure of Ca(2+)-loaded porcine calbindin D9k
      determined by nuclear magnetic resonance spectroscopy.
AB  - The three-dimensional solution structure of native, intact porcine calbindin D9k
      has been determined by distance geometry and restrained molecular dynamics
      calculations using distance and dihedral angle constraints obtained from 1H NMR
      spectroscopy. The protein has a well-defined global fold consisting of four
      helices oriented in a pairwise antiparallel manner such that two pairs of helix
      loop-helix motifs (EF-hands) are joined by a linker segment. The two EF-hands are
      further coupled through a short beta-type interaction between the two Ca(2+)
      binding loops. Overall, the structure is very similar to that of the highly
      homologous native, minor A form of bovine calbindin D9k determined by X-ray
      crystallography [Szebenyi, D. M. E., & Moffat, K. (1986) J. Biol. Chem. 261, 8761
      8776]. A model structure built from the bovine calbindin D9k crystal structure
      shows several deviations larger than 2 A from the experimental distance
      constraints for the porcine protein. These structural differences are efficiently
      removed by subjecting the model structure to the experimental distance and
      dihedral angle constraints in a restrained molecular dynamics protocol, thereby
      generating a model that is very similar to the refined distance geometry derived
      structures. The N-terminal residues of the intact protein that are absent in the
      minor A form appear to be highly flexible and do not influence the structure of
      other regions of the protein. This result is important because it validates the
      conclusions drawn from the wide range of studies that have been carried out on
      minor A forms rather than the intact calbindin D9k.

PMID- 1734953
TI  - Sequential 1H NMR assignments of kistrin, a potent platelet aggregation inhibitor
      and glycoprotein IIb-IIIa antagonist.
AB  - Sequence-specific nuclear magnetic resonances assignments have been obtained for
      the protons of kistrin. Kistrin is a small naturally occurring snake venom
      protein that inhibits platelet aggregation by blocking the interaction of
      fibrinogen with the membrane-bound glycoprotein IIb-IIIa (GP IIb-IIIa), a
      receptor from the integrin family. Kistrin has an Arg-Gly-Asp sequence which is
      believed to form an adhesion recognition sequence that is essential for activity.
      Therefore, the interaction between kistrin and GP IIb-IIIa may provide important
      information on the motif used by integrins to recognize their target proteins
      which bear RGD sequences. Kistrin consists of 68 residues and contains six
      intramolecular disulfide bonds. Although one-third of the amide protons are
      protected from exchange with the solvent, there appears to be little or no
      regular secondary structure. The large number of NOE's between residues separated
      by two and three positions in the sequence indicates that the protein contains a
      large number of tightly packed loops. Along with the sequential assignments, this
      paper also discusses the construction and use of computerized data bases for
      manipulating NMR results. A strategy for computer-assisted sequential resonance
      using these data bases is also presented.

PMID- 1734954
TI  - Site-specific binding constants for actinomycin D on DNA determined from
      footprinting studies.
AB  - We report site-specific binding constants for the intercalating anticancer drug
      actinomycin D (Act-D), binding to a 139-base-pair restriction fragment from pBR
      322 DNA. The binding constants are derived from analysis of footprinting
      experiments, in which the radiolabeled 139-mer is cleaved using DNase I, the
      cleavage products undergo gel electrophoresis, and, from the gel autoradiogram,
      spot intensities, proportional to amounts of cleaved fragments, are measured. A
      bound drug prevents DNase I from cleaving at approximately 7 bonds, leading to
      decreased amounts of corresponding fragments. With the radiolabel on the 3' end
      of the noncoding strand (A-label), we measured relative amounts of 54 cleavage
      products at 25 Act-D concentrations. For cleavage of the 139-mer with the label
      on the 3' end of the coding strand (G-label), relative amounts of 43 cleavage
      products at 11 Act-D concentrations were measured. These measurements give
      information about approximately 120 base pairs of the restriction fragment
      (approximately 12 turns of the DNA helix); in this region, 14 strong and weak Act
      D binding sites were identified. The model used to interpret the footprinting
      plots is derived in detail. Binding constants for 14 sites on the fragment are
      obtained simultaneously. It is important to take into account the effect of drug
      binding at its various sites on the local concentration of probe elsewhere. It is
      also necessary to include in the model weak as well as strong Act-D sites on the
      carrier DNA which is present, since the carrier DNA controls the free-drug
      concentration. As expected, the strongest sites are those with the sequence (all
      sequences are 5'----3') GC, with TGCT having the highest binding constant, 6.4 x
      10(6) M-1. Sites having the sequence GC preceded by G are weak binding sites,
      having binding constants approximately 1 order of magnitude lower than those of
      the strong sites. Also, the non-GC-containing sequences CCG and CCC bind Act-D
      with a binding constant comparable to those of the weak GGC sites. The analysis
      may reveal drug-induced structural changes on the DNA, which are discussed in
      terms of the mechanism of Act-D binding.

PMID- 1734955
TI  - Structural changes and enhancements in DNase I footprinting experiments.
AB  - In footprinting experiments, an increase in DNA cleavage with addition of ligand
      to a system may be due to a ligand-induced structural change. Ligand binding also
      enhances cleavage by displacing the cleavage agent from ligand-binding sites,
      thus increasing its concentration elsewhere. The theory and characteristics of
      this mass-action enhancement are given, and it is shown how it may be recognized.
      Results of DNase I footprinting of small oligomers, with actinomycin D as ligand,
      are analyzed to reveal which enhancements are due to mass action, and which can
      reasonably be ascribed to structural changes. Patterns in the footprinting plots
      from our experiments on actinomycin D binding to a 139-base-pair DNA fragment
      (with DNase I as a probe) are studied in the same way. The likely origins of
      these patterns are discussed, as are enhancements occurring with other probes
      commonly used in footprinting experiments.

PMID- 1734956
TI  - Apolipoprotein E: phospholipid binding studies with synthetic peptides from the
      carboxyl terminus.
AB  - We have previously shown that the synthetic peptide apoE(129-169) forms lipid
      peptide complexes with dimyristoylphosphatidylcholine (DMPC) with an L:P molar
      ratio of 125:1; the peptide in the isolated complex contains approximately 56%
      alpha-helicity. These results verify the presence of an amphipathic alpha-helix
      in this region of apoE as predicted by Chou-Fasman analysis and hydrophobicity
      calculations. To further define the lipid binding regions of apoE, we have
      synthesized four peptides, apoE(211-243), -(202-243), -(267-286), and -(263-286),
      from the carboxyl terminus of apoE and studied their lipid binding properties;
      apoE(202-243) contains two potential amphipathic helices. Although all four
      peptides formed alpha-helices in the helix-forming solvent 30%
      hexafluoropropanol, we found that only apoE(263-286) formed a stable complex with
      DMPC. The peptide contained approximately 80% alpha-helicity, and its Trp
      fluorescence spectrum was blue-shifted by 20 nm in the complex which had an L:P
      ratio of 163:1. We conclude that this sequence is a newly identified lipid
      binding region of apoE and that the amphipathic helices 203-221 and 226-243 are
      too hydrophilic to bind phospholipid.

PMID- 1734957
TI  - Kinetics of the lamellar-inverse hexagonal phase transition determined by time
      resolved X-ray diffraction.
AB  - The kinetics of the lamellar (L alpha)-inverse hexagonal (HII) phase transition
      in diacylphosphatidylethanolamine (PE)--water systems were probed with time
      resolved X-ray diffraction. Transition kinetics in the fast time regime
      (approximately 100 ms) were studied by initiating large temperature jumps (up to
      30 degrees C) with a 50-ms electrical current pulse passed through a lipid-salt
      water dispersion, resulting in ohmic heating of the sample. Diffraction with a
      time resolution to 10 ms was acquired at the National Synchrotron Light Source.
      The time constant for the phase transition for 1,2-dioleoyl-sn-glycero-3
      phosphoethanolamine (DOPE) was on the order of 100 ms for the largest temperature
      jumps recorded. Faster transition behavior was found for a 1,2-dielaidoyl-sn
      glycero-3-PE mixture. The HII lattice parameters for both systems were seen to
      swell from an initial value commensurate with the lamellar lattice to the final
      equilibrium value. The rate of swelling was seen to be independent of the
      magnitude of the temperature jump. For small temperature jumps (less than 10
      degrees C), the phase transition kinetics slow dramatically, and transition
      studies can readily be performed on a conventional rotating anode X-ray source.
      At 4 degrees C, a DOPE sample was observed to slowly convert to the hexagonal
      phase over the course of a week, with the decay in the lamellar intensity fitting
      a power law behavior over four decades of time. This power law behavior is shown
      to have interesting consequences to the determination of the phase transition
      temperature of lipid-water dispersions by conventional methods such as
      calorimetry.

PMID- 1734958
TI  - Investigation of anion binding to neutral lipid membranes using 2H NMR.
AB  - The binding of aqueous anions (ClO4-, SCN-, I-, and NO3-) to lipid bilayer
      membranes composed of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) was
      investigated using deuterium (2H) and phosphorus-31 (31P) nuclear magnetic
      resonance (NMR) spectroscopy. The ability of these anions to influence the 2H NMR
      quadrupole splittings of POPC, specifically labeled at the alpha or beta position
      of the choline head group, increased in the order NO3- much less than I- less
      than SCN- less than ClO4-. In the presence of these chaotropic anions, the
      quadrupole splitting increased for alpha-deuterated POPC and decreased for beta
      deuterated POPC, indicating a progressive accumulation of negative charge at the
      membrane surface. Calibration of the 2H NMR quadrupole splittings with the amount
      of membrane-bound anion permitted binding isotherms to be generated for
      perchlorate, thiocyanate, and iodide, up to concentrations of 100 mM. The binding
      isotherms were analyzed by considering electrostatic contributions, according to
      the Gouy-Chapman theory, as well as chemical equilibrium contributions. For
      neutral POPC membranes, we obtained ion association constants of 32, 80, and 115
      M-1 for iodide, thiocyanate, and perchlorate, respectively. These values increase
      in the order expected for a Hofmeister series of anions. We conclude that the
      factor determining whether a particular anion will bind to lipid bilayers is the
      ease with which that anion loses its hydration shell.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1734959
TI  - Deuteron nuclear magnetic resonance study of the dynamic organization of
      phospholipid/cholesterol bilayer membranes: molecular properties and viscoelastic
      behavior.
AB  - The influence of cholesterol on the dynamic organization of 1,2-dimyristoyl-sn
      glycero-3-phosphocholine (DMPC) bilayers was studied by deuteron nuclear magnetic
      resonance (2H NMR) using unoriented and macroscopically aligned samples. Analysis
      of the various temperature- and orientation-dependent experiments were performed
      using a comprehensive NMR model based on the stochastic Liouville equation.
      Computer simulations of the relaxation data obtained from phospholipids
      deuterated at the 6-, 13- and 14-position of the sn-2 chain and cholesterol
      labeled at the 3 alpha-position of the rigid steroid ring system allowed the
      unambiguous assignment of the various motional modes and types of molecular order
      present in the system. Above the phospholipid gel-to-liquid-crystalline phase
      transition, TM, 40 mol % cholesterol was found to significantly increase the
      orientational and conformational order of the phospholipid with substantially
      increased trans populations even at the terminal sn-2 acyl chain segments.
      Lowering the temperature continuously increases both inter- and intramolecular
      ordering, yet indicates less ordered chains than found for the pure phospholipid
      in its paracrystalline gel phase. Trans-gauche isomerization rates on all
      phospholipid alkyl chain segments are slowed down by incorporated cholesterol to
      values characteristic of gel-state lipid. However, intermolecular dynamics remain
      fast on the NMR time scale up to 30 K below TM, with rotational correlation times
      tau R parallel for DMPC ranging from 10 to 100 ns and an activation energy of ER
      = 35 kJ/mol. Below 273 K a continuous noncooperative condensation of both
      phospholipid and cholesterol is observed in the mixed membranes, and at about 253
      K only a motionally restricted component is left, exhibiting slow fluctuations
      with correlation times of tau R perpendicular greater than 1 microsecond. In the
      high-temperature region (T greater than TM), order director fluctuations are
      found to constitute the dominant transverse relaxation process. Analysis of these
      collective lipid motions provides the viscoelastic parameters of the membranes.
      The results (T = 318 K) show that cholesterol significantly reduces the density
      of the cooperative motions by increasing the average elastic constant of the
      membrane from K = 1 x 10(-11) N for the pure phospholipid bilayers to K = 3.5 x
      10(-11) N for the mixed system.

PMID- 1734960
TI  - Importance of phosphatidylethanolamine for association of protein kinase C and
      other cytoplasmic proteins with membranes.
AB  - Biological membranes exhibit an asymmetric distribution of phospholipids.
      Phosphatidylserine (PS) is an acidic phospholipid that is found almost entirely
      on the interior of the cell where it is important for interaction with many
      cellular components. A less well understood phenomenon is the asymmetry of the
      neutral phospholipids, where phosphatidylcholine (PC) is located primarily on
      exterior membranes while phosphatidylethanolamine (PE) is located primarily on
      interior membranes. The effect of these neutral phospholipids on protein
      phospholipid associations was examined using four cytoplasmic proteins that bind
      to membranes in a calcium-dependent manner. With membranes containing PS at a
      charge density characteristic of cytosolic membranes, protein kinase C and three
      other proteins with molecular masses of 64, 32, and 22 kDa all showed great
      selectively for membranes containing PE rather than PC as the neutral
      phospholipid; the calcium requirements for membrane-protein association of the 64
      and 32-kDa proteins were about 10-fold lower with membranes containing PE;
      binding of the 22-kDa protein to membranes required the presence of PE and could
      not even be detected with membranes containing PC. Variation of the PS/PE ratio
      showed that membranes containing about 20% PS/60% PE provided optimum conditions
      for binding and were as effective as membranes composed of 100% PS. Thus, PE, as
      a phospholipid matrix, eliminated the need for membranes with high charge density
      and/or reduced the calcium concentrations needed for protein-membrane
      association. A surprising result was that PKC and the 64- and 32-kDa proteins
      were capable of binding to neutral membranes composed entirely of PE/PC or PC
      only. The different phospholipid headgroups altered only the calcium required for
      membrane-protein association. For example, calcium concentrations at the midpoint
      for association of the 64-kDa protein with membranes containing PS, PE/PC, or PC
      occurred at 6, 100, and 20,000 microM, respectively. Thus, biological probes
      detected major differences in the surface properties of membranes containing PE
      versus PC, despite the fact that both of these neutral phospholipids are often
      thought to provide "inert" matrices for the acidic phospholipids. The selectivity
      for membranes containing PE could be a general phenomenon that is applicable to
      many cytoplasmic proteins. The present study suggested that the strategic
      location of PE on the interior of the membranes may be necessary to allow some
      membrane-protein associations to occur at physiological levels of calcium and PS.

PMID- 1734961
TI  - Isolation and characterization of a stable activation intermediate of the
      lysosomal aspartyl protease cathepsin D.
AB  - Procathepsin D is the intracellular aspartyl protease precursor of cathepsin D, a
      major lysosomal enzyme. Procathepsin D is rapidly processed inside the cell, and,
      thus, examination of its proteolyic activation and structure has been difficult.
      To study this proenzyme, a nonglycosylated form of the human fibroblast
      procathepsin D was expressed in Escherichia coli, refold in vitro, and purified
      by affinity chromatography on pepstatinyl agarose. Sequence analysis of the
      refolded, autoactivated enzyme allowed determination of the autoproteolytic
      cleavage site. The sequence surrounding this cleavage site between residues
      LeuP26 and IleP27 (in the "pro" region) resembled the first cleavage site found
      during activation of other aspartyl proteases. Thus, the autoactivated
      procathepsin D is analogous to the pepsin activation intermediate, which has been
      termed pseudopepsin. The enzymatic activity, thermal and pH stability, and
      fluorescence spectra of pseudocathepsin D were compared to mature, predominantly
      two-chain, cathepsin D isolated from human placenta. The results indicated that
      pseudocathepsin D and mature enzyme have a similar Km toward a peptide substrate
      and cleave a protein substrate at identical sites. Temperature stability of the
      recombinant enzyme was similar to that of the tissue-derived enzyme. However, the
      recombinant enzyme had increased stability at low pH when compared to the
      glycosylated tissue-derived two-chain cathepsin D. Fluorescence spectra of the
      recombinant and tissue-derived enzymes were identical. Thus, the absence of
      asparagine-linked oligosaccharides and the presence of the remaining segment of
      propeptide did not significantly alter the structural and enzymatic properties of
      the enzyme.

PMID- 1734962
TI  - Identification of two cysteine residues forming a pair of vicinal thiols in
      glucosamine-6-phosphate deaminase from Escherichia coli and a study of their
      functional role by site-directed mutagenesis.
AB  - The nucleotide sequence of the nagB gene in Escherichia coli, encoding
      glucosamine-6-phosphate deaminase, located four cysteinyl residues at positions
      118, 219, 228, and 239. Chemical modification studies performed with the purified
      enzyme had shown that the sulfhydryl groups of two of these residues form a
      vicinal pair in the enzyme and are easily modified by thiol reagents. The
      allosteric transition to the more active conformer (R), produced by the binding
      of homotropic (D-glucosamine 6-phosphate or 2-deoxy-2-amino-D-glucitol 6
      phosphate) or heterotropic (N-acetyl-D-glucosamine 6-phosphate) ligands,
      completely protected these thiols against chemical modification. Selective
      cyanylation of the vicinal thiols with 2-nitro-5-(thiocyanato)benzoate, followed
      by alkaline hydrolysis to produce chain cleavage at the modified cysteines, gave
      a pattern of polypeptides which allowed us to identify Cys118 and Cys239 as the
      residues forming the thiol pair. Subsequently, three mutated forms of the gene
      were constructed by oligonucleotide-directed mutagenesis, in which one or both of
      the cysteine codons were changed to serine. The mutant proteins were
      overexpressed and purified, and their kinetics were studied. The dithiol formed
      by Cys118 and Cys239 was necessary for maximum catalytic activity. The single
      replacements and the double mutation affected catalytic efficiency in a similar
      way, which was also identical to the effect of the chemical block of the thiol
      pair. However, only one of these cysteinyl residues, Cys239, had a significant
      role in the allosteric transition, and its substitution for serine reduced the
      allosteric interaction energy, due to a lower value of KT.

PMID- 1734963
TI  - X-ray absorption fine structure study of the active site of zinc and cobalt
      carboxypeptidase A in their solution and crystalline forms.
AB  - A comparative study on the metal environment of Zn(II)-carboxypeptidase A (ZnCPD)
      and Co(II)-carboxypeptidase A (CoCPD) in their solution and crystalline forms
      using the X-ray absorption fine structure (XAFS) technique has been conducted.
      The first coordination sphere of Zn for ZnCPD in its solution state is found to
      consist of two distributions of atoms, with four atoms (N or O) located at an
      average distance of 2.03 +/- 0.01 A and one atom (N or O) located at 2.57 +/-
      0.04 A. The four-atom distribution remains the same for ZnCPD in its crystalline
      state, but the fifth atom is found at 2.36 +/- 0.04 A. Examination of the higher
      coordination shell, between 2.7 and 4.2 A, reveals the presence of two
      imidazoles. Combined with X-ray crystallographic results, a structural model is
      proposed. The four atoms at an average distance of 2.03 A are assigned to the two
      delta 1 nitrogens of His-69 and His-196, one epsilon 1 oxygen of Glu-72, and the
      oxygen of a coordinated water molecule. The atom at 2.57 A for ZnCPD in solution
      is assigned to the epsilon 2 oxygen of Glu-72. The results for CoCPD in solution
      are similar with the four atoms at an average distance of 2.08 +/- 0.01 A and one
      atom at 2.50 +/- 0.04 A, which moves to 2.34 +/- 0.04 A in the crystalline
      enzyme. The intensity of the 3d "pip" peak for CoCPD is consistent with a
      distorted tetragonal metal geometry for the solution form of the enzyme which is
      converted to a more pentacoordinated metal site for the crystalline enzyme. The
      first shell distribution of crystalline CoCPD is quite disordered, which may be
      largely due to the disorder of His-69 and His-196 as indicated by higher shell
      analysis. Thus, the XAFS studies show that the metal coordination spheres in the
      zinc and cobalt enzymes are quite similar in the solution state but differ from
      their crystalline counterparts. The XAFS studies provide the necessary background
      for measurement of substrate- and inhibitor-promoted structural changes in the
      metal coordination sphere of the zinc and other metal-substituted
      carboxypeptidases in the solution state.

PMID- 1734964
TI  - pH dependence of the interaction of hirudin with thrombin.
AB  - The kinetics of the inhibition of human alpha-thrombin by recombinant hirudin
      have been studied over the pH range from 6 to 10. The association rate constant
      for hirudin did not vary significantly over this pH range. The dissociation
      constant of hirudin depended on the ionization state of groups with pKa values of
      about 7.1, 8.4, and 9.2. Optimal binding of hirudin to thrombin occurred when the
      groups with pKa values of 8.4 and 9.0 were protonated and the other group with a
      pKa of 7.1 was deprotonated. The pH kinetics of genetically engineered forms of
      hirudin were examined in an attempt to assign these pKa values to particular
      groups. By using this approach, it was possible to show that protonation His51
      and ionization of acidic residues in the C-terminal region of hirudin were not
      responsible for the observed pKa values. In contrast, the pKa value of 8.4 was
      not observed when a form of hirudin with an acetylated alpha-amino group was
      examined, and, thus, this pKa value was assigned to the alpha-amino group of
      hirudin. The requirement for this group to be protonated for optimal binding to
      thrombin is discussed in terms of the crystal structure of the thrombin-hirudin
      complex. Examination of this structure allowed the other pKa values of 7.1 and
      9.2 to be tentatively attributed to His57 and the alpha-amino group of Ile16 of
      thrombin.

PMID- 1734965
TI  - Expression and mutagenesis of thrombospondin.
AB  - Thrombospondin is a 420,000-dalton adhesive glycoprotein that is composed of
      three subunits of equivalent molecular weight. When the cDNA for the complete
      coding region of the human endothelial cell thrombospondin subunit is expressed
      in mouse NIH 3T3 cells, a 420,000-dalton protein is synthesized and secreted. The
      expressed protein comigrates with human platelet thrombospondin both in the
      presence and in the absence of a reducing agent. The expressed protein binds to a
      monoclonal anti-thrombospondin antibody, heparin, and calcium. In addition to the
      420,000-dalton protein, the transfected cell lines also express a variable amount
      of a 140,000-dalton polypeptide. When the culture supernatants that are produced
      by cells that are expressing thrombospondin are applied to heparin-Sepharose, the
      420,000-dalton and the 140,000-dalton proteins are bound to the column and are
      eluted with buffer containing 0.55 and 0.3 M NaCl, respectively. The 140,000
      dalton protein only binds to heparin-Sepharose in the presence of calcium.
      Deletion of the region of homology with procollagen results in defective assembly
      of the trimer. Deletion of the type 1 or type 2 repeats results in decreased
      stability of the subunit with the predominant polypeptides that are expressed
      having molecular weights of 127,000 and 130,000, respectively. These polypeptides
      retain low-affinity heparin-binding activity. High-affinity heparin binding is
      markedly diminished by mutations in either of two sequence motifs that include
      clusters of lysines and arginines.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1734966
TI  - Interaction between the heavy and the regulatory light chains in smooth muscle
      myosin subfragment 1.
AB  - The interaction between the heavy and the regulatory light chains within chicken
      gizzard myosin heads was investigated by using a zero-length chemical cross
      linker, 1-ethyl-3-[3-(dimethylamino)-propyl]carbodiimide (EDC). The chicken
      gizzard subfragment 1 (S-1) used was treated with papain so that the heavy chain
      was partly cleaved into the NH2-terminal 72K and the COOH-terminal 24K fragments
      and the regulatory light chain into the 16K fragment. S-1 was reacted with EDC
      either alone or in the presence of ATP or F-actin. In all cases, the 16K fragment
      of the regulatory light chain formed a covalent cross-link with the 24K heavy
      chain fragment but not with the 72K fragment. The 38K cross-linked peptide, which
      was the product of cross-linking between the 16K light chain and the 24K heavy
      chain fragments, was isolated and further cleaved with cyanogen bromide and
      arginylendopeptidase. Smaller cross-linked peptides were purified by reverse
      phase HPLC and then characterized by amino acid analysis and sequencing. The
      results indicated that cross-linking occurred between Lys-845 in the heavy chain
      and Asp-168, Asp-170, or Asp-171 in the regulatory light chain. The position of
      the cross-linked lysine was only three amino acid residues away from the
      invariant proline residue mapped as the S-1-rod hinge by McLachlan and Karn
      [McLachlan, A. D., & Karn, J. (1982) Nature (London) 299, 226-231]. We propose
      that the COOH-terminal region of the regulatory light chain is located in the
      neck region of myosin and that this region and the phosphorylation site of the
      regulatory light chain together may play a role in the phosphorylation-induced
      conformational change of gizzard myosin.

PMID- 1734967
TI  - Posttranslational modification of Klebsiella pneumoniae flavodoxin by covalent
      attachment of coenzyme A, shown by 31P NMR and electrospray mass spectrometry,
      prevents electron transfer from the nifJ protein to nitrogenase. A possible new
      regulatory mechanism for biological nitrogen fixation.
AB  - A strain of Escherichia coli (71-18) that produces ca. 15% of its soluble
      cytoplasmic protein as a flavodoxin, the Klebsiella pneumoniae nifF gene product,
      has been constructed. The flavodoxin was purified using FPLC and resolved into
      two forms, designated KpFldI and KpFldII, which were shown to have identical N
      terminal amino acid sequences (30 residues) in agreement with that predicted by
      the K. pneumoniae nifF DNA sequence. 31P NMR, electrospray mass spectrometry, UV
      visible spectra, and thiol group estimations showed that the single cysteine
      residue (position 68) of KpFldI is posttranslationally modified in KpFldII by the
      covalent, mixed disulfide, attachment of coenzyme A. KpFldII was inactive as an
      electron carrier between the K. pneumoniae nifJ product (a pyruvate-flavodoxin
      oxidoreductase) and K. pneumoniae nifH product (the Fe-protein of nitrogenase).
      This novel posttranslational modification of a flavodoxin is discussed in terms
      of the regulation of nitrogenase activity in vivo in response to the level of
      dissolved O2 and the carbon status of diazotrophic cultures.

PMID- 1734968
TI  - Sequential resonance assignments of oxidized high-potential iron-sulfur protein
      from Chromatium vinosum.
AB  - 2D NMR spectra of the high-potential iron-sulfur protein (HiPIP) from Chromatium
      vinosum have been used to obtain partial resonance assignments for the oxidized
      paramagnetic redox state of the protein. Sequence-specific assignments were made
      using NOESY and COSY spectra in H2O and D2O of the following backbone segments:
      Asn-5-Arg-33, Glu-39-Asp-45, Gly-55-Cys-63, Gly-68-Ala-78, and Leu-82-Gly-85.
      NOESY spectra with a spectral width wide enough to include the hyperfine-shifted
      resonances revealed numerous NOE contacts between these signals and those in the
      main envelope of the proton spectrum. With the aid of the X-ray crystal structure
      [Carter, C.W., Kraut, J., Freer, S. T., Xuong, N. H., Alden, R. A., & Bartsch, R.
      G. (1974) J. Biol. Chem. 249, 4212], these NOEs permitted seven of the nine
      hyperfine-shifted signals to be assigned to three of the cysteine residues
      liganded to the metal cluster (Cys-43, Cys-46, and Cys-77). The other two
      hyperfine-shifted signals produced no detectable NOEs to other resonances in the
      spectrum and were tentatively assigned to the remaining cysteinyl ligand (Cys
      63). These assignments, in conjunction with recent theoretical models of the
      electronic structure of the Fe4S4 cluster [Noodleman, L. (1988) Inorg. Chem. 27,
      3677; Bertini, I., Briganti, F., Luchinat, C., Scozzafava, A., & Sola, M. (1991)
      J. Am. Chem. Soc. 113, 1237], indicate that the iron atoms coordinated to Cys-63
      and Cys-77 are those of the mixed-valence Fe(3+)-Fe2+ pair whereas Cys-43 and Cys
      46 are ligands to the Fe(3+)-Fe3+ metal pair.

PMID- 1734969
TI  - Sequence-specific 1H NMR assignments and solution structure of bovine pancreatic
      polypeptide.
AB  - Sequence-specific 1H NMR assignments for the 36 residue bovine pancreatic
      polypeptide (bPP) have been completed. The secondary and tertiary structure of
      bPP in solution has been determined from experimental NMR data. It is shown that
      bPP has a very well-defined C-terminal alpha-helix involving residues 15-32.
      Although regular secondary structure cannot be clearly defined in the N-terminal
      region, residues 4-8 maintain a rather ordered conformation in solution. This is
      attributed primarily to the hydrophobic interactions between this region and the
      C-terminal helix. The two segments of the structure are joined by a turn which is
      poorly defined. The four end residues both at the N-terminus and the C-terminus
      are highly disordered in solution. The overall fold of the bPP molecule is very
      closely similar to that found in the crystal structure of avian pancreatic
      polypeptide (aPP). The RMS deviation for backbone atoms of residues 4-8 and 15-32
      between the bPP mean structure and the aPP crystal structure is 0.65 A, although
      there is only 39% identity of the residues. Furthermore, the average
      conformations of some (mostly from the alpha-helix) side chains of bPP in
      solution are closely similar to those of aPP in the crystal structure. A large
      number of side chains of bPP, however, show significant conformational averaging
      in solution.

PMID- 1734970
TI  - Assignment of the 1H NMR spectrum and secondary structure elucidation of the
      single-stranded DNA binding protein encoded by the filamentous bacteriophage IKe.
AB  - By means of 2D NMR techniques, all backbone resonances in the 1H NMR spectrum of
      the single-stranded DNA binding protein encoded by gene V of the filamentous
      phage IKe have been assigned sequence specifically (at pH 4.6, T = 298 K). In
      addition, a major part of the side chain resonances could be assigned as well.
      Analysis of NOESY data permitted the elucidation of the secondary structure of
      IKe gene V protein. The major part of this secondary structure is present as an
      antiparallel beta-sheet, i.e., as two beta-loops which partly combine into a
      triple-stranded beta-sheet structure, one beta-loop and one triple-stranded beta
      sheet structure. It is shown that a high degree of homology exists with the
      secondary structure of the single-stranded DNA binding protein encoded by gene V
      of the distantly related filamentous phage M13.

PMID- 1734971
TI  - Transition-state characterization: a new approach combining inhibitor analogues
      and variation in enzyme structure.
AB  - A new strategy of potentially broad application for probing transition-state (TS)
      analogy in enzymatic systems is described in this paper. The degree to which a
      series of phosphonate inhibitors act as TS analogues of rat carboxypeptidase A1
      has been determined for the wild-type enzyme, for the R127K, R127M, and R127A
      mutants, and for the R127A mutant in the presence of 0.5 M guanidine
      hydrochloride. The impact that the mutations have on the inverse second-order
      rate constants (Km/kcat) for substrate hydrolysis is mirrored by the effect on
      the inhibition constants (Ki) for the corresponding phosphonate inhibitors. These
      results demonstrate that the phosphonate moiety mimics some of the electronic as
      well as the geometric characteristics of the TS. A similar but distinctly
      separate correlation is observed for tripeptide analogues in comparison to
      analogues of the dipeptide Cbz-Gly-Phe, reflecting an anomalous mode of binding
      for the latter system. The selective rate increases and corresponding enhancement
      in inhibitor binding observed on addition of 0.5 M guanidine hydrochloride to the
      R127A mutant indicate that the exogenous cation can assume the role played by Arg
      127 in stabilizing the TS and in providing substrate selectivity at the P2
      position.

PMID- 1734972
TI  - Primary structure of the Thermoplasma proteasome and its implications for the
      structure, function, and evolution of the multicatalytic proteinase.
AB  - The proteasome or multicatalytic proteinase is a high molecular mass multisubunit
      complex ubiquitous in eukaryotes but also found in the archaebacterial proteasome
      is made of two different subunits only, and yet the complexes are almost
      identical in size and shape. Cloning and sequencing the gene encoding the small
      (beta) subunit of the T. acidophilum complex completes the primary structure of
      the archaebacterial proteasome. The similarity of the derived amino acid
      sequences of 233 (alpha) and 211 (beta) residues, respectively, indicates that
      they arose from a common ancestral gene. All the sequences of proteasomal
      subunits from eukaryotes available to date can be related to either the alpha
      subunit or beta-subunit of the T. acidophilum "Urproteasome", and they can be
      distinguished by means of a highly conserved N-terminal extension, which is
      characteristic for alpha-type subunits. On the basis of circumstantial evidence
      we suggest that the alpha-subunits have regulatory and targeting functions, while
      the beta-subunits carry the active sites.

PMID- 1734973
TI  - Recognition of tertiary structure in tRNAs by Rh(phen)2phi3+, a new reagent for
      RNA structure-function mapping.
AB  - With photoactivation Rh(phen)2phi3+ promotes strand cleavage at sites of tertiary
      interaction in tRNA. The rhodium complex, which binds double-helical DNA by
      intercalation in the major groove, yields no cleavage in double-helical regions
      of the RNA or in unstructured single-stranded regions. Instead, Rh(phen)2phi3+
      appears to target regions which are structured so that the major groove is open
      and accessible for stacking with the complex, as occurs where bases are triply
      bonded. So as to examine the specificity of this novel reagent and to evaluate
      its use in probing structural changes in RNAs, cleavage studies have been
      conducted on two structurally characterized tRNAs, tRNA(Phe) and tRNA(Asp) from
      yeast, the unmodified yeast tRNA(Phe) transcript, and a chemically modified
      tRNA(Phe), as well as on a series of tRNA(Phe) mutants. On tRNA(Phe) strong
      cleavage is observed at residues G22, G45, U47, psi 55, and U59; weaker cleavage
      is observed at A44, m7G46, and C48. On tRNA(Asp) cleavage is found at residues
      A21 through G26, psi 32, and U48, with minor cleavage apparent at A44, G45, A46,
      psi 55, U59, and U60. There is a striking similarity in cleavage observed on
      these tRNAs, and the sites of cleavage mark regions of tertiary folding. Cleavage
      on the unmodified tRNA(Phe) transcript resembles closely that found on native
      yeast tRNA(Phe), but additional sites, primarily in the anticodon loop and stem,
      are evident. The results indicate that globally the structures containing or
      lacking the modified bases appear to be the same; the differences in cleavage
      observed may reflect a loosening or alteration in the structure due to the
      absence of the modified bases. Cleavage results on mutants of tRNA(Phe)
      illustrate Rh(phen)2phi3+ as a sensitive probe in characterizing tRNA tertiary
      structure. Results are consistent with other assays for structural or functional
      changes. Uniquely, Rh(phen)2phi3+ appears to target directly sites of tertiary
      interaction. Cleavage results on mutants which involve base changes within the
      triply bounded region of the molecule indicate that it is the structure of the
      triply bonded array rather than the individual nucleotides which are being
      targeted. Chemical modification to promote selective depurination of the third
      base (m7G46) involved in the triple in the folded, native tRNA leads to the
      reduction of cleavage by the metal complex; this result shows directly the
      importance of the stacked triple base structure for recognition by the metal
      complex.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1734974
TI  - A segment-based approach to protein secondary structure prediction.
AB  - Amino acid sequence patterns have been used to identify the location of turns in
      globular proteins [Cohen et al. (1986) Biochemistry 25, 266-275]. We have
      developed sequence patterns that facilitate the prediction of helices in all
      helical proteins. Regular expression patterns recognize the component parts of a
      helix: the amino terminus (N-cap), the core of the helix (core), and the carboxy
      terminus (C-cap). These patterns recognize the core features of helices with a
      95% success rate and the N- and C-capping features with success rates of 56% and
      48%, respectively. A metapattern language, ALPPS, coordinates the recognition of
      turns and helical components in a scheme that predicts the location and extent of
      alpha-helices. On the basis of raw residue scoring, a 71% success rate is
      observed. By focusing on the recognition of core helical features, we achieve a
      78% success rate. Amended scoring procedures are presented and discussed, and
      comparisons are made to other predictive schemes.

PMID- 1734975
TI  - Three-dimensional structure of soybean trypsin/chymotrypsin Bowman-Birk inhibitor
      in solution.
AB  - The three-dimensional structure of soybean trypsin/chymotrypsin Bowman-Birk
      inhibitor in solution has been determined by two-dimensional 1H nuclear magnetic
      resonance spectroscopy and dynamical simulated annealing using the program XPLOR.
      The structure was defined by 907 NOEs involving intra- and interresidue contacts
      which served as distance constraints for a protocol of dynamical simulated
      annealing. In addition, 48 phi angle constraints involving non-proline amino
      acids, 29 chi angle constraints, six omega angle constraints for the X-Pro
      peptide bond, and 35 stereoassignments for prochiral centers were incorporated
      during the course of the calculation. The protein is characterized by two
      distinct binding domains for serine protease. Each domain is comprised of a beta
      hairpin (antiparallel beta-sheet and a cis-proline-containing type VIb reverse
      turn) with a short segment making a third strand of antiparallel beta-sheet. The
      structure determination and refinement are described, and the structure is
      compared to other structures of Bowman-Birk inhibitors as well as other families
      of serine protease inhibitors.

PMID- 1734976
TI  - A marketing plan for the nineties.

PMID- 1734977
TI  - Structured skin care regimen to prevent perineal dermatitis in the elderly.
AB  - A preliminary investigation was conducted to determine the efficacy of a
      structured skin care regimen to prevent perineal dermatitis in incontinent
      geriatric psychiatry patients. A 10-week, prospective, clinical trial was
      conducted (n = 15). Four weeks (weeks 2 to 5) were devoted to monitoring the
      unstructured pretreatment nursing skin care practice and to determining the
      incidence of perineal dermatitis in incontinent patients. Four weeks (weeks 7 to
      10) were also spent implementing and observing the structured nursing skin care
      regimen. The study revealed that 33% (three) of the subjects in the unstructured
      skin care group and 33% (two) of the subjects in the structured skin care group
      had perineal dermatitis. In subjects with a combination of urine and stool
      incontinence perineal dermatitis developed within 2 days. The findings suggest
      that perineal dermatitis occurs quickly in the presence of urine and stool
      incontinence. Further research is needed to validate the efficacy of a structured
      skin care regimen to prevent perineal dermatitis.

PMID- 1734978
TI  - Infection in the cancer patient with an ostomy.
AB  - One of the most common reasons for ostomy surgery today is cancer. Because cancer
      is frequently treated with combined therapy, the surgery that results in an
      ostomy may be only one component of the overall therapy. The ET nurse is
      frequently the only nurse who cares for the patient on a consistent basis as he
      or she crosses medical-surgical therapies, and the ET nurse may be the one to
      first notice changes in the patient. Knowledge of the increased risks of
      infection and methods of prevention and therapeutic approaches are critical to
      the care of a patient who is undergoing such therapy.

PMID- 1734980
TI  - Bowel and bladder management in a child.

PMID- 1734979
TI  - Collaborative atmosphere: rectal pouching in the burn center.
AB  - Collaborative practice between nursing specialties opens up opportunities for
      expanded and improved quality care. Rectal pouching in the burn center is one of
      these options; it was used in this case with a patient who received cultured
      epithelial autograft. Pouching practices from the literature are reviewed. A
      description of rectal pouching to provide stool containment and protection of the
      wound bed is detailed. Problems with the pouching procedure and potential
      solutions are also discussed. A summary statement of this highly successful
      method of stool containment, which is used to guard against wound infection,
      concludes the article.

PMID- 1734981
TI  - "ET" and the elderly.

PMID- 1734982
TI  - Persons who have stomas: violent injury versus disease.
AB  - Victims of violence may have injuries that necessitate the construction of
      stomas. The purposes of this retrospective study were to (1) describe demographic
      and perioperative variables for persons who had fecal stomas as a result of
      violent injury and (2) to compare these variables with those for persons who had
      stoma construction because of disease. Medical records of 44 persons who had
      stoma construction performed at a level I trauma center were reviewed. Victims of
      violence (n = 26) were generally young, black men with minimal income and no
      health insurance. Stomas were primarily colostomies of varied construction.
      Incisions were left open to heal by second intention. Violent behavior is an
      important cause of injury-related disability in the United States. ET nurses have
      important roles in teaching, in providing emotional support, and in participating
      in discharge planning for a patient who has a stoma that is a result of violent
      injury.

PMID- 1734983
TI  - Antidiarrhoeal drugs for acute diarrhoea in children.

PMID- 1734984
TI  - Psychological aspects of lower urinary tract infections in women.
AB  - OBJECTIVE: To determine whether women with the urethral syndrome can be
      distinguished from those with urinary tract infection by case notes, clinical
      symptoms, or psychiatric state. DESIGN: Longitudinal survey of consecutive women
      presenting with dysuria and frequency. SETTING: General practice and community.
      SUBJECTS: 58 patients with the urethral syndrome and 44 patients with a urinary
      tract infection, mean age 39.9 years. MAIN OUTCOME MEASURES: Results of analysis
      of serial midstream urine specimens, patients' self rated physical symptoms and
      responses to 60 item general health questionnaire at presentation and after
      resolution of symptoms, and results of psychiatric assessment with the clinical
      psychiatric interview. RESULTS: 4 of 42 patients with a urinary tract infection
      had recently changed sexual partner compared with none of 58 with the urethral
      syndrome. Dysuria and nocturia were more common in patients with urinary tract
      infections than those with the urethral syndrome (mean (SD) score for dysuria
      5.37 (2.39) v 4.57 (2.13), p less than 0.05; nocturia in 39/44 (88%) patients v
      40/58 (69%), chi 2 = 5.5, p less than 0.02). Both groups showed transient high
      levels of distress which resolved with the physical symptoms, but no psychiatric
      difference distinguished them. CONCLUSION: The urethral syndrome is not
      associated with increased psychiatric morbidity.

PMID- 1734985
TI  - Blood glucose concentrations and progression of diabetic retinopathy: the seven
      year results of the Oslo study.
AB  - OBJECTIVE: To study insulin dependent diabetic patients for change in non
      proliferative retinopathy and its relation to glycaemic control and to various
      clinical background data. DESIGN: Prospective study with follow up for seven
      years. SETTING: Outpatient departments of university hospitals. MAIN OUTCOME
      MEASURES: Glycated haemoglobin concentration; degree of retinopathy. RESULTS:
      Retinopathy worsened by an overall increase in counts of microaneurysms and
      haemorrhages from 17 (SD 25) to 45 (58) (p = 0.005). Intensified insulin
      treatment and home blood glucose monitoring improved concentrations of glycated
      haemoglobin (HbA1) from 11.2% (2.2%) at the start of the study to a mean of 9.5%
      (1.5%) over the seven years of the study (p less than 0.0001). A mean value for
      HbA1 greater than 10% was associated with an increased risk of progression of
      retinopathy and a mean value less than 8.7% was associated with a diminished
      risk. Multiple regression analysis identified four independent variables as
      indicative of outcome of retinopathy after seven years: HbA1 value at baseline;
      the change in HbA1 from start to the mean level through the seven years; duration
      of diabetes; and retinopathy at start. Age, blood pressure, and urinary albumin
      excretion were not related to the presence or progression of retinopathy.
      CONCLUSION: Secondary intervention by long term lowering of glycated haemoglobin
      has a beneficial impact on non-proliferative retinopathy. A four factor
      regression model can determine patients at high risk of severe retinopathy.

PMID- 1734986
TI  - Voice after laryngectomy.

PMID- 1734987
TI  - Blood pressure in first 10 years of life: the Brompton study.
AB  - OBJECTIVES: To determine the normal range of blood pressure and its pattern of
      change in the first 10 years of life. To estimate at what age (if any) children
      consistently appear in one part of the blood pressure distribution and at what
      age familial correlations in blood pressure become significant. DESIGN:
      Longitudinal cohort study. SETTING: South east England. SUBJECTS: 2088 children
      of both sexes born consecutively in Farnborough Hospital, Kent, and their
      parents. MAIN OUTCOME MEASURE: Blood pressure measured by Doppler ultrasonography
      and sphygmomanometry. RESULTS: Systolic blood pressure rose from a mean of 88.5
      mm Hg at age 6 months to 96.2 mm Hg at 8 years measured with a 8 cm cuff and from
      89.1 mm Hg at age 5 years to 94.3 mm Hg at age 10 years measured with a 12 cm
      cuff. The larger cuff gave blood pressure readings about 6 mm Hg lower. This
      effect was independent of body weight and arm circumference. Diastolic blood
      pressure rose from 57.8 mm Hg at 5 years to 61.8 mm Hg at 10 years (12 cm cuff).
      There was only about 1 mm Hg difference between sexes. Blood pressure was
      correlated with weight, weight adjusted for height, height, and arm circumference
      at all ages studied. The correlation coefficient of repeated yearly measurements
      increased steadily with age from 0.28 at 2 years to 0.59 at 10 years. The
      correlation coefficients between child's blood pressure and mother's average
      blood pressure increased from 0.1 at age 1 year to 0.23 at age 10. CONCLUSIONS:
      Blood pressure changes relatively little between the ages of 6 months and 10
      years. Yet because of the increasing strength of between occasion and family
      correlations, children are more consistently occupying a specific part of the
      blood pressure distribution as they grow older. Studies in children should help
      determine why some adults have hypertension and others do not.

PMID- 1734988
TI  - Homozygous haemoglobin O disease and conjugated hyperbilirubinaemia in a Sudanese
      family.

PMID- 1734989
TI  - Side of origin of epithelial ovarian cancer.

PMID- 1734990
TI  - School attendance as a factor in deliberate self poisoning by 12-15 year old
      adolescents.

PMID- 1734991
TI  - Prescribing at the hospital-general practice interface. I: Hospital outpatient
      dispensing policies in England.
AB  - OBJECTIVE: To describe the outpatient dispensing policies of major acute
      hospitals in England. DESIGN: Postal questionnaire survey in November 1990.
      SETTING: All (278) major acute hospitals in England with more than 250 beds,
      excluding maternity, paediatric, or psychiatric hospitals; nine hospitals
      declined. PARTICIPANTS: Hospital chief pharmacists. MAIN OUTCOME MEASURES:
      Current dispensing policy and exceptions to it; when the policy was formed; and
      who was involved in its formation. RESULTS: Completed questionnaires were
      received from 200 (72%) of the hospitals approached. The quantities of drugs
      dispensed to outpatients ranged from zero in 12 hospitals to unlimited amounts in
      nine; nearly half (92) dispensed a 14 days' supply of drugs. The greater the
      restriction on outpatient dispensing, the more recently the policy had been
      introduced (chi 2 for trend = 7.15; df = 1; p less than 0.01). Permissible
      exceptions to the policy included the consultant's specific request (134
      hospitals), difficulty in obtaining drugs in the community (102), urgent need for
      start of treatment (49), and certain types of patients (41) or drugs or their
      regimens (104). Groups who were neither represented on the hospital committee
      concerned with policy formation nor consulted before policy changes included
      regional health authorities in 122 hospitals, district health authorities in 101
      hospitals, and general practitioners in 32 hospitals. CONCLUSIONS: Outpatient
      dispensing policies varied considerably among the hospitals surveyed, but they
      seemed to be moving towards greater restrictions on the supply of drugs given to
      outpatients.

PMID- 1734992
TI  - Failed hip replacements.

PMID- 1734994
TI  - Prescribing at the interface between hospitals and general practitioners.

PMID- 1734993
TI  - Prescribing at the hospital-general practice interface. II: Impact of hospital
      outpatient dispensing policies in England on general practitioners and hospital
      consultants.
AB  - OBJECTIVE: To assess the impact on general practitioners and hospital consultants
      of hospital outpatient dispensing policies in England. DESIGN: Postal
      questionnaire and telephone interview survey of general practitioners and
      hospital consultants in January 1991. SETTING: 94 selected major acute hospitals
      in England. PARTICIPANTS: 20 general practitioners in the vicinity of each of 94
      selected hospitals and eight consultants from each, selected by chief
      pharmacists. MAIN OUTCOME MEASURES: Proportions of general practitioners unable
      to assume responsibility for specialist drugs and of consultants wishing to
      retain responsibility; association between dispensing restrictions and the
      frequency of general practitioners being asked to prescribe hospital initiated
      treatments. RESULTS: Completed questionnaires were obtained from 1207 (64%) of
      1887 general practitioners and 457 (63%) of 729 consultants. 570 (46%) general
      practitioners felt unable to take responsibility for certain treatments,
      principally because of difficulty in detecting side effects (367, 30%),
      uncertainty about explaining treatment to patients (332, 28%), and difficulty
      monitoring dosage (294, 24%). Among consultants 328 (72%) wished to retain
      responsibility, principally because of specialist need for monitoring (93, 20%),
      urgent need to commence treatment (64, 14%), and specialist need to initiate or
      stabilise treatment (63, 14%). The more restricted the drug supply to
      outpatients, the more frequently consultants asked general practitioners to
      prescribe (p less than 0.01) and complete a short course of treatment initiated
      by the hospital (p less than 0.001). CONCLUSIONS: Restrictive hospital outpatient
      dispensing shifts clinical responsibility on to general practitioners. Hospital
      doctors should be able to retain responsibility for prescribing when the general
      practitioner is unfamiliar with the drug or there is a specialist need to
      initiate, stabilise, or monitor treatment.

PMID- 1734995
TI  - Medical education.

PMID- 1734996
TI  - Transport: a public health issue.

PMID- 1734997
TI  - Unstable asthma and theophylline.

PMID- 1734998
TI  - Medically unexplained physical symptoms.

PMID- 1734999
TI  - Passive smoking and otitis media with effusion.

PMID- 1735000
TI  - Preventing AIDS now.

PMID- 1735001
TI  - Case definitions for AIDS surveillance in Africa.

PMID- 1735002
TI  - Chorionic villus sampling.

PMID- 1735003
TI  - Preventing AIDS now.

PMID- 1735004
TI  - Genitourinary tract infections in pregnancy and low birth weight.

PMID- 1735005
TI  - More oncologists, please.

PMID- 1735006
TI  - Unemployment rates: an alternative to the Jarman index?

PMID- 1735007
TI  - The health of Europe.

PMID- 1735008
TI  - Euthanasia around the world.

PMID- 1735009
TI  - Hexamethylmelamine and low or moderate dose cisplatin with or without pyridoxine
      for treatment of advanced ovarian carcinoma: a study of the Eastern Cooperative
      Oncology Group.
AB  - A total of 248 analyzable patients with Stages III-IV ovarian epithelial cancer
      (114 with and 134 without prior chemotherapy) were randomized to one of four
      cisplatin (DDP)-hexamethylmelamine (HMM) regimens. In each, HMM, 200 mg/m2 was
      given orally daily on days 8-21 of each 21-day cycle. DDP was given i.v. on Day 1
      at a dose of 37.5 mg/m2 (regimens A and B) or 75 mg/m2 (regimens C and D). In
      addition, since pyridoxine administration has been reported to reduce the
      neurotoxicity of HMM, that agent was given at a dose of 300 mg/m2 orally on Days
      1-21 in regimens B and D. Randomization was stratified for performance status (0
      1, 2-3) and largest tumor diameter at entry (greater than 2- less than or equal
      to 10 cm, greater than 10 cm) for previously untreated patients, and for
      performance status and time from initial diagnosis to entry on study (less than
      or equal to 1 year, greater than 1 year) for previously treated patients. The
      overall response rate (PR + CR) was 54%, with 25% of patients achieving a
      complete response. The 61% response rate with the higher dose DDP regimens was
      significantly greater than the 47% response rate with the lower dose regimens (p
      = 0.031). Multivariate analysis identified higher DDP dose, age less than 60
      years, no prior chemotherapy, small tumor bulk and favorable tumor grade as
      significant prognosticators for response. The overall median response duration
      was 8.3 months (range 1-70 months). Prior chemotherapy, pyridoxine
      administration, recent diagnosis, and large tumor size were identified by
      multivariate analysis as factors adversely affecting response duration. Patients
      treated with the higher dose DDP regimens had more severe nausea, vomiting, and
      neurotoxicity. This study demonstrates that the combination of DDP + HMM is an
      effective regimen for advanced ovarian carcinoma that yields response rates
      comparable to other more complex regimens, and that there is a dose-response
      relationship for DDP in ovarian cancer. Although pyridoxine administration
      significantly reduced neurotoxicity, its adverse effect on response duration
      suggests that the agent should not be administered with DDP or HMM. The mechanism
      by which pyridoxine may unfavorably affect response duration deserves further
      investigation.

PMID- 1735010
TI  - Phase I-II trial of high-dose melphalan in previously untreated stage III
      multiple myeloma: Cancer and Leukemia Group B study 8512.
AB  - To study the efficiency of high-dose melphalan in previously untreated patients
      with advanced myeloma, we performed a Phase I-II trial. Twenty-eight patients
      were treated at dose level of 60-140 mg/m2. Each patient was first treated with a
      priming dose of cyclophosphamide (300 mg) followed by high-dose melphalen 1 week
      later. One course of therapy was given. Patients were then followed without
      further therapy until relapse. Clinical and laboratory features of the 28
      patients in this study included: median age 63, performance status 0-2,
      hypercalcemia 21%, bone pain 82%, paraprotein types: IgG 76%, Iga 20%, and
      paraproteinuria 71%. Because none of the patients achieved complete remission
      (CR) at 60 mg/m2, despite life-threatening toxicity in all patients, the dose
      level was rapidly increased to 140 mg/m2, a dose previously reported to induce a
      high percentage of CR. At this dose, CR was achieved in only 1 of 11 patients
      (9%). This patient had multiple plasmacytomas without generalized bone marrow
      involvement. One additional patient at 100 mg/m2 achieved CR. Of the whole group,
      12 achieved PR. Durations of remissions were generally short: CR 6.3 and 18+
      months and PR 2.3-18 month, median 6.9 months. Life-threatening myelosuppression
      was universal with prolonged pancytopenia. Treatment-related deaths from sepsis
      were observed in 29% of patients. The median survival of the entire group was
      15.6 months. Older patients in this trial did not tolerate high-dose melphalen
      therapy well; this resulted in a high proportion of toxic deaths and poor overall
      survival.

PMID- 1735011
TI  - Use of recombinant human interleukin-2 in conjunction with bone marrow
      transplantation as a model for control of minimal residual disease in malignant
      hematological disorders: I. Treatment of murine leukemia in conjunction with
      allogeneic bone marrow transplantation and IL-2-activated cell-mediated
      immunotherapy.
AB  - Immunotherapy with recombinant human interleukin-2 (IL-2) and allogeneic spleen
      cells has led to significant antitumor effects in B-cell leukemia- (BCL1) bearing
      mice following transplantation with T-lymphocyte-depleted allogeneic bone marrow
      cells. Graft versus leukemia (GVL) effects were studied in a model mimicking
      minimal residual disease following bone marrow transplantation (BMT). Lethally
      irradiated (BALB/c x C57BL/6)F1 recipients were reconstituted with 20 x 10(6) T
      lymphocyte-depleted C57BL/6 bone marrow cells mixed with 10(4) to 10(6) BCL1
      cells followed by administration of sequential increments of allogeneic C57BL/6
      spleen cells; 10(6) cells on Day +1, 10(7) cells on Day +5, and 5 x 10(7) cells
      on Day +9, with or without concomitant IL-2 treatment (intraperitoneal injections
      of 20,000 U twice daily for 3 days) together with each spleen cell
      administration. All mice receiving 10(4)-10(6) BCL1 cells developed marked
      splenomegaly by Day +21 and all adoptive recipients of 10(5) spleen cells
      obtained from these mice developed leukemia within 21-36 days. Treatment of mice
      which received 10(4) BCL1 cells by either three courses of low dose IL-2 or three
      increments of allogeneic spleen cells alone and certainly by a combination of
      both resulted in normalization of splenomegaly on Day +21, but only adoptive
      recipients of 10(5) spleen cells obtained from mice treated by both allogeneic
      spleen cells and IL-2 (10/10) or allogeneic spleen cells alone (8/10) were
      disease free (greater than 100 days). Mice inoculated with 10(5) BCL1 cells
      developed mild splenomegaly on Day +21 after IL2 treatment alone, but showed no
      clinical evidence of disease following administration of allogeneic spleen cells
      or both allogeneic spleen cells and IL-2. Following adoptive transfer of 10(5)
      spleen cells obtained from each treated group no leukemia (greater than 100 days)
      was evident in recipients of spleen cells obtained from mice treated with both
      allogeneic spleen cells and IL-2 (10/10) whereas a partial effect was observed in
      mice treated by allogeneic spleen cells only (4/10). Mice inoculated with a high
      dose of BCL1 cells (10(6] showed some delay in onset of splenomegaly, but no
      curative antileukemic effects could be observed even following a synergistic
      combination of IL-2 and allogeneic spleen cells. Our data suggest that
      immunocompetent allogeneic lymphocytes may play an important role against
      leukemic relapse and thus cell therapy may be used therapeutically to treat
      minimal residual disease after BMT even following initial reconstitution with T
      cell-depleted bone marrow cells.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1735013
TI  - Patenting life.

PMID- 1735012
TI  - Pseudomonas aeruginosa infection in cancer patients.
AB  - Pseudomonas aeruginosa is an important cause of infection in immunosuppressed
      patients, particularly those with cancer. However, it is being recognized with
      greater frequency in patients who appear to be immunocompetent. Changes in modern
      lifestyles have led to the appearance of some new manifestations of pseudomonas
      infection including corneal ulceration and keratitis associated with contact
      lenses, and hot-tub- or whirlpool-associated folliculitis. These represent
      additional hazards to patients with cancer. Many studies, both in animals and
      humans, have contributed to our knowledge of the pathogenesis, immunology,
      treatment, and prevention of pseudomonas infections. Although the aminoglycosides
      represented a significant step forward in the treatment of these infections, of
      greater importance was the discovery of the antipseudomonal penicillins. These
      antibiotics are more effective than the aminoglycosides in neutropenic patients,
      who are especially susceptible to pseudomonal infections. The older
      antipseudomonal penicillins (carbenicillin, tircarcillin) have largely been
      replaced by newer ones (mezlocillin, azlocillin, pipercillin) which are more
      potent in vitro against P. aeruginosa. Although the accepted therapeutic practice
      has been to utilize a penicillin in combination with an aminoglycoside, the
      introduction of newer beta lactam agents and fluoroquinolones with
      antipseudomonal properties offers the possibility of other approaches to
      combination therapy. These include the combination of a penicillin or a
      cephalosporin or the combination of a quinolone with an aminoglycoside or a
      betalactam antibiotic. However, the development of newer antimicrobial agents is
      not likely to be a lasting solution to the problem of pseudomonas infections.
      Since pseudomonas infection often progresses rapidly, optimal results will always
      depend upon the prompt initiation of appropriate therapy in febrile patients,
      particularly those who are at high risk. The use of granulocyte transfusions has
      proved to be of limited benefit. Early data with the use of monoclonal antibodies
      is promising, and the results of large-scale trials are eagerly awaited. It is
      hoped that continuing investigation of pseudomonas vaccines will lead to the
      discovery of effective prophylaxis for highly susceptible patients. It is also
      hoped that with the availability of GM-CSF it will become possible to reduce the
      period of risk for serious infections. Finally, a reduction in the frequency of
      microbiologically proven P. aeruginosa infections in cancer patients should not
      lead to the assumption that these organisms do not constitute a problem in such
      patients anymore. The use of prophylactic antibiotics and prompt empiric
      antibiotic coverage for therapy has resulted in this decline. Cultures are
      therefore unlikely to be positive with the same frequency as they were before
      antimicrobial prophylaxis and empiric antibiotic therapy became standard
      practice.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1735014
TI  - New developments in protein isolation, purification, and characterization.
AB  - The most significant advancements in techniques and methods for protein
      purification and analysis have been made in liquid chromatography and in
      electrophoresis. In the area of chromatography, adsorbents based on new affinity
      principles have been prepared. New packing materials have facilitated the rapid
      progress of high-performance techniques. A great many new techniques in the field
      of electrophoresis have emerged. On an analytical scale, electrophoretic methods
      in two dimensions or in capillaries are unsurpassed in resolution power.
      Development of techniques for protein transfer between different media is a
      prerequisite for a full exploitation of the new methods. Modern techniques for
      analysis of submicrogram quantities facilitate the separation, detection, and
      characterization of complex protein mixtures.

PMID- 1735015
TI  - Is more better?

PMID- 1735016
TI  - Acute renal failure.

PMID- 1735017
TI  - Acute tubular necrosis: differences between oliguria and nonoliguria.

PMID- 1735018
TI  - Diuretic and vasopressor usage in acute renal failure: a synopsis.

PMID- 1735019
TI  - Hyperkalemic emergencies.

PMID- 1735020
TI  - Dialysis options in the critically ill patient: hemodialysis, peritoneal
      dialysis, and continuous renal replacement therapy.

PMID- 1735021
TI  - SCUF/CAVH/CAVHD: critical differences.

PMID- 1735022
TI  - Neonatal peritoneal dialysis in acute renal failure.

PMID- 1735023
TI  - Dialysis in the pediatric intensive care unit: a case study.

PMID- 1735024
TI  - Dialysis in the surgical intensive care patient: a case study.

PMID- 1735025
TI  - Comparison of search strategies on CD Plus/MEDLINE.

PMID- 1735026
TI  - Primum non nocere.

PMID- 1735027
TI  - Low-osmolarity contrast media.

PMID- 1735028
TI  - Understanding psychotropic drugs.

PMID- 1735029
TI  - Interchangeability of oral contraceptive products.

PMID- 1735030
TI  - Guidelines for a phlebotomy chair.

PMID- 1735031
TI  - Call display: a telephone disservice.

PMID- 1735032
TI  - Call Display: a telephone disservice.

PMID- 1735033
TI  - Laughing all the way to the bank.

PMID- 1735034
TI  - Canadian Coordinating Office for Health Technology Assessment.

PMID- 1735035
TI  - The "overpass syndrome".

PMID- 1735036
TI  - The fight against tobacco: sustaining the momentum.

PMID- 1735037
TI  - Intravenous immune globulin use in children. Infectious Diseases and Immunization
      Committee, Canadian Paediatric Society.

PMID- 1735038
TI  - Advance directives: are they an advance? Advance Directives Seminar Group, Centre
      for Bioethics, University of Toronto.

PMID- 1735039
TI  - Snowmobile-related deaths in Ontario: a 5-year review.
AB  - OBJECTIVES: To investigate the demographic characteristics and circumstances
      surrounding fatal snowmobile accidents in Ontario, to examine the risk factors
      and to observe any fatality trends over the study period. DESIGN: Case series.
      PATIENTS: All 131 people who died accidentally while operating a snowmobile in
      Ontario from 1985-86 to 1989-90. Records were obtained from the chief coroner's
      office; registration data were obtained from the Ministry of Transportation.
      RESULTS: Although the absolute number of deaths increased each year, owing to a
      rapid increase in the number of registered snowmobiles, the risk of death from
      snowmobile accidents remained relatively constant. Deaths occurred most
      frequently in northeastern Ontario. Youths and men predominated among the
      victims. Fatal accidents occurred more often on lakes (in 66% of the cases in
      which this information was known) than on roads (in 26%) or trails (in 8%).
      Weekend fatalities predominated, and deaths occurred most often during times of
      suboptimal lighting (from 4 pm to 8 am). The driver was killed in 84% of the
      cases in which the person's role was known. Alcohol use before death was
      implicated in 69% of the cases, the level exceeding the Ontario legal limit in
      59%. CONCLUSION: Snowmobile-related deaths result from factors that are generally
      avoidable. Strategies need to be instituted to reduce the rate of these events.

PMID- 1735040
TI  - A survey of medical quality assurance programs in Ontario hospitals.
AB  - OBJECTIVE: To determine the prevalence and types of medical quality assurance
      practices in Ontario hospitals. DESIGN: Survey. SETTING: All teaching, community,
      chronic care, rehabilitation and psychiatric hospitals that were members of the
      Ontario Hospital Association as of May 1990. PARTICIPANTS: The person deemed by
      the chief executive officer of each hospital to be most responsible for medical
      administration. INTERVENTION: A questionnaire to obtain information on each
      hospital's use of criteria audit, indicators inventory, occurrence screening and
      reporting, and utilization review and management (URM) activities. OUTCOME
      MEASURES: Prevalence of the use of the quality assurance activities, the people
      responsible for the activities and the relative success of the URM program in
      modifying physicians' performance. RESULTS: Of the 245 member hospitals
      participants from 179 (73%) responded. Criteria audits were performed in 136
      (76%), indicators inventory in 43 (24%), occurrence screening in 44 (25%),
      occurrence reporting in 61 (34%) and URM in 123 (69%). In-hospital deaths were
      reviewed in 157 (88%) of the hospitals. In all, 87 (55%) of the respondents from
      hospitals that had a URM program or were developing one indicated that their
      program was successful in modifying physicians' practices, and 29 (18%) reported
      that it was not successful; 26 (16%) stated that the effect was still unknown,
      and 16 (10%) did not respond. Seventy (40%) stated that results of tissue reviews
      were reported at least 10 times per year and 94 (83%) that medical record reviews
      were reported at least as often. The differences in the prevalence of the quality
      assurance activities between the hospitals were not found to be significant.
      CONCLUSIONS: Many Ontario hospitals are conducting a wide variety of quality
      assurance activities. Further study is required to determine whether the
      differences in prevalence of these activities between hospitals would be
      significant in a larger, perhaps national, sample. Strategies are needed to
      ensure universal involvement and participation in the improvement of the quality
      of care and the assessment of the cost-effectiveness of health care treatments.
      Recommendations to achieve these objectives are suggested.

PMID- 1735041
TI  - Coronary artery bypass grafting: how much does it cost?
AB  - OBJECTIVE: To calculate the cost of coronary artery bypass grafting (CABG) and to
      compare it with the costs determined in two previous Canadian studies. DESIGN:
      Retrospective cost-analysis study. SETTING: A tertiary care referral hospital.
      PATIENTS: Fifty patients who had undergone successful triple and quadruple CABG
      between Jan. 3 and 30, 1989. MAIN RESULTS: The cost of CABG per patient varied
      from $10,982 to $33,676 (mean $14,328) (in 1988 Canadian dollars). The cost
      tended to increase with age and number of vessels grafted. Compared with the
      patients in the two previous Canadian studies our patients were older, had more
      vessels grafted and cost more to treat, even after the total hospital costs were
      adjusted for inflation. CONCLUSIONS: The population undergoing CABG is changing:
      it is older and has more diseased vessels. These changes have had a significant
      impact on the cost of CABG. Further study is required to determine the outcome
      and benefit of CABG in this group of patients.

PMID- 1735042
TI  - [Precautions for international travelers].

PMID- 1735043
TI  - The patient as interface between genes and the environment.

PMID- 1735044
TI  - Effect of tobacco smoking on the nervous system. 1921.

PMID- 1735045
TI  - Tobacco smoke. 1923.

PMID- 1735046
TI  - Tobacco from a medical point of view. 1926.

PMID- 1735047
TI  - Modern methods in the treatment of carcinoma. 1930.

PMID- 1735048
TI  - AIDS court case could lead to higher costs, CMA spokesman warns.

PMID- 1735049
TI  - Anencephalic infants as organ donors: beware the slippery slope.

PMID- 1735050
TI  - Ontario seeks solution to chronic shortages of francophone MDs.

PMID- 1735051
TI  - Toronto-based foundation tries to combat underfunding in women's health research.

PMID- 1735052
TI  - Canadian Medical Association Policy Summary: maintenance of competence.

PMID- 1735053
TI  - Medical training in the United States.

PMID- 1735054
TI  - The vascular history and physical examination.
AB  - The value of the vascular examination cannot be over-estimated. Symptoms of
      vascular disease present in the foot and lower extremity may actually be
      manifestations of severe life-threatening disease. Symptoms, their location, and
      the frequency and quality of the patient's pain often provide valuable clues for
      the clinician's diagnosis. Central nervous system symptoms, ocular disturbances,
      cardiac symptoms, impotence, or constitutional disturbances may all indicate
      systemic arterial disease. Risk factors for this disease include smoking,
      hypertension, hyperlipidemia, genetic predisposition, diabetes, emotional stress,
      and physical inactivity. Those factors attributable to hypercoagulability and
      venous disease are birth control pill use, estrogen chemotherapy, obesity,
      prolonged immobilization, paralysis, previous thrombotic episodes, venous stasis
      disease, and varicose veins. An accurate bilateral assessment of blood pressure,
      pulses, and capillary perfusion is of critical importance. Careful inspection of
      the extremity for trophic changes, skin color, texture, temperature, edema,
      ulceration, atrophy, or paresis, will provide clues of vasculopathy. A relatively
      accurate assessment of circulatory status may be obtained without the use of
      exotic instruments. Simple tests such as the elevation and dependency tests,
      capillary bed return test, venous filling time test, along with blood pressure,
      pulse, and possibly oscillometry data are valuable in arterial evaluation. Such
      venous tests as inspection, percussion, Homan's sign, Trendelenburg, and Perthes'
      tourniquet are useful in the determination of the presence of venous disease.
      Fortunately, over the past few years tremendous advances have been made in the
      technology of the vascular laboratory. If symptoms are discovered during the
      vascular history and physical examination, the complete noninvasive study will
      provide impressive data to quantitate and specifically establish the diagnosis.

PMID- 1735055
TI  - Peripheral vascular dis in the lower extremity.

PMID- 1735056
TI  - Primary podiatric care of the vascularly compromised patient.
AB  - Primary podiatric care encompasses patient education, disease prevention,
      diagnosis, treatment, and patient referral. When performed on a regular basis,
      primary podiatric care can delay or prevent some of the complications associated
      with the vascularly compromised patient.

PMID- 1735057
TI  - Diabetes and peripheral vascular disease.
AB  - The classic Framingham Study suggests that the duration of diabetes is a
      contributing factor in the development of PVD. The major objective of all
      podiatric physicians should be to provide patients with the necessary information
      about the severity of their disease, particularly alerting them that
      noncompliance may lead to a lower extremity amputation and enlisting them as part
      of the treatment team in managing their condition.

PMID- 1735058
TI  - Vasospastic disorders.
AB  - Any disruption of the lymphatic system, including vessels and nodes, precludes
      the mobilization of lymph, resulting in the accumulation of colloidal material in
      the intercellular spaces. This article outlines the lymphatic system development
      and anatomy, leg lymph composition and flow, and diagnostic approaches and
      treatment for various forms of primary and secondary lymphedema.

PMID- 1735059
TI  - Lymphatic diseases.
AB  - The microcirculation is the keystone of bodily homeostasis. Although it may be
      altered organically as in arteriolosclerosis and diabetic angiopathy, its unique
      architecture makes it prone to spasticity. This article discusses vasospasticity
      and diagnostic approaches and treatment for Raynaud's vasospasticity,
      acrocyanosis, and livedo reticularis.

PMID- 1735060
TI  - Smoking and peripheral vascular disease. Podiatric medical update.
AB  - Although there is strong evidence that cigarette smoking is perhaps the major
      risk factor associated with peripheral occlusive vascular disease, there still
      appears to be little indication that clinicians in podiatric medicine and
      patients recognize this. When smoking is combined with other risk factors such as
      diabetes mellitus, the probability of developing peripheral arterial disease is
      greatly increased. In addition, smoking appears to accelerate the natural history
      of the process of atherogenesis and thrombosis. Diabetic neuropathy seems to have
      a greater prevalence when the patient has a history of an increased number of
      pack years smoked. By eliminating smoking, patients can often receive
      considerable relief from intermittent claudication and other sequelae of
      occlusive vascular disease, including the avoidance of amputation of the lower
      extremity. Patient care routinely should include efforts to prevent individuals
      from smoking as well as advice to smokers to stop. Podiatrists need to become a
      more prominent source of information about the hazards of smoking and should
      freely share this knowledge with their patients.

PMID- 1735061
TI  - Exercise and peripheral vascular disease.
AB  - The use of exercise as a nonsurgical therapy for peripheral arterial disease has
      been shown to be effective. Studies have demonstrated improved walking
      tolerances, alterations in skeletal muscle metabolism, and improved blood
      distribution with exercise.

PMID- 1735062
TI  - Evaluation of arterial blood flow in the lower extremity.
AB  - Podiatrists need to evaluate arterial blood flow to determine whether arterial
      flow is compatible for healing following a contemplated surgery, to determine
      whether arterial flow is at a compatible level to prevent tissue necrosis or heal
      an ischemic ulcer, and to determine whether the patient should be referred to a
      vascular surgeon for consideration of the possible surgery. This article
      addresses these needs and provides guidelines to help make these assessments.

PMID- 1735063
TI  - Invasive diagnostic imaging of the lower extremities.
AB  - Invasive arterial imaging techniques are crucial to the preoperative evaluation
      of patients requiring arterial surgery. Venography is important in patients who
      are candidates for venous reconstruction, and it is also useful in the difficult
      diagnosis of deep venous thrombosis. The authors discuss the development of
      angiographic techniques, indications for use, patient preparation, and potential
      complications. Several examples of these tests are illustrated.

PMID- 1735064
TI  - Lower extremity arterial occlusive disease.
AB  - The clinician must first understand the natural history of chronic lower
      extremity ischemia before making a decision regarding therapeutic options.
      Clearly, mild ischemia as evidenced by claudication does not place the patient at
      significant risk for limb loss. Initial conservative treatment emphasizing
      abstinence from tobacco products, control of underlying medical maladies, and an
      exercise program, along with patient reassurance, will adequately treat the
      majority of claudicators. When ischemia is present, patient education regarding
      foot care and avoidance of trauma are beneficial. Limb-threatening ischemia often
      requires revascularization. Adequate preoperative cardiologic evaluation and
      intraoperative monitoring have greatly reduced the morbidity and mortality of
      arterial reconstruction. Selection of the appropriate recipient vessel and bypass
      conduit enables limb salvage, whereas amputation would have been performed just a
      few years ago. Continued analysis of treatment outcomes will further define
      appropriate intervention in the future.

PMID- 1735065
TI  - Peripheral vascular surgery.
AB  - Patients may present with a wide range of manifestations of arterial occlusive
      disease. The clinician must be able to assess the magnitude of the arterial flow
      diminution and thereby determine the appropriate treatment regimen. A careful
      history, physical examination, and pertinent noninvasive vascular laboratory
      tests should provide adequate information for the clinician to establish the
      severity of disease and the need to pursue a medical or surgical treatment plan.
      Patient evaluation must be carried out expeditiously, especially when limb
      threatening conditions such as infection or gangrene exist, because these
      problems may progress rapidly and result in major lower extremity amputation.

PMID- 1735066
TI  - Venous diseases.
AB  - Deep venous thrombosis and its sequelae, pulmonary embolism, recurrence, and the
      postthrombotic syndrome, affects a staggering number of patients. Deep venous
      thrombosis is a frequent postoperative complication, especially after certain
      orthopedic operations. Pulmonary embolism is the third leading cause of death in
      the United States, and the postthrombotic syndrome effects an estimated 500,000
      Americans. Prompt diagnosis and treatment of thromboembolic disease is important,
      but prevention may be the key to lessening the number of patients with venous
      disease in the future.

PMID- 1735067
TI  - Hispanic patients with head and neck cancer do not have a worse prognosis than
      Anglo-American patients.
AB  - This study was undertaken to determine whether the survival of Hispanic patients
      with squamous cell carcinoma of the head and neck was different from that of
      Anglo-American patients. The charts of 275 male patients with a diagnosis of
      squamous cell carcinoma of the head and neck at one Veterans Administration
      Hospital were reviewed in an attempt to identify prognostic indicators for both
      ethnic groups. No differences were observed between Anglo-American and Hispanic
      patients with respect to sites of the primary tumor, age at diagnosis,
      performance status, or the frequency of surgery, radiation therapy, or
      chemotherapy; however, there was a tendency for Hispanic patients to have
      received more treatment. There also was a trend (P = 0.12) for Hispanic patients
      to have a more advanced stage of cancer. Hispanic patients lost significantly
      more weight (P less than 0.001) and had significantly lower serum albumin levels
      (P less than 0.0001). According to the results of multivariate survival analyses,
      the variables that were predictive of a poor prognosis included advanced stage of
      disease, decreased serum albumin levels, increased weight loss, administration of
      chemotherapy, lack of radiation therapy or surgery, and advanced age. Ethnicity
      was not a significant predictor of survival either in univariate analyses, or
      within patients with the same stage of disease, or after adjustment for other
      prognostic factors. In conclusion, the natural history of squamous cell carcinoma
      of the head and neck is the same for Hispanic and Anglo-American patients.

PMID- 1735068
TI  - A phase II study of piritrexim in patients with advanced squamous head and neck
      cancer.
AB  - Piritrexim (PTX) is a newly developed lipid-soluble folate antagonist that
      crosses the cell membrane by a simple, rapid, carrier-independent diffusion
      process. A Phase II study was conducted to evaluate the activity of PTX in 34
      patients with previously chemotherapy-naive squamous cell cancer of the head and
      neck area (SCCHN). Among them, 30 patients had received previous radiation
      therapy and/or surgery. Of 33 patients who could be examined, 3 had a complete
      response (CR), 6 had a partial response (PR), 11 had no change, and 13 had
      disease progression. The overall response rate (CR + PR) was 27% (9 of 33; 95%
      confidence interval, 13% to 46%). The response duration ranged from 36 to 360 +
      days (median, 162) and was similar to the best studies reported with
      methotrexate. The three most severe side effects (Grades 3 and 4 by World Health
      Organization criteria) were leukopenia, thrombocytopenia, and mucositis. These
      occurred in 41%, 26%, and 15% of the 34 patients, respectively. This study
      established PTX as an agent with some activity in SCCHN. The use of PTX in
      combination chemotherapeutic regimens needs to be explored.

PMID- 1735069
TI  - Mouse rosettes and surface immunoglobulin in small lymphocytic lymphoma.
      Importance in immunophenotyping and differential diagnosis.
AB  - Cell suspensions from lymphoid tissue of 82 small lymphocytic lymphoma (SLL), 8
      intermediate lymphocytic lymphoma (ILL), 286 other B-non-Hodgkin's lymphoma (B
      NHL), and 248 reactive lymphadenopathy (RLA) cases were analyzed to evaluate the
      diagnostic significance of mouse-rosette (M-rosette) assay, and surface
      immunoglobulin clonality (SIg) and level of expression. In SLL, 55 were M-rosette
      positive (67.07%) and 72 SIg positive (87.8%), with weak fluorescence in 63 and
      strong fluorescence in 9 cases. Of 10 SIg-negative cases, 9 were M-rosette
      positive; of 27 M-rosette-negative cases, 26 were SIg positive. Seven of the nine
      cases with strong fluorescence were M-rosette positive. In other B-NHL, 252 were
      M-rosette negative (88.11%) and 245 SIg positive (85.66%), with strong
      fluorescence in 211 and weak fluorescence in 34 cases. Thirty-two of the 34 cases
      with weak fluorescence were M-rosette negative. Of the RLA cases, 213 were M
      rosette negative (85.89%) and 1 SIg positive (0.4%). The study demonstrated the
      independent expression of M-rosettes and SIg in SLL and their complementary role
      in diagnosis. It showed that positive results for M-rosettes and weak
      fluorescence are characteristic of SLL, that M-rosette negativity and strong
      fluorescence are characteristic of other B-NHL, and that M-rosette negativity and
      polyclonal SIg are characteristic of RLA. In 26 cases with paired data for CD5, M
      rosettes, and SIg, a positive result for M-rosettes was superior to CD5 in
      differentiating SLL from other B-NHL. Intermediate lymphocytic lymphoma
      frequently showed weak SIg fluorescence and M-rosette negativity.

PMID- 1735070
TI  - Establishment of a new Hodgkin's cell line (HD-70) of B-cell origin.
AB  - A new Hodgkin's cell line, designated HD-70, was established from the peripheral
      blood of a 69-year-old man with Hodgkin's disease of nodular sclerosing type. The
      cell line grows in a single cell suspension and has a doubling time of 28 hours.
      The cells have a round or irregular nucleus or multiple nuclei in relatively
      abundant cytoplasm that is positive for acid phosphatase, alpha-naphthyl butyrate
      esterase, and periodic acid-Schiff stains. HD-70 cells are positive for CD30 (Ki
      1/Ber-H2), CD15 (Leu-M1), and CD71 (OKT9) antigens and contain cytoplasmic
      immunoglobulin (Ig) (A, kappa). Southern blot analysis showed that the cells have
      Ig heavy and kappa light chain gene rearrangement and lack T-cell receptor gene
      rearrangement. Chromosome analysis disclosed that the cells have a human
      karyotype with complicated abnormalities, including a 14q+. Heterotransplantation
      of the HD-70 cell line into newborn hamsters treated with antilymphocyte serum
      produced massive tumors with remarkable fibrosis and collagen band formation.
      These tumors displayed histologic features similar to those of the nodular
      sclerosing type tumor of the patient. Such fibrosis production and collagen band
      formation in heterotransplanted tumors suggest that a certain cytokine that
      induces fibrosis might be produced by HD-70 cells. This cell line may be useful
      for understanding the biology and pathogenesis of Hodgkin's disease.

PMID- 1735071
TI  - The prognostic significance of total serum cholesterol in patients with Hodgkin's
      disease.
AB  - In the current retrospective study, the authors investigated the prognostic
      significance of total serum cholesterol values at the time of diagnosis in
      patients with Hodgkin's disease (n = 179). Cholesterol values were significantly
      lower in these patients than in age- and sex-matched controls. Subgroups with
      advanced stages (P less than or equal to 0.01), poor response to therapy (P =
      0.04), and relapse after complete response (P = 0.026) (but not with bulky
      disease) had lower cholesterol values. By univariate analysis (cut-point value,
      140 mg/dl), the 5-year survival rate was 2.5 times higher in patients with normal
      cholesterol values than in hypocholesterolemic patients (P less than 0.00009).
      Hypocholesterolemia was retained as an adverse, independent prognostic factor by
      multivariate Cox regression analysis. The authors concluded that total serum
      cholesterol values at the time of diagnosis may be a parameter with unrecognized
      significance in Hodgkin's disease.

PMID- 1735072
TI  - Hodgkin's disease in Kenya.
AB  - A total of 136 patients with Hodgkin's disease (HD) seen at a national referral
      hospital in Kenya over a 15-year period were studied. The overall male-to-female
      ratio was 2.6:1, with 65% of patients younger than 20 years of age. The bimodal
      incidence of HD frequently seen in the developed nations was absent, and the
      histologic pattern of the disease was similar to that seen in other African
      countries. Fifty percent of patients had advanced-stage disease when first seen.
      Over two thirds of patients treated had a clinical remission, and the relapse
      rate in all stages was approximately 30%. Therapy-related complications were
      common, with frequent myelosuppression and younger patients more susceptible.

PMID- 1735073
TI  - Neuraxis dissemination in pediatric brain tumors. Response to preirradiation
      chemotherapy.
AB  - Of 29 consecutive children treated for malignant primary tumors of the central
      nervous system (CNS) at this institution, postoperative examination showed
      radiographic or cytologic evidence of neuraxis dissemination in 10 (34%). Given
      the historically poor results in disseminated CNS tumors treated with surgery and
      radiation therapy alone, these ten patients were treated prospectively with an
      investigational Phase II protocol consisting of preirradiation cisplatin (90
      mg/m2 on day 1) and etoposide (150 mg/m2 on days 3 and 4). The diagnoses included
      medulloblastoma (n = 4), malignant glioma (n = 3), cerebral primitive
      neuroectodermal tumor (n = 1), pineoblastoma (n = 1), and mixed glioma of the
      brainstem (n = 1). Postoperative neuraxis scanning with computed tomography,
      magnetic resonance imaging, or spinal myelography showed measurable intracranial
      or spinal metastases in all children. The cerebrospinal fluid (CSF) cytologic
      examination was positive for tumor cells in five. The best responses, based on
      serial imaging of neuraxis metastases, included two complete responses, four
      partial responses, and three stable disease states. One patient had progressive
      disease at the primary site despite stable disease in the spine; progressive
      neuraxis disease was documented in only one patient during chemotherapy.
      Clearance of tumor cells from the CSF was documented in three patients. The
      adverse effects of chemotherapy, consisting of transient myelosuppression and
      mild ototoxicity, were minimal. Reversible neurologic deterioration occurred in
      two patients; one patient became acutely quadriplegic after a prolonged
      convulsive seizure without radiographic evidence of tumor progression.

PMID- 1735074
TI  - Patients with cancer and their spouse caregivers. Perceptions of the illness
      experience.
AB  - This study focuses on patterns of response between patients with cancer and their
      spouse caregivers to examine the reliability of spouse informants in research and
      clinical settings. Thirty dyads (patient with cancer-spouse caregiver couples;
      total n = 60) were interviewed concurrently in their homes concerning patient
      functioning, psychologic distress, physical symptoms, caregiver perceptions of
      patient functioning, and marriage quality. Couples had been married an average of
      32 years. Patients had either the lung or colon as their primary cancer site, and
      one third had metastasis. Correlations between 14 variable pairs and cross
      tabulation of scale scores suggest that spouse caregivers agree with patients on
      objective measures with observable referents (e.g., ability to dress
      independently). Partners disagree on subjective aspects of patient functioning
      (e.g., depression, fear of future, and confidence in treatment) and marriage
      quality. Almost without exception, caregivers viewed patients' functioning more
      negatively than patients described themselves. Patients, however, viewed marital
      quality more negatively than did caregivers. It was concluded that caregivers can
      serve as proxies for patients with cancer in research and clinical settings when
      objective data are sought. Data from both spouses are needed, however, to
      complete the picture of subjective illness experiences in patients with cancer,
      including perceptions of pain and disease symptoms.

PMID- 1735075
TI  - Pharmacokinetic and pharmacodynamic studies with mitoxantrone in the treatment of
      patients with nasopharyngeal carcinoma.
AB  - The pharmacokinetics and pharmacodynamics of mitoxantrone were studied in 15
      patients with advanced nasopharyngeal carcinoma (NPC) after single intravenous
      rapid infusion (12 to 14 mg/m2). Mitoxantrone plasma concentrations and urinary
      excretion were measured specifically with the use of a high-performance liquid
      chromatographic method with ultraviolet detection at 242 and 658 nm. The
      pharmacokinetic parameters are described adequately by a three-compartment model
      with a terminal half-life of 71.5 +/- 40.1 hours and a volume of distribution of
      5037 +/- 2377 l. The total plasma clearance was 743 +/- 462 ml/minute, and the
      renal clearance was 18.8 +/- 8.49 ml/minute. Within 72 hours, 1.8 +/- 0.6% of the
      administration dose was excreted in urine as mitoxantrone parent compound. From
      the urinary excretion rate data, glomerular filtration and possible tubular
      reabsorption were the mechanisms involved in the urinary excretion of
      mitoxantrone. The values for unbound fraction (%) in plasma at time 0 and 5
      minutes were 2.88 +/- 0.91% and 3.25 +/- 1.19%, with an average of 3.04 +/-
      1.01%. The degree of protein binding of mitoxantrone was not affected by
      concentration (P greater than 0.05) in Chinese patients with NPC. The response
      rate for mitoxantrone was poor in this study. Clinical studies have demonstrated
      that mitoxantrone was generally well tolerated. Only very low incidences of
      nausea, vomiting, and alopecia were observed. The mild and rapidly reversible
      dose-limiting hematologic toxic effects have proven leukopenia. Although the
      toxicities reported here were tolerated for most patients, other combination
      regimens including mitoxantrone or other administration routes may be considered
      and need to be evaluated carefully.

PMID- 1735076
TI  - Extent of nasopharyngeal carcinoma involvement inside the nasopharynx. Lack of
      prognostic value on local control.
AB  - A study on the use of fiberscopic examination and multiple biopsy specimens taken
      from the nasopharynx in the assessment of the extent of nasopharyngeal carcinoma
      (NPC) involvement inside the nasopharynx found that the involvement often was
      more extensive than the detected with conventional methods. In the current study,
      247 patients with NPC were studied with the use of fiberscopic examination, and
      multiple biopsy specimens were taken from the superior wall, posterior wall, and
      lateral wall of the nasopharynx on both sides. It was confirmed that the tumor
      often involved the nasopharynx extensively. Also, the extent of primary tumor
      involvement inside the nasopharynx was correlated with the American Joint
      Committee (AJC) T stage and the degree of paranasopharyngeal extension of the
      tumor (P = 0.0100 and 0.0009, respectively), as well as with the size of the
      largest node and the lowest neck level involved by the node in the ipsilateral
      neck (P = 0.0005 and 0.005, respectively). However, the extent of primary tumor
      involvement inside the nasopharynx, expressed as either the number of the six
      standard sites or the number of the AJC subsites that were involved, had no
      predictive value on the control of the primary tumor (P = 0.3773 and 0.7794,
      respectively) at a median follow-up time of 27 months. Except when salvage
      brachytherapy is contemplated for persistent or recurrent NPC, the extent of
      primary tumor involvement inside the nasopharynx should not be routinely studied.

PMID- 1735077
TI  - A case-control study of diet and social factors in cancer of the esophagus in
      Transkei.
AB  - A study of 100 patients with cancer of the esophagus and 100 controls matched for
      sex, age, and educational level was done in Transkei, with extensive inquiries
      into diet and social habits. The significant risk factors found were use of
      Solanum nigrum as a food (relative risk, 3.6), smoking (relative risk, 2.6), and
      use of traditional medicines (relative risk, 2.1). Consumption of traditional
      beer was not a risk factor.

PMID- 1735078
TI  - A phase II trial of 5-fluorouracil and recombinant alpha-2a-interferon in
      previously untreated metastatic gastric carcinoma.
AB  - A Phase II clinical trial of the combination of 5-fluorouracil (5-FU) and
      recombinant alpha-2a-interferon (alpha-2a-IFN) was conducted in 44 patients.
      Patients had not received chemotherapy previously and had measurable metastatic
      gastric carcinoma. 5-FU was administered as a continuous infusion at a dose of
      750 mg/m2/d for 5 consecutive days and as an intravenous bolus at a dose of 750
      mg/m2 weekly for 7 weeks beginning on day 12. Recombinant alpha-2a-IFN was
      administered subcutaneously at a dose of 9 x 10(6) U three times a week during
      weeks 1 to 8. Patients were examined for response during week 9. Of 44 patients
      entered, 40 could be examined for response. Nine patients experienced a partial
      clinical response and one achieved a complete response, for an overall response
      rate of 25% (95% confidence interval, 13% to 41%). The median duration of
      response was 13 weeks (range, 9 to 67 weeks) and the median survival time was 29
      weeks. Grade 3 to 4 toxicities included granulocytopenia (nine patients),
      diarrhea (three patients), oral mucositis (seven patients), skin rash (one
      patient), and fatigue (four patients). One patient died of neutropenic sepsis.
      This regimen had modest activity with significant toxicity and produced responses
      of short duration. It did not appear to be superior to existing treatments of
      metastatic gastric carcinoma.

PMID- 1735079
TI  - Adenoma--carcinoma sequence or "de novo" carcinogenesis? A study of adenomatous
      remnants in a population-based series of large bowel cancers.
AB  - Although it is well known that colorectal cancers can arise on a preexisting
      adenoma or de novo, the relative importance of these two pathways is still highly
      controversial. The authors studied the proportion of cancers with adenomatous
      remnants in a nonselected population-based series of 1630 resected colorectal
      cancers, so that they could estimate by subsite the importance of the adenoma
      carcinoma sequence. Four factors appeared to be related independently to the
      presence of adenomatous tissue within cancers in a multiple logistic model: tumor
      extension, growth pattern, location, and size. It appeared that infiltrating and
      ulcero-infiltrating tumors, which represented 39.8% of all resected colorectal
      cancers, very rarely displayed adenomatous tissue (0.5%), whereas it was more
      common in fungating and ulcero-fungating cancers (25.8%; P less than 0.001). In
      these exophytic cancers, the presence of adenomatous tissue was related very
      closely to the tumor size and extension, and it was seen in as many as 83% of
      small cancers (less than 2 cm) limited to the mucosa or submucosa. Right colon
      cancer showed consistently fewer adenomatous remnants than left colon or rectal
      cancer. These figures suggest that there are roughly two types of colorectal
      cancers, one of the infiltrating or ulcero-infiltrating type, which usually would
      arise de novo and account for approximately 40% of all colorectal cancer cases,
      and the exophytic type, which would mainly follow an adenoma-carcinoma sequence,
      although some might be de novo cancers, in particular in the right colon.

PMID- 1735080
TI  - A phase I trial of 5-fluorouracil, folinic acid, and alpha-2a-interferon in
      patients with metastatic colorectal carcinoma.
AB  - The mechanisms of biochemical modulation of 5-fluorouracil (5-FU) cytotoxicity by
      folinic acid (FA) have been elucidated, and the clinical use of this combination
      has improved response rates and survival in patients with metastatic colorectal
      cancer. Recently, Phase II trials also showed potential synergism between alpha
      2a-interferon (rHuIFN-alpha 2a) and 5-FU. Therefore, a Phase I trial of these
      three agents 5-FU, FA, and rHuIFN-alpha 2a was conducted in patients with
      metastatic colorectal cancer. The drugs were given over 5 days, with dose
      escalation of either rHuIFN-alpha 2a or 5-FU. Fifty-five eligible patients were
      treated at eight dosing levels. The maximal tolerated dose (MTD) was as follows:
      5-FU 430 mg/m2/d intravenously (IV) on days 1 to 5, FA 200 mg/m2 IV on days 1 to
      5, and rHuIFN-alpha 2a 4.0 x 10(6) U/m2/d subcutaneously on days 1 to 5. The dose
      limiting toxicities were mucositis and neutropenia. Objective responses were seen
      at most dosing levels, and overall 15 of 55 patients (27%; 95% confidence
      interval, 16% to 41%) responded (median duration, 6.5 months). A Phase II trial
      using the MTD is ongoing.

PMID- 1735081
TI  - A chronopharmacologic phase II clinical trial with 5-fluorouracil, folinic acid,
      and oxaliplatin using an ambulatory multichannel programmable pump. High
      antitumor effectiveness against metastatic colorectal cancer.
AB  - A significant increase in the dose intensity of chemotherapy with
      fluoropyrimidines and platinum complexes has resulted from selective circadian
      timing and/or circadian modulation of the infusion rate. The relevance of such
      chronopharmacologic strategy for improving the outcome of metastatic colorectal
      cancer was evaluated in an extended Phase II clinical trial involving 93
      patients. Of these, 49% previously had received chemotherapy and/or radiation
      therapy. The drugs 5-fluorouracil (5-FU, 700 mg/m2/d) and folinic acid (FA, 300
      mg/m2/d) combined with oxaliplatin (l-OHP, a nonnephrotoxic platinum complex, 25
      mg/m2/d) were infused continuously for 5 days every 3 weeks. In a pilot
      randomized study, the infusion of all three drugs at a constant rate resulted in
      World Health Organization (WHO) Grade 3 or 4 toxicity in all four patients
      compared with no such toxicity in four patients if the infusion rate was
      modulated according to circadian rhythms. In this Phase II trial, drug delivery
      was modulated sinusoidally over the 24-hour day with peak flow rates at 4 AM for
      5-FU and FA and at 4 PM for l-OHP, using an ambulatory programmable-in-time pump.
      All patients and 784 of 839 courses (93%) were evaluable for toxicity. Dose
      limiting toxicities (WHO Grade 2 to 4) included diarrhea (19% of courses) and
      vomiting (35% of courses). In addition, WHO Grade 2 to 4 hematologic or mucosal
      toxicity, respectively, occurred in 2.5% and 7% of courses. Two toxic deaths were
      encountered. Peripheral sensory neuropathy led to discontinuation of l-OHP in 14
      patients after 7 to 12 courses; it completely disappeared within 3 months. Fifty
      four of the 93 patients had an objective response (58%; 95% confidence limits,
      48% to 68%), irrespective of previous treatment or prior documented progression
      while receiving standard chemotherapy with 5-FU and FA or continuous 5-FU.
      Complete responses (CR) were seen in 6 patients (4 of which were proved
      histologically) and, after surgery, in 12 additional patients (overall CR rate,
      18 of 93 [19%]; 95% confidence limits, 11% to 27%). Median progression-free
      survival (PFS) and overall survival were, respectively, 10 and 15 months,
      irrespective of prior therapy. Both PFS and survival were significantly longer in
      patients with a good performance status (PS, 0 or 1, by WHO criteria;
      respectively, 12 and 21 months) than in patients with poor PS (respectively, 8
      and 10 months; P less than 0.01, by log-rank test). This chronopharmacologic
      protocol may have circumvented, to some extent, both the natural and acquired
      resistance of colorectal cancer to chemotherapy.

PMID- 1735082
TI  - An immunohistochemical study with an estrogen receptor-related protein (ER-D5) in
      human colorectal cancer.
AB  - The ER-D5 antigen is a protein associated with the estrogen receptor that is
      present only in estrogen receptor-positive tissues. To clarify the estrogen
      receptor in colon cancer, the localization of ER-D5 was studied
      immunohistochemically. Forty-three of 171 (25.1%) specimens of colon cancer
      showed reactivity for ER-D5. Reactivity was seen only in the cytoplasm. No
      reactivity was seen in cancer limited to the mucosa or in adenoma, but submucosal
      cancers showed a rate of positivity similar to cancers that involved lamina
      muscularis and beyond. Estradiol staining was done on serial sections from 56
      specimens. There was a significant relationship between reactivity for estradiol
      and that for ER-D5. In the 15 specimens where both ER-D5 and estradiol were
      positive, the distribution of estradiol was similar to that of ER-D5. It was
      concluded that the immunohistochemical localization of ER-D5 indirectly shows
      that of the estrogen receptor in colorectal cancer tissues.

PMID- 1735083
TI  - A clinicopathologic study on neural invasion in cancer of the pancreatic head.
AB  - Thirty-four patients who had resection of cancer of the pancreatic head were
      examined clinicopathologically to elucidate neural invasion of cancer of the
      pancreatic head to the extrapancreatic nerve plexus. Invasion of cancer to the
      retropancreatic tissue (rp+) was observed in 29 (85%) of the 34 patients, and
      neural invasion to the extrapancreatic nerve plexus was observed in 21 (72%) of
      the 29 patients with rp+. The incidence of invasion to the second region of the
      nerve plexus of the pancreatic head was high (14 patients; 67%). The degree of
      the neural invasion tended to increase as the intrapancreatic neural invasion
      became more severe and lymph vessel invasion more marked. Based on these
      findings, en bloc resection of the retropancreatic tissue involving the nerve
      plexus and fat tissue is necessary in the surgical treatment of cancer of the
      pancreatic head.

PMID- 1735084
TI  - A prospective trial of early detection of pancreatic cancer by ultrasonographic
      examination combined with measurement of serum elastase 1.
AB  - The accuracy of ultrasonographic examination combined with measurement of
      elastase 1 levels for early detection of pancreatic cancer was evaluated
      prospectively. Abdominal ultrasonographic examination and measurement of serum
      elastase 1 levels were done within 2 weeks after the initial visit to the clinic
      in a total of 2098 patients older than 35 years of age with symptoms suggesting
      pancreatic disease. Those in which one or both of these examinations had abnormal
      results underwent additional tests such as endoscopic retrograde
      cholangiopancreatography and computed tomography. Of those with
      pancreatosonograms with abnormal results with or without abnormally high serum
      elastase 1 levels, 19 patients eventually were found to have pancreatic cancer.
      No patients with pancreatic cancer, a normal level of serum elastase 1, and a
      pancreatosonogram with normal results were found, but follow-up studies revealed
      one pancreatic cancer in 189 patients after technically unsatisfactory
      ultrasonographic examination. In 9 (45%) of the 20 cases detected in this study,
      the pancreatic cancers were resectable, and two (10%) were less than 2.0 cm in
      longest diameter. These findings indicate that this combined examination is
      useful for early detection of pancreatic cancer. However, no pancreatic cancer
      was found in patients with abnormally high serum elastase 1 levels without a
      pancreatosonogram with abnormal results. Moreover, a combination of
      ultrasonographic examination and measurement of the elastase 1 level did not
      raise the diagnostic accuracy over that of ultrasonographic examination alone.
      These findings indicate that ultrasonographic examination alone is useful in
      screening for early pancreatic cancer.

PMID- 1735085
TI  - Expression of MDR1 and glutathione S transferase-pi genes and chemosensitivities
      in human gastrointestinal cancer.
AB  - The relationship was analyzed between drug resistance and MDR1 (with MDR
      signifying multiple drug resistance) and glutathione S transferase-pi (GST-pi)
      gene expression in four stomach and four colon cancer cell lines. Northern blot
      analysis by pmdr1 probe showed that stomach cancer cell lines had no detectable
      level of MDR1 mRNA expression. By contrast, some levels of MDR1 mRNA expression
      were found in two colon cancer cell lines, indicating doxorubicin resistance. To
      examine the MDR1 mRNA in each cell level, in situ hybridization was used. It was
      found that all colon cell lines and two stomach cell lines had more silver grains
      per cell than KB cells (a human KB kidney epidermoid carcinoma cell line).
      However, the number of silver grains in each cell was heterogeneous in the colon
      and stomach cell lines. Low-level MDR1 mRNA expression could be detected even in
      cell lines without MDR1 mRNA expression by northern blot hybridization. These
      results suggest the possibility that all gastrointestinal cell lines can acquire
      multiple drug resistance. In addition, all examined gastrointestinal cell lines
      had high GST-pi mRNA expression. This GST-pi gene expression shows cisplatin
      resistance in the examined cell lines. Heterogeneity of GST-pi mRNA expression
      also was shown at the cellular level.

PMID- 1735086
TI  - A clinicopathologic and immunohistochemical study of gastrointestinal stromal
      tumors.
AB  - The clinicopathologic and immunohistochemical features in 120 cases of
      gastrointestinal stromal tumor (GIST) were reviewed. Excluding 24 cases of
      gastric schwannoma, 96 cases of GIST consisting of 62 benign tumors and 34
      sarcoma (low grade, 17; high grade, 17), with 9 cases arising in the esophagus,
      57 in the stomach, 28 in the small intestine, and 2 in the colon, were studied.
      All esophagus and colon tumors were benign and resembled a conventional leiomyoma
      histologically. However, the gastric and small intestine benign tumors mostly
      showed histologic features of cellular or epithelioid leiomyoma.
      Immunohistochemically, desmin caused a positive reaction in all esophagus and
      colon tumors, but only 26% of gastric and small intestine tumors. However, muscle
      specific actin (HHF35) caused a positive reaction in most GIST (92%). The 10-year
      survival rates of the patients with gastric sarcoma and those with intestinal
      sarcoma were 74% and 17%, respectively. These results showed that histologic and
      immunohistochemical features were distinctly different, depending on the location
      in the gastrointestinal tract; that most GIST, excluding schwannoma, had smooth
      muscle differentiation; and that sarcomas had a more favorable prognosis when
      they occurred in the stomach rather than the intestine.

PMID- 1735087
TI  - Familial microcephaly with normal intelligence in a patient with acute
      lymphoblastic leukemia.
AB  - The authors describe a family with two children with microcephaly and normal
      intelligence, in which acute lymphoblastic leukemia developed in one of the
      siblings. An autosomal recessive pattern of inheritance is suggested by the
      pedigree. This is consistent with the literature, which the authors reviewed. All
      of the patients have similar phenotypic features, with some demonstrating
      chromosomal instability. It is important to recognize this syndrome because of
      the increased risk of lymphoreticular malignancy.

PMID- 1735088
TI  - Frequency of eosinophilia in adult T-cell leukemia/lymphoma.
AB  - Cases of adult T-cell leukemia/lymphoma (ATLL) display several peculiar clinical
      features, including skin rash, hypercalcemia, and an increase in the absolute
      neutrophil count. The patients rarely have pronounced eosinophilia. In this
      study, the eosinophilia observed in lymphoproliferative disorders of 62 patients
      with ATLL, 27 with T-cell lymphoma (TL), and 19 with B-cell lymphoma (BL) was
      investigated. The incidence of eosinophilia (greater than or equal to
      570/microliters) was higher in patients with ATLL than in patients with TL or BL.
      Thirteen patients with ATLL (21.0%), 3 with TL (11.1%), and 2 with BL (10.5%) had
      eosinophilia. Of these patients, three with ATLL and one with TL who had a
      pathologic diagnosis of immunoblastic lymphadenopathy (IBL) showed pronounced
      eosinophilia up to 10,934/microliters. Because the number of eosinophils in the
      peripheral blood of these patients correlated both with the number of ATLL cells
      and the degree of lymphadenopathy and because this fluctuated with chemotherapy,
      it seems likely that the secretion of some lymphokines by the lymphoma cells is
      responsible for the eosinophilia.

PMID- 1735089
TI  - Response of brain metastases from breast cancer to systemic chemotherapy.
AB  - In a prospective, nonrandomized study, the response of brain metastases (BM) from
      breast cancer to a standard systemic chemotherapy regimen was measured by
      clinical follow-up and serial computed tomography (CT) scans. Treatment consisted
      of 4-week courses of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) in
      20 patients or 3-week courses of cyclophosphamide, doxorubicin, and 5
      fluorouracil (CAF) in 2 patients. Seven patients had previously received CMF or
      CAF as adjuvant treatment or for progressive systemic disease. Another seven
      patients had been previously treated for BM with the use of surgery and/or
      radiation therapy (RT). Based on the results of clinical follow-up and CT scan, a
      response that lasted at least 6 weeks was seen in 13 patients (59%; 95%
      confidence interval, 37% to 80%), including 4 of the 7 patients with recurrent
      BM. Objective tumor regression occurred after two courses of chemotherapy in 76%
      of the patients who could be examined and after six courses in 47%. The median
      duration of neurologic remission in the 13 patients was 30 weeks (range, 15 to 66
      weeks). The median overall survival time was 25 weeks (range, 2 to 83 weeks). The
      response rate of systemic disease paralleled the neurologic response. When
      compared with a matched group of historical control subjects treated with RT
      alone, chemotherapy induced a higher rate of neurologic response and led to a
      longer survival time. These results warrant further studies on the use of
      chemotherapy in BM from breast cancer.

PMID- 1735090
TI  - Past pregnancy is associated with axillary node involvement in women with breast
      cancer.
AB  - In 186 women with breast cancer, there was a progressive increase in the
      proportion of axillary nodal involvement as the number of pregnancies increased
      from zero to two or more (P = 0.026). Logistic regression analysis demonstrated
      that this effect was independent of the known relationship of age and tumor size
      to nodal involvement. Race and history of breast feeding had no influence on
      nodal involvement.

PMID- 1735091
TI  - Tumor hormone receptor status and recurrences in premenopausal patients with node
      negative breast carcinoma.
AB  - To ascertain the prognostic significance of tumor hormone receptor status in
      premenopausal patients with node-negative breast cancer, a retrospective review
      of 199 patients who met these criteria was conducted. Of these 199 patients,
      estrogen receptor (ER) data were available for 147. One hundred four patients
      (71%) had ER-negative disease and 22 (21%) exhibited local or distant recurrence
      with a median follow-up time of 85.4 months. Thirteen patients in this group had
      died of breast cancer. Of the 43 patients who had ER-positive disease, 5 (12%)
      had recurrences and 2 died of breast cancer. After observing patients for a
      longer period of time (median follow-up time, 85.4 months), no statistically
      significant differences in disease-free survival (DFS) or overall survival (OS)
      were demonstrated. However, as seen in our first analysis of this group at 45
      months, tumor size after a median follow-up time of 85.4 months continues to have
      significant prognostic implications, regardless of ER status.

PMID- 1735093
TI  - The hypnozoite and relapse in primate malaria.
AB  - Although the phenomenon of malarial relapse was known to the ancients, the
      mechanism has only recently been explained satisfactorily. The long-held
      hypothesis of a tissue "cycle" in primate malaria as a cause of relapse did not
      fit clinical and experimental observations. A latent stage for Plasmodium spp. in
      the liver, for which there is now extensive morphological and experimental
      confirmation, best explains both the relapse phenomenon and the long prepatent
      periods seen with some strains of Plasmodium vivax. These latent stages
      (hypnozoites) have been detected in three relapsing malarias and have been found
      to persist in the liver as uninucleate parasites for up to 229 days after
      sporozoite inoculation. They have been found in in vitro cultures of two species
      of Plasmodium, and their ultrastructure has been partially described.

PMID- 1735092
TI  - Agents of newly recognized or infrequently encountered mycobacterial diseases.
AB  - This paper reviews recent information on the systematics and clinical
      significance of potentially pathogenic environmental mycobacteria. A short
      history of these mycobacteria is given. Information on species for which clinical
      and systematic aspects have already been well documented, i.e., Mycobacterium
      kansasii, M. marinum, M. scrofulaceum, M. simiae, M. szulgai, M. ulcerans, M.
      xenopi, and members of the M. fortuitum complex, is updated. Although the M.
      avium complex was extensively reviewed in earlier literature, major new
      systematic and clinical information is presented in some detail. Species that
      have received very limited prior coverage, i.e., M. asiaticum, M. haemophilum, M.
      malmoense, and M. shimoidei, are the main subjects of this review and are
      discussed in detail. The rare infections attributed to species that are normally
      considered nonpathogenic, i.e., M. gastri, M. gordonae, the M. terrae complex,
      and most of the rapidly growing mycobacteria outside of the M. fortuitum complex,
      are critically reviewed. Finally, suggestions are offered for practical measures
      that can minimize the risk of failing to isolate or misidentifying some of the
      more obscure potentially pathogenic environmental mycobacteria that are only
      infrequently recognized.

PMID- 1735094
TI  - Microbiological aspects of peritonitis associated with continuous ambulatory
      peritoneal dialysis.
AB  - The process of continuous ambulatory peritoneal dialysis has provided a useful,
      relatively inexpensive, and safe alternative for patients with end-stage renal
      disease. Infectious peritonitis, however, has limited a more widespread
      acceptance of this technique. The definition of peritonitis in this patient
      population is not universally accepted and does not always include the laboratory
      support of a positive culture (or Gram stain). In part, the omission of clinical
      microbiological findings stems from the lack of sensitivity of earlier
      microbiological efforts. Peritonitis results from decreased host phagocytic
      efficiency with depressed phagocytosis and bactericidal capacity of peritoneal
      macrophages. During episodes of peritonitis, fluid movement is reversed, away
      from the lymphatics and peritoneal membrane and toward the cavity. As a result,
      bloodstream infections are rare. Most peritonitis episodes are caused by
      bacteria. Coagulase-negative staphylococci are the most frequently isolated
      organisms, usually originating from the skin flora, but a wide array of microbial
      species have been documented as agents of peritonitis. Clinical microbiology
      laboratories need to be cognizant of the diverse agents so that appropriate
      primary media can be used. The quantity of dialysate fluid that is prepared for
      culture is critical and should constitute at least 10 ml. The sensitivity of the
      cultural approach depends on the volume of dialysate, its pretreatment (lysis or
      centrifugation), the media used, and the mode of incubation. The low
      concentration of microorganisms in dialysate fluids accounts for negative Gram
      stain results. Prevention of infection in continuous ambulatory peritoneal
      dialysis patients is associated with the socioeconomic status of the patient,
      advances in equipment (catheter) technology, and, probably least important, the
      application of prophylactic antimicrobial agents.

PMID- 1735096
TI  - Autoimmunity in the age of molecular biology.

PMID- 1735095
TI  - Giardiasis.
AB  - Giardiasis is one of the most common pathogenic intestinal protozoal infections
      worldwide. Giardia lamblia is the most frequently identified etiologic agent in
      outbreaks associated with the ingestion of surface water, often due to
      ineffective filtration or pretreatment. In addition to humans, other sources of
      infection include beavers, perhaps muskrats, and possibly domestic animals. A low
      infecting dose (10 to 25 cysts) is reported to be sufficient to produce human
      infection. Clinical manifestations range from asymptomatic to a transient or
      persistent acute stage, with steatorrhea, intermittent diarrhea, and weight loss,
      or to a subacute or chronic stage that can mimic gallbladder or peptic ulcer
      disease. Diagnosis is usually based on repeated stool examinations but
      examination of duodenal fluid or biopsy material may also be necessary. Enzyme
      immunoassay or indirect immunofluorescence methods for direct detection of
      antigen or whole organisms in clinical specimens have also been developed. These
      tests are reported to be more sensitive than routine stool examination.
      Demonstration of serum immunoglobulin M and G antibodies may help differentiate
      recent from past infection or help detect recurrence in individuals who have been
      treated previously. Serum immunoglobulin A levels may be a useful indicator of
      exposure in waterborne outbreaks of diarrhea. Drugs available for treatment
      within the United States include metronidazole, quinacrine hydrochloride, and
      furazolidone.

PMID- 1735097
TI  - Clinical and molecular aspects of autoimmune diseases.

PMID- 1735098
TI  - Manipulation of anti-DNA idiotypes: a possible treatment approach to autoimmune
      diseases.

PMID- 1735099
TI  - Cytokines in autoimmune diseases.

PMID- 1735100
TI  - Sjogren's syndrome and autoimmunity.

PMID- 1735101
TI  - New approaches to the genetics of autoimmune disease.

PMID- 1735102
TI  - Clinical and molecular aspects of autoimmune endocrine disease.

PMID- 1735103
TI  - New approaches to the molecular analysis of the spondyloarthropathies.

PMID- 1735104
TI  - Immunopathogenesis of autoimmunity following human immunodeficiency virus
      infection.

PMID- 1735105
TI  - Molecular analysis of autoantibody production.

PMID- 1735106
TI  - Mechanisms of anti-DNA antibody expression in normal and aberrant immunity.

PMID- 1735107
TI  - Anti-DNA idiotypes: their pathogenic role in autoimmunity.

PMID- 1735108
TI  - Ultrastructural localization of sialylated glycoconjugates in cells of the
      salamander olfactory mucosa using lectin cytochemistry.
AB  - An indirect gold-labeling method utilizing the lectin from Limax flavus was
      employed to characterize the subcellular distribution of sialic acid in
      glycoconjugates of the salamander olfactory mucosa. The highest density of lectin
      binding sites was in secretory vesicles of sustentacular cells. Significantly
      lower densities of lectin binding sites were found in secretory granules of
      acinar cells of both Bowman's and respiratory glands. Lectin binding in acinar
      cells of Bowman's glands was confined primarily to electron-lucent regions and
      membranes of secretory granules. In the olfactory mucus, the density of lectin
      binding sites was greater in the region of mucus closest to the nasal cavity than
      in that closest to the epithelial surface. At the epithelial surface, the density
      of lectin binding sites associated with olfactory cilia was 2.4-fold greater than
      that associated with microvilli of sustentacular cells or non-ciliary plasma
      membranes of olfactory receptor neurons, and 7.9-fold greater than non
      microvillar sustentacular cell plasma membranes. Lectin binding sites were
      primarily associated with the glycocalyx of olfactory receptor cilia. The cilia
      on cells in the respiratory epithelium contained few lectin binding sites. Thus,
      sialylated glycoconjugates secreted by sustentacular cells are preferentially
      localized in the glycocalyx of the cilia of olfactory receptor neurons.

PMID- 1735109
TI  - Localization of basic fibroblast growth factor in a subpopulation of rat sensory
      neurons.
AB  - The distribution of basic fibroblast growth factor (bFGF)-immunoreactivity (IR)
      was studied in rat sensory and autonomic ganglia. In postnatal and adult
      sympathetic superior cervical ganglia and in adult parasympathetic otic ganglia
      no bFGF-staining was found. Postnatal and adult neural crest- and placode-derived
      sensory ganglia displayed intensive bFGF-IR in a neuronal subpopulation. This
      subpopulation was characterized by use of consecutive sections of adult dorsal
      root ganglia stained with antibodies against substance P, somatostatin, bombesin,
      and bFGF. Basic FGF was colocalized with the somatostatin/bombesin subpopulation
      but not with substance P.

PMID- 1735110
TI  - Significance of the peri-insular extracellular matrix for islet isolation from
      the pancreas of rat, dog, pig, and man.
AB  - The presence and distribution in the peri-insular region of extracellular matrix,
      and in particular basement membrane, was investigated in a comparative study
      comprising pancreata of rat, dog, pig, and man. Basement membrane markers,
      collagen type-IV and laminin, were determined immunohistochemically. Additional
      information pertaining to the structural relationships between endocrine and
      exocrine pancreas, in particular cell-to-cell and cell-to-matrix contacts, was
      obtained by electron microscopy. In pig, very little peri-insular capsule is
      present, and the structural integration of the porcine islet in the exocrine
      pancreas almost exclusively depends on cell-to-cell adhesion. In the canine
      pancreas, the islets are almost completely encapsulated with very little direct
      exocrine-to-endocrine cell-to-cell contact. In rat and man, the situation is
      intermediate with a tendency towards predominance of cell-to-matrix adhesion. The
      intra-insular adhesion mechanisms depend largely on cell-to-cell adhesion in all
      four species. The ultrastructural results suggest that collagenase preparations
      employed in islet isolation procedures should be of high purity as to preserve
      the protease-sensitive intra-islet cell-to-cell adhesion. Under these conditions,
      however, the endocrine-to-exocrine cell-to-cell contacts will be conserved also,
      resulting in an exocrine-tissue contamination of the islets of Langerhans.
      Consequently, additional steps for the effective removal of exocrine tissue and
      the purification of islets are required.

PMID- 1735111
TI  - The optic lobe of Drosophila melanogaster. II. Sorting of retinotopic pathways in
      the medulla.
AB  - We present a quantitative evaluation of Golgi-impregnated columnar neurons in the
      optic lobe of wild-type Drosophila melanogaster. This analysis reveals the
      overall connectivity pattern between the 10 neuropil layers of the medulla and
      demonstrates the existence of at least three major visual pathways. Pathway 1
      connects medulla layer M10 to the lobula plate. Input layers of this pathway are
      M1 and M5. Pathway 2 connects M9 to shallow layers of the lobula, which in turn
      are tightly linked to the lobula plate. This pathway gets major input via M2.
      Pathways 1 and 2 receive input from retinula cells R1-6, either via the lamina
      monopolar cell L1 (terminating in M1 and M5) or via L2 and T1 (terminating in
      M2). Neurons of these pathways typically have small dendritic fields. We discuss
      evidence that pathways 1 and 2 may play a major role in motion detection. Pathway
      3 connects M8 to deep layers of the lobula. In M8 information converges that is
      derived either from M3 (pathway 3a) or from M4 and M6 (pathway 3b), layers that
      get their major input from L3 and R8 or L4 and R7, respectively. Some neurons of
      pathway 3 have large dendritic fields. We suggest that they may be involved in
      the computation of form and colour. Possible analogies to the organization of
      pathways in the visual system of vertebrates are discussed.

PMID- 1735112
TI  - Local production of fibronectin by ectopic human retinal cells.
AB  - The distribution of fibronectin mRNA and fibronectin in adult human retina and
      epiretinal membranes was investigated by in situ hybridisation and
      immunohistochemical techniques. The cells in normal adult retina contained little
      or no fibronectin mRNA and the retina only showed fibronectin immunoreactivity in
      retinal vessels. The cells in detached neuroretina did not contain fibronectin
      message but the vitreoretinal interface of the detached retina exhibited variable
      fibronectin immunoreactivity. Retinal glia, retinal pigment epithelium and
      fibroblast-like cells in membranes at the vitreoretinal juncture (epiretinal
      membranes) showed variable labelling with the fibronectin mRNA probe and all the
      membranes immunostained for fibronectin. No difference could be detected between
      membrane cell types in the intensity of labelling with the mRNA probe or for
      fibronectin immunoreactivity. The results indicate that cells in situ in attached
      and detached adult human retina do not produce fibronectin. Although fibronectin
      at the vitreoretinal juncture in retinal detachment is probably partly derived
      from plasma fibronectin resulting from breakdown of the blood-retinal barrier,
      ectopic retinal cells produce fibronectin and contribute to the glycoprotein
      epiretinal membranes.

PMID- 1735113
TI  - Immunohistochemical localization of transthyretin in glomerular peripolar cells
      of newborn sheep.
AB  - Purified transthyretin has been isolated from sheep serum. Antiserum raised
      against this protein has been used with an indirect immunoperoxidase
      histochemical technique to identify transthyretin in newborn lamb kidney tissue.
      Transthyretin was found in proximal tubule cells and in glomerular peripolar
      cells. Preabsorption studies using purified transthyretin protein indicate that
      the immunoreactivity of the antiserum is specific to transthyretin.

PMID- 1735114
TI  - High frequency of ciliated neuropeptide Y-immunoreactive neurons in rat striatum.
AB  - An analysis of the ultrastructure of neuropeptide Y-immunoreactive neurons in rat
      striatum revealed the presence of a cilium in half of the neurons serially
      sectioned in part, and in a quarter of the neurons observed in single sections.
      It is speculated that the cilium is a developmental remnant, i.e., a sign of the
      less differentiated state of the NPY-containing neurons compared with the other
      neurons, and that this could explain the plasticity of this type of neuron after
      lesions.

PMID- 1735115
TI  - Calcitonin gene-related peptide (CGRP)-immunoreactive nerve plexuses in the renal
      pelvis and ureter of rats.
AB  - The distribution of calcitonin gene-related peptide-immunoreactive nerve fibers
      in the renal pelvis and ureter was examined by immunohistochemistry using whole
      mount preparations and cryostat sections. The patterns of innervation were
      contrasted between the pelvis and ureter; the immunoreactive nerve fibers in the
      pelvis ran parallel to the long axis of each of the circular and longitudinal
      muscle layers, causing a lattice-like appearance of the nerve fibers. In the
      ureter, the immunoreactive fibers were accumulated in the subepithelial region
      and the longitudinal muscle. In both the pelvis and ureter, a portion of the
      nerve fibers of smaller caliber showed a swollen or beaded structure; they were
      located in the musculature and beneath the epithelium extending for considerable
      distances. Ligation of the ureter caused a marked decrease in the immunoreactive
      nerves in the pelvis and the proximal portion of the ureter, suggesting that the
      axonal flow in the calcitonin gene-related peptide-containing neurons of the
      ureter runs towards the pelvis.

PMID- 1735116
TI  - Immunohistochemical localization of Na(+)-dependent glucose transporter in rat
      jejunum.
AB  - Glucose is actively absorbed via a Na(+)-dependent active glucose transporter (Na
      GT) in the small intestine. We raised a polyclonal antibody against the peptide
      corresponding to amino acids 564-575 of rabbit intestinal Na-GT, and localized it
      immunohistochemically in the rat jejunum. By means of immunofluorescence
      staining, Na-GT was located at the brush border of the absorptive epithelial
      cells of the intestinal villi. Electron-microscopic examination showed that Na-GT
      was localized at the plasma membrane of the apical microvilli of these cells.
      Little Na-GT was found at the basolateral plasma membrane. Along the crypt-villus
      axis, all of the absorptive epithelial cells in the villus were positive for Na
      GT. In addition to the brush border staining, the supranuclear positive staining,
      which was shown to be the Golgi apparatus by use of electron microscopy, was seen
      in cells located between the base to the middle of the villus. Cells in crypts
      exhibited little or no staining for Na-GT. Goblet cells scattered in the
      intestinal epithelium were negative for Na-GT staining. These observations show
      that Na-GT is specific to the apical plasma membrane of the absorptive epithelial
      cells, and that the onset of Na-GT synthesis may occur near the crypt-villus
      junction.

PMID- 1735117
TI  - Salinity tolerance and structure of external and internal gills in tadpoles of
      the crab-eating frog, Rana cancrivora.
AB  - Salinity tolerance and histology of gills were studied in Rana cancrivora larvae.
      The tadpoles at the external gill stages (W stages 21-22) were able to survive in
      media containing up to 40% seawater, but died in water of higher salinity. Their
      external gills appear to have no critical role in adaptation to seawater.
      However, advanced tadpoles with internal gills (T-K stages I-XVIII) were able to
      tolerate 50% or higher seawater. In the internal gills, there are numerous
      mitochondria-rich cells (MR cells) scattered on the ventral and lateral epithelia
      of the gill arches and the gill tufts in both freshwater- and seawater-acclimated
      tadpoles. In freshwater-acclimated tadpoles there are three types of MR cell: (1)
      microplicated, (2) microvillous, and (3) apically vacuolated. In tadpoles
      acclimated to dilute seawater, the ratio of type-1 to type-2 cells is lower,
      although all three types of MR cell are present. In 60%-seawater-acclimated
      tadpoles, a few MR cells with a lumen and concave cytoplasm at the apical
      membrane (type 4) are present. The changes in MR cell morphology under ambient
      conditions of low or high salinity may reflect alterations in the physiological
      roles of the gills with regard to transport of ions.

PMID- 1735118
TI  - Receptor-mediated endocytosis of testicular transferrin by germinal cells of the
      rat testis.
AB  - The present study examines events of the Sertoli cell iron delivery pathway
      following the secretion of diferric testicular transferrin (tTf) into the
      adluminal compartment of the rat seminiferous epithelium. The unidirectional
      secretion of tTf by Sertoli cells was verified, in vivo, and it was shown that
      this protein is internalized by adluminal germ cells. It was further determined
      by Scatchard analysis that this internalization was mediated by high affinity
      transferrin binding sites on the surface of round spermatids, numbering 1453/cell
      and displaying a Kd = 0.6 x 10(-9) M. Northern blot analysis of RNA isolated from
      adluminal germ cells, namely spermatocytes, round spermatids and elongating
      spermatids, indicated that these cells expressed Tf receptor mRNA and ferritin
      mRNA in levels inversely related to their stage of maturation. Finally it was
      determined that following binding and internalization in round spermatids, Tf
      became associated with the endosomal compartment and was recycled back to the
      cell surface. This study illustrates the immediate fate of tTf once it is
      secreted by the Sertoli cells. Thus, diferric tTf binds of Tf receptor on the
      surface of adluminal germ cells, is internalized by receptor-mediated endocytosis
      and the apoTf-Tf receptor complex is recycled back to the cell surface where
      apotTf is released into the adluminal fluid.

PMID- 1735119
TI  - The presence and distribution of Antho-RFamide-like material in scyphomedusae.
AB  - The nervous systems of the scyphomedusae Chrysaora hysoscella, Cyanea capillata
      and Cyanea lamarckii (Phylum Cnidaria) were stained using an anti-serum against
      the anthozoan neuropeptide Antho-RFamide. Staining was widespread in all three
      species. In Chrysaora, the antiserum revealed nerve nets in the subumbrella and
      exumbrella ectoderm, in both faces of the oral lobes, and in the endoderm lining
      the subumbrella and exumbrella surfaces of the gastric cavity. The most prominent
      staining occurred in a dense plexus of neurons in the ectoderm at the base of the
      tentacles. This nerve net sent projections into the subumbrella ectoderm. For the
      most part, staining in the two species of Cyanea was similar to that in
      Chrysaora, with a few exceptions. These include the presence, in Cyanea, of an
      obvious tentacular nerve tract and nerve nets associated with clusters of
      cnidocytes in the tentacles. Radioimmunoassays of extracts from Chrysaora and
      Cyanea lamarkii revealed that both species contain large amounts of Antho-RFamide
      like material (up to 55 nmol/animal). The results indicate that Antho-RFamide
      like neuropeptides are widespread in scyphomedusae.

PMID- 1735120
TI  - Degeneration of osteoblasts involved in intramembranous ossification of fetal rat
      calvaria.
AB  - Ossification of calvariae from day-21 rat fetuses was reinvestigated by electron
      microscopy using different fixation techniques (glutaraldehyde/OsO4, tannic acid,
      ruthenium red, K-pyroantimonate). An osteoid layer with scattered mineral
      deposits was found at the mineralization front. Directly beyond this layer, a
      sheet of one to two layers of necrotic and degenerating osteoblasts was present.
      Above this sheet, normal and healthy cells were seen, formed by six to eight
      layers of flattened cells, embedded in a collagenous matrix. The osteoblasts on
      the less mineralizing opposite side of the calcified calvariae and the osteocytes
      embedded in the calcified calvariae appeared healthy. Closer inspection of the
      necrotic zone revealed apatite crystals in vesicles which most probably
      originated from mitochondria of the degenerated cells. Large K-pyroantimonate
      deposits were found throughout the osteoid and the necrotic zone, whereas only
      small granules were scattered in the cytoplasm and at the plasma membrane of the
      healthy cells directly adjacent to the necrotic zone. A concept of
      intramembranous mineralization is outlined, according to which osteoblasts store
      enormous amounts of calcium, which are liberated by physiological cell death in
      the vicinity of the mineralizing front.

PMID- 1735121
TI  - An identified dorsal unpaired median neurone and bilaterally projecting neurones
      exhibiting bovine pancreatic polypeptide-like/FMRFamide-like immunoreactivity in
      abdominal ganglia of the migratory locust.
AB  - Three antisera were used to study the distribution and anatomy of bovine
      pancreatic polypeptide (BPP)-like/FMRFamide-like immunoreactive neurones within
      the unfused abdominal ganglia of the migratory locust, Locusta migratoria. All
      the antisera used stained two or more clusters of perikarya, localized anteriorly
      and posteriorly near the midline within each unfused abdominal ganglion. Double
      labelling experiments with intracellular dye injection, or differential
      backfilling, combined with subsequent immunostaining were carried out to identify
      these neurones. Two of the antisera (antisera 1 and 2, both raised against
      FMRFamide) stained three groups of midline neurones, located anterior dorsal,
      anterior ventral and posterior dorsal within the ganglion. Neurones of the former
      of these two clusters projected via the anterior median nerve to a neurohaemal
      organ. The posterior cluster of midline cells comprised immunopositive perikarya
      all but one of which also projected via the anterior median nerve to innervate
      the neurohaemal organ. Double labelling with Lucifer yellow and antisera 1 and 2
      showed that the remaining neurone was the previously identified dorsal unpaired
      median (DUM)heart 1 neurone. The third antiserum (AK141), also raised against
      FMRFamide, stained neurones within an anterior dorsal cluster, and in a posterior
      cluster. Double labelling with differential Co2+/Ni(2+)-backfilling and the
      antiserum 3 (AK141) demonstrated that the large neurones of both clusters
      belonged to the population of bilaterally projecting neurones (BPNs), including
      the DUMheart1 neurone. Since the antisera cross-react with BPP and fail to label
      neurones when preadsorped with BPP or FMRFamide, we conclude that the labelled
      neurones contain polypeptides of the FMRFamide/BPP-family.

PMID- 1735123
TI  - Physical and biochemical characterization of the cloned LYS5 gene required for
      alpha-aminoadipate reductase activity in the lysine biosynthetic pathway of
      Saccharomyces cerevisiae.
AB  - The LYS5 and LYS2 genes of Saccharomyces cerevisiae are required for the
      synthesis of alpha-aminoadipate reductase in the lysine pathway. The LYS5 gene,
      originally cloned as a DNA insert of the plasmid pSC5, has been subcloned on a
      3.2 kb SphI-Sau3AI DNA fragment of the recombinant plasmid pSR7. An internal 2.1
      kb HpaI-HpaI DNA fragment of the subclone, upon Southern hybridization, exhibits
      homology with HpaI-restricted wild-type S. cerevisiae genomic DNA. The lys5+
      transformants exhibited alpha-aminoadipate reductase activity similar to that of
      wild-type cells. S1 nuclease analysis localizes the transcription initiation site
      relative to the detailed restriction map, and reveals the direction of
      transcription, as well as the transcript size of the LYS5 gene which can be no
      greater than 1.65 kb. From this it is estimated that the encoded polypeptide is
      appreciably smaller than the 4 kb LYS2 gene product. These results provide a
      physical and biochemical characterization of the cloned LYS5 gene. Based on these
      observations, it is concluded that the LYS5 gene encodes a relatively small
      polypeptide of the large heteropolymeric alpha-aminoadipate reductase.

PMID- 1735122
TI  - Gene database for the fission yeast Schizosaccharomyces pombe.
AB  - As an aid to the fission yeast genome project, we describe a database for
      Schizosaccharomyces pombe consisting of both genetic and physical information. As
      presented, it is therefore both an updated gene list of all the nuclear genes of
      the fission yeast, and provides an estimate of the physical distance between two
      mapped genes. Additionally, a field indicates whether the sequence of the gene is
      available. Currently, sequence information is available for 135 of the 501 known
      genes.

PMID- 1735124
TI  - A mating deficient and temperature-sensitive lethal mutant of Schizosaccharomyces
      pombe defines a new fertility locus.
AB  - A recessive mutant allele, mef1-84, of a novel locus mapping on the left arm of
      chromosome I, between ade3 and ura1, 5 cM apart from lys5, confers temperature
      sensitive growth and mating deficiency at the non-restrictive temperatures for
      growth. Two other mutations suppress the phenotype conferred by mef1-84: sts1-1
      suppresses the temperature-sensitive growth only, and smd1-35 suppresses both
      temperature-sensitive growth and mating deficiency.

PMID- 1735125
TI  - Transcript analysis of penicillin genes from Penicillium chrysogenum.
AB  - The presence of a transcriptional control simultaneously affecting the expression
      of the three penicillin biosynthetic genes, pcbAB, pcbC, and penDE (pen genes),
      was demonstrated in Penicillium chrysogenum. Using probes specific to each gene,
      it was observed that the highest level of expression of the pen genes occurred
      during exponential growth, in both the original ancestral strain (NRRL1951) and a
      high-penicillin producing strain P2. Expression also occurred in the presence of
      high concentrations of glucose, indicating that carbon catabolite repression was
      not directly involved in the regulation. Transcription of the pen genes appeared
      to cease as the growth rate decreased. Growth was limited in a fermenter by the
      rate of oxygen transfer. The phosphoglycerate kinase gene (pgk), used as a
      control, was strongly induced by the reduced oxygen levels, suggesting a stress
      related response. By maintaining optimum growth conditions in fermenters, no
      induction of the pgk gene was observed whereas expression of the pen genes could
      be maintained. It was also possible to re-establish expression of the pen genes,
      after normal cessation, by the addition of cycloheximide to the culture medium.

PMID- 1735126
TI  - Cloning and expression of a chitinase gene from the hyperparasitic fungus
      Aphanocladium album.
AB  - Recombinant clones from a cDNA library of an Aphanocladium album chitinase
      overproducing mutant strain were isolated by screening with antiserum against a
      39 kDa chitinase purified from this hyperparasitic fungus. Analysis of the
      isolated positive clones indicated that most of them carried the same cDNA. A
      cDNA from this group was used as a hybridization probe to isolate an 8 kb DNA
      fragment from a genomic library of the wild-type strain. The chitinase 1 gene was
      mapped to this fragment by two independent approaches. Its partial DNA sequence
      was in perfect agreement with an amino-terminal peptide sequence obtained by
      sequencing 23 amino acids of the 39 kDa chitinase. Its transfer in Fusarium
      oxysporum resulted in a transformant producing both a protein of about 39 kDa
      that cross-reacted with the chitinase antiserum and a chitinase activity that was
      inhibited by the same antiserum. Northern blot analysis indicates that the cloned
      chitinase gene was subject to catabolite repression and appeared inducible by
      chitin.

PMID- 1735127
TI  - Plastid DNA from Pyrenomonas salina (Cryptophyceae): physical map, genes, and
      evolutionary implications.
AB  - Cryptomonads are thought to have arisen from a symbiotic association between a
      eukaryotic flagellated host and a eukaryotic algal symbiont, presumably related
      to red algae. As organellar DNAs have proven to be useful tools in elucidating
      phylogenetic relationships, the plastid (pt) DNA of the cryptomonad alga
      Pyrenomonas salina has been characterized in some detail. A restriction map of
      the circular 127 kb ptDNA from Pyrenomonas salina was established. An inverted
      repeat (IR) region of about 5 kb separates two single-copy regions of 15 and 102
      kb, respectively. It contains the genes for the small and large subunit of rRNA.
      Ten protein genes, coding for the large subunit of ribulose-1,5-bisphosphate
      carboxylase, the 47 kDa, 43 kDa and 32 kDa proteins of photosystem II, the
      ribosomal proteins L2, S7 and S11, the elongation factor Tu, as well as the alpha
      and beta-subunits of ATP synthase, have been localized on the restriction map
      either by hybridization of heterologous gene probes or by sequence homologies.
      The gene for the plastidal small subunit (SSUr) RNA has been sequenced and
      compared to homologous SSU regions from the cyanobacterium Anacystis nidulans and
      plastids from rhodophytes, chromophytes, euglenoids, chlorophytes, and land
      plants. A phylogenetic tree constructed with the neighborliness method and
      indicating a relationship of cryptomonad plastids with those of red algae is
      presented.

PMID- 1735128
TI  - One-step transformation of yeast in stationary phase.
AB  - A fast yeast-transformation technique has been developed by adding thio compounds
      to alkali-ion based protocols and incubating at 45 degrees C. This procedure is
      especially recommended for cells from stationary phase at a density up to 2.5 x
      10(8) cells/ml. It involves only one step for the preparation and transformation
      of competent cells within 30 min. The yield was more than 10(4)
      transformants/microgram plasmid DNA. This protocol is easy to scale up for many
      DNA samples and is also applicable for yeast cells from different types of
      storages.

PMID- 1735129
TI  - The DNA repair gene PSO3 of Saccharomyces cerevisiae belongs to the RAD3
      epistasis group.
AB  - The mutant allele pso3-1 of Saccharomyces cerevisiae confers sensitivity to
      treatment with UV365nm (UVA) light-activated mono- and bi-functional psoralens.
      When pso3-1 is combined in double mutants with selected rad and pso mutant
      alleles and subjected to 8-MOP + UVA treatment, epistatic interaction with regard
      to survival is observed with pso1, pso2, and rad3. With the same treatment the
      combination of pso3-1 with rad6 and rad52 leads to synergistic interaction. For
      the monofunctional agent 3-carbethoxypsoralen (3-CPs) the analysis of double
      mutants yields the same results as with the bifunctional 8-methoxypsoralen (8
      MOP) with the exception of the pso1-1pso3-1 double mutant. Here we find an
      additive interaction, i.e., the sensitivities of both parental strains are summed
      in the double mutant, which indicates a different substrate specificity of the
      repair activity encoded by the PSO1 and PSO3 genes.

PMID- 1735130
TI  - Differential muscarinic receptor mRNA expression by freshly isolated and cultured
      bovine aortic endothelial cells.
AB  - Endothelial cells, either in vivo or freshly isolated, respond when exposed to
      muscarinic agonists with an increase in cytosolic free calcium concentration
      ([Ca2+]i) and release of endothelium-derived relaxing factor (EDRF). When placed
      in culture, however, endothelial cells rapidly lose these responses, which may be
      related to changes in muscarinic receptor expression. Northern blot analysis of
      poly(A) + RNA from freshly isolated or cultured bovine aortic endothelial cells
      was used to address this problem. Through the use of specific cDNA probes
      complementary to the nonconserved regions of the m1, m2, m3, m4, and m5
      muscarinic receptors, mRNA transcripts for the m1 (3.9 kb), m2 (3.8 kb), and m3
      (3.1 kb) receptor subtypes were identified in freshly isolated endothelial cells,
      whereas m1 and m3 transcripts were identified in aortic smooth muscle. In
      contrast, cultured endothelial cells contained mRNA for only the m2 receptor
      subtype. Transcripts for the m4 or m5 receptors were not detected in either
      freshly isolated or cultured endothelial cells. Since m1 and m3 receptor subtypes
      are coupled to phospholipase C, activation of which is required for EDRF release,
      these observations may explain the failure of muscarinic agonists to elicit a
      rise in [Ca2+]i and EDRF release from cultured endothelial cells.

PMID- 1735131
TI  - Effect of temperature change on the permeability of eel rete capillaries.
AB  - The changes in the permeability properties of the rete capillaries of the eel in
      response to temperature shifts were studied during countercurrent perfusion at
      constant flow and pressure. Tracers and oxygen were added to the arterial
      perfusate. From the ratio of end concentrations of arterial to venous capillaries
      divided by surface area, calculated from rete weight, a value for the ratio of
      permeability to flow, P/F, with dimensions in centimeters-2 was estimated.
      Because flow and surface area are constant, this provides an index of how
      permeability varies with time. A group of paracellular (albumin, sucrose, and
      sodium) and cellular (antipyrine, water, and oxygen) probes were used. When the
      temperature of the perfusate was raised abruptly from 25 degrees C to 35 degrees
      C, P/F values rose continuously and irreversibly from 0.042 +/- 0.009 to 0.281 +/
      0.112 cm-2 (mean +/- SEM) for 125I-albumin, from 0.082 +/- 0.006 to 1.74 +/-
      0.070 cm-2 for [14C]sucrose, and from 0.32 +/- 0.06 to 2.78 +/- 0.62 cm-2 for
      22Na, whereas they were not modified for [14C]antipyrine, [3H]water, and O2.
      Gradual increase of temperature was accompanied by a smaller rise in sucrose and
      sodium permeability and no change in albumin permeability; with decrease, the
      change was reversible.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735132
TI  - JE mRNA accumulates rapidly in aortic injury and in platelet-derived growth
      factor-stimulated vascular smooth muscle cells.
AB  - The early response to vascular injury is characterized by migration of
      inflammatory cells, including monocytes, and platelets to the damaged vessel
      wall. These inflammatory cells may serve as a source of growth factors and
      cytokines that stimulate vascular smooth muscle cell (VSMC) migration and
      proliferation associated with intimal hyperplasia. JE is a platelet-derived
      growth factor (PDGF)-inducible "early" gene that encodes a monocyte
      chemoattractant and, as such, could play an important role in inflammation. We
      now report that JE mRNA levels are increased in intact aorta after balloon
      injury. The time course of this increase, with maximal levels at 4 hours, is
      similar to that seen in PDGF-treated cultured rat aortic VSMCs. The accumulation
      of JE mRNA in cultured VSMCs is accompanied by a marked increase in the secretion
      of JE protein. The elevation of JE mRNA levels in VSMCs shows specificity for
      PDGF, because angiotensin II, alpha-thrombin, and epidermal growth factor fail to
      increase JE mRNA levels. In contrast to 3T3 fibroblasts, the accumulation of JE
      mRNA in VSMCs in response to PDGF is predominantly due to an increase in JE mRNA
      stability. The accumulation of JE mRNA in VSMCs stimulated by PDGF appears to
      occur via a novel pathway(s) independent of Ca2+ mobilization, Na(+)-H+ exchange,
      protein kinase C activation, or elevation in cAMP levels. These findings suggest
      that VSMCs may take part in the early inflammatory response after injury through
      the production of JE, a potent monocyte chemoattractant. Finally, our data
      suggest that JE may be a marker for PDGF-specific effects on VSMCs, both in vitro
      and in vivo. Thus, in addition to direct effects on VSMC growth and migration,
      PDGF may play a role in the early inflammatory response after vascular injury by
      inducing chemoattractants, such as that encoded by JE.

PMID- 1735133
TI  - Effect of a cigarette smoke extract on the metabolism of the proinflammatory
      autacoid, platelet-activating factor.
AB  - Cigarette smoking is associated with an increased incidence of a number of
      diseases. Minimal information is available at the molecular level concerning the
      mechanism of action of cigarette smoke. Platelet-activating factor (PAF) is one
      of the most potent proinflammatory agents described. PAF concentration may be
      regulated by the degradation of PAF as catalyzed by the plasma enzyme, PAF
      acetylhydrolase (PAF-AH). This enzyme is associated with the lipoprotein
      fraction. The exposure of low density lipoprotein to a cigarette smoke extract
      (CSE) has been shown to alter the charge of low density lipoprotein and its
      uptake by macrophages. The activity of PAF-AH in the lipoprotein fraction has
      been assayed after exposure to CSE. The activity of PAF-AH was inhibited by the
      CSE in a dose-dependent manner. The inhibition of PAF-AH by the CSE was not
      altered by superoxide dismutase or catalase addition. Sulfhydryl compounds
      prevented and reversed the inhibition of PAF-AH caused by CSE. The inhibitor
      present in CSE was not nicotine, its major metabolic product, (-)-cotinine, or
      several compounds known to be present in the extract. The charge alteration
      reaction(s) and PAF-AH inhibition appear to be localized at different sites of
      the lipoprotein molecule. The observed inhibition may account for the increase in
      the plasma PAF concentration that is known to occur in smokers. The increase of
      PAF may contribute to the increased incidence of cardiovascular and lung diseases
      known to be present in smokers.

PMID- 1735134
TI  - Genetically engineered endothelial cells remain adherent and viable after stent
      deployment and exposure to flow in vitro.
AB  - Intravascular stents, currently in experimental human use for recurrent arterial
      stenosis, are plagued by subacute thrombosis. As a therapeutic approach to stent
      related thrombosis, we and others have suggested coating stents with endothelial
      cells before implantation. In a previous study we demonstrated the feasibility of
      coating stents with endothelial cells that were genetically modified to secrete
      large amounts of human tissue plasminogen activator. In the present study we
      attempted both to develop a clinically applicable protocol for stent seeding and
      to test whether seeded cells would remain adherent to stents after exposure to
      pulsatile flow. Endothelial cells were harvested from the saphenous veins of
      sheep with survival of the donor animals. Harvested cells were transduced with a
      retroviral vector containing a marker gene and seeded onto catheter-mounted
      stents under sterile conditions. Scanning electron microscopy revealed complete
      coverage of the stent surfaces by seeded cells. Stents were expanded and exposed
      to pulsatile flow in vitro. Substantial cell retention was observed on the
      lateral stent surfaces by light microscopy and scanning electron microscopy;
      fewer cells were seen on the luminal and abluminal surfaces. Removal of seeded
      cells from flow-exposed stents by trypsin digestion resulted in the recovery of
      approximately 70% of the seeded cells. These cells were viable and healthy as
      judged by their ability to proliferate to confluence with the same kinetics as
      control (non-flow-exposed) cells. Autologous genetically modified endothelial
      cells can be seeded onto catheter-mounted stents in a sterile manner, and stent
      deployment under flow conditions results in substantial retention of viable
      cells.

PMID- 1735135
TI  - Influence of platelet-vessel wall interactions on leukocyte rolling in vivo.
AB  - The influence of platelet-vessel wall interactions on leukocyte rolling was
      investigated in rabbit mesenteric venules (diameter, 21-40 microns) using
      intravital videomicroscopy. Puncture of the wall with glass micropipettes (tip, 6
      8 microns) evoked the formation of a thrombus in all venules. In most vessels,
      emboli were produced as well. The rolling of leukocytes (i.e., their movement
      along the vessel wall at a velocity clearly lower than that of the other blood
      cells) was quantitated simultaneously in vessel segments upstream and downstream
      from a thrombus up to 10 minutes after puncture. During embolization the number
      of rolling leukocytes decreased significantly from the upstream to the downstream
      vessel segment (median decrease, 45%; p less than or equal to 0.001). It was
      still decreased by approximately 50% after embolization had stopped, indicating
      that the decrease in leukocyte rolling was not caused by inclusion of leukocytes
      in the emboli. In venules without embolization, leukocyte rolling did not change
      systematically, indicating that fluid dynamic changes induced by the thrombus do
      not influence leukocyte rolling. Inhibition of prostaglandin formation with
      aspirin (100 mg/kg) almost completely abolished the influence of the
      thromboembolic reaction on leukocyte rolling, but blockade of thromboxane A2
      receptors with sulotroban (30 mg/kg) had no effect. In conclusion, this is the
      first report on a functional interaction in vivo, at a site of vessel wall
      injury, between platelets, vascular cells, and leukocytes. The findings suggest
      that substances produced by activated platelets and/or damaged vascular cells
      diminish leukocyte rolling. The identity of these substances is not yet clear,
      but the present study indicates that prostaglandins other than thromboxane A2 are
      involved.

PMID- 1735136
TI  - Pulmonary vasodilator response to vagal stimulation is blocked by N omega-nitro-L
      arginine methyl ester in the cat.
AB  - The effect of N omega-nitro-L-arginine methyl ester (L-NAME), an inhibitor of
      endothelium-derived relaxing factor production, on the vasodilator response to
      efferent vagal stimulation was investigated in the pulmonary vascular bed of the
      intact-chest cat under conditions of controlled blood flow and constant left
      atrial pressure. When pulmonary vascular tone was increased with U46619, efferent
      vagal stimulation decreased lobar arterial pressure in a stimulus-frequency
      dependent manner. The decreases in lobar arterial pressure were enhanced by
      pretreatment with reserpine, were blocked by atropine, and were not altered by
      propranolol, indicating that the neurogenic vasodilator response was cholinergic
      in nature. The decreases in lobar arterial pressure in response to vagal
      stimulation and to exogenously administered acetylcholine were reduced after
      administration of L-NAME (100 mg/kg i.v.). Although L-NAME decreased pulmonary
      vasodilator responses to vagal stimulation and to acetylcholine, responses to
      adenosine, nicorandil, lemakalim, isoproterenol, prostaglandin E1, sodium
      nitroprusside, and 8-bromo-cGMP, agents that act by a variety of mechanisms, were
      not decreased. These results are consistent with the hypothesis that efferent
      vagal stimulation releases acetylcholine, which dilates the pulmonary vascular
      bed by stimulating the production of nitric oxide or a labile nitroso compound
      from L-arginine.

PMID- 1735137
TI  - Indexing tricarboxylic acid cycle flux in intact hearts by carbon-13 nuclear
      magnetic resonance.
AB  - Although the tricarboxylic acid (TCA) cycle is the prime means of carbon
      metabolism for energy generation in normal myocardium, the noninvasive
      quantification of TCA cycle flux in intact cardiac tissues is difficult. A novel
      approach for estimating citric acid cycle flux using 13C nuclear magnetic
      resonance (NMR) is presented and evaluated experimentally by comparison with
      measured myocardial oxygen consumption over a wide range of cardiac contractile
      function in intact, beating rat hearts. Continuous series of 13C NMR spectra,
      obtained after the introduction of [2-13C]acetate as substrate, quantified the
      time course of 13C appearance in the carbon positions of myocardial glutamate,
      which are sequentially enriched via citric acid cycle metabolism. A TCA cycle
      flux parameter was calculated using the premise that TCA cycle flux is inversely
      proportional to the time difference between 13C appearance in the C-4 and C-2
      positions of glutamate (glutamate delta t50 [minutes]), which are enriched in
      subsequent "turns" of the TCA cycle. This TCA cycle flux parameter, termed KT,
      correlated strongly with myocardial oxygen consumption over a range of developed
      pressures in hearts perfused with 5 mM acetate (r = 0.98, p less than 0.001), as
      well as in separate studies in hearts perfused with 5 mM glucose and 0.5-0.8 mM
      acetate (r = 0.94, p less than 0.001). Results of numerical modeling of 13C
      glutamate kinetics suggest that this TCA cycle flux parameter, KT, is relatively
      insensitive to changes in metabolite pool sizes that could occur during
      metabolism of other substrates or during conditions of altered oxygen
      availability. Additional studies in separate hearts indicated that the time
      course of 13C appearance in citrate, which is predominantly mitochondrial in the
      rat heart, is similar to that in glutamate, further supporting the premise that
      the described 13C NMR parameters reflect mitochondrial citric acid cycle activity
      in intact cardiac tissues.

PMID- 1735138
TI  - Early changes in extracellular potassium in ischemic rabbit myocardium. The role
      of extracellular carbon dioxide accumulation and diffusion.
AB  - The role of local accumulation and diffusion of CO2 to modify cellular loss and
      extracellular accumulation of K+ during the initial, reversible phase of
      myocardial ischemia was investigated in isolated, cylindrical papillary muscles
      of the rabbit. The muscles were blood-perfused through their vascular tree and
      placed in a (permanently flowing) humidified gas mixture with predetermined
      partial pressures of N2, O2, and CO2. Ischemia was produced by total arrest of
      perfusion and O2 withdrawal from the gas mixture. With surface PCO2 kept constant
      during ischemia, [K+]o varied markedly with muscle geometry. After 10 minutes of
      ischemia, K+ accumulation was approximately 2.5 mM in muscles with a radius of
      0.35 mm and approximately 14 mM in muscles with a radius of 0.9 mm, indicating
      that a large fraction of K+ accumulation was dependent on diffusion of a volatile
      metabolite. Computer simulation of CO2 accumulation and diffusion within a tissue
      cylinder suggested a close phenomenological relation between PCO2 and [K+]o in
      ischemia. This was confirmed by the finding that an increase of tissue PCO2 in
      small cylinders before or during ischemia by externally applied CO2 produced an
      increase in K+ accumulation. The importance of CO2 diffusion for local
      inhomogeneities in K+ within the same preparation was demonstrated by showing
      [K+]o gradients with simultaneous or consecutive measurements between the
      papillary muscle cylinders and the adjacent septum and within 300 microns from
      the surface of the papillary muscle cylinders. These gradients predict an
      inhomogeneity of impulse conduction that might contribute to the genesis of
      ventricular arrhythmias. Besides the demonstration that accumulation and
      diffusion introduce inhomogeneities of [K+]o in ischemia, our results suggest
      that a significant component of cellular ischemic K+ loss is associated with
      production and extrusion of metabolic acid. On the basis of previous measurements
      of pHo and pHi in identical conditions, possible mechanisms of ischemic cellular
      K+ loss are discussed.

PMID- 1735139
TI  - Vascular responses to activated leukocytes after regression of atherosclerosis.
AB  - Activation of leukocytes in vivo produces marked constriction of large arteries
      in atherosclerotic, but not in normal, monkeys. We tested the hypotheses that
      vasoconstrictor responses to activated leukocytes in vivo may be abnormal during
      hypercholesterolemia before the development of atherosclerotic lesions and that
      responses may return to normal after the regression of atherosclerosis.
      Leukocytes were activated by injection of the chemotactic peptide formyl
      methionine-leucine-phenylalanine (fMLP) into the blood-perfused hind limb of four
      groups of cynomolgus monkeys: monkeys fed a normal diet (normal group, n = 18),
      monkeys fed an atherogenic diet for 3-4 months (hypercholesterolemic group, n =
      6), monkeys fed an atherogenic diet for 20 months (atherosclerotic group, n =
      19), and monkeys fed an atherogenic diet for 18 months, followed by a normal diet
      for 20 months (regression group, n = 14). Baseline resistance of large arteries
      was 1.5 +/- 0.2 (mean +/- SEM), 2.0 +/- 0.6, 3.5 +/- 0.4 (p less than 0.05 versus
      normal), and 1.7 +/- 0.2 mm Hg/ml/min per 100 g tissue for the normal,
      hypercholesterolemic, atherosclerotic, and regression groups, respectively.
      Injection of fMLP did not change resistance of large arteries in normal or
      hypercholesterolemic monkeys. Injection of fMLP increased resistance of large
      arteries by 3.0 +/- 0.7 mm Hg/ml/min per 100 g tissue in atherosclerotic monkeys
      and by 1.3 +/- 0.4 mm Hg/ml/min per 100 g tissue in regression monkeys (p less
      than 0.05 versus atherosclerotic and normal). Thus, abnormal vasoconstriction in
      response to activation of leukocytes persists, but to a lesser extent, after
      regression. In contrast, vasoconstrictor responses to serotonin, which were
      potentiated in atherosclerotic monkeys, were normal after regression.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1735140
TI  - Brain ouabain and central effects of dietary sodium in spontaneously hypertensive
      rats.
AB  - High sodium intake (HNa) increases brain ouabainlike activity (OLA) in rats. In
      spontaneously hypertensive rats (SHR), HNa exaggerates development of
      hypertension and pressor and sympathoexcitatory responses to stress. To
      investigate whether dietary sodium-induced changes in brain OLA play a functional
      role, responses of mean arterial pressure (MAP), heart rate (HR), and renal
      sympathetic nerve activity (RSNA) to intracerebroventricular ouabain and to
      mental stress and intracerebroventricular alpha 2-adrenoceptor agonist guanabenz
      alone or preceded by intracerebroventricular ouabain were recorded in conscious
      SHR and Wistar-Kyoto (WKY) rats maintained from 4 to 8 weeks of age on different
      sodium diets: 1) low sodium intake (LNa, 17 mumol), 2) normal sodium intake (NNa,
      101 mumol), and 3) HNa (1,370 mumol). SHR on NNa showed significantly higher MAP
      and RSNA compared with WKY rats on NNa. HNa or LNa significantly increased or
      decreased MAP but had no effects on resting RSNA in SHR and had no effects on
      resting MAP and RSNA in WKY rats. Intracerebroventricular ouabain induced dose
      dependent increases in MAP, RSNA, and HR. In both SHR and WKY rats, LNa
      significantly enhanced these responses. In contrast, HNa significantly attenuated
      these responses only in SHR. Air stress increased and intracerebroventricular
      guanabenz decreased MAP, HR, and RSNA. The magnitudes of increases and decreases
      were significantly larger in SHR than in WKY rats. In WKY rats, dietary sodium
      did not change these responses. In contrast, in SHR, HNa significantly enhanced
      MAP, HR, and RSNA responses to air stress or intracerebroventricular
      guanabenz.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735141
TI  - Signal transduction by G proteins in cardiac tissues.
AB  - The role of G proteins in mediating the responses of the heart to circulating
      catecholamines and to the influences of the autonomic nervous system is of
      special interest to cardiologists. It is evident that G proteins are essential
      links in the cascade of biochemical events that ensure when neurotransmitters and
      hormones interact with receptors on myocardial cells. It is likely [corrected]
      that dysfunction of G proteins plays a role in cardiovascular pathophysiology.
      With current methodologies, especially molecular biological and recombinant DNA
      techniques, and with transgenic animal models that can relate physiological
      function and specific gene dosage, some cardiovascular diseases may be traced to
      G protein-related defects.

PMID- 1735142
TI  - Diagnosis of thoracic aortic dissection. Magnetic resonance imaging versus
      transesophageal echocardiography.
AB  - BACKGROUND: Aortic dissection requires prompt and reliable diagnosis to reduce
      the high mortality. The purpose of this study was to assess the reliability of
      both ECG-triggered magnetic resonance imaging (MRI) and transesophageal two
      dimensional echocardiography combined with color-coded Doppler flow imaging (TEE)
      for the diagnosis of thoracic aortic dissection and associated epiphenomena.
      METHODS AND RESULTS: Fifty-three consecutive patients with clinically suspected
      aortic dissection were subjected to a dual noninvasive imaging protocol in random
      order; imaging results were compared and validated against the independent
      morphological "gold standard" of intraoperative findings (n = 27), necropsy (n =
      7), and/or contrast angiography (n = 53). No serious side effects were
      encountered with either imaging method. In contrast to a precursory screening
      transthoracic echogram, the sensitivities of both MRI and TEE were 100% for
      detecting a dissection of the thoracic aorta irrespective of its location. The
      specificity of TEE, however, was lower than the specificity of MRI for a
      dissection (TEE, 68.2% versus MRI, 100%; p less than 0.005), which resulted
      mainly from false-positive TEE findings confined to the ascending segment of the
      aorta (TEE, 78.8% versus MRI, 100%; p less than 0.01). In addition, MRI proved to
      be more sensitive than TEE in detecting the formation of thrombus in the false
      lumen of both the aortic arch (p less than 0.01) and the descending segment of
      the aorta (p less than 0.05). There were no discrepancies between the two imaging
      techniques in detecting the site of entry to a dissection, aortic regurgitation,
      or pericardial effusion. CONCLUSIONS: Both MRI and TEE are atraumatic, safe, and
      highly sensitive methods to identify and classify acute and subacute dissections
      of the entire thoracic aorta. TEE, however, is associated with lower specificity
      for lesions in the ascending aorta. These results may still favor TEE as a semi
      invasive diagnostic procedure after a precursory screening transthoracic echogram
      in suspected aortic dissection, but they establish MRI as an excellent method to
      avoid false-positive findings. Anatomic mapping by MRI may emerge as the most
      comprehensive approach and morphological standard to guide surgical
      interventions.

PMID- 1735143
TI  - Multicenter experience with balloon mitral commissurotomy. NHLBI Balloon
      Valvuloplasty Registry Report on immediate and 30-day follow-up results. The
      National Heart, Lung, and Blood Institute Balloon Valvuloplasty Registry
      Participants.
AB  - BACKGROUND: Balloon mitral commissurotomy can increase mitral valve areas and
      reduce symptoms in selected patients with mitral stenosis. The National Heart,
      Lung, and Blood Institute Balloon Valvuloplasty Registry was organized to address
      concerns regarding differences in patient selection and technique and to report
      the current clinical outcome. METHODS AND RESULTS: In 24 cooperating centers, 738
      patients had balloon mitral commissurotomy. Baseline clinical, echo Doppler, and
      cardiac catheterization data, procedure details, and hemodynamic and 30-day
      clinical outcome were reported. Overall, 81% of the patients were women (mean
      age, 54 +/- 15 years), and 24% had moderate or severe other valvular lesions.
      When single- and double-balloon procedures were compared, the final mitral valve
      area was larger (1.7 +/- 0.7 versus 2.0 +/- 0.8 cm2, p = 0.0009), increase in
      mitral regurgitation was similar (4% versus 12%, p = 0.08), and interatrial
      shunts occurred more frequently (2% versus 12%, p = 0.04) after double-balloon
      procedures. Increase in mitral valve area was weakly related to mitral valve
      morphology as assessed by an echo score (r = -0.15). Multivariate predictors of
      improved clinical status at 30 days were cases performed in larger-volume
      centers, baseline mitral valve area greater than 0.5 cm2, and age less than 70
      years. At 30-day follow-up, 4% of the patients with completed procedures had
      mitral valve surgery, 3% had died, and 83% had their overall condition improved.
      Patients with mixed mitral stenosis or regurgitation and isolated mitral stenosis
      had a similar course, but fewer patients with multivalve disease became
      asymptomatic. CONCLUSIONS: Balloon mitral commissurotomy, as practiced in a broad
      range of experienced centers, produced significant short-term hemodynamic and
      clinical improvements. Balloon mitral commissurotomy can be considered an
      effective treatment option in patients with symptomatic mitral stenosis.

PMID- 1735144
TI  - Complications and validity of pulmonary angiography in acute pulmonary embolism.
AB  - BACKGROUND: The Prospective Investigation of Pulmonary Embolism Diagnosis
      (PIOPED) addressed the value of ventilation/perfusion scans in acute pulmonary
      embolism (PE). The present study evaluates the risks and diagnostic validity of
      pulmonary angiography in 1,111 patients who underwent angiography in PIOPED:
      METHODS AND RESULTS: Complications were death in five (0.5%), major nonfatal
      complications in nine (1%), and less significant or minor in 60 (5%). More fatal
      or major nonfatal complications occurred in patients from the medical intensive
      care unit than elsewhere: five of 122 (4%) versus nine of 989 (1%) (p less than
      0.02). Pulmonary artery pressure, volume of contrast material, and presence of PE
      did not significantly affect the frequency of complications. Renal dysfunction,
      either major (requiring dialysis) or less severe, occurred in 13 of 1,111 (1%).
      Patients who developed renal dysfunction after angiography were older than those
      who did not have renal dysfunction: 74 +/- 13 years versus 57 +/- 17 years (p
      less than 0.001). Angiograms were nondiagnostic in 35 of 1,111 (3%), and studies
      were incomplete in 12 of 1,111 (1%), usually because of a complication.
      Surveillance after negative angiograms showed PE in four of 675 (0.6%).
      Angiograms, interpreted on the basis of consensus readings, resulted in an
      unchallenged diagnosis in 96%. CONCLUSIONS: The risks of pulmonary angiography
      were sufficiently low to justify it as a diagnostic tool in the appropriate
      clinical setting. Clinical judgment is probably the most important consideration
      in the assessment of risk.

PMID- 1735145
TI  - Five- to fifteen-year follow-up after Fontan operation.
AB  - BACKGROUND: The purpose of this study was to estimate survival and quality of
      outcome and assess factors associated with outcome for patients out 5 to 15 years
      from their Fontan operation. METHODS AND RESULTS: We studied 352 patients who had
      the Fontan operation prior to 1985. The overall 1-, 5-, and 10-year survival was
      77%, 70%, and 60%, respectively. The following factors were significantly
      associated with lower survival: univentricular heart or complex congenital
      anomalies other than tricuspid atresia, early calendar year of operation,
      heterotaxia syndromes, early age at operation, increased pulmonary artery
      pressure, atrioventricular valve dysfunction, and higher (worse) New York Heart
      Association class. Reoperations were necessary for 103 of the 352 patients. At
      least 20% of the survivors have or have had cardiac arrhythmias requiring
      antiarrhythmic medication or mechanical pacemaker insertion. Between 7% and 10%
      of the patients have had or had protein-losing enteropathy/hypoproteinemia. At 5
      years postoperatively, 122 patients (34.7%) were alive with a better New York
      Heart Association functional classification than preoperatively. Fifty-eight
      patients (16.5%) were alive and in the same functional classification, but 126
      (35.8%) died within the first 5 years or were in a worse functional
      classification. Thirty-nine patients were doing excellently and 29 patients
      poorly 5 years after the operation. Of the surviving patients, 43% can do as much
      exercise as their peers, whereas 3% are incapable of exercise. CONCLUSIONS: To
      assure good functional long-term outcome in addition to survival, clinicians must
      exclude from selection for Fontan operation patients known to be at high risk for
      death or poor outcome.

PMID- 1735146
TI  - Baroreflex sensitivity and heredity in essential hypertension.
AB  - BACKGROUND: Abnormalities in baroreflex control of heart rate may be important in
      the pathogenesis of essential hypertension. METHODS AND RESULTS: To investigate
      the influence of heredity on baroreflex function, we measured baroreflex
      sensitivity in 40 untreated patients with essential hypertension grouped by the
      presence (FH+) or absence (FH-) of a family history of hypertension and in 24
      normotensive counterparts. Baroreflex sensitivity was assessed by both high
      pressure (phenylephrine bolus) and low-pressure (amyl nitrite inhalation)
      stimuli. Subject groups were matched for age, blood pressure, body weight, and
      race. Baroreflex sensitivity (in milliseconds per millimeter of mercury) assessed
      by amyl nitrite inhalation was 24.3 +/- 2.8 in FH- normotensives, 12.3 +/- 1.7 in
      FH+ normotensives, 15.4 +/- 3.3 in FH- hypertensives, and 8.1 +/- 1.2 in FH+
      hypertensives. Baroreflex sensitivity assessed by phenylephrine bolus was 28.8 +/
      5.6 in FH- normotensives, 19.3 +/- 2.8 in FH+ normotensives, 19.1 +/- 2.0 in FH-
      hypertensives, and 13.6 +/- 1.3 in FH+ hypertensives. Two-factor analysis of
      variance showed significant effects on baroreflex sensitivity for blood pressure
      status (normotensive versus hypertensive) and for family history of hypertension.
      After control line (controlling) for the effects of several variables, including
      age, mean arterial pressure, body weight, and race through multiple linear
      regression analysis, the effect of family history of hypertension on baroreflex
      sensitivity was still highly significant. Indeed, of all variables investigated,
      family history of hypertension was the strongest unique baroreflex sensitivity
      predictor. CONCLUSIONS: These data suggest that the impairment in baroreflex
      sensitivity in hypertension is in part genetically determined and may be an
      important hereditary component in the pathogenesis of essential hypertension.

PMID- 1735147
TI  - Plasma endothelin correlates with the extent of pulmonary hypertension in
      patients with chronic congestive heart failure.
AB  - BACKGROUND: Endothelin is a family of potent vasoconstrictor peptides of vascular
      endothelial origin. Although it has been proposed that the vasoconstrictor
      effects of endothelin are produced at the local vascular level, increased plasma
      concentration of endothelin has been identified in cardiovascular disorders.
      METHODS AND RESULTS: We tested whether immunoreactive endothelin-1 could be
      detected by radioimmunoassay in plasma of congestive heart failure patients and
      whether levels correlated with hemodynamic characteristics. Twenty congestive
      heart failure patients (New York Heart Association class II-IV) were sampled in
      the morning after an overnight fast, before medication. Cardiac index was
      decreased to 2.14 +/- 0.45 l/m/m2, and pulmonary wedge pressure was increased to
      22 +/- 7 mm Hg. The ranges of pulmonary pressures were: systolic, 22-100 mm Hg,
      mean, 13-61 mm Hg, and diastolic, 8-42 mm Hg. The endothelin-1 level was 9.07 +/-
      4.13 pg/ml (range, 4-19 pg/ml), which was increased compared with 12 normals (3.7
      +/- 0.6 pg/ml; range, 2.8-4.7 pg/ml); the difference was statistically
      significant (p less than 0.0001). Endothelin-1 significantly correlated with
      pulmonary pressures (systolic, r = 0.78; mean, r = 0.80; diastolic, r = 0.77; all
      p less than 0.003) and pulmonary vascular resistance (r = 0.65, p less than
      0.01). Endothelin-1 strongly correlated with the resistance ratio (pulmonary
      vascular resistance/systemic vascular resistance) (r = 0.88, p less than 0.0001).
      Stepwise multiple regression analysis confirmed the significance of these
      observations. CONCLUSIONS: Elevated immunoreactive endothelin-1 specifically
      correlated with the extent of pulmonary hypertension in congestive heart failure
      patients. Whether endothelin-1 is a regional mediator of pulmonary hypertension
      or a marker for its occurrence requires additional evaluation.

PMID- 1735148
TI  - Contractile properties and Ca2+ release activity of the sarcoplasmic reticulum in
      dilated cardiomyopathy.
AB  - BACKGROUND: We performed a comparative study on Ca2+ release activity of the
      sarcoplasmic reticulum and calcium sensitivity of contractile apparatus of
      chemically skinned myocardial fibers obtained from four nonfailing human hearts
      and 13 excised hearts from patients with idiopathic dilated cardiomyopathy.
      METHODS AND RESULTS: Ca2+ sensitivity of contractile apparatus was studied by
      following the isometric tension developed by chemically skinned myocardial fibers
      challenged with solutions of decreasing pCa. Ca2+ release from sarcoplasmic
      reticulum was monitored indirectly by measurement of the isometric tension
      developed by skinned fibers challenged with caffeine. We observed no significant
      difference of Ca2+ sensitivity and cooperativity between normal myocardium (pCa50
      = 6.00 +/- 0.05; Hill coefficient, nHill = 2.07 +/- 0.10) and dilated
      cardiomyopathy (pCa50 = 6.03 +/- 0.07; nHill = 2.72 +/- 0.30) when the fibers
      were stretched to 130% of the resting length. We also found that both in normal
      myocardium and dilated cardiomyopathy, stretching to 150% of the resting length
      increased the Ca2+ sensitivity of the contractile system; pCa50 = 6.21 +/- 0.01
      and 6.13 +/- 0.04 in normal and dilated cardiomyopathy, respectively, whereas in
      dilated cardiomyopathy there was a decrease of Hill coefficient with stretching
      that was not observed in the control group. The caffeine threshold in idiopathic
      dilated cardiomyopathy was markedly increased compared with the control group,
      1.94 +/- 0.27 mmol/l and 0.29 +/- 0.04 mmol/l caffeine, respectively, whereas
      there were no significant differences in the extent and rate of caffeine-induced
      Ca2+ release. CONCLUSIONS: These results indicate that in idiopathic dilated
      cardiomyopathy there is no alteration of contractile and regulatory proteins; on
      the contrary, the gating mechanism of the Ca2+ release channel of sarcoplasmic
      reticulum is abnormal, suggesting a possible involvement of the excitation
      contraction coupling in the pathogenesis of this disease. It should also be taken
      into account, however, that the increased caffeine threshold in dilated
      cardiomyopathy would be a result of the enhanced resistance to the skinning
      procedure secondary to the modification of lipid species and/or content in
      sarcoplasmic reticulum membrane.

PMID- 1735149
TI  - One-year results of the Thrombolysis in Myocardial Infarction investigation
      (TIMI) Phase II Trial.
AB  - BACKGROUND: The Thrombolysis in Myocardial Infarction (TIMI) Phase II Trial
      randomized 3,339 patients to either an invasive (INV, n = 1,681) or a
      conservative (CON, n = 1,658) strategy after intravenous recombinant tissue-type
      plasminogen activator (rt-PA) for acute myocardial infarction. METHODS AND
      RESULTS: The patients assigned to the INV strategy routinely underwent cardiac
      catheterization, and when anatomically appropriate, percutaneous transluminal
      coronary angioplasty (PTCA) or coronary artery bypass grafting 18-48 hours after
      infarction. CON patients had these procedures only in response to the occurrence
      of spontaneous or provoked ischemia. One-year follow-up data are available in
      3,316 patients (99.3%). The primary trial end point, death and nonfatal
      reinfarction, occurred in 14.7% of INV patients and in 15.2% of CON patients (p =
      NS). When analyzed individually, there was no difference (p = NS) in death (INV,
      6.9%; CON, 7.4%) or recurrent infarction (INV, 9.4%; CON, 9.8%) between the two
      groups. Anginal status at 1 year was also similar. Cardiac catheterization and
      PTCA were performed more often in INV (98.0% and 61.2%, respectively) compared
      with CON (45.2% and 20.5%, respectively) patients. At 1 year, the cumulative
      number of patients who underwent coronary bypass surgery (INV, 17.5%; CON, 17.3%)
      was similar in the two groups. CONCLUSIONS: The INV and CON strategies resulted
      in similar favorable outcomes at 1 year of follow-up. In particular, the rates of
      mortality and reinfarction were not different and were impressively low in both
      groups. One possible advantage of the INV strategy was detected in subgroup
      analyses. In patients with a history of myocardial infarction, the data are
      suggestive that 1-year mortality was lower in INV patients (10.3%) than in CON
      patients (17.0%) (p = 0.03).

PMID- 1735150
TI  - Evidence implicating nonmuscle myosin in restenosis. Use of in situ hybridization
      to analyze human vascular lesions obtained by directional atherectomy.
AB  - BACKGROUND: Identification of genes that are specifically activated in restenosis
      lesions after percutaneous transluminal angioplasty represents a necessary step
      toward molecular manipulation designed to inhibit cellular proliferation
      responsible for such lesions. Whereas quiescent smooth muscle cells (contractile
      phenotype) preferentially express smooth muscle myosin, proliferating smooth
      muscle cells (synthetic phenotype) have been shown to preferentially express
      nonmuscle myosin in vitro. Accordingly, we analyzed the expression of a recently
      cloned isoform of human nonmuscle myosin heavy chain (MHC-B) in fresh human
      restenotic lesions. METHODS AND RESULTS: A total of 10 lesions, including four
      restenosis (three superficial femoral arterial lesions and one saphenous vein
      bypass lesion) and six primary (four superficial femoral arterial lesions and two
      coronary arterial lesions) obtained percutaneously by directional atherectomy,
      were processed for examination by in situ hybridization. In total, 150 tissue
      sections of restenotic lesions (66 sections), primary lesions (78 sections), and
      normal internal mammary artery (six sections) were hybridized with the nonmuscle
      MHC-B probe. Restenotic lesions showed intense hybridization to the nonmuscle MHC
      B cRNA probe, as demonstrated by a clustering of more than 20 grains per cell
      nucleus in 80% of the cells examined within a high-power field (x250); in
      contrast, an equivalent degree of hybridization was observed in only 7% of cells
      within primary lesions (p less than 0.001). Results of immunocytochemistry using
      monoclonal antibody to smooth muscle actin indicated that cells demonstrating
      strong hybridization were smooth muscle in origin. CONCLUSIONS: These findings
      demonstrate that 1) human vascular tissue obtained by percutaneous directional
      atherectomy constitutes appropriate biopsy material for gene expression studies
      at the mRNA level, and 2) nonmuscle MHC-B mRNA is present in greater abundance
      among restenotic versus primary vascular stenoses. These observations thus
      provide a rational basis to explore restenotic lesions on a larger scale to
      identify genes that are activated in these lesions and establish potential
      targets for future gene therapy.

PMID- 1735151
TI  - Migratory activity of human smooth muscle cells cultivated from coronary and
      peripheral primary and restenotic lesions removed by percutaneous atherectomy.
AB  - BACKGROUND: The successful cultivation of human smooth muscle cells (SMC) from
      coronary and peripheral atherosclerotic lesions removed by percutaneous
      directional atherectomy is described. METHODS AND RESULTS: Sixty-seven patients
      in whom plaque material was obtained compose the study population. A total of 73
      lesions from both coronary (n = 38) and peripheral (n = 35) arteries of primary
      (n = 50) and restenotic origin (n = 23) were studied. Successful cultivation was
      significantly (p less than 0.001) dependent on the quantity of plaque material
      submitted. Fifty-five percent of patients in whom atherectomy specimens were
      removed from coronary lesions yielded an adequate SMC population in comparison to
      89% of those from peripheral arteries (p less than 0.01). Cultivation was not
      dependent on the age and sex of patients, lesion origin, risk factors,
      medications, or incidence of unstable angina. In an attempt to quantify SMC
      activity, migratory velocity was measured with a computer-assisted motion
      analysis system. SMC migratory velocity was found to be significantly (p less
      than 0.001) greater in restenotic than in primary plaque material. This finding
      was confirmed for both coronary and peripheral lesions. CONCLUSIONS: Our data
      suggest that elevated SMC migratory activity may be an important mechanism in the
      development of restenotic lesions.

PMID- 1735152
TI  - Electrogram criteria for identification of appropriate target sites for
      radiofrequency catheter ablation of accessory atrioventricular connections.
AB  - BACKGROUND: Catheter ablation of accessory atrioventricular (AV) connections
      using radiofrequency current has been demonstrated to be effective in the
      majority of patients with the Wolff-Parkinson-White syndrome or paroxysmal
      supraventricular tachycardia involving a concealed accessory AV connection.
      However, electrogram criteria have not been established to guide attempts at
      radiofrequency catheter ablation. METHODS AND RESULTS: The characteristics of
      local electrograms recorded at successful and unsuccessful sites of
      radiofrequency catheter ablation were determined in 132 patients. Electrograms
      recorded at a total of 438 sites were analyzed: 338 recorded during ablation of
      90 manifest accessory AV connections and 100 recorded during ablation of 44
      concealed accessory AV connections. During ablation of manifest accessory AV
      connections, the independent predictors of outcome were electrogram stability (p
      less than 0.001), the interval between activation of the ventricular electrogram
      and onset of the QRS complex (p less than 0.001), and the presence of an
      accessory AV connection potential (p less than 0.001). Radiofrequency energy
      delivery at sites demonstrating stable electrograms, a probable or possible
      accessory AV connection potential, and activation of the local ventrical
      electrogram before the onset of the QRS complex had a 57% probability of success
      compared with a 3% probability of success at sites without these features. During
      ablation of concealed accessory AV connections, the independent predictors of
      outcome were electrogram stability (p = 0.02), the presence of an accessory AV
      connection potential (p = 0.05), and the presence of retrograde continuous
      electrical activity (p = 0.04). Sites demonstrating a stable local electrogram,
      an accessory AV connection potential, and retrograde continuous electrical
      activity had an 82% probability of success compared with only a 5% probability of
      success at sites demonstrating none of these features. CONCLUSIONS: The local
      electrogram parameters of greatest importance in predicting the success or
      failure of radiofrequency catheter ablation of accessory AV connections are
      electrogram stability, the presence of an accessory AV connection potential, and
      the timing of ventricular activation relative to the QRS complex (for manifest
      accessory AV connections) or retrograde continuous electrical activity (for
      concealed accessory AV connections). Awareness of these variables during attempts
      at radiofrequency catheter ablation of accessory AV connections may minimize the
      number of unnecessary applications of radiofrequency energy.

PMID- 1735153
TI  - Physiological substrate for antidromic reciprocating tachycardia. Prerequisite
      characteristics of the accessory pathway and atrioventricular conduction system.
AB  - BACKGROUND: Although the anatomic "substrate" for the occurrence of antidromic
      reciprocating tachycardia (ART) has been previously examined, the underlying
      physiological substrate for this unusual arrhythmia in patients with the Wolff
      Parkinson-White syndrome has not been thoroughly characterized. METHODS AND
      RESULTS: The electrophysiological properties of the accessory pathway and normal
      ventriculoatrial conduction system in 30 patients with ART and a single accessory
      pathway were compared with those observed in a control group of 36 patients
      without this arrhythmia to elucidate the critical physiological substrate
      essential for the development and maintenance of ART. Inducible ART had a mean
      cycle length of 286 +/- 31 msec. The average retrograde ventriculoatrial
      conduction system effective refractory period in ART patients was significantly
      less than that in the control group (244 +/- 32 versus 291 +/- 46 msec, p =
      0.0002). All of the ART patients showed retrograde conduction over the normal
      conduction system at cycle lengths of less than or equal to 360 msec; 23 had 1:1
      conduction to less than or equal to 300 msec, and 16 showed 1:1 propagation at
      cycle lengths of less than or equal to 260 msec. The shortest cycle length
      accompanied by 1:1 retrograde propagation over the normal conduction system in
      patients with ART was also significantly less than that observed in the control
      group (274 +/- 39 versus 347 +/- 73 msec, p less than 0.001). The accessory
      pathway anterograde ERP in ART patients with 1:1 retrograde conduction over the
      normal ventriculoatrial conduction system at cycle lengths of less than or equal
      to 360 was significantly less than that seen in comparable control patients (247
      +/- 23 versus 284 +/- 56 msec, p = 0.001), and the accessory pathway location was
      significantly further from the atrioventricular node in 21 patients with ART
      undergoing surgery than that in 22 operated control patients (3.8 +/- 0.8 versus
      2.9 +/- 0.8 mapping units, p = 0.0025) who also had retrograde ventriculoatrial
      conduction to cycle lengths of less than or equal to 360 msec. No significant
      differences in anterograde atrioventricular conduction system properties,
      retrograde accessory pathway refractoriness, or shortest ventricular pacing cycle
      lengths maintaining 1:1 conduction via the accessory pathway were observed
      between groups. CONCLUSIONS: This quantitative characterization of the properties
      of conduction and refractoriness of both the accessory pathway and
      ventriculoatrial conduction system and the relation between these characteristics
      and the accessory pathway location in ART patients provides additional insight
      into the prerequisites for the initiation and maintenance of this rhythm
      disturbance.

PMID- 1735154
TI  - Incidence and mechanism of interruption of reentrant ventricular tachycardia with
      rapid ventricular pacing.
AB  - BACKGROUND: Information concerning the electrophysiological characteristics of
      the reentrant circuit is still limited. To understand the incidence and mechanism
      of pacing-induced interruption of ventricular tachycardia (VT), rapid pacing was
      performed to entrain VT, and the local electrogram at the VT origin and the
      surface electrocardiogram were analyzed. METHODS AND RESULTS: Among 25 patients,
      evidence of transient entrainment was confirmed in 20 patients, but the critical
      paced cycle length at which VT was interrupted was obtained in 13 patients when
      the paced cycle length was decreased in steps of 10 msec. During pacing at the
      critical cycle length (defined as block cycle length), changes in the local
      electrogram at VT origin were confirmed in all of the 13 patients; that is, 1) a
      change in morphology and 2) a change in the timing of activation: a sudden
      shortening in the stimulus to local electrogram time (third entrainment criterion
      by Waldo). The two changes mean that the exit is activated from a different
      direction (retrograde capture) because of an orthodromic block in the slow
      conduction zone. The QRS complex in the surface electrocardiogram showed a change
      in configuration from the fusion complex to the fully paced one at the same time
      when the exit was captured antidromically. CONCLUSIONS: Based on our observations
      in these patients, ventricular tachycardia interruption is very often associated
      with orthodromic block in the reentrant circuit at a critical cycle length of
      rapid pacing.

PMID- 1735155
TI  - Prevalence, circumstances, mechanisms, and risk stratification of sudden cardiac
      death in unipolar single-chamber ventricular pacing.
AB  - BACKGROUND: Permanent cardiac pacing is well established for the improvement of
      prognosis and quality of life in patients with severe bradycardia. However,
      sudden cardiac death still remains an unresolved problem, as it occurs in
      approximately 20-30% of paced patients. This 2-year follow-up study was directed
      at prospectively assessing prevalence, circumstances, and mechanisms of sudden
      death in 2,021 permanently paced patients. METHODS AND RESULTS: During the
      observation period, 220 patients (11%) died (mean pacing interval, 50.5 +/- 7
      months). Lethal cerebrovascular events in 66 of 220 patients (30%) and sudden
      death in 49 of 220 patients (23%) were the two most frequently reported modes of
      death. Nonsudden (first year, 20%; subsequent years, 6.9%; p less than 0.01) and
      sudden death mortality rate (4% versus 1.8%, p less than 0.05) were highest
      during the first year. Mortality was unrelated to the patient's activity status
      at the time of death. Sudden cardiac death occurred more often in male patients
      (increased risk, 1.7 versus female patients; p less than 0.001) and patients
      younger than 60 years of age (5.2 versus patients older than 60 years, p less
      than 0.001). Patients with severe bradycardia (sudden death rate, 28%), severe
      atrioventricular block (25%), or atrial fibrillation with low ventricular rate
      (25%) before pacemaker implantation were more likely to suffer from sudden
      cardiac death than patients with previous syncopal attacks (sudden death rate,
      15%) or sick sinus syndrome (17%). The highest incidence of sudden death was
      observed in patients with bifascicular and trifascicular bundle branch block. In
      this group, 35% of patients died suddenly during the follow-up period compared
      with 18% of patients without bundle branch block. In a subsequent study in 90
      consecutive patients with various types of bundle branch block, undersensing of
      up to 13% of ectopic ventricular beats occurred in patients with bifascicular
      block. Pacing-induced tachyarrhythmias and ventricular fibrillation were
      documented in 10% of undersensed ectopic ventricular beats as well as in the
      setting of atrial fibrillation associated with ventricular arrhythmias.
      CONCLUSIONS: Young age, male sex, and a severely diseased heart indicated by the
      presence of bifascicular and trifascicular bundle branch block are the strongest
      predictive clinical parameters for sudden cardiac death, especially in the first
      year after pacemaker implantation.

PMID- 1735156
TI  - Variant angina pectoris. Role of coronary spasm in the development of fixed
      coronary obstructions.
AB  - BACKGROUND: It has been suggested that recurring coronary artery spasm may lead
      to the development of fixed atherosclerotic coronary obstructions. METHODS AND
      RESULTS: We studied 10 patients with typical Prinzmetal's variant angina in whom
      the disease remained active for years and in whom occlusive coronary spasm
      occurred reproducibly at the same arterial site during repeat coronary
      arteriography (25 +/- 12 months after initial angiography). At initial
      evaluation, four patients had significant (greater than or equal to 50% fixed
      coronary diameter reduction) one-vessel coronary artery disease, and six had
      nonsignificant disease. Spasm developed at stenotic sites (20-65% diameter
      reduction) in nine patients and at an angiographically normal site in one
      patient. Progression of coronary disease was assessed in 62 segments: 10 spastic
      (of which nine were stenotic) and 52 nonspastic (eight stenotic and 44
      angiographically normal), using computerized arteriography. Mean diameters
      (millimeters) of spastic segments, nonspastic stenoses, and angiographically
      normal nonspastic segments were not significantly different at first and second
      arteriograms (1.52 +/- 0.14 versus 1.43 +/- 0.21, 1.32 +/- 0.17 versus 1.12 +/-
      0.23, and 2.40 +/- 0.12 versus 2.42 +/- 0.12, respectively). Stenosis progression
      (from 65% diameter reduction to total occlusion) occurred in one patient at a
      spastic site and in two at nonspastic sites (from 34% to 65% and from 84% to
      100%). Complicated stenoses suggestive of plaque fissuring were not observed
      during the study. CONCLUSIONS: In patients with chronic Prinzmetal's variant
      angina without myocardial infarction, stenosis progression was not frequently
      observed at spastic sites despite the recurrence of focal coronary spasm over
      relatively long periods of time.

PMID- 1735157
TI  - Regional thallium uptake in irreversible defects. Magnitude of change in thallium
      activity after reinjection distinguishes viable from nonviable myocardium.
AB  - BACKGROUND: Thallium reinjection immediately after stress-redistribution imaging
      identifies ischemic but viable myocardium in as many as 50% of the regions
      characterized by conventional redistribution imaging as irreversibly injured.
      However, we have previously shown that some regions in which irreversible defects
      persist despite reinjection are metabolically active, and hence viable, by
      positron emission tomography. In the current study, we determined whether the
      severity of reduction in thallium activity within irreversible defects on
      redistribution images and the magnitude of change in regional thallium activity
      after reinjection can further discriminate viable from nonviable myocardium in
      such defects. METHODS AND RESULTS: We studied 150 patients with coronary artery
      disease by exercise thallium tomography using the rest-reinjection protocol. The
      three sets of images (stress, redistribution, and reinjection) were then analyzed
      quantitatively. The increase in regional thallium activity from redistribution to
      reinjection was computed, normalized to the increase observed in a normal region,
      and termed "differential uptake." Of the 175 myocardial regions designated to
      have irreversible thallium defects on conventional 3-4 hour redistribution
      images, 132 had only mild-to-moderate reduction in thallium activity (51-85% of
      normal activity), and 43 had severe reduction in thallium activity (less than or
      equal to 50% of normal activity). Thallium reinjection resulted in enhanced
      relative activity in 60 of 132 (45%) of the mild-to-moderate irreversible defects
      and 22 of 43 (51%) of the severe irreversible defects, leaving roughly half of
      these defects remaining irreversible after reinjection. However, in regions that
      appeared to remain irreversible despite reinjection, the magnitude of
      differential uptake differed between mild-to-moderate (74 +/- 14%) and severe (35
      +/- 16%) irreversible defects (p less than 0.001). All regions with mild-to
      moderate defects demonstrated greater than 50% differential uptake after
      reinjection. In contrast, all except two of the regions with severe irreversible
      defects demonstrated differential uptake of less than 50%. Fifteen patients also
      underwent positron emission tomography at rest with 18F-fluorodeoxyglucose (FDG)
      and 15O-water. FDG uptake was present in 91% of regions with mild-to-moderate
      reduction in thallium activity, and the results of differential uptake and FDG
      data were concordant in 81% of these regions. CONCLUSIONS: These data indicate
      that the magnitude of thallium uptake after reinjection differs between mild-to
      moderate and severe irreversible defects on standard 3-4 hour redistribution
      images. The substantial differential uptake of thallium (greater than 50%) after
      reinjection in mild-to-moderate defects, even when relative thallium activity
      does not increase appreciably (and the defect appears to remain irreversible),
      coupled with preserved metabolic activity by positron emission tomography,
      supports the concept that such mild-to-moderate irreversible defects represent
      viable myocardium.

PMID- 1735158
TI  - Evidence of genetic heterogeneity in five kindreds with familial hypertrophic
      cardiomyopathy.
AB  - BACKGROUND: Recently, two families with hypertrophic cardiomyopathy have been
      shown to have mutations in the cardiac beta-myosin heavy chain gene (beta-MHC)
      located on the long arm of chromosome 14. METHODS AND RESULTS: We have performed
      linkage analysis of five newly ascertained pedigrees with more than 50
      chromosomal markers detecting polymorphisms. Our findings confirm the linkage to
      beta-MHC gene locus on chromosome 14 in one family (LOD score, 4.50) and suggest
      linkage to the same gene in another kindred. Chromosome 14 markers were not
      linked to the disease gene in the other three kindreds, however, and a test for
      genetic heterogeneity was statistically significant. Moreover, markers for the
      beta-MHC gene identified affected individuals who were recombinants with respect
      to this gene and the disease phenotype in these three kindreds. CONCLUSIONS:
      These results provide conclusive evidence that hypertrophic cardiomyopathy in
      separate families is caused by mutations in disease genes at two or more
      locations in the genome.

PMID- 1735159
TI  - Prevalence of cardiovascular risk factors in rural and urban Costa Rica.
AB  - BACKGROUND: Coronary artery disease (CAD) is becoming more prevalent in
      developing countries, particularly in the urban areas, in contrast to the CAD
      mortality trends observed in some industrialized nations. METHODS AND RESULTS: We
      determined the prevalence of cardiovascular risk factors (hypertension, diabetes,
      smoking, obesity, total cholesterol greater than or equal to 240 mg/dl and
      greater than or equal to 200 less than or equal to 239 mg/dl, low density
      lipoprotein (LDL) cholesterol greater than or equal to 160 mg/dl and greater than
      130 less than or equal to 159 mg/dl, and high density lipoprotein (HDL)
      cholesterol less than 35 mg/dl) in 222 men and 243 women from rural and urban
      areas of Puriscal, Costa Rica, using the American Cholesterol Education Program
      guidelines. Urban Puriscal men had a significantly (p less than 0.05) higher
      prevalence of borderline high-risk total cholesterol (26% versus 14%), borderline
      high-risk LDL cholesterol (21% versus 11%), smoking (32% versus 13%), and higher
      prevalence of low HDL cholesterol (34% versus 24%), hypertension (16% versus
      13%), diabetes (4.5% versus 2.7%), obesity (21% versus 14%), and saturated fat
      intake greater than 15% of calories (14% versus 7%) than rural men from Puriscal.
      No significant differences between rural and urban women were found for any of
      the cardiovascular risk factors. Urban Puriscal residents were also more
      sedentary than rural Puriscal residents. CONCLUSIONS: These data indicate that
      modifiable risk factors are more prevalent in urban than in rural Puriscal, Costa
      Rica, particularly in men.

PMID- 1735160
TI  - Intravenous pretreatment with A1-selective adenosine analogues protects the heart
      against infarction.
AB  - BACKGROUND: Recent data from this laboratory indicate that pretreatment with
      adenosine can protect the heart against infarction via A1-receptors, but because
      of systemic hypotension, adenosine had to be given into the coronary circulation.
      METHODS AND RESULTS: In this study, we tested whether the protection could be
      achieved by intravenous administration of the A1-selective adenosine agonists N6
      (phenyl-2R-isopropyl)-adenosine (PIA) and 2-chloro-N6-cyclopentyladenosine
      (CCPA). Nine groups of open-chest anesthetized rabbits were subjected to 30
      minutes of regional coronary ischemia and 3 hours of reperfusion. Infarct size
      was determined by tetrazolium staining. Control hearts receiving no treatment had
      38 +/- 4% of the risk zone infarcted. Preconditioning with 5 minutes of ischemia
      and 10 minutes of reperfusion before ischemia limited the infarct to 8 +/- 4%.
      Intravenous PIA 15 minutes before 30-minute ischemia also limited infarct size to
      6 +/- 2% at the highest dose. CCPA offered similar protection. When the PIA was
      given at reperfusion, infarct size was 46 +/- 6%, indicating that receptor
      activation must precede ischemia to protect. Pretreatment with CGS 21680, a
      selective A2-receptor agonist, caused identical hypotension but failed to limit
      infarct size (43 +/- 3%), indicating again that the A1-receptor is involved. When
      rabbits pretreated with PIA were paced at 220 beats per minutes, PIA still
      limited infarct size (16 +/- 4%), indicating that protection was not the result
      of bradycardia. CONCLUSIONS: These results indicate that stimulation of adenosine
      A1-receptors causes the heart to become resistant to ischemia and that this
      protection can be achieved with intravenous administration of A1-selective
      agents.

PMID- 1735161
TI  - High-current stimuli to the spared epicardium of a large infarct induce
      ventricular tachycardia.
AB  - BACKGROUND: Previous studies have demonstrated that both ventricular tachycardia
      (VT) and ventricular fibrillation (VF) may begin as figure-eight reentry: VT with
      a longer cycle length from spared tissue adjacent to an infarct by programmed
      stimulation and VF with a shorter cycle length from noninfarcted tissue by a
      large premature S2 stimulus. These results suggest that the type of tissue or
      cycle length of the arrhythmia rather than the mode of induction determines
      whether the figure eight becomes sustained VT or degenerates into VF. Thus, a
      protocol similar to that by which a VF threshold is determined may induce VT
      rather than VF when performed in the spared tissue over an infarct. METHODS AND
      RESULTS: In 10 dogs, 4 days after occlusion-reperfusion of the left anterior
      descending coronary artery, 10 S1 stimuli were delivered from a total of 34 right
      and left ventricular sites outside the infarct. An epicardial S2 stimulus over
      the infarct was increased in 10-mA steps and introduced in diastole at decreasing
      cycle lengths of 5 msec until VT or VF was induced. Sustained monomorphic figure
      eight VT was induced from 24 S1 sites and VF from nine (p = 0.03). The mean cycle
      lengths for the initial six arrhythmic cycles was 152 +/- 33 msec for VT and 115
      +/- 13 msec for VF (p less than 0.001). Mean transmural infarct extent was 80% in
      five dogs with only VT, 63% in three dogs with both VT and VF, and 15% in two
      dogs with only VF. Different morphologies of VT were induced by changing the S1
      site, the S2 strength, or the S1S2 coupling interval. In 25 of the 34
      arrhythmias, the central part of the initial figure-eight pathway was oriented
      opposite the S1 activation sequence in that region. CONCLUSIONS: A large S2
      stimulus over a nontransmural infarct induces VT if the spared myocardium is
      thin. This study introduces a useful technique for inducing sustained monomorphic
      VT in which the location and direction of the figure-eight pathway are known a
      priori and in which different morphologies of sustained VT can be produced by
      changing the S1 site.

PMID- 1735162
TI  - Acute hibernation and reperfusion of the ischemic heart.
AB  - BACKGROUND: Recovery from prolonged low-flow ischemia was studied in isolated,
      isovolumically beating neonatal piglet hearts (n = 11) and compared with controls
      (n = 5). METHODS AND RESULTS: Hearts were perfused with red blood cell-enhanced
      Krebs-Henseleit buffer with physiological oxygen-carrying capacity. Left
      ventricular mechanical function was assessed with a fluid-filled balloon.
      Measurements of peak systolic pressure, pressure-rate product (PRP), and
      +dP/dtmax were obtained at various filling pressures. Myocardial oxygen delivery
      and metabolism (MVO2) and lactate uptake were measured at 30-minute intervals.
      Control data were obtained with coronary flow (CF) set at 2 ml.min-1.g-1. CF was
      then reduced to 0.2 ml.min-1.g-1 for 2 hours. Thereafter, reperfusion was
      instituted at control levels. Hearts not subjected to ischemia were studied at
      identical time intervals. In these, function remained at greater than 80% after
      more than 3.5 hours of study. Reduction of CF to 10% was accompanied by an abrupt
      diminution in function (pressure-rate product) and MVO2 to 20% of control and by
      lactate release. These measures remained constant for the full 2 hours of
      ischemia. Incremental return of CF caused a lockstep increase in mechanical
      function and metabolism. At 30 minutes of reperfusion, PRP was 78% of time
      matched controls (p = 0.05), and dP/dtmax did not differ. Increasing calcium to 5
      mmol/l returned PRP (and dP/dtmax) to preischemia levels. Myocardial ATP and
      creatine phosphate concentrations were identical in both groups, although
      glycogen was lower in the ischemic hearts. CONCLUSIONS: Acute hibernation is
      associated with protection of the in vitro heart from prolonged normothermic
      ischemia. Systolic function was only modestly lower, and velocity (dP/dtmax) did
      not differ from control hearts. The minimal "stunning" was fully reversible with
      calcium.

PMID- 1735163
TI  - Importance of intraluminal pressure on hemodynamics and vasoconstriction
      responses of stenotic arteries.
AB  - BACKGROUND: Clinical and morphological studies clearly indicate that most human
      coronary artery stenoses are capable of vasomotion. Variable ischemic thresholds,
      ischemia unrelated to work load, and variant angina further show the presence and
      importance of vasoconstriction in coronary artery stenosis. Despite the
      importance of vasoconstriction, the effect of intraluminal pressure on the
      hemodynamic response to vasoconstrictors has not yet been examined. Intraluminal
      pressure is a primary determinant of vessel size and the force opposing
      vasoconstriction. Accordingly, we examined the effects of intraluminal pressure
      on the hemodynamic response to norepinephrine (NE)-induced vasoconstriction.
      METHODS AND RESULTS: In canine carotid arteries perfused with physiological salt
      solution, pressures at the proximal and distal ends of the artery, as well as
      flow, were continuously recorded. We altered intraluminal pressure using three
      diverse interventions: changes in perfusion pressure, decreasing distal
      resistance, and collaterals. In normal, nonstenotic arteries, NE decreased the
      external vessel diameter but did not reduce flow. Perfusion pressure changes did
      not affect the ED50 of the NE-diameter relation. After an intraluminal stenosis
      was created, NE-induced constriction decreased flow. The threshold concentration
      of NE needed to decrease flow decreased as the perfusion pressure decreased (38.5
      +/- 17.9, 2.3 +/- 1.3, and 0.12 +/- 0.1 x 10(-7) mol/l for 125, 100, and 75 mm Hg
      of perfusion pressure, respectively; p less than 0.05). Lowering distal
      resistance decreased stenotic pressure and decreased the threshold NE
      concentration from 5.4 +/- 1.9 to 0.34 +/- 0.2 x 10(-7) mol/l (p less than 0.05),
      and increasing stenotic pressure with collaterals increased the threshold NE
      concentration from 2.6 +/- 1.4 to 7.5 +/- 4.6 x 10(-7) mol/l (p less than 0.05).
      CONCLUSIONS: In stenotic arteries, interventions that lowered the intraluminal
      pressure decreased the threshold NE concentration needed to decrease flow, and
      interventions that raised the intraluminal pressure increased the threshold NE
      concentration. This pressure-dependent constrictor sensitivity affects the
      vasomotor tone and is important in pathophysiology of ischemia occurring with
      hypotension (low perfusion pressure) or mild increase in myocardial oxygen demand
      (low distal arteriolar resistance). The results also suggest that collaterals, by
      maintaining stenotic pressure, could decrease the constrictor sensitivity and
      prevent ischemia.

PMID- 1735164
TI  - Changes in myocardial blood flow during development of and recovery from
      tachycardia-induced cardiomyopathy.
AB  - BACKGROUND: Chronic supraventricular tachycardia (SVT) causes a dilated
      cardiomyopathy and myocyte injury. Termination of SVT improves left ventricular
      (LV) function but is associated with LV hypertrophy. Changes in myocardial blood
      flow (MBF) that may accompany the development of and recovery from SVT
      cardiomyopathy might have a significant effect on LV function and myocyte
      structure. The goal of this study was to relate changes in LV function, myocyte
      composition, and coronary vascular structure to changes in MBF with the
      development and recovery of SVT cardiomyopathy. METHODS AND RESULTS: LV function
      and MBF were measured in three groups of conscious pigs: sham control (control; n
      = 8), after 3 weeks of atrial pacing (SVT, 240 beats per minute; n = 8), and
      after a 4-week recovery from SVT (post-SVT; n = 8) by echocardiography
      catheterization and microspheres. Measurements were made under three states: 1)
      at rest with a basal heart rate, 2) rapid atrial pacing (240 beats per minute),
      and 3) during adenosine infusion (1.5 mumol/l.kg-1.min-1) without pacing. LV
      myocyte, capillary, and arteriole morphometric studies were performed in five
      additional pigs from each group using histochemistry and electron microscopy. LV
      fractional shortening was lower and left atrial pressure was significantly higher
      in the SVT group compared with control at rest, during pacing, and with adenosine
      (p less than 0.05). In the post-SVT group, fractional shortening returned to
      control values at rest and with adenosine, but fell from control values with
      pacing (p less than 0.05). Left atrial pressure fell in the post-SVT but remained
      significantly higher than control (p less than 0.05). LV/body weight ratio was
      significantly increased in the post-SVT group (p less than 0.05). In all states,
      SVT LVMBF was significantly reduced from control values (rest, 0.8 +/- 0.3 versus
      1.6 +/- 0.3 ml-min-1.g-1; pacing, 1.2 +/- 0.2 versus 3.1 +/- 0.3 ml.min-1.g-1;
      adenosine, 1.4 +/- 0.3 versus 4.4 +/- 0.4 ml.min-1.g-1, respectively, p less than
      0.05). In the post-SVT group, LVMBF was similar to control at rest (1.3 +/- 0.2
      ml.min-1.g-1) but was significantly lower than control with pacing and adenosine
      (2.0 +/- 0.4 and 2.5 +/- 0.5 ml.min-1.g-1, respectively, p less than 0.05).
      Myofibrillar content fell significantly with SVT compared with control (42 +/- 5
      versus 61 +/- 3%, p less than 0.05) and returned to control values in the post
      SVT group (64 +/- 3%). Capillary density remained unchanged in the SVT and post
      SVT groups, but capillary luminal diameter decreased and arteriole diameter
      increased in the SVT group (p less than 0.05). CONCLUSIONS: The LV dysfunction
      and myocyte injury with SVT cardiomyopathy were associated with reduced MBF.
      Early recovery from SVT cardiomyopathy resulted in hypertrophy with normal MBF at
      rest, but significantly reduced coronary reserve.

PMID- 1735165
TI  - In vivo relation of intramyocardial blood volume to myocardial perfusion.
      Evidence supporting microvascular site for autoregulation.
AB  - BACKGROUND: The goal of this study was to explore the role of several factors
      that affect intramyocardial blood volume by using minimally invasive computed
      tomography. Anesthetized dogs were scanned with the dynamic spatial
      reconstructor, a high-speed tomographic scanner, during injection of a bolus of
      iohexol into the aortic root. METHODS AND RESULTS: In control dogs, it is
      indicated that the fraction of myocardium that is blood (FMB, %) relates to
      myocardial perfusion (F, milliliters per gram per minute) in that region as FMB
      congruent to a.F1/2, where a = 9.5 +/- 1.2% (milliliters times minute per
      gram)1/2 (mean +/- SD) in the subendocardium and a = 9.6 +/- 1.1% in the
      subepicardium. In another group of dogs, for the myocardium perfused by a
      stenosed epicardial artery, a increased to approximately 10 for a 25-43% stenosis
      (or pressure gradient of 9 mm Hg across narrowing) and to greater than 11 for a
      50-55% stenosis (or pressure gradient of 40 mm Hg across narrowing). In these
      dogs, flow was not impaired under control hemodynamic conditions, but the usual
      increase of flow (i.e., flow reserve) observed under maximum vasodilation
      conditions was impaired. In another group of dogs, progressive embolization
      (using 15-microns-diameter microspheres) of the left ventricular myocardial
      microcirculation caused the value of a to remain at approximately 9.5 with
      embolization up to 50% of the fatal dose of microspheres, but it then decreased
      progressively with embolization to 4.6 at the fatal dose. CONCLUSIONS: We
      conclude that the FMB/F relation reflects hemodynamic conductance at the
      microvascular level.

PMID- 1735166
TI  - Imaging the rejecting heart. In vivo detection of major histocompatibility
      complex class II antigen induction.
AB  - BACKGROUND: Mice with abdominal heterotopic heart transplants were studied to
      determine whether scintigraphic detection of an increase in major
      histocompatibility complex (MHC) class II antigen expression could be used as a
      noninvasive method for diagnosing early rejection. METHODS AND RESULTS:
      Allografts from C3H/He (H2k) donors were transplanted into BALB/c (H2d)
      recipients (n = 18). Two of the 18 allografted mice were treated with
      cyclosporine (15 mg/kg/day), and two isografted mice served as controls. Each
      mouse was injected intravenously with 100 microCi of 111In-labeled anti-MHC class
      II monoclonal antibodies (10-2-16 and 14-4-4S) 24 hours before scintigraphy.
      After imaging, the mice were killed for tissue counting and histopathology.
      Radiotracer uptake in the grafts reflected the severity of rejection as
      determined by histopathological criteria. The percent injected dose per gram of
      tissue in excised grafts was 4.8 +/- 1.8 (mean +/- SD) for normal grafts (n = 8),
      11.1 +/- 9.7 for grafts with grade IA rejection (n = 3, NS), 18.0 +/- 3.8 for
      grafts with grade IIIA rejection (n = 4, p less than 0.001 versus normal), 18.7
      +/- 3.2 for grafts with grade IIIB rejection (n = 3, p less than 0.001 versus
      normal), and 22.6 +/- 5.4 for grafts with severe rejection (grade IV) (n = 3, p
      less than 0.001 versus normal). Rejecting allografts with lymphocyte infiltration
      but without significant myocyte necrosis could be identified by this
      scintigraphic method. In the BALB/c donor-C57BL/6 (H2b, IE-) recipient
      combination, rejecting allografts were visualized by 14-4-4S (anti-IEk,d,p,r)
      antibody but not by 10-2-16 (anti-IAk,r,s,f) antibody. This difference shows that
      class II antigens induced on donor hearts are solely responsible for the antibody
      uptake in positive scintigrams of rejecting allografts. CONCLUSIONS: We conclude
      that 111In-labeled anti-MHC class II antigen antibody imaging is a sensitive and
      noninvasive method for detecting cardiac allograft rejection.

PMID- 1735167
TI  - Programmed electrical stimulation and drugs identify two subgroups of ventricular
      tachycardias occurring 16-24 hours after occlusion of the left anterior
      descending artery.
AB  - BACKGROUND: Spontaneous sustained ventricular tachycardia (VT) occurring 16-24
      hours after left anterior descending (LAD) coronary artery occlusion in the
      canine heart is most likely based on abnormal automaticity. In vitro, it has been
      demonstrated that the rate of the arrhythmia and the effect of overdrive pacing
      depends on the maximal diastolic potential (MDP). The MDP is also of importance
      in understanding the effect of antiarrhythmic drugs. To study 1) the possible
      presence of different responses to overdrive pacing and 2) the relation between
      the response to overdrive pacing and the effect of different antiarrhythmic drugs
      in the intact heart, we investigated the effect of 1) (prolonged) pacing and 2)
      lidocaine (3 mg/kg), verapamil (0.4-1.0 mg/kg), or flunarizine (2 mg/kg) during
      VT. METHODS AND RESULTS: In 21 conscious dogs with chronic atrioventricular
      block, 60 sustained VTs were observed 1 day after LAD occlusion. During VT,
      pacing with interstimulus intervals of 400, 300, and 200 msec for 15, 60, and 120
      seconds was done on 40 VTs. Based on their response to pacing, VTs were divided
      into a pacing-suppressible (PS group) and a pacing-nonsuppressible group (PNS
      group). The mean cycle length in the PS group was significantly longer (410 +/-
      50 msec) than in the PNS group (360 +/- 35 msec, p less than or equal to 0.01).
      Suppression was directly related to the rate and duration of pacing. Spontaneous
      recurrence of VTs was observed after 26 +/- 45 seconds. Lidocaine and verapamil
      increased cycle length of the suppressible VTs and terminated them, whereas
      flunarizine had no effect. Except for verapamil, which increased cycle length of
      the VTs, no effects were seen in the PNS group. CONCLUSIONS: In conscious dogs
      showing sustained VTs 16-24 hours after LAD occlusion, 1) the slower VTs can be
      suppressed by pacing, verapamil, and lidocaine but not by flunarizine, and 2) the
      faster VTs are not affected by pacing, lidocaine, and flunarizine, and are only
      slowed by verapamil. These findings are compatible with in vitro findings of
      abnormal automaticity, with the slower VTs originating from a higher MDP than the
      faster VTs.

PMID- 1735168
TI  - Percutaneous delivery of low-level laser energy reverses histamine-induced spasm
      in atherosclerotic Yucatan microswine.
AB  - BACKGROUND: Previous in vitro experiments performed in our laboratory have shown
      that low-level laser energy may produce prompt reduction in isometric tension of
      vascular smooth muscle. The present study was designed to extend these previous
      in vitro findings to an in vivo model and thereby investigate the hypothesis that
      laser light delivered percutaneously in vivo could successfully reverse arterial
      spasm. METHODS AND RESULTS: Spasm defined as greater than 50% reversible
      reduction in luminal diameter persisting for greater than or equal to 5 minutes
      was successfully provoked by injection of histamine (100-400 micrograms/kg) in 13
      arteries among 10 atherosclerotic Yucatan microswine; the magnitude of histamine
      induced vasoconstriction was then documented angiographically by repeated
      injections of contrast media for as long as 30 minutes (controls). After return
      of angiographic luminal diameter to baseline, spasm was reproduced with a second
      injection of histamine into the same artery. Representative wavelengths generated
      by ultraviolet (UV), visible, and infrared lasers were then delivered
      percutaneously via conventional fiberoptics to the site of spasm, and
      angiographic assessment was repeated for as long as 30 minutes (treatment trial).
      In three arteries treated with UV (351 nm) light from an excimer laser,
      angiographic luminal diameter narrowing decreased from 100% to 23.9%, 50.0% to
      9.3%, and 76.0% to 42.3%, respectively. The magnitude of laser-induced increase
      in luminal diameter was 50.2 +/- 22.7%, which was significantly greater than the
      magnitude of relaxation observed spontaneously during the control trials (10.9 +/
      9.8%, p = 0.02). Visible light from a helium-neon (632 nm) laser accomplished
      complete reversal of histamine-induced spasm in two of four arteries; in the
      remaining two arteries, luminal diameter narrowing percentages were reduced from
      57.0% to 20.0% and from 76.5% to 30.8%, respectively. The magnitude of helium
      neon laser-induced relaxation (55.8 +/- 17.9%) was again significantly greater
      than that observed during the control trials (0.9 +/- 1.9%, p = 0.01). Finally,
      infrared irradiation from a diode-pumped neodymium:yttrium aluminum garnet (1,064
      nm) laser decreased histamine-induced luminal diameter narrowing in three
      arteries from 100% to 21.4%, 56.0% to 8.7%, and 68.3% to 35.3%, respectively. The
      magnitude of infrared laser-induced improvement in luminal diameter narrowing was
      53.0 +/- 23.3%, which was significantly greater than that observed during the
      control trials (12.9 +/- 10.7%, p = 0.01). In three additional arteries,
      fiberoptic sham trials (without laser irradiation) failed to produce relaxation
      of histamine-induced spasm. CONCLUSIONS: These findings document for the first
      time that light-induced relaxation of vascular smooth muscle, previously
      documented in vitro, may be reproduced in vivo.

PMID- 1735169
TI  - Heat shock protein induction in rat hearts. A role for improved myocardial
      salvage after ischemia and reperfusion?
AB  - BACKGROUND: To test the hypothesis that the heat shock response is associated
      with improved myocardial salvage after myocardial ischemia and reperfusion, rats
      treated with prior whole-body hyperthermia and 24 hours of recovery (n = 26) or
      20 minutes of ischemic pretreatment and 8 hours of recovery (n = 24) and control
      rats (n = 27, n = 24, for hyperthermic and ischemic pretreatment, respectively)
      were subjected to 35 minutes of left coronary artery (LCA) occlusion and 120
      minutes of reperfusion. METHODS AND RESULTS: Although ventricular samples from
      rats subjected to either hyperthermia (n = 7) or ischemic pretreatment (n = 6)
      all showed induction of HSP72 (heat shock protein), Western blot analysis
      revealed significantly greater amounts of HSP72 in samples obtained from rats
      subjected to hyperthermia compared with those from rats subjected to ischemic
      pretreatment. Control rats (n = 7) showed no significant presence of myocardial
      HSP72. After 35 minutes of LCA occlusion and 2 hours of reperfusion, infarct size
      was significantly reduced in heat-shocked rats compared with controls (8.4 +/-
      1.7%, n = 26 versus 15.5 +/- 1.9%, n = 27; p = 0.007; mean +/- SEM; infarct
      mass/left ventricular mass x 100). There were no significant differences in left
      ventricular (LV) systolic pressure, heart rate, LV dP/dt, or rate-pressure
      product between heat-shocked (n = 11) and control (n = 14) rats during the
      ischemic period. There were no differences in infarct size between ischemically
      pretreated and control rats subjected to 35 minutes of ischemia and reperfusion
      (9.7 +/- 2.1%, n = 23 versus 10.0 +/- 2.1, n = 24; p = NS). CONCLUSIONS: In this
      model of ischemia and reperfusion, prior heat shock was associated with
      significantly improved myocardial salvage after 35 minutes of LCA occlusion and
      reperfusion. This improved salvage was correlated with marked HSP72 induction and
      was independent of the hemodynamic determinants of myocardial oxygen supply and
      myocardial oxygen demand during the ischemic period. In contrast, mild HSP72
      induction by ischemic pretreatment was not associated with improved myocardial
      salvage after myocardial ischemia and reperfusion. Thus, the absolute levels of
      HSP72 may be important in conferring protection from ischemic injury in this
      animal model.

PMID- 1735170
TI  - Coronary cyclic flow variations "precondition" ischemic myocardium.
AB  - BACKGROUND: Repeated brief episodes of myocardial ischemia performed by
      mechanical clamping of a coronary artery "precondition" the heart and reduce
      infarct size after a subsequent sustained ischemia. It is not known, however,
      whether spontaneous episodes of transient ischemia caused by formation of
      platelet thrombi, which may occur in unstable angina, have a similar
      cardioprotective effect. METHODS AND RESULTS: Therefore, our objective was to
      determine whether brief spontaneous thrombotic episodes of ischemia/reperfusion
      could limit infarct size and preserve contractile function following 60 minutes
      (protocol 1) or 90 minutes (protocol 2) of sustained ischemia and 4-4.5 hours of
      reperfusion in the canine model. Before the sustained coronary occlusion, dogs
      underwent a 30-minute "treatment" period consisting of: no intervention (control
      group), four repeated episodes of 3-minute mechanical occlusion plus 5-minute
      reperfusion (preconditioned group), or coronary artery stenosis and endothelial
      injury, resulting in a mean of four spontaneous episodes of cyclic flow
      variations (CFV group) caused by formation and dislodgment of platelet thrombi.
      In protocol 1 (60-minute sustained ischemia plus 4.5-hour reperfusion), infarct
      size was significantly smaller in both the preconditioned and CFV groups compared
      with controls (3.5 +/- 1.4%,* 3.4 +/- 2.1%,* and 9.9 +/- 2.7% of the myocardium
      at risk, respectively; *p less than 0.05 versus control). In contrast, neither
      preconditioning nor CFV preserved contractile function: Segment shortening during
      sustained occlusion was equally depressed at -15% to -20% of baseline values
      among the three groups and equally stunned at +12% to +18% of baseline during the
      4.5 hours of reflow. In protocol 2 (90-minute sustained ischemia plus 4-hour
      reperfusion), only CFV continued to exert a cardioprotective effect: Infarct size
      averaged 15.0 +/- 4.1%, 7.4 +/- 2.5%,* and 16.5 +/- 4.4% of the region at risk in
      the preconditioned, CFV, and control groups, respectively (*p less than 0.05
      versus control). Contractile function, however, was similar among all three
      groups both during 90 minutes of sustained occlusion and throughout 4 hours of
      reperfusion. CONCLUSIONS: We therefore conclude that repeated coronary thrombus
      formation preconditions the ischemic myocardium: In fact, in contrast to
      mechanical preconditioning, cardioprotection provided by CFV persisted following
      90 minutes of sustained coronary occlusion. However, preconditioning by
      thrombotic or mechanical occlusion neither preserved myocardial contractile
      function during sustained coronary occlusion nor prevented stunning after
      reperfusion. These data raise the possibility that clinical episodes of unstable
      angina prior to acute myocardial infarction may precondition the ischemic
      myocardium.

PMID- 1735171
TI  - Conjunctive enhancement of enzymatic thrombolysis and prevention of thrombotic
      reocclusion with the selective factor Xa inhibitor, tick anticoagulant peptide.
      Comparison to hirudin and heparin in a canine model of acute coronary artery
      thrombosis.
AB  - BACKGROUND: Effective thrombolytic recanalization of an occluded coronary vessel
      is often limited by acute thrombotic reocclusion, which has galvanized the search
      for effective adjunctive or conjunctive antithrombotic agents. METHODS AND
      RESULTS: Recombinant versions of tick anticoagulant peptide (rTAP) and hirudin
      (rHIR) are highly selective and potent polypeptide inhibitors of factor Xa and
      thrombin, respectively. The comparative antithrombotic efficacies of rTAP, rHIR,
      and heparin, administered conjunctively with recombinant tissue-type plasminogen
      activator (rt-PA), on thrombolytic reperfusion and reocclusion, were determined
      in a canine model of occlusive coronary artery thrombosis with a superimposed
      critical stenosis. In this model, a platelet-rich occlusive thrombus was formed
      after damage to the intimal surface of the left circumflex coronary artery
      induced by electrolytic injury. Fifteen minutes after occlusion, the dogs
      received a systemic intravenous administration of either saline (control),
      heparin (200 units/kg bolus + 2 units/kg/min, heparin (HEP) 200 or 100 units/kg
      bolus + 1 unit/kg/min, HEP 100), rHIR (50 or 100 micrograms/kg/min, rHIR 50 or
      100, respectively), or rTAP (100 micrograms/kg/min, rTAP 100) followed 15 minutes
      later by rt-PA (100 micrograms/kg bolus + 10 micrograms/kg/min over 90 minutes).
      Infusions of the conjunctive agents were discontinued 60 minutes after
      termination of rt-PA. The incidence and time (mean +/- SEM) to thrombolytic
      reperfusion were determined for control (five of 12; 68.0 +/- 7.8 minutes), HEP
      100 (six of eight; 40.1 +/- 8.3 minutes), HEP 200 (six of eight; 39.8 +/- 9.5
      minutes), rHIR 50 (six of eight; 51.7 +/- 14.6 minutes), rHIR 100 (eight of
      eight; 19.5 +/- 4.2 minutes), and rTAP 100 (eight of eight; 22.8 +/- 10.0
      minutes). The incidence and time to reocclusion after rt-PA were determined for
      control (four of five; 45.7 +/- 12.5 minutes), HEP 100 (four of six; 18.2 +/-
      10.7 minutes), HEP 200 (five of six; 26.2 +/- 20.7 minutes), rHIR 50 (four of
      six; 47.3 +/- 21.6 minutes), rHIR 100 (six of eight; 89.8 +/- 5.9 minutes), and
      rTAP 100 (three of eight; 54.0 +/- 16.3 minutes). All of the dogs that reoccluded
      in the rHIR 100 group did so after termination of the inhibitor infusion, whereas
      two of the three dogs in the rTAP 100 group that reoccluded did so during the
      inhibitor infusion. Coronary artery blood flow was characterized by intermittent
      periods of reocclusion and recanalization in all groups except rTAP 100.
      CONCLUSIONS: The potent antithrombotic effects of rTAP in this model directly
      implicate de novo thrombin formation as a major source of thrombin activity
      within the highly thrombogenic residual thrombus. These findings suggest that
      direct inhibition of prothrombinase activity may be an effective strategy in the
      development of a new class of conjunctive agents.

PMID- 1735172
TI  - Mechanism of global functional recovery despite sustained postischemic regional
      stunning.
AB  - BACKGROUND: The mechanisms whereby reperfusion of a 20-minute coronary occlusion
      result in global functional recovery despite persistent regional dysfunction were
      studied in 11 open-chest reflex-blocked dogs. METHODS AND RESULTS: Pressure
      volume and pressure-thickness relations were simultaneously determined before,
      during, and after reperfusion of left anterior descending artery (LAD) occlusion.
      Wall thickness was determined by sonomicrometry in both ischemic and remote
      regions. Chamber systolic function was assessed by end-systolic pressure-volume
      relations (ESPVR) obtained by conductance catheter and defined by a slope (Ees)
      and volume shift at a common end-systolic pressure (delta Ves). LAD occlusion
      produced regional systolic thinning (-7 +/- 6%) and global left ventricular
      dysfunction (ESPVR shifted rightward (delta Ves = +8.6 +/- 5.1 ml, p less than
      0.001) with no Ees change). After nearly 1 hour of reperfusion, LAD region
      thickening remained markedly reduced at 4 +/- 7% (versus 23 +/- 8%, control), yet
      chamber systolic function fully recovered (ESPVR shifted back leftward delta Ves
      = -8.9 +/- 6.5 ml). Ischemia induced a leftward shift and systolic thinning of
      LAD region pressure-thickness relations. Reperfusion returned end-systolic
      pressure-thickness relations halfway to their control position and diastolic
      relations fully to control position. This was primarily due to increased passive
      stiffening in about half the hearts and a partial return of active function in
      the remaining ones. The net effect was to eliminate systolic thinning over a
      physiological loading range, thus normalizing chamber systolic performance.
      Reflex activation, remote hyperfunction, or altered chamber loading did not
      account for the postreperfusion disparity between global and regional function.
      CONCLUSIONS: These data suggest a mechanism to account for greater functional
      benefits of reperfusion beyond that anticipated from regional wall motion
      analysis.

PMID- 1735173
TI  - Effects of high arterial oxygen tension on function, blood flow distribution, and
      metabolism in ischemic myocardium.
AB  - BACKGROUND: Although oxygen inhalation therapy has long been used in the
      treatment of acute myocardial ischemia, experimental evidence that increased
      arterial PO2 has any beneficial effect in the absence of hypoxemia is equivocal.
      In this study, we used a swine model of subendocardial myocardial ischemia to
      determine the effects of arterial hyperoxia on regional myocardial contractile
      function (sonomicrometry), myocardial blood flow distribution (microspheres), and
      regional myocardial glycolytic metabolism (carbon isotope-labeled substrates).
      METHODS AND RESULTS: In 10 domestic swine, the left anterior descending coronary
      artery was cannulated and flow to this artery was strictly controlled via a
      roller pump in the perfusion circuit. Arterial PO2 was controlled by manipulating
      inspired oxygen concentration (FIO2). Low-flow myocardial ischemia was induced by
      reducing pump flow to 50% of the control value, which diminished regional
      endocardial systolic shortening to 30-50% of normal. After a 15-minute period of
      flow stability, each animal was exposed in randomized order to two additional 15
      minute experimental periods: coronary normoxia (PO2 = 90-110 mm Hg) and coronary
      hyperoxia (PO2 greater than 400 mm Hg). At each level of oxygenation, we measured
      regional myocardial function, regional myocardial blood flow and metabolism, and
      hemodynamic indexes of myocardial oxygen demand. Myocardial ischemia during
      normoxia reduced systolic shortening to 10.9 +/- 5.3% in the ischemic zone.
      Hyperoxia increased ischemic zone systolic shortening substantially to 15.2 +/-
      4.6%. During myocardial ischemia, endocardial blood flow was decreased to 0.26 +/
      0.06 ml.g-1.min-1 in the ischemic zone. During hyperoxia, endocardial blood flow
      rose to 0.34 +/- 0.10 ml.g-1.m-1. The endocardial: epicardial flow ratio was 0.45
      +/- 0.18 in the initial ischemia period and rose to 0.61 +/- 0.23 in the
      hyperoxic period. Myocardial ischemia increased regional uptake of glucose,
      conversion of glucose to released lactate, and net myocardial lactate release. In
      the ischemic myocardium, coronary hyperoxia decreased both chemically measured
      lactate production and isotopically measured lactate release and decreased
      glucose extraction and the conversion of glucose to lactate. CONCLUSIONS: These
      data demonstrate for the first time that increasing arterial PO2 to high levels
      during acute low-flow myocardial ischemia improves both function and flow
      distribution in the ischemic myocardium and decreases glycolytic metabolism in
      the ischemic zone. The degree of improvement in contractile function (5% absolute
      increase in systolic shortening or 25% change normalized to preischemic values)
      is consistent with the observed increase in subendocardial blood flow.

PMID- 1735174
TI  - TIMI IIB follow-up. Lessons for clinicians and investigators.

PMID- 1735175
TI  - Vascular biology and invasive cardiology. The streams are beginning to merge.

PMID- 1735176
TI  - Prevalence, circumstances, mechanisms, and risk stratification of sudden cardiac
      death in artificial ventricular pacing.

PMID- 1735177
TI  - Myocardial preconditioning. Part of the adenosine revival.

PMID- 1735178
TI  - Pathogenesis of edema in constrictive pericarditis.

PMID- 1735179
TI  - Report of the Task Force on the Availability of Cardiovascular Drugs to the
      Medically Indigent.

PMID- 1735180
TI  - Cryoglobulins and the immunopathological manifestations of autoimmune disease.

PMID- 1735181
TI  - Decreased immunoreactive beta-endorphin in mononuclear leucocytes from patients
      with rheumatic diseases.
AB  - The neuroendocrine polypeptide hormone beta-endorphin (beta-END), which is
      released from various tissues including the anterior pituitary gland and cells of
      the immune system, has recently been implicated as having an immunoregulatory
      role. We used a radioimmunoassay to measure beta-END levels in circulating
      mononuclear leucocytes from normal subjects and patients with various rheumatic
      diseases. Levels of beta-END in leucocytes from patients were lower than in
      leucocytes from healthy subjects (P less than 0.001). Whereas levels of beta-END
      in leucocytes from patients with the various rheumatic disorders were not
      significantly different, an inverse correlation was found between beta-END levels
      in leucocytes and expression of rheumatoid factor (P less than 0.025) and
      erythrocyte sedimentation rate (P less than 0.025). This study demonstrates
      decreased content of beta-END in cells of the immune system related to parameters
      of inflammatory activity in rheumatic diseases.

PMID- 1735182
TI  - Rheumatoid factors in mice bearing the lpr or gld mutation. Selective production
      of rheumatoid factor cryoglobulins in MRL/MPJ-lpr/lpr mice.

PMID- 1735183
TI  - Flare-up of experimental arthritis in mice with murine recombinant IL-1.
AB  - Intra-articular injections of murine recombinant IL-1 (mrIL-1) during the chronic
      phase of antigen-induced arthritis (AIA) induced a flare-up of the smouldering
      inflammation. The exacerbation was characterized by acute and transient joint
      swelling and this coincided with the extravascular accumulation of neutrophils.
      IL-1 injected into arthritic joints of neutropenic mice demonstrated that joint
      swelling was independent of the neutrophil influx into the joint. Both phenomena
      were absent when IL-1 was injected into a naive joint. The IL-1-induced flare-up
      was not T cell mediated as in the antigen-induced flare-up, and suggestive
      evidence is presented that IL-1 sensitivity depended on the resident macrophage
      population. This explained why the hypersensitivity is not restricted to the
      immunologically mediated arthritis but reflects a more general hypersensitivity
      of previously injured joints, e.g. zymosan-induced arthritis and IL-1-affected
      joints. In addition, IL-1 could also potentiate the antigen-specific flare-up of
      chronic AIA and prolongs the duration of the exacerbation. Our data indicate that
      joints bearing a chronic infiltrate are at risk from exacerbations in two ways: a
      T cell mediated rechallenge with antigen, and a non-specific reactivation by
      systemic and local IL-1 generation.

PMID- 1735184
TI  - Quantitative studies of monoclonal antibody 5-1-6-induced proteinuric state in
      rats.
AB  - Murine monoclonal antibody (MoAb) 5-1-6 was already reported to bind to
      epithelial cell foot processes and to cause proteinuria in rats. In vivo kinetics
      of the injected MoAb 5-1-6, relationship between the quantity of kidney-binding
      antibody and proteinuria, and changes in the amount of antigenic molecule
      recognized by this MoAb in the proteinuric state were studied. The amount of
      total kidney-binding antibody (TKAb) as determined 1 h after a 2 mg
      administration was 50.8 +/- 10.4 micrograms/2 kidneys, and TKAb declined to 1.9
      +/- 0.4 at day 15. The minimum dose of MoAb required to induce proteinuria was
      125 micrograms as the injected dose. This dose corresponded to 12.8 micrograms of
      TKAb at 1 h and 0.34 micrograms of TKAb at day 5. The amount of MoAb 5-1-6
      binding to isolated normal glomeruli was also shown to exceed 147.7
      micrograms/76,000 glomeruli, indicating proteinuria to be induced provided more
      than 8.7% (= 12.8/147.7) of the critical epitopes is specifically occupied by
      MoAb. The total amount of MoAb 5-1-6 bound to glomeruli in vivo and in vitro was
      assayed with [125I]-labelled anti-mouse IgG. The amount of [125I] anti-mouse IgG
      bound to glomeruli was 6.93 +/- 0.45 micrograms/10,000 glomeruli from rat 5 days
      after this MoAb injection and 26.58 +/- 0.66 micrograms/10,000 control glomeruli,
      indicating the decrease in the number of MoAb 5-1-6-recognized antigen molecules
      in glomeruli isolated from the rat in proteinuric state induced by this MoAb.
      Thus, the MoAb 5-1-6-recognized molecule itself may principally function to
      regulate the permeability of the glomerular capillary wall and the decrease of
      the molecule may lead to proteinuria.

PMID- 1735185
TI  - Thymus lymphocytes in uraemic rats and the effect of thymosin fraction 5 in vivo.
AB  - Thymus lymphocyte subsets in uraemic rats were studied using monoclonal
      antibodies. Severe and moderate uraemia was induced in rats, and sham-operated
      and normal rats were used as the controls. As a result, the weight of the thymus
      decreased in uraemic rats. As for lymphocyte subsets, the frequency of W3/25+OX8+
      decreased and those of W3/25-OX8-, W3/25+OX8- and W3/25- OX8+ relatively
      increased in uraemic rats. All these changes were more significant in severely
      uraemic than in moderately uraemic rats. When thymosin fraction 5 (TF5) was
      administered to severely uraemic rats, the weight of the thymus increased and the
      lymphocytes subsets normalized. These results suggest that uraemia may cause a
      maturational impairment of thymus lymphocytes by the depression of thymic hormone
      secretion.

PMID- 1735186
TI  - Mucosal cell-mediated immunity to mycobacterial, enterobacterial and other
      microbial antigens in inflammatory bowel disease.
AB  - Culture studies have suggested that Mycobacterium paratuberculosis may play a
      role in the aetiology of Crohn's disease. However, evidence of sensitization to
      mycobacterial antigens amongst patients with Crohn's disease has not yet been
      adequately demonstrated. Previous studies of cell-mediated immunity (CMI) in
      Crohn's disease were restricted to responses of peripheral blood mononuclear
      cells (PBMC) to mycobacterial antigens. In this study we have investigated the
      proliferative responses of both PBMC and mesenteric lymph node mononuclear cells
      (MLNMC) to a range of mycobacterial and non-mycobacterial antigens. There was no
      evidence of specific sensitization in the responses of MLNMC and PBMC from
      patients with inflammatory bowel disease (IBD) to the mycobacterial antigens.
      However, anergy to M. paratuberculosis could not be excluded. IBD MLNMC responses
      to most antigens were generally greater than those of PBMC, which were often
      undetectable. When compared with controls, there was evidence of increased CMI to
      a range of non-mycobacterial antigens, especially Yersinia enterocolitica,
      amongst both MLNMC and PBMC from patients with Crohn's disease and ulcerative
      colitis (UC). These results do not provide support to the proposed role of
      mycobacteria in the pathogenesis of Crohn's disease, but indicate that further
      investigation may determine a role for bacterial-specific T cell-mediated
      responses in the pathogenesis of IBD.

PMID- 1735187
TI  - Subclass composition and J-chain expression of the 'compensatory'
      gastrointestinal IgG cell population in selective IgA deficiency.
AB  - The subclass distribution of IgG-producing immunocytes was examined by two-colour
      immunohistochemistry in gastrointestinal mucosa of 14 patients with selective
      serum IgA deficiency providing the following biopsy material: gastric (n = 1);
      jejunal (n = 12); colonic (n = 1); and rectal (n = 2). All except two patients
      suffered from various infections, and coeliac disease was observed in six of
      them. Control reference data were based on biopsies from immunologically intact
      subjects, including histologically normal jejunal (n = 10) and large bowel (n =
      10) mucosa and stomach mucosa with slight chronic gastritis (n = 8). The total
      mucosal population of immunoglobulin-producing cells per 500 microns gut length
      unit was only slightly decreased in IgA deficiency because of an increased number
      of IgG (30%) and especially IgM (71%) immunocytes. The IgG1 immunocyte proportion
      in the proximal gut (median 87%) was higher than that in the comparable controls
      (gastric 69%, jejunal 66%). A similar trend was seen in the distal gut (69%)
      compared with controls from the large bowel mucosa (55%). Conversely, IgG2 and
      IgG3 cell proportions were significantly decreased compared with the respective
      controls from the proximal gut. The same was true for IgG4, which also was
      significantly reduced in jejunal mucosa. Paired staining for cytoplasmic J chain
      and immunoglobulin isotype showed 71% positivity for jejunal IgG-producing cells
      in IgA deficiency, which was somewhat reduced compared with comparable controls
      (89%). J chain appeared to be preferentially expressed by IgG1 cells (75%), but
      was also found in IgG2 (70%), IgG3 (32%) and IgG4 cells (33%). IgM-producing
      cells showed a J-chain positivity (99%) in IgA deficiency similar to normal
      (100%). Our results suggested that the block in mucosal B cell differentiation to
      IgA expression in the proximal gut is mainly located immediately upstream to the
      CH alpha 1 gene, giving excessive terminal maturation of J-chain-positive IgG1
      immunocytes.

PMID- 1735188
TI  - Antibodies to acetylcholine receptors in myasthenia gravis. In vitro synthesis by
      peripheral blood lymphocytes before and after thymectomy.
AB  - Pokeweed mitogen (PWM)-driven in vitro synthesis of antibodies to the
      acetylcholine receptor (PSA) was studied in non-thymoma patients with myasthenia
      gravis. In a group of 46 patients, the occurrence of PSA was related to the
      presence of the thymus or, in operated patients, the absence of a clinical effect
      of thymectomy. Sixteen patients were followed before and soon after thymectomy.
      PSA disappeared in all patients, at least temporarily, between 6 weeks and 1 year
      afterwards, independent of the clinical course and eventual clinical effect of
      the operation. A recurrence was found only in one of the five patients who
      derived no benefit from the operation. These findings support the hypothesis that
      the therapeutic effect of thymectomy can be explained by removal of a source of
      autoreactive lymphocytes. There was no correlation between the changes in serum
      levels of a-AChR and clinical improvement, suggesting a minor role of circulating
      peripheral blood lymphocytes (PBL) and the thymus in the total production of a
      AChR.

PMID- 1735189
TI  - Antibodies against C1q in anti-glomerular basement membrane nephritis.
AB  - The prevalence of antibodies against the collagen-like region of the subcomponent
      of the first component of complement, C1q, was investigated in 11 patients with
      anti-glomerular basement membrane (GBM) nephritis. Anti-C1q antibodies (anti
      C1qAb) were detected in seven patients. IgG anti-C1qAb were found in four and IgA
      anti-C1qAb in five patients. During follow up of the patients a relationship was
      observed between the levels of IgG anti-C1qAb and the levels of anti-GBM
      antibodies (anti-GBMAb). Gelfiltration experiments indicated that both IgG anti
      C1qAb as well as IgG anti-GBMAb were monomeric and that binding also occurred
      with the F(ab')2 fragments of the antibodies. Although anti-C1qAb and anti-GBMAb
      are both directed against a collagen-like structure, it was demonstrated by means
      of inhibition experiments that anti-C1qAb and anti-GBMAb are directed against
      different antigenic sites. Comparison of patients with anti-GBM nephritis with
      and without anti-C1qAb revealed that there were no differences in disease
      activity or disease severity. Therefore, the results of this study suggest that
      anti-C1qAb do not play a direct pathogenetic role in anti-GBM nephritis.

PMID- 1735190
TI  - The role of interferon-gamma in lymphocytic thyroiditis: its functional and
      pathological effect on human thyrocytes in culture.
AB  - Interferon-gamma (IFN-gamma) has been recognized to possess diverse non
      immunological effects on epithelial cells such as cellular growth and
      differentiation. We have previously demonstrated that IFN-gamma suppressed
      thyroid-stimulating hormone (TSH)-stimulated thyroglobulin (TG) synthesis in
      human thyrocytes through inhibition of TG gene transcription. To define the
      pathological mechanism involved in the action of IFN-gamma, we studied the
      ultrastructural changes of human thyrocytes cultured in monolayer. Stimulation of
      the thyrocytes with TSH 10 mU/ml for 2 days resulted in marked increase in TG
      release into the medium. This was accompanied by elongation of microvilli,
      increase in follicles and acinar formation, increase in secretory granules and
      prominence of Golgi apparatus and rough-surfaced endoplasmic reticulum. Addition
      of IFN-gamma (500 U/ml) resulted in marked degeneration with shrinkage of the
      cell membrane, vacuolation of cytoplasm, swollen mitochondria and presence of
      lysosomal granules. Co-culturing the thyrocytes with the IFN-gamma and TSH
      resulted in suppression of the morphological responsiveness to TSH. There was
      also suppression of TSH-induced TG secretion. However, at 500 U/ml IFN-gamma did
      not cause lysis of the thyrocytes as estimated by the cellular DNA content.
      Furthermore, binucleated cells were frequently encountered in those wells that
      were treated with IFN-gamma for either 2 or 5 days. The findings suggest that IFN
      gamma resulted in de-differentiation and degeneration of the thyrocytes, which
      subsequently regained the growth potential and showed attempts at regeneration.
      This may explain why most patients with lymphocytic thyroiditis recover from the
      acute injury and do not suffer from permanent hypothyroidism.

PMID- 1735191
TI  - Levels of soluble IL-2 receptor in plasma from asthmatics. Correlations with
      blood eosinophilia, lung function, and corticosteroid therapy.
AB  - Evidence now suggests that eosinophils and T lymphocytes infiltrating bronchial
      tissues may play a key role in the pathophysiology of asthma. Circulating
      eosinophils, lung function, and plasma soluble IL-2 receptor (sIL-2R) were
      measured in 42 asthmatic patients referred for symptomatic asthma. The patients
      were divided into two groups based on the presence or absence of atopy. The group
      of non-atopic asthmatics was further divided according to the patients'
      requirement for long term oral corticosteroids. The mean sIL-2R +/- s.d. was 36.3
      +/- 9.9 pM in the control group, 28.9 +/- 9.2 pM in the atopic asthmatics, 43.3
      +/- 18.07 pM in the non-atopic asthmatics without oral steroid therapy, but was
      increased in the steroid-treated group (62.2 +/- 19.3 pM, P less than 0.01). A
      significant correlation was found between FEV1 and circulating eosinophils in
      atopic asthmatics and in non-atopic asthmatics without oral corticosteroid
      therapy, but not in the steroid-treated group. Furthermore, significant
      correlations were found between sIL-2R and FEV1, and between sIL-2R and blood
      eosinophils, in the group of non-atopic asthmatics not on oral steroid therapy.
      No such correlations were evidenced in the other groups of asthmatics. Similar
      results were obtained during the clinical course of three non-atopic patients
      followed for more than 1 year. These data suggest that T cell activation appears
      more prominent in non-atopic asthma than in atopic asthma. Moreover, it appears
      that T cell activation can occur in severe forms of asthma despite steroid
      treatment. Finally, the results suggest a possible link between T cell
      activation, eosinophils, and lung function, which may reflect a particular
      pathogenetic mechanism involved in non-atopic asthma.

PMID- 1735192
TI  - Antigenic specificity and subset analysis of T cells isolated from the
      bronchoalveolar lavage and pleural effusion of patients with lung disease.
AB  - Cellular infiltrates of bronchoalveolar lavage (BAL) and pleural effusion from
      patients with tuberculosis (TB) and lung cancer were characterized for the
      presence of different T cell subsets by phenotypic analysis. The specificity of
      the T cells for mycobacterial antigens was then compared for the two disease
      compartments. The composition of T cell subsets within the BAL, in contrast to
      pleural effusion cells (PEC), revealed evidence of sequestration of CD8+ cells.
      BAL T cells were found to be a predominantly CD29+ DR+ memory population of
      activated cells. Although polyclonal populations of BAL T cells proliferated
      poorly to Mycobacterium tuberculosis antigens, mycobacterial antigen-reactive
      monoclonal T cell populations could be derived from the alveolar compartment. Two
      clones were shown to recognize the 65-kD heat shock protein of mycobacteria, and
      one of these clones recognized a conserved sequence of the molecule. Several BAL
      derived clones, responding to a mycobacterial soluble extract, did not, however,
      recognize purified mycobacterial antigens, previously identified as highly
      stimulatory for PEC-derived T cells. T cell clones, derived from PEC of two TB
      patients, responded to the 38-kD and 71-kD, as well as the 65-kD mycobacterial
      antigens. Examination of the activation requirements of BAL-derived T cell
      clones, specific for mycobacterial antigens, revealed that exogenous IL-2 was
      necessary for the T cells to sustain proliferation. This was in contrast to the
      mycobacterial antigen-reactive T cells cloned from PEC. These results suggest
      that T cell populations with distinct antigen specificities and activation
      requirements are present in BAL and PEC.

PMID- 1735193
TI  - Soluble IL-2 receptor and tumour necrosis factor-alpha in plasma of haemophilia
      patients infected with HIV.
AB  - We measured plasma concentrations of soluble receptors for IL-2 (sIL-2R) and
      tumour necrosis factor-alpha (TNF-alpha) in 149 haemophilia patients. Soluble IL
      2R levels were elevated in 37% of 62 HIV-seronegative patients (mean 570 +/- 27
      U/ml versus 361 +/- 17 U/ml in the control group, P less than 0.0001), in 78% of
      68 HIV-seropositive patients (928 +/- 49 U/ml, P less than 0.0001), and in 95% of
      19 AIDS/ARC patients (1578 +/- 199 U/ml, P less than 0.0001 compared with
      controls and with HIV-seronegative patients; P less than 0.005 compared with HIV
      seropositive asymptomatic patients). A negative correlation was observed between
      sIL-2R, relative and absolute numbers of CD4+ cells (P less than 0.0001), and
      CD4/CD8 ratios (P less than 0.0001). There was also a negative correlation
      between sIL-2R in plasma and the cellular expression of IL-2R (P less than
      0.001). We found a significant association of sIL-2R and plasma neopterin (P less
      than 0.0001). With progression of the disease from HIV-seronegative to
      seropositive without symptoms and to full manifestation of AIDS/ARC, sIL-2R
      plasma levels increased. The highest levels were found at the time of diagnosis
      of AIDS/ARC, but the levels decreased again during the following 18 months. Eight
      per cent of HIV-seronegative patients, 32% of HIV-seropositive patients, and 24%
      of patients with AIDS/ARC had increased plasma TNF-alpha. We conclude that sIL-2R
      and TNF-alpha plasma levels are elevated in HIV-infected haemophilia patients and
      that sIL-2R is a marker for disease progression from asymptomatic HIV
      seropositive to AIDS/ARC.

PMID- 1735194
TI  - Phagocytosis of Giardia lamblia trophozoites by cytokine-activated macrophages.
AB  - Phagocytosis of Giardia lamblia trophozoites by cytokine-activated and non
      activated bone marrow-derived macrophages was examined in vitro. Macrophages
      treated with recombinant interferon-gamma (IFN-gamma) and bacterial
      lipopolysaccharide (LPS) ingested a significantly higher number of in vitro-grown
      trophozoites than untreated macrophages. Maximal uptake of parasites occurred
      after 4 h and 6 h of incubation where 81.4% and 79.1% of macrophages were
      positive for trophozoites. Other cytokines tested, IL-2, IL-3, IL-4, IL-5, GM
      CSF, CSF-1 and tumour necrosis factor-alpha (TNF-alpha) either alone or in
      combination with LPS, failed to activate macrophages to phagocytose G. lamblia.
      The induction of this activated macrophage anti-microbial function was achieved
      pharmacologically using phorbol myristate acetate (PMA) and ionophore A23187. The
      giardicidal activity of macrophages activated with IFN-gamma and LPS or that
      induced by PMA and A23187 was inhibited by H-7, indicating the role for protein
      kinase C in the intracellular events following activation.

PMID- 1735195
TI  - Anti-P30 IgA antibodies as prenatal markers of congenital toxoplasma infection.
AB  - This study extends a previous study and confirms that the detection of anti-P30
      IgA antibodies is very helpful in the diagnosis of acute acquired or congenital
      toxoplasmosis. Moreover, we demonstrate that an anti-P30 IgA response can be
      mounted in the fetuses infected by Toxoplasma gondii during their intra-uterine
      life as early as week 23 of gestation. A double-sandwich ELISA described in our
      previous work was used to detect anti-P30 IgA antibodies in 1378 human serum
      samples collected from 551 patients, including 162 fetuses whose mothers had been
      infected by T. gondii during pregnancy, 46 congenitally infected and 90
      uninfected newborns and 253 women suspected of having been infected during
      pregnancy, including the mothers of fetuses and newborns previously described.
      Anti-P30 IgA antibodies were detected in all cases of acute toxoplasmosis but in
      no case of chronic toxoplasmosis: in the majority of cases, the IgA antibody
      titre fell below cut-off in 3-9 months. Among the 46 congenitally infected
      newborns, anti-P30 IgA antibodies were detected in sera of 41 infected newborns
      (38 at birth, two in the first months of life, one in the seventh month of life),
      while anti-P30 IgM antibodies were detected in only 30 cases at birth and in one
      case during the first month of life. Among 162 fetuses, anti-P30 IgA response was
      observed in five infected fetuses, but was not detected in either 152 uninfected
      fetuses or in five fetuses considered as infected. The absence or presence of
      anti-P30 IgA antibodies in the fetus is discussed in relation to the date of
      maternal infection and collection of the fetal blood. It clearly appears from our
      study that the combined testing of both IgM and IgA in the fetus and the newborn
      is essential for a more efficient diagnosis of infection.

PMID- 1735196
TI  - Involvement of HLA class II molecules in acquisition of staphylococcal
      enterotoxin A-binding activity and accessory cell activity in activation of human
      T cells by related toxins in vascular endothelial cells.
AB  - Human umbilical vascular endothelial cells (HUVEC) express HLA class II molecules
      upon stimulation with recombinant human interferon-gamma (IFN-gamma).
      Staphylococcal enterotoxin (SE) A (SEA)-binding assay using [125I]-SEA showed the
      presence of specific SEA binding in HUVEC stimulated with IFN-gamma but not in
      unstimulated HUVEC. Levels of HLA class II expression and SEA-binding increased
      as the IFN-gamma concentration and the period of stimulation were increased.
      Binding of [125I]-SEA to the IFN-gamma-stimulated HUVEC was reduced markedly by
      an anti-DR/DP MoAb. T cells produced IL-2 upon stimulation with a group of SEs
      (SEA, SEB, SEC, SED and SEE) in the presence HUVEC stimulated with IFN-gamma but
      not in the presence of control HUVEC. The level of accessory cell activity in the
      IFN-gamma-stimulated HUVEC was related to the level of HLA class II expression
      and SEA-binding activity. Antibodies to HLA class II molecules almost completely
      inhibited the response. These results indicate that HLA class II molecules are
      directly involved in the acquisition of these activities in HUVEC.

PMID- 1735197
TI  - The distal radioulnar joint. Symposium.

PMID- 1735198
TI  - Distal radioulnar joint arthroplasty. Current concepts.
AB  - Arthroplasty techniques for the distal radioulnar joint can be grouped into
      several categories. These are resectional or excisional arthroplasty,
      hemiresection or partial resectional arthroplasty, ulnar shortening, or
      replacement arthroplasty. These techniques are used in varying conditions and
      situations. Once the function of the radioulnar joint is understood, the choice
      of arthroplasty technique is simplified. This article presents the theoretical
      basis for selecting a particular type of arthroplasty technique in any patient.
      The author's hemiresection interposition technique of arthroplasty developed in
      the mid 1970s. Sufficient results have now been published that an assessment of
      the efficacy of the procedure is available. The author's current concept is that
      detailed and increasing experience with the procedure has uncovered some problems
      and some modifications. The major indications for the hemiresections arthroplasty
      and its alternatives must be in the armamentarium of those dealing with this
      joint.

PMID- 1735199
TI  - The Sauve-Kapandji procedure.
AB  - In 1936, Sauve and Kapandji described a procedure that included an arthrodesis
      across the distal radioulnar joint and created a pseudarthrosis of the ulna,
      proximal to the fusion, to restore pronation and supination. The author has used
      this technique because preservation of the head of the ulna minimizes the
      potential for some of the complications that can follow its excision. Retention
      of the head of the ulna would secure a more normal transmission of loads across
      the wrist, maintain full support to the carpal condyle and to the extensor carpi
      ulnaris tendon, and preserve the normal contour and appearance of the wrist. This
      paper presents the author's experience using this procedure in 37 wrists with
      rheumatoid arthritis, osteoarthrosis and posttraumatic changes of the distal
      radioulnar joint, and chondromalacia of the head of the ulna. This is a
      satisfactory operation, although not infallible. It is probably contraindicated
      when treating the unstable or frankly subluxed or dislocated distal radioulnar
      joint, ulna dorsal, a therapeutic problem for which there is no reliable
      solution. Indications for the Sauve-Kapandji technique are discussed in relation
      to other operations frequently used for the distal radioulnar joint.

PMID- 1735200
TI  - The "wafer" procedure. Partial distal ulnar resection.
AB  - A technique of partial resection of the distal ulna ("wafer" procedure) for the
      treatment of patients with symptomatic tears of the triangular fibrocartilage
      complex or mild ulnar impaction syndrome or both is described. The distal 2-4 mm
      of the distal ulna is resected while preserving the distal radioulnar joint and
      the styloid process of the ulna and the ligaments attached to it. The triangular
      fibrocartilage can be debrided, repaired, or partially excised. The wafer
      procedure has several advantages and avoids some of the potential complications
      of other treatment methods.

PMID- 1735201
TI  - Stabilization of the distal ulna by transfer of the pronator quadratus origin.
AB  - Surgical and nonsurgical treatment of distal radioulnar joint instability has
      characteristically been unsatisfactory. This present paper presents a surgical
      method involving the removal and transfer of the origin of the pronator quadratus
      to a more dorsal position, which effectively gives a dynamic stabilization to the
      joint. Temporary internal immobilization is performed with a transverse Kirschner
      wire that is removed at four weeks, and graded physical therapy is started at
      that time.

PMID- 1735202
TI  - Bone-fibrin mixture in spinal surgery.
AB  - When bone grafting is performed adjacent to the spinal cord, instability of the
      grafted bone can result in compression of the spinal cord. To prevent this
      complication, fibrin sealant was mixed with the fine fragments of autogeneic
      bone, and the resultant pastelike mixture was used as a graft material. Operative
      procedures performed were posterolateral fusion (11 cases), anterior fusion
      (seven cases), and grafting into the bone defect (one case). After solidification
      of fibrin sealant, the autogeneic bone grafts were found to be firmly fixed in
      place, resulting in good bony fusion, and there were none of the neurologic
      symptoms associated with graft instability. No neurotoxicity was observed in any
      of these patients. Fibrin sealant was found to be an effective material for
      spinal surgery.

PMID- 1735203
TI  - Anatomy of the distal radioulnar joint.
AB  - The distal radioulnar joint (DRUJ) is of the utmost importance in treatment of
      fractures of the distal radius. To improve the treatment of these fractures,
      knowledge of the anatomy and biomechanics of the DRUJ is essential. Three major
      findings from anatomic specimen studies of the DRUJ are discussed. The radius of
      the curvature of the sigmoid notch is 4-7 mm larger than that of the ulnar head,
      and consequently pronation and supination are a combined rotation and sliding
      movement in the DRUJ. The ulnar head has an average inclination of 20 degrees
      relative to the long axis of the ulna. Being parallel to the ulnar head, the
      sigmoid notch of the radius should have the same inclination. In the DRUJ,
      stability supported by joint surface architecture is minimal, and the ligament is
      therefore of particular importance to the stability.

PMID- 1735204
TI  - Epidural compression in the spinal canal caused by excessive adipose tissue. A
      case report.
AB  - Excessive deposition of fat in the epidural space is rare. In a recent review of
      the literature, there were 15 reported cases, 14 were associated with steroid use
      and one was attributed to hypothyroidism. This report reviews treatment of a
      patient with symptoms of cauda equina compression caused by epidural adipose
      tissue. He had no history of steroid use or obvious evidence of an underlying
      endocrinopathy.

PMID- 1735205
TI  - Coffin-Lowry syndrome associated with calcium pyrophosphate crystal deposition in
      the ligamenta flava.
AB  - Clinical and ultrastructural study of four cases of Coffin-Lowry syndrome (CLS),
      a heritable disorder with peculiar facies, stooped posture, vertebral changes,
      and mental retardation, is reported. Three of the four cases had myelopathy
      caused by calcification of the ligamenta flava in early adulthood. These patients
      demonstrated that CLS is a calcium pyrophosphate dihydrate crystal deposition
      disease, and it is postulated that a metabolic abnormality in collagen and in
      proteoglycans are responsible for some aspects of CLS.

PMID- 1735206
TI  - Latissimus dorsi transfer for the treatment of irreparable tears of the rotator
      cuff.
AB  - Sixteen irreparable, massive rotator cuff tears were treated with latissimus
      dorsi transfer and reviewed after an average of 33 months. There were no
      neurovascular complications or infections. Pain relief was satisfactory in 94% of
      the shoulders at rest and in 81% on exertion. Flexion was 83 degrees
      preoperatively and 135 degrees postoperatively. The functional value of the
      shoulder averaged 73% of an age- and gender-adjusted normal score. For the 12
      shoulders with a functional subscapularis, it averaged 82%; for those four
      without a functioning subscapularis, 48%. If the subscapularis was torn and could
      not be adequately repaired, latissimus dorsi transfer was of no value. In cases
      with good subscapularis function but irreparable defects in the external rotator
      tendons, restoration of approximately 80% of normal shoulder function was
      obtained, indicating that latissimus dorsi transfer is a safe and valuable
      alternative for the treatment of this specific type of irreparable rotator cuff
      tear.

PMID- 1735207
TI  - The Hitchcock procedure. A cause for failure: a case report.
AB  - A 40-year-old man with a tenodesis of the long head of the biceps brachii in the
      bicipital groove (Hitchcock's operation) for bicipital tendinitis had recurrence
      of pain seven months after the operation. Roentgenograms of the acromiohumeral
      interval, taken when the patient tensed the biceps brachii, showed significant
      upward migration of the humeral head with a decrease in the acromio-humeral
      interval on the operated side. The authors postulate that resection of the
      stabilizing, intraarticular segment of the long head of the biceps in the
      Hitchcock's procedure allowed the short head to draw the humeral head proximally,
      resulting in a decrease in the acromiohumeral interval and recurrence of
      impingement. This is one possible explanation for the poor long-term results of
      the Hitchcock procedure.

PMID- 1735208
TI  - Conservative treatment of rotator cuff tears.
AB  - Among 124 shoulders in 114 patients with complete rotator cuff tears who had been
      treated conservatively from 1980 until 1989, 62 shoulders in 54 patients were
      observed to identify the findings on initial examinations and correlate them with
      the final results. The follow-up period averaged 3.4 years. According to modified
      criteria of Wolfgang, 51 shoulders in 45 patients (82%) rates satisfactory
      (excellent or good). The overall scores of pain, motion, and function improved
      significantly. The results were less satisfactory in patients observed more than
      six years. The patients with satisfactory results (Group 1) and unsatisfactory
      results (Group 2) among those observed more than five years were compared. In
      Group 1, the scores of pain, motion, and strength improved significantly at
      follow-up examinations, whereas those of function did not. In Group 2, no
      improvement was recognized in any categories. The only significant differences in
      the initial findings between the two groups were the active abduction angle and
      the abduction strength: the patients in Group 1 retained a good range of motion
      and strength, whereas those with unsatisfactory results had a limited range and
      muscle weakness on first examinations. Conservative treatment affords
      satisfactory results when it is given to the patients with well-preserved motion
      and strength, although in some cases function may deteriorate with time.

PMID- 1735209
TI  - A histopathologic study of late aseptic loosening of cemented total hip
      prostheses.
AB  - Eighteen patients being treated for revision total hip arthroplasty for aseptic
      loosening an average of 9.5 years after primary cemented hip arthroplasty were
      studied. The patients were found to have been symptomatic an average of one year
      before revision. Review of the roentgenograms at the time of revision revealed
      that most patients had moderate to severe loosening of the prostheses by
      Charnley's criteria. These findings were confirmed at surgery. Study of the
      tissue surrounding the prostheses suggests that the prominent particles were
      methylmethacrylate "pearls" caused by cement fragmentation. These particles were
      surrounded by histiocytes that were actively synthesizing and releasing protein.
      Cement fragmentation and not polyethylene wear may be the major cause of late
      aseptic loosening of cemented hip prostheses.

PMID- 1735210
TI  - Evaluation of the hip with pigmented villonodular synovitis. A case report.
AB  - Pigmented villonodular synovitis (PVNS) is an uncommon disorder of the synovium
      that rarely involves the hip joint. The natural history of an untreated case of
      PVNS is presented herein. A young adult with a painful hip and destructive
      changes on plain roentgenograms requires further diagnostic evaluation. The
      relative value of current imaging techniques is discussed in this report. Plain
      roentgenograms alone often suggest the correct diagnosis of PVNS of the hip, but
      traditional criteria have proven to be inaccurate. Computed tomography (CT) is
      helpful in demonstrating the location and degree of bone loss throughout the
      pelvis and assists in determining the need for bone graft or prosthetic
      modification in preoperative planning. Experience with magnetic resonance imaging
      (MRI) in this disorder is limited, but no clear advantage over CT has been
      demonstrated thus far. Three-dimensional reconstruction has provided no useful
      information not already found on plain CT or MRI. For diagnostic accuracy and
      effective preoperative planning, evaluation should include a complete blood
      count, sedimentation rate, CT scan, and MRI.

PMID- 1735211
TI  - Torsional fixation of the femoral component in total hip arthroplasty. The effect
      of surgical press-fit technique.
AB  - Rotational loading of the femoral component has recently emerged as a prime
      factor for causing loosening and failure of total hip replacements. In this study
      the effect of surgical press-fit technique on torsional fixation of the femoral
      component was evaluated. The commonly used line-to-line reaming technique was
      compared to an underreaming technique using both four-fifths and one-third porous
      coated anatomic medullary locking (AML) implants. Rotational micromotion,
      permanent rotational displacement, and slop displacement between bone and implant
      were measured with linearly variable differential transducers under torsional
      loading. The line-to-line reamed group showed significantly greater motion than
      both underreamed groups for all micromotion parameters. This was especially true
      for the slop displacement test, which revealed large amounts of displacement
      after a single moderate torsional load, whereas in the underreamed groups
      significantly less loosening was found. The line-to-line reaming technique did
      not achieve good rotational fixation of the femoral component. Superior
      rotational stability was accomplished only when the diaphysis was underreamed and
      tight diaphyseal fixation was achieved. The extent of the porous coating on the
      stem did not have a significant effect.

PMID- 1735212
TI  - The blood supply of the human distal radioulnar joint and the microvasculature of
      its articular disk.
AB  - The arterial blood supply of the distal radioulnar joint was investigated in 35
      upper extremities taken from 22 fresh cadavers (11 newborns and 11 adults using
      the India ink injection and tissue-clearing techniques according to Spalteholz).
      Microvasculature of the articular disk of the distal radioulnar joint was also
      performed in 35 articular disks taken from 22 fresh human cadavers, 11 newborn
      and 11 adults using the same technique. It was found that the general blood
      supply to the joint is received mainly from the palmar and dorsal branches of the
      anterior interosseous artery. These branches, after dividing at the proximal
      border of the pronator quadratus, arborize in a fanlike fashion around the joint
      and their small ramifications penetrate and vascularize the capsule and the
      articular disk from the palmar, dorsal, and medial sides. The terminal branches
      of the anterior interosseous artery reinforced by the posterior interosseous
      artery and a small branch of the ulnar artery give the direct peridiscal vessels
      to the palmar, medial, and dorsal margins of the articular disk, which arborize
      and anastomose with one another and form the terminal capillary networks that end
      at the peripheral segments of the disk in a series of terminal capillary loops,
      leaving the inner segments devoid of blood vessels. The posterior interosseous
      artery anastomoses at the distal part of the forearm with one of the terminal
      rami of the dorsal branch of the anterior interosseous artery and, in that way,
      contribute to the vascularization of the dorsal capsule of the distal radioulnar
      joint. The ulnar artery gives off a small branch that anastomoses with one of the
      terminal ramifications of the palmar branch of the anterior interosseous artery
      and contributes to the formation of a small arterial arch on the anteromedial
      side of the distal ulna, supplying the anteromedial capsule and the basistyloid
      area of the ulna. Both ulnar and radial arteries contribute to the vascularity of
      the joint through the collateral network of the palmar and dorsal carpal arches.
      In the articular disk, the major central portion of the disk is avascular and
      only its peripheral, palmar, medial, and dorsal margins are vascularized. The
      proportion of vascularized zone to avascular zone depends on the age of the
      subject and, in newborns, is approximately 33%. In adults, only 25% of the
      peripheral segments are vascularized.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1735213
TI  - Titanium hip implants for improved magnetic resonance and computed tomography
      examinations.
AB  - The value of magnetic resonance imaging (MRI) for assessment of the hip has been
      demonstrated, particularly in cases of avascular necrosis. Magnetic resonance
      imaging can be used to provide anatomic evaluation of the femoral head,
      acetabulum, hip joint, joint fluid, and the surrounding structures. MR
      examinations of two patients with hip fractures fixed with stainless steel hip
      implants were compared with nine patients with hip fractures fixed with titanium
      hip implants, one of which showed avascular necrosis of the femoral head. The
      titanium implants resulted in less MRI artifacts, allowing for improved depiction
      of the femoral head and surrounding soft tissue. For this reason titanium
      fixation devices are recommended as a substitute for stainless steel in the hip
      joint region in a patient who may need future MR examination.

PMID- 1735214
TI  - Transient osteopenia of the hip joint in children.
AB  - Two pediatric cases of transient osteopenia of the hip joint are reported.
      Roentgenograms showed bone atrophy in the femoral head, the femoral neck, and the
      pelvis. Bone scintigrams showed a higher accumulation. At the follow-up study,
      osteopenia disappeared in both cases, however coxa magna was recognized in one
      case. The emphasis is on differential diagnosis from more severe disease, because
      the syndrome is characterized by spontaneous resolution.

PMID- 1735215
TI  - Preoperative flexion. Does it influence postoperative flexion after posterior
      cruciate-retaining total knee arthroplasty?
AB  - This study analyzed data from 313 posterior-cruciate-sparing total knee
      replacements to determine the influence of preoperative flexion on postoperative
      flexion. The patients with limited flexion preoperatively demonstrated an
      improvement in flexion postoperatively. By contrast, patients with more than 105
      degrees of flexion preoperatively demonstrated a decrease in flexion
      postoperatively. The study indicated a migration towards the mean range of
      motion. These findings were true for the total pool of patients and for each
      subgroup of patients based on diagnosis, cement status of the tibia, and implant
      type. The data suggests that flexion does not change beyond the first
      postoperative year.

PMID- 1735216
TI  - The effect of patellar button placement and femoral component design on patellar
      tracking in total knee arthroplasty.
AB  - The effects of patellar button position and femoral component design on patellar
      tracking were investigated roentgenographically and arthroscopically using fresh
      frozen adult anatomic specimen knees. Patellar tracking was evaluated for
      medial/lateral position and tilting angle deviation by comparing preoperative
      normal values to total knee replacement performance with the following variables:
      (1) femoral component design; symmetrical total condylar type with a 3-mm central
      patellar groove and a component with a 3-mm raised lateral patellar flange and 1
      mm deepened patellar groove; and (2) patellar button placement; central
      insertion; and 10-mm medialized insertion. In the roentgenographic study,
      medialized position of the patellar button allowed the bony portion of the
      patella to assume its normal lateral position and tilt throughout the knee range
      of motion. A combination of medialized position of the patellar button and
      deepening of the patellar groove provided the most anatomically correct position
      and the most normal tilting of the bony structure of the patella. In the
      arthroscopic study, the centralized patellar position caused significant lateral
      tracking and subluxation relative to the femoral component, whereas the
      medialized position eliminated this tracking disorder. Deepening the patellar
      groove minimized the intraarticular tracking abnormality and constrained the
      patellar button in the patellar groove. These results show that the position of
      the patellar button and femoral component design exert a major influence on
      patellar tracking.

PMID- 1735217
TI  - Relation of the fibular head sign to other signs of anterior cruciate ligament
      insufficiency. A follow-up letter to the editor.
AB  - The fibular head sign is a clinical finding that seems not to have been
      previously reported for the diagnosis of chronic anterior cruciate ligament
      insufficiency (ACLI) associated with lateral rotatory instability of the knee
      joint. The fibular head could be palpated as a prominent bony lump, felt
      subcutaneously in the posterior lateral corner of the popliteal fossa. In a
      prospective study of 20 patients with ACLI, the mean age of the patients (15
      males, five females) at the time of assessment was 26 years (range, 18-57 years).
      The left knee was involved in 11 patients, the right knee in the remaining nine
      patients. All the patients sustained their knee ligament injury in sporting
      activities except one patient who was involved in a motor vehicular accident. The
      majority of the patients had instability-related symptoms for more than six
      months. After history taking, physical examination in the clinic, and examination
      under anesthesia, and arthroscopy in the operating room of all patients, it was
      determined that there were 13 ACL injuries, four posterior cruciate ligament
      (PCL) injuries, and three combined A/PCL injuries. All ACL injury patients had a
      prominent fibular head sign. Other associated signs included passive
      hyperextension of 10-20 degrees, and major anterolateral, and to a lesser degree
      a posterolateral, rotatory instability. The fibular head sign was negative in
      isolated posterior cruciate injuries and in combined A/PCL injuries.

PMID- 1735218
TI  - Soft-tissue management with prosthetic replacement for sarcomas around the knee.
AB  - The soft-tissue management was reviewed in 46 consecutive primary and nine
      revision segmental knee resections with prosthetic reconstruction performed for
      sarcomas around the knee. From January 1983 until August 1986, before the
      extensive use of free-tissue transfer in these patients, 20 primary segmental
      knee reconstructions were performed with five patients receiving gastrocnemius
      rotation flaps, and one patient receiving a late free flap (Group I). In this
      group, three patients were converted to an above-knee amputation because of wound
      problems. From August 1986 to August 1988, free-tissue transfer was available and
      extensively used in addition to rotation flaps to manage 26 primary (Group II)
      and nine revision (Group III) segmental knee reconstructions. In contrast to
      Group I, none of the patients in Groups II or III required amputation or
      conversion to a nonlimb-sparing procedure for soft-tissue management. None of the
      patients in this study received radiation therapy to their extremities.
      Chemotherapy protocols were similar in Groups I and II with 22 of 26 patients in
      Group I and 19 of 20 in Group II receiving treatment. The availability and
      expertise to perform free and rotational flaps at the time of initial excision
      provides greater selection and improved outcome for those patients whose wounds
      are closed primarily. The capability to perform free and rotation flaps at
      initial resection and for postoperative wound management is a major determinant
      of ultimate success in patients having reconstruction after excision of sarcomas
      about the knee.

PMID- 1735219
TI  - The innervation of the human meniscus.
AB  - Fourteen menisci from seven anatomic specimens were examined to identify their
      innervation. After staining by a modified gold chloride method, the menisci were
      sectioned on a sliding microtome and were studied under a light microscope. Free
      nerve endings in the peripheral and the medial thirds of the meniscal body were
      identified, and three types of encapsulated mechanoreceptors were found in the
      anterior and posterior horns. Based on these findings and a review of the
      relevant literature, it is considered that menisci both receive and transmit
      proprioceptive information. Therefore, they not only are stabilizers of this
      joint, but also contribute to the function of deep sensitivity.

PMID- 1735220
TI  - C-reactive protein (CRP) levels after elective orthopedic surgery.
AB  - The levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)
      were determined by serial measurements after four types of uncomplicated elective
      orthopedic surgery. The type of operations chosen for this study were total hip
      arthroplasty (primary, n = 109; and revisions caused by aseptic loosening, n =
      9), unicondylar knee arthroplasty (n = 39), and lumbar microdiskectomy (n = 36).
      In all patients, CRP levels increased after surgery, reaching peak levels on the
      third day after hip arthroplasties (primary, 116 +/- 43 mg/l; revisions, 136 +/-
      58 mg/l) and on the second day after knee arthroplasties (140 +/- 46 mg/l) and
      lumbar microdiskectomy (48 +/- 27 mg/l). C-reactive protein levels usually
      dropped to normal (less than 10 mg/l) within 21 days after surgery. No
      correlations were found between CRP response and the type of anesthesia, amount
      of bleeding, transfusion, operation time, administered drugs, age, or gender.
      Erythrocyte sedimentation rate increased to peak levels about five days after
      surgery, followed by a slow and irregular decrease. Still, 42 days after
      uncomplicated operations ESR often remained elevated. In conclusion, the level of
      CRP must be considered a better diagnostic aid for the early detection of
      postoperative infections than ESR. It can be assumed that the rapid decline in
      CRP after uncomplicated orthopedic surgery will be interrupted by a second rise
      or by a persisting elevated level if infectious complications occur.

PMID- 1735221
TI  - Arthroscopic management of pyarthrosis.
AB  - Sixteen patients (average age, 38 years; range, 20-63 years) with pyarthrosis
      were treated during a ten-year period by arthroscopic techniques consisting of
      joint debridement and application of suction drains, combined with appropriate
      antibiotics. There were 13 knees, two shoulders, and one ankle in the series. At
      the first visit to the authors' institution, patients typically had fever,
      leukocytosis, elevated sedimentation rate, and localized joint findings, such as
      generalized tenderness, swelling, effusion, and painful, limited range of motion
      in almost every joint involved. Most patients were seen two to five days after
      the onset of symptoms. After the initial culture and sensitivity were obtained
      and broad-spectrum antibiotics were administered, all patients were taken to the
      operating room on an emergency basis. At an average follow-up evaluation of 36
      months (range, 14-48 months), the results have been excellent to good, without
      evidence of recurrence.

PMID- 1735222
TI  - A model for evaluating the strength of bones lengthened by distraction
      osteogenesis.
AB  - In an effort to evaluate the strength of bones lengthened by distraction
      osteogenesis, a modified Ilizarov-type external fixator was applied to the right
      tibiae of five adult mongrel dogs. Diaphyseal corticotomies were performed, and
      distraction (lengthening) was carried out at a rate of approximately 1 mm per day
      for 20 days. After completion of the lengthening, the animals were killed, the
      fixators were removed, and the right and left tibiae were harvested and stripped
      of soft tissue. The ends of all harvested bones were fixated in
      polymethylmethacrylate to allow testing on a materials testing system (MTS)
      machine. Testing under torsional loads was performed on the MTS machine (50
      degrees maximum angle of rotation at ten seconds) until failure. The right tibiae
      were lengthened an average of 12 mm (range, 7-15 mm). The slopes of the linear
      portion of the torque versus rotation curves were determined. A comparison of
      slopes revealed a mean change in stiffness between test and control bones of
      20.32% (range, 0.64%-40.5%). All tibiae exhibiting mature regenerate bone
      demonstrated stiffness greater than the matched controls (range, 0.64-24.09%
      stiffer). Four of five dogs had problems with proximal and distal ring
      impingement. This study presents a reproducible model for evaluating the strength
      of bones lengthened by distraction osteogenesis. The lengthened bones that
      exhibited bony or mature regeneration were as strong as the control bones.

PMID- 1735223
TI  - Spontaneous gluteal artery rupture resulting in compartment syndrome and sciatic
      neuropathy. Report of a case in Ehlers-Danlos syndrome.
AB  - Spontaneous arterial rupture is an uncommon but potentially life-threatening
      event. In this case spontaneous bleeding from a gluteal artery resulted in a
      gluteal compartment syndrome and sciatic neuropathy. Bleeding is best managed by
      arteriography and embolization. Similar in pathophysiology to the more common leg
      and forearm compartment syndromes, gluteal compartment syndromes are treated with
      fasciotomy. Spontaneous arterial bleeding in an extremity may be the initial
      symptom in patients with a rare form of Ehlers-Danlos syndrome. Additional
      evaluation for the presence of significant abdominal and intracranial arterial
      involvement is mandatory. Family members should also be evaluated for this
      hereditary condition.

PMID- 1735224
TI  - Rib perichondrial autografts in full-thickness articular cartilage defects in
      rabbits.
AB  - This study investigated the resurfacing of full-thickness articular defects in
      the adult rabbit medial femoral condyle using a rib perichondrial graft. The
      graft was secured to a 4-mm-diameter bone core removed from the femoral condyle.
      Two postoperative treatment protocols were studied: one group had ad libitum cage
      activity (CAGE; n = 95) and the other group received two weeks of passive motion
      (PM; n = 73; eight hours per day, five days per week) followed by cage activity.
      Animals in both groups were killed at six, 12, 26, and 52 weeks. Repair tissue
      resembling hyaline cartilage formed in a majority of animals at all time periods
      and in both postoperative treatment groups. The overall success rates in which
      repair tissue formed were 58% in the CAGE group and 56% in the PM group. However,
      over time, a maturation of the neocartilage into nearly normal hyaline articular
      cartilage was noted with the percentage of Type II collagen increasing from 55%
      at six weeks to 82% at one year. The complex shear modulus of the repair tissue
      for both groups became similar to normal cartilage with increased healing time.
      There was no statistical difference in shear moduli between the two treatment
      modalities. These results show that cartilage repair tissue derived from rib
      perichondrium could mature into hyaline articular cartilage over time and would
      not degrade by one year after repair.

PMID- 1735225
TI  - Longitudinal growth and growth-plate activity in the lower extremity.
AB  - Teleroentgenograms of the lower extremity in 244 children (123 boys and 121
      girls) were made at six-month intervals from age seven until skeletal maturity.
      Lengths were measured to determine the growth remaining in the femur and tibia.
      The subjects were healthy, well-nourished, middle class Americans, mostly of
      Northwest European descent. The percentage of growth occurring at each lower
      extremity growth plate was determined by roentgenstereophotogrametric analysis.
      The growth occurring at the distal femoral and proximal tibial growth plates was
      determined by multiplying the proportion of growth occurring at each age by the
      longitudinal growth remaining. The proportion of growth occurring at each growth
      plate is not equal. Also, growth-plate activity is not constant or average
      throughout growth. Overall, approximately 70% of growth in the femur occurs at
      the distal growth plate. The proportion of growth occurring in the distal femoral
      growth plate in girls varies from 60% at seven years of age to 90% at age 14.
      Similarly, the contribution of the distal femoral growth plate in boys varies
      from 55% at seven years of age to 90% at age 16. Overall, the contribution of the
      proximal tibial growth plate is approximately 57%. In girls, this varies from 50%
      at seven years of age to 80% at age 14. In boys it varies from 50% at seven years
      of age to 80% at age 16. From the age of seven to skeletal maturity, the distal
      femur contributes approximately 1.3 cm per year to femoral growth, except in the
      last two years, when it contributes half that amount.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1735226
TI  - Pericytes as a supplementary source of osteoblasts in periosteal osteogenesis.
AB  - In the adult rat femur, lifting a periosteum strip with microscopic bone flakes
      on its deep surface, if performed without damaging the surrounding
      microcirculation, rapidly leads to new bone formation and angiogenesis. Using
      vascular labeling, the pericytes and endothelial cells (ECs) were labeled with
      monastral blue (MB) in the preformed, preexisting postcapillary venules of the
      periosteal microcirculation. MB was detectable by light and electron microscopy
      and it persisted in some of the daughter cells. Between one and 21 hours, the MB
      labeling was restricted to the pericytes and ECs of postcapillary venules.
      Immediately afterward, both pericytes and ECs of these vessels were activated and
      continued to show MB. The phenomenon of pericyte activation includes enlargement,
      disruption of their basal lamina, separation from the walls of the preformed
      vessels, and the presence of mitotic figures. At this stage, activated pericytes
      with MB in their cytoplasm, fibroblast-like cells, and transitional cell forms
      between them were seen in interstitial areas. After 27 hours, vascular buds
      appeared and MB was detected in some ECs and pericytes. Between three and six
      days, when bone-tissue development was observed, some osteoblasts were MB
      labeled. Previous findings support the hypothesis that when the periosteum is
      activated, the process of bone formation from cells already present in the
      periosteum is augmented by proliferation and differentiation of pericytes, which
      contribute a supplementary population of osteoprogenitor cells.

PMID- 1735227
TI  - The pericyte as a possible osteoblast progenitor cell.
AB  - Bovine capillary and microvessel pericytes were grown in monolayer in standard
      tissue culture medium supplemented with 10% newborn calf serum at various oxygen
      tensions for up to ten weeks. The pericytes synthesized alkaline phosphatase and
      formed colonies that mineralized. Energy dispersive X-ray spectrometry revealed
      the presence of calcium and phosphate, showed positive staining for collagen and
      glycosaminoglycan, and, most importantly, demonstrated the synthesis of
      osteocalcin. Cell proliferation, hydroxyproline production, and alkaline
      phosphatase synthesis were greatest in 3% oxygen, whereas osteocalcin production
      was least in 3% oxygen. These findings demonstrate that the capillary or
      microvessel pericyte exhibits phenotypic expressions in vitro that are similar to
      that of in vitro bone cells, and these expressions may be somewhat oxygen
      dependent. It is suggested from these findings that the capillary or microvessel
      pericyte may be an osteoblast precursor cell.

PMID- 1735228
TI  - Histologic structure of the articular disk of the human distal radioulnar joint.
AB  - A histologic study of the structure of the articular disk of the distal
      radioulnar joint in humans was performed on 57 disks from 37 fresh cadavers that
      included fetuses and individuals up to age 65 years. The specimens were stained
      with hematoxylin and eosin, orcein, and Mallory and Mann-Dominici's methods, and
      studied with the light microscopy. It was found that the disks of adults were
      basically formed of the so-called fibrocartilagenous tissue composed of an
      intercellular substance in which there were interwoven wavelike collagen fiber
      bundles and between them three specific types of cells: (1) rather sparse
      fibrocytes mostly situated in dorsal and palmar margins, (2) predominant and
      constant chondroid cells dispersed throughout the disk, and (3) less-frequent
      real chondocytes distributed mostly in the central parts. This basic tissue is
      modified according to the age of the subjects and functional requirements. In
      fetuses and newborns, it is almost completely fibrous and very cellular, while in
      adults, it is more cartilaginous with significantly reduced cellularity. The
      structure of various parts of disks is adapted to the functional stresses exerted
      on them. In central parts exposed to pressure, the tissue is more cartilaginous,
      while peripheral, massive margins, subjected mostly to traction, are built in a
      ligamentlike pattern. The ulnar and carpal surfaces are adapted to the gliding
      movements of the ulna and carpus. It is concluded that the articular disk in
      humans, which is basically of fibrocartilagineous nature, is a dynamic structure
      biomechanically, predetermined and changing with aging.

PMID- 1735229
TI  - Partial excision of lower shaft of ulna for deformity following Colles's
      fracture. 1913.

PMID- 1735230
TI  - Serum and other calcium fractions in patients after severe musculoskeletal
      trauma.
AB  - Alterations in serum calcium fractions after trauma may be of clinical
      importance. For investigation of this problem, serum calcium fractions were
      studied prospectively in 42 patients with severe musculoskeletal injuries. The
      severity of trauma was assessed with the Apache II severity of disease
      classification system. Serum ionized calcium, total calcium, pH, albumin, and
      arterial blood gases were measured daily for the first five days after admission.
      The fat embolism syndrome developed in eight patients; they were more severely
      injured than the others, and they had significantly lower levels of serum ionized
      calcium for all five days of the study. There was a strong negative correlation
      between the Apache II score and serum ionized calcium. Ionized hypocalcemia has a
      strong association with development of the complications of severe
      musculoskeletal trauma, such as the fat embolism syndrome.

PMID- 1735231
TI  - The distal radioulnar joint. Anatomic and functional considerations.
AB  - The distal radioulnar joint is functionally coupled with the proximal radioulnar
      joint, thus forming a mechanism for the longitudinal rotation of the hand. Distal
      radioulnar mobility is derived from the geometry of the joint, joint surfaces,
      and radioulnar connections. There is a structural and functional separation
      between the distal radioulnar and carpal joints, giving the possibility of
      pronation and supination in every position of the hand to the forearm. As for the
      stability of the joints involved, the ulnar articular disk plays an essential
      role. Being part of both distal radioulnar and carpal joints, the disk has very
      specific morphologic features that not only are individualized to the function of
      both joints but also stabilize the joints in their independent movements.
      Developmental data give the strong impression of an architectural scheme, of
      which the distal radioulnar joint is only a part. Traumatic lesions at the distal
      radioulnar joint and disturbances in normal distal radioulnar alignment have to
      be viewed, therefore, in a wider context.

PMID- 1735232
TI  - Biomechanics of the distal radioulnar joint.
AB  - The distal radioulnar joint (DRUJ) is a complex joint involved in pronosupination
      and ulnocarpal motion and support. The ulnar head, in a rolling, sliding motion,
      moves from the dorsal to the volar rim of the sigmoid notch as the joint moves
      from pronation to supination. The triangular fibrocartilage (TFC) is taut first
      dorsally and then volarly in the same sequence. The ulnar carpus is supported
      variably, as a function of ulnar length relative to the radial articular surface,
      by the pole of the distal ulna through the TFC. The TFC does not resist the
      pistonlike movement of the DRUJ, which occurs under dynamic loading. The coronal
      alignment of the DRUJ minimizes shear stress on the articular surfaces because of
      its alignment with the rotational axis of the forearm. Ulnar variance is a factor
      in the development of several clinical conditions.

PMID- 1735233
TI  - Evolution of the distal radioulnar joint.
AB  - The evolution of the wrist joint began 400 million years ago with the pectoral
      fins in primitive fish. The five-rayed extremity with 13 carpal bones and a
      syndesmotic distal radioulnar joint first appeared in the primitive amphibian,
      Eryops, some 230 million years ago. These characteristics remained similar
      through the evolution of the amphibians and of mammals and were retained when
      primates evolved to hominids. As later-developing, larger-sized hominids began
      competing for food, brachiation (the ability to swing from tree branch to tree
      branch) became more important, and a synovial distal radioulnar joint evolved,
      allowing pronation/supination of the wrist. The development of bipedalism freed
      the upper extremity from the requirements of locomotion, placing greater emphasis
      on increasing wrist mobility. The ability to supinate and pronate was an immense
      advantage to hominids in caring for their young, defending themselves, and
      gathering food. It was also critical in efficient tool handling, which developed
      two million years ago. The mobility of the distal radioulnar joint, along with
      the prehensile thumb and increasing brain function, are hallmarks of the late
      evolving hominids.

PMID- 1735234
TI  - The distal radioulnar joint in relation to the whole forearm.
AB  - The functional anatomy of the distal radioulnar joint was studied in relation to
      the whole forearm, using three fresh-frozen, above-elbow amputation specimens.
      The specimens demonstrate how the proximal and distal radioulnar joints together
      form a bicondylar joint of special character. The proximal "condyle," the radial
      head, rotates axially, whereas the distal "condyle," the ulnar head, is fixed
      with respect to rotation. The ordinary articulation of a bicondylar joint (pure
      axial rotation) is thereby changed into pronation-supination. Axial rotation is
      preserved proximally, while distally the radius swings around the ulnar head. The
      mobile radius is distally attached to the stable ulnar head by the dorsal and
      volar radioulnar ligaments, the dorsal ligament being tight for stabilization in
      supination and the volar ligament being tight in pronation. The ulnar head also
      serves as a keystone, carrying the load of the radius. Removal of the ulnar head
      allows the radius to "fall in" towards the ulna, with narrowing of the
      interosseous space.

PMID- 1735235
TI  - Traumatic disruption of the triangular fibrocartilage complex. Pathoanatomy.
AB  - The surgical pathology in 42 cases of traumatic triangular fibrocartilage complex
      (TFCC) disruption comprised a spectrum of injury resulting in five basic stages
      of increasingly severe ulnar wrist instability. In all cases, detachment of the
      articular disk from its ulnar insertion was the principal cause of distal
      radioulnar joint instability; in 28 (67%), concomitant injury to the adjacent
      extensor carpi ulnaris sheath, the ulnocarpal ligaments, or the peritriquetral
      ligaments compounded the instability. Thus, rather than an isolated event,
      peripheral disruption of the disk often proved the major constituent of
      multicomponent lesions--lesions consistently suitable for repair. In this series
      of destabilizing TFCC disruption requiring operative treatment, awareness that
      some injuries selectively affect the articular disk, whereas others compromise
      wider zones of wrist anatomy, was essential to successful surgery.

PMID- 1735236
TI  - The distal joint of the radius and ulna. Diagnostic studies and treatment
      rationale.
AB  - Three areas of functional anatomy are present in the distal ulna. Each of these
      has a specific function in load bearing of the wrist, rotation of the forearm,
      and maintenance of the relationship between the radius and ulna. The distal
      portion of the ulna serves as a suspensory post for ligaments that stabilize the
      ulnar border of the wrist. The midportion of the distal ulna contains the load
      bearing triangular fibrocartilage complex. The proximal portion of the distal
      ulna articulates with the radius at the sigmoid notch and participates in forearm
      rotation. Each of these areas is assessed in problems related to ligament
      instability, load bearing, and range of motion. Mechanical problems that affect
      the distal joint of the radius and ulna include the affects of trauma,
      degenerative change, and inflammatory disease. Each of these requires evaluation
      in the treatment of joint derangement. Diagnostic studies that relate to problems
      in the distal radioulnar joint area include standard roentgenographs,
      arthrograms, magnetic resonance (MR) scanning, and arthroscopy. Each of these
      studies has particular advantages and disadvantages in providing data for
      analysis of joint malfunction. A medical history, physical examination, and use
      of proper diagnostic studies will assist in an appropriate diagnosis of problems
      in the distal joint of the radius and ulna.

PMID- 1735237
TI  - Radial head fractures and their effect on the distal radioulnar joint. A
      rationale for treatment.
AB  - Nineteen patients were treated with open reduction and internal fixation for
      radial head fractures. Open reduction and internal fixation was performed to
      avoid radial head excision and the possible development of distal radioulnar
      joint dysfunction. Follow-up observation, which averaged 11.7 months, revealed
      that no patient developed wrist pain. Range of motion of the elbow and forearm
      was found to be complete in 14 patients and minimally restricted in four.
      Fourteen patients were pain free with full activity, and four had mild to
      moderate pain after heavy labor. One patient subsequently required radial head
      excision. Based on these findings and the authors continued disappointment with
      treatment of distal radioulnar joint dysfunction caused by proximal radial
      migration after radial head excision, the authors recommend early open reduction
      and internal fixation of all displaced or angulated radial head fractures.

PMID- 1735238
TI  - A Darrach procedure for distal ulnar pathology derangements.
AB  - Despite technologic advancements including arthrography, arthroscopy, and
      magnetic resonance imaging, pain in the distal radioulnar and ulnar carpal joints
      continues to baffle clinicians. Before the wide use of these diagnostic tests,
      the authors based their diagnosis of distal ulnar carpal joint derangement on the
      physical examination, history, and plain film roentgenographs. For eight patients
      who did not respond to conservative measures, a limited Darrach procedure was
      performed with highly satisfactory results. The specific technical aspects of
      this procedure are described. The postoperative results of the patients are
      presented with one to eight years of follow-up evaluation.

PMID- 1735240
TI  - Abstracts of papers presented at the Ninety-Third Annual Meeting of the American
      Society for Clinical Pharmacology and Therapeutics. Orlando, Florida, March 18
      20, 1992.

PMID- 1735239
TI  - Complex dislocations of the distal radioulnar joint. Recognition and management.
AB  - Contrary to most reported series, it has been the authors' experience that
      dislocations of the distal radioulnar joint (DRUJ) associated with fractures of
      the forearm are frequently irreducible. This report reviews the authors'
      experience with these injuries, focusing on the recognition and management of
      what the authors call "complex" DRUJ dislocations: dislocations characterized by
      obvious irreducibility, recurrent subluxation, or "mushy" reduction caused by
      soft tissue or bone interposition. From 1984 until 1989, at the authors'
      institution, 11 patients were treated for fractures of the radius associated with
      dislocations of the DRUJ. Eight of these patients had a classic Galeazzi fracture
      dislocation. Two patients had severe open radius and ulnar fractures. One had an
      unstable comminuted intraarticular fracture of the distal radius. Of these 11
      patients, four had "complex" dislocations of the DRUJ. In two cases, the extensor
      carpi ulnaris was displaced volar to the distal ulna, necessitating open
      reduction. A third case involved delayed recognition of multiple wrist and
      forearm joint dislocations associated with a severe open fracture of both bones
      of the forearm and required late exploration, reduction, and temporary internal
      fixation. A fourth case involved recurrent dorsal subluxation of the distal ulna
      after open reduction and internal fixation of a comminuted intraarticular distal
      radius fracture. It is clear that complex dislocations of the DRUJ occur more
      frequently than previously noted. Careful attention to these injuries during
      initial reduction attempts will reveal "mushy" or unobtainable reductions, an
      important indication for exploration for entrapped tendon, bone, or soft tissue.

PMID- 1735241
TI  - Cardiac tumors: diagnosis and management.
AB  - The first step towards the diagnosis of cardiac neoplasia is made when the
      clinician considers the diagnosis. While the classically described signs and
      symptoms of left-atrial myxomas are noteworthy, the vast majority of patients
      present with symptomatology that is less specific--either of a constitutional
      nature, or related to right- or left-sided congestion. Likewise, the physical
      examination may rarely disclose classic auscultatory signs, but is more likely to
      confirm the presence of the right- or left-sided congestion inferred from
      history. Peripheral, embolic, or vasculitis lesions should raise suspicion of the
      diagnosis. Nevertheless, the majority of patients will be diagnosed by the
      unexpected detection of a tumor at the time of echocardiography. Transthoracic
      echocardiography remains the procedure of choice in screening for cardiac
      neoplasia. It has excellent sensitivity for intracavitary and endocardial
      lesions. Myocardial lesions are also well imaged. Pericardial lesions, with or
      without extension into contiguous structures, are poorly visualized and, here,
      magnetic resonance imaging is unquestionably the superior investigative approach.
      Further, a limited degree of tissue characterization is possible with the latter
      technology. Transesophageal echocardiography is ideally suited for the
      examination of suspected tumors involving the atria, interatrial septum, superior
      vena cava, atrioventricular valves and, to a lesser extent, the ventricles. These
      three imaging modalities clearly complement one another and the choice of
      application will depend upon factors including the patient's transthoracic
      echogenicity, the availability of magnetic resonance imaging or transesophageal
      echocardiography, cost, and the physical status of the patient.

PMID- 1735242
TI  - Investigative bronchoscopy in subjects with asthma and other obstructive
      pulmonary diseases. Whether and when.

PMID- 1735243
TI  - Preoperative physiology and lung resection. Scan? Exercise? Both?

PMID- 1735244
TI  - Is a VO2 plateau necessary?

PMID- 1735245
TI  - Still going around on the flow-volume loop.

PMID- 1735246
TI  - Aortic dissection. The diagnostic dilemma resolved.

PMID- 1735247
TI  - Disposable jet nebulizers. How reliable are they?
AB  - We studied the frequency of malfunction, variability in rate of nebulization, and
      effect of this variability on aerosol particle size of eight disposable jet
      nebulizer models produced by six manufacturers. Four of eight models showed
      visual signs of malfunction, including spraying of large, individually visible
      droplets, leaking of nebulizer solution, and air leaks that completely prevented
      nebulization. Variability of nebulization rate within specific models ranged from
      57 to 129 percent. The model with the largest variability of nebulization rate
      was also associated with an unacceptably large variability in particle size. In
      contrast, two models with smaller variability in nebulization rate had greater
      consistency of particle size. These results indicate poor quality control by some
      manufacturers in the disposable nebulizer industry. The data suggest that
      purchasing agents should consider reliability as well as cost before selecting a
      specific nebulizer model and that their evaluation should include physical
      testing of multiple units of each model under consideration.

PMID- 1735248
TI  - Adult respiratory distress syndrome. Sequence and importance of development of
      multiple organ failure. The Prostaglandin E1 Study Group.
AB  - STUDY OBJECTIVE: To determine the epidemiology of multiple organ failure (MOF) in
      patients with the adult respiratory distress syndrome. PATIENTS: We followed up
      50 patients with serial determinations of respiratory and nonrespiratory organ
      function for seven days after diagnosis. DESIGN: Data were stratified between
      patients who died and those who survived (defined as hospital discharge).
      MEASUREMENTS AND RESULTS: Values that did not differ at any time between the two
      groups of patients included oxygen availability, oxygen consumption, oxygen
      extraction, PaCO2, respiratory rate, heart rate, systolic blood pressure, cardiac
      output, stroke index, systemic vascular resistance, and temperature. Patients who
      died had greater defects in oxygenation (from day 1 through day 7). They also
      exhibited decreased arterial oxygen content (from day 1 to day 4), decreased
      mixed venous oxygen content (day 1), increased peak inspiratory pressure (present
      on day 2, persisted to day 5, reappeared on day 7), decreased diastolic blood
      pressure (seen on days 1 through 3, reappeared on day 7), and increased mean
      pulmonary artery pressure (seen on days 2 and 3). Nonsurvivors also exhibited
      greater degrees of thrombocytopenia (from day 1 to day 4). Decreases in pH (seen
      on day 1, reappeared from days 4 to 7), abnormalities in liver function (seen
      only on day 1), and increases in serum creatinine levels (appeared on day 7) were
      also observed. CONCLUSIONS: Multiorgan dysfunction (MOD) was frequently observed
      in both groups of patients. Alterations in organ function and the pattern of
      abnormalities were often subtle and would not be characterized as significant
      organ dysfunction by most available organ scoring systems. Adult respiratory
      distress syndrome is a manifestation of systemic disease produced by widespread
      increases in endothelial permeability; lung dysfunction dominates the early
      clinical course. When respiratory function is supported, it becomes evident that
      alterations occur in other organs. Multiorgan failure is really a misnomer; the
      term emphasizes end-stage changes. Multiorgan dysfunction is common and often
      resolves without progressing to MOF. Alternatively, MOD can progress to MOF.

PMID- 1735249
TI  - Postoperative pleural changes after coronary revascularization. Comparison
      between saphenous vein and internal mammary artery grafting.
AB  - Coronary artery bypass grafting (CABG) is commonly performed with a saphenous
      vein graft (SVG) and/or an internal mammary artery graft (IMA). We hypothesized
      that there would be a higher incidence of pleural changes after CABG in patients
      who underwent IMA grafting because pleurotomy is usually performed. In the
      present study, the pre and the 6th postoperative day chest roentgenograms of 122
      patients who received CABG were reviewed. The incidence of effusion in the
      patients who received only SVG was 43 percent (23/54) and did not differ
      significantly (p greater than 0.05) from the incidence in the patients who also
      had IMA 41 percent (28/68). Almost all of the patients (43/51) had unilateral
      left-sided pleural effusions. Most of the effusions were small and did not
      require treatment. The incidence of effusion was not higher in patients with
      enlargement of their cardiac silhouette or atelectasis and was not related to the
      presence of chest tubes. The incidence of pleural thickening was higher in the
      IMA group (49 percent) than in the SVG group (31 percent) but the difference did
      not achieve statistical significance (p greater than 0.05). We conclude that
      there is a high (approximately 40 percent) incidence of small effusions and
      thickening after CABG. The incidence of pleural effusion and pleural thickening
      do not appear to be influenced by the type of surgery (IMA vs SVG). We speculate
      that the effusions are due to pericardial inflammation.

PMID- 1735250
TI  - Determinants of outcome in lesions of the thoracic aorta in patients with
      multiorgan system trauma.
AB  - Of all patients presenting at our level 1 trauma center with multiorgan system
      injuries, 33 have been identified with acute lesions of the thoracic aorta. Mean
      severity injury score was 24 +/- 3. Four patients underwent resuscitative
      thoracotomy upon arrival in the emergency department. One survived and fully
      recovered. The rest underwent diagnostic procedures and repair of aortic lesions
      in conjunction with surgical treatment of other injured organ systems. The
      overall survival rate was 82 percent. Survivors arrived significantly faster to
      the ED and had lesser degree of multiorgan system injuries. There was no
      difference in the time spent to make the diagnosis of acute aortic disruption for
      survivors and nonsurvivors, nor was a difference in time to arrive in the
      operating room once the diagnosis of aortic injury has been established.
      Morbidity was related to ischemia to distal organs in four patients of whom two
      presented with multiple lesions of the thoracic aorta; two remained paralyzed and
      two had only lower limb spasticity. All discharged survivors were alive at 12
      months' follow-up. The type of surgical repair did not influence the outcome of
      patients with single, typical aortic lesions; however, "clamp/sew" technique was
      not adequate when multiple aortic tears were found intraoperatively. The outcome
      of surgical treatment of the traumatic aortic lesions of patients with polytrauma
      may be influenced by the speed of arrival to the ED, the magnitude of multiorgan
      system involvement, and the application of appropriate surgical technique for
      repair according to the intrathoracic findings and the timing of aortic repair
      vis-a-vis other surgical treatment.

PMID- 1735251
TI  - Respiratory response and ventilatory muscle recruitment during arm elevation in
      normal subjects.
AB  - Despite the fact that the arms are used extensively in daily life and that some
      of the muscles of the shoulder girdle share both a respiratory and a positional
      function for the arms, surprisingly little is known about the respiratory
      response to unsupported upper extremity activity. To determine the respiratory
      consequences of simple arm elevation during tidal breathing, we measured minute
      ventilation (VE), tidal volume (VT), respiratory rate (f), heart rate (HR),
      oxygen uptake (VO2), and carbon dioxide production (VCO2) in 22 normal subjects
      seated with arms elevated in front of them to shoulder level (AE) for 2 min and
      down at the sides (AD) for the same time period. The sequence was randomized.
      Compared with AD, during AE there were significant increases in VO2 (336 +/- 18
      vs 289 +/- 14 ml/min, p less than 0.001), VCO2 (315 +/- 23 vs 245 +/- 16 ml/min,
      p less than 0.001), HR (84 +/- 6 vs 73 +/- 4 beats/min, p less than 0.05), VE
      (11.5 +/- 0.9 vs 9.3 +/- 0.6 L/min, p less than 0.001), and VT (868 +/- 66 vs 721
      +/- 48 ml, p less than 0.001). In 11 subjects, breath-by-breath metabolic and
      ventilatory parameters were studied with AD for 2 min, AE for 2 min, and with AD
      for 3 min while also recording gastric (Pg), pleural (Ppl), and
      transdiaphragmatic pressures (Pdi). With AE, there was a significant increase in
      Pg at end inspiration (PgI, 15.4 +/- 3.2 vs 11.9 +/- 2.7 cm H2O, p less than
      0.01) and in Pdi (26.5 +/- 3.4 vs 21.4 +/- 2.4 cm H2O, p less than 0.01) with no
      change in Pg at end expiration (PgE) or in Ppl. The increases in VO2, VCO2, VE,
      and VT during arm elevation persisted for 2 min after arm lowering, whereas Pgi
      and Pdi abruptly dropped as the arms were lowered. We conclude that simple arm
      elevation during tidal breathing results in significant increases in metabolic
      and ventilatory requirements. These increased demands are associated with higher
      PgI and Pdi suggesting an increased diaphragmatic contribution to the generation
      of ventilatory pressures. The sudden drop in Pg with arm lowering indicate a
      change in ventilatory muscle and or torso recruitment independent of the
      metabolic drive and ventilatory needs. These findings may help explain the
      limitation that has been reported in some normal subjects and in many patients
      with lung disease during unsupported upper extremity activity.

PMID- 1735252
TI  - Sleep-disordered breathing in the healthy elderly. Clinically significant?
AB  - We evaluated sleep/wake, medical, and psychological parameters in a cohort of
      healthy men and women between 50 and 80 years of age. Consistent with previous
      investigations of sleep-disordered breathing (SDB) in older persons, nocturnal
      breathing disturbances were quite common in our normal-aged subjects, with more
      than 15 percent experiencing five or more SDB events per hour of sleep. However,
      when SDB indices were correlated with comprehensive measures of daytime
      functioning, the number of statistically significant relationships was at or
      below expectations from chance alone. Additionally, comparison of high-SDB
      subjects (AHI greater than or equal to 5) with low-SDB subjects (AHI less than 5)
      failed to reveal reliable differences on measures of daytime functioning. We
      conclude that SDB occurring in otherwise healthy older persons is not a cause for
      immediate concern, although longitudinal studies may yet demonstrate significant
      long-term sequelae of SDB in this population.

PMID- 1735253
TI  - Failure of inhaled corticosteroids to modify bronchoconstrictor or bronchodilator
      responsiveness in middle-aged smokers with mild airflow obstruction.
AB  - We have compared the effects of three-month periods of treatment with an inhaled
      corticosteroid, budesonide 600 micrograms twice daily and with placebo on
      bronchial responses to inhaled histamine and to bronchodilators in a double-blind
      crossover trial in 14 middle-aged male smokers (mean age, 59.6 years) with mild
      airways obstruction (mean FEV1 2.42 L, 80 percent predicted [range, 48 to 110
      percent]). Responsiveness to inhaled histamine was assessed monthly by the
      provocative concentration (mg/ml) reducing FEV1 by 20 percent (PC20).
      Bronchodilator response to a combination of inhaled salbutamol (5 mg) and
      ipratropium (0.5 mg) was assessed before and after three months' treatment.
      Compliance with treatment was checked by weighing aerosol canisters, and by
      measuring plasma budesonide and metabolites. There was no significant change in
      FEV1 (budesonide mean 2.38 L [SEM 0.17] vs placebo 2.40 L [0.17]), vital capacity
      (budesonide mean 3.69 L [0.17] vs placebo 3.81 L [0.17]) or in bronchodilator
      responsiveness (mean increase over baseline FEV1, budesonide 11.6 [2.7] percent
      vs placebo 10.5 [3.2] percent). There was a small overall reduction in
      bronchoconstrictor responsiveness over the period of the trial, but there was no
      effect of 12 weeks of budesonide treatment compared with 12 weeks of placebo
      treatment (mean log PC20 during budesonide 0.595 [SEM 0.063], placebo 0.591 [SEM
      0.055]). Following the three-month crossover trial, six men continued for nine
      more months to receive budesonide in a single-blind trial and the results were
      compared with those in six men who took no active treatment for the subsequent
      nine months. No improvements in baseline spirometry, home peak flow measurements,
      bronchoconstrictor or bronchodilator responsiveness were observed after 12 months
      of budesonide treatment. Thus, a regimen of budesonide treatment that
      consistently attenuates bronchial responsiveness in asthmatic subjects had no
      effect in these men; larger and longer trials will be required to establish
      whether a subgroup of smokers shows a favorable response.

PMID- 1735254
TI  - Exercise testing in the evaluation of patients at high risk for complications
      from lung resection.
AB  - Exercise testing was performed on 37 patients with resectable lung lesions who
      were deemed inoperable because of any of the following risk factors: (1) FEV1
      less than or equal to 40 percent of predicted; (2) radionuclide calculated
      postlobectomy FEV1 less than or equal to 33 percent of predicted; or (3) arterial
      PCO2 greater than or equal to 45 mm Hg. The patients who reached a peak level of
      oxygen consumption during exercise (VO2Peak) of greater than or equal to 15
      ml/kg/min were offered surgical treatment. Patients with a VO2Peak of less than
      15 ml/kg/min were referred for nonsurgical management and excluded from the
      study. Eight patients underwent lung resection. Their pulmonary function revealed
      a severe obstructive lung defect with a group mean predicted FEV1 of 40 +/- 6
      percent, an FEV1/FVC ratio of 47 +/- 10, a radionuclide calculated postlobectomy
      FEV1 of 31 +/- 4 percent, and a mean arterial PCO2 of 44 +/- 6 mm Hg. No
      relationship was found between each patient's exercise performance and
      spirometric function. Six of the patients had an uncomplicated postoperative
      course. Two patients had complications but no patient died as a result of surgery
      or postoperative complications. All patients were discharged from the hospital
      within 22 days (mean = 9.8 days). We conclude that exercise testing is a useful
      complement to conventional cardiopulmonary evaluation used in selecting patients
      for lung resection.

PMID- 1735256
TI  - Acute silicosis responding to corticosteroid therapy.
AB  - The course of acute silicosis usually is relentlessly progressive. Death results
      from cor pulmonale and respiratory failure, with mycobacterial infection a
      frequent serious complication. Attempts to treat the illness generally have been
      unavailing. We report an unusual case of acute silicosis in which improvement in
      clinical status, chest x-ray film findings and pulmonary function occurred
      following therapy with corticosteroids. To our knowledge, this is the first such
      case reported in the medical literature.

PMID- 1735255
TI  - Blood transfusion and lung function in children with thalassemia major.
AB  - Pulmonary function tests were performed at rest and following blood transfusion
      on 17 patients with thalassemia major. At rest, diffusion capacity was
      significantly reduced (mean of 57 percent), and forced vital capacity was mildly
      reduced (mean of 85 percent). In two of the patients, arterial oxygen tension was
      low. Other pulmonary function results were in the normal range. Following blood
      transfusion, a significant drop was seen in arterial oxygen tension (PaO2 of 22
      mm Hg) and in forced vital capacity (FVC) of 32 percent. These changes were
      dramatic and require further explanation.

PMID- 1735257
TI  - Thoracic magnetic resonance imaging in the evaluation of HIV-1/AIDS pneumonitis.
AB  - Magnetic resonance imaging of the thorax was performed on ten occasions in eight
      HIV-positive patients with a clinical picture suggestive of Pneumocystis carinii
      pneumonia. The diagnosis of PCP was subsequently confirmed on six occasions.
      Patients without PCP had low MRI profusion scores, while four of six patients
      with PCP had MRI profusion scores greater than 6/21. Neither the chest
      roentgenogram appearance nor computer-generated T1 and T2 relaxation times could
      reliably distinguish between these two groups. Magnetic resonance imaging may be
      useful in the early and noninvasive diagnosis of PCP in HIV-positive patients.

PMID- 1735258
TI  - Pneumocystis carinii pneumonia in patients with connective tissue disease.
AB  - Four patients with PCP complicating a CTD are described. Rising serum lactate
      dehydrogenase levels were documented during an asymptomatic period associated
      with corticosteroid dosage tapering, weeks prior to the development of acute
      pulmonary symptoms. The diagnosis of PCP was established by FOB in each patient.

PMID- 1735259
TI  - Evening-to-morning blood pressure variations in snoring patients with and without
      obstructive sleep apnea.
AB  - This study was designed to test a hypothesis that patients with sleep apnea have
      higher blood pressure in the morning, following a night spent in apnea and
      hypoxemia, than in the evening. To accomplish this, we prospectively studied a
      set of 611 patients referred to our clinic because of suspicion of sleep apnea.
      All patients had full nocturnal polysomnography, including measurement of
      snoring. Blood pressure was measured in the evening, prior to onset of sleep, and
      in the morning, immediately on awakening. We found that patients without apnea
      and hypoxemia had lower blood pressure in the morning compared with the evening
      value, while patients with severe sleep apnea and hypoxemia had higher blood
      pressure in the morning; these evening-to-morning blood pressure differences,
      although statistically significant, were small, typically 1 to 4 mm Hg. Morning
      blood pressures were higher in patients with sleep apnea and hypoxemia than in
      nonapneic normoxic patients. However, this difference disappeared after the
      groups were matched for age and body mass index. We conclude that (1) patients
      with sleep apnea and nocturnal hypoxemia lose the expected morning dip in
      arterial blood pressure, and (2) age and body mass index are more important
      correlates of blood pressure than apnea and nocturnal oxygen desaturation. We
      speculate that the loss of evening-to-morning drop in blood pressure, if present
      over a long period of time, may lead to sustained elevations in arterial blood
      pressure frequently observed in patients with sleep apnea.

PMID- 1735260
TI  - Physiologic evaluation of pressure support ventilation by nasal mask in patients
      with stable COPD.
AB  - We evaluated the physiologic effects of pressure support ventilation by nasal
      route (NPSV) in eight patients with severe stable COPD and chronic hypercapnia
      who were randomly submitted to 2-h sessions of NPSV both with a portable
      ventilator (Respironics BIPAP device) and with a standard ventilator (Bird 6400ST
      device) at an inspiratory airway pressure of 22 cm H2O. Two sessions with each
      ventilator were performed using an FIO2 of 0.21 in each patient on two
      consecutive days. One patient did not tolerate either form of ventilation.
      Comparison of spontaneous with BIPAP ventilation showed a significant improvement
      in pH, PaCO2, and PaO2. Ventilatory pattern assessed by a respiratory inductive
      plethysmograph showed a significant increase in minute ventilation (VE), VT, and
      Ttot. Integrated surface diaphragmatic EMG activity measured only during BIPAP
      device ventilation decreased from that measured during spontaneous breathing.
      Similar changes in blood gases and ventilatory pattern were observed during
      ventilation by the Bird 6400ST except for VT/Ti ratio, which significantly
      increased. Comparison of baseline with measurements performed 12 h after the
      whole cycle of treatment showed a significant increase in pH and VE and a
      decrease in PaCO2. We conclude that short-term NPSV may be useful in improving
      respiratory pattern and blood gases in stable COPD patients with chronic
      hypercapnia.

PMID- 1735261
TI  - The effects of exercise on serum potassium levels.
AB  - In view of the significant influence of potassium on the heart, a decision was
      made to study the effect of exercise on this important ion in two exercise groups
      of different intensity. The first group consisted of 44 individuals with known
      coronary artery disease participating in a supervised cardiac rehabilitation
      program while the other consisted of 30 healthy joggers. Postexercise mean
      potassium levels were higher in both groups than resting baseline values. In
      addition, 5 of 44 participants in the coronary artery disease group experienced
      major potassium increases of 0.9 mmol/L or more while 7 of 30 healthy joggers
      experienced this magnitude of increase. Remaining unanswered is the question of
      whether such abrupt rises in potassium levels in this subset of patients alter
      their vulnerability to cardiac rhythm and conduction disturbances. A question is
      also raised as to whether rapid return of potassium levels to baseline
      postexercise contributes to any risks.

PMID- 1735262
TI  - Ventilation-perfusion inequalities during graft rejection in patients undergoing
      single lung transplantation for primary pulmonary hypertension.
AB  - We report herein data on single lung transplant (SLT) recipients with primary
      pulmonary hypertension (PPH). One patient did well following surgery but died on
      the 30th postoperative day due to cytomegalovirus pneumonia. The remaining two
      patients initially did well with unlimited exercise tolerance following
      transplantation, but then developed marked dyspnea on exertion and hypoxemia on
      postoperative days 144 and 120, respectively. Pulmonary function testing showed
      marked deterioration of function and transbronchial lung biopsy specimens
      revealed acute graft rejection in one patient and evidence of chronic graft
      rejection in the second patient. Quantitative ventilation-perfusion lung scanning
      demonstrated a marked decrease in ventilation to the transplanted lung in both
      cases associated with only a mild decrease in perfusion. This V/Q mismatch
      resulted in markedly decreased arterial oxygen saturations, widened alveolar
      arterial oxygen gradients, and clinically debilitating dyspnea. We conclude that
      rejection may result in significant V/Q mismatch and hypoxemia in PPH patients
      undergoing SLT, which may limit the use of this specific type of surgery for PPH.

PMID- 1735263
TI  - Impact of transesophageal echocardiography on the treatment of patients with
      aortic dissection.
AB  - To determine the impact of transesophageal echocardiography (TE) on the treatment
      of patients with aortic dissection, the clinical course and outcome of 18
      patients with TE diagnosis of dissection were analyzed. Ascending aortic
      dissection was present in nine patients, of whom six had surgery with
      confirmation of TE findings. Angiography was performed in only two of these
      patients and was falsely negative in one patient. Angiography was not performed
      in the three patients who were not surgical candidates. In the nine patients who
      had descending aortic dissection, angiography was performed in seven patients, of
      whom two underwent surgery. Information provided by angiography did not change
      the treatment of these patients. Thus, TE provides a prompt and accurate
      diagnosis in aortic dissection obviating the need for angiography in most
      patients.

PMID- 1735264
TI  - The effects of verapamil on training in patients with ischemic heart disease.
AB  - Verapamil is a calcium-channel blocking agent with antianginal and antiarrhythmic
      properties that have been widely studied. Its myocardial depressant effect is
      well known. The purpose of this study was to examine the effects of verapamil on
      the training response in patients with ischemic heart disease. The study group
      consisted of 41 male patients with a mean age of 53.3 +/- 7.2 years who had
      suffered a myocardial infarction or had undergone coronary artery bypass surgery
      8 to 12 weeks previously. They were chosen on a consecutive basis from eligible
      patients entering a cardiac rehabilitation program. With use of a double-blind
      technique, 21 patients were assigned to receive verapamil, 120 mg three times
      daily, while the other 20 were given an identical placebo. Each patient underwent
      exercise stress testing in the untreated state to permit comparison between tests
      performed on commencement and completion of training. The training effect was
      determined by comparing exercise response before and after the eight-week
      program. There was an increase in exercise duration (p less than 0.001) and a
      decrease in functional aerobic impairment (p less than 0.001), without difference
      between the two groups. Energy expenditure increased in both groups, but the
      highest level was achieved by those receiving active treatment (p less than
      0.02). Heart rate for equal workload was significantly reduced after training (p
      less than 0.001), although this was lower in the placebo patients (p less than
      0.001) and the patients who had a recent myocardial infarction (p less than
      0.01). It appears that treatment with verapamil does not impair the development
      of a training effect in patients with ischemic heart disease who are undergoing
      organized training.

PMID- 1735265
TI  - ST segment depression in right-sided electrocardiographic leads in patients with
      acute myocardial infarction.
AB  - The presence of ST segment depression in right-sided electrocardiographic leads
      has been infrequently reported in the literature. We report the cases of two
      patients with anterolateral and posterior myocardial infarctions with ST segment
      depression in right-sided electrocardiographic leads. We hypothesize that this
      electrocardiographic change is a reciprocal expression of ST segment elevation of
      the opposing left ventricular wall.

PMID- 1735266
TI  - Evaluation and treatment of acute myocardial infarction complicating systemic
      lupus erythematosus.
AB  - Coronary artery disease has emerged as an important cause of death in young
      patients with SLE. We report three cases of acute myocardial infarction in young
      lupus patients who underwent emergent coronary angiography. One patient had a
      large coronary aneurysm and died five months later from myocarditis. The other
      two patients underwent coronary angioplasty. The difficulty in distinguishing
      coronary arteritis from premature atherosclerosis and its relevance to methods of
      treatment is discussed.

PMID- 1735267
TI  - Frequency and correlates of the saw-tooth pattern of flow-volume curves in an
      epidemiological survey.
AB  - The object of this report was to assess the possibility of identifying saw-tooth
      patterns on flow-volume curves in men aged 28 to 58 years. We studied the
      frequency of these patterns and their relationships with two indirect signs of
      UAO increase in FEV1/PEF and FEF50%/FIF50% ratios--as well as with clinical and
      functional data. Twenty-six of the 360 subjects surveyed, ie, 7.2 percent, had
      flow oscillations in the inspiratory and/or expiratory part of flow-volume
      curves, corresponding to the definition of the saw-tooth pattern. We observed
      significant relationships between the saw-tooth pattern and the mean FEV1/PEF
      ratio. In 97 subjects, the proportion of those with saw-tooth patterns was 13.4
      percent, and the mean FEF50%/FIF50% ratio was 1.53 in those with the pattern vs
      1.07 in those without it. These results show that the saw-tooth pattern was not
      rare in these men.

PMID- 1735268
TI  - Postthoracotomy respiratory muscle mechanics during incentive spirometry using
      respiratory inductance plethysmography.
AB  - We undertook this study to characterize the postthoracotomy compartmental
      displacement and respiratory mechanical changes occurring during and after the
      performance of the incentive spirometry maneuver. We also evaluated the effect of
      recumbency angle on compartmental recruitment. Sixteen patients were randomized
      to perform incentive spirometry either at 30 degrees or 60 degrees recumbency
      angle. They were studied using respiratory inductance plethysmography to measure
      tidal volume, respiratory frequency, inspiratory time, rib cage motion/tidal
      volume ratio, inspiratory duty cycle, and inspiratory flow. Patients were studied
      before surgery and on postoperative days 1 and 3. Statistical analysis was
      accomplished using multiple measures ANOVA with post-hoc Student's t-tests when
      appropriate. Preoperative incentive spirometry augmented VT by increasing both
      VT/TI and TI. Postoperatively, the incentive recruitment of VT was reduced, a
      result of a decrease in TI and TI/TTOT; VT/TI was unchanged. There was
      postoperative decrease of AB and AB/VT during incentive spirometry, greatest in
      the 60 degrees group. Our results characterize the nature of the respiratory
      recruitment afforded by incentive spirometry, before and after thoracotomy. We
      also found evidence of postthoracotomy diaphragmatic derecruitment during
      incentive spirometry exacerbated by a high recumbency angle.

PMID- 1735269
TI  - The relationship between airway responsiveness measured before and after the
      allergen-induced late asthmatic response.
AB  - Single blind allergen (Ag) and saline solution bronchial challenges were
      performed on two successive study days in ten asthmatic subjects. Histamine
      challenges were performed before, at approximately 2 h (or after resolution of
      the immediate bronchial response [IR]), and 24 h after saline solution or Ag
      inhalation. Specific airway conductance (SGaw) was measured after delivery of
      challenge agents until a 50 percent fall in SGaw was observed. The SGaw was
      monitored over 8 h for immediate and late asthmatic responses (LAR). Results were
      expressed as provocative concentrations eliciting a 50 percent decrease in SGaw
      (SGawPC50HIS). No significant changes from baseline SGaw or SGawPC50HIS were
      demonstrated after saline solution. Eight subjects (dual reactors) exhibited both
      an IR and LAR after Ag and two had isolated IRs. Of the eight dual reactors, five
      had greater than 50 percent decreases in SGawPC50HIS immediately after resolution
      of the IR and six exhibited such decrements 24 h after Ag provocation. Mean
      baseline SGawPC50HIS (N = 10) on the Ag challenge day was 3.2 +/- 4.59 mg/ml and
      decreased to 0.92 +/- 4.56 mg/ml at 102 to 187 minutes after Ag (p = 0.0009) and
      was significantly decreased from baseline at 1.47 +/- 3.8 mg/ml 24 h after Ag (p
      = 0.0004). One of the two patients with isolated IR also showed an early onset
      increase in airway responsiveness (EOR). There was a significant correlation
      between the percentage of fall from baseline in SGawPC50HIS immediately after the
      IR and that at 24 h after Ag (r = 0.811, p = 0.005). There was no significant
      correlation between the decrease in SGawPC50HIS after the IR and the magnitude of
      the LAR. These data suggest that (1) the early events occurring prior to the LAR
      may determine changes in airway responsiveness observed at 24 h after Ag
      challenge, and (2) the EAR to histamine is not exclusively associated with the
      LAR.

PMID- 1735270
TI  - A prospective study of community-acquired pneumonia in Hong Kong.
AB  - A prospective study of community-acquired pneumonia in Hong Kong was carried out
      between January and December, 1988. Ninety adults (57 male) with a mean age of
      57.3 years were admitted to the Prince of Wales Hospital with community-acquired
      pneumonia. The etiologic diagnosis of pneumonia was made in 37 cases (41
      percent). Pneumococcal infection was diagnosed in 11 patients (12 percent). The
      same number of patients had pulmonary tuberculosis presenting as acute pneumonia.
      It could not be differentiated from other causes of pneumonia on clinical and
      radiologic grounds, although pleural effusion and upper lobe involvement were
      more common in patients with tuberculosis. Chlamydia species were identified in
      five patients (6 percent) and Mycoplasma pneumoniae was identified in three
      patients (3 percent). There was no case of Legionnaires' disease. The etiologic
      agent could not be identified in 59 percent of cases. The low incidence of
      etiologic diagnosis of community-acquired pneumonia was probably related to the
      widespread use of antibiotics in private practice. Tuberculosis is an important
      cause of community-acquired pneumonia in Hong Kong and this diagnosis should be
      considered in patients who fail to respond to first-line antibiotics.

PMID- 1735271
TI  - Four-stage tuberculin testing in elderly subjects induces age-dependent
      progressive boosting.
AB  - We administered four sequential tuberculin skin tests (5 TU, PPD) with intervals
      of one week to 223 subjects older than 65 years of age to evaluate whether
      elderly subjects demonstrated progressive boosting. Indurations of at least 10 mm
      with increases of at least 6 mm (over the previous test) were considered
      significant reactions, and these were found in 29 percent of the subjects after
      test 1, in 43 percent after test 2, in 53 percent after test 3, and in 57 percent
      after test 4 (p less than 0.05), ie, only about 50 percent of all the positives
      were detected after the first test. The percentage of positive reactors was
      inversely related to age (p less than 0.001), yet this age-dependent difference
      decreased with increasing number of tests. For the 65- to 74-year-old age group,
      44 percent reacted positively after the first test and after three tests almost a
      plateau of 65 to 70 percent positive reactors was reached, suggesting that a
      minority only of about 30 to 35 percent of these geriatric patients might have
      outlived their bacilli or were never infected. For the 75- to 84-year-old age
      group, 24 percent reacted after the first test and 55 percent reacted after the
      fourth one. For the older than 85-year-old age group, 19 percent positive
      reactors were found after the first test and 46 percent were found after the
      fourth test, without clear-cut leveling off toward a plateau value, suggesting
      that additional tests would induce further boosting. Mean diameters of positive
      reactions were 15 to 24 mm, and were mostly at least 12 mm larger than in the
      previous tests. These data support the hypothesis that the negative tuberculin
      reaction, which is often found in elderly subjects, is mainly due to the failing
      immune response to tuberculin antigen that can be restored progressively by
      repeated administrations. These findings, furthermore, emphasize that especially
      in elderly, care should be taken not to interpret a boosting reaction as a
      conversion and especially that neither a two-step testing as recommended by the
      ATS and CDC (Am Rev Respir Dis 1990; 142:723-35) nor even a four-step testing may
      suffice to detect all positives in this type of population.

PMID- 1735272
TI  - The radiologic diagnosis of autopsy-proven ventilator-associated pneumonia.
AB  - An abnormal chest roentgenogram is essential for the diagnosis of ventilator
      associated pneumonia. The diagnostic accuracy of various roentgenographic signs
      of pneumonia has not been assessed previously in the portable anteroposterior
      roentgenograms obtained in ventilated patients. Seven roentgenographic signs (air
      bronchograms, alveolar infiltrates, silhouette sign, cavities, fissure abutment,
      atelectasis, and asymmetric infiltrates superimposed on diffuse bilateral
      infiltrates) were evaluated for their accuracy in predicting pneumonia alone, in
      combination with other signs, or in combination with clinical parameters. The
      last roentgenogram prior to autopsy of 69 ventilated patients was interpreted by
      three reviewers and the above signs were correlated with autopsy evidence of
      pneumonia. Pneumonia was present in 24 (35 percent) of the 69 autopsies. No
      roentgenographic sign had a diagnostic efficiency of greater than 68 percent. By
      stepwise logistic regression, the presence of air bronchograms was the only
      roentgenographic sign that correlated with pneumonia in the total group,
      correctly predicting 64 percent of pneumonias. In patients without adult
      respiratory distress syndrome (ARDS), the presence of air bronchograms or
      alveolar infiltrates correlated with pneumonia, while in patients with ARDS, no
      roentgenographic sign and only the clinical parameter of purulent sputum
      correlated with pneumonia. Only a minority (7/22) of worsening alveolar
      infiltrates in all groups were due to pneumonia and were often confused with
      ARDS. Alveolar hemorrhage occurred with a surprising frequency (38 percent of
      autopsies), including 13/45 (29 percent) patients without pneumonia. Alveolar
      hemorrhage was associated with 29 percent of multiple air bronchograms and 30
      percent of bilateral alveolar infiltrates in patients without pneumonia. We
      conclude that in intubated patients with diffuse bilateral roentgenographic
      infiltrates, no roentgenographic sign correlates well with pneumonia. No clinical
      parameter added to the accuracy of either an alveolar infiltrate or an air
      bronchogram in patients without diffuse infiltrates. Pulmonary hemorrhage and/or
      infarction are frequent autopsy findings in intubated patients and may be
      confused radiologically with pneumonia.

PMID- 1735273
TI  - Percutaneous dilatational tracheostomy. Results and long-term follow-up.
AB  - Ciaglia et al first reported percutaneous dilatational subcricoid tracheostomy in
      1985. We are now reporting the results on 165 patients with follow-up on 52
      patients who went on to decannulation. Our technique has been slightly modified
      and these points are emphasized. To date, there have been no significant
      perioperative or postoperative complications and no long-term complications on 52
      patients who were followed clinically, postdecannulation, for from four months to
      five years. The procedure is recommended as simple, safe, and cost-effective. We
      feel it is the technique of choice for routine elective tracheostomy.

PMID- 1735274
TI  - Bronchoalveolar lavage in alcoholic liver cirrhosis. T-lymphocyte subsets and
      immunoglobulin concentrations.
AB  - The purpose of this study was to determine the phenotype profiles of immune
      effector cells and the concentrations of immunoglobulins in the lower respiratory
      tract of non-smoking patients with alcoholic liver cirrhosis (ALC). Nine
      nonsmoking patients with liver biopsy-proved ALC (grade B or C cirrhosis in
      Child's classification), free of clinical pulmonary symptoms, and with normal
      chest roentgenogram were included in the study. The control group included 12
      healthy nonsmokers. Each patient had fiberoptic bronchoscopy with bronchoalveolar
      lavage (BAL). The number of T cells and of lymphocyte subpopulations was
      determined by immunofluorescence studies using monoclonal antibodies that were
      specific for CD3, CD4, and CD8 markers. Patients with ALC exhibited a
      dramatically increased percentage of CD8+ cells in BAL that induced a low CD4/CD8
      ratio (0.96 +/- 0.15 vs 1.8 +/- 0.12 in healthy controls). Further
      characterization of lymphocyte subsets' dual immunofluorescence analysis
      demonstrated that most of the CD8+ alveolar lymphocytes had a phenotype of
      cytotoxic cells (CD8+ CD11b-; 48 percent +/- 13 in ALC vs 10 percent +/- 5 in
      controls). ALC was associated with an appreciable alveolar-capillary "leak" as
      demonstrated by a significant increase in BAL fluid albumin. In addition, the
      concentrations of immunoglobulins in BAL fluid were significantly greater in ALC
      than in controls. However, the relative (to albumin) coefficient of excretion of
      IgG, A, and M in and alpha 2-macroglobulin BAL fluid was not significantly
      different between controls and ALC. Our results indicate that increased
      proportions of CB8+ and especially of CD8+ CD11b- cells are a common feature in
      the lower respiratory tract of nonsmoking patients with ALC. These changes may be
      of potential functional importance in the regulation of the local pulmonary
      immune response in ALC.

PMID- 1735275
TI  - Pulmonary hypertension and human immunodeficiency virus infection. Two reports
      and a review of the literature.
AB  - Pulmonary hypertension may be primary (idiopathic) or secondary. While the
      etiologies for secondary pulmonary hypertension are diverse, infection with the
      human immunodeficiency virus (HIV) has not been included. To date there have been
      16 reported cases of pulmonary hypertension in the HIV-infected population.
      Plexogenic arteriopathy was the most common pathologic finding. We report two HIV
      infected patients who were concomitantly found to have pulmonary hypertension
      with plexogenic arteriopathy. One patient had lymphocytic interstitial
      pneumonitis, an entity not previously associated with pulmonary hypertension. We
      review the 16 previous cases of pulmonary hypertension and HIV infection and
      discuss this association.

PMID- 1735276
TI  - Respiratory function in multiple sclerosis. Utility of clinical assessment of
      respiratory muscle function.
AB  - PURPOSE: The aim of this study was to assess the utility of clinical assessment
      of respiratory muscle weakness in MS. PATIENTS AND METHODS: We studied 40 MS
      patients who performed pulmonary function tests using standard procedures and
      measures of respiratory muscle strength. Descriptive clinical indices included a
      history of detailed neurologic findings, including upper and lower extremity
      weakness, cerebellar signs, and evidence of cerebral lesions and other clinical
      signs including dependence in activities of daily living, shortness of breath,
      weak voice, dysarthria and dysphagia. We devised an index comprised of four
      clinical signs: the patient's report of difficulty in clearing pulmonary
      secretions and his report of a weakened cough, the examiner's observation of the
      patient's cough, and ability to count on a single exhalation. RESULTS: Mean
      values of TLC (95 percent +/- 14) VC (91 percent +/- 19), and RV (106 percent +/-
      34) were normal. By contrast, MVV (68 percent +/- 20), PImax (74 percent +/- 27)
      and PEmax (51 percent +/- 22) were decreased. Stepwise multiple regression
      indicated that the best single predictor of expiratory muscle weakness was the
      index score; the combination of index score, upper extremity weakness, and
      maximal voluntary ventilation accounted for 60 percent of the variance in PEmax.
      CONCLUSION: We conclude that clinical assessment is a better predictor of
      respiratory muscle weakness than spirometry and that a systematic clinical
      assessment supplemented by respiratory muscle assessment and MVV can uncover
      subtle respiratory muscle weakness in patients with MS.

PMID- 1735277
TI  - Oxygen uptake plateau during maximal treadmill exercise in children.
AB  - The leveling of oxygen uptake at high work loads has been utilized to define
      maximal VO2 during progressive exercise testing. Exercise studies in children
      have indicated, however, that a VO2 plateau can commonly be demonstrated in less
      than one half of subjects. To examine the potential contributions of subject
      effort, aerobic fitness, and nonaerobic performance to this variability, 15
      children ages 7 to 10 years performed progressive treadmill walking to exhaustion
      with a ramp protocol. The VO2 plateau was defined as a change in VO2 during the
      final minute of exercise less than 2 SD below the mean of increases between the
      previous 4 to 5 submaximal minutes. Five subjects (33.3 percent) demonstrated a
      plateau. No significant differences in mean peak VO2, heart rate, or respiratory
      exchange ratio were observed between plateau and nonplateau groups. Testing
      results of speed (50-yard sprint) and leg power (vertical jump) were also
      similar. These findings suggest that following: (1) subject effort, aerobic
      fitness, and nonaerobic factors do not explain the presence or absence of a VO2
      plateau during exercise testing of children; and (2) a VO2 plateau should not be
      used as a requirement for defining VO2max during treadmill testing in this age
      group.

PMID- 1735278
TI  - Infected radial artery pseudoaneurysms occurring after percutaneous cannulation.
AB  - During a ten-month period in 1988 at our institution, we identified three
      infected radial artery pseudoaneurysms (RAPAs) associated with arterial lines. A
      retrospective chart review to 1983 identified three additional cases, all
      occurring in 1986. In the six-year period of 1983 through 1988, during which
      approximately 12,500 radial artery catheters were placed, the incidence of RAPA
      formation was 6/12,500 (0.048 percent). Five of the six cases were associated
      with Staphylococcus aureus infection. The duration of radial artery cannulation
      was significantly longer in patients who developed a pseudoaneurysm (12.5 days)
      than in those patients who did not suffer this complication (4.3 days). Patients
      in whom infected RAPAs occurred also tended to be older (mean, 71.6 years) than
      the average age (54 years) for all patients admitted to the intensive care unit
      (ICU). They also tended to have long stays in the ICU prior to development of
      RAPA, the shortest stay being 11 days and the average being 51 days. Risk factors
      for the development of this complication may include advanced age, longer
      duration of catheterization and hospitalization, and infection with S aureus.

PMID- 1735279
TI  - A comparison of the effects of bid and qid dosing on compliance with inhaled
      flunisolide.
AB  - Noncompliance with inhaled steroids is a well-recognized problem in asthma
      therapy. We compared compliance with bid and qid regimens of inhaled flunisolide
      in 16 asthmatic subjects. Patients were instructed to take four inhalations bid
      for T1 to establish baseline compliance. During T2, half (group A) continued this
      dosing regimen, while the other half (group B) switched to two inhalations qid.
      Group A compliance did not significantly change from T1 to T2. The percentage of
      days with less than eight inhalations (underuse) for group B, however, increased
      from 20.2 +/- 40.3 in T1 (bid dosing) to 57.1 +/- 49.6 in T2 (qid dosing) (p less
      than 0.001). Concomitantly, the number of daily inhalations decreased from 7.9 +/
      2.5 to 6.8 +/- 3.1 (p less than 0.01). Reduced compliance with qid dosing was
      due in large part to an increase in frequency of six inhalations per day,
      resulting from tid use. Compliance with inhaled flunisolide, therefore, was worse
      with qid than bid dosing.

PMID- 1735280
TI  - Management of bacterial pneumonia in ventilated patients. Protected
      bronchoalveolar lavage as a diagnostic tool.
AB  - We conducted a prospective study to determine the effectiveness of protected
      bronchoalveolar lavage (PBAL) in diagnosing pneumonia in ventilated patients and
      the usefulness of bronchoscopic data in treating ventilated patients. Entrance
      criteria were (1) fever and a new or progressive infiltrate on chest
      roentgenogram with either leukocytosis or a macroscopically purulent tracheal
      aspirate, and (2) no antibiotic therapy for at least 48 h before bronchoscopy.
      Twenty-five ventilated patients met entrance criteria for the study and completed
      the protocol. PBAL was effective in retrieving distal airway secretions with a
      minimal degree of contamination as indicated by a specificity and a negative
      predictive value of 100 percent. Bacterial isolates grew in all patients with
      pneumonia at a concentration greater than or equal to 100,000 cfu/ml, with a
      median growth of 500,000 cfu/ml. The presence of a two-log difference between the
      highest quantitative culture count in patients without pneumonia and the lowest
      quantitative culture count in patients with pneumonia allowed a clearer
      determination of a patient's status, with regard to pneumonia, compared with the
      significant overlap in unprotected BAL. Gram and Giemsa stains of the PBAL were
      positive in all patients with pneumonia and negative in those without pneumonia.
      All but one patient with pneumonia received narrow-spectrum antibiotic therapy.
      All patients without infection had no antibiotic administered. Clinical and
      roentgenographic criteria could not discriminate between patients with and
      without pneumonia, confirming the findings of previous investigations. The
      results of microscopic and culture analyses of the PBAL effluent proved useful in
      directing antibiotic treatment in patients with pneumonia and in avoiding
      unnecessary antibiotic use in those patients without pneumonia.

PMID- 1735281
TI  - Veno-arterial carbon dioxide gradient in human septic shock.
AB  - Recent reports have shown that venous hypercarbia, resulting in a widening of the
      veno-arterial difference in PCO2 (dPCO2), is related to systemic hypoperfusion in
      various forms of low-flow state. Although septic shock usually is a hyperdynamic
      state, other factors can influence the CO2 production and elimination, and thus
      dPCO2 in septic shock This study examined the dPCO2 and acid-base balance
      together with cardiac output measurements and oxygen-derived variables in 64
      adult patients with documented septic shock. For a total of 191 observations, a
      significant exponential relation between dPCO2 and CO was found. At time of first
      measurement, 15 patients had an increased dPCO2 (above 6 mm Hg) and a higher
      mixed venous PCO2 (PvCO2) (47.2 +/- 10.0 vs 35.9 +/- 7.3 mm Hg, p less than
      0.001). These patients had a lower cardiac index (2.9 +/- 1.3 vs 3.8 +/- 2.0
      L/min.m2, p less than 0.01), a higher oxygen extraction ratio, but a similar VO2
      than patients with normal dPCO2. The higher dPCO2 could also be related to an
      impaired CO2 elimination as indicated by a higher PaCO2 and a lower PaO2/FIO2 in
      these patients. Nonsurvivors had a significantly higher dPCO2 than survivors (5.9
      +/- 3.4 vs 4.4 +/- 2.3 mm Hg, p less than 0.05) in the presence of similar
      cardiac output. The higher dPCO2 in these patients was probably related to the
      higher blood lactate levels (7.7 +/- 5.3 mmol/L vs 4.5 +/- 2.8 mmol/L, p less
      than 0.01) and the more severe pulmonary impairment (SaO2 90 +/- 8 percent vs 95
      +/- 4 percent, p less than 0.001). Arteriovenous oxygen content difference
      (dAVO2) and VO2 were similar in survivors and nonsurvivors. In conclusion, dPCO2
      patients with septic shock is related principally to cardiac output but
      apparently also to the degree of pulmonary impairment. Although dPCO2 is larger
      in nonsurvivors, its prognostic value is modest.

PMID- 1735282
TI  - Nocturnal nasal intermittent positive pressure ventilation with bi-level positive
      airway pressure (BiPAP) in respiratory failure.
AB  - The purpose of this study was to assess the efficacy of bi-level positive airway
      pressure (BiPAP) ventilation through a nasal mask in the treatment of eight
      patients with hypoventilatory respiratory failure and nocturnal CO2 retention.
      Nocturnal CO2 retention was significantly reduced in all patients with the
      application of BiPAP during sleep (p less than 0.01). Daytime somnolence was
      relieved and dyspnea improved after three months of home BiPAP therapy. All
      patients tolerated home BiPAP therapy, and two patients who had previously been
      treated with volume ventilation via nasal mask found BiPAP more comfortable.
      There were no changes in FEV1 or FVC after three months of BiPAP. Daytime PaCO2
      improved slightly or remained stable in all patients after three months of home
      BiPAP. BiPAP nasal ventilation is effective in reducing nocturnal CO2 retention
      short term in hypoventilatory respiratory failure due to obesity hypoventilation
      syndrome, chest wall restriction, or neuromuscular disease. Further studies in
      patients with COPD may be warranted.

PMID- 1735283
TI  - Oxygenation and ventilation during cardiopulmonary resuscitation utilizing
      continuous oxygen delivery via a modified pharyngeal-tracheal lumened airway.
AB  - Use of continuous transtracheal oxygen delivery systems combined with rhythmic
      chest compressions can provide excellent oxygenation and ventilation during
      cardiopulmonary resuscitation. However, occasional displacement of the
      transtracheal catheter results in life-threatening pneumomediastinal
      complications. We investigated using the pharyngeal lumen of a pharyngeal
      tracheal lumened airway (PtL) as an alternative delivery system for continuous
      oxygen flow in 21 large mongrel dogs. Excellent ventilation was possible in
      anesthetized, apneic, and paralyzed dogs in normal sinus rhythm from the
      "bellows" effect of chest compressions. The hypercapnia and respiratory acidemia
      resulting from 5 min of complete apnea in ten dogs during normal sinus rhythm was
      readily corrected (p less than 0.01). In an additional 11 dogs, external chest
      compressions were performed and oxygen was delivered continuously via the PtL
      during 20 min of ventricular fibrillation. During this period of cardiac arrest,
      pH declined (7.38 +/- 0.01 vs 7.19 +/- 0.02; p less than 0.01), but PaCO2 (35 +/-
      1 vs 38 +/- 3 mm Hg) and PaO2 (67 +/- 2 vs 68 +/- 3 mm Hg) were not significantly
      different from prearrest values. Successful resuscitation was achieved in 8 of 11
      (73 percent) animals, which is similar to the results in historical controls with
      endotracheal intubation. No pneumomediastinal complications were seen with use of
      the PtL. We conclude that using the pharyngeal lumen of the PtL for continuous
      delivery of oxygen combined with external chest compressions can provide a safe
      and effective mode of oxygenation and ventilation during cardiac arrest.

PMID- 1735284
TI  - Continuous negative extrathoracic pressure ventilation, lung water volume, and
      central blood volume. Studies in dogs with pulmonary edema induced by oleic acid.
AB  - The effect of continuous positive-pressure ventilation (CPPV) on extravascular
      lung water volume has been investigated, but there is only one report which
      studied the effect of continuous negative extrathoracic pressure ventilation
      (CNETPV). The effect of CNETPV on central blood volume (CBV) has not been
      studied. Changes in intrathoracic pressure by CNETPV may alter lung water volume
      and CBV. In this study the effects of CNETPV on lung water volume and CBV were
      compared with those of intermittent positive-pressure ventilation (IPPV) and CPPV
      in dogs with pulmonary edema induced by oleic acid. Nine mongrel dogs were
      anesthetized and given oleic acid at 0.06 ml/kg intravenously to induce pulmonary
      edema; CNETPV was applied with a cuirass and a negative thoracic pressure
      ventilator (Kimura OKT-100) for 1 h. Extravascular lung water volume (as
      extravascular thermal volume [EVTV]) and CBV were estimated with the double
      indicator dilution method using thermal-sodium; PEEP and continuous negative
      extrathoracic pressure were matched to produce the same increments in FRC. The
      EVTV increased during CNETPV but did not change during CPPV. The CBV decreased
      during CPPV but did not change during CNETPV. An increase of transmural pulmonary
      microvascular pressure was thought to be one of the reasons for the increase in
      EVTV with CNETPV.

PMID- 1735285
TI  - The clinical utility of postinfarction risk prediction. Performance perspective
      of electrophysiologic and other variables.

PMID- 1735286
TI  - Mechanisms of obstructive sleep apnea.
AB  - This article has reviewed the anatomic, compliance, reflex, and respiratory
      muscle variables that affect upper airway caliber and abnormalities which may
      precipitate upper airway collapse during sleep. One or more of these variables
      may be important in the mechanism of OSA in any given patient. First, anyone with
      anatomic narrowing of the upper airway is susceptible to OSA. However, we do know
      if anatomic narrowing of the upper airway is necessary for the development of
      OSA. Surely, heavy snoring produces pharyngeal trauma and possibly edema or
      inflammation, which in turn may narrow the upper airway. Submucosal adipose
      tissue or cervical adipose tissue may compress the airway when the tonic
      electrical activity of the pharyngeal muscles decreases with sleep onset. Data
      reviewed support the idea that the upper airway of OSA patients may be more
      collapsible than the upper airway of nonapneic subjects. Intrinsic tissue
      abnormalities have not been demonstrated that might be responsible for this
      collapsibility. Changes in collapsibility found are consistent with, and may be
      due to, changes in tonic and phasic contraction of upper airway muscles.
      Abnormalities in reflexes affecting upper airway size surely might exist in OSA.
      Edema or inflammation of pharyngeal tissues might not only narrow the upper
      airway but might also impair normal function of the receptors responsible for
      initiating protective reflexes. We propose the fluctuation between a low- and a
      high-drive state contributes to upper airway collapse in OSA. With this
      fluctuation the balance of forces and critical pressure concepts discussed above
      come into play (Fig 6). By stimulating upper airway inspiratory muscles, CO2
      eliminates the hypoapneic, low-drive, high-resistance periods and thereby reduces
      the number of apneas. In addition, preferential stimulation of upper airway
      muscle activity dilates the upper airway per se. If the relative value of each of
      these factors can be determined diagnostically, perhaps therapy can be made more
      specific. By being more specific, therapy should be more successful than the
      present practice of prescribing a particular therapy, regardless of the specific
      mechanism responsible for the OSA in a given patient.

PMID- 1735287
TI  - Contemporary clinical trials in acute respiratory distress syndrome.

PMID- 1735288
TI  - An asymptomatic hilar mass.

PMID- 1735289
TI  - Ceftazidime monotherapy for pulmonary melioidosis in a traveler returning from
      Thailand.
AB  - A patient with deteriorating pulmonary melioidosis rapidly recovered after
      treatment with ceftazidime. To prevent possible relapses, an oral maintenance
      regimen of amoxicillin and clavulanic acid was prescribed for a period of three
      months. Melioidosis is caused by Pseudomonas pseudomallei. It is an insidious
      disease because of its variable clinical presentation, possible long-term
      asymptomatic carriage, broad-spectrum resistance to first-line antibiotics, and
      high mortality rate. As in our patient, the diagnosis should be particularly
      considered when there is reduced immunologic resistance and previous exposure in
      endemic areas, such as Southeast Asia.

PMID- 1735290
TI  - Problem of management of obstructive cardiomyopathy.

PMID- 1735291
TI  - Pulmonary edema as a radiologic manifestation of venous air embolism secondary to
      dental implant surgery.
AB  - Three serial cases of fatal venous air embolism were reported after mandibular
      prosthetic dental surgery. Initially attributed to anesthetic factors, the deaths
      resulted from intraosseous irrigation with coolant tap water and air. Pulmonary
      edema was seen on chest roentgenograms and might have suggested the cause of
      death.

PMID- 1735292
TI  - An artifact induced by negative pressure ventilation.
AB  - This report draws attention to an artifact that influences the qualitative
      information gained from respiratory inductance plethysmography during negative
      pressure ventilation with a cuirass. This artifact may prevent identification of
      upper airway obstruction, a manageable complication of this mode of ventilation.

PMID- 1735293
TI  - Continuous murmur in Lutembacher syndrome analyzed by Doppler echocardiography.
AB  - A continuous murmur was heard in a 47-year-old woman with Lutembacher syndrome.
      Transesophageal and intraoperative Doppler echocardiography revealed the murmur
      originating from the accelerated blood flow passing through the small atrial
      septal defect. To our knowledge, this is the first reported case of a continuous
      murmur in Lutembacher syndrome analyzed by Doppler echocardiography.

PMID- 1735294
TI  - Pneumococcal crepitant cellulitis caused by a bronchocutaneous fistula.
AB  - An elderly woman who had received radiation treatment for carcinoma of the lung
      presented with erythema, crepitus and pain over the scapular area. Streptococcus
      pneumoniae was isolated in pure culture from the subcutaneous tissues, and a
      bronchocutaneous fistula was demonstrated.

PMID- 1735295
TI  - Inadvertent loss of bronchoscopy instruments in the tracheobronchial tree.
AB  - Equipment malfunction is a rare complication of flexible fiberoptic bronchoscopy.
      We report an unusual example of equipment failure resulting in the inadvertent
      introduction of a foreign body (the tip of a cleaning brush) into the bronchial
      tree of a patient during FFB. In addition, we review several other cases in which
      problems have been caused by malfunction of accessory equipment. Careful
      inspection of all cleaning and biopsy utensils should reduce the chance of
      iatrogenically introducing a foreign body from the bronchoscope channel into the
      patient's airway. We suggest that biopsy forceps are the best retrieval
      instrument to use when the foreign body involved is a brush or a piece of wire.

PMID- 1735296
TI  - Reversible pulmonary artery obstruction in a patient with bronchogenic carcinoma.
      Diagnosis by two-dimensional and Doppler echocardiography.
AB  - Neoplastic invasion of the pulmonary arteries, although common, rarely results in
      obstruction to right ventricular outflow. We report an unusual case of severe
      pulmonary hypertension, right ventricular dilatation, and righ ventricular
      dysfunction resulting from pulmonary arterial compression by bronchogenic
      carcinoma. The diagnosis was made by two-dimensional and Doppler echocardiography
      and supported by computed tomographic findings. Echocardiography was used to
      follow the patient's response to therapy and documented the subsequent resolution
      of pulmonary arterial obstruction.

PMID- 1735297
TI  - Chylous transport of amiodarone.
AB  - A patient receiving amiodarone for longstanding ventricular dysrhythmias
      presented with idiopathic chylothorax. During drainage of chylothorax for
      pleurodesis, serial plasma amiodarone concentrations declined while pleural fluid
      concentrations remained stable. Chylous transport of amiodarone and other lipid
      bound drugs should be recognized to avert complications during chylothorax
      drainage.

PMID- 1735298
TI  - Pulmonary manifestations of Staphylococcus aureus septicemia.
AB  - This study includes 140 episodes (138 cases) of Staphylococcus aureus septicemia,
      made up mostly of community-acquired, nonintravenous drug abuse (nonIVDA) cases.
      Unlike other series, injury wounds and skin or soft tissue infections were the
      most common sites of primary infection. In spite of a different patient
      population and lack of cases with tricuspid valvular endocarditis, the lungs were
      still the most common site of secondary infectious foci and most developed within
      two weeks of onset of the septicemia.

PMID- 1735299
TI  - Aspiration injury due to polyacrylamide.
AB  - Acute lung injury secondary to aspiration of polyacrylamide, a synthetic polymer
      used widely in industry, has not been previously described in man or animal. We
      report the case of a 26-year-old man who aspirated polyacrylamide gel while
      cleaning it out of a tank truck. Subsequently, severe airway obstruction and lung
      parenchymal damage developed, and the patient died. At autopsy, numerous
      polyacrylamide particles were found in the lungs, along with extensive
      bronchiolar and alveolar damage.

PMID- 1735300
TI  - Unruptured congenital aneurysm of the left sinus of Valsalva presenting as acute
      right ventricular failure.
AB  - A patient with unruptured congenital aneurysm of the left coronary sinus of
      Valsalva presented with acute right-sided heart failure due to right ventricular
      outflow tract obstruction. The mechanism for such an acute presentation may have
      been a sudden increase in the size of the aneurysm. The surgical importance of
      this lesion is the combined aortocameral approach which is seldom required for
      correction of such aneurysms.

PMID- 1735301
TI  - Respiratory failure and cor pulmonale associated with tracheal mucoid
      accumulation from a SCOOP transtracheal oxygen catheter.
AB  - Transtracheal oxygen (TTO) delivery for patients with chronic hypoxemia has been
      used increasingly since its introduction in 1982. Most complications have been
      relatively minor and usually occur in conjunction with catheter placement. This
      report describes two patients with long-term catheter use who developed
      increasing respiratory failure and cor pulmonale, at least in part, due to a
      large tracheal mucus plug.

PMID- 1735302
TI  - Transmission of tuberculosis to hospital workers by a patient with AIDS.
AB  - A patient with acquired immunodeficiency syndrome (AIDS) was admitted to a
      hospital with cough and fever and after 29 days was transferred to a hospice. He
      was eventually shown to have active pulmonary tuberculosis. This diagnosis was
      obscured clinically by simultaneous infection with Pneumocystis carinii and
      Mycobacterium avium complex (MAC). Laboratory recognition of Mycobacterium
      tuberculosis was delayed because of overgrowth of cultures by MAC but was later
      established using DNA probe techniques. Thirty (19 percent) of 158 health care
      workers who had been exposed to this patient had conversion of their tuberculin
      skin tests. Diagnostic difficulties and nosocomial transmission of tuberculosis
      may occur when patients with AIDS have mixed mycobacterial infections.

PMID- 1735303
TI  - Nontraumatic acute anterior mediastinitis in two HIV-positive heroin addicts.
AB  - We present the cases of two young heroin addicts seropositive for HIV who had
      life-threatening spontaneous acute anterior mediastinitis due to Staphylococcus
      aureus. This was the consequence of the spreading to the mediastinum of an
      infection of the chest wall. Complete cure was achieved with antibiotics and
      surgical drainage. Spontaneous mediastinitis should arouse suspicion of the
      possibility of HIV infection.

PMID- 1735304
TI  - Steroid-responsive alveolitis associated with ulcerative colitis.

PMID- 1735305
TI  - Complex cryptococcal empyema.
AB  - Cryptococcus neoformans continues to present diagnostic and treatment challenges
      in patients with underlying malignant neoplasms. Cryptococcal empyema is a
      relatively rare complication of cryptococcal disease. It is important to
      distinguish whether uncontrolled malignancy or cryptococcal infection is
      responsible for the effusion. We used traditional diagnostic approaches,
      bronchoscopy and transthoracic fine needle aspiration, to verify the presence of
      the organism but continued to have treatment failure until adequate drainage was
      established.

PMID- 1735306
TI  - Pulsus paradoxus in anaphylactic shock due to urokinase administration.

PMID- 1735307
TI  - On being fair to the pulmonary artery catheter.

PMID- 1735308
TI  - Contents of chest wall cold abscess flowing into the epidural space in miliary
      tuberculosis.

PMID- 1735309
TI  - Arterial or venous? You make the call.

PMID- 1735310
TI  - Sexism or satire? Response to a special communication.

PMID- 1735311
TI  - Tissue invasion by Mansonella ozzardi in a patient with adenocarcinoma.

PMID- 1735312
TI  - Multifactorial index of preoperative risk factors in colon resections.
AB  - Our aim was to analyze the predictive value of a variety of preoperative risk
      factors on operative outcomes. We reviewed all colorectal resections performed in
      a single hospital between January 1985 and May 1990. Nine hundred seventy-two
      resections were performed on 825 patients. We studied 17 preoperative risk
      factors generated from various medical risk categories. Using the multivariate
      discriminant function analysis, we calculated that 11 of the 17 risks were of
      significance in predicting outcomes (all with P less than or equal to 0.031).
      These factors included emergent operation, age greater than or equal to 75 years,
      congestive heart failure (CHF), prior abdominal or pelvic radiation therapy,
      corticosteroid use, albumin less than 2.7 g/dl, chronic obstructive pulmonary
      disease (COPD), previous myocardial infarction (MI), diabetes, cirrhosis, and
      renal insufficiency. The classification function generated by the discriminant
      analysis was used to categorize patients into one of four risk groups depending
      on their "risk score." The index used to develop each patient's "risk score"
      ranged from six points for an emergency operation to one point for diabetes. The
      mortality rates for the various risk groups were as follows: Group 1, zero to
      four points, 1 percent; Group 2, five to eight points, 10 percent; Group 3, 9 to
      13 points, 19 percent; Group 4, greater than 13 points, 33 percent. In contrast
      to previous reports, we showed that age greater than or equal to 75 years alone
      is not a major preoperative risk factor but, rather, acts as a modifier for the
      other predictors of postoperative complications. We then assessed clinical
      questions concerning specific preoperative risks, such as steroid use, obesity,
      inflammatory bowel disease, COPD, and prior laparotomy, and their associated
      specific postoperative complications and have developed prevention strategies
      based on these findings. Through the use of the risk index, we also were able to
      assess an individual patient's operative risk more accurately.

PMID- 1735313
TI  - Randomized, controlled study on adjuvant immunochemotherapy with PSK in
      curatively resected colorectal cancer. The Cooperative Study Group of Surgical
      Adjuvant Immunochemotherapy for Cancer of Colon and Rectum (Kanagawa).
AB  - A randomized, controlled trial of adjuvant immunochemotherapy with PSK (Kureha
      Chemical Industry Co., Tokyo, Japan) in curatively resected colorectal cancer was
      studied in 35 institutions in the Kanagawa prefecture. From March 1985 to
      February 1987, 462 patients were registered. Four hundred forty-eight of those
      patients (97.0 percent) satisfied the eligibility criteria. The control group
      received mitomycin C intravenously on the day of and the day after surgery,
      followed by oral 5-fluorouracil (5-FU) administration for over six months. The
      PSK group received PSK orally for over three years, in addition to mitomycin C
      and 5-FU as in the control group. At the end of February 1990, the median follow
      up time for this study was four years (range, three to five years). The disease
      free survival curve and the survival curve of the PSK group were better than
      those of the control group, and differences between the two groups were
      statistically significant (disease-free survival, P = 0.013; survival, P =
      0.013). These results indicate that adjuvant immunochemotherapy with PSK was
      beneficial for curatively resected colorectal cancer.

PMID- 1735314
TI  - Conservative surgery for early cancer of the distal rectum.
AB  - From 1967 through 1988, 36 patients underwent local excision of a distal rectal
      cancer as an initial operative procedure with curative intent. A diagnostic,
      preoperative protocol was performed to assess the histologic grade of the tumor,
      the depth of penetration in the rectal wall, and the presence of positive lymph
      nodes or distant metastases. All patients had a transanal local excision
      performed under general anesthesia. If preoperative criteria were not confirmed
      by histopathologic specimen examination, a major operation was advised. To
      increase the chance of local control, external adjuvant radiotherapy was used in
      T2 cancers. Postoperative mortality was 0 percent. The postoperative complication
      rate was 9.3 percent. The observed local recurrence rate was 3 percent, and the
      rectal cancer-specific death rate was 6 percent. We compared these results with
      those obtained in 70 concomitant patients operated on by us employing a
      traditional resection for Dukes' A rectal cancer. There are no statistically
      significant differences between groups. In light of our findings, a policy of
      curative local excision is justified in accurately selected cases of distal
      rectal cancer.

PMID- 1735315
TI  - Influence of sleep on anal sphincteric pressure in health and after ileal pouch
      anal anastomosis.
AB  - Fecal incontinence at night may be a disturbing consequence of ileal pouch-anal
      anastomosis (IPAA). The hypothesis was that decreases in anal canal resting
      pressure occur as sleep deepens and that the decreases are more profound in pouch
      patients with incontinence than in controls. Using a sleeve catheter assembly for
      recording intraluminal and canal pressure and polysomnographic recordings of
      sleep stages, progressive decreases in anal canal resting pressure with deepening
      sleep occurred in 11 healthy controls (mean +/- SEM: 57 +/- 3 mm Hg to 43 +/- 3
      mm Hg: P less than 0.05) and in 11 patients after IPAA (55 +/- 3 mm Hg to 42 +/-
      4 mm Hg; P less than 0.05). Minute-to-minute variations in mean pressure were
      also found in both controls and IPAA patients, and they were greater at night in
      patients (P less than 0.05), except during rapid eye movement (REM) sleep. In
      three patients, resting pressure during REM sleep decreased markedly to 31 +/- 8
      mm Hg. This decrease plus the variations in pressure during REM sleep led to
      incontinence. In conclusion, decreases in anal resting pressure coupled with
      marked minute-to-minute variations in pressure during sleep occurred in controls
      and in patients after IPAA and, when profound, led to nocturnal fecal
      incontinence in some patients.

PMID- 1735316
TI  - Effect of intraoperative radiation on the tensile strength of small bowel
      anastomoses.
AB  - Increasing interest in the use of preoperative or intraoperative radiation
      therapy for cancer has led to concerns regarding tissue healing and integrity
      subsequent to treatment. This is especially so for intestinal anastomoses
      incorporating irradiated bowel, where poor healing may lead to anastomotic
      disruption and sepsis. One hundred thirty Sprague-Dawley rats were randomized
      into five groups as follows: both limbs, one limb, or neither limb of an
      anastomosis received 2,000 R of radiation intraoperatively. A fourth group had a
      segment of small bowel irradiated, with no anastomosis; a fifth group had the gut
      exposed by celiotomy. The control groups and all anastomoses underwent tensile
      strength measurements on the seventh postoperative day, with findings as follows:
      no anastomosis, no irradiation, 143.75 g; no anastomosis, irradiated, 114.50 g;
      anastomosis, no irradiation, 85.273 g; anastomosis, one limb irradiated, 78.100
      g; anastomosis, both limbs irradiated, 59.00 g. There was no statistical
      difference in tensile strength of the anastomosis between when neither limb and
      when just one limb was irradiated. However, when both limbs were irradiated, the
      loss of strength was statistically significant (P = 0.002). Irradiation damage
      scores were assigned using Black et al.'s histologic scoring system. These scores
      were not significantly different between the irradiated segments. Inflammation
      and fibrosis scores for the anastomoses were also not significantly different.
      These results indicate that, in rats, anastomotic healing is impaired only when
      both limbs of the anastomosed intestine are irradiated. The normal strength of
      the anastomosis with only one limb irradiated cannot be explained by differences
      in inflammation, fibrosis, or radiation damage and is caused by an undetermined
      factor.

PMID- 1735317
TI  - Partial colectomy and coloanal anastomosis for idiopathic megarectum and
      megacolon.
AB  - Adult patients with an idiopathic megarectum or megacolon can experience severe
      constipation requiring surgical treatment. Some of these patients have a proximal
      colon of normal diameter, with dilatation involving only the left or distal colon
      and rectum. The results of partial colonic and rectal resection with coloanal
      anastomosis in such patients have been reviewed. Seven patients (two female and
      five male) underwent a coloanal anastomosis over a seven-year period. The median
      age at operation was 19 years, the mean age at onset of symptoms was five years,
      and the mean follow-up period was one year. Five patients experienced a return to
      normal bowel frequency with the loss of most symptoms. One patient has an
      ileostomy because of persistent constipation after the procedure. One subject
      died because of postoperative bleeding from the anastomosis and subsequent
      cardiac and respiratory complications. This operation may have a place in the
      treatment of severe constipation caused by idiopathic megarectum and megacolon,
      but careful preoperative motility studies and meticulous attention to operative
      technique are required for a good outcome.

PMID- 1735318
TI  - Immunocytochemical analysis of receptors for estrogen and progesterone in fine
      needle aspirates from anal epidermoid carcinoma.
AB  - Fifteen patients with anal epidermoid carcinoma were examined with percutaneous
      or transanorectal fine needle aspiration (FNA) cytology. Aspirates from all
      patients allowed cytologic verification of the diagnosis. Estrogen receptor (ER)
      and progesterone receptor (PgR) were analyzed using an immunohistochemical
      technique well adapted for steroid receptor analysis in hormone-dependent
      carcinomas. Neither ER nor PgR could be detected in any of the aspirates. This
      finding is somewhat unexpected since there is a strong female predominance in
      this tumor type. However, our findings do not negate that sex steroid hormones
      may indirectly play a role in the tumorigenesis of anal epidermoid carcinoma.

PMID- 1735319
TI  - Newly designed occluder pin for presacral hemorrhage.
AB  - Conventional hemostatic measures are often unsatisfactory in presacral venous
      bleeding occurring during surgical mobilization of the rectum. We designed a new
      type of hemorrhage occluder pin, with a ridged shaft, which may be rapidly placed
      into the sacrum to control hemorrhage. The aims of this study were 1) to assess
      the best pin shaft length by measuring the thickness of human sacral vertebral
      bodies, 2) to measure the forces needed to pull the newly designed pin out of the
      human sacrum compared with conventionally shaped titanium thumbtacks, and 3) to
      assess clinically the efficacy of the new device. Four fresh cadaveric pelves
      were isolated and cut on a sagittal plane, and the thickness of each vertebral
      body was measured. Titanium pins, both with ridged and with smooth shafts, were
      used. Twelve-millimeter-shaft pins were used for S1 and S2, and 7-mm pins were
      used for S3, S4, and S5. Pins were inserted into each sacral vertebra, and the
      forces needed to extract them from the bone were measured by computerized
      dynamometry. Significantly more force was required to extract ridged vs. smooth
      pins, both with 12-mm and with 7-mm shafts. There was no significant difference
      between the forces needed to pull out 12-mm vs. 7-mm pins. The new pin was
      successfully used to stop presacral hemorrhage in three patients with no
      complications one, three, and six months after surgery. This newly designed
      hemorrhage occluder pin may represent an improved method of controlling presacral
      venous hemorrhage.

PMID- 1735320
TI  - Influence of myectomy, ileal valve, and ileal reservoir on the ecology of the
      ileum.
AB  - Fecal bacteriology, fecal volatile fatty acids, and ileal mucosal morphology were
      studied in dogs after ileoanal anastomosis alone, ileoanal anastomosis and
      myectomy, ileoanal anastomosis and myectomy with ileoileal valve, and ileoanal
      anastomosis with duplicated (J) ileal reservoir. The ratio of anaerobes to
      aerobes was significantly less in stool from dogs which had undergone ileoanal
      anastomosis compared with each of the other three groups (P less than 0.01). The
      numbers of streptococci and clostridia both were significantly less in stool from
      dogs with ileoanal anastomosis alone than in any other group. The concentrations
      of fecal acetic and propionic acids were significantly less in dogs with ileoanal
      anastomosis alone than in any other group (P less than 0.05), but there were no
      significant differences in the concentrations of fecal butyric or valeric acids.
      The severity of mucosal inflammation and degree of villous atrophy were more
      marked in the ileum of J reservoirs (P less than 0.01), and the percentage of
      stool retained after defecation was greater (P less than 0.05) in dogs with J
      reservoirs than in any other group. Therefore, the use of myectomy resulted in
      significant changes in the ecology of the distal ileum although changes typical
      of pouchitis were seen only in dogs with J reservoirs.

PMID- 1735321
TI  - Diminutive colonic polyps: an indication for colonoscopy.
AB  - A prospective study investigated the significance of solitary diminutive colonic
      polyps discovered during screening flexible sigmoidoscopy. Eighty-two patients
      with a solitary diminutive polyp (less than or equal to 5 mm) underwent
      colonoscopy after cold biopsy of the index polyp. Of the patients with
      adenomatous index polyps, 42.5 percent had proximal neoplastic polyps. Of the
      patients with hyperplastic index polyps, proximal neoplastic polyps were found in
      38.9 percent. These data suggest that diminutive polyps identified during
      flexible sigmoidoscopy, whether adenomatous or hyperplastic, place the patient in
      the intermediate risk group for colorectal neoplasia. We recommend that any
      patient with polyps seen during screening sigmoidoscopy, regardless of
      histopathology, should undergo colonoscopy.

PMID- 1735322
TI  - Does a proximal colostomy affect colorectal anastomotic healing?
AB  - Fecal diversion has been implicated as an etiologic factor in anastomotic
      stenosis following colorectal surgery, particularly following the use of circular
      anastomotic stapling devices. However, experimental confirmation of the effects
      of fecal diversion on anastomotic healing is virtually nonexistent. The purpose
      of this study was to serially evaluate colorectal anastomotic healing with
      proximal colostomy (COL) and without it (CON; control) using two anastomotic
      techniques in a porcine model. Fifty-two (28 CON; 24 COL) mixed-breed female pigs
      had colorectal anastomoses using either a two-layer hand-sewn (HS) or an EEA
      (U.S. Surgical Corporation, Norwalk, CT) circular stapled (CS) technique.
      Anastomotic blood flow was measured using laser Doppler velocimetry (LDV). At
      second surgery (5, 11, 60, or 120 days postoperatively), the following data were
      collected: repeat LDV, gross and microscopic anastomotic inflammatory scores,
      anastomotic diameter, and bursting pressure. There were no significant
      differences in anastomotic blood flow (LDV), inflammatory scores, or incidence of
      leak or stenosis between the CON and COL groups or between anastomotic
      techniques. Bursting pressure was significantly lower for the COL group at day 11
      but not any other postoperative day (POD). Proximal colostomy does not appear to
      exert adverse effects on colorectal anastomotic healing. The choice of colorectal
      anastomotic technique should not be influenced by the need for proximal
      colostomy.

PMID- 1735323
TI  - Trend of large bowel tuberculosis and the relation with pulmonary tuberculosis.
AB  - From 1965 to 1989, 60 cases of large bowel tuberculosis among 116 cases of
      abdominal tuberculosis are reviewed and analyzed. Lesions located in the cecum or
      ileocecal region were found in 49 of the 60 cases. Most of the patients (50/60)
      received surgical intervention, but the definite diagnoses had never been proved
      until surgery. The diagnoses were proved by histopathologic examination in these
      50 cases. Antituberculosis medications were given for at least nine months in all
      patients. Twenty-nine of the 50 patients who received operations had primary
      anastomosis during the operations, and no leakage occurred. Evidence of pulmonary
      tuberculous lesions could be found in 40 of the 60 cases. Positive findings of
      tubercle bacilli in sputum smear or culture were noted in 13 cases. The positive
      rate of sputum examinations decreased during 1980 to 1989; 25.6 percent (10/39)
      were positive from 1965 to 1979 and 14 percent (3/21) were positive from 1980 to
      1989. In the meantime, there was a steady decline in the cases of large bowel
      tuberculosis in the most recent few years. An antituberculosis program has been
      carried out in the past 40 years with remarkable effect in the Taiwan area, but
      the possibility of intestinal tuberculosis still exists. The authors suggest that
      surgeons keep tuberculosis in mind when they are dealing with patients who suffer
      from intestinal obstruction of unknown origin with the suspected findings of
      pulmonary tuberculosis in chest x-ray films.

PMID- 1735324
TI  - Arterial thromboembolic complications of inflammatory bowel disease. Report of
      three cases.
AB  - Extraintestinal manifestations of inflammatory bowel disease are legion and are
      demonstrated in one-third of those afflicted. In general, they do not mandate
      surgery. Three patients with active pancolonic ulcerative colitis developed
      arterial thromboembolic complications prior to surgical treatment. Thromboembolic
      complications are not fully understood, as is evidenced by the paucity of
      information in the literature, and only sporadic cases of arterial thromboemboli
      are found. These have been described primarily in the postsurgical patient. To
      ascertain whether others have encountered similar cases, a survey form was
      distributed to members of The American Society of Colon and Rectal Surgeons,
      yielding an additional 54 patients with thromboembolic complications.
      Approximately two-thirds were deep venous thromboses and/or pulmonary emboli. Ten
      patients had cerebrovascular accidents, and eight had arterial emboli. Eleven
      patients, over 21 percent, suffered multiple events. There were four resultant
      mortalities. An arterial thromboembolic event in a patient with ulcerative
      colitis is usually associated with pancolonic disease, has a poor long-term
      prognosis, and is an indication for colectomy.

PMID- 1735325
TI  - Multiple colorectal neoplasms in a young adult with hypogammaglobulinemia. Report
      of a case.
AB  - We report on a 22-year-old man with congenital hypogammaglobulinemia who
      developed multiple colorectal neoplasms. An immunodeficiency had been diagnosed
      in the patient since two years of age, and this time many tumors of the sigmoid
      colon and rectum were detected by barium enema and fiberscopy. Abdominoperineal
      resection was performed, and the resected specimen revealed 29 polyps, including
      9 adenocarcinomas and 20 adenomas. The carcinomas, measuring 0.8 to 11.0 cm in
      size, showed various depths of invasion, and the adenomas, measuring 0.2 to 1.5
      cm in size, showed various degrees of epithelial atypia. DNA analysis
      demonstrated that the tumors were heterogeneous, showing different DNA index and
      ploidy patterns. The pathogenetic relation between malignancy and
      immunodeficiency is also reviewed.

PMID- 1735326
TI  - "House" advancement pedicle flap for anal stenosis.
AB  - Long strictures of the anal canal, extending from the dentate line to the
      perianal skin, have challenged surgeons for many years. Numerous techniques have
      been devised to treat anal strictures. A technique to relieve an anal stenosis
      that involves the entire circumference and the length of the anal canal from the
      dentate line onto the perianal skin is described. It has two principal
      advantages: 1) it provides a broad skin flap for the entire length of the
      involved anal canal; and 2) it provides primary closure of the donor site. In
      addition, it avoids extensive mobilization of tissue, the flap maintains good
      blood supply with minimal tension, and there is no small tip prone to necrosis.

PMID- 1735327
TI  - Local excision of rectal tumors: specimen orientation.
AB  - Transanal local excision is a management option for patients with rectal tumors.
      An important final step in this operation is specimen orientation. A simple
      technique is described for specimen preparation, ideally performed by the surgeon
      in the operating room. This technique is recommended as the concluding step, for
      it can be as important as the local excision itself in regard to the
      determination of adequacy of resection and the need for additional treatment.

PMID- 1735328
TI  - Practice parameters for the management of anal fissure. The Standards Task Force
      American Society of Colon and Rectal Surgeons.
AB  - It should be recognized that these guidelines should not be deemed inclusive of
      all proper methods of care or exclusive of methods of care reasonably directed to
      obtaining the same results. The ultimate judgment regarding the propriety of any
      specific procedure must be made by the physician in light of all of the
      circumstances presented by the individual patient.

PMID- 1735329
TI  - A scoring system for diagnosing irritable bowel: time to try again?

PMID- 1735330
TI  - Irritable bowel syndrome. Still far from a positive diagnosis.
AB  - The diagnosis of irritable bowel syndrome requires the exclusion of any
      associated organic disease: a positive diagnosis would avoid expensive and
      potentially dangerous diagnostic procedures. A scoring system has been proposed
      for positive diagnosis where more than 44 points excluded organic digestive
      disease. The aim of this study was to determine the usefulness of this scoring
      system in a different setting. Patients (1257) consecutively referred to our
      medical division were admitted to the study and 270 of these, complaining of
      abdominal symptoms, were scored on the Kruis system method. The positive
      predictive value (53.8% for men and 81.5% for women) and the sensitivity (46.7%
      and 59.5%) did not appear to be adequate. The negative predictive value (91.6%
      and 87.3%) and the specificity (93.5 and 95.4%) gave higher results, but two
      cases of neoplasia and nine cases of other organic digestive diseases were not
      identified or suggested. We believe that this scoring system may be useful only
      as a first step in a diagnostic flow chart.

PMID- 1735331
TI  - Enteric and central contributions to intestinal dysmotility in irritable bowel
      syndrome.
AB  - The aim of the study was to further elucidate the pathophysiology of irritable
      bowel syndrome and its subgroups by examining and comparing alterations in small
      bowel motility, specifically phase II and phase III components of the migrating
      motor complex. Prolonged recordings of interdigestive small bowel motility were
      obtained during both diurnal and nocturnal periods in 20 patients with irritable
      bowel syndrome--10 with predominant constipation and 10 with predominant diarrhea
      -and in 10 healthy subjects. Diurnal amplitude (mean +/- SD) of phase III
      activity fronts was lower (P less than 0.05) in constipation-predominant patients
      (16.3 +/- 3.1 mm Hg) than in diarrhea-predominant patients (20.2 +/- 3.1) or
      controls (20.9 +/- 2.7). Similar findings were observed nocturnally. Phase III
      cycle length was also significantly prolonged diurnally in constipation
      predominant patients when compared to the other groups. In the diarrhea
      predominant group repetitive and rapidly propagated bursts of contractions were
      observed in eight patients, and this pattern occupied a significantly greater
      proportion of phase II motor activity than in controls. These alterations in
      phase II and in phase III components of the migrating motor complex suggest that
      both local (enteric) and more central mechanisms may operate to produce
      intestinal dysmotility in the irritable bowel syndrome and that these mechanisms
      differ according to the predominant alteration of bowel habit.

PMID- 1735332
TI  - Functional adaptation of rat remnant colon after proximal hemicolectomy.
AB  - Functional adaptation of the remnant intestine after extensive resection of small
      bowel is well documented. The effects of partial resection of large bowel on the
      remaining colon have not been characterized. Transepithelial potential (VT),
      tissue resistance (RT), and short-circuit current (Isc) were measured in vitro
      across distal colonic tissue of rats three weeks after proximal hemicolectomy
      with ileotransversotomy and compared to the same parameters measured in the
      distal colon of control animals. In a second series of experiments, an in vivo
      perfusion technique was used to measure changes in sodium, potassium, and water
      transport in distal colon following proximal hemicolectomy. A 2.5-fold increase
      in VT (P less than 0.01), a 62% increase in RT (P less than 0.001), and a 35%
      increase in Isc (P less than 0.05) were observed three weeks following
      hemicolectomy when compared to control animals. A 64% increase in net sodium
      absorption (P less than 0.025), no significant change in net potassium transport,
      and a 115% increase in net water absorption (P less than 0.01) were demonstrated
      in hemicolectomized animals when compared to control. It is concluded that in the
      rat the distal colon is capable of functional adaptation to increase net sodium
      and water absorption within three weeks after proximal hemicolectomy. The
      mechanism responsible for this adaptive process has yet to be defined. Our
      findings may explain the lack of chronic diarrhea in patients undergoing right
      hemicolectomy.

PMID- 1735333
TI  - Association of constipation with neurologic diseases.
AB  - To investigate possible etiologic influences on the development of constipation,
      the present study examines the concordant occurrence of constipation with other
      diseases. Using 8.8 million Medicare patients hospitalized in the United States
      during 1987, the frequency distribution of all three-digit International
      Classification of Diseases (ICD) codes was compared in constipated patients and
      patients without constipation. Most associations and the closest associations
      were observed between constipation and neurologic diseases, the majority of which
      resulted from damage to the central nervous system. Associations between
      constipation and disorders of the spine also involved neuronal damage. The
      influence of potential confounding factors such as immobility or pain on the
      development of constipation was assessed and found to be minimal. The frequent
      association of constipation with disorders involving neuronal malfunction
      suggests that disruption of the neural modulation of colonic motility may play an
      important role in the development of constipation.

PMID- 1735334
TI  - Gut hormones and gastrointestinal motility in children with cystic fibrosis.
AB  - Intestinal dysmotility may be an important factor contributing to various
      gastrointestinal complications associated with cystic fibrosis. Motilin,
      enteroglucagon, neurotensin, and peptide YY may each play a role as endocrine
      hormones influencing gastrointestinal motor activity. Fasting children with
      cystic fibrosis (N = 8) and controls (N = 18) received a liquid nutrient test
      meal (fat 4 g/100 ml, protein 4 g/100 ml, carbohydrate 20 g/100 ml, 125 kcal/100
      ml; 200 ml/m2) containing lactulose (5 g/100 ml), and the plasma concentrations
      of these peptides were studied. Mouth-to-cecum transit time was simultaneously
      studied using the breath H2 technique. Fasting levels of peptide YY and the
      postprandial response of all four peptides were significantly increased in those
      with cystic fibrosis. In repeat studies on those with cystic fibrosis after a
      period of altered pancreatic enzyme supplementation, no significant changes in
      peptide concentrations were observed. A rise in breath H2 permitting estimation
      of mouth-to-cecum transit time was noted in 17 control subjects (70-220 min,
      median 140). In contrast, a rise occurred in only two with cystic fibrosis after
      low-dose enzyme (70 and 180 min), and four after high-dose enzyme replacement
      (120-230 min, median 155). Altered gut hormone secretion may play a role in the
      pathophysiology of intestinal dysmotility in patients with cystic fibrosis.

PMID- 1735335
TI  - Short-chain fatty acids do not alter jejunal motility in man.
AB  - Short-chain fatty acids (SCFAs) alter ileal and colonic motility, but their
      effects on duodenojejunal motility are unknown. Simultaneous jejunal manometric
      recordings and hydrogen breath tests after lactulose were performed in eight
      healthy subjects during continuous duodenal infusion of either saline or SCFAs.
      These experiments were conducted in the fasting state and postprandially. The
      effects of various boluses of SCFAs on duodenojejunal motility were also
      determined in six subjects. During the fasting period, the number and
      characteristics of migrating motor complex, prolonged propagated contractions,
      discrete clustered contractions, motility index, and orocecal transit time were
      similar during saline and SCFAs. Similarly, the motility index and the duration
      of the postprandial period were not different between SCFAs and saline after the
      meal. The motility index was significantly increased after each of the 100-ml
      boluses (saline or SCFAs), but was not altered after the 12.5-ml boluses,
      suggesting a volume-related effect. Thus, SCFAs do not seem to affect proximal
      small bowel motility in healthy humans.

PMID- 1735336
TI  - Effects of the prodrug loperamide oxide, loperamide, and placebo on jejunal motor
      activity.
AB  - This crossover, double-blind study investigated the effects of single oral doses
      of the prodrug loperamide oxide, which is reduced gradually to loperamide in the
      intestine, and loperamide on jejunal motor activity in 12 fasting healthy men.
      Five minutes after a phase III of the migrating motor complex (MMC), 2 mg
      loperamide oxide, 4 mg loperamide oxide, 4 mg loperamide, or placebo were
      administered. Thereafter, motor activity 10-30 cm abroad the ligament of Treitz
      was recorded with five catheter orifices at 3-cm intervals over 4 hr. Number of
      contractions and area under curve increased significantly with 4 mg loperamide
      and 4 mg loperamide oxide, the increases with loperamide oxide occurring more
      gradually. Placebo and 2 mg loperamide oxide had no discernible effects. With
      both 4 mg loperamide and 4 mg loperamide oxide, phase I of the MMC was slightly
      prolonged and phase II and the time from drug administration to the onset of the
      first phase III slightly shortened. The percentage of aborally propagated
      contractions in phase II increased with all active treatments, whereas the
      occurrence of phases III was not altered.

PMID- 1735337
TI  - Mucosal protective effects of vitamin E and misoprostol during acute radiation
      induced enteritis in rats.
AB  - Cytotoxic effects of ionizing radiation on gastrointestinal epithelium may be
      mediated by oxygen free radicals. Therapeutic intervention directed toward
      oxidant scavenging and increasing tissue oxygen tension may provide a novel
      approach to management. We investigated the effects of a nonenzymatic oxygen
      radical scavenger (vitamin E) and an exogenous PGE1 analog known to increase
      mucosal blood flow (misoprostol) on acute radiation enteritis. Rats were
      pretreated with: (1) vitamin E, (2) misoprostol, or (3) a combination of both
      agents prior to 10 Gy abdominal radiation. Three days following irradiation, net
      fluid absorption using in vivo isolated loops, mucosal histology, and mucosal
      morphometry using a computerized videoplan were determined in jejunum, ileum, and
      colon. Nonirradiated control intestine demonstrated net fluid absorption in all
      segments, which was not altered by vitamin E and/or misoprostol treatment.
      Irradiation significantly reduced net fluid absorption in jejunum, ileum, and
      colon. Vitamin E administered prior to irradiation maintained jejunal, ileal, and
      colonic fluid absorption near control levels. In contrast misoprostol or a
      combination of vitamin E and misoprostol did not provide protection against the
      injury caused by abdominal irradiation. Alterations in intestinal fluid
      absorption occurred without significant changes in histologic or morphometric
      appearance. In conclusion, ionizing radiation reduces in vivo intestinal fluid
      absorption without significant changes in histologic or morphometric appearance.
      Treatment with vitamin E, but not misoprostol, protects gastrointestinal mucosa
      against radiation-induced absorptive injury.

PMID- 1735338
TI  - Analysis of clinical course of postoperative recurrence in Crohn's disease of
      distal ileum.
AB  - In the present study we have investigated whether in patients with Crohn's
      Disease the clinical course remains the same from the initial disease to
      postoperative recurrent disease. Fifty-eight resected patients who developed a
      postoperative recurrence were followed for 4.2 +/- 3 years (median 3 years). The
      yearly frequency of flare-up was 1.9 +/- 1.0 (median 1.5) in the initial disease
      and 1.7 +/- 1.0 (median 1.7) in recurrent disease. In patients who experienced
      complications during the initial disease, the frequency of complications during
      the course of recurrent disease was significantly higher than in the others
      (27/42 vs 3/16, P = 0.002). The frequency of obstruction and extraintestinal
      manifestations in the recurrent disease was higher in patients who suffered these
      complications in the initial disease than in those who did not (19/29 vs 6/29, P
      = 0.0006, and 4/5 vs 4/53, P = 0.0008). The cumulative probability of
      complication during the course of recurrent disease was higher in patients with
      complications during the initial disease (P less than 0.001). The survival
      analysis showed that the cumulative probability of obstruction and
      extraintestinal complication in recurrent disease was higher in patients who
      suffered these complications in the initial disease (P less than 0.005). These
      data indicate that the clinical course of Crohn's disease of the distal ileum
      remains the same from the initial disease to postoperative recurrent disease.
      This study also suggests that the short-term course of recurrent disease can
      reasonably be predicted.

PMID- 1735339
TI  - Evaluation of hepatic density change by dynamic CT in healthy humans and in
      patients with chronic liver diseases.
AB  - Dynamic computed tomography using 0.4 ml/kg of 65% meglumine diatrizoate was
      performed to estimate pharmacokinetics of contrast media in the liver in healthy
      controls (N = 11), in patients with chronic viral hepatitis (N = 17), posthepatic
      liver cirrhosis (N = 21), and alcoholic liver cirrhosis (N = 23). The time of
      peak enhancement (the time interval between peak aortic and liver enhancement)
      was significantly different between each group. Alcoholic liver cirrhosis was the
      most prolonged, followed by posthepatic liver cirrhosis, chronic viral hepatitis,
      and finally controls. A peak enhancement time of 28 sec had a diagnostic accuracy
      of 97% for chronic liver diseases. A time greater than 44 sec had a diagnostic
      accuracy for cirrhosis of 96%. The decay time (the time from peak enhancement of
      the liver to the curve's center of gravity) was also significantly different
      between each group. Again, alcoholic liver cirrhosis was the longest, followed by
      posthepatic liver cirrhosis, chronic viral hepatitis, and then the controls.
      Dynamic computed tomography has many potential applications in studying
      intrahepatic physiologic events and may contain diagnostic information for
      chronic liver diseases.

PMID- 1735340
TI  - Measurement of bile acid half-life using [75Se]HCAT in health and intestinal
      diseases. Comparison with [75Se]HCAT abdominal retention methods.
AB  - The diagnostic values in detecting terminal ileum dysfunction using [75Se]HCAT
      have been assessed for two different scintigraphic techniques in 58 subjects. The
      measurement of [75Se]HCAT T1/2 in the enterohepatic circulation by daily
      gallbladder scintigraphy showed 78% sensitivity, 96% specificity, 96% positive
      predictive value, and 78% negative predictive value at the optimal cutoff level
      of 2.0 days; lower--but not significantly different--figures were observed for
      [75Se]HCAT total abdominal retention four and seven days after isotope
      administration, at the optimal cutoff levels of 40% and 22%, respectively.
      [75Se]HCAT T1/2 was then evaluated in 60 patients with various intestinal
      diseases. Sixty-nine percent (9/13) of patients with diarrhea of obscure origin
      showed abnormal [75Se]HCAT T1/2. Bile acid malabsorption using [75Se]HCAT can be
      investigated by the noninvasive measurement of its enterohepatic T1/2 and may
      play a pathogenetic role in patients with diarrhea of obscure origin.

PMID- 1735341
TI  - Regulation of surface expression of high-affinity receptors for epidermal growth
      factor (EGF) in hepatocytes by hormones, differentiating agents, and phorbol
      ester.
AB  - Freshly isolated adult rat hepatocytes exhibit a nonhomogeneous population of
      epidermal growth factor (EGF) receptors with about 10,000 high-affinity binding
      sites (Kd 20 pM) and about 200,000 low-affinity sites (Kd 600 pM) per cell. With
      culturing as primary monolayers under conditions where the cells show a marked
      increase in the sensitivity to the growth-stimulatory effect of EGF, a gradual
      reduction in the number of EGF receptors and an almost complete loss of high
      affinity EGF receptors is seen. Insulin, which promotes growth of hepatocytes in
      concert with EGF, enhances the down-regulation of these high-affinity receptors.
      The differentiating (and growth-inhibitory) agent n-butyrate counteracts this
      down-regulation and preserves the high-affinity receptors. This effect of
      butyrate is synergistic with the glucocorticoid agent dexamethasone. Another
      differentiating agent, dimethylsulfoxide (DMSO), also counteracts the down
      regulation of high-affinity EGF receptors. Moreover, the tumor promoter,
      tetradecanoylphorbol acetate (TPA), down-regulates the EGF receptor. This effect
      is particularly evident when studying the high-affinity receptors up-regulated by
      prior treatment with butyrate plus dexamethasone. Taken together these results
      provide strong support for the notion that an inverse relationship exists between
      expression of high-affinity EGF binding and responsiveness to growth activation
      by EGF.

PMID- 1735342
TI  - Outcome of hepatic amebic abscesses managed with three different therapeutic
      strategies.
AB  - Three different approaches to hepatic abscesses due to Entamoeba histolytica were
      compared in 51 patients. The three modes of therapy utilized were: medical
      therapy with nitroimidazoles (N = 11 patients), open surgical drainage (N = 9
      patients), and percutaneous drainage using ultrasound guidance followed by
      intralesional nitroimidazole administration (N = 31 patients). The results with
      each form of therapy were assessed clinically and by abdominal ultrasound.
      Patients receiving combined US-guided drainage and intralesional chemotherapy
      experienced a faster and overall better clinical response, which was confirmed
      also by sonographic follow-up of the hepatic lesions. This better response was
      associated with faster resolution, fewer relapses, and less residual hepatic
      scarring than either with medical therapy alone or open surgical drainage
      combined with medical therapy.

PMID- 1735343
TI  - Hepatobiliary excretion of bacterial formyl-methionyl peptides in rat. Structure
      activity studies.
AB  - The bacterial chemotactic peptide formyl-met-leu-phe and its radioiodinated
      analog formyl-met-leu-[125I]tyr are rapidly excreted by the liver into bile
      following portal or systemic venous infusions in rats or after absorption from
      the gut lumen. To determine the molecular structural requirements for
      hepatobiliary excretion of formyl-methionyl peptides, structure-activity studies
      using portal venous infusions of 24 structural analogs of formyl-met-leu-tyr were
      performed in rats with biliary cannulae. Hepatic extraction of peptides was
      studied in vivo using external gamma counting after portal infusion. Efficient
      hepatobiliary excretion was not restricted to bioactive formyl peptides, but
      showed a broad specificity for different amino-acylated (formyl, acetyl,
      propionyl, carbobenzoxy) di- and tripeptides and no requirement for methionine in
      position one or for a free carboxy terminus. However, nonacylated peptides and an
      acyl-amino acid showed little excretion. Hepatic extraction of peptide was also
      related to N-acylation. Hepatic extraction and excretion of N-acyl peptides were
      also related to hydrophobicity. Thus, the presence of an N-acyl group is the key
      determinant of biliary excretion of inflammatory bacterial f-met peptides in the
      rat.

PMID- 1735344
TI  - Sphincter of Oddi dysfunction and unexplained abdominal pain: clinical and
      manometric study.
AB  - Unexplained, biliary-type abdominal pain is often attributed to an abnormal
      pressure profile of the sphincter of Oddi. In spite of this assumption, the true
      prevalence of this type of motor dysfunction among cholecystectomized patients
      with unexplained abdominal pain is not known. We studied 64 postcholecystectomy
      patients who were thought to have sphincter of Oddi dysfunction. Radiologically,
      other than a dilated common bile duct in some, they had no anatomic derangement
      of their pancreatobiliary tract to explain their symptoms. They were categorized
      into three groups on the basis of four objective findings suggesting abnormal
      biliary emptying mechanism. Basal sphincter of Oddi pressure, frequency of phasic
      contractions, and proportion of retrograde contractions were determined in all
      patients. Twenty-six (41%) of the patients demonstrated at least one motor
      abnormality, 16 (25%) had two, and 10 (16%) had all three abnormal parameters.
      The pressure profile of the sphincter was normal in 38 or 59% of the patients.
      Seventy-three percent (73%) of the patients in group I, who had three or four of
      the objective findings for sphincter of Oddi dysfunction, demonstrated at least
      one motor abnormality. Sixty percent of this group demonstrated an increased
      basal sphincter of Oddi pressure. On the other hand, only 19% of the patients in
      group III, who had none of the objective findings, revealed a motor abnormality.
      Increased basal sphincter of Oddi pressure was noted in 7% of this group. We
      conclude that, sphincter of Oddi dysfunction, as diagnosed manometrically,
      explains the recurrent biliary type abdominal pain in a minority of
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735345
TI  - Gallbladder hypokinesia and normal gastric emptying of liquids in patients with
      dyspeptic symptoms. A double-blind placebo-controlled clinical trial with
      cisapride.
AB  - Gastric and gallbladder emptying after a standard liquid meal were studied in 65
      patients with early satiety, bloating, pain at the right hypochondrium or the
      epigastrium, nausea, and occasionally vomiting. Fifty normal subjects were
      studied as a control group. Gastric and gallbladder emptying were evaluated by
      means of real-time ultrasonography (RUS). Serial RUS scans were made after a 12
      hr fast and every 15 min after a standard meal for 2 hr. Patients were considered
      to have delayed gastric emptying or hypokinetic gallbladder when gastric
      diameters and gallbladder volume evaluated 45 min after meal were 2 SD above the
      corresponding mean values of the normal subject group. Fifteen patients (23%)
      were found with delayed gastric emptying and 20 (30.7%) a reduced gallbladder
      emptying. None of our patients showed delayed gastric emptying and hypokinetic
      gallbladder simultaneously. The 20 patients with reduced gallbladder emptying
      were included in a double-blind randomized, placebo controlled, change-over study
      with cisapride (10 mg three times a day) for 30 days. Cisapride treatment
      reversed the gallbladder hypomotility within the normal range while placebo did
      not change the response to meal. Symptom score improved significantly after
      cisapride and placebo. It is concluded that in dyspeptic patients with reduced
      gallbladder response to a meal cisapride may be of help in improving the kinetic
      abnormality. Dyspeptic symptoms, however, do not seem to be corrected with the
      described gallbladder motor abnormality.

PMID- 1735346
TI  - Pancreatic ductal and interstitial pressures in cats with chronic pancreatitis.
AB  - We investigated the etiology of interstitial hypertension in chronic pancreatitis
      by examining the relationship between pancreatic ductal and interstitial
      pressures in cats. The main pancreatic duct was cannulated in the tail of the
      gland and perfused at 1, 2, or 5 ml/hr, to simulate pancreatic secretion.
      Intraductal and interstitial pressures were measured in four groups of animals:
      (1) normal cats; (2) normal cats after acutely narrowing the main duct to 25% of
      its original diameter; (3) normal cats after encasing the body and tail in a
      rigid latex capsule; and (4) cats with chronic pancreatitis created by narrowing
      the main duct five weeks earlier. Duct perfusion increased intraductal pressure
      in all of the cats, but significantly more in groups 2, 3, and 4 compared to
      group 1. Pancreatic interstitial pressure was unchanged by duct perfusion in
      groups 1 and 2, but increased in groups 3 and 4. We concluded that the compliant
      tissue of the normal pancreas expanded to effectively dissipate the increase in
      duct pressure associated with duct perfusion. In chronic pancreatitis, the
      inelastic parenchyma and capsule limited the distensibility of the gland, which
      resulted in elevated interstitial pressures during duct perfusion.

PMID- 1735347
TI  - Protective effect of antithrombin III in acute experimental pancreatitis in rats.
AB  - In the present study we investigated the therapeutic action of antithrombin III
      (AT III) in taurocholate-induced experimental pancreatitis with high lethality in
      rats. High-dose AT III treatment greatly improved the survival rate not only when
      given as pretreatment but also when given 2 hr after induction. No favorable
      effect on survival rate was observed on administration after 5 hr. Both
      intravascular and intraperitoneal AT III administration locally restored
      decreased AT III levels in the peritoneal cavity and increased plasma AT III to
      supranormal levels. The primary pancreatic insult seemed to be unaffected by the
      treatment, because neither the rise in plasma lipase nor the development of
      ascites or the extension of the pancreatic necrosis were diminished. Because
      heparin pretreatment of the rats was also effective, the mechanism of the
      beneficial action was probably mediated by inhibition of the proteases of the
      coagulation cascade, thereby preventing intravascular coagulation in the pancreas
      and distant organs and subsequent systemic complications. The high efficacy of AT
      III treatment in this experimental model may stimulate clinical studies
      evaluating the efficacy of AT III treatment in an early stage of acute
      pancreatitis.

PMID- 1735348
TI  - Serum pancreatic enzymes in HIV-seropositive patients.
AB  - Serum concentrations of trypsin and elastase I were determined in 109 HIV Ab
      positive patients (52 asymptomatic HIV-infected patients, 25 with lymphadenopathy
      syndrome, and 32 with acquired immunodeficiency syndrome) to assess the
      prevalence of possible pancreatic damage in these patients. Serum trypsin was
      abnormally elevated in 46 of the 109 patients (42.2%): 19 of the 52 asymptomatic
      HIV-infected patients (36.6%), 9 of the 25 with lymphadenopathy syndrome (36%),
      and 18 of the 32 with acquired immunodeficiency syndrome (56.3%). Serum elastase
      1 was elevated in 14 of the 109 HIV Ab-positive patients (12.8%): 3 of the 52
      asymptomatic HIV-infected patients (5.8%), 3 of the 25 with lymphadenopathy
      syndrome (12%), and 8 of the 32 with acquired immunodeficiency syndrome (25%).
      None of the patients with abnormally high serum pancreatic enzyme concentrations
      had clinically evident pancreatic disease. There was no statistically significant
      difference in serum levels of trypsin and elastase I between drug addicts and
      nonaddicts, between alcoholics and nonalcoholics, or between those with
      cytomegalovirus infection and those without. A significant inverse relationship
      was found between serum enzyme concentrations and the number of CD4+ lymphocytes.
      The results of this study show that high levels of serum trypsin and elastase are
      present in an elevated percentage of patients with acquired immunodeficiency
      syndrome, suggesting that the pancreas is frequently damaged in this disease. The
      finding of abnormally high serum enzyme concentrations not only in patients with
      AIDS, but also in asymptomatic carriers and in patients with lymphadenopathy
      syndrome suggests an association between HIV infection and the development of
      pancreatic lesions.

PMID- 1735349
TI  - Manometric patterns using esophageal body and lower sphincter characteristics.
      Findings in 1013 patients.
AB  - In order to determine the actual spectrum of abnormal esophageal motility,
      manometric patterns in 1013 consecutive tracings were established using a
      classification method that employs esophageal body and lower esophageal sphincter
      (LES) characteristics. Peristaltic performance and contraction wave parameters
      were measured in the esophageal body; basal pressure and relaxation were included
      for the LES. Nine hundred thirty (92%) of the tracings could be completely
      classified, and 33 different patterns were observed (915 occurring at a rate
      greater than 1%). Abnormalities were most common in contraction wave parameters
      (661 tracings, 65%), and least common in LES relaxation (105 tracings, 10%).
      Patterns most typical of achalasia and diffuse esophageal spasm were found in
      6.4% and 5.0% of tracings, respectively. Statistical analysis of the patterns
      demonstrated that significant bidirectional predictive associations between
      categories were restricted to features representing pathology-based motor
      disorders (ie, achalasia and "scleroderma-esophagus"). This systematic
      classification method is capable of recognizing and cataloging common findings of
      motor dysfunction in the esophageal body and LES as well as uncommon patterns
      representing traditional motility disorders. Our findings provide reference data
      for clinical esophageal manometry.

PMID- 1735350
TI  - Randomized, double-blind, placebo-controlled crossover trial of pirenzepine in
      patients with gastroesophageal reflux.
AB  - A muscarinic receptor subtype 1 (M1) antagonist, pirenzepine, recently has been
      shown to be relatively free of the usual anticholinergic side effects on
      esophageal smooth muscle and thus has been implicated for the treatment of
      gastroesophageal reflux disease (GERD). However, the effect of pirenzepine on
      GERD remains to be defined. Thirteen patients who demonstrated GERD in a baseline
      24-hr ambulatory intraesophageal pH monitoring study were randomized in a double
      blind crossover fashion to receive pirenzepine and placebo. An ambulatory 24-hr
      intraesophageal pH monitor was used to assess reduction in reflux (esophageal pH
      less than 4.0) with respect to position (upright vs supine), to total number of
      reflux episodes, and to episodes greater than 5 min. A significant effect for
      pirenzepine was seen for episodes greater than 5 min (t = 2.61, P = 0.023) and a
      trend towards significance was seen for total (upright and supine positions
      combined) percent time of reflux (t = 2.13, P = 0.055). Although not
      statistically significant, pirenzepine consistently showed greater reduction in
      all parameters of reflux tested. A greater reduction in percent time of reflux in
      supine vs upright positions (pirenzepine: 58.9% vs 21.4%; placebo: 43.6% vs 7.3%)
      may be clinically important in prevention of esophageal injury due to reflux in
      the recumbent position. Pirenzepine may provide a unique alternative for some
      GERD patients who may be refractory to other therapies of GERD.

PMID- 1735351
TI  - Esophageal motor dysfunction years after radiation therapy.
AB  - Well-known complications of radiation to the esophagus are acute esophagitis and
      strictures. Although radiologic studies have demonstrated motor abnormalities
      after radiation treatment, clinical aspects have not been described adequately,
      nor have manometric evaluations been reported. Clinical presentation of dysphagia
      long after treatment also has not been reported. We describe herein three
      patients who presented with dysphagia years after radiation therapy.
      Radiographic, endoscopic, histologic, and manometric studies supported our
      conclusion that these patients suffered from radiation-induced esophageal motor
      dysfunction. This report indicates the need, in the proper setting, to consider
      radiation-induced motor dysfunction as a cause of dysphagia even decades after
      radiation treatment.

PMID- 1735352
TI  - Tissue-type plasminogen activator of colonic mucosa in ulcerative colitis.
      Evidence of endothelium-derived fibrinolytic activation.
AB  - Microvascular endothelial alterations are thought to be a crucial step for
      development of hemorrhagic changes in various pathological states. In this study,
      we determined the activity and amount of tissue-type plasminogen activator (t-PA)
      in the biopsy specimens from sigmoid colon of patients with ulcerative colitis to
      evaluate endothelial alterations and vascular changes of permeability. The
      results of this investigation revealed that mucosal amount of t-PA in the active
      stage of ulcerative colitis was two- to threefold higher than in healthy
      controls, while t-PA levels in plasma samples showed no remarkable differences
      among the groups. Increased t-PA activity appeared to correlate well to the
      degree of inflammation of colonic mucosa, and t-PA amount was still increased in
      the inactive stage. The present study indicates that t-PA determination in
      colonic biopsy specimens may be useful for the evaluation of clinical activity of
      ulcerative colitis in terms of the mucosal microvascular endothelial changes.

PMID- 1735353
TI  - Squamous cell carcinoma of the pancreas. Report of an unusual case and review of
      the literature.
AB  - Squamous cell carcinoma is an uncommon form of cancer of the pancreas, comprising
      0.5-3.5% of cases. We report an unusual case that occurred in a very young woman
      and showed cystic characteristics. Interesting radiographic features included
      extensive pancreatic calcifications and pancreatic duct communication to the
      mass. A literature review of this rare form of pancreatic cancer is also
      provided.

PMID- 1735354
TI  - Effect of total hepatectomy on coagulation and glucose homeostasis in the pig.
AB  - It has been suggested recently that patients with fulminant liver failure should
      be prepared for transplantation by early hepatectomy, yet the acute effects of
      removal of the liver upon the coagulation profile and certain hormones are not
      known. This study was conducted on totally hepatectomized pigs that survived up
      to 27 hr. Measurements were made of serum insulin, plasma glucagon (IRG and GLI),
      glucose, catecholamines, and the coagulation profile. The increase in serum
      insulin was directly related to levels of plasma glucose--there was a 100-fold
      increase in animals with plasma glucose levels greater than 400 mg/100 ml and
      none when blood glucose was less than 100 mg/100 ml. Plasma glucagon showed a
      sharp transient increase within 1 hr of hepatectomy and a slow rise thereafter
      with levels apparently unrelated to serum insulin or plasma glucose. There was a
      transient increase in plasma adrenaline but a sharp continuous increase in plasma
      norepinephrine. No changes of note occurred in the coagulation profile--even
      levels of fibrinogen only declined by 20% in 27 hr. The study has shown that
      early total hepatectomy is safe as far as changes in coagulation are concerned
      but changes in serum insulin and especially plasma norepinephrine may be of more
      significance.

PMID- 1735355
TI  - Adult "idiopathic" extrahepatic venous thrombosis. Importance of putative
      "latent" myeloproliferative disorders and comparison with cases with known
      etiology.
AB  - The etiology of extrahepatic venous obstruction (EHVO) is unknown in 50% of
      cases. Recently the presence of a "latent" myeloproliferative disorder has been
      reported in adults with "idiopathic" EHVO. We evaluated the course of these
      patients to establish if any putative latent myeloproliferative disorder
      influenced the clinical course compared to those with a known cause. Among 132
      EHVO patients, 78 (59%) had a known etiology, 7 (5%) with an overt
      myeloproliferative disorder. The "idiopathic" group had 54 patients; 24 (13 men,
      11 women) were diagnosed after 15 years of age, (median 38 years, range 17-70)
      with a median follow up of 96 months (19-372). Only 2 (8%) developed an overt
      myeloproliferative disorder. These 24 had a similar pattern of bleeding and onset
      of ascites as those with known cause. In EHVO failure to diagnose a latent
      myeloproliferative disorder does not influence the course of variceal bleeding,
      and thus has little prognostic significance.

PMID- 1735356
TI  - Splenic and portal venous obstruction in chronic pancreatitis. A prospective
      longitudinal study of a medical-surgical series of 266 patients.
AB  - The aim of this study was a prospective search for splenoportal venous
      obstruction (SPVO) in a medical-surgical series of 266 patients with chronic
      pancreatitis who were followed up a mean time of 8.2 years. SPVO was
      systematically searched for using ultrasonography and then confirmed by
      angiography or computed tomography. SPVO was found in 35 patients (13.2%) but was
      symptomatic in only two. Initial obstruction involved the splenic vein in 22
      patients, the portal vein in 10, and the superior mesenteric vein in three. Since
      venous obstruction extended from the splenic to the portal vein in five patients,
      the prevalence of portal obstruction was 5.6% (15/266). Acute pancreatitis and
      pseudocysts were the probable cause of SPVO in 91.4% of our cases. Half the cases
      of splenic venous obstruction were related to pseudocysts of the caudal pancreas.
      Esophageal varices were found in two patients and gastric varices in four at the
      time of diagnosis and during follow-up. At the end of follow-up, 12 patients had
      undergone splenopancreatectomy (N = 11) or splenectomy (N = 1). Only one patient
      was operated on for massive esophageal variceal bleeding, and another patient
      died due to intractable colic variceal bleeding. In four of six patients operated
      on with portal vein obstruction, surgery was difficult due to venous collaterals.
      Ten patients were not operated on and 13 patients operated on were not treated
      for SPVO. The mean follow-up after diagnosis of SPVO for these final 23 patients
      was 28.9 months. None of these patients bled.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735357
TI  - Esophageal strictures following endoscopic variceal sclerotherapy. Antecedents,
      clinical profile, and management.
AB  - We have evaluated 169 patients with portal hypertension receiving endoscopic
      variceal sclerotherapy in order to assess the predisposing factors, clinical
      profile, and treatment response of sclerotherapy-induced esophageal strictures.
      Of the 129 patients included in the final analysis, 20 (15.5%) developed
      persistent esophageal stricture. No significant difference was found with respect
      to age, nature of sclerosant (absolute alcohol, ethanolamine oleate, or sodium
      tetradecyl sulfate), etiology of portal hypertension, Child's class, initial
      variceal score, or intensity of sclerotherapy schedule between the patients who
      developed strictures and those who did not. However, female sex (P less than
      0.01) and persistent esophageal ulceration (P less than 0.05) did predispose to
      stricture formation. Sclerotherapy-induced strictures presented with a variable
      grade of dysphagia, were always solitary, and were localized to the lower end of
      esophagus. Most of these could be dilated rapidly using Eder-Puestow metal olives
      (3.15 +/- 0.80 dilatation sessions per patient). Stricture formation did
      interrupt an effective sclerotherapy program but only temporarily, and successful
      variceal obliteration could be obtained after stricture dilatation.

PMID- 1735358
TI  - Familial primary biliary cirrhosis associated with impaired concanavalin A
      induced lymphocyte transformation in relatives. Two family studies.
AB  - The familial occurrences of biochemical and immunological abnormalities and
      histocompatibility antigens were studied in 18 healthy first-degree relatives of
      patients with primary biliary cirrhosis (PBC) in two families. In each of these
      two families, there were two members who suffered from PBC. All relatives had
      normal serum aspartate aminotransferase, alkaline phosphatase, bilirubin, total
      cholesterol, and immunoglobulins except the two, who had a mild elevation of
      alkaline phosphatase without cholestasis. Autoantibodies were present in some
      relatives; five (28%) for antithyroglobulin antibody and antithyroid microsomal
      antibody, one (6%) for antimitochondrial and antinuclear antibody, and one (6%)
      for rheumatoid factor. Abnormalities of T or B lymphocytes in peripheral blood
      were detected in two (11%) relatives. Impairment of concanavalin A-induced
      lymphocyte transformation determined by ethidium bromide fluoroassay was found in
      seven (39%) relatives, although an abnormal response for phytohemagglutinin was
      detected in none of the relatives. The HLA haplotypes were not necessarily
      associated with positive autoantibodies or impaired concanavalin A-induced
      lymphocyte transformation in these families. These findings suggest that
      impairment of concanavalin A-inducible lymphocytes (mainly suppressor T cells) is
      one of the contributing factors in the development of PBC.

PMID- 1735359
TI  - Intrafamilial variation in hereditary hemochromatosis.
AB  - A review of 57 families with hereditary hemochromatosis revealed three pairs of
      HLA-identical, sex-matched siblings in which the younger sibling demonstrated
      considerably more iron loading than the older sibling. Liver biopsy, chemical
      hepatic iron determination, iron absorption studies, and number of venesections
      required were used to support these observations. Nineteen pairs of HLA
      identical, sex-matched siblings homozygous for hemochromatosis were found in
      which the iron loading was more marked in the older sibling. There was no
      evidence of blood loss, difference in alcohol consumption, or dietary iron
      loading to explain the increased iron loading in the younger sibling. These three
      families demonstrate that the rate of iron accumulation may vary within a family
      and that the extent of iron loading in hereditary hemochromatosis is not solely
      dependent on the duration of iron accumulation.

PMID- 1735360
TI  - Changes in plasma and duodenal cholecystokinin concentrations after pancreatic
      duct occlusion in rats.
AB  - The changes in plasma and duodenal cholecystokinin (CCK) concentrations after
      pancreatic duct occlusion were examined in rats. The rats were sacrificed 1, 3,
      7, 10, 14, and 30 days after occlusion of the duct. Histological examination
      showed acute inflammation on days 1 and 3 after duct occlusion, interstitial
      fibrosis and regenerative changes on days 7, 10, and 14, and pancreatic atrophy
      on day 30. The plasma CCK concentration increased from 0.45 pM to 2.0 pM after
      the occlusion and then remained high throughout the observation period. In
      contrast to the stable increase in plasma CCK concentration, the CCK content in
      the duodenum increased on days 1 and 3, decreased on day 7, increased on day 10,
      reaching over the control level on day 14, and then returned to the control level
      on day 30. Administration of boiled and 10-fold concentrated rat pancreatic juice
      or human pancreatic secretory trypsin inhibitor for seven days after pancreatic
      duct occlusion reversed the decrease in duodenal CCK content. The major molecular
      forms of duodenal CCK were CCK-8, -33, and -58. These results indicate that (1)
      basal plasma CCK concentration did not reflect the duodenal CCK content, (2)
      duodenal CCK content was well correlated with a decrease in inflammation in the
      pancreas, and (3) a nonenzymatic component in the pancreatic juice reversed the
      decrease in duodenal CCK content and body weight caused by pancreatic duct
      occlusion.

PMID- 1735361
TI  - Helicobacter pylori and luminal gastric pH. Relationships in nonulcer dyspepsia.
AB  - The relationships between gastric pH and Helicobacter pylori infection were
      studied in 37 consecutive subjects affected with nonulcer dyspepsia. Each
      underwent esophagogastroduodenoscopy with multiple gastric biopsies for both H.
      pylori and histologic assessment, and 24-hr antral pH monitoring. H. pylori was
      harbored by 59.5% of the subjects with whole gastric spread of infection in all
      but one patient. Histologic gastritis was shown in 70.3% of the subjects. H.
      pylori was strongly associated with gastritis, both antral nonatrophic and
      multifocal atrophic. The ranges of 24-hr pH values were 1.3-6.9 in the H. pylori
      positive and 1.2-6.8 in the H. pylori-negative group. Differences in pH values
      between the two groups were not significant. Moreover, the mean percent time
      duration of pH above 2, 4, and 6 did not significantly differ between the two
      groups. Therefore, this study has shown that chronic H. pylori infection is not
      related to luminal gastric pH.

PMID- 1735362
TI  - Nonsteroidal antiinflammatory drugs and mortality from peptic ulceration in West
      Germany: 1952-1989.
AB  - Previous epidemiological studies have examined peptic ulcer mortality in West
      Germany until 1980 and reported decreasing mortality rates for young and middle
      aged people and increasing mortality rates for elderly people. Data on ulcer
      mortality until 1989 show that these trends have continued. The rise in mortality
      rates in the oldest age groups could be explained partially by their greater life
      expectancy, thus increasing the risk of lethal ulcer complications. Analysis of
      NSAID consumption in relation to the mortality pattern shows that there is an
      inverse correlation between NSAID consumption as measured by the number of
      prescriptions and peptic ulcer mortality. It is concluded that NSAID consumption
      is not responsible for the mortality pattern of peptic ulcer in West Germany.

PMID- 1735363
TI  - Intragastric nicotine protects against 40% ethanol-induced gastric mucosal injury
      despite pretreatment with propranolol or N-ethylmaleimide in rats.
AB  - We tested the hypotheses that the protective effect of intragastric nicotine
      against ethanol-induced gastric mucosal injury is dependent on propranolol- or N
      ethylmaleimide-sensitive mechanisms. Propranolol was administered in doses (2 and
      20 mg/kg) that provided dose-related blockade of beta-adrenoceptors (significant
      decreases in heart rate). N-Ethylmaleimide was administered in doses that
      previously had been shown to increase gastric vascular permeability (10 mg/kg) or
      inhibit gastric mucosal sulfhydryl compounds (50 mg/kg). At 0.5 hr after these or
      control subcutaneous pretreatments, the rats received intragastric nicotine (4
      mg/kg) or vehicle. One hour later 40% ethanol was given intragastrically. The
      gastric corpus mucosal lesions were recorded by polaroid photographs after
      another hour, and their areas measured unbiasedly by computerized image analysis.
      The results showed that N-ethylmaleimide, but not propranolol, aggravated ethanol
      induced gastric mucosal injury. The protective effect of intragastric nicotine
      was not modified by either pretreatment. We conclude that the mechanism mediating
      intragastric nicotine protection against 40% ethanol-induced gastric mucosal
      injury is independent of propranolol- or N-ethylmaleimide-sensitive mechanisms.

PMID- 1735364
TI  - Role of endogenous secretin and cholecystokinin in intraduodenal oleic acid
      induced inhibition of gastric acid secretion in rats.
AB  - We investigated a possible role of endogenous secretin and cholecystokinin (CCK)
      in inhibition of gastric acid secretion induced by intraduodenal administration
      of oleic acid in rats. Intraduodenal administration of oleic acid emulsion in a
      dose of 1 mmol/hr resulted in significant inhibition of gastric acid secretion
      stimulated by intravenous infusion of pentagastrin (0.3 micrograms/kg/hr), and
      this was accompanied by an increase in the plasma concentration of both secretin
      and CCK, from 1.2 +/- 0.08 pM and 20.6 +/- 1.2 pM to 4.3 +/- 0.18 pM and 31.6 +/-
      0.9 pM, respectively (P less than 0.001). Intravenous infusion of secretin (0.05
      CU/kg/hr) inhibited pentagastrin-stimulated gastric acid secretion, but CCK-8
      (0.03 micrograms/kg/hr) failed, although intravenous infusion of secretin and CCK
      in those doses produced plasma levels comparable to the levels achieved in
      response to oleic acid administration. Furthermore, the oleic acid-induced
      suppression of gastric acid secretion was blocked significantly by intravenous
      injection of rabbit anti-secretin serum (0.1 ml), but not by intravenous infusion
      of a CCK-receptor antagonist, CR 1409 (5 mg/kg/hr). Thus, the results of this
      study indicate that endogenous secretin rather than CCK is involved in the
      hormonal mechanism regulating the inhibition of gastric acid secretion by
      intestinal fat in rats.

PMID- 1735365
TI  - Neurotensin prevents intestinal mucosal hypoplasia in rats fed an elemental diet.
AB  - Liquid elemental diets are associated with mucosal hypoplasia of both the small
      intestine and colon. Neurotensin, a tridecapeptide widely distributed in the gut,
      is trophic for the small intestine of rats fed a normal chow diet. The purpose of
      this study was to determine whether neurotensin could reverse the hypoplasia of
      intestinal mucosa that is associated with feeding a liquid elemental diet. Forty
      male Sprague-Dawley rats were randomized into five groups. Four groups were fed
      (for seven days) a glutamine-free liquid elemental diet. Subcutaneous injection
      of saline (control) or neurotensin (33, 100 or 300 micrograms/kg) were given to
      the groups of rats every 8 hr for seven days. Group five (Chow) received rat chow
      ad libitum for seven days. Rats were killed on day 8, and the proximal jejunum,
      distal ileum, and proximal colon removed. Mucosal weight, DNA, RNA, and protein
      contents were determined. Neurotensin (300 micrograms/kg) increased the
      cellularity of the small intestinal mucosa and reversed mucosal hypoplasia due to
      an elemental diet; a more pronounced effect was noted in the jejunum compared to
      the ileum. Neurotensin (33 and 100 micrograms/kg) increased mucosal DNA content
      in the jejunum but was not effective in reversing the hypoplasia. Neurotensin had
      no effect on growth of colonic mucosa. These results suggest that neurotensin may
      be an important trophic hormone for the small intestine. Administration of
      neurotensin may alleviate hypoplasia of the small bowel mucosa and maintain
      functional integrity of the gut during prolonged feeding of an elemental diet.

PMID- 1735366
TI  - PAF-acether and acetylhydrolase in stool of patients with Crohn's disease.
AB  - PAF-acether (PAF) is a phospholipid mediator with potent biological effects on
      the digestive tract. We report the presence of PAF in stool of patients with
      active Crohn's disease (39.1 +/- 13.5 ng/g of stool, mean +/- SEM, N = 19) and
      its absence in patients with irritable bowel syndrome with diarrhea and diarrhea
      with malabsorption. Fecal PAF acetylhydrolase activity was higher (P less than
      0.04) in patients with Crohn's disease as compared to patients with irritable
      bowel syndrome with diarrhea and diarrhea with malabsorption. We also report a
      solid-phase extraction of fecal PAF using silica minicolumns, which yielded
      results highly correlated with those obtained with a high-performance liquid
      chromatography method (r = 0.86, P less than 0.001, N = 16). These findings may
      allow us to implicate PAF in the onset and perpetuation of digestive tract
      inflammatory symptoms observed during Crohn's disease. They would warrant to
      investigate the influence of various therapeutic agents, including PAF
      antagonists, on fecal PAF levels during inflammatory digestive ailments.

PMID- 1735367
TI  - Reinnervation of villi of rat jejunum following severe mucosal damage.
AB  - We studied the time course of the regeneration of the jejunal mucosa of the rat
      after it was damaged by exposure to the surfactant, benzalkonium chloride. We
      placed particular emphasis on assessing the morphology of the nerve fibers within
      the villi during and after regeneration. The application of benzalkonium chloride
      resulted in virtually complete loss of villi within the treated segment; however,
      the crypts were only partially damaged. The mucosa began to regenerate within 6
      hr of the insult. The villus lengths and crypt depths returned to pretreatment
      values within two to four days. The mucosal innervation was assessed through
      immunohistochemistry for vasoactive intestinal peptide (VIP), neuropeptide Y
      (NPY), and neuron-specific enolase (NSE). At all stages of regeneration, VIP,
      NPY, and NSE immunopositive fibers within the lamina propria extended to the tips
      of the villi. The density of the immunopositive fibers in the lamina propria at
      four days after mucosal insult was similar to that in control tissues regardless
      of the neuronal marker visualized. We conclude that the nerve fibers innervating
      the small intestinal mucosa grow at a rate of approximately 100 microns/day and
      that the entire length of each villus contains nerve fibers throughout the
      regeneration process. The innervation of the regenerated mucosa appears identical
      to that of control mucosa.

PMID- 1735368
TI  - Duodenal varices. A neglected cause of massive, recurrent gastrointestinal
      bleeding.
AB  - Bleeding from duodenal varices in portal hypertension may not be recognized,
      resulting in a delay in diagnosis. Early detection is important as duodenal
      varices are a potential source of massive hemorrhage. We report two cases with
      recurrent upper gastrointestinal hemorrhage in whom accurate diagnosis was made
      only after extensive investigation including repeated endoscopic examination.

PMID- 1735369
TI  - Acute upper gastrointestinal hemorrhage caused by gallstone impaction in the
      duodenal bulb.
AB  - An unusual case of upper gastrointestinal hemorrhage caused by gallstone
      impaction in the duodenal bulb (Bouveret's syndrome) is reported. Endoscopy was
      used to make the diagnosis rapidly and surgery was performed to provide
      definitive treatment. Bouveret's syndrome must be kept in mind as a rare cause of
      upper gastrointestinal hemorrhage.

PMID- 1735370
TI  - Chronic intestinal pseudoobstruction with myopathy and ophthalmoplegia. A
      muscular biochemical study of a mitochondrial disorder.
AB  - The association of chronic intestinal pseudoobstruction with ophthalmoplegia has
      been reported previously in visceral myopathies. We report a case of this
      association in which muscle mitochondria had a crystalline appearance, a dense
      core, and decreased cytochrome c oxidase and succinate cytochrome c reductase
      activities. The absence of evident mitochondrial DNA deletion in the skeletal
      muscle of this patient does not exclude the possibility of localized deletion or
      mutation of mitochondrial DNA in digestive muscle.

PMID- 1735371
TI  - Familial visceral myopathy. A family with involvement of four generations.
AB  - A family with the autosomal dominant form of familial visceral myopathy is
      described involving four generations. The members illustrate several different
      clinical presentations including severe constipation, diarrhea, alternating
      constipation and diarrhea, volvulus, urinary tract infection, and retention of
      urine. One patient's history suggested that the uterus may have been involved.
      Diagnosis of this rare disease requires an awareness of the variable presentation
      and a careful histological examination of full-thickness sections of bowel. The
      potential pitfalls in both histological and clinical diagnosis of this condition
      are demonstrated in this family's history. The extensive involvement of small and
      large bowel in at least two family members is unusual in the autosomal dominant
      form of the disease, but their course has so far been favorable, lending further
      evidence to the impression that prognosis is good. This is of importance for
      genetic counseling of families who have this very rare disease.

PMID- 1735372
TI  - Villous adenomatosis of duct of Wirsung revealed by wirsungorragie: evolution and
      surgical management.
AB  - A patient presenting with wirsungorragie was found to have a villous adenoma of
      the duct of Wirsung. The lesion was treated by a left pancreatectomy. Five years
      later he presented with recurrent wirsungorragie and was found to have a villous
      adenomatosis of the main pancreatic duct and of its side branches. This time a
      Whipple procedure was performed, achieving a total pancreatectomy. The patient
      has remained well for 12 months. This case of villous adenomatosis is, to our
      knowledge, the first one to be revealed by a wirsungorragie.

PMID- 1735373
TI  - Fulminant hepatic failure in nonmetastatic renal cell carcinoma.
AB  - Paraneoplastic manifestations including reversible abnormal serum liver
      biochemistry are known to occur in at least one third of patients with renal cell
      carcinoma. This hepatic dysfunction has always been regarded as benign in nature
      and attributed to reactive nonspecific hepatitis. In contrast to this belief, we
      report here a more devastating course of an asymptomatic patient with
      nonmetastatic renal cell carcinoma which ranged from mere serum liver
      biochemistry derangement to a fatal end with fulminant hepatic failure within 10
      days. To our knowledge, this is the first report of such a case.

PMID- 1735374
TI  - [The endoscopic treatment of malignant biliary tract stenoses with
      endoprostheses].
AB  - In 65 patients (36 men, 29 women; mean age 74 [43-90] years) obstructive jaundice
      caused by malignant biliary stenosis was treated by endoscopic retrograde
      insertion of a 10 or 12 F synthetic endoprosthesis. The rate of complications of
      the endoscopic intervention was 5% (n = 3), 30-day mortality rate was 11% (n = 7)
      and method-related mortality was 8% (n = 5). Good drainage was achieved in 39 of
      41 patients (95%) with the 12 F endoprosthesis, and in 15 of 21 patients with a
      10 F one (71%) (P less than 0.001). Renewed jaundice due to prosthesis occlusion
      occurred in 31 patients an average of 103 (11-350) days after placement. Interval
      until occlusion correlated with the site of the stenosis and the length of the
      endoprosthesis. Jaundice recurred earlier in patients with long prostheses and
      proximal biliary stenosis than in those with a short prosthesis and distal
      stenosis. In 20 patients with renewed jaundice the endoprosthesis was replaced
      endoscopically. At that time 13 of the patients had a cholangitis. Occlusion of
      the new endoprosthesis was more common in patients with cholangitis (9 of 13)
      than those without (2 of 7; P less than 0.05). These findings indicate that
      endoscopic biliary tract drainage should be performed with as short a 12 F
      endoprosthesis as possible. In view of the potential need for early change of
      endoprosthesis the biochemical parameters of cholestasis should be regularly
      monitored.

PMID- 1735375
TI  - [Transient complete AV block as a sequela of Borrelia myocarditis].
AB  - A 49-year-old man suddenly developed dyspnoea, sweating, fever (up to 38.5
      degrees C), vertigo and angina. After emergency admittance to hospital the ECG
      showed 3 degrees A-V block, requiring temporary pacemaker insertion. The patient
      reported that a month before he had been bitten, probably by a tick. Serological
      tests demonstrated a recent Borrelia infection (rise of IgG antibody titre to
      1:2048, IgM antibody titre to 1:128). Coronary angiography excluded any
      haemodynamically significant coronary heart disease as a cause of the conduction
      disorder. Myocardial biopsy showed changes pointing to a past myocarditis. This
      suggested Borrelia infection as the cause of the complete A-V block. Under
      treatment with broad-spectrum antibiotics for 15 days the fever subsided and the
      ECG became normal. Shortly before discharge, an elevated pulmonary wedge pressure
      on 150 W exercise indicated persistence of mild left-ventricular failure.

PMID- 1735376
TI  - [The therapy of advanced breast carcinoma in men].
AB  - Four men (mean age 50 [42-57] years) were treated for advanced carcinoma of the
      breast, two of them by chemotherapy alone. Survival time in the latter two after
      start of the chemotherapy was 5 and 8 months, respectively. The third patient
      received both hormone and chemotherapy from the start because of unfavourable
      prognostic criteria. For 15 months the tumour stage remained unchanged until the
      patient developed incomplete paraplegia which improved greatly after
      decompression laminectomy. This has been followed for four months by renewed
      hormonal and chemotherapy. The fourth patient received tamoxifen for seven
      months, with intrapleural administration of cytostatic agents and finally
      pleurectomy for recurrent malignant pleural effusions. For 4 months he has again
      been receiving hormonal and chemotherapy. These cases illustrate that if there
      are unfavourable prognostic criteria chemotherapy should be added to conventional
      hormone therapy.

PMID- 1735377
TI  - [The therapy of corrosive esophageal burns].

PMID- 1735378
TI  - [Acute respiratory infections by Chlamydia pneumoniae].

PMID- 1735379
TI  - [The consideration of physicians in practice in the classification of senior
      physicians according to the Federal Employees Collective Wage Agreement. The
      judgement of the Wupperthal Labor Court of 24 January 1990].

PMID- 1735380
TI  - [The antiphospholipid syndrome].

PMID- 1735381
TI  - [Antirheumatics and anticoagulants].

PMID- 1735382
TI  - [Primary sclerosing cholangitis].

PMID- 1735383
TI  - [Hyperprolactinemia in malignant lymphomas].

PMID- 1735384
TI  - [Chorion villi biopsy: a boon or risky alternative in prenatal diagnosis?].

PMID- 1735385
TI  - [The chemical composition of gallstones and their suitability for litholysis and
      lithotripsy].
AB  - The chemical composition of gallstones removed at surgery from 107 patients (81
      women, 26 men; mean age 59 [18-85] years) was examined. In 64 women (79%) and 21
      men (81%) microchemical analysis demonstrated concrements with a more than 50%
      cholesterol content (500 mg/g). Using as definition of cholesterol stones a 75%
      cholesterol content, only 35 women (43%) and 10 men (39%) would be classified as
      cholesterol stone carriers. Grossly visible layer formation was present in 18
      stones; in eight stones calcium content was higher in the outer layer than in the
      core. There was no demonstrable relationship between gallstone composition and
      age.

PMID- 1735386
TI  - [The coincidence of rapidly progressing dilated cardiomyopathy and primary
      hyperparathyroidism. The course before and after the removal of a parathyroid
      adenoma].
AB  - Severe cardiac arrhythmias (Lown class IVa), rapid loss of physical capacity and
      dyspnoea on the slightest exertion occurred in a 55-year-old man with idiopathic
      dilated cardiomyopathy. In the preceding year he had recurrent diarrhoea and lost
      23 kg in weight. He was found to have hypercalcaemia (3-3.2 mmol/l). The heart
      failure significantly improved under treatment with twice daily 12.5 mg
      captopril, 100 mg spironolactone daily, furosemide 40 mg twice daily, and
      digitoxin 0.07 mg daily. The arrhythmia responded to verapamil 80 mg and
      quinidine 160 mg, both drugs three times daily. Primary hyperparathyroidism was
      found to be the cause of the hypercalcaemia (parathormone 84 pmol/l). After the
      parathyroid adenoma had been removed the patient's condition again improved
      markedly. There were only rare monotopic extrasystoles, cardiac size regressed,
      and diuretics were no longer necessary. His medication at present is verapamil
      (80 mg three times daily), captopril (12.5 mg three times daily) and digitoxin
      (0.07 mg daily). It is concluded that the hypercalcaemia influenced the severity
      of the cardiomyopathy. It would seem that both intra- and extracellular calcium
      homoeostasis is of great importance in dilated cardiomyopathy.

PMID- 1735387
TI  - [Hemangiosarcoma of the liver. The diagnostic difficulties and therapeutic
      possibilities].
AB  - A 65-year-old man complained of decreasing physical capacity and weakness over
      the preceding six months, associated with marked painless jaundice and
      subsequently ascites. Despite extensive tests, some invasive, in three different
      hospitals no cause was found of the patient's symptoms and the marked though
      nonspecific abnormalities of various biochemical values (raised bilirubin
      concentration; increased alkaline phosphatase activity). Liver transplantation
      was performed because of progressive liver failure, without a firm diagnosis
      being established. At operation the liver was found to contain a
      haemangiosarcoma. The patient died 14 months after the transplantation of a
      suppurative cholangitis. At autopsy neither metastases nor recurrences were
      found.

PMID- 1735388
TI  - [The modern diagnosis of malignant melanoma].

PMID- 1735389
TI  - [Premedication before endoscopies].

PMID- 1735390
TI  - [The prescription of substitute drugs for the drug-dependent].

PMID- 1735391
TI  - [Fish poisoning: the causal role of histamine].

PMID- 1735392
TI  - Environmental Mutagen Society, 23rd annual scientific meeting. Reno, Nevada,
      March 15-19, 1992. Abstracts.

PMID- 1735393
TI  - Acid-base status following glycine absorption in transurethral surgery.
AB  - Forty patients were studied at precisely timed 10 min intervals during
      transurethral prostatic resection under epidural analgesia. Blood gases, serum
      sodium, and volumetric irrigating-fluid balance were measured. A decrease in the
      serum sodium level of less than 5 mmol litre-1 was recorded in 28 patients (the
      'normal TUR' group). In 12 patients, the decrease was 5 mmol litre-1 or more,
      which corresponded to an average absorption of irrigant of 1 litre of 2.2%
      glycine solution (range 0.6-2.9; the 'absorption' group). Mild metabolic acidosis
      often developed during the operations, but this was of similar degree in the two
      groups. It was concluded that uptake of irrigating fluid containing glycine does
      not alter the acid-base status so long as the TUR syndrome does not develop.

PMID- 1735394
TI  - General anaesthesia versus epidural anaesthesia for primary caesarean section--a
      comparative study.
AB  - Forty-seven healthy parturients undergoing elective Caesarean section were
      randomly allocated to either general anaesthesia (n = 24) or epidural anaesthesia
      (n = 23) under standardized anaesthetic and surgical conditions. Seven women of
      the epidural group required additional systemic analgesia or sedation following
      delivery of the neonate. Nine of 24 newborns obtained 1-min Apgar scores below 7
      after general anaesthesia compared to only 3/23 after epidural anaesthesia. The
      time period to establish normal colour in the babies was 2.2 min after epidural
      and 4.9 min after general anaesthesia. Three of the 24 general-anaesthesia
      newborns demonstrated a tendency to hypotonia compared to only one in the
      epidural group. Twenty-four hours and 7 days after delivery all infants of both
      groups were completely normal. At the time of delivery maternal PO2 was higher in
      the general anaesthesia compared to the epidural group, due to higher inspired
      oxygen concentrations. Comparable results were obtained in umbilical PO2 venous
      values; lower pH values, however, were observed in the umbilical artery after
      general anaesthesia. There were no significant differences in the glucose levels
      between the groups. A significant correlation was established between uterine
      incision-delivery interval and 1-min neonatal Apgar scores in the general
      anaesthesia group, but not in the epidural group. Our investigation did not show
      either the incision-delivery interval or the start of operation-delivery interval
      to play a role in neonatal outcome. Epidural anaesthesia is superior to general
      anaesthesia in Caesarean section under normal conditions with regard to neonatal
      outcome. Whether this is also true for critical conditions cannot be concluded
      from this study.

PMID- 1735395
TI  - Intravenous tramadol for post-operative pain--comparison of intermittent dose
      regimens with and without maintenance infusion.
AB  - Thirty-five ASA Grade I-II females received tramadol 150 mg intravenously
      followed randomly and double-blind by an infusion of either tramadol 15 mg h-1
      (Group I) or saline (Group II) and tramadol 100 mg bolus on demand for the
      treatment of post-operative pain. Patients in Group I required 60% less tramadol
      on demand (P less than 0.01) and had better pain relief after operation (P less
      than 0.05) than those in the group given saline. Total tramadol consumption,
      however, was about 30% higher in Group I (P less than 0.05) and was associated
      with an increased incidence of minor side-effects. In both groups median serum
      tramadol concentrations peaked at 15 and 60 min and decreased after the second
      peak steadily (P less than 0.001). Tramadol failed to relieve pain within 2 h
      after the beginning of treatment in 6% (Group I) and 20% (Group II) of the
      patients. It is suggested that use of an i.v. maintenance tramadol infusion in
      addition to on-demand i.v. tramadol boluses is a safe and recommended mode of
      post-operative intravenous pain therapy.

PMID- 1735396
TI  - Comparison of intravenous diclofenac, indomethacin and oxycodone as post
      operative analgesics in patients undergoing knee surgery.
AB  - The non-steroidal anti-inflammatory drugs diclofenac, indomethacin and oxycodone
      were compared in the treatment of pain after arthroscopy or arthrotomy of the
      knee in a double-blind, randomized trial. A single and, if needed, a repeated
      dose of one of the following six dose and drug alternatives was given
      intravenously for post-operative pain relief: diclofenac 37.5 mg or 75 mg,
      indomethacin 25 mg or 50 mg and oxycodone 5 mg or 10 mg. Oxycodone 5 mg i.v. was
      used as a rescue medication whenever the patient needed further pain relief after
      the two doses of the trial drugs. The observation period was 14 h. In the
      diclofenac group the patients needed significantly less trial and rescue
      analgesics than in the indomethacin (P less than 0.001) and oxycodone (P less
      than 0.05) groups, the latter groups being equal in this respect. Both the
      duration from the first trial drug infusion to the second trial medication and to
      the first rescue medication were significantly longer in the diclofenac group
      than in the indomethacin group (P less than 0.05 and less than 0.01,
      respectively).

PMID- 1735397
TI  - Effect of chronic nifedipine therapy on the haemodynamic response to
      phenylephrine before and during halothane anaesthesia.
AB  - We evaluated the effect of chronic oral nifedipine therapy (30-80 mg day-1) on
      the haemodynamic response to the alpha 1-agonist phenylephrine (PE) in 10
      patients before and during halothane anaesthesia. The response was compared to a
      control group of eight patients not taking any cardiovascular drugs. No patients
      had ganglionic, beta-adrenergic, or muscarinic pharmacological blockade as in
      prior studies in the literature, and thus had intact cardiovascular reflexes. In
      all patients, PE caused a dose-related increase in arterial pressure and fall in
      heart rate and cardiac index. The response in patients taking nifedipine was not
      significantly different from that measured in controls. One-per-cent halothane in
      oxygen did not alter the overall haemodynamic response to PE in either group.

PMID- 1735398
TI  - Interaction between thiopentone and subhypnotic doses of ketamine.
AB  - The hypnotic effects of thiopentone and ketamine were studied in ASA Grade I
      female patients aged 20-30 without premedication. The dose-response curves of
      ketamine 0.4 mg kg-1 and thiopentone following ketamine 0.4 mg kg-1 were
      determined by probit analysis. The interaction between ketamine and thiopentone
      was found to be an antagonistic one. This effect can be interpreted as a
      consequence of the different neurophysiological spectra of action of the two
      drugs.

PMID- 1735399
TI  - Sympathetic blockade by thoracic epidural anaesthesia suppresses renin release in
      response to hypotension, but activates the vasopressin system.
AB  - To determine whether or not the blockade of sympathetic efferents by epidural
      anaesthesia blunts the normal increase in plasma renin activity in response to
      hypotension, we assessed the effect of hypotensive thoracic epidural anaesthesia
      with widespread sympathetic blockade on plasma renin activity. Plasma renin
      activity and vasopressin concentration, arterial pressure, and serum osmolality
      were measured in 17 patients before and after random epidural injection of either
      6.7 ml of 0.75% bupivacaine (n = 7) or the same volume of saline (n = 10). As an
      indicator for efferent sympathetic drive, skin temperatures were measured on the
      hand and foot. A decrease in mean arterial pressure by more than 25% of baseline
      values was prospectively defined as hypotension requiring intervention. Thoracic
      epidural anaesthesia induced a decrease in mean arterial pressure of 24 mmHg
      (range 16-47) from 101 mmHg to 77 mmHg (P less than 0.001 vs. saline). Despite
      hypotension, plasma renin activity remained unchanged [medians 2.9 ng ml-1 h-1 (0
      9.1) vs. 3.4 ng ml-1 h-1 (0-13.8)]. In contrast, vasopressin concentrations
      increased from a median of 3.8 pg ml-1 (0.5-8.2) to 6.0 pg ml-1 (4.2-33.6; P =
      0.025). Both hand and foot skin temperatures increased significantly indicating
      widespread extent of sympathetic blockade. Serum osmolality did not change. With
      epidural saline, variables remained unchanged. Thus, during hypotension induced
      by widespread attenuation of efferent sympathetic drive through thoracic epidural
      anaesthesia, renin activity did not change, whilst vasopressin concentrations
      increased significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735400
TI  - A prospective evaluation of the failure rate of spinal anaesthesia for
      transurethral prostatic resection.
AB  - The rate of failed spinal anaesthesia, defined as the need for unplanned general
      anaesthesia, was evaluated in a prospective study involving 137 patients
      undergoing transurethral resection of the prostate (TURP). The incidence of
      sensations at the operative site which did not require general anaesthesia was
      also evaluated. Attention to details was emphasized in the technique. Patients
      randomly received either hyperbaric Niphanoid tetracaine (n = 74; 6 or 10 mg) or
      hyperbaric bupivacaine (n = 61; 6 mg), with or without adrenaline. General
      anaesthesia was necessary in one patient (0.72%). Twelve additional patients
      reported sensations at the operative site which were rapidly relieved by light
      intravenous supplementation with low doses of fentanyl and/or thiopentone. The
      patients reporting sensations did not differ in demographic characteristics,
      spinal technique, local anaesthetic, or degree of sensory or motor blockade.
      Addition of adrenaline to the 6-mg doses of both tetracaine and bupivacaine
      decreased the incidence of sensations at the operative site.

PMID- 1735401
TI  - Tympanometry for middle-ear effusion in unconscious ICU patients.
AB  - Eighty-six bilateral impedance audiometries were performed weekly in 35
      unconscious ICU patients. Tympanometry showed the presence of middle-ear effusion
      in 43.3% of the examinations (80% of the patients). The incidence of effusion was
      significantly higher in patients older than 50 years, in intubated and
      mechanically ventilated patients and in the presence of microbial colonization of
      the upper airways. The acoustic reflex (AR) was characterized by increased
      threshold values in 23.8% of the examinations and was absent in 41.3%. Abnormal
      or absent ARs were usually associated with middle-ear effusion or tube
      malfunction.

PMID- 1735402
TI  - The additional work of breathing through Portex Polar 'Blue-Line' pre-formed
      paediatric tracheal tubes.
AB  - The work of breathing through north- and south-facing Portex Polar 'Blue-Line'
      paediatric tracheal tubes of sizes 3.0-7.0 mm ID has been measured using
      sinusoidal flow at equivalent ventilatory rates of 10-50 breaths min-1 with tidal
      volumes of 10-500 ml. North-facing tubes are designed to sit with the connection
      on the forehead after intubation, whilst south-facing ones are designed so that
      the connection sits on the chin of the patient. It was found that the total work
      of breathing through north-facing tubes is approximately 8% higher than the total
      work of breathing through south-facing tubes of the same size, irrespective of
      tidal volume or respiration rate. The total work of breathing was dependent on
      total tube length but independent of tube design. The endotracheal connectors
      themselves were found to contribute a significant proportion of the total work of
      breathing but there was no significant difference between the inspiratory and
      expiratory performance of the tubes.

PMID- 1735403
TI  - Influence of the pulmonary circulation on adrenaline pharmacokinetics during
      cardiopulmonary resuscitation.
AB  - The influence of the pulmonary circulation on the pharmacokinetics and -dynamics
      of endogenously released, and intravenously injected (10 micrograms kg-1), and
      endobronchially (e.b.) administered (100 micrograms kg-1) adrenaline was
      investigated in an animal cardiopulmonary-resuscitation (CPR) model. During
      resuscitation 80% of endogenously released and i.v. adrenaline was eliminated
      before reaching the arterial circulation, whereas arterial availability of
      adrenaline was higher than mixed-venous availability in the e.b.-medicated
      animals. Success of resuscitation seemed to depend on maximum adrenaline
      concentrations and drug availability in arterial blood. Although the average
      amount of endogenously released adrenaline was calculated to be equivalent to an
      i.v. bolus of 8 micrograms kg-1, additional i.v. or e.b. adrenaline medication
      resulted in higher arterial plasma concentrations, improved circulation during
      CPR, and better resuscitability. It is concluded that, even without a specific
      pulmonary metabolism, a drastic decrease in blood flow can lead to significant
      arterio-venous gradients in plasma concentrations and availability of a drug with
      a very high clearance like adrenaline.

PMID- 1735404
TI  - Physiological changes and gastro-intestinal symptoms as a result of ultra
      endurance running.
AB  - One hundred and seventy-two competitors of the Swiss Alpine Marathon, Davos,
      Switzerland, 1988, volunteered for this research project. Of these volunteers 170
      (158 men, 12 women) finished the race (99%). The race length was 67 km with an
      altitude difference of 1,900 m between the highest and lowest points. Mean age
      was 39 (SEM 0.8) years. Average finishing times were 8 h 18 min (men) and 8 h 56
      min (women). Loss of body mass averaged 3.4% body mass [mean 3.3 (SEM 0.2)%; 4.0
      (SEM 0.4)%; men and women, respectively]. Blood samples from a subgroup of 89
      subjects (6 women and 83 men) were taken prior to and immediately after
      completion of the race. Changes in haemoglobin (9.3 mmol.l-1 pre-race, 9.7 mmol.l
      1 post-race) and packed cell volume (0.44 pre, 0.48 post-race) were in line with
      the moderate level of dehydration displayed by changes in body mass. Mean plasma
      volume decreased by 8.3%. No significant changes in plasma osmolality, sodium, or
      chloride were observed but plasma potassium did increase by 5% (4.2 mmol.l-1 pre
      race, 4.4 mmol.l-1 post-race). Mean fluid consumption was 3290 (SEM 103) ml.
      Forty-three percent of all subjects, and 33% of those who gave blood samples,
      complained of gastro-intestinal (GI) distress during the race. No direct
      relationship was found between the quantity or quality of beverage consumed and
      the prevalence of GI symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735405
TI  - Seasonal changes in performance and free testosterone: cortisol ratio of elite
      female rowers.
AB  - The aim of this study was to investigate the seasonal behaviour of the plasma
      free testosterone: cortisol ratio (FTCR) and to relate hormonal changes to daily
      training volume and performance parameters on a rowing ergometer in elite female
      rowers. During 9 months of training preceding the 1988 Olympic Games the resting
      values of the FTCR in six elite female rowers were regularly (ten times) studied.
      Daily training volume was analysed in terms of rowed distance (lrowed) and time
      (t). In addition, two performance parameters, the power at 4.0 mmol.l-1 lactate
      concentration in the blood and the maximal power, were determined by a test on a
      rowing ergometer. The results indicated that the mean FTCR test value did not
      differ significantly from the level of the initial test or from the mean value of
      the directly preceding test. A significant negative correlation (r = -0.98, P
      less than 0.01) between FTCR and lrowed was found in a period i.e. at a training
      camp, when there was a sudden increase in training volume. When FTCR was related
      to t a significant positive correlation (r = 0.88, P less than 0.05) was found
      only for the period at the training camp. Our data further suggested that the
      FTCR alone was not an adequate indicator for the anabolic/catabolic balance in
      elite female rowers. This finding was contrary to previous findings in elite male
      rowers. However, in training practice the FTCR seems useful as an indicator of
      the hormonal training status of elite female rowers when complemented with data
      about total and free testosterone, performance parameters and knowledge
      concerning cyclic variations of the FTCR.

PMID- 1735406
TI  - Relationship between plasma potassium and ventilation during successive periods
      of exercise in men.
AB  - During and after two successive incremental cycle ergometer tests (tests A and
      B), plasma potassium concentration ([K+]p), plasma pH (pHp), plasma partial
      pressure of carbon dioxide, blood lactate concentration ([Lac-]b) and ventilation
      (VE) were measured. While there was a good correlation between the increase in
      [K+]p and VE or pHp, respectively, in test A, in test B a close correlation was
      found only between the increase in VE and [K+]p (r greater than 0.9 for nearly
      all single cases; r was 0.84 and 0.89 for all (pooled) cases in tests A and B,
      respectively; the correlation coefficients between changes in pHp and VE in tests
      A and B were r = 0.74 and r = 0.28, respectively, and r = 0.89 and r = 0.10
      between the changes in [Lac-]b and VE in tests A and B). The close relationship
      for individuals between VE and [K+]p in tests A and B supported the hypothesis
      that the extracellular increase in [K+] may contribute to the ventilatory drive
      during exercise. The comparison of the results of tests A and B further indicated
      that the relationship between pHp and VE was dependent on the experimental
      design, and that pHp and VE changes are unlikely to be cause and effect.

PMID- 1735407
TI  - Metabolic, body temperature and hormonal responses to repeated periods of
      prolonged cycle-ergometer exercise in men.
AB  - This study was designed to find out whether rest intervals and prevention of
      dehydration during prolonged exercise inhibit a drift in metabolic rate, body
      temperature and hormonal response typically occurring during continuous work. For
      this purpose in ten healthy men the heart rate (fc), rectal temperature (Tre),
      oxygen uptake (VO2), as well as blood metabolite and some hormone concentrations
      were measured during 2-h exercise at approximately 50% maximal oxygen uptake
      split into four equal parts by 30-min rest intervals during which body water
      losses were replaced. During each 30-min exercise period there was a rapid change
      in Tre and fc superimposed on which, these values increased progressively in
      consecutive exercise periods (slow drift). The VO2 showed similar changes but
      there were no significant differences in the respiratory exchange ratio,
      pulmonary ventilation, mechanical efficiency and plasma osmolality between
      successive periods of exercise. Blood glucose, insulin and C-peptide
      concentrations decreased in consecutive exercise periods, whereas plasma free
      fatty acid, glycerol, catecholamine, growth hormone and glucagon concentrations
      increased. Blood lactate concentrations did not show any regular drift and the
      plasma cortisol concentration decreased during the first two exercise periods and
      then increased. In conclusion, in spite of the relatively long rest intervals
      between the periods of prolonged exercise and the prevention of dehydration
      several physiological and hormonal variables showed a distinct drift with time.
      It is suggested that the slow drift in metabolic rate could have been
      attributable in the main to the increased concentrations of heat liberating
      hormones.

PMID- 1735408
TI  - Glycogen depletion and resynthesis in the rat after downhill running.
AB  - To study the effect of downhill running on glycogen metabolism, 94 rats were
      exercised by running for 3 h on the level or down an 18 degrees incline. Muscle
      and liver glycogen concentrations were measured before exercise and 0, 48 and 52
      h postexercise. Rats were not fed during the first 48 h of recovery but ingested
      a glucose solution 48 h postexercise. Downhill running depleted glycogen in the
      soleus muscle and liver significantly more than level running (P less than 0.01).
      The amount of glycogen resynthesized in the soleus muscle and liver in fasting or
      nonfasting rats was not altered significantly by downhill running (P greater than
      0.05). On every day of recovery the rats were injected with dexamethasone, which
      induced similar increases in glycogen concentration in the soleus muscle and
      liver after the 52nd h of the postexercise period in the case of downhill and
      level running. The glycogen depletion and repletion results indicated that, under
      our experimental conditions, downhill running in the rat, a known model of
      eccentric exercise, affected muscle glycogen metabolism differently from
      eccentric cycling in humans.

PMID- 1735409
TI  - Sodium citrate ingestion and its effects on maximal anaerobic exercise of
      different durations.
AB  - The effects of an alkalising agent were studied in ten subjects who participated
      in anaerobic testing on a cycle ergometer to determine the effectiveness of
      sodium citrate (0.5 g.kg-1 body mass) as an ergogenic aid during exercise of 10
      s, 30-s, 120-s and 240-s duration. Blood was collected prior to, after ingestion
      of sodium citrate (NaHCO3), and postexercise, from a heated (43-46 degrees C)
      fingertip and analysed immediately postcollection for pH, partial pressure of
      oxygen and carbon dioxide, base excess and blood bicarbonate. Total work
      undertaken (kJ) and peak power (W) achieved during the tests was also obtained
      via a work monitor unit. The results indicated that a dose of 0.5 g.kg-1 body
      mass sodium citrate had no ergogenic benefit for exercise of either 10-s or 30-s
      duration. Blood bicarbonate concentrations, however, were significantly increased
      (P less than 0.05) following ingestion of the citrate during these trials.
      Exercise periods of 120 s and 240 s were significantly increased (P less than
      0.05) above the control and placebo conditions following sodium citrate
      ingestion. Blood bicarbonate concentrations were again increased above control
      and placebo conditions and blood lactate concentrations were also increased
      following the citrate trials. The pH decreased significantly (P less than 0.05)
      in all trials below the control and placebo conditions. On the basis of the
      exercise undertaken in this study we would suggest that a dose of 0.5 g.kg-1 body
      mass of sodium citrate could improve anaerobic exercise performance of 120-s and
      240-s duration.

PMID- 1735410
TI  - Muscle fatigue and efficiency in relation to interval duration of successive
      contractions.
AB  - The work output, energy consumption and efficiency during repetitive dynamic
      contractions were calculated for rat extensor digitorum longus muscle. The
      muscles performed 40 successive dynamic contractions at 37 degrees C (with
      occluded bloodflow) with interval durations of either 500, 250 or 167 ms. The
      muscle-tendon complexes were allowed to shorten at the velocity at which they
      could exert their highest power output (50 mm.s-1). Work output in the first
      contraction was the same among the three groups with different interval
      durations. The reduction in work output during the series of contractions
      differed among the groups, mainly in the last part of the exercise period. In the
      group with the longest interval duration, work output steadily decreased over the
      whole contraction period and at the end was approximately 72% of the output in
      the first contraction. In contrast, after the 30th contraction, work output
      decreased at a significantly higher rate of approximately 3% of each contraction
      in the groups with the intermediate and the shortest interval duration. After the
      last contraction, work output in these groups was approximately 52% of the work
      output in the first contraction. These differences in fatigue coincided with
      differences in the reduction in adenosine 5'-triphosphate and the production of
      inosine-5'-monophosphate. Total work output was not significantly different among
      the three groups with different interval durations, indicating that the different
      reductions in work output in the last contractions only had a minor influence on
      total work output of all 40 contractions. Also high-energy phosphate consumption
      and efficiency were not significantly different over these three exercise
      periods. Thus with the protocol used no interval dependent pattern of efficiency
      could be detected.

PMID- 1735411
TI  - Carnosine and anserine concentrations in the quadriceps femoris muscle of healthy
      humans.
AB  - The content of anserine and carnosine in the lateral portion of the quadriceps
      femoris muscle of 50 healthy, human subjects has been studied. Anserine was
      undetectable in all muscle samples examined. Muscle carnosine values for the
      group conformed to a normal distribution with a mean (SD) value of 20.0 (4.7)
      mmol.kg-1 of dry muscle mass. The concentration of carnosine was significantly
      higher in the muscle of male subjects (21.3, 4.2 mmol.kg-1 dry mass) than in
      females of a similar age and training status (17.5, 4.8 mmol.kg-1 dry mass) (P
      less than 0.005). The test-retest reliability of measures was determined on a
      subgroup of 17 subjects. No significant difference in mean carnosine
      concentration was found between the two trials [21.5 (4.0) and 22.0 (5.2) mmol.kg
      1 dry muscle mass; P greater than 0.05]. The importance of carnosine as a
      physicochemical buffer within human muscle was examined by calculating its
      buffering ability over the physiological pH range. From the range of carnosine
      concentrations observed (7.2-30.7 mmol.kg-1 dry muscle mass), it was estimated
      that the dipeptide could buffer between 2.4 and 10.1 mmol H+.kg-1 dry mass over
      the physiological pH range 7.1-6.5, contributing, on average, approximately 7% to
      the total muscle buffering. This suggests that in humans, in contrast to many
      other species, carnosine is of only limited importance in preventing the
      reduction in pH observed during high intensity exercise.

PMID- 1735412
TI  - Hypertrophy without increased isometric strength after weight training.
AB  - Eight men (20-23 years) weight trained 3 days.week-1 for 19 weeks. Training
      sessions consisted of six sets of a leg press exercise (simultaneous hip and knee
      extension and ankle plantar flexion) on a weight machine, the last three sets
      with the heaviest weight that could be used for 7-20 repetitions. In comparison
      to a control group (n = 6) only the trained group increased (P less than 0.01)
      weight lifting performance (heaviest weight lifted for one repetition, 29%), and
      left and right knee extensor cross-sectional area (CAT scanning and computerized
      planimetry, 11%, P less than 0.05). In contrast, training caused no increase in
      maximal voluntary isometric knee extension strength, electrically evoked knee
      extensor peak twitch torque, and knee extensor motor unit activation
      (interpolated twitch method). These data indicate that a moderate but significant
      amount of hypertrophy induced by weight training does not necessarily increase
      performance in an isometric strength task different from the training task but
      involving the same muscle group. The failure of evoked twitch torque to increase
      despite hypertrophy may further indicate that moderate hypertrophy in the early
      stage of strength training may not necessarily cause an increase in intrinsic
      muscle force generating capacity.

PMID- 1735413
TI  - Segmental inhibition of laser-evoked brain potentials by ipsi- and
      contralaterally applied cold pressor pain.
AB  - An experiment was designed to quantify the inhibitory effect of cold pressor pain
      (ice water immersion) on brain potentials evoked by acute laser-induced pain. One
      hand (including the C7 dermatome) was immersed into ice water and simultaneously
      the laser-evoked brain potentials were elicited consecutively from the right and
      left lower forearms within the C7 dermatomes. The cold pressor pain was
      continuously rated on a visual analogue scale (VAS). The size of the averaged
      brain potentials evoked from the ipsi- and contralateral C7 dermatomes were
      reduced significantly during cold pressor pain. The largest decrease was obtained
      for the potentials evoked within the C7 dermatome ipsilateral to the cold pressor
      pain. The size (power) of the brain potentials to individual stimuli could be
      measured and was correlated to the intensity of the cold pressor pain (VAS
      score). During the onset phase of cold pressor pain, there was a decrease in
      power of the individual brain potentials evoked from the C7 dermatome
      contralateral to the cold pressor pain but the potentials, evoked from the C7
      dermatome ipsilateral to cold pressor pain, were decreased more. The overall
      rating of the laser-induced pain intensity showed that the perceived intensity
      was lowest when evoked from the dermatome concurrently exposed to cold pressor
      pain.

PMID- 1735414
TI  - Effect of short-term exercise training on muscle glycogen in resting conditions
      in rats fed a high fat diet.
AB  - It has been reported that exercise training increases muscle glycogen storage in
      rats fed a high carbohydrate (CHO) diet in resting conditions. The purpose of
      this study was to examine whether a 3-week swimming training programme would
      increase muscle glycogen stores in rats fed a high-fat (FAT) diet in resting
      conditions. Rats were fed either the FAT or CHO diet for 7 days ad libitum, and
      then were fed regularly twice a day (between 0800 and 0830 hours and 1800 and
      1830 hours) for 32 days. During this period of regular feeding, half of the rats
      in both dietary groups had swimming training for 3 weeks and the other half were
      sedentary. The rats were not exercised for 48 h before sacrifice. All rats were
      killed 2 h after their final meal (2030 hours). The glycogen contents in red
      gastrocnemius muscle, heart and liver were significantly higher in sedentary rats
      fed the CHO diet than in those fed the FAT diet. Exercise training clearly
      increased glycogen content in soleus, red gastrocnemius and heart muscle in rats
      fed the CHO diet. In rats fed the FAT diet, however, training did not increase
      glycogen content in these muscles or the heart. Exercise training resulted in an
      87% increase of total glycogen synthase activity in the gastrocnemius muscle of
      rats fed the CHO diet. However, this was not observed in rats fed the FAT diet.
      The total glycogen phosphorylase activity in the gastrocnemius muscle of the rats
      of both dietary groups was increased approximately twofold by training.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1735415
TI  - Do muscle fibre size and fibre angulation correlate in pennated human muscles?
AB  - Several studies have reported estimations of the total number of fibres in a
      muscle, e.g. before and after training or before and after inactivity. In those
      investigations a combination of computed tomographic estimations of muscle size
      and morphological studies of fibre size has most often been used. There have been
      doubts about the reliability of those studies on pennate muscles, since changes
      in muscle fibre size have been said to alter fibre angulation and thus the number
      of fibres that will cross a section. If such an alteration in fibre angulation
      takes place with an increase in fibre size, there ought to be some correlation
      between fibre size and fibre angulation. The present study was designed to test
      whether repetitive estimations of muscle fibre angulation could be performed in
      vivo and if any such correlation could be found between fibre size and fibre
      angulation. A group of 15 women volunteered to take part in the study. Repeated
      ultrasonographic recordings were made on five subjects on 3 consecutive days to
      test the repeatability of ultrasonographic measurement of fibre angulation. Both
      muscle morphological analyses and ultrasonographic measurements of fibre
      angulation were performed on the other 10 subjects. Ultrasonographic measurement
      of fibre angulation was found to be reproducible since no variation between
      measurements made on different days was found. When trying to correlate muscle
      fibre size to the muscle fibre angulation, measured ultrasonographically, no
      significant correlation was found.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735416
TI  - Effect of endurance training on excessive CO2 expiration due to lactate
      production in exercise.
AB  - We attempted to determine the change in total excess volume of CO2 output (CO2
      excess) due to bicarbonate buffering of lactic acid produced in exercise due to
      endurance training for approximately 2 months and to assess the relationship
      between the changes of CO2 excess and distance-running performance. Six male
      endurance runners, aged 19-22 years, were subjects. Maximal oxygen uptake
      (VO2max), oxygen uptake (VO2) at anaerobic threshold (AT), CO2 excess and blood
      lactate concentration were measured during incremental exercise on a cycle
      ergometer and 12-min exhausting running performance (12-min ERP) was also
      measured on the track before and after endurance training. The absolute
      magnitudes in the improvement due to training for CO2 excess per unit of body
      mass per unit of blood lactate accumulation (delta la-) in exercise (CO2
      excess.mass-1.delta la-), 12-min ERP, VO2 at AT (AT-VO2) and VO2max on average
      were 0.8 ml.kg-1.l-1.mmol-1, 97.8 m, 4.4 ml.kg-1. min-1 and 7.3 ml.kg-1.min-1,
      respectively. The percentage change in CO2 excess.mass-1.delta la- (15.7%) was
      almost same as those of VO2max (13.7%) and AT-VO2 (13.2%). It was found to be a
      high correlation between the absolute amount of change in CO2 excess.mass-1.delta
      la-, and the absolute amount of change in AT-VO2 (r = 0.94, P less than
      0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735417
TI  - Day-to-day changes in oxygen uptake kinetics at the onset of exercise during
      strenuous endurance training.
AB  - The aim of this study was to assess the effect of strenuous endurance training on
      day-to-day changes in oxygen uptake (VO2) on-kinetics (time constant) at the
      onset of exercise. Four healthy men participated in strenuous training for 30
      min.day-1, 6 days.week-1 for 3 weeks. The VO2 was measured breath-by-breath every
      day except Sunday at exercise intensities corresponding to the lactate threshold
      (LT) and the onset of blood lactate accumulation (OBLA) which were obtained
      before training. Furthermore, an incremental exercise test was performed to
      determine LT, OBLA and maximal oxygen uptake (VO2max) before and after the
      training period and every weekend. The 30-min heavy endurance training was
      performed on a cycle ergometer 5 days.week-1 for 3 weeks. Another six men served
      as the control group. After training, significant reductions of the VO2 time
      constant for exercise at the pretraining LT exercise intensity (P less than 0.05)
      and at OBLA exercise intensity (P less than 0.01) were observed, whereas the VO2
      time constants in the control group did not change significantly. A high
      correlation between the decrease in the VO2 time constant and training day was
      observed in exercise at the pretraining LT exercise intensity (r = -0.76; P less
      than 0.001) as well as in the OBLA exercise intensity (r = -0.91; P less than
      0.001). A significant reduction in the blood lactate concentration during
      submaximal exercise and in the heart rate on-kinetics was observed in the
      training group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735418
TI  - Determinants of isometric muscle strength in men of different ages.
AB  - Values of maximal isometric strength of five muscle groups and associated factors
      including occupational status, life style and health were studied in three groups
      of men aged from 31 to 35, 51 to 55, and 71 to 75 years. The results indicated
      significant differences between the age groups in isometric handgrip, elbow
      flexion, knee extension, trunk extension and trunk flexion strength. In the
      youngest group, the manual workers tended to have higher strength values in all
      muscle groups than the lower and higher status white collar workers, whereas
      among the middle-aged and oldest men the manual workers tended to have the
      poorest performance. Good self-rated health and the intensity of physical
      exercise during leisure were positively associated with muscle strength in the
      youngest and middle-aged groups whereas in the oldest group the most important
      variable was home gymnastics. The multivariate structural equation models of
      isometric strength differed somewhat among the age groups and in these models the
      above-mentioned variables accounted for from 33% to 43% of the variance in
      isometric strength within the age groups. The results illustrated the most
      important factors associated with isometric strength in samples of men of
      different ages and also provided suggestions as to how these determinants might
      influence comparisons between different age groups in respect of muscle strength.

PMID- 1735420
TI  - Blood flow through the ophthalmic veins during exercise in humans.
AB  - The blood from the face flows into the intracranium through the ophthalmic veins
      when human subjects become hyperthermic. To investigate a possible mechanism
      underlying this change in direction of flow, five young men were subjected to
      either passive body warming or exercise on a cycle ergometer, in a climatic
      chamber whose air temperature and relative humidity were 28 degrees C and 40%.
      Tympanic (Tty) and oesophageal temperatures, forehead sweat rate (msw), skin
      blood flow (Qsk) and blood flow through the ophthalmic vein (Qov) were measured,
      and the mean skin (Tsk) and mean body (Tb) temperatures were computed. Passive
      body warming was induced by a box-shaped body warming unit enclosing all but the
      subject's head. Exercise was performed either at an intensity of 60% maximal
      oxygen consumption or with the intensity increasing in increments. During both
      tests, msw and Qsk started to increase shortly after the imposition of the heat
      load. The Qov began to change with the venous blood flowing from the face into
      the intracranium and a complete reversal in the direction of Qov (from the face
      to the intracranium) came significantly later than the increases in msw and Qsk.
      The Tty at the time of flow reversal was the same in both tests. The Tsk (and
      hence Tb) at flow reversal was, however, significantly higher during passive body
      warming than during exercise. The mechanism for switching the direction of Qov
      appeared to have been triggered by a high temperature in the brain, and not by
      thermal input from the periphery of the body.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735419
TI  - Changes in sex hormone binding globulin, high density lipoprotein cholesterol and
      plasma lipids in male cyclists during training and competition.
AB  - This study was performed on 13 professional race-cyclists to examine changes in
      sex hormone binding globulin (SHBG), high density lipoprotein cholesterol (HDL-C)
      and serum lipid concentrations after training and after competition. While SHBG,
      total cholesterol and phospholipids increased and free fatty acids (FFA)
      decreased significantly during training, HDL-C and FFA increased and SHBG and
      triglycerides (TG) decreased significantly during the competition period. These
      latter changes in serum lipids and lipoproteins were assumed to be a direct
      effect of utilisation of muscle and plasma TG as fuels for exertion occurring
      only in extreme exercise. Changes in SHBG concentrations indicated that they were
      dependent on the conditions of the physical effort and could be related not only
      to the concentrations of androgens but also to the reduction in body mass.

PMID- 1735421
TI  - The primary structure of fatty-acid-binding protein from nurse shark liver.
      Structural and evolutionary relationship to the mammalian fatty-acid-binding
      protein family.
AB  - The primary structure of a fatty-acid-binding protein (FABP) isolated from the
      liver of the nurse shark (Ginglymostoma cirratum) was determined by high
      performance tandem mass spectrometry (employing multichannel array detection) and
      Edman degradation. Shark liver FABP consists of 132 amino acids with an
      acetylated N-terminal valine. The chemical molecular mass of the intact protein
      determined by electrospray ionization mass spectrometry (Mr = 15124 +/- 2.5) was
      in good agreement with that calculated from the amino acid sequence (Mr =
      15121.3). The amino acid sequence of shark liver FABP displays significantly
      greater similarity to the FABP expressed in mammalian heart, peripheral nerve
      myelin and adipose tissue (61-53% sequence similarity) than to the FABP expressed
      in mammalian liver (22% similarity). Phylogenetic trees derived from the
      comparison of the shark liver FABP amino acid sequence with the members of the
      mammalian fatty-acid/retinoid-binding protein gene family indicate the initial
      divergence of an ancestral gene into two major subfamilies: one comprising the
      genes for mammalian liver FABP and gastrotropin, the other comprising the genes
      for mammalian cellular retinol-binding proteins I and II, cellular retinoic-acid
      binding protein myelin P2 protein, adipocyte FABP, heart FABP and shark liver
      FABP, the latter having diverged from the ancestral gene that ultimately gave
      rise to the present day mammalian heart-FABP, adipocyte FABP and myelin P2
      protein sequences. The sequence for intestinal FABP from the rat could be
      assigned to either subfamily, depending on the approach used for phylogenetic
      tree construction, but clearly diverged at a relatively early evolutionary time
      point. Indeed, sequences proximately ancestral or closely related to mammalian
      intestinal FABP, liver FABP, gastrotropin and the retinoid-binding group of
      proteins appear to have arisen prior to the divergence of shark liver FABP and
      should therefore also be present in elasmobranchs. The presence in shark liver of
      an FABP which differs substantially in primary structure from mammalian liver
      FABP, while being closely related to the FABP expressed in mammalian heart
      muscle, peripheral nerve myelin and adipocytes, opens a further dimension
      regarding the question of the existence of structure-dependent and tissue
      specific specialization of FABP function in lipid metabolism.

PMID- 1735422
TI  - Purification, primary structure and molecular cloning of a rat ribosomal protein
      showing homology with yeast ribosomal protein YL34.
AB  - 1. A new 17-kDa mammalian ribosomal protein (PR17) was purified to homogeneity
      from the rat exocrine pancreas. The purification procedure was based on acidic
      extraction of a heat-denatured homogenate, ammonium-sulfate precipitation,
      hydrophobic chromatography on phenyl-Sepharose and analytical reverse-phase HPLC
      on mu Bondapak C18. Fractions of interest were collected using an antiserum
      directed against the first (1-14) moiety of somatostatin (1-28). 30 micrograms
      pure RP17 were obtained from 1 g fresh pancreas. 2. A short 111-b cDNA encoding
      RP17 was amplified from rat pancreatic first-strand cDNA template by using two 64
      fold degenerate heptadecamer primers in the DNA-polymerase-chain reaction. From
      the sequence of amplified cDNA, an unambiguous oligonucleotide probe was designed
      to screen a rat pancreatic cDNA library. A cDNA clone coding for RP17 was
      isolated, whose nucleotide sequence, with an open reading frame coding for 155
      amino acids (molecular mass of 17,199 Da), confirmed the partial amino acid
      sequences directly obtained from the purified protein. 3. Northern-blot analysis
      showed that a similar 0.75-kb transcript was present in rat pancreas, in the rat
      pancreatic acinar cell line AR 4-2J and in the human neuroblastoma cell-line NB
      OK-1, the highest level being in the latter two preparations, despite similar
      levels of RP17 in all three preparations, as tested with a rabbit antiserum
      directed against purified RP17. 4. The N-terminal sequence of both RP17 and the
      ribosomal protein YL43 from Saccharomyces cerevisiae (39 amino acid residues)
      showed a high degree of identity (77%), indicating that RP17 is a mammalian
      homolog of yeast ribosomal protein YL43.

PMID- 1735424
TI  - Identification of specific carboxyl groups on Anabaena PCC 7119 flavodoxin which
      are involved in the interaction with ferredoxin-NADP+ reductase.
AB  - Flavodoxin from the nitrogen-fixing cyanobacteria Anabaena PCC 7119 forms an
      electron-transfer complex with ferredoxin--NADP+ reductase (FNR) from the same
      organism. The complex is mainly governed by electrostatic interactions between
      side-chain amino groups of the reductase and carboxyl residues of flavodoxin. In
      order to localize the binding site on flavodoxin, chemical modification of its
      carboxyl groups has been carried out. Treatment of flavodoxin with a water
      soluble carbodiimide, N-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC), in the
      presence of a nucleophile, glycine ethyl ester, caused a time-dependent
      modification of the protein that is responsible for the loss of its ability to
      participate as electron carrier in the photoreduction of NADP+ by chloroplast
      membranes, and also in NADPH--cytochrome-c reductase activity, by about 85%.
      Nevertheless, the ability of flavodoxin to receive electrons from the reducing
      side of photosystem I was much less affected. The inhibition was enhanced at low
      pH, suggesting that carboxylic acid groups were the target of chemical
      modification. Treated flavodoxin failed to form covalent complexes with FNR and
      the dissociation constant for the non-covalent complex with FNR was fourfold
      higher. After tryptic digestion of a sample of flavodoxin modified by EDC in the
      presence of [1-14C]glycine ethyl ester, two major radioactive peptides were
      isolated. The first protein fragment contained three carboxylic residues (Asp123,
      Asp126 and Asp129), corresponding to the region where long-chain flavodoxins show
      an insert compared to short-chain flavodoxins. The second peptide corresponded to
      a similar region, either in the amino acid sequence or in the three-dimensional
      structure of the protein and also containing three carboxyl groups (Asp144,
      Glu145 and Asp146). Four of these carboxyl groups (Asp123, Asp126, Asp144 and
      Asp146) are highly conserved in all long-chain flavodoxins, suggesting that they
      could play an essential role in substrate recognition.

PMID- 1735423
TI  - Interaction of the low-molecular-mass, guanine-nucleotide-binding protein with
      the actin-binding protein and its modulation by the cAMP-dependent protein kinase
      in bovine platelets.
AB  - Platelets have been shown to possess several, different, low-molecular-mass,
      guanine-nucleotide-binding proteins (G-proteins) with molecular masses about 20
      30 kDa. We report here that a 25-kDa G-protein copurified with the bovine
      platelet actin-binding protein (ABP), a cross-linker of actin filaments which is
      known to generate the three-dimensional network of actin. Both the G-protein and
      ABP were recovered in a fraction that was insoluble in Triton X-100 and were
      extracted in 0.6 M NaCl. Gel-filtration chromatography of the high-salt extract
      and rechromatography in a low-salt solution indicated that the two proteins may
      be associated with each other. The association of the two proteins was suggested
      by cosedimentation of the G-protein with the actin gel formed by actin and ABP.
      The amounts of the cosedimented G-protein and ABP was unaffected by guanosine-5'
      O-[beta-thio]diphosphate and guanosine-5'-O-[gamma-thio]triphosphate, but the G
      protein, not ABP, was partially released from the actin gel by phosphorylating
      ABP with cAMP-dependent protein kinase. Thus, the association of the two proteins
      was affected by modification of ABP, but not by modification of G-proteins. The
      physiological significance of the possible association of the two proteins might
      be that the membrane skeleton functions as a modulator of the G-protein, rather
      than that the G-protein modulates the function of the membrane skeleton which
      comprises ABP.

PMID- 1735425
TI  - Localization of two interchain disulfide bridges in dimers of bovine alpha s2
      casein. Parallel and antiparallel alignments of the polypeptide chains.
AB  - Carboxymethylation of bovine skimmed milk with 14C-labelled iodoacetic acid
      followed by purification of the alpha s2-casein dimer showed that all four
      cysteine residues in the protein are engaged in disulfide linkages. Mass
      spectrometry and sequence analysis of cystine-containing tryptic peptides
      revealed the presence of two interchain disulfide bridges in the protein.
      Sequence analysis of disulfide-linked peptides resulting from an enzymatic
      cleavage between the bridges demonstrated that the individual chains in the
      dimers are either aligned in an antiparallel or a parallel orientation. The
      identity of some of the disulfide-linked peptides was further verified by
      performic acid oxidation followed by sequence analysis of the resulting peptides.

PMID- 1735426
TI  - 1-Deoxy-1-phosphatidylethanolamino-lactitol-type neoglycolipids serve as
      acceptors for sialyltransferases from rat liver golgi vesicles.
AB  - 1-Deoxy-1-phosphatidylethanolamino-lactitols (LacPtdEtns), 1-deoxy-1
      phosphatidylethanolamino-sialyllactitols (NeuAcLacPtdEtns) and their
      corresponding N-acetylated derivatives were synthesized and characterized by fast
      atom-bombardment mass spectrometry (FAB MS). The neoglycolipids were used as
      acceptors for sialyltransferases from rat liver Golgi vesicles. Sialylation rates
      were as good as or even better than those obtained with the corresponding
      authentic acceptors lactosylceramide (LacCer) and ganglioside GM3. The
      sialylation of LacPtdEtns and NeuAcLacPtdEtns yielded sialyl and disialyl
      compounds, respectively, as shown by FAB MS analysis of the reaction products.
      The results of competition experiments indicate that the neoglycolipids and the
      authentic acceptors are sialylated by the same sialyltransferases.

PMID- 1735427
TI  - An intestinal galactose-specific lectin mediates the binding of murine IgE to
      mouse intestinal epithelial cells.
AB  - A number of lactose-binding lectins have recently been identified in the rat and
      mouse intestine, one of which corresponds to the C-terminal domain of IgE-binding
      proteins, originally identified in rat basophilic leukemia (RBL) cells and mouse
      3T3 fibroblasts. In the present report, we describe the affinity purification of
      a rat intestinal lactose-specific lectin which binds murine IgE antibodies. This
      binding most likely occurs via the immunoglobulin carbohydrate chains, as it is
      inhibited by lactose. This intestinal lectin molecule is also immunologically
      related to the previously described IgE-binding protein (epsilon BP) isolated
      from RBL cells, since it is recognized by antibodies raised against recombinant
      epsilon BP. This intestinal form of epsilon BP has a molecular mass of 17.5 kDa,
      which is much lower than that of its RBL cell analogue (31 kDa). The attachment
      of IgE to the mouse intestinal epithelium was demonstrated by
      immunohistochemistry, along with the presence of a corresponding mouse intestinal
      epsilon BP. The carbohydrate-dependent nature of this attachment was established
      by demonstrating that IgE binding to mouse epithelium was specifically abolished
      by lactose (4 mM) and by a blood-group-A-active tetrasaccharide (0.2 mM), but not
      by mannose (10 mM). Finally, the association of IgE with the mouse intestinal
      epithelium was prevented by competition with the purified IgE-binding lectin
      isolated from rat intestine. Although the physiological function of this
      intestinal protein is still unknown, the finding that IgE binds to a lectin in
      the intestinal epithelium pinpoints a possible novel mechanism for the regulation
      of IgE-mediated disorders, such as food allergy.

PMID- 1735428
TI  - Structure of yeast pGKL 128-kDa killer-toxin secretion signal sequence.
      Processing of the 128-kDa killer-toxin-secretion-signal-alpha-amylase fusion
      protein.
AB  - The linear double-stranded DNA plasmid pGKL1 in yeast encodes a killer toxin
      consisting of 97-kDa, 31-kDa and 28-kDa subunits. A 128-kDa protein precursor of
      the 97-kDa and 31-kDa subunits, was first synthesized with a 29-amino-acid
      extension at its NH2-terminus as a secretion signal sequence. In the present
      study, the property of this signal sequence was studied by the analysis of a
      fusion protein with mouse alpha-amylase. Using the secretion signal sequence of
      the killer protein, the mouse alpha-amylase was successfully secreted into the
      culture medium. An intracellular precursor form of alpha-amylase was identified
      and purified. Analysis of the NH2-terminal sequence of this precursor molecule
      indicated that it corresponded to the secretory intermediate (pro form) of alpha
      amylase with the removal of the hydrophobic segment (Met1-Gly16) of the secretion
      signal. Both the secretion of alpha-amylase into the culture medium and the
      detection of the pro-alpha-amylase species in the cells were prohibited by a sec
      11 mutation, or by the conversion of Gly to Val at the 16th position of the
      secretion signal. These results strongly suggest that the cleavage occurs between
      Gly16 and Leu17 by a signal peptidase, and that this cleavage is required for the
      secretion of alpha-amylase into the medium. Based on the data from the NH2
      terminal amino acid sequences of secreted alpha-amylases, we conclude that the 29
      amino-acid secretion signal present in the 128-kDa killer toxin precursor protein
      is a prepro structure.

PMID- 1735429
TI  - The differential transcriptional activity of two amphibian U1 small-nuclear RNA
      genes correlates with structural differences in the proximal sequence element.
AB  - We previously analyzed the transcription of an axolotl U1 small-nuclear RNA
      (snRNA) gene (AmU1) by microinjection into Xenopus laevis oocytes. In such an
      assay, AmU1 showed a low template activity compared to that of an X. laevis U1
      snRNA gene (XlU1B2). Swapping the proximal sequence element (PSE) with that of
      XlU1B2 was required for AmU1 to acquire a transcription level equal to that of
      XlU1B2. In the present work, we examine the functional importance of the
      nucleotides that are common or different in both PSEs with the aim of identifying
      which nucleotides within the Xenopus U1 PSE are critical for this enhancement of
      Ambystoma mexicanum U1 snRNA transcription. The PSE mutation analysis showed that
      the central, phylogenetically conserved C-58/C-57 doublet is absolutely required
      for U1 promoter activity. In the 3' portion of this element, a CGC to ATG change
      (positions -54/-52) which partially restores the XlU1B2 PSE sequence, enables the
      AmU1 gene to gain the same transcriptional activity as XlU1B2. Remarkably, in
      this clustered point mutation, the sole C-54 to A-54 change is sufficient to
      obtain this increased level. Therefore, the activity of the AmU1 gene in injected
      Xenopus oocytes is strongly affected by a single sequence difference between AmU1
      and XlU1B2 PSEs. This finding underscores the crucial importance of the
      nucleotide identity at position -54 to the function of the Xenopus U1 PSE.

PMID- 1735430
TI  - Engineering mammalian aspartyl-tRNA synthetase to probe structural features
      mediating its association with the multisynthetase complex.
AB  - Aspartyl-tRNA synthetase from higher eukaryotes is a component of a multienzyme
      complex comprising nine aminoacyl-tRNA synthetases. The cDNA encoding cytoplasmic
      rat liver aspartyl-tRNA synthetase was previously cloned and sequenced. This work
      reports the identification of structural features responsible for its association
      within the multisynthetase complex. Mutant and chimeric proteins have been
      expressed in mammalian cells and their structural behavior analyzed. A wild-type
      rat liver aspartyl-tRNA synthetase, expressed in Chinese hamster ovary (CHO)
      cells, associates within the complex from CHO cells, whereas a mutant enzyme with
      a deletion of 34 amino acids from its amino-terminal extremity does not. A
      chimeric enzyme, made of the amino-terminal moiety of rat liver aspartyl-tRNA
      synthetase fused to the catalytic domain of yeast lysyl-tRNA synthetase, has been
      expressed in Lys-101 cells, a CHO cell line with a temperature-sensitive lysyl
      tRNA synthetase. The fusion protein is stable in vivo, does not associate within
      the multisynthetase complex and cannot restore normal growth of the mutant cells.
      These results establish that the 3.7-kDa amino-terminal moiety of mammalian
      aspartyl-tRNA synthetase mediates its association with the other components of
      the complex. In addition, the finding that yeast lysyl-tRNA synthetase cannot
      replace the aspartyl-tRNA synthetase component of the mammalian complex,
      indicates that interactions between neighbouring enzymes also play a prominent
      role in stabilization of this multienzyme structure and strengthened the view
      that the multisynthetase complex is a discrete entity with a well-defined
      structural organization.

PMID- 1735431
TI  - Functional study of the human thyroid peroxidase gene promoter.
AB  - Structure/function relationships in the human thyroid peroxidase gene promoter
      have been studied by deletion and mutation analyses and confronted with footprint
      patterns obtained with thyroid nuclear extracts and the purified thyroid
      transcription factor TTF-1. Crude nuclear extracts from dog thyroid primary
      cultures were shown to contain a binding activity recognizing the -119 to -105
      segment of the promoter (coordinates relative to the transcriptional start site).
      Deletion, or site-directed mutagenesis of this segment dramatically reduced
      transcriptional activity in transient expression experiments on gene fusions of
      the thyroid peroxidase promoter and the growth hormone reporter. This binding
      activity was increased in nuclear extracts from thyrocytes cultured in the
      presence of the cAMP-agonist forskolin. A mutation that decreased the promoter
      function in forskolin-stimulated thyrocytes resulted in weakening of the
      corresponding footprint. The binding site displays no significant sequence
      similarities with known cAMP-responsive elements. Mutagenesis of another region
      of the promoter (-99 to -94) induced the binding of an additional factor,
      resulting in a dramatically enhanced promoter activity. We show that the thyroid
      specific transcriptional factor TTF-1 is not directly involved in the above
      mentioned interactions and provide evidence suggesting that, in spite of
      displaying a similar binding pattern to thyroperoxidase and thyroglobulin
      promoters in vitro, TTF-1 plays a less important role in the former. Altogether,
      our data delineate the minimal thyroid peroxidase gene promoter in the human and
      identify the binding sites of two trans-activating factors, one of them being
      potentially the mediator of a non-conventional cAMP control, independent of the
      cAMP-responsive element and factor AP-2.

PMID- 1735432
TI  - Photoaffinity labelling of cholinesterases. Discrimination between active and
      peripheral sites.
AB  - Two para-dialkylaminobenzenediazonium salts, the dimethylamino (A) and
      dibutylamino (B) derivatives, are presented as structural probes for
      acetylcholinesterase and butyrylcholinesterase. While being reversible
      competitive inhibitors in the dark, A and B behave, upon irradiation and through
      the formation of arylcation species, as irreversible labels of ammonium-binding
      sites of both enzymes. The observed variations of the different inactivation rate
      constants point to a different structural environment for acetylcholinesterase
      binding and butyrylcholinesterase-binding sites. Moreover, in the case of
      acetylcholinesterase, protection experiments with specific ligands (edrophonium
      and propidium) showed that the dimethylamino salt A exclusively labels the
      hydrolytic anionic site, whereas the dibutylamino salt B also labels the
      peripheral site. Specificities and stoechiometries of the incorporations were
      determined and, in the case of acetylcholinesterase, the irradiated protein was
      submitted to chemical degradation. Peptide maps were obtained by gel-permeation
      chromatography and HPLC, giving access to labelled peptides which belong either
      to the active or to the peripheral site.

PMID- 1735433
TI  - Three-dimensional 15N-1H-1H and 15N-13C-1H nuclear-magnetic resonance studies of
      HPr a central component of the phosphoenolpyruvate-dependent phosphotransferase
      system from Escherichia coli. Assignment of backbone resonances.
AB  - We have performed three-dimensional NMR studies on a central component of the
      phosphoenolpyruvate-dependent phosphotransferase system of Escherichia coli,
      denoted as HPr. The protein was uniformly enriched with 15N and 13C to overcome
      spectral overlap. Complete assignments were obtained for the backbone 1H, 15N and
      13C resonances, using three-dimensional heteronuclear 1H NOE 1H-15N multiple
      quantum coherence spectroscopy (3D-NOESY-HMQC) and three-dimensional
      heteronuclear total correlation 1H-15N multiple-quantum coherence spectroscopy
      (3D-TOCSY-HMQC) experiments on 15N-enriched HPr and an additional three
      dimensional triple-resonance 1HN-15N-13C alpha correlation spectroscopy (HNCA)
      experiment on 13C, 15N-enriched HPr. Many of the sequential backbone 1H
      assignments, as derived from two-dimensional NMR studies [Klevit, R.E., Drobny,
      G.P. & Waygood, E.B. (1986) Biochemistry 25, 7760-7769], were corrected. Almost
      all discrepancies are in the helical regions, leaving the published antiparallel
      beta-sheet topology almost completely intact.

PMID- 1735434
TI  - Localization of a vitamin-D-binding protein interaction site in the COOH-terminal
      sequence of actin.
AB  - The serum vitamin D binding protein is the carrier of vitamin D and its
      derivatives in the plasma. One of the known roles of this protein is to sequester
      monomeric actin in the blood, therefore implicating this protein in actin
      elimination. However, its binding site at the surface of actin is poorly
      delimited. We report here the results of a study which locates, using several
      actin fragments together with immunological probes, a vitamin D binding protein
      site near the COOH-terminal extremity. Thus, the interface is delimited by the
      sequence 360-372 in subdomain I of actin.

PMID- 1735435
TI  - Chemical modification of cholecystokinin-A receptors in rat pancreatic membranes.
AB  - Chemical modification of amino acids was used to probe the molecular structure of
      the cholecystokinin-A (CCK-A) receptor on rat pancreatic membranes. Radioligand
      binding studies with [3H]N-(2,3-dihydro-1-methyl-2-oxo-5-phenyl-1H-1,4
      benzodiazepin-3- yl)1H- 2-carboxamide [(+/-)-[3H]L-364,718], a tritiated highly
      potent CCK-A receptor antagonist, enabled the evaluation of the effects caused by
      the modifying reagents. The apparent fragility of the receptor protein
      necessitated the development of a modification procedure without wash and
      centrifugation steps. Treatment of a concentrated membrane preparation with the
      group-specific agents N-ethylmaleimide, phenylglyoxal and diethylpyrocarbonate,
      subsequent dilution and incubation at lower temperatures (20 degrees C instead of
      the more generally used 37 degrees C) proved successful. All modifiers affected
      the binding characteristics for both agonists and antagonists considerably. CCK-A
      receptor coupling to guanosine-nucleotide-binding proteins was substantially
      diminished upon modification with N-ethylmaleimide and diethylpyrocarbonate, as
      could be concluded from the effects on the (+/-)-[3H]L-364,718 displacement by
      the cholecystokinin C-terminal octapeptide (CCK-8). The ligand-binding site was
      affected by all three reagents, as could be inferred from the specific protection
      obtained with the CCK-A receptor antagonist, lorglumide. It therefore appears
      that sulfhydryl, arginyl, and histidyl residues form an essential part of the
      ligand-binding domain on the CCK-A receptor and that sulfhydryl and histidyl
      residues are also involved in the signal-transduction pathway.

PMID- 1735436
TI  - Purification and characterization of F420H2-dehydrogenase from Methanolobus
      tindarius.
AB  - The oxidation of F420H2 (reduced coenzyme F420) is a key reaction in the final
      step of methanogenesis. This step is catalyzed in Methanolobus tindarius by the
      membrane-bound F420H2-dehydrogenase which was purified 31-fold to apparent
      homogeneity. The apparent molecular mass of the native enzyme was 120 kDa. Sodium
      dodecyl sulfate/polyacrylamide gel electrophoresis revealed the presence of five
      different subunits of apparent molecular masses of 45 kDa, 40 kDa, 22 kDa, 18 kDa
      and 17 kDa. The purified F420H2-dehydrogenase, which was yellowish, contained 16
      +/- 2 mol iron and 16 +/- 3 mol acid-labile sulfur/mol enzyme. No flavin could be
      detected. The oxygen-stable enzyme catalyzed the oxidation of F420H2 (apparent Km
      = 5.4 microM) with methylviologen and metronidazole as electron acceptors at a
      specific rate of 13 mumol.min-1.mg-1 (kcat = 25.5 s-1). The isoelectric point was
      at pH 5.0. The temperature optimum was at 37 degrees C and the pH optimum at 6.8.

PMID- 1735437
TI  - Preparation and kinetic properties of 5-ethylphenazine-lactate-dehydrogenase-NAD+
      conjugate, a semisynthetic lactate oxidase showing a hide-and-seek effect.
AB  - 5-Ethylphenazine-lactate-dehydrogenase-NAD+ conjugate (EP(+)-LDH-NAD+) was
      prepared by linking poly(ethylene glycol)-bound 5-ethylphenazine and
      poly(ethylene glycol)-bound NAD+ to lactate dehydrogenase. The average number of
      the ethylphenazine moieties bound per molecule of enzyme subunit was 0.46, and
      that of the NAD+ moieties was 0.32. This conjugate is a semisynthetic enzyme
      having lactate oxidase activity using oxygen or 3-(4,5-dimethyl-2-thiazolyl)-2,5
      diphenyl-2H-tetrazolium bromide (MTT) as an electron acceptor; to make such
      conjugates seems to be a general method for artificially converting a
      dehydrogenase into an oxidase. When the concentration of oxygen or MTT is varied,
      the oxidase activity fits the Michaelis-Menten equation with the following
      kinetic constants: for the reaction system with oxygen, the turnover number per
      subunit is 2.3 min-1 and Km for oxygen is 1.91 mM; and for the system with MTT,
      the turnover number is 0.25 min-1 and Km for MTT is 0.076 mM. At the initial
      steady state of the oxidase reaction, only 2.1% of the NAD+ moieties of the
      conjugate are in the free state (i.e. not bound in the coenzyme-binding site of
      the lactate dehydrogenase moiety) and the rest are hidden in the coenzyme site;
      almost all the NAD+ moieties are in the reduced state. The apparent
      intramolecular rate constant for the reaction between a free NADH moiety and an
      oxidized ethylphenazine moiety is 2.3 s-1 and 2.1 s-1 for the systems with oxygen
      and with MTT, respectively. The apparent effective concentration of the free NADH
      moiety for the ethylphenazine moiety is 5.5 microM and is much smaller than that
      (0.34 mM) of the ethylphenazine moiety for the free NADH moiety; this difference
      is due to the effect of hiding the NADH moiety in the binding site, as the hidden
      NADH moiety cannot react with the ethylphenazine moiety.

PMID- 1735438
TI  - Principles for designing enzyme-like catalysts based on the rate-acceleration
      mechanisms of semisynthetic oxidases.
AB  - Combinations of substrate-binding sites and catalytic groups constitute various
      kinds of enzyme-like catalysts. The design of such catalysts can be evaluated by
      the enhancement of the overall catalytic activity by combining these parts into
      one catalyst. For a catalyst having one substrate-binding site and one catalytic
      group, an equation was obtained which shows the relationship between the rate
      acceleration due to the combination, the affinity of the site (1/Kd), intrinsic
      effective concentration (kin/kex) and substrate concentration ([S]). The
      intrinsic effective concentration is the ratio of the first-order rate constant
      (kin) of the intramolecular reaction between the catalytic group and the bound
      substrate and the second-order rate constant (kex) of the intermolecular reaction
      between the catalytic group and the free substrate; the value depends on the
      method of linking the catalytic group and the binding site. This equation
      provides the following principles for designing catalysts of this type with a
      considerable grade of rate-acceleration: [S] less than or equal to kin/kex and
      (1/10)[S] less than or equal to Kd less than or equal to kin/kex. To increase
      kin/kex, the structure of the binding site is required not to reduce the
      reactivity of the bound substrate, and the linker connecting the binding site and
      the catalytic group is required to be flexible and to have an appropriate length.
      A subunit structure is also found to be effective to improve the catalytic
      activity: the activity of an n-mer is at most n2 times as high as that of the
      monomer. As for the substrate-binding sites, the sites of natural enzymes and
      antibodies are good candidates because various kinds of binding sites with high
      affinity and specificity to the corresponding substrates are available. In
      addition, the equation relating the rate-acceleration with Kd, kin/kex, and [S]
      is used for explaining the catalytic efficiency of enzymes energetically. The
      principle for designing a multifunctional catalyst having several kinds of
      binding sites for its substrates and intermediates and several kinds of catalytic
      groups was then investigated. In this case, the diffusion of the intermediates
      strongly affects the activity of the multifunctional catalyst, and such a
      diffusion process was also analyzed. On the basis of these analyses, the
      following principles were obtained.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1735439
TI  - Dissection of the ribonuclease T1 subsite. The transesterification kinetics of
      Asn36Ala and Asn98Ala ribonuclease T1 for minimal dinucleoside phosphates.
AB  - Ribonuclease T1 contains a subsite which by interacting with the leaving
      nucleoside N of GpN dinucleoside phosphate substrates, contributes to catalysis
      [Steyaert, J., Wyns, L. & Stanssens, P. (1991) Biochemistry 30, 8661-8665]. The
      Asn36Ala and Asn98Ala mutations reduce the transesterification rates of GpA, GpC
      and GpU considerably whereas they have virtually no effect on the
      transesterification kinetics of the synthetic substrate guanosine 3'-(methyl
      phosphate) (GpMe) (in which the leaving nucleoside is replaced by methanol),
      indicating that the Asn36 and Asn98 side chains are part of the RNase T1 subsite
      [Steyaert, J., Haikal, A. F., Wyns, L. & Stanssens, P. (1991) Biochemistry 30,
      8666-8670]. The kinetics of the Asn36Ala, Asn98Ala and wild-type catalyzed
      transesterification of guanosine 3'-(5'-D-ribosyl phosphate) (GpRib), another GpN
      analog in which the leaving groups is replaced by D-ribose, enables the mapping
      of the subsite interactions provided by Asn36 and Asn98. We find that the Asn36
      amide function contributes 4.6 kJ/mol to catalysis through interactions with the
      ribose moiety of the leaving nucleoside. Asn98 is at least in part responsible
      for the subsite preference for cytidine; the Asn98 side chain preferentially
      binds cytosine as the leaving nucleoside base.

PMID- 1735440
TI  - New site-directed reversible inhibitors of 3-hydroxy-3-methylglutaryl-CoA
      reductase.
AB  - 1. CoA-thioether analogues of 3-hydroxy-3-methylglutaryl-CoA containing an
      additional methyl group at positions 2, 6(methyl at C3) or 4 of the acyl residue
      were prepared. To probe for hydrophobic interaction, their inhibitory properties
      were determined with 3-hydroxy-3-methylglutaryl-CoA reductase purified from
      baker's yeast. The CoA-thioethers were purely competitive inhibitors whose
      affinity to the reductase was near to that of the physiological substrate. 2. CoA
      sulfoxides derived from the CoA-thioethers displayed affinities to the reductase
      superior to that of the physiological substrate (Km = 7 microM). Depending on the
      degree of recognition of diastereomers by the enzyme, the inhibitor constants of
      the two best inhibitors vary from Ki = 200 nM and Ki = 80 nM (diastereomeric
      mixtures) to 25 nM and 20 nM, respectively (if only one diastereomer would
      interact with the enzyme).

PMID- 1735441
TI  - Mechanism of racemization of amino acids by aspartate aminotransferase.
AB  - Aspartate aminotransferase (mitochondrial isoenzyme from chicken) has been found
      to racemize very slowly dicarboxylic amino acid substrates in the presence of
      their cognate oxo acids [Kochhar, S. & Christen, P. (1988) Eur. J. Biochem. 175,
      433-438]. Tyrosine, phenylalanine and alanine are racemized at the same rate
      although they undergo the transamination reaction 3-5 orders of magnitude more
      slowly than the dicarboxylic substrates. Similarly, the truncated enzyme
      aspartate aminotransferase-(27/32-410) catalyzes the racemization at the same
      rate as the native enzyme, while its rate of transamination is decreased to 3% of
      that of the native enzyme. Apparently, the rate-limiting step in racemization is
      not immediately linked to the transamination cycle. Decreasing the water
      concentration in the reaction medium by adding methanol at 0 degrees C
      drastically reduces the rate of racemization without affecting the rate of
      transamination. On the basis of these and additional kinetic data and the model
      of the three-dimensional structure of the active site, we conclude that a water
      molecule is responsible for the protonation of C alpha of the coenzyme-substrate
      intermediate from the wrong side. The diffusion of the water molecule into the
      interior of the enzyme appears to be the rate-limiting step in aspartate
      aminotransferase-catalyzed racemization.

PMID- 1735442
TI  - Purification and characterization of proteinase yscJ, a new yeast peptidase.
AB  - A newly recognized peptidase, designated proteinase yscJ, was purified from the
      yeast Saccharomyces cerevisiae. The enzyme is of non-vacuolar origin and cleaves
      the Tyr-Lys bond of the synthetic peptide substrate Cbz-Tyr-Lys-Arg-NH-Ph (Cbz,
      benzyloxycarbonyl; NH-Ph, 4-nitroanilide) and the Glu-Lys bond of the substrate
      Boc-Glu-Lys-Lys-NH-Mec (Boc, butoxycarbonyl; Mec, 4-methylcoumarinyl) with high
      efficiency. Optimum pH for cleavage of Cbz-Tyr-Lys-Arg-NH-Ph is in the range 7.0
      7.5. The purified enzyme has a molecular mass of approximately 58 kDa, as judged
      by gel filtration on a Superose 12 FPLC column. Mercury compounds and EDTA were
      found to be potent inhibitors of proteinase yscJ activity.

PMID- 1735443
TI  - Extended type-1 chain glycosphingolipid antigens. Isolation and characterization
      of trifucosyl-Leb antigen (III4V4VI2Fuc3Lc6).
AB  - A Lewis-b-active glycosphingolipid containing a repetitive type-1 chain
      carbohydrate core was isolated from human colonic adenocarcinoma cell line
      Colo205. This glycosphingolipid was purified by HPLC and preparative high
      performance thin-layer chromatography and its structure elucidated by positive
      ion fast-atom-bombardment mass spectrometry with collision-induced
      disassociation, 1H-NMR spectroscopy and methylation analysis. The
      glycosphingolipid was found to be a trifucosylated derivative of this novel
      carbohydrate core, having the following structure: [formula; see text].

PMID- 1735444
TI  - Primary structure and import pathway of the rotenone-insensitive NADH-ubiquinone
      oxidoreductase of mitochondria from Saccharomyces cerevisiae.
AB  - The gene encoding the yeast mitochondrial rotenone-insensitive internal NADH:
      ubiquinone-6 oxidoreductase has been sequenced. The DNA sequence indicates the
      presence of an open reading frame of 1539 bp predicted to encode a protein of 513
      amino acid residues (57.2 kDa). The NADH dehydrogenase is synthesized as a
      precursor protein containing a signal sequence of 26 residues. In vitro import
      experiments show that the precursor NADH dehydrogenase is cleaved to the mature
      size by the matrix processing peptidase. Both cleavage and translocation across
      the mitochondrial membrane(s) are dependent on the membrane potential component
      of the proton-motive force. Comparison of the protein sequence of the yeast NADH
      dehydrogenase with the data bank indicates that the enzyme from yeast is
      homologous to the NADH dehydrogenase of Escherichia coli (22.2% identical
      residues). Both NADH dehydrogenases contain in the central part of the protein a
      sequence predicted to fold into a beta alpha beta structure involved in the
      binding of NADH or FAD(H2). Various aspects of the protein structure are
      discussed.

PMID- 1735445
TI  - Carnitine biosynthesis in hepatic peroxisomes. Demonstration of gamma
      butyrobetaine hydroxylase activity.
AB  - We have investigated whether hepatic peroxisomes are capable of synthesizing
      carnitine. When purified peroxisomes were incubated with gamma-butyrobetaine, a
      precursor of carnitine, formation of carnitine was observed. These results
      indicate that peroxisomes contain gamma-butyrobetaine hydroxylase, the enzyme
      which catalyzes the final step in the biosynthesis of carnitine. This enzyme was
      previously believed to be present only in the cytosol. gamma-Butyrobetaine
      hydroxylase activity in peroxisomes was not due to cytosolic contamination as
      evaluated by marker enzyme analysis. When proliferation of peroxisomes was
      induced by clofibrate treatment, gamma-butyrobetaine hydroxylase/mass liver
      increased by 7.6-fold and the specific activity by 2.5-fold. We conclude that
      hepatic peroxisomes synthesize carnitine and this synthesis becomes substantial
      under conditions of peroxisomal proliferation.

PMID- 1735446
TI  - Differential proteolytic sensitivity of yeast fatty acid synthetase subunits
      alpha and beta contributing to a balanced ratio of both fatty acid synthetase
      components.
AB  - The Saccharomyces cerevisiae genes FAS1 and FAS2 encoding the beta and alpha
      subunit of yeast fatty acid synthetase (FAS), respectively, were individually
      deleted by one-step gene disruption. Northern blot analysis of RNA from the
      resulting fas null allele mutants indicated that deletion of FAS2 did not
      influence the transcription of FAS1, while FAS2 transcription was significantly
      reduced in the delta fas1 strain. These data suggest an activating role of
      subunit beta on FAS2 gene expression or, alternatively, a repression of FAS2 by
      an excess of its own gene product. Compared to the intact alpha 6 beta 6 complex,
      the individual FAS subunits synthesized in the delta fas1 or delta fas2 strains
      exhibit a considerably increased sensitivity towards the proteinases present in
      the yeast cell homogenate. Using yeast mutants specifically defective in the
      vacuolar proteinases yscA (PRA1/ PEP4 gene product) and/or yscB (PRB1 gene
      product), it was shown that in vitro, subunit alpha is efficiently degraded by
      proteinase yscA while for degradation of subunit beta, the combined action of
      proteinases yscA and yscB is necessary. In vivo, besides the vacuolar
      proteinases, an additional proteolytic activity specifically affecting free FAS
      subunit alpha becomes increasingly apparent in cells entering the stationary
      growth phase. In contrast, under similar conditions uncomplexed FAS subunit beta
      is stable in strains lacking the vacuolar proteinases yscA and yscB. The reduced
      FAS subunit levels, at the stationary phase, were independent of the
      corresponding FAS transcript concentrations. Thus, differential degradation
      pathways are obviously removing an excess of either FAS subunit, at least under
      starvation conditions. A combination of both regulation of FAS gene expression
      and proteolysis of free FAS polypeptides may therefore explain the equimolar
      amounts of both FAS subunits observed in yeast wild-type cells.

PMID- 1735447
TI  - Biogenesis of the yeast vacuole (lysosome). Mutation in the active site of the
      vacuolar serine proteinase yscB abolishes proteolytic maturation of its 73-kDa
      precursor to the 41.5-kDa pro-enzyme and a newly detected 41-kDa peptide.
AB  - The codon of the catalytic serine in the active site of the vacuolar serine
      proteinase yscB (PrB) was changed to alanine, yielding the mutant gene prb1
      Ala519. Following replacement of the wild-type PRB1 allele with prb1-Ala519, only
      a 73-kDa molecule was detected by immunoprecipitation with PrB-specific
      antiserum. The size of the mutant molecule corresponds to the unprocessed
      cytoplasmic precursor (pre-super-pro-PrB), as detected in sec61 mutants, when
      translocation into the endoplasmic reticulum is blocked. However, the mutant
      molecule is completely translocated into the secretory pathway, as indicated by
      protection from proteinase K digestion in spheroplast lysates in the absence of
      detergent. When N-glycosylation was inhibited in prb1-Ala519 mutant cells by
      tunicamycin, a smaller molecule of about 71 kDa appeared consistent with single N
      glycosylation and signal-sequence cleavage of the translocated mutant PrB
      molecule in the endoplasmic reticulum. Thus, the active-site mutation prevents
      the wild-type processing of the N-glycosylated 73-kDa precursor of PrB to the
      41.5 kDa pro-PrB in the endoplasmic reticulum. In order to characterize the
      processing of wild-type super-pro-PrB in more detail, we generated antibodies
      against the non-enzymatic superpeptide domain of the 73-kDa precursor expressed
      in Escherichia coli. We find that, in addition to pro-PrB, a distinct protein
      (superpeptide) with a mobility of about 41 kDa in SDS/PAGE is generated in the
      endoplasmic reticulum. Pulse-chase experiments indicate rapid degradation of the
      41-kDa superpeptide in wild-type cells. Correspondingly, the superpeptide was
      virtually undetectable by immunoblotting wild-type cell extracts. In contrast, no
      degradation of radioactively labeled 41-kDa superpeptide was observed within 60
      min in mutant strains deficient in the vacuolar proteinase yscA (PrA), in which
      maturation of vacuolar pro-PrB to active PrB is blocked. Accordingly,
      superpeptide antigenic material was readily detected by immunoblotting cell
      extracts and enriched in vacuolar preparations of PrA deficient mutant cells.
      These results indicate that the superpeptide and pro-PrB travel to the vacuole,
      where the superpeptide is rapidly degraded upon pro-PrB activation to PrB. Using
      purified vacuoles, rapid degradation of the superpeptide was reconstituted in
      vitro by addition of either mature PrA or mature PrB. However, the PrA-triggered
      in vitro degradation of the superpeptide required PrB activity, as this process
      was inhibited in the presence of the PrB inhibitor chymostatin.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1735448
TI  - Modifications of hepatic alpha-1-acid glycoprotein and albumin gene expression in
      rats treated with phenobarbital.
AB  - The serum level of alpha 1-acid glycoprotein (alpha 1-AGP) is significantly
      increased in various animal species by treatment with cytokines, glucocorticoids
      and phenobarbital. The mechanisms responsible for the cytokine-induced and
      glucocorticoid-induced increases are now well documented, but not so in the case
      of phenobarbital. The main purpose of this study was to assess whether
      phenobarbital acts on alpha 1-AGP synthesis in the liver at the transcriptional
      or translational level. Male Dark Agouti rats received 70 mg phenobarbital/kg
      daily for 7 days. The analysis of total hepatic RNA showed that a single
      injection of phenobarbital induced an 11-fold increase in phenobarbital-dependent
      cytochrome P450IIB mRNA, whereas seven injections of phenobarbital were required
      to induce a maximum 5.5-fold increase in alpha 1-AGP mRNA. Concurrently, the
      transcription rate of the alpha 1-AGP gene rose 3.5-fold. Hepatocytes isolated
      after the seventh injection of phenobarbital showed a threefold increased
      capacity to secrete alpha 1-AGP, corresponding to a 3.2-fold increased alpha 1
      AGP mRNA content in the liver. In conditions in which its effect on the induction
      of alpha 1-AGP synthesis was maximum, phenobarbital caused a 30% reduction in
      liver albumin mRNA and in albumin secretion by isolated hepatocytes, resulting
      from a 60-70% reduction in the rate of transcription of the albumin gene measured
      in isolated nuclei. We conclude that the effect of phenobarbital on alpha 1-AGP
      and albumin gene expression occurs at the transcriptional rather than the
      translational level.

PMID- 1735449
TI  - Site-specific O-glycosylation of human granulocyte/macrophage colony-stimulating
      factor secreted by yeast and animal cells.
AB  - To compare the site specificity of O-glycosylation in lower and higher
      eukaryotes, we expressed human granulocyte/macrophage colony-stimulating factor
      (hGM-CSF) in the yeast Saccharomyces cerevisiae and in COS-1 cells. Analyses of
      specific hGM-CSF mutants secreted by yeast led to the conclusion that efficient O
      glycosylation in yeast requires residues S9 and T10. However, only S9 is used as
      an attachment point for an extended O-glycosyl chain in a 15.5-kDa hGM-CSF form.
      A 14.5-kDa hGM-CSF form, secreted by yeast, appears substituted by single
      mannosyl residues at both positions S9 and T10, indicating that O-glycosylation
      at T10 inhibits extension of the O-glycosyl chain attached to S9. As in yeast
      cells, the addition of O-glycosyl chains to hGM-CSF secreted by COS-1 cells
      requires the presence of S9 and T10 residues. These results demonstrate that,
      inspite of different biosynthetic routes, the selection of O-glycosylation sites
      is similar between lower and higher eukaryotes.

PMID- 1735450
TI  - Regulation of Schwann cell proliferation: mechanisms involved in peripheral nerve
      development.

PMID- 1735451
TI  - Cooperation of p53 and polyoma virus middle T antigen in the transformation of
      primary rat embryo fibroblasts.
AB  - Cell transformation in vivo seems to be a multistep process. In in vitro studies
      certain combinations of two oncogenes, a cytoplasmic gene product together with a
      nuclear gene product, are sufficient to transform primary rodent cells. Polyoma
      virus large T antigen can immortalize and, in cooperation with polyoma virus
      middle T antigen, transform primary cells. On the other hand mutant mouse p53 can
      also immortalize and, in cooperation with an activated Ha-ras oncogene, transform
      primary cells. In the present study we analyzed whether mutant p53 can replace
      polyoma virus large T antigen in a cell transformation assay with polyoma virus
      middle T antigen. Transfection of mutant p53 alone resulted in a cell line which
      had retained the actin cable network, grew poorly in medium with low
      concentration of serum, and failed to grow in semisolid agar. Cotransfection of
      mutant p53 together with polyoma virus middle T led to cells which grew in medium
      containing low serum concentration, grew well in semisolid agar, and displayed an
      altered morphology with the tendency to overgrow the normal monolayer. By these
      criteria these cells were considered fully transformed. The rate of p53 synthesis
      was similar in both cell lines. However, only p53 from the transformed cell line
      turned out to be stable. Cells transformed by mutant p53 and polyoma virus middle
      T expressed nearly the same amount of the c-src-encoded pp60c-src protein as
      cells transformed by the same p53 and cotransfected activated Ha-ras oncogene.
      However, only the polyoma virus middle T/p53-transformed cells exhibited an
      elevated level of pp60c-src-specific tyrosine kinase activity. Thus, despite
      different mechanisms leading to cell transformation, mutant p53 can replace
      polyoma virus large T antigen and polyoma virus middle T can replace the
      activated Ha-ras oncogene in cell transformation.

PMID- 1735452
TI  - Differential expression of PKC isoforms and PC12 cell differentiation.
AB  - Recent reports indicate that the protein kinase inhibitor H7 is capable of
      inducing both morphological and functional differentiation of a number of neural
      cell types. This investigation demonstrates that H7 potentiates the neurogenic
      properties of nerve growth factor (NGF) in PC12 cells with a concomitant change
      in the accumulation of the beta II-protein kinase C (beta IIPKC) isoform protein
      without changes in either alpha or gamma. However, NGF alone stimulates a
      coordinate increase in all three isoforms. The assay of acetylcholine esterase as
      a functional marker of neuronal differentiation demonstrates that H7 alone is not
      capable of stimulating morphological or functional differentiation in PC12 cells.
      H7 synergizes with NGF through a PKC-dependent pathway and by differential
      expression of PKC subtypes. The expression of the PKC transcripts for alpha, beta
      II, and gamma all undergo simultaneous yet differential changes in their patterns
      of expression during treatment with H7 and/or NGF. These data suggest that
      isoform switching is regulated primarily at the protein level. Last, these
      findings suggest that expression of PKC isoforms is tightly coupled with neuronal
      differentiation and may play a role in the maintenance of the differentiated
      state.

PMID- 1735453
TI  - Dynamics of the dATP pool in cultured mammalian cells.
AB  - Conditions for labeling the dATP pool of V79 and 3T3 cells from
      [3H]deoxyadenosine (salvage) or [3H]adenine (via ribonucleotide reduction) were
      established. With deoxyadenosine the specific radioactivity of dATP reached a
      constant value after 60 min. In resting 3T3 cells this value was 30 times higher
      than in S-phase cells. Turnover of dATP and absolute rates of DNA synthesis and
      excretion of breakdown products of dATP were determined from the accumulation of
      isotope in various compartments and the specific activity of dATP. In S-phase
      cells the dATP pool had a half-life of 4 min, identical to that of dTTP
      determined earlier. Deoxyadenosine was the major breakdown product of dATP in the
      presence of an inhibitor of adenosine deaminase. The rate of deoxyadenosine
      excretion of V79 cells amounted to 4% of the rate of dATP incorporation into DNA.
      Inhibition of DNA replication increased deoxyadenosine excretion 5- to 10-fold,
      demonstrating a continued de novo synthesis of dATP, albeit at a slightly reduced
      rate. Our results fit a model involving a substrate cycle between dAMP and
      deoxyadenosine regulating the dATP pool, similar to the model of substrate cycles
      involved in the regulation of pyrimidine deoxyribonucleotide pools developed
      earlier.

PMID- 1735454
TI  - Expression of c-fos and c-jun mRNA in the developing chicken lens: relationship
      to cell proliferation, quiescence, and differentiation.
AB  - The in vivo developmental pattern of c-fos and c-jun mRNA expression has been
      examined in the embryonic chicken lens using a coupled reverse
      transcription/polymerase chain reaction assay. Levels of each mRNA were measured
      in the central epithelium, equatorial epithelium, and fiber cell mass at 6, 10,
      14, and 19 days of development. The results showed that c-fos and c-jun mRNAs
      accumulated during development of the embryonic chicken lens epithelium as the
      proportion of proliferating cells decreased, suggesting that quiescent epithelial
      cells express high levels of both protooncogene mRNAs. Cells in the early stages
      of terminal differentiation near the lens equator also contained relatively high
      levels of c-fos and c-jun mRNA. As lens fiber cells matured, the number of copies
      of c-fos mRNA per cell decreased markedly, while c-jun mRNA increased. These
      findings demonstrate that c-fos and c-jun are differentially regulated during
      terminal differentiation of lens fiber cells and suggest that these
      protooncogenes are expressed in lens epithelial cells following cell cycle
      arrest.

PMID- 1735455
TI  - Stimulation of proliferation of HL60 cells by low concentrations of 12-O
      tetradecanoylphorbol-13-acetate and its relationship to the mitogenic effects of
      insulin.
AB  - The effects of the phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) on
      the growth and differentiation of cultured human acute promyelocytic leukemia
      (HL60) cells have been studied using cells growing in a fully defined medium
      consisting of RPMI 1640 supplemented with selenium dioxide, insulin, and either
      transferrin or ferric citrate. High concentrations of TPA (greater than 1 nM)
      cause the expected inhibition of proliferation and induction of macrophage-like
      differentiation. In contrast, in cells deprived of insulin, which continue to
      grow at a slow rate, lower concentrations of TPA stimulate proliferation without
      inducing differentiation. A TPA concentration between 0.03 and 0.3 nM will
      approximately double the long-term rate of thymidine incorporation into DNA and
      the rate of increase in cell density. Low-TPA becomes progressively less able to
      stimulate further proliferation as the insulin concentration is increased and is
      virtually without effect on cells stimulated by an optimal insulin concentration
      (5 micrograms ml-1). Insulin itself stimulates proliferation to a greater extent
      than low-TPA, increasing the long-term rate of thymidine incorporation and the
      rate of increase in cell density by three- to fourfold. The ability of higher
      concentrations of TPA to induce differentiation is independent of the presence of
      insulin. Low-TPA also stimulates the short-term incorporation of thymidine
      (during a 1-h pulse after 1 or 2 days incubation) by three- to fourfold, as
      compared to a sevenfold stimulation by insulin. The proliferation response to low
      TPA concentrations provides a useful model for dissecting the signalling pathways
      that control cell proliferation following stimulation by insulin and activators
      of protein kinase C.

PMID- 1735456
TI  - Mitogenic effects of bacterial neuroaminidase and lactosylceramide on human
      cultured fibroblasts.
AB  - Exogenously added bacterial neuraminidase and lactosylceramide both stimulated
      the growth of cultured human skin fibroblasts. Neuraminidase (100 units/ml)
      increased DNA synthesis 1.9-fold and cell density 1.4-fold after 24 and 48 h,
      respectively, in culture. Treated fibroblasts contained less ganglioside NeuAc
      alpha 2-3Gal beta 1-4GlcCer (GM3), presumably due to neuraminidase-catalyzed
      hydrolysis to lactosylceramide. Addition of lactosylceramide (100 microM) to the
      fibroblast culture medium also increased DNA synthesis threefold within 24 h and
      cell density twofold after 48 h. These findings are compatible with a mechanism
      by which the proliferation of human fibroblasts is regulated by the relative
      levels of GM3 and lactosylceramide in the plasma membrane.

PMID- 1735457
TI  - Role of spectrin in Amoeba proteus, as studied by microinjection of anti-spectrin
      monoclonal antibodies.
AB  - Spectrin is a major protein accounting for about 5% of whole-cell proteins in
      Amoeba proteus, and the precipitation of spectrin by intracellular injection of
      purified anti-spectrin monoclonal antibodies has a profound effect on cell
      morphology, motility, and movement-related cell activities in amoebae. Thus,
      amoebae injected with anti-spectrin antibodies show drastic changes in their
      shape and movement, suggesting that amoeba spectrin plays an important structural
      role, unlike nonerythroid spectrins in other cells. However, precipitation of
      spectrin does not affect the distribution of F-actin in amoebae.

PMID- 1735458
TI  - Internalization efficiency of the transferrin receptor.
AB  - Quantitative ultrastructural and biochemical methods have allowed us to obtain a
      coherent set of data on the internalization efficiency of the transferrin
      receptor (TfR). In confluent cell cultures we find that (1) the initial
      internalization rate of transferrin is approximately 10% per minute, and (2)
      around 10% of cell-surface TfRs are present in coated pits. From these data a
      lifetime of coated pits of ca. 1 min is derived. Furthermore, we show that coated
      pits constitute 1.1-1.4% of the plasma membrane area in confluent cell cultures.
      Thus, the TfR is concentrated six- to ninefold in coated pits compared to
      resident plasma membrane proteins. Moreover, we show that the concentration of
      TfRs in coated pits is cell density dependent, since only around 5% of the
      receptors are present in coated pits in low-density cultures. Correspondingly,
      the internalization of TfRs in high-density cell cultures is roughly twice as
      efficient as that in low-density cell cultures. The reduced TfR internalization
      efficiency at low cell density is accounted for by a concomitant decrease to
      0.55% in the relative surface area occupied by coated pits.

PMID- 1735459
TI  - Differentiation of A31T6 proadipocytes to adipocytes: a flow cytometric analysis.
AB  - A flow cytometric assay has been developed which provides precise, quantitative
      information on the accumulation of cytoplasmic triglycerides in individual A31T6
      proadipocytes as they differentiate into adipocytes. The opportunity to measure
      multiple optical parameters on a cell-by-cell basis has enabled us to monitor
      phenotypic aspects of differentiation with a greater level of sensitivity than
      was previously possible. Using the fluorescent hydrophobic probe, Nile red, we
      have found that as a cell proceeds along the differentiation pathway, the gold
      fluorescence signal from the cell increases, reflecting the accumulation of
      cytoplasmic lipid droplets. The value of the ratio of gold to red fluorescence
      defines a cell as being differentiated or undifferentiated. The greater
      resolution afforded by this cytometric method over more conventional approaches
      has allowed us to determine (1) the presence of an undifferentiated population of
      cells whose existence is not detected by conventional phase microscopy, (2) that
      insulin is not required to drive differentiation in this system, though the rate
      of differentiation is increased when the cells are exposed to insulin in
      combination with dexamethasone, (3) that exposure to a combination of insulin and
      dexamethasone results in a lower accumulation of lipid in a cell than does
      exposure to either agent alone, and (4) that A31T6 cells show the same response
      to differentiation-promoting agents whether applied at the time of plating or at
      confluence.

PMID- 1735460
TI  - The expression pattern of the pyruvate dehydrogenase E1 alpha subunit genes
      during spermatogenesis in adult mouse.
AB  - The expression patterns of the testis-specific and somatic forms of the pyruvate
      dehydrogenase (PDH) E1 alpha subunit genes were examined in adult mouse testis by
      in situ hybridization with specific cDNA probes and by immunostaining. A
      considerable increase in the mRNA level of the testis-specific PDH E1 alpha gene
      was observed in spermatocytes at the pachytene stage. The expression gradually
      decreased in spermatids as spermiogenesis progressed (especially after step 11)
      and it was not detectable in residual bodies. Transcripts of the testis-specific
      PDH E1 alpha gene were not identified in nongerminal Leydig and Sertoli cells. In
      contrast, the expression of the somatic form of the PDH E1 alpha gene was
      detected in spermatogonia, Leydig cells, and Sertoli cells at a low level.
      Transcripts of the somatic form of the PDH E1 alpha gene were not identified in
      other types of germ cells in adult mouse testis. Immunostaining with a PDH E1
      alpha-specific antibody showed that the synthesis of PDH E1 alpha protein was
      dramatically increased in primary spermatocytes and that PDH E1 alpha protein
      existed abundantly in pachytene spermatocytes. The amount of PDH E1 alpha protein
      remained at a high level throughout spermiogenesis; however, it declined
      remarkably in epididymal spermatozoa. Leydig cells, Sertoli cells, and
      spermatogonia had low levels of PDH E1 alpha protein. These results suggest that
      (1) the transcription switch from the somatic form of the PDH E1 alpha gene to
      the testis-specific PDH E1 alpha gene occurs during the first meiotic prophase of
      spermatogenesis in adult mouse testis, and (2) PDH E1 alpha protein coded for by
      the testis-specific PDH E1 alpha gene is involved in the development of
      spermatogenic cells especially at stages after first meiotic prophase until the
      end of spermiogenesis in the testis.

PMID- 1735461
TI  - Distribution of the surface antigen HAM-4 and cytoskeleton during reformation of
      bile-canalicular structures in rat primary cultured hepatocytes.
AB  - The distribution of rat bile-canalicular surface antigen (HAM-4 antigen) and
      cytoskeletal elements (microtubules, actin filaments, and cytokeratin filaments)
      was examined during the reformation of bile-canalicular structures (BC
      structures) in primary cultures of dissociated hepatocytes obtained following
      collagenase perfusion. HAM-4 antigen, which initially dispersed after cell
      dissociation, became focused into regions of cell-to-cell contact even before
      formation of BC-structures. Typical bile-canalicular microvilli also appeared in
      these regions before the intercellular spaces were completely closed. Finally,
      after in vitro reformation of BC, HAM-4 antigen was localized specifically at the
      BC-surface. The process of BC-reformation and the intracellular organization of
      actin and cytokeratin filaments were not significantly affected by microtubule
      inhibitors (nocodazole, colcemid, and colchicine). However, the localization of
      HAM-4 antigen molecules at the surface of BC was disrupted by these inhibitors,
      suggesting that the distribution of HAM-4 antigen, which represents a marker for
      the reconstruction of surface polarity, is dependent on microtubule function.

PMID- 1735462
TI  - Cloned endothelium derived from autoimmune vascular disease retain structural and
      functional characteristics of normal endothelial cells.
AB  - MRL/1pr mice demonstrate anatomic specificity in their development of vasculitis
      including the small- and medium-sized muscular arteries of the mesentery. To
      define the functional role of endothelium in vasculitis, we have cloned
      endothelial cells derived from inflamed small- and medium-sized arteries. Primary
      cells were derived by enzymatic dispersement and endothelial cells were selected
      by utilizing a combination of specific culture conditions. Cloned endothelium
      were developed utilizing limiting dilution cultures supplemented by endothelial
      cell growth factor. The cloned endothelial cells express many structural features
      of mature endothelial cells including Factor VIII-RA, non-muscle-specific actin,
      and Weibel-Palade bodies. Functionally, the clones express functional receptors
      for the scavenger pathway for LDL metabolism. The cells do not express Class I
      MHC antigens; however, IFN-beta and IFN-gamma stimulate Class I MHC expression
      after 24 h, which induces lysis of virus-infected cloned endothelium by Class I
      restricted virus-primed T cells. In direct contrast to site-identical vascular
      smooth muscle cells (VSMCs), endothelial cells do not spontaneously express Class
      II MHC antigens, nor do they secrete biologically relevant levels of IL-1 unless
      triggered by lipopolysaccharide. The availability of site-specific cloned
      endothelium along with cloned VSMCs from autoimmune mice should resolve major
      experimental controversies involving the pathophysiology of inflammatory vascular
      disease.

PMID- 1735463
TI  - Identification and localization of a nucleolin homologue in onion nucleoli.
AB  - A protein homologous to nucleolin, a major nucleolar protein with multifunctional
      features involved in pre-rRNA synthesis and early processing, has been identified
      and localized in situ in onion root meristematic cells by different techniques,
      which have included the use of an antibody raised against hamster nucleolin. The
      protein was identified on Western blots of nucleolar proteins as a 64-kDa band,
      by means of the anti-nucleolin antibody, bismuth staining, and the silver
      staining-nucleolar organizer (Ag-NOR) method. The experiments also suggested that
      nucleolin could be a target of these two cytochemical stainings. Although the 64
      kDa band corresponds to a major nucleolar protein, it is a minor one among total
      nuclear proteins. The same techniques were used in situ at the ultrastructural
      level, and the immunogold detection of the nucleolin homologue was quantitatively
      evaluated. The protein accumulates in the transition area from nucleolar
      fibrillar centers to the dense fibrillar component, which is considered to be the
      structural result of ribosomal gene transcription. Out of this transition area,
      the dense fibrillar component may be divided into two regions, proximal and
      distal with respect to fibrillar centers, which show, respectively, the
      significant and unsignificant presence of nucleolin; we interpret this fact as
      the expression of the topological arrangement of pre-rRNA processing. Fibrillar
      centers themselves showed a weak but significant labeling with the anti-nucleolin
      antibody. However, bismuth staining was absent from the interior of fibrillar
      centers, indicating that the nucleolin in them is not phosphorylated. Ag-NOR
      staining uniformly covered fibrillar centers and the dense fibrillar component
      (at least in its proximal region), but it did not stain condensed chromatin
      inclusions in heterogeneous fibrillar centers, showing that the binding of
      nucleolin to chromatin is associated with its decondensation. This work provides
      additional evidence of the high phylogenetic conservation of molecular motifs
      which take part in ribosome biogenesis.

PMID- 1735464
TI  - Cell growth inhibition by prostaglandin A2 results in elevated expression of
      gadd153 mRNA.
AB  - Treatment of Hela cells with prostaglandin A2 (PGA2) resulted in a marked
      inhibition of cell proliferation which was associated with a significant
      induction of gadd153 mRNA, a member of a novel class of genes associated with
      growth arrest and DNA damage. Induction of gadd153 mRNA was specific to
      prostaglandins capable of arresting cell growth and was dose-dependent with the
      maximum effect seen at 36 microM PGA2. Induction was rapid, occurring within 2-4
      h and reaching a maximum by 8 h. These effects were reversible as removal of PGA2
      resulted in a rapid decline in gadd153 mRNA levels coincident with resumption of
      cell growth. PGA2 induction of gadd153 mRNA was completely prevented by the
      presence of actinomycin D at a concentration sufficient to block transcription
      and was partially inhibited (50%) by the protein synthesis inhibitor
      cycloheximide. The presence of the protein kinase inhibitor 2-aminopurine
      decreased the PGA2 induction of gadd153 mRNA by greater than 90%, suggesting that
      cellular kinases play a role in the induction of gadd153 by PGA2. Thus PGA2
      mediated growth arrest provides a useful model to further define the role of
      gadd153 in the negative control of cell growth.

PMID- 1735465
TI  - The epidermal growth factor receptor is associated with actin filaments.
AB  - In this paper we describe our investigations on the association of receptors for
      the epidermal growth factor (EGF) with the cytoskeleton of A431 cells. In order
      to determine which filamentous system the EGF receptors are associated to, the
      cytoskeletal fraction to which these receptors bind was isolated. Second, the
      possible colocalization of EGF receptors with different cytoskeletal elements was
      examined in A431 cells. By selective extractions of the A431 cytoskeletons, it is
      shown that more than 90% of the cytoskeleton-associated EGF receptors are removed
      from the cytoskeletons together with the actin filamentous system. During several
      cycles of poly- and depolymerization of actin isolated from A431 cells, the EGF
      receptor precipitates together with the actin containing filaments, indicating
      that EGF receptors are able to bind in vitro to actin filaments. With
      immunofluorescence studies we show that EGF receptors especially colocalize with
      actin filaments. These results demonstrate that the EGF receptor is associated
      specifically with actin filaments in A431 cells.

PMID- 1735466
TI  - Biochemical and behavioral recovery in a rodent model of Parkinson's disease
      following stereotactic implantation of dopamine-containing liposomes.
AB  - We have developed and characterized dopamine-containing liposomes which exhibited
      in vitro sustained release of dopamine for over 40 days. These liposomes were
      stereotactically implanted into the partially denervated corpus striatum of rats
      subjected to unilateral lesions of the substantia nigra. In vivo release of
      dopamine into striatal extracellular fluid was monitored by microdialysis and
      behavior was assessed by quantifying apomorphine-induced asymmetric rotation.
      Extracellular dopamine levels in the partially denervated striatum of the
      dopamine liposome-treated rats were greater than the levels in the lesioned rats
      which received control liposomes and these levels remained elevated for 25 days.
      In parallel, those rats which received dopamine liposomes exhibited partial
      behavioral recovery, with attenuation of asymmetric rotation following systemic
      apomorphine administration. These results suggest that dopamine-containing
      liposomes can partially ameliorate the deficits associated with a rodent model of
      Parkinson's disease, and demonstrate the potential of this technology as a method
      for the controlled delivery of therapeutic agents into discrete areas of the
      brain.

PMID- 1735467
TI  - Monoamine oxidases of the brains and livers of macaque and cercopithecus monkeys.
AB  - We assessed the two forms of monoamine oxidase (MAO), MAO-A and MAO-B, in
      discrete regions of the brain and in cerebral micro- and macrovessels, choroid
      plexus, and liver of three species of monkeys: African Green, rhesus, and
      cynomolgus. MAO was determined by specific [3H]pargyline binding which is
      stoichiometric and irreversible and by measuring the rate of oxidation of several
      substrates. Cerebral micro- and macrovessels had low MAO content. Regional brain
      MAO did not vary by more than one-fold in the brains of each of the three species
      of monkeys and was higher in the basal ganglia than in the cerebral cortex or
      cerebellum. MAO in the choroid plexus was low, while the liver had higher MAO
      activity than any of the brain samples. The vast majority of MAO in all the
      tissues that we examined was of the MAO-B type, and specific [3H]pargyline
      binding correlated well with the oxidation rate of 1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine. These results show marked similarities in brain MAO
      distribution between monkey and man. Or the three monkey species, the African
      Green monkey had the lowest MAO activity in its cerebral microvessels, which
      constitute the blood-brain barrier, although the small number of observations in
      each group did not allow statistical analyses of the differences.

PMID- 1735468
TI  - Chronic intrastriatal injection of the excitatory amino acid receptor antagonist
      L-kynurenic acid in rat produces selective neuron sparing lesions.
AB  - Heritable neurodegenerative diseases may be associated with one or more
      endogenous neurotoxins whose actions on neurons lead to the degenerative changes.
      One metabolite of tryptophan, the amino acid L-kynurenic acid (L-KYN), was
      chronically injected into the striatum of the male rat to test its potential as
      an endogenous neurotoxin. L-KYN, at concentrations of approximately five times
      its normal brain levels, produced a large lesion with relative selective neuron
      sparing. The L-KYN-induced lesion presented three concentric regions: a central
      necrotic zone, a thin pyknotic zone, and an outermost spongiose zone. The number
      of GABA-ergic neurons were markedly reduced (approximately 76%), while
      cholinesterase-positive neurons were also lost. The NADPH diaphorase-positive
      neurons were the most resistant to L-KYN neurotoxicity and were spread throughout
      the spongiose zone. The brain levels of L-KYN are abnormal in patients with the
      neurodegenerative disorder Huntington's disease and as a neurotoxin L-KYN may
      play a role in the etiology of this disease. Of further significance, the fact
      that L-KYN is neurotoxic contraindicates the use of this excitatory amino acid
      receptor antagonist as a therapeutic agent in the treatment of neurodegenerative
      disorders.

PMID- 1735469
TI  - Differential distribution of parvalbumin-immunoreactive pericellular clusters of
      terminal boutons in developing and adult monkey neocortex.
AB  - Basket cells are GABAergic inhibitory interneurons and known regulators of
      pyramidal cells, the major class of excitatory neurons in neocortex. Parvalbumin
      (PV), a calcium binding protein, has been colocalized with GABA in cortical
      neurons (Celio, 1986. Science 231: 995-998) and has been reported to be present
      in the terminal boutons of basket neurons forming pericellular clusters in monkey
      neocortex (Hendry et al. 1989. Exp. Brain Res. 76: 467-472). In this study, we
      used immunohistochemical methods to evaluate the regional and laminar
      distributions of PV-immunoreactive (PV-IR) pericellular clusters of terminal
      boutons in the neocortex of neonatal, infant, adolescent, and adult rhesus
      monkeys. PV-IR pericellular clusters were composed of labeled terminal boutons
      that outlined the somata and proximal dendrites of large pyramidal neurons in
      layers III and V of primary motor cortex, layers V and VI of primary visual
      cortex, and layer V of visual association cortex (area 18). This laminar pattern
      was present in neonatal animals and did not change with age in motor cortex.
      However, in the visual regions of adolescent and adult animals, such PV-IR
      structures were not detected. PV-positive pericellular clusters were not observed
      in the prefrontal cortex at any age. The pattern of distribution of PV-containing
      pericellular clusters paralleled that of a subpopulation of pyramidal neurons
      containing nonphosphorylated neurofilament proteins (NFP); double labeling
      studies confirmed that a subgroup of NFP-positive pyramidal neurons were the
      targets of PV-IR pericellular clusters. The distribution of PV-IR pericellular
      clusters was compared to that of PV-IR terminal boutons of another class of
      interneurons, the chandelier cells. Terminal boutons of chandelier neuron axons
      align in vertical rod-like structures known as cartridges. Subpopulations of
      chandelier axon cartridges have been previously shown to be PV-IR and their
      distribution in visual and prefrontal cortices has been described (DeFelipe et
      al. 1989. Brain Res. 503: 49-54; Lewis and Lund. 1990. J. Comp. Neurol. 293: 599
      615). These two types of structures composed of PV-IR terminal boutons tended to
      be present in different laminae in all regions and ages examined, except in layer
      III of primary motor cortex where both PV-IR pericellular clusters and chandelier
      cartridges were found. These findings indicate that in monkey neocortex PV
      immunoreactivity is present in pericellular clusters of terminal boutons that are
      likely to arise from basket cells.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1735470
TI  - Convergent inputs to single neurons in two different subdivisions of
      somatosensory forepaw digit cortex of the raccoon.
AB  - The aim of this study was to compare the physiological properties of single
      neurons in the glabrous (G) and heterogeneous (H) subdivisions of primary
      somatosensory digit 3 cortex of adult raccoons. Extracellular recordings were
      obtained from 50 G neurons whose receptive fields (RFs) were confined to the
      glabrous skin of a digit, and 41 H neurons whose RFs were located on hairy skin,
      claws, or mixtures of skin types. Both electrical and mechanical stimulation of
      the digits were used to assess excitatory neuronal responsiveness. The two sets
      of neurons, which had nearly identical depth distributions, differed considerably
      in their input convergence: (i) the percentage of neurons (%N) responding to
      electrical or mechanical stimulation of each off-focus digit and (ii) the number
      of digits from which individual cells could be driven were significantly greater
      for H neurons. Those G and H cells which could be excited by off-focus inputs
      were examined for probability of response (P), number of spikes per response
      (S/R), and latency of response (L) to digit stimulation. Surprisingly, for input
      from any one digit, there were no significant differences in these response
      properties between the two sets of neurons. However, inputs from different (on
      focus versus off-focus) digits varied significantly and revealed patterns of
      response properties that were qualitatively similar for both G and H neurons.
      Specifically, %N and P decreased while L increased symmetrically with distance of
      each off-focus digit from the central on-focus digit 3, reflecting corresponding
      variations in the synaptic accessibility and conduction time of off-focus
      excitatory inputs. In contrast, S/R values were very similar for all digits,
      suggesting that the synaptic strength of off-focus inputs is regulated
      independently of accessibility. Finally, preliminary findings indicated that
      denervation of the third digit caused a decrease in off-focus response latencies,
      while the normal latency profile across digits was retained. This suggests that
      the previously existing pattern of off-focus inputs to G and H neurons provides a
      template for denervation-induced cortical reorganization, whereby the synaptic
      efficacy of off-focus inputs is increased by disinhibition or facilitation.

PMID- 1735471
TI  - Experimental evidence of selective axonal regeneration in allogenic and isogenic
      Y-chambers.
AB  - Studies on axonal regeneration in Y-chambers over the past decade have
      consistently provided evidence of preferential growth toward a distal nerve
      piece. However, these findings are in contrast to the observations by Weiss and
      Taylor (1944. J. Exp. Zool. 95: 233-257), indicating that in fresh aortic Y
      chambers regenerating axons had no tendency to grow into a channel containing a
      distal nerve piece as compared to an open channel. The discrepancy between Weiss
      and Taylor's findings and those of later authors remains unexplained. In the
      present study we repeated the investigations by Weiss and Taylor, using both
      isogenic and allogenic aortic Y-chambers. In control groups the aorta graft was
      frozen and treated chemically to kill all cells and to deactivate possible growth
      factors of protein nature. In these groups preferential growth toward the distal
      nerve was pronounced although such specificity in growth was evident also in the
      nontreated types of aortic chambers. The findings do not support the results
      presented by Weiss and Taylor.

PMID- 1735472
TI  - Intracellular effects of QX-314 and Cs+ in hippocampal pyramidal neurons in vivo.
AB  - The effects of intracellular diffusion of the lidocaine derivative anesthetic QX
      314 and of Cs+, which block Na+ and K+ conductances, respectively, were
      investigated in vivo in rat CA1 and CA3 pyramidal neurons to demonstrate slow
      Ca(2+)-related events. QX-314 loading prevented fast Na+ spikes, but slower
      presumably Ca2+ spikes remained. A slower and a faster duration type of QX-314
      resistant spikes were observed. The former had high thresholds, while the latter
      was activated at moderate depolarized levels. The slower and the faster QX-314
      resistant spikes fired at frequencies up to 8/s and 35/s and were 35-60 and 5-10
      ms in duration, respectively. With Cs+ loading, pyramidal neurons depolarized and
      slow, presumably Ca2+, and fast Na+ spikes widened. Fast spikes usually showed a
      prominent shoulder and a slower repolarization. No differences were observed
      between drug effects in CA1 and CA3 neurons. In terms of their possible
      participation in theta rhythm genesis the slow QX-314-resistant events display
      the correct frequency and duration and can oscillate regeneratively.

PMID- 1735473
TI  - Effect of 4-methylcatechol on sciatic nerve growth factor level and motor nerve
      conduction velocity in experimental diabetic neuropathic process in rats.
AB  - This study examined the effects of 4-methylcatechol (4-MC), a nonamine catechol
      compound, on the neuropathic process of streptozotocin (STZ)-induced diabetic
      rats. 4-MC is one of the potent stimulators of nerve growth factor (NGF)
      synthesis at the cellular level and in cultured sciatic nerve segments of rats.
      Diabetic rats showed a statistically significant fall in sciatic motor nerve
      conduction velocity (MNCV) and a significantly reduced NGF content in the sciatic
      nerve (38.5 +/- 2.8% of control, P less than 0.01) during the experimental period
      of 4 weeks. 4-MC treatment of the diabetic rats for 4 weeks starting from the STZ
      injection elevated the NGF content (140% of untreated diabetic rats, P less than
      0.05) and prevented the reduction in MNCV, but no effect on high blood glucose
      levels was seen. These findings suggest that decreased NGF levels in the sciatic
      nerve of the experimental diabetic rat may be involved in the development of the
      diabetic neuropathic process and that 4-MC, which can elevate endogenous NGF
      levels in vivo, may compensate for the inhibitory effect of STZ on the NGF level
      in progressive diabetic neuropathy.

PMID- 1735474
TI  - Protein kinase C activity and subcellular distribution in rat brain following
      repeated electroconvulsive seizures.
AB  - Protein kinase C (PKC) activity was measured in samples of neocortex, cerebellum,
      and hippocampus from adult rats receiving a series of 10 electroconvulsive
      seizures (ECS). Rats were sacrificed immediately and at various intervals from 15
      min to 24 h after the last seizure. From 77 to 84% of total PKC activity was
      found in the cytosol versus the membrane fraction. PKC activity in cerebellum was
      significantly higher than in neocortex (15%, P less than 0.05). Repeated ECS
      treatment did not affect total PKC activity nor its distribution between membrane
      and cytosolic fractions when compared with sham ECS controls. This finding is in
      keeping with reports that adrenergic-stimulated phosphoinositol turnover is not
      altered 24 h following repeated ECS.

PMID- 1735475
TI  - Gestational hyperandrogenism.

PMID- 1735476
TI  - A step toward solving some of the problems of cryopreservation.

PMID- 1735477
TI  - In vitro fertilization in unstimulated cycles: the University of Southern
      California experience.
AB  - OBJECTIVE: To describe the clinical experience of our center with in vitro
      fertilization (IVF) in unstimulated cycles and to provide a comparison to
      stimulated cycles. DESIGN: Spontaneous ovulatory cycles were triggered with human
      chorionic gonadotropin in the midcycle, and 78 aspirations for IVF were
      performed, with the remainder of the IVF cycle proceeding in a standard manner.
      SETTING: The IVF program of the University of Southern California and the
      California Medical Center, Los Angeles, California. PATIENTS: Spontaneously
      ovulatory women (n = 46) with predominantly pelvic factor as their principal
      cause of infertility, under the age of 40, and no male factor. INTERVENTIONS:
      Human chorionic gonadotropin administration in midcycle, follicle aspiration,
      IVF, and embryo transfer. MAIN OUTCOME MEASURES: Embryo implantation and
      pregnancy. RESULTS: Seventy-eight follicle aspirations resulted in 11 clinical
      (14%) and 9 ongoing (12%) pregnancies. The per embryo implantation rate was 13%
      clinical and 11% ongoing. There was no decrease in per cycle pregnancy rates
      (PRs) for up to three unstimulated cycles. CONCLUSIONS: Unstimulated IVF is a
      viable alternative to stimulated cycles with PRs approximately one half those of
      stimulated cycles. It is reasonable to offer patients up to three cycles of
      unstimulated IVF without expecting a decrease in PRs.

PMID- 1735478
TI  - The predictive value of a single, early human chorionic gonadotropin measurement
      and the influence of maternal age on pregnancy outcome in an infertile
      population.
AB  - A single early quantitative hCG measurement 16 to 18 days after timed
      insemination has prognostic value with regard to pregnancy outcome in an
      asymptomatic, infertile population. Further, there is a statistically significant
      difference in the predictive value for hCG levels in patients less than or equal
      to 35 years compared with patients greater than 35 years of age. Interestingly,
      the same age-dependent phenomenon was observed when analyzing the predictive
      value of sonographically detected fetal heart motion at 5 weeks post-ovulation.
      We suggest that any investigation on pregnancy outcome, or its prediction should
      consider the impact of maternal age as a potentially significant covariate.

PMID- 1735479
TI  - An evaluation of Flowgel as an intraperitoneal barrier for prevention of
      postsurgical adhesion reformation.
AB  - Both Flowgel and Interceed(TC7) effectively inhibited postsurgical adhesion
      formation in the rabbit model. Given the unique handling characteristics of
      Flowgel, this material may have significant potential for use as an adjuvant in
      laparoscopic infertility procedures.

PMID- 1735480
TI  - The response of patients with polycystic ovarian disease to human menopausal
      gonadotropin therapy after ovarian electrocautery or a luteinizing hormone
      releasing hormone agonist.
AB  - OBJECTIVE: To compare the effect of ovarian electrocautery versus an intranasal
      (IN) luteinizing hormone-releasing hormone agonist (LH-RH-a) in the response of
      patients with polycystic ovarian disease (PCOD) to human menopausal gonadotropin
      (hMG) therapy. DESIGN: A prospective study with serial randomization of patients
      in two groups for treatment with ovarian electrocautery + hMG or LH-RH-a + hMG.
      SETTING: A teaching hospital reproductive endocrinology clinic. PATIENTS: Thirty
      three women with PCOD who failed to conceive after six treatment cycles with hMG.
      MAIN OUTCOME MEASURES: Midcycle and luteal phase endocrinology, ovulation,
      pregnancy rates (PRs), and miscarriage rates. RESULTS: There was no difference in
      the ovulation or PRs between the two groups. However, the number of cycles with
      multiple dominant follicles, the luteal phase serum testosterone, and the
      miscarriage rate were lower in the group pretreated with ovarian electrocautery.
      CONCLUSIONS: Pretreatment of patients with PCOD with ovarian electrocautery may
      be a better alternative to IN LH-RH-a therapy for induction of ovulation with
      hMG.

PMID- 1735481
TI  - Polycystic ovaries as a relative protective factor for bone mineral loss in young
      women with amenorrhea.
AB  - OBJECTIVE: To examine the impact of polycystic ovaries (PCO) on bone mineral
      density in amenorrheic women of reproductive age. DESIGN: A retrospective
      analysis and comparison of polycystic ovarian syndrome (PCOS) with non-PCOS
      amenorrheic women. A subgroup of patients with ultrasound (US)-diagnosed PCO was
      also investigated. SETTING: Specialist clinic in reproductive endocrinology.
      PATIENTS, PARTICIPANTS: Six hundred ten consecutive cases, mean age of 29.8 +/-
      7.5 years, with current history of amenorrhea of various causes. MAIN OUTCOME
      MEASURE: Bone mineral density in the lumbar spine (L1 to L4) as measured by dual
      energy x ray absorptiometry, in relation to PCOS, US-diagnosed PCO, and US
      findings of normal ovaries. RESULTS: Amenorrheic patients with PCOS were found to
      be younger (P less than 0.001), with higher body mass index (P less than 0.001),
      were more estrogenized, as measured by endometrial thickness and uterine cross
      sectional area (P less than 0.001), and had higher bone mineral density (P less
      than 0.001) compared with non-PCOS amenorrheic patients. CONCLUSIONS: Patients
      with amenorrhea because of PCOS and those with US-diagnosed PCO have a higher
      bone density compared with amenorrheic patients with normal ovaries as detected
      by US scan.

PMID- 1735482
TI  - Tamoxifen increases plasma estrogen-binding equivalents and has an estradiol
      agonistic effect on histologically normal premenopausal and postmenopausal
      endometrium.
AB  - OBJECTIVE: To determine the effects of single dose tamoxifen on plasma estrogen
      (E)-binding equivalents and endometrial estradiol (E2) and progesterone (P)
      receptors. DESIGN: Controlled clinical study. SETTING: Normal human volunteers
      were studied in an academic research environment. PATIENTS: Premenopausal and
      postmenopausal women with histologically normal endometrium undergoing curettage
      or hysterectomy were selected. INTERVENTIONS: Tamoxifen was administered orally;
      blood and endometrial samples were collected 4 to 96 hours after tamoxifen
      administration. MAIN OUTCOME MEASURES: Plasma E-binding equivalents, endometrial
      cytosolic and nuclear E2 and P receptors. RESULTS: (1) Plasma E-binding
      equivalents increased eightfold at 4 to 24 hours of tamoxifen administration and
      declined exponentially thereafter, reaching control levels at 73 to 96 hours.
      Plasma E-binding equivalents were not affected by endogenous E2 levels. (2)
      Endometrial total E2 and P receptor levels increased in all women 2.9 to 19.2
      fold after tamoxifen. (3) Tamoxifen resulted in an increase in the fraction of
      the E2 receptor measured in the nuclear extract 2.1 to 7.5-fold in midcycle,
      secretory, and menopausal endometria but not in proliferative endometrium.
      CONCLUSIONS: (1) Tamoxifen has an E2 agonistic effect on histologically normal
      human endometrium. (2) Irrespective of the total level of the endometrial E2
      receptor, the nuclear capacity of that receptor in vivo is limited (approximately
      75% to 80% of the total level).

PMID- 1735483
TI  - Cardiolipin antibody levels are not influenced by leukocyte immunotherapy in
      patients experiencing recurrent spontaneous abortion.
AB  - OBJECTIVE: To confirm that leukocyte immunotherapy stimulates the production of
      cardiolipin antibodies and to relate changes to pregnancy outcome. PATIENTS:
      Fifty patients with idiopathic recurrent abortion were studied. Thirty-six
      patients received injections of their partners' leukocytes; 14, injected with
      their own cells, served as controls. DESIGN: Cardiolipin antibodies were measured
      a month before and after leukocyte immunization. Patients who became pregnant
      were immunized a second time in early pregnancy, and cardiolipin antibodies were
      again measured a month later. RESULTS: Thirty-six patients immunized with their
      partners' leukocytes showed no appreciable change in cardiolipin antibody levels
      a month after vaccination. Twenty-nine of them subsequently became pregnant and
      were immunized again in early pregnancy: again, no change in cardiolipin antibody
      level was observed. There was no difference between the minority who aborted
      again and the majority who subsequently had successful pregnancies nor between
      those who responded to immunotherapy by producing cytotoxic antilymphocyte
      antibodies and those who did not. CONCLUSION: Leukocyte immunotherapy does not
      stimulate cardiolipin antibody production in women with normal pretreatment
      levels of the autoantibody.

PMID- 1735484
TI  - Long-acting oral bromocriptine (Parlodel SRO) in the treatment of
      hyperprolactinemia.
AB  - OBJECTIVES: To compare the effect of Parlodel SRO (Sandoz, Basel, Switzerland), a
      long-acting oral bromocriptine, to Parlodel (Sandoz) and to study the chronic
      effects of Parlodel SRO. DESIGN: The study was twofold: (1) random, double-blind
      and (2) open. SETTING: Patients were studied in an academic environment.
      PATIENTS: Hyperprolactinemic patients were selected. Sixteen patients were
      treated during 1 month. Ten patients completed the 1-year follow-up.
      INTERVENTIONS: Parlodel SRO or Parlodel was administered during 1 month (first 15
      days: 5 mg/d; afterwards: 10 mg/d). Parlodel SRO was given during 1 year in
      variable doses (maximal 20 mg/d). MAIN OUTCOME MEASURES: Prolactin (PRL) levels,
      clinical improvement, and side effects were evaluated. RESULTS: After 1 month,
      63% of the patients in both groups had normal PRL and 43% had menses. Side
      effects were similar. After 1 year all patients except one had normal PRL levels,
      and 89% were ovulating. CONCLUSIONS: The efficacy, tolerability, and long
      duration of action of Parlodel SRO make it an excellent alternative for the
      treatment of hyperprolactinemic patients.

PMID- 1735485
TI  - Evaluation of tubal patency by transvaginal sonosalpingography.
AB  - OBJECTIVE: To evaluate tubal patency by transvaginal sonosalpingography. DESIGN:
      Comparative study of transvaginal sonosalpingography with chromolaparoscopy in
      subjects with unknown tubal function. SETTING: Outpatient infertility clinic at
      Zeynep Kamil Maternity Hospital in Istanbul, Turkey. PATIENTS: Forty-two cases of
      unknown tubal function with infertility complaints were included. INTERVENTIONS:
      Isotonic saline was injected into the uterine cavity through a catheter. MAIN
      OUTCOME MEASURES: Transvaginal sonosalpingography is a safe, easy, and cost
      effective procedure for screening tubal status. RESULTS: The results obtained
      from transvaginal sonosalpingography and laparoscopy were completely consistent
      for 29 cases (76.32%) and partially consistent for 8 cases (21.05%). Transvaginal
      sonosalpingography accurately showed patency in 26 patients and bilateral
      nonpatency in 3 patients. CONCLUSIONS: Transvaginal sonosalpingography, with its
      accuracy and safety, is a promising screening and diagnostic technique in the
      evaluation of tubal patency on ambulatory basis.

PMID- 1735486
TI  - Chimerism as the etiology of a 46,XX/46,XY fertile true hermaphrodite.
AB  - OBJECTIVE: To determine the conceptional events resulting in a 46,XX/46,XY true
      hermaphrodite and to report the first pregnancy in a 46,XX/46,XY true
      hermaphrodite with an ovotestis. DESIGN: Chromosome studies were performed on
      patient lymphocytes and fibroblasts. Red cell antigens, human leukocyte antigens,
      and presence of Y-chromosome deoxyribonucleic acid were analyzed. Findings were
      compared with parental and sibling blood group data. SETTING: Genetics clinic and
      laboratories of a university hospital. RESULTS: These studies demonstrated that
      our patient is a chimera, with dual maternal and paternal contributions. In
      addition, despite the presence of an ovotestis, she conceived and delivered a
      child. CONCLUSIONS: The mechanism for chimerism in this case could be
      fertilization of (1) the secondary oocyte and first polar body; (2) the ovum and
      first polar body; (3) the ovum and second polar body; or (4) fusion of two
      embryos.

PMID- 1735487
TI  - Perceptions of infertility and treatment stress in females as compared with males
      entering in vitro fertilization treatment.
AB  - OBJECTIVE: To determine gender similarities and differences in perceptions of
      infertility and anticipated treatment stress in couples enrolling for in vitro
      fertilization (IVF) treatment. DESIGN: Both partners were evaluated at enrollment
      of IVF treatment. The evaluation was part of the screening procedure. SETTING:
      The Department of Obstetrics and Gynecology at a teaching hospital. PATIENTS,
      PARTICIPANTS: Two hundred consecutive couples who entered an IVF treatment
      program. MAIN OUTCOME MEASURES: Self-report questionnaire included items on the
      duration of infertility, degree of social support, effect of infertility on
      sexual relationship, expected likelihood of achieving pregnancy, anticipation of
      stress during treatment, and a self-rating scale of emotional reactions to
      infertility. RESULTS: The women anticipated more stress in IVF treatment but also
      rated greater degree of social support than the men. Both partners overestimated
      their chances of a successful treatment outcome. Factor analysis of the
      Infertility Scale produced three factors that were similar for both sexes. The
      first factor represented the desire to have a child as a major focus of life with
      inadequacy of the male role, social functioning and work efficiency, and pressure
      to have a child following. CONCLUSIONS: Women reported more stress, but the
      factors affecting stress of infertility were very similar for both partners. The
      intense focus on having a child was the predominant factor in anticipated stress
      of IVF treatment for both males and females.

PMID- 1735488
TI  - A prospective, randomized trial comparing two different intrauterine insemination
      regimens in controlled ovarian hyperstimulation cycles.
AB  - OBJECTIVE: To compare a single periovulatory intrauterine insemination (IUI) with
      a regimen employing two IUIs, one before ovulation and one after ovulation, in
      patients undergoing controlled ovarian hyperstimulation with human menopausal
      gonadotropins (hMG) combined with human chorionic gonadotropin (hCG). DESIGN: A
      randomized, prospective trial. PARTICIPANTS: Thirty-one consecutive patients
      undergoing 49 cycles of controlled ovarian hyperstimulation/IUI were studied in a
      tertiary care setting. MAIN OUTCOME MEASURES: Ovulation was determined
      sonographically. The establishment of a clinical pregnancy was defined by either
      ultrasonographic verification of cardiac activity within an intrauterine fetus,
      or histologic confirmation of trophoblast in a surgical specimen. RESULTS:
      Clinical pregnancies developed in 2 of 23 cycles in the single insemination
      group, compared with 12 of the 23 cycles in the double insemination group. Cycle
      fecundity was significantly higher for group II (0.522) than for group I (0.087)
      patients (P = 0.003). CONCLUSION: In hMG/hCG cycles, two IUIs timed as described
      above are superior to one periovulatory insemination.

PMID- 1735489
TI  - Embryo implantation rates in oocyte donation: a prospective comparison of tubal
      versus uterine transfers.
AB  - OBJECTIVE: To compare pregnancy and implantation rates in tubal and uterine
      transfers during a hormonal replacement cycle in an oocyte donation program.
      DESIGN: Prospective randomized. PATIENTS: Forty-two consecutive patients who
      entered an oocyte donation program. INTERVENTIONS: Twenty-two patients were
      assigned for uterine transfer and 20 for tubal embryo transfer (ET). RESULTS:
      Twenty-three pregnancies were achieved, 12 (54.5%) after uterine transfers and 11
      (57.9%) after tubal transfers. Implantation rates in both groups are not
      significantly different (17.4% uterine transfers versus 21.5% tubal ETs).
      CONCLUSIONS: Our results suggest that in hormonal replacement cycles (uniform
      endometrial stimulation) there is no advantage in transferring embryos to the
      fallopian tube. Furthermore, embryo quality and endometrial receptivity appear to
      be significantly more important than the time of entrance of an embryo to the
      uterine cavity in determining its chances of implantation.

PMID- 1735490
TI  - The use of transvaginal color flow imaging after in vitro fertilization to
      identify optimum uterine conditions before embryo transfer.
AB  - OBJECTIVE: To assess whether a measure of uterine blood flow impedance (the
      pulsatility index, PI) as determined by transvaginal ultrasonography with color
      blood flow imaging, may be used to assess endometrial receptivity immediately
      before the time of embryo transfer (ET) after assisted conception. DESIGN: A
      prospective study of infertile women who had undergone treatment to induce
      multiple follicular development followed by ultrasound-guided oocyte retrieval.
      The oocytes were fertilized in vitro. SETTING: The Hallam Medical Centre.
      PATIENTS: Eight-two women (22 to 44 years of age) who all had three or four good
      quality embryos available for transfer to the uterus. INTERVENTIONS: All women
      were examined by transvaginal ultrasonography, with color flow imaging and blood
      flow analysis, immediately before ET. MAIN OUTCOME MEASURES: The mean PI of the
      left and right uterine arteries, the pregnancy rate (PR) (%), the embryo
      implantation rate (%), and the multiple PR (%). RESULTS: The patients were
      grouped according to whether the PI was low (1.00 to 1.99), medium (2.00 to
      2.99), or high (3+). There were 27 women in the low PI group, 36 in the medium,
      and 19 in the high. The PR (%), embryo implantation rate (%), and multiple PR (%)
      were 41%, 15.3%, and 27.3% for the low PI group and 47%, 22.2%, and 47.1% for the
      medium PI group. There were no pregnancies in the high PI group. Thus 35% (19/54)
      of women who failed to become pregnant had a PI value greater than 3.0.
      CONCLUSIONS: These data suggest that the PI value on the day of ET could be used
      to: (1) increase the implantation rate by showing which embryos should be
      cryopreserved until the uterus is more receptive and (2) reduce the multiple PR
      by indicating that the number of embryos transferred should be limited when the
      uterus is most receptive.

PMID- 1735491
TI  - CA-125 is present in significant concentrations in periovulatory follicles of in
      vitro fertilization patients.
AB  - OBJECTIVE: To evaluate the presence of CA-125 in follicular fluid (FF) and its
      possible correlation to FF estradiol (E2), progesterone (P) and testosterone (T)
      and in vitro fertilization and embryo transfer (IVF-ET) outcome. DESIGN: Twenty
      eight patients undergoing IVF-ET were randomly chosen and 123 FF were sampled.
      SETTING: Clinical IVF-ET program and immunology laboratory for tumor diagnosis in
      a university tertiary care center. PATIENTS: Pure tubal factor patients treated
      by midluteal (long) gonadotropin-releasing hormone agonist protocol coupled with
      follicular phase human menopausal gonadotropin. INTERVENTIONS: Transvaginal
      follicular aspiration followed 48 hours later by ET. MAIN OUTCOME MEASURES: The
      28 treatment cycles resulted in six gestations including five take-home infants.
      The mean levels (+/- SD) were 30.1 +/- 66.0 U/ML for CA-125, 28.5 +/- 58.1 ng/ML
      for E2, 2,360.5 +/- 2,846.3 ng/ML for P, and 7.22 +/- 7.08 ng/ML for T. The FF CA
      125 levels were found to be widely divergent in different follicles of the same
      patient. There was no significant correlation between FF CA-125 and E2, P, T,
      oocyte fertilization, embryo quality, and pregnancy rates. CONCLUSIONS: CA-125
      exists in significant amounts in FF of periovulatory follicles of IVF-ET
      patients. Intrafollicular CA-125 secretion is neither interrelated to follicular
      steroidogenesis nor is correlated to the outcome of IVF-ET.

PMID- 1735492
TI  - Primary testicular lesions in the twisted testis.
AB  - OBJECTIVE: To investigate primary lesions in twisted testes. DESIGN: The
      histologic study of testicular specimens obtained from men who had suffered
      testicular torsion. SETTING: The conditions required for material selection were
      the knowledge of the exact time of torsion and the presence of recognizable
      seminiferous epithelium cells. PATIENTS: Two hundred eighteen testicular torsions
      treated in La Paz Hospital, Madrid, Spain, from 1970 to 1990. MAIN OUTCOME
      MEASURES: After rejection of specimens that did not fulfill the conditions for
      selection, 109 biopsy and orchidectomy specimens from pubertal and adult males
      were studied to determine if primary lesions are superimposed to lesions
      secondary to anoxia. RESULTS: The following primary tubular lesions were found:
      (1) focal hypospermatogenesis (5 biopsies and 1 orchidectomy specimen; these
      testes showed degree I, II, or III anoxic lesions); (2) hypoplastic zones with
      only immature and hyperplastic Sertoli cells (3 orchidectomy specimens with
      degree III lesions); (3) zones of Sertoli-cell-only tubules that only contained a
      normal amount of mature appearing Sertoli cells (5 orchidectomy specimens with
      degree III lesions); and (4) intratubular calcifications (1 orchidectomy specimen
      with degree III lesions). In two cases with degree III lesions, more than one
      primary testicular lesion could be observed. CONCLUSIONS: An important number of
      twisted testes bear primary lesions that might had been involved in torsion
      development. The real percentage is probably even higher than that found in this
      study (14%) because the material obtained (biopsies) in many cases was
      insufficient to ensure complete exploration and because primary lesions are not
      recognizable in areas with pronounced anoxic lesions.

PMID- 1735493
TI  - Capacitated sperm cells react with different types of antisperm antibodies than
      fresh ejaculated sperm.
AB  - OBJECTIVE: To determine if sera of some women have antibodies against capacitated
      but not freshly ejaculated sperm. DESIGN: The sera of 66 women undergoing in
      vitro fertilization (IVF) were tested for sperm antibodies after 1 hour and 18
      hours of sperm incubation in the maternal sera. Subsequently, 5 sera were tested
      with capacitated versus noncapacitated sperm cells. SETTING: The study was
      carried out in a university hospital department. PATIENTS, PARTICIPANTS: The
      patients were 66 consecutive couples undergoing IVF. INTERVENTIONS: Sera and
      semen that were taken for routine tests as part of the IVF procedures were used.
      MAIN OUTCOME MEASURES: A case with IVF failure associated with late appearance of
      sperm antibodies prompted us to study the detection of sperm antibodies after 1
      hour and 18 hours incubation. RESULTS: Of 37 cases negative for sperm antibodies
      after 1 hour incubation, 7 demonstrated high levels of antibodies after 18 hours
      incubation. In 21 of 23 cases with low or intermediate levels of antibodies after
      1 hour incubation, significantly higher levels (P less than 0.05) of antibodies
      were found after 18 hours. Different and higher levels of sperm antibodies were
      observed in five sera after incubation of 1 hour with capacitated sperm as
      compared with noncapacitated controls. CONCLUSIONS: Major antigenic differences
      may exist between capacitated and noncapacitated sperm. In some women sperm
      antibodies are reactive against capacitated sperm only. This has no certain
      clinical significance but may explain certain cases of IVF failure, unexplained
      infertility, and part of the variation in sperm antibodies testing methods.

PMID- 1735494
TI  - The relative distribution of viable sperm in the antegrade and retrograde
      portions of ejaculates obtained after electrostimulation.
AB  - OBJECTIVE: To determine the relative concentration, motility, and viability of
      spermatozoa in the antegrade and retrograde portions of the ejaculate after
      electroejaculation in spinal cord injured men. DESIGN: Retrospective. SETTING:
      University outpatient clinic providing tertiary care in reproductive
      rehabilitation. PATIENTS: The antegrade and retrograde portions of 22 ejaculates
      obtained from five spinal cord-injured men were analyzed for sperm density, mean
      sperm motility, and percentage of total motile and viable sperm yield. RESULTS:
      The number of spermatozoa were uniformly distributed between the antegrade
      (54.4%) and retrograde (45.6%) ejaculates. However, of the total sperm yield in
      both compartments, 66.3% of the motile spermatozoa and 71% of the viable sperm
      were found in the antegrade compartment (P less than 0.05). Additionally, mean
      sperm motility was significantly higher in the antegrade ejaculate (P less than
      0.05). CONCLUSIONS: Significantly impaired sperm motility and viability are noted
      in the retrograde ejaculate. Efforts should therefore be directed to maximizing
      the antegrade portion of the electro-ejaculate and optimizing the technique of
      preserving functional sperm in the intravesical compartment.

PMID- 1735495
TI  - Formation of reactive oxygen species in spermatozoa of infertile patients.
AB  - OBJECTIVE: To determine the incidence of reactive oxygen species formation in
      semen of a population of patients consulting for infertility. DESIGN: The
      incidence of reactive oxygen species formation in whole semen and in washed
      spermatozoa was studied. The values obtained were correlated with semen
      parameters. The effect of the type of sperm washing on reactive oxygen species
      formation was also investigated. SETTING: Semen samples from patients consulting
      for infertility and control subjects were obtained by masturbation after 3 days
      of sexual abstinence. Reactive oxygen species formation was measured in whole
      semen, sperm suspension washed by Percoll gradients, or repeated centrifugations.
      Sperm motility parameters were measured by computer-aided sperm analysis.
      PATIENTS, PARTICIPANTS: Fertile control men and an unselected population of
      patients consulting for infertility. INTERVENTIONS: None. MAIN OUTCOME MEASURE:
      Reactive oxygen species formation by fresh semen specimen or washed spermatozoa
      was measured in a computer-driven LKB 1251 Luminometer (LKB-Wallac, Turku,
      Finland). RESULTS: Reactive oxygen species formation was detected in 40% of the
      semen with spermatozoa from infertile patients, whereas none was found in 6
      azoospermic men and 10 control men. The level of reactive oxygen species
      formation was inversely correlated to the semen volume, the percentage of motile
      spermatozoa, and sperm linearity both in semen and in Percoll-washed spermatozoa.
      Washing by repeated centrifugation-resuspension increased 20- to 50-fold sperm
      reactive oxygen species formation. This enhancement was caused by the
      centrifugation itself and by the removal of seminal plasma. Both morphologically
      normal and abnormal spermatozoa produced reactive oxygen species. CONCLUSION: The
      data suggest that reactive oxygen species formation by spermatozoa may be a
      significant cause for male infertility.

PMID- 1735496
TI  - The effect of tubal injection of methotrexate on fertility in the rabbit.
AB  - OBJECTIVE: To investigate the fertility of rabbits after tubal injection of
      methotrexate (MTX). DESIGN: The side of injection of MTX was randomly decided in
      a prospective experimental trial. PARTICIPANTS: Fourteen female New Zealand White
      Rabbits were believed to be of normal reproductive status. INTERVENTIONS:
      Methotrexate or Ringer's solution were injected into the tubes of the rabbits.
      The nidation index was used to measure the fertility of the animals. RESULTS: The
      average nidation index of the control tubes was not statistically different of
      the one of the tubes treated with MTX. CONCLUSION: Tubal injection of MTX has no
      adverse effect on fertility of rabbits. It seems ethical to investigate tubal
      injection of MTX as an alternative to laparoscopic management of unruptured
      ectopic pregnancy in the human.

PMID- 1735497
TI  - Preclinical models for human pre-embryo biopsy and genetic diagnosis. I.
      Efficiency and normalcy of mouse pre-embryo development after different biopsy
      techniques.
AB  - OBJECTIVE: To compare the usefulness of three micromanipulative methods at two
      different stages of pre-embryo development and to assess possible effects on
      postbiopsy survival and development. DESIGN: Four-cell and eight-cell mouse pre
      embryos were biopsied using enucleation, aspiration, or extrusion of single
      blastomeres. After biopsy, pre-embryos were observed for in vitro and in vivo
      development. SETTING: Laboratories of The Jones Institute for Reproductive
      Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical
      School. PATIENTS, PARTICIPANTS: Only mice were used. INTERVENTIONS: Pre-embryo
      biopsy, developmental normalcy and pre-embryo transfer were studied. MAIN OUTCOME
      MEASURE(S): Few pre-embryos died as a result of biopsy trauma. High postbiopsy
      survival rates were associated with normal intrauterine and postnatal
      development. RESULTS: Expanded blastocyst formation rates from four-cell and
      eight-cell pre-embryos were 94.6%, 96.7% (controls); 80.7%, 89.1% (enucleation);
      90.1%, 91.7% (aspiration); 83.1%, 91.5% (extrusion), respectively. Live birth
      rates at the four-cell stage were slightly lower in the enucleation group than in
      the blastomere aspiration and extrusion groups or controls (49.2% versus 58.8%,
      56.3% and 66.7%, respectively). For the eight-cell stage, there were no
      differences between the groups. No developmental abnormalities were found in body
      or organ weights, in neonates or at 3 weeks of age, or in their subsequent
      ability to reproduce a second generation. CONCLUSIONS: Biopsy of mouse pre
      embryos produces only a small loss of viability because of trauma and permits
      normal prenatal and postnatal development among surviving pre-embryos.

PMID- 1735498
TI  - Preclinical models for human pre-embryo biopsy and genetic diagnosis. II.
      Polymerase chain reaction amplification of deoxyribonucleic acid from single
      lymphoblasts and blastomeres with mutation detection.
AB  - OBJECTIVE: To demonstrate the use of the polymerase chain reaction in the
      amplification of deoxyribonucleic acid (DNA) from single human lymphoblasts and
      mouse blastomeres. Amplified target genes for diagnosis of sickle cell anemia and
      Tay-Sachs are shown. Similarly, the sparce fur mouse model for ornithine
      transcarbamylase deficiency was used as an X-linked system for demonstration of
      mutation detection after biopsy of a single blastomere. A new diagnostic method
      for the detection of the ornithine transcarbamylase mutation using the
      restriction enzyme Mse I is presented. Accuracy and reproducibility were assured.
      DESIGN: Polymerase chain reaction proficiency test for amplification from single
      cells was studied. Also, accuracy of mutation detection systems was demonstrated.
      SETTING: Laboratories of The Jones Institute for Reproductive Medicine,
      Department of Obstetrics and Gynecology, Eastern Virginia Medical School.
      PATIENTS, PARTICIPANTS: We used the sparse fur mouse model and human blood cells.
      INTERVENTIONS: Pre-embryo biopsy, polymerase chain reaction amplification, and
      mutation detection were performed. MAIN OUTCOME MEASURES: Accuracy and
      reproducibility of DNA amplification without contamination, as well as efficient
      diagnostic analysis, from both single somatic and embryonic cells were shown.
      RESULTS: DNA amplification from single cells was uniformly rapid (6 to 10 hours)
      reproducible (n = 220) and accurate (n = 52). CONCLUSIONS: Our findings support
      the feasibility of clinical application for pre-embryo biopsy and genetic
      diagnosis of specific heritable diseases.

PMID- 1735499
TI  - Establishing a program of oocyte donation in Brazil.
AB  - Oocyte donation is a novel alternative for the treatment of patients who have
      infertility associated with ovarian failure. Both IVF-ET and GIFT represent new
      techniques of treatment for this group of patients. Synchronization between donor
      and recipient is very simple and also flexible. In our study population, four
      patients received oocyte or embryo donation after at least 20 days of E
      replacement, and two of them conceived a clinical pregnancy. Apparently, the
      flexibility of our protocol of E replacement allows an extension of the
      proliferative phase in cases that need to have additional time to synchronize the
      recipient's cycle to that of the donors.

PMID- 1735500
TI  - Ovulation induction in women with premature ovarian failure: a prospective,
      crossover study.
AB  - A prospective crossover study comparing ovulation induction techniques in eight
      women with premature ovarian failure is presented. These patients were treated
      with FSH rebound techniques using the GnRH-a, LA, alone in one treatment cycle
      and the same plus menopausal gonadotropins in the other treatment cycle. Two
      women ovulated in each group. We conclude that ovulation does occur in women with
      premature ovarian failure, but that luteal P may be inadequately secreted.

PMID- 1735501
TI  - Three-contrasts method hysteroscopy: the use of real-time ultrasonography for
      monitoring intrauterine operations.
AB  - Thirty-four patients were operated on by the technique of three-contrasts method
      hysteroscopy in this article. In three-contrasts method hysteroscopy, sonography
      guidance was used instead of laparoscopy guide. The distending medium introduced
      into the uterus during hysteroscopy and injected normal saline into the bladder
      and abdomen (which flowed into the posterior cul-de-sac) created these three
      contrasts. As a result, the walls of the uterus were clearly seen at sonography.
      Advantages and disadvantages of this technique have been described in detail.

PMID- 1735502
TI  - Serum relaxin concentrations in patients with out-of-phase endometrial biopsies.
AB  - When luteal phase relaxin concentrations were summed to give an integrated
      measure (pg/mL per cycle), relaxin was found to be significantly lower in those
      cycles with an out-of-phase endometrial biopsy. In addition, peak relaxin
      concentrations were lower in out-of-phase cycles compared with normal cycles.
      These data indicate that relaxin secretion may be related to normal luteal
      function and suggest that shortening of the luteal phase results in reduced
      relaxin production. Measurement of circulating relaxin may prove to be useful in
      making the diagnosis of out-of-phase biopsy and needs to be assessed for its
      usefulness in diagnosing abnormal luteal function.

PMID- 1735503
TI  - Serum progesterone and uterine curettage in differential diagnosis of ectopic
      pregnancy.
AB  - The implementation of a serum P less than 5.0 ng/mL is important because it
      resolves the differential diagnosis of EP by enabling timely uterine curettage.
      Curettage with examination of curettings or documentation of falling hCG can be
      used to prevent unnecessary laparoscopies in patients undergoing spontaneous
      abortions and can make possible definitive diagnosis and medical treatment of EP
      completely eschewing anesthesia and surgery.

PMID- 1735504
TI  - Ultrastructural aspects of endometrial surface in Kartagener's syndrome.
AB  - The endometrium of an infertile patient with Kartagener's syndrome showed initial
      secretory phase characteristics at SEM, whereas TEM analysis demonstrated several
      alterations in the central and peripheral microtubular distribution in 87% of the
      cilia examined. Such aspects seemed appropriate for a normal implantation, but
      the ciliary immotility or dyskinesia could cause an altered flow of the
      endometrial secretions and compromise the upstream movement of the spermatozoa.

PMID- 1735505
TI  - Peripheral T-lymphocyte activation and estrogen status.

PMID- 1735506
TI  - Clinical decision making: elevate or reduce to a science?

PMID- 1735508
TI  - Florida's IPN continues to be a forerunner in addressing nursing impairment.

PMID- 1735507
TI  - Clinical decision making: elevate or reduce to a science?

PMID- 1735510
TI  - Update on HIV/AIDS education requirement for re-licensure.

PMID- 1735509
TI  - Legislative assistant spends day with public health nurses.

PMID- 1735511
TI  - Implementation in Florida--one hospital's approach.

PMID- 1735512
TI  - Nurses to educate patients about end-of-life decisions.

PMID- 1735513
TI  - Medical complications of alcoholism.

PMID- 1735514
TI  - Alcoholism in the elderly.

PMID- 1735515
TI  - Eating disorders: a look at the basics.

PMID- 1735516
TI  - Shouldn't any research done by a nurse be considered nursing research?

PMID- 1735517
TI  - Colorectal cancer prevention: a primary care approach.
AB  - Colorectal cancer is a prevalent, deadly disease of the elderly. It is typically
      asymptomatic until advanced, and then responds poorly to treatment. Asymptomatic
      precursor lesions may afford both an opportunity to study carcinogenesis and to
      intervene and prevent cancer deaths. Prevention strategies focus on either
      primary prevention of polyps and cancers (mainly through dietary measures) and
      secondary detection and removal of precursor polyps and early cancers. Despite
      shortcomings in both strategies, dietary recommendations and screening tests for
      select patients may play an important role in reducing mortality.

PMID- 1735518
TI  - Geriatric primary care: a European perspective, Part II.
AB  - Europe is considered the parent of geriatric medicine, which was first recognized
      as a specialty in the United Kingdom. For the benefit of U.S. primary care
      physicians, GERIATRICS Editor-in-Chief Robert N. Butler, MD, convened a panel of
      leading European geriatricians in Lausanne, Switzerland, for a discussion of the
      successes and problems they are encountering in providing medical care to the
      aging world population. In Part I (Geriatrics 1992; 47 [Jan]:31-41) panelists
      described the healthcare services available to the elderly. In Part II, they
      discuss treatment and evaluation of dementia, use of hypnotics, rehabilitation
      approaches, and dietary and exercise recommendations for the elderly.

PMID- 1735519
TI  - Caring for nursing home patients: strategies to avoid conflict.
AB  - The need for primary care physicians to care for nursing home patients will
      continue to increase as America's population ages. Although some conflicts
      persist, nursing home practice can be gratifying for the physician if certain
      patient care strategies are followed. Measures that can help make the practice
      more efficient and rewarding include careful planning, setting limits on the
      practice, establishing patient goals early, developing a strong rapport with
      nursing home staff and patients' families, and gaining an understanding of local
      and federal regulations. Primary care physicians can also play a significant role
      in improving the quality of life for patients in this setting.

PMID- 1735520
TI  - Thyroid dysfunction: managing the ocular complications of Graves' disease.
AB  - The pathophysiology of Graves' orbitopathy has yet to be illucidated, but much
      can be done to reverse the potentially blinding effects of this debilitating
      ocular disease. Although only 5 to 10% of patients suffer severe ocular
      complications, many have significant signs and symptoms requiring ophthalmic
      medical and surgical intervention. Numerous systemic and topical therapies exist
      for all aspects of the ocular effects of hyperthyroidism, but clear clinical
      indications or advantages are lacking. Surgical therapies for residual
      abnormalities have solidified under recent clinical guidelines.

PMID- 1735521
TI  - Fibroproliferation in liver disease: role of monocyte factors.
AB  - Fibroproliferation was measured as the uptake of [3H]thymidine into fibroblasts.
      Human fibroblasts were incubated with 200 microliters monocyte-conditioned
      medium, the 0.22 microns filtrate from cultured monocytes, in Dulbecco's modified
      Eagle medium supplemented with controlled process serum replacement 2, a fetal
      calf serum substitute with low mitogenic activity. Increasing the numbers of
      fibroblasts resulted in a parallel increase in thymidine uptake to a maximal
      level. Fibroblasts (2 x 10(3] were plated into microwell plates and incubated
      with monocyte-conditioned medium for 72 hr. At 16 hr before harvest, 1 muCi
      [3H]thymidine was added. Cells were harvested with phosphate-buffered saline and
      washed, and the filters were counted. Fibroblasts incubated with Dulbecco's
      modified Eagle medium and controlled process serum replacement 2 showed minimal
      thymidine uptake. Fibroblasts incubated with Dulbecco's modified Eagle medium
      plus monocyte-conditioned medium from monocytes stimulated with 10 micrograms/ml
      lipopolysaccharides showed a sixfold increase in thymidine uptake over
      fibroblasts in Dulbecco's modified Eagle medium and controlled process serum
      replacement 2 alone. Fibroblasts incubated with Dulbecco's modified Eagle medium
      plus monocyte-conditioned medium from monocytes of patients with liver disease (n
      = 20) showed a 10-fold elevation in thymidine uptake compared with Dulbecco's
      modified Eagle medium and controlled process serum replacement 2. Results
      indicated that preincubation of monocyte-conditioned medium with either anti
      interleukin-1 beta (12.5 half-maximal units, 4 degrees C, 16 hr) or catalase
      (1,870 IU, 25 degrees C, 1 hr) did not alter the fibroproliferative activity of
      the monocyte-conditioned medium, suggesting that neither interleukin-1 beta nor
      activated oxygen intermediates were involved in fibroproliferation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1735522
TI  - Oral bile acid treatment and the patient with Zellweger syndrome.
AB  - The cerebrohepatorenal syndrome of Zellweger is a congenital syndrome of multiple
      manifestations, including hepatomegaly and liver dysfunction. Treatment is
      generally of a supportive nature, aimed at improving nutrition and growth,
      controlling the central nervous system symptoms and limiting progression of liver
      disease. Because the liver disease in Zellweger syndrome may be attributed to an
      overproduction and accumulation of cholestanoic acids, exacerbated by diminished
      primary bile acid synthesis, we hypothesized that primary bile acid
      administration would be beneficial in improving liver function by a mechanism
      involving down-regulation in the synthesis of these atypical bile acids. We
      report here the clinical and biochemical responses to primary bile acid
      administration in a 2-mo-old boy who was seen with the typical signs of Zellweger
      syndrome. Liver disease was evident from hepatomegaly and elevated serum liver
      enzymes and bilirubin. The diagnosis was supported by markedly elevated serum
      very long chain fatty acids and the bile acids dihydroxycholestanoic acid and
      trihydroxycholestanoic acid. Confirmation of the lack of peroxisomes was
      established by electron microscopy. When the patient was 6 mo old, the primary
      bile acids cholic acid and chenodeoxycholic acid, (100 mg each/day) were
      administered orally. A significant improvement in biochemical indices of liver
      function occurred with a normalization of the serum bilirubin and liver enzymes
      and a histological improvement in the extent of inflammation and bile duct
      proliferation and disappearance of cannalicular plugs. Serum and urinary
      cholestanoic acids showed a significant decrease within a few days. A striking
      and sustained increase in growth was observed after therapy, and an improvement
      in neurological symptoms was noted. In conclusion, this study indicates that
      primary bile acid therapy improves liver function and growth in the patient with
      peroxisomal dysfunction and should be considered in the supportive therapies for
      this condition.

PMID- 1735523
TI  - Fragmentation of bile duct stones by extracorporeal shock-wave lithotripsy: a
      five-year experience.
AB  - Over 5 yr, 103 elderly patients (mean age = 70 yr) with bile duct stones (mainly
      not amenable to endoscopic extraction) underwent adjuvant extracorporeal shock
      wave lithotripsy using a first-generation kidney lithotripter. Disintegration of
      stones was achieved after a mean of 1.4 sessions in 92% of the patients.
      Spontaneous passage of fragments into the duodenum occurred in one fourth of the
      patients, and endoscopic extraction of fragments was necessary in 75% of the
      patients, resulting in complete clearance of the bile duct stones in 91 (88%) of
      103 patients. The most important adverse effect was septic disease after
      extracorporeal shock-wave lithotripsy in 4% of the patients. The 30-day mortality
      rate was 1% (one patient), and another 15 patients died during a mean follow-up
      of 26 +/- 14 mo (mainly of causes unrelated to biliary tract disease). Two of 91
      patients who had been rendered stone free were readmitted because of recurrent
      stone disease during the follow-up period. Of the 43 patients who still had their
      gallbladders during extracorporeal shock-wave lithotripsy, 14% subsequently
      underwent cholecystectomy. These data show that extracorporeal shock-wave
      lithotripsy of bile duct stones is a useful and safe adjunct to nonsurgical
      procedures for the removal of calculi in the biliary tree.

PMID- 1735524
TI  - Prognostic features and role of liver transplantation in severe corticosteroid
      treated autoimmune chronic active hepatitis.
AB  - To identify prognostic features and to define the role of liver transplantation
      in severe autoimmune chronic active hepatitis, findings before and after
      corticosteroid therapy in 111 patients were correlated with outcome and compared
      with the findings in 24 patients who had been selected independently for liver
      transplantation. Patients whose condition deteriorated during corticosteroid
      treatment were younger (32 +/- 3 yr vs. 43 +/- 2 yr; p less than 0.02) than those
      who experienced remission, but no individual features predicted outcome. Patients
      in whom therapy failed required longer durations of continuous treatment than did
      those who experienced remission (60 +/- 14 mo vs. 20 +/- 12 mo; p = 0.001). Of 13
      patients who did not experience remission within 4 yr, 9 (69%) ultimately
      deteriorated. Ascites developed more often in those patients whose therapy failed
      and who died of liver failure than in counterparts who survived (86% vs. 33%).
      Patients undergoing transplantation were similar to those whose treatment failed,
      but they died less frequently (8% vs. 56%, p less than 0.01). Indeed, the 5-yr
      survival rate after transplantation was comparable to that of patients who had
      entered remission (92% vs. 100%). Successive biopsy samples failed to disclose
      recurrent autoimmune hepatitis after transplantation. Human leukocyte antigens
      A1, B8 occurred more commonly in patients in whom treatment failed or who
      underwent transplantation (70% vs. 41%, p less than 0.05). We conclude that
      failure to achieve remission within 4 yr and the human leukocyte antigen A1, B8
      phenotype are associated with poor prognosis. Manifestations of liver
      decompensation, such as ascites, in patients who have been unable to experience
      remission justify consideration of transplantation.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1735525
TI  - Portal-vein obstruction in children leads to growth retardation.
AB  - The portal vein is the main source of blood and hepatotrophic factors to the
      liver. Partial portal-vein ligation in rats results in reduced growth compared
      with that in control rats. To investigate whether extrahepatic portal vein
      obstruction occurring in early childhood influences growth in humans,
      anthropometric and nutritional assessments were prospectively carried out in 61
      patients with extrahepatic portal vein obstruction. Comparisons were made with
      183 matched healthy controls using National Center of Health Statistics
      reference. Fifty-one percent of children with extrahepatic portal vein
      obstruction had stunted growth (height for age less than 90% of normal), compared
      with 16% of controls (p less than 0.01). Growth retardation was severe in
      patients with longer (greater than 5 yr) than with shorter (less than 2.5 yr)
      duration of clinical portal hypertension (height for age, 88.0 +/- 3.2 vs. 95.1
      +/- 3.0; p less than 0.01). Little difference was seen in the energy intake
      (1,302 +/- 463 kcal/day vs. 1,335 +/- 449 kcal/day; p = not significant) and
      weight for height index (83.6 +/- 9.3 vs. 88.0 +/- 7.9; p = not significant)
      between extrahepatic portal vein obstruction patients and controls. This
      suggested that despite comparable nutrition, marked growth retardation occurred
      in extrahepatic portal vein obstruction patients. Incremental growth velocity was
      studied in 31 patients; in 24 (73%) the baseline Z score (-2.1 +/- 0.2) had
      decreased further (-2.4 +/- 0.2) at the end of follow-up (15.5 +/- 1.6 mo).
      Although the incremental height velocity was only 56% of the expected height,
      incremental weight gain was 98% of the expected weight for the attained
      height.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735526
TI  - Isolated hepatic lipocytes and Kupffer cells from normal human liver:
      morphological and functional characteristics in primary culture.
AB  - The development of techniques for isolating hepatic lipocytes (Ito, stellate or
      fat-storing cells) from rodents has been instrumental in defining their role in
      hepatic vitamin A storage and fibrogenesis. In this study, we developed a method
      for the purification of lipocytes and Kupffer cell from wedge sections of normal
      human liver and examined their properties in primary culture. Sections of donor
      liver (400 to 600 gm) harvested but not used for transplantation were perfused in
      situ with University of Wisconsin solution and used for lipocyte isolation within
      48 hr. Cells were isolated by catheter perfusion of the wedge through several
      large vessels with L-15 salts, Pronase and collagenase, followed by Larex density
      gradient centrifugation. Lipocytes were plated on either uncoated plastic or a
      basement membrane-like gel. Lipocyte and Kupffer cell yields were 2.3 +/- 0.6 x
      10(5) and 8.6 +/- 1.4 x 10(5) cells, respectively, per gram of liver (n = 5).
      Lipocyte purity was 91% as assessed by vitamin A autofluorescence, and Kupffer
      cell purity was 83% as determined by uptake of fluorescinated staphylococci.
      Lipocytes cultured on the plastic spread within 48 to 72 hr, displaying slightly
      more heterogeneous retinoid droplet size than comparable rat cells; on a basement
      membrane gel, the cells remained aggregated and spherical with occasional
      spindlelike extensions. Lipocytes on plastic expressed procollagens I and III,
      collagen IV and laminin by immunocytochemistry, and types I, III and IV
      procollagen messenger RNAs by RNAse protection. Northern blot and polymerase
      chain reaction, respectively. Transmission electron microscopy of lipocytes at 7
      days demonstrated a prominent rough endoplasmic reticulum and contractile
      filaments. Scanning electron microscopy revealed a smooth cell surface with
      perinuclear droplets beneath the cell membrane. With continued primary culture on
      plastic (more than 7 days), cells appeared "activated" (i.e., increased spreading
      and diminished retinoid droplets) and began proliferating as assessed by nuclear
      autoradiography and [3H]thymidine incorporation. Kupffer cells observed by
      scanning electron microscopy in early primary culture displayed prominent
      membrane ruffling and lamellipodia. In summary, we have established a
      reproducible method for the isolation and primary culture of human lipocytes and
      Kupffer cells.

PMID- 1735527
TI  - Drug-induced prolonged cholestasis in adults: a histological semiquantitative
      study demonstrating progressive ductopenia.
AB  - Drug-induced acute hepatitis may be followed by prolonged cholestasis despite the
      withdrawal of the drug. Eight patients suffering from prolonged cholestasis
      caused by several drugs were investigated with sequential liver biopsies. At the
      early stage, lesions of acute cholangitis were observed in most patients; at the
      chronic phase, ductopenia, defined by the absence of interlobular bile ducts in
      at least 50% of small portal tracts, was demonstrated in all patients. Ductopenia
      might be the consequence of acute cholangitis; the degree of ductopenia and the
      chronicity of the disease might be directly related to the severity of the early
      acute damage of bile ducts. Consequently, in patients with severe cholestasis
      related to drugs, research of early morphological signs of acute cholangitis and
      then of ductopenia seems to be important.

PMID- 1735528
TI  - High cardiac output of advanced liver disease persists after orthotopic liver
      transplantation.
AB  - This study measured cardiac output before and 1 or 2 yr after orthotopic liver
      transplantation in 23 patients. Cardiac output was measured by thermodilution
      before transplantation and by first-pass radionuclide angiocardiography at follow
      up. Study patients were selected as those doing well clinically and by standard
      laboratory tests at 1-yr and 2-yr reevaluations with no evidence of rejection:
      six had mild recurrent hepatitis shown on biopsy samples. Hepatocyte function was
      normal at the time of the study as shown by galactose elimination capacity of 442
      +/- 90 mg/min. Medications were cyclosporine and prednisone in all patients,
      azathioprine in 10 patients and a combination of antihypertensive therapy to
      maintain diastolic blood pressure less than 90 mm Hg in 20 patients. Mean (+/-
      S.D.) pretransplantation cardiac output was 9.1 +/- 3.1 L/min and remained
      elevated at 8.3 +/- 2.1 L/min 1 yr, and 9.6 +/- 2.6 L/min (n = 13) 2 yr after
      transplantation. A significant (p less than 0.001) correlation was found between
      pretransplant and follow-up cardiac output. End diastolic, end systolic and
      stroke volumes are all increased in a pattern similar to that seen in end-stage
      cirrhosis. These data show that the high cardiac output of the hyperdynamic state
      of advanced liver disease persists after liver transplantation. The mechanisms
      and consequences of this require further study.

PMID- 1735529
TI  - Human leukocyte antigen typing of siblings in hereditary hemochromatosis: a cost
      approach.
AB  - To assess the clinical value of human leukocyte antigen typing in the diagnosis
      and management of hereditary hemochromatosis, 105 siblings of 35 proband cases of
      hemochromatosis were retrospectively analyzed to study whether the exclusion of
      human leukocyte antigen typing would have adversely affected management. All
      siblings and probands had already been tested for human leukocyte antigen-A and
      human leukocyte antigen-B typing, serum ferritin and transferrin saturation. The
      median age of siblings was 55 yr (range = 11 to 82). Siblings were categorized
      according to putative genotype (homozygote, heterozygote and normal) using human
      leukocyte antigen typing. Phenotypic expression of hemochromatosis was considered
      to be iron overload as indicated by an elevated ferritin (male = greater than 350
      micrograms/L, female = greater than 200 micrograms/L) and/or transferrin
      saturation (greater than 55%). Six of 37 homozygotes had a normal ferritin and
      transferrin saturation, with five of these patients under 32 yr old. No putative
      heterozygotes with both an abnormal ferritin and transferrin saturation were
      seen, although 12 of 48 (25%) heterozygotes had either an elevated ferritin or
      transferrin saturation. Twenty of 20 normal siblings had a normal ferritin and
      transferrin saturation. To assess the cost of screening with and without human
      leukocyte antigen typing, a cost model simulation was used that compared the
      costs of both methods in a hypothetical family (proband, homozygote, heterozygote
      and normal sibling).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735530
TI  - Effect of alpha-tocopherol on hepatic mixed function oxidases in hepatic
      ischemia/reperfusion.
AB  - This study was done to determine the relationship between microsomal lipid
      peroxidation during hepatic ischemia/reperfusion and alteration in cytochrome P
      450-dependent drug metabolism. Rats were pretreated with alpha-tocopherol to
      inhibit lipid peroxidation or with vehicle (soybean oil) and then subjected to 60
      min no-flow hepatic ischemia in vivo. Control animals were time-matched sham
      ischemic animals. After 1, 5 or 24 hr of reperfusion, liver microsomes were
      isolated and cytochrome P-450 and mixed function oxidases were studied. In
      vehicle-treated ischemic rats, serum ALT levels peaked at 5 hr (5,242 +/- 682
      U/L) and were significantly reduced by alpha-tocopherol pretreatment (1,854 +/-
      229 U/L, p less than 0.01). Similarly, microsomal lipid peroxidation was elevated
      in the vehicle-treated ischemic group, but this elevation was prevented by alpha
      tocopherol pretreatment. Microsomal cytochrome P-450 content and aminopyrine-N
      demethylase activity were both decreased in vehicle-treated ischemic rats to 60%
      and 70% of sham-ischemic control levels, respectively. Although alpha-tocopherol
      restored cytochrome P-450 content to the level of sham-ischemic control rats,
      aminopyrine-N-demethylase activity remained at 76% of control with alpha
      tocopherol treatment (p less than 0.01 compared with sham-ischemic control). In
      contrast to what was seen with cytochrome P-450 and aminopyrine-N-demethylase,
      aniline p-hydroxylase activity was elevated in the vehicle-treated ischemic rats
      compared with sham-ischemic control rats. These increases were prevented by alpha
      tocopherol pretreatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735531
TI  - Evidence that an iron chelator regulates collagen synthesis by decreasing the
      stability of procollagen mRNA.
AB  - Iron chelation has been shown previously to decrease collagen synthesis at a
      posttranslational level by inhibiting prolyl 4-hydroxylase, one of the key
      enzymes in collagen metabolism. On the other hand, recent in vivo studies of iron
      overload in rats suggest that iron could specifically activate collagen gene
      expression in liver tissues. These findings led us to investigate whether iron
      chelation might also affect collagen gene expression and posttranslational
      modification. Our data indicate that alpha,alpha'-dipyridyl, an iron chelator, at
      a concentration of 1 mmol/L, decreased steady-state levels of type I procollagen
      messenger RNA by 42% (p less than 0.001) without affecting beta-actin messenger
      RNA levels. Nuclear runoff studies demonstrated that transcription of the type I
      procollagen gene was unchanged by alpha,alpha'-dipyridyl. However, the turnover
      rate of type I procollagen messenger RNA was increased by 30%. This
      pretranslational inhibition of collagen synthesis was not due to decreased lipid
      peroxidation, because thiobarbituric acid-reactive substances were unchanged by
      alpha,alpha'-dipyridyl. However, cycloheximide totally abolished the effect,
      indicating that de novo protein synthesis was required.

PMID- 1735532
TI  - The effect of bile salts on carbonic anhydrase.
AB  - Bile salts are potent inhibitors of bovine carbonic anhydrase and human carbonic
      anhydrase I and human carbonic anhydrase II. To further characterize the binding
      of bile salts to carbonic anhydrase, rate constants for the CO2 hydration
      reaction in the presence of deoxycholate, cholate, glycocholate and taurocholate
      were determined using stop-flow experiments. Values for the Michaelis-Menton
      dissociation constant for bovine carbonic anhydrase, human carbonic anhydrase I
      and human carbonic anhydrase II were found to be 5.2, 9.2 and 13.2 mmol/L,
      respectively. The inhibition constant values for the various bile salts tested
      ranged from 0.1 to 1 mmol/L for bovine carbonic anhydrase, 1.6 to 2.4 mmol/L for
      human carbonic anhydrase I and 0.09 to 0.7 mmol/L for human carbonic anhydrase
      II. Our results suggest a mechanism of noncompetitive carbonic anhydrase
      inhibition for bile salts. Bile-salt binding to carbonic anhydrases as measured
      by scanning molecular sieve chromatography resulted in an increase in partition
      radius, molecular volume and surface area. The partition radius increased from 24
      A to 28 A in the presence of 2.5 mmol/L sodium deoxycholate at critical micelle
      concentration. As determined by sedimentation equilibrium measurements,
      approximately 1 gm of carbonic anhydrase will bind 0.03 gm of deoxycholate,
      suggesting three to six binding sites for bile salt on the carbonic anhydrase
      molecule. The conformational changes and inhibition of carbonic anhydrases
      resulting from bile-salt binding may be important to the regulation of enzymatic
      activity in tissues along the enterohepatic circulation; by limiting bicarbonate
      availability this interaction may also contribute to the metabolic derangements
      seen in patients with cholestatic liver disease.

PMID- 1735533
TI  - S-adenosylmethionine protects against acetaminophen hepatotoxicity in two mouse
      models.
AB  - Because S-adenosylmethionine promotes synthesis of hepatic glutathione in chronic
      liver disease and is well tolerated in man, we investigated its use as an
      antidote to acetaminophen hepatotoxicity in two mouse models. In C57Bl6 mice,
      deaths were abolished by S-adenosylmethionine given within 1 hr of 3.3 mmol/kg
      body wt acetaminophen (0 of 32 vs. 13 of 49, p less than 0.005) and reduced if
      given 2 to 5 hours after acetaminophen administration (4 of 42 vs. 13 of 49, p
      less than 0.01). Mixed disulfate/tosylate salt of S-adenosylmethionine abolished
      mortality in C3H mice given 2 mmol/kg body wt acetaminophen (0 of 24 vs. 4 of 18;
      p less than 0.05). In both mouse models, S-adenosylmethionine reduced depletion
      of plasma (median = 20.8 mumol/L vs. 14.6 mumol/L) and liver glutathione (198%
      vs. 100%; p less than 0.05), liver damage and release of AST after acetaminophen
      administration. Pretreatment with buthionine sulfoximine, which inhibits
      glutathione synthesis, abolished the beneficial effect of S-adenosylmethionine on
      survival and plasma glutathione level. S-adenosylmethionine reduces acetaminophen
      hepatotoxicity by metabolism of the active moiety to glutathione. This benefit
      may last as long as 5 hr after acetaminophen ingestion.

PMID- 1735534
TI  - Influence of albumin on the net sinusoidal efflux of the organic anion
      dibromosulfophthalein from rat liver.
AB  - Besides being excreted into bile, several anionic drugs and anionic drug
      conjugates are excreted from liver into plasma by a carrier-mediated process
      (sinusoidal efflux). In the study presented here, we investigated the influence
      of albumin on the net sinusoidal efflux of an organic anion from isolated
      perfused liver, with net sinusoidal efflux defined as the resultant of efflux and
      reuptake. We tested the hypothesis that albumin exerts its effect on net
      sinusoidal efflux through inhibition of repeat uptake rather than on the
      sinusoidal efflux process itself. We also studied possible acinar heterogeneity
      in net sinusoidal efflux rate of the organic anion. Isolated rat livers were
      preloaded with the nonmetabolizable anionic model compound dibromosulfophthalein
      in the absence (type I) or presence (type II) of bovine serum albumin.
      Fluorescence microscopy of dibromosulfophthalein in liver sections showed
      selective zone 1 loading after type I loading and homogeneous acinar distribution
      after type II loading. The rate of net sinusoidal efflux and biliary excretion
      was then studied in single-pass perfusions with various concentrations of bovine
      serum albumin in the medium. Net sinusoidal efflux of dibromosulfophthalein
      showed a marked dependence on albumin concentration in both type I and type II
      experiments. Net efflux rate reached a maximal value at a medium concentration of
      300 mumol/L bovine serum albumin and was not increased further at 600 mumol/L.
      The initial uptake rate of dibromosulfophthalein was not significantly different
      in the 300 mumol/L and 600 mumol/L bovine serum albumin experiments.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1735535
TI  - Changes in transcripts of basement components during rat liver development:
      increase in laminin messenger RNAs in the neonatal period.
AB  - The expression of laminin and type IV collagen messenger RNA in rat liver was
      investigated in relation to liver development. Levels of messenger RNA for
      laminin chains A, B1 and B2, and alpha 1 and alpha 2 chains of type IV collagen
      were studied by Northern-blot and dot-blot analysis. Although the expression of
      messenger RNAs for laminin B1 and B2 chains was higher in 19-day gestational
      fetal liver when compared with the adult, the highest level was detected in 15
      day newborns. This finding coincides with the final establishment of the mature
      liver. Laminin A messenger RNA was not detected in the 19-day gestational fetus
      or in the neonatal period. In contrast, alpha 1-(IV) and alpha 2-(IV) collagen
      messenger RNAs maintained high levels in the early neonate and then decreased
      gradually after 15 days. Our findings suggest that during late stages of liver
      ontogeny the main components of liver basement membrane proteins undergo a
      significant alteration in their synthesis. The data further suggest that laminin
      may play a role in the final stages of hepatic differentiation.

PMID- 1735536
TI  - Regulation of perfluorooctanoic acid--induced peroxisomal enzyme activities and
      hepatocellular growth by adrenal hormones.
AB  - A wide variety of compounds, including hypolipidemic drugs, plasticizers and
      other industrial chemicals, have been found to cause liver enlargement and
      hepatic peroxisome proliferation by mechanisms that are unclear. Although thyroid
      and sex hormones have been shown to modulate the hepatic response to these
      chemicals, the role of adrenal hormones in these phenomena is not clear, and a
      few studies have produced conflicting data. Therefore this study was undertaken
      to investigate the role of adrenal hormones in hepatomegaly and peroxisomal
      enzyme induction caused by peroxisomal proliferators and to further delineate the
      interrelationship between these parameters. Because adrenalectomy alters hepatic
      drug metabolism, we have used the nonmetabolizable proliferator perfluorooctanoic
      acid. Our data show that hepatomegaly caused by perfluorooctanoic acid depends on
      corticosterone, the major glucocorticoid in rodents. Liver growth caused by
      perfluorooctanoic acid appears to be predominantly hypertrophic in nature, and
      DNA synthesis in response to perfluorooctanoic acid predominates in periportal
      regions of the liver lobule. Data also show that although induction of
      peroxisomal beta-oxidation by perfluorooctanoic acid is independent of adrenal
      hormones, induction of catalase is dependent on the presence of these hormones.
      This study supports the contention that induction of activities of various
      peroxisomal enzymes is controlled by different regulatory mechanisms.

PMID- 1735537
TI  - Temporal relationship of peripheral vasodilatation, plasma volume expansion and
      the hyperdynamic circulatory state in portal-hypertensive rats.
AB  - Peripheral vasodilatation and plasma volume expansion are required to generate
      the hyperdynamic circulatory state observed in portal hypertension. To determine
      which of these factors is the initial event and to assess their temporal
      relationship with the development of hyperdynamic circulation, we sequentially
      measured plasma volume (by 125I-albumin dilution), cardiac index (by
      thermodilution), mean arterial pressure (by catheterization), superior mesenteric
      and iliac arterial flows (by Doppler flowmetry) and calculated total and regional
      peripheral resistances in portal-hypertensive rats. Experimental groups were
      studied from day 1 through day 4 after partial portal-vein ligation (n = 110) or
      sham operation (n = 111). Decreased total peripheral resistance was detected
      within a day of portal-vein ligation (4.18 +/- 0.21 mm Hg.min.ml-1 x 100 gm vs.
      5.19 +/- 0.16 mm Hg.min.ml-1 x 100 gm; p less than 0.01). Plasma volume increased
      significantly on day 2 (4.31 +/- 0.07 ml.100 gm-1 vs. 3.86 +/- 0.04 ml.100 gm-1;
      p less than 0.05). Cardiac index and regional blood flows increased in parallel
      with plasma volume elevation. On day 4, maximum values of plasma volume (4.49 +/-
      0.08 ml.100 gm-1 vs. 3.73 +/- 0.03 ml.100 gm-1) coincided with fully developed
      hyperdynamic circulation, as shown by a significant elevation in cardiac index
      (32.3 +/- 0.6 ml.min-1 x 100 gm-1 vs. 25.5 +/- 1.2 ml.min-1 x 100 gm-1), iliac
      and mesenteric blood flow. On day 1, vasodilatation was present in the iliac
      arterial circulation. In contrast, the superior mesenteric artery vascular bed
      showed vasoconstriction in response to the protal outflow block.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1735538
TI  - An improved model of acetaminophen-induced fulminant hepatic failure in dogs.
AB  - We have established an improved model of fulminant hepatic failure in dogs.
      Buthionine sulfoximine is used to inactivate glutathione synthesis, and small
      increments of acetaminophen are given intravenously to maintain the plasma level
      at approximately 200 micrograms/ml for 20 hr. This regimen produces severe liver
      injury along with many of the features seen in humans with acetaminophen
      poisoning. The first sign of impending liver failure is hypoglycemia. This occurs
      about 15 hr into the experiment and requires treatment with a continuous infusion
      of glucose. Between 15 and 20 hr, serum ALT activity begins to rise, indicating
      the onset of liver necrosis. Over the following 15 to 20 hr ALT activity
      continues to rise and is accompanied by an increase in bilirubin, a prolongation
      of the prothrombin time and the development of fetor hepaticus. Thirty to 48 hr
      after the initial acetaminophen dose, the animals begin to exhibit symptoms of
      encephalopathy and progress from lethargy to the inability to maintain posture
      and then coma, seizures and death. Liver biopsy specimens obtained at several
      stages throughout the study showed progressive necrosis, ultimately resulting in
      the complete destruction of zones 2 and 3.

PMID- 1735539
TI  - Pathogenesis of arterial hypotension in cirrhotic rats with ascites: role of
      endogenous nitric oxide.
AB  - Nitric oxide is a vasodilator tonically secreted by endothelial cells that is
      involved in the regulation of arteriolar tone. This study, which includes two
      protocols, was performed to investigate whether nitric oxide plays a role in the
      pathogenesis of arterial hypotension in cirrhosis with ascites. In protocol 1,
      the administration of increasing doses (25, 50, 250, 500 and 1,000 micrograms.kg
      1.min-1) of the nitric oxide biosynthesis inhibitor N omega-nitro-L-arginine to
      18 conscious rats with cirrhosis and ascites produced, at each dose tested, a
      significantly greater increase in arterial pressure than in 17 conscious control
      rats. At the lowest dose of N omega-nitro-L-arginine, arterial pressure
      significantly rose in cirrhotic rats but not in controls. In protocol 2, arterial
      pressure, estimated renal plasma flow, glomerular filtration rate and sodium
      excretion were measured in 12 cirrhotic rats with ascites and 10 control rats
      before and during the sequential infusion of previously selected doses of N omega
      nitro-L-arginine (25, 50 and 250 micrograms.kg-1.min-1). Changes in arterial
      pressure reproduced those observed in protocol 1. In control rats, N omega-nitro
      L-arginine caused a decrease in estimated renal plasma flow without affecting
      glomerular filtration rate or sodium excretion. In contrast, N omega-nitro-L
      arginine administration to cirrhotic animals did not produce any appreciable
      renal vasoconstrictor effect, and it increased glomerular filtration rate and
      sodium excretion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735540
TI  - Treatment of refractory ascites: is dialytic ultrafiltration better than
      paracentesis?

PMID- 1735541
TI  - Pulmonary dysfunction in advanced liver disease.

PMID- 1735542
TI  - Lower rates of postbiopsy bleeding: needle vs. technique.

PMID- 1735543
TI  - Identification of genetic differences in debrisoquine hydroxylase activity.

PMID- 1735544
TI  - Data watch. Survey tracks hospital renovation activity.

PMID- 1735545
TI  - The sagging safety net. Emergency departments on the brink of crisis.
AB  - U.S. hospitals are facing an emergency care crisis. At the same time emergency
      departments are overflowing with uninsured patients seeking primary care,
      violence-related trauma cases are soaring, leaving underfunded trauma systems on
      the verge of collapse. In a special cover package, we explore the causes of the
      crisis, the current prospects for change, and related issues in emergency care
      today. Beginning on page 26, we present an overview of the crisis, with
      particular attention to the breakdown of trauma systems. Starting on page 30, we
      look at the growing threat of violence itself entering hospital EDs; on pages 34
      35, we examine how hospitals are attracting and retaining critically needed
      clinicians, and how trauma systems are dealing with ongoing shortages of
      specialists. On pages 37-38, we explore the patient satisfaction question; and on
      pages 38-39, we present the latest data on emergency care utilization from the
      American Hospital Association.

PMID- 1735546
TI  - In a time of change, construction planning takes on complex new dimensions.
AB  - While construction budgets appear to be tighter in the wake of Medicare's fold-in
      of inpatient capital payment, hospitals are going ahead with ambitious plans for
      expansion and renovation. But construction planning is increasingly becoming more
      interwined with overall strategic planning.

PMID- 1735547
TI  - Business and labor move forward via joint health care reform plan.

PMID- 1735548
TI  - Direct contracting: employers look to hospital-physician partnerships to control
      costs.
AB  - Direct contracting is gaining popularity as employers seek new ways to control
      health care costs. Eliminating third parties like HMOs and PPOs can create long
      term savings, but it's much more complicated than many hospitals realize, experts
      warn.

PMID- 1735549
TI  - How to give MDs a greater role in management.

PMID- 1735550
TI  - Boards, execs more savvy about CEO contracts.

PMID- 1735551
TI  - Service basics attract new outpatient lab users.

PMID- 1735552
TI  - Poor HIS sales trigger reduced systems support.

PMID- 1735553
TI  - Credentialing program demise a 'disappointment'.

PMID- 1735554
TI  - Hospitals use employee opinion on job candidates.

PMID- 1735555
TI  - IRS, AMA limit hospital-MD joint ventures.

PMID- 1735556
TI  - Physician recruitment: a three-step strategy.

PMID- 1735557
TI  - DNA polymorphism of HLA class II genes in primary biliary cirrhosis.
AB  - We investigated the DNA restriction fragment length polymorphism of the major
      histocompatibility complex class II genes: HLA-DRB, -DQA, -DQB, DPA, -DPB, the
      serologically defined HLA-A, B, C, DR antigens, and the primed lymphocyte typing
      defined HLA-DP antigens in 23 Danish patients with primary biliary cirrhosis
      (PBC) and in healthy Danes. The following genetic markers were found with
      increased frequencies in PBC: HLA-B8 (relative risk, RR = 2.4, P less than 0.05,
      'corrected' P greater than 0.05), HLA-DR3 (RR = 3.4, P less than 0.01,
      'corrected' P less than 0.05), the DRB3*01/02/03 (DRw52) associated DRB Bgl II
      9.1 kilobase (kb) fragment (RR = 2.9; P less than 0.05, 'corrected' P greater
      than 0.05), the DQA1*0501 associated DQA Taq I 4.8 kb fragment (RR = 3.1; P less
      than 0.05, 'corrected' P greater than 0.05), the DQB1*0201 (DQw2) associated DQB
      Hin dIII 11.5 kb fragment (RR = 3.1; P less than 0.05, 'corrected' P greater than
      0.05). No DNA fragments specific for DRB1*0301 (DR3) could be identified. The
      frequencies in PBC of other genetic markers including DRw8, DRB1*08, HLA-DP
      antigens, DPA, and DPB genes did not differ significantly from those in controls.
      The associations between PBC and B8, DR3, DQA1*0501, and DQB1*0201, which are
      frequently found together on the same haplotype, are at variance with recent
      reports on associations between PBC and Drw8. The discrepancy suggests that PBC
      is genetically heterogenous.

PMID- 1735558
TI  - Hemopoietic histocompatibility (Hh-1) phenotype and the regulation of its
      expression.
AB  - Hybrid resistance (HR) is primarily controlled by the genes of the Hemopoietic
      histocompatibility-1 (Hh-1) locus within the H-2 complex. HR is a consequence of
      the Hh-1-controlled target determinants in homozygous parental strain mice and
      their absence in heterozygous F1 hybrid mice. To examine the mechanism that
      controls the Hh-1 phenotype, three independent clones of somatic cell hybrids
      between parental lines EL-4 (C57BL/6 origin, H-2b) and R1 (C58 origin, H-2k) were
      studied. The line EL-4 is Hh-1b-positive and is subject to HR by H-2b
      heterozygous F1 mice, but R1 lacks the Hh-1b allele and is not susceptible to HR.
      Of the three hybrid clones, F263.2 is Hh-1b-positive, whereas the other two,
      F262.2 and F264.2, are Hh-1b-negative, as judged by these cells' capacity to
      compete in vivo with the grafted parental C57BL/6 bone marrow cells in the
      resistant (C57BL/6 x C3H)F1 mice. All three clones express the H-2b and H-2k
      class I antigens equally well, are susceptible to activated NK cells to the same
      extent, and all carry four copies of chromosome 17. However, Southern analysis
      reveals that clone F263.2 contains three copies of H-2b chromosome and one H-2k,
      whereas the other two clones carry two copies each of the parental chromosome 17.
      The results suggest that the relative copy number of specific alleles is the
      crucial determinant of the Hh-1 phenotype, and render unlikely both the gene
      dosage hypothesis and the trans-acting dominant suppression hypothesis to account
      for the noncodominant expression of the Hh-1 phenotype.

PMID- 1735559
TI  - Conservation of the promoter region of DRA-like genes from nonhuman primates.

PMID- 1735560
TI  - The recombination activating genes, RAG 1 and RAG 2, are on chromosome 11p in
      humans and chromosome 2p in mice.
AB  - The recombination activating genes RAG-1 and RAG-2 are adjacent genes that act
      synergistically to activate variable-diversity-joining (V(D)J) recombination.
      Southern analysis of hybrid cell lines derived from patients with the Wilms tumor
      aniridia-genitourinary defects-mental retardation (WAGR) syndrome and from
      mutagenized cell hybrids selected for deletions in chromosome 11 has allowed us
      to map the chromosomal location of the human RAG locus. The RAG locus defines a
      new interval of human chromosome 11p, but is not associated with any genetically
      mapped human disease. Guided by the chromosomal localization of the human
      recombination activating genes, we have also mapped the location of the mouse Rag
      locus.

PMID- 1735561
TI  - Reactivity of small blood vessels in hypertension: relation with structural
      changes. State of the art lecture.
AB  - Small blood vessels, particularly small arteries of 150-300 microns in lumen
      diameter and larger arterioles of 50-150 microns in lumen diameter, are the most
      important location of the arterial bed that undergoes changes resulting in the
      increased peripheral resistance that characterizes elevated blood pressure. This
      article reviews these morphological and functional alterations of small blood
      vessels. Study of mesenteric small arteries with a lumen diameter of 220-260
      microns revealed consistently a reduced external and lumen diameter in renal and
      deoxycorticosterone acetate-salt hypertensive rats early in the evolution of
      hypertension. The media of the vessel wall was significantly thickened in the
      hypertensive rats, and the media/lumen ratio was increased. Although the tension
      that developed in response to different vasoconstrictors was not elevated or was
      even decreased in hypertensive rats, exaggerated transmural pressures resulted in
      the isolated blood vessels as a consequence of the law of Laplace because of the
      narrowed lumen. Similar findings were obtained in small resistance arteries from
      subcutaneous gluteal biopsies of hypertensive humans. In arterioles, on the other
      hand, decreases in the density of blood vessels (rarefaction) and in vasomotion
      amplitude may play a more important role than reductions in lumen diameter. As a
      consequence of the design of small resistance blood vessels and as a result of
      functional and structural alterations, which may be primary to or a consequence
      of high blood pressure, the pressor effect of vasoconstrictors is amplified and
      interacts with other factors to contribute to the maintenance of elevated blood
      pressure even if the intrinsic response of vascular smooth muscle to these agents
      is not exaggerated.

PMID- 1735562
TI  - Localization of components of the kallikrein-kinin system in the kidney: relation
      to renal function. State of the art lecture.

PMID- 1735563
TI  - Insulin enhances pressor responses to norepinephrine in rat mesenteric
      vasculature.
AB  - Hyperinsulinemia and insulin resistance have been proposed to play a role in
      human and experimental hypertension. To characterize this relation further, we
      examined the pressor responses to periarterial nerve stimulation (PNS) and
      norepinephrine infusion in the isolated mesenteric vasculature of the normal rat
      before and after insulin (10, 100, and 1,000 microunits/ml) infusion. The pressor
      responses to PNS were similar before and after insulin, except at the highest
      dose of insulin (1,000 microunits/ml) and the highest frequency of PNS (10 Hz).
      However, insulin significantly increased the pressor responses to norepinephrine.
      This increase in responsiveness was evident at all doses of insulin studied. In
      contrast, insulin did not affect the pressor responses to either angiotension II
      or serotonin administration. The mechanism or mechanisms for the augmented
      pressor response to norepinephrine after insulin infusion remain to be
      determined. However, the selectivity of the response for norepinephrine and the
      absence of a marked pressor increase after PNS indicate that the mechanism
      probably involves either the alpha-receptor itself or an amplification of the
      postreceptor signal transduction. The role of chronic hyperinsulinemia and
      insulin resistance in the pathogenesis of essential hypertension requires further
      study.

PMID- 1735564
TI  - Chemical renal medullectomy and arterial pressure response to sinoaortic
      denervation.
AB  - We investigated in conscious Wistar-Kyoto rats the effect of chemical renal
      medullectomy on the responses of mean arterial pressure, arterial pressure
      lability, and heart rate to sinoaortic deafferentation (SAD). Chemical
      medullectomy was obtained by the intravenous administration of 2-bromoethylamine
      hydrobromide (2-BEA) 2-3 weeks before SAD or sham SAD. Chemically medullectomized
      rats were compared with control rats treated with saline. In control rats, the
      increase in mean arterial pressure elicited by SAD was not significantly greater
      than that produced by sham SAD. In medullectomized rats, SAD significantly
      increased mean arterial pressure compared with sham SAD. No direct relation was
      observed between the response of mean arterial pressure to SAD and the grade (1,
      2, or 3) of lesion of the renal papilla. In control rats, SAD increased
      significantly arterial pressure lability. Chemical medullectomy did not affect
      basal lability or the increased lability after SAD. No direct relation was
      observed between increased arterial pressure lability due to SAD and the grade of
      lesion of the renal papilla. SAD produced a conspicuous tachycardia in control
      rats. Chemical medullectomy did not affect basal heart rate or the tachycardia
      produced by SAD. No direct relation was observed between the extent of this
      tachycardia and the grade of lesion of the renal papilla. These data indicate
      that lesions of the renal papilla lead to a significant increase in mean arterial
      pressure after SAD, without affecting basal pressure or heart rate. In addition,
      SAD per se did not increase significantly the mean arterial pressure in control
      rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735565
TI  - Actions of cromakalim in isolated human saphenous vein.
AB  - The present study was performed to evaluate the effect of cromakalim on human
      vein in vitro. Branches of human saphenous vein (leftovers), obtained from
      patients undergoing heart revascularization surgery, were cut into rings and
      suspended in an organ chamber filled with Krebs-Ringer solution for the
      measurement of isometric contractile force. Concentration-response curves to
      norepinephrine and serotonin were constructed before and after pretreatment with
      cromakalim. The concentration-response curves to norepinephrine and serotonin
      were displaced to the right, and the maximal responses to both agonists were
      significantly inhibited by cromakalim in a concentration-dependent manner.
      Following sustained contraction induced by prostaglandin F2 alpha or 20 mM KCl,
      the cumulative addition of cromakalim to the organ chamber produced a
      concentration-dependent relaxation. However, in veins precontracted with 60 mM
      KCl the addition of cromakalim in concentrations of up to 10(-5) M did not induce
      relaxation. The relaxation induced by cromakalim in veins precontracted with
      prostaglandin F2 alpha was significantly inhibited by glibenclamide. These
      results indicate that cromakalim has a dilator effect in human vein that may play
      a helpful role in the treatment of angina. The venodilator effect of cromakalim
      in human saphenous vein probably involves activation of adenosine triphosphate
      regulated potassium channels.

PMID- 1735566
TI  - Effectiveness of atenolol in the treatment of hypertension during pregnancy.
AB  - This study assessed the effectiveness of atenolol in the treatment of moderate
      and severe hypertension during pregnancy. Seventy patients (mean age, 30.3 +/-
      6.0 years), 35.7% primiparous, were included. Three groups were formed according
      to Davey and MacGillivray's classification: 1) chronic hypertension without
      proteinuria (12 patients), 2) gestational hypertension without proteinuria (52
      patients), and 3) preeclampsia (six patients). Treatment with atenolol was
      started when blood pressure was 150/100 mm Hg or higher after 48 hours' rest. The
      treatment lasted at least 1 week; follow-up was every 2 weeks up to week 36, and
      from then on, weekly up to delivery. If blood pressure exceeded 160/110 mm Hg and
      the fetus was not yet mature, a second drug was added. A significant decrease in
      blood pressure was observed in the three groups (group 1: 155.8 +/- 15.0/100.8 +/
      7.6 versus 135.0 +/- 12.9/85.0 +/- 6.7 mm Hg; group 2: 154.2 +/- 13.6/104.9 +/-
      9.3 versus 129.6 +/- 10.2/83.7 +/- 9.1 mm Hg; group 3: 158.3 +/- 27.1/104.1 +/-
      8.0 versus 129.1 +/- 6.6/87.5 +/- 6.1 mm Hg). The doses of atenolol were 62.5 +/-
      23.0 mg/day in group 1, 70.0 +/- 30.0 mg/day in group 2, and 100.0 +/- 41.0
      mg/day in group 3. There was no fetal mortality. No significant difference
      occurred in newborn body weights. Four babies from group 2 mothers had an Apgar
      score of less than 7 at 1 minute, but only one remained abnormal after 5 minutes.
      In the same group, three cases of respiratory distress were observed.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1735567
TI  - Cadralazine for the treatment of preeclampsia. An open, noncomparative, dose
      finding pilot study.
AB  - The antihypertensive effect, tolerability, and influence on placental and fetal
      circulation of cadralazine, a 6-substituted derivative of 3-hydrazinopyridoxine
      structurally related to hydralazine, was assessed in 46 preeclamptic patients in
      the third trimester of pregnancy and with diastolic blood pressure of 100-120 mm
      Hg after 24 hours of bed rest. Patients who fulfilled the inclusion criteria at
      the initial report (24-48-hour run-in period after hospitalization) entered the
      titration period. During titration, cadralazine was administered at an initial
      dose of 5 mg once a day; if after 3 days diastolic blood pressure was still above
      90 mm Hg, 5 mg more was added for another 3 days, and so forth, until the maximum
      dose (20 mg once a day) was reached. Patients who did not lower diastolic blood
      pressure below 90 mm Hg were considered nonresponders; those who achieved the
      desired diastolic level (responders) entered the maintenance period, which lasted
      until delivery. Eight patients delivered during the titration period (premature
      discontinuation group). A significant decrease in systolic and diastolic blood
      pressures was observed between the initial report and the titration period.
      During titration, there were 27 responders (71%) and 11 nonresponders. One of the
      responders was lost to follow-up. Cadralazine proved to be effective in lowering
      blood pressure levels; in the group of responders, a mean diastolic reduction of
      20% was observed. This significant decrease was not affected by the diastolic
      blood pressure increase observed at the end of gestation. No adverse effects from
      the drug were observed on fetal development or immediate postnatal adaptation to
      stress during labor, and only mild maternal side effects were detected
      (headache).

PMID- 1735568
TI  - Renal effects of angiotensin II inhibition during increases in renal venous
      pressure.
AB  - Increases in renal venous pressure have been shown to consistently increase renal
      interstitial pressure; however, not until renal interstitial pressure is
      increased threefold is a natriuresis noted in normal animals. Since the
      intrarenal angiotensin II (Ang II) concentration has been postulated to increase
      with increasing renal venous pressure, the antinatriuretic action of Ang II could
      override the natriuretic effect of increased renal interstitial pressure.
      Therefore, the role of Ang II in the natriuretic response to increased renal
      venous pressure was examined in 10 pentobarbital-anesthetized dogs. Mean arterial
      pressure, renal blood flow, renal interstitial pressure, glomerular filtration
      rate, urinary sodium excretion, plasma renin activity, and prostaglandin E2
      excretion were measured at renal venous pressures of 3, 15, and 30 mm Hg. The
      measurements were repeated after the administration of captopril (1 mg/kg i.v.
      bolus, n = 5) or [Sar1,Ile8]Ang II (50 micrograms/kg i.v. bolus + 50
      micrograms/kg/hr infusion, n = 5). Under control conditions, mean arterial
      pressure, renal blood flow, plasma renin activity, and prostaglandin E2 excretion
      remained unchanged when renal venous pressure was increased. The elevations in
      renal venous pressure increased renal interstitial pressure from 7 +/- 2 to 12 +/
      2 and 22 +/- 4 mm Hg, while sodium excretion remained unchanged until renal
      venous pressure was 30 mm Hg. In the captopril-treated group, increasing renal
      venous pressure increased renal interstitial pressure as under control
      conditions; however, sodium excretion (23 +/- 4, 19 +/- 4, and 27 +/- 6 mueq/min)
      was not significantly increased even at the highest renal venous
      pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735569
TI  - Changes in vascular resistance during carotid occlusion in normal and
      baroreceptor-denervated rats.
AB  - In the present study, we investigated changes in mesenteric, renal, and
      hindquarter vascular resistance during the pressor response produced by bilateral
      carotid occlusion (BCO) in conscious, freely moving normal and denervated
      (aortic, carotid, or both) rats. BCO was performed using special previously
      implanted cuffs. In control normal rats, the increase in mean arterial pressure
      (MAP) during early and late responses (37 +/- 4 and 21 +/- 2 mm Hg, respectively)
      was related to increased renal (125 +/- 12% and 45 +/- 10%) and mesenteric (38 +/
      13% and 41 +/- 5%) but not hindquarter (14 +/- 4% and 8 +/- 7%) vascular
      resistance. In aortic-denervated rats, the greater MAP increase in early and late
      responses (57 +/- 4 and 44 +/- 4 mm Hg, respectively) compared with normal rats
      was related to a marked increase in hindquarter (137 +/- 26% and 106 +/- 26%) and
      mesenteric (104 +/- 14% and 66 +/- 9%) vascular resistance. In carotid-denervated
      rats, MAP increase and change in vascular resistance were similar to those values
      observed in control rats. Sinoaortic-denervated rats showed a greater MAP
      increase (34 +/- 4 mm Hg) during late response and a reduced increase in renal
      vascular resistance (46 +/- 6%) during early response.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1735570
TI  - Chronic lesion of rostral ventrolateral medulla in spontaneously hypertensive
      rats.
AB  - We studied the effects of chronic selective neuronal lesion of rostral
      ventrolateral medulla on mean arterial pressure, heart rate, and neurogenic tone
      in conscious, unrestrained spontaneously hypertensive rats. The lesions were
      placed via bilateral microinjections of 30 nmol/200 nl N-methyl-D-aspartic acid.
      The restimulation of this area with N-methyl-D-aspartic acid 15 days postlesion
      failed to produce a pressor response. One day postlesion, the resting mean
      arterial pressure was significantly decreased in lesioned rats when compared with
      sham rats (100 +/- 7 versus 173 +/- 4 mm Hg, p less than 0.05). Fifteen days
      later, the lesioned group still showed values significantly lower than the sham
      group (150 +/- 6 versus 167 +/- 5 mm Hg, p less than 0.05). No significant heart
      rate differences were observed between the sham and lesioned groups. The
      ganglionic blocker trimethaphan (5 mg/kg i.v.) caused similar reductions in mean
      arterial pressure in both lesioned and sham groups. The trimethaphan-induced
      hypotension was accompanied by a significant bradycardia in lesioned rats (-32 +/
      13 beats per minute) but a tachycardia in sham rats (+33 +/- 12 beats per
      minute) 1 day postlesion. Therefore, rostral ventrolateral medulla neurons appear
      to play a significant role in maintaining hypertension in conscious spontaneously
      hypertensive rats. Spinal or suprabulbar structures could be responsible for the
      gradual recovery of the hypertension in the lesioned rats.

PMID- 1735571
TI  - Baroreceptor reflex control of heart rate during development of coarctation
      hypertension.
AB  - To study whether resetting of the baroreceptors is accompanied by normal reflex
      activity to the heart, we analyzed time-course changes of pressure, heart rate,
      baroreceptor reflex sensitivity, and plasma renin activity during the development
      of coarctation hypertension. Baseline heart rate was measured daily, and plasma
      renin activity and reflex changes in heart rate (bolus injections of either
      phenylephrine or nitroprusside, 0.2-25.6 micrograms/kg i.v.) were recorded at
      different times in coarcted and sham-coarcted rats. Hypertension was stable
      (approximately 39% from baseline mean arterial pressure of 112 +/- 3 mm Hg),
      whereas heart rate (333 +/- 4 beats per minute) showed a biphasic behavior:
      bradycardia at 6 hours (264 +/- 7 beats per minute) and tachycardia at 5 days
      (418 +/- 14 beats per minute). On day 10 of hypertension, heart rate was normal.
      Plasma renin activity was markedly increased only after 6 hours (4.9 times).
      Reflex bradycardia exhibited a progressive impairment: The slopes of the
      regression lines between changes in heart rate and changes in mean arterial
      pressure were not significantly reduced at 6 and 48 hours when the resetting was
      in development (changes of 17% and 28% from a control of -1.89 +/- 0.20 beats per
      minute/mm Hg) but were significantly depressed after the resetting had been
      completed (-51% and -56% at 5 and 10 days, respectively). Reflex tachycardia was
      significantly reduced in all periods studied (75%, 78%, 52%, and 61% at 6 hours
      and 2, 5, and 10 days, respectively; -3.92 +/- 0.42 beats per minute/mm Hg in
      sham rats).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735572
TI  - Pressure-induced constriction of the afferent arteriole of spontaneously
      hypertensive rats.
AB  - In uncomplicated essential hypertension, renal blood flow, glomerular filtration
      rate, and glomerular capillary pressure are within the normal range despite
      elevated renal perfusion pressure, suggesting abnormally high resistance of the
      preglomerular vessels. Among various preglomerular vascular segments, the
      afferent arteriole (Af-Art) is thought to be the site responsible for most
      resistance. However, little is known about the vascular reactivity of the Af-Art
      or its alteration in hypertension. In this study, we tested the hypothesis that
      pressure-induced constriction is exaggerated in Af-Arts from spontaneously
      hypertensive rats (SHRs). Single Af-Arts were microdissected from kidneys of SHRs
      and normotensive control Wistar-Kyoto (WKY) rats and were microperfused in vitro.
      When pressure in the Af-Art was increased stepwise from 20 to 80 mm Hg, luminal
      diameter increased similarly in both WKY and SHR Af-Arts (from 10.0 +/- 0.8 to
      18.6 +/- 1.3 microns and from 10.1 +/- 1.2 to 16.9 +/- 1.5 microns,
      respectively). However, when pressure was further increased to 140 mm Hg, the
      diameter remained unchanged in WKY Af-Arts (19.2 +/- 1.9 microns), whereas it
      decreased significantly to 11.1 +/- 0.9 microns in those from SHRs. We conclude
      that pressure-induced constriction is exaggerated in SHR Af-Arts, which may
      contribute to the development and maintenance of hypertension.

PMID- 1735573
TI  - Expression of alpha-smooth muscle actin in the developing kidney vasculature.
AB  - To determine whether alpha-smooth muscle (alpha-SM) isoactin is expressed in the
      maturing kidney as well as the changes associated with maturation, we processed
      for immunocytochemistry kidney sections from Wistar-Kyoto rats at various
      prenatal (15, 17, 19, and 20 days) and postnatal (2, 5, 10, 15, and 90 days) ages
      using a monoclonal anti-alpha-SM actin antibody. At 15 days of gestation, only a
      few mesenchymal cells contained alpha-SM actin. However, other fetal vasculature
      structures (heart, aorta, peripheral blood vessels) expressed alpha-SM actin.
      Vascular localization was first observed at 17 days of gestation in larger
      corticomedullary vessels. As maturation progressed, actin expression accompanied
      the outward growth and branching of the kidney vasculature. During fetal life (17
      days), alpha-SM actin also was expressed within juxtamedullary glomeruli. As the
      centrifugal maturation of nephrons proceeded, intraglomerular expression extended
      to outer cortical glomeruli. After 10 days of postnatal life, once glomerular
      development was completed, intraglomerular expression was no longer present.
      Peritubular capillaries expressed alpha-SM actin during early (fetal and
      neonatal) development, but not in the adult kidney. We conclude that 1)
      expression of alpha-SM actin in the developing kidney is delayed with respect to
      other vascular beds, 2) expression of alpha-SM actin follows the centrifugal
      pattern of nephrovascular development, and 3) glomerular and peritubular
      capillary expression of alpha-SM actin is a transient developmental phenomenon
      associated with active glomerulogenesis and capillary growth.

PMID- 1735574
TI  - Renal denervation normalizes pressure and baroreceptor reflex in high renin
      hypertension in conscious rats.
AB  - High renin hypertension is usually accompanied by impairment of the baroreceptor
      reflexes. This feature has been mostly ascribed to overactivity of the renin
      angiotensin system. However, renal nerves could also modulate the baroreceptor
      reflexes. In the present experiments, the effect of renal denervation on the
      depressed baroreceptor reflexes was studied in rats subjected to aortic ligation
      between the renal arteries. Renal denervation of the ischemic kidney was
      performed at the same time as aortic ligation. The resulting effects on arterial
      pressure, heart rate, plasma renin activity, and baroreceptor reflex control of
      heart rate were studied 10-12 days after ligation and denervation. Aortic
      ligation induced high levels of mean arterial pressure (166 +/- 6 versus 110 +/-
      3 mm Hg in controls), heart rate (380 +/- 9 versus 352 +/- 8 beats per minute in
      controls), and plasma renin activity (44 +/- 5 versus 6 +/- 1.2 ng angiotensin
      I/ml/hr). The baroreceptor reflex sensitivity for bradycardia and tachycardia was
      significantly reduced (-0.18 +/- 0.04 and -0.18 +/- 0.05, respectively, versus 
      2.3 +/- 0.01 and -2.4 +2- 0.1 beats per minute per mm Hg in controls).
      Denervation of the ischemic kidney attenuated the development of hypertension in
      aortic-ligated rats (122 +/- 3 mm Hg), lowering heart rate (319 +/- 8 beats per
      minute) and normalizing baroreceptor reflex sensitivity to bradycardia (-2.0 +/-
      0.2 beats per minute per mm Hg) and to tachycardia (-4.0 +/- 0.1 beats per minute
      per mm Hg). Plasma renin activity was also normalized (4.3 +/- 2.4 ng angiotensin
      I/ml/hr).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735575
TI  - Centrally infused bradykinin increases baroreceptor reflex sensitivity.
AB  - Kinins are present in the central nervous system, and central administration of
      bradykinin increases blood pressure and heart rate. In this study, we determined
      the effect of intracerebroventricular infusion of bradykinin on the baroreceptor
      reflex of conscious rats. Male Wistar rats were anesthetized with thiobarbital
      (40 mg/kg i.p.), and chronic intracerebroventricular cannulas (25 gauge) were
      implanted into the lateral ventricles. Baroreceptor control of heart rate was
      evaluated by recording reflex heart rate changes (beats per minute) in response
      to mean arterial pressure changes (mm Hg) produced by bolus injection of
      phenylephrine (0.5-20 micrograms/kg i.v.) or sodium nitroprusside (0.5-25
      micrograms/kg i.v.). The ratio beats per minute/mm Hg or the mean slope of the
      individual regression lines of the relation between heart rate and mean arterial
      pressure changes for increases or decreases in arterial pressure was used as an
      index of baroreceptor reflex sensitivity. Baroreceptor control of heart rate was
      evaluated within 1 and 3 hours of intracerebroventricular infusion of bradykinin
      (7.5 micrograms/7 microliters/hr) or saline (7 microliters/hr). There was no
      change in basal mean arterial pressure or heart rate during central bradykinin
      infusion (112 +/- 2 mm Hg and 402 +/- 18 beats per minute in the control period).
      After 1 hour of central bradykinin infusion, there was a significant increase of
      baroreceptor reflex sensitivity for increments in mean arterial pressure (-2.91
      +/- 0.26 versus -1.5 +/- 0.24 beats per minute/mm Hg in the control period; p
      less than 0.01, paired Student's t test). In contrast, no significant changes
      were observed for the reflex tachycardia. Similar results were obtained with 3
      hours of infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735576
TI  - Effect of selective denervation of baroreceptors on pulmonary ventilation and
      arterial pressure lability in rat.
AB  - Earlier studies report that sinoaortic baroreceptor denervation (SAD) in rats
      causes moderate elevation of mean arterial pressure along with a marked increase
      of arterial pressure lability (APL). In this context, we studied the effects of
      selective aortic denervation (AD) or selective carotid denervation (CD) on the
      regulation of blood pressure. In addition, we evaluated the effects of selective
      or total baroreceptor denervation on pulmonary ventilation and ventilation
      related changes of arterial pressure. Mean arterial pressure was evaluated by
      computer-assisted techniques, and ventilation was measured by whole body
      plethysmography on conscious freely moving rats. With this approach, equal
      increases of mean arterial pressure were obtained for rats that had undergone AD,
      CD, and SAD. The APL was higher in SAD rats than in selectively denervated rats.
      CD and AD rats had an elevated APL relative to sham-operated animals, and its
      increase was approximately equal for the two selectively denervated groups. Total
      as well as selective denervation had relatively small effects on ventilation and
      on the general pattern of breathing. In all groups, this pattern consisted of
      regular ventilation, periodically interrupted by single deeper breaths. In SAD,
      AD, and CD animals, these larger tidal volumes were associated with marked
      transient reductions of mean arterial pressure, whereas small decreases of
      pressure occurred in sham-operated rats. The results indicate that both groups of
      baroreceptors must be present to keep mean arterial pressure at its normal level.
      Moreover, both receptor groups are equally important in reducing APL. Ventilation
      contributes to generation of APL after total or selective baroreceptor removal.
      Such ventilation-induced pressure changes are kept at a minimum in baroreceptor
      intact rats.

PMID- 1735577
TI  - Identification of cardiovascular neurons in the rostral ventromedial medulla in
      anesthetized rats.
AB  - Recent studies have identified a region in the rostral ventromedial medulla
      (RVMM) of rats that appears to be involved in cardiovascular function. Since
      these studies used either microinjection of lidocaine or electrical stimulation,
      the exact contribution of intrinsic neurons as opposed to fibers of passage could
      not be determined. The present study was performed to map the location of neurons
      in RVMM from which changes in mean arterial pressure could be elicited by the
      microinjection of the excitatory amino acid analogue N-methyl-D-aspartic acid
      (NMDA) (20 ng/50 nl), which selectively activates cell bodies in barbiturate
      anesthetized rats. Microinjection of NMDA into RVMM most often (53%) elicited
      pressor responses (31 +/- 7 mm Hg). On the basis of these responses, RVMM was
      determined to encompass a large portion of the nucleus gigantocellularis 0.5-1.5
      mm lateral to the midline, 0.5-3.5 mm above the ventral surface, and extending
      from the rostral to the caudal pole of the facial nucleus. Depressor responses (
      21 +/- 3 mm Hg) were found at all levels of RVMM but were most concentrated and
      of the largest magnitude in the rostral and caudal poles of RVMM. Microinjection
      of the inhibitory neurotransmitter glycine (500 mM) was used to determine whether
      neurons in RVMM were contributing to the maintenance of arterial pressure.
      Microinjection of glycine decreased arterial pressure (-15 +/- 2 mm Hg)
      throughout most of RVMM. Unexpectedly, increases in mean arterial pressure (24 +/
      3 mm Hg) were elicited by microinjection of glycine into the same region in RVMM
      in which NMDA most frequently elicited pressor responses.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1735578
TI  - Early depression of the baroreceptor sensitivity during onset of hypertension.
AB  - We studied the correlation of changes in gain sensitivity of the baroreceptors
      and the development of resetting of the baroreceptors 2 and 6 days after the
      onset of hypertension produced by subdiaphragmatic aortic constriction in rats.
      Mean arterial pressure of anesthetized rats was maintained at approximately the
      same level as that of conscious rats, and baroreceptor function curves were
      studied on a beat-to-beat basis by computer. After 2 days of hypertension, the
      difference between the systolic pressure threshold and the control diastolic
      pressure was -13 +/- 2 mm Hg (125 +/- 3 versus 138 +/- 4 mm Hg). Individual
      values showed that in seven of nine hypertensive rats, the difference was less
      than 15 mm Hg, indicating complete resetting. After 6 days of hypertension, all
      rats exhibited complete resetting, when the systolic pressure threshold was
      similar to control diastolic pressure (143 +/- 4 versus 141 +/- 2 mm Hg),
      indicating that more than 2 days of hypertension is necessary for full
      displacement of the pressure thresholds when all hypertensive rats are
      considered. Slopes of the baroreceptor curves after 2 and 6 days of hypertension
      showed that baroreceptor gain was depressed by 25% and 34%, respectively. The
      difference was not statistically significant (1.07 +/- 0.054% versus 0.94 +/-
      0.049% and 1.43 +/- 0.075% in controls). When changes in pressure were
      circumscribed to a more physiological range, a depression of 25% in response to
      +10 mm Hg and 37% in response to -10 mm Hg was observed.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1735579
TI  - Rapid eye movement sleep deprivation and hypertension. Genetic influence.
AB  - We studied the importance of genetic predisposition in the development of stress
      induced hypertension in the spontaneously hypertensive rat (SHR), Wistar-Kyoto
      (WKY) rat, and borderline hypertensive rat (BHR; first-generation offspring of
      SHR and WKY). Rats were submitted to seven 72-hour sessions of rapid eye movement
      sleep deprivation (REM-sd) every other week during 13 weeks. Tail arterial
      pressure was determined throughout the experiment. At the end of the study, mean
      arterial pressure (direct measurement), sympathetic activity (acute blockade with
      propranolol and phentolamine), and ventricular weight were determined. Results
      showed that REM-sd induced sustained hypertension only in rats with a partial
      predisposition to developing hypertension (BHRs). Values of tail arterial
      pressure at the end of the study were BHR REM-sd, 175 +/- 1.6 mm Hg and control
      BHR, 155.9 +/- 0.9 mm Hg, p less than 0.05; SHR REM-sd, 219 +/- 2.6 mm Hg and
      control SHR, 211.9 +/- 3.4 mm Hg, NS; WKY REM-sd, 123.9 +/- 2 mm Hg and control
      WKY, 125.4 +/- 2.2 mm Hg, NS. Stressed groups showed higher reduction of mean
      arterial pressure than their controls when submitted to sympathetic blockade (SHR
      REM-sd, -75.7 +/- 13.2 mm Hg and control SHR, -60 +/- 4.5 mm Hg, p less than
      0.05; BHR REM-sd, -38.4 +/- 3.6 mm Hg and control BHR, -24.3 +/- 2.1 mm Hg, NS;
      WKY REM-sd, -34.4 +/- 2.5 mm Hg and control WKY, -25.6 +/- 3.3 mm Hg, NS). REM-sd
      increased ventricular weight in all strains. These increments showed no
      correlation with blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735580
TI  - Doppler ultrasonography for the detection of renal artery stenosis in
      transplanted kidneys.
AB  - The objective of this study was to evaluate the importance of Doppler
      ultrasonography in diagnosing renal artery stenosis in transplanted kidneys using
      angiography as the accepted gold standard. Fourteen kidney graft recipients with
      clinical severe hypertension, impaired renal function, or both had their renal
      artery blood flow studied by Doppler ultrasonography before angiography. Seven
      patients had renal artery stenosis diagnosed by angiography. In six of them, the
      same diagnosis was achieved by Doppler ultrasonography, and in one patient,
      Doppler ultrasonography and angiography showed total occlusion of the renal
      artery. In six patients, both exams were normal. The only false-negative result
      was in an 8-year-old patient whose graft was placed in the left flank. The
      Doppler ultrasonography specificity was 100% and its sensitivity was 87.5%. The
      predictive value of a positive test was 100%; the predictive value of a negative
      test was 85.7%. Doppler ultrasonography of the renal artery in transplanted
      kidneys showed an accuracy of 92.86% in diagnosing renal artery stenosis. Because
      the technique is noninvasive, it should be considered as a first-line screening
      test.

PMID- 1735581
TI  - Ventricular function by radionuclide ventriculography in malignant hypertension.
AB  - Malignant hypertension is a unique and natural model for the study of
      abnormalities of left ventricular function due to arterial hypertension, because
      the development and regression of these abnormalities can be observed in a short
      period. Studies of ventricular function by radionuclide ventriculography, either
      before or after therapy, have not been previously reported in malignant
      hypertensive patients. We used this methodology to study left ventricular
      function in 17 malignant/accelerated hypertensive patients at the time of
      admission to the hospital and 3, 6, and 9 months after discharge. Seventy percent
      of patients (12 of 17) had symptoms of congestive heart failure at admission. We
      compared these data with those obtained in 12 normotensive subjects and 13 mild
      to-moderate untreated hypertensive patients. Blood pressure of malignant
      hypertensive patients was 213 +/- 26/140 +/- 17 mm Hg at admission and 165 +/-
      23/101 +/- 15 after 9 months of therapy. Radionuclide ventriculography at
      admission showed that peak filling rates of malignant hypertensive patients (2.13
      +/- 0.21 end-diastolic volume [counts] [EDV]/sec) were significantly lower than
      those in normotensive subjects (2.40 +/- 0.41) and in mild-to-moderate
      hypertensive patients (2.46 +/- 0.21). In contrast, peak ejection rates were
      significantly higher in malignant hypertensive patients (3.44 +/- 0.38 EDV/sec)
      than in the two control groups (3.01 +/- 0.32 and 3.10 +/- 0.43, respectively).
      Ejection fractions were similar in the three groups of patients. After 9 months
      of therapy, peak filling rates of malignant hypertensive patients increased to
      2.38 +/- 0.35 EDV/sec, whereas peak ejection rates decreased to 2.89 +/- 0.43
      EDV/sec, both not significantly different from data in controls.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1735582
TI  - Familial aggregation of arterial blood pressure and possible genetic influence.
AB  - The aggregation of arterial blood pressure, weight, and height were compared
      between family members of children and adolescents with blood pressure
      percentiles at or above 95 (group 1) and at or below 50 (group 2). Weight,
      height, and systolic and diastolic blood pressures were significantly higher in
      siblings and target individuals of group 1 (p less than 0.001). Weight and
      systolic and diastolic blood pressures were significantly higher in mothers of
      group 1 (p less than 0.001). Covariant analysis comparing the average systolic
      and diastolic blood pressures of both groups controlled by age, age and weight,
      and age and Quetelet index revealed that the arterial blood pressure of mothers,
      siblings, and target individuals remained higher in group 1 (p less than 0.05 to
      p less than 0.001). These observations show a strong familial aggregation of
      arterial blood pressure not dependent only on physical development and also raise
      the question of a genetic basis as a possible mechanism of systemic arterial
      hypertension.

PMID- 1735583
TI  - Vascular reactivity in young adults and cardiovascular disease. A prospective
      study.
AB  - Cardiovascular reactivity in response to the cold pressor test has been
      associated with an increased risk of coronary heart disease in middle-aged men.
      We studied 905 white male medical students, median age 22 years, in the Johns
      Hopkins Precursors Study. Systolic blood pressure, systolic blood pressure change
      during the cold pressor test, smoking, cholesterol, Quetelet index, and family
      history of coronary heart disease were measured on enrollment during 1948-1964.
      Incidence of cardiovascular morbidity and mortality was ascertained by annual
      questionnaires and death certificates. There was no association between change in
      systolic blood pressure during the cold pressor test, whether examined as a
      continuous variable or a 20 mm Hg or more rise, and the risk of subsequent
      cardiovascular disease or coronary heart disease. These findings did not change
      after adjustment for cardiovascular disease risk factors. Previously reported
      associations may have been due to preexisting arteriosclerosis, which increases
      the rise in systolic blood pressure during the cold pressor test. We conclude
      that cardiovascular reactivity to the cold pressor test in young adulthood is not
      a strong predictor of future cardiovascular disease.

PMID- 1735584
TI  - The effect of upright tilt on nifedipine-induced natriuresis.
AB  - Calcium channel blockers are antihypertensive agents with diuretic actions. Yet
      edema occurs in some patients receiving long-term treatment with these drugs. As
      with other vasodilators, stimulation for fluid retention could result from
      systemic vasodilation. We speculated that the upright posture could enhance
      sodium retention. To test this hypothesis, we studied the effect of upright tilt
      in 10 patients before and after the oral administration of 20 mg nifedipine.
      Before nifedipine upright tilt caused a 41% drop in the sodium excretion rate,
      from 0.27 +/- 0.04 to 0.16 +/- 0.03 meq/min (p less than 0.05). Fractional sodium
      excretion decreased by 46%, from 2.4 +/- 0.5 to 1.3 +/- 0.3% (p less than 0.01).
      Urinary volume and renal plasma flow also decreased (p less than 0.05). Plasma
      renin activity (PRA) rose by 46% (p less than 0.005). With the patients in the
      supine posture nifedipine increased the sodium excretion rate to 0.49 +/- 0.09
      meq/min (p less than 0.05). Fractional sodium excretion was 3.1 +/- 0.6 meq/min
      (p = 0.2). The natriuresis took place despite a fall in mean blood pressure and a
      significant rise in PRA (up 115% from prenifedipine supine values, p less than
      0.005). Renal plasma flow also increased (p less than 0.01). The upright tilt
      caused a reversal of the nifedipine-induced natriuresis. The sodium excretion
      rate dropped to 0.23 +/- 0.05 meq/min and fractional sodium excretion to 1.3 +/-
      0.2% (both not different from control). This drop in natriuresis occurred while
      mean blood pressure was at its lowest and PRA was 254% above the initial levels
      (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735585
TI  - Endothelium-dependent and endothelium-independent effects of adenosine
      diphosphate in renovascular hypertension.
AB  - Norepinephrine-induced responses in isolated perfused mesenteric vascular bed
      from normotensive and renovascular hypertensive rats were examined in the
      presence of adenosine diphosphate (ADP, 2 x 10(-6) M). Responses to
      norepinephrine were significantly greater in vessels from hypertensive rats.
      Norepinephrine-induced contractions increased after the removal of endothelium. N
      omega-Nitro-L-arginine (L-NOARG), a potent inhibitor of nitric oxide formation,
      similarly increased contractions. The greatest responses were obtained, however,
      after treatment of the vascular segments with methylene blue. The presence of ADP
      caused significant endothelium-dependent decreases in contractions. Although
      decreases caused by ADP in vessels with endothelium after treatment with L-NOARG
      were not statistically significant, a tendency to decreased responses seems to
      suggest that L-NOARG diminishes but does not completely prevent the effect of ADP
      in mesenteric vessels. Methylene blue partially reduced the endothelium-dependent
      ADP-induced relaxant effects in sham-operated nephrectomized rats. A tendency to
      increased contractions to norepinephrine was observed in the presence of ADP
      after removal of endothelium. Thus, in the mesenteric resistance arteries of the
      rat under stimulation by ADP, it appears that nitric oxide released from L
      arginine and the activity of soluble guanylate cyclase account only in part for
      the endothelium-dependent decreased responses to norepinephrine. When nitric
      oxide formation or soluble guanylate cyclase activity are depressed
      simultaneously with endothelium damage, ADP released from platelets or red blood
      cells may be an important factor that acts synergically with vasoconstrictor
      stimuli.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735586
TI  - Angiotensin converting enzyme inhibitors versus calcium antagonists in the
      treatment of diabetic hypertensive patients.
AB  - Angiotensin converting enzyme inhibitors and calcium antagonists are effective
      agents for controlling high blood pressure in diabetic patients. We selected 30
      type II diabetic patients with proteinuria and evaluated the effect of these
      drugs on renal function and proteinuria. In a double-blind trial, patients
      received either 40 mg/day enalapril or 40 mg/day nifedipine during 12 months.
      They also received a hypoproteic diet with 0.8 g/kg wt/day of protein. In the
      enalapril group (10 men and eight women), mean arterial blood pressure was 112.0
      +/- 12 mm Hg, creatinine clearance was 58.6 +/- 12.4 ml/min, and 24-hour
      proteinuria was 4.36 +/- 3.23 g/24 hr before treatment. After treatment, mean
      arterial blood pressure was 82.0 +/- 8.30 mm Hg (p less than 0.001), creatinine
      clearance was 66.6 +/- 13.8 ml/min (NS), and 24-hour proteinuria was 0.56 +/-
      0.78 g/24 hr (p less than 0.001). In the nifedipine group (six men and six
      women), mean arterial blood pressure was 114.0 +/- 8.0 mm Hg, creatinine
      clearance was 67.8 +/- 19.6 ml/min, and 24-hour proteinuria was 2.84 +/- 1.31
      g/24 hr before treatment. After treatment, mean arterial blood pressure was 86.0
      +/- 7.0 mm Hg (p less than 0.001), creatinine clearance was 51.4 +/- 7.9 ml/min
      (p less than 0.001), and 24-hour proteinuria was 2.66 +/- 0.89 g/24 hr (NS).
      These results show a similar hypotensive action and different renal effects
      between these two drugs after 12 months of treatment.

PMID- 1735587
TI  - Effect of bradykinin on isolated mesenteric arteries of the rat.
AB  - Bradykinin is a potent vasodilator peptide; however, its half-life in vivo is
      very short because of various plasma and tissue peptidases that hydrolyze
      bradykinin to inactive fragments. We studied the role of kininase II (angiotensin
      converting enzyme) and neutral endopeptidase 24.11 (enkephalinase) in the
      catabolism of bradykinin in vascular tissue by determining the effect of
      inhibitors of kininase II (captopril) and of endopeptidase 24.11 (phosphoramidon)
      on the action of bradykinin on rat isolated mesenteric arteries. Because
      bradykinin may induce prostaglandin formation and release, we also studied the
      effect of a cyclooxygenase inhibitor, indomethacin, on the action of bradykinin.
      The mesenteric bed was isolated from rats (250-300 g) with rats under either
      anesthesia and was perfused with Krebs' solution (4 ml/min) containing
      phenylephrine (0.5-1.0 microgram/ml) to produce a mean perfusion pressure of 120
      130 mm Hg. Bradykinin (2.5-40.0 ng), injected as a bolus, produced a dose
      dependent decrease in perfusion pressure. In the presence of indomethacin (1.0
      microgram/ml), the amplitude of the vasodilator responses to bradykinin was not
      significantly affected, although the duration of the responses was increased
      approximately two to four times. In the presence of captopril (1.0 microgram/ml),
      bradykinin elicited either a vasodilator or a biphasic effect. The vasodilator
      effect was greatly potentiated by captopril, whereas the duration of the response
      was unchanged when compared with control experiments. When present, the pressor
      responses were also dose related. In the presence of indomethacin plus captopril,
      bradykinin produced only a fall in perfusion pressure that lasted five to six
      times longer than without any treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735588
TI  - Inhibition of nitric oxide, bradykinin, and prostaglandins in normal rats.
AB  - We assessed the vasodilator effect of endothelium-derived nitric oxide by
      inhibiting its formation with NG-monomethyl L-arginine (LNMMA) on systemic and
      regional hemodynamics in conscious, normotensive rats, using the radioactive
      microsphere technique. In rats injected with 10 mg/kg LNMMA (n = 8), mean blood
      pressure increased by 16.2 +/- 2.6 mm Hg, and heart rate decreased by 54.3 +/-
      16.7 beats per minute. In comparison with rats injected with 5% dextrose (n =
      14), cardiac index was lower by 35.6% (p less than 0.01), and total peripheral
      vascular resistance was higher by 51.6% (p less than 0.01); regional blood flows
      were lower and vascular resistance higher in most organs. Changes were
      significant in the heart, kidney, stomach, large intestine, skin, and adrenals (p
      less than 0.05). Preinjection of 100 mg/kg L-arginine prevented the pressor
      response but only partially attenuated the other hemodynamic effects of LNMMA.
      Combination of LNMMA with the bradykinin antagonist (D-Arg-Arg-Pro-Hyp-Gly-Thi
      Ser-D-Phe-Thi-Arg)trifluoroacetic acid (50 micrograms/min for 5 minutes) did not
      produce systemic or regional effects different from those obtained with LNMMA
      alone. Combination of LNMMA with indomethacin (10 mg/kg) resulted in additional
      changes in the cerebral circulation, blood flow decreasing by an additional 44.2%
      (p less than 0.01) and vascular resistance increasing by 75.3% (p less than 0.01)
      compared with changes produced by LNMMA alone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735589
TI  - Hypokalemia, glucose intolerance, and hyperinsulinemia during diuretic therapy.
AB  - Hypokalemia and glucose intolerance may result from diuretic therapy. Increases
      in plasma insulin and glucose levels have been observed in thiazide-treated
      hypertensive patients and have been attributed to a diminished insulin
      sensitivity induced by diuretic therapy. To investigate the effects of
      hypokalemia on glucose tolerance and insulin secretion, we studied 21 essential
      and nine diabetic hypertensive patients after 4 weeks of placebo and after 4
      weeks of chlorthalidone therapy (25 mg/day). Plasma glucose and insulin levels
      were measured for a 3-hour period after a 75-g glucose oral dose. Hypokalemia
      developed in seven of the essential hypertensive patients (HK group), whereas
      only one diabetic patient had decreased plasma potassium levels to below 3.5
      meq/l. The results obtained in the HK group after chlorthalidone showed that
      plasma glucose and insulin values increased after the oral glucose load to levels
      significantly higher than those observed after placebo. In contrast, the patient
      who remained normokalemic after chlorthalidone did not show any change in plasma
      insulin and glucose levels during glucose tolerance testing. These results show
      that diuretic therapy may induce hyperglycemia and hyperinsulinemia and suggest
      that potassium depletion is involved in the increase in insulin resistance that
      has been demonstrated during thiazide therapy.

PMID- 1735590
TI  - Submandibular enzymatic vasoconstrictor messenger RNA in rat kidney.
AB  - Recently, we reported the isolation and identification of a potent
      vasoconstrictor enzyme from the rat submandibular gland, a member of the rat
      kallikrein gene family, which we named submandibular enzymatic vasoconstrictor
      (SEV). We studied whether messenger RNA (mRNA) for SEV is present in the kidney
      and isolated glomeruli, using the polymerase chain reaction assay with primers
      specific to the entire rat kallikrein family that would amplify a 430-bp fragment
      from their mRNA. As a probe we used a phosphorus-32-labeled oligonucleotide
      specific for SEV mRNA. A fragment of the predicted size was obtained on Southern
      blot for amplified renal RNA; however, no signal was obtained with glomerular
      RNA. To further confirm the presence of SEV mRNA in the kidney, polymerase chain
      reaction was repeated using primers specific to SEV mRNA that would amplify a 372
      bp fragment from SEV mRNA alone. Again, a fragment of the predicted size was
      obtained on Southern blot after amplification of renal RNA but not RNA from the
      glomeruli. Southern blot of polymerase chain reaction-amplified RNA with primers
      that amplified the entire kallikrein gene family, using kallikrein complementary
      DNA that recognizes all members of the kallikrein gene family as a probe,
      revealed a 430-bp fragment for both renal and glomerular RNA, indicating that
      glomeruli contain mRNA for a member or members of the kallikrein family other
      than SEV. When the Southern blots were hybridized with a 32P-labeled
      oligonucleotide probe specific for glandular kallikrein, a fragment of the
      predicted size was obtained from amplified renal RNA but not glomerular
      RNA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735591
TI  - Bayesian analysis supports use of ambulatory blood pressure monitors for
      screening.
AB  - To assess whether there is a role for ambulatory blood pressure monitoring (ABPM)
      in screening for hypertension, we conducted Bayesian analysis of office blood
      pressure (OBP) as a diagnostic "test" in populations with different prior
      probabilities (PP) of hypertension. OBP was considered a positive test if
      systolic blood pressure was greater than 140 mm Hg or diastolic pressure was
      greater than 90 mm Hg. Chosen daytime ABPM cutoffs for a "gold standard"
      diagnosis of hypertension were systolic pressure of 139 and diastolic pressure of
      88 mm Hg. Sensitivity and specificity of OBP were determined in 72 patients with
      established hypertension (PP = 1). After 3 weeks off therapy, OBP was 168 +/-
      3/101 +/- 1 and ABPM was 151 +/- 2/94 +/- 1 mm Hg. Systolic ABPM was in the
      normotensive range in 17 patients and diastolic in 15 patients. OBP was falsely
      positive in 14 and 15 of these patients, respectively. Thus, sensitivity and
      specificity of OBP were 0.8909 and 0.1765 (systolic) and 0.9825 and 0
      (diastolic). These data cannot be extrapolated to populations with lower PPs for
      use of Bayes' theorem. Hence, we calculated sensitivity and specificity for PP =
      0 from published series of ABPM in normotensive subjects and used our
      measurements and these calculations in arithmetic interpolations for populations
      with PP 0.1-0.9. Sigmoid relations between PP and predictability of hypertension
      by a positive OBP were disclosed by use of Bayes' theorem. Their best-fit cubic
      polynomials predict that an elevated OBP will misdiagnose hypertension 46-50% of
      the time in a general population (PP = 0.2) but only 8-9% in a specialty practice
      (PP = 0.9).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735592
TI  - Blood pressure control in children of Cordoba, Argentina.
AB  - The aims of the present study were 1) to evaluate blood pressure (BP) and its
      distribution curve in a highly representative population of children and
      adolescents from Cordoba, Argentina, to determine the normal BP pattern, and 2)
      to establish the relation between other factors and BP levels. BP data recorded
      during the years 1984-1987 were evaluated in 280,584 children and adolescents
      aged 5-15 years (52.1% boys and 47.9% girls) corresponding to the nine sanitary
      districts of the province (urban, rural, mountain, and plains areas), which
      represent 75% of the children of the whole province. Recordings were carried out
      by trained physicians who used pediatric BP cuffs and calibrated
      sphygmomanometers. Korotkoff periods 1 and 5 were considered as the systolic and
      diastolic BP, respectively. BP was recorded in groups of three to five students
      with students in a sitting position as part of the routine physical examination
      and after a thorough explanation of the methodology. For statistical analysis,
      the Student's t test and stepwise regression analysis were used. Percentile
      tables and curves were prepared for each age and sex group. Weight and height
      values were added to the information obtained. Diastolic BP was greater in girls
      than in boys between the ages of 11 and 14. Systolic BP was lower and diastolic
      BP was higher in the US Task Force study compared with these findings. Of all the
      independent variables evaluated, weight influenced BP the most. Age had less
      influence on BP when height and weight were normalized by regression
      analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735593
TI  - Severe hypertension induces disturbances of renal autoregulation.
AB  - To study if the severity of hypertension could be associated with disturbances of
      the autoregulation of renal blood flow and glomerular filtration, we compared the
      renal hemodynamic and functional responses to acute blood pressure reductions of
      a group of patients with moderate essential hypertension (n = 10) with those of a
      group of patients with severe hypertension (n = 10). Blood pressure was reduced
      to normal levels by a stepwise infusion of sodium nitroprusside, and effective
      renal blood flow (by 131I-hippuran), glomerular filtration rate (by endogenous
      creatinine clearance), and filtration fraction were determined. After acute blood
      pressure normalization, effective renal blood flow and glomerular filtration rate
      were significantly reduced in patients with severe hypertension (-41.6 +/- 8.3%
      and -44.7 +/- 6.8%, respectively; p less than 0.01 for both) but not in those
      with moderate hypertension (+4.9 +/- 9.1% and +6.2 +/- 13.3%, respectively; NS).
      Filtration fraction remained unchanged in both groups. These results show that
      severe but not moderate essential hypertensive patients have a displacement to
      the right of the lower limit of the renal autoregulation curve due to impaired
      vasodilation to maintain adequate renal blood flow during acute reductions of
      blood pressure. This impairment may be due to anatomic or functional defects of
      preglomerular vessels, or to both. Furthermore, the inability to maintain
      adequate glomerular filtration in these circumstances shows that patients with
      severe hypertension also have an impaired ability to adjust postglomerular
      vasomotor tone in the face of reductions in glomerular blood flow.

PMID- 1735594
TI  - Renin distribution in the rabbit renal microvasculature.
AB  - Immunocytochemical studies have shown that renin, which is normally located in
      the juxtaglomerular afferent arteriole, may also be found farther upstream toward
      the interlobular artery during chronic stimulation of the renin-angiotensin
      system. We assessed the renin distribution along the renal microvasculature using
      both quantitative analysis and immunocytochemistry in rabbits that received a
      normal sodium diet (0.48% NaCl), a low sodium diet (0.04% NaCl), or enalapril (1
      mg/kg/day) for 4 weeks. From the outer cortex we microdissected 1) the proximal
      portion of the afferent arteriole (p-AF) extending from the interlobular artery
      to a point 50 microns from the glomerulus, 2) the distal 50 microns including its
      intact terminus (d-AF), and 3) the glomerulus without the vascular pole (GL) and
      measured their renin content. In controls, renin was 0.3 +/- 0.2, 27.0 +/- 5.2,
      and 2.8 +/- 0.5 ng angiotensin I/hr/arteriole (or GL) in the p-AF, d-AF, and GL,
      respectively. The low sodium diet and enalapril increased renin in the d-AF (53.1
      +/- 6.9 and 68.4 +/- 8.1, respectively) but not in the GL (3.3 +/- 1.0 and 3.6 +/
      0.7). In the p-AF, both caused a small increase (delta = 1.5); however, this
      increase was minuscule compared with the large increase in the d-AF (delta =
      41).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735595
TI  - Stimulation of endothelial cell prostaglandin production by angiotensin peptides.
      Characterization of receptors.
AB  - Angiotensin II stimulates prostaglandin release in blood vessels via activation
      of angiotensin receptors present in endothelium, vascular smooth muscle cells, or
      both. We evaluated the response of angiotensin II, angiotensin I, and [des-Phe8]
      angiotensin II [angiotensin-(1-7)] on prostaglandin release in porcine aortic
      endothelial cells. Incubation of cell monolayers with angiotensin I and
      angiotensin-(1-7), but not angiotensin II, stimulated the release of
      prostaglandin E2 and prostaglandin I2 in a dose-dependent manner (10(-10) to 10(
      6) M) with an EC50 of approximately 1 nM. In addition, we characterized the
      angiotensin receptor subtypes mediating prostaglandin synthesis by using subtype
      selective antagonists. Angiotensin I-stimulated prostaglandin synthesis was not
      altered by either of the nonselective classical angiotensin receptor antagonists
      [Sar1,Thr8]angiotensin II or [Sar1,Ile8]angiotensin II. In contrast, either the
      angiotensin subtype 1 (AT1) antagonist DuP 753 or the subtype 2 (AT2) antagonist
      CGP42112A significantly attenuated the prostaglandin release in response to
      angiotensin I. However, PD123177, another AT2 antagonist, did not inhibit
      angiotensin I-stimulated prostaglandin release. Angiotensin-(1-7)-induced
      prostaglandin release was significantly attenuated by [Sar1,Thr8]angiotensin II
      (10(-6) M) and PD123177 (10(-6) M) but not by [Sar1,Ile8]angiotensin II, DuP 753,
      or CGP42112A. Higher doses (10(-5) M) of DuP 753 and CGP42112A attenuated the
      angiotensin-(1-7) response. These data suggest that in porcine aortic endothelial
      cells, angiotensin I and angiotensin-(1-7) but not angiotensin II are potent
      stimuli for prostaglandin synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735596
TI  - Possible role of the vascular renin-angiotensin system in hypertension and
      vascular hypertrophy.
AB  - To investigate the vascular renin-angiotensin system in two-kidney, one clip
      (2K1C) hypertension, we measured angiotensinogen messenger RNA (mRNA) in the
      aorta and aortic and plasma angiotensin II (Ang II) concentration in 2K1C rats
      during early (4 weeks) and chronic (16 weeks) phases. Four weeks after clipping,
      there was no significant change in aortic angiotensinogen mRNA in both groups.
      However, the levels of plasma and aortic Ang II in 2K1C rats were significantly
      elevated compared with levels in control rats (p less than 0.05). Sixteen weeks
      after clipping, aortic angiotensinogen mRNA in 2K1C rats did not differ compared
      with the level in control rats. The aortic Ang II level in 2K1C rats was
      significantly increased compared with that in control rats (p less than 0.05),
      whereas there was no significant difference in the plasma Ang II level between
      the groups during this chronic phase. During both phases, morphological studies
      in 2K1C rats showed arteriosclerotic changes, with a significant increase in the
      wall-to-lumen ratio (p less than 0.01). The present study is the first to
      demonstrate an increase in vascular Ang II levels and concomitant morphological
      arteriosclerotic changes during both the early and chronic phases in 2K1C rats.
      Together with the results of our previous study that demonstrated an elevation of
      vascular renin activity during the early phase and increased vascular angiotensin
      converting enzyme activity during the chronic phase, we conclude that the
      elevated vascular renin activity and vascular angiotensin converting enzyme
      activity during each phase may play a dominant role in the increase in vascular
      Ang II observed during both phases.

PMID- 1735597
TI  - Nonprostanoid endothelium-derived factors inhibit renin release.
AB  - Although endothelium-derived prostaglandin I2 stimulates renin release, exogenous
      endothelium-derived relaxing factor (EDRF) can inhibit it. To characterize the
      role of EDRF as an endogenous regulator of renin release, we inhibited or
      stimulated its production in rat renal cortical slices in vitro. Renin
      concentration in the incubation medium was determined by radioimmunoassay for
      angiotensin I (Ang I) generation. NG-Monomethyl-L-arginine (LNMMA) (10(-4) M),
      which blocks EDRF formation, significantly enhanced basal renin release from
      kidney slices by more than 50% in control medium (40.0 +/- 14.3 ng Ang I/hr/mg/30
      min; p less than 0.01) or in medium treated with 1.6 x 10(-5) M meclofenamate
      (50.8 +/- 8.4 ng Ang I; p less than 0.025). Isoproterenol (10(-5) M)-stimulated
      renin release (40.0 +/- 14.3 ng Ang I; p less than 0.02) was not modified by
      LNMMA; addition of L-arginine (10(-5) M), the precursor of EDRF, did not change
      basal but blocked isoproterenol stimulation of renin. Nitroprusside (10(-5) M)
      completely reversed melittin-stimulated renin release. Endothelin-1, an
      endothelium-derived vasoconstrictor, inhibits renin release and stimulates EDRF
      and prostaglandin synthesis. To determine whether any of the renin-inhibiting
      effect of endothelin-1 was due to its stimulation of EDRF, we compared the effect
      of endothelin-1 on cortical slices with and without EDRF inhibition. Endothelin-1
      (10(-7) M) decreased renin by 36.7 +/- 10.9 ng Ang I (p less than 0.01) compared
      with controls, and the response was the same after either LNMMA or hemoglobin
      treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735598
TI  - Renin-angiotensin-aldosterone system in normal and hypertensive pregnancy.
      Response to postural stimuli.
AB  - Most studies that have attempted to distinguish pregnancy-induced hypertension
      from chronic hypertension in pregnancy include arbitrary clinical definitions and
      morphological reports based on renal biopsy. To evaluate whether these conditions
      have different responses to stimuli to the renin-angiotensin-aldosterone system,
      we studied four normal nonpregnant women, eight normal pregnant women, 10 women
      with pregnancy-induced hypertension, and 14 with chronic hypertension in
      pregnancy, in the third trimester of pregnancy, after they had sequentially
      adopted the supine, the left lateral recumbent, and the orthostatic positions for
      90 minutes each. Postural maneuvers did not significantly change mean arterial
      pressure in pregnancy-induced hypertensive or in normal pregnant women, although
      in chronic hypertensive women, a significant reduction in this parameter was
      observed in left lateral recumbency. The renin-angiotensin-aldosterone system was
      significantly less activated with women in the supine position in pregnancy
      induced hypertensive and chronic hypertensive women; however, as opposed to
      pregnancy-induced hypertensive women, those with chronic hypertension reassumed
      their humoral response to upright posture, which was accompanied by a significant
      reduction in sodium excretion. The parallelism between plasma renin activity and
      aldosterone levels, absent in normal pregnancy, returned in pregnancy-induced
      hypertensive and chronic hypertensive women in the erect posture (r = 0.73, p
      less than 0.01; r = 0.68, p less than 0.01, respectively). These data suggest
      that the adoption of the left lateral recumbent position in pregnancy reduces
      mean arterial pressure only in chronic hypertensive women. Moreover, in chronic
      hypertension, the upright position provoked a significant response of the renin
      angiotensin-aldosterone system. This effect was not observed in women with
      pregnancy-induced hypertension.

PMID- 1735599
TI  - Potent constrictor actions of endothelin-1, endothelin-2, and endothelin-3 in rat
      isolated portal vein.
AB  - In rings of rat portal vein, endothelin-1, endothelin-2, and endothelin-3 caused
      graded slow contractions and potentiated spontaneous contractions. The apparent
      EC50 values and maximal responses to 30 nM endothelin were 1.4 nM and 0.96 g for
      endothelin-1, 5.2 nM and 0.65 g for endothelin-2, and 1.7 nM and 0.62 g for
      endothelin-3 (n = 4-12). At concentrations producing half the contraction
      triggered by 80 mM KCl, the order of potencies was endothelin-1 greater than
      U46619 = angiotensin II greater than bradykinin greater than substance P greater
      than phenylephrine. Longitudinal portal-mesenteric vein preparations developed
      very modest contractions to endothelin-1 (0.13 g at 30 nM; n = 5), but their
      responses to 80 mM KCl and phenylephrine were greater than those of rings.
      Responses of rings to endothelin-1 were profoundly reduced in Ca(2+)-free medium,
      but less inhibition was obtained after incubation with nicardipine (up to 1
      microM) and/or nickel (up to 0.5 mM), phorbol (up to 0.3 microM), staurosporine
      (up to 10 nM), or cromakalim (3 microM). Indomethacin (5.6 microM) did not affect
      responses to endothelin-1. Cromakalim (0.1-3 microM) also relaxed rings
      constricted with 0.3 nM endothelin-1, and this effect was partially reversed by
      glibenclamide (3 microM). Thus, endothelins, especially endothelin-1, are potent
      constrictors of portal vein rings but not of portal-mesenteric vein strips. Their
      action appears to rely largely on Ca2+ influx from the external medium (only in
      part via L- and T-type Ca2+ channels) and activation of protein kinase C but not
      on eicosanoid generation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735600
TI  - Effects of 1 M NaCl cerebroventricular injection on renal and baroreceptor reflex
      functions.
AB  - Our purpose was to study the influence of the stimulation of the
      cerebroventricular system on some mechanisms related to hydrosaline equilibrium
      and blood pressure regulation. Renal function and blood pressure (group 1) as
      well as the baroreceptor reflex (group 2) were studied. In group 1, we measured
      diuresis, natriuresis, creatinine clearance, lithium clearance, and blood
      pressure in control rats and after stimulation of the cerebroventricular system
      with 1 M NaCl solution. In group 2, we evaluated the baroreceptor reflex,
      producing an increase of blood pressure with an injection of phenylephrine to
      obtain baroreceptor reflex curves--characterized by threshold, point of
      inflection, heart period range, gain, and systolic pressure corresponding to half
      the heart period range (SBP50)--in control and experimental rats injected with
      saline and 1 M NaCl solution, respectively. In group 1 experimental rats, we
      observed a significant increase in diuresis, natriuresis, blood pressure, and
      glomerular filtration rate. A substantial increase was also registered in sodium
      filtered load and reabsorbed sodium in the proximal convoluted tubule and distal
      nephron. No differences were observed either in fractional proximal tubule or in
      distal nephron sodium reabsorption. In group 2 experimental rats, mean arterial
      blood pressure, threshold, point of inflection, and SBP50 were significantly
      higher than in control rats. By contrast, a decrease in gain and heart period
      range was observed. No difference was obtained in heart rate. Our results
      demonstrate that the increase of the natriuresis is due, at least in part, to an
      increase in sodium filtered load.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735601
TI  - Sister chromatid exchanges and chromosome aberrations in lymphocytes of nurses
      handling antineoplastic drugs.
AB  - Chromosomal aberrations (CA) and sister-chromatid exchanges (SCE) were
      investigated in peripheral lymphocytes of 15 nurses and nurse's aides handling
      cytostatic agents in hospital oncology units. Significantly increased frequencies
      were noted for both CA and SCE rates when the exposed individuals were compared
      with 15 nurses working in other hospital units and to a control sample matched by
      sex and age. This points to the need for emphasizing protective measures in the
      handling of anti-neoplastic agents.

PMID- 1735602
TI  - Plasminogen activator system in human breast cancer.
AB  - We measured antigen levels of 2 kinds of plasminogen activator, tissue-type
      plasminogen activator (t-PA) and urokinase-type plasminogen activator (UK), as
      well as those of their primary inhibitors, type-I plasminogen activator inhibitor
      (PAI-1) and type-2 plasminogen activator inhibitor (PAI-2), in tissue extracts
      from benign and malignant breast tumors. Tumor tissue samples from 40
      fibroadenomas and 40 breast cancers were examined. t-PA antigen levels were the
      same in the 2 groups. Malignant tumors contained higher levels of UK antigen than
      did benign tumors. In the case of breast cancer, UK antigen levels of tumors with
      axillary lymph-node involvement were significantly higher than those of tumors
      without lymph-node involvement. PAI-1 and PAI-2 antigen levels of breast-cancer
      tissue samples were higher than those of fibroadenoma samples. PAI-1 antigen
      levels of carcinomas with lymph-node involvement were also significantly higher
      than those of carcinomas without node involvement. PAI-2 antigen levels, on the
      contrary, were higher in carcinomas without node involvement. UK, PAI-1 and PAI-2
      antigen levels are potentially excellent independent factors for prediction of
      the metastatic potential of breast cancers.

PMID- 1735603
TI  - Association between childhood rhabdomyosarcoma and maternal history of
      stillbirths.
AB  - A case/control study of childhood rhabdomyosarcoma (RMS) was conducted utilizing
      information from birth records. Cases among Connecticut residents age 19 and
      younger diagnosed between 1960 and 1988 were identified from the Connecticut
      Tumor Registry files. Connecticut birth certificates were located for 103 of the
      130 cases identified. A random sample of control birth certificates was frequency
      matched to the cases by year of birth, sex, and ethnic origin, with a
      control:case ratio of 2:1. Information abstracted from birth certificates
      included birth weight, length of pregnancy, plurality, birth order, mother's
      prior stillbirths, mother's age, father's age, and father's occupation. Data were
      analyzed by conditional logistic regression. The major finding was an association
      between RMS and the mother having had one prior stillbirth or more (odds ratio =
      3.7; 95% confidence interval = 1.5 to 8.9). Particularly noteworthy was the
      observation that 6 mothers of cases, but no mothers of controls, had had 2 or
      more prior stillbirths. The trend for increasing risk of RMS with increasing
      number of mother's prior stillbirths was highly significant (p = 0.0004). This
      association suggests that RMS and a class of stillbirths share a common etiologic
      factor. This factor may be genetic or may involve in utero exposure to an
      exogenous or endogenous agent.

PMID- 1735604
TI  - Smoking and colorectal cancer risk: data from the Melbourne Colorectal Cancer
      Study and brief review of literature.
AB  - Lifetime smoking data were obtained from 715 colorectal cancer cases and 727
      age/sex matched community controls as one part of a large, comprehensive,
      population-based study of colorectal cancer aetiology and survival in Melbourne,
      Australia, The Melbourne Colorectal Cancer Study. Statistically significant
      associations were found for those males smoking handrolled cigarettes and for
      cigar-/pipe-smoking males with colon cancer. Review of 18 previous case control
      studies of colorectal cancer showed an elevated risk for cigar-smoking black
      males in one study, a statistically non-significant increased risk for current
      smokers in one of 3 cohort studies and a statistically significant elevation of
      risk for smokers in 2 of 3 studies of adenomatous large-bowel polyps. Although at
      present there is insufficient evidence to link smoking with large-bowel cancer,
      the possibility that ingested tobacco is in some way carcinogenic for the
      colorectal mucosa may be worth further study.

PMID- 1735605
TI  - Isolation and characterization of a monoclonal antibody, K1, reactive with
      ovarian cancers and normal mesothelium.
AB  - We have isolated a new monoclonal antibody (MAb), K1, that reacts with an epitope
      on the surface of human ovarian carcinoma cells. This antibody was generated by
      immunization of mice with periodate-treated human ovarian carcinoma (OVCAR-3)
      cells. These mice had been previously made tolerant with normal human kidney
      membranes. Spleen lymphocytes from these mice were selected prior to fusion using
      a panning purification method on living OVCAR-3 cells. Initial screening of
      surface-reactive clones was performed in a single day using immunofluorescence on
      living OVCAR-3 cells, and secondary screening was performed using
      immunoperoxidase histochemistry on cryostat sections of normal human tissues and
      human tumors. The K1 clone was subcloned and identified as an IgM isotype, but
      was subsequently isotype-switched to IgG1K using a panning selection method. When
      evaluated by immunohistochemistry, the antigen reactive with K1 was found in many
      ovarian non-mucinous tumors, as well as in squamous tumors of the esophagus, and
      cervical cancer. The only normal adult human tissues showing uniform reactivity
      with K1 were the mesothelia of the peritoneal, pleural and pericardial cavities.
      There was also limited reactivity with epithelia of the trachea, tonsil and
      Fallopian tube. A similar tissue reactivity for K1 was found in tissues from
      cynomolgus monkeys. K1 reacted with many of the same tissues and tumors as the
      previously identified antibody OC125, but several lines of evidence indicate that
      K1 reacts with a different epitope and probably a different molecule, when
      compared to OC125. This evidence included assays employing immunofluorescence
      competition, double-label immunofluorescence, and solid-phase and live-cell
      radioimmunoassays. Since our data indicate that the antigen reactive with the K1
      antibody is a new molecular species, we have named the antigen CAK1. Unlike the
      shed antigen CA125, CAK1 was only cell-associated and was not found in the
      supernatant of cultured OVCAR-3 cells or in the blood of ovarian cancer patients.
      The K1 antibody may be useful as a targeting agent for therapy and in the
      diagnosis of ovarian carcinoma, as well as some other human cancers.

PMID- 1735606
TI  - Infrequent mutation of the ras genes in skin tumors of xeroderma pigmentosum
      patients in Japan.
AB  - By using PCR amplification and oligonucleotide mismatch hybridization, base
      substitution mutations of the ras genes in 26 skin tumors of Japanese xeroderma
      pigmentosum (XP) patients were studied. Thin sections of tumor tissues which were
      fixed and embedded in paraffin blocks were used in this study. After analyzing
      codons 12, 13 and 61 of the H-, K- and N-ras genes by using 66 oligomer probes,
      we detected only one mutation of the K-ras gene at codon 61 in one tumor sample.
      All the other tumors were therefore considered not to have a mutation in the ras
      genes. These results suggest that mutations of the ras genes are not particularly
      associated with skin tumors of Japanese XP patients.

PMID- 1735607
TI  - Immunological analysis of 17 beta-hydroxysteroid dehydrogenase in benign and
      malignant human breast tissue.
AB  - The expression of 17 beta-hydroxysteroid dehydrogenase (17-HSD) enzyme protein
      was studied in benign and malignant human breast tissue using the time-resolved
      immunofluorometric assay (IFMA), immunoblotting and immunohistochemistry. The
      presence and distribution of estrogen and progestin receptors was also analyzed
      immunohistochemically. Cytosolic 17-HSD concentrations in malignant breast
      specimens were highly variable (less than or equal to 0.2-311 ng/mg protein). As
      was previously found for the placental enzyme, the molecular weight of the 17-HSD
      expressed in malignant breast tissue was 35 kDa, estimated following
      polyacrylamide gel electrophoresis and immunoblotting. The cellular distribution
      of 17-HSD was further studied by immunohistochemistry. Immunostaining for 17-HSD
      was observed in 71% of the benign breast lesions (fibroadenomas and cases of
      mastopathia chronica) and in 47% of the cancer specimens (intra-ductal
      carcinomas, invasive ductal carcinomas). In benign lesions, the staining was
      exclusively localized in the cytoplasm of epithelial cells, with no
      immunoreactivity in the stromal cells. The staining in the cancer specimens was
      also detected only in the cytoplasm of malignant epithelial cells. A strong or
      moderate expression of 17-HSD was related to the presence of PR in the specimen
      (chi 2 = 4.657, p = 0.031). However, the expression of PR was not a prerequisite
      for expression of 17-HSD in all the cancer specimens. Our data suggest that, in
      addition to the reported regulation of 17-HSD by progestins, other factors are
      also involved in this process in breast tissue.

PMID- 1735608
TI  - Identification and immunochemical characterization of IgA in sera of patients
      with mammary tumors.
AB  - It has been reported that several types of human cancer are associated with
      elevated levels of class-A immunoglobulins (Ig) and IgA-containing immune
      complexes. Moreover, most previous work has come up against the lack of IgA
      reactivity for chemically defined antigen (Ag). To overcome this, we first
      evaluated possible immunological binding in sera of patients with mammary tumors
      or malignant hematologic diseases and controls on a mouse monoclonal anti
      idiotypic antibody (Ab2), internal image of conjugated benzo(a)pyrene (BP) coated
      on well plates. Using this indirect ELISA, a statistically highly significant
      immunological binding was found in sera of patients with mammary tumors of every
      grade, type and size. This immunological binding was linked to the IgA isotype.
      Second, we performed competition experiments between a BP conjugate coated on
      well-plates and anti-anti-"BP-like" antibodies (Ab) previously incubated with
      rabbit idiotypic antibodies (Ab1) directed against conjugated BP. A part of these
      anti-anti-BP-like Ab, raised in rabbits immunized with human IgA of patients with
      mammary tumors, recognized the Ag-combining site of polyclonal Ab1, previously
      developed in a rabbit immunized with BP conjugates. It appears that part of the
      human Ig from sera of patients with mammary tumors shares common idiotopes with
      rabbit polyclonal Ab1 raised against conjugated BP.

PMID- 1735609
TI  - Fatty-acid composition of breast and iliac adipose tissue in breast-cancer
      patients.
AB  - In order to determine to what extent the fatty-acid composition of breast adipose
      tissue is representative of the body-fat composition in breast carcinoma, we
      compared the fatty-acid composition of breast adipose tissue to that of iliac fat
      in breast-cancer patients. Triglycerides from the 2 sites were purified by thin
      layer chromatography and fatty-acid composition was determined by capillary gas
      chromatography. Compared with iliac fat, mammary fat was higher in saturated
      (33.2 +/- 3.9 vs. 24.4 +/- 1.6%; p = 0.0001) and lower in mono-unsaturated (48.0
      +/- 2.2 vs. 54.8 +/- 2.7%; p = 0.0001) and poly-unsaturated fatty acids (16.6 +/-
      3.7 vs. 18.0 +/- 3.1%; p = 0.0001). A positive correlation was found between the
      2 sites for linoleate (r = 0.95; p = 0.0003), alpha-linolenate (r = 0.83; p =
      0.01), palmitate (r = 0.78; p = 0.02) and palmitoleate (r = 0.76; p = 0.02). No
      relationship was observed for stearic and oleic acids. We conclude that breast
      and iliac fat differ with regard to fatty-acid composition. The interpretation of
      fatty-acid composition of the body stores in breast-cancer patients, as an
      indicator of long-term intake of dietary fat, should take into account the
      sampling site of stored lipids.

PMID- 1735610
TI  - Clinical and biological significance of HSP89 alpha in human breast cancer.
AB  - In order to isolate and characterize genes whose expression may be altered in
      breast malignancy, we screened a cDNA library with a polyclonal anti-serum
      against breast-cancer-metastasis membranes and isolated several immunopositive
      clones. One of these, AJ1, was analyzed in detail and found to be expressed at
      varying levels as a 3.3-kb mRNA in all of 143 breast cancers. High expression was
      associated with lymph-node involvement (p = 0.03). Comparison between high- and
      low-expressing groups showed a significant difference at 4 and 6 years for both
      overall (p = 0.004 and p = 0.002 respectively) and disease-free (p = 0.0001 and p
      = 0.04 respectively) survival, but not at 11 years. AJ1 was expressed at much
      lower levels in non-malignant biopsies as compared with malignant tissue (p =
      0.001). Expression was observed in breast-cancer cell lines MCF-7, ZR-75-1, T47D,
      MDA-MB-231 and HBL 100. Partial sequence analysis of the 620 bp clone showed
      complete homology with human heat-shock protein 89 alpha. In addition to being
      heat-inducible in all the breast cell lines examined, AJ1 levels were increased
      by estradiol (blocked by cyclohexamide and tamoxifen), EGF, oxytocin and
      vasopressin in a time-dependent manner in MCF-7 cells and by estradiol, EGF,
      prolactin and hydrocortisone in T47D cells. In MDA-MB-231 cells, EGF caused down
      regulation of AJ1 mRNA levels. The increasing evidence for the association of
      heat-shock proteins with steroid receptors suggests that AJ1 may play an
      important role in the control of estrogen-receptor transcriptional activity in
      breast cancers.

PMID- 1735611
TI  - Different behaviour of mouse-human chimeric antibody F(ab')2 fragments of IgG1,
      IgG2 and IgG4 sub-class in vivo.
AB  - Mouse-human chimeric monoclonal antibodies (MAbs) of 3 different human IgG sub
      classes directed against carcinoembryonic antigen (CEA) have been produced in SP
      0 cells transfected with genomic chimeric DNA. F(ab')2 fragments were obtained by
      pepsin digestion of the purified chimeric MAbs of human IgG1, IgG2 and IgG4 sub
      class and of parental mouse MAb IgG1. The 4 F(ab')2 fragments exhibit similar
      molecular weight by SDS-PAGE. They were labelled with 125I or 131I and high
      binding (80 to 87%) to purified unsolubilized CEA was observed. In vivo, double
      labelling experiments indicate that the longest biological half-life and the
      highest tumour-localization capacity is obtained with F(ab')2 from chimeric MAb
      of human IgG2 sub-class, whereas F(ab')2 from chimeric MAb IgG4 give very low
      values for these 2 parameters. F(ab')2 from chimeric MAb IgG1 and from parental
      mouse MAb yield intermediate results in vivo. Our findings should help to select
      the appropriate human IgG sub-class to produce chimeric or reshaped MAb F(ab')2
      to be used for tumour detection by immunoscintigraphy and for radioimmunotherapy.

PMID- 1735612
TI  - Regulation of natural antibody binding and susceptibility to natural killer cells
      through Zn(++)-inducible ras oncogene expression.
AB  - Changes in the natural resistance phenotype were examined for the 2H1, 10T 1/2
      cells expressing the activated human H-ras oncogene under the transcriptional
      regulation of the zinc-inducible mouse metallothionein-I promoter. Culture of the
      cells in 50 microM ZnSO4 induced an increase in ras protein p21 levels which were
      maximal within 1 day. Natural-antibody (NAb) binding was significantly increased
      following 2 days of cell culture in ZnSO4 and continued to increase up to 4 days.
      The increased NAb binding returned to uninduced levels within 2 days following
      the removal of added zinc ions from the culture medium. The cells also exhibited
      a significant increase in natural killer (NK) cell sensitivity following 2 days
      in ZnSO4. This was maintained as long as the zinc was in the medium, but returned
      to uninduced levels within 1 day following its removal. The results show that NAb
      binding and susceptibility to NK cells increased following ras oncogene
      expression in 10T 1/2 cells and that both parameters were regulated by p21
      expression. Repeated i.v. administration of whole-serum NAb prior to tumor
      inoculation reduced the number of early tumors following s.c. injection of Zn(++)
      induced 2Hl cells into Zn(++)-treated C3H/HeN mice, consistent with an in vivo
      role for NAb in the defense against ras-transformed cells. In contrast, small but
      statistically significant reductions in NAb binding were observed following v-H
      ras transformation of NIH 3T3 cells or v-src transformation of 10T 1/2. The data
      argue for an NAb- and NK-cell-susceptible phase of ras-induced tumor development
      which is a prerequisite for these mediators to contribute to a first line of
      defense against incipient neoplasia, and suggest that characteristics of the
      recipient cell and the transforming oncogene are important in determining the
      natural resistance phenotype.

PMID- 1735613
TI  - Interleukin-1 produced by tumorigenic fibroblasts influences tumor rejection.
AB  - Oncogene-transformed BALB/c-3T3 fibroblasts which spontaneously or upon immune
      activation with cytokines and lipopolysaccharide (LPS) generate IL-1 alpha, were
      tested for their tumorigenicity as well as their interaction with natural immune
      defense by NK cells and macrophages. Oncogene-transformed fibroblasts were weakly
      tumorigenic, since not all mice developed tumors despite application of high
      doses of tumor cells. This was independent of the immune status of the host.
      However, in the immunocompetent host those transformed fibroblast lines which
      spontaneously produced IL-1 alpha grew only transiently and then regressed. After
      induction of IL-1 alpha production, a decrease in the rate of tumor take was
      noted and the rate of regression of developing tumors was increased. Regression
      of IL-1-producing transformed fibroblasts was strongly reduced but not completely
      abolished in sublethally irradiated mice. This indicated that IL-1 production may
      predominantly influence T-cell-mediated defense, but some influence on non
      adaptive immunity could not be excluded a priori. IL-1 production did not
      influence susceptibility of transformed fibroblasts towards NK cells and
      macrophages. However, IL-1-producing transformed fibroblasts were most potent
      stimulators of NK cells and macrophages, the stimulatory effect being locally
      restricted. In conclusion, IL-1 producing, oncogene-transformed fibroblasts which
      generated the cytokine constitutively or upon immune-activation, were rejected
      from the tumor-bearing host following initial growth. Fibroblast-induced local
      activation of NK cells and macrophages was shown to play some role in tumor graft
      rejection. The influence of IL-1 production of transformed fibroblasts on T-cell
      mediated defense is addressed in the accompanying report.

PMID- 1735614
TI  - Induction of synthesis of manganous superoxide dismutase in L-M(pNTnF) cells
      carrying an inducible TNF gene.
AB  - Based on findings that the cytotoxic effects of tumor necrosis factor (TNF) are
      closely related to levels of intracellular oxygen radicals, and on the results of
      TNF gene transfection studies, the hypothesis was made that endogenous TNF
      (enTNF) acts as a protective factor against exogenous TNF by inducing inhibitors
      or scavengers of oxygen radicals. In order to test this hypothesis, we
      investigated the intracellular levels of manganous superoxide dismutase (MnSOD)
      and glutathione (GSH) in L-M(pNTnF) cells carrying a TNF gene induced by
      dexamethasone (DM). When L-M(pNTnF) cells were treated with DM they expressed
      enTNF, and acquired resistance to exogenous TNF. There was no change in the GSH
      concentration after enTNF induction, but a 1.9- to 3.9-fold increase in MnSOD
      levels was noted. Our findings suggest that enTNF exerts its protective function
      against the cytocidal effect of exogenous TNF by inducing MnSOD production.

PMID- 1735615
TI  - Influence of dose and schedule on the therapeutic efficacy of 131I-labelled
      monoclonal antibody 139H2 in a human ovarian cancer xenograft model.
AB  - The therapeutic efficacy of various doses and schedules of 131I-labelled anti
      episialin monoclonal antibody (MAb) 139H2 was assessed in the NIH:OVCAR-3 human
      ovarian cancer xenograft model. Radioimmunotherapy was started at the time s.c.
      tumors were well established (100 to 300 mm3). The anti-tumor effects induced by
      i.v. injections of 131I-MAb 139H2 were dose- and schedule-dependent. Optimal
      growth inhibition and long-lasting complete tumor regressions were obtained with
      2 injections of 500, 700 or 750 muCi 131I-MAb 139H2 per mouse given with a 2-week
      interval. The percentage of tumors with more than 50% reduction of their initial
      volume after treatment with a total dose of 1,000 muCi 131I-MAb 139H2 per mouse,
      given as 10 injections of 100 muCi (3 x/week), 4 injections of 250 muCi (2
      x/week), 10 injections of 100 muCi (5 x/week) within a period of 3 weeks, or 2
      injections of 500 muCi with a 2-week interval, was 9%, 40%, 64% and 75%
      respectively. Unlabelled MAb 139H2 did not affect tumor growth, while the effects
      of 131I-control MAb were minor and transient. 131I-MAb 139H2 treatment did not
      select for outgrowth of episialin-negative cells in the OVCAR-3 xenografts.
      Highest absorbed doses of whole-body-radiation were calculated for 2 injections
      (500 to 750 muCi 131I-MAb 139H2) given with the 2-week interval. The radiation
      dose to the tumor after a single injection of 500 muCi 131I-MAb 139H2 was 1,300
      cGy over 7 days, which appeared slightly lower than the dose calculated after
      administration of a tracer dose of iodinated MAb 139H2.

PMID- 1735616
TI  - Induction of IL-4 secretion by the radiation leukemia virus (RadLV): role in
      autocrine growth stimulation of RadLV infected pre-leukemic cells.
AB  - Intrathymic inoculation of radiation-leukemia virus (RadLV) into C57BL/6 mice
      induces a population of pre-leukemic (PL) T cells which progress into clonal,
      mature thymic lymphomas after a latency period of 3 to 5 months. In order to
      understand how PL cells are retained in the thymus for a prolonged period of time
      we determined whether RadLV infected cells secrete and/or respond to a T-cell
      growth factor that may be involved in the long-term maintenance of a thymic PL
      cell pool. We have previously found that in vitro proliferation of RadLV-infected
      PL cells is IL-4-dependent. Here we show that RadLV induces IL-4 secretion and IL
      4 receptor (IL-4R) expression in normal thymic lymphocytes. RadLV-infected PL
      thymocytes express IL-4R and secrete IL-4. Their IL-4 secretion could be enhanced
      if incubated in the presence of RadLV and this enhancement was inhibited by anti
      RadLV antibodies. Several RadLV-induced lymphoma lines secreted IL-4 and/or
      expressed IL-4R, but these features were not essential for their continuous
      growth. The results suggest that RadLV induces IL-4-dependent autocrine growth
      which maintains a population of PL T cells in the thymus. Transition from a PL
      state to overt thymic lymphoma involves emancipation of a PL cell from IL-4
      dependency.

PMID- 1735617
TI  - Growth-inhibitory effect of quercetin and presence of type-II estrogen-binding
      sites in human colon-cancer cell lines and primary colorectal tumors.
AB  - We studied the effect of quercetin (Q) on the proliferation of HT-29, WiDr, COLO
      201, and LS-174T human colon cancer cell lines. Q, between 10 nM and 10 microM,
      exerted a dose-dependent, reversible inhibition of cell proliferation. Cell-cycle
      analysis revealed that the growth-inhibitory effect of Q was due to a blocking
      action in the G0/G1 phase. Using a whole-cell assay with 17 beta-[3H]-estradiol
      as tracer, we demonstrated that all these cell lines contain type-II estrogen
      binding sites (type-II EBS). By using Q and other chemically related flavonols
      (3,7-4'-trimethoxyquercetin, 3,7,3',4'-tetramethoxyquercetin, kaempferol, morin,
      and rutin), we observed that the affinities of these compounds for type-II EBS
      are correlated with their growth-inhibitory potential. Furthermore, the Q
      sensitivity of the colon cancer cell lines was correlated with the number of type
      II EBS/cell. Then Q could regulate colon cancer cell growth through a binding
      interaction with type-II EBS. This mechanism could also be active in vivo as we
      have observed that cytosolic type-II EBS are present in primary colorectal
      cancers and that Q is effective in inhibiting the in vitro bromodeoxyuridine
      incorporated by neoplastic cells in these cancers.

PMID- 1735618
TI  - Combination therapy with thymosin alpha 1 potentiates the anti-tumor activity of
      interleukin-2 with cyclophosphamide in the treatment of the Lewis lung carcinoma
      in mice.
AB  - In this study we have investigated the effects of thymosin alpha 1 (T alpha 1)
      and interleukin-2 (IL-2), singly or in combination with cyclophosphamide (CY), on
      tumor growth, survival and cytotoxicity in C57Bl/6NCrlBR mice with Lewis lung
      carcinoma (3LL). Combined administration of T alpha 1 plus IL-2, after CY
      treatment, was much more effective than use of each biological response modifier
      (BRM) alone, and induced complete tumor regression in all of the mice studied.
      Combination immunotherapy alone without CY only slightly reduced the rate of
      tumor growth, and these results are in accordance with previous studied which
      showed that the 3LL carcinoma is resistant to cytokines. Combined chemo
      immunotherapy also increased the cytotoxicity of spleen cells and markedly
      enhanced long-term survival in all treated animals. Depletion of immune cells,
      using either total-body sub-lethal irradiation (400 rads) or antibodies directed
      against T-cell (anti-CD4 and CD8) or NK-cell (anti-asialo GM1) populations,
      abolished the positive response to combination therapy. Histological analysis of
      the tumors obtained from mice treated with combination chemo-immunotherapy
      revealed a high number of infiltrating lymphoid cells surrounding a well
      circumscribed area of necrosis consisting solely of dead cells. Our studies show
      that T alpha 1 potentiates IL-2-induced cytotoxic activities in vitro as well in
      vivo, and that these compounds have a powerful anti-tumor action when associated
      with chemotherapy.

PMID- 1735619
TI  - The persistence of poverty under welfare states and the prospects for its
      abolition.
AB  - This article examines the relationship between poverty and the welfare state and
      attempts to answer the question as to why poverty has persisted under all welfare
      states. Several major reasons for the persistence of poverty are advanced, and
      the author argues that the main factor underlying the failure to abolish poverty
      is the conflict between economic policy and social policy. The challenge to
      welfare states from the New Right is examined--particularly the contention that
      welfare states themselves create poverty and dependence--in the light of evidence
      of the impact of the Thatcher government's policies in Britain. Finally, the
      author proposes an alternative approach to the abolition of poverty, one that is
      based on the integration of economic and social policy.

PMID- 1735620
TI  - The political and moral economy of aging: not such strange bedfellows.
AB  - The authors develop E.P. Thompson's concept of moral economy as a useful
      complement to contemporary political economic analysis in problem areas involving
      moral conflict. Defined as the shared assumptions underlying norms of reciprocity
      in which an economic system is grounded, moral economy is seen as holding
      particular relevance for the study of aging. The evolution of pension systems,
      the "senior revolt" against catastrophic coverage in the United States, and
      debates over the allocation of health resources between generations are used to
      illustrate the utility of a combined political and moral economy for enriching
      our understanding in these areas. Marx's concept of a "morality of emancipation"
      is described as holding particular promise for the development of a new moral
      economy of old age that would move beyond alienation by giving broad attention to
      quality of life issues at each stage of the life course.

PMID- 1735621
TI  - Toward a political and moral economy of aging: an alternative perspective.
AB  - A conceptual framework for empowerment of the elderly is proposed, using
      variations on Gramsci's hegemony and Thompson's moral economy to complement
      recent political economic and social psychological theories. The political
      economy and social psychology of aging highlight structural constraints and
      actors' reactions without articulating a model for empowerment. Gramsci's idea of
      hegemony as new moral and philosophical leadership calls for principles of social
      and economic organization deserving assent because they maximize people's chances
      for a decent life at all ages. Hegemony, as normalizing dominance, reveals ways
      in which the elderly may be disempowered as well as possibilities for
      intervention. Underlying diverse forms of hegemony are economic arrangements and
      an array of cultural norms. In contrast to Thompson, the authors argue that norms
      implicit in moral economy vary with changes in social context. In the process,
      two ideal types of moral economy are elaborated, grounded in exchange value and
      use value, respectively. Empowerment may be found through a moral economy
      grounded in use value appropriate to advanced industrial society that is
      consonant with Gramsci's new hegemony. Implications for health and income
      maintenance policies are explored.

PMID- 1735622
TI  - Kerala State, India: radical reform as development.
AB  - Kerala State in southwestern India has achieved some of the third world's best
      rates of life expectancy, literacy, and infant mortality, despite one of the
      lowest per capita incomes. Especially notable is the nearly equal distribution of
      development benefits to urban, rural, male, female, high-caste, and low-caste
      sections of the populations. An even population distribution, a cosmopolitan
      trading history, and the development of militant worker and small farmer
      organizations led by dedicated activists provide the main explanations for
      Kerala's achievements. Land reform has redistributed wealth and political power
      from a rich elite to small holders and landless laborers. Public food
      distribution at controlled prices, large-scale public health actions, accessible
      medical facilities, and widespread literacy combine with and reinforce each other
      to maintain and expand Kerala's achievements. Serious unemployment threatens the
      Kerala experiment, but Kerala nonetheless offers important lessons to development
      planners, policymakers, and third world activists.

PMID- 1735623
TI  - Infant mortality and crisis in Mexico.
AB  - Data derived from the Encuesta Nacional de Fecundidad y Salud (ENFES) confirm
      that overall levels of infant mortality in Mexico have been steadily declining.
      However, a more specific analysis furnishes evidence that this decline has
      occurred at varying rates within different social groups, reflecting an increase
      in social inequalities. The analytical strategy used in this article leads to
      three basic conclusions: (1) the impact of the economic crisis on infant
      mortality is reflected not in a reversal of the declining trend but an increase
      in social inequalities; (2) certain variables universally accepted as
      determinants of infant mortality, such as mother's education, seem nonsignificant
      for some social sectors; and (3) certain biodemographic characteristics assumed
      to have a uniform mortality-related behavior vary among sectors, suggesting that
      even these constants are determined by social factors.

PMID- 1735624
TI  - Report of the commission on health research for development and the countries of
      the south.
AB  - Of late, governments of affluent countries have become more brazen in using
      United Nations organizations and other global commissions as tools to serve their
      political and economic interests. WHO and UNICEF have been used by these
      governments to impose technocentric and dependence-promoting programs on
      countries of the South. The report of the Commission on Health Research for
      Development is yet another effort in that direction. It advocates international
      cooperation in health research. It merely adds to the bulk of documents on
      international health research. It is ahistorical. It does not analyze why WHO and
      UNICEF and the governments of affluent countries imposed global programs on
      immunization and diarrheal and respiratory diseases without bothering to gather
      even the most elementary data about them. There is a method in the brashness.
      Worse still, it ignores the rich heritage of health research of the past half a
      century in countries such as India, Indonesia, and Thailand. It is yet another
      effort to obscure the message of self-reliance contained in the Alma-Ata
      Declaration on Primary Health Care.

PMID- 1735625
TI  - Malaria eradication and the selective approach to health care: some lessons from
      Ethiopia.
AB  - Analysis of the failure of the World Health Organization's global malaria
      campaign has contributed to the formulation of the primary health care concept as
      the basic international strategy for health improvement. The Primary Health Care
      Conference held in Alma-Ata in 1978 was to have ended the period of vertical
      disease control programs, such as the one against malaria, stressing instead the
      integration of these programs into horizontal community-based health systems.
      Malaria control programs, however, have not been integrated well--or in some
      cases at all--into primary health care networks. An analysis of the Ethiopian
      experience, as part of the worldwide malaria eradication program, illustrates the
      political and economic forces that have worked against the move from vertical to
      integrated malaria control activities, and from vertical to integrated health
      programs more generally.

PMID- 1735626
TI  - Struggle and revolt in the Spanish health policy process: the changing role of
      the medical profession.
AB  - Many changes have taken place in the professional status and political role of
      the Spanish medical profession during the process of construction of the health
      care system (1940-1990). There is a strong correlation between the different
      characteristics of the several phases of construction of the national health care
      system and some of the changes in the status, organization, and political
      activity of the medical profession. The democratic transition coincided with
      changes in the orientation of the system brought about by financial imperatives,
      which forced readjustments in the survival and political projects of the
      profession. The creation of a democratic regime has allowed the medical
      profession to create its own independent mechanisms of interest representation
      and has given rise to a process of negotiation of the new political relations
      (and their mechanisms) between the State and the profession. The last 15 years
      have witnessed important transformations in some parameters of the profession, in
      its political organization, its political role, and its relation with the State.

PMID- 1735627
TI  - The welfare state, class, and gender.
AB  - If we compare the welfare state countries with others, from the point of view of
      both health and health services, the crisis concerns primarily the second group
      of countries. Nevertheless, difficulties arise also for welfare state policies.
      The problem is how to respond to neoconservative attacks on social and health
      rights, and how to change the bureaucratic and medicalized bias of the welfare
      state. The "golden era" of social insurance and health services, conceived as
      free access to funds to cope with all the growing needs of the population, is
      over. Limitations, controls, and priorities have to be established. In Italy and
      similar countries, the tendency is toward restricting health care for those who
      have greater needs, cutting funds for prevention, and creating greater
      inequalities. It is clear that the state must intervene to reduce social
      inequalities, but at the same time some existing differences (sexual, cultural,
      ethnic) have an intrinsic value that must be recognized. A policy of free-choice
      welfare is useful, and has nothing to do with the selective measures that are
      being introduced. Moreover, a key point has become the relationship between class
      and gender. The working class continues to be exploited, but new phenomena arise,
      connected with production and social reproduction and not limited to this sphere.
      It is true that gender includes social classes, but no social class may represent
      both sexes, or different ethnic groups, or gender itself.

PMID- 1735628
TI  - The drug lag issue: the debate seen from an international perspective.
AB  - This article reviews the literature related to the "drug lag" issue, i.e., the
      issue of whether important new drugs are introduced relatively late, or, in
      certain cases, are introduced at all, in a particular country. The literature can
      be divided into two main parts: studies primarily related to the delay in
      introduction of new drugs and studies primarily related to the number of
      introduced new drugs. Most studies have found the United States, Sweden, and
      Norway to have a long delay in the introduction of new drugs. The United Kingdom
      and (West) Germany in general have the shortest delay. There are also large
      differences in the number of introduced new drugs. In most studies, the United
      States and Norway have introduced far fewer new drugs than any other
      industrialized country. In general (West) Germany, France, the United Kingdom,
      and Italy have introduced the largest number of new drugs. One of the reviewed
      studies presented a relationship between regulatory processing time and delay in
      introduction. Another study found an increasing influence of regulatory
      stringency on the number of introduced new drugs in a country. If a country's aim
      is to decrease the delay in introduction and/or to increase the introduction of
      important new drugs, a review of the local regulatory agencies and the
      regulations seems worthwhile.

PMID- 1735629
TI  - The other who is also the same: the relevance of epidemics in space and time for
      prevention of HIV infection.
AB  - The history of epidemics reveals the imposition of controls over time and space
      on the sick and powerless other in the interests of the well and powerful same.
      In contrast, effective prevention requires the sharing of values, space, and
      time: coevality in the broadest sense. Adolescents are seen as merely
      transitional: they were children in the recent past, they will be adults in the
      recent future. Thus as an other who must become the same, they are seen as out of
      time and threatening. Conventional adults fear uncontrolled sexuality, especially
      if it is perceived as taking place out of time and is therefore anachronistic or
      in the wrong places, out of bed and through the wrong orifices (anatopistic).
      These unshared cultural perceptions are a barrier against both education for life
      and effective prevention of HIV infection.

PMID- 1735630
TI  - The new corporate health ethic: lifestyle and the social control of work.
AB  - A corporate health ethic, forged in U.S. industry in the 20th century, clearly
      demarcated boundaries between private and workplace health concerns. This article
      advances evidence that the boundary is blurring, and argues that trends in
      workplace initiatives, including employee assistance, wellness programs, and drug
      screening, are giving shape to a new corporate health ethic. The new ethic
      emphasizes workers' lifestyles on and off the job, engendering a shift in
      corporate jurisdiction over employee health and behavior. Economic arguments such
      as "health care cost containment" are commonly offered as explanations for these
      new health initiatives. But the authors see the new ethic as a deeper response to
      a changing corporate environment and, more fundamentally, as emblematic of
      changes in the social control of work and productivity. They argue that the new
      health ethic may be a harbinger of new forms of social control in the workplace.

PMID- 1735631
TI  - IMS, ISBA cooperation yields new laws on advance directives.
AB  - Iowans have greater control over their medical care, thanks to the cooperative
      efforts of the Iowa State Bar Association and the Iowa Medical Society.

PMID- 1735632
TI  - 'Code of civility' for attorneys, physicians.
AB  - Representatives of the ISBA and IMS ar working on a modern version of 1956
      vintage practice principles governing lawyer-physician relationships.

PMID- 1735633
TI  - An interview with the president of the ISBA.

PMID- 1735634
TI  - Clinical use of adenosine.
AB  - Adenosine (Adenocard) is a new injectable antiarrhythmic agent indicated for the
      acute treatment of paroxysmal supraventricular tachycardia (PSVT) including PSVT
      associated with the Wolff-Parkinson-White syndrome. Many physicians are not yet
      familiar with its actions, indications and side effects.

PMID- 1735635
TI  - Patient Self-Determination Act.

PMID- 1735636
TI  - Sexual harassment in the workplace: minimize your liability.

PMID- 1735637
TI  - A physician's day in court: 2 perspectives.

PMID- 1735638
TI  - Instrumentation control and automation in the control of biological effluent
      treatment.
AB  - The role of instrumentation, control, and automation (ICA) in the management,
      operation, and control of domestic and industrial wastewater treatment works is
      examined following an historical account of developments in the UK over the past
      two decades. Included also are aspects of process optimization and process
      selection, taking into account size and types of works and populations served.
      The particular ICA requirements of individual unit processes are examined and the
      effects of unattended operation and remote supervision are considered. Particular
      attention is paid to measurement technology, the shortcomings of available
      instruments and systems, and recent developments of relevance, with particular
      emphasis being placed on microelectronic and fibre- and electro-optic-based
      sensors and on the role of advanced commenting methods including expert systems.
      Progress with biologically based sensors is also discussed.

PMID- 1735639
TI  - Generalized multiple-regression techniques with interaction and nonlinearity for
      system identification in biological treatment processes.
AB  - A class of multiple regression models, called "generalized multiple-regression"
      (GMR) is proposed. GMR has the advantages of being easy and rapid to fit, and
      uses standard multilinear regression software. It has an advantage over ARIMA
      models in modeling nonlinearity and linear and nonlinear interactions among
      variables. Its main disadvantage is that, if there are many independent
      variables, the reduction of degrees of freedom may be important. It is less
      parsimonious than other models, but availability of increased computational power
      makes this not a serious disadvantage. The GMR models are compared to
      autoregressive transfer function models and feedforward back propagation neural
      network models. In the case of modeling effluent volatile suspended solids, GMR
      models were superior to both linear autoregressive models and neural network
      models. The neural network models did, however, outperform the linear models. In
      the case of modeling sludge volume index, both GMR and the neural network model
      were unable to improve upon ARIMA models. It was concluded that ARIMA models may,
      in some cases, produce the most parsimonious model, but in other cases they may
      miss important process behaviors. The GMR models showed robust capability to
      describe complex data.

PMID- 1735640
TI  - Neutron response of a polyethylene-moderated superheated drop detector.
AB  - Monte Carlo neutron transport calculations were performed to obtain the neutron
      response functions of a superheated drop detector (SDD-100) that is surrounded by
      polyethylene of various thicknesses. The calculational results suggest that a SDD
      100 surrounded by 2.54 cm of polyethylene gives the best dose-equivalent response
      in a free neutron field. Results were confirmed by a sequence of experiments
      using various neutron sources. This polyethylene-moderated SDD-100 is ideal for
      use as an area neutron dose monitor.

PMID- 1735641
TI  - Detection and determination limits for thermoluminescence dosimetry.
AB  - The statistical theory of detection and determination limits is applied to
      thermoluminescence dosimetry (TLD), and equations are derived for calculating the
      limits. Three different levels of testing a TLD system are described, and a test
      procedure is given for each level. An example from a working system is presented,
      and the dependence of detection and determination limits on background radiation
      exposure is shown. The results show the importance of clearly defining the terms
      used to describe the low-dose performance of a TLD system.

PMID- 1735642
TI  - Application of glow curve analysis methods to improve TLD-100 dose reassessment
      performance.
AB  - This paper presents a method of improving the TLD-100 dose reassessment
      performance. This method consists of applying numerical analysis techniques for
      evaluating the TLD-100 phototransferred thermoluminescence (PTTL) glow curve.
      From this analysis, a simple procedure for estimating the ultraviolet background
      components usually present in phototransferred thermoluminescence (TL) signals
      has been established. This procedure has been implemented in a computer program
      which performs the automatic evaluation of the glow curves and extracts the dose
      information contained in the PTTL curves. The use of this computer-aided
      evaluational method has enabled the extension of the working range of estimated
      absorbed dose down to 0.2-0.5 mGy with very adequate operational quality for
      doses even below the conventionally admitted lower reestimation limit
      (approximately 2 mGy). Because TL readout is a destructive process, the ability
      to reestimate doses can be important in any kind of dosimetric activity, such as
      operational dosimetry programs. The other commonly used dosimeter, film, uses a
      nondestructive readout and, therefore, presents some advantages over TLD when
      dose reassessment is necessary. With the reported improvements in the TLD-100
      dose reassessment performance, the full range of absorbed doses covered by film
      dosimetry can now be reliably reassessed using TLD-100 dosimeters.

PMID- 1735643
TI  - Discovery of a 137Cs hot particle in municipal wastewater treatment sludge.
AB  - Analysis of primary treatment sludge from a municipal wastewater treatment plant
      revealed elevated 137Cs concentrations in one sample. This elevated activity was
      associated with a radioactive particle that, when isolated and quantified, was
      found to contain 1.82 kBq of 137Cs. Additional analysis indicated an absence of
      alpha activity, and energetic beta radiation, if present, was less than the 137Cs
      activity. The particle was approximately 50 microns in diameter, appeared not to
      be an aggregate, and was nonmetallic.

PMID- 1735644
TI  - Calculating the calibration coefficient for radon measurements with the bare LR
      115-II track detector.
AB  - Model calculations were performed to determine the calibration coefficient for
      radon measurements using a bare LR 115-II track detector. Calculations were based
      on an expression for stopping power for heavily charged particles, as well as on
      the Monte Carlo method. The sensitivity of the LR 115-II detector depends on
      equilibrium factor F, and it has been calculated for various values of F. For
      equilibrium factor F = 1, the calibration coefficient in this calculation was 89
      m-1 (10.3 Bq d m-3 per tracks cm-2) for the removed layer, which was 5.5 microns
      thick.

PMID- 1735645
TI  - Behavior of Chernobyl fallout radionuclides in peat combustion.
AB  - The fallout from the explosion and fire at the Chernobyl nuclear power plant
      concentrated levels of up to 10 kBq 137Cs kg-1 dry weight in the fuel peat
      harvested during the summer of 1986 in Finland. We investigated the behavior of
      fallout radionuclides 137Cs, 134Cs, 106Ru, 144Ce, 125Sb, 95Zr, and 110mAg
      together with naturally occurring 210Pb and 226Ra in the combustion of this
      contaminated peat in four different power plants. The elements antimony,
      ruthenium, lead, and cesium were enriched on the smallest particles, indicating
      that they were in a volatile chemical form, while cerium, zirconium, and radium
      were nonvolatile at the combustion temperatures. This result confirms the
      previous finding that ruthenium is volatile in combustion. Although metallic
      ruthenium requires 2,310 degrees C to melt, some of its oxides melt and evaporate
      at much lower temperatures.

PMID- 1735646
TI  - Mathematical aspects of a rotating point source with an application to
      megavoltage shielding.
AB  - This study developed the mathematics of a rotating point source. The relative
      dose and the dose rate were numerically evaluated at various positions along the
      cardinal axes, both with and without a 1-m-thick concrete barrier. The point
      source model was compared to experimental data gathered at an operational
      megavoltage radiation therapy facility.

PMID- 1735647
TI  - Analyzing uranium concentrations in drinking water samples in India using the
      fission-track technique.
AB  - The "dry" fission-track registration method was used to analyze uranium
      concentrations in drinking water samples collected from various water sources in
      some cities of India. A nuclear track detector made of plastic was used for
      registering fission tracks. Results showed a uranium concentration in drinking
      water of 0.67-20.26 micrograms L-1.

PMID- 1735648
TI  - Mortality among workers at Oak Ridge National Laboratory.

PMID- 1735649
TI  - Mortality of workers at the Oak Ridge National Laboratory.

PMID- 1735650
TI  - A juggling act with values of maximum permissible concentration of radionuclides
      in air and water.

PMID- 1735651
TI  - Effects of two types of head coverings in the rewarming of patients after
      coronary artery bypass graft surgery.
AB  - In this experimental study we examined the effects of two types of head coverings
      in the rewarming of patients who have had coronary artery bypass graft surgery
      during the initial 8-hour postoperative period. A third group with no head
      coverings served as a control. Eighty-one patients were randomly assigned to one
      of the three treatment groups; rectal temperatures were recorded on admission and
      hourly for the next 8 hours. An analysis of variance between the three groups
      revealed no statistically significant differences (p less than 0.05) in the
      length of time for patients to reach normothermia and in the net temperature gain
      achieved. Irrespective of the groupings, however, patients who took 5 hours or
      less to reach normothermia exhibited statistically significant differences (p
      less than 0.05) compared with patients who took longer: the former patients
      tended to be younger, the lowest induced operating room temperature tended to be
      higher, their admission temperatures tended to be higher, and minutes of
      cardiopulmonary bypass tended to be fewer.

PMID- 1735652
TI  - Comparability of the thermodilution cardiac output method: proximal injectate
      versus proximal infusion lumens.
AB  - In this study we examined the relationship between cardiac output (CO)
      measurements obtained from the proximal injectate lumen and the proximal infusion
      lumen of a thermodilution pulmonary artery catheter. The research was predicated
      on the belief that a strongly significant relationship would provide the
      clinician with an alternative lumen for measuring CO. Twenty-one subjects were
      selected by using a nonprobability convenience sampling method. With ice
      temperature injectate, four injections were performed into one lumen followed by
      four injections into the alternate lumen. CO values were computed with installed
      data management physiologic monitors. A Pearson's Product-Moment Correlation
      Coefficient was calculated, and the result verified a strong positive correlation
      between CO values (r = 0.96, p = less than 0.0001). Results of a paired t test
      demonstrated no statistically significant differences between CO means. These
      findings lend direction for minimizing the potential risk of catheter
      contamination associated with the manipulation of intravenous lines containing
      vasoactive medications. It also may save time for the critical care clinician who
      is trying to balance tasks such as CO measurements and titration of vasoactive or
      inotropic medications.

PMID- 1735653
TI  - The association between interdisciplinary collaboration and patient outcomes in a
      medical intensive care unit.
AB  - We prospectively studied the relationship between interdisciplinary collaboration
      and patient outcomes in the medical intensive care unit (MICU) using nurses' and
      residents' reports of amount of collaboration involved in making decisions about
      transferring patients from the MICU to a unit with a less intense level of care.
      Either readmission to the MICU or death was considered a negative patient
      outcome. Nurses' reports of collaboration were significantly (p = 0.02) and
      positively associated with patient outcome, controlling for severity of illness.
      Patient predicted risk of negative outcome decreased from 16%, when the nurse
      reported no collaboration in decision making, to 5% when the process was fully
      collaborative. There was an interaction of collaboration with availability of
      alternative choices in the transfer decision-making situation. When alternatives
      were available, collaboration was more strongly associated with patient outcome.
      There was no significant relationship between residents' reports of collaboration
      and patient outcomes. The correlation between amount of collaboration reported by
      nurses and residents about the same decisions was quite low (r = 0.10).

PMID- 1735654
TI  - Empathy of intensive care nurses and critical care family needs assessment.
AB  - In this study we explored the relationship between the empathy of intensive care
      unit (ICU) nurses and their ability to assess accurately the perceived needs of
      family members of patients hospitalized in ICU settings. Thirty family needs were
      studied by using Molter's 1983 revision of the Critical Care Family Needs
      Inventory (CCFNI). Data consisted of 92 pairs of CCFNI responses obtained from 92
      family members of ICU patients and 60 ICU nurses providing direct care for these
      patients. Multiple regression analysis was performed to determine the extent to
      which empathy and nursing experience contribute to accurate assessment of the
      needs of ICU family members. The more emphatic ICU nurses were, the greater their
      ability to assess ICU family members' needs accurately on six of the needs
      studied (p less than or equal to 0.05). Length of nursing experience negatively
      affected the nurse's ability to assess three of the ICU family members' needs
      accurately (p less than 0.05).

PMID- 1735655
TI  - The spouse: a factor in recovery after acute myocardial infarction.
AB  - Literature supports the concept that the response of a patient's spouse
      influences the recovery process of a patient after an acute myocardial infarction
      (AMI). This was a 6-month, longitudinal, descriptive study of 17 married couples
      in which one of the pair experienced his or her first AMI. The study examined the
      question: "Is there a relationship between the spouse's social support, family
      stress, marital satisfaction, and sexual comfort and the patient's recovery after
      AMI?" Data were collected at three times during the 6-month period after AMI.
      Results showed a significant relationship between the spouse's family stress,
      marital satisfaction, and sexual comfort and the patient's recovery. Also, a
      significant relationship was found between the spouse's sexual comfort and
      marital satisfaction. This was the first reported study that examined sexual
      comfort over time and investigated sexual activities other than intercourse.

PMID- 1735656
TI  - Ludwig's angina.
AB  - Ludwig's angina is a cellulitis frequently occurring as a result of infections of
      the second and third lower molar. Despite a decrease in mortality from 50% to
      less than 10% since the introduction of antibiotics, it remains a rare but life
      threatening illness. The potential for rapid respiratory obstruction is the
      greatest concern. Familiarity with the anatomy of the neck and recognition of
      symptoms are essential for effective treatment. Treatment focuses on maintenance
      of an airway, antibiotic therapy, and surgery. Asphyxia, aspiration,
      mediastinitis, pneumonia, empyema, and septicemia are possible complications.

PMID- 1735657
TI  - Assessing delirium in the acute care setting.
AB  - Delirium is a common, disruptive, costly, and at times lethal condition found
      among patients in the acute care setting. Nurses can be the first to discover its
      presence and thereby reduce the time to treatment. Identifying delirium requires
      a knowledge of its clinical features, a mastery of the bedside cognitive mental
      status examination, critical judgment in distinguishing delirium from other
      psychiatric disorders, and appropriate nursing interventions based on ongoing
      assessment. In this article we review elements of such an approach and illustrate
      common clinical challenges for nurses with case examples.

PMID- 1735658
TI  - Relationships among health beliefs, self-efficacy, and exercise adherence in
      patients with coronary artery disease.
AB  - Management of the pathologic progression of coronary artery disease requires life
      style changes in patients, but the level of compliance with medical
      recommendations is low. Critical care nurses have a unique opportunity to
      encourage patients to assume responsibility for their health care and life-style
      behavior. In this study we developed a model to identify the relationships among
      variables that explained adherence to a recommended exercise regimen. The
      variables studied included self-efficacy, perceived severity, barriers, benefits,
      and cues to action.

PMID- 1735659
TI  - Effect of venous support on edema and leg pain in patients after coronary artery
      bypass graft surgery.
AB  - The purpose of this study was to assess the effect of external venous support on
      edema and pain in the saphenous graft leg of patients who had coronary artery
      bypass graft surgery (CABG) 5 days and 1 month after surgery. Fifty-six patients
      who had CABG surgery were randomly assigned to the experimental (n = 24) or
      control (n = 32) group. Subjects in the experimental group wore graded
      compression support hose. Edema was assessed by using ankle, calf, and thigh
      circumference measurements. Pain was measured on a visual analog scale. Hose were
      effective in preventing edema during hospitalization, but results at 1 month were
      inconclusive. There was no difference in leg pain for experimental and control
      subjects. That a number of patients in the experimental group were unable to
      complete the study suggests that off-the-shelf, thigh-high support hose may not
      be useful for individuals with disproportionately large thighs. Further
      investigation of the long-term effects of support hose is warranted.

PMID- 1735660
TI  - Lung hyperinflation caused by inappropriate ventilation resulting in
      electromechanical dissociation: a case report.
AB  - Lung hyperinflation has been demonstrated to occur in patients with obstructive
      lung disease requiring mechanical ventilation. A dramatic case of pulmonary
      hyperinflation occurred in the early resuscitative period after initial
      intubation and manual ventilation leading to the development of electromechanical
      dissociation. Once the presence of lung hyperinflation was recognized,
      manipulation of the patient's ventilator settings allowed resolution of the lung
      hyperinflation and reversal of the detrimental hemodynamic effects it produced.
      This case illustrates that lung hyperinflation should be included in the
      differential diagnosis of electromechanical dissociation. In selected patients if
      pneumothorax, hypovolemia, cardiac tamponade, and myocardial infarction are
      excluded as causes and pulmonary hyperinflation is suspected, then a trial of
      adjusted ventilation to decrease the lung hyperinflation may be useful.

PMID- 1735661
TI  - Digoxin toxicity presenting as altered mental status in a patient with severe
      chronic obstructive lung disease.
AB  - Gastrointestinal and cardiac manifestations are the commonly considered features
      of digoxin toxicity. This report describes a patient with severe chronic
      obstructive lung disease whose primary manifestation of digoxin toxicity is acute
      alteration of mental status. Neurologic dysfunction may be the sole manifestation
      of digitalis toxicity. The diagnosis of digoxin toxicity should be considered in
      elderly patients with altered mental status, even when serum levels are within a
      therapeutic range.

PMID- 1735662
TI  - In-use comparison of latex gloves in two high-risk units: surgical intensive care
      and acquired immunodeficiency syndrome.
AB  - This study was designed to compare use patterns and leakage of gloves from two
      high-risk units: a surgical intensive care unit (SICU) and an acquired
      immunodeficiency syndrome (AIDS) unit. During a 3-month interval, the use of
      gloves during clinical procedures by nursing personnel was observed and recorded.
      A total of 2900 latex examination gloves were collected and tested in the
      laboratory by the watertight leakage test: 59% (1714) were from the SICU and 41%
      (1186) from the AIDS unit. Twenty-four percent (700) of all gloves leaked: 29%
      (500/1714) leaked when worn by staff in the SICU as compared with 17% (200/1186)
      leakage rate in the AIDS unit (chi-square = 57.32, p less than 0.05). This
      difference could be attributed in part to higher levels of stress to the gloves
      and longer wearing time in the SICU.

PMID- 1735663
TI  - Meningococcal conjunctivitis.

PMID- 1735664
TI  - Comparison of thermodilution and transthoracic electrical bioimpedance cardiac
      outputs.

PMID- 1735665
TI  - On the use of the moments method of estimation to obtain approximate maximum
      likelihood estimates of linkage between a genetic marker and a quantitative
      locus.
AB  - The approximate maximum likelihood method of Luo & Kearsey (1989) to determine
      the parameters of a segregating quantitative trait locus (QTL) in an F2
      population by linkage to a genetic marker is compared to the 'true' maximum
      likelihood estimates derived by scanning the seven parameter likelihood space.
      The two methods did not yield identical results, and diverged markedly for a
      dominant QTL loosely linked to the genetic marker. Further study is suggested to
      evaluate other methods that do not simultaneously maximize the likelihood for all
      parameters.

PMID- 1735666
TI  - The Seventh International Conference on Chemical Modifiers of Cancer Treatment-
      Part I. Clearwater, Florida, 2-5 February 1991.

PMID- 1735667
TI  - Tissue oxygen manipulation and tumor blood flow.

PMID- 1735668
TI  - Measurement of oxygen diffusion distance in tumor cubes using a fluorescent
      hypoxia probe.
AB  - Oxygen diffusion distance was measured in solid tumor "cubes" prepared by
      excising the tumor from the mouse and incubating 1-2 mm sided tumor cubes in
      spinner culture flasks with fluorescent drugs (AF-2 or DM113) which bind to
      hypoxic cells. After incubation, frozen sections were prepared and examined for
      AF-2 or DM113 binding using a fluorescence image processing system.
      Alternatively, cubes were stained with a slowly penetrating fluorescent dye,
      Hoechst 33342, prior to disaggregation and measurement of AF-2 binding using flow
      cytometry. The distance from the cube surface to the AF-2 stained region (i.e.,
      the thickness of the unstained rim) was used as an indication of oxygen diffusion
      distance, which depends on the square root of the tumor oxygen consumption rate.
      Oxygen diffusion distance was dependent on tumor type, external oxygen
      concentration, and temperature during incubation with AF-2, but was unaffected by
      tumor size up to 1.2 gm or position of the cube within the tumor. Oxygen
      diffusion distances (in planar geometry) measured for cubes prepared from SCCVII,
      RIF-1, Lewis lung or WiDr tumors were 107, 123, 153 and 193 microns,
      respectively. For SCCVII and WiDr tumors, the percentage of blood vessels
      separated by a distance greater than double the mean oxygen diffusion distance
      was used as an indication of the hypoxic fraction.

PMID- 1735669
TI  - Effect of carboxyhemoglobin on tumor oxygen unloading capacity in patients with
      squamous cell carcinoma of the head and neck.
AB  - Hemoglobin and blood gas parameters, with special attention to the influence of
      carboxyhemoglobin, were studied in 115 head and neck cancer patients undergoing
      radiotherapy. In 712 weekly blood samples, the values of total hemoglobin,
      carboxyhemoglobin (CO-Hb), and p50 were measured and the total oxygen content in
      the arterial and tumor venous blood was estimated. The difference between these
      values express the tumor oxygen unloading capacity (t-OUC). CO-Hb ranged from 0
      12% and showed a significant inverse relationship with t-OUC. This was caused by
      a reduced amount of effective hemoglobin combined with a left shift of the
      oxyhemoglobin dissociation curve (reduced p50). Overall, the tumor oxygen
      utilization decreased from 70% to 52% as a function of an increase in CO-Hb from
      0 to 12%.

PMID- 1735670
TI  - Reoxygenation associated radiosensitization after chronic hypoxia: effect of
      temperature and oxygen tension.
AB  - A431 human squamous carcinoma cells reoxygenated after 12 hr hypoxia were found
      to be more radiosensitive than aerobic cells not previously exposed to hypoxia.
      Experiments were carried out to investigate the effect of temperature and oxygen
      tension during the hypoxia and the reoxygenation periods on the sensitization
      effect. Incubation at 0 degrees C during 12 hr of hypoxia inhibited the
      sensitization seen after reoxygenation. During the reoxygenation period, reduced
      temperature did not modify the levels of enhancement but suppressed the decay of
      the sensitization. If oxygen tension during 12 hr of hypoxia was less than 10
      ppm, maximal enhancement by reoxygenation was seen, but there was no enhancement
      if the oxygen concentration was greater than 1%. In cells subjected to less than
      10 ppm oxygen for 12 hr, the level of sensitization by reoxygenation in 2 to 20%
      oxygen concentration was similar. The results indicate that radiosensitization by
      reoxygenation may require metabolic change(s) of cells during both the hypoxia
      and reoxygenation periods. The sensitization may also involve oxygen dependent
      species of reactions.

PMID- 1735671
TI  - Improving the radiation response in a C3H mouse mammary carcinoma by normobaric
      oxygen or carbogen breathing.
AB  - The limited therapeutic benefit from nitroimidazoles has renewed the interest in
      normobaric oxygen as a hypoxic cell radiosensitizer. In this experimental study
      we have tried to modify the oxygenation of a C3H mammary carcinoma by flushing
      tumor-bearing mice with oxygen or carbogen for 5 min before and during treatment.
      The response to these treatments was evaluated by the changes in radiation
      induced tumor control (TCD50) and by the changes in tumor hypoxic fraction (HF).
      Irradiation was given either as a large, single dose or as five equal, daily
      fractions. High levels of oxygen in the inspired air were found to decrease the
      TCD50 significantly. The enhancement ratios were in the range of 1.2-1.4 (p less
      than 0.05) for both single dose and fractionated irradiation, which suggests that
      hypoxic cells may be important even when reoxygenation is believed to be complete
      between fractions. The change in TCD50 corresponded to a decrease in the fraction
      of clonogenic hypoxic cells from 12% to 3-4% (p less than 0.05). Tumor blood flow
      was not significantly influenced by the gas treatment. This study thus shows that
      normobaric oxygen/carbogen inhalation may significantly improve the local tumor
      control by reducing the diffusion related hypoxia within tumors.

PMID- 1735672
TI  - Influence of carboxyhemoglobin level on tumor growth, blood flow, and radiation
      response in an experimental model.
AB  - Carboxyhemoglobin (HbCO) is formed when carbon monoxide is bound to hemoglobin.
      High levels of HbCO are known to reduce the amount of oxygen that can be carried
      to the tissues. This experimental study focuses on the influence of HbCO on the
      growth, blood flow, and radiation response of an experimental mouse tumor. The
      study was designed to mimic the clinical situation where heavy smokers are
      undergoing radiotherapy while having a high HbCO level. The tumor was a C3H
      mammary carcinoma grown in the feet of CDF1 mice. Chronic exposure to carbon
      monoxide, resulting in 10% HbCO, increased the tumor volume doubling time from
      2.5 to 3.5 days (p less than 0.05). The acute exposure to carbon monoxide prior
      to and during irradiation significantly raised the radiation dose required to
      control the tumor locally. The TCD50 increased from 54 Gy in air breathing mice
      (HbCO 0-2%) to 57 Gy (HbCO 7-9%) and 61 Gy (HbCO 20-23%). This increase
      corresponded to an increase in the fraction of clonogenic hypoxic tumor cells
      from 0.12 in air breathing animals to 0.21 and 0.41, respectively. The tumor
      blood flow, determined by the 86RbCl extraction technique, decreased to 63%
      (n.s.) and 50% (p less than 0.05) for low and high HbCO levels, respectively.

PMID- 1735673
TI  - Flavone acetic acid as a modifier of endothelial cell function.
AB  - Flavone acetic acid (FAA) causes significant regression of larger established
      tumors in murine systems in vivo, but is only slightly toxic in vitro. This in
      vivo effect is thought to be indirect, or immunological, rather than a direct
      cytotoxic effect on tumor cells. Using the WHFIB fibrosarcoma, which grows both
      in vivo and in vitro, and the murine endothelial cell line B10, we have studied
      the effect of FAA on the survival of tumor and endothelial cells in vitro. The
      times taken for 1 mg ml-1 FAA to reduce survival to 0.1 surviving fraction were
      63 hr for B10 and greater than 85 hr for WHFIB in vitro. WHFIB tumors in vivo
      were more sensitive than tumor cells in vitro, a single dose of 150 mg kg-1 FAA
      inducing a tumor growth delay of 10 days at treatment size + 2 mm. As FAA is more
      toxic to tumor-bearing animals than to those which are non-tumor bearing the
      effect of tumor conditioned medium on the cytotoxicity of FAA toward B10 cells
      was studied; no enhanced effect was seen. As FAA is only weakly cytotoxic in
      vitro to endothelial cells, and even less so to tumor cells, sublethal effects of
      FAA on endothelial cell function in vitro were studied. The permeability of
      monolayers of human unbilical vein endothelial cells (HUVEC) in vitro is
      transiently increased by FAA. Also, procoagulant activity of HUVEC is induced by
      FAA and this activity is further enhanced in the presence of a factor isolated
      from Meth-A tumor cells.

PMID- 1735674
TI  - A comparison of vascular-mediated tumor cell death by the necrotizing agents
      GR63178 and flavone acetic acid.
AB  - A vascular component of tumor damage has been identified for the anticancer agent
      GR63178. The necrotizing activity of this drug and of flavone acetic acid has
      been compared with their ability to induce growth delay in six murine tumor
      models. At 24 hr, after a fixed dose of flavone acetic acid (200 mg/kg), all six
      tumor types appeared 80-100% necrotic histologically, although growth delays
      ranging from 3 to 79 days were measured. GR63178 (200 mg/kg) induced more
      variable degrees of necrosis (10 to 95%), but a uniformly small delay in growth
      (0 to 4 days). These data illustrate that the absence of a tumor-growth response
      should not be automatically equated with an absence of drug activity. Without
      assessing tumor response histologically, agents with unusual mechanisms of action
      may be missed, despite their potential for killing large numbers of tumor cells.

PMID- 1735675
TI  - Effects of calcium channel blockers on renal function in mice.
AB  - Tumor blood flow modification is currently under investigation as a possible
      means of optimizing current cancer therapies, with particular respect to
      improving the efficacy of bioreductive agents. A variety of calcium channel
      blockers have been shown to modify tumor perfusion in model systems, and may be
      valuable as potentiators of both bioreductive and conventional drugs. We report
      the effects of nifedipine, verapamil, flunarizine, and cinnarizine on renal
      function in C3H mice, assayed by clearance of simultaneously injected 51Cr
      ethylenediamine tetraacetate. Nifedipine at 10 mg kg-1 blocked 51Cr
      ethylenediamine tetraacetate clearance for 30 min and reduced its subsequent rate
      of clearance by a factor (+/- 2 se) of 2.4 +/- 0.6. At 1 mg kg-1 it reduced the
      rate of clearance by a factor of 1.2 +/- 0.2. Verapamil at 10 mg kg-1 blocked
      51Cr ethylenediamine tetraacetate clearance for 10 min and reduced its subsequent
      rate of clearance by a factor of 1.5 +/- 0.3, but had no effect at 1 mg kg-1.
      Flunarizine had no effect at 50 mg kg-1 or at 5 mg kg-1, but cinnarizine at 50 mg
      kg-1 reduced clearance rate by a factor of 1.2 +/- 0.1. The data show that some
      of these vasoactive agents, nifedipine and verapamil in particular, can severely
      compromise renal function and may, therefore, affect the plasma pharmacokinetics
      of co-administered drugs that are cleared by the kidney.

PMID- 1735676
TI  - Effect of flunarizine on micro-regional distributions of intravascular HbO2
      saturations in RIF-1 and KHT sarcomas.
AB  - Flunarizine, a calcium channel-blocker, preferentially active on peripheral blood
      vessels and red blood cells, has previously been shown to increase not only tumor
      blood flow, but also both chemosensitivity and radiosensitivity. The mechanisms
      behind these effects are not clear at present, and different tumor lines have
      been demonstrated to respond quite differently to the same flunarizine treatment.
      To clarify the underlying mechanisms at the micro-regional level, the present
      investigation examined the effects of flunarizine on spatially-resolved
      distributions of intravascular oxyhemoglobin (HbO2) saturations. Tumors were
      implanted s.c. in the flanks of C3H mice and grown to a volume of 500-1000 mm3.
      Flunarizine was injected i.p. at 5 mg/kg; animals were anesthetized, and
      following a 20 min delay, tumors were quick-frozen. HbO2 saturations were
      determined cryospectrophotometrically at systematically selected sites across
      each tumor cross-section. Three primary questions were addressed: (a) Does
      flunarizine have a direct effect on tumor oxygen delivery as measured by
      intravascular HbO2 saturations? (b) Are changes in oxygen delivery uniformly
      distributed throughout the tumor volume? (c) Are HbO2 distributions for tumor
      lines of dissimilar radiobiological hypoxic fraction affected similarly by
      flunarizine? For KHT tumors, flunarizine substantially increased the % vessels
      greater than or equal to 10% saturated throughout the tumor volume, with a
      somewhat larger increase for the interior vessels than for the peripheral
      vessels. In contrast, for the RIF-1 tumors, HbO2 saturations following
      flunarizine remained near control levels. These results indicate that fundamental
      differences in vascular geometry, hemodynamics, or blood rheology may exist
      between the KHT and RIF-1 tumor lines, and furthermore, that the response of one
      tumor line to a given blood-flow modifier may be completely unrelated to that of
      another.

PMID- 1735677
TI  - Relationship between the hydralazine-induced changes in murine tumor blood supply
      and mouse blood pressure.
AB  - The relationship between hydralazine-induced changes in blood pressure and tumor
      blood flow was investigated in restrained but non-anesthetized CDF1 mice bearing
      C3H/Tif foot tumors. Mean arterial blood pressure measurements were made using
      the procedure of carotid cannulation, and tumor blood flow was estimated using
      laser Doppler flowmetry. Hydralazine doses from 0.1 to 5.0 mg/kg were tested.
      Following hydralazine administration the maximum changes in blood pressure and
      blood flow were apparent within 10-15 min and were maintained for at least 30 min
      after injection. Blood pressure decreased with increasing hydralazine dose,
      achieving a maximum reduction of 50% at 2.5 mg/kg. Tumor blood flow was found to
      be increased by 30% at the lowest hydralazine dose (0.1 mg/kg), even though blood
      pressure was decreased by 10% at this dose. At hydralazine doses producing a 15%
      or greater blood pressure drop, blood flow decreased, reaching an 80-90%
      reduction between 2.5 and 5.0 mg/kg.

PMID- 1735678
TI  - Tumor blood flow changes induced by chemical modifiers of radiation response.
AB  - This study was designed to investigate blood flow changes induced by chemical
      agents that are commonly used in combination with radiation therapy. The hypoxic
      cell cytotoxin RSU 1069 at a dose of 100 mg/kg was shown to reduce blood flow by
      80% in both SCCVII and C3H mammary tumors. Blood flow reductions of 30-40% were
      also observed in both tumors following administration of the radiation sensitiser
      pimonidazole (Ro-03-8799) at a dose of 500 mg/kg. Moreover studies in the C3H
      mammary tumor indicated that this effect was tumor size-dependent, being more
      profound and of longer duration in 500 mg than in 100 mg tumors. Blood flow
      decreases were also observed in the SCCVII tumor after administration of
      adriamycin at a dose of 15 mg/kg. Blood flow decreased by over 80% immediately
      after drug administration but recovered to remain 20% below control values 1 hr
      after drug administration. In contrast to the other agents studied, cis platinum
      at a dose of 2 mg/kg produced a small 20-30% increase in blood flow which
      persisted over the 1 hr observation period. The potential implications of these
      findings are discussed.

PMID- 1735679
TI  - Blood flow modification in the SCCVII tumor: effects of 5-hydroxytryptamine,
      hydralazine, and propranolol.
AB  - The effects of hydralazine, 5-hydroxytryptamine (5-HT), and propranolol on blood
      flow in the SCCVII tumor were assessed using laser Doppler flowmetry. Both
      hydralazine and 5-HT, at doses of 1 and 5 mg/kg, reduced blood flow, as did
      propranolol at 10 mg/kg. Hydralazine and 5-HT at doses of 0.25 mg/kg slightly
      increased tumor blood flow, and a 10-20% increase in blood flow was also observed
      after 1 mg/kg of propranolol. However, propranolol at 1 mg/kg enhanced the blood
      flow reduction observed with 1 mg/kg of hydralazine. The concomitant
      administration of hydralazine and propranolol at these doses also translated into
      increased potentiation of the tumor cytotoxicity of the hypoxic cell cytotoxin
      RSU-1069.

PMID- 1735680
TI  - Magnetic resonance spectroscopy studies on experimental murine and human tumors:
      comparison of changes in phosphorus metabolism with induced changes in vascular
      volume.
AB  - The responses of two experimental murine tumors and two human tumor xenografts to
      the vasodilator hydralazine were compared using two magnetic resonance
      spectroscopy endpoints. Changes in tumor metabolism were determined using 31P MRS
      where inorganic phosphate levels relative to total phosphate (Pi/total) were
      measured, and alteration in tumor blood volume was examined using 19F MRS with
      perfluorooctylbromide (PFOB) as tracer. The integrated 19F signal from PFOB is
      dose dependent and stable for at least 2 hr after injection. The murine tumors
      SCCVII/Ha and KHT both showed changes in tumor metabolism after hydralazine, as
      an increase in Pi/total. However, hydralazine reduced vascular volume in the KHT
      tumor, demonstrated by reduced 19F signal from PFOB, but no such reduction was
      seen in the SCCVII/Ha tumor. In contrast, hydralazine had no effect on phosphorus
      metabolism in the HT29 and HX118 human tumor xenografts, but reduced vascular
      volume in both tumors. These results demonstrate that the effects of vasoactive
      agents such as hydralazine on tumor phosphorus metabolism are only partially
      consistent with changes in vascular volume, measured by the 19F MRS technique.

PMID- 1735681
TI  - The response of spontaneous and transplantable murine tumors to vasoactive agents
      measured by 31P magnetic resonance spectroscopy.
AB  - 31P magnetic resonance spectroscopy has been used to compare the effects of the
      vasoactive agents hydralazine and flunarizine on the oxygenation of the
      transplantable tumors, SCCVII/Ha and 16C, and a range of spontaneous mammary
      tumors arising in the breeding stock in the Genetics Division at the Radiobiology
      Unit. The vasodilator hydralazine, previously shown to increase the
      radiobiological hypoxic fraction of transplantable murine tumors, increased
      inorganic phosphate to total phosphate (Pi/total) in SCCVII/Ha and 16C tumors.
      However, only two spontaneous tumors responded to this agent (2/12). The calcium
      antagonist flunarizine, which sensitizes the SCCVII tumor to X rays, consistent
      with a reduction in hypoxic fraction, reduced Pi/total in this and the 16C tumor.
      Further, most spontaneous tumors tested (8/10) responded to this agent, as
      measured by a reduction in Pi/total. These results point to fundamental
      differences between transplantable and spontaneously arising tumors in mice in
      their response to vasoactive agents.

PMID- 1735682
TI  - Determination of changes in tumor blood perfusion after hydralazine treatment by
      dynamic paramagnetic-enhanced magnetic resonance imaging.
AB  - Magnetic resonance imaging, using the paramagnetic chelate gadopentetate
      dimeglumine as a perfusing agent, was used to investigate the effect of the
      vasoactive drug hydralazine on tumor blood perfusion. The method requires
      measurements of the magnetic resonance image intensity changes with time on a pre
      selected region of interest in the tumor image, immediately following intravenous
      injection of gadopentetate dimeglumine. The present study showed that the initial
      slope of the intensity-time curve can be used, to a first approximation, to infer
      tumor blood perfusion. With the dynamic imaging technique, it was demonstrated
      that, in the KHT sarcoma implanted intramuscularly in the hind leg of C3H/HeN
      mice, intraperitoneal administration of hydralazine reduced the volume-averaged
      tumor blood perfusion in a dose-dependent manner. The intrinsically high spatial
      resolution of magnetic resonance imaging allows a detailed study of the
      heterogeneous nature of tumor blood perfusion. The potential applications of this
      imaging technique to study the differential effects of hydralazine on perfusion
      between tumor and normal tissues will be discussed. The clinical utility of the
      technique should be promising because of its non-invasive nature.

PMID- 1735683
TI  - Biochemical modification of therapeutic response.

PMID- 1735684
TI  - Measurement of incorporation of bromodeoxyuridine into DNA by high performance
      liquid chromatography using a novel fluorescent labelling technique.
AB  - 5'-Bromo-2-deoxyuridine (BUdR) is a halogenated pyrimidine analogue that is an
      efficient radiosensitizer through its incorporation into DNA in place of
      thymidine. Radiosensitization is proportional to percentage replacement and we
      present here a novel derivatization technique that specifically labels the
      thymidine and BUdR with 4-bromomethyl-7-methoxycoumarin (BrMMC) to give the
      highly fluorescent coumarin derivatives which are quantitated using high
      performance liquid chromatography (HPLC). This allows for a simple single-stage
      DNA hydrolysis and sensitive peak detection. Data are presented showing the
      incorporation with time of BUdR into the DNA of Chinese hamster V79 cells.
      Attention is also drawn to the care needed in the selection of enzymes required
      for DNA digestion.

PMID- 1735685
TI  - Iododeoxyuridine incorporation and radiosensitization in three human tumor cell
      lines.
AB  - Iododeoxyuridine is a halogenated pyrimidine and non-hypoxic cell radiosensitizer
      currently being used in clinical trials. The amount of radiosensitization by
      IdUrd is related to the amount of incorporation of the drug into a cell's DNA.
      These experiments were carried out in three human tumor cell lines (lung, glioma,
      and melanoma) in monolayer culture exposed to concentrations of IdUrd from 0.1-10
      microM for one and three cell cycles before irradiation to determine
      incorporation and sensitization as a function of drug exposure. Except for the
      lung cell line, which required greater than 1 microM IdUrd, these cells
      demonstrate radiosensitization when exposed to 0.1 microM or greater of IdUrd.
      Maximum sensitization occurred at 10 microM IdUrd for all the cell lines at three
      cell cycles. The percent thymidine replacement by IdUrd increased with increasing
      concentrations, but was cell line dependent. Maximum percent replacement occurred
      at 10 microM at three cell cycles for all the cell lines: lung = 22.4%, glioma =
      32.0%, and melanoma = 39.1%. The relationships between percent thymidine
      replacement and sensitization are not identical across these human tumor cell
      lines. If IdUrd is going to be a successful radiosensitizer in clinical trials,
      sustained plasma levels of 10 microM or greater for at least three cell cycles
      should be achieved during irradiation. This may be best accomplished with
      repeated short exposures to IdUrd (three cell cycles or approximately 4 days in
      these cell lines) every 1-2 weeks during radiation. Measurements of thymidine
      replacement in a tumor biopsy should be attempted prior to radiation to develop a
      predictive assay for radiosensitization.

PMID- 1735686
TI  - Correlation of sensitizer enhancement ratio with bromodeoxyuridine concentration
      and exposure time in human cervical carcinoma cells treated with low dose rate
      irradiation.
AB  - The effect of a range of bromodeoxyuridine concentrations and exposure times on
      the sensitizer enhancement ratio of two human cervical carcinoma cell lines
      treated with low rate irradiation was evaluated. Both cell lines show a linear,
      though different, dose response to low dose rate irradiation at dose rates up to
      0.62 Gy/hr. Cells were pre-incubated with 0, 1, 5, or 10 microM bromodeoxyuridine
      for 0, 24, or 48 hr prior to low dose rate irradiation. Based on the survival of
      cells exposed to 4 Gy, delivered at 0.62 Gy/hr, a slope was determined for an
      exponential survival curve for each bromodeoxyuridine concentration and exposure
      time. Sensitizer enhancement ratios were calculated as the ratio of the slopes of
      the treated and untreated cells from a particular exposure time. Ratios increased
      linearly initially with a plateauing at higher levels with respect to the product
      of bromodeoxyuridine concentration and time of exposure for both cell lines with
      similar degrees of enhancement. A linear relationship has been noted previously
      for acute irradiation of hamster cells over a similar range of sensitizer
      concentrations and exposure times. At the highest dose-time points (540 microM
      hr) ratios of greater than 2 were attained, which were comparable to results
      obtained following acute radiation exposures of V-79 cells. These results
      demonstrate that significant sensitizer enhancement ratios with low dose
      irradiation can be obtained in human tumor cells after exposures of 2 to 3
      doubling times using relatively low concentrations of sensitizer.

PMID- 1735687
TI  - Modulation of iododeoxyuridine-mediated radiosensitization by 5-fluorouracil in
      human colon cancer cells.
AB  - The incorporation of 5-iodo-2'-deoxyuridine (IdUrd), a thymidine analog
      radiosensitizer, can be increased by the use of modulators such as 5-fluorouracil
      (FUra). FUra is a particularly attractive potential modulator to use against
      colorectal cancer, as it is the most active single agent in the treatment of this
      disease. To begin to define the conditions for the optimal combination of IdUrd
      and FUra in the treatment of patients with colorectal cancer, a study was
      conducted of the effect of FUra on IdUrd-mediated radiosensitization in cultured
      HT29 human colon cancer cells. It was found that when cells were exposed to
      concentrations of IdUrd typical of those obtained through intravenous exposure (1
      3 microM), FUra (1 microM) increased radiosensitization beyond that which would
      be predicted for the same extent of incorporation produced by incubation with
      IdUrd alone. This increase appeared to result from a combination of at least two
      effects: FUra-mediated cell cycle redistribution and increased IdUrd
      incorporation. When a higher concentration of IdUrd (10 microM) was used with
      FUra (1 microM), cell cycle distribution returned to nearly normal, and
      radiosensitization was equal to that predicted by the extent of incorporation of
      IdUrd. These data demonstrate that the combination of FUra and IdUrd can produce
      radiosensitization both through increased IdUrd incorporation and cell cycle
      redistribution. Furthermore, they suggest that, in the presence of a modulator,
      it may not be necessary to achieve high levels of IdUrd incorporation to produce
      significant tumor radiosensitization.

PMID- 1735688
TI  - 5-chlorodeoxycytidine, a radiosensitizer effective against RIF-1 and Lewis lung
      carcinoma, is also effective against a DMBA-induced mammary adenocarcinoma and
      the EMT-6 tumor in BALB/c mice.
AB  - 5-Chlorodeoxycytidine (CldC), coadministered with modulators of pyrimidine
      metabolism, is an effective radiosensitizer of murine tumors. Past studies that
      utilized RIF-1 tumors in C3H mice and Lewis lung carcinoma (LLC) in BDF1 mice
      have been extended with an emphasis on using multiple cycles of drug
      administration followed by irradiation of LLC and the use of two additional tumor
      models. Four of seven cures of BDF1 mice bearing LLC were obtained with three
      doses of 20 Gy irradiation, in which the first and third dose were preceded by a
      "Standard Protocol" that includes N-(phosphonacetyl)-L-aspartic acid (PALA), 5
      fluorodeoxycytidine (FdC), tetrahydrouridine, and the radiosensitizer, 5
      chlorodeoxycytidine. No cures were obtained in groups of mice receiving radiation
      alone or drugs alone, and there were no "no takes" in untreated control groups
      (six mice/group). Extensive tumor inhibition, exceeding that obtained with drugs
      or radiation alone, was obtained with two cycles of drugs and radiation combined
      when a dimethybenzanthracene-induced mammary adenocarcinoma was used in BALB/c
      mice. With the EMT-6 tumor in BALB/c mice, doses of 10 and 20 Gy were
      administered 9 and 16 days after tumor implantation, each preceded with the
      Standard Protocol; this resulted in a tumor growth delay of 24 days. No tumor
      growth delay occurred with drugs or radiation alone. The omission of PALA, FdC or
      CldC from the Standard Protocol resulted in loss of tumor control, which was
      obtained with the complete protocol. The fact that 5-chlorodeoxycytidine is an
      effective radiosensitizer in four rodent tumor systems is compelling evidence
      that it has potential as a radiosensitizer of human tumors, especially in view of
      its tumor selectivity and its resistance to catabolism when used with modulators
      of its metabolism, and in view of the high levels of the key enzymes in human
      tumors, which can convert 5-chlorodeoxycytidine to 5-chlorodeoxyuridine
      triphosphate, the proximate radiosensitizer.

PMID- 1735689
TI  - Phase I study of high dose 5-fluorouracil and high dose Leucovorin with low dose
      phosphonacetyl-L-aspartic acid in patients with advanced malignancies.
AB  - Twenty-eight patients with refractory advanced malignancies were treated with a
      24 hr infusion of 5-fluorouracil (5-FU), Leucovorin (LV), and N-(phosphonacetyl)
      L-aspartic acid (PALA) weekly. Twenty-seven patients were evaluable for the
      assessment of toxicity and anti-tumor activity. PALA was administered as
      intravenous bolus over 15 min at a fixed dose, 250 mg/m2 24 hr before the start
      of 5-FU and LV infusions. 5-FU was initially administered at 750 mg/m2 and was
      incrementally increased to 2600 mg/m2. LV was administered in a fixed dose of 500
      mg/m2 concurrently with 5-FU over a 24-hr period. The course was repeated weekly.
      Diarrhea, stomatitis, nausea, and vomiting were among dose-limiting toxic
      effects. Other toxicities observed were hand-foot syndrome, hair loss of
      scalp/eyelashes, overall weakness, rhinitis, and chemical conjunctivitis. Maximum
      tolerated dose (MTD) of 5-FU in this combination and schedule was 2600 mg/m2.
      Seven of 14 patients treated at 2600 mg/m2 were able to tolerate the chemotherapy
      on a weekly basis without interruption. The other seven patients required dose de
      escalation, a majority of whom contained 5-FU at a dose of 2100 mg/m2. Twenty
      three of 27 patients had been previously treated. Eight patients achieved a
      partial response, all of whom were previously treated, except three patients. A
      complete response was observed in a patient with pancreatic carcinoma, previously
      untreated. Overall response rate for the patients who were treated at the 5-FU
      dose of 2100 mg/m2 or 2600 mg/m2 is 9 of 18 patients (50%).

PMID- 1735690
TI  - Cell cycle dependence of epidermal growth factor induced radiosensitization.
AB  - The effect of epidermal growth factor on the radiation response of two human
      squamous carcinoma cell lines, A431 (from vulva) and SiHa (from cervix), was
      examined. In both lines, cells in S phase were more radioresistant than cells in
      other cell cycle phases. Epidermal growth factor present after irradiation
      enhanced the radiation response of A431 cells in different cell cycle phases,
      whereas no effect was seen for SiHa cells. The enhancement was maximum with 10
      ng/ml epidermal growth factor and was associated mainly with a reduction in the
      shoulder region of the cell survival curve. The ratio between the n values of the
      control and epidermal growth factor treated total cell population, G1, S, and G2M
      cells is 2.2, 4.1, 1.7, and 2.2, respectively. Epidermal growth factor reduced
      plating efficiency by about 50% for A431 cells in different cell cycle phases
      whereas a slight increase in plating efficiency was seen for SiHa cells. The
      present results indicate that epidermal growth factor related radiosensitization
      is dependent on both cell line and cell cycle.

PMID- 1735691
TI  - Concepts and developments in radiosensitization of mammalian cells.

PMID- 1735692
TI  - Correlation of the radiosensitization potency afforded by nitroacridine
      intercalators with their electron scavenging efficiency in DNA.
AB  - Nitracrine (1-NC) and its nitro-positional analogues are electron-affinic DNA
      intercalating compounds that act as hypoxic cell radiosensitizers in cell
      culture, but are too rapidly metabolized to provide radiosensitization in vivo.
      We have explored the electron-trapping efficiencies of nitroacridines to see if
      such compounds can scavenge radicals formed in irradiated DNA and if the
      efficiency of such trapping is related to their radiosensitization properties. We
      have shown that a correlation does indeed exist as 1-NC, the most potent
      radiosensitizer, scavenges approximately 45% of the migrating electrons (formed
      by attachment of eaq- to the DNA) compared with approximately 4% for 4-NC, the
      least efficient radiosensitizer. The quenching of the delayed fluorescence from
      acridine orange bound to DNA was also used to probe intracellular uptake and
      association with DNA. The results are in accord with earlier measurements of
      average uptake and a suggestion that intercalators which form DNA complexes with
      short residence times will be preferable to highly bound agents as
      radiosensitizers. Since 1-NC possesses the smallest association constant with DNA
      of the four compounds, it is suggested that its high radiosensitization potency
      may well be related to it being able to interact with more radical sites on the
      DNA than the other analogues, in addition to its capture of migrating electrons
      in DNA.

PMID- 1735693
TI  - Mechanistic studies of enhanced in vitro radiosensitization and hypoxic cell
      cytotoxicity by targeting radiosensitizers to DNA via intercalation.
AB  - In an effort to increase the molar efficiency of 2-nitroimidazoles as hypoxic
      cell radiosensitizers and cytotoxins, they have been linked to a DNA
      intercalating group. The lead compound in this series, NLP-1, is a 2
      nitroimidazole, linked at the one position to a phenanthridine ring system via a
      three carbon chain. Studies of the hypoxic cell specific radiosensitizing
      properties and hypoxic cell selective toxicity of NLP-1 toward CHO AA8-4 cells
      show the drug does have enhanced efficiency compared to the untargeted 2
      nitroimidazole, misonidazole, based on external drug concentrations. To see if
      this enhanced efficiency was due to the proposed mechanism, targeting to DNA, or
      to a general increase in the intracellular concentration of the drug, its uptake
      and accumulation intracellularly were determined. Radioactive NLP-1 was
      synthesized labelled with 14C at the 2 position of the imidazole ring. Cells were
      incubated with the radioactive drug under aerobic and hypoxic exposure
      conditions, and intracellular levels of the drug were determined by a spin
      through-oil technique. Results indicated that, at a drug concentration of 0.5 mM,
      there was no net accumulation of the drug over the external drug levels after
      aerobic exposure. Under hypoxic conditions, the drug did accumulate
      intracellularly, presumably because of hypoxia specific drug metabolism.
      Experiments with radioactive misonidazole labelled with 14C in the 2 position of
      the imidazole ring were run as controls. These results suggest that, under the
      conditions used, NLP-1 has an increased molar efficiency as a hypoxic cell
      radiosensitizer and cytotoxin, compared to misonidazole, based on intracellular
      drug concentrations.

PMID- 1735694
TI  - Dual function nitroimidazoles less toxic than RSU 1069: selection of candidate
      drugs for clinical trial (RB 6145 and/or PD 130908.
AB  - Following the toxicity and synthetic difficulties encountered with the hypoxic
      cell radiosensitizer RSU 1069, efforts have focused on development of a superior
      analogue. Two compounds, RB 6145 and PD 130908, have emerged from this program
      which overcome the instability and synthetic problems associated with RSU 1069
      while retaining favorable biological activity. Both agents show comparable
      radiosensitizing activity to RSU 1069 following oral or i.p. administration to
      mice bearing the KHT or RIF-1 tumors. Sensitizing efficiency is about 10 X
      greater than that observed for misonidazole or etanidazole. Toxicity toward
      hypoxic tumor cells in vivo is demonstrated by clamping tumors (for 60 min)
      following administration of PD 130908 or RB 6145. Both are effective hypoxic
      cytotoxins, but less potent than RSU 1069. Systemic toxicity is substantially
      reduced following oral drug administration. Further, doses achievable following
      fractionated drug treatments are sufficiently high to produce significant levels
      of radiosensitization.

PMID- 1735695
TI  - NLA-1: a 2-nitroimidazole radiosensitizer targeted to DNA by intercalation.
AB  - Targeting of electron affinic radiosensitizers to DNA via reversible non-covalent
      intercalative binding has potential for increasing sensitizer concentrations
      locally at the DNA target while decreasing accessibility to reductases
      responsible for bioactivation and cytotoxicity. We have prepared an DNA-targeted
      acridine-linked 2-nitroimidazole (NLA-1) as an example of such a compound. NLA-1
      binds reversibly to DNA with an affinity similar to 9-aminoacridine, and is
      approximately 1000 times more potent than MISO as a cytotoxin, despite a similar
      reduction potential. It shows less enhancement of cytotoxicity under hypoxia (5-
      to 6-fold) than does MISO (approximately 11-fold), but is a potent hypoxia
      selective radiosensitizer in AA8 cells with a concentration for an enhancement
      ratio of 1.6 (C1.6) of 9 microM. The mean intracellular concentration at the C1.6
      is 400 microM, on which basis its potency is about twice that of MISO. The in
      vitro therapeutic index (aerobic cytotoxic potency/hypoxic C1.6) of NLA-1 is
      approximately 6-fold lower than that for MISO. NLA-1 lacks radiosensitizing
      activity against SCCVII or EMT6 tumors in vivo at the maximum tolerated dose
      (MTD) of 100 mumol.kg-1.

PMID- 1735696
TI  - Radiosensitizing, toxicological, and pharmacokinetic properties of hydroxamate
      analogues of nitroimidazoles as bifunctional radiosensitizers/chemical modifiers.
AB  - We examined the pharmacokinetics of KIH-802, potassium 2-nitroimidazole-1
      acetohydroxamate, using its radioisotope-labelled compound and the acute toxicity
      in mice. We discovered that the concentration of KIH-802 was very low in the
      brain and its LD50 was nearly half the value of that of MISO. We also present
      here new 2-nitroimidazole radiosensitizers/chemical modifiers (KIN-804, 811, 831,
      841, 844, 821, 823 and 824) designed to enhance their sensitizing ability
      intensely by substituting various biologically active groups, such as hydroxamic
      acids and oximes, with moderate lipophilicity to the aromatic ring, if necessary,
      through some spacers. The sensitizing effects of all compounds were estimated to
      be almost equal to or better than that of MISO. The results of their toxicities
      shows that new hydroxamates KIN-804 and 831 are less toxic than KIH-802 and MISO.
      Their in vitro enhancement ratios are 2.00 and 1.75, respectively, compared with
      those of KIH-802, MISO and SR-2508, 1.77, 1.72 and 1.72, respectively, at each
      dose of 1 mM for EMT6/KU single cell. We concluded that they may be superior
      radiosensitizers of hydroxamic acid analogues to KIH-802.

PMID- 1735697
TI  - Intratumoral and parametrial infusion of a 3-nitrotriazole (AK-2123) in the
      radiotherapy of the uterine cervix cancer: stage II-III--preliminary positive
      results.
AB  - Based on a clinical differential effect of the action of a new hypoxic cell
      radiosensitizer, AK-2123 (a 3-nitro-1,2,4-triazole), on locally advanced cervix
      cancer (Stage II-B and III-B), a Phase I/II clinical trial has been carried out
      on 80 consecutive patients. They were intratumorally injected with AK-2123, wt 1%
      and 2%, 30 min before the delivery of external radiation therapy. The short-term
      effects show that exophytic types of lesions respond far better than endophytic
      types and AK-2123 may be replacing intracavitary radium for exophytic Stage II-B
      cervix cancer as the standard therapy for this neoplasm in our patients.
      Treatment is well tolerated and no neurological toxicity has been noted.

PMID- 1735698
TI  - Metabolic rate modification of nitrotriazole radiosensitizers by sulfur
      substitution of side chain.
AB  - The pharmacokinetic properties and radiosensitizing activities in vitro and in
      vivo of a series of 3-nitro-1,2,4-triazole (NTA) derivatives with a -CH2(C =
      Y)NH(CH2)nZCH3 (Y, Z = O or S; n = 2 or 3) group in the side chain at N-1
      position of NTA were investigated with respect, particularly, to the effects of
      sulfur substitution in the side chain of NTA. The sulfur substitution for an
      oxygen atom in the side chain NTA radiosensitizers increased the rho value, but
      gave rise to little effect on the one-electron reduction potential. The
      derivatives bearing a thioether group (-CH2SCH3) in the side chain were slightly
      less effective both in vitro on hypoxic EMT6/KU cells and in vivo on SCCVII
      tumors than their oxygen analogs (-CH2OCH3). The thioether compounds tended to
      metabolize rapidly. The thioamide compound showed high sensitizing activity in
      vitro, but metabolized very slow.

PMID- 1735699
TI  - Fluorine modification of nitroazole radiosensitizers for the enhancement of
      sensitizing activity with lowering toxicity: a pharmacokinetic characterization.
AB  - Pharmacokinetic characterization of various nitroazole radiosensitizers was
      carried out to clarify the effect of fluorine modification of the side-chain
      groups on the sensitizing activity and the acute toxicity. The in vivo
      tumor/plasma partition coefficient (PTP) of sensitizers increased with increase
      in the octanol/water partition coefficient (Pow) up to approximately 0.3 and was
      almost unity (maximum) for sensitizers with their Pow values larger than
      approximately 0.3. This relationship was observed commonly for all types of
      sensitizers independent of the fluorine modification. The in vivo brain/plasma
      partition coefficient (PBP) of sensitizers increased with increase in the Pow,
      attaining a constant value of almost unity at Pow greater than 0.5 for non
      fluorine sensitizers or at Pow greater than 1.5 for fluorine-modified
      sensitizers. The maximum brain-affinity factor ((FB,t)max = (CB,t)max/Ds, where
      (CB,t)max and Ds are the maximum intrabrain concentration and the administered
      dose of sensitizer, respectively) was proportional to the maximum tumor-affinity
      factor ((FT,t)max = (CT,t)max/Ds, where (CT,t)max is the maximum intratumor
      concentration of sensitizer), depending on the side-chain structure of the
      sensitizer. A series of non-fluorine and fluorine-modified nitroazole
      derivatives, including N-(2'-hydroxyethyl)-2,2-difluoro-3-(3''-nitro-1'
      triazolyl)propionamide (KU-2285), gave a smaller brain to tumor ratio of
      approximately 1/7. The toxicity index defined by 1/LD50/7 was parallel to the
      sensitizing activity measured by 1/DS,1.5 (DS,1.5 is the sensitizer dose to
      obtain the SER of 1.5 in vivo). The therapeutic risk index defined by
      Ds,1.5/LD50/7 depended on the side-chain structures of sensitizers. The DB,1
      5LD50-/7 values of KU-2285 and ethanidazole (SR-2508) were 1/3 that of
      misonidazole (MISO). The sensitizers were smaller Ds,1.5/LD50/7 values showed
      higher sensitizing activities as their tumor affinities increased, without an
      increase in serious toxicity.

PMID- 1735700
TI  - Combined modality treatment with ternary Cu(II) complexes and X rays.
AB  - Ternary Cu(II) complexes with bidentate malonato- and heterocyclic amine ligands
      were tested with regard to cytotoxicity and potentiation of x-ray induced cell
      killing in V79 cells. Two lead complexes were also tested in a tumor assay using
      the MTG-B murine adenocarcinoma model growing in the flanks of female C3H/HeJ
      mice. One complex, [2,2'-bipyridyl malonatoCu(II)] (RL-5077), produced sensitizer
      enhancement ratios (SER's) of 1.8 (hypoxic conditions) and 1.0 (oxic conditions)
      in vitro when irradiation followed 1 hr exposure to the drug at 100 microM. When
      RL-5077 was administered at doses of 1/2 (11.65 mg/kg) or 1/4 (5.25 mg/kg) the
      maximum tolerated dose (MTD), 15 min prior to a locally delivered dose of 20 Gy,
      enhancement ratios (ER's) of 1.6 and 2, respectively, resulted. The second lead
      complex, [1,10 phenanthroline (malonato)Cu(II)hydrate] (RL-5027), produced SER's
      of 1.8 and 1.2 under hypoxic and oxic conditions, respectively, at a
      concentration of 25 microM. Injection of RL-5027 (5 mg/kg) resulted in toxicity
      without enhancement in combination with radiation. Analogues of these two
      complexes have been synthesized in an effort to optimize the potentiation of
      radiation effects while minimizing toxicity to drug alone and increasing water
      solubility of the drug. Further studies of the structure-activity relationship of
      Cu(II) ternary complexes using in vitro radiosensitization as the endpoint have
      identified four classes of ligands with varying biological activity and have
      supplied information about the effects of group substitution on solubility,
      toxicity, and radiation potentiation. This group of complexes represents a new
      class of radiopotentiators that deserves further investigation into its potential
      for clinical use.

PMID- 1735701
TI  - Radiation pneumotoxicity in rats: modification by inhibitors of angiotensin
      converting enzyme.
AB  - The present study determined whether inhibitors of angiotensin converting enzyme
      (ACE) can ameliorate radiation-induced pulmonary endothelial dysfunction and
      pulmonary fibrosis in rats sacrificed 2 months after a range of single doses of
      60Co gamma rays to the right hemithorax. Four indices of pulmonary endothelial
      function were monitored: right lung ACE and plasminogen activator (PLA) activity,
      and prostacyclin (PGI2) and thromboxane (TXA2) production. Hydroxyproline (HP)
      content served as an index of pulmonary fibrosis. Rats consumed either control
      powdered chow or feed containing one of five modifying agents continuously after
      irradiation. The modifiers included three ACE inhibitors: Captopril, CL242817,
      and CGS13945, respectively, a thiol, a thioacetate, and a nonthiol compound. All
      of the ACE inhibitors are analogues of proline. Two additional modifiers were
      tested: penicillamine, a thiol with no ACE inhibitory activity; and
      pentoxifylline, a vasodilator that is neither a thiol nor an ACE inhibitor.
      Radiation produced a dose-dependent decrease in lung ACE and PLA activity, and an
      increase in PGI2 and TXA2 production and in HP content. All ACE inhibitors
      attenuated the radiation-induced suppression in lung ACE and PLA activity. All
      thiol or thioacetate compounds ameliorated the radiation-induced increase in
      PGI2, TXA2, and HP. The two agents that were both thiols and ACE inhibitors
      (Captopril and CL242817) spared all of the radiation reactions, while the
      compound that was neither a thiol nor an ACE inhibitor (pentoxifylline) spared
      none of the reactions. These data suggest a novel application for ACE inhibitors
      in general, and for Captopril in particular, as modifiers of radiation
      pneumotoxicity.

PMID- 1735702
TI  - American Society of Andrology, 17th annual meeting. March 27-30, 1992, Bethesda,
      Maryland. Abstracts.

PMID- 1735703
TI  - The Clp proteins: proteolysis regulators or molecular chaperones?

PMID- 1735705
TI  - Functional analysis of the sialyltransferase complexes in Escherichia coli K1 and
      K92.
AB  - The polysialyltransferase (polyST) structural gene, neuS, for poly alpha
      2,8sialic acid (PSA) capsule synthesis in Escherichia coli K1 was previously
      mapped near the kps region 1 and 2 junction (S. M. Steenbergen and E. R. Vimr,
      Mol. Microbiol. 4:603-611, 1990). Present Southern and colony blot hybridization
      results confirmed that neuS was a region 2 locus and indicated apparent homology
      with neuS from E. coli K92, bacteria that synthesize a sialyl alpha 2,8-2,9
      linked polymer. A K1- mutant with an insertion mutation in neuS was complemented
      in trans by K92 neuS, providing direct evidence that neuS encoded the PSA
      polymerase. A 2.9-kb E. coli K1 kps subclone was sequenced to better characterize
      polyST. In addition to neuS, the results identified a new open reading frame,
      designated neuE, the linker sequence between regions 1 and 2, and the last gene
      of region 1, kpsS. The kpsS translational reading frame was confirmed by
      sequencing across the junction of a kpsS'-lacZ+ fusion. PolyST was identified by
      maxicell analysis of nested deletions and coupled in vitro transcription
      translation assays. PolyST's derived primary structure predicted a 47,500-Da
      basic polypeptide without extensive similarity to other known proteins. PolyST
      activity was increased 31-fold and was membrane localized when neuS was cloned
      into an inducible expression vector, suggesting, together with the polyST primary
      structure, that polyST is a peripheral inner membrane glycosyltransferase.
      However, polyST could not initiate de novo PSA synthesis, indicating a functional
      requirement for other kps gene products. The existence of a sialyltransferase
      distinct from polyST was suggested by identification of a potential polyprenyl
      binding motif in a C-terminal membrane-spanning domain of the predicted neuE gene
      product. Direct evidence for a quantitatively minor sialyltransferase activity,
      which could function to initiate PSA synthesis, was obtained by phenotypic
      analysis of mutants with multiple defects in sialic acid synthesis, degradation,
      and polymerization. The results provide an initial molecular description of K1
      and K92 sialyltransferase complexes and suggest a possible common function for
      accessory kps gene products.

PMID- 1735704
TI  - Mutation of the miaA gene of Agrobacterium tumefaciens results in reduced vir
      gene expression.
AB  - vir regulon expression in Agrobacterium tumefaciens involves both chromosome- and
      Ti-plasmid-encoded gene products. We have isolated and characterized a new
      chromosomal gene that when mutated results in a 2- to 10-fold reduction in the
      induced expression of vir genes by acetosyringone. This reduced expression occurs
      in AB minimal medium (pH 5.5) containing either sucrose or glucose and containing
      phosphate at high or low concentrations. The locus was cloned and used to
      complement A. tumefaciens strains harboring Tn5 insertions in the gene. Sequence
      analysis of this locus revealed an open reading frame with strong homology to the
      miaA locus of Escherichia coli and the mod5 locus of Saccharomyces cerevisiae.
      These genes encode tRNA: isopentenyltransferase enzymes responsible for the
      specific modification of the A-37 residue in UNN codon tRNA species. The function
      of the homologous gene in A. tumefaciens was proven by genetic complementation of
      E. coli miaA mutant strains. tRNA undermodification in A. tumefaciens miaA mutant
      strains may reduce vir gene expression by causing a reduced translation
      efficiency. A slight reduction in the virulence of these mutant Agrobacterium
      strains on red potato plants, but not on tobacco, tomato, kalanchoe, or sunflower
      plants, was observed.

PMID- 1735706
TI  - Role of alternative promoter elements in transcription from the nar promoter of
      Escherichia coli.
AB  - The effects of mutations in the -10, -35, and Fnr box regions of the narGHJI
      promoter of Escherichia coli were determined by assaying the expression of beta
      galactosidase from narG::lacZ fusion plasmids under aerobic and anaerobic
      conditions. A 1-base change in the -10 hexamer completely abolished expression,
      whereas a 3-base change to create the consensus TATAAT resulted in significant
      aerobic as well as anaerobic expression. A mutation in the putative -35 hexamer
      did not affect anaerobic expression but reduced aerobic expression from the
      construction with the -10 consensus sequence. A mutation in the Fnr box severely
      reduced anaerobic expression but did not affect aerobic expression. When the
      complete 5' region of the nar operon including the NarL box was present, nitrate
      stimulated both aerobic and anaerobic expression. Stimulation of expression by
      nitrate occurred in an fnr mutant but not in a narL mutant. We conclude that the
      rate of transcription of the nar operon is dependent on two distinct modes of
      transcription. One mode, which occurs at low levels, depends on the -10 and -35
      hexamer sequences and is dramatically enhanced by changing the -10 sequence to
      the consensus TATAAT. The second depends on the -10 and Fnr box sequences but is
      independent of the -35 sequence. This second mode occurs at a very high level
      under anaerobic conditions when Fnr is activated and is also enhanced by changing
      the -10 sequence to the consensus TATAAT. NarL, activated by nitrate, stimulated
      both modes of transcription, indicating that it does not act through Fnr but that
      it directly affects the interaction of RNA polymerase with the promoter.

PMID- 1735707
TI  - A self-transmissible, narrow-host-range endogenous plasmid of Rhodobacter
      sphaeroides 2.4.1: physical structure, incompatibility determinants, origin of
      replication, and transfer functions.
AB  - Rhodobacter sphaeroides 2.4.1 naturally harbors five cryptic endogenous plasmids
      (C. S. Fornari, M. Watkins, and S. Kaplan, Plasmid 11:39-47, 1984). The smallest
      plasmid (pRS241e), with a molecular size of 42 kb, was observed to be a self
      transmissible plasmid which can transfer only to certain strains of R.
      sphaeroides. Transfer frequencies can be as high as 10(-2) to 10(-3) per donor
      under optimal mating conditions in liquid media in the absence of oxygen.
      pRS241e, designated the S factor, was also shown to possess a narrow host range,
      failing either to replicate or to be maintained in Escherichia coli,
      Agrobacterium tumefaciens, and Rhizobium meliloti. It was further revealed that
      one of the remaining four endogenous plasmids, pRS241d, was also transmissible at
      a frequency similar to that of the S. factor. As a cointegrate with pSUP203, S
      was maintained in E. coli, providing sufficient DNA from which a physical map of
      S could be constructed. Progressive subcloning of S-factor DNA, in conjunction
      with assays of plasmid transfer, led to the localization and identification of
      oriV (IncA), IncB, and the putative oriT locus. The DNA sequence of the 427 bp
      containing oriTs revealed topological similarity to other described oriT
      sequences, consisting of an A-T-rich DNA region, several direct and inverted
      repeats, and putative integration host factor (IHF)-binding sites, and was shown
      to be functional in promoting plasmid transfer.

PMID- 1735708
TI  - Chromosome transfer in Rhodobacter sphaeroides: Hfr formation and genetic
      evidence for two unique circular chromosomes.
AB  - A 600-bp oriT-containing DNA fragment from the Rhodobacter sphaeroides 2.4.1 S
      factor (oriTs) (A. Suwanto and S. Kaplan, J. Bacteriol. 174:1124-1134, 1992) was
      shown to promote polarized chromosomal transfer when provided in cis. A Kmr-oriTs
      sacR-sacB (KTS) DNA cassette was constructed by inserting oriTs-sacR-sacB into a
      pUTmini-Tn5 Km1 derivative. With this delivery system, KTS appeared to be
      randomly inserted into the genome of R. sphaeroides, generating mutant strains
      which also gained the ability to act as Hfr donors. An AseI site in the Kmr
      cartridge (from Tn903) and DraI and SnaBI sites in sacR-sacB (the levansucrase
      gene from Bacillus subtilis) were employed to localize the KTS insertion
      definitively by pulsed-field gel electrophoresis. The orientation of oriTs at the
      site of insertion was determined by Southern hybridization analysis. Interrupted
      mating experiments performed with some of the Hfr strains exhibited a gradient of
      marker transfer and further provided genetic evidence for the circularity and
      presence of two chromosomal linkage groups in this bacterium. The genetic and
      environmental conditions for optimized mating between R. sphaeroides strains were
      also defined. The results presented here and our physical map of the R.
      sphaeroides 2.4.1 genome are discussed in light of the presence of two
      chromosomes.

PMID- 1735709
TI  - cis-acting regulatory elements involved in oxygen and light control of puc operon
      transcription in Rhodobacter sphaeroides.
AB  - Transcriptional expression of the puc operon in Rhodobacter sphaeroides is highly
      regulated by both oxygen and light. The approximately 600 bp of DNA upstream of
      the 5' ends of the two puc-specific transcripts encompasses two functionally
      separable cis-acting domains. The upstream regulatory region (URS) (-629 to -150)
      is responsible for enhanced transcriptional regulation of puc operon expression
      by oxygen and light. The more proximal upstream region (downstream regulatory
      region [DRS]), containing putative promoter(s), operator(s), and factor binding
      sites (-150 to -1), is involved in unenhanced transcriptional expression of the
      puc operon under aerobic and anaerobic conditions. Thus, the DRS shows normal
      derepression of puc operon expression when cells are shifted from aerobic to
      photosynthetic growth conditions in terms of percent change but does not show the
      potential range of expression that is only observed when elements of the URS are
      present. Because of these observations, we have made a distinction between
      anaerobic control (describing the shift) and oxygen control (describing the
      magnitude of derepression). Promoter(s) and/or activator function(s) of the puc
      operon is associated with a 35-bp DNA region between -92 and -57. Homologous
      sequences at -10 to -27 and -35 to -52 appear to involve additional regulatory
      elements: mutations at -12 (A to C) and -26 (G to A) result in partial
      derepression of puc operon expression under conditions of high aeration. Both
      point mutations require the upstream regulatory region (-629 to -150) to be
      present in cis for partial derepression of puc operon transcription under aerobic
      conditions. Immediately upstream of the promoter and/or activator region are
      overlapping consensus sequences for IHF (integratin host factor) and FNR
      (fumarate nitrate reductase) (-105 to -129). This region appears to be essential
      for enhanced expression of the puc operon. Thus, these two regulatory domains
      (URS and DRS) appear to involve approximately seven unique regulatory elements.
      In addition, the data reveal a direct interaction between the URS (-629 to -150)
      and the DRS (-150 to -1).

PMID- 1735710
TI  - Isolation and characterization of trans-acting mutations involved in oxygen
      regulation of puc operon transcription in Rhodobacter sphaeroides.
AB  - Transcriptional expression of the puc operon in Rhodobacter sphaeroides 2.4.1 is
      dependent on the partial pressure of oxygen. By using transcriptional fusions in
      trans of a promoterless fragment derived from the aminoglycoside-3'
      phosphotransferase gene of Tn903 to puc operon-specific DNA containing a 629-bp
      5' cis-acting regulatory region involved in the expression of puc-specific mRNA,
      we selected Kmr colonies under aerobic conditions. Two broad classes of
      mutations, trans and cis, which are involved in O2 control of puc operon
      transcription, fall into several distinct phenotypic classes. The cis-acting
      regulatory mutations are characterized in detail elsewhere (J.K. Lee and S.
      Kaplan, J. Bacteriol. 174:1146-1157, 1992). Two trans-acting regulatory mutants,
      CL1a and T1a, which are B800-850- Car- and apparently B875-, respectively, were
      shown to derepress puc operon transcription in the presence of oxygen. The
      mutation giving rise to CL1a has been shown to act at the puc operon-specific cis
      acting upstream regulatory region (-629 to -92). On the other hand, the mutation
      giving rise to T1a, identifying a second trans-acting regulatory factor(s),
      appears to act at both the upstream (-629 to -92) and the downstream (-92 to -1)
      regulatory regions of the puc operon as well as at the level(s) of
      bacteriochlorophyll and carotenoid biosyntheses, as revealed by the presence of
      the B800-850 complex under chemoheterotrophic growth conditions. Both the B800
      850- Car- phenotype and the trans-acting effect on puc operon expression in
      mutant CL1a were complemented with a 2.2-kb DNA fragment located within the
      carotenoid gene cluster. Mutant T1a was complemented with a 7.0-kb EcoRI
      restriction fragment containing the puhA gene and its flanking DNA (6.3 kb) to
      restore expression of the B875 complex and to suppress the trans-acting effect
      resulting in the loss of 02 control. Under chemoheterotrophic conditions, mutant
      T1a was highly unstable, segregating into a PS- mutant designated T4.

PMID- 1735711
TI  - Purification and characterization of a two-component monooxygenase that
      hydroxylates nitrilotriacetate from "Chelatobacter" strain ATCC 29600.
AB  - An assay based on the consumption of nitrilotriacetate (NTA) was developed to
      measure the activity of NTA monooxygenase (NTA-Mo) in cell extracts of
      "Chelatobacter" strain ATCC 29600 and to purify a functional, NTA-hydroxylating
      enzyme complex. The complex consisted of two components that easily dissociated
      during purification and upon dilution. Both components were purified to more than
      95% homogeneity, and it was possible to reconstitute the functional, NTA
      hydroxylating enzyme complex from pure component A (cA) and component B (cB). cB
      exhibited NTA-stimulated NADH oxidation but was unable to hydroxylate NTA. It had
      a native molecular mass of 88 kDa and contained flavin mononucleotide (FMN). cA
      had a native molecular mass of 99 kDa. No catalytic activity has yet been shown
      for cA alone. Under unfavorable conditions, NADH oxidation was partly or
      completely uncoupled from hydroxylation, resulting in the formation of H2O2.
      Optimum hydroxylating activity was found to be dependent on the molar ratio of
      the two components, the absolute concentration of the enzyme complex, and the
      presence of FMN. Uncoupling of the reaction was favored in the presence of high
      salt concentrations and in the presence of flavin adenine dinucleotide. The NTA
      Mo complex was sensitive to sulfhydryl reagents, but inhibition was reversible by
      addition of excess dithiothreitol. The Km values for Mg(2+)-NTA, FMN, and NADH
      were determined as 0.5 mM, 1.3 microM, and 0.35 mM, respectively. Of 26 tested
      compounds, NTA was the only substrate for NTA-Mo.

PMID- 1735712
TI  - The Agrobacterium tumefaciens vir gene transcriptional activator virG is
      transcriptionally induced by acid pH and other stress stimuli.
AB  - A set of Agrobacterium tumefaciens operons required for pathogenesis is
      coordinately induced during plant infection by the VirA and VirG proteins. The
      intracellular concentration of VirG increases in response to acidic media, and
      this response was proposed to be regulated at the level of transcription at a
      promoter (P2) that resembles the Escherichia coli heat shock promoters. To test
      this hypothesis, we first constructed a virG-lacZ transcriptional fusion. A
      strain containing this fusion had higher levels of beta-galactosidase activity in
      acidic media than in media at neutral pH. Second, primer extension analysis of
      virG indicated that acidic media stimulated the transcription of this promoter.
      To determine whether P2 is a member of a heat shock-like regulon in A.
      tumefaciens, five agents that induce E. coli heat shock genes were tested for
      their abilities to induce a P2-lacZ fusion in A. tumefaciens. P2 was most
      strongly induced by low pH, was moderately stimulated by CdCl2 or mitomycin C,
      and was slightly induced by P2 as measured by beta-galactosidase activity and
      primer extension analysis. Induction by these treatments did not require any Ti
      plasmid-encoded function or the chromosomally encoded RecA protein. We also pulse
      labeled cellular proteins after a shift to low pH and detected several proteins
      whose synthesis was induced by these conditions. We conclude that P2 is primarily
      induced by acid pH and secondarily by certain other stimuli, each of which is
      stressful to cell growth. This stress induction is at least partly independent of
      the heat shock and SOS responses.

PMID- 1735713
TI  - Restriction endonuclease mapping of the HI2 incompatibility group plasmid R478.
AB  - A restriction map of the 272-kb IncHI2 plasmid R478 was constructed by using the
      enzymes ApaI, XbaI, SalI, and XhoI. The map was derived from cloned restriction
      fragments from R478 inserted into cosmid and plasmid vectors as well as from
      double-digestion analysis of R478 and R478 miniplasmids. All previously known
      resistance determinants were cloned from R478, and their positions were located
      on the restriction map. A region involved in incompatibility was cloned and
      mapped. The location of a previously unreported arsenite resistance gene was also
      determined. The genes encoding tellurite resistance, colicin B resistance, and
      phage inhibition were found to be associated with a 6.7-kb SalI fragment of R478.

PMID- 1735714
TI  - Cloning and sequence analysis of the Chlamydia trachomatis spc ribosomal protein
      gene cluster.
AB  - We identified and sequenced a segment of Chlamydia trachomatis chromosomal DNA
      that shows homology to the Escherichia coli spc and distal region of the S10
      ribosomal protein (r-protein) operons. Its sequence revealed a high degree of
      nucleotide and operon context conservation with the E. coli r-protein genes. The
      C. trachomatis spec operon contains the r-protein genes for L14, L24, L5, S8, L6,
      L18, S5, L15, and Sec Y along with the genes for r-proteins L16, L29, and S17 of
      the S10 operon. The two operons are separated by a 16-bp intragenic region which
      contains no transcription signals. However, a putative promoter for the
      transcription of the spc operon was found 162 nucleotides upstream of the CtrL14e
      start site; it revealed significant homology to the E. coli consensus promoter
      sequences. Interestingly, our results indicate the absence of any structure
      resembling an EcoS8 regulatory target site on C. trachomatis spc mRNA in spite of
      significant amino acid identity between E. coli and C. trachomatis r-proteins.
      Also, the intrinsic aminoglycoside resistance in C. trachomatis is unlikely to be
      mediated by CtrL6e since E. coli expressing CtrL6e remained susceptible to
      gentamicin (MIC less than 0.5 micrograms/ml).

PMID- 1735715
TI  - Mutagenesis of ribosomal protein S8 from Escherichia coli: defects in regulation
      of the spc operon.
AB  - The structural features of Escherichia coli ribosomal protein S8 that are
      involved in translational regulation of spc operon expression and, therefore, in
      its interaction with RNA have been investigated by use of a genetic approach. The
      rpsH gene, which encodes protein S8, was first inserted into an expression vector
      under the control of the lac promoter and subsequently mutagenized with
      methoxylamine or nitrous acid. A screening procedure based on the regulatory role
      of S8 was used to identify mutants that were potentially defective in their
      ability to associate with spc operon mRNA and, by inference, 16S mRNA. In this
      way, we isolated 39 variants of the S8 gene containing alterations at 34
      different sites, including 37 that led to single amino acid substitutions and 2
      that generated premature termination codons. As the mutations were distributed
      throughout the polypeptide chain, our results indicate that amino acid residues
      important for the structural integrity of the RNA-binding domain are not
      localized to a single segment. Nonetheless, the majority were located within
      three short sequences at the N terminus, middle, and C terminus that are
      phylogenetically conserved among all known eubacterial and chloroplast versions
      of this protein. We conclude that these sites encompass the main structural
      determinants required for the interaction of protein S8 with RNA.

PMID- 1735716
TI  - Reattachment of surface array proteins to Campylobacter fetus cells.
AB  - Campylobacter fetus strains may be of serotype A or B, a property associated with
      lipopolysaccharide (LPS) structure. Wild-type C. fetus strains contain surface
      array proteins (S-layer proteins) that may be extracted in water and that are
      critical for virulence. To explore the relationship of S-layer proteins to other
      surface components, we reattached S-layer proteins onto S- template cells
      generated by spontaneous mutation or by serial extractions of S+ cells with
      water. Reattachment occurred in the presence of divalent (Ba2+, Ca2+, Co2+, and
      Mg2+) but not monovalent (H+, NH4+, Na+, K+) or trivalent (Fe3+) cations. The 98
      , 125-, 127-, and 149-kDa S-layer proteins isolated from strains containing type
      A LPS (type A S-layer protein) all reattached to S- template cells containing
      type A LPS (type A cells) but not to type B cells. The 98-kDa type B S-layer
      protein reattached to SAP- type B cells but not to type A cells. Recombinant 98
      kDa type A S-layer protein and its truncated amino-terminal 65- and 50-kDa
      segments expressed in Escherichia coli retained the full and specific
      determinants for attachment. S-layer protein and purified homologous but not
      heterologous LPS in the presence of calcium produced insoluble complexes. By
      quantitative enzyme-linked immunosorbent assay, the S-layer protein copy number
      per C. fetus cell was determined to be approximately 10(5). In conclusion, C.
      fetus cells are encapsulated by a large number of S-layer protein molecules which
      may be specifically attached through the N-terminal half of the molecule to LPS
      in the presence of divalent cations.

PMID- 1735717
TI  - DNA sequences and characterization of dtxR alleles from Corynebacterium
      diphtheriae PW8(-), 1030(-), and C7hm723(-).
AB  - The structural gene encoding DtxR, an iron-dependent diphtheria tox regulatory
      element, has recently been cloned and sequenced from the C7(-) strain of
      Corynebacterium diphtheriae (J. M. Boyd, M. Oza, and J. R. Murphy, Proc. Natl.
      Acad. Sci. USA 87:5972, 1990). We report here the molecular cloning, DNA sequence
      analysis, and characterization of DtxR from the PW8(-), 1030(-), and C7hm723
      strains of C. diphtheriae. While the sequence of dtxR from PW8(-) is identical to
      that of the C7(-) allele, the sequence of dtxR from the 1030(-) strain is only
      91.4% identical; however, the deduced amino acid sequence of DtxR from 1030(-)
      differs by only 6 of 678 amino acids. Moreover, DtxR from all three strains is
      shown to regulate expression of beta-galactosidase from a tox promoter-operator
      (toxPO)-lacZ transcriptional fusion. In contrast, the dtxR allele from the iron
      insensitive tox constitutive mutant C7hm723 was found to have a single G----A
      transition, resulting in a substitution of Arg-47 to His and the loss of tox
      regulatory activity in recombinant Escherichia coli.

PMID- 1735718
TI  - Mutual adjustment of glucose uptake and metabolism in Trypanosoma brucei grown in
      a chemostat.
AB  - The mutual adjustment of glucose uptake and metabolism in the insect stage of the
      protozoan parasite Trypanosoma brucei was studied. T. brucei was preadapted in
      the chemostat to conditions in which either glucose or proline served as the
      major carbon and energy source. Cells were grown and adapted to either energy or
      non-energy limitation at a low dilution rate (0.5 day-1) or a high dilution rate
      (1 day-1). The cells were then used in short- to medium-term uptake experiments
      with D-[14C]glucose as a tracer. In time course experiments a steady state was
      reached after 15 min regardless of the preadaptation conditions. This steady
      state level increased with increasing glucose availability during preadaptation.
      The rate of glucose uptake and the hexokinase activity were linearly correlated.
      In short-term 5- to 90-s) uptake experiments a high transport rate was measured
      with cultures grown in excess glucose, an intermediate rate was measured with
      proline-grown cultures, and a low rate was measured in organisms grown under
      glucose limitation. Glucose metabolism and proline metabolism did not affect each
      other during the 15-min incubations. Glucose uptake, as a function of the
      external glucose concentration, did not obey simple Michaelis-Menten kinetics but
      could be described by a two-step mechanism: (i) transport of glucose by
      facilitated diffusion and (ii) subsequent metabolism of glucose. The respective
      rates of the two steps were adjusted to each other. It is concluded that T.
      brucei is capable of adjusting the different metabolic processes in a way that
      gives maximum energy efficiency at the cost of short-term flexibility.

PMID- 1735719
TI  - Expression of bacterial mercuric ion reductase in Saccharomyces cerevisiae.
AB  - The gene merA coding for bacterial mercuric ion reductase was cloned under the
      control of the yeast promoter for alcohol dehydrogenase I in the yeast
      Escherichia coli shuttle plasmid pADH040-2 and transformed into Saccharomyces
      cerevisiae AH22. The resulting transformant harbored stable copies of the merA
      containing hybrid plasmid, displayed a fivefold increase in the MIC of mercuric
      chloride, and synthesized mercuric ion reductase activity.

PMID- 1735720
TI  - Transcriptional activation of the Listeria monocytogenes hemolysin gene in
      Bacillus subtilis.
AB  - The prfA gene of Listeria monocytogenes was recently reported to be required for
      expression of hly, which encodes a pore-forming hemolysin essential for
      pathogenicity (M. Leimeister-Wachter, C. Haffner, E. Domann, W. Goebel, and T.
      Chakraborty, Proc. Natl. Acad. Sci. USA 87:8336-8340, 1990). We demonstrate here
      that a hly-lacZ fusion introduced into Bacillus subtilis is strongly activated
      when the prfA gene product is supplied in trans under the control of an isopropyl
      beta-D-thiogalactopyranoside-inducible promoter, Pspac. Moreover, the PrfA
      dependent activation of hly is abolished by point mutations in a 14-bp DNA
      palindromic sequence present in the 5' upstream region of hly. This indicates
      that PrfA is both necessary and sufficient for hly transcriptional activation and
      establishes the palindrome as the likely target sequence for PrfA interaction.
      The presence of a palindrome in the upstream regions of three additional L.
      monocytogenes genes clustered near hly suggests that PrfA may serve as a
      transcriptional activator for a major virulence regulon of L. monocytogenes. In
      addition, the ability of PrfA to activate its target promoters effectively in B.
      subtilis suggests that further analysis of this regulon and perhaps other aspects
      of L. monocytogenes gene regulation might be carried out in part through
      reconstruction experiments in B. subtilis.

PMID- 1735721
TI  - Analysis of the Bacillus subtilis tyrS gene: conservation of a regulatory
      sequence in multiple tRNA synthetase genes.
AB  - The Bacillus subtilis tyrS gene, which encodes tyrosyl-tRNA synthetase (TyrTS),
      was isolated, and its nucleotide sequence was determined. The cloned gene was
      shown to complement an Escherichia coli tyrS (Ts) mutant. The predicted amino
      acid sequence exhibited 70% identity to that of Bacillus stearothermophilus TyrTS
      and 55% identity to that of E. coli TyrTS, while identity to a second cryptic B.
      subtilis TyrTS gene, designated tyrZ, was only 27%. Primer extension analysis
      indicated that tyrS transcription initiated at a vegetative promoter sequence
      located 300 nucleotides upstream of the AUG start codon. The mRNA leader region
      was found to contain an inverted repeat sequence resembling a transcriptional
      terminator. Expression of a transcriptional tyrS-lacZ fusion was found to be
      induced by starvation for tyrosine in a tyrosine auxotroph (tyrA1). Transcription
      initiation was unaffected by tyrosine starvation. Deletion of the terminator
      region in a tyrS-lacZ fusion resulted in high-level constitutive expression.
      Immediately preceding the putative terminator was sequence element found to be
      conserved in the upstream region of a number of Bacillus tRNA synthetase genes as
      well as in the ilv-leu biosynthetic operon; mutation of this element in tyrS
      resulted in low-level uninducible expression. The conservation of this sequence
      element suggests that aminoacyl-tRNA synthetase genes and the ilv-leu operon may
      be regulated by a common mechanism in Bacillus spp.

PMID- 1735722
TI  - Malate dehydrogenase from Chlorobium vibrioforme, Chlorobium tepidum, and
      Heliobacterium gestii: purification, characterization, and investigation of
      dinucleotide binding by dehydrogenases by use of empirical methods of protein
      sequence analysis.
AB  - Malate dehydrogenase (MDH; EC 1.1.1.37) from strain NCIB 8327 of the green sulfur
      bacterium Chlorobium vibrioforme was purified to homogeneity by triazine dye
      affinity chromatography followed by gel filtration. Purification of MDH gave an
      approximately 1,000-fold increase in specific activity and recoveries of
      typically 15 to 20%. The criteria of purity were single bands on sodium dodecyl
      sulfate (SDS) and nondenaturing polyacrylamide electrophoresis (PAGE) and the
      detection of a single N terminus in an Edman degradation analysis. MDH activity
      was detected in purified preparations by activity staining of gels in the
      direction of malate oxidation. PAGE and gel filtration (Sephadex G-100) analyses
      showed the native enzyme to be a dimer composed of identical subunits both at
      room temperature and at 4 degrees C. The molecular weight of the native enzyme as
      estimated by gel filtration was 77,000 and by gradient PAGE was 74,000. The
      subunit molecular weight as estimated by SDS-gradient PAGE was 37,500. N-terminal
      sequences of MDHs from C. vibrioforme, Chlorobium tepidum, and Heliobacterium
      gestii are presented. There are obvious key sequence similarities in MDHs from
      the phototrophic green bacteria. The sequences presented probably possess a
      stretch of amino acids involved in dinucleotide binding which is similar to that
      of Chloroflexus aurantiacus MDH and other classes of dehydrogenase enzymes but
      unique among MDHs.

PMID- 1735723
TI  - Role of the two-component leader sequence and mature amino acid sequences in
      extracellular export of endoglucanase EGL from Pseudomonas solanacearum.
AB  - The egl gene of Pseudomonas solanacearum encodes a 43-kDa extracellular
      endoglucanase (mEGL) involved in wilt disease caused by this phytopathogen. Egl
      is initially translated with a 45-residue, two-part leader sequence. The first 19
      residues are apparently removed by signal peptidase II during export of Egl
      across the inner membrane (IM); the remaining residues of the leader sequence
      (modified with palmitate) are removed during export across the outer membrane
      (OM). Localization of Egl-PhoA fusion proteins showed that the first 26 residues
      of the Egl leader sequence are required and sufficient to direct lipid
      modification, processing, and export of Egl or PhoA across the IM but not the OM.
      Fusions of the complete 45-residue leader sequence or of the leader and
      increasing portions of mEgl sequences to PhoA did not cause its export across the
      OM. In-frame deletion of portions of mEGL-coding sequences blocked export of the
      truncated polypeptides across the OM without affecting export across the IM.
      These results indicate that the first part of the leader sequence functions
      independently to direct export of Egl across the IM while the second part and
      sequences and structures in mEGL are involved in export across the OM. Computer
      analysis of the mEgl amino acid sequence obtained from its nucleotide sequence
      identified a region of mEGL similar in amino acid sequence to regions in other
      prokaryotic endoglucanases.

PMID- 1735724
TI  - Compositional analysis of Helicobacter pylori rough-form lipopolysaccharides.
AB  - Sodium dodecyl sulfate-polyacrylamide gel electrophoresis was used to analyze the
      macromolecular heterogeneity of lipopolysaccharides (LPS) from seven fresh
      clinical isolates and three culture collection strains of the human pathogen
      Helicobacter pylori. All the clinical isolates produced smooth-form LPS with O
      side chains of relatively homogeneous chain length, whereas the culture
      collection strains yielded rough-form LPS. A better yield of the latter LPS was
      obtained when combined protease pretreatment and hot phenol-water extraction were
      used than when the conventional phenol-water technique alone was used for
      extraction. The LPS of the three culture collection strains (S-24, C-5437, and
      NCTC 11637) were chemically characterized. Constituents common to all the LPS
      were fucose, D-mannose, D-glucose, D-galactose, D-glycero-D-manno-heptose, L
      glycero-D-manno-heptose, and 3-deoxy-D-manno-2-octulosonic acid. The molar ratios
      of the hexoses differed between different strains, thereby reflecting structural
      differences. Phosphate, phosphorylethanolamine, and pyrophosphorylethanolamine
      were present also. Free lipid A contained D-glucosamine and fatty acids, with
      phosphate and a minor amount of ethanolamine. The major fatty acids were ester-
      and amide-bound 3-hydroxyoctadecanoic acid and ester-bound octadecanioc and 3
      hydroxyhexadecanoic acids, with minor amounts of ester-bound tetradecanoic and
      hexadecanoic acids. In addition to the uncommonly long 3-hydroxy fatty acids, an
      unusual phosphorylation pattern was deduced to be present in the lipid A.

PMID- 1735725
TI  - Identification and analysis of the genes coding for the putative pyruvate
      dehydrogenase enzyme complex in Acholeplasma laidlawii.
AB  - A monospecific antibody recognizing two membrane proteins in Acholeplasma
      laidlawii identified a plasmid clone from a genomic library. The nucleotide
      sequence of the 4.6-kbp insert contained four sequential genes coding for
      proteins of 39 kDa (E1 alpha, N terminus not cloned), 36 kDa (E1 beta), 57 kDa
      (E2), and 36 kDa (E3; C terminus not cloned). The N termini of the cloned E2, E1
      beta, and native A. laidlawii E2 proteins were verified by amino acid sequencing.
      Computer-aided searches showed that the translated DNA sequences were homologous
      to the four subenzymes of the pyruvate dehydrogenase complexes from gram-positive
      bacteria and humans. The plasmid-encoded 57-kDa (E2) protein was recognized by
      antibodies against the E2 subenzymes of the pyruvate and oxoglutarate
      dehydrogenase complexes from Bacillus subtilis. A substantial fraction of the E2
      protein as well as part of the pyruvate dehydrogenase enzymatic activity was
      associated with the cytoplasmic membrane in A. laidlawii. In vivo complementation
      with three different Escherichia coli pyruvate dehydrogenase-defective mutants
      showed that the four plasmid-encoded proteins were able to restore pyruvate
      dehydrogenase enzyme activity in E. coli. Since A. laidlawii lacks oxoglutarate
      dehydrogenase and most likely branched-chain dehydrogenase enzyme complex
      activities, these results strongly suggest that the sequenced genes code for the
      pyruvate dehydrogenase complex.

PMID- 1735726
TI  - Cloning and sequencing of the gene coding for alcohol dehydrogenase of Bacillus
      stearothermophilus and rational shift of the optimum pH.
AB  - Using Bacillus subtilis as a host and pTB524 as a vector plasmid, we cloned the
      thermostable alcohol dehydrogenase (ADH-T) gene (adhT) from Bacillus
      stearothermophilus NCA1503 and determined its nucleotide sequence. The deduced
      amino acid sequence (337 amino acids) was compared with the sequences of ADHs
      from four different origins. The amino acid residues responsible for the
      catalytic activity of horse liver ADH had been clarified on the basis of three
      dimensional structure. Since those catalytic amino acid residues were fairly
      conserved in ADH-T and other ADHs, ADH-T was inferred to have basically the same
      proton release system as horse liver ADH. The putative proton release system of
      ADH-T was elucidated by introducing point mutations at the catalytic amino acid
      residues, Cys-38 (cysteine at position 38), Thr-40, and His-43, with site
      directed mutagenesis. The mutant enzyme Thr-40-Ser (Thr-40 was replaced by
      serine) showed a little lower level of activity than wild-type ADH-T did. The
      result indicates that the OH group of serine instead of threonine can also be
      used for the catalytic activity. To change the pKa value of the putative system,
      His-43 was replaced by the more basic amino acid arginine. As a result, the
      optimum pH of the mutant enzyme His-43-Arg was shifted from 7.8 (wild-type
      enzyme) to 9.0. His-43-Arg exhibited a higher level of activity than wild-type
      enzyme at the optimum pH.

PMID- 1735727
TI  - Characterization and comparison of Clostridium cellulovorans endoglucanases
      xylanases EngB and EngD hyperexpressed in Escherichia coli.
AB  - By the use of a T7 expression system, endoglucanases-xylanases EngB and EngD from
      Clostridium cellulovorans were hyperexpressed and purified from Escherichia coli.
      The two enzymes demonstrated both endoglucanase and xylanase activities. The
      substrate specificities of both endoglucanases were similar except that EngD had
      four-times-greater p-nitrophenyl beta-1,4-cellobiosidase activity. The two
      proteins were very homologous (80%) up to the Pro-Thr-Thr region which divided
      the protein into -NH2- and -COOH-terminals. The -COOH- region of EngB has high
      homology to the endoglucanases and a xylanase from Clostridium thermocellum and
      to an endoglucanase from Clostridium cellulolyticum and did not show strong
      binding to cellulose (Avicel). However, the -COOH- region of EngD, which had
      homology to the cellulose-binding domains of Cellulomonas fimi exo- and
      endoglucanases and to Pseudomonas fluorescens endoglucanase, demonstrated binding
      ability to cellulose even when the domain was fused to the N-terminal domain of
      EngB. By probing the Avicel-purified cellulase complex (F8) with anti-EngB and
      anti-EngD antibodies, both EngB and EngD were shown to be present on the
      cellulase complex of C. cellulovorans. Many proteins homologous to EngB and EngD
      were also present on the complex.

PMID- 1735728
TI  - The subtilin gene of Bacillus subtilis ATCC 6633 is encoded in an operon that
      contains a homolog of the hemolysin B transport protein.
AB  - Sequence analysis upstream from the subtilin structural gene (spaS) in Bacillus
      subtilis ATCC 6633 revealed several open reading frames, SpaB, SpaC, and SpaD.
      SpaB, consisting of 599 amino acid residues, shows excellent homology with a
      variety of membrane translocator proteins, such as HlyB from Escherichia coli and
      some mammalian multidrug resistance proteins. When the spaB gene was interrupted
      by integration of a chloramphenicol acetyltransferase gene, the ability of the
      cell to produce subtilin, as determined by a halo assay, was lost. The homology
      of SpaB to translocator proteins, including transmembrane and ATP-binding
      regions, suggests that SpaB may play a role in subtilin secretion. The SpaB open
      reading frame overlaps with another open reading frame called SpaC, and the
      possibility that the SpaB and SpaC proteins become fused by frameshifting is
      considered. Regions of homology between SpaD (177 residues) and HlyD were also
      found, suggesting that SpaD may participate with SpaB in translocation of
      subtilin through the membrane. Although no readily interpretable homologies to
      SpaC (442 residues) were found, its sequence suggests that it is membrane
      associated. The absence of rho-independent transcription terminators between
      these open reading frames suggests that they are all part of the same operon.

PMID- 1735729
TI  - Design of temperature-sensitive penicillinase repressors by replacement of Pro in
      predicted beta-turn structures.
AB  - Pro residues in predicted beta-turn structures were substituted with other amino
      acids to obtain temperature-sensitive penicillinase repressors (PenI). A mutant
      repressor (P70L; Pro-70 is substituted with Leu) was inactive at 48 degrees C and
      penP gene expression was derepressed (1,200 U/OD660 [optical density at 660 nm]
      ), although the mutant was still active at 30 degrees C (27 U). The heat
      induction ratio (penicillinase activity at 48 degrees C compared with that at 30
      degrees C) of the mutant was 98 times higher than that of the wild type (i.e., 44
      versus 0.45). This result indicated that the side chain of the Leu residue in
      P70L destroyed the proper folding of the repressor protein at the elevated
      temperature, whereas the Pro residue of the wild-type repressor stabilized this
      predicted beta-turn structure even at 48 degrees C. When the Pro residue was
      replaced by amino acid residues with smaller side chains (i.e., Gly and Ala),
      these mutant repressors were less temperature sensitive than P70L. These data
      suggest that the presence of the Pro residue in the beta-turn structure could be
      one of the key factors in stabilizing protein structure at elevated temperatures.

PMID- 1735730
TI  - The central domain of Rhizobium leguminosarum DctD functions independently to
      activate transcription.
AB  - Sigma 54-dependent transcriptional activators such as Escherichia coli NtrC,
      Rhizobium meliloti NifA, and Rhizobium leguminosarum DctD share similar central
      and carboxy-terminal domains but differ in the structure and function of their
      amino-terminal domains. We have deleted the amino-terminal and carboxy-terminal
      domains of R. leguminosarum DctD and have demonstrated that the central domain of
      DctD, like that of NifA, is transcriptionally competent.

PMID- 1735731
TI  - Expression of the proliferation-associated Ki-67 antigen of transferrin receptors
      and of DNA polymerase alpha in human tumour lines: implications for in vitro
      chemoresistance.
AB  - To compare the time course of in vitro expression of various proliferation
      associated markers including Ki-67 antigen, transferrin receptors (TfR), and DNA
      polymerase alpha, six human tumour cell lines of different histological origin
      were studied under defined conditions. Proliferation markers were demonstrated by
      peroxidase/anti-peroxidase staining using specific monoclonal antibodies, and
      their expression was compared to results obtained from [3H]-thymidine
      incorporation assays and cell counting. Expression of all proliferation markers
      began to increase during the lag phase, and occurred earlier than elevations of
      [3H]dT incorporation and cell numbers were recorded. Maximum expression was
      observed before cell growth reached plateau phase. The time courses of expression
      of DNA polymerase and Ki-67 were almost identical. The closest correlation of
      [3H]dT incorporation with time course of expression of proliferation-associated
      markers was observed, when intranuclear staining of DNA polymerase was analysed.
      TfR were expressed earlier than the polymerase and Ki-67. Since TfR were also
      found at remarkable levels in resting cells, they seem less proliferation
      specific than Ki-67 and DNA polymerase. While in rapidly growing cell lines more
      than 95% of the cells expressed Ki-67, TfR, and more than 75% DNA polymerase in
      cell nuclei, a malignant melanoma and a pleural mesothelioma line displayed fewer
      than 35% of cells stained for DNA polymerase in cell nuclei during log phase.
      Determination of growth fractions by monoclonal antibodies may thus contribute to
      the prediction of chemoresistance by identifying quiescent cells that are not
      sensitive to S-phase-specific drugs.

PMID- 1735733
TI  - Local hyperthermia enhances cyclophosphamide, ifosfamide and cis
      diamminedichloroplatinum cytotoxicity on human-derived breast carcinoma and
      sarcoma xenografts in nude mice.
AB  - Antitumour response and toxicity of locally applied hyperthermia with or without
      cyclophosphamide, ifosfamide, and cis-diamminedichloroplatinum (cisplatin) have
      been compared. The model systems were human breast carcinoma (MX1/3) and human
      sarcoma (S117) grown in nude mice. In order to detect changes of tumour
      oxygenation intratumoral PO2 and pH were measured before, during and following
      hyperthermia. In both human tumour lines a monotherapy with one of the cytotoxic
      drugs or with hyperthermia caused a transient growth delay, while the combination
      of the same dose of the drugs with hyperthermia (at 43 degrees C for 1 h)
      resulted in complete tumour remissions. During hyperthermia, in both tumour types
      oxygenation was improved. Intratumoral pH remained practically unchanged.

PMID- 1735732
TI  - Effect of a bovine hemoglobin preparation on the response of the FSaIIC
      fibrosarcoma to chemotherapeutic alkylating agents.
AB  - Polymerized bovine hemoglobin solutions (PBHS) are being actively investigated as
      blood substitutes. In studies analogous to those we conducted with
      perfluorochemical emulsions/carbogen, we have examined the effect of PBHS +/-
      carbogen (95% O2, 5% CO2) breathing on the antitumor efficacy of melphalan,
      cyclophosphamide, N,N'-bis(2-chloroethyl)-N-nitrosourea (BCNU) and cis
      diamminedichloroplatinum(II) (cis-platin). The tumor growth delay of the FSaIIC
      fibrosarcoma treated with melphalan (10 mg/kg), cyclophosphamide (150 mg/kg),
      cisplatin (10 mg/kg) and BCNU (15 mg/kg) was increased about 2.2-fold, about 2.1
      fold, about 1.2-fold and about 1.5-fold, respectively, when PBHS (12 mg/kg) was
      administered i.v. before each drug was injected i.p. The tumor growth delay
      produced by each drug was further increased when carbogen breathing for 6 h was
      allowed after administration of the drug and PBHS. In tumor cell survival
      experiments 24 h following drug treatment, the addition of PBHS increased the
      tumor cell killing of both melphalan and cyclophosphamide by about a factor of 10
      at the lowest doses of each drug tested (10 mg/kg for melphalan and 100 mg/kg for
      cyclophosphamide) compared to the drug alone. However, at higher drug doses this
      effect was lost. The toxicity of each antitumor agent toward bone marrow
      (granulocyte/macrophage-colony-forming units) was increased 2- to 3-fold by the
      combined treatment. These results suggest that use of PBHS +/- carbogen breathing
      may add significantly to the efficacy of antitumor alkylating agents, however,
      the in vivo/in vitro data suggest that there will be increased bone marrow
      toxicity with this approach. This needs to be taken into account in the design of
      clinical trials.

PMID- 1735734
TI  - Antitumour and immunological activity of a beta 1----3/1----6 glucan from
      Glomerella cingulata.
AB  - The in vivo antitumour activity of a beta 1----3/1----6 glucan from the fungus
      Glomerella cingulata was investigated in vivo. The glucan exhibited a strong
      inhibition of tumour growth of the allogeneic Sarcoma-180 as well as the
      syngeneic DBA/2-MC.SC-1 fibrosarcoma with inhibition ratios up to 100%. Against
      the hormone sensitive Noble-Nb-R prostate carcinoma the glucan alone showed a
      moderate antitumour effect, whereas in combination with diethylstilbestrol an
      almost complete regression of the tumour could be achieved. It could be
      demonstrated that a highly ordered structure of the glucan is not essential for
      the antitumour activity. Since the glucan expressed no direct cytotoxic effects,
      the immunomodulating activity was investigated in vitro in order to get an
      indication for a possible mode of action. In the lymphocyte transformation assay
      the glucan at a dose of 100 micrograms/ml caused a fourfold increase in the
      proliferation of murine spleen lymphocytes. Moreover, the glucan stimulated the
      phagocytosis of zymosan by bone marrow macrophages up to 100%. However, the
      glucan was not able to render macrophages cytotoxic against P-815 mastocytoma
      cells.

PMID- 1735735
TI  - Tumours induced by Moloney murine sarcoma virus are clonal in rats, not clonal in
      mice.
AB  - Moloney murine sarcoma virus (M-MSV) induces rapidly growing tumours in adult
      mice of most conventional strains. Rats are less susceptible to M-MSV
      oncogenesis, but the few rhabdomyosarcomas that do develop after viral
      inoculation of newborn animals closely resemble conventional malignancies: they
      develop after a long latency, grow progressively, and metastasize to regional
      lymph nodes and lungs. Southern blot analysis with a v-mos-specific probe of M
      MSV-induced tumours in both species demonstrated an oligo-, monoclonal pattern of
      exogenous v-mos integration only in the rat system, while mouse tumours were not
      clonal in origin. Furthermore, the same type of analysis of lymph node and lung
      metastases showed that cell clones already present in the primary rat lesion
      colonized secondary sites during tumour progression. Apparently, Moloney murine
      leukemia virus (M-MuLV) was not involved in rhabdomyosarcoma pathogenesis since M
      MuLV-specific DNA sequences could not be demonstrated in three of the six rat
      tumours. Finally, in all mouse tumours, unintegrated linear M-MSV proviruses
      could be readily detected.

PMID- 1735736
TI  - Factors influencing the response and survival of patients with liver metastases
      from breast cancer receiving OK-432-combined adoptive immunotherapy.
AB  - The response and survival of 26 patients with liver metastases from breast
      cancer, who received OK-432-combined adoptive immunotherapy from 1984 to 1990,
      were evaluated. OK-432-combined adoptive immunotherapy was comprised sequential
      treatment via the hepatic artery with a streptococcal preparation, OK-432 (1-5
      KE), and adoptive transfer of lymphocytes expanded in T-cell growth factor and
      sonicated tumor extract antigen. Seventeen (65%) patients responded to the
      therapy. The median survival time of all patients after treatment was 13 months
      (range, 2-63 months). Of the 20 prognostic factors analyzed, performance status
      (PS) alone was related to response (P less than 0.01). The response rate of the
      patients with a PS of 0-2 was 83% but only 25% in those with a PS of 3 or 4. In
      univariate analysis, 11 factors significantly influenced the survival: tumor
      response; size of primary tumor; menopausal status; PS; serum bilirubin, albumin,
      lactate dehydrogenase and glutamate-oxalate transaminase (aspartate
      aminotransferase); the extent of liver involvement; and the number and the
      proliferation rate of transferred lymphocytes. The MST was 22.8 months for the
      responders versus 2.8 months for the nonresponders (P less than 0.01). In
      multivariate analysis, the most important factor associated with survival was the
      tumor response, as well as PS, liver involvement, lactate dehydrogenase and
      albumin. These results suggest that OK-432-combined adoptive immunotherapy can be
      considered a candidate for a randomised control study and these factors should be
      used for stratification.

PMID- 1735737
TI  - Impact of laparotomy finding of significant intraabdominal adhesions on the
      surgically defined complete response rate to subsequent salvage intraperitoneal
      chemotherapy.
AB  - One possible explanation for the failure of the high concentrations of cytotoxic
      agents achieved following intraperitoneal (i.p.) drug delivery to produce a
      favorable response in patients with ovarian cancer is the inability of the drug
      containing fluid to be adequately distributed throughout the peritoneal cavity,
      usually because of intraabdominal adhesion formation. To evaluate the influence
      of the severity of adhesions, observed at the time of laparotomy performed
      immediately preceding the initiation of i.p. therapy, on the ability to achieve a
      surgically defined complete response (S-CR), we retrospectively reviewed the
      operative reports of 70 patients with small-volume residual ovarian cancer
      treated on one of three phase-2 salvage i.p. trials at the Memorial Sloan
      Kettering Cancer Center. The S-CR rate in the 36 patients with limited adhesion
      formation observed upon entering the peritoneal cavity was 28%, compared to 35%
      in the 34 patients with extensive adhesions (P greater than 0.05). In 33 patients
      treated with a phase-2 cisplatin-based i.p. program, who had previously responded
      to systemic platinum, 47% (8/17) and 44% (7/16) of those with limited and
      extensive adhesions, respectively, achieved a S-CR (P greater than 0.05). We
      conclude that the presence of extensive adhesions observed within the peritoneal
      cavity at the time of a laparotomy performed immediately prior to the initiation
      of i.p. therapy does not have a negative impact on the potential to achieve an S
      CR, assuming it is technically feasible to lyse all significant adhesions prior
      to the completion of the operative procedure.

PMID- 1735738
TI  - Does malignant transformation of benign soft-tissue tumours occur? A
      clinicomorphological study of ten initially misdiagnosed soft-tissue sarcomas.
AB  - Ten soft-tissue sarcomas out of a consecutive series of 201 neoplasms are
      described, in which the clinical histories were suggestive of malignant
      transformation of a benign lesion excised from the same location 2-97 months
      before. Each of the 10 preceding soft-tissue neoplasms was reviewed
      histologically and reclassified as either highly (n = 8) or moderately
      differentiated (n = 2) sarcomas. Irrespective of the primary treatment, these
      initially misdiagnosed tumours showed an overall better prognosis than the whole
      group of soft-tissue sarcomas (5- and 10-year survival rates 76% versus 44%, and
      52% versus 30% respectively). Their clinical course was, however, characterized
      by up to 6 (mean 2.9) local recurrences. From the total series of 201 tumours the
      authors conclude that soft-tissue sarcomas other than malignant schwannomas in
      the setting of von Recklinghausen's disease only exceptionally, if ever, arise
      from benign precursors.

PMID- 1735739
TI  - Theory-based advanced rehabilitation nursing: is it a reality?

PMID- 1735740
TI  - Rehabilitation: umbrella for health care.

PMID- 1735741
TI  - Exercise: wellness maintenance for the elderly client.

PMID- 1735742
TI  - Group support for families during the acute phase of rehabilitation.

PMID- 1735743
TI  - Community-based rehabilitation.

PMID- 1735744
TI  - A rehabilitation clinical nurse specialist: evaluation of the role in a home
      health care setting.

PMID- 1735745
TI  - Rehabilitation takes to the road.

PMID- 1735746
TI  - Rehabilitation case managers: ahead of their time.

PMID- 1735747
TI  - Children with chronic conditions growing up in institutions: issues regarding
      habilitation.

PMID- 1735748
TI  - The interdisciplinary team: research and education.

PMID- 1735749
TI  - Withdrawal symptoms in a postoperative patient.

PMID- 1735750
TI  - Immunopathogenesis of HIV infection.
AB  - The early natural history of HIV does not differ markedly from that of other
      lymphotropic pathogens. However, the HIV lentivirus has a number of unique
      features that not only facilitate escape from the host immune response but
      eventually lead to dysfunction and destruction of the immune system. Actual cure
      will not be possible until a way to eliminate the stored virus is found.

PMID- 1735751
TI  - Who owns our genes?

PMID- 1735752
TI  - Anemia in the hospitalized patient.

PMID- 1735753
TI  - Still a question?

PMID- 1735754
TI  - Symptoms of low blood pressure.

PMID- 1735755
TI  - Whither our children?

PMID- 1735756
TI  - A case of pseudo pseudogout.

PMID- 1735757
TI  - Cyanotic heart disease in a young woman.

PMID- 1735758
TI  - Acute abdominal pain in a dialysis patient.

PMID- 1735759
TI  - Chlamydial disease in women.

PMID- 1735760
TI  - Current concepts in anticoagulation.
AB  - Anticoagulation therapy continues to evolve as more precise indications for its
      use are recognized. With adoption of the international normalized ratio, safer
      and more effective application is in the offing. Newer uses are discussed.

PMID- 1735761
TI  - The missing volumes.

PMID- 1735763
TI  - The shield of invulnerability.

PMID- 1735762
TI  - Kala-azar: the long anguish of the black sickness.

PMID- 1735764
TI  - Deficiencies in factors IX and VIII: what is now known.
AB  - Genetic defects both gross and subtle have recently been identified in about 900
      patients with hemophilia A or B. The defects, which include deletions,
      insertions, and point mutations, reveal much about genetic structure-function
      relationships in hemophilia. These insights will lead to improved treatment of
      bleeding disorders and perhaps to their cure.

PMID- 1735765
TI  - A sterilized woman who did not feel right.

PMID- 1735766
TI  - Aggressive therapy of acute MI in the elderly.
AB  - In elderly patients with myocardial infarction, clinicians face a management
      catch-22: Mortality is increased in the absence of therapy, which is often
      withheld because elderly patients may succumb to its complications. What to do?
      Evidence from recent studies suggests that the benefits of aggressive therapy
      with early thrombolysis may outweigh the risks.

PMID- 1735767
TI  - Unilateral pulmonary edema.
AB  - Awareness of pathophysiology and differential diagnosis of this entity is crucial
      for management. Edema may be ipsilateral or contralateral to the perfusion
      defect, or may be variable. A variable case is presented.

PMID- 1735768
TI  - AIDS and alcohol: concerns for the physician.
AB  - Persons who abuse alcohol have not been specifically targeted for education on
      prevention of AIDS, yet failure to address the connection between alcohol and HIV
      transmission may carry a heavy price.

PMID- 1735769
TI  - Effects of gamma-interferon on major histocompatibility complex antigen
      expression and lymphocytic infiltration in the 9L gliosarcoma brain tumor model:
      implications for strategies of immunotherapy.
AB  - Effects of gamma-interferon (IFN-gamma) on immune parameters in the 9L
      gliosarcoma model were examined. IFN-gamma increased class I major
      histocompatibility complex (MHC) expression in 9L cells in vitro. In vivo,
      intratumor injections of IFN-gamma led to increased numbers of inflammatory cells
      within the tumor and class II+ mononuclear phagocytes at its periphery, and
      increased MHC class I or II expression by endothelial and ependymal cells. Class
      I expression in 9L cells themselves was not increased. This suggests that there
      may be inhibition of class I induction in vivo for certain cell types, for which
      immunotherapies based on non-MHC restricted mechanisms may be more effective.

PMID- 1735770
TI  - Anti-GM1 IgA antibodies in Guillain-Barre syndrome.
AB  - Serum anti-GM1 IgA antibodies were detected in 15 of 53 (28%) patients with the
      acute Guillain-Barre syndrome (GBS) and in one of 26 (4%) patients with other
      neurological diseases. Although nine GBS patients had anti-GM1 IgA titers of
      1:200 or less, six patients had titers of 1:800 or more. Some GBS patients with
      anti-GM1 IgA antibodies also had antibodies against GD1b or GM2 or both. The
      presence of markedly elevated anti-GM1 IgA was associated with a poor clinical
      outcome at 6 and 12 months following onset of the GBS. The possible pathogenetic
      role of anti-GM1 IgA antibodies remains to be established.

PMID- 1735771
TI  - Intrathecal synthesis of soluble class I antigens in multiple sclerosis.
AB  - We have studied the intrathecal synthesis of soluble class I antigens (sHLA),
      reflected by the index IH = (CSF sHLA/serum sHLA)/(CSF albumin/serum albumin), in
      multiple sclerosis (MS). IH was increased in patients in relapse, but normal in
      patients in remission; these findings show that there is a high lymphocyte
      activation within the central nervous system in patients with clinically active
      MS.

PMID- 1735772
TI  - Effect of parenteral administration of GM1 on cytokines and anti-ganglioside
      antibody patterns. Preliminary report in normal human individuals.
AB  - To assess the effects of monosialoganglioside GM1 on some immunological
      parameters, 12 healthy men were treated with 100 mg GM1 i.m. daily for 15 days.
      Before and after treatment, the following were studied: (1) serum levels of
      antibodies against GM1, asialo-GM1 (aGM1), GM2 and GD1b; (2) serum levels of
      interleukin (IL)-1 beta, IL-2, soluble IL-2 receptor (sIL-2R), tumor necrosis
      factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma); (3) IL-1 beta and TNF
      alpha production by peripheral blood monocytes (PBMO). Anti-ganglioside antibody
      and cytokine serum levels were not affected by exogenous GM1 administration with
      the exception of a transient increase in anti-GM1 antibody titer observed in one
      subject. In addition, no inhibition of IL-1 beta and TNF-alpha production by PBMO
      was observed. These preliminary data do not support a potential immunogenic or
      immunomodulatory function for in vivo administered GM1.

PMID- 1735773
TI  - Computer program for planning and evaluating microplate experiments.
AB  - A microcomputer program is described for planning and statistically evaluating
      microplate and other similar experiments. This program is written in BASIC and
      can be run on any PC XT/AT compatible computer under DOS. The first part of the
      program writes the protocol of the experiment into a disk file and sends it to a
      printer and also prints specifications for the addition of ingredients. The
      second part of the program calculates means and standard deviations of the values
      measured for all groups of samples. It is also possible for the program to
      calculate activation coefficients, coefficients of modulation and percentages of
      suppression for special groups. Inputting the required data can be performed
      manually from the keyboard or automatically from disk files.

PMID- 1735774
TI  - A quantitative immunoassay using chicken antibodies for detection of native and
      recombinant alpha-amidating enzyme.
AB  - A sensitive competitive ELISA has been developed for the detection and
      quantitation of native and recombinant alpha-amidating enzyme. Chickens immunized
      with purified enzyme (75 kDa) isolated from a rat medullary thyroid carcinoma,
      produced IgY antibodies specific for the native enzyme. The assay is defined by a
      standard curve with a linear range of 0.78-12.5 ng/ml in phosphate-buffered
      saline, and a limit of sensitivity for detection of the enzyme of 0.20 ng/ml. The
      immunoassay is capable of detecting enzyme from both tumor derived sources, and
      from cells genetically engineered to secrete the enzyme into tissue culture
      medium containing up to 10% fetal calf serum.

PMID- 1735775
TI  - Propagation of a mouse myeloma cell line J558L producing human CD4 immunoglobulin
      G1.
AB  - Transfected mouse myeloma cells are of increasing interest for the production of
      a wide variety of solubilised recombinant fusion proteins. A stably transfected
      J558L mouse myeloma subclone (J558L-CD4) secreting human CD4-immunoglobulin type
      G1 receptor (CD4-H gamma 1) was employed as a model system for cell suspension
      culture and expression of chimaeric molecules. Cells were grown up to 3-5 x 10(6)
      cells/ml in serum-free and protein-reduced DHI medium consisting of a mixture of
      DMEM, HamF12 and IMDM media supplemented with transferrin, insulin, Primatone RL
      and Pluronic F68. Primatone RL was the essential growth-promoting factor in
      protein-free medium. The soluble CD4-H gamma 1 receptor, the production of which
      was not growth-associated, accumulated in the medium to concentrations of 40
      micrograms/ml with a specific formation rate of 0.18 micrograms/10(6) cells/h in
      conventional cultures. The cell density was further increased by growing the
      cells in dialysis tubing or by using a perfusion system with cell retention.
      Because of the continuous exchange of nutrients and metabolic end-products
      average concentrations of 35 x 10(6) cells/ml were achieved. CD4-H gamma 1
      accumulated in the dialysis tubing up to 1.3 mg/ml. After an initial rapid growth
      period, a ten-fold reduction in specific nutrient consumption rates and metabolic
      end-product formation was observed. Chimaeric proteins purified by protein G
      chromatography from conventional and perfusion cultures were indistinguishable
      when compared by SDS-PAGE, limited proteolysis and isoelectric focusing analysis
      (isoelectric point: 8.5-8.6).

PMID- 1735776
TI  - The use of spent renal dialysis membranes for the isolation of large numbers of
      human neutrophils for biochemical studies. Application to purification of the
      myeloid IgA receptor (Fc alpha R).
AB  - Human neutrophils (PMN) can be eluted from spent Cuprophan renal dialysis
      membranes in large numbers (10(9)-10(10) per dialyser cartridge) and in
      relatively high purity by washing the membranes with 0.35 M NaCl. This offers the
      possibility of isolating relatively large amounts (10(-4)-10(-3) g) of minor PMN
      proteins such as those expressed on the cell surface. Here the technique is
      applied to the purification of the neutrophil IgA receptor (Fc alpha R). Affinity
      chromatography on IgA-Sepharose of NP-40 extracts of 125I-labelled PMN isolated
      from fresh venous blood routinely gave a receptor preparation showing one diffuse
      band, Mr 50-70 kDa, upon analysis by SDS-PAGE and autoradiography. When the same
      method was used with larger numbers of unlabelled PMN from fresh venous blood or
      renal dialysis membranes a preparation was obtained which gave multiple bands
      upon analysis by SDS-PAGE silver stained gels due to contamination of the
      receptor with cytoplasmic proteins which bound non-specifically to the IgA
      Sepharose. Most of these contaminants could be removed by chromatography of the
      IgA-Sepharose eluates on wheat germ agglutinin-Sepharose.

PMID- 1735777
TI  - An improved haemolytic plaque assay for the detection of cells secreting antibody
      to bacterial antigens.
AB  - Recent advances in the development of conjugate polysaccharide vaccines for human
      use have stimulated interest in the use of assays detecting antibody-secreting
      cells (AbSC) with specificity for bacterial antigens. Here we present improved
      haemolytic plaque-forming cell (PFC) assays detecting AbSC with specificity for
      tetanus and diphtheria toxoid as well as for Haemophilus influenzae type b and
      pneumococcal capsular polysaccharides. These assays were found to be less time
      consuming, more economical and yielded 1.9-3.4-fold higher plaque numbers than
      traditional Jerne-type PFC assays. In the case of anti-polysaccharide AbSC of the
      IgG isotype, the increase was as high as 7.4-11.8 times. Evidence is presented
      that the pronounced improvement in the detection of the latter is due to the
      presence of aggregating anti-IgG antibody from the beginning of the assay. It is
      proposed that in the case of low affinity of anti-polysaccharide antibodies
      aggregation of secreted monomeric antibody (IgG) is critical for plaque formation
      and increases the avidity of binding to target cells.

PMID- 1735778
TI  - IgG subclass distribution of anti-HBs antibodies following vaccination with cDNA
      HBsAg.
AB  - Serum samples were obtained during follow-up of nine young adults vaccinated over
      1 year with cDNA hepatitis B antigen. The absolute amounts of anti-HBs IgG
      subclass antibodies present in the sera were determined by comparing the optical
      densities (OD) obtained using an antigen-specific ELISA with those obtained by
      serial dilutions of known amounts of human IgG1-4. The calibration curves for
      each IgG subclass were corrected for the corresponding coating efficiency. Our
      data suggest that HBs antibody responses of vaccinated subjects occur in all IgG
      subclasses but IgG1 and IgG2 are the major subclasses involved.

PMID- 1735779
TI  - Escherichia coli heat-stable enterotoxin (STa)-biotin conjugates for the
      titration of STa antisera by an enzyme-linked immunosorbent assay.
AB  - The development of a new approach to the diagnosis of infectious diarrhoea,
      caused by Escherichia coli heat-stable enterotoxin (ST), was preceded by a
      preliminary study. The purpose of the latter was to establish whether three
      preparations of ST produced by a human isolate of enterotoxigenic E. coli (STa),
      obtained at different steps of the purification procedure (involving Amberlite
      XAD2 resin chromatography (P3), a gel filtration chromatography on a Biogel P4
      (P2) or a disc-gel electrophoresis (P1)), could be employed to titrate antisera
      to STa using an ST-biotin enzyme-linked immunosorbent assay (ELISA). The solid
      phase STa was obtained by first coupling the toxin to biotinyl-N
      hydroxysuccinimide and then binding this conjugate to avidin adsorbed to flat
      bottomed polystyrene microtitre plates. Using these reagents, the assay
      conditions were examined. Checkerboard tests determined optimal biotin-P3, P2 or
      P1 toxin conjugate concentrations to be used as the immunosorbent for P3, P2 and
      P1 antiserum titration. The immunosorbent prepared with STa purified only on
      Amberlite XAD2 resin was unable to differentiate significantly between P3, P2 or
      P1 antisera. Immunosorbent prepared with P2 or P1 detected widely differing
      titres between the three antisera and gave more sensitive results. Only small but
      questionable differences were observed between P2 and P1 toxin preparations.

PMID- 1735780
TI  - An oscillating bubble chamber for laboratory scale production of monoclonal
      antibodies as an alternative to ascitic tumours.
AB  - A simple roller bottle was constructed to house three dialysis tubes, each with a
      capacity of 75 ml. Cells were grown inside the dialysis tubing, which was
      immersed in ordinary DMEM medium without serum supplement. Cultures of hybridomas
      at medium or low density (2 X 10(5) cells/ml) could be expanded directly in the
      dialysis tubes to attain a high cell density of the order of 10(7)/ml. Continuous
      gentle stirring of the cells was possible, since the design causes a bubble to
      oscillate along the length of each tube. The six cell lines tested all gave
      antibody concentrations of between 1.1 and 2.3 mg/ml at 20 days. Such an in vitro
      apparatus obviates the need to employ ascites production, because it is as simple
      or simpler than the injection of mice, and the in vitro product is very rich in
      antibody, whilst containing low amounts of contaminating proteins.

PMID- 1735781
TI  - Separation of peripheral blood lymphocytes with low platelet and erythrocyte
      contamination, using ADP aggregation.
AB  - A simple and inexpensive method to obtain substantially platelet-free and
      erythrocyte-free lymphocyte preparations from human peripheral blood has been
      established, using a modification of the technique published by Vives et al.
      (1971). Lymphocyte levels of up to 3 x 10(6) per ml blood have been obtained,
      with 2-3% platelet and erythrocyte contamination per ml blood, by pre-aggregating
      platelets with low concentrations of adenosine 5'diphosphate (ADP).

PMID- 1735782
TI  - Measurement of lysozyme by an enzyme-linked immunosorbent assay.
AB  - In this study an enzyme-linked immunosorbent assay has been developed for the
      determination of lysozyme in saliva, serum and urine. The assay relies on the
      detection of specific protein rather than lytic activity, a property which has
      been shown to be most suitable for the quantitation of lysozyme in mucin
      containing substances. Our results indicate that no pretreatment is necessary for
      the immunochemical method. The assay is sensitive to concentrations as low as 1
      microgram lysozyme/l. The intra-assay and inter-assay coefficients of variation
      were 5.9% and 15.8% respectively. The lysozyme level in whole saliva was 55.53 +/
      30.35 mg/l, in serum the level was 0.64 +/- 0.15 mg/l and in urine it was 0.17
      +/- 0.22 mg/l. Comparisons between immunochemical determination and lytic assays
      showed a good correlation (serum, r = 0.79, P less than 0.01; saliva, r = 0.85, P
      less than 0.005; treated saliva, r = 0.96, P less than 0.001).

PMID- 1735783
TI  - Establishment of anti-human neuroblastoma-selective isotype-switch variants.
AB  - Isotype-switch variants of monoclonal antibodies occur spontaneously at low
      frequency in hybridoma cultures. We have established gamma 2b variants from the
      gamma 1/kappa antibody-secreting murine hybridoma CE7 and gamma 2a-secreting
      variants from a selected CE7 gamma 2b clone. The CE7 antibodies selectively
      recognize a cell surface glycoprotein of 185 kDa expressed on all human sympatho
      adrenomedullary cells. The switch-variants were obtained by a stepwise cloning
      strategy and selected by an isotype-specific solid-phase sandwich ELISA. The
      frequency of the switch variants was 1-2 x 10(-5) for both isotypes. Using ELISA
      inhibition technique it was demonstrated that the selected variants were able to
      bind to the same epitope of neuroblastoma as the original CE7 gamma 1. Southern
      blot analysis showed that the functionally rearranged VH and VL genes of CE7
      gamma 1, CE7 gamma 2a and CE7 gamma 2b antibodies were identical. The N terminal
      FR1 amino acid sequence of the L chains was identical in all three isotypes and
      the H chains were blocked for Edman degradation. Regarding the possible
      applications of CE7 antibodies the different isotypes were assayed for their
      cytolytic activity as measured by complement-mediated 51Cr release of IMR-32
      neuroblastoma cells.

PMID- 1735784
TI  - Simultaneous multiple synthesis of peptide-carrier conjugates.
AB  - Recently, the multipin approach for simultaneous multiple peptide synthesis was
      applied to the analysis of T cell determinants by using a novel cleavage method
      (Maeji et al., 1990). A diketopiperazine forming linker allowed cleavage of
      peptides into aqueous buffer which, without further purification, could be used
      immediately in cell culture assays. Another potential application of the
      technique is the simultaneous cleavage and coupling of peptides to immunogenic
      carriers. Without further purification the resulting conjugates can be used for
      the production of antipeptide antisera. The choice of carrier and conjugation
      chemistry is not restricted as peptide/pin cleavage occurs in aqueous solution
      over a range of pH and ionic strength. The method was assessed using the 2,4
      dinitrophenyl group as a model hapten, diphtheria toxoid as the carrier, and N
      (epsilon-maleimidocaproyloxy)succinimide as the cross-linking reagent. The
      resulting DNP-DT conjugate was used to prepare high titered specific anti-DNP
      antisera in mice.

PMID- 1735785
TI  - Unexpected interaction of some anti-TNP hybridoma antibodies with Superose HPLC
      gel filtration resins.
AB  - Five different hybridoma antibodies (the isotypes IgG1, IgG2a and IgG2b),
      reactive with TNP, showed increased elution times when gel filtered on a Superose
      12 HPLC column corresponding to apparent molecular weights ranging from 54 kDa to
      120 kDa compared to the normal of 150 kDa. One of the antibodies (C1901-B4) was
      studied in detail showing that the unusual gel filtration behaviour was localized
      to the Fab part of the molecule. SDS-PAGE analysis showed that the intact
      antibodies had normal molecular weights. Gel filtration on a Toyosoda G-3000SW
      HPLC column and Sephadex G-150 as well as Sepharose 6B generally showed normal
      elution times. These results support the hypothesis that the retardation on the
      Superose gel is probably due to aromatic interactions between amino acid residues
      supposedly exposed in the hypervariable region (i.e., the antibody combining
      site) of the antibody, and the gel matrix which is rich in ether O-atoms created
      during the manufacturing process. If this hypothesis is correct one might expect
      such interactions between Superose resins and antibodies of many different
      specificities in which aromatic amino acids are exposed in the combining sites.

PMID- 1735786
TI  - Calculation of lytic units for the expression of cell-mediated cytotoxicity.
AB  - Over the past 10 years, the lytic unit has become the most common means by which
      activity is expressed in cell-mediated cytotoxicity assays. The strengths and
      weaknesses of the lytic unit as a summary of cytotoxicity are discussed, and
      computational methods reviewed. The fundamental "assumption of proportional
      effect" which is implicit in the interpretation of lytic units is described and
      empirically tested. Based on extensive data from the assay of human natural
      killer (NK) activity against K562 targets, simplified computational methods are
      recommended. The proposed methods are easily explained, may be made robust to
      occasional erratic data, and permit a reasonable interpretation of lytic units
      even when the assumption of proportional effect breaks down.

PMID- 1735787
TI  - Ciliary beating in three dimensions: steps of a quantitative description.
AB  - We document a novel approach for quantitative assessment of ciliary activity,
      exemplified in rapid three-dimensional cyclic motion of the frontal cirri of
      Stylonychia. Cells held under voltage-clamp control are stimulated by step pulses
      to elicit reproducible hyperpolarization- or depolarization-induced ciliary motor
      responses. High-speed video recording at 200 fields per second is used for
      imaging ciliary organelles of the same cell in two perspectives: the axial view
      and, following cell rotation by 90 degrees, the lateral view. From video
      sequences of typically 1 s, the contours of the cirral images are determined and
      digitized. Computer programs are established to (1) reduce an observed image to a
      "ciliary axis", (2) sort series of axes by template to generate an averaged
      ciliary cycle in 2D-projection, and (3) to associate the generalized axial and
      lateral 2D-images for generation of a sequence of three-dimensional images, which
      quantitatively represent the cycle in space and time. The method allows us to
      produce predetermined perspectives of images selected from the ciliary cycle, and
      to generate stereo views for graphical representation of ciliary motion. The
      approach includes a potential for extraction of the complete microtubular sliding
      program of a cilium under reproducible electric stimulation of the ciliary
      membrane.

PMID- 1735788
TI  - Diagnosis of atrial fibrillation from surface electrocardiograms based on
      computer-detected atrial activity.
AB  - A computerized method to detect atrial fibrillatory activity on the surface
      electrocardiogram is presented. After ventricular activity was canceled by
      creating a remainder electrocardiogram, significant differences were found in the
      percent power of the remainder electrocardiograms for a group of rhythms with
      atrial fibrillation (mean +/- SD; lead V1, 47.4 +/- 29.7%; lead II, 39.4 +/-
      26.8%) and a control group (irregular rhythms or rhythms without readily
      detectable P waves; lead V1, 17.6 +/- 14.6%; lead II, 19.2 +/- 13.9%) for both
      leads (p less than 0.0001). A discrimination algorithm that classified a rhythm
      as atrial fibrillation if the percent power was greater than 32% and if
      noncoupled P waves were not present had a specificity of 90.0% and a sensitivity
      of 69.7% for the training set and a specificity of 87.8% and a sensitivity of
      68.3% for the test set. In addition, the algorithm correctly detected all 66 of
      the 66 sinus rhythms tested. The algorithm produced good results that may be
      incorporated into arrhythmia interpretation systems to improve their specificity.

PMID- 1735789
TI  - Rate-dependent accessory pathway conduction due to phase 3 and phase 4 block.
      Antegrade and retrograde conduction properties.
AB  - Six patients who had antegrade phase 3 and phase 4 block in the accessory pathway
      were examined. In each patient, antegrade conduction over the accessory pathway
      was absent both at the sinus rate and at slower heart rates. During premature
      atrial stimulation a "window" of accessory pathway conduction was identified in
      all patients. The outer limits of the window ranged from 480 ms to 670 ms. The
      inner limits ranged from 410 ms to 620 ms. The durations of the window ranged
      from 20 ms to 160 ms. Three patients with orthodromic atrioventricular reentrant
      tachycardia showed preserved retrograde accessory pathway conduction. The
      remaining three patients had impaired retrograde accessory pathway conduction.
      One of the patients showed retrograde phase 4 block in the accessory pathway. In
      two patients, retrograde concealed conduction in the accessory pathway induced by
      ventricular stimulation prolonged the outer limit of the window in the antegrade
      accessory pathway conduction. These findings suggest that the mechanism of
      antegrade phase 3 and phase 4 block in the accessory pathway may be spontaneous
      diastolic depolarization in the accessory pathway and conduction disturbance at
      the ventricular and/or atrial insertion of the accessory pathway.

PMID- 1735790
TI  - Effect of pacing drive cycle length on induction of sustained monomorphic
      ventricular tachycardia.
AB  - To assess the effect of pacing drive cycle length on induction of sustained
      monomorphic ventricular tachycardia, 40 patients were prospectively studied in
      the drug-free state. Ventricular extrastimuli were sequentially delivered at the
      same coupling interval at each of three drive cycle lengths (600, 500, and 400
      ms) before the coupling interval was shortened and the process repeated. This
      protocol was continued until sustained monomorphic ventricular tachycardia was
      induced at all three drive cycle lengths or until pacing was completed through
      three extrastimuli. Of the 27 patients in whom sustained monomorphic ventricular
      tachycardia was induced, tachycardia was induced at all 3 drive cycle lengths in
      12 (44%), only 2 drive cycle lengths in 11 (41%), and only 1 drive cycle length
      in 4 (15%) patients. Although the yield of inducible ventricular tachycardia
      increased with each additional extrastimulus, this yield increased even further
      with the use of multiple drive cycle lengths. In 10 of 11 patients, failure to
      induce ventricular tachycardia at any drive cycle length was not due to failure
      to achieve at that drive cycle length the critical extrastimulus coupling
      interval required to induce tachycardia at other drive cycle lengths. Induction
      of sustained monomorphic ventricular tachycardia is often drive cycle length
      specific, and failure to induce tachycardia cannot be explained by failure to
      achieve critically short coupling intervals. Pacing at multiple drive cycle
      lengths increases the yield of induced ventricular tachycardia.

PMID- 1735791
TI  - Characteristic abnormal features of body surface potential maps predictive of
      ventricular tachycardia following coronary artery occlusion in dogs.
AB  - In a search for features predictive of ventricular arrhythmias in myocardial
      ischemia, the body surface potential maps of 17 dogs with coronary artery
      occlusion were studied. Ventricular tachycardia occurred in 9 (53%) of the 17
      dogs. Multiple distribution of the abnormal potential minimum was found in 6
      (67%) of the 9 dogs with (group A) and none of the 8 dogs without ventricular
      tachycardia (group B). The difference was statistically significant (p less than
      0.01). The abnormal "early reversal" phenomenon of potential distribution was
      observed in 6 (67%) of group A and 7 (88%) of group B. The difference was not
      statistically significant (p greater than 0.05). The area of abnormal negative
      potential was 28.0 +/- 8.5 cm2 for group A and 14.5 +/- 5.5 cm2 for group B (p
      less than 0.001). The abnormal negative potential lasted for 25.4 +/- 3.5 ms in
      group A and 10.1 +/- 5.1 ms in group B (p less than 0.001). The abnormally early
      appearance of potential minimum lasted for 24.2 +/- 5.1 ms in group A and 10.5 +/
      5.4 ms in group B (p less than 0.001). The data suggest that the distribution,
      area, and duration of the abnormal negative potential of the body surface
      potential map are useful in the prediction of ventricular tachycardia associated
      with coronary artery occlusion.

PMID- 1735792
TI  - Effect of strontium on action potential repolarization in rabbit sinoatrial node
      cells.
AB  - Using standard microelectrode techniques, the effects of strontium (Sr++) ions on
      action potential (AP) repolarizations in rabbit sinoatrial node (SAN) cells were
      studied. In a nominally magnesium-free, calcium-free solution, Sr++ (0.5-3.55
      mmol) produced an early afterdepolarization (EAD) and a prolongation of the AP.
      Until now, no experimental evidence has been presented in favor of an EAD
      mechanism in SAN cells. Superfusion of the SAN cells with 0.5 mmol Sr++ solution
      containing 1-5 mmol magnesium (Mg++) or 0.5 mmol calcium (Ca++) did not induce
      the EAD. Increasing the extracellular Mg++ to 1-5 mmol did not affect the EAD
      induced by superfusion with 3.55 mmol Sr++ solution. Increasing the extracellular
      Ca++ to 0.5 mmol suppressed the 3.55 mmol Sr(++)-induced EAD. The presence of 0.3
      mmol manganese (Mn++) suppressed the EAD induced by superfusion with 0.5 mmol
      Sr++ solution. The EAD did not occur in the presence of 1 x 10(-6) mol
      nitrendipine or 2 x 10(-6) mol diltiazem hydrochloride. The presence of 0.03 mmol
      Mn++ did not significantly alter the 0.5 mmol Sr(++)-induced EAD. These results
      suggest that a slow inward Sr++ current through the Ca++ channel has an important
      role in the development of the EAD.

PMID- 1735793
TI  - Catheter ablation of hemodynamically compromising incessant atrioventricular
      tachycardia.
AB  - A 27-year-old woman was admitted to the Georgetown University Hospital with
      refractory hemodynamically compromising incessant atrioventricular tachycardia. A
      single left-sided accessory pathway was identified and successfully modified
      acutely. Endocardial delivery of direct current energy provided an extremely
      effective therapeutic intervention resulting in termination of atrioventricular
      tachycardia and restoration of stable hemodynamic status. Although a second
      ablation procedure was necessary to permanently interrupt accessory pathway
      conduction, the patient has remained free of symptoms without medications for 13
      months.

PMID- 1735794
TI  - Atrioventricular nodal reentrant tachycardia with retrograde block induced by
      aprindine.
AB  - Two patients are described who had atrioventricular nodal reentrant tachycardia
      (AVNRT) with 1:1 relationship in the control state, but in whom a varying degree
      of VA block during AVNRT was observed during therapy with aprindine. Aprindine,
      however, did not cause anterograde blockade of conduction over the slow AV nodal
      pathway during tachycardia. These observations support the conclusion that the
      bulk of atrial muscle is not a requisite part of the tachycardia circuit in AVNRT
      and that antiarrhythmic drugs may have disparate effects on conduction in the
      retrograde and anterograde limbs of the circuit.

PMID- 1735795
TI  - Implications of macroscopic source strength on cardiac cellular activation
      models.

PMID- 1735796
TI  - Spontaneous beat-to-beat variability of the ventricular repolarization duration.
AB  - The spontaneous beat-to-beat variability of the ventricular repolarization
      duration was investigated in 21 healthy subjects (age 25-71 years; mean, 40
      years) during the basal state in a recumbent position. For each subject,
      approximately 1,000 consecutive cycles were analyzed with an automated technique.
      The time series of the RR, QT, and RT intervals generate histograms that
      approximate normal distributions and have mean standard deviations of 57.0 ms,
      5.4 ms, and 4.3 ms, respectively. Spectral analysis was used to detect rhythmical
      oscillations in these time series. The power spectra densities of both heart rate
      and ventricular repolarization during show peaks in the same frequency bands: low
      frequency (0.05-0.12 Hz) and high frequency (0.2-0.4 Hz). The power distribution
      between these two bands observed in the ventricular repolarization duration
      spectra was found to be the reverse of that in heart rate spectra (p less than
      0.005).

PMID- 1735797
TI  - Nurses in the news: from invisible to visible.

PMID- 1735798
TI  - Issues and trends in nursing service administration education.
AB  - The Council on Graduate Education for Administration in Nursing (CGEAN) was
      established to further the development and improvement of graduate education for
      administration in nursing. The Council seeks to identify the nature and direction
      of education for administration in nursing in various healthcare systems,
      providing guidelines for programs offering administration. A major goal of CGEAN
      is facilitating dialogue between nursing service administrators and graduate
      level educators who are engaged in teaching and research related to
      administration in nursing. This column, sponsored by members of the Council, will
      analyze and respond to position statements and trends related to the delivery of
      health services and graduate education for administrators in nursing.

PMID- 1735799
TI  - Nurse executive practice--into the next millennium: from limbo dancer to pole
      vaulter.
AB  - Nurse executives, administrators, and managers are constantly being challenged by
      the changes in healthcare. Although it sometimes seems there is really nothing
      new, proactive visionary nurse administrators can rediscover, redesign, and
      redirect their own and others' activities to achieve organizational
      effectiveness. Such approaches require periodic examination of all strategies and
      practices--past, present, and future--for their relevance, practicality, and
      success. The editors of "Executive Development" reflect on topics important to
      organizational life.

PMID- 1735800
TI  - Decision-making autonomy in nursing.
AB  - Current nursing literature has suggested that nurses may have low needs or
      preferences for decision-making autonomy. In this study, the authors found that
      nurses differed in their preferences for decision-making autonomy in three types
      of work-related decisions. Employed nurses with a greater preference for autonomy
      were more satisfied with their jobs, and those with little or no such preference
      were less satisfied, as they gained decision-making influence over patient care
      and unit management. The authors discuss implications for designing and
      implementing decision-making programs.

PMID- 1735801
TI  - Stirring the social pot. Community effects of program and policy research.
AB  - The increasing interest in a national health program will lead to major changes
      in healthcare. The coming changes will be larger perhaps than those of the past
      decade and almost certainly will be outward--outside large institutions, into
      communities. Community relations will become increasingly important and therefore
      should become a part of studies to guide administrative decisions regarding
      program development. Administrators and their research collaborators should be
      aware of the unintended "side effects" of such community-oriented research. These
      effects have organizational and research implications that decision makers may
      choose to use to build community-organization alliances and promote public
      education to create supportive and informed consumers and a responsive healthcare
      system.

PMID- 1735802
TI  - Radiation protection for nurses. Regulations and guidelines.
AB  - Rules and regulations of federal agencies and state radiation protection programs
      provide the bases for hospital policy regarding radiation safety for nurses.
      Nursing administrators should work with the radiation safety officer at their
      institutions to ensure that radiation exposures to staff nurses will be as low as
      reasonably achievable and that special consideration will be given to pregnant
      nurses. Nurses' fears about their exposure to radiation can be greatly reduced
      through education.

PMID- 1735803
TI  - Critical pathways in home healthcare.
AB  - Administrators and directors of home health agencies are increasingly accountable
      for the productive use of resources and quality patient outcomes. However, few
      reliable ways exist to measure and influence these components. The author
      proposes the use of the critical pathway typically used in acute care case
      management as an efficient tool to guide home health nursing practice. The author
      presents the process for developing a critical pathway for congestive heart
      failure patients in a home health agency, as well as results of a study
      determining when nursing interventions were implemented.

PMID- 1735804
TI  - Head nurse role redesign. Improving satisfaction and performance.
AB  - In a correlational study with 110 head nurses in 10 hospitals, the author
      developed and tested a model for use in role redesign in nursing. Results provide
      data useful in the redesign of the head nurse role in hospitals in order to
      provide greater job satisfaction and improved outcomes for patients, nurses, and
      the organization.

PMID- 1735805
TI  - Into Iraq. Nursing organization in a combat support hospital.
AB  - Nurses from various backgrounds were joined together to become a cohesive combat
      support hospital during Operation Desert Shield and Operation Desert Storm. The
      author recounts how this was accomplished and how the hospital became a competent
      organization through a particular formula for success, along with preparation,
      discipline, and purpose.

PMID- 1735806
TI  - Satisfaction: it's more than effectiveness and efficiency.

PMID- 1735807
TI  - Case management in rural areas. Definition, clients, financing, staffing, and
      service delivery issues.
AB  - How does case management in rural areas differ from that in urban areas? How does
      the informal system of family, church, neighbors, and volunteers affect case
      management in rural areas? What are the strengths and problems of rural case
      management? The authors report the attitudes of rural case managers and attendees
      at a conference sponsored by two homecare organizations to these and other
      questions related to rural case management.

PMID- 1735808
TI  - Transformational leadership in nursing service. A test of theory.
AB  - What are the leadership dimensions that result in low turnover or work
      satisfaction? Intellectual stimulation, charisma, and individual consideration
      constitute aspects of transformational leadership that are suggested to enhance
      retention and staff satisfaction. In this study, the authors tested
      transformational leadership theory in one nursing department with an executive,
      11 midlevel administrators, and 77 staff registered nurses. Findings support the
      predictions. Composed of teachable components, transformational factors are
      similar to leadership qualities described in magnet hospitals, offering positive
      implications for nursing administration and professional nursing practice.

PMID- 1735809
TI  - ProPAC.

PMID- 1735810
TI  - Anesthesia for premature and term infants: perioperative implications.

PMID- 1735811
TI  - Safety and efficacy of theophylline in children with asthma.

PMID- 1735812
TI  - Comparative trial in infants of four conjugate Haemophilus influenzae type b
      vaccines.
AB  - We performed a double-blind, randomized trial to compare the immunogenicity and
      reactogenicity of four conjugate Haemophilus influenzae type b vaccines given to
      infants 2, 4, and 6 months of age. Adverse reactions attributable to the vaccines
      were few and minor. The rates of systemic reactions did not differ among the
      various vaccines and were similar to those seen among children receiving
      conventional diphtheria-tetanus-pertussis vaccine. However, the four conjugate H.
      influenzae type b vaccines differed markedly in ability to stimulate antibody
      production. Mean antibody levels after three injections of polyribosylribitol
      phosphate conjugated with mutant diphtheria protein (PRP-CRM) or
      polyribosylribitol phosphate conjugated with tetanus toxoid (PRP-T) were 3.08
      micrograms/ml and 3.64 micrograms/ml, respectively, significantly higher than
      those after the use of polyribosylribitol phosphate conjugated with outer
      membrane protein of Neisseria meningitidis (PRP-OMP) (1.14 micrograms/ml) or
      polyribosylribitol phosphate conjugated with diphtheria toxoid (PRP-D) (0.28
      microgram/ml). Only PRP-OMP produced a clinically pertinent elevation in antibody
      level after two injections (0.84 microgram/ml); the third injection of PRP-OMP
      produced a modest but statistically significant further elevation in mean
      antibody level (1.14 micrograms/ml). Only 29% of infants receiving PRP-D had
      antibody levels of 1 micrograms/ml, compared with 55%, 75%, and 83% of those
      receiving PRP-OMP, PRP-CRM, and PRP-T, respectively. We conclude that all four
      vaccines are safe and that all but PRP-D appear appropriate for use in a primary
      immunization series during infancy. The unique serologic response to PRP-OMP
      offers both advantages and disadvantages in comparison with PRP-CRM and PRP-T.

PMID- 1735813
TI  - Management of bowel dysfunction in children with spinal cord disease or injury by
      means of the enema continence catheter.
AB  - Because bowel dysfunction in children with spinal cord impairment is a common and
      disabling problem that does not have adequate treatment, we evaluated the enema
      continence catheter developed in Toronto, Canada. Thirty-one children and their
      families were taught to administer a 20 ml/kg saline enema through this device.
      The children's bowel functions were evaluated 18 and 20 months after the start of
      the program. Six of the children dropped out of the study in the first 2 weeks
      and nine dropped out after between 18 and 30 months. For those remaining in the
      study, the proportion of continent stools rose from 28% to 94% (p less than
      0.01); constipated stools dropped from 55% to 15% (p less than 0.01).
      Satisfaction with the bowel program increased, and five children were able to
      switch from diapers to lined underwear. No adverse effects were reported, and the
      amount of time required for toileting did not increase. Although compliance with
      the regimen was difficult for some families and its use carries potential risks,
      we believe that it can provide significant improvement in the bowel care of
      selected persons with spinal cord impairment.

PMID- 1735814
TI  - Limitations of the Glasgow Coma Scale in predicting outcome in children with
      traumatic brain injury.
AB  - OBJECTIVE: To study the hypothesis that, in the absence of an ischemic-hypoxic
      state, children with severe traumatic brain injury and with unfavorable Glasgow
      Coma Scale scores may have good recovery. DESIGN: Retrospective, observational,
      cross-sectional study with factorial design. SETTING: Inpatient population in a
      university hospital. PATIENTS: Seventy-nine children with traumatic brain injury
      admitted to the intensive care unit. INTERVENTIONS: All patients received close
      monitoring and strict control of intracranial pressure (less than 20 mm Hg) and
      cerebral perfusion pressure (greater than 60 mm Hg). MEASUREMENTS AND RESULTS:
      Admission Glasgow Coma Scale score, survival, need for cardiopulmonary
      resuscitation, presence of shock, peak intracranial pressure, duration of coma,
      Glasgow Outcome Scale score, and the results of neuropsychologic tests were
      analyzed. Of 79 children, 70 (89%) survived. Although the mortality rate was
      higher among patients with Glasgow Coma Scale scores of 3 to 5, 14 (64%) of 22 of
      these children survived. Nonsurvivors had a significantly higher incidence of
      shock and need for cardiopulmonary resuscitation. Except for two patients who had
      prolonged hypoxemia, all children, including those with Glasgow Coma Scale scores
      of 3 to 5, had a satisfactory outcome (Glasgow Outcome Scale scores of 4 or 5).
      Neuropsychologic outcome was not significantly different in the survivors with
      Glasgow Coma Scale scores of 3 to 5 and those with Glasgow Coma Scale scores of 6
      or more. CONCLUSIONS: A low Glasgow Coma Scale score does not always accurately
      predict the outcome of severe traumatic brain injury; in the absence of hypoxic
      ischemic injury, children with traumatic brain injury and Glasgow Coma Scale
      scores of 3 to 5 can recover independent function.

PMID- 1735815
TI  - Prognostic indicators of joint destruction in systemic-onset juvenile rheumatoid
      arthritis.
AB  - We retrospectively reviewed the charts and radiographs of 38 patients with
      systemic-onset juvenile rheumatoid arthritis, attempting to identify early in the
      disease course the clinical and laboratory observations most predictive of the
      later development of destructive arthritis. In 12 of the patients, destructive
      arthritis developed within 2 years of disease onset. When first examined, these
      patients could not readily be differentiated from those in whom joint destruction
      did not develop, but they more commonly had hepatosplenomegaly (p less than
      0.04), serositis (p less than 0.01), and a lower mean serum albumin concentration
      (26.7 vs 31.3 gm/L; p less than 0.02). However, by 6 months after onset, patients
      with destructive arthritis more frequently had persistent systemic symptoms (92%
      vs 12%; p less than 0.0001), polyarthritis (67% vs 19%; p less than 0.0005), a
      lower mean hemoglobin level (95 vs 114 gm/L; p less than 0.001), a higher mean
      leukocyte count (21.2 vs 10 x 10(9)/L; p less than 0.0003), a higher mean
      platelet count (794 vs 400 x 10(9)/L; p less than 0.0001), and a higher mean
      erythrocyte sedimentation rate (43 vs 24 mm/hr; p less than 0.05). Multivariate
      analysis of the results at 6 months revealed that persistent systemic symptoms
      and a platelet count greater than or equal to 600 x 10(9)/L were the variables
      most highly predictive of the later development of joint destruction. We conclude
      that patients at high risk for the development of destructive arthritis may be
      identified within 6 months of disease onset, thereby indicating the need for more
      aggressive early therapy.

PMID- 1735816
TI  - Association between severity of gastrointestinal prodrome and long-term prognosis
      in classic hemolytic-uremic syndrome.
AB  - To determine whether severity of the prodromal gastrointestinal illness is
      associated with the course and complications of the extraintestinal
      manifestations of hemolytic-uremic syndrome, we conducted a retrospective review
      of children (n = 509) hospitalized with hemolytic-uremic syndrome. Those who came
      to the hospital with colitis and rectal prolapse associated with hemolytic-uremic
      syndrome (group I, n = 40) were compared with an equal number of time-matched
      children with hemolytic-uremic syndrome but without prolapse (group II). Children
      in group I had evidence of more severe colitis than children in group II had, as
      indicated by increased frequency of bloody diarrhea (p less than 0.001) and
      longer duration of diarrhea (p less than 0.001). However, they also had more
      severe extraintestinal manifestations during hemolytic-uremic syndrome, including
      edema (p less than 0.0001), severe thrombocytopenia (p less than 0.0001),
      prolonged anuria (p less than 0.001), and seizures (p = 0.036). Long-term
      prognosis for recovery of renal function was worse for group I than group II.
      Within group II, patients with bloody diarrhea had milder extraintestinal illness
      than those with prolapse but more severe extraintestinal illness than those with
      watery diarrhea. Analysis of Kaplan-Meier survival curves demonstrated a better
      prognosis for return of normal renal function in the children with watery
      diarrhea but without prolapse (p = 0.009) than in children with bloody diarrhea
      or prolapse. These data demonstrate that the severity of the gastrointestinal
      prodrome reflects the severity of the extraintestinal acute microangiopathic
      process and the resulting long-term outcome. Widespread vascular damage, often
      followed by permanent sequelae, is characteristic of patients with the most
      severe colitis.

PMID- 1735817
TI  - Age-related changes in human blood lymphocyte subpopulations.
AB  - Flow cytometric analysis of major lymphocyte populations and their subsets
      reveals age-related changes in the cellular human immune system. Immunophenotypic
      markers were evaluated in 110 normal pediatric subjects, divided into groups of
      newborn infants, infants aged 2 days to 11 months, and children aged 1 to 6 years
      and 7 to 17 years; results were then compared with those obtained from 101 normal
      adults aged 18 to 70 years. Comparisons among age groups from newborn infants
      through adults reveal progressive declines in the absolute numbers of leukocytes,
      total lymphocytes, and T, B, and natural killer (NK) cells. The percentages of T
      cells within the total lymphocyte population increase with age, in both CD4+ and
      CD8+ subsets. Percentages of B and NK cells are higher in newborn infants than in
      adults. The expression of the activation markers interleukin-2R and HLA-DR on T
      cells increases with age, as does the NK-associated expression of CD57 on CD8
      cells. The proportions of B lymphocytes that coexpress CD5 or CDw78 decrease with
      age, whereas expression of Leu-8 and CD23 increases. The proportion of CD4 cells
      bearing the CD45RA and Leu-8 markers is consistently lower in adults than in
      children. These data may serve as a reference range for studies of pediatric
      subjects.

PMID- 1735818
TI  - Urinary excretion of human growth hormone in children with short stature:
      correlation with pituitary secretion of human growth hormone.
AB  - Thirty-five children with short-stature underwent insulin-loading and sleep tests
      for assessment of secretion of human growth hormone. Correlations between the
      levels of human growth hormone in the serum and urine during the tests were
      examined to elucidate the clinical significance of urinary human growth hormone
      levels in short children. The concentration and total amount of human growth
      hormone in the urine correlated significantly with the peak concentration of
      serum human growth hormone (r = 0.81, p less than 0.001 and r = 0.80, p less than
      0.001, respectively) and the integrated concentration of human growth hormone (r
      = 0.85, p less than 0.001 and r = 0.85, p less than 0.001, respectively) in the
      insulin-loading test. The concentration and total amount of human growth hormone
      in the morning urine also correlated significantly with the peak concentration of
      serum human growth hormone (r = 0.80, p less than 0.001 and r = 0.70, p less than
      0.001, respectively) and the integrated concentration of serum human growth
      hormone (r = 0.80, p less than 0.001 and r = 0.72, p less than 0.001,
      respectively) in the sleep test. The concentration or total amount of human
      growth hormone in the urine differed significantly among children with human
      growth hormone deficiency, those with nonendocrine short stature, and those with
      normal stature (p less than 0.05). These data suggest that measurement of human
      growth hormone in the urine may be used to assess secretion of human growth
      hormone, serving as a screening test for human growth hormone deficiency in
      children.

PMID- 1735819
TI  - Effect of growth hormone treatment on hyperinsulinemia associated with Turner
      syndrome.
AB  - To determine whether the insulin resistance in patients with Turner syndrome,
      which may be exaggerated by treatment with human growth hormone, leads to
      excessive insulin secretion, we applied the hyperglycemic glucose-clamp technique
      to produce a standard hyperglycemic stimulus (6.9 mmol/L, or 125 mg/dl, greater
      than fasting plasma glucose level for 120 minutes) in seven patients with Turner
      syndrome and in seven healthy children. These studies were repeated in the
      patients after 6 to 12 months of therapy with growth hormone. Fasting plasma
      levels of insulin were comparable in control subjects and patients before therapy
      but increased significantly in the patients after 6 to 12 months of treatment
      with growth hormone. Despite identical glucose increments in the two groups
      during the glucose-clamp procedure, both first- and second-phase insulin
      responses were significantly greater in the patients than in the control
      subjects. Moreover, the hyperinsulinemic responses to glucose were markedly
      exaggerated in the patients after their treatment with growth hormone, reaching
      values (first phase 474 +/- 100 pmol and second phase 826 +/- 100 pmol; p less
      than 0.02 vs pretreatment values) that were almost threefold greater than those
      in control subjects (p less than 0.001). Nevertheless, the rate of insulin
      stimulated glucose metabolism during the last 60 minutes of the clamp procedure
      was similar in all three groups of studies. Glycosylated hemoglobin, total
      cholesterol level, and blood pressure remained normal in patients after therapy
      with growth hormone. We conclude that glucose-stimulated insulin response is
      increased in patients with Turner syndrome and that these alterations are further
      exaggerated by treatment with growth hormone. These hyperinsulinemic responses
      appear to compensate for reductions in insulin sensitivity.

PMID- 1735820
TI  - Accelerated growth rates in children treated with growth hormone after renal
      transplantation.
AB  - To determine the usefulness of growth hormone treatment among children with renal
      allografts, we treated nine children with functioning renal transplants who were
      less than 16 years of age and had poor growth. The nine children, who were aged
      12.6 +/- 4.0 years, had (1) heights greater than 2.5 SD less than the mean for
      age, (2) growth rates less than or equal to 5 cm/yr, and (3) additional growth
      potential, as assessed by bone age (8.9 +/- 2.8 year). Insulin-like growth factor
      I, thyrotropin, and thyroid hormone levels were normal for age in all children.
      Growth hormone treatment increased growth rates from 1.9 +/- 1.1 cm/yr to 7.2 +/-
      1.8 cm/yr without accelerating skeletal maturation and without advancing pubertal
      status. During growth hormone treatment, serum creatinine concentration rose from
      140 +/- 50 to 190 +/- 80 mumol/L (1.6 +/- 0.6 to 2.1 +/- 0.9 mg/dl) (p less than
      0.05), and creatinine clearances decreased from 0.79 +/- 0.37 to 0.58 +/- 0.30
      ml/sec per 1.73 m2 (47 +/- 22 to 35 +/- 18 ml/min per 1.73 m2) (p less than 0.05)
      but then remained stable. Growth rates of two patients returned to pretreatment
      rates when growth hormone treatment was discontinued after 5 and 7 months because
      of increased serum creatinine values. Growth hormone treatment may be useful as
      adjunctive therapy for increasing growth rates in selected children with renal
      allografts who have poor growth; however, serum creatinine concentrations should
      be closely monitored during such treatment.

PMID- 1735821
TI  - Descriptive study of genital variation in healthy, nonabused premenarchal girls.
AB  - This descriptive colposcopic study of the genitals of symptom-free young girls
      not thought to have been sexually abused was undertaken to contribute toward our
      understanding of normal female genital anatomy in this age group. Girls were
      examined and photographed, with labial traction in a supine frog-leg position
      while they were under anesthesia before minor elective surgery. The final study
      sample consisted of 79 premenarchal girls, aged between 3 months and 11 years 7
      months (mean, 5 years 4 months). The study demonstrated wide anatomic variation
      and a high frequency of minor irregularities that have previously been noted in
      studies of sexually abused girls. Specific findings included increased
      vascularity (44%), midline avascular areas (27%), "ragged" posterior fourchette
      epithelium (18%), notch configuration of the posterior fourchette (10%), delicate
      tethers between the hymen and perihymen (14%), hymenal bumps between the 3 and 9
      o'clock positions (11%), and asymmetry of the hymenal tissue (9%). Girls who at
      initial examination had apparently abnormal vestibules had either large hymenal
      orifices (11%) or multiple irregularities (11%). The study emphasizes the danger
      of overinterpreting small anatomic findings when one is evaluating the
      possibility of sexual abuse in girls; such findings may lie within the range of
      normal variation.

PMID- 1735822
TI  - Sexual abuse in girls: what have we learned about genital anatomy?

PMID- 1735823
TI  - Association of poor clinical status and heavy exposure to tobacco smoke in
      patients with cystic fibrosis who are homozygous for the F508 deletion.
AB  - We examined the association between clinical status and exposure to tobacco smoke
      in 44 patients homozygous for the F508 cystic fibrosis mutation. Heavy exposure
      to tobacco smoke was significantly associated with lower Shwachman scores, poorer
      results of pulmonary function tests, and a fivefold increase in the number of
      pulmonary-related hospitalizations during the previous year.

PMID- 1735824
TI  - The clitoral index: a determination of clitoral size in normal girls and in girls
      with abnormal sexual development.
AB  - Clitoral measurements were obtained in normal children; small increases in
      clitoral dimensions were associated with growth and puberty. Patients with
      androgen excess had major increases in clitoral size, clearly different from
      normal values.

PMID- 1735825
TI  - Quadriplegia after chiropractic manipulation in an infant with congenital
      torticollis caused by a spinal cord astrocytoma.
AB  - An infant with congenital torticollis underwent chiropractic manipulation, and
      within a few hours had respiratory insufficiency, seizures, and quadriplegia. A
      holocord astrocytoma, with extensive acute necrosis believed to be a result of
      the neck manipulation, was found and resected. We believe that every child with
      torticollis, regardless of age, should undergo neurologic and radiologic
      evaluation before any form of physical treatment is instituted.

PMID- 1735826
TI  - Acute infantile cardiomyopathy as a presenting feature of mucopolysaccharidosis
      VI.
AB  - An infant with a diagnosis of acute infantile cardiomyopathy was subsequently
      shown to have mucopolysaccharidosis VI. The mucopolysaccharidoses should be
      included in the differential diagnosis of infantile cardiomyopathy.

PMID- 1735827
TI  - Reversible hypertrophic cardiomyopathy associated with nesidioblastosis.
AB  - An infant with persistent hyperinsulinism had hypertrophic cardiomyopathy that
      progressed until near-total pancreatectomy was performed. After pancreatectomy
      the condition resolved. Hyperinsulinism may be a cause of treatable
      cardiomyopathy.

PMID- 1735828
TI  - Paraneoplastic syndrome manifesting as chronic cerebellar ataxia in a child with
      Hodgkin disease.
AB  - An 8-year-old boy had nausea and vomiting associated with nystagmus, ataxia, and
      dysarthria of acute onset. Three years later he had a mass in the anterior
      mediastinum as a result of Hodgkin disease of mixed cellularity. This association
      of paraneoplastic cerebellar degeneration with Hodgkin disease has been described
      in adults.

PMID- 1735829
TI  - Dose-dependent responses to macrophage-targeted glucocerebrosidase in a child
      with Gaucher disease.
AB  - Long-term studies of a child with Gaucher disease indicated that the response to
      treatment with macrophage-targeted glucocerebrosidase (glucosylceramidase) is
      dose dependent, and that the hematologic response precedes the skeletal response.

PMID- 1735830
TI  - Randomized trial of granulocyte transfusions versus intravenous immune globulin
      therapy for neonatal neutropenia and sepsis.
AB  - We prospectively studied newborn infants with sepsis and neutropenia who were
      randomly selected to receive standard supportive care and either adjuvant
      granulocyte transfusions or intravenous immune globulin (IVIG) infusions; 21
      infants received granulocyte transfusions and 14 received IVIG infusions. Half of
      the patients were premature (gestational age less than or equal to 32 weeks); the
      average postnatal age was 5 days (range 3 to 8 days). All infants had neutropenia
      by the criteria of Manroe et al., and the mean average bone marrow neutrophil
      storage pool ranged between 35% and 37%. There were no significant differences
      with respect to serum IgG, IgA, IgM, and total hemolytic complement values
      between treatment groups or between survivors and nonsurvivors. Clinical severity
      as defined by hypoxia, acidosis, and hypotension was similar between treatment
      groups. Group B streptococcus was the most common organism identified and
      accounted for almost 33% of all bacterial isolates. There was a significantly
      different survival rate in the group receiving polymorphonuclear leukocyte
      transfusions (100%, 21/21) compared with the group receiving IVIG infusions (64%,
      9/14; p = less than 0.03). There were no significant complications in either
      treatment group with respect to fluid overload, secondary infection, blood group
      sensitization, pulmonary complications, or graft-versus-host disease. This pilot
      study suggests a possible benefit of granulocyte transfusions compared with 'IVIG
      therapy in the adjuvant treatment of neonatal neutropenia and overwhelming
      bacterial sepsis.

PMID- 1735831
TI  - Hypertrophic cardiomyopathy associated with dexamethasone therapy for
      bronchopulmonary dysplasia.
AB  - The potential induction of cardiac effects by high-dose dexamethasone therapy was
      evaluated prospectively in 13 respirator-dependent infants with bronchopulmonary
      dysplasia by means of two-dimensional and M-mode echocardiography. The initial
      divided dose of dexamethasone was 500 micrograms/kg per day, tapered
      progressively for as long as 6 weeks. Evaluations were made before treatment and
      at 3, 7, 14, 21, 28, 35, and 42 days after the start of dexamethasone therapy.
      This regimen was associated with a significant (p less than 0.01) increase in
      thickness of the interventricular septum (2.60 +/- 0.09 to 4.00 +/- 0.16 mm),
      diastolic left ventricular free wall (2.80 +/- 0.13 to 4.06 +/- 0.20 mm), and
      diastolic right ventricular free wall (1.55 +/- 0.08 to 2.02 +/- 0.12 mm). In
      addition, seven dexamethasone-treated infants but no control infants had systolic
      anterior motion of the mitral valve (p less than 0.001). These effects were
      transient, reached their maximal degree by the third week of treatment, and
      approached pretreatment conditions by the sixth week of treatment. Ejection
      fraction was not affected; heart rate and mean arterial pressure were transiently
      increased during dexamethasone therapy. We conclude that a transient absolute
      myocardial hypertrophy is associated with dexamethasone therapy in infants with
      bronchopulmonary dysplasia. The mechanism or mechanisms through which this
      hypertrophy arises and the cardiopulmonary implications are unclear.

PMID- 1735832
TI  - Relationship between determinants of oxygen delivery and respiratory
      abnormalities in preterm infants with anemia.
AB  - To study the relationship between anemia and breathing abnormalities in preterm
      infants, we measured oxygen supply and demand in two groups of anemic infants
      less than or equal to 32 weeks of gestational age. Six-second apnea density was
      less than 1% in one group and greater than or equal to 5% in the other. There
      were no differences in hemoglobin concentration, available oxygen, oxygen
      consumption, or Doppler-determined cardiac output between the two groups of
      infants. Furthermore, in anemic preterm infants with apnea density greater than
      or equal to 5%, reductions in 6-second apnea density were similar after
      erythrocyte transfusion (mean +/- SEM: from 8.6% +/- 1.1% to 4.7% +/- 0.7%) or
      after an isovolemic infusion of 5% albumin (from 9.0% +/- 1.4% to 4.7% +/- 0.7%).
      These results show no relationship between measures of oxygen delivery and
      respiratory irregularities, and indicate that volume expansion may play a role in
      ameliorating the pneumocardiogram abnormalities.

PMID- 1735833
TI  - Neonatal hematocrit and maternal glycemic control in insulin-dependent diabetes.
AB  - We hypothesized that in infants of diabetic women neonatal hematocrit would
      correlate with third-trimester maternal glycemic control. Neonatal hematocrit
      correlated with the maternal total glycosylated hemoglobin level at delivery (r =
      0.36; p less than 0.05) but not at 36 weeks of gestation in 32 mother-infant
      pairs. Improved maternal glycemic control during late gestation may decrease the
      incidence of neonatal polycythemia.

PMID- 1735834
TI  - Phototherapy and the brain-stem auditory evoked response in neonatal
      hyperbilirubinemia.
AB  - The latencies of peak V and interpeaks I-V and III-V in the brain-stem auditory
      evoked response of infants with hyperbilirubinemia before phototherapy were
      significantly greater than those in a control group of infants. These values of
      the brain stem auditory-evoked response improved significantly during
      phototherapy and correlated significantly with the declining bilirubin levels.
      Improvement continued after phototherapy, despite a rebound of serum bilirubin
      concentrations.

PMID- 1735835
TI  - Factors associated with condom use among sexually active female adolescents.
AB  - A health belief model of condom use was used to identify factors associated with
      condom use in 390 sexually active female adolescents, aged 12 through 19 years,
      recruited at the time of a visit for reproductive health care. Fifty-six percent
      were white and the remainder black. Nineteen percent had genitourinary infections
      with Chlamydia trachomatis. Forty-six percent reported having had more than one
      sexual partner in the preceding year. Reported condom use for at least one
      specific reason (prevention of pregnancy, sexually transmitted disease, or
      acquired immunodeficiency syndrome) increased as behavioral, emotional, and
      sexually transmitted disease risk decreased, and as cognitive maturity and
      positive condom attitudes increased. Although uses of condoms to prevent
      pregnancy, sexually transmitted disease, and acquired immunodeficiency syndrome
      were positively intercorrelated, each made a contribution to explaining condom
      use at most recent coitus (odds ratios 2.95, 3.96, and 2.81, respectively). After
      statistical adjustment for the reported reasons for previous condom use,
      behavioral risk was the only additional factor associated with condom use at the
      most recent sexual encounter; women who participated in more risk behaviors
      (substance and alcohol use and minor delinquency) were less likely to have used a
      condom (odds ratio 0.61). Knowledge about sexually transmitted disease and
      acquired immunodeficiency syndrome, and concurrent use of contraceptive pills,
      were not related to condom practices. The data suggest that adolescents'
      perceptions about condoms, including the individual functions of condoms for
      contraception and for prevention of sexually transmitted disease, may be
      important in determining their use. Engaging in unprotected intercourse may be
      part of a larger behavioral domain that includes other unhealthy behaviors.

PMID- 1735836
TI  - Association of pulmonary hypertension with congenital portal hypertension in a
      child.

PMID- 1735837
TI  - Hypercalciuria in osteogenesis imperfecta.

PMID- 1735838
TI  - Addendum to report of partial hypoxanthine-guanine phosphoribosyl transferase
      deficiency.

PMID- 1735839
TI  - "Transient" congenital hypoparathyroidism.

PMID- 1735840
TI  - Oral captopril test in children.

PMID- 1735841
TI  - Kawasaki disease and rug shampooing.

PMID- 1735842
TI  - Graduate medical education.

PMID- 1735843
TI  - Neutrophil values in infants born at high altitudes.

PMID- 1735844
TI  - Hyperinsulinemia, cardiomyopathy, and diazoxide therapy.

PMID- 1735845
TI  - Results of laboratory surveillance of very low birth weight infants treated with
      a synthetic surfactant.
AB  - During two randomized, controlled trials comparing single prophylactic doses of
      air placebo and a synthetic surfactant, Exosurf Neonatal, many routine laboratory
      measurements were made in small premature infants during the first week of life.
      Values for serum electrolytes, urea, creatinine, phospholipid, cholesterol,
      glucose, calcium, bilirubin, and liver enzymes, as well as for hemoglobin,
      leukocyte and platelet counts, and urinalysis, did not differ between the placebo
      and surfactant-treated infants. There was no evidence that prophylactic
      administration of this synthetic surfactant causes alterations in standard
      laboratory tests in small premature infants.

PMID- 1735846
TI  - Pulmonary mechanics and energetics in preterm infants who had respiratory
      distress syndrome treated with synthetic surfactant.
AB  - Pulmonary mechanics and energetics were determined in 32 neonates with
      respiratory distress syndrome, who were randomly assigned to receive treatment
      with an exogenous synthetic surfactant, Exosurf Neonatal, or air placebo.
      Pulmonary mechanics were measured before and 2 hours after surfactant (n = 13) or
      air placebo (n = 19) treatment, then longitudinally at 24, 48, and 72 hours after
      treatment, and again at 7, 14, and 28 days of age. There were no significant
      differences in the values for pulmonary mechanics or energetics 2 hours after the
      first dose of surfactant. Improvement in pulmonary mechanics was apparent 24
      hours after surfactant treatment, when dynamic compliance was 36% greater than in
      the placebo group (p less than 0.03). Lung compliance values were also higher in
      surfactant-treated infants 48 and 72 hours after treatment, with a maximal
      increase of 64% at 7 days of age (p less than 0.03). Surfactant treatment also
      caused a significant decrease in total pulmonary resistance at 48 and 72 hours
      after initial treatment and at 14 days of age (p less than 0.04). Similarly, a
      decrease in flow-resistive work of breathing was demonstrated 24, 48, and 72
      hours after surfactant treatment. At 28 days of age, pulmonary mechanics were not
      different in the two groups. We conclude that beneficial effects of surfactant on
      pulmonary mechanics were not apparent 2 hours after dosing but were evident 24
      hours after dosing and persisted for the first 7 to 14 days of life.

PMID- 1735847
TI  - Pulmonary mechanics in premature infants one month after treatment with synthetic
      surfactant.
AB  - During the double-blind, multicenter trials of the synthetic surfactant Exosurf
      Neonatal, we measured pulmonary mechanics at 28 days of age in 30 surfactant- or
      placebo-treated infants. In the 20 surfactant-treated and 10 air-treated infants
      studied, there were no differences in lung compliance or resistance at 28 days of
      age. These observations suggest that improvements in pulmonary function reported
      early in the neonatal course after the administration of exogenous surfactant are
      not detectable at 28 days of age.

PMID- 1735848
TI  - Energy expenditure during synthetic surfactant replacement therapy for neonatal
      respiratory distress syndrome.
AB  - Little information is available on the energy expenditure of infants with
      increased work of breathing from respiratory distress syndrome (RDS). A study was
      carried out to determine whether surfactant replacement therapy modifies
      respiratory gas exchange in newborn infants with RDS and an arterial-alveolar
      oxygen tension ratio of less than 0.22. In a double-blind, placebo-controlled,
      rescue trial, infants received either two 5 ml/kg doses of a synthetic
      surfactant, Exosurf Neonatal, or air placebo. Of 23 infants ventilated for RDS,
      11 were randomly assigned to receive air and 12 to receive surfactant. Oxygen
      consumption, carbon dioxide production, respiratory quotient, and metabolic rate
      were measured by computerized, closed-circuit, indirect calorimetry.
      Concomitantly, transcutaneous oxygen and carbon dioxide tension were continuously
      recorded. Oxygen consumption and carbon dioxide production remained constant
      during the period infants received surfactant. In patients randomly assigned to
      surfactant, a decrease in respiratory quotient was observed after the first (p
      less than 0.025) but not the second dose. This decrease was possibly related to a
      change in substrate utilization. The improved clinical outcomes reported among
      infants receiving surfactant were not accompanied by changes in energy
      expenditure.

PMID- 1735849
TI  - Controlled trial of a single dose of synthetic surfactant at birth in premature
      infants weighing 500 to 699 grams. The American Exosurf Neonatal Study Group I.
AB  - In a multicenter, double-blind, placebo-controlled trial conducted at 23
      hospitals in the United States, a single prophylactic 5 ml/kg dose of a synthetic
      surfactant (Exosurf Neonatal) or air placebo was administered shortly after birth
      to 215 infants with birth weights of 500 to 699 gm. Despite stratification at
      entry by birth weight and gender, by chance female infants predominated in the
      air placebo group and male infants predominated in the surfactant group. Among
      infants receiving synthetic surfactant, improvements in oxygen requirements were
      significant at 2 hours after birth (p = 0.014) and persisted for 3 days (p =
      0.001); improvements in the alveolar-arterial partial pressure of oxygen gradient
      were significant at 6 hours after birth (p = 0.01) and persisted for 3 days (p =
      0.008). Improvements in mean airway pressure were not significant at 2 or at 6
      hours after birth (p = 0.622 and 0.083, respectively), but became significant
      thereafter and persisted for 3 days (p = 0.002). Pneumothorax was reduced by
      slightly more than half (25 vs 11; p = 0.014); death from respiratory distress
      syndrome (RDS) was also reduced (26 vs 15; p = 0.046). Overall neonatal
      mortality, however, was not significantly reduced (58 vs 46; p = 0.102). Other
      complications of RDS and prematurity were not altered, except that pulmonary
      hemorrhage occurred significantly more frequently in infants receiving synthetic
      surfactant (2 vs 12; p = 0.006). These findings indicate that a single
      prophylactic dose of synthetic surfactant in infants weighing 500 to 699 gm at
      birth improves lung function, incidence of air leak, and death from RDS but not
      overall mortality. The only safety problem identified was an increase in
      pulmonary hemorrhage.

PMID- 1735850
TI  - Elastase activity and surfactant protein concentration in tracheal aspirates from
      neonates receiving synthetic surfactant.
AB  - Neutrophil elastase activity and the concentration of surfactant proteins A and B
      (SP-A, B) were measured in tracheal aspirate fluid from preterm neonates who were
      treated with the synthetic surfactant Exosurf Neonatal or air placebo in
      randomized, placebo-controlled, clinical trials. Elastase activity was
      transiently reduced in surfactant-treated infants on the second day of life, but
      the reduction was not sustained. In placebo-treated infants with established
      respiratory distress syndrome, tracheal aspirate SP-A was low on the first day of
      life and increased with time as respiratory distress syndrome resolved. In
      infants with respiratory distress syndrome treated with surfactant, significantly
      higher levels of SP-A were observed by 2 days after treatment and were maintained
      through at least the sixth day of life. These data suggest that lung inflammation
      is not increased and that endogenous surfactant secretion may be stimulated, not
      suppressed, by treatment with synthetic surfactant.

PMID- 1735851
TI  - Pulmonary hemorrhage in premature infants after treatment with synthetic
      surfactant: an autopsy evaluation. The American Exosurf Neonatal Study Group I,
      and the Canadian Exosurf Neonatal Study Group.
AB  - In an across study analysis of five multicenter, placebo-controlled trials of the
      synthetic surfactant, Exosurf Neonatal in infants weighing at least 700 gm, the
      incidence of clinical pulmonary hemorrhage was 1.9% in treated infants and 1.0%
      in control infants. To investigate whether a similar increase was also present
      histologically at postmortem examination, a blinded retrospective review of all
      autopsy reports from infants dying during these five trials was conducted.
      Pulmonary hemorrhage was present in 55% of 159 infants undergoing autopsy; the
      incidence was not different in infants treated with surfactant or air placebo.
      Birth weight was inversely related to the incidence of pulmonary hemorrhage in
      both groups. Pulmonary pathologic findings significantly associated with
      pulmonary hemorrhage included pulmonary interstitial emphysema and necrotizing
      laryngotracheitis in both groups. In the surfactant group, patent ductus
      arteriosus, intraventricular hemorrhage, and pneumothorax were significantly more
      frequent among those who developed pulmonary hemorrhage. In contrast to clinical
      diagnosis, pathologic diagnosis of pulmonary hemorrhage at autopsy was not more
      common in infants treated with Exosurf Neonatal.

PMID- 1735852
TI  - Retrospective search for bleeding diathesis among premature newborn infants with
      pulmonary hemorrhage after synthetic surfactant treatment. The American Exosurf
      Neonatal Study Group I, and the Canadian Exosurf Neonatal Study Group.
AB  - In an across study analysis of five multicenter, placebo-controlled trials of the
      synthetic surfactant, Exosurf Neonatal, involving infants with birth weights 700
      gm or greater the incidence of clinical pulmonary hemorrhage was 1.9% in treated
      infants and 1.0% in control infants. To determine whether this apparent increase
      in pulmonary hemorrhage was the result of a bleeding diathesis, we
      retrospectively reviewed charts for 39 of 41 infants with clinical pulmonary
      hemorrhage. The incidence of nonpulmonary bleeding was the same in control- and
      surfactant-treated infants. Platelet counts, hematocrit values, and the number of
      transfusions with platelets or red blood cells did not differ between the two
      groups. There was no evidence that surfactant treatment was specifically
      associated with a generalized bleeding diathesis.

PMID- 1735853
TI  - Postoperative pressure elevation. A rational approach to its prevention and
      management.

PMID- 1735854
TI  - Active transport system of prostaglandins: clinical implications and
      considerations.
AB  - We hypothesize that two factors are essential in the development of epinephrine
      induced cystoid macular edema (CME): (1) the stimulation of prostaglandin
      synthesis by some tissues, presumably the anterior uvea by epinephrine; (2) the
      dysfunction of the active transport (Bito's pump) which is responsible for the
      removal of prostaglandins from intraocular fluids. We conducted several
      experimental studies to confirm these hypotheses. The results strongly suggest
      that epinephrine maculopathy is induced by a mechanism involving prostaglandins
      or, possibly, other related eicosanoids and not simply by epinephrine itself, as
      has been postulated. This suggests the existence of some common factors in the
      pathogenesis of epinephrine maculopathy and aphakic or pseudophakic CME.

PMID- 1735855
TI  - Postoperative inflammation following cataract extraction caused by bacterial
      contamination of the cleaning bath detergent.
AB  - Five of 16 patients who had uncomplicated cataract extraction with intraocular
      lens (IOL) implantation within a 2.5 day period experienced increased anterior
      segment inflammation on their first postoperative day. Four of these five
      patients had phacoemulsification and one a planned extracapsular cataract
      extraction. All had posterior chamber IOL implantation in the capsular bag. In
      all patients, this anterior segment inflammation cleared with topical steroids
      over two to three weeks with no evident residual ocular effects. A careful search
      for the possible cause of the inflammation showed that the ultrasonic cleaning
      bath and Weck liquid detergent used to clean the instruments contained Klebsiella
      pneumoniae bacteria. Further investigation demonstrated the presence of a heat
      stable endotoxin produced by the bacteria. We postulate that endotoxin remaining
      on the instruments after cleaning and sterilization caused this postoperative
      anterior segment inflammation. To the best of our knowledge, these are the first
      reported cases caused by contaminated liquid detergent.

PMID- 1735856
TI  - Excimer laser ablation of a corneal protuberance.
AB  - The ablation of a post-traumatic superficial corneal nodule with an argon
      fluoride excimer laser is reported. Three months postoperatively the area had a
      smooth surface with no distortion of adjacent cornea.

PMID- 1735857
TI  - Consultation section. A female with unilateral high myopia has become contact
      lens intolerant and developed an exodeviation of the myopic eye when wearing
      spectacles.

PMID- 1735858
TI  - Collagel--a new viscoelastic substance for ophthalmic surgery.
AB  - A clinical trial comparing the viscoelastic properties of Collagel (human
      collagen) and Healon (sodium hyaluronate) was performed. Collagel was well
      tolerated and produced no untoward reaction in the eye. Flare cell measurement
      was performed during the seven day postoperative period. The initial peak and
      decline of flare and cell determination showed a similar course in groups treated
      with Collagel or Healon. A transient increase in intraocular pressure was seen.
      Endothelial cell loss following surgery was similar in the Collagel and Healon
      groups. There were no significant differences in intraocular pressure, corneal
      thickness, endothelial cell density, or visual acuity during the postoperative
      period. These results suggest that this new viscoelastic substance is comparable
      to Healon in respect to the parameters described.

PMID- 1735859
TI  - Three versus four radial keratotomy incisions.
AB  - Radial keratotomy (RK) is currently performed with four or eight semi-radial
      incisions. To evaluate the effect of a theoretically more stable three-incision
      RK pattern, centripetal incisions were made in 16 human donor eyes (eight pairs),
      using a double-edged diamond blade set to 90% of central pachymetry and a 3.5 mm
      optical clear zone. Intraocular pressure was maintained at 15 mm Hg during
      surgery and while keratometry readings were made. One randomly selected eye of
      each pair had three radial incisions made at 12, 4 and 8 o'clock; the other eye
      had four radial incisions at 12, 3, 6, and 9 o'clock. Corneal flattening was 6.08
      diopters (D) with four incisions and 4.84 D with three incisions (P less than
      .05). Astigmatism increased 0.44 D and 0.69 D, respectively (P greater than .1).
      Histologically measured mean incision depth (77.4%) did not differ significantly
      between the groups (P greater than .1). This study shows that 80% of the effect
      of a four-incision RK pattern can be obtained with a theoretically more stable
      three-incision pattern.

PMID- 1735860
TI  - Excimer laser intrastromal keratomileusis: case reports.
AB  - We report the results in six eyes on which we performed a new surgical method:
      intrastromal corneal excimer laser photoablation following lamellar corneal
      keratectomy with a microkeratome. The study was designed to evaluate the clinical
      and refractive efficacy of the procedure, to assess the behavior of the cornea
      following stromal photoablation, and to evaluate the relationship between the
      number of laser pulses and the decrease of myopia. The technique demonstrated an
      excellent corneal response to photoablation but a poor refractive predictability.

PMID- 1735861
TI  - Effect of small incision intraocular lens surgery on postoperative inflammation
      and astigmatism. A study of the AMO SI-18NB small incision lens.
AB  - A single center, single surgeon, randomized, prospective clinical trial was
      performed comparing the effectiveness of small (3.5 mm to 4.0 mm) incision
      intraocular lens surgery and a larger (6.0 mm) incision in improving uncorrected
      visual acuity and reducing post-operative inflammation and surgically induced
      astigmatism. One hundred twelve eligible unilateral cases were randomized to
      receive a 3.5 mm to 4.0 mm incision with implantation of an Allergan Medical
      Optics three-piece SI-18NB silicone lens (56 cases) or a 6.0 mm incision with
      implantation of a three-piece biconvex poly(methyl methacrylate) lens (56 cases).
      At one day after surgery, significantly (P less than .01) more patients with 3.5
      mm incisions had 20/40 or better uncorrected visual acuity than patients with 6.0
      mm incisions (45% vs 20%). Forty percent of patients with 6.0 mm incisions vs 14%
      of patients with 3.5 mm incisions had visual acuities of 20/100 or worse. At one
      day after surgery, the larger incision group had significantly higher (P less
      than .01) mean keratometric cylinder (2.28 diopters vs 1.28 diopters in the small
      incision group). The two groups were comparable by three months. Laser flare/cell
      meter measurements were taken for each group but showed no significant
      differences in mean flare or cell measurements between the groups.

PMID- 1735862
TI  - Ultrastructure of cells cultured onto various intraocular lens materials.
AB  - The response of three cell types (human fibroblasts, monocytes, and platelets),
      cultured or seeded onto different intraocular lens materials, was analyzed by
      ultrastructural examination. The materials considered were poly(methyl
      methacrylate) (PMMA), heparin surface-modified PMMA, plasma-treated PMMA, and
      hydrogel. Significant differences in density and distribution of the cultured
      cells were demonstrated among these materials. The ultrastructure of the cells
      appeared to be normal, except in one case. Disorganization of the points of focal
      contact and of the cytoskeletal elements was found in the fibroblasts cultured
      onto all materials except PMMA. Morphological evidence of cell activation was
      observed for some materials, but this requires confirmation by more specific
      immunocytochemical tests.

PMID- 1735863
TI  - Inflammatory response in the rabbit eye after intraocular implantation with
      poly(methyl methacrylate) and heparin surface modified intraocular lenses.
AB  - Early inflammatory responses in rabbit eyes after anterior chamber implantation
      with poly(methyl methacrylate) (PMMA) and heparin surface modified intraocular
      lenses (IOLs) and after cataract extraction and implantation with PMMA and
      heparin surface modified intraocular lenses (IOLs) were investigated between 1
      and 30 days postoperatively. The number of white blood cells in the aqueous
      humor, the distribution of white blood cell subsets, and the interleukin-1 (IL
      1b) levels were studied. At one day postoperatively, there was a significantly
      smaller number of white blood cells in eyes with heparin surface modified IOLs
      than in eyes with PMMA IOLs after both anterior chamber implantation and cataract
      surgery and capsular bag implantation. At one day postoperatively, 87% of the
      cell population in eyes with PMMA IOLs were neutrophilic granulocytes. Two days
      later the neutrophilic granulocytes had decreased to 13% and at seven days they
      were gone. At 14 days the frequency was 7% and at 30 days it was 27%. The
      fraction of monocytes/macrophages in the cell population was 9% (day 1), 79% (day
      3), 94% (day 7), 81% (day 14), and 72% (day 30). The fraction of lymphocytes was
      low throughout the test period (1% to 10%). The percentages were almost the same
      in eyes with heparin surface modified IOLs and there was no significant
      difference in the distribution of white blood cell subsets between the two lens
      materials. The IL-1 was not detected in any of the samples (day 3, day 7, and day
      30). Inactivated macrophages and/or levels under detection limits could be the
      reason.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735864
TI  - Use of in vitro models of bovine corneal endothelial cells to determine the
      relative toxicity of viscoelastic agents.
AB  - Healon, Viscoat and Amvisc Plus (Amvisc+) are commercial preparations containing
      hyaluronic acids of different molecular weights and viscosities. Cytotoxicity of
      these preparations to the corneal endothelium may be a factor in postsurgical
      recovery of the cornea. Using different in vitro models of bovine corneal
      endothelial cells (BCEC), three experiments to compare the possible detrimental
      effects of these viscoelastic agents were designed. In the confluent model,
      confluent BCEC were exposed to viscoelastic agents and the control to Balanced
      Salt Solution Plus (BSS+) for one hour and the nuclear density (nuclei/mm2) was
      assessed at 24 and 168 hours. At both times, the BCEC exposed to Healon showed
      the highest nuclear densities. In the preconfluent model, BCEC were treated for
      one hour at 48 hours post-seeding. The nuclear density of the BCEC was assessed
      at 24 hours. The BCEC exposed to Healon showed the highest density, followed by
      those exposed to Amvisc+ and then Viscoat. In the proliferation model, BCEC were
      cultured in media containing 1%, 5%, and 10% viscoelastic agents. The growth
      curves based on nuclear densities at 0, 24, 72, 120, and 168 hours in all
      treatment groups did not differ significantly from the control. The results
      indicate that the undiluted Healon was significantly less toxic in the
      preconfluent and confluent BCEC models.

PMID- 1735865
TI  - Heparin surface modified intraocular lenses. Three-month follow-up of a
      randomized, double-masked clinical trial.
AB  - Two types of intraocular lenses (IOLs) were used in a controlled, randomized,
      double-masked clinical trial. The study lens was a one-piece, poly(methyl
      methacrylate) (PMMA) lens with heparin grafted on the entire surface. The control
      lens was identical in all respects but lacked the heparin surface. The IOLs were
      implanted in the capsular bag after extracapsular cataract extraction in 266
      patients. No unexpected reactions or severe complications occurred. The
      postoperative visual acuity of all cases at the three-month visit was 20/40 or
      better in 91.6% of the heparin group and in 86.2% of the control group. When
      excluding cases with preoperative pathology, 97% of the heparin group and 95% of
      the control group had a visual acuity of 20/40 or better. A mild iritis was
      observed in one case of the heparin group and in four cases of the control group
      at three months. At three months there was a statistically significant difference
      between the heparin surface modified and control IOLs for both the number of
      patients with cellular precipitates and the number of precipitates per IOL. From
      the present data we conclude that during the first three postoperative months
      heparin surface modified lenses are more biocompatible than PMMA lenses.

PMID- 1735866
TI  - Indications for and results of intraocular lens explantation.
AB  - We reviewed the medical records of 97 patients who had 101 consecutive
      intraocular lens (IOL) explantation procedures, with or without exchange, at the
      University of Florida Eye Center from January 1, 1983, to December 31, 1987. The
      majority of the removed IOLs were anterior chamber styles (53.9%), followed by
      iris-fixated lenses (33.7%). The most common indications for surgery included
      pseudophakic bullous keratopathy (PBK)--69%, uveitis-glaucoma-hyphema (UGH)
      syndrome--9%, and IOL instability--7%. The best visual outcome was seen in
      patients with IOL instability; 50% achieved 20/40 or better visual acuity. Forty
      one percent of patients with PBK, who had IOL explantation/exchange combined with
      penetrating keratoplasty, achieved 20/40 or better visual acuity. The poorest
      visual outcome was seen in patients with the UGH syndrome; 83% had a final acuity
      of 20/200 or worse. However, these patients achieved resolution of their pain and
      inflammation and better control of their intraocular pressure as a result of the
      surgery. Complications leading to IOL explantation tended to occur months to
      years after the original surgery in patients with closed-loop, semi-flexible
      anterior chamber lenses and iris-fixated lenses. Posterior chamber lenses were
      most often removed because of complications unrelated to the implant.

PMID- 1735867
TI  - Optical quality of intraocular lenses.
AB  - The ANSI Z80.7 standard for intraocular lens quality is being updated. This paper
      identifies areas that require revision and suggests that a clear distinction
      between the lens design and the quality control test methods be made. The
      standard monofocal lens design consists of two spherical surfaces, and lens power
      can be specified by the thick lens equation, using body temperature refractive
      index values at a wavelength of 550 nm. Interferometry might be used as a primary
      manufacturing test method for poly(methyl methacrylate) lenses; tolerance values
      for lens surface errors are suggested. Other test methods can also be used.
      Measuring the modulation transfer function in fluid may be the most useful.

PMID- 1735868
TI  - Minimizing anisometropia in bilateral pseudophakia.
AB  - One hundred twenty patients who had bilateral posterior chamber intraocular lens
      implantation were analyzed for postoperative anisometropia. All pairs of lenses
      had the same A constant and similar designs. Several parameters were analyzed to
      identify patients at higher risk for clinically significant anisometropia upon
      implantation of the second eye and determine whether the results of the first eye
      could be used to modify the implant power selected for the second eye to reduce
      the risk of anisometropia. In most cases, simply using the value of the linear
      regression prediction for emmetropia in the second eye without modifications
      minimized anisometropia.

PMID- 1735869
TI  - Effect of music therapy in the postanesthesia care unit: a nursing intervention.
AB  - This study examined the effect of music on pain, hemodynamic variables, and
      respiration in the PACU, and the impact of music on patients' recall of their
      PACU experience. Sixty patients scheduled for thyroid, parathyroid, or breast
      surgery under general anesthesia were studied. Patients were randomly assigned
      into three groups: group 1, control, not wearing headphones; group 2, wearing
      headphones but hearing no music; and group 3, wearing headphones and listening to
      music. A visual analogue pain scale was used to rate patients' perception of
      pain. There was no difference in pain level, morphine requirement, hemodynamics,
      respiration, or length of stay in the PACU among the 3 groups, yet the music
      group was able to wait significantly longer before requiring analgesia on the
      nursing unit. Patients who listened to music perceived their PACU experience as
      significantly more pleasant than the patients in the other two groups as recalled
      both 1 day and 1 month later.

PMID- 1735870
TI  - Acute postoperative hypertension in the hypertensive patient.
AB  - Acute postoperative hypertension (APH) has been documented in the PACU. Over half
      of the patients who exhibit APH have pre-existing primary hypertension. Sustained
      blood pressure (BP) elevation increases the risk of myocardial ischemia,
      infarction, surgical site bleeding, or cerebral hemorrhage in these patients.
      Following surgery and anesthesia, increased sympathetic stimulation caused by a
      high level of circulating catecholamines can lead to APH. Some direct
      perioperative stimulants include pain, anxiety, hypoxia, hypercapnia,
      hypothermia, shivering, volume overload, and bladder distension. Nursing
      interventions are directed toward identifying and relieving the cause of APH.
      Antihypertensive drug therapy with vasodilators or adrenergic inhibitors is used
      if initial nursing interventions are not effective. Vasodilators frequently used
      are hydralazine, sodium nitroprusside, and nitroglycerin. Nicardipine has
      recently been introduced as an intravenous calcium channel blocker. Vasodilators
      are effective in BP reduction but may cause reflex tachycardia when used alone.
      Adrenergic inhibitors, such as esmolol and labetalol, block alpha and/or beta
      receptors to decrease heart rate and BP. Labetalol's effectiveness, relative
      freedom from side effects, and ease of administration have made it a useful drug
      in the treatment of APH.

PMID- 1735871
TI  - Practical points in understanding local anesthetics.
AB  - It has been the purpose of this article to discuss the pharmacology and
      physiology of local anesthetics. By having an understanding of local anesthetics
      at this level, the PACU nurse should have a better understanding of the
      consequences of employing local anesthetics in regional anesthesia.

PMID- 1735872
TI  - Change, conflict, and coping.
AB  - Managing in a health care organization requires the ability to cope with a
      constantly changing environment in which the manager is often caught in a
      situation of conflict. Developing a broader perspective on the problem and
      reframing one's thought process allows more opportunity to deal with the issues
      through logical rather than crisis management.

PMID- 1735873
TI  - Copying could be costly.
AB  - Thanks to modern technology, photocopying is quick, easy, and inexpensive. Or is
      it? One of the largest awards ever made for copyright infringement was levied in
      a case involving the use of material copied from publications without permission.
      This article presents a short discussion about US and international copyright
      protection, fair use, and work for hire. Suggestions for additional information
      are offered.

PMID- 1735874
TI  - Family issues: organization issues.

PMID- 1735875
TI  - Serum 2,3,7,8-tetrachlorodibenzo-p-dioxin levels of New Zealand pesticide
      applicators and their implication for cancer hypotheses.
AB  - BACKGROUND: The phenoxyherbicide 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) has
      been widely used by professional pesticide applicators in New Zealand since
      before 1950. Epidemiologic studies of the risk of cancer and birth defects have
      been conducted in this group of workers, but little is known about the extent of
      their exposure to the 2,4,5-T contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin
      (TCDD), a potent carcinogen in animals. PURPOSE: The objective of this study was
      to determine whether the blood serum levels of TCDD in a group of professional
      2,4,5-T applicators in New Zealand were greater than those of a matched control
      group not involved in 2,4,5-T spraying. METHODS: Of 548 men employed as
      professional pesticide applicators in New Zealand from 1979 through 1982, nine
      were selected who had sprayed pesticides, although not necessarily 2,4,5-T, for
      at least 180 months. These applicators had sprayed 2,4,5-T for a range of 83-372
      months. We measured the blood serum levels of polychlorinated dibenzo-p-dioxins
      and dibenzofurans, which were substituted with chlorine at the 2,3,7,8 position,
      in the nine pesticide applicators and in a matched group of nine control
      subjects. RESULTS: The average serum level of TCDD for applicators was almost 10
      times that for the matched control subjects, while the average levels of all
      other congeners and isomers measured in the two groups did not differ
      substantially. TCDD levels in eight of the nine applicators were higher than
      those in the control subjects (mean difference, 47.7 parts per trilion). The
      variation in TCDD levels among the applicators was related to their duration of
      work exposure to 2,4,5-T. CONCLUSIONS: On the basis of our findings in these
      subjects in New Zealand, we conclude that increased risks of cancer from brief
      exposure to phenoxyherbicides reported in other countries are probably not
      attributable to the TCDD that contaminates 2,4,5-T. We cannot determine from
      these results, however, whether TCDD exposure from prolonged use of 2,4,5-T poses
      significant health risks.

PMID- 1735876
TI  - Effect of interleukin-2 on biodistribution of monoclonal antibody in tumor and
      normal tissues in mice bearing SL-2 thymoma.
AB  - BACKGROUND: Our laboratory demonstrated previously that treatment with a tumor
      specific, radiolabeled anti-Thy 1 murine monoclonal antibody (MAb) in mice can
      eradicate a T-cell lymphoma mass, but the doses required were toxic to normal
      organs. Approaches to increase MAb concentration in tumor tissue versus normal
      tissue may overcome this problem. Interleukin-2 (IL-2) has been shown to increase
      capillary permeability, as indicated by extravasation of albumin. PURPOSE: The
      purpose of this study was to determine whether increased extravasation of MAb at
      the tumor site might result in selective binding to tumor antigen, increasing
      localization of radiolabeled MAb at the tumor site. METHODS: We studied the
      effect of IL-2 on biodistribution of 1A14 MAb (anti-Thy 1.1) in normal AKR/Cum
      (Thy 1.2+) mice and in AKR/Cum mice bearing SL-2, a spontaneous T-cell lymphoma
      (Thy 1.1+), compared with biodistribution of albumin in normal mice and
      biodistribution of the nonreactive G3G6 MAb in tumor-bearing mice. IL-2 was given
      intravenously in the tail vein in doses of 0, 25,000, 50,000, 100,000, or 200,000
      U twice a day for a total of seven doses over 3.5 days. Mice received injections
      of a mixture of 1A14 MAb (250 muCi/100 micrograms) and albumin or G3G6 MAb (145
      muCi/100 micrograms) in a total volume of 200 microL at 12 hours after the last
      IL-2 dose. RESULTS: In normal mice, IL-2 caused a dose-dependent increase of both
      radiolabeled MAb and albumin in the spleen, liver, lung, and lymph node, but it
      spared the brain. In tumor-bearing mice, IL-2 resulted in higher levels of MAb in
      the tumors 72 hours after receiving injections, with 17.5% and 24.3% of the
      injected dose per gram of tumor present in the mice pretreated with 100,000 or
      200,000 U of IL-2 twice a day for 3.5 days, compared with 13.4% in the controls.
      In IL-2-treated mice, levels of MAb were greater in the tumors than in critical
      normal organs; the differences were statistically significant for tumors versus
      lungs at 24 hours after injection and for tumors versus livers at 48 hours and 72
      hours after injection. CONCLUSIONS: These results suggest that pretreatment with
      IL-2 may lead to enhanced distribution of tumor-specific MAb to the tumor site,
      compared with normal tissues, thus increasing therapeutic efficacy of
      radiolabeled MAb.

PMID- 1735877
TI  - Suppression of anti-interferon alpha-2a antibody formation in patients with
      mycosis fungoides by exposure to long-wave UV radiation in the A range and
      methoxsalen ingestion.

PMID- 1735878
TI  - Effect of dietary fat on human breast cancer growth and lung metastasis in nude
      mice.

PMID- 1735879
TI  - Human genetics, bioethics, and the law.

PMID- 1735880
TI  - Use of very-high-dose chemotherapy with autologous bone marrow transplantation in
      treatment of breast cancer.

PMID- 1735881
TI  - Dietary factors in colorectal cancer and their possible effects on earlier stages
      of hyperproliferation and adenoma formation.

PMID- 1735882
TI  - Congress weighs NIH bid for patent rights to human genes.

PMID- 1735883
TI  - Tumor virologists' reunion recalls century of research.

PMID- 1735884
TI  - Mimetics may one day replace peptide antibodies.

PMID- 1735885
TI  - Lung cancer rates in white males leveling off.

PMID- 1735886
TI  - Phase I-II trial of erythropoietin in the treatment of cisplatin-associated
      anemia.
AB  - BACKGROUND: Cancer patients undergoing chemotherapy with cisplatin-containing
      regimens often develop anemia. Although the cause is multifactorial,
      erythropoietin deficiency appears to play an important role. Recombinant human
      erythropoietin (epoetin) has been reported to be effective in reversing cisplatin
      associated anemia in animal studies but not in clinical trials. PURPOSE: This
      pahse I-II clinical trial was designed to assess the safety and efficacy of
      treatment with epoetin for anemia associated with cisplatin chemotherapy.
      METHODS: Twenty-one cancer patients treated with cisplatin and manifesting anemia
      (hemoglobin level less than 110 g/L) received epoetin at escalating doses (25,
      50, 100, or 200 U/kg body weight) intravenously five times a week for 4 weeks.
      RESULTS: Epoetin was well tolerated, and a maximal tolerated dose was not
      reached. Two patients experienced hypertension, which responded to standard
      antihypertensive therapy. No dose-dependent severe toxic effects were seen. The
      increase in hemoglobin levels from baseline on day 1 of the study was
      statistically significant after 4 weeks of epoetin therapy in the groups
      receiving 100 U/kg (mean change +/- SD = 19 +/- 13 g/L; P = .03) or 200 U/kg
      (mean change = 24 +/- 17 g/L; P = .007). A clinical response--an increase in
      hemoglobin level greater than 10 g/L--was achieved in 12 patients after 4 weeks
      of treatment. For these responders, the mean increase in hemoglobin level was 25
      +/- 3.3 g/L over the level observed at the same time in the chemotherapy cycle
      preceding epoetin treatment, and this increase was statistically significant (P =
      .0001). Neither serum erythropoietin level nor hemoglobin level predicted a
      patient's response to epoetin. CONCLUSIONS: These preliminary findings suggest
      that epoetin is effective and well tolerated for the reversal of cisplatin
      associated anemia, with the 100-U/kg and 200-U/kg dose levels offering optimal
      clinical response. IMPLICATIONS: We are conducting a phase III trial to determine
      the effect of epoetin on transfusion requirements in patients undergoing
      chemotherapy.

PMID- 1735887
TI  - Society and vascular surgery--the need for humanism and research.

PMID- 1735888
TI  - Accuracy of lower extremity arterial duplex mapping.
AB  - We performed lower extremity arterial duplex mapping from the aortic bifurcation
      to the ankle in 150 consecutive patients evaluated for aortic and lower extremity
      arterial reconstruction and compared lower extremity arterial duplex mapping in a
      blinded fashion to angiography. On the basis of history, physical examination,
      and four-cuff segmental Doppler pressures individual lower extremities were
      classified as normal, isolated aortoiliac disease, infrainguinal disease, and
      multilevel inflow and outflow disease. For vessels proximal to the tibial
      arteries, lower extremity arterial duplex mapping was analyzed for its ability to
      insonate individual arterial segments, detect a 50% or greater stenosis, and
      distinguish stenosis from occlusion. In the tibial arteries lower extremity
      arterial duplex mapping was evaluated for its ability to visualize tibial vessels
      and to predict interruption of tibial artery patency from origin to ankle. Lower
      extremity arterial duplex mapping visualized 99% of arterial segments proximal to
      the tibial vessels, with overall sensitivities for detecting a 50% or greater
      lesion ranging from 89% in the iliac vessels to 67% at the popliteal artery.
      Stenosis was successfully distinguished from occlusion in 98% of cases. In the
      tibial vessels lower extremity arterial duplex mapping was better at visualizing
      anterior tibial and posterior tibial artery segments (94% and 96%) than peroneal
      artery segments (83%), (p less than 0.001). Overall sensitivities for predicting
      interruption of tibial artery patency were 90% for the anterior tibial, 90% for
      the posterior tibial, and 82% for the peroneal. Clinical disease category did not
      influence in a major way the accuracy of lower extremity arterial duplex mapping
      in either above-knee or below-knee vessels.

PMID- 1735889
TI  - Popliteal entrapment as a result of neurovascular compression by the soleus and
      plantaris muscles.
AB  - Intermittent claudication may occur in well-conditioned athletes because of an
      unusual form of popliteal artery entrapment that results from overtraining. These
      patients complain of calf muscle cramping, rapid limb fatigue, and occasional
      paresthesias on the plantar surface of the foot when running on inclines or when
      repetitive jumping is performed. Results of plethysmographic screening tests for
      popliteal entrapment are positive in these patients. Magnetic resonance
      angiography and intravenous digital subtraction angiography studies, however, do
      not demonstrate findings typical of anatomic popliteal entrapment. No evidence
      exists of aberrant positioning of the popliteal artery in foot neutral
      positioning, but with forced plantar flexion, the neurovascular bundle is
      deviated and compressed laterally. Surgical exploration of the popliteal fossa
      demonstrates no obvious musculotendinous abnormality. Symptoms of claudication
      and arterial compression are relieved by surgical release of the soleus muscle
      from its tibial attachments, resection of its fascial band, and resection of the
      plantaris muscle.

PMID- 1735890
TI  - Infected femorodistal bypass: is graft removal mandatory?
AB  - Infected lower extremity bypass grafts have been associated with high rates of
      limb loss. Traditionally treatment has included graft excision. To compare
      aggressive local treatment, without graft removal, with more conventional graft
      excision, we reviewed 38 consecutive patients with 39 infected lower extremity
      bypasses treated during the last 10 years. The grafts used were prosthetic in 33
      cases, vein in 4, and composite in 2. Median follow-up was 2.7 years. Twenty
      eight infected grafts were treated with either complete (14) or partial (14)
      graft removal. Nine new grafts were placed. Recurrent infection developed in five
      cases, and two patients died of complications of graft infection. Ten of 20 limbs
      at risk were lost. Eleven patients with patent bypasses (4 vein, 2 composite, 5
      prosthetic) were treated without graft excision. Treatment of five patients in
      this group included muscle transposition. Five patients were treated with
      incision and drainage of abscesses, and one had excision of a persistent sinus
      tract. One patient underwent major amputation 6.3 years after treatment of graft
      infection. Limb salvage was significantly higher (p = 0.012, log-rank test) than
      in patients treated with graft excision. One patient died, and no recurrent
      infections developed; these were not significant differences compared with those
      having graft excision. We conclude that aggressive local treatment of infected
      lower extremity bypass grafts, including drainage, debridement, and muscle
      transposition may treat infection in selected patients without the need for graft
      removal and with rates of limb salvage superior to those obtained with excisional
      therapy.

PMID- 1735891
TI  - Heparin-induced thrombocytopenia in the newborn.
AB  - This pilot study was initiated to determine whether heparin-induced
      thrombocytopenia occurs in the newborn and whether thromboembolic complications
      in the newborn could be related to heparin-induced thrombocytopenia. Thirty-four
      infants in whom thrombocytopenia (less than 70,000/mm3) (n = 23), precipitous
      (30% to 50%) fall in platelet count (n = 5), or thromboses (n = 6) developed
      while they were receiving heparin were studied. Heparin-associated antiplatelet
      antibodies were demonstrated in 14 infants by platelet aggregation testing. The
      average gestational age (29 +/- 6 weeks); birth weight (1300 +/- 945 gm); and
      platelet count at birth (234,000/mm3 +/- 111,000/mm3) of these 14 infants did not
      differ statistically from the 20 infants without heparin-associated antiplatelet
      antibodies. An umbilical artery catheter was inserted in all infants except a
      single patient from each group. Aortic thrombosis was documented by abdominal
      ultrasonography in 11 of 13 (85%) infants with heparin-associated antiplatelet
      antibodies. One patient died with a midgut volvulus before the aorta could be
      examined. Five aortic thromboses were detected in the 20 infants without heparin
      associated antiplatelet antibodies. Bleeding was not associated with the heparin
      induced thrombocytopenia. One patient with previously demonstrated
      thrombocytopenia and heparin-associated antiplatelet antibodies had recurrent
      thrombocytopenia when reexposed to heparin; her platelet count recovered after
      heparin withdrawal. Thus heparin-induced thrombocytopenia does occur in preterm
      and term infants receiving heparin and is associated with arterial thromboses.
      Therefore infants receiving any form or amount of heparin must be carefully
      monitored for heparin-induced thrombocytopenia.1+

PMID- 1735892
TI  - Preoperative carotid artery screening in elderly patients undergoing cardiac
      surgery.
AB  - The role of preoperative screening for carotid artery disease in elderly patients
      undergoing cardiac surgical procedures is not clearly established. This
      prospective study was designed to determine the prevalence of carotid disease in
      this population and to identify preoperative risk factors for carotid artery
      stenosis. During a 54-month interval, 1087 patients of a consecutive series of
      1184 patients 65 years of age and older who underwent cardiac surgical procedures
      (91% had coronary artery disease) were evaluated before operation with carotid
      duplex ultrasonography. The prevalence of disease was 17.0% for 50% or greater
      stenosis and 5.9% for 80% or greater stenosis. With use of a stepwise, logistic
      regression model of 12 preoperative variables, five variables were found by
      multivariate analysis to be significant (p less than or equal to 0.05) predictors
      of 80% or greater stenosis: female sex, peripheral vascular disease, history of
      transient ischemic attack or stroke, smoking history, and left main coronary
      artery disease. If all patients with at least one risk factor were screened, then
      this model predicts that 95% of patients with 80% or greater stenosis and 91% of
      patients with 50% or greater stenosis would be identified before operation. The
      probability of carotid disease in a given patient can also be estimated (range,
      5% to 65%). Carotid endarterectomy combined with cardiac surgical procedures was
      performed on 46 patients who were either symptomatic (16) or had 80% or greater
      stenosis (30). The overall stroke rate for the 1087 patients was 2.0% (22
      patients), and the 30-day mortality rate was 5.2% (56 patients).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1735893
TI  - Carotid artery replacement in conjunction with resection of squamous cell
      carcinoma of the neck: preliminary results.
AB  - Squamous cell carcinoma can invade the carotid artery. The treatment options then
      include irradiation, "palliative peeling" of tumor from the artery, and carotid
      resection with ligation or in-line grafting. Twelve patients with invasion of the
      carotid artery by cancer had en bloc resection of the artery and tumor.
      Reconstruction after in-line carotid artery grafting with autogenous vein was
      completed with a myocutaneous flap. No neurologic events occurred perioperatively
      or during the follow-up period of 3 to 50 months. Computed tomography and
      arteriography were unreliable in predicting tumor involvement of the carotid
      artery. Three patients died during the study--two of unrelated causes, and one of
      metastases. None of the patients showed evidence of local recurrence from 3 to 50
      months. In two of four wound infections the carotid artery graft was exposed.
      This was successfully treated by a myocutaneous flap. The mean survival for the
      group was 18 months. Resection and in-line bypass grafting of the carotid artery
      invaded by cancer can safely be performed in irradiated and potentially infected
      fields.

PMID- 1735894
TI  - Acute traumatic aortic aneurysm: the Duke experience from 1970 to 1990.
AB  - Improvements in the operative management of acute traumatic thoracic aortic
      aneurysm have resulted in safe and expeditious repair. Nonetheless, multisystem
      injuries continue to inflict significant numbers of deaths. From 1970 to 1990,
      108 patients with acute traumatic thoracic aortic aneurysm were evaluated. Mean
      injury severity score, excluding aortic injury, was 17.5. Ninety-three patients
      (86%) survived beyond initial resuscitation and came to operation. Median
      interval from injury to aortic repair was 8 hours (range, 2 hours to 19 days);
      there were five operative deaths. Lethal nonaortic injuries included 18 closed
      head injuries, four myocardial contusions, two intraabdominal vascular injuries,
      and one pulmonary contusion. The overall mortality rate was 39% of total
      admissions (42 of 108), and 29% of survivors of resuscitation (27 of 93). It is
      significant that only 11 of the 42 deaths (26%) were directly attributable to
      thoracic aortic aneurysm. Adjuncts to prevent spinal cord ischemia (shunt/bypass)
      were used in 76 patients, whereas 12 underwent clamp/repair. Postoperative
      paraplegia developed in 5 of 79 patients (6.8%, including 4 of 68 (5.9%) repaired
      with shunt/bypass and 1 of 11 (9.1%) repaired with clamp/repair (p = NS). Among
      those who developed paraplegia, the injury severity score was 27.0, and the
      median interval from injury to repair was 4.9 hours (range, 2 to 6.5).
      Intraoperative hypotension occurred in three of five patients with paraplegia.
      Death in patients with thoracic aortic aneurysm is due primarily to associated
      injuries and has remained relatively constant over the 20-year period of review.
      Overall injury severity, intraoperative hypotension, and extensive aortic tissue
      destruction may correlate with the development of postoperative paraplegia;
      however, a larger population sample is required to confirm this conclusion. A
      plea is made for standardized reporting of all patients with thoracic aortic
      aneurysm.

PMID- 1735895
TI  - Intraabdominal paraanastomotic aneurysms after aortic bypass grafting.
AB  - Although the reported incidence of intraabdominal paraanastomotic aneurysms after
      abdominal aortic bypass grafting ranges from 1% to 15%, the true incidence is
      unknown because few studies have used routine, serial radiographic or sonographic
      imaging studies. Since July 1, 1988, we have used yearly abdominal sonography
      examinations to monitor our patients with aortic grafts. In the first 33 months
      we studied 138 patients. Medical records of 111 of these were available for
      review and form the basis of this report. Eleven patients (10%) were found to
      have intraabdominal paraanastomotic aneurysms ranging in overall size from 4.1 to
      6.2 cm (mean, 5.0 +/- 0.7 cm). The mean time between operation and detection of
      an aneurysm was 144 +/- 101 months (range, 8 to 336 months). Three
      paraanastomotic aneurysms occurred within 3 years of operation, and the remaining
      eight occurred late (7 to 28 years). By life-table analysis, the incidence of
      paraanastomotic aneurysms was 27% at 15 years. Paraanastomotic aneurysms were
      classified as either pseudoaneurysms (presumed disruption of the anastomotic
      suture line, n = 7) or as true aneurysms (widening of the adjacent aorta, n = 4).
      True aneurysms occurred only after repair of an abdominal aortic aneurysm,
      whereas pseudoaneurysms were more frequent after bypass for occlusive disease.
      The finding of paraanastomotic aneurysms in 10% of our patients supports the use
      of yearly sonography for routine follow-up after aortic grafting.

PMID- 1735896
TI  - Comparison of cardiac morbidity between aortic and infrainguinal operations.
      Study of Perioperative Ischemia (SPI) Research Group.
AB  - We prospectively compared the differences in perioperative cardiac ischemic
      events in 140 patients undergoing major abdominal (n = 53) versus infrainguinal
      (n = 87) vascular operations. Preoperative dipyridamole thallium cardiac
      scintigraphy was performed in a subset of 38 of these patients, with treating
      physicians blinded to the test results. Myocardial ischemia was measured during
      operation with use of continuous 12-lead electrocardiography (ECG) and
      transesophageal echocardiography. Continuous two-lead ambulatory ECG (Holter
      monitoring) was performed before, during, and after operation for 4 days. Outcome
      events were cardiac death, nonfatal myocardial infarction, unstable angina,
      ventricular tachycardia, and congestive heart failure. Results of the study
      indicated that most demographic variables, such as age, hypertension, cigarette
      smoking, serum cholesterol, were comparable between patients having aortic or
      infrainguinal arterial operations. However, in the infrainguinal group more
      patients had diabetes, second vascular operations, angina pectoris, heart
      failure, dysrhythmias, and used digitalis. Abnormalities in preoperative Holter
      monitoring, ECGs, and thallium scan abnormalities were equivalent between groups.
      During operation, whereas Holter and ECG abnormalities were comparable, more
      patients undergoing aortic procedures suffered ischemia as determined by
      transesophageal echocardiography (26% vs 10%, p = 0.019). After operation there
      were 21 (24%) outcome events in patients having infrainguinal bypasses compared
      with 15 (28%) patients having aortic procedures (p = NS). Ischemia by Holter
      monitoring (n = 133) occurred after operation in 46 (57%) patients having
      infrainguinal operations compared with 16 (31%) patients having aortic
      reconstructions (p = 0.005). Because preoperative cardiac disease and adverse
      cardiac outcomes occurred with similar or even greater frequency in both groups
      of patients, we conclude that the risk for postoperative cardiac ischemic events
      in lower extremity vascular operations is at least as great as for aortic
      operations.

PMID- 1735897
TI  - Color-flow duplex scanning for the surveillance and diagnosis of acute deep
      venous thrombosis.
AB  - Compared with conventional duplex imaging, color-flow scanning facilitates the
      identification of veins (especially below the knee), decreases the need to assess
      Doppler flow patterns and venous compressibility, and allows veins to be surveyed
      longitudinally. These advantages translate into a less demanding and time
      consuming examination. This study was designed to determine the accuracy of color
      flow scanning for detecting acute deep venous thrombosis in patients in whom the
      diagnosis is clinically suspected and in asymptomatic patients at high risk for
      developing postoperative deep venous thrombosis. The diagnostic group included 77
      limbs of 75 patients, and the surveillance group included 190 limbs of 99
      patients undergoing total hip or knee replacement. All patients were
      prospectively examined with color-flow scanning and phlebography. In the
      diagnostic group, the incidence of thrombi in below-knee veins (47%) was
      approximately equal to that in above-knee veins (43%); but in the surveillance
      group, the incidence of thrombi in below-knee veins (41%) far exceeded that in
      veins above the-knee (3%). Nonocclusive clots and clots isolated to a single
      venous segment were more common in the surveillance group. In symptomatic
      patients, color-flow scanning was 100% sensitive and 98% specific above the knee
      and 94% sensitive and 75% specific below the knee. In the surveillance group,
      color-flow scanning was significantly (p less than 0.001) less sensitive (55%)
      for detecting thrombi, 93% of which were confined to the tibioperoneal veins.
      Negative predictive values were 100% and 88% for the diagnostic and surveillance
      limbs, respectively. Positive predictive values were 80% for the diagnostic limbs
      and 89% for the surveillance limbs. Color-flow scanning effectively excludes
      above-knee deep venous thrombosis in symptomatic patients and asymptomatic high
      risk patients and predicts the presence of above-knee thrombi in patients in the
      diagnostic group with reasonable accuracy (97%). We conclude that color-flow
      scanning is as accurate as conventional duplex imaging and, because of its
      advantages, is the noninvasive method of choice for evaluating patients with
      suspected deep venous thrombosis. Its role in the surveillance of patients at
      high risk remains to be determined and awaits further clinical evaluation.

PMID- 1735898
TI  - Valvular reflux after deep vein thrombosis: incidence and time of occurrence.
AB  - From December 1986 to December 1990, 268 patients with acute deep vein thrombosis
      were studied in our laboratory. From this group 107 patients (123 legs with deep
      vein thrombosis) were placed in our long-term follow-up program. The
      documentation of valvular reflux and its site was demonstrated by duplex
      scanning. The duplex studies were done at intervals of 1 and 7 days, 1 month,
      every 3 months for the first year, and then yearly thereafter. The mean follow-up
      time for these patients was 341 days. In addition, reflux was evaluated in 502
      patients with negative duplex study results and no previous history of deep vein
      thrombosis or chronic venous insufficiency. In the patients with acute deep vein
      thrombosis, valvular incompetence was noted in 17 limbs (14%) at the time of the
      initial study. Reflux was absent in 106 limbs (86%). In this last group reflux
      developed in 17% of the limbs by day 7. By the end of the first month, 37%
      demonstrated reflux. By the end of the first year, more than two thirds of the
      involved limbs had developed valvular incompetence. The distribution of reflux at
      the end of the first year of follow-up was the following: (1) popliteal vein,
      58%; (2) superficial femoral vein, 37%; (3) greater saphenous vein, 25%; and (4)
      posterior tibial vein, 18%. Reflux seems to be more frequent in the segments
      previously affected with deep vein thrombosis. Among cases where segments were
      initially affected with thrombi, after 1 year the incidence of reflux was 53%,
      44%, 59%, and 33% for the common femoral vein, superficial femoral, popliteal
      vein, and posterior tibial vein, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1735899
TI  - Surgical management of severe acute lower extremity ischemia.
AB  - Seventy-four patients (70 men [95%], 4 women [5%], mean age, 63 years) with
      severe, acute lower limb ischemia (acute clinical deterioration and absent pedal
      Doppler signals) caused by either arterial thrombosis (n = 68) or embolism (n =
      6) underwent urgent surgical management consisting of operative revascularization
      with or without amputation in 67 patients (91%) and primary amputation alone in 7
      patients (9%). Sixty-one patients (82%) had severely threatened limb viability,
      and 13 (18%) had major irreversible ischemic limb changes at presentation. Eighty
      six percent of patients were initially anticoagulated with heparin. Seventy
      percent underwent preoperative angiography. Surgical revascularization included
      42 inflow and 20 outflow arterial reconstructions and 9 thrombectomy or
      embolectomy procedures. Mean follow-up was 17 months (range, 0 to 64). Life-table
      primary patency at 36 months for arterial reconstructions was 81% for inflow and
      78% for outflow procedures. Cumulative limb salvage was 70% at 1 month and 68% at
      36 months. Patient survival was 85% at 1 month and 51% at 36 months. No death was
      directly attributable to complications related to limb reperfusion, and no
      patient required dialysis for myoglobinuria. We conclude that management of
      severe, acute lower limb ischemia with early amputation of nonviable limbs and
      heparinization, angiography, and prompt operative revascularization for
      threatened but viable extremities minimizes morbidity and mortality rates, while
      maximizing limb salvage. These results may be useful for comparison with
      comparable groups of patients treated with thrombolytic or endovascular
      modalities.

PMID- 1735900
TI  - Peripheral vascular bypass in juvenile-onset diabetes mellitus: are aggressive
      revascularization attempts justified?
AB  - This study was performed to evaluate the results of peripheral vascular
      reconstruction for arterial occlusive disease in patients with juvenile-onset
      diabetes mellitus. The results of 67 bypass procedures performed on 60 patients
      with juvenile-onset diabetes mellitus between Jan. 1, 1984 and Dec. 31, 1989,
      were reviewed. These patients had a mean age of 44.4 years (range, 29 to 59
      years), with an average age of onset of diabetes mellitus of 9.8 years (range, 1
      to 19 years). These procedures comprised 5.5% (67 to 1214) of the bypasses
      performed on diabetic patients during the same time period at a single
      institution. Fifty-four of 67 (91%) procedures were performed for limb salvage.
      Fifty-four (81%) procedures were primary infrainguinal bypasses with saphenous
      vein (femoropopliteal 19, femorodistal or popliteal-distal 35). Six procedures
      (9%) were revision procedures, four (6%) were in-flow procedures, and three (4%)
      were infrainguinal procedures with polytetrafluoroethylene. Thirty-day morbidity
      and mortality rates were 31% and 0%, respectively. Actuarial patency and limb
      salvage rates of the primary vein graft group were 66.0% (+/- 10.7) and 83.4% (+/
      8.0%), respectively, at 24 months. Cumulative survival of the entire group at 2
      years was 84.1%. Although follow-up in this study is relatively short (24
      months), the results suggest that the outcome of vascular reconstruction in
      patients with juvenile-onset diabetes mellitus is acceptable when compared with
      procedures performed in adult-onset diabetic and nondiabetic populations. The
      presence of juvenile-onset diabetes mellitus should not diminish the vascular
      surgeon's expectations of a successful outcome when considering lower extremity
      revascularization in these patients.

PMID- 1735901
TI  - Is long vein bypass from groin to ankle a durable procedure? An analysis of a ten
      year experience.
AB  - Long vein bypass from the femoral artery to the level of the ankle may be
      performed with good initial success despite extreme bypass length and limited
      outflow tracts. However, the long-term performance of these bypasses remains to
      be defined. During the last 10 years we have performed single greater saphenous
      vein in situ bypass to the ankle level in 270 patients. There were 187 male and
      83 female patients, and 61% of the patients were diabetic. The operative
      mortality rate was 3.7%. Cumulative bypass patency was 79% at 3 years and 73% at
      5 years. In a similar manner, limb salvage was 93% at 3 years and 89% at 5 years.
      The patency rate was similar for various inflow arteries (common femoral, 88
      cases; proximal superficial femoral, 135 cases; and deep femoral, 41 cases) and
      outflow tracts (dorsal pedal, 72 cases; anterior tibial, 59 cases; posterior
      tibial, 72 cases, and peroneal, 67 cases). Short bypasses, composite bypasses,
      free-vein grafts, and bypasses proximal to 10 cm above the ankle were excluded
      from this analysis. These data show that a long bypass to the ankle level for
      limb salvage is a durable procedure. The basic concept of bypassing all occlusive
      disease to the distal open artery in patients undergoing limb salvage should be
      an acceptable dictum. Excellent long-term patency and limb salvage rates are
      achievable by following this principle.

PMID- 1735902
TI  - The dorsalis pedis bypass--moderate success in difficult situations.
AB  - Recent reports have documented excellent results for inframalleolar
      reconstructions. We reviewed our outcomes for dorsalis pedis bypass and report a
      more modest rate of success. We analyzed reasons for failure. Sixty-nine patients
      underwent 73 dorsalis pedis bypass procedures between 1984 and 1991. Seventy
      eight percent of the patients were diabetics. Inflow was from the external iliac
      in 1, femoral in 35, popliteal in 34, and tibial in 3. The operative indication
      was gangrene in 57%, ulcer in 22%, and rest pain in 21%. Forty-six percent of
      limbs had foot infection, with six requiring minor amputation before the bypass
      and 24 requiring minor amputation after bypass. There was one perioperative
      death. Twenty-nine grafts failed over the course of the series. The primary
      patency rate at 2 years was 59.2%. The limb salvage rate was 73.5%. Of the 10
      perioperative failures, four were due to continued foot infection, four to
      marginal vein quality, and two to skin necrosis of the bypass incisions. Graft
      failure occurred at 3 to 30 months in 10 of 14 patients who had deficient
      anterior arches, with segmental occlusion of the dorsalis pedis or its branches.
      Six of the 14 patients with extensive infections of the forefoot or extensive
      heel ulcers required amputation with patent bypasses. In dorsalis pedis bypass,
      failure to achieve limb salvage was more likely in patients with marginal vein
      quality, deficient anterior pedal arches, and extensive foot infection. In
      patients where the chance of failure appears to be unacceptably high, primary
      amputation should be considered.

PMID- 1735903
TI  - The seventh John Homans Lecture: heroes in vascular surgery.

PMID- 1735904
TI  - Dissecting aneurysms of the main trunk of the superior mesenteric artery.
AB  - We treated four symptomatic patients who were admitted with a spontaneous and
      isolated dissecting aneurysm of the superior mesenteric artery. All four patients
      underwent operation. The superior mesenteric artery was repaired by means of
      either a bypass graft in two cases or an endoaneurysmorraphy in the latter two
      cases. Complete symptomatic relief with no postoperative complications was
      achieved in every case. The arterial repairs remained patent, and the patients
      remained free of symptoms, with follow-up ranging from 6 to 47 months. The
      available literature on this unusual lesion is reviewed.

PMID- 1735905
TI  - Bilateral traumatic internal carotid artery dissections: case report.
AB  - Bilateral internal carotid artery dissections after blunt cervicofacial trauma
      are rare, with 16 cases being previously published. Management is presumed to be
      an extension of the dominant therapy for unilateral dissection, that being
      anticoagulant therapy; however, bilateral stenoses engender questions of threat
      to total cerebral blood flow. We herein present a patient who suffered bilateral
      type B dissections and who then had progression of the process on anticoagulant
      therapy, resulting in an unusual carotid reconstruction.

PMID- 1735906
TI  - Renal autotransplantation in the management of a ureteroarterial fistula: a case
      report and review of the literature.
AB  - A 57-year-old woman who had been treated with an indwelling ureteral stent for
      over a year was admitted with massive gross hematuria caused by a fistula between
      the left ureter and hypogastric artery. Despite intensive radiographic
      evaluation, the definitive diagnosis was made only at the time of surgical
      exploration. Because of radiation-induced retroperitoneal fibrosis, midureteral
      obstruction, and prior pelvic and abdominal surgery, primary ureteral repair was
      not possible, and renal autotransplantation was performed. This case illustrates
      the need to consider the diagnosis of ureteroarterial fistula in patients with
      massive hematuria who have chronic indwelling stents, and the feasibility of
      autotransplantation when primary ureteral repair is not feasible.

PMID- 1735907
TI  - Fourth annual meeting of the American Venous Forum, Coronado, California,
      February 26-28, 1992. Abstracts.

PMID- 1735908
TI  - Ruptured abdominal aortic aneurysm: an editorial.

PMID- 1735909
TI  - Cells derived from omental fat tissue and used for seeding vascular prostheses
      are not endothelial in origin.

PMID- 1735910
TI  - Cocaine, alcohol mix in body to form even longer lasting, more lethal drug.

PMID- 1735911
TI  - Infants, children test positive for cocaine after exposure to second-hand crack
      smoke.

PMID- 1735912
TI  - Cocaine deaths reported for century or more.

PMID- 1735914
TI  - From the Centers for Disease Control. Vigorous physical activity among high
      school students--United States, 1990.

PMID- 1735913
TI  - From cell populations to human populations, cardiovascular research examines
      possibilities.

PMID- 1735915
TI  - From the Centers for Disease Control. International task force for disease
      eradication.

PMID- 1735916
TI  - From the Centers for Disease Control. Iguana-associated salmonellosis--Indiana,
      1990.

PMID- 1735917
TI  - Red cell distribution width in alcohol abuse and iron deficiency anemia.

PMID- 1735918
TI  - Red cell distribution width in alcohol abuse and iron deficiency anemia.

PMID- 1735920
TI  - Ads from the Partnership for a Drug-Free America.

PMID- 1735919
TI  - Relation between serum cholesterol and hematocrit.

PMID- 1735921
TI  - Cost-shifting in Oregon.

PMID- 1735922
TI  - Potential therapeutic effects of ritanserin in Cushing's disease.

PMID- 1735923
TI  - Bury me as a pipe smoker.

PMID- 1735924
TI  - Compliance with live, oral Ty21a typhoid vaccine.

PMID- 1735925
TI  - Diuretics, serum and intracellular electrolyte levels, and ventricular
      arrhythmias in hypertensive men.
AB  - OBJECTIVE: To investigate the patterns of electrolyte abnormalities resulting
      from thiazide administration and whether they cause ventricular arrhythmias, and
      to help resolve the controversy over whether clinicians should routinely
      prescribe potassium-conserving therapy to all patients treated with thiazides.
      DESIGN: Double-blind, randomized controlled trial. PARTICIPANTS: A total of 233
      hypertensive men aged 35 to 70 years. INTERVENTIONS: Participants were withdrawn
      from prior diuretic treatment and were replenished with oral potassium chloride
      and magnesium oxide. They were then randomized to 2 months of treatment with (1)
      hydrochlorothiazide; (2) hydrochlorothiazide with oral potassium; (3)
      hydrochlorothiazide with oral potassium and magnesium; (4) hydrochlorothiazide
      and triamterene; (5) chlorthalidone; or (6) placebo. MAIN OUTCOME MEASURES:
      Ventricular arrhythmias on 24-hour Holter monitoring and serum and intracellular
      potassium and magnesium levels. RESULTS: Of the 233 participants, 212 (91%)
      completed the study. Serum potassium levels were 0.4 mmol/L lower in the
      hydrochlorothiazide group than in the placebo group (P less than 0.01), and this
      mean difference was not affected by supplementation with potassium, with
      potassium and magnesium, or with triamterene. However, the supplements did
      prevent the occasional occurrence of marked hypokalemia; all 12 of the men who
      developed serum potassium levels of 3.0 mmol/L or less were among the 90 who
      received diuretics without supplementation (P less than 0.01). Similarly, the
      overall proportion of men with ventricular arrhythmias was not affected by
      randomized treatment, but there was a twofold increase in the proportion with
      arrhythmias among the 12 men with serum potassium levels of 3.0 mmol/L or less (P
      = .02). Serum magnesium and intracellular potassium and magnesium levels were not
      reduced by hydrochlorothiazide, nor were they related to ventricular arrhythmias.
      CONCLUSIONS: In the majority of hypertensive patients, treatment with 50 mg/d of
      hydrochlorothiazide does not cause marked hypokalemia or ventricular arrhythmias.
      However, because some individuals will develop hypokalemia after starting
      diuretic therapy, serum potassium levels should be monitored and potassium
      sparing strategies should be used when indicated.

PMID- 1735926
TI  - Incidence of lymphomas and other cancers in HIV-infected and HIV-uninfected
      patients with hemophilia.
AB  - OBJECTIVE: To determine the types and rates of cancers occurring in excess in the
      presence of infection with the human immunodeficiency virus type 1 (HIV-1).
      DESIGN: Cohort analytic study of HIV-infected and HIV-uninfected subjects
      followed for up to 12 years. SETTING: Fifteen hemophilia treatment centers.
      PATIENTS: A total of 1701 patients with hemophilia, of whom 1065 (63%) were HIV-1
      seropositive. MAIN OUTCOME MEASURES: Morphologic classification and incidence
      rates of cancers. MAIN RESULTS: The incidence of non-Hodgkin's lymphoma after HIV
      seroconversion averaged 0.15 case per 100 person-years (95% confidence interval
      [CI], 0.08 to 0.25) and rose exponentially with increasing duration of HIV
      infection. Although the greatest absolute risk of lymphoma was in the oldest age
      group, the relative increase compared with general population rates was 38-fold
      in subjects 10 to 39 years old and 12-fold in older subjects (P less than .05).
      The CD4+ T-lymphocyte levels for lymphoma cases were similar to HIV-positive
      subjects without the acquired immunodeficiency syndrome (AIDS) who had been
      infected for the same length of time. The incidence of Kaposi's sarcoma was
      increased 200-fold (95% CI, 20 to 700). The incidence of cancers other than non
      Hodgkin's lymphoma and Kaposi's sarcoma were not increased in the HIV-positive
      subjects (ratio of observed to expected cases, 0.9 [95% CI, 0.4 to 1.9]). The HIV
      negative subjects had no significant increase in cancer incidence. CONCLUSIONS:
      HIV infection has restricted effects on cancer incidence that are only partly
      explained by immunosuppression. Paradoxically, improvements in therapy of HIV
      infection that prolong survival may lead to further increases in HIV-associated
      lymphoma.

PMID- 1735927
TI  - Delayed diagnosis of infants with abnormal neonatal screens.
AB  - OBJECTIVE: To identify infants who were diagnosed clinically with a condition
      that previously had been detected by a state neonatal screening program, but who
      had failed to receive medical attention in a timely fashion. DESIGN: A
      descriptive case series of infants over a 2-year period from 1989 to 1991.
      SETTING: An academically affiliated tertiary care pediatric hospital, a major
      referral center for children with abnormal results on state neonatal screening
      tests. PATIENTS: All patients who (1) had a diagnosis suspected clinically, (2)
      had confirmation of disease, and (3) were subsequently found to have had abnormal
      screening results. MAIN OUTCOME MEASURES: Age at clinical diagnosis, morbidity
      due to delay in diagnosis, and postnatal medical follow-up. RESULTS: Ten children
      were identified, three with 21-hydroxylase deficiency and seven with a
      hemoglobinopathy. In each case, the screening program had clear documentation
      that the office of the physician of record had received prompt telephone
      communication of the abnormal result. The mean age at clinical diagnosis was 32
      days for the children with 21-hydroxylase deficiency and 215 days for those with
      sickle cell anemia, substantially longer than is mandated by proper neonatal
      screening practice. Potentially life-threatening complications of the underlying
      disease were present in six children. CONCLUSIONS: A significant number of
      neonates who have metabolic disorders appropriately identified by a neonatal
      screening test may fail to receive timely treatment. Consideration should be
      given to implementing a system of directly contacting the parents of all
      presumptive positive cases by the state screening program.

PMID- 1735928
TI  - High prevalence of recent cocaine use and the unreliability of patient self
      report in an inner-city walk-in clinic.
AB  - OBJECTIVE: To determine the prevalence of recent cocaine use and the reliability
      of patient self-reported cocaine use. DESIGN: A survey with blinded comparison to
      a criterion standard. SETTING: Walk-in clinic of a large public hospital in
      metropolitan Atlanta, Ga. PARTICIPANTS: Male patients, aged 18 to 39 years,
      presenting to the triage desk for immediate care during weekdays. Of the 415
      eligible men who agreed to participate (acceptance rate, 82%), the average age
      was 29.5 years, 91.6% were black, and 89% were uninsured. INTERVENTION: None.
      MAIN OUTCOME MEASURES: Comparison of self-reported illicit drug use with results
      from urinary immunoassays for benzoylecgonine, a major cocaine metabolite.
      Determination of which drug history questions produce the most accurate responses
      using anonymous urine testing as the criterion standard. RESULTS: Thirty-nine
      percent of patients tested positive for the presence of benzoylecgonine and were
      statistically more likely to be older, black, and have a prior history of
      sexually transmitted disease (P less than .01). Seventy-two percent of men with
      positive urinary assays denied illicit drug use in the 3 days prior to sampling.
      When queried with several formats, subjects with positive urine assays were more
      likely to admit to "any illegal drug" use (87.5%) than to the more specific "any
      form of cocaine" use (60.6%) within the prior year (P less than .0001).
      CONCLUSIONS: These results underscore the magnitude of cocaine abuse among black,
      inner-city men. Patient self-report of illicit drug use is highly inaccurate.
      Accuracy of self-report may be increased by asking less specific questions.

PMID- 1735929
TI  - The uninsured and the debate over the repeal of the Massachusetts universal
      health care law.
AB  - OBJECTIVES: The debate in Massachusetts over the repeal of the first state-based
      "pay or play" universal health plan is discussed using data from a survey of 1066
      Massachusetts households. The survey attempted to measure the problems of the
      uninsured, to estimate the likelihood that they would buy insurance if offered,
      and to calculate the proportion of the uninsured who would be covered under an
      employer mandate. DESIGN: A survey conducted in person and by telephone in 1066
      households, with an oversample of uninsured households, using stratification,
      clustering, disproportionate sampling, and poststatistical weighting.
      PARTICIPANTS: Adults aged 18 years and older who were knowledgeable about the
      insurance status of persons in their household. MAIN OUTCOME MEASURES: Insurance
      status, employment status, access to and use of health services, and willingness
      to purchase health insurance. RESULTS: First, the present system of hospital
      based uncompensated care in Massachusetts is inadequate by itself to meet the
      needs of uninsured residents. Uninsured persons are less likely than insured ones
      to seek medical care for chronic health problems and serious symptoms requiring
      evaluation. Second, 83% of uninsured families and 24% of uninsured individual
      respondents would purchase one of several insurance options with 30% of the cost
      subsidized. Last, the employer mandate provisions of the legislation would cover
      43% of the uninsured in Massachusetts. CONCLUSION: In the current economic
      climate, the political viability of the universal health care plan and similar
      national initiatives is uncertain given the intractable conflict between
      perceptions of the financial stability of small businesses that do not offer
      insurance and the health care needs of uninsured individuals.

PMID- 1735930
TI  - Informed consent in tests of patient reliability.

PMID- 1735931
TI  - Improvement of optic nerve head appearance after surgery for pseudotumor cerebri.

PMID- 1735932
TI  - [Nd-YAG laser therapy of tracheobronchial lesions by malignant tumor].
AB  - Thirty-seven patients with tracheobronchial lesions by malignant tumor were
      treated with Nd-YAG laser. Thirty-seven patients were twenty-three males and
      fourteen females and ages ranged from 34 to 79 years. Diseases included were
      primary tracheal tumor in 3 cases, lung cancer in 16 (8 squamous cell carcinoma,
      5 adenocarcinoma, 2 large cell carcinoma, 1 small cell carcinoma), cancer of
      adjacent organs in 9 (5 thyroid cancers, 4 esophageal cancers), and metastatic
      cancer to the lung or mediastinal lymph nodes in 9 (4 renal cell carcinoma, 2
      thyroid cancer, one patient respectively, colon cancer and breast cancer).
      Intermittent irradiation of YAG laser was done for 0.5 second at 30-40 Watt
      through flexible bronchoscope under local anesthesia. It was repeated 1 to 41
      times (mean 4.1 times) and energy amount was 148 Joules to 18,513 Joules (mean
      3,305 J). The result was; stenosis disappeared in 22 cases (59.4%), improved in
      14 (37.8%), and in one case YAG laser therapy discontinued due to intractable
      bleeding. The Nd-YAG laser therapy for tracheobronchial lesions by malignant
      tumor is very useful to improve dyspnea or atelectasis.

PMID- 1735933
TI  - [Nd-YAG laser treatment of tracheo-bronchial stenotic lesions].
AB  - Fourteen patients were treated with a Nd-YAG laser. Treatment to relieve airway
      stenosis was administered on fifteen occasions, and on one occasion to treat an
      obstruction. In each case the flexible fiberoptic bronchoscope was used. In 4
      emergency cases, three involving tracheal lesions and one involving a bronchial
      lesion, the airway was widened and the patients' condition was improved after
      laser ablation. In the palliative treatment of 12 lesions, the stenoses were
      severed and treated at an interval of time varying between one and three weeks.
      Complications occurred in 3 cases. There were 2 instances of massive haemorrhage
      and one of pneumothorax which occurred while treating the 5 stenoses situated at
      broncho-plastic anastomoses.

PMID- 1735934
TI  - [YAG laser therapy of central airway stenosis].
AB  - Endoscopic Nd-YAG laser therapies were performed in 11 cases of central airway
      stenosis. There were 5 cases of malignant tumor and 6 cases of benign disease.
      Three cases underwent emergency procedure, and all cases got benefit. In 2 cases
      they were performed for preoperative preparation, and effective in all cases. In
      6 cases with benign stenosis they were performed for airway dilation, and
      effective in 2 cases, non-effective in 3, and could be evaluated in one. We
      concluded that endoscopic Nd-YAG laser irradiation was effective for emergency
      procedure and preoperative preparation. Non-effective cases were 2 cases of post
      bronchoplasty and 1 case of post Lineac irradiation. And there was no indication
      of Nd-YAG therapy in the lesions developing longitudinally for long distance and
      with deformities of cartilaginous ring, and those without information of distal
      airway from stenosis.

PMID- 1735935
TI  - [Endoscopic Nd-YAG laser treatment of tracheobronchial lesions].
AB  - Eight cases treated with Nd-YAG laser via fiberoptic bronchoscopy were studied.
      Four of them were primary lung cancer, one was tracheal invasion of thyroid
      cancer and three were postintubation lesions of trachea. In six cases, Nd-YAG
      laser treatment was effective for enlargement of the airway lumen and improvement
      of their symptoms. In the cases of advanced lung cancer, not only local findings
      of the tumor but also clinical stage and possibility of adjuvant therapy must be
      considered to apply this procedure. In the cases of postintubation tracheal
      stenosis (except polypoid lesions), T-tube stenting or surgical reconstruction
      must be followed after laser treatment. Nd-YAG laser treatment can be useful for
      the tracheobronchial lesions such as primary tracheal tumors, lung cancer,
      metastatic tumors, postintubation tracheal stenosis and so on if applied
      precisely.

PMID- 1735936
TI  - [Laser vaporization for tracheobronchial lesions using a double intubation
      technique under general anesthesia].
AB  - A method for simple and safe management of laser vaporization is described.
      Following intubation with a thin endobronchial tube which is removed from a twin
      lumen tube, a thick endotracheal tube for a bronchial fiberscope is intubated.
      This double intubation technique provides for a safe and long operation without
      danger of vapor inhalation.

PMID- 1735937
TI  - [Use of airway stent subsequent to endoscopic Nd-YAG laser treatment in central
      airway obstruction].
AB  - Ten cases of central airway obstruction mainly caused by extrinsic compression
      due to the growth of extratracheal malignant tumors or longitudinal extension of
      tracheal adenoid cystic carcinomas, underwent palliative intubation subsequent to
      endoscopic Nd-YAG laser treatment. Mean length of the severe stenosis in these
      cases was 4.4 cm (3-7 cm). Sole application of endoscopic Nd-YAG laser to the
      stenosis failed relief of the symptom and an immediate palliative intubation was
      recommended. Mean time of the temporary intubation was 7 days (4-11 days). Airway
      was maintained by this intubation and also retained enough after extubation.
      Therefore, it seemed that, in a palliative treatment of the central airway severe
      stenosis, usefulness of the combination management of Nd-YAG laser with following
      temporary intubation was revealed. However, in order to maintain the airway for
      recurrence of the obstruction, use of indwelling airway stents seemed a better
      application. The longest period of follow-up in the cases treated by indwelling
      airway stents was 6 months and one of the cases is a now in comfortable state.

PMID- 1735938
TI  - [Therapeutic application of Nd-YAG laser treatment for the chest surgery area].
AB  - Laser therapy is now a well-established procedure and an accepted method of
      treatment in thoracic surgery. Therefore, using Nd-YAG laser (Model Md-50 Y) at
      hospital, we had discussed for the technique and its indication of laser
      therapeutic application against chest diseases. The following results were
      obtained; 1) The first object of endoscopic laser therapy is to keep the normal
      air-way from tracheobronchial stenosis or its bleeding as fast as possible. 2) As
      this laser techniques are not only the quick expansion of the residual lung but
      also relative absence of air-leak and blood loss, they are indicated for open
      lung biopsy or partial resection of metastatic lung tumors, particularly in
      patients with poor pulmonary function. 3) In conjunction with standard surgical
      technique of chest surgery, this laser treatment provides numerous other
      possibilities which facilitate the achievement of the therapeutic goal of
      surgical operation on the lungs.

PMID- 1735939
TI  - [Endoscopic Nd-YAG laser therapy and tracheobronchial surgery].
AB  - We applied endoscopic Nd-YAG laser therapy to eight cases before the
      tracheobronchial surgery (six lung cancers and two metastatic tracheal tumors).
      The preoperative application of Nd-YAG laser is a useful choice for the release
      of air way stenosis, the defining the border of tumor extension and the securing
      endotracheal intubation for anesthesia. More cases come into the category of
      surgical indication when Nd-YAG laser is applied, combined with chemotherapy
      and/or radiation. Preoperative evaluation of the limit of tracheobronchial
      resection as well as the method of the reconstruction are essential, however, the
      precise line of the dissection should be determined by knowing the histological
      finding of the resected by during the operation to make sure of the operative
      radicality.

PMID- 1735940
TI  - [The advantages of laser assist in parenchyma-sparing pulmonary resection].
AB  - The advantages of laser irradiation were investigated retrospectively, using a
      total of 89 parenchyma-sparing pulmonary resection (PSPR) for localized lung
      lesions which included 42 conventional wedge resection (CWR), 8 PSPR using
      electrocoagulator (PE) and 39 PSPR using CO2 laser or Nd:YAG laser (PCYL). The
      major axes of the lesions in PNYL (25.4 +/- 10 mm) were significantly (p =
      0.0387) longer than that in CWR (20.3 +/- 11.3 mm). The amount of bleeding during
      operation was similar in three groups. The mean value of the amount of
      postoperative exudation from the thoracic drains in PCYL (615 ml) was only 60 ml
      more than that in CWR. Bloody sputum was observed for 4.8 days in PCYL and 5.0
      days in CWR, whereas 7.1 days in PE. Air leak was observed 33.3% in PCYL, 37.5%
      in PE, whereas 22.5% in CWR, that continued for 1.7 days (mean value) in PCYL,
      1.6 days in PE and 2.0 days in CWR. Decrease (differences between preoperative
      and postoperative lung functions/volume of the lesions) in FVC and FEV1.0 in PCYL
      (mean values = 221, 158) and PE (174, 135) were less than that in CWR (339, 204).
      Laser assist in PSPR revealed advantages in hemostasis comparing with PE, and in
      parenchyma-sparing comparing with CWR. And no clear difference between PCYL and
      CWR in bleeding during operation, the amount of postoperative exudation and
      postoperative air leak. CO2 laser is reported that has higher potential in
      vaporization or cutting but lower ability in hemostasis comparing with Nd:YAG
      laser, so authors would express that Nd:YAG laser assist is most safe and
      effective in parenchyma-sparing lung resection.

PMID- 1735941
TI  - [Usefulness of Nd-YAG laser for the excision of multiple lung metastases and
      segmentectomy for primary lung cancer].
AB  - Since 1986, limited resection of 561 pulmonary metastases in 25 patients was
      performed with the neodymium:yttrium-aluminum-garnet (Nd-YAG) laser. Use of the
      laser enabled a local excision of both superficially located and deep-seated
      tumors that would otherwise have required segmentectomy or lobectomy for safe
      removal. As a result, the 5-year survival rate for these patients was 40.3%.
      Since 1988, we also developed laser segmentectomy to treat primary lung cancer,
      and performed this procedure on 25 lung cancer patients. Of those, twenty-one
      patients had T1N0 disease. All are alive now and have had no local recurrence.
      The pulmonary distortion, which leads to impairment and loss of pulmonary
      function, was minimal in laser resection when compared to other procedures such
      as stapled resection or the casual ligation-division technique. In conclusion, we
      have found the Nd-YAG laser to be an effective tool both for preserving pulmonary
      function and for obtaining clear safety margins.

PMID- 1735942
TI  - [Application of the Nd-YAG laser for surgical resection of pulmonary metastases].
AB  - We used Nd-YAG laser equipment for operations on pulmonary metastatic tumors in
      order to preserve the residual pulmonary functions simultaneously with local
      curability by utilizing the features of the contact and non-contact types of
      equipment. The subjects were patients showing no lymph node metastasis in the
      preoperative diagnosis. The equipment used was Nd-YAG laser model 6,000 with a
      surgical probe and contact tip attached. Thoracotomy was performed by a method
      involving minimum invasion in accordance with the tumor localization to prevent
      reduction of the postoperative respiratory function as much as possible. An
      incision was made in the pleura and lung using the contact tip with an output of
      about 25 Watts with the surgical margin separated sufficiently from the tumor,
      and the tumor was resected. Coagulative hemostasis was apt to occur in the small
      vessels. To eliminate postoperative hemostasis and residual tumors, non-contact
      type irradiation was performed at the surgical margin at an output of about 50-70
      Watts. Finally, the pleura were sutured. This method has been used so far on 10
      cases of pulmonary metastatic tumors, and in all cases, the amount of
      hemorrhaging during the operation was small, the operating time was short and the
      postoperative reduction in respiratory function was slight. In cases of bilateral
      multiple pulmonary metastases, as many as 30 resections were performed, but no
      recurrences have been seen in any of the cases to date. Although the usefulness
      of this method still cannot be confirmed because of the small number of cases
      involved, this method seems promising from the standpoints of local curability
      and preservation of pulmonary functions.

PMID- 1735943
TI  - [Application and limitation of laser pulmonary resection].
AB  - A new type of laser handpiece, bipolar Nd-YAG laser dissector, was experimentally
      applied for laser pulmonary resection of the dogs. The lung was completely and
      easily divided by the use of the bipolar laser dissector without scissors. The
      dissected edge without cartilages was completely sealed and additional stitches
      by threads was not required. But massive leakage of air was obvious from the
      dissected bronchus. The cause of unsuccessful sealing of the bronchus was
      supposed to be an unequal tissue remodeling, because of a very high melting point
      of cartilages compared with other tissue. We conclude that the bipolar Nd-YAG
      laser dissector contributes segmental pulmonary resection at the level without
      bronchi and it should not be applied for pulmonary resection containing bronchial
      cartilages.

PMID- 1735944
TI  - [Application of laser in the treatment of spontaneous pneumothorax and
      emphysema].
AB  - From August 1990 to August 1991, sixteen patients with bullae or blebs
      (pneumothorax 9, giant bullae 5, bullous emphysema 2) were treated by CO2 laser
      ablation under limited thoracotomy. We found the irradiation of bullae or blebs
      by CO2 laser quite effective in eliminating these bullous lesions which were
      often multiple and inoperable by conventional methods. Histological examination
      revealed the wall of bullae where CO2 laser was applied became thick with dense
      fibrous tissues and degenerated collagen fibers which, however, were not
      disrupted. The procedure was safe and we were able to operate patients with
      disabling emphysema. Because CO2 laser can penetrate only 0.2-0.3 mm of tissue
      thickness, it is suitable for the ablation of bullous lesions which have thin
      walls and rapidly shrink and collapse by irradiation leaving thick walled scar
      tissues. Removing multiple bullae and blebs in patients with bullous emphysema
      can improve gas exchange by reducing dead spaces and elevating the diaphragm
      which is often flat and downward displaced because of hyperinflation in these
      patients. We are planning to incorporate thoracoscopy for this operation to make
      the procedure less invasive.

PMID- 1735945
TI  - [Thoracoscopic laser coagulation shrinkage of blebs in the treatment of
      spontaneous pneumothorax].
AB  - As a thoracoscopic treatment for spontaneous pneumothorax, electrocautery has
      been mainly used. But contact type electrocautery has a risk of perforation of
      blebs. We adopted carbon monoxide laser (wave length 5.4 microns) and good
      coagulation shrinkage of blebs could be obtained by non-contact irradiation. CO
      laser was delivered by As-S glass fiber and power of fiber tip was 2-4 W.
      Compared with Nd-YAG laser (wavelength 1.06 microns), CO laser showed lower risk
      of perforation of blebs. Thoracoscopic CO laser coagulation shrinkage of blebs
      proved to be a important method of treatment for patient of spontaneous
      pneumothorax.

PMID- 1735946
TI  - [Experience of Nd-YAG laser treatment in roentogenographically occult
      bronchogenic squamous cell carcinoma].
AB  - Out of 201 patients with roentogenographically occult bronchogenic squamous cell
      carcinoma, 165 lesions underwent surgical operations, while 41 lesions underwent
      non-invasive therapy. The 5-year survival rate including all causes of death, was
      significantly higher in the surgical operation group than that in the non
      invasive therapy group (83% vs 43%). Among 14 cases who received Nd-YAG laser
      treatment, one case died but 4 cases are alive bearing cancer. Since time span of
      follow-up period is short, it is hard to say that the prognosis of the Nd-YAG
      laser therapy in fair. Nd-YAG laser treatments were effective for cancers which
      did not invade beyond bronchial cartilage. From the bronchoscopic examinations
      and studies with resected lungs, we suggest that Nd-YAG laser treatments may be
      effective when cancer is extended within 10 mm wide and has only a slight
      findings in bronchoscopy.

PMID- 1735947
TI  - [Photodynamic therapy of roentgenographically occult lung cancer].
AB  - Between December 1983 and August 1990 25 patients (a total of 29 carcinomas) with
      roentgenographically occult lung cancer were treated by PDT at National Kinki
      Central Hospital for Chest Diseases. A complete remission (CR) occurred in 21
      carcinomas (72%). Of 19 carcinomas with tumor length of 1 cm or less, 17 ones
      (89.5%) achieved a CR. Of 21 carcinomas with visible tumor of the peripheral
      area, 17 ones (85.7%) achieved a CR. Five carcinomas relapsed from 7 to 18 months
      after PDT. The length of tumor and the visibility of peripheral area of tumor are
      important factors for CR and relapse. Fourteen patients (56%) had double, triple
      or quadruple cancers. Until now, 10 patients died. The main causes of death were
      metachronous secondary cancers and respiratory or heart failure. PDT have a
      potential to become an alternative to surgical resection as the primary treatment
      for early stage roentgenographically occult lung cancer.

PMID- 1735948
TI  - [An experience of laser therapy of lung cancer complicated with hemophilia A].
AB  - We applied an endoscopic Nd-YAG laser therapy for an early hilar lung cancer
      complicated with hemophilia A in a patient of 62-year-old male. Abnormality was
      pointed out by means of sputum cytology. But, no shadow of tumor was observed by
      chest x-ray films and computed tomogram. By a bronchoscopy, a mild irregular
      mucomembrane and stenosis without tumor were exhibited. By means of cytological
      diagnosis of an abrasive-washing specimen of that region, the presence of
      squamous cell carcinoma was proved. Also, he was diagnosed as factor VIII
      deficient hemophilia A. So we performed him a laser therapy in place of the
      operation and with an intrabronchial arterial infusion. After the laser
      treatment, the conditions progressed better without any recurrence but about one
      and a half years later, an intrapulmonary metastasis occurred. Then, radiation
      and chemotherapy have been applied and at present, the patient is in a good state
      although under the tumor-bearing condition.

PMID- 1735949
TI  - [Surgical treatment of arrhythmia].

PMID- 1735950
TI  - [Management of airway obstruction using the neodymium-yttrium-aluminium-garnet
      laser].
AB  - The neodymium-yttrium-aluminium-garnet laser (Nd-YAG laser) has proved to be
      useful therapeutic tool for the management of endobronchial lesions. Between
      February 1983 and January 1991, 16 patients received endobronchial laser therapy
      at the Nagasaki University Hospital, 7 patients for tracheal stenosis, and 9 for
      endobronchial obstruction. In 4 patients with tracheal stenosis, the therapy was
      performed in an emergency. The type of lesions were lung cancer in 7 patients,
      thyroid cancer in 3, tracheal tumor (squamous cell carcinoma, and chondrosarcoma)
      in 2, esophageal cancer in 1, bronchial submucosal tumor in 1, and
      tracheobronchial tuberculosis in 2. Good symptomatic relief was obtained in 13
      patients. One patient died from massive bleeding in the left main stem bronchus.
      Reobstruction had occurred in 2 patients with cicatricial lesion in right main
      stem bronchus. In patients with an unresectable malignant lesion, concurrent
      radiotherapy was needed to prevent the reobstruction.

PMID- 1735951
TI  - Ewing's sarcoma: new approaches to histogenesis and molecular plasticity.

PMID- 1735952
TI  - Human natural killer cells: clonally distributed specific functions and
      triggering surface molecules.

PMID- 1735953
TI  - Cellular and molecular mechanisms of renal carcinogenesis induced by avian
      erythroblastosis virus.
AB  - Besides erythroleukemias and sarcomas, avian erythroblastosis virus strain ES4
      (AEV-ES4) induces renal adenocarcinomas (RCas) in chickens. To search for the
      cells of origin and the mechanism of the development of RCas, we investigated the
      RCas produced by td359AEV, a mutant of AEV-ES4 which lacks a leukemogenic effect,
      but which is sarcomagenic. Spindle cell sarcomas in various organs and RCas
      developed in a high number of chickens inoculated with td359AEV. RCas were tubulo
      cystopapillary structures of basophilic cells and originated only from
      differentiated principal cells (PCs) of the renal collecting duct system. The
      origin of tumors from PCs was indicated by connections of tumor epithelium to
      segments of the collecting duct system, including connecting tubules and cortical
      and medullary collecting ducts. Tumor cells showed typical mucopolysaccharide
      containing vacuoles which are characteristic of chicken PCs. Viral particles were
      observed throughout the kidney. Moreover, the highest numbers of particles as
      well as budding-images of them were seen (apart from tumor cells) in podocytes
      and distal tubule cells which did not undergo neoplastic change. The
      susceptibility of PCs to undergo neoplastic transformation could not be related
      to a particular activation state of the erbB gene, in view of the fact that cerbB
      expression was detected by in situ hybridization in the epithelium lining the
      Bowmann's capsule and the entire renal tubule system. From data of Northern blot
      and in situ hybridization techniques, it was suggested that the neoplastic
      transformation of PCs was elicited by overexpression of the v-erbB oncogene, a
      feature of tumor cells already detected in renal tubules lined by basophilic
      proliferating cells, the first stages of renal carcinogenesis induced by
      td359AEV. According to Southern blot analysis, td359AEV proviruses were randomly
      inserted in tumor DNAs and the RCas were polyclonal in nature.

PMID- 1735954
TI  - Neuroendocrine differentiation in adrenocortical carcinoma. New
      immunohistochemical findings supported by electron microscopy.
AB  - Ten adrenocortical carcinomas including two tumors with clinically detectable
      corticosteroid production, were immunohistochemically analyzed for their
      intermediate filament proteins, and for neuroendocrine markers. Keratins were
      present in 6 of 10, vimentin in all 10, and the 68 kilodalton kD neurofilament
      subunit protein in 6/10 tumors. Keratins numbers 8 and 18 were most prevalent,
      whereas only traces of keratins 19 and 7 were found. Eight tumors were positive
      for synaptophysin at least focally, and 3 showed extensive positivity in more
      than 30% of tumor cells. The tumors showed approximately similar levels of neuron
      specific enolase (NSE) expression as judged by immunohistochemistry. Chromogranin
      was not detected, and there was no immunoreactivity for 3 neuropeptides
      (calcitonin, gastrin, somatostatin). In normal adrenal cortex, neuron-specific
      enolase, synaptophysin and neurofilaments were restricted to the nerves seen
      between the cortical cells. Electron microscopy revealed clusters of dense-core
      granules in 4 of 5 tumors, consistent with neuroendocrine granules. These results
      indicate that adrenocortical carcinomas may show signs of neuroendocrine
      differentiation and share some features with the adrenal medullary tumors.

PMID- 1735955
TI  - Association of the human spasmolytic polypeptide and an estrogen-induced breast
      cancer protein (pS2) with human pancreatic carcinoma.
AB  - The human pS2 gene, isolated from the breast carcinoma cell line MCF-7 and shown
      to be under estrogen transcriptional control in a subclass of breast cancer cells
      was reported to be secreted in normal stomach surface epithelial cells, whereas
      additional gastrointestinal tissues like pancreas and colon do not secrete pS2 at
      all. In porcine pancreas, a spasmolytic polypeptide (sharing domains of homology
      with pS2) was observed; a corresponding human gene (hSP) was shown to be active
      in normal stomach mucosa. hSP and pS2 gene activity in normal and neoplastic
      pancreas tissues was then compared. Whereas both genes are inactive in normal
      pancreatic cells, activation of the pS2 sequence in a primary pancreatic
      carcinoma cell culture and in 23 tumor tissues was noted when investigated by
      immunostaining. In all cases when pS2 showed a regular 0.6 kb transcript, hSP
      displayed a transcript of 0.7 kb. Six of these tumors showed a reduced pS2
      immunoreactivity and, at the same time, aberrant pS2 mRNA bands and a complete
      shut-down of the hSP gene were noted. In one case, whereas normal pancreas
      remained negative, the corresponding tumor and its metastasis displayed regular
      transcripts of pS2 and hSP. This remarkably high correlation suggests that pS2
      and hSP expression in the pancreatic tumors, but not in their corresponding
      healthy tissue is significantly linked to molecular steps leading to
      tumorigenesis.

PMID- 1735956
TI  - Regions with abundant neurofibrillary pathology in human brain exhibit a
      selective reduction in levels of binding-competent tau and accumulation of
      abnormal tau-isoforms (A68 proteins).
AB  - Paired helical filaments, the dominant filamentous components of Alzheimer's
      disease (AD), neurofibrillary tangles (NFT), neuropil threads, and the dystrophic
      neurites associated with amyloid rich senile plaques, are composed of abnormally
      phosphorylated derivatives of tau known as A68 proteins. Indeed the inappropriate
      phosphorylation of Ser396, which is adjacent to the microtuble binding domain in
      tau, may contribute to the transformation of tau into A68 and prevent A68 from
      efficiently binding to microtubules. The reduced levels of normal soluble tau
      proteins in AD brains may be the consequence of a multi-step process whereby
      normal tau is converted into A68 and sequestered in paired helical filaments. To
      elucidate the events involved in this process, we compared the relative levels of
      binding-competent (BC) and binding-incompetent (BI) tau with the level of A68 in
      six different regions (hippocampus, fornix, frontal grey and white matter, and
      cerebellar grey and white matter) of fresh AD and control brains. When the AD
      brains were compared as a group with neurologically normal and diseased non-AD
      controls, quantitative immunoblot analysis demonstrated a selective reduction of
      BC tau in regions of the AD brains with abundant neurofibrillary lesions (NFTs,
      neuropil threads, and senile plaque neurites) and in their associated white
      matter areas. The level of BI tau was similar in both AD and control brains. In
      contrast, A68 was present only in the AD brains, but it was confined to those
      brain regions with abundant NFTs, neuropil threads, and senile plaques. We view
      the reductions in BC tau in fornix and frontal white matter to be a consequence
      of the reductions in their associated grey matter regions i.e., hippocampus and
      frontal grey matter. Although there is no strict relationship between the
      reduction of BC tau and the level of A68 within an individual brain, the
      comparison of the AD group with the control group suggests that the grey matter
      of the affected regions may be the site for the conversion of BC tau into A68.
      Further, this process may occur rapidly or via pathways that do not involve BI
      tau since the levels of BI tau were similar in AD and control brains. Although
      the complete sequence of events leading to the transformation of tau into A68 and
      paired helical filaments remains to be elucidated, our data provide compelling
      evidence that A68 proteins are generated from tau-proteins in selected regions of
      the AD brain where neurofibrillary lesions comprised of paired helical filaments
      accumulate.

PMID- 1735957
TI  - Biological characteristics of primary cultures of human gallbladder epithelial
      cells.
AB  - Epithelial cells of the gallbladder have potential to represent an important
      model for studies of ductal epithelial in normal and pathological states. We
      therefore initiated studies to establish human gallbladder epithelial cells
      (GBEC) in culture. GBEC were isolated by trypsinization of small tissue fragments
      from human gallbladders obtained at cholecystectomy; cells were plated on tissue
      culture dishes and grown in defined MCDB 153 medium containing added growth
      factors. In this medium, GBEC showed a plating efficiency of approximately 1%;
      those GBEC that attached formed colonies and proliferated, as demonstrated by
      autoradiographic analysis of [3H]thymidine incorporation into DNA. Cultured GBEC
      expressed two markers found on GBEC in situ, i.e., gamma-glutamyl transpeptidase
      and cytokeratin 19. By using various attachment substrates, with and without
      added serum, increased plating efficiency and better growth were achieved. When
      type IV collagen was used as substrate and 10% fetal bovine serum was added to
      MCDB 153, passage of GBEC was possible, and cells proliferated through five to
      six population doublings. GBEC in culture under all conditions eventually
      enlarged, showed vacuolization, and demonstrated irreversible growth arrest.
      Nonetheless, the culture conditions described here allow for preparation of large
      quantities of highly enriched human GBEC.

PMID- 1735958
TI  - Investigation of nuclear c-MYC oncoprotein expression in human hematopoiesis:
      suitability of a rapid and reliable semiquantitative evaluation system.
AB  - The biologic functions mediated by the nuclear protooncogene, c-MYC are
      correlated to gene dosage. Since automated quantification programs are expensive,
      time-consuming and not easily available, and since analysis by flow cytometry is
      difficult in the case of nuclear antigens, we examined the suitability and
      reproducibility of a semiquantitative in situ evaluation system. This system was
      based on the percentage of nuclear area staining positively, and comprised the
      following categories: 0: negative, 1+: single scattered grains of the
      immunocytochemical staining product, 2+: confluence of grains to patches but less
      than 50% nuclear area positive, and 3+: greater than 50% positive nuclear area.
      In addition, sensitivity and specificity of two anti-c-MYC antibodies were
      investigated. Although both antibodies differed slightly in staining pattern and
      sensitivity, the four quantification categories were applicable for
      immunostainings of both antisera and highly reproducible when re-evaluated by the
      same observer (r = 0.98; p = 0.0001) or a second investigator (rAb155 = 0.98, rAb
      DCPm = 0.96; p = 0.0001), both reading blindly and independently. Comparing our
      semiquantitative evaluation categories and results of computer-assisted image
      analysis, the percentage of positive nuclear area (p less than 0.0001), the
      median staining intensity (p less than 0.0001), and the product of both (p less
      than 0.0001) differed significantly in the four evaluation categories. This
      result still held true after correction for nuclear size, which differed
      appreciably in various cell types (p less than 0.0001). The product of positive
      nuclear area, staining intensity and nuclear size (microns 2), which best
      approximates the absolute amount of c-MYC within a certain cell, was clearly
      different within the four staining categories (p less than 0.0001) and did not
      depend on cellular morphology within the staining categories 0 to 2. Also, the
      immunocytochemical technique proved highly reproducible (median day/day variance
      0.65% (0-13); r = 0.995). The practicability of this system for
      semiquantification was demonstrated by (a) correlation of H score values of
      immunocytochemical stainings with densitometric scans of Western blots and (b) by
      the fact that peripheral blood lymphocytes, Phytohemagglutinin stimulated blasts,
      13 cases of multiple myeloma and HL-60 cells differed concerning their estimated
      c-MYC amounts (p = 0.0125). This confirms on the effector molecule level results
      previously reported from mRNA in situ and Northern blotting analyses. We conclude
      that a simple and highly reproducible evaluation system can be used for in situ
      comparison of nuclear oncogene dosage.

PMID- 1735959
TI  - Use and understanding of adverbial conjuncts: a developmental study of
      adolescents and young adults.
AB  - The use and understanding of two types of adverbial conjuncts, concordant (e.g.,
      similarly, moreover, consequently) and discordant (e.g., contrastively, rather,
      nevertheless), was examined developmentally in 120 adolescents and young adults.
      Four groups of 30 students participated. Mean ages of the groups were 12:9,
      15:10, 19:2, and 23:8 (years:months). The results demonstrated an increasing
      ability to use and understand these words in the written mode. An interesting
      discrepancy emerged between the use and the understanding of adverbial conjuncts,
      a finding that resembled the well-documented discrepancy between the use and the
      understanding of spoken words in young children. Although young adults had
      mastered the words in terms of their understanding, they continued to show some
      difficulty using the words correctly. It was also found that the two types of
      conjuncts were equally difficult, a result that failed to support Piaget's (1928)
      hypothesis concerning the greater difficulty of discordant connectives. Factors
      that may contribute to the development of adverbial conjuncts are discussed.

PMID- 1735960
TI  - Comprehension problems in children with specific language impairment: literal and
      inferential meaning.
AB  - A group of 61 schoolchildren with specific language impairment (SLI) was compared
      with a control group on a comprehension task, in which the child was questioned
      about a story that had been presented either orally or as a series of pictures.
      Half the questions were literal, requiring the child to provide a detail that had
      been mentioned or shown explicitly in the story. The remainder required the child
      to make an inference about what had not been directly shown or stated. SLI
      children were impaired on this task, even after taking into account
      "comprehension age," as assessed on a multiple-choice test. However, the effects
      of mode of presentation and question type were similar for control and SLI
      groups. Children who fitted the clinical picture of semantic-pragmatic disorder
      had lower scores than other SLI children on this task. In addition, they were
      more prone to give answers that suggested they had not understood the question.
      However, as with the other SLI children, there was no indication that they had
      disproportionate difficulty with inferential questions. It is concluded that SLI
      children are impaired in constructing an integrated representation from a
      sequence of propositions, even when such propositions are presented nonverbally.

PMID- 1735961
TI  - Measurement of communicative intentions in normally developing children during
      structured and unstructured contexts.
AB  - The purpose of this study was to examine the effect of sampling context on
      measurements of communicative intentions expressed by 15 normally developing
      children during the prelinguistic, one-word, and multiword stages. A
      communication sample using both structured and unstructured contexts was
      collected from each subject as he or she interacted with a clinician and parent
      at each language stage. Direct comparisons were made between the uses of requests
      and comments during the structured and unstructured sampling contexts. The
      results indicated that the mean number of requests and comments increased
      significantly from the prelinguistic to the multiword stage in both contexts.
      Significantly more requests were used during the structured context, but no
      significant difference was found between the numbers of comments used in the two
      contexts. Factors to consider in sampling communication from developmentally
      young children are discussed.

PMID- 1735962
TI  - Echolalic responses by a child with autism to four experimental conditions of
      sociolinguistic input.
AB  - Studies of the immediate verbal imitations (IVIs) of subjects with echolalia
      report that features of linguistic or social input alone affect the number of
      IVIs elicited. This experimental study of a child with echolalia and autism
      controlled each of these variables while introducing a systematic change in the
      other. The subject produced more (p less than .05) IVIs in response to unknown
      lexical words presented with a high degree of directiveness (Condition D) than in
      response to three other conditions of stimulus presentation (e.g., unknown
      lexical words, minimally directive style.) Thus, an interaction between the
      effects of linguistic and social input was demonstrated. IVIs were produced
      across all conditions, primarily during first presentations of lexical stimuli.
      Only the IVIs elicited by first presentations of the lexical stimuli during
      Condition D differed significantly (p less than .05) from the number of IVIs
      elicited by first presentations of lexical stimuli in other conditions. These
      findings viewed together suggest that the occurrence of IVIs was related, at
      least for this child, to an uncertain or informative event and that this response
      was significantly greater when the lexical stimuli were unknown and presented in
      a highly directive style.

PMID- 1735963
TI  - Measurable outcomes of instructions to modify normal parent-child verbal
      interactions: implications for indirect stuttering therapy.
AB  - This study was a preliminary analysis of the differential effects of instructions
      to slow maternal speech rate, or to slow and simplify maternal speech when
      conversing with normally fluent children. Twenty mothers and their normally
      fluent children participated. Instructions to slow maternal rate resulted in
      maternal speech simplification as a by-product. No significant differences were
      found between the effects of the two sets of instructions. Furthermore,
      children's speech rate and language complexity did not parallel maternal
      adjustments. These last findings are problematic for some of the premises that
      underlie the use of parental counseling as a component of indirect therapy for
      stuttering.

PMID- 1735964
TI  - Auditory temporal acuity in normally achieving and learning-disabled college
      students.
AB  - Recent research has suggested that deficits in several
      metalinguistic/phonological abilities, such as short-term verbal memory and
      phoneme segmentation, may be etiologic factors in specific reading disability,
      and it has been speculated that these weaknesses may result from a more
      fundamental deficit in the processing of temporal, auditory stimuli. This study
      examined the auditory temporal processing skills of reading-disabled, math
      disabled, and normally achieving college students. The math-disabled group was
      included to control for the possibility that poor temporal processing is a
      "marker" variable for learning disability rather than being related specifically
      to reading disability. Subjects were assessed on a battery of psychophysical
      tasks that included five tests of temporal processing. The reading-disabled group
      performed significantly more poorly on the temporal tasks but performed as well
      as the other groups on the simple pitch and loudness discrimination tasks. In
      spite of the significant difference on the temporal tasks, the majority of
      reading-disabled subjects performed within the same range as the subjects in the
      other two groups, and there were also some normally reading subjects who
      performed poorly on the temporal processing tasks. These findings suggest that
      poor temporal processing is neither a necessary nor a sufficient cause of reading
      disability, but that there is a modest association between the two domains.

PMID- 1735965
TI  - Auditory distortion products measured with averaged auditory evoked potentials.
AB  - The purpose of this investigation was to describe the properties of averaged
      auditory evoked potential distortion products (AEP-DPs) in guinea pigs. This
      study provided a step toward developing a clinical index of nonlinear processing
      of auditory signals and supplied a baseline for studies evaluating the effect of
      cochlear damage on AEP-DPs. The amplitude of the AEP-DPs was evaluated as a
      function of f2/f1 ratio (1.12-1.52) and primary frequency (500 Hz-2000 Hz). The
      amplitude of the AEP cubic difference tone (AEP-CDT) increased with increasing
      f2/f1 ratio for the 500-Hz f1 primary and remained constant for the 800-Hz and
      1700-Hz f1 primaries. The AEP-CDT generated by the 1100-Hz and 1400-Hz f1
      primaries was maximum for the middle f2/f1 ratios (1.22, 1.32, and 1.42). The AEP
      CDT could not be distinguished from the noise floor for the 2000-Hz f1 primary.
      The AEP difference tone (AEP-DT) was larger and more frequently identified than
      the AEP-CDT. The amplitude of the AEP-DT decreased with an increase in f2/f1
      ratio. The decrease was more pronounced for low-frequency f1 primaries than for
      high-frequency f1 primaries.

PMID- 1735966
TI  - Effects of stimulus phase on the normal auditory brainstem response.
AB  - The purpose of this investigation was to determine the effects of stimulus phase
      on the latencies and morphology of the auditory brainstem response (ABR) of
      normal-hearing subjects. Although click stimuli produced equivalent ABR latencies
      for the rarefaction and condensation phases, the subtraction of the waveforms
      from the two phases yielded a difference potential. Tone pip stimuli produced
      polarity differences that were inversely related to stimulus frequency: the
      higher the frequency, the smaller the ABR latency differences between responses
      to rarefaction and condensation stimuli, and the smaller the difference
      potentials. Thus, whereas the latency of click-evoked ABR is dominated by high
      frequency responses with equivalent latencies regardless of stimulus phase, low
      frequency responses contribute to the overall morphology of the ABR that yields
      the phasic difference potential. The implications of these findings are discussed
      with reference to subjects with high-frequency hearing losses.

PMID- 1735967
TI  - Comparison of responses to air, water, and closed-loop caloric irrigators.
AB  - Three types of commercially available caloric irrigation units--air, water, and
      closed-loop--were evaluated for nystagmus response patterns and comfort.
      Electronystagmographic recordings were analyzed for slow-phase velocity, response
      duration, amplitude, frequency, and test-retest reliability. Significant
      differences were found among the three types of irrigators, between warm and cool
      irrigators, and between male and female subjects. Test-retest reliability was
      adequate for all three units. Subjects clearly favored the closed-loop system
      over the water and air irrigators, but the water irrigator yielded the most
      robust caloric response.

PMID- 1735968
TI  - Speech perception in adult subjects with familial dyslexia.
AB  - Speech perception was investigated in a carefully selected group of adult
      subjects with familial dyslexia. Perception of three synthetic speech continua
      was studied: /a/-/e/, in which steady-state spectral cues distinguished the vowel
      stimuli; /ba/-/da/, in which rapidly changing spectral cues were varied; and
      /sta/-/sa/, in which a temporal cue, silence duration, was systematically varied.
      These three continua, which differed with respect to the nature of the acoustic
      cues discriminating between pairs, were used to assess subjects' abilities to use
      steady state, dynamic, and temporal cues. Dyslexic and normal readers
      participated in one identification and two discrimination tasks for each
      continuum. Results suggest that dyslexic readers required greater silence
      duration than normal readers to shift their perception from /sa/ to /sta/. In
      addition, although the dyslexic subjects were able to label and discriminate the
      synthetic speech continua, they did not necessarily use the acoustic cues in the
      same manner as normal readers, and their overall performance was generally less
      accurate.

PMID- 1735969
TI  - Coupling of FM systems to individuals with unilateral hearing loss.
AB  - This study examined the attenuation characteristics of five FM system sound
      delivery options for a group of 10 adults and 15 children (5-13 years). Sound
      delivery options included a tube-fitting, lightweight headphones, a CROS earmold
      with tubing, a CROS earmold with a snap-ring, and a standard snap-ring earmold
      with a vent. Attenuation was defined as the difference between probe-tube
      microphone measures of the ear canal resonance and the SPL in the ear canal with
      each sound delivery option in place. A statistically significant but clinically
      inconsequential difference in attenuation for the CROS earmold with tubing was
      noted between adults and children. No significant differences in attenuation for
      any of the other sound delivery options were noted between adults and children.
      An investigation of the relationship between magnitude of attenuation and
      percentage of the ear canal occluded suggests that degree of occlusion is a major
      factor in determining degree of attenuation provided by a particular sound
      delivery option. Results also indicate that significant attenuation of high
      frequency signals can occur with earmolds commonly considered nonoccluding.
      Caution should be used in fitting hearing aids or FM systems to individuals with
      normal high-frequency hearing sensitivity to prevent attenuation of unamplified
      high-frequency speech information.

PMID- 1735970
TI  - Acoustic interpretation of the voice range profile (phonetogram).
AB  - The voice range profile (VRP) is a display of vocal intensity range versus
      fundamental frequency (F0). Past measurements have shown that the intensity range
      is reduced at the extremes of the F0 range, that there is a gradual upward tilt
      of the high- and low-intensity boundaries with increasing F0, and that a ripple
      exists at the boundaries. The intensity ripple, which results from tuning of
      source harmonics to the formants, is more noticeable at the upper boundary than
      the lower boundary because higher harmonics are not energized as effectively near
      phonation threshold as at maximum lung pressure. The gradual tilt of the
      intensity boundaries results from more effective transmission and radiation of
      acoustic energy at higher fundamental frequencies. This depends on the spectral
      distribution of the source power, however, At low F0, a smaller spectral slope
      (more harmonic energy) produces greater intensity. At high F0, on the other hand,
      a shift of energy toward the fundamental results in greater intensity. This
      dependence of intensity on spectral distribution of source power seems to explain
      the reduced intensity range at higher F0. An unrelated problem of reduced
      intensity range at low F0 stems from the inherent difficulty of keeping F0 from
      rising when subglottal pressure is increased.

PMID- 1735971
TI  - The late auditory evoked potential masking-level difference as a function of
      noise level.
AB  - The purpose of this study was to determine whether the masking-level difference
      (MLD) obtained with the late (P2) auditory evoked potentials has characteristics
      similar to those reported for the behavioral MLD with respect to the effects of
      noise level. Psychoacoustic studies have shown that the magnitude of the MLD
      increases as a function of the noise level. In the present study, P2 thresholds
      were measured in SoNo (signals and noise in phase at the ears) and S pi No
      (signals out of phase and noise in phase at the ears) conditions for noise levels
      of 0-60 dB pressure spectrum level (Lps). Subjects were 5 normal-hearing young
      adults. The difference in SoNo and S pi No thresholds, or the MLD, increased
      linearly as the noise levels increased through 60 dB Lps, whereas the behavioral
      MLD magnitude is reported to saturate at high noise levels. These results suggest
      that the late-potential MLD reflects characteristics similar to, but not
      identical with, those of the behavioral MLD.

PMID- 1735972
TI  - Spectral pattern discrimination by children.
AB  - This research measured the ability of 47 children, aged 4-9 years, to use
      spectral shape cues to discriminate among random-intensity sounds. The children
      were tested in forced-choice paradigms that were embedded in a video game format.
      Two classes of sounds were studied: tonal complexes with sinusoidally rippled
      amplitude spectra, and synthetic speech sounds (isolated vowels and consonants).
      The discriminability of the sounds was measured both in quiet and in a background
      of wide-band noise. Although the intersubject variability in performance was
      high, especially among the youngest children, the results revealed a substantial
      age effect. For both classes of sounds, the performance of the younger children
      was significantly poorer than the performance of an adult control group. However,
      there was no evidence in the data that the masking effect of the noise was
      greater for the children than for the adults.

PMID- 1735973
TI  - Effects of aging on time-gated isolated word-recognition performance.
AB  - This investigation was designed to study real-time isolated monosyllabic word
      recognition performance and the feasibility of applying time-gated NU-6 word
      recognition test materials for real-time assessment of older listeners. Methods
      and materials developed in a previous investigation were used to obtain time
      gated performance measures from 37 older listeners (mean age = 69 years). The
      older listener performance measures were compared with extant data from 20
      normally hearing young adult listeners (mean age = 22 years). Specifically,
      listener confidence and accuracy by gate as well as listener isolation point,
      confidence at the isolation point, and total acceptance point measures were
      evaluated. The results show that major events in the real-time understanding
      process occur at a slower pace among older listeners. The data indicate that the
      time-gating method has excellent potential for future research among elderly
      listeners.

PMID- 1735974
TI  - Comparing tongue positioning by normal-hearing and hearing-impaired children
      during vowel production.
AB  - Glossometric measures of tongue positions of 10 normal-hearing (NH) and 10
      profoundly hearing-impaired (HI) children were compared during production of the
      eight vowels /i,I,E,ae,u,U,o,a/. The NH subjects used tongue positions with
      distinct vertical distances from the hard palate and discrete tongue shapes to
      distinguish the front vowels and the back vowels. The HI subjects produced vowels
      using a reduced vertical range and singular flat, high-back tongue shape. Token
      to-token variability was greater for the HI subjects. Listener identifications of
      the vowels produced by the HI subjects fell in three categories: highly variable
      responses to /i/, low vowels for /I,E,ae,a/, and back vowels for /u,U,o/. The
      centralized, generally undifferentiated tongue positions and listener
      identifications for the HI subjects coincided with suppositions made from
      previous perceptual, acoustic, and physiologic findings.

PMID- 1735975
TI  - Articulation rate in 3- and 5-year-old children.
AB  - The major purposes of this study were to provide normative data on articulation
      rate in preschool children and to examine the influence on articulation rate of
      age, gender, context, and utterance length. The subjects were twenty 3-year-old
      children and twenty 5-year-old children, equally balanced for gender. Durational
      measures of utterances were analyzed in syllables and phones per second in both
      spontaneous and imitated speech contexts. The articulation rate of the 5-year-old
      subjects was significantly faster than that of the 3-year-olds. Spontaneous
      speech was significantly faster and more variable than imitated speech. Some
      gender differences were found. Measures in syllables per second and phones per
      second, although not always yielding identical results, were found to be highly
      correlated.

PMID- 1735976
TI  - Cross-cultural attitudes toward speech disorders.
AB  - Speech-language pathologists serving multicultural populations may encounter
      unfamiliar beliefs about speech disorders among the members of different
      cultures. This study used a questionnaire to look at attitudes toward four
      disorders (cleft palate, dysfluency, hearing impairment, and misarticulations)
      among 166 university students representing English-speaking North American
      culture and several other cultures (e.g., Chinese, Southeast Asian, Hispanic).
      The results showed significant group differences on items involving the subjects'
      beliefs about the emotional health of persons with speech disorders and about the
      potential ability of speech-disordered persons to change their own speech.

PMID- 1735977
TI  - Vocal tract area function estimation from midsagittal dimensions with CT scans
      and a vocal tract cast: modeling the transition with two sets of coefficients.
AB  - The generation of area functions from measurements of the sagittal section is an
      important step in the study of the relation between vocal tract geometry and
      speech acoustics. We present a new model to perform this transformation, inspired
      by the alpha beta model of Heinz & Stevens (1965). Our model is based on analysis
      of a vocal tract cast for large sagittal dimensions and for small sagittal
      dimensions on CT scans of the vocal tract constriction zones for the three
      cardinal vowels [i, a, u] of French. We extracted two sets of coefficients,
      appropriate for large and small sagittal dimensions respectively. We then
      compared the predictions of the model with those of other models from the
      literature. Finally, the usefulness of this dual coefficient procedure for the
      acoustic simulation of vowels was tested using sagittal sections generated by an
      acoustic model of the vocal tract.

PMID- 1735978
TI  - Articulatory function after resection of the tongue and floor of the mouth:
      palatometric and perceptual evaluation.
AB  - Linguapalatal contact patterns and the time course of changes in contacts during
      utterances of/asa, ata, a sa, aca/ were measured using electropalatography (EPG).
      The relations between these data and perceptual scores in 17 glossectomized
      patients after various surgical methods were examined. The linguapalatal contact
      patterns produced during perceptually less distorted sounds varied with the place
      and manner of articulation. Patterns having very few contacts or a posterior
      groove produced more distorted /s/ sounds; however, types of EPG patterns
      producing less distorted /s/ sounds were relatively frequent. Distortion of the
      and /c/ sounds was less often produced by variation of the EPG patterns, whereas
      /t/ sounds were most frequently judged to be highly distorted. Patterns that
      showed complete constriction along the dental arch or constriction on the
      anterior portion of the hard palate, as well as rapid release for plosion by the
      tongue tip, produced less distorted /t/ sounds. The results revealed that
      glossectomized patients often evidenced defective stop sounds. It was concluded
      that mobility rather than volume of the residual tongue is required to produce
      less distorted stops.

PMID- 1735979
TI  - Stuttered and normal speech events in early childhood: the validity of a
      behavioral data language.
AB  - A set of 200 utterances from stuttering and normally speaking children aged 2-4
      years was obtained. Each utterance contained a disfluency. A group of 5
      sophisticated listeners assigned one of Johnson's eight disfluency categories to
      each of the 200 utterances. These clinicians showed poor agreement in the
      categories they assigned. Subsequently, the 200 disfluencies were presented to a
      group of generalist clinician listeners and a group of unsophisticated listeners,
      who were asked to judge whether each disfluency was "stuttering" or "normal." The
      disfluencies judged with high agreement to be "stuttering" and the disfluencies
      judged with high agreement to be "normal" were not categorically distinguished by
      the disfluency categories assigned previously by the sophisticated listeners.
      Further, judged presence of various disfluency categories accounted for only a
      small portion of the variance in numbers of "stuttering" judgments assigned to
      disfluencies. It is concluded that it is justifiable to question the validity of
      the data language used by researchers to describe stuttered and normal speech in
      early childhood. Several implications of this conclusion are discussed.

PMID- 1735980
TI  - Acoustic integrity of speech production in children with moderate and severe
      hearing impairment.
AB  - Ten normally hearing and 10 age-matched subjects with moderate-to-severe hearing
      impairment were recorded producing a protocol of 18 basic syllables
      [/pi/,/pa/,/pu/;/bi/,/ba/,/bu/; /ti/,/ta/,/tu/ ;/di/,/da/,/du/; /ki/,/ka/,/ku/;
      /gi/,/ga/,/gu/] repeated five times. The resulting 90 syllables were digitized
      and measured for (a) total duration; (b) voice-onset time (VOT) of the initial
      consonant; (c) fundamental frequency (F0) at midpoint of vowel; and (d) formant
      frequencies (F1, F2, F3), also measured at midpoint of vowel. Statistical
      comparisons were conducted on (a) average values for each syllable, and (b)
      standard deviations. Although there were numerical differences between normally
      hearing and hearing-impaired groups, few differences were statistically
      significant.

PMID- 1735981
TI  - Phonological behavior in toddlers with slow expressive language development.
AB  - Toddlers with slow expressive language development were compared to normally
      speaking age-mates on three global measures of phonological behavior: the average
      level of complexity of their syllable structures, the number of different
      consonant phonemes produced, and the percentage of consonants correctly produced
      in intelligible utterances. The groups were found to differ significantly on all
      three variables. Further analyses were done, breaking the groups down into
      narrower age ranges. These comparisons also revealed differences between late
      talking and normal youngsters. Detailed analyses of the range of phonemes and
      syllable structures produced, as well as the appearance of phoneme classes within
      syllable structures and positions, revealed that late talkers showed a delayed
      rather than a deviant pattern of phonological development. The implications of
      these findings for identifying and monitoring expressive delay in toddlers are
      discussed.

PMID- 1735982
TI  - Change and thoracic surgery.

PMID- 1735983
TI  - University of Wisconsin solution versus crystalloid cardioplegia for human donor
      heart preservation. A randomized blinded prospective clinical trial.
AB  - We have previously shown the safety and efficacy of University of Wisconsin
      solution for hypothermic preservation of the human donor heart in a pilot group
      of 16 transplant recipients. The present study is a randomized clinical trial
      comparing University of Wisconsin solution to conventional preservation using
      crystalloid cardioplegia and saline storage within a 4-hour limit of ischemia.
      Heart transplant recipients (n = 42) were randomized into two groups: those
      receiving hearts preserved by University of Wisconsin solution, the UWS group (n
      = 22), and those receiving hearts preserved in the conventional manner, the CCS
      group (n = 20). Recipient age, gender, heart disease, and preoperative inotropic
      support and donor age, gender, and mean ischemic time in hours (UWS 2 hours 36
      minutes, range 1 hour 36 minutes to 2 hours 53 minutes; CCS 2 hours 20 minutes,
      range 1 hour 20 minutes to 2 hours 44 minutes; p = not significant) were similar.
      Significant differences observed between the two groups included (1) mean time
      (minutes) from reperfusion to achieve a stable rhythm, (2) need for
      intraoperative defibrillations, (3) need for transient cardiac pacing, and (4)
      integrated postoperative creatinine kinase and aspartate aminotransferase release
      over 48 hours. There was no difference in postoperative electrocardiogram,
      endomyocardial biopsy, or hemodynamics. One UWS patient died of sepsis and
      another of a ruptured cerebral aneurysm. UWS is safe for donor organ arrest and
      preservation despite high viscosity and potassium concentration. When compared
      with CCS hearts, hearts preserved in UWS regained electrical activity more
      rapidly and had better myocardial protection as demonstrated by enzymatic
      analysis. Further investigation is required to determine the effects of UWS
      preservation on long-term survival, to determine the prevalence of rejection and
      graft atherosclerosis, and to test the ability of UWS to extend donor ischemic
      time in human cardiac transplantation.

PMID- 1735984
TI  - Future horizons of lung preservation by application of a platelet-activating
      factor antagonist compared with current clinical standards. Euro-Collins flush
      perfusion versus donor core cooling.
AB  - With the introduction of platelet-activating factor antagonists, a direct
      inhibition of ischemia-induced reperfusion injury can be achieved by prevention
      of platelet activation, reduction of microvascular leakage, and platelet
      activating factor-induced bronchoconstriction. At present, two preservation
      methods are established for clinical lung preservation: (1) donor core cooling by
      extracorporeal circulation and (2) pulmonary artery flush with Euro-Collins
      solution and prostacyclin. We compared the quality of organ preservation obtained
      with these methods to the application of a platelet-activating factor antagonist
      (WEB 2170; 0.3 mg/kg) for the donor, perfusion solution, and throughout the first
      6 hours of reperfusion in combination with prostacyclin (20 ng/kg/min) and Euro
      Collins solution (60 ml/kg). Eighteen heterotopic heart and orthotopic left lung
      transplants were performed in three groups of six dogs each after 6 hours of cold
      ischemia (group I, donor core cooling; group II, Euro-Collins flush and
      prostacyclin; group III, Euro-Collins flush, prostacyclin, and WEB 2170).
      Myocardial preservation was achieved with St. Thomas' Hospital solution (20
      ml/kg) in all groups. After transplantation, cardiorespiratory function was
      assessed at an inspired oxygen fraction of 0.4. After transplantation, superior
      results were observed in group III, as expressed by significantly improved
      oxygenation, while cardiac output and pulmonary artery pressures were similar in
      all groups. We concluded that the use of the platelet-activating factor
      antagonist WEB 2170 resulted in better lung preservation than current clinical
      standards.

PMID- 1735985
TI  - Cardiac 5'-nucleotidase activity increases with age and inversely relates to
      recovery from ischemia.
AB  - The metabolic basis for the enhanced tolerance of immature hearts to ischemia
      remains to be elucidated. Loss of high-energy phosphate nucleotides occurs during
      ischemia/reperfusion in mature (adult) hearts through the breakdown of adenosine
      triphosphate, diphosphate, and monophosphate (nondiffusible) to adenosine (freely
      diffusible). However, previous work has shown that after ischemia nondiffusible
      nucleotides are better retained by immature (neonatal) hearts than by mature
      hearts. The enzyme responsible for the conversion of adenosine monophosphate to
      adenosine is 5'-nucleotidase. We therefore hypothesized lower activity of this
      enzyme in neonatal than in adult myocardium. The purposes of this study were (1)
      to document 5'-nucleotidase activities in neonatal and adult rabbit myocardium
      and (2) to correlate differences of 5'-nucleotidase activity with functional
      recovery from ischemia. Neonatal (5- to 10-day-old) and adult (4- to 6-month-old)
      rabbit hearts were isolated and perfused (retrograde Langendorff). A left
      ventricular balloon measured functional parameters. Hearts were subjected to 20
      minutes of global 37 degrees C ischemia and 10 minutes of reperfusion followed by
      freeze clamping. Tissue homogenates were assayed for 5'-nucleotidase by the
      linked formation of nicotinamide-adenine dinucleotide at 340 nm (Arkesteijn
      method). Postischemic recovery of developed pressure was 86% +/- 3% in neonates
      (n = 5) versus 38% +/- 3% in adults (n = 8) (mean +/- standard deviation) (p less
      than 0.01). 5'-Nucleotidase activity was 4400 +/- 1208 nmol/min/gm in neonates (n
      = 5) versus 13,938 +/- 830 nmol/min/gm in adults (n = 8) (mean +/- standard
      deviation) (p less than 0.01). We conclude that (1) 5'-nucleotidase activity is
      68% lower in neonatal than in adult myocardium and (2) functional recovery after
      ischemia inversely relates to 5'-nucleotidase activity.

PMID- 1735986
TI  - Long-term preservation of explanted hearts perfused with L-aspartate-enriched
      cardioplegic solution. Improved function, metabolism, and ultrastructure.
AB  - The effects of supplementing oxygenated St. Thomas' Hospital cardioplegic
      solution No. 2 with L-aspartate and/or D-glucose for the long-term preservation
      of excised rat hearts were determined with isolated working heart preparations.
      Left ventricular function was assessed at 37 degrees C with a crystalloid
      perfusate, before cardioplegic arrest and after 20 hours of low-flow perfusion
      (1.5 ml/min) with continuing arrest at 4 degrees C, and after this period, again
      at 37 degrees C with a crystalloid perfusate. Four groups (n = 8/group) of hearts
      were studied with four cardioplegic solutions: St. Thomas' Hospital solution
      alone, St. Thomas' Hospital solution with aspartate 20 mmol/L, St. Thomas'
      Hospital solution with glucose 20 mmol/L, and St. Thomas' Hospital solution plus
      both aspartate and glucose (20 mmol/L each). The addition of glucose to St.
      Thomas' Hospital solution made no significant difference in the recovery of
      aortic flow rates (17.7% +/- 8.6% and 21.6% +/- 7.8% of prearrest values), but
      when aspartate or aspartate and glucose were present, hearts showed significant
      improvements (89.8% +/- 5.2% and 85.0% +/- 6.2%, respectively). These
      improvements were associated with a reduction in the decline of myocardial high
      energy phosphates during reperfusion, a reduction in cellular uptake of Na+ and
      Ca++, and a reduction in ultrastructural damage. These results indicate that low
      flow perfusion with St. Thomas' Hospital solution plus aspartate can considerably
      extend the duration of safe storage of explanted hearts.

PMID- 1735987
TI  - Benefits of glucose and oxygen in multidose cold cardioplegia.
AB  - We tested the effects of glucose and oxygen in cardioplegic solutions on
      myocardial protection in the isolated perfused working rat heart. Recovery from 2
      hours' hypothermic (8 degrees C) cardioplegic arrest was examined in 93 hearts.
      Cardioplegic solution, which was delivered every 15 minutes, was supplemented
      with glucose 28 mmol/L as a substrate or sucrose 28 mmol/L as a nonmetabolizable
      osmotic control; it was equilibrated with either 98% oxygen or 98% nitrogen, both
      with 2% carbon dioxide. Four combinations of hyperkalemic cardioplegic solution
      were studied: nitrogen-sucrose, nitrogen-glucose, oxygen-sucrose, and oxygen
      glucose. During hypothermic arrest, oxygenation of cardioplegic solution greatly
      reduced myocardial lactate production and prevented ischemic contracture as
      indicated by coronary vascular resistance. Glucose increased lactate production
      modestly but significantly only when the cardioplegic solution was nitrogenated.
      Although end-arrest myocardial adenosine triphosphate and creatine phosphate were
      greatly increased by oxygenation of cardioplegic solution (p less than 0.005), we
      could not detect improved preservation of these high-energy phosphates by
      glucose. Averaged over reperfusion, percent recovery of cardiac output for the
      nitrogen-sucrose, nitrogen-glucose, oxygen-sucrose, and oxygen-glucose solutions
      was 32.3% +/- 6.1%, 45.9% +/- 4.6%, 44.5% +/- 4.6%, and 62.2% +/- 4.5%,
      respectively. Oxygenation of the glucose solution or addition of glucose to the
      oxygenated solution significantly improved recovery of cardiac output. The
      benefits of glucose and oxygen were additive, so that the oxygen-glucose
      cardioplegic solution provided the best functional recovery. We conclude that the
      addition of glucose to the fully oxygenated multidose cold cardioplegic solution
      improves functional recovery without increasing lactate production during arrest.

PMID- 1735988
TI  - Applicability of noncardioplegic coronary bypass to high-risk patients. Selection
      of patients, technique, and clinical experience in 3000 patients.
AB  - Although some surgeons still prefer noncardioplegic coronary bypass, most
      surgeons are skeptical of its suitability for high-risk patients. We analyzed the
      first 3000 patients who had primary coronary bypass without cardioplegia since
      our program's inception. Patients with reoperations, valve operations, or carotid
      endarterectomies were excluded. Multivariate predictors of operative death
      included age, sex, left ventricular dysfunction, preoperative intraaortic balloon
      pumping, and urgency of operation. Eight hundred seventy-nine patients (29%) were
      more than 70 years of age; 795 (27%) were female; 290 (9.7%) had an ejection
      fraction less than 0.30, and another 77 (2.6%) had left ventricular aneurysms;
      196 (6.5%) had an acute myocardial infarction, and another 397 (13%) had a
      myocardial infarction less than 1 week preoperatively; 917 (31%) had rest pain in
      the hospital (preinfarction angina). Only 790 (26%) had elective operations. The
      overall operative mortality rate was 1.47% (44/3000): The mortality rate for
      elective operations was 0.5% (4/790); urgent 1.7% (28/1687); emergency 2.3%
      (12/523). In patients with an ejection fraction less than 0.30 the mortality rate
      was 6.2% (18/290); with age more than 70 years, it was 3.9% (34 of 879); with
      acute myocardial infarction it was 3.1% (6/196); and with left ventricular
      aneurysmectomy it was 1.3% (1/77). Inotropic support after leaving the operating
      room was needed in 6.6% (199 patients), and 1% (30 patients) required new
      intraaortic balloon pumping postoperatively (two of these 30 patients died).
      These results provide reassurance that noncardioplegic coronary artery bypass
      grafting provides excellent myocardial protection and operating conditions for
      primary coronary bypass and is particularly suitable for high-risk patients.

PMID- 1735989
TI  - Durability of porcine valves at fifteen years in a representative North American
      patient population.
AB  - Isolated aortic (n = 857) or mitral (n = 793) valve replacement with a porcine
      bioprosthesis was performed in 1650 patients between 1971 and 1980. Follow-up
      (total = 12,012 patient-years) extended to more than 15 years and was 96%
      complete. Patient age ranged from 16 to 87 years; mean age was 59 +/- 11 years
      (+/- 1 standard deviation) for the aortic valve replacement cohort and 56 +/- 12
      years for the mitral valve replacement cohort. The operative mortality rates were
      5% +/- 1% (+/- 70% confidence limits) and 8% +/- 1%, respectively, for the aortic
      and mitral subgroups. Estimated freedom from structural valve deterioration (+/-
      1 standard error of the mean) after 10 and 15 years was significantly higher for
      the aortic than for the mitral valve replacement subgroup (85% +/- 0.4% and 63%
      +/- 3% versus 78% +/- 2% and 45% +/- 3%, respectively, p = 0.001). Reoperation
      free actuarial estimates were also significantly greater for the aortic valve
      replacement cohort: 83% +/- 2% and 57% +/- 3% versus 78% +/- 2% and 43% +/- 3%
      for mitral valve replacement at 10 and 15 years, respectively. The mortality rate
      for reoperative aortic valve replacement was 11% +/- 1%; it was 8% +/- 1% for
      reoperative mitral valve replacement. Importantly, the estimates of freedom from
      valve-related death (including sudden, unexplained deaths) were relatively high
      at 10 and 15 years: 78% +/- 2% and 69% +/- 3% in the aortic cohort and 74% +/- 2%
      and 63% +/- 3% in the mitral cohort (p = not significant). Excluding sudden,
      unexplained deaths, these estimates were 81% +/- 3% (aortic) and 73% +/- 4%
      (mitral) at 15 years. Thromboembolism-free rates were 84% +/- 3% (aortic) and 78%
      +/- 6% (mitral) at 15 years, and freedom from anticoagulant-related hemorrhage
      was 96% +/- 1% and 89% +/- 2%, respectively. At the time of current follow-up,
      13% of patients having aortic valve replacement and 50% of patients having mitral
      valve replacement were receiving warfarin sodium. The hazard functions for
      thromboembolism and prosthetic valve endocarditis were constant and remained less
      than 1%/pt-yr over the entire follow-up period.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1735990
TI  - Donor heart valves: electron microscopic and morphometric assessment of cellular
      injury induced by warm ischemia.
AB  - Cryopreserved allograft valves are increasingly being used as valvular
      replacements. Leaflet fibroblast viability has been suggested to influence
      clinical durability. The warm ischemic time is thought to be a critical
      determinant of this cell viability. The purpose of this study was to apply
      quantitative morphometric methods to characterize, by transmission electron
      microscopy, valvular cellular injury resulting from progressive warm ischemic
      time. Porcine aortic valves were harvested with a spectrum of warm ischemic times
      (40 minutes and 2, 6, 12, 24, and 36 hours; five valves per warm ischemic time; n
      = 30) and processed by standard electron microscopic methods. To ensure
      randomized tissue selection within each warm ischemic time interval, we randomly
      selected one thin section from each leaflet. The first ten cells in each thin
      section were photographed and cellular injury was assessed (cell disruption,
      dilation of endoplasmic reticulum, cytoplasmic edema, nuclear and mitochondrial
      changes). Nine hundred micrographs have been analyzed by Cochran-Mantel-Haenszel
      statistics to determine if a significant association between warm ischemic time
      and cellular injury exists. Our findings indicate a significant association
      between reversible cell injury through 24 hours of warm ischemic injury (p less
      than 0.0001). Furthermore, a significant association between irreversible cell
      injury and progressive warm ischemia through 36 hours was also found. These
      findings indicate that the ischemic interval after donor death is associated with
      progressive leaflet cell injury. Cellular damage begins shortly after donor death
      and continues incrementally throughout 36 hours. After 2 hours of warm ischemic
      injury 37% of the cells had morphologic evidence of injury. After 6 hours of warm
      ischemic injury the number of injured cells increased to 73%. By 36 hours 22% of
      the cells appeared normal. Irreversible cell injury increases with prolonged
      ischemia and becomes quantitatively impressive at 24 hours, by which time 26% of
      cells are so affected. Conversely, some cells are resistant to irreversible
      injury for a prolonged ischemic interval.

PMID- 1735991
TI  - Clinical evaluation of the Omniscience cardiac valve prosthesis. Follow-up of up
      to 6 years.
AB  - From January 1984 to June 1989, 259 Omniscience valve prostheses were implanted
      in 225 patients. Of the 225 patients; 143 (63.6%) received mitral, 48 (21.3%)
      aortic, and 34 (15.1%) double valve replacements. The early mortality rate was
      8.9%; 97.6% of the patients were included in this study. These patients represent
      a cumulative follow-up of 407.9 patient-years, with a mean follow-up of 2.03 +/-
      0.1 (standard error) years. The late mortality rate was 4.03% overall, which
      corresponds to 2.0% +/- 0.7%/pt-yr (SE). The annual rate of valve endocarditis
      was 1.0% +/- 0.5%/pt-yr (SE). The linearized rate of thromboembolism was 1.2% +/-
      0.5%/pt-yr (SE). Anticoagulant-related hemorrhage occurred in 15 patients with an
      annual rate of 3.7% +/- 0.9%/pt-yr (SE). The linearized rate of valve thrombosis
      was 0.2% +/- 0.2%/pt-yr (SE). By echocardiography the mean mitral valve opening
      was 75.9 +/- 3.1 degrees (standard deviation) for 27 patients. During follow-up
      study, 136 (70.8%) patients were in New York Heart Association class I, 44
      (22.9%) were in class II, and 12 (6.3%) were in class III; there were 25 (11.1%)
      patients in class II, 166 (73.8%) in class III, and 34 (15.1%) in class IV
      preoperatively. Actuarial freedom from thromboembolism was 94.5% +/- 3.6% (SE);
      freedom from endocarditis, 97.8% +/- 1.0% (SE); freedom from anticoagulant
      related hemorrhage, 91.5% +/- 2.0% (SE); freedom from valve thrombosis 99.1% +/-
      0.8% (SE); and freedom from hemolysis 98.5% +/- 1.2% (SE). Actuarial survival at
      6 years is 94.0% + 2.3% (SE) overall. In conclusion, the overall rate of valve
      related complications with this valve is low.

PMID- 1735992
TI  - Heart valve replacement with the Sorin tilting-disc prosthesis. A 10-year
      experience.
AB  - From 1978 to 1988, 697 patients with a mean age of 48 +/- 11 years (range 5 to 75
      years) received a Sorin tilting-disc prosthesis; 358 had had aortic valve
      replacement, 247 mitral valve replacement, and 92 mitral and aortic valve
      replacement. Operative mortality rates were 7.8%, 11.3%, and 10.8%, respectively,
      in the three groups. Cumulative duration of follow-up is 1650 patient-years for
      aortic valve replacement (maximum follow-up 11.4 years), 963 patient-years for
      mitral valve replacement (maximum follow-up 9.9 years) and 328 patient-years for
      mitral and aortic valve replacement (maximum follow-up 9.4 years). Actuarial
      survival at 9 years is 72% +/- 4% after mitral valve replacement, 70% +/- 3%
      after aortic valve replacement, and 50% +/- 12% after mitral and aortic valve
      replacement, and actuarial freedom from valve-related deaths is 97% +/- 2% after
      mitral valve replacement, 92% +/- 2% after aortic valve replacement, and 62% +/-
      15% after mitral and aortic valve replacement. Thromboembolic events occurred in
      21 patients with aortic valve replacement (1.3% +/- 0.2%/pt-yr), in 12 with
      mitral valve replacement (1.2% +/- 0.3% pt-yr), and in seven with mitral and
      aortic valve replacement (2.1% +/- 0.8%), with one case of prosthetic thrombosis
      in each group; actuarial freedom from thromboembolism at 9 years is 92% +/- 3%
      after mitral valve replacement, 91% +/- 3% after aortic valve replacement, and
      74% +/- 16% after mitral and aortic valve replacement. Anticoagulant-related
      hemorrhage was observed in 15 patients after aortic valve replacement (0.9% +/-
      0.2%/pt-yr), in 9 after mitral valve replacement (0.9% +/- 0.3%/pt-yr), and in 6
      with mitral and aortic valve replacement (0.9% +/- 0.5%/pt-yr); actuarial freedom
      from this complication at 9 years is 94% +/- 2% after aortic valve replacement,
      91% +/- 4% after mitral valve replacement, and 68% +/- 16% after mitral and
      aortic valve replacement. Actuarial freedom from reoperation at 9 years is 97% +/
      2% after mitral and aortic valve replacement, 92% +/- 4% after mitral valve
      replacement, and 89% +/- 3% after aortic valve replacement, with no cases of
      mechanical fracture. The Sorin valve has shown a satisfactory long-term overall
      performance, comparable with other mechanical prostheses, and an excellent
      durability that renders it a reliable heart valve substitute for the mitral and
      aortic positions.

PMID- 1735993
TI  - Late results after repair of aortic insufficiency associated with ventricular
      septal defect.
AB  - The late results of 70 patients aged 1.96 to 35.9 (mean 10.1) years who had
      repair of ventricular septal defect and aortic insufficiency from 1968 to 1988
      were reviewed. The ventricular septal defect was subcristal in 50 and
      subpulmonary in 20 patients. Two thirds were situated immediately below some part
      of the right coronary leaflet with prolapse of that leaflet. Most of the
      remainder were below the right commissure or the anterior part of the noncoronary
      leaflet with prolapse of one or both adjacent leaflets. Associated structural
      defects, usually including some fusion at a commissure, were present in 18 of the
      70 patients and occurred more often with a ventricular septal defect in or below
      the commissure between the right and noncoronary leaflets (p less than 0.001).
      Follow-up ranged from 1.9 to 19.6 (mean 9.8) years. There were no early deaths or
      cases of atrioventricular block, but there were two late deaths. Patient survival
      rate was 96% at 10 years. Freedom from valvuloplasty failure and freedom from
      reoperation were 76% and 85%, respectively, at 10 years. The major predictor for
      failure by multivariate analysis was the presence of an associated structural
      defect (p less than 0.01). Age at repair and position of the ventricular septal
      defect were not significant risk factors. We conclude that aortic valvuloplasty
      produces good palliation in most children. The few failures occurred early and
      chiefly in patients with associated structural valve defects that occurred more
      frequently in children who had a ventricular septal defect in the right
      commissure, where both the right and noncoronary leaflets may be affected.

PMID- 1735994
TI  - Oblique transseptal left atriotomy for optimal mitral exposure.
AB  - Twenty patients underwent mitral valve replacement or other surgical procedures
      within the left atrium with Dubost's transseptal left atriotomy. The left atrium
      was grossly enlarged in six patients. Exposure was considered to be excellent in
      13 patients and poor in only two. One patient (with a second aortic and mitral
      valve replacement) required a permanent pacemaker after operation, none had a
      residual shunt at the atrial level, and none required reoperation for bleeding.
      The Dubost transseptal left atriotomy affords excellent exposure of left atrial
      structures, is easy to close, and does not increase the prevalence of
      postoperative rhythm disturbances.

PMID- 1735995
TI  - Bilateral lung transplantation for cystic fibrosis. The Toronto Lung Transplant
      Group.
AB  - Between March 1988 and March 1991, 17 patients underwent bilateral lung
      transplantation for end-stage lung disease caused by cystic fibrosis. There were
      11 male and six female patients. Ages ranged from 19 to 41 years (mean age 28
      years). Preoperative mean arterial oxygen tension with the patient breathing room
      air was 54 +/- 6 mm Hg; forced vital capacity, 1.8 +/- 0.7 L; forced expiratory
      volume in 1 second, 0.9 +/- 0.3 L; and 6-minute walk test, 506 +/- 44 m.
      Immunosuppression consisted of cyclosporine, azathioprine, and prednisone.
      Induction immunosuppression was obtained with Minnesota antilymphocyte globulin.
      All patients received perioperative antibiotics according to sputum cultures and
      sensitivities. There were six operative deaths, four of which resulted from
      bacterial infection. Two patients required a second transplantation, one
      receiving a single lung and one undergoing bilateral lung replacement.
      Significant functional improvement was observed in all survivors. At 3 months
      follow-up, mean arterial oxygen tension on room air was 95 +/- 6 mm Hg (p less
      than 0.01); forced vital capacity, 3 +/- 0.8 L (p less than 0.01); forced
      expiratory volume in 1 second, 2.6 +/- 0.9 L (p less than 0.01); and 6-minute
      walk test, 678 +/- 47 m (p less than 0.01). The actuarial survival rate was 66%
      at 3 months and 58% at 6, 12, and 24 months. The most frequent cause of morbidity
      and mortality was acute pneumonia resulting from Pseudomonas cepacia. For
      patients with respiratory failure caused by cystic fibrosis, bilateral lung
      transplantation is an effective treatment option associated with significant
      functional improvement.

PMID- 1735996
TI  - Pulmonary transplantation. Early and late results. The Toronto Lung Transplant
      Group.
AB  - Between November 1983 and March 1991, we performed 50 single and 40 double lung
      transplants in 82 recipients. Early deaths occurred in six (13%) single and in
      eight (21%) double lung transplant recipients. Late deaths occurred in 11 (28%)
      single and in one (3%) double lung recipients. Twenty-three of 37 (62%) single
      and 17 of 24 (71%) double lung transplant recipients have survived at least 1
      year after the operation. In patients surviving at least 3 months after the
      operation (36 of 47 single lung transplant [77%] and 28 of 37 double lung
      transplant recipients [76%]), significant improvement occurred in arterial blood
      gases, pulmonary function tests, and exercise capacity. During our initial
      experience, airway anastomotic complications were the main cause of early
      morbidity and mortality. With newer surgical techniques and improved
      perioperative care, airway complications are now uncommon. Infectious
      complications, either bacterial (Pseudomonas cepacia) or viral (cytomegalovirus),
      are now the main cause of early mortality. Chronic rejection in the form of
      obliterative bronchiolitis has become a frequent cause of late morbidity.

PMID- 1735997
TI  - Heart-lung transplantation in situs inversus. A case report in a patient with
      Kartagener's syndrome.
AB  - After a long history of recurrent chronic pulmonary infections in a 25-year-old
      woman with Kartagener's syndrome, a heart-lung transplantation was performed. A
      modified surgical procedure was needed to perform transplantation because of the
      presence of a situs inversus, which is usually associated with bronchiectasis and
      sinusitis in this congenital syndrome. A large single atrium was created with
      both the right and left recipient atria used to facilitate anastomosis with the
      donor's right atrium. The patient was discharged after resolution of early
      ventilatory complications and is in good condition 8 months after
      transplantation.

PMID- 1735998
TI  - Lung transplantation. Analysis of thirty-six consecutive procedures performed
      over a twelve-month period. The Washington University Lung Transplant Group.
AB  - A consecutive series of 36 lung transplant procedures in 35 patients, performed
      over a 12-month period, has been reviewed. There were 14 men and 21 women
      undergoing 23 single, 12 bilateral, and one en bloc double lung transplant. There
      were one hospital death and three late deaths in the series, giving a hospital
      survival rate of 97.2% and a 1-year actuarial survival figure of 91.7%. Airway
      complications occurred in six patients (17.2%), one of whom died. Cytomegalovirus
      infection was demonstrated in 18 patients (51%), but no deaths have resulted. The
      most common cardiac complication was an atrial tachyarrhythmia (nine patients,
      25.7%) and three patients had a cardiac arrest, but all were successfully
      resuscitated. Twelve patients required a further 25 surgical procedures after
      transplantation; however, renal and hematologic complications were uncommon. The
      prevalence and management of the other associated complications is discussed.

PMID- 1735999
TI  - Surgery for effort thrombosis of the subclavian vein.
AB  - Between February 1988 and March 1991, 28 patients with effort thrombosis of the
      subclavian vein were treated with a combined approach of thrombolytic therapy
      followed by surgical therapy. Three categories were seen: group I (six patients),
      acute stage (less than 5 days); group II (seven patients), subacute stage (6 days
      to 2 weeks); and group III (15 patients), chronic stage (more than 2 weeks).
      Group III was divided into two subgroups: subgroup A, seven patients with a short
      obstructed segment (less than 1/2 inch), and subgroup B, eight patients with a
      long-obstructed segment (1 to 6 inches). During venography a catheter is placed
      within the thrombus for continuous infusion of urokinase (3000 U/kg/hr) for 12 to
      24 hours. After complete clot lysis, resection of the first rib via a
      subclavicular approach is undertaken. Vein patch angioplasty was required in two
      patients in group I, six in group II, and seven in group III, subgroup A. Bypass
      of long-obstructed vein segments was attempted in only four (group III, subgroup
      B). Decompression and reestablishment of normal vein caliber was achieved in 100%
      of groups I and II and in 86% of group III, A. In only one patient of group III,
      B, a saphenous vein bypass remained open (25%). Operative technique is described.

PMID- 1736000
TI  - Quantitative analysis of regional wall thickening by transesophageal
      echocardiography.
AB  - To develop a method for quantitative analysis of regional left ventricular
      function from transesophageal two-dimensional echocardiograms, we conducted
      studies 10 and 20 minutes after induction of anesthesia in 16 patients with
      normal hearts who were undergoing minor orthopedic operations. Wall thickening
      was measured with the centerwall method along 100 chords drawn perpendicular to a
      line constructed around the center of the ventricular wall, midway between the
      endocardial and epicardial contours. Thickening, either normalized by the length
      of the end-diastolic perimeter or expressed as a percentage of the end-diastolic
      wall thickness at each chord, was compared with measurements of endocardial
      motion. Wall motion was relatively diminished in the anteroseptal region and
      enhanced on the contralateral wall, but wall thickening was homogeneous
      throughout the contour. Normalized wall thickening was significantly less
      variable (standard deviation/mean, 0.47 +/- 0.13) in the normal population than
      were either percent wall thickening (0.53 +/- 0.012) or wall motion (0.51 +/-
      0.09) (p less than 0.005 for both comparisons). There was no significant change
      in regional or global function between 10 minutes and 20 minutes after the
      induction of anesthesia. In summary, normalized wall thickening as a parameter of
      regional left ventricular function is more homogeneous and less variable in
      subjects with normal hearts than is endocardial motion because wall thickening
      measurements are not subject to cardiac translocation artifacts. This low
      variability suggests that normalized wall thickening measured by the centerwall
      method may prove particularly useful for intraoperative and postoperative
      monitoring of regional left ventricular function by transesophageal
      echocardiography in patients undergoing both cardiac and noncardiac surgical
      procedures.

PMID- 1736001
TI  - Continuous monitoring of blood oxygen saturation of internal jugular vein as a
      useful indicator for selective cerebral perfusion during aortic arch replacement.
AB  - We continuously monitored blood oxygen saturation in the internal jugular vein
      during selective cerebral perfusion for aortic arch operations and evaluated its
      efficacy as an indicator of cerebral oxygen metabolism. The selective cerebral
      perfusion method was applied in 11 patients who underwent operations for aortic
      arch replacement. Blood oxygen saturation in the internal jugular vein was
      continuously monitored at the bulbus jugularis with a fiberoptic catheter during
      the operation. Perfusion flow of 500 ml/min was continued for 134.7 +/- 14.9
      minutes under moderate hypothermia at 25 degrees C, and bilateral temporal
      arterial pressure was 40 to 60 mm Hg. Blood gas data were used to estimate oxygen
      consumption, oxygen extraction ratio, and lactate uptake in the cerebrum. No
      patients had postoperative cerebral complications. Cerebral oxygen consumption
      was 2.93 +/- 0.4 ml/min/100 gm under general anesthesia at 36 degrees C. While
      selective cerebral perfusion at 25 degrees C decreased consumption to 0.92 +/-
      0.39 ml/min/100 gm, it fell to about 30% of its former value. Blood oxygen
      tension in the internal jugular vein showed no significant correlation with
      rectal temperature. Selective cerebral perfusion did not significantly affect
      cerebral lactate uptake. In contrast, blood oxygen saturation in the internal
      jugular vein was significantly affected by temperature and cerebral flow during
      selective cerebral perfusion, and blood oxygen saturation in the internal jugular
      vein correlated closely with cerebral oxygen extraction ratio (r = 0.91).
      Cerebral oxygen metabolism was thus well maintained, and continuous monitoring of
      blood oxygen saturation in the internal jugular vein was found to serve as a
      useful indicator under selective cerebral perfusion during operations for aortic
      arch replacement.

PMID- 1736002
TI  - Cerebrovascular and cerebral metabolic effects of alterations in perfusion flow
      rate during hypothermic cardiopulmonary bypass in man.
AB  - Recent experimental and clinical investigations provide conflicting evidence
      regarding the effects of changes in the systemic flow rate from the pump
      oxygenator on cerebral blood flow and the cerebral metabolic rate of oxygen
      consumption. However, the results of existing clinical studies are difficult to
      interpret because of the confounding effects of differences in management of
      arterial carbon dioxide tension and use of anesthetic and vasoactive agents
      during cardiopulmonary bypass. To clarify the relationship among perfusion flow
      rate, cerebral blood flow, and cerebral metabolic rate of oxygen consumption in
      man during hypothermic cardiopulmonary bypass, we varied perfusion flow rate in
      random order to either 1.75 or 2.25 L.min-1.m-2 and studied cerebral blood flow
      (measured by clearance of xenon 133) and cerebral metabolic rate of oxygen
      consumption (estimated as the product of cerebral blood flow and the cerebral
      arteriovenous oxygen content difference) in patients managed with both the alpha
      stat (group 1) and the pH-stat (group 2) methods of pH and arterial carbon
      dioxide tension adjustment. We measured the cerebral arteriovenous oxygen content
      difference using radial arterial and jugular venous bulb blood samples. In each
      patient other variables known to exert effects on cerebral blood flow and
      cerebral metabolic rate of oxygen consumption, including temperature, arterial
      carbon dioxide tension, arterial oxygen tension, mean arterial pressure, and
      hematocrit, were maintained constant between measurements. In both groups, mean
      arterial pressure at both pump flow rates was similar because of spontaneous
      reciprocal alterations in systemic vascular resistance, that is, as perfusion
      flow rate declined, systemic vascular resistance increased; as perfusion flow
      rate increased, systemic vascular resistance declined. Under these tightly
      controlled conditions, pump flow variation per se exerted no effect on cerebral
      blood flow or cerebral metabolic rate of oxygen consumption in either group.

PMID- 1736003
TI  - Surgical treatment of acute type A dissecting aneurysm, with preservation of the
      native aortic valve and use of biologic glue. Follow-up to 6 years.
AB  - We present an analysis of 59 patients operated on between 1983 and 1987 for acute
      type A dissecting aneurysm with aortic valve insufficiency. The ascending aorta
      was replaced with a Dacron tube, the layers of the dissection were unified with
      gelatin-resorcine-formaldehyde glue, and the natural aortic valve was preserved.
      Follow-up every 6 months was subject to actuarial analysis. The hospital
      mortality rate was 22%. The survivors were studied for 35.9 +/- 18.6 months (mean
      +/- standard deviation). Eight patients died (six of cardiovascular causes, one
      of cancer of the colon, and one of an unknown cause). Seventeen (36.9%) had
      aortic insufficiency, eight mild and nine moderate to severe. Four patients with
      severe insufficiency had reoperation with valve replacement. Excluding patients
      who have died or undergone reoperation, 29 of the remainder (90.6%) are free of
      symptoms. The follow-up survival rate is 61% +/- 6.93% (standard error) including
      hospital mortality. It is 55.4% +/- 7% (standard error) excluding reoperation and
      44.2% +/- 7.1% (standard error) additionally excluding modest or severe aortic
      insufficiency. The use of gelatin-resorcine-formal glue allowed preservation of
      the native aortic valve, obviating the need for anticoagulants, and no embolic or
      hemorrhagic episodes were registered.

PMID- 1736004
TI  - Effects of dilation with a balloon catheter on the endothelium of the internal
      thoracic artery.
AB  - Controlled dilation of the internal thoracic artery with a balloon catheter has
      been reported to effectively treat intraoperative arterial spasm. It has been
      shown in laboratory animals that dilation of the internal thoracic artery at
      prescribed shear force levels will not cause intimal damage. Using scanning
      electron and light microscopy, we have examined the effects of calibrated balloon
      dilation on the endothelium of the human internal thoracic artery. In 10 patients
      with bilateral internal thoracic artery grafting, the artery was dilated with a
      Fogarty IMAG balloon catheter (Baxter Healthcare Corporation, Edwards Division,
      Santa Ana, Calif.) that was withdrawn at tensions of 20 or 30 gm. Arterial
      segments and nondilated control specimens were prepared for scanning electron
      microscopy. The intimal surface of each internal thoracic artery was evaluated by
      assigning a score (from 0 to 3) to 10 examined scanning electron microscopy
      fields; subsequently the arterial tissue was viewed by light microscopy with
      paraffin-embedded sections stained for elastic tissue. Arteries were obtained
      from three additional patients so that the microscopic appearance of the arteries
      could be observed after rough manipulation or removal of the balloon without
      shearing. The results of this study are as follows: (1) By scanning electron
      microscopy, dilated internal thoracic arteries yielded consistently higher scores
      than the control arteries, reflecting severe, tension-dependent alterations of
      the endothelium, which included marked desquamation of endothelial cells, with
      extensive areas of complete denudation and pronounced attachment of platelets to
      these areas; (2) endothelial injury occurred by inflation alone, without shearing
      by the inflated balloon; (3) by light microscopy, the internal thoracic arteries
      showed (a) fenestrations of the internal elastic lamina with occasional
      transmigration of smooth muscle cells through these gaps and (b) foci of intimal
      thickening without overt atherosclerotic lesions. We conclude that the
      endothelium of human internal thoracic arteries is highly vulnerable to balloon
      dilation, which can severely injure the intimal surface. For this reason we
      prefer not to include this procedure in our protocol for preparing the internal
      thoracic artery.

PMID- 1736005
TI  - Penetrating thoracic wounds caused by plastic bullets.
AB  - Thoracic penetrating injuries caused by a new plastic bullet were studied to
      determine the nature of the wounds and the appropriate management. Twenty-six
      casualties from the Israeli-Palestinian conflict (Intifada) were included. The
      organs most commonly involved were lung (n = 21), bony chest wall (n = 9), heart
      (n = 3), and diaphragm. Bleeding was at least moderate in 20 patients, amounting
      in all patients to an average of 975 ml. Thoracotomy was required in 11 patients
      (42%) mainly because of cardiac injury (n = 3) and aortic or other arterial
      bleeding (n = 3). Simple oversewing of severed organs (n = 8) or ligation of
      bleeding vessels (n = 3) was satisfactory. Two patients died (7.7% mortality);
      one after major liver resection; the other was dead on arrival. We conclude that
      plastic bullets have a linear course unless displaced by the bony chest wall,
      when they tend to fragment and cause simple fractures. Fired from a presumed
      range of at least 70 m, plastic bullets behave like low-velocity missiles, and
      tissue destruction is minimal. Management should be similar to that of civilian
      thoracic penetrating trauma.

PMID- 1736006
TI  - Surgery for Wolff-Parkinson-White syndrome in the very young.

PMID- 1736007
TI  - Benign bronchoesophageal fistula: reopening four months after double stapling
      without division.

PMID- 1736008
TI  - A dilatable prosthesis for banding the pulmonary artery: initial clinical
      experience.

PMID- 1736009
TI  - c-abl function in normal and chronic myelogenous leukemia hematopoiesis: in vitro
      studies with antisense oligomers.
AB  - By using antisense oligomers the functional role of the c-abl proto-oncogene in
      the in vitro growth of bone marrow hematopoietic progenitors from normal subjects
      and patients with chronic myelogenous leukemia (CML) has been evaluated. Light
      density bone marrow cells (LDBMs) were depleted of adherent cells, pre-incubated
      for 15 h with the appropriate oligomer at a concentration of 14 microns, and then
      plated in methylcellulose for the evaluation of colony formation. Both anti-exon
      Ia and anti-exon Ib antisense oligomers produced a significant inhibition of
      normal day 14 CFU-GM growth in vitro (n = 5, 41 +/- 11%, and 36 +/- 7%,
      respectively; p less than 0.01). In contrast, normal BFU-E growth was not
      significantly influenced by antisense oligomers (n = 5, 14 +/- 21% and 7 +/- 19%,
      respectively; p less than 0.05). These findings were confirmed by plating CD34
      positive progenitors. When interleukin 3 (IL-3) (100 ng/ml) was added to the
      culture medium during the preincubation of LDBMCs, the inhibitory effects of
      antisense oligomers on normal CFU-GM growth were abolished. Seven patients with
      CML were also studied, all of whom had cytogenetic evidence of 100% clonal
      hematopoiesis. In five patients in the chronic phase, antisense oligomers were
      inhibitory on in vitro growth of both day 14 CFU-GM (37 +/- 20% and 37 +/- 15%, p
      less than 0.05) and BFU-E (45 +/- 15% and 41 +/- 11%, p less than 0.05), and this
      inhibition was not removed by pre-incubation with IL-3. No significant effect was
      observed on cluster or colony formation in two patients with CML in accelerated
      or blastic phase, and on in vitro growth of clonogenic cells from the Ph1
      positive K-562 cell line. These findings (i) confirm previous observations
      showing a lineage specific requirement of c-abl function in normal hematopoiesis,
      and (ii) suggest that the residual c-abl expression has a role in chronic phase
      CML hematopoiesis, as its inhibition impairs both myeloid and erythroid colony
      formation in vitro.

PMID- 1736010
TI  - Transformation of murine pre-B-lymphocytes by v-erb-B: progression to growth
      factor independence and tumorigenicity.
AB  - v-erb-B is the principal transforming gene of avian erythroblastosis virus, a
      replication defective retrovirus that transforms erythroid and fibroblast cells
      in vitro and causes erythroleukemia and fibrosarcoma in vivo. We have used a
      recombinant murine retrovirus, based on the truncated genome of Moloney murine
      leukemia virus and containing a chimeric gag-v-erb-B gene, to determine the
      murine hematopoietic cells transformed by v-erb-B. Infection of day 16.5 murine
      embryonal cells in liquid culture with this virus resulted in the outgrowth of
      foci of loosely to non-adherent hematopoietic cells which grew in close
      association with an adherent monolayer. After several weeks in culture a clonal
      population of transformed pre-B-lymphocytes emerged from this transformation
      initiated, though still growth factor dependent, population. These transformed
      cells were growth factor independent, and were tumorigenic in syngeneic mice. The
      results indicate that although v-erb-B can initiate transformation of murine
      hematopoietic cells, additional events are required for establishment of the
      fully transformed growth factor independent, tumorigenic phenotype. This v-erb-B
      induced progression from growth factor dependence to independence provides an in
      vitro model system for analysing events involved in the initiation and
      maintenance of leukemia.

PMID- 1736011
TI  - Detection of residual disease in translocation (14;18) positive non-Hodgkin's
      lymphoma, using the polymerase chain reaction: a comparison with conventional
      staging methods.
AB  - This paper reports the detection of residual lymphoma cells in blood and bone
      marrow samples from patients with translocation (t) (14;18) positive non
      Hodgkin's lymphoma by the polymerase chain reaction (PCR) compared with
      conventional staging techniques. In 15 of 22 samples, in which no lymphoma cells
      could be detected by morphological examination, t(14;18) positive cells were
      detected by PCR. In 13 of 21 samples, in which a monoclonal B-cell population was
      not detectable by immunological marker analysis, PCR was positive. The clinical
      status (physical examination, imaging techniques, leucocyte count, and
      occasionally morphology and immunological marker analysis) was documented in 30
      patients at the time of PCR analysis. In three of 19 patients with clinical
      evidence of disease, circulating t(14;18) positive cells were not detectable by
      PCR. Five of 11 patients in clinical remission from 7 to 47 months, showed
      t(14;18) positive cells in the blood. Our data show that PCR analysis in t(14;18)
      positive non-Hodgkin's lymphoma offers a powerful tool in the study of residual
      disease.

PMID- 1736012
TI  - Mutations of the p53 gene in B-cell lymphoblastic acute leukemia: a report on 60
      cases.
AB  - Exons 5 to 8 of the p53 gene were examined for mutations in 60 patients with B
      cell acute lymphoblastic leukemia (ALL), including 50 cases of precursor-B-cell
      ALL, nine cases of Burkitt (L3) ALL and one case of atypical ALL with surface
      immunoglobulins and t(8:14) translocation but L2 morphology. Karyotype was
      available in all patients. DNA was analyzed by polymerase chain reaction, single
      strand conformation polymorphism analysis, and nucleotide sequencing. Three
      patients showed point mutations in exons 7 or 8, including two of the nine
      patients with Burkitt ALL and one of the 50 patients with precursor-B-cell ALL.
      These findings suggest that p53 gene mutations are rare in precursor-B-cell ALL
      but may be more frequent in Burkitt ALL. In the three patients with p53
      mutations, however, the relevance of those mutations to the development or
      progression of leukemia remained uncertain.

PMID- 1736013
TI  - Prognostic value of S-phase white blood cell count in B-cell chronic lymphocytic
      leukemia.
AB  - Eighty previously untreated patients with B-cell chronic lymphocytic leukemia (B
      CLL) were analyzed to study the proliferation rate of their peripheral blood (PB)
      leukocytes to determine its relationship with the extension of the disease and
      its value in discriminating among patients with similar tumor cell mass. The 80 B
      CLL patients were distributed into two different groups according to the absolute
      count of PB S-phase leukocytes: a low proliferative group (less than 1 x 10(9)/I)
      of 48 patients and a high proliferative group (greater than or equal to 1 x
      10(9)/I) of 32 patients. The high proliferative group displayed a higher
      incidence of splenomegaly (p less than 0.005), hepatomegaly (p less than 0.08),
      anemia (p less than 0.02) and thrombocytopenia (p less than 0.03) as well as a
      higher lymphocytic infiltration both in PB (p less than 0.0004) and in bone
      marrow (BM) (p less than 0.003). These patients also showed a higher incidence of
      a diffuse pattern of BM involvement (p less than 0.04), advanced clinical stages
      [stage III/IV (p less than 0.03) and group C (p less than 0.04)] and infections
      (p less than 0.0008) together with significantly lower IgG (p less than 0.03) and
      IgM (p less than 0.03) serum levels. Regarding the immunophenotype, there was a
      greater percentage of either CD19+ (p less than 0.06) and CD19+ CD5+ (p less than
      0.05) B-cells, together with a greater reactivity for both the CD25 (p less than
      0.04) and CD9 (p less than 0.08) antigens in the high proliferative group.
      According to the prognostic value of the PB S-phase leukocyte count it was seen
      that patients with low S-phase white blood cell (WBC) numbers displayed a
      significantly higher survival (p less than 0.03). In addition, multivariate
      analysis revealed that the S-phase WBC count, although partially related to other
      clinical and biological prognostic factors, displayed an important independent
      value in predicting early deaths in patients with B-CLL.

PMID- 1736014
TI  - Primary myelodysplastic syndromes: analysis of prognostic factors in 235 patients
      and proposals for an improved scoring system.
AB  - In an attempt to identify prognostic factors for survival and leukemic
      transformation, 235 untreated patients with primary myelodysplastic syndromes
      (MDS) were analyzed in a single center retrospective study. To the well known FAB
      classification of MDS a supplementary group of patients with pure sideroblastic
      anemia (PSA) was added, characterized by the absence of dysplastic features of
      non-erythroid cells. Accordingly, the morphological subtypes were refractory
      anemia (RA), n = 55; PSA, n = 40; RA with ring sideroblasts (RARS), n = 33; RA
      with excess of blasts (RAEB), n = 53; RAEB in transformation (RAEB/T) n = 29; and
      chronic myelomonocytic leukemia (CMML), n = 25. Having screened 28 clinical,
      cytological, and laboratory parameters by univariate analysis, multiple
      regression analysis identified six variables with independent prognostic value:
      percentage of bone marrow blasts, serum LDH activity, PSA, hemoglobin
      concentration, age, and platelet count. If patients with PSA were excluded, the
      FAB classification no longer contributed independent prognostic information.
      Based on the results of this multivariate analysis, a simple scoring system was
      devised for predicting the survival of patients with MDS. A score of unity was
      allocated to each of the following parameters: bone marrow blasts greater than or
      equal to 5%, LDH greater than 200 U/I, hemoglobin less than or equal to 9 g/dl,
      and platelets less than or equal to 100 x 10(9)/I. As a function of their total
      score, patients were divided into three risk groups (group A, score 0; group B,
      score 1-2; group C, score 3-4), which differed significantly in both survival and
      rates of leukemic transformation. The cumulative survival 2 years after diagnosis
      was 91% in group A, 52% in group B, and 9% in group C (p less than 0.00005). The
      actuarial risk of transformation to acute myeloid leukemia at 2 years was 0, 19,
      and 54%, respectively (p less than 0.05). The inclusion of LDH enzyme levels
      qualified this scoring system for an accurate assessment of patients with CMML
      whose prognosis is viewed too favorably when rated by other scores. Furthermore,
      this score was able to identify those patients with RA and RARS who, without
      showing an excess of marrow blasts, have an unfavorable prognosis.

PMID- 1736015
TI  - Interstitial deletion of the long arm of chromosome 9 as the sole anomaly in
      acute myeloid leukaemia is associated with dyserythropoiesis.

PMID- 1736016
TI  - HTLV-1 associated myelopathy/tropical spastic paraparesis with adult T-cell
      leukemia.

PMID- 1736017
TI  - Nursing home case-mix classification and residents suffering from cognitive
      impairment: RUG-II and cognition in the Texas case-mix data base.
AB  - Case-mix reimbursement systems for nursing home care are now in use or under
      consideration in over 20 states. Though many in the long-term care field still
      debate the relative merits of the various systems, those systems based on the
      Resource Utilization Groups-II (RUG-II) system used in New York seem to be
      increasingly popular. However, one of the more serious questions raised
      concerning RUG-like systems is whether they fully acknowledge the role played by
      cognitive deficits in determining nursing home residents' care needs. The results
      of this research indicate: 1) that resource provision and cognitive status are
      correlated, 2) that residents with higher levels of cognitive impairment appear
      most frequently in RUG-II categories that have higher case-mix weights, 3) that
      simply adding some measure of cognitive function does not significantly increase
      the power of these models, and 4) that the RUG-II model predicts the level of
      care resources provided to the cognitively intact much better than it predicts
      those provided to residents suffering from relatively severe disorientation.
      These results imply that such classification systems may create disincentives for
      the admission of the most cognitively impaired residents and that the care of
      these individuals, more than others, may be dependent on facility-to-facility
      variation.

PMID- 1736018
TI  - Variations in the use of cesarean delivery for dystocia: lessons about the source
      of care.
AB  - Aggregate data show variations in the use of cesarean delivery according to the
      source of care, which suggests that rising cesarean rates are at least in part
      attributable to nonmedical factors. In the research presented here, the
      likelihood of cesarean delivery is examined for low-risk, primiparous women with
      physicians who practice in a single hospital but are from three practice
      organizations--a health maintenance organization (HMO), private practice, and a
      hospital clinic--while controlling for a wide spectrum of clinical factors.
      Maternal age was found to be a dominant factor in determining the decision for a
      cesarean delivery, independent of clinical risk and physicians' practice
      organization. Only among women in their optimal childbearing years (25 to 29
      years) was having an HMO physician associated with a lower likelihood of cesarean
      delivery. The authors conclude that lowering the primary cesarean rate in the
      1990's may require more reeducation and clinical policy formulation, with
      particular attention being paid to maternal age, and less reorganization of
      services than the aggregate data suggests.

PMID- 1736019
TI  - Contractual arrangements between HMOs and primary care physicians: three-tiered
      HMOs and risk pools.
AB  - Concern about certain contractual arrangements between health maintenance
      organizations (HMOs) and primary care physicians has led policymakers to consider
      curbing these arrangements; one law has already been passed. However, these
      arrangements are complex and their impact is neither obvious nor well understood.
      This article first presents a conceptual approach to understanding the
      relationship between HMOs and primary care physicians and discusses how they
      influence the locus of financial risk and managerial control. It then refines
      understanding of two critical dimensions (three-tiered HMOs and risk pools) by
      examining survey responses of 260 HMOs (representing over 50% of total HMO
      enrollment.) Results of the evaluation led to the conclusion that primary care
      physicians in three-tiered HMOs are sheltered from some of the financial
      incentives and contractual arrangements enacted by the HMO and that the reason
      for using risk pools may be due more to peer group effects or interaction with
      other incentives, rather than the direct financial implications of the risk pool
      on individual physicians. These concepts and observations have relevance for
      other types of health care systems in this country and elsewhere. Policymakers
      risk enacting misguided policies unless they understand the details of these
      arrangements.

PMID- 1736020
TI  - Paid work and unpaid help by caregivers of the disabled and frail elders.
AB  - Informal caregiving by women, and to a lesser extent by men, is a major source of
      assistance for the chronically disabled and most dependent older persons living
      in the community. However, because women's commitment to career employment may
      diminish, this source of help at the time when (according to demographic trends)
      the number of very old Americans will increase, the effect of employment on the
      time they devote to informal caregiving is an important social and economic
      issue. This study examines two related research questions: 1) how the time
      allocated to paid work affects the time devoted to unpaid caregiving and 2) how
      caregiving responsibilities affect work outside the home. The results differ for
      full-time and part-time work. Estimating a simultaneous equation model, it was
      found that 1) full-time employment by caregivers reduces the time they allocate
      to providing unpaid help by 20 hours a week and 2) female caregivers were much
      less likely than their male counterparts to have full-time jobs. Results also
      indicate that 1) part-time employment by caregivers has no statistically
      significant effect on caregiving and 2) caregiving has no effect on women's part
      time employment.

PMID- 1736021
TI  - Verbal consultation regarding prescription drugs: findings from a statewide
      study.
AB  - In 1984 the Wisconsin Division of Health showed interest in patients' receipt of
      verbal consultation for prescription drugs and included relevant questions in the
      Wisconsin Health Status survey to: 1) investigate the receipt of verbal
      consultation for new and refill prescriptions, 2) allow a comparison of state
      results with those of a national study that used similar sampling and data
      collection procedures, and 3) more closely examine the relationships between
      receipt of verbal consultation and such variables as prescription status (new or
      refill), age, sex, race, and education. Data were collected from 2,135 randomly
      selected respondents using Computer Assisted Telephone Interviewing with random
      digit dialing. After controlling for elapsed time since last prescription, log
      linear analyses showed the importance of prescription status (new and refill) and
      respondent's age as correlates of consultation by pharmacy personnel, while
      prescription status, age, and sex were significant for prescribers. For both
      prescribers and pharmacy personnel, the authors found no association between
      client education and receipt of verbal consultation. The absence of verbal
      consultation cannot be entirely accounted for by client characteristics or
      prescription status. Based upon their experience, the authors encourage continued
      monitoring of prescribers' and pharmacists' provision of verbal consultation
      through questions contained in state and national health status surveys.

PMID- 1736022
TI  - Profits, community role, and hospital closure: an urban and rural analysis.
AB  - The number of hospital closures increased substantially after the implementation
      of Medicare's Prospective Payment System (PPS). This acceleration in closures
      raised a number of concerns over current payment policies and their impact on
      access. This paper investigates hospital closures that occurred in 1985 through
      1988. A hospital's financial status and mission or community standing were found
      to be determinants of hospital closure. Closed hospitals are much less likely to
      be publicly owned but more likely to offer fewer facilities and services, and
      have fewer cases. This may suggest that the patients directly affected by the
      closure can be absorbed by other hospitals or other nonhospital providers.
      Profitability is associated with the Medicare case-mix index and the share of
      Medicare patients. The findings also suggest that the case mix index may be
      rewarding some small hospitals in excess of the costs attributable to case-mix.
      For both urban and rural hospitals, a low share of Medicare patients increased
      the risk of hospital closure, independently of the relationship between Medicare
      share and profit. The share of Medicare patients also affected closure
      indirectly, through its effects on profit. Competition appears to affect the odds
      of closure through its effects on the number of cases. In addition, hospitals in
      areas with small or declining population are more at risk than other hospitals in
      both urban and rural areas.

PMID- 1736023
TI  - Measuring physician mental workload: reliability and validity assessment of a
      brief instrument.
AB  - This study examined the reliability and validity of a brief six-item instrument
      to measure the mental workload experienced by residents for specific patient
      visits to an ambulatory care clinic. Participating in the study were twenty-two
      residents in postgraduate years 1 through 3 who were working in the general
      outpatient clinic of an inner city, private, nonprofit community hospital.
      Cronbach's alpha coefficient for the instrument was 0.80. Findings supported
      several theory-based hypotheses on determinants and performance consequences of
      mental workload. Mental workload was positively correlated with fatigue (r =
      0.42, P = 0.03) and inversely correlated with residents' self-rated experience
      with patients' problems (r = -0.65, P less than 0.001). Residents' performance
      was measured through self-ratings and faculty physicians' ratings. Mental
      workload was inversely correlated with self-rated performance (r = -0.67, P less
      than 0.001). The correlation of mental workload with faculty physician ratings
      that reflected the technical dimension of patient care (physician examination,
      medications, and procedures) was r = -0.38 (P = 0.04). With mental workload
      squared, the correlation was r = -0.45 (P = 0.02) and the form of the
      relationship, consistent with the hypothesis, was a slightly downward sloping
      curve. Limitations of this research are discussed as well as suggestions for
      further research.

PMID- 1736024
TI  - Inhibition of [3H]dopamine and [3H]serotonin uptake by cocaine: comparison
      between chopped tissue slices and synaptosomes.
AB  - Cocaine inhibits both [3H]dopamine and [3H]serotonin uptake in rat striatum and
      nucleus accumbens. In a chopped tissue slice preparation, the inhibition curve
      for [3H]dopamine uptake is biphasic, suggesting two components of uptake, whereas
      the curve for [3H]serotonin uptake is steep and apparently monophasic. In
      synaptosomal preparations, both curves are monophasic. Monensin, a sodium
      ionophore, inhibits uptake but does not change the shape of the cocaine
      inhibition curve in synaptosomes, suggesting that the biphasic inhibition curves
      in slices are not likely due to differential sodium gradients across the slices.
      In tissue slices, only the component which is more sensitive to inhibition by
      cocaine and related drugs is inhibitable by nicotine. This suggests that the two
      components of dopamine uptake in tissue slices may be differentially regulated.

PMID- 1736025
TI  - Effect of mazindol administration on (3H)-N-methylscopolamine binding to rat
      cerebral cortex.
AB  - Mazindol has been shown to produce anorexia in several animal species including
      humans, and its pharmacological effects may be elicited by blockade of neuronal
      reuptake of dopamine and norepinephrine. Chronic treatment of rats with mazindol
      (10 mg/kg daily, p.o.) caused an increase in muscarinic receptor density (Bmax =
      874.7 femtomoles/mg protein) as compared to controls (Bmax = 629.1 femtomoles/mg
      protein) in the cerebral motor cortex. An increase in dissociation constant (Kd)
      values was also observed which changes from 0.57 nM (control) to 1.17 nM after
      mazindol treatment. The mechanism underlying the observed effect of mazindol on
      receptors could be related to processes involving other neurotransmitters which
      also regulate cholinergic activity in the CNS. However, the implications of the
      eventual dopaminergic control on muscarinic receptors in the cortex is still an
      open question.

PMID- 1736026
TI  - Evidence nitric oxide mediates the vasodepressor response to hypoxia in sino
      denervated rats.
AB  - Systemic hypoxia, produced in deeply anesthetized, paralyzed rats in which
      arterial chemoreceptors were denervated, elicited a decrease in arterial pressure
      (AP) averaging -47 mmHg. Systemic administration of NG-nitro-L-arginine (L
      NO2Arg), an inhibitor of nitric oxide (NO) synthase, attenuated the hypoxic
      depressor response by 79% and elevated AP by 21 mmHg. The effects of L-NO2Arg on
      the hypoxic depressor response and arterial pressure were reversed by systemic
      administration of L- but not D-arginine. Elevation of AP with arginine
      vasopressin or reduction of AP with nitroprusside to the pre-L-NO2Arg levels did
      not modify the fall of AP to hypoxia. Endogenous NO synthesized in vivo from L
      arginine, mediates most of the hypoxic depressor response.

PMID- 1736027
TI  - Long-term facilitation of social recognition in rats by vasopressin related
      peptides: a structure-activity study.
AB  - The effect of several vasopressin-related peptides was investigated in the social
      recognition paradigm, that consists of two successive encounters of a resident
      and a juvenile rat. The decrease of social investigation time of the resident rat
      during the second encounter served as a measure for social recognition. Single
      administration (3.0 micrograms, s.c.) of the vasopressin (AVP)-related peptides
      AVP-(1-8), AVP-(1-7) or AVP-(1-6), injected just after the first encounter,
      resulted in social recognition after 24 hours. Such an effect was not observed
      after placebo treatment or an injection with AVP-(1-5), [pGlu4, Cyt6]AVP-(4-8),
      [pGlu4, Cyt6]-AVP-(4-9), AVP-(7-9) or oxytocin-(1-6)-NH2. The peptide AVP-(1-6)
      was also active when administered in a dose of 0.3 micrograms in contrast to
      other peptides. Thus, vasopressin related peptides induce long term facilitation
      of social recognition and this action resides in the covalent ring structure of
      vasopressin. This effect resembles the vasopressin-induced facilitation of
      particular memory processes, as revealed with other behavioral paradigms.

PMID- 1736028
TI  - Persistent depletion of striatal dopamine and cortical norepinephrine in mice by
      1-methyl-4-phenyl-1,2,3,6-tetrahydro-3-pyridinol (MPTP-3-OL), an analog of MPTP.
AB  - MPTP-3-ol injected s.c. once daily for 4 days resulted in a dose-dependent
      depletion of striatal dopamine and cortical norepinephrine one week after the
      last dose. MPTP-3-ol was approximately one-fourth as potent as MPTP (1-methyl-4
      phenyl-1,2,3,6-tetrahydropyridine) in causing these effects. MPTP-3-ol was
      oxidized by monoamine oxidase in mouse brain in vitro and resulted in MPP+ (1
      methyl-4-phenylpyridinium) formation in brain in vivo, both at about one-fourth
      the rates with MPTP. The in vitro metabolism of MPTP-3-ol was inhibited by
      deprenyl, a selective inhibitor of monoamine oxidase type B, and deprenyl
      pretreatment also blocked the depletion of striatal dopamine and cortical
      norepinephrine in vivo. Pretreatment with EXP 561, an inhibitor of catecholamine
      uptake, also prevented the dopamine- and norepinephrine-depleting effects of MPTP
      3-ol. Thus, substitution of a hydroxy group on the 3-position of MPTP retains its
      neurotoxic potential toward catecholamine neurons but reduces potency by
      decreasing the rate of oxidation via monoamine oxidase type B.

PMID- 1736029
TI  - Nicotine-induced sensitization to ambulatory stimulant effect produced by daily
      administration into the ventral tegmental area and the nucleus accumbens in rats.
AB  - Bilateral injections of nicotine (30 micrograms/side) into the ventral tegmental
      area (VTA) and the nucleus accumbens (NACC) increased the ambulatory activity in
      rats. Moreover, daily injections of nicotine (10, 20 and 30 micrograms/side) into
      the VTA and the NACC for 6 successive days produced sensitization to the
      ambulatory stimulant effect of nicotine. Sensitization produced by daily
      injections of nicotine (20 micrograms/side) into both the sites was maintained
      for withdrawal periods of 10 days. Mecamylamine (2 mg/kg, i.p.), SCH23390 (0.05
      mg/kg, i.p.) and spiperone (0.1 mg/kg, i.p.) antagonized nicotine-induced
      sensitization to the ambulatory stimulant nicotine-induced sensitization to the
      ambulatory stimulant effect produced by daily injections into the VTA. These
      results suggest that nicotine-induced sensitization to the ambulatory stimulant
      effect involves the stimulation of the mesolimbic dopaminergic pathway through
      the nicotinic acetylcholine receptor (nAChR) in the VTA and the NACC.

PMID- 1736030
TI  - mCPP but not TFMPP is an antagonist at cardiac 5HT3 receptors.
AB  - The prototypic arylpiperazines, meta-chlorophenylpiperazine (mCPP), meta
      trifluoromethylphenylpiperazine (TFMPP) and quipazine are widely studied
      serotonergic ligands with nonselective effects at 5HT1 and 5HT2 receptor
      subtypes. The present study was designed to compare the affinities of these
      arylipiperazines at 5HT3 receptors, and to determine agonist or antagonist
      activity at 5HT3 receptors. Quipazine showed high affinity at brain 5HT3
      receptors (IC50 = 4.4 nM) and was a potent agonist of the von Bezold-Jarisch
      reflex in anesthetized rats, a response mediated by cardiac 5HT3 receptors. In
      concentrations that activated 5HT3 receptors, quipazine also antagonized
      serotonin-induced bradycardia in anesthetized rats. Taken together, these data
      suggest that quipazine is an agonist/antagonist with high affinity at 5HT3
      receptors in both brain and cardiac tissue. Although mCPP also showed relatively
      high affinity at brain 5HT3 receptors (IC50 = 61.4 nM), it did not activate the
      von Bezold-Jarisch reflex; instead, mCPP potently antagonized serotonin-induced
      bradycardia. Thus, mCPP acts as an antagonist at 5HT3 receptors in the periphery.
      Although both quipazine and mCPP possessed relatively high affinity at brain 5HT3
      receptors, TFMPP did not bind appreciably to 5HT3 receptors in brain (IC50 = 2373
      nM) and neither activated nor inhibited cardiac 5HT3 receptors. That TFMPP did
      not interact with 5HT3 receptors, whereas quipazine and mCPP did, is in marked
      contrast to the similar effects of all three arylpiperazines at other serotonin
      receptors. The selectivity of TFMPP for 5HT1 and 5HT2 receptors (i.e., its
      minimal affinity for 5HT3 receptors) suggests that this arylpiperazine may be a
      preferred ligand relative to mCPP when studying 5HT1 or 5HT2 receptor mediated
      responses.

PMID- 1736031
TI  - Is hepatic glycogen content a regulator of glucagon secretion?
AB  - The role of plasma glucose as a major regulator of glucagon secretion is well
      established. However, this feedback regulation appears to break down in several
      states in which a closer relationship is apparently evident between plasma
      glucagon and hepatic glycogen content. Therefore, we assessed plasma glucagon as
      well as glucose response (delta glucose) to intravenous (IV) bolus administration
      of 1 mg glucagon after an overnight fast (a reliable and accurate estimate of the
      magnitude of hepatic glycogen content) in a population of normal subjects and
      subjects with hepatic cirrhosis and hyperthyroidism, both of which are disorders
      characterized by hepatic glycogen depletion. Plasma glucose concentrations were
      not significantly different in either group. However, plasma glucagon and insulin
      concentrations were significantly increased and delta glucose significantly
      decreased in both cirrhotic patients and hyperthyroid patients as compared with
      normal subjects. Furthermore, a significant relationship (r = -.55, P less than
      .0001) was noted between delta glucose and plasma glucagon, but not plasma
      insulin. Therefore, we believe that pancreatic alpha-cell function may be
      dependent on hepatic glycogen content. Moreover, the primary action of glucagon
      may be to induce gluconeogenesis in the absence of hepatic glycogen stores due to
      declining insulin concentrations or insulin resistance.

PMID- 1736032
TI  - Uptake and hydrolysis of glycylglutamine at the blood-brain barrier.
AB  - Using an organ balance technique in dogs, we recently found that liver, skeletal
      muscle, kidney, and intestine participate in clearance of glycylglutamine from
      plasma. The purpose of the present study was to investigate whether brain does
      the same. The study of arteriovenous differences of glycylglutamine across brain,
      during continuous infusion of this dipeptide (12 mumol.min-1.kg-1) in dogs,
      showed an arteriovenous difference that was never significantly different from
      zero. To establish a basis for this lack of clearance, we investigated uptake and
      hydrolysis of glycylglutamine at the blood-brain barrier. The study of brain
      uptake index of glycylglutamine in rats showed that it was not significantly
      different from that of sucrose, an impermeable marker (3.2 +/- 0.4 v 3.5 +/- 0.4,
      n = 4 to 5). When isolated brain capillaries were incubated with glycylglutamine,
      uptake was only modestly above background activity and appeared to be due to
      nonspecific binding. Finally, the plasma membrane of brain capillaries lacked
      hydrolase activity against glycylglutamine. In conclusion, brain appears to be
      unique among organs in lacking any mechanism for clearance of glycylglutamine
      from plasma.

PMID- 1736033
TI  - Short-term energy balance in patients with infections: carbohydrate-based versus
      fat-based diets.
AB  - The effects of a carbohydrate-based diet (50% carbohydrate calories, 30% fat
      calories, 20% protein calories) versus a fat-based diet (28% carbohydrate
      calories, 55% fat calories, 17% protein calories) on oxidation rates of
      carbohydrate, fat, and protein were assessed in 12 patients with infections by
      indirect calorimetry and estimation of urea nitrogen production rate. The diets
      were given continuously for 18 hours in a randomized cross-over study on 2
      consecutive days. Energy supply (kcal/d) was adjusted individually to meet the
      energy expenditure measured on the preceding day after an overnight fast and was
      1,647 +/- 129 (SEM) for the carbohydrate-based diet and 1,655 +/- 131 for the fat
      based diet. Oxidation rates (kcal/d) for carbohydrate (carbohydrate-based diet,
      525 +/- 70; fat-based diet, 363 +/- 84) were different between the diets (P less
      than .05), whereas no difference could be found for fat (carbohydrate-based diet,
      820 +/- 117; fat-based diet, 968 +/- 136) and protein (carbohydrate-based diet,
      252 +/- 29; fat-based diet, 236 +/- 23). However, during carbohydrate-based
      feeding, carbohydrate balance (288 +/- 93 kcal/d) and fat balance (-327 +/- 107
      kcal/d) were significantly different from zero (P less than .05), indicating
      continuous oxidation of endogenous fat and storage of administered glucose.
      During the fat-based diet, carbohydrate and fat balances were not different from
      zero. A correlation between energy and substrate balances was not seen during
      either diet.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736034
TI  - Influence of free testosterone on antigen levels of plasminogen activator
      inhibitor-1 in premenopausal women with central obesity.
AB  - Women with upper body obesity are at increased risk for cardiovascular disease
      (CVD). Several studies have demonstrated a reduced fibrinolytic activity in these
      patients, mainly due to an enhanced activity of plasminogen activator inhibitor-1
      (PAI-1). Since an increase of androgenic activity is a feature of central obesity
      in women, the present study was aimed at evaluating the possibility of a
      relationship between androgens and PAI-1 (antigen and activity) in 20
      premenopausal women, 10 with upper body obesity and 10 controls. In obese women,
      PAI-1 antigen showed a positive Pearson correlation with free testosterone (FT),
      insulin, c-peptide, triglycerides (TG), and waist to hip ratio (WHR) (P less than
      .01), whereas PAI-1 activity correlated positively only with insulin and WHR (P
      less than .01). In control women, PAI-1 antigen and activity were positively
      related only to TG (P less than .01). When we applied the multiple regression
      model with stepwise backward method to our data, both PAI-1 antigen and activity
      did not maintain any significant association. However, when the data from both
      the groups were pooled (n = 20), and PAI-1 antigen was considered as the
      dependent variable, body weight (Sig T = 0.0001), TG (Sig T = 0.0053), FT (Sig T
      = 0.013), and luteinizing hormone (LH) (Sig T = 0.0474) met the stepwise
      criteria, suggesting an independent effect of each of these parameters on PAI-1
      antigen. On the other hand, when PAI-1 activity was tested as the dependent
      variable, only body weight maintained a significant relationship with this
      parameter (Sig T = 0.0006).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736035
TI  - The exogenous origin of trimethylamine in the mouse.
AB  - Although it is now generally regarded that the origin of urinary trimethylamine
      (TMA) is via the action of intestinal microflora on precursors such as choline,
      little direct evidence exists. The normal production of urinary TMA was shown to
      be absent in germ-free mice and greatly reduced in antibiotic-pretreated animals.
      Cohabitation of germ-free mice with conventional animals restored their ability
      to excrete TMA. This study invokes a fundamental role for the intestinal
      microflora in the provision of TMA from precursors within the food.

PMID- 1736036
TI  - The influence of meal composition on plasma serotonin and norepinephrine
      concentrations.
AB  - Reports concerning changes in plasma neurotransmitter values that result from
      dietary manipulations have not been published so far. The influence of various
      meal compositions on platelet-poor plasma (PPP) serotonin (5-HT) and
      norepinephrine (NE) levels was investigated. Healthy volunteers were subjected to
      three test meals: a carbohydrate-rich meal (86% carbohydrates), a protein-rich
      meal (70% protein), and a fat-rich meal (92% fat). After a carbohydrate-rich
      meal, PPP 5-HT values increased significantly (4.47-fold, P less than .02),
      whereas a smaller increase (1.66-fold, P = NS) was observed after a fat-rich
      meal. These effects on PPP 5-HT values could be correlated with insulin plasma
      levels. A protein-rich meal significantly reduced (P = 0.0011) PPP 5-HT to 28% of
      initial values, despite an increase in plasma insulin levels. This study has
      shown that (1) changes in meal compositions influence PPP 5-HT and, to a lesser
      extent, NE values; (2) the resulting changes in PPP 5-HT levels parallel those
      reported for brain neurotransmitters; and (3) these results seem to indicate that
      PPP 5-HT levels may be a model for brain synthesis and release of 5-HT.

PMID- 1736037
TI  - ACAT activity in freshly isolated human mononuclear cell homogenates from
      hyperlipidemic subjects.
AB  - Acyl-coenzyme A:cholesterol acyltransferase (ACAT) catalyzes the esterification
      of cholesterol in human mononuclear cells (MNC). In order to assess the
      relationship between lipid levels and ACAT activity in circulating MNC, we
      measured the rate of [14C]oleoyl-CoA incorporation into cholesterol ester in
      freshly isolated MNC homogenates from hyperlipidemic subjects. Baseline, off
      treatment results obtained in 14 hypertriglyceridemic subjects (eight type IV and
      six type III) and seven subjects with familial hypercholesterolemia (FH) due to
      the same deletion of greater than 10 kb on the low-density lipoprotein (LDL)
      receptor gene were compared with values determined in 12 healthy normolipidemic
      subjects. The rate of cholesterol esterification was 45 +/- 28 pmol/5 min/mg cell
      protein in healthy normolipidemic controls. This rate was significantly higher in
      type IV subjects (84 +/- 52 pmol/5 min/mg cell protein, P less than .05) and FH
      subjects (67 +/- 25 pmol/5 min/mg cell protein, P less than .05). The values were
      more dispersed in type III subjects; the mean value for the group (72 +/- 46
      pmol/5 min/mg cell protein) was not statistically different from the control.
      Hypertriglyceridemic patients were then treated with 6 g/d of omega-3 fatty
      acids. This resulted in a significant reduction in plasma total triglycerides and
      very-low-density lipoprotein (VLDL)-cholesterol in both type III subjects (-57%
      and -51%, P less than .05) and type IV subjects (-62% and -62%, P less than .01).
      The reduction in VLDL concentration was associated with a significantly lower
      ACAT activity in MNC homogenates from type IV subjects (from 84 +/- 52 to 60 +/-
      36 pmol/5 min/mg cell protein, P less than .05), but not from type III
      hypertriglyceridemic subjects (from 72 +/- 46 to 73 +/- 36 pmol/5 min/mg cell
      protein). In conclusion, we found that cholesterol esterification in human MNC is
      elevated in hyperlipidemic subjects and can be decreased with normalization of
      lipid levels. However, ACAT activity changes occurring with treatment are
      heterogeneous among hyperlipidemic subjects, suggesting that factors other than
      plasma lipid level reduction affect ACAT activity in vivo.

PMID- 1736038
TI  - Prevalence of carnitine depletion in critically ill patients with undernutrition.
AB  - The aim of this study was to evaluate to what extent secondary carnitine
      deficiency may exist based on the prevalence of subnormal carnitine status in
      patients with critical illness and abnormal nutritional state. Healthy control
      patients (n = 12) were investigated and compared with patients with possible
      secondary carnitine deficiency, ie, patients with overt severe protein-energy
      malnutrition (PEM, n = 28), postoperative long-term (greater than 14 days)
      parenteral glucose feeding (250 g glucose/d, n = 7), severe liver disease (n =
      10), renal insufficiency (n = 7), and sustained septicemia with increased
      metabolic rate (n = 8). Nutritional status, energy expenditure, creatinine
      excretion, and blood biochemical tests were measured in relationship to free and
      total carnitine concentrations in plasma and skeletal muscle tissue, as well as
      urinary excretion of free and total carnitine. The overall mortality rate was 48%
      within 30 days of the investigation in study patients with the highest mortality
      in liver disease (90%). The hospitalization range was 14 to 129 days in study
      patients. Most study patients had lost weight (4% to 19%) and had abnormal body
      composition. Patients with liver disease, septicemia, renal insufficiency, and
      those on long-term glucose feeding had significantly higher than predicted
      metabolic rate (+25% +/- 3%), while patients with severe malnutrition had
      decreased metabolic rate compared with controls. Patients with liver disease had
      increased plasma concentrations of free (96 +/- 16 mumol/L) and total (144 +/- 27
      mumol/L) carnitine compared with controls (45 +/- 3, 58 +/- 7 mumol/L,
      respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736039
TI  - Dose-response studies on the metabolic effects of a growth hormone pulse in
      humans.
AB  - Whereas the lipolytic and diabetogenic consequences of sustained growth hormone
      (GH) exposure are well described, the metabolic effects of a short-lived
      physiological GH pulse have only recently been reported. To assess the possible
      dose-response of such short-term bolus administration of GH, six healthy, male
      subjects were each studied thrice for 4 1/2 hours after an intravenous (IV) bolus
      of either 70, 140, or 350 micrograms GH, resulting in peak GH concentrations of
      10, 15, and 34 micrograms/L. Observed results include: (1) Time- (but not dose-)
      dependent changes (P less than .05) in plasma glucose and an acute (from 10
      minutes onward), persistent, 40% decrease in forearm glucose uptake. Total
      glucose turnover decreased steadily with time on all occasions. (2) Time- and
      dose-dependent increases (P less than .05) in the concentrations of circulating
      lipid intermediates, with an increase of 3-hydroxybutyrate (3-OHB) from a basal
      of 35 mumol/L to peak values of 108 +/- 34 (70 micrograms), 176 +/- 46 (140
      micrograms), and 232 +/- 51 mumol/L (350 micrograms), forearm uptake of 3-OHB
      changed in parallel. (3) Respiratory exchange ratio decreased (P less than .05)
      with increasing GH doses (indicating increased lipid and decreased glucose
      oxidation), and energy expenditure remained unaffected. (4) Concentrations of
      insulin, C-peptide, and glucagon were unchanged throughout all studies. We
      conclude that the stimulating effects of a modest GH bolus on circulating lipid
      intermediates and lipid oxidation are dose-dependent. This finding underlines the
      potential role of GH as a principal physiological regulator of fuel consumption
      in the maintenance of metabolic homeostasis.

PMID- 1736040
TI  - Skeletal muscle is a major site of lactate uptake and release during
      hyperinsulinemia.
AB  - During conditions of increased glucose disposal, plasma lactate concentrations
      increase due to an increase in plasma lactate appearance. The tissue sites of the
      elevated lactate production are controversial. Although skeletal muscle would be
      a logical source of this lactate, studies using the limb net balance technique
      have failed to demonstrate a major change in net lactate output when plasma
      glucose disposal is increased. Because the limb balance technique underestimates
      production of a substrate when the limb not only produces but also consumes that
      substrate, we infused 3-14C-lactate basally and during a hyperinsulinemic
      euglycemic clamp in seven normal volunteers to determine plasma lactate
      appearance, forearm lactate fractional extraction, and forearm lactate uptake and
      release. After 3 hours of hyperinsulinemia, glucose and lactate turnovers
      increased from basal values of 11.8 +/- 0.13 and 12.2 +/- 0.59 to 32.6 +/- 3.4
      and 16.5 +/- 1.07 mumol/(min.kg), accompanied by an increase in plasma lactate
      from 0.88 +/- 0.07 to 1.16 +/- 0.09 mmol/L (P less than .05). Forearm lactate
      extraction increased from 27% +/- 2% to 38% +/- 2% (P less than .001), resulting
      in an increase in forearm lactate uptake from 0.65 +/- 0.09 to 1.18 +/- 0.08
      mumol/(min.100 mL tissue) (P less than .001). Although forearm lactate net output
      decreased during hyperinsulinemia, forearm lactate production increased from 1.04
      +/- 0.12 basally to 1.69 +/- 0.13 mumol/(min.100 mL). When forearm data was
      extrapolated to whole body, muscle could account for 41% +/- 4% of systemic
      lactate appearance basally and 45% +/- 4% during hyperinsulinemia.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1736041
TI  - Physiological elevations of plasma beta-endorphin alter glucose metabolism in
      obese, but not normal-weight, subjects.
AB  - The present study was undertaken to evaluate the metabolic and hormonal responses
      to physiologic elevations of plasma beta-endorphin concentrations in both normal
      weight and obese healthy subjects. The infusion of synthetic human beta-endorphin
      (4.5 ng/kg/min) produced the following: (1) in normal-weight subjects, no
      significant change of plasma glucose and pancreatic hormones (insulin, C-peptide,
      and glucagon), a significant plasma free fatty acids (FFA) increase, and a
      suppression of glycerol plasma levels; (2) in obese subjects, significant
      increases of glucose, insulin, C-peptide, and glucagon, a progressive decline of
      circulating FFA, and no change in glycerol plasma levels. In obese subjects, the
      intravenous administration of naloxone, given as a bolus (5 mg injected in 5
      minutes) before the start of beta-endorphin infusion, reduced the plasma glucose
      response to the opioid by approximately half, annulled the pancreatic hormonal
      responses, and also reduced the FFA, but not glycerol, response. In normal-weight
      subjects, naloxone pretreatment did not induce any change of the flat glucose and
      hormonal responses to beta-endorphin, but reversed its effects on circulating FFA
      and glycerol. These data suggest that physiological elevations of plasma beta
      endorphin concentrations produce metabolic and hormonal effects in obese subjects
      significantly different from those occurring in normal-weight subjects; these
      effects are partially naloxone-sensitive, suggesting the mediation of endogenous
      opioid receptors.

PMID- 1736042
TI  - Magnetic resonance imaging of body fat of athletes compared with controls, and
      the oxidative metabolism of estradiol.
AB  - The extent of 2-hydroxylation of estradiol (E2), which yields a non-estrogenic
      metabolite (2-OHE1), increased significantly with decreasing subcutaneous fat
      (ScF)/total volume percent (TV%) and total fat (TF)/TV% evaluated by magnetic
      resonance imaging (MRI) for five athletes during low- and high-intensity
      training, and four controls. The increase in 2-hydroxylation with decreasing
      adiposity was associated with anovulation and amenorrhea among the athletes.

PMID- 1736043
TI  - Evidence against the hypothesis that hyperinsulinemia increases sympathetic
      nervous system activity in man.
AB  - To test the hypothesis that physiologic hyperinsulinemia activates the
      sympathetic nervous system in humans, we measured changes in plasma
      norepinephrine as well as epinephrine concentrations during euglycemic
      hyperinsulinemic clamp experiments in which normal volunteers were infused with
      insulin for up to 12 hours, at rates chosen to simulate the basal and
      postprandial hyperinsulinemia seen in insulin-resistant states. Infusions of
      insulin increased plasma insulin threefold (to approximately 200 pmol/L) and 15
      fold (to approximately 1,000 pmol/L) in simulations of fasting and postprandial
      hyperinsulinemia. In neither experiment did plasma norepinephrine or epinephrine
      change significantly. In control experiments in which saline was infused for 12
      hours, plasma epinephrine increased twofold (P less than .05), but plasma
      norepinephrine did not change. Therefore, we conclude that hyperinsulinemia of
      the magnitude seen in the insulin-resistant humans does not increase sympathetic
      nervous system activity.

PMID- 1736044
TI  - Catch-up growth following Escherichia coli infection in weanling rats.
AB  - Infection is detrimental to growth, making it a serious problem for both humans
      and animals. To explore factors responsible for the restoration of tissue protein
      stores following infection, we developed a model of Escherichia coli infection
      suitable for studies of protein metabolism in growing animals. Weanling female
      Sprague-Dawley rats were given a single intraperitoneal injection of E coli
      (approximately 10(9) colony forming units [CFU]/kg body weight); control rats
      were injected with vehicle alone. Two days later, infected rats had lower (P less
      than .05) body weight (-11%), food intake (-49%), daily nitrogen balance (-64%),
      and lower protein mass of gastrocnemius muscle (-21%), tibialis anterior muscle (
      23%), gastrointestinal tract (-15%), skin (-16%), and carcass (14%), compared
      with control rats. There was complete catch-up in terms of body weight,
      cumulative nitrogen balance, and carcass and tissue protein masses within 3 weeks
      of infection. Catch-up was achieved predominantly by increasing (P less than .05)
      the apparent nitrogen digestibility of the diet, thereby increasing the amount of
      nitrogen available to the body. Food intake did not increase and urinary nitrogen
      did not decrease during catch-up growth. E coli peritonitis in weanling rats
      provides a simple and useful model for the study of the effects of infection on
      growth and protein metabolism in growing animals.

PMID- 1736045
TI  - Impaired glucose disposal following mild hypoglycemia in nondiabetic and type I
      diabetic humans.
AB  - Insulin-mediated glucose disposal was studied immediately prior to and following
      moderate hypoglycemia in nondiabetic subjects and subjects with insulin-dependent
      (type I) diabetes mellitus (IDDM), the latter having varying epinephrine
      secretory capacities. Plasma insulin concentration was fixed throughout the study
      at approximately 300 to 400 pmol/L to avoid effects of waning insulin action and
      plasma glucose was clamped at either 5 mmol/L (euglycemic control) or at 3.1
      mmol/L (hypoglycemic) periods of 120 minutes. Baseline (clamp 1) and
      postexperiment (clamp 2) periods were assessed for net glucose disposal (as a
      function of the exogenous glucose infusion rate) and glucose kinetics using 3H
      glucose. In normal subjects, glucose disposal increased progressively by 132%
      during control studies but only by 57% with intervening hypoglycemia (P less than
      .005). Similarly, 33% during hypoglycemia, P less than .025). These changes were
      mediated by reduction of whole-body glucose uptake (rate of glucose disappearance
      [Rd], [3H]-3-glucose) and metabolic clearance rates with comparable suppression
      of hepatic glucose production in both groups. The increase in plasma free-fatty
      acids (FFA) following hypoglycemia was modest but greater in subjects with IDDM
      (P less than .01), whereas IDDM had reduced concentrations of epinephrine (P less
      than .01) and glucagon (P less than .005) during hypoglycemia. In subjects with
      IDDM but not in normal subjects, the change in posthypoglycemia glucose disposal
      was inversely correlated with the increase in plasma norepinephrine (R2 = .54, P
      less than .004) and epinephrine (R2 = .32, P less than .04). Glucose disposal did
      not correlate with other counterregulatory hormones, plasma FFA, or antecedent
      glycemic control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736046
TI  - Measurements of tissue sorbitol in diabetes mellitus: enzyme method versus gas
      liquid chromatography.
AB  - Two methods are commonly used to measure sorbitol in mammalian tissues. The first
      uses sorbitol dehydrogenase for a coupled enzymatic reaction; unfortunately,
      other polyols are also substrates for this enzyme. The second uses gas-liquid
      chromatography (GLC) for separation of polyols and mass quantitation of sorbitol.
      A comparison of these two methods for the measurement of sorbitol in duplicate
      samples of lens, nerve, and erythrocytes indicates that GLC of polyol acetates
      consistently finds less sorbitol than measured by sorbitol dehydrogenase.
      Erythritol, threitol, ribitol, arabitol, and galactitol are polyols found in
      variable quantities in these tissues, which have a variable influence on the
      activity of sorbitol dehydrogenase and therefore alter sorbitol quantitation with
      this enzyme. Moreover, there is an unidentified substance(s) that reacts with
      sorbitol dehydrogenase which seems to increase in association with hyperglycemia
      in the lens and nerve, but not in erythrocytes. The quantity of this unknown
      substance(s) seems to be reduced by the aldose reductase inhibitor sorbinil in
      erythrocytes and to a lesser extent sciatic nerve and lens. Since enzymatic
      sorbitol quantitation in the lens, nerve, and erythrocytes is influenced by many
      known and unknown factors other than sorbitol, we recommend that GLC of polyol
      acetates be used to measure sorbitol in biologic tissues.

PMID- 1736047
TI  - The value of cardiotocograph monitoring in midwifery.

PMID- 1736048
TI  - Malaria prevention.

PMID- 1736049
TI  - The gatekeeper role of general practice.

PMID- 1736050
TI  - Geriatric assessment by general practitioners.

PMID- 1736051
TI  - Isosporiasis in the aboriginal population of Queensland.
AB  - OBJECTIVE: To report on the endemicity of Isospora belli in Queensland. DESIGN: A
      10-year retrospective survey of data from routine parasitological surveillance of
      Queensland Aboriginal communities, by microscopic examination of preserved faecal
      specimens. SETTING: The Aboriginal Health Programme of the Queensland Department
      of Health and Medical Services. POPULATION: Children under 15 years of age from
      all the Aboriginal communities of Queensland. RESULTS: Oocysts of I. belli were
      detected in 33 (0.2%) of a total of 17,642 faecal samples examined. CONCLUSION:
      Isosporiasis is endemic in the Queensland Aboriginal population. It is likely to
      be more common than indicated, because the infection is difficult to diagnose,
      and the techniques used to identify the organism were not particularly sensitive.
      It is predicted that isosporiasis will be recognised with increasing frequency as
      a cause of diarrhoea in Aboriginal and white Australians who develop AIDS.

PMID- 1736052
TI  - Emergency transport of critically ill children: stabilisation before departure.
AB  - OBJECTIVE: To provide up-to-date practical information, relevant to Australian
      conditions and practice, on stabilising the condition of critically ill children
      who need transport to a paediatric hospital. DATA SOURCES AND SELECTION:
      Information on current resuscitation practice was sought from relevant original
      articles and reviews in the recent medical literature, from textbooks and
      monographs published in the last 10 years. DATA SYNTHESIS AND CONCLUSIONS: A
      recent study found that 47% of 100 children who needed emergency interhospital
      transfer experienced problems which should have been preventable by greater
      availability to referring doctors of information on pretransport stabilisation of
      critically ill children. Hypoventilation, hypoxaemia and hypotension are commonly
      found in critically ill children before transport, as are difficulties with
      endotracheal tube care, sedation and analgesia. Mild physiological disturbances
      are likely to become severe and life-threatening during transfer unless they are
      corrected before departure. Early discussion of the child's problems and the
      transfer plan with senior staff at the nearest paediatric intensive care unit may
      be helpful in planning the pre-transfer resuscitation.

PMID- 1736053
TI  - Sex steroid hormones and breast cancer: is there a link with oral contraceptives
      and hormone replacement therapy?
AB  - OBJECTIVE: To determine whether use of sex steroid hormones for contraception and
      hormone replacement therapy alters the risk of breast cancer, and whether the
      risk varies with their composition, duration of use, the period of a woman's life
      when the hormones are used, and after successful treatment for breast cancer.
      DATA SOURCES: The results of important epidemiological reports, readily available
      from the English literature and published since 1981, were evaluated, using
      reports of basic scientific work as a background to the problem. STUDY SELECTION:
      An attempt was made to obtain most of the relevant reports. Twenty case-control
      and seven cohort studies were available on the oral contraceptive pill (OCP) and
      eleven case-control and five cohort studies on hormone replacement therapy (HRT).
      DATA EXTRACTION: The relative risk estimates for breast cancer (and their 95%
      confidence intervals) determined by each report were tabulated according to the
      specific conditions of analysis, for example users under age 25, duration of use.
      Results by meta-analysis from previous studies were also used to determine risk.
      A significant positive association was present when the risk estimate exceeded
      1.0 and the 95% confidence interval did not cross 1.0. DATA SYNTHESIS: Among OCP
      users, the vast majority of reports showed no significant risk of breast cancer-
      overall, longest duration of use, and use before first full-term pregnancy.
      However, a positive association between breast cancer and users under age 25 was
      found in three of eight reports. Similarly, the majority of reports showed no
      significant risk of breast cancer among HRT users, overall as well as in relation
      to duration of use and interval since first use. There was no increased risk with
      additional progestogen; it may be protective. An improved prognosis was found in
      users who developed breast cancer. On the limited data, use of hormones for
      postmenopausal symptoms did not appear to be harmful to women who had been
      successfully treated for breast cancer. CONCLUSIONS: The review revealed good
      evidence that use of sex steroid hormones had no significant effect on the risk
      of breast cancer, whether given for contraception or hormone replacement. There
      was some concern about increased risk with prolonged use of the OCP, especially
      in younger women. At present, use of these hormones is a matter of informed
      choice, with individual considerations of the risk-benefit ratio.

PMID- 1736054
TI  - Prenatal diagnosis and successful intrauterine treatment of a female fetus with
      21-hydroxylase deficiency.
AB  - OBJECTIVE: To present the first reported Australian case of prenatal treatment of
      a female fetus with congenital adrenal hyperplasia resulting from 21-hydroxylase
      deficiency. CLINICAL FEATURES: A couple whose son had congenital adrenal
      hyperplasia resulting from 21-hydroxylase deficiency sought prenatal diagnosis
      and treatment in their next pregnancy. INTERVENTION: Maternal treatment with
      dexamethasone was commenced at seven weeks' gestation to suppress androgen
      production by the fetal adrenal glands and prevent virilisation of an affected
      female fetus. At ten weeks' gestation chorionic villus sampling demonstrated a
      female fetus, who was shown subsequently to be affected by means of a linkage
      method in which probes to HLA genes DQA and DRB were used as markers for the 21
      hydroxylase genes. Increased 17-hydroxyprogesterone and androstenedione
      immunoactivity in amniotic fluid obtained at 14.5 weeks confirmed the fetus to be
      affected and demonstrated incomplete suppression of fetal adrenal androgen
      production. Dexamethasone was continued to term and maintained suppression of the
      fetal and maternal adrenal glands. OUTCOME: The infant was born with normal
      female genitalia. Growth retardation was present but the relationship between
      this and the dexamethasone treatment remains uncertain. The mother had excessive
      weight gain during pregnancy. CONCLUSION: Dexamethasone treatment commenced in
      the first weeks of pregnancy can prevent or reduce virilisation of female fetuses
      with congenital adrenal hyperplasia resulting from 21-hydroxylase deficiency.

PMID- 1736055
TI  - Is sarcocystosis common in Sydney?

PMID- 1736056
TI  - Pneumocystis thyroiditis.

PMID- 1736057
TI  - Availability of sleep studies.

PMID- 1736058
TI  - Failure to demonstrate contrast nephrotoxicity.

PMID- 1736059
TI  - Heterosexual transmission of HIV in Victoria: implications for contact tracing
      and sex tourism.

PMID- 1736060
TI  - Overseas medical practitioners and "racial discrimination".

PMID- 1736061
TI  - Ruptured abdominal aortic aneurysms: does an incorrect initial diagnosis
      prejudice survival?

PMID- 1736062
TI  - Gregg's rubella legacy 1941-1991.

PMID- 1736063
TI  - Depo-Medrol.

PMID- 1736064
TI  - Flying obstetric and gynaecology service--rural anaesthesia.

PMID- 1736065
TI  - General practitioners and over-servicing.

PMID- 1736066
TI  - Terminal restlessness--its management and the role of midazolam.

PMID- 1736067
TI  - Intranasal meningoencephalocele causing recurrent meningitis in a 25-year-old
      Caucasian man.

PMID- 1736068
TI  - Spiroplasmas and spongiform encephalopathies.

PMID- 1736069
TI  - The biological significance of dioxins and other organochlorines.

PMID- 1736070
TI  - Attempted suicide in Adelaide and Perth.

PMID- 1736071
TI  - Failure of 500 mg ciprofloxacin therapy in male urethral gonorrhoea.

PMID- 1736072
TI  - Surrogate therapy for sexual dysfunction.

PMID- 1736073
TI  - Vacuum devices in the treatment of impotence.

PMID- 1736075
TI  - An epidemiological study of snake bite envenomation in Papua New Guinea.

PMID- 1736074
TI  - Endometrial ablation or hysterectomy?

PMID- 1736077
TI  - Lead: subtle forms and new modes of poisoning.

PMID- 1736076
TI  - Hypophosphataemia in a comatose alcoholic.

PMID- 1736078
TI  - Firearms legislation and suicide.

PMID- 1736079
TI  - Boxing.

PMID- 1736080
TI  - Women, cardiovascular disease and hormone replacement therapy.

PMID- 1736081
TI  - Firearms suicides in Australia.
AB  - OBJECTIVE: To examine the rates of suicide by firearms in the five larger
      Australian States during 1968-1989, and to relate them to differences between
      those States. We hypothesised that (i) restrictive gun legislation will have
      reduced the firearms suicide rate in South Australia after 1980, and (ii)
      firearms suicides would be shown to be more common in States with larger
      rural:urban population ratios. DESIGN: Data supplied by the Australian Bureau of
      Statistics were analysed by sex, State and year of suicide. Differences between
      the firearms suicide rates of capital city and rural dwellers, and of different
      age-groups, were recorded. RESULTS: Firearms suicide rates in South Australia
      declined significantly after 1980, following proclamation of gun legislation, in
      contrast to the four other larger States where an increase in firearms suicides
      was recorded. The firearms suicide rate in Queensland has remained consistently
      higher than in the other four larger States during 1968-1989. The number of
      Australian firearms suicides per year fell by 25% from a peak of 572 in 1987 to
      451 in 1989. CONCLUSIONS: Further reductions in the Australian firearms suicide
      rate might be achieved by tightening gun laws and by a media campaign aimed at
      reducing easy access by males to guns in rural households.

PMID- 1736082
TI  - Youth suicide in New South Wales: urban-rural trends.
AB  - OBJECTIVE: The study tested the hypotheses that (i) the rate of suicide by
      firearms among youth (aged 10-19 years) is increasing at a greater rate than
      rates of suicide by other methods; (ii) the rate of youth suicide in rural New
      South Wales is significantly higher than those in urban areas; and (iii) the
      increase in youth suicide by means of firearms is occurring at a greater rate in
      rural males aged 15-19 years than in other groups. DESIGN: Data were obtained
      from the NSW Office of the Australian Bureau of Statistics concerning 735 youth
      suicides in NSW between 1964 and 1988. These were reviewed for information
      concerning residential area and method of death. Five five-year periods were
      used, and rates were calculated with population figures obtained in the census
      years for the same age and sex group. RESULTS: From 1964 to 1988, suicide by
      firearms has risen most substantially, from 3.4 to 5.6 per 100,000 per year in 15
      19-year-old males. There has also been a substantial increase in 15-19-year-old
      male suicides by hanging (0.7 to 3.4 per 100,000 per year). Poisoning suicides
      have declined among females and males in the past 15 years. Suicide rates in
      Sydney, Newcastle and Wollongong have remained stable. In rural cities, they have
      increased from 1.5 to 4.7 per 100,000 per year (F = 4.9, P less than 0.02) while
      in rural municipalities and shires they have increased from 1.3 to 6.4 (F = 14.6,
      P less than 0.0001). The suicide rate of 15-19-year-old males has shown a modest
      increase in Sydney and no change in Newcastle or Wollongong, but the rate for 15
      19-year-old males in rural cities has more than doubled, from 5.1 to 12.5 (F =
      7.7, P less than 0.003), while in rural municipalities and shires, the rate has
      increased more than fivefold, from 3.9 to 20.7 (F = 9.3, P less than 0.001).
      There has been no significant change in the suicide rates of 15-19-year-old
      females, or in 10-14-year-olds. The rate of suicide by firearms among 15-19-year
      old males has not risen significantly in rural cities, but in rural
      municipalities and shires the rates have risen fivefold from 2.8 to 14.8 (F =
      5.6, P less than 0.01). CONCLUSIONS: Each hypothesis was confirmed. An increase
      of this magnitude is not an artefact of coroners' verdicts. The findings are
      believed to be due to ready access to firearms, the use of alcohol and drugs
      (particularly in firearms suicides) and increasing socioeconomic, health, and
      identity problems for rural youth, especially males.

PMID- 1736083
TI  - Percutaneous aortic valvuloplasty.
AB  - OBJECTIVE: To determine the short-term and long-term results of percutaneous
      aortic valvuloplasty. DESIGN: A retrospective follow-up study. SETTING: The
      Cardiac Catheterisation Laboratory and Cardiovascular Medicine Unit of a teaching
      hospital. PATIENTS: Eighteen patients with severe aortic stenosis who were not
      accepted for surgery; there were 11 men and 7 women, mean age 79 +/- 4.5 years.
      INTERVENTIONS: Percutaneous transluminal aortic valvuloplasty (PTAV) by means of
      balloon catheter techniques. MAIN OUTCOME MEASURES: Patient survival and
      symptomatic status. RESULTS: PTAV resulted in a significant decrease in the
      aortic valve pressure gradient from 64.8 +/- 23.2 mmHg to 38 +/- 14.7 mmHg (mean
      +/- SD) (P less than 0.00001) in the 18 patients and a significant increase in
      the mean aortic valve area from 0.4 +/- 0.16 cm2 to 0.6 +/- 0.18 cm2 (P less than
      0.0001) in 14 patients. Complications occurred in seven patients; two of them,
      who had been in terminal heart failure with a low output state before PTAV, died.
      Fifteen patients improved in at least one New York Heart Association functional
      class early after PTAV and one patient had an aortic valve replacement. In follow
      up of between 5 and 32 months (mean, 13.3 +/- 7.7 months) six patients are in a
      better functional class than before PTAV, one patient is in Class IV, one patient
      had an aortic valve replacement and seven patients died (three died of cardiac
      failure and four of non-cardiac causes). CONCLUSIONS: PTAV has a place as a
      palliative procedure in selected patients with aortic stenosis in whom another
      condition precludes aortic valve replacement.

PMID- 1736084
TI  - Promotion of attendance for mammographic screening through general practice: a
      randomised trial of two strategies.
AB  - OBJECTIVE: To compare the effectiveness of two strategies--patient education and
      practitioner recommendation--in encouraging women to attend for mammographic
      screening. DESIGN: The study was a prospective randomised controlled trial. Women
      aged between 40 and 70 years attending a general practitioner participated in the
      study. Consenting, eligible women were randomly allocated to one of the two
      strategy groups. SETTING: The study was conducted in private general practice in
      Newcastle, New South Wales. PARTICIPANTS: The general practitioners who took part
      in the study were a non-random sample of practitioners: 20 were approached, two
      declined to participate, and five failed to begin recruitment, leaving 13
      practitioners who took part in the study. A total of 302 women aged 40-69 were
      recorded as attending the surgeries during recruitment sessions. Twenty women did
      not consent to the study and 73 were ineligible. Thirty-four women were not given
      the intervention because the general practitioner forgot or did not have time.
      There were 92 women in the simple recommendation group and 83 women in the
      patient education group. INTERVENTIONS: An intensive patient education approach
      based on health belief principles was compared with a simple recommendation by
      the general practitioner that the woman have a mammogram. MAIN OUTCOME MEASURE:
      Attendance rates were calculated from screening service attendance records.
      RESULTS: No significant difference in attendance rates was observed between the
      two groups, 82% of the simple recommendation group and 91% of the patient
      education group attended for screening. CONCLUSIONS: These results suggest that
      mammographic screening can be effectively promoted in general practice without
      extensive patient education.

PMID- 1736085
TI  - Prevalence of intellectual handicap in Western Australia: a community study.
AB  - OBJECTIVE: To produce comprehensive community based data on individuals with
      intellectual handicap, the level of retardation, associated handicaps and
      demographic data. DESIGN: Multiple sources of ascertainment were used to identify
      all children in birth cohorts, 1967-1976 inclusive, who had an IQ less than 70.
      SETTING: The majority of cases were ascertained through Western Australian
      government agencies that provide services for the intellectually handicapped.
      Other sources included the support branch of the education department, private
      schools and the children's hospital. PATIENTS: In all, 1602 children, aged
      between 6 and 16 years, fitted the study criteria. RESULTS: The prevalence of
      intellectual handicap was found to be 8.9 per 1000 live male births and 6.3 per
      1000 live female births with an overall rate of 7.6. The figures for mild,
      moderate, severe and profound retardation were 3.0, 2.4, 1.0 and 0.6 per 1000,
      respectively, with 0.8 per 1000 with an unknown IQ. Cerebral palsy occurred in
      20% and epilepsy in 13% in addition to intellectual handicap. There was a
      significantly higher rate among those from rural compared with urban areas: 9.9
      v. 6.5 per 1000 live births, respectively. CONCLUSIONS: This comprehensive
      epidemiological data on intellectual handicap in Western Australia will be of
      value in the planning of services, including screening and genetic counselling,
      and for the evaluation of care. The rural preponderance, in particular, is worthy
      of further evaluation.

PMID- 1736086
TI  - Measles at an international gymnastics competition--Indiana, 1991.
AB  - On September 7, 1991, the Indiana State Department of Health (ISDH) was notified
      of three suspected measles cases among athletes from New Zealand (NZ)
      participating in an international gymnastics competition September 6-15 in
      Indianapolis (Marion County). Among those potentially at risk for measles were
      approximately 700 athletes and 1200 coaches, trainers, and managers from 51
      countries; an estimated 2500 volunteers and staff; international media, families,
      and employees; and approximately 60,000 spectators attending the competition.
      This report summarizes the epidemiologic investigation of these cases.

PMID- 1736087
TI  - Safety-belt and helmet use among high school students--United States, 1990.
AB  - During 1988, injuries were the leading cause of death among persons aged 15-19
      years in the United States. More than half (53%) of these deaths were motor
      vehicle related, including crashes involving bicycles and motorcycles with motor
      vehicles (CDC, unpublished data, 1988). Among persons aged 15-19 years, motor
      vehicle-related injuries are the leading contributor to hospital and emergency
      department medical costs associated with injuries (1). This article presents 1990
      self-reported data from U.S. students in grades 9-12 regarding the prevalence of
      three behaviors that reduce the risk for injuries from motor-vehicle crashes
      safety-belt use, motorcycle-helmet use, and bicycle-helmet use.

PMID- 1736088
TI  - Eastern equine encephalitis virus associated with Aedes albopictus--Florida,
      1991.

PMID- 1736089
TI  - Mortality patterns--United States, 1989.
AB  - During 1989, 2,150,466 deaths were registered in the United States--17,533 fewer
      deaths than the record-high number recorded in 1988. In 1989, as for at least the
      past 20 years, nearly three fourths of deaths were attributable to the first four
      leading causes of death--heart disease, cancer, stroke, and unintentional injury.
      This report summarizes mortality data compiled by CDC's National Center for
      Health Statistics (NCHS) for 1989 (1) and compares patterns with 1988.

PMID- 1736090
TI  - Transcription in vivo within the replication origin of the Escherichia coli
      chromosome: a mechanism for activating initiation of replication.
AB  - Within the replication origin, oriC, of the Escherichia coli chromosome, novel in
      vivo transcripts were detected which proceeded rightward and whose production was
      activated by DnaA protein. In contrast, DnaA protein repressed the previously
      described ori-L leftward transcription. The former should introduce negative
      supercoiling, and the latter positive supercoiling, into the 13-mers. The effects
      of transcription on the initiation of replication were also investigated by
      making constructs with promoters placed near oriC. Transcription was found to
      enhance the origin activity only when it was oriented in such a way as to
      introduce negative supercoiling into the 13-mers. From these results, we propose
      that transcription within oriC regulates replication initiation by altering the
      topology of the 13-mer region.

PMID- 1736091
TI  - Molecular structure of the DNA cross-link repair gene SNM1 (PSO2) of the yeast
      Saccharomyces cerevisiae.
AB  - A 3.2 kb yeast DNA fragment containing the DNA interstrand cross-link-specific
      repair gene SNM1 has been sequenced. Two genes were identified. SNM1 has an open
      reading frame of 1983 bp and codes for a 661 amino acid protein. Hydrophobic
      analysis shows that the protein is most probably not directly membrane bound. The
      second gene, UGX1, has an open reading frame of 573 bp coding for a polypeptide
      of 191 amino acid residues. The two genes are arranged head to head and share a
      192 bp divergent promoter region that contains three TATAAA motives, two for the
      SNM1 and one for the UGX1 locus. Gene UGX1 has no apparent influence on the
      sensitivity of the cell to cross-linking nitrogen mustard, as its disruption in
      wild type does not increase sensitivity to nitrogen mustard and the presence of
      multiple copies of the gene fails to complement the nitrogen mustard sensitivity
      phenotype of snm1 disruption mutants. Northern analysis revealed that the
      expression of SNM1 yields an average of 0.3 copies/cell of a 2.4 kb transcript,
      while expression of UGX1 yields higher levels of a 0.8 kb poly(A)+ RNA.

PMID- 1736092
TI  - An intragenic map of the brlA locus of Aspergillus nidulans.
AB  - We have constructed an intragenic map for the Aspergillus nidulans brlA gene,
      mutants in which are distinguishable by visual criteria only. Most of the leaky
      phenotype mutants map near the right (3') end. The gene shows distinct
      recombinational polarity consistent with recombination initiation at the promoter
      (centromere-proximal) end of the gene. brlA12 and brlA20 mutants gave abnormal
      DNA restriction patterns consistent with the III; VIII and VI; VIII
      translocations, respectively, determined by haploidization.

PMID- 1736093
TI  - Synergistic effect of upstream sequences, CCAAT box elements, and HSE sequences
      for enhanced expression of chimaeric heat shock genes in transgenic tobacco.
AB  - The thermoregulated expression of the soybean heat shock (hs) gene Gmhsp17.3-B is
      regulated via the heat shock promoter elements (HSEs), but full promoter activity
      requires additional sequences located upstream of the HSE-containing region.
      Structural features within this putative enhancer region include a run of simple
      sequences which are also present upstream of HSE-like sequences of other soybean
      hs genes, and three perfect CCAAT box sequences located immediately upstream from
      the most distal HSE of the promoter. A series of heterologous and homologous
      promoter fusions linked to the chloramphenicol acetyl transferase (CAT) gene was
      constructed and examined in transgenic tobacco plants. The region containing the
      AT-rich domain of the 5' flanking region was unable to direct transcription from
      the TATA box of a truncated delta CaMV35S promoter. Heat-inducible CAT activity
      was detectable when additional sequences from the native promoter containing
      three CCAAT boxes and a single HSE were present in the constructions. Complete
      reconstitution of the native hs promoter/enhancer region increased hs specific
      CAT activities only very little, but deletion of CCAAT box sequences reduced CAT
      expression five-fold. Our results suggest that AT-rich sequences have a moderate
      effect on thermoinducible expression levels of the soybean heat shock gene and
      that CCAAT box sequences act cooperatively with HSEs to increase the hs promoter
      activity.

PMID- 1736094
TI  - Transformation frequencies are enhanced and vector DNA is targeted during
      retransformation of Leptosphaeria maculans, a fungal plant pathogen.
AB  - Leptosphaeria maculans, a fungal pathogen of Brassica spp., was successfully
      transformed with the vector pAN8-1, encoding phleomycin resistance. Protoplasts
      of a vigorous Phleor transformant were then retransformed using the partially
      homologous vector, pAN7-1 which encodes hygromycin B resistance. Retransformation
      of this strain to hygromycin resistance occurred at frequencies that were
      consistently twofold higher than with the original recipient strain. Linearised
      pAN7-1 DNA transformed phleomycin-resistant protoplasts at higher frequencies
      still. All the transformants that were tested retained a phleomycin-resistant
      phenotype (20/20). Molecular analysis of five transformants generated with
      circular pAN7-1 DNA indicated that in four cases the pAN7-1 vector had integrated
      into pAN8-1 sequences. These results suggest that transformation frequencies in
      L. maculans are limited by the ability of vector DNA to integrate into the
      genome. Hence, construction of strains with target sites for integration may
      prove to be a generally useful method for improving transformation frequencies of
      poorly characterised filamentous fungi, particularly when using heterologous
      vectors. This would greatly facilitate the identification of genes by transfer of
      gene libraries and the standardisation of chromosomal location effects in studies
      of expression of nested promoter deletions.

PMID- 1736095
TI  - In vitro interactions of integration host factor with the ompF promoter
      regulatory region of Escherichia coli.
AB  - Previous work has shown that integration host factor (IHF) mutants have increased
      expression and altered osmoregulation of OmpF, a major Escherichia coli outer
      membrane protein. By in vitro analysis the possibility was investigated that IHF
      interacts directly with the ompF promoter region. Gel retardation assays and
      DNase I protection experiments showed that IHF binds to two sites in the ompF
      promoter region centered at positions -180 and -60 relative to the start of
      transcription. Gel electrophoresis studies with circularly permuted ompF promoter
      fragments indicated that IHF binding strongly increased a small intrinsic bend in
      the ompF promoter region. The addition of IHF to a purified in vitro
      transcription system strongly and specifically inhibited ompF transcription. This
      inhibition was reversed by increasing the concentration of OmpR, a positive
      activator required for ompF expression, suggesting that IHF may inhibit ompF
      transcription by altering how OmpR interacts with the ompF promoter.

PMID- 1736096
TI  - Regulation of the gua operon of Escherichia coli by the DnaA protein.
AB  - The guaBA operon determines production of the two enzymes required to convert
      hypoxanthine to guanine at the nucleotide level during guanine nucleotide
      biosynthesis. Two DnaA boxes, binding sites for the DNA replication-initiating
      DnaA protein, are present in the gua operon, one at the gua promoter (guaP) and
      the other within the guaB coding sequence. Regulation of the guaBA operon by DnaA
      protein was studied using strains carrying chromosomal gua-lacZ fusions. In these
      strains beta-galactosidase acts as a reporter enzyme for transcription initiated
      at guaP. When the intracellular levels of DnaA were increased (by induction of a
      multicopy plasmid carrying the dnaA gene fused to the tac promoter) transcription
      from the gua promoter was repressed. Reducing the intracellular level of DnaA,
      either by sequestration with an oriC plasmid or by placing a temperature
      sensitive dnaA mutant at the restrictive temperature, resulted in increased
      transcription from guaP. Thus the transcriptional activity of the gua operon is
      coupled, through the DnaA protein, to the DNA replication cycle. Repression of
      guaP by DnaA was dependent on the presence of both boxes in the gua-lacZ fusion;
      constructs containing only the box at guaP were unaffected by DnaA.

PMID- 1736097
TI  - A plant histone gene promoter can direct both replication-dependent and 
      independent gene expression in transgenic plants.
AB  - Chimeric genes containing the beta-glucuronidase (GUS) gene under the control of
      different Arabidopsis histone H3 and H4 promoters were found to be highly
      expressed in transient expression experiments using tobacco protoplasts. The
      activity of one of these promoters, H4A748, was further analyzed. The kinetics of
      H4A748-GUS activity are very similar to these of a CaMV 35S-GUS constitutive gene
      during protoplast culture. No increase in H4A748-GUS activity was found after 24
      h of protoplast culture when DNA synthesis starts, nor was the GUS activity
      affected when an inhibitor of DNA synthesis was included in the culture medium.
      This failure to detect any replication-dependent activity is most likely to be
      due to the fact that transient transcription of the introduced construct is
      restricted to the first 24 h following transfection. Stable integration of the
      H4A748-GUS gene into tobacco plants showed that the histone promoter could confer
      increased expression in meristematic tissues but it is also expressed to
      significant levels in non-proliferating tissues. Protoplasts prepared from these
      transgenic tobacco plants were cultivated under different conditions that affect
      DNA synthesis. Analysis of H4A748-GUS activity revealed (i) the existence of a
      basal replication-independent activity and (ii) a replication-dependent activity
      induced in parallel with DNA synthesis. These results show that the histone H4
      promoter is able to direct both replication-dependent and -independent gene
      expression.

PMID- 1736098
TI  - Cell-free transcription of the nifH1 gene of Methanococcus thermolithotrophicus
      indicates that promoters of archaeal nif genes share basic features with the
      methanogen consensus promoter.
AB  - The nifH1 gene of Methanococcus thermolithotrophicus, which encodes the putative
      dinitrogenase reductase of an archaeon, was accurately transcribed in a
      homologous cell-free transcription system. Extracts of cells grown with N2 or
      ammonia as nitrogen source initiated transcription at the nifH1 promoter with
      similar efficiencies. We confirmed that cells grown under non-N2-fixing
      conditions do not contain significant amounts of nifH1-specific mRNA. The levels
      of cell-free transcription initiation at the nifH1 promoter were similar to those
      observed at a tRNA promoter. The DNA sequence from -40 to +5 relative to the
      initiator nucleotide of nifH1 mRNA contained all the information required for
      promoter activity. A mutational analysis of this section of DNA demonstrated that
      a TATA box at -25 and the TTGT motif (initiator element) at the transcription
      start site are essential for cell-free transcription. These elements are similar
      to the structural determinants of a known tRNA promoter of Methanococcus.
      Mutation of a sequence, showing homology to the bacterial NifA site, which
      overlaps the transcription start site, did not affect promoter activity. Hence,
      cell-free transcription of the Methanococcus nifH1 gene is independent of
      upstream activator elements and does not require alternate cis-acting sequences
      that differ from the methanogen consensus promoter. These findings suggest that
      the activation of nif promoters is brought about by fundamentally different
      mechanisms in Archaea and bacteria.

PMID- 1736099
TI  - Genomic organization of an alpha-zein gene cluster in maize.
AB  - The genes encoding the alpha-zein proteins of maize constitute a large multigene
      family of some 75 genes. This multigene family can be divided into four
      subfamilies based on the nucleotide sequences of their genes and the deduced
      amino acid sequences of their proteins. We describe for the first time evidence
      of a clustering of five alpha-zein subfamily 4 (SF4) genes that are members of
      one of the major alpha-zein subfamilies in a 56 kb region of the genome of the
      maize inbred line W22. None of the other three known alpha-zein gene subfamilies
      (SF1, SF2, or SF3) are present in this cluster. The genomic region was
      reconstructed using restriction endonuclease maps to identify and align three
      overlapping cosmid clones isolated from a genomic library. The alpha-zein genes
      are not evenly spaced; the minimum distance between genes is 3.5 kb; the maximum
      is 13 kb. All the alpha-zein genes in the cluster have the same transcriptional
      orientation. The location and sequences of some of the repetitive DNA elements in
      this gene cluster were determined. We estimate that there are a minimum of eight
      repetitive DNA elements in this region. The sequences of the repetitive elements
      (not functionally defined) are located between or among the alpha-zein genes. The
      regions containing two of these repetitive elements (Rep1 and Rep4) have been
      sequenced; they are about 15 kb apart in the genome. These repetitive elements
      have similar sequences for about 300 bp out of the 400 bp compared. The regions
      of sequence similarity, however, are in reverse orientation to one
      another.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736100
TI  - Cloning of a superoxide dismutase gene from Listeria ivanovii by functional
      complementation in Escherichia coli and characterization of the gene product.
AB  - A gene encoding superoxide dismutase (EC 1.15.1.1., SOD) was isolated from a
      plasmid library of chromosomal DNA from Listeria ivanovii by functional
      complementation of an SOD-negative Escherichia coli host. The nucleotide sequence
      of the cloned gene was determined and contained an open reading frame which codes
      for a protein of 202 amino acid residues (calculated molecular weight 22755 Da
      including the amino-terminal methionine residue). Comparison of the deduced amino
      acid sequence of L. ivanovii SOD with previously reported SOD amino acid
      sequences revealed considerable homologies with Fe- and Mn-dependent SODs.
      Enzymatic analyses using cell lysates and the purified recombinant enzyme
      indicated that this SOD is manganese-dependent. The recombinant SOD accounted for
      up to 30% of the total soluble protein in recombinant E. coli and protected sodA
      sodB mutants against the toxic effects of paraquat. Subunits of the recombinant
      Listeria SOD and of both E. coli SODs formed enzymatically active hybrids in
      vivo.

PMID- 1736101
TI  - Transcriptional analysis and promoter mapping of the fdxA gene which encodes the
      7Fe ferredoxin (FdII) of Rhodobacter capsulatus.
AB  - The structural gene (fdxA) coding for ferredoxin II (FdII) of the photosynthetic
      bacterium Rhodobacter capsulatus has been previously cloned and sequenced.
      Transcription of the fdxA gene was studied by mRNA analyses and by use of plasmid
      borne fdxA::lacZ translational fusions. The transcription start site was mapped
      23 bp upstream of the initiation codon, as deduced from analysis of mRNA by mung
      bean nuclease protection and primer extension experiments. A motif resembling the
      canonical sequence observed in sigma 70-dependent Escherichia coli promoters is
      present at the expected distance (-10/-35) from the proposed transcription start
      site. mRNA analysis by Northern hybridization revealed a fdxA-specific transcript
      of approximately 0.4 kb, indicating that fdxA is transcribed as a single
      gene.fdxA expression, as measured by the activity of the fdxA::lacZ fusion, was
      found to be constant during growth and reached a similar level under all growth
      conditions tested. These results suggest that FdII is constitutively synthesized
      in R. capsulatus.

PMID- 1736102
TI  - The CDC26 gene of Saccharomyces cerevisiae is required for cell growth only at
      high temperature.
AB  - We have cloned and sequenced the wild-type CDC26 gene and a mutant allele, cdc26
      1, of Saccharomyces cerevisiae. Nucleotide sequence analysis revealed that the
      gene we cloned was the same as SCD26, a dosage-dependent suppressor of cdc26.
      However, the cloned gene is in fact the CDC26 gene, because a nucleotide
      substitution in cdc26-1 was found to be a nonsense mutation in this sequence.
      Disruption of this gene conferred thermosensitive cell growth and the disrupted
      cdc26 gene could not complement the cdc26-1 mutant allele. Thus, the CDC26 gene
      is required for cell growth only at high temperature.

PMID- 1736103
TI  - A case-control study of screening sigmoidoscopy and mortality from colorectal
      cancer.
AB  - BACKGROUND: The efficacy of sigmoidoscopic screening in reducing mortality from
      colorectal cancer remains uncertain. A randomized trial would be ideal for
      clarifying this issue but is very difficult to conduct. Case-control studies
      provide an alternative method of estimating the efficacy of screening
      sigmoidoscopy. METHODS: Using data on the 261 members of the Kaiser Permanente
      Medical Care Program who died of cancer of the rectum or distal colon from 1971
      to 1988, we examined the use of screening by rigid sigmoidoscopy during the 10
      years before the diagnosis and compared it with the use of screening in 868
      control subjects matched with the case subjects for age and sex. RESULTS: Only
      8.8 percent of the case subjects had undergone screening by sigmoidoscopy, as
      compared with 24.2 percent of the controls (matched odds ratio, 0.30; 95 percent
      confidence interval, 0.19 to 0.48). Adjustment for potential confounding factors
      increased the odds ratio to 0.41 (95 percent confidence interval, 0.25 to 0.69).
      The negative association was as strong when the most recent sigmoidoscopy was 9
      to 10 years before diagnosis as it was when examinations were more recent. By
      contrast, for 268 subjects with fatal colon cancer above the reach of the
      sigmoidoscope and for 268 controls, the adjusted odds ratio was 0.96 (95 percent
      confidence interval, 0.61 to 1.50). The specificity of the negative association
      for cancer within the reach of the sigmoidoscope is consistent with a true
      efficacy of screening rather than a confounding by unmeasured selection factors.
      CONCLUSIONS: Screening by sigmoidoscopy can reduce mortality from cancer of the
      rectum and distal colon. A screening once every 10 years may be nearly as
      efficacious as more frequent screening.

PMID- 1736104
TI  - Long-term risk of colorectal cancer after excision of rectosigmoid adenomas.
AB  - BACKGROUND AND METHODS: Surveillance by repeated colonoscopy is currently
      recommended for patients with colorectal adenomas. We assessed the long-term risk
      of colorectal cancer after rigid-instrument sigmoidoscopy and polypectomy in 1618
      patients with rectosigmoid adenomas (tumor of the rectum or distal sigmoid colon)
      who did not undergo surveillance. A total of 22,462 person-years of observation
      were accrued (mean, 14 years per patient). RESULTS: The incidence of subsequent
      rectal cancer in these patients was similar to that in the general population
      (standardized incidence ratio, 1.2; 95 percent confidence interval, 0.7 to 2.1).
      Most rectal cancers developed in patients whose adenomas had been inadequately
      removed; the risk was very low after complete removal. The risk of subsequent
      colon cancer depended on the histologic type, size, and number of adenomas in the
      rectosigmoid. Among 842 patients with a rectosigmoid adenoma that was
      tubulovillous, villous, or large (greater than or equal to 1 cm), colon cancer
      developed in 31 patients. The standardized incidence ratio was 3.6 (95 percent
      confidence interval, 2.4 to 5.0) overall and 6.6 (95 percent confidence interval,
      3.3 to 11.8) if there were multiple rectosigmoid adenomas. Among the remaining
      776 patients with only small, tubular adenomas (whether single or multiple),
      colon cancer developed in only 4 patients. The standardized incidence ratio in
      this group was 0.5 (95 percent confidence interval, 0.1 to 1.3). CONCLUSIONS:
      Follow-up colonoscopic examinations may be warranted in patients with
      tubulovillous, villous, or large adenomas in the rectosigmoid, particularly if
      the adenomas are also multiple. In patients with only a single, small tubular
      adenoma that is only mildly or moderately dysplastic (43 percent of our series),
      however, surveillance may not be of value because the risk of cancer is so low.

PMID- 1736105
TI  - Familial clustering of cardiovascular disease in patients with insulin-dependent
      diabetes and nephropathy.
AB  - BACKGROUND: Patients who have insulin-dependent diabetes mellitus and nephropathy
      have an excess of cardiovascular disease. Familial factors may in part account
      for this phenomenon. METHODS: We identified 61 white patients under 65 years of
      age with insulin-dependent diabetes who had nephropathy, and then matched them
      with 61 diabetic patients without nephropathy. We determined the prevalence of
      cardiovascular disease in the parents of these patients with use of information
      obtained from death certificates or from the World Health Organization
      questionnaire for cardiovascular disease. RESULTS: The rates of ascertainment of
      information were 96 percent (n = 117) for the parents of diabetic patients with
      nephropathy and 95 percent (n = 116) for the parents of patients without
      nephropathy. Cardiovascular disease was more often a direct cause of death among
      the parents of diabetic patients with nephropathy (40 percent vs. 22 percent, P
      less than 0.03), and the combined morbidity and mortality from cardiovascular
      disease in this group was greater than that in the parents of diabetic patients
      without nephropathy (31 percent vs. 14 percent, P less than 0.01). The age
      adjusted and sex-adjusted relative risk of cardiovascular disease in this group
      of parents was 2.9 (95 percent confidence interval, 1.5 to 5.5; P less than
      0.001). Moreover, a paternal history of cardiovascular disease was associated
      with a significantly increased risk of nephropathy in the diabetic patient after
      the analysis was adjusted for age, sex, and duration of diabetes (odds ratio,
      3.2; 95 percent confidence interval, 1.3 to 7.9; P less than 0.01). Among the
      diabetic patients with nephropathy, those who had had a cardiovascular event were
      much more likely to have a family history of cardiovascular disease (odds ratio,
      6.2; 95 percent confidence interval, 2.0 to 19.0; P less than 0.005) than those
      who had not had such an event. CONCLUSIONS: Among patients with insulin-dependent
      diabetes, a parental history of cardiovascular disease is significantly
      associated with the development of nephropathy and, among those with nephropathy,
      increases the likelihood of cardiovascular disease.

PMID- 1736106
TI  - Hodgkin's disease.

PMID- 1736107
TI  - How sure is sure enough?

PMID- 1736108
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 10-1992. A 41-year-old woman with a swollen left leg, pelvic
      mass, and bilateral hydronephrosis.

PMID- 1736109
TI  - Screening sigmoidoscopy for colorectal cancer.

PMID- 1736110
TI  - The new tuberculosis.

PMID- 1736111
TI  - Postmenopausal estrogen therapy and cardiovascular disease.

PMID- 1736112
TI  - Postmenopausal estrogen therapy and cardiovascular disease.

PMID- 1736113
TI  - Postmenopausal estrogen therapy and cardiovascular disease.

PMID- 1736114
TI  - Postmenopausal estrogen therapy and cardiovascular disease.

PMID- 1736115
TI  - Fetal fibronectin and preterm labor.

PMID- 1736116
TI  - Circadian variation in vascular tone.

PMID- 1736117
TI  - Circadian variation in vascular tone.

PMID- 1736118
TI  - Response of refractory thrombotic thrombocytopenic purpura to extracorporeal
      immunoadsorption.

PMID- 1736119
TI  - Contractile properties of the diaphragm.

PMID- 1736120
TI  - Contractile properties of the diaphragm.

PMID- 1736121
TI  - Physicians and occupational medicine.

PMID- 1736122
TI  - Physicians and occupational medicine.

PMID- 1736123
TI  - Physicians and occupational medicine.

PMID- 1736124
TI  - Shortages of antimycobacterial drugs.

PMID- 1736125
TI  - [A prospective study of the effectiveness of thermal bath treatments in patients
      with rheumatoid arthritis].

PMID- 1736126
TI  - [Cell biology from a medical viewpoint. XI. Peroxisomes: unmasking of a hidden
      organelle by studies of the Zellweger syndrome].

PMID- 1736127
TI  - [Vaccination against influenza; encourage it or adopt a wait and see attitude?].

PMID- 1736128
TI  - [No difference in effectiveness measured between treatment in a thermal bath and
      in an exercise bath in patients with rheumatoid arthritis].
AB  - OBJECTIVE: To determine whether hydrotherapy in a thermomineral institution is
      superior to the same hydrotherapy in an ordinary hospital exercise-bath. DESIGN:
      Controlled therapeutic trial. SETTING: The thermomineral institution at Arcen and
      the exercise bath at the Maasland Hospital in Sittard, the Netherlands. PATIENTS
      AND METHODS: 46 patients with rheumatoid arthritis were treated in a by a skilled
      physiotherapist, according to a standardized exercise-scheme: 27 were treated in
      the thermomineral institution and 19 (control-group) in the hospital exercise
      bath. Each patient received 12 treatments in 12 weeks. ENDPOINTS PARAMETERS:
      Morning stiffness, erythrocyte sedimentation rate, Ritchie index, amount of pain,
      answers to 11 questions concerning the activities of daily life, and psychosocial
      aspects of the disease. The various subjective and objective parameters were
      scored by the same physician. RESULTS: Statistically significant improvement was
      observed in both groups concerning morning stiffness. Other subjective parameters
      improved, but did not reach significance. Objective parameters did not change
      significantly. Between-group differences were not found. CONCLUSION: Hydrotherapy
      has a positive effect on some subjective but not on objective parameters in
      patients with rheumatoid arthritis, whether it is applied in a thermomineral
      institution or an ordinary hospital exercise bath.

PMID- 1736129
TI  - [Opinions of family physicians and specialists on vaccination against influenza].
AB  - About 50 percent of the patients who because of an underlying disease should be
      vaccinated annually against influenza, do not receive the vaccine. One of the
      major reasons is that they are not informed by their physicians about the need to
      be vaccinated. To understand the attitude of the physicians concerning influenza
      vaccination and the way the vaccination of these patients is organized,
      questionnaires were send to 250 general practitioners, 125 cardiologists and 125
      pulmonologists in the Netherlands. Eighty-four percent of the questionnaires were
      returned. The results show that the physicians were well informed about the
      indications for vaccination. A minority of the physicians had doubts about the
      efficacy of the vaccine. Both specialists and general practitioners agreed that
      vaccination should be performed by the general practitioner. Instruction of the
      patients and application of the vaccine were generally rather well organized. It
      is to be expected, however, that improvement of the organization will enhance the
      rate of vaccination against influenza in the Netherlands.

PMID- 1736130
TI  - [Implementation of influenza vaccination in 3 hospitals].
AB  - In two general hospitals and one university hospital questionnaires were handed
      out to 646 outpatients who because of underlying diseases should be vaccinated
      annually against influenza. Questions concerned whether a patient was vaccinated,
      and if the vaccine had not been administrated, what the reason was. Answered
      questionnaires were received from 595 patients (92%). In the particular year 333
      patients (56%) had received the vaccine. The majority of the immunized patients
      had received personal advice from their physician to have the vaccine. Lack of
      advice, the belief that vaccination is unnecessary, and fear of side effects were
      the most important reasons for not having the vaccine. We conclude that personal
      advice from the patients' physician, sending annual reminders to patients and
      offering the vaccine to patients in an easily accessible way, are the essential
      elements for a successful vaccination strategy.

PMID- 1736131
TI  - [Exogenous ochronosis, a little-known side effect of hydroquinone-containing
      ointments].
AB  - Two patients with exogenous ochronosis, an unfamiliar side effect of hydroquinone
      containing bleaching creams, are presented. This disorder is characterized by
      progressive darkening of the area to which the cream is applied. Histologically
      there is deposition of yellow-brown pigment in the dermis, in addition to
      degeneration of collagen and elastic fibres. The chemical composition of the
      ochronotic material and the pathogenesis of this paradoxical effect of
      hydroquinone are unknown. Hydroquinone containing creams should not be used for
      longer than two years. If there is no improvement within six months, application
      should be discontinued.

PMID- 1736132
TI  - [Sulfonylurea preparations and hypoglycemia].

PMID- 1736133
TI  - [EDTA-chelation treatment].

PMID- 1736134
TI  - [Antiseptic wound treatment agents; an overview].

PMID- 1736135
TI  - [Anticoagulants in non-rheumatic atrial fibrillation].

PMID- 1736136
TI  - [Clinical findings and diagnosis of Yersinia enterocolitica infections; a
      retrospective study in Friesland].

PMID- 1736137
TI  - [The surgical treatment of rheumatoid arthritis].

PMID- 1736138
TI  - [Surgical treatment of ischemic ventricular septum rupture].

PMID- 1736139
TI  - [Promotion of neurological recovery using drugs following acute traumatic spinal
      cord lesions].

PMID- 1736140
TI  - [Treatment of psoriasis using dithranol].

PMID- 1736141
TI  - [Gonadotrophins and induction of (super)ovulation].

PMID- 1736142
TI  - [Neck lymph node dissection in squamous cell carcinoma originating in the head
      and-neck area; the significance for the prognosis].
AB  - Neck dissection has a therapeutical as well as a prognostic relevance with
      respect to regional recurrence and distant metastases. Between January 1973 and
      July 1986 576 neck dissections in 511 patients (396 men, 115 women, among whom
      486 with squamous cell carcinoma of the head and neck, and 14 with neck
      metastases of an unknown primary tumour) were performed at the department of
      Otolaryngology-Head and Neck Surgery of the Free University Hospital, Amsterdam.
      Patients with tumour at the margins were excluded. Recurrence-free curves were
      calculated according to Kaplan-Meier and the log rank test was used to test the
      differences. All patients underwent a comprehensive neck dissection and were
      irradiated postoperatively when three or more tumour-positive nodes or extranodal
      spread were reported by the pathologist. Endpoint for analysis was occurrence of
      an ipsilateral neck recurrence or of a distant metastasis. Figures were corrected
      for a simultaneous recurrence at a higher level. A total of 29 neck recurrences
      (7.2%; n = 523) and 26 distant metastases (10.7%; n = 281) were demonstrated in
      the 5-year follow-up period. The number of positive nodes was of prognostic
      significance for both events (p = 0.039 and p = 0.0027). Extranodal spread was
      shown only to increase the incidence of distant metastases (p = 0.017), whereas
      its prognostic value with regard to recurrence in the neck was nullified by the
      strict institution of postoperative radiotherapy. It is recommended to give
      radiotherapy to patients with two positive nodes and possibly to every patient
      with a histopathologically positive neck.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736143
TI  - [Prognostic factors for the survival time in gallbladder carcinoma].
AB  - Survival of 74 patients with proven gallbladder carcinoma was studied
      retrospectively. Initial treatment consisted of cholecystectomy, cholecystectomy
      and common bile duct exploration, bypass procedure (hepatojejunostomy) or
      laparotomy and biopsy or percutaneous biliary drainage. Staging (according to the
      American Joint Committee on Cancer) was the most important determinant for
      survival (chi 2 = 29.34; df 3; p less than 0.001). Most individual complaints
      such as pain (chi 2 = 1.66;), nausea/vomiting (chi 2 = 0.35), and palpable mass
      (chi 2 = 2.62) were not related significantly with survival. However cachexia
      (chi 2 = 17.12; df I; p less than 0.001) was correlated with decreased survival.
      Establishing the diagnosis preoperatively was associated with significantly
      shorter survival (chi 2 = 22.67; df I; p less than 0.001) than establishment at
      the moment of hospitalisation. In a hospital where a radical surgical treatment
      is not performed, less invasive non surgical therapy (insertion of an
      endoprosthesis) could probably be considered for this group of patients. Selected
      patients should be referred to a centre for a radical surgical approach.

PMID- 1736144
TI  - [Function-oriented budgeting and budget-oriented functioning].

PMID- 1736145
TI  - [Dilemmas in the diagnosis and treatment of spinal epidural metastases].

PMID- 1736146
TI  - [Dilemmas in the diagnosis and treatment of spinal epidural metastases].

PMID- 1736147
TI  - [Echography in the 1st pregnancy trimester is prognostically valuable].

PMID- 1736148
TI  - [Echography in the 1st pregnancy trimester is prognostically valuable].

PMID- 1736149
TI  - [Conform breathing sounds].

PMID- 1736150
TI  - [Transient ischemic attacks, non-invalidating brain infarcts and the prevention
      of worse: current findings on treatment].

PMID- 1736151
TI  - [30 mg acetylsalicylic acid per day is equally effective as 238 mg in patients
      following a transient ischemic attack or a non-invalidating brain infarct, and
      with fewer side effects].

PMID- 1736152
TI  - Assessment: techniques associated with the diagnosis and management of sleep
      disorders. Report of the Therapeutics and Technology Assessment Subcommittee of
      the American Academy of Neurology.
AB  - Polysomnography and measurements of physiologic sleepiness (MSLT/MWT) have been
      established as effective and safe in identifying many sleep/wake disorders, and
      have identified and defined a number of specific conditions such as SDB,
      narcolepsy, idiopathic CNS hypersomnia, periodic movements of sleep, and the REM
      sleep behavior disorder. The performance of these studies requires specialized
      equipment and accommodations. This technology, coupled with other clinical
      information and appropriate medical tests, particularly in experienced hands, is
      valuable in the diagnosis, classification, and treatment of patients with sleep
      disorders.

PMID- 1736153
TI  - The unexpected benefit of stealth.

PMID- 1736154
TI  - Imagery mnemonics and memory remediation.
AB  - This paper evaluates the claim that imagery mnemonic techniques are useful in
      remediation of memory disorders in brain-damaged patients. Clinical research has
      confirmed that such techniques can lead to improved performance on formal testing
      in a number of neurologic disease populations and following lesions of either the
      left or right hemisphere. However, those patients with more severe forms of
      amnesia and those with medial or bilateral damage do not improve unless the
      learning task is highly structured. Even among patients who show improvement on
      formal testing, there is little evidence that they maintain the use of these
      techniques in similar learning tasks or generalize the use to new learning
      situations. Imagery mnemonics also appear to be of little practical value in the
      daily activities that are of most concern to brain-damaged patients themselves.
      The effectiveness of imagery mnemonics appears to depend upon the patients'
      motivation and insight rather than upon their intelligence or educational level.
      Instead of training patients in specific mnemonic techniques, clinicians should
      promote the development of "meta-cognitive" skills and the acquisition of
      knowledge about domains of practical significance.

PMID- 1736155
TI  - Alzheimer's disease transmission: possible artifact due to intercurrent illness.

PMID- 1736156
TI  - Type and extent of hemispheric brain infarctions and clinical outcome in early
      and delayed middle cerebral artery recanalization.
AB  - We evaluated the influence of time of recanalization or degree of initial
      leptomeningeal collateral blood flow in cardioembolic or arterio-arterial middle
      cerebral artery (MCA) occlusion on infarct size and clinical outcome in a series
      of 34 consecutive acute stroke patients with main stem (N = 31) or major branch
      (N = 3) occlusions using CT, initial cerebral arteriography (N = 21), repetitive
      close-meshed transcranial Doppler ultrasonography, and a neurologic stroke scale.
      We treated 15 patients with tissue plasminogen activator intravenously within the
      first 6 hours. The type and size of infarction depended on the location of the
      occluding lesions within the MCA trunk. Proximal MCA occlusion always led to
      infarction involving the striatum and internal capsule. Sixty-five percent of
      patients showed recanalization of the occluded MCA within 1 week. Following MCA
      recanalization, hyperperfusion was present in 38 to 44% of cases. There was a
      marginally significant relation between size of infarction on CT and
      recanalization time within the first 24 hours. The more rapidly recanalization
      occurred, the smaller the size of the infarct. When recanalization time was
      greater than 8 hours, the lesions always extended to the cortex. An additional
      good leptomeningeal collateral blood flow significantly reduced the size of the
      infarct and improved clinical outcome after 17 days and after 10 months. Early
      recanalization of embolic MCA occlusions within up to 8 hours, in conjunction
      with good transcortical collateralization, has a favorable impact on infarct size
      and outcome and may constitute the therapeutic window of opportunity.

PMID- 1736157
TI  - Infarcts with a cardiac source of embolism in the NINDS Stroke Data Bank:
      neurologic examination.
AB  - To gain insight into neurologic signs relevant to the diagnosis of cardiogenic
      embolism, we analyzed data from 1,290 patients with cerebral infarcts in the
      NINDS Stroke Data Bank. Based solely on the presence of potential cardiac sources
      of embolism, we divided patients into groups of high (N = 250), medium (N = 167),
      and low (N = 873) risk of a cardiogenic mechanism for their stroke. Diminished
      level of consciousness was highly associated with the presence of a cardiac
      source of embolism. Of the four primarily cortical deficits assessed, three
      (visual field abnormalities, neglect, and aphasia) showed a highly significant
      graded relationship to the cardiac risk groups. For the fourth cortical deficit
      (other nonlanguage cognitive functions), this relationship did not attain
      statistical significance. Conversely, hemiparesis without sensory or cortical
      deficits had a strong inverse association to the presence of a cardiac source of
      embolism. This inverse association was weaker for sensorimotor strokes and
      nonexistent for pure sensory strokes. Although some neurologic findings had
      highly significant associations with the presence of a cardiac source of
      embolism, their predictive value for an embolic source was low.

PMID- 1736158
TI  - Fatal familial insomnia: clinical and pathologic study of five new cases.
AB  - In 1986, we reported two anatomoclinical observations of a familial condition
      that we called "fatal familial insomnia" (FFI). We now present the pedigree as
      well as the clinical and neuropathologic findings in five new subjects. The
      pedigree includes 288 members from six generations. Men and women are affected in
      a pattern consistent with an autosomal dominant inheritance. The age of onset of
      the disease varies between 37 and 61 years; the course averages 13 months with a
      range of 7 to 25 months. Progressive insomnia (polygraphically proven in two
      cases); autonomic disturbances including hyperhidrosis, hyperthermia,
      tachycardia, and hypertension; and motor abnormalities including ataxia,
      myoclonus, and pyramidal dysfunction, were present in every case, but with
      variable severity and time of presentation. Sleep and autonomic disorders were
      the earliest signs in two subjects, motor abnormalities were dominant in one, and
      others had intermediate clinical patterns. Pathologically, all the cases had
      severe atrophy of the anterior ventral and mediodorsal thalamic nuclei. Other
      thalamic nuclei were less severely and inconsistently affected. In addition, most
      of the cases had gliosis of the cerebral cortex, a moderate degree of cerebellar
      atrophy with "torpedoes," and severe atrophy of the inferior olivary nuclei. One
      case also showed spongy degeneration of the cerebral cortex. We conclude that all
      the lesions were primary, and that FFI is a multisystem disease in which the
      different structures are primarily affected with different severity. The insomnia
      appears to correlate best with the major thalamic pathology. The possibility that
      FFI belongs to the group identified as prion diseases or diseases transmitted by
      unconventional agents is examined.

PMID- 1736159
TI  - Diminished curiosity in patients with probable Alzheimer's disease as measured by
      exploratory eye movements.
AB  - Clinical accounts of Alzheimer's disease (AD) suggest that some patients exhibit
      markedly diminished curiosity and initiative early in the course of their
      illness. Such behavioral changes are extremely difficult to measure
      experimentally. We studied one aspect of curiosity by measuring exploratory eye
      movements in response to provocative visual stimuli in 12 patients with probable
      AD and 10 matched controls. Subjects viewed slides, each of which contained an
      incongruous or irregular figure paired with a congruous or regular one. Unlike
      controls, who spent significantly more time viewing the incongruous stimuli, AD
      patients distributed their viewing time equally and spent significantly less time
      than controls looking at the novel stimuli. Additionally, when presented with
      picture slides containing an unexpected element, AD patients exhibited diminished
      visual exploration overall and decreased attention to the incongruous part.
      Further analyses suggest that the results cannot be adequately explained by a
      general decline in cognition or by problems with ocular motility or directing
      visual attention. We conclude that AD patients exhibit diminished curiosity which
      can be measured by the study of exploratory eye movements.

PMID- 1736160
TI  - Interrater reliability in the neuropathologic diagnosis of Alzheimer's disease.
AB  - Three neuropathologists evaluated brain sections from 43 aged subjects for the
      presence of Alzheimer's disease. Moderate-to-substantial agreement was obtained.
      After discussion of disparate diagnoses, agreement was almost perfect for
      standardized and substantial for personal criteria. We conclude that
      reproducibility can be improved if diagnoses based on standardized criteria are
      discussed by at least two neuropathologists.

PMID- 1736161
TI  - Motor blocks in Parkinson's disease.
AB  - Freezing episodes and related phenomena (as a general term, motor blocks [MBs])
      are poorly understood, particularly disabling, and a therapeutically frustrating
      problem in Parkinson's disease (PD). Epidemiologic and clinical characteristics
      of MBs, as well as risk factors to develop MBs, have never been fully addressed.
      Herein, we report our database survey on 990 PD patients, of whom 318 (32%) had
      MBs. The majority of MBs were linked to gait. Start hesitation occurred in 86%,
      blocking on turning in 45%, and blocking in narrow spaces in 25% of patients.
      Initial parkinsonian symptoms in the upper body and tremor as the initial motor
      symptom were less likely to be associated with the presence of MBs (odds ratios
      [OR] 0.6 and 0.7, respectively), while initial symptoms affecting gait or trunk
      had higher association with MBs (OR = 1.58). Longer disease duration, higher
      Hoehn and Yahr stage, and longer duration of levodopa treatment are all
      significantly associated with the presence of MBs. We observed significant
      association between the existence of MBs and levodopa-induced dyskinesias to
      suggest similar pathophysiology. We propose that MBs in PD are abnormal retrieval
      or execution of complex motor tasks that can occur as a result of disease
      progression or as short- or long-term side effects of levodopa treatment.

PMID- 1736162
TI  - Selegiline as initial treatment in de novo parkinsonian patients.
AB  - To investigate the efficacy and safety of selegiline in the early phase of
      Parkinson's disease (PD), we carried out a placebo-controlled, double-blind,
      parallel trial. De novo PD patients were randomized to receive either selegiline
      (10 mg/d) or matching placebo. We continued selegiline or placebo until levodopa
      therapy became necessary and assessed the disability using three different rating
      scales at baseline, after 3 weeks, at 2, 4, 8, and 12 months, and at every 4
      months thereafter. Fifty-two patients were eligible for the analysis, 27 in the
      selegiline group and 25 in the placebo group. The median duration of time before
      levodopa had to be initiated was 545 +/- 90 days with selegiline and 372 +/- 28
      days with placebo (p = 0.03). Disability was significantly less in the selegiline
      group than in the placebo group up to 12 months. The period of time during which
      the mean total Columbia University Rating Scale score stayed below the baseline
      was used to express the initial symptomatic effect of the treatments. The
      difference in this initial improvement time between the two groups was about 3
      months and did not alone explain the difference in the delay of the need to start
      levodopa therapy. Selegiline was well tolerated and there were no severe side
      effects. We conclude that selegiline delays the need to start levodopa in de novo
      PD patients, has symptomatic efficacy, and possibly retards the progression of
      the disease.

PMID- 1736163
TI  - Autosomal dominant spinocerebellar ataxia: locus heterogeneity in a Nebraska
      kindred.
AB  - SCA1 is an adult-onset autosomal dominant ataxia that is genetically linked to
      loci on chromosome 6p. A highly informative GT-repeat marker, D6S89, has been
      closely linked to the SCA1 locus in five large kindreds. We have used this marker
      to perform linkage analysis in a smaller autosomal dominant ataxia family
      consisting of five generations designated as the Nebraska kindred. This kindred
      includes 33 affected (12 living) and 40 first-generation at-risk individuals. We
      examined eight affected individuals; all had gait and limb ataxia. We analyzed
      the D6S89 locus by the polymerase chain reaction. Based on the analysis of 31
      individuals from this kindred, we statistically excluded linkage to D6S89 for
      moderate-to-tight linkage (less than 11% recombination). These data clearly
      demonstrate genetic heterogeneity among the autosomal dominant ataxias. In
      addition, we obtained linkage data for HLA-A and SCA1 in this kindred. Comparison
      of HLA-A with D6S89 shows the latter marker to be more powerful. Use of D6S89 and
      other highly polymorphic markers in this region will greatly facilitate genetic
      classification of ataxias and make presymptomatic diagnosis of SCA1 feasible.

PMID- 1736164
TI  - Immunosuppression promotes CNS remyelination in chronic virus-induced
      demyelinating disease.
AB  - Immunosuppression using cyclophosphamide or anti-T cell monoclonal antibodies
      (mAbs) directed at CD4 or CD8 promoted remyelination of CNS axons in the spinal
      cords of mice infected chronically with Theiler's virus. Treatment with a mAb
      directed at class II major histocompatibility gene products did not increase the
      extent of CNS remyelination. Following immunosuppressive treatment, quantitative
      morphometry revealed a five- to sevenfold increase in new myelin synthesis.
      Proliferating nervous system cells were identified at the edges of remyelinated
      lesions by their incorporation of [3H]thymidine. CNS remyelination occurred in
      mice depleted of selected subsets of T lymphocytes despite the local persistence
      of viral antigen. These findings indicate that CNS remyelination occurs as a
      normal consequence of primary myelin injury, but factors associated with immune T
      cells somehow impair remyelination. Interference with the function of immune T
      cells enhances CNS remyelination by oligodendrocytes. Similar depletion of immune
      T cells may allow for enhanced remyelination in the CNS of patients with chronic
      multiple sclerosis.

PMID- 1736165
TI  - Elevated CSF beta-endorphin immunoreactivity in Rett's syndrome: report of 158
      cases and comparison with leukemic children.
AB  - Because some symptoms of Rett's syndrome are suggestive of excessive endogenous
      opioid activity, we measured the levels of beta-endorphin-like immunoreactivity
      in lumbar CSF from 158 affected female patients and from 13 female controls. The
      mean (+/- SE) control level of beta-endorphin immunoreactivity in CSF was 35.3 +/
      2.8 pg/ml (range, 23 to 48 pg/ml), whereas those with Rett's syndrome had a mean
      level of 95.3 +/- 3.6 pg/ml (range, 31 to 293 pg/ml). The levels of beta
      endorphin immunoreactivity in initial CSF samples exceeded the control range in
      90% of the patients with Rett's syndrome. The mean beta-endorphin
      immunoreactivity was also elevated in CSF from leukemic children (119.2 +/- 16.9
      pg/ml; range, 40 to 159 pg/ml), relative to the control group. These results are
      consistent with the hypothesis that some symptoms of Rett's syndrome may be
      associated with excessive endogenous opioid levels in the CNS.

PMID- 1736166
TI  - The expression of a cerebellar degeneration-associated neural antigen in human
      tumor line cells.
AB  - We examined the expression of the paraneoplastic cerebellar degeneration
      associated autoantigen (PCD-AA) protein in human tumor lines of different origins
      by using an immunoaffinity-purified antibody from a patient with paraneoplastic
      cerebellar degeneration (PCD) and uterine adenocarcinoma. Immunocytochemical
      studies revealed that this antigen is expressed in the cytoplasm of two different
      uterine carcinoma lines and the tumor lines of neural origin as well as in the
      cytoplasm of a normal skin fibroblast line. By immunoblot analysis, we detected a
      52-kd antigen identical to the PCD-AA protein in all the cell lines studied,
      including a colon adenocarcinoma line, a small-cell lung carcinoma line, and a
      squamous cell lung carcinoma line. These results indicate that the PCD-AA protein
      is expressed in a wide range of tumor cells. In this respect, this antigen is
      distinguishable from the cerebellar degeneration-related--34 antigen, of which
      expression is confined to tumor lines of neuroectodermal origin and not detected
      in colon, breast, or ovarian carcinoma lines derived from patients without PCD.
      These findings suggest the variability of the immune response to antigens in PCD.

PMID- 1736167
TI  - Very-late-onset adrenoleukodystrophy: possible precipitation of demyelination by
      cerebral contusion.
AB  - We report the clinical history, neuroradiology, and autopsy findings in a patient
      with very late onset, at age 57, of adrenoleukodystrophy (ALD) presenting with
      dementia, hemianopia, and gait apraxia. Open brain biopsy, elevated plasma very
      long-chain fatty acids, and autopsy confirmed the diagnosis of ALD. Demyelinative
      lesions were most extensive at the site of a recent cerebral contusion. CNS
      trauma may have precipitated or accelerated demyelination in this patient
      carrying the ALD gene.

PMID- 1736168
TI  - Dystonia, clinical lateralization, and regional blood flow changes in temporal
      lobe seizures.
AB  - We analyzed the lateralizing value of ictal dystonia and head-turning in temporal
      lobe epilepsy, and sought the biologic basis of these clinical signs by studying
      the regional changes in perfusion with ictal single-photon emission computed
      tomography (SPECT). We identified unilateral temporal lobe epilepsy in 40 of 42
      patients undergoing evaluation for temporal lobe surgery, and with ictal SPECT
      all 40 showed striking hyperperfusion of the epileptogenic temporal lobe. Twenty
      five of the 40 patients showed unilateral or predominantly unilateral upper limb
      dystonia, which was opposite the epileptic temporal lobe in all cases. Analysis
      of regional count ratios in cases with ictal dystonia, compared with those
      without, showed significant changes only in the basal ganglia. Specifically, we
      found that ictal dystonia was associated with a relative increase in perfusion of
      the basal ganglia opposite the dystonic limb. Although we found 26 cases with
      head-turning, the sign was of no lateralizing value, even when only those with
      major or "tonic" versions (n = 11) were analyzed. Slight increases in cortical
      blood flow on the side opposite the direction of version were associated with
      head-turning, irrespective of the side of seizure focus. In clinical practice,
      ictal SPECT is a highly accurate aid in the lateralization of temporal lobe foci,
      in addition to providing a new method to investigate the pathophysiology of
      clinical signs in focal seizures.

PMID- 1736169
TI  - Magnetic resonance demonstration of intracranial CSF flow in children.
AB  - We determined the feasibility and value of studying intracranial CSF flow in
      children with potential CSF pathway problems using a cardiac gated cine magnetic
      resonance (MR) format. We studied 15 consecutive patients with a variety of
      clinical problems that suggested possible CSF pathway problems. The diagnoses
      included Chiari malformation, Dandy-Walker syndrome, external hydrocephalus,
      cerebellar tumor, CNS histoplasmosis, and tuberculous meningitis. In addition to
      documenting the feasibility of the technique in children (7 of 15 were less than
      2 years of age), we derived significant new information relative to pathogenesis
      and/or therapy. The study provides preliminary evidence supporting intracranial
      CSF flow studies at the time of routine MR imaging of appropriate children.

PMID- 1736170
TI  - Nicotine-sensitive paresis.
AB  - Immediately after a patient with myoclonus epilepsy smoked a nicotine-containing
      cigarette, tetraparesis and hyperreflexia with ankle clonus developed, but
      disappeared within several minutes. During paresis, the H-reflex size of the
      soleus muscle increased, EEG showed more slow waves than before smoking, and the
      cerebral perfusion increased around the motor cortex as shown by single photon
      emission CT. A similar effect occurred when the patient chewed nicotine gum, and
      smoking a cigarette with a high nicotine content induced severe positive and
      negative myoclonus after the development of tetraparesis. Administration of the
      C6-type nicotinic antagonist mecamylamine not only countered the smoking effect,
      but ameliorated the spontaneous positive and negative myoclonus. Mecamylamine may
      prove useful for the treatment of positive and negative myoclonus in myoclonus
      epilepsy.

PMID- 1736171
TI  - Epilepsy due to neurocysticercosis: analysis of 203 patients.
AB  - We reviewed clinical, EEG, and CT findings of 203 patients with epilepsy due to
      neurocysticercosis. Seizures were generalized in 121 patients and partial in 82.
      Thirty-two patients had focal signs and eight had papilledema. Eighty-one had
      generalized and 16 had focal EEG abnormalities. CT showed parenchymal brain
      calcifications in 53 patients and cysts in 150. There was an increased rate of
      focal signs in patients with single cysts as compared with patients with multiple
      cysts, and focal EEG abnormalities were present only in patients with single
      cysts. Fifty patients were lost to follow-up. The remaining 153 patients were
      followed for 28 +/- 6 months; of these, 31 had calcifications and 122 had cysts.
      Anticonvulsants were started after the first visit in every patient. The 31
      patients with calcifications remained free of seizures. Ninety-five of the 122
      patients with cysts were also treated with anticysticercal drugs; of these, 79
      (83%) had control of seizures. In contrast, only seven (26%) of 27 patients who
      did not receive anticysticercal drugs had control of seizures, indicating a
      strong correlation between the use of anticysticercal drugs and seizure control.
      Finally, of the 21 patients in whom anticonvulsants were withdrawn, 16 had
      relapses.

PMID- 1736172
TI  - Migraine, suicidal ideation, and suicide attempts.
AB  - We examined the risk of suicide attempts and suicidal ideation separately in
      persons with (1) migraine with aura alone, (2) migraine with aura and coexisting
      major depression, (3) migraine without aura alone, and (4) migraine without aura
      and coexisting major depression. Persons with migraine with aura alone and
      migraine with aura and coexisting major depression had significantly higher rates
      of suicide attempts and suicidal ideation compared with persons with neither
      migraine nor major depression. The rates of suicide attempts and suicidal
      ideation in persons with migraine with aura and major depression were higher than
      the combined rates in persons with major depression alone and migraine with aura
      alone. In contrast, migraine without aura was not associated with an increased
      risk for suicide attempts and suicidal ideation.

PMID- 1736173
TI  - Memory function in normal aging.
AB  - We evaluated memory function in a group of 161 community-dwelling, cognitively
      normal individuals aged 62 to 100 years recruited as part of the Mayo Clinic
      Alzheimer's Disease Patient Registry. We used the Free and Cued Selective
      Reminding Test and the Rey Auditory Verbal Learning Test to evaluate two aspects
      of memory function thought to be sensitive to the effects of aging: learning
      (acquisition) and delayed recall (forgetting). The results were quite consistent
      and demonstrated that learning or acquisition performance declines uniformly with
      increasing age but is not related to education. Delayed recall or forgetting,
      however, remained relatively stable across age when adjusted for the amount of
      material initially learned. These findings are relevant for assessing normal
      memory function relative to the early impairments found in dementia and form a
      baseline against which memory performance can be assessed by the clinician. In
      particular, suspicion regarding a disorder of brain function affecting memory
      processes should be raised if learning performance declines more rapidly than
      expected or if delayed recall is impaired to any significant extent.

PMID- 1736174
TI  - Tremor in MPTP-induced parkinsonism.
AB  - We assessed clinical and electrophysiologic characteristics of tremor in patients
      with parkinsonism induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP).
      Four of seven patients with moderate to severe MPTP-induced parkinsonism
      exhibited a tremor indistinguishable from the characteristic rest tremor of
      Parkinson's disease (PD). The pathology induced by MPTP in one human case is
      confined to the substantia nigra, but in nonhuman primates, the locus ceruleus or
      the ventral tegmental area can also be affected. These findings suggest that the
      pathophysiology of rest tremor in PD might result from damage to either the
      substantia nigra alone or in combination with damage to one or more of these
      other regions.

PMID- 1736175
TI  - Dopamine-receptor autoradiography of human narcoleptic brain.
AB  - Although the pathology of human narcolepsy is unknown, studies of human and
      canine narcolepsy have suggested that dopamine metabolism may be disturbed. We
      used quantitative autoradiography to assess dopamine D1- and D2-receptor binding
      in basal ganglia and amygdala of five narcoleptic and 17 control human brains. In
      caudate, narcoleptic brains had a statistically significant increase of 57% in D1
      receptor binding, and large but not significant increases of 54% in medial globus
      pallidus D1 binding, 63% in caudate D2-receptor binding, 95% in lateral globus
      pallidus D2 binding, and 93% in lateral amygdala D2 binding. We found no major
      changes in the putamen or in the basal or accessory basal nuclei of the amygdala.
      These results suggest that narcolepsy is associated with upregulation of dopamine
      receptors in specific areas of the brain, although medications used prior to
      death may have contributed to the findings.

PMID- 1736176
TI  - A noninvasive protocol for anterior temporal lobectomy.
AB  - We report the results of a protocol for choosing candidates for temporal
      lobectomy using a standard battery of objective tests without intracranial
      electrodes. We assigned each test a level of importance, and an algorithm was
      used to determine whether temporal lobectomy could be performed. Fifty-one
      patients (total pool, 103 patients) met protocol requirements and had an anterior
      temporal lobectomy with a mean follow-up of 39.4 months (range, 21 to 64 months),
      most remaining on anticonvulsant therapy. Eighty percent are seizure free, 12%
      have less than 3 seizures per year or only nocturnal seizures, and 8% have
      greater than 80% reduction in seizure frequency. One-third of patients who failed
      protocol criteria did not have temporal lobe seizures when studied with
      intracranial electrodes. We analyzed and modified the algorithm after comparing
      these patients with others who were poor candidates for temporal lobectomy. We
      conclude that this protocol is effective and recommend using such an objective
      algorithm.

PMID- 1736177
TI  - Atypical Creutzfeldt-Jakob disease in an American family with an insert mutation
      in the PRNP amyloid precursor gene.
AB  - An American family of English origin with an unusually early onset and long
      duration form of Creutzfeldt-Jakob disease (CJD) had a heterozygous insert
      mutation in the region of repeating octapeptide coding sequences between codons
      51 and 91 of the PRNP gene on chromosome 20. Affected members were 23 to 35 years
      old at the onset of illnesses that lasted from 4 to 13 years, yet experimental
      transmission of disease from the proband (11-year duration) produced a typically
      brief incubation period and duration of illness in each of three inoculated
      primates. Also, the PrP amyloid protein that accumulates in CJD brain was only
      barely detectable in extracted brain tissue from one case with massive spongiform
      change and was undetectable in another case with no spongiform change, perhaps
      because of epitope shielding by a configurational change in the protein induced
      by the mutation. Analysis of this and other families with similar inserts
      suggests that such mutations in the PRNP gene not only predispose to CJD, but
      also modify its phenotypic expression.

PMID- 1736178
TI  - Cognitive functioning in cancer patients: effect of previous treatment.
AB  - Neuropsychological analysis of 47 cancer patients with widely metastatic disease
      and significant previous treatment indicated that 34% had cognitive deficits.
      Previous treatment with biologic response modifiers was associated with a 53%
      frequency of cognitive abnormalities, whereas only 18% of patients who were never
      treated with biologics had such impairments. The possibility that neurobehavioral
      abnormalities will result from metastatic disease and treatment regimens is an
      important factor in determining the risks and benefits of therapy.

PMID- 1736180
TI  - Coma with triphasic wave pattern in EEG as a complication of temporal arteritis.
AB  - Coma is rare in temporal arteritis (TA). We describe a patient with TA who
      suddenly developed coma with a triphasic EEG pattern that resolved after
      initiation of steroid treatment. Although the arterial lesions in TA are
      segmental in nature, TA may present with signs of diffuse neurologic deficit;
      early treatment can result in complete resolution.

PMID- 1736179
TI  - Toxoplasmosis with early intracerebral hemorrhage in a patient with the acquired
      immunodeficiency syndrome.
AB  - Cerebral hemorrhage is a rare complication of the acquired immunodeficiency
      syndrome. We report a case of multifocal hemorrhage in a 37-year-old homosexual
      man with cerebral toxoplasmosis. Histopathologic examination, performed at
      cerebral autopsy, confirmed the findings on CT and MRI.

PMID- 1736181
TI  - Longitudinal study of essential tremor.
AB  - We measured wrist tremor and forearm EMG in 18 patients with essential tremor on
      two occasions separated by periods of 4 to 8 years. The frequency of tremor
      decreased 0.28 Hz to 3.21 Hz in 10 patients and changed less than 0.25 Hz in the
      remaining eight patients. Thus, the frequency of essential tremor may decrease
      over time.

PMID- 1736182
TI  - Periodic triphasic waves in levodopa-induced encephalopathy.
AB  - Four patients with idiopathic Parkinson's disease developed subacute confusional
      states, associated with delusions, hallucinations, and myoclonus, following an
      increase in the dose of levodopa. The EEG revealed periodic generalized triphasic
      waves. The clinical condition and EEG cleared following levodopa dose reduction
      or discontinuation. This is the first report of encephalopathy associated with
      periodic triphasic activity following levodopa treatment.

PMID- 1736183
TI  - Anti-inflammatory agents as a therapeutic approach to Alzheimer's disease.
AB  - Postmortem analyses of Alzheimer's disease (AD) brain tissue reveal reactive
      microglia expressing high levels of major histocompatibility complex (MHC)
      glycoproteins, immunoglobulin receptors, and complement receptors; small but
      significant numbers of T-lymphocytes infiltrating tissue; enhanced cytokine and
      cytokine receptor expression; and profuse immunoreactivity for complement
      proteins of the classic pathway colocalized with senile plaques, dystrophic
      neurites, and some neurofibrillary tangles. Protectin, clusterin, and
      vitronectin, three proteins designed to defend host cells against "bystander
      lysis" caused by the membrane attack complex of complement, are all expressed at
      high levels in AD tissue but not in normal tissue. Taken together, these findings
      indicate that immune-mediated autodestructive processes may occur in AD. In view
      of the urgency to find treatments for AD and disappointing results with the many
      classes of pharmacologic agents that have so far been given clinical trials,
      exploration of the effectiveness of anti-inflammatory agents may now be
      warranted.

PMID- 1736184
TI  - The history of the blink reflex.

PMID- 1736185
TI  - Robert Boyle and a corpuscular model of tremor.

PMID- 1736186
TI  - Paralysis of fourth cranial nerve due to superior-cerebellar artery aneurysm.

PMID- 1736187
TI  - Acute ventricular dilatation in adult meningococcal meningitis.

PMID- 1736188
TI  - Acute encephalopathy associated with the eosinophilia-myalgia syndrome.

PMID- 1736189
TI  - Creutzfeldt-Jakob disease in a pathologist.

PMID- 1736190
TI  - MS and syringomyelia.

PMID- 1736191
TI  - Hemorrhagic infarction.

PMID- 1736192
TI  - Nurses must change society ...

PMID- 1736193
TI  - Reference list dated.

PMID- 1736194
TI  - Structure decision-making & authority systems.

PMID- 1736195
TI  - Cost, standards, quality and technology.

PMID- 1736197
TI  - The art of "breaking set".

PMID- 1736196
TI  - Why executive information systems are important.

PMID- 1736198
TI  - Implications of RBRVS fees for RNs.

PMID- 1736199
TI  - Legislation introduces equal pay for nonphysician providers.

PMID- 1736200
TI  - A model for costing and pricing nursing service.

PMID- 1736201
TI  - Budget variance analysis and justification.

PMID- 1736202
TI  - Budget response to volume variability.

PMID- 1736203
TI  - Pediatric payors and providers.

PMID- 1736204
TI  - Director of nursing planning and finance: a new role.

PMID- 1736205
TI  - Psychiatric mental health nursing specialist process evaluation criteria.

PMID- 1736206
TI  - Goal-directed temporal plans of care.

PMID- 1736207
TI  - Evaluating readiness of recent graduates.

PMID- 1736208
TI  - Health issues: from rhetoric to reform.

PMID- 1736209
TI  - Costing two streamlined nursing procedures.

PMID- 1736210
TI  - Northern California's innovative recruitment efforts.

PMID- 1736211
TI  - Franciscan Children's Hospital goes wireless.

PMID- 1736212
TI  - CD-ROMs: libraries at your fingertips.

PMID- 1736213
TI  - Choosing a staffing agency.

PMID- 1736214
TI  - Befrienders: hospital volunteers at work.

PMID- 1736215
TI  - Education: learning the pitfalls of codependency.

PMID- 1736216
TI  - Disposables v. reusables in OR practice: Part I, Weighing contributions to
      patient care.

PMID- 1736217
TI  - Dentistry comes of age.

PMID- 1736218
TI  - Increasing knowledge of AIDS/HIV infection through continuing education.
AB  - A survey of dentists found significant differences among groups with varying
      amounts of continuing education with respect to knowledge about AIDS. These
      findings suggest focused continuing education may be beneficial.

PMID- 1736219
TI  - The incredible odontogenic keratocyst.
AB  - The aggressive behavior and high recurrence rate of the odontogenic keratocyst
      make it unique among odontogenic cysts. Successful treatment requires meticulous
      evaluation and diagnosis, proper surgical management and continued follow up.

PMID- 1736220
TI  - The sophisticated dental practitioner. General principles influencing diet,
      nutrition and human behavior.

PMID- 1736221
TI  - AIDS and the dental profession.

PMID- 1736222
TI  - Organized dentistry benefits young dentists too.

PMID- 1736223
TI  - And a Happy New Year.

PMID- 1736224
TI  - The other side of the story.

PMID- 1736225
TI  - Credit where due.

PMID- 1736226
TI  - Sterile surroundings.

PMID- 1736227
TI  - [The era of molecular genetics. New perspectives in hematology].
AB  - The unprecedently swift developments in molecular genetics opened up a new era in
      haematology. The regulation of the expression of globin genes and its
      coordination with the expression of genes coding for other red cell specific
      proteins, as well as molecular genetics of some intrinsic haemolytic anaemias and
      the clinically important recent results revealing the genetic regulation of iron
      metabolism are discussed. New unfolding concepts of the physiological regulation
      of the haemopoetic stem cell and the multistep development of its malignant
      transformation are reported. The unlimited possibilities rendered by the rDNA
      technology in diagnostics and therapy of haematological diseases is pointed out.
      The present state of art of gene therapy including the first trials with gene
      transplantation in humans is discussed.

PMID- 1736228
TI  - [Tumor necrosis factor production in septic conditions following pancreatitis
      (preliminary report)].
AB  - Detectable TNF levels in sera 33% of patients with sepsis following pancreatitis
      have been found. No correlation was observed between serum TNF concentration and
      the severity of illness. However, monocytes and granulocytes of septic patients
      exerted higher TNF-mediated cytotoxicity than leukocytes of normal blood donors.
      The in vitro TNF-producing capacity was also higher in the patients in the study
      group, and it decreased only before fatal outcoming of sepsis. Our results
      suggest that determination of the TNF-producing capacity of leukocytes might be
      more informative than measurement of the serum TNF level in the evaluation of the
      severity or prognosis of sepsis.

PMID- 1736229
TI  - [Experience with ciprofloxacin therapy of salmonellosis gastroenteritica].
AB  - Five days' ciprofloxacin treatment resulted quick clinical improvement in all of
      the 45 patients with salmonella gastroenteritis and stool cultures of 35 patients
      became negative. The advantages of ciprofloxacin treatment are analysed in
      comparison with previous antibiotics. Indications for new quinolones in the
      treatment of salmonella gastroenteritis are summarized. It is emphasized that
      antibiotic therapy is unnecessary in mild cases of salmonella gastroenteritis.
      This is demonstrated on the basis of case reports of 12 patients with symptomatic
      treatment too.

PMID- 1736230
TI  - [Relationship between weight increase during pregnancy and weight of the
      newborn].
AB  - The data of first 1000 first-born, non-malformed, mature (greater than or equal
      to 2500 g) offspring of participants in the Hungarian "Optimal" Family Planning
      Programme were evaluated. The mean maternal weight gain during pregnancy was 13
      kg which was modified by the body weight of women. Maternal weight gain exceeded
      13 kg in 54% of pregnant women. There was an obvious positive correlation between
      maternal weight gain and birth weight which was calculated as 26.6 g/kg.

PMID- 1736231
TI  - [Prinzmetal angina pectoris causing diagnostic and therapeutic problems].
AB  - A 53 year old patient was hospitalized because of retrosternal oppression which
      was unrelated to effort and recurred in the early morning hours. An esophageal
      diverticulum and a hiatal hernia were found. The patient had complaints in spite
      of medical therapy and an operation was performed because of his oesophageal
      disorders. After operation the patient had the same pain. A cardiologist was
      asked, who suggested Prinzmetal variant angina. During arteriography coronary
      artery disease was found. Coronary bypass surgery was indicated and performed,
      after that procedure the patient was and remained free of any complaints. This
      observation reaffirmed Prinzmetal original statement "The key to the diagnosis
      ... is the taking of a painstaking history".

PMID- 1736232
TI  - [In memoriam Antal Rozsas].

PMID- 1736233
TI  - [Bone marrow transplantation and its status in Hungary].

PMID- 1736234
TI  - [Pathomechanism of tetany reaction].

PMID- 1736235
TI  - [Surrogate motherhood or nursing-mother pregnancy].

PMID- 1736236
TI  - [Follow up studies on patients with Buerger's disease treated with omentum
      transplantation].

PMID- 1736237
TI  - [Results of cholesterol screening in Budapest].

PMID- 1736238
TI  - [Possibilities of preventing alopecia after cytostatic therapy].

PMID- 1736239
TI  - [The non-ulcer dyspepsia syndrome].

PMID- 1736240
TI  - Pathology annual: nineteen ninety-two. Part I.

PMID- 1736241
TI  - Adrenal cortical neoplasms in the pediatric and adolescent age group.
      Clinicopathologic study of 30 cases with emphasis on epidemiological and
      prognostic factors.

PMID- 1736242
TI  - Transmucosal needle aspiration biopsy via the fiberoptic bronchoscope. Value and
      limitations in the cytodiagnosis of tumors and tumor-like lesions of the lung.

PMID- 1736243
TI  - A pathologist's perspective on the sudden infant death syndrome--1991.

PMID- 1736244
TI  - Invasive lobular carcinoma of the breast. The importance of an alveolar growth
      pattern.

PMID- 1736245
TI  - What is intestinal neuronal dysplasia?

PMID- 1736246
TI  - Oncocytes, oncocytosis, and oncocytic tumors.

PMID- 1736247
TI  - Ploidy analysis and cerebrospinal fluid nephelometry as measures of clinical
      outcome in childhood choroid plexus neoplasia.

PMID- 1736248
TI  - Solitary rectal ulcer syndrome. Mucosal prolapse syndrome.

PMID- 1736249
TI  - Histological criteria for the diagnosis of reflux esophagitis.

PMID- 1736250
TI  - The organization and delivery of clinical genetics services.
AB  - Advances in genetics, including mapping the human genome, improved therapy for
      genetic disorders, recognition of the role of genetic factors in common diseases
      of adulthood, and new screening tests for carrier detection and presymptomatic
      diagnosis create an increased demand for and awareness of clinical genetic
      services. These services, focusing on diagnosis, management, and genetic
      counseling, had been supported by a variety of state, provincial, federal, and
      foundation grants. As clinical genetics has evolved from a service with roots in
      research provided solely at academic medical centers to one widely available in
      the community, the services in the United States are increasingly provided on a
      fee-for-service basis in various settings including private hospitals, state
      supported outreach clinics, and free-standing genetics centers, whereas in Canada
      they are generally based in university hospital settings and are covered by
      universal health care. Given the limited numbers of clinical geneticists and
      genetic counselors now practicing, much of the application in this decade of new
      genetic technologies and knowledge will fall upon primary care physicians.

PMID- 1736251
TI  - Medical genetics I.

PMID- 1736252
TI  - Teratology in pediatric practice.
AB  - A range of infections, physical agents, maternal diseases and metabolic states,
      drugs, and chemicals have been demonstrated to be human teratogens. These agents
      cause structural or functional disabilities postnatally in exposed embryos and
      fetuses. Such disabilities are potentially totally preventable through public
      education and awareness. Pediatricians must be able to recognize potential
      teratogenic exposures, diagnose teratogenically-induced disabilities, and be
      knowledgeable in the natural history of these disorders so that they can support
      and educate those who care for these children in the home and in the community.

PMID- 1736253
TI  - Support groups for patients with genetic disorders and their families.
AB  - In conclusion, those working in pediatric clinics owe it to themselves to know
      about the relatively new team member, the genetic support group. As the human
      genome becomes less mysterious to professional and patient alike and as its
      demystification creates an ever-increasing number of ethical and social dilemmas,
      consumers and professionals, interested perhaps for different reasons in finding
      treatment and cure, must work together as partners. Availability of medical care
      for the family who must cope with a genetic disorder is only one part of the
      total health picture. Access to communication with and compassion of one family
      with another family, of one child with another child, of one parent with another
      parent, within a support group of caring persons, proves one of the most
      meaningful medical tools that pediatricians can offer their patients. Those
      working within the walls of the pediatric clinic are in a crucial place to
      address the comprehensive needs of families with genetic disorders and to
      identify the role of the genetic support group in a treatment plan.

PMID- 1736254
TI  - Dysmorphologic diagnosis for the pediatric practitioner.
AB  - Attaining an accurate diagnosis in children with congenital abnormalities is an
      important and sometimes vital part of their care. With a basic knowledge of the
      types and causes of birth defects, the pediatric clinician often can arrive at a
      correct diagnosis, even in children with rare syndromes or multiple anomalies.
      This article reviews the four major mechanisms that produce congenital defects,
      discusses the various types and subtypes of structural anomalies, and provides an
      algorithmic approach to their diagnosis.

PMID- 1736255
TI  - Pregnancy loss, stillbirth, and neonatal death. A guide for the pediatrician.
AB  - The complete clinical evaluation of pregnancy loss, stillborn infants, and
      neonatal deaths can result in the anticipation of an accurate diagnosis in a high
      percentage of cases. Appropriate focused fetal studies may include a clinical
      examination, fetal karyotype, photographs, skeletal radiographs, fetal autopsy,
      examination of the placenta and cord, and occasionally cultures or DNA studies.
      Knowledge of specific causes of fetal death and their clinical presentation can
      greatly assist the pediatrician in choosing the most appropriate studies. Many of
      the disorders leading to fetal death carry significant genetic recurrence risks,
      making an accurate diagnosis even more crucial. As our understanding of the
      causes of pregnancy loss improves, so does our ability to provide families with
      accurate counseling regarding their reproductive options.

PMID- 1736256
TI  - Ethnocultural approaches to genetics.
AB  - Human cultural needs are not easily categorized, studied, or taught to others
      outside the group. Generalizations about groups are made to increase the
      awareness of differences and commonalities. It is hoped that this increased
      sensitivity will serve as a catalyst for the individual to develop a greater
      awareness of the importance of culture in delivery of genetic services.

PMID- 1736257
TI  - Registries of birth defects and genetic diseases.
AB  - Registries can be very useful scorecards for tracking the occurrence of birth
      defects and genetic diseases and for monitoring the effectiveness of prevention
      programs. They can also help us to identify causes and risk factors and develop
      new prevention approaches. For registries to be useful, however, their data must
      be precise and focus on time, place, person, and diagnosis.

PMID- 1736258
TI  - Ethical issues in genetics.
AB  - Clinical genetics encompasses all ethical issues in medicine and health care.
      Geneticists, like all health care practitioners, regularly encounter problems of
      truth telling, paternalism, confidentiality, and rationing. The facts and
      circumstances under which familial ethical questions arise differ among
      specialties, but the underlying ethical questions cut across disciplines. The
      purpose of this article is to provide a review of the ethical issues that
      commonly arise in the clinical practice of genetics. Accordingly, the goal is
      primarily to identify common positions and justifications for various approaches
      as well as to identify consensus where they seem to exist.

PMID- 1736259
TI  - Genetic diagnosis based on molecular analysis.
AB  - This article presents the significant advances made in the area of applied
      molecular genetics in recent years. DNA analysis is now possible for a large
      number of single gene disorders. The type of testing available for those
      disorders most commonly dealt with by pediatricians is briefly outlined. Rapid
      advancement is expected to continue as new techniques are developed and mutations
      detected. This in turn will lead to extending DNA applications from the family
      with an affected child to using DNA for population screening of certain
      disorders.

PMID- 1736260
TI  - Prognosis in fetal tetralogy of Fallot.
AB  - The outcome in a series of 23 cases of tetralogy of Fallot diagnosed prenatally
      was compared to published figures for this condition when (a) identified
      postnatally or (b) treated surgically. There was a marked difference in the
      survival between these groups, with the highest mortality (75%) occurring when
      the diagnosis had been made prenatally. The high incidence of chromosomal and
      extracardiac anomalies in this group (60%) largely accounted for the discrepancy.
      This, and the potential for progressive changes in the anatomy of the defect
      during pregnancy, must be taken into account by the pediatric cardiologist
      offering prognosis in early pregnancy.

PMID- 1736261
TI  - Countercurrent aortography: an alternative to cardiac catheterization in infancy.
AB  - Countercurrent aortography via a peripheral artery was used to clarify the aortic
      arch anatomy in 25 infants in whom cross-sectional and Doppler evaluation was
      inconclusive. Ages ranged from 3 days to 11 months (median 9 days), and 80% were
      neonates. The suspected diagnosis was aortic coarctation in 21 infants,
      interrupted aortic arch in two, recoarctation in one, and vascular ring in one. A
      countercurrent aortogram provided adequate diagnostic information in 24 infants.
      A diagnosis of coarctation was confirmed in 15, interruption of the aortic arch
      in two, and vascular ring in one. In six infants countercurrent aortography
      excluded the presence of anomalies of the aortic arch. In only one infant, who
      had an anomalous origin of the right subclavian artery from the descending aorta,
      did this technique fail to provide adequate information. The only complication
      observed was transient ischemia of the arm in one patient. Countercurrent
      aortography is a minimally invasive procedure that can provide adequate
      angiographic information without the need for cardiac catheterization in patients
      with inconclusive echocardiographic evaluation. Injection into a right upper limb
      artery is preferred, because it gives better opacification of the ascending and
      transverse aortic arch than injection into a left one.

PMID- 1736262
TI  - Central venous catheterization in infants and children with congenital heart
      diseases: experiences with 500 consecutive catheter placements.
AB  - In a prospective study results of central venous catheter (CVC) placements in a
      consecutive group of 500 patients with less than 20 kg body weight undergoing
      cardiac surgery were evaluated. The incidence of previous cardiac surgery was 21%
      and the incidence of factors preventing the primary puncture of the right jugular
      or innominate vein was 13.4%. The anesthesiologists were free to select the
      catheterization technique, site of puncture, and catheter type. All CVC
      insertions were performed prior to surgery under continuous circulatory
      monitoring and optimal positioning of the anesthetized patient. Ninety-six
      percent of all catheterizations were successful, 81% of them on the first
      attempt. In the 4% of cases where catheterization failed, a CVC had to be placed
      by the surgeon. Of all catheters, 66% were positioned via the right internal
      jugular (IJV) or innominate vein (IV), 8% via the left, 16% via an external
      jugular vein (EJV), and 5% via other veins. Seventy-six percent of CVC insertions
      were performed with the Seldinger technique. Of the four catheter types used in
      this study, double lumen catheters were most frequently selected (38%). Placement
      of 22-ga single lumen catheters was preferred in infants with less than 5 kg body
      weight, in spite of their tendency to kink. Observed complications (10% arterial
      puncture, 4% hematoma, and 1% intrathoracic bleeding) never required immediate
      surgical intervention. Careful selection of appropriate catheters, as well as
      extensive experience and knowledge of the anatomical structures involved in
      special heart defects, helped to keep the risk of complications low.

PMID- 1736263
TI  - Echocardiographic evaluation of the aortic root and mitral valve in children and
      adolescents with isolated pectus excavatum: comparison with Marfan patients.
AB  - Pectus excavatum, mitral valve prolapse (MVP), and dilated aortic root occur
      frequently in patients with Marfan's syndrome (MS). Patients with isolated pectus
      excavatum (IPE) have a high prevalence of MVP, but it is not known whether aortic
      root dilatation is a risk in those patients. To test the hypothesis that IPE and
      MS represent a spectrum of connective tissue dystrophy with MV and aortic root
      involvement, two-dimensional (2D) echocardiography was used to measure the aortic
      root diameter and assess for MVP in IPE (n = 31), MS (n = 14), and normal (n =
      16) gender- and age-matched patients. Aortic root was measured in parasternal
      long- and short-axis views, just above the aortic sinuses, at end systole, in six
      cardiac cycles, and averaged. Parasternal long-axis view was used to assess for
      MVP. Aortic root diameter in IPE patients was not different from that in normal
      subjects, 24 +/- 4 mm vs 22 +/- 4 mm (p = NS), respectively, both were
      significantly smaller than that in MS patients (30 +/- 5 mm; p less than 0.05).
      MVP was present in 17 of 31 (55%) IPE patients vs 12 of 14 (86%) MS patients (p =
      NS) and in only 1 of 16 (6%) normal subjects (p less than 0.05) vs both IPE and
      MS. We conclude that young patients with IPE represent an isolated form of
      connective tissue abnormality because of the presence of pectus excavatum and
      MVP, but this is different from the systemic involvement of MS because of the
      lack of other systemic findings, including aortic root dilatation and changes in
      body habitus.

PMID- 1736264
TI  - Imperforate tricuspid valve with dysplasia of the right ventricular myocardium,
      pulmonary valve, and coronary artery: a clinicopathological study of nine cases.
AB  - Nine cases of imperforate tricuspid valve associated with dysplasia of the right
      ventricular myocardium, pulmonary valve, and right coronary artery are described.
      The mean frontal QRS axis of the electrocardiograms did not indicate left axis
      deviation in seven of the nine. Two-dimensional echocardiograms showed an
      imperforate tricuspid valve, normally aligned atrioventricular septum, and an
      irregular-shaped right ventricular cavity with a thin wall. In three cases with
      absence of the pulmonary valve, pulsed Doppler echocardiograms of the right
      ventricular outflow tract revealed antegrade flow during systole and retrograde
      flow during diastole, and selective angiography through a persistent ductus
      arteriosus showed retrograde filling of the blind-ended right ventricular cavity
      via the main pulmonary artery. Necropsy examinations showed an imperforate
      tricuspid valve with a thin-walled aneurysmal right ventricle in all six cases
      examined. Pulmonary atresia was observed in two cases, and the absence of the
      pulmonary valve in four. The right coronary artery was hypoplastic in four cases
      and absent in two. A shunt operation should be carried out in early infancy to
      prevent hypoxia after closure of the ductus arteriosus.

PMID- 1736265
TI  - Hemodynamic effects of peritoneal dialysis in three children following open heart
      surgery.
AB  - We studied the hemodynamic responses of peritoneal dialysis (PD) in three
      children following open heart surgery. Hemodynamic measurements were made prior
      to a dialysis run, following the instillation of dialysis solution (20 ml/kg),
      and immediately prior to and 5 min after drainage of the peritoneal cavity. The
      same protocol was repeated 48 h later. There was a significant increase in right
      atrial pressure (RAP) and mean pulmonary artery pressure upon instillation of the
      dialysate into the peritoneal cavity (p less than 0.01). However, cardiac index,
      mean arterial blood pressure (MAP), systemic (SVRI) and pulmonary vascular
      resistances (PVRI), left atrial pressure (LAP), and oxygen saturation did not
      change significantly. There were no significant differences between responses in
      the initial study and that performed 48 h later. PD is associated with modest
      right-sided hemodynamic changes which, in this small group of patients, did not
      compromise patient care.

PMID- 1736266
TI  - Acquired coarctation of the aorta.
AB  - Coarctation of the aorta is usually caused by a congenital narrowing of the
      aorta. This report describes two children who developed hypertension secondary to
      an acquired coarctation of the aorta. In one patient the coarctation was
      temporally related to umbilical artery catheterization and was associated with
      thrombosis and aneurysmal dilatation of the aorta. In the second patient, the
      coarctation occurred after surgical aortotomy during the removal of an
      intrathoracic neuroblastoma. Patients who have interventional damage to the aorta
      should be periodically examined for the appearance of a coarctation. Although an
      acquired coarctation of the aorta is an infrequent complication of invasive or
      surgical procedures, it should be identified since it represents a remediable
      cause of hypertension in children.

PMID- 1736267
TI  - Catheter embolization of pulmonary arteriovenous fistulas in an infant.
AB  - An infant with pulmonary arteriovenous fistulas is described. Surgical ligation
      of the fistulas and limited resection of parenchyma from the right lung was
      followed at 11 months of age, by successful steel coil embolization of residual
      fistulas.

PMID- 1736268
TI  - Sick sinus syndrome and diffuse impairment of the conduction system in a child:
      successful pacing with a steroid eluting endocardial pacing lead.
AB  - A 9-year-old patient who had had a syncope was found to have atrial flutter in a
      resting electrocardiogram (ECG). Brief phases of sinus arrest had previously
      occurred after drug conversion to sinus rhythm. Structural heart disease was
      excluded by cardiac catheterization and angiography. Electrophysiologic study
      revealed a sick sinus syndrome, associated with diffuse impairment of the
      conduction system (supra-, infra-, and intrahisian block). Epimyocardial and an
      endocardial pacemaker implantation failed because of high stimulation threshold,
      after 3 years and 2 weeks, respectively. At the third implantation a steroid
      eluting endocardial pacing lead was used and satisfactory pacing was still
      present 2 years later.

PMID- 1736269
TI  - Chloramphenicol toxicity associated with severe cardiac dysfunction.
AB  - A 9-month-old infant experienced severe chloramphenicol toxicity associated with
      high serum levels (313 micrograms/ml). Cardiovascular collapse with
      cardiomyopathic changes and impaired left ventricular function was documented by
      echocardiography. Serial echocardiographic evaluation showed resolution of the
      cardiomyopathic findings as the chloramphenicol levels were spontaneously
      cleared. Clinical course was complicated by the development of liver disease and
      coagulopathy compatible with disseminated intravascular consumption. Patient's
      recovery was complete and uneventful, nevertheless, chloramphenicol toxicity in
      childhood is associated with a significant mortality rate of 40%. The related
      impaired cardiac function, although reversible, appears to play a major role in
      the pathogenesis and eventual outcome in this syndrome.

PMID- 1736270
TI  - Left ventricular function and myocardial mass after aortic valvotomy in infancy.
AB  - Eighteen of 25 survivors of aortic valvotomy in infancy were reinvestigated by
      cross-sectional echocardiography a mean of 7.5 (2.3-13.4) years after surgery.
      They had been operated at a median age of 38 (5-330) days. At the follow-up
      examination the gradient across the aortic valve was 41 +/- 19 (15-85) mmHg and
      the ejection fraction was 0.73 +/- 0.10 (0.48-0.84). Left ventricular (LV) end
      diastolic volume was 66 +/- 17 (33-191) ml/m2. LV mass was 96 +/- 36 (44-204)
      g/m2 and the LV mass volume index (LVMVI) (mass divided by end-diastolic volume)
      was 1.43 +/- 0.4 (0.9-2.28). Eleven of 18 patients had an abnormally high mass
      volume index compared with 95 age-matched controls with structurally normal
      hearts. The correlation between the residual pressure gradient across the aortic
      valve and mass volume index yielded an r value of 0.75 (p less than 0.0004). One
      patient had been reoperated and underwent resection of a subaortic stenosis 4
      years after the initial operation. Four patients with a resting gradient of more
      than 50 mmHg and one with grade 4 aortic regurgitation are scheduled for further
      surgical treatment. We conclude that, although LV function was normal in most
      patients who underwent aortic valvotomy in infancy, LV mass remains elevated in a
      significant number of patients, who may remain at risk of developing
      subendocardial ischemia.

PMID- 1736271
TI  - Infantile cardiac hemangioendothelioma.
AB  - A 4-month-old infant with cardiac hemangioendothelioma presented with
      thrombocytopenia, and pericardial effusion, as well as signs and symptoms of
      heart failure. This is the first reported case of infantile cardiac hemangioma
      successfully treated with steroids.

PMID- 1736272
TI  - Gaucher's disease with mitral and aortic involvement: echocardiographic findings.
AB  - Cardiac involvement in Gaucher's disease has been reported in only a few
      patients, mostly adults with pericardial changes. We describe findings in two
      siblings with Gaucher's disease, aged 15 and 9 years respectively, in whom mitral
      and aortic valve lesions were evaluated by auscultation and echocardiography. In
      both cases the mitral and aortic valves were thick and restricted in motion.
      Continuous Doppler echocardiography revealed significant mitral regurgitation and
      mitral stenosis. At the aortic valve level there was a systolic pressure
      gradient. Echocardiographic investigation of patients with suspected cardiac
      involvement with Gaucher's disease is recommended.

PMID- 1736273
TI  - Right ventricular outflow obstruction by anomalies of the tricuspid valve: report
      of a windsock diverticulum.
AB  - A 9-month-old infant with a clinical diagnosis of double outlet from the right
      ventricle, subaortic ventricular septal defect, and muscular subpulmonary
      obstruction underwent surgical repair. The defect was corrected and the right
      ventricular infundibulum enlarged with a patch. Eight hours after the operation
      there was a sudden collapse which rapidly progressed to cardiac arrest and death.
      Postmortem examination of the heart confirmed the clinical diagnosis but noted
      that the subpulmonary obstruction was caused by a "windsock" deformity of the
      tricuspid valve which was not identified at operation. The variants of
      malformations of the tricuspid valve causing subpulmonary obstruction are
      reviewed.

PMID- 1736274
TI  - Transient ventricular septal hypertrophy in the first year of life associated
      with neonatal brain injury.

PMID- 1736275
TI  - Density dependent polarized secretion of a prostatic epithelial cell line.
AB  - The polarized secretions (apical/basal) of newly synthesized total protein and
      proteases from prostatic epithelial sheets of PA-III cells grown in dual
      compartment chambers were investigated at various cell densities and culture
      conditions. PA-III cells grown in a serum free defined medium (SFDM) form
      morphologically polarized monolayers of epithelial cells. These cells secreted
      their 35S-methionine labeled total protein in a predominantly apical direction
      (apical/basal ratio, 4-8 fold), with a lesser proportion of protein secreted
      apically at lower cell densities of the PA-III cell monolayer. PA-III cells grown
      in 5% fetal calf serum (FCS) are morphologically squamous, comparable to the
      anaplastic phenotype, and exhibited an inversion of polarized total protein
      secretion (apical/basal ratio, 0.4-0.9 fold), with an increased proportion of
      total protein secreted in a basal direction at lower cell densities. Since the
      culture of PA-III cells in FCS may approximate the anaplastic phenotype we
      investigated the polarized secretion of proteases from these cells at various
      cell densities, and compared them with the secretory pattern of protease
      secretion from polarized PA-III cells cultured in SFDM. At lower cell densities
      of the PA-III cells grown in FCS the polarity of protease secretion was inverted
      such that metalloproteinases, tissue type plasminogen activator, and a 72 kD
      gelatinase were secreted in a predominantly basal direction, as well as urokinase
      and a gelatinase of 26 kD that were secreted more or less equally into the apical
      and basal compartments of the chambers. On the other hand, for cultures of PA-III
      cells grown in SFDM the aforementioned proteases exhibited predominantly an
      apically directed polarity of secretion. These results suggest that the
      anaplastic phenotype characterized by a loss of polarized structure may also be
      characterized by a functional loss or inversion of polarized secretion. The
      consequences of such a loss or inversion of polarized secretion would be to
      increase the localized concentrations of proteases along the basal domain of
      cells thereby facilitating degradation of the basement membrane and interstitial
      tissue in vivo.

PMID- 1736276
TI  - Evidence for a non-estrogenic cytostatic effect of estramustine on human
      prostatic carcinoma cells in vivo.
AB  - Estramustine is one of the main metabolites of estramustine phosphate
      (EstracytR), a drug used in the treatment of advanced prostatic cancer. In the
      present study the hormone independent human prostatic carcinoma cell line DU 145
      implanted subcutaneously in nude mice (NMRI) was used to investigate the mode of
      action of estramustine in vivo. Metaphase arrest was found in mice treated with
      estramustine intraperitoneally, 200 and 400 micrograms daily for 2 weeks, 5 days
      a week. A significant dose dependent decrease in the number of anaphase figures
      was found. A 7 to 8 fold increase in the number of abnormal metaphases, i.e.,
      highly contracted and unaligned chromosomes, was found. Uptake and retention of
      3H-estramustine was found in tumour tissue. No increase in the mitotic index or
      the number of abnormal metaphases was found in animals treated with polyestradiol
      phosphate (EstradurinR). This is the first time evidence has been presented
      demonstrating the anti-mitotic effect of estramustine in vivo.

PMID- 1736277
TI  - A local direct effect of pituitary graft on growth of the lateral prostate in
      rats.
AB  - Prolactin and testosterone are synergistic in stimulating growth of the rat
      prostate. The lateral lobe is more sensitive to this synergism than the ventral
      and dorsal lobes. To investigate whether prolactin acts directly in the rat
      prostate or indirectly through another systemic mediator, anterior pituitary
      grafts (1 mm3) were implanted in the lateral prostate of castrated Sprague-Dawley
      rats in whom a 0.5 cm or 1.0 cm testosterone-filled silastic tubing was implanted
      subcutaneously at the same time. Rats were randomly assigned to receive either
      the pituitary or a muscle chip of similar size grafted beneath the fascia lateral
      to the lateral prostate. Twenty-one days later, serum prolactin levels were not
      elevated in pituitary-grafted animals and were not significantly different from
      those in muscle-grafted rats. The mean lateral prostate weight on the grafted
      side in pituitary-implanted rats with 1.0 cm testosterone tubing was 43% heavier
      than either that of the contralateral side or the corresponding weights in muscle
      implanted rats. In pituitary-implanted rats with 0.5 cm testosterone tubing, the
      mean lateral prostate weight on the grafted side was 60% heavier than either that
      of the contralateral side or that of the corresponding weights in muscle
      implanted rats. The weight of the ventral and dorsal lobes of the prostate was
      not significantly affected by the presence of pituitary grafts in one of the
      lateral lobes. The local effect of prolactin on the lateral prostate was further
      demonstrated by an overall decline in tissue concentrations of
      dihydrotestosterone in the grafted side. These results provided evidence to
      indicate that there was a direct effect of prolactin on growth of the lateral
      prostate in rats.

PMID- 1736278
TI  - Distribution of estradiol-17 beta hydroxysteroid oxidoreductase in the urogenital
      tract of control and neonatally estrogenized male mice: immunohistochemical,
      enzymehistochemical, and biochemical study.
AB  - The present study was conducted to investigate the regional distribution of the
      enzymes catalyzing the interconversion of the hydroxyl and carbonyl groups at C
      17 of the estrogen molecule within the male urogenital tract of adult mouse and
      to test the hypothesis, whether regional differences in the distribution are
      critical for estrogen responses. The highest ratios of NADPH-dependent 3H
      estrogen reduction to oxidation at C-17 of cell-free homogenates were obtained
      from coagulating gland and seminal vesicle as well as from the prostatic and
      lower intrapelvic urethra, which are considered the most estrogen-sensitive parts
      of the male urogenital tract. Both NADP- and NAD-dependent oxidation of 3H-17
      beta-estradiol were low or nondetectable at these sites. The epithelium of the
      lower and prostatic urethra as well as the periurethral collecting ducts were
      stained with the antibody prepared against human placental 17 beta-hydroxysteroid
      oxidoreductase. The NAD-dependent 3H-estradiol-17 beta oxidase activity was
      highest in the bladder epithelium, and the activity declined sharply in the
      urinary tract from the bladder downward. The lowest detectable activities were
      found in vas deferens and prostate (combined ventral and dorsolateral lobes). The
      uneven distribution of estradiol-17 beta oxidase activity may provide additional
      explanation for the regional differences of estrogen responses. The NADPH
      dependent 17 beta-reduction of estrone and the immunohistochemical staining of
      the human placental estradiol-17 beta oxidoreductase antigenicity were not
      significantly altered after neonatal estrogenization. These findings do not lend
      any support to the idea that the increased estrogen sensitivity observed after
      neonatal estrogenization is associated with changes in 17 beta-oxidoreduction.
      However, the possibility remains that there are specific sites (e.g., epithelium
      of prostatic urethra and collecting ducts) in which the changes in 17 beta
      oxidoreduction of estrogen does play a role in the regulation of estrogen action.

PMID- 1736279
TI  - Distribution of lactoferrin in the normal and inflamed human prostate: an
      immunohistochemical study.
AB  - A polyclonal rabbit antibody to lactoferrin was used to localize the distribution
      of lactoferrin within the different zones of the normal human prostate as well as
      within the inflamed human prostate. Cases of normal central zone, peripheral
      zone, periurethral glandular tissue, as well as cases in which foci of moderate
      to severe inflammation, along with varying degrees of inflammation-related
      atrophy, were studied. In cases with inflammation, the staining pattern of
      lactoferrin was compared to the staining pattern of prostate-specific antigen.
      Within the central zone, lactoferrin staining occurred in numerous individual
      cells peppered throughout the epithelium as well as within multiple
      intraepithelial lumens (lacunae). These lacunae were often numerous enough to
      give the central zone epithelium a fenestrated appearance; they were not seen in
      any of the other regions of the prostate. With the exception of an occasional
      individual cell or isolated positive gland, normal peripheral zone exhibited very
      little lactoferrin activity. Staining within the transition zone was similar to
      that seen in the peripheral zone. Staining within the urethral lining of the
      epithelium in the periurethral glands showed a distinct pattern of frequent
      intense staining involving the entire gland; frequent individual positive cells
      were also often seen. Three patterns of staining were identified in prostatic
      inflammation. Mild periglandular chronic inflammation produced foci of epithelial
      lactoferrin positivity that coincided precisely with the areas of inflammation.
      Severe acute inflammation produced strong staining within luminal secretions
      while cytoplasmic staining was limited to the luminal surface of the epithelium.
      Post-inflammatory atrophy showed intense diffuse lactoferrin staining in the
      scant cytoplasm of the atrophic epithelium. In 12 of the 17 cases of inflammation
      that were studied, areas of post-inflammatory atrophy or severe inflammation
      commonly showed absence of prostate specific antigen staining and epithelium that
      was strongly lactoferrin-positive. Within the normal human prostate, lactoferrin
      appears to be produced primarily within the epithelium of the central zone,
      periurethral glands, and lining epithelium of the prostatic urethra. Lactoferrin
      filled central zone lacunae appear to be structures unique to the central zone.
      The distribution of lactoferrin in the periurethral glands and urethral lining
      epithelium, along with the intense production of lactoferrin in the presence of
      inflammation, and the preservation of lactoferrin production in severe
      inflammation or atrophy suggest that lactoferrin may be a key component of the
      inflammatory response within the human prostate.

PMID- 1736280
TI  - Ha-ras oncogene activation in mammary glands of N-methyl-N-nitrosourea-treated
      rats genetically resistant to mammary adenocarcinogenesis.
AB  - A single dose of N-methyl-N-nitrosourea given to sexually immature female Buf/N
      rats produces a high incidence of mammary adenocarcinomas. A large percentage of
      these tumors contain the Ha-ras oncogene, activated by a G----A transition at the
      second nucleotide of codon 12. Copenhagen rats, on the other hand, are completely
      resistant to mammary tumor induction by a number of carcinogens, including N
      methyl-N-nitrosourea. Here we show, using a sensitive method involving PCR, that
      codon 12 Ha-ras mutations occur in the mammary glands of both Buf/N and
      Copenhagen rats 30 days after N-methyl-N-nitrosourea treatment. These mutations
      were evenly distributed among individual mammary glands and were present in
      purified mammary epithelial cells. In Buf/N rats, the fraction of cells
      containing a mutated Ha-ras allele increased by a factor of 10-100 between 30 and
      60 days, whereas in Copenhagen rats, there was no such increase during this time
      period. We conclude that the resistance of the Copenhagen rat to mammary
      carcinogenesis is not due to a defect in initiation but rather appears to be due
      to the inability of cells containing a mutated ras allele to undergo sustained
      clonal expansion.

PMID- 1736281
TI  - Transactivation of the proenkephalin gene promoter by the Tax1 protein of human T
      cell lymphotropic virus type I.
AB  - Human T-cell lymphotropic virus type I (HTLV-I), an etiologic agent for adult T
      cell leukemia, is strongly associated with certain neurological diseases. The
      HTLV-I genome encodes a protein, Tax1, that transactivates viral gene
      transcription. CD4-positive T helper lymphocytes express the proenkephalin gene,
      and enkephalins have been implicated as neuroimmunomodulators. We have
      investigated the effect of Tax1 on the proenkephalin gene promoter in C6 rat
      glioma cells and demonstrated its transactivation. Analysis using 5' deletion
      mutants of the promoter region showed that sequences upstream of base pair -190
      are necessary for maximal transactivation. Forskolin, a cAMP modulator,
      synergistically increased Tax1-mediated transactivation of the proenkephalin
      promoter. Neither Tax1 transactivation alone nor Tax1/cAMP synergism exclusively
      involved cAMP-responsive elements. Endogenous proenkephalin gene expression
      increased in Tax1-expressing C6 cells. Since HTLV-I infects lymphocytes, which
      express proenkephalin mRNA, Tax1 transregulation of proenkephalin expression may
      provide bidirectional communication between the nervous and immune systems in
      HTLV-I-related diseases.

PMID- 1736282
TI  - In vivo duplication of genetic elements by the formation of stem-loop DNA without
      an RNA intermediate.
AB  - Gene duplication through cDNA synthesis by reverse transcriptase is believed to
      have played an important role in the diversification of genomes during evolution.
      Here, we demonstrate that a genomic DNA sequence can be duplicated in vivo as a
      result of template switching. When an inverted repeat (IR) structure was inserted
      in a site downstream from a ColE1 plasmid origin of DNA replication,
      transformation of Escherichia coli cells with this plasmid resulted in the
      production of a new DNA fragment encompassing the region from the origin to the
      center of the IR structure. The structure of this DNA molecule is composed of a
      long stem-loop formed by a single-stranded DNA, in which the loop is formed by
      the IR structure. The DNA fragment is designated slDNA, for stem-loop DNA. The
      experiments in this study suggest that during DNA replication, template switching
      at the stem-loop structure formed by the IR structure gives rise to slDNA
      utilizing the nascent DNA strand or the parental strand as a template. The
      mechanistic implications of slDNA synthesis, and its possible roles in genome
      evolution, are discussed.

PMID- 1736283
TI  - Effects of different DNA polymerases in ligation-mediated PCR: enhanced genomic
      sequencing and in vivo footprinting.
AB  - We have developed a simplified procedure for the ligation-mediated polymerase
      chain reaction (LMPCR) using Thermococcus litoralis DNA polymerase (Vent DNA
      polymerase). We show that Vent DNA polymerase produces correct, blunt-ended
      primer extension products with substantially higher efficiency than Thermus
      aquaticus (Taq) DNA polymerase or modified T7 DNA polymerase (Sequenase). This
      difference leads to significantly improved genomic sequencing, methylation
      analysis, and in vivo footprinting with LMPCR. These improvements include
      representation of all bands with more uniform intensity, clear visualization of
      previously difficult regions of sequence, and reduction in the occurrence of
      spurious bands. It also simplifies the use of DNase I cut DNA for LMPCR
      footprinting.

PMID- 1736284
TI  - Ectopic lymphokine gene expression in human peripheral blood lymphocytes in vivo.
AB  - An animal model to study the effects of ectopic expression of cytokines involved
      in cell growth and differentiation has been established. Retrovirus vectors
      containing the human interleukin 6 cDNA were used to produce high titer virus
      producing lines. Human peripheral blood lymphocytes (hPBLs) were successfully
      infected with the retrovirus and engrafted into severe combined immunodeficient
      mice. The majority of the animals were engrafted with hPBLs, as determined by the
      presence of human glucose phosphate isomerase. Furthermore, six of seven mice
      engrafted with hPBLs infected with high titer virus and detectable hPBLs present
      in the spleen expressed the retroviral human interleukin 6 gene. Importantly,
      human interleukin 6 protein was expressed at physiologically significant levels
      in these mice. These results demonstrate that models for human disease and
      immunotherapy involving retrovirus-mediated gene transfer into human cells can be
      developed in mice.

PMID- 1736285
TI  - Structural basis for the nucleic acid binding cooperativity of bacteriophage T4
      gene 32 protein: the (Lys/Arg)3(Ser/Thr)2 (LAST) motif.
AB  - To identify the functional residues of the N-terminal B region of bacteriophage
      T4 gene 32 protein involved in its cooperative binding to single-stranded nucleic
      acids, a process dependent on homotypic protein-protein interaction, we have
      studied the interaction of the protein with synthetic peptides containing
      different portions of this domain. Gel-permeation chromatography showed that a 6
      acryloyl-2-dimethylaminonaphthalene (acrylodan)-labeled fluorescent peptide
      corresponding to the first 17 residues of gene 32 protein formed a complex with
      whole protein. The fluorescence was blue-shifted 14 nm upon interaction with
      intact protein, and somewhat less so (7-11 nm) with cleavage products of the
      protein lacking B domains. The intrinsic tryptophan fluorescence of whole and
      truncated protein was quenched by this peptide and by the nonderivatized peptide.
      The peptide bound tightly to truncated protein at both 0.015 and 0.44 M Na+, with
      a stoichiometry of 1:1. Similar tryptophan quenching or acrylodan blue shifts
      were obtained with peptides corresponding to residues 1-9 and 3-8, but not
      residues 1-4, 5-9, or 5-17, indicating that the essential amino acids are
      contained within positions 3-8, Lys-Arg-Lys-Ser-Thr-Ala. Several other DNA
      binding proteins contain a LAST motif with documented involvement of these
      residues in nucleic acid interaction. The amino acid and coding sequence of
      residues 110-114, a region proposed to be involved in nucleic acid binding, is
      virtually identical to that of residues 3-7. Based on these observations, we have
      formulated a model for the cooperative interactions of gene 32 protein with
      single-stranded nucleic acids.

PMID- 1736286
TI  - Transcription factor TFIID induces DNA bending upon binding to the TATA element.
AB  - The TATA box-binding factor TFIID plays a primary role in the process of
      transcription initiation by RNA polymerase II and its regulation by various gene
      specific factors. Here we employ a permuted binding site/gel retardation assay
      with recombinant yeast and human TFIID to show that this factor induces DNA
      bending around the TATA element. These results are consistent with the presence
      of G + C-rich sequence elements flanking the consensus TATA element and led to
      the recently confirmed suggestion that TFIID interacts with the TATA element via
      the minor groove. They also raise the possibility that TFIID-induced bending
      might facilitate promoter interactions of other general factors in the
      preinitiation complex or interactions between general transcription factors and
      regulatory factors bound at upstream sites.

PMID- 1736287
TI  - Reduced expression of AP27 protein, the product of a growth factor-repressible
      gene, is associated with diminished adipocyte differentiation.
AB  - We have recently characterized an adipocyte cDNA (clone 5) that is enhanced in
      expression by environmental and hormonal conditions favoring adipogenic
      differentiation. Moreover, certain agents including fibroblast growth factor and
      phorbol 12-myristate 13-acetate (but not epidermal growth factor) markedly
      inhibit clone 5 gene expression and prevent TA1 cell differentiation. These
      results led us to propose that a threshold level of the clone 5 gene product
      (AP27 protein) is required for triggering adipocyte differentiation. We have
      constructed vectors that direct the synthesis of clone 5 antisense RNA to reduce
      the levels of AP27 in adipogenic cell lines TA1 and 3T3-L1. We show here that
      when these cells express clone 5 antisense RNA, they fail to undergo
      morphological differentiation, whereas adipogenesis is unaffected in cells
      expressing antisense beta-actin or ferritin heavy-chain RNA. We further show that
      cells expressing clone 5 antisense RNA (but not the other antisense RNAs) are
      unable to induce the expression of characteristic "adipocyte-specific" mRNAs. The
      level of inhibition of differentiation by clone 5 antisense RNA correlates with
      decreased levels of AP27 protein. These results provide strong evidence that
      expression of AP27 is linked to adipogenic differentiation and that AP27 may be a
      component of an as-yet-uncharacterized signal-transduction pathway required for
      the triggering of adipocyte differentiation.

PMID- 1736288
TI  - Regulation of glycine tRNA gene expression in the posterior silk glands of the
      silkworm Bombyx mori.
AB  - The glycine tRNA genes in silkworm Bombyx mori contain two regulatory regions
      upstream of the transcription start site as identified by direct transcription of
      5' deletion mutants, transcription competition, gel mobility shift assays, and
      footprinting. A positive regulatory region is present in the immediate 5'
      flanking sequences of the four tRNA 1Gly clones studied. This region is essential
      for cell-free transcription in homologous extracts. A negative regulatory region
      is present farther upstream, and transcription competition experiments indicate
      its presence in three of the four clones examined.

PMID- 1736289
TI  - Duplication-targeted DNA methylation and mutagenesis in the evolution of
      eukaryotic chromosomes.
AB  - Mammalian genomes are threatened with gene inactivation and chromosomal
      scrambling by recombination between repeated sequences such as mobile genetic
      elements and pseudogenes. We present and test a model for a defensive strategy
      based on the methylation and subsequent mutation of CpG dinucleotides in those
      DNA duplications that create uninterrupted homologous sequences longer than about
      0.3 kilobases. The model helps to explain both the diversity of CpG frequencies
      in different genes and the persistence of gene fragmentation into exons and
      introns.

PMID- 1736290
TI  - Distribution of interspersed repeats (Alu and Kpn) on NotI restriction fragments
      of human chromosome 21.
AB  - Interspersed repeated sequences (Alu and Kpn) were used as probes to detect a set
      of Not I restriction fragments of human chromosome 21 from the hybrid cell line
      WAV17. Forty different Not I fragments, ranging in size from less than 0.05
      megabase (Mb) to 7.0 Mb, were identified. The total length of these fragments was
      47.3 Mb. This length provides an estimate of the minimum size of the chromosome
      and a minimum number of fragments to be ordered to create a complete restriction
      map. The average length Not I fragment is 1.2 Mb. Alu and Kpn fragments are not
      always coincident: a 2.9-Mb fragment is detected with Kpn but not with Alu, and
      13 fragments, ranging from less than 0.05 Mb to 5.6 Mb, are detected with Alu but
      not with Kpn; the 26 remaining fragments, covering 75% (35.3 Mb) of the total
      length, are detected with both repetitive probes. The presence of so many
      noncoincident fragments and the high variation of the hybridization signal
      intensities of the fragments suggest a very nonuniform distribution of Kpn and
      Alu repeats.

PMID- 1736291
TI  - Tamoxifen prevents induction of hepatic neoplasia by zeranol, an estrogenic food
      contaminant.
AB  - Zeranol (alpha-zearalanol) is a beta-resorcylic acid lactone (RAL) that has
      estrogen activity. It is synthesized by molds and is difficult to avoid in human
      food products. We tested the ability of this mycoestrogen to damage the liver of
      the Armenian hamster, a rodent that is especially sensitive to hepatotoxic
      effects of exogenous estrogens. Zeranol induced acute hepatotoxicity and,
      subsequently, hepatic carcinogenesis; both effects were blocked by tamoxifen,
      suggesting estrogen receptor mediation. Because zeranol is acting alone as a
      primary initiator of hepatic neoplasms, this model provides an unusual
      opportunity to study the pathogenesis of estrogen-initiated tumorigenesis.

PMID- 1736292
TI  - A relationship between the helical twist of DNA and the ordered positioning of
      nucleosomes in all eukaryotic cells.
AB  - A large number of measurements of nucleosome repeat lengths are analyzed and are
      found to exhibit preferential quantization to a set of values related by integral
      multiples of the helical twist of DNA. This implies that the nucleosomal DNA
      content is preferentially quantized, which in turn implies that linker DNA
      lengths are preferentially quantized. This study confirms and extends previous
      observations in the literature that had suggested, but not firmly established,
      that linker lengths might be quantized. The quantization of repeat lengths
      applies even for very long repeat lengths. This suggests a model for the origin
      of the quantization, in which the quantization arises from the requirements of
      higher-order chromatin structure.

PMID- 1736293
TI  - Intron-exon organization of the gene for the multifunctional animal fatty acid
      synthase.
AB  - The complete intron-exon organization of the gene encoding a multifunctional
      mammalian fatty acid synthase has been elucidated, and specific exons have been
      assigned to coding sequences for the component domains of the protein. The rat
      gene is interrupted by 42 introns and the sequences bordering the splice-site
      junctions universally follow the GT/AG rule. However, of the 41 introns that
      interrupt the coding region of the gene, 23 split the reading frame in phase I,
      14 split the reading frame in phase 0, and only 4 split the reading frame in
      phase II. Remarkably, 46% of the introns interrupt codons for glycine. With only
      one exception, boundaries between the constituent enzymes of the multifunctional
      polypeptide coincide with the location of introns in the gene. The significance
      of the predominance of phase I introns, the almost uniformly short length of the
      42 introns and the overall small size of the gene, is discussed in relation to
      the evolution of multifunctional proteins.

PMID- 1736294
TI  - Direct measurement of brain glucose concentrations in humans by 13C NMR
      spectroscopy.
AB  - Glucose is the main fuel for energy metabolism in the normal human brain. It is
      generally assumed that glucose transport into the brain is not rate-limiting for
      metabolism. Since brain glucose concentrations cannot be determined directly by
      radiotracer techniques, we used 13C NMR spectroscopy after infusing enriched D-[1
      13C]glucose to measure brain glucose concentrations at euglycemia and at
      hyperglycemia (range, 4.5-12.1 mM) in six healthy children (13-16 years old).
      Brain glucose concentrations averaged 1.0 +/- 0.1 mumol/ml at euglycemia (4.7 +/-
      0.3 mM plasma) and 1.8-2.7 mumol/ml at hyperglycemia (7.3-12.1 mM plasma).
      Michaelis-Menten parameters of transport were calculated to be Kt = 6.2 +/- 1.7
      mM and Tmax = 1.2 +/- 0.1 mumol/g.min from the relationship between plasma and
      brain glucose concentrations. The brain glucose concentrations and transport
      constants are consistent with transport not being rate-limiting for resting brain
      metabolism at plasma levels greater than 3 mM.

PMID- 1736295
TI  - Profound specific suppression by antigen of persistent IgM, IgG, and IgE antibody
      production.
AB  - Ongoing, high-titer T-cell-dependent immune responses in adult mice, consisting
      of IgM, IgG, and IgE anti-fluorescein antibodies, can be specifically and
      substantially reduced (90-99%) when the mice are injected with appropriate doses
      of fluoresceinated dextran of defined molecular weight and hapten valence. This
      suppressive form of the antigen is nontoxic and specific, as responses to other
      antigens are unaffected. The suppression is long lasting and reduces high
      affinity antibodies most markedly. Moreover, plasma cell secretion of specific
      antibody is virtually eliminated. This demonstrates that the reduction in
      antibody titer is not simply due to masking of serum antibody by the suppressive
      polymer. The results are discussed with reference to proposed models of B-cell
      and T-cell tolerance. Extension of these findings to disease-related immunogens
      may yield effective antigen-specific treatments of human allergy and autoimmune
      diseases.

PMID- 1736296
TI  - Isolation of a src homology 2-containing tyrosine phosphatase.
AB  - Tyrosine phosphorylation is controlled by the opposing actions of tyrosine
      kinases and phosphotyrosine phosphatases (PTPs). src homology 2 domains (SH2) are
      found in several types of signaling proteins, including some tyrosine kinases.
      These domains bind phosphotyrosyl proteins and thus help promote signal
      transduction. Using mixed oligonucleotide-directed polymerase chain reactions,
      two previously undescribed rat PTP cDNA fragments were generated. Through
      subsequent screening of rat megakaryocyte and human erythroleukemia libraries, we
      obtained a full-length coding sequence for one of these fragments. This cDNA, SH
      PTP1, encodes a tyrosine phosphatase containing two highly conserved SH2 domains.
      SH-PTP1, with a 2.4-kilobase mRNA, a predicted open reading frame of 595 amino
      acids, and a structure suggesting a nontransmembrane protein, is expressed
      primarily in hematopoietic and epithelial cells. When expressed in Escherichia
      coli, SH-PTP1 possesses PTP activity. The structure of SH-PTP1 establishes an
      additional branch of the tyrosine phosphatase family and suggests mechanisms
      through which tyrosine phosphatases might participate in signal transduction
      pathways.

PMID- 1736297
TI  - Long-term expression of human adenosine deaminase in vascular smooth muscle cells
      of rats: a model for gene therapy.
AB  - Gene transfer into vascular smooth muscle cells in animals was examined by using
      recombinant retroviral vectors containing an Escherichia coli beta-galactosidase
      gene or a human adenosine deaminase (adenosine aminohydrolase, EC 3.5.4.4) gene.
      Direct gene transfer by infusion of virus into rat carotid arteries was not
      observed. However, gene transfer by infection of smooth muscle cells in culture
      and seeding of the transduced cells onto arteries that had been denuded of
      endothelial cells was successful. Potentially therapeutic levels of human
      adenosine deaminase activity were detected over 6 months of observation,
      indicating the utility of vascular smooth muscle cells for gene therapy in
      humans.

PMID- 1736298
TI  - Mechanism of DNase I hypersensitive site formation within the human globin locus
      control region.
AB  - The human beta-like globin gene locus contains embryonic, fetal, and adult globin
      genes that are regulated in a developmentally timed, as well as a tissue
      specific, manner. The locus control region (LCR), located 5' of the globin genes,
      is characterized by four erythroid-specific nuclease-hypersensitive sites within
      native chromatin. These sites contain the active elements of the LCR. The LCR
      establishes an active chromatin conformation across the globin locus and enhances
      globin gene expression in transfected erythroleukemia cells and transgenic mice.
      We have used 5' DNase I hypersensitive site (HS) 4 as a model to define the
      minimum elements necessary for site formation. We have identified a 101-base-pair
      fragment within 5' HS4 that is the active site-forming element. DNase I footprint
      and gel-mobility shift assays have identified binding sites for transcription
      factors AP-1/NF-E2, Sp-1, and GATA-1 within the HS-forming element. We conclude
      that HS formation, the characteristic feature of the LCR in nuclear chromatin,
      requires interaction between erythroid-specific and ubiquitous nuclear proteins.

PMID- 1736299
TI  - Amino acid sequence of the mRNA cap-binding protein from human tissues.

PMID- 1736300
TI  - Kinetics of expression of multiply spliced RNA in early human immunodeficiency
      virus type 1 infection of lymphocytes and monocytes.

PMID- 1736301
TI  - Materials derived from biomass/biodegradable materials.
AB  - Interest in biodegradable plastics made from renewable resources has increased
      significantly in recent years. PHBV (polyhydroxybutyrate-polyhydroxyvalerate)
      copolymers are good examples of this type of materials. This paper provides an
      overview of the manufacturing process, properties, biodegradability, and
      application/commercial issues associated with PHBV copolymers. They are naturally
      produced by bacteria from agricultural raw materials, and they can be processed
      to make a variety of useful products, where their biodegradability and
      naturalness are quite beneficial. PHBV copolymers are still in the first stage of
      commercialization. But they are presented in this paper as an example of how new
      technology can help meet society's needs for plastics and a clean environment.

PMID- 1736302
TI  - A new approach to evaluating carcinogenic risk.
AB  - Carcinogenic risk assessments are based on extrapolating from high-dose chronic
      rodent-feeding studies to human-exposure levels. A serious problem is that about
      half of all substances tested at their respective maximum tolerated dose (MTD)
      are found to induce cancer. The MTD as currently defined has been criticized
      because it may stimulate cell proliferation in susceptible tissues. Such
      chemically induced mitogenesis is postulated to increase the probability that
      neoplasia will develop at the affected site. It is proposed that, in the
      development of an MTD for a given substance, chemically induced mitogenesis be
      considered an undesirable toxic manifestation. Hence, mitogenesis should not be
      induced by a substance fed at its true MTD. Since MTDs determined in this fashion
      are likely to be lower than those developed using current criteria, an added
      level of protection is introduced by employing a safety factor similar to that
      used now in determining acceptable daily intakes for noncarcinogenic food
      additives. In calculating acceptable daily intakes, the usual safety factor is
      100; i.e., the acceptable daily intake is set at 1% of the no-observed-effect
      level. Hence it is proposed that the acceptable daily level of exposure to a
      substance that does not induce cancer at its MTD as defined herein be set at 1%
      of that MTD. On the other hand, a chemical that induces cancer at its MTD as
      defined herein would continue to be regulated as is customary now.

PMID- 1736303
TI  - Identification of a negative regulatory element involved in tissue-specific
      expression of mouse renin genes.
AB  - The 5' flanking region of the mouse renin genes (Ren-1d and Ren-2d) contains two
      motifs that are homologous to known negative regulatory elements (NREs). Ren-2d
      has a 150-base-pair (bp) insertion 5' to the upstream putative NRE (NRE-1), which
      is lacking in Ren-1d. We tested the functionality of these sequences by using
      site-directed mutagenesis to delete individually each putative NRE from Ren-1d
      and to delete the 150-bp insertion from Ren-2d. We examined the effect of these
      mutations on the expression of the reporter gene chloramphenicol
      acetyltransferase, which was expressed from a truncated thymidine kinase promoter
      fused to the renin regulatory region. This plasmid was transfected into human
      choriocarcinoma JEG-3 cells. Only the upstream NRE (positions -619 to -597) was
      found to be functional in Ren-1d. The deletion of a 150-bp insertion from Ren-2d
      resulted in the suppression of chloramphenicol acetyltransferase activity to the
      level of Ren-1d expression. These data suggest that the upstream NRE that is
      functional in Ren-1d, but not in Ren-2d, may be partly responsible for
      differential expression of the renin genes in various tissues. The molecular
      mechanism of the NRE was examined by studying its interaction with nuclear
      proteins in submandibular gland and JEG-3 cells by gel-mobility-shift assays.
      Specific nuclear protein binding was observed only to the upstream NRE and the
      molecular mass of this protein was approximately 72 kDa as determined by
      Southwestern blot analysis. Thus our results suggest that both Ren-1d and Ren-2d
      conserve a cis-acting NRE in the 5' flanking region. In Ren-1d, this NRE could
      bind a specific nuclear protein resulting in the inhibition of Ren-1d expression
      in these tissues. On the other hand, the NRE in Ren-2d is nonfunctional due to
      interference by an adjacent 150-bp insertion.

PMID- 1736304
TI  - Genotypic analysis of mutations in Taq I restriction recognition sites by
      restriction fragment length polymorphism/polymerase chain reaction.
AB  - Point mutations in somatic cells play a role in the etiology of several classes
      of human pathologies. Experimental procedures are required that allow the
      detection and quantitation of such mutations in disease-related genes in tissue
      biopsy samples without the need for the selection of mutated cells. We describe
      the genotypic analysis of single base pair mutations in the Taq I endonuclease
      recognition sequence TCGA, residues 2508-2511 of exon 2 of the human c-H-ras1
      gene, by the restriction fragment length polymorphism/polymerase chain reaction
      (RFLP/PCR) approach. The high thermostability of Taq I endonuclease allows the
      continuous removal of eventual residual wild-type sequences during the
      thermocycling of the PCR and reduces polymerase errors in the final RFLP/PCR
      product to a minimum. As few as five copies of a mutant standard containing two
      base pair changes in the chosen Taq I site could be rescued from 10(8) copies of
      wild-type DNA. Taq I RFLP/PCR holds promise for the monitoring of mutations in
      biochemical epidemiology.

PMID- 1736305
TI  - The third chromophore of DNA photolyase: Trp-277 of Escherichia coli DNA
      photolyase repairs thymine dimers by direct electron transfer.
AB  - Photolyases repair pyrimidine dimers in DNA by converting the light energy of 300
      to 500-nm photons into chemical energy. Enzymes from various organisms contain
      two chromophore cofactors (FADH2 and either methenyltetrahydrofolate or 8-hydroxy
      5-deazaflavin) that absorb the low-energy photons and initiate splitting of the
      cyclobutane ring by a radical mechanism. Here, we show that, in addition to these
      two chromophores, in the far UV range, direct excitation of one specific
      tryptophan residue (out of 15 total) in the polypeptide chain of Escherichia coli
      photolyase leads to splitting of the cyclobutane ring with high quantum yield
      (phi = 0.56), independent of the other chromophores. The specific tryptophan
      residue responsible for photosensitized repair was identified as Trp-277 by site
      specific mutagenesis.

PMID- 1736306
TI  - Function of specific 2'-hydroxyl groups of guanosines in a hammerhead ribozyme
      probed by 2' modifications.
AB  - The importance of the 2'-hydroxyl group of several guanosine residues for the
      catalytic efficiency of a hammerhead ribozyme has been investigated. Five
      ribozymes in which single guanosine residues were substituted with 2'-amino-, 2'
      fluoro-, or 2'-deoxyguanosine were chemically synthesized. The comparison of the
      catalytic activity of the three 2' modifications at a specific position allows
      conclusions about the functional role of the parent 2'-hydroxyl group.
      Substitutions of nonconserved nucleotides within the ribozyme caused little
      alteration in the catalytic activity relative to that obtained with the
      unmodified ribozyme. In contrast, when either of the guanosines within the single
      stranded loop between stem I and stem II of the ribozyme was replaced by 2'
      deoxyguanosine or 2'-fluoro-2'-deoxyguanosine, the catalytic activities of the
      resulting ribozymes were reduced by factors of at least 150. The catalytic
      activities of the corresponding ribozymes containing 2'-amino-2'-deoxyguanosine
      substitutions at these positions, however, were both reduced by factors of 15.
      These effects resulted from decreases in the respective kcat values, whereas
      variations in the Km values were comparatively small. A different pattern of
      reactivity of the three 2' modifications was observed at the guanosine
      immediately 3' to stem II of the ribozyme. Whereas both 2'-deoxyguanosine and 2'
      amino-2'-deoxyguanosine at this position showed catalytic activity similar to
      that of the unmodified ribozyme, the activity of the corresponding 2'-fluoro-2'
      deoxyguanosine-containing ribozyme was reduced by a factor of 15. The
      implications of these substitution-specific reactivities on the functional role
      of the native 2'-hydroxyl groups are discussed.

PMID- 1736307
TI  - Structural and enzymatic characterization of a purified prohormone-processing
      enzyme: secreted, soluble Kex2 protease.
AB  - The prohormone-processing Kex2 protease of the budding yeast Saccharomyces
      cerevisiae can be converted from an intracellular membrane protein to a soluble,
      secreted, and active form by deletion of the transmembrane domain and C-terminal
      tail. One such molecule was purified to near homogeneity from the culture medium
      of an overexpressing yeast strain. Amino acid sequence analysis revealed that the
      N terminus of mature Kex2 protease is created by a potentially autoproteolytic
      cleavage at Lys108-Arg109, prior to the domain homologous to subtilisin, followed
      by trimming of Leu-Pro and Val-Pro dipeptides by the Ste13 dipeptidyl
      aminopeptidase. Kinetic parameters were examined using fluorogenic peptidyl
      methylcoumarin amide substrates. Initial burst titration indicated that the
      preparation was entirely active. Measurements of dependence of activity on pH
      yielded a simple curve suggesting titration of a single ionizable group. Activity
      was half-maximal at pH 5.7 and nearly constant from pH 6.5 to 9.5. Discrimination
      between substrates was as great as 360-fold in Km and 130-fold in kcat.
      Substrates with a Lys-Arg dipeptide preceding the cleaved bond were preferred,
      having kcat/Km values up to 1.1 x 10(7) sec-1.M-1. The enzyme cleaved substrates
      having Arg-Arg, Pro-Arg, Ala-Arg, and Thr-Arg with increased Km but with
      unchanged kcat. In contrast, the enzyme displayed a dramatically lower kcat for a
      Lys-Lys substrate with a smaller increase in Km. Thus the two residues preceding
      the cleaved bond may play distinct roles in the selectivity of binding and
      cleavage of prohormone substrates.

PMID- 1736308
TI  - Syndecan expression regulates cell morphology and growth of mouse mammary
      epithelial tumor cells.
AB  - S115 mouse mammary epithelial cells lose their epithelial morphology and become
      tumorigenic when exposed to steroids. We have recently reported that testosterone
      exposure results in the suppression of syndecan expression, suggesting that this
      cell surface proteoglycan may influence S115 cell phenotype. We now report that a
      similar suppression and morphological response of S115 cells can be achieved by
      glucocorticoid exposure. We introduced into S115 cells an exogenous gene
      construct containing the full-length human syndecan cDNA under the control of a
      glucocorticoid-inducible retroviral promoter, in order to study the effect of
      syndecan expression on S115 cell behavior. Glucocorticoid-induced re-expression
      of syndecan in S115 cells restored an epithelial phenotype, while control
      transfectants and parental S115 cells exhibited an altered, nonepithelial
      phenotype. Moreover, the S115 cells expressing exogenous syndecan revealed a
      reduced ability to form colonies in soft agar. Therefore, the maintenance of
      epithelial morphology and normal growth of S115 cells are dependent on syndecan
      expression.

PMID- 1736309
TI  - Retinoic acid-dependent transactivation of major histocompatibility complex class
      I promoters by the nuclear hormone receptor H-2RIIBP in undifferentiated
      embryonal carcinoma cells.
AB  - H-2RIIBP is a member of the nuclear hormone receptor superfamily that binds to
      the region II enhancer of major histocompatibility complex (MHC) class I genes.
      The binding occurs through the GG(T/A)CA motif present also in many other genes.
      The role of H-2RIIBP in developmental regulation of MHC class I genes has been
      studied in undifferentiated N-Tera2 embryonal carcinoma cells by transient
      cotransfection of an expressible H-2RIIBP plasmid and a chloramphenicol
      acetyltransferase reporter gene linked to the MHC class I promoter. Transfection
      of the expression plasmid led to production of H-2RIIBP transcripts and enhanced
      MHC class I promoter activity in cells that were treated with retinoic acid but
      not yet differentiated. Retinoic acid concentrations required for transactivation
      overlapped with those capable of inducing morphological differentiation and
      expression of endogenous MHC class I genes in these cells. This enhancement was
      mediated by region II, as a heterologous thymidine kinase promoter driven by
      region II also served as a target for H-2RIIBP transactivation. Deletion of the
      bulk of the DNA-binding domain or the ligand-binding domain of H-2RIIBP, but not
      of the N-terminal domain, abolished transactivation, indicating that the former
      two domains are critical for the enhancement. Moreover, H-2RIIBP transactivation
      exhibited a strict cell-type restriction. As observed in other cell lines, N
      Tera2 cells that had undergone differentiation failed to elicit transactivation,
      suggesting that H-2RIIBP acts in concert with a cofactor expressed in
      undifferentiated N-Tera2 cells that requires retinoic acid for its function.
      These results suggest that H-2RIIBP can function as a developmentally specific
      transcription factor for MHC class I genes.

PMID- 1736310
TI  - Structural analysis of a carcinogen-induced genomic rearrangement event.
AB  - We have explored the mechanism of genomic rearrangement in a hamster fibroblast
      cell culture system in which rearrangements are induced 5' to the endogenous
      thymidine kinase gene by chemical carcinogen treatment. The wild-type region
      around one rearrangement breakpoint was cloned and sequenced. With this sequence
      information, the carcinogen-induced rearrangement was cloned from the
      corresponding rearranged cell line by the inverse polymerase chain reaction.
      After the breakpoint fragment was sequenced, the wild-type rearrangement partner
      (RP15) was isolated by a second inverse polymerase chain reaction of unrearranged
      DNA. Comparison of the sequence of the rearrangement breakpoint with the wild
      type RP15 and 5' thymidine kinase gene regions revealed short repeats directly at
      the breakpoint, as well as nearby A + T-rich regions in each rearrangement
      partner. Pulsed-field electrophoresis analysis demonstrated that this
      rearrangement is an interstitial deletion of 35 kilobases. Southern blot analysis
      of the RP15 region in unrearranged parental cells showed a demethylated CpG
      island and a complex of DNase I-hypersensitive sites adjacent to the breakpoint
      in the region deleted by the rearrangement. Therefore, these studies reveal
      interesting sequence and chromatin features near the rearrangement breakpoints
      and suggest a role for nuclear organization in the mechanism of carcinogen
      induced genomic rearrangement.

PMID- 1736311
TI  - Analysis of CpG suppression in methylated and nonmethylated species.
AB  - The development of nearest-neighbor analysis led to the finding that the
      frequency of the dinucleotide CpG is markedly depressed in vertebrates. One
      explanation of this suppression is that methylation of CpG found in vertebrates
      represents a mutational hot spot through deamination of methylcytidine to
      thymidine. We have examined the role of methylated CpG as a factor in CpG
      suppression by comparing CpG distributions in coding regions of 121 genes from
      six species, three with methylated DNA and three with nonmethylated DNA. Overall
      base composition shows that all species exhibit CpG suppression, with the
      methylated forms showing significantly greater suppression than nonmethylated
      forms. When the data are analyzed by CpG position, the mean values of the
      methylated forms exhibit greater suppression than nonmethylated forms at
      positions I-II and II-III, but there is considerable overlap of suppression
      scores for individual species. At position III-I, CpG suppression is marked in
      all methylated species, and it is reversed in all nonmethylated species. Our
      analysis supports the hypothesis that CpG patterns at positions II-III and III-I
      in methylated forms are affected by mutation acting through deamination of
      methylcytidine to thymidine. We speculate that the excess of CpGs at position III
      I in nonmethylated forms may be related to a requirement for minimal thermal
      stability of the DNA.

PMID- 1736312
TI  - J chain synthesis and secretion of hexameric IgM is differentially regulated by
      lipopolysaccharide and interleukin 5.
AB  - Two functional polymeric forms of IgM can be produced by antibody-secreting B
      cells. Hexameric IgM lacks detectable J (joining) chain and activates complement
      17-fold better than pentameric IgM, which usually contains one J chain per
      pentamer. Using the inducible B-cell lymphoma CH12, we determined if the
      synthesis of a particular polymeric form of IgM is a fixed property of B cells or
      can be altered. Lipopolysaccharide (LPS)-stimulated CH12 cells produced mixtures
      of IgM hexamers and pentamers, resulting in antibody with high complement-fixing
      activity. In contrast, interleukin-5-stimulated CH12 cells secreted predominantly
      pentameric IgM, with a correspondingly lower lytic activity. Differences in lytic
      activity were due only to the amount of hexameric IgM in the secreted antibody.
      Interleukin 5 stimulated higher production of J chain RNA and protein than LPS,
      while LPS induced the highest levels of the secretory form of mu protein. The
      amount of hexameric IgM secreted was therefore inversely proportional to the
      level of intracellular J chain protein in the responding B cells. We conclude
      that the biologic function of IgM produced by B cells differs depending on how
      they are stimulated and that this difference may be regulated by the relative
      availabilities of J chain and secretory mu proteins during IgM polymerization.

PMID- 1736313
TI  - Preservation of metabolic activity in lyophilized human erythrocytes.
AB  - Normal human erythrocytes (RBC) were freeze-dried under conditions that caused
      minimal modification in normal RBC metabolic activities. Because of the known
      effects of long-term storage on metabolic activities, we studied the effects of
      our lyophilization process on RBC metabolism. Of all the metabolic enzymes
      studied, only triosephosphate isomerase (D-glyceraldehyde-3-phosphate ketol
      isomerase, EC 5.3.1.1), enolase (2-phospho-D-glyceratehydro-lyase, EC 4.2.1.11),
      and pyruvate kinase (ATP:pyruvate O2-phosphotransferase, EC 2.7.1.40) were
      decreased when compared with fresh control nonlyophilized RBC. The activities of
      these enzymes did not differ significantly from those of blood bank RBC.
      Concentrations of high-energy intermediates, ATP, and 2,3-diphosphoglycerate,
      along with lactate and ATP production were decreased in lyophilized RBC. No
      enzymes of the pentose phosphate shunt were altered during lyophilization. In
      addition, our data show that lyophilized RBC possess an intact capacity to (i)
      synthesize adenine nucleotides and (ii) reduce MetHb to Hb and, thus, maintain
      the Hb in a functional physiologic state similar to fresh nonlyophilized RBC. The
      present study demonstrates the possibility of lyophilizing RBC in a manner that
      maintains normal metabolic and enzymatic function upon rehydration.

PMID- 1736314
TI  - Adaptive evolution of degrees and kinds of neoplastic transformation in cell
      culture.
AB  - Human cancers undergo protracted complex development from benign to malignant
      states, as most thoroughly documented in the mole-to-melanoma sequence. The early
      stages of the sequence tend to redifferentiate into normal tissues; the later
      stages progress to ever increasing multiplication and malignancy. When placed
      under the growth constraint of either crowding or low serum concentrations, the
      NIH 3T3 line of mouse cells readily undergoes transformation, expressed in the
      development of foci of cells that continue to multiply at confluence when the
      rest of the population has stopped. If the nontransformed cells are maintained
      for 3 months by frequent low-density passages in high concentrations of calf
      serum, they gradually lose the capacity to undergo transformation when the
      constraints are applied. The same conditions of passage have been used to reverse
      the transformation, both processes resembling in principle the reversal of the
      early stages of the mole-to-melanoma sequence. When the frequent low-density
      passages are made in high concentrations of fetal bovine serum, which supports a
      slightly lower growth rate than an equal concentration of calf serum, the degree
      of transformation is gradually increased, so that the foci become more numerous,
      broader, and thicker, reaching a maximum in successive assays at about 3 months
      of passaging. A diversity of focal morphologies is sporadically generated in the
      calf serum passage by exposing the cells to various concentrations of calf serum
      for 14 days of growth and confluency before assaying them. The dependence of the
      number, density, and morphology of foci on the environment in which the cells had
      been grown before assay reinforces the evidence that the transformation is an
      epigenetic process. The fact that these effects develop in culture gradually over
      an extended period of time suggests parallels to the characteristically long-term
      early regression and later progression, as well as the diversity of the mole-to
      melanoma sequence, and may also be representative of other cancers.

PMID- 1736315
TI  - Niobium/aluminum filters reduce patient exposure.
AB  - Reducing patient exposure while maintaining image quality is key to
      radiographers. In a comparison study of different filters, the authors found that
      a combined niobium/aluminum filter provides substantial reduction of entrance
      skin exposure with fairly small increases in tube loading and little loss of
      image contrast.

PMID- 1736316
TI  - Using qualitative research in radiologic technology.
AB  - Qualitative research is an underused methodology in radiologic technology that
      has valid applications for patient care, professional practice and education.
      This article discusses uses of qualitative methodology in the health professions
      and describes specific applications for the radiologic sciences.

PMID- 1736317
TI  - Continuing education: do mandates matter?
AB  - This study questions the assumption that radiographers lack the motivation to
      voluntarily participate in continuing professional education. Results of the
      author's survey of radiographers in 22 Central Florida hospitals--where state law
      mandates completion of 12 hours of CPE biannually--showed significant differences
      in participation due to motivational orientation and selected professional,
      educational and personal characteristics.

PMID- 1736318
TI  - Cadaver imaging proves valuable learning method.
AB  - In evaluating the project as a whole, students expressed feeling greater
      worthwhileness through participation in a special project. They enjoyed working
      as a team with faculty in an imaging environment and reported having fun and
      learning simultaneously. Also, students felt a sense of accomplishment in
      contributing to medical students' learning by participating in this service
      experience. This helped reinforce their role in health care and the need for
      cooperative relationships in medical education and practice. Based on student and
      faculty perceptions, this learning method is considered a valuable alternative to
      traditional means of performance practice and clinical education. The project's
      success is the result of: Its organization to meet the needs of both the service
      commitment and a learning environment. The motivational nature of a special
      voluntary experience alternative. The highly interactive and dynamic nature of
      the imaging sessions. The realistic feedback for performance with opportunity for
      analysis and improvement. While it is evident that a cadaver resource must exist
      to make such a project a viable option for radiography programs, those with such
      a resource should consider integrating it with the more traditional learning
      methods. Many program sponsors may have similar resources available in their
      environments for projects that provide imaging services as well as unique
      learning laboratories for radiography students. Close interaction with health
      educators and researchers along with creative investigation may reveal
      opportunities for special projects.

PMID- 1736319
TI  - Medical imaging improved beyond belief.

PMID- 1736320
TI  - Learning theories: something for everyone.

PMID- 1736321
TI  - The forces behind accreditation.

PMID- 1736322
TI  - In search of fungus artifactus.

PMID- 1736323
TI  - Postsynaptic potentiation and desensitization at the vertebrate end-plate
      receptors.

PMID- 1736324
TI  - Movement, posture and equilibrium: interaction and coordination.

PMID- 1736325
TI  - Development of serotoninergic system in the brain and spinal cord of the chick.
AB  - (1) Development of serotonin positive cells and fibers was immunohistochemically
      studied by the use of an antibody against serotonin. (2) Serotoninergic neurons
      were first observed in the immature rohmbencephalon raphe nuclei on embryonic day
      (E)4, where two clusters of serotonin positive neurons were located: one observed
      at the rostral part of the rohmbencephalon corresponding to the dorsal raphe
      nuclei had many serotonin positive cells: the other located at the caudal part of
      the rohmbencephalon corresponding to the medullary raphe nuclei of the adult
      animals had only a small number of serotoninergic cells. (3) By E8 the number of
      serotonin positive cells in the brain stem increased, and virtually all the raphe
      nuclei found in an adult animal were located. (4) Serotonin positive fibers in
      the marginal layer reached up to the diencephalon and telencephalon on E6 and E8,
      respectively. (5) Serotonin positive cells were found beside the midline regions
      in the ventral part of the spinal cord of the embryonic as well as posthatching
      chick. (6) Because almost all the serotoninergic fibers in the spinal cord
      originated from the brain stem raphe nuclei, propriospinal serotonin positive
      cells were considered as phylogenetic vestiges. (7) Serotoninergic fibers were
      first found in the marginal layer of the cervical and lumbar spinal cord on E6
      and E8, respectively. (8) There was a waiting period of a few days before they
      penetrated into the mantle layer. (9) Terminal arbolization of the serotoninergic
      fibers started from late embryonic periods (E16 less than), and was maximized
      within one week of hatching. (10) Thereafter the density of serotonin positive
      fibers decreased in all the regions of the spinal cord. (11) Developmental
      changes of the density of serotonin determined with a high performance liquid
      chromatography were the same as those determined through immunohistochemistry.
      Namely the density of serotonin increased linearly from E6 to hatching period,
      and reached the maximum value one week posthatching. (12( The density of the
      serotonin in the adult spinal cord was about half of the maximum value. (13) It
      is to say that the densities of serotonin and serotoninergic fibers transiently
      increased around one week posthatching. (14) Following the transient increase
      serotoninergic fibers were eliminated from the neuropil, the fibers were
      localized in the specific regions of the motor nucleus: motor neuron pools of
      extensor muscles of the hip joint in the lumbosacral spinal cord.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1736326
TI  - Results of postoperative radiation therapy in medullary carcinoma of the thyroid:
      a retrospective study by the French Federation of Cancer Institutes--the
      Radiotherapy Cooperative Group.
AB  - Between 1971 and 1989, 59 patients received external radiation therapy with a
      curative intent. There were 25 females and 34 males, ranging in age from 19 to
      87. No patients had distant metastasis at the onset of treatment. The majority of
      patients had a total thyroidectomy (55/59), generally combined with neck
      dissection. Residual tumour was left in 11 cases, and 44 patients had positive
      cervical nodes. Using megavoltage radiotherapy, the whole neck and the upper
      mediastinum area were most often irradiated through a large anterior Y-shaped
      field without laryngeal shielding. The mean dose to the tumoral bed was 54 Gy.
      Dysphagia was observed in 32 patients (11, 17 and 5 scores were grade 1, 2 and 3,
      respectively). Dyspnea occurred in five cases and in two of these cases, it was
      considered to be severe. Local recurrences were noted in 18 (30%) patients, most
      of them occurring within the fields of irradiation. Parameters such as age, sex,
      total dose, irradiated volumes or cervical node enlargement did not modify the
      local control rate. The same conclusions can be drawn for distant failures.
      Thirty five patients are still alive and among them, 24 have no evidence of
      disease. The average length of survival is 70.5 months and is shortened by the
      occurrence of distant failures except in patients with bone metastases.

PMID- 1736327
TI  - Intraluminal low-dose rate brachytherapy for malignant endobronchial obstruction.
AB  - From October 1985 through October 1989, 87 patients underwent 105 intraluminal
      brachytherapy treatments for endobronchial or endotracheal malignant tumors. Low
      dose rate iridium-192 seeds were used. Of the 60 patients treated for primary
      lung carcinoma, 52 patients (87%) had previously received full-course external
      beam radiotherapy to the tumor sites. Ten patients were treated for symptomatic
      metastatic disease, and one patient had extension of tumor into the trachea from
      carcinoma of the cervical esophagus. Clinical or bronchoscopic improvement was
      noted in 42 patients (59%). No significant difference in the response rate was
      observed between various types of tumor. Patients who were treated with a
      radiation dose larger than 2500 cGy at a 2 cm radius had a significantly greater
      response rate (77%) than patients treated with a dose less than 2500 cGy (38%) (p
      = 0.001). A trend toward better results was apparent in patients who had
      undergone Nd:YAG laser bronchoscopy in the 2 weeks before brachytherapy. The
      treatments were well tolerated, and the incidence of serious complications was
      low and acceptable.

PMID- 1736328
TI  - Elevation of mouse kidney thiol content following administration of glutathione.
AB  - We have found that kidney glutathione and cysteine content in C3H mice can be
      increased by intraperitoneal administration of either glutathione (GSH) or
      glutathione disulfide (GSSG). Kidney thiol content is maximal 20-60 min after
      administration of 1000 mg/kg glutathione and returns to normal values by 2 h. The
      same time-course of thiol perturbation was observed when acivicin, an inhibitor
      of gamma-glutamyl transpeptidase, was administered 15 min prior to GSSG
      administration. The increase in kidney thiols after GSSG administration appears
      to saturate, with little additional increase as the administered dose is
      increased above 750 mg/kg. There was no significant change in liver GSH or
      cysteine after GSSG administration. We suggest that glutathione administration
      may provide a strategy for selective radioprotection or chemoprotection of
      specialized cells which can effectively utilize systemic GSH precursors.

PMID- 1736329
TI  - The effect of two fractions of radiation, delivered in air or in hyperbaric
      oxygen, on the Fib/T tumour in WHT mice pretreated with a hypoxic gas mixture.
AB  - The response of the Fib/T tumour to equal fractions of radiation, spaced by an
      interval of 24 hours, was determined in tumour-bearing mice that were pretreated
      either with 8% oxygen for 48 h or with air. An increase in tumour cell kill
      occurred in the group of animals that received a low oxygen pretreatment. Tumour
      cell kill was further and significantly increased if mice were retained in the
      low oxygen environment for the 24-h interval between radiation fractions.
      Possible explanations for these findings are proposed and discussed. The effect
      of a 48 h 8% oxygen exposure in modifying the response of the Fib/T tumour to two
      fractions of radiation, both delivered in hyperbaric oxygen, was also
      investigated. The low oxygen pretreatment did not significantly alter the tumour
      response to radiation given under conditions of hyperbaric oxygenation.

PMID- 1736330
TI  - Fractionation response and repair kinetics of radiation-induced heart failure in
      the rat.
AB  - Local heart irradiation with single or fractionated doses leads to heart failure
      after dose-dependent latency times. Clinical symptoms of heart failure are
      dyspnoea at rest, apathy and subcutaneous oedema. Animals autopsied when they
      presented with these symptoms, have a congested liver and occasional pleural
      effusions. The left ventricle is dilated, showing a reduction in wall thickness
      by 15-17% of control values. Histological examination reveals a focal
      degeneration and necrosis of about 23% of the total myocardial volume. Loss of
      alkaline phosphatase activity from myocardial capillaries, which is known to
      precede myocardial degeneration, involves 77% of the myocardium. These findings
      at the time of manifest heart failure are constant, independent on whether injury
      to the heart was inflicted by single-dose or fractionated irradiation or whether
      heart failure developed within a relatively short time after high total doses or
      within many months after low total doses. The latent time of heart failure
      therefore can be considered an appropriate endpoint for comparison of treatment
      groups. From experiments giving 1, 2, 4, or 10 dose fractions, a low alpha/beta
      ratio of 3.7 Gy (95% confidence interval 1.8-5.6 Gy) can be calculated. When the
      time interval between dose fractions is varied in a split-dose experiment, time
      intervals of up to 3 h do not increase the survival time significantly. This
      appears to indicate very slow repair of sublethal damage. On the other hand, it
      cannot be excluded that pathogenetic mechanisms independent of cell death in the
      renewing cell population contribute to this effect, making an interpretation of
      the alpha/beta ratio in terms of cell survival parameters of a defined target
      cell population difficult.

PMID- 1736331
TI  - Late radiation response of canine mediastinal tissues.
AB  - The mediastinal tissues which included heart, lung, trachea and esophagus of 70
      adult beagle dogs were irradiated to a range of total radiation doses between 24
      and 68 Gy given in 2, 3 and 4 Gy fractions. The purpose of the study was the
      calculation of alpha/beta ratios for morphologic and functional changes of the
      mediastinal tissues. Functional assays including echocardiography,
      electrocardiography, right heart hemodynamics and cardiac output were performed.
      Histomorphometric analyses of all tissues included in the field were done 2 years
      after treatment. Euthanasia was performed on 7 of 70 dogs prior to 2 years due to
      congestive heart failure and seven other dogs had signs of heart failure 2 years
      after treatment. Heart failure was thought to be caused by either pericardial
      effusions or constrictive pericarditis in these dogs. Heart failure occurred at
      doses of 62 and 68 Gy given in 2 Gy fractions, 60 Gy given in 3 Gy fractions and
      52 Gy given in 4 Gy fractions. The ED50 values for pericardial fibrosis for 2, 3
      and 4 Gy fractions were 46.1, 43.9 and 26.6 Gy, respectively. An alpha/beta ratio
      of 2.5 Gy was calculated by direct quantal response analysis. Small foci of
      myocytolytic lesions were detected in 11 dogs. Calculated ED50 values for
      myocytolysis were 70.4 Gy given in 2 Gy fractions and 50.8 Gy given in 4 Gy
      fractions. The estimated alpha/beta ratio was 3.2 Gy. Heart rates determined from
      physical examination and frequency of S-T segment changes increased with
      increasing dose. No other dose related changes were found in any of the other
      functional parameters. Functional changes were detected in the 14 dogs with
      clinical signs of heart failure. Focal consolidation and subpleural fibrosis were
      present in the irradiated lung volume. These late changes had no detectable
      physiologic effect in these dogs because of the small volume of lung irradiated.
      The ED50 values for lung consolidation were 54.3, 45.8 and 26.6 Gy after 2, 3 or
      4 Gy fractions, respectively. The estimated alpha/beta ratio was 3.4 Gy. No dose
      related changes could be detected in the trachea or esophagus at 2 years after
      treatment. These results demonstrate that lung and pericardium are the most
      responsive tissues in the mediastinum within the first 2 years after treatment.
      Myocardial lesions were present with high ED50 values, but were not found to be
      functionally significant at 2 years after irradiation. Human clinical data
      indicate that longer observation periods are needed for development of these
      lesions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1736332
TI  - Dose escalation for stage C (T3) prostate cancer: minimal rectal toxicity
      observed using conformal therapy.
AB  - The treatment of stage C (T3) adenocarcinoma of the prostate using external beam
      radiation therapy (RT) reportedly achieves clinical local control of
      approximately 70-80%. A dose relationship to local control has been demonstrated
      in prostate cancer, although a dose-related increase in complications has also
      been observed. To determine the maximum dose deliverable to the prostate gland
      while maintaining an acceptable complication rate, a prospective dose-escalation
      trial using a conformational planning and dose-delivery technique was initiated
      for patients with stage C (T3) disease. Initial results reported here are
      encouraging.

PMID- 1736333
TI  - Curietherapy versus external irradiation combined with curietherapy in stage II
      squamous cell carcinoma of the mobile tongue.

PMID- 1736334
TI  - Reirradiation of recurrent head and neck cancers: external and/or interstitial
      radiation therapy.
AB  - Recurrent cancer in the head and neck is not an uncommon clinical problem. The
      average cure rate of these patients has been reported to vary between 30 and 40%
      and most failures are due to locoregional relapses. After a previous full course
      of radiation, surgery is the salvage modality of choice; however, if surgery was
      not feasible for whatever reason, reirradiation has been offered to some
      patients. To establish the role of reirradiation in head and neck cancer, we
      analyzed a 13-year experience with patients reirradiated in the DDHCC. The
      reirradiation was performed between 1970 and 1980 by means of external beam
      radiation therapy (ERT series; n = 55) and between 1985 and 1988 by external
      radiation combined with interstitial radiation therapy (IRT +/- ERT series; n =
      18). A minimum follow-up of 3 years was allowed for. An improvement in local
      control was observed (50% vs. 29%) for the IRT +/- ERT series and the ERT series,
      respectively. The improvement in local control was not reflected in a survival
      benefit; i.e. an actuarial overall survival of 20% at 5 years was observed in
      both series. No treatment-related deaths occurred. However, for the patients that
      were controlled at the reirradiated site, 28% (4/16 of the ERT series and 3/9 of
      the IRT +/- ERT series) did experience severe side effects.

PMID- 1736335
TI  - Endosonographic diagnosis of submucosal upper gastrointestinal tract tumors.
AB  - Endoscopic ultrasound (EUS) was performed in 37 patients with upper
      gastrointestinal tract submucosal tumors (SMT). Fourteen of these were located in
      the esophagus, 20 in the stomach, and 3 in the duodenum. In 26 patients
      histologic confirmation was achieved by operation (n = 15) or biopsy/puncture (n
      = 11). EUS was able to visualize all tumors and, with one exception, determined
      their originating wall layer correctly. It became evident that myogenic tumors
      arise from the echo-poor layers (second layer and fourth--that is, muscularis
      propria) and that other lesions, such as cysts or fibromas, originate from the
      third, echo-rich layer (submucosa). Tumor size was correctly (+/- less than 5 mm)
      predicted in 87% of cases. Computed tomography, performed in 22 patients, was
      successful in visualizing the SMT in only two-thirds of cases. No single
      endosonographic criterion could be obtained which enabled accurate
      differentiation between benign and malignant SMT. However, from a clinical point
      of view, it seems reasonably safe to regard smaller (less than 3 cm), smoothly
      demarcated SMT as benign and follow them up by repeated EUS, especially in
      patients at risk for surgery. Larger masses (greater than 5 cm) and those with
      irregular borders should be suspected of being malignant. In the future,
      application of new, small ultrasound probes that can be used during conventional
      endoscopy (two SMT were visualized successfully) may greatly simplify the
      procedure.

PMID- 1736336
TI  - Effect of duodenal ulcer healing induced by omeprazole and ranitidine on the
      generation of gastroduodenal eicosanoids, platelet-activating factor, pepsinogen
      A, and gastrin in duodenal ulcer patients.
AB  - The effect of duodenal ulcer healing induced by omeprazole on gastroduodenal
      generation of eicosanoids, platelet-activating factor (PAF), pepsinogen A, and
      gastrin was evaluated. Sixty patients with endoscopically proven duodenal ulcer
      were randomized to receive 20 mg omperazole once daily or 300 mg ranitidine at
      bedtime for 2 weeks. Patients whose ulcers did not heal were treated for an
      additional 2 weeks. Endoscopic biopsy specimens and serum samples were obtained
      before and after treatment. There was no significant difference in the healing
      rate between the two treatment modalities. At 2 weeks healing rates were 60% and
      56% in the omperazole and ranitidine groups, respectively, whereas at 4 weeks the
      respective healing rates were 96% and 86%. Ulcer healing induced by omeprazole
      and ranitidine was not accompanied by significant changes in mucosal leukotriene
      B4 or C4 generation. Mucosal PAF significantly decreased in patients treated with
      omeprazole for 4 weeks. In omperazole-treated patients there was a trend towards
      increase in mucosal prostaglandin E2 generation which was significant in the
      fundus after 4 weeks of treatment. After 2 weeks of omeprazole treatment, serum
      gastrin and pepsinogen A levels almost doubled when compared with their
      pretreatment levels. In conclusion, duodenal ulcer healing with 20 mg omeprazole
      daily is not superior to healing rates with 300 mg ranitidine at bedtime after
      both 2 and 4 weeks of treatment. In omeprazole-treated subjects ulcer healing was
      accompanied by a significant decrease in mucosal PAF generation and increased
      levels of serum gastrin and pepsinogen A.

PMID- 1736337
TI  - Effect of Helicobacter pylori on serum pepsinogen I and plasma gastrin in
      duodenal ulcer patients.
AB  - Duodenal ulcer patients have increased serum pepsinogen I (PGI) concentrations
      and an increased prevalence of Helicobacter pylori infection. We have examined
      the effect of eradicating the infection on PGI. In 12 duodenal ulcer patients in
      whom H. pylori was successfully eradicated, the median basal PGI was 90 ng/ml
      (range, 37-252) before treatment and fell to 74 ng/ml (28-197) 1 month after
      treatment (p less than 0.01). In 12 patients in whom therapy failed to eradicate
      the infection, the PGI was 87 ng/ml (35-128) before treatment and remained
      unchanged at 83 ng/ml (36-119) 1 month after treatment. In the group with
      successful eradication the median basal plasma gastrin was 43 ng/l (15-95) before
      treatment and fell to 30 ng/l (17-75) 1 month after treatment (p less than
      0.003), but there was no change in the corresponding values in the group without
      eradication (55 ng/l; range, 25-120, and 45 ng/l; range, 5-175; p = 0.9). In
      conclusion, eradication of H. pylori results in a fall in PGI and plasma gastrin,
      and these changes are not due merely to the anti-H. pylori drugs themselves or to
      discontinuation of previous ulcer therapy.

PMID- 1736338
TI  - Breath methane and colorectal cancer.
AB  - The association between colorectal cancer and breath methane is controversial. We
      compared a group of 59 patients with unresected colorectal cancer with a group of
      control subjects matched for age and sex. We also studied 43 of the cancer
      patients before and 3-6 months after resection. Sixty-three per cent of the
      patients with unresected carcinoma and 56% of the control subjects were methane
      excretors (NS). We found no significant change in methane excretion status after
      resection. Because recent colonic cleansing has been shown to influence methane
      production in the colon, 15 breath methane excretors were studied immediately
      before the start of cleansing, on the day of colonoscopy, and on the 7th day
      thereafter. Forty per cent became breath-methane-negative on the day of
      colonoscopy, but all 15 were excretors with a median of 60% of the precleansing
      concentration on the 7th day. The present study does not confirm an association
      between breath methane and colorectal cancer. It is unlikely that colonic
      cleansing procedures influenced the results of this study.

PMID- 1736339
TI  - Adrenergic and cholinergic regulation of gastric mucus phospholipid secretion.
AB  - The influence of adrenergic and cholinergic agonists on phospholipid secretion in
      gastric mucosal cells maintained in the presence of [3H]choline was investigated.
      The secretion of [3H]choline phospholipids over a 30-min period averaged 1.98% of
      the total cellular labeled phospholipids in the absence of any mediator and was
      enhanced by the beta-adrenergic agonist isoproterenol to a greater extent than by
      the cholinergic agonist pilocarpine. A 2-fold increase in phospholipid secretion
      was achieved with isoproterenol, whereas pilocarpine produced a 1.3-fold
      increase. The stimulatory effect of isoproterenol was inhibited by alprenolol,
      and that of pilocarpine by atropine. The phospholipids secreted in response to
      isoproterenol showed a 30% decrease in lysophosphatidylcholine, whereas a 2.1
      fold enrichment in this phospholipid occurred with pilocarpine. The results
      demonstrate the involvement of neural mediators in the regulation of phospholipid
      secretion in gastric mucus.

PMID- 1736340
TI  - DNA ploidy, S-phase fraction, and G2 fraction as prognostic determinants in human
      pancreatic cancer.
AB  - The DNA ploidy, S-phase fraction (SPF), and G2 fraction of pancreatic cancer
      tissue was measured by flow cytometry in 95 patients. Forty-nine per cent (n =
      47) had a diploid DNA index, and 51% (n = 48) of tumours were aneuploid.
      Aneuploid tumours and high-grade tumours had significantly higher S-phase and G2
      fraction values than diploid tumours or low-grade tumours. Diploid and tetraploid
      tumours had a more favourable prognosis than non-tetraploid aneuploid tumours (p
      = 0.0020) during the mean follow-up of 6 years. The type of therapy (p = 0.07),
      histologic grade (p = 0.06), SPF (p = 0.1), and G2 fraction (p = 0.02) had
      predictive value in survival analysis as well. In multivariate survival analysis,
      including flow-cytometric, histologic, and clinical variables, diploidy and
      tetraploidy had independent predictive value. The results suggest that flow
      cytometry might be used in grading of pancreatic cancer. Such a grading would
      have practical value if new modes of therapy are being developed. Forty-one per
      cent of multiple samples had a heterogeneous DNA index when multiple samples were
      used. Consequently, flow cytometric analysis of pancreatic cancer using multiple
      samples is recommended.

PMID- 1736341
TI  - Nocturnal gastric secretion in duodenal ulcer patients and healthy controls.
      Ranges and reproducibility.
AB  - The nocturnal gastric acid secretion of 22 male duodenal ulcer patients was
      compared with that of 47 healthy male volunteers. Median nocturnal acid output
      was greater in duodenal ulcer patients (55 mmol versus 33 mmol 10 h-1; p =
      0.013), but there was almost complete overlap of the ranges. Five duodenal ulcer
      patients and three volunteers had nocturnal outputs of acid previously considered
      to be pathognomonic of the Zollinger-Ellison syndrome in the absence of other
      evidence of a gastrinoma. Nineteen healthy volunteers underwent a repeat study to
      assess the reproducibility of nocturnal gastric acid output. Median
      intraindividual variability (+/- distribution-free 95% confidence limits) was 23%
      (-34% to +72%). Studies of nocturnal gastric secretion are of no diagnostic
      value, and their variability should be taken into consideration when evaluating
      gastric antisecretory drugs.

PMID- 1736342
TI  - Causes of death during the first 5 years of a randomized trial of mass screening
      for colorectal cancer with fecal occult blood test.
AB  - The main purpose of population screening for colorectal cancer is to reduce
      mortality from the disease. The criteria of death from colorectal cancer are
      defined in the present randomized trial of 61,938 persons between 45 and 74 years
      old, and the need for an impartial death review committee was demonstrated.
      Causes of death within the first 5 years are described within subgroups of the
      test group and compared with those in the control group. Death rates were higher
      among non-responders to screening than among controls and among those in whom
      Hemoccult-II had been performed at least once. Persons with negative Hemoccult-II
      had a lower death rate than controls. The overall autopsy rate was 32%. Lethal
      complications from treatment of colorectal neoplasia were evaluated per se. Death
      from colorectal cancer occurred in 74 persons in the total screening group and in
      91 among controls. Sources of bias are discussed. A method of evaluating possible
      benefit to those being screened is suggested. Final results cannot be expected
      before 1996.

PMID- 1736343
TI  - Effects of acute psychologic stress on small-intestinal motility in health and
      the irritable bowel syndrome.
AB  - Psychologic stress may be a provoking factor in the alterations in phase-2 motor
      activity of the migrating motor complex (MMC) which have been recorded in
      patients with the irritable bowel syndrome (IBS). To test this, changes in phase
      2 duodenojejunal motor activity during 20 min of psychologic stress in 10
      patients with IBS were compared with those shown by 10 healthy subjects.
      Autonomic arousal in response to the stressor was assessed by cardiovascular
      responses and self-reported levels of anxiety and tension. IBS and controls
      showed a significant cardiovascular and subjective response to stress which was
      comparable in the two groups. In general, duodenal phase-2 motor activity was
      suppressed during stress in both IBS and controls. Jejunal motor activity showed
      a similar inhibitory response in both groups, but the change in motility index
      was significant for controls only. Qualitatively, stress did not cause clustered
      contractions in either the IBS or the control group. However, in IBS patients
      with clustered contractions in the basal period there was inhibition of this
      pattern during stress. These findings suggest that acute psychologic stress
      profoundly suppresses, rather than enhances, duodenojejunal MMC phase-2 motility
      in healthy subjects. IBS patients, irrespective of their underlying phase-2 motor
      pattern show similar, although less marked, changes in motility.

PMID- 1736344
TI  - Reliability of in situ measurements of colorectal polyps.
AB  - A reliable and sensitive in situ method for measuring polyp size is fundamental
      for growth studies of colonic polyps. A measuring probe inserted through a
      colonoscope can give a visual assessment of polyp diameter, and from a picture of
      the polyp the area of the polyp on the picture can be calculated by computerized
      analysis. To test the reliability and sensitivity of these two in situ
      measurements, 43 colonic polyps (mean diameter, 8.5 mm; range, 4-20 mm) removed
      by snare diathermy resection were examined. The maximal diameter was measured,
      and two Polaroid pictures taken of each polyp. After polypectomy each polyp was
      subjected to extracorporeal reassessment of diameter and measurement of weight
      and volume. By computerized analysis of the pictures the following variables were
      estimated: 1) area of the polyp on the picture; 2) largest diameter; 3) maximum
      width 90 degrees on the largest diameter; 4) maximum distance from centre of
      gravity; and 5) minimum distance from centre of gravity. Results showed good
      correlation between diameter measured in situ and after removal (r = 0.93),
      diameter raised to the 3rd power and weight (r = 0.93), and also to volume (r =
      0.77). Area analysis compared with weight was less good (r = 0.72). A very high
      correlation was demonstrated between weight and volume (r = 0.99). We conclude
      that the measurement of diameter in situ with a measuring probe is sensitive and
      somewhat more reliable than computerized analysis of size. The present 3-year
      follow-up and intervention study will show which of the two methods is preferable
      for evaluation of polyp growth.

PMID- 1736345
TI  - Unilateral vagal denervation suppresses omeprazole-induced trophic effects on the
      denervated side of the rat stomach.
AB  - In several experimental animals treatment with large doses of the proton pump
      inhibitor omeprazole leads to hypergastrinemia and with time to trophic effects
      in the acid-producing part of the stomach, most notably an increased density of
      the histamine-producing enterochromaffin-like (ECL) cells. The trophic effects
      are thought to reflect the increase in circulating gastrin. In the present study
      unilateral vagal denervation in the rat partly suppressed the tropic effects seen
      in the denervated side of the stomach but not those in the intact side after
      treatment with omeprazole for 10 weeks. Unilateral vagal denervation
      significantly reduced the proliferative stimulus of omeprazole on the ECL cells
      in the denervated part of the stomach. Thus, an intact vagal innervation appears
      to be essential for the capacity of the oxyntic mucosa, including the ECL cells,
      to respond to elevations in serum gastrin. We suggest that gastrin and the vagus
      interact to maintain trophic control of the oxyntic glands.

PMID- 1736346
TI  - Radiolucent and calcified pancreatic lithiasis: two different diseases. Role of
      alcohol and heredity.
AB  - One hundred and eighteen consecutive patients presenting with pancreatic calculi
      have been studied by means of plain films of the abdomen and endoscopic
      retrograde cholangiopancreatography. Patients were divided into the following
      groups: 1) Evenly calcified calculi, 74 patients, 66 men, aged at onset (M +/-
      SM) 40 +/- 10 years; daily consumption of alcohol, 157 +/- 121 g, and of tobacco,
      26 +/- 15 cigarettes. Two patients presented with another case in the same
      family. Composition of calculi--at least 95% calcium salts and a degraded form of
      lithostathine S (formerly called PSP S2-5)--was similar in the Occidental
      alcoholic and in the tropical form: calcified calculi are probably related to
      alcohol and nutritional disorders. 2) Radiolucent stones, 17 patients, 12 men and
      5 women, aged at onset 38 +/- 18 years. These patients had a low alcohol and
      tobacco consumption. There were four familial cases. 3) Radiolucent core with a
      calcified shell (target calculi), 27 cases, 23 men; age at onset, 38 +/- 15
      years; daily ethanol consumption, 111 +/- 93, and tobacco, 19 +/- 15 cigarettes.
      There were two familial cases. It has been shown that these calculi originated
      from transparent calculi that later calcified. The frequency of women and of
      familial cases was significantly greater in groups 2 + 3 than in group 1. The
      consumption of alcohol and tobacco and the proportion of men were significantly
      lower in group 2 than in groups 1 and 3. We discuss the role of heredity in
      lithostathine precipitation and of alcohol in calcium precipitation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1736347
TI  - Experimental clogging of biliary endoprostheses. Role of bacteria, endoprosthesis
      material, and design.
AB  - The major problem facing patients treated with biliary endoprostheses is their
      frequent clogging, necessitating their exchange. Clogged endoprostheses contain
      mainly bacteria embedded in an amorphous proteinaceous material with the
      occasional presence of food fibres. We studied this problem in an in vitro model,
      evaluating the role of bacteria, endoprosthesis design, and material in sludge
      formation. We found endoprostheses perfused with artificially contaminated bile
      to contain significantly more sludge than those perfused with sterile bile (p
      less than 0.05). The amount of sludge varied with the bacterial species used.
      Endoprostheses perfused with bacteria producing beta-glucuronidase were not
      associated with a particularly large amount of sludge. Endoprostheses with side
      holes contained significantly more sludge than those without (p less than 0.05).
      Furthermore, endoprostheses made of material with a low friction coefficient,
      such as Teflon, contained significantly less sludge than endoprostheses made of
      materials with a higher friction coefficient, such as polyethylene and
      polyurethane (p less than 0.05). These results emphasize the role of bacteria in
      endoprostheses clogging and clearly demonstrate the harmful effect that side
      holes have on endoprosthesis function.

PMID- 1736348
TI  - A steroid enema, budesonide, lacking systemic effects for the treatment of distal
      ulcerative colitis or proctitis.
AB  - The aim of this study was to evaluate whether budesonide enema (2 mg/100 ml) had
      a significantly better effect than placebo in the treatment of distal ulcerative
      colitis or proctitis. The trial was of controlled, randomized, double-blind
      design and included 41 treated patients. The treatment time was 4 weeks, with
      revisits after 2 and 4 weeks. If no improvement was seen, the patient could be
      switched over to open-label therapy with budesonide enema. Sigmoidoscopy,
      histology, blood chemistry, and diary cards were used for estimating the effect
      of treatment. The results showed that budesonide was superior to placebo.
      Sigmoidoscopy and biopsy scores improved significantly (p less than 0.01) in
      budesonide-treated patients compared with placebo. Significantly more patients
      switched over to open budesonide treatment in the placebo group owing to lack of
      efficacy compared with budesonide (p less than 0.001). No drug-related adverse
      experiences occurred, and there was no decrease in endogenous morning plasma
      cortisol levels. It is concluded that budesonide enema appears to be an effective
      and safe treatment for distal ulcerative colitis and proctitis.

PMID- 1736349
TI  - PCR amplification of specific alleles.

PMID- 1736350
TI  - The medfly in California.

PMID- 1736351
TI  - The medfly in California.

PMID- 1736352
TI  - Transmittal of hepatitis C.

PMID- 1736353
TI  - Anti-cancer drug IL-2 may finally be approved.

PMID- 1736354
TI  - Roche eases PCR restrictions.

PMID- 1736355
TI  - NIH's vision runs into political reality.

PMID- 1736356
TI  - Determining what immune cells see.

PMID- 1736357
TI  - New theory of diabetes etiology riles immunologists.

PMID- 1736358
TI  - Priming the brain's language pump.

PMID- 1736359
TI  - Working memory.
AB  - The term working memory refers to a brain system that provides temporary storage
      and manipulation of the information necessary for such complex cognitive tasks as
      language comprehension, learning, and reasoning. This definition has evolved from
      the concept of a unitary short-term memory system. Working memory has been found
      to require the simultaneous storage and processing of information. It can be
      divided into the following three subcomponents: (i) the central executive, which
      is assumed to be an attentional-controlling system, is important in skills such
      as chess playing and is particularly susceptible to the effects of Alzheimer's
      disease; and two slave systems, namely (ii) the visuospatial sketch pad, which
      manipulates visual images and (iii) the phonological loop, which stores and
      rehearses speech-based information and is necessary for the acquisition of both
      native and second-language vocabulary.

PMID- 1736360
TI  - Experimental phylogenetics: generation of a known phylogeny.
AB  - Although methods of phylogenetic estimation are used routinely in comparative
      biology, direct tests of these methods are hampered by the lack of known
      phylogenies. Here a system based on serial propagation of bacteriophage T7 in the
      presence of a mutagen was used to create the first completely known phylogeny.
      Restriction-site maps of the terminal lineages were used to infer the
      evolutionary history of the experimental lines for comparison to the known
      history and actual ancestors. The five methods used to reconstruct branching
      pattern all predicted the correct topology but varied in their predictions of
      branch lengths; one method also predicts ancestral restriction maps and was found
      to be greater than 98 percent accurate.

PMID- 1736361
TI  - Ordered self-assembly of polypeptide fragments to form nativelike dimeric trp
      repressor.
AB  - Subdomain-size proteolytic fragments of Escherichia coli trp repressor have been
      produced that assemble in defined order to regenerate fully native dimers. By
      characterization of the secondary and tertiary structures of isolated and
      recombined fragments, the structure of assembly intermediates can be correlated
      with the kinetic folding pathway of the intact repressor deduced from
      spectroscopic measurement of folding rates. The nativelike structure of these
      intermediates provides further evidence that protein folding pathways reflect the
      stabilities of secondary structural units and assemblies found in the native
      state. The proteolytic method should be generally useful in adding structural
      detail to spectroscopically determined folding mechanisms.

PMID- 1736362
TI  - Toward a dynamical structure of DNA: comparison of theoretical and experimental
      NOE intensities.
AB  - Comparisons of experimental and calculated interproton nuclear Overhauser effect
      (NOE) buildup curves for duplex d(CGCGAATTCGCG)2 have been made. The calculated
      NOEs are based on molecular dynamics simulations including counterions and water
      and on the single-structure canonical A, B, and crystal forms. The calculated NOE
      effects include consideration of the motions of individual interproton vectors
      and the anisotropic tumbling of the DNA. The effects due to inclusion of
      anisotropic tumbling are much larger than those due to the local motion, and both
      improve the agreement between calculated and experimental results. The
      predictions based on the dynamical models agree significantly better with
      experiment than those based on either of the canonical forms or the crystal
      structure.

PMID- 1736363
TI  - The Son of sevenless gene product: a putative activator of Ras.
AB  - The Son of sevenless (Sos) gene functions in signaling pathways initiated by the
      sevenless and epidermal growth factor receptor tyrosine kinases. The Sos gene has
      now been isolated and sequenced. Its product is a 1595-amino acid protein similar
      to the CDC25 protein in Saccharomyces cerevisiae, a guanine nucleotide exchange
      factor that activates Ras. These results imply a role for the ras pathway in
      Drosophila neuronal development.

PMID- 1736365
TI  - Myelodysplastic syndromes: introduction.

PMID- 1736364
TI  - Linguistic experience alters phonetic perception in infants by 6 months of age.
AB  - Linguistic experience affects phonetic perception. However, the critical period
      during which experience affects perception and the mechanism responsible for
      these effects are unknown. This study of 6-month-old infants from two countries,
      the United States and Sweden, shows that exposure to a specific language in the
      first half year of life alters infants' phonetic perception.

PMID- 1736366
TI  - Biology and pathogenesis of the myelodysplastic syndromes.

PMID- 1736367
TI  - Chromosome abnormalities in myelodysplastic syndromes.

PMID- 1736368
TI  - In vitro marrow culture studies in the myelodysplastic syndromes.

PMID- 1736369
TI  - Classification and morphologic features of the myelodysplastic syndromes.

PMID- 1736370
TI  - Leukemias and myelodysplastic syndromes secondary to drug, radiation, and
      environmental exposure.
AB  - The median latency of 2 degrees MDS/AL is 4 to 5 years. A high percentage of
      patients with 2 degrees MDS/AL convert to 2 degrees AL. Survival of either is
      less than 1 year. A constellation of morphologic abnormalities from all 3 cell
      lines produces a unique appearance. Both 2 degrees MDS and 2 degrees AL are
      difficult to classify by the FAB system. With the exception of the identification
      of karyotypic abnormalities, the biology of 2 degrees MDS/AL remains largely
      unexplored. Alterations of chromosomes 5 and 7 predominate, but other associated
      cytogenetic abnormalities are being increasingly recognized. A synthesis of data
      regarding 2 degrees MDS/AL resulting from the treatment of several primary
      malignancies generates the tentative conclusions that (a) many of the alkylating
      agents, and the nonclassic alkylating agent procarbazine, are leukemogens; (b)
      melphalan is a more potent leukemogen than cyclophosphamide. None of the other
      alkylating agents has been clearly established to be more or less potent than
      another; (c) increasing duration or amount of alkylator-based chemotherapy
      increases the risk of leukemogenesis; (d) low doses of radiation delivered to
      large volumes of bone marrow are weakly leukemogenic. High doses of radiation
      delivered to small volumes are not. Due to the latter, there is minimal additive
      risk for 2 degrees MDS/AL among studies using alkylator-based chemotherapy and
      radiotherapy, either concurrently or sequentially; (e) the older patient (greater
      than 40) is at increased risk for 2 degrees MDS/AL, at least in Hodgkin's
      disease. Children may be at lesser risk than adults, and younger children at
      lesser risk than older children; (f) the risk of 2 degrees MDS/AL peaks within
      the first decade after treatment for the primary malignancy. The incidence rates
      during the second decade are low. Identified occupational/environmental risks for
      2 degrees MDS/AL include benzene, ambient and diagnostic radiation exposure, and
      perhaps ethylene oxide. The similarities in karyotype abnormalities among
      leukemic cells of those whose occupations expose them to chemical hazard, and
      those who are exposed to cytotoxic agents, suggest that many more environmental
      leukemogens have yet to be discovered. Karyotype is an important prognostic
      factor for both achievement of CR and for survival. Nonaggressive treatment
      approaches have not proven useful, although the use of hematopoietic growth
      factors offers promise in this area. Combination chemotherapy is justified in
      patients with adequate performance statuses and "favorable" karyotypes.
      Allogeneic bone marrow transplantation is currently the only curative approach,
      and can be applied without attempts to first reduce the leukemic burden.

PMID- 1736371
TI  - Chemotherapy and bone marrow transplantation for myelodysplastic syndromes.

PMID- 1736372
TI  - Duplex sonography of the carotid arteries.
AB  - Duplex sonography is the best noninvasive modality for investigation of possible
      carotid artery stenosis. By using the above described techniques, almost all
      significant stenoses can be detected and categorized correctly. Knowledge of
      common pitfalls in the performance and interpretation of the examination is
      essential to avoid misdiagnosis. Color imaging is a helpful addition to
      conventional duplex imaging, but is not essential to the performance of high
      quality examinations.

PMID- 1736373
TI  - Peripheral arterial duplex ultrasonography.

PMID- 1736374
TI  - Pseudotruncus arteriosus (type I).

PMID- 1736375
TI  - Ultrasound evaluation of deep venous thrombosis.
AB  - Ultrasonography has achieved the role of the contemporary diagnostic tool for the
      assessment of DVT. Routine use of venography to assess for lower extremity clot
      is very difficult to justify. Long-term follow-up of patients has provided
      sufficient documentation that ultrasonography can successfully supplant the
      venogram. Only with regard to calf vein thrombosis is there still uncertainty
      about the need to occasionally rely on venography. Radiologists must become
      cognizant of the capabilities of ultrasonography and facile in its
      interpretation. Performance of this test should be available in every
      institution. The nonradiological literature is replete with articles documenting
      the use of venous ultrasonography and encouraging its routine use for venous clot
      evaluation.

PMID- 1736376
TI  - Basic principles and clinical applications of magnetic resonance angiography.

PMID- 1736377
TI  - Doppler principles.

PMID- 1736378
TI  - The role of the vascular laboratory in clinical decision-making.

PMID- 1736379
TI  - When to save the ruptured spleen.

PMID- 1736380
TI  - Selected management of pancreatic pseudocysts: operative versus expectant
      management.
AB  - BACKGROUND: The aim of this study was to determine if nonoperative,
      noninterventional expectant management of pancreatic pseudocysts is warranted in
      selected patients. METHODS: From 1980 to 1985, 114 patients with the diagnosis of
      pancreatic pseudocyst were evaluated. RESULTS: Forty-six patients underwent
      primary operative therapy, with 13% undergoing emergency operations for
      pseudocyst-related complications. Although no operative deaths occurred,
      significant morbidity occurred in 26% of patients (emergency operations, 67%;
      elective procedures, 10%). The remaining 68 patients were initially treated
      selectively with a nonoperative, expectant approach. Severe, life-threatening
      complications in this group followed up for a mean of 46 months occurred in only
      6 patients (9%); 19 patients eventually underwent elective operation directed at
      either the pseudocyst or other complications related to pancreatitis. Overall, in
      patients managed by a nonoperative approach, resolution of the pseudocyst
      occurred in 57% of the 24 patients with satisfactory radiographic follow-up, with
      38% resolving more than 6 months after diagnosis. Although patients eventually
      undergoing operation tended to have larger pancreatic pseudocysts than the
      patients managed successfully nonoperatively (6.9 vs 4.9 cm), no serious
      complications occurred in seven patients with pancreatic pseudocysts greater than
      10 cm who were treated expectantly. CONCLUSIONS: A nonoperative,
      noninterventional, expectant approach is warranted in the management of selected
      patients with pancreatic pseudocysts.

PMID- 1736381
TI  - Long-term follow-up of children with colon and gastric tube interposition for
      esophageal atresia.
AB  - BACKGROUND: There are two major methods of esophageal substitution for children
      born with long-gap esophageal atresia. This study was undertaken to see whether
      one method of substitution emerged as clearly superior to the other. METHODS:
      Twenty-four UK children who received a colon transposition for esophageal atresia
      were compared with 15 US children with esophageal atresia who received a gastric
      tube. The charts of all patients were reviewed. Follow-up data were obtained by
      questionnaire, and more than 80% of patients were personally evaluated at follow
      up clinics. RESULTS: At follow-up US children were 3 1/2 to 18 1/2 years of age;
      UK children were 7 1/2 to 19 years of age. Most of the children fell at or below
      the 10th percentile for height and weight, reflecting the tendency for
      prematurity in infants with esophageal atresia. One half of the children needed
      to eat slowly and to avoid certain meats. Dysphagia was rare. Older children ate
      socially with their friends without embarrassment. Early complications were
      technical; there were few late complications, and no difference was apparent
      between the two groups. CONCLUSIONS: In subjects who were growing, no difference
      was noted between the two methods of substitution as far as nutrition, growth,
      patient acceptability, or complications, early or late. Both groups functioned
      well and appeared to improve with the passage of time.

PMID- 1736382
TI  - Nutritional status seven years after Roux-en-Y gastric bypass surgery.
AB  - BACKGROUND: Nutritional deficiencies in patients after Roux-en-Y gastric bypass
      operations have been mainly attributed to dietary restriction. However, most of
      these studies have been performed during the period of greatest caloric
      restriction. METHODS: Two hundred patients who were morbidly obese were followed
      for 6 to 8 years (mean, 6.7 years) after Roux-en-Y gastric bypass surgery. Each
      underwent a thorough physical examination and behavioral and nutritional
      assessments, including hemoglobin, red blood cell indices, serum iron content,
      iron binding capacity, and serum vitamin B12 and folic acid concentrations.
      RESULTS: Data obtained from blood tests disclosed a significant gradual decrease
      of the mean serum hemoglobin (p less than or equal to 0.0000), mean corpuscular
      volume (p less than 0.001), and iron saturation (p less than or equal to 0.0000).
      Mean vitamin B12 concentration improved during the last 3 years of follow-up. The
      mean values of iron saturation and vitamin B12 were not correlated with the
      patients' weight loss. Meat intolerance was observed in 51%, 60.3%, 59.5%, and
      55.1% of the patients during the 0 to 12 months, 13 to 24 months, 25 to 72
      months, and 73 to 96 months after surgery, respectively. A significant
      correlation was found between the eating habits and the laboratory values. The
      mean serum iron saturation, vitamin B12, and folic acid were significantly higher
      in patients who eat meat than in patients who do not eat meat (piron less than
      0.0046, pB12 less than 0.0052, folate less than 0.01). In addition, oral vitamin
      and mineral supplements significantly improved the nutritional status of the
      patients. The patients had no caloric malnutrition or protein deficiency.
      CONCLUSIONS: Roux-en-Y gastric bypass induces long-term changes in eating habits,
      independent of caloric intake. Iron continuously declines 6 to 8 years after
      surgery, depending (significantly) on the eating behavior, but not on the caloric
      intake.

PMID- 1736383
TI  - Pacing the human stomach.
AB  - The aim of this study was to document the pattern of human gastric pacesetter
      potentials after abdominal operation and to determine whether the potentials
      could be paced by electrical stimuli. Ten patients undergoing cholecystectomy had
      temporary serosal electrodes positioned along the greater curvature of the
      stomach. Bipolar myoelectric recordings and attempts at electrical pacing were
      made after operation. On postoperative day 1, the pacesetter potentials had a
      regular frequency (3.2 +/- 0.1 cycles/min), and no gastric dysrhythmias were
      evident. The distal stomach of nine of ten patients could be entrained by pacing
      the proximal electrodes (forward pacing) to a maximal rate of 4.3 +/- 0.3
      cycles/min (p less than 0.05 versus nonpacing) without a change in propagation
      velocity or direction. Backward pacing (maximum rate, 3.9 +/- 0.2 cycles/min) was
      possible in six patients. Forward pacing was successful by day 3 in only four of
      ten patients, and backward pacing was successful in none of ten patients. A meal
      given a median of 3.5 days after operation did not change the pacesetter
      potential frequency, rhythm, or direction of propagation, and three of ten
      patients had successful forward pacing after a meal. In conclusion, a regular
      pattern of gastric pacesetter potentials is present after cholecystectomy. The
      gastric pacesetter potentials can be paced with electrical stimuli, although
      refinements of the pacing electrodes or stimuli will be needed to achieve long
      term pacing. Pacing holds promise as a potential treatment for gastric
      myoelectrical disorders.

PMID- 1736384
TI  - Liver transplantation by "face-a-face" venacavaplasty.
AB  - A modification of the technique of liver transplantation by the face-a-face
      venacavaplasty is described and the use in four patients reported. This technique
      enables livers with a small vena cava to be inserted in an anatomic fashion and
      should help increase the use of such grafts where disparity between vessel size
      exists.

PMID- 1736385
TI  - Encephalo-omental synangiosis in the management of moyamoya disease.
AB  - Moyamoya disease is a chronic occlusive cerebrovascular disorder characterized by
      stenosis of the intracranial internal carotid artery often accompanied by
      stenosis of the anterior and/or middle cerebral arteries. This results in
      cerebral ischemia, which manifests clinically as transient, repetitive episodes
      of hemiplegia, dysarthria, and involuntary movements. This case report documents
      a patient in whom an initial extracranial-intracranial bypass (superficial
      temporal-middle cerebral artery) failed to alleviate the ischemic symptoms. In a
      subsequent procedure, a pedicle graft of omentum was created and through a
      subcutaneous tunnel was placed on the right cerebral cortex. Over a 2 1/2-year
      period, this has resulted in a dramatic resolution of the patient's
      symptomatology. The report delineates the condition and reviews other therapeutic
      options.

PMID- 1736386
TI  - Small vessel occlusion in acute acalculous cholecystitis.
AB  - Ischemia is one mechanism implicated in the pathogenesis of acute acalculous
      cholecystitis. Gallbladder specimen arteriography was performed to define the
      comparative status of cystic artery runoff in the macroscopically normal
      gallbladder (n = 10), in acute gallstone-associated cholecystitis (n = 10), and
      in acute acalculous cholecystitis (n = 7). Standardized film exposure and
      quantity of contrast medium administered permitted objective intergroup
      comparison. Compared to the macroscopically normal gallbladder, specimens of
      acute gallstone-associated cholecystitis exhibited arterial dilatation and
      extensive venous filling. In contrast, multiple arterial occlusions, with absent
      or minimal venous filling, were consistent features of acute acalculous
      cholecystitis; the degree of arteriographic abnormality for acute acalculous
      cholecystitis corresponded to the severity of gallbladder pathologic findings.
      Small vessel occlusion, on the basis of low splanchnic flow or intravascular
      coagulation, may be a fundamental element in the pathogenesis of acute acalculous
      cholecystitis.

PMID- 1736387
TI  - Xanthine oxidase: its role in the no-reflow phenomenon.
AB  - This study was designed to probe the hypothesis that oxygen-derived free radicals
      are involved in initiation of the no-reflow phenomenon. We developed a
      reproducible model of no reflow in the rat hind limb. Laser Doppler studies
      confirmed that the hind limbs perfused well after 2 or 4 hours of ischemia, but
      perfusion ceased in the first 10 minutes after 6 hours of ischemia. Venous blood
      samples and biopsy specimens of skin and muscle were taken after 2 and 4 hours of
      ischemia to study tissue injury. Blood samples were evaluated for xanthine
      oxidase (XO), xanthine dehydrogenase, and creatine phosphokinase (CPK)
      activities. Conjugated dienes and iodine 125-labeled albumin extravasation were
      quantified in tissue samples. Groups of animals were treated with inhibitors of
      XO (allopurinol), antioxidant enzymes (superoxide dismutase plus catalase), and
      free radical scavengers (dimethyl sulfoxide and dimethyl thiourea) to assess the
      roles of free radicals in ischemia-reperfusion injury in the hind limbs. After 4
      hours of ischemia followed by reperfusion, plasma XO activity rose threefold over
      preischemia levels (p less than 0.05). Xanthine dehydrogenase activity did not
      change; conjugated diene levels in muscle rose twofold; CPK levels rose sixfold,
      and 125I albumin extravasation rose twofold (p less than 0.05). Pretreatment with
      the XO inhibitor allopurinol reduced XO activity to negligible levels and
      significantly attenuated conjugated diene levels, CPK levels, and albumin
      extravasation. Albumin extravasation was also significantly attenuated by
      pretreating animals with superoxide dismutase together with catalase, dimethyl
      thiourea, and dimethyl sulfoxide. In all animals pretreated with allopurinol or
      superoxide dismutase and catalase, reperfusion persisted after 6 hours of
      ischemia. These data suggest that, in ischemia followed by reperfusion, tissue
      injury is related to oxygen products derived from XO activity.

PMID- 1736388
TI  - Interferon-gamma attenuates hemorrhage-induced suppression of macrophage and
      splenocyte functions and decreases susceptibility to sepsis.
AB  - Although it is known that interferon-gamma synthesis and macrophage functions are
      depressed after hemorrhage, it remains to be determined whether systemic
      administration of interferon-gamma has any effect on hemorrhage-induced
      depression of macrophage and splenocyte functions. To study this, C3H/HEN mice
      were bled to a mean blood pressure of 35 mm Hg, maintained for 60 minutes, and
      followed by adequate fluid resuscitation. The mice then received either 1000
      units interferon-gamma or saline solution (vehicle). Peritoneal (pM phi) and
      splenic (sM phi) macrophages and splenocytes were isolated 24 hours later. PM phi
      antigen presentation was measured by coculturing pM phi with the D10.G4.1 cell
      clone. Major histocompatibility complex class II (Ia) antigen expression was
      determined by direct immunofluorescence. Cytokine release by pM phi, sM phi, and
      splenocytes was assessed with specific bioassays. For survival studies, mice were
      subjected to sepsis 3 days after hemorrhage. Treatment with interferon-gamma
      restored (p less than or equal to 0.05) hemorrhage-induced suppression of pM phi
      antigen presentation capacity and Ia antigen expression and increased (p less
      than or equal to 0.05) interleukin-1 and tumor necrosis factor release by pM phi
      and sM phi, as well as splenocyte proliferation (p less than or equal to 0.05).
      Interferon-gamma also decreased (p less than or equal to 0.007) the
      susceptibility to sepsis after hemorrhage. Thus interferon-gamma represents a
      potent agent for treating hemorrhagic shock-induced immunosuppression and for
      increasing the ability of the host defense system to combat bacterial infections
      after hemorrhage.

PMID- 1736389
TI  - Effect of nutritional status on organic anion clearance by the swine liver.
AB  - Hepatic dysfunction follows a wide range of insults. Impaired excretion of
      organic dyes such as bilirubin often occurs before other obvious clinical defects
      in metabolic processes. Indocyanine green (ICG) is excreted through pathways
      similar to those of bilirubin. To determine the effectiveness of ICG as a marker
      of hepatic dysfunction related to clinical malnutrition, pigs received 5 mg/kg
      ICG with simultaneous sampling from the hepatic vein, pulmonary artery, and aorta
      over 3 hours. Group I remained well nourished, group II was fasted to a weight
      loss equal to 20% of initial body weight, and group III was fasted to a 20%
      weight loss and then refed until the animals regained their initial weight. Both
      systemic and intrinsic hepatic clearance were depressed significantly with
      fasting but returned above baseline after refeeding. No significant difference
      appeared between systemic and intrinsic hepatic clearance. Extraction ratios were
      low in all groups. In outbred swine, ICG clearance reflects the function of
      hepatic organic anion excretion in vivo, and venous sampling reflects intrinsic
      hepatic clearance. The impairment of the carrier-mediated transport system is
      reversible with refeeding.

PMID- 1736390
TI  - The value of hepatic artery reconstruction as a technique in rat liver
      transplantation.
AB  - The importance of hepatic artery reconstruction in the success of liver
      transplantation in the rat has been studied. Rat liver grafts were performed with
      or without reanastomosis of the hepatic artery, both in rejector and nonrejector
      donor/recipient combinations. No significant improvement in recipient survival
      was found when arterialization was performed, and histologic studies showed no
      differences in hepatocyte or bile duct architecture between arterialized and
      nonarterialized groups. Thus, arterialization does not make an important
      contribution to the outcome of liver transplantation in the rat; biliary
      complications associated with the nonarterialized method appear to be technique
      related rather than the result of ischemia.

PMID- 1736391
TI  - Interleukin-6 as a new indicator of inflammatory status: detection of serum
      levels of interleukin-6 and C-reactive protein after surgery.
AB  - Postoperative serum interleukin-6 (SIL-6) and C-reactive protein (SCRP) levels
      were examined in 71 patients who underwent various types of abdominal surgery.
      Similar time-dependent changes in SIL-6 and SCRP levels were observed in 12
      patients despite differences in surgical procedures and liver function among the
      patients. SIL-6 started to increase within 3 hours after the beginning of the
      operation and reached a peak after 24 hours. SCRP started to increase after 12
      hours and was maximum at 48 to 72 hours. The increase in SIL-6 at 24 hours (delta
      IL-6) showed a close correlation with that of SCRP at 48 hours (delta CRP) in 53
      patients without liver cirrhosis. In 18 patients with liver cirrhosis, delta CRP
      relative to delta IL-6 was less than that in patients without cirrhosis and was
      poorly correlated with the latter. delta IL-6 was correlated with the length of
      time of the operation and blood loss in both groups, but delta CRP showed no
      significant correlation with these factors in either group. These findings
      indicate that the increase in IL-6 triggered by a surgical procedure may function
      as a hepatocyte-stimulating factor and that monitoring of SIL-6 may be more
      helpful than monitoring of SCRP for estimation of inflammatory status and early
      detection of an acute-phase response.

PMID- 1736392
TI  - End-to-end anastomosis between a prosthesis and a vein of different diameters: a
      technique that maintains a straight vascular axis.
AB  - In a composite femoropopliteal bypass, the intermediate anastomosis between a
      vascular prosthesis and the available vein is often difficult to carry out
      because of a discrepancy of the diameter between the two vessels. The end-to-end
      anastomosis is performed by working with the elasticity of the venous tissue
      resulting in anastomotic kinking. A technique keeping the vascular axis straight
      between two vessels of different diameters and elasticity is presented.

PMID- 1736393
TI  - Colon invasion by primary splenic lymphoma: a case report and review of the
      literature.
AB  - Primary splenic lymphoma accounts for 1% of lymphomas. The definition of primary
      splenic lymphoma is controversial and its clinical presentation is variable. This
      report describes a patient with primary non-Hodgkin's lymphoma of the spleen with
      transmural colonic invasion. This unique case represents the first reported
      instance of splenic lymphoma with histologically demonstrated invasion to the
      colonic mucosa. The clinical and pathologic features of this case and primary
      splenic lymphoma in general are reviewed.

PMID- 1736394
TI  - Pneumoperitoneum and signs of peritonitis from a pleuroperitoneal shunt.
AB  - Pleuroperitoneal shunting has become an increasingly popular therapeutic option
      for the control of intractable pleural effusions. However, there exists a paucity
      of information regarding institutional and individual experiences with this
      technique. We report an unusual complication of a Denver pleuroperitoneal shunt
      that resulted in pneumoperitoneum and a clinical picture of diffuse peritonitis
      from a ruptured abdominal viscus. The cause of this condition was continuous
      decompression of a pneumothorax into the peritoneal cavity, through the shunt.

PMID- 1736395
TI  - Normocalcemia thirteen years after successful parathyroid allografting in a
      recipient of a renal transplant.
AB  - Two months after receiving a cadaveric renal allograft, a 36-year-old woman
      received a parathyroid allograft from a living unrelated donor, who was
      haploidentical to the renal donor. Her preoperative 24-hour urinary excretion of
      calcium was 0.18 gm/24 hrs, and after operation it decreased to 0.004 gm/24 hrs,
      (normal, less than 0.20 gm/24 hrs). The C-terminal parathyroid hormone level
      increased from 155 pg/ml (normal, 275 to 675 pg/ml) to 327 pg/ml after operation.
      The N-terminal parathyroid hormone level in her grafted arm has varied between
      2.5 to 10 times the level in her nongrafted arm. Thirteen years later, both
      allografts are functioning normally. To our knowledge, this is the longest
      functioning parathyroid allograft.

PMID- 1736396
TI  - Management of common bile duct obstruction associated with spontaneous
      perforation of the biliary tree.
AB  - Spontaneous perforation of the extrahepatic biliary tree during infancy is an
      uncommon event. The cause of bile duct perforation is unclear, but one-quarter of
      reported cases have been associated with a stone or bile sludge obstructing the
      distal common bile duct. A 4-week-old girl had jaundice, and a DISIDA (99m
      technetium diisopropyl iminodiacetic acid) scan revealed perforation of the
      biliary tree. Exploratory surgery showed distal common bile duct obstruction with
      proximal perforation. No attempt was made to remove the obstructing lesion
      because of duct inflammation. Common bile duct obstruction persisted until week 5
      after surgery when cholangiography revealed free flow of contrast into the
      duodenum through a common bile duct of normal caliber without a filling defect.
      In the presence of acute inflammation associated with perforation of the biliary
      tree, exploration of the common bile duct to relieve a distal obstruction could
      prove hazardous. Our case and a review of the literature suggest that the
      obstructing stone or sludge may pass spontaneously if managed expectantly.

PMID- 1736397
TI  - [Acute epididymitis or testicular torsion?--the differential diagnosis is not
      always simple].
AB  - Torsion of the spermatic cord continues to be a diagnostic dilemma. All lesions
      suspicious for torsion should therefore be explored. Acute epididymitis can
      nowadays more often be treated based on microbiological results. In most children
      and many elderly pathological findings in the lower urinary tract have to be
      evaluated and treated.

PMID- 1736398
TI  - [Practical advice for the care of patients with indwelling bladder catheters].
AB  - Catheterizing a patient, whether short or long term, was once defined as a simple
      task, but it is not without complications (infection, calcification, and urethral
      stenosis). The author makes several recommendations for the care of patients with
      indwelling catheters.

PMID- 1736399
TI  - [Suprapubic urinary diversion using Cystofix--an alternative to the urethral
      indwelling catheter].
AB  - Suprapubic Cystofix-cystostomy is a valuable alternative to the Foley-catheter.
      The advantages of suprapubic cystostomy are mainly a reduction of urinary tract
      infections, inflammatory reactions in the lower urinary tract and avoidance of
      late urethral strictures after transurethral catheterism. There are a few
      contraindications to be considered, mainly an empty bladder and coagulation
      disorders. The complication rate of suprapubic Cystofix-cystostomy, usually gross
      haematuria, is very low. Cystofix-cystostomy is as useful for short term urinary
      drainage as for long term drainage in the case of chronic voiding disorders.

PMID- 1736400
TI  - [Biopsy of the testis].
AB  - Biopsy of the testis has been considered for a long time and continues to be an
      acknowledged method of examination in the framework of investigation of male
      infertility. A classical indication for this is the repeated statement of
      azoospermia with normal size of the testes. On part of the spermogram, the
      indication for testicular biopsy is however not limited just to azoospermia. On
      the other hand, one can do without a biopsy when the size of the testes is less
      than 2.5 cm, as almost certainly a pronounced testicular atrophy which cannot be
      influenced will be present. Diagnosis of testicular precancerous conditions
      represents a more recent indication for biopsy of the testis which will probably
      gain more importance in the future. Anamnestic and clinical informations and
      above all the correct fixation and treatment of the specimen are an absolute
      prerequisite for the perfect interpretation of the bioptic picture.

PMID- 1736401
TI  - [Preventive measures in stones due to infection, uric acid and cystine].
AB  - General prophylaxis of renal stone formation consists of 1. high fluid intake and
      2. modest consumption of protein-rich foods. Specific prophylactic measures are
      based on pathophysiologic mechanisms of stone formation. In infection-induced
      renal stones, combined treatment with culture specific antibiotics and complete
      stone removal is of utmost importance. In all cases where stone fragments cannot
      be removed completely and/or partial obstruction remains, long-term antibiotics
      in combination with urine acidification by methionine (urine pH 5.6 to 6.2) are
      most appropriate. Prophylaxis of uric acid stones primarily consists of reducing
      purine intake and alkalizing the urine by potassium citrate. Only if this regimen
      failed or gout occurred, allopurinol should be administered. In patients with
      cystine stones, urine volume should be increased to greater than 3000 ml/die.
      Alkalizing the urine to a pH greater than 7.5 rises cystine solubility, whereas
      cystine excretion may be reduced by a diet low in sodium and/or low in
      methionine/cysteine. Thiols form mixed thiol-cysteine disulfides that are many
      times more soluble than cystine in urine; because of their high rate of adverse
      side-effects, however, these compounds are of lowest priority in the treatment of
      cystine stones. There is no convincing evidence for the efficacy of high dose
      ascorbic acid treatment in cystinuria.

PMID- 1736402
TI  - [Intracavernous self-injection in impotence].
AB  - On the basis of new diagnostic methods, 50 to 80% of impotent men show organic
      changes which are potentially responsible for erectile dysfunction. In our
      institution 409 consecutive patients have been submitted to the programme of
      intracavernous self-injection of papaverine. In 11% of the patients erectile
      function was normalized after a series of self-injections. 25% use papaverine
      regularly at home, and 64% discontinued the self-injections. Many of these
      patients did not accept this form of therapy. Side effects are rare and harmless.
      Early information about the intracavernous self-injection therapy by the
      physician can help to avoid unnecessary investigations.

PMID- 1736403
TI  - [Surgical refertilization following vasectomy--an increasing need].
AB  - Surgical refertilization by vaso-vasostomy, taking place a long time after
      vasectomy, gains increasing importance in men whose partnership condition has
      changed since the time of sterilization. Apart from the surgical technique, the
      length of time between vasectomy and vaso-vasostomy, the age of the patient and
      immunological factors are of importance for the success of the vaso-vasostomy,
      that is the procreation of sound children. From the view of the surgical
      technique the single-layered anastomosis without splinting, carried out with
      magnifying glasses, produces satisfactory results comparable to those of more
      complicated techniques (operation microscope). The success rate of recanalization
      is between 80 and 95%. However, the rate of refertilization (ejaculation of
      fertile sperms) is between 50 and 70% only. Firstly, this discrepancy is based on
      the space of time between vasectomy and vaso-vasostomy. If the vasectomy has
      taken place more than ten years ago, the prognosis is significantly poorer.
      Secondly, it is based on the occurrence of circulating sperm antibodies after
      vasectomy. This rare immunological phenomenon, which is based on a disturbed
      resorption of sperms, reduces the fertility considerably. Thirdly, the age of the
      patient is of importance. If the patient is more than 50 years old at the time of
      surgery, the fertility is significantly reduced, as the spermatogenesis
      deteriorates in this age group under normal conditions as well. In spite of these
      reservations the surgical refertilization after vasectomy by means of
      vasovasostomy is a promising method, that can be recommended to the patient
      concerned.

PMID- 1736404
TI  - [Hematuria and diagnostic procedures].
AB  - In the past ten years the strategies for evaluation of hematuria seem to have
      quite changed. Lately published articles show diverging opinion especially
      concerning the value of IVP and sonography. We propose an evaluation procedure
      with regard to the practitioner and the everyday routine using urinalysis
      including search for dysmorphic erythrocytes and cytology, sonography, IVP and
      cystourethroscopy for screening. Sonography and IVP are in our opinion
      complementary tests regarding accuracy of screening the renal parenchyma and the
      urothelial channel respectively. and the urothelial channel respectively. Other
      tests are used only specifically for detailed information about pathological
      findings during evaluation.

PMID- 1736405
TI  - [Hormones and mammary tumors in the bitch: a review].
AB  - Toxicity studies as well as epidemiological studies in veterinary medicine have
      shown that both ovarian steroids and a large number of synthetic derivatives may
      promote the formation of mammary tumours in dogs. Abnormalities in pituitary
      function, particularly in the secretion of growth hormones, have been assumed to
      be involved in this process. In the present paper the possible role of endogenous
      and exogenous hormones in the pathogenesis of mammary tumours in bitches is
      reviewed. The available evidence suggests that steroid hormones may act at an
      early stage in the development of tumours by stimulating the proliferation of
      normal epithelium. This results in an increase in the number of susceptible
      cells. In addition a growth-stimulating action may be exerted upon cells which
      have undergone partial malignant transformation, but possibly to a lesser extent
      upon fully malignant cells at a late stage of tumour development. In advanced
      mammary cancers steroid receptors are frequently absent, which may indicate a
      more autonomous pattern of growth. It seems justified to conclude that in
      clinical practice ovariectomy at an early age as a measure to prevent oestrus is
      to be preferred to progestin treatment with regard to the risk of mammary
      carcinoma. Still, there is no indication that in dogs, ovariectomy will reduce
      the risk of metastasis once the animal is presented with a mammary carcinoma. The
      earlier assumption that overproduction of growth hormone is an important factor
      in the pathogenesis of spontaneous mammary tumours in the dogs could not be
      proven. The role of prolactin and of thyroid hormones in this process continues
      to be uncertain.

PMID- 1736407
TI  - [Necropsy findings in fattening pigs during the period 1979-1989].
AB  - Necropsy findings of 1041 fattening pigs, during the period of 1979-1989 are
      presented. The pigs originated from one veterinary practice association.
      Enterotoxicosis associated with E. coli serotype O149:K91:K88 was the most
      prevalent diagnosis, followed by fibrinous pleuropneumonia due to Actinobacillus
      pleuropneumoniae. A decrease was noticed for Aujeszky disease during the late
      years. After 1985 an increase was found for torsio mesenterialis. In 1.7% of the
      cases no post mortem diagnosis could be made.

PMID- 1736406
TI  - [Lead poisoning in cattle in Northern Netherlands. Follow-up study of 2 farms].
AB  - The after-effects of a serious lead intoxication were studied. This intoxication
      was caused by contaminated feed. Calves and cows of two dairy farms were examined
      up to half a year after the incident with the contaminated feed in October 1989.
      Clinical signs were observed and blood samples were taken. Blood parameters like
      zinc-protoporphyrin (ZPP), haemoglobin, RBC, WBC, MCV, haematocrit, MCHC, and the
      blood lead levels were analysed. Cattle of one of the most afflicted farms showed
      severe effects of lead intoxication: blindness, muscle twitching and
      hyperirritability. Two animals died. Forty percent of the affected cows had to be
      slaughtered. The ZPP levels in calves of this farm were still elevated after six
      months. The zinc-protoporphyrin level in blood seemed to coincide better with the
      clinical signs than the blood lead level. Animals with less than 3 mg ZPP/l RBC
      showed no irreversible effects of the lead intoxication. It is suggested that ZPP
      could be a useful predictor for the after-effects of lead intoxication.

PMID- 1736408
TI  - [Aspiration pneumonia].

PMID- 1736409
TI  - [Once again: patellar dislocation].

PMID- 1736410
TI  - [Euthanasia].

PMID- 1736411
TI  - [12 years control of hog cholera in the EEC].

PMID- 1736412
TI  - Altered distribution of 109cadmium in mice during viral infection.
AB  - The distribution of the toxic heavy metal cadmium (Cd) was studied in Coxsackie
      virus B3 (CB3)-infected Balb/c mice by whole-body autoradiography and gamma
      counting. The distribution of 109Cd was studied 4 days post CB3-inoculation and
      10 min after intravenous injection of 0.21 microgram of Cd/kg body weight. Whole
      body autoradiography results showed that the distribution of 109Cd is greatly
      changed during this viral infection. This newly discovered distribution was
      mainly visible as a greatly increased accumulation in the renal and adrenal
      cortices. After impulse counting of selected organs it was found that the normal
      accumulation of 109Cd in the kidneys (184,354 +/- 30,961 c.p.m.) was increased by
      47% (P less than 0.05) during CB3 infection (270,503 +/- 54,780 c.p.m.). In
      contrast to healthy animals, some infected mice showed accumulation of 109Cd in
      the spleen. These results show for the first time that an invading micro-organism
      can change the distribution of an environmental pollutant.

PMID- 1736413
TI  - Cellular localization and hormonal regulation of 7,12-dimethylbenz[a]anthracene
      mono-oxygenase activity in the rat ovary.
AB  - To identify the ovarian cell type(s) responsible for the metabolism of 7,12
      dimethylbenz[a]anthracene (DMBA) and their dependence on hormonal influences,
      DMBA mono-oxygenase activity was determined in primary cultures of cells
      dispersed from rat ovaries and separated by centrifugation on discontinuous
      Percoll density gradients. The contents of progesterone and oestradiol in the
      different cell cultures were characterized. Moreover, the morphological
      appearance of ovarian cells obtained from untreated and pregnant mare's serum
      gonadotropin (PMSG)-treated rats was examined. It is concluded from experiments
      with immature PMSG-treated rats, that DMBA mono-oxygenase activity is localized
      in follicular granulosa (and/or theca) cells. This activity decreases during
      luteinization, and is recovered in a population of cells harvested at a higher
      density on the Percoll gradient. The xenobiotic-metabolizing activity was not
      correlated to the rate of biosynthesis of progesterone or oestradiol in isolated
      cells, measured in the presence or absence of human chorionic gonadotropin and/or
      testosterone. However, a certain dependence of DMBA metabolism on steroids and/or
      steroid-synthesizing enzymes could not be excluded. For example, DMBA mono
      oxygenase activity was markedly increased in a cell population, tentatively
      identified as granulosa cells, obtained from untreated mature rat ovaries upon
      addition of testosterone, which is the substrate for oestrogen synthesis, to the
      cell culture.

PMID- 1736414
TI  - Alteration in surface structure of Clara cells and pulmonary cytochrome P-450b
      level in rats exposed to ozone.
AB  - Changes in the surface structure of Clara cells in the terminal bronchioles
      following exposure of rats to 0.4 ppm ozone (O3) for 14 days were evaluated and
      compared to the content of pulmonary cytochrome P-450, an enzyme active in
      xenobiotic metabolism. Exposure to O3 caused a striking alteration of Clara cells
      in the terminal bronchiole. After 6 h exposure apical protrusions of Clara cells
      enlarged and these Clara cells formed clusters. However after 24 h exposure, the
      Clara cells decreased in number and flattened. They increased in number and
      enlarged again during the subsequent period of exposure. By the 14th day of O3
      exposure the number of Clara cells had increased significantly. The content of
      cytochrome P-450b (IIB1), a main isozyme of pulmonary cytochromes P-450 of rats,
      was determined by an immuno-blotting method using anti-cytochrome P-450b
      antibody. The cytochrome P-450b in the rats exposed to O3 increased significantly
      to 1.37- and 1.81-times that of the control on the 7th and 14th days,
      respectively. Immuno-electron microscopy demonstrated that cytochrome P-450b was
      localized abundantly in endoplasmic reticulum of Clara cells. Morphological
      alterations in Clara cells appear to be closely related with changes in the
      cytochrome P-450b content of the lung.

PMID- 1736415
TI  - Comparative tumor-initiating ability of 7H-dibenzo(c,g)carbazole and
      dibenz(a,j)acridine in mouse skin.
AB  - N-heterocyclic aromatics are environmentally important carcinogenic pollutants
      produced by incomplete combustion of organic material. 7H-Dibenzo-(c,g)carbazole
      (DBC), is a potent skin and systemic carcinogen, whereas dibenz(a,j)acridine
      (DBA), is a carcinogen with local effects. Therefore, the overall objective of
      these studies was to determine the initiating ability of DBC and DBA in mouse
      skin using an initiation-promotion protocol. Acetone-, TPA- or BaP-treated
      animals were used as negative and positive controls, respectively. DBC, DBA or
      BaP (200 nmol) dissolved in acetone was applied once to the backs of thirty
      shaved Hsd:(ICR)Br female mice, followed 2 weeks later with 2 micrograms of TPA
      in 50 microliters of acetone applied twice a week for up to 24 weeks. Skin tumors
      developed in 26, 17 and 27 animals, respectively. DBC plus TPA produced a
      significant influx of dermal macrophages similar to that seen for BaP. Initiation
      with BaP, DBC or DBA moderated the effect of TPA on most other dermal parameters,
      particularly neutrophils. These data indicate that, DBC, with apparently
      different activation pathways than BaP shows similar tumor initiating ability and
      morphological changes as BaP.

PMID- 1736416
TI  - Contribution of acetone and osmotic-diuresis by streptozotocin-induced diabetes
      in attenuation of cephaloridine nephrotoxicity.
AB  - Previous studies have indicated that cephaloridine nephrotoxicity was reduced in
      streptozotocin (STZ)-induced diabetic rats. Experiments were performed to
      investigate if a shorter duration of diabetes would reduce cephaloridine
      nephrotoxicity. Studies were also conducted to examine the contribution of
      osmotic diuresis and ketone accumulation to the mechanism for reduced toxicity.
      Male Fischer 344 (F344) rats were injected with 30 mg/kg STZ or vehicle. Seven
      days after STZ or vehicle administration, the animals were treated (i.p.) with
      1500 mg/kg cephaloridine. Increased kidney weight, blood urea nitrogen (BUN)
      level and decreased renal cortical slice accumulation of p-aminohippurate (PAH)
      and tetraethyl-ammonium (TEA) were measured in the normoglycemic group. No
      differences in renal function were detected between diabetic groups treated with
      cephaloridine or vehicle (PFC). Pretreatment of euglycemic rats with 0 or 10%
      dextrose in the drinking water and by oral gavage failed to prevent the renal
      damage produced by 1500 mg/kg cephaloridine despite glucosuria and urine output
      comparable to diabetic animals. However, dextrose-diuresis afforded a slight
      reduction in toxicity as indicated by changes in kidney weight and renal cortical
      slice accumulation of PAH and TEA. Pretreatment (oral) with 0 or 1.5 ml/kg
      acetone had no effect on cephaloridine toxicity (1000 mg/kg, i.p.). These
      findings suggested that attenuation of cephaloridine toxicity may be independent
      of the duration of diabetes. These results also indicated that glucose-mediated
      osmotic diuresis and acetone accumulation cannot account for reduced
      cephaloridine toxicity in diabetic rats.

PMID- 1736417
TI  - Placental aryl hydrocarbon hydroxylase activity and placental calcifications.
AB  - Induction of aryl hydrocarbon hydroxylase (AHH) activity in the placenta as a
      result of maternal exposure to polycyclic aromatic hydrocarbons contained in
      cigarette smoke has been well documented. Furthermore, calcifications are more
      prevalent in the placentas of pregnant smokers than in those of non-smokers. The
      present study examines whether this latter relationship could be explained by the
      induction of AHH activity in the placenta. AHH levels were determined at birth in
      141 unselected pregnant women admitted for delivery. Macroscopic placental
      examination was performed for vascular lesions, abnormalities of placental shape,
      of the cord and parameters of placental maturity such as basal and parenchymatous
      calcifications. Significant increases in the prevalence of calcifications of the
      placental basal plates and parenchyma with the induction of placental AHH were
      found. A similar significant association between smoking and AHH activation was
      also observed. These findings remained unchanged when controlling for smoking
      status assessed both by questionnaire and presence of cotinine in mother's urine.
      Moreover, the apparent association between smoking 'factor' and calcifications
      disappeared when controlling for AHH induction. Therefore, the association
      between smoking and placental calcifications previously related could be mediated
      by the AHH induction.

PMID- 1736418
TI  - Effect of cadmium on the monolayer maintenance of vascular endothelial cells in
      culture.
AB  - We investigated the effect of cadmium on the maintenance of the monolayer of
      vascular endothelial cells to clarify a possible involvement of endothelium
      injury in cadmium-induced vascular disorders. Endothelial cells from bovine aorta
      were cultured with cadmium chloride (0.5, 1.0, 2.0 or 5.0 microM) for 24 or 72 h.
      A histological observation revealed that a de-endothelialized space was formed in
      the monolayer by cadmium treatment; the number of endothelial cells was
      significantly decreased by the metal. Cadmium significantly decreased the number
      of growing endothelial cells with a significant decrease in the [3H]thymidine
      incorporation, suggesting that cadmium inhibited the cell proliferation. On the
      other hand, cadmium significantly increased the detachment of [3H]thymidine
      labeled endothelial cells from the monolayer with a parallel increase in the
      lactate dehydrogenase activity in the medium. From these results, it was
      suggested that cadmium impairs the endothelial cell monolayer; the de
      endothelialized space was formed by both an increase in the cell detachment by
      cadmium cytotoxicity and a retardation of the repair of the space which was due
      to an inhibition of the cell proliferation caused by the metal.

PMID- 1736419
TI  - Protective effect of NG-nitro-L-arginine (N5-[imino(nitroamino)methyl]-L
      ornithine) against cyanide-induced convulsions in mice.
AB  - The effects of NG-nitro-L-arginine (NNA; an inhibitor of the oxidative L-arginine
      pathway) on convulsions induced by cyanide were investigated in mice. NNA
      prevented cyanide-induced convulsions in a dose-dependent manner. Furthermore,
      the inhibitory effect against convulsions induced by cyanide with NNA was
      abolished by pretreatment of L-arginine. However, NNA did not change blood
      cyanide levels in mice 5 min after injection of potassium cyanide. Since NNA
      prevents against oxidative L-arginine pathway-dependent guanylate cyclase
      activation in intact cells, it was suggested that the protection against cyanide
      induced convulsions with NNA may be due to the inhibition of guanylate cyclase.
      In support, methylene blue, an inhibitor of guanylate cyclase, elicited a similar
      inhibition against convulsions induced by cyanide.

PMID- 1736420
TI  - Long-term results of knee synovectomy in pigmented villonodular synovitis.
AB  - 1. Pigmented villonodular synovitis (PVS) commonly affects the knee as a
      monoarticular proliferative process. The etiology is not understood. 2. Partial
      synovectomy for localized PVS and wide synovectomy for diffuse PVS institute a
      favorable result, despite a rather high rate of recurrence at long-term follow
      up. 3. Cases that involve bony erosion have a low incidence of recurrence but
      present an unsatisfactory prognosis even after curettage and wide synovectomy
      (postoperative progress of osteoarthritic changes).

PMID- 1736421
TI  - Honesty: the best policy in nursing practice.
AB  - 1. In the process of delivering patient care, nurses are constantly faced with
      choices of actions that can be either honest or dishonest. Dishonesty may be
      selected out of a desire to protect oneself, the patient, or even the doctor. 2.
      Although nurses must often choose between being honest and dishonest, being
      dishonest violates the trust placed in the nurse and undermines the nursing
      profession; dishonesty is never justified. 3. To err and to not set the record
      straight is dishonest and leads to lack of self-respect, lack of respect from
      others, lack of trust from patients and coworkers, lack of credibility, patient
      harm, and occasionally to lawsuits.

PMID- 1736423
TI  - Don't recap those needles!

PMID- 1736422
TI  - When patients die in the operating room.

PMID- 1736424
TI  - The changing role of the pediatric OR nurse.
AB  - 1. OR nurses are trained to listen, observe, and pass the necessary
      instrumentation. On their road to gain professional status, they must not forget
      the need to improve clinical and professional skills as well as why they went
      into nursing: patient care. 2. Many OR nurses do not try to eliminate fears, no
      matter what the age of their patients, and some may have even added to patient
      fears. Although such nurses are the exception, OR nurses should strive to keep
      themselves from being classified as uncaring. 3. Preoperative tours and
      postoperative visits should become an essential part of the surgical experience.
      Ideas and concerns should be addressed, and changes to enhance future surgical
      procedures should be discussed.

PMID- 1736425
TI  - Perioperative care of the craniotomy patient: a review.
AB  - 1. Knowledge of the patient and the planned positioning allows the perioperative
      nurse to prepare for the needs of the individual craniotomy patient in surgery.
      2. Microsurgical instrumentation often required with a craniotomy requires
      special handling and care. 3. Methylene blue should never be used in
      neurosurgical procedures. 4. The sitting position for posterior fossa surgery
      requires special precautions.

PMID- 1736426
TI  - [Dementia research in Denmark].

PMID- 1736427
TI  - [The social breakdown in senile dementia and physician's role].

PMID- 1736428
TI  - [The admission and discharge patterns of patients with dementia in psychiatric
      hospitals].
AB  - This paper describes the admission and discharge pattern in a psychiatric
      hospital for 315 senile and arteriosclerotic demented patients (290.09, 293.09
      ICD-8) aged 65 years and over and admitted for the first time. 47% (149) of the
      patients were admitted from other hospitals and temporary stays in nursing homes.
      A total of 203 (65%) of the patients experienced one or more changes of residence
      during the three months prior to admission to the psychiatric hospital. A Kaplan
      Meier analysis showed that 25% of the patients were still hospitalized 48 weeks
      after admission. A total of 62 patients died in the psychiatric hospital, one
      patient was still hospitalized when the investigation ceased. Of those discharged
      alive 201, (80%) were discharged to nursing homes 26 (10%) to their own homes and
      25 (10%) to hospitals. Of those who had their own home at the time of admission
      and were discharged alive only 16% were discharged to their own homes, the
      remainder were discharged to nursing homes and hospitals. On account of the many
      changes of environment the demented patients experience prior to admission to the
      psychiatric hospital, they risk developing confusional psychoses which may be
      disastrous to their physical and mental health.

PMID- 1736429
TI  - [Use of psychopharmaceuticals and commitment in psychiatric admissions of elderly
      patients with dementia].
AB  - Case records of 404 elderly patients (aged 65 years or more) who were admitted
      for the first time to the Psychiatric Hospital in Aarhus were investigated
      retrospectively. In 315 patients the diagnoses were senile dementia (290.09) and
      arteriosclerotic dementia (293.09) according to ICD-8. Information about use of
      psychotropic drugs before admission and on discharge alive was obtained from the
      patient case records. In the present study, the use of drugs was not found to be
      correlated with age, sex and degree of dementia. Significantly fewer committed
      patients were treated with psychoactive drugs and significantly fewer lived
      independently in their own homes. Only 42 (13%) patients had a crude psychiatric
      disorder while 251 (80%) were admitted on account of unacceptable behaviour. 90%
      of the latter group of patients had been treated with one or more psychoactive
      drugs on admission. The risks involved in the use of psychoactive drugs are
      discussed. On account of demographic changes in the Danish population and the
      recent decrease in psychiatric hospital beds and nursing home beds, it is
      recommended that the patterns of committed admissions of demented patients to
      psychiatric hospitals should be followed closely.

PMID- 1736430
TI  - [Shunt-nephritis].
AB  - Infection in ventriculo-atrial shunts implanted for relief of raised intracranial
      pressure may, in rare cases, result in glomerulonephritis (shunt-nephritis). Most
      frequently, infection with low-virulent bacteria is concerned. This results in
      mild or subclinical symptoms with the subsequent risk that the condition is
      overlooked. The glomerular damage is considered to be precipitated by deposition
      of immune complexes in the kidneys and subsequent activation of the complement
      system. The renal manifestations consist of varying degrees of proteinuria,
      haematuria and reduction of renal function. Treatment consists of removal of the
      shunt. If continued relief of pressure in the ventricular system is necessary, a
      ventriculo-peritoneal shunt should be implanted. Normally, the prognosis of the
      renal disease is good. If the diagnosis and treatment are delayed, irreversible
      renal damage may result. Regular control of urine (proteinuria, haematuria) and
      blood (Hb, serumcreatinine and serum complement) are recommended in the follow up
      control of patients with ventriculo-atrial shunts.

PMID- 1736431
TI  - [Septic sacroiliitis].
AB  - Septic sacroiliitis (SSI) is a rare form of pyogenic arthritis, which
      unrecognized or inadequately treated may cause longterm morbidity and eventually
      lasting disability. SSI is most frequently diagnosed among young adults,
      especially in drug abusers. Based on a literature survey three cases of SSI are
      presented, each representing characteristic aspects of SSI. The condition should
      be considered in cases of acute or subacute onset of pain in the gluteal region,
      hip or low back accompanied by fever. Laboratory findings are variable and non
      specific. Definite bacteriologic diagnosis is only achieved in about 75% of the
      cases. In almost all of the cases, Tc-99m-MDP bone scintigraphy will in almost
      all the cases show increased uptake in the affected joint within one week after
      onset of symptoms. Generally antibiotic treatment leads to complete recovery.

PMID- 1736432
TI  - [201-thallium myocardial scintigraphy before and after percutaneous transluminal
      coronary angioplasty].
AB  - We describe our experience from the first 30 patients treated with percutaneous
      transluminal coronary angioplasty (PTCA) in the Cardiologic Department P,
      Gentofte Hospital. The main purpose was to evaluate the value of thallium
      scintigraphy performed before and three months after PTCA. After PTCA, 23 (77%)
      had no angina and 22 (73%) had normal exercise-ECG. On the basis of the
      scintigraphies before PTCA, the patients were divided into two groups: In group
      1, five had normal scintigraphy and 14 reversible perfusion defects only. In
      group 2, all 11 patients had both persistent and reversible defects. In patients
      without persistent defects, significantly more were free from angina. No
      difference was observed between group 1 and 2 in percentage stenosis of the
      vessel or in reduction of the diameter. Significant reduction in the extent of
      reversible perfusion defects after PTCA was observed in both groups and also in
      the extent of persistent defects in group 2. In about 1/3 of the patients, the
      changes in percentage stenosis after PTCA and in the perfusion as judged by the
      scintigraphies differed. Therefore, as the two methods supplement each other, the
      main conclusions are: 1) Evaluation of the revascularization procedure is more
      reliable if a scintigraphy is obtained both before and after PTCA than if only
      coronary arteriography is performed. 2) Scintigraphy alone suffices for the three
      month follow-up examination, partly because it gives better information about the
      myocardial perfusion than does the arteriography, partly because scintigraphy is
      a noninvasive procedure.

PMID- 1736433
TI  - [Idiopathic interstitial pulmonary fibrosis. Clinical picture, diagnosis,
      treatment and prognosis].
AB  - Idiopathic pulmonary fibrosis (IPF) was found to have a higher incidence than
      previously assumed and the population involved was younger. These findings were
      made in a retrospective investigation during the period 1986-1990. The condition
      should be suspected on the basis of the radiographic characteristics, reduced
      lung volume (TLC), decreased DLco during testing of pulmonary function, hypoxemia
      at rest and also the symptoms revealed in the medical history. It is of
      importance for planning of treatment that the diagnosis of IPF is confirmed early
      by excision biopsy of pulmonary tissue. Patients with IPF were treated
      successfully by intravenous administration of a solution of 500 mg
      methylprednisolone in 500 ml isotonic glucose. This regime is administered for
      three consecutive days and supplemented by azathioprine as required. In order to
      prevent further progression of this chronic disease, patients with IPF should be
      followed-up at frequent intervals.

PMID- 1736434
TI  - [Pyonephrosis on account of an ectopic ureterocele].
AB  - A case of isolated pyonephrosis on account of an ectopic ureterocele in a
      thirteen-month-old boy without bacteriuria is presented. The importance of early
      diagnosis and treatment is emphasized.

PMID- 1736435
TI  - [Tendency to edema as the initial symptom of hyperthyroidism].
AB  - Peripheral oedema which is not of cardiac origin may be an early clinical sign of
      hyperthyroidism. Measurement of the thyroid parameters is recommended in patients
      with sudden onset of oedema of the lower limbs and tachycardia without any
      immediate cause.

PMID- 1736436
TI  - [Discomfort once again].

PMID- 1736437
TI  - [Nature products--advertising and acknowledgement].

PMID- 1736438
TI  - [The forensic diagnosis: "chronic disease"].

PMID- 1736439
TI  - [Hemophilia. Treatment of bleeders and the significance of their social
      situation].

PMID- 1736440
TI  - [Social conditions of hemophiliacs].
AB  - The objects of this investigation were 1. to describe the social conditions of
      haemophiliacs by means of questionnaires and to compare these with the population
      as a whole and 2. to investigate the social integration of haemophiliacs as
      assessed by type of family, occupation, club membership and contact with family
      and friends. The group investigated consisted of all Danish haemophiliacs with
      moderate to severe factor VIII and IX deficiency and cases of severe von
      Willebrand's disease. 64% replied (n = 135). Comparison by the age stratification
      with the population as a whole, showed that fewer haemophiliacs in the age group
      25-44 years lived with partners and children and that more lived with their
      parents or alone. Haemophiliacs had a higher school education and more
      haemophiliacs were currently receiving occupational training. The occupational
      frequency was low for all age groups and more haemophiliacs had reduced working
      hours. The frequencies of contact with friends and family and access to practical
      assistance corresponded to that of the population as a whole. Social integration
      was correlated directly with school education and occupational training and
      satisfaction with contact with other people and inversely correlated with age,
      contact with social welfare offices and number of social payments received. Only
      a total of 6% of haemophiliacs were very poorly socially integrated.

PMID- 1736441
TI  - [Electric stimulation (ECT) in Parkinson disease].
AB  - A case report and a review of the literature concerning electroconvulsive therapy
      (ECT) in the treatment of Parkinson's disease with special reference to the
      therapy of "on-off" phenomena is given. The first report of positive effect
      appeared in 1959 and, with a single exception, all published articles on this
      topic point to a positive outcome of ECT. There seems to be a specific anti
      Parkinsonian effect alongside the well-known effect on various psychotic
      conditions. ECT thus must be considered a valuable intervention when drug therapy
      is insufficient, when prolonged medication leads to decreased efficacy, or when
      patients develop neuro-psychiatric manifestations. A short review of the
      pathophysiological mechanisms which may underly the effect of ECT in Parkinson's
      disease is given.

PMID- 1736442
TI  - [Magnesium and ischemic heart disease].
AB  - Our knowledge about magnesium in health and disease has increased during the past
      ten years. Many authors have demonstrated possible magnesium depletion in the
      population as a whole and particularly among cardiac patients receiving
      diuretics. Evidence suggests that this magnesium depletion may play a role in the
      development of arteriosclerosis. It has been demonstrated that long term
      supplementation of the diet with magnesium reduces the frequency of heart
      disease. However, the matter is still not proven. It is postulated further that
      magnesium depletion aggravates the outcome of acute myocardial infarct and has a
      tendency to provoke arrhythmia. Finally, it has been shown that the potassium
      depletion frequently observed among cardiac patients may actually arise from
      magnesium depletion. On this basis, many authors have employed magnesium therapy
      in various cardiac diseases. Some authors have demonstrated that magnesium
      therapy reduces the mortality in AMI patients. These studies are, however, too
      few and too limited to be conclusive. In order to investigate this question, an
      international multicentre trial (ISIS-4) will be conducted to investigate the
      influence of magnesium therapy on the mortality after acute myocardial
      infarction.

PMID- 1736443
TI  - [Assessment of the diagnostic yield of cerebral CT in children].
AB  - In order to show if an excessive use of cerebral computed tomography of children
      (aged 0 to 15 years) existed, scans from 157 patients from a single X-ray
      department was examined. The clinical information which was presented on referral
      of the patients was also investigated. No excessive use was proven, as 26.1% of
      the patients showed pathological changes on the scans. But the investigation also
      showed that the percentage could probably be higher if more (if not all) patients
      was examined by a neurologist before referral to the X-ray-department.

PMID- 1736444
TI  - [Ileus of the small intestine during the neonatal period. Treatment and
      prognosis].
AB  - During 13 years, 47 infants were treated for mechanical ileus resulting from
      intestinal obstruction located proximally to the coecum (duodenal obstruction,
      malrotation, jejuno-ileal obstruction and meconium ileus). The mortality and
      morbidity were low. A total of three infants died; all of them in the immediate
      postoperative period. One infant died on account of rupture of the anastomosis;
      in two infants, death was caused by pulmonary complications and disseminated
      intravasal coagulation. Seven reoperations were performed and among these five
      infants on account of adhesions-/fibrous band ileus. At follow-up examination
      five infants were slightly underweight and retarded in growth; only one child had
      troublesome gastrointestinal problems. We recommend the use of antenatal
      ultrasound in the 30th week of gestation more frequently and always when
      polyhydramnios is present. This should raise the suspicion of gastrointestinal
      obstruction. Postnatal screening for associated congenital anomalies should also
      be done, since these are the most frequent cause of death in this patient
      category.

PMID- 1736445
TI  - [Monitoring of anesthesia during magnetic resonance imaging].
AB  - Clinical employment of magnetic resonance scanning presents great diagnostic
      possibilities, partly in the form of the quality of the imaging and also on
      account of the possibilities for carrying out spectroscopic measurements by mens
      of which in vivo non-invasive chemical analysis of drug concentrations in the
      tissues may be performed. In anticipation of the possibility of employing MR
      scanning as an important diagnostic aid for assessing the causes of
      unconsciousness in patients in intensive care, attempts have been made to
      establish reliable and justifiable equipment for monitoring which can render
      possible investigation of unconscious or anaesthetized patients in scanners with
      magnetic fields of over 1.5 Tesla. The medical technical difficulties involved
      are mentioned and the solutions which are employed in the Danish scientific
      Centre for Magnetic Resonance in Hvidovre Hospital in Copenhagen are described.
      This monitoring includes continuous ECG recording, measurements of pulse and
      blood-pressure once per minute and continual monitoring of respiration including
      concentrations of carbon dioxide in the inspired and expired air and the
      concentration of oxygen in the inspired air. In addition, model solutions have be
      outlined for establishing mechanical ventilation with the servorespirator and the
      possibility of producing an employable pulse oxymeter is described. It is stated
      that, provided all of the elements in the above mentioned model solution for
      monitoring during anaesthesia in the MR laboratory have been carried out, it is
      considered justifiable to place all patients, including children, in the MR
      scanner.

PMID- 1736446
TI  - [Improved technique--improved diagnosis. An example from cytogenetics].
AB  - The chromosomes of a severely retarded male with extreme kyphoscoliosis and
      obesity 20 years were reexamined by in situ hybridization of the centromere
      region. Partial trisomy 18 was revealed.

PMID- 1736448
TI  - [Legally induced abortions in 1990].

PMID- 1736449
TI  - [Commitment as a substitute to nursing home care? A history about a precedent
      creating verdict according to the new psychiatric law].

PMID- 1736447
TI  - [Bilateral epidural hematomas].
AB  - Bilateral epidural haematomata are rare and comprise only approximately 2% of all
      the intracranial haematomata. The symptomatology frequently differs from that of
      unilateral haematomata in that lateralisation is frequently absent. Most
      commonly, protracted or secondary development of clouding of consciousness is
      encountered. In cases of head injury, the above mentioned symptoms are
      indications for emergency computed tomographic (CT) scanning. When operation is
      performed early, the prognosis is good.

PMID- 1736450
TI  - [Mammographic screening].

PMID- 1736451
TI  - [Statistic mumbo-jumbo].

PMID- 1736452
TI  - [Air moisturizing].

PMID- 1736454
TI  - [Smoking cessation].

PMID- 1736453
TI  - [Vaccination against yellow fever].

PMID- 1736455
TI  - [Hypoglycemia in diabetes mellitus. Symptoms, epidemiology, physiopathology,
      causes and treatment].
AB  - Hypoglycaemia is the commonest side effect of insulin treatment. The symptoms and
      occurrence of hypoglycaemia in patients with diabetes mellitus, treated or not
      treated with insulin, are reviewed. The hormonal and metabolic changes during
      insulin-induced hypoglycaemia in non-diabetics and causes of the defective
      counter-regulation in insulin-treated diabetic patients is found primarily in the
      defective insulin treatment available at present. The occurrence of hypoglycaemia
      may be reduced by improved understanding of the pathological physiology of
      insulin-treated diabetes mellitus and instruction of the patient.

PMID- 1736456
TI  - [A double-blind trial of nicotine patches in smoking cessation].
AB  - The use of nicotine chewing gum combined with psychological support improves the
      success rate in stopping smoking. We studied the safety and efficacy of a
      transdermal nicotine patch in stopping smoking. We conducted a double-blind
      randomized study comparing the effect of a 16-hour nicotine patch (15 +/- 3.5 mg
      of nicotine in 16 hours) with those of a placebo patch. Of the 289 smokers (207
      women and 82 men) enrolled in the study, 145 were treated with nicotine patches
      and 144 with placebo patches for 16 weeks. The rates of sustained abstinence were
      significantly better with active treatment than with the placebo: 53, 41, 24 and
      17% of those in the nicotine-patch group were abstinent after 6, 12, 26, and 52
      weeks, respectively, as compared with 17, 10, 5 and 4% of those in the placebo
      patch group (p less than 0.0001). Only two subjects with the nicotine patch and
      one with the placebo patch withdrew from the study because of side effects. The
      nicotine skin patch proved to be safe and effective, as demonstrated by a higher
      rate of abstinence than with the placebo.

PMID- 1736457
TI  - [Impedance cardiography--non-invasive measurement of central hemodynamic data].
AB  - The theory, method and apparatus behind a new computer technology for
      transthoracic electrical bioimpedance are described. Measurements and
      calculations of changes in the electrical conductivity of the thoracic segment
      during systolic upstroke provides the basis for non-invasive determination of
      stroke volume and cardiac output. Bioimpedance further offers a sensitive
      indicator of the content of thoracic fluid. Reports comparing measurements of
      cardiac output in various clinical conditions by bioimpedance versus invasive
      methods in general show good correlation. The field of applications and
      limitations of bioimpedance are described. Measurements are reproducible and the
      method can also be used in evaluating the cardiodynamic exercise response.

PMID- 1736458
TI  - [P-pills and risk of breast cancer. A review of studies published 1970-1990].
AB  - A review of five cohort and 33 case-control studies provides evidence of an
      increased risk of breast cancer in women aged less than 45 years who were exposed
      to oral contraceptives for 5-10 years. It is probable that the increased risk is
      related to oral contraceptive use before the first pregnancy. No association was
      found between oral contraceptive use and breast cancer risk in women aged 45
      years or more.

PMID- 1736459
TI  - [Information on AIDS among persons aged 16-20 years].
AB  - In order to illustrate whether the AIDS and "Safe sex" campaigns have influenced
      young people, an investigation originally made in 1985 was repeated in October
      1989; the objects being sexual knowledge, sexual experience and contraception
      among persons aged 16-20 years. A representative random sample consisting of 359
      women (percentage replies 77.9) and 400 men (percentage replies 76.3) who were
      over 16 but not yet 21 years was interviewed personally by the professional
      interviewer staff of the Institute for Social Research. A total of 72% (n = 547)
      had been informed about AIDS at school, most of these were among the youngest
      participants. Simultaneously, 43% (n = 326) considered that school was the best
      source of information. School thus appears to be an effective channel of
      information about AIDS to young people. TV/radio were also found to be important
      channels of information while only few participants stated that they had received
      the best information in their homes. The majority of replies to questions about
      AIDS were in complete agreement with the messages in the informative campaigns.
      In conclusion, it is stated that the replies were markedly uniform without any
      obvious connection with sex, age, background or experience. Significantly more of
      the men, however, considered that their knowledge about AIDS was adequate.

PMID- 1736460
TI  - [Has the age at sexual debut changed after the Safe Sex Campaign?].
AB  - In 1984, immediately before information about AIDS had reached the general public
      and the campaign for "Safe sex" had begun in earnest, 286 women (percentage
      replies 75.3) and 336 men (percentage replies 77.8) who were over 16 years but
      not yet 21 years were interviewed about sexual knowledge, sexual experience and
      contraception. In October 1989, the investigation was repeated and 359 women
      (percentage replies 77.9) and 400 men (percentage replies 76.3) participated.
      Both of the investigations were carried out as personal interviews by the
      professional interviewer staff of the Institute for Social Research. The age
      profiles for the first coitus were found to be practically identical in the two
      investigations. The median age for the first coitus was calculated to be 16.7
      years in 1984 and 16.8 years in 1989 for females and 16.9 years for males in both
      1984 and 1989. In both of the investigations, the majority stated that the first
      coitus was with a person of the same age group. Just under 1/4 of the women and
      nearly 1/3 of the men stated that the first coitus was also the first for the
      partner. In the 1989 investigation, significantly more stated that they had
      employed contraception at the first coitus. The campaign for "Safe sex" had
      recommended condoms. In the 1989 investigation, 61.0% of the women and 62.0% of
      the men had employed condoms at the first coitus as compared with 36.5% of the
      women and 42.1% of the men, five years previously. Parental advice about
      contraception had also changed as a great many more stated that their parents had
      advised them to use condoms as a contraceptive measure in the 1989 investigation.
      Among the young people who had not yet had coitus, 24.4% of the women and 34.7%
      of the men stated in 1989 that they always had a condom handy when they thought
      they might need it.

PMID- 1736461
TI  - [Pancreato-pleural fistula in a patient with chronic pancreatitis].
AB  - A case with pancreaticopleural fistula formation in a 33-year-old man with
      alcohol-induced chronic pancreatitis with a pseudocyst in the head of the
      pancreas is reported. The patient was treated with repeated pleurocentesis, but
      the fistula first closed and was drained after treatment with the somatostatin
      analogue, sandostatin, for 38 days and total parenteral nutrition for 26 days
      probably because a spontaneous pancreaticogastric fistula had then formed. At the
      most recent outpatient control re-examination of the pancreas with ultrasound no
      cyst was shown.

PMID- 1736462
TI  - [Corkscrew esophagus].
AB  - "Corkscrew oesophagus" is characterised on the basis of two case reports and
      attention is drawn to thoracic pain of oesophageal origin. Corkscrew oesophagus
      is a radiological diagnosis and is characterised by twisted segments in the
      distal third of the oesophagus. The condition can sometimes be demonstrated
      endoscopically and it is due to a basic disturbance in the motility of the
      oesophagus. Painful conditions in the oesophagus are most frequently caused by
      gastro-oesophageal reflux or disturbances in motility and the latter is
      frequently complicated by reflux oesophagitis. Pain of oesophageal origin is
      frequently a diagnosis by exclusion and requires exclusion of ischaemic heart
      disease. The initial treatment should be directed to the reflux oesophagitis. The
      diagnosis and information about the origin of the pain and the benign course of
      the condition will calm the majority of the patients and remove their fear of a
      possible fatal heart disease.

PMID- 1736463
TI  - [Cardiovascular diseases in Denmark in the year 2000. Occurrence, treatment and
      technology, developmental trends].

PMID- 1736464
TI  - [Asthma as an immediate cause of death].

PMID- 1736465
TI  - [Traffic chemistry--seen in the rear-view mirror].

PMID- 1736466
TI  - [Menochaos].

PMID- 1736467
TI  - [A direct military attack on the hospital in Osijek].

PMID- 1736468
TI  - The epidemiology and prevention of sexually transmitted diseases.
AB  - Each year, approximately 12 million cases of STDs occur in the United States,
      including an estimated 1.4 million cases of gonorrhea, 130,000 cases of syphilis,
      4 million cases of chlamydia, 500,000 to 1 million cases of human papillomavirus,
      200,000 to 500,000 cases of genital herpes, and 45,000 cases of AIDS. These
      numbers should be viewed cautiously, because many STDs are not reported, many are
      not easily diagnosed, and many are asymptomatic or inapparent. The control of
      STDs can be achieved only through the continuing efforts of physicians to
      recognize and treat STDs and to counsel patients routinely in prevention.

PMID- 1736469
TI  - Fungal infections of the external genitalia.
AB  - In the era of the debilitated or immuno-compromised patient, fungal infections
      may become more prevalent. Unusual lesions of the external genitalia may be a
      manifestation of systemic infection. The urologist should be aware of this
      possibility when confronted with an unusual ulcer, inflammation, induration, or
      "abscess" of the external genitalia.

PMID- 1736470
TI  - Pigmentary disorders and inflammatory lesions of the external genitalia.
AB  - Many cutaneous processes can involve the external genitalia as a part of the
      general involvement of the skin. Other processes may affect only the genitalia,
      such as several pigmentary disorders and inflammations. As a result, these
      conditions may be mistaken for sexually transmitted diseases. It is important to
      include these conditions in the differential diagnosis.

PMID- 1736471
TI  - Benign lesions of the external genitalia.
AB  - Benign external genital lesions, being uncommon, can cause a significant
      diagnostic dilemma for the physician and anxiety for the patient. These lesions
      can be grouped into three categories: vascular lesions, nevi, and benign new
      growths.

PMID- 1736472
TI  - Acquired immunodeficiency syndrome. A venereal disease.
AB  - AIDS is clearly the most lethal of all the STDs. The universal adherence to
      "safe" sexual practices is required in order to try to limit this epidemic.
      Unfortunately, the other forms of transmission of HIV, intravenous injection and
      via the fetal-placental circulation, have ensured that simply altering the sexual
      practices of society would not be sufficient to end this epidemic quickly.

PMID- 1736473
TI  - Premalignant lesions and nonsquamous malignancy of the penis and carcinoma of the
      scrotum.
AB  - Premalignant lesions of the penis include cutaneous horn, balanitis xerotica
      obliterans, and leukoplakia. The true incidence of progression of each of these
      to squamous-cell carcinoma is unknown. Bowenoid papulosis, erythroplasia of
      Queyrat, and Bowen's disease are histologically identical to in situ carcinoma.
      Although the first is consistently benign, the latter two regularly evolve into
      invasive cancer. Malignant scrotal lesions include squamous-cell carcinoma,
      liposarcoma, leiomyosarcoma, basal-cell carcinoma, extramammary Paget's disease,
      erythroplasia of Queyrat, malignant melanoma, and metastases. Hemangioma can be
      confused with carcinoma.

PMID- 1736474
TI  - Balanitis and balanoposthitis.
AB  - Balanitis is an inflammation of the glans penis. There are several etiologic
      agents, including bacterial and yeast infections, parasitic infestations, and
      trauma or irritants. Plasma-cell balanitis and balanitis xerotica obliterans are
      two distinct clinical entities. The authors review the clinical and pathologic
      features and the treatment options for these conditions.

PMID- 1736475
TI  - Gangrene and Fournier's gangrene.
AB  - Fournier's gangrene is an aggressive disease affecting the perineum. Clearly, it
      can no longer by considered idiopathic in its origin, as most infection can be
      localized to a cutaneous, urethral, or rectal source. It presents in a broad age
      range and can have an indolent onset, thus requiring a high index of suspicion.
      It may be fulminant and progressive in the case of immunocompromise and
      underlying debilitating illnesses. Despite aggressive antibiotic therapy and
      debridement, it is associated with a high mortality rate. This rate has been
      higher in older patients, those with a rectal focus, and diabetics. Hyperbaric
      oxygen therapy has shown some promise in shortening hospital stays, increasing
      wound healing, and decreasing the gangrenous spread when used in conjunction with
      surgical debridement and antibiotics. New reconstructive efforts, such as medial
      thigh myocutaneous flaps, have improved the cosmetic aftermath of the extensive
      debridement. Fournier's gangrene remains a true urologic emergency, which
      mandates aggressive initial care by means of early recognition, early hemodynamic
      stabilization, and the institution of parenteral broad-spectrum antibiotics. This
      is followed by multiple debridements and in some cases urinary or rectal
      diversion. The concomitant use of hyperbaric oxygen therapy in selected cases
      followed by meticulous reconstructive surgery and salvage has further reduced the
      mortality rate and improved the cosmetic outcome.

PMID- 1736476
TI  - Management of voiding dysfunction with an implantable neuroprosthesis.
AB  - We have been very encouraged by these preliminary results concerning the efficacy
      and safety of functional electrical neuromodulation in the management of chronic
      voiding complaints. There are a large number of patients within the standard
      practice of urology who are potential candidates for this form of management. The
      techniques of peripheral nerve evaluation and implantation are relatively simple
      to master and free of significant risks or complications. If the long-term
      results of the multicenter clinical trial parallel our preliminary results, this
      is a technique which should be embraced by urologists as a significant
      therapeutic advance in our field.

PMID- 1736477
TI  - Update on bacterial sexually transmitted disease.
AB  - Sexually transmitted diseases (STDs) are the most frequently reported bacterial
      infections. In 1990, slightly more than 700,000 cases of gonococcal disease were
      reported to the Centers for Disease Control, and the estimated incidence of
      chlamydial infections is 3 million to 4 million annually. Bacterial genital ulcer
      diseases such as syphilis and chancroid are increasing in epidemic proportions.
      The author reviews bacterial STDs in two categories: exudative mucosal infections
      and genital ulcer diseases.

PMID- 1736478
TI  - Sexually transmitted diseases and their relation to male infertility.
AB  - Controversy surrounds the role of sexually transmitted diseases in male
      infertility. Because our understanding of male infertility is limited, and
      because diagnostic tests such as semen analysis including culture and leukocyte
      count are variable, definitive conclusions on STDs and their effect on
      infertility cannot be substantiated. Prospective investigations of infertile
      couples using appropriate control groups, sophisticated semen collection
      protocols, proper microbiologic techniques, and standardization of seminal fluid
      analysis are required to understand the role of STDs in male infertility.
      Regardless of the ongoing research to delineate the role of STDs in male
      infertility, advocating primary prevention by increasing public awareness of the
      negative effects of STDs and the use of contraceptive methods to prevent the
      spread of STDs is mandatory for the health care professional.

PMID- 1736479
TI  - Sexually transmitted protozoal infections. Trichomonas vaginalis, Entamoeba
      histolytica, and Giardia lamblia.
AB  - Collectively, protozoa account for the largest number of STDs worldwide. Although
      these organisms can be eradicated effectively in the individual patient, their
      high asymptomatic carriage rate appears to have a significant influence on their
      continued transmission. The best hope for eradication of these organisms lies in
      a high index of suspicion in high-risk populations and the careful evaluation and
      treatment of sexual partners of infected persons.

PMID- 1736480
TI  - Determination of the calcium binding capacity to discriminate between urines of
      calcium stone formers and healthy persons.
AB  - Calcium binding by undiluted fasting urine has been tested as a means of
      demonstrating the capacity of urine from control subjects and calcium stone
      patients to hold spontaneous precipitation of stone forming compounds.
      Preliminary data are promising with respect to the possibility that controls and
      patients can be separated.

PMID- 1736481
TI  - The dual effect of urinary macromolecules on the crystallization of calcium
      oxalate endogenous in urine.
AB  - The nucleation-promoting and growth-inhibiting activities of urinary
      macromolecules on the crystallization of calcium oxalate endogenous in urine of
      stoneformers and normal controls were studied by freezing the ultrafiltrate and
      retenate fractions of concentrated whole urine (pH 5.3, 1,250 mosmol/kg). Among
      the normal controls, macromolecules nominally of 10-20 kDa showed nucleation
      promoting and growth-inhibiting activities; the 5-10 kDa population was incapable
      of such effects but did cooperate with molecules greater than 10 kDa in enhancing
      the effect. In the case of stone-formers, molecules in the nominal ranges of 5-10
      kDa and 10-20 kDa when considered separately were not active in the aspects
      studied but collectively could cooperate to produce pronounced effects.
      Application of the test to urine ultrafiltrate reconstituted with polyanionic
      macromolecules recovered from urine indicated that molecules from stoneformers
      were more powerful than those from normal controls in bringing about promotion of
      nucleation and inhibition of growth of crystals from urinary calcium oxalate.

PMID- 1736482
TI  - Rationale for local toxicity of calcium chelators.
AB  - Calcium chelating agents, such as ethylenediaminetetraacetate are toxic to
      urothelium. Their capacity to form complexes with calcium ions, which is the
      basis for their chemolytical effectiveness, also determines their toxicity. A
      decrease of chemolytical effectiveness by prior saturation of the chelator with
      Ca2+ or by lowering the pH to levels unfavourable for calcium binding
      significantly diminishes tissue injury. Exchange of Mg2+ ions does not, however,
      diminish tissue damage. The clinical use of calcium ligands is therefore unsafe.

PMID- 1736483
TI  - Analysis of calcium, iron, copper and zinc contents of nucleus and crust parts of
      urinary calculi.
AB  - In this study we compared the concentrations of calcium, iron, copper and zinc in
      the nucleus and the crust parts of various kinds of urinary calculi. We found
      that the mean concentrations of iron, zinc and copper in the nucleus parts of the
      stones were statistically higher than those in the crust parts. We attempted to
      explain this finding by two different approaches. Inter- and intra-correlations
      were also sought between the elements in the nucleus and crust parts. These
      correlations suggested a complex relationship between the elements of the urinary
      calculi.

PMID- 1736484
TI  - Crystalluria in marathon runners. IV. Black subjects.
AB  - Crystal sizes (scanning electron microscopy) and distributions (Coulter Counter)
      as well as 24-h urinary sodium (Na) and calcium (Ca) excretions (flame atomic
      absorption) were determined in a group of black South African runners immediately
      after a marathon and again 3 weeks later. White runners and black and white
      control subjects were included in the study. Particle volume-size histograms for
      black controls and black runners were identical. There was no significant
      difference in the Na excretion of all the groups. However, while urinary Ca
      excretion was significantly raised in white runners relative to white controls,
      Ca excretion in black runners was unchanged relative to their controls. It is
      postulated that the lower rates of urinary Ca excretion may result from lower
      rates of Ca resorption from bone in response to the cyclical loading of running
      in black marathon runners. The results of this study suggest that black marathon
      runners are not prone to the same increased risk of renal stone formation as are
      white runners.

PMID- 1736485
TI  - The influence of pH and urine composition on urease enzymatic activity in human
      urine.
AB  - It is reasonable to assume that the rate of pH increase in urine induced by
      urease-producing microorganisms is one of the factors which determine whether
      crystallisation with subsequent stone formation will occur or not. To evaluate
      how the time needed to increase urine pH varies between different urine samples
      and how it depends on urine composition, a standardised amount of urease was
      added to different human urine samples. The incubations were performed in a pH
      stat. This allowed simultaneous study of how urease enzymatic activity depends on
      urine pH and how it varies between different urines. The enzymatic activity was
      found to be negatively correlated to urine pH and to vary between different
      urines. The rate of the pH increase varied markedly between different urines.
      Small pH increases depended on the native urine pH and urease enzymatic activity.
      Higher pH increases up to the levels of phosphate crystallisation depended more
      on urine phosphate, the major urine buffer. The results presented show that urine
      composition influences the urease-induced pH increase. This might have clinical
      implications.

PMID- 1736486
TI  - The influence of pelvic nerve transection on the neuromuscular system of the
      canine urinary bladder.
AB  - We previously reported that bladder overdistension led to denervation and
      subsequent supersensitivity of the detrusor muscle to acetylcholine. Therefore,
      to exclude the influence of bladder overdistension, we produced a low-pressure
      bladder in female mongrel dogs using an indwelling urethral catheter, and
      performed pelvic neurectomy (decentralization). We examined the effects of
      decentralization on the neuromuscular system of the bladder. The contraction
      response levels of bladder strips in dogs 1 and 2 weeks after neurectomy was low,
      and significantly different from that of bladder strips in the control group. The
      dose-response curves of dogs 4 and 8 weeks after neurectomy showed a shift to the
      left when compared to those of the control group, indicating a significant
      increase in sensitivity of the bladder strips. Many cholinergic terminal and
      varicosity profiles had a normal ultrastructure in all of the groups subjected to
      neurectomy, while some had degenerating profiles representing clear axoplasm
      without any recognizable organelles. Microphotographs of bladder obtained from
      dogs with spontaneous catheter loss showed degenerating axons, which were
      observed more frequently than in bladders kept empty with indwelling urethral
      catheters. Micturition in the dogs with spontaneous catheter loss was achieved by
      overflow incontinence without catheterization. These findings suggest that post
      synaptic nerve degeneration may be augmented by impairment of micturition,
      followed by decentralization. Our observations also suggest that post-synaptic
      nerve degeneration (denervation) plays an important role in the increased
      sensitivity of the detrusor muscle to acetylcholine in the parasympathetically
      decentralized urinary bladder, whether denervation is due to trans-synaptic
      degeneration or impairment of micturition.

PMID- 1736487
TI  - Effect of acute distension on cholinergic innervation of the rat urinary bladder.
AB  - The effect of short-term urinary bladder distension on its cholinergic
      innervation was studied in Sprague-Dawley rats. Distension was induced for 3 h by
      forced diuresis and balloon outlet obstruction, and whole thick biopsy specimens
      were taken from the dome and lateral side of the anterior body 2, 7 and 21 days
      afterwards. The acetylcholinesterase (AChE) method was used to demonstrate the
      cholinergic nerves in the distended bladder wall. Cholinergic hypoinnervation was
      observed 7 days after the distension, persisting up to 21 days, although AChE
      reactive nerves were then observed to be more numerous. The distribution of
      hypoinnervation was uneven, being more marked in the lateral side of the anterior
      body than in the dome. The distribution of AChE-reactive nerves varied even in
      the same biopsies, with areas of total hypoinnervation occurring next to areas of
      slightly diminished innervation. This was especially true 21 days after
      distension. The findings indicate transient damage to the cholinergic
      innervation, which may in turn explain the prolonged voiding difficulties often
      seen after catheterization of an overdistended bladder in a patient with urinary
      retention. The short-lasting effect of bladder dilatation therapy used to treat
      detrusor instability or interstitial cystitis may be due to the fairly rapid
      regeneration of cholinergic innervation.

PMID- 1736488
TI  - Urinary endothelin (ET1) in complete ureteric obstruction in the miniature pig.
AB  - Segmental renal scarring occurs in experimental obstructive uropathy in the
      multipapillary porcine kidney, and segmental abnormalities in renal perfusion are
      likely to be responsible. This preliminary study examines the urinary excretion
      of the potent locally active vasoconstrictor endothelin 1 (ET 1) in a pig model
      of renal obstruction and subsequent relief. Significant urinary excretion of ET 1
      from the postobstructive kidney was found to occur after longstanding
      obstruction. Preglomerular arteriolar stenosis may be the cause of the renal
      ischaemia in obstruction that is at first reversible but later becomes
      irreversible if the stimulus persists. ET 1 may be implicated in the pathogenesis
      of this injury.

PMID- 1736489
TI  - Estimation of irrigant absorption during transurethral resection of the prostate.
      Assessment of fluorescein as a marker.
AB  - Absorption of irrigating solution may complicate transurethral resection of the
      prostate (TURP), and a system which warns of fluid overload reliably would be of
      benefit in the prevention of these complications. Fluorescein can easily be
      detected at very low concentrations in blood and can be added to the irrigating
      solution in amounts invisible to the naked eye, providing a possible means of
      easily monitoring the absorption of irrigant solution during TURP. To test this
      hypothesis, the plasma concentration of fluorescein was determined at intervals
      after intraperitoneal injection in rats. Although the published data on
      fluorescein suggest that it meets the criteria for a suitable marker substance to
      be introduced into the irrigant solution, the results show that plasma
      fluorescein is constant and not dose related. The addition of fluorescein to the
      irrigant solution would not provide a quantitative means of determining the
      volume of irrigant absorbed. The use of other substances may provide the answer
      to this major clinical problem. We have defined a set of criteria which such a
      substance should fulfil.

PMID- 1736490
TI  - Investigations on macromolecular precipitation inhibitors of calcium oxalate.
AB  - Certain important aspects of the urine oxalate tolerance test (OTT) have been
      revised. The stirring system has been changed and the test has been adapted to
      the kinetics of calcium oxalate precipitation. True equilibrium conditions are
      now ensured during the measurements. Furthermore, the endogenous oxalate
      concentration is determined and taken into consideration. As a result of these
      changes, the significance of the test results has greatly improved. The effects
      of the addition of small amounts of zinc on the precipitation of calcium oxalate
      have been used in a new variation of the OTT. This new test makes it possible to
      discriminate much faster and more simply between recurrent stone-formers and
      other subjects. Tamm-Horsfall protein (THP) has been tested for its effect on the
      precipitation of calcium oxalate by means of OTT. THP inhibits the precipitation
      of calcium oxalate, but THP of stone-formers has a diminished inhibitory
      activity. The inhibitory activity of this protein strongly depends on the method
      by which it is isolated.

PMID- 1736491
TI  - Environmental factors in the pathophysiology of recurrent idiopathic calcium
      urolithiasis (RCU), with emphasis on nutrition.
AB  - A number of environmental factors are under discussion as possibly implicated in
      the etiology of RCU. On the basis of data in the literature and our own results,
      we attempted a critical weighting up of the possible contributions of climate,
      pollution, stress, nutrition in general and especially oxalate and minerals in
      the nutrition. It was concluded that there is a need for more in-depth research
      into the response of the body to challenges from the environment, in particular
      nutrition.

PMID- 1736492
TI  - Tamm-Horsfall glycoprotein--inhibitor or promoter of calcium oxalate monohydrate
      crystallization processes?
AB  - The processes of calcium oxalate monohydrate (COM) crystal nucleation, growth and
      aggregation (agglomeration) generally have been studied using a wide variety of
      assay systems/conditions. This paper reviews the apparently conflicting data on
      the effects of Tamm-Horsfall glycoprotein (THP) on COM crystallization processes
      in vitro, with the main emphasis on crystal aggregation. According to its well
      known physico-chemical properties, THP has a dual role in modifying crystal
      aggregation: at high pH and low ionic strength (IS). THP is a powerful crystal
      aggregation inhibitor. Upon lowering pH and raising IS, THP viscosity increases,
      leading to reduced crystal aggregation inhibition. In the presence of additional
      calcium ions, some THPs even become strong promoters of crystal aggregation. This
      phenomenon seems to be more pronounced in THPs isolated from recurrent calcium
      stone formers whose proteins exhibit an abnormally high tendency of
      polymerization. Recent studies suggest an inherited molecular abnormality of THP
      among some severe recurrent calcium stone formers.

PMID- 1736493
TI  - Urolithiasis, inhibitors and promoters.
AB  - The aim of this work is to evaluate the role and importance of inhibitors and
      promoters in urolithiasis. Carrying in mind theoretical considerations, we
      conclude that in urolithogenic processes, inhibitors and promoters could only
      play a decisive role in the "idiopathic" oxalocalcic urolithiasis. We classify
      the "idiopathic" oxalocalcic stone-formers into three main groups, considering
      inhibitory and promoting factors. It is shown that such classification is in good
      agreement with the clinical results observed in a group of 88 "idiopathic"
      oxalocalcic stone-formers.

PMID- 1736494
TI  - Role of citric acid in primary hyperparathyroidism with renal lithiasis.
AB  - Nephrolithiasis is presented in 18-40% of patients with primary
      hyperparathyroidism. Our work suggests that citrate, an inhibitor of calcium
      salts, could be involved in the presence of renal lithiasis because
      hyperparathyroid stone formers show less citrate elimination than nonstone
      formers.

PMID- 1736495
TI  - Advances in medical treatment of renal stones.

PMID- 1736496
TI  - Prevention of recurrent stone formation: long time results under treatment based
      on an extended metabolic investigation.

PMID- 1736497
TI  - Correlation between 1.25 dihydroxyvitamin D serum levels and fractional rate of
      intestinal calcium absorption in hypercalciuric nephrolithiasis. Role of
      phosphate.
AB  - Different mechanisms could explain the elevated calcium elimination, the main
      cause of calcium oxalate renal stones. Our results suggest that phosphate levels
      are decreased in patients with absorptive hypercalciuric nephrolithiasis and
      elevated serum dihydroxyvitamin D. This could be the reason why in this group of
      patients oral phosphate treatment prevented hypercalciuria and renal lithiasis.

PMID- 1736498
TI  - Recurrent nephrolithiasis in renal tubular acidosis. Metabolic profiles, therapy
      and course.
AB  - 13 patients with recurrent urolithiasis and distal renal tubular acidosis (RTA I)
      were investigated for lithogenic metabolic disorders. Treatment was given and the
      patients observed for periods of up to 10 years.

PMID- 1736499
TI  - Nocturnal penile tumescence in cigarette smokers with erectile dysfunction.
AB  - We examined the relationship between cigarette smoking and erectile physiology in
      314 men with erectile dysfunction. All of the men studied were currently
      cigarette smokers. Evaluations included interviews, physical examinations, and
      polysomnographic assessment of sleep-related erections. Penile rigidity during
      nocturnal erection inversely correlated with the number of cigarettes smoked per
      day. Smoking was also associated with indices of impairment on autonomic function
      tests and some measures of penile blood pressure. The group of men who smoked the
      most (more than 40 cigarettes per day) had the fewest minutes of nocturnal
      tumescence and detumesced fastest. These data are discussed with respect to the
      results of studies performed in dogs that demonstrated smoking-related reduction
      in arterial flow and venous restriction. Our findings suggest that smoking may
      further compromise penile physiology in men experiencing difficulty in
      maintaining erections long enough for satisfactory intercourse.

PMID- 1736500
TI  - Diethylstilbestrol in treatment of postorchiectomy vasomotor symptoms and its
      relationship with serum follicle-stimulating hormone, luteinizing hormone, and
      testosterone.
AB  - Vasomotor symptoms such as hot flushes and profuse sweating have been described
      after bilateral orchiectomy. We evaluated 26 patients who had undergone bilateral
      orchiectomy for prostatic carcinoma to determine the incidence of vasomotor
      symptoms and the efficacy of low-dose diethylstilbestrol (DES) in the treatment
      of those symptoms. Measurements of serum follicle-stimulating hormone (FSH),
      luteinizing hormone (LH), and testosterone were performed to look for endocrine
      patterns which may be related to the presence of vasomotor symptoms. Fourteen
      patients (54%) reported the presence of vasomotor symptoms beginning one to four
      weeks after surgery. These patients were treated with DES or placebo in a double
      blind crossover trial. The frequency and severity of hot flushes were
      significantly reduced during the time DES was given. This was accomplished with a
      low dose of 1 mg daily of DES which avoids the cardiovascular complications of
      higher doses. We found no correlation between the presence, severity, or
      frequency of hot flushes and serum gonadotropin or testosterone concentrations.

PMID- 1736501
TI  - Multivariate case-control study of survival following transurethral resection of
      prostate.
AB  - Although prevalence of perioperative mortality following transurethral resection
      of the prostate (TURP) has steadily declined as reported in several review
      studies, it has been suggested that with extended follow-up after TURP, mortality
      exceeds that of an age-matched population. The sample selected for this study was
      drawn from a data base of 2,005 men who entered a urologic health-screening
      program. The sample included a group of 25 patients who underwent TURP and a
      group of 50 age-matched control patients with symptoms of prostatism. Patients
      were followed for six years, a total of 450 observed person-years. Multivariate
      analyses based on a general linear model approach for the dependent variable of
      survival were used to assess gains in predictive efficiency due to combinations
      of TURP versus control, time, and patient variables. F-ratio hypothesis tests of
      coefficients of multiple determination for the models indicated that TURP did
      account for a significant amount of the variability of survival but only after
      five years of follow-up. However, a far larger proportion of the variance in
      survival was explained by other patient variables of age, preoperative risk,
      comorbidity factors, and postoperative urinary disease after all effects due to
      TURP, follow-up years, and operation cohort years were held constant in the
      survival prediction equation.

PMID- 1736502
TI  - Preservation of urosexual functions after radical cystectomy.
AB  - Nerve-sparing radical cystectomy with ileocecal bladder substitute is highly
      recommended for male patients with schistosomal bladder carcinoma and for
      selected male patients with transitional cell carcinoma. Twenty-three patients
      underwent this procedure with preservation of the distal one third of prostatic
      capsule and inframontanal urethra, reinforcement of the ileocecal valve, and
      tightening of the two levator ani muscles over the cecourethral anastomosis.
      Urodynamic study revealed that the closed ileocecal segment is a highly compliant
      reservoir, and coupled with a reinforced ileocecal valve and distal urethral
      mechanism resulted in a low incidence of ureteral reflux (15%) and a high degree
      of urinary continence (100% by day and 40% by night). The procedure does not
      appear to undermine the principles of oncologic surgery, offers the psychologic
      and functional benefits of urethral micturition for all patients, and preserves
      erectile potency in half of them.

PMID- 1736503
TI  - Analysis of imaging modalities, staging systems, and prognostic indicators for
      renal cell carcinoma.
AB  - A retrospective analysis of 314 patients with renal cell carcinoma was done
      focusing mainly on imaging modalities and prognostic significance of tumor stage
      using both the Robson and TNM systems. Computerized tomography (CT) scan proved
      to be the most effective modality for staging. Overall staging accuracy was 62
      and 68 percent for TNM and Robson staging, respectively, and understaging was
      more frequent than overstaging. The actuarial five-year survival using the Robson
      system was 73 percent for Stage A, 68 percent Stage B, 51 percent Stage C, and 20
      percent Stage D. The main limitation of the Robson system is the heterogeneity of
      the Stage C group which includes patients with renal vein and those with nodal
      involvement with a significant difference in survival. The survival by the TNM
      system showed no difference in those with T1, T2, T3a and T3b disease but a
      significant difference in those with T3c or T4a. One hundred sixteen patients
      (37%) presented with metastatic disease with a median survival of seventeen
      months (range 2-204) for those with solitary metastasis and six months (range 1
      132) for those with multiple metastases (the difference was not statistically
      significant). Except for anecdotal cases, nephrectomy with or without treatment
      of the metastases did not seem to affect survival significantly. The presence of
      spindle cell, alone or in association with clear or granular cell, affected the
      prognosis adversely. Thirty-one patients had their tumors identified
      incidentally. Their stage at diagnosis was earlier than the symptomatic group
      (Stage T1-T2: 77% vs 34%), and there was a significant difference in the disease
      free survival at fifty-four months between the two groups (79% vs 57%,
      respectively).

PMID- 1736504
TI  - Nuclear morphometry in prognosis of renal adenocarcinoma.
AB  - Nuclear morphometry was carried out on 95 parenchymatous adenocarcinomas of the
      kidney treated by radical nephrectomy and hilar lymphadenectomy and followed up
      for at least five years. The study assessed nuclear area, nuclear perimeter,
      major diameter, nucleolar area, nuclear shape factor, and nuclear size. There was
      a significant statistical correlation between survival and the morphometric
      parameters and between the parameters themselves except for nuclear shape factor.
      The multiple regression proved that nuclear area is the factor which shows the
      greatest statistical significance for prognosis. Taking a mean nuclear area of 35
      microns 2 allowed two prognostic groups to be established regardless of stage,
      with those below the threshold having a good prognosis and those above it having
      a poor prognosis: 96.7 percent of patients with a good prognosis survived after
      five years (60 months) compared with 17.2 percent of those with a poor prognosis.

PMID- 1736505
TI  - Primary endourologic re-establishment of urethral continuity after disruption of
      prostatomembranous urethra.
AB  - A new technique for the early management of traumatic disruption of the
      prostatomembranous urethra has been used in 4 consecutive young patients.
      Urethral realignment by stenting the injured urethra with a catheter was achieved
      by combined urethroscopy and suprapubic instrumentation one to three days after
      the injury. We describe herein our experience with this technique and we suggest
      that it could be a valuable alternative in posterior urethral repair.

PMID- 1736506
TI  - Twelve-month comparison of two treatments for erectile dysfunction: self
      injection versus external vacuum devices.
AB  - This study directly compared two nonsurgical treatments for erectile dysfunction,
      self-injection of papaverine/phentolamine and external vacuum devices, in terms
      of usage rates, effectiveness, side effects, dropout rates, and impact on patient
      sexual and psychologic functioning. Both alternatives were regularly,
      successfully, and safely used by patients, though dropout rates were higher for
      self-injection. Both produced erections of improved quality, and effected
      sustained improvements in frequency of intercourse, orgasm, and sexual
      satisfaction. Spontaneous erections also improved with both treatments. General
      psychiatric symptomatology was decreased, and anxiety was improved. There were no
      differences between the two treatments in sexual or psychologic impact. Relative
      contraindications and esthetic considerations are presented.

PMID- 1736507
TI  - Endoscopic management of complications of continent urinary diversion.
AB  - The Kock pouch continent ileal reservoir has become a therapeutic option for
      those patients requiring urinary diversion. Complications of this procedure do
      occur but fortunately many of these may be managed endoscopically without need
      for open surgical exploration. This report describes experience with 55 patients
      treated by endoscopic surgery for complications of Kock pouch urinary diversion.
      This includes 45 patients with stones, 3 with stenotic afferent nipple valves, 3
      with suspicion of ureteral or renal pelvic tumor, and 4 with retained upper
      urinary tract stents. These patients may be treated with intravenous sedation
      only on an outpatient basis. The procedure was successful in all but 2 patients.
      One complication occurred when extravasation was noted from the afferent limb.
      The patient was treated by internal diversion, and follow-up urogram done in
      forty-eight hours was normal. This experience confirms that endoscopic surgery is
      an attractive option for treatment of many of the complications resulting from
      creation of a Kock pouch ileal reservoir.

PMID- 1736508
TI  - Clinical value of scrotopenogram for evaluating varicocele and erectile
      dysfunction.
AB  - While there is as yet no established theory regarding a possible relationship
      between varicocele and erectile failure, it is not uncommon to encounter those
      cases in which two conditions coexist clinically. We describe a new technique to
      identify these two conditions by a single injection of radioisotope. In
      scrotopenogram, varicocele is diagnosed by comparing the radioactivity in each
      hemiscrotum during the five minutes after injection of radioisotope. Then, after
      the patient is exposed to audiovisual sexual stimulation, the dynamic penile flow
      is measured for the next thirty minutes. We evaluated 185 impotent patients and 9
      patients with varicocele. In the 185 erectile failure patients, varicoceles were
      also present in 33 (17.8%). In the 9 patients who presented themselves chiefly
      with varicoceles, 3 (33.3%) also had erectile failure. Thus, in 194 patients 36
      (18.5%) cases of combined conditions were identified by the scrotopenogram
      technique. We believe this new technique could be an alternative method for
      noninvasively examining impotent patients with varicoceles.

PMID- 1736509
TI  - Infected multicystic displastic kidney.

PMID- 1736510
TI  - Transitional cell carcinoma of bladder in thirteen-year-old boy.
AB  - We report a rare case of primary epithelial bladder tumor in a thirteen-year-old
      boy. Histologically, the tumor was that of a solitary and papillary transitional
      cell carcinoma, grade 1. This tumor was detectable at cystoscopic examination,
      and cytologic procedures were without benefit for a diagnosis.

PMID- 1736511
TI  - Endoscopic correction of primary vesicoureteric reflux in children.
AB  - Sixty-nine children with 113 refluxing ureters were followed prospectively after
      treatment with endoscopic injection of subureteric polytetrafluoroethylene
      (sting). The 50 female and 19 male patients had a total of 105 procedures. Thirty
      eight patients have had their vesicoureteric reflux (VUR) resolved, and 16 now
      have asymptomatic grade I or II reflux, giving a combined patient VUR improvement
      rate of 80 percent.

PMID- 1736512
TI  - Temporal separation of cough-induced urethral and bladder pressure spikes in
      women with urinary incontinence.
AB  - The time separation of cough-induced urethral and bladder pressure spikes were
      studied in 32 female patients: 16 with urinary incontinence due to sphincter
      incompetence, 9 with urinary incontinence and a competent urethral closure
      mechanism, and 7 after incontinence surgery. There were no significant
      differences in time separation between the three groups at different positions in
      the urethra. Age and menopausal status did not affect time separation of pressure
      spikes. It is concluded that time separation of pressure spikes during cough
      cannot be used as a discriminator of the etiology of urinary incontinence.
      Surgery does not restore the latency seen in normal continent women and may
      restore continence by a mechanism different from that of normal continent women.

PMID- 1736513
TI  - Interferon-induced reversible acute renal failure with nephrotic syndrome.
AB  - Although there has been considerable experience with interferons in clinical
      trials during the past decade, acute renal failure as a side effect of interferon
      treatments has rarely been reported. We report a case in which acute renal
      failure with nephrotic syndrome was associated with therapy with two types of
      interferons. We note incomplete return of renal function upon withdrawal of
      therapy.

PMID- 1736514
TI  - External spermatic sheath injection for vasal nerve block.

PMID- 1736515
TI  - Anterior rectal wall hematoma: complication of transrectal ultrasound-guided
      biopsy of prostate.
AB  - Transrectal biopsy of the prostate, because of its directness and simplicity, is
      utilized by many practicing urologists to obtain prostatic tissue for histologic
      evaluation. Complications arising from this procedure are primarily of an
      infectious origin and less commonly of a vascular etiology. We report on the
      first known patient in whom a large hematoma of the anterior rectal wall with
      nearly total occlusion of the rectal lumen developed following a transrectal
      ultrasound-guided biopsy of the prostate. Guidelines to reduce the likelihood of
      vascular complications following biopsy of the prostate gland for patients
      consuming medications that may alter normal platelet function or interfere with
      the various clotting factors are described.

PMID- 1736516
TI  - Primary radiologic realignment of membranous urethral disruptions.
AB  - A forty-two-year-old man with a traumatic, membranous urethral disruption
      underwent initial suprapubic catheter urinary diversion followed by a primary
      realignment twenty-one days after injury. Realignment was accomplished
      radiologically using an anterograde guide wire engaged by a retrograde stone
      basket and subsequent Foley catheter placement over the wire. The patient has
      remained totally continent, having partial erections, two years after injury,
      with no further intervention.

PMID- 1736517
TI  - Excretory urography during extracorporeal shock-wave lithotripsy: a localization
      alternative.
AB  - An alternative localization technique or extracorporeal shock wave lithotripsy
      using devices that use fluoroscopic targeting is presented. Excretory urography
      during lithotripsy can provide valuable targeting information and the results of
      treatment in a manner that may prove useful in the treatment of urinary calculi.

PMID- 1736518
TI  - Hematuria following bladder augmentation.

PMID- 1736519
TI  - Acquired cystic disease of kidney associated with renal cell carcinoma in chronic
      dialysis patients.
AB  - We describe 2 cases of acquired cystic disease of the kidney (ACDK) associated
      with renal cell carcinoma in patients treated with long-term hemodialysis. Both
      patients have had dialysis for five and eight years, respectively. Renal cell
      carcinomas of these patients are small, averaging 2 cm in diameter. They are
      clear cell type. Atypical epithelial hyperplasia arising from cystic areas can be
      seen intermingling with carcinoma. This confirms that atypical epithelial
      hyperplasia is a precursor of renal cell carcinoma. Although the incidence of
      renal cell carcinoma arising in ACDK is on the rise, the issue of how to manage
      patients with ACDK remained unsettled and required further study.

PMID- 1736520
TI  - Enuresis and voiding cystourethrogram.

PMID- 1736521
TI  - Kinetics of tomato golden mosaic virus DNA replication and coat protein promoter
      activity in Nicotiana tabacum protoplasts.
AB  - We have analyzed the replication kinetics of the DNA A and DNA B genome
      components of the geminivirus tomato golden mosaic virus (TGMV) in protoplasts
      derived from Nicotiana tabacum suspension culture. In addition, the kinetics of
      TGMV coat protein promoter activity, as measured by expression of a beta
      glucuronidase (GUS) reporter, have been examined. In our protoplast system,
      double-stranded DNA forms of both viral genome components appeared by 18 hr post
      transfection, while single-stranded DNA accumulated to detectable levels after 18
      24 hr. Expression of GUS from the TGMV coat protein promoter did not require
      viral DNA replication, nor was it dependent on expression of AL1, the only viral
      gene necessary for DNA replication. However, maximal expression was achieved
      following AL1-mediated replication of DNA A. GUS activity from replicating
      templates exceeded that from nonreplicating templates by 60- to 90-fold.
      Expression of the GUS reporter gene from nonreplicating viral DNA templates was
      similar to GUS expression from the 35S promoter of cauliflower mosaic virus in N.
      tabacum protoplasts.

PMID- 1736522
TI  - Parvovirus H-1 P38 promoter requires the trans-activation region (tar), an SP1
      site, and a TATA box for full activity.
AB  - In the parvovirus H-1 P38 promoter, there are sequences identified as a TATA box,
      an SP1 site, and a trans-activation responsive element (tar). It was previously
      shown that the parvovirus H-1 nonstructural protein NS1 positively regulates the
      expression of the P38 promoter for the viral capsid protein gene via the tar. To
      characterize the tar element further, a series of single-point mutations of the
      tar was constructed and the mutants were compared to wild-type for the trans
      activation of the P38 promoter using a cat reporter gene. Most of the tar
      mutations had a negative effect on the P38 promoter and some of them reduced
      activity as much as 70%. However, when several mutants with multiple-point
      mutations in the tar were tested, no significant additive effect was observed. We
      examined the function of the SP1 site in the trans-activation of the P38 promoter
      by replacing the wild-type SP1 sequence with synthetic DNA fragments, OSP1 or
      2SP1, containing no SP1 or two SP1 sites respectively, in a P38 construct with a
      cat reporter gene. The results indicate that P38 expression varies in proportion
      to the number of SP1 sites, suggesting a role for the SP1 site during trans
      activation by NS1. The role of the TATA box on the P38 promoter was also examined
      by mutagenizing TATA to CACG. The activity of this promoter was reduced to 43%.
      When a construct mutated at both the SP1 and TATA box sites was tested for its
      activity, about 22% of the wild-type activity remained, implying that this
      remaining activity was contributed largely by the tar element. A model is
      proposed for how the tar element activates the wild-type and SP1-TATA minus
      promoters in the presence of NS1.

PMID- 1736523
TI  - Expression of ORF-69 of turnip yellow mosaic virus is necessary for viral spread
      in plants.
AB  - Turnip yellow mosaic virus (TYMV) RNA has two extensively overlapping open
      reading frames (ORFs) encoding noncapsid proteins. The longest of these, ORF-206,
      is essential for RNA replication. We have investigated the expression and role of
      ORF-69 (encoding a protein with a MW of 69K) using specific antiserum and mutant
      genomic RNAs designed to interrupt ORF-69 expression. TYC69 antiserum
      immunoprecipitated a protein with an apparent MW of 75K (p69) from in vitro
      translations of TYMV RNA. Mutant RNAs with stop codons inserted at nucleotides
      139, 178, and 178/224 in ORF-69 expressed ORF-69 at very low levels in vitro.
      These mutants replicated to wild-type levels in turnip or Chinese cabbage
      protoplasts, but were not recovered from any leaves of inoculated plants. These
      results suggest that ORF-69 products are dispensible for replication, but are
      required for viral spread. Revertant and pseudorevertant viruses with
      uninterrupted ORF-69 were recovered from plants showing delayed onset of symptoms
      after inoculation with two of the above mutants, indicating the importance of ORF
      69 expression in establishing a systemic infection in plants. ORF-69 expression
      could be detected using Western blots in extracts from young, symptomatic leaves
      of infected plants. A single band with an apparent MW of 75-80K was detected in
      leaves infected with cDNA-derived viral RNAs, while a doublet was detected after
      infection with type strain viral RNA, suggesting the presence of two ORF-69
      alleles or differential post-translational modification.

PMID- 1736524
TI  - Translational effects and sequence comparisons of the three serotypes of the
      reovirus S4 gene.
AB  - Reovirus S4 RNA codes for the dsRNA-binding polypeptide sigma 3, a major virion
      outer capsid component that also has translational effects in both infected and
      transfected mammalian cells. To compare the composition and properties of the
      three different serotypes of sigma 3, a DNA copy of the type 2 gene was cloned
      and sequenced. The total lengths (1196) and the sequences of leader (33
      nucleotides) and trailer (66 nucleotides) regions are highly conserved among the
      three S4 serotypes. The type 1 and 3 S4 genes are highly related (77 mismatches).
      However, the type 2 gene contains many mismatches relative to the type 1 and 3
      genes (260 and 270 positions, respectively). Most of the mismatches are third
      position changes, resulting in sigma 3 polypeptides that are 90% or more
      identical. Transient expression vectors, constructed by replacing the
      chloramphenicol acetyltransferase (CAT) gene in pRSVCAT with S4 DNA, were used to
      test the effects of polypeptide sigma 3 on CAT expression in cotransfected COS
      cells. Transfection with the correctly oriented DNAs resulted in synthesis of the
      corresponding sigma 3 polypeptides which enhanced CAT expression. The type 2 and
      type 3 S4 genes were considerably more stimulatory than type 1 when compared to
      CAT DNA alone. However, with all three serotypes the CAT activity was
      significantly higher in cells cotransfected with S4 DNA in the correct
      orientation as compared to the reverse arrangement.

PMID- 1736525
TI  - PreS1-specific binding proteins as potential receptors for hepatitis B virus in
      human hepatocytes.
AB  - Cellular receptors play an important role in viral pathogenesis. Until now, there
      has been no reliable information on the receptor(s) for hepatitis B virus (HBV).
      Therefore, we attempted to identify specific receptors in human hepatocytes using
      an immunological approach. Anti-idiotypic (Ab2) antibodies were raised in rabbits
      against our monoclonal antibody (MAb1) F35.25. MAb1 F35.25 (i) recognized the
      hepatocyte receptor binding site on HBV (located between amino acid residues 21
      and 47 of the preS1 sequence) and (ii) blocked the attachment of preS1-positive
      HBV particles to human hepatocytes. The presence of Ab2 antibodies in rabbit sera
      was determined by the ability of antisera to inhibit Id (Ab1)/antigen (HBV)
      recognition. Affinity-purified Ab2 IgGs to F35.25 represented an internal image
      for the preS1 domain 12-53. Our present studies indicate that Ab2 IgGs to F35.25
      (i) recognized the membrane-associated structure of the preS1-specific HBV
      receptor in a HepG2 cell binding assay, as visualized by immunoenzymatic
      staining; (ii) strongly bound to a major 35-kDa component and to three other
      related proteins of 50, 43, and 40 kDa in extracts of HepG2 cells; and (iii)
      reacted with several soluble and membrane-associated proteins in normal human
      liver cells. The binding was insensitive to reduction. All preS1 binding proteins
      were V8 protease sensitive and endoglycosidase H resistant. The 35-kDa species
      was trypsin resistant and generated a band of 32 kDa by endoglycosidase F
      treatment. Together, our results suggest that the identified preS1-specific
      binding proteins may be involved in the putative complex structure of the
      hepatocyte receptor for HBV.

PMID- 1736526
TI  - Human immunodeficiency virus type 2 envelope glycoprotein: differential CD4
      interactions of soluble gp120 versus the assembled envelope complex.
AB  - Utilizing a recombinant vaccinia expression system, we investigated the
      biological properties and CD4 receptor interactions of the envelope glycoproteins
      of a noncytopathic human immunodeficiency virus type 2 strain, termed HIV-2/ST,
      and a highly cytopathic variant derived from it. The efficiency and host cell
      range of syncytium formation by the recombinant glycoproteins of both viruses
      were highly restricted compared to those of prototypic strains of HIV (HIV-2/ROD
      or HIV-1/IIIB). However, the glycoprotein of cytopathic but not wild-type ST
      generated numerous large syncytia in the human T-cell line Sup T1 from which it
      was derived. A single cell line (Molt 4 clone 8) was permissive to fusion by both
      wild-type and cytopathic ST envelopes, but only the glycoprotein of cytopathic ST
      could be inhibited with a soluble form of the viral receptor CD4 (sCD4). While
      these results indicated major differences in the envelope glycoprotein-CD4
      receptor interactions of wild-type versus cytopathic ST, direct and competition
      binding assays utilizing soluble external glycoprotein (SU) and sCD4 surprisingly
      revealed equivalent low binding affinity for both viruses. From these experiments
      we conclude that relevant biological properties (e.g., CD4 binding, cytopathic
      potential, and sCD4 neutralization) of HIV viruses which differ in their
      pathogenic potential are reflected in the sCD4 interactions of the assembled
      native envelope complex (as on cell or virion surfaces) but not the soluble SU
      glycoprotein.

PMID- 1736527
TI  - Characterization of vaccinia virus glycoproteins by monoclonal antibody
      precipitation.
AB  - Monoclonal antibodies were used to characterize vaccinia virus glycoproteins
      known to be incorporated into the envelope of extracellular enveloped vaccinia
      (EEV) virus. The 89K hemagglutinin, 42K, and 23-28K glycoproteins were
      predominantly expressed as late vaccinia proteins. The 89K glycoprotein was
      sulfated and phosphorylated but not acylated. 89K precursor proteins of 32K,
      41.5K, and 52K were detected. The former had a molecular weight expected from the
      deduced amino acid sequence of the hemagglutinin gene. A 76K glycoprotein that
      did not contain methionine and was not sulfated or phosphorylated was
      precipitated late in infection by the anti-hemagglutinin monoclonal antibody. The
      appearance of this protein was inhibited by rifampicin and it may thus result
      from 89K cleavage. A 220K complex contained some or all of the hemagglutinin gene
      products linked by disulfide bonds. The 42K glycoprotein was not sulfated or
      phosphorylated but was acylated. This glycoprotein was disulfide bonded with the
      EEV 37K nonglycosylated envelope protein. The 23-28K glycoprotein was not
      sulfated but was both phosphorylated and acylated. The 23-28K glycoprotein group
      of five proteins had a common protein backbone that was differentially
      glycosylated. Pulse-chase, glycosylation inhibition with tunicamycin, and
      glycosidase experiments established that the precursor to the 23-28K
      glycoproteins was a 21K protein. Members of this protein family formed dimers of
      approximately 55K through disulfide bonds.

PMID- 1736528
TI  - Unique nucleotide differences in the conserved 3' termini of brome mosaic virus
      RNAs are maintained through their optimization of genome replication.
AB  - To explore the functionality and conservation of specific base differences in the
      3' 200 nucleotides of brome mosaic virus (BMV) RNA-1 (1t) and RNA-2 (2t) with
      respect to the 3' end of RNA-3 (3t), all possible permutations were used to
      exchange these regions among the genomic RNAs. When all RNAs bore the 1t
      promoter, total RNA accumulation was only 15% of wild type; when the 2t or 3t
      promoter was present on all three RNAs total RNA accumulation was reduced to 30
      or 35% of wild type. Two major processes were found to be involved in these
      dramatic differences. The first reflects the distinct and competitive strengths
      of the (-)-strand promoters in these sequences, which were shown to have a 3t
      greater than 1t greater than 2t hierarchy. The second is the importance of the
      context of upstream sequences in which the 3' promoter is placed. Important
      contributions of the 3t promoter in preferential amplification of RNA-3 were
      apparent from changed RNA 1 + 2: 3 ratios and reduced progeny accumulation from
      transfections using the RNA-3/1t chimera. These interactions contribute to
      temporal modulation as well as overall optimization of viral RNA functions,
      leading to selection and maintenance of the specific base differences present in
      the otherwise highly conserved 3' 200 nucleotides of each genomic RNA component
      of BMV.

PMID- 1736529
TI  - Frequent and rapid emergence of mutated pre-C sequences in HBV from e-antigen
      positive carriers who seroconvert to anti-HBe during interferon treatment.
AB  - Hepatitis B virus (HBV) variants which cannot express e-antigen (HBeAg) are
      characteristic for many viremic anti-HBe positive chronic carriers who often have
      particularly severe and fluctuating hepatitis. Whether such variants are selected
      for and are less amenable to interferon treatment is under dispute. Therefore, by
      DNA amplification and direct sequencing we have investigated the emergence of HBV
      pre-C sequence variants in nine e-antigen positive chronic carriers, all of whom
      seroconverted to anti-HBe or lost HBeAg during interferon treatment, and in three
      of whom no viral DNA was detectable after interferon treatment. In most, but not
      all of the patients we found newly emerging pre-C sequences in a subpopulation of
      the viral genomes that included silent point mutations, amino acid changes, start
      and stop codon and frameshift mutations. The emergence of these mutations was
      paralleled by a drastic decrease of viremia during treatment. The observed
      mutations appeared most frequently during interferon treatment. Some of the
      mutations appeared or disappeared late after interferon treatment concomitant
      with anti-HBe antibody development. The appearance or lack of mutations in the
      pre-C region of a subpopulation of HBV of these patients was independent of
      successful virus elimination. These data indicate that interferon treatment is
      frequently associated with the simultaneous fall in titer of viral DNA by several
      orders of magnitude and the emergence of novel pre-C sequences, some of them
      preventing HBeAg expression. However, the presumably immune-mediated selection
      for pre-C mutant viruses and decrease in viremia under interferon treatment
      appears not to be prognostic for successful or unsuccessful virus elimination.

PMID- 1736530
TI  - Measles virus inhibits mitogen-induced T cell proliferation but does not directly
      perturb the T cell activation process inside the cell.
AB  - Measles virus (MV) inhibits lymphocyte function in patients, as well as in cells
      infected in vitro. The proliferation of phytohemagglutinin-stimulated T
      lymphocytes is suppressed by in vitro MV infection, as shown by the diminished
      incorporation of [3H]thymidine into DNA and the reduced frequency of cells in the
      S phase of the cell cycle, as compared with mock-infected cells. MV infection
      itself, however, does not completely block DNA synthesis in infected cells,
      because infected T cells expressing MV antigens on the cell surface, isolated by
      fluorescence-activated cell sorter, could still proliferate. Northern blot
      analysis indicated that the expression of genes induced during T cell activation,
      such as those encoding interleukin 2 (IL-2), c-myc, IL-2 receptor, IL-6, c-myb,
      and cdc-2, was not significantly suppressed in MV-infected cells, suggesting that
      MV does not interfere with the T cell activation process. When anti-MV serum or
      carbobenzoxy-D-Phe-L-Phe-Gly, a synthetic oligopeptide known to inhibit MV
      induced fusion, was added 24 hr after infection, the inhibition of T cell
      proliferation was reversed in a dose-dependent manner. From these results we
      propose a model for the inhibition of T cell proliferation by MV; MV
      glycoproteins expressed on the cell surface of infected cells interact with the
      MV receptor or other molecules on the cell membrane of adjacent T cells, which in
      turn affects the proliferation of those T cells.

PMID- 1736531
TI  - Recombinant vaccinia virus producing the prM and E proteins of yellow fever virus
      protects mice from lethal yellow fever encephalitis.
AB  - Four recombinant vaccinia viruses were constructed for expression of different
      portions of the 17D yellow fever virus (YFV-17D) open reading frame. A
      recombinant, vP869, expressing prM and E induced high titers of neutralizing and
      hemagglutination inhibiting antibodies in mice and was protective against
      intracranial challenge with the French neurotropic strain of YFV. Levels of
      protection were equivalent to those achieved by immunization with the YFV-17D
      vaccine virus. Recombinant vaccinia viruses expressing E and NS1, C prM, E, NS1,
      or only NS1 failed to protect mice against challenge with YFV despite eliciting
      antibodies to NS1. The vP869-infected HeLa cells produced a particulate
      extracellular hemagglutinin (HA) similar to that produced by YFV-infected cells,
      supporting previous studies with Japanese encephalitis virus (Mason et al.,
      1991), suggesting that the ability of recombinant vaccinia virus to produce
      extracellular HA particles is important for effective flavivirus immunity.

PMID- 1736532
TI  - Substantial portions of the 5' and intercistronic noncoding regions of cowpea
      chlorotic mottle virus RNA3 are dispensable for systemic infection but influence
      viral competitiveness and infection pathology.
AB  - Cowpea chlorotic mottle virus (CCMV) has a tripartite, positive strand RNA
      genome. Genomic RNA3 (2.2 kb) encodes the 3a nonstructural protein and the coat
      protein, which are dispensable for viral RNA synthesis in protoplasts, but
      required for systemic infection of whole plants. In protoplasts, portions of the
      5' and intercistronic noncoding regions of CCMV RNA3 are also dispensable for
      RNA3 replication and for transcription of the subgenomic coat protein mRNA. To
      determine whether these noncoding sequences are required for systemic infection,
      a series of 5' and intercistronic deletions in RNA3 were tested for their effects
      on the infection of cowpea plants, a natural host of CCMV. The results refine the
      mapping of the subgenomic mRNA promoter and show that at least 144 bases in the
      5' noncoding region and at least 125 bases in the intercistronic noncoding region
      of CCMV RNA3 are dispensable for systemic infection. For mutants with deletions
      within these regions, no differences were noted in the rate of infection spread,
      and the level of virus accumulation in systemically infected tissue 10-14 days
      postinoculation was 60-100% of wild type (wt). However, the largest viable
      intercistronic deletion transformed the nearly symptomless appearance of wt CCMV
      infections to an extensive, bright yellow chlorosis, showing that infection
      pathology can be altered by mutations with a regulatory rather than a protein
      coding character. In addition, neither 5' nor intercistronic deletion mutants
      competed effectively with wt CCMV in whole plant co-infection experiments; i.e.,
      such mutants were not detectable in systemically infected tissue after co
      inoculation with wt CCMV. Thus, although substantial portions of both the 5' and
      the intercistronic noncoding regions of CCMV RNA3 are dispensable for individual
      systemic infection, these segments contribute to the competitive fitness of the
      virus and influence interaction with the host, as evidenced by symptom response.

PMID- 1736533
TI  - Characterization of the potyviral HC-pro autoproteolytic cleavage site.
AB  - The helper component-proteinase (HC-Pro) encoded by potyviruses functions to
      cleave the viral polyprotein by an autoproteolytic mechanism at the HC-Pro C
      terminus. This protein belongs to a group of viral cysteine-type proteinases and
      has been shown previously to catalyze proteolysis between a Gly-Gly dipeptide.
      The amino acid sequence requirements surrounding the HC-Pro C-terminal cleavage
      site of the tobacco etch virus polyprotein have been investigated using site
      directed mutagenesis and in vitro expression systems. A total of 51 polyprotein
      derivatives, each differing by the substitution of a single amino acid between
      the P5 and P2' positions, were tested for autoproteolytic activity. Substitutions
      of Tyr (P4), Val (P2), Gly (P1), and Gly (P1') were found to eliminate or nearly
      eliminate proteolysis. Substitutions of Thr (P5), Asn (P3), and Met (P2'), on the
      other hand, were permissive for proteolysis, although the apparent processing
      rates of some polyproteins containing these alterations were reduced. These
      results suggest that auto-recognition by HC-Pro involves the interaction of the
      enzymatic binding site with four amino acids surrounding the cleavage site.
      Comparison of the homologous sequences of five potyviral polyproteins revealed
      that the residues essential for processing are strictly conserved, whereas the
      nonessential residues are divergent. The relationship between HC-Pro and other
      viral and cellular cysteine-type proteinases is discussed.

PMID- 1736534
TI  - Characterization of a novel nuclear localization signal in the HTLV-I tax
      transactivator protein.
AB  - The Tax trans-activator protein of the type I human T-cell leukemia virus is
      expressed predominantly in the nuclei of cells. However, this viral trans
      activator is distinguished from most other nuclear proteins by the absence of a
      short highly basic nuclear localization signal. Previous mutational analyses of
      the tax gene revealed that many of the missense mutations involving the amino
      terminus of Tax resulted in a predominantly cytoplasmic pattern of expression. We
      now report that the amino terminal 48 residues of Tax comprise a functional
      nuclear localization signal as demonstrated by the ability of this region to
      retarget expression of a large cytoplasmic protein to the nucleus.

PMID- 1736535
TI  - Nonreplicating viral vectors as potential vaccines: recombinant canarypox virus
      expressing measles virus fusion (F) and hemagglutinin (HA) glycoproteins.
AB  - The development of canarypox virus (CPV) recombinants expressing the
      hemagglutinin (HA) and fusion (F) glycoproteins of measles virus (MV) is
      described. Inoculation of the CPV-MV recombinants into avian or nonavian tissue
      culture substrates led to the expression of authentic MVF and MVHA as determined
      by radioimmunoprecipitation and surface immunofluorescence. In contrast to avian
      derived tissue culture, no productive replication of the CPV recombinant was
      evident in tissue culture cells derived from nonavian origin. On inoculation of
      dogs, a species restricted for avipoxvirus replication, the recombinants elicited
      a protective immune response against a lethal canine distemper virus (CDV)
      challenge. The level of MV neutralizing antibodies and the level of protection
      induced against CDV challenge achieved by the host-restricted CPV vector were
      equivalent to that obtained by vaccinia virus vectors expressing the same MV
      antigens.

PMID- 1736536
TI  - The mass of the Sindbis virus nucleocapsid suggests it has T = 4 icosahedral
      symmetry.
AB  - The mass of the nucleocapsid of the alphavirus Sindbis was determined by scanning
      transmission electron microscopy. The nucleocapsid was found to have an average
      mass of 10.54 x 10(6) Da with the largest percentage of particles showing a mass
      of 10.7 to 10.9 x 10(6) Da. These data predict that the nucleocapsid contains 240
      copies of protein and is a T = 4 icosahedron.

PMID- 1736537
TI  - Rapid sequence evolution of street rabies glycoprotein is related to the highly
      heterogeneous nature of the viral population.
AB  - The sequence of the glycoprotein gene of a street rabies virus was determined
      directly using fragments of a rabid dog brain after PCR amplification. Compared
      with that of the prototype strain CVS, this sequence displayed 10% divergence in
      overall amino acid composition. However only 6% divergence was noted in the
      ectodomain suggesting that structural constraints are exerted on this portion of
      the glycoprotein. A human strain isolated on cell culture from the saliva of a
      patient with clinical rabies had only five amino acid differences with the canine
      isolate, an indication of their close relatedness. These differences could have
      originated during transmission from dog to dog, or from dog to man, or during
      isolation on cell culture; they are nonetheless indicative of a genetic evolution
      of street rabies virus. This evolution was further evidenced by the selection of
      cell-adapted variants which displayed new amino acid substitutions in the
      glycoprotein. One of them concerned antigenic site III where arginine at position
      333 was replaced by glutamine. As expected this substitution conferred resistance
      to a site IIIa monoclonal antibody (MAb), but surprisingly did not abolish
      neurovirulence for adult mice. However, a decrease in the neurovirulence of the
      cell-adapted variant in the presence of a site IIIa specific MAb was noted,
      suggesting that neurovirulence was due to a subpopulation neutralizable by the
      MAb. Simultaneous presence of both the parental and variant sequences was indeed
      evidenced in the brain of a mouse inoculated with the cell-adapted variant;
      during multiplication in the mouse brain, the frequency of the parental sequence
      rose from less than 10% to nearly 50%, indicating the selective advantage
      conferred by arginine 333 in nervous tissue. Altogether these results were
      suggestive of an intrinsic heterogeneity of street rabies virus. This
      heterogeneity was further demonstrated by the sequencing of molecular clones of
      the glycoprotein gene, which revealed that only one-third of the viral genomes
      present in the brain of a rabid dog had the consensus sequence. Two-thirds of the
      clones analyzed displayed from one to three amino acid substitutions. Such
      heterogeneous populations have been referred to as quasispecies, a concept which
      implies heterogeneous populations kept together in a dynamic equilibrium. This
      equilibrium could be rapidly displaced, giving the virus the capacity to adapt
      easily to new environmental conditions.

PMID- 1736538
TI  - Yeast killer virus transcription initiation in vitro.
AB  - Killer virions isolated from infected Saccharomyces cerevisiae cells contain an
      RNA polymerase activity which catalyzes the transcription in vitro of positive
      polarity RNAs from the L-A and M double-stranded RNA genomic segments of the
      virus. The RNA polymerase can initiate transcription in vitro with gamma-thio
      GTP, whose thiophosphate group is found on the 5' terminus of transcripts.
      Transcripts produced in vitro by the virion-associated RNA polymerase in the
      presence of 7mGpppG are significantly more active as translational templates than
      are transcripts produced in its absence. However, unlike Escherichia coli RNA
      polymerase transcripts from viral cDNA made in the presence of 7mGpppG,
      transcripts produced by viral RNA polymerase in the presence of 7mGpppG fail to
      bind to antibody against 7mG.

PMID- 1736539
TI  - Stability of p53 protein in rat cells transformed by various viral transforming
      genes.
AB  - To clarify the correlation between metabolic stabilization of p53 protein and
      cellular transformation, we transformed the normal rat cell line F2408 with
      various viral transforming genes and examined the expression and stability of p53
      protein in these transformed cells by pulse-chase immunoprecipitation
      experiments. As expected, the level of p53 in the SV40-transformed rat cell line
      was higher than that in the normal cell line and its stability was also
      increased. In contrast, in cells transformed with the E7 and E6 genes of human
      papillomavirus type 16, the level and stability of p53 were similar to those in
      the normal cells. In cells transformed by the middle T or large T of
      polyomavirus, v-K-ras, and v-src, the levels and stabilities of p53 were also not
      elevated, although the level of p53 was increased in activated c-H-ras
      transformed cells without an increase in its stability. These results show that
      increased stability and expression of the p53 protein are not common events in
      viral transformation of the rat cell line. In addition, we demonstrated with a
      monoclonal antibody specific for the mutant form of p53 that cellular
      transformation by viral transforming genes does not involve mutational activation
      of p53 to an oncogenic form.

PMID- 1736540
TI  - Properties of a new virus belonging to nodaviridae found in larval striped jack
      (Pseudocaranx dentex) with nervous necrosis.
AB  - Spherical virus particles were purified from larval striped jack (Pseudocaranx
      dentex) with nervous necrosis. The virus consists of nonenveloped particles,
      about 25 nm in diameter, and contains two single-stranded, positive-sense RNA
      molecules with molecular weights of 1.01 x 10(6)Da (RNA 1) and 0.49 x 10(6)Da
      (RNA 2), respectively. The RNAs do not have poly(A) sequences at the 3' terminus.
      Virus structural proteins consist of two proteins with molecular weights of 42
      and 40 kDa. When translated into cell-free extracts of rabbit reticulocytes, RNA
      1 directed the synthesis of the 1a protein (100 kDa), whereas RNA 2 synthesized
      the 2a protein (42 kDa), which is probably the coat protein of the virus, and a
      polypeptide of 40 kDa which appears to be the processed form of the 42-kDa
      protein. Under electron microscopic observation, the virus particles were found
      in the tissues of the central nervous system of the affected larval striped jack.
      From morphological and biochemical properties of the virus, we identified this
      virus as a new member of the family of Nodaviridae and designated it striped jack
      nervous necrosis virus.

PMID- 1736541
TI  - Interferon-gamma-induced assembly block in the replication cycle of adenovirus 2:
      augmentation by tumour necrosis factor-alpha.
AB  - Replication of adenovirus 2 (Ad-2) is inhibited in A 549 cells pretreated with
      interferon-gamma (IFN-gamma). The antiviral effect is synergistically enhanced by
      the simultaneous presence of tumor necrosis factor-alpha (TNF-alpha) before
      infection. Under conditions of strong inhibition of virus progeny formation,
      viral DNA synthesis and [35S]methionine incorporation into most late viral
      proteins are only marginally impaired. Pulse chase experiments indicate a partial
      inhibition of processing of viral proteins. Viral proteins are not degraded and
      capsomeres accumulate in the inhibitor-treated cells. Capsid formation, on the
      other hand, is strongly inhibited in the cytokine-treated cells. The inhibition
      of Ad-2 replication in A 549 cells by IFN-gamma and TNF-alpha is caused,
      therefore, by a block in the maturation of Ad-2.

PMID- 1736542
TI  - Role of asparagine-linked glycosylation in human immunodeficiency virus type 1
      transmembrane envelope function.
AB  - Transmembrane envelope protein (TM) residues 100, 105, and 128 of human
      immunodeficiency virus type 1 (HIV-1) strain HXB2 are potential sites for
      asparagine-linked oligosaccharide additions which are conserved among HIV-1
      isolates, and all other lentivirus TM proteins. Site-specific mutants of each of
      the asparagine residues did not eliminate the ability of the virus to infect and
      replicate in CD4+ cells, but infectivity was reduced with all of these mutants,
      and syncytia induction was attenuated with two of these mutants. Studies of
      envelope expression of the mutant with the most severe defect demonstrated no
      significant effects on envelope protein synthesis, conformation, processing,
      multimerization, or release into the culture medium, suggesting that N-linked
      oligosaccharides are important in the specific fusion activity of TM.

PMID- 1736543
TI  - Sensitive method for identification of minor hepatitis B mutant viruses.
AB  - There is increasing evidence for selection of hepatitis B virus (HBV) mutants
      during the natural course of infection, after immunization, and during interferon
      therapy. These mutants can prolong viral persistence, escape immune-mediated
      elimination, and influence the clinical sequelae of infection. Here we describe a
      sensitive and reliable method that allows detection of HBV mutants within a
      heterogeneous virus population. The method consists of amplification of HBV DNA
      with vector-HBV hybrid primers, efficient and enzyme-free cloning of the
      amplified DNA fragment, identification by hybridization with synthetic
      oligonucleotide probes, and sequencing of the cloned DNA fragments. We
      demonstrate that up to 10(5) HBV DNA fragments can be obtained in cloned form
      from a single amplification reaction, the ratio of HBV pre-C "wild-type" and
      mutant sequences of heterogeneous populations can be determined, and very minor
      virus subpopulations can be identified. The method can be applied to other viral
      or nonviral nucleic acid sequence variation studies and should help to resolve
      the role of mutant and wild-type viruses in pathogenesis and the forces driving
      their selection.

PMID- 1736544
TI  - Effect of myristoylation on p27 nef subcellular distribution and suppression of
      HIV-LTR transcription.
AB  - The effect of myristoylation on p27nef subcellular distribution and suppression
      of HIV-1 transcription was examined by transfecting COS-7 cells with plasmids
      expressing either myristoylated (pSVnef) or nonmyristolyated p27nef (pSVnefala2).
      Similar levels of myristoylated and nonmyristoylated p27nef were expressed with
      only the product of the pSVnef plasmid being myristoylated. Immuno-histochemical
      microscopy and radioimmunoprecipitation revealed myristolyated p27nef only in the
      membrane fraction while nonmyristolyated p27nef was found distributed between the
      nucleus and the cytosol fractions. The effect of myristoylation on p27nef
      suppression of HIV LTR controlled transcription was examined in transient
      transfected COS cells and in CEM human T-cell clones consituitively expressing
      either myristolyated or nonmyristolyated p27nef by cotransfecting with a
      chloramphenicol acetyltransferase (CAT) plasmid under control of the HIV-1 LTR.
      In both systems, myristoylated p27nef exhibited a 13- to 18-fold inhibition of
      basal CAT activity while the nonmyristolyated mutant and the same plasmid
      carrying the nef gene in a reverse orientation inhibited CAT activity one- to two
      fold. These results confirm the cytoplasmic membrane localization of p27nef and
      establish that its subcellular targeting is dependent on covalently attached
      myristate. The data also provide further evidence that p27nef acts as a
      transcriptional suppressor and establishes for the first time that myristolyation
      is required for the full manifestation of this effect.

PMID- 1736545
TI  - Induction of ribonucleotide reductase activity in cells infected with African
      swine fever virus.
AB  - Infection of Vero cells with African swine fever virus (ASFV) resulted in a
      marked increase in ribonucleotide reductase activity. The induction of
      ribonucleotide reductase was detected early after infection and was proportional
      to the multiplicity of infection. Inhibition of viral DNA replication did not
      affect the induction of the enzyme. Several characteristics could distinguish the
      virus-induced from the normal cell enzyme. ASFV-induced ribonucleotide reductase
      was inhibited by magnesium, was more strongly inhibited by hydroxyurea, and had a
      fourfold lower Km. The virus-induced enzyme was inhibited by deoxyribonucleoside
      triphosphates and by ATP. The isolation of hydroxyurea-resistant ASFV mutants
      provided genetic evidence for the viral origin of the induced ribonucleotide
      reductase. The resistance to hydroxyurea was due to a threefold overproduction of
      ribonucleotide reductase, as compared to enzyme induction by wild-type ASFV.
      Hydroxyurea had similar effect in vitro on ribonucleotide reductases induced by
      wild-type or mutant virus. The gene for the small subunit of the viral enzyme was
      mapped within a 2.3-kb fragment by hybridization with an oligonucleotide probe
      designed from a conserved aminoacid sequence of eukaryotic and viral
      ribonucleotide reductases.

PMID- 1736546
TI  - Molecular analysis of the trans-activating IE-2 gene of Orgyia pseudotsugata
      multicapsid nuclear polyhedrosis virus.
AB  - A second immediate early (IE) regulatory gene of the baculovirus Orgyia
      pseudotsugata multicapsid nuclear polyhedrosis virus (OpMNPV) has been
      identified. The IE-2 gene which is homologous to the IE-N gene of Autographa
      californica MNPV was mapped to the HindIII A fragment of OpMNPV between 0.41 to
      1.37 map units. The IE-2 gene codes for a predicted protein of 45,640 Da and
      analysis of the amino acid sequence shows that the protein has a highly basic
      amino terminal domain and a cysteine-rich domain that is similar to a zinc finger
      motif that is also found in the baculovirus proteins GC30 and PE-38. The IE-2
      gene is expressed as a 1.3-kb transcript that was detectable by 0.5 hr
      postinfection (hr p.i.), reached maximum steady state levels by 6 hr p.i., and
      declined slightly by 48 hr p.i. Cis-acting 5' regulatory sequences were analyzed
      by deletion analysis of the IE-2 promoter linked to the reporter gene
      chloramphenicol acetyl transferase. Maximum expression was obtained when the IE-2
      promoter contained sequence 275 bp upstream from the transcriptional start site.
      trans-Activation analysis revealed that IE-2 trans-activated the IE-1 promoter
      and in addition appeared to be autoregulatory.

PMID- 1736547
TI  - Tandemly repeated sequence at the 3' end of the IE-2 gene of the baculovirus
      Orgyia pseudotsugata multicapsid nuclear polyhedrosis virus is an enhancer
      element.
AB  - An enhancer element was identified in the virus Orgyia pseudotsugata multicapsid
      nuclear polyhedrosis virus (OpMNPV) that is located adjacent to the 3' end of the
      IE-2 gene and 5' to an open reading frame that codes for a predicted protein that
      has 37% homology to the AcMNPV PE-38 gene. The OpMNPV enhancer (OpE) consists of
      a 66-bp element that is tandemly repeated partially or completely 12 times. The
      OpE sequences were shown to increase gene expression from the Autographa
      californica MNPV delayed early p39 promoter independently of position or
      orientation, and were also shown to increase expression from the promoter of the
      OpMNPV immediate early gene, IE-2. Sequences homologous to the OpE sequences were
      mapped by Southern blot hybridization to four additional locations around the
      OpMNPV genome. This indicates that OpMNPV is similar to other baculoviruses such
      as AcMNPV, Lymantria dispar MNPV, and Choristoneura fumiferana MNPV that have
      homologous regions in several locations in the genome.

PMID- 1736548
TI  - High-dose intravenous immunoglobulin treatment in Graves' ophthalmopathy.
AB  - We have evaluated the efficacy of high-dose intravenous immunoglobulin treatment
      in Graves' ophthalmopathy, and have carried out a prospective randomized clinical
      trial, including a single-blind evaluation, whereby 14 patients were assigned to
      two different treatment groups: 7 patients were treated with intravenous
      immunoglobulin and orbital radiotherapy (Group 1) and 7 patients were given
      intravenous immunoglobulin alone (Group 2). The results of the intravenous
      immunoglobulin treatment were also compared with those obtained in a Historical
      Control Group (12 patients) treated with systemic methylprednisolone and orbital
      irradiation. Degree of ocular involvement and response to treatment were assessed
      by ophthalmopathy index. The mean initial and final ophthalmopathy index showed
      no significant difference among the three groups. Comparison between the mean
      initial and final ophthalmopathy index showed a statistically significant
      reduction (p less than 0.005) in all three groups, the observed changes being
      confirmed by orbital computerized tomography in Groups 1 and 2. Corticosteroid
      treatment was associated with major and minor side effects, while no important
      adverse reactions were observed during intravenous immunoglobulin treatment. Even
      considering our results as preliminary, we conclude that intravenous
      immunoglobulin treatment is effective and safe in improving Graves'
      ophthalmopathy.

PMID- 1736549
TI  - Glucocorticoid receptor and inhibition of 3-O-methyl-D-glucose uptake by
      glucocorticoids in peripheral blood leukocytes from normal humans: correlation
      between receptor level and hormone effect in vitro.
AB  - We have measured the glucocorticoid receptor concentration in mononuclear and
      polymorphonuclear leukocytes, both of which were isolated from peripheral blood
      from ten healthy male volunteers. In parallel, the inhibitory effect of
      dexamethasone on 3-O-methyl-D-glucose uptake was assayed in the corresponding
      mononuclear leukocytes. The glucocorticoid receptor levels in mononuclear
      leukocytes correlated with those in polymorphonuclear leukocytes, and there was a
      linear relationship between the cellular glucocorticoid receptor levels and
      glucocorticoid-mediated inhibition of the uptake of 3-O-methyl-D-glucose in
      mononuclear leukocytes. When mononuclear leukocytes were incubated in the
      presence of 8-bromo-cAMP, cellular glucocorticoid receptor levels increased and a
      more pronounced inhibitory effect of dexamethasone was observed on the transport
      of 3-O-methyl-D-glucose. We conclude that the cellular glucocorticoid receptor
      levels in peripheral blood leukocytes reflect in vitro responsiveness to
      glucocorticoids in mononuclear leukocytes from healthy males, and that the
      individual responsiveness may alter upon changes in the cellular levels of
      glucocorticoid receptor.

PMID- 1736550
TI  - Clinical heterogeneity of 21-hydroxylase deficiency of sibs with identical 21
      hydroxylase genes.
AB  - Congenital adrenal hyperplasia due to 21-hydroxylase deficiency is a disorder
      with different clinical manifestations, that results from mutations in the P
      450(c21) gene. Direct sequence analysis of P-450(c21) genes in a family
      demonstrates that patients with different clinical forms of congenital adrenal
      hyperplasia can have identical P-450(c21) genes, suggesting that other effects
      play a role in developing the different clinical forms.

PMID- 1736551
TI  - Progressive and concurrent deterioration of vagus-stimulated and hypoglycemia
      induced glucagon secretion in streptozotocin-diabetic rats.
AB  - The effects of left cervical vagus nerve stimulation on glucagon secretion were
      studied in streptozotocin-diabetic and age-matched control adult male rats. At
      two-week intervals, after the induction of streptozotocin-diabetes,
      streptozotocin-diabetic and age-matched control rats were anesthetized with
      chloral hydrate (350 mg/kg, ip). Left cervical vagus nerves were electrically
      stimulated via a Grass stimulator with 5-volt monophasic pulses of 3 msec
      duration at a frequency of 20 Hz for 1, 2, and 4 min. Arginine-induced glucagon
      secretion was also determined. Vagus nerve-stimulated (2 and 4 min) glucagon
      secretion deteriorated as the duration of streptozotocin-diabetes increased.
      Glucagon secretion in response to vagus nerve stimulation was virtually absent by
      12 weeks of streptozotocin-diabetes. However, arginine-induced glucagon secretion
      was unaffected. Subsequent experiments showed that the defect in glucagon
      secretion from vagal stimulation occurred concurrently with that seen from
      insulin-induced hypoglycemia. These results indicate that the impaired
      hypoglycemia-induced glucagon secretion in long-term streptozotocin-diabetic rats
      may be correlated with the deterioration of the parasympathetic nervous system
      transmission in streptozotocin-diabetes.

PMID- 1736552
TI  - The plateau phase rat goiter contains a sub-population of TSH-responsive
      follicular cells capable of proliferation following transplantation.
AB  - In the rat, chronic TSH stimulation leads to self-limited thyroid hyperplasia,
      goitrogenesis, and TSH-responsive thyroid tumors. The current studies were aimed
      at clarifying the mechanism by which hormone-responsive, proliferating follicular
      cells arise in quiescent plateau phase rat goiters. Enzymatically monodispersed
      rat thyrocytes from early plateau phase and involuting goiters were analyzed for
      the capacity to form thyroid follicular units after transplantation into
      syngeneic recipients. Goiters induced with two different regimens contained
      substantial numbers of cells capable of proliferating into functioning thyroid
      follicular tissue after transplantation. The clonogenic fractions of cells from
      goiters induced by 3-amino-1,2,4-triazole or KClO4/Remington low iodine diet were
      significantly lower than that of cells from control glands. Furthermore, the
      clonogenic fraction of cells from the KClO4 goiters was also found to be
      significantly less than that of cells from aminotriazole goiters despite similar
      TSH levels in the cell donors. The hormone responsiveness of the clonogenic
      goiter cells and the histological appearance and functional capacity of the
      thyroid tissue which arose after grafting were indistinguishable from controls.
      We conclude that the capacity to clonally proliferate into follicular units is a
      specific trait which characterizes a unique subset of follicular cells and
      speculate that the hormone-responsive tumors which typically appear in the
      chronically stimulated rat thyroid originate from cells within this subset.

PMID- 1736553
TI  - Performance Based Development Systems (PDBS). Interview by Eve Henderson.

PMID- 1736554
TI  - Writing a research proposal for AFNR: how to fill out AFNR-4.

PMID- 1736556
TI  - Memories of Jenny.

PMID- 1736555
TI  - A story of hope and courage. Interview by Darlene Konduc.

PMID- 1736557
TI  - Your last days.

PMID- 1736558
TI  - Is nursing information significant in determining resource allocation?

PMID- 1736559
TI  - Specialization in nursing: its history and its future.
AB  - Advances in knowledge and technology in the health care field has made
      specialization in nursing inevitable. The history of specialization points to a
      need for standardizing specialty nursing education. The options for standardizing
      specialization include post-RN certification, incorporating specialization into
      basic nursing education, or allowing specialization only at the masters level.
      The pathway for specialization must be clearly defined with recognition for
      specialized nursing practice to keep nurses at the bedside and promote job
      satisfaction.

PMID- 1736560
TI  - Coronary risk factors and the severity of angiographic coronary artery disease in
      members of high-risk pedigrees.
AB  - Affected members of early coronary pedigrees in Utah are at markedly increased
      risk for the development of clinical coronary heart disease (CHD). The
      relationship between the presence of coronary risk factors and the severity of
      angiographic coronary artery disease (CAD) in 53 members of high-risk Utah
      pedigrees was examined. Mean angiographic severity scores were higher in familial
      hypercholesterolemia or familial low high-density lipoprotein cholesterol (HDL-C)
      pedigrees than in type III hyperlipidemia or familial combined hyperlipidemia
      pedigrees. One sibling pair with hyperhomocyst(e)inemia had the highest mean
      angiographic severity scores. Clinical CHD (p less than 0.0001), increasing low
      density lipoprotein cholesterol (LDL-C) (p = 0.0107), and decreasing HDL-C (p =
      0.0068) were significant predictors of angiographic CAD severity. There appeared
      to be an interaction between gender and body mass index but not between gender
      and serum lipids in the prediction of angiographic CAD severity. Results of the
      present study in members of high-risk Utah pedigrees are consistent with results
      from other angiographic studies in non-high-risk persons. Of particular interest
      is the suggested independent predictive value of low HDL-C for angiographic CAD
      severity in members of high-risk pedigrees.

PMID- 1736561
TI  - Oxidative status of lipoproteins in coronary disease patients.
AB  - Oxidized low-density lipoprotein (LDL) may play an important role in
      atherogenesis. The oxidative status of isolated LDL and very low-density
      lipoprotein (VLDL) were investigated in 23 patients with proven coronary disease
      and in 23 healthy asymptomatic control subjects. Oxidized cholesterol (4
      cholesten-3-one and 20 alpha-OH cholesterol) was identified in LDL and VLDL from
      both groups. The content of cholesterol and 4-cholesten-3-one in LDL from
      patients was significantly increased in comparison with values from the control
      subjects. Lipid peroxidation, as assessed by malondialdehyde (MDA) formation, was
      barely detectable in native LDL and VLDL from the two groups. However, after
      incubation with a free radical-producing system, MDA levels in LDL from patients
      were significantly higher than those in control subjects. Lysine reactivity in
      LDL after incubation with an oxidizing agent, CuSO4, was similar between groups.
      However, lysine reactivity to CuSO4 in VLDL from patients was less than that in
      control subjects. Our results suggest that LDL levels from patients with coronary
      disease have an elevated oxidized cholesterol content and are more susceptible to
      peroxidative modification. Conversely, the LDL apoprotein does not appear to have
      been oxidatively modified in these patients. The data are consistent with a role
      for oxidized LDL in coronary artery disease and indicate that the LDL lipid may
      be an important oxidation site.

PMID- 1736562
TI  - Inhibition of platelet aggregation by prostacyclin is attenuated after exercise
      in patients with angina pectoris.
AB  - We tested whether alteration of platelet sensitivity to prostacyclin (PGI2) is
      involved in the activation of platelets induced by exercise in patients with
      stable angina. Twenty patients and 20 control subjects underwent treadmill
      testing. Blood samples were obtained before and immediately after exercise for
      plasma thromboxane B2 (TXB2) and 6-keto-PGF1 alpha (6kP) assays and platelet
      aggregation studies. Dose-response curves for platelet aggregation to collagen
      were obtained in the presence and absence of 1 nmol/L PGI2 to quantify the
      antiaggregation effects of PGI2. At rest, platelet aggregation by collagen was
      enhanced in the patients. However, platelets were more sensitive to exogenous
      PGI2, apparently associated with lower plasma 6kP levels in the patients. After
      exercise, plasma TXB2 levels increased in the patients but not in the control
      subjects. Plasma 6kP levels remained unchanged and platelet sensitivity to PGI2
      decreased in the patients whereas these values increased in the control subjects.
      The exercise-induced changes in platelet sensitivity to PGI2 correlated with
      those of platelet adenylate cyclase activity in response to 1 nmol/L PGI2 (r =
      0.787, p less than 0.01). Thus impaired sensitivity of platelets to PGI2, in
      addition to the reduced response of prostanoid secretion, might be relevant to
      the platelet activation associated with exercise in patients with stable angina.

PMID- 1736563
TI  - Differences in plasma beta-endorphin and bradykinin levels between patients with
      painless or with painful myocardial ischemia.
AB  - To verify whether plasma beta-endorphin and bradykinin affects the
      pathophysiology of myocardial ischemia and the perception of cardiac pain, 35
      patients with coronary artery disease were subjected to treadmill testing and 48
      hour Holter ECG monitoring to measure their pain thresholds. Patients were
      divided into two groups during exercise testing: group 1 (N = 19) who had ST
      segment depression, and group 2 (N = 16), who had chest pain. Both groups were
      then compared with 12 age-matched control subjects. Pain thresholds were measured
      after Holter ECG monitoring, and blood samples were drawn before and immediately
      after exercise. No statistical differences were noted between groups 1 and 2 with
      regard to the severity of myocardial ischemia as assessed by ST segment
      depression or exercise tolerance time. The frequency of the episodes of silent
      myocardial ischemia in group 1 was found to be significantly (p less than 0.05)
      higher than that in group 2. The duration of the episodes of silent myocardial
      ischemia in group 1 was 41.9 minutes (range 3 to 343 minutes), which was
      significantly (p less than 0.05) longer than that in group 2 (11.5 minutes; range
      0 to 74). The pain threshold in group 1 was a statistically (p less than 0.05)
      higher value than that in group 2. Although the resting plasma beta-endorphin
      level in group 1 was not statistically significantly different from values in
      either group 2 or the control group, during exercise the plasma beta-endorphin
      levels in both group 1 and the control group were significantly (p less than
      0.05) elevated in comparison with their resting levels.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1736564
TI  - Efficacy of three-channel ambulatory electrocardiographic monitoring for the
      detection of myocardial ischemia.
AB  - The recognition of silent myocardial ischemia (SMI) has been demonstrated to have
      important clinical relevance. Two-channel ambulatory (Holter)
      electrocardiographic recording is a commonly utilized method for detecting
      transient electrocardiographic ST segment changes representative of SMI. It has
      been suggested that the analysis of two channels alone may not adequately detect
      SMI. We therefore evaluated the diagnostic yield of three channels using a three
      channel electrocardiographic monitoring device in 46 consecutive patients (age 61
      +/- 9 years) undergoing percutaneous transluminal coronary angioplasty of an
      isolated single-vessel stenosis. Modified bipolar chest leads V2, V5, and AVF (CM
      V2, CM-V5, and CS-AVF) were utilized for analysis. The percent detection of ST
      segment changes from various combinations of two-lead recordings were compared to
      the total three leads, and an absolute transient ST segment shift (STSS) of
      greater than or equal to 1 mm during balloon inflation was considered as evidence
      of myocardial ischemia. One patient was excluded because of the need for
      ventricular pacing during balloon inflation. A total of 33 of 45 patients had
      STSS in all three leads (percent detection = 73%), while 32 (71%) had STSS in the
      two-lead grouping with the highest diagnostic yield (CM-V2/CM-V5; p = ns). Of the
      various two-lead combinations studied, leads CM-V2 and CM-V5 provided the best
      lead set overall for the detection of ischemic STSS. Three-channel ambulatory
      electrocardiographic recording only marginally improves upon the detection of
      ischemia when compared with standard (CM-V2/CM-V5 or CM-V5/CS-AVF) two-channel
      ambulatory electrocardiographic recordings.

PMID- 1736565
TI  - Prognostic value of dipyridamole thallium-201 scintigraphy in patients with
      stable chest pain.
AB  - The usefulness of dipyridamole testing with planar thallium-201 scintigraphy for
      assessing risk of subsequent cardiac events was evaluated in 373 patients with
      stable chest pain. Follow-up information was complete in 362 patients (mean age
      64 +/- 9 years). During an average follow-up period of 18 months, cardiac events
      occurred in 59 patients--unstable angina in 27, nonfatal acute myocardial
      infarction in 11, and death from cardiac causes in 21. A history of previous
      myocardial infarction, congestive heart failure, or coronary bypass surgery
      before the study, or the presence of an abnormal scan or one with a fixed
      perfusion defect was associated with a significantly increased frequency of
      subsequent cardiac events (p less than 0.05). However, the presence of a
      reversible perfusion defect was not associated with increased risk (p = 0.1872).
      Stepwise logistic regression showed that a history of coronary artery bypass
      surgery before the study and the presence of a fixed perfusion defect were the
      only variables with independent predictive value for occurrence of a subsequent
      cardiac event (p less than 0.05). Survival analysis revealed a significantly
      increased cardiac event rate in patients with abnormal scans compared with those
      with normal scans over a 30-month follow-up period (p less than 0.01). We
      conclude that dipyridamole testing with thallium-201 scintigraphy can provide
      prognostic information concerning risk of future cardiac events in patients with
      stable chest pain. The presence of a fixed perfusion defect in particular
      identifies patients at increased risk.

PMID- 1736566
TI  - The predictive value of silent ischemia at an exercise test before discharge
      after an episode of unstable coronary artery disease. RISC Study Group.
AB  - The prognostic value of silent ischemia during a symptom-limited predischarge
      exercise test (ET) was evaluated in 740 men after an episode of unstable angina
      or non-Q wave myocardial infarction. The 51% of patients with ST depression at
      the ET had a higher rate of myocardial infarction or death after 1 year (18%)
      compared with those without ST depression (9%; p less than 0.01). This increased
      risk was not influenced by the presence or absence of pain at the ET: 18.3% in
      patients with painful ischemia compared with 18.1% in patients with silent
      ischemia. However, ST depression combined with pain at the ET predicted a higher
      incidence of class III or IV angina at follow-up (43.9% compared with 16.7% in
      the group with asymptomatic ST depression; p less than 0.001). Because
      revascularization in addition to alleviating symptoms also enhances the prognosis
      in certain groups of patients, selections for coronary angiography and possible
      revascularization should not be made only on the basis of symptoms but also on
      the presence of myocardial ischemia, whether symptomatic or not.

PMID- 1736567
TI  - The effects of intravenous infusions of selective adenosine A1-receptor and A2
      receptor agonists on myocardial reperfusion injury.
AB  - To determine the efficacy of very low doses of adenosine on myocardial
      reperfusion injury and whether its effect is receptor mediated, 78 rabbits
      underwent 30 minutes of left circumflex artery occlusion and 48 hours of
      reperfusion. Animals were randomly assigned to receive one of three doses of
      adenosine, cyclopentyladenosine (a selective A1-receptor agonist), or CGS 21680C
      (a selective A2-receptor agonist). The drugs were infused for 65 minutes
      beginning 5 minutes before reperfusion. A significant reduction in histologically
      determined infarct size was noted with all three doses of adenosine, intermediate
      and low doses of the A1-receptor agonist (cyclopentyladenosine), and high and
      intermediate doses of the A2-receptor agonist (CGS 21680C). Furthermore, all
      three adenosine receptor agonists afforded similar degrees of protection. Results
      of this study demonstrate that intravenous infusions of very low doses of
      adenosine significantly enhance myocardial salvage and this protection is
      receptor mediated. Furthermore, the administration of the A1-receptor agonist
      would be clinically appealing, since it would avoid the potential side effects
      associated with activation of A2 receptors.

PMID- 1736568
TI  - Reduction of reperfusion injury with preoperative rapid intravenous infusion of
      taurine during myocardial revascularization.
AB  - To assess a possible free-radical scavenging action of taurine during coronary
      artery bypass grafting, 12 patients were randomly divided into two equal groups.
      One to 3 hours before surgery, they received a rapid intravenous infusion of
      either placebo (group 1) or taurine (5 gm) (group 2). During surgery, biopsy
      samples were taken before ischemia (preischemic samples) and after 10 minutes of
      reperfusion (reperfusion samples). Lipoperoxidation was determined by
      hydroperoxide-initiated chemiluminescence of heart homogenates, and myocardial
      cell damage was assessed by electron microscopy. The values for chemiluminescence
      in preischemic and reperfusion samples from group 1 were 7500 +/- 1600 and 18,600
      +/- 4600 cpm/mg of protein, respectively (p less than 0.03). This difference was
      not observed in group 2 where the values were 10,050 +/- 2700 and 11,800 +/- 4200
      cpm/mg of protein, for preischemic and reperfusion samples, respectively. The
      number of severely damaged mitochondria (grades 3 and 4) in reperfusion samples
      from group 1 increased significantly compared to preischemic samples (25 +/- 8%
      vs 12 +/- 3%, p less than 0.01). Conversely no differences were observed between
      the number of severely damaged mitochondria in reperfusion and preischemic
      samples from group 2 (8 +/- 3% vs 8 +/- 2%). The number of damaged and necrotic
      myocytes increased in group 1 after reperfusion from 22 +/- 9% to 34 +/- 10% (p
      less than 0.03) and from 10 +/- 7% to 26 +/- 20% (p = NS), respectively. No
      changes were observed between reperfusion and preischemic samples in group 2.
      Treatment with taurine seems to reduce lipoperoxidation and decrease cell damage
      at the time of reperfusion.

PMID- 1736569
TI  - The transient nature of the effect of ischemic preconditioning on myocardial
      infarct size and ventricular arrhythmia.
AB  - We sought to determine whether short periods of preconditioning ischemia limited
      infarct size in a model of low coronary collateral flow and whether the effects
      of preconditioning were transient or long-lasting. Rats underwent 90 minutes of
      coronary occlusion followed by reperfusion. In one group, the rats were
      preconditioned by three 3-minute occlusions, each separated by 5 minutes of
      reperfusion. The size of the myocardial infarcts were smaller in the
      preconditioned group (24.9 +/- 7.8% of the risk zone developed necrosis) versus
      the nonpreconditioned group (60.7 +/- 5.3%, p less than 0.01). In addition, the
      incidence of ventricular arrhythmias was reduced by preconditioning. However,
      when there was a delay of 1 hour or more between the brief episodes of
      preconditioning and the longer 90-minute occlusion, the beneficial effects of
      preconditioning were lost. Thus preconditioning reduced the volume of myocardium
      infarcted and the incidence of ventricular arrhythmias during a subsequent period
      of prolonged ischemia; however, these beneficial effects were transient.

PMID- 1736570
TI  - Use of rapid serial sampling of creatine kinase MB for very early detection of
      myocardial infarction in patients with acute chest pain.
AB  - To determine how early myocardial infarction can be detected, serial creatine
      kinase MB concentrations were sampled in 313 patients during triage of acute
      (less than 12 hours) chest pain. Serum was sampled on hospital arrival (baseline)
      and hourly for 3 hours (total of four samples). Creatine kinase MB concentrations
      were subsequently analyzed for their ability to detect infarction. Infarction was
      present in 70 patients (22%) and was diagnosable from the index
      electrocardiograms in 27 of these (39%). Sensitivity and specificity for
      detection of infarction were 76% and 72%, respectively, as determined from
      baseline MB values only and increased with each additional sample to a maximum of
      92% and 96%, respectively, in all four samples. Analysis of two serum samples
      taken 2 hours apart showed a sensitivity of 94% and a specificity of 91%. If
      these results are confirmed, improved initial diagnostic accuracy with this rapid
      assay technique in acute chest pain may (1) conserve resources when initial
      suspicion of infarction is low, (2) identify patients with infarction appropriate
      for early intervention, and (3) avoid premature hospital discharge of patients
      with infarction.

PMID- 1736571
TI  - Stress-induced ST segment shift in leads V3R and V4R after acute myocardial
      infarction.
AB  - A total of 107 patients with acute myocardial infarction underwent a dobutamine
      stress test and received increasing doses of the drug (5, 10, 15, 20, and up to
      40 micrograms/kg/min). Coronary angiography was performed within the first month.
      The 12 conventional ECG leads plus the right chest leads V3R and V4R were
      recorded under basal conditions and after each dose of dobutamine. In 51 patients
      (group A) there was an ST shift greater than or equal to 0.5 mm in the right
      chest leads, with two different patterns: rightward (V2 less than V1 less than
      V3R V less than V4R) (n = 26) and leftward (V2 less than V1 less than V3R greater
      than V4R) (n = 25). In 56 patients (group B) no ST shift in the right chest leads
      was induced. An ST segment elevation greater than or equal to 0.5 mm in V4R was
      43% sensitive and 86% specific for the detection of proximal right coronary
      artery disease. Four subgroups were established in group A: A1R, rightward ST
      elevation (n = 23); A1L, leftward ST elevation (n = 12); A2R, rightward ST
      depression (n = 3); and A2L, leftward ST depression (n = 13). Group A1R had
      predominantly inferior infarcts and right coronary artery stenoses, group A1L had
      predominantly anterior infarcts and left anterior descending coronary stenoses,
      and group A2L had posteroinferior infarcts and right or left circumflex stenoses,
      all of them with low sensitivity (less than 50%) and high specificity (greater
      than 87%) for a such diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736572
TI  - The RSR' complex not related to right bundle branch block: diagnostic value as a
      sign of myocardial infarction scar.
AB  - An abnormal electrocardiographic (ECG) wave pattern--the RSR' complex--associated
      with a wide QRS (greater than or equal to 110 msec), unrelated to right bundle
      branch block (RBBB) or left bundle branch block (LBBB) was identified in 26
      patients with old myocardial infarction. Patients were assigned to three groups:
      in group I (n = 13) the RSR' was present in the precordial leads; in group II (n
      = 9) the RSR' was present in the inferior limb leads; and in group III (n = 4)
      the RSR' was present in both. For each patient a severe segmental wall motion
      abnormality (akinetic in 16 and dyskinetic in 10 patients) consistent with
      myocardial infarction scar tissue was detected using the equilibrium radionuclide
      angiocardiogram (n = 24) and the two-dimensional echocardiogram (n = 2). The
      abnormal RSR' complex arises from a terminal conduction delay (dissimilar to
      either RBBB or LBBB using the vectorcardiogram) of left ventricular (LV)
      depolarization within impaired tissue surrounding the infarct scar. This study
      suggests that the RSR' complex, a unique mural conduction defect, although poorly
      sensitive has specific diagnostic value and reliability as a sign of myocardial
      infarction scar.

PMID- 1736573
TI  - Compensatory and noncompensatory left ventricular dilatation after myocardial
      infarction: time course and hemodynamic consequences at rest and during exercise.
AB  - Survival after myocardial infarction decreases with left ventricular dilatation,
      although dilatation at 4 weeks was found to be compensatory. To study this
      apparent discrepancy, prospective simultaneous volume and hemodynamic
      measurements at rest were extended in 39 patients with small and 37 with large
      myocardial infarctions from 4 (range 2 to 6) days and 4 (range 3 to 5) weeks to 6
      (range 5 to 8) months after myocardial infarction and were repeated during
      exercise. In small myocardial infarctions, end-diastolic volume index (EDVI)
      decreased from 4 days to 6 months; ejection fraction, stroke volume index (SVI),
      and end-systolic volume index (ESVI) remained unchanged. SVI increased during
      exercise at 4 weeks and at 6 months. In large myocardial infarctions (n = 37)
      ESVI (4 days = 38 +/- 3, 4 weeks = 47 +/- 3,* 6 months = 52 +/- 3*; *p less than
      0.05 versus 4 days) and EDVI (4 days = 72 +/- 3, 4 weeks = 86 +/- 5,* 6 months =
      92 +/- 5* ; *p less than 0.05 versus 4 days and p less than 0.05 versus 4 weeks)
      increased at constant wedge pressure. SVI remained unchanged beyond 4 weeks (4
      days = 35 +/- 2, 4 weeks = 42 +/- 2*, 6 months = 42 +/- 2*; *p less than 0.05
      versus 4 days) and increased during exercise at 4 weeks (rest = 45 +/- 2,
      exercise = 55 +/- 3; p less than 0.05) but not at 6 months (rest = 42 +/- 3,
      exercise = 45 +/- 3; p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736574
TI  - Clinical evaluation of cardiac function by ambulatory ventricular scintigraphic
      monitoring (VEST): validation and study of the effects of nitroglycerin and
      nifedipine in patients with and without coronary artery disease.
AB  - Global left ventricular function and ECGs were continuously monitored by
      radionuclide ambulatory ventricular function monitoring (VEST) and validated
      against multigated blood pool analysis (MUGA) and left ventriculography in 26
      subjects (study 1). Ejection fraction by VEST (Y) showed good correlation with Y
      = 5.5 +/- 0.79 X (r = 0.91), Y = 1.7 +/- 0.86 X' (r = 0.91), and Y = 11.6 + 0.68
      X" (r = 0.82) to sitting and supine MUGA and left ventriculography, respectively.
      In study 2 left ventricular function and ECGs were evaluated at rest and during
      exercise without any drug (control), with nitroglycerin, and with nifedipine in
      21 patients with coronary disease (group I) and six normal subjects (group II).
      In group I abnormal ejection fraction responses (exercise increase less than or
      equal to 6%) during the control exercise period were found in 15 patients (71%),
      ST segment abnormalities in seven (33%), and chest pain in four (18%). Control
      exercise increased end-diastolic volume (100 to 112 +/- 8%) and end-systolic
      volume (53 +/- 15% to 63 +/- 22%) and decreased the ejection fraction (47 +/- 15%
      to 43 +/- 21%). The ejection fraction during exercise increased after
      nitroglycerin (50 +/- 22%) or nifedipine (54 +/- 21%) (p less than 0.05). In
      group II the ejection fraction was unchanged between rest and exercise with or
      without nitroglycerin or nifedipine. Thus combined radionuclide and ECG
      monitoring by VEST could detect changes in left ventricular function at rest and
      during exercise over a prolonged period and demonstrated that nitroglycerin and
      nifedipine improved cardiac function in the ischemic setting with an increased
      ejection fraction in the upright position.

PMID- 1736575
TI  - Comparison of gray-scale and B-color ultrasound images in evaluating left
      ventricular systolic function in coronary artery disease.
AB  - To confirm whether or not echocardiographic B-color images (temperature, magenta,
      rainbow) are superior to ordinary gray-scale images, 62 coronary artery disease
      (CAD) patients (42 men and 20 women) underwent gray-scale and B-color
      echocardiography and cineangiography within 24 hours. Left ventricular (LV)
      volume was derived from angiography using the single-plane area-length method and
      was derived from echocardiography using single-plane modified Simpson's formula.
      In predicting angiographic volume, the correlations between B-color images and
      angiography were similar to that between the gray-scale image and angiography. In
      evaluating LV ejection fraction, the correlation coefficients between B-color
      images and angiography (temperature r = 0.93, magenta r = 0.93, rainbow r = 0.92)
      were slightly higher than that between the gray-scale image and angiography (r =
      0.85) (p less than 0.05). We conclude that B-color images yield estimates of LV
      volumes that are of similar accuracy to gray-scale images in patients with CAD.

PMID- 1736576
TI  - Hypotension during dobutamine stress echocardiography: initial description and
      clinical relevance.
AB  - Hypotension during exercise treadmill testing is correlated with the presence of
      coronary artery disease, its severity, and prognosis. The importance of
      hypotension during dobutamine stress testing has not been previously reported to
      our knowledge. We reviewed 43 cases of hypotension occurring in 42 patients out
      of a total of 116 consecutive stress dobutamine echocardiographic procedures
      performed in a total of 112 patients. Of the 42 patients with hypotension, 20
      underwent cardiac catheterization. Regional wall motion abnormalities induced by
      dobutamine infusion were found in 13 of these patients, all of whom had
      significant (greater than or equal to 70% diameter reduction) coronary artery
      disease. The remaining seven patients without regional wall motion abnormalities
      did not have significant coronary artery disease at catheterization. Of the
      remaining 22 patients with dobutamine-induced hypotension, 20 had no induced
      regional wall motion abnormalities, were not catheterized, and were followed
      clinically. None of these patients had a cardiac event during a mean follow-up
      period of 11.5 months. We conclude that hypotension during dobutamine stress
      echocardiography in the absence of regional wall motion abnormalities does not
      indicate significant coronary artery disease or portend an adverse prognosis.

PMID- 1736577
TI  - Flecainide therapy in patients treated for supraventricular tachycardia with near
      normal left ventricular function.
AB  - Concerns about the safety and efficacy of class IC antiarrhythmic agents have
      arisen as a result of the recent CAST data. We reviewed records of 175
      consecutive patients treated with flecainide between July 1, 1988 and July 5,
      1989. One hundred ten patients with normal or mildly impaired left ventricular
      function and symptomatic supraventricular arrhythmias were identified. Follow-up
      data were obtained on 102 patients for a mean of 14 months. The average duration
      of flecainide therapy was 13 months. Tachyarrhythmias treated included atrial
      fibrillation/flutter, atrioventricular reentry, and atrioventricular nodal
      reentry. Flecainide provided effective antiarrhythmic therapy in 62% of the
      patients and was discontinued in 38% of the patients. Left atrial size did not
      predict treatment failure. Two patients developed proarrhythmic events
      (nonsustained ventricular tachycardia). There were no deaths during the follow-up
      period. In conclusion, flecainide provides safe and effective therapy for
      supraventricular tachyarrhythmias in patients with normal or mildly impaired left
      ventricular function.

PMID- 1736578
TI  - Optimal late potential criteria for reducing false positive signal-averaged
      electrocardiograms.
AB  - The purposes of this study were to determine for signal-averaged
      electrocardiograms in normal subjects: (1) the incidence of false positives for
      various filter frequencies and late potential criteria and (2) reproducibility
      over time. In 46 normal volunteers, the QRS vector magnitude was bidirectionally
      high-pass filtered at 25, 40, and 100 Hz. As high-pass filter frequency
      increased, QRS duration decreased from 98 +/- 9 to 92 +/- 9 msec (p less than
      0.0001), terminal QRS root mean square voltage decreased from 60 +/- 41 to 14 +/-
      9 microV (p less than 0.0001), and terminal QRS low amplitude signal duration
      increased from 27 +/- 7 to 41 +/- 14 msec (p less than 0.0001). For individual
      parameters, the incidence of false positive tests ranged from 2% to 41%, whereas
      there were no false positive tests for the combination of abnormal QRS duration
      plus either root mean square voltage or low amplitude signal duration.
      Measurements were repeated after 6.4 +/- 0.3 months in 26 subjects and were
      highly reproducible at all filter settings. The potentially high incidence of
      false positive tests with some criteria has important implications for the use of
      signal-averaged electrocardiography as a screening test in patient populations
      with various arrhythmia risks.

PMID- 1736579
TI  - Transesophageal low-energy synchronous cardioversion of atrial
      flutter/fibrillation in the dog.
AB  - The purpose of this study was to determine the feasibility and efficacy of
      terminating atrial flutter/fibrillation using low-energy synchronous shocks
      delivered through a transesophageal catheter in dogs with talc-induced
      pericarditis. Atrial flutter/fibrillation was induced by employing the pulse
      train method. The minimum effective cardioversion energy level was compared for
      three different methods--method A, delivery between a distal esophageal electrode
      and a proximal esophageal electrode; method B, delivery of shocks through a
      distal esophageal electrode and a plate placed on the chest; method C,
      transthoracic cardioversion. The minimum effective cardioversion energy level did
      not differ significantly between methods A and B (1.30 +/- 0.46 joules versus
      1.29 +/- 0.35 joules). Transesophageal cardioversion decreased the defibrillation
      threshold three- to fourfold from that of conventional transthoracic
      cardioversion. There were no complications of heart block, ventricular
      fibrillation, or any pathologic evidence of esophageal injury. Thus
      transesophageal low-energy synchronous cardioversion is considered a feasible and
      effective method for the treatment of atrial flutter/fibrillation.

PMID- 1736580
TI  - Predictors of prognosis in severe chronic heart failure.
AB  - A total of 127 patients with chronic heart failure referred to our exercise
      laboratory were studied retrospectively to identify parameters predictive of
      prognosis. Patients were followed for a mean of 14.6 months. The group as a whole
      had severe ventricular dysfunction with a median ejection fraction of 17% and a
      median peak rate of oxygen consumption of 13.7 ml/kg/min. During the follow-up
      period 23 patients (18%) died and 18 (14%) underwent cardiac transplantation. The
      effect of the following variables on outcome (death or transplantation) were
      examined: age, cause of heart failure, cardiothoracic ratio on chest radiography,
      left ventricular end-systolic dimension on echocardiography, left ventricular
      ejection fraction on radionuclide ventriculography, mean dose of diuretic, plasma
      sodium and urea concentrations, and peak oxygen consumption during exercise.
      Although all variables except cause of heart failure affected outcome on
      univariate analysis, multivariate analysis identified three variables that were
      statistically significant and independent predictors of outcome. In order of
      importance these were plasma sodium level, left ventricular ejection fraction and
      peak oxygen consumption. Even in this group of patients with severe heart
      failure, these variables were predictive of outcome.

PMID- 1736581
TI  - Lung and myocardial thallium-201 kinetics in resting patients with congestive
      heart failure: correlation with pulmonary capillary wedge pressure.
AB  - Increased lung thallium-201 activity occurs with exercise in patients with severe
      coronary artery disease as a result of increased pulmonary capillary wedge
      pressure. No study has shown resting lung kinetics in chronic congestive heart
      failure. To better understand the relationship between lung and myocardial
      thallium uptake and pulmonary capillary wedge pressure, this study was performed.
      Resting lung and myocardial thallium uptake, expressed as a ratio, were compared
      with simultaneous pulmonary capillary wedge pressure in 16 patients with
      congestive heart failure and cardiomyopathy, all New York Heart Association class
      IV. There were no variations in pulmonary capillary wedge pressure throughout the
      study protocol. There was a significant reduction in the lung/myocardium thallium
      ratio from 10 to 60 minutes (0.83 +/- 0.30 to 0.59 +/- 0.17; p less than 0.001).
      At 60 minutes after thallium injection there was a linear correlation between the
      lung/myocardium ratio and capillary wedge pressure with an r value of 0.62 (p
      less than 0.01). Thus thallium-201 washout is rapid despite persistence of
      pulmonary capillary wedge pressure elevation, indicating that clearance does not
      imply resolution of congestive heart failure. In addition, a significant but
      imprecise correlation was found between capillary pressure and the
      lung/myocardium ratio. Rapid changes in lung activity during the early
      postinjection period may limit the clinical use of the lung/myocardium ratio.

PMID- 1736582
TI  - Therapeutic effect of oral dipyridamole on myocardial perfusion and cardiac
      performance in patients with hypertrophic cardiomyopathy.
AB  - Recent studies have indicated that myocardial ischemia could occur and could play
      an important role in the pathophysiology of patients with hypertrophic
      cardiomyopathy (HCM). We therefore investigated whether or not dipyridamole--a
      selective coronary vasodilating agent--could favorably modify myocardial
      perfusion and the clinical manifestations in 20 patients with HCM (19
      nonobstructive and one mildly obstructive) with an average age of 50 years. Oral
      dipyridamole, 150 mg/day for 2 weeks, prevented reversible perfusion defects
      initially observed in six patients on baseline exercise thallium-201 (201TI)
      scintigraphy and significantly increased the 201TI clearance (40 +/- 13% to 44 +/
      12%), while one patient developed new reversible perfusion defects. There were
      significant increases in echocardiographic fractional shortening and treadmill
      exercise time and reductions in cardiac size and supraventricular arrhythmias
      with dipyridamole therapy. These observations suggest that coronary vasodilation
      with dipyridamole may improve myocardial perfusion and cardiac function in
      patients with HCM.

PMID- 1736583
TI  - Mechanisms for an abnormal radionuclide left ventricular ejection fraction
      response to exercise in patients with chronic, severe aortic regurgitation.
AB  - To clarify the mechanisms for an abnormal radionuclide left ventricular (LV)
      ejection fraction response to exercise in patients with chronic, severe aortic
      regurgitation (AR), we studied seven control patients and 21 patients with AR. We
      used exercise radionuclide angiography and catheterization of the right and left
      sides of the heart to obtain a calculation of LV chamber elastance. The control
      and AR groups had similar heart rates, systolic blood pressure responses to
      exercise, and exercise durations. In both patient groups, LV end-diastolic volume
      did not change with exercise. In contrast to the decrease in LV end-systolic
      volume (p less than 0.05) and increase in LV ejection fraction (p less than 0.01)
      in the control group, LV end-systolic volume in the patients with AR increased,
      resulting in little change in their LV ejection fraction. By stepwise multiple
      regression analysis, the radionuclide LV ejection fraction at peak exercise in
      patients with AR was determined by the LV chamber elastance, LV end-systolic
      volume, and stroke volume at peak exercise (cumulative r = 0.79, p less than
      0.02); the change in radionuclide LV ejection fraction from rest to peak exercise
      was determined by the corresponding change in systemic vascular resistance,
      regurgitant index, and LV end-diastolic and end-systolic volumes (cumulative r =
      0.88, p less than 0.02). These data demonstrate that in patients with AR, the
      radionuclide LV ejection fraction at peak exercise is principally determined by
      the cumulative effects of chronic, severe AR on LV systolic chamber performance,
      and the change in radionuclide LV ejection fraction from rest to peak exercise is
      principally established by peripheral vascular responses.

PMID- 1736584
TI  - Percutaneous mitral valvotomy with the Inoue balloon catheter in children and
      adults: immediate results and early follow-up.
AB  - Percutaneous mitral balloon valvotomy (PMV) using the Inoue balloon catheter was
      attempted in 60 consecutive patients with severe symptomatic mitral stenosis.
      There were 10 children (mean age 13 years) and 50 adults (mean age 31 years).
      Forty patients were females and 20 were males; 53 were in sinus rhythm. The
      procedure was technically successfully performed in 57 (95%) patients. There were
      no deaths or thromboembolic complications. Balloon valvotomy was done using a 22
      to 30 mm diameter catheter with the echo/Doppler guided stepwise mitral
      dilatation technique. After PMV the mean left atrial pressure decreased from 23.0
      +/- 5.0 to 14.0 +/- 4.0 mm Hg (p less than 0.001). The mean mitral valve gradient
      (MVG) decreased from 15.0 +/- 4.0 to 6.0 +/- 2.0 mm Hg (p less than 0.001). The
      mitral valve area (Gorlin formula) increased from 0.7 +/- 0.2 to 1.6 +/- 0.4 cm2
      (p less than 0.001). The mitral valve area as determined by echocardiography
      increased from 0.8 +/- 0.1 to 1.9 +/- 0.3 cm2 (p less than 0.001). Mild mitral
      regurgitation (MR) developed in six patients (11%) and increased by one grade in
      another five patients (9%). No patient developed severe mitral regurgitation.
      Mitral valve area at mean follow-up of 4.8 months remained unchanged at 1.9 +/-
      0.3 cm2. We conclude that PMV, using the Inoue balloon catheter, is safe and
      effective in the treatment of severe mitral stenosis in children and adults,
      without inducing significant mitral regurgitation.

PMID- 1736585
TI  - Superiority of nonpharmacologic therapy compared to propranolol and placebo in
      men with mild hypertension: a randomized, prospective trial.
AB  - We compared the effects of nonpharmacologic therapy, propranolol monotherapy, and
      placebo on blood pressure, metabolic, exercise, and quality of life variables in
      a 12-week, randomized, placebo-controlled trial of 79 male patients with
      hypertension. A significant reduction in diastolic blood pressure was observed
      with both nondrug therapy (-8.0 +/- 1.08 mm Hg) and propranolol (-9.5 +/- 1.46 mm
      Hg) compared to placebo (-0.1 +/- 2.01 mm Hg). However, only patients receiving
      nonpharmacologic therapy showed a reduced body mass index, lower total and low
      density lipoprotein serum cholesterol levels, and increased exercise tolerance
      compared to both propranolol and placebo. Patients receiving propranolol felt
      less anxious and unsure but showed a significant decrement in nocturnal penile
      tumescence compared to both placebo and nondrug therapy. Patients receiving
      nondrug therapy felt more energetic and reported improved sexual arousal and
      greater sexual satisfaction after treatment. Reductions in blood pressure in the
      nondrug treatment group were related to both weight reduction and improved
      fitness. We conclude that nondrug therapy is effective in controlling blood
      pressure in men with mild hypertension and is associated with improvements in
      weight, lipoprotein levels, and exercise tolerance compared to both propranolol
      and placebo. Quality of life assessments further support the use of nondrug
      therapy in this context.

PMID- 1736586
TI  - Prevention of sudden death in survivors of myocardial infarction: a decision
      analysis approach.
AB  - During the first year after myocardial infarction, 5% to 15% of patients die, and
      the majority of deaths occur suddenly. Highly efficacious therapy, such as the
      implantable cardioverter-defibrillator, may reduce the chance of sudden death,
      but broad application is limited by associated risks. Hence, attempts to identify
      patients at high risk so they can receive therapy are desirable. Subgroups with
      high or low sudden death risks can be identified based on left ventricular
      function. Further risk stratification using programmed electrical stimulation and
      the signal-averaged ECG has been advocated, but the best strategy is unknown.
      Using a decision analysis model, we compared the 1-year survival rates in
      survivors of myocardial infarction treated with the implantable cardioverter
      defibrillator either empirically or based on screening with the signal-averaged
      ECG and programmed electrical stimulation. The best strategy for selecting
      patients for therapy depended on the pre-therapy sudden death risk. For patients
      at low risk, such as those with well-preserved ventricular function,
      antiarrhythmic therapy selected with screening tests or given empirically
      increased both the mortality rate resulting from the adverse effects of therapy
      and the excellent survival rate without therapy. In the moderate-risk population,
      both empiric and stratified approaches reduced mortality, but stratification
      substantially limited the number of patients receiving unnecessary therapy. In
      the high-risk population, empiric treatment achieved the best survival rate, and
      screening resulted in only a small reduction in the number of patients treated
      unnecessarily.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736587
TI  - Novel coronary interventional devices: an update.
AB  - Interventional cardiologists today are overwhelmed by a hugh array of new high
      technology investigatory devices at their disposal for the treatment of coronary
      arterial obstructive disease. These include the various atherectomy and laser
      devices, developed and introduced into clinical practice with the promise and
      intent of solving the limitations of conventional balloon angioplasty, namely
      those of acute closure and restenosis. But as more experience and data are
      obtained from the application of these devices, it is becoming clear that the
      latter have generally not been able to accomplish what they were intended to do.
      Although the immediate success rates have been uniformly high, acute closure has
      persisted and restenosis remains unabated. Nevertheless, some of these new
      devices have shown some fairly encouraging results in specific clinical
      circumstances. The targeted use of these instruments may prove to be a step in
      the right direction. This article reviews the current state of the art and the
      potential utility of certain of these devices.

PMID- 1736588
TI  - Serum albumin, coronary heart disease, and death.
AB  - To confirm a reported association between elevated serum albumin concentrations
      and reduced risk of death in middle-aged white men and to determine whether such
      associations exist for CHD incidence in white men and CHD and death in white
      women and black men and women, data were examined from the NHANES I Epidemiologic
      Follow-up Study. Over a follow-up period of 9 to 16 years, serum albumin
      concentrations of 4.5 gm/dl or more were associated with reduced risk of CHD
      incidence in white men aged 45 to 64 years (RR = 0.51; 95% CL = 0.36, 0.73) and
      in white women aged 45 to 74 years (RR = 0.70; 95% CL = 0.55, 0.88), independent
      of baseline risk factors. Independent reductions in risk of death from all
      causes, cardiovascular diseases, and noncardiovascular diseases were also seen in
      white men and women. Relative risk of death from all causes at ages 45 to 74
      years in the white population was 0.73 (95% CL = 0.62, 0.85) for men and 0.71
      (95% CL = 0.59, 0.85) for women. Similar reductions in risk of death from all
      causes and cardiovascular diseases were seen in black men and women, despite the
      small numbers. Further studies are needed to confirm these findings for women and
      black persons and to elucidate mechanisms for the effect of serum albumin.

PMID- 1736589
TI  - Acute thrombotic coronary occlusion secondary to chest trauma treated with
      intracoronary thrombolysis.

PMID- 1736590
TI  - Markedly decreased coronary blood flow in secondary polycythemia.

PMID- 1736591
TI  - Extreme QT prolongation solely due to reversible myocardial ischemia in single
      vessel coronary disease.

PMID- 1736592
TI  - Anomalous left circumflex coronary artery from the right pulmonary artery: first
      adult case report.

PMID- 1736593
TI  - Coronary involvement in Cogan's syndrome.

PMID- 1736594
TI  - Early exercise testing after successful percutaneous transluminal coronary
      angioplasty: a word of caution.

PMID- 1736595
TI  - Transesophageal echocardiographic diagnosis of acute aortic dissection
      complicating cocaine abuse.

PMID- 1736596
TI  - Subclinical traumatic aortic injury diagnosed by transesophageal
      echocardiography.

PMID- 1736597
TI  - Ventricular fibrillation induced by transesophageal atrial pacing in asymptomatic
      Wolff-Parkinson-White syndrome.

PMID- 1736598
TI  - Discrepancy between head-up tilt test results utilizing different protocols in
      the same patient.

PMID- 1736599
TI  - Percutaneous mitral valvotomy by Inoue catheter in young patients with mitral
      stenosis.

PMID- 1736600
TI  - Transesophageal echocardiographic diagnosis of complex false aneurysm with aorto
      left atrial communication complicating aortic valve and root replacement.

PMID- 1736601
TI  - Repair of postcatheterization femoral pseudoaneurysms by color flow ultrasound
      guided compression.

PMID- 1736602
TI  - Role of diet and exercise in the management of hyperinsulinemia and associated
      atherosclerotic risk factors.
AB  - Hyperinsulinemia, hypertension, hypertriglyceridemia and obesity are independent
      risk factors for coronary artery disease and are often found in the same person.
      This study investigated the effects of an intensive, 3-week, dietary and exercise
      program on these risk factors. The group was divided into diabetic patients (non
      insulin-dependent diabetes mellitus [NIDDM], n = 13), insulin-resistant persons
      (n = 29) and those with normal insulin, less than or equal to 10 microU/ml (n =
      30). The normal groups had very small but statistically significant decreases in
      all of the risk factors. The patients with NIDDM had the greatest decreases.
      Insulin was reduced from 40 +/- 15 to 27 +/- 11 microU/ml, blood pressure from
      142 +/- 9/83 +/- 3 to 132 +/- 6/71 +/- 3 mm Hg, triglycerides from 353 +/- 76 to
      196 +/- 31 mg/dl and body mass index from 31.1 +/- 4.0 to 29.7 +/- 3.7 kg/m2.
      Although there was a significant weight loss for the group with NIDDM, resulting
      in the decrease in body mass index, 8 of 9 patients who were initially overweight
      were still overweight at the end of the program, and 5 of the 8 were still obese
      (body mass index greater than 30 kg/m2), indicating that normalization of body
      weight is not a requisite for a reduction or normalization of other risk factors.
      Insulin was reduced from 18.2 +/- 1.8 to 11.6 +/- 1.2 microU/ml in the insulin
      resistant group, with 17 of the 29 subjects achieving normal fasting insulin
      (less than 10 microU/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736603
TI  - ST-segment depression during dipyridamole infusion, and its clinical,
      scintigraphic and hemodynamic correlates.
AB  - The goal of this study was to determine whether dipyridamole-induced ST-segment
      depression reflects more severe or extensive myocardial hypoperfusion than the
      absence of this electrocardiographic finding. The clinical, hemodynamic and
      scintigraphic correlates of ST-segment depression during intravenous dipyridamole
      infusion were studied in 204 consecutive patients undergoing dipyridamole stress
      thallium-201 (Tl-201) imaging for evaluation of coronary artery disease. Of 182
      patients with a diagnostic baseline electrocardiogram, 28 (15%) developed ST
      depression after dipyridamole. Patients with ST depression, compared with those
      without, were older (64 +/- 1 vs 60 +/- 1 years; p less than 0.03) and had a
      higher frequency of chest pain (57 vs 23%; p less than 0.001) and a higher heart
      rate-blood pressure product (12.7 +/- 0.6 vs 11.2 +/- 0.2 x 10(3); p less than
      0.008) after dipyridamole. Patients with ST depression were more likely to have
      Tl-201 redistribution (64 vs 38%; p less than 0.02) and a greater number of
      redistribution defects (2.3 +/- 0.04 vs 0.9 +/- 0.1, p less than 0.001) than were
      those without ST depression. By multivariate logistic regression analysis, the
      most powerful correlate of ST depression was the number of segments having Tl-201
      redistribution (p less than 0.001). Other independent correlates were presence of
      chest pain, heart rate at Tl-201 injection, and age. Thus, the determinants of
      dipyridamole-induced ST-segment depression include the scintigraphic extent of
      reversible hypoperfusion, as well as indexes of myocardial oxygen demand.

PMID- 1736604
TI  - Effect of dipyridamole therapy on myocardial ischemia in patients with stable
      angina pectoris receiving concurrent anti-ischemic therapy.
AB  - The effects of oral dipyridamole on exercise performance and anginal symptoms
      were evaluated in 15 men with stable angina pectoris. In a double-blind,
      randomized, crossover design, patients received 75 mg of dipyridamole or placebo
      every 8 hours for 2 weeks in addition to their previously prescribed cardiac
      medications. Graded exercise tolerance testing was performed twice before
      randomization, at the end of each treatment period, and after single-blind
      placebo washout. When compared with baseline tests, the time to onset of 0.1 mV
      ST-segment depression was similar between dipyridamole and placebo treatments
      (316 +/- 89 vs 345 +/- 102 seconds, respectively, p = not significant). No
      significant differences existed between treatments in the peak systolic blood
      pressure-heart rate product or in the duration of exercise. Angina pectoris
      occurred during all 3 baseline exercise tests in 7 of the 15 subjects; the time
      to onset of angina was unchanged by either treatment. Analysis of symptom diaries
      conducted in 13 patients revealed no significant alteration in reported anginal
      symptoms during dipyridamole treatment compared with placebo treatment (0.6 +/-
      0.9 vs 0.3 +/- 0.4 episodes per week). Ambulatory electrocardiographic monitoring
      in 12 patients revealed few episodes of ischemia during daily activities with no
      alteration in frequency of episodes during treatment periods. Plasma
      concentrations of dipyridamole did not correspond with the outcomes of exercise
      testing. It is concluded that chronic oral dipyridamole therapy given in its
      usual clinical dose does not adversely affect exercise performance, daily anginal
      episodes or ambulatory ischemia in patients receiving concurrent anti-ischemic
      medication.

PMID- 1736605
TI  - Plasma platelet-derived growth factor levels in coronary circulation in unstable
      angina pectoris.
AB  - To examine whether plasma platelet-derived growth factor (PDGF) levels are
      elevated in the coronary circulation of patients with unstable angina, the plasma
      PDGF levels in the coronary sinus and aortic root were simultaneously examined in
      14 patients with unstable angina, 15 with stable exertional angina, and 15
      control subjects. The mean plasma PDGF level (pg/ml) in the coronary sinus was
      significantly higher (p less than 0.01) in patients with unstable angina than in
      those with stable exertional angina and in control subjects (502.1 +/- 98.7 vs
      301.3 +/- 62.5, and 312.7 +/- 62.6). However, there were no significant
      differences in mean plasma PDGF levels in the aortic root among the 3 groups. It
      is concluded that PDGF release is increased in the coronary circulation in
      patients with unstable angina.

PMID- 1736606
TI  - Platelet function after in vivo and in vitro treatment with thrombolytic agents.
AB  - Whereas in vitro studies showed that plasmin may induce both inhibition and
      activation of platelets, in vivo and ex vivo investigations suggested that
      thrombolytic agents are responsible for platelet stimulation. To gain further
      information on this topic, ex vivo platelet function was studied in 24 subjects
      with acute myocardial infarction treated with streptokinase or recombinant tissue
      type plasminogen activator (rt-PA). Ten patients with acute myocardial infarction
      who did not receive thrombolytic treatment were also investigated. The data shows
      that at the end of thrombolytic infusion, the maximal extent of platelet
      aggregation and adenosine triphosphate release was reduced in treated patients
      compared with that in untreated ones. In subjects treated with streptokinase, the
      defect in platelet aggregation derived from both cellular and plasmatic defects.
      Plasmatic beta-thromboglobulin concentration was significantly reduced after
      streptokinase, but unchanged after rt-PA. Three days after thrombolytic
      treatment, platelet aggregation of patients receiving streptokinase or rt-PA was
      not significantly different from that of untreated subjects. A similar defect in
      platelet function was obtained in vitro, incubating normal platelet-rich plasma
      with pharmacologic concentrations of streptokinase. Again, platelet function
      defect derived from both cellular and plasmatic damages. It cannot be excluded
      that platelet activation occurs in patients with acute myocardial infarction
      during the very early phases of thrombolytic treatment. However, it is suggested
      that a transient defect in platelet function follows both streptokinase and rt-PA
      infusion.

PMID- 1736607
TI  - Identification of patients at high risk for recurrence of sustained ventricular
      tachycardia after healing of acute myocardial infarction.
AB  - A prognostic index for nonfatal recurrences of ventricular tachycardia (VT) was
      developed using a retrospective analysis of a group of 206 patients with
      sustained monomorphic VT or ventricular fibrillation (VF) after healing of acute
      myocardial infarction. 74 patients (36%) (64 with VT and 10 with VF) had
      recurrences of sustained monomorphic VT during 3.4 +/- 9 years of follow-up.
      Three clinical variables were selected and weighted by stepwise logistic
      discriminant analysis of the study group. They were coded as follows: interval of
      myocardial infarction to arrhythmia (less than 2 months = 1; 2 to 6 months = 2;
      greater than 6 months = 3), drug therapy with or without sotalol (with = 1,
      without = 2), and VT or VF as the presenting arrhythmia (VT = 1, VF = 2). The
      prognostic index was: 3.41 - (0.56 x interval) - (1.94 x therapy) + (0.86 x
      arrhythmia). This index was validated prospectively in a test group of 158
      consecutive patients with VT or VF after healing of acute myocardial infarction.
      Patients were allocated into different classes with decreasing prognostic index
      values associated with increasing risk for recurrences of VT. In the test group,
      27 of 158 (17%) patients (22 with VT and 5 with VF) had recurrences of VT (follow
      up of 2 +/- 2 years). Two risk classes of patients were identified: high risk for
      recurrences of VT (61%) corresponding to patients with a negative index; and low
      risk (4%) consisting of those with a positive index. Thus, using O as the cutoff
      point, the sensitivity, specificity, and positive and negative predictive values
      were 81, 89, 62 and 96%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736608
TI  - Correlation of the complete version of the Selvester QRS scoring system with
      quantitative anatomic findings for multiple left ventricular myocardial infarcts.
AB  - The correlation between myocardial infarct size estimated by the complete version
      of the Selvester QRS scoring system and that documented by pathoanatomic studies
      has been reported for single anterior, inferior and posterolateral infarcts.
      Although previous studies described electrocardiographic changes in patients with
      multiple infarcts, no quantitative documentation of the ability of such changes
      to estimate the total amount of left ventricular infarction has been reported.
      This study of 32 patients with anatomically documented multiple infarcts shows a
      significant correlation between QRS-estimated and anatomically documented sizes
      (r = 0.44; p = 0.01), which is less than that previously reported for single
      infarcts in the anterior, inferior and posterolateral locations. Several of the
      54 electrocardiographic criteria were never satisfied. Criteria for posterior
      infarction were seldom present, suggesting "cancellation effect" of coexisting
      anterior infarction. These results will be the basis for future modification of
      QRS criteria for estimating myocardial infarct size.

PMID- 1736609
TI  - Percutaneous transluminal coronary rotary ablation with Rotablator (European
      experience).
AB  - This study reports the results from 3 European centers using rotary ablation with
      Rotablator, a device that is inserted into the coronary artery and removes
      atheroma by grinding it into millions of tiny fragments. Rotary ablation was
      performed in 129 patients. Primary success (reduction in percent luminal
      narrowing greater than 20%, residual stenosis less than 50%, without
      complications) was achieved by rotary angioplasty alone in 73 patients (57%). An
      additional 38 patients (29%) had successful adjunctive balloon angioplasty. Thus
      primary success was achieved in 111 patients (86%) at the end of the procedure.
      Acute occlusion occurred in 10 patients (7.7%). Recanalization was achieved by
      balloon angioplasty in 7: urgent bypass grafting was undertaken in 2. Q-wave and
      non-Q-wave myocardial infarction occurred in 3 and 7 patients, respectively. No
      deaths occurred. Follow-up angiography was performed in 74 patients (60%).
      Restenosis, defined as the recurrence of significant luminal narrowing (greater
      than 50%) occurred in 17 of 37 patients (46%) who underwent rotary ablation
      alone, and 11 of 37 patients (30%) who had adjunctive balloon angioplasty. The
      overall angiographic restenosis rate was 37.8%. In conclusion, rotary ablation is
      technically feasible, and relatively safe in the coronary circulation. The low
      primary success rate reflects the limited size of the device, which can be
      introduced through available guiding catheters, and limits the use of rotary
      ablation as a stand-alone procedure to lesions in small arteries or in distal
      locations. No reduction in restenosis was seen, but the role of this device
      combined with balloon angioplasty in larger arteries needs to be further defined.

PMID- 1736610
TI  - Quantitative angiographic follow-up of the coronary Wallstent in native vessels
      and bypass grafts (European experience--March 1986 to March 1990).
AB  - The coronary stent has been investigated as an adjunct to percutaneous
      transluminal coronary angioplasty to obviate the problems of early occlusion and
      late restenosis. From March 1986 to March 1990, 265 patients (308 lesions) were
      implanted with the coronary Wallstent in 6 European centers. For this study, the
      patients were analyzed according to date of implantation (group 1, March 1986 to
      January 1988; group 2, February 1988 to March 1990) and vessel type (native
      arteries versus bypass grafts). Quantitative angiographic follow-up was performed
      in 82% of the study patients. The early in-hospital occlusion rate in the overall
      group was 15%. Group 1 patients had a 20% rate in contrast to 12% rate in group 2
      (p = not significant [NS]). The early occlusion rate in native vessels and bypass
      grafts was 19 and 8%, respectively (p = 0.019). Restenosis was determined by 2
      criteria (criterion 1, greater than or equal to 0.72 mm loss in minimal luminal
      diameter from poststent to follow-up; criterion 2, greater than or equal to 50%
      diameter stenosis at follow-up) within the stent and in the segments immediately
      proximal and distal to the stent. The restenosis rate with criterion 1 was 43% in
      the overall group of patients, 35% in group 1 versus 49% in group 2 (p = NS), and
      34% in native vessels versus 54% in bypass grafts (p = 0.016). The second
      criterion was met by 27% of patients in the overall group, 21% in group 1 versus
      32% in group 2 (p = NS), and 18% in native vessel versus 39% in bypass grafts (p
      = 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736611
TI  - Effects of the dipyridamole test on left ventricular function in coronary artery
      disease.
AB  - The dipyridamole stress test is used with thallium-201 to detect areas of
      inhomogeneity of blood flow that point to coronary artery disease (CAD). It is
      unclear whether dipyridamole produces inhomogeneous perfusion only or whether it
      actually decreases net flow in the obstructed vessels and produces true ischemia.
      It is also unclear what effect dipyridamole has on global and segmental left
      ventricular function. Therefore, ejection fraction, segmental wall motion and
      ventricular volume equivalents were measured before and after dipyridamole in 113
      patients and 32 normal subjects. Ejection fraction responded in an abnormal
      fashion in 98 patients (87%), decreasing from 49 +/- 11% to 43 +/- 13% (p less
      than 0.0001), whereas it increased in 29 normal subjects (90%) from 57 +/- 6% to
      64 +/- 10% (p less than 0.0001). Wall motion worsened distinctly in 75 patients
      (66%), and pressure/volume ratio deteriorated in 72%. The effect of dipyridamole
      lasted between 10 and 25 minutes, but was promptly reversed by aminophylline.
      These findings indicate that dipyridamole generally induces true ischemia in CAD.
      Furthermore, the degree of dysfunction is related to the angiographically
      assessed severity of CAD. The shortness of breath (seen in 10% of patients) may
      be partially explained by the findings, and it seems advisable to give
      aminophylline to every patient in order to promptly correct left ventricular
      dysfunction.

PMID- 1736612
TI  - Improvement in left ventricular systolic function after successful radiofrequency
      His bundle ablation for drug refractory, chronic atrial fibrillation and
      recurrent atrial flutter.
AB  - Incessant supraventricular tachyarrhythmia may lead to a reversible impairment of
      left ventricular (LV) function. This issue was investigated in 10 patients (aged
      64 +/- 13 years) who underwent radiofrequency His bundle ablation for control of
      drug refractory, chronic atrial fibrillation (n = 9) and recurrent atrial flutter
      (n = 1). LV function was assessed by 2-dimensional guided M-mode echocardiography
      within 24 hours (baseline) and 49 +/- 18 days (follow-up) after successful
      ablation, both during VVI pacing at 70 beats/min. Fractional shortening increased
      from 28 +/- 9% at baseline to 35 +/- 8% at follow-up (p = 0.006). This increase
      in fractional shortening was due to a significant reduction of end-systolic
      diameter from 41 +/- 10 to 36 +/- 10 mm (p = 0.02), whereas there was no
      appreciable change in end-diastolic diameter (56 +/- 7 to 55 +/- 10 mm; p = 0.5).
      These changes were substantially greater in patients with baseline impairment of
      LV function (fractional shortening less than 27%). Fractional shortening
      increased by 12% (p = 0.14) in patients with normal LV function (n = 5) and by
      44% (p = 0.02) in those with impaired LV function at baseline (n = 5). The
      greater increase in fractional shortening in patients with preexisting LV
      impairment was due to a more pronounced decline in end-systolic dimensions (
      11.9%; p = 0.08) compared with that of patients with normal LV function at
      baseline (-9.21%; p = 0.2). End-diastolic diameter showed no significant change
      in either group (-3.53% [p = 0.8] and -0.58% [p = 0.4]).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1736613
TI  - Frequency of recurrent atrial fibrillation after catheter ablation of overt
      accessory pathways.
AB  - The effect of successful catheter ablation of overt accessory pathways on the
      incidence of atrial fibrillation (AF) was studied in 129 symptomatic patients
      with (n = 75) or without (n = 54) previous documented AF. Fourteen had had
      ventricular fibrillation. Factors predictive of recurrence were examined,
      including electrophysiologic parameters. Atrial vulnerability was defined as
      induction of sustained AF (greater than 1 minute) using single, then double,
      atrial extrastimuli at 2 basic pacing cycle lengths. When compared to patients
      with only reciprocating tachycardia, patients with clinical AF included more men
      (77 vs 54%, p = 0.008) and were older (35 +/- 12 vs 29 +/- 12 years, p = 0.01).
      They had a significantly shorter cycle length leading to anterograde accessory
      pathway block (252 +/- 42 vs 298 +/- 83 ms, p less than 0.001), greater
      incidences of atrial vulnerability (89 vs 24%, p less than 0.001) and subsequent
      need for cardioversion (51 vs 15%, p less than 0.001). After discharge, the
      follow-up period was 35 +/- 12 months (range 18 to 76); 7 patients with previous
      spontaneous AF (9%) had recurrence at a mean of 10 months after ablation. Age,
      presence of structural heart disease accessory pathway location, atrial
      refractory periods and accessory pathway anterograde conduction parameters were
      not predictive of AF recurrence. Persistence of atrial vulnerability after
      ablation was the only factor associated with further recurrence of AF. Atrial
      vulnerability was observed after ablation in only 56% of patients with previous
      AF versus 89% before ablation. It is concluded that successful catheter ablation
      of accessory pathways prevents further recurrence of AF in 91% of
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736614
TI  - Efficacy of intravenous sotalol for suppressing inducibility of supraventricular
      tachycardias at rest and during isometric exercise.
AB  - The efficacy of intravenous sotalol (1 mg/kg) for suppressing inducibility of
      supraventricular tachycardias (SVT) with different electrophysiologic mechanisms
      was studied in 30 consecutive patients referred for an electrophysiologic study
      because of paroxysmal SVT. Orthodromic SVT using accessory atrioventricular (AV)
      connection was inducible in 14 patients, AV nodal reentrant SVT in 8, and
      intraatrial SVT in 8 before administration of sotalol, Isometric handgrip
      exercise facilitated the inducibility of SVT in 8 patients who were noninducible
      at rest. After intravenous sotalol, 7 of 14 patients (50%) with orthodromic SVT,
      8 of 8 (100%) with AV nodal reentrant SVT, and 8 of 8 (100%) with intraatrial
      reentrant SVT became noninducible into sustained SVT, Isometric exercise
      facilitated the inducibility of only 3 nonsustained SVT runs after sotalol
      infusion, and exercise did not reverse the prolongation of refractory periods of
      the atrium, AV node, accessory pathway and ventricle caused by sotalol. During a
      mean follow-up period of 18 +/- 7 months, none of the 14 patients who remained
      noninducible into sustained SVT during the stress test after intravenous sotalol
      and tolerated long-term oral sotalol therapy had recurrence of symptomatic SVT.
      Thus, sotalol is efficacious for suppressing SVT with AV nodal or intraatrial
      reentrant mechanism, but less efficacious in patients with accessory AV pathway.
      The beta-blocking and cellular antiarrhythmic effects of sotalol are not
      significantly reversed by exercise.

PMID- 1736615
TI  - Conversion of typical to "atypical" atrioventricular nodal reentrant tachycardia
      after radiofrequency catheter modification of the atrioventricular junction.
AB  - Typical atrioventricular (AV) nodal reentry tachycardia (AVNRT) is characterized
      by anterograde activation over a slowly conducting pathway and by retrograde
      activation through a rapidly conducting pathway. Preliminary reports suggest that
      radiofrequency catheter modification can eliminate typical AVNRT while preserving
      anterograde conduction. Radiofrequency catheter modification was used to treat 88
      patients with typical AVNRT. After baseline electrophysiologic evaluation, the
      ablation catheter was positioned proximal and superior to the site of maximal His
      deflection. Radiofrequency energy was applied until there was significant
      attenuation of retrograde conduction, and elimination of AVNRT inducibility.
      Eighty-one patients were successfully treated and form the basis of this report.
      A new paroxysmal supraventricular tachycardia with RP greater than PR interval
      was induced at electrophysiologic testing after successful ablation in 9 patients
      (11%). Mean atrial-His activation time was 140 +/- 31 ms, and the
      ventriculoatrial activation time was 170 +/- 46 ms. This arrhythmia was induced
      only with ventricular pacing during isoproterenol infusion and appeared to be
      mediated by AV nodal reentry. New retrograde dual AV nodal physiology after
      modification was more frequent in patients with atypical tachycardia than in
      those without (4 of 9 vs 2 of 72; p less than 0.0001). Although none of the
      patients were treated, only 1 of 9 had an episode of spontaneous atypical
      tachycardia during a mean follow-up of 12 months. Results of this study confirm
      that typical AVNRT can be rendered noninducible without the complete destruction
      of reentrant pathways. Because induction of "atypical" AVNRT was not predictive
      of spontaneous arrhythmia recurrence, it should not be an indication for
      additional ablation sessions or long-term drug therapy.

PMID- 1736616
TI  - Effect of epinephrine on the efficacy of the internal cardioverter-defibrillator.
AB  - To evaluate the effect of sympathetic activation on the efficacy of the
      implantable cardioverter-defibrillator (ICD) in converting ventricular
      tachycardia (VT) or ventricular fibrillation (VF), 32 patients who received an
      ICD because of life-threatening VT/VF underwent 1 week postimplant ICD testing
      both before and after infusion of 25 (16 patients) or 50 (16 patients) ng/kg/min
      of epinephrine for greater than or equal to 12 minutes. These infusion rates are
      known to result in plasma epinephrine concentrations comparable to mild-moderate
      stress. The patients' mean age was 63 +/- 10 years; 26 had coronary artery
      disease, 2 had dilated cardiomyopathy and 4 had no evidence of structural heart
      disease. VT and VF were induced in 16 patients each by programmed stimulation or
      alternating current. Among the 16 patients with VT, the first ICD discharge (26
      to 30 J) was effective in 15 patients in the baseline state and in all 16
      patients during epinephrine infusion. Among patients with VF, the first ICD
      discharge (26 to 30 J) terminated VF in all patients in the baseline state,
      compared with 12 of 16 patients during epinephrine infusion (p less than 0.05).
      In 4 patients, VF was terminated during epinephrine infusion only by the second
      or third ICD discharge (30 J). In conclusion, physiologic increases in the plasma
      epinephrine concentration may increase the number and energy of shocks needed to
      terminate VF.

PMID- 1736617
TI  - Clinical and electrophysiologic effects of intravenous dofetilide (UK-68,798), a
      new class III antiarrhythmic drug, in patients with angina pectoris.
AB  - Dofetilide (UK-68,798) is a new class III antiarrhythmic agent. In animal
      experiments it selectively prolongs the refractory periods parallel to the action
      potential duration without any influence on upstroke velocity or conduction
      parameters. The present double-blind, placebo-controlled study was designed to
      show the effect of dofetilide on basic electrophysiologic parameters in patients
      with coronary artery disease. Eighteen patients (aged 31 to 64 years) with
      symptoms of stable angina pectoris admitted for routine coronary angiography were
      recruited. They were randomly allocated to receive either placebo or 1 of 2 dose
      levels of dofetilide intravenously with 6 patients in each group. Paired
      electrophysiologic variables were compared before and after administration of
      dofetilide. Both active dose levels produced significant prolongations (p less
      than 0.05) of 10 to 23% in atrial effective refractory period, 6 to 16% in
      ventricular effective refractory period and 11 to 15% in ventricular functional
      refractory period. Atrial functional refractory period was prolonged by 14 to 22%
      at the high-dose level (p less than 0.05). No effect was observed on conduction
      parameters (PA, AH, HV, PR or QRS intervals), sinus cycle length or sinus node
      recovery. The selective prolongation of the refractory periods in both atrium and
      ventricle, combined with a lack of effect on cardiac conduction parameters,
      indicates that this drug could be useful in the treatment of both atrial and
      ventricular reentrant tachyarrhythmias and fibrillation.

PMID- 1736618
TI  - Effects of heart failure on baroreflex control of sympathetic neural activity.
AB  - Baroreflex control of heart rate, vascular resistance and norepinephrine is
      impaired in patients with heart failure, but recent animal studies demonstrate
      preserved baroreflex control of sympathetic nerve activity in this disorder.
      Studies were therefore performed to compare baroreflex control of efferent
      sympathetic nerve activity to muscle in 10 normal subjects (age mean +/- SEM 21
      +/- 1 years) and in 11 patients with moderate to severe heart failure (age 48 +/-
      5 years, New York Heart Association class II to IV, left ventricular ejection
      fraction 19 +/- 2%, pulmonary capillary wedge pressure 27 +/- 2 mm Hg, cardiac
      index 2.04 +/- 0.22 liters/min/m2). Baroreflex activation was produced by
      intravenous infusion of phenylephrine (0.5 to 2.0 micrograms/kg/min) and
      deactivation by infusion of nitroprusside (0.4 to 2.5 micrograms/kg/min). During
      phenylephrine infusion, comparable increases in mean arterial pressure were
      produced in normal subjects (89 +/- 2 to 99 +/- 3 mm Hg, p less than 0.01) and in
      patients with heart failure (90 +/- 2 to 99 +/- 3 mm Hg, p less than 0.01). The
      patients with heart failure exhibited significantly attenuated (p less than 0.01
      for normal vs heart failure) decreases in heart rate (93 +/- 5 to 90 +/- 6
      beats/min, p = not significant [NS]) compared with normal subjects (67 +/- 3 to
      58 +/- 4 beats/min, p less than 0.01) and tended to demonstrate attenuated
      sympathoinhibitory responses to this pressor stimulus. More strikingly, patients
      with heart failure demonstrated significant impairment of baroreflex responses
      during nitroprusside-induced baroreceptor deactivation. In normal subjects,
      nitroprusside produced a decrease in mean arterial (90 +/- 2 to 80 +/- 3 mm Hg, p
      less than 0.001) and right atrial (4 +/- 1 to 2 +/- 1 mm Hg, p less than 0.01)
      pressures with a resultant reflex increase in heart rate (68 +/- 3 to 81 +/- 4
      beats/min, p less than 0.001) and muscle sympathetic nerve activity (326 +/- 74
      to 746 +/- 147 U/min, p less than 0.01). In patients with heart failure (n = 10),
      nitroprusside produced comparable (p = NS for normal vs heart failure) decreases
      in mean arterial (89 +/- 2 to 77 +/- 2 mm Hg, p less than 0.001) and right atrial
      (6 +/- 1 to 1 +/- 1 mm Hg, p less than 0.001) pressures, but did not
      significantly alter heart rate (91 +/- 6 to 97 +/- 4 beats/min, p = NS) or
      sympathetic nerve activity (936 +/- 155 to 1179 +/- 275 U/min, p = NS).(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1736619
TI  - Effect of captopril on cardiac parasympathetic activity in chronic cardiac
      failure secondary to coronary artery disease.
AB  - Thirty-two patients with chronic cardiac failure underwent 24-hour ambulatory
      electrocardiographic monitoring on 2 separate occasions: 20 patients before and
      during treatment with captopril, and 12 acting as controls. Heart rate
      variability was calculated by counting the number of times successive RR interval
      differences were greater than 50 ms (this measurement being a reliable index of
      cardiac parasympathetic activity). During treatment with captopril, group mean
      total counts increased to 1,032 (range 48 to 7,437) from 482 (range 23 to 6,120)
      (p = 0.002). There was no change in mean hourly waking or sleeping heart rates.
      In the control group, no changes were seen: group mean total counts on the first
      occasion were 340 (range 120 to 3,255) and on the second occasion 400 (range 154
      to 3,300) (p = not significant). These results show that treatment with
      angiotensin-converting enzyme inhibitors increases cardiac parasympathetic
      activity in patients with chronic cardiac failure. This may be relevant to the
      improved prognosis of this group of patients when treated with angiotensin
      converting enzyme inhibitors.

PMID- 1736620
TI  - Late (two-year) follow-up after percutaneous balloon mitral valvotomy.
AB  - Percutaneous balloon mitral valvotomy (PBMV) compares well with surgical
      commissurotomy, showing comparable improvement in symptoms and catheterization
      proven valve area early after the procedure. This study reports the New York
      Heart Association class, mitral valve area calculated by echocardiography, and
      the results of transseptal cardiac catheterization 2 years after PBMV. The data
      are compared with the status immediately before and after PBMV. Forty-one
      patients returned to enter the study (mean follow-up time 24 +/- 3 months). All
      patients were evaluated clinically by the same investigator who had seen them at
      the time of PBMV. Transseptal cardiac catheterization and echocardiographic
      analysis (2-dimensional and Doppler echocardiography) were performed on the same
      day. At follow-up, 17 patients were class I, 20 were class II, and 4 were class
      III. Although the mitral valve area calculated by cardiac catheterization
      increased significantly from immediately before to immediately after PBMV there
      was a decrease in the calculated mitral valve area at 2-year follow-up.
      Echocardiographic analysis did not show as large an increase in mitral area,
      immediately after PBMV, and no significant decrease in mitral valve area at 2
      years (before PBMV planimetry 1.1 +/- 0.1 cm2; immediately after 1.8 +/- 0.1 [p
      less than 0.05]; follow-up 1.6 +/- 0.1 [p = not significant compared with
      immediately after PBMV]). Doppler halftime measurements were similar. PBMV is
      effective therapy with good midterm results for selected patients with mitral
      stenosis.

PMID- 1736621
TI  - Reproducibility of quantitative backscatter echocardiographic imaging in normal
      subjects.
AB  - Cyclic backscatter variation is useful in differentiating normal from ischemic
      and myopathic myocardium; however, there are few data on the reproducibility of
      clinical cyclic variation measurements. Therefore, a study using 2-dimensional
      and M-mode backscatter imaging was performed in 20 normal male subjects by 2
      observers at an initial session and by 1 of the observers after 1 week. Cyclic
      variation on M-mode was calculated as the difference between the end-diastolic
      backscatter and the backscatter at the nadir. Two-dimensional determinations of
      backscatter were made using a single frame at end-diastole and one at end
      systole. The cyclic change was the difference between backscatter measured in the
      end-diastolic and end-systolic frames. There were no statistically significant
      differences in analysis of variance among the grouped repeated measurements in
      either the interventricular septum or the posterior left ventricular wall. At the
      initial session, cyclic backscatter variation in the posterior wall using M-mode
      techniques was 5.9 +/- 1.8 dB (SD). The cyclic change in backscatter in the
      septal wall, using the 2-dimensional technique, was 4.3 +/- 2.4 dB. In the
      posterior wall, the cyclic change in backscatter was 5.7 +/- 1.7 dB. Pairwise
      observer correlations between repeated measurements ranged from -0.48 to 0.45.
      Thus, although there were no significant differences in group means on repeat
      measurements, repeated measurements in individual subjects were not reliably
      reproduced because of limited independent sampling of backscatter measurements at
      only 2 points in the heart cycle. Increased independent sampling and measurement
      from a backscatter waveform throughout the cardiac cycle may improve
      reproducibility of measurements.

PMID- 1736622
TI  - Effects of cardiac transplantation on ventilatory response to exercise.
AB  - Patients with heart failure frequently exhibit an excessive ventilatory response
      to exercise, which is acutely unaltered by therapeutic interventions. To
      investigate whether these ventilatory responses resolve after cardiac
      transplantation, 15 ambulatory patients with severe heart failure underwent
      exercise testing with measurement of respiratory gases before and 1.4 +/- 0.6
      years [corrected] after transplantation. Ventilatory response was also measured
      in 7 age-matched, sedentary control subjects. Left ventricular ejection fraction
      at rest and hemodynamic measurements were obtained before and after
      transplantation in all patients. After transplantation, ejection fraction at rest
      increased from 16 +/- 6 to 56 +/- 10%, pulmonary capillary wedge pressure
      declined from 26 +/- 8 to 12 +/- 5 mm Hg, and cardiac index increased from 1.7 +/
      0.5 to 2.8 +/- 0.5 liters/min/m2 (all p less than 0.001). Peak oxygen
      consumption increased from 11.8 +/- 1.9 to 19.2 +/- 3.1 ml/kg/min (p less than
      0.001), but remained significantly lower than that in control subjects (33.4 +/-
      6.9 ml/kg/min; p less than 0.01). Minute ventilation (VE) was significantly
      reduced after transplantation, but excessive compared with normal values.
      Ventilation at a carbon dioxide production of 1 liter/min decreased significantly
      after cardiac transplantation (52.1 +/- 7.9 to 38.8 +/- 3.8 liters; p less than
      0.01), but remained elevated when contrasted to that in control subjects (31.4 +/
      3.4 liters; p less than 0.05). Ventilatory response to exercise is significantly
      improved after cardiac transplantation; however, VE remains excessive. This may
      reflect an attenuated cardiac output response to exercise, abnormal
      intrapulmonary pressures or persistent deconditioning.

PMID- 1736623
TI  - Influence of residual blood flow in the infarct-related artery on ventricular
      tachycardia after myocardial infarction.

PMID- 1736624
TI  - Prevalence of silent myocardial ischemia detected by 24-hour ambulatory
      electrocardiography, and its association with new coronary events at 40-month
      follow-up in elderly diabetic and nondiabetic patients with coronary artery
      disease.

PMID- 1736625
TI  - Detection of patent foramen ovale by transcranial contrast Doppler ultrasound.

PMID- 1736626
TI  - Estimation of pulmonary arterial wedge pressure by pulsed Doppler
      echocardiography and phonocardiography.

PMID- 1736627
TI  - Richard Lower (1631-1691): a pioneer of cardiologic research.

PMID- 1736628
TI  - Assessment by echocardiogram of left ventricular diastolic function in healthy
      subjects using the atrioventricular plane displacement.

PMID- 1736629
TI  - Cytologic analysis of pericardial effusion complicating extracardiac malignancy.

PMID- 1736630
TI  - Thallium stress tests in asymptomatic diabetics.

PMID- 1736631
TI  - Seismocardiography is not a new term.

PMID- 1736632
TI  - Single Inoue balloon catheter versus double Mansfield balloon catheter techniques
      in percutaneous balloon mitral valvuloplasty.

PMID- 1736634
TI  - Importance of family history in adolescent gallbladder disease.

PMID- 1736633
TI  - Clinical features of vascular thrombosis following varicella.
AB  - OBJECTIVE: To define the clinical characteristics, neuroimaging features, and
      outcome of five patients with post-primary varicella zoster virus infection
      hemiparesis and to offer a hypothesis to explain the predilection for the
      involvement of the cerebral vasculature in this condition. DESIGN: Patient
      series. SETTING: Five patients were treated during a 14-month period in a private
      pediatric neurology practice in a medium-size southwestern city. INTERVENTIONS:
      Steroids (two patients) and antiplatelet drugs (two patients). No observed
      effects of therapy. RESULTS: The onset of the hemiparesis occurred several weeks
      (mean, 5.4 weeks) following an episode of the chickenpox. Magnetic resonance
      imaging was more sensitive than computed tomography or angiography in
      demonstrating the area of involvement deep in the cerebral hemispheres. The
      prognosis was good regardless of the therapy administered, as all patients
      recovered completely or nearly completely. CONCLUSIONS: Primary varicella zoster
      virus infection with delayed-onset hemiparesis typically occurs approximately 6
      weeks after primary varicella zoster virus infection. Magnetic resonance imaging
      is the most sensitive neuroimaging tool in these children. The prognosis is good,
      with recovery of function and no recurrences in our patients. The innervation of
      the carotid artery and the characteristics of the varicella zoster virus itself
      together provide the local and systemic factors that may trigger the vasculopathy
      responsible for this syndrome.

PMID- 1736635
TI  - Pathological case of the month. Wilson's disease (hepatolenticular degeneration).

PMID- 1736636
TI  - Radiological case of the month. Absent pulmonic valve presenting with congenital
      lobar emphysema.

PMID- 1736637
TI  - Picture of the month. Congenital syphilis.

PMID- 1736638
TI  - God, gays, and health care provision.

PMID- 1736639
TI  - Tetralogy of Fallot. The spectrum of severity in a regional study, 1981-1985.
AB  - The combined medical and surgical mortality rate for 125 infants with tetralogy
      of Fallot registered in the Baltimore-Washington Infant Study from 1981 to 1985
      was 28% (mean age at follow-up for living infants, 40 months). Despite early
      diagnosis and successful early repair in many infants, significant risk factors
      for death included pulmonary atresia, major additional cardiac anomalies, major
      noncardiac malformations, low birth weight, and prematurity. There is a wide
      spectrum of severity, ranging from infants with isolated tetralogy and no risk
      factors who have an excellent prognosis to infants with three or more risk
      factors and a high probability of neonatal death. Further treatment advances will
      improve outcome in some, but not all, infants. A regional all-inclusive study of
      a specific cardiac defect can define research and treatment challenges not
      obvious from selected clinical series.

PMID- 1736640
TI  - Breath-holding spells in childhood.
AB  - Childhood breath-holding spells are a common and frightening phenomenon occurring
      in healthy, otherwise normal children. They have been well recognized for several
      hundred years. There appear to be two clinical forms: the cyanotic type and the
      pallid type, referring to the color change exhibited by the child during the
      episode. Prior research concerning the underlying pathophysiologic mechanisms
      involved in breath-holding spells has implicated an autonomic nervous system
      dysregulation. Cerebral anoxia is the ultimate factor responsible for the loss of
      consciousness observed in the severe forms of breath-holding spells. The clinical
      and epidemiologic aspects of breath-holding spells are herein summarized. The
      pertinent respiratory and neural physiologic interactions involved are
      delineated, as well as practical treatment approaches.

PMID- 1736641
TI  - The problem of indigent children: shutting off the supply.

PMID- 1736642
TI  - Is there a 'gold standard' for drug detection in pregnancy?

PMID- 1736644
TI  - Bones of today, bones of tomorrow.

PMID- 1736643
TI  - Autologous transfusions for neonates using placental blood. A cautionary note.

PMID- 1736645
TI  - Bone mineral density in 15- to 21-year-old eumenorrheic and amenorrheic subjects.
AB  - The purposes of this study were to compare the lumbar spine bone mineral density
      of eumenorrheic and amenorrheic white subjects aged 15 to 21 years, and to
      describe the femoral neck bone mineral density in the eumenorrheic subjects.
      Twenty-eight eumenorrheic females had lumbar bone mineral density (mean +/- SD)
      of 1.213 +/- 0.117 g/cm2, and femoral neck bone mineral density of 1.032 +/-
      0.092 g/cm2 measured with dual energy x-ray absorptiometry. Bone mineral density
      at neither site was related to age, energy intake, or calcium intake. Femoral
      neck bone mineral density was related to energy expenditure. Body composition was
      measured with total body electrical conductivity, and bone mineral density at
      both sites was related to body weight as much as fat-free mass. Eight amenorrheic
      subjects had a lumbar spine bone mineral density of 1.057 +/- 0.113 g/cm2, which
      was lower than in the eumenorrheic group. However, when controlling for weight,
      this difference was not significant. Peak lumbar and femoral neck bone mineral
      density may be reached at midadolescence.

PMID- 1736646
TI  - Retrieval of placental blood from the umbilical vein to determine volume,
      sterility, and presence of clot formation.
AB  - From August 1988 to October 1989, 60 specimens of citrate-phosphate-dextrose
      adenine anticoagulated blood were retrieved from the placental umbilical veins of
      newborns from three gestational age groups. The specimens were removed with a
      needle and syringe apparatus and placed directly into sterile transfusion packs.
      The specimens were evaluated for the volume obtained, sterility, and presence of
      macroscopic clots. A blood volume sufficient to provide at least one transfusion
      (10 mL/kg) for 87% of the premature infants studied was retrieved from the
      placenta. A greater blood volume per unit of birth weight was recovered from the
      placentas of the smaller newborns. A 12% positive culture frequency and a 7%
      frequency of detectable clots were identified. These rates of occurrence suggest
      the need for further studies to determine the origins of these complicating
      factors before the adoption of this technique in the clinical setting. These
      findings support the hypothesis that, with proper patient selection and with
      specimen culture and filtration, placental blood may be a viable option for the
      autologous transfusion of sick, premature infants.

PMID- 1736647
TI  - Very low birth weight and growth to age 8 years. I: Weight and height.
AB  - We determined the heights and weights at ages 2, 5, and 8 years for the following
      three cohorts of children: group 1 with birth weights between 500 and 999 g;
      group 2 with birth weights between 1000 and 1499 g; and group 3 with birth
      weights more than 2500 g. By age 8 years, group 3 children were significantly
      heavier and taller than all children in groups 1 and 2 combined; group 1 children
      were significantly shorter than those in group 2, but their weights were similar.
      From ages 2 to 5 years, annual increments in weight and height were similar in
      all three groups; however, between ages 5 and 8 years, children in group 3 grew
      faster than those in groups 1 and 2 combined, and children in group 1 had smaller
      height increments than those in group 2. Of children with birth weights less than
      1500 g, with a weight or height under the 10th percentile at age 2 years, only
      approximately one half were still below the 10th percentile for the corresponding
      measurement at age 8 years. Health variables determined before birth, such as
      maternal height or birth weight ratio, were more important than health after
      birth in predicting a height or weight below the 10th percentile at age 8 years
      in children with birth weights less than 1500 g.

PMID- 1736648
TI  - Very low birth weight and growth to age 8 years. II: Head dimensions and
      intelligence.
AB  - The occipitofrontal circumference was measured in all available children in the
      following cohorts at ages 2, 5, and 8 years: group 1, consisting of 79 children
      with birth weight between 500 and 999 g; group 2, with 111 children with birth
      weight between 1000 and 1499 g; and group 3 with 56 children with birth weight
      greater than 2500 g; all were white with no signs of moderate or severe cerebral
      palsy. National Center for Health Statistics reference values indicated
      substantially more children with an occipitofrontal circumference lower than the
      10th percentile, particularly at age 2 years, compared with Nellhaus reference
      data. Occipitofrontal circumference was the head measurement best correlated with
      the Full Scale IQ on the Wechsler Intelligence Scale for Children-Revised.
      Dolichocephaly, often seen in very-low-birth-weight children was unrelated to IQ,
      and correction of occipitofrontal circumference for dolichocephaly was rarely of
      clinical importance.

PMID- 1736649
TI  - Multiple realities. Teaching rounds in an inpatient pediatric service.
AB  - Teaching rounds are a mainstay of most educational programs for interns and
      residents, but little is known about how they are conducted and the role they
      play in house staff members' learning. We performed a qualitative study of
      teaching rounds in an inpatient adolescent service using five data sources:
      observations, interviews, house staff ratings, results of a house staff retreat,
      and documents outlining faculty responsibilities. Interns, senior residents, and
      faculty members expressed differing views regarding the purpose, process, and
      content of rounds; mutual roles and expectations; and time management. An
      interactive teaching format focused around the visit of a patient to the
      conference room stimulated house staff interest and learning to a greater extent
      than did more traditional case presentations and lectures. These results suggest
      a need to develop a consensus among faculty and house staff regarding the
      purpose, content, and process of rounds.

PMID- 1736650
TI  - Body size and composition of perimenarchal girls.
AB  - A number of measurements are reported on a cross-sectional sample of girls who
      were studied at times ranging from 54 months prior to menarche to 82 months after
      menarche. Included are anthropometric measurements, lean weight, body fat,
      abdomen-hip ratio, skeletal size, bone age, muscle strength, and urinary
      hydroxyproline excretion. The years preceding menarche are associated with an
      array of physiological and anatomical changes, making it difficult to assign a
      causative role to any one of them.

PMID- 1736651
TI  - Indications of early obesity in low-income Hmong children.
AB  - OBJECTIVE: To determine if there is evidence of obesity in low-income Hmong
      children. DESIGN: Cross-sectional survey. SETTING: Women, Infants, and Children
      clinics in Minneapolis, Minn. PARTICIPANTS: 271 US-born Hmong children, ages 1.00
      through 4.99 years. SELECTION PROCEDURES: Consecutive sample of all Hmong
      children seen in two clinics between September and December 1989. INTERVENTIONS:
      None. MEASUREMENTS/MAIN RESULTS: Heights and weights were measured and converted
      to National Center for Health Statistics z scores of weight for age, height for
      age, and weight for height. Relative to National Center for Health Statistics
      reference data, mean height-for-age z scores decline progressively after age 2
      years to--1.2 z at age 4.5 years. Mean weight-for-height z scores exceeded the
      National Center for Health Statistics reference significantly at ages 3 and 4
      years, and there was more than a fourfold excess of Hmong children beyond the
      95th percentile in weight for height at these ages. CONCLUSIONS: There is
      evidence of early obesity in Hmong children, an ethnic group heretofore
      considered to be a low risk for obesity.

PMID- 1736652
TI  - Findings from the preparticipation athletic examination and athletic injuries.
AB  - This study investigated the relationships between the findings from a
      standardized preparticipation athletic examination, the sport played, and
      athletic injuries requiring treatment by a physician and/or requiring the athlete
      to miss one or more games. Of public high school students receiving a
      preparticipation athletic examination during the 1989-1990 academic year, 674
      (56%) either completed a telephone interview or returned a mailed questionnaire
      at the end of the academic year. The sample consisted of 408 (60.5%) blacks and
      243 (36.1%) whites; 470 (69.7%) of the subjects were males. The subjects ranged
      in age from 13 to 20 years (mean +/- SD, 16.1 +/- 1.2 years), and participated in
      at least 10 school sports. Injuries were reported by 29.5% of the athletes. The
      highest proportion of athletes injured occurred among male football (36.3%),
      female basketball (33.3%), male baseball (19.4%), male soccer (17.2%), and female
      track and field (15.8%) participants. Responses by the athletes and their parents
      on the standardized health history were significantly associated with injuries in
      several specific areas. Knee injuries were associated with previous knee
      injuries, knee surgery, and history of injuries requiring medical treatment.
      Ankle injuries were associated with previous ankle injuries and previous injuries
      requiring medical treatment. Both arm and other leg injuries were associated with
      previous fractures. Male athletes with either abnormal knee or ankle findings
      from the physical examination were more likely to injure the knee or ankle,
      respectively. However, the sensitivities and positive predictive values of these
      relationships are weak. These data suggest that the preparticipation athletic
      examination may not predict certain athletic injuries and that additional
      prevention efforts for specific body areas of injury are needed in certain
      sports.

PMID- 1736653
TI  - Severe insulin resistance and diabetes mellitus in mandibuloacral dysplasia.
AB  - Mandibuloacral dysplasia (MAD) is a syndrome with onset in midchildhood. The
      predominant characteristics of MAD include flexion contractures; mandibular
      hypoplasia; loss of body fat; atrophic, speckled skin; and progressive osteolysis
      of the clavicles. We studied three males with MAD. Each had lipodystrophy of the
      extremities, with sparing of the face and neck. All had moderate hyperlipidemia.
      In response to oral glucose, each had a diabetic response, with peak insulin
      levels between 2870 and 22,960 pmol/L. Insulin-stimulated glucose disposal was
      determined in two patients with MAD. At an insulin infusion rate of 120 mU/m2 per
      minute, glucose disposal was less than 25% of that measured at similar levels of
      insulinemia in nondiabetic control subjects, indicating marked insulin resistance
      in patients with MAD. The insulin resistance occurred without obesity, excessive
      levels of counterregulatory hormones, or anti-insulin-receptor antibodies. We
      suggest that MAD is a previously undescribed form of lipodystrophic insulin
      resistant diabetes mellitus.

PMID- 1736654
TI  - Re: Maternal smoking and tubal pregnancy.

PMID- 1736655
TI  - Re: "The effect on the stratum-specific odds ratios of nondifferential
      misclassification of a dichotomous covariate".

PMID- 1736656
TI  - Particulate air pollution and daily mortality in Steubenville, Ohio.
AB  - Particulate air pollution has been associated with daily mortality in London,
      England, both in the smog episodes of the 1950s and at the lower pollution levels
      of the late 1960s and early 1970s. Replicating these findings in the United
      States has been difficult, because particulates are usually sampled every sixth
      day. Replication, particularly with a gravimetric measure of particulates, is
      important in assessing the causality of the relation. Daily measurements of total
      suspended particulates by high volume gravimetric sampler are available for the
      Steubenville, Ohio, metropolitan area. These were matched to daily mortality
      counts from the detail mortality tapes of the National Center for Health
      Statistics. Deaths of residents which occurred outside the Steubenville Standard
      Metropolitan Statistical Area were excluded. Because of the much smaller
      population, the average total number of deaths per day in the Steubenville
      Standard Metropolitan Statistical Area over the 11-year period 1974-1984 was
      about 1% of the deaths in a typical London winter. Despite this reduced
      statistical power, total suspended particulate count was significantly associated
      with increased daily mortality in Poisson regression analyses controlling for
      season and temperature. An increase in particulates of 100 micrograms/m3 was
      associated with a 4% increase in mortality on the succeeding day. Associations
      with sulfur dioxide were not significant after adjustment for particulates. The
      relation appeared to continue at levels well below the current National Ambient
      Air Quality Standard.

PMID- 1736657
TI  - Association of smoking and alcohol drinking with residential fire injuries.
AB  - To investigate whether tobacco, alcohol, and their combined use are important
      risk factors for fire injuries, the authors analyzed data from a population-based
      case-control study in King County, Washington, between 1986 and 1987. Cases (n =
      116) were households with at least one fatal or nonfatal unintentional
      residential fire injury reported to the Washington State Fire Incident Reporting
      System from 1984 through 1985. Controls were selected by random digit dialing (n
      = 256). After adjustment for household size, number of male household members,
      total household income, and education of the head of the household, the odds
      ratio for fire injury in households whose members collectively smoked 1-9
      cigarettes per day was 1.5 (95% confidence interval (CI) 0.6-4.2) relative to
      households with no smokers; for 10-19 cigarettes per day, the odds ratio was 6.6
      (95% CI 2.5-17.5), and for 20 or more cigarettes per day, it was 3.6 (95% CI 1.9
      7.2). Although households with alcohol drinkers who consumed five or more drinks
      per occasion were found to be at increased risk in the crude analysis,
      multivariate analysis suggested that this was partly because drinkers tended to
      live in households with higher smoking levels. Thus, even though households with
      alcohol drinkers who consume five or more drinks per occasion may be at increased
      risk of residential fire injury, smoking appears to be the more important
      underlying risk factor.

PMID- 1736658
TI  - Family history of reproductive cancers and ovarian cancer risk: an Italian case
      control study.
AB  - The relation between family history of ovarian, breast, and endometrial cancer
      and risk of epithelial ovarian carcinoma was analyzed within the framework of a
      case-control study conducted from 1983 to 1989. The study included 755 cases of
      ovarian cancer and 2,023 controls in hospital for a spectrum of acute
      nongynecologic, hormonal, or neoplastic conditions in the Greater Milan area,
      Italy. Eighteen cases (2%) and 24 controls (1%) reported a history of ovarian
      cancer in a first-degree relative: The corresponding multivariate adjusted odds
      ratio (OR) was 1.9 (95% confidence interval (CI) 1.1-3.6). The risk of ovarian
      cancer was elevated in women reporting a family history of breast cancer (OR =
      1.6, 95% CI 1.1-2.3), but no significant association emerged with a family
      history of endometrial cancer (OR = 1.3, 95% CI 0.8-1.7). When the data were
      stratified by family history of breast cancer, a family history of ovarian cancer
      was over 10 times more frequent in both cases and controls who reported a family
      history of breast cancer than in cases and controls reporting no family history
      of breast cancer. The estimated odds ratio for ovarian cancer associated with a
      family history of the disease was 2.3 (95% CI 1.1-4.5) in women not reporting a
      family history of breast cancer, but no association emerged in the subgroup of
      women reporting a family history of breast cancer. These results confirm that a
      family history of ovarian cancer increases the risk of the disease, but the
      percentage of ovarian cancer cases explained by a family history of the disease
      is small: Less than 1% of observed cases in this study could be attributed to
      this "family risk factor."

PMID- 1736659
TI  - Chlamydia trachomatis infection in women: a need for universal screening in high
      prevalence populations?
AB  - Chlamydia trachomatis is the most prevalent sexually transmitted bacterial
      pathogen. Nevertheless, selective, rather than universal, screening for chlamydia
      has been recommended, largely because testing is expensive and requires
      considerable technical expertise. A total of 1,348 women in four family planning
      clinics in San Francisco, California, were screened from March 1987 to January
      1988 to identify criteria for selective screening. Of these, 9.2% had a positive
      chlamydia test using direct fluorescence. Logistic regression analysis identified
      five factors associated with infection: age less than 25 years, cervical
      friability, single marital status, a new sexual partner within the past 3 months,
      and lack of barrier contraceptive use. No single risk factor or combination of
      risk factors had both a high sensitivity and a high positive predictive value for
      infection. While screening all women who were unmarried would detect 93% of those
      with chlamydia, the positive predictive value of 10.7% was not much higher than
      the overall prevalence. Conversely, screening all women with cervical friability,
      which had a positive predictive value of 23.2%, would only detect 11% of those
      with chlamydia. On the basis of the authors' findings, selective screening should
      not be used in high prevalence populations in which all women are at risk and
      should be screened for chlamydia.

PMID- 1736660
TI  - Aspergillus fumigatus sternal wound infections in patients undergoing open heart
      surgery.
AB  - During a 21-month period (July 1986-April 1988), six patients who underwent open
      heart surgery at Holston Valley Hospital and Medical Center in Kingsport,
      Tennessee, developed sternal would infections caused by Aspergillus fumigatus.
      All patients required sternectomy, reconstructive surgery, and long term
      amphotericin B therapy; no patient died. By univariate analysis, the following
      were significantly associated with A. fumigatus sternal would infection: chronic
      lung disease, a recent history of pneumonia, a greater mean number of admission
      diagnoses, and a particular surgeon. However, multivariate analysis identified
      chronic lung disease as the only independent risk factor and the best predictor
      of A. fumigatus sternal wound infections. No factors related to the surgical
      procedure or operating room personnel were associated with infection. A review of
      the characteristics of the patients undergoing open heart surgery showed that
      since 1985, there had been a trend for these patients at Holston Valley Hospital
      and Medical Center to be older and sicker, which may have contributed to the
      occurrence of infections never observed before. Despite an extensive
      investigation, no environmental source for A. fumigatus was identified. A.
      fumigatus, however, grew from the bronchial washing of one patient at the time
      the sternal wound infection was diagnosed, and a prospective study showed that
      the rate of A. fumigatus colonization among open heart surgery patients was the
      same as the rate of sternal wound infections caused by A. fumigatus. These data
      suggest that patients with chronic lung disease and respiratory colonization with
      A. fumigatus are at increased risk for A. fumigatus sternal wound infections
      after open heart surgery.

PMID- 1736661
TI  - Socioeconomic status, John Henryism, and blood pressure in black adults. The Pitt
      County Study.
AB  - The joint influence of socioeconomic status and John Henryism on blood pressure
      was examined in a probability sample of 1,784 black adults aged 25-50 years in
      Pitt County, North Carolina, in 1988. John Henryism was measured by means of the
      John Henryism Active Coping Scale. Socioeconomic status (low, medium, and high)
      was based on respondents' education and occupation. Prior research indicated
      that, for blacks, the inverse association between socioeconomic status and
      hypertension may be stronger for individuals who score high in John Henryism. In
      this more urban sample of blacks, the hypothesized interaction achieved modest
      statistical support (p less than 0.08) only for hypertension prevalence. For
      individuals with high levels of John Henryism, adjusted prevalences declined with
      increasing socioeconomic status (29.4%, 26.2%, and 20.5% for low, medium, and
      high socioeconomic status, respectively); for individuals with low levels of John
      Henryism, hypertension prevalence was similar in the low (22.6%) and medium
      (22.8%) socioeconomic categories but higher in the high socioeconomic category
      (25.9%). Elevated psychological stress in white-collar workers was probably
      responsible for the nonsignificant inverse gradients between socioeconomic status
      and mean blood pressures and for the weak interaction between socioeconomic
      status and John Henryism with regard to hypertension prevalence.

PMID- 1736662
TI  - Cross-sectional and longitudinal associations between high density lipoprotein
      cholesterol and women's employment.
AB  - This study examined the association between women's employment and high density
      lipoprotein (HDL) cholesterol. Subjects were 1.998 women aged 25-64 years who
      were sampled by the first MONICA Augsburg Survey (Monitoring of Trends and
      Determinants in Cardiovascular Disease). The women were sampled from the
      population of Augsburg, Federal Republic of Germany, in 1984-1985, were followed
      up for 3 years, and were reexamined in 1987-1988. In cross-sectional analysis
      (1984-1985), the mean HDL cholesterol level of employed women was 3.4 mg/dl
      higher than that of full-time homemakers (p less than 0.001). After adjustment
      for age, body mass, cigarette smoking, consumption of coffee and alcohol, use of
      sex hormones, leisure-time physical activity, and reproductive history, this
      difference decreased to 2.1 mg/dl and remained statistically significant (p less
      than 0.01). As was predicted from the cross-sectional findings, the mean HDL
      cholesterol levels of women who gave up employment and became full-time
      homemakers during the follow-up period decreased by 3.04 mg/dl (p less than
      0.01), whereas homemakers who became employed showed no significant change in HDL
      cholesterol levels. The change in mean HDL cholesterol of employed women who had
      become homemakers could be explained in part by changes in alcohol consumption
      and in number of pregnancies. The authors conclude that giving up employment is
      related to life-style changes that are associated with a decrease in HDL
      cholesterol levels. Furthermore, the findings suggest that employment may exert a
      beneficial influence on coronary risk in women that is consistent with a positive
      association between employment and HDL cholesterol.

PMID- 1736663
TI  - Corroboration of sexual histories among male homosexual couples.
AB  - Using data from a study of human immunodeficiency virus transmission among
      homosexual male partners from Boston, Massachusetts, the authors compared self
      reported sexual histories among 155 index-partner pairs during 1985-1988.
      Overall, high levels of agreement were observed for all reported sexual
      activities. Agreement on anal sex was very high (Spearman's r = 0.78-0.79, p less
      than or equal to 0.001; kappa = 0.76-0.88, p less than or equal to 0.001). Level
      of agreement did vary significantly by a couple's drug and alcohol use; the
      heavier substance user generally reported fewer sexual encounters than the
      lighter user. These results have important implications in sexual behavior
      research and show that among homosexual men, self-reports of sexual behavior may
      be reasonably valid.

PMID- 1736664
TI  - Effects of nondifferential exposure misclassification in ecologic studies.
AB  - Although many authors have argued against inferring individual-level exposure
      disease relations from ecologic data because of the potential "ecological
      fallacy." the availability of data from diverse populations promotes the
      continued use of this rapid and inexpensive study design. In ecologic studies,
      the exposure status of groups is often defined by the proportion of individuals
      exposed. In these studies, nondifferential exposure misclassification of
      individuals is shown to produce overestimation of exposure-disease associations
      that may be extreme when the ecologically derived rate ratios are applied to
      individuals. This overestimation contrasts with the bias toward the null
      resulting from nondifferential misclassification of a binary exposure in
      epidemiologic studies conducted at the individual level. Given the magnitude of
      the potential bias from nondifferential exposure misclassification and other
      sources, quantitative estimates of individual-level rate ratios from ecologic
      data should be interpreted with extreme caution.

PMID- 1736665
TI  - Tests for trend and dose response: misinterpretations and alternatives.
AB  - Tests for overall trend, such as the Mantel extension test, are not tests for
      monotonic dose response. A survey of epidemiologic articles shows widespread
      misinterpretation of the Mantel extension test and overstatement of evidence for
      monotonic dose response when there are few exposed subjects. To properly evaluate
      the hypothesis that risk continues to increase with further increases in
      exposure, one must examine several statistics and estimates. Given sufficient
      data, nonparametric or polynomial regression analyses can provide more detailed
      dose-response information.

PMID- 1736666
TI  - American Journal of Occupational Therapy--Buyers Guide, 92.

PMID- 1736667
TI  - Cranial capacity evolution in Homo erectus and early Homo sapiens.
AB  - This paper investigates patterns of cranial capacity evolution in Homo erectus,
      early Homo sapiens, and in regional subsamples of H. erectus. Specifically,
      models explaining evolution of cranial capacity in these taxa are evaluated with
      statistical techniques developed for the analysis of time series data. Regression
      estimates of rates of evolution in cranial capacity are also obtained. A non
      parametric test for trend suggests that cranial capacity in both H. erectus and
      early H. sapiens may increase significantly through time. Cranial capacity in an
      Asian subsample of H. erectus (comprised of Chinese and Indonesian specimens)
      increases significantly through time. Other subsamples of H. erectus (African,
      Chinese, and Indonesian) do not appear to increase significantly through time.
      Regression results generally corroborate results of the test for trend. Spatial
      and temporal variation may characterize evolution of cranial capacity in H.
      erectus. Different patterns of cranial capacity evolution may distinguish H.
      erectus from early H. sapiens.

PMID- 1736668
TI  - Brief communication: the popliteal sesamoid bone (cyamella) in primates.
AB  - A study of 246 adult nonhuman primates belonging to 34 genera indicates that a
      popliteal sesamoid bone is always present in the tendon of the popliteus muscle
      in Prosimii and Callitrichidae. The bone occurs only variably in Atelidae and
      Pongo, and is usually absent in Gorilla. The bone is absent, or very rare, in
      Cebus, Cercopithecidae, Hylobatidae, Pan, and humans. When the bone is present,
      it articulates with the posterior part of the articular surface of the lateral
      condyle of the tibia, and lies very close to the head of the fibula, at the
      angulated part of the popliteal tendon, near the tendomuscular junction. The
      presence of the popliteal sesamoid bone in primates is a primitive character.

PMID- 1736669
TI  - Brief communication: histological age estimation using rib and clavicle.
AB  - Histological methods for estimating age at death using osteon population
      densities for the rib, clavicle, and rib and clavicle combined are presented.
      Predicting formulas were generated from a sample of 40 individuals of known age,
      sex, and race. Independent samples of 12 ribs and 7 clavicles were used to test
      the formulas. Mean differences between known and predicted ages were 1.1 years,
      2.6 years, and 3.4 years for the clavicle, rib and clavicle combined, and rib
      formulas respectively. An analysis of variance found no significant differences
      among the means for predicted and known ages. Since the formula based upon rib
      and clavicle combined has the higher standard error and r2, and includes data
      from different bones, it should provide better overall accuracy and reliability,
      and is recommended whenever both bones are available.

PMID- 1736670
TI  - Obituary: Frederick S. Hulse, 1906-1990.

PMID- 1736671
TI  - Reassessment of the paleoenvironment and preservation of hominid fossils from
      Hadar, Ethiopia.
AB  - Samples of paleosols from locality AL-333, known for numerous specimens of
      Australopithecus afarensis, were analyzed in order to reconstruct the original
      soils and environment of burial of the associated fossil hominids. The bones were
      found in swale-like features, within the calcareous and coarse-grained basal
      portion of a paleosol. This is more like an assemblage of bones buried during a
      single depositional episode, such as a flood, than an assemblage accumulated on a
      soil over a long period of time by carnivores or other means of death. What
      killed the hominids remains unclear, but considering the association of
      originally disarticulated bones of such hydraulically distinct types as phalanges
      and maxillae, it is very likely that they died and partially rotted at or very
      near this site. The paleosols at AL-333, here named the Fo and Go clay paleosols,
      have calcareous rhizoconcretions, granular surface horizons, prismatic peds, and
      shallow calcareous nodules and stringers like soils now supporting grassy
      woodland in semiarid regions. Although this group of hominids was buried in
      streamside gallery woodland, there is evidence from Laetoli, Tanzania, that A.
      afarensis ventured out into open wooded grassland as well. Evidence for this
      should be sought from other paleosols at Hadar.

PMID- 1736672
TI  - Further evidence on relative dental maturation and somatic developmental rate in
      hominoids.
AB  - New data on hominoid dental development are presented. Individual bivariate
      pairings of all mandibular teeth were made for African apes and humans. Data were
      analyzed with a full linear regression model. No statistically significant
      differences were found among apes, although a consistent pattern of earlier
      incisal development was observed in Pan relative to Gorilla. This is concordant
      with an earlier fusion of the premaxillary:maxillary suture in Pan. Only one
      tooth pair differed significantly by sex among apes. Two biologically distinct
      human samples (Libben and Hamann-Todd), although assessed differently (extraction
      and radiography) yielded virtually identical results. Humans differ from apes
      only by earlier relative calcification of their anterior teeth. This can be
      viewed as a consequence of reduced facial prognathism and a shift in hominid
      canine function.

PMID- 1736673
TI  - Porotic hyperostosis: a new perspective.
AB  - Porotic hyperostosis is a paleopathologic condition that has intrigued
      researchers for over a century and a half. It is now generally accepted that
      anemia, most probably an iron deficiency anemia, is the etiologic factor
      responsible for lesion production. Although there can be a number of factors
      involved in the development of iron deficiency anemia, a dietary explanation has
      often been invoked to explain the occurrence of porotic hyperostosis in past
      human skeletal populations. In fact, porotic hyperostosis has been referred to as
      a "nutritional" stress indicator. Traditionally those groups with a higher
      incidence of porotic hyperostosis have been considered to be less successful in
      adapting to their environment or more nutritionally disadvantaged than other
      groups. A new perspective is emerging that is challenging previous views of the
      role of iron in health and disease, thus having profound implications for the
      understanding of porotic hyperostosis. There is a new appreciation of the
      adaptability and flexibility of iron metabolism; as a result it has become
      apparent that diet plays a very minor role in the development of iron deficiency
      anemia. It is now understood that, rather than being detrimental, hypoferremia
      (deficiency of iron in the blood) is actually an adaptation to disease and
      microorganism invasion. When faced with chronic and/or heavy pathogen loads
      individuals become hypoferremic as part of their defense against these pathogens,
      thus increasing their susceptibility to iron deficiency anemia. Within the
      context of this new perspective porotic hyperostosis is seen not as a nutritional
      stress indicator, but as a indication that a population is attempting to adapt to
      the pathogen load in its environment.

PMID- 1736674
TI  - On comparing biological shapes: detection of influential landmarks.
AB  - For problems of classification and comparison in biological research, the primary
      focus is on the similarity of forms. A biological form consists of size and
      shape. Several approaches for comparing biological forms using landmark data are
      available. If the two biological forms are demonstrated to be different, the next
      important issue is to localize the differences by identifying those areas which
      differ most between the two objects. In this paper we suggest a technique to
      detect influential landmarks, those which contribute most to the difference
      between forms. We study the effectiveness of the technique using three
      dimensional simulated data sets and two examples. Results suggest that the
      technique is useful in the study of biological form and its variation.

PMID- 1736675
TI  - Cranial growth in the squirrel monkey (Saimiri sciureus): a quantitative analysis
      using three dimensional coordinate data.
AB  - Improvements in data gathering technology have made it possible to quickly and
      accurately digitize large numbers of objects. The three dimensional coordinates
      of 44 homologous landmarks were obtained from a sample of 104 squirrel monkey
      (Saimiri sciureus) crania. After sorting by sex, the crania were assigned to one
      of four dental age groups. Two quantitative methods, Euclidean distance matrix
      analysis (EDMA) and finite element scaling analysis (FESA), were used to study
      craniofacial form change during growth within each sex. Form differences between
      the sexes at each developmental age were also examined. Both sexes show a small
      amount of cranial growth overall; however, there are areas of substantial local
      growth. These areas include the anterior neurocranium and basicranium, the
      basioccipital, and the anterior palate. Sexual dimorphism in the craniofacial
      complex is minimal. The most dimorphic regions are the orbitonasal portion of the
      lower face, the cranial base, and the palate.

PMID- 1736676
TI  - Positional behavior of Pan troglodytes in the Mahale Mountains and Gombe Stream
      National Parks, Tanzania.
AB  - The positional behavior of habituated adult chimpanzees and baboons was observed
      for 784 hr in a year-long study. Comparisons between species were made to
      establish the distinctiveness of chimpanzee positional behavior and habitat use.
      Brachiation (sensu stricto, i.e., hand-over-hand suspensory locomotion) was
      observed in low frequencies among chimpanzees, and its significance for
      chimpanzee anatomy is judged slight. Although no significant differences were
      found between sympatric baboons and chimpanzees in the proportion of time spent
      in the terminal branches, or in the mean diameter of weight-bearing strata,
      chimpanzees exhibited evidence of a terminal branch adaptation in that they,
      unlike baboons, used postures among smaller supporting strata different from
      those used among larger supports. Among chimpanzees, unimanual arm-hanging was
      most common among the smallest strata and was associated with smaller mean and
      median support diameter than other postures. Unimanual arm-hanging was the only
      common behavior among chimpanzees that usually involved complete abduction of the
      humerus. A number of behaviors often subsumed under the label "quadrumanous
      climbing" were distinguished in this study. Compared to baboons and other
      cercopithecoids, chimpanzees did not show increased frequencies of large-stratum
      vertical climbing, and their vertical climbing did not involve significant
      humeral abduction. Arm-hanging (i.e., unimanual suspension) and vertical climbing
      distinguish chimpanzee positional behavior from that of monkeys.

PMID- 1736677
TI  - Interactive control of pulsed field gel electrophoresis via real time monitoring.
AB  - The migration of DNA fragment bands through a slab gel can be monitored by UV
      absorption at 254 nm and imaged by a charge-coupled device (CCD) camera.
      Background correction and immediate viewing of band positions to interactively
      change the field program in pulsed-field gel electrophoresis is possible
      throughout the run via this detection scheme. The use of absorption removes the
      need for staining or radioisotope labelling, thereby simplifying sample
      preparation and reducing hazardous waste generation. This leaves the DNA in its
      native state and further analysis can be performed without destaining. The
      optimization of buffer concentration, electric field strength, temperature,
      agarose concentration, as well as pulse duration can considerably reduce total
      run time. For example, DNA from 2 to 850 kb can be separated in 3 h on a 7-cm gel
      with interactive control of the pulse time, which is 10 times faster than using a
      constant field program.

PMID- 1736678
TI  - Nitroprusside and methylene blue methods for silicone membrane differentiated
      flow injection determination of sulfide in water and wastewater.
AB  - Hydrogen sulfide evolved from an acidified sample is pre-concentrated by
      permeation in a stationary alkaline acceptor solution enclosed in a silicone
      rubber sample loop. Depending on the sample volume pre-concentrated, the
      applicable analytical range spans low micrograms/L to tens of mg/L for both
      methods. The methylene blue method is more sensitive by a factor of approximately
      30 and actually permits practical determinations in the sub-micrograms/L levels.
      The limit of detection (LOD) for the nitroprusside method ranges from 20
      micrograms/L for a 20 microL sample by conventional flow-injection determination
      (no membrane, throughput 30 samples/h) to less than 2 micrograms/L for 12 mL
      sample pre-concentrated in the membrane system (throughput 5 samples/h). The
      membrane is highly resistant to fouling and permits analysis of untreated
      wastewater samples bearing suspended solids, oil, grease, etc. without any
      pretreatment. No significant interference is observed with either chemistry.
      Although the nitroprusside chemistry is less sensitive, it does not involve the
      use of concentrated aggressive reagents and is recommended unless ultratrace
      determinations are essential. Viable reaction mechanisms are proposed for both of
      these chemistries.

PMID- 1736679
TI  - Dual-field and flow-programmed lift hyperlayer field-flow fractionation.
AB  - Field and flow programming and their combination, dual programming, are shown to
      extend the particle size range to which a single flow/hyperlayer field-flow
      fractionation (FFF) run is applicable to approximately 1-50 microns. The
      rationale for programming flow/hyperlayer FFF (or other forms of lift hyperlayer
      FFF) is to expand the diameter range of micron size particles that can be
      resolved in a single run. By contrast, the reason for programming normal-mode
      FFF, the only kind of programming previously realized in FFF, is to reduce the
      analysis time of submicron particle samples of considerable size variability.
      These differences are explained in detail in relationship to the basic mechanisms
      governing retention in normal, steric, and lift hyperlayer FFF. Experiments are
      described in which field, flow, and dual programming are used to expand the
      accessible diameter range of flow/hyperlayer FFF. An example is shown in which 11
      sizes of latex microspheres in the 2-48-microns diameter range are separated by
      dual programming in 11 min.

PMID- 1736680
TI  - Distribution and dendritic features of three groups of rat olivocochlear neurons.
      A study with two retrograde cholera toxin tracers.
AB  - Cholera toxin B subunit conjugated to horseradish peroxidase, and unconjugated
      cholera toxin B subunit are useful tools for retrograde tract tracing. Unilateral
      injection of either cholera toxin preparation into the cochlea results in
      excellent labeling of olivocochlear neurons, as judged by the Golgi-like filling
      of cell bodies, dendrites, and even axons. By this approach, we have studied the
      light microscopic cytology and topographic distribution of olivocochlear neurons
      and counted their numbers in Sprague-Dawley rats. The olivocochlear system of
      rats can be divided into three subgroups. The lateral olivocochlear system,
      composed of small cells located exclusively within the ipsilateral lateral
      superior olive (relative to the test cochlea), and a medial olivocochlear system,
      composed of large cells bilaterally dispersed within the ventral nucleus of the
      trapezoid body, conformed to previous topographic descriptions. A third subgroup
      of approximately 110 large cells, herein termed shell neurons, was labeled by
      both tracers, but was not well recognized in previous studies. Shell neurons and
      their dendrites surround the ipsilateral, and to a much lesser extent the
      contralateral, lateral superior olive. Lateral olivocochlear neurons do not
      project their dendrites outside the gray matter of the lateral superior olive,
      while dendrites belonging to shell neurons penetrate into that nucleus as well as
      into other auditory brain stem nuclei and the surrounding reticular formation.
      Medial olivocochlear neurons usually project dendrites ventrally into the
      trapezoid body and are always excluded from the lateral superior olive.

PMID- 1736681
TI  - Preferential differentiation of the bile ducts along the portal vein in the
      development of mouse liver.
AB  - The development of bile ducts in the mouse liver was studied histochemically,
      with special reference to their preferential differentiation around the portal
      vein. Both portal vein and hepatic vein shared a common origin, the
      omphalomesenteric vein. In the early development of the liver, haematopoietic
      cells were predominant around both veins. With the progressive development of
      intrahepatic bile ducts, the following three steps were observed: cluster
      formation of type I hepatocytes around the portal vein, formation of primitive
      bile duct structures and basal lamina, then formation of ducts surrounded by
      connective tissue structures composed of type I and type III collagens and lectin
      binding sites, which were predominant around the portal vein compared to the
      hepatic vein. These results suggest that the deposition of abundant connective
      tissue structures around the portal vein is a prerequisite for the cell
      differentiation and basal lamina formation in the bile duct precursors. A
      possible mechanism of the aggregation of type I hepatocytes around the portein
      vein is also discussed.

PMID- 1736682
TI  - Afferent organization of the lateral reticular nucleus in the rat: an anterograde
      tracing study.
AB  - The organization of the afferent projections to the lateral reticular nucleus of
      the rat was investigated following placement of horseradish peroxidase-conjugated
      wheatgerm agglutinin into the red nucleus, fastigial nucleus, various levels of
      the spinal cord or the sensorimotor area of the cerebral cortex. The pattern of
      distribution of anterogradely labelled profiles visualized with
      tetramethylbenzidine revealed that the caudal three-fourths of the lateral
      reticular nucleus received a large, topographically organized projection from the
      entire length of the contralateral spinal cord. The lateral part of the rostral
      half of the lateral reticular nucleus received a small projection from the
      contralateral red nucleus, the dorsal part of the middle third of the nucleus
      received a diffuse projection from the contralateral fastigial nucleus, and the
      extreme rostromedial part of the nucleus received a sparse projection from the
      contralateral cerebral cortex. The dorsal part of the middle third of the lateral
      reticular nucleus also received a small projection from the ipsilateral cervical
      spinal cord. The distribution of afferent fibres from different levels of the
      spinal cord, red nucleus, and fastigial nucleus overlapped substantially in the
      middle third of the lateral reticular nucleus, whereas the cerebral cortical
      receiving area was separate. These data suggest that the middle third of the
      lateral reticular nucleus integrates spinal and supraspinal impulses to the
      cerebellum, while the rostral part of the nucleus is involved in a separate
      cerebral cortico-cerebellar pathway.

PMID- 1736683
TI  - Intimate apposition of the glomus and smooth muscle cells (g-s connection) in the
      carotid labyrinth of juvenile bullfrogs.
AB  - Intimate apposition of the glomus and smooth muscle cells (g-s connection) was
      found in almost all glomus cells of the carotid labyrinths in juvenile bullfrogs,
      Rana catesbeiana. There were three types of g-s connection: between thin
      processes (0.1-0.2 micron in width) without dense-cored vesicles of glomus cells
      and smooth muscle cells; between thick processes (1.0-1.5 microns in width) with
      dense-cored vesicles of glomus cells and smooth muscle cells; and between the
      tongue-like projections of smooth muscle cells and the flat surface of the glomus
      cell. In some cases, a single glomus cell made g-s connections with several
      smooth muscle cells. Exocytosis often occurs at the g-s connection. Afferent and
      efferent synapses were found on the glomus cells with g-s connections. Reciprocal
      synapses were also observed. On the basis of these findings, the second and third
      types of g-s connection are presumed to participate in vascular regulation.

PMID- 1736684
TI  - Morphology of a dicephalic cat.
AB  - A detailed anatomical study of a dicephalic iniodymic monosomic cat in
      conjunction with the morphogenetical implications of the observed anomalies is
      presented. The animal exhibited two heads joined at the level of an anomalous
      medial exoccipital bone. Two brains and two foramina magna were present. The
      vertebral column was single but the cranial cervical vertebrae (C2 to C5) had
      doubled bodies. Cervical rachischisis with myeloschisis were associated defects.
      Two nasopharyngeal and oropharyngeal cavities converged caudally into a single
      laryngopharynx. The esophagus, larynx and trachea were single. Duplication of the
      tongue and hyoid apparatus was present. Palatoschisis affected both oral
      cavities. Hypoplasia of the anatomical structures in the medial aspects of both
      heads was observed. Microphthalmia was also observed in both medial eyes.
      Comparative aspects of the morphology, causative agents, and mechanisms and
      anomalous morphogenesis of anterior duplications are reviewed and discussed.

PMID- 1736685
TI  - Meso-diencephalic regions projecting to spinal cord and dorsal column nuclear
      complex in the hedgehog-tenrec, Echinops telfairi.
AB  - The distribution of neurons projecting to the spinal cord and dorsal column
      nuclear complex was investigated in the mesodiencephalic regions of the lesser
      hedgehog-tenrec, Echinops telfairi (Insectivora) by using the retrograde flow
      technique. While only few neurons projected to the dorsal column nuclear complex,
      numerous cells were found to give rise to spinal projections. Rubro-spinal
      neurons of various sizes were distributed over the entire rostrocaudal extent of
      the contra-lateral nucleus; a few neurons were also located ipsilaterally, Unlike
      that of the opossum, the projection appeared to be somatotopically organised.
      Interstitio-spinal neurons were differentiated into several subpopulations
      according to their location and laterality of projection. In the ipsilateral
      periventricular grey, in addition, there was a distinct population of cells
      possibly corresponding to the nucleus of Darkschewitsch. The mesencephalic
      central grey contained relatively few labeled neurons, the great majority of them
      being mesencephalic trigeminal, ectopic cuneiform or midline cells. Labeled
      cuneiform and midline cells, on the other hand, were quite numerous, extending
      both from a level just caudal to the trochlear nucleus to levels far beyond the
      rostral tip of the somatic oculomotor nucleus. The discrepancy between the poorly
      differentiated oculomotor nuclei and the apparently well-developed Edinger
      Westphal complex is discussed. Hypothalamo-spinal neurons were essentially
      restricted to dorsal regions: the hypothalamic paraventricular nucleus (PAV), the
      dorso-medial (DmHy) and dorso-intermediate cell groups as well as the lateral
      hypothalamic zone. The latter two cell groups were bilaterally labeled, while the
      labeled neurons in DmHy and PAV were located predominantly ipsilaterally. Labeled
      neurons in the amygdala, colliculus superior and mesencephalic trigeminal nucleus
      were only found following cervical injections; all other mentioned areas and the
      posterior commissure complex projected to, at least, midthoracic level.

PMID- 1736686
TI  - Normal colon of Sprague-Dawley rats. An immunohistochemical study.
AB  - The patterns of expression of the human-tumor-associated antigens, CO17-1A, GA73
      3, BR55-2, GICA19-9, CA50 and carcino-embryonic antigen (CEA) were studied in the
      normal colonic mucosa (the last three also in the serum) of Sprague-Dawley rats.
      Four immunohistochemically different segments were identified: caecum, ascending
      colon, transverse colon and descending colon. The immunohistochemical reactions
      of the cells at the lower part of the crypt were essential for the distinction of
      the four segments. In the caecum, the MAbs 17-1A, 73-3 and 19-9 stained the
      glycocalyx of the cells of the lower part of the crypts and the Golgi apparatus
      of the intercalated cells (IC). MAb55-2 stained very weakly the goblet-like cells
      (GLC) of the lower part of the crypt of transverse colon, in addition to a nearly
      complete lack of reaction in the upper part of the crypts. In the ascending
      colon, the lower part of the crypts showed a characteristic diffuse staining of
      the intercalated cells with MAb55-2. The perinuclear and mucosal staining
      observed in the GLC of the transverse colon with MAbs 17-1A, 73-3 and 19-9 as
      against the supranuclear and Golgi zone staining observed in the GLC/goblet cells
      (GC)/columnar cells (CC) of the lower part of crypts of the descending colon with
      the same MAbs, distinguished the former segment from the latter. The IC
      demonstrated by immunohistochemistry in the lower parts of the crypts of caecum
      and ascending colon appear to correspond to the replicating cells of the colonic
      crypts.

PMID- 1736687
TI  - A direct projection from the medial vestibular nucleus to the cervical spinal
      dorsal horn of the rat, as demonstrated by anterograde and retrograde tracing.
AB  - Phaseolus vulgaris leucoagglutinin and wheat germ agglutinin-horseradish
      peroxidase were iontophoretically injected into different parts of the vestibular
      nuclear complex (VNC) of the rat. Injections centered into the caudal part of the
      medial vestibular nucleus revealed a vestibulospinal projection predominantly to
      the dorsal horn of the cervical spinal cord, besides the expected projection to
      the intermediate zone (IZ) and ventral horn (VH). While most of the anterogradely
      labelled fibres could be localized in laminae III to V, some scattered fibres
      were also seen in laminae I and VI. Lamina II remained free of labelling. The
      dorsal horn (DH) area with detectable anterograde labelling showed a rostrocaudal
      extension from C1-C6. Injections into other parts of the VNC labelled fibres and
      terminals in the IZ and VH while the DH remained almost free of labelling.
      Additionally, fluorogold and wheat germ agglutinin-horseradish peroxidase were
      pressure- or iontophoretically injected at different levels into the spinal cord
      to confirm the projection to the dorsal horn by means of retrograde tracing.
      Labelled neurons in the area of the medial vestibular nucleus (MVN), from which
      anterograde labelling in the DH was obtained, were only detectable after
      fluorogold and wheat germ agglutinin-horseradish peroxidase injections into the
      cervical spinal cord, in particular its DH. This projection from the caudal
      medial vestibular nucleus to the dorsal horn of the cervical spinal cord probably
      enables the VNC to influence sensory processing in the DH, in addition to its
      well-established influence on posture and locomotion via projections to the
      intermediate zone and ventral horn.

PMID- 1736688
TI  - Effect and distribution of intravenously injected 125I-endothelin-1 in rat kidney
      and lung examined by electron microscopic radioautography.
AB  - The morphological effect of endothelin-1 (ET-1) and the distribution of
      endothelin-binding sites on the kidney and lung was investigated ultrastructually
      by intravenous injection of [125I]-ET-1 into rats. About 10% decrease of the
      diameter of glomeruli was observed at 10 min after the injections of ET-1 or
      [125I]-ET-1 (1.3-2.4 nmole/kg). When localization of [125I]-ET-1 in the kidney
      was examined by light and electron microscopic radioautography, silver grains
      were preferably localized on the fenestrated endothelial cells of glomeruli and
      peritubular capillary endothelial cells. Some grains were also localized on the
      interdigitating processes of urinary tubules. Quantitative analysis of silver
      grains in the glomeruli showed that 83% of grains were located on the fenestrated
      endothelial cells, 12% on the podocytes of visceral cells, and 5% on mesangial
      cells at 10 min. After 60 min, 50% of silver grains were incorporated into the
      cytoplasm of fenestrated endothelial cells. In contrast to glomeruli, silver
      grains were rare on the arteries and large arterioles. However, a few silver
      grains were often observed on the smooth muscle cells of small arterioles (8-20
      microns in diameter). In the lung, 70% of silver grains were located on the
      alveolar capillary endothelial cells. These results indicate the abundance of ET
      receptors on the glomerular fenestrated endothelium, peritubular fenestrated
      endothelium and alveolar capillary endothelium.

PMID- 1736689
TI  - Binding of 125I-endothelin-1 to fat-storing cells in rat liver revealed by
      electron microscopic radioautography.
AB  - Localization of intravenously injected [125I]-endothelin-1 was examined in rat
      liver by light and electron microscopic radioautography. At 10 min after
      injection, silver grains were localized along the sinusoidal wall, i.e., mostly
      on the thin processes of fat-storing cells and sinusoidal endothelial cells, and
      also on the Kupffer cells and the microvilli of hepatocytes. About 35% of the
      total silver grains were located on the processes of fat-storing cells at 10 min.
      The grain density (number of silver grains/cell area) of fat-storing cells was
      three-fold that of Kupffer cells, and 18-fold that of hepatocytes. At 60 min, 60%
      of the total grains were observed on the fat-storing cells, though the value of
      grain density was not changed. Silver grains were internalized into the cytoplasm
      of fat-storing cells and often associated with multivesicular bodies. In
      contrast, the grain density of endothelial cells and Kupffer cells decreased with
      time. These results indicate that hepatic fat-storing cells have a considerable
      number of endothelin-binding sites, and incorporate bound endothelin into
      cytoplasm.

PMID- 1736690
TI  - Pediatric transesophageal echocardiography. Present and future.

PMID- 1736691
TI  - A comfortable hypothesis reevaluated. Cerebral metabolic depression and brain
      protection during ischemia.

PMID- 1736692
TI  - Intraoperative echocardiography for evaluation of congenital heart defects in
      infants and children.
AB  - To determine the accuracy, utility, and limitations of intraoperative
      transesophageal echocardiography (TEE) in infants and children, we performed
      prebypass and postbypass TEE in 90 children undergoing surgical repair of
      congenital heart lesions, comparing the results to those obtained using
      intraoperative epicardial echocardiography and pre- and postoperative precordial
      echocardiography. Patients ranged in age from 4 days to 21 yr (mean 4.1 yr) and
      in weight from 3 to 68 kg (mean 15.4 kg). Prebypass, we obtained high-quality,
      two-dimensional TEE images in 86 patients, with correction of the preoperative
      precordial diagnosis in 3 and confirmation of the preoperative diagnosis in the
      rest. Adequate epicardial images were obtained in 78 patients, with confirmation
      of the preoperative diagnosis in all. Shunt lesions that were well delineated
      prebypass by both TEE and epicardial imaging included interatrial,
      interventricular, and atrioventricular septal defect lesions. TEE failed to
      detect the exact size and location of lesions involving the right ventricular
      outflow tract, i.e., doubly committed subarterial (supracristal) ventricular
      septal defects. Regurgitant lesions (n = 30) were identified and their severity
      evaluated in all patients by both TEE and epicardial imaging. Obstructive lesions
      (n = 33), excluding those involving the right ventricular outflow tract, were
      well defined by both echocardiographic approaches. Postbypass, we obtained high
      quality, two-dimensional, color and Doppler TEE images in 86 patients and
      epicardial images in 78 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736693
TI  - Neuropathologic findings after long-term intrathecal infusion of morphine and
      bupivacaine for pain treatment in cancer patients.
AB  - Epidural or intrathecal infusions of morphine and bupivacaine mixtures are
      presently used for the treatment of "refractory" cancer pain even though the
      neurotoxic potential of such mixtures is unknown. The pathologic findings of the
      spinal column, the meninges, the nerve roots, and the spinal cord, and the
      clinical neurologic deficits were recorded in 15 patients (5 men and 10 women),
      aged 26-83 (median 68) yr, treated for 4-274 (median 81) days with intrathecal
      infusions of morphine (with preservatives [sodium metabisulfite and sodium
      edetate]) and bupivacaine mixtures, given through open, subcutaneously tunneled
      nylon catheters. Six patients had been subjected to radiation therapy (20-96 Gy),
      applied over the spinal column, and four had been treated with antineoplastics
      believed to be neurotoxic. Ten patients had various neurologic deficits before
      the intrathecal treatment. The cumulative doses (ranges) given intrathecally
      were: morphine 33-11,900 mg, sodium metabisulfite 3.3-1,050 mg, sodium edetate
      0.33-105 mg, and bupivacaine 10-41,400 mg; cumulative volumes were 16-9,400 ml.
      The concentrations of the drugs in the mixtures were: morphine 0.25-4.0 mg/ml,
      sodium metabisulfite 0.025-0.40 mg/ml, sodium edetate 0.0025-0.04 mg/ml, and
      bupivacaine 3.0-4.75 mg/ml. The osmolality of the mixtures in vitro ranged from
      282 to 286 mOsm/kg and the pH from 4.1 to 4.6. The pathologic findings consisted
      of vertebral metastases (n = 6), epidural and/or intrathecal tumor masses (n =
      8), focal subdural fibrosis (n = 6), infiltration of mononuclear cells in the
      subarachnoid space (n = 10), and discrete injuries (nerve fiber degeneration or
      fibrosis) to the anterior (five patients) and posterior (seven) nerve roots, and
      spinal cord (tumor compression [one], slight thickening of the leptomeninges
      [one], and thrombosis of a spinal artery and medullary infarction [one]). In none
      of the cases was any reaction against the nylon catheter within its subarachnoid
      course recorded. The neuropathologic findings were not related to the duration or
      cumulative doses of the intrathecal treatment. No new neurologic deficits that
      could be attributed to the intrathecal administration of the opiate-bupivacaine
      mixtures were recorded. The neuropathologic and clinical neurologic findings in
      cancer patients treated with intrathecal morphine-bupivacaine mixtures appeared
      similar to those in animals and humans reported with either intrathecal morphine
      or bupivacaine alone.

PMID- 1736694
TI  - Epidural clonidine after cesarean section. Appropriate dose and effect of prior
      local anesthetic.
AB  - Epidurally administered clonidine represents a new approach to postcesarean
      section pain therapy, yet the appropriate bolus dose and infusion to provide
      effective pain relief have not been defined. In addition, whether 2
      chloroprocaine, a commonly used local anesthetic for intraoperative anesthesia,
      interferes with clonidine's analgesia, as it does with that of opioids, has not
      been examined. In this study, using a randomized, blinded design, 63 women
      received either bupivacaine or 2-chloroprocaine for epidural anesthesia for
      cesarean section and then received, upon request for analgesia in the recovery
      room, epidural clonidine 400 micrograms or 800 micrograms bolus, each followed by
      a 24-h infusion of 40 micrograms/h, or an equivalent volume bolus and infusion of
      saline. In the bupivacaine group, both clonidine doses produced equivalent
      analgesia, as determined by pain scores and time to first supplemental
      intravenous morphine request, and sustained analgesia was produced by clonidine
      infusion, as measured by need for supplemental morphine. In contrast, 2
      chloroprocaine diminished analgesia from 800 micrograms by 21% and abolished
      analgesia from 400 micrograms clonidine. After 2-chloroprocaine, sustained
      analgesia from continuous clonidine infusion was present only in the group who
      had received 800 micrograms clonidine. Clonidine did not alter resolution of
      residual local anesthetic sensory blockade, as measured by 2- or 4-segment
      regression following either local anesthetic, but did prolong duration of motor
      blockade in women receiving bupivacaine. Clonidine produced small decreases in
      heart rate and blood pressure. One patient received iv fluids for hypotension;
      one had asymptomatic bradycardia resolving without therapy; and one had mild
      hypoxemia with snoring during clonidine-induced sedation, responding to
      supplemental oxygen.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736695
TI  - Intravenous diclofenac coupled with PCA fentanyl for pain relief after total hip
      replacement.
AB  - Postoperative pain relief immediately after major surgery cannot be achieved with
      opioids alone in all patients without respiratory depression or other significant
      side effects. This investigation was conducted to determine whether the need for
      opioids and the incidence of side effects can be reduced while maintaining the
      quality of pain relief using a nonsteroidal antiinflammatory drug as an adjuvant
      to an opioid. The analgesic efficacy and safety of patient-controlled analgesia
      using fentanyl with and without intravenous diclofenac were compared after total
      hip replacement. Forty patients were randomly assigned to receive either
      diclofenac 75 mg as an initial intravenous loading dose followed by an infusion
      of 5 mg per hour or saline in a double-blind fashion. The amount of fentanyl
      administered was recorded. The patients assessed their pain intensity verbally
      and on a visual analogue scale at intervals of 4 h. The diclofenac group showed a
      significant reduction in the amount of fentanyl administered during the first 16
      h postoperatively as compared to the placebo group (0.65 mg +/- 0.2 vs. 1.08 mg
      +/- 0.4 respectively, P less than 0.01), and also reported less pain at 16 h
      (median score on visual analogue scale 0.75 vs. 2.4 respectively, P less than
      0.05)). There were no differences in side effects, postoperative blood loss,
      plasma activated partial thromboplastin time, or Ivy bleeding time between the
      groups. In conclusion, the addition of diclofenac led to a reduction in fentanyl
      requirement but did not have any other significant advantages in the treatment of
      pain following major orthopedic surgery.

PMID- 1736696
TI  - The accuracy of train-of-four monitoring at varying stimulating currents.
AB  - Train-of-four (TOF) monitoring of neuromuscular block at submaximal current
      stimulation has been recommended because it is less painful than monitoring at
      supramaximal stimulation. The measurement error, however, when using submaximal
      stimulation has not as yet been fully elucidated. The authors therefore
      quantified the measurement error of TOF monitoring at low currents near the
      initial threshold for stimulation (ITS) by assessing precision (the difference
      between duplicated TOF ratios measured at the same current) and accuracy (the
      difference between TOF ratios at lesser currents and the TOF ratio at 58 mA,
      which served as the reference standard method). A stable neuromuscular block at a
      TOF ratio of 0.40 and subsequently 0.70 was established in 20 patients using a
      continuous infusion of atracurium. The ulnar nerve was stimulated at the wrist
      using TOF stimulation, and the evoked twitch response of the adductor pollicis
      muscle was measured with a force-displacement transducer. The stimulating current
      was varied in 5-mA steps between ITS and 55 mA. Whereas there were no statistical
      significant differences between the mean TOF ratios at the different currents,
      the standard deviation increased with decreasing currents (P less than 0.01 at
      currents less than 40 mA). The precision was acceptable except at ITS, where the
      limits of precision (mean intracurrent difference in TOF ratio +/- two standard
      deviations) exceeded 0.05, which was the chosen acceptable difference. The
      standard deviation of the accuracy was significantly increased at currents less
      than or equal to ITS + 25 mA (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736697
TI  - Eye injuries associated with anesthesia. A closed claims analysis.
AB  - Claims against anesthesiologists for eye injuries were analyzed as part of the
      ASA Closed Claims Project. Eye injury occurred in 3% of all claims in the
      database (71 of 2,046). The payment frequency for eye injury claims was higher
      than that for non-eye injury claims (70% vs. 56%; P less than or equal to 0.05).
      The median cost of eye injury claims was less than that for other claims ($24,000
      vs. $95,000; P less than or equal to 0.01). Two distinct subsets were identified.
      The first was characterized by corneal abrasion during general anesthesia (25 of
      71 claims; 35%). Claims for corneal abrasion were characterized by low incidence
      of permanent injury (16%) and low median payment ($3,000). Reviewers were able to
      identify a mechanism of injury in only 20% of claims for corneal abrasion. The
      second subset of eye injury was characterized by patient movement during
      ophthalmologic surgery (21 of 71; 30%). Blindness was the outcome in all cases.
      Sixteen of the claims involving movement occurred during general anesthesia, and
      5 occurred during monitored anesthesia care. The median payment for claim
      involving movement was 10 times greater than for non-movement claims ($90,000 vs.
      $9,000; P less than or equal to 0.01). Anesthesiologist reviewers deemed the care
      rendered in the general anesthesia "movement" claims as meeting standards in only
      19% of claims. From the perspective of patient safety, as well as risk
      management, these data suggest two specific needs: research directed at better
      understanding of the etiology of corneal abrasion and clinical strategies
      designed to assure patient immobility during ophthalmic surgery.

PMID- 1736698
TI  - Does epidural administration of butorphanol offer any clinical advantage over the
      intravenous route? A double-blind, placebo-controlled trial.
AB  - The differential effects of intravenous versus epidural administration of short
      acting, lipid-soluble opioids is controversial. This study was undertaken to
      compare these two routes of administration using the mixed agonist-antagonist
      opioid, butorphanol. Forty-five women undergoing elective cesarean delivery at
      term under epidural lidocaine anesthesia were randomized to receive a single
      bolus of either epidural or intravenous butorphanol 2 mg or saline control for
      postoperative analgesia. At precisely 60 min after the last dose of epidural
      local anesthetic, all patients received a simultaneous epidural and intravenous
      injection in a randomized, double-blinded fashion. The intravenous group received
      butorphanol intravenous and saline epidurally; the epidural group received saline
      intravenous and butorphanol epidurally; and a control group received saline via
      both routes. When additional analgesia was requested, all patients received
      patient-controlled analgesia (PCA) with intravenous morphine (2-mg demand dose, 7
      min lockout interval). Analgesia was quantitated using a visual analogue scale
      and subsequent PCA morphine requirements. The interval from study drug injection
      until first request for PCA use was equivalent for the intravenous and epidural
      groups (89 +/- 9 and 83 +/- 8 min, respectively) and significantly longer than in
      control group (39 +/- 4 min, P less than 0.001, intravenous and epidural vs.
      control). Analgesia was equivalent in the intravenous and epidural groups at all
      observation points, and pain scores were significantly lower than control for the
      first 120 min after study drug injection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736699
TI  - A comparison of the cerebral protective effects of isoflurane and mild
      hypothermia in a model of incomplete forebrain ischemia in the rat.
AB  - The present study was undertaken to examine the cerebral protective properties
      attributed to isoflurane and at the same time to compare its protective effects
      with those of mild hypothermia (temperature reduction by 3 degrees C). Twenty-one
      fasted Wistar-Kyoto rats were assigned to one of three groups (n = 7); 1.3 MAC
      (end-tidal) isoflurane-normothermia (pericranial temperature 38.0 degrees C), 1.3
      MAC halothane-normothermia, and 1.3 MAC halothane-hypothermia (pericranial
      temperature 35.0 degrees C during ischemia). In each animal the trachea was
      intubated and the lungs were mechanically ventilated. Each animal was subjected
      to temporary incomplete forebrain ischemia induced by 10 min of bilateral carotid
      artery occlusion with simultaneous hypotension (mean arterial pressure 35 mmHg)
      induced by trimetaphan and blood withdrawal. After a 3-day survival period,
      perfusion-fixation was performed, and two blinded observers assessed
      histopathologic injury according to a four-point scale (0 = no damage; 1 = less
      than 10% of neurons damaged; 2 = 10-50% damaged; and 3 = greater than 50%
      damaged). The assessment was performed at two points in the rostrocaudal axis
      chosen to permit evaluation of regions with varying levels of ischemic damage. In
      the rostral sections, in the isoflurane- and halothane-normothermia groups,
      moderate to severe injury was observed in striatum, cerebral cortex, hippocampus
      (CA1 and CA3 areas), and reticular nucleus of the thalamus (e.g., the median
      scores for the CA1 area were 3 in both the halothane-hypothermia and the
      isoflurane-normothermia groups), and there were no differences between the two
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736700
TI  - Halothane changes the relationships between lung resistances and lung volume.
AB  - The authors hypothesized that relaxation of airway smooth muscle by halothane
      lessens the dependence of airway resistance on lung volume, and that halothane
      alters the relationship between pulmonary resistance and lung volume by changing
      both the airway and tissue components of pulmonary resistance. The relationship
      among airway resistance, tissue resistance, and lung volume was examined in
      mongrel dogs before and during the administration of halothane, both in airways
      with reduced smooth muscle tone (after vagotomy) and during moderate increases in
      smooth muscle tone caused by vagus nerve stimulation (VNS). Resistance were
      measured at several levels of positive end-expiratory pressure (PEEP, 4-15 cmH2O)
      using an alveolar capsule technique. Before halothane administration, airway
      resistance increased at low PEEP; VNS accentuated this increase. Tissue
      resistance increased at low PEEP only during VNS. Halothane had no significant
      effect on any resistance before VNS. During VNS, halothane markedly blunted
      increases in airway resistance and tissue resistance as PEEP decreased. The
      authors conclude that during stimulation of airway smooth muscle in dogs,
      halothane attenuates increases in airway resistance and tissue resistance with
      reductions in lung volume in dogs. Thus, moderate changes in lung volume have
      little effect on these resistances during halothane anesthesia under these
      conditions.

PMID- 1736701
TI  - The effects of propofol on brain electrical activity, neurologic outcome, and
      neuronal damage following incomplete ischemia in rats.
AB  - This study compares the effects of propofol and fentanyl/N2O on spontaneous brain
      electrical activity, neurologic outcome, and neuronal damage due to incomplete
      cerebral ischemia in rats. Thirty Sprague-Dawley rats were assigned to one of
      three groups: group 1 (n = 10) received 70% N2O in O2 plus fentanyl (bolus 10
      micrograms.kg-1, infusion 25 micrograms.kg-1.h-1); group 2 (n = 10) received 70%
      N2 in O2 and propofol (infusion 0.8-1.2 mg.kg-1.min-1) adjusted to maintain EEG
      burst suppression during ischemia; group 3 (n = 10) was anesthetized with
      propofol and received 6 ml.kg-1 10% glucose intraperitoneally 15 min before the
      start of ischemia. Incomplete cerebral ischemia was produced by right common
      carotid artery occlusion combined with hemorrhagic hypotension (35 mmHg) for 30
      min. Arterial blood gases, pH, and rectal temperature were kept constant in all
      groups. Plasma glucose was lower during ischemia in propofol-anesthetized rats
      compared to that in fentanyl/N2O- (P = 0.009) and glucose-loaded propofol-treated
      rats (P = 0.008). Neurologic outcome and brain tissue injury were significantly
      better in propofol-anesthetized compared to fentanyl/N2O-anesthetized rats (P
      less than 0.05). Elevated plasma glucose in propofol-treated rats resulted in
      similar neurologic outcome and histopathologic injury as seen in propofol
      anesthetized rats given no glucose. Recovery of EEG theta-alpha activity after
      ischemia was inversely correlated to neurologic deficit (fentanyl/N2O: r = -0.71;
      propofol: r = -0.83; P less than 0.01). These results show that propofol improves
      neurologic outcome and decreases neuronal damage from incomplete cerebral
      ischemia when compared to fentanyl/N2O. This effect is not dependent on plasma
      glucose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736702
TI  - Transcranial electrical stimulation with Limoge's currents decreases halothane
      requirements in rats. Evidence for the involvement of endogenous opioids.
AB  - Transcutaneous cranial electrical stimulation with Limoge's currents has been
      shown to facilitate anesthesia/analgesia in surgical patients. However, the
      neurobiologic substrate of this effect remains unknown. The present study was
      designed to analyze the influence of transcranial electrical stimulation (TCES)
      on halothane requirements in rats and the contribution of the central endogenous
      opioid, alpha 2-adrenergic and 5-hydroxytryptamine (5-HT1 and 5-HT2) serotonergic
      systems to this effect. The influence of TCES on the MAC of halothane (MACH) and
      its reversibility by a subcutaneous 2 mg/kg naloxone injection were first
      determined in 20 rats using a randomized blinded protocol. MACH was decreased
      markedly in stimulated animals (TCES, n = 10) in comparison with sham-operated
      nonstimulated rats (controls, n = 10): MACH = 0.60 +/- 0.15, mean +/- SD, versus
      1.07 +/- 0.05 vol%, P less than 0.001. In TCES animals, naloxone administration
      restored MACH values to the levels of controls but failed to affect MACH in
      controls. The influence of the duration of TCES applied prior to MACH
      determination was further investigated in 30 animals. The magnitude of MACH
      reduction was significantly increased with the cumulative duration of
      stimulation. For each duration of stimulation tested, administration of a 5
      micrograms intracerebroventricular (icv) dose of the enkephalinase inhibitor
      thiorphan significantly enhanced TCES effects (P less than 0.05). Finally, the
      icv administration of a 15-micrograms naloxone dose appeared to reverse
      completely the MACH reduction elicited by TCES (n = 8, P less than
      0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736703
TI  - Coronary microcirculation during halothane, enflurane, isoflurane, and adenosine
      in dogs.
AB  - We investigated the effects of clinically administered volatile anesthetics and
      of adenosine on the microvasculature of the in situ beating canine heart.
      Thirteen dogs were studied during general anesthesia with an opioid
      (piritramide), which was infused throughout the experiments. Measurements were
      obtained in each animal at control (piritramide only) and during hypotension
      (mean arterial pressure 60 mmHg) induced by halothane, enflurane, isoflurane, and
      adenosine. Using epiillumination and fluorescence microscopy, 354 arterial
      microvessels with diameters from 20 to 450 microns were examined through all
      experimental periods. Hypotension by halothane, enflurane, isoflurane, and
      adenosine reduced coronary vascular resistance by 13%, 23%, 40%, and 85%,
      respectively. Coronary venous PO2 was unchanged from control with halothane (+/-
      0%) and enflurane (+7%) and significantly increased with isoflurane (+16%) and
      adenosine (+65%). Left ventricular blood flow decreased significantly during
      halothane (-35%) and enflurane (-23%); was unchanged from control during
      isoflurane (-9%); but significantly increased during adenosine (+397%). Coronary
      arterial and arteriolar diameters increased with all hypotensive agents.
      Vasodilation was least with halothane, intermediate with enflurane and
      isoflurane, and most pronounced with adenosine. Diameters increased considerably
      more in vessels with initial diameters below 100 microns as opposed to larger
      vessels. Calculation of microvascular segmental resistances revealed that the
      maximum conductance changes during volatile anesthetics were located in the
      vessel segments visualized by microscopy, i.e., in vessels larger than 20
      microns. However, this was not the case with adenosine. We conclude that volatile
      anesthetics induce coronary vasodilation by preferentially acting on vessels with
      diameters from 20 microns to approximately 200 microns, whereas adenosine, in
      addition, has a pronounced impact on the small precapillary arterioles.

PMID- 1736704
TI  - Prostaglandin-related microvascular dilation in pentobarbital- and etomidate
      anesthetized rats.
AB  - Etomidate is characterized by minimal systemic cardiovascular effects, but its
      effect on the microvasculature has not been assessed. We compared the
      microvasculature of etomidate-anesthetized animals to that of animals
      anesthetized with pentobarbital, since its effects on the microvasculature are
      known. Male Sprague-Dawley rats were anesthetized with etomidate or
      pentobarbital. The cremaster muscle was prepared for microscopic viewing, leaving
      the neural and vascular supply intact. Small arterioles were near their maximal
      diameters in etomidate-anesthetized rats, whereas the pentobarbital group had a
      large dilator capacity (maximal diameter-basal diameter/basal diameter). The
      effect on resting arteriolar diameters of endothelium-derived relaxing factor
      (EDRF) and prostaglandin synthesis inhibitors was tested. Dilator capacity was
      not affected by the EDRF inhibitor nitro-L-arginine, but it was significantly
      increased by mefenamic acid and ibuprofen in etomidate-anesthetized animals. To
      test whether dilator and constrictor mechanisms were normal, serotonin
      concentration-response curves were obtained in pentobarbital and etomidate
      anesthetized animals with and without mefenamate or ibuprofen present. The
      dilation of small arterioles to serotonin in the etomidate groups with mefenamate
      or ibuprofen was not significantly different from that of the pentobarbital
      groups. Serotonin produced a comparable constriction of large arterioles in both
      anesthetic groups. The topical application of etomidate to the cremaster muscle
      did not affect arteriolar diameters. Thus, etomidate appears to trigger the
      release of dilator prostaglandins in striated muscle through a central or
      indirect mechanism.

PMID- 1736705
TI  - Left tension pneumothorax mimicking myocardial ischemia after percutaneous
      central venous cannulation.

PMID- 1736706
TI  - Postoperative unilateral pulmonary edema: possible amiodarone pulmonary toxicity.

PMID- 1736707
TI  - Intrathecal fentanyl alleviates spasticity in the presence of tolerance to
      intrathecal baclofen.

PMID- 1736708
TI  - Incidental discography during celiac plexus block.

PMID- 1736709
TI  - Subdural block during attempted caudal epidural analgesia for labor.

PMID- 1736710
TI  - Epidural alfentanil: is it volume- or concentration-dependent?

PMID- 1736711
TI  - Discrepancies in upper-limb blood pressure and their impact on internal mammary
      artery-coronary artery grafting.

PMID- 1736712
TI  - Symptoms following lumbar puncture may be related to decreased cerebrospinal
      fluid pressure and/or venous dilation.

PMID- 1736713
TI  - Airway management with a special tube in an infant with bronchial obstruction.

PMID- 1736714
TI  - Spontaneous ventilation through transtracheal access.

PMID- 1736715
TI  - Case report: an unusual reaction to foods?

PMID- 1736716
TI  - Blood histamine levels following graded cold challenge in atypical acquired cold
      urticaria.
AB  - Acquired cold urticaria with a negative cold stimulation test has been described
      in seven patients in whom the standard ice cube test did not induce localized
      urticaria. Subsequent total body cold exposure induced a generalized urticaria. A
      patient with this syndrome is presented where blood histamine levels rose from 9
      to 60 micrograms/dL after a negative local cold stimulation test and from 60 to
      90 micrograms/dL after total body cold exposure. Urticaria occurred only after
      generalized cold exposure. Blood histamine levels following the ice cube test may
      represent a sensitive method to diagnose this form of atypical acquired cold
      urticaria, without subjecting the patient to the risk of anaphylaxis reported
      following total body cold exposure.

PMID- 1736717
TI  - Why mix ROC with RAST?

PMID- 1736718
TI  - Comparison of skin testing and three in vitro assays for specific IgE in the
      clinical evaluation of immediate hypersensitivity.
AB  - A new assay, Pharmacia CAP System (PCS), for allergen-specific IgE (sIgE) was
      evaluated in 198 new patients presenting with respiratory symptoms to an urban
      allergy practice. An experienced allergist examined each patient and clinically
      assessed sensitivity to timothy, short ragweed, Alternaria tenuis, cat, or D.
      farinae. Puncture and selected intracutaneous skin tests (ST) with these inhalant
      extracts were then performed. The physician again rated the likelihood of
      clinical sensitivity to each inhalant, and serum was obtained for sIgE
      measurements by Phadebas RAST, modified RAST, and PCS. Results of the three in
      vitro tests (IVT) correlated well with each other and generally agreed with
      physician assessments and ST results. Individual differences for extracts and
      assay methods were identified. A few patients with negative ST had positive IVT,
      but more patients with positive ST were negative by IVT. Modified RAST had
      greater sensitivity but less specificity than the other two IVT. Analysis of
      receiver operating characteristic curves showed that sensitivity of the three
      assays when compared at the 95% level of specificity, did not differ. This result
      suggests that the cutoff criterion for a positive modified RAST result is too low
      and should be reevaluated. Skin tests remain the most sensitive and specific test
      available. The Pharmacia CAP System is a clinically useful assay for sIgE and
      appears to be a clear advancement for IVT technology.

PMID- 1736719
TI  - Immunology of diabetes mellitus.
AB  - Insulin-dependent diabetes is an autoimmune disease that may be becoming more
      prevalent. It has a polygenic mode of inheritance with a major gene being present
      in the HLA DQ locus on chromosome 6. Inferential data suggest that environmental
      factors may be important to genetic penetrance albeit we still lack proof for
      involvement of often maligned viruses. Patients with IDD and their families are
      predisposed to organ-specific autoimmunities which should be routinely screened
      for. Autoantibodies to insulin, to a beta cell cytoplasmic lipid containing
      moiety and to a beta cell protein of 64KDa, which is believed to be the GABA
      forming enzyme GAD, can be used to predict IDD among relatives and probably the
      general population as well. Immunosuppressive therapy can modify the course of
      IDD after diagnosis and should be able to delay the clinical onset if given
      before diagnosis. Rigorous insulin therapy should also be given as needed to
      control hyperglycemia and avoid glucose toxicity to the islets. Such trials are
      now underway.

PMID- 1736720
TI  - Thromboxane A2 synthetase inhibitor (OKY-046) improves abnormal mucociliary
      transport in asthmatic patients.
AB  - The effect of a thromboxane A2 synthetase inhibitor (OKY-046, 400 mg po/day) on
      mucociliary transport was investigated in 19 asthmatic patients. The nasal
      clearance time, as measured by the saccharin test, was prolonged in asthmatics
      (60.2 +/- 8.4 SE min) compared with normal controls (15.1 +/- 3.4 SE min). Within
      4 weeks after OKY-046 administration, the nasal clearance time had improved (27.4
      +/- 4.4 SE min, P less than .01) and the amount of sputum had decreased 30% (P
      less than .01). These results indicate that thromboxane A2 plays an important
      role in mucociliary transport in patients with asthma.

PMID- 1736721
TI  - Pentapeptide activity.

PMID- 1736722
TI  - Influenza vaccine testing in egg sensitive patients.

PMID- 1736723
TI  - Abstracts presented at the 48th Annual meeting of the American College of Allergy
      and Immunology. November 16-20, 1991, New York, New York.

PMID- 1736724
TI  - Withholding and withdrawing life-sustaining therapy. Ethical considerations.

PMID- 1736725
TI  - Withholding and withdrawing life-sustaining therapy. Practical considerations.

PMID- 1736726
TI  - The challenge of medical decision making. Balancing patient autonomy and
      physician responsibility.

PMID- 1736727
TI  - Reduced forced vital capacity in California grape workers. What does it mean?

PMID- 1736728
TI  - Reduced FVC among California grape workers.
AB  - Pulmonary disease due to organic and inorganic dust inhalation represents a
      significant health problem in the agricultural community. In response to concern
      over the potential adverse health effects of agricultural exposures, and to
      address the question of whether the specific crop worked was associated with
      decreased lung function, we conducted a cross-sectional survey of pulmonary
      function in a population of 238 grape workers, 355 tomato workers, and 166 citrus
      workers in California's Central Valley. In addition, 92 workers (66 males and 26
      females) performed spirometry before and after an 8-h work shift. Multiple
      regression analysis of pulmonary function in all 759 workers revealed that age,
      height, and smoking-adjusted mean preshift FVC was lower in grape workers than in
      citrus workers in each of three sex and age groups studied: decreased 314 ml for
      males greater than or equal to 25 yr of age p less than 0.05, 82 ml for males
      less than 25 yr, and 83 ml for females greater than or equal to 20 yr. Mean
      adjusted preshift FVC was also lower in grape workers than tomato workers
      (decreased 249 ml in males greater than or equal to 25 yr [p less than 0.05], 51
      ml for males less than 25 yr, and 46 ml for females greater than or equal to 20
      yr). Adjusted mean FEV1 was not different by crop, but FEV1/FVC and forced
      expiratory flow from 25 to 75% of the FVC (FEF25-75) were significantly elevated
      in grape workers of the three age and sex groups compared with citrus or tomato
      workers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736729
TI  - Relationship of pulmonary function to radiographic interstitial fibrosis in 2,611
      long-term asbestos insulators. An assessment of the International Labour Office
      profusion score.
AB  - Radiographic evidence of interstitial fibrosis (IF) secondary to asbestos
      inhalation (using the International Labour Office [ILO] profusion of small
      irregular opacities) was compared with FVC as an independent indicator of IF. In
      addition, spirometric indices of airflow (FEV1/FVC and FET25-75%) were correlated
      with the radiographic profusion score. A study of 2,611 long-term insulators was
      well designed for these analyses since all subjects were from the same trade,
      there were sufficient (n = 515) nonsmokers to assess the effects of asbestos
      exposure in the absence of smoking, most (60%, n = 1,557) of the workers had
      parenchymal abnormalities (scores greater than or equal to 1/0), and there was a
      greater prevalence of high scores than in other published series (347 workers or
      13.3% had scores greater than or equal to 2/1). Looking at all subjects, the FVC
      decreased as profusion score increased. The FVC was abnormal (88.0% of predicted)
      even when the profusion score was clearly normal (0/0). The FVC was lower at any
      score in smokers and in workers with pleural thickening (more so with diffuse
      thickening). There was, however, no difference in FVC between intermediate scores
      0/1 versus 1/0 and 1/2 versus 2/1. Airflow increased with greater profusion,
      tending to overcome a decrease seen at lesser profusion scores. These results
      provide a greater understanding of the relationships among profusion scores,
      smoking, pleural diseases, and pulmonary function.

PMID- 1736730
TI  - Epidemiology of infection by nontuberculous mycobacteria. Mycobacterium avium,
      Mycobacterium intracellulare, and Mycobacterium scrofulaceum in acid, brown-water
      swamps of the southeastern United States and their association with environmental
      variables.
AB  - Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum
      (MAIS) organisms were isolated and identified from waters, soils, aerosols, and
      droplets ejected from water collected from four geographically separate aquatic
      environments (Okefenokee Swamp, GA; Dismal Swamp, VA; Claytor Lake, VA; and
      Cranberry Glades, WV) during several seasons. Recovery of MAIS was significantly
      higher from waters, soils, and aerosols collected from the two acid, brown-water
      swamps located in the southeastern coastal plain. High MAIS numbers correlated
      with warmer temperature, low pH, low dissolved oxygen, high soluble zinc, high
      humic acid, and high fulvic acid. This research, in relation to previous findings
      for the geographic distribution and physiologic ecology of MAIS, supports the
      conclusion that waters, soils, and aerosols of the acid, brown-water swamps of
      the southeastern United States coastal plain represent major environmental
      sources likely connected with the higher incidence of human infection in this
      region.

PMID- 1736731
TI  - Effects of ambient ozone on respiratory function and symptoms in Mexico City
      schoolchildren.
AB  - The effects of ambient ozone (O3) on respiratory function and acute respiratory
      symptoms were evaluated in 143 7- to 9-yr-old schoolchildren followed
      longitudinally at 1- to 2-wk intervals over a period of 6 months at three schools
      in Pedregal, Mexico City. The maximum O3 level exceeded the World Health
      Organization guideline of 80 ppb and the U.S. standard of 120 ppb in every week.
      For an increase from lowest to highest in the mean O3 level during the 48 hr
      before spirometry (53 ppb), logistic regression estimated relative odds of 1.7
      for a child reporting cough/phlegm on the day of spirometry. For the full
      population, the mean O3 level during the hour before spirometry, not adjusted for
      temperature and humidity, predicted a significant decrement in FVC but not in
      FEV1 or FEF25-75. In contrast, the mean O3 level during the previous 24-, 48-,
      and 168-h periods predicted significant decrements in FEV1 and FEF25-75 but not
      in FVC. Ozone was consistently associated with a greater decrement in lung
      function for the 15 children with chronic phlegm as compared with the children
      without chronic cough, chronic phlegm, or wheeze. Ozone in the previous 24-, 48-,
      and 168-h periods predicted decrements in FEV1 for children of mothers who were
      current or former smokers, but not for children of mothers who were never
      smokers. Many of these effects were reduced in multiple regression analyses
      including temperature and humidity, as temperature and O3 were highly
      correlated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736732
TI  - Respiratory allergy and the relationship between early childhood lower
      respiratory illness and subsequent lung function.
AB  - In a study of 159 school-age children whose histories of outpatient visits for
      lower respiratory illness (LRI) had been documented from early infancy, we
      observed lower mean levels of small airway function in boys who had experienced
      two or more episodes of wheezing-associated LRI before 6 yr of age. To determine
      whether allergy was an important factor influencing this result, we examined
      relationships among the results of RAST tests for seven common inhalant allergens
      and concurrent lung function in 126 subjects who consented to venipuncture.
      Increasing values for the sum of scores for the seven RAST tests were associated
      with progressively lower mean levels of small airways function in boys with
      histories of recurrent wheezing LRI during the preschool years. The association
      of allergy with lower levels of lung function was largely accounted for by dust
      mite allergy. RAST results were not correlated with lung function in boys who had
      experienced zero or 1 wheezing LRI before 6 yr of age or in girls. A history of
      recurrent wheezing LRI during the preschool years was also associated with
      significantly lower mean levels of small airways function in boys who had
      negative RAST tests. A subset of 49 boys was reevaluated after an average
      interval of 4 yr with RAST tests, spirometry, and methacholine challenge. Dust
      mite allergy was associated with an increased prevalence of bronchial
      hyperreactivity independent of early childhood wheezing LRI history.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1736733
TI  - Pulmonary performance of elderly normal subjects and subjects with chronic
      obstructive pulmonary disease exposed to 0.3 ppm nitrogen dioxide.
AB  - Symptoms and changes in pulmonary function of subjects with chronic obstructive
      pulmonary disease (COPD) and elderly normal subjects, induced by a 4-h exposure
      to 0.3 ppm NO2, were investigated using a double-blind, crossover design with
      purified air. The 5-day experimental protocol required approximately 2 wk with at
      least a 5-day separation between randomized 4-h exposures to either NO2 or air
      which included several periods of exercise. Over a 2-yr period, COPD subjects,
      all with a history of smoking, consisting of 13 men and 7 women (mean age of 60.0
      yr) and 20 elderly normal subjects of comparable age and sex were evaluated.
      During intermittent light exercise, COPD subjects demonstrated progressive
      decrements in FVC and FEV1 compared with baseline with 0.3 ppm NO2, but not with
      air. Differences in percent changes from baseline data (air-NO2) showed an
      equivocal reduction in FVC by repeated measures of analysis of variance and cross
      over t tests (p less than 0.10). Subgroup analyses suggested that responsiveness
      to NO2 decreased with severity of COPD; in elderly normal subjects, NO2-induced
      reduction in FEV1 was greater among smokers than never-smokers. A comparison of
      COPD and elderly normal subjects also revealed distinctions in NO2-induced
      responsiveness.

PMID- 1736734
TI  - The lung health study: airway responsiveness to inhaled methacholine in smokers
      with mild to moderate airflow limitation. The Lung Health Study Research Group.
AB  - As part of a multicenter clinical trial (Lung Health Study), methacholine
      inhalation challenge testing was performed in 5,877 current cigarette smokers,
      ages 35 to 59 yr (mean 48.5 +/- 6.8 yr), with borderline to moderate airflow
      limitation (FEV1/FVC ratio 63.0 +/- 5.5). The test was successfully completed in
      96.4% of subjects, of whom 63% were male and 95.9% were white. Symptomatic
      reactions to methacholine were rarely severe enough to require evaluation by a
      trial physician. Nonspecific airways hyperresponsiveness (AHR) was defined as a
      greater than or equal to 20% decline in FEV1 from the post-diluent control value
      after inhalation of less than or equal to 25 mg/ml methacholine. AHR was noted in
      a significantly higher percentage of women (85.1%) than men (58.9%). Moreover,
      nearly twice as many women as men (46.6 and 23.9%, respectively) responded to
      less than or equal to 5 mg/ml of methacholine. In both men and women, baseline
      degree of airways obstruction and clinical center were strongly associated with
      AHR (p less than 0.001), whereas age was not. Additional associations with AHR
      were analyzed in men and women separately using logistic regression after
      adjustment for baseline lung function, age, and center-to-center differences. In
      men, AHR was significantly related to symptoms of wheeze, chronic cough and/or
      sputum, and a history of asthma or hay fever (p less than 0.004), but not to
      current or lifetime tobacco use. By contrast, among women, AHR was not
      significantly associated with chronic cough and/or phlegm (p greater than 0.05)
      or a past history of asthma or hay fever (p greater than 0.1) and was only weakly
      related to wheeze and current asthma (p = 0.04), as well as to cigarette pack
      years (p = 0.044). These results indicate that most continuing smokers with
      functional evidence of early chronic obstructive pulmonary disease have
      nonspecific AHR that is strongly related to gender and baseline lung function
      and, to a lesser extent, to respiratory symptoms. The reason for the striking
      effect of gender on AHR in early chronic obstructive pulmonary disease is unclear
      but cannot be attributed to male-female differences in age, cigarette use,
      presence of asthma, or baseline degree of airflow obstruction.

PMID- 1736735
TI  - Alveolar macrophage content of isoferritins and transferrin. Comparison of
      nonsmokers and smokers with and without chronic airflow obstruction.
AB  - Alveolar macrophages (AM) contain iron and ferritin, and concentrations of both
      are increased in AM of smokers compared with nonsmokers. Ferritin stores iron in
      a nontoxic form but can release iron in the presence of reducing agents and
      thereby catalyze the generation of toxic hydroxyl radicals via the Haber-Weiss
      reaction. Two distinct isoferritins are found in peripheral monocytes, L ferritin
      and H ferritin. H ferritin is the predominant isoferritin in human monocytes and
      is more effective than L ferritin in detoxifying iron in vitro. In this study we
      quantitated content of H and L ferritins, transferrin, and iron in AM recovered
      by bronchoalveolar lavage (BAL) of 24 subjects, including eight nonsmokers, eight
      smokers with normal spirometry, and eight smokers with chronic airflow
      obstruction (CAO). Of total AM ferritin in nonsmokers 95% was composed of L
      ferritin. Smokers without CAO demonstrated a 6.5-fold increase in the AM content
      of L ferritin (1,886 +/- 266 versus 290 +/- 51 ng, mean +/- SEM; p less than
      0.0001) and a 3.8-fold increase in H ferritin (61 +/- 18 versus 16 +/- 2 ng per 1
      x 10(6) AM, p less than 0.01) compared with nonsmokers. Compared with smokers
      without CAO, AM recovered from smokers with CAO demonstrated a greater increase
      in L ferritin (5,059 +/- 493 versus 1,886 +/- 266 ng per 1 x 10(6) AM, p less
      than 0.002) but a similar increase in H ferritin (64 +/- 8 versus 61 +/- 18 per 1
      x 10(6) AM).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736736
TI  - Response of young asthmatic patients to inhaled sulfuric acid.
AB  - The intent of this study was to explore the effects of inhalation of [H+] defined
      here as acid airborne particles at near ambient concentrations on the pulmonary
      function of adolescent asthmatic subjects. During rest and exercise, 22
      adolescent asthmatic subjects inhaled atmospheres containing either clean air or
      sulfuric acid particles (H2SO4) through a mouthpiece. The concentration of
      hydrogen ion at the mouthpiece ([H+]) ranged from 1.18 to 3.59 mumol/m3 (51 to
      176 micrograms/m3 of H2SO4). The lower range of [H+] is near the peak values
      measured during the summer months in the eastern United States and Canada.
      Pulmonary function and oral ammonia levels were measured before and after
      exposure in all subjects. Significant group responses to [H+] were seen in FEV1
      (p = 0.016) and FVC (p = 0.039) measured 2 to 3 min post-exposure. Also, the
      slopes of the change in pulmonary function versus [H+] were computed for each
      subject. The slopes of changes in FEV1 and Vmax50 and Vmax75 versus [H+] were
      related to the subject's response to a standard exercise treadmill test,
      specifically to the subject's percentage decrease in FEV1 after exercise
      challenge. Pulmonary function changes 20 min postexposure did not show a
      significant group response to [H+] exposure; however, the relationship between
      percentage FEV1 decrease after exercise and the individual slopes of Vmax50 and
      Vmax75 persisted for at least 20 min after exposure.

PMID- 1736737
TI  - Tumor necrosis factor causes bronchial hyperresponsiveness in rats.
AB  - We have previously reported that exposure of rats to aerosolized endotoxin (LPS)
      causes a transient, dose-dependent increase in bronchial responsiveness (BR) to 5
      hydroxytryptamine (5HT), 90 min after exposure. In the present study we examined
      whether LPS induces the release of tumor necrosis factor (TNF) in the airways and
      whether TNF contributes to the increase in BR. After 90 min following exposure to
      aerosolized LPS, at a concentration of 1 or 10 micrograms/ml, TNF concentrations
      in bronchoalveolar lavage (BAL) fluid were 17.9 +/- 6.9 and 80.5 +/- 7.8 U/ml,
      respectively. No TNF was detected in BAL fluid of saline-exposed animals. At 90
      min after exposure to aerosolized recombinant human TNF (rhTNF) (1 microgram/ml)
      an increase in BR was observed: the provocative concentration of 5HT causing a
      50% increase in lung resistance (PC50RL 5HT) was 2.7 +/- 0.4 versus 4.4 +/- 0.3
      microgram/kg in saline-exposed animals (p less than 0.01). Pretreatment with anti
      TNF antibodies 30 min before LPS exposure significantly diminished the increase
      in BR: PC50RL 5HT was 2.3 +/- 0.4 versus 1.2 +/- 0.5 microgram/kg in control
      pretreated LPS-exposed rats (p less than 0.01). Exposure to aerosolized TNF also
      induced a significant influx of neutrophils in BAL fluid (12.1 +/- 3.7 versus 1.7
      +/- 0.4% in saline-exposed animals) (p less than 0.01). The LPS-induced
      neutrophil influx in BAL fluid was partly inhibited by pretreatment with anti-TNF
      antibodies (55.2 +/- 5.1 versus 76.0 +/- 3.9%) (p less than 0.01). We conclude
      that TNF causes bronchial hyperresponsiveness and airway inflammation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1736738
TI  - Blood gas changes in nonasthmatic rhinitis during and after nonspecific airway
      challenge.
AB  - Noninvasive blood gas monitoring is a new, simple, and reliable method for
      assessing hyperreactivity associated with bronchial asthma. In this study, 104
      atopic rhinitic subjects with no history of wheezing and 104 healthy volunteers
      were challenged with ultrasonically nebulized distilled water (UNDW). Blood gases
      were monitored transcutaneously (PtcO2 and PtcCO2) over 42 min (20 min for
      electrode stabilization, 3 min for monitoring a steady baseline, 5 min during
      UNDW, and 14 min after UNDW). Mean baseline PtcO2 and PtcCO2 values were
      comparable in the two groups. In rhinitic subjects only, a sudden decrease in
      PtcCO2 (starting immediately after the beginning of the challenge and maximal
      34.7 +/- 0.4 mm Hg SEM versus baseline 41.8 +/- 0.2 SEM mm Hg at the third minute
      of UNDW exposure) was induced by the challenge and proved significant (p less
      than 0.001). In the same subjects, a slightly delayed decrease in PtcO2 (starting
      immediately after the end of UNDW inhalation and maximal 64.5 +/- 1.1 mm Hg SEM
      versus baseline 78.3 +/- 0.7 SEM mm Hg at 4 min post-UNDW) was also induced by
      the challenge and proved highly significant (p less than 0.001). The effects of
      UNDW inhalation on blood gases in normal subjects were negligible and
      nonsignificant. UNDW in nonasthmatic rhinitis but not in normal subjects gives
      rise to a sudden hyperventilation and to gas-exchange abnormalities presumably
      reflecting a ventilation-perfusion mismatching, which, however, is of shorter
      duration in rhinitic than in asthmatic subjects.

PMID- 1736739
TI  - Effect of regional alveolar hypoxia on gas exchange in pulmonary edema.
AB  - We studied the effects of left lower lobe (LLL) alveolar hypoxia on ventilation
      perfusion (VA/Q) heterogeneity in anesthetized dogs with acute (1-h-old) and
      mature (24-h-old) permeability pulmonary edema, induced by intravenous
      administration of 0.05 ml/kg of oleic acid. The left upper lobe was removed and a
      bronchial divider was placed to allow separate ventilation of the right lung
      (fraction of inspired oxygen [FIO2] = 1.0) and the LLL (FIO2 = 1.0 or 0.05). Gas
      exchange was assessed using the multiple inert gas elimination technique. In
      acute pulmonary edema, LLL hypoxia reduced LLL blood flow and increased true
      shunt of the LLL compared with a hyperoxic control group. VA/Q heterogeneity of
      the LLL was markedly increased, indicated by increases in the logarithmic
      standard deviation of the perfusion distribution (log SDQ) and the retention
      index of dispersion corrected for shunt (DISPR*). Increases in true shunt and log
      SDQ were significantly greater than those observed with lobar hypoxia in normal
      lungs before oleic acid injury. In mature oleic acid injury, LLL alveolar hypoxia
      resulted in a similar reduction in LLL blood flow and increase in inert gas shunt
      and DISPR*. We conclude that lobar alveolar hypoxia increased VA/Q heterogeneity
      of the hypoxic lobe to a greater degree in oleic acid-induced pulmonary edema
      compared with normal lungs. Phase of oleic acid injury (acute versus mature) did
      not affect gas exchange during alveolar hypoxia.

PMID- 1736740
TI  - Regional and systemic oxygen delivery/uptake relations and lactate flux in
      hyperdynamic, endotoxin-treated dogs.
AB  - Pathologic oxygen supply dependency (PO2SD) may be etiologic in multisystem organ
      failure (MSOF) and has been related to mortality in sepsis. Although elevated
      lactate levels are generally assumed to be a marker of anaerobiosis in these
      patients, endotoxin may increase serum lactate by inactivation of pyruvate
      dehydrogenase (PDH), unrelated to tissue PO2. We hypothesized that regional
      lactate flux may correlate poorly with local oxygen delivery in sepsis. This
      study examined both the whole-body (WB) and regional (isolated hind limb L and
      gut G) responses to endotoxin infusion in terms of oxygen delivery, oxygen
      uptake, and lactate flux in 12 pentobarbital-anesthetized dogs. To separate
      hypoxia-induced lactate production from that related to inactivation of PDH by
      endotoxin, half the dogs received dichloroacetate (DCA), a PDH activator. After
      endotoxin and volume resuscitation, each animal had low systemic vascular
      resistance with normal to high cardiac output. Despite adequate oxygen delivery
      to WB, L, and G, arterial lactate levels rose significantly. A 30-min hypoxic
      challenge (12% FIO2) did not increase lactate levels but did increase WB O2
      uptake. DCA normalized lactate levels without influencing oxygen delivery and
      uptake relations. These data show that lactate levels in endotoxic states may be
      a poor marker of tissue hypoxia and may be more related to PDH activity.

PMID- 1736741
TI  - Flow and volume dependence of respiratory system flow resistance in patients with
      adult respiratory distress syndrome.
AB  - Using a simple and rapid technique, we studied the flow and volume dependence of
      the total resistance of the respiratory system (Rrs) in six patients with ARDS.
      At any given inflation volume, Rrs decreased progressively with increasing flow
      (V) according to the following hyperbolic function: Rrs = a/V + b, where a and b
      are constants. At any fixed inflation flow, Rrs increased progressively with
      increasing inflation volume. The observed flow and volume dependence of Rrs is
      probably mainly due to the viscoelastic properties of the pulmonary and chest
      wall tissues. The flow and volume dependence of Rrs found in the patients with
      ARDS is qualitatively similar to that previously observed in normal anesthetized
      paralyzed subjects. In ARDS, however, Rrs was considerably greater than in the
      normal subjects, indicating that besides a low respiratory compliance ARDS is
      characterized by a high flow resistance. This mainly reflects increased effective
      flow resistance of the pulmonary and chest wall tissues, although airway
      resistance is also higher than normal.

PMID- 1736742
TI  - Resolution of laryngeal injury following translaryngeal intubation.
AB  - Translaryngeal intubation (TLI) causes mucosal ulcerations of the vocal cords and
      posterior laryngeal commissure. Usually these ulcers heal by primary
      reepithelialization, but occasionally laryngeal granulomas or strictures develop
      at these ulcer sites. The incidence of granuloma and stricture formation and the
      variables influencing abnormal laryngeal healing following TLI are not well
      understood. A group of 54 patients who experienced prolonged TLI were followed
      prospectively to determine the resolution rate of laryngeal injury. Direct
      fiberoptic laryngoscopy was performed at either extubation or tracheostomy and
      repeated every 2 wk until the larynx returned to normal or a persistent laryngeal
      abnormality was identified. Laryngeal symptoms were assessed at these same time
      points. In 5 patients (9%) the appearance of the larynx was normal at extubation,
      and in 42 patients (78%) laryngeal healing occurred by primary
      reepithelialization within 8 wk. Four patients (7%) developed laryngeal
      granulomas, which required surgical removal in all but one case. No patients in
      this series developed laryngeal strictures. Three patients (6%) died before
      complete follow-up. Laryngeal symptoms, particularly hoarseness, resolved as the
      larynx healed. Performance of tracheostomy, age, TLI for more than 10 days, and
      severe laryngeal injury at extubation did not influence the median time to
      resolution of laryngeal abnormalities. Abnormal laryngeal healing following TLI
      is uncommon but is not exacerbated by prolonged TLI (more than 10 days), severe
      laryngeal injury at extubation, or performance of a tracheostomy.

PMID- 1736743
TI  - Efficacy of nocturnal nasal ventilation in patients with restrictive thoracic
      disease.
AB  - We tested the efficacy of nocturnal nasal ventilation (NNV) using the BIPAP
      ventilator in patients with restrictive thoracic diseases by withdrawing them
      from NNV for an average of 1 wk. One male and five female patients were enrolled
      in the study; four with restrictive chest wall diseases, and two with muscular
      dystrophies. All patients had chronic CO2 retention (PaCO2 greater than 50 mm Hg)
      and had been improved by using NNV for at least 2 months before the study. Four
      patients were switched to the BIPAP ventilator from standard portable volume
      ventilators at least 1 month prior to the study without changes in gas exchange
      or symptoms. After withdrawal of NNV, patients had no deterioration in daytime
      vital signs, pulmonary functions, maximal inspiratory or expiratory pressures, or
      arterial blood gases compared with measures made immediately before withdrawal
      and 1 wk after resumption. However, patients had more dyspnea at rest, increased
      daytime somnolence, more morning headaches, less daytime energy, and felt less
      rested in the morning during withdrawal of NNV. Furthermore, nocturnal monitoring
      demonstrated greater tachycardia, tachypnea, oxygen desaturation, and
      hypoventilation during withdrawal of NNV. We conclude that NNV administered by
      the BIPAP ventilator is effective in ameliorating nocturnal hypoventilation and
      daytime symptoms in patients with chronic CO2 retention caused by severe
      restrictive thoracic diseases. These data also suggest that the efficacy of NNV
      may depend more on amelioration of nocturnal hypoventilation than on resting of
      ventilatory muscles.

PMID- 1736744
TI  - Effect of breathing pattern and level of ventilation on pulmonary fluid
      filtration in dog lung.
AB  - The effect of breathing pattern and level of ventilation on fluid filtration in
      the lung under edema forming conditions was studied in an in situ left upper lobe
      (LUL) canine preparation. LUL weight was continuously monitored. In Group 1, rate
      of edema formation (delta W/delta t) was measured In seven dogs at two vascular
      pressures (35 and 45 mm Hg) while the LUL was randomly ventilated under six
      conditions. At equivalent vascular pressures and mean airway pressures (Paw) (and
      hence, mean operating lung volume), increasing respiratory frequency (f) enhanced
      delta W/delta t. This was reversed when minute ventilation (VE) was returned to
      baseline by reducing tidal volume (VT), even when Paw were matched to baseline.
      Increasing VT also enhanced delta W/delta t whether VE was increased (J Appl
      Physiol 1988; 64:1900) or not (present study) and whether Paw was matched to
      baseline. In Group 2 delta W/delta t was measured at fixed VT and f while
      inspiratory/expiratory time ratio (TI/TE) was switched from 1:1 to 1:6.
      Shortening inspiratory time by increasing inspiratory flow rate had no effect on
      delta W/delta t. We conclude that increasing VE, whether by raising VT or f,
      promotes greater edema formation by mechanisms that are independent of vascular
      pressure or operating lung volume. Increasing VT appears to have an additional
      adverse effect over and above that of increased VE.

PMID- 1736745
TI  - Cardiac output response to continuous positive airway pressure in congestive
      heart failure.
AB  - The effects of nasal continuous positive airway pressure (CPAP) were examined
      during cardiac catheterization in 22 patients with congestive heart failure
      (CHF). CPAP was applied at a level of 5 cm H2O pressure. Hemodynamic measurements
      were made at baseline and while on CPAP. We hypothesized that patients with high
      left ventricular (LV) diastolic pressures would experience an increase in cardiac
      index (CI). To test this hypothesis, patients were divided into two groups based
      on their baseline pulmonary capillary wedge pressure (PCWP): one group of 11
      whose PCWP was greater than or equal to 12 mm Hg (high-PCWP group) and a second
      group of 11 whose PCWP was less than 12 mm Hg (low-PCWP group). Among the high
      PCWP group (mean PCWP +/- SEM = 19.0 +/- 2.7 mm Hg), CI rose significantly while
      on CPAP (from 2.48 +/- 0.26 to 2.82 +/- 0.26 L/min/m2, p less than 0.01). Stroke
      volume index (SVI) also rose significantly (from 52.6 +/- 7.0 to 64.1 +/- 8.0
      ml/m2, p less than 0.001). In contrast, among the low-PCWP group (PCWP = 8.3 +/-
      0.6 mm Hg), CI decreased significantly while on CPAP (from 3.14 +/- 0.44 to 2.89
      +/- 0.62 ml/m2, p less than 0.025). SVI fell but not significantly while on CPAP
      (from 75.5 +/- 8.4 to 74.2 +/- 8.5 ml/m2). Multiple stepwise linear regression
      analysis revealed that the only significant correlate of the magnitude of change
      in CI in response to CPAP was baseline PCWP (r = 0.50, p less than
      0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736746
TI  - Lipid content of alveolar lining material collected by bronchoalveolar lavage.
      Improved methods for measuring the major lipid classes.
AB  - Current methods for measuring lung lipids obtained by bronchoalveolar lavage are
      time consuming and require sample extraction with organic solvents. Here we
      utilized enzymatic methods for measuring the major phospholipid classes found in
      human bronchoalveolar lavage fluid (BALF), namely phosphatidylcholine and
      phosphatidylglycerol, as well as the neutral lipid cholesterol. These assays can
      be carried out on as little as 200 microliters lavage fluid in 96-well microtiter
      plates without the need for organic solvents. Results were verified by comparison
      with HPLC and chemical methods. The measured values by all three methods were in
      agreement with previous studies in which lipid analysis was performed by thin
      layer chromatography. By contrast to thin-layer chromatography, however, the
      methods described here can be efficiently performed with small quantities of
      material without sacrificing accuracy. This methodology can facilitate the
      characterization of the major surfactant-associated lipids in BALF and foster
      improved understanding of the role of these lipids in human lung disease.

PMID- 1736747
TI  - Polyethylene glycol-conjugated superoxide dismutase attenuates septic lung injury
      in guinea pigs.
AB  - Reactive oxygen species (ROS), including superoxide anions, play an important
      role in mediating acute lung injury. We examined whether polyethylene glycol
      conjugated superoxide dismutase (PEG-SOD) attenuates lung injury in Escherichia
      coli-treated guinea pigs. Twenty-four guinea pigs were divided into four groups:
      (1) control group; (2) septic group, in which live E. coli (2 x 10(9)/kg) were
      injected intravenously; (3) pretreatment group, in which PEG-SOD (2,000 IU/kg)
      was injected intravenously 15 min before E. coli; and (4) posttreatment group, in
      which PEG-SOD (2,000 IU/kg) was injected intravenously 30 min after E. coli. Lung
      injury was assessed by the concentration ratio of 125I-labeled albumin in lung
      tissue and bronchoalveolar lavage (BAL) fluid relative to plasma (L/P and BAL/P),
      lung wet-to-dry weight ratio, and the number of neutrophils in BAL fluid. Plasma
      half-life of PEG-SOD in normal guinea pigs was 13.5 h. L/P, lung wet-to-dry
      weight ratio, and the number of neutrophils in BAL fluid decreased in both
      pretreatment and posttreatment groups compared with the septic group. BAL/P
      decreased in the pretreatment group but not in the posttreatment group compared
      with the septic group. After the animal model studies, we investigated the effect
      of PEG-SOD on the human neutrophil extracellular generation of ROS stimulated by
      phorbol myristate acetate (PMA) in lucigenin-dependent chemiluminescence (CL).
      PEG-SOD at concentrations greater than or equal to 0.1 U/ml inhibited PMA-induced
      CL in a dose-dependent manner. We also examined the effect of PEG-SOD on the
      neutrophil intracellular generation of ROS using flow cytometry to assess
      intracellular hydroethidine oxidation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736748
TI  - Characterization of colony stimulating factor activity in the human respiratory
      tract. Comparison of healthy smokers and nonsmokers.
AB  - The number and function of pulmonary macrophages are critical to lung
      homeostasis. To characterize factors normally present in the human respiratory
      tract that can influence these parameters, bronchoalveolar lavage (BAL) fluid
      obtained from healthy smokers and nonsmokers was assayed for the presence of
      colony-stimulating factor (CSF) activity. Concentrated BAL fluid from both
      populations was capable of inducing incorporation of [3H]thymidine by murine
      macrophages. The mean increase (+/- SEM) in incorporation over control cultures
      not exposed to BAL fluid was 0.98 +/- 0.22 for nonsmokers and 2.25 +/- 1.19 for
      smokers (p less than 0.001). This CSF bioactivity was characterized as macrophage
      CSF (M-CSF) by virtue of its action on murine macrophages, the detection of M-CSF
      protein by a specific ELISA assay, and the inability to detect other macrophage
      active CSFs, granulocyte macrophage-CSF (GM-CSF) and interleukin-3 (IL-3), in a
      proliferation assay employing the MO7E cell line. There was a significant
      correlation between macrophage number in BAL samples and measureable bioactivity
      among both smokers and nonsmokers (r = 0.763; p less than 0.001). This suggested
      that macrophages themselves are a source of the M-CSF detected in BAL fluid. To
      examine this possibility, slot-blot analysis of macrophage RNA was performed.
      Constitutive expression of comparable amounts of M-CSF mRNA and protein was found
      in cells from both smokers and nonsmokers. However, macrophages obtained from a
      randomly selected subset of four smokers but none of five nonsmokers exhibited
      increased production of M-CSF in response to an inflammatory stimulus,
      lipopolysaccharide (LPS; 5 ng/ml). M-CSF added to macrophage cultures was
      degraded by nonsmokers' cells as expected over 24 h.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1736749
TI  - Influence of cigarette smoking on bronchoalveolar lavage cellularity in asbestos
      induced lung disease.
AB  - To investigate the influence of cigarette smoking on bronchoalveolar lavage (BAL)
      cellularity in asbestos-induced lung disease, we compared BAL cells in asbestos
      exposed, nondiseased subjects (n = 20) with those with either asbestosis (n = 25)
      or asbestos-induced pleural fibrosis (n = 28). Patients with asbestosis (ILO
      greater than or equal to 1/0) had higher concentrations of BAL macrophages (p =
      0.04), neutrophils (p = 0.003), and eosinophils (p = 0.01), while patients with
      asbestos-induced pleural fibrosis (circumscribed plaques and diffuse pleural
      thickening) had higher concentrations of BAL lymphocytes (p = 0.02). Within our
      study population, however, cigarette smoking (smoking status or pack-years of
      smoking) was strongly associated with BAL macrophages, neutrophils, and
      eosinophils but was not associated with the concentration of BAL lymphocytes.
      Using multivariate analysis, we found that although asbestosis remained
      associated with higher concentrations of BAL macrophages, neutrophils, and
      eosinophils, cigarette smoking had a far greater contribution to the
      concentrations of BAL macrophages and eosinophils than did asbestosis. Although
      cigarette smoking accounted for 17 to 18% of the variance of BAL macrophages and
      eosinophils, asbestosis was associated with approximately 6% of the variance
      associated with these cells. In contrast, the concentration of BAL neutrophils
      remained associated with asbestosis and was not influenced by smoking behavior.
      We conclude that cigarette smoking strongly influences BAL cellularity
      (macrophages and eosinophils) in our patients with asbestosis but does not appear
      to affect the type or concentration of BAL cells in patients with asbestos
      induced pleural fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736750
TI  - Decreased intrapulmonary killing of Mycoplasma pulmonis after short-term exposure
      to NO2 is associated with damaged alveolar macrophages.
AB  - Previous studies have shown that exposure of pathogen-free C57BL/6N mice to 5 or
      10 ppm NO2 increases the severity of murine respiratory mycoplasmosis and that
      this effect is associated with decreased intrapulmonary killing of Mycoplasma
      pulmonis. The purposes of the present studies were to determine the effects of
      doses of NO2 lower than 5 ppm on pulmonary clearance and to provide experimental
      links between NO2 exposure, defects in intrapulmonary killing, and alterations in
      alveolar macrophages. Exposure to less than 5 ppm NO2 had no effect on
      intrapulmonary killing of M. pulmonis. Bronchoalveolar lavage cells killed M.
      pulmonis in vitro only if they were allowed to associate with mycoplasmas in
      vivo. Prior exposure to NO2 abrogated killing in this in vivo-in vitro model.
      More than 95% of the BAL cells were macrophages, and more than 98% of the cell
      associated mycoplasmas were on or in alveolar macrophages. Immediately after
      exposure, the viability of alveolar macrophages was 89 +/- 4% in the control
      group, 56 +/- 19% in the group receiving M. pulmonis alone, 23 +/- 7% in the
      group receiving 10 ppm NO2, and 16 +/- 6% in the group receiving both M. pulmonis
      and NO2 exposures. Viability was significantly decreased following exposure to 10
      and 5 ppm NO2 but not following exposure to 2 ppm. Both viability and
      intrapulmonary killing were depressed at 3 days after exposure to NO2 but were
      normal by 7 days after exposure. The cellular target of NO2 exposure in relation
      to intrapulmonary killing of M. pulmonis appears to be the alveolar macrophages.

PMID- 1736751
TI  - Evidence for in vivo generation of cytotoxic T cells. PPD-stimulated lymphocytes
      from tuberculous pleural effusions demonstrate enhanced cytotoxicity with
      accelerated kinetics of induction.
AB  - Mycobacterium tuberculosis is a bacterial pathogen capable of survival and
      replication within human macrophages. Cytotoxic T cells are thought to be
      important for the eradication of infected macrophages. To test this hypothesis,
      pleural effusion lymphocytes from patients with tuberculous pleuritis were
      stimulated in vitro with PPD, and proliferation and cytotoxicity were assessed by
      thymidine incorporation and chromium release, respectively. The level and
      kinetics of generation of antigen-specific cytotoxicity were measured and
      compared with those in autologous peripheral blood, control peripheral blood, and
      nontuberculous effusions. Both proliferation and cytotoxicity in tuberculous
      pleural effusions were augmented and accelerated in comparison to autologous or
      control peripheral blood. By contrast, low levels of cytotoxicity were observed
      in nontuberculous effusions, without evidence of accelerated kinetics. Cell
      subset fractionation by panning indicated that the cytotoxicity was mediated by
      CD4+ cells. The accelerated kinetics of induction of PPD-specific cytotoxic T
      cells demonstrated here suggests reactivation of in vivo generated cytotoxic T
      cells. These findings provide evidence that cytotoxic T cells are induced at the
      site of pathology in vivo and suggest that these cells play an important role in
      protection in vivo against infection with tuberculosis.

PMID- 1736752
TI  - Combined toxicity of zidovudine and antituberculosis chemotherapy.
AB  - Because antituberculosis agents and zidovudine are commonly used in HIV-infected
      patients, we performed a cohort study to determine the toxicity of such combined
      therapy. A group of 24 consecutive human immunodeficiency virus (HIV)-infected
      patients with tuberculosis who received concomitant antituberculosis therapy and
      zidovudine (tuberculosis group) were compared with 24 patients who received
      zidovudine but not antituberculosis medications (comparison group). Comparison
      patients were matched to tuberculosis patients by age, sex, ethnic group, month
      of starting zidovudine, and CD4 cell count. Most tuberculosis patients received
      isoniazid, rifampin, pyrazinamide, and ethambutol initially, followed by
      isoniazid and rifampin for a mean total duration of 8.4 months. Baseline clinical
      and laboratory parameters in tuberculosis and comparison patients were similar,
      except for the mean hemoglobin (11.2 g/dl in tuberculosis patients versus 12.9
      g/dl in comparison patients, p = 0.03). The mean zidovudine dose in tuberculosis
      and comparison patients was approximately 500 mg/day, and the mean duration of
      zidovudine therapy was 10.3 and 9.6 months, respectively. Symptoms occurred
      during therapy with similar frequency in both groups. The frequency and severity
      of leukopenia and granulocytopenia were similar in tuberculosis and comparison
      patients, but marked anemia (hemoglobin less than 9.5 g/dl) developed in 50% of
      tuberculosis patients and 17% of comparison patients (p = 0.03). The maximum
      decrease in hemoglobin during therapy was similar in both groups (mean of 2.0
      versus 1.6 g/dl, respectively), suggesting that the higher frequency of marked
      anemia in tuberculosis patients was due to their lower baseline hemoglobin
      values. Although transfusions were required in five tuberculosis patients and one
      comparison patient, zidovudine was not permanently discontinued in any patient
      because of anemia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736753
TI  - Effect of clonidine in obstructive sleep apnea.
AB  - The current treatment of choice for obstructive sleep apnea is continuous
      positive airway pressure. However, not all patients tolerate this form of
      therapy. We evaluated the effect of clonidine hydrochloride, an alpha 2
      adrenergic agonist with REM-suppressant activity, in eight male patients with
      obstructive sleep apnea. In each patient, sleep-stage distribution and breathing
      pattern in two all-night sleep studies performed during a 10-day course of
      clonidine were compared with those of two control and two placebo nights. A dose
      of 0.2 mg of clonidine administered orally at bedtime totally suppressed REM
      sleep in two patients. In the other six patients, the same dose decreased percent
      time spent in REM sleep from a control of 13.4 +/- 1.0 to 8.6 +/- 1.4% (mean +/-
      SEM, p less than 0.05). The latency to REM sleep increased in the latter group
      from a control of 129 +/- 9 to 308 +/- 24 min (p less than 0.001). Clonidine had
      no effect on the frequency and duration of non-REM breathing abnormalities. Under
      clonidine, the level of nocturnal hypoxemia improved in six patients. This was
      due to a total suppression of REM and the consequent lack of REM apneas in two
      patients. In four patients, upper airway obstruction disappeared during period of
      unsuppressed REM sleep, and SaO2 remained above 90% throughout this sleep stage.
      Clonidine transformed the pattern of sleep-disordered breathing during
      unsuppressed REM in the other two patients from that of repetitive obstructive
      hypopneas associated with persistent hypoxemia to occlusive apneas and cyclical
      hypoxemia. These results were observed consistently in all patients during both
      clonidine-sleep studies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736754
TI  - Studies in the genetics of obstructive sleep apnea. Familial aggregation of
      symptoms associated with sleep-related breathing disturbances.
AB  - Previous studies of single families have suggested that familial factors may be
      important in the pathogenesis of obstructive sleep apnea. In this report, the
      role of inheritance in obstructive sleep apnea was assessed by quantitating the
      degree of familial clustering of symptoms associated with sleep-related breathing
      disorders. In total, 272 subjects from 29 families identified through an index
      case with obstructive sleep apnea and 21 control families with no relative known
      to have sleep apnea were studied with questionnaires that ascertained health
      status and symptoms. The unadjusted odds ratios of habitual or disruptive
      snoring, breathing pauses, and excessive day-time sleepiness in subjects with a
      single relative with the same symptom were 1.40 to 1.53 (p less than 0.05). Odds
      ratios increased progressively for subjects with increasing numbers of
      symptomatic relatives). Adjustment for body mass index, age, and gender modestly
      reduced these odds ratios to 1.33 to 1.42. These data suggest a significant
      familial aggregation of symptoms associated with sleep-disordered breathing that
      appears independent of familial similarities in weight.

PMID- 1736755
TI  - Effect of ethanol on the arousal response to airway occlusion during sleep in
      normal subjects.
AB  - The effect of ethanol on the arousal response to airway occlusion during non
      rapid eye movement sleep was studied in normal male subjects by testing the
      response to the occlusion of a face mask covering the nose and mouth on a control
      (C) and an ethanol (E) ingestion (2 ml/kg of 50% vodka) night in random order. In
      part A, five subjects breathed room air while in part B another five subjects
      breathed a mixture of air and oxygen adjusted to maintain a baseline sleeping
      SaO2 of 98%. In both parts, the time to arousal (TTA) was significantly longer on
      E nights. The TTA (mean +/- SEM) in part A on C versus E nights was 14.6 +/- 1.9
      versus 20.6 +/- 1.4 s in stage 2 and 19.9 +/- 1.9 versus 29.2 +/- 1.8 in stage
      3/4 (p less than 0.01). The corresponding values in part B were 22.2 +/- 3.6
      versus 39.9 +/- 8.4 in stage 2 and 32.1 +/- 4.1 versus 63.7 +/- 9.6 in stage 3/4
      (p less than 0.01). In part B, the maximum deflections in airway pressure were
      measured at a supraglottic location during airway occlusion to reflect the degree
      of inspiratory effort. The maximum airway suction pressure preceding arousal was
      significantly higher on E nights. Conversely, the rate of increase in inspiratory
      effort (maximum pressure) during occlusion was decreased by E. We conclude that
      moderate ethanol ingestion prolongs the time to arousal following airway
      occlusion by increasing the threshold of inspiratory effort associated with
      arousal and by decreasing the rate of increase in the magnitude of inspiratory
      efforts.

PMID- 1736756
TI  - Adenosine stimulation, ventilation, and arousal from sleep.
AB  - The mechanism for arousal from sleep resulting from respiratory stimuli is
      unclear. We hypothesized that arousal is a result of increasing ventilation
      during sleep. To determine if this is true we compared minute ventilation at the
      point of arousal from non-REM sleep produced by the respiratory stimulant
      adenosine to that resulting from progressive hypercapnic stimulation. If this
      hypothesis is correct, the quantity of breathing immediately preceding arousal
      from sleep should be similar for each stimulus. We monitored electroencephalogram
      (EEG), electromyogram (EMG), end-tidal CO2, and inspired minute ventilation (VI)
      in five healthy young men during full-night sleep studies. Sleep state was
      monitored during the baseline state, during an intravenous infusion of 80
      micrograms/kg/min of adenosine, and during multiple trials of progressive
      hyperoxic hypercapnia. Arousal from sleep occurred in association with increased
      breathing 4.2 +/- 1.1 times during adenosine infusion, 2.0 +/- 0 times during
      hypercapnic stimulation, and 4.0 +/- 0.6 times in the absence of stimulated
      breathing (spontaneously) per subject. Minute ventilation for the breath
      preceding arousal associated with adenosine stimulation (13.0 +/- 1.4 L/min) was
      similar to that preceding arousal caused by hypercapnia (12.9 +/- 1.1 L/min). In
      each case this level of breathing was greater than that preceding spontaneously
      occurring arousals (8.2 +/- 1.1 L/min), p less than 0.05). Although variable
      between subjects, there was a high correlation for these two variables within
      subjects (R = 0.96, p = 0.01). These data support the hypothesis that increasing
      ventilation induces arousal from sleep when ventilation is increased regardless
      of the stimulus producing this rising drive to breathe.

PMID- 1736757
TI  - Detection of inspiratory resistive loads by heart-lung transplant recipients.
AB  - Human heart-lung transplantation recipients (HL) are models for the effects of
      selective lower respiratory tract denervation. We used a series resistor to
      examine thresholds of inspiratory flow resistance perception among 16 HL in
      comparison with 15 normal control subjects (C) and 12 heart transplant recipients
      (H). HL and C were closely age matched. H subjects were older and had mildly
      reduced lung volumes compared with the other groups. The perception threshold was
      defined as the added resistance (delta R) detected by subjects at 50% of random,
      blinded presentations. These delta R were subsequently expressed as a fraction of
      the airway resistance of the subject and baseline resistance of the apparatus
      (delta R/Raw + Rapparatus), otherwise known as the Weber fraction. The mean +/-
      SEM Weber fractions were nearly identical for HL and C (0.32 +/- 0.05 versus 0.34
      +/- 0.05, respectively). The Weber fraction of H (0.74 +/- 0.17) was
      significantly greater than those of both other groups (p less than 0.05 by
      Kruskal-Wallis test). We conclude that lower respiratory tract afferents do not
      play a significant role in the perception of inspiratory resistive loads. The
      finding of an abnormally high Weber fraction in the heart transplant population
      remains unexplained but may be a function of age or restrictive pulmonary
      defects.

PMID- 1736758
TI  - Relationship of respiratory effort sensation to expiratory muscle fatigue during
      expiratory threshold loading.
AB  - We investigated whether fatigue of the expiratory muscle, that is, the abdominal
      muscle, may account for a change in the respiratory effort sensation in normal
      subjects during expiratory threshold loading. The respiratory effort sensation
      was scored using a modified Borg scale. Expiratory muscle fatigue was assessed
      both from changes in the maximal static expiratory pressure and in the centroid
      frequency (fc) of the abdominal muscle electromyogram (EMG). Expiratory threshold
      loading (magnitude of threshold; 40 to 60% of the maximal expiratory pressure at
      FRC, breathing frequency = 15/min, and duty cycle = 0.5) was continued until
      exhaustion or for 30 min. Loading was repeated following a 15-min recovery period
      after the end of the first expiratory loading. The maximal static expiratory
      pressure during loading (Pmmax) decreased initially and then remained decreased.
      Decreases were smaller with the 40% load (22 +/- 6%, SEM) than with the 60% load
      (37 +/- 3%) (p less than 0.05). The decrease during the second run of the 60%
      load was greater than during the first (p less than 0.01 by ANOVA). The maximal
      expiratory pressure at TLC before the second run of the 60% load was decreased by
      9 +/- 3% compared with the control (p less than 0.02) but that with the 40% load
      was not. The fc with the 60% load decreased initially by 8 +/- 1% and then
      remained constant, although no change was observed with the 40% load.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1736759
TI  - A factor analysis of dyspnea ratings, respiratory muscle strength, and lung
      function in patients with chronic obstructive pulmonary disease.
AB  - The purpose of this study was to demonstrate that clinical ratings of dyspnea and
      physiologic function are separate dimensions underlying the pathophysiology of
      chronic obstructive pulmonary disease (COPD). We used principal-components factor
      analysis to confirm these dimensions using data collected prospectively in 86
      symptomatic patients with COPD. Three different instruments were used to rate
      dyspnea: a modified Medical Research Council (MRC) scale, the oxygen cost diagram
      (OCD), and the baseline dyspnea index (BDI). Measures of physiologic function
      included standard spirometric measures (forced vital capacity [FVC] and forced
      expiratory volume in one second [FEV1]) and maximal inspiratory (PImax) and
      expiratory (PEmax) mouth pressures. Age of the 65 male and 21 female subjects was
      62.9 +/- 1.2 yr (mean +/- SEM). All three clinical scales were significantly
      correlated with physiologic function (range of r values, 0.32 to 0.45; p less
      than 0.05), except for the relationship between the MRC scale and PEmax (r = 
      0.14; p = NS). The factor analysis yielded three factors that accounted for 71.9%
      of the total variance of the data: clinical ratings of dyspnea (MRC scale, OCD,
      and BDI) loaded on the first factor; maximal respiratory pressures and gender
      loaded on the second factor; and lung function and age loaded on the third
      factor. Additional post hoc factor analysis provided similar results when the
      sample was divided into two subgroups by randomization, by severity of dyspnea
      ratings, or by severity of airflow obstruction. We conclude that dyspnea ratings,
      maximal respiratory pressures, and lung function are separate factors or
      quantities that independently characterize the condition of patients with
      COPD.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736760
TI  - Group B streptococcus has no effect on piglet diaphragmatic force generation.
AB  - Recent studies indicate that diaphragmatic contractility is adversely affected by
      bacterial infection. Using transdiaphragmatic pressure (Pdi) with phrenic nerve
      stimulation, the effect of continuous Group B Streptococcus (GBS) infusion on
      diaphragmatic force output was studied in seven anesthetized, spontaneously
      breathing 1-month old piglets. Pdi was measured under baseline condition (50%
      O2/50% N2) and at 1, 2, and 4 h of GBS infusion. The GBS was infused at a level
      that caused a doubling of the pulmonary artery pressure and a 32% decrease in
      cardiac output but which avoided hypotension or acidosis--both of which can
      decrease diaphragmatic contractility. In addition, the piglets were kept
      hyperoxic (PaO2 greater than 100) and no piglet with hypercapnia (PaCO2 greater
      than 65) was studied, as hypoxia and hypercapnia also can cause respiratory
      muscle dysfunction. Pdi in response to phrenic nerve stimulation did not change
      during GBS infusion. We conclude that GBS infusion, in the absence of
      hypotension, hypercapnia, hypoxia, or acidosis, has no effect on diaphragmatic
      force generation in the piglet.

PMID- 1736761
TI  - The impact of grain dust on respiratory health.

PMID- 1736762
TI  - Evaluation of a new method for assessing arterial oxygen pressure, avoiding
      arterial blood collection.
AB  - Arterial computed PO2 (PO2 com) was computed from SaO2 ear and finger capillary
      pH using equations of Severinghaus and Ellis, and compared with measured arterial
      PaO2 in 100 patients with chronic obstructive pulmonary disease (76 men, aged 42
      to 82 yr). SaO2 ear ranged from 73 to 98%. There was no significant difference
      between SaO2 ear and SaO2 com (calculated from PaO2 and arterial pH), nor between
      arterial pH and pHc (capillary blood). Mean directly measured finger capillary
      oxygen tension, PcO2, was lower than PaO2 by 10.1 mm Hg +/- 5.4 SD. Mean bias of
      (PaO2-PO2 com) was -0.22 mm Hg +/- 2.6 SD. When subdivided by range, bias, and SD
      of mean bias of (PaO2-PO2 com) were -0.47 mm Hg +/- 2.5 with SaO2 ear less than
      95% and 0.1 mm Hg +/- 2.9 with SaO2 ear greater than 95%. We conclude that PaO2
      may be reliably computed from SaO2 ear and capillary pH when SaO2 ear is less
      than 98%.

PMID- 1736763
TI  - Direct effects on airway smooth muscle contractile response caused by endothelin
      1 in guinea pig trachealis.
AB  - Endothelin-1 (ET-1), a peptide derived from vascular endothelial cells, causes
      tracheal smooth muscle (TSM) relaxation followed by sustained contraction when
      administered intravenously in guinea pigs by a mechanism that depends upon an
      intact airway epithelium. To elucidate the potential role of the epithelium in
      modulating the response to ET-1 and the potential effects of local release of ET
      1, we studied the effects of topical application of ET-1 to a segment of TSM in
      situ. An epithelium smooth muscle preparation that does not disrupt normal
      anatomic relationships was used; smooth muscle contraction was measured
      isometrically in vivo. Application of 10(-10) mol/cm2 ET-1 to the epithelial
      surface in six animals caused 2.27 +/- 0.45 g/cm active tension (AT) of the TSM
      segment after 30 min (p less than 0.05 versus baseline); an initial relaxation
      response was not observed. Endothelin-1 was dose-dependent and was 1,000 times
      more potent than acetylcholine in causing AT in TSM. Pretreatment with ET-1 did
      not alter the subsequent response to acetylcholine. Contraction elicited by
      topical application of ET-1 persisted greater than 3 h. In five animals in which
      the epithelium was removed, 10(-10) mol/cm2 ET-1 caused 4.45 +/- 0.92 g/cm AT
      after 30 min (p less than 0.05 versus intact epithelium). These data suggest that
      topical application of ET-1 elicits responses that are different from those
      elicited in the same preparation after intravenously administered ET-1: (1) TSM
      contraction that is not preceded by a transient relaxation phase, and (2)
      contraction that is not reduced after removal of the epithelium.

PMID- 1736764
TI  - Isoniazid-associated hepatitis deaths: a review of available information.

PMID- 1736765
TI  - Assessing precision and accuracy in blood gas proficiency testing.

PMID- 1736766
TI  - Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for
      candidal vaginitis.
AB  - OBJECTIVE: To assess whether daily ingestion of yogurt containing Lactobacillus
      acidophilus prevents vulvovaginal candidal infections. DESIGN: Crossover trial
      for at least 1 year during which patients were examined for candidal infections
      and colonizations while receiving either a yogurt-free or a yogurt-containing
      diet. Patients served as their own controls. SETTING: Ambulatory infectious
      disease center in a teaching hospital providing tertiary care. PATIENTS: Thirty
      three women with recurrent candidal vaginitis were eligible after recruitment
      from community practices and clinics and through advertising. Twelve patients
      were eliminated for protocol violations. Of the remaining 21 patients, 8 who were
      assigned to the yogurt arm initially refused to enter the control phase 6 months
      later. Thus, 13 patients completed the protocol. INTERVENTIONS: Women ate yogurt
      for 6 months of the study period. MEASUREMENTS: Colonization of lactobacilli and
      candida in the vagina and rectum; candidal infections of the vagina. MAIN
      RESULTS: Thirty-three eligible patients were studied. A threefold decrease in
      infections was seen when patients consumed yogurt containing Lactobacillus
      acidophilus. The mean (+/- SD) number of infections per 6 months was 2.54 +/-
      1.66 in the control arm and 0.38 +/- 0.51 per 6 months in the yogurt arm (P =
      0.001). Candidal colonization decreased from a mean of 3.23 +/- 2.17 per 6 months
      in the control arm to 0.84 +/- 0.90 per 6 months in the yogurt arm (P = 0.001).
      CONCLUSION: Daily ingestion of 8 ounces of yogurt containing Lactobacillus
      acidophilus decreased both candidal colonization and infection.

PMID- 1736767
TI  - Evaluation of syncope by upright tilt testing with isoproterenol. A nonspecific
      test.
AB  - OBJECTIVE: To determine the proportion of patients with syncope of unknown
      etiology who have a positive response to upright tilt testing and to determine
      the specificity of this test as a marker for vasodepressor syncope. DESIGN:
      Comparison of upright tilt testing with isoproterenol in patients with syncope of
      unknown etiology and in controls. SETTING: Outpatient clinics of a tertiary care
      center. PATIENTS: A total of 20 patients with syncope of unknown etiology and 40
      controls matched by age, sex, and lack of underlying cardiovascular or other
      diseases had upright tilt testing with isoproterenol infusion. Controls consisted
      of two groups (groups I and II) who had slightly different methods of tilt
      testing in conjunction with isoproterenol. INTERVENTIONS: Upright tilt testing at
      80 degrees from horizontal was done for up to 15 minutes. If end points were not
      reached, infusion of isoproterenol was started at 1 microgram/min and increased
      with graded increments in infusion rates up to 5 micrograms/min. MEASUREMENTS:
      The development of syncope or presyncope in association with hypotension,
      bradycardia, or both. MAIN RESULTS: Positive response to tilt testing in patients
      with syncope was 75% (95% CI, 55% to 95%); it was 65% in control group I (CK, 44%
      to 86%) and 45% in control group II (CI, 20% to 70%). Case patients and controls
      with positive tilt-test responses were similar with respect to time to completion
      of the test, mean total isoproterenol dose, mean isoproterenol dose level at
      completion, average mean blood pressure at completion, mean heart rate at
      completion, mean decline in systolic blood pressure, and decline in mean blood
      pressure or heart rate (P greater than 0.05 for all comparisons). Further,
      symptoms during tilt testing in case patients with positive responses were
      similar to those in controls with positive tilt-test results. CONCLUSIONS: The
      rate of positive tilt testing in patients with syncope is equivalent to that in
      controls without a history of syncope. The low specificity of this test makes its
      use as a marker for vasodepressor syncope questionable.

PMID- 1736768
TI  - Treating sickle cell pain like cancer pain.
AB  - OBJECTIVE: To assess the effect of a structured analgesic regimen on hospital use
      by patients with sickle cell disease. INTERVENTION: Intravenous and oral
      controlled-release morphine was used instead of intramuscular meperidine and
      short-acting oral opioids for the treatment of sickle cell pain. DESIGN: Time
      series in which emergency and admission records for four 6-month periods before
      and two 6-month periods after the institution of the new analgesic protocol were
      reviewed. SETTING: Inner-city university hospital providing care for adults with
      sickle cell disease. PATIENTS: All patients (an average of 50) who used the
      emergency department of the inpatient medical service for treatment of sickle
      cell crisis during the study periods. MEASUREMENTS AND MAIN RESULTS: The number
      of admissions for sickle cell pain decreased by 44%, total inpatient days by 57%,
      length of hospital stay by 23%, and the number of emergency department visits by
      67% after initiation of the morphine protocol. Hospital use remained at these
      lower levels one year later. Similar declines were seen for a subset of 15
      patients who had a history of frequent admissions for sickle cell pain and who
      used this hospital exclusively and accounted for more than half of the admissions
      for sickle cell disease. CONCLUSIONS: A pain-control program modeled on regimens
      used to treat chronic cancer pain reduced hospital use by adult patients with
      sickle cell pain.

PMID- 1736769
TI  - Mechanical restraint use and fall-related injuries among residents of skilled
      nursing facilities.
AB  - OBJECTIVE: To evaluate the association between mechanical restraint use and the
      occurrence of injurious falls among persons residing in skilled nursing
      facilities. DESIGN: Prospective observational cohort study. SETTING: Twelve
      skilled nursing facilities in southern Connecticut. PARTICIPANTS: The 397 persons
      who were mobile and unrestrained at baseline. MEASUREMENTS: Restraint use was
      defined both as the number of days restrained and as "never," "intermittently,"
      or "continually" restrained. The primary outcome measure was the occurrence of a
      serious fall-related injury. Analyses were done on the entire cohort as well as
      on a subgroup hypothesized as having a high risk for falls. MAIN RESULTS: During
      one year of follow-up, 122 subjects (31%) became restrained, 83 intermittently
      and 39 continually. A serious fall-related injury was experienced by 5% (15 of
      275) of unrestrained, compared with 17% (21 of 122) of restrained, subjects (chi
      square = 12.478; P less than 0.001). Restraint use remained independently
      associated with serious injury after adjusting for other factors, both in the
      entire cohort (adjusted odds ratio, 10.2; 95% CI, 2.8 to 36.9) and in the high
      risk subgroup (adjusted odds ratio, 6.2; CI, 1.7 to 22.2). Among the 305 subjects
      who experienced two or fewer falls, the proportion having a serious injury was
      15% for restrained subjects compared with 4% for unrestrained subjects
      (difference in proportions 11%, CI, 4% to 17%), whereas the comparable
      proportions for the 92 subjects who experienced more than two falls were 20% and
      16%, respectively. Results were similar in the high-risk subgroup. CONCLUSIONS:
      Mechanical restraints were associated with continued, and perhaps increased,
      occurrence of serious fall-related injuries after controlling for other injury
      risk factors. Study results suggest the need to consider whether restraints
      provide adequate, if any, protection.

PMID- 1736770
TI  - Efficacy and risks of moricizine in inducible sustained ventricular tachycardia.
AB  - OBJECTIVE: To assess the efficacy and toxicity of moricizine in treating patients
      with serious ventricular arrhythmias and inducible sustained ventricular
      tachycardia. DESIGN: Uncontrolled clinical trial. SETTING: The intensive care and
      telemetry units of Northwestern Memorial Hospital, St. Francis Hospital and
      Medical Center, and Lenox Hill Hospital. PATIENTS: Twenty-six patients with
      sustained ventricular arrhythmias or hemodynamically significant nonsustained
      ventricular tachycardia, most of whom failed therapy with at least one class I
      antiarrhythmic agent. INTERVENTION: Patients were treated with moricizine, 400 to
      1000 mg/d. MEASUREMENT: Efficacy was assessed by the results of programmed
      ventricular stimulation done during moricizine therapy. MAIN RESULTS: Seven of
      the 26 patients (27%) developed life-threatening ventricular proarrhythmia during
      moricizine loading. Three patients had incessant sustained ventricular
      tachycardia, two had incessant nonsustained ventricular tachycardia, one had new
      sustained ventricular tachycardia, and one had new cardiac arrest. One of these
      patients died of intractable ventricular fibrillation. No clinical or
      electrophysiologic variables clearly identified those at risk for proarrhythmia.
      Only 3 of 26 patients (12%) became noninducible on moricizine. CONCLUSION:
      Moricizine has a low rate of efficacy and carries a considerable risk for life
      threatening proarrhythmia in patients with serious ventricular arrhythmias and
      inducible ventricular tachycardia who have failed therapy with other class I
      antiarrhythmic agents.

PMID- 1736771
TI  - Electrophysiologic response to moricizine in patients with sustained ventricular
      arrhythmias.
AB  - OBJECTIVE: To assess the short-term efficacy and safety of moricizine in patients
      receiving electrophysiologically guided therapy for sustained ventricular
      arrhythmias refractory to treatment with class IA antiarrhythmic agents. DESIGN:
      Uncontrolled clinical trial. SETTING: Referral-based teaching medical center.
      PATIENTS: Twenty-one patients (18 of whom had coronary artery disease) with a
      mean left ventricular ejection fraction of 32% +/- 11% who presented with
      sustained ventricular tachycardia (13 patients), syncope (4 patients), or cardiac
      arrest (4 patients). INTERVENTIONS: Moricizine, 743 +/- 85 mg daily.
      MEASUREMENTS: Electrophysiologic testing in the drug-free state and after
      administration of moricizine unless sustained arrhythmias occurred. MAIN RESULTS:
      Sustained ventricular tachycardia was inducible in the absence of antiarrhythmic
      drugs in 20 patients and was not suppressed by moricizine in any patient. Four
      patients had six episodes of spontaneous ventricular tachycardia while receiving
      moricizine. A probable proarrhythmic response occurred in four patients.
      CONCLUSION: In patients with compromised left ventricular function caused by
      coronary artery disease in whom class IA antiarrhythmics were ineffective,
      moricizine was ineffective in suppressing sustained ventricular arrhythmias and
      resulted in proarrhythmic effects in some patients.

PMID- 1736772
TI  - Graft-versus-host disease in a liver transplant recipient.

PMID- 1736773
TI  - Prudent strategies for elective red blood cell transfusion.
AB  - OBJECTIVE: To review the literature on the appropriateness of red blood cell
      transfusion and current physician practice, with emphasis on the physiologic and
      symptomatic implications of elective transfusion in the treatment of anemia. DATA
      SOURCES: Studies on the therapeutic use of red blood cell transfusion were
      identified through a search of MEDLINE (1966 to the present) and through a manual
      review of bibliographies of identified articles. In addition, evidence was
      solicited from selected experts in the field and recent consensus panels that
      have developed transfusion guidelines. DATA SYNTHESIS: No controlled trials of
      blood transfusion were identified, but data were available on four issues
      relevant to transfusion practice: current physician practice and evidence for
      excessive use of red blood cell transfusion; physiologic adaptation to anemia;
      human tolerance of low hemoglobin levels; and strategies for reducing homologous
      transfusion requirements. CONCLUSIONS: Despite the recent decline in red blood
      cell use because of concerns about infection, current transfusion practice
      remains variable because physicians have disparate views about its
      appropriateness. The remarkable human tolerance of anemia suggests that
      clinicians can accept hemoglobin levels above 70 g/L (7 g/dL) in most patients
      with self-limited anemia. In patients with impaired cardiovascular status or with
      anemias that will not resolve spontaneously, however, the data are insufficient
      to determine minimum acceptable hemoglobin levels, and therapy must be guided by
      the clinical situation. Several therapeutic strategies and pharmacologic
      interventions are available in the perioperative and non-operative settings to
      further reduce red blood cell use.

PMID- 1736774
TI  - The corporate organization of hospital work: balancing professional and
      administrative responsibilities.
AB  - The development of the hospital into a corporation has influenced the care of
      patients and the work of the professional staff. As a corporate enterprise, the
      modern hospital has a private agenda aimed at increasing growth and efficiency
      with an emphasis on technical services, professionals as employees, and patients
      as customers. These changes have resulted in a decrease in trustee and
      professional authority and an increase in administrative control. This shift in
      the control structure has continued in response to the need for accounting and
      regulation of services and in response to demands for increased growth and
      efficiency made by an increasingly competitive market environment. Strategies for
      the reorganization of hospital staff aimed at improving both inpatient and
      outpatient care are reviewed. The reorganization of the institution and staff,
      using either a staff group-practice corporation or an administrative staff model,
      is proposed. Clinicians have new responsibilities for developing collective
      arrangements for institutional governance, for allocating institutional
      resources, for providing public accountability regarding the use of these
      resources, and for defining the missions of care.

PMID- 1736775
TI  - Enriching the doctor-patient relationship by inviting the patient's perspective.
AB  - Doctors and patients alike are saddened and angered by the distance that
      increasingly interferes with their interactions. Two complementary strategies may
      enhance the human quality of clinical care and improve outcomes. First, the
      doctor and patient can undertake a systematic "patient's review" that addresses
      seven dimensions of care: 1) respect for patient's values, preferences, and
      expressed needs; 2) communication and education; 3) coordination and integration
      of care; 4) physical comfort; 5) emotional support and alleviation of fears and
      anxieties; 6) involvement of family and friends; and 7) continuity and
      transition. Incorporating the "review" into the clinical encounter encourages
      both patient and doctor to confront individual preferences and values and offers
      patients an explicit framework for participating actively in their care. Second,
      using survey instruments designed to solicit focused reports from patients that
      address each dimension of care, doctors can gather aggregate feedback about their
      practices. Such reports move beyond anecdote and can serve as screening tests
      that uncover areas in doctors' practices that merit improvement. In addition,
      patients can join doctors in developing solutions to problems uncovered by
      patients' reports.

PMID- 1736776
TI  - Lactobacillus prophylaxis for Candida vaginitis.

PMID- 1736777
TI  - An invitation to join a controversy.

PMID- 1736778
TI  - The nicotine transdermal patch: a cautionary note.

PMID- 1736779
TI  - Wilson disease--penicillamine therapy and late presentation.

PMID- 1736780
TI  - Wilson disease--penicillamine therapy and late presentation.

PMID- 1736781
TI  - Serum cholesterol as a prognostic factor after myocardial infarction.

PMID- 1736782
TI  - Reversal of the nephrotic syndrome by colchicine in amyloidosis of familial
      Mediterranean fever.

PMID- 1736783
TI  - Rheumatoid arthritis-like disease after alpha-interferon therapy.

PMID- 1736784
TI  - Mortality rate of community-acquired pneumonia: 1944 and today.

PMID- 1736785
TI  - Hepatitis B--an occupational risk for butchers?

PMID- 1736786
TI  - Testing remedies for the shortage of organs.

PMID- 1736787
TI  - "A poisoned tooth".

PMID- 1736788
TI  - Intraoperative parathyroid hormone estimation: a valuable adjunct to parathyroid
      surgery.
AB  - Serial measurements of serum intact parathyroid hormone (PTH) and adjusted total
      calcium levels were performed on 10 patients during unilateral neck exploration
      for a solitary parathyroid adenoma localised preoperatively by ultrasound scan.
      Frozen section was performed peroperatively to establish the presence of
      parathyroid tissue. Levels of PTH were shown to be within the normal range within
      15 min of adenoma removal (a mean of 13.4% of their preoperative values),
      allowing clear early distinction from unsuccessful surgery where no change
      occurred. Frozen section wrongly identified thyroid tissue as parathyroid in one
      case leading to a failure of the initial neck exploration. Our findings show that
      intraoperative PTH measurements can accurately predict whether all
      hyperfunctioning parathyroid tissue has been removed. This is not always possible
      using frozen section techniques. The wider use of intraoperative PTH measurement,
      particularly in difficult cases, may avoid the need for prolonged explorations to
      identify all four glands and, perhaps, biopsy of normal glands, replacing the
      current standard use of frozen section as a more reliable indicator of the
      success of parathyroid surgery.

PMID- 1736789
TI  - Paraoesophageal hiatus hernia: surgery for all ages.
AB  - The results of surgery for paraoesophageal hiatus hernia over a 10-year period
      have been studied. From a group of 26 symptomatic patients, elective repair has
      been undertaken in 20 (mean age of 65.6 years) and emergency repair in four (mean
      age of 73.1 years). Emergency surgery was associated with a fivefold increase in
      mortality, and anatomical repair gave a satisfactory result in 90% (CI 77-100) of
      survivors. Surgical treatment should be considered for all symptomatic patients
      with paraoesophageal hiatus hernia.

PMID- 1736790
TI  - Contamination of underwater seal drainage systems in thoracic surgery.
AB  - The incidence of bacteriological contamination of drainage fluid (water
      constituting the underwater seal plus drainage effluent) was studied in 38
      patients (50 chest drains), up to 6 days after thoracotomy. No bacteriological
      contamination was demonstrated in any of the samples taken during this period of
      time. We conclude that the underwater seal drainage system may be left for up to
      6 days postoperatively without change of any of its components and without risk
      of contamination.

PMID- 1736791
TI  - Management of synchronous arterial occlusions using intra-arterial thrombolysis.
AB  - Three patients presented with multiple acute arterial occlusions in separate limb
      vessels. The diagnosis was confirmed by angiography. Each patient was
      successfully treated by simultaneous infusion of low-dose intra-arterial
      streptokinase into each occlusion. All of the patients were improved clinically
      and in two patients completely normal pressure indices were restored.

PMID- 1736792
TI  - Unsuccessful outpatient counselling to help patients with peripheral vascular
      disease to stop smoking.

PMID- 1736793
TI  - Injury to the superior mesenteric artery during pancreatectomy for chronic
      pancreatitis.
AB  - Four cases are described of injury to the superior mesenteric artery (SMA) during
      pancreatectomy for chronic pancreatitis. Review of the literature indicates that
      this is a rare event. In three patients (arterial ligation, 2; haemorrhage, 1),
      the injury was immediately recognised and successfully repaired. In the fourth
      (with probable occlusion of the vessel), the problem was not appreciated at
      operation and the patient eventually died. Vessels adherent to a pseudocyst are
      at particular risk of injury, as in two of our patients. Two patients had ectopic
      origin of the right hepatic artery. Since awareness of such vascular anomalies is
      important, we now perform selective mesenteric angiography in all patients
      requiring pancreatic resections, whether proximal or distal.

PMID- 1736794
TI  - How does computer-aided diagnosis improve the management of acute abdominal pain?
AB  - The introduction of standardised data-collection forms and computer-aided
      diagnosis has been found to be associated with improved diagnosis and management
      of patients with acute abdominal pain. The mechanism by which such benefits
      accrue has been the subject of some controversy. Detailed analysis of 5193
      patients from one hospital shows that the major benefit from such diagnostic aids
      was the accurate early diagnosis of non-specific abdominal pain by senior house
      officers in the accident and emergency department; this in turn led to fewer
      admissions and fewer operations with negative findings. Clinical data about
      patients with acute abdominal pain should be recorded on structured information
      sheets by junior doctors and early positive diagnosis should be encouraged before
      decisions affecting the patient's management are made. Improved computer support
      may confer further benefits.

PMID- 1736795
TI  - Combined surgical audit by microcomputer involving units in four health regions.
AB  - General surgeons from hospitals in four well-separated health districts collected
      audit data about their patients using common software. They pooled their results
      in order to make comparisons between their practices. Data on 22,497 admissions
      including 17,473 operations were available. The data were found to be easy to
      collect and analyse using this program. There were significant differences in
      overall complication rates between the four centres, but these seem to be
      explained by differences in the emergency workload, case mix, and age range of
      the population treated. A study of inguinal hernia repairs and appendectomies
      showed low complication rates with no significant differences between centres,
      with the single exception of a higher incidence of wound problems in one centre.
      Because of the multiplicity of factors affecting them, complication rates could
      only be properly understood in a professional surgical context. Isolated figures
      would be open to damaging misrepresentation. Meetings between surgeons well armed
      with their own results seem to be the best way to forward the audit process.

PMID- 1736796
TI  - Prevention of occupational transmission of HIV in the ENT clinic.
AB  - Much attention has been focused on the risks of inoculation with the human immune
      deficiency virus in the operating theatre. However, less emphasis has been placed
      on infection resulting from outpatient exposure to this pathogen. A survey of
      current protective measures undertaken by ENT consultants in the outpatient
      clinic in the United Kingdom is presented. The precautions employed by the
      majority of these subjects are inadequate and non-universal. A review of the risk
      factors and subsequent safety recommendations is detailed.

PMID- 1736797
TI  - Blood transfusion: an overused resource in colorectal cancer surgery.
AB  - The use of blood transfusion was examined in 476 patients who underwent curative
      surgery for large bowel cancer. Of these patients, 128 were not transfused while
      348 received a total of 1174 units of blood. A patient was considered over
      transfused if the predischarge haemoglobin was more than 12 g/dl. Using this
      criteria and accepting that single unit transfusions should be avoided,
      transfusion could have been avoided in 30% of the patients and a total of 377
      units were given unnecessarily. Major under-transfusion did not occur; no patient
      being discharged with a haemoglobin of less than 9 g/dl. This study shows that
      blood transfusion is overused and the reasons for its use rarely recorded. In
      view of the morbidity related to transfusion, it is suggested that surgeons and
      anaesthetists reappraise their transfusion policy and the first step in this must
      be to record the reason for transfusion.

PMID- 1736798
TI  - Surgical excision alone is adequate treatment for primary colorectal cancer.
AB  - This debate examines the arguments for and against the proposal that surgical
      excision alone is adequate treatment for primary colorectal cancer. The arguments
      in favour are that the results from curative surgery are excellent and that
      despite many trials of adjuvant chemotherapy, radiotherapy and immunotherapy, the
      proposed benefits remain unproven. Recent improvements in surgical technique,
      particularly for dissection of rectal tumours, have shown the way towards further
      improvement using surgery alone, and it is clear from a national survey that
      technical factors related to individual surgeons play a large part in determining
      recurrence rates. With optimum primary treatment, surgical excision alone is
      indeed adequate therapy. The arguments against this motion are that although a
      considerable number of patients do survive with surgery, the 5-year survival rate
      is poor when there is extensive local invasion or lymphatic metastases. Surgery
      starts therapy by reducing the tumour load, but other modalities are required to
      destroy the cells which might subsequently develop into metastases. Trial results
      with adjuvant therapy are encouraging, although many contain too few patients. We
      cannot be content with the results of treatment of Dukes' Stage B and C tumours;
      more trials are needed to determine the best treatment for these patients.

PMID- 1736799
TI  - Portoenterostomy scissors: a new instrument for surgery in the porta hepatis.
AB  - A new design of scissors is described which has been found to be extremely useful
      during dissection of the porta hepatis. In particular its use is recommended for
      the portoenterostomy procedure of infancy (Kasai's operation).

PMID- 1736800
TI  - Simulated laparoscopic cholecystectomy.
AB  - A new simulator specifically designed for practising techniques in laparoscopic
      cholecystectomy is described. The simulator is inexpensive and utilises pig
      gallbladders. It allows a surgeon to practice without the need for assistance.

PMID- 1736801
TI  - Cetrimide lavage: ineffective and potentially toxic.

PMID- 1736802
TI  - A controlled trial of short-term versus standard axillary drainage after axillary
      clearance and iridium implant treatment of early breast cancer.

PMID- 1736803
TI  - Pulse oximetry in closed limb fractures.

PMID- 1736804
TI  - Assessment of burn injury in the accident and emergency department: a review of
      100 referrals to a regional burns unit.

PMID- 1736805
TI  - CA15-3: a reliable indicator of metastatic bone disease in breast cancer
      patients.
AB  - Carcinoma of the breast is the most common malignancy in women and is frequently
      associated with metastatic bone disease and its associated osteolytic morbidity
      and mortality. Traditional radiological methods for mass screening bony
      secondaries are not cost-effective. We examined the value of the tumour marker
      'CA15-3' as an alternative to conventional isotope bone scintigraphy. A total of
      218 patients with breast cancer was evaluated over a 4-year period. Venous CA15-3
      levels were obtained at 3-monthly intervals and bone scintigraphy annually or if
      the patient developed locomotor symptoms or exhibited elevated CA15-3 levels. Of
      these patients, 33 with metastatic breast carcinoma had an elevated tumour marker
      level at the time of diagnosis of their metastases; bone metastases alone = 15/17
      (88%), soft tissue metastases alone = 2/6 (33%), simultaneous bony and soft
      tissue metastases = 7/10 (70%). The preponderance of an elevated CA15-3 in
      metastatic bone disease, be it in isolation or in combination with non-bone
      metastases, yields a sensitivity, specificity and positive predictive value of
      81.5%, 66% and 92%, respectively. Although 22 of the 27 patients had an elevated
      CA15-3 at the time of diagnosis of their bone metastases, the remaining five
      patients (with tumour marker levels in the normal range) showed a similar, albeit
      a delayed, increase (median = 3 months). Thus, all metastatic bone disease
      patients demonstrated elevated marker levels. We recommend CA15-3 as a simple,
      reliable and inexpensive screening method for detecting bone metastases in the
      patient with breast carcinoma.

PMID- 1736806
TI  - Measuring change in surgical practice.
AB  - We reviewed the work of a single general surgical firm over six years--about
      11,500 patient episodes. Although the workload remained approximately constant, a
      severe reduction in the number of available beds was accompanied by a marked
      change towards shorter duration of stay. This affected particularly the elective
      cases. Previous authors, when trying to predict requirement of hospital beds,
      have accepted that duration of stay and number of beds available are independent
      variables; this was not what we observed.

PMID- 1736807
TI  - A weekend orthopaedic initiative list scheme.
AB  - The feasibility and safety of running an elective orthopaedic service at the
      weekend is demonstrated. Weekend timing of such surgery appears to be very
      popular with patients. The cost of not assessing patients pre-operatively in
      terms of theatre time lost is shown.

PMID- 1736808
TI  - A guide to the use of electronic bulletin boards.
AB  - Data transfer between distant computers is potentially a rapid and efficient
      method of gathering and disseminating information. Bulletin Boards can coordinate
      this activity but their benefit is proportional to the number of users. The
      initial telephonic connection between computers and the subsequent data transfer
      is complex; this review attempts to explain some of the theory and problems
      involved.

PMID- 1736809
TI  - Further studies with short duration ribavirin aerosol for the treatment of
      influenza virus infection in mice and respiratory syncytial virus infection in
      cotton rats.
AB  - Ribavirin aerosol administration has been shown to be effective in the treatment
      of respiratory syncytial virus (RSV) infections in infants and in influenza A and
      B virus infections in young adults. Long treatment schedules and potential for
      environmental contamination have stimulated the search for alternative dosing
      schedules. Thus, we attempted to determine the length of time of ribavirin
      aerosol necessary for effective treatment of influenza and RSV. In RSV-infected
      cotton rats, aerosolization for just 30 min with high-dose ribavirin (HDR:60 mg
      ribavirin/ml in reservoir), 3 times daily, reduced viral lung titers/gm of tissue
      by 1.1 log10. In influenza virus-infected mice, 15 min of aerosolized HDR, 3
      times daily, was effective in reducing both mortality and pulmonary virus titers
      (1.1 log10 reduction). When the intervals between aerosol administration each day
      were equally divided (i.e., q.8 h), the treatments were most effective. Treatment
      for 45 min, once daily, was not as effective as divided doses. Calculations of
      ribavirin concentrations in respiratory secretions following 15 min treatment in
      mice with HDR indicated that drug levels dropped below the ED50 for influenza
      viruses after about 9 h. A daily dosage of ribavirin, estimated to be 8-15 mg/kg,
      was effective for the treatment of influenza and RSV infections.

PMID- 1736810
TI  - A comparison of gag, pol and rev antisense oligodeoxynucleotides as inhibitors of
      HIV-1.
AB  - Sequences from the gag, pol and rev regions of the RF strain of HIV-1 (HIV-1RF)
      were chosen as targets for antisense phosphorothioate oligodeoxynucleotides (S
      oligos). These sequences were the p18/p24 junction in gag, the active site of HIV
      protease in pol; a sequence from the first exon of the rev gene and S
      oligodeoxycytidylic acid controls. Compounds were tested against HIV-1 in both
      acutely and chronically infected cells. The results show that these
      phosphorothioate analogues tested in acutely infected cells were active in the
      0.1-2 microM range, were dependent on chain length but had no sequence
      specificity. To study the mechanism of action, the time of addition of S-oligos
      to acutely infected cells was delayed for up to 48 h post-infection. It was found
      that antiviral activity was lost when compounds were added to the cultures later
      than 10 h post-infection. With chronically infected cells only the antisense rev
      sequence showed activity at 30 microM and neither of the gag or pol antisense
      sequences has a significant effect on HIV replication at 50 microM. These results
      are consistent with previous in vitro studies which demonstrate that antisense S
      oligodeoxynucleotides have several modes of action.

PMID- 1736811
TI  - Comment on the paper: A three-dimensional model to analyze drug-drug
      interactions. Prichard, M.N. and Shipman, C., Jr. (1990) Antiviral Res. 14, 181
      206.

PMID- 1736812
TI  - Practice models for perioperative nursing, effectiveness initiative being
      explored by Project Teams.

PMID- 1736813
TI  - Intraoperative echocardiography. An essential tool in cardiac surgery.

PMID- 1736814
TI  - Arterial blood gas interpretation. Improving perioperative skills.

PMID- 1736815
TI  - Reducing blood contamination and injury in the OR. A study of the effectiveness
      of protective garments and OR procedures.

PMID- 1736816
TI  - From thesis to publication. Preparing your school paper for publication.

PMID- 1736817
TI  - Position statement on the role of the RN in the management of patients receiving
      i.v. conscious sedation for short-term therapeutic, diagnostic, or surgical
      procedures.

PMID- 1736818
TI  - Position statement on the role of the RN in the management of analgesia by
      catheter techniques (epidural, intrathecal, intrapleural, or peripheral nerve
      catheters).

PMID- 1736819
TI  - AORN quality improvement standards for perioperative nursing.

PMID- 1736820
TI  - Proposed recommended practice. Steam and ethylene oxide (EO) sterilization.

PMID- 1736821
TI  - AIDS and nursing. Attitudes and knowledge of AIDS affect comfort in providing
      care.

PMID- 1736822
TI  - Passing surgical instruments, sharps without injury.

PMID- 1736823
TI  - Advance directives and the Patient Self-Determination Act.

PMID- 1736824
TI  - Injectable local anesthetics.

PMID- 1736825
TI  - Annotated tray lists save time, decrease errors.
AB  - We have achieved more consistency in instrument processing by using the annotated
      tray lists. This improved consistency has resulted in fewer errors and damaged
      instruments. Important tasks, such as lubricating the instruments, are not being
      overlooked inadvertently or performed incorrectly by staff. Productivity has
      increased because information is available when questions arise. Technicians do
      not have to look through large procedure manuals or ask other technicians to
      identify instruments and perform specific procedures. While the tray lists do not
      replace formal procedure manuals, they are helpful adjuncts for personnel who
      prepare the surgical trays.

PMID- 1736826
TI  - AORN revised statement on the patient and health care workers with human
      immunodeficiency virus (HIV) and other bloodborne diseases.

PMID- 1736827
TI  - [What is the role of statistics in medical science?--a critical essay].
AB  - In the present paper, the fundamental problems of statistics used in medical
      science are discussed, based on radical criticism and thorough examination of
      statistical ideas and methods which are popularly used in the medical field of
      today. The formal applications of statistical test and estimation theories in
      mathematical statistics and further belief in double-blind experimental design
      are frequently found in medical science, where the meaning of population is not
      made clear and the true characteristics of "statistical test and estimation" and
      of "double-blind experimental design" are either not understood or are
      misunderstood. These facts bring many evil influences on medical ideas leading to
      medical trials. Radical criticism and thorough examination are necessary for the
      return of medical research to the right path. New statistical ideas and methods
      must be developed on the basis of the considerations mentioned above. The use of
      statistics must be made with a modest attitude and exploratory or detective ideas
      must be adopted, in so far as medical trials are administered, with human mind,
      to individuals who are intricate and multifarions in reaction. Medical trials and
      statistics are to be unified in order that desirable results may emerge in human
      world, enhancing the validity of their contents each other. Here, for example,
      the exploratory method of multidimensional data analysis and the idea of optimal
      control with QOL of individuals in medical trials are explained.

PMID- 1736828
TI  - [Clinical approach to infection in patients with malignancy].

PMID- 1736830
TI  - [The strategy against post-operative infection in the patients with esophageal
      cancer].
AB  - Post-operative infection with esophageal cancer patients was investigated. The
      subjects were 325 esophageal cancer patients. The most frequent infectious
      complication after the surgery was pneumonia, followed by anastomosis between the
      cervical esophagus and plastic stomach tube. The bacteria frequently found in
      infectious lesions were pseudomonas or staphylococcus. The more severe infection
      the patients had, the more gram negative bacteria were found. Bacterial
      examination during operation showed that more than 80% bacteria was gram
      negative. Since esophageal cancer patients had a low nutritional state, their
      immune function was impaired and infection was apt to occur post-operatively.
      Therefore, special nutritional care was indispensible, such as essential fatty
      acid, BCAA, and glutamine supplementation.

PMID- 1736829
TI  - [Evaluation of the importance of infection as cause of death in patients with
      malignancy: an analysis of autopsy cases].
AB  - The autopsy records of patients who died at Keio University Hospital from January
      1, 1970 through December 31, 1974 and from January 1, 1985 through December 31,
      1989, were reviewed and their main diseases and the causes of death were
      determined. The contribution of infections to the death of each patient was
      classified as follows: Class 1: Infection is the only cause of death. Class 2:
      Infection is the predominant cause of death. Class 3: Non-infectious disease is
      the predominant cause of death. Class 4: Infection is independent of patient's
      death. The total number of autopsy cases and cases with malignancy were 1,140 and
      664 in the early 1970's and 1,136 and 826 in the late 1980's, respectively.
      Patients with hematologic malignancies totalled 90 and 95 in the two periods,
      respectively. In the early 1970's, 35% of patients with malignancies died of
      infections [classified as Class 1 (25%) and Class 2 (10%)], and in the late
      1980's, 32% of cancer patients died of infections (Class 1 20% and Class 2 12%,
      respectively). The most important infectious disease was pulmonary infection in
      the two periods. In patients with other than hematologic cancers (solid cancers),
      63% and 58% of patients died of pulmonary infection in the early 1970's and the
      late 1980's, respectively. The rate of solid cancer patients who died of systemic
      infection rose from 7% in the early 1970's to 21% in the late 1980's. In
      hematologic cancer patients, the importance of pulmonary infection and that of
      systemic infection were comparable in the two periods. Fungus infection in
      hematologic cancer patients was a serious problem in the two periods, but it
      became more important in the late 1980's. The most important cause of death of
      cancer patients in the two periods was the cancers themselves; 39% of patients in
      the early 1970's and 43% in the late 1980's, respectively, died of marasmus or
      insufficiency of vital organs due to cancer.

PMID- 1736831
TI  - [Comparative study of UFT plus mitomycin C and UFT plus doxorubicin in
      adenocarcinoma. Hirosaki Cooperative Group of Cancer Chemotherapy].
AB  - A multicenter cooperative study was conducted to compare the clinical efficacy of
      UFT-M (UFT, Mitomycin C (MMC)) and UFT-D (UFT, Doxorubicin (DXR)). A total of 62
      cases with adenocarcinoma were enrolled in this study. Eligible cases included 25
      patients with gastric cancer, 22 with pancreas or biliary tract cancer and 10
      with other cancers. They were divided into two groups; 30 in UFT-M and 27 in UFT
      D. The treatment schedules were as follows: UFT 400-600 mg/day orally every day,
      MMC 4-6 mg/m2, IV, every week (UFT-M); UFT 400-600 mg/day orally every day, DXR
      20 mg/m2, IV, every 3 weeks (UFT-D). For gastric cancer, 3 of 17 cases treated by
      UFT-M showed PR, whereas no case showed PR in UFT-D. As for toxicity, bone marrow
      suppression was more commonly observed in UFT-M than in UFT-D. There was no
      statistical difference in survival between the two treatment regimens. These
      results suggested that UFT-D was not effective but UFT-M was a more promising
      combination therapy against advanced gastric cancer.

PMID- 1736832
TI  - [Preoperative role of angiotensin II induced hypertension chemotherapy (IHC) in
      advanced gastric carcinoma].
AB  - To investigate the role of preoperative IHC in advanced gastric carcinoma,
      clinical, surgical and pathological stagings of 13 patients were analysed
      retrospectively. These patients were treated with a 3-drug combination of
      adriamycin, 5-fluorouracil and mitomycin C under angiotensin II induced
      hypertensive state. The response rate was 69.2% and mean survival time was 850.2
      days. "Down staging" in surgical stage was observed in 5 out of 13 cases (38.3%),
      and in pathological stage 7 cases (53.8%) "down staging" was achieved. Mean
      survival time of "pathological down-staging" cases was significantly longer than
      that of "non-down-staging" cases (1039.6 vs 322.1 days, p less than 0.01,
      generalized Wilcoxon test). IHC brings selective increase of drug delivery to
      tumor tissue, and will be useful as preoperative chemotherapy in advanced gastric
      carcinoma in terms of "down staging".

PMID- 1736833
TI  - [Neo-adjuvant chemotherapy with cisplatin, 5-fluorouracil, vindesine in head and
      neck cancer].
AB  - Neo-adjuvant chemotherapy with CDDP combination was introduced into the treatment
      of advanced head and neck cancer. Twenty-three patients with s.c.c of head and
      neck were given combination chemotherapy consisting of CDDP, VDS and 5-FU before
      surgical treatment in our department. CR and PR of this trial in all patients
      were 4 and 35%, respectively. The WBC nadir occurred around 2 weeks later, but
      all the patients recovered prior to the next cycle or surgical treatment. Renal
      dysfunction, nausea, vomiting and depilation were generally mild. VDS is useful
      as one of the neo-adjuvant drugs for the treatment of head and neck cancer. Long
      term observation in connection with this treatment is required.

PMID- 1736834
TI  - [Effect of treatment schedule of an antitumor platinum complex, DWA2114R, on the
      antitumor activity].
AB  - Effects of treatment schedule of (-)-(R)-2-aminomethylpyrrolidine (1,1
      cyclobutanedicarboxylato) platinum (II) monohydrate, DWA2114R, on the antitumor
      activity against murine colon adenocarcinoma (Colon 26) and Lewis lung carcinoma
      (3LL) were examined. Colon 26 or 3LL tumors were transplanted s.c. into the flank
      and subsequently DW A2114R was given i.v. by single or multiple injections. The
      tumor weight was determined on days 14 or 25 and the antitumor effect was
      evaluated by GIR%. Although the total dose of DWA2114R was identical in both
      schedules, single injection was superior to multiple. Effect of treatment
      schedule of cis-dichlorodiammine-platinum (II), CDDP, and cis-diammine (1, 1
      cyclobutanedicarboxylato) platinum (II), CBDCA, on the antitumor activities were
      the same as in case of DWA 2114R, i.e., single injection was superior to
      multiple.

PMID- 1736835
TI  - [Combination therapy of a new platinum complex, DWA2114R with various antitumor
      agents against mouse tumors in vivo].
AB  - In vivo antitumor activity of (-)-(R)-2-aminomethylpyrrolidine (1, 1
      cyclobutanedicarboxylato) platinum (II) monohydrate (DWA2114R) in combination
      with various antitumor agents was examined using mouse leukemia P388, Meth-A
      fibrosarcoma and M5076 reticulum cell sarcoma. The combination treatment of
      DWA2114R with cyclophosphamide, 5-fluorouracil, adriamycin, etoposide or
      vindesine showed synergistic effects on the prolongation of survival time of mice
      bearing P388. Among these combinations, combination of DWA2114R with adriamycin
      or vindesine showed a good synergism. In the combination treatment with vindesine
      against Meth-A which is not so sensitive to platinum agent, DWA2114R showed a
      synergistic or additive effect, but cis-diamminedichloroplatinum (II) (CDDP)
      showed subadditive. Three-drug combination of DWA2114R or CDDP with
      cyclophosphamide and adriamycin was examined in mice inoculated i.p. or s.c. with
      M5076. In both models, the combination of DWA2114R was more active than that of
      CDDP at the dose less than 1/16-fold of the dose of CDDP which is the ratio of
      two drugs in clinical trial.

PMID- 1736836
TI  - [A case of recurrent malignant glioma treated by superselective intraarterial
      chemotherapy with a combination of etoposide and cisplatin].
AB  - Superselective intraarterial infusion of etoposide and cisplatin was performed in
      a patient with recurrent malignant glioma located in the left midbrain extending
      to thalamus which had progressed after two courses of radiotherapy and
      chemotherapy with various anticancer agents. Infusion of etoposide (80 mg/m2) and
      cisplatin (80 mg/m2) at the basilar top did not result in any neurological
      deficits when infused for 60 minutes with intermittent infusion of papaverine and
      nicardipine. CT scan carried out 6 days after chemotherapy demonstrated
      disappearance of the tumor.

PMID- 1736837
TI  - [A case report of multiple bone metastases of breast carcinoma effectively
      treated with mild chemo-endocrine therapy].
AB  - A woman with multiple bone metastases three years after radical mastectomy for
      right breast carcinoma was admitted to the Department of Radiology, National
      Hakodate Hospital. She underwent radiotherapy for the metastasis of the seventh
      cervical vertebra, and her back pain decreased. Six courses of combination
      chemotherapy were undertaken using MTX, CPM, 5-FU, VCR and predonine, but her
      multiple bone metastases progressed. Then, she was treated with chemo-endocrine
      therapy which consisted of tamoxifen 30 mg daily and CPM 100 mg daily given
      orally. Two months later, UFT 400 mg daily was administered instead of CPM. This
      therapy has been effective for 8 years, and she has remained alive and well. On
      bone scintigram, the abnormal radioisotope uptake almost disappeared. Also, X-ray
      film showed no osteolytic change and no destruction of bone. These results
      suggest that it is important to select a suitable combination of drugs for each
      patient with advanced breast carcinoma.

PMID- 1736838
TI  - [Standard deviation of inhibition index of chemosensitivity testing using the MTT
      assay].

PMID- 1736839
TI  - [Interaction of (-)-(R)-2-aminomethylpyrrolidine (1,1-cyclobutanedicarboxylato)
      platinum (II) monohydrate with DNA as determined by a nitrocellulose filter
      binding assay].

PMID- 1736840
TI  - [Intensive carboquone and cryopreserved autologous bone marrow transplantation
      for relapsed malignancies].

PMID- 1736841
TI  - [Studies on a slow releasing anticancer agent for prevention of peritoneal
      recurrence of advanced gastrointestinal carcinomas (clinical study)].

PMID- 1736842
TI  - [Clinical pharmacology of anticancer agents (Part 4). Antimetabolites (1)].
AB  - 1. Pharmacodynamics and pharmacokinetics of antimetabolites. Antimetabolites are
      administered in the form of a base or its riboside, which is incorporated into
      the cell and converted to an active or inactive metabolite. The active metabolite
      remain in the cell inhibiting the enzymes to catalyze nucleotide synthesis for
      nucleotide triphosphate formation, but the inactive metabolites are rapidly
      excreted out of the cell. The inhibitory effect of antimetabolites on nucleotide
      formation is correlated with factors, such as maintenance of drug blood level,
      incorporation of the drug into the cell, activation and inactivation of the drug,
      affinity of the active form to the corresponding enzyme, and change in pool size
      of the intermediate metabolites in nucleotide synthesis. The salvage synthesis
      occurring at the higher level of the enzymes catalyzing nucleotide synthesis to
      counteract the inhibition by the drug is also correlated with the nucleotide
      formation. II. Pyrimidine antagonists 1. Cytosine arabinoside (ara-C) and its
      derivatives Ara-C is rapidly converted to ara-CTP and ara-U. The former remains
      in the cell and inhibits DNA polymerase, but the latter is excreted rapidly out
      of the cell. A small portion of ara-C is incorporated into DNA, which results in
      the degradation of DNA as demonstrated by reduced sedimentation of bulk DNA in
      alkaline sucrose gradient centrifugation and the ladder DNA fragmentation with a
      minimum fragment of approximately 180 base pairs and its conjugates in agarose
      gel electrophoresis. Behenoyl ara-C (BHAC) is highly lipophilic and highly
      distributed in the erythrocyte stroma and membrane fraction of leukocytes after
      iv infusion. The incorporated BHAC is released after the plasma BHAC level
      decreases, which suggests that erythrocytes can be a drug reservoir after iv
      infusion. Therefore, severe anemia should be treated before BHAC chemotherapy for
      longer maintenance of the plasma BHAC level. 2. 5-Fluorouracil (5-FU) and its
      derivatives Activation of 5-FU in the cells is metabolized by uracil metabolizing
      enzymes to FUMP and FdUMP. FUMP is further metabolized to FdUMP and is also
      incorporated to RNA. FdUMP produces a ternary complex with thymidylate synthetase
      and leucovorin; subsequently, conversion of dUMP to dTMP is strongly inhibited.
      Thus, FUMP and FdUMP inhibit RNA and DNA metabolism, respectively. Enzyme
      activity during 5-FU metabolism and consequently the degree of inhibition of DNA
      and RNA syntheses markedly differ with the tumor cell species. This should be
      taken into consideration when performing chemotherapy of malignancies.

PMID- 1736843
TI  - [European School of Oncology (ESO)--gastric cancer treatment strategy].

PMID- 1736844
TI  - Testosterone, free testosterone, non-sex hormone-binding globulin-bound
      testosterone, and free androgen index: which testosterone measurement is most
      relevant to reproductive and sexual function in men with epilepsy?

PMID- 1736845
TI  - Three-dimensional in vivo mapping of brain lesions in humans.
AB  - We describe a multistep technique for three-dimensional reconstruction and
      analysis of brain lesions in vivo, based on the manipulation of magnetic
      resonance raw data obtained with a special protocol. The technique permits the
      direct visual identification of neuroanatomical landmarks in each brain specimen
      and eliminates the need to rely on averaged templates of human brain sections,
      which can be a source of lesion localization error. The technique also allows for
      the bidirectional cross-reference between data points in two-dimensional slices
      and in volume reconstruction and for the projection of subcortical structures
      onto the three-dimensional cortical surface. The three-dimensional lesion mapping
      technique can be applied to research with the lesion method in both human and
      nonhuman primates, to the planning of neurosurgical lesion approach, and to the
      teaching of neuroanatomy.

PMID- 1736846
TI  - Supplementary and primary sensory motor area activity in Parkinson's disease.
      Regional cerebral blood flow changes during finger movements and effects of
      apomorphine.
AB  - We have measured with single-photon emission tomography the regional cerebral
      blood flow changes that occurred in the supplementary motor areas and in the
      primary sensory motor areas during sequential finger-to-thumb opposition
      movements of the right hand in seven akinetic patients with Parkinson's disease
      and in nine normal volunteers. Parkinsonian patients were studied before ("off"
      condition) and after a subcutaneous injection of apomorphine hydrochloride which
      was able to switch them "on" (on condition). In normal volunteers and
      parkinsonian patients in the on condition, regional cerebral blood flow
      significantly increased in the supplementary motor areas and in the contralateral
      primary sensory motor cortex but not in the ipsilateral primary sensory motor
      cortex. On the contrary, no significant regional cerebral blood flow change was
      observed in these areas in parkinsonian patients in the off condition. These
      results support the hypothesis that a functional cortical motor area
      deafferentation is involved in the pathophysiological makeup of akinesia and that
      this abnormality is reversed by dopaminergic drugs.

PMID- 1736847
TI  - Protein redistribution diet remains effective in patients with fluctuating
      parkinsonism.
AB  - Forty-three carbidopa-levodopa (Sinemet)-treated parkinsonian patients with
      protein-sensitive motor fluctuations were started on the protein redistribution
      diet within the past 48 months. Thirty patients (70%) are still using the diet
      successfully after more than 12 months (mean duration, 33.6 months; range, 12 to
      48 months). The diet was discontinued in the other 13 cases. In 10 of these 13
      patients, the protein redistribution diet was discontinued for a variety of
      reasons, despite continued sensitivity to dietary protein; in only three patients
      (7%), those with the most severe and complicated disease, was the protein
      redistribution diet stopped because of its limited therapeutic benefit. The
      protein redistribution diet is a simple adjunct to the treatment of Parkinson's
      disease that can significantly prolong the efficacy of levodopa therapy in many
      fluctuating "end-stage" patients.

PMID- 1736848
TI  - The neuropsychological features of mitochondrial myopathies and
      encephalomyopathies.
AB  - Detailed testing of higher cerebral function was performed in 36 patients with
      mitochondrial myopathies and encephalomyopathies. Fourteen of these patients were
      thought to be cognitively impaired on clinical grounds. The assessments included
      tests of general intellectual ability and focal tests of memory, language, and
      perception. Twenty-one (58%) of the 36 patients who were tested had evidence of
      general intellectual deterioration, with focal cognitive deficits of variable
      degree. Of the remaining 15 patients in whom there was no evidence of general
      intellectual decline, five displayed focal cognitive deficits. In only 10
      patients was there evidence of cerebral dysfunction. The range and extent of
      cognitive deficits in mitochondrial myopathies are greater than predicted by
      their clinical presentations.

PMID- 1736849
TI  - In vivo phosphorus magnetic resonance spectroscopy in multiple sclerosis.
AB  - Localized phosphorus magnetic resonance spectroscopy at 1.5 T was performed in 39
      patients with multiple sclerosis and in 15 healthy controls. The multiple
      sclerosis spectra showed increased creatine phosphate levels. This increase was
      correlated with the severity of the handicap and was greater in patients with a
      progressive course of the disease than in patients with relapsing-remitting
      disease. No clear abnormalities were observed in the spectra of patients with
      multiple sclerosis regarding the phosphomonoesters, phosphodiesters, inorganic
      phosphate, and beta-adenosine triphosphate or with respect to pH values. There
      was an increased creatine phosphate level in the spectra in relation to a low
      metabolic state of the brain.

PMID- 1736850
TI  - Brain-stem auditory evoked potentials in human immunodeficiency virus
      seropositive patients with and without acquired immunodeficiency syndrome.
AB  - Brain-stem auditory evoked potentials were recorded in 35 human immunodeficiency
      virus (HIV)-seropositive subjects from the Centers for Disease Control groups III
      and IV, 24 HIV-negative drug abusers, and 62 normal healthy controls. None of the
      patients had evidence of neurological complications. History of alcohol
      consumption was an exclusion criterion. The values of central conduction times I
      V and III-V showed significant differences between the HIV-seropositive subjects
      and normal healthy controls, as well as between the HIV-seropositive subjects and
      HIV-negative drug abusers. Central conduction times I-III showed no differences
      between groups, except in the left ear of Centers for Disease Control group IV
      compared with controls. No statistical differences were found in the central
      conduction times between HIV-negative drug abusers and normal healthy controls.
      The results suggest a subclinical involvement of the upper brain stem in HIV
      infection. It could be produced by direct action of the virus on central nervous
      system structures.

PMID- 1736851
TI  - Progressive vision loss. A rare manifestation of familial cavernous angiomas.
AB  - We studied four generations of a family in which the index case had progressive
      loss of vision secondary to a cavernous angioma of the optic nerve and chiasm.
      Magnetic resonance imaging of the brain revealed multiple, asymptomatic
      intracerebral cavernous angiomas. Brain magnetic resonance imaging scans of the
      family members revealed multiple cavernous angiomas in the brother and paternal
      grandfather, but none in the father or his siblings. Autopsy reports of the
      paternal great grandfather noted multiple cavernous angiomas in the brain and
      abdominal viscera. We believe our patient to be the sixth reported case in which
      a cavernous angioma involved the optic chiasm and optic nerve. Magnetic resonance
      imaging is a sensitive and specific method of detecting cavernous angiomas.
      Cavernous angiomas have an autosomal dominant pattern of inheritance with
      variable penetrance. Surgical intervention in patients with symptomatic cavernous
      angiomas depends on the location and size of the lesion and associated surgical
      risks.

PMID- 1736852
TI  - Cerebral blood flow deficits in hereditary essential myoclonus.
AB  - Hereditary essential myoclonus is a disease in which segmental myoclonus is the
      sole clinical abnormality and whose cause is unknown. It is characterized by an
      early onset, a benign course, an autosomal dominant pattern of inheritance, the
      absence of any other neurologic dysfunction, and normal results of auxiliary
      tests. Cerebral blood flow studies of a father and son with this disease showed a
      cortical blood flow reduction contralateral to the myoclonus symptoms. We
      postulate the cause to be a focal unilateral subcortical cerebral lesion, either
      in the basal ganglia or in the brain stem, with subsequent cortical
      deafferentation.

PMID- 1736853
TI  - Neurologic disease described in the Journal of Empirical Psychology (Gnothi
      Sauton oder Magazin zur Erfahrungsseelenkunde), 1783-1793.
AB  - Know Thyself or Journal of Empirical Psychology (Gnothi Sauton oder Magazin zur
      Erfahrungsseelenkunde), 1783-1793, was the first of its kind--concentrating on
      nervous and mental disturbances and marking the beginning of periodical
      neuropsychiatric publications. The editor, Karl Philipp Moritz, and the
      contributors, many of them lay people, were particularly interested in
      disturbances of language and consciousness. Descriptions of epilepsy, Sydenham's
      chorea, jargon aphasia, and dementia are briefly summarized. The case material
      from the Journal was soon translated and integrated in later work. The Journal
      itself and its "empirical" approach became a model for publications that
      followed.

PMID- 1736854
TI  - Practice guidelines in neurology. Will they get us where we want to go?

PMID- 1736855
TI  - The Canadian Health Care System: the shape of things to come?

PMID- 1736856
TI  - The formation of moisture droplets on the posterior surface of intraocular lenses
      during fluid/gas exchange procedures.

PMID- 1736857
TI  - Ophthalmology is the single largest recipient of Medicare specialty
      disbursements.

PMID- 1736858
TI  - Falls in elderly patients with glaucoma.

PMID- 1736859
TI  - Capsulorhexis and corneal magnification.

PMID- 1736860
TI  - Pemphigus and pemphigoid.

PMID- 1736861
TI  - Late infectious endophthalmitis from exposed glaucoma setons.

PMID- 1736863
TI  - Trends in physician income.

PMID- 1736862
TI  - Superficial granular corneal dystrophy with amyloid deposits.

PMID- 1736864
TI  - Can aspirin be used safely for patients with proliferative diabetic retinopathy?

PMID- 1736865
TI  - Spectacles vs contact lenses in the correction of unilateral axial myopia.

PMID- 1736866
TI  - Sclerochoroidal calcification.
AB  - We studied 19 patients with sclerochoroidal calcification. The findings were
      bilateral in 16 patients and unilateral in the remaining three patients. The
      lesions, which were usually multifocal, had two characteristic appearances,
      plaque-like and tumorlike. Eleven patients had relatively flat, irregularly
      shaped, plaque-like, yellow-white lesions located between the arcades and the
      equator. Eight patients had more elevated tumorlike lesions, ranging up to 6 mm
      in height. All showed patterns on echography consistent with calcification. The
      calcification was often documented in both the choroid and sclera; sometimes it
      appeared only in the choroid, but never only in the sclera. Calcium metabolism
      appeared to be normal in all but two of the nine patients in whom it was
      investigated. Idiopathic sclerochoroidal calcification has a characteristic
      echographic and ophthalmoscopic appearance and may be more common than has been
      realized.

PMID- 1736867
TI  - Through curettage in the treatment of chronic canaliculitis.
AB  - While various techniques have been proposed for the treatment of canaliculitis,
      there have been no published series that evaluate the efficacy of simple
      curettage in the treatment of persistent or recurrent canaliculitis. We report
      the effectiveness of thorough, simple curettage (without canaliculotomy) in 11
      patients with chronic canaliculitis. All patients had a history of canaliculitis
      related symptoms for a minimum of 6 months and clinically detectable canalicular
      concretions before initial treatment. Thorough, simple curettage (without
      canaliculotomy) resolved the chronic canaliculitis in all of the patients. Ten of
      the 11 patients were cured with a maximum of two sessions of curettage. One
      patient required three treatments of curettage and silicone intubation for common
      canalicular narrowing to render her free of symptoms. No surgical complications
      occurred in any of the patients. Our report confirms the effectiveness and low
      morbidity of thorough curettage in the treatment of persistent or recurrent cases
      of canaliculitis.

PMID- 1736868
TI  - Clinical comparison of grafts stored in McCarey-Kaufman medium at 4 degrees C and
      in corneal organ culture at 31 degrees C.
AB  - Twenty-eight paired human corneas were preserved in minimal essential medium at
      31 degrees C and in McCarey-Kaufman medium at 4 degrees C. These grafts were then
      transplanted in pairs of patients with keratoconus who were age matched as
      closely as possible. These pairs received donor corneas from the same donor, so
      for each pair the donor age and time from death to preservation were the same.
      Visual acuity, central corneal thickness, and endothelial cell counts were
      compared. During the 1- to 2-year study period, no statistically significant
      difference in visual acuity, corneal thickness, or endothelial cell density was
      found between grafts stored in minimal essential medium and those stored in
      McCarey-Kaufman medium.

PMID- 1736869
TI  - Rate and pattern of neuroretinal rim area decrease in ocular hypertension and
      glaucoma.
AB  - The neuroretinal rim areas of 123 eyes (from five normal subjects, 75 patients
      with ocular hypertension, and 43 patients with glaucoma) were measured to
      determine the rate and pattern of rim area change during 5 to 15 years (mean, 10
      years) of follow-up. Fifty-seven percent of the patients with ocular hypertension
      and 79% of those with glaucoma showed a statistically significant slope of rim
      area decrease, a high rate of loss being associated with a high initial rim area.
      Ninety percent of the variation of rim area loss was accounted for by variables
      other than the ones measured herein, however (age, disc area, initial rim area,
      and intraocular pressure). The yearly loss of rim area was 0.23% of the initial
      area in normal subjects, 0.47% and 2.75% in the patients with stable and
      deteriorating ocular hypertension, respectively, and 3.47% in the patients with
      deteriorating glaucoma. The pattern of rim area change was linear in 49% of the
      patients with a statistically significant rim area decrease, episodic in 22%, and
      curvilinear in 29%.

PMID- 1736870
TI  - Optic disc size in exfoliative, primary open angle, and low-tension glaucoma.
AB  - We examined the magnification-corrected optic disc size in 54 patients with
      exfoliative glaucoma, 61 patients with primary open angle glaucoma, and 50
      patients with low-tension glaucoma. The mean optic disc area in low-tension
      glaucoma was statistically significantly larger than that in primary open angle
      and exfoliative glaucoma. The mean values of eyes with primary open angle and
      exfoliative glaucoma did not differ significantly from each other. Frequency
      distribution of the optic disc size showed, however, that all three diagnostic
      groups differed significantly from each other. Small discs were more frequent in
      eyes with exfoliative glaucoma, and large discs were more frequent in eyes with
      low-tension glaucoma. In primary open angle glaucoma, small and large optic discs
      were found equally frequently. It is possible that in some eyes large optic discs
      are vulnerable to even low intraocular pressures due to qualitative properties of
      the extracellular matrix.

PMID- 1736871
TI  - Glaucomatous parapapillary atrophy. Occurrence and correlations.
AB  - Glaucomatous optic nerve damage is typically associated with intrapapillary
      changes, such as neuroretinal rim loss. In this study, parapapillary
      chorioretinal atrophy was evaluated in 691 normal eyes, 1081 glaucomatous eyes,
      and 31 eyes with ocular hypertension. It was significantly larger and occurred
      more often in the glaucomatous eyes (parapapillary atrophy area, 1.07 +/- 0.83
      mm2) (mean +/- SD) than in the normal eyes (0.55 +/- 0.64 mm2) or in the eyes
      with ocular hypertension (0.55 +/- 0.37 mm2). These differences were significant
      also for eyes with moderate glaucomatous damage (0.86 +/- 0.62 mm2).
      Parapapillary chorioretinal atrophy was associated with shallow glaucomatous
      cupping, diffuse nerve fiber loss, a marked tessellated fundus, and only
      moderately elevated intraocular pressure. It increased with a decreasing
      neuroretinal rim area. It showed a spatial correlation to neuroretinal rim loss
      inside the optic disc. In unilateral glaucoma, it was larger in the affected eye
      than in the unaffected eye. Parapapillary chorioretinal atrophy is associated
      with glaucoma.

PMID- 1736872
TI  - Block excision of cystic and diffuse epithelial ingrowth of the anterior chamber.
      Report on 32 consecutive patients.
AB  - From 1980 to 1990, 32 consecutive patients with progressive cystic or diffuse
      epithelial ingrowth of the anterior chamber were treated successfully with block
      excision. This technique consists of simultaneous removal of adjacent iris, pars
      plicata of ciliary body, and all layers of sclera and cornea in contact with the
      lesion acting as a shell. The resulting defect is covered by a tectonic
      corneoscleral graft. Twelve patients had suffered from perforating ocular injury,
      10 patients had previously undergone cataract extraction, and 10 patients had
      various causes of epithelial ingrowth. Cystic epithelial ingrowth occurred in 27
      patients, diffuse sheetlike epithelial ingrowth occurred in four patients, and
      one lesion was identified as foreign body granuloma. On histopathologic
      examination, all but two patients revealed epithelial involvement of the surface
      of the ciliary body. All patients were followed up for an average of 60.1 months
      (range, 1 to 120 months). Long-term visual acuity was better than 20/60 in 37.5%
      of the patients. No recurrence of ingrowth was noted and enucleation was not
      necessary. Our results indicate that block excision currently may be the
      treatment of choice for cystic and diffuse sheetlike epithelial ingrowth of the
      anterior chamber.

PMID- 1736873
TI  - Subepithelial fibrosis after myopic epikeratoplasty. Report of a case.
AB  - A 29-year-old man with a -22.00-diopter myopia in the right eye underwent a
      planar, nonfreeze myopic epikeratoplasty and postoperatively developed a central
      subepithelial opacity. The opacity recurred after two superficial keratectomies;
      finally, another epikeratoplasty was performed. Light microscopic examination of
      the original button showed that the epithelium was thickened, collagenous
      subepithelial fibrocellular tissue was present, and Bowman's layer was focally
      disrupted. The stroma was edematous and peripherally scarred with scattered
      keratocytes. Examination by transmission electron microscopy revealed keratocytes
      lying anterior and posterior to Bowman's layer. The subepithelial fibrocellular
      tissue corresponded to an area of a break in Bowman's layer and probably
      originated from the donor stroma. The break in Bowman's layer may have been
      caused by the microkeratome cuts, but its origin is not certain.

PMID- 1736874
TI  - Iris sector heterochromia as a marker for neural crest disease.
AB  - A 6-month-old female infant with biopsy-proved Hirschsprung's disease had
      associated sector heterochromia of the irides. The association between sector
      heterochromia and Hirschsprung's disease has been previously reported and both
      conditions have been ascribed to neural crest defects. Histologic characteristics
      of the ocular involvement have not previously been reported, to our knowledge.
      Histopathologic examination of the globes revealed decreased iris stroma,
      decreased pigmentation in the anterior stroma, and reduced numbers of pigment
      producing cells in the affected areas. Both the ocular and gastrointestinal
      findings reflect abnormalities in tissues of neural crest origin.

PMID- 1736875
TI  - Choristoma of the optic nerve and chiasm.
AB  - A 21-year-old patient with a biopsy-proved choristomatous malformation of the
      optic nerve and chiasm is presented. The patient experienced progressive
      unilateral vision loss and optic atrophy. A gadolinium-enhanced magnetic
      resonance image demonstrated chiasmal involvement that was not evident on
      computed tomographic scan or visual field testing. We believe this is the third
      reported case of a choristomatous malformation of the optic nerve and chiasm and
      the first report of magnetic resonance imaging findings.

PMID- 1736876
TI  - Evaluation of the retinal toxicity and pharmacokinetics of dexamethasone after
      intravitreal injection.
AB  - The intravitreal injection of steroids may be potentially useful in the treatment
      of endophthalmitis and other ocular inflammatory diseases. The retinal toxicity
      and intraocular turnover of aqueous solutions of dexamethasone sodium phosphate
      in doses ranging from 440 to 4000 micrograms were evaluated in the rabbit;
      evaluation was also performed for a 0.1-mL injection of a commercially available
      preparation (dexamethasone phosphate [Decadron] injection, 4 mg/mL). After the
      440-micrograms dose, a transient increase in staining of the Muller cells was
      observed, which normalized after 2 days. Progressively higher doses resulted in
      an increasing spectrum of disorganization in Muller and other retinal cells. The
      half-life of the intravitreally injected drug was 3.48 hours. These findings
      suggest a primary interference in Muller cell function, possibly through
      dexamethasone-induced alterations in retinal glutamate or glucose metabolism.

PMID- 1736877
TI  - A new technique for visualization of the human retinal vasculature.
AB  - Adenosine diphosphatase, an endothelial cell ectoenzyme that hydrolyses adenosine
      5'-diphosphate to adenosine monophosphate, has been used histochemically to study
      the human retinal vasculature in flat mounts or as flat-embedded tissue that can
      be sectioned. In all retinas, reaction product was confined almost exclusively to
      the vasculature, with arteries having more reaction product than veins or
      capillaries. Adenosine diphosphatase activity was observed in endothelium, smooth
      muscle cells, pericytes, and erythrocytes. In the more elaborate version of the
      technique, the adenosine diphosphatase-incubated retinas were flat embedded in
      glycol methacrylate. This allowed study of the retinal vasculature in dual
      perspective: en bloc with the use of dark-field microscopy and specific areas of
      interest histologically sectioned for further evaluation. The technique is simple
      and preserves angioarchitecture because the retinas are intact, and patency of
      the vasculature can be determined.

PMID- 1736878
TI  - Blood-retinal barrier breakdown caused by diode vs argon laser
      endophotocoagulation.
AB  - We compared the effects of argon and diode laser endophotocoagulation on blood
      retinal barrier breakdown using real-time magnetic resonance imaging following
      intravenous gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) injection.
      Endophotocoagulation was performed on eyes of pigmented rabbits with either the
      argon or the diode laser to produce ophthalmoscopically similar lesions. Magnetic
      resonance imaging studies were performed either 2 or 7 days after laser
      treatment, and coronal T1-weighted proton images were obtained in the first 20
      minutes following Gd-DTPA injection. The mean signal intensity over a region of
      interest in the vitreous cavity was analyzed, and an initial rate analysis was
      performed on each time-course curve. Two days after treatment, argon laser
      treated eyes showed significantly greater leakage of Gd-DTPA than diode laser
      treated eyes. The leakage in both groups was substantially reduced by
      posttreatment day 7. Histopathologic examination performed 2 days following
      photocoagulation showed less damage of the retinal pigment epithelium and more
      severe occlusion of the choriocapillaris and deep choroidal vessels in diode
      laser-treated eyes. These changes may serve to explain the observed differences
      in Gd-DTPA leakage.

PMID- 1736879
TI  - Pituitary adenoma presenting as unilateral proptosis.

PMID- 1736880
TI  - Lens-sparing vitreoretinal surgery in infants.
AB  - Lensectomy is routinely performed in infant eyes undergoing vitreoretinal
      surgery. Using a two-port system, we performed pars plicata vitrectomy and
      membrane peeling without removal of the crystalline lens. Surgical manipulations
      were done in the postequatorial region in eyes with areas of attached peripheral
      retina. Eight of 10 eyes showed no evidence of postoperative cataract formation.
      In no instance was a peripheral retinal break created. In selected cases,
      vitreoretinal surgery can be performed in infant eyes without the need for lens
      removal.

PMID- 1736881
TI  - Expression, purification and characterization of a mouse-human chimeric antibody
      and chimeric Fab' fragment.
AB  - B72.3 is a mouse monoclonal antibody against a tumour-associated antigen, TAG72,
      which recognizes breast, ovarian and colorectal tumour tissue. A mouse-human
      chimeric version of B72.3 has been expressed in Chinese-hamster ovary cells. This
      molecule has the binding specificity of B72.3 and constant regions from human
      IgG4. The chimeric B72.3 assembles to intact IgG and recognizes TAG72 as well as
      B72.3 in competitive binding assays. A proportion of the chimeric B72.3 (approx.
      10%) does not form inter-heavy-chain disulphide bonds but still assembles into
      the IgG tetramer. This appears to be a general property of human IgG4 molecules.
      Co-expression of the chimeric light chain with a chimeric Fd' gene resulted in
      the expression of functional Fab'. Very little F(ab')2 is produced, although the
      Fab' can be oxidized to the dimeric F(ab')2 in vitro. The production of Fab' and
      F(ab')2 by this method is an attractive alternative to proteolytic digestion of
      IgG. The ability to produce these molecules in large quantities will allow the
      production and testing of a range of anti-tumour antibody and antibody fragment
      conjugates.

PMID- 1736882
TI  - Effects of litter removal on the lipolytic response and the regulatory components
      of the adenylate cyclase in adipocytes isolated from lactating rats.
AB  - The effects of litter removal on the status of different components of the
      hormone-sensitive adenylate cyclase system were analysed in plasma membranes of
      rat adipocytes. These effects were correlated with the decreased lipolytic
      response of adipose tissue. No changes in total number of A1 adenosine receptors
      or their affinity were detected in response to litter removal. In contrast, beta
      adrenergic receptors showed a decrease (35%) in total number of receptors,
      without any significant change in their affinity. The status of alpha-GS and
      alpha-Gi, the alpha-subunits of G proteins which mediate stimulation and
      inhibition respectively of adenylate cyclase, were probed by cholera- and
      pertussis-toxin-catalysed ADP-ribosylation respectively and by immunoblot.
      Associated with litter removal, decreases of 63% and 62% in the incorporation of
      [alpha 32P]ADP-ribose catalysed by cholera toxin and pertussis toxin into alpha
      Gs and alpha-Gi respectively were detected. Immunoblotting using RM/1 (anti-alpha
      Gs) and AS/7 (anti-alpha-Gi) antisera also showed decreases in the levels of
      alpha-Gs (52%) and alpha-Gi (55%) in adipocyte membranes from litter-removed rats
      compared with lactating rats. Alterations in the status of hormone-sensitive
      adenylate cyclase components, such as those described herein, may be biochemical
      mechanism(s) by which adipose tissue shows a decreased lipolytic response during
      recovery from lactation.

PMID- 1736883
TI  - Sensitivity of monomeric and dimeric forms of bovine seminal ribonuclease to
      human placental ribonuclease inhibitor.
AB  - We have studied the inhibition of bovine pancreatic RNAase (RNAase A) and bovine
      seminal RNAase in its native dimeric form (RNAase BS-1) and in monomeric
      carboxymethylated form (MCM RNAase BS-1) by human placental RNAase inhibitor
      (RNAase inhibitor) in order to understand the effect of enzyme structure on its
      response to the inhibitor. Study of the inhibition as a function of inhibitor
      concentration revealed that RNAase A and MCM RNAase BS-1 were inhibited fully and
      the inhibitor-sensitivities of the two were comparable. But under identical
      inhibitor concentrations RNAase BS-1 was found to be virtually insensitive to the
      inhibitor; at higher (3-10-fold) inhibitor concentrations marginal inhibition of
      the native enzyme could be observed. When RNAase BS-1 was pretreated with 5 mM
      dithiothreitol (DTT) and assayed, it exhibited greater inhibitor-sensitivity,
      presumably as a result of its partial monomerization on exposure to DTT. This DTT
      mediated change in the response of RNAase BS-1 to the inhibitor did not, however,
      seem to occur either in the assay conditions (which included DTT) or even when
      the enzyme was pretreated with DTT in the presence of the substrate, suggesting
      an effect of the substrate on the enzyme behaviour towards the inhibitor.
      Independently, gel-filtration runs revealed that, although DTT treatment caused
      monomerization of RNase BS-1, this change did not take place when DTT treatment
      was carried out in the presence of the substrate. From our observations, we infer
      that differential inhibitor-sensitivity of the dimeric and monomeric forms of
      RNAase BS-1, the relative contents of the two forms and the influence of the
      substrate on them may be important determinants of the net enzyme activity in the
      presence of the inhibitor.

PMID- 1736884
TI  - Mechanistic studies on tyrosinase-catalysed oxidative decarboxylation of 3,4
      dihydroxymandelic acid.
AB  - Mushroom tyrosinase, which is known to convert a variety of o-diphenols into o
      benzoquinones, has been shown to catalyse an unusual oxidative decarboxylation of
      3,4-dihydroxymandelic acid to 3,4-dihydroxybenzaldehyde [Sugumaran (1986)
      Biochemistry 25, 4489-4492]. The mechanism of this reaction was re-investigated.
      Although visible-region spectral studies of the reaction mixture containing 3,4
      dihydroxymandelic acid and tyrosinase failed to generate the spectrum of a
      quinone product during the steady state of the reaction, both trapping
      experiments and non-steady-state kinetic experiments provided evidence for the
      transient formation of unstable 3,4-mandeloquinone in the reaction mixture. The
      visible-region spectrum of mandeloquinone resembled related quinones and
      exhibited an absorbance maximum at 394 nm. Since attempts to trap the second
      intermediate, namely alpha,2-dihydroxy-p-quinone methide, were in vain,
      mechanistic studies were undertaken to provide evidence for its participation.
      The decarboxylative quinone methide formation from 3,4-mandeloquinone dictates
      the retention of a proton on the alpha-carbon atom. Hence, if we replace this
      proton with deuterium, the resultant 3,4-dihydroxybenzaldehyde should retain the
      deuterium present in the original substrate. To test this hypothesis, we
      chemoenzymically synthesized alpha-deuterated 3,4-dihydroxymandelic acid and
      examined its enzymic oxidation. Our studies reveal that the resultant 3,4
      dihydroxybenzaldehyde retained nearly 90% of the deuterium, strongly indicating
      the transient formation of quinone methide. On the basis of these findings it is
      concluded that the enzymic oxidation of 3,4-dihydroxymandelic acid generates the
      conventional quinone product, which, owing to its unstability, is rapidly
      decarboxylated to generate transient alpha,2-dihydroxy-p-quinone methide. The
      coupled dienone-phenol re-arrangement and keto-enol tautomerism of this quinone
      methide produce the observed 3,4-dihydroxybenzaldehyde.

PMID- 1736885
TI  - Relative expression of cytochrome P450 isoenzymes in human liver and association
      with the metabolism of drugs and xenobiotics.
AB  - Cytochrome P450s play a central role in the metabolism and disposition of an
      extremely wide range of drugs and chemical carcinogens. Individual differences in
      the expression of these enzymes may be an important determinant in susceptibility
      to adverse drug reactions, chemical toxins and mutagens. In this paper, we have
      measured the relative levels of expression of cytochrome P450 isoenzymes from
      eight gene families or subfamilies in a panel of twelve human liver samples in
      order to determine the individuality in their expression and whether any forms
      are co-regulated. Isoenzymes were identified in most cases on Western blots based
      on the mobility of authentic recombinant human cytochrome P450 standards. The
      levels of the following P450 proteins correlated with each other: CYP2A6, CYP2B6
      and a protein from the CYP2C gene subfamily, CYP2E1 and a member of the CYP2A
      gene subfamily, CYP2C8, CYP3A3/A4 and total cytochrome P450 content. Also, the
      levels of two proteins in the CYP4A gene subfamily were highly correlated. These
      correlations are consistent with the relative regulation of members of these gene
      families in rats or mice. In addition, the level of expression of specific
      isoenzymes has also been compared with the rate of metabolism of a panel of
      drugs, carcinogens and model P450 substrates. These latter studies demonstrate
      and confirm that the correlations obtained in this manner represent a powerful
      approach towards the assignment of the metabolism of substrates by specific human
      P450 isoenzymes.

PMID- 1736886
TI  - Coupling of D2 dopamine receptors to G-proteins in solubilized preparations of
      bovine caudate nucleus.
AB  - 1. The coupling of D2 dopamine receptors and G-proteins has been examined in
      cholate-solubilized preparations of bovine caudate nucleus. 2. No receptor-G
      protein coupling could be detected in solubilized preparations obtained in 0.3%
      cholate, but if this preparation is diluted 5-fold, coupling is re-established.
      3. The dilution process was examined, and it was shown that the change in ionic
      strength was an important factor in modulating the observed receptor-G-protein
      interaction. 4. Ionic strength was shown, however, not to be the primary
      determinant of receptor-G-protein coupling. This is likely to be the formation,
      upon dilution of the preparation, of vesicles in which receptor and G-protein
      reassociate. 5. The formation of vesicles upon dilution was examined by a variety
      of techniques, including thermal-stability studies, gel filtration,
      centrifugation and electron microscopy.

PMID- 1736887
TI  - Importance of thiol groups in ligand binding to D2 dopamine receptors from brain
      and anterior pituitary gland.
AB  - The effects of the thiol group reagent 5,5'-dithiobis-(2-nitrobenzoic acid)
      (DTNB) on D2 dopamine receptors have been examined in three brain regions
      (caudate nucleus, putamen and olfactory tubercle), and in the anterior and
      neurointermediate lobes of the pituitary gland. Whereas the receptors in brain
      were insensitive to DTNB, a dose-dependent inhibition of [3H]spiperone binding to
      D2 receptors in both lobes of the pituitary gland was observed. The effects in
      the pituitary could be reversed by subsequent treatment with dithiothreitol and
      could be prevented by prior occupancy of the receptor binding site with a ligand.
      The effect of DTNB was to decrease the number of ligand-binding sites without
      altering the affinity of those remaining. The results show that modification of a
      thiol group of the D2 dopamine receptor in the two lobes of the pituitary gland
      tested here significantly affects ligand binding. There is therefore a difference
      between the D2 dopamine receptor populations in brain and pituitary in their
      sensitivity to modification by DTNB, and this may imply the existence of
      different receptor isoforms in the two issues.

PMID- 1736888
TI  - Concomitant stimulation by vasopressin of biliary and perfusate calcium fluxes in
      the perfused rat liver.
AB  - Changes in perfusate Ca2+ (measured with a Ca(2+)-selective electrode) and
      changes in bile calcium (measured by atomic absorption spectroscopy) were
      continuously and simultaneously monitored after infusion of (a) vasopressin, (b)
      glucagon and (c) both vasopressin and glucagon together to the perfused rat
      liver. Also monitored were perfusate glucose and oxygen concentrations and bile
      flow. Vasopressin induces a sharp, transient, pulse of increased bile flow and
      increased bile calcium within 1 min of infusion, concomitant with rapid changes
      in perfusate Ca2+ fluxes, glucose output and oxygen uptake. This is immediately
      followed by a decrease in both bile flow and bile calcium for as long as the
      hormone is administered. Changes induced by glucagon are a relatively slow onset
      of perfusate Ca2+ efflux and oxygen uptake, but rapid glucose output, and a small
      but significant and transient decrease in bile flow and bile calcium which,
      despite the continued infusion of the hormone, spontaneously and rapidly returns
      to normality. However, the greatest responses are observed after co
      administration of both hormones. Coincident with the augmented perfusate Ca2+
      fluxes (influx) seen in earlier work, there occurs within 1 min of vasopressin
      infusion a sharp increase in bile secretion and bile calcium greater in magnitude
      than that produced by vasopressin alone. Immediately thereafter bile secretion
      and bile calcium decline below basal values and remain there for as long as the
      hormones are administered. Glucagon and vasopressin therefore each have opposing
      effects on bile flow and bile calcium. However, the action of vasopressin is
      enhanced by the prior administration of glucagon. The data thus reveal features
      about the actions of glucagon and Ca(2+)-mobilizing hormones on bile flow and
      bile calcium not previously recorded and provide a novel framework around which
      the whole issue of hepato-biliary Ca2+ homoeostasis can be assessed in normal and
      diseased liver.

PMID- 1736889
TI  - Isolation of cleaved prolactin variants that stimulate DNA synthesis in specific
      cell types in rat pituitary cell aggregates in culture.
AB  - Using an affinity column of monoclonal antibodies against rat prolactin (PRL),
      PRL immunoreactive material secreted by rat pituitary aggregate cell cultures was
      purified in milligram amounts from the culture medium. Further purification of
      the PRL immunoreactive molecules was achieved by anion-exchange and reversed
      phase h.p.l.c. At least four variants could be distinguished which showed PRL
      like bioactivity in the Nb2 lymphoma bioassay. On SDS/PAGE two variants migrated
      as single bands under both reducing and non-reducing conditions. The two other
      variants migrated as single bands under non-reducing conditions, but yielded
      under reducing conditions two fragments, the larger of which had molecular masses
      of approx. 16 and 17 kDa respectively. These variants were therefore considered
      to be cleaved PRL (clPRL) variants, and were designated clPRL-1 and clPRL-2
      respectively. These variants were not artefactually produced at low pH during the
      h.p.l.c. purification step. Each of the clPRLs represented about 0.6-1.0% of
      total PRL. The cleavage site of clPRL-1, determined by N-terminal and C-terminal
      amino acid sequence analysis, was in the large disulphide loop between Tyr-145
      and Leu-146. Purified clPRL-1 added to pituitary aggregate cell cultures from 14
      day-old female rats in the presence of the dopamine agonist bromocriptine
      increased [3H]thymidine incorporation into DNA in gonadotrophs and thyrotrophs,
      but not in other pituitary cell types. Under the same experimental conditions the
      main forms of PRL and clPRL-2 were inactive. These data demonstrate that PRL is
      cleaved within the pituitary gland between specific amino acid residues, and that
      PRL cleaved between Tyr-145 and Leu-146 may have a specific biological role as a
      paracrine growth regulator in this tissue.

PMID- 1736890
TI  - Wheat and barley allergens associated with baker's asthma. Glycosylated subunits
      of the alpha-amylase-inhibitor family have enhanced IgE-binding capacity.
AB  - A 16 kDa protein, designated CM16*, which strongly binds IgE from baker's-asthma
      patients has been identified as a glycosylated form of the previously reported
      WTAI-CM16, which is a subunit of the wheat tetrameric alpha-amylase inhibitor. A
      glycosylated form (CMb*) of BTAI-CMb, the equivalent inhibitor subunit from
      barley, has been also found to have significantly enhanced IgE-binding capacity.
      In all, 14 purified members of the alpha-amylase/trypsin-inhibitor family showed
      very different IgE-binding capacities when tested by a dot-blot assay. The
      glycosylated components CM16*, CMb* and the previously described non-glycosylated
      14.5 kDa allergen from barley (renamed BMAI-1) were found to be the strongest
      allergens.

PMID- 1736891
TI  - Differential sensitivity of insulin- and adaptive-regulation-induced system A
      activation to microtubular function in skeletal muscle.
AB  - 1. Insulin and adaptive regulation are known to stimulate system A amino acid
      transport activity in skeletal muscle. The present study was designed to
      investigate whether activation of system A in muscle is a consequence of
      processes which rely on microtubule or microfilament function. To that end,
      extensor digitorum longus (EDL) muscles were incubated in the presence of
      colchicine and cytochalasin D, well-known inhibitors of microtubule and
      microfilament activity respectively. 2. Basal alpha-(methyl)aminoisobutyric acid
      (MeAIB) uptake decreased after incubation with 5 microM-colchicine in a time
      dependent manner. In keeping with this, adaptive regulation of MeAIB uptake
      caused by prolonged incubation in the absence of amino acids was substantially
      decreased in the presence of colchicine. 3. Under these conditions, stimulation
      of MeAIB uptake by insulin was unaltered in muscle in the presence of colchicine.
      This contrasted with the insulin-induced stimulation of MeAIB uptake by isolated
      rat hepatocytes, which was markedly decreased by colchicine. 4. Cytochalasin D,
      an agent that disrupts microfilaments, did not inhibit basal or insulin
      stimulated MeAIB uptake by the incubated muscle. 5. Neither colchicine nor
      cytochalasin D modified the stimulatory effect of insulin on 3-O-methylglucose
      uptake by EDL muscle. 6. We conclude that up-regulation of system A by synthesis
      of new carriers depends on the integrity of microtubular function both in
      skeletal muscle and in hepatocytes. Microtubules might play a role in the
      movement of system A-containing vesicles from the Golgi network to the plasma
      membrane.

PMID- 1736892
TI  - Insertion of isolated insulin receptors into placental membrane vesicles.
AB  - Purified human insulin receptors were inserted into placental plasma-membrane
      vesicles by fusion of membranes with receptor-lysophosphatidylcholine micelles.
      Scatchard analysis of insulin binding showed that about 10-15% of the added
      receptors became inserted into the membrane. The receptor number could be
      increased about 3-fold, corresponding to approx. 5 pmol of receptor/mg of
      membrane protein. The receptors became firmly bound to the membrane, as they
      could not be removed by extensive wash. The insertion of exogenous receptors
      could be demonstrated by immunoblotting. The inserted insulin receptor had the
      same insulin-binding affinity as the isolated receptor and the endogenous
      receptor of the membrane. Insulin binding in the presence or absence of Triton X
      100 revealed that more than 80% of the exogenous receptors had a right-side-out
      orientation. Function of the inserted receptors, as observed by insulin
      stimulated autophosphorylation, could be demonstrated. About 80% of the added
      lysophospholipid, corresponding to approx. 160 nmol of lysophospholipid/mg of
      membrane protein, became integrated into the membrane and was partly metabolized
      to phospholipid and to non-esterified fatty acid. The method of insertion of
      isolated insulin receptors using the natural detergent, lysophospholipid, may be
      a method for insertion of receptors into intact cells, where the
      lysophospholipid, as in the plasma-membrane vesicles, will be acylated to
      phospholipid.

PMID- 1736893
TI  - Glucose induces the translocation and the aggregation of glycogen synthase in rat
      hepatocytes.
AB  - Incubation of rat hepatocytes with glucose results in a decrease in the amount of
      glycogen synthase activity found in supernatants obtained after centrifugation of
      cell homogenates at 9200 g. The enzymic activity was quantitatively recovered in
      the sediments. This effect of translocation was dose- and time-dependent and
      correlated with the amount of immunoreactive enzyme determined by immunoblotting
      in both fractions. Hydrolysis by alpha-amylase of glycogen accumulated upon
      incubation with the sugar did not affect the translocation pattern. Translocation
      was also observed when cells were incubated with 2-deoxyglucose, which did not
      result in accumulation of glycogen. Immunocytochemical evidence indicates that
      glucose induces the aggregation of glycogen synthase molecules into clusters
      which are recovered in the sediments. These results indicate that glucose, in
      addition to activating glycogen synthase, may trigger changes in the localization
      of the enzyme in the cell.

PMID- 1736894
TI  - Role of protein kinase C in the acrosome reaction of mammalian spermatozoa.
AB  - Mammalian spermatozoa undergo a Ca(2+)-dependent exocytotic event before
      fertilization which is known as the acrosome reaction. The process of exocytosis
      in several cell systems is mediated by a protein kinase C (PKC)-catalysed
      phosphorylation. Addition of phorbol 12-myristate-13-acetate or the membrane
      permeant diacylglycerol analogue 1-oleoyl-2-acetylglycerol, which are potent
      activators of PKC, to bovine spermatozoa resulted in stimulation of the acrosome
      reaction. This stimulation was inhibited by low concentrations (50% inhibition at
      0.7 nM) of the PKC inhibitor staurosporine. PKC specific activity in bovine
      spermatozoa is extremely low in comparison with other cells; however, it is
      comparable with the activity found in human spermatozoa. Immunohistochemical
      analysis using anti-PKC antibodies revealed staining in the equatorial segment,
      the post-acrosomal region and the upper region of the head. We propose that PKC
      is involved in the mammalian sperm acrosome reaction.

PMID- 1736895
TI  - Polymorphism and proteolytic fragments of granulocyte membrane cofactor protein
      (MCP, CD46) of complement.
AB  - Human granulocytes (polymorphonuclear leucocytes, PMN) possess a membrane
      cofactor protein (MCP, CD46), which is structurally and functionally distinct
      from the MCPs of other cell types: it shows a single broad band of 56-80 kDa
      (without the doublet pattern characteristic of MCP) on SDS/PAGE and has less
      affinity for complement component C3b. We purified PMN MCP using monoclonal
      antibodies in order to study the molecular differences between it and other MCPs.
      Several forms of PMN MCP with size heterogeneity were noted on SDS/PAGE and by
      immunoblotting. O-Glycanase treatment decreased this heterogeneity, yielding a
      fast-migrating component identical in position on SDS/PAGE to the O-glycanase
      treated MCP of other cells. The cell-specific variation of MCP, therefore, arises
      from post-translational glycosylation and not from a difference in primary
      structure. The Factor I cofactor activity of PMN MCP was more efficient in
      cleaving the methylamine-treated complement components C4/C3 than was MCP from
      other cells, which shared a similar potency of cofactor activity on a weight
      basis. Two types of small-form PMN MCP were identified during purification. These
      were 42 kDa and 30 kDa in size; the former was recognized by M177 (a monoclonal
      antibody against the active site marker), possessed N-linked sugars [located on
      the short consensus repeats (SCRs)] but not O-linked ones (on the Ser/Thr-rich
      region), and retained cofactor activity for C3b/C4b cleavage, similar in potency
      to that of other MCPs. The functionally active soluble form of MCP was observed
      specifically in PMN. Protease inhibitors did not inhibit liberation of the
      fragments, although the generated fragments became susceptible to serine
      proteases. The findings show that the SCRs are the functional domain of MCP and
      that the MCP proteolysis found only in PMN may modulate the properties of PMN
      MCP. In conclusion, the structural features of PMN MCP largely reflect a
      variability in the O-linked sugars, and the decreased affinity for C3b may be in
      part attributable to proteolysis.

PMID- 1736896
TI  - The pattern of plant annexin gene expression.
AB  - Peptide sequence data derived from a plant annexin, P34 [Smallwood, Keen & Bowles
      (1990) Biochem. J. 270, 157-161] was used to design amplimers for PCR. A unique
      fragment of 95 bp, amplified from tomato (Lycopersicon esculertum) genomic DNA,
      was used in Northern analyses and demonstrated a differential pattern of
      expression in vegetative tissues of tomato, potato (Solanum tuberosum) and barley
      (Hordeum vulgare). The tissue-specific abundance of the annexin transcript was
      found to correlate closely with abundance of annexin protein as revealed by their
      partial purification and analysis with antisera specific for annexins isolated
      from tomato suspension-culture cells.

PMID- 1736897
TI  - 'Macromolecular crowding' is a primary factor in the organization of the
      cytoskeleton.
AB  - We propose that, in the cell, the reversible conversion of actin filaments into
      actin bundles is controlled by the concentration of the macromolecules [we have
      employed poly(ethylene glycol) 6000 to mimic the macromolecules of the cell] as
      well as by the nature of the ancillary cytoskeletal proteins that decorate actin
      filaments. The proposal is based on the following evidence. (1) Under our
      experimental conditions the transition from filaments into bundles occurs at
      increasing concentrations of poly(ethylene glycol), with the following sequence:
      caldesmon-actin, 3%; filamin-actin, 4-5%; caldesmon-tropomyosin-actin, 5-7%;
      actin, 6-7%; tropomyosin-actin, 9-10%. (2) Under conditions of low osmoelastic
      stress [3% poly(ethylene glycol)], preformed caldesmon-actin bundles are
      dissociated by the addition of either tropomyosin or tropomyosin-decorated actin.
      The dissociation of the bundles promoted by the addition of tropomyosin-decorated
      actin is faster than that promoted by the addition of tropomyosin.

PMID- 1736898
TI  - Molecular analysis of Xenopus laevis SPARC (Secreted Protein, Acidic, Rich in
      Cysteine). A highly conserved acidic calcium-binding extracellular-matrix
      protein.
AB  - SPARC (Secreted Protein, Acidic, Rich in Cysteine) is expressed as a 1.6 kb mRNA
      in Xenopus laevis. On the basis of cDNA sequence analysis, Xenopus SPARC has a
      core Mr of 32643, with one potential N-glycosylation site. Western analysis of
      SPARC isolated from Xenopus long bone indicates that the mature protein has an Mr
      of 43,000. At the amino acid level, Xenopus SPARC has 78-79% sequence similarity
      to mouse, bovine and human SPARC. The least-conserved region is found within the
      N-terminal glutamic acid-rich domain, with the C-terminal Ca(2+)-binding domain
      being the most conserved. Adult Xenopus tissues show the same pattern of tissue
      specific distribution of SPARC mRNAs as adult mouse.

PMID- 1736899
TI  - Purification and characterization by fast-atom-bombardment mass spectrometry of
      the polymorphonuclear-leucocyte-elastase-generated A alpha (1-21) fragment of
      fibrinogen from human blood after incubation with calcium ionophore A23187.
AB  - The stimulation of human blood with a Ca2+ ionophore, A23187, leads to activation
      of polymorphonuclear leucocytes (PMN) with release of small amounts of
      catalyticaly active elastase, as demonstrated by the formation of a
      characteristic product, the N-terminal A alpha (1-21) peptide of the Aa subunit
      of fibrinogen. The identity of the peptide was initially established by
      radioimmunoassay (r.i.a.) with an antibody raised to A alpha (1-21). We now
      provide independent confirmation of the formation of A alpha (1-21) by fast-atom
      bombardment-m.s. analysis of the fractions separated chromatographically after
      spiking of plasma samples with peptide labelled with [2H8]Phe at position 8.
      Identity of the peptides was established on the basis of their chromatographic
      retention time and by the distinct peaks in the mass spectra of these fractions.
      The relative intensities of the molecular ions of natural and labelled peptides
      were measured. On the basis of a comparison of the peaks of similar intensities,
      the concentration of the natural peptide at the time of spiking was close (79%)
      to the amount obtained by r.i.a. An additional peptide, des-alanyl-A alpha (2
      21), was also seen. The total amount of material measured by r.i.a. could be
      accounted for by the sum of these two provides. The addition of label and assay
      by m.s. has provided an independent physical-chemical method for identifying A
      alpha (1-21) as a characteristic product of PMN elastase release in whole blood,
      but which is absent in freshly drawn blood.

PMID- 1736900
TI  - Effects of cyclofenil diphenol, an agent which disrupts Golgi structure, on
      proteoglycan synthesis in chondrocytes.
AB  - 1. Cyclofenil diphenol (F6060), a weak non-steroidal oestrogen, was shown
      previously to inhibit [35S]proteoglycan synthesis [Mason, Lineham, Phillipson &
      Black (1984) Biochem. J. 223, 401-412] and to induce fragmentation of the Golgi
      apparatus into small vesicles [Lancaster, Fryer, Griffiths & Mason (1989) J. Cell
      Sci. 92, 271-280] in cultures of Swarm chondrosarcoma chondrocytes. Two
      structurally related compounds, F6204 and F6091, show a similar concentration
      related effect, with complete inhibition of [35S]proteoglycan synthesis at 90
      micrograms/ml. The apparent [3H]protein synthesis is only approx. 40% inhibited
      with [3H]lysine as precursor. Stilboestrol, clomiphene and tamoxiphen are also
      potent inhibitors of [35S]proteoglycan synthesis. 2. Syntheses of chondroitin 4
      [35S]sulphate and chondroitin 6-[35S]sulphate, which are Golgi-mediated events,
      are inhibited 40-68% and 3-48% respectively by concentrations of cyclofenil
      between 50 and 70 micrograms/ml. [3H]Hyaluronan synthesis, which occurs by a
      different mechanism at the plasma membrane, is inhibited by 47-66%. These results
      suggest that cyclofenil may act via more than one inhibitory mechanism.
      Cyclofenil diphenol inhibits polymerization of chondroitin sulphate on to p
      nitrophenyl beta-xyloside even when the chondrocytes are loaded with the
      initiator prior to treatment. 3. Cyclofenil diphenol interferes with the cellular
      uptake of amino acids via the system A carrier, as shown by inhibition of uptake
      of methylaminoisobutyric acid, a specific substrate for this system. The drug had
      no effect on the uptake of 2-deoxyglucose by the cells. 4. Cyclofenil diphenol
      (90 micrograms/ml) caused a decrease in the pool size of UDP-N-acetylglucosamine,
      UDP-N-acetylgalactosamine and UDP-hexoses, but this was insufficient to account
      for the accompanying profound inhibition of [35S]proteoglycan synthesis. Entry of
      [3H]glucosamine into the cell and into the UDP-N-acetylhexosamine pool did not
      appear to be affected. 5. Cyclofenil diphenol inhibited the substitution of 3H
      labelled proteoglycan core protein with chondroitin sulphate chains. Core protein
      was identified in treated cultures on the basis of immunoprecipitation with an
      antiserum against the hyaluronate-binding region and distinguished from
      precipitated proteoglycan on SDS/PAGE.

PMID- 1736901
TI  - Deficiency of 5'-deoxy-5'-methylthioadenosine phosphorylase activity in
      malignancy. Absence of the protein in human enzyme-deficient cell lines.
AB  - The absence of 5'-deoxy-5'-methylthioadenosine phosphorylase (MTAase) activity in
      malignant cells, and the putative localization of its gene, suggest that this
      enzyme deficiency might be due to a genomic alteration also involving a tumour
      suppressor gene. We studied the possible occurrence of inactive forms of the
      protein in two MTAase-negative cell lines, namely K562 and Jurkat, by
      immunochemical methods. Two highly specific antisera, directed against different
      epitopes of the phosphorylase [Della Ragione, Oliva, Gragnaniello, Russo, Palumbo
      & Zappia (1990) J. Biol. Chem. 265, 6241-6246], were used to carry out
      immunotitration and immunoblotting analyses, as well as to investigate the
      biosynthesis of the enzyme. No MTAase protein was detected by Western-blotting
      technique performed under conditions where all the phosphorylase-positive samples
      gave a clear band at the MTAase subunit molecular mass. No cross-reacting
      material was observed by a sensitive immunotitration method which permitted the
      detection of as low as 0.5 ng of protein. Moreover, the results obtained by
      [35S]methionine-labelling experiments ruled out phosphorylase biosynthesis in the
      negative cell lines. Altogether, these data suggest that an alteration at the
      gene level hampering the specific mRNA biosynthesis or resulting in an
      untranslatable mRNA is the cause of the enzyme deficiency in the MTAase-negative
      cell lines studied.

PMID- 1736902
TI  - Induction of glutathione S-transferase P-form in primary cultured rat liver
      parenchymal cells by co-planar polychlorinated biphenyl congeners.
AB  - Alterations in protein synthesis in primary cultured rat liver parenchymal cells
      were examined after their exposure to the potent carcinogens, polychlorinated
      biphenyl (PCB) congeners. Co-planar PCB congeners (3,4,5,3',4'-PCB and
      3,4,5,3',4',5'-PCB) (10 nM) induced a protein, the Mr of which was 25,000 (25 k
      protein) under denaturing conditions. However, non-co-planar PCB congeners and
      several xenobiotics, which induce microsomal proteins, did not induce the 25 k
      protein. By using immunoblotting, the 25 k protein was identified as glutathione
      S-transferase P-form (GST-P, 7-7, EC 2.5.1.18).

PMID- 1736903
TI  - Variation in the P2-S2 stereochemical selectivity towards the enantiomeric N
      acetylphenylalanylglycine 4-nitroanilides among the cysteine proteinases papain,
      ficin and actinidin.
AB  - 1. Values of the kinetic specificity constant, kcat./Km, for the hydrolysis of N
      acetyl-L-phenylalanylglycine 4-nitroanilide (I) and of its D-enantiomer (II)
      catalysed by ficin (EC 3.4.22.3) and by actinidin (EC 3.4.22.14) at pH 6.0, I 0.1
      mol/l, 8.3% (v/v) NN-dimethylformamide and 25 degrees C were determined by using
      initial-rate data with [S] much less than Km and weighted nonlinear regression
      analysis as: for ficin, (kcat./Km)L = 271 +/- 6 M-1.s-1, (kcat./Km)D = 2.9 +/-
      0.1 M-1.s-1, and for actinidin (kcat./Km)L = 13.3 +/- 0.7 M-1.s-1, (kcat/Km)D =
      0.34 +/- 0.01 M-1.s-1.2. These data and analogous values for the corresponding
      reactions catalysed by papain (EC 3.4.22.2), (kcat./Km)L = 2064 +/- 31 M-1.s-1,
      (kcat./Km)D = 5.5 +/- 0.1 M-1.s-1, demonstrate marked variation in stereochemical
      selectivity for substrates (I) and (II) among the three cysteine proteinases with
      the following values for the index of stereochemical selectivity Iss =
      (kcat./Km)L/(kcat./Km)D: for papain, 375; for ficin 93; for actinidin 39. 3.
      Model building suggests ways in which, for the papain-catalysed reactions,
      binding interactions involving the extended acyl groups of the substrates may
      need to change as the reaction proceeds from adsorptive complex (ES) to
      tetrahedral intermediate (THI) before its rate-determining, general acid
      catalysed collapse to acylenzyme intermediate. In particular, satisfactory
      alignment in the catalytic site at the THI stage of the acylation process appears
      to demand rotation of the substrate moiety about its long axis. 4. The different
      consequences of this rotation for the L- and D-enantiomers suggest that for
      closely related systems the greater the extent of this rotational adjustment the
      greater would be the value of Iss.5. For the actinidin-substrate combinations,
      model building suggests that even at the ES complex stage of catalysis it is not
      possible to approach optimized P2-S2 contacts and the three hydrogen-bonding
      interactions deduced for papain-ligand complexes in the absence of significant
      movement of protein conformation. Possible binding modes in which some of the
      interactions deduced for papain are relaxed are discussed. Consideration of
      postulated binding modes in the various transition states is shown to account for
      the order of reactivity reflected in values kcat./Km for the four reactions
      involving papain (Pap) and actinidin (Act) with the L- and D-enantiomeric
      substrates: Pap-L much greater than Act-L greater than Pap-D much greater than
      Act-D.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1736905
TI  - Serum magnesium levels in asthmatic patients during acute exacerbations of
      asthma.
AB  - The purpose of this study was to determine whether serum magnesium levels in
      asthmatic patients during acute exacerbations differ from those of a control
      population. Twenty-three known asthmatics presenting to the emergency department
      in acute exacerbation (cases) and 15 nonasthmatic patients (controls) matched for
      age, sex, race, and socioeconomic status had serum magnesium assays drawn.
      Admission criteria were: age 18 to 50 years with no history of alcoholism, heart
      disease, renal disease, or diuretic use. Patients giving a history of pregnancy
      were excluded. Serum magnesium levels were not significantly different in the two
      study populations, nor did they correlate with the severity of asthma (mean
      values: cases, 2.04 +/- 0.159 versus controls, 2.03 +/- 0.134 mg/dL; SD of the
      difference of the means = .048). An analysis for beta-error demonstrated the true
      difference of the means to be less than .1 (95% confidence) or less than .13 (99%
      confidence). In conclusion, serum magnesium levels in asthmatics are not
      significantly different from those of a control nonasthmatic population. They are
      not clinically useful for predicting the severity of disease.

PMID- 1736904
TI  - Peroxisomal fatty acid oxidation and inhibitors of the mitochondrial carnitine
      palmitoyltransferase I in isolated rat hepatocytes.
AB  - Fatty acid oxidation was studied in the presence of inhibitors of carnitine
      palmitoyltransferase I (CPT I), in normal and in peroxisome-proliferated rat
      hepatocytes. The oxidation decreased in mitochondria, as expected, but in
      peroxisomes it increased. These two effects were seen, in variable proportions,
      with (+)-decanoylcarnitine, 2-tetradecylglycidic acid (TDGA) and etomoxir. The
      decrease in mitochondrial oxidation (ketogenesis) affected saturated fatty acids
      with 12 or more carbon atoms, whereas the increase in peroxisomal oxidation (H2O2
      production) affected saturated fatty acids with 8 or more carbon atoms. The
      peroxisomal increase was sensitive to chlorpromazine, a peroxisomal inhibitor. To
      study possible mechanisms, palmitoyl-, octanoyl- and acetyl-carnitine
      acyltransferase activities were measured, in homogenates and in subcellular
      fractions from control and TDGA-treated cells. The palmitoylcarnitine
      acyltransferase was inhibited, as expected, but the octanoyltransferase activity
      also decreased. The CoA derivative of TDGA was synthesized and tentatively
      identified as being responsible for inhibition of the octanoylcarnitine
      acyltransferase. These results show that inhibitors of the mitochondrial CPT I
      may also inhibit the peroxisomal octanoyl transferase; they also support the
      hypothesis that the octanoyltransferase has the capacity to control or regulate
      peroxisomal fatty acid oxidation.

PMID- 1736906
TI  - Interobserver agreement in the examination of acute ankle injury patients.
AB  - The authors' objective was to describe a method for measuring interobserver
      agreement and to determine the reliability of physical findings used by emergency
      physicians to assess ankle injury patients. A 3-month prospective survey was
      designed for use in the emergency departments of two university hospitals.
      Participants were a convenience sample of 100 adult blunt ankle injury patients.
      Pairs of emergency staff physicians assessed 22 standardized physical findings in
      each patient without knowledge of the other assessment. Agreement for each
      variable was measured by the kappa coefficient, the ratio of actual agreement to
      potential agreement beyond chance. The variables with the highest interobserver
      agreement and their kappa values were ability to bear weight (.83); bone
      tenderness at the base of the fifth metatarsal (.78), at the posterior edge of
      lateral malleolus (.75), and at the tip of the medial malleolus (.66); and
      combinations of bone tenderness (.76). Less reliable variables included soft
      tissue tenderness (.41) or degree of swelling (.18) of the anterior talofibular
      ligament, ecchymosis (.39), range of motion (.33), bone tenderness at the
      proximal fibula (-.01), and the anterior drawer sign (-.03). High kappa values
      indicate that several physical findings, including ability to bear weight and
      selected sites of bone tenderness, may be reliably assessed in ankle injury
      patients. This knowledge may give physicians more confidence in their physical
      examination and allow development of reliable clinical guidelines to diminish the
      reliance on radiography in ankle injuries.

PMID- 1736907
TI  - Visualization of ingested medications in the stomach by ultrasound.
AB  - The authors describe a potential application of ultrasound in detection of pills
      in the stomach, and report the first case of its use in a patient. Thirty pills
      were studied in vitro by ultrasound. All were clearly detected, with better
      imaging compared with plain radiography. Four pills with slow disintegration
      (sustained release or enteric coated) and two with fast disintegration (immediate
      release) were further studied by ultrasound, following their ingestion by human
      volunteers. All four pills with slow disintegration were clearly visualized in
      the stomach, while detection of the other two pills was inconsistent. A sustained
      release phenytoin capsule was detected by ultrasound in the stomach of a patient
      3 hours after its ingestion. Ultrasound is a potential diagnostic tool in
      detection of pills in the stomach following acute ingestion. Its use, however,
      seems to be limited to sustained-release or enteric-coated preparations.

PMID- 1736908
TI  - Intracranial injury following minor head trauma.
AB  - One hundred twelve patients presenting with a Glascow Coma Scale (GCS) score
      greater than or equal to 13 with a history of minor head trauma were
      prospectively studied to determine if certain historic or physical examination
      variables would predict which of these patients were at increased risk for
      intracranial injury. Patients either underwent cranial computed axial tomography
      (CT) or were followed up by phone at 4 weeks to determine major morbidity or
      mortality. Thirty-five patients underwent CT scanning of the head and eight
      demonstrated intracranial injury. Five patients were treated nonoperatively, and
      three patients had neurosurgical intervention. One patient died following
      surgery. At the 4-week follow-up no patient was found to have suffered any major
      morbidity or mortality. Stepwise logistic regression found age over 40 years (P =
      .05, odds ratio = 6.4, 95% confidence interval 1.0 to 38.8) and complaint of
      headache (P = .039, odds ratio 8.167, 95% confidence interval 1.074 to 62.09) to
      be significantly predictive of intracranial injury. All eight patients with
      positive CTs had a GCS score of 15. The authors conclude that intracranial injury
      does exist in patients suffering minor head trauma with a GCS score of 13 or
      above. Age over 40 years and complaint of headache are associated with an
      increased risk of intracranial injury.

PMID- 1736909
TI  - Long-term local effects of intraosseous infusion on tibial bone marrow in the
      weanling pig model.
AB  - The weanling pig model was used to determine the long-term local effects, if any,
      on tibial bone marrow after intraosseous (IO) infusion of resuscitation fluid and
      drugs at standard dosages. One of six IO treatments (two normal saline boluses
      [20 mL/kg]; bolus sodium bicarbonate [1 mEq/kg]; 10% sodium bicarbonate infusion
      at a maintenance rate for 1 hour; bolus 1:10,000 epinephrine [0.01 mg/kg];
      1:10,000 epinephrine solution infusion, 1 microgram/kg/min for 1 hour; or
      dopamine infusion, 10 micrograms/kg/min for 1 hour) was randomly administered via
      the left tibia to 18 pigs at 4 weeks of age. The animals were subsequently
      followed for 3 months, after which marrow from the same space and peripheral
      blood were examined. Marrow from the right tibia of each animal served as
      control; untreated historic controls were also used for comparison. Examination
      of the marrow revealed normal cell differentials in all limbs in all groups.
      Overall cellularity was somewhat decreased in the experimental limbs of the
      normal saline bolus group when compared with same-animal control limbs, perhaps
      due to the pressure effect from rapid injection. Peripheral blood counts and
      differentials in these and all other animals were normal. The authors conclude
      that IO administration of commonly used resuscitative medications does not result
      in significant adverse effects in the tibial bone marrow in this model.

PMID- 1736910
TI  - Internal cardiac massage and mediastinal irrigation in hypothermic cardiac
      arrest.
AB  - Two unconscious patients with unknown past medical histories were found to be
      severely hypothermic, with core temperatures of 80.2 degrees F and 86.7 degrees
      F, respectively. During the course of active internal rewarming, both patients
      sustained a cardiac arrest. Emergency thoracotomies were immediately done, and
      internal cardiac massage with warmed mediastinal irrigation was performed.
      Spontaneous cardiac activity developed in both patients. Within 24 hours after
      resuscitation, both patients were responsive and following commands.

PMID- 1736911
TI  - Bedside ultrasound in decision making for emergency surgery: its role in medical
      intensive care patients.
AB  - During an 18-month period the authors followed 1,024 patients referred to a
      general medical intensive care unit. A total of 7% of these patients underwent
      emergency surgery at some point during their admission. The role of abdominal
      ultrasound in the decision-making process for these emergency surgical
      interventions was evaluated and the patients were identified for whom the
      pathologic result of sonography was regarded sufficient to operate without any
      additional imaging procedures. Of 71 patients with unexpected surgical
      emergencies, abdominal ultrasound provided a definite diagnosis for 18 patients
      (25%), and the decision to operate could be made without delaying for further or
      more invasive diagnostic techniques. In all cases the sonographic diagnosis was
      confirmed during the operation. The critical care patients most likely to benefit
      from bedside ultrasound in a surgical emergency were those with hemorrhage of
      unknown origin (44%) or septicemia from an undetected focus (39%). The most
      frequent site of operation where ultrasound was considered diagnostic was the
      urinary tract (56%), particularly in emergencies following renal transplantation.

PMID- 1736912
TI  - Arteriovenous malformation of the vein of Galen: a rare cerebral arteriovenous
      malformation.
AB  - A 32-year-old male presented to the emergency department for evaluation of a 12
      day history of altered mental status. Workup revealed the presence of an
      arteriovenous malformation (AVM) of the great vein of Galen, an exceedingly rare
      and often fatal type of cerebral vascular malformation. Concurrent aneurysmic
      dilatation of the vein, a frequent finding associated with this type of AVM,
      resulted in compression of the aqueduct of Sylvius and acute hydrocephalus. A
      brief review of cerebral AVMs is presented, with specific attention to the
      pathophysiology, clinical presentation, and emergent treatment of those that
      involve the vein of Galen.

PMID- 1736913
TI  - Prehospital bicarbonate use in cardiac arrest: a 3-year experience.
AB  - The American Heart Association no longer recommends the routine use of sodium
      bicarbonate in cardiac arrests. Reasons cited include the lack of documented
      effect on clinical outcome and potential adverse effects of metabolic alkalosis
      and hypernatremia. We reviewed 36 months of experience with 619 nontrauma adult,
      prehospital cardiac arrest patients to identify 273 successful resuscitations who
      had emergency department blood gases and electrolytes performed. Determination of
      complications associated with prehospital intravenous sodium bicarbonate and its
      impact on survival in resuscitated patients was undertaken. Fifty-eight patients
      did not receive sodium bicarbonate (NO HCO3 group) and had short cardiopulmonary
      resuscitation (CPR) times (7.4 +/- 5.5 minutes). Two hundred fifteen patients did
      receive sodium bicarbonate (HCO3 group) and had significantly longer CPR times
      (23.3 +/- 13.5 minutes, P less than or equal to .001). Both groups demonstrated
      routine early chest compression and hyperventilation as evidenced by no
      significant difference in paramedic response time or rate of intubations. Initial
      emergency department blood gas results of both groups were not significantly
      different. No patients in the NO HCO3 group had hypernatremia (sodium [Na]+
      greater than 150), whereas four patients (2%) in the HCO3 group were
      hypernatremic. Eight patients (14%) in the NO HCO3 group and 37 patients (17%) in
      the HCO3 group were alkalotic with pH values greater than 7.49 (P = NS). Six
      patients (10%) of the NO HCO3 group and 24 patients (11%) of the HCO3 group had a
      metabolic component to the alkalosis as defined by a positive base excess value
      (P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736914
TI  - Pediatric chest pain: case report of a malignant cause.
AB  - Pediatric chest pain is not an uncommon presenting complaint in the emergency
      department. Although the majority of cases are benign, the authors report on a
      patient with a fetal case of myocarditis. A discussion of myocarditis and its
      management as well as differential diagnosis is included.

PMID- 1736915
TI  - Peripartum cardiac failure in a woman with Graves' disease.
AB  - A case of peripartum cardiac failure is reported in a 20-year-old gravida 3, para
      3 black female. The patient was 6 weeks postpartum. Graves' disease had been
      diagnosed in the first trimester of her pregnancy. The patient presented to the
      emergency department with complaints of fever, abdominal pain, shortness of
      breath, and chest pain. Physical examination revealed signs of congestive heart
      failure and anasarca. Chest x-ray revealed bilateral pleural effusions, and an
      abdominal series was consistent with ascites. Bedside electrocardiogram revealed
      pan-hypokinesis of all four cardiac chambers. The authors believe that this is
      the first case reported in the literature of peripartum cardiac failure occurring
      in a patient with Graves' disease.

PMID- 1736916
TI  - Simultaneous bilateral spontaneous pneumothorax: case report.
AB  - A 22-year-old previously healthy male was admitted to the emergency department
      for chest pain and dyspnea of 1-day's duration. He had a history of heavy
      smoking. The patient was cyanotic, agitated, and severely dyspneic. Lung
      auscultation revealed severe diffuse bronchospasm and equally diminished breath
      sounds on both sides. Nasotracheal intubation and mechanical ventilation were
      performed shortly after admission due to acute respiratory failure. Simultaneous
      bilateral spontaneous pneumothorax was diagnosed from the chest x-ray, and chest
      tube drainage was immediately performed bilaterally. Computerized tomography of
      the chest 1 month later showed diffuse emphysematous bullae of the lungs. The
      case presented here should increase physicians' awareness of this rare form of
      spontaneous pneumothorax and its diverse manifestations.

PMID- 1736917
TI  - Safety of pre-hospital therapy with morphine sulfate.
AB  - The safety of prehospital pharmacologic therapy has not been well studied. The
      authors evaluated field use of morphine sulfate (MS) in San Francisco County over
      a 6-month period. Paramedics assessed patients for ischemic chest pain (ICP)
      and/or pulmonary edema (PE), made base hospital contact, and administered 2- to 4
      mg doses of intravenous morphine according to treatment protocols. Clinical
      assessments and patient responses to therapy were recorded by both field
      paramedics and emergency department (ED) physicians. Safety was evaluated by
      determining the (1) accuracy of paramedic field assessment, (2) appropriateness
      of field administration of MS, and (3) therapeutic complications. During the
      study period, paramedics administered MS to 84 patients. In 69 cases paramedic
      assessment of either ICP and/or PE corresponded to ED physician diagnosis. In
      five cases paramedics correctly recognized ICP but missed physical findings of
      PE. In this group the paramedics' assessment was considered inaccurate but the
      judgement to give MS was considered appropriate. In the remaining 10 cases
      paramedics identified ICP or PE but the ED physician diagnosed a different
      condition. These assessments were considered inaccurate and the management
      inappropriate. Therefore, overall paramedic accuracy was 77% (true rate 73% to
      82%, 95% confidence interval); appropriateness of therapy was 88% (true rate 85%
      to 92%, 95% confidence interval); and the overall complication rate was 6% (true
      rate 2% to 12%, 95% confidence interval). Complications of respiratory depression
      or hypotension occurred in only one of the cases in which MS was inappropriately
      administered.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736918
TI  - Unsuspected heterotopic pregnancy in a woman without risk factors.
AB  - A 27-year-old woman presented to the emergency department with abdominal pain.
      One week prior to this she had had an ultrasound which revealed an intrauterine
      pregnancy (IUP). A second ultrasound performed at our institution revealed an
      intrauterine pregnancy along with a concomitant ectopic pregnancy which had
      ruptured. This case emphasizes that coincident pregnancies may occur in women who
      are without risk of ectopic pregnancy or multiple gestations. In addition,
      ultrasound must be evaluated fully for heterotopic pregnancy in all women.

PMID- 1736919
TI  - Anaphylaxis from administration of intravenous thiamine.
AB  - The routine administration of intravenous thiamine in the emergency department
      has become widespread. Although anaphylaxis from intravenous thiamine is felt to
      be uncommon, it can be life threatening. The authors present such a case and
      review the literature regarding this clinical entity. This case of anaphylactic
      reaction appears to be the first instance reported since 1946 in the US
      literature. However a review revealed that cases of anaphylaxis from thiamine
      have been reported with some regularity in the non-US literature. Given the large
      number of patients treated without side effects, it seems that thiamine is
      relatively safe. However, this case illustrates that the assumption that thiamine
      is a drug with a completely innocuous nature is not totally accurate.

PMID- 1736920
TI  - Occult fractures of the femoral neck.
AB  - Occult fractures of the femoral neck can be subtle or even undetectable on plain
      radiographs. Yet, untreated, the morbidity of this fracture significantly
      increases. This report discusses the clinical and radiologic findings seen in
      occult fractures of the femoral neck. It also discusses the role of tomograms,
      bone scan, computed tomography, and magnetic resonance imaging in further
      delineating this entity.

PMID- 1736921
TI  - Neuroimaging of fractureless transforamen magnum penetrating injury of the
      cerebellum.
AB  - An unusual case of penetrating injury to the cerebellum by a foreign body is
      described. The authors recommend plain radiographs and computed tomography to
      rule out fractures of the skull vault and base and the upper cervical spine, as
      well as to ascertain the presence and location of foreign bodies. Magnetic
      resonance imaging is ideal for the follow-up assessment of brain damage.

PMID- 1736922
TI  - Magnesium deficiency: recognition and treatment in the emergency medicine
      setting.
AB  - Magnesium deficiency and its clinical manifestations are common in patients
      presenting to the emergency department. Assessment of the total body magnesium
      status of a patient is problematic since the serum magnesium concentration, the
      only readily available clinical test for this condition, may not be accurate in
      predicting the intracellular magnesium concentration. Therefore, empiric
      magnesium therapy should be considered in high-risk patients. Since magnesium
      participates in numerous metabolic processes in the body, a deficiency can affect
      multiple organ systems and present clinically in a variety of ways. Magnesium
      deficiency is reviewed in this paper with regard to therapeutic implications;
      specific treatment guidelines are given including dose, infusion rate, and
      magnesium preparation. Magnesium is also reviewed with regard to its homeostasis
      and metabolic role in the body. Special mention is made regarding precautions for
      use of magnesium in the setting of renal insufficiency.

PMID- 1736923
TI  - An analysis of reimbursement for outpatient medical care in an urban hospital
      emergency department.
AB  - The investigators examined the demographic and clinical factors associated with
      the collection experience in a series of 786 patients who were treated in an
      urban hospital emergency department (ED) but not admitted to the hospital. They
      found that 57% of the total net charge of $150,489 had been paid within 180 days.
      This rate can be compared with an average inpatient collection rate of 85% at 180
      days. Seven factors were found to account for the collection rate variation,
      making up 38.4% of the total variation. Age, gender, primary diagnosis, season of
      visit, time of arrival, and residence were not found to be main contributors.
      Insufficient collection rates may be an indication that EDs increasingly are
      becoming a financial risk to hospitals. The hospital's collection experience will
      become more important as an indicator of financial risk if the costs of operating
      EDs continue to escalate and collection rates do not improve. Both the costs of
      providing a service and the amount of the charge actually collected are valid
      concerns to those operating EDs.

PMID- 1736924
TI  - Observation medicine: an annotated bibliography.

PMID- 1736925
TI  - Minor head trauma.

PMID- 1736926
TI  - Kerr Insta-Char Activated Charcoal Product.

PMID- 1736927
TI  - Less problems for ears!

PMID- 1736928
TI  - A gender difference in the association between salt sensitivity and family
      history of hypertension.
AB  - We examined 174 subjects (82 men and 92 women) with essential hypertension to
      determine whether gender played an important role in the association of blood
      pressure (BP) familial disposition, and hypertension. To evaluate the salt
      sensitivity of BP, we measured changes in blood pressure after restricting salt
      intake from about 15 g/day to less than 3 g/day. The familial disposition to
      hypertension was categorized into four groups according to the presence or
      absence of hypertension in the father, mother, and siblings. If none, one, two,
      or three family members had hypertension, they were assigned the FH(-), FH(+),
      FH(++), and FH( ) groups, respectively. Only in women did the FH(-) group show a
      significantly smaller blood pressure reduction than that of the other groups. The
      mean BP reduction in the four groups was 4.1 +/- 1.9, 8.5 +/- 1.1, 10.1 +/- 1.5,
      and 11.2 +/- 2.8 mm Hg (mean +/- SEM), respectively. This difference in BP
      reduction was not observed in men. Multiple regression analysis, using percent
      changes in mean BP as the dependent variable and other factors as independent
      variables, also showed a significant partial correlation coefficient for familial
      disposition to hypertension only in women. Thus, the relationship between salt
      sensitivity and familial disposition to hypertension differed according to
      gender. This difference may provide an important insight into the hereditary
      nature of hypertension.

PMID- 1736929
TI  - Discrepancies in recording systolic blood pressure of elderly persons by
      ambulatory blood pressure monitor.
AB  - Agreements between auscultatory blood pressure measurements and recordings of the
      Suntech Accutracker II ambulatory blood pressure monitor (ABPM) were examined in
      103 participants ages 23 through 91 to estimate influence of age on accuracy of
      automated recordings. Simultaneous auscultation by two technicians and recording
      by the ABPM were compared. Technicians demonstrated close agreement in
      auscultation of blood pressure. Mean systolic blood pressure measured by ABPM was
      5.6 mm Hg lower and mean ABPM diastolic blood pressure was 6.3 mm Hg lower than
      average auscultatory blood pressure measured by technicians (P less than .0001).
      Discrepancies in systolic blood pressure measurements between technicians and
      ABPM were associated with age and systolic blood pressure. The age effect,
      controlled for gender and race, was a 0.15 mm Hg increase in systolic blood
      pressure discrepancy per year of age. Discrepancies in diastolic blood pressure
      measurements were associated with race but not with age or body size
      measurements. Automated recordings of blood pressure by this ABPM may have
      systematic bias compared to auscultation which exceeds current standards for ABPM
      instrumentation. For systolic blood pressure, this bias increases with age and
      may affect interpretation of ABPM recordings in elderly persons.

PMID- 1736930
TI  - Insulin resistance in secondary hypertension.
AB  - The insulin sensitivity of five essential hypertensive patients was compared to
      five patients with renovascular hypertension, five patients with primary
      hyperaldosteronism, and five normotensive subjects, using the euglycemic
      hyperinsulinemic clamp technique. Essential hypertensive patients had
      significantly lower insulin sensitivity than patients with hyperaldosteronism and
      renovascular hypertensive patients (P = .0066, P = .004, respectively).
      Hyperaldosteronism patients also had less insulin sensitivity than renovascular
      hypertensive patients (P = .016). A significant negative correlation was found
      between body mass index and insulin sensitivity index for essential hypertension
      patients only (r = -0.87, P less than .003). No such correlation was found in the
      secondary hypertension patients. The findings suggest a causal relationship
      between insulin resistance and the development of essential hypertension.
      Secondary hypertension, on the other hand, is not such an insulin resistant
      state.

PMID- 1736931
TI  - Dipyridamole decreases circulating renin-angiotensin system activity in
      hypertensive patients.
AB  - To study the effect of adenosine on renin release, n = 6 hypertensive patients,
      while on a constant 80 to 100 mEq/24 h Na+ diet, received oral 150 mg
      dipyridamole (an adenosine uptake inhibitor) three times daily for 3 days while
      upright plasma renin activity (PRA) and plasma aldosterone, urinary aldosterone,
      plasma and urinary Na+,K+, and creatinine clearance were monitored the day before
      (basal) the first and third day of the treatment and the day after the withdrawal
      (recovery). As compared to basal and to recovery, dipyridamole significantly
      decreased PRA, and plasma and urinary aldosterone without affecting plasma and
      urinary Na+ and K+, creatinine clearance, blood pressure, and heart rate. These
      data, showing that dipyridamole decreases PRA and aldosterone, confirm also in
      hypertensives that endogenous adenosine inhibits the circulating renin
      angiotensin-aldosterone system.

PMID- 1736932
TI  - Gender differences in left ventricular structure and function in young adults
      with normal or marginally elevated blood pressure.
AB  - Gender differences in left ventricular structure and function were evaluated in
      68 male and 69 female young adults (mean age 30 +/- 7 years) with normal or
      marginally elevated blood pressure. Left ventricular mass index was greater in
      men than in women, even after controlling for blood pressure. There were no
      significant gender differences in left ventricular systolic function. Doppler
      indices of diastolic filling were also similar in men and women. Thus, men have a
      significantly greater left ventricular mass index than women, but this difference
      in ventricular size is not associated with differences in systolic or diastolic
      function.

PMID- 1736933
TI  - The Trial of Antihypertensive Interventions and Management (TAIM) Study. Final
      results with regard to blood pressure, cardiovascular risk, and quality of life.
AB  - The Trial of Antihypertensives Interventions and Management (TAIM) was a
      multicenter double-blind placebo-controlled clinical trial of drug and diet
      combinations for the treatment of mild hypertension among 878 participants, ages
      21 to 65, 110% to 160% ideal weight, and with baseline diastolic blood pressure
      90 to 100 mm Hg. The drugs used were placebo, chlorthalidone (25 mg/daily) or
      atenolol (50 mg/daily). The diets studied were usual, weight loss, sodium
      reduction/potassium increase. Trial end points were 6-month diastolic blood
      pressure change, cardiovascular risk change, and quality of life change. Either
      drug combined with weight loss produced the greatest blood pressure reduction of
      15 mm Hg, compared to 8 mm Hg on placebo/usual diet. Adding sodium restriction to
      either drug did not enhance blood pressure lowering effect. Drugs outperformed
      diet in terms of antihypertensive effect. However, those on placebo and assigned
      to weight reduction who lost more than 4.5 kg and those on sodium restriction who
      reduced sodium to less than 70 mEq daily lowered blood pressure to a similar
      extent as those on either of the two drugs alone. Cardiovascular risk at 6 months
      relative to baseline ranged from 0.85 in weight loss/atenolol subgroup to 1.04 in
      the usual diet/chlorthalidone subgroup. Blacks were more responsive to
      chlorthalidone plus weight loss and whites to atenolol plus weight loss. Quality
      of life, as measured by scales of distress and well-being, was favorably affected
      by weight reduction. Although there were few side effects of the drugs and most
      patients improved on most parameters, sexual complaints were worsened among those
      on chlorthalidone and usual diet compared to placebo.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1736934
TI  - Difficulties with cytosolic free calcium measurement. Comment on the study by
      Yokokawa et al.

PMID- 1736935
TI  - Commentary on the Trial of Antihypertensive Interventions and Management (TAIM)
      Study.

PMID- 1736936
TI  - Excess prevalence of extracranial carotid artery lesions in renovascular
      hypertension.
AB  - High renin hypertension has been associated with a higher risk of stroke than low
      to-normal renin hypertension. Accordingly, we investigated prospectively the
      prevalence of the extracranial carotid artery lesions in a case-control study of
      70 patients (38 women and 32 men, aged 16 to 77 years) without history or
      symptoms of cerebrovascular disease. Renovascular hypertension was diagnosed in
      35 patients on the basis of the angiographic demonstration of renal artery
      stenosis and of the favorable outcome after revascularization. It was caused by
      atherosclerosis in 20 patients and by fibrodysplasia in 15. Each renovascular
      hypertensive patient was individually matched with a control with primary
      hypertension for sex, race, age, blood pressure levels, duration of hypertension,
      smoking, diabetes mellitus, total serum cholesterol, and triglycerides. Carotid
      arteries were evaluated by a High Resolution Duplex system (Biosound 2000, probe
      4 cm, 8 mHz). Our results show that after the matching the two groups were
      similar in terms of demographic features and overall cardiovascular risk profile
      (all P = NS). In renovascular hypertensives the prevalence of carotid artery
      lesions (82.6%) was significantly (P less than .01) higher than in primary
      hypertensives (42.9%). The higher prevalence of lesions in renovascular
      hypertension was observed not only in patients with atherosclerosis (100% v 55%,
      P less than .001), but also in those with fibrodysplasia (57% v 27%, P less than
      .01). Thus, for the same demographic features and overall cardiovascular risk
      profile, renovascular hypertension carries a more detrimental effect on the
      carotid artery than primary hypertension.

PMID- 1736937
TI  - Spatial visualization of the maturing HIV-1 core and its linkage to the envelope.
AB  - The core of late states of maturing human immunodeficiency virus type 1 (HIV-1)
      has been visualized in three dimensions at approximately 7 nm resolution by
      electron microscopic tomography. After budding, approximately 25 nm thick
      precursor material is observed densely assembled inside the viral envelope. Upon
      proteolysis the core material is transported and condensed in the center of the
      virion. The core, 100 nm in length, spans the entire diameter of the virion
      showing a 40-60 nm wide free end and a narrow end approximately 20 nm. A model of
      the core is derived consisting of two fibers packed into a bilateral, elongated
      structure. Two ends of the fibers are compacted together, forming one narrow end
      of the core, while the two other fiber ends are situated more loosely together
      allowing for flexibility. Structural maturation of the virus could be reflected
      by the degree of compactness of the core. The narrow end of the core is observed
      attached to the envelope with a conspicuous core-envelope link (CEL).

PMID- 1736938
TI  - Lectin-carbohydrate interactions and infectivity of human immunodeficiency virus
      type 1 (HIV-1).
AB  - The aim of this study was to determine whether mannosyl-specific lectins,
      especially Concanavalin A (ConA), may bridge HIV-1 env glycoproteins to cell
      membranes to increase virus binding to its targets, and to what extent this
      lectin-carbohydrate interaction can modify HIV-1 infectivity for monocytic
      compared with lymphoid cells. Monocytic U937 and lymphoid CEM cells, which both
      express surface mannose, were utilized. Whether first incubated with env
      glycoprotein or with the cells, lectins bound both to the cells and to
      radiolabeled recombinant gp160 (rgp160). Thus, they enhanced rgp160 adsorption to
      the cells in a methyl-alpha-mannose inhibitable manner. ConA did not appear to
      bind to the V1 domain of CD4 at the U937 cell surface since Leu3a binding was not
      blocked in the presence of ConA, nor was recombinant CD4 retained on a ConA
      agarose affinity matrix. Moreover, enhanced rgp160 binding to the cells was CD4
      independent, since it was not modified by preincubating the cells with Leu3a.
      Finally, ConA did not inhibit the binding of CD4-IgG3 chimeric molecules to
      virions immobilized on nitrocellulose membrane, which argues against the
      possibility that it interferes with the interaction of gp120 and CD4. However,
      both when incubated with the virus or with the cells and despite mediating
      enhanced binding of env glycoprotein, ConA neutralized HIV-1 infectivity for
      monocytic U937 as well as for lymphoid CEM cells. In this respect, ConA behaves
      like neutralizing antibodies which do not interfere with CD4 binding of gp120 but
      rather with some later event that leads to virus entry. These findings obtained
      with plant lectins may be of relevance in vivo, inasmuch as endogenous mannosyl
      binding proteins, which are known to function as opsonins, have been reported to
      inhibit in vitro infection by HIV-1.

PMID- 1736939
TI  - Inhibition of HIV production in cells containing an integrated, HIV-regulated
      diphtheria toxin A chain gene.
AB  - Construction of a DNA plasmid that expresses a diphtheria toxin A chain (DT-A)
      gene under control of human immunodeficiency virus (HIV-1) proteins Tat and Rev
      has been described. Here the generation of HeLa cell clones containing
      integrated, HIV-regulated DT-A sequences is reported. Five such clones were
      identified by their decreased expression of a luciferase reporter gene
      transiently cotransfected with Tat- and Rev-encoding plasmids. The decreased
      luciferase expression most probably was due to activation of the integrated DT-A
      gene because higher luciferase activity could be restored by introducing either
      DT antitoxin or a gene encoding a mutant, DT-resistant elongation factor 2 (the
      intracellular target for DT-A). Analysis by polymerase chain reaction (PCR)
      indicated that all clones expressed DT-A encoding RNA. The clones were then
      transfected with an HIV proviral clone and were tested for HIV production; all
      five clones demonstrated substantially impaired HIV production compared with
      parental HeLa cells, as shown by p24 assays of culture supernatants. Our success
      in generating these cell lines indicates that extremely low basal expression has
      been achieved in view of the high cellular lethality of DT-A. HIV-regulated
      expression of DT-A may be applicable as a gene therapy approach for the acquired
      immune deficiency syndrome (AIDS), to bring about selective suicide of HIV
      infected cells before production of viral progeny.

PMID- 1736940
TI  - Distinct populations of human immunodeficiency virus type 1 in blood and
      cerebrospinal fluid.
AB  - The nucleotide sequence of the gp41 transmembrane protein coding region of human
      immunodeficiency virus type 1 (HIV-1) proviral DNA obtained from blood and
      cerebrospinal fluid (CSF) from 6 individuals was determined by direct sequencing
      of polymerase chain reaction (PCR)-amplified DNA. The direct sequencing approach
      was performed to avoid errors introduced by Taq polymerase during the
      amplification reaction. In 3 of 6 paired samples distinct sequence differences
      between proviral DNA from blood and CSF, ranging from 0.64% to 1.73%, were
      detected. The greatest diversity (4.2% different amino acids) was found between
      paired samples of a patient suffering from AIDS encephalopathy, with most of the
      differences clustering near the carboxy-terminal end of gp41. The results
      demonstrate that genetically different populations of HIV-1 may be present in
      different biological compartments and specific neurotropic HIV variants may
      exist.

PMID- 1736941
TI  - Modulation of normal human erythropoietic progenitor cells in long-term liquid
      cultures after HIV-1 infection.
AB  - Long-term bone marrow cultures (LTBMC) have been infected by two isolates of
      human immunodeficiency virus type 1 (HIV-1) (HIV-1 LAV and HIV-1 NDK) at
      multiplicities of infection ranging from 10(2) to 2.10(6) tissue culture
      infectious units (TCIU) per 10(6) bone marrow mononuclear cells (BMMNC). These
      infected cells are nonproducer cells and the viruses can be rescued by coculture
      with peripheral blood lymphocytes, cord blood lymphocytes, or BMMNC and not by
      the CEM cell line. HIV-1 clearly is not cytopathic for these cells. Following
      production and growth of erythroid burst-forming units (BFU-E) and erythroid
      colony-forming units (CFU-E) for at least 6 weeks after infection with HIV-1 NDK,
      colony assays displayed a 50% inhibition of BFU-E production during 3 weeks of
      LTBMC. This was followed by a stimulation phase. On the contrary, HIV-1 LAV
      induces a 150% stimulation of BFU-E production, followed by 50% inhibition.
      Production of CFU-E was inhibited by 80-100% with the two isolates of HIV-1 after
      four weeks of LTBMC. Stimulatory and inhibitory activities were recovered from
      supernatants of infected LTBMC and lymphoid CEM cell lines, suggesting that HIV-1
      induces release of a humoral factor responsible for disruption of hemopoietic
      progenitor cell production in vitro and consequently for hematologic
      abnormalities in AIDS patients.

PMID- 1736942
TI  - Population sequence analysis of a simian immunodeficiency virus (32H reisolate of
      SIVmac251): a virus stock used for international vaccine studies.
AB  - The virus structural genes gag and env (both gp120 and gp41 regions) of the 32H
      isolate of SIVmac251 were amplified using the polymerase chain reaction (PCR).
      The proviral template used in the PCR was DNA isolated from cells used to prepare
      several experimental SIV vaccines, which have been tested in simians, and a
      standard challenge stock of virus, which has been used in international
      collaborative studies. The PCR products were cloned and the nucleotide sequences
      of several clones were determined for each gene. From a comparison of the
      sequences obtained the predominant amino acid sequences of gag and env were
      predicted and the degree of sequence heterogeneity was determined. Conserved and
      more variable regions of each protein were identified. The gp120 region of env
      was more heterogeneous than gag or the transmembrane protein of env (gp41).
      Within gp120, sequence variability was concentrated to specific regions
      equivalent to the V1, V2, and, to a lesser extent, the C1 regions identified for
      human immunodeficiency virus type 1 (HIV-1). In contrast the region equivalent to
      the hypervariable "V3-loop" of HIV-1 was highly conserved. The implications of
      the data is discussed in relation to the ability of this virus stock to prepare
      effective vaccines against SIV.

PMID- 1736943
TI  - Investigation of human immunodeficiency virus fusion peptides. Analysis of
      interrelations between their structure and function.
AB  - The N-terminal region of the human immunodeficiency virus type 1 (HIV-1) gp41
      appears to be involved in virus-cell membrane fusion. To study the influence of
      fusion domain structure on gp41 interaction with artificial lipid membranes, two
      families of peptides were synthesized. The peptides of the first family starting
      from the C-terminal Gly-532 of gp160 (BRU isolate) were assembled in a stepwise
      manner to N-terminus of gp41(Ala-517). These hydrophobic peptides, containing 10
      16 amino acid residues (a.a.), were able to form channel-like current fluctuation
      through planar lipid membranes, and the longest 15-16 a.a. peptides lysed the
      liposomes. Peptides of the second family beginning from the C-terminal Arg-538
      and continuing to Val-510 contained several hydrophilic amino acid residues.
      These 15-22 a.a. peptides also increased the conductance of planar lipid bilayers
      and lysed liposomes. The degree of liposome lysis depended upon peptide length
      and concentration. The attachment of gp120 C-terminal amino acid or peptides to N
      terminus of 517-538 peptide resulted in complete loss of activity. The effects of
      the second family of peptides on membranes were reduced to a great extent at
      acidic pH. The conjugation of 22 a.a. Lys peptide with bovine serum albumin
      decreased its lytic activity. The circular dichroism study of these peptides
      revealed alpha-helix configuration in hydrophobic and aqueous media only for deca
      and longer peptides. The electron microscopy of 22 a.a. peptide performed in the
      aqueous medium showed large spherical aggregates about 0.5-0.7 micron in diameter
      consisting of long filaments approximately 5 nm in diameter. Other tested
      peptides could generate only short strings. Thus, the effects of fusion peptides
      on lipid membranes depends on their sequence and length, secondary and tertiary
      structures, and freedom of their N-terminus.

PMID- 1736944
TI  - NdYAG laser treatment of dentinal hypersensitivity.
AB  - Eighteen per cent of all patients have some degree of sensitivity and a range of
      therapies has been devised to alleviate this condition. An electronic monitoring
      machine was constructed which allowed for air stream, directed at a patient's
      tooth, to be started by the clinician and halted by the patient when the
      sensation of pain in the tooth became too unpleasant to tolerate. The time for
      which the patient could tolerate the air flow was electronically measured in
      units of 1/50th second. By measuring the patient's reaction time on each visit
      and correcting the readings obtained for 'tooth pain time' using these figures, a
      quantitative measure of sensitivity change is achieved. Using this system, a
      clinical trial has been conducted to test the efficacy of the NdYAG dental laser.
      The 30 patients treated had an average tooth pain time initially of 1.2 seconds.
      Following laser treatment patients were recalled at 3, 7 and 14 days. At the 2
      week review, this figure had increased to 7.8 seconds, which was found to be
      statistically significant. Control (unlased) teeth demonstrated an average
      improvement of only 1.7 seconds (not statistically significant). Patients'
      subjective assessment of sensitivity pain on a 0-10 scale averaged 8.0 before
      treatment. This reduced to 3.7 after treatment. Treatment of this condition can
      thus be performed easily and painlessly with a predictable response and
      considerable patient satisfaction.

PMID- 1736945
TI  - An investigation of replantation of traumatically avulsed permanent incisor
      teeth.
AB  - The success of treatment of 46 replanted, avulsed permanent incisors in 36
      children was investigated in relation to some of the factors which have been
      reported to affect prognosis. Treatment was considered to have been successful if
      the tooth was still present in the mouth and required no further treatment. If
      more treatment was necessary, the outcome was considered to be uncertain, while
      if the tooth had been lost a failure was recorded. Treatment was considered to be
      successful for 21 teeth, uncertain for 20 teeth and a failure for 5 teeth. A
      significant relationship was found between success and the method of storing the
      avulsed tooth, with milk, saliva or saline being the best media. No relationship
      was demonstrated between the time the avulsed tooth was out of the mouth and
      success. Root resorption was the most frequent complication of replantation and
      occurred in 24 teeth. However, no significant relationship between resorption and
      the time that the avulsed tooth was out of the mouth was demonstrated.

PMID- 1736946
TI  - Multifocal hairy leukoplakia associated with Kaposi's sarcoma.
AB  - An HIV-seropositive patient presented with multifocal lesions of both hairy
      leukoplakia and Kaposi's sarcoma, hairy leukoplakia being present in the
      epithelium covering the Kaposi's sarcoma lesions. The findings suggest that hairy
      leukoplakia in immunocompromised patients is both more common and more widely
      distributed than is generally recognised.

PMID- 1736947
TI  - 'Proper words in proper places'.

PMID- 1736948
TI  - The medical arts.
AB  - There were 152 entries for the Medical Arts Society's annual exhibition and all
      were shown at the Westminster Gallery, London on October 14-19, last year. The
      show displayed an exhibition of skill in the mediums of painting, printmaking,
      sculpture and drawing and prizes were awarded on merit.

PMID- 1736949
TI  - 'Computers in dentistry'.

PMID- 1736950
TI  - 'Computers in dentistry'.

PMID- 1736951
TI  - 'An urgent remedy needed'.

PMID- 1736952
TI  - Sugar intake and dental caries.

PMID- 1736953
TI  - 'Management of fissure caries'.

PMID- 1736954
TI  - Post-smallpox eradication policies.

PMID- 1736955
TI  - Expanded programme on immunization. Global Advisory Group--Part I.

PMID- 1736956
TI  - Acquired immunodeficiency syndrome (AIDS)--data as at 1 January 1992.

PMID- 1736957
TI  - Expanded programme on immunization. Global Advisory Group--Part II.

PMID- 1736958
TI  - Tobacco or health. Smoking as a cause of cancer.

PMID- 1736959
TI  - Influenza.

PMID- 1736960
TI  - Application of multivariate analyses of enzymic data to classification of members
      of the Actinobacillus-Haemophilus-Pasteurella group.
AB  - Outer membrane vesicles and fragments from Actinobacillus actinomycetemcomitans,
      Actinobacillus lignieresii, Actinobacillus ureae, Haemophilus aphrophilus,
      Haemophilus paraphrophilus, Haemophilus influenzae, Haemophilus parainfluenzae,
      Pasteurella haemolytica, and Pasteurella multocida were isolated and examined
      semiquantitatively for 19 enzyme activities by using the API ZYM micromethod. The
      enzyme contents of vesicles and fragments were compared with the enzyme contents
      of whole cells of the same organisms. Enzymic data were analyzed by using
      principal-component analysis and soft independent modeling of class analogy. This
      technique allowed us to distinguish among the closely related organisms A.
      actinomycetemcomitans, H. aphrophilus, and H. paraphrophilus. A.
      actinomycetemcomitans was divided into two groups of strains. A. lignieresii fell
      outside or on the border of the A. actinobacillus class. A. ureae, H. influenzae,
      H. parainfluenzae, P. haemolytica, and P. multocida fell outside the A.
      actinomycetemcomitans, H. aphrophilus, and H. paraphrophilus classes.

PMID- 1736961
TI  - Antigenic and genomic relatedness among Ehrlichia risticii, Ehrlichia sennetsu,
      and Ehrlichia canis.
AB  - Antigenic and genomic relatedness among Ehrlichia risticii, E. sennetsu, and E.
      canis was analyzed by enzyme-linked immunosorbent assay, Western blotting
      (immunoblotting) and DNA-DNA hybridization. E. risticii and E. sennetsu were
      serologically related, and their Western blot antigen profiles were nearly
      identical. Two antigens of E. sennetsu corresponding to the 28- and 51-kDa
      antigens of E. risticii were apparently larger than the E. risticii antigens, and
      the 55-kDa antigen of E. risticii appeared to be unique to this species. The 110
      , 70-, and 44-kDa antigens of these two species were identical, as determined by
      the use of monospecific antibodies. DNA homology between these two species was
      high. On the other hand, E. canis was antigenically least reactive with the
      antisera to E. risticii and E. sennetsu. However, a dog convalescent-stage E.
      canis antiserum recognized antigens in the other two species which were different
      from those recognized by their homologous antisera. Similarly, homology between
      the DNA of E. canis and the DNAs of the other two species was very minimal. These
      results indicate that E. risticii and E. sennetsu are closely related both at the
      genomic and antigenic levels and that the relationship of these two species with
      E. canis is minimal.

PMID- 1736962
TI  - Electrophoretic heterogeneity of ribosomal protein AT-L30 among actinomycete
      genera.
AB  - The ribosomal proteins from 17 type strains of species belonging to various
      actinomycete genera were compared by two-dimensional polyacrylamide gel
      electrophoresis. I detected a striking variability among certain ribosomal
      proteins (designated AT-L30 proteins) with respect to electrophoretic mobility in
      the first dimension. In contrast, such variability was not observed among
      ribosomal L30 proteins from other bacteria, such as Escherichia coli, Bacillus
      subtilis, Pseudomonas aeruginosa, and Staphylococcus aureus. Although
      actinomycete AT-L30 proteins from different taxa exhibited considerable
      heterogeneity in electrophoretic mobility, within each genus the proteins had a
      specific mobility characteristic. On the basis of this observation, the ribosomal
      AT-L30 proteins from 11 type strains of species belonging to the mycolic acid
      containing genera Nocardia, Rhodococcus, Gordona, and Tsukamurella were analyzed.
      The relative electrophoretic mobilities of AT-L30 protein preparations from these
      strains, as determined by two-dimensional gel electrophoresis, revealed that the
      genera Nocardia, Rhodococcus, Gordona, and Tsukamurella can be sharply separated
      from each other. My results are consistent with the previously discussed view
      that each of these genera merits separate genus status.

PMID- 1736963
TI  - Polyacrylamide gel electrophoresis analysis of ribosomal protein AT-L30 from an
      actinomycete genus, Streptosporangium.
AB  - We analyzed the ribosomal AT-L30 proteins from 11 type strains of species
      belonging to the genus Streptosporangium. The electrophoretic mobilities of the
      AT-L30 preparations from these strains, as determined by two-dimensional
      polyacrylamide gel electrophoresis, revealed that they could be divided into
      three groups. The first group contained Streptosporangium viridogriseum, S.
      viridogriseum subsp. kofuense, and S. albidum, while the second group contained
      S. roseum, S. album, S. vulgare, S. nondiastaticum, S. fragile, S.
      violaceochromogenes, and S. amethystogenes. S. corrugatum was a member of the
      third group. These groups were completely consistent with Nonomura's previous
      classification, which was based on morphological criteria. The results of partial
      amino acid sequencing of AT-L30 preparations from several representative strains
      strongly supported the hypothesis that each of the three groups of the genus
      Streptosporangium merits separate generic status.

PMID- 1736964
TI  - Assignment of Listeria grayi and Listeria murrayi to a single species, Listeria
      grayi, with a revised description of Listeria grayi.
AB  - The genomic relatedness between Listeria grayi and Listeria murrayi was
      reevaluated by using DNA-DNA hybridization, multilocus enzyme electrophoresis,
      and rRNA restriction fragment length polymorphism techniques. The high levels of
      similarity observed between the strains of these two species confirmed the data
      published since 1973 and indicated that they should be considered members of a
      single species. On grounds of priority, the species should be named L. grayi.

PMID- 1736965
TI  - Classification of coryneform bacteria associated with human urinary tract
      infection (group D2) as Corynebacterium urealyticum sp. nov.
AB  - Urealytic strains of coryneform bacteria that are designated Corynebacterium
      group D2 and are isolated from human urine are a cause of urinary tract
      infections. Cell wall and lipid analyses confirmed that these organisms are
      members of the genus Corynebacterium but can be separated from other species in
      the genus on the basis of DNA base composition and DNA-DNA hybridization values.
      Biochemically, strains in this taxon can be distinguished from other
      Corynebacterium spp. by their failure to produce acid from carbohydrates, by
      their failure to reduce nitrates, and by their ability to hydrolyze urea. We
      regard these bacteria as a new species of the genus Corynebacterium and propose
      the name Corynebacterium urealyticum. The type strain is strain NCTC 12011 (=
      ATCC 43042).

PMID- 1736966
TI  - Proposal to change the genus designation Serpula to Serpulina gen. nov.
      containing the species Serpulina hyodysenteriae comb. nov. and Serpulina innocens
      comb. nov.
AB  - The bacterial genus Serpula Stanton et al. 1991 is illegitimate due to the
      existence of a fungal genus Serpula Pers. ex S. F. Gray. Consequently, a new
      genus designation, Serpulina, is proposed for this spirochete genus. Serpula
      hyodysenteriae, the type species, and Serpula innocens Stanton et al. 1991,
      therefore, become Serpulina hyodysenteriae comb. nov. and Serpulina innocens
      comb. nov.

PMID- 1736967
TI  - Validation of the publication of new names and new combinations previously
      effectively published outside the IJSB. List No. 40.

PMID- 1736968
TI  - Notification that new names and new combinations have appeared in the IJSB.

PMID- 1736969
TI  - Helicobacter muridarum sp. nov., a microaerophilic helical bacterium with a novel
      ultrastructure isolated from the intestinal mucosa of rodents.
AB  - Helical organisms with novel ultrastructural characteristics were isolated from
      the intestinal mucosa of rats and mice. These bacteria were characterized by the
      presence of 9 to 11 periplasmic fibers which appeared as concentric helical
      ridges on the surface of each cell. The cells were motile with a rapid
      corkscrewlike motion and had bipolar tufts of 10 to 14 sheathed flagella. The
      bacteria were microaerophilic, nutritionally fastidious, and physiologically
      similar to Helicobacter species and Wolinella succinogenes but could be
      differentiated from these organisms by their unique cellular ultrastructure.
      Using 16S rRNA sequencing, we found that strain ST1T (T = type strain) was
      related to previously described Helicobacter species, "Flexispira rappini," and
      W. succinogenes. The closest relatives of strain ST1T were Helicobacter mustelae
      and "F. rappini" (average similarity value, 96%). On the basis of phylogenetic
      data, strain ST1T (= ATCC 49282T) represents a new species of the genus
      Helicobacter, for which we propose the name Helicobacter muridarum.

PMID- 1736970
TI  - Analysis of bacteriolytic activity patterns, a novel approach to the taxonomy of
      enterococci.
AB  - The bacteriolytic activities of different group D streptococcal species on
      various media and substrates were studied. Our results showed that all of the
      enterococcal species which we tested had bacteriolytic activity on at least one
      of the media used, while the group D nonenterococcal species had no such
      activity. In addition, using culture media containing different additives and
      different pH values, we defined seven major groups of bacteriolytic activity
      (lyogroups), each of which overlapped with one species (four lyogroups), two
      species (two lyogroups), or four species (one lyogroup). The detection of
      enterococcal lyogroups proved to be as reliable for species identification as the
      conventional methods presently in use.

PMID- 1736971
TI  - Taxonomic study of the genus Brachybacterium: Brachybacterium nesterenkovii sp.
      nov.
AB  - A new species, Brachybacterium nesterenkovii, is proposed for a group of
      coryneform bacteria that were isolated from milk products. These organisms have
      morphological, biochemical, and chemotaxonomic characteristics that are peculiar
      to the genus Brachybacterium. In contrast to strains of the only previously
      described species of the genus, Brachybacterium faecium, the representatives of
      the new species lack glycine in their peptidoglycan, although the peptidoglycan
      is of the same general type, and have large amounts of rhamnose in their cells.
      The strains of B. nesterenkovii exhibit no serological relationship with strains
      of B. faecium; in a numerical phenotypic analysis the two species were easily
      separated and formed clear-cut clusters. DNA-DNA hybridization between the type
      strains of B. faecium and B. nesterenkovii showed a level of homology of 22%.
      Strain 35 (= IMV Ac-752) is the type strain of B. nesterenkovii.

PMID- 1736972
TI  - Ambulatory chemotherapy.

PMID- 1736973
TI  - The value of magnetic resonance imaging in assessment of carcinoma of the cervix
      and its response to radiotherapy.

PMID- 1736974
TI  - Local and systemic eosinophilia in patients with carcinoma of the uterine cervix
      undergoing radiation therapy: correlation with radiation response.
AB  - Forty-nine patients with squamous carcinoma of the uterine cervix undergoing
      supervoltage 60Co radiotherapy were investigated to determine the significance of
      quantitation of eosinophils in the tumour tissue as well as in blood. The blood
      absolute eosinophil count (AEC) at presentation was higher in patients with
      Stages III and IV disease (0.52 +/- 0.09 x 10(9)/l, mean +/- SEM) when compared
      with early stages (Stages I and II, 0.35 +/- 0.07 x 10(9)/l). Forty-four patients
      (90%) showed a steady rise in AEC during the course of therapy. The patients
      showing good radiation response (n = 13, greater than or equal to 50%
      regression), displayed a more pronounced rise in AEC during the course of
      radiotherapy (0.66 +/- 0.24 x 10(9)/l) and had more eosinophils in the tumour
      tissue (7.4 +/- 0.66/oil immersion field) than the poor responders (n = 36, less
      than 50% regression, rise in eosinophil count 0.22 +/- 0.04 x 10(9)/l,
      eosinophils in tumour tissue 2.9 +/- 0.55/oil emersion field, P less than 0.0001
      for both parameters). We conclude that quantitation of eosinophils in blood and
      tumour tissue before and during radiotherapy in patients with squamous carcinoma
      of the uterine cervix is useful in predicting radiation response.

PMID- 1736975
TI  - Histiocytosis X: does radiotherapy still have a role?
AB  - Seventeen cases of histiocytosis X are presented (11 children and 6 young adults,
      with the usual male predominance), having a minimum follow-up of 1 year and a
      maximum of 20 years. In these age groups, even small doses of radiation should
      not be given without careful consideration, but fairly low doses carry only a
      small risk and may be very useful in management. Unlike chemotherapy,
      radiotherapy can be confined to the affected area, or to the area causing
      symptoms. All but two of our patients had radiotherapy for bone deposits; only
      one failed to show a complete response. In addition, the diabetes insipidus of
      two children responded immediately to radiation of the pituitary. One patient,
      however, after responding well to radiation for bone deposits, suffered
      increasing symptoms due to lung involvement and the latter showed no response.
      This striking contrast in radiosensitivity is hard to explain, given the
      identical histology obtained by biopsy from each site, but it has been noted many
      times by others.

PMID- 1736976
TI  - Intra-arterial adriamycin, conventionally fractionated radiotherapy and
      conservative surgery for soft tissue sarcomas.
AB  - Thirteen patients with soft tissue sarcomas were treated with a combination of
      intra-arterial Adriamycin, conventionally fractionated radiotherapy (2 Gy per
      day), and conservative surgery (trimodal therapy). Severe acute complications
      occurred in 10 patients: 3 brachial artery thromboses, 6 delayed wound healing, 4
      wound infections, and 3 cases of necrosis of the skin plus subcutaneous tissues.
      Three patients have developed local recurrence. Five patients are alive, 4 of
      whom are disease-free, and the median follow up time of surviving patients is 56
      months. One has significant impairment of limb function due to joint ankylosis.
      An additional 2 patients were treated with intra-arterial Adriamycin and
      conservative surgery for local recurrence after previous surgery and
      radiotherapy; both died of subsequent metastatic disease, one having a further
      local recurrence. One patient with multifocal angiosarcoma was treated with intra
      arterial Adriamycin and radiotherapy but no surgery, and is alive free of disease
      49 months later. The combination of radiotherapy and intra-arterial Adriamycin
      with surgery resulted in significant acute toxicity. This small study has not
      demonstrated any improvement in local control compared with that expected with
      conservative surgery and radiotherapy alone.

PMID- 1736977
TI  - Preoperative radiotherapy for initially inoperable extremity soft tissue
      sarcomas.
AB  - The results and complications of a combination of preoperative radiotherapy and
      surgery in the treatment of 70 patients with large or fixed extremity soft tissue
      sarcomas are reported. Sixty-one patients were referred with a primary tumour and
      9 had recurrences. Thirty-three patients had tumours in the thigh and 38 tumours
      were fixed to neighbouring structures. The mean preoperative dose was 53 Gy
      (range 21-75). Eleven patients received a postoperative boost to tumour site.
      Four patients received preoperative intra-arterial Adriamycin. Overall, 42
      patients (60%) responded to the radiotherapy, 4 with complete tumour resolution.
      Eighty per cent of those receiving greater than or equal to 60 Gy responded and a
      significant correlation between 2 Gy equivalent dose and response was
      demonstrated (P less than 0.005). The degree of tumour necrosis was increased in
      23 of 52 evaluable patients following radiotherapy, although there was no
      correlation with dose or clinical response. There have been eight local
      recurrences and 17 deaths after a median follow-up of 2 years. Tumour size less
      than 10 cm was the only significant factor in the development of local recurrence
      (P = 0.04). Thirty-six patients developed immediate postoperative complications:
      9 major (13%), 13 moderate (19%) and 14 minor (20%). Increasing patient age was
      the only significant independent factor for the development of complications (P =
      0.015). Preoperative radiotherapy will usually permit limb conservation of
      extremity sarcomas which otherwise would be inoperable or require amputation.
      However, the increased incidence of wound complications in older patients demands
      meticulous technique.

PMID- 1736978
TI  - Growth hormone and breast cancer.

PMID- 1736979
TI  - Treatment of lower limb basal cell and squamous cell carcinomas with
      radiotherapy.
AB  - In order to evaluate the role of photon based radiotherapy regimens in the
      treatment of lower limb basal cell and squamous carcinomas, a retrospective
      analysis of the results of X-ray treatment to 65 such lesions in 60 patients was
      made. The mean age was 73.3 years, with a range of between 46 and 93 years.
      Seventy-seven per cent (46/60) of the patients were female. The overall
      recurrence rate was 4.6% (3/65), and the radionecrosis rate was 9.2% (6/65), with
      no significant bias in terms of sex or laterality. For regimens giving an NSD of
      between 1700 rets and 1850 rets to a surface area of less than 30 cm2, the risk
      of treatment failure was less than 6%.

PMID- 1736980
TI  - Improving communication with oncology patients: taping the consultation.
AB  - Patients are often dissatisfied with the information provided for them by
      doctors. A simple cheap method of improving communication by tape recording the
      initial consultation with oncology outpatients is described. Analysis of 100
      taped consultations by a subsequent questionnaire revealed that patients and
      their relatives claimed enormous benefit from the opportunity to hear the
      consultation again.

PMID- 1736981
TI  - Selection of young women with high-risk breast cancer for adjuvant systemic
      therapy.
AB  - Biological criteria of tumour aggressiveness have recently been recommended for
      use in selecting high-risk cases for adjuvant systemic therapy after primary
      treatment of breast cancer. Without them, the clinician has considerable
      difficulty in balancing the morbidity of cytotoxic therapy against the possible
      benefits. Consistent evidence that patients under the age of 35 years have the
      worst prognosis of all age groups, while those in the 45-49 age group have the
      best prognosis, should help in a decision on suitable adjuvant treatment for
      either node-positive or node-negative young women with breast cancer.

PMID- 1736982
TI  - Seminoma or sarcoid?
AB  - A 33-year-old man subsequently diagnosed as having sarcoidosis presented with the
      clinical features of a testicular tumour with metastatic spread to para-aortic
      lymph nodes. Histological examination of the testis and para-aortic lymph node
      biopsy showed florid granulomatous change and a Kveim test was positive. This is
      a previously unreported presentation of sarcoidosis and emphasizes that
      histological confirmation of malignancy is essential prior to institution of
      cytotoxic therapy.

PMID- 1736983
TI  - Breast metastases to bones of the extremities: simultaneous involvement of all
      four limbs.
AB  - Metastases to bones of the hands and feet are unusual, and simultaneous
      metastases to the bones of more than one extremity in a given patient is an
      extremely rare occurrence with only five previous case reports. In each of these
      cases the bones of two extremities were affected. A case is presented where the
      bones of both hands and both feet exhibited bone metastases. A second case with
      foot bone metastases is recorded. In both cases the primary tumour was a breast
      carcinoma. Theories of causation of such metastases are discussed.

PMID- 1736984
TI  - Intermittent superior vena cava syndrome caused by a Hickman catheter.
AB  - A case of intermittent superior vena cava syndrome caused by a Hickman catheter
      is reported. The symptoms resolved on removal of the catheter. The use of
      anticoagulants in conjunction with indwelling venous catheters is discussed.

PMID- 1736985
TI  - Dramatic response of recurrent invasive thymoma to high doses of corticosteroids.
AB  - We report the case of a widely invasive thymoma non-associated with myasthenia
      gravis which responded only to high doses of corticosteroids. We review the other
      few reported cases of complete response achieved by this treatment and we stress
      the possible use of high doses of corticosteroids in the management of recurrent
      invasive thymoma.

PMID- 1736986
TI  - The disulfide bonds in antibody variable domains: effects on stability, folding
      in vitro, and functional expression in Escherichia coli.
AB  - The formation of the disulfide bonds in the variable domains VH and VL of the
      antibody McPC603 was found to be essential for the stability of all antigen
      binding fragments investigated. Exposure of the Fv fragment to reducing
      conditions in vitro resulted in irreversible denaturation of both VH and VL. In
      vitro refolding of the reduced Fv fragment was only possible when the disulfide
      bonds were allowed to form under oxidizing conditions. The analysis of a series
      of mutants of the Fv fragment, the Fab fragment and the single-chain Fv fragment,
      all secreted into the periplasm of Escherichia coli, in which each of the
      cysteine residues of the variable domains was replaced by a series of other amino
      acids, showed that functional antigen binding fragments required the presence of
      both the disulfide bond in VH and the one in VL. These results were also used to
      devise an alternative expression system based on the production of insoluble
      fusion proteins consisting of truncated beta-galactosidase and antibody domains,
      enzymatic cleavage, and refolding and assembly in vitro. This strategy should be
      useful for providing access to unstable antibody domains and fragments.

PMID- 1736987
TI  - Conformational isomerism of endothelin in acidic aqueous media: a quantitative
      NOESY analysis.
AB  - The conformational features of endothelin-1 (ET-1) in mixed water/ethylene glycol
      media have been studied by two-dimensional 1H NMR experiments throughout the pH
      range 3.2-7.2. At pH less than 5 all backbone NH signals can be observed, and
      NOESY experiments provided a large set of dipolar cross-peaks. Cross-peak
      intensities from each experiment (different mixing times and H2O versus D2O) were
      converted to distance constraints using a novel algorithm (program DISCON) for
      removing spin diffusion effects and thus obtain cross-rates rather than cross
      peak intensities. A set of 168 nonstereospecific distance bounds (average
      experimental precision, +/- 0.38 A) was used in dynamics simulated annealing
      refinements. Two consensus structural features were found--a reverse turn at Ser5
      ---Asp8 and an alpha-helical stretch from Lys9 to Cys15; however, after
      constraint-free minimization, structures generated using XPLOR-1.5, CONGEN, and
      DISCOVER all violated at least 32% of the bounds by more than 0.2 A, which we
      ascribe to conformational isomerism. When the constraints were modified to
      reflect subsequent experimental data and to eliminate constraints that could not
      be obeyed by any single conformer structure, the relaxed structures still
      violated at least 15% of this more limited and looser set of constraints.
      Therefore, a modified procedure for constrained dynamics refinement (using XPLOR
      2.1), which allows for conformational isomerism outside of the central helical
      core region, was developed. This "conformer search procedure" produced structures
      which fell into five tightly defined conformational clusters. The two most
      populated clusters correspond to a rotation of the 8,9-amide unit. The conformer
      which we propose as the major contributor at pH 3.2-5.8 was defined to a backbone
      rmsd of 0.51 A over residues 1----15. An alternative description of the motional
      averaging in segments of the endothelin structure as extensive randomization
      rather than rapid interconversion between a small number of discreet conformers
      was ruled out by an analysis of NH shift-temperature gradients and exchange
      rates. This analysis suggests that small delta delta/delta T values need not
      correlate with H-bonding for conformational mixtures. In ET-1 the greatest
      motional averaging occurs from Ser2 through Ser5 (not in the C-terminus) and may
      be so extensive as to approximate a flexible random coil population as high as
      30%. The C-terminus shows less rapid and less extensive conformational averaging,
      but no definitive structures for individual conformers could be derived in the
      absence of stereospecific constraints. The pharmacological implications of the
      consensus structural features are discussed.

PMID- 1736988
TI  - Spectroscopic evidence for an intermediate in the T6 to R6 allosteric transition
      of the Co(II)-substituted insulin hexamer.
AB  - The phenol-induced conformational transition in the insulin hexamer is known to
      involve a large change in structure wherein residues 1-8 of the insulin B-chain
      are transformed from an extended coil (T-state) to a helix (R-state). This change
      in protein conformation both exposes a cryptic protein pocket on each subunit to
      which phenol binds and forces the HisB10 zinc sites to undergo a change in
      coordination geometry from octahedral to tetrahedral [Derewenda, U., Derewenda,
      Z., Dodson, E. J., Dodson, G. G., Reynolds, C. D., Smith, G. D., Sparks, C., &
      Swensen, D. (1989) Nature 338, 593-596]. Substitution of Co(II) for Zn(II) at the
      HisB10 sites introduces a sensitive chromophoric probe of the structural and
      chemical events that occur during this allosteric transition [Roy, M., Brader, M.
      L., Lee, R. W.-K., Kaarsholm, N. C., Hansen, J. F., & Dunn, M. F. (1989) J. Biol.
      Chem. 264, 19081-19085]. In this study, using rapid-scannig stopped-flow (RSSF)
      UV-visible spectroscopic studies, we demonstrate that a transient chemical
      intermediate is formed during the phenol-induced conversion of Co(II)-substituted
      hexamer from the T-state to the R-state. Decomposition of the RSSF spectra gave a
      spectrum for the intermediate with d-d transitions consistent with the assignment
      of the intermediate as either a distorted tetrahedral or a 5-coordinate Co(II)
      species. Possible structures for the intermediate and the implications of these
      findings to the allosteric mechanism are considered.

PMID- 1736989
TI  - Fluorescence, CD, attenuated total reflectance (ATR) FTIR, and 13C NMR
      characterization of the structure and dynamics of synthetic melittin and melittin
      analogues in lipid environments.
AB  - The structure and dynamics of synthetic melittin (MLT) and MLT analogues bound to
      monomyristoylphosphatidylcholine micelles, dimyristoylphosphatidylcholine
      vesicles, and diacylphosphatidylcholine films have been investigated by
      fluorescence, CD, attenuated total reflectance (ATR) FTIR, and 13C NMR
      spectroscopy. All of these methods provide information about peptide secondary
      structure and/or about the environment of the single tryptophan side chain in
      these lipid environments. ATR-FTIR data provide additional information about the
      orientation of helical peptide segments with respect to the bilayer plane. Steady
      state fluorescence anisotropy, fluorescence lifetime, and 13C NMR relaxation data
      are used in concert to provide quantitative information about the dynamics of a
      single 13C-labeled tryptophan side chain at position 19 in lipid-bound MLT, and
      at positions 17, 11, and 9, respectively, in lipid-bound MLT analogues. Peptide
      chain dynamics are probed by NMR relaxation studies of 13C alpha-labeled glycine
      incorporated into each of the MLT peptides at position 12. The cumulative
      structural and dynamic data are consistent with a model wherein the N-terminal
      alpha-helical segment of these peptides is oriented perpendicular to the bilayer
      plane. Correlation times for the lysolipid-peptide complexes provide evidence for
      binding of a single peptide monomer per micelle. A model for the membranolytic
      action of MLT and MLT-like peptides is proposed.

PMID- 1736990
TI  - Light-induced charge separation in Rhodopseudomonas viridis reaction centers
      monitored by Fourier-transform infrared difference spectroscopy: the quinone
      vibrations.
AB  - Static FTIR light-induced difference spectra have been recorded for reaction
      centers from Rhodopseudomonas viridis in the following charge-separated states:
      P+QA(-)-PQA, P+QB(-)-PQB, I(-)-I, I-QA(-)-IQA, and I-QA(2-)-IQA. A comparison of
      the I(-)-I difference spectra with the I-QA(-)-IQA difference spectra reveals new
      bands which can be assigned to QA- vibrations; these vibrations are also observed
      in the P+QA(-)-PQA and P+QB(-)-PQB difference spectra. Through an analysis of all
      of the static difference spectra, the electron-transfer pathway can be monitored
      in the infrared from the primary donor, P, to the secondary acceptor, QB, via the
      intermediate acceptor, I, and the primary acceptor, QA. The difference spectra
      are dominated by absorbance changes of prosthetic groups, with very few
      identifiable contributions from amino acids and little overall structural change
      in the protein backbone, involving only one or two residues for the various
      charge-separated states. Oxidation of the primary donor in the reaction center
      shows the characteristic absorbance changes of the 9-keto and 10-ester carbonyl
      groups observed upon oxidation of bacteriochlorophyll b in a non-hydrogen-bonded
      environment [Ballschmiter, K. H., & Katz, J. J. (1969) J. Am. Chem. Soc. 91, 2661
      2677]. Reduction of the quinones in the reaction center yields absorbance changes
      of the carbonyls observed during reduction of quinones in a hydrogen-bonded
      environment [Bauscher, M., Nabedryk, E., Bagley, K., Breton, J., & Mantele, W.
      (1990) FEBS Lett. 261, 191-195].(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1736991
TI  - A 31P NMR study of mitochondrial inorganic phosphate visibility: effects of Ca2+,
      Mn2+, and the pH gradient.
AB  - The effects of external pH, temperature, and Ca2+ and Mn2+ concentrations on the
      compartmentation and NMR visibility of inorganic phosphate (Pi) were studied in
      isolated rat liver mitochondria respiring on succinate and glutamate.
      Mitochondrial matrix Pi is totally visible by NMR at 8 degrees C and at low
      external concentrations of Pi. However, when the external Pi concentration is
      increased above 7 mM, the pH gradient decreases, the amount of matrix Pi
      increases, and the fraction not observed by NMR increases. Raising the
      temperature to 25 degrees C also decreases the pH gradient and the Pi fraction
      observed by NMR. At physiologically relevant concentrations, Ca2+ and Mn2+ do not
      seem to play a major role in matrix Pi NMR invisibility. For Ca2+ concentrations
      above 30 nmol/mg of protein, formation of insoluble complexes will cause loss of
      Pi signal intensity. For Mn2+ concentrations above 2 nmol/mg of protein, the Pi
      peak can be broadened sufficiently to preclude detection of a high-resolution
      signal. The results indicate that mitochondrial matrix Pi should be mostly
      observable up to 25 degrees C by high-resolution NMR. While the exact nature of
      the NMR-invisible phosphate in perfused or in vivo liver is yet to be determined,
      better success at detecting and resolving both Pi pools by NMR is indicated at
      high field, low temperature, and optimized pulsing conditions.

PMID- 1736992
TI  - X-ray diffraction reconstruction of the inverted hexagonal (HII) phase in lipid
      water systems.
AB  - The structure of the inverted hexagonal (HII) phase in biological lipid-water
      systems is studied to examine the physical interactions which drive the
      polymorphic phase behavior and which are also thought to play a relevant role in
      biological membrane function. A method is derived which yields the complex phase
      factors of the HII phase diffraction amplitudes from examination of a single
      sample. This method is applied to a low-resolution Fourier reconstruction of the
      HII phase in dioleoylphosphatidylethanolamine (DOPE) + water, specifically to
      examine deviations from the presumed circular model of the HII phase. It is found
      that the average radius of the water core, Rw, as determined from a Fourier
      reconstruction, is in good agreement with previously measured values of Rw
      obtained from more time-consuming traditional methods [Tate, M. W., & Gruner, S.
      M. (1989) Biochemistry 28, 4245]. In addition to the average value of Rw, the
      Fourier reconstruction also can be used to determine the true shape of the water
      core. It is found that the water core is circular to within 5% of Rw when the
      unit cell size is less than approximately 75 A. Above 75 A, however, a definite
      shape deformation becomes apparent, with radial noncircularities of 5-10%,
      probably in response to the increased entropic cost of packing the hydrocarbon
      chains into the anisotropic environment of the HII unit cell [Kirk, G. L.,
      Gruner, S. M., & Stein D. E. (1984) Biochemistry 23, 1093]. As a more direct
      probe of the packing anisotropy, Fourier reconstructions of DOPE + dodecane and
      DOPE + squalene systems were compared with the reconstruction of DOPE. These oils
      are known to promote the low temperature occurrence of the HII phase, presumably
      by a reduction in the hydrocarbon packing stress. In support of this hypothesis,
      the alkanes were observed to relax the water core to a circular shape for even
      large lattices. In addition, anisotropy of the electron density near the end of
      the lipid chains is reduced when alkane is added, implying a more uniform
      hydrocarbon packing environment, consistent with the results of neutron
      diffraction upon the addition of deuterated decane [Turner, D. C., Gruner, S. M.,
      & Huang, J. (1992) Biochemistry (following paper in this issue)].

PMID- 1736993
TI  - Distribution of decane within the unit cell of the inverted hexagonal (HII) phase
      of lipid-water-decane systems determined by neutron diffraction.
AB  - The addition of a free alkane such as decane to lipid-water systems is known to
      promote the formation of a low-temperature inverted hexagonal (HII) phase [Kirk,
      G. L., & Gruner, S. M. (1985) J. Phys. (Paris) 46, 761]. Kirk et al. [Kirk, G.
      L., Gruner, S. M., & Stein, D. E. (1984) Biochemistry 23, 1093] have discussed
      the hydrocarbon packing anisotropy in the HII unit cell and have suggested that
      free alkane will distribute in a way that reduces this packing anisotropy by
      allowing the lipid chain environment to become more uniform. By combining neutron
      and X-ray diffraction data to do a Fourier reconstruction of the HII phase of
      dioleoylphosphatidylethanolamine (DOPE) + water + deuterated decane, it was found
      that the decane preferentially partitions into the interstitial regions of the
      HII unit cell where it should be the most effective in alleviating the
      hydrocarbon chain packing stress, supporting the suggestion of Kirk et al. Using
      the distribution of decane within the unit cell, we have calculated the lipid
      length distribution for the situations with and without added alkane. With a
      suitable molecular model, this lipid length distribution may eventually be used
      to calculate the free energy change upon the addition of alkane. Such a
      measurement is important for a more realistic understanding of the interactions
      which lead to the formation of the HII phase.

PMID- 1736994
TI  - Substitution of Torpedo acetylcholine receptor alpha 1-subunit residues with
      snake alpha 1- and rat nerve alpha 3-subunit residues in recombinant fusion
      proteins: effect on alpha-bungarotoxin binding.
AB  - A fusion protein consisting of the TrpE protein and residues 166-211 of the
      Torpedo acetylcholine receptor alpha 1 subunit was produced in Escherichia coli
      using a pATH10 expression vector. Residues in the Torpedo sequence were changed
      by means of oligonucleotide-directed mutagenesis to residues present in snake
      alpha 1 subunit and rat nerve alpha 3 subunit which do not bind alpha
      bungarotoxin. The fusion protein of the Torpedo sequence bound 125I-alpha
      bungarotoxin with high affinity (IC50 = 2.5 x 10(-8) M from competition with
      unlabeled toxin, KD = 2.3 x 10(-8) M from equilibrium saturation binding data).
      Mutation of three Torpedo residues to snake residues, W184F, K185W, and W187S,
      had no effect on binding. Conversion of two additional Torpedo residues to snake,
      T191S and P194L, reduced alpha-bungarotoxin binding to undetectable levels. The
      P194L mutation alone abolished toxin binding. Mutation of three Torpedo alpha 1
      residues to neuronal alpha 3-subunit residues, W187E, Y189K, and T191N, also
      abolished detectable alpha-bungarotoxin binding. Conversion of Try-189 to Asn
      which is present in the snake sequence (Y189N) abolished toxin binding. It is
      concluded that in the sequence of the alpha subunit of Torpedo encompassing Cys
      192 and Cys-193, Try-189 and Pro-194 are important determinants of alpha
      bungarotoxin binding. Tyr-189 may interact directly with cationic groups or
      participate in aromatic-aromatic interactions while Pro-194 may be necessary to
      maintain a conformation conductive to neurotoxin binding.

PMID- 1736995
TI  - Noncovalent interactions of poly(adenosine diphosphate ribose) with histones.
AB  - Covalent linkage of ADP-ribose polymers to proteins is generally considered
      essential for the posttranslational modification of protein function by poly(ADP
      ribosyl)ation. Here we demonstrate an alternative way by which ADP-ribose
      polymers may modify protein function. Using a highly stringent binding assay in
      combination with DNA sequencing gels, we found that ADP-ribose polymers bind
      noncovalently to a specific group of chromatin proteins, i.e., histones H1, H2A,
      H2B, H3, and H4 and protamine. This binding resisted strong acids, chaotropes,
      detergents, and high salt concentrations but was readily reversible by DNA. When
      the interactions of variously sized linear and branched polymer molecules with
      individual histone species were tested, the hierarchies of binding were branched
      polymers greater than long, linear polymers greater than short, linear polymers
      and H1 greater than H2A greater than H2B = H3 greater than H4. For histone H1,
      the target of polymer binding was the carboxy-terminal domain, which is also the
      domain most effective in inducing higher order structure of chromatin. Thus,
      noncovalent interactions may be involved in the modification of histone functions
      in chromatin.

PMID- 1736996
TI  - Evidence for processivity and two-step binding of the RNA substrate from studies
      of J1/2 mutants of the Tetrahymena ribozyme.
AB  - J1/2 of the Tetrahymena ribozyme, a sequence of three A residues, connects the
      RNA-binding site to the catalytic core. Addition or deletion of bases from J1/2
      improves turnover and substrate specificity in the site-specific endonuclease
      reaction catalyzed by this ribozyme: G2CCCUCUA5 (S) + G in-equilibrium G2CCCUCU
      (P) + GA5. These paradoxical enhancements are caused by decreased affinity of the
      ribozyme for S and P [Young, B., Herschlag, D., & Cech, T.R. (1991) Cell 67,
      1007]. An additional property of these mutant ribozymes, decreased fidelity of
      RNA cleavage, is now analyzed. (Fidelity is the ability to cleave at the correct
      phosphodiester bond within a particular RNA substrate.) Introduction of deoxy
      residues to give "chimeric" ribo/deoxyribooligonucleotides changes the positions
      of incorrect cleavage. Previous work indicated that S is bound to the ribozyme by
      both base pairing and teritary interactions involving 2'-hydroxyl groups of S.
      The data herein strongly suggest that the P1 duplex, which consists of S base
      paired with the 5' exon binding site of the ribozyme, can dock into tertiary
      interactions in different registers; different 2'-hydroxyl groups of S plug into
      tertiary contacts with the ribozyme in the different registers. It is concluded
      that the mutations decrease fidelity by increasing the probability of docking out
      of register relative to docking in the normal register, thereby giving cleavage
      at different positions along S. These data also show that the contribution of
      J1/2 to the teritiary interactions is indirect, not direct. Thus, a structural
      role of the nonconserved J1/2 is indicated: this sequence positions S to optimize
      tertiary binding interactions and to ensure cleavage at the phosphodiester bond
      corresponding to the 5' splice site. Substitution of sulfur for the nonbridging
      pro-RP oxygen atom at the normal cleavage site has no effect on (kcat/Km)S but
      decreases the fraction of cleavage at the normal site in reactions catalyzed by
      the -3A mutant ribozyme, which has all three A residues of J1/2 removed. Thus,
      the ribozyme chooses where to cleave S after rate-limiting binding of S,
      indicating that docking can change after binding and suggesting that the ribozyme
      could act processively. Indeed, it is shown that the +2A ribozyme cleaves at one
      position along an RNA substrate and then, before releasing that RNA product,
      cleaves it again.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1736997
TI  - Recognition of specific DNA sequences by mitomycin C for alkylation.
AB  - Synthetic oligodeoxyribonucleotides were reacted with mitomycin C (MC) under
      conditions which restricted MC to monofunctional alkylating activity. The yields
      of monofunctional alkylation of oligonucleotides with variable sequence were
      determined by enzymatic digestion of the reaction mixture to unreacted
      nucleosides and the product of alkylation, a MC-deoxyguanosine adduct (2),
      followed by quantitative analysis by HPLC. The relative yields of 2 reflected
      relative monoalkylation reactivities. They were compared in a series of
      oligonucleotides having the sequence 5'-NGN' in which the 5'-base was varied
      while the 3'-base was kept constant as T. Under Na2S2O4 activation conditions a
      striking enhancement of the yield was observed at the 5'-CG sequence: 36%,
      compared to 2% at 5'-AG and 4.1% at 5'-TG. The 5'-GG sequence also showed
      enhanced reactivity although to a lesser extent (14.7%). The enhancements were
      specific to the duplex state of the oligonucleotides. Using NADPH:cytochrome c
      reductase as the reducing agent gave similar results. MC activated by acidic pH
      also displayed 5'-CG alkylation specificity. 10-Decarbamoyl-MC activated by
      Na2S2O4 showed the same 5'-CG specificity as MC. Replacement of deoxyguanosine by
      deoxyinosine in the opposite strand at a 5'-CG site abolished the enhancement of
      alkylation. Such replacement at a 5'-GG site had a similar effect. It was found
      that the base 3' to the guanine had only a relatively modest modulating effect on
      the enhanced reactivity of the G at the 5'-CG sequence. This 3'-base effect
      appeared to be independent of the 5'-base of the 5'-NGN' triplet. The order of
      reactivity is 3'-(C greater than T greater than A).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1736998
TI  - Lateral interactions of pig apolipoprotein A-1 with egg yolk phosphatidylcholine
      and with cholesterol in mixed monolayers at the triolein-saline interface.
AB  - Interfacial tensions of egg yolk phosphatidylcholine (PC) and cholesterol
      monolayers adsorbed at the triolein-saline interface were measured in the
      presence and absence of pig apolipoprotein A-1 (apoA-1) in the saline phase. In
      the absence of apoA-1, the adsorptions of PC and cholesterol at the interface
      from the triolein phase are cooperative, showing large lateral attractive
      interactions between the PC molecules and the cholesterol molecules in the
      monolayer. In the presence of apoA-1, the PC adsorption is anti-cooperative,
      indicating strong lateral attractive interactions between the PC and the apoA-1
      molecules, i.e., apparently, repulsive lateral interactions between the PC
      molecules. On the other hand, lateral interactions of very low magnitude are
      observed between the cholesterol and apoA-1 molecules in the monolayer. Values of
      the lateral interaction energy are evaluated from the adsorption data by the
      Defay-Prigogine-Flory theory of monolayers. The large difference in lateral
      interaction energy with apoA-1 between PC and cholesterol in a mixed monolayer is
      discussed in connection with current problems in lipoprotein catabolism: reverse
      cholesterol transport, alterations in affinity of lipid particles to apoA-1, and
      formation of high-density lipoproteins and abnormal lipoproteins.

PMID- 1736999
TI  - Heat capacity changes for protein-peptide interactions in the ribonuclease S
      system.
AB  - Two fragments of pancreatic ribonuclease A, a truncated version of S-peptide
      (residues 1-15) and S-protein (residues 21-124), combine to give a catalytically
      active complex designated ribonuclease S. We have substituted the wild-type
      residue Met-13 with six other hydrophobic residues ranging in size from alanine
      to phenylalanine and have determined the thermodynamic parameters associated with
      binding of these analogues to S-protein by titration calorimetry in the
      temperature range 5-25 degrees C. The heat capacity change (delta Cp) associated
      with binding was obtained from a global analysis of the temperature dependences
      of the free energies and enthalpies of binding. The delta Cp's were not
      correlated in any simple fashion with the nonpolar surface area (delta Anp)
      buried upon binding.

PMID- 1737000
TI  - Binding of protein synthesis initiation factor 4E to oligoribonucleotides:
      effects of cap accessibility and secondary structure.
AB  - The binding of rabbit globin mRNA to the 25-kDa cap binding protein eIF-4E from
      human erythrocytes was found to be 5.3-fold stronger than the binding of the cap
      analogue m7GpppG to eIF-4E [Gross et al. (1990) Biochemistry 29, 5008-5012]. In
      order to investigate whether this effect is due to the longer sequence of
      nucleotides in globin mRNA or to other features such as cap accessibility or
      secondary structure, oligoribonucleotide analogues of rabbit alpha-globin mRNA
      were synthesized by T7 RNA polymerase from a synthetic oligodeoxynucleotide
      template in the presence of m7GpppG; these oligoribonucleotide analogues possess
      varying degrees of cap accessibility and secondary structure. Equilibrium
      association constants for the interaction of these oligoribonucleotides and
      purified human erythrocyte eIF-4E were obtained from direct fluorescence
      titration experiments. The data indicate that while the presence of the m7G cap
      is required for efficient recognition by eIF-4E, the cap need not be completely
      sterically accessible, since other structural features within the mRNA also
      influence binding.

PMID- 1737001
TI  - Use of recombinant biotinylated aequorin in microtiter and membrane-based assays:
      purification of recombinant apoaequorin from Escherichia coli.
AB  - Aequorin is a calcium-dependent bioluminescent protein isolated from the
      hydromedusan Aequorea victoria. The gene for aequorin has been cloned and
      overexpressed in Escherichia coli [Prasher et al. (1985) Biochem. Biophys. Res.
      Commun. 126, 1259; Prasher et al. (1987) Biochemistry 26, 1326]. Higher levels of
      expression have recently been obtained by subcloning aequorin cDNA into the pRC23
      plasmid vector such that its expression is under control of the lambda PL
      promoter [Cormier et al. (1989) Photochem. Photobiol. 49, 509]. Purification of
      recombinant apoaequorin from E. coli containing this new recombinant plasmid
      (pAEQ1.3) was accomplished by a two-step procedure involving gel filtration and
      anion-exchange chromatography on Sephadex G-100 and DEAE-Sepharose, respectively.
      Typically, 400-500 mg of recombinant protein was obtained from 100 L of
      fermentation culture. The purified recombinant apoaequorin could be converted to
      aequorin in high yield upon incubation with synthetic coelenterate luciferin,
      dissolved oxygen, and a thiol reagent with a photon yield similar to the native
      photoprotein. Detection of recombinant aequorin in the Dynatech ML1000 Microplate
      luminometer was linear between 10(-18) and 10(-12) mol, and little loss of
      specific activity was observed when the protein was derivatized with biotin. The
      biotinylated derivative was stable when frozen, lyophilized, or stored at 4
      degrees C. The feasibility of using biotinylated aequorin as a nonradioactive tag
      was established by its application in a variety of solid-phase assay formats
      using the high-affinity streptavidin/biotin interaction. A microtiter-based
      bioluminescent immunoassay (BLIA) using biotinylated aequorin and the ML1000
      luminometer was developed for the detection of subnanogram amounts of a
      glycosphingolipid (Forsmann antigen). In addition, nanogram to subnanogram
      quantities of protein antigens and DNA, immobilized on Western and Southern
      blots, respectively, were detected on instant and X-ray films using biotinylated
      aequorin.

PMID- 1737002
TI  - Characterization of the secondary structure of calmodulin in complex with a
      calmodulin-binding domain peptide.
AB  - The interaction between calcium-saturated chicken calmodulin and a peptide
      corresponding to the calmodulin-binding domain of the chicken smooth muscle
      myosin light chain kinase has been studied by multinuclear and multidimensional
      nuclear magnetic resonance methods. Extensive 1H and 15N resonance assignments of
      calmodulin in the complex have been obtained from the analysis of two- and three
      dimensional nuclear magnetic resonance spectra. The assignment of calmodulin in
      the complex was facilitated by the use of selective labeling of the protein with
      alpha-15N-labeled valine, alanine, lysine, leucine, and glycine. These provided
      reference points during the main-chain-directed analysis of three-dimensional
      spectra of complexes prepared with uniformly 15N-labeled calmodulin. The pattern
      of nuclear Overhauser effects (NOE) seen among main-chain amide NH, C alpha H,
      and C beta H hydrogens indicates that the secondary structure of the globular
      domains of calmodulin in the complex closely corresponds to that observed in the
      calcium-saturated state of the protein in the absence of bound peptide. However,
      the backbone conformation of residues 76-84 adopts an extended chain conformation
      upon binding of the peptide in contrast to its helical conformation in the
      absence of peptide. A sufficient number of NOEs between the globular domains of
      calmodulin and the bound peptide have been found to indicate that the N- and C
      terminal regions of the peptide interact with the C- and N-terminal domains of
      calmodulin, respectively. The significance of these results are discussed in
      terms of recently proposed models for the structure of calmodulin-peptide
      complexes.

PMID- 1737003
TI  - Localization of the binding site for streptococcal protein G on human serum
      albumin. Identification of a 5.5-kilodalton protein G binding albumin fragment.
AB  - Protein G is a streptococcal cell wall protein with separate and repetitively
      arranged binding domains for immunoglobulin G (IgG) and human serum albumin
      (HSA). In this work, the binding of protein G to HSA was studied. The results
      suggest that a single binding site is present on HSA: the apparent size of the
      HSA-protein G complex (230 kDa) corresponded to two or three HSA molecules bound
      to one protein G molecule, and Ouchterlony immunodiffusion did not yield any
      precipitate between protein G and HSA. HSA was cleaved by pepsin and CNBr into
      several fragments which were identified by SDS-PAGE and N-terminal amino acid
      sequencing, and the binding of protein G to the fragments was studied in Western
      blot experiments. The results indicated that the binding area was located in
      disulfide loops 6-8, involving both the second (loop 6) and the third (loops 7
      and 8) domain of HSA. One of the protein G binding pepsin fragments, with an
      apparent molecular mass of 5.5 kDa, located in loops 7 and 8, was isolated and
      found to completely inhibit the binding between protein G and the intact HSA,
      again suggesting a single protein G binding site on serum albumin. Reducing the
      disulfide bonds of HSA, and subsequent alkylation of the half-cystine residues,
      significantly decreased the affinity for protein G. Protein G bound to albumin
      from baboon, cat, guinea pig, hamster, hen, horse, man, mouse, and rat, but not
      to albumin from cow, dog, goat, pig, rabbit, sheep, snake, or turkey.

PMID- 1737004
TI  - Immunogenic peptides corresponding to the dominant antigenic region alanine-597
      to cysteine-619 in the transmembrane protein of simian immunodeficiency virus
      have a propensity to fold in aqueous solution.
AB  - Two synthetic peptides corresponding to the N- and C-terminal halves of a 23
      amino acid sequence representing an immunodominant domain of the simian
      immunodeficiency virus of macaque origin (SIVmac) were examined for
      conformational preferences in aqueous solution by proton nuclear magnetic
      resonance methods. The two constituent peptides, termed A12-7 (Ala597-Ile-Glu-Lys
      Tyr-Leu-Glu-Asp-Gln-Ala-Gln607) and A12-9 (Leu608-Asn-Ala-Trp-Gly-Cys-Ala-Phe-Arg
      Gln-Val-Ser619), were found to contain a considerable conformational preference
      for states in which the backbone phi and psi angles populate the alpha region of
      the Ramachandran plot. Further, for peptide A12-9, the types and intensities of
      the nuclear Overhauser effect (NOE) connectivities between protons in the
      polypeptide backbone suggest that these states appear to include helical turns.
      The temperature dependence of the amide proton chemical shifts indicates that
      some degree of intramolecular hydrogen bonding occurs in these peptides. These
      results are consistent with a model in which immunogenic peptides which induce
      antibodies reactive with the intact protein from which the peptide sequence was
      derived contain conformational preferences in water solution for states other
      than the extended-chain forms typically found in "random coil" peptides.

PMID- 1737005
TI  - Folding kinetics of T4 lysozyme and nine mutants at 12 degrees C.
AB  - The kinetics of unfolding and refolding of T4 lysozyme and nine of its mutants
      have been investigated as a function of guanidinium chloride concentration at 12
      degrees C. All show simple two-state, first-order kinetics. Two types of mutants
      were studied: proline-alanine interchanges and substitutions at position 3 with
      side chains of varying hydrophobicity. Crystal structures are available for seven
      of the ten proteins. The effect of mutations on the folding kinetics is more
      pronounced and complex than on equilibrium thermodynamics. The proteins fall into
      two broad kinetic classes with one class rather close to the wild type. P86A is a
      mutant with marked changes in kinetics but only a very small change in stability.
      Since the 86 position is in the middle of an alpha-helix, the indications are
      that the helix containing an A residue is more stable in the transition state
      than one containing a P residue. The other mutants are more complicated, with the
      refolding and unfolding rates unequally affected by the mutations. On the basis
      of comparisons with other investigations, we conclude that the rate-determining
      step in the presence of guanidinium chloride is not the same as in aqueous
      solution and that it most likely precedes it. The indications are that we are
      studying the formation of a transition intermediate which is destabilized by the
      denaturant and which resembles the A intermediate of the framework or molten
      globule models for protein folding.

PMID- 1737006
TI  - Stabilities of disulfide bond intermediates in the folding of apamin.
AB  - Apamin is an 18-residue bee venom peptide with the sequence CNCKAPETALCARRCQQH
      amide and contains 2 disulfide bonds connecting C-1 to C-11 and C-3 to C-15. In
      the folding of reduced, unfolded apamin to native apamin with two disulfide
      bonds, the one-disulfide folding intermediate states are not populated to
      significant levels. To study the properties of the one-disulfide intermediates,
      we have synthesized two peptide models to mimic the one-disulfide intermediates,
      Apa-1 and Apa-2, in which two cysteines in the sequence have been replaced by
      alanines. These peptides can form only one of the native disulfide bonds, C-1 to
      C-11 in the case of Apa-1 and C-3 to C-15 in the case of Apa-2. The stabilities
      of these disulfide bonds have been measured as a function of pH, concentration of
      urea, and temperature, in order to understand which contributions stabilize the
      disulfide-bonded structures. Using oxidized and reduced glutathione, the
      equilibrium constants for forming the disulfide bonds at 25 degrees C and pH 7.0
      are 0.018 M for Apa-1 and 0.033 M for Apa-2 and show little dependence on pH or
      temperature. Both disulfide bonds are destabilized slightly (by approximately a
      factor of 2) between 0 and 8 M urea. Circular dichroism spectra indicate that
      although both Apa-1 and Apa-2 exhibit some structure, Apa-2 exhibits more than
      Apa-1. The results suggest that in the folding of apamin, the one-disulfide
      intermediate containing the C-3 to C-15 disulfide bond, as in Apa-2, is favored
      slightly. Secondary structure provides modest stabilization to this intermediate.

PMID- 1737007
TI  - pH-induced folding/unfolding of staphylococcal nuclease: determination of kinetic
      parameters by the sequential-jump method.
AB  - On the basis of previous stopped-flow pH-jump experiments, we have proposed that
      the acid- and alkaline-induced folding/unfolding transition of staphylococcal
      nuclease, in the time range 2 ms to 300 s, follows the pathway N0 in equilibrium
      with D1 in equilibrium with D2 in equilibrium with D3, in which D1, D2, and D3
      are three substates of the unfolded state and N0 is the native state. The stopped
      flow "double-jump" technique has been employed to test this mechanism and to
      determine the rate constants which would not be accessible by the direct pH jump
      because of the lack of fluorescence signal, i.e., the rates for the conversion of
      D1 to D2 and of D2 to D3. In the forward jump, a protein solution kept at pH 7.0
      was mixed with an acidic or alkaline solution to the final pH of 3.0 or 12.2,
      respectively. The mixed solution was kept for varying periods of time, called the
      delay time, tD. A second mixing (the back jump) was launched to bring the protein
      solution back to pH 7.0. The time course of the Trp-140 fluorescence signals
      recovered in the back jump was analyzed as a function of tD. Kinetics of the
      unfolding were found to be triphasic by the double-jump method, contrary to the
      monophasic kinetics observed by the direct pH jump. Complex kinetics of unfolding
      are expected with the proposed kinetic scheme.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737008
TI  - Engineering surface charge. 1. A method for detecting subunit exchange in
      Escherichia coli glutathione reductase.
AB  - The gene gor encoding Escherichia coli glutathione reductase was mutated to
      create a positively charged N-terminal extension consisting of five arginine
      residues followed by a factor Xa cleavage site to the enzyme polypeptide chain.
      The modified protein assembled in vivo to yield a dimeric enzyme with kinetic
      parameters indistinguishable from those of wild-type glutathione reductase. The N
      terminal extension could not be released by treatment with factor Xa but could be
      removed by exposure to trypsin, again without effect on the enzyme activity. The
      modified enzyme was readily separated from the wild-type enzyme by means of ion
      exchange chromatography or nondenaturing polyacrylamide gel electrophoresis.
      Incubation of the modified and wild-type enzymes, separately or as a mixture,
      with NADH led to their partial inactivation, and activity was restored by
      exposure to 1 mM reduced glutathione. No hybrid dimer was formed in the mixture
      of modified and wild-type enzymes, as judged by polyacrylamide gel
      electrophoresis, strongly suggesting that the inactivation induced by NADH was
      not due to dissociation of the parental dimers. The addition of otherwise benign
      positively or negatively charged extensions to the N- or C-terminal regions of
      the constituent polypeptide chains of oligomeric enzymes offers a simple route to
      detecting hybrid formation and the causative subunit dissociation and exchange.

PMID- 1737009
TI  - Engineering surface charge. 2. A method for purifying heterodimers of Escherichia
      coli glutathione reductase.
AB  - Two gor genes encoding different mutants of Escherichia coli glutathione
      reductase have been expressed in the same E. coli cell, leading to the creation
      of a hybrid form of the enzyme dimer. One of the gor genes carried, in addition
      to various directed mutations, a 5' extension that encodes a benign penta
      arginine "arm" added to the N-terminus of the glutathione reductase polypeptide
      chain [Deonarain, M.P., Scrutton, N.S., & Perham, R.N. (1992) Biochemistry
      (preceding paper in this issue)]. This made possible, by means of ion-exchange
      chromatography or nondenaturing polyacrylamide gel electrophoresis, the facile
      separation of the hybrid enzyme from the two parental forms. Moreover, the two
      subunits in the hybrid enzyme could be made to carry different mutations. In this
      way, glutathione reductases with only one active site per dimer were generated:
      the effects of replacing tyrosine-177 with glycine in the NADPH-binding site,
      which greatly diminishes the Km for glutathione and switches the kinetic
      mechanism from ping-pong to ordered sequential, and of replacing His-439 with
      glutamine in the glutathione-binding site, which greatly diminishes the Km for
      NADPH, were both found to be restricted to the one active site carrying the
      mutations. This system of generating separable enzyme hybrids is generally
      applicable and should make it possible now to undertake a more systematic study
      of catalytic mechanism and assembly for the many enzymes with quaternary
      structure.

PMID- 1737010
TI  - Catalysis at the interface: the anatomy of a conformational change in a
      triglyceride lipase.
AB  - The crystal structure of an extracellular triglyceride lipase (from a fungus
      Rhizomucor miehei) inhibited irreversibly by diethyl p-nitrophenyl phosphate
      (E600) was solved by X-ray crystallographic methods and refined to a resolution
      of 2.65 A. The crystals are isomorphous with those of n-hexylphosphonate ethyl
      ester/lipase complex [Brzozowski, A. M., Derewenda, U., Derewenda, Z. S., Dodson,
      G. G., Lawson, D. M., Turkenburg, J. P., Bjorkling, F., Huge-Jensen, B., Patkar,
      S. A., & Thim, L. (1991) Nature 351, 491-494], where the conformational change
      was originally observed. The higher resolution of the present study allowed for a
      detailed analysis of the stereochemistry of the change observed in the inhibited
      enzyme. The movement of a 15 amino acid long "lid" (residues 82-96) is a hinge
      type rigid-body motion which transports some of the atoms of a short alpha-helix
      (residues 85-91) by over 12 A. There are two hinge regions (residues 83-84 and 91
      95) within which pronounced transitions of secondary structure between alpha and
      beta conformations are caused by dramatic changes of specific conformational
      dihedral angles (phi and psi). As a result of this change a hydrophobic area of
      ca. 800 A2 (8% of the total molecule surface) becomes exposed. Other triglyceride
      lipases are also known to have "lids" similar to the one observed in the R.
      miehei enzyme, and it is possible that the general stereochemistry of lipase
      activation at the oil-water interfaces inferred from the present X-ray study is
      likely to apply to the entire family of lipases.

PMID- 1737011
TI  - Crystal structure at 1.5-A resolution of d(CGCICICG), an octanucleotide
      containing inosine, and its comparison with d(CGCG) and d(CGCGCG) structures.
AB  - The octadeoxyribonucleotide d(CGCICICG) has been crystallized in space group
      P(6)5(22) with unit cell dimensions of a = b = 31.0 A and c = 43.7 A, and X-ray
      diffraction data have been collected to 1.5-A resolution. Precession photographs
      and the self-Patterson function indicate that 12 base pairs of Z-conformation DNA
      stack along the c-axis, and the double helices pack in a hexagonal array similar
      to that seen in other crystals of Z-DNA. The structure has been solved by both
      Patterson deconvolution and molecular replacement methods and refined in space
      group P(6)5 to an R factor of 0.225 using 2503 unique reflections greater than
      3.0 sigma (F). Comparison of the molecules within the hexagonal lattice with
      highly refined crystal structures of other Z-DNA reveals only minor
      conformational differences, most notably in the pucker of the deoxyribose of the
      purine residues. The DNA has multiple occupancy of C:I and C:G base pairs, and
      C:I base pairs adopt a conformation similar to that of C:G base pairs.

PMID- 1737012
TI  - Hexagonal phase forming propensity detected in phospholipid bilayers with
      fluorescent probes.
AB  - The fluorescence emission spectrum of N epsilon-dansyl-L-Lys undergoes a marked
      blue shift when incorporated from aqueous solution into phospholipid bilayers.
      This shift is greater for membranes composed of dipalmitoleoylphosphatidylcholine
      than for membranes of dipalmitoleoylphosphatidylethanolamine. With the latter but
      not the former lipid, the fluorescence emission from N epsilon-dansyl-L-Lys is
      markedly temperature-dependent. The marked temperature dependence of N epsilon
      dansyl-L-Lys fluorescence in bilayers of dipalmitoleoylphosphatidylethanolamine
      is greatest as the sample is heated close to the bilayer to hexagonal phase
      transition temperature. The fluorescence emission properties of another probe of
      membrane surface hydrophobicity, Laurdan, also exhibit marked changes at
      temperatures just below the bilayer to hexagonal phase transition temperature. At
      these temperatures, the generalized polarization begins to increase rather than
      decrease with temperature, and the emission intensity decreases markedly. Such
      effects are not observed over the same temperature range with
      phosphatidylcholine. Thus, both dansyl-L-lysine and Laurdan provide probes to
      measure changes in the physical properties of membrane bilayers which occur when
      these bilayers are heated close to the temperature required for transition to the
      hexagonal phase.

PMID- 1737013
TI  - Modulation of progesterone receptor binding to progesterone response elements by
      positioned nucleosomes.
AB  - In cells, steroid hormone receptors interact with target enhancer elements on
      nucleosomes to regulate transcription of genes. To elucidate how nucleosomes can
      potentially regulate the interactions of steroid receptors with steroid response
      elements, we have examined the effects of nucleosome positioning and histone
      source on the binding of the progesterone receptor to DNA elements on nucleosomes
      reconstituted in vitro. We find that the affinity of the receptor for its
      response element is dependent on the position of the element within the
      nucleosome, but not on the histone source, active or inactive chromatin. Our
      results suggest that the strength of DNA-histone interactions within the
      nucleosome modulates the binding of progesterone receptor to response elements.
      Thus, nucleosome positioning is likely to influence the function of steroid
      receptors in vivo.

PMID- 1737014
TI  - Miniantibodies: use of amphipathic helices to produce functional, flexibly linked
      dimeric FV fragments with high avidity in Escherichia coli.
AB  - We have designed dimeric antibody fragments that assemble in Escherichia coli.
      They are based on single-chain FV fragments, with a flexible hinge region from
      mouse IgG3 and an amphiphilic helix fused to the C-terminus of the antibody
      fragment. The sequence of the helix was taken either from that of a previously
      reported four-helix bundle design or from a leucine zipper, optionally extended
      with a short cysteine-containing peptide. The bivalent fragments associate in
      vivo, either with covalent linkage or with a monomer-dimer equilibrium, and
      results from ultracentrifugation sedimentation studies and SDS-PAGE are
      consistent with dimers. All constructs are able to bind to surface-bound antigen
      under conditions in which only bivalent but not monovalent antibody fragments
      bind. The covalent bundle helix construct shows binding characteristics nearly
      identical to those of the much larger whole mouse antibody, resulting in
      substantially more stable immunoglobulin-antigen complexes than in the case of
      monovalent fragments. This modular design of natural and engineered protein
      domains directly leads to a boost of avidity, and it allows the construction of
      bispecific antibody fragments in functional form in E. coli.

PMID- 1737015
TI  - Correlation of tryptophan fluorescence intensity decay parameters with 1H NMR
      determined rotamer conformations: [tryptophan2]oxytocin.
AB  - While the fluorescence decay kinetics of tyrosine model compounds [Laws, W. R.,
      Ross, J. B. A., Wyssbrod, H. R., Beechem, J. M., Brand, L., & Sutherland, J. C.
      (1986) Biochemistry 25, 599-607] and the tyrosine residue in oxytocin [Ross, J.
      B. A., Laws, W. R., Buku, A., Sutherland, J. C., & Wyssbrod, H. R. (1986)
      Biochemistry 25, 607-612] can be explained in terms of heterogeneity derived from
      the three ground-state chi 1 rotamers, a similar correlation has yet to be
      directly observed for a tryptophan residue. In addition, the asymmetric indole
      ring might also lead to heterogeneity from chi 2 rotations. In this paper, the
      time-resolved and steady-state fluorescence properties of [tryptophan2]oxytocin
      at pH 3 are presented and compared with 1H NMR results. According to the
      unrestricted analyses of individual fluorescence decay curves taken as a function
      of emission wavelength and a global analysis of these decay curves for common
      emission wavelength-independent decay constants, only three exponential terms are
      required. In addition, the preexponential weighting factors (amplitudes) have the
      same relative relationship (weights) as the 1H NMR-determined chi 1 rotamer
      populations of the indole side chain. 15N was used in heteronuclear coupling
      experiments to confirm the rotamer assignments. Inclusion of a linked function
      restricting the decay amplitudes to the chi 1 rotamer populations in the
      individual decay curve analyses and in the global analysis confirms this
      correlation. According to qualitative nuclear Overhauser data, there are two chi
      2 populations. Depending upon the degree of correlation between chi 2 and chi 1,
      there may be from three to six side-chain conformations for the tryptophan
      residue. The combined fluorescence and NMR results are consistent with a rotamer
      model in which either (i) the chi 2 rotations are fast compared to the
      fluorescence intensity decay of the tryptophan residue, (ii) environmental
      factors affecting fluorescence intensity decay properties are dominated by chi 1
      interactions, or (iii) the chi 2 and chi 1 rotations are highly correlated.

PMID- 1737016
TI  - Conformational changes in the metal-binding sites of cardiac troponin C induced
      by calcium binding.
AB  - Isotope labeling of recombinant normal cardiac troponin C (cTnC3) with 15N
      enriched amino acids and multidimensional NMR were used to assign the downfield
      shifted amide protons of Gly residues at position 6 in Ca(2+)-binding loops II,
      III, and IV, as well as tightly hydrogen-bonded amides within the short
      antiparallel beta-sheets between pairs of Ca(2+)-binding loops. The amide protons
      of Gly70, Gly110, and Gly146 were found to be shifted significantly downfield
      from the remaining amide proton resonances in Ca(2+)-saturated cTnC3. No
      downfield-shifted Gly resonance was observed from the naturally inactive site I.
      Comparison of downfield-shifted amide protons in the Ca(2+)-saturated forms of
      cTnC3 and CBM-IIA, a mutant having Asp65 replaced by Ala, demonstrated that Gly70
      is hydrogen bonded to the carboxylate side chain of Asp65. Thus, the hydrogen
      bond between Gly and Asp in positions 6 and 1, respectively, of the Ca(2+)
      binding loop appears crucial for maintaining the integrity of the helix-loop
      helix Ca(2+)-binding sites. In the apo- form of cTnC3, only Gly70 was found to be
      shifted significantly downfield with respect to the remaining amide proton
      resonances. Thus, even in the absence of Ca2+ at binding site II, the amide
      proton of Gly70 is strongly hydrogen bonded to the side-chain carboxylate of
      Asp65. The amide protons of Ile112 and Ile148 in the C-terminal domain and Ile36
      in the N-terminal domain data-sheets exhibit chemical shifts consistent with
      hydrogen-bond formation between the pair of Ca(2+)-binding loops in each domain
      of Ca(2+)-saturated cTnC3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737017
TI  - Triple-helix formation and cooperative binding by oligodeoxynucleotides with a 3'
      3' internucleotide junction.
AB  - Triple-helix formation by oligodeoxynucleotides in a sequence-specific manner is
      limited to polypurine tracts of duplex DNA. To increase the number of
      biologically relevant targets for triple-helix formation, we have utilized
      oligodeoxynucleotides containing a 3'-3' internucleotide junction to allow for
      binding to opposite strands of duplex DNA. Molecular modeling was used to aid in
      the design of the xylose dinucleoside linker 1 that is rigid and minimizes the
      number of conformers to minimize the entropy of binding. Thermal denaturation
      studies show that a 3'-3'-linked oligodeoxynucleotide, bearing nine nucleotides
      on each side of the linker, has a higher Tm (47.6 degrees C) than that of a 21
      mer binding to a single polypurine tract (45.3 degrees C). Binding domain
      minimization studies and sequence-specific alkylation of a target duplex
      demonstrate a high degree of cooperativity between the two triple-helix binding
      domains, thus allowing for an increase in the number of biologically relevant
      targets for triple-helix formation.

PMID- 1737018
TI  - A fully active variant of dihydrofolate reductase with a circularly permuted
      sequence.
AB  - The amino acid sequence of mouse dihydrofolate reductase was permuted circularly
      at the level of the gene. By transposing the 3'-terminal half of the coding
      sequence to its 5' terminus, the naturally adjacent amino and carboxyl termini of
      the native protein were fused, and one of the flexible peptide loops at the
      protein surface was cleaved. The steady-state kinetic constants, the dissociation
      constants of folate analogues, and the degree of activation by both mercurials
      and salt as well as the resistance toward digestion by trypsin were almost
      indistinguishable from those of a recombinant wild-type protein. Judged by these
      criteria, the circularly permuted variant has the same active site and overall
      structure as the wild-type enzyme. The only significant difference was the lower
      stability toward guanidinium chloride and the lower solubility of the circularly
      permuted variant. This behavior may be due to moving a mononucleotide binding
      fold from the interior of the sequence to the carboxyl terminus. Thus,
      dihydrofolate reductase requires neither the natural termini nor the cleaved loop
      for stability, for the conformational changes that accompany catalysis as well as
      the binding of inhibitors, and for the folding process.

PMID- 1737019
TI  - Diadenosine tetraphosphate binding protein from human HeLa cells: purification
      and characterization.
AB  - The ubiquitous dinucleotide P1,P4-di(adenosine-5') tetraphosphate (Ap4A) has been
      proposed to be involved in DNA replication and cell proliferation, DNA repair,
      platelet aggregation, and vascular tonus. A protein binding specifically to Ap4A
      is associated with a multiprotein form of DNA polymerase alpha (pol alpha 2) in
      HeLa cells. The Ap4A binding protein from HeLa cells has been purified to
      homogeneity starting from pol alpha 2 complex. The Ap4A binding protein is
      hydrophobic and is resolved from the pol alpha 2 complex by hydrophobic
      interaction chromatography on butyl-Sepharose and subsequently purified to
      homogeneity by chromatography on Mono-Q and Superose-12 FPLC columns. The Ap4A
      binding activity elutes as a single symmetrical peak upon gel filtration with a
      molecular mass of 200 kDa. Upon polyacrylamide gel electrophoresis under
      nondenaturing conditions, the purified protein migrates as a single protein of
      200 kDa. Upon electrophoresis under denaturing conditions, the binding activity
      is resolved into two polypeptides of 45 and 22 kDa, designated as A1 and A2,
      respectively. A1 and A2 can be cross-linked using the homobifunctional cross
      linking agent disuccinimidyl suberate. The cross-linked protein migrates as a
      single protein of 210 kDa on polyacrylamide gels under denaturing conditions,
      suggesting that these two polypeptides are subunits of a single protein. The
      purified protein binds Ap4A efficiently, and by Scatchard analysis, we have
      determined a dissociation constant of 0.25 microM, indicating high affinity of
      Ap4A binding protein to its ligand. ATP is not required for the binding activity.
      The nonionic detergent Triton X-100 is necessary for stabilizing the purified
      protein. Amino acid composition analysis indicates that A1 and A2 are distinct.

PMID- 1737020
TI  - Differential scanning calorimetric study of the thermal unfolding of mutant forms
      of phage T4 lysozyme.
AB  - In two recent papers, we reported the effects of several point mutations on the
      thermodynamics of the thermal unfolding of the lysozyme of phage T4 as determined
      by differential scanning calorimetry. The mutants studied were R96H [Kitamura,
      S., & Sturtevant, J.M. (1989) Biochemistry 28, 3788-3792] and T157 replaced by A,
      E, I, L, N, R, and V [Connelly, P., Ghosaini, L., Hu, C.-Q., Kitamura, S.,
      Tanaka, A., & Sturtevant, J.M. (1991) Biochemistry 30, 1887-1891]. Here we report
      the results of a similar study of the single mutations A82P, A93P, and G113A and
      the double mutation C54T:C97A. The three single mutants all show small apparent
      stabilization at pH 2.5 and 46.2 degrees C (the denaturational temperature of the
      wild-type protein), amounting to -0.5 +/- 0.4 kcal mol-1 in free energy, whereas
      the double mutant shows a weak apparent destabilization, +0.8 +/- 0.4 kcal mol-1.
      As in all our previous studies of mutant proteins, the enthalpy changes produced
      by these mutations are in general of much larger magnitude than the corresponding
      free energy changes and frequently of opposite sign.

PMID- 1737021
TI  - The chemical shift index: a fast and simple method for the assignment of protein
      secondary structure through NMR spectroscopy.
AB  - Previous studies by Wishart et al. [Wishart, D. S., Sykes, B. D., & Richards, F.
      M. (1991) J. Mol. Biol. (in press)] have demonstrated that 1H NMR chemical shifts
      are strongly dependent on the character and nature of protein secondary
      structure. In particular, it has been found that the 1H NMR chemical shift of the
      alpha-CH proton of all 20 naturally occurring amino acids experiences an upfield
      shift (with respect to the random coil value) when in a helical configuration and
      a comparable downfield shift when in a beta-strand extended configuration. On the
      basis of these observations, a technique is described for rapidly and
      quantitatively determining the identity, extent, and location of secondary
      structural elements in proteins based on the simple inspection of the alpha-CH 1H
      resonance assignments. A number of examples are provided to demonstrate both the
      simplicity and the accuracy of the technique. This new method is found to be
      almost as accurate as the more traditional NOE-based methods of determining
      secondary structure and could prove to be particularly useful in light of the
      recent development of sequential assignment techniques which are now almost NOE
      independent [Ikura, M., Kay, L. E., & Bax, A. (1990) Biochemistry 29, 4659-4667].
      We suggest that this new procedure should not necessarily be seen as a substitute
      to existing rigorous methods for secondary structure determination but, rather,
      should be viewed as a complement to these approaches.

PMID- 1737022
TI  - Proton nuclear Overhauser effect study of the heme active site structure of
      chloroperoxidase.
AB  - Chloroperoxidase, a glycoprotein from the mold Caldariomyces fumago, has been
      investigated in its ferric low-spin cyanide-ligated form through use of nuclear
      Overhauser effect (NOE) spectroscopy to provide information on the heme pocket
      electronic/molecular structure. Spin-lattice relaxation times for the hyperfine
      shifted heme resonances were found to be three times less than those in
      horseradish peroxidase. This must reflect a slower electronic relaxation rate for
      chloroperoxidase than for horseradish peroxidase as a consequence of axial
      ligation of cysteine in the former versus histidine in the latter enzyme.
      Isoenzymes A1 and A2 of chloroperoxidase show the largest chemical shift
      differences near the heme propionate on the basis of NOE measurements. This
      suggests that the primary structure differences for the two isoenzymes are
      communicated to the heme group through the ring propionate substituents. A
      downfield peak has been detected in chloroperoxidase with chemical shift, T1, and
      line width characteristics similar to those of the C epsilon-H proton of the
      distal histidine residue. The NOE pattern and T1's of the peaks in the 0.0 to 
      5.0 ppm upfield region are consistent with the presence of an arginine amino acid
      residue in the heme pocket near either the 1-CH3 or 3-CH3 group. Existence of
      catalytically important distal histidine and arginine amino acid residues in
      chloroperoxidase shows it to be structurally similar to peroxidases rather than
      to the often compared monooxygenase, cytochrome P-450. This result supports the
      earlier conclusions of Sono et al. [Sono, M., Dawson, J.H., Hall, K., & Hager,
      L.P. (1986) Biochemistry 25, 347-356].

PMID- 1737023
TI  - Mutational analysis of carbamyl phosphate synthetase. Substitution of Glu841
      leads to loss of functional coupling between the two catalytic domains of the
      synthetase subunit.
AB  - The synthetase subunit of Escherichia coli carbamyl phosphate synthetase has two
      catalytic nucleotide-binding domains, one involved in the activation of HCO3- and
      the second in phosphorylation of carbamate. Here we show that a Glu841----Lys841
      substitution in a putative ATP-binding domain located in the carboxyl half of the
      synthetase abolishes overall synthesis of carbamyl phosphate with either
      glutamine or NH3 as the nitrogen source. Measurements of partial activities
      indicate that while HCO3(-)-dependent ATP hydrolysis at saturating concentrations
      of substrate proceeds at higher than normal rates, ATP synthesis from ADP and
      carbamyl phosphate is nearly completely suppressed by the mutation. These results
      indicate Glu841 to be an essential residue for the phosphorylation of carbamate
      in the terminal step of the catalytic mechanism. The Lys841 substitution also
      affects the kinetic properties of the HCO3- activation site. Both kcat and Km for
      ATP increase 10-fold, while Km for HCO3- is increased 100-fold. Significantly,
      NH3 decreases rather than stimulates Pi release from ATP in the HCO3(-)-dependent
      ATPase reaction. The increase in kcat of the HCO3(-)-dependent ATPase reaction,
      and an impaired ability of the Lys841 enzyme to catalyze the reaction of NH3 with
      carboxy phosphate, strongly argues for interactions between the two catalytic ATP
      sites that couple the formation of enzyme-bound carbamate with its
      phosphorylation.

PMID- 1737024
TI  - A low molecular weight platelet inhibitor of factor XIa: purification,
      characterization, and possible role in blood coagulation.
AB  - A low molecular weight platelet inhibitor of factor XIa (PIXI) has been purified
      250-fold from releasates of washed and stimulated human platelets. Molecular
      weight estimates of 8400 and 8500 were determined by gel filtration and SDS
      polyacrylamide gel electrophoresis, respectively, although a second band of Mr
      5000 was present upon electrophoresis. The inhibitor does not appear to be one of
      the platelet-specific, heparin-binding proteins, since it neither bound to nor
      was affected by heparin. An amount of PIXI which inhibited by 50% factor XIa
      cleavage of the chromogenic substrate S2366 (Pyr-Glu-Pro-Arg-pNA-2H2O) only
      slightly inhibited (5-9%) factor XIIa, plasma kallikrein, plasmin, and activated
      protein C and did not inhibit factor Xa, thrombin, tPA, or trypsin, suggesting
      specificity for factor XIa. Kinetic analyses of the effect of PIXI on factor XIa
      activity demonstrated mixed-type, noncompetitive inhibition of S2366 cleavage and
      of factor IX activation with Ki's of 7 x 10(-8) and 3.8 x 10(-9) M, respectively.
      Immunoblot analysis showed that PIXI is not the inhibitory domain of protease
      nexin II, a potent inhibitor of factor XIa also secreted from platelets. Amino
      acid analysis showed that PIXI has no cysteine residues and, therefore, is not a
      Kunitz-type inhibitor. PIXI can prevent stable complex formation between alpha 1
      protease inhibitor and factor XIa light chain as demonstrated by SDS
      polyacrylamide gel electrophoresis. The inhibition by PIXI of factor XIa
      catalyzed activation of factor IX and its capacity to prevent factor XIa
      inactivation by alpha 1-protease inhibitor, combined with the specificity of PIXI
      for factor XIa among serine proteases found in blood, suggest a role for PIXI in
      the regulation of intrinsic coagulation.

PMID- 1737025
TI  - Covalent modification and active site-directed inactivation of a low molecular
      weight phosphotyrosyl protein phosphatase.
AB  - Covalent modification experiments were conducted in order to identify active site
      residues of the 18-kDa cytoplasmic phosphotyrosyl protein phosphatases. The
      enzyme was inactivated by diethyl pyrocarbonate, phenylglyoxal, cyclohexanedione,
      iodoacetate, iodoacetamide, phenylarsine oxide, and certain epoxides in a manner
      consistent with the modification of active site residues. Phenylglyoxal and
      cyclohexanedione both bind to the active site in a rapid preequilibrium process
      and thus act as active site-directed inhibitors. The pH dependencies of the
      inactivation by iodoacetate and by iodoacetamide were examined in detail and
      compared with rate data for the alkylation of glutathione as a model compound.
      The enzyme inactivation data permitted the determination of pKa values of two
      reactive cysteines at or near the active site. Although phosphomycin is simply a
      competitive inhibitor of the enzyme, it was found that 1,2-epoxy-3-(p
      nitrophenoxy)propane (EPNP) and (R)- and (S)-benzylglycidol act as irreversible
      covalent inactivators, consistent with the importance of a hydrophobic moiety on
      the substrate in controlling substrate specificity. EPNP exhibits characteristics
      of an active site-directed inactivator, with a preequilibrium binding constant
      somewhat smaller than that of phosphate ion. The pH dependencies of inactivation
      of EPNP and (S)-benzylglycidol are identical to that observed for iodoacetamide
      and similar to that for iodoacetate, suggesting that they modify similar groups.
      Sequencing of the tryptic digests of the EPNP-labeled enzyme indicates that Cys
      62 and Cys-145 are labeled. Phenylarsine oxide acts as a very slow, tight-binding
      inhibitor of the enzyme. The results are interpreted in terms of an active site
      model that incorporates a histidine-cysteine ion pair, similar to that present in
      papain.

PMID- 1737026
TI  - Characterization of a calcium- and lipid-dependent protein kinase associated with
      the plasma membrane of oat.
AB  - A protein kinase that is activated by calcium and lipid has been partially
      purified from the plasma membrane of oat roots. This protein kinase cross-reacts
      with four monoclonal antibodies directed against a soluble calcium-dependent
      protein kinase from soybean described previously [Putman-Evans, C. L., Harmon, A.
      C., & Cormier, M. J. (1990) Biochemistry 29, 2488-2495; Harper, J. F., Sussman,
      M. R., Schaller, G. E., Putnam-Evans, C., Charbonneau, H., & Harmon, A. C. (1991)
      Science 252, 951-954], indicating that the oat enzyme is a member of this calcium
      dependent protein kinase family. Immunoblots demonstrate that the membrane
      derived protein kinase is slightly larger than that observed in the cytosolic
      fraction of oat. Limited digestion of the membrane-derived kinase with trypsin
      generates a smaller water-soluble kinase that is still activated by calcium but
      is no longer activated by lipid. When posthomogenization proteolysis is
      minimized, the bulk of the immunoreactive kinase material is localized in the
      membrane. These results suggest that a calcium-dependent protein kinase observed
      in the supernatant fraction of oat extracts may originate in situ from a calcium-
      and lipid-dependent protein kinase which is associated with the oat plasma
      membrane. They further indicate that, in contrast to animal cells, the
      predominant calcium- and lipid-dependent protein kinase associated with the
      plasma membrane of plant cells has biochemical properties and amino acid sequence
      unlike protein kinase C.

PMID- 1737027
TI  - Proteins associated with the messenger ribonucleoprotein particle for the
      estrogen-regulated apolipoprotein II mRNA.
AB  - The stability of the mRNA for apolipoprotein (apo) II is regulated by estrogen
      [Gordon et al. (1988) J. Biol. Chem. 263, 2625-2631]. On the hypothesis tha
      estrogen regulation of apoII mRNA stability is mediated through mRNA-protein
      interaction, we have examined the messenger ribonucleoprotein particle (mRNP) for
      apoII mRNA following release from chicken liver polyribosomes. Polyribosomes
      containing undegraded apoII mRNA were obtained when tissue was homogenized
      without detergent, and polyribosomes were isolated following simultaneous
      addition of detergent and magnesium to a 20000g supernatant. ApoII mRNP released
      by EDTA sedimented at 12-18 S in sucrose gradients, and banded at rho = 1.4 g/mL
      in CsCl isopycnic centrifugation, indicative of a 3:1 ratio of protein to mRNA. A
      fraction in which apoII mRNP was enriched to 40-50% of total mRNP was prepared by
      successive size fractionation steps on sucrose gradients. Proteins associated
      with sucrose gradient enriched apoII mRNP were examined by iodination of UV-cross
      linked proteins followed by SDS-polyacrylamide gel electrophoresis. Comparisons
      of proteins in highly enriched apoII mRNP to proteins in mRNP from non-estrogen
      treated rooster liver did not reveal any differences. This result suggests that
      the major proteins associated with apoII mRNA are mRNP proteins also associated
      with the bulk of liver mRNAs.

PMID- 1737028
TI  - Disulfide exchange folding of insulin-like growth factor I.
AB  - The disulfide exchange folding properties of insulin-like growth factor I (IGF-I)
      have been analyzed in a redox buffer containing reduced (10 mM) and oxidized (1
      mM) glutathione. Under these conditions, the 3 disulfide bridges of the 70 amino
      acid peptide were not quantitatively formed. Instead, five major forms of IGF-I
      were detected, and these components were concluded to be in equilibrium as their
      relative amounts were similar starting from either reduced, native, or a
      mismatched variant of IGF-I containing two non-native disulfides. The different
      components in the mixtures were trapped by thiol alkylation using vinylpyridine
      and subsequently isolated by reverse-phase HPLC. The purified variants were
      further characterized using plasma desorption mass spectrometry and peptide
      mapping. Two of the five different forms were identified as native and mismatched
      IGF-I. One form was a variant with only one disulfide bond, and the other two
      major components had two disulfides formed. In a separate experiment, early
      refolding intermediates were trapped by pyridylethylation after only 90 s of
      refolding in the glutathione buffer, starting from reduced IGF-I. The
      intermediates were identical to the components observed at equilibrium, but at
      different relative concentrations. On the basis of the disulfide bond patterns of
      the different components in the equilibrium mixtures, we conclude that the
      disulfide between cysteines-47 and -52 in IGF-I is an unfavorable high-energy
      bond that may exist in the native molecule in a strained configuration.

PMID- 1737029
TI  - Mutations at the dimer, hexamer, and receptor-binding surfaces of insulin
      independently affect insulin-insulin and insulin-receptor interactions.
AB  - Mutagenesis of the dimer- and hexamer-forming surfaces of insulin yields
      analogues with reduced tendencies to aggregate and dramatically altered
      pharmacokinetic properties. We recently showed that one such analogue, HisB10---
      Asp, ProB28----Lys, LysB29----Pro human insulin (DKP-insulin), has enhanced
      affinity for the insulin receptor and is useful for studying the structure of the
      insulin monomer under physiologic solvent conditions [Weiss, M. A., Hua, Q. X.,
      Lynch, C. S., Frank, B. H., & Shoelson, S. E. (1991) Biochemistry 30, 7373-7389].
      DKP-insulin retains native secondary and tertiary structure in solution and may
      therefore provide an appropriate baseline for further studies of related
      analogues containing additional substitutions within the receptor-binding surface
      of insulin. To test this, we prepared a family of DKP analogues having potency
      altering substitutions at the B24 and B25 positions using a streamlined approach
      to enzymatic semisynthesis which negates the need for amino-group protection. For
      comparison, similar analogues of native human insulin were prepared by standard
      semisynthetic methods. The DKP analogues show a reduced tendency to self
      associate, as indicated by 1H-NMR resonance line widths. In addition, CD spectra
      indicate that (with one exception) the native insulin fold is retained in each
      analogue; the exception, PheB24----Gly, induces similar perturbations in both
      native insulin and DKP-insulin backgrounds. Notably, analogous substitutions
      exhibit parallel trends in receptor-binding potency over a wide range of
      affinities: D-PheB24 greater than unsubstituted greater than GlyB24 greater than
      SerB24 greater than AlaB25 greater than LeuB25 greater than SerB25, whether the
      substitution was in a native human or DKP-insulin background. Such "template
      independence" reflects an absence of functional interactions between the B24 and
      B25 sites and additional substitutions in DKP-insulin and demonstrates that
      mutations in discrete surfaces of insulin have independent effects on protein
      structure and function. In particular, the respective receptor-recognition
      (PheB24, PheB25), hexamer-forming (HisB10), and dimer-forming (ProB28, LysB29)
      surfaces of insulin may be regarded as independent targets for protein design.
      DKP-insulin provides an appropriate biophysical model for defining structure
      function relationships in a monomeric template.

PMID- 1737030
TI  - Binding of basic peptides to acidic lipids in membranes: effects of inserting
      alanine(s) between the basic residues.
AB  - We studied the binding of peptides containing five basic residues to membranes
      containing acidic lipids. The peptides have five arginine or lysine residues and
      zero, one, or two alanines between the basic groups. The vesicles were formed
      from mixtures of a zwitterionic lipid, phosphatidylcholine, and an acidic lipid,
      either phosphatidylserine or phosphatidylglycerol. Measuring the binding using
      equilibrium dialysis, ultrafiltration, and electrophoretic mobility techniques,
      we found that all peptides bind to the membranes with a sigmoidal dependence on
      the mole fraction of acidic lipid. The sigmoidal dependence (Hill coefficient
      greater than 1 or apparent cooperativity) is due to both electrostatics and
      reduction of dimensionality and can be described by a simple model that combines
      Gouy-Chapman-Stern theory with mass action formalism. The adjustable parameter in
      this model is the microscopic association constant k between a basic residue and
      an acidic lipid (1 less than k less than 10 M-1). The addition of alanine
      residues decreases the affinity of the peptides for the membranes; two alanines
      inserted between the basic residues reduces k 2-fold. Equivalently, the affinity
      of the peptide for the membrane decreases 10-fold, probably due to a combination
      of local electrostatic effects and the increased loss of entropy that may occur
      when the more massive alanine-containing peptides bind to the membrane. The
      arginine peptides bind more strongly than the lysine peptides: k for an arginine
      residue is 2-fold higher than for a lysine residue. Our results imply that a
      cluster of arginine and lysine residues with interspersed electrically neutral
      amino acids can bind a significant fraction of a cytoplasmic protein to the
      plasma membrane if the cluster contains more than five basic residues.

PMID- 1737031
TI  - Distances between the antigen-binding sites of three murine antibody subclasses
      measured using neutron and X-ray scattering.
AB  - For three different murine immunoglobulins (IgG subclasses 1, 2a, and 2b), the
      distances between their antigen-binding sites have been measured using neutron
      scattering from deuterated antigens complexed with proteated IgG. Neutron
      scattering data were measured for each antibody-antigen complex in a 41% D2O
      solvent. Unlike the proteated antibody molecule, the deuterated antigens are
      strongly contrasted against the 41% D2O solvent and give rise to a scattering
      profile that contains an interference term related to the distance between the
      deuterated antigens. For all three subclasses, the damping of this interference
      term, which gives information on the relative flexibility of the antigen-binding
      sites, indicates that a single distance is inadequate to describe the observed
      scattering and a distribution of distances is needed. The scattering profile has
      been modeled for each subclass to give the mean distance between the antigens and
      the variance of this distance. For all three IgG subclasses, the mean distance is
      between 117 and 134 A, and the variance is large (approximately 40 A), indicating
      a high degree of flexibility of the Fab arms. Small-angle X-ray scattering
      measurements on the same samples are consistent with the neutron-scattering
      results.

PMID- 1737032
TI  - Role of hydrophobic forces in bilayer adhesion and fusion.
AB  - With the aim of gaining more insight into the forces and molecular mechanisms
      associated with bilayer adhesion and fusion, the surface forces apparatus (SFA)
      was used for measuring the forces and deformations of interacting supported lipid
      bilayers. Concerning adhesion, we find that the adhesion between two bilayers can
      be progressively increased by up to two orders of magnitude if they are stressed
      to expose more hydrophobic groups. Concerning fusion, we find that the most
      important force leading to direct fusion is the hydrophobic attraction acting
      between the (exposed) hydrophobic interiors of bilayers; however, the occurrence
      of fusion is not simply related to the strength of the attractive interbilayer
      forces but also to the internal bilayer stresses (intrabilayer forces). For all
      the bilayer systems studied, a single basic fusion mechanism was found in which
      the bilayers do not "overcome" their short-range repulsive steric-hydration
      forces. Instead, local bilayer deformations allow these repulsive forces to be
      "bypassed" via a mechanism that is like a first-order phase transition, with a
      sudden instability occurring at some critical surface separation. Some very slow
      relaxation processes were observed for fluid bilayers in adhesive contact,
      suggestive of constrained lipid diffusion within the contact zone.

PMID- 1737033
TI  - Polarity decrease at the adhesive junction between two model membranes containing
      gangliosides.
AB  - The increased electrical conductance previously observed between two model
      membranes containing gangliosides suggests the creation of a new environment in
      the adhesive junction [Brewer, G. J., & Thomas, P.D. (1984) Biochim. Biophys.
      Acta 776, 279]. In order to provide a mechanism for this novel finding, we now
      report an investigation of the micropolarity in the adhesive junction. Emission
      from the fluorescent probe PRODAN is a sensitive measure of polarity of the probe
      environment. A bimodal linear relationship correlates the emission wavelength
      from PRODAN with the inverse of solvent dielectric constant (1/epsilon). A better
      single linear relationship is obtained using Reichardt's relative polarity
      measure (RPM). Creation of two macroscopic spherical lipid bilayers from
      phosphatidylcholine, brain gangliosides, and PRODAN allowed selective excitation
      and observation of fluorescence from either a single bilayer or the double
      bilayer in the adhesive junction. The reported PRODAN polarity of -0.57 in a
      single ganglioside-containing membrane was midway between the polarity of water
      and n-hexane, suggesting PRODAN localization near the lipid carbonyls. The
      adhesive junctional region exhibited two new less polar environments of PRODAN
      fluorescence, RPM = -0.45 and -0.29. These measures are consistent with a
      relatively dehydrated immobilized phase. These changes were not observed in the
      adhesion zone between two membranes made with phosphatidylcholine without
      gangliosides. The changes in molecular structure in the junction that could be
      responsible for the altered PRODAN emission are discussed. A decrease in the
      hydrocarbon thickness of junctional membranes or a decrease in the aqueous
      junctional polarity could be responsible for the polarity decrease reported by
      PRODAN.

PMID- 1737034
TI  - Congregation of gangliosides at the junction between two model membranes.
AB  - The diversity and distribution of gangliosides in vertebrate tissue suggests an
      important role in cellular recognition. Two types of experiments are reported to
      test the hypothesis that gangliosides can congregate to form an adhesive junction
      between two membranes. First, to monitor ganglioside distribution and mobility in
      different regions of two large spherical bilayer membranes, fluorescent
      derivatives of natural gangliosides were synthesized. Second, the cation carrier
      nonactin was used as a conductance probe to measure the membrane surface
      potential, which would be altered if there were a redistribution of the charged
      gangliosides. These studies were conducted in large spherical artificial
      membranes made from egg phosphatidylcholine or oleoylpalmitoylphosphatidylcholine
      with 0-12 mol % bovine brain gangliosides dissolved in n-decane. The fluorescent
      gangliosides utilized were lucifer yellow adducts to the sialic acids (LY
      gangliosides) or a cis-paranaric acid substitution of the N-acyl moiety in the
      ceramide portion of gangliosides GM1 and GD1a (paranaryl-GM1 and paranaryl-GD1a).
      The polarized fluorescence from the adhesive junction between two membranes
      containing LY-gangliosides or either paranarylganglioside was compared to that in
      nonadhesive regions. For LY-gangliosides, total fluorescence in the junction
      decreased with time, possibly due to electrostatic repulsion of this highly
      charged derivative. For paranarylgangliosides, fluorescence in the junction
      increased 7-fold with time, suggesting congregation of this ganglioside. In both
      cases, a measure of rotational mobility, fluorescence anisotropy, increased
      dramatically, about 2-fold, as expected for restricted mobility of adhesive
      compounds. Independent evidence for congregation of charge-bearing gangliosides
      was found with the conductance probe nonactin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737035
TI  - Correlation between phosphorylation of the chemotaxis protein CheY and its
      activity at the flagellar motor.
AB  - Phosphorylation of the chemotaxis protein CheY by its kinase CheA appears to play
      a central role in the process of signal transduction in bacterial chemotaxis. It
      is presumed that the role is activation of CheY which results in clockwise (CW)
      flagellar rotation. The aim of this study was to determine whether this activity
      of CheY indeed depends on the protein being phosphorylated. Since the
      phosphorylation of CheY can be detected only in vitro, we studied the ability of
      CheY to cause CW rotation in an in vitro system, consisting of cytoplasm-free
      envelopes of Salmonella typhimurium or Escherichia coli having functional
      flagella. Envelopes containing just buffer rotated only counterclockwise.
      Inclusion of CheY caused 14% of the rotating envelopes to go CW. This fraction of
      CW-rotating envelopes was not altered when the phosphate potential in the
      envelopes was lowered by inclusion of ADP together with CheY in them, indicating
      that CheY has a certain degree of activity even without being phosphorylated.
      Attempts to increase the activity of CheY in the envelopes by phosphorylation
      were not successful. However, when CheY was inserted into partially-lysed cells
      (semienvelopes) under phosphorylating conditions, the number of CW-rotating cells
      increased 3-fold. This corresponds to more than a 100-fold increase in the
      activity of a single CheY molecule upon phosphorylation. It is concluded that
      nonphosphorylated CheY can interact with the flagellar switch and cause CW
      rotation, but that this activity is increased by at least 2 orders of magnitude
      by phosphorylation. This increase in activity requires additional cytoplasmic
      constituents, the identity of which is not yet known.

PMID- 1737036
TI  - Profilin-actin complexes directly elongate actin filaments at the barbed end.
AB  - We demonstrate that the profilin-G-actin complex can elongate actin filaments
      directly at the barbed end but cannot bind to the pointed end. During elongation,
      the profilin-actin complex binds to the barbed filament end, whereupon profilin
      is released, leaving the actin molecule behind. This was first proposed by Tilney
      [Tilney, L. G., et al. (1983) J. Cell Biol. 97, 112-124] and demonstrated by
      Pollard and Cooper [(1984) Biochemistry 23, 6631-6641] by electron microscopy. We
      show that a model without any outside energy supply, in contrast to the mechanism
      proposed by Pollard and Cooper, can be fitted to our and their [Kaiser et al.
      (1986) J. Cell Biol. 102, 221-226] findings. Input of outside energy is necessary
      only if profilin-mediated elongation continues after free G-actin has been
      lowered to or below the critical concentration observed at the barbed end in the
      absence of profilin.

PMID- 1737037
TI  - Effects of salt concentration and H1 histone removal on the differential scanning
      calorimetry of nuclei.
AB  - The effects of increasing NaCl concentrations on the melting profiles of
      chromatin in isolated nuclei contradicted published claims that structural
      transitions near 76 degrees C (Tn-7), near 89 degrees C (Tn-8), and near 105
      degrees C (Tn-10) were respectively the melting of linker DNA, the melting of
      extended nucleosomal strands, and the collapse of nucleosomes in the 300-A fiber.
      Contrary to expectations of such an interpretation, decreases in salt
      concentration stabilized Tn-7 and failed to eliminate Tn-10. Moreover, nuclei
      depleted of H1 histone, which is known to be essential for the formation of the
      300-A fiber, gave the same melting profile as intact nuclei with regard to the
      relative magnitudes of Tn-8 and Tn-10. The effect of salt concentration on the
      melting profiles and the insensitivity of Tn-8 and Tn-10 to H1 histone removal
      supports the notion that Tn-7 is the collapse of the nucleosome while Tn-8 and Tn
      10 are respectively the unstacking of nucleotide bases in relaxed chromatin and
      supercoiled chromatin. The identification of Tn-8 as the unstacking of bases in
      relaxed DNA, and Tn-10 as unstacking in supercoiled DNA, shows that scanning
      calorimetry can be used to measure the state of repair of DNA in the nucleus. The
      gain in Tn-8 at the expense of Tn-10 that is seen as the mitotic index drops and
      differentiation occurs suggests that nicks accumulate in the DNA, perhaps because
      the gross aggregation of the inactive majority of the chromatin makes it
      inaccessible to repair enzymes.

PMID- 1737038
TI  - 31P NMR spectra of oligodeoxyribonucleotide duplex lac operator-repressor
      headpiece complexes: importance of phosphate ester backbone flexibility in
      protein-DNA recognition.
AB  - The 31P NMR spectra of various 14-base-pair lac operators bound to both wild-type
      and mutant lac repressor headpiece proteins were analyzed to provide information
      on the backbone conformation in the complexes. The 31P NMR spectrum of a wild
      type symmetrical operator, d(TGTGAGCGCTCACA)2, bound to the N-terminal 56-residue
      headpiece fragment of a Y7I mutant repressor was nearly identical to the spectrum
      of the same operator bound to the wild-type repressor headpiece. In contrast, the
      31P NMR spectrum of the mutant operator, d(TATAGAGCGCTCATA)2, wild-type headpiece
      complex was significantly perturbed relative to the wild-type repressor-operator
      complex. The 31P chemical shifts of the phosphates of a second mutant operator,
      d(TGTGTGCGCACACA)2, showed small but specific changes upon complexation with
      either the wild-type or mutant headpiece. The 31P chemical shifts of the
      phosphates of a third mutant operator, d(TCTGAGCGCTCAGA)2, showed no
      perturbations upon addition of the wild-type headpiece. The 31P NMR results
      provide further evidence for predominant recognition of the 5'-strand of the 5'
      TGTGA/3'-ACACT binding site in a 2:1 protein to headpiece complex. It is proposed
      that specific, strong-binding operator-protein complexes retain the inherent
      phosphate ester conformational flexibility of the operator itself, whereas the
      phosphate esters are conformationally restricted in the weak-binding operator
      protein complexes. This retention of backbone torsional freedom in strong
      complexes is entropically favorable and provides a new (and speculative)
      mechanism for protein discrimination of different operator binding sites. It
      demonstrates the potential importance of phosphate geometry and flexibility on
      protein recognition and binding.

PMID- 1737039
TI  - Rates of spontaneous exchange of synthetic radiolabeled sterols between lipid
      vesicles.
AB  - 14C-labeled sterols with structural variation in the polar function [3 alpha-OH,
      3-O(CH2)2O-(CH2)2O(CH2)2OH, 3 alpha-NH2, 3 beta-NH2, and 3-OC(O)CHN = N] and at
      the 7 position (7-oxo, 7 alpha-OH, and 7 beta-OH) were synthesized and
      incorporated into unilamellar vesicles for studies of the rates of transfer to an
      excess of acceptor vesicles. Cholesterol, cholestanol, and epicholesterol
      underwent full exchange in a single kinetic pool, and 90% of the 3 alpha
      triethoxycholesterol was exchangeable in one pool. Biphasic kinetics with full
      exchangeability were observed for cholesterylamines, which bear a positive charge
      at the 3 position; the slow phase reflects the high activation energy for inner
      to-outer leaflet movement of the charged lipid. Biphasic kinetics were also found
      for cholesteryl diazoacetate, indicating that this photoaffinity probe and
      cholesterol have different mechanisms of transfer. Sterols that are more
      hydrophilic than cholesterol as estimated by reversed-phase high-performance
      chromatography (elution with acetonitrile-2-propanol, 4:1 v/v, with varying
      proportions of water) gave faster exchange rates than cholesterol, whereas
      sterols that are more hydrophobic gave slower exchange rates. However, the rates
      of [14C]sterol desorption from the lipid-water interface are not correlated with
      the relative sterol hydrophobicity as estimated by the logarithm of the capacity
      factors using acetonitrile-2-propanol-water as the mobile phase. These studies
      suggest that the interaction of sterols with phospholipids provides the principal
      physical-chemical basis for determining the rates of spontaneous exchange of
      sterols between bilayers.

PMID- 1737040
TI  - Raman spectroscopic study of semisynthetic species of cerebroside sulfate: two
      types of hydrocarbon chain interdigitation.
AB  - Raman spectroscopy was used to study the phase behavior of several semisynthetic
      species of the acidic glycosphingolipid cerebroside sulfate (CBS) which occur in
      myelin. The C-H stretching mode region at 2800-3100 cm-1 of C18:0-CBS, C24:0-CBS,
      and C26:0-CBS, and the alpha-hydroxy fatty acid species C18:0h-CBS, was studied
      in the presence of 2 M Li+ and 2 M K+. Earlier studies have shown that K+ shields
      the negative charge on the sulfate more effectively than Li+, thus promoting
      intermolecular hydrogen-bonding interactions between the lipid molecules. Indeed,
      a novel broad background feature was present in the Raman spectra from 2900 to
      3200 cm-1, which was attributed to O-H stretch associated with intermolecular
      hydrogen bonding between lipid hydroxyl groups. After subtraction of this broad
      feature, the intensities of the lipid C-H stretching vibrational transitions
      could be determined. These indicated that in K+, the degree of order (intrachain
      conformation and lateral chain-chain interactions) of C18:0-CBS, whose
      hydrocarbon region is fairly symmetrical in chain length, is similar to that of
      the symmetric chain length glycerolipid dipalmitoylphosphatidylcholine, while the
      degree of order is lower in Li+, as a result of the increased lateral charge
      repulsion of the head groups in Li+. Two phase transitions were observed for the
      highly asymmetric species C24:0-CBS and C26:0-CBS in K+ but only one transition
      in Li+.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737041
TI  - Role of carbohydrate modification in the production and secretion of human
      granulocyte macrophage colony-stimulating factor in genetically engineered and
      normal mesenchymal cells.
AB  - Colony-stimulating factors (CSFs) are a group of acidic glycoproteins which
      stimulate the proliferation and differentiation of hematopoietic progenitor cells
      in vitro and stimulate hemopoiesis in vivo. Human GM-CSF contains two N-linked
      carbohydrate side chains of the complex acidic type and several sites of O-linked
      carbohydrate clustered on serine and threonine residues near the N-terminus of
      the molecule. Previous studies have failed to detect a significant functional
      role for the carbohydrate modification characteristic of human GM-CSF. Using
      permanent cell lines and transient expression systems which produce moderate to
      high levels of native or carbohydrate-deficient forms of the growth factor, the
      role of carbohydrate modification in the biosynthesis and secretion of GM-CSF was
      studied. Unlike a number of other secreted glycoproteins, the transient time and
      secretory efficiency of several carbohydrate-deficient mutants of GM-CSF are
      indistinguishable from those of the native growth factor in BHK, 293, COS, and
      ldlD cells. Furthermore, normal human endothelial cells and fibroblasts, which
      normally produce the growth factor, can synthesize and secrete GM-CSF that lacks
      all forms of carbohydrate modification. These studies help to point out the range
      of roles played by carbohydrate modification in the biosynthesis, assembly, and
      secretion of glycoprotein hormones.

PMID- 1737042
TI  - DNA sequence of the yeast transketolase gene.
AB  - Transketolase (EC 2.2.1.1) is the enzyme that, together with aldolase, forms a
      reversible link between the glycolytic and pentose phosphate pathways. We have
      cloned and sequenced the transketolase gene from yeast (Saccharomyces
      cerevisiae). This is the first transketolase gene of the pentose phosphate shunt
      to be sequenced from any source. The molecular mass of the proposed translated
      protein is 73,976 daltons, in good agreement with the observed molecular mass of
      about 75,000 daltons. The 5'-nontranslated region of the gene is similar to other
      yeast genes. There is no evidence of 5'-splice junctions or branch points in the
      sequence. The 3'-nontranslated region contains the polyadenylation signal
      (AATAAA), 80 base pairs downstream from the termination codon. A high degree of
      homology is found between yeast transketolase and dihydroxyacetone synthase
      (formaldehyde transketolase) from the yeast Hansenula polymorpha. The overall
      sequence identity between these two proteins is 37%, with four regions of much
      greater similarity. The regions from amino acid residues 98-131, 157-182, 410
      433, and 474-489 have sequence identities of 74%, 66%, 83%, and 82%,
      respectively. One of these regions (157-182) includes a possible thiamin
      pyrophosphate (TPP) binding domain, and another (410-433) may contain the
      catalytic domain.

PMID- 1737043
TI  - Inhibition of the cation-induced reversible changes in excitation energy
      distribution in thylakoids of BASF 13.338-grown plants.
AB  - Measurements of relative quantum yields of Photosystem II and Photosystem I
      partial reactions and room-temperature chlorophyll a fluorescence of thylakoids
      in high- and low-salt media showed that the cation-induced changes in the
      excitation energy distribution were inhibited in the thylakoids isolated from pea
      plants grown in the presence of sublethal concentration of the pyridazinone
      herbicide BASF 13.338. Simultaneous measurement of Photosystem II and Photosystem
      I fluorescence emission kinetics at 77 K showed that the ability of cations to
      regulate excitation energy spillover from Photosystem II to Photosystem I was
      inhibited in thylakoids of the BASF-grown plants. Cation regulation of the
      absorption cross-section of the photosystems was not affected. Electron
      microscope data revealed that the proportion of stroma membranes relative to
      grana membranes was markedly less in the thylakoids of the BASF-grown plants.
      Furthermore, when the thylakoids were resuspended in low-salt medium, no
      unstacking of the grana was detected. The observed inhibition of cation-induced
      spillover change was presumably due to loss of ability of these photosynthetic
      membranes to undergo unstacking in low-salt medium.

PMID- 1737044
TI  - Effect of thermoinduced changes in T4 bacteriophage structure on the process of
      molecular recognition of 'host' cells.
AB  - By means of high-precision acoustic measurements and by methods of fluorescent
      and electron microscopy, investigations have been performed of thermoinduced
      conformational changes in T4 bacteriophage and its thermolabile mutants altered
      in baseplate proteins (gene products 7, 8, 10). A relationship was found between
      the conformational changes in T4 bacteriophage structure in the temperature range
      of 33-45 degrees C and the efficiency of bacteriophage adsorption and the changes
      in the orientation of long tail fibers. The possibility of heat regulation of
      'recognition' of 'host' cells by bacterial viruses is suggested.

PMID- 1737045
TI  - Reaction rate with suspended lipase catalyst shows similar dependence on water
      activity in different organic solvents.
AB  - We have studied the effect of thermodynamic water activity (a W) on the initial
      rate of esterification catalysed by an immobilised lipase (Lipozyme) suspended in
      an organic reaction mixture. The catalyst and the organic phase were separately
      pre-equilibrated to the same aw value. The rate shows similar dependence on aw in
      reaction mixtures based on five different organic solvents ranging in polarity
      from pentan-3-one to hexane, and in a liquid reactant mixture. There is a maximum
      at aw about 0.5, with a decline to 30-70% at aw of either 0.9 or less than 0.01.
      When the rates are presented in terms of water concentration in the organic phase
      (or total water content of the system), the maxima for the various solvents come
      at very different positions, reflecting the widely varying solubilities of water
      in the organic phase.

PMID- 1737046
TI  - Proteinase-catalyzed activation of porcine heart muscle pyruvate dehydrogenase
      and identification of its cleavage site.
AB  - Porcine heart muscle pyruvate dehydrogenase (PDH, EC 1.2.4.1) with subunit
      composition alpha 2 beta 2 catalyzes the initial decarboxylation step of an
      oxidative decarboxylation sequence of pyruvate. Highly purified PDH, was further
      activated several-fold by limited digestion with trypsin, Staphylococcus aureus
      V8 proteinase (V8) or papain. The activation with these proteinases required
      about 10 min to attain a maximal level, lasted 1/2-2 h and thereafter decreased
      gradually. Addition of an inhibitor of each proteinase resulted in an immediate
      cessation of any further changes in the enzymatic activity. The optimal pH of the
      proteinase-activated PDH was not affected. Proteinases increased the maximum
      velocity and the apparent Km values for pyruvate, but the Hill coefficients for
      pyruvate were unchanged. Proteinase-activated PDH was capable of associating two
      other component enzymes to produce large unit resembling the native complex. The
      Coomassie brilliant blue stained gels after SDS-PAGE showed that the PDH alpha
      subunit (41 kDa) was cleaved by trypsin or V8 into two major fragments (31 and 10
      kDa), whereas PDH beta was unaffected. By amino-terminal sequence analyses of
      these fragments the trypsin cleavage sites were identified as Arg-273 and Arg-282
      and the V8 cleavage sites were Glu-277 and Glu-280.

PMID- 1737047
TI  - Isolation of a 5-hydroxybenzimidazolyl cobamide-containing enzyme involved in the
      methyltetrahydromethanopterin: coenzyme M methyltransferase reaction in
      Methanobacterium thermoautotrophicum.
AB  - Formaldehyde conversion into methyl-coenzyme M involves (a) reaction of the
      substrate with 5,6,7,8-tetrahydromethanopterin (H4MPT) giving 5,10-methylene
      H4MPT, followed by its reduction to 5-methyl-H4MPT and (b) transfer of the methyl
      group from the latter compound to coenzyme M. The reactions were studied in a
      resolved system from Methanobacterium thermoautotrophicum strain delta H. The
      first part (a) of the reactions was catalyzed by the 55% ammonium sulfate
      supernatant of cell-free extracts. The methyltransferase step (b) was dependent
      on an oxygen-sensitive enzyme, called methyltransferase a (MTa). Isolation of MTa
      was achieved by gel filtration on Sephacryl S-400. MTa was a high-molecular
      weight complex of at least 2000 kDa and between 900 to 1500 kDa when purified in
      the absence and presence of the detergent CHAPS, respectively. The enzyme
      consisted of 100 kDa units composed of three subunits in an alpha beta gamma
      configuration with apparent molecular masses of 35, 33 and 31 kDa, respectively.
      The corrinoid, 5-hydroxybenzymidazolyl cobamide (B12HBI, Factor III) copurified
      with MTa and the latter contained 2 nmol B12HBI per mg protein. B12HBI present in
      MTa could be methylated under the appropriate conditions by 5-methyl-H4MPT. These
      findings suggest that the corrinoid is a prosthetic group of MTa. MTa may be
      homologous to the corrinoid membrane protein purified before from M.
      thermoautotrophicum strain Marburg (Schulz, H., Albracht, S.P.J., Coremans,
      J.M.C.C. and Fuchs, G. (1988) Eur. J. Biochem. 171, 589-597).

PMID- 1737048
TI  - The major plasma kallikrein inhibitor of guinea pig plasma.
AB  - A plasma kallikrein inhibitor in guinea pig plasma (KIP) was purified to
      homogeneity. KIP is a single chain protein and the apparent molecular weight is
      estimated to be 59,000 by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. In amino acid composition, KIP is similar to human and mouse
      alpha 1-proteinase inhibitors and mouse contrapsin. KIP forms an equimolar
      complex with plasma kallikrein in a dose- and time-dependent fashion. The
      association rate constants for the inhibition of guinea pig plasma kallikrein by
      KIP, alpha 2-macroglobulin, C1-inactivator and antithrombin III were 2.5 +/-
      0.3.10(4), 2.4 +/- 0.4.10(4), 6.6 +/- 0.5.10(4) and 9.1 +/- 0.6.10(2),
      respectively. Comparison of the association rate constants and the normal plasma
      concentrations of the four inhibitors demonstrates that KIP is ten-times as
      effective as alpha 2-MG and other two inhibitors are marginally effective in the
      inhibition of kallikrein. KIP inhibits trypsin and elastase rapidly, and thrombin
      and plasmin slowly, but is inactive for chymotrypsin and gland kallikrein. These
      results suggest that KIP is the major kallikrein inhibitor in guinea pig plasma
      and the proteinase inhibitory spectrum is unique to KIP in spite of the molecular
      similarity to alpha 1-proteinase inhibitor.

PMID- 1737049
TI  - Subtilisin from Bacillus subtilis strain 72. The influence of substrate
      structure, temperature and pH on catalytic properties.
AB  - Kinetic constants for the hydrolysis of the series of p-nitroanilide peptide
      substrates catalyzed by subtilisin from Bacillus subtilis strain 72 have been
      determined. The series of N-protected p-nitroanilides of the Z-A2-A1-pNA, Z-A3-A2
      A1-pNA, Z-A4-A3-A2-A1-pNA types (Z-, benzyloxycarbonyl-1; -pNA, p-nitroanilide;
      A1-An, amino acid residues of the L-configuration) have been used. Subsite S1
      reveals a preference for hydrophobic amino acid residues, i.e., leucine and
      phenylalanine. A preference for Leu over Phe at this position is manifested at
      the catalytic step, but not during the binding process. The beta-branched (Val,
      Ile) and the basic (Arg) amino acid residues cannot interact with the S1 subsite
      and the hydrolysis of the corresponding peptides occurs exclusively at the A2-A1
      bond. If S1/A1 interactions are weak (Ala, Nva, Nle), the amino acid residue A1
      can interact with subsites S1 and S'1 resulting in the hydrolysis at two bonds
      (A1-pNA and A2-A1). The data obtained suggests that the S'1 subsite is of broad
      selectivity. Subsite S2 reveals a preference for small amino acid residues. At pH
      5.5-9 and below 50 degrees C, the subtilisin study does not lose its activity. At
      higher temperatures a rapid thermoinactivation occurs. Substrate binding
      stabilizes the enzyme. The temperature dependences of the kinetic and
      thermodynamic parameters suggest that the enzyme exists in two, i.e., 'cold' and
      'hot' forms. At 22 degrees C the 'cold' form turns into the 'hot' one possibly
      owing to a conformational change. The enzyme-substrate complex does not exhibit
      such behavior and exists in only one form in the whole temperature range studied.
      The activity of an uncomplexed enzyme is controlled by a group of pKa = 7.2 +/-
      0.1, which probably belongs to the histidine imidazole.

PMID- 1737050
TI  - Phosphorylation of the cardiac isoform of calsequestrin in cultured rat myotubes
      and rat skeletal muscle.
AB  - Calsequestrin is a high-capacity Ca(2+)-binding protein and a major constituent
      of the sarcoplasmic reticulum (SR) of both skeletal and cardiac muscle. Two
      isoforms of calsequestrin, cardiac and skeletal muscle forms, have been described
      which are products of separate genes. Purified forms of the two prototypical
      calsequestrin isoforms, dog cardiac and rabbit fast-twitch skeletal muscle
      calsequestrins, serve as excellent substrates for casein kinase II and are
      phosphorylated on distinct sites (Cala, S.E. and Jones, L.R. (1991) J. Biol. Chem
      266, 391-398). Dog cardiac calsequestrin is phosphorylated at a 50 to 100-fold
      greater rate than is rabbit skeletal muscle calsequestrin, and only the dog
      cardiac isoform contains endogenous Pi on casein kinase II phosphorylation sites.
      In this study, we identified and examined both calsequestrin isoforms in rat
      muscle cultures and homogenates to demonstrate that the cardiac isoform of
      calsequestrin in rat skeletal muscle was phosphorylated in vivo on sites which
      are phosphorylated by casein kinase II in vitro. Phosphorylation of rat skeletal
      muscle calsequestrin was not detected. In tissue homogenates, cardiac and
      skeletal muscle calsequestrin isoforms were both found to be prominent substrates
      for endogenous casein kinase II activity with cardiac calsequestrin the preferred
      substrate. In addition, these studies revealed that the cardiac isoform of
      calsequestrin was the predominant form expressed in skeletal muscle of fetal rats
      and cultured myotubes.

PMID- 1737051
TI  - Circular dichroism of cysteine proteinases from papaya latex. Evidence of
      differences in the folding of their polypeptide chains.
AB  - Two forms of proteinase omega were isolated from a commercial preparation of
      chymopapain (EC 3.4.22.6) by means of cation-exchange liquid chromatography.
      Their circular dichroism (CD) spectra in the 182-320 nm region indicated that the
      two forms possess closely related structures. For comparison, we also recorded
      the CD spectra of chromatographically purified samples of papain (EC 3.422.2) and
      the most abundant form of chymopapain. According to the qualitative criteria
      proposed by Manavalan and Johnson (1983) Nature 305, 831-832), the spectral
      characteristics of papain correctly indicate that this protein belongs to the
      alpha + beta class. Proteinase omega is also placed in the alpha + beta category,
      while chymopapain seems to be an alpha/beta protein. Quantitative estimation of
      secondary structures yielded contents of helices and parallel beta-sheet that
      were higher in the case of chymopapain. Thus, the results of this work suggest
      that there are some differences in the folding pattern of chymopapain with
      respect to the other two proteinases. This proposal seems unexpected when the
      high amino acid sequence identity among these enzymes is considered.

PMID- 1737052
TI  - An enzyme immunoassay and immunoblot analysis for curculin, a new type of taste
      modifying protein: cross-reactivity of curculin and miraculin to both antibodies.
AB  - We have developed an enzyme immunoassay method for curculin, a new type of taste
      modifying protein. This method can accurately quantify 0.05-20 ng of curculin, a
      sensitivity about 3000-times that of the psychometric method. The content of
      curculin in the fruit of Curculigo latifolia increased gradually until 3 weeks
      after artificial pollination and dramatically at 4 weeks, to finally reach 1.3 mg
      per fruit. Immunoblot analysis indicated that antiserum to curculin was faintly
      reactive with miraculin, but not with thaumatin or monellin.

PMID- 1737053
TI  - Inactivation of wheat-germ aspartate transcarbamoylase by the triazinyl dye,
      procion red HE3B.
AB  - Aspartate transcarbamoylase from wheat germ is irreversibly inactivated by the
      triazinyl dye Procion Red HE3B. Since triazinyl dyes may mimic nucleotides, and
      UMP is a known allosteric modifier of this enzyme, the reaction was studied to
      elucidate whether the dye is an 'affinity label' for the enzyme. The reaction is
      apparently first order in the first 5-10 min, but is more complex in the longer
      term and does not go to completion. Kinetic analysis of the initial phase
      suggests that there are two parallel reactions, one saturable (dye binds
      reversibly before reaction) and one non-saturable (biomolecular). The apparent
      rate constant kapp (i.e. the sum of the rate constants for the parallel
      reactions) varies only slightly over the pH range 7-10. In the presence of a
      number of active centre ligands, as well as the allosteric ligand UMP, there is a
      clear increase in kapp. This finding is contrary to the reduction in rate of
      inactivation (protection) normally provided by ligands against active-site
      directed reagents, suggesting that in the saturable reaction, there is a
      conformational change upon dye-binding that increases the exposure of the
      essential residue(s) with which the dye reacts. These results show that, although
      it probably inactivates by reaction with specific amino-acid residues, the dye is
      not bound at the substrate-binding or allosteric sites, i.e. it is not an
      affinity-labeling reagent in the usual sense.

PMID- 1737054
TI  - Fluorescence properties of native and photooxidised proteinase K: the X-ray model
      in the region of the two tryptophans.
AB  - The fluorescence properties of proteinase K are described and related to the X
      ray model refined at 1.48 A resolution. Upon excitation of proteinase K at 295 nm
      the fluorescence is determined by the two tryptophan residues, Trp-8 and Trp-212.
      The tryptophans are partly buried just below the surface of the molecule. Neither
      Trp is in a highly hydrophobic environment, suggesting that this cannot be the
      explanation for the fluorescence at 330 nm: formation of exiplexes with adjacent
      peptide bonds would seem to be the more likely cause. Trp-8 is located in a
      'cavity', close to an internal cluster of water molecules. The contribution of
      Trp-8 to the total indole emission is 60% and that of Trp-212 is 40%. The
      tryptophan fluorescence quantum yield is constant in the pH range 3-9. The
      fluorescence spectrum resulting from the simultaneous excitation of the tyrosyl
      and tryptophyl residues at 280 nm is dominated by the indole fluorophores: 61% of
      the light absorbed by the tyrosyl side chains is transferred to the two indole
      rings. Iodide and caesium are not efficient quenchers of the proteinase K
      tryptophan fluorescence, which is explained by restricted access of the ions to
      the somewhat buried Trp side chains and by electrostatic repulsion of caesium
      ions. Acrylamide quenching proceeds via both a dynamic and a static process and
      the data show homogeneity of the indole fluorescence arising from fluorophores in
      similar environments. The activation energy for the thermal deactivation of the
      excited tryptophans is 54 kJ mol-1. This value is substantially higher than those
      found for other proteinases from microorganisms and arises from the
      thermostability of proteinase K. Photooxidation of proteinase K in the presence
      of proflavine follows the kinetics of a first order reaction. The two tryptophans
      differ in their photoreactivity, Trp-212 being considerably more reactive.

PMID- 1737055
TI  - Comparison of characteristics of bovine aromatic L-amino acid decarboxylase with
      human enzyme.
AB  - Aromatic L-amino acid decarboxylase (AADC) was purified from bovine adrenal
      medulla and properties of this enzyme were compared with those of AADC from human
      pheochromocytoma. The molecular weights of the subunits were identical between
      human and bovine enzymes and estimated to be 50,000 by SDS-polyacrylamide gel
      electrophoresis. An isoelectric point of the human enzyme was 5.7, while the
      bovine enzyme showed several distinct bands at the region of pH 4.9-5.3 in the
      absence of urea. Multiplicity of the isoelectric point of bovine AADC disappeared
      in the presence of urea. These results showed that there were some differences
      between the properties of human and bovine AADC in spite of the high homology
      (88%) in their primary structures.

PMID- 1737056
TI  - Effect of iron and retinoic acid on the control of transferrin receptor and
      ferritin in the human promonocytic cell line U937.
AB  - The effect of changes in iron availability and induction of differentiation on
      transferrin receptor expression and ferritin levels has been examined in the
      promonocytic cell line U937. Addition of iron (as 200 micrograms/ml saturated
      transferrin) or retinoic acid (1 microM) both caused approx. 70% reduction in the
      average number of surface transferrin receptors, while the iron chelator
      desferrioxamine caused an 84% increase. Comparable changes also occurred in the
      levels of transferrin receptor mRNA. Neither iron nor retinoic acid significantly
      altered the half-life of transferrin receptor mRNA in the presence of actinomycin
      D (approx. 75 min) but a 10-fold increase in stability occurred in the presence
      of desferrioxamine. Iron and retinoic acid both caused an increase in
      intracellular ferritin levels (approx. 4-and 3-fold, respectively), while
      desferrioxamine reduced ferritin levels by approx. two-thirds. The effect of iron
      and retinoic acid added together did not differ greatly from that of each agent
      alone. None of the treatments greatly affected levels of L-ferritin mRNA.
      Virtually no H-ferritin mRNA was detected in U937 cells. These results show that
      changes in ferritin and transferrin receptor caused by treatment with retinoic
      acid are similar to those induced by excess iron, and suggest that changes in
      these proteins during cell differentiation are due to redistribution of
      intracellular iron into the regulatory pool(s), rather than to iron-independent
      mechanisms.

PMID- 1737057
TI  - Urinary excretion of thromboxane and prostacyclin metabolites during chronic low
      dose aspirin: evidence for an extrarenal origin of urinary thromboxane B2 and 6
      keto-prostaglandin F1 alpha in healthy subjects.
AB  - In vivo biosynthesis of thromboxane and prostacyclin is currently evaluated by
      measuring urinary excretion of selected metabolites. Urinary thromboxane B2
      (TXB2) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) (non-enzymatic
      hydrolysis products of thromboxane and prostacyclin) are thought to derive from
      renal biosynthesis of the parent compounds, while enzymatic metabolites such as
      2,3-dinor-TXB2 and 2,3-dinor-6-keto-PGF1 alpha appear to be mainly derived from
      systemic (platelet) thromboxane and (vascular) prostacyclin, respectively. Using
      immunoaffinity extraction and high-resolution gas chromatography-negative ion
      chemical ionization mass spectrometry (HRGC-NICIMS), we measured the paired
      excretion of non-enzymatic and enzymatic metabolites of thromboxane and
      prostacyclin in healthy subjects before, during and after an eight-day schedule
      of oral low-dose aspirin (30 mg/day), a treatment known to inhibit platelet and
      perhaps vascular but not renal cyclooxygenase. Low-dose aspirin cumulatively
      reduced urinary excretion of TXB2 and 2,3-dinor-TXB2 (about 80% inhibition on day
      8 of aspirin treatment, P less than 0.01), as well as 6-keto-PGF1 alpha and 2,3
      dinor-6-keto-PGF1 alpha (about 45% inhibition on day 8 of aspirin treatment, P
      less than 0.01). Excretion of all metabolites recovered slowly after aspirin
      withdrawal. Urinary PGE2, taken as an index of renal cyclooxygenase activity, was
      not inhibited by aspirin. A highly significant correlation was found between
      paired excretion values of non-enzymatic vs. enzymatic metabolites of thromboxane
      and prostacyclin in all individuals studied (TXB2 vs. 2,3-dinor-TXB2 (r = 0.91 +/
      0.03); 6-keto-PGF1 alpha vs. 2,3-dinor-6-keto-PGF1 alpha (r = 0.92 +/- 0.06],
      irrespective of aspirin treatment. TXB2/2,3-dinor-TXB2 and 6-keto-PGF1 alpha/2,3
      dinor-6-keto-PGF1 alpha mean ratios remained unchanged throughout the experiment.
      These data do not support the view that urinary TXB2 and 6-keto-PGF1 alpha derive
      mainly from renal biosynthesis in healthy subjects, but rather suggest that they
      may represent a fraction of systemic (platelet) thromboxane and (vascular)
      prostacyclin escaping metabolism. These data also suggest that chronic low-dose
      aspirin may partly inhibit vascular prostacyclin in addition to platelet
      thromboxane biosynthesis.

PMID- 1737058
TI  - Selective inhibition of the synthesis of phosphoenolpyruvate carboxykinase in
      freshly isolated proximal tubule cells.
AB  - The behaviour of renal phosphoenolpyruvate carboxykinase (PEPCK) in non-growing
      kidney cell suspension culture was investigated. In heterogeneous kidney cells,
      glomeruli-proximal tubule mixtures and purified proximal tubule fragments, the
      enzyme activity fell with a t1/2 of 3.3 h. Hormonal additions did not modify the
      process. The fall was also observed in cells prepared from animals preinduced
      with dexamethasone. The in vitro response of PEPCK is tissue specific. The
      decline was not the result of a decrease in cell viability, enzyme leakage nor
      due to the mitochondrial translocation of cytosolic PEPCK. The response observed
      is due to the selective inhibition of the synthesis of the enzyme and its
      destruction by non-lysosomal mechanisms. Acute and chronic acidification do not
      affect PEPCK activity. However, the degradation of PEPCK is temperature dependent
      and is greatly accelerated by glutathione.

PMID- 1737059
TI  - Effects of anti-oxidants on ornithine decarboxylase in mitogenically-activated T
      lymphocytes.
AB  - Reactive oxygen species formation is an early event following lymphocyte
      activation and may trigger other biochemical processes. Anti-oxidants
      (desferrioxamine (DES), nordihydroguaiaretic acid (NDGA) and potassium
      ferricyanide) inhibit human and murine T cell proliferation in vitro. Since an
      increase in ornithine decarboxylase (ODC) activity is an essential concomitant of
      T lymphocyte proliferation, we have examined in vitro the effects of anti
      oxidants on this activity increase. ODC activity in mouse lymph node T cells
      increased steadily from 6-24 h after addition of concanavalin A. The combination
      of phorbol myristate acetate (PMA) and ionomycin also stimulated ODC activity in
      these cells. The anti-oxidants DES, NDGA and ferricyanide strongly inhibited the
      increase in ODC activity seen in response to either concanavalin A or
      PMA/ionomycin. Dose-response curves for the inhibitory effects of the anti
      oxidants on DNA synthesis and ODC activity at 48 h after mitogen addition were
      very similar. Addition of putrescine or spermidine (10-100 microM) could not
      overcome the block in DNA synthesis induced by DES. Although the anti-oxidants
      inhibited the ODC activity increase in mitogen-stimulated T cells, they did not
      decrease mRNA levels for the enzyme. These results suggest that intracellular
      formation of reactive oxygen species is involved in the induction of ODC activity
      by a mechanism exerted at a posttranscriptional stage. The anti-oxidants can be
      employed as tools to elucidate contingent relationships between some
      intracellular events that follow T cell activation.

PMID- 1737060
TI  - Efflux and accumulation of amino nitrogen in relation to the volume of rat renal
      inner medullary cells exposed to media of variable osmolality.
AB  - The rate of efflux of 2-amino[14C]isobutyric acid (AIB) from pre-loaded slices of
      rat renal inner medulla has been followed during incubation in media whose
      osmolality was varied between 350 and 2500 mosmol/kg H2O by adjustment of NaCl
      and urea concentrations. Efflux was biphasic, and it was assumed that the second,
      slower phase represented mainly cellular loss of AIB. As a function of cell
      volume (water content) the mean net rate of 2nd phase efflux declined far more
      abruptly (-36%) during an increase in external osmolality from 350 to 720
      mosmol/kg than during further increase to 2500 mosmol/kg, over which range the
      rate of efflux fell by only a further 12%. Conversely, relative decrements of
      steady-state cell water contents during these two transitions were -17% and -37%,
      respectively. It is probable that in strongly hyperosmolal media (above 720
      mosmol/kg) reduction in the rate of amino acid catabolism, with resultant
      cellular accumulation, becomes more important than passive efflux as a
      determinant of cell amino nitrogen content, and that this is caused by the enzyme
      destabilizing effect of high intracellular concentrations of permeant urea. This
      interpretation is supported by the finding in the present study that
      trimethylamine N-oxide, which is known to counteract the destabilizing effect of
      urea, completely inhibited the accumulation of amino nitrogen (ninhydrin-positive
      substances) in media stronger than 720 mosmol/kg, as well as leading to further
      reduction of steady-state cell water contents, but was without effect on either
      variable in more dilute media. It is proposed that, under the conditions of this
      investigation, amino acids contribute to cell volume maintenance mainly by efflux
      and by metabolic accumulation under mildly and strongly hyperosmolal conditions,
      respectively, and that this interpretation is consistent with recent findings on
      the fluctuations in medullary levels of Na+, urea and total amino nitrogen in the
      intact kidneys of rats during acute water diuresis and oliguria (Law, R.O. (1991)
      Pflugers Arch. 418, 442-446).

PMID- 1737061
TI  - Analysis and discrimination of necrosis and apoptosis (programmed cell death) by
      multiparameter flow cytometry.
AB  - Necrosis and apoptosis are two distinct modes of cell death which differ in
      morphology, mechanism and incidence. Membrane disruptants, respiratory poisons
      and hypoxia cause ATP depletion, metabolic collapse, cell swelling and rupture
      leading to inflammation. These are typical features of necrosis. Apoptosis plays
      a crucial role in embryogenesis and development and is also prevalent in tumours.
      It is characterised by cell shrinkage, chromatin condensation and systematic DNA
      cleavage. Apoptotic cells are rapidly engulfed by phagocytes, thus preventing
      inflammatory reaction to degradative cell contents. In vivo, apoptosis is almost
      impossible to quantify due to problems of heterogeneity and the short half-life
      of an apoptotic cell. In vitro, mechanistic studies are further complicated by a
      late phase of apoptosis where the cell membrane becomes permeable to vital dyes
      and which occurs in the absence of phagocytes. Here we describe a novel and rapid
      multiparameter flow cytometric assay which discriminates and quantifies viable,
      apoptotic and necrotic cells via measurement of forward and side light scatter
      (proportional to cell diameter and internal granularity, respectively) and the
      DNA-binding fluorophores Hoechst 33342 and propidium. It is anticipated that
      mechanistic studies of apoptosis in a variety of cell types will greatly benefit
      from this mode of analysis.

PMID- 1737062
TI  - Red cell filterability determined using the cell transit time analyzer (CTTA):
      effects of ATP depletion and changes in calcium concentration.
AB  - Cell transit time analysis (CTTA) is a new filtrometric technique for assessing
      red blood cell deformability by measuring the conductivity change caused by
      passage of erythrocytes through a polycarbonate filter. Most reported studies to
      date using CTTA have focused on the transit time (TT), the duration of passage of
      an individual red cell through a micropore. Bulk flow rate has not been
      previously measured via CTTA. The use of new enzyme based cleaning solutions make
      it possible to reduce clogging in micropore filters. Therefore, valid measures of
      the number of red cell transits per unit time (counts/s: C/S) can now be
      obtained. We evaluated both parameters, TT and C/S, as indicators of red cell
      filterability. Our goal was to evaluate the effect of metabolic changes shown by
      alternative techniques to affect red cell deformability. The two best established
      factors are changes in intracellular [ATP] and [Ca2+]. ATP depletion produces a
      very small increase in TT but a very marked decrease in C/S. In contrast, the
      addition of low concentrations of calcium produces an increase in TT with minimal
      decrease in C/S. The effects of calcium appear to be complex. The substantial
      changes in intracellular calcium induced by the ionophore A23187 result in a
      curvilinear pattern of increase in transit times and reduction in counts per s.
      Lanthanum, which inhibits egress of intracellular calcium, causes an increase in
      TT with a drop in C/S. We conclude that CTTA demonstrates the same changes in red
      cell deformability measurable by alternative filtrometric techniques; however,
      CTTA furnishes two separate and independent parameters which may be used to
      evaluate red cell deformability.

PMID- 1737063
TI  - Potentiation of epidermal growth factor receptor protein-tyrosine kinase activity
      by sulfate.
AB  - The protein-tyrosine kinase activity of the epidermal growth factor (EGF)
      receptor is critical for EGF-stimulated cell growth, although little is known
      about the molecular details of its enzymatic activity. Previous studies have
      found that EGF receptor kinase activity can be stimulated by factors such as
      ammonium sulfate ((NH4)2SO4), but the manner in which (NH4)2SO4 induces this
      effect is unclear. Therefore, we have explored the processes by which (NH4)2SO4
      potentiated tyrosine kinase activity to better understand not only the molecular
      events involved in (NH4)2SO4 activation, but also the kinetic properties and
      mechanism of the EGF receptor. In this study, the addition of an optimum
      concentration of (NH4)2SO4 (250 mM) resulted in a 5-fold stimulation of kinase
      activity toward the peptide substrate, angiotensin II. The sulfate group is
      primarily involved in this action, since other salts containing SO4(2-) increased
      kinase activity similarly, whereas salts containing Cl- and F- had less of an
      effect, and divalent salts such as HPO4(2-) and NaVO4(2-) were inhibitory at
      doses of 1 mM or more. In addition, EGF receptor kinase activation by (NH4)2SO4
      did not strictly correlate with changes in the ionic strength or conductivity of
      the solution. However, several lines of evidence suggest that SO4(2-) directly
      alters the kinetic properties of the EGF receptor kinase: (1) the maximum
      velocity (Vmax) and Km (ATP) for EGF receptor phosphorylation of angiotensin II
      were substantially higher in the presence of (NH4)2SO4. (2) EGF receptor kinase
      activity in the absence of (NH4)2SO4 required either Mn2+ or Mg2+, yet in the
      presence of (NH4)2SO4, only Mn2+ supported the increase in kinase activity. (3)
      Ammonium sulfate addition altered the product inhibition pattern of ADP versus
      angiotensin II, suggesting that an enzyme-angiotensin II-ADP complex can form in
      the presence of (NH4)2SO4 but not in its absence. (4) The near-maximal rate of
      self-phosphorylation was not affected by (NH4)2SO4 but the apparent Km (ATP) was
      greatly increased. From these results, we propose a model for (NH4)2SO4
      stimulation of EGF receptor kinase activity in which SO4(2-) interacts directly
      with the receptor or receptor-Mn(2+)-ATP complex and alters reactant binding and
      the catalytic efficiency of the tyrosine kinase.

PMID- 1737064
TI  - Ethanol is a potent stimulator of phosphatidylcholine breakdown in cultured rat
      hepatocytes.
AB  - Addition of ethanol (17 to 340 mM) to cultured rat hepatocytes stimulated the
      breakdown of phosphatidylcholine phospholipases D and C as measured by an
      increase in the rate of release of choline and phosphocholine into the medium.
      The effects of ethanol were mimicked by propanol, dimethylsulfoxide and to a
      lesser extent methanol. The magnitude of the stimulation seen with ethanol was
      equivalent to and additive to that produced by glucagon vasopressin,
      norepinephrine, A23187 or PMA. In contrast, ethanol (340 mM) stimulated PI
      specific phospholipase C activity by less than 20%. An equivalent stimulation of
      PC-specific phospholipase D and C was seen with as little as 20 mM ethanol and a
      100% increase was seen with 340 mM ethanol. Ethanol did not significantly affect
      the ability of vasopressin, norepinephrine, ATP or A23187 to stimulate PI
      specific phospholipase C. It is concluded that while ethanol is only a weak
      stimulator of PI-specific phospholipase C, it is a potent stimulator of
      phosphatidylcholine breakdown in rat hepatocytes.

PMID- 1737065
TI  - Peroxide-metabolizing systems of the crystalline lens.
AB  - The ability of transparent and cataractous human, rabbit and mice lenses to
      metabolize hydrogen peroxide in the surrounding medium was evaluated. Using a
      chemiluminescence method in a system of luminol-horseradish peroxidase and a
      photometric technique, the temperature-dependent kinetics of H2O2 decomposition
      by lenses were measured. The ability of opaque human lenses to catalyze the
      decomposition of 10(-4) M H2O2 was significantly decreased. However, this was
      reversed by the addition of GSH to the incubation medium. Incubation of the mice
      lenses with the initial concentration H2O2 10(-4) M led to partial depletion of
      GSH in normal and cataractous lenses. Human cataractous lenses showed decreased
      activities of glutathione reductase, glutathione peroxidase (catalyzing reduction
      of organic hydroperoxides including hydroperoxides of lipids), superoxide
      dismutase, but no signs of depletion in activities of catalase or glutathione
      peroxidase (utilizing H2O2). The findings indicated an impairment in peroxide
      metabolism of the mature cataractous lenses compared to normal lenses to be
      resulted from a deficiency of GSH. An oxidative stress induced by accumulation of
      lipid peroxidation products in the lens membranes during cataract progression
      could be considered as a primary cause of GSH deficiency and disturbance of the
      redox balance in the lens.

PMID- 1737066
TI  - Niemann-Pick type II fibroblasts exhibit impaired cholesterol esterification in
      response to sphingomyelin hydrolysis.
AB  - Fibroblasts from patients with Niemann-Pick Type II disease, including the
      panethnic type C (NPC) and Nova Scotia Acadian type D (NPD) forms, exhibit
      reduced or delayed stimulation of cholesterol esterification by low density
      lipoprotein (LDL). Based on recent evidence that cholesterol esterification can
      also be stimulated by cell surface sphingomyelin hydrolysis, we have compared the
      response of normal, NPC and NPD fibroblasts to treatment with exogenous
      sphingomyelinase (SMase). Staphylococcus aureus SMase (greater than 0.05 U/ml)
      hydrolyzed over 90% of endogenous sphingomyelin within 1 h and increased
      incorporation of [3H]oleic acid into cholesterol-[3H]oleate after an initial lag
      in all three cell types. However, normal levels of cholesterol esterification
      were not observed for NP Type II fibroblasts: four NPD cell lines exhibited an
      average of 32% of normal response while cholesterol esterification was only 20%
      in two well-characterized NPC lines. A third NPC line exhibited normal response
      to SMase despite greater than 90% impairment of LDL-stimulated cholesterol
      esterification. Incubation of fibroblasts with LDL followed by SMase produced a
      synergistic response, particularly in NPC cells where there was little response
      to either treatment alone. Chloroquine abolished LDL-stimulated cholesterol
      esterification in normal fibroblasts but had no effect on the response to SMase,
      indicating that lysosomal enzymes may not be involved in SMase-mediated
      cholesterol esterification. These results suggest that intracellular processing
      of cholesterol derived from either LDL or release from the plasma membrane (by
      sphingomyelin hydrolysis) is affected in Niemann-Pick Type II cells and that
      these pathways can complement one another in the stimulation of cholesterol
      esterification.

PMID- 1737067
TI  - A novel polymorphism of apolipoprotein A-IV is the result of an asparagine to
      serine substitution at residue 127.
AB  - We have identified a hitherto unknown genetic polymorphism of apolipoprotein A-IV
      (apoA-IV). The molecular basis for this polymorphism is an A to G substitution at
      nucleotide 1687 resulting in an Asn to Ser change of amino acid 127. The
      frequencies of the two apoA-IV alleles (designated apoA-IV127Asn and apoA
      IV127Ser), determined by Hin c II restriction analysis of PCR amplified exon
      three of the apoA-IV gene, were 0.788 and 0.212, respectively, in a Finnish
      population sample. Allele frequencies of another polymorphism due to a Thr to Ser
      substitution at amino acid 347 were determined using Hinf I restriction analysis.
      The allele frequencies were 0.823 for apoA-IV347Thr and 0.177 for apoA-IV347Ser.
      None of the apoA-IV polymorphisms (apoA-IV127:Asn----Ser, apoA-IV347:Thr----Ser
      and apoA-IV360:Gln----His) had any effect on plasma lipid and lipoprotein
      concentrations in cohorts of dyslipidemic men and in a population sample of
      normolipidemic controls. There was also no association between the history of
      previous myocardial infarction and any of the apoA-IV alleles.

PMID- 1737068
TI  - Large deletion of androsterone UDP-glucuronosyltransferase gene in the inherited
      deficient strain of Wistar rats.
AB  - LA Wistar rats have a deficiency of androsterone UDP-glucuronosyltransferase
      (UDPGT) and are present in Wistar rat colonies around the world. In order to
      clarify the molecular mechanism of the deficiency, androsterone UDPGT cDNA clone,
      pGT2 was isolated from rat liver cDNA library and was digested with restriction
      enzymes to afford three probes for Northern and Southern blot analyses in HA
      (normal), heterozygous LA and LA Wistar rats. In Northern blot analysis,
      androsterone UDPGT mRNA was totally absent in LA Wistar rat liver. Southern blot
      analysis suggested a large deletion of androsterone UDPGT gene in the rats.
      Genomic DNA amplifications with synthetic primers which have nucleotide sequences
      corresponding to the 5'-region of androsterone UDPGT cDNA, suggested that
      androsterone UDPGT gene has exon 1 with a length of some 700 bp and that this
      exon is deleted in LA Wistar rats. Based on these lines of evidence, it is
      concluded that the large portion of androsterone UDPGT gene is deleted in LA
      Wistar rats, which results in the absence of androsterone UDPGT mRNA and
      consequently the corresponding enzyme protein.

PMID- 1737069
TI  - The validity of the cholesterol nucleation assay.
AB  - The validity of the cholesterol nucleation assay rests on the assumption that all
      cholesterol crystals are removed at the start of the assay so that de novo
      formation of crystals can be studied. In this paper we have tested the validity
      of this assumption. Cholesterol crystals were added to supersaturated model bile.
      Subsequently the mixtures were either filtered over a 0.22 micron filter or
      centrifuged at 37 degrees C for 2 h at 100,000 x g. After ultracentrifugation the
      isotropic interphase was collected. Using polarized light microscopy no crystals
      could be visualized in this fraction. However, the nucleation time of the
      isotropic interphase decreased from 6.8 +/- 1.1 days to 1.8 +/- 0.2 days (mean +/
      S.E., P less than 0.01, n = 5) when 10-100 micrograms/ml crystals were added
      prior to centrifugation. Similar results were observed when instead of
      centrifugation the mixtures containing crystals were filtered. After filtration
      over a 0.22 micron filter no crystals could be detected in the filtrate. Yet the
      nucleation time of the filtrate decreased from 6.4 +/- 0.7 days to 3.1 +/- 0.5
      days (mean +/- S.E.) when 10 micrograms/ml cholesterol crystals were added before
      filtration (n = 10, P less than 0.01). Since no cholesterol crystals could be
      detected at the start of the assay the reduction in nucleation time must have
      been brought about by cholesterol microcrystals that passed through the filter.
      Supplementation of cholesterol crystals to model bile did not accelerate the
      nucleation time when the samples were passed over a 0.02 micron filter,
      indicating that the size of the microcrystals was larger than 20 nm. The effect
      of addition of cholesterol crystals prior to filtration over a 0.22 micron filter
      was also tested in the crystal growth assay recently developed by Busch et al.
      ((1990) J. Lipid Res. 31, 1903-1909). Addition of crystals had only a minor
      effect on the assay. In conclusion, the reduced nucleation time of biles from
      gallstone patients is probably not only due to the presence of promoting or the
      absence of inhibiting proteins, but can be caused by the presence of small
      cholesterol crystals in these biles.

PMID- 1737070
TI  - The chemical characterization of melanin contained in substantia nigra of human
      brain.
AB  - The pigment of substantia nigra human brain has been extracted by a mild
      procedure consisting of washes with phosphate buffer, methanol and incubation
      with SDS-proteinase. Pyrolysis gas chromatography mass spectrometry, infrared
      spectrometry, termogravimetric analysis and elemental analysis were the
      techniques used for the chemical characterization. An indole moiety bound to a
      sulfur containing amino acid and to palmitic acid were the main aspects found in
      the structure. The presence of a 7% inorganic component was observed. This
      probably contains Fe, Cu, Zn and Cr which are also relevant, for the formation
      and the role of melanin in substantia nigra neurons. The fatty acid moiety is
      chemically bound to the indole structure as it was not eliminated by repeated
      methanol washing. The same situation occurs for the sulfur containing group.
      Considering these data and the most abundant molecules present in substantia
      nigra the precursor of neuromelanin seems to be a cysteinyl-catechol, to which is
      then bound a palmityl group.

PMID- 1737071
TI  - Expression of the mouse c-abl type IV proto-oncogene product in the insect cell
      baculovirus system.
AB  - The cellular gene c-abl is the normal homologue of the transforming gene (v-abl)
      within the genome of the Abelson leukaemia virus. The cDNA sequence coding for
      the cellular form of the murine abl gene (c-abl type IV) has been inserted into
      the baculovirus transfer vector, pAc36C, so that the c-abl gene is under the
      control of the polyhedrin promoter of Autographa californica nuclear polyhedrosis
      virus (AcNPV). Spodoptera frugiperda cells infected with the recombinant transfer
      vector in the presence of wild type AcNPV DNA yielded recombinant, polyhedrin
      negative virus that expressed moderate levels of the c-Abl protein (representing
      approx. 0.5-1% of the stained cellular proteins as determined by densitometric
      scanning). The insect derived c-Abl protein was compared to the P210-BCR/ABL
      protein from K562 cells, a cell line derived from a patient with chronic
      myelogenous leukaemia. Antibodies raised against synthetic peptides based on c
      abl encoded peptides react with the insect derived c-Abl. In addition, the
      baculovirus derived c-Abl protein has a tyrosine kinase activity as demonstrated
      by phosphorylation of a synthetic polypeptide and also by autophosphorylation.
      Phosphoamino acid analysis of immunoprecipitated, autophosphorylated baculovirus
      derived c-Abl protein indicates that the majority of label incorporated is on the
      tyrosine residues. Immunofluorescence microscopy has been used to show that the
      majority of the c-Abl protein expressed in cells infected with recombinant virus
      is located in the nuclear and plasma membranes.

PMID- 1737072
TI  - Fatty acid beta-oxidation in leukocytes from control subjects and medium-chain
      acyl-CoA dehydrogenase deficient patients.
AB  - In recent years an increasing number of inherited diseases in man have been
      identified in which there is an impairment in mitochondrial fatty acid oxidation.
      Diagnosis is usually done by gas-chromatographic analysis of urine, which may
      give difficulties, since urinary abnormalities may only be present
      intermittently. We therefore studied whether leukocytes could be used to study
      mitochondrial beta-oxidation directly. The results described herein show that
      leukocytes are able to beta-oxidize octanoate and palmitate. Furthermore, clear
      abnormalities in octanoate beta-oxidation were found in leukocytes from patients
      with an established deficiency of medium-chain acyl-CoA dehydrogenase, suggesting
      that measurement of octanoate and palmitate beta-oxidation in leukocytes may
      contribute to rapid diagnosis of medium-chain acyl-CoA dehydrogenase deficiency
      and presumably other mitochondrial beta-oxidation disorders.

PMID- 1737073
TI  - The Atlantic gap: clinical trials in Europe and the United States.

PMID- 1737074
TI  - Controlled trial of bright light for nonseasonal major depressive disorders.
AB  - Psychotropic drug-free hospitalized veterans with nonseasonal major depressive
      disorders or depressed forms of bipolar disorder were treated with light for 1
      week. Twenty-five patients were randomly assigned to bright white light treatment
      (2000-3000 lux), and 26 patients were randomized to dim red light placebo control
      treatment. Unlike those treated with dim red light, those treated with bright
      white light showed declines in three measures of depression during treatment.
      Partial relapse appeared within 2 days. A global depression score showed a
      statistically significant (p = 0.02) difference favoring bright white light
      treatment. Two bright-light-treated patients became mildly hypomanic, but side
      effects were mild. Improvement was not correlated with patient expectations;
      indeed, patients expected somewhat greater benefit from the placebo. Patients
      treated in summer responded as well as those treated in winter. Baseline
      electroencephalogram (EEG) sleep stage data (e.g., rapid eye movement; REM
      latency) did not predict treatment responses. These 1-week treatment results
      suggest that bright light might produce benefits for patients with nonseasonal
      depression. Bright light should not be recommended for routine clinical
      application before additional assessments with longer treatment durations are
      done.

PMID- 1737075
TI  - Noradrenergic function in panic disorder. Effects of intravenous clonidine
      pretreatment on lactate induced panic.
AB  - To assess the role of noradrenergic stimulation during lactate-induced panic, ten
      patients with panic disorder who panicked during a standard sodium-lactate
      infusion underwent a repeat infusion following intravenous clonidine
      pretreatment. Although clonidine significantly lowered prelactate systolic blood
      pressure, the drug did not significantly lower prelactate anxiety levels, as
      reflected by the Acute Panic Inventory (API). Clonidine blocked lactate-induced
      panic in four of ten subjects, a significant effect. Clonidine treatment also
      significantly attenuated lactate-panic symptoms, as reflected by time to panic
      and API comparison between trials. Nevertheless, over half the subjects still
      panicked in response to lactate despite clonidine. This preliminary study
      suggests that reduction of central noradrenergic activity by clonidine, at least
      at the dosage levels employed in the current study, only partially attenuates
      panic response to lactate. Noradrenergic theories of panic may not therefore
      fully account for lactate panicogenesis.

PMID- 1737076
TI  - Characterization of a synaptic antigen of interest in neuropsychiatric illness.
AB  - Monoclonal antibodies exhibiting relative differences in binding to brain
      homogenates from diseased versus control brains may be useful probes into the
      molecular pathology of neuropsychiatric illness. To be of value, the antibodies
      must be useful in characterization of the antigens putatively involved in the
      illness. An antibody called EP10 showed some differences in binding to
      homogenates from a small sample of schizophrenia brains compared with controls.
      In the present study, the antigen for this antibody was characterized in control
      brains using quantitative, immunocytochemical, and biochemical techniques. The
      antigen is a 38,000 dalton synaptic vesicle protein, which is identical to
      synaptophysin by immunological criteria. However, the EP10 epitope is of
      interest, as this binding site does not appear to be present in rat or bovine
      synaptophysin. Brain regional studies using EP10 indicate that the antigen may be
      present in only a subset of synaptic terminals. Further studies are required to
      fully characterize the epitope, and to determine the significance of the earlier
      findings related to schizophrenia.

PMID- 1737077
TI  - Temporal lobe dysfunction and electrodermal nonresponding in schizophrenia.
AB  - The present study examined the biological correlates of electrodermal activity in
      63 patients with DSM-III diagnosed chronic schizophrenia. Subjects were
      administered a battery of neuropsychological tests sensitive to temporal lobe,
      frontal lobe, and overall brain functioning. Brain morphology was evaluated by
      calculating the size of the lateral ventricles, measuring the width of the third
      ventricle, and rating the extent to which cortical sulci were visible.
      Electrodermal hyporesponsiveness was associated with impaired performance on
      tests that assessed temporal lobe functioning. No association was found between
      the brain morphology indices and electrodermal activity.

PMID- 1737078
TI  - Early return to REM sleep after nocturnal awakening in depression.
AB  - Sixteen male outpatients with major depression and 20 age-equated healthy
      controls were awakened from rapid eye movement (REM) sleep between 1:30 and 3:30
      AM, and the rapidity of return to REM sleep was determined. The time it took to
      return to REM sleep was reduced in depressives compared with controls: 61.6 (17.9
      SD) min versus 80.6 (24.9 SD) min, respectively (p = 0.01). The time elapsed
      until the return to REM sleep was significantly correlated with baseline REM
      latency in controls (but not depressives). In contrast, return to REM time was
      significantly correlated with depression severity scores in depressives (but not
      controls). There was no evidence to support the hypothesis that the more rapid
      return to REM sleep in depression was caused by a slow wave sleep deficit. The
      mechanism underlying the rapid return of REM sleep in depression thus may be
      related to a severity-linked disturbance, such as a proposed increase in REM
      "pressure."

PMID- 1737079
TI  - Paradoxical effects of adrenal steroids on the brain: protection versus
      degeneration.

PMID- 1737080
TI  - Effect of fluoxetine on plasma desipramine and 2-hydroxydesipramine.

PMID- 1737081
TI  - MRI, cerebral pathology, and schizophrenia.

PMID- 1737082
TI  - An IgE mechanism in autistic hypersensitivity?

PMID- 1737083
TI  - Depersonalization following nitrazepam withdrawal.

PMID- 1737084
TI  - The age of Karl Ludwig Kahlbaum.

PMID- 1737085
TI  - Phospholipase A2 in schizophrenia.

PMID- 1737086
TI  - Clinical, biologic, and histologic features of late relapses in diffuse large
      cell lymphoma.
AB  - After completing chemotherapy and achieving a complete remission (CR), patients
      with diffuse intermediate-grade lymphoma and immunoblastic lymphoma are usually
      considered cured if they are able to maintain that remission continuously for 24
      months. Recently, we observed a number of patients with these disorders who
      relapsed after a continuous CR of greater than or equal to 30 months from the
      beginning of therapy or 24 months from completing chemotherapy. This finding led
      us to examine 503 consecutive cases to determine the risk of late relapse and
      their clinical and biologic features. We found that the overall risk of late
      relapse of those who attained CR was 6.8%, but several features at presentation
      were associated with a high risk: (1) the presence of a divergent histology; (2)
      a sclerosing large cell lymphoma; (3) a diagnosis based on an extranodal site
      with no nodal tissue available for examination. When none of these features were
      present, the risk of late relapse was minimal (only 3%). When any of these
      features was present, the risk was 14%. Most striking was the 43% late relapse
      rate of patients with divergent histology. All but one of the eight B-cell tumors
      studied at relapse showed kappa light chain restriction. Five of these eight has
      a low S phase at the time of relapse, suggesting chemotherapeutic selection of a
      clone of cells with a low proliferative potential that could have given rise to
      the late relapse. Nucleic acid flow cytometry and immunophenotypic studies on
      three tumors at initial diagnosis and after relapse failed to support the
      hypothesis of a second de novo lymphoma and were consistent with a true
      recurrence of the original tumor. The results of salvage chemotherapy in this
      group of late relapses showed a high CR rate (57%) but no evidence of a trend for
      cure in the time to treatment failure curve. In contrast to the experience with
      Hodgkin's disease, retreatment with the same or a similar regimen used for the
      original induction was not associated with durable response. Clinicians should be
      aware of the potential for a late relapse in cases with divergent histology and
      the need for new treatment strategies for such cases.

PMID- 1737087
TI  - Clonal development and karyotype evolution during leukemogenesis of BCR/ABL
      transgenic mice.
AB  - The Philadelphia (Ph) translocation is responsible for the generation of the
      chimeric BCR/ABL oncogene. The Ph chromosome constitutes the earliest detectable
      chromosome abnormality in chronic myelogenous leukemia and is also found in acute
      lymphoblastic leukemia. Mice transgenic for a P190 BCR/ABL-producing DNA
      construct develop lymphoblastic leukemia/lymphoma and provide an opportunity to
      study early stages of the disease as well as progression. In this study, we have
      karyotyped the bone marrow of 10 19-day-old BCR/ABL P190 transgenic mice from a
      line that reproducibly develops leukemia/lymphoma. Leukemic cells from 17
      terminally ill transgenic founders and progeny were also karyotyped as well as
      bone marrow transplant recipients of leukemic donor marrow. Karyotypically
      visible aberrations were absent from the early stages of BCR/ABL P190-generated
      leukemia and normal metaphases could be found even in the terminal stages of the
      disease. A high frequency of aneuploidy was found in advanced leukemia, with a
      marked preference for the gain of mouse chromosomes 12, 14, or 17. These results
      point to a primary role for BCR/ABL in leukemogenesis and suggest a destabilizing
      effect of the BCR/ABL gene on the regulation of cell division.

PMID- 1737088
TI  - High expression of transforming growth factor-beta long cell cycle times and a
      unique clustering of S-phase cells in patients with acute promyelocytic leukemia.
AB  - Expression of transforming growth factor-beta (TGF-beta), which inhibits the
      proliferation of hematopoietic progenitors, was investigated simultaneously with
      cell cycle characteristics in 63 bone marrow biopsies from 23 cases with acute
      promyelocytic leukemia (APL). Bromodeoxyuridine (BrdU) was administered to every
      patient (17 newly diagnosed) for determination of the labeling index (LI) and the
      durations of S-phase (Ts) and the cell cycle (Tc) of leukemic promyelocytes. APL
      cases had lower LI both in the bone marrow aspirate (6.1% v 11.4%, P = .008) and
      biopsy (21.1% v 28.0%, P = .001) and longer Tc (93.6 hours v 56.0 hours, P =
      .002) when compared with other French-American-British subtypes. TGF-beta
      expression (detected by a monoclonal anti-TGF-beta 2/beta 3 antibody) was
      dramatically high, especially in interstitial areas of the biopsies. S-phase
      cells were found as geographically restricted islands of proliferation (GRIPs) in
      20 of 22 cases. Weekly biopsies showed an increment in TGF-beta on day 7 of
      therapy in 13 of 17 cases, while in vivo differentiation was noted in 9 of 15. We
      conclude that the presence of high TGF-beta expression may explain the biologic
      basis for the slowly cycling nature of leukemic promyelocytes in APL as well as
      the unique clustering of S-phase cells observed in GRIPs.

PMID- 1737089
TI  - Characterization and comparison of the red blood cell membrane damage in severe
      human alpha- and beta-thalassemia.
AB  - The aim of the present work was to understand the pathophysiology of the severe
      human thalassemias as represented by beta-thalassemia intermedia and hemoglobin
      (Hb) H (alpha-thalassemia) disease. We have previously shown that the material
      properties of the red blood cell (RBC) and its membrane differ in severe alpha-
      and beta-thalassemia, and we now show that this difference is probably caused by
      accumulation of alpha-globin chains at the cytoskeleton in beta-thalassemia,
      whereas beta-globin chains are associated with the cytoskeleton in alpha
      thalassemia. In both alpha- and beta-thalassemia, some of these globin chains
      have become oxidized as evidenced by loss of the free thiols. Furthermore, there
      is similar evidence of oxidation of protein 4.1 in beta-thalassemia, whereas beta
      spectrin appears to be subject to oxidation in alpha-thalassemia. These
      observations support the idea that the association of partly oxidized globin
      chains with the cytoskeleton results in oxidation of adjacent skeletal proteins.
      The abnormality of protein 4.1 in beta-thalassemia is consistent with a prior
      observation, and is also in accord with the known importance of protein 4.1 in
      maintenance of membrane stability, a property that is abnormal in beta
      thalassemic membranes.

PMID- 1737090
TI  - Oxidative red blood cell membrane injury in the pathophysiology of severe mouse
      beta-thalassemia.
AB  - In severe human beta-thalassemia, the pathophysiology relates to accumulation of
      excess alpha-globin chains at the membrane. One hypothesis is that membrane
      associated alpha-globin by virtue of it's iron or hemichromes produces oxidation
      of adjacent membrane proteins. The availability of a mouse model of severe beta
      thalassemia, as well as a transgenic (thalassemic-sickle) mouse that expresses
      12% of human beta s-chain, has allowed us to study the effect of graded
      accumulation of alpha-chains at the red blood cell (RBC) membrane on the clinical
      status of the animal and on the material properties of its RBCs. Proteins from
      control, beta-thalassemic, and transgenic mouse RBC membranes were analyzed for
      evidence of oxidation, as measured by thiol-disulfide exchange chromatography,
      which detects intramolecular sulfhydryl oxidation. Ratios of oxidized globin to
      protein 7 were calculated and increased amounts were seen in thalassemic mice as
      compared with control mice and transgenic mice. Furthermore, there were increased
      amounts of thiol-free protein 4.1 in the thalassemic mice, compared with very
      small amounts in the control mice and intermediate amounts in the transgenic
      mice. Membrane mechanical stability as assessed by ektacytometry showed that the
      thalassemic mouse RBCs were markedly unstable. Transgenic mouse RBCs showed
      intermediate levels of membrane instability compared with the controls. We
      propose that this oxidized globin, in conjunction with oxidized protein 4.1,
      accounts (at least in part) for membrane instability. A 12% increase in beta s
      globin chain synthesis (by decreasing excess globin available) confers
      considerable protection against both oxidative damage and the consequent membrane
      instability.

PMID- 1737091
TI  - Growth in children after bone marrow transplantation: busulfan plus
      cyclophosphamide versus cyclophosphamide plus total body irradiation.
AB  - Growth was assessed during the first and second years following bone marrow
      transplantation (BMT) in 47 children treated by either busulfan plus
      cyclophosphamide (BU/CY) (n = 24) or cyclophosphamide plus fractionated total
      body irradiation (CY/TBI) (n = 23). Before transplant, the median height was only
      0.2 SD below age- and sex-adjusted means (range, -2.5 to +3.0). Height was
      greater than 2.0 SD below normal in only three patients (6%). The pretransplant
      heights were comparable in the BU/CY and CY/TBI groups (-0.1 v -0.6 SD, P = .35).
      Following transplant, median 1- and 2-year heights were 0.7 and 0.9 SD below
      normal, respectively. Growth rates were 2.2 SD and 1.4 SD below normal during the
      first and second years, respectively. Growth rates were greater than 2.0 SD below
      normal in 24 of 47 (51%) at 1 year and in 12 of 31 (39%) at 2 years after
      transplant. Growth rates in patients treated with BU/CY were comparable to those
      treated with CY/TBI during both years: -2.5 versus -1.7 SD during the first year
      (P = .19, Wilcoxon), and -1.5 versus -1.1 SD during the second year (P = .61).
      Growth rates during the second year correlated with growth rates during the first
      year (r = .36, P = .046). Growth rates during the first year were lower in
      patients who had been given prior cranial irradiation, those who were near
      pubertal age at the time of transplant, and those who were transplanted for a
      disease other than acute lymphoblastic leukemia (ALL). During the second year,
      poor rates of growth were associated only with the use of corticosteroids after
      transplant.

PMID- 1737092
TI  - Significance of detection of occult non-Hodgkin's lymphoma in histologically
      uninvolved bone marrow by a culture technique.
AB  - Prolonged disease-free survival of patients with recurrent or resistant non
      Hodgkin's lymphoma (NHL) has been achieved with high-dose therapy followed by
      autologous bone marrow transplantation (ABMT). A concern with the use of ABMT is
      that the marrow that is reinfused may contain undetected NHL cells with the
      potential to reestablish metastatic disease in the recipient. Using a culture
      technique that is sensitive for detecting occult lymphoma cells in BM, we
      analyzed histologically normal marrow harvests from 59 consecutive patients with
      intermediate- or high-grade NHL who were candidates for high-dose therapy and
      ABMT. The culture results indicated that 22 of the patients had occult lymphoma
      in their marrow. Forty-three patients underwent high-dose therapy followed by
      ABMT. Twenty-four achieved a complete clinical remission. Those with occult
      lymphoma in their harvests (11 patients) continued to relapse for up to 3 years,
      whereas no relapses were observed beyond 8 months in 13 patients receiving marrow
      that did not contain detectable lymphoma cells using the culture technique. The
      relapses in the patients who achieved a complete remission occurred at sites of
      prior bulky disease rather than at new sites, suggesting that the ability to
      detect occult lymphoma cells in marrow is a marker of biologic aggressiveness
      and/or resistance to therapy, or that the reinfused cells could only grow in
      previously involved sites. The detection of lymphoma cells in marrow used for
      ABMT is an important adverse prognostic factor, and appears to be independent of
      other clinical predictors of outcome such as sensitivity or resistance of disease
      to prior chemotherapy.

PMID- 1737093
TI  - Nucleolar proteins B23 and C23 as target antigens in chronic graft-versus-host
      disease.
AB  - Previously we observed that sera from recipients of allogeneic bone marrow
      transplants who developed extensive chronic graft-versus-host disease (GVHD)
      intensively stained the nucleolar region of target cells in indirect
      immunofluorescence microscopy. To identify the target antigens, immunoblotting
      experiments were performed using isolated nuclei, isolated nucleoli, and purified
      nuclear and nucleolar proteins as the antigen source. The nucleolar
      phosphoproteins B23 and C23 were identified as the main target antigens. Eleven
      of 19 extensive chronic GVHD sera reacted with these nucleolar phosphoproteins.
      In addition, four sera recognized histone H1, and two sera recognized the nuclear
      lamins A and C. Our patients reacting with the nucleolar proteins had symptoms
      resembling that of scleroderma or Sjogren's syndrome.

PMID- 1737094
TI  - Transplantation of bone marrow cells from transgenic mice expressing the human
      MDR1 gene results in long-term protection against the myelosuppressive effect of
      chemotherapy in mice.
AB  - Many human cancers that are initially responsive to chemotherapy eventually fail
      to respond to treatment. For some drugs, dose escalation that may be required for
      a cure cannot be achieved because sensitive tissues such as bone marrow (BM)
      limit cytotoxic therapy. Approaches to prevent or circumvent BM toxicity are
      therefore a high priority of research on dose escalation protocols. In this
      study, we have transplanted BM cells from transgenic mice that constitutively
      express physiologic amounts of a functional human multidrug resistance (MDR1)
      cDNA to lethally irradiated C57BL/6 x SJL F1 mice (n = 36). From 6 weeks to 10
      months after the transplant, all animals contained MDR1 DNA in spleen and BM
      specimens as indicated by Southern blot analysis, and expressed MDR1 messenger
      RNA in BM samples as detected by slot blot analysis. In addition, these animals
      were resistant to the myelosuppressive effect of doxorubicin, daunomycin, taxol,
      vinblastine, vincristine, etoposide, and actinomycin D, whereas control animals
      that were reconstituted with normal BM were drug sensitive. Finally, the
      chemoprotection afforded by the MDR1 gene could readily be reversed by adding
      chemosensitizers such as cyclosporin A and R-verapamil to chemotherapy. Hence, it
      appears that BM cells expressing the human MDR1 gene maintain this function after
      transplantation to host animals for a minimum of 10 months, and confer multidrug
      resistance to these BM recipients. This selective advantage conferred by
      expression of the MDR1 cDNA suggests a strategy for the use of MDR1 gene therapy
      in cancer chemotherapy and for the introduction of otherwise nonselectable genes
      into BM.

PMID- 1737095
TI  - Basophil and mast cell lineages in vitro and in vivo.

PMID- 1737096
TI  - Demonstration of a human epsilon-globin gene silencer with studies in transgenic
      mice.
AB  - The human epsilon-globin gene displays normal developmental regulation in
      transgenic mice; it is expressed only in embryonic and in definitive erythroid
      cells. We show here that deletion of a negative element located between -182 and 
      467 bp upstream of the epsilon-globin gene cap site results in continuation of
      epsilon gene expression in the definitive erythroblasts of the fetal liver and in
      the red blood cells of adult transgenic mice. These data provide direct in vivo
      evidence that cis acting silencing elements are involved in the developmental
      control of the epsilon-globin gene.

PMID- 1737097
TI  - Complications and outcome in childhood acute lymphoblastic leukemia with
      hyperleukocytosis.
AB  - Hyperleukocytosis (greater than or equal to 100 x 10(9) leukocytes/L) was
      identified at diagnosis of acute lymphoblastic leukemia in 64 of 358 patients
      enrolled on St Jude Total Therapy Study XI from February 1984 to September 1988.
      These children received a seven-drug induction regimen followed by high-dose
      methotrexate, cranial irradiation at 1 year of remission, and 120 weeks of
      continuation therapy with rotational administration of four drug pairs. The 27
      patients with leukocyte counts greater than or equal to 200 x 10(9)/L underwent
      initial cytoreduction via leukapheresis or exchange transfusions. The complete
      remission rate for patients with hyperleukocytosis (94%) was similar to that for
      the overall series (96%). Stepwise regression analysis showed that
      hyperleukocytosis was significantly associated with age less than 1 year at
      diagnosis, T-cell immunophenotype, leukemic cell ploidy less than or equal to 50
      chromosomes, organomegaly, and elevated lactic dehydrogenase. The 27 patients
      with extreme hyperleukocytosis (greater than 200 x 10(9)/L) different from the
      other 37 children only in a higher frequency of French-American-British (FAB) L2
      morphology. Estimated 4-year event-free survival (EFS) was 52% +/- 8% (SE) for
      patients with hyperleukocytosis versus 79% +/- 4% for patients with leukemic
      counts less than 100 x 10(9)/L (P less than .0001). Patients with leukocyte
      counts of 100 to 200 x 10(9)/L had a significantly better EFS than those with
      counts greater than 200 x 10(9)/L (64% +/- 10% v 34% +/- 14%; P = .04). Thus, the
      therapy in this trial proved satisfactory for children with leukocyte counts of
      100 to 200 x 10(9)/L; further study is needed to improve the outlook for children
      with counts greater than 200 x 10(9)/L.

PMID- 1737098
TI  - Intensive chemotherapy with mitoxantrone and high-dose cytosine arabinoside
      followed by granulocyte-macrophage colony-stimulating factor in the treatment of
      patients with acute lymphocytic leukemia.
AB  - Thirty-four adults with refractory acute lymphocytic leukemia received salvage
      therapy with mitoxantrone 5 mg/m2 intravenously over 1 hour daily for 5 days and
      cytosine arabinoside (ara-C) 3 g/m2 intravenously over 2 hours every 12 hours for
      six doses, followed by granulocyte-macrophage colony-stimulating factor (GM-CSF)
      125 microgram/m2 intravenously over 4 hours daily until recovery of granulocytes
      above 2.0 x 10(3)/microL. Their outcome was compared with 29 prognostically
      similar historical control patients treated with the identical chemotherapy
      without GM-CSF. Overall, the complete response rates were similar in the
      treatment and control groups (13 of 34 [38%] v 11 of 29 [38%]). There was a trend
      for less remission induction mortality in the GM-CSF-treated patients (2 of 34
      [6%] v 6 of 29 [21%]; P = .08), but, conversely, a higher rate of resistant
      disease (19 of 34 [56%] v 10 of 29 [34%]; P = .09). Recovery of granulocyte
      counts above 500/microL was significantly faster in the GM-CSF-treated group (25
      days v 33 days; P less than .01), but there was no reduction in the incidence of
      febrile episodes (91% v 93%) or of documented infections (59% v 59%). Survival
      was prolonged in the GM-CSF-treated patients but was not of clinical relevance
      (31 v 20 weeks; P = .05). In summary, the addition of GM-CSF to intensive
      chemotherapy in refractory adult ALL was associated with a reduction in the
      remission induction mortality, probably secondary to a shorter duration of
      granulocytopenia, but not with an improvement in complete response rates.

PMID- 1737099
TI  - Monoclonal antibodies specific for low-affinity interleukin-3 (IL-3) binding
      protein AIC2A: evidence that AIC2A is a component of a high-affinity IL-3
      receptor.
AB  - Mouse interleukin-3 (IL-3) binds to its receptor with high and low affinities.
      Using anti-Aic2 antibody, two distinct cDNAs (AIC2A and AIC2B) were isolated. The
      AIC2A gene encodes a protein of 120 Kd that binds IL-3 with low affinity, whereas
      the AIC2B gene encodes a protein that is 91% identical to AIC2A at the amino acid
      level, but which does not bind IL-3. To study the structure of the functional
      high-affinity IL-3 receptor (IL-3R), we generated specific monoclonal antibodies
      against the AIC2A protein. We produced a soluble AIC2A protein by inserting a
      termination codon at the beginning of the transmembrane domain of the AIC2A cDNA.
      Soluble AIC2A protein expressed in COS7 cells was purified to homogeneity and
      three anti-AIC2A monoclonal antibody-producing hybridomas (3D1, 3D4, and 9D3)
      were obtained from a rat immunized with the purified soluble AIC2A protein. The
      antibodies were specific for the AIC2A protein and did not bind to the AIC2B
      protein. Using chimeric receptors between AIC2A and AIC2B, recognition sites of
      the antibodies were mapped. The antibodies immunoprecipitated a 120-Kd protein
      from IL-3-dependent PT18 cells. The N-terminal sequence of the 120-Kd protein was
      consistent with the predicted processing site of the signal sequence of the AIC2A
      protein. Staining of IL-3-dependent and IL-3-independent cell lines with the 9D3
      antibody were consistent with the IL-3 binding. The 9D3 antibody inhibited both
      the high-affinity IL-3 binding and the low-affinity binding, as well as IL-3
      dependent proliferation. These results indicate that the AIC2A protein is a
      binding component of a high-affinity IL-3R.

PMID- 1737100
TI  - Heterogeneity in filamentous actin content among individual human blood
      platelets.
AB  - The content of filamentous actin in individual platelets was measured by flow
      cytometry, using a fluorescent probe specific for filamentous actin (F-actin), 7
      nitrobenz-2-oxa-1,3-phallacidin (NBD-phallacidin). NBD-phallacidin binding to
      fixed platelets was specific in that either pretreatment of platelets with
      unlabeled phallacidin or absorption of NBD-phallacidin by rabbit skeletal F
      actin, but not globular actin (G-actin), resulted in a significant loss in the
      bound fluorescent probe. Mean NBD-phallacidin binding to fixed platelets varied
      with the agonist and paralleled the changes in F-actin reported with the DNAse I
      inhibition assay. (1) NBD-phallacidin binding increased with stimulation by ADP,
      U46619 (a prostaglandin H2 analogue), or collagen and paralleled shape change.
      (2) Epinephrine did not increase NBD-phallacidin binding. (3) Platelets treated
      at 4 degrees C contained more F-actin than did platelets kept at 37 degrees C.
      (4) Cytochalasin D (10 mumol/L) inhibited the increase of phallacidin binding to
      individual platelets stimulated by either ADP or U46619. In measurements of
      cytosolic free calcium concentration ([Ca2+]i) by flow cytometry in Indo-1-loaded
      platelets, ADP's dose-response for actin polymerization was similar to that for
      calcium mobilization. As shown by flow cytometry, a tail population that had a
      minimal increase in F-actin upon stimulation with ADP or U46619 also contained
      the platelets with the least forward and right angle light scattering, which are
      functions of platelet size and shape. When platelets treated with NBD-phallacidin
      were incubated with S12-murine monoclonal antibody (a marker of alpha-granule
      secretion detected by phycoerythrin-conjugated antimouse IgG second antibody),
      phallacidin fluorescence paralleled S12 binding. Thus, human blood platelets are
      heterogeneous in regard to actin polymerization at rest and in association with
      platelet activation; different degrees of phallacidin binding may identify
      functionally different platelet populations.

PMID- 1737101
TI  - Platelet adhesion to laminin: role of Ca2+ and Mg2+ ions, shear rate, and
      platelet membrane glycoproteins.
AB  - The adhesion of platelets to purified laminin under flow conditions was
      investigated. Adhesion to laminin was strongly dependent on the presence of
      divalent cations. In the absence of cations platelet adhesion (8% coverage in 5
      minutes) was maximal at a shear rate of 100/s and no adhesion could be detected
      at shear rates above 800/s. In the presence of 0.8 mmol/L Mg2+ and 2 mmol/L Ca2+
      platelet adhesion reached its maximum (30% coverage) around 800/s. At 1,800/s
      platelets still adhered to purified laminin (coverage of 6%). Antibodies against
      the E8 domain of laminin and antibodies against the alpha 6 and beta 1 chains of
      platelet membrane glycoprotein very late activation antigen-6 (VLA-6), completely
      inhibited adhesion. No inhibition was found with antibodies against glycoprotein
      IIb:IIIa, against the alpha 2 chain of VLA-2, and against the alpha 5 chain of
      VLA-5. Fibronectin and von Willebrand factor were not involved in laminin
      dependent adhesion. Anti-VLA-6 partly inhibited platelet adhesion to the
      extracellular matrix of endothelial cells at shear rates below 800/s.
      Preincubation of the matrices with antilaminin E8 antibodies did not influence
      the adhesion. These results show that purified laminin supports platelet adhesion
      and that the presence of VLA-6 is important for platelet adhesion under flow
      conditions. The protein in the matrix with which VLA-6 interacts is currently
      unknown.

PMID- 1737102
TI  - Localization of platelet osteonectin at the internal face of the alpha-granule
      membranes in platelets and megakaryocytes.
AB  - Osteonectin is a 32-Kd phosphoglycoprotein originally described in bone but also
      found in platelets. Platelet and bone osteonectin are different both structurally
      and immunologically. We have previously shown that platelet osteonectin, by
      binding to thrombospondin, is involved in the secretion-dependent phase of the
      platelet aggregation process. In this study, we used antiosteonectin antibodies
      in combination with immunogold labeling to investigate by electron microscopy the
      fine localization of osteonectin within normal and gray platelets. Using both a
      polyclonal and monoclonal antibody ON3, osteonectin was specifically located at
      the internal face of alpha-granule membranes within normal platelets. Osteonectin
      was not distributed within all alpha-granules, probably because of its low
      platelet content. In addition, using immunofluorescence, osteonectin could also
      be detected in immature and mature megakaryocytes with a granular pattern of
      staining, suggesting that osteonectin is synthesized by megakaryocytes. Using
      platelets from two patients with gray platelet syndrome, osteonectin was absent
      within all abnormal small alpha-granules, but was detected in some rare normal
      sized alpha-granules. In separate double-label studies, thrombospondin and von
      Willebrand factor did not colocalize with osteonectin in resting platelets.
      However, osteonectin was located at the inner face of the alpha-granules, as it
      is for alpha-granule membrane protein GMP-140 and glycoprotein IIb-IIIa. These
      results, taken together with the fact that monoclonal antibodies to osteonectin
      bind only to the surface of activated platelets, suggest that platelet
      osteonectin is redistributed to the cell surface during fusion of alpha-granule
      membranes with the plasma membrane.

PMID- 1737103
TI  - Mechanisms of corticosteroid action in immune thrombocytopenic purpura (ITP):
      experimental studies using ITP-prone mice, (NZW x BXSB) F1.
AB  - To determine the mechanism by which platelet counts increase after corticosteroid
      therapy for human immune thrombocytopenic purpura (ITP), we studied the platelet
      kinetics using prednisolone (PDN)-treated ITP-prone mice, (NZW x BXSB) F1 (W/B
      F1). An increase in platelet counts was observed in W/B F1 mice (n = 10, mean +/-
      SD, 1,202 +/- 202 x 10(3)/microL) 4 weeks after treatment with PDN (2 mg/kg/d);
      no increase occurred in nontreated W/B F1 mice (n = 5,651 +/- 126, P less than
      .005). Prolonged platelet life-spans (PLSs) were observed in treated W/B F1 mice
      (1.29 +/- 0.40 days), but not in nontreated controls (0.60 +/- 0.24 days, P less
      than .01). No increase in platelet production (platelet turnover) was found in
      PDN-treated W/B F1 mice, but significant decreases in platelet-associated
      antibodies (PAAs) and platelet-bindable serum antibodies (PBAs) were noted.
      Studies on organ localization of radiolabeled platelets showed that hepatic
      uptake significantly decreased in the treated W/B F1 mice, but not in nontreated
      W/B F1 mice. To elucidate the effect of PDN on the reticulo-endothelial
      phagocytic activity in W/B F1 mice, we studied in vivo clearance of IgG
      sensitized, 51Cr-labeled autologous erythrocytes. W/B F1 mice treated with PDN
      showed a marked impairment of their ability to clear these cells, although PDN
      had little effect on the number of splenic or hepatic macrophage Fc gamma
      receptors. These results and our previous findings of splenectomy suggest that
      PDN improves platelet counts not only by suppressing systemic reticulo
      endothelial phagocytic function but also by reducing antibody production.

PMID- 1737104
TI  - Adhesive protein expression on thrombin-stimulated platelets: time-dependent
      modulation of anti-fibrinogen, -fibronectin, and -von Willebrand factor antibody
      binding.
AB  - Platelets contain a pool of endogenous adhesive proteins that can be released and
      may bind to surface membrane receptors under appropriate conditions. Because the
      binding of exogenous fibrinogen to platelets was shown previously to be
      accompanied by a time-dependent decrease in fibrinogen accessibility to antibody
      and enzymes, studies were performed to evaluate changes in the expression of
      endogenous fibrinogen released from thrombin-stimulated platelets using
      monospecific polyclonal and monoclonal antibody F(ab')2 fragments. Parallel
      studies were performed to compare the expression of released fibronectin and von
      Willebrand factor (vWF). Binding of polyclonal antibody F(ab')2 fragments
      directed against individual adhesive proteins was inhibited by EDTA or the 10E5
      monoclonal antibody, suggesting that fibrinogen, fibronectin, and vWF expression
      was mediated, in large part, by divalent cation-dependent interactions with the
      glycoprotein IIb-IIIa complex. Interestingly, when polyclonal antibody F(ab')2
      fragments were added to platelet suspensions at discrete times after thrombin
      stimulation, antifibrinogen F(ab')2 binding decreased by 72% +/- 15% (mean +/-
      SD, n = 22) over a 60-minute time course, whereas antifibronectin and anti-vWF
      antibody F(ab')2 fragment binding changed minimally (6% +/- 23%, n = 22 and 3% +/
      26%, n = 14, respectively). Similar observations were made with monoclonal
      antibodies. Parallel experiments using 125I-labeled fibrinogen as a marker
      indicated that the observed decrease in antifibrinogen F(ab')2 binding was not
      accompanied by fibrinogen dissociation. Moreover, antibody accessibility to
      platelet-bound fibrinogen could be restored after Triton X-100 platelet lysis.
      The data suggest that fibrinogen, fibronectin, and vWF are not coordinately
      expressed on thrombin-stimulated platelets. Rather, fibrinogen expression appears
      transient compared with the expression of fibronectin and vWF. The ability of
      platelets to secrete and organize adhesive proteins on their surface is likely to
      have important implications for hemostasis and thrombosis.

PMID- 1737105
TI  - Spectrum of toxicities of amino acid methyl esters for myeloid cells is
      determined by distinct metabolic pathways.
AB  - L-leucine methyl ester (Leu-OMe), Leu-Leu-OMe, Phe-OMe, and Glu-(OMe)2 are toxic
      to mononuclear phagocytes (M phi) and neutrophils. In the present studies, the
      mechanism of this toxicity was examined. A concentration of NH4Cl known to
      neutralize lysosomal pH and to block conversion of Leu-OMe to the dipeptide
      condensation product Leu-Leu-OMe inhibited Leu-OMe- or Glu-(OMe)2- but not Leu
      Leu-OMe-mediated M phi toxicity. Leu-OMe-, Glu-(OMe)2-, or Leu-Leu-OMe-mediated
      killing of M phi was prevented by Gly-Phe-CHN2, a specific inhibitor of the thiol
      protease, dipeptidyl peptidase I (DPPI). Neither NH4Cl nor Gly-Phe-CHN2 prevented
      Phe-OMe-mediated M phi toxicity. In contrast, inhibition of M phi serine esterase
      activity prevented Phe-OMe- but not Leu-OMe- or Glu-(OMe)2-mediated killing of M
      phi. The myeloid tumor lines U937, HL60, and THP-1 were found to be uniformly
      enriched in DPPI and susceptible to Leu-Leu-OMe but not Leu-OMe toxicity. Whereas
      HL60 were resistant to Phe-OMe, THP-1 cells were killed by this agent. Incubation
      of peripheral blood mononuclear cells with Leu-OMe resulted in loss of natural
      killer (NK) functions and cytotoxic T lymphocytes (CTL) precursors, a process
      that requires the DPPI-dependent generation of membranolytic polymerization
      products. Phe-OMe had no toxic effects on NK cells or CTL precursors. These
      results indicate that Leu-OMe and Glu-(OMe)2 toxicity for M phi is related to the
      production of higher molecular weight hydrophobic polymerization products via the
      sequential action of two nonserine esterase lysosomal enzymes. In contrast, Phe
      OMe toxicity for myeloid cells was found to correlate with serine esterase
      mediated intracellular trapping of high concentrations of the free amino acid
      Phe. These distinct enzymatic mechanisms may provide a unique means of targeting
      agents capable of selectively deleting cells of myeloid lineage.

PMID- 1737106
TI  - Mutational activation of the N-ras oncogene assessed in primary clonogenic
      culture of acute myeloid leukemia (AML): implications for the role of N-ras
      mutation in AML pathogenesis.
AB  - The number of steps involved in the pathogenesis of acute myeloid leukemia (AML)
      is unclear. The initiating event would be expected to exist in all leukemic
      cells, but subsequent events may be subclonal. If several genetic events occur,
      they may cooperate within the same cell or be alternatively acquired by different
      subclones. These possibilities cannot be adequately analyzed in DNA prepared
      directly from patient specimens. In this study, N-ras mutations demonstrable in
      DNA prepared from peripheral blood of 10 patients with AML were examined in
      primary in vitro colonies (AML-colony-forming units [CFU]) grown from these
      patients. Both colonies containing the mutant gene and colonies containing normal
      allele only were obtained from each patient. The proportion of colonies
      containing no mutant allele varied among patients (5% to 57%). A subset of
      mutation containing colonies appeared to have lost the normal allele in nine of
      10 AML cases analyzed. In the four cases with two N-ras mutations, the two
      mutations were found to exist in different subclones. In these cases, macroscopic
      colonies (AML-MCFU) were also obtained using an assay system designed to select
      for earlier clonogenic cells than in the AML-CFU assay. The N12cys mutation in
      AML10 was found in the CFU, but not in the MCFU, and the N12asp mutation in AML43
      was found in the MCFU, but not in the CFU. These results suggest that N-ras
      mutation is a postinitiation event in AML that contributes to the outgrowth of
      more malignant subclones. Where two mutations are found in a case of AML, they
      appear to have been acquired by separate subclones, which may show different
      degrees of differentiation.

PMID- 1737107
TI  - Antiproliferative effects of interleukin-4 on freshly isolated non-Hodgkin
      malignant B-lymphoma cells.
AB  - The pattern of in vitro growth response of freshly isolated non-Hodgkin malignant
      lymphoma B cells (NHML) to cytokines was investigated. Ten tumor specimens of low
      or intermediate-grade malignancy were selected for study. To assess their
      proliferative capacity in vitro, B-lymphoma cells were activated through ligation
      of their surface Ig receptor with insolubilized anti-IgM antibodies or
      Staphylococcus aureus strain Cowan I (SAC). In the great majority of cases,
      interleukin-2 (IL-2) was the sole factor that significantly and reproducibly
      stimulated DNA synthesis in NHML activated through their surface Igs. Other B
      cell tropic factors, including IL-4, IL-5, IL-6, and tumor necrosis factor-alpha
      (TNF-alpha), failed to elicit a growth response in most of the IL-2-responsive
      neoplastic samples. However, one specimen among 10 exhibited the opposite pattern
      of response and proliferated following culture with IL-4 and anti-Ig reagents,
      but not after IL-2 stimulation. Three specimens could also be induced for DNA
      synthesis on cross-linking of their surface Igs in the absence of exogenous
      growth factors. Although IL-4 could not support the in vitro growth of the
      majority of NHML cases, it strongly suppressed the proliferative signals
      delivered to these cells by anti-Ig reagents used alone or in combination with IL
      2. Our data suggest that, in most cases, IL-4 essentially provides growth
      inhibitory signals to NHML when they are activated through their surface Ig
      receptors and as such may be considered to be a valid candidate for future
      therapy of this type of mature B-cell malignancy.

PMID- 1737108
TI  - Russian report: doctors and health service reform.

PMID- 1737109
TI  - Who speaks for whom?

PMID- 1737110
TI  - ABC of vascular diseases. Deep venous insufficiency and occlusion.

PMID- 1737111
TI  - Noise: breaking the silence.

PMID- 1737112
TI  - Dogs that bite.

PMID- 1737113
TI  - Dogs that bite.

PMID- 1737114
TI  - Apnea monitors and accidental strangulation.

PMID- 1737115
TI  - Dogs that bite.

PMID- 1737116
TI  - Febrile convulsions.

PMID- 1737117
TI  - Restraint of children in cars.

PMID- 1737118
TI  - Dangers of ozone depletion.

PMID- 1737119
TI  - Heart valve records falsified.

PMID- 1737120
TI  - Infection acquired from transplant donor.

PMID- 1737121
TI  - Risk factors in Alzheimer's disease.

PMID- 1737122
TI  - Intravenous magnesium in suspected acute myocardial infarction.

PMID- 1737123
TI  - Urinary incontinence.

PMID- 1737124
TI  - The health of the nation.

PMID- 1737125
TI  - Endometrial resection or abdominal hysterectomy in menorrhagia?

PMID- 1737126
TI  - "Do not resuscitate" orders.

PMID- 1737127
TI  - "Do not resuscitate orders.

PMID- 1737128
TI  - Understanding Marfan's syndrome.

PMID- 1737129
TI  - GP trainees' views on hospital obstetric vocational training.

PMID- 1737130
TI  - Rugby injuries.

PMID- 1737131
TI  - The health strategy.

PMID- 1737132
TI  - AIDS campaigns: putting the message across.

PMID- 1737133
TI  - Doctors convicted of manslaughter.

PMID- 1737134
TI  - Wasted drugs in HIV infection and AIDS.

PMID- 1737135
TI  - Clinical trials in community pharmacies.

PMID- 1737136
TI  - Psychiatric symptoms and low blood pressure.

PMID- 1737137
TI  - Guillain-Barre syndrome revisited.

PMID- 1737138
TI  - Preventing infection in laboratories.

PMID- 1737139
TI  - Using tympanometry to detect glue ear in general practice.

PMID- 1737140
TI  - Bone banks.

PMID- 1737141
TI  - AIDS and hepatitis B in the former Soviet Union.

PMID- 1737142
TI  - Low blood pressure, low mood?
AB  - OBJECTIVE: To determine whether a set of physical symptoms is associated with low
      blood pressure and to investigate the possible role of psychological factors in
      their occurrence. DESIGN: Analysis of data collected by questionnaire and
      physical screening from the first phase of the Whitehall II study, a cohort study
      of an employed population. SETTING: 23 civil service departments in London.
      SUBJECTS: 10,314 male and female London based civil servants aged between 35 and
      55. MAIN OUTCOME MEASURES: Symptoms of dizziness-giddiness and unexplained
      tiredness; psychological functioning as measured by the 30 item general health
      questionnaire in which the response "no more than usual" to an item about disease
      was scored as indicating chronic illness. RESULTS: Dizziness-giddiness in men and
      unexplained tiredness in both men and women were significantly related to low
      systolic blood pressure. There was a highly significant inverse relation between
      general health questionnaire score and systolic blood pressure for both men and
      women, which persisted after controlling for potentially confounding variables,
      including age, body mass index, drug treatment, physical illness, and exercise.
      This association of low blood pressure with physical symptoms was no longer
      significant when general health questionnaire score was controlled for.
      CONCLUSIONS: There seems a strong relation between low systolic blood pressure
      and minor psychological dysfunction. Associated physical symptoms seem to be
      secondary to the primary disturbance in mental state.

PMID- 1737143
TI  - What happens to homeless mentally ill people? Follow up of residents of Oxford
      hostels for the homeless.
AB  - OBJECTIVES: To follow up severely mentally ill residents of hostels for the
      homeless to determine their social and psychiatric outcome. DESIGN: Follow up at
      18 months of hostel residents previously assessed with psychiatric and
      behavioural measures. SETTING: Two Oxford hostels for the homeless. SUBJECTS: 48
      hostel residents previously identified as disabled by mental illness. MAIN
      OUTCOME MEASURES: Current housing, admissions to psychiatric hospital, violent or
      antisocial behaviour, and score on standardised behavioural rating. RESULTS: 45
      of the 48 residents were traced. 27 had remained in the hostels; only 10 had been
      rehoused, mainly in bedsits or with their families. 16 had a poor outcome as
      judged by death (four subjects), lengthy hospital readmission (two), marked
      deterioration in behaviour (six), sleeping rough (one), or disappearance (three).
      CONCLUSION: More effort is needed to provide suitable housing for homeless
      mentally ill people.

PMID- 1737144
TI  - Alcohol consumption and its relation to cardiovascular risk factors in British
      women.
AB  - OBJECTIVE: To examine the relation between alcohol consumption and risk factors
      for coronary heart disease in women. DESIGN: Cross sectional study of a
      stratified random sample of the population grouped into five categories of
      habitual alcohol consumption. SETTING: People registered with general
      practitioners at two large health centres in east Bristol, England. SUBJECTS:
      1048 women aged 25-69 years. MAIN OUTCOME MEASURES: Fasting plasma concentrations
      of insulin, total cholesterol, total triglycerides, and high density lipoprotein
      cholesterol, including its subfractions HDL2 and HDL3, and body mass index.
      RESULTS: Compared with non-drinkers women consuming a moderate amount of alcohol
      (1-20 g/day) had lower plasma concentrations of triglycerides, by 0.19 mmol/l
      (95% confidence interval 0.07 to 0.35); cholesterol, by 0.4 mmol/l (0.19 to
      0.61); and insulin, by 1.4 mU/l (0.43 to 1.97) and a lower body mass index, by
      1.2 kg/m2 (0.43 to 1.97). They also had higher concentrations of high density
      lipoprotein cholesterol, by 0.09 mmol/l (0.03 to 0.15); HDL2 cholesterol by 0.05
      mmol/l (-0.02 to 0.10) and HDL3 cholesterol, by 0.06 mmol/l (0.06 to 0.11). All
      these were independent of body mass index, smoking habits, and taking oral
      contraceptives. CONCLUSIONS: Moderate alcohol consumption is associated with
      lower levels of cardiovascular risk factors in women. Insulin may have a central
      role.

PMID- 1737145
TI  - Effect of "fast track" admission for acute myocardial infarction on delay to
      thrombolysis.
AB  - OBJECTIVE: To evaluate the impact of a fast track triage system for patients with
      acute myocardial infarction. DESIGN: Comparison of delays in admission to
      hospital and in receiving thrombolytic treatment before and after introducing
      fast track system with delays recorded in 1987-8. Patients fulfilling clinical
      and electrocardiographic criteria for myocardial infarction were selected for
      rapid access to the cardiac care team, bypassing evaluation by the medical
      registrar. SETTING: Major accident and emergency, cardiac and trauma centre.
      SUBJECTS: 359 patients admitted to the cardiac care unit during 1 February to 31
      July 1990 with suspected acute infarction. MAIN OUTCOME MEASURES: Accuracy of
      diagnosis and delay from arrival at hospital to thrombolytic treatment. RESULTS:
      248 of the 359 patients had myocardial infarction confirmed, of whom 127 received
      thrombolytic treatment. The fast track system correctly identified 79 out of 127
      (62%) patients who subsequently required thrombolytic treatment. 95% (79/83) of
      patients treated with thrombolysis after fast track admission had the diagnosis
      confirmed by electrocardiography and enzyme analysis. The median delay from
      hospital admission to thrombolytic treatment fell from 93 minutes in 1987-8 to 49
      minutes in fast track patients (p less than 0.001). Delay in admission to the
      cardiac care unit was reduced by 47% for fast tract patients (median 60 minutes
      in 1987-8 v 32 minutes in 1990, p less than 0.001) and by 25% for all patients
      (60 minutes v 45 minutes, p less than 0.001). CONCLUSION: This fast track system
      requires no additional staff or equipment, and it halves inhospital delay to
      thrombolytic treatment without affecting the accuracy of diagnosis among patients
      requiring thrombolysis.

PMID- 1737146
TI  - Irritable bowel syndrome in the general population.
AB  - OBJECTIVE: To determine the prevalence of symptoms compatible with a clinical
      diagnosis of irritable bowel syndrome in the general population. DESIGN:
      Validated postal questionnaire sent to 2280 subjects randomly selected in 10 year
      age bands from the lists of eight general practitioners. The Manning criteria
      were used to define irritable bowel syndrome. SETTING: Urban population in
      Southampton and mixed urban-rural population in Andover, Hampshire. RESULTS: A
      response of 71% yielded 1620 questionnaires for analysis, of which 412 (25%)
      reported more than six episodes of abdominal pain in the preceding year, with 350
      (22%) reporting symptoms consistent with the diagnosis of irritable bowel
      syndrome. The male: female ratio was 1:1.38. More subjects with irritable bowel
      syndrome had constipation and diarrhoea and 35% with the syndrome reported rectal
      bleeding compared with an overall prevalence of 20%. Other symptoms and
      conditions including heartburn, dyspepsia, flushing, palpitations, migraine, and
      urinary symptoms were significantly more common in the group with irritable bowel
      syndrome. Abdominal pain in childhood was more common in the subjects with
      irritable bowel syndrome (12%) than without (3%). One third of the group with
      irritable bowel syndrome had sought medical advice during the study period
      (male:female ratio 1:1.21); consultation behaviour was influenced by age and the
      presence of associated symptoms, varied considerably among patients registered
      with different general practitioners, and was poorly correlated with symptom
      severity. CONCLUSION: Symptoms consistent with a diagnosis of irritable bowel
      syndrome are present in almost one quarter of the general population and tend to
      be associated with a number of other complaints and conditions, some of which may
      reflect smooth muscle dysfunction.

PMID- 1737147
TI  - Prevalence of HIV infection among ex-prisoners in England.

PMID- 1737148
TI  - A clinical trial of minocycline in lepromatous leprosy.

PMID- 1737149
TI  - Suffocation from misuse of gas masks during the Gulf war.

PMID- 1737150
TI  - Using clinicopathological analysis of general practitioner skin surgery to
      determine educational requirements and guidelines.
AB  - OBJECTIVE: To study the impact of skin surgery in general practice on the
      workload of a pathology laboratory and to identify what further training might be
      helpful. DESIGN: Analysis of skin biopsy specimens from general practitioners
      before and after their new contract to determine numbers of specimens, changes in
      diagnoses, adequacy of treatment of malignant tumours, and areas of low
      diagnostic accuracy. SETTING: District general hospital. SUBJECTS: All 1017 skin
      biopsy specimens from general practice for 15 months before and 12 months after
      the new general practitioner contract. RESULTS: The number of pathology specimens
      received increased from 16 to 65 per month (median = 6 submitted by each general
      practitioner in the post-contract year). The proportion of the more common
      pathological diagnoses was unchanged between the two periods, but the proportion
      of correctly diagnosed naevi, cysts, and seborrhoeic keratoses increased in the
      second. Although few diagnoses were overtly incorrect, accurate diagnosis of
      dermatofibromas and malignancies decreased after the contract, and the overall
      correct diagnosis rate for seborrhoeic keratoses, dermatofibromas, rashes, and
      malignancies was below 30%. Only nine out of 21 squamous cell carcinomas were
      adequately excised with tumour free margins, and follow up of malignant tumours
      may have been inadequate. CONCLUSIONS: Skin surgery in general practice has
      advantages but matters of concern are the increase in laboratory workload, the
      excision of some benign lesions, and the inappropriateness of biopsy of rashes.
      Squamous cell carcinoma and other malignant tumours submitted for pathological
      examination were often unsuspected and inadequately excised, and heightened
      suspicion is recommended. Pathology request forms may need redesigning to
      encourage provision of clinical details.

PMID- 1737151
TI  - Diagnostic value of microtympanometry in primary care.
AB  - OBJECTIVE: To determine the reliability, validity, and feasibility of a new hand
      held microtympanometer. DESIGN: Comparison of microtympanometry by two
      independent observations of a general practitioner and a nurse, and against a
      validated reference instrument. SETTING: Primary care health centre of a school
      for the deaf in the United States. SUBJECTS: 111 schoolchildren receiving a
      regular check up. MAIN OUTCOME MEASURES: Tympanometry with the Grason Stadler 28,
      classified with a slightly modified Jerger's classification. RESULTS:
      Interobserver reliability was 0.95 (Cohen's kappa). Results of microtympanometry
      were highly comparable with results of the reference instrument (likelihood ratio
      of positive results, 161.2). CONCLUSIONS: The microtympanometer could be used in
      general practice: it is hand held, child friendly, easy to handle, and accurate.

PMID- 1737152
TI  - Policy on cigarette advertising and coverage of smoking and health in European
      women's magazines.

PMID- 1737153
TI  - Who's for growth hormone?

PMID- 1737154
TI  - FHSA medical advisers: friends or foes?

PMID- 1737155
TI  - Prison medicine: beginning again.

PMID- 1737156
TI  - Drug treatment for acute upper gastrointestinal bleeding.

PMID- 1737157
TI  - Omeprazole versus placebo for acute upper gastrointestinal bleeding: randomised
      double blind controlled trial.
AB  - OBJECTIVE: To investigate the possible therapeutic role of omeprazole, a powerful
      proton pump inhibitor, in unselected patients presenting with upper
      gastrointestinal bleeding. DESIGN: Double blind placebo controlled parallel group
      study. Active treatment was omeprazole 80 mg intravenously immediately, then
      three doses of 40 mg intravenously at eight hourly intervals, then 40 mg orally
      at 12 hourly intervals. Treatment was started within 12 hours of admission and
      given for four days or until surgery, discharge, or death. SETTING: The medical
      wards of University and City Hospitals, Nottingham. SUBJECTS: 1147 consecutive
      patients aged 18 years or more admitted over 40 months with acute upper
      gastrointestinal bleeding. MAIN OUTCOME MEASURES: Mortality from all causes; rate
      of rebleeding, transfusion requirements, and operation rate; effect of treatment
      on endoscopic appearances at initial endoscopy. RESULTS: Of 1147 patients
      included in the intention to treat analysis, 569 received placebo and 578
      omeprazole. No significant differences were found between the placebo and
      omeprazole groups for rates of transfusion (302 (53%) placebo v 298 (52%)
      omeprazole), rebleeding (100 (18%) v 85 (15%)), operation (63 (11%) v 62 (11%)),
      and death (30 (5.3%) v 40 (6.9%)). However, there was an unexpected but
      significant reduction in endoscopic signs of upper gastrointestinal bleeding in
      patients treated with omeprazole compared with those treated with placebo (236
      (45%) placebo v 176 (33%) omeprazole; p less than 0.0001). CONCLUSIONS:
      Omeprazole failed to reduce mortality, rebleeding, or transfusion requirements,
      although the reduction in endoscopic signs of bleeding suggests that inhibition
      of acid may be capable of influencing intragastric bleeding. Our data do not
      justify the routine use of acid inhibiting drugs in the management of
      haematemesis and melaena.

PMID- 1737158
TI  - Relation of fetal and infant growth to plasma fibrinogen and factor VII
      concentrations in adult life.
AB  - OBJECTIVE: To determine whether reduced fetal and infant growth are associated
      with higher plasma fibrinogen and factor VII concentrations in adult life.
      DESIGN: Follow up study of men born during 1920-30 whose weights at birth and at
      1 year had been recorded by health visitors, and men born during 1935-43 whose
      size at birth had been measured in detail. SETTING: Hertfordshire and Preston,
      England. SUBJECTS: 591 men born in east Hertfordshire who still lived there and
      148 men born in Preston who still lived in or close to the city. MAIN OUTCOME
      MEASURES: Plasma fibrinogen and factor VII concentrations. RESULTS: Among men in
      Hertfordshire mean plasma fibrinogen and factor VII concentrations fell with
      increasing weight at 1 year (from 3.21 g/l in men of less than or equal to 18 lb
      to 2.93 g/l in men greater than or equal to 27 lb and from 122% of standard to
      103%; p less than 0.001, p less than 0.005 respectively). The trends were
      independent of cigarette smoking, alcohol consumption, body mass index, and
      social class. Neither plasma fibrinogen nor factor VII concentration was related
      to birth weight. In men in Preston, however, fibrinogen concentration fell
      progressively as the ratio of placental weight to birth weight decreased (p =
      0.01). CONCLUSIONS: Reduced growth in fetal life and infancy is strongly related
      to high plasma concentrations of the haemostatic factors fibrinogen and factor
      VII. This may be a persisting response to impaired liver development during a
      critical early period.

PMID- 1737159
TI  - Diabetes in prison: can good diabetic care be achieved?
AB  - OBJECTIVE: To investigate the clinical characteristics and metabolic control of
      diabetic patients given structured diabetic care in prison. DESIGN: Survey of
      diabetic men serving prison sentences during a 22 month period in a large British
      prison. SETTING: HM Prison, Walton, Liverpool. SUBJECTS: 42 male diabetic
      prisoners, of whom 23 had insulin dependent and 19 non-insulin dependent
      diabetes. MAIN OUTCOME MEASURES: Episodes of diabetic instability, glycated
      haemoglobin concentrations, body mass index. RESULTS: No serious diabetic
      instability occurred. Between the initial assessment by the visiting consultant
      diabetologist and a second assessment 10 weeks later glycated haemoglobin
      concentrations had fallen from 10.8 (SD 2.9)% to 9.8 (2.4)% (p less than 0.05) in
      prisoners with insulin dependent diabetes and from 8.7 (1.9)% to 7.6 (1.2)% (p
      less than 0.05) in those with non-insulin dependent diabetes. Good glycaemic
      control continued, a mean glycated haemoglobin concentration of 7.6 (1.5)% being
      recorded in seven men remaining in prison for six to 18 months. Mean body mass
      index (weight (kg)/(height(m))2) did not change during the study (insulin
      dependent prisoners 23.3 (SD 2.1), non-insulin dependent prisoners 27.9 (3.8)).
      CONCLUSIONS: Good diabetic metabolic control is usual in prison, probably due to
      the rigid dietary regimen, no alcohol, and compliance with treatment. Many
      younger men had defaulted from their home diabetic clinics, and imprisonment
      allowed screening for diabetic complications and reassessment of treatment.
      Structured diabetic care should be offered in all prisons.

PMID- 1737160
TI  - Diurnal variation in incidence of stroke: Oxfordshire community stroke project.
AB  - OBJECTIVE: To determine whether diurnal variation occurs in the onset of stroke.
      DESIGN: Community based study over four years. SETTING: Oxfordshire, United
      Kingdom. SUBJECTS: 105,000 people, of whom 675 had a first ever stroke. 545 had a
      cerebral infarction, 66 had primary intracerebral haemorrhage, 33 had
      subarachnoid haemorrhage, and in 31 the type of stroke was not known. MAIN
      OUTCOME MEASURES: Time of stroke and degree of activity at onset. RESULTS: In the
      578 patients for whom it was known whether onset occurred while asleep or awake,
      the proportion with onset during sleep was 25% (135/545) for cerebral infarction,
      17% (11/66) for primary intracerebral haemorrhage, and 0% (0/33) for subarachnoid
      haemorrhage. This difference persisted if patients in whom it was not known
      whether they were asleep or awake at onset were classed as asleep. For all stroke
      types together there was a significant (chi 2 = 218.7, p less than 0.001) diurnal
      variation with a morning peak between 0800 and 1000, which persisted even after
      allowing for strokes first noted on waking by redistributing the hour of onset
      through the preceding eight hours (chi 2 = 47, p less than 0.001). A significant
      diurnal variation was also found in the onset of cerebral infarction (peak 0800
      1000, chi 2 = 208.4, p less than 0.001). Fewer patients had other forms of stroke
      and the diurnal variations for primary intracerebral haemorrhage (peak 1000-1200)
      and subarachnoid haemorrhage (peaks 0800-1000 and 1800-2000) were not
      significant. There seemed to be a second smaller peak for all types of stroke.
      CONCLUSIONS: All types of stroke are most likely to occur after waking in the
      morning. The cause of the circadian variation requires further study.

PMID- 1737161
TI  - Octreotide and Graves' ophthalmopathy and pretibial myxoedema.

PMID- 1737162
TI  - Quality of data in the Manchester orthopaedic database.
AB  - OBJECTIVE: To determine the completeness and accuracy of data in a computerised
      clinical information system (Manchester orthopaedic database) in comparison with
      the data available through the Hospital Activity Analysis. DESIGN: Retrospective
      review of case notes, computer data, and Hospital Activity Analysis data.
      SETTING: Orthopaedic unit in a district general hospital in Manchester. SUBJECTS:
      200 random patient records distributed through the period of use of the computer
      system (1 October 1988 to 31 March 1990) and 121 records for random admissions
      between 1 April 1989 and 31 March 1990, 71 of which were included in the previous
      sample. MAIN OUTCOME MEASURES: Conformity of the computer record key words and
      Hospital Activity Analysis codes to an ideal key word record and ideal code
      record drawn up by one investigator from the clinical notes; overall quality
      (completeness times accuracy). RESULTS: Overall completeness of the data in the
      orthopaedic database was 62% and the accuracy was 96%. Completeness improved
      after feedback to doctors on the use of key words in regular audit meetings.
      Completeness was higher in inpatient than outpatient records (69.9% v 53.7%, p
      less than 0.001) and when a new key word was required compared with missing and
      incorrect key words (both p less than 0.001). Completeness was lower when the key
      word was required of a senior registrar (p less than 0.05). Accuracy was not
      significantly different. The completeness of Hospital Activity Analysis data was
      90.5% and accuracy 69.5%. Thus the overall data quality was similar in both
      systems. CONCLUSIONS: Even in a system designed for simple and efficient data
      capture, compliance by users was poor. Accuracy was high, suggesting that users
      understood the principles of data entry. Completeness of data capture can be
      improved by providing feedback to users on use of the system and performance.
      Improvements in future versions of the software should improve performance.

PMID- 1737163
TI  - Quality assurance in Finland.

PMID- 1737164
TI  - ABC of vascular diseases. Acute ischaemia of the leg.

PMID- 1737165
TI  - Hazards of pharmacological tests of growth hormone secretion in childhood.

PMID- 1737166
TI  - Drinking water--doubts about quality.

PMID- 1737167
TI  - Europe and nutrition: prospects for public health.

PMID- 1737168
TI  - Rationing.

PMID- 1737169
TI  - Economic approach to priority setting.

PMID- 1737170
TI  - Cost effectiveness of magnetic resonance imaging.

PMID- 1737171
TI  - Cost effectiveness of magnetic resonance imaging.

PMID- 1737173
TI  - Chorionic villus sampling.

PMID- 1737172
TI  - Glasgow coma scale and gag reflex.

PMID- 1737174
TI  - Chaos theory.

PMID- 1737175
TI  - Could an outbreak of poliomyelitis occur in the UK?

PMID- 1737176
TI  - Resuscitation and hypothermia.

PMID- 1737177
TI  - Caring for larger lists.

PMID- 1737178
TI  - Training in obstetrics.

PMID- 1737179
TI  - Bioeconomics and behavioural ecology. Special issue in honor of Colin W. Clark.

PMID- 1737180
TI  - Design of a clinical engineering management information system.

PMID- 1737181
TI  - Collaboration between nurse researchers and biomedical engineers.

PMID- 1737182
TI  - Development of a digital signal acquisition system for epilepsy surgery.

PMID- 1737183
TI  - A comprehensive cardiovascular waveform analysis program for IBM-compatible
      personal computers.
AB  - Computerized cardiovascular waveform processing has become a necessary and
      fundamental tool in the analysis of physiologic data. The availability of
      numerous commercial data-analysis programs has significantly enhanced the
      efficiency of waveform analysis. Many such programs come with their own
      programming language, which enables the researcher to create an application
      program suited to a specific series of calculations. Once written, an application
      program can significantly increase the efficiency with which data from a specific
      experiment can be analyzed. However, creating or modifying a program for each new
      experimental protocol can be time-consuming, especially in the error-detection
      and verification stages. Single-purpose programs also prove somewhat inflexible
      to unexpected changes in experimental formats. These problems suggested the need
      for a more flexible program, but one that is nevertheless specifically suited to
      the analysis of cardiovascular signals. This need led to the development of a
      program designed in collaboration with surgeons and physiologists. This program
      addresses some important analysis problems in cardiovascular research, and allows
      the user to survey and manipulate cardiovascular waveforms in an intuitive and
      spontaneous manner.

PMID- 1737184
TI  - Comparative study of a 15-MHz focused ultrasonic transducer and a 15-MHz
      unfocused ultrasonic transducer for clinical in-vivo skin-thickness measurements
      in human subjects.
AB  - A commercial focused 15-MHz immersion ultrasonic transducer and a commercial
      unfocused 15-MHz thickness-gaging ultrasonic transducer were evaluated for invivo
      skin-thickness measurements in humans. The unfocused transducer produced thicker
      skin measurements than did the focused transducer but both measurements were
      generally within previously reported ranges. The differences in the determined
      thicknesses may have been a result of the uneven nature of the dermissubcutaneous
      tissue interface and the ability of the focused transducer to better follow this
      interface.

PMID- 1737185
TI  - Evaluation of finger blood pressure monitoring instruments.
AB  - Self-blood pressure monitoring can be critical in the management of hypertension,
      but it is often awkward and cumbersome. One attempt to improve the ease with
      which such measurements are made was the development of electronic, digital,
      automatic monitors for measurement of blood pressure in the finger. The purpose
      of this study was to evaluate the accuracy, reliability, failure rate, and ease
      of operation of these devices. While these finger devices were found easier to
      use than the traditional brachial-artery methods, their accuracies and
      reliabilities were lower. The greater responsiveness of the digital arteries to
      changes in local conditions is suggested as the cause of the lesser accuracy and
      reliability. The author concludes that blood pressure in the digital arteries of
      the finger is not sufficiently representative of general systemic blood pressure
      for clinical purposes.

PMID- 1737186
TI  - Artificial respiration in the anesthetized horse using bilateral, percutaneous,
      cervical phrenic-nerve stimulation with needle electrodes: a preliminary report.
AB  - In this preliminary study, artificial respiration was produced in four
      anesthetized horses using trains of stimuli applied to long needle electrodes
      inserted bilaterally at the base of the neck. The needles were insulated to
      within 1 cm of the tips. The frequency of the stimuli (0.1 msec) was 35/sec and
      the train duration (duration of inspiration) was 1 sec. Inspired volume increased
      with increasing stimulus intensity. In two animals, inspired volumes of 6 liters
      were achieved. In another animal 4.5 liters was achieved and in another, 2.5
      liters. This lower value probably represented less-than-optimal electrode
      placement. Artificial percutaneous electrophrenic respiration was maintained for
      half an hour in every animal using a minute volume equivalent to that when
      breathing spontaneously.

PMID- 1737187
TI  - Modern management of heart failure.
AB  - All grades of symptomatic heart failure have a high mortality rate due to
      progressive heart failure and sudden death. The aims of management are to
      establish the correct diagnosis and to select treatment to improve both
      symptomatology and prognosis.

PMID- 1737188
TI  - Prenatal and postnatal damage to the male reproductive organs.
AB  - Various prenatal and postnatal conditions exert a harmful influence on the normal
      development of the male reproductive organs, and in severe cases lead to
      sterility in adult life. Early diagnosis is of special importance as effective
      treatment may be possible in many cases.

PMID- 1737189
TI  - Reorganizing medical education.
AB  - The education of doctors has not kept up with changes in medicine, medical
      technology and the organization of health services. Training at undergraduate and
      postgraduate level can be rigid and is at times inappropriate. Continuing medical
      education needs expansion. A review of the work and lifestyle of junior hospital
      doctors is needed.

PMID- 1737190
TI  - Osteochondroma in a British neolithic skeleton.
AB  - The skeletal remains of past populations provide an important source of
      information on the natural history of disease. Relatively few cases of bone
      tumours have been reported in archaeological material. This paper describes one
      of the oldest occurrences of osteochondroma to have been identified in a human
      skeleton.

PMID- 1737191
TI  - The coiled spring.
AB  - Radiological terminology includes a number of interesting and often amusing terms
      intended to help us understand and remember the pathological abnormality being
      described. What radiological sign is illustrated in Fig. 1 and what condition
      does it represent?

PMID- 1737192
TI  - Tonsils, obesity and obstructive sleep apnoea.
AB  - In this article the normal effects of anaesthesia on breathing are defined.
      Specific threats to the airway are identified and illustrated by reference to
      common clinical conditions.

PMID- 1737193
TI  - Medicine through the looking glass.

PMID- 1737194
TI  - Ocular complications of leprosy.

PMID- 1737195
TI  - Understanding NHS pensions.
AB  - How much pension will you receive from the NHS Superannulation Scheme upon
      retirement? Some hospital doctors do not have a clear idea of the likely benefits
      or indeed any appreciation of the ancillary features included in the NHSSS. It is
      therefore appropriate to begin this series of articles on pension options for
      doctors with an overview of the NHS Scheme.

PMID- 1737196
TI  - Airsick patients.

PMID- 1737198
TI  - Insulin resistance and blood pressure.

PMID- 1737197
TI  - Inappropriate surgery for testicular cancer.

PMID- 1737199
TI  - Free thin osteo-onychocutaneous flaps from the big toe for reconstruction of the
      distal phalanx of the fingers.
AB  - Free osteo-onychocutaneous flaps from the big toe have frequently been used for
      the reconstruction of distal phalangeal loss of the fingers. The thickness of the
      fatty tissue, however, makes these flaps bulky. We believe this disadvantage can
      be overcome with a free thin osteo-onychocutaneous flap from the big toe and
      consider this thin composite flap to be a superior method of reconstruction for
      the treatment of distal phalangeal loss.

PMID- 1737200
TI  - Conservative treatment of deep partial thickness hand burns--a long term audit of
      outcome.
AB  - Fourteen patients with 23 burned hands assessed as deep partial thickness were
      studied. Fourteen (61%) hands re-epithelialised within 3 weeks. A detailed hand
      assessment at a mean of 19 months post-injury was carried out. The functional
      outcome compared favourably with a group of matched normal controls. There was no
      statistically significant functional difference between the 7 late grafted hands
      and the 16 spontaneously healed hands except for total passive motion. Seventeen
      (74%) hands were considered by the patients to be functionally as good as before
      the injury.

PMID- 1737201
TI  - Role of perivenous areolar tissue in the viability of venous flaps: an
      experimental study on the inferior epigastric venous flap of the rat.
AB  - This study was performed to investigate how the perivenous areolar tissue affects
      survival of the rat inferior epigastric venous flap model designed by Yuen and
      Leung (1991). Five groups of flaps were studied; group A--flap based on an
      inferior epigastric vein and areolar tissue; group B--flap with a skeletonised
      vein; group C--control, nonvascularised flap; group D--flap based on perivascular
      areolar tissue alone; group E--flap with a skeletonised artery and vein. Each
      group included 40 flaps; 20 of them had a silicone sheet placed under the flap,
      the other 20 did not. All flaps of group E survived. The success rate of group A
      with and without a silicone sheet was 60% and 90% respectively. All flaps of the
      other groups (B, C, D) necrosed. Histological examination of the pedicle showed
      that many minute vascular channels (single-cell-layered capillaries) were present
      apart from the inferior epigastric vein. This result confirms the importance of
      the perivenous areolar tissue in perfusion of the skin island, at least, in the
      inferior epigastric venous flap in the rat.

PMID- 1737202
TI  - A new experimental model: the vascular pedicle cutaneous flap over the dorsal
      aspect (flank and hip) of the rat.
AB  - Cutaneous vascular anatomy of the flank and the hip was studied in the rat.
      Investigation was done by anatomical dissection, ink injection to the axial
      artery and flap harvesting in living rats. Anatomical dissection and India ink
      injection revealed that the rat's flank and hip skin derives its blood supply
      from the iliac branch of the iliolumbar artery, which originates from the lateral
      aspect of the abdominal aorta. The vascular territory of the iliac branch of the
      iliolumbar artery was defined as follows: the medial border--along the midline of
      the back from the 12th rib to the proximal part of the tail; the lateral border
      anterior axillary line corresponding with the length of the medial border; the
      cephalic border--a line joining the medial and lateral border at the level of the
      12th rib; and the caudal border--the posterior lateral line of the hip. On the
      basis of the vascular territory demarcated by India ink injection, bilateral
      vascular pedicle island cutaneous flaps were harvested in living rats. Results
      showed total survival of all flaps. This flap is easily made, and it could be
      used as a reliable model for flap research.

PMID- 1737204
TI  - The effect of immediately preoperative adjuvant radiotherapy in the surgical
      treatment of primary cutaneous malignant melanoma.
AB  - A historical series of patients with primary cutaneous malignant melanoma is
      reviewed. These patients had been treated with a single therapeutic dose of
      irradiation to the tumour and surrounding skin immediately before surgical
      excision. Some patients had also received a single necrotising dose of
      radiotherapy to the tumour itself. Recurrence and survival rates have been
      examined retrospectively in the light of reviewed histology, and compared with
      other published series. Preoperative radiotherapy was found to have no
      significant influence on the outcome of surgical treatment of primary malignant
      melanoma.

PMID- 1737203
TI  - The effects of soft tissue coverage on bone graft resorption in the craniofacial
      region.
AB  - Experiments were performed to study the amount of resorption of endochondral bone
      grafts in pockets covered by muscle tissue compared to pockets covered by
      subcutaneous tissue in immature rabbits at 16 weeks post-grafting. In the first
      group the grafts were used as onlays on the buccal surfaces of the mandible with
      cover by masseter on one side of the face and subcutaneous tissues on the other.
      The second experiment was similar but the grafts were fixed semi-rigidly with
      wiring. In the third the grafts were used as onlays on the cranium with muscle or
      subcutaneous tissue coverage. The fourth group of bone grafts were implanted into
      muscle and subcutaneous tissue pockets in the abdominal wall. Bone graft
      resorption was significantly greater when covered by muscle than by subcutaneous
      tissue. This effect is probably mediated by movement imparted to the graft by
      adjacent active muscle, and over-rides any benefits of increased vascularising
      potential muscle may have. Semi-rigid fixation offered no protection against this
      effect.

PMID- 1737205
TI  - The Krakatau syndrome; a late complication of retroglandular mammary
      augmentation.
AB  - A late complication of retroglandular mammary augmentation is described, in which
      severe fibrous capsular contraction with calcification of the capsule causes
      pressure atrophy of the centre of the mammary gland and sometimes even atrophy of
      the underlying pectoralis major muscle. The complication was observed in six
      patients. Two representative cases are described and the treatment is discussed.

PMID- 1737206
TI  - Delayed debulking of free muscle flaps for aesthetic contouring debulking of free
      muscle flaps.
AB  - Although denervated muscle and myocutaneous free flaps atrophy over a period of
      time, when used for surface coverage they may remain bulky, resulting in a less
      than optimal aesthetic result. With the availability of a number of donor sites,
      soft tissue defects can often be reconstructed with like tissue in a single
      stage. Even though the goal of all plastic surgeons is to achieve a good cosmetic
      result, special circumstances might dictate that need take precedence over form.
      We have had six cases where a bulky muscle was used to achieve well vascularised
      coverage. After wound closure had been successfully accomplished, a secondary
      debulking procedure was performed safely for a final acceptable aesthetic result.

PMID- 1737207
TI  - The horn flap: a curved V-Y advancement flap with lateral pedicle.
AB  - The Horn Flap, a curved V-Y advancement flap with a radially based subcutaneous
      pedicle, has proven to be a versatile, reliable method of reconstruction
      following excision of small facial lesions, particularly in the medial canthal
      area. Entry of the pedicle on the radial, or concave, side makes significant
      advancement possible.

PMID- 1737208
TI  - A method of repairing the no. 3 facial cleft.
AB  - A method of correction of an incomplete no. 3 facial cleft in an infant is
      presented. It is compared with previously described repairs, and its advantages
      are outlined.

PMID- 1737209
TI  - External rhinoplasties: indications for use.
AB  - The technique, indications and role of external rhinoplasty in nasal surgery are
      presented. The technique has been utilised in 563 patients with a minimum follow
      up of 18 months. The external approach has been especially helpful in the
      severely twisted nose, secondary rhinoplasty, augmentation rhinoplasty,
      congenital deformities of the nose, closure of septal perforations and in the
      teaching and learning of rhinoplasty. In this series there were no reported
      complications attributable to the external approach.

PMID- 1737210
TI  - Lower eyelid reconstruction by multiple subcutaneous pedicle flaps: a new method.
AB  - In this paper we present an original technique for the reconstruction of the full
      thickness of the lower eyelid after excision of neoplasms. The method is based on
      the mobilisation of multiple pedicle subcutaneous flaps outlined in the same
      eyelid and supported by a chondro-mucosal graft. This technique is used for
      central and off-central losses which involve the outer rim or up to 75% of the
      width of the whole eyelid. This method is an alternative to the Hughes (1945),
      Mustarde (1981), Tenzel and Stewart (1978) and McGregor (1973) techniques which
      we have previously used for this type of reconstruction. The follow-up is
      satisfactory in terms of the oncological, functional and aesthetic aspects, which
      represent an inseparable triad in reconstructive eyelid surgery.

PMID- 1737211
TI  - Transtibial transposition of gastrocnemius muscle and musculocutaneous flaps.
AB  - The medial and lateral gastrocnemius muscle flaps have become the workhorses of
      proximal calf reconstruction since their initial description by McCraw et al. in
      1977. Since that time many authors have presented varying and often ingenious
      techniques by which the range of these flaps can be expanded. This report adds
      another modification of the standard gastrocnemius muscle flap: transtibial
      transposition of the muscle through the posterior cortex.

PMID- 1737212
TI  - Free medial gastrocnemius myocutaneous flap transfer with neurovascular
      anastomosis to treat Volkmann's contracture of the forearm.
AB  - Some articles have reported the use of medial gastrocnemius transfer to repair
      soft-tissue defects caused by trauma and inflammation (Morris, 1978; Feldman et
      al., 1978; Arnold and Mixter, 1983). However, we have not found any report
      describing the use of free medial gastrocnemius myocutaneous flap transfer with
      neurovascular anastomosis to treat Volkmann's contracture of the forearm. Since
      1982, 20 cases of Volkmann's contracture of the forearm have been treated by
      transfer of medial gastrocnemius flap with neurovascular anastomosis. These 20
      patients ranged in age from 6-18 years, with a mean of 10 years. There were 18
      males and 2 females. All cases resulted from ischaemia of the extrinsic and
      intrinsic muscles of the forearm and hand. The most common causes were severe
      supracondylar fractures or, less frequently, fracture-dislocations of the elbow.
      Six to twenty months after operation, the transplanted muscles exhibited normal
      electromyographic potentials, good volume and contractile power with satisfactory
      functional recovery of the forearms. The deformities of the hand and wrist were
      also corrected. In this paper we describe the anatomy of the donor site and the
      operative procedure.

PMID- 1737213
TI  - Cross leg posterior tibial artery fasciocutaneous island flap for reconstruction
      of lower leg defects.
AB  - We have utilised a posterior tibial artery flap from the opposite healthy limb
      for reconstruction of defects of middle and lower third of leg in 6 patients. The
      flap can be based either distally or proximally as the need be. The results have
      been quite encouraging.

PMID- 1737214
TI  - The exposed total knee replacement prosthesis: a new classification and treatment
      algorithm.
AB  - The increased frequency of total knee replacement arthroplasty (TKRA) has been
      reflected in the number of patients with exposed prostheses referred to this
      unit. An algorithm has been developed to assist in the preoperative assessment of
      the wound and this has been tested on 25 patients with wound breakdown following
      TKRA. The grade of exposure so derived predicts the most appropriate surgical
      management. The algorithm, grading system and proposed management are described.

PMID- 1737215
TI  - Squamous cell carcinoma in a tube pedicle forty years after jaw reconstruction.
AB  - Forty years following extensive jaw resection for adenocarcinoma in a young man,
      and innovative mandibular reconstruction, a squamous cell carcinoma developed in
      the tubed pedicle flap used to provide lining for the floor of the mouth. The
      case is described and a brief history of the early methods of mandibular
      reconstruction is presented.

PMID- 1737216
TI  - Reduced thrombogenicity.

PMID- 1737217
TI  - Xeroderma pigmentosum.

PMID- 1737218
TI  - The dartos myocutaneous flap--reply.

PMID- 1737219
TI  - Anterolateral thigh flap: technical tip to facilitate elevation.

PMID- 1737220
TI  - Neonatal cleft lip repair.

PMID- 1737221
TI  - Acute effects of cigarette smoking on microcirculation of the thumb.
AB  - The acute effect of smoking on the microcirculation of the skin of the thumb was
      investigated in healthy volunteers. Twenty-two were smokers and 10 were non
      smokers. The flow was assessed by means of laser Doppler flowmetry. The smokers
      inhaled 2 cigarettes. During smoking of their first and second cigarette
      respectively, a mean decrease in laser Doppler flow of 23.8% and 29.0% was seen
      (p = 0.03; p = 0.01). Ten minutes after smoking this decrease was recovered by
      half. This experiment confirms that one should prohibit smoking of cigarettes pre
      and postoperatively for optimal wound healing conditions.

PMID- 1737222
TI  - Prevention of blindness in giant cell arteritis by corticosteroid treatment.
AB  - Ninety-six patients with giant cell arteritis (GCA) seen from 1968 to 1985 were
      studied with regard to the starting dose of prednisolone and the development of
      serious ocular complications, which proved to be very few after treatment was
      started. Those starting on 20 mg of prednisolone or less daily fared at least as
      well as those starting on higher doses. Analysis of the literature does not
      support the belief that higher doses provide greater protection from blindness.

PMID- 1737223
TI  - Does a sterile urethritis occur in Reiter's syndrome secondary to
      gastrointestinal infection?

PMID- 1737224
TI  - A patient with rheumatoid arthritis and lymphoma.

PMID- 1737225
TI  - A rheumatologist in India.

PMID- 1737226
TI  - Bilateral adrenal infarction, hypoadrenalism and splinter haemorrhages in the
      'primary' antiphospholipid syndrome.
AB  - We describe a patient with a 3-year history of recurrent deep vein thromboses
      (DVT) of the lower limbs, who developed adrenal insufficiency following
      withdrawal of warfarin therapy. Multiple splinter haemorrhages of the nail beds
      were evident, simultaneous with the development of adrenal infarction in the
      absence of infective endocarditis. CT scans of the adrenal glands were consistent
      with bilateral adrenal infarctions. The patient had persistently high titres of
      IgG anticardiolipin antibodies (aCL) over the previous 4 years in the absence of
      antinuclear antibodies (ANA), antibodies to double stranded deoxyribonucleic acid
      (dsDNA) or extractable nuclear antigens (ENA). Thrombocytopenia and an
      intermittently positive Coombs' test had been noted. Previous episodes of DVT
      were associated with inadequate warfarin control and a period of warfarin
      resistance. He conforms to a diagnosis of a 'primary' antiphospholipid syndrome.

PMID- 1737227
TI  - Juvenile chronic arthritis and Wegener's granulomatosis.
AB  - We present a case of Wegener's granulomatosis in a teenage boy with systemic
      onset juvenile chronic arthritis. We discuss the implication of these two
      uncommon conditions coexisting in one patient. The recent characterization of the
      antineutrophil cytoplasmic antibody (ANCA) as a marker of small vessel vasculitis
      has helped in the differential diagnosis of pulmonary renal syndromes.

PMID- 1737228
TI  - IgM-rheumatoid factors measured by ELISA in non-rheumatoid sera: comparison of
      human and rabbit Fc fragments as antigens.

PMID- 1737229
TI  - Meninogococcal infection: diagnostic and therapeutic pitfalls.

PMID- 1737230
TI  - Plasma ascorbic acid concentrations in osteoporotic outpatients.

PMID- 1737231
TI  - Are nodules in RA the result of manual work?

PMID- 1737232
TI  - Confusional syndrome as the presenting form of calcium pyrophosphate dihydrate
      deposition disease.

PMID- 1737233
TI  - Interaction between the cell surface and the extracellular matrix.

PMID- 1737234
TI  - Effect of dominancy on severity in rheumatoid arthritis.
AB  - Joint use has been felt to increase the severity of rheumatoid synovitis. Ninety
      three patients with definite or classical rheumatoid arthritis (RA) were studied
      blind for clinical and radiological findings to see the effect of dominancy on
      the severity of the arthritis. The dominant side showed significantly greater
      total swelling scores (P less than 0.0001) and total tenderness scores (P less
      than 0.01). This was explained predominantly by greater severity of arthritis in
      dominant arms and hands. X-rays of the dominant hands and wrists showed more
      joint space narrowing (P less than 0.04) and erosion (P less than 0.01), but no
      differences in malalignment scores. There were no differences between dominant
      and non-dominant sides on frequency of intra-articular injections or use of
      splinting, but the dominant side received more surgical operations (P less than
      0.02).

PMID- 1737235
TI  - Musculoskeletal pain in Omanis, and the relationship to joint mobility and body
      mass index.
AB  - In a house-to-house population survey of representative areas of Oman, 920 adults
      were examined and questioned about musculoskeletal pain. Back pain was reported
      in 42% of females and 25% of males, and knee pain in 15% of females and 18% of
      males. Hip pain occurred in only three females (0.6%) and one male (0.2%), which
      is consistent with a protective effect of squatting. In rural communities
      musculoskeletal pain was more common, and less anatomically localized. Joint
      mobility scores were higher in females than males and, at all nine sites included
      in the Beighton score, laxity was significantly more common in females than
      males. The scores declined with age, and were higher than those reported in
      Europeans and similar to those in Africans and Indians. Extreme joint laxity
      (score 7-9), seen only in females, was associated with increased symptoms in
      those aged 16-25 years. Body mass index was higher in females with back or knee
      pain than in those without such pain. In males, only knee pain was associated
      with higher body mass index.

PMID- 1737236
TI  - Is the appearance of rheumatoid nodules in a rheumatoid patient well controlled
      on methotrexate an indication to stop the drug?

PMID- 1737237
TI  - A generic health status instrument in the assessment of rheumatoid arthritis.
AB  - Seventy-three patients with RA were assessed by means of the Nottingham Health
      Profile (NHP), the Arthritis Impact Measurement Scales (AIMS) and a number of
      clinical measures. Patients with RA scored higher than controls on the NHP scales
      for energy, pain, mobility and sleep. Energy, pain, mobility and emotions scales
      of the NHP correlate significantly with other measures such as clinical
      assessments, matching scales of the AIMS and the Beck Depression Inventory,
      indicating satisfactory validity for the instrument with RA. Five of the six
      scales of the NHP are stable on retesting. The social scale of the NHP on the
      other hand does not correlate with the matching instrument of the AIMS and is
      relatively unstable over time. Measurement properties of generic health status
      instruments such as the NHP will require serious attention as they are
      increasingly used in evaluation studies.

PMID- 1737238
TI  - Vertebral osteoporosis in rheumatoid arthritis patients: effect of low dose
      prednisone therapy.
AB  - The effect of low dose prednisone therapy on spinal bone mass is controversial.
      We measured lumbar trabecular and cortical bone mineral density (BMD) in 74
      rheumatoid arthritis (RA) patients by dual energy quantitative computerized
      tomography in a cross-sectional study. The presence of vertebral deformities was
      evaluated on a lateral spine radiograph. Patients who had never been treated with
      corticosteroids (n = 44) were compared with patients on long-term low dose (less
      than or equal to 10 mg/day) prednisone therapy (n = 30). After correction for
      confounding variables the lumbar BMD was highly significantly influenced by
      prednisone therapy in postmenopausal patients (estimated influence -31.2% on
      trabecular BMD and -37.2% on cortical BMD). Vertebral deformities were also
      significantly more frequent in prednisone treated postmenopausal patients. No
      negative effect of prednisone treatment could be demonstrated in male patients.
      In contradiction to previous reports we conclude that long-term prednisone
      therapy may be associated with development of spinal osteoporosis in
      postmenopausal RA patients, even when low doses are used.

PMID- 1737239
TI  - Prevention of vesicoureteric reflux by endoscopic injection.

PMID- 1737240
TI  - The persistent indwelling catheter.

PMID- 1737241
TI  - Vesico-coccygeal fistula revealing pelvic malakoplakia.

PMID- 1737242
TI  - Spontaneous rupture of the bladder in interstitial cystitis.

PMID- 1737243
TI  - Rate of development of ureteric obstruction in idiopathic retroperitoneal
      fibrosis (peri-aortitis).

PMID- 1737244
TI  - Re: Adverse urinary symptoms after total abdominal hysterectomy--fact or fiction?
      M.D. Griffith-Jones et al. Br. J. Urol., 67, 295-297, 1991.

PMID- 1737245
TI  - Re: The growing teratoma syndrome. G. M. Jeffery et al. Br. J. Urol., 67, 195
      202, 1991.

PMID- 1737246
TI  - Agreement between clinical methods of measurement of urinary frequency and
      functional bladder capacity.
AB  - We assessed the agreement between 2 methods of data gathering of particular
      interest in urology: patient questionnaire and examination vs. frequency-volume
      charts. One hundred consecutive patients consulting our out-patient clinic were
      chosen for this study; 88 completed the study. Urinary frequency and bladder
      capacity were evaluated in each patient by using the above methods. The agreement
      between different methods of measurement was assessed by determining whether the
      2 methods were interchangeable, a condition occurring if results of both methods
      fall within predetermined limits of variability. The results showed poor
      agreement between subjectively estimated urinary frequency and chart-determined
      urinary frequency. Moreover, different methods of measuring bladder capacity
      (endoscopic vs. chart) gave different results. Since chart-determined data are
      probably a more valid indication of urinary habits, we suggest that frequency
      volume charts should be used more often in the investigation and follow-up of
      patients with micturition disorders.

PMID- 1737247
TI  - Endoscopic implantation of collagen (GAX) for the treatment of urinary
      incontinence.
AB  - Sixteen women whose ages ranged from 42 to 73 years (mean 57) and 2 men, aged 76
      and 80 years respectively, were treated for urinary stress incontinence with
      transurethral implantation of submucosal glutaraldehyde cross-linked collagen
      (GAX); 15 females had had several continence operations previously and 1 female
      was totally incontinent following low anterior resection of the sigmoid colon for
      cancer. All but 2 patients received 8 ml GAX in a single operative session under
      general anaesthesia. Before implantation, patients underwent urodynamic
      evaluation, cystoscopy, urinary stress test and the two-thirds capacity pad
      weighing test. Post-operative evaluations were carried out after 3, 6 and 9
      months and included urinary flow rate, urine analysis, residual urine
      determination and the two-thirds pad weighing test. The results were encouraging.
      After 3 months, 8/18 patients were cured, 7/18 had improved and 3/18 had failed
      to respond. Nine months post-operatively, 7 patients were still continent, 8 had
      improved and 3 remained unchanged. One of the improved group had a reinjection 18
      months post-operatively and has been continent since then. We feel that GAX
      collagen injection is a safe and easy method for the treatment of urinary stress
      incontinence; it has no observable or measurable morbidity.

PMID- 1737248
TI  - Transurethral polytef injection for post-prostatectomy urinary incontinence.
AB  - This report deals with 720 incontinent males injected with Polytef paste. In all
      cases the incontinence resulted from some form of prostatic surgery. All patients
      had been incontinent for at least 1 year. Approximately 88% of patients
      incontinent from transurethral resection (TURP) were cured or improved; 74% of
      patients undergoing prostatectomy were improved, and approximately 67% of
      patients incontinent after radical prostatectomy were cured or improved. No major
      complications or clinical evidence of particle migration were observed. Our 20
      plus years' experience with Polytef paste has shown it to be a safe and effective
      method for the treatment of post-operative male incontinence, with a high success
      rate.

PMID- 1737249
TI  - Is injected polytetrafluoroethylene (Polytef) carcinogenic?
AB  - Injectable polytetrafluoroethylene (Polytef) has been used in many patients for
      vocal cord augmentation and for the management of urinary incontinence since the
      early 1960s and non-injectable forms have been used for sutures, hernia repair,
      replacement of the stapes, hip prostheses, cardiac valves and vascular grafts.
      Since 1984, many children have been treated with subureteric Polytef injection
      for the management of vesicoureteric reflex. Its use in young patients has
      heightened the concern about particle migration and carcinogenesis, particularly
      in view of the fact that the substance may be in the patient for decades. The
      available evidence does not confirm a significant carcinogenic effect in humans;
      rather it suggests that, if there is a risk, it is extremely low. However, human
      specimens, taken decades after the implantation of Polytef, and long-term, non
      rodent animal experiments are needed to substantiate the probable safety of
      Polytef in children.

PMID- 1737250
TI  - Stamey-Martius procedure for severe genuine stress incontinence.
AB  - There are few options now available to treat patients with severe genuine stress
      incontinence caused by urethral failure. These patients usually have a low
      maximum urethral closure pressure (less than 20 cm of water) and anterior vaginal
      wall scarring caused by previous surgery. In 32 such patients we used the Martius
      fat pad insertion procedure, in addition to the Stamey procedure, and achieved a
      91% symptomatic success rate over a mean 13-month follow-up period. Because of
      its simplicity, reliability and low morbidity, we recommend this procedure in
      this difficult group of patients before performing a sling procedure or insertion
      of an artificial urinary sphincter.

PMID- 1737251
TI  - Neurogenic bladder dysfunction in lumbar intervertebral disc prolapse.
AB  - Lumbar disc prolapse with urinary dysfunction is an uncommon condition. The
      clinical, pathological and follow-up details of 30 patients are presented.
      Detrusor recovery is rare and most patients are left with an areflexic bladder.
      Female patients with lumbar disc prolapse and an areflexic detrusor who strain to
      empty their bladders are likely to develop genuine stress incontinence. This may
      be managed by the early institution of intermittent self-catheterisation, which
      may reduce the need for incontinence surgery.

PMID- 1737252
TI  - Intravesical foreign bodies: five-year review.
AB  - All manner of foreign bodies have been extracted from the bladder. Introduction
      into the bladder may be through self-insertion, iatrogenic means or migration
      from adjacent organs. Extraction should be tailored according to the nature of
      the foreign body and should minimise bladder and urethral trauma. Complete
      extraction should also be confirmed by panendoscopy at the end of the extraction
      procedure. A 5-year review of our experience in this field has been conducted and
      the management and complications of intravesical foreign bodies are described. Of
      the 15 patients presenting to this department, 11 presented acutely and 4
      presented with chronic symptoms due to complications which arose later. The
      possibility of an intravesical foreign body should be considered in any patient
      with chronic unexplained lower urinary tract symptoms.

PMID- 1737253
TI  - DNA analysis in predicting survival of irradiated patients with transitional cell
      carcinoma of bladder.
AB  - A total of 115 patients with invasive transitional cell carcinoma of the bladder
      underwent radical radiotherapy between 1975 and 1986 and were followed up until
      the end of 1990. Apart from routine clinical observations, flow cytometric DNA
      measurements made on fresh tumour material were available for analysis. Actuarial
      cancer-free survival controlling for response to treatment was analysed with the
      log-rank test, bivariate and multivariate analyses using Cox's stepwise
      regression model on probable prognostic factors. The overall actuarial 5-year
      cancer-free survival rate was 30%. Survival was significantly correlated with
      response to treatment: 59% for patients with complete regression and 5% for those
      with residual tumour. Prognostic factors that significantly correlated with death
      from cancer were advanced stage, large size, incomplete resection, ureteric
      obstruction, anaemia, carcinoma in situ grade 3 and occurrence of more than one
      aneuploid cell population. However, only 3 of these factors were of independent
      power in the multivariate analysis: stage, size and carcinoma in situ. Of 21
      patients with a history of primary or secondary carcinoma in situ, 19 died from
      cancer during follow-up: 18 of the 21 patients had tumours that were aneuploid
      with more than one aneuploid cell population. It is concluded that curative
      radiotherapy can be successful only in patients with less advanced tumours
      assessed according to clinical stage and size, aneuploid tumours with not more
      than one aneuploid cell line, no carcinoma in situ, no ureteric obstruction, and
      in whom a complete transurethral resection of the exophytic tumour is possible.

PMID- 1737254
TI  - The use of a bladder pressure warning device during transurethral prostatic
      resection decreases absorption of irrigation fluid.
AB  - During a period of 4 weeks 102 patients underwent transurethral prostatic
      resection (TURP). Of these, 50 were randomly allocated to the use of an
      intravesical pressure device which warned the surgeon at a pressure elevation of
      1.5 kPa. Ethanol (1%) was used as a marker in the irrigation fluid (glycine
      2.2%), and absorption of ethanol-tagged irrigation fluid was detected by
      measurements in the expired air. In 28 patients absorption took place (in 8 of
      the 50 patients equipped with the warning device and in 20 of the 52 without the
      device). The greatest absorption was seen in the group without the device. No
      differences were found between the groups with regard to age, resected mass,
      resection time, resection speed, or haemorrhage. Patients who absorbed irrigation
      fluid were slightly older and bled more, and the resected mass was larger. The
      use of a pressure warning device reduces the amount of irrigation fluid absorbed
      and the number of patients who absorb irrigation fluid, and minimises the risk of
      the TUR syndrome.

PMID- 1737255
TI  - Disodium pamidronate identifies differential osteoclastic bone resorption in
      metastatic prostate cancer.
AB  - In a controlled trial the effects of the osteoclast inhibitor disodium
      pamidronate were studied over a 6-month period in men with metastatic bone
      disease from prostate cancer. Using serial biochemical measurement of metabolic
      bone activity, and complementary subjective and quantitative bone histology, the
      effects of pamidronate were evaluated in tumour-free and metastatic regions of
      the skeleton, enabling analysis of the differential mechanisms of bone
      destruction in this disease. Following treatment, abnormally high markers of bone
      breakdown fell significantly (fasting urine hydroxyproline/creatinine (OHP): P
      less than 0.05; fasting urine calcium excretion (CaE): P less than 0.0001),
      confirming that activated osteoclasts play an integral role in the osteolytic
      process. Serial histomorphometry of bone from tumour-free areas showed that
      pamidronate restored abnormal levels of bone erosion to normal in 93% of cases.
      Suppression of bone destruction was also evident within metastases, although this
      was incomplete. The results confirm that osteoclast overactivity is responsible
      for a significant proportion of the accelerated osteolysis seen in both tumour
      free and infiltrated bone in patients with prostate cancer. The differential
      effects in tumour-free and infiltrated bone suggest that the mechanisms of
      osteoclast activation may differ in metastatic and non-metastatic regions of the
      skeleton.

PMID- 1737256
TI  - Changes in detrusor innervation with relief of outflow tract obstruction.
AB  - In 10 patients with urodynamically proven outflow tract obstruction, detrusor
      biopsies were taken prior to and following relief of obstruction. The changes in
      detrusor innervation were compared following the relief of obstruction within the
      study group and also with an age-matched control group who were urodynamically
      normal. There was a significant reduction in detrusor innervation in the study
      group when compared with controls pre-operatively. Within the study group there
      was a significant increase in detrusor innervation in 8 patients following relief
      of outflow tract obstruction. Persistence of symptoms after prostatectomy may be
      explained by failure of detrusor reinnervation.

PMID- 1737257
TI  - Stress relaxation phenomenon in the healthy female urethra.
AB  - Following dilatation, urethral pressure declines over the next few seconds to a
      state of equilibrium. The stress relaxation parameter, Pt0.5, was defined as the
      relative pressure decrease 0.5 s after dilatation, where the pressures at 0.1 s
      and at the new equilibrium were set to 100% and 0% respectively. Pt0.5 was
      calculated from 171 urethral dilatations performed at each of 3 urethral sites of
      measurement in 10 healthy volunteers. It was found to be independent of the rate
      and size of urethral dilatation. It showed a fairly high reproducibility rate
      when repeated after 1 h and 1 week. Pt0.5 was calculated to approximately 60%
      with no variation along the urethra. The parameter is assumed to be useful in
      evaluating urethral sphincter function. Although the method can be performed
      without special urodynamic equipment, the frequency response of the pressure
      measurement system must be adequate.

PMID- 1737258
TI  - Urethral stress relaxation phenomenon in healthy and stress incontinent women.
AB  - Urethral stress relaxation was induced by sudden forced dilatation. The stress
      relaxation parameter, Pt0.5, was defined as the relative pressure decrease 0.5 s
      after dilatation, where the pressures at 0.1 s and at the new equilibrium were
      set to 100% and 0% respectively. Pt0.5 was calculated in 28 healthy and 30 women
      with genuine stress incontinence. Measurements were performed at the bladder
      neck, in the high pressure zone and in the distal urethra. The measurements
      showed that all along the urethra, Pt0.5 was statistically significantly greater
      in the healthy women than in the incontinent women, the greatest difference being
      found at the bladder neck. Although there was a slight overlap in values between
      the 2 groups, this parameter seems useful in differentiating between competent
      and incompetent urethral sphincters.

PMID- 1737259
TI  - Mullerian duct (prostatic utricle) cyst: diagnosis and treatment in subfertile
      males.
AB  - Mullerian duct cysts causing ejaculatory duct obstruction were discovered in 26
      subfertile males; 21 patients had either azoospermia or very severe
      oligozoospermia. Characteristic seminal findings were a small volume ejaculate
      with acid pH and little or no fructose. The lesions were demonstrated by
      vasography and treated by endoscopic incision. After surgery there was a distinct
      improvement in volume of the ejaculate and sperm concentration in 10 patients,
      although another 10 patients continued to have azoospermia or severe
      oligozoospermia due to either persisting obstruction or secondary epididymal
      blocks. Eight female partners became pregnant.

PMID- 1737260
TI  - Treatment decision for stage I non-seminomatous germ cell tumours based on the
      risk factor "vascular invasion".
AB  - Surveillance has become an alternative treatment modality for stage I non
      seminomatous germ cell tumours with reported relapse rates of up to 30% in
      retrospective studies. Results obtained in our retrospective study showed
      vascular invasion in primary tumours to be the risk factor with the highest
      negative predictive value. Since January 1985 patients with stage I non
      seminomatous germ cell tumours have been stratified by the presence or absence of
      vascular invasion in the primary tumour: those without vascular invasion (n = 26;
      group A) were subjected to a rigorous surveillance programme, while those with
      vascular invasion (n = 22; group B) were given 2 chemotherapy courses of
      bleomycin, etoposide and platinum in the hope of preventing progression. Relapse
      rates were 3.8% and 9% in groups A and B, respectively. The pooled relapse rate
      for both groups A and B (n = 48) was 6.2% (3/48). After a mean follow-up time of
      36 months 95.8% (46/48) of the patients were without evidence of disease.

PMID- 1737261
TI  - Non-invasive management of impotence with transcutaneous nitroglycerin.
AB  - Nitroglycerin plasters were applied to the penis in 10 impotent men and the
      erectile effect assessed. During laboratory testing all patients achieved an
      erectile response. Self-administration of nitroglycerin patches restored potency
      in 4 patients and was preferred to papaverine auto-injection by 3. Headache was a
      common side effect during initial administration. An attempt to treat impotence
      with nitroglycerin plaster seems worthwhile before starting extensive
      investigations or invasive treatment.

PMID- 1737262
TI  - Gastrocystoplasty in children.
AB  - We report our experience of gastrocystoplasty in 8 children (mean age 10.1 years)
      with compromised renal function (mean creatinine 186 mmol/l, mean glomerular
      filtration rate 39 ml/min/1.73 m2). Current follow-up ranges from 11 to 35 months
      (mean 21). The physiological outcome of the procedure has been excellent, with
      improved biochemical and urodynamic parameters in all cases. Six patients are off
      H2-receptor blockers and are asymptomatic. In 2 children we have encountered
      significant symptoms related to acid secretion in the bladder. Detailed
      investigations suggest that the excess aciduria is related to the size of the
      gastric patch in 1 patient. The second child underwent renal transplantation 5
      months after gastrocystoplasty and it is postulated that his immunosuppressive
      regimen (which includes prednisolone) may be responsible for the increased acid
      secretion. It is concluded that gastrocystoplasty is a very satisfactory
      alternative to intestinal segment bladder enhancement in children with
      compromised renal function, but the size of the gastric patch is critical in
      determining the resultant acid secretion. Post-transplantation immunosuppressive
      therapy may increase acid production from the gastric patch; since the children
      most suitable for gastrocystoplasty are also those likley to require
      transplantation, this aspect requires further study.

PMID- 1737263
TI  - A male pseudohermaphrodite with Noonan's syndrome.

PMID- 1737264
TI  - Bilateral hydronephrosis secondary to breast carcinoma metastasising to the
      bladder.

PMID- 1737265
TI  - Seminal vesicle cyst, renal agenesis and epididymitis in a 50-year-old patient.

PMID- 1737266
TI  - Vesicosigmoid fistula as an incidental finding accompanying bladder cancer.

PMID- 1737267
TI  - Bacteriology of anal fistulae.
AB  - Anal fistulae are said to arise from cryptoglandular infection of the anal
      glands, which lie within the intersphincteric space. The type and virulence of
      the micro-organism responsible may determine whether an anal fistula develops.
      The microbiology of chronic anal fistulae has not been reported previously.
      Twenty-five consecutive anal fistulae were studied prospectively (eight
      intersphincteric fistulae, 12 trans-sphincteric fistulae, two suprasphincteric
      fistulae, one extrasphincteric fistula, one superficial fistula, one anovaginal
      fistula). There were 18 men and seven women, with a median age of 42 (range 22
      71) years. Patients with Crohn's disease or acute anorectal suppuration were
      excluded. In 18 patients, 0.1 ml granulation tissue from the track of the fistula
      was obtained and processed within 4 h using standard microbiological techniques.
      Sixty-nine isolates representing at least 17 species were obtained. The
      predominant organisms were Escherichia coli (22 per cent), Enterococcus spp. (16
      per cent) and Bacteroides fragilis (20 per cent). The majority of the growths
      were obtained only from enrichment. Bacteria from only one patient grew at a
      dilution of 10(3). Granulation tissue from 25 patients was processed for
      mycobacterial culture, and Mycobacterium tuberculosis was grown from one patient.
      No other mycobacterium was isolated. The chronic inflammation in anal fistulae
      does not seem to be maintained by either excessive numbers of organisms or
      organisms of an unusual type.

PMID- 1737268
TI  - Proctoscopic polyp delivery after colonoscopic polypectomy.

PMID- 1737269
TI  - Temporary loop ileostomy following restorative proctocolectomy.
AB  - A retrospective study compared the outcome of restorative proctocolectomy in
      patients who had a covering ileostomy (n = 53) with those who had no proximal
      stoma (n = 32). Those who had a loop ileostomy had a higher incidence of
      anastomotic leakage (21 per cent), pelvic abscess (32 per cent) and postoperative
      fistula (28 per cent) than those with no covering ileostomy (6, 12 and 12 per
      cent respectively). Intestinal obstruction occurred in 23 per cent of those with
      an ileostomy, compared with 6 per cent in those who had no stoma. The functional
      outcome was identical.

PMID- 1737270
TI  - Results of extensive surgery for liver metastases in colorectal carcinoma.
AB  - Hepatic resections were performed during the past 13 years on 31 patients with
      hepatic metastases from colorectal carcinoma. Of the 31 patients, 22 underwent
      lymph node dissection of the hepatic hilus. Ten patients underwent removal of
      recurrent lesions in the liver, lung, adrenal gland and brain after initial
      hepatic resection. The overall 5-year survival rate was 45 per cent. The outcome
      for six patients who underwent repeat hepatectomy after an initial hepatectomy
      was significantly better than for nine patients with unresectable recurrence (P
      less than 0.01). Six of the 22 patients who underwent lymph node dissection had
      nodes positive for tumour. Two of the six patients underwent repeat hepatectomy
      and are alive after 49 and 66 months. Three- and 4-year survival rates of
      patients with positive lymph nodes were both 40 per cent. Repeat hepatectomy and
      dissection of hilar lymph nodes improves prognosis in selected patients with
      hepatic metastases of colorectal cancer.

PMID- 1737271
TI  - Cholecystectomy and gallbladder conservation.

PMID- 1737272
TI  - Therapeutic perihepatic packing in complex liver trauma.
AB  - Packing for control of haemorrhage was used in 22 of 294 patients undergoing
      surgery for liver trauma over a 6-year period. The major indication for packing
      was transfusion-induced coagulopathy. Sixteen patients had blunt trauma and six
      penetrating trauma including five gunshot wounds; 19 patients had major right
      lobe injuries, three left lobe and five also had hepatic vein injuries. Packing
      provided definitive control of bleeding in 18 patients but four patients had
      recurrent bleeding due to hepatic artery injury (three) and hepatic vein injury
      (one); three required further surgery and bleeding was controlled in the fourth
      by selective hepatic artery embolization. Six patients died and in two of these
      recurrent bleeding, despite packs, was a contributing factor. Mean blood loss in
      the six patients who died was 18 (range 10-30) units, compared with 13.1 (range 8
      30) units in survivors. Packs were removed from the 16 survivors at laparotomy at
      a mean of 3.1 days after insertion; six patients rebled during pack extraction
      and were successfully repacked. Major morbidity occurred in 12 of the 16
      survivors. Seven patients developed intra-abdominal sepsis following packing, one
      of whom died. Therapeutic liver packing provides life-saving control of hepatic
      bleeding which is frequently aggravated by coagulopathy. This approach permits
      resuscitation in an intensive care unit and subsequent planned relaparotomy for
      retrieval of packs and further intervention as necessary.

PMID- 1737273
TI  - Hepatic transplantation in children using reduced size allografts.
AB  - The shortage of paediatric liver donors has led to the use of reduced size
      hepatic allografts. Between July 1987 and July 1990, 30 reduced size orthotopic
      liver transplantations were performed in 24 children aged between 3 months and 7
      years. All patients were in advanced chronic or acute liver failure and were
      considered unlikely to survive for long enough for a size-matched donor to become
      available. The most common indication was biliary atresia. The median
      intraoperative blood loss was 75 (range 13-1015) ml kg-1. Nine patients have died
      and seven have undergone retransplantation, four successfully. Seven patients had
      portal vein hypoplasia with a high graft failure rate due to ischaemic
      infarction. There was significant morbidity from biliary tract complications,
      leading to further operations in four cases. The 1-year actuarial survival rate
      was 62 per cent.

PMID- 1737274
TI  - Hypercalcaemia associated with inflammatory pseudotumour of the spleen.

PMID- 1737275
TI  - Simple solution to the short oesophagus encountered at abdominal fundoplication.

PMID- 1737276
TI  - Effects of fine needle aspiration on subsequent mammograms.
AB  - The effects of fine needle aspiration on subsequent mammography were studied in a
      group of women who were referred with palpable breast lumps. Fifty-two women aged
      between 36 and 73 (median 53) years underwent mammography before and within 5
      days of needle aspiration. Preaspiration and postaspiration mammograms were
      examined 'blind' by one radiologist. In ten cases, a difference was seen between
      the preaspiration and postaspiration films. In seven (aged 36-50 years) this was
      due to aspirated cysts. In three the differences were unexpected and were more
      significant, although the radiological diagnosis was not altered. If this
      proportion is extrapolated for a large number of patients then significant
      numbers of artifacts from fine needle aspiration might be seen on mammograms. It
      is possible that some might be interpreted falsely as malignant and some small
      cancers might be obscured. Women accepted mammography more readily before
      aspiration than after.

PMID- 1737277
TI  - Marking of specimens in patients undergoing stereotactic wide local excision for
      breast cancer.

PMID- 1737278
TI  - Outpatient treatment of non-lactational breast abscesses.
AB  - Eighteen consecutive patients with non-lactational breast abscesses have been
      treated by aspiration (ten patients), surgical drainage after application of
      local anaesthetic cream (seven patients) or a combination of aspiration and local
      anaesthetic cream drainage (one patient) combined with a 2-week course of either
      amoxycillin and clavulanic acid or cephradine and metronidazole. All abscesses
      resolved completely within 2 weeks of treatment and all 18 patients expressed
      satisfaction with the method of treatment used. The majority of patients with
      breast abscesses can now be managed as outpatients.

PMID- 1737279
TI  - Breast abscesses and cigarette smoking.
AB  - An 11-year retrospective review of women with breast abscesses presenting to a
      district general hospital was performed. A total of 122 women were identified
      with a breast abscess: 85 (70 per cent) with non-lactational abscesses and 37 (30
      per cent) with an abscess in the puerperium. Six of 37 lactational and 24 of 85
      non-lactational abscesses recurred. Sixteen mammillary fistulae developed, all
      following incision and drainage of non-lactational breast abscesses. Women with
      non-lactational breast abscesses were more likely to smoke cigarettes (P less
      than 0.005). Breast abscesses containing anaerobic bacteria were significantly
      more likely to occur in current cigarette smokers (P less than 0.05). Women with
      non-lactational breast abscesses who were heavy cigarette smokers were more
      likely to suffer recurrent abscesses (P less than 0.01). There was histological
      evidence of duct ectasia on biopsy in 25 women with non-lactational abscesses and
      21 of 25 were current smokers. Mammillary fistulae developed more frequently in
      current smokers (P less than 0.03). Cigarette smoking is important in the natural
      history of non-lactational breast abscesses and may predispose to anaerobic
      breast infections and the development of mammillary fistulae.

PMID- 1737280
TI  - Pancreas and islet transplantation.

PMID- 1737281
TI  - Progress in the management of head injury.
AB  - Three 1-year surveys of head injury management spanning a 9-year period in a
      single regional centre are presented. There was a reduction in total numbers of
      head injury admissions after guidelines for admission and referral were
      implemented. More liberal use of computed tomography resulted in detection of a
      greater number of intracranial haematomas with the majority detected in non
      comatose patients. The early mortality rate in severe head injury fell from 45
      per cent to 34 per cent despite referral of large numbers of patients with
      multiple injuries and a substantial proportion (12 per cent) of patients aged
      more than 70 years in whom outcome did not improve. Total occupied bednights and
      bednights occupied per surviving patient with severe head injury fell over the
      period of study. Care for patients with significant head injury should be based
      on regional neurosurgical units associated with trauma services.

PMID- 1737282
TI  - Early cardiorespiratory findings after severe blunt thoracic trauma and their
      relation to outcome.
AB  - This study examined the initial haemodynamic and oxygen transport patterns in 24
      patients with severe blunt thoracic trauma in whom immediate monitoring with
      femoral and pulmonary artery catheters was required after admission to the
      intensive care unit. All patients required mechanical ventilation and were
      studied before receiving inhalational anaesthesia and within 12 h of injury. Two
      groups of patients were identified; nine patients (group 1) had an impaired left
      ventricular stroke work index (LVSWI) and 15 patients had a normal LVSWI (group
      2). There were no significant differences in the abbreviated injury scale score
      for the chest, the total injury severity score, or the mean ages of the two
      groups. There were significant differences in stroke volume index, 32 versus 56
      ml m-2 (P less than 0.001), and cardiac index, 3.2 versus 5.3 l min-1 m-2 (P less
      than 0.001), and therefore in oxygen delivery, 469 versus 852 ml min-1 m-2 (P
      less than 0.001), despite apparently adequate volume expansion using the same
      protocol and clinical criteria in both groups. Oxygen consumption was not
      significantly different in the two groups, 135 versus 157 ml min-1 m-2, because
      of a higher oxygen extraction ratio in group 1, 29 versus 19 per cent (P less
      than 0.001), and hence lower mixed venous oxygen saturation, 73 versus 82 per
      cent (P less than 0.02). Seven patients in group 1 died (78 per cent) compared
      with two in group 2 (13 per cent). Early depression of cardiac function is
      associated with poor outcome in patients with thoracic trauma, and measurements
      of oxygen transport variables may influence resuscitation and the timing of
      surgical procedures.

PMID- 1737283
TI  - Effect of transforming growth factor beta and basic fibroblast growth factor on
      steroid-impaired healing intestinal wounds.
AB  - A longitudinal intestinal wound model in the pig was used to assess the effect of
      parenteral steroids (betamethasone 12 mg 50 kg-1 intramuscularly twice daily) on
      breaking load. Steroid treatment significantly decreased the breaking load of
      wounds in the ileum and colon in comparison with wounds from saline-treated
      animals. In a further group of animals receiving steroids, paired longitudinal
      wounds were constructed. One wound of a pair was treated with a local application
      of transforming growth factor beta (TGF-beta) (5 micrograms per wound) or basic
      fibroblast growth factor (5 micrograms per wound) in a collagen suspension. The
      other wound was treated with a collagen suspension alone. Ileal wounds treated
      with TGF-beta were significantly stronger than collagen-treated controls at 7
      days. The steroid-induced impairment of breaking load in intestinal wounds is
      partially reversed by a local application of TGF-beta in a collagen suspension at
      the time of surgery.

PMID- 1737284
TI  - Factors influencing the healing of distal amputations performed for lower limb
      ischaemia.
AB  - A total of 235 toes were amputated during 125 operations on 100 consecutive
      patients with lower limb ischaemia. The overall amputation wound healing rate for
      the series was 58.4 per cent and limb salvage was achieved in 66 patients. Toe
      amputation was performed under local anaesthesia in 57 cases and 32 (56 per cent)
      of these healed primarily, not significantly different from the healing rate of
      41 (60 per cent) of 68 under general anaesthesia. Reconstructive arterial surgery
      was performed in conjunction with toe amputation in 39 patients; the healing rate
      with reconstruction was 32 (82 per cent) of 39, significantly better than the 41
      (48 per cent) of 86 patients not undergoing bypass surgery (P less than 0.001).
      There was no difference in healing rates when comparing diabetic and non-diabetic
      patients. Multiple regression analysis demonstrated that reconstructive arterial
      surgery was the only factor which had an independent and significant influence on
      toe amputation healing. The use of local anaesthesia for distal amputation has no
      deleterious effects on wound healing.

PMID- 1737285
TI  - Early reoperation after major vascular surgery: a four-year prospective analysis.
AB  - Between 1 January 1985 and 31 December 1988, 1176 major vascular operations were
      performed on 1040 patients by the Oxford Regional Vascular Service, of which 136
      (12 per cent) were reoperations within 30 days of the initial procedure (110
      patients). Sixty-seven (49 per cent) of the reoperations were attempted
      revascularizations, 43 (32 per cent) were amputations, and surgery for bleeding
      accounted for 18 (13 per cent). Of the first reoperations 71 (65 per cent) were
      successful, but among the remaining 39 patients, 17 underwent 26 further
      reoperations, 15 of which were reoperations for revascularization. The 30-day
      mortality rate for patients undergoing one reoperation was 13 per cent; this rose
      to 35 per cent if more than one reoperation was performed. Early reoperation
      after major vascular surgery is common and carries a high operative mortality.
      This should be borne in mind when obtaining the informed consent of the patient.

PMID- 1737286
TI  - Doppler ultrasonographic localization of the cephalic vein: a new technique to
      simplify the insertion of central venous catheters.

PMID- 1737287
TI  - Laser-assisted angioplasty for arterial occlusion of the lower limb: initial
      results and follow-up.
AB  - A flashlamp-pumped pulsed dye laser operating at either 480 or 504 nm, coupled to
      an integral ball-tipped optical fibre, was used to recanalize occluded lower limb
      arteries. All channels created by the laser were augmented with balloon
      dilatation. We have treated 78 limbs in 71 patients; 46 limbs (59 per cent) had
      rest pain and 22 (48 per cent) of these had tissue loss. The median occlusion
      length was 18 (range 0.5-58) cm. Technical success was achieved in 58 limbs (74
      per cent) with clinical success in 46 (59 per cent). Success rates fell with
      increasing length of occlusion. Two patients died in the perioperative period. A
      subgroup of 22 patients with marked discrete arterial calcification had a lower
      technical success rate than the subgroup without calcification (50 per cent
      versus 84 per cent, P less than 0.01). Both subgroups displayed a similar pattern
      of reclosure during follow-up. The cumulative patency rate after technical
      success was 67 per cent at 6 months and 45 per cent at 12 months. Forty-six (59
      per cent) limbs avoided bypass surgery or amputation. Laser-assisted angioplasty
      may offer an alternative to femoropopliteal bypass, although the former procedure
      is not as durable.

PMID- 1737288
TI  - Low-dose intra-arterial thrombolysis in the treatment of occluded vascular
      grafts.
AB  - As the use of intra-arterial thrombolysis increases, its application to specific
      areas requires definition. The results of treatment of occluded vascular grafts
      are presented. Thrombolysis using streptokinase or tissue plasminogen activator
      was planned in the treatment of 18 occluded vascular grafts (five aortofemoral
      bifurcation grafts and 13 infrainguinal grafts). Two patients, both with
      infrainguinal occlusions, did not receive thrombolytic therapy and were
      considered failures of treatment. Successful lysis occurred in three of five
      aortofemoral grafts, in both infrainguinal vein grafts and in five of nine
      infrainguinal synthetic grafts. The overall success rate was approximately 60 per
      cent. Two-thirds of the patients required no intervention following successful
      lysis. Percutaneous transluminal angioplasty was not found to be a useful
      additional procedure. A review of the literature revealed that intra-arterial
      thrombolysis is significantly more successful in the treatment of suprainguinal
      graft occlusion than in infrainguinal occlusions, there being no difference
      between infrainguinal vein and synthetic grafts. Provided that the limb is viable
      and there are no contraindications, intra-arterial thrombolysis is a useful means
      of clearing occluded grafts.

PMID- 1737289
TI  - Haemodynamic significance of calf veins.

PMID- 1737290
TI  - Survival after local recurrence of soft tissue sarcoma.

PMID- 1737291
TI  - Suture technique and perianastomotic tumours.

PMID- 1737292
TI  - Selective uptake of glutamine in the gastrointestinal tract.

PMID- 1737293
TI  - Surgery for Crohn's disease in childhood.

PMID- 1737294
TI  - Aluminum and Alzheimer's disease.

PMID- 1737295
TI  - Aluminum and Alzheimer's disease.

PMID- 1737296
TI  - The right to remain psychotic.

PMID- 1737297
TI  - The right to remain psychotic.

PMID- 1737298
TI  - More problems with drug names.

PMID- 1737299
TI  - Familial combined hyperlipoproteinemia.

PMID- 1737300
TI  - Occupational therapy in the community.

PMID- 1737301
TI  - Covert influence?

PMID- 1737302
TI  - A survey of resuscitation training in Canadian undergraduate medical programs.

PMID- 1737303
TI  - Shut out flu.

PMID- 1737304
TI  - Generic drugs in Canada.

PMID- 1737305
TI  - Emergency care and the patient in the long-term care facility.

PMID- 1737306
TI  - Ethics of euthanasia.

PMID- 1737307
TI  - Ethics of euthanasia.

PMID- 1737308
TI  - Diatribe cloaked in scientific language.

PMID- 1737309
TI  - Invalidite temporaire et troubles emotifs [Temporary disability and emotional
      disorders.

PMID- 1737310
TI  - Health care technology assessment: linking science and policy-making.

PMID- 1737311
TI  - Small-area variations: what are they and what do they mean? Health Services
      Research Group.

PMID- 1737312
TI  - Pharmacologic management of refractory depression.
AB  - OBJECTIVE: To review published clinical trials of the pharmacologic management of
      refractory depression. DATA SOURCES: MEDLINE was searched for relevant articles
      published from 1983 to 1990. The bibliographies of review articles were searched
      for additional references. Studies of nonpharmacologic treatments, such as
      electroconvulsive therapy, were not included. STUDY SELECTION: Eleven studies
      were found that did not contain obvious digressions from several methodologic
      assessment criteria (adapted from the McMaster guidelines for the evaluation of
      clinical trials). Further scrutiny by a nonblind reviewer resulted in the
      selection of four reports that were considered acceptable. An assessment by a
      second reviewer, blind as to author, results and journal name, confirmed this
      judgement. DATA EXTRACTION: Data describing response to the treatments were
      extracted by a single (nonblind) reviewer. Post-hoc power estimates and 95%
      confidence intervals were calculated whenever possible. DATA SYNTHESIS: The
      efficacy of augmenting an antidepressant regimen with lithium carbonate,
      triiodothyronine or reserpine was not supported by findings from the clinical
      trials reviewed. However, many trials with negative results lacked adequate
      statistical power to exclude the possibility of the drug's efficacy. The use of a
      monoamine oxidase inhibitor was supported by the one study that met the review's
      methodologic criteria. However, this study was not conducted under double-blind
      conditions. CONCLUSION: The generally recommended strategies for the
      pharmacologic treatment of refractory depression are not supported by
      methodologically sound studies.

PMID- 1737313
TI  - Nature of the clinical difficulties of first-year family medicine residents under
      direct observation.
AB  - OBJECTIVE: To determine and classify the difficulties of first-year family
      medicine residents observed during clinical interviews. DESIGN: Retrospective,
      descriptive study. SETTING: Family practice unit at a teaching hospital.
      PARTICIPANTS: Forty-seven of the 56 first-year family medicine residents during
      their 2-month compulsory rotation in ambulatory family medicine, between July
      1983 and December 1988, and 4 physicians who supervised the residents. MAIN
      OUTCOME MEASURE: The residents' difficulties noted on the observation forms. MAIN
      RESULTS: A total of 1500 difficulties were observed during 194 interviews, an
      average of 7.7 (standard deviation 5.2) per interview. There were 167 different
      difficulties, which were classified into seven categories (introduction, initial
      contract, body of the interview, techniques and organization, interpersonal
      aspects, final contract and miscellaneous) and 20 subcategories. The 17 most
      frequently noted difficulties accounted for 40% of the total. CONCLUSIONS: The
      results constitute a useful starting point for developing a classification of
      residents' difficulties during clinical interviews. We believe that the list of
      difficulties is applicable to residents at all levels and in other specialties,
      especially in ambulatory settings. The list can be used to develop learning
      materials for supervisors and residents.

PMID- 1737314
TI  - Neonatal congenital diaphragmatic hernia and extracorporeal membrane oxygenation.
AB  - OBJECTIVE: To describe the outcome of infants with congenital diaphragmatic
      hernia (CDH) presenting early who were referred for possible extracorporeal
      membrane oxygenation (ECMO). DESIGN: Retrospective descriptive study. SETTING:
      Neonatal Intensive Care Unit of the Royal Alexandra Hospital, Edmonton. PATIENTS:
      Fifteen infants referred to our program since its introduction, in February 1989;
      13 received ECMO. The criterion for ECMO was the presence of an oxygen index of
      more than 40 on three occasions within 2 hours. INTERVENTION: ECMO was performed
      by means of cannulation of the right carotid artery and jugular vein for 111.0
      hours on average. RESULTS: In 5 of the 13 infants who underwent ECMO the
      procedure was performed after surgical repair; all were successfully weaned off
      ECMO, and the cannula was removed without incident. In the remaining eight ECMO
      was started before surgical repair; of the six who received it during repair four
      ultimately survived. None of the previously described predictors of outcome for
      CDH, including diagnosis before 25 weeks' gestation (in six cases), were useful
      in determining the survival of the patients. Bleeding was the most common
      complication and cause of death. CONCLUSION: ECMO is associated with survival in
      infants with CDH who fail to respond to conventional therapy and who have a poor
      prognosis according to previously established criteria.

PMID- 1737315
TI  - Effects of a medical team coordinator on length of hospital stay.
AB  - OBJECTIVE: To determine the effect of a medical team coordinator (MTC) on the
      length of stay in a teaching hospital. DESIGN: Randomized controlled trial.
      SETTING: Two of four general medical clinical teaching units (CTUs). PATIENTS:
      Patients admitted to the CTUs between July and October 1990 except those who were
      admitted directly to an intensive care unit or whose death was expected within 48
      hours. The 267 patients were randomly assigned to receive either standard medical
      care or standard medical care plus MTC services. INTERVENTION: The MTC was a
      baccalaureate nurse whose role was to facilitate administrative tasks such as
      discharge planning, to coordinate tests and procedures, and to collect and
      collate patient information. MAIN OUTCOME MEASURES: Length of hospital stay. A
      subgroup of 40 patients was asked to complete a brief survey on medical care
      information and satisfaction. RESULTS: The MTC intervention reduced the mean
      length of stay by 1.97 days (p less than or equal to 0.04, 95% confidence
      interval [CI] 1.02 to 2.92 days). Subanalysis by diagnostic group revealed that
      most of this effect was in an ill-defined group of disorders. In the survey more
      patients in the MTC group than in the other group reported being satisfied with
      their medical care (89% v. 62%; p less than or equal to 0.05, 95% CI 2% to 52%).
      CONCLUSIONS: The services of an MTC help to reduce the length of hospital stay
      for some groups of patients. Further research is necessary to examine which
      components of the MTC intervention are most effective and in what conditions.

PMID- 1737316
TI  - Update: transmission of HIV infection during invasive dental procedures.

PMID- 1737317
TI  - Obesity and coronary heart disease.

PMID- 1737319
TI  - Eating the leek. 1912.

PMID- 1737318
TI  - The use of BCG. 1948.

PMID- 1737320
TI  - Doctors can improve on way they deliver bad news, MD maintains. Interview by
      Evelyne Michaels.

PMID- 1737321
TI  - Alberta college latest to tackle issue of physician-related sexual abuse.

PMID- 1737322
TI  - Medicine without moralizing is the aim of Montreal's "street doctors".

PMID- 1737323
TI  - MDs angry as most pharmacies continue to sell "number one cause of death".

PMID- 1737324
TI  - Cases involving "20th-century diseases" start landing in British courts.

PMID- 1737325
TI  - Canadian health care system source of lively debate in journals.

PMID- 1737326
TI  - CMA and other members of lobby group develop five-point plan for Canada's health
      care future.

PMID- 1737327
TI  - MDs, nurses play major role in success of "sexuality clinics" at Ottawa high
      schools.

PMID- 1737328
TI  - STDs' economic impact felt in both developed and Third World countries, meeting
      told.

PMID- 1737329
TI  - Patients' right to die becoming major issue for MDs and MPs.

PMID- 1737330
TI  - Bill C-203 is a worthwhile effort but contains some flaws.

PMID- 1737331
TI  - Disseminating tumor cells and their interactions with leukocytes visualized in
      the brain.
AB  - Brain tumors are increasingly prevalent. Recent advances focus attention on
      individual, disseminated tumor cells that cannot be imaged or eliminated. Cells
      of the immune system may be ideally suited to attack individual tumor cells, but
      more basic understanding is needed. We describe a rat model, using the lacZ
      reporter gene, that allows identification of individual tumor cells, and tumor
      leukocyte interactions in vivo. The model demonstrates how widely tumor can
      disseminate, without secondary tumorigenesis or recruitment of nonneoplastic
      cells. It demonstrates that leukocytes have access to disseminating tumor. Among
      its many applications, this work lays a foundation for developing cell-mediated
      immunotherapy against individual brain tumor cells.

PMID- 1737332
TI  - Interleukin 9 is expressed by primary and cultured Hodgkin and Reed-Sternberg
      cells.
AB  - We show by mRNA hybridization analysis and immunostaining using a mouse
      monoclonal antibody (moAb) to recombinant human interleukin 9 (IL-9) that both
      primary and cultured Hodgkin and Reed-Sternberg (H-RS) cells produce IL-9
      transcripts and protein and express surface binding sites for IL-9. In addition,
      the growth of H-RS cells obtained from the HDLM-2 line (abundantly producing IL-9
      transcripts) was significantly inhibited when anti-IL-9 moAb or an IL-9 antisense
      oligodeoxyribonucleotide was added to cultures. Excess addition of recombinant
      human IL-9 relieved the effects of anti-IL-9 moAb on HDLM-2 growth. Growth of H
      RS cells of the KM-H2 line, which displays only low amounts of IL-9 detectable
      upon hybridization of polyadenylic acid-selected RNA only, was not affected by
      anti-IL-9 moAb. The proliferative capacity of KM-H2 cells in soft agar and liquid
      suspension cultures was, however, augmented at least 3-fold when cells were
      exposed to recombinant human IL-9. In conclusion, our results show that IL-9 is
      expressed by H-RS cells and point to a possible role of this molecule as a growth
      factor for these cells.

PMID- 1737333
TI  - Infrequent p53 mutation in mouse tumors with deregulated myc.
AB  - An invariant genetic lesion in mouse plasmacytomas is deregulated expression of c
      myc as a consequence of chromosomal translocation. However, retroviral and
      transgenic studies suggest that additional genetic lesions may contribute to the
      genesis of plasmacytomas. The p53 tumor suppressor gene is a likely contributor
      to this genetic lesion, since there is a high incidence of p53 mutation in
      Burkitt's lymphomas and B-ALL (L3), both of which contain translocations
      involving c-myc analogous to those in plasmacytomas. In addition, p53 has been
      shown to be a transcriptional modulator of c-myc expression. In a survey of 27
      mouse plasmacytomas by single-strand conformation polymorphism, we identified a
      single mutation (3.7% incidence), suggesting that p53 lesions are not frequent
      contributors to plasmacytomagenesis. A similar study of macrophage-monocyte
      tumors generated by a c-myc-containing retrovirus also indicates a lack of p53
      involvement in deregulated c-myc expression. These results suggest that the
      specific maturation stage of transformed B-lymphocytes, independent of c-myc
      deregulation, may be the critical factor which determines the involvement of
      mutant p53.

PMID- 1737334
TI  - Re: R. Grundel and H. Rubin, Effect of interclonal heterogeneity on the
      progressive, confluence-mediated acquisition of the focus-forming phenotype in
      NIH-3T3 populations. Cancer Res., 51:1003-1013, 1991.

PMID- 1737335
TI  - A new form of cytochrome P-450 responsible for mutagenic activation of 2-amino-3
      methylimidazo[4,5-f]quinoline in human livers.
AB  - Antibodies to P-450IA2 strongly inhibited the mutagenic activation of 2-amino-3
      methylimidazo [4,5-f]quinoline (IQ) and 3-amino-1-methyl-5H-pyrido[4,3-b]indole
      acetate but not aflatoxin B1 in human liver microsomes. The anti-rat P-450IA2
      antibodies were capable of recognizing two proteins which show different
      mobilities on sodium dodecyl sulfate-polyacrylamide gel electrophoresis of human
      liver microsomes. A new form of cytochrome P-450 (designated P-450-HM4) cross
      reactive with anti-rat P-450IA2 antibodies showing that the smaller molecular
      weight was purified from human liver microsomes by means of the fast-performance
      liquid chromatography system. The molecular weight of P-450-HM4 was estimated to
      be 49,000, which was apparently different from that of P-450PA (human P-450IA2).
      The antibodies to P-450-HM4 did not cross-react with P-450PA (human P-450IA2) but
      inhibited to various extents the mutagenic activation of IQ in microsomes from
      human livers. In addition, P-450-HM4 showed significant mutagen-producing
      activity from IQ in a reconstituted system. Together with these and other results
      reported previously, it is concluded that at least two forms of cytochrome P-450
      [P-450-HM4 and P-450PA (human P-450IA2)] are involved in the mutagenic activation
      of IQ in human liver.

PMID- 1737336
TI  - Tumor-reactive T-cells accumulate in lung cancer tissues but fail to respond due
      to tumor cell-derived factor.
AB  - The purpose of this study was to elucidate a possible immune response to tumor
      cells mediated by tumor-infiltrating lymphocytes (TIL) in lung cancer. In flow
      cytometry, the majority of T-cells of TIL were CD45RA-, CD45RO+, and CDw29high,
      and expressed HLA-DR. The expression of interleukin 2 receptor beta chain
      increased in both CD4+ and CD8+ TIL compared with both types of T-cells in
      peripheral blood. These results indicate that the major population of TIL is
      activated memory T-cells. The TIL preparation, which was usually contaminated
      with 5 to 10% tumor cells, did not exhibit any response in autologous mixed
      lymphocyte-tumor culture even in the presence of interleukin 2 (IL-2) in all five
      cases tested. Although purified T-cells from TIL showed the positive response in
      only 1 of 10 cases tested without addition of IL-2, it occurred in 7 of 10 cases
      in the addition of a low concentration of IL-2. The IL-2-dependent response to
      irradiated autologous tumor cells was suppressed when nonirradiated autologous
      tumor cells were added to the culture. Culture supernatants of four lung cancer
      cell lines and freshly prepared lung cancer cells obtained from 6 cases exhibited
      suppressive activity against anti-CD3 antibody-induced mitogenesis of peripheral
      blood mononuclear cells from healthy donors. We suggest that, taken together, (a)
      the major population of TIL in lung cancer are activated memory T-cells, and they
      include tumor-reactive ones, and that (b) the function of the TIL is impaired by
      unavailability of IL-2 and/or by suppression due to lung cancer cell-derived
      factor(s).

PMID- 1737337
TI  - Parental occupation and childhood astrocytoma: results of a case-control study.
AB  - Parental occupations were investigated as possible risk factors for astrocytoma,
      the most frequently occurring brain tumor in children. A case-control study of
      163 pairs was performed. Cases under 15 years of age at diagnosis in 1980-1986
      were identified through the tumor registries of eight hospitals in Pennsylvania,
      New Jersey, and Delaware. Controls were selected by random-digit dialing and were
      matched to cases on age, race, and telephone area code. Occupations before the
      child's conception, during the pregnancy, and after the child's birth were
      studied separately. We did not observe any strong associations. Significantly
      more fathers of cases were electrical or electronic repairmen, a subgroup of an
      occupational category previously associated with increased risk. An excess of
      case mothers employed as nurses was observed, which was significant for mothers
      of children diagnosed before 5 years of age. Elevated although not significant
      odds ratios were observed for some white collar and professional occupations in
      case parents; for paternal exposure to paint and paternal occupation in the paper
      and pulp mill industry, both in the period after the child's birth; and for
      maternal occupation as a hairdresser. The lack of strong associations may have
      resulted from low statistical power for some job groupings. Our study, unlike
      previous studies, focused on a single type of brain tumor: childhood astrocytoma.
      Thus our results suggest that some parental occupations associated with childhood
      brain tumors in previous studies may not be risk factors for childhood
      astrocytoma.

PMID- 1737338
TI  - Reversibility of catechol-induced rat glandular stomach lesions.
AB  - The potential reversibility of glandular stomach lesions induced by the
      clastogen, catechol, was examined in groups of male F344 rats treated
      continuously with 0.8% catechol in the diet for 12, 24, 48, 72, or 96 weeks.
      After a return to basal diet for 84, 72, 48, 24, and 0 weeks, respectively, the
      animals were killed for histopathological examination. Incidences of submucosal
      hyperplasia, adenomas and adenocarcinomas, average number of tumors per rat, and
      the size of tumors in rats treated with catechol for 12, 24, 48, 72, and 96 weeks
      increased time dependently. After cessation of catechol treatment, although
      average number of tumors per rat slightly decreased, the size of tumors tended to
      increase. Labeling indices in both tumorous and nontumorous areas decreased after
      cessation of catechol treatment. The results thus indicate that whereas some
      submucosal hyperplasias or adenomas may regress, others have the potential to
      develop into adenomas or adenocarcinomas. However, tumor growth does depend to a
      certain extent on continued catechol treatment.

PMID- 1737339
TI  - NAD(P)H:quinone oxidoreductase gene expression in human colon carcinoma cells:
      characterization of a mutation which modulates DT-diaphorase activity and
      mitomycin sensitivity.
AB  - NAD(P)H:quinone oxidoreductase (DT-diaphorase; DTD) is an obligate two-electron
      reductase which may play a role in the bioactivation of antitumor quinones such
      as mitomycin C (MMC). We studied 10 colon carcinoma cell lines showing different
      levels of DTD activity (range, 0-3447 nmol/min/mg protein), as measured by the
      reduction of dichlorophenolindophenol. Expression of the NAD(P)H:quinone
      reductase gene (NQO1), which codes for the DTD enzyme, as measured by a
      polymerase chain reaction amplification technique was then correlated with
      enzymatic activity in all cell lines. HT-29 cells, which have intermediate DTD
      activity (769 +/- 144 nmol/min/mg protein, mean +/- SD) and are sensitive to MMC,
      showed high NQO1 expression relative to beta-actin (taken as 100% here for
      comparative purposes). BE cells which have no detectable DTD activity and are
      resistant to MMC showed moderate NQO1 expression (91% of HT-29). RNA single
      strand conformational polymorphism analysis and subsequent sequencing of BE
      complementary DNA revealed a C to T mutation in the NQO1 complementary DNA. This
      confers a proline to serine substitution in the amino acid sequence of the
      protein. Additionally, HCT-116 cells showed both moderate DTD activity (390 +/-
      41 nmol/min/mg protein) and NQO1 expression (41% of HT-29), while resistant
      subclones of these cells, exposed to MMC during 11 and 44 weeks, showed low gene
      expression (5 and 9% of HT-29 respectively) and enzymatic activity (11 +/- 6 and
      36 +/- 16 nmol/min/mg protein). These results support the ideas that reductive
      activation of MMC by DTD may be important in the cytotoxicity of MMC and that
      polymerase chain reaction may be a useful technique for quantitating the relative
      expression of genes in human tumors.

PMID- 1737340
TI  - Human uterine endometrial adenocarcinoma: characteristic acquirement of synthetic
      potentials for II3SO3-LacCer and ganglio series sulfoglycosphingolipids after
      transfer of the cancer cells to culture.
AB  - The acidic glycosphingolipid composition of human uterine endometrial
      adenocarcinoma was compared with those of normal uterine endometrium at the
      proliferative and the secretory phases. Upon chemical composition analysis, no
      significant transformation-associated change of these glycolipids was observed.
      However, when cancer cells from the patients with human uterine endometrial
      adenocarcinoma were transferred to culture, the composition of
      glycosphingolipids, particularly sulfoglycosphingolipids, was significantly
      altered after the 70th doubling time. I3SO3-GalCer, which was contained in the
      original tissues of uterine endometrial adenocarcinomas, disappeared completely
      from the cultured cells at the 70th doubling time, whereas II3SO3-LacCer and
      ganglio series sulfoglycosphingolipids, which were originally contained in a
      trace amount or not present at all in the cancer tissues, became the major
      components in the total acidic glycosphingolipids in the cultured cells. Also,
      among cell lines established from several gynecological cancers, which include
      uterine cervical squamous carcinoma, uterine endometrial adenocarcinoma, ovarian
      clear cell carcinoma, choriocarcinoma, uterine sarcoma, ovarian sarcoma, and
      vulvar melanoma, only those cells derived from uterine endometrial adenocarcinoma
      expressed II3SO3-LacCer and ganglio series sulfoglycosphingolipids and the
      synthetic activities of these sulfoglycolipids, indicating that uterine
      endometrial adenocarcinoma cells characteristically lose the sulfotransferase to
      GalCer and acquire the sulfotransferase to LacCer after being transferred to
      culture in vitro. Thus, the unique sulfoglycosphingolipids and sulfotransferase
      are useful markers for the characterization of uterine endometrial adenocarcinoma
      among human gynecological cancers.

PMID- 1737341
TI  - Localization of shed human tumor gangliosides: association with serum
      lipoproteins.
AB  - Tumor gangliosides are biologically active (immunosuppressive and tumor
      enhancing) cell surface molecules which are shed into the circulation in vivo.
      However, the mechanism of transport of these molecules (i.e., in solution or
      bound to proteins or other lipids) is not known. To resolve this question we
      traced, by direct chemical detection, the serum localization of a specific human
      tumor ganglioside, GD2, shed by neuroblastoma cells. Sera from patients with
      tumors were separated into the lipoprotein fractions [very low-density
      lipoprotein, low-density lipoprotein (LDL), and high-density lipoprotein] and
      lipoprotein-depleted serum. All three lipoprotein fractions contained GD2. 73% of
      the total GD2 was present in the LDL fraction, while very low-density lipoprotein
      and high-density lipoprotein contained 21 and 6%, respectively. Significantly,
      lipoprotein-depleted serum, which would contain both albumin-bound and free
      ganglioside, was devoid of GD2. Thus, shed neuroblastoma tumor gangliosides are
      exclusively associated with the serum lipoprotein (and predominantly LDL)
      fractions in vivo. These findings have implications for the immunological
      detection of these molecules and the development of approaches to their removal.

PMID- 1737342
TI  - Baculovirus recombinant expressing a secreted form of a transmembrane carcinoma
      associated antigen.
AB  - GA733-2 is a monoclonal antibody-defined, 40-kDa glycoprotein antigen that is
      associated with carcinomas of various origins. Hydrophobicity analysis of the
      protein sequence predicted by complementary DNA (cDNA) has suggested that the
      GA733-2 antigen is a type I membrane protein. In this study, the polymerase chain
      reaction was used in a strategy to omit cDNA sequences for the transmembrane and
      cytoplasmic domains, thereby converting the extracellular domain into a secretory
      protein. Full-length and truncated cDNAs were cloned into the baculovirus
      transfer vector pVL1392 and introduced into Autographa californica nuclear
      polyhedrosis virus by homologous recombination. The full-length cDNA baculovirus
      recombinant directed the expression of a 40-kDa glycoprotein that was confined to
      infected Spodoptera frugiperda cells, whereas cells infected with the truncated
      cDNA baculovirus recombinant abundantly secreted a 31-kDa glycoprotein into the
      culture medium. Recombinant secretory antigen displayed an in vitro
      immunoreactivity to monoclonal antibody and an in vivo immunogenicity in mice
      that were similar to native antigen. The facile purification of mg quantities of
      carcinoma-associated antigen will enable an evaluation of its immunogenicity in
      cancer patients.

PMID- 1737343
TI  - Ammine/amine platinum(IV) dicarboxylates: a novel class of platinum complex
      exhibiting selective cytotoxicity to intrinsically cisplatin-resistant human
      ovarian carcinoma cell lines.
AB  - Using a panel of six human ovarian carcinoma cell lines varying by two orders of
      magnitude in terms of cisplatin cytotoxicity, we have investigated the in vitro
      antitumor activity of a series of novel alkylamine ammine
      dicarboxylatodichloroplatinum(IV) complexes of the general formula c,t,c
      [PtCl2(OCOR1)2NH3(RNH2)]. A clear relationship existed between increasing the
      number of carbons in the R1 substituent and increasing cytotoxicity up to R1 =
      C5H11. In terms of changing the R group, maximum cytotoxic effects were conferred
      by alicyclic substituents. Furthermore, increasing the alicyclic ring size from
      cyclobutane through to cycloheptane resulted in increasing cytotoxicity. The
      agents with longer axial chains (e.g., JM300, R = cyclohexyl, R1 = C6H13) were
      significantly more cytotoxic than cisplatin and, moreover, exhibited a selective
      cytotoxic effect against the most intrinsically cisplatin-resistant cell lines
      (e.g., for HX/62, cisplatin 50% inhibitory concentration, 12.6 microM; SKOV-3,
      cisplatin 50% inhibitory concentration, 4.4 microM and 41 M; cisplatin 50%
      inhibitory concentration, 0.23 microM; JM300 was 840-, 440-, and only 34-fold
      more active, respectively). The dicarboxylates JM221 (R = cyclohexyl, R1 = C3H7)
      and JM244 (R = n-propyl, R1 = C6H5) also retained activity against a 4-fold
      cisplatin-acquired resistant variant of the 41M cell line. At least part of the
      increased cytotoxicity of the dicarboxylate, JM221, over cisplatin appeared to be
      attributable to an increased intracellular accumulation. This novel class of
      platinum compound represents a valuable lead in the development of a "third
      generation" agent capable of exhibiting activity against clinical disease
      currently resistant to cisplatin.

PMID- 1737344
TI  - Identification of a human tumor-derived lipolysis-promoting factor.
AB  - Our previous studies have demonstrated the production and release of a tumor
      derived factor that promoted lipolysis in normal adipocytes. We further
      demonstrated that this in vitro lipolysis was correlated with the in vivo loss of
      total carcass lipids induced by the presence of the same tumor. This study
      identified and isolated this "lipolysis-promoting" factor (LPF), released into
      the extracellular environment (conditioned media) by the human A375 melanoma cell
      line, which appears to be responsible for the previously demonstrated induction
      of in vitro and in vivo lipolytic activity. Unlike previously described non-tumor
      derived molecules, such as tumor necrosis factor-alpha/cachectin, which have been
      implicated in cancer cachexia, the LPF induces alterations in lipid metabolism
      similar to those observed in cancer patients. The biochemical nature of human
      tumor-derived LPF appears to be a heat-stable molecule with an apparent molecular
      weight of approximately 6000. The lipolysis-promoting activity was
      trichloroacetic acid precipitable, but not precipitable with protamine sulfate or
      extractable with chloroform:methanol. Its activity appears to be resistant to
      enzymatic treatments with protease K, trypsin, Pronase, RNase, and DNase, as well
      as to periodate oxidation. Immunochemically, LPF appears to be distinct from
      tumor necrosis factor-alpha/cachectin. Furthermore, in contrast to the mechanism
      of action of tumor necrosis factor-alpha/cachectin, the mechanism of "lipolysis
      promotion" by LPF appears to be by the induction of cellular lipase activity.

PMID- 1737345
TI  - The fate of antibodies bound to the surface of tumor cells in vitro.
AB  - The fate of monoclonal antibodies binding to the surface of human tumor cells in
      vitro was investigated. Seven antibodies, labeled with 125I, were tested on four
      cell lines, which included a melanoma and carcinomas of the ovary, kidney, and
      lung. The antibodies were selected only by the criterion that they not be rapidly
      internalized via coated pits, so that they would be representative of most
      antibodies reacting with cell surface antigens. After allowing binding during a 2
      h incubation, unbound antibody was removed, and the release of intact or degraded
      antibody in the supernatant was monitored. The data demonstrate that most bound
      antibody was gradually degraded and released from the cell over a 2-3-day period,
      probably via internalization, while only a small fraction, less than 20% for most
      antibodies, appeared to dissociate intact. One exceptional antibody, MW207,
      dissociated largely intact. The release of intact antibody was virtually complete
      within 4 h, and radioactivity released after this time was predominantly in
      degraded form. These results demonstrate that antibody binding to the surface of
      viable cells must in general be considered irreversible, and hence the concept of
      affinity is not applicable. Since an Fab fragment of one of the antibodies
      dissociated rapidly, such irreversible binding appears to require bivalent
      attachment. Another conclusion of this study is that most antibodies binding to
      the cell surface are gradually internalized, which we suggest is due to the
      normal turnover of cell surface constituents via non-clathrin-dependent
      endocytosis. Several experimental approaches indicated that a large fraction of
      antibody retained by the cells, for at least 2 days after binding, was present at
      the cell surface.

PMID- 1737346
TI  - Immunological effects of treatment with sequential administration of recombinant
      interferon gamma and alpha in patients with metastatic renal cell carcinoma
      during a phase I trial.
AB  - Many anticancer mechanisms of the interferons have been proposed but none have
      been associated with clinical response to date. The biological activities of the
      interferons in vivo have included effects upon the natural killer cell, T- and B
      lymphocytes, and macrophages. This report details a prospective study of the
      immunological effects on peripheral blood mononuclear cells of sequentially
      administered recombinant (r) interferon (IFN) gamma and rIFN alpha in 28 patients
      with metastatic renal cell carcinoma. Natural killer cell activity, T-cell
      phenotype (CD4, CD8, CD56, CD16, CD4/HLA-DR, CD8/HLA-DR, CD56/HLA-DR) and 2',5'
      oligoadenylate synthetase were measured prior to therapy, during therapy, and
      following completion of treatment. Statistical analysis of all parameters was
      performed for the entire group, by individual patient, by dosage, by time, and by
      clinical response. An overall significant depression in natural killer cell
      activity and in the percentage of circulating CD56, CD16, and CD8+ cells were
      noted. Significant increases in 2',5'-oligoadenylate synthetase and in the
      percentage of circulating CD4 cells were also noted. Although an association
      between the magnitude of change in percentage of CD16+ cells and 2',5'
      oligoadenylate synthetase and dosage of rIFN gamma and rIFN alpha, respectively,
      was observed, optimal biological dose of this sequence of rIFNs could not be
      determined due to the limited number of patients. A decrease in the percentage of
      circulating CD8+ cells was observed among patients with objective clinical
      response (partial and complete). Sequentially administered rIFN gamma and rIFN
      alpha can modulate immunological parameters in vivo in patients with metastatic
      renal cell carcinoma. A fall in percentage of circulating CD8+ cell is associated
      with response and suggests that this sequence of rIFN alpha and rIFN gamma might
      influence T-cell mediated antitumor activity.

PMID- 1737347
TI  - The combined effects of dietary fat, protein, and energy intake on azoxymethane
      induced intestinal and renal carcinogenesis.
AB  - Two 3 x 3 factorial experiments were conducted to examine the effects of dietary
      protein (8, 16, and 32% of energy from casein) and dietary fat (12, 24, and 48%
      of energy from corn oil) on the initiation and promotion of azoxymethane-induced
      carcinogenesis in rats. For the initiation study, 33 weanling male Sprague-Dawley
      rats were randomized to each of nine diets fed ad libitum. Azoxymethane was
      administered s.c. between the fourth to sixth weeks of feeding, providing a total
      dose of 6 mg/100 g body weight. All rats were subsequently fed a common diet
      containing 16% energy from protein and 24% energy from fat for an additional 30
      to 38 weeks. For the promotion study, all rats were fed a common diet containing
      16% of energy from protein and 12% of energy from fat until the completion of
      azoxymethane administration, when 33 rats were randomized to each of nine diets
      varying in fat and protein content and fed these diets until sacrifice. Low
      protein diets during the initiation phase were associated with increased risk of
      renal adenocarcinomas (P less than 0.001) and mesenchymal (P = 0.005)
      malignancies. No other statistically significant relationships were found between
      the levels of dietary fat or protein and the prevalence of malignant lesions of
      the small intestine, colon, or kidney in either the initiation or promotion study
      (although polypoid adenocarcinoma of the colon increased suggestively from 13 to
      19 to 26% of rats with increasing dietary protein during initiation). Results of
      a multiple logistic regression analysis, combining both studies, showed that ad
      libitum energy intake was significantly associated with intestinal
      carcinogenesis. The odds of finding an intestinal adenocarcinoma increased by 6.2
      +/- 2.6% (SE) for each additional kilocalorie of mean daily ad libitum intake (P
      = 0.014). The quintile of rats which consumed the least averaged 60 kcal/day,
      while the most voracious quintile averaged 74 kcal/day. This 14 kcal/day
      difference in mean ad libitum intake corresponded to more than a doubling (146%
      increase) of the odds of developing an intestinal adenocarcinoma. These studies
      suggest that ad libitum energy intake is a critical factor modulating
      experimental colon carcinogenesis.

PMID- 1737348
TI  - Resistance to cytolysis by tumor necrosis factor alpha in malignant gynecological
      cell lines is associated with the expression of protein(s) that prevent the
      activation of phospholipase A2 by tumor necrosis factor alpha.
AB  - Although there are a limited number of cell lines that are sensitive to cytolysis
      by tumor necrosis factor alpha (TNF alpha), the vast majority are resistant. The
      analysis of TNF alpha-sensitive cells has shown that phospholipase A2 is
      activated by TNF alpha in these cells and that the activity of phospholipase A2
      is required for their cytolysis. Many cell lines that are resistant to TNF alpha
      mediated cytolysis are dependent on the maintenance of protein synthesis for
      their resistance. We have recently shown that this is also true for TNF alpha
      resistant cell lines derived from cervical (ME-180 and SiHa) and ovarian (SK-OV-3
      and OVCAR-3) carcinomas, in that they are sensitive to cytolysis by TNF alpha
      only in the presence of protein synthesis inhibitors. Here we show that the TNF
      alpha-mediated cytolysis of these resistant cell lines in the presence of the
      protein synthesis inhibitor emetine is similar to that of sensitive cells, in
      that cytolysis is inhibited by the inhibitors of phospholipase A2. The
      measurement of the release of radiolabeled material from cervical and ovarian
      carcinoma cell lines prelabeled with [3H]arachidonic acid showed that not only
      was phospholipase A2 required for the cytolysis of these cells by TNF alpha in
      the presence of protein synthesis inhibitors, but more importantly, phospholipase
      A2 was not activated by TNF alpha unless protein synthesis was inhibited. These
      results indicate that a protein synthesis-dependent resistance mechanism
      expressed by these cell lines blocks TNF alpha-mediated cytolysis by preventing
      the activation of phospholipase A2 by TNF alpha.

PMID- 1737349
TI  - cis-Diamminedichloroplatinum(II) induces c-jun expression in human myeloid
      leukemia cells: potential involvement of a protein kinase C-dependent signaling
      pathway.
AB  - cis-Diamminedichloroplatinum(II) (CDDP) is a chemotherapeutic agent known to
      inhibit DNA, RNA, and protein synthesis. The cytotoxicity of this drug is thought
      to result from the formation of DNA intrastrand cross-links. The present work
      demonstrates that treatment of human myeloid leukemia cells (HL-60, U-937, and KG
      1) with CDDP is associated with increased expression of the c-jun gene and that
      this effect is related to activation by a transcriptional mechanism. The results
      also demonstrate that treatment with CDDP is associated with increases in protein
      kinase C (PKC) activity. Furthermore, the finding that pretreatment with H7, an
      inhibitor of PKC, abrogates the effect of CDDP on c-jun expression suggested the
      involvement of PKC in this process. Down-regulation of PKC by prolonged
      pretreatment with 12-O-tetradecanoylphorbol-13-acetate was also associated with
      inhibition of CDDP-induced c-jun expression. The results further demonstrate that
      there is a temporal relationship between the CDDP-induced increase in c-jun
      expression and the occurrence of internucleosomal DNA cleavage characteristic of
      programmed cell death. These findings suggest that c-jun may be involved in the
      cellular response to DNA-damaging agents, such as CDDP, and that this effect may
      be mediated by a PKC-dependent pathway.

PMID- 1737350
TI  - Radiation-induced apoptosis in a murine T-cell hybridoma.
AB  - Induction of an apoptotic cell death was studied in a mouse T-cell hybridoma.
      Apoptosis was induced in these cells following exposure to dexamethasone, X
      radiation, 43 degrees C heat shock, A254 light, and hydrogen peroxide. In 5-Gy
      exposed cells, a radiation-induced G2 phase cell cycle progression block was
      maximum by 8 h. The cells began to escape this progression block by 10 h. Nuclear
      DNA fragmentation and uptake of the vital dye trypan blue began at 12 and 14 h,
      respectively, and were complete by 28 h. X-radiation-induced cell death was
      diminished when cells were irradiated in the presence of dimethyl sulfoxide,
      indicating that cell death was induced by oxidative cell damage. Substitution of
      nuclear DNA with bromodeoxyuridine enhanced death in cells exposed to either X
      radiation or A310 light, indicating that apoptosis could be induced by DNA
      damage. The results are consistent with radiation-induced apoptosis being
      stimulated by oxidative DNA damage. DNA damage stimulates a long-lived signal
      which controls the expression of apoptosis. Apoptosis is expressed in the G1
      phase of the cell cycle subsequent to the cell irradiation.

PMID- 1737351
TI  - Selective tumor localization and improved therapeutic index of anthracyclines
      encapsulated in long-circulating liposomes.
AB  - We have investigated the tissue distribution, toxicity, and antitumor activity of
      anthracyclines encapsulated in hydrogenated phosphatidylinositol (HPI)-containing
      liposomes which show a characteristic long circulation time in plasma (J. Natl.
      Cancer Inst., 81: 1484-1488, 1989). Phosphatidylglycerol (PG)-containing
      liposomes were used for comparison. Doxorubicin (DOX) or epirubicin (EPI) was
      encapsulated in the aqueous interior of small (65-100 nm mean diameter) HPI or PG
      liposomes. The DOX and EPI levels in i.m. tumor implants of the J6456 lymphoma
      were significantly raised by delivery in HPI liposomes but not by delivery in PG
      liposomes. No such increase was observed in normal muscle tissue. When DOX
      encapsulated in HPI liposomes was injected i.v. into BALB/c mice bearing an
      ascitic form of the J6456 lymphoma, more than 10% of the injected dose was
      recovered in the ascitic fluid in liposome-associated form. No significant
      accumulation of liposomal drug was observed in peritoneal washes from tumor-free
      mice. DOX encapsulation in either PG- or HPI-containing liposomes reduced the
      lethal toxicity of the drug in mice. However, only the HPI-DOX formulation was
      significantly more active than free DOX in the treatment of the ascitic J6456
      tumor at all dose levels tested. Therapeutic results with EPI encapsulated in HPI
      liposomes also showed an efficacy superior to that of free EPI. These studies
      provide evidence that anthracyclines delivered in long-circulating liposomes
      extravasate with relative selectivity in tumor areas, improving the overall
      therapeutic index.

PMID- 1737352
TI  - Fludarabine infusion potentiates arabinosylcytosine metabolism in lymphocytes of
      patients with chronic lymphocytic leukemia.
AB  - Our previous work has shown that incubation of K562 cells or lymphocytes from
      patients with advanced chronic lymphocytic leukemia (CLL) with arabinosyl-2
      fluoroadenine (F-ara-A) potentiates the rate of arabinosylcytosine 5'
      triphosphate (ara-CTP) synthesis during subsequent treatment with
      arabinosylcytosine (ara-C). To test the biochemical modulation of ara-CTP in a
      clinical setting, we designed a protocol to administer fludarabine (Fludara, F
      ara-AMP) and ara-C in a pharmacologically directed sequence for patients with CLL
      refractory to conventional fludarabine therapy. ara-C was infused in seven
      patients with progressive CLL at a dose rate that maximizes ara-CTP accumulation
      (0.5 g/m2 during 2 h). Fludarabine (30 mg/m2 during 30 min) was infused 20 h
      later, followed by a second, identical dose of ara-C at 24 h, when the
      concentration of F-ara-A 5'-triphosphate (F-ara-ATP) was maximal in CLL cells.
      Comparison of ara-CTP pharmacokinetics in circulating CLL cells demonstrated that
      the ara-CTP area under the curve increased by a median of 1.5-fold (range, 1.1-
      to 1.7-fold) after fludarabine infusion. Plasma pharmacokinetics indicated that
      neither the median steady-state ara-C concentrations nor the levels of its
      deamination product arabinosyluracil were significantly affected by fludarabine
      infusion. The median rate of ara-CTP elimination was slightly faster after
      fludarabine treatment (t1/2, 6.7 versus 5.8 h), suggesting that catabolism of ara
      CTP was not responsible for the increased ara-CTP area under the curve. The rate
      of ara-CTP accumulation by CLL cells after fludarabine infusion, however, was
      increased by a median of 1.3-fold in seven of the eight patients (range, 1.2- to
      1.8-fold); the peak occurred within 1 h of the end of the infusion. In vitro
      incubation of leukemic lymphocytes with F-ara-A before ara-C also showed a median
      1.3-fold increase in the rate of ara-CTP accumulation. Thus, infusion of
      fludarabine before ara-C augments ara-CTP metabolism in leukemic lymphocytes.
      This knowledge should be considered in the design of combination chemotherapy.

PMID- 1737353
TI  - Development of humoral immune responses against a macrocyclic chelating agent
      (DOTA) in cancer patients receiving radioimmunoconjugates for imaging and
      therapy.
AB  - The development of stable immunoconjugates by the advent of macrocyclic metal
      chelating agents (DOTA) has enabled us to study the ability of 111In-DOTA-labeled
      monoclonal antibodies to detect tumor lesions in a pilot radioimmunolocalization
      study, as well as to evaluate the kinetics, toxicity, and efficacy of i.p.
      administered 90Y-DOTA-labeled murine monoclonal antibody in a Phase I/II clinical
      trial of advanced ovarian cancer. The development of serum sickness-like
      reactions in three of six treated patients, in the absence of previous monoclonal
      antibody administration, led us to study the potential immunogenicity of the new
      chelate. Six patients with ovarian cancer received 25 mg of HMFG1 monoclonal
      antibody coupled with 90Y-DOTA (doses of radioactivity, 15 to 25 mCi),
      administered i.p. Eight patients with various malignant tumors received low doses
      (220 micrograms to 1 mg) of monoclonal antibodies, labeled with 111In-DOTA, i.v.
      for imaging studies. Using a solid-phase enzyme-linked immunosorbent assay
      method, the immunogenicity of DOTA was evaluated. Serial dilutions of patients'
      sera, before and after imaging or therapy with DOTA-coupled monoclonal
      antibodies, as well as sera from patients who did not receive DOTA-coupled
      antibody, were screened on enzyme-linked immunosorbent assay plates coated with
      human serum albumin (HSA), HSA-2-iminothiolane, and HSA-2-iminothiolane-benzyl
      DOTA. All patients treated with i.p. monoclonal antibody developed anti-DOTA
      antibodies. Four of eight patients who received i.v. "imaging" doses of DOTA
      coupled monoclonal antibody developed antibodies against DOTA. The levels of anti
      DOTA response correlated with the amount of injected radioimmunoconjugate (r =
      0.889, P less than 0.001). None of the patients who received DOTA-coupled
      antibody had detectable antibodies against the macrocycle before immunoconjugate
      administration. We then addressed further the restriction of the immune response
      against the macrocycle. We found that there was no or very low response against
      the aromatic ring attached to DOTA. Most, if not all, of the immune response is
      directed against the DOTA ring structure. Affinity purification of anti-DOTA
      antibody from serum enabled quantitation of these antibodies in the serum of
      patients. An inverse, statistically significant correlation was observed between
      the percentage of binding inhibition of a patient's serum to DOTA, by HSA-2
      iminothiolane-DOTA (100 micrograms/ml) and the level of anti-DOTA immunoglobulin
      in the serum.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1737354
TI  - Circadian variation of tumor blood flow in rat subcutaneous tumors and its
      alteration by angiotensin II-induced hypertension.
AB  - Circadian fluctuation in tumor blood flow of the rat subcutaneous tumor was
      investigated. Tumor tissue blood flows in the daytime zone (10 a.m. to 4 p.m.)
      and in the nighttime zone (10 p.m. to 4 a.m.) in both the first phase (doubling
      time of tumor volume = 1.7 days) and the second phase (doubling time of tumor
      volume = 5.7 days) of growth of the LY80 tumor in rats were measured using the
      hydrogen gas clearance technique. In the first phase of tumor growth, the tumor
      blood flow was 20.3 +/- 12.2 ml/min/100 g in the daytime zone (n = 22) and 46.6
      +/- 19.3 ml/min/100 g in the nighttime zone (n = 22). In the second phase, tumor
      blood flow was 9.6 +/- 5.7 ml/min/100 g in the daytime zone (n = 45) and 19.4 +/-
      8.2 ml/min/100 g in the nighttime zone (n = 38). Tumor blood flow in the
      nighttime zone was significantly higher than that in the daytime zone (first
      phase, P less than 0.001; second phase, P less than 0.001). However, there were
      no significant differences in the mean arterial blood pressure, tumor size, and
      body weight of rats between the daytime zone and the nighttime zone. There was
      also a marked difference in the effect of angiotensin II-induced hypertension on
      tumor blood flow between the daytime zone and the nighttime zone. These results
      suggest that circadian fluctuations in tumor blood flow should be carefully
      considered when developing strategies to maximize the effectiveness of cancer
      therapy in relation to the flow rate of circulating blood.

PMID- 1737355
TI  - SMS 201.995 inhibits in vitro and in vivo growth of human colon cancer.
AB  - The effect of a long-acting somatostatin analogue SMS 201.995 (SMS; Sandoz) on
      basal and gastrin-stimulated growth of 4 human colon cancer lines was studied in
      vitro and in vivo. Proliferation assay was done with overnight
      [75Se]selenomethionine uptake after 5 days of incubation. Gastrin concentrations
      used were 5e-10 M and 1e-7 M. SMS concentrations were from 2e-12 M to 2e-7 M.
      Cell lines LIM 1215, LIM 2405, and LIM 2412 were inhibited dose-dependently in
      both basal and gastrin-stimulated groups. LIM 1863 was slightly stimulated. Based
      on in vivo growth characteristics, LIM 2412 and LIM 2405 were selected for
      xenograft study. The dose of 50 micrograms/kg/day was arrived at after a
      preliminary experiment showed it to be safe and effective. The LIM 2412
      xenografts in the SMS-treated animals were 473.3 +/- 99.9 (SD) versus 838.1 +/-
      111.3 mm3 in control (P less than 0.05) after 20 days. The LIM 2405 tumors were
      also significantly inhibited (81.2 +/- 30.0 versus 245.7 +/- 48.3 mm3, P less
      than 0.01). The effect of SMS appeared to be reversible. Oral SMS at 200
      micrograms/kg/day was not absorbed. This study suggests that SMS may have direct
      antitumor effects in human colon cancer.

PMID- 1737356
TI  - Changes in microtubules, microtubule-associated proteins, and intermediate
      filaments during the differentiation of HL-60 leukemia cells.
AB  - The cytoskeleton is composed mainly of microtubules (MT), microfilaments, and
      intermediate filaments (IF) that form a structural network which connects
      cellular membranes, cytoplasmic organelles, and the nucleus. Since the
      cytoskeleton may be involved in modulating signal transduction and in the
      morphological and structural changes that occur during cellular proliferation and
      differentiation, cytoskeletal changes were measured by immunofluorescence
      microscopy and fluorescence-activated cell sorter analysis during the
      differentiation of HL-60 leukemia cells induced by retinoic acid (RA).
      Differentiated HL-60 cells exhibited increased staining intensity and altered
      organization of MT and IF, as visualized by immunofluorescence microscopy with
      anti-tubulin monoclonal antibody and anti-vimentin antibody, respectively. A new
      procedure was developed and used to measure the content of the cytoskeletal
      components of HL-60 cells during the process of maturation. HL-60 cells were
      fixed with formaldehyde in an MT-stabilizing buffer, permeabilized using L
      lysophosphatidylcholine, stained for immunofluorescent measurement with
      antibodies specific for particular cytoskeletal components, and analyzed by flow
      cytometry. Terminally differentiated cells produced by exposure to RA contained
      larger amounts of MT and the IF vimentin. During the course of the maturation
      process, a transient increase in the amounts of the microtubule-associated
      proteins, (MAPs) MAP2 and tau, occurred. An RA-supersensitive clone, designated
      HL-60/S4, and an RA-resistant clone, designated HL-60/R3, were developed by
      mutagenization and selection. Use of these clones supported the concept that the
      observed changes in MT, MAPs, and vimentin were associated with the
      differentiation process rather than being due to other effects produced by the
      retinoid. Thus, the findings suggest that changes in MT, MAPs, and IF are
      important to the terminal maturation of leukemia cells.

PMID- 1737357
TI  - Ploidy and specific karyotypic changes during promotion with phenobarbital,
      2,5,2',5'-tetrachlorobiphenyl, and/or 3,4,3'4'-tetrachlorobiphenyl in rat liver.
AB  - Polychlorinated biphenyls are a group of industrial chemicals that are widely
      distributed in the environment. Since these compounds occur as mixtures, studies
      of their possible interactive effects are important. In order to determine
      whether an interaction of 2,5,2',5'-tetrachlorobiphenyl (TCB) with 3,4,3',4'-TCB
      occurs during multistage hepatocarcinogenesis in vivo, like that previously
      observed in lymphocytes in vitro (L. M. Sargent et al., Mutat. Res., 224: 79-88,
      1989), we exposed rats to a single initiating dose of diethylnitrosamine (DEN),
      10 mg/kg after a 70% partial hepatectomy, and subsequently to 0.1 ppm 3,4,3',4'
      TCB and/or 10 ppm 2,5,2',5'-TCB in the diet for 1 year. Administration of each of
      the TCBs alone after DEN initiation resulted in a low incidence of chromosomal
      damage in hepatocytes; but when the two were given together after DEN initiation,
      there was a more than additive effect on this parameter at both 7 and 12 months
      which was highly significant. Administration of the TCBs alone or in combination
      in the absence of DEN initiation also resulted in chromosomal damage, approaching
      that seen in livers of animals initiated with DEN when sacrificed at 12 months.
      In animals receiving 0.05% phenobarbital for a 12-month period after initiation
      with DEN, a significant degree of chromosomal breakage and fragment formation
      occurred both in hepatocytes expressing the ectoenzyme gamma
      glutamyltranspeptidase (GGT) and in those that were GGT negative. However, the
      GGT-negative cells showed a significantly lower incidence of chromosomal damage
      than the GGT-positive hepatocytes. Exposure to phenobarbital for 7 months after
      DEN initiation resulted in no significant chromosomal damage in hepatocytes,
      whether GGT positive or GGT negative. Some degree of specificity in chromosomal
      alterations was seen in hepatocytes of animals initiated with DEN and promoted
      either with a combination of TCBs or with phenobarbital. The most frequent
      alterations seen were a trisomy of chromosome 1 or of its long arm and a monosomy
      of chromosome 3 or its short arm. Some chromosome 7 aberrations were also seen.
      The highest frequency of specific aberrations occurred in hepatocytes from rats
      that also bore hepatocellular carcinomas, suggestive of the hypothesis that genes
      involved in the development of hepatic carcinoma may reside in chromosome 1
      and/or 3 of the rat.

PMID- 1737358
TI  - Quantitative ultrastructural effects of cisplatin (Platinol), carboplatin (JM8),
      and iproplatin (JM9) on neurons of freshwater snail Lymnaea stagnalis.
AB  - Qualitative and quantitative ultrastructural effects of the platinum compounds
      cisplatin (Platinol), carboplatin (JM8), and iproplatin (JM9) were studied on two
      types of identified peptidergic neuron (caudodorsal cells, light green cells) in
      the pond snail Lymnaea stagnalis. Depending on the parameter under investigation,
      either one or both cell types were studied. Central nervous systems of the snail
      were incubated for 5 and 20 h in various identical and equitoxic drug
      concentrations. Cisplatin had the most severe effects. Platinol, i.e., cisplatin
      dissolved in NaCl solution with the addition of HCl (pH 2.0-3.0), as well as
      cisplatin dissolved in snail Ringer's solution (pH 7.8), caused swelling of axons
      and distensions of the intercellular spaces. This drug induced an increase in
      chromatin clump size in the caudodorsal cells (20-h incubation), while
      carboplatin and iproplatin induced the formation of many small chromatin clumps.
      Incubation in snail Ringer's solution (controls) and cisplatin affect the
      morphology of the nucleoli. At high dosages of cisplatin, the nucleoli of light
      green cells were transformed into homogeneous dense structures. The data indicate
      that platinum compounds react with nuclear and nucleolar DNA. All three drugs
      affected the activity and organization of the rough endoplasmic reticulum and the
      Golgi apparatus of the peptidergic neurons studied (qualitative observations).
      These effects, which point to a reduced neuropeptide synthesis, may be secondary,
      i.e., exerted via inhibition of RNA synthesis and ribosome formation (nucleoli).
      The fact that the number of neuropeptide granules in the cytoplasm of the cells
      remained constant (both cell types) may indicate that granule transport was also
      inhibited. Cisplatin and iproplatin induced an increase in the number of
      lysosomes in the light green cells. The number of lipid droplets in these cells
      was not affected by drug treatment. The results corroborate clinical data
      indicating that cisplatin is highly neurotoxic. Despite conflicting clinical
      data, observations on the snail neurons suggest that iproplatin is also
      neurotoxic, although less than cisplatin. Carboplatin is minimally neurotoxic,
      which is in accordance with clinical data. The central nervous system of Lymnaea
      is a suitable model for studying possible neurotoxic effects of platinum
      compounds.

PMID- 1737359
TI  - Quantitative mapping of 4'-iododeoxyrubicin in metastatic squamous cellcarcinoma
      by secondary ion mass spectrometry (SIMS) microscopy.
AB  - Secondary ion mass spectrometry microscopy enables quantitative mapping of
      chemical elements in tissue sections. It was used for the detection of 127I
      contained in 4'-iododeoxyrubicin (IDX). Metastatic cutaneous squamous cell
      carcinoma from 7 patients participating in a phase I study (IDX dose, 80 mg/m2,
      10-min i.v. infusion) were biopsied 10 min after drug administration and compared
      to 3 controls who did not receive any treatment (one squamous cell carcinoma and
      2 gastric carcinomas). Biopsy specimens were fixed and embedded in methacrylate
      resin. Then, serial semithin sections (3 microns) were analyzed simultaneously
      with ionic and optimal microscopes in order to identify the histological
      structures given by the 31P distribution in which 127I in IDX was mapped. The
      iodine signal was undetected in controls and found mainly in the nuclei of tumor
      cells of the treated patients. Its concentration, measured in at least 30 nuclei
      of each specimen, was undetectable in 8% of the nuclei and 91% of them were
      within 1 and 16 ng/mg. The mean concentration of each specimen ranged from 5 to
      23 ng/mg. This study demonstrates the capacity of ion microscopy to localize a
      cytotoxic drug (IDX) in a human biopsy specimen without the need for radioactive
      labeling and enables the evaluation of drug penetration in cancer cells which is
      critical for its activity.

PMID- 1737360
TI  - Chemically induced forestomach papillomas in transgenic mice carry mutant human c
      Ha-ras transgenes.
AB  - Forestomach papillomas and skin papillomas were induced very efficiently by a
      single dose administration of the chemical carcinogen methylnitrosourea (MNU) in
      transgenic mice (rasH2 line) carrying human hybrid c-Ha-ras genes, which encode
      the prototype p21 gene product. The incidence of forestomach papillomas was dose
      dependent; when 50 mg/kg of MNU were administered i.p., all of the transgenic
      mice (56 of 56) developed forestomach papillomas within 12 weeks after
      administration, whereas 5 and 0.5 mg/kg of MNU induced papillomas in 2 of 19 and
      1 of 19 mice, respectively. Nine of 56 transgenic mice (16%) also developed skin
      papillomas at sites wounded by bites or scratches. Only 1 of 77 nontransgenic
      littermates developed forestomach papillomas after administration of 50 mg/kg of
      MNU, and no skin papillomas appeared within 12 weeks after MNU administration.
      The transgenes (integrated copy number, 5-6) in the tumors developed in 55 of 56
      affected transgenic mice (98%) contained at least 1 copy of the transgene that
      was activated by somatic point mutation at the 12th codon, from GGC (Gly) to GAC
      (Asp). Because somatic point mutations at the 12th or 61st codon of transgenes
      have never been detected in normal tissues of transgenic mice thus far examined,
      these mutational activations of transgenes are tumor-specific events. RNA
      expression of these activated transgenes was also detected. From these results,
      it is suggested that somatic mutational activation of the human c-Ha-ras
      transgene plays a causative role in the occurrence of forestomach and skin
      papillomas induced by MNU administration in these transgenic mice. This
      transgenic mouse provides a unique screening system for chemicals that induce or
      suppress papillomagenesis.

PMID- 1737361
TI  - Control of Ha-ras-mediated mammalian cell transformation by Escherichia coli
      regulatory elements.
AB  - Inducible eukaryotic promoters, particularly those responsive to glucocorticoids
      or heavy metals, have been extensively used to study the consequences of
      induction of a target gene in mammalian cells. An alternative approach, intended
      to improve the selectivity of gene induction and to minimize perturbation of
      chromatin structure, is to utilize elements from prokaryotic regulatory systems
      that are unlikely to be shared by mammalian cells. We and others previously have
      shown that the lac repressor can function in mammalian cells and repress
      expression of a reporter gene controlled by a eukaryotic promoter containing a
      lac operator sequence. The reporter gene can be specifically activated by
      administration of the lactose analogue isopropyl beta-D-thiogalactoside. The
      target genes tested so far encode the biochemical and histochemical markers,
      chloramphenicol acetyltransferase and beta-galactosidase. As a model system to
      establish whether or not the lactose regulatory system can also be used to
      effectively modulate a cellular phenotype, NIH 3T3 cells were made transgenic for
      a constitutively expressed lacI gene, encoding lac repressor, and an activated
      human Ha-ras gene directed by a simian virus 40 promoter within which a lac
      operator sequence had been embedded. In the absence of inducer, cells were
      phenotypically untransformed. Consequent to isopropyl beta-D-thiogalactoside
      administration, four biological end points characteristic of a transformed
      phenotype were observed. Consistent with transformation, the cells assumed an
      altered morphology; they displayed a reduced density inhibition of growth; they
      acquired the capacity to grow in soft agar; and they were released from a G0
      block following serum deprivation. The data demonstrate that regulation of gene
      expression in mammalian cells by the lactose regulatory system affords a
      sensitive means for modulating cellular phenotype.

PMID- 1737362
TI  - Aflatoxin-transformed C3H/10T1/2 cells overexpress protein kinase C and have an
      altered response to phorbol ester treatments.
AB  - The aflatoxin B1-transformed C3H/10T1/2 (10T1/2) cell line 7SA has disordered
      growth in culture and is tumorigenic in syngeneic mice. Chronic exposure (14
      days) of 10T1/2 and 7SA cells to phorbol 12,13-dibutyrate (PDBu) increased the
      saturation density of 10T1/2 cells but dramatically slowed the entry of 7SA cells
      into the log phase of growth without affecting their final saturation density.
      Similar PDBu treatment of low-density cultures dramatically decreased the size of
      7SA colonies. Both cell lines bound [3H]PDBu in a specific and saturable manner.
      Analysis of this binding yielded linear Scatchard plots for both cell lines with
      distinctly different Kd values (10.7 nM for 10T1/2 versus 54.5 nM for 7SA). The
      total amount of [3H]PDBu bound was 2-fold greater in the 7SA cells versus the
      10T1/2 cell line. Both cell lines released arachidonic acid following a 2-h
      exposure to PDBu; however, the magnitude of the response of the 7SA cells was
      only one-half that of the 10T1/2 cells. Western blot analysis of protein kinase C
      (PKC) using specific anti-PKC antibodies revealed a greater total amount of PKC
      alpha in the 7SA cells relative to an equal number of 10T1/2 cells. No
      immunoreactive PKC alpha was found in either cell line 16 h after exposure to 600
      nM PDBu; however, PKC alpha returned to control levels in both cell lines 24 h
      after removal of the phorbol ester. These results suggest that an overexpression
      of PKC alpha may play a role in the altered biological properties of aflatoxin
      transformed 10T1/2 cells.

PMID- 1737363
TI  - Microfilament-disrupting agents prevent the formation of apoptotic bodies in
      tumor cells undergoing apoptosis.
AB  - Apoptosis is a form of cell death in which the cell "participates," such that
      metabolic energy and often protein synthesis are required for the death to occur.
      Once begun, the process of apoptosis proceeds in an ordered fashion. In the
      earliest phase DNA fragmentation occurs, accompanied by cell shrinkage and
      dilation of the endoplasmic reticulum. This is followed by cell fragmentation
      with the formation of sealed membrane vesicles, termed apoptotic bodies. In the
      present study we have demonstrated that the fungal metabolite cytochalasin B
      inhibits cell fragmentation and the formation of apoptotic bodies, probably by
      its ability to interfere with actin polymerization. This effect was seen when HL
      60 cells were pretreated with cytochalasin B and then exposed to one of a number
      of apoptosis-inducing agents, including UV irradiation, camptothecin,
      aphidocholin, or PMA plus ionomycin. The observed effect was not peculiar to HL
      60 cells, inasmuch as it was also seen for both Molt-4 and U-937 cell lines.
      Cytochalasin B had no effect on DNA fragmentation occurring in the earliest stage
      of apoptosis, and it appeared to have no inhibitory effects on nuclear
      fragmentation. Staurosporin had an effect similar to that seen with cytochalasin
      B, probably due to its ability to inhibit protein kinase C, which is a known
      potentiator of microfilament assembly. These data demonstrate that microfilament
      assembly is necessary for the formation of apoptotic bodies in the later stages
      of the apoptotic process.

PMID- 1737364
TI  - Mechanism of interferon action in hairy cell leukemia: a model of effective
      cancer biotherapy.
AB  - Hairy cell leukemia (HCL) is one of the few malignancies for which alpha
      interferon (IFN alpha) is considered effective first-line therapy. However, the
      mechanisms of action of this agent in vivo have been the subject of much debate;
      in particular, the issue of whether clinical improvement in IFN-alpha-treated HCL
      patients is dependent upon enhancement of host defenses or upon direct actions of
      IFN alpha upon the hairy cell remains unresolved. In this review, we examine the
      evidence supporting both lines of argument and synthesize this information within
      the framework of clinical studies of IFN alpha in HCL, the purpose being to
      determine which proposed mechanisms of IFN alpha action are indeed effective in
      vivo. From our analysis, it appears that the beneficial effects of IFN alpha upon
      immune function are important in decreasing the frequency of infectious
      complications of HCL but that these effects are probably not responsible for
      hairy cell elimination and cannot therefore account for major responses to IFN
      alpha therapy. We conclude that the primary mechanism of action of IFN alpha in
      HCL involves the induction of hairy cell differentiation towards a stage less
      responsive to growth factor stimulation, the primary consequence being
      proliferative inhibition. These effects may mimic events that occur during normal
      lymphocyte development, suggesting that the benefits of biotherapeutic agents
      might best be harnessed via studies of the effects of multiple and sequential
      biological response modifiers upon the growth and differentiation patterns of
      normal and malignant cells. Hairy cell leukemia could thus serve as an excellent
      model in which to investigate combined cancer biotherapy; the implications of our
      present understanding of IFN alpha in HCL to the biotherapy of cancer are
      discussed.

PMID- 1737365
TI  - Cooperative estrogen receptor interaction with consensus or variant estrogen
      responsive elements in vitro.
AB  - Specific binding of estradiol-liganded, partially purified calf uterine estrogen
      receptor (ER) to a 38-base pair estrogen responsive element (ERE) consensus
      sequence, containing the inverted repeat 5'-GGTCAnnnTGACC-3', was measured in
      vitro. The ERE sites were inserted as single or multiple tandem copies in a
      plasmid vector [p GEM-7Zf(+)]. Results showed that one dimeric ER can interact
      with one ERE, and steric constraints do not inhibit binding of ER to adjacent
      EREs. Molybdate-stabilized monomeric (4S) ER did not bind to EREs. ER bound to
      single and tandem double EREs with Kd values of 0.24 and 0.23 nM, respectively.
      When the plasmid contained three or more tandem copies of the ERE, ER bound in a
      cooperative manner, as indicated by convex Scatchard plots and Hill coefficients
      greater than 1.5. To determine those characteristics of the consensus sequence
      that are important for maximal high-affinity ER binding, ten variant ERE oligomer
      sequences were synthesized and cloned into pGEM-7Zf(+) as single copies or as
      four copies in tandem. ER binding affinity was maximal for the consensus ERE and
      was reduced for variants containing one or two nucleotide changes in the inverted
      repeat. The number of nucleotides separating the inverted repeat in the ERE was
      critical for high-affinity ER binding. Certain sequence-variant EREs when cloned
      as single copies bound less ER compared to the consensus ERE, yet when cloned as
      four tandem copies, ER binding displayed cooperativity by Scatchard and Hill
      analyses. Results demonstrate that cooperative interactions noted in vivo by
      others are present when measured in vitro. Results strongly imply that the
      number, spacing, and nucleotide sequence of EREs could precisely control the
      amount of ER binding to estrogen-responsive genes.

PMID- 1737366
TI  - Interferon-stimulated genes in interferon-sensitive and -resistant chronic
      myelogenous leukemia patients.
AB  - alpha-Interferon induces hematological and cytogenetic remissions in some
      individuals with newly diagnosed Philadelphia-positive chronic myelogenous
      leukemia. However, interferon-resistant disease occurs in a consistent patient
      subset (primary resistance) and develops during therapy in additional patients
      (secondary resistance). Several alpha-interferon-inducible genes have been
      characterized. In interferon-resistant cell line variants, defects in these genes
      have been implicated in the mechanisms mediating resistance. We have, therefore,
      evaluated mRNA expression of four interferon-stimulated genes (ISGs) following
      alpha-interferon therapy. Twenty-seven chronic myelogenous leukemia patients (ten
      interferon-sensitive patients, 17 interferon-resistant patients) were studied.
      Peripheral blood samples were collected prior to and 1 to 7 days after starting
      interferon therapy and analyzed for the expression of 2'-5' oligoadenylate
      synthetase, ISG-15, ISG-54, and 6-16 transcripts. Following therapy with alpha
      interferon, 2'-5' oligoadenylate synthetase, ISG-54, and 6-16 transcripts were
      discerned in all patients regardless of their response to interferon. The ISG-15
      message was detected in eight of nine interferon-sensitive and in 15 of 16
      interferon-resistant patients, as well. Overall, no consistent defect in the ISG
      system could be identified. Therefore, lack of induction of these genes cannot
      explain resistance to alpha-interferon in chronic myelogenous leukemia patients.
      Other mechanisms such as posttranslational modification, leading to defects in
      the ISG corresponding proteins, may play a role in the development of resistance.

PMID- 1737367
TI  - Influence of intracellular glutathione on selenite-mediated growth inhibition of
      canine mammary tumor cells.
AB  - The present studies demonstrate that the ability of supplemental selenite to
      alter the in vitro growth of canine mammary tumor cell line 13 was dependent on
      the quantity and duration of selenium exposure and on the culture density.
      Exposure to 3.2 microM selenite did not significantly alter growth but led to an
      increase in intracellular glutathione (GSH). The severity of growth inhibition
      between 3.2 and 9.6 microM selenite was dependent on the duration of exposure and
      culture density. The toxicity of selenite generally increased as the culture
      density increased. Likewise, changes in intracellular GSH were dependent on the
      quantity and duration of selenite exposure and the culture density. Depressing
      intracellular GSH by increasing the culture density or by incubating with
      buthionine sulfoximine; a specific inhibitor of gamma-glutamyl cysteine
      synthetase, increased the severity of growth inhibition caused by selenite and
      markedly increased cellular retention of selenium. Nevertheless, marked cellular
      retention of selenium did not occur until growth was inhibited by more than 50%.
      The present studies revealed that the log of the molar ratio of GSH to selenium
      correlated negatively with the severity of growth inhibition (P less than
      0.0001). These studies suggest that cellular toxicity of selenite is dependent on
      the regulation of the GSH:selenium ratio. An inability to regulate this ratio
      likely leads to the accumulation of toxic seleno compounds.

PMID- 1737368
TI  - No change in repair capacity of mouse lung irradiated three months after a single
      dose of cyclophosphamide.
AB  - The repair capacity of mouse lung was determined at 3 months after a single i.p.
      injection of cyclophosphamide (Cy) at a maximally tolerated dose of 275 mg/kg.
      Mice were irradiated to the whole thorax only with 1, 2, 9, or 15 fractions of X
      rays using doses/fraction ranging from 1.2 to 11 Gy. Breathing rate (breaths per
      minute), histology and pulmonary mortality were used to assess lung damage. Raw
      breathing rate data were converted to quantal response data by scoring the number
      of mice in each dose group in each fractionation schedule with a breathing rate
      1.3 times the breathing rate of control mice. Dose-response curves of mortality
      and the converted breathing rate data were constructed at 15 weeks after
      irradiation (approximately 28 weeks after drug treatment) fitted by logit
      analysis and 50% effective doses with 95% confidence limits obtained. Values of
      alpha/beta were obtained by using the direct analysis method of H. D. Thames et
      al. (Int. J. Radiat. Biol., 49:999-1009, 1986). The alpha/beta for mice given Cy
      3 months before radiation was 3.69 Gy (95% confidence limits, 2.83, 4.69 Gy) and
      3.06 Gy (95% confidence limits, 2.31, 3.99 Gy) for the lethality data and
      breathing rate data, respectively. These alpha/beta values are in good agreement
      with the previously published ranges of alpha/beta of 3 to 4 Gy for mouse lung
      not given Cy previously. Because the repair capacity of the target cells of a
      tissue govern the fractionation response and choice of fractionation regimen in
      clinical radiotherapy, these data indicate that the fractionation regimen used
      can remain the same as that used in non-drug-treated lungs when the lung is
      irradiated 3 months after exposure to Cy.

PMID- 1737369
TI  - Cellular mechanisms associated with the lack of chronic thermotolerance
      expression in HeLa S3 cells.
AB  - Chronic thermotolerance is an operational definition for that resistance to cell
      killing by heat which develops during a protracted exposure at temperatures
      generally in the range of 41.5-42.5 degrees C which is usually observed as a
      reduction in the slope of the survival curve. While Chinese hamster ovary (CHO)
      cells are generally more sensitive to high-temperature heat shock than HeLa
      cells, studies of cells maintained in suspension culture at 41.5 degrees C
      demonstrated CHO cells to be more resistant to cell killing at this temperature
      than HeLa cells, due to the expression of chronic thermotolerance in the hamster
      cell line and the corresponding lack of chronic thermotolerance expression in the
      HeLa cell line. Experiments were conducted in the two cell lines while heating
      under identical conditions, in order to detect any cell line-specific changes in
      heat-induced perturbation of cell cycle progression and the expression of chronic
      thermotolerance. Our results showed that CHO cells exhibited a G1 block which
      lasted throughout the course of the 32-h heating period. HeLa cells, however,
      failed to accumulate in G1, progressing instead into S phase where spontaneous
      premature chromosome condensation and nuclear fragmentation were observed. This
      accumulation of cells with condensed chromatin possessing S-phase DNA content
      exhibited a linear, one-to-one functional relationship with the fraction of dead
      cells. Previous studies (M.A. Mackey and W.C. Dewey, Int. J. Hyperthermia, 5:405
      415, 1989) demonstrated that synchronized S-phase CHO cells heated at 41.5
      degrees C and 42 degrees C were unable to express chronic thermotolerance.
      Therefore, we hypothesize that progression of cells out of G1 phase into S and G2
      M phases leads to lethal processes that prevent the expression of chronic
      thermotolerance in the HeLa cell line. This hypothesis is strengthened by the
      observed correlation between the accumulation of "mitotic-like" cells and
      decreased survival, suggesting that the G1 block observed in CHO cells is
      causally connected with the expression of chronic thermotolerance.

PMID- 1737370
TI  - c-myc amplification is a better prognostic factor than HER2/neu amplification in
      primary breast cancer.
AB  - Amplification of the c-myc and HER2/neu genes was found in 20 and 23%,
      respectively, of primary breast cancer tissues derived from 282 patients (median
      follow-up, 74 months). c-myc amplification was observed more frequently in larger
      tumors (P = 0.01) and in lymph node-positive patients (P = 0.01) but was not
      associated with age, menopausal status, or with differentiation grade or steroid
      receptor status. c-myc amplification was strongly negatively correlated with
      HER2/neu amplification (P less than 0.001). In univariate analysis, amplification
      of c-myc proved to be a significant predictor of reduced relapse-free and overall
      survival (for both, P less than 0.001). In multivariate analysis for relapse-free
      survival, c-myc amplification significantly (P = 0.001) added to the prognostic
      power of tumor size (P less than 0.001), lymph node status (P less than 0.001),
      and estrogen receptor status (P = 0.003), with the highest relative failure rate
      (1.8) after lymph node status (2.2). In this pilot study, c-myc amplification was
      predictive for outcome, especially among patients with node-negative disease or
      steroid receptor-positive tumors; 51 and 46% differences in actuarial 5-year
      recurrence rates when compared to patients with tumors with normal c-myc gene
      copy numbers, respectively. HER2/neu amplification was not associated with
      relapse-free survival but weakly with shorter overall survival in univariate
      analysis (P = 0.035). Only in the relatively small subgroup of steroid receptor
      negative tumors, HER2/neu amplification may identify those patients with an
      increased risk of death. In conclusion, amplification of c-myc is an independent
      powerful prognosticator, particularly in node-negative and steroid receptor
      positive breast cancer, whereas HER2/neu amplification may be of limited
      prognostic value, only in steroid receptor-negative disease.

PMID- 1737371
TI  - Cytokine responses to intraventricular injection of interleukin 2 into patients
      with leptomeningeal carcinomatosis: rapid induction of tumor necrosis factor
      alpha, interleukin 1 beta, interleukin 6, gamma-interferon, and soluble
      interleukin 2 receptor (Mr 55,000 protein).
AB  - Interleukin 2 (IL-2) is a potent immunostimulant that causes the release of
      secondary cytokines and the production of lymphokine-activated killer cells. We
      investigated the cellular and cytokine responses to injection of recombinant
      human IL-2 into the human cerebrospinal fluid of 11 patients with metastatic
      tumors involving the spinal or cerebral leptomeninges. After initial
      intraventricular IL-2 administration (1.25 x 10(5) to 2 x 10(6) Cetus
      units/injection), cerebrospinal fluid samples were collected at intervals from 0
      to 24 h. Enzyme-linked immunosorbent assay results indicated that IL-2 levels
      gradually decreased during the first 24 h, with an average t1/2 between 4 and 8
      h. Induction of tumor necrosis factor alpha, interleukin 1 beta, interleukin 6,
      gamma-interferon, and interleukin 2 receptor (p55) was also assessed by enzyme
      linked immunosorbent assay. Tumor necrosis factor alpha and interleukin 6 levels
      peaked at 2 to 4 h and 4 to 6 h, with concentrations between 71 to 1,714 pg/ml
      and 942 to 10,500 pg/ml, respectively. Interleukin 1 beta, gamma-interferon, and
      soluble IL-2 receptor peaked later, during 6 to 12 h; the levels achieved were
      234 pg/ml, 25 NIH units/ml, and 207 units/ml, respectively. All cytokine
      concentrations returned to near baseline between 12 and 24 h; however, the
      soluble IL-2 receptor levels remained elevated. Additional observations included
      a rapid influx of neutrophilic leukocytes, followed by a prolonged presence of
      lymphocytes. These data indicate a broad and complex potential of the immune
      response in the central nervous system, as well as further define the cytokine
      cascade in response to IL-2 alone.

PMID- 1737372
TI  - Human lymphoblastoid cells with acquired resistance to C2-desamino-C2-methyl-N10
      propargyl-5,8-dideazafolic acid: a novel folate-based thymidylate synthase
      inhibitor.
AB  - We describe the characterization of human lymphoblastoid cell lines with acquired
      resistance (greater than 20,000-fold) to a novel folate-based thymidylate
      synthase (TS) (EC 2.1.1.45) inhibitor, C2-desamino-C2-methyl-N10-propargyl-5,8
      dideazafolic acid (ICI198583). This acquired resistance was associated with a 64
      fold amplification of the TS gene, a similar elevation in the corresponding mRNA,
      and an approximately 200-fold increase in both TS activity and TS protein. This
      amplification was maintained when the cells were grown in the absence of the
      selective agent, ICI198583, for 340 generations. TS isolated from one of the
      resistant cell lines, W1-L2:C1, displayed inhibition kinetic parameters similar
      to those of TS isolated from the parent W1-L2 cell line. It thus appears unlikely
      that resistance is due to an altered TS enzyme having a lower affinity for
      ICI198583. The resistant cell line, W1-L2:C1, was cross-resistant to other folate
      based TS inhibitors but was as sensitive as the parent cell line, W1-L2, to 5
      fluorodeoxyuridine. The W1-L2:C1 cell line was collaterally sensitive to the
      classical dihydrofolate reductase (EC 1.5.1.3) inhibitor methotrexate as well as
      to the lipophilic dihydrofolate reductase inhibitors metoprine and 2,4-diamino-5
      methyl-6-[(3,4,5-trimethoxyanilino)methyl]quinazolin e glucuronic acid salt (also
      called trimetrexate). When the W1-L2 and W1-L2:C1 cell lines were exposed to 1
      microM ICI198583 for 24 h they accumulated the same concentration of total
      cellular ICI198583 polyglutamates despite the fact that the latter cell line
      accumulated a 300-fold greater concentration of ICI198583 monoglutamate. As
      polyglutamates, the tetra- and pentaglutamate forms predominated in the W1-L2
      cell line, whereas the diglutamate form predominated in the W1-L2:C1 cell line,
      with few higher polyglutamates being detected. The lack of tri- and higher
      polyglutamates of ICI198583 (i.e., the more active species) in the W1-L2:C1 cell
      line may also contribute to the observed resistance. These findings may have
      important implications in light of the rapid onset of resistance to antifolates
      in the clinic.

PMID- 1737373
TI  - Expression of O6-methylguanine-DNA methyltransferase in six human medulloblastoma
      cell lines.
AB  - Six well characterized human medulloblastoma cell lines (D283 Med, Daoy, D341
      Med, D384 Med, D425 Med, and D458 Med) were examined for the expression of O6
      methylguanine-DNA methyltransferase (MGMT) by activity and Western and Northern
      blot analysis. High levels of MGMT activity were present in D283 Med, Daoy, D341
      Med, and D384 Med (1.36, 0.80, 1.68, and 1.62 pmol/mg of protein, respectively),
      but negligible MGMT activity was detected in D425 Med and D458 Med (0.06 and 0.05
      pmol/mg of protein, respectively), which were derived separately at different
      times from the same patient. The presence of MGMT protein and its transcript was
      demonstrated in D283 Med, Daoy, D341 Med, and D384 Med, but both the protein and
      the mRNA were undetectable in D425 Med and D458 Med. Nevertheless, all six cell
      lines contained an apparently unaltered MGMT gene, as determined by Southern blot
      analysis. The absence of MGMT activity in D425 Med and D458 Med is likely due to
      the absence of the protein, resulting from a lack of transcription of the MGMT
      gene. The varying levels of expression of MGMT in medulloblastoma cells found in
      this study should provide a molecular basis for drug design and selection in
      chemotherapy of this tumor.

PMID- 1737374
TI  - Biotransformation in carcinogen-induced diploid and polyploid hepatocytes
      separated by centrifugal elutriation.
AB  - Biotransformation in carcinogen-induced diploid and polyploid hepatocytes was
      studied using isozyme-selective substrates for several enzyme pathways. Diploid
      hepatocytes were induced by partial hepatectomy, a single injection of
      diethylnitrosamine, and 4 weeks of 2-acetylaminofluorene (2-AAF) feeding. Then,
      after an additional 3-5 weeks on the control diet, diploid and polyploid
      hepatocytes were separated from freshly isolated hepatocytes by centrifugal
      elutriation. Benzo(a)pyrene hydroxylase, ethoxyresorufin O-deethylase, and
      methoxycoumarin O-demethylase activities were approximately 15-40% lower in the
      diploid hepatocyte fraction than in the polyploid cell fraction. Activities of 1
      chloro-2,4-dinitrobenzene, glutathione S-transferase, 3-hydroxy-benzo(a)pyrene or
      4-hydroxybiphenyl UDP-glucuronosyltransferase, and DT-diaphorase were not
      different in the two cell fractions. Determination of activity during the 2-AAF
      treatment indicated that 2-AAF increased 7-ethoxyresorufin O-deethylase and 3
      hydroxybenzo(a)pyrene glucuronosyltransferase activities by 300 and 200%,
      respectively, in both the diploid and polyploid hepatocyte fractions.
      Administration of phenobarbital for 4 days at the end of the control diet period
      increased ethoxyresorufin and methoxycoumarin dealkylations by 2- and 4-fold, and
      3-hydroxybenzo(a)pyrene glucuronidation and 1-chloro-2,4-dinitrobenzene
      conjugation with glutathione by 1.5- to 2-fold in both hepatocyte fractions.
      Slight increases in benzo(a)pyrene hydroxylation and 4-hydroxybiphenyl
      glucuronidation were also evident in diploid cells. Although there is a slight
      decrease in cytochrome P-450-dependent monooxygenase activities, these data
      indicate that carcinogen-induced diploid hepatocytes do not show the typical
      toxicant-resistant phenotype observed in preneoplastic hepatocytes of altered
      liver foci, which are characterized by large decreases in monooxygenase
      biotransformations as well as increased activities of several phase II enzymes.
      This finding is compatible with the hypothesis that 2-AAF-induced nonploidizing
      growth of diploid hepatocytes is caused by nontoxic mechanisms in the present
      experimental paradigm. In addition, carcinogen-induced diploid cells respond to
      phenobarbital in a manner similar to that of polyploid hepatocytes.

PMID- 1737375
TI  - Inhibitory effect of green tea in the drinking water on tumorigenesis by
      ultraviolet light and 12-O-tetradecanoylphorbol-13-acetate in the skin of SKH-1
      mice.
AB  - Green tea was prepared by extracting 12.5 g of green tea leaves twice with 500 ml
      of boiling water, and the extracts were combined. This 1.25% green tea extract
      (1.25 g of tea leaves/100 ml of water) contained 4.69 mg of green tea extract
      solids per ml and was similar in composition to some green tea beverages consumed
      by humans. A 2.5% green tea extract (2.5 g of tea leaves/100 ml of water) was
      prepared similarly. Treatment of female SKH-1 mice with 180 mJ/cm2 of ultraviolet
      B light (UVB) once daily for 7 days resulted in red sunburn lesions of the skin.
      The intensity of red color and area of these lesions were inhibited in a dose
      dependent fashion by the administration of 1.25 or 2.5% green tea extract as the
      sole source of drinking water before and during UVB treatment. Treatment of
      female SKH-1 mice with 180 mJ/cm2 of UVB once daily for 10 days followed 1 wk
      later by twice weekly application of 12-O-tetradecanoylphorbol-13-acetate for 25
      wk resulted in the development of skin tumors. The formation of skin tumors was
      inhibited by administration of 1.25% green tea extract as the sole source of
      drinking water prior to and during the 10 days of UVB treatment and for 1 wk
      after UVB treatment. In additional experiments, female SKH-1 mice were treated
      with 200 nmol of 7,12-dimethylbenz(a)anthracene followed 3 wk later by
      irradiation with 180, 60, or 30 mJ/cm2 of UVB twice weekly for 30 wk. UVB-induced
      formation of skin tumors and increased spleen size were inhibited by
      administration of 1.25% green tea extract as the sole source of drinking water
      prior to and during the 30 wk of UVB treatment. In these experiments, treatment
      of the animals with the green tea extract not only decreased the number of skin
      tumors but also decreased substantially the size of the tumors. In additional
      studies, SKH-1 mice were initiated by topical application of 200 nmol of 7,12
      dimethylbenz(a)anthracene followed by twice weekly application of 12-O
      tetradecanoylphorbol-13-acetate for 25 wk. Administration of 1.25% green tea
      extract as the sole source of drinking water during promotion with 12-O
      tetradecanoylphorbol-13-acetate reduced the number and incidence of skin tumors.

PMID- 1737376
TI  - Effect of O6-benzylguanine on the sensitivity of human tumor xenografts to 1,3
      bis(2-chloroethyl)-1-nitrosourea and on DNA interstrand cross-link formation.
AB  - We have previously shown that O6-benzylguanine can be used to deplete cells of
      the DNA repair protein O6-alkylguanine-DNA alkyltransferase and to enhance the
      sensitivity of human glioma (SF767) and colon tumor (HT29) cells to the cytotoxic
      effects of alkylnitrosoureas. In the present study, the combination of O6
      benzylguanine and 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) was evaluated in
      vitro to determine the number of DNA interstrand cross-links formed and in vivo
      to compare the therapeutic index with that of BCNU alone. The number of DNA
      interstrand cross-links, as measured by alkaline elution, was increased in HT29
      cells treated with 10 microM O6-benzylguanine for 2 h prior to BCNU exposure
      compared to cells treated with BCNU only. The number of single strand breaks was
      not increased by prior exposure to O6-benzylguanine. To evaluate the therapeutic
      index, HT29 and SF767 cells were grown as xenografts in nude mice and the tumor
      growth rate after treatment with BCNU alone was compared with the rate after
      treatment with O6-benzylguanine and BCNU. Treatment was administered i.p. when
      tumors reached 100-200 mm3. For animals bearing HT29 xenografts that were treated
      with 60 mg/kg O6-benzylguanine 1 h prior to 20 mg/kg BCNU, the average time for
      tumor volume to increase by 200% was 25 days, compared to 10 days for animals
      treated with 20 mg/kg BCNU alone. For animals bearing SF767 xenografts, the tumor
      growth of controls was not significantly different from that of animals treated
      with O6-benzylguanine alone or BCNU alone up to the maximally tolerated dose (50
      mg/kg). For these 3 groups, the average time for tumors to reach 300 mm3 was 9-12
      days. However, when animals were treated with 80 mg/kg O6-benzylguanine 1 h prior
      to receiving 20 mg/kg BCNU tumor size did not increase for at least 21 days. Our
      studies demonstrate that the therapeutic index of BCNU can be increased when
      given in combination with O6-benzylguanine.

PMID- 1737377
TI  - Metabolism and DNA binding of 2-nitropyrene in the rat.
AB  - 2-Nitropyrene (2-NP), a contaminant of ambient air, is a potent bacterial mutagen
      in the Ames assay and induces leukemia/lymphoma in female Sprague-Dawley rats. To
      understand the mechanistic basis for its tumorigenic activity, it is essential to
      elucidate the metabolic pathways of 2-NP in vivo. Such knowledge will also assist
      in developing analytical methods for monitoring human exposure to
      nitropolynuclear aromatic hydrocarbons in ambient air. Thus, 2-nitro[U-4,5,9,10
      14C]pyrene was synthesized and administered to male F344 rats by intragastric
      gavage at a dose of 30 mg (0.4 mCi/mM)/kg body weight. During the first 48 h,
      57.5% of the dose was eliminated in the feces and 9.7% was eliminated in the
      urine. Correspondingly, after 168 h, 58.9 and 10.6% were excreted in feces and
      urine, respectively. Fecal metabolites (isolated amounts) included 6-hydroxy-2
      acetylaminopyrene (19.5%), 6-hydroxy-2-aminopyrene (10.4%), 2-aminopyrene
      (10.0%), 2-acetylaminopyrene (0.8%), and unmetabolized 2-nitropyrene (10.0%). 6
      Hydroxy-2-acetylaminopyrene, 6-hydroxy-2-aminopyrene, and 2-aminopyrene were
      identified as their acetyl derivatives by comparison of their chromatographic
      retention times, mass spectra, and UV spectra to those of synthetic standards.
      Urinary metabolites included 6-hydroxy-2-acetylaminopyrene (2.0%); glucuronide
      conjugates were tentatively identified (3.2%). The results of this study indicate
      that nitroreduction and ring oxidation are metabolic pathways in vivo. For DNA
      binding studies, rats were treated with 2-nitro[4,5,9,10-3H]pyrene [1.6 mg (598
      mCi/mM)/kg body weight]. The levels of binding (pM bound/mg DNA) were as follows:
      1.3, liver; 1.14, mammary tissue; 0.65, lung; 1.67, kidney; and 1.8, bladder.
      Upon high-performance liquid chromatographic analysis of the DNA hydrolysate
      (liver, mammary, and kidney), approximately 2.0% of the radioactivity coeluted
      with the synthetic markers derived from nitroreduction, N-(deoxyguanosin-8-yl)-2
      aminopyrene and N-(deoxyadenosin-8-yl)-2-aminopyrene. Thus, simple nitroreduction
      of 2-NP does not significantly contribute to the total DNA binding of 2-NP
      metabolites in vivo. The significance of each pathway for the tumorigenic effects
      of 2-NP remains to be examined.

PMID- 1737378
TI  - Growth-inhibitory action of an estrogen-chlorambucil conjugate (KM2210) in human
      breast cancer cell line MCF-7: its relation to reduction of estrogen receptor and
      transforming growth factor-alpha secretion.
AB  - We investigated the effects of a benzoate of an estradiol-chlorambucil conjugate
      (KM2210) and chlorambucil on growth, estrogen receptor, and secretion of
      transforming growth factor (TGF)-alpha in the hormone-dependent human breast
      cancer cell line MCF-7. In the presence of 10(-10)-10(-6) M KM2210, the estrogen
      induced growth of MCF-7 was completely inhibited. Inhibited growth of MCF-7
      treated with 10(-8) or 10(-6) M KM2210 for 4 days was not rescued by removal of
      the drug and the addition of estradiol. By treatment of MCF-7 with KM2210 for 4
      days, estrogen receptor-binding sites were decreased at 10(-8) M and were not
      detected at 10(-6) M but were unaltered by 10(-8) M chlorambucil. Moreover,
      estrogen receptor immunoreactivity and the level of estrogen receptor mRNA were
      decreased through treatment with 10(-6) M KM2210 for 4 days. These suppressions
      occurred prior to the onset of inhibitory action on MCF-7 growth. Secretion of
      TGF-alpha from MCF-7 was decreased by 4 days of treatment with 10(-8) and 10(-6)
      M KM2210 but not with chlorambucil. The addition of exogenous TGF-alpha generally
      restored the growth of MCF-7 treated with 10(-8) M KM2210. We concluded that
      KM2210 has irreversible or at least long-standing inhibitory effect on estrogen
      dependent growth of MCF-7. It is conceivable that the decrease of estrogen
      receptor renders the cell unable to respond to estrogen with increased TGF-alpha
      secretion and succeeding cell growth.

PMID- 1737379
TI  - Inhibition of experimental metastasis and cell adhesion of B16F1 melanoma cells
      by inhibitors of protein kinase C.
AB  - Phorbol esters which activate protein kinase C (PKC) have been shown to enhance
      experimental lung metastasis. Therefore, it was reasoned that inhibitors of PKC
      might also modulate metastasis. We have investigated this possibility using a PKC
      inhibitor, MDL 27,032 [4-propyl-5(4-pyridinyl)-2(3H)-oxazolone], as well as
      staurosporine and H-7. Treatment of B16F1 murine melanoma cells with MDL 27,032
      for 24 h in culture and subsequent i.v. injection of the cells into mice resulted
      in greater than 90% inhibition of lung metastasis. Inhibition of metastasis was
      time dependent, with 90% of maximum inhibition occurring by 8 h of incubation.
      The 50% inhibitory concentration (IC50) for inhibition of metastasis with MDL
      27,032 was 7 microM, a value similar to that for the inhibition of B16F1 membrane
      associated PKC (IC50 = 13 microM) but not cytosolic PKC (IC50 = 54 microM). B16F1
      cells treated with MDL 27,032 for 24 h were less adherent than untreated cells to
      extracellular matrix/basement membrane proteins. Adhesion to fibrinogen and
      collagen IV was inhibited (IC50 = 6 microM and 48 microM, respectively) by MDL
      27,032, whereas adherence to laminin and fibronectin was not affected, indicating
      that the drug affects specific adhesion molecules. MDL 27,032-treated cells were
      also found to be less adherent than untreated cells to human umbilical vein
      endothelial cells. The phosphorylation of an 80-kDa B16F1 cell plasma membrane
      protein was stimulated under conditions known to stimulate PKC activity, and MDL
      27,032 inhibited this phosphorylation in a dose-dependent manner. MDL 27,032 was
      more potent than H-7 for the inhibition of metastasis but was significantly less
      potent than staurosporine. These results support the hypothesis that there is a
      critical role for PKC-mediated phosphorylation of cell surface adhesion receptors
      in metastasis.

PMID- 1737380
TI  - Beta 2-microglobulin gene is mutated in a human colon cancer cell line (HCT)
      deficient in the expression of HLA class I antigens on the cell surface.
AB  - The human colon cancer cell line HCT does not express any detectable HLA class I
      antigens on the cell surface. RNA blot analyses showed that HCT cells synthesize
      easily detectable levels of heavy chains as well as beta 2-microglobulin (beta
      2m) transcripts. Experiments of immunoprecipitation revealed the presence of
      intracellular HLA heavy chains and the absence of beta 2m molecules. Sequencing
      studies, performed on polymerase chain reaction-mediated amplification of beta 2m
      specific complementary DNAs, indicated that in HCT cells both beta 2m genes are
      mutated. The first mutation consists of an 11-base deletion, corresponding to the
      first 11 base pairs of the second exon of the beta 2m gene. This mutation alters
      the reading frame, starting from the third amino acid residue of the mature beta
      2m protein, resulting in the synthesis of a 31-amino acid peptide with no
      remarkable homology to any of the sequences stored in the protein database. The
      second mutation is a point mutation (C----A), resulting in a UAA stop codon
      corresponding to the 10th amino acid residue of the mature beta 2m. Therefore, it
      would appear that in HCT cells the beta 2m genes have undergone two different
      mutational changes. This is the first molecular demonstration of beta 2m
      mutations in a human epithelial cell line.

PMID- 1737381
TI  - CA54/61 as a marker for epithelial ovarian cancer.
AB  - Using a new one-step, double-determinant enzyme immunoassay, we performed
      quantitative measurements of a mucin-type glycoprotein antigen (CA54/61) that we
      recently detected in sera of ovarian carcinoma patients. When the cutoff value
      was set at 12 units/ml, at which a high diagnostic efficiency was demonstrated
      [or at 20 units/ml (mean + 3 SD of healthy females)], the positive rates of
      ovarian serous, mucinous, clear cell, and endometrioid carcinomas were 76% (or
      63%), 63% (or 55%), 57% (or 52%), and 50% (or 38%), respectively. Even in
      mucinous cystadenocarcinoma, more than one-half of the cases were positive,
      indicating the potential utility of the assay in the diagnosis of mucinous
      tumors. In sera from patients with benign ovarian tumors, only 9% (or 4%) of the
      cases were positive, indicating the quite high specificity of this test for
      ovarian carcinomas. To make a comparison between CA54/61 and CA125, we set the
      cutoff level of CA125 at 110 units/ml, at which value a high diagnostic
      efficiency was demonstrated [or at 35 units/ml (mean + 3 SD of healthy females)].
      When both CA54/61 and CA125 were assessed in sera from 36 patients with mucinous
      cystadenocarcinoma, the positive rates of CA54/61 and CA125 were 64% (or 56%) and
      36% (or 56%), respectively, suggesting that CA54/61 is of clinical value as a new
      tumor marker for ovarian cancers, including mucinous tumors.

PMID- 1737382
TI  - Altered gene expression of c-myc, epidermal growth factor receptor, transforming
      growth factor-alpha, and c-erb-B2 in an immortalized human breast epithelial cell
      line, HMT-3522, is associated with decreased growth factor requirements.
AB  - Activation of protooncogenes and constitutive secretion of autocrine growth
      factors are thought to be involved in the uncontrolled growth of cancer cells. We
      have attempted to elucidate the role of oncogenes and growth factors in the
      premalignant progression of human breast epithelial cells by using an
      immortalized, nontumorigenic, near-diploid human mammary epithelial cell line,
      HMT-3522, derived from a fibrocystic lesion and established in our laboratory.
      During propagation in tissue culture, the growth factor requirements of the HMT
      3522 cells decreased simultaneously with an amplification and overexpression of
      the c-myc protooncogene. Other protooncogenes related to human breast cancer were
      unaltered with regard to gene copy number and expression. In passage 118, in
      which the most important growth factor still was epidermal growth factor (EGF),
      we were able to isolate an EGF-independent subline (S2). The EGF independence of
      S2 was accompanied by an overexpression of the mRNAs for epidermal growth factor
      receptor (EGF-R), transforming growth factor-alpha, and c-erb-B2 as compared to
      the EGF-dependent subline (S1). Moreover, by application of a blocking anti-EGF-R
      antibody, growth of S2 cells in EGF-free medium was inhibited significantly,
      indicating that EGF-R was involved in an autocrine loop probably with
      transforming growth factor-alpha as ligand. Neither the late passages of S1 cells
      nor S2 cells were tumorigenic after subcutaneous transplantation to athymic mice.
      Our results indicate that c-myc amplification and overexpression are correlated
      with a decreased requirement for growth factors. Even when these alterations are
      combined with immortalization and EGF independence, they are insufficient for
      malignant transformation of these human breast epithelial cells.

PMID- 1737383
TI  - CA 72-4 measurement of tumor-associated glycoprotein 72 (TAG-72) as a serum
      marker in the management of gastric carcinoma.
AB  - The presence of three distinct serum markers of carcinoma, tumor-associated
      glycoprotein 72 (TAG-72; as measured by the CA 72-4 assay), CA 19-9, and
      carcinoembryonic antigen (CEA), was evaluated in 194 patients diagnosed with
      either malignant (n = 94) or benign (n = 100) gastric disease. Of the 94 patients
      diagnosed with gastric carcinoma, the percentage of patients whose serum samples
      were positive for TAG-72, CA 19-9, or CEA was 42.6, 31.9, and 20.2%,
      respectively. Furthermore, fewer false positive samples were observed for TAG-72
      than either CA 19-9 or CEA. The analysis of serum TAG-72, CA 19-9, and CEA levels
      in patients diagnosed with early (stage I and II) versus advanced (stage III and
      IV) disease revealed a significantly higher level of TAG-72 and CA 19-9 in the
      serum of patients with advanced stage gastric carcinoma. The serum samples were
      also analyzed to determine whether any advantage might be gained by
      simultaneously measuring two or more of the tumor markers. The data clearly
      indicate that the measurement of TAG-72 with CA 19-9 significantly increased the
      percentage of gastric carcinoma patients with positive serum levels of either
      antigen. This advantage was achieved with no significant increase in the number
      of false positives. Twenty-one patients were followed postsurgically for up to 3
      years to determine whether the appearance or reappearance of TAG-72, CA 19-9, or
      CEA accurately predicted disease recurrence. Positive serum TAG-72 levels
      correlated with disease recurrence in 7 of 10 patients, compared with 5 and 2
      patients for CA 19-9 and CEA, respectively. The findings suggest that serum TAG
      72 as measured by the CA 72-4 assay may be a useful marker for late stage gastric
      carcinoma and its measurement alone or in combination with CA 19-9 may have
      utility in the clinical management of gastric carcinoma.

PMID- 1737384
TI  - Effectiveness of a lysyl chlorin p6/chlorin p6 mixture in photodynamic therapy of
      the subcutaneous 9L glioma in the rat.
AB  - A new photosensitizer, LCP, a combination of lysyl chlorin p6 and chlorin p6, was
      synthesized and tested for effectiveness in photodynamic therapy using s.c.
      implanted 9L glioma tumors in rats. Tumors were irradiated with 664-nm light 4 h
      after LCP injection. Mean intratumoral temperature elevations were less than 4
      degrees C using a power density of 50 mW/cm2 for 33.3 min (100 J/cm2). Subsequent
      experiments examining histological changes and tumor regrowth used a power
      density of 50 mW/cm2 and total energy densities of 25, 50, and 100 J/cm2.
      Microscopically, an energy density-dependent coagulation necrosis of tumor cells
      occurred in treated tumors. Long term inhibition of tumor growth was achieved
      only at an energy density of 100 J/cm2. Side effects of treatment were seen only
      in the irradiated area and consisted of coagulation necrosis of normal tissues in
      rats treated at 50 and 100 J/cm2, including severe skin necrosis. Exposure of
      rats to fluorescent room light did not cause any macroscopically detectable skin
      damage. Our data indicate that photodynamic destruction of s.c. 9L glioma tumors
      using LCP as a photosensitizer results in significant tumor growth inhibition and
      that further study of LCP is warranted.

PMID- 1737385
TI  - Antitumoral and endocrine effects of (+)-vorozole in rats bearing
      dimethylbenzanthracene-induced mammary tumors.
AB  - The antitumoral activity of vorozole, a potent and specific nonsteroidal
      aromatase inhibitor, against 7,12-dimethylbenz(a)anthracene-induced estrogen
      dependent mammary adenocarcinoma was evaluated in 257 Sprague-Dawley rats. Twice
      daily p.o. administration of 1 and 5 mg/kg of the racemate R 76713 for 42 days
      induced almost complete regression of tumors, inhibited the appearance of new
      tumors, and reduced multiplicity of the remaining tumors. Antitumoral effects
      observed after ovariectomy or treatment with 5 mg/kg twice a day were not
      significantly different. R 76713, the racemate, (+)-vorozole (both at 2.5 mg/kg
      twice a day), and ovariectomy all similarly reduced tumor growth at 42 days by
      90% or more, lowered the number of existing tumors, and prevented the appearance
      of new tumors. The less active levo-enantiomer (-)-vorozole at the same dose did
      not alter tumor growth. Vorozole reduced serum estradiol to the levels measured
      in ovariectomized animals. Serum progesterone levels were lowered, but to a much
      lesser extent than after ovariectomy, while serum luteinizing hormone and
      follicle-stimulating hormone concentrations increased, but also much less than
      after ovariectomy. On the other hand, the androgen levels, which remained
      undetectable or decreased after ovariectomy, markedly rose after vorozole
      treatment. These endocrine changes, observed in intact female rats, were not
      detected in ovariectomized animals demonstrating the ovarian origin of the
      endocrine changes induced by vorozole.

PMID- 1737386
TI  - Camptothecin induces differentiation and stimulates the expression of
      differentiation-related genes in U-937 human promonocytic leukemia cells.
AB  - We have studied the effect of the DNA topoisomerase I inhibitor camptothecin on
      growth, differentiation, and gene expression in U-937 human promonocytic leukemia
      cells. At a concentration of 20 nM, camptothecin caused significant DNA strand
      breakage and decreased the growth activity by accumulating cells preferentially
      at the G2 phase of the cycle. The growth arrest occurred concomitantly with an
      increase in cell size. Under those conditions, camptothecin induced
      differentiation, as demonstrated by (a) the capacity of the cells to generate
      reactive oxygen species, (b) the increase in the surface expression of the
      leukocyte integrins CD11b/CD18 and CD11c/CD18, (c) the increase in the cellular
      content of the intermediate filament protein vimentin, and (d) the decrease in
      the surface expression of the transferrin receptor. Camptothecin also induced the
      expression of differentiation markers in other human myeloid cells, namely, the
      promonocytic THP-1 and the myelomonocytic HL-60 cell lines. Northern blot assays
      revealed that camptothecin stimulated the expression of CD11b, CD11c, and
      vimentin at the mRNA level. Moreover, the drug increased the transcription rate
      of the vimentin gene, as shown by "run-on" transcription assays.

PMID- 1737387
TI  - A rationale for carboplatin treatment and abdominal hyperthermia in cancers
      restricted to the peritoneal cavity.
AB  - The purpose of this study was to optimize the treatment of cancers restricted to
      the peritoneal cavity by combining i.p. chemotherapy with abdominal hyperthermia.
      In vitro experiments demonstrated that the uptake of carboplatin into CC531 tumor
      cells was increased at temperatures higher than 41.5 degrees C at dose levels of
      5 and 50% cell kill. Carboplatin-DNA adduct formation and cytotoxicity, however,
      were already increased at temperatures of about 40 degrees C, indicating that
      carboplatin-DNA adduct formation and consequently cytotoxicity could be enhanced
      by mild hyperthermia (temperatures in the range of 39-41.5 degrees C). CC531
      tumor bearing rats were treated i.v. and i.p. with carboplatin (6.15 mg/kg) in
      combination with regional hyperthermia of the abdomen (41.5 degrees C for 1 h).
      The mean temperature was 41.5 +/- 0.3 degrees C (SD) in the peritoneal cavity and
      40.5 +/- 0.3 degrees C in the esophagus. Enhanced platinum concentrations were
      found in peritoneal tumors (factor 3) and in kidney, liver, spleen, and lung (a
      factor 2 average), after the combined i.v. or i.p. carboplatin-hyperthermia
      treatment. Pharmacokinetic data of i.p. CBDCA combined with hyperthermia
      demonstrated an increased tumor exposure for total and ultrafiltered platinum in
      plasma. The areas under the concentration x time curve for total platinum at 37
      degrees C and 41.5 degrees C were 69 and 210 microM/h, respectively; for
      ultrafiltered platinum these values were 47 and 173 microM/h. This may have been
      due to a slower elimination of platinum from the blood at the higher temperature
      (t1/2 beta for total platinum 99 and 156 min at 37 and 41.5 degrees C,
      respectively). The direct exposure of the tumor via the peritoneal fluid appeared
      to diminish, since the area under the curve for total platinum was lower at 41.5
      degrees C than at 37 degrees C (576 microM/h versus 1255 microM/h, respectively).
      Our results indicate that the advantage of adding hyperthermia is caused by an
      increased drug exposure of the tumor via the circulation. This was supported by
      the fact that platinum concentrations in peritoneal tumors after carboplatin
      treatment at elevated temperatures were similar for the i.p. and i.v. routes.

PMID- 1737388
TI  - Nonglycolytic acidification of murine radiation-induced fibrosarcoma 1 tumor via
      3-O-methyl-D-glucose monitored by 1H, 2H, 13C, and 31P nuclear magnetic resonance
      spectroscopy.
AB  - The effects of 3-O-methyl-D-glucose (3-OMG) on subcutaneously implanted murine
      radiation-induced fibrosarcoma 1 tumor were examined with 2H, 13C, and 31P
      nuclear magnetic resonance (NMR) in situ. Using 31P NMR, changes in tumor high
      energy phosphate metabolism were monitored for 2.5 h after i.p. administration of
      3-OMG (8.1 g/kg body weight); tumor pH decreased by a mean maximum of 0.52 +/-
      0.05 (SE) (n = 10), [PCr] decreased by 54%, [NTP] decreased by 35%, and [Pi]
      increased by 36%. Tumor blood flow, as measured by 2H NMR monitoring of D2O
      washout kinetics, decreased by 40% at 1 h and by 47% at 2 h after 3-OMG injection
      (n = 4). This substantial tumor acidification (pH decrease much greater than
      0.1), expected to require a glycolytic substrate (Hwang et al., Cancer Res., 51:
      3108-3118, 1991), is surprising in light of the previously documented
      metabolically inert nature of 3-OMG. In situ 13C NMR spectroscopy, following [6
      13C]3-OMG i.p. injection, examined the possibility of the glycolytic metabolism
      of 3-OMG. However, only the C-6 resonance of 3-OMG was detected (n = 6); no
      resonances from [6-13C]3-OMG-6-phosphate or [3-13C]lactate were observed. These
      results confirmed that 3-OMG was not metabolized in radiation-induced
      fibrosarcoma 1 tumor. At the completion of the in situ 13C NMR experiments,
      tumors were freeze clamped, and perchloric acid extraction was performed. High
      resolution 1H NMR measurement of lactate concentrations showed no statistically
      significant difference in control tumor extracts (from mice not receiving i.p.
      injection; n = 5) and in tumor extracts from mice administered i.p. [6-13C]3-OMG
      (n = 5), indicating that there was no significant increase in lactate level in
      the tumor extracts from mice administered i.p. 3-OMG due to increased plasma
      glucose concentration. The results of these 1H and 13C NMR studies indicated that
      the radiation-induced fibrosarcoma 1 tumor acidification caused by i.p.
      administration of 3-OMG was not due to a direct (3-OMG----lactate) or an indirect
      (systemic glucose----lactate) increase in tumor lactic acid levels.

PMID- 1737389
TI  - Binding of aflatoxin B1 metabolites in extrahepatic tissues in fetal and infant
      mice and in adult mice with depleted glutathione levels.
AB  - Whole-body autoradiography of 3H-labeled aflatoxin B1 (AFB1) in adult C57BL mice
      pretreated with the glutathione (GSH)-depleting agent phorone showed accumulation
      of tissue-bound radioactivity in the nasal olfactory and respiratory mucosa, the
      mucosa of the nasopharyngeal duct, and the tracheal and esophageal mucosa, which
      was not seen in unpretreated adult mice. The altered distribution pictures
      induced by the phorone are probably related to decreased tissue levels of GSH.
      The AFB1 is likely to be bioactivated locally in the extrahepatic tissues; in
      nonpretreated mice the reactive AFB1 metabolite formed is probably scavenged by
      GSH via the action of glutathione-S-transferase, whereas in the mice with
      depleted GSH levels a binding to tissue macromolecules will instead take place.
      The mechanism indicated above is supported by results of in vitro experiments in
      which the nasal olfactory mucosa and the esophageal mucosa were shown to have a
      capacity to form tissue-bound 3H-AFB1 metabolites. This formation was decreased
      when the incubations were performed in the presence of GSH. In addition, the
      treatments of mice with phorone were shown to induce a strong GSH depletion in
      the nasal olfactory mucosa and the esophageal mucosa. In autoradiographic studies
      performed with 1- and 5-day-old infant mice a marked localization of bound 3H
      AFB1 metabolites was found in the nasal olfactory mucosa, and in the 5-day-old
      infant there was also a labeling of the mucosa of the nasopharyngeal duct, the
      pharyngeal and esophageal mucosa, and the tracheal mucosa. Experiments in vitro
      with the nasal olfactory mucosa of 5-day-old infants demonstrated a marked
      binding of 3H-AFB1 metabolites in this tissue. Incubations together with GSH
      decreased this binding, although the inhibition was less marked than in the adult
      animal. The in vivo accumulation of bound AFB1 metabolites in the extrahepatic
      tissues of the infant mice may be related to low glutathione-S-transferase (GST)
      activity in the tissues of the young animals. In addition, some extrahepatic
      tissues may have a considerable capacity to bioactivate the AFB1 at early age.
      Autoradiography of 3H-AFB1 in pregnant mice showed a labeling of the fetal nasal
      olfactory mucosa at day 18 but not at day 14 of gestation. This indicates that
      AFB1-bioactivating enzymes develop in the fetal nasal olfactory mucosa in late
      gestation.

PMID- 1737390
TI  - Differential effects of bryostatin 1 and phorbol ester on human breast cancer
      cell lines.
AB  - The effects of the protein kinase C (PKC) activators, phorbol ester 12-O
      tetradecanoyl-13-phorbol acetate (TPA) and the marine natural product, bryostatin
      1, on the growth and morphology of human breast cancer cell lines were examined.
      TPA (1 to 100 nM) inhibited growth of four of six cell lines by up to 75% in 5
      day cultures. Bryostatin 1 inhibited growth of only MCF-7 cells and only at a
      high dose (100 nM). However, bryostatin 1 completely antagonized the growth
      inhibition and morphological changes induced by TPA in MCF-7 cells. The divergent
      effects of these two agents are associated with differing effects on PKC activity
      and isoform expression in MCF-7 cells. TPA induced rapid translocation of the PKC
      alpha isozyme and PKC activity to the membrane fraction of MCF-7 cells. In
      contrast, bryostatin 1 treatment resulted in the loss of the PKC-alpha isozyme
      and PKC activity from both cytosolic and membrane compartments within 10 min of
      treatment. In coincubation assays the bryostatin 1 effect was dominant over that
      of TPA. Similar effects on PKC-alpha isozyme and PKC activity were seen in a
      second cell line whose growth was inhibited by TPA but not by bryostatin 1, MDA
      MB-468. In contrast, in the T47D cell line, where TPA was not growth inhibitory,
      TPA failed to induce translocation of PKC-alpha to the cell membrane. Bryostatin,
      however, still caused loss of PKC-alpha isozyme and PKC activity from cytosolic
      and membrane fractions. Thus, differential actions of bryostatin 1 and TPA on PKC
      activity and alpha-isoform level in the membrane-associated fraction of MCF-7 and
      MDA-MB-468 cells may account for the divergent effects of these two agents on
      cell growth and morphology. These results suggest that the PKC-alpha isoform may
      specifically play a role in inhibiting growth of human breast cancer cells.

PMID- 1737391
TI  - Effects of target antigen competition on distribution of monoclonal antibody to
      solid tumors.
AB  - Monoclonal antibody (MoAb) 11A and MoAb 13A recognize normal murine cell surface
      glycoproteins, which are also expressed in high concentrations on Line 1 lung
      carcinoma. Studies were initiated to examine the competition in vivo for
      radiolabeled MoAb between sites on the tumor versus sites on normal tissue.
      Quantitative 2-site assay of the alpha 6 beta 4 integrin recognized by MoAb 11A
      showed that major sites of expression are tumor, intestine, and skin.
      Microdistribution studies show that at doses of 125I-labeled MoAb 11A less than
      the total body antigen load, the MoAb bound to beta 4 endothelial cells with
      little extravasation to epithelial sites. As the MoAb dose was increased, and
      endothelial sites became saturated, deposition at epithelial sites including skin
      and tumor became apparent. Quantitative radioimmunoassay with MoAb 13A,
      recognizing CD44 (P100), demonstrated major sites of expression as tumor,
      intestine, liver and, to a lesser extent, spleen and skin. Microdistribution
      studies at low doses of 125I-labeled MoAb showed deposition mainly in the liver
      and spleen sinusoids, whereas higher doses were necessary to maximize MoAb
      accumulation in tumor. The rapid access of MoAb to target antigen is the most
      important parameter in efficient localization of MoAb. Access of antigen outside
      the vascular space is regulated at least in part by the permeability of the
      endothelial barrier. Of the organs studied, antigen accessibility increases in
      the following order: lung epithelium less than skin epithelium less than
      intestine and uterus epithelium less than epithelial tumors less than liver and
      spleen sinusoids less than intervascular sites. Antigens in easily accessible
      sites interact with MoAb first and must be saturated before MoAb will penetrate
      to less accessible areas. Thus, the extent of competition of antigen for
      available MoAb depends not only on the amount of antigen, but also on the site at
      which it is expressed. Doses that achieve maximum binding to tumor sites can be
      predicted if accurate target antigen quantities and sites of expression are
      known.

PMID- 1737392
TI  - Expression of calcyclin in human melanoma cell lines correlates with metastatic
      behavior in nude mice.
AB  - Since our aim was to isolate and identify new progression markers of human
      cutaneous melanoma, we applied the differential hybridization technique, in which
      we compared the gene expression in two subsequent stages of this progression.
      Tumors in nude mice arising after transplantation and serial passage in vivo of
      either the horizontally and early vertically growing part or the advanced
      vertically growing part of a primary melanoma of the same patient were used for
      this assay. This resulted in the isolation of a number of complementary DNA
      clones that were differentially expressed. Based on the marked difference in
      expression, one of them, designated pMW1, was chosen for further characterization
      and appeared to be coding for calcyclin, a cell cycle-regulated protein,
      belonging to a family of small calcium-binding proteins. Calcyclin expression was
      elevated in high-metastatic human melanoma cell lines in nude mice compared to
      low-metastatic ones. Immunoprecipitation of calcyclin showed that the
      differential expression at the RNA level is also reflected at the protein level.
      These findings show that expression of calcyclin is related to metastasis of
      human melanoma cell lines in nude mice and emphasize the role of this family of
      calcium-binding proteins in neoplastic progression as was reported for the mouse
      homologue of calcyclin and other members of the same family.

PMID- 1737393
TI  - Nuclear enlargement induced by hepatocarcinogens alters ploidy.
AB  - Treatment of rats with low doses of hepatocarcinogens is associated with a number
      of phenomena, including nuclear enlargement and altered nucleocytoplasmic
      compartmentation, which potentially reflect initiatory changes. Since a number of
      investigations have indicated that changes in ploidy may relate to the
      development of altered foci and/or hepatocellular carcinomas in liver, and since
      nuclear enlargement may be associated with changes in DNA content, we examined
      the ploidy of rat hepatocytes following essentially nontoxic low-dose carcinogen
      treatment. Treatments with thioacetamide, 2-acetylaminofluorene, or
      dimethylnitrosamine were all associated with a notable shift of nuclei from
      diploid to tetraploid, in the apparent absence of nuclear replication. These
      changes were similar in magnitude to that associated with the substantial liver
      regeneration induced by carbon tetrachloride. If it is argued that cell
      replication is a necessary prerequisite for the completion of initiation, these
      data suggest that there may be thresholds for initiation.

PMID- 1737394
TI  - Hepatitis B virus replication in well differentiated mouse hepatocyte cell lines
      immortalized by plasmid DNA.
AB  - The primary hepatocytes cultured from adult BALB/c mice were readily transfected
      by plasmid DNA and could be immortalized at a frequency of approximately 0.1 to
      0.6 x 10(-7) cells/micrograms of the transfected DNA. There was no detectable
      plasmid DNA at the tenth cell passages. A total of five mouse hepatocyte cell
      lines were established. Most of them were tumorigenic. Three of the established
      mouse hepatocyte cell lines were well differentiated, since they expressed liver
      specific genes. Further transfection of these three well differentiated mouse
      hepatocyte cell lines with hepatitis B virus (HBV) DNA showed that the HBV
      transfected cells had integrated HBV genomes, HBV-specific mRNA transcripts, and
      expression of hepatitis B surface and hepatitis B core antigens. One of the
      lines, ML-3Neo (HBV), even secreted HBV-like particles. Furthermore, circulating
      hepatitis B surface antigens were detected in the sera of BALB/c mice bearing ML
      3Neo (HBV) tumors. These cell lines provide a convenient model for future studies
      on the host immune reaction against HBV and on the transformation of hepatocytes
      by HBV and other cellular oncogenes and the determination of their effects on
      hepatocellular differentiation.

PMID- 1737395
TI  - Tumor necrosis factor alpha induces apoptosis in mammary adenocarcinoma cells by
      an increase in intranuclear free Ca2+ concentration and DNA fragmentation.
AB  - The incubation of human mammary adenocarcinoma cells (BT-20) with tumor necrosis
      factor alpha in the absence or presence of cycloheximide resulted in progressive
      DNA fragmentation. This was preceded by a sustained increase in intracellular
      free Ca2+ concentration and was not detected in cells pretreated with
      intracellular Ca2+ chelators, calmodulin antagonists, or activators of protein
      kinase C. Image analysis of fura-2-loaded BT-20 cells treated with tumor necrosis
      factor alpha revealed that, in many cells, the initial increase in Ca2+ level
      occurred in a cellular region that corresponded to the localization of the
      nucleus. Our findings suggest that tumor necrosis factor alpha can promote an
      increase in intranuclear free Ca2+ which, in turn, may stimulate Ca(2+)-dependent
      endonuclease activity, resulting in DNA fragmentation and apoptosis.

PMID- 1737396
TI  - Site-dependent differences in sensitivity of LOX human melanoma tumors in nude
      rats to dacarbazine and mitozolomide, but not to doxorubicin and cisplatin.
AB  - Three model systems involving LOX human malignant melanoma cells in nude rats
      were used to compare the chemosensitivity of tumors growing in different tissues.
      Groups of 4-18 rats with either s.c. xenografts, lung tumor colonies, or bone
      metastases were treated with cisplatin, doxorubicin, dacarbazine, or
      mitozolomide. The antitumor effect in the s.c. model was expressed as specific
      growth delay, and in the experimental metastasis studies as relative increase in
      life span (RILS), calculated on the basis of observed disease-free survival.
      Cisplatin had a moderate but significant effect on the progression of LOX tumor
      growth in all three systems. Doxorubicin was clearly more efficacious, but for
      both drugs tumor-free survivors were rare or absent. Importantly, for each of the
      compounds the levels of response were roughly the same in all three models, with
      specific growth delay and RILS values in the range of 0.2-0.3 for cisplatin and
      0.5-0.9 for doxorubicin. In contrast, a significant site-dependent difference in
      sensitivity of the LOX tumors was observed for two alkylating agents. Thus,
      dacarbazine, which temporarily caused complete regression of s.c. xenografts
      (specific growth delay = 21.0), showed a moderate activity in the lung tumor
      model (RILS = 1.0) but had only a limited effect (RILS = 0.4) on bone metastases.
      Mitozolomide gave a curative effect in 6 of 10 animals with s.c. and in 4 of 4
      animals with lung tumors, whereas in the bone metastasis model it was only
      slightly superior to doxorubicin (RILS = 1.1). In preliminary attempts to
      elucidate the underlying mechanisms, no site-dependent differences in drug
      distribution and in two cellular detoxifying systems were detected. The data
      demonstrate the usefulness of the LOX models for studying the clinically relevant
      problem of site-dependent tumor response to chemotherapy.

PMID- 1737397
TI  - In vitro and in vivo enhancement of ricin-A chain immunotoxin activity by novel
      indolizine calcium channel blockers: delayed intracellular degradation linked to
      lipidosis induction.
AB  - With regard to increasing the clinical potential of ricin A-chain immunotoxins
      (RTA-ITs), a novel class of calcium channel blockers, indolizines SR33557 [2
      isopropyl-1-[4-(3-N-methyl-N-(3,4-dimethoxy-beta-
      phenethyl)amino)propyloxy)benzenesulfonyl))indolizine] and SR33287 [isopropyl-2
      ((1-butylamino-3-propyl)oxy-4-benzoyl)-3-indolizine], were evaluated for their
      ability to enhance RTA-IT activity in vitro and in vivo. Five microM SR33287 and
      5 microM SR33557 were potent enhancers of both anti-Thy 1.2 AT15E RTA-IT (84- and
      64-fold, respectively) on T2 cells and anti-CD5 T101 (622- and 538-fold) and T101
      F(ab')2 RTA-IT (34- and 28-fold) on CEM III cells. This was superior to the
      effect achieved by both 10 microM verapamil and 10 mM NH4Cl, albeit slightly
      inferior to that of 50 nM monensin and 5 microM perhexiline. Murine T2 lymphoma
      cells bearing the Thy 1.2 antigen were injected i.v. in Thy 1.2 (-) BL. 1.1 mice
      (median survival time, 17.7 days). Intravenous treatment with 10 micrograms of
      AT15E RTA-IT prolonged the survival of mice (median survival time, 26.8 days).
      When 400 micrograms of SR33287 were coinjected i.v. with 10 micrograms of AT15E
      RTA-IT, mouse survival was further increased, with 5 of 6 mice surviving, disease
      free, over 42 days. SR33287 had a significant impact on the intracellular routing
      of 125I-AT15E RTA-IT, which induced a greater than 2-fold increase in
      intracellular intact AT15E RTA-IT at 90 min. This effect on RTA-IT half-life was
      distinctly different from that observed with either NH4Cl or monensin and may be
      linked to the inhibition of acid lysosomal sphingomyelinase by SR33287, leading
      to cellular lipidosis. In conclusion, indolizines appear to be promising agents
      not only for immunotoxin enhancement but also for increasing the activity of any
      number of targeted therapeutic agents where modifying either the intracellular
      routing or increasing the intracellular half-life of the ligand would be
      beneficial to its cytotoxic activity.

PMID- 1737398
TI  - Induction of covalent DNA adducts in rodents by tamoxifen.
AB  - The antiestrogen tamoxifen, increasingly used as adjuvant treatment for breast
      cancer, has been found to covalently modify DNA of rodents. For instance, the
      liver DNA of female Sprague-Dawley rats treated with a single injection of
      tamoxifen contained two DNA adducts. Four additional DNA adducts were formed and
      adduct concentrations increased 5- 7- and 10-15-fold after three and six
      tamoxifen injections, respectively, from levels observed after a single dose. The
      accumulation of DNA adducts with repeated administrations of tamoxifen to rodents
      may make this drug a poor choice for the chronic preventative treatment of breast
      cancer.

PMID- 1737399
TI  - Inverse relationship between trk expression and N-myc amplification in human
      neuroblastomas.
AB  - We examined the expression of the trk protooncogene in a series of 82
      neuroblastomas to determine its relationship to N-myc amplification and
      expression, disease stage, patient age, and survival. We found that virtually all
      stage I, II, and IV-S patients had moderate to high levels of trk expression,
      whereas most advanced stage neuroblastomas had low or absent levels. All but one
      tumor with N-myc amplification had low or absent trk expression, and the one
      exception was regressing at the time it was resected. Conversely, all
      neuroblastomas identified by mass screening had moderate to high expression of
      trk, and all these patients are surviving. Thus, trk expression was associated
      with an absence of N-myc amplification, lower disease stage, lower patient age,
      and favorable outcome. Tumors with high trk expression may be more likely to
      differentiate, regress spontaneously, or respond well to therapy.

PMID- 1737400
TI  - Unique association of p53 mutations with undifferentiated but not with
      differentiated carcinomas of the thyroid gland.
AB  - Thyroid neoplasms show a wide variety of lesions varying from slowly growing
      differentiated adenocarcinomas to rapidly proliferating undifferentiated
      carcinomas. There has been some histopathological evidence that the
      undifferentiated thyroid carcinomas are derived from differentiated carcinomas.
      Moreover, it is suspected that some genetic events might be associated with such
      changes. In the present study, mutations in the p53 gene were investigated by
      direct sequencing analysis after polymerase chain reaction amplification of exons
      5 to 8, using paraffin-embedded primary tumors and cultured cells. No mutations
      in exons 5 to 8 were detected in 10 differentiated papillary adenocarcinomas,
      whereas 6 of 7 undifferentiated carcinomas were found to carry base substitution
      mutations. Sequencing analysis confirmed mutations at codons 135 (TGC----TGT),
      141 (CCC----CCT), 178 (CAC----GAC), 213 (CGA----TGA), 248 (CGG----CAG, CGG---
      TGG), and 273 (CGT----TGT). The spectrum of mutations (G:C to A:T transitions in
      7 of 8) might be a specific feature of the spontaneous cancers. The results
      strongly suggest that, in human thyroid glands, p53 mutations play a crucial role
      in the progression of differentiated carcinomas to undifferentiated ones.

PMID- 1737401
TI  - Partial purification of a human DNA glycosylase acting on the cyclic carcinogen
      adduct 1,N6-ethenodeoxyadenosine.
AB  - We previously reported that a variety of human cells and tissues contained a
      Mr35,000 DNA-binding protein which selectively recognized a single 1,N6
      ethenoadenine in a defined 25-base double-stranded oligonucleotide (B. Rydberg et
      al., Proc. Natl. Acad. Sci. USA, 88: 6839-6842, 1991). We now demonstrate that
      incubation of the same duplex with 50-fold partially purified binding protein
      from human placenta results in release of the free 1,N6-ethenoadenine base,
      indicative of DNA glycosylase action. This enzyme activity appears unique in that
      it excises a cyclic adduct resulting from a known human carcinogen.

PMID- 1737402
TI  - Adenosine's effectiveness in long RP' re-entrant tachycardia: additional evidence
      of the decremental qualities of the retrograde limb.
AB  - Adenosine's ability to terminate atrioventricular (AV) re-entrant
      supraventricular tachycardia is well documented. Typically, termination occurs as
      a consequence of transient conduction block in the atrioventricular node, a
      tissue with decremental qualities. However, the atrioventricular node is not
      always the site of action when adenosine is used on the re-entrant types of long
      RP' tachycardias. These tachycardias are, in part, characterized by the
      decremental qualities of the retrograde limb of the tachycardia circuit, which,
      in turn, are typically exemplified by retrograde Wenckebach during ventricular
      (VVI) pacing during intracardiac electrophysiology studies. This case report
      involves adenosine's ability to block conduction in the retrograde limb of the
      permanent form of junctional reciprocating tachycardia to provide further
      evidence as to the AV "nodelike" decremental qualities of this limb.

PMID- 1737403
TI  - Catastrophic thrombus development despite systemic heparinization during coronary
      angioplasty: possible relationship to nonionic contrast.
AB  - Two cases of catastrophic thrombus formation during coronary angioplasty occurred
      shortly after the operators began using nonionic contrast. This occurred despite
      systemic heparinization, the adequacy of which was documented by activated
      clotting times (ACT). Both cases were resistant to balloon inflation and one was
      refractory to intracoronary thrombolysis. There is a considerable body of
      evidence documenting that low-osmolality contrast media, especially those that
      are nonionic, have less anticoagulant effect than standard contrast media.
      Several reports have also been published suggesting possible relationships
      between nonionic contrast and intravascular thrombus formation during coronary
      angiography and angioplasty. These data are reviewed and recommendations made for
      utilization of these contrast media.

PMID- 1737404
TI  - Documentation of successful treatment of prosthetic mitral valve thrombosis with
      intravenous urokinase infusion for twenty-four hours.
AB  - Prosthetic valve thrombosis is a life-threatening situation requiring prompt
      diagnosis and treatment. Treatment has usually been surgical and has been
      associated with a high mortality. Thrombolytic therapy is a therapeutic
      alternative to surgery and has been successful in a number of cases. This report
      concerns the technique used to diagnose the condition, treatment strategy, and
      documentation of the results of therapy.

PMID- 1737405
TI  - John Hunter (1728-1793).

PMID- 1737406
TI  - Acronyms and myocardial infarction studies.

PMID- 1737407
TI  - The postcardiac injury syndromes.
AB  - Late pericarditis following myocardial infarction, cardiac surgery, or trauma is
      referred to as postmyocardial infarction syndrome (PMIS) or postcardiotomy
      syndrome (PCS), respectively. The term postcardiac injury syndrome (PCIS) is used
      to encompass both these entities. PCIS is characterized by fever,
      pleuropericardial pain, pericarditis, and pulmonary involvement. Abnormal
      laboratory findings include leukocytosis, high sedimentation rate, and chest x
      ray abnormalities of pleural effusion with or without pulmonary infiltrates.
      Evidence supports an immunopathic etiology; viruses may play a contributing role.
      The course is benign but rare complications include tamponade, constriction,
      anemia, and coronary bypass graft occlusion. Anti-inflammatory agents are
      helpful; indo-methacin and steroids are preferably avoided. Rarely, PMIS-like
      syndrome may occur following pulmonary embolism. Anticoagulation and steroids
      have been used successfully in the latter situation.

PMID- 1737408
TI  - Oblique cine MRI for the evaluation of aortic regurgitation: comparison with
      cineangiography.
AB  - The results of oblique cine magnetic resonance imaging (MRI) through a long axis
      slice of the left ventricle in 40 patients was compared with cineangiography in
      order to determine the usefulness of cine MR imaging for the evaluation of aortic
      regurgitation (AR). A diastolic dark low-intensity flow signal extending from the
      aortic valve into the left ventricle was seen in all 30 patients with AR, and in
      none of the 10 patients without AR. The length and area of the low-intensity
      signal due to the regurgitant flow were planimetered, and the ratio to the length
      and area of the left ventricle was calculated. The best correlation with
      angiography was with the ratio of the area of the low-intensity signal (ALIS) to
      the area of the left ventricle (ALV); it correctly classified the degree of
      regurgitation in 28 of the 30 patients (93.3%). The ALIS/ALV ratio was under 25%
      in all 11 patients with angiographic mild AR, 26-50% in 10 of the 11 patients
      with moderate AR, and over 51% in 7 of the 8 patients with severe AR. Thus the
      results point to a high degree of correlation between long axis oblique cine MRI
      and cineangiography in the identification of AR and in providing a
      semiquantitative estimation of its severity.

PMID- 1737409
TI  - Changes of diastolic function induced by cigarette smoking: an echocardiographic
      study in patients with coronary artery disease.
AB  - In 28 chronic smokers (11 women, 17 men, 53 +/- 10 years old) with coronary
      artery disease (greater than 75% stenosis), left ventricular (LV) relaxation and
      filling behavior was assessed before and after inhalation of 0.9 mg nicotine (1
      cigarette) by echocardiography. The following acute nicotine-mediated changes
      were noted (one-sided Wilcoxon test): heart rate increased from 67 to 81
      beats/min (p greater than .001); the early diastolic flow (E wave) integral
      decreased from 49 to 39 mm (p less than .001); the late diastolic flow integral
      (A wave) increased from 36 to 41 mm (p less than .01). Consecutively, the ratio
      between E and A wave flow integrals decreased from 1.4 to 0.9 (p less than .001);
      the atrial contribution to LV filling rose from 42 to 53% (p less than .001); and
      the isovolumetric relaxation period increased from 89 to 122 ms (p less than
      .001). In cigarette smokers with coronary artery disease acute administration of
      nicotine hence causes a shift of mitral blood flow from early (E wave) to late (A
      wave) diastole and a prolongation of the isovolumetric relaxation time. Thus,
      cigarette smoking significantly affects LV diastolic function independently of
      its role as a risk factor for coronary atherosclerosis.

PMID- 1737410
TI  - Coronary hemodynamic effects of systemic thrombolysis in patients with unstable
      angina.
AB  - Intracoronary (i.c.) thrombus is a frequent finding in patients with unstable
      angina (UA). Accordingly, thrombolytic treatment could be beneficial, as
      resolution of thrombus might result in increased delivery of blood flow to the
      ischemic regions. To test this hypothesis, we studied 13 patients with active UA
      and ST-segment shift in the anterior leads. Coronary angiography was performed
      and great cardiac vein blood flow (GCVF; thermodilution) was measured in all
      patients 25 +/- 14 h after the last chest pain episode. Following angiography,
      patients received i.v. urokinase (UK: 1,000,000 IU/30 min); aortic pressure and
      GCVF were measured before and every 10 min following drug infusion, for a total
      time of 90 min. At baseline angiography, 5 of 13 patients (Group 1) had evidence
      of i.c. thrombus (intraluminal filling defect or thrombotic subocclusion) in the
      ischemia-related left coronary artery, whereas 8 patients (Group 2) did not.
      Group analysis showed that UK increased GCVF and decreased anterior coronary
      resistance in Group 1 (respectively, from 86 +/- 33 to 114 +/- 41 ml/min: p less
      than 0.005; and from 1.37 +/- 0.68 to 1.01 +/- 0.44 mmHg/ml/min: p less than
      0.05) but not in Group 2 (both: p = NS). In conclusion, UK has been shown to
      increase regional coronary blood flow in selected patients presenting with active
      UA, as well as evidence of i.c. thrombus at early angiography. Heterogeneity of
      angiographic findings could explain controversies in trials dealing with
      thrombolysis in UA.

PMID- 1737411
TI  - Effect of diuretic therapy on the electrocardiographic response to exercise.
AB  - For nearly 30 years clinicians have assumed that diuretic therapy, per se, even
      in the absence of clinical hypokalemia, can cause false-positive exercise ST
      segment responses. The precept has stubbornly persisted in the literature and in
      the day-to-day interpretation of exercise tests in clinical settings. The
      assumption probably originated with very early studies of patients on diuretics,
      in which other causes of false-positive tests were not excluded. This study was
      undertaken to show that diuretic therapy alone is not sufficient to cause ST
      depression. Twenty healthy male volunteers, aged 18 to 35, with normal history
      and physical examinations, echocardiograms, electrocardiograms, serum
      electrolytes, renal function tests and exercise tests, took 50 mg of
      hydrochlorothiazide daily for four weeks. Exercise tests, serum electrolytes, and
      renal function tests were repeated at Weeks 2 and 4. The administration of the
      diuretic resulted in a statistically significant reduction in serum potassium
      (from 4.37 +/- 0.37 to 3.96 +/- 0.28, and 3.94 +/- 0.31 mEq/l at 2 and 4 weeks,
      respectively). There were no abnormal ST-segment shifts on any of the exercise
      tests. It is concluded that exercise-induced ST-segment shifts in otherwise
      healthy young male normokalemic subjects who are taking diuretics should not be
      ascribed to a false-positive response to diuretics.

PMID- 1737412
TI  - Paradoxical effect of long-term treatment of nifedipine on total ischemic load in
      patients with stable angina pectoris.
AB  - In 50 patients with stable effort angina the effect of three drugs, metoprolol,
      nifedipine, and diltiazem was assessed by analyzing exercise stress test response
      and ambulatory ECG recordings. Both metoprolol and diltiazem caused a significant
      increase in time to ischemic threshold during exercise and a significant decrease
      of maximum ST-segment depression (during exercise and ambulatory ECG monitoring)
      and in the average number of daily ischemic episodes. Only metoprolol
      significantly reduced heart rate and rate-pressure product at the ischemic
      threshold during exercise. In the group of patients treated with nifedipine no
      significant improvement was observed in exercise tolerance or in number of
      ischemic episodes/24 h. Moreover, the subset of nonresponders in the two methods
      was larger than in the other two groups. In some of these patients a clearcut
      worsening of total ischemic load was observed, despite the control of symptoms.
      This adverse effect might be attributed to the different consequences of the
      vasodilatory effect of nifedipine on blood flow through stenosed vessels.

PMID- 1737413
TI  - Temporal bone fractures in children: a review with emphasis on long-term
      sequelae.
AB  - A 10-year retrospective study of pediatric basilar skull fractures identified 120
      patients with temporal bone fractures, of which 92 had otolaryngologic and
      audiologic evaluations. The otologic data provide documentation of the nature,
      common physical findings, complications, and management of these fractures. The
      prognosis of hearing impairment in children caused by temporal bone fractures is
      elucidated, as 76 of the 92 patients were available for long-term follow-up.
      Close interaction between involved services evaluating and treating pediatric
      trauma cases is mandatory for optimal patient outcome. A literature review of the
      presentation, complications, and management of pediatric temporal bone fractures
      is presented.

PMID- 1737414
TI  - Ohio's infant hearing screening and assessment program. A decade in development.
AB  - The early detection of hearing impairments in infants is essential to the
      initiation of medical and educational services which will enhance optimal
      development of communication and social skills. Ohio has successfully implemented
      a legislatively mandated two-tiered Infant Hearing Screening and Assessment
      Program. This statewide screening program is in accordance with the child find
      and early intervention services requirements of P.L. 99-457.

PMID- 1737415
TI  - An open letter to the pediatrician: hearing loss in children.

PMID- 1737416
TI  - Nasal obstruction in the neonate and infant.
AB  - The neonate is a preferential nasal breather; therefore, nasal obstruction in the
      neonatal period may cause significant sequelae. Although the uncommon choanal
      atresia is the main condition to be excluded, many other possible causes exist. A
      systematic approach to the workings of nasal obstruction in the neonate and
      infant is outlined so that appropriate management can be instituted.

PMID- 1737417
TI  - The current management of sinusitis in children.
AB  - The paranasal sinuses are common sites of infection in children. The diagnosis of
      sinusitis may be challenging because the sinus cavities are small and variably
      contoured, the clinical manifestations are often nonspecific, and the radiologic
      findings may be equivocal. Because many local and systemic factors contribute to
      sinusitis in children, the therapeutic regimens vary. In addition to conventional
      medical approaches, new surgical procedures and improved anesthetic techniques
      have made functional endonasal sinus surgery an excellent management tool for
      selected patients with chronic or recurrent disease.

PMID- 1737418
TI  - The role of computed tomography in the diagnosis of subperiosteal abscess of the
      orbit.
AB  - Periorbital cellulitis is a frequent complication of sinusitis in children.
      Subperiosteal abscess (SPA), however, is an uncommon sequela and may lead to
      serious complications if not promptly and adequately treated. A series of 13
      consecutive patients who underwent orbital computed tomographic (CT) scans from
      January 1, 1986, to June 30, 1989, to investigate the possibility of SPA were
      reviewed. As demonstrated in this series, the diagnosis of subperiosteal abscess
      remains a clinical one that may be supported, but not determined, by an orbital
      CT scan. Cautious interpretation of these studies is advocated. Aggressive
      surgical therapy in appropriate clinical situations will lead to more rapid
      resolution of the disease process and fewer complications.

PMID- 1737419
TI  - New concepts in care of the pediatric ear and related structures.

PMID- 1737420
TI  - Neonatal respiratory distress secondary to an obstructing nasopharyngeal dermoid.
AB  - A case presentation of a newborn infant with intermittent, complete airway
      obstruction secondary to a pedunculated nasopharyngeal dermoid is presented. The
      differential diagnosis of obstructing nasopharyngeal lesions of the neonatal
      period is discussed, and an organized management strategy is proposed.

PMID- 1737421
TI  - Stridor in infants and children: ambulatory evaluation and operative diagnosis.
AB  - The presence of stridor in the young child suggests a congenital or acquired
      abnormality of the large diameter airways. The diagnostic evaluation of the
      stridulous child is discussed. Emphasis is placed on those outpatient examination
      techniques and radiographic studies which can define the nature of the offending
      airway lesion(s).

PMID- 1737422
TI  - The old and new of acute laryngotracheal infections.
AB  - Laryngotracheal infections in childhood frequently result in airway obstruction,
      the major symptom of which is stridor. The primary aims of management are to
      establish a diagnosis rapidly and to maintain or secure the child's airway.
      Medical treatment and airway stabilization measures vary for the three most
      prevalent laryngotracheal infections--supraglottitis, laryngotracheitis, and
      bacterial tracheitis--as well as for older and newer infectious airway entities.

PMID- 1737423
TI  - Diagnosis of acute thoracic aortic dissection using combined echocardiography and
      computed tomography.
AB  - Acute dissection of the thoracic aorta is a life-threatening emergency requiring
      a diagnosis which is rapid, accurate and safe, and which will distinguish between
      dissections involving the ascending and descending aorta. In the absence of any
      general agreement on the best method of making this diagnosis we studied the use
      of combined echocardiography and contrast-enhanced computed tomography (CT) to
      diagnose acute aortic dissection. Over a 3 year period 23 patients were
      investigated in this way. Aortic dissection was demonstrated in 18 cases,
      involving the ascending aorta in 15, and the descending aorta alone in three. The
      diagnosis of aortic dissection was confirmed in 13 patients at surgery, in one at
      aortography and in one at autopsy. Three patients died without surgery or autopsy
      being performed to confirm the diagnosis and the subsequently which accounted for
      their symptoms. This combined approach has proved a valuable and safe means of
      investigating aortic dissection.

PMID- 1737424
TI  - Computed tomography of paranasopharyngeal spaces: normal variations and criteria
      for tumour extension.
AB  - In 137 normal CT scans of the nasopharynx, the parapharyngeal spaces at the
      nasopharynx level were asymmetrical in 30%. Their difference in width and
      distance from the midline was greater than 1 mm in 51% and 44% respectively. Fat
      was absent in the interpterygoid fascia in 20%, in the alar fascia in 28%, in the
      prevertebral space in 35%, and in the retropharyngeal space in 99% of patients.
      Assessment of tumour extension to the paranasopharyngeal space usually relies on
      symmetry and fascial fat planes. As either feature may not be present in the
      normal person, the relation of the tumour to two lines representing two fascial
      planes is proposed as a complementary method for the evaluation of tumour
      extension.

PMID- 1737425
TI  - Does conventional tomography still have a place in glottic cancer evaluation?
AB  - Computed tomography (CT) can detect laryngeal cancer invading the pre-epiglottic,
      paraglottic spaces, laryngeal cartilages, and soft tissues, but in T1 and limited
      T2 tumours its main value is in evaluating subglottic extent. Conventional
      tomography in the coronal plane has been used with reasonable success to detect
      both subglottic and ventricular invasion and is less expensive than CT. Twenty
      nine cases of glottic carcinoma of all stages were examined clinically,
      endoscopically and radiographically by both coronal conventional tomography and
      CT. The results of these imaging studies are compared in this investigation,
      stressing their relationship to clinical findings (and stage), especially vocal
      and cord mobility. Coronal conventional tomography was found to be as accurate as
      CT for sublottic spread in nine cases of T1 and T2A cancer with normal vocal cord
      mobility. Conventional tomography had a slight tendency to overestimate
      ventricular and false cord involvement (two out of seven patients) with T1
      glottic cancer. When mobility was impaired (four cases) or absent (15 cases), CT
      added data which changed staging and/or treatment plan in six cases. In seven
      others it was suggestive of a more advanced stage.

PMID- 1737426
TI  - Computed tomographic assessment of patients following radical surgery for
      malignant mesothelioma.
AB  - Serial computed tomographic (CT) scans of the thorax and upper abdomen were
      performed in eight patients following radical surgery (pleuro-pneumonectomy) for
      diffuse malignant mesothelioma of the pleura. The post-operative appearances
      included a well defined membrane lining the pleuro-pneumonectomy space in seven
      cases; in two cases this resembled the original tumour. In six patients there was
      upward abdominal visceral displacement on the side of the surgery due to
      diaphragmatic resection; this resulted in contralateral mediastinal shift in four
      patients. One patient required a diaphragmatic prosthesis which produced a
      distinctive CT appearance. CT suggested recurrent mesothelioma in five cases.
      Although two patients had evidence of intrathoracic recurrence, in three patients
      the only feature was the non-specific finding of abdominal ascites. The normal CT
      appearances after pleuro-pneumonectomy should be recognized to facilitate
      radiological interpretation. With careful application CT is of value for the
      assessment of recurrent disease in patients following radical surgery for
      malignant mesothelioma.

PMID- 1737427
TI  - Case report: pancreatic mediastinal pseudocyst--an unusual cause of palpitations.
AB  - We describe a case of pancreatic mediastinal pseudocyst which presented
      atypically with palpitations due to marked cardiac compression. Computed
      tomography (CT) showed a large abdominal pseudocyst extending through the
      diaphragm into the posterior mediastinum. Surgical drainage produced rapid
      symptomatic relief and the pseudocyst resolved completely within 2 months.

PMID- 1737428
TI  - Case report: metadiaphyseal chondroblastoma.

PMID- 1737429
TI  - Case report: CT and MRI of the cauda equina syndrome in ankylosing spondylitis.
AB  - The clinical and radiological findings in a patient with long-standing ankylosing
      spondylitis who developed the clinical features of a cauda equina syndrome are
      presented. CT and MRI revealed characteristic expansion of the lumbar spinal
      canal with scalloping of the laminae and spinous processes related to the
      presence of dorsal dural diverticulae. MRI permitted confident exclusion of other
      intradural pathology without recourse to invasive investigations.

PMID- 1737430
TI  - Case report: heparin-induced thrombocytopenia--a complication presenting to the
      vascular radiologist.
AB  - Heparin-induced thrombocytopenia is an infrequent complication of heparin which
      causes thrombocytopenia and thrombosis. The vascular radiologist can expect to
      come across several cases in his/her career. A high index of suspicion is
      required for early diagnosis. This may befall the radiologist who is asked to
      provide thrombolytic treatment in a heparinized patient. We present such a case
      and discuss the clinical presentation, pathogenesis and management of heparin
      induced thrombocytopenia.

PMID- 1737431
TI  - Case report: calcified brain metastases from an osteogenic sarcoma.

PMID- 1737432
TI  - Diagnosis of peripheral haemangiomas.

PMID- 1737433
TI  - Peritoneal mesothelioma: the role of computed tomography in diagnosis and follow
      up.
AB  - Computed tomography (CT) was performed on 15 patients with proven peritoneal
      mesothelioma. Eight of these patients underwent follow-up CT. It was found that a
      discrete and measurable mass is unusual in comparison with the common occurrence
      of ascites and that therefore CT has little role in quantifying the disease.
      Ascites is usually a prominent feature. Other features (e.g. omental
      infiltration) were evaluated and these could be used to assess disease
      progression.

PMID- 1737434
TI  - Duplex Doppler US in patients with medical renal disease: resistive index vs
      serum creatinine level.
AB  - The relationship between resistive index of arterial Doppler waveform of the
      native kidney and serum creatinine level has been studied using duplex Doppler
      sonography in 40 patients with medical renal disease and 28 normal controls. The
      resistive index of the normal control group and the medical renal disease group
      was 0.627 +/- 0.042 and 0.823 +/- 0.237, respectively, with statistically
      significant difference. In the group with medical renal disease, there was a
      statistically significant correlation between the resistive index and the level
      of serum creatinine. The study suggests that duplex Doppler sonography may be
      helpful in evaluation of renal functional status in patients with medical renal
      disease.

PMID- 1737435
TI  - Pancreatic and renal mobility.
AB  - One hundred and forty-five patients undergoing ultrasound examination for
      unrelated symptomatology were examined with respect to pancreatic position.
      Patients likely to have distorted upper abdominal anatomy were excluded. All
      patients were examined in the supine and left posterior oblique positions in the
      sagittal and transverse planes. The position of the head of the pancreas was
      noted in the following positions: pre-caval, pre-aortic and to the left of the
      aorta. The pancreas was not visualized in both positions in 25 patients, and
      these were excluded from the study. The pancreas changed position with patient
      movement in 45 patients. In eight females a change in position of the right
      kidney was also noted. This study demonstrates that pancreatic and to a lesser
      extent renal mobility is common, particularly in women. Attention is drawn to
      this finding which may cause distortion of the biliary and pancreatic anatomy.
      The altered landmarks may cause confusion in the interpretation of normal and
      abnormal structures.

PMID- 1737436
TI  - Pancreatic pseudocysts: treated with dual drainage.
AB  - Four patients with retrogastric pancreatic pseudocysts were successfully treated
      by the combined placement of a transgastric external drain and a cystogastric
      stent. We describe the advantages of using external transgastric drainage along
      with the cystogastric stent.

PMID- 1737437
TI  - Radiological appearances of small intestinal leiomyomas.
AB  - During a 5 year period we have identified leiomyomas of the small intestine in
      six patients using enteroclysis. Gastrointestinal bleeding were the presenting
      symptoms in five and partial small bowel obstruction in one. The time interval
      between the onset of symptoms and radiological diagnosis ranged between 3 months
      and 5 years. All patients had previously been investigated by a number of
      endoscopic and barium radiology examinations and one had undergone a
      nondiagnostic laparotomy. The jejunum was the site of involvement in one patient
      and the ileum in five. The growth was intraluminal in two cases, extraluminal in
      three and bidirectional (dumb-bell) in one. Radiological appearances included
      round or broad-based semilunar intraluminal filling defects with encroachment of
      the lumen, or intussusception, displacement and/or indentation of the intestinal
      wall with effacement of the overlying mucosa or an ulcer crater, tenting
      deformity and mass effect on neighbouring loops. All six patients came to
      operation. Pre-operative radiological diagnosis was correct in five and
      suggestive in one. There was excellent correlation between the radiological
      appearances and morphology of the pathology specimens.

PMID- 1737438
TI  - Focused microbiologic surveillance by specific hospital unit as a sensitive means
      of defining antimicrobial resistance problems.
AB  - An annual summary of susceptibility patterns for the predominant clinical
      isolates from hospitalized patients can be of considerable assistance in
      selecting antimicrobial agents for sepsis of unclear etiology, as well as for
      guiding empiric therapy for other serious infections. Yearly summaries of the
      susceptibility patterns of the predominant clinical isolates from all patients
      hospitalized at Vanderbilt University Hospital (VUH) from July 1987 through June
      1991 revealed only minor differences over time in susceptibility patterns.
      However, the clinical impression of physicians treating patients in various
      intensive care units (ICUs) was that there were serious resistance problems in
      some units. To better define the prevalence of clinical isolates and their
      susceptibility patterns for patients within ICUs at VUH, we utilized a "focused
      microbiologic surveillance" technique that addressed each unit separately. Both
      the predominant clinical isolates and their susceptibility patterns were
      determined and compared with those from the hospital as a whole. Because
      susceptibility patterns of clinical isolates by site of infection within these
      units were considered important, we also reviewed the summaries of susceptibility
      patterns for blood, sputum, and urine isolates from patients in ICUs and compared
      these with the summaries from each ICU and from the hospital. No major resistance
      problems were identified on a hospital-wide basis. In contrast, focused
      microbiologic surveillance by specific hospital ICU revealed important
      differences in the prevalence of pathogens among units and at different times. In
      1987, Pseudomonas aeruginosa was the single most common Gram-negative organism
      isolated in the neonatal unit, while Acinetobacter spp. were rarely isolated. By
      1991, this trend was completely reversed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737439
TI  - Comparison of susceptibility to beta-lactam antimicrobial agents among bacteria
      isolated from intensive care units.
AB  - Evaluating microbial isolation and susceptibility patterns from institutional
      settings is a well-established component of ongoing infection control activities.
      At the University of Michigan Hospitals, susceptibility profiles for selected
      bacteria tested from 1984 to 1989 were analyzed for major changes in the
      percentage of organisms susceptible to beta-lactam antimicrobials. Data on
      bacteria isolated from respiratory specimens obtained from 1433 patients in
      intensive care units (ICUs) during a 10-month interval were compared with like
      data obtained from 750 non-ICU patients. Antimicrobial agents studied were chosen
      based on hospital formulary availability and prevailing usage in the institution.
      Susceptible and moderately susceptible categories were combined for purposes of
      reporting, since empiric therapeutic doses would cover strains having both
      susceptibility levels. Antimicrobic susceptibilities were compared and
      differences analyzed among the ICUs. Major shifts in susceptibility were noted
      during the 5-year period. The incidence and susceptibility profiles of the
      microorganisms varied considerably between ICU and non-ICU patients. Pseudomonas
      aeruginosa isolates from individual ICUs showed large variations in prevailing
      susceptibilities, with the burn unit harboring the most resistant strains.
      However, the neurological, surgical, and critical care medicine units also showed
      large numbers of antimicrobial-resistant pseudomonads. Among Enterobacter cloacae
      isolates, only imipenem showed a high level of activity against both ICU and
      total hospital isolates. When examined by individual ICU, however, imipenem
      resistance was seen in the general medicine and burn units. The burn and
      pediatric ICUs showed increased rates of recovery of beta-lactam-resistant E.
      cloacae isolates, although significantly high resistance rates were seen
      throughout all ICUs. The surgical ICU was noted to have an abnormally high
      incidence of lower respiratory infections caused by P. aeruginosa. The
      antibiogram indicated that one possible epidemic strain was involved. However,
      when the isolates were subjected to fatty-acid profiling by gas-liquid
      chromatography, it was found that cross-contamination with five discernible
      strains had occurred among the ten patients tested. These preliminary data
      suggest that resistant pseudomonads can be harbored and spread within an ICU, and
      that the ICU can act as a reservoir of resistance that is spread to a "step-down"
      unit.

PMID- 1737440
TI  - The current and future impact of antimicrobial resistance among nosocomial
      bacterial pathogens.
AB  - The selection of drug-resistant microorganisms has generally been associated with
      the widespread use of antimicrobial agents. The emergence of these antimicrobial
      resistance has an undesirable impact that often severely limits the use of these
      drugs that could have otherwise been identified as "drugs of first choice." Among
      the most serious drug-resistance problems, the chromosomally mediated type -I
      beta-lactamase mechanism has become more common among the infecting Gram-negative
      bacteria. Type-I beta-lactamases are routinely identified in Enterobacter spp.,
      Citrobacter freundii, Proteus vulgaris, Pseudomonas spp., Providencia spp.,
      Morganella spp., Serratia spp., and various nonfermenters, including
      Acinetobacter spp., and can be induced to high production when exposed to certain
      beta-lactam antibiotics (for example, ceftazidime or cefoxitin). These organisms
      can also undergo spontaneous mutations to become high-level constitutive beta
      lactamase producers, thus remaining resistant to most beta-lactam antibiotics.
      This has been the most common event at our medical center since 1986. Plasmid
      mediated beta-lactamases and bacterial cell membrane protein alterations also
      confer resistance, resulting in clinically important challenges. At the
      University of Iowa Hospitals and Clinics, beta-lactam-resistant Pseudomonas,
      Citrobacter, and Enterobacter were observed over a 2-year period, an event that
      correlated with the introduction of the "third-generation" cephalosporin
      ceftazidime to the formulary. As ceftazidime use increased from 1986 to 1988, the
      minimal inhibitory concentrations (MICs) for not only ceftazidime but also some
      other "third-generation" cephems increased for Pseudomonas aeruginosa. Similarly,
      susceptibility of Citrobacter spp. and Enterobacter spp. declined during this
      period for ceftazidime and, to a lesser extent, the unrelated broad-spectrum
      penicillin, piperacillin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737441
TI  - Microbial resistance surveillance techniques. Blood culture versus multiple body
      site monitoring.
AB  - The continuing problem of nosocomial bacterial infections has resulted in the
      development of new techniques to monitor their prevalence and detect the
      emergence of drug resistance. "Focused microbial surveillance," in which
      bacterial incidence and antimicrobial susceptibilities are assessed by specific
      hospital units, provides unique information in the evaluation of emerging
      outbreaks of resistant Gram-negative pathogens. Within a given unit, however,
      pooled microbiologic data may be misleading, since they reflect only the average
      of multiple susceptibilities and may represent either colonization or infection.
      Formerly, at the University of Iowa Hospitals and Clinics, bacterial surveillance
      within a particular unit had typically been performed using blood-sample
      analysis, which was viewed as an effective index of the activity of most classes
      of antimicrobial agents. However, specific body site surveillance (wounds,
      sputum, urine, and so forth) may offer advantages over blood-culture analysis
      with some forms of resistance (or types of bacteria), such as stably derepressed
      type-I beta-lactamase production, which seems to develop rather quickly. Site
      specific surveillance may enable earlier detection of rapidly emerging resistant
      strains and the identification of virulent new serotypes or specific causes. Our
      data demonstrated that there is a greater probability of detecting resistant
      bacterial strains of Enterobacter colonizing and subsequently producing
      infections in the respiratory tract, urinary tract, or wound site. There was a
      time delay of almost 3 years between first observing resistant strains in sputum,
      urine, or pus and encountering them in an alarming incidence among blood
      cultures. Other studies confirm this particular phenomenon. In a survey of
      penicillin-resistant enterococci, the majority of clinical isolates were obtained
      from sites other than blood: seven from urine; five from wounds; two each from
      rectal swabs, ascitic fluid, and blood; and one each from a peritoneal catheter,
      Bartholin's cyst abscess, and pancreatic abscess. Effective techniques for
      selective surveillance should be both sensitive and cost effective. Current
      evidence suggests that site-specific monitoring (wounds, sputum, pleural
      effusions, urine, and feces) offers the advantages of more rapid identification
      of resistance trends prior to their appearance in the bloodstream cultures.

PMID- 1737442
TI  - Trends in antibiotic utilization and bacterial resistance. Report of the National
      Nosocomial Resistance Surveillance Group.
AB  - The increasing use of "third-generation" cephalosporins has been associated with
      a rising prevalence of resistant bacteria possessing type-I beta-lactamases. At
      Millard Fillmore Hospital (Buffalo, New York), we observed an unusually high
      occurrence of multiply resistant Enterobacter cloacae infections, especially in
      the intensive care unit. Susceptibilities were found to have declined
      substantially from 1988 to 1990, most notably for ceftazidime and mezlocillin,
      which decreased from 83% to 54% and from 85% to 64%, respectively. During the
      same period, there was a substantial increase in the use of ceftazidime and a
      decline in the use of the broad-spectrum penicillins. The latter drugs had been
      used in combination with an aminoglycoside as the primary empiric antibiotic
      therapy for nosocomial infections. This change in antibiotic-prescribing patterns
      was coincident with the decline in E. cloacae susceptibility, and therefore the
      emergence of multiply resistant E. cloacae was probably a direct consequence of
      the increased prescribing of ceftazidime. The experience at out institution led
      to the formation of the National Nosocomial Resistance Surveillance Group (NNRSG)
      to determine whether this antibiotic use-mediated resistance was a nationwide
      phenomenon. Clinical pharmacists and medical microbiologists were recruited and
      asked to complete a survey of hospital demographics, antibiotic purchases
      (between the beginning of 1988 and the third quarter of 1990), and bacterial
      susceptibilities of six representative organisms to 12 commonly used antibiotics
      (primarily broad-spectrum penicillins and cephalosporins). Evaluable data were
      obtained from 18 hospitals varying widely in bed capacity, antibiotic use, and
      geographic location.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737443
TI  - A review of traditional resistance surveillance methodologies and infection
      control.
AB  - The hospital affords an excellent environment for the proliferation of pathogenic
      bacteria and for the selection of antimicrobial-resistant strains. This article
      traces the evolution of microbiologic surveillance techniques and highlights some
      of the more effective means of infection control. Traditional surveillance
      methods relied on nationwide antimicrobial susceptibility data for practical
      information regarding the nature of infectious disease trends in order to guide
      the selection of appropriate empiric antibiotic therapy. The application of
      nationwide antibiograms to the local hospital setting may mask the local
      emergence of rapidly developing resistances, such as chromosomally mediated type
      I beta-lactamase resistance, which has been associated with increased use of
      certain cephalosporins. "Focused surveillance" techniques yield improved
      detection of emerging localized resistances within specific hospital units. In
      addition to unit-specific surveillance, many hospitals are now observing the
      advantages of an infection site-specific monitoring program. Judicious use of
      newer antimicrobials and implementation of detailed hospitalwide surveillance
      procedures will help to minimize the spread of epidemic and resistant infections.
      It remains the responsibility of the infection control and antibiotic utilization
      or advisory committees to make appropriate recommendations concerning the
      selection, restriction, and proper use of the newer extended-spectrum
      antibiotics. The clinical microbiology laboratory as a source of information
      remains a key participant in a quality program.

PMID- 1737444
TI  - Therapeutic and epidemiologic recommendations to reduce the spread of type-I beta
      lactamase resistance.
AB  - The objectives of this United States Consensus Panel meeting were to evaluate the
      effectiveness of current surveillance systems for the detection of bacterial
      resistance as well as to formulate recommendations that can assist hospitals in
      determining actions that should be taken when a resistance problem is detected.
      These recommendations may be particularly helpful in controlling the emergence
      and spread of type-I beta-lactamase resistance. Numerous case reports of
      antimicrobial resistance among Enterobacter species, Pseudomonas aeruginosa, and
      other Gram-negative nosocomial pathogens known to produce type-I beta-lactamases
      have appeared in the literature since the introduction of the newer "third
      generation" cephalosporins. The widespread use of these newer antimicrobial
      agents, often selected as standard therapy for serious hospital-acquired
      infections, has been associated with a corresponding increase in resistance to
      them. The failure of hospitalwide surveillance methods to describe the scope of
      this problem, especially among the most critically ill patients, may have
      resulted in a false sense of security among some infectious disease specialists
      and clinicians prescribing these antimicrobials as empiric therapy. High-level
      resistance in individual hospital units may be masked in hospitalwide
      antibiograms. A variety of conclusions and recommendations were formulated based
      on the collective experiences of the Consensus Panel members. Microbiology
      laboratories must make it a high priority to identify markers that will assist in
      rapidly identifying resistant organisms. Cooperative efforts are needed among
      users of commercial and automated microbiology test instruments to standardize
      results and to improve quality control, thereby making the data more directly
      comparable between laboratories.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737445
TI  - Antibiotic resistance. Epidemiology and therapeutics.

PMID- 1737446
TI  - Trigeminal neuralgia.
AB  - Although the full and precise etiology of TN still awaits further elucidation,
      this extremely painful disorder can be treated successfully by a variety of
      techniques, pharmacologic and surgical, with minimal side effects. There is no
      excuse in the 1990's for patients with TN not to be diagnosed promptly and
      treated expeditiously and successfully.

PMID- 1737447
TI  - The psychosocial effects of ambiguous genitalia.

PMID- 1737448
TI  - General overview and treatment considerations of anorexia and bulimia.

PMID- 1737449
TI  - Practical aspects of the pharmacotherapy of headache.

PMID- 1737450
TI  - Leuko-araiosis: description and clinical correlates.
AB  - The term leuko-araiosis as predicted by Hachinski may now have outlived its
      usefulness. Careful delineation of the white matter changes seen in MR imaging by
      use of the MR characteristics and by the location of the lesions may reduce the
      apparent heterogeneity of the associate clinical and neuropathological findings.
      As currently defined, leuko-araiosis is seen in aggregate more commonly in
      subjects with cerebro-vascular disease or with cerebro-vascular risk factors but
      it is a common finding associated with aging in otherwise normal, healthy elderly
      subjects. Its clinical significance as an isolated finding in these populations
      should therefore be treated cautiously. Its appearance should alert the physician
      however to seek for and treat potential cerebro-vascular risk factors.

PMID- 1737451
TI  - Time to abandon routine albumin supplementation.

PMID- 1737452
TI  - Hand in glove.

PMID- 1737453
TI  - Effect of hypoalbuminemia and parenteral nutrition on free water excretion and
      electrolyte-free water resorption.
AB  - OBJECTIVE: To measure the effect of human albumin supplementation during
      parenteral nutrition on serum albumin concentrations, colloid oncotic pressure,
      free water clearance, electrolyte-free water resorption, and sodium excretion.
      DESIGN: Prospective, randomized, controlled trial. SETTING: Tertiary care center.
      PATIENTS: Thirty adult, hypoalbuminemic patients who required parenteral
      nutrition. INTERVENTIONS: Parenteral nutrition (control) or parenteral nutrition
      plus human albumin 25 g/L as a continuous infusion (treatment) for a 5-day study
      period. MEASUREMENTS: On days 1 and 5, serum albumin concentration, colloid
      oncotic pressure, free water clearance, electrolyte-free water resorption, and
      sodium excretion were measured. RESULTS: Serum albumin concentrations increased
      significantly from day 1 to day 5 in both groups (control: 2.0 +/- 0.1 [mean +/-
      SEM] vs. 2.3 +/- 0.1 g/dL [20 +/- 1 vs. 23 +/- 1 g/L], p = .02; treatment: 2.2 +/
      0.1 vs. 3.5 +/- 0.2 g/dL [22 +/- 1 vs. 35 +/- 2 g/L], p = .0001). Day 5 serum
      albumin concentrations were significantly higher in the treatment group compared
      with control (p = .0001). Colloid oncotic pressure increased significantly from
      day 1 to day 5 in the treatment group (17.8 +/- 0.8 vs. 25.1 +/- 1.0 mm Hg, p =
      .0001), and was significantly higher than control at day 5 (p = .0001). No
      significant differences were found for free water clearance, electrolyte-free
      water resorption, or sodium excretion within or between groups. CONCLUSIONS: In
      hypoalbuminemic patients, human albumin supplementation during parenteral
      nutrition results in significant increases in serum albumin concentrations and
      colloid oncotic pressure, but has no apparent effect on free water clearance,
      electrolyte-free water resorption, or sodium excretion.

PMID- 1737454
TI  - Anatomy of a defective barrier: sequential glove leak detection in a surgical and
      dental environment.
AB  - OBJECTIVES: a) To determine the frequency of perforations in latex surgical
      gloves before, during, and after surgical and dental procedures; b) to evaluate
      the topographical distribution of perforations in latex surgical gloves after
      surgical and dental procedures; and c) to validate methods of testing for latex
      surgical glove patency. DESIGN: Multitrial tests under in vitro conditions and a
      prospective sequential patient study using consecutive testing. SETTING: An
      outpatient dental clinic at a university dental school, the operating suite in a
      medical school affiliated with the Veteran's Hospital, and a biomechanics
      laboratory. PERSONNEL: Surgeons, scrub nurses, and dental technicians
      participating in 50 surgical and 50 dental procedures. METHODS: We collected 679
      latex surgical gloves after surgical procedures and tested them for patency by
      using a water pressure test. We also employed an electronic glove leak detector
      before donning, after sequential time intervals, and upon termination of 47
      surgical (sequential surgical), 50 dental (sequential dental), and in three
      orthopedic cases where double gloving was used. The electronic glove leak
      detector was validated by using electronic point-by-point surface probing,
      fluorescein dye diffusion, as well as detecting glove punctures made with a 27
      gauge needle. RESULTS: The random study indicated a leak rate of 33.0% (224 out
      of 679) in latex surgical gloves; the sequential surgical study demonstrated
      patency in 203 out of 347 gloves (58.5%); the sequential dental study showed 34
      leaks in the 106 gloves used (32.1%); and with double gloving, the leak rate
      decreased to 25.0% (13 of 52 gloves tested). While the allowable FDA defect rate
      for unused latex surgical gloves is 1.5%, we noted defect rates in unused gloves
      of 5.5% in the sequential surgical, 1.9% in the sequential dental, and 4.0% in
      our electronic glove leak detector validating study. In the sequential surgical
      study, 52% of the leaks had occurred by 75 mins, and in the sequential dental
      study, 75% of the leaks developed by 30 mins. In terms of the anatomical
      localization, the thumb and forefinger accounted for more than 60% of the
      defects. There were no differences in the frequency of glove leaks between the
      left and right hand. Leak rates were highest for the surgeon (52%), followed by
      the first assistant (29%) and the scrub nurse (25%). No false negatives were
      noted using the electronic glove leak detector; one false positive was seen out
      of 225 gloves tested (0.44%), as noted in our validation studies. CONCLUSIONS:
      Significantly high glove leak rates were noted after surgical and dental
      procedures, indicating that the present day latex surgical gloves can become an
      incompetent barrier once they are used. Unused latex surgical gloves demonstrated
      a higher rate of defects than allowed by the Food and Drug Administration
      standards, indicating substantial noncompliance of quality control standards by
      manufacturers as well as inadequate governmental oversight. Double gloving, or
      the use of thicker latex surgical gloves, would probably reduce the frequency of
      glove leaks. Latex surgical gloves should be tested for patency before use and
      during surgical and dental procedures.

PMID- 1737455
TI  - Complications of endotracheal intubation and mechanical ventilation in infants
      and children.
AB  - OBJECTIVE: To assess the frequency of complications of endotracheal intubation
      and mechanical ventilation. DESIGN: Prospective cohort study. SETTING: Pediatric
      tertiary multidisciplinary ICU. PATIENTS: Eight hundred sixty-nine serial
      patients, of whom 500 were endotracheally intubated and 431 were mechanically
      ventilated. INTERVENTIONS: Daily clinical observation. MAIN OUTCOME MEASURES:
      Age, diagnosis, endotracheal tube size, type of ventilator and humidification,
      duration of intubation and mechanical ventilation, ventilatory settings, and
      complications (accidental extubation, tissue damage, endobronchial intubation,
      postintubation stridor, endotracheal tube blockage, pulmonary airleak,
      bronchopulmonary dysplasia, pulmonary atelectasis) were recorded. RESULTS: The
      median patient age was 10 months (25th and 75th quartiles: 1 month and 15 yrs).
      The median duration of endotracheal intubation and mechanical ventilation was 4
      days and 2 days, respectively. A total of 186 complications were recorded in 119
      (24%) patients. No deaths were due to intubation or ventilation. The overall
      frequency of accidental extubation was 3.2% of patients at a rate of 1.26
      extubations/100 intubation days. In nonventilated, unsedated patients with croup
      or epiglottitis, the frequency of accidental extubation was 23% at a rate of
      11.83 extubations/100 intubation days. Lung atelectasis occurred in 7.8%, airleak
      in 6.8%, and infection in 2.3% of patients. Other complications included tissue
      damage (3.4%), endobronchial intubation (2.4%), postintubation stridor (2.4%),
      bronchopulmonary dysplasia (2.3%), and endobronchial tube blockage (0.8%).
      CONCLUSIONS: Complications were related to the duration of intubation and
      mechanical ventilation.

PMID- 1737456
TI  - Hormonal responses to trauma.
AB  - OBJECTIVES: To review the hormonal changes that have been reported after trauma,
      to define their etiologies, and to describe their consequences. DATA SOURCES:
      Literature review using MEDLINE and original data. DATA SYNTHESIS: Hormonal
      responses to trauma are bidirectional. Functional derangements include increases
      in adrenocorticotropin hormone and cortisol, growth hormone, and prolactin
      levels. In contrast, gonadotropin and gonadal steroid, and thyroid hormone
      concentrations decrease. The response is immediate but not necessarily sustained
      for those hormones that respond with increased secretion, whereas the effect may
      not become apparent for several hours, may be maximal after 1 to 4 days, and may
      persist for the duration of illness for those hormones that decrease. The
      reduction in hormone concentrations generally reflect diminished secretion, with
      the exception of the thyroid hormones where altered metabolic pathways and
      enhanced metabolic clearance play a major role. CONCLUSIONS: The changes in
      circulating levels do not appear to be injury specific, but tend to reflect the
      severity of the traumatic insult, and there are some data for cortisol and
      thyroxine that show their concentrations may be of predictive value. In head
      injured patients, structural as well as functional pituitary changes may be
      present. Patients may show varying degrees of pituitary insufficiency. However,
      the presence of hyperprolactinemia strongly suggests involvement of the
      hypothalamus. With the exception of bonafide hypopituitarism, the relevance of
      the hormonal changes after trauma awaits clarification.

PMID- 1737457
TI  - Chloride ion in intensive care medicine.
AB  - OBJECTIVE: To review the physiology of the chloride ion and its relationship to
      various disease states encountered in the ICU. Special emphasis was paid to the
      renal handling of chloride and its role in the evaluation of the urine and serum
      anion gaps. Metabolic acidosis and alkalosis are discussed. DATA SOURCES: English
      language articles were identified through a search of the MEDLINE and Index
      Medicus databases. Bibliographies of retrieved articles were examined for
      relevant articles. STUDY SELECTION: Approximately 125 articles and 25 textbook
      chapters were reviewed. Those articles most applicable to the ICU were used.
      Information contained in text chapters was included primarily in the tables. DATA
      EXTRACTION: All available information was reviewed and analyzed by the authors
      before inclusion. DATA SYNTHESIS: Guidelines for the evaluation of urine and
      serum electrolyte concentrations are presented. The use of the urine anion gap is
      discussed, particularly as it relates to the diagnosis of hyperchloremic
      metabolic acidosis. Stool chloride provides information relevant to congenital
      and acquired diarrheas. The evaluation of metabolic acidosis requires the
      calculation of the serum anion gap. Both normal and increased gap acidoses are
      discussed, although increased gap acidoses are more commonly encountered in the
      ICU. Urine chloride is invaluable in defining whether the metabolic alkalosis is
      sodium-chloride responsive (urine chloride less than 10 mmol/L) or sodium
      chloride-unresponsive (urine chloride greater than 20 mmol/L). CONCLUSIONS:
      Measurement of chloride is a valuable tool in the evaluation and treatment of a
      variety of disorders. Serum chloride is most helpful in assessing both normal and
      increased anion gap metabolic acidoses, while urine chloride finds utility in the
      diagnosis of metabolic alkalosis and hyperchloremia metabolic acidosis. The
      evaluation of any disturbance in chloride homeostasis that defies easy
      explanation necessitates the measurement of stool electrolytes.

PMID- 1737458
TI  - Electrolyte abnormalities in critically ill children.
AB  - OBJECTIVE: To provide a brief overview of the causes, diagnosis, and therapies of
      electrolyte abnormalities frequently seen in critically ill children. DATA
      SOURCE: Published articles and bibliographies identified from pertinent review
      articles and books published in the past 20 yrs on fluid and electrolyte therapy
      in children. CONSTRAINT: The review includes only human studies and articles
      published in the English language. STUDY SELECTION: Human studies pertaining to
      abnormalities of water homeostasis, sodium, potassium, calcium, and magnesium
      homeostasis in children were selected. Prospective randomized studies were
      selected as much as possible. DATA EXTRACTION: Pertinent data abstracted from
      multiple, independent clinical studies were used to develop an approach to
      electrolyte abnormalities in critically ill children. DATA SYNTHESIS: An approach
      to diagnosis and therapies of common electrolyte abnormalities in critically ill
      children. CONCLUSIONS: Electrolyte abnormalities are common in critically ill
      children and can be easily treated once recognized. Further studies are needed to
      better understand the role of ionized calcium and magnesium in neonatal and
      pediatric critical illness.

PMID- 1737459
TI  - Hypocalcemia in critically ill patients.
AB  - PURPOSE: To review calcium regulation, causes of hypocalcemia during critical
      illness, clinical features and treatment of hypocalcemia, hemodynamic effects of
      calcium administration, calcium-catecholamine interactions, and the role of
      calcium in ischemic injury. DESIGN: Representative articles from the medical
      literature are used to support the discussion of selected aspects of calcium
      metabolism which are important to the practice of critical care medicine.
      SUBJECTS: Results from both animal and human investigations and both in vitro and
      in vivo studies are discussed. RESULTS: Circulating calcium levels are best
      measured using ionized calcium electrodes. Ionized hypocalcemia is common in
      critically ill patients and usually results from impaired parathyroid hormone
      secretion or action, impaired vitamin D synthesis or action, or calcium
      chelation/precipitation. Ionized hypocalcemia most commonly presents as
      cardiovascular or neuromuscular insufficiency. Mild ionized hypocalcemia (greater
      than 0.8 mmol/L) is usually asymptomatic and frequently does not require
      treatment. Moderate-to-severe ionized hypocalcemia is best treated with iv
      calcium in the critically ill patient. The majority of studies report no increase
      in cardiac output but a significant increase in BP after iv calcium
      administration. When administered with beta-adrenergic agonists, calcium
      frequently impairs their cardiovascular actions. Intracellular calcium
      dysregulation is common during ischemic and shock states. Agents which increase
      intracellular calcium may be harmful during cellular ischemia. CONCLUSIONS:
      Alterations in calcium regulation and calcium concentrations are common during
      critical illness. Optimal management of altered calcium concentrations requires
      an understanding of the pathophysiology behind these alterations.

PMID- 1737460
TI  - Magnesium-adenosine triphosphate in the treatment of shock, ischemia, and sepsis.
AB  - PURPOSE: To review the rationale for adenosine triphosphate-magnesium chloride
      (ATP-MgCl2) administration in shock, ischemia, and sepsis; the beneficial effects
      on cellular and organ functions and survival; and possible mechanisms of these
      effects. DATA SOURCES: Current literature review. STUDY SELECTION: Articles
      deemed most pertinent, current, and representative were utilized. DATA SYNTHESIS:
      Despite apparent, adequate resuscitation of hypovolemic shock and sepsis in
      experimental animals and patients, persistent cellular and organ dysfunction is
      apparent. Disturbances in organ microcirculation and tissue hypoxia appear to
      play an important role. These disturbances occur when the energy needs are
      increased. Because of the theoretical benefits of ATP-MgCl2 as an energy source,
      as well as a vasodilator, the administration of ATP-MgCl2 has been investigated
      extensively, and considerable evidence suggests that ATP-MgCl2 restores the
      depressed cell and organ functions following ischemia, hypovolemic shock, and
      sepsis. CONCLUSIONS: ATP-MgCl2 improves cellular and organ function and survival
      following experimental shock, ischemia, and sepsis. Studies also indicate that
      ATP-MgCl2 can be administered safely in experimental animals and in normal human
      volunteers, as well as in patients following various adverse circulatory
      conditions. Further trials should be undertaken to determine the effects on cell
      and organ function in patients following traumatic shock and sepsis.

PMID- 1737461
TI  - Metabolic and anatomic thyroid emergencies: a review.
AB  - PURPOSE: To review the diagnosis and management of thyroid diseases, both
      metabolic (thyroid storm and myxedema coma) and anatomic (substernal goiter,
      lymphoma, anaplastic carcinoma) that may require intensive care therapy. DATA
      SOURCES: English-language articles were identified through a search of the
      MEDLINE and Index Medicus databases. Bibliographies of retrieved articles were
      examined for relevant articles. STUDY SELECTION: Approximately 250 articles were
      reviewed. Those articles deemed most representative were utilized. Case reports
      were included to highlight rare, but potentially lethal complications. DATA
      EXTRACTION: All data were analyzed by one observer. Limitations of the data are
      discussed. DATA SYNTHESIS: Guidelines for determining the etiology of thyrotoxic
      crisis are outlined. Criteria for distinguishing critically ill hypothyroid
      patients from those patients with the euthyroid sick syndrome are given. Therapy
      for both disorders must be aggressive and multifaceted, and detailed management
      is indicated. Substernal goiter is almost always benign, but may cause various
      acute complications, including dyspnea, respiratory failure, superior vena caval
      syndrome, esophageal varices (downhill), and others. Surgery almost always
      corrects the problem. Lymphomas present with rapid thyroid enlargement. Recent
      studies suggest that surgery may assume more of a supportive role, used
      principally to obtain adequate tissue for histologic classification. CONCLUSIONS:
      Thyroid disorders can produce emergencies requiring the attention of multiple
      medical and surgical specialists. While management is often successful, future
      studies should address the following three areas: a) optimization of thyroid
      hormone dose for treatment of myxedema coma; b) clarification of the role of
      radiotherapy and/or chemotherapy for thyroid lymphoma; and c) more effective
      therapy for anaplastic carcinoma.

PMID- 1737462
TI  - An evaluation of the physical and functional characteristics of resuscitators for
      use in pediatrics.
AB  - OBJECTIVE: To evaluate the physical and functional characteristics of pediatric
      self-inflating resuscitators. DESIGN: Tested under simulated clinical conditions.
      Results were analyzed by descriptive analysis. SETTING: A pulmonary laboratory in
      a university hospital. METHODS: Eight new pediatric self-inflating resuscitators
      were obtained from the manufacturers and evaluated for functional characteristics
      including: a) fraction of delivered oxygen at 10 L/min and a tidal volume of 300
      mL; b) maximum stroke volume against no resistance; and c) maximum cycling
      frequency at -5 degrees C, 20 degrees C, and 48 degrees C. The resuscitators were
      also evaluated for physical characteristics, including potential for misassembly,
      pressure relief valves, expiratory valve leak, and inspiratory resistance.
      RESULTS: All resuscitators met the minimum standards of the Canadian Standards
      Association and American Standards for Testing of Materials. However, one bag
      cycled at only 32 breaths/min at -5 degrees C, marginally within accepted
      standards. Only five self-inflating resuscitators had pop-off valves. These
      valves malfunctioned, with valve activation occurring well above the accepted
      standards. Three of the self-inflating resuscitators could be misassembled for
      use. Four of the resuscitators were unable to deliver tidal volumes required for
      preoxygenation in a 20-kg child. CONCLUSIONS: While these self-inflating
      resuscitators met the minimum standards, they are all unable to deliver 100%
      oxygen. One unit is probably not appropriate in the out-of-hospital setting when
      ambient temperatures are less than 0 degrees C. Those resuscitators that can be
      misassembled are dangerous in unskilled hands. In addition, reliance on pop-off
      valve activation to limit airway pressure is dangerous.

PMID- 1737463
TI  - Effect of increased intra-aortic balloon pressure on catheter volume:
      relationship to changing altitudes.
AB  - OBJECTIVE: To evaluate the effect of intra-aortic balloon membrane response under
      increasing intracatheter pressure by indexing these data to associated barometric
      pressures that occur with changes in altitude. DESIGN: A static compliance test
      was performed to assess the effect of internal pressure on intra-aortic balloon
      compliance (simulating helium gas within the intra-aortic balloon affected by
      barometric pressure). Testing consisted of incrementally increasing pressure
      within eight percutaneous intra-aortic balloons from four leading manufacturers.
      SETTING: The University of Utah Department of Mechanical Engineering Laboratory.
      PATIENTS: No patients were involved. This study was a bench test lab study.
      INTERVENTIONS: No patient interventions were utilized. RESULTS: Results for all
      trials showed a curvilinear relationship between intracatheter pressure and
      balloon volume. Clinically significant balloon expansion data were obtained, with
      manufacturer variation observed at moderate-to-high pressures. CONCLUSIONS: Based
      on the results of this study, recommendations for operation of intra-aortic
      balloon pumps during altitude ascent and descent are proposed, from which
      individual institutional protocols may be developed.

PMID- 1737464
TI  - Midazolam-induced angioedema and bronchoconstriction.

PMID- 1737465
TI  - Shortcomings of acute physiology and chronic health evaluation II.

PMID- 1737466
TI  - Small-bore feeding tubes.

PMID- 1737467
TI  - Guidelines for care: a surgical perspective.

PMID- 1737468
TI  - Order of markers on chromosome 21.

PMID- 1737469
TI  - A Bayesian analysis for mapping from radiation hybrid data.

PMID- 1737470
TI  - Physical mapping by multiple pairwise analysis.

PMID- 1737471
TI  - A statistical and numerical view of the chromosome 21 physical map data.

PMID- 1737472
TI  - An application of empirical Bayes methods to updating linkage information on
      chromosome 21.

PMID- 1737473
TI  - Mapping of chromosome 21 markers in the Venezuelan pedigree.

PMID- 1737474
TI  - Using recombinant chromosomes to map new markers.

PMID- 1737475
TI  - Multilocus mapping strategies on chromosome 21 data sets: comparison of results
      from family data, radiation hybrids, and somatic cell hybrids.

PMID- 1737476
TI  - Construction and comparison of chromosome 21 radiation hybrid and linkage maps
      using CRI-MAP.

PMID- 1737477
TI  - Preliminary ranking procedures for multilocus ordering based on radiation hybrid
      data.

PMID- 1737478
TI  - Disequilibrium on chromosome 21 in some Utah families.

PMID- 1737479
TI  - Genetic Analysis Workshop 7: recent progress in statistical methods.

PMID- 1737480
TI  - A novel pedigree plotting algorithm.

PMID- 1737481
TI  - Compilation for fast calculation over pedigrees.

PMID- 1737482
TI  - ELODs for three loci.

PMID- 1737483
TI  - A multisample bootstrap approach to the estimation of maximized-over-models lod
      score distributions.

PMID- 1737484
TI  - Linkage analysis of two-locus diseases under single-locus and two-locus analysis
      models.

PMID- 1737485
TI  - Genetic Analysis Workshop 7: summary of the melanoma workshop.

PMID- 1737486
TI  - Description of the National Cancer Institute melanoma families.

PMID- 1737487
TI  - The Dutch FAMMM family material: clinical and genetic data.

PMID- 1737488
TI  - The study of nevi in British twins: study design and description of the data set.

PMID- 1737489
TI  - Number, size, and histopathology of nevi in Utah kindreds.

PMID- 1737490
TI  - Clinical aspects of hereditary melanoma in Australia.

PMID- 1737491
TI  - Preliminary evaluation of linkage between chromosome 1p markers and nevus
      densities in the Utah data.

PMID- 1737492
TI  - Sib-pair linkage analysis applied to pedigrees with melanoma and dysplastic nevi.

PMID- 1737493
TI  - Multivariate genetic analysis of nevus measurements and melanoma.

PMID- 1737494
TI  - Linkage analysis of malignant melanoma with the chromosome 1 markers D1S47 and
      PND.

PMID- 1737495
TI  - Analysis of nevus count data from twins.

PMID- 1737496
TI  - Genetic relationship between nevus count or nevus density and cutaneous malignant
      melanoma.

PMID- 1737497
TI  - Regressive logistic models in linkage analysis of the cutaneous malignant
      melanoma-dysplastic nevus syndrome.

PMID- 1737498
TI  - Is the genetics of moliness simply the genetics of sun exposure? A path analysis
      of nevus counts and risk factors in British twins.

PMID- 1737499
TI  - Segregation analysis of total nevus density and estimation of lifetime risk and
      average onset age of melanoma.

PMID- 1737500
TI  - Inheritance of nevus number and size in melanoma/DNS kindreds.

PMID- 1737501
TI  - Linkage analysis of melanoma alone and chromosome 1p markers PND, D1S47, and
      LMYC.

PMID- 1737502
TI  - Genetic linkage and affected pedigree member analysis in malignant melanoma.

PMID- 1737503
TI  - Linkage analysis with adjustment for covariates: a method combining peeling with
      Gibbs sampling.

PMID- 1737504
TI  - Multivariate analysis of nevus counts in twins.

PMID- 1737505
TI  - Genetic analysis of cutaneous melanoma and dysplastic nevi under varying
      phenotypic definitions.

PMID- 1737506
TI  - Genetic analysis of nevus density in melanoma families.

PMID- 1737507
TI  - Estimated power to detect linkage in three CM/DN data sets.

PMID- 1737508
TI  - Investigation of major gene and covariate effects using a new Poisson process
      model.

PMID- 1737509
TI  - Segregation analysis in cutaneous malignant melanoma/dysplastic nevus syndrome
      families.

PMID- 1737510
TI  - Fitting genetic data using Gibbs sampling: an application to nevus counts in 38
      Utah kindreds.

PMID- 1737512
TI  - Genetic Analysis Workshop 7: issues in gene mapping and detection of major genes.
      Dayton, Ohio, October 14-16, 1990.

PMID- 1737511
TI  - PEDSCORE analysis of identical by descent (IBD) marker allele distributions among
      family members with cutaneous melanoma.

PMID- 1737513
TI  - Genetic Analysis Workshop 7: radiation hybrid and somatic cell hybrid mapping of
      chromosome 21.

PMID- 1737514
TI  - Genetic Analysis Workshop 7: mapping chromosome 21 linkage markers.

PMID- 1737515
TI  - Radiation hybrid mapping.

PMID- 1737516
TI  - The role of somatic cell hybrids in physical mapping.

PMID- 1737517
TI  - Chromosome 21 genetic linkage data set based on CEPH pedigrees.

PMID- 1737518
TI  - The gene order problem when using somatic cell hybrids.

PMID- 1737519
TI  - Comparisons of radiation hybrid mapping and linkage mapping.

PMID- 1737520
TI  - Radiation hybrid mapping by minimization of the number of obligate chromosome
      breaks.

PMID- 1737521
TI  - A theory for radiation hybrid (Goss-Harris) mapping: application to proximal 21q
      markers.

PMID- 1737522
TI  - Accepting parental responsibility: "future questioning" as a means to avoid
      foster home placement of children.

PMID- 1737523
TI  - The impact of family structure on the adjustment of adopted children.
AB  - Psychological and academic adjustments were assessed in a group of 130 adopted
      children (six to 12 years of age) living in five different family constellations:
      only children, children with younger adopted siblings only, children with younger
      biological siblings only, children with older adopted siblings only, and children
      with older biological siblings only. Few differences were found from one cluster
      to another, suggesting that family structure, while complicating the dynamics of
      adoptive family life, plays a minor role in adoption adjustment.

PMID- 1737524
TI  - The Family Connection Center: an innovative visiting program.
AB  - Child-family visiting in out-of-home care is at the heart of determining whether
      the family will be reunified or other permanency plans will be made. A purchase
      of-service arrangement enables a voluntary agency to carry a portion of the
      visiting process for a public agency in a coordinated operation. A separately
      funded unit of the voluntary agency offers a visiting service for children of
      divorce whose parents are at serious odds with each other.

PMID- 1737525
TI  - Glutathione infusion potentiates glucose-induced insulin secretion in aged
      patients with impaired glucose tolerance.
AB  - OBJECTIVE: To evaluate the effect of glutathione infusion on beta-cell response
      to glucose in elderly people with impaired glucose tolerance (IGT). RESEARCH
      DESIGN AND METHODS: Ten patients with normal glucose tolerance and 10 patients
      with IGT were matched for age (mean +/- SE, 72.1 +/- 2.8 vs. 71.0 +/- 3.4 yr),
      body mass index (23.1 +/- 1.1 vs. 22 +/- 2.1 kg/m2), and sex (6/4 vs. 5/5,
      men/women) underwent glutathione infusion (10 mg/min) under basal conditions and
      during 75-g oral glucose tolerance tests and intravenous glucose tolerance tests
      (0.33 g.kg body wt-1.3 min-1). Patients with IGT were also submitted to
      euglycemic-hyperinsulemic and hyperglycemic glucose clamps. RESULTS: In subjects
      with normal glucose tolerance, glutathione infusion failed to affect beta-cell
      response to glucose. In contrast, glutathione significantly potentiated glucose
      induced insulin secretion in patients with IGT. Furthermore, in the latter group
      studied by hyperglycemic clamps, glutathione infusion significantly potentiated
      the beta-cell response to glucose when plasma glucose levels varied between 10
      and 15 mM. This effect disappeared at plasma glucose levels greater than 15 mM.
      No effect of glutathione on insulin clearance and action was observed.
      CONCLUSIONS: Glutathione infusion enhances insulin secretion in elderly people
      with IGT.

PMID- 1737526
TI  - Care of diabetic pregnant women by primary-care physicians. Reported strategies
      for managing pregestational and gestational diabetes.
AB  - OBJECTIVE: To ascertain the strategies used by primary-care physicians for
      treating pregestational and gestational diabetes mellitus (GDM) during pregnancy,
      because many women with pregnancies complicated by these types of diabetes are
      treated by physicians who have no special training in intensive diabetes
      management. RESEARCH DESIGN AND METHODS: Two hundred twenty-four family-practice
      (FP) physicians and 184 obstetrics/gynecology (OB/GYN) physicians were surveyed
      by mail. RESULTS: When compared with OB/GYNs, FPs were less likely to screen all
      pregnant women for GDM (P = 0.03), use multiple-injection insulin regimens (P =
      0.004) or self-monitoring of blood glucose (SMBG) (P = 0.01) for Pre-GDM
      patients, and refer these patients to a specialist for medical (P = 0.01) or
      ophthalmologic (P less than 0.001) care. FPs were more likely to implement
      insulin therapy (P = 0.003), SMBG (P = 0.02), and examine eyes for retinopathy (P
      less than 0.001) when treating gestational patients. CONCLUSIONS: These data show
      that there are considerable discrepancies between the strategies used by FPs and
      OB/GYNs and also suggest that physicians in both groups are under-utilizing
      recommended treatment strategies described in publications targeted specifically
      to primary-care physicians. Increased exposure to and dissemination of guidelines
      for diabetes management and additional medical school and postgraduate education
      programs are recommended as methods to improve utilization of these strategies.

PMID- 1737527
TI  - Accuracy of a filter paper method for measuring glycosylated hemoglobin.
AB  - OBJECTIVE: To compare glycosylated hemoglobin (GH) results obtained by filter
      paper fingerstick collection and mailed for assay by affinity chromatography with
      results from a venous sample assayed by ion-exchange chromatography (HbA1) in a
      local laboratory. RESEARCH DESIGN AND METHODS: Fifty-eight volunteer subjects
      with insulin-dependent diabetes mellitus (IDDM), aged 5-24 yr, included patients
      at a referral-based IDDM clinic and subjects in an ongoing research study. We
      obtained two blood samples from each subject. One was collected by fingerstick
      onto filter paper, the other by venipuncture into a vacutainer. We sent filter
      paper samples to the Diabetes Research Laboratory (Univ. of Missouri, Columbia,
      MO) for analysis. Vacutainer samples were sent to the Clinical Chemistry
      Department of the Clinical Laboratory, University of Colorado Health Sciences
      Center. RESULTS: Results were highly correlated (r = 0.89, P = 0.0001). Fifty
      nine percent were classified identically when results were normalized to SD units
      and grouped to suggest levels of clinical concern. CONCLUSIONS: The filter paper
      method is a convenient, accurate measure of glycosylated hemoglobin in young
      people with IDDM. It should be considered a credible alternative research and
      clinical tool.

PMID- 1737528
TI  - Prevalence of diabetes and impaired glucose tolerance among Navajo Indians.
AB  - OBJECTIVE: To estimate the prevalence of diabetes mellitus and impaired glucose
      tolerance and the incidence of clinically diagnosed diabetes in a community of
      Navajo Indians. RESEARCH DESIGN AND METHODS: We conducted a survey of a
      representative Navajo community screened for diabetes 3 yr previously. We used 75
      g oral glucose tolerance tests to determine the prevalence of diabetes mellitus
      and impaired glucose tolerance and conducted medical record reviews to identify
      cases of diabetes that were diagnosed during routine medical care after the
      earlier study. RESULTS: By World Health Organization diagnostic criteria, the age
      adjusted diabetes prevalence among 419 Navajo Indians 20-74 yr of age was 13.9%
      (95% confidence interval [CI] 9.2-18.5) for men and 18.4% (95% CI 14-22.8) for
      women. The ratio of the prevalence of diabetes among the Navajo population
      studied to that in the general United States population was 2.5. The prevalence
      of impaired glucose tolerance was 8% (95% CI 3.3-12.7) among men and 12.9% (95%
      CI 7.9-17.9) among women. Based on clinical diagnoses of diabetes made during
      routine medical care, mean +/- SE age-adjusted incidence of diagnosed diabetes
      among men was 8.6 +/- 4.3/1000 person-yr and 11.1 +/- 4.4/1000 person-yr among
      women. CONCLUSIONS: Although lower than that of some other tribes, the prevalence
      of diabetes among Navajo Indians is substantially higher than that in the general
      U.S. population. The high rate of clinical diagnoses suggests that the prevalence
      of the disease may continue to rise.

PMID- 1737529
TI  - Effects of human insulin on insulin binding antibody production in nondiabetic
      subjects.
AB  - OBJECTIVE: To test the hypothesis that human insulin may have a low
      immunogenicity and that short-term exposure may not cause endogenous insulin
      antibody production. RESEARCH DESIGN AND METHODS: Randomized double-blind
      prospective study. Serum samples collected for insulin binding antibodies and
      measured by a sensitive immunochemical assay. Subjects were seven healthy
      nondiabetic patients who had never received exogenous insulin. Each subject
      received 6 separate monthly injections of human insulin. On four occasions, both
      regular and NPH insulin were administered. On the other two occasions, either NPH
      or regular insulin was administered alone. RESULTS: Mean +/- SE basal insulin
      antibody levels (1.2 +/- 0.2 micrograms/L) increased to a maximal level of 4.5 +/
      0.8 micrograms/L after four injections. Thereafter, antibody levels declined to
      an end-of-study value of 2.5 +/- 0.3 micrograms/L. This represented a highly
      significant overall increase (P less than 0.001). A control group of six insulin
      dependent diabetic subjects treated with human insulin over the same period as
      the test subjects demonstrated no change in insulin antibody concentrations (2.8
      +/- 0.7-2.7 +/- 0.6 micrograms/L). CONCLUSIONS: These results suggest that human
      insulin preparations, when administered subcutaneously, may be more immunogenic
      than previously considered. The antigenic response was rapid, because only four
      subcutaneous injections were sufficient to produce insulin antibody levels in
      nondiabetic patients similar to those observed in insulin-dependent diabetic
      patients receiving chronic insulin replacement therapy.

PMID- 1737530
TI  - Odyssey.

PMID- 1737531
TI  - Magic bullets, reportable disease, and prevention of childhood diabetes.

PMID- 1737532
TI  - Glutamate decarboxylase: an autoantigen in IDDM.

PMID- 1737533
TI  - Exercise in NIDDM may be a prescription for protection.

PMID- 1737534
TI  - New clues to IDDMs origins.

PMID- 1737535
TI  - Community-based retinopathy clinics.

PMID- 1737536
TI  - Effect of gemfibrozil on intermediate-density lipoproteins in NIDDM patients. A
      retrospective study.

PMID- 1737537
TI  - Topical capsaicin in painful diabetic neuropathy. Effect on sensory function.
AB  - OBJECTIVE: To examine the effect of capsaicin on sensory function in painful
      diabetic neuropathy. RESEARCH DESIGN AND METHODS: We examined the effects of
      topical 0.075% capsaicin cream on thermal and vibration thresholds in 22 subjects
      with painful diabetic neuropathy who participated in a double-blind vehicle
      controlled therapeutic trial. RESULTS: After 8 wk of use, there was no
      significant change in warm and vibration thresholds, but the cold threshold was
      significantly reduced by capsaicin and vehicle creams to an equal degree. In
      fewer subjects who used capsaicin cream in an open-label study, there was no
      significant effect on sensory thresholds after up to 32 wk of use. CONCLUSIONS:
      Although our results and those of others show no adverse effects of topical
      0.075% capsaicin on human sensory function, even in subjects with preexisting
      neuropathic sensory impairment, the small number of subjects tested does not
      justify an inferential statement on safety. Further studies in more subjects are
      warranted to ensure the long-term safety of capsaicin for pain relief in humans.

PMID- 1737538
TI  - Normalization of composition of triglyceride-rich lipoprotein subfractions in
      diabetic subjects during insulin infusion with programmable implantable
      medication system.
AB  - OBJECTIVE: To investigate whether long-term improved glycemic control by
      intraperitoneal insulin infusion normalizes the compositional abnormalities of
      triglyceride (TG)-rich lipoproteins in insulin-dependent diabetes mellitus
      (IDDM). RESEARCH DESIGN AND METHODS: Seven subjects were studied before and 12-14
      mo after initiation of treatment with the programmable implantable medication
      system (PIMS). Plasma TG levels were measured, and the composition of three TG
      rich lipoprotein subfractions (Svedberg flotation [Sf] greater than 400, 100-400,
      and 20-100) were analyzed before and every 1.5 for 7.5 h after ingestion of corn
      oil. RESULTS: PIMS significantly improved glycemic control, as measured by mean
      blood glucose (P less than 0.02), and HbA1 (P less than 0.001, paired t test)
      levels. Weight loss was also observed during PIMS treatment. Significant changes
      occurred in the composition of TG-rich lipoprotein subfractions during PIMS
      treatment in both the fasting (P less than 0.002) and the postprandial (P less
      than 0.0001) state. Most changes were in the direction of nondiabetic values.
      PIMS treatment reduced the total cholesterol enrichment in IDDM subjects in all
      three subfractions in the postprandial state and the very-low-density lipoprotein
      subfractions (Sf 100-400 and 20-100) in the fasting state. Multivariate analysis
      showed that the compositional changes were affected by improved glycemic control,
      as assessed by both mean blood glucose and HbA1, whereas the very-low-density
      lipoprotein compositional changes were by both the improved glycemic control and
      body weight. CONCLUSIONS: In IDDM subjects during PIMS treatment, there was
      normalization of most abnormalities in the composition of fasting and
      postprandial TG-rich lipoproteins, including enrichment in total cholesterol,
      which is considered atherogenic.

PMID- 1737539
TI  - Effect of conventional and intensified insulin therapy on free-insulin profiles
      and glycemic control in NIDDM.
AB  - OBJECTIVE: To investigate the effects on 24-h insulin and glucose profiles of two
      and four-dose insulin regimens in patients with non-insulin-dependent diabetes
      mellitus (NIDDM) who have failed oral agent therapy. RESEARCH DESIGN AND METHODS:
      Ten patients with NIDDM and 10 matched nondiabetic control subjects took part in
      the study, a randomized crossover trial with 8-wk treatment periods. We
      determined 24-h profiles of blood glucose and free insulin in control subjects
      and patients when they were taking oral agents and at the end of each treatment
      period. The two-dose regimen was mixed (15% regular, 85% NPH) insulin given
      before breakfast and dinner, and the four-dose regimen was regular insulin given
      before meals and NPH given at 2200. RESULTS: Patients taking oral agents had
      higher mean blood glucose than control subjects (mean +/- SE 12.6 +/- 0.6 vs. 4.5
      +/- 0.1 mM, P less than 0.0001) and similar 24-h insulin concentrations but lower
      postprandial insulin concentrations (at breakfast, 87.6 +/- 13.8 vs. 228.6 +/-
      29.4 pM, P less than 0.01). Mean 24-h insulin concentrations were the same on two
      and four-dose regimens, and both regimens caused basal hyperinsulinemia.
      Glycemic control also improved. Postprandial insulin peaks were higher at lunch
      and dinner on the four-dose regimen, and postprandial blood glucose was lower.
      Fasting proinsulin was elevated in patients compared with the control subjects
      (25.1 +/- 4.7 pM vs. 5.0 +/- 0.9 pM, P less than 0.001) and was suppressed to
      normal during insulin treatment. CONCLUSIONS: Two- and four-dose insulin regimens
      can achieve similar glycemic control. Both regimens cause basal hyperinsulinemia
      but normalize the hyperproinsulinemia observed during failure of oral agent
      therapy. Four-dose insulin regimens offer few advantages to the glycemic control
      achieved with two-dose regimens but may be more physiological.

PMID- 1737540
TI  - Lipid status after pancreas-kidney transplantation.
AB  - OBJECTIVE: This study was performed to determine the net effects of euglycemia,
      resolution of renal failure, immunosuppressant drugs, and hyperinsulinemia on
      fasting lipid profiles of patients with renal failure and insulin-dependent
      diabetes mellitus (IDDM) after combined pancreas-kidney transplantation (PKT).
      RESEARCH DESIGN AND METHODS: Thirty subjects with IDDM received PKT between April
      1989 and October 1990, and all were studied. Mean +/- SE age was 35.2 +/- 1.3 yr;
      19 recipients were men, and 11 were women. All had a functioning pancreatic
      allograft post-PKT. Fasting lipid profiles including total cholesterol (C),
      triglyceride (TG), high-density lipoprotein cholesterol (HDL-chol), and C/HDL
      chol were compared before and after PKT (38-555 days divided into groups:
      preoperation and 0-2, 3-8, and 9-19 mo). RESULTS: Significant hyperlipidemia was
      observed preoperatively (means +/- SE): C, 5.92 +/- 0.27 mM; HDL-chol, 1.07 +/-
      0.09 mM; TG, 5.85 +/- 0.56 mM; and C/HDL-chol, 6.49 +/- 0.83. All lipids and
      C/HDL-chol dropped immediately after PKT (0-2 mo vs. preoperation, all P less
      than 0.01, except HDL-chol). After this immediate postoperative period, C, HDL
      chol, and TG stabilized at new concentrations. C (5.44 +/- 0.22 mM) and TG (4.54
      +/- 0.48 mM) levels were less than preoperation (not statistically significant
      and P less than 0.05, respectively). HDL-chol was greater than preoperative
      values (1.29 +/- 0.06 mM, P less than 0.05). C/HDL-chol dropped after PKT (0-2
      mo, 4.85 +/- 0.18, P less than 0.01) and continued to decrease throughout the
      observation period (3-8 mo, 4.42 +/- 0.23; 9-19 mo, 4.23 +/- 0.23; both P less
      than 0.01 vs. preoperation). There was no statistical difference between lipid
      concentrations in male and female subjects. CONCLUSIONS: The lipid status of
      subjects with IDDM and renal failure was abnormal before PKT and once lipid
      concentrations stabilized after PKT (greater than 2 mo), HDL-chol was higher and
      TG and C/HDL-chol levels were significantly lower than preoperative values. If
      these changes are sustained, risk of future cardiovascular disease in this group
      of patients might be significantly reduced.

PMID- 1737541
TI  - Parental and professional estimates of self-care independence of children and
      adolescents with IDDM.
AB  - OBJECTIVE: To report the results of a survey of 490 parents of children with
      insulin-dependent diabetes mellitus (IDDM) regarding the children's mastery of 38
      diabetes-care skills. Parental responses are contrasted with those of a previous
      survey in which 229 diabetes professionals estimated ages at which typical
      children with IDDM master the same skills. RESEARCH DESIGN AND METHODS: Parents
      were recruited at five pediatric endocrinology clinics with a response rate of
      88.9%. RESULTS: For 33 of 38 skills, professionals' median mastery age estimates
      exceeded, by greater than or equal to 1 yr, the median ages that parents reported
      skill mastery by their estimates, children. Despite the parent-professional
      disagreement about mastery-age their survey responses yielded substantial
      agreement about the order of mastery of specific skills. The data also revealed
      two profiles of comparative results. For many items, parents reported earlier
      skill mastery, but parental and professional estimates eventually converged
      during adolescence. These skills consisted of rote, motoric acts, or more complex
      tasks for which errors yield relatively certain aversive consequences. For other
      skills, more professional estimated skill mastery among adolescents than did
      parents. These skills required substantial organization and self-regulation by
      the adolescent, involved treatment components for which the aversive consequences
      of errors are deferred and uncertain, or they were skills infrequently required
      of most patients with IDDM. CONCLUSIONS: The parent-professional discordance
      revealed by this survey illustrates the importance of clear specification of
      treatment responsibilities, careful monitoring of self-care competence, and
      periodic reeducation of children with IDDM.

PMID- 1737542
TI  - Randomized comparison of metabolic control achieved by intraperitoneal insulin
      infusion with implantable pumps versus intensive subcutaneous insulin therapy in
      type I diabetic patients.
AB  - OBJECTIVE: To compare intraperitoneal implantable insulin infusion (IP) to
      subcutaneous (SC) intensive insulin therapy. RESEARCH DESIGN AND METHODS: Twenty
      one insulin-dependent (type I) diabetic patients aged 24-61 yr underwent a 3-mo
      treatment optimization using multiple SC daily injections or external pumps.
      Patients were then randomized (time 0 mo) to IP infusion using Infusaid
      programmable pumps or continuation on SC intensive insulin for 6 mo. RESULTS: No
      differences were noted between study and control group data. However,
      longitudinal within-group comparisons from baseline showed that glycosylated
      hemoglobin improved to near-normal in both groups: IP, 9.0 +/- 0.5 vs. 7.8 +/-
      0.6% (P less than 0.05) and SC, 8.4 +/- 0.5 vs. 7.5 +/- 0.3% (P less than 0.5) at
      0 and 4 mo, respectively (normal less than 6.9%). The percentage of blood glucose
      tests greater than 11 mM at 0 and 6 mo was 28 +/- 5 vs. 16 +/- 4% in the IP group
      (P less than 0.05) and 22 +/- 5 vs. 24 +/- 7% in the SC group (NS). At 0 and 6
      mo, the standard deviation of blood glucose values, an index of glycemic
      fluctuations, was 4.3 +/- 0.4 vs. 3.2 +/- 0.5 mM in the IP group (P less than
      0.05) and 3.7 +/- 0.3 vs. 4.0 +/- 0.4 mM in the SC group (NS). Weight, insulin
      dosages, circulating lipid levels, and the frequency of severe hypoglycemic
      reactions and biochemical hypoglycemias were similar and did not change in the
      two groups. CONCLUSIONS: IP-implantable pumps compared with SC intensive insulin
      therapy have similar effects on most metabolic variables and are equally
      effective at achieving near-normal glycemic levels. Only longitudinal data
      suggest that IP treatment may be more effective at limiting glycemic
      fluctuations.

PMID- 1737543
TI  - Natural course of remission in IDDM during 1st yr after diagnosis.
AB  - OBJECTIVE: To describe the natural course of clinical remission in insulin
      dependent diabetes mellitus (IDDM) when insulin dose is minimized without loss of
      target glycemia and to identify factors that predict clinical remission. RESEARCH
      DESIGN AND METHODS: Ninety-five patients, who were placebo-treated control
      subjects in the Canadian-European multicenter randomized trial of cyclosporin A
      in recent-onset IDDM, were studied. RESULTS: The mean insulin dose decreased
      during the first months after diagnosis, with a nadir at 3 mo, when 27% of the
      patients did not require insulin to maintain target glycemia. At 1 yr, 10% of
      patients still did not need insulin. Patients not receiving insulin who had
      glycosylated hemoglobin within the normal range were called remitters. Mean basal
      and glucagon-stimulated C-peptide values were significantly (P less than 0.025)
      higher in remitters than nonremitters at the start of the study. Therefore, all
      patients were divided into those with values above the mean stimulated C-peptide
      (0.4 nM) and those with values below the mean at entry. The probability of
      entering a remission with a stimulated C-peptide greater than 0.4 nM was 10 times
      as high (P less than 0.05) as for those with a stimulated C-peptide below this
      level. Surprisingly, the beginning and end of the remission were associated with
      neither major changes in C-peptide levels nor islet cell antibody and insulin
      antibody titer. A more rapid loss of stimulated C-peptide occurred in patients
      who lacked HLA-DR3 and -DR4 (P less than 0.05 at mo 9). CONCLUSIONS: This study
      shows a higher spontaneous clinical remission rate than expected during the 1st
      yr after diagnosis. Preserved beta-cell function at entry predicts a greater
      chance of entering a remission, and a more rapid loss of beta-cell function was
      seen in patients without HLA-DR3 and -DR4.

PMID- 1737544
TI  - Benefits and risks with glyburide and glipizide in elderly NIDDM patients.
AB  - OBJECTIVE: To compare the efficacy, benefits, and risks of glyburide and
      glipizide in elderly patients with non-insulin-dependent diabetes mellitus
      (NIDDM). RESEARCH DESIGN AND METHODS: Twenty-one elderly outpatients (mean age 70
      yr) were treated for 8 wk, after being dose-titrated to achieve a fasting plasma
      glucose (FPG) concentration of less than 7.8 mM with glyburide or glipizide in a
      randomized crossover trial. FPG and postprandial plasma glucose, serum C-peptide,
      and HbA1c levels were measured. In 13 patients, self-monitoring of blood glucose
      (SMBG) with a memory meter was performed seven times per week. RESULTS: Glipizide
      (11.9 mg) and glyburide (8.4 mg) produced similar fasting and postprandial plasma
      glucose and HbA1c concentrations. No significant differences in basal or
      stimulated C-peptide levels were detected. Despite a few patient reports of
      hypoglycemia, a high incidence of SMBG readings less than 4.5 mM was attributed
      to the use of both drugs. CONCLUSIONS: Both treatments proved effective for
      glycemic control; however, both second-generation sulfonylureas are associated
      with a significant risk of hypoglycemia in elderly NIDDM patients. The proper use
      of sulfonylureas in this population should include close surveillance of
      ambulatory glucose monitoring and intensive and repeated patient education about
      the risks of hypoglycemia.

PMID- 1737545
TI  - Topical capsaicin in painful diabetic neuropathy. Controlled study with long-term
      follow-up.
AB  - OBJECTIVE: We conducted an 8-wk controlled study with topical 0.075% capsaicin in
      subjects with chronic severe painful diabetic neuropathy who were unresponsive or
      intolerant to conventional therapy. Capsaicin is an alkaloid found in capsicum
      peppers and produces desensitization to noxious thermal, chemical, and mechanical
      stimuli when applied topically. RESEARCH DESIGN AND METHODS: In 22 randomly
      assigned subjects, either capsaicin or vehicle cream was applied to painful areas
      4 times/day. Pain measurements were recorded at baseline and at 2-wk intervals
      for 8 wk. RESULTS: Capsaicin treatment was more beneficial than vehicle treatment
      in the overall clinical improvement of pain status, as measured by physician's
      global evaluation (P = 0.038) and by a categorical pain severity scale (P =
      0.057). Decrease in mean pain intensity by a visual analogue scale was 16% in
      capsaicin-treated and 4.1% in vehicle-treated subjects. Mean pain relief on
      visual analogue scale was 44.6 and 23.2%, respectively. In a follow-up open-label
      study, approximately 50% of subjects reported improved pain control or were
      cured, and 25% each were unchanged or worse. A burning sensation at the
      application site was noted by some subjects but both its magnitude and duration
      decreased with time. CONCLUSIONS: Results from this preliminary study suggest
      that topical 0.075% capsaicin may be of value in subjects with diabetic
      neuropathy and intractable pain.

PMID- 1737546
TI  - Community-based epidemiological study on diabetes in Pu-Li, Taiwan.
AB  - OBJECTIVE: To determine the prevalence and possible risk factors associated with
      diabetes in Pu-Li, Taiwan. RESEARCH DESIGN AND METHODS: The project was a
      community-based cross-sectional study with stratified cluster sampling of
      residents greater than or equal to 30 yr of age. Medical students conducted home
      visit interviews with public health nurses, drew fasting blood samples from 1738
      of 2573 registered residents greater than or equal to 30 yr of age in Pu-Li,
      Taiwan. RESULTS: The prevalence of diabetes, including those with a history of
      diabetes and newly diagnosed cases determined by modified World Health
      Organization criteria, was 12.4%. With the standard world population of Segi, the
      age-adjusted prevalences were 6.9% for previous diabetes and 4.4% for new
      diabetes. The age-specific prevalence of diabetes increased significantly with
      age for new diabetes cases but not for previously diagnosed cases. To study
      factors associated with diabetes, we first applied univariate analysis.
      Stratified analyses by age and sex were used for interaction assessment. A
      significant interaction effect on diabetes was found between age and sex.
      Logistic regression was used for multivariate analysis. The final model showed
      that, after controlling for all other covariates, the significant factors
      associated with diabetes were family history of diabetes (father and/or mother,
      yes vs. no, odds ratio [OR] 3.13, 95% confidence interval [CI] 1.17-8.33),
      obesity (yes vs. no, OR 2.69, 95% CI 1.09-6.63), and age (continuous, OR 1.04,
      95% CI 1.00-1.08). Locality and physical activity were not significantly
      correlated with diabetes. CONCLUSIONS: The age-adjusted prevalence of diabetes in
      Pu-Li were 6.9% for previous diabetes and 4.4% for new diabetes. Possible risk
      factors associated with diabetes with logistic regression were family history of
      diabetes, obesity, and age. Locality and physical activity were not significantly
      correlated with diabetes.

PMID- 1737547
TI  - Relationship of self-efficacy and binging to adherence to diabetes regimen among
      adolescents.
AB  - OBJECTIVE: To test the hypothesis that poorer adherence to diabetes care is
      related to four variables associated with self-concept in adolescents with
      diabetes: self-esteem, self-efficacy, depression, and binging behavior. In
      addition, we expected adolescent females to be less adherent to diabetes care.
      RESEARCH DESIGN AND METHODS: We recruited 193 consecutive patients (aged 13-18
      yr) with insulin-dependent diabetes mellitus during their regular quarterly visit
      to a diabetes clinic in a large urban hospital. Participants completed the
      Rosenberg Self-Esteem Scale, the Children's Depression Inventory, an assessment
      of the frequency of binging in the past 3 mo, and parallel forms of an adherence
      scale and a self-efficacy scale that were developed for use in this study.
      RESULTS: Adolescents who reported lower adherence tended to report lower self
      esteem (r = 0.45, P less than 0.001) and self-efficacy (r = 0.57, P less than
      0.001), more depressive symptoms (r = -0.50, P less than 0.001), more binging (r
      = -0.36, P less than 0.001), and had higher HbA1c (r = -0.24, P less than 0.001)
      than those with higher adherence scores. Together, the psychological variables
      accounted for 50% of the variance in adherence. There was no sex difference in
      reported binging, but, as expected, adolescent females reported less adherence
      overall (F[7,184] = 2.5, P = 0.018). CONCLUSIONS: Treatment adherence in
      adolescents with insulin-dependent diabetes mellitus is associated with
      behavioral and psychological variables. These findings suggest that specific
      behavioral and cognitive interventions could be used to improve adherence in
      those individuals who lack confidence in their ability to perform diabetes
      related tasks.

PMID- 1737548
TI  - Increasing trend of outpatient management of children with newly diagnosed IDDM.
      Colorado IDDM Registry, 1978-1988.
AB  - OBJECTIVE: To examine the management of newly diagnosed insulin-dependent
      diabetes mellitus (IDDM) in Colorado over time and to determine the prevalence of
      outpatient care at IDDM diagnosis on a statewide basis. RESEARCH DESIGN AND
      METHODS: The Colorado IDDM Registry was used to assess medical care at the
      diagnosis of IDDM in 1182 patients less than 18 yr of age between 1978 and 1988.
      RESULTS: Twenty-three percent of children with IDDM in Colorado reported never
      being hospitalized during the diagnosis period. Treatment of IDDM at diagnosis
      (outpatient vs. inpatient) did not differ by age, sex, or ethnicity/race.
      Patients living in rural counties were less likely to have been treated as
      outpatients at diagnosis than those living in urban counties. Physicians at
      specialized diabetes clinics (e.g., The Barbara Davis Center for Childhood
      Diabetes and The Childrens Hospital) were more likely to treat newly diagnosed
      children in an outpatient setting than physicians not affiliated with these
      clinics. The proportion of patients receiving only outpatient care at IDDM
      diagnosis increased from 6% in 1978 to 35% in 1988. This increase can be
      attributed to three factors: 1) an increase in the number of Colorado children
      diagnosed at The Barbara Davis Center, where outpatient care is strongly
      advocated; 2) a change in treatment practices at The Childrens Hospital away from
      routine hospitalization at onset; and 3) a steady increase in outpatient care for
      newly diagnosed diabetic children by physicians who were not affiliated with the
      aforementioned specialized diabetes clinics. CONCLUSIONS: The relatively new
      practice of outpatient care at diagnosis of IDDM increased between 1978 and 1988
      in Colorado, in both specialized diabetes clinics and physicians' practices not
      affiliated with specialized clinics.

PMID- 1737549
TI  - [Hypertension caused by endocrine disorders].

PMID- 1737550
TI  - [Spontaneous hypoglycemia].

PMID- 1737551
TI  - [The adrenal cortex and its hormones. A short description of theory and clinical
      aspects as well as introduction into some fundamental concepts in endocrinology].

PMID- 1737552
TI  - [Hyperparathyroidism: pathology, diagnosis and therapy].

PMID- 1737553
TI  - [Gynecological endocrinology].

PMID- 1737554
TI  - [Adrenogenital syndrome].

PMID- 1737555
TI  - [Literature services for nursing].

PMID- 1737556
TI  - [Information gathering for nursing].

PMID- 1737557
TI  - [Activities of daily living: nursing of a sickly nursing model].

PMID- 1737558
TI  - [Cushing's disease and acromegaly. Treatment of hormone active pituitary
      adenomas].

PMID- 1737559
TI  - [The quality of life after total gastrectomy for stomach carcinoma.
      Esophagojejunal plication with pouch versus esophagojejunostomy without pouch].
AB  - A group of 178 patients with total gastrectomy for gastric carcinoma were divided
      into two groups matched for sex, age, tumour stage and follow-up interval (29
      pairs, 46 men and 12 women; mean age 63.4 [39-74] years) according to the type of
      reconstruction performed, oesophagojejunal plication with pouch or simple
      oesophagojejunostomy without pouch. Those with left-extended gastrectomy, follow
      up period of 9 months or less, and local recurrence or metastasis were excluded.
      Quality of life was evaluated by means of three standardized questionnaires sent
      to all the patients: (1) general physical complaints; (2) satisfaction with life;
      and (3) psychosocial burden. Patients with pouch reconstruction declared more
      favourable results in 90 of the 94 questions contained in the questionnaire (96%)
      than the patients without pouch. Patients in the former group also had
      significantly fewer general physical complaints (P less than or equal to 0.05)
      and were significantly more satisfied with life (P less than or equal to 0.05)
      than those without pouch. Correlation analysis for the entire group (n = 58)
      indicated significant relationships especially between quality of life and
      postoperative nutrition and body weight. Technical surgical problems of total
      gastrectomy having largely been solved, the question of quality of life must
      increasingly determine the choice of treatment.

PMID- 1737560
TI  - [Complications in the course of the Muckle-Wells syndrome].
AB  - A 35-year-old woman had since early childhood suffered from recurrent urticaria
      like rash, intermittent fever, arthralgia and pancochlear inner-ear deafness. At
      the age of 17 years she also developed a steroid-resistant nephrotic syndrome,
      found to be due to renal amyloidosis (type AA). The triad of renal amyloidosis,
      inner-ear deafness and recurrent urticaria is characteristic of Muckle-Wells
      syndrome, which has a hereditary basis. Rapidly progressive renal failure
      necessitated long-term haemodialysis and two renal transplantations. The
      accompanying immunosuppressive treatment with corticosteroids, azathioprin and,
      later, cyclophosphamide brought about a remission of the joint and skin
      abnormalities. After removal of the first donor kidney and termination of
      immunosuppressive treatment the syndrome recurred with subacute growth of an
      amyloid goitre as well as amyloidosis of the optic nerve. A few weeks before
      death a malignant non-Hodgkin lymphoma of the stomach was demonstrated. It was
      presumably a complication of long-term immunosuppression and not of the Muckle
      Wells syndrome. The patient died of the complications of combination
      chemotherapy. Necropsy revealed generalized amyloidosis.

PMID- 1737561
TI  - [The therapy of malignant melanoma].

PMID- 1737562
TI  - [Amylin--a newly identified pancreatic peptide and its relationship to diabetes
      mellitus].

PMID- 1737563
TI  - [Stents: intravascular, endoluminal and transparenchymatous].

PMID- 1737564
TI  - [The therapy of arm venous thrombosis].

PMID- 1737565
TI  - [Drains in the hospital].

PMID- 1737566
TI  - [Percutaneous endoscopic gastrostomy].

PMID- 1737567
TI  - [The prevention of nonsteroidal antirheumatic agent-associated gastropathy].

PMID- 1737568
TI  - Ethical principles and guidelines for scientific experiments on animals. Swiss
      Academy of Medical Sciences and Swiss Academy of Sciences.

PMID- 1737569
TI  - Photon emission from normal and tumor human tissues.
AB  - Photon emission in the visible and near ultraviolet range by samples of human
      tissue removed during surgery has been measured by means of a low noise
      photomultiplier coupled to a data acquisition system. The results show that among
      the 25 analyzed samples the 9 from normal tissues had an emission rate of the
      order of some tens of photons/cm2 min, while most of the 16 tumor tissue samples
      had a very much higher rate.

PMID- 1737570
TI  - New C26 delta-lactones from the Dufour's gland of the urticating ant Tetramorium
      aculeatum.
AB  - (6R*)-[(2S*)-2-hydroxyheneicos-12-enyl]-5,6-dihydro-2H-pyran-2-one (1) degree is
      the major constituent of the secretion of freshly dissected Dufour's gland of the
      urticating ant Tetramorium aculeatum. In solution, compound 1 is slowly
      transformed into (1S*,5R*,7S*)-7-(nonadec-10-enyl)-2,6-dioxabicyclo[3.3.1] nonan
      3-one (2) degrees on standing. The structures of compounds 1 and 2 have been
      established on the basis of their spectral and chemical properties. Compound 1
      could be responsible for the urticating properties of the ant.

PMID- 1737571
TI  - Shock induces a long-lasting elevation of blood glucose in Aplysia.
AB  - Glucose, and not trehalose, was found to be the main blood sugar in Aplysia
      californica. Changes in blood glucose in response to stress produced by electric
      shock were measured in blood obtained both from animals dissected within ten
      minutes of shocking and from catheterized animals at various intervals, up to two
      and a half hours after the shock. Electric shock increased blood glucose levels.
      The rise in blood sugar continued as long as two and a half hours after shock.

PMID- 1737572
TI  - A study of macromolecular diffusion through native porcine mucus.
AB  - A diffusion chamber technique based on time-lag analysis for the estimation of
      effective diffusion coefficients of radiolabelled macromolecules of varying
      molecular weights through native mucus gel is reported. For all solutes studied,
      a reduction in effective diffusion coefficients was observed with a retardation
      of solute flux in both aqueous and mucus layers. Over the molecular weight range
      of solutes investigated (126-186,000 Daltons), a consistent effect of molecular
      weight was evident with regard to the retarding effect of mucus. No apparent or
      absolute molecular weight cut-off for macromolecular transfer was exhibited.
      However, at high molecular weights (greater than 30,000 Daltons) the retardation
      was greatly enhanced. The results confirm that mucus can be regarded as a gel
      with finite pores, but that it does not constitute an absolute barrier to even
      high molecular weight solutes.

PMID- 1737573
TI  - The endothelium-dependent relaxation of human middle cerebral artery: effects of
      activated neutrophils.
AB  - Neutrophils, activated by 4 beta-phorbol-12 beta-myristate-13 alpha-acetate,
      decreased acetylcholine-induced relaxation of strips of human middle cerebral
      artery precontracted with noradrenaline. This effect was prevented by catalase,
      but not by superoxide dismutase. Nifedipine, propranolol and, less markedly,
      captopril reduced the decrease in acetylcholine-induced relaxation. Aspirin and
      dipyridamole did not reduce it.

PMID- 1737574
TI  - Changes in erythrocyte membrane lipid composition affect the transient decrease
      in membrane order which accompanies insulin receptor down-regulation.
AB  - We have recently demonstrated, using electron paramagnetic resonance (EPR)
      spectroscopy, that insulin receptor internalization in response to insulin
      incubation (down-regulation) in human erythrocytes is accompanied by a transient
      decrease in membrane order, as measured by the 2T' parallel order parameter.
      Since membrane lipids play such an important role in receptor internalization, we
      investigated the possible effects that an alteration of the normally-occurring
      lipid profile might have on down-regulation and the concomitant transient
      decrease in membrane order. Consequently, human erythrocytes enriched with
      cholesterol and erythrocytes from cirrhotic patients were examined, because both
      of these groups of cells have a higher cholesterol/phospholipid molar ratio
      (CH/PL) than controls. The 5-nitroxystearate spin label, which inserts into the
      lipid bilayer of cell membranes, was used to monitor changes in 2T' parallel for
      a 3-h period at 37 degrees C. We report here that both cholesterol-enriched and
      cirrhotic erythrocytes do not down-regulate, as demonstrated by binding assays,
      and that they do not show the typical transient decrease in membrane order
      observed in controls. The results seem to indicate that a more ordered membrane
      inhibits internalization of the insulin receptor in erythrocytes, and that an
      increase in membrane disorder is necessary for insulin receptor down-regulation.

PMID- 1737575
TI  - Effects of the adenylate cyclase activator forskolin and its inactive derivative
      1,9-dideoxyforskolin on insect cytochrome P-450 dependent steroid hydroxylase
      activity.
AB  - The adenylate cyclase activator forskolin and its pharmacologically inactive
      derivative 1,9-dideoxyforskolin were found to inhibit in a dose-dependent fashion
      the ecdysone 20-monooxygenase activity associated with wandering stage larvae of
      Drosophila melanogaster and fat body and midgut from last instar larvae of the
      tobacco hornworm, Manduca sexta. The concentrations of these labdane diterpenes
      required to elicit a 50% inhibition of the cytochrome P-450 dependent steroid
      hydroxylase activity in the insect tissues ranged from approximately 5 x 10(-6)
      to 5 x 10(-4) M.

PMID- 1737576
TI  - Peptide YY enhances NaCl and water absorption in the rat colon in vivo.
AB  - Peptide YY (PYY) is thought to possess paracrine and endocrine functions. The
      highest concentrations of this peptide are in the colonic mucosa. The effect of
      PYY on electrolyte and water transport in the rat colon was studied in vivo.
      Under urethane anesthesia, rat colonic loops were perfused at a constant rate
      with physiological buffer solution containing phenol red as a nonabsorbable
      volume marker, and net movements of water, sodium, chloride and potassium in the
      perfused colon were determined every 10 min. Intravenous administration of PYY
      produced a dose-dependent increase in the net absorption of sodium chloride and
      water, as well as a decrease in the net secretion of potassium. PYY inhibited the
      reduction in net absorption of sodium chloride and water evoked by vasoactive
      intestinal peptide (VIP), but did not affect the VIP-evoked increase in net
      potassium secretion. These findings suggest that PYY acts as an enhancer of
      sodium chloride and water absorption and as an antagonist to VIP-induced
      secretion in the colon.

PMID- 1737577
TI  - Effects of ovariectomy on removal of collagen bundles in the postpartum uterus of
      the mouse.

PMID- 1737578
TI  - Proopiomelanocortin expression in the skin during induced hair growth in mice.
AB  - We demonstrate for the first time a hair cycle-dependent gene and protein
      expression of proopiomelanocortin in mouse skin in vivo. Northern blot detected
      POMC mRNA with an apparent size of 0.9 kb in anagen but not telogen skin. Western
      blot emphasized a specific protein of 30-33 kDa recognized by anti beta-endorphin
      in late but not early anagen or telogen skin. By immunocytochemistry, beta
      endorphin antigen was localized in the sebaceous gland in a hair cycle dependent
      manner.

PMID- 1737579
TI  - Multiplication of human-derived Pneumocystis carinii in severe combined
      immunodeficient (SCID) mice.
AB  - Clinically healthy SCID mice were infected intratracheally with Pneumocystis
      carinii (PC) of human origin. The data obtained provides unambiguous evidence
      that progressive multiplication of PC organisms of human origin takes place in
      the lungs of experimentally infected animals. SCID mice that were infected with
      human-derived PC also revealed a markedly greater number of mouse PC organisms in
      their lungs than the controls. All the SCID recipients of human PC died by day 65
      post infection, whereas the controls, housed under identical conditions, started
      dying significantly later due to severe mouse pneumocystosis. This animal model
      could be used for the maintenance and propagation of human PC, and for evaluating
      strategies for treating human pneumocystosis.

PMID- 1737580
TI  - Transfer of T-cell mediated immunity to Hymenolepis nana from mother mice to
      their neonates.
AB  - Administration of lymph node cells from Hymenolepis nana-infected mice into
      lactating mothers, or directly suckling neonates successfully transferred
      immunity to the neonates. The capacity of lymph node cells to transfer immunity
      was completely abrogated by pretreatment with anti-Thy-1.2 monoclonal antibody
      and complement.

PMID- 1737581
TI  - Shape change of human blood platelets: reliable and fast detection by quasi
      elastic light scattering.
AB  - Quasi-elastic light scattering has been used for the first time to obtain
      reliable information about the morphology of platelets under physiological
      conditions within a short time. By measuring two independent parameters
      (electrophoretic mobility and diffusion coefficient) it is possible to
      distinguish between different stages of shape change on the one hand, and between
      shape change and binding of particles to the platelet surface without shape
      change on the other hand.

PMID- 1737582
TI  - Common antigenic properties of a g-type (goose) and a c-type (duck) egg white
      lysozyme: antibody responses in rabbits and mice.
AB  - Embden goose (GEWL) and Barbary duck (DEWL) egg white lysozymes possess different
      amino acid sequences corresponding to the g-type and c-type, respectively. GEWL
      was shown to be a better immunogen than DEWL in both rabbits and mice. The
      antigenicity of the two lysozymes was tested using different techniques (i.e.
      indirect ELISA, inhibition tests and immunoabsorption experiments). Injection of
      either GEWL or DEWL into rabbits and mice induced both specific antibodies and
      cross-reacting antibodies. Moreover, anti-GEWL antibodies, in contrast to anti
      DEWL antibodies, did not cross-react with hen egg white lysozyme (HEWL), a c-type
      lysozyme. While the structure of GEWL was not modified after binding to plastic,
      DEWL was denaturated, but it did keep some native epitopes. It was concluded that
      g-type and c-type lysozymes, which have different amino acid sequences, exhibit
      strong common antigenic properties.

PMID- 1737583
TI  - Variation in regulation of aflatoxin biosynthesis among isolates of Aspergillus
      flavus.
AB  - Two new phenotypes of Aspergillus flavus which exhibit novel patterns of
      aflatoxin production have been identified and characterized. In one of the new
      variants of A. flavus, aflatoxin is made in the absence of carbohydrate and
      concomitantly with growth, without a lag period. A second variant did not produce
      aflatoxin in the presence or absence of carbohydrate. Chemical mutagenesis of
      this nonaflatoxigenic strain resulted in mutant strains which produced aflatoxin
      on carbohydrate-containing media. The aflatoxin production pattern observed in
      these mutants resembled the typical production scheme, with a lag period through
      log phase growth.

PMID- 1737584
TI  - A new cell line (XTY) from a tumor of Xenopus laevis.
AB  - A new cell line (XTY) was derived from a tumor of a female Xenopus laevis. This
      cell line has been proliferating in standard amphibian culture medium for more
      than 4 years (470 generations) and has a doubling time of 75.5 h at 25 degrees C.
      The cells aggregate into large groups, and their stellate morphology and the
      expression of desmin demonstrated by immunocytochemistry suggest that their
      origin is not epithelial.

PMID- 1737585
TI  - Chemical basis of pupal cannibalism in a caterpillar (Utetheisa ornatrix).
AB  - The moth Utetheisa ornatrix derives protection against predation from systemic
      pyrrolizidine alkaloids (PAs) that it sequesters as a larva from its foodplants
      (Leguminosae, Crotalaria spp.). We here show, in laboratory tests, that Utetheisa
      deficient in body PA can make up for the chemical shortfall by cannibalizing
      pupae. We present evidence indicating that cannibalism in larvae is elicited not
      by hunger, but possibly by PA deficiency itself, and that in making cannibalistic
      choices larvae prefer PA-containing over PA-free pupae. PAs themselves, either in
      crystalline form or as additives to food items, proved phagostimulatory to
      larvae. In nature Utetheisa tend to pupate away from their foodplant, essentially
      out of reach of larval attack. The threat of cannibalism may have contributed to
      the evolution of this pupation behavior.

PMID- 1737586
TI  - 24th annual meeting of the Swiss Societies for Experimental Biology
      (USGED/USSBE). March 19-20, 1992, Basel. Abstracts.

PMID- 1737587
TI  - Rapid cytological diagnosis during thyroid surgery.
AB  - The authors report the results of the use of intra-operative cytological
      examinations of the thyroid gland. In their hands, the method has a 96.3%
      accuracy in 757 patients with thyroid disorder. Benign conditions and malignant
      tumours can be correctly diagnosed. False negative diagnosis can arise with well
      differentiated follicular carcinoma and the differentiation of follicular adenoma
      may be difficult. Atypical adenomas may give a false positive diagnosis. The
      incorrect diagnosis of chronic lymphocytic thyroiditis is unlikely when
      sufficient attention is given to the whole clinical picture.

PMID- 1737588
TI  - Breast cancer: a study into the value of a historical group as comparative
      material for new methods of treatment.
AB  - A large group of consecutive patients were studied who had been treated for a
      primary breast carcinoma by a radical mastectomy at the Netherlands Cancer
      Institute, during the period of 1960-1974. One of the objectives of that
      retrospective study was to record the results of treatment of a historical group
      of patients in such a way that they could presumably serve as a reference for new
      methods of treatment of breast cancer. To verify the validity of this
      presumption, the present study compares the treatment results of patients from
      the EORTC trial 10801, which addresses the value of breast conserving procedures,
      with that of matched controls from the historical group mentioned above. Matching
      was carried out with respect to the following prognostic factors: age, tumor
      size, localization, (number of) positive axillary nodes and grade of malignancy.
      Analysis of the results strongly suggests that the prognosis for the patients
      from the historical group is worse than for both groups of patients from the
      trial 10801. Therefore, this study again confirms that a historical group is not
      suitable as comparative material for new ways of treatment of breast cancer, and
      that prospective randomized studies are required to test new treatment schedules.

PMID- 1737589
TI  - Multicentric breast tumour: an anatomical-clinical study of 100 cases.
AB  - Multicentric tumours (MT) represent a potential limit to the treatment by
      conservative surgery of cancer of the breast. In order to determine which
      anatomical-clinical features of breast cancer would indicate the highest risk of
      MT, we studied 100 patients with MT and 452 patients with unicentric tumours
      (UT), all of whom had been subjected to radical mastectomy during the period 1980
      to 1988. Statistical analysis showed a significant difference between the two
      groups of parameters for bilateral breast cancer (with regard both to
      metachronous and synchronous lesions), for primary tumours of over 2 cm in size,
      for both lobular and invasive ductal histotypes and for involvement of the nipple
      areola complex. Therefore, if the indications in favour of conservative surgery
      are applied accurately in combination with radiation therapy, the clinical and
      biological significance of multicentricity is minimized.

PMID- 1737590
TI  - Prognostic value of serum levels of immunoglobulins (IgA, IgM, IgG, IgE) in
      patients with colorectal cancer.
AB  - In the present study, the serum immunoglobulin levels of 100 patients with
      colorectal cancer who had undergone antitumor therapy, were measured before and
      during therapy. We received three samples before therapy and further samples
      every 2 months after initiation of therapy. It was found that the group of
      patients having increased IgG (P less than 0.05) and perhaps IgM (P less than
      0.1) levels showed a longer time to progression of disease and prolonged overall
      survival time. Based on this finding we conclude that survival can potentially be
      correlated with immunoglobulin levels. Studies with large numbers of patients,
      and orientated towards the correlation of immunoglobulin levels with specific
      clinical parameters may prove that immunoglobulins can play a prognostic role in
      survival for colorectal cancer patients.

PMID- 1737591
TI  - The prognostic value of argyrophil nucleolar organiser regions (AgNORs) in
      colorectal cancer.
AB  - Argyrophil nucleolar organiser regions (AgNORs) are increased in a variety of
      malignant cells compared with normal cells, and a recent study has claimed that
      AgNORs have prognostic value in colorectal cancer. We have studied the AgNOR
      counts in tumours from 95 colonic resections performed in 94 patients in whom a
      minimum 5 year follow-up was available. In 71 pathological specimens adjacent
      normal mucosa was also examined. There was a significant difference between
      AgNORs per cell in normal mucosa (median 1.46, range 1.10-1.80) compared with
      tumour cells (median 1.92, range 1.42-2.95, P less than 0.001). There were no
      significant differences in average AgNORs per cell between tumours in each Dukes'
      stage or category of differentiation. The average AgNORs per cell in tumours of
      patients surviving disease-free for 5 years was the same as that in tumours of
      patients dying of colonic cancer recurrence. We conclude that AgNORs have no
      prognostic value in colorectal cancer and are not correlated with Dukes' staging
      or differentiation of the tumour.

PMID- 1737592
TI  - Combination of serum carcino-embryonic antigen and C-reactive protein--a useful
      test in preoperative staging of colorectal cancer.
AB  - The value of the simultaneous estimation of serum carcino-embryonic antigen (CEA)
      and C-reactive protein (CRP) concentrations in staging patients with colorectal
      neoplasias was evaluated. The study included 95 patients with benign or malignant
      epithelial tumors of colon and rectum. The simultaneous negative values of CEA
      and CRP were able to exclude stage D tumors with a specificity of 92.6% (P less
      than 0.001). Simultaneously positive values of CEA and CRP were able to diagnose
      stage C or D tumors with a specificity of 92.1% (P less than 0.001). It is
      concluded that the combination of CEA and CRP tests can substantially contribute
      to the preoperative staging and assessment of the extent of colorectal cancer.

PMID- 1737593
TI  - Assessment of breast cancer size: a comparison of methods.
AB  - Two hundred women presenting with primary breast carcinoma were studied to find
      the most accurate single or combination of methods to assess breast tumour size.
      Correlations of the maximum clinical, mammographic and ultrasound tumour diameter
      were made with maximum histological diameter. Tumour size could be assessed
      clinically in all 200 patients, and overestimated the size of small tumours and
      underestimated large tumours (P less than 0.001). Mammographic measurement, which
      was possible in 145 (72.5%), underestimated the size of large tumours (P less
      than 0.01). Only 100 women underwent ultrasound examination (size assessed in
      86%) and this modality tended to underestimate the size of all tumours (P less
      than 0.05). All methods of measurement showed similar correlations with
      histological size. Stepwise linear regression showed that the most accurate and
      practical estimation could be made using the formula: Histological size = 0.5 x
      mammographic size + 0.5 x clinical size. We conclude that clinical measurement of
      breast cancer size is as accurate as that from mammography or ultrasound.
      Accuracy can be improved by the use of a simple formula of both clinical and
      mammographic measurements.

PMID- 1737594
TI  - Breast reconstruction using latissimus dorsi island flap without an
      endoprosthesis.
AB  - Breast reconstruction using a modified latissimus dorsi island flap is presented.
      The whole muscle is raised on its vascular pedicle, folded beneath the skin
      island and sutured in layers, thus substituting the volume of an endoprosthesis.
      The method may give satisfactory results in carefully selected cases (mostly in
      women with a small contralateral breast). It can also be applied in
      reconstruction after subcutaneous mastectomy.

PMID- 1737595
TI  - Radioimmunoscintigraphy of metastatic breast carcinoma.
AB  - Seventeen patients with breast cancer underwent preoperative
      radioimmunoscintigraphy (RIS). Planar and tomographic imaging techniques (single
      photon emission computerised tomography--SPECT) were studied using Indium-111
      labelled anti-epithelial membrane antigen (EMA) antibodies for tumour
      localisation. Overall imaging sensitivities were reasonable with correct
      identification of around 90% of primary lesions and 50% of secondary lesions.
      Planar imaging was more sensitive than SPECT for identification of superficial
      lesions such as the primary lesions (88% vs 56%) and axillary metastases (59% vs
      53%). SPECT was necessary, however, for detection of deeper lesions such as
      internal mammary chain metastases and often served as an adjunct rather than an
      alternative to planar imaging. RIS, therefore, may contribute to more accurate
      staging of breast cancer, although further technical advances in RIS would
      enhance this contribution.

PMID- 1737596
TI  - MRI or CT in the preoperative diagnosis of bone tumours.
AB  - The value of magnetic resonance imaging (MRI) and computed tomography (CT) in the
      diagnosis of bone tumours was investigated in a prospective study of 25 patients.
      MRI is superior to CT because it permits multidirectional exposures. Moreover,
      the tumour can be readily distinguished from the neurovascular structures without
      injection of contrast medium. MRI gives better contrast than CT, making it
      possible to study the relationship to the soft tissues, bone marrow and joints
      more accurately. On the other hand, CT gives a better picture of the destruction
      of cortical bone. With neither MRI nor CT can the exact tumour length be
      measured. Neither MRI nor CT permits an exact, reliable diagnosis. Owing to the
      relatively slow exposure technique in combination with respiratory movements,
      depiction of the thoracic wall is less satisfactory with MRI than with CT. If
      both techniques are available, MRI is preferred. In view of the fact that MRI
      apparatus is still less widely available, it should be borne in mind that CT also
      allows an adequate investigation of skeletal lesions.

PMID- 1737597
TI  - Acinic cell carcinoma of the salivary glands. A long term follow-up study of 15
      cases.
AB  - Fifteen cases of acinic cell carcinoma of the salivary glands were evaluated
      retrospectively with respect to histological and clinical data. DNA content
      assessment was carried out in six cases by cytophotometry. The majority of tumors
      were located in the parotid gland and were Stage I at presentation. There was a
      female predominance and the mean age at primary diagnosis was 51.2 years for
      females and 41.0 for males. The solid-acinar cell pattern was the most frequently
      observed and the tumors were 'diploid' in all the six cases studied. Surgery was
      the therapeutic modality in all cases (enucleation in seven, superficial
      parotidectomy in three and total parotidectomy in five) and, in four of them, was
      complemented with radiotherapy. The clinical course was characterized by
      recurrence in 10 cases, metastases occurred in three patients and one patient
      died of the tumor. Of the seven recurrent cases, six were treated by enucleation
      and one by superficial parotidectomy. The histological pattern showed no
      correlation with the clinical course or DNA content. Acinic cell carcinoma has a
      significant morbidity with a high recurrence rate which seems to be largely
      influenced by the type of surgery employed. Wide surgical excision of the
      neoplasia, which includes total parotidectomy in the parotid cases, is
      recommended in order to reduce the frequency of recurrence of the tumor.

PMID- 1737598
TI  - Primary breast carcinoma in patients with malignant melanoma.
AB  - Malignant melanoma and primary breast cancer are tumours which have an
      association based on genetic and hormonal factors. It is not generally
      appreciated that there is an increased incidence of melanoma in patients with
      breast cancer and vice versa. We present two cases of patients who developed
      breast carcinoma following previous treatment for melanoma. We review previous
      reports of this association and examine the theoretical reasons why this should
      be so. Medical practitioners should be aware of this association in order to
      alter their index of suspicion appropriately.

PMID- 1737599
TI  - Malignant schwannoma of the breast.
AB  - A case of rare, malignant schwannoma of the breast has been analysed with regard
      to its history and diagnostic problems, such as the mammographic pattern and the
      role of cytology in the preoperative mesenchymal suggestion.

PMID- 1737600
TI  - Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior
      maxilla.
AB  - Patients from multicenters were treated with sinus lift graft operations and
      placement of implants. Surgical procedures healed uneventfully with minimum pain,
      swelling, or morbidity. Grafts healed with few complications or failures.
      Implants placed into the grafts support prosthetic reconstruction and are
      predictable over time. The question of what graft material to use is discussed.
      Grafts of non-resorbable HA (Interpore 200), bovine cortical HA (Bio-Oss),
      resorbable HA (OsteoGen), and freeze-dried demineralized bone powder and granules
      are presented. Results of biopsy, histometry, backscattered electron microscopy,
      cell labeling, and special stain suggest consistent bone growth into a variety of
      graft materials. In the authors' opinion investigation must continue to 1.
      Determine the healing time for different graft materials. At present, anecdotal
      evidence suggests that sinus grafts of autogenous bone heal for 4 to 6 months;
      freeze-dried demineralized bone heals for 12 to 16 months; and alloplastic
      materials with freeze-dried demineralized bone heal for 9 to 11 months. 2.
      Evaluate histologic evidence of bone growth into different bone replacement graft
      materials. 3. Evaluate the long-term follow-up and success of implants placed
      within sinus grafts. 4. Determine the remodeling potential of different hard
      tissue graft materials under implant functional loads.

PMID- 1737601
TI  - The Integral Implant System: prosthetic considerations.
AB  - Patients who are totally edentulous and who have been doomed to discomfort, pain,
      and dysfunction because of the inability to use complete dentures have been
      rehabilitated using various implant systems. Implants should only be considered
      after exhaustive medical history taking and diagnostic wax-ups. A variety of
      prosthetic techniques can be employed to restore various forms of edentulism. The
      Integral Implant System has proven to be a highly successful foundation to
      restore the patient to optimum function.

PMID- 1737602
TI  - The history of the diagnosis and treatment of ectopic pregnancy: a medical
      adventure.
AB  - From its indirect reference by Abulcasis (936-1013) and until the 19th century
      the ectopic pregnancy was known as a universally fatal accident. By reporting
      successful treatment of tubal pregnancy with salpingectomy in 1884 Robert Lawson
      Tait (1845-1899) started an era of almost 70 years of exclusively extirpative
      treatment of ectopic pregnancy. The technologic revolution of the 20th century
      improved diagnostic capabilities so that diagnosis of unruptured ectopic
      pregnancy becomes feasible and even mandatory. Side by side our understanding of
      the natural history of ectopic pregnancy improved. Many patients with early
      resolving ectopic pregnancies escape surgical treatment. Preservation of future
      fertility became possible with the introduction of conservative surgical
      procedures and with the use of methotrexate. The main achievement in the
      treatment of ectopic pregnancy over the past 110 years is the dramatic decrease
      in mortality rate: from 72-90% in 1880 to 0.14% in 1990.

PMID- 1737603
TI  - Detection of Candida cell forms in Pap smears during pregnancy.
AB  - In a prospective study of 124 urban black pregnant women, 43% had Candida
      isolated from endocervical cultures and 20% had Candida cell forms on cytological
      Pap-stained cervical specimens. The presence of Candida cell forms on Pap smears
      had a better correlation with Candida colonisation when normal lactobacillary
      flora was present, when Trichomonas vaginalis parasites were absent and when the
      infecting Candida species was C. albicans. Positive cultures were strongly
      related to a number of clinical signs and symptoms, but Pap smears were not.
      Neither Candida culture nor Candida cells in Pap smear revealed an association
      with premature delivery, birth weight, severe neonatal morbidity or mortality. We
      confirm that the routine cervical Pap smear is not a sensitive method for
      diagnosing symptomatic fungal infection. More specifically, some of the Pap smear
      characteristics, such as disturbed lactobacillary flora or co-infection with T.
      vaginalis, interfere with accurate diagnosis.

PMID- 1737604
TI  - Folate status during pregnancy: relationship with alcohol consumption, other
      maternal risk factors and pregnancy outcome.
AB  - This study was designed to identify the factors affecting folate status in
      pregnant women and to explore the relationship between folate status and alcohol
      consumption during pregnancy. For this purpose, 347 French women were recruited
      during 1985-1986 on their first visit to the antenatal clinic at Roubaix Hospital
      (northern France). Alcohol consumption was ascertained by a standardized
      interview. Folate status assessment was available for 246 pregnant women who were
      not given folate supplementation. Average folate levels during pregnancy were
      lower among young women and smokers. Serum folate values diminished with the
      educational level, and red cell folate values increased with high parity.
      Unexpectedly, high red cell folate values were strongly related with high alcohol
      consumption after adjustment for the maternal risk factors associated with
      alcohol consumption and folate status. This was probably because in the Roubaix
      region where the study was conducted women consume mostly beer, which contains
      folates. Pregnancy outcome was not related to folate levels; birthweight was
      negatively associated with alcohol consumption during the first trimester of
      pregnancy.

PMID- 1737605
TI  - Incidence and cause of postpartum urinary stress incontinence.
AB  - Urinary leakage was reported in 53.5% of our patients at least once during
      pregnancy. Multigravidae and women older than 30 were affected more often than
      primigravidae or women younger than 30. 6.2% of all women, who were continent
      before pregnancy, developed permanent stress incontinence after vaginal delivery.
      As a conclusion, it can be said, that vaginal delivery itself predisposes for
      permanent stress urinary incontinence (SUI). Factors, which increase the trauma
      to the pelvic floor (tear, no episiotomy, forceps or vacuum extraction), show a
      higher incidence of postpartum persisting SUI without statistic significance.
      Labour management with epidural anaesthesia showed a statistically proven lower
      incidence of postpartum persisting SUI in comparison to the pudendal block.

PMID- 1737606
TI  - Successful treatment of failed AID cases by use of gamete intra-fallopian
      transfer using donor semen (GIFT (D)).
AB  - Over a 13-month period in a newly opened assisted conception unit at the Women's
      Hospital, Liverpool, gamete intra-fallopian transfer using donor semen, GIFT (D)
      was offered to eighteen couples who had failed to conceive after numerous cycles
      of treatment with artificial insemination by donor semen (AID). The indication
      for the use of donor semen was either azo- or severe oligoaesthenospermia, and,
      in addition, the female partners have been exhaustively investigated with no
      major cause found to account for the couple's infertility. Using a basic
      clomiphene citrate and human menopausal gonadotrophin protocol it was possible to
      achieve a pregnancy rate of 56% per GIFT (D) cycle. As a consequence of these
      results it is now our policy to treat couples whose infertility is due to an
      unresolvable male factor with AID for 12 cycles only. If they have been
      unsuccessful in achieving a pregnancy after this time, they are offered GIFT (D).

PMID- 1737607
TI  - Oxygen tension in follicular fluid falls with follicle maturation.
AB  - The increase in follicular diameter during maturation is accompanied by an
      increase in vascular supply. The oxygen tension (PO2) in the follicular fluid of
      the growing follicle should therefore give an insight whether the oxygen delivery
      during this pertinent process is sufficient. Follicular fluid of 20 patients
      subjected to in vitro fertilization and embryo transfer were sampled in
      heparinized glass capillaries which were placed between the puncturing needle and
      the collecting reservoir. All patients were treated with human menopausal
      gonadotropin (HMG) and follicle-stimulating hormone (FSH). The PO2, PCO2 and pH
      of the follicular fluid were measured with an automatic gas analyser (Ciba
      Corning). Simultaneously, the same parameters were estimated in maternal
      capillary blood taken from the arterialized well perfused earlobe. Follicular
      size was measured by ultrasound. With growing follicular size (FS), the oxygen
      partial pressure (PO2) fell from 80 to 50-60 mmHg (PO2 = 114.4-3.3.FS; r = 0.79)
      while the carbondioxide partial pressure (PCO2) in the follicle increased from 35
      to 50 mmHg (PCO2 = 15.1 +/- 1.9.FS; r = 0.71). In correlation to these results,
      the pH in follicular fluid fell from 7.40 to 7.30 (pH = 7.6-0.019.FS; r = 0.62).
      The correlation between the PCO2 and the pH demonstrates a deviation from the
      regression line if no metabolic alterations take place (delta log PCO2/delta pH =
      -0.69). The increase in ovarian blood flow during follicular maturation is
      obviously not sufficient to bridge the growing diffusion distance between the
      capillary network surrounding the follicle and its center.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1737608
TI  - Sister chromatid exchange frequencies in a group of individuals with unfavorable
      reproductive health.
AB  - Sister chromatid exchange (SCE) frequencies and other cytogenetic parameters were
      investigated in peripheral blood lymphocytes from 92 subjects comprising 44
      parents of malformed offspring or repeated fetal wastage (Group I) and 48
      controls, age and sex matched, having normal reproductive health (Group II). The
      karyotypes were normal and the mean mitotic indices were comparable in both
      groups. The mean frequency of SCE per metaphase in Group I (8.67 +/- 0.32) was
      significantly higher than the mean for group II (6.65 +/- 0.16), and the cellular
      replicative index in Group I (1.78 +/- 0.04) was significantly different from
      that of Group II (1.66 +/- 0.03). The results are discussed in the light of the
      present understanding of the etiology and mechanism of production of sister
      chromatid exchanges.

PMID- 1737609
TI  - Lifestyles of men in barren couples and their relationships to sperm quality.
AB  - This study is based on a questionnaire which focused on the possible association
      between lifestyle factors and male fertility in a group of 252 men attending our
      laboratory in connection with a fertility investigation. Their answers were
      correlated to sperm quality. No association could be documented between sperm
      quality and smoking habits, coffee drinking, a moderate alcohol intake, exposure
      to heat (sauna, hot baths, type of underwear, sedentary activities) or physical
      activities in their leisure time. In contrast, the reported average ejaculation
      frequency was significantly positively correlated to the motility of the sperm (%
      progressive) but inversely related to the proportion of sperm with abnormal
      morphology and semen volume. This indicates that the lifestyle of the subject has
      little, if any, impact on semen quality, at least within the limits recorded in
      the present study.

PMID- 1737610
TI  - Hormone replacement therapy and changes on pituitary function.
AB  - The aim of this study is to know how the pituitary function is affected by
      several delivery systems of estrogen replacement therapy. 116 menopausal women
      (54 natural and 62 surgical) were placed into three groups that received
      replacement therapy and in one control group. We determined prolactine (PRL),
      gonadotropins and 17 beta-estradiol (E2). We found a decrease in gonadotropin
      levels in treated patients with a natural menopause, and an increase in
      gonadotropin levels in the groups treated with conjugated estrogens in surgical
      menopausal women. 17 beta-E2 was found to be increased in all treated groups,
      mainly in the continuous therapy group (P less than 0.05). PRL was found to be
      decreased in patients treated with conjugated estrogens (oophorectomized and not
      oophorectomized) (P less than 0.05). Although these differences can not be
      attributed to the presence of the ovaries, we think that they may be the result
      of the treatment.

PMID- 1737611
TI  - Intranasal administration of estradiol in combination with progesterone to
      oophorectomized women: a pilot study.
AB  - A pilot study was done to investigate the pharmacokinetics and acceptability of
      an intranasal 17 beta-estradiol/progesterone formulation. This formulation
      contained dimethyl-beta-cyclodextrin as a solubilizer and absorption enhancer of
      the steroid hormones. The study was performed in four oophorectomized and
      hysterectomized patients. After nasal delivery of 0.34 mg estradiol and 0.85 mg
      progesterone, concentration-time curves of progesterone, estradiol and its
      metabolite estrone were established. Rapid absorption of progesterone and
      estradiol was demonstrated. Progesterone peak-levels (3.9-6.7 nmol/l) exceeded
      the levels which are found in the follicular phase of the menstrual cycle, but
      did not reach the levels of the luteal phase. Comparison with an earlier reported
      study in which only estradiol was administered shows that the addition of
      progesterone does not alter the absorption and pharmacokinetics of estradiol. The
      nasal formulation was well accepted by the four patients and no adverse effects
      were noted.

PMID- 1737612
TI  - Disturbed reproductive performance in extreme folic acid deficient golden
      hamsters.
AB  - We studied the effects of folic acid-deficient diets on maternal red blood cell
      folate level and reproductive performance in golden hamsters (Mesocricetus
      auratus, Waterhouse). Animals on the same day of oestrous cycle were put together
      and finally divided into three groups. Each group comprised at least 12 mature
      female hamsters. The animals were given three different diets, which were
      commenced before mating. The feeding regimens comprised a standard diet (group
      1), or a folic acid-deficient diet which started either 2 weeks (group 2) or 16
      weeks (group 3) prior to mating. The regimens were continued until sacrifice of
      the animals on day 9 of pregnancy. Pregnancy was realized by caging a male with a
      selected female during the night of ovulation. Just prior to sacrifice, blood
      samples were drawn to measure maternal folic acid levels in red blood cells. The
      pregnant uteri were removed and the embryonic sacs were carefully dissected away
      from the uterus. The number of sacs per pregnant animal was noted. Extreme folic
      acid deficiencies were confirmed in the pregnant golden hamsters on a folic acid
      deficient diet which started 16 weeks prior to mating as compared to those on a
      standard diet and on a folic acid-deficient diet which started 2 weeks prior to
      mating. This deficiency appears to interfere with normal reproductive
      performance. It caused early embryonic loss several days after mating and
      resulted, finally, in restoration of the oestrous cycle.

PMID- 1737613
TI  - Prognosis for pre-eclampsia complicated by 5 g or more of proteinuria in 24
      hours.
AB  - Forty-two women with pregnancies complicated by pre-eclampsia and heavy
      proteinuria greater than or equal to 5 g/24 h were referred for conservative
      management to the high-risk obstetric unit in the John Radcliffe Hospital,
      Oxford, over a period of 5 years. Hyperuricaemia preceded the onset of heavy
      proteinuria in all 42 women. Most of the women had severe hypertension, but none
      developed eclampsia and there were no major maternal complications. Delivery was
      necessary within 2 weeks of onset of severe proteinuria in 88.1% of cases,
      although in some very preterm pregnancies delivery could be deferred for 3 or
      more weeks. Thirty-five women (83%) were delivered by caesarean section, 91% of
      whom were delivered urgently before the onset of labour. The high rate of urgent
      preterm operative delivery underlines the uncertainty of advanced pre-eclampsia
      and the need for close monitoring if delivery is to be deferred. Perinatal
      mortality was high; all the perinatal deaths occurred in babies of less than 29
      weeks gestation. Despite heavy proteinuria, postpartum recovery was good. Three
      months after delivery, all but one patient had no significant proteinuria. There
      was no evidence of residual renal dysfunction. Although the outlook for pre
      eclampsia with heavy proteinuria is limited, in a few cases pregnancy can be
      prolonged for significant periods of time without apparently prejudicing maternal
      safety and permitting enhancement of maturity at birth. The observations justify
      cautious conservative management even when heavy proteinuria is present.

PMID- 1737614
TI  - Casein kinase II inhibits the DNA-binding activity of Max homodimers but not
      Myc/Max heterodimers.
AB  - Max is a heterodimeric partner of the Myc oncoprotein with sequence-specific DNA
      binding activity. We found that the DNA-binding activity of bacterially expressed
      Max homodimers was inhibited in an ATP-dependent reaction by phosphorylation in
      vitro with purified bovine casein kinase II (CKII). In contrast, phosphorylation
      of Max and/or Myc by CKII had no inhibitory or stimulatory effect on the DNA
      binding activity of Myc/Max heterodimers. By deletion analysis and site-directed
      mutagenesis, the inhibitory domain was localized to a CKII phosphorylation site
      in the amino terminus of Max. Finally, extracts prepared from NIH-3T3 cell lines
      that overexpress Max contained a phosphorylated Max protein which, following
      phosphatase treatment or heterodimerization with Myc, was capable of sequence
      specific DNA-binding activity. Immunoprecipitation experiments confirmed that Max
      was also phosphorylated in NIH-3T3 cells, demonstrating that Max phosphorylation
      may have an important physiological function.

PMID- 1737615
TI  - Active genes in budding yeast display enhanced in vivo accessibility to foreign
      DNA methylases: a novel in vivo probe for chromatin structure of yeast.
AB  - Unlike higher eukaryotes, where an inverse correlation has been generally
      observed between gene expression and methylation of CpG sites, the budding yeast
      Saccharomyces cerevisiae lacks DNA methylation. Gene regulatory mechanisms can
      function independently of DNA methylation in yeast, and yeast strains expressing
      foreign DNA methylases that modify adenine and CpG residues have been found to be
      viable. We have used such strains to determine whether the transcriptional status
      of genes can influence the level of their DNA methylation in vivo. Several genes
      were tested, for example, GAL1, -7, and -10, PHO5, HMRa and HML alpha, and STE2
      and STE3. Surprisingly, we found that all the genes displayed severalfold more
      methylation in the expressed state as compared to the repressed state. This
      procedure serves as a novel in vivo probe for the chromatin structure of yeast
      and potentially for higher eukaryotes.

PMID- 1737616
TI  - Saccharomyces telomeres assume a non-nucleosomal chromatin structure.
AB  - The chromatin structures of the telomeric and subtelomeric regions on chromosomal
      DNA molecules in Saccharomyces cerevisiae were analyzed using micrococcal
      nuclease and DNAse I. The subtelomeric repeats X and Y' were assembled in
      nucleosomes. However, the terminal tracts of C1-3A repeats were protein protected
      in a particle larger than a nucleosome herein called a telosome. The proximal
      boundary of the telosome was a DNase I hypersensitive site. This boundary between
      the telosome and adjacent nucleosomes was completely accessible to Escherichia
      coli dam methylase when this enzyme was expressed in yeast, whereas a site 250 bp
      internal to the telomeric repeats was relatively inaccessible. Telosomes could be
      cleaved from chromosome ends with nuclease and solubilized as protein-DNA
      complexes. Immunoprecipitation of chromosomal telosomes with antiserum to the
      RAP1 protein indicated that RAP1 was one component of isolated telosomes. Thus,
      the termini of chromosomal DNA molecules in yeast are assembled in a non
      nucleosomal structure encompassing the entire terminal C1-3A tract. This
      structure is separated from adjacent nucleosomes by a region of DNA that is
      highly accessible to enzymes.

PMID- 1737617
TI  - Induction of specific macronuclear developmental mutations by microinjection of a
      cloned telomeric gene in Paramecium primaurelia.
AB  - In Paramecium, the differentiation of a highly polyploid macronucleus from a
      diploid nucleus is accompanied by an extensive reorganization of the genome,
      involving reduction in chromosome size and formation of new telomeres at
      heterogeneous, but reproducible, positions. The results presented here, as well
      as work by others, indicate that telomere addition regions are not strictly
      determined by the micronuclear sequence, but are at least partially controlled by
      the old macronucleus. It is shown that microinjecting a high copy number of a
      plasmid containing the G surface antigen gene into the macronucleus of wild-type
      cells specifically modifies the processing of the G gene-bearing micronuclear
      chromosome at the following autogamy. Telomeric repeats are added upstream of the
      gene, rather than at their wild-type position 5 kb downstream of its 3' end,
      resulting in the deletion of the gene from the new macronucleus. This
      macronuclear mutation is unstable at the following autogamy, giving rise to many
      different telomere addition regions in different postautogamous clones. However,
      after several successive autogamies, cell lines can be obtained in which the
      telomeres reproducibly form in the same region. In crosses with wild-type cells,
      these macronuclear mutations show cytoplasmic inheritance; the micronuclei of the
      mutants are shown to be fully functional. The implications for the mechanism of
      choice of telomere addition sites are discussed.

PMID- 1737618
TI  - A specific ovarian tumor protein isoform is required for efficient
      differentiation of germ cells in Drosophila oogenesis.
AB  - Mutations within the ovarian tumor (otu) gene result in abnormal ovarian
      development. It has been proposed that otu phenotypes result from abnormal germ
      cell division and differentiation. To understand better what role otu performs in
      oogenesis we have undertaken an analysis of protein expression from the otu
      locus. Anti-otu antibodies recognize two proteins from Drosophila ovary extracts
      with apparent molecular masses of 98 and 104 kD. Sequence analysis of otu cDNAs
      suggests that these proteins are translated from two mRNAs generated by
      alternative splicing of a 126-bp exon between the sixth and seventh exon of the
      smaller transcript. Analysis of otu protein expression in eight mutants indicates
      a correlation between the accumulation of the 104-kD isoform and
      predifferentiated germ cells and suggests that there is a developmental shift in
      the accumulation of the two isoforms upon differentiation of germ cells.
      Furthermore, the 104-kD isoform appears to be required for efficient
      differentiation of germ cells. Immunostaining of otu proteins is restricted to
      the cytoplasm of germ cells, and a rapid loss of oocyte immunostaining during
      stage 11 suggests that there is a rapid and selective degradation of otu proteins
      within the oocyte but not within its 15 interconnected nurse cells.

PMID- 1737619
TI  - DNA sequence requirements for generating paused polymerase at the start of hsp70.
AB  - RNA polymerase II is transcriptionally engaged but paused approximately 25
      nucleotides from the start site of the hsp70 gene of Drosophila melanogaster in
      uninduced (non-heat-shocked) flies. Here, we identify regions of the hsp70
      promoter that are required for formation of this paused polymerase. Various hsp70
      promoter sequences are substituted for promoter sequences of a yolk protein gene,
      yp1, which, in males, is normally not expressed and has no paused polymerase. Run
      on assays with nuclei of male transgenic flies are used to measure the level of
      paused polymerase on the hybrid genes. Sequences that reside upstream of the
      hsp70 TATA element, when fused upstream of the yp1 TATA element, specify the
      formation of a paused polymerase on the 5' end of this hybrid gene. Within this
      region are multiple copies of the GAGA element, which is known to bind a
      constitutively expressed factor. This element appears to play a role in
      generating the pause. Also, in the absence of much of this upstream region, hsp70
      sequences in the vicinity of the transcriptional start and pause site participate
      in specifying the pause. Deletions of the pause site reduce the level of paused
      polymerase but do not lead to constitutive transcription. However, a connection
      between transcription and pausing is seen. The level of paused polymerase on the
      various hybrid hsp70-yp1 promoters correlates with the promoter's potential to
      direct heat-induced transcription.

PMID- 1737620
TI  - TFIID can be rate limiting in vivo for TATA-containing, but not TATA-lacking, RNA
      polymerase II promoters.
AB  - We have studied the effect of exogenous expression of the basal transcription
      factor TFIID on the activities of several different TATA-containing and TATA
      lacking promoters. Overexpression of TFIID from a transfected plasmid in
      Drosophila Schneider cells resulted in substantial concentration-dependent
      increases in expression from a cotransfected minimal TATA-containing promoter.
      Overexpression of TFIID activated expression from all TATA-containing promoters
      tested, with the maximum level of activation being inversely proportional to the
      strength of the promoter. In contrast, expression from TATA-less promoters was
      not enhanced, and could in fact be reduced, by increased expression of TFIID.
      Consistent with these findings overexpression of TFIID had opposite effects on
      Sp1-mediated activation observed from minimal synthetic promoters consisting of
      Sp1-binding sites and either a TATA box or initiator element. We discuss the
      significance of these results in terms of the role of TFIID in the initiation of
      transcription and as a possible regulatory target for expression from TATA
      containing promoters, as well as the role TFIID may play in expression from TATA
      less promoters.

PMID- 1737621
TI  - Extinction of alpha 1-antitrypsin gene expression in somatic cell hybrids:
      evidence for multiple controls.
AB  - Expression of the liver-specific alpha 1-antitrypsin (alpha 1AT) gene is
      extinguished in hepatoma/fibroblast hybrids. To define the mechanism of
      extinction, we identified DNA sequences involved in this process by transiently
      transfecting mutant alpha 1AT promoters into parental and hybrid cells. The wild
      type alpha 1AT promoter (-554 to +44 bp) was highly expressed in rat hepatoma
      cells, but activity was 100-fold less in fibroblasts or cell hybrids. Mutations
      in this region failed to activate alpha 1AT expression in nonhepatic cells, but
      mutations in the binding site for liver factor B1 (LF-B1) reduced hepatic
      specific expression greater than 100-fold. Furthermore, the hybrid cells failed
      to express LF-B1-binding activity and mRNA. This suggested that alpha 1AT
      extinction in hybrids might be an indirect, lack-of-activation phenotype mediated
      primarily through repression of LF-B1. To test this possibility, we stably
      transfected an LF-B1 expression cassette into parental and hybrid cells and
      monitored expression of transfected and endogenous alpha 1AT genes. Surprisingly,
      although constitutive LF-B1 expression could activate alpha 1AT-CAT transgenes in
      these cells, it neither prevented nor reversed extinction of the chromosomal
      alpha 1AT genes. We conclude that although extinction of the LF-B1 trans
      activator accompanies alpha 1AT extinction in cell hybrids, it does not play a
      causal role in this process.

PMID- 1737622
TI  - Relevance of Ki-67 expression in the classification of non-Hodgkin's lymphomas: a
      morphometric and double-immunostaining study.
AB  - The proliferation of reactive and neoplastic cells was retrospectively assessed
      in 92 cases of non-Hodgkin's lymphoma by morphometry using a double
      immunoenzymatic technique including surface markers and the monoclonal antibody
      Ki-67. The findings were compared with the histological diagnosis. The overall Ki
      67 positivity is not always a good measure of the corresponding corrected values
      and therefore we recommend that a correction should be made for the total number
      of complementary lymphocytes in the tumour. Taking the macrophages and the Ki-67
      positivity of the reactive cells into account does not generally add any
      information. There was no difference in reactive cell content between follicular
      (counted within follicles) and diffuse lymphomas within the tumour areas. The
      value of the group mean for low-grade follicular (nodular) lymphomas was
      significantly higher than that of diffuse low-grade lymphomas, but not
      significantly different from that of intermediate-grade lymphomas. High-grade
      lymphomas exhibited significantly greater Ki-67 positivity than those of
      intermediate grade. In 76% of the cases there was significant agreement between
      malignancy grade (low/intermediate malignant versus high malignant) at 45%
      corrected Ki-67 counts.

PMID- 1737623
TI  - Low-grade gastric B-cell lymphoma of mucosa-associated lymphoid tissue (MALT): a
      multifocal disease.
AB  - Gastrectomy specimens from five patients following gastroscopic biopsies which
      showed low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) were
      examined by serially sectioning and paraffin wax embedding using a 'swiss roll'
      technique. This procedure allowed the construction of a map of the specimen on
      which the distribution of the lymphoma could be plotted. In each case confluent
      lymphoma was identified. In addition small foci of lymphoma consisting of 1-4
      lymphoid follicles surrounded by neoplastic centrocyte-like cells were seen. The
      positions of these 'micro-lymphomas' were plotted on the gastrectomy maps,
      showing multiple foci distributed throughout the gastric mucosa. The
      identification of these microscopic lesions may explain the development of local
      relapse, often after a long disease-free interval, in patients with gastric MALT
      lymphoma treated by partial gastrectomy where excision appears to have been
      complete. Patients treated in this way should, therefore, be followed-up
      indefinitely, with regular endoscopy and gastric biopsy, in order to identify
      early local disease relapse.

PMID- 1737624
TI  - Frequent expression of haemopoietic and non-haemopoietic antigens by neoplastic
      plasma cells: an immunohistochemical study using formalin-fixed, paraffin
      embedded tissue.
AB  - There is increasing evidence that neoplastic plasma cells express various
      haemopoietic and non-haemopoietic antigens. Since this issue could raise problems
      in diagnostic histopathology, we have investigated 51 cases of multiple myeloma
      (plasmacytoma) systematically with a broad panel of antibodies applicable on
      paraffin-embedded and mildly decalcified tissue. In approximately 90% of the
      cases the neoplastic plasma cells reacted with at least one antibody detecting
      haemopoietic antigens: MB2 (75%), DF-T1/CD 43 (59%), UCHL1/CD 45RO (47%), Ki-B3
      (41%), anti-LCA/CD 45 (40%), L26/CD 20 (26%), 4KB5/CD 45RA (18%), Ber H2/CD 30
      (10%), anti-neutrophil elastase (4%), anti-Leu-7/CD 57 (8%), Dako-M1/CD 15 (2%),
      KP1/CD 68 (2%) and anti-glycoprotein IIIa (2%). In approximately 70% of the cases
      the cells reacted with antibodies against non-haemopoietic antigens: anti
      epithelial membrane antigen (65%), BMA120 (53%), anti-vimentin (44%), anti-pan
      cytokeratin/KL1 (8%), anti-carcino-embryonic antigen (6%) and HMB45 (6%). Lack of
      awareness of the frequent expression of both haemopoietic and non-haemopoietic
      antigens by neoplastic plasma cells could lead to mis-diagnosis of plasmacytomas
      as malignant lymphomas or even as carcinomas or sarcomas.

PMID- 1737625
TI  - Localized deposition of amyloid in articular cartilage.
AB  - The frequency, nature and tissue distribution of localized amyloid deposits in
      articular cartilage of young and elderly patients, with and without evidence of
      arthritic disease, was determined. Localized amyloid deposits in articular
      cartilage were not found in young patients with osteoarthritis of the hip or
      chondromalacia/osteoarthritis of the patella. However, in elderly patients with
      osteoarthritis of the hip, amyloid deposits were commonly found, although at no
      greater frequency than in elderly patients with no evidence of arthritis. Amyloid
      deposits were commonly present (in 95% of cases) in osteoarthritis of the knee
      joint and in the articular cartilage of all joints containing pyrophosphate
      deposits. Similar deposits of amyloid were also found in the articular cartilage
      of 40-45% of rheumatoid joints. These findings indicate that localized amyloid
      deposits in the articular cartilage are largely age-related and not due to
      specific pathological alterations affecting articular cartilage.

PMID- 1737626
TI  - An assessment of involucrin as a diagnostically useful immunohistochemical marker
      in lung tumours.
AB  - A previous report has described involucrin as a specific immunohistochemical
      marker of squamous differentiation in lung carcinomas. The aim of our study was
      to examine the expression of this antigen in a wide variety of lung tumours, with
      particular attention to its potential value in the typing of biopsy specimens. We
      found that immunostaining for involucrin was common in squamous carcinomas but
      was also found in adenocarcinomas, adenosquamous carcinomas, large cell
      carcinomas and carcinosarcomas. Small cell carcinomas, carcinoid tumours and
      mesotheliomas were negative. Contrary to previous claims, this marker appears to
      have little diagnostic utility in the typing of lung tumours.

PMID- 1737627
TI  - Carcinoma of the thyroid at a young age--a review of 23 patients.
AB  - Twenty-three children and adolescents with thyroid carcinoma who were 20 years
      old or younger at the time of initial treatment were followed for a mean time of
      9.5 years. Of the tumours, 21 were papillary and two follicular carcinomas. The
      majority (91%) of the 23 cases showed extra-thyroidal extension of the tumour. An
      association with chronic thyroiditis was observed in 30% of the cases. There was
      no history of irradiation of the head and neck in any patients. Relapse occurred
      in eight patients, lung metastases in two and local recurrences in six; one
      patient died from lung metastases 3 months after initial treatment. Male
      patients, advanced stage of tumour, less differentiated histological features and
      DNA aneuploidy were associated with a higher frequency of relapse. The prognosis
      of thyroid carcinomas in children and adolescents is not so good as is generally
      believed.

PMID- 1737628
TI  - Psammomatous melanotic schwannoma arising in the dermis in a patient with
      Carney's complex.

PMID- 1737629
TI  - Silverworker's finger: an unusual occupational hazard mimicking a melanocytic
      lesion.

PMID- 1737630
TI  - Intrathoracic schwannoma of the vagus nerve.

PMID- 1737631
TI  - Primary malignant melanoma of the oesophagus.

PMID- 1737632
TI  - Large cell lymphoma with fibrillary matrix.

PMID- 1737633
TI  - Mixed cloacogenic carcinoma of male urethra.

PMID- 1737634
TI  - Overwhelming septicaemia due to Streptococcus pneumoniae: unexpected autopsy
      findings.

PMID- 1737635
TI  - Tumour phase of mycosis fungoides in the tongue.

PMID- 1737636
TI  - Quantitative differentiation of the haptoglobin-related gene product from
      haptoglobin in human plasma: a possible test for tumor-associated antigen.
AB  - The haptoglobin-related gene product (HGRP) having greater than 90% sequence
      homology with plasma haptoglobin, has recently been implicated as a tumor maker
      of recurrent breast cancer. Therefore, availability of a monoclonal antibody
      which is specific to the HGRP and ensuing ELISAs to quantitate the HGRP without
      cross-reactivity with plasma haptoglobin will allow determination of the clinical
      value of the HGRP in human plasma under various pathophysiological conditions. A
      peptide representing the first 34 residues of the N-terminal portion of the HRGP
      was synthesized and conjugated to keyhole limpet hemocyanin (KLH) to immunize
      Balb/c mice. Hybrid clones that produced specific antibodies to HRGP were
      screened with the same peptide but conjugated to bovine serum albumin (HRGP-BSA).
      From 12 hybridoma clones that recognized HGRP-peptide, we obtained one IgM
      producing clone (27.5) by limiting dilution technique that selectively reacted
      with HGRP-peptide with minimal cross-reactivity with haptoglobin. Using a
      separate monoclonal antibody, clone 21.7, which is directed to the alpha subunit
      of haptoglobin, we developed an enzyme-linked immunosorbent assay (ELISA) to
      determine the quantities of the HGRP in human plasma, which will allow assessment
      of HGRP as a clinical marker of malignancy.

PMID- 1737637
TI  - Rapid isolation of immunoglobulin variable genes from cell lysates of rat
      hybridomas by polymerase chain reaction.
AB  - The isolation of the rearranged immunoglobulin genes from a hybridoma cell line,
      which is a prerequisite for the construction of a recombinant antibody, can
      easily be achieved by polymerase chain reaction. Here we demonstrate that this
      method, which was originally described for cloning murine immunoglobulin genes
      from cDNA, is also applicable for rat genes. We show that the procedure also
      works with crude cell lysates as starting material, thereby greatly reducing the
      time required for sample preparation. In addition we have sequenced the
      nonfunctional heavy chain variable gene of the fusion partner X63Ag8.653, which
      was readily amplified from our hybridoma cells, and whose sequence has been so
      far unknown.

PMID- 1737638
TI  - Chicken antibodies: a tool to avoid interference by human anti-mouse antibodies
      in ELISA after in vivo treatment with murine monoclonal antibodies.
AB  - Human anti-murine antibodies (HAMA) can be found in serum of many patients who
      have received murine monoclonal antibodies for diagnosis or therapy. These
      antibodies are known to give false positive results in sandwich-type assays (e.g.
      ELISA or RIA). This interference problem will increase in the future as more
      patients are treated with murine monoclonal antibodies in vivo. HAMA can also be
      found in sera from patients that has not been treated with monoclonal antibodies.
      In this work we have studied the interference of HAMA in sandwich ELISAs
      containing antibodies from different species. HAMA, present in the sample, may
      react both with the capture antibody and the detection antibody in these assays
      to give a false positive reaction. HAMA did not react with chicken IgG, and if
      one of (or both) the capture and detection antibody was of avian origin, the
      interference of HAMA in sandwich assays could be avoided.

PMID- 1737639
TI  - Enhanced transfection of a bacterial plasmid into hybridoma cells by
      electroporation: application for the selection of hybrid hybridoma (quadroma)
      cell lines.
AB  - A procedure was investigated to transduce a bacterial plasmid containing a
      specific drug resistance marker (pSV2-neo), into a hybridoma cell line using
      electroporation. The effect of several buffers and the form of plasmid DNA
      (circular or linearized) on the stable transfection frequency were examined. When
      complete cell culture medium (DMEM) was used as electroporation buffer, we
      observed a two-fold increase in post-pulse viability and a ten- to thirty-fold
      increase in the transfection frequency of pSV2-neo, as compared with HEPES
      buffered 0.15 M sodium chloride. Supplementing DMEM with fetal bovine serum (DMEM
      + FBS) had some beneficial effect on post-pulse viability of the cells after
      electroporation, but did not markedly increase stable transfection frequency as
      compared with DMEM alone. Furthermore, with DMEM + FBS, the intact plasmid was
      transfected as effectively as linearized PSV2-neo. However, when using HEPES
      buffered saline, the transfection frequency of pSV2-neo increased two-fold after
      linearization as compared with intact plasmid. The drug resistance was used
      successfully as a marker for the selection of hybrid hybridoma (quadroma) cell
      lines after fusing two different hybridoma cell lines, producing anti-fibrin and
      anti-plasminogen activator antibodies respectively. The quadroma cells produced
      bispecific antibodies that are capable of accumulating plasminogen activator on a
      fibrin surface.

PMID- 1737640
TI  - Isolation and characterization of a monoclonal anti CK-2 alpha subunit antibody
      of the IgG1 subclass.
AB  - A monoclonal antibody was produced against the recombinant human alpha subunit of
      CK-2. The antibody was of the IgG1 subclass and it was isolated from serum-free
      cell culture media and purified by affinity chromatography on Protein G
      Sepharose. The antibody can be used to detect specifically the CK-2 alpha subunit
      in immunoblots from tissue extracts. An ELISA detection test was also established
      which also allows the identification of the CK-2 alpha subunit.

PMID- 1737641
TI  - Production of novel monoclonal antibodies against rabbit platelet factor four.
AB  - Ten hybridomas producing monoclonal antibodies (Mabs) against rabbit platelet
      factor 4 (PF4) were obtained from the fusion of splenocytes from mice immunized
      with purified rabbit PF4 and NSO mouse myeloma cells. When the reactivities of
      these monoclonal antibodies were determined by enzyme-linked immunosorbent assay
      and immunoblotting with human and rabbit PF4, they showed a high degree of
      specificity. Only one Mab recognized an epitope common to the human and rabbit
      molecules, the other nine reacted only with the rabbit protein. All the
      antibodies recognized, in crude platelet lysates, a band that comigrates with the
      purified PF4 protein. None of these antibodies cross-reacted with major rabbit or
      human platelet-poor plasma proteins. The significance of the Mabs in
      immunological and physiological studies is discussed.

PMID- 1737642
TI  - Development and characterization of a panel of monoclonal antibodies against the
      novel subtilisin-like proprotein processing enzyme furin.
AB  - Monoclonal antibodies were raised against the recently discovered subtilisin-like
      proprotein processing enzyme furin. As immunogen, a bacterially expressed hybrid
      protein was used which consisted of glutathione S-transferase fused to almost the
      entire human furin protein. Ten monoclonal antibodies were obtained and these
      could be divided into four categories on the basis of their reactivity towards a
      number of bacterially expressed hybrid proteins, each of which contained a
      different portion of human furin. Four of the monoclonal antibodies did not
      recognize mouse furin. All monoclonal antibodies were tested for their
      applicability in Western blot and immunofluorescence analysis. Western blot
      analysis was performed with COS-1 cells in which biologically active forms of
      human and mouse furin were expressed transiently under control of the SV40 late
      promoter. This approach was necessary, since physiological levels of fur gene
      encoded proteins appeared to be very low. In cells transfected with human or
      mouse fur cDNA, a protein of about 100 kDa and a doublet of about 90 kDa could be
      detected with most of the monoclonal antibodies. Some of these antibodies
      appeared to be also reactive in immunofluorescence analysis of transfected COS-1
      cells.

PMID- 1737643
TI  - Immunoglobulins secreted by a hybrid-hybridoma: analysis of chain assemblies.
AB  - In addition to the bispecific antibody, the hybrid-hybridoma 28.19.8 secretes
      antibodies monospecific for carcinoembryonic antigen (CEA) and antibodies
      monospecific for vinca alkaloids. By exhaustive affinity purification, the
      immunoglobulins isolated by Protein A chromatography from ascitic fluid have been
      fractionated into four populations, three of which are immunoreactive. Studies on
      these fractions by FPLC, SDS-PAGE, and a variety of ELISAs have shown that seven
      of the ten possible combinations of heavy and light chains exist as
      immunoreactive forms. The results suggest that the other three inactive
      combinations are also secreted by the hybrid-hybridoma.

PMID- 1737644
TI  - Influence of somatic cell hybridization and human serum on the generation and
      stability of human hybridomas.
AB  - We describe an approach that allows the generation of stable hybridomas secreting
      antigen specific human IgG antibodies with an efficiency comparable to that of
      the generation of IgM and IgA secreting hybridomas. This was achieved by
      evaluating means to increase the frequency of human hybridoma formation and the
      stability of the generated hybridoma cells when subjected to conditions for large
      scale growth. To this end, we generated new fusion lines with an increased human
      DNA content and modified the culture system. However, the application of these
      new fusion lines primarily resulted in unstable giant cells. As a consequence, we
      evaluated whether the viability of newly formed hybrids between existing fusion
      lines and lymphoblastoid cell lines might be improved. In an attempt to provide
      as many components necessary for the growth of antibody secreting hybridomas as
      possible, we propagated fused cells in medium supplemented with human serum. Our
      results show that with this approach the frequency of initially growing hybrids
      was significantly increased. Furthermore, only in culture medium supplemented
      with human serum was it possible to obtain stable IgG secreting clones.

PMID- 1737645
TI  - Endothelium-derived contracting factors.
AB  - The endothelium not only mediates relaxation but is a source of contracting
      factors. Endothelium-dependent contractions are elicited by physical and chemical
      stimuli (i.e., hypoxia, pressure, and stretch) and autacoids, local and
      circulating hormones. The mechanism of endothelium-dependent contractions to
      hypoxia involves withdrawal of nitric oxide. The endothelial cyclooxygenase
      pathway can produce thromboxane A2, prostaglandin H2, and superoxide anions. The
      peptide endothelin is a potent contracting factor; its production is stimulated
      by vasopressor hormones, platelet-derived factors, coagulation products, and
      cytokines, whereas endothelium-derived nitric oxide, prostacyclin, and a smooth
      muscle cell-derived inhibitory factor reduce endothelin production. In
      hypertension, the release of cyclooxygenase-dependent endothelium-derived
      contracting factors to stretch, acetylcholine, and platelet-derived products is
      augmented. Vascular endothelin production in hypertension remains controversial
      but appears mostly normal; it is augmented in the presence of vascular disease or
      renal insufficiency. The endothelium-dependent inhibition of endothelin-induced
      contractions is reduced in hypertension while the reactivity of vascular smooth
      muscle may be normal, increased, or reduced. The potentiating effects of low
      concentrations of endothelin on contractions to norepinephrine are augmented with
      aging and hypertension. In atherosclerosis, the production of the cyclooxygenase
      dependent endothelium-derived contracting factors and endothelin is enhanced.
      Thus, endothelium-derived contracting factors can profoundly affect vascular tone
      and counteract relaxing factors produced within the endothelium. In hypertension
      and atherosclerosis, the role of contracting factors appears to become more
      dominant, leading to an imbalance of endothelium-dependent vascular regulation.

PMID- 1737646
TI  - Endothelin stimulated by angiotensin II augments contractility of spontaneously
      hypertensive rat resistance arteries.
AB  - In cultured endothelial cells, endothelin is produced after stimulation with
      angiotensin II. The effects of angiotensin II and endothelin-1 on vascular
      sensitivity to norepinephrine were studied in perfused rat mesenteric resistance
      arteries. Expression of endothelin messenger RNA (mRNA) was determined in
      endothelial cells obtained from the mesenteric circulation. Perfusion (5 hours)
      of the arteries with angiotensin II (10(-7) M) potentiated contractions in
      arteries with endothelium induced by norepinephrine in spontaneously hypertensive
      rats but not Wistar-Kyoto rats. The potentiation was inhibited by phosphoramidon
      and an endothelin antibody. Short-term stimulation (1 hour) with angiotensin II
      did not cause the potentiation. Stimulation with angiotensin I (10(-7) M; 5
      hours) caused a potentiation prevented by captopril. In endothelial cells
      collected from the mesenteric arterial bed of spontaneously hypertensive rats,
      endothelin-specific mRNA was constitutively expressed, and the level of
      endothelin transcripts was increased by angiotensin II (10(-7) M). Threshold
      concentrations of exogenous endothelin-1 potentiated contractions induced by
      norepinephrine in arteries with and without endothelium of spontaneously
      hypertensive rats but not Wistar-Kyoto rats. Thus, angiotensin II stimulates the
      endothelial production of endothelin in situ and therapy potentiates contractions
      to norepinephrine in mesenteric resistance arteries of spontaneously hypertensive
      rats. This suggests that vascular endothelin production acts as an amplifier of
      the pressor effects of the renin-angiotensin system that may play an important
      role in hypertension.

PMID- 1737647
TI  - Kinins, nitric oxide, and the hypotensive effect of captopril and ramiprilat in
      hypertension.
AB  - We investigated the role of kinins in the acute depressor effect of captopril and
      ramiprilat in spontaneously hypertensive rats. Since the vasodepressor action of
      kinins may be linked to the generation of prostaglandins and endothelium-derived
      relaxing factors, we also investigated the role of prostaglandins and nitric
      oxide in the blood pressure reduction caused by angiotensin converting enzyme
      inhibitors. To this end, we contrasted the hypotensive effects of captopril (10
      mg/kg i.v.), ramiprilat (2 mg/kg i.v.), and the angiotensin II antagonist DuP 753
      (30 mg/kg i.v.) in spontaneously hypertensive rats with and without pretreatment
      with a kinin antagonist (D-Arg-Arg-Pro-Hyp-Gly-Thi-Ser-D-Phe-Thi-Arg
      trifluoroacetic acid) (200 micrograms/kg/min i.v.), an inhibitor of nitric oxide
      synthesis (NG-monomethyl-L-arginine) (15 mg/kg + 10 mg/kg/hr i.v.), or an
      inhibitor of prostaglandin synthesis (indomethacin) (10 mg/kg i.v.). The kinin
      antagonist did not affect blood pressure in spontaneously hypertensive rats but
      did attenuate the hypotensive effect of captopril and ramiprilat; the kinin
      antagonist did not minimize the depressor action of DuP 753. The nitric oxide
      synthesis inhibitor increased blood pressure in spontaneously hypertensive rats
      and attenuated the hypotensive effect of captopril, ramiprilat, and DuP 753, but
      it did not impede the hypotensive effect of sodium nitroprusside. Pretreatment of
      hypertensive rats with indomethacin did not modify the acute hypotensive effect
      of ramiprilat or captopril. These data suggest a contribution of endogenous
      kinins and nitric oxide to the acute antihypertensive effect of captopril and
      ramiprilat in spontaneously hypertensive rats and of nitric oxide to the
      hypotensive effect of DuP 753.

PMID- 1737648
TI  - Angiotensin II-induced changes in guanine nucleotide binding and regulatory
      proteins.
AB  - Systemic infusion of angiotensin II, a potent agonist, using doses that are
      initially subpressor, eventually produces sustained blood pressure elevation and
      reductions in glomerular capillary ultrafiltration coefficient characterized by
      enhanced signal transduction to angiotensin II and other agonists. In this
      setting, there is a significant increased affinity of angiotensin II binding to
      smooth muscle and glomerular mesangial receptors and enhanced sensitivity and
      magnitude of angiotensin II-induced decrements in cyclic AMP. Since G proteins
      are important modulators of binding and signal transduction, the present studies
      were designed to test the hypothesis that differences in the relative amounts of
      G proteins may be present and have accounted for differences observed. G proteins
      were identified and quantitated by isoelectric focusing/sodium dodecyl sulfate
      polyacrylamide gel electrophoresis, radiolabeling in the presence of activated
      toxins with [gamma-32P]NAD+, immunoprecipitation, and immunoblotting. A 168% and
      465% increase in pertussis toxin-catalyzed ADP ribosylation of alpha 40-41 was
      found in angiotensin II-treated groups over control groups for glomerular and
      mesenteric membranes, respectively. Immunoblotting revealed a 250% and 35%
      increase in the levels of the Gi isoforms alpha i-2 and alpha i-3, respectively,
      and a decrease of 53% in alpha i-1 from the angiotensin II-treated group. No
      differences were observed in cholera toxin labeling or immunoblotting of Gs.
      These results demonstrate multiple mechanisms whereby angiotensin-induced signal
      transduction can be modulated involving both the receptors and G proteins. These
      observed differences in G proteins in systemic and renal vasculature accompanying
      angiotensin II infusion suggest the possibility of a regulatory role in the
      pathophysiology of angiotensin II-induced hypertension and renal disease.

PMID- 1737649
TI  - Enhanced myogenic responsiveness of renal interlobular arteries in spontaneously
      hypertensive rats.
AB  - We recently demonstrated that the interlobular artery (ILA) constricts in
      response to elevating renal arterial pressure (RAP), suggesting that the ILA
      contributes to renal autoregulation. In the present study, we examined the
      segmental myogenic responsiveness of the ILA in kidneys from Wistar-Kyoto (WKY)
      rats and spontaneously hypertensive rats (SHR). The tapered nature of the ILA
      allowed us to characterize the regional responsiveness, using the basal diameter
      to define segments as either proximal (greater than 60 microns), intermediate (40
      60 microns), or distal (less than 40 microns). At 80 mm Hg, segmental diameters
      were similar in WKY and SHR arteries (proximal, 76.0 +/- 3.1 versus 71.6 +/- 3.5
      microns; intermediate, 48.2 +/- 1.4 versus 48.1 +/- 1.7 microns; distal, 30.7 +/-
      0.9 versus 27.9 +/- 1.3 microns for WKY and SHR, respectively). In both strains,
      intermediate and distal segments exhibited graded reductions in diameter as RAP
      was elevated, whereas proximal segments did not. Pressure-induced decrements in
      the diameters of distal ILA segments were similar in WKY (-24 +/- 2%) and SHR (
      20 +/- 2%; p greater than 0.1). The intermediate ILA of SHR exhibited an
      augmented myogenic responsiveness, constricting at lower RAP levels and
      exhibiting greater maximal decrements in diameter at 180 mm Hg (i.e., -19 +/- 2%
      and -12 +/- 2% for SHR and WKY, respectively; p less than 0.05). Nifedipine (1.0
      microM) reduced pressure-induced vasoconstriction of intermediate and distal ILA
      segments by 56 +/- 11% and 79 +/- 7%, respectively, in WKY.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1737650
TI  - Mechanism of neurally induced monkey mesenteric artery relaxation and
      contraction.
AB  - Physiological importance in vasodilator innervation alleviating noradrenergic
      neurogenic vasoconstriction has not been clarified. Isolated monkey mesenteric
      artery strips denuded of the endothelium responded to nerve stimulation by
      electrical pulses or nicotine with a contraction, which was potentiated by Ng
      nitro-L-arginine, a nitric oxide synthesis inhibitor, but not by the D
      enantiomer. The potentiation was abolished by L-arginine. NG-Nitro-L-arginine did
      not potentiate the response to exogenous norepinephrine nor did it increase the
      release of [3H]norepinephrine from adrenergic nerves electrically stimulated. The
      contraction was reversed by treatment with phentolamine and guanethidine to a
      relaxation, which was abolished by NG-nitro-L-arginine. The inhibition was
      reversed by L- but not D-arginine. The relaxant response was not influenced by
      atropine, timolol, or indomethacin. These findings strongly suggest the
      importance of reciprocal nitric oxide-related (nitroxidergic) vasodilator and
      noradrenergic vasoconstrictor innervation in the regulation of monkey arterial
      tone.

PMID- 1737651
TI  - Control of the erythrocyte free Ca2+ concentration in essential hypertension.
AB  - Since Ca2+ ions seem to directly participate in the control of erythrocyte
      membrane structure and deformability and because cell Ca2+ metabolism has been
      repeatedly proposed to be modified in hypertension, the intracellular calcium ion
      concentration ([Ca2+]i) was investigated in red blood cells from hypertensive and
      normotensive subjects. [Ca2+]i was measured by using the fluorescent Ca2+
      chelator fura-2. Red blood cell [Ca2+]i was increased in hypertensive compared
      with normotensive subjects in the whole population and further increased when
      hypertensive were compared with age-matched normotensive subjects. An inverse
      relation between age and [Ca2+]i was observed when calculated with blood pressure
      adjusted. In hypertensive patients, high [Ca2+]i values were associated with a
      reduced erythrocyte deformability. The initial rate of 45Ca2+ uptake did not
      differ between the two blood pressure groups. Similarly, when the extracellular
      Ca2+ concentration was elevated from 1 to 2 mmol/l, [Ca2+]i increased by 16 +/-
      4% (p less than 0.03) in red blood cells from both groups, thus maintaining a
      significant difference between hypertensive and normotensive subjects. Under
      these conditions, the addition of 10(-7) mol/l nicardipine, a dihydropyridine
      Ca2+ antagonist, decreased [Ca2+]i by 15 +/- 4% (p less than 0.05) and 7 +/- 5%
      in erythrocytes from hypertensive and normotensive subjects, respectively,
      thereby reducing the difference in [Ca2+]i observed between these two groups.
      This nicardipine effect was positively correlated to the initial [Ca2+]i. In the
      presence of 5 mumol/l W7, a calmodulin antagonist, [Ca2+]i increased
      significantly only in erythrocytes from hypertensive patients (26 +/- 6%, p less
      than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737652
TI  - Magnesium supplementation prevents the development of alcohol-induced
      hypertension.
AB  - The effect of chronic alcohol administration on blood pressure was investigated
      in 7-week-old Wistar rats. Tail-cuff blood pressure was significantly higher in
      rats who received 15% ethanol in drinking water than in control rats.
      Intracellular free calcium concentration of lymphocytes was increased, while
      magnesium concentration of erythrocyte, aorta, and skeletal muscle and
      erythrocyte ouabain-sensitive 22Na efflux rate constant (Kos) were decreased in
      alcohol-induced hypertensive rats but not in control rats. Extracellular fluid
      volume was also increased in alcohol-administered rats. Oral magnesium
      supplementation (1% MgO in rat chow) attenuated the development of alcohol
      induced hypertension accompanied by increased magnesium concentration of
      erythrocyte, aorta, skeletal muscle, and Kos and decreased intraerythrocyte
      sodium concentration. Norepinephrine half-life time of the heart and spleen was
      also increased in magnesium-supplemented rats. Blood pressure significantly
      correlated positively with intracellular calcium concentration and extracellular
      fluid volume, negatively with magnesium concentration of erythrocyte, aorta,
      skeletal muscle, and Kos. These results suggest that increased intracellular
      calcium, which was partly due to magnesium depletion and suppressed sodium pump
      activity, and expanded body fluid volume had a possible role in the development
      of alcohol-induced hypertension. It is also suggested that oral magnesium
      supplementation had a hypotensive effect on alcohol-induced hypertension possibly
      through decreased intracellular sodium concentration caused by an activation of
      sodium pump and decreased sympathetic nervous activity.

PMID- 1737653
TI  - Aftereffects of exercise on regional and systemic hemodynamics in hypertension.
AB  - Several studies have indicated that a single bout of physical exercise induced a
      significant antihypertensive effect during the hours after the activity. However,
      little information is presently available on the underlying hemodynamic changes.
      We examined 13 essential hypertensive patients and nine normotensive subjects in
      a randomized, crossover study design during 3 hours after a 30-minute period of
      upright leg cycling at 50% of peak aerobic capacity and during 3 hours after a 30
      minute control period of rest. Blood pressure, heart rate, cardiac output, total
      peripheral resistance, and regional vascular resistance in the forearm as well as
      venous plasma catecholamine concentrations were measured repeatedly. After
      exercise, systolic (-11 +/- 2 mm Hg) and diastolic (-4 +/- 1 mm Hg) blood
      pressures, total peripheral resistance (-27 +/- 5%), forearm vascular resistance
      (-25 +/- 6%), and plasma norepinephrine levels (-21 +/- 7%) were significantly (p
      less than or equal to 0.05) decreased, and cardiac output was increased (+31 +1-
      8%) compared with control in hypertensive subjects. In contrast, in normotensive
      subjects blood pressure, forearm vascular resistance, and plasma norepinephrine
      were unchanged, and systemic hemodynamics changed to a lesser extent than in
      hypertensive subjects after exercise. It is concluded that a decrease in regional
      vascular resistance in skeletal muscles and possibly in the skin in hypertensive
      patients may contribute importantly to the antihypertensive effect of prior
      exercise. A decreased sympathetic nervous activity, as seen from lower plasma
      norepinephrine levels, may be involved in this effect.

PMID- 1737654
TI  - Genetic influences on the urinary excretion of aldosterone in children.
AB  - Several studies have shown an inverse relation between blood pressure and plasma
      aldosterone levels. Since blood pressure is in part genetically regulated, we
      looked for evidence that genetic factors might also affect aldosterone
      production. The nocturnal urinary excretion rate was used to estimate aldosterone
      production, and electrolyte excretion rates were used to estimate sodium and
      potassium intakes. Studies were carried out in monozygotic (MZ) (n = 37 pairs)
      and dizygotic (DZ) (n = 26 pairs) twins, aged 6-17 years. Both groups of twins
      were white. The intraclass correlation coefficient for aldosterone excretion was
      0.686 (p = 0.0001) for MZ twins, and 0.290 (p = 0.079) for DZ twins, indicating
      high heritability for the aldosterone excretion rate. In a second study, we
      looked for a racial effect on the genetic regulation of aldosterone excretion.
      Siblings from both black and white families (72 black siblings and 157 white
      siblings) were selected from an ongoing longitudinal study. Mean values for
      nocturnal aldosterone excretion, rates measured every 6 months over 1.5-3.5
      years, were used in the analysis. The intraclass correlation coefficient for
      aldosterone excretion, adjusted for sodium and potassium excretion, was 0.510 (p
      = 0.001) for black siblings and 0.087 (p = 0.228) for white siblings, indicating
      a strong familial aggregation for aldosterone excretion in black children. In
      conclusion, studies in twins showed that regulation of urinary aldosterone
      excretion in children is determined partially by genetic factors. A familial
      component affecting the aldosterone excretion rate appears to be much stronger in
      blacks than in whites.

PMID- 1737655
TI  - Frederick Akbar Mahomed.
AB  - Frederick Akbar Mahomed was an Englishman of mixed Indian and Irish descent who
      made substantial contributions to the study of high blood pressure in a short
      professional life from 1872 to 1884. He was strongly influenced by the previous
      work of Richard Bright on kidney disease at his own hospital (Guy's Hospital in
      London) and by the contemporary pathological studies of Gull and Sutton on
      arteriolar changes in persons with high blood pressure. In detailed clinical
      studies, he separated chronic nephritis with secondary hypertension from what we
      now term essential hypertension. He described the constitutional basis and
      natural history of essential hypertension and pointed out that this disease could
      terminate with nephrosclerosis and renal failure. His clinical studies were done
      without the benefit of a sphygmomanometer but with the aid of a quantitative
      sphygmogram that he had initially developed while a medical student. He described
      characteristic features of the pressure pulse in patients with high blood
      pressure and in persons with arteriosclerosis consequent on aging. These pressure
      wave changes have recently been verified and explained. He contributed to a
      number of other advances in medical care, including blood transfusion and
      appendectomy for appendicitis. He initiated the Collective Investigation Record
      for the British Medical Association; this organization collected data from
      physicians practicing outside the hospital setting and was the precursor of
      modern collaborative clinical trials. Mahomed died from typhoid fever, almost
      certainly contracted from one of his patients, at age 35 at the height of his
      career.

PMID- 1737656
TI  - "White coat" hypertension.

PMID- 1737657
TI  - The Georgia Centenarian Study.

PMID- 1737658
TI  - Personality, life events and coping in the oldest-old.
AB  - This paper compares older adults in their sixties, eighties, and 100s on
      personality, experience of life events, and coping. A secondary goal was to test
      a structural model of adaptation. Participants (165) filled out a personality
      inventory, life-event lists, and coping and mental health measures. Results
      revealed differences in personality: centenarians scored higher on dominance,
      suspiciousness, and imagination. While centenarians scored lower on active
      behavioral coping than other age groups, they used cognitive strategies when
      coping with health and family events. Results from the structural equation model
      indicated that extraversion and anxiety predicted morale and mental health.

PMID- 1737659
TI  - The influences of cognitive resources on adaptation and old age.
AB  - In the Georgia Centenarian Study, cognitive resources were estimated by fluid and
      crystallized intelligence, acquisition and retrieval of new information,
      retrieval of familiar information, and problem-solving ability in community
      dwelling and nondemented adults ranging from sixty to one hundred plus years of
      age. Five clusters of results were found: 1) cognitive performances were lower
      for the older cohorts; 2) when cognitive activities were dependent on everyday
      experiences, no age-related problem-solving decline was found; 3) physical health
      and mental health can significantly influence cognitive performances; 4)
      cognitive and personality factors can combine to account for a larger amount of
      adaptation variance than can be accounted for by either of the factors alone; and
      5) individuals with a high level of intelligence and affect sustain their
      instrumental activities of daily living. Cognitive resources were an important
      contributor to successful adaptation for the oldest-old.

PMID- 1737660
TI  - Religiosity and adaptation in the oldest-old.
AB  - Previous research has yielded mixed results with respect to the relationship
      between religiosity and adaptation in older adults. Most studies show that
      religiosity is stable over the life span, but that religiosity may or may not be
      related to such factors as physical and mental health, life satisfaction, and
      coping. This study adds to earlier investigations by including centenarians among
      the sample. The preliminary results of this research project support earlier
      findings that religiosity does not change significantly as one ages, although
      there is a trend in the results that suggests otherwise. The results also
      indicate a significant relationship between religiosity and physical health but
      no significant relationship between religiosity and mental health and life
      satisfaction. Religiosity and coping are strongly related, and there is the
      suggestion that religious coping mechanisms might be more important in the oldest
      old.

PMID- 1737661
TI  - Nutritional patterns of centenarians.
AB  - This study compares the dietary patterns of centenarians (n = 24) with elderly
      adults in their sixties (n = 54) and eighties (n = 47). Compared to the younger
      cohorts, centenarians consumed breakfast more regularly, avoided weight loss
      diets and large fluctuations in body weight, consumed slightly more vegetables,
      and relied on their doctor and family more than on the news media for nutrition
      information. On the other hand, centenarians were less likely to consume diets
      low in fat and to comply with nutritional guidelines designed to reduce the risk
      of chronic disease. Elderly black men consumed diets higher in sweets and fat
      compared to black women and white men and women. Nearly three times as many
      blacks expressed the desire to eat more nutritiously. High nutrition risks,
      particularly in blacks, were associated with lower physical and mental health and
      impaired activities of daily living.

PMID- 1737662
TI  - The Georgia Centenarian Study: comments from friends.

PMID- 1737663
TI  - Anomalous coronary arteries: angiographic findings in 80 patients.
AB  - Among 13010 adults who underwent coronary arteriography, 80 (0.61%) patients had
      a total of 83 anomalous coronary arteries. Thirty-three (41%) of the patients
      were of Hispanic origin, while out of the entire population studied 30% were
      Hispanic. The right coronary artery was the most common anomalous vessel. It was
      identified in 50 (62%) patients, arising in 35 from the left aortic sinus, in 14
      from the posterior sinus, and in 1 from the left coronary artery. An anomalous
      circumflex artery was recognized in 22 (27%) patients. Nine (11%) patients
      presented an anomalous left anterior descending artery, 1 patient an anomalous
      left main coronary artery, and another an anomalous septal perforator artery.
      Twenty-three (29%) patients had concomitant congenital heart abnormalities, most
      commonly. bicuspid aortic valve and mitral valve prolapse. In each of 5 patients
      with complex congenital heart disease the course of the anomalous vessel could
      have interfered with a surgical procedure. In 4 cases anomalous coronary arteries
      were associated with either anomalous systemic venous circulation or anomalous
      cardiac veins. In 5 (6%) patients only, the anomalous coronary artery was solely
      responsible for a clinical event. Coronary atherosclerosis of the anomalous
      arteries was found in 28% of the patients, while the overall incidence of the
      disease in this series was 65%. Thus, anomalous coronary arteries are associated
      with a high incidence of congenital heart diseases, but do not appear to be
      associated with an increased risk for development of coronary atherosclerosis.
      The angiographic recognition of these vessels is important in patients who
      undergo coronary angioplasty or cardiac surgery. Variations in the frequency of
      congenital coronary anomalies as reported herein may be attributed to a genetic
      background.

PMID- 1737664
TI  - Resection of right atrial lymphoma in a patient with AIDS.
AB  - Although cardiac problems are common in acquired immunodeficiency syndrome, there
      is limited experience with heart surgery in this group of patients. We report a
      case in which a right atrial lymphoma was resected to alleviate tricuspid valve
      obstruction in a patient with AIDS. The patient did well for approximately 7
      months. At that time, he developed multiple complications of AIDS and
      deteriorated rapidly; he died 8 months after operation. Cardiac surgery can be
      successfully performed in AIDS patients. However, the late outcome is compromised
      by the nature of the underlying viral infection.

PMID- 1737665
TI  - Adverse effects of epinephrine in patients with advanced left ventricular
      dysfunction: analysis of ventriculo-arterial coupling.
AB  - We examined the response of ventriculo-arterial coupling to epinephrine in 19
      patients with normal left ventricular function and with left ventricular
      dysfunction of various degrees using a conductance catheter. They were divided
      into three groups: group I, seven patients without left ventricular wall motion
      abnormality; group II, six patients with ejection fraction of 45-60%; group III,
      six patients with ejection fraction of 28-40%. Changes in the slope of the end
      systolic pressure-volume relationship (end-systolic elastance), the effective
      arterial elastance, the ratio of effective arterial elastance to end-systolic
      elastance and the ventricular work efficiency during administration of two
      different doses of epinephrine (0.05 and 0.1 micrograms/kg/min) were compared
      among the three groups. At baseline there were no significant differences among
      the three groups in the ratio of effective arterial elastance to end-systolic
      elastance, or ventricular work efficiency. At the lower dose of epinephrine, the
      mean ratio of effective arterial elastance to end-systolic elastance decreased
      and the mean ventricular work efficiency increased in any groups. At the higher
      dose of epinephrine the mean ratio of effective arterial elastance to end
      systolic elastance further decreased and the mean ventricular work efficiency
      further increased in groups I and II. However, the mean ratio of effective
      arterial elastance to end-systolic elastance did not decrease but the mean
      ventricular work efficiency even decreased in group III. Thus, in patients with
      advanced left ventricular dysfunction, even a high dose of epinephrine does not
      modulate the ventriculo-arterial coupling to increase ventricular work
      efficiency.

PMID- 1737666
TI  - Immunosuppressive therapy in inflammatory myocarditis: long-term follow-up.
AB  - Sixteen patients (12 male and 4 female, age 2-46 years) with endomyocardial
      biopsy-proven myocarditis were prospectively evaluated with immunosuppressive
      therapy including azathioprine and prednisolone in addition to other standard
      measures. Patients were either in NYHA class IV (n = 12) or class III (n = 4).
      Twelve patients showed improvement and the remaining 4 continued to deteriorate:
      2 died at 1 and 2 months after therapy and the other 2 were lost to follow-up
      after 4-6 weeks of therapy. Three of the 12 patients who showed significant
      improvement, after sudden omission of therapy (at 8 weeks, 6 and 8 months)
      worsened and died. One patient who showed significant improvement died suddenly
      after 9 months of therapy while playing football. The remaining patients have
      shown significant clinical and haemodynamic improvement with normalization of
      myocardial morphology. Serial haemodynamic studies revealed a significant fall in
      cardiothoracic ratio (before: 62.3 +/- 4.7%; 3 months: 55.1 +/- 3.1%, P less than
      0.0001; 6-12 months: 50.6 +/- 1.5%, P less than 0.0001), mean pulmonary artery
      pressure (before: 34.3 +/- 13.05 mm; 3 months: 20.4 +/- 8.71 mm, P less than
      0.01; 6-12 months: 20.0 +/- 2.75 mm, P less than 0.01) and mean pulmonary artery
      wedge pressure (before: 26.0 +/- 9.07 mm; 3 months 14.0 +/- 5.63 mm, P less than
      0.001; 6-12 months: 13.2 +/- 4.57 mm, P less than 0.001). The left ventricular
      ejection fraction improved from 24.3 +/- 8.36% to 35.8 +/- 9.72% (P less than
      0.001) at 3 months and 49.8 +/- 18.2% (P less than 0.0001) at 6-12 months of
      therapy. Two patients have been subsequently lost to follow-up whereas the
      remaining 6 patients are on follow-up for 1-4 years after therapy and are doing
      fine. Our uncontrolled observations suggest that immunosuppressive therapy may be
      useful in patients with inflammatory myocarditis.

PMID- 1737667
TI  - Propionyl-L-carnitine: a new compound in the metabolic approach to the treatment
      of effort angina.
AB  - The effects of propionyl-L-carnitine on exercise tolerance of 12 patients with
      stable exertional angina were assessed in a double-blind, placebo-controlled,
      cross-over protocol using serial exercise tests. Compared to placebo, propionyl-L
      carnitine significantly increased total work from 514 +/- 199 to 600 +/- 209 W (P
      less than 0.05) (17%) and prolonged exercise time and time to ischemic threshold
      from 515 +/- 115 to 565 +/- 109 sec (P less than 0.05) (10%) and from 375 +/- 102
      to 427 +/- 93 sec (P less than 0.01) (14%), respectively. ST segment depression
      at the highest common work level was significantly reduced from 0.19 +/- 0.08 to
      0.15 +/- 0.08 mV (P less than 0.05) (21%). No significant changes in heart rate,
      systolic blood pressure, and rate-pressure product at rest, at the highest common
      work level, on appearance of the ischemic threshold, or at peak exercise were
      observed after propionyl-L-carnitine treatment. No side effects were observed
      under propionyl-L-carnitine treatment. This study shows that propionyl-L
      carnitine can significantly improve exercise tolerance in patients with stable
      angina. Our data seem to confirm that propionyl-L-carnitine most likely exerts
      its protective action via the metabolic pathway.

PMID- 1737668
TI  - Circadian variation of ventricular tachycardia in patients with coronary arterial
      disease.
AB  - Sudden cardiac death and ischaemic cardiac events occur in a circadian pattern.
      Because ventricular tachycardia is thought to play an important role in sudden
      cardiac death, the episodes of spontaneous ventricular tachycardias (greater than
      3 consecutive beats) (n = 1314) were analysed from 24-hour long term
      electrocardiographic recordings in 34 patients with coronary arterial disease to
      determine whether circadian rhythm exists in spontaneous ventricular tachycardia.
      Twelve patients had suffered cardiac arrest, four patients had a history of
      syncope, and palpitation was the indication for electrocardiographic recordings
      in eighteen patients. Analysis using chronobiologic single cosinor method showed
      a significant circadian variation in the occurrence of ventricular tachycardia
      episodes with the peak occurring at 6 a.m. Similar circadian rhythm was also
      observed in the occurrence of the longest episode of ventricular tachycardia.
      Ischaemic ST-segment depression preceded the longest ventricular tachycardia
      episode only in one patient. Thus, a circadian rhythm occurs also in spontaneous
      episodes of ventricular tachycardia, a finding which is similar to that in sudden
      cardiac death.

PMID- 1737669
TI  - Enhanced release of atrial natriuretic factor during exercise-induced myocardial
      ischaemia in patients after acute myocardial infarction.
AB  - To determine whether acute myocardial ischaemia induced by dynamic exercise can
      lead to changes in plasma levels of atrial natriuretic factor, we performed
      symptom-limited bicycle electrocardiographic tests in 20 males with recent acute
      myocardial infarction and in 8 control males. Ten patients developed exercise
      induced myocardial ischaemia and 10 patients did not. There were no significant
      differences between the two groups with regard to age, site of myocardial
      infarction, urinary sodium, atrial sizes, radionuclide left ventricular ejection
      fraction, workload, baseline and peak-exercise heart rate, baseline and peak
      exercise rate-pressure product, duration of exercise. Also baseline atrial
      natriuretic factor concentrations were similar in both groups (ischaemic
      patients: 34.51 +/- 15.73 pg/ml; nonischaemic patients: 27.17 +/- 8.74 pg/ml,
      NS), while peak-exercise atrial natriuretic factor concentrations were higher in
      patients with exercise-induced myocardial ischaemia (112.31 +/- 35.5 pg/ml) than
      in the others (80.46 +/- 23.43 pg/ml) (P less than 0.05). After 15 minutes of
      recovery, plasma atrial natriuretic factor levels were still raised only in the
      ischaemic patients (63.3 +/- 15.44 pg/ml, P less than 0.01), returning to
      baseline after 30 minutes in both groups. In control subjects, the behaviour of
      atrial natriuretic factor resembled that of the patients without exercise-induced
      ischaemia, with a significant increase at peak-exercise (from baseline levels of
      23.1 +/- 10.5 pg/ml to peak-exercise levels of 91.3 +/- 14.5 pg/ml, P less than
      0.0005) and a rapid return to baseline levels after 15 minutes of recovery (28.5
      +/- 10.6 pg/ml, NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737670
TI  - Provocation of supraventricular tachycardias by an intravenous class I
      antiarrhythmic drug.
AB  - Antiarrhythmic drugs may aggravate or induce ventricular arrhythmia. The
      induction of a supraventricular tachycardia or its facilitation has rarely been
      reported. The purpose of the study was to know whether the potential for
      supraventricular proarrhythmic effect of a class Ia intravenous antiarrhythmic
      drug can be exposed during electrophysiologic study. Ajmaline was chosen because
      of its short duration of action. The protocol of the study consisted of an
      electrophysiological study and programmed atrial stimulation using 1 and 2
      extrastimuli on driven rhythm and atrial pacing up to second-degree
      atrioventricular block. Then 1 mg/kg of ajmaline was injected and atrial pacing
      was performed 3 minutes after its injection. Supraventricular proarrhythmic
      effect of ajmaline was defined as the spontaneous occurrence of a
      supraventricular tachycardia or the facilitation of its induction. Seventy
      patients among 1955 presented a proarrhythmic effect: 63 developed a
      supraventricular tachyarrhythmia (atrial flutter, fibrillation, tachycardia) and
      7 an atrioventricular reentrant tachycardia, either spontaneously (n = 23) or
      during atrial pacing (n = 47). Risk factors were identified in most patients: old
      age, underlying heart disease, history of spontaneous supraventricular
      tachycardia and/or induction of a supraventricular tachycardia by 2 extrastimuli
      on driven rhythm in the control state (34 patients), sinus node dysfunction (22
      patients). Compared with patients without proarrhythmic supraventricular effect
      only the history of spontaneous supraventricular tachycardia and the existence of
      a sinus node dysfunction were significantly more frequent (P less than 0.05) in
      patients with proarrhythmic effect of ajmaline. In conclusion, the
      supraventricular proarrhythmic effect of intravenous ajmaline exists and is
      related both to the electrophysiologic characteristics of the drug and to the
      arrhythmia substrate. The results indicate that a supraventricular
      tachyarrhythmia may be induced by a class I antiarrhythmic drug.

PMID- 1737671
TI  - Immunohistochemical and histochemical profile of Aschoff bodies in rheumatic
      carditis in excised left atrial appendages: an immunoperoxidase study in fresh
      and paraffin-embedded tissue.
AB  - We have evaluated the nature of Aschoff cells within Aschoff bodies seen in 35 of
      100 excised left atrial appendages from cases of rheumatic mitral stenosis who
      underwent closed mitral valvotomy. These were tested using a panel of monoclonal
      and polyclonal antisera by the indirect immunoperoxidase staining for leucocyte
      common antigen, macrophage, desmin, vimentin, alpha-1-antitrypsin, alpha-1
      antichymotrypsin, lysozyme, acid phosphatase and nonspecific esterase. The
      Aschoff cell gave strong reactivity with monoclonal antisera to vimentin,
      macrophage and variable reaction with polyclonal antisera known to recognise
      macrophages/histiocytes in tissues, namely alpha-1-antitrypsin, alpha-1
      antichymotrypsin and lysozyme. These were also strongly positive for acid
      phosphatase and nonspecific esterase. The Aschoff cell lacked affinity for desmin
      and only an occasional cell in 4 out of 20 and 6 out of 35 cases showed a weak
      reaction with myoglobin and leucocyte common antigen, respectively. Intense
      consistent reactivity with several histiocytic markers affirms the genesis of
      these cells from macrophages/histiocytes and not muscle cells; a controversy
      which must be laid to rest!

PMID- 1737672
TI  - Resolution of spontaneous echocardiographic contrast after percutaneous balloon
      mitral commissurotomy.

PMID- 1737673
TI  - Prenatal diagnosis of tetralogy of Fallot with absence of the leaflets of the
      pulmonic valve.
AB  - Tetralogy of Fallot with absence of the leaflets of the pulmonic valve is
      relatively rare. We describe the prenatal diagnosis of this malformation in two
      fetuses. The association between the agenesis of the arterial duct and absence of
      the valvar leaflets is discussed. The diagnosis of the syndrome in the presence
      of dilated and pulsatile pulmonic arteries is easy to make. It should allow early
      counselling and planning of early care after delivery.

PMID- 1737674
TI  - Preventable sudden death in patients receiving angiotensin converting enzyme
      inhibitors and loop/potassium sparing diuretic combinations.
AB  - Angiotensin-converting-enzyme inhibitors are frequently used in conjunction with
      diuretics in the treatment of congestive cardiac failure. We report two cases in
      which use of a proprietary combination diuretic containing a loop diuretic and
      potassium sparing agent with an angiotensin converting enzyme inhibitor was
      associated with hyperkalaemic cardiac arrest. Successful resuscitation from the
      arrest permitted elucidation of its mechanism. We believe that this outcome has
      not previously been reported, and emphasise the importance of electrolyte
      monitoring in patients receiving angiotensin converting enzyme inhibitors
      particularly if prescribed in addition to fixed combination proprietary
      diuretics.

PMID- 1737675
TI  - Aortic coarctation endarteritis and aneurysm: diagnosis by transoesophageal
      echocardiography.
AB  - A 17-year-old girl developed infective endarteritis, caused by Staphylococcus
      aureus, at the site of a previously undiagnosed aortic coarctation.
      Transoesophageal echocardiography revealed a clinically unsuspected false
      aneurysm. Foreknowledge of the presence of the aneurysm proved to be life saving
      when an acute deterioration required emergency surgery.

PMID- 1737676
TI  - Characteristics of transient myocardial ischaemia and acute occlusion in the
      immediate post-angioplasty period.
AB  - Holter monitoring was used to assess the incidence and characteristics of
      myocardial ischaemia immediately after successful coronary angioplasty in 24
      patients. In 5 patients a total of 16 episodes of ST depression were recorded.
      All were asymptomatic but ranged from 4 minutes to over 20 hours in duration.
      These patients, however, made an uncomplicated recovery, as did 18 patients with
      no ischaemic episodes. In the remaining patient, initially labile, but then,
      fixed ST elevation, accompanied by chest pain occurred. Subsequent angiography
      demonstrated acute vessel occlusion. These labile ischaemic changes indicate that
      prior to complete occlusion the vessel may be in a dynamic state when
      antispasmodic and antithrombotic therapies may be of value.

PMID- 1737677
TI  - Isolated right ventricular infarction mimicking additional infero-posterior left
      ventricular infarction.
AB  - A case of isolated right ventricular infarction mimicking additional infero
      posterior left ventricular infarction on the surface electrocardiogram is
      presented. Gross dilatation of the right ventricle was probably responsible for
      the electrocardiographic findings.

PMID- 1737678
TI  - Balloon nitinol device: a new possibility for the fixation of balloons in large
      arteries.
AB  - We propose a balloon with nitinol needles for the closure of large vessels
      avoiding the risk of embolisation. To demonstrate the possibility of application,
      we utilised a prototype consisting of a polyurethane balloon with one nitinol
      needle which reached the shape for securing the balloon to the vessel wall after
      changing the temperature of the device. If further research and experimentation
      in animals are favorable, it will be possible for the interventional cardiologist
      to occlude large vessels and perhaps intracardiac shunts easily without danger of
      embolisation.

PMID- 1737679
TI  - Calcium intake in Western countries.

PMID- 1737680
TI  - Mupirocin in the treatment of impetigo.

PMID- 1737681
TI  - Synthetic dressings.

PMID- 1737682
TI  - Bacillary angiomatosis.

PMID- 1737683
TI  - Wounds that will not heal: the Buruli ulcer.

PMID- 1737684
TI  - Rational approach to wound care.

PMID- 1737685
TI  - Therapy of chronic idiopathic urticaria with nifedipine.

PMID- 1737686
TI  - "Two-step" pemphigus induction by ACE-inhibitors.
AB  - Pemphigus lesions appeared in a 58-year-old man who was taking captopril for his
      hypertension. Drug withdrawal resulted in complete remission of the eruption. The
      subsequent use of enalapril as an antihypertensive agent caused a recurrence of
      pemphigus lesions along with onset of itching and dermographism. Intercellular
      antibodies were not found. Discontinuance of enalapril therapy had no effect on
      the clinical course. Steroid treatment was needed to resolve the eruption.
      Recently repeated immunofluorescent studies disclosed intercellular IgG
      antibodies in the serum at a low titer. Pemphigus induction could be initially
      related to the thiol acantholytic property of captopril. Subsequent production of
      intercellular antibodies and drug-activation of the kinin system could be
      responsible for relapsing.

PMID- 1737687
TI  - Differentiation of bullous pemphigoid from epidermolysis bullosa acquisita on
      frozen skin biopsies.
AB  - Patients with bullous pemphigoid and epidermolysis bullosa acquisita may have
      similar clinical, histologic, and routine immunohistologic features. These two
      diseases can be distinguished by routine diagnostic studies either on a patient's
      serum tested by indirect immunofluorescence on salt-split normal skin or by
      obtaining a fresh perilesional skin biopsy, inducing a split at the lamina
      lucida, and testing for the site of IgG deposition by direct immunofluorescence.
      Often the serum studies are negative, while direct immunofluorescent studies
      yield the characteristic linear IgG staining of the basement membrane zone. To
      eliminate the need for a repeat biopsy to make a laboratory differential
      diagnosis, we studied the efficacy of salt-splitting perilesional skin biopsies
      that had been previously submitted and frozen for routine direct
      immunofluorescent studies. The biopsies were thawed, salt-split, and processed
      for direct immunofluorescence. Three epidermolysis bullosa acquisita biopsies and
      seven bullous pemphigoid biopsies examined demonstrated IgG staining at sites
      consistent with their respective diagnoses. The IgG appeared in the dermal side
      of the split biopsies in epidermolysis bullosa acquisita and predominantly, or
      exclusively, in the epidermal side in bullous pemphigoid. Thus the direct
      immunofluorescent study of previously frozen and subsequently salt-split skin
      biopsies may be used for the differential diagnosis of bullous pemphigoid from
      epidermolysis bullosa acquisita. In most cases, it may eliminate the need for a
      repeat biopsy.

PMID- 1737688
TI  - Bullous diseases in Malaysia: epidemiology and natural history.
AB  - The characteristics of three primary bullous diseases, pemphigus, pemphigoid, and
      dermatitis herpetiformis, seen in this country, probably reflecting this region,
      are discussed and compared to those reported in the literature in the West. One
      hundred and forty-eight patients with bullous diseases were seen over a period of
      15 years. The criteria for confirmation of clinical diagnosis were the findings
      of the direct immunofluorescent test. Pemphigus vulgaris was the commonest
      bullous disease. The incidence of bullous pemphigoid was highest in the Indians
      of Malaysian origin, and they are also more likely to develop pemphigus vulgaris
      than any other ethnic group. Linear IgA type formed the entire group of
      dermatitis herpetiformis. The granular type was not seen at all. The patients
      were treated with prednisolone alone or together with methotrexate or
      azathioprine. Dapsone alone controlled the dermatitis herpetiformis. The known
      association between pemphigus and other diseases with immunologic disturbances
      was not found in this study. The natural history of the bullous disease as seen
      in the follow-up patients is described. Deaths in pemphigus and pemphigoid were
      more due to either complications of steroid therapy or unassociated diseases than
      the primary disease itself. Introduction of immunofluorescence as a diagnostic
      tool in pemphigus and extension of this facility to other bullous diseases has
      led to detailed characterization of these diseases as seen in the West; however,
      publications in English dealing with epidemiologic aspects of bullous diseases in
      this region are rare.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737689
TI  - Pemphigus vulgaris following a cutaneous thermal burn.
AB  - Pemphigus vulgaris developed in a 59-year-old man following a cutaneous thermal
      burn. This is an example of induced pemphigus and should be included with the
      small number of cases where this sequence has been reported.

PMID- 1737690
TI  - Carotenoderma: a possible pit-fall in the immunopathologic diagnosis of pemphigus
      vulgaris.
AB  - A 30-year-old woman presented with an orange-yellow discoloration of the skin,
      most noticeable on the palms and soles and nasolabial folds; sclera appeared
      normal. The patient had observed the abnormal pigmentation of her skin 3 months
      earlier and noticed that it had become more evident after a sauna she had taken 2
      days before our examination. In the last 3 years the patient's diet included
      about 2 kg of oranges daily (which are notoriously rich in carotene) following
      her own original idea. Complete laboratory analyses were normal. In particular,
      thyroid and liver function tests were in the normal range as were serum lipid
      levels. The serum carotene levels were 410 mg/dL (NV 20-150 mg/dL) and the levels
      of vitamin A 68 mg/dL (NV 25-60 mg/dL). A punch biopsy, taken from the palm of
      the right hand, observed under an optic microscope showed an autofluorescence in
      the superficial horny layer and a pemphigus-like pattern of intercellular
      autofluorescence. A month after the interruption of the orange-rich diet, the
      abnormal coloration of the skin disappeared and serum levels of carotene and
      vitamin A were normal.

PMID- 1737691
TI  - Porokeratosis of Mibelli following heart transplant.
AB  - A 59-year-old white man with a history of Sydenham's chorea received a mitral
      valve prosthesis in 1962. He sustained an anterolateral myocardial infarction in
      1983. In 1984, he received a heart transplant. To prevent heart rejection, he was
      initially treated with cyclosporine 12 mg/kg/day and prednisone 90 mg b.i.d. In
      1987, azathioprine 100 mg daily was added. In 1989, at the time of our
      evaluation, his medications included cyclosporine 80 mg b.i.d., prednisone 10 mg
      b.i.d., and azathioprine 75 mg/day. Since his heart transplant surgery he had not
      taken any thiazide medication. The patient noted a lesion on his right thigh; the
      lesion appeared in 1986, 2 years after his heart transplant. On examination in
      1989, the lesion was a 2 cm wide annular plaque with a shiny atrophic center and
      raised border. Both the clinical appearance and pathology were consistent with a
      diagnosis of porokeratosis of Mibelli. No family history of porokeratosis was
      elicited.

PMID- 1737692
TI  - Granuloma annulare and disseminated herpes zoster.
AB  - A 71-year-old man was admitted to the Wake Forest University/Baptist Hospital
      Medical Center on February 1, 1989, with pharyngitis and a cutaneous eruption
      that began that day. The past history was significant for a diagnosis of chronic
      lymphocytic leukemia (CLL) made in 1984, and for longstanding hypertension,
      severe coronary artery disease, and prostatic hypertrophy. The patient had
      required no therapy for his CLL until August, 1988, when he developed hemolytic
      anemia and was treated with oral chlorambucil, 4 mg/day, and a tapering course of
      prednisone. By December, 1988, the prednisone therapy had been discontinued, but
      the patient required hospital admission for pneumococcal pneumonia, which
      responded well to intravenous antibiotic therapy. One day prior to the current
      admission the patient complained of persistent fevers, sore throat, productive
      cough, and headache. He noted a new cutaneous eruption on the day of admission in
      February, 1989. The past history was positive for occasional herpes stomatitis.
      The patient did not know if he had previously been infected with varicella. Skin
      examination revealed multiple (greater than 20), single, and grouped vesicles in
      a generalized distribution involving the bilateral trunk, head, neck, arms, and
      legs. The heaviest involvement was on the right posterior auricular area and on
      the neck. A Tzanck preparation obtained from an early lesion was positive for
      multinucleated giant cells. Viral culture was negative at 24 hours and at 1 week.
      A skin biopsy of an early vesicular lesion was performed and revealed
      intraepidermal vesicles with acantholysis and giant cells.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1737693
TI  - Keratitis, ichthyosis, and deafness (KID) syndrome: management with chronic oral
      ketoconazole therapy.
AB  - Extensive cutaneous mycoses have been described in patients with the keratitis,
      ichthyosis, and deafness (KID) syndrome. We present a case occurring in a 48-year
      old woman where improvement in the ichthyosiform dermatosis, stabilization of her
      ocular disease, and apparent partial prevention of further cutaneous malignancies
      occurred in association with ketoconazole therapy.

PMID- 1737694
TI  - Bulgarian dermatology.

PMID- 1737695
TI  - Inflammatory tinea capitis (kerion) mimicking dissecting cellulitis.

PMID- 1737696
TI  - Teaching and learning materials in leprosy (TALMILEP) (a joint project of ILEP-
      International Federation of Anti Leprosy Associations.

PMID- 1737697
TI  - Introduction of anthralin into dermatology.

PMID- 1737698
TI  - Can we diagnose a drug-induced pemphigus?

PMID- 1737699
TI  - Therapeutic use of "prizing" and its effect on self-concept of elderly clients in
      nursing homes and group homes.
AB  - The purpose of this study was to ascertain the effect of nurse high prizing and
      nurse low prizing during group therapy in changing the self-concept of
      institutionalized aged persons. The hypothesis tested was that institutionalized
      aged clients participating in group therapy who receive nurse high prizing will
      show an increase in self-concept as measured by the Tennessee Self-Concept Scale
      (TSCS) when compared with those aged clients in the same settings participating
      in group therapy who receive nurse low prizing or those aged clients constituting
      the matched control groups. The study used an existing data source generated from
      the research of Williams and Lindell to conduct a secondary analysis of a
      variable not previously investigated. Mean difference scores from the posttest
      total self-concept score and subscales of the TSCS were analyzed in conjunction
      with the levels of prizing within the experimental and control groups. Using the
      Scale for Rating Prizing, two nurse raters judged the degree of prizing on 40
      randomly extracted video segments. The findings indicated that 47.1% of those
      subjects who received low prizing decreased in self-concept; 68.4% of those who
      received high prizing increased in self-concept. No change in self-concept was
      noted in the control group. Findings were significant at the .0001 level.
      Investigating the effect of nurse high and low levels of prizing on client self
      concept completes the Rogerian trilogy of therapist-offered conditions with this
      same sample of subjects. Extension of previous studies adds to the ever-growing
      body of nursing knowledge and increases the certitude, casualty, and
      generalizability of such investigations.

PMID- 1737700
TI  - Treating depression in well older adults: use of diaries in cognitive therapy.
AB  - A study was conducted with 103 community-based, low-income, well elderly persons
      who resided in high-rise apartments and were functionally independent. The
      nursing framework was Roy and Roberts' (1981) adaptation model and techniques
      from Beck's (1976) theory on cognitive therapy. This study had the dual purpose
      of determining nurses' ability to identify normal adaptive reactive depression
      and use techniques from cognitive therapy for depressed subjects. These nurses
      were able to identify depression using the Diagnostic and Statistical Manual of
      Mental Disorders (third edition, revised) guidelines with 92% accuracy.
      Participants were divided into three groups: control group, crafts group, and
      experimental group. Over 8 weeks, the experimental group received nursing
      intervention aimed at reinforcing positive input thought patterns. Daily diaries
      were used for discussion. The experimental group demonstrated a significant
      reduction in depressive symptoms. The group receiving craft classes decreased
      their depression scores, suggesting attention-effects depression. The control
      group demonstrated no significant change in depression scores.

PMID- 1737701
TI  - Ethical issues in restructuring of psychiatric services.
AB  - The restructuring of health care services is occurring at an increasing rate.
      Among those most common are the types known as vertical integration, illustrated
      by the development of psychiatric services within acute care settings. These
      restructured psychiatric services have implications for psychiatric care and
      nursing. In some instances, they raise ethical issues. The purpose of this
      article is to explore ethical issues in restructuring of psychiatric services and
      to offer suggestions for retaining quality nursing care.

PMID- 1737702
TI  - Psychiatric-mental health nursing: career characteristics, professional
      activities, and client attributes of members of the American Nurses Association
      Council of Psychiatric Nurses.
AB  - As the twenty-first century approaches, psychiatric nursing is reviewing its past
      and speculating about its future. This article reports on the current status of
      525 psychiatric-mental health nurses. The nurses responded to a questionnaire
      designed to elicit information on career characteristics, professional
      activities, and client attributes. The nurses work primarily in acute care
      institutions or hospitals. The typical client is white, middle class, and adult.
      The focus of care in mental health is moving to the community. If psychiatric
      nurses want a viable role in the mental health system of the future, they must
      begin to develop a system of care for at-risk populations in the community now.

PMID- 1737703
TI  - Milieu therapy: a review of development of this concept and its implications for
      psychiatric nursing.
AB  - Milieu therapy has long existed as an effective treatment modality for the
      mentally ill. It has also been a significant aspect of psychiatric-mental health
      nursing practice for several decades. This article reviews the history of milieu
      therapy and the role that psychiatric-mental health nursing staffs have in its
      implementation. The authors suggest strategies for milieu management and future
      implications for milieu therapy.

PMID- 1737704
TI  - Nursing program to meet the challenge of caring for patients with water
      intoxication.
AB  - This article describes a program that is effective in working with psychiatric
      patients who have trouble with excessive water intake. The purpose of the program
      is to provide consistent treatment in a controlled and therapeutic environment in
      which the special needs of these patients can be met. We incorporate a variety of
      nursing interventions suggested by the literature to help meet the goals of the
      program. As a result of the program, disruptive behavior has decreased and
      patients have learned skills to help them manage their illness. An additional
      benefit of the program is that working with water intoxication patients is no
      longer stressful for staff.

PMID- 1737705
TI  - Supply and demand factors in the determination of Medicare expenditures.
AB  - This article presents multivariate estimates of the effects of supply-side
      factors (e.g., provider reimbursement) and demand-side factors (e.g., beneficiary
      ability to pay) on state-level expenditures per enrollee in Medicare Part A and
      Part B. The results indicate that a 1 percent increase in elderly income
      significantly increases the propensity to use Medicare Part B services, resulting
      in a 0.45 percent increase in Part B expenditures per enrollee. By contrast,
      patients' ability to pay has a much weaker effect on Part A expenditures. Changes
      in provider reimbursement also exert a substantial effect on expenditures. A 1
      percent rise in the Medicare Prevailing Charge Index raises Medicare Part B
      expenditures by 0.43 percent. Collectively, the findings of this study suggest
      that both limits on Medicare reimbursement to providers and increased beneficiary
      liability have substantial effects on Medicare costs. Whatever the merits of
      arguments for or against such controls, the responsiveness of Medicare
      expenditures to equal percentage changes in supply and demand factors appears to
      be of a similar order of magnitude.

PMID- 1737706
TI  - Medicare use in the last ninety days of life.
AB  - The introduction of Medicare's prospective payment system (PPS) has led to
      changes in the way hospitals are being used. This article examines concomitant
      changes in the use of Medicare-covered services during the last 90 days of life,
      using data on more than 34,000 Medicare beneficiaries who died during the years
      1982-1986. We focus on questions pertaining to changes in practice patterns that
      include location of death, hospital utilization, use of other covered services,
      and spending. We find that use of hospitals and other health services by Medicare
      beneficiaries during the last 90 days of life changed markedly over this period,
      which included the introduction of PPS in late 1983. The percentage of deaths
      occurring in hospitals decreased sharply from 1982 to 1986, especially in PPS
      states relative to waivered states; this effect seems primarily due to reductions
      in length of stay rather than reduced admission rates, which did not change
      significantly. Use of home care, durable medical equipment (DME), and physicians'
      office services also increased sharply during the last 90 days of life, but with
      no consistent evidence that the introduction of PPS was associated with these
      changes or with the level or mix of Medicare expenditures for these patients.
      Medicare spending in this period of life rose at the same rate as medical care
      price inflation, and about 75 percent of reimbursements continued to be hospital
      payments, despite the utilization changes.

PMID- 1737707
TI  - Predicting length of stay for patients with psychoses.
AB  - The Computerized Psychiatric Severity Index (CPSI) and 22 patient variables were
      used to predict length of hospitalization for 304 psychiatric patients in DRG 430
      who were diagnosed with schizophrenia or affective disorder and had no secondary
      diagnoses. Length of stay, which correlated .96 with total charges, was used as
      the dependent variable (measure of resource use). The patient variables and CPSI
      score explained 32.5 percent of the variation in length of stay for all of DRG
      430 (27.5 percent for affective disorder patients and 70.3 percent for
      schizophrenia patients). Addition of the treatment variable "receipt of ECT"
      (electroconvulsive therapy) permitted the regression models to explain 40.9
      percent of the variation in length of stay (36.24 percent for affective disorder
      and 71.22 percent for schizophrenia). In each regression model, maximum CPSI
      score was significant, indicating that much heterogeneity in DRG 430 can be
      explained by CPSI. Using one payment for such a diverse group places health care
      institutions at great risk of financial loss. Our study indicates that a
      continuing need exists for research in the area of case-mix measures for
      psychiatric inpatients.

PMID- 1737708
TI  - Adapting the SERVQUAL scale to hospital services: an empirical investigation.
AB  - Defining and measuring the quality of service has been a major challenge for
      health care marketers. A comprehensive service quality measurement scale
      (SERVQUAL) is empirically evaluated for its potential usefulness in a hospital
      service environment. Active participation by hospital management helped to
      address practical and user-related aspects of the assessment. The completed
      expectations and perceptions scales met various criteria for reliability and
      validity. Suggestions are provided for the managerial use of the scale, and a
      number of future research issues are identified.

PMID- 1737709
TI  - An operational definition of the homebound.
AB  - Homebound status is a critical eligibility criterion for Medicare reimbursement
      of some home care services, yet little discussion has been undertaken to
      establish a valid definition of it. We propose an operational definition of
      homebound status, and we measure its validity for community-dwelling elderly in
      the Massachusetts Health Care Panel Study (MHCPS). The MHCPS is a longitudinal
      study of a cohort of elderly persons (N = 1,625), which began in 1974, with
      follow-up surveys in 1976, 1980, and 1985. Validity was measured by comparing
      responses from the operational measure to persons' responses to questions that we
      judged should be associated with a valid measure of homebound status. This
      construct validity method resulted in correlations that were significant and in
      the expected direction, and that suggested that this operational measure is a
      highly specific, moderately sensitive, valid measure. These results underscore
      the need for researchers investigating the homebound to discuss the validity and
      limitations of their homebound measures, and in what context these measures are
      useful.

PMID- 1737710
TI  - A randomized trial of the cost effectiveness of VA hospital-based home care for
      the terminally ill.
AB  - All admissions to a 1,100-bed Department of Veterans Affairs (VA) hospital were
      screened to identify 171 terminally ill patients with informal caregivers who
      were then randomly assigned to VA hospital-based team home care (HBHC, N = 85) or
      customary care (N = 86). Patient functioning, and patient and caregiver morale
      and satisfaction with care were measured at baseline, one month, and six months.
      Health services utilization was monitored over the six-month study period and
      converted to cost. Findings included no differences in patient survival,
      activities of daily living (ADL), cognitive functioning, or morale, but a
      significant increase in patient (p = .02) and caregiver (p = .005) satisfaction
      with care at one month. A substitution effect of HBHC was seen. Those in the
      experimental group used 5.9 fewer VA hospital days (p = .03), resulting in a
      $1,639 or 47 percent per capita saving in VA hospital costs (p = .02). As a
      result, total per capita health care costs, including HBHC, were $769 or 18
      percent (n.s.) lower in the HBHC sample, indicating that expansion of VA HBHC to
      serve terminally ill veterans would increase satisfaction with care at no
      additional cost.

PMID- 1737711
TI  - Laser ignition of surgical drapes.

PMID- 1737712
TI  - Do pledgets protect the tracheal tube cuff from lasers?

PMID- 1737713
TI  - Laser contact tips and tracheal tubes.

PMID- 1737714
TI  - Understanding the fire hazard.

PMID- 1737716
TI  - Stockert/Shiley CAPS multiflow roller pump stoppages.

PMID- 1737715
TI  - Preventing, preparing for, and managing surgical fires.

PMID- 1737717
TI  - Circulating-fluid pumps: do not use for ECMO.

PMID- 1737718
TI  - Laser-resistant tracheal tubes.

PMID- 1737719
TI  - Antibacterial therapy of community-acquired chest infections.

PMID- 1737720
TI  - Uptake of minocycline by Escherichia coli.
AB  - Uptake of tetracyclines into Escherichia coli was assessed with a strain carrying
      a tetA-lacZ translational fusion, in which expression of the enzyme is controlled
      by the pSC101 tetR repressor gene, by examining beta-galactosidase induction. The
      ability of tetracycline analogues to induce beta-galactosidase synthesis was
      correlated with their hydrophobicity, such that hydrophobic analogues were poor
      enzyme inducers. Treatment of E. coli with polymyxin B nonapeptide (PMBN)
      rendered cells more permeable to minocycline, but not to tetracycline.

PMID- 1737721
TI  - Antibiotic resistance and plasmids in Staphylococcus aureus from normal
      populations.
AB  - Antibiotic resistance, plasmid profiles and plasmid structures were examined in
      nasal Staphylococcus aureus collected from a random sample of normal individuals
      in the mid 1960s and from women at an antenatal clinic in 1989. The results were
      generally similar except for an increase in the resistance to penicillin in the
      later sample. The plasmid population had changed little though more uncategorized
      plasmids were evident in the 1960s samples.

PMID- 1737722
TI  - The treatment of non-typhi salmonellosis.

PMID- 1737723
TI  - Comparative in-vitro activity of new quinolones against clinical isolates and
      resistant mutants.
AB  - The in-vitro activity of five new fluoroquinolones, WIN 57273, sparfloxacin,
      fleroxacin, temafloxacin and ciprofloxacin was determined against 543 recent
      clinical isolates and eight quinolone resistant strains derived by mutation and
      their five parent strains. WIN 57273 was the most active compound against Gram
      positive bacteria, sparfloxacin had a broad spectrum which was similar to that of
      ciprofloxacin. Ciprofloxacin showed the greatest activity against Gram-negative
      bacteria. Temafloxacin showing some activity against Gram-positive organisms and
      Acinetobacter spp. Fleroxacin was the least active compound studied. Compared to
      wild type parent strains, the mutated strains produced the following results. In
      Enterobacter cloacae OmpF deficiency increased the MICs of all quinolones by 8-32
      fold. In Pseudomonas aeruginosa OmpF deficiency had a limited effect, Omp D2
      deficiency combined with an increased lipopolysaccharide content produced greater
      resistance, i.e. 4-16-fold; mutations in gyrase were associated with variously
      increased MICs, depending on the strain and compound tested.

PMID- 1737724
TI  - In-vitro activity of imipenem, in comparison with cefuroxime and ciprofloxacin,
      against coagulase-negative staphylococci in broth and peritoneal dialysis fluid.
AB  - The activity of cefuroxime, ciprofloxacin and imipenem against 50 coagulase
      negative staphylococci (CNS) strains isolated from patients with peritonitis
      while on continuous ambulatory peritoneal dialysis (CAPD) was examined. Strains
      were cultured in both used peritoneal dialysis fluid (PUD) and broth (ISB) in an
      atmosphere of air with 5% CO2. MICs of cefuroxime, ciprofloxacin and imipenem
      differed significantly between the two media for 40%, 26% and 42% of strains,
      respectively. In three-quarters of these cases the MICs were higher in PUD
      compared to ISB. The ability of each antibiotic to kill six strains of CNS
      adherent to silicone rubber was also examined. Once again, differences in killing
      were noted between the two media. At least two-thirds of the strains remained
      viable in the presence of concentrations of antibiotic equal to the MBC of each
      antibiotic and at least one-third survived antibiotic concentrations equivalent
      to those attained during treatment. Assessment of activity in PUD may provide a
      more realistic test for antibiotics to be used in the treatment of CAPD
      peritonitis.

PMID- 1737725
TI  - Multicentre study on antibiotic susceptibilities of anaerobic bacteria to
      cefoperazone-sulbactam and other antimicrobial agents.
AB  - The antibiotic susceptibilities of 241 anaerobic bacteria recovered from six
      geographic sites in North America were tested by agar dilution to cefoperazone
      sulbactam and other drugs. Of the 189 Bacteroides fragilis group isolates, only
      one was resistant to cefoperazone-sulbactam (0.5%) or ampicillin-sulbactam
      (0.5%), and none was resistant to ticarcillin-clavulanate or chloramphenicol. No
      resistance to cefoperazone-sulbactam was observed among the other Bacteroides
      spp., Clostridium spp., or Peptostreptococcus spp. Resistance to cefoperazone
      sulbactam is not commonly observed against anaerobic bacteria recovered from
      different geographical sites across North America.

PMID- 1737726
TI  - In-vivo and in-vitro studies on the effect of amphotericin B on endothelin
      release.
AB  - Since amphotericin B nephrotoxicity is mediated, in part by hypoxic tubular
      injury, the role of endothelin in the renal vasoconstriction, characteristic of
      amphotericin toxicity has been studied. Intact and salt depleted rats were
      infused with amphotericin B (20 micrograms/kg per min) or 5% dextrose over 20
      min. Plasma endothelin levels determined at the conclusion of the infusion
      period, did not differ between the experimental groups, despite a marked
      reduction in renal blood flow noted in rats infused with amphotericin B.
      Amphotericin B (10(-5)-10(-7) M) did not stimulate endothelin release from
      cultured bovine aortic endothelial cells. However, in a model of chronic
      amphotericin nephrotoxicity produced by repeated daily intraperitoneal injections
      of amphotericin B (5 mg/kg) to salt depleted rats, renal failure was associated
      with elevated plasma endothelin levels (29.3 +/- 4.4 fmol/mL, vs 10.8 +/- 1.2
      fmol/mL in salt depleted controls, P less than 0.01). We conclude that while
      plasma endothelin may be increased in chronic amphotericin B nephropathy, this
      peptide does not mediate the acute renal vasoconstriction associated with the
      infusion of this drug.

PMID- 1737727
TI  - Enterococcus faecium strains susceptible to ampicillin.

PMID- 1737728
TI  - Detection of methicillin resistance in Staphylococcus aureus and coagulase
      negative staphylococci with the semi-automated API (ATB-plus) system.

PMID- 1737729
TI  - Susceptibility testing of cefpirome.

PMID- 1737730
TI  - Effect of cilastatin on the urinary metabolism of FCE 22101 in the rat.

PMID- 1737731
TI  - Pefloxacin penetration of renal parenchyma.

PMID- 1737732
TI  - Failure of oral ciprofloxacin in suppressing Staphylococcus aureus carriage in
      haemodialysis patients.

PMID- 1737733
TI  - Simultaneous major depression and panic disorder: treatment with
      electroconvulsive therapy.
AB  - BACKGROUND: Major depression and panic disorder commonly occur together. Patients
      with simultaneous depression and panic disorder may have a higher lifetime rate
      of suicide attempts and an overall worse prognosis than patients with either
      depression or panic disorder alone. In addition, preliminary work suggests that
      some of these patients may not respond satisfactorily to antidepressants. In this
      report, we describe the clinical courses of eight consecutive patients with
      simultaneous major depression and panic disorder who were referred for ECT at our
      institution. METHOD: Eight consecutive patients who met DSM-III-R criteria for
      simultaneous major depression and panic disorder received ECT. All eight patients
      were evaluated by a structured clinical interview and the patients' major
      depression and panic disorder were evaluated with a 7-point Clinical Global
      Impressions severity rating scale. RESULTS: Before ECT was begun, each subject's
      panic disorder and depression were rated as at least markedly ill. After
      receiving ECT, all eight showed improvement in their depression. In addition,
      none of the eight patients reported having a panic attack from the time of their
      fourth ECT treatment until discharge. CONCLUSION: In this report, eight
      consecutive patients with simultaneous major depression and panic disorder
      improved with ECT. Further work is required which examines the potential utility
      of ECT in treating these patients.

PMID- 1737734
TI  - T3 augmentation of antidepressant treatment in T4-replaced thyroid patients.
AB  - BACKGROUND: Clinicians may not consider using the thyroid hormone liothyronine
      sodium (levorotary isomer of triiodothyronine [T3]) for augmentation of
      antidepressant drugs in depressed patients who are also receiving the precursor
      hormone levothyroxine (levorotary isomer of thyroxine [T4]) for thyroid disease.
      We now report on the successful use of T3 augmentation therapy in seven of nine
      depressed patients who were also receiving T4 for thyroid disease. METHOD:
      Following an earlier single case report, we prescribed T3 augmentation therapy
      for eight depressed patients who had not responded to an adequate antidepressant
      drug trial and who were receiving T4 therapy for thyroid disease. T3 was
      prescribed in open-label fashion, and response was judged by the clinician, whose
      assessment was supplemented by the use of standardized rating scales. RESULTS:
      Seven of the nine patients were judged to respond to T3 augmentation. CONCLUSION:
      These results are consistent with a report of differential effects for T3 versus
      T4 augmentation in depressed patients free of thyroid disease. The results have
      implications for the treatment of depression in the presence of thyroid disease
      and for the mechanism of thyroid hormone potentiation of antidepressants.

PMID- 1737735
TI  - The use of low-dose intranasal midazolam to treat panic disorder: a pilot study.
AB  - BACKGROUND: Drug therapy of panic disorder, despite the intermittent nature of
      the panic attack, requires daily administration of antidepressants, which are
      often not tolerated, or benzodiazepines, which can result in physical dependence
      and withdrawal. The use of rapidly acting, low-dose intranasal midazolam to
      prevent incipient panic suggested itself to us as a novel alternative treatment
      strategy. METHOD: We conducted a 6-week double-blind, placebo-controlled,
      crossover-design pilot study of the safety and efficacy of p.r.n. low-dose
      intranasal midazolam in five patients diagnosed with DSM-III-R panic disorder.
      RESULTS: One to two drops of midazolam (approximately 0.25 to 0.5 mg) was well
      tolerated and highly effective in preventing incipient panic attacks and in
      reducing the overall weekly frequency of attacks. CONCLUSION: Intermittent
      intranasal midazolam shows promise as a novel alternative treatment for panic,
      but a controlled study of its efficacy and safety (including abuse potential)
      must be conducted.

PMID- 1737736
TI  - An examination of syndromal validity and diagnostic subtypes in social phobia and
      panic disorder.
AB  - BACKGROUND: We investigated whether patients with DSM-III-R panic disorder and
      patients with social phobia could be distinguished on the basis of selected
      demographic variables and by several commonly used anxiety and phobia rating
      scales. METHOD: Sixty-six patients with social phobia and 60 patients with panic
      disorder (42 with and 18 without agoraphobia) were studied. Subjects completed a
      battery of self-report measures that assessed phobic fears, avoidance, and
      related problems. RESULTS: Social phobic patients showed an earlier age at onset
      than the panic disorder group, and there was a trend for more social phobics to
      have never married. Social phobics reported significantly greater levels of
      social phobic avoidance and distress, fear of negative evaluation, and avoidance
      of social situations than the panic disorder patients who reported more overall
      anxiety and rated themselves as significantly more avoidant of situations
      involving exposure to public places and to blood or injury. Discriminant function
      analyses showed that social phobic and panic disorder patients can be reliably
      discriminated on these scales. CONCLUSION: The results of this study lend further
      support for the validity of the DSM-III-R nosologic distinctions between social
      phobia and panic disorder. Furthermore, generalized social phobia appears to be
      remarkably different from discrete social phobia on these measures. This study
      provides less support for considering panic disorder with agoraphobia to be
      distinct from panic disorder without agoraphobia.

PMID- 1737737
TI  - Symptom relapse in bulimia nervosa and obsessive compulsive disorder after
      treatment with serotonin antagonists.

PMID- 1737738
TI  - Fluoxetine-lithium treatment for kleptomania.

PMID- 1737739
TI  - Bipolar disorder and Crohn's disease.

PMID- 1737740
TI  - The intermetamorphosis syndrome.

PMID- 1737741
TI  - Treatment of imipramine-resistant recurrent depression, III: Efficacy of
      monoamine oxidase inhibitors.
AB  - BACKGROUND: The effectiveness of monoamine oxidase inhibitors (MAOIs) in
      tricyclic resistant depression has received surprisingly little systematic study.
      METHOD: Patients who failed to respond to sustained, adequate treatment with the
      tricyclic imipramine (mean maximum dosage = 260 mg/day) and interpersonal
      psychotherapy were withdrawn from imipramine and treated in a standardized, but
      open-label 6-week trial with either phenelzine (N = 4; 60 mg/day) or
      tranylcypromine (N = 36; mean = 38.5 mg/day) and continued interpersonal
      psychotherapy. RESULTS: Forty of 42 patients (95%) completed the trial, of whom
      23 (58%) responded to treatment. Highly significant improvement was documented on
      measures of depression, reversed neurovegetative symptoms, and somatic symptoms.
      Response was significantly correlated with severity of depression (pre-MAOI score
      on the Hamilton Rating Scale for Depression), severity of a composite score of
      anergic and reversed neurovegetative features, and low levels of improvement
      during initial imipramine/interpersonal psychotherapy. Of patients who met
      criteria for proposed subforms of anergic or atypical depression, 67% (18/27)
      responded (p less than .05); 77% (17/22) of patients who scored above the mean on
      the composite measure of anergic and reversed neurovegetative features responded
      (p less than .01). CONCLUSION: These findings provide strong evidence of the
      utility of MAOIs in tricyclic-resistant depression, especially in patients with
      features such as fatigue, volitional inhibition, motoric retardation,
      hypersomnia, and/or weight gain.

PMID- 1737742
TI  - The P2 element of the td intron is dispensable despite its normal role in
      splicing.
AB  - The P2 region of group I introns has been proposed to be involved in the correct
      positioning of the P1 5'-splice site duplex in the catalytic core (Michel, F.,
      and Westhof, E. (1990) J. Mol. Biol. 216, 585-610). The behavior of delta P2
      deletion mutants of the td intron is consistent with this hypothesis. The delta
      P2 mutants are capable of site-specific hydrolysis, indicating that the
      conformation of the ribozyme is not grossly altered, but they are incapable of
      transesterification reactions at the splice sites, as would be predicted if P1 is
      not appropriately aligned within the catalytic core. Nevertheless, the function
      of the P2 element can be bypassed in specific pseudorevertants isolated by
      genetic selection from the delta P2 mutants. These results, together with
      phylogenetic data, support the existence of alternate strategies to create a
      functional P1-core interaction.

PMID- 1737743
TI  - Oxidation-reduction-sensitive binding of lung protein to rat catalase mRNA.
AB  - Air-breathing organisms experience an elevated concentration of oxygen mainly
      under two conditions. One occurs at birth when the O2 tension in the lung
      increases from approximately 25 torr present in utero to approximately 100 torr.
      The lungs, in particular, are also exposed to hyperoxia when oxygen is
      administered for therapeutic reasons. Under hyperoxic conditions, increased lung
      antioxidant enzyme activity is important for survival. The molecular basis for
      the increase in antioxidant enzyme gene expression under these circumstances is
      not well understood; in hyperoxia-exposed neonatal rats the elevation of lung
      catalase activity is not due to an increased rate of transcription but is
      associated with an increased concentration of catalase mRNA due to enhanced
      stability of the mRNA (Clerch, L.B., Iqbal, J., and Massaro, D. (1991) Am. J.
      Physiol. 260, L428-L433). We now show that neonatal rat lung protein forms
      specific complexes with catalase mRNA; this binding is redox-sensitive since when
      oxidizing agents are added binding is abolished but is restored by reducing
      agents. Our data also indicate lungs from hyperoxia-exposed rats have a larger
      proportion of catalase RNA-binding protein in oxidized form than lungs from air
      breathing rats. This redox-sensitive binding of protein to catalase mRNA may be
      important in the control of catalase gene expression.

PMID- 1737744
TI  - Inactivation of endothelin I by deamidase (lysosomal protective protein).
AB  - Deamidase cleaves ester and peptide bonds in various substrates and deamidates
      protected COOH-terminal amino acids. It preferentially hydrolyzes peptides which
      contain hydrophobic amino acids in the P1' and/or P1 position. Because the COOH
      terminal end of endothelin I contains the hydrophobic sequence -Ile19-Ile20-Trp21
      OH, we investigated whether human deamidase, purified from platelets, could
      inactivate this peptide. We found that deamidase readily cleaved off Trp21 with
      an acid pH optimum, a Km = 22 microM, a kcat of 1454 min-1, and a kcat/Km of 68
      microM-1 min-1. We also found the enzyme to be present in target cells of
      endothelin, in vascular smooth muscle cells. Extracts of cultured vascular smooth
      muscle cells cleave both the synthetic fluorescent substrate 5
      dimethylaminonaphthalene-1-sulfonyl(Dns)-Phe-Leu-Arg and endothelin I by
      releasing the COOH-terminal amino acid. The reaction was inhibited by diisopropyl
      fluorophosphate, benzyloxycarbonyl-Gly-Leu-Phe-CH2Cl, and p
      chloromercuribenzenesulfonate, which inhibit the purified deamidase, but not by
      inhibitors of some other peptidases. The rate of hydrolysis of endothelin I in
      the soluble, 100,000 x g final supernatant of the homogenized smooth muscle cells
      was 2.1 mumol/h/mg and 3.1 mumol/h/mg for Dns-Phe-Leu-Arg. Thus, smooth muscles,
      platelets, and many other tissues which contain the deamidase can inactivate
      endothelin by cleaving the COOH-terminal tryptophan.

PMID- 1737745
TI  - Recognition of substrates by tyrosylprotein sulfotransferase. Determination of
      affinity by acidic amino acids near the target sites.
AB  - The sulfation of proteins by tyrosylprotein sulfotransferase (TPST) is highly
      site-specific. In this study, we examined the sequence specificity of the target
      site for TPST by determining the kinetics of rat liver TPST with peptides related
      to the sequence of the C4 component of complement. The data obtained from this
      study demonstrate that selective elimination of negative charges from the -5 to
      +5 region of the acceptor tyrosine, either by removal or by isosteric
      substitution or the acidic amino acids in the region, produced a substantial
      change in the Km value, with relatively little effect on Vmax. Substitutions at 
      1 and +1 positions increase the Km value by 22- and 4-fold, respectively, whereas
      removal of the acidic amino acids from the -5, -4, or +4 positions increased the
      Km values by a factor of 2-4. The effect of elimination of an acidic amino acid
      on the Km value was constant and specific for its particular position in relation
      to tyrosine, and the effect of modification of more than one amino acid was
      multiplicative. This study provides evidence that: 1) acidic residues near
      tyrosines promote sulfation by increasing the affinity of enzyme-substrate
      binding and have little effect on catalytic rate; 2) the contribution of each
      acidic residue to affinity for TPST is independent and varies according to
      position relative to the acceptor tyrosine; and 3) the enzyme interacts with a
      segment of at least 4-5 residues on each side of the tyrosine, with the residues
      on the -1 and +1 positions being the most important determinants. In general,
      residues on the NH2-terminal side of the tyrosine have a greater effect on
      affinity for TPST.

PMID- 1737746
TI  - Cloning of TFC1, the Saccharomyces cerevisiae gene encoding the 95-kDa subunit of
      transcription factor TFIIIC.
AB  - The yeast gene encoding the 95-kDa subunit of the class III gene transcription
      factor TFIIIC was cloned. This gene, termed TFC1 (transcription factor C, gene
      1), was isolated by screening a lambda gt11 yeast cDNA expression library using a
      polyclonal antiserum preparation which was previously shown to specifically
      recognize the 95-kDa subunit of yeast TFIIIC (Parsons, M. C., and Weil, P. A.
      (1990) J. Biol. Chem. 265, 5095-5103). TFC1 was found to be a single copy gene
      which contained a continuous open reading frame about 2 kilobases in length. TFC1
      was shown to encode the 95-kDa subunit of TFIIIC by several criteria. Like the
      authentic yeast protein, the protein encoded by TFC1 had an apparent molecular
      weight of 95,000. In addition, the protein encoded by the TFC1 gene bound to the
      same antibody species as the yeast 95-kDa subunit of TFIIIC. Last, the sizes of
      the cleavage products of the Escherichia coli-expressed protein were
      indistinguishable from those of the cleavage products of the bona fide yeast 95
      kDa protein.

PMID- 1737747
TI  - Identification of chromophore binding domains of yeast DNA photolyase.
AB  - Photolyases contain two chromophores, flavin plus either methenyltetrahydrofolate
      (MTHF) or 8-OH-5-deazaflavin (HDF). Amino acid sequence comparison reveals that
      all photolyases sequenced to date have extensive sequence homology in the
      carboxyl-terminal half; in the amino-terminal region the folate and deazaflavin
      class enzymes are more homologous to other members of the same class. This
      modular arrangement of sequence homologies suggests that the amino-terminal half
      of photolyase is involved in MTHF or HDF binding whereas the carboxyl-terminal
      half carries the flavin binding site. In this study we attempted to identify such
      structural domains of yeast photolyase by partial proteolysis and gene fusion
      techniques. Partial digestion with chymotrypsin yielded an amino-terminal 34-kDa
      fragment containing tightly bound MTHF and a carboxyl-terminal 20-kDa polypeptide
      which lacked chromophore or DNA binding activity. However, a fusion protein
      carrying the carboxyl-terminal 275 amino acids of yeast photolyase bound
      specifically to FAD but not to MTHF or DNA. We conclude that the amino-terminal
      half of yeast photolyase constitutes the folate binding domain and that the
      carboxyl-terminal half carries the flavin binding site.

PMID- 1737748
TI  - Molecular cloning and characterization of grancalcin, a novel EF-hand calcium
      binding protein abundant in neutrophils and monocytes.
AB  - A novel EF-hand Ca(2+)-binding protein we have called grancalcin has been
      identified and characterized. This protein is particularly abundant in
      neutrophils and monocytes, with relatively small amounts in lymphocytes. The cDNA
      for this protein has been cloned and sequenced. The sequence predicts that the
      protein is composed of 217 amino acids, with a molecular mass of 24,010 daltons.
      It contains four EF-hand calcium-binding motifs and exhibits strong homology to
      sorcin, one of two proteins overexpressed in multidrug-resistant cells whose
      function is unknown. There are potentially one phosphorylation and two
      glycosylation sites. The 1.65-kilobase mRNA is detected in bone marrow and is
      present in neutrophils, monocytes, macrophages, B and T lymphocytes, and the
      promyelocytic cell line HL60s. The protein displays a Ca(2+)-dependent
      translocation to the granules and plasma membrane of neutrophils, suggesting that
      it might play an effector role in the specialized functions of these cells.

PMID- 1737749
TI  - Modulation of the mitochondrial permeability transition pore. Effect of protons
      and divalent cations.
AB  - We have studied the induction of the mitochondrial cyclosporin A-sensitive
      permeability transition pore (PTP) by the bifunctional SH group reagent
      phenylarsine oxide (PhAsO). Addition of nanomolar concentrations of the
      electroneutral H(+)-K+ ionophore nigericin to nonrespiring mitochondria in
      sucrose medium determines a dramatic increase of the time required for PTP
      induction by PhAsO, while no effect of nigericin is apparent in KCl medium. Using
      mitochondria loaded with the internal pH indicator 2',7'-bis(carboxyethyl)-5(6)
      carboxyfluorescein, we show that the effect of nigericin is mediated by the
      ionophore-induced acidification of matrix pH. Indeed, experimental manipulation
      of pHi by a number of treatments indicates that PTP induction is directly related
      to matrix pH, in that the PTP induction process becomes slower as pHi decreases
      at constant pHo. PTP induction by PhAsO in respiration-inhibited mitochondria is
      stimulated by Ca2+ and inhibited by a series of divalent cations. Since PhAsO
      induces the PTP even in the presence of excess EGTA and in the absence of
      respiration (Lenartowicz, E., Bernardi, P., and Azzone, G.F. (1991) J. Bioenerg.
      Biomembr. 23, 679-688), we have been able to study the Ca2+ dependence of the
      induction process. We show that the apparent Km for Ca2+ activation is about 10(
      5) M and that Ca2+, cyclosporin A, and inhibitory Me2+ ions behave as if they
      were competing for the same binding site(s) on the pore. Since similar results
      are obtained from patch-clamp experiments on the mitochondrial megachannel
      (Szabo, I., Bernardi, P., and Zoratti, M. (1992) J. Biol. Chem. 267, 2940-2946),
      we suggest that (i) the PTP and the mitochondrial megachannel are the same
      molecular structures and (ii) the same factors affect both the process of pore
      induction and its open-closed orientation.

PMID- 1737750
TI  - Derivation of the amino acid sequence of rat C-reactive protein from cDNA cloning
      with additional studies on the nature of its dimeric component.
AB  - Rat C-reactive protein (CRP) is unique among mammalian CRPs in being a
      glycoprotein and in containing a covalently linked dimer in its pentameric
      structure. To investigate these features, cDNA clones encoding rat CRP were
      isolated from an expression library, and the primary structure of the protein was
      derived. Taken along with the results of Northern blotting, we conclude that a
      single mRNA of approximately 2,500 nucleotides codes for a precursor of rat CRP
      with a signal sequence of 19 amino acids and a polypeptide of 211 amino acids,
      the latter sharing extensive homology with human, rabbit, and mouse CRPs. The
      deduced sequence agreed with results obtained from partial microsequencing and
      mapping by fast atom bombardment-mass spectrometry. Two potential sites for N
      glycosylation (Asn-128 and Asn-147) and a C-terminal heptapeptide (Leu-205 to Ser
      211, containing two cysteines at positions 208 and 209) were unique to rat CRP.
      The protein was also shown to be composed of five apparently identical monomers,
      two of which form a dimer linked by two interchain disulfide bonds involving Cys
      208 and Cys-209. These same cysteines form an intrachain disulfide bond in the
      other three monomers. The primary structure of rat CRP and the basis of dimer
      formation have, therefore, been elucidated.

PMID- 1737751
TI  - The glycine-rich domain of nucleolin has an unusual supersecondary structure
      responsible for its RNA-helix-destabilizing properties.
AB  - Nucleolin, a major nucleolar protein implicated in preribosome assembly and
      transcriptional regulation, possesses a C-terminal domain unusually rich in
      glycine, arginine, and phenylalanine residues. A polypeptide (p10), corresponding
      to this domain, has been synthesized by means of an Escherichia coli expression
      system and purified to homogeneity. Nitrocellulose binding assays have clearly
      shown that this domain of nucleolin is capable of interacting with RNA, and
      indeed all nucleic acids tested, in an efficient but nonspecific manner. A
      combination of circular dichroism and infrared spectroscopy provide strong
      evidence that repeated beta-turns are a major structural component of this
      polypeptide, which is entirely consistent with its amino acid composition and
      above all the presence of repeat motifs such as RGGF. Circular dichroism
      technique also shows that the interaction of p10 with RNA involves an unstacking
      of the nucleotide bases and an unfolding of the RNA secondary structure. While
      the role of the C-terminal domain of nucleolin in vivo has yet to be established,
      our findings suggest that it may act to unfold regions of ribosomal RNA so that a
      second domain of nucleolin has access to its specific binding site.

PMID- 1737752
TI  - Low structural specificity for nucleoside triphosphates as antagonists of ADP
      induced platelet activation.
AB  - Although the platelet ADP receptor is thought to exhibit a high degree of
      structural selectivity, adenosine 5'-O-(thiotriphosphate) (ATP alpha S) is a
      potent inhibitor of ADP-induced platelet activation and has been recently shown
      to bind with high affinity (Kd 3 +/- 0.1 nM) to formaldehyde-fixed platelets and
      to be photoincorporated into an 18-kDa fragment beginning at Tyr-198 of
      glycoprotein (GP) IIb alpha (Greco, N. J., Yamamoto, N., Jackson, B. W., Tandon,
      N. N., Moos, M., Jr., and Jamieson, G. A. (1991) J. Biol. Chem. 266, 13627
      13633). Further studies have now shown that guanosine 5'-O-(thiotriphosphate)
      (GTP alpha S) also binds to high affinity sites (Kd 4.7 +/- 0.9 nM; 13,600 +/-
      1,140 sites/platelet) and to low affinity sites (Kd 470 +/- 85 nM; 135,900 +/-
      19,400 sites/platelet). Competition binding studies showed that all GTP alpha S
      binding sites were accessible to ADP and vice versa. The corresponding pyrimidine
      nucleotide cytidine 5'-O-(thiotriphosphate) (CTP alpha S) was found to be
      similarly effective in competing in the binding of ADP and both 5'-O
      (thiotriphosphates) as well as uridine 5'-O-(thiotriphosphate) (UTP alpha S) were
      potent inhibitors of platelet shape change and aggregation. Ultraviolet
      irradiation of platelets in the presence of either [35S]GTP alpha S or [35S]UTP
      alpha S resulted in their specific incorporation into the alpha chain of GPIIb as
      previously shown with [35S]ATP alpha S. These results show that the structure of
      the nucleotide base has little influence on its ability to occupy the ADP-binding
      site on platelets, to function as an inhibitor of ADP-induced activation or to be
      photoincorporated into GPIIb alpha.

PMID- 1737753
TI  - The complete cDNA sequence of bovine coagulation factor V.
AB  - Lack of availability of a primary structure for bovine factor V has hindered
      detailed analysis of a vast majority of structure-function correlations on this
      molecule. To determine the primary structure of bovine factor V, we used liver
      mRNA as a template for the synthesis of three cDNA libraries. The sequences of
      seven overlapping cDNA clones infer two bovine factor V variants. Variant 1
      results in a 6910-basepair (bp) cDNA including 103 bp of 5'-untranslated
      sequence, 6633 bp of coding sequence and 171 bp of 3'-untranslated sequence with
      a putative polyadenylation site. Variant 2 differs only in the size of the coding
      sequence (6618 bp). The open reading frame translates to factor V consisting of
      2211 (or 2206) amino acids including a 28-amino acid signal peptide. Comparison
      of the amino acid sequences with human factor Va reveals 84% identity for the
      heavy and 86% for the light chains. In contrast, the B domain (connecting region)
      exhibits only 59% identity relative to the human molecule. The bovine B domain
      contains two repeats of a 14-amino acid structure that is contained only once in
      the human sequence. Bovine factor V lacks one of the nine amino acid repeats and
      one of the 17 amino acid repeats present in the human B domain. Factor V has
      little homology to the factor VIII molecule in the B domain. The 17-amino acid
      repeat missing in bovine factor V allows identification of an 18-amino acid
      sequence that is homologous to the B domain of human factor VIII. These 18 amino
      acids may either constitute the unique vestige of a divergent evolution between
      the B domains of factors V and VIII or reveal the convergent evolution toward a
      critical epitope involved in the activation of both procofactors.

PMID- 1737754
TI  - Expression, regulation, and tissue distribution of the Ch21 protein during
      chicken embryogenesis.
AB  - The Ch21 protein is one of the marker proteins whose synthesis and secretion by
      differentiating tibia chondrocytes is progressively increased during chicken
      embryogenesis (Descalzi-Cancedda, F., Manduca, P., Tacchetti, C., Fossa, P.,
      Quarto, R. and Cancedda, R. (1988) J. Cell Biol. 107, 2455-2463). We report the
      corresponding full-length cDNA sequence and the complete primary structure of the
      protein, which contains a 20-residue signal peptide. The synthesis of the protein
      is directed by a 1450-base mRNA characterized by an unusually long 5'
      untranslated leader sequence and is regulated only at the transcriptional level
      as shown by run-off transcription assays. During differentiation, maximal
      expression of the protein characterizes stage II hypertrophic chondrocytes. In
      situ hybridization on embryo sections reveals that the protein is expressed by
      several structures derived from the chondrogenic lineage and that, in addition,
      it is a major translational product in granulocytes. High cell density largely
      influences the expression of the Ch21 protein in chondrocyte cultures. When
      embryonic avian cells of different origin are grown to confluency, the expression
      of the Ch21 protein is observed in only some of the cell lines. Thus quiescence
      per se is not the primary factor determining the expression of the protein.

PMID- 1737755
TI  - The yeast ribosomal protein S7 and its genes.
AB  - Ribosomal protein S7 of Saccharomyces cerevisiae is encoded by two genes RPS7A
      and RPS7B. The sequence of each copy was determined; their coding regions differ
      in only 14 nucleotides, none of which leads to changes in the amino acid
      sequence. The predicted protein consists of 261 amino acids, making it the
      largest protein of the 40 S ribosomal subunit. It is highly basic near the NH2
      terminus, as are most ribosomal proteins. Protein S7 is homologous to both human
      and rat ribosomal protein S4. RPS7A and RPS7B contain introns of 257 and 269
      nucleotides, respectively, located 11 nucleotides beyond the initiator AUG. The
      splicing of the introns is efficient. Either RPS7A or RPS7B will support growth.
      However, deletion of both genes is lethal. RPS7A maps distal to CDC11 on
      chromosome X, and RPS7B maps distal to CUP1 on chromosome VIII.

PMID- 1737756
TI  - A DNA exonuclease induced during meiosis of Schizosaccharomyces pombe.
AB  - In meiotic cells of the fission yeast Schizosaccharomyces pombe, a DNA
      exonuclease activity increased approximately 5-fold after premeiotic S-phase and
      decreased to the initial level before the meiotic divisions. We have purified
      this activity, designated exonuclease I, to near homogeneity. The activity co
      purified with a polypeptide with an apparent molecular weight of 36,000. With a
      linear double-stranded DNA substrate, exonuclease I degraded only the 5'-ended
      strand from each end to produce 3'-single-stranded tails. The enzyme also acted
      on nicked circular DNA with comparable affinity. The meiotic induction of
      exonuclease I and its mode of action, similar to that of recombination-promoting
      exonucleases from bacteria, suggest that exonuclease I is involved in meiotic
      homologous recombination in S. pombe.

PMID- 1737757
TI  - Identification of amino acids essential for calmodulin binding and activation of
      smooth muscle myosin light chain kinase.
AB  - Smooth muscle myosin light chain kinase (smMLCK) is a Ca(2+)-calmodulin (CaM)
      dependent enzyme that phosphorylates the 20-kDa light chains of myosin. In a
      previous study (Bagchi, I.C., Kemp, B.E., and Means, A.R. (1989) J. Biol. Chem.
      264, 15843-15849), we expressed in bacteria a 40-kDa fragment of smMLCK that
      displayed Ca(2+)-CaM-regulated catalytic activity. Initial mutagenesis
      experiments indicated that Gly811 and Arg812 were important for CaM-dependent
      activation of this 40-kDa enzyme. We have now carried out site-directed
      mutagenesis within the CaM-binding domain (Ser787 to Leu813) of this enzyme to
      identify amino acids that are critical for CaM binding and activation. Our
      studies reveal that the individual mutation of several hydrophobic amino acid
      residues such as Leu813, Ile810, and Trp800 and the glycine residue Gly804 also
      resulted in a severe decrease in or complete loss of CaM binding and activation
      of smMLCK. The hydrophobic residue (Trp800) and the basic residue (Arg812), both
      of which are mandatory for CaM binding to smMLCK, occur in analogous positions
      within the CaM-binding domain of a number of CaM-regulated enzymes. We conclude
      from these results that CaM binding by smMLCK is determined by an interplay of
      specific hydrophobic and electrostatic interactions which appear to be conserved
      among various target enzymes of CaM.

PMID- 1737758
TI  - Human stomach aldehyde dehydrogenase cDNA and genomic cloning, primary structure,
      and expression in Escherichia coli.
AB  - An aldehyde dehydrogenase isozyme, ALDH3, which is strongly expressed in the
      stomach, may play a role in the oxidation of toxic aldehydes. Using reverse
      genetic approach, we cloned and characterized the cDNA and the gene for the
      ALDH3. The full length cDNA is 1624 base pairs (bp) in length and contains an
      open reading frame encoding 453 amino acid residues. The deduced amino acid
      sequence shows a high degree of resemblance to that of rat hepatocarcinoma ALDH.
      The human ALDH3 gene spans about 8 kb in length and consists of 10 exons. The
      putative TATA and CCAAT boxes are located in the consensus upstream distance from
      the transcription initiation site. Southern blot analysis of total genomic DNA
      argues against the proposed two-gene model for the ALDH3 isozymes (Yin, S.-J.,
      Cheng, T.-C., Chang, C.-P., Chen, Y.-J., Chao, Y.-C., Tang, H.-S., Chang, T.-M.,
      and Wu, C.-W. (1988) Biochem. Genet. 26, 343-360). Northern blot hybridization
      and analysis of PCR amplification products of cellular RNA demonstrated the
      existence of a high level of ALDH3 mRNA in human stomach and hepatoma cells, but
      a very low level in the normal liver. Expression of ALDH3 cDNA in Escherichia
      coli yielded a protein of 55 kDa, which exhibited kinetic properties similar to
      that found in ALDH3 isozyme purified from human stomach and liver, and was
      hybridizable with rabbit anti-human-hepatoma ALDH serum.

PMID- 1737759
TI  - The folding of hirudin adopts a mechanism of trial and error.
AB  - Reduced and denatured hirudin (65 amino acids and 3 disulfides) refolds in vitro
      to become an active molecule. The folding process adopts a mechanism of "trial
      and error" without predominant pathways. Throughout the entire folding process,
      the 6 cysteines were about equally involved in the disulfide shuffling. Among the
      first 20% of 3-disulfide species accumulated during the early phase of refolding,
      two-thirds were inactive and were reshuffled in the presence of thiol catalyst to
      regain correct disulfide pairing. When refolding was performed in the presence of
      strong denaturant (guanidinium chloride) without thiol catalyst, 8% of the active
      hirudin was obtained. This figure is close to the probability (6.7%) that would
      be expected from the random disulfide pairing of a molecule containing 6
      sulfhydryl groups.

PMID- 1737760
TI  - Fluorescence energy transfer between the primer and the beta subunit of the DNA
      polymerase III holoenzyme.
AB  - We report here our initial success in using fluorescence energy transfer to map
      the position of the subunits of the DNA polymerase III holoenzyme within
      initiation complexes formed on primed DNA. Using primers containing a fluorescent
      derivative 3 nucleotides from the 3'-terminus and acceptors of fluorescence
      energy transfer located on Cys333 of the beta subunit, a donor-acceptor distance
      of 65 A was measured. Coupling this distance with other information enabled us to
      propose a model for the positioning of beta within initiation complexes.
      Examination of the fluorescence properties of a labeled primer with the unlabeled
      beta subunit and other assemblies of DNA polymerase III holoenzyme subunits
      allowed us to distinguish all of the known intermediates of the holoenzyme
      catalyzed reaction. Specific fluorescence changes could be assigned for primer
      annealing, Escherichia coli single-stranded DNA-binding protein binding, 3'----5'
      exonucleolytic hydrolysis of the primer, DNA polymerase III* binding, initiation
      complex formation upon the addition of beta in the presence of ATP, and DNA
      elongation. These fluorescence changes are sufficiently large to support future
      detailed kinetic studies. Particularly interesting was the difference in
      fluorescence changes accompanying initiation complex formation as compared to
      binding of DNA polymerase III holoenzyme subunit assemblies. Initiation complex
      formation resulted in a strong fluorescence enhancement. Binding of DNA
      polymerase III* led to a fluorescence quenching, and transfer of beta to primed
      DNA by the gamma delta complex did not change the fluorescence. This demonstrates
      a rearrangement of subunits accompanying initiation complex formation. Monitoring
      fluorescence changes with labeled beta, we have determined that beta binds with a
      stoichiometry of one monomer/primer terminus.

PMID- 1737761
TI  - Rapid ADP-evoked currents in human platelets recorded with the nystatin
      permeabilized patch technique.
AB  - "Whole-cell" patch recordings using nystatin permeabilization were made from
      single human platelets during application of agonists from a "puffer" pipette. In
      platelets clamped near the resting potential and bathed in Na+ saline, 40 microM
      ADP activated a transient inward current within tens of milliseconds. At -73 mV
      the current lasted between 0.1 and 1 s and had a peak of between 13 and 31 pA in
      different cells. Ion substitution experiments indicated that the channel is
      permeable to Na+,K+, and Ba2+ and presumably also to Ca2+, but is not permeable
      to Cl-. The single channel conductance was 15 pS (near the resting potential) in
      nominally Ca(2+)-free saline and 11 picosiemens in BaCl2 saline. Thrombin, at 1
      unit/ml, did not elicit detectable currents during a 3-s application in platelets
      bathed in 1 mM Ca2+, Na+ saline. Under the same conditions, in fura-2-loaded
      cells, thrombin-evoked Ca2+ entry (monitored by Mn2+ quench) was detectable after
      a delay of 1.4 s. This suggests that early thrombin-evoked Ca2+ entry occurs via
      small conductance channels, below the resolution of the patch clamp technique, or
      by an electroneutral pathway. The ADP-evoked channel has the requisite speed of
      activation to account for the rapid Ca2+ influx observed during stopped-flow
      studies of agonist-evoked changes in [Ca2+]i.

PMID- 1737762
TI  - Calcium and catecholamine interactions with adrenal chromogranins. Comparison of
      driving forces in binding and aggregation.
AB  - The soluble core of catecholamine storage vesicles in the adrenal medulla
      contains high concentrations of the cations calcium (20 mM) and catecholamine
      (600 mM). Do these cations interact with the abundant vesicle core anionic
      proteins, the chromogranins? We investigated the binding of calcium and
      norepinephrine (NE) to bovine adrenal chromogranins by equilibrium dialysis. Both
      calcium and NE were bound saturably by chromogranins, with low affinity (Kd
      values of 1.3 x 10(-4) M and 2.1 x 10(-3) M), but high capacity (17 and 32 mol of
      ligand/mol of chromogranin A). Both ligands bound maximally at a pH greater than
      5.5 and were displaced by competing cations in a pattern (trivalent greater than
      divalent greater than monovalent) consistent with electrostatic components to the
      interactions. Binding of calcium and NE was not impaired by prior heat
      denaturation of the chromogranins, and chromogranin A was involved in both
      binding reactions. Calcium but not NE binding was enhanced by nonpolar solvents.
      Temperature dependence studies indicated that calcium binding to chromogranins
      was largely entropy-driven, while NE binding was driven by a significantly
      negative (favorable) change in enthalpy (5760 cal/mol), even in the face of an
      unfavorable entropy. Exposure of chromogranins to calcium or NE resulted in
      precipitation (aggregation) as analyzed by centrifugation and sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis. NE was a more effective chromogranin
      precipitant than calcium, and in combination, the NE effect was antagonized by
      calcium. Precipitation of chromogranins by both calcium and NE was inhibited by
      NaCl at ionic strengths comparable with those of the ligands. These data suggest
      that chromogranins bind and are precipitated by calcium and NE at affinities
      compatible with their in situ concentrations, but that the interactions exhibit
      different thermodynamic driving forces. Furthermore, NE may trigger an enthalpy
      driven conformational change in chromogranins, resulting in aggregation.

PMID- 1737763
TI  - Substrate recognition determinants of the mitogen-activated 70K S6 kinase from
      rat liver.
AB  - The mitogen-activated 70K S6 kinase has an apparent Km for 40 S ribosomal
      subunits of 0.25 microM. The apparent Km for a synthetic peptide derived from the
      carboxyl terminus of S6 and containing all of the in vivo sites of
      phosphorylation was 2.5-fold higher. A number of shorter peptides revealed that
      the substrate recognition determinants for the preferred site of phosphorylation,
      Ser236, reside in a seven-amino acid stretch of S6, residues 231-217. Critical to
      recognition is a block of 3 consecutive arginines, especially Arg231 and Arg233.
      In contrast, replacement of Ser235 or the preferred site of phosphorylation,
      Ser236, with alanine has little effect on the apparent Km. Based on this data the
      consensus recognition sequence would be Arg-(Arg)-Arg-X-X-Ser-X. A number of
      kinases known to phosphorylate S6, including cAMP-dependent protein kinase and
      protein kinase C and the 92K S6 kinase II, were also tested for their ability to
      phosphorylate a decapeptide containing all the critical recognition determinants.
      Finally, a synthetic peptide containing a putative 70K S6 kinase autoinhibitory
      domain did not serve as a substrate for the enzyme but did inhibit its activity,
      although much less effectively than a synthetic peptide containing all the
      recognition determinants.

PMID- 1737764
TI  - A mutation in the consensus ATP-binding sequence of the RecD subunit reduces the
      processivity of the RecBCD enzyme from Escherichia coli.
AB  - We have constructed a mutant form of the RecBCD enzyme from Escherichia coli with
      a lysine to glutamine change in the consensus ATP-binding sequence in the RecD
      subunit (Korangy, F., and Julin, D.A. (1992a, 1992b) J. Biol. Chem., 1727-1732;
      1733-1740). We compare here the kinetics of double-stranded DNA-dependent ATP
      hydrolysis by the mutant (RecBCD-K177Q) and wild-type enzymes. We included
      heparin to trap enzyme not bound to DNA, or the single-stranded DNA-binding (SSB)
      protein from Escherichia coli to prevent the enzyme from binding to single
      stranded DNA products and partially single-stranded reaction intermediates. The
      ATP hydrolysis kinetics in either case show a rapid burst phase followed by a
      slower second phase. The wild-type enzyme hydrolyzes an amount of ATP about equal
      to the DNA nucleotide concentration in the rapid phase. The amount of ATP
      hydrolyzed by the RecBCD-K177Q enzyme in the burst is about 8-10-fold lower than
      the wild-type, in the presence of either heparin or SSB. The burst magnitude of
      the wild-type enzyme with heparin is proportional to the size of the DNA from
      about 1,420 to 22,400 base pairs whereas that of the mutant is independent of the
      DNA size. The wild-type enzyme completely degrades a 6,250-base pair DNA
      substrate with no partially degraded molecules visible on agarose gels. RecBCD
      K177Q enzyme reaction mixtures in the presence of SSB protein contain a
      heterogeneous mixture of partially degraded molecules of 2,000-5,000 base pairs.
      These results indicate that the RecBCD-K177Q enzyme is less processive than the
      wild-type enzyme.

PMID- 1737765
TI  - Iron-catalyzed oxidative modification of glucose-6-phosphate dehydrogenase from
      Leuconostoc mesenteroides. Structural and functional changes.
AB  - As a variety of eukaryotic cells age, the specific activity of glucose-6
      phosphate dehydrogenase (Glu-6-PDH) declines as much as 50%. Because of the
      central role of this enzyme in metabolism, it is important to define factors
      responsible for this loss in enzyme activity. We report that Glu-6-PDH from
      Leuconostoc mesenteroides is rapidly inactivated by micromolar concentrations of
      Fe2+ and H2O2. Inactivation correlated with the formation of one carbonyl
      functionality/enzyme subunit, indicating that inactivation is the result of site
      specific oxidative modification. Our results suggest that Fe2+ binds to the
      glucose 6-phosphate binding site and that interaction of the enzyme-bound Fe2+
      with H2O2 leads to the oxidative modification of amino acids essential for enzyme
      activity. Partially inactivated enzyme remained predominantly in the dimeric
      form, and no change in the apparent affinity of the remaining active subunits for
      substrate was observed. Partial inactivation did, however, lead to a decrease in
      the thermal stability of the remaining activity. This decrease in thermal
      stability could be largely overcome by the addition of glucose 6-phosphate. Thus,
      although exposure to H2O2 and Fe2+ results in the irreversible inactivation of
      Glu-6-PDH, the resulting modification is selective, leads to the formation of
      heterodimers of both active and inactive subunits, and does not appear to cause
      large scale structural changes. Our results demonstrate the inherent
      susceptibility of Glu-6-PDH from L. mesenteroides to modification by an oxidation
      system known to exist in vivo. An assessment of the physiological significance of
      Fe(2+)-catalyzed oxidation of Glu-6-PDH awaits extension of these studies to
      mammalian sources known to accumulate less active or inactive forms of the enzyme
      as a function of age.

PMID- 1737766
TI  - Systems analysis of the tricarboxylic acid cycle in Dictyostelium discoideum. I.
      The basis for model construction.
AB  - A steady-state model of the tricarboxylic acid cycle was constructed using a
      dynamic systems analysis computer program, METASIM. The model was based on
      radioactive tracer analyses which provided flux relationships and compartmented
      metabolite concentrations. Ten of the enzymes modeled were purified and
      characterized from Dictyostelium discoideum. Although experimentally determined
      enzyme mechanisms and constants were used in the model, Vmax values were found to
      be unreliable, i.e. they did not reflect enzyme activity in vivo. This value was
      therefore calculated as the only unknown in each enzyme kinetic equation and
      called Vvivo, to distinguish it from Vmax determined in vitro.

PMID- 1737767
TI  - Systems analysis of the tricarboxylic acid cycle in Dictyostelium discoideum. II.
      Control analysis.
AB  - A steady-state computer model of the tricarboxylic cycle in Dictyostelium
      discoideum was analyzed using metabolic control theory. The steady state had
      variations of less than 0.04% over the last half of the simulation for both
      metabolite concentrations and fluxes. Metabolite and flux control coefficients
      were determined by varying enzymatic activities within 2% of their initial values
      and simulating the responses of metabolite concentrations and fluxes to these
      changes. Under these conditions, summation properties were met for most
      metabolite and all flux control coefficients. Maximum flux control coefficients
      were found for succinate dehydrogenase (0.35), malic enzyme (0.24), and malate
      dehydrogenase (-0.18). Comparable control was found for the reaction supplying
      pyruvate (0.14) and for the sum of the input amino acids (0.43), which serve as
      an energy source for D. discoideum. The time-dependent processes by which a new
      steady state was established were examined after increasing malic enzyme or
      malate dehydrogenase activities. This provided a method for an analysis of the
      mechanisms by which the observed control coefficients were generated. In
      addition, the effects of increasing the stimuli within 5-20% of the original
      enzyme activity were examined. Under these conditions, more typical of
      experimental stimuli and measurable responses, the metabolic model failed to
      return to steady state, and thus summation properties were not met. Whether
      "true" steady states ever occur or whether metabolic control theory can be
      applied in vivo is discussed.

PMID- 1737768
TI  - Inactivation of thrombin by murine peritoneal macrophages.
AB  - We recently showed that murine peritoneal macrophages cultured in vitro express
      potent prothrombinase activity (Lindahl, U., Pejler, G., Bogwald, J., and
      Seljelid, R. (1989) Arch. Biochem. Biophys. 273, 180-188). In the present report,
      we demonstrate that the macrophages also express anticoagulant activity by
      inactivating the thrombin that is formed due to the action of the prothrombinase.
      Addition of exogenous purified thrombin to the macrophage cultures resulted in
      inactivation of the enzyme at a maximum rate of approximately 5
      micrograms/h/10(6) cells. The inactivation appeared to be specific for thrombin,
      since neither Factor Xa, chymotrypsin, nor trypsin, three serine proteases
      exhibiting homology with thrombin, were inactivated by the macrophages. Thrombin
      inactivating activity was not secreted into the culture medium. Inhibitors of
      endocytosis did not decrease the rate by which thrombin was inactivated,
      suggesting that internalization of the coagulation factor was not required. In
      contrast, the thrombin-inactivating activity was strongly inhibited by the
      polycation Polybrene. Anion-exchange chromatography of extracts obtained after
      Triton X-100-solubilization of the macrophages demonstrated that the thrombin
      inactivating activity exhibited a high negative charge. Incubation of the
      thrombin-inactivating activity recovered after anion-exchange chromatography with
      unlabeled thrombin, followed by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis analysis, showed that thrombin was proteolytically cleaved into
      defined fragments. Similar proteolytic fragments were obtained when 125I-labeled
      thrombin was added to macrophage cultures. Degradation of thrombin was blocked by
      phenylmethanesulfonic fluoride, an inhibitor of serine proteases, but not by
      inhibitors of other classes of proteases. Thrombin that had been chemically
      modified at its active site was degraded at the same rate by the macrophages as
      active thrombin. Taken together, these findings indicate that the murine
      macrophages express surface-bound serine protease activity that specifically
      inactivates thrombin by proteolytic cleavage. The significance of thrombin
      inactivating activity in relation to the involvement of macrophage procoagulant
      activity in the immune response is discussed.

PMID- 1737769
TI  - Formation of a free acyl adenylate during the activation of 2-propylpentanoic
      acid. Valproyl-AMP: a novel cellular metabolite of valproic acid.
AB  - A study of the activation of valproic acid (2-n-propylpentanoic acid) by a
      soluble extract of rat liver mitochondria in the presence of ATP, CoASH, and
      MgCl2 revealed that, in addition to valproyl-CoA, an unknown UV-absorbing
      compound is formed which is the sole product when CoASH is omitted from the
      incubation mixture. The unknown compound, which was purified by high performance
      liquid chromatography, was identified as valproyl adenylate (valproyl-AMP) by
      mass spectrometry and by its enzymatic conversion to valproyl-CoA in the presence
      of CoASH. Valproyl-AMP exists, at least partially, in a free, not-enzyme-bound
      form. Its rate of formation is linear with time and increases 5-fold when the pH
      is decreased from 8 to 6.8. Valproyl-AMP was also identified when the metabolism
      of valproate was investigated with rat liver mitochondria and rat hepatocytes.
      Since the synthesis of valproyl-AMP is inhibited by octanoate, medium-chain acyl
      CoA synthetase (EC. 6.2.1.2) may be responsible for its formation. This study
      establishes that during the activation of valproic acid to valproyl-CoA free
      valproyl-AMP is formed which is a novel cellular metabolite of valproic acid.

PMID- 1737770
TI  - The structure of tracheobronchial mucins from cystic fibrosis and control
      patients.
AB  - Tracheobronchial mucin samples from control and cystic fibrosis patients were
      purified by gel filtration chromatography on Sephacryl S-1000 and by density
      gradient centrifugation. Normal secretions contained high molecular weight
      (approximately 10(7] mucins, whereas the cystic fibrosis secretions contained
      relatively small amounts of high molecular weight mucin together with larger
      quantities of lower molecular weight mucin fragments. These probably represent
      products of protease digestion. Reducing the disulfide bonds in either the
      control or cystic fibrosis high molecular weight mucin fractions released
      subunits of approximately 2000 kDa. Treating these subunits with trypsin released
      glycopeptides of 300 kDa. Trypsin treatment of unreduced mucin also released
      fragments of 2000 kDa that could be converted into 300-kDa glycopeptides upon
      disulfide bond reduction. Thus, protease-susceptible linkages within these mucins
      must be cross-linked by disulfide bonds so that the full effects of proteolytic
      degradation of mucins remain cryptic until disulfide bonds are reduced. Since
      various combinations of protease treatment and disulfide bond reduction release
      either 2000- or 300-kDa fragments, these fragments must represent important
      elements of mucin structure. The high molecular weight fractions of cystic
      fibrosis mucins appear to be indistinguishable from control mucins. Their amino
      acid compositions are the same, and various combinations of disulfide bond
      reduction and protease treatment release products of identical size and amino
      acid composition. Sulfate and carbohydrate compositions did vary considerably
      from sample to sample, but the limited number of samples tested did not
      demonstrate a cystic fibrosis-specific pattern. Thus, tracheobronchial mucins
      from cystic fibrosis and control patients are very similar, and both share the
      same generalized structure previously determined for salivary, cervical, and
      intestinal mucins.

PMID- 1737771
TI  - Involvement of phage T5 tail proteins and contact sites between the outer and
      inner membrane of Escherichia coli in phage T5 DNA injection.
AB  - The penetration of phage T5 DNA into the Escherichia coli envelope takes place
      through ion channels (Boulanger, P., and Letellier, L. (1992) J. Biol. Chem. 267,
      3168-3172). To identify putative phage protein(s) involved in the formation of
      these channels, E. coli cells were infected at 37 degrees C with radioactively
      labeled phage and their envelopes were fractionated. After a flotation gradient,
      proteins belonging to the phage tail were recovered both in fractions containing
      the contact sites between the inner and outer membranes and in the outer
      membrane. The electrophoretic banding pattern of phage proteins indicates that
      the contact sites were enriched in the protein pb2. Moreover, infected cells were
      significantly enriched in contact sites as compared to intact cells. There was no
      enrichment of contact sites and very little radioactivity was found in this
      fraction and in the outer membrane when the cells were infected at 4 degrees C
      (i.e. under conditions where the phage does not inject its DNA). These results
      suggest that both contact sites and pb2 may play a central role in the
      translocation of phage T5 DNA.

PMID- 1737772
TI  - Selective antagonism of thyroid hormone action by retinoic acid.
AB  - Thyroid hormone (T3) and retinoic acid (RA) regulate gene transcription by
      binding to similar nuclear receptors. We have investigated the effects of RA,
      alone and in combination with T3, on a number of T3-responsive genes expressed in
      rat pituitary adenoma cells. Like T3, RA increased growth hormone gene expression
      in GH3 as well as in GH1 cells, and the effects of the hormones were additive. In
      contrast, RA alone had little effect on the expression of the beta 2 form of T3
      receptor (TR beta 2), which is markedly decreased by T3. Remarkably, however, RA
      completely inhibited the down-regulation of TR beta 2 mRNA by T3. RA alone also
      had little effect on TR beta 1 mRNA, but its presence did not prevent the up
      regulation of TR beta 1 mRNA by T3. The target-gene-specific antagonism of T3
      action by RA was observed in both GH cell lines. Nuclear run-on assays
      demonstrated that the effect occurred at the level of TR beta 2 gene
      transcription, and the half-life of the TR beta 2 mRNA was unchanged by RA in the
      presence or absence of T3. The half-maximal RA dose required for these effects
      suggested that they were mediated by one or more of the nuclear receptors for RA.
      Indeed, GH3 cells contain mRNAs encoding the three distinct RA receptor subtypes,
      alpha, beta, and gamma, as well as retinoid X receptors. These results
      demonstrate that the effects of RA and T3 on gene expression are dependent on the
      nature of the target gene as well as on hormonal interactions, probably at the
      level of the receptors.

PMID- 1737773
TI  - Evidence that the hormone-binding domain of the mouse glucocorticoid receptor
      directly represses DNA binding activity in a major portion of receptors that are
      "misfolded" after removal of hsp90.
AB  - After dissociation of cytosolic heteromeric glucocorticoid receptor complexes by
      steroid, salt, and other methods, only 35-60% of the dissociated receptors can
      bind to DNA-cellulose. The DNA-binding and non-DNA-binding forms of the
      dissociated receptors have the same Mr and are phosphorylated to the same extent
      (Tienrungroj, W., Sanchez, E. R., Housley, P. R., Harrison, R. W., and Pratt, W.
      B. (1987) J. Biol. Chem. 262, 17347-17349). The basis for the different DNA
      binding activities is unknown, but the DNA-binding fraction of the receptor has a
      more basic pI than the non-DNA-binding fraction (Smith, A. C., Elsasser, M. S.,
      and Harmon, J. M. (1986) J. Biol. Chem. 261, 13285-13292). We have separated the
      non-DNA-binding state of the receptor from the DNA-binding state and then cleaved
      it with trypsin and chymotrypsin. We find that the 15-kDa tryptic fragment
      derived from the non-DNA-binding state of the dissociated receptor is fully
      competent in binding DNA, whereas the 42-kDa chymotryptic fragment containing
      both the hormone-binding and DNA-binding domains does not bind DNA. Trypsin
      cleavage of the molybdate-stabilized untransformed receptor also yields a 15-kDa
      fragment that is fully competent in binding DNA. Reducing agents do not restore
      DNA-binding to the non-DNA-binding fraction of the receptor and the hormone
      binding domain can be separated from the DNA-binding domain on nonreducing gel
      electrophoresis. These results argue that the two domains are not linked by
      disulfide bridges, and they are consistent with the proposal that there are two
      least energy states of folding after dissociation of hsp90. A significant portion
      of the receptors is "misfolded" in such a manner that the steroid binding domain
      is directly preventing DNA-binding activity.

PMID- 1737774
TI  - Aspartylglycosaminuria in a non-Finnish patient caused by a donor splice mutation
      in the glycoasparaginase gene.
AB  - Aspartylglycosaminuria is a lysosomal storage disease caused by deficient
      activity of glycoasparaginase (EC 3.5.1.26), and it occurs with a high frequency
      among Finns. We have recently shown that the molecular defect in all Finnish
      aspartylglycosaminuria patients examined to date consists of two single base
      changes in the heavy chain of glycoasparaginase (Mononen, I., Heisterkamp, N.,
      Kaartinen, V., Williams, J. C., Yates, J. R., III, Griffin, P. R., Hood, L. E.,
      and Groffen, J. (1991) Proc. Natl. Acad. Sci U.S.A. 88, 2941-2945). This is the
      first report on the identification of the molecular defect causing
      aspartylglycosaminuria in a patient of non-Finnish origin. Total RNA from
      fibroblasts of a black American aspartylglycosaminuria patient was isolated,
      first-strand cDNA was synthesized, and the cDNA encoding glycoasparaginase was
      amplified by the polymerase chain reaction. The patient's mRNA nucleotide
      sequence was different from the normal sequence by a deletion of 134 nucleotides
      at positions 807-940. Nucleotide sequence analysis of the normal
      glycoasparaginase gene demonstrated that the deletion corresponded precisely to a
      134-base pair exon. Moreover, analysis of the splice sites demonstrated a single
      base change, G to T, that altered the donor splice site of the exon deleted in
      the patient's mRNA. This change led to an exon-skipping event resulting in a
      frame shift and generation of a stop codon.

PMID- 1737775
TI  - Global conformational changes in allosteric proteins. A study of Escherichia coli
      cAMP receptor protein and muscle pyruvate kinase.
AB  - One of the basic features in allosteric regulation involves long range
      transduction of information. Based on crystallographic data on protein systems
      that are regulated by allosteric mechanisms, a global conformational change has
      always been observed. It is, therefore, important and useful to correlate the
      cooperativity of global structural change with the mode of binding of the
      regulatory ligand. Two systems were chosen for study, namely Escherichia coli
      cAMP receptor protein and muscle pyruvate kinase, which show negative and
      positive cooperativity in the binding of allosteric ligands, respectively.
      Quantitative titration of the global structural change, monitored by a high
      precision analytical gel chromatography technique, was conducted as a function of
      allosteric effector concentration. The results obtained for cAMP receptor protein
      show that the protein undergoes contraction upon binding of cAMP. The decreases
      in Stokes radius associated with complex formation are 0.1 +/- 0.1 and 0.7 +/-
      0.1 A when one and two cAMP-binding sites are filled, respectively. The results
      for the pyruvate kinase system show a concerted structural change that
      quantitatively match the predicted behavior based on equilibrium constants
      derived from the analysis of steady state kinetic data by a two-state model.
      Hence, for these two systems, these results show that negative and positive
      cooperativity are correlated with sequential and concerted modes of structural
      change, respectively.

PMID- 1737776
TI  - Reduced S-adenosylhomocysteine hydrolase. Kinetics and thermodynamics for binding
      of 3'-ketoadenosine, adenosine, and adenine.
AB  - S-Adenosylhomocysteine hydrolase (SAHase) was resolved into apoenzyme and NAD+ by
      acidic ammonium sulfate treatment. The apoenzyme was catalytically inactive, but
      could be reconstituted to active enzyme with NAD+. Reduced SAHase (ENADH) that
      was prepared by reconstitution of the apoenzyme with NADH was catalytically
      inactive. ENADH was oxidized by 3'-ketoadenosine to active SAHase. The recovery
      of activity paralleled the oxidation of enzyme-bound NADH. The association rate
      constant for ENADH and 3'-ketoadenosine was 6.1 x 10(2) M-1 s-1, and the
      dissociation rate constant was calculated to be 4 x 10(-7) s-1. This association
      rate constant was considerably smaller than the association rate constant for
      adenosine and SAHase (greater than 10(7) M-1 s-1). However, the observed pseudo
      first-order rate constant for reaction of 3'-ketoadenosine with ENADH (0.6 s-1
      with 1 mM 3'-ketoadenosine) approached kcat for the hydrolytic reaction (1.2 s
      1). Thus, bound 3'-ketoadenosine probably reacted sufficiently rapidly with ENADH
      to be considered a kinetically competent intermediate. The dissociation constants
      of SAHase for adenosine and 4',5'-dehydroadenosine, substrates for the enzyme,
      were 9 and 14 microM, respectively. In contrast, the dissociation constants of
      ENADH for 3'-ketoadenosine and 4',5'-dehydro-3'-ketoadenosine, intermediates of
      the catalytic reaction, were significantly lower with values of 600 and 300 pM,
      respectively. The equilibrium constant for reduction of enzyme-bound NAD+ in the
      absence of an adenosine analogue, as estimated from cyanide binding studies, was
      10-fold more favorable than that for free NAD+. ENADH was highly fluorescent
      (emission maximum 428 nm, excitation 340 nm) with a quantum yield that was six
      times that of free NADH. Since SAHase reduced by adenosine was not highly
      fluorescent, enzyme-bound intermediates quenched the fluorescence of enzyme-bound
      NADH. Adenosine and adenine quenched the fluorescence of ENADH. Cyanide formed a
      complex with SAHase that was analogous to ENADH. Adenine stabilized this complex
      sufficiently that addition of 65 microM adenine and 25 mM cyanide to SAHase
      caused total complex formation with loss of over 95% of the catalytic activity.

PMID- 1737777
TI  - High and low affinity receptors for human interleukin for DA cells/leukemia
      inhibitory factor on human cells. Molecular characterization and cellular
      distribution.
AB  - Radioiodinated recombinant human interleukin DA (HILDA)/leukemia inhibitory
      factor (LIF) purified from conditioned medium of Chinese hamster ovary
      transfected cells enabled the identification of specific receptor sites on a
      variety of human cell types. Using low concentrations (up to 500 pM) of the
      ligand iodinated at a high specific radioactivity, high affinity receptors
      (equilibrium dissociation constant Kd in the range of 30-100 pM) were first
      demonstrated. They were expressed at low levels by human peripheral blood
      monocytes but not by lymphocytes, NK cells, granulocytes, and platelets. The
      myelomonocytic cell line THP1 as well as the T lymphoma cell line HSB2 and the
      lymphoblastoid B cell line DAB were also receptor-negative. In contrast, most of
      the non-lymphoid tumoral cell lines tested, including melanomas, neuroblastomas,
      and carcinomas, expressed high affinity HILDA/LIF receptors at variable levels
      (Bmax from 20 to 600 sites/cell). The kinetics of HILDA/LIF high affinity binding
      to the choriocarcinoma JAR cell line were characterized at 4 degrees C with
      association and dissociation rate constants of k1 = 2.2 10(9) M-1 min-1 and k-1 =
      0.0084 min-1, respectively, corresponding to a steady-state dissociation constant
      k1/k-1 = 3.8 pM. The subsequent use of higher concentrations of HILDA/LIF labeled
      at a lower specific radioactivity enabled the identification of a low affinity
      component on several cell lines (Kd in the range of 1-4 nM; Bmax from 1,000 to
      5,000 sites/cell). On JAR cells, this low affinity component was characterized by
      association and dissociation rate constants at 4 degrees C of k1 = 7.3 10(7) M-1
      min-1 and k-1 = 0.19 min-1, respectively (k-1/k1 = 2.6 nM). Affinity cross
      linking of HILDA/LIF to JAR cells showed two cross-linked species under both
      reducing and nonreducing conditions corresponding to receptor species of 120 and
      250 kDa, respectively. Whereas both bands had similar intensities under high
      affinity conditions, the higher band predominated under low affinity conditions.
      Our data suggest that the 250-kDa chain could constitute the low affinity binding
      component whereas the association of both 250- and 120-Da subunits would form the
      high affinity structure.

PMID- 1737778
TI  - Gi down-regulation as a mechanism for heterologous desensitization in adipocytes.
AB  - Prolonged incubation of rat adipocytes with (-)N6-phenylisopropyl adenosine (PIA)
      (an A1 adenosine receptor agonist) leads to down-regulation of each of the three
      subtypes of Gi (Green, A., Johnson, J. L., and Milligan, G. (1990) J. Biol. Chem.
      265, 5206-5210). To determine whether other inhibitors of adenylylcyclase would
      have similar actions, we incubated adipocytes in primary culture with PIA,
      prostaglandin E1 (PGE1), or nicotinic acid. After various times cells were
      homogenized, and crude membrane fractions were analyzed on Western blots using
      antipeptide antisera to alpha- and beta-subunits of G-proteins (SG1 (which binds
      to alpha i1 and alpha i2), I3B (which binds to alpha i3), BN2 (binds to beta
      subunits) and CS1 (recognizes forms of alpha s)). PIA and PGE1 caused
      approximately 90% down-regulation of alpha i1 and alpha i3, and about 50% loss of
      alpha i2 and beta-subunits. In contrast, nicotinic acid at concentrations up to 1
      mM had no effect on levels of any of these Gi subtypes. None of the compounds
      altered levels of either a 43- or 47-kDa form of alpha s. PIA caused about a 50%
      decrease in binding of [3H]DPCPX (an A1 adenosine receptor antagonist),
      indicating adenosine receptor down-regulation; however, neither PGE1 nor
      nicotinic acid treatment altered [3H]DPCPX binding. None of the treatments
      affected the activity of adenylylcyclase when measured in the presence of 100
      microM forskolin and 10 mM Mn2+, indicating that the catalytic subunit of
      adenylylcyclase is not altered. To determine whether Gi down-regulation results
      in heterologous desensitization, we incubated adipocytes with maximally effective
      concentrations of PIA (300 nM), PGE1 (3 microM), or nicotinic acid (1 mM) for 4
      days. The cells were then washed and incubated for an additional 30 min with
      various concentrations of these compounds to determine their ability to inhibit
      lipolysis. PIA caused a (marked) decrease in the sensitivity of the cells to both
      PIA and PGE1, thus indicating heterologous desensitization. Similarly, PGE1
      decreased the sensitivity of the cells to both PGE1 and PIA, again demonstrating
      heterologous desensitization. In contrast, prolonged incubation with nicotinic
      acid decreased the sensitivity of the cells to nicotinic acid but had no effect
      on the sensitivity of the cells to PIA. Adenylylcyclase in membranes from PGE1
      treated cells showed decreased sensitivity to inhibition by PIA. In contrast,
      adenylylcyclase showed normal sensitivity to PIA in membranes from nicotinic acid
      treated cells.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1737779
TI  - GTP but not GDP analogues promote association of ADP-ribosylation factors, 20-kDa
      protein activators of cholera toxin, with phospholipids and PC-12 cell membranes.
AB  - ADP-ribosylation factors (ARFs) are a family of approximately 20-kDa guanine
      nucleotide-binding proteins initially identified by their ability to enhance
      cholera toxin ADP-ribosyltransferase activity in the presence of GTP. ARFs have
      been purified from both membrane and cytosolic fractions. ARF purified from
      bovine brain cytosol requires phospholipid plus detergent for high affinity
      guanine nucleotide binding and for optimal enhancement of cholera toxin ADP
      ribosyltransferase activity. The phospholipid requirements, combined with a
      putative role for ARF in vesicular transport, suggested that the soluble protein
      might interact reversibly with membranes. A polyclonal antibody against purified
      bovine ARF (sARF II) was used to detect ARF by immunoblot in membrane and soluble
      fractions from rat pheochromocytoma (PC-12) cell homogenates. ARF was
      predominantly cytosolic but increased in membranes during incubation of
      homogenates with nonhydrolyzable GTP analogues guanosine 5'-O-(3
      thiotriphosphate), guanylyl-(beta gamma-imido)-diphosphate, and guanylyl-(beta
      gamma-methylene)-diphosphate, and to a lesser extent, adenosine 5'-O-(3
      thiotriphosphate). GTP, GDP, GMP, and ATP were inactive. Cytosolic ARF similarly
      associated with added phosphatidylserine, phosphatidylinositol, or cardiolipin in
      GTP gamma S-dependent fashion. ARF binding to phosphatidylserine was reversible
      and coincident with stimulation of cholera toxin-catalyzed ADP-ribosylation.
      These observations may reflect a mechanism by which ARF could cycle between
      soluble and membrane compartments in vivo.

PMID- 1737780
TI  - Two novel Streptomyces protein protease inhibitors. Purification, activity,
      cloning, and expression.
AB  - In contrast to the Gram-negative bacteria, Gram-positive bacteria such as
      Streptomyces lack a mucopolysaccharide cell wall which allows them to produce and
      secrete a variety of proteins directly into their environment. In an effort to
      understand and eventually exploit the synthesis and secretion of proteins by
      Streptomyces, we identified and characterized two naturally occurring abundantly
      produced proteins in culture supernatants of Streptomyces lividans and
      Streptomyces longisporus. We purified these 10-kDa proteins and obtained partial
      amino acid sequence information which was then used to design oligonucleotide
      probes in order to clone their genes. Analysis of the sequence data indicated
      that these proteins were related to each other and to several other previously
      characterized Streptomyces protein protease inhibitors. We demonstrate that both
      proteins are protein protease inhibitors with specificity for trypsin-like
      enzymes. The presumptive signal peptidase cleavage sites and subsequent
      aminopeptidase products of each protein are characterized. Finally, we show that
      the cloned genes contain all of the information necessary to direct synthesis and
      secretion of the proteins by Streptomyces spp. or Escherichia coli.

PMID- 1737781
TI  - Effects of gamma-carboxyglutamic acid and epidermal growth factor-like modules of
      factor IX on factor X activation. Studies using proteolytic fragments of bovine
      factor IX.
AB  - Factor IX is a vitamin K-dependent zymogen of a serine protease. The NH2-terminal
      half of the molecule consists of a Ca(2+)-binding gamma-carboxyglutamic acid
      (Gla)-containing module and two modules homologous to the epidermal growth factor
      (EGF) precursor. To elucidate the role of these non-catalytic modules of factor
      IXa beta in factor X activation, we have isolated and characterized fragments of
      bovine factor IX, containing one or both of the EGF-like modules as well as these
      modules linked to the Gla module. The fragments were used as inhibitors of factor
      IXa beta-mediated factor X activation in a plasma clotting system and in systems
      with purified components of the Xase complex. Fragments consisting of either the
      two EGF-like modules of factor IX linked together or the NH2-terminal EGF-like
      module alone were found to inhibit factor Xa generation both in the presence and
      absence of the cofactor, factor VIIIa. Moreover, a fragment consisting of the
      corresponding modules of factor X had a similar effect. We therefore propose that
      factor IXa beta and factor X interact directly through their EGF-like modules on
      or in the vicinity of a phospholipid surface. We have also found that the
      isolated Gla module of factor IX inhibits the formation of factor Xa both in the
      presence and absence of phospholipid but not in the absence of factor VIIIa. Our
      results are compatible with a model of the Xase complex, in which both the serine
      protease part and the Gla module of factor IXa beta interact with factor VIIIa.

PMID- 1737782
TI  - Isolation and characterization of a novel receptor-type protein tyrosine kinase
      (hek) from a human pre-B cell line.
AB  - In this report we describe the identification and characterization of a novel
      tumor-associated receptor-type tyrosine kinase (hek). We produced a monoclonal
      antibody (III.A4) that detected a novel glycoprotein on the immunizing pre-B cell
      acute lymphoblastic leukemia cell line (LK63). This antigen was shown to be
      expressed sporadically on hemopoietic tumor cell lines and on ex vivo tumors.
      However, using antibody staining, the molecule was undetectable on normal
      tissues. Further biochemical characterization showed this molecule (hek) to be a
      phosphoroprotein. This observation taken together with the tumor-associated
      nature of hek expression suggested that hek might be a receptor-type protein
      tyrosine kinase. This was demonstrated by affinity purification of hek. In in
      vitro kinase experiments the purified hek protein was autophosphorylated on
      tyrosine and also mediated tyrosine phosphorylation of casein. Purified hek was
      subjected to N-terminal amino acid sequence analysis which showed that hek had a
      unique N terminus. Amino acid sequence determination of peptides from a V8
      protease digest of hek yielded one 21-amino acid stretch of sequence which showed
      close homology with the eph subfamily of protein tyrosine kinases. These studies
      show hek to be a novel human tumor-associated protein tyrosine kinase, which by
      analogy with previously characterized protein tyrosine kinase proto-oncogenes,
      may have a role in tumorigenesis.

PMID- 1737783
TI  - The folding and cell surface expression of CD4 requires glycosylation.
AB  - Human CD4, a monomeric T cell surface glycoprotein, is required for T helper cell
      activation and is also the receptor for the human immunodeficiency virus. There
      have been conflicting reports as to whether glycosylation of CD4 is required for
      its cell surface expression. To clarify the effect of glycosylation on surface
      expression, folding, and intracellular sorting of CD4, we generated a series of
      mutant cDNAs in which one, the other, or both glycosylation recognition sites
      were eliminated. Using in vitro transcription and translation we confirmed that
      both potential glycosylation sites of CD4 were utilized. Transient expression of
      the mutants in HeLa cells demonstrated that glycosylation at either site was
      necessary and sufficient for cell surface expression. Finally, we showed that
      unglycosylated CD4 produced in HeLa cells was incorrectly folded and retained
      intracellularly, probably in the endoplasmic reticulum.

PMID- 1737784
TI  - The deduced sequence of the transcription factor TFIIIA from Saccharomyces
      cerevisiae reveals extensive divergence from Xenopus TFIIIA.
AB  - TFIIIA is an RNA polymerase III transcription factor that binds to the internal
      control region of the 5 S RNA gene as the first step in the assembly of a
      transcription complex. We have identified the gene encoding TFIIIA from
      Saccharomyces cerevisiae. Protein synthesized in vitro from the cloned gene has
      the same size, DNA-binding properties, and transcription factor activity as does
      purified yeast TFIIIA. Examination of the deduced sequence of the 50-kDa yeast
      transcription factor revealed the presence of nine zinc-finger motifs, a
      characteristic of Xenopus TFIIIA. Although the conservation of these nine
      putative DNA-binding domains is striking, the amino acid sequence throughout the
      corresponding fingers of the yeast and amphibian TFIIIAs has diverged extensively
      and in many instances the spacing between the residues that coordinate the zinc
      ions differs between the two proteins. A unique feature of the yeast protein is
      an 81-amino acid domain interrupting the repeated zinc-finger motifs between
      fingers 8 and 9. Additionally, the yeast and amphibian proteins differ in both
      the size and sequence of the amino- and carboxyl-terminal domains flanking the
      zinc fingers. The gene encoding yeast TFIIIA is present in single copy in the S.
      cerevisiae genome and is essential for cell viability. A carboxyl-terminal
      truncated form of the protein containing 4.5 zinc-finger motifs retains the
      ability to bind to DNA but is no longer active in promoting transcription in
      vitro.

PMID- 1737785
TI  - Thyroid hormone stimulation of NADPH P450 reductase expression in liver and
      extrahepatic tissues. Regulation by multiple mechanisms.
AB  - The role of thyroid hormone in regulating the expression of the flavoprotein
      NADPH cytochrome P450 reductase was studied in adult rats. Depletion of
      circulating thyroid hormone by hypophysectomy, or more selectively, by treatment
      with the anti-thyroid drug methimazole led to a 75-85% depletion of hepatic
      microsomal P450 reductase activity and protein in both male and female rats.
      Thyroxine substantially restored P450 reductase activity at a dose that rendered
      the thyroid-depleted rats euthyroid. Microsomal P450 reductase activity in
      several extrahepatic tissues was also dependent on thyroid hormone, but to a
      lesser extent than in liver (30-50% decrease in kidney, adrenal, lung, and heart
      but not in testis from hypothyroid rats). Hepatic P450 reductase mRNA levels were
      also decreased in the hypothyroid state, indicating that the loss of P450
      reductase activity is not a consequence of the associated decreased availability
      of the FMN and FAD cofactors of P450 reductase. Parallel analysis of S14 mRNA,
      which has been studied extensively as a model thyroid-regulated liver gene
      product, indicated that P450 reductase and S14 mRNA respond similarly to these
      changes in thyroid state. In contrast, while the expression of S14 and several
      other thyroid hormone-dependent hepatic mRNAs is stimulated by feeding a high
      carbohydrate, fat-free diet, hepatic P450 reductase expression was not increased
      by this lipogenic diet. Injection of hypothyroid rats with T3 at a
      supraphysiologic, receptor-saturating dose stimulated a major induction of
      hepatic P450 reductase mRNA that was detectable 4 h after the T3 injection, and
      peaked at approximately 650% of euthyroid levels by 12 h. However, this same
      treatment stimulated a biphasic increase in P450 reductase protein and activity
      that required 3 days to reach normal euthyroid levels. T3 treatment of euthyroid
      rats also stimulated a major induction of P450 reductase mRNA that was maximal
      (12-fold increase) by 12 h, but in this case no major increase in P450 reductase
      protein or activity was detectable over a 3-day period. Together, these studies
      establish that thyroid hormone regulates P450 reductase expression by
      pretranslational mechanisms. They also suggest that other regulatory mechanisms,
      which may involve changes in P450 reductase protein stability and/or changes in
      the translational efficiency of its mRNA, are likely to occur.

PMID- 1737786
TI  - Ornithine delta-aminotransferase mutations in gyrate atrophy. Allelic
      heterogeneity and functional consequences.
AB  - Ornithine delta-aminotransferase is a nuclear-encoded mitochondrial matrix enzyme
      which catalyzes the reversible interconversion of ornithine and alpha
      ketoglutarate to glutamate semialdehyde and glutamate. Inherited deficiency of
      ornithine delta-aminotransferase results in ornithine accumulation and a
      characteristic chorioretinal degeneration, gyrate atrophy of the choroid and
      retina. We have surveyed the ornithine delta-aminotransferase genes of gyrate
      atrophy patients for mutations. Using a variety of techniques, we discovered and
      molecularly characterized 21 newly recognized ornithine delta-aminotransferase
      alleles. We determined the consequences of these and three previously described
      mutations on ornithine delta-aminotransferase mRNA, antigen, and enzyme activity
      in cultured fibroblasts. The majority (20/24) of these alleles produce normal
      amounts of normally sized ornithine delta-aminotransferase mRNA. By contrast,
      only 2/24 had normal amounts of ornithine delta-aminotransferase antigen.
      Reproducing these mutations by site-directed mutagenesis and expressing the
      mutant ornithine delta-aminotransferase in Chinese hamster ovary cells confirms
      that several of these mutations inactivate ornithine delta-aminotransferase and
      cause gyrate atrophy in these patients.

PMID- 1737787
TI  - Membrane-associated carbonic anhydrase from rat lung. Purification,
      characterization, tissue distribution, and comparison with carbonic anhydrase IVs
      of other mammals.
AB  - Carbonic anhydrase (CA) IV was purified to homogeneity from rat lung microsomal
      and plasma membranes. The single N-terminal amino acid sequence showed 55%
      similarity to that reported for human CA IV. A monospecific antibody to the 39
      kDa rat enzyme that cross-reacts on Western blots with CA IVs from other
      mammalian species was produced in rabbits. Digestion of rat lung enzyme with
      endoglycosidase (peptide-N-glycosidase F) reduced the Mr to 36,000, suggesting
      that rat CA contains one N-linked oligosaccharide chain. All of eight additional
      mammalian CA IVs that were examined also contained oligosaccharide chains, as
      evidenced by reduction in Mr from 52,000 (cow, sheep, and rabbit), 42,000 (pig,
      guinea pig, and dog), and 39,000 (mouse and hamster) to 36,000 after treatment of
      the respective lung microsomal membranes with peptide-N-glycosidase F. The 36-kDa
      human enzyme showed no change in molecular mass with this treatment. Thus, the
      human CA IV is the exceptional one in lacking carbohydrate. Rat lung CA IV was
      found to be relatively resistant to sodium dodecyl sulfate and to be anchored to
      membranes by a phosphatidylinositol-glycan linkage; both properties were found to
      be shared by other mammalian CA IVs. Western blot analysis indicated distribution
      of CA IV in rat tissues other than kidney and lung where it was previously known
      to be present. CA IV was particularly abundant in rat brain, muscle, heart, and
      liver, all locations where the CA IV enzyme was not known to be present
      previously. None was detected in rat skin or spleen.

PMID- 1737788
TI  - An array of insulin-activated, proline-directed serine/threonine protein kinases
      phosphorylate the p70 S6 kinase.
AB  - This study characterizes the insulin-activated serine/threonine protein kinases
      in H4 hepatoma cells active on a 37-residue synthetic peptide (called the SKAIPS
      peptide) corresponding to a putative autoinhibitory domain in the carboxyl
      terminal tail of the p70 S6 kinase as well as on recombinant p70 S6 kinase. Three
      peaks of insulin-stimulated protein kinase active on both these substrates are
      identified as two (possibly three) isoforms of the 40-45-kDa erk/microtubule
      associated protein (MAP)-2 kinase family and a 150-kDa form of cdc2. Although
      distinguishable in their substrate specificity, these protein kinases together
      with the p54 MAP-2 kinase share a major common specificity determinant reflected
      in the SKAIPS peptide: the requirement for a proline residue immediately carboxyl
      terminal to the site of Ser/Thr phosphorylation. In addition, however, at least
      one peak of insulin-stimulated protein kinase active on recombinant p70, but not
      on the SKAIPS peptide, is present although not yet identified. MFP/cdc2
      phosphorylates both rat liver p70 S6 kinase and recombinant p70 S6 kinase
      exclusively at a set of Ser/Thr residues within the putative autoinhibitory
      (SKAIPS peptide) domain. erk/MAP kinase does not phosphorylate rat liver p70 S6
      kinase, but readily phosphorylates recombinant p70 S6 kinase at sites both within
      and in addition to those encompassed by the SKAIPS peptide sequences. Although
      the tryptic 32P-peptides bearing the cdc2 and erk/MAP kinase phosphorylation
      sites co-migrate with a subset of the sites phosphorylated in situ in insulin
      stimulated cells, phosphorylation of the p70 S6 kinase by these proline-directed
      protein kinases in vitro does not reproducibly activate p70 S6 kinase activity.
      Thus, one or more erk/MAP kinases and cdc2 are likely to participate in the
      insulin-induced phosphorylation of the p70 S6 kinase. In addition to these
      kinases, however, phosphorylation of the p70 S6 kinase by other as yet
      unidentified protein kinases is necessary to recapitulate the multisite
      phosphorylation required for activation of the p70 S6 kinase.

PMID- 1737789
TI  - Gene conversion confined to a direct repeat of the acceptor splice site generates
      allelic diversity at human glycophorin (GYP) locus.
AB  - The glycophorin locus (GYP) on the long arm of chromosome 4 encodes antigens of
      the MNSs blood group system and displays considerable allelic variation among
      human populations. The genomic structure and organization of a variant
      glycophorin allele specifying a novel Miltenberger (Mi)-related phenotype, MiX,
      were examined. This variant probably arose from a gene conversion event involving
      a direct repeat of the acceptor splice site. Southern blot analysis indicated
      that MiX gene derived its 5' and 3' portions from glycophorin B or delta gene but
      its internal part from glycophorin A or alpha gene. Genomic sequences
      encompassing the rearranged regions of the MiX gene were amplified by single copy
      polymerase chain reaction. Direct DNA sequencing showed that during the formation
      of MiX gene, a short stretch of alpha exon III with a donor splice site has
      replaced a silent sequence in the delta gene containing a cryptic acceptor splice
      site. The upstream delta-alpha breakpoint is flanked by the direct repeats of the
      acceptor splice site, whereas the down-stream alpha-delta breakpoint is located
      in the adjacent intron. This segmental transfer produced a new composite exon
      whose expression not only transactivated a portion of silent sequence but also
      created intraexon and interexon hybrid junctions that characterize the antigenic
      specificities of MiX glycophorin. The identification of MiX as yet another delta
      alpha-delta hybrid different from MiIII and MiVI in gene conversion sites
      suggests that shuffling of expressed and unexpressed sequences through particular
      genomic DNA motifs has been an important mechanism for shaping the antigenic
      diversity of MNSs blood group system during evolution.

PMID- 1737790
TI  - DNA wrapping and bending by a mitochondrial high mobility group-like
      transcriptional activator protein.
AB  - Mitochondrial transcription factor 1 (mtTF1) is the only accessory protein known
      to be required for accurate and efficient promoter recognition by mammalian
      mitochondrial RNA polymerase. It activates transcription by binding immediately
      upstream of transcriptional start sites and shows an inherent flexibility in
      primary DNA sequence requirement. By application of a purification strategy
      designed for human and mouse mtTF1, a protein resembling mtTF1 was recently
      isolated from yeast mitochondria; its size (19 kDa), DNA-binding properties, and
      amino acid composition suggest identity to HM, a previously described abundant
      protein of yeast mitochondria. Both human and yeast proteins show a general
      ability to wrap or condense and unwind DNA in vitro and bend DNA at specific
      sequences. Recent determinations of the amino acid sequences of the human and
      yeast proteins reveal that both contain domains homologous to the nuclear high
      mobility group (HMG) proteins which have been implicated in diverse functions
      such as chromatin compaction and transcription stimulation. The ability to unwind
      and bend DNA may be fundamental to the documented roles of the mammalian protein
      in mitochondrial DNA transcription and replication priming and suggests a similar
      function for the yeast protein in yeast mitochondria.

PMID- 1737791
TI  - DNA binding properties of an HMG1-related protein from yeast mitochondria.
AB  - The DNA binding properties of ABF2, an abundant protein found in the mitochondria
      of the yeast Saccharomyces cerevisiae have been examined in detail. ABF2 is
      closely related to the vertebrate high mobility group protein HMG1 and like HMG1,
      ABF2 will introduce negative supercoils into a relaxed, double-stranded circular
      DNA molecule in cooperation with a DNA topoisomerase. Additionally, ABF2 binds
      approximately 5-10 times more tightly to negatively supercoiled DNA than to
      relaxed circular or linear DNA. Although ABF2 binds to most random double
      stranded sequences with roughly equal affinity, its binding within certain key
      regulatory regions is qualitatively quite different. First, ABF2 binding induces
      a distinct pattern of DNA bending within the chromosomal origin of DNA
      replication, ARS1. Second, ABF2 binding to all nuclear replication origins
      tested, in addition to a critical mitochondrial promoter and replication origin,
      is clearly nonrandom as visualized by DNase1 footprinting. Analysis of the
      sequences found within these regions as well as competition experiments with
      synthetic DNA molecules suggest that site-specific DNA binding may be
      accomplished by the phased distribution of short stretches of poly(dA), which
      exclude ABF2 binding. These patterns of ABF2 DNA binding suggest a role for the
      protein in genome organization and site-specific regulation of transcription or
      DNA replication.

PMID- 1737792
TI  - A triple helix-forming oligonucleotide-intercalator conjugate acts as a
      transcriptional repressor via inhibition of NF kappa B binding to interleukin-2
      receptor alpha-regulatory sequence.
AB  - Oligonucleotide-directed triplex formation within upstream regulatory sequences
      is envisioned as a potential tool for gene inhibition. However, this approach
      requires that triple helix-forming oligonucleotides are chemically modified, so
      that the triplex is stable under physiological conditions. Here, we have compared
      several chemical modifications of an oligonucleotide, targeted to a natural 15
      base pair homopyrimidine.homopurine sequence located in the upstream regulatory
      region of the gene encoding the interleukin-2 receptor alpha chain (p55, IL-2 R
      alpha). Methylation of the cytosines strongly stabilized the triplex. Further
      attachment of an intercalating agent (acridine) dramatically increased the
      stability of the triplex, as assessed by Tm measurements or by band shift assays.
      Furthermore, the acridine-derivatized oligonucleotide was more efficient in
      competing away high affinity DNA-binding proteins, as assessed by restriction
      enzyme inhibition assays. Using a novel footprinting assay, we have further shown
      that the interaction of the methylcytosine-substituted, acridine-derivatized
      oligonucleotide with a plasmidic target, harboring the IL-2 R alpha regulatory
      region, remains highly sequence specific, occurs at physiological pH and is
      independent of the superhelicity of the plasmid. Acridine derivatization did not
      impair the exquisite target specificity of triplex formation, since the
      derivatized oligonucleotide inhibited the binding of nuclear proteins to the
      overlapping NF kappa B enhancer sequence on an IL-2 R alpha target and not on the
      related human immunodeficiency virus long terminal repeat target. Finally, the
      oligonucleotide inhibited the NF kappa B-dependent tax-induced transcriptional
      activation of the IL-2 R alpha chloramphenicol acetyltransferase construct in
      live cells, whereas it did not have any effect on a human immunodeficiency virus
      long terminal repeat chloramphenicol acetyltransferase construct. We conclude
      that this modified oligonucleotide acts as a transcriptional repressor for the IL
      2 R alpha gene via triple helix formation with regulatory sequences.

PMID- 1737793
TI  - Triacylglycerol hydrolysis in isolated hepatic endosomes.
AB  - Three endosomal compartments including the compartment for uncoupling receptor
      and ligand (CURL), multivesicular bodies (MVB), and a putative recycling fraction
      (retrosomes) were isolated from rat liver homogenates fifteen minutes after a
      bolus injection of very low density lipoprotein (VLDL) was delivered into a
      femoral vein. Assays for enzyme markers indicate a minimal contamination with
      either lysosomes or Golgi. The increase in specific activity of the radiolabeled
      ligand (VLDL) during the isolation procedure from homogenate to MVB, demonstrates
      a 200-250-fold purification of this organelle. All three fractions have the
      ability to catabolize triacylglycerol substrate both as triolein and as VLDL
      triacylglycerol. Furthermore, incubation of isolated endosomes following
      injection of endogenously labeled VLDL demonstrate their ability to hydrolyze
      VLDL triacylglycerol in situ. Three distinct lipolytic pH optima were found at pH
      5.5, 7.1, and 8.6. The effects of serum, MgCl2, CaCl2, NaCl, sodium dodecyl
      sulfate, bile acids, and antibody to hepatic triacylglycerol lipase on the
      individual endosome fractions demonstrated distinct lipolytic activities in the
      different compartments. Results indicate that both an endosomal neutral lipase as
      well as hepatic triacylglycerol lipase make a significant contribution to
      lipolytic processing of endocytosed lipoproteins prior to their resecretion of
      further processing in hepatic lysosomes.

PMID- 1737794
TI  - Secreted and cellular proteochondroitin sulfates of a human B lymphoblastoid cell
      line contain different protein cores.
AB  - Proteoglycans of the human B lymphoblastoid cell line LICR-LON-HMy2 were
      metabolically labeled with [35S]sulfate. High-density fractions of 35S-labeled
      material separated by CsCl gradient ultracentrifugation were further purified by
      anion exchange chromatography and gel filtration. Two proteoglycans, isolated
      from cell lysates and culture supernatants, were characterized by gel filtration
      and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) in
      combination with enzymatic degradation. Treatment with chondroitinase AC
      completely degraded the glycosaminoglycan moiety of the proteoglycans. Three to 4
      chondroitin sulfate chains (average molecular mass = 26 kDa) were estimated for
      each of the two proteoglycans. Differences between the proteochondroitin sulfates
      (CSPG) were observed in the content of N-linked oligosaccharides. After
      chondroitinase AC treatment the resulting band in SDS-PAGE of the secreted CSPG
      was sensitive to treatment with endoglycosidase F (Endo F) which further reduced
      the molecular mass from 30 to 21.5 kDa, whereas the band of the cellular CSPG
      after chondroitinase AC treatment (molecular mass = 30 kDa) remained resistant to
      Endo F treatment. The composition of amino acids was different in the protein
      cores, suggesting differences in the primary structure. Both CSPG contained a
      high percentage of glycine and serine. For both CSPG a molecular mass of
      approximately 135 kDa was deduced from the hydrodynamic sizes of the
      glycosaminoglycan chains obtained after alkaline/borohydride treatment and the
      migration of the protein/oligosaccharide complexes in SDS-PAGE. 75% of all
      [35S]sulfate-labeled molecules were found in the culture supernatant and 25% in
      the cellular fraction. 35S-Labeled material in the culture supernatant consisted
      exclusively of intact CSPG, whereas 35S-Labeled molecules in the cellular
      preparation consisted largely of free chondroitin sulfate chains. Only 8.3% of
      the cellular material, isolated from the microsomal fraction, was intact CSPG. In
      pulse-chase experiments maximal secretion of CSPG was found after 4 h, comprising
      approximately 40% of totally synthesized CSPG. From these experiments we
      tentatively conclude that a small proportion of CSPG synthesized by LICR-LON-HMy2
      cells is membrane-associated, a larger portion is secreted, and another portion
      is intracellularly degraded.

PMID- 1737795
TI  - Selective inactivation of the Arg-Gly-Asp-Ser (RGDS) binding site in von
      Willebrand factor by site-directed mutagenesis.
AB  - In order to assess the requirement for the Arg-Gly-Asp-Ser (RGDS) consensus
      adhesion sequence in von Willebrand factor (vWF) for vWF binding to platelets and
      endothelial cells, point mutations were introduced into this sequence by site
      directed mutagenesis. A glycine to alanine substitution yielded RADS-vWF, while
      an aspartate to glutamate substitution resulted in RGES-vWF. Recombinant RADS-vWF
      and RGES-vWF, purified from transformed Chinese hamster ovary cells, were
      compared with recombinant wild type vWF (WT-vWF) in functional assays with
      platelets and human umbilical vein endothelial cells (HU-VECs). High molecular
      weight RADS-vWF and RGES-vWF multimers inhibited binding of 125I-vWF to a mixture
      of insolubilized native type I and III collagen and competed effectively with
      125I-vWF for binding to formalin-fixed platelets in the presence of ristocetin,
      indicating functional collagen and platelet glycoprotein Ib binding. However,
      RADS-vWF and RGES-vWF were unable to displace the binding of 125I-vWF to thrombin
      or ADP-activated platelets. The attachment of HUVECs to either RADS-vWF or RGES
      vWF coated surfaces was reduced and spreading was almost completely inhibited,
      compared with WT-vWF. We conclude that point mutations of the RGDS sequence in
      vWF selectively impair binding to platelet glycoprotein IIb/IIIa and the HUVEC
      vitronectin receptor.

PMID- 1737796
TI  - Human estrogen receptor mutants with altered estrogen and antiestrogen ligand
      discrimination.
AB  - A structural characteristic of many antiestrogens (AEs) is a bulky side chain
      with basic or polar functional groups that may interact with charged and polar
      amino acids near the hormone-binding site in the estrogen receptor. Recently, we
      have identified Cys530 as the residue of the human estrogen receptor that is the
      site of covalent labeling by aziridine analogs of estrogens (Es) and AEs (Harlow,
      K. W., Smith, D. N., Katzenellenbogen, J. A., Greene, G. L., and
      Katzenellenbogen, B. S. (1989) J. Biol. Chem. 264, 17476-17485). Since the
      aziridine function is on the bulky side chain of these ligands, Cys530 must be at
      or near the site of those side chain interactions. To probe these interactions,
      we have, by site-directed mutagenesis, made mutant human estrogen receptors in
      which charged and polar amino acids near Cys530 are changed (Glu523 to Gln,
      Lys529 and Lys531 to Gln, Asn532 to Asp, and Asp538 to Asn) so as to alter charge
      with minimal steric alteration. These receptors were expressed in mammalian
      (Chinese hamster ovary or COS-1) cells and assayed for their binding affinity for
      Es and AEs, their interaction with estrogen-responsive element DNA, and their
      ability to activate or suppress transcription of estrogen-responsive reporter
      genes. Two of the estrogen receptor mutants, KKN-QQD (mutation of Lys529, Lys531,
      and Asn532 to Gln529, Gln531, and Asp532, respectively) and KK-QQ (mutation of
      Lys529 and Lys531 to Gln529 and Gln531, respectively), in which the local charge
      is changed from +2 to -1 or 0, respectively, display an affinity for estradiol
      (E2) 5-10 times lower than that of the wild-type receptor, which is attributable
      to an enhanced rate of E2 dissociation. Although these mutant receptors have
      reduced affinity for a variety of Es, they retain unaltered affinity for AE. The
      profiles of transcriptional activation of reporter genes by various
      concentrations of E2 show that these two mutants (KKN-QQD and KK-QQ) require 40-
      and 15-fold higher E2 concentrations, respectively, to achieve half-maximal
      activity. In contrast, mutants E523Q and D538N, with changes at amino acids
      further from Cys530, were unaltered in their hormone binding and transactivation
      activity by E or AE. Interestingly, the AEs 4-hydroxytamoxifen, LY 117018, U
      23469M, and ICI 164384 were 15-30-fold more effective in inhibiting E2-stimulated
      transcription by mutants KKN-QQD and KK-QQ compared to the wild-type
      receptor.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1737797
TI  - Phosphorylation of brush border myosin I by protein kinase C is regulated by
      Ca(2+)-stimulated binding of myosin I to phosphatidylserine concerted with
      calmodulin dissociation.
AB  - Brush border myosin I from chicken intestine is phosphorylated in vitro by
      chicken intestinal epithelial cell protein kinase C. Phosphorylation on serine
      and threonine to a maximum of 0.93 mol of P/mol of myosin I occurs within an
      approximately 20 kDa region at the end of the COOH-terminal tail of the 119-kDa
      heavy chain. The effects of Ca2+ on myosin I phosphorylation by protein kinase C
      are complex, with up to 4-fold stimulation occurring at 0.5-3 microM Ca2+, and up
      to 80% inhibition occurring at 3-320 microM Ca2+. Phosphorylation required that
      brush border myosin I be in its phosphatidylserine vesicle-bound state.
      Previously unknown Ca2+ stimulation of brush border myosin I binding to
      phosphatidylserine vesicles was found to coincide with Ca2+ stimulation of
      phosphorylation. A myosin I proteolytic fragment lacking approximately 20 kDa of
      its tail retained Ca(2+)-stimulated binding, but showed reduced Ca(2+)
      independent binding. Ca(2+)-dependent phosphatidylserine binding is apparently
      due to the concomitant phosphatidylserine-promoted, Ca(2+)-induced dissociation
      of up to three of the four calmodulin light chains from myosin I. Four highly
      basic putative calmodulin-binding sites in the Ca(2+)-dependent
      phosphatidylserine binding region of the heavy chain were identified based on the
      similarity in their sequence to the calmodulin- and phosphatidylserine-binding
      site of neuromodulin. Calmodulin dissociation is now shown to occur in the low
      micromolar Ca2+ concentration range and may regulate the association of brush
      border myosin I with membranes and its phosphorylation by protein kinase C.

PMID- 1737798
TI  - Conversion of monocyte chemoattractant protein-1 into a neutrophil attractant by
      substitution of two amino acids.
AB  - The small cytokine monocyte chemoattractant protein-1 has structural similarity
      to the neutrophil chemoattractant interleukin-8, but each protein is specific in
      attracting its own target cell. To investigate the structural basis of this cell
      type specificity, we have developed an Escherichia coli expression system for the
      monocyte chemoattractant and mutagenized selected amino acid residues to ones
      found at the corresponding positions of interleukin-8. We find that a double
      mutation of tyrosine 28 and arginine 30 to leucine and valine, respectively,
      causes a drastic decrease in chemotactic activity toward monocytes with the
      appearance of a novel (interleukin-8-like) neutrophil chemotactic activity.
      Computer graphic analysis predicts that, with the double substitution, a putative
      receptor binding groove of the monocyte chemoattractant protein would become
      topographically similar to that of interleukin-8. We therefore postulate that one
      or both of these amino acid residues are part of the binding contact of these
      small cytokines and their receptors.

PMID- 1737799
TI  - Diverse biologic properties imparted by the c-fgr proto-oncogene.
AB  - The c-fgr proto-oncogene specifies a nonreceptor protein-tyrosine kinase, p55c
      fgr, a member of the src family. In the present study, we have mutagenized c-fgr
      to mimic alterations found at the 3' end of the v-fgr oncogene and have
      investigated the biologic effects of normal and mutant p55c-fgr expression. Genes
      lacking 10 or 13 codons at the 3' end, as well as a gene encoding phenylalanine
      instead of tyrosine at codon 523, were potent oncogenes when transfected into NIH
      3T3 cells. Specific enzymatic activities of the more highly transforming gene
      products were 3-4-fold greater than that of p55c-fgr. In vivo, the amount of
      tyrosine phosphorylation of cellular proteins was directly proportional to
      potency in focus-forming assays. These findings are the first to identify highly
      transforming mutations of the c-fgr proto-oncogene. The proto-oncogene was also
      active in transforming assays, demonstrably greater than that of a kinase
      deficient mutant. Foci arising in c-fgr-transfected cultures expressed abundant
      enzyme that was normal by a number of criteria. In addition, growth rates for
      cells expressing p55c-fgr were restricted, as compared with cells expressing a
      kinase-deficient protein or cells transformed by proteins with high specific
      enzymatic activities. Thus, enzymatically active p55c-fgr can simultaneously
      activate transforming and growth inhibitory pathways.

PMID- 1737800
TI  - Regulated expression of alpha 2,6-sialyltransferase by the liver-enriched
      transcription factors HNF-1, DBP, and LAP.
AB  - Tissue-specific carbohydrate structures are thought to result from the selective
      expression of specific terminal glycosyltransferases responsible for their
      synthesis. However, little is known about the regulation of the expression of
      these enzymes. Previous analysis of the distribution of one such enzyme, beta
      galactoside alpha 2,6-sialyltransferase, revealed that its expression is tissue
      restricted, with highest levels being found in the liver. Examination of the gene
      suggested that its expression is regulated at the level of transcription by
      multiple promoters, one of which is strongly active in the liver. In this present
      work, an analysis of the liver-restricted promoter was undertaken to identify the
      promoter elements necessary for liver-restricted expression. Footprinting
      studies, 5' deletion analysis, and site-directed mutagenesis identified two cis
      elements which were potentially important in the tissue-specific expression of
      this promoter. One of these elements contains a consensus binding site for the
      liver-enriched transcription factor hepatocyte nuclear factor-1 alpha, while the
      other is a consensus binding site for the liver-specific factors D-binding
      protein and liver-enriched transcriptional activator protein. Expression vectors
      containing cDNAs of these factors are capable of trans-activating transcription
      of the alpha 2,6ST promoter, demonstrating their ability to regulate
      transcription of this promoter. Together, these results suggest that tissue
      specific glycosylation can be regulated at the level of transcription by the same
      factors involved in the expression of a number of other tissue-specific genes.

PMID- 1737801
TI  - Analysis of phosphoprotein p19 by liquid chromatography/mass spectrometry.
      Identification of two proline-directed serine phosphorylation sites and a blocked
      amino terminus.
AB  - p19 is a highly conserved 19-kDa cytosolic protein that undergoes phosphorylation
      in mammalian cells upon activation of several distinct signal transduction
      pathways. Its expression is widespread but developmentally regulated. To
      determine the in vivo phosphorylation site(s) of p19, the protein was purified
      from bovine brain and resolved into the unphosphorylated form (p19) and a mixture
      of the two predominant phospho-forms (pp19). Proteolytic fragments of p19 and
      pp19 were examined by liquid chromatography/mass spectrometry (LC/MS). We
      detected ion masses corresponding to fragments spanning the entire amino acid
      sequence as deduced from the cDNA except for those predicted to contain an
      unmodified amino terminus. Instead, the digests revealed ions corresponding to
      peptides lacking the initiator methionine and containing an N-acetylated alanine
      at the amino terminus. The analysis of pp19, but not that of p19, revealed two
      sets of ions representing peptides whose m/z values differed by 80 atomic mass
      units, the incremental mass of a phosphate residue. These putative phosphate
      bearing peptides were sensitive to alkaline phosphatase treatment. Using combined
      trypsin and V8 protease digestions, the phosphorylation sites were mapped to Ser
      25 and Ser-38, in the peptides Leu-Ile-Leu-Ser*-Pro-Arg and Phe-Pro-Leu-Ser*-Pro
      Pro-Lys, respectively. Interestingly, both phosphoserines are in a very similar
      sequence context, suggesting that a single proline-directed serine protein
      kinase, possibly p34cdc2, is responsible for phosphorylation of both sites in
      vivo.

PMID- 1737802
TI  - A multicomponent protein of a fission yeast that promotes joint molecule
      formation from homologous DNAs.
AB  - We developed a quantitative assay ("homologous pairing gel assay") adequate for
      the purification of the activity promoting the formation of joint molecules, an
      intermediate of homologous recombination ("homologous pairing"). With this assay,
      one can measure the extent of homologous pairing between a single-stranded DNA
      and a strand of 3H-labeled double-stranded DNA by crude enzyme preparations.
      Since the total activity did not significantly change during the sporulation
      process, we tried to purify the activity from a whole cell extract of mitotic
      cells of a fission yeast, (Schizosaccharomyces pombe). Through quantitative
      assaying of a single fraction or of mixed fractions, we obtained three fractions,
      all of which were required for the maximum level of the ATP-independent
      homologous pairing: Fractions 65, 100, and 30. In Fractions 100 and 30,
      polypeptides of approximately 100 and approximately 30 kDa (the 100- and 30-kDa
      polypeptides), respectively, were the sole detectable components. Fraction 65
      contained a polypeptide of approximately 65 kDa (the 65-kDa polypeptide) as the
      major component and also small amounts of the 30- and 100-kDa polypeptides.
      Fraction 65 by itself promoted homologous pairing, but the reaction was saturated
      at a level of approximately 20% of the maximum level achieved with the recA
      protein. Even when added in excess, Fraction 30 or 100 alone did not promote
      detectable homologous pairing. A mixture of Fractions 65 and 100 at a rather
      strict optimum ratio only promoted homologous pairing, the level being 50-70%
      that with the recA protein, suggesting a stoichiometric complex of these
      polypeptides as the active form. Fraction 30 alone did not enhance the reaction
      with Fraction 65, but stimulated homologous pairing promoted by the optimum
      mixture of Fractions 65 and 100 to the maximum level achieved with the recA
      protein. Therefore, the homologous pairing-promoting protein from the fission
      yeast is likely to be a multicomponent protein.

PMID- 1737803
TI  - Identification, characterization, and resolution of the in vivo phosphorylated
      form of the D1 photosystem II reaction center protein.
AB  - The chloroplast-encoded D1 protein of oxygenic photosynthetic organisms is a
      component of the photosystem II reaction center. Previously, we detected an
      electrophoretic variant of D1 which was generated in vivo in granal-localized
      reaction centers in a light dependent manner (Callahan, F.E., Ghirardi, M.L.,
      Sopory, S.K., Mehta, A.M., Edelman, M., and Mattoo, A.K. (1990) J. Biol. Chem.
      265, 15357-15360). In the present study, we identify this modified form as
      phosphorylated D1. The in vivo phosphorylation occurs on a threonine residue(s)
      localized within 1 kDa from the N terminus and is identical to the
      phosphorylation of D1 catalyzed in vitro by a redox-regulated thylakoid-bound
      protein kinase. While virtually all of the D1 protein present in thylakoids can
      be phosphorylated in vitro, the steady-state level of phosphorylated D1 in vivo
      varies with light intensity and did not exceed 20% of the total D1 under the
      conditions of this study.

PMID- 1737804
TI  - Characterization of human 3 beta-hydroxysteroid dehydrogenase/delta 5-delta 4
      isomerase gene and its expression in mammalian cells.

PMID- 1737805
TI  - Characterisation of health and social development.
AB  - The relative performance of less developed countries in their health, demographic
      and economic sectors was assessed by means of comparative indices constructed
      with the help of a factor analysis. This approach reduces the problems usually
      associated with such indices, like the arbitrary weighting of their components.

PMID- 1737806
TI  - Determinants of child mortality in south-west Uganda.
AB  - Anthropometric and sociodemographic variables were taken from 4320 children in a
      baseline survey carried out in March-April 1988 in the district of Mbarara, south
      west Uganda. After 12 months a follow-up survey assessed the mortality of the
      children during the preceding year. Lack of ownership of cattle, recent arrival
      in the village, using candles for lighting, being of birth order higher than 5
      and having a father with less than 8 years of schooling were significantly
      associated with child mortality. The addition of mid-upper arm circumference
      significantly improved the logistic model of socioeconomic variables and
      mortality and did not diminish the predictive power of socioeconomic variables in
      relation to increased mortality. This suggests that nutritional status and
      specific socioeconomic factors are both, independently, important predictors of
      child mortality.

PMID- 1737807
TI  - The influence of religious affiliation on surname repetition in marriages in
      Tiszaszalka, Hungary.
AB  - The repeated-pairs of surnames in marriages (RP) approach is applied to the
      population of Tiszaszalka in north-eastern Hungary. The results indicate that:
      (1) lineage-like behaviour in mate choice results in population subdivision in
      both the Catholics and the Protestants of the village; (2) unlike in some other
      Tiszahat villages, the isonymous and the repeating unions in Tiszaszalka occur in
      different lineages so, in neither of these subpopulations are isonymous and
      repeating unions monopolised by a few lineages; (3) religious affilitation
      influences the mating structure of the population as measured by RP summary
      scores.

PMID- 1737808
TI  - Changes in age at marriage of women in rural north India.
AB  - There has been a dramatic increase in age at marriage for women in a rural area
      of north India. Age at marriage rose from under 12 years before 1930 to about 19
      years in 1988, mainly as a result of socioeconomic development and advances in
      education of women.

PMID- 1737809
TI  - Given name relationships support surname 'genetics': a note and correction.
AB  - Analysis of a further four samples of first names in the index of marriages
      registered in England and Wales in the first 3 months of 1975 support the claim
      that there is no significant difference of 'between' versus 'within' registration
      district Ri. Since given names show none of the localisation seen in surnames,
      the surname geography is ascribable to genetic rather than cultural factors of
      personal naming. The correct formulations for coefficient of relationship by
      isonymy are given.

PMID- 1737810
TI  - Coital frequency and twinning. A comment.

PMID- 1737811
TI  - Measurement of post-partum amenorrhoea in Bangladesh.
AB  - Reported information on the duration of post-partum amenorrhoea usually shows
      considerable number preference, particularly at 6-monthly intervals. This paper
      presents a technique for smoothing such amenorrhoea data using a modified
      exponential curve. An attempt has also been made to estimate the average number
      of months a mother is expected to remain amenorrhoeic.

PMID- 1737812
TI  - Birth order and health status in a British national sample.

PMID- 1737813
TI  - Lactation, nutrition and fertility and the secretion of prolactin and
      gonadotrophins in Mopan Mayan women.
AB  - The effect of lactation on menstrual cycles, ovulation and conception was studied
      in a group of non-contracepting Amerindian Mopan Mayan women. Anthropological
      observations of relevant events were made over a 21-month period. Blood samples
      were assayed to determine the plasma concentrations of prolactin, luteinising
      hormone, follicle stimulating hormone, human chorionic gonadotrophin, placental
      lactogen, oestrogen, progesterone and cortisol. The data show that: frequent and
      prolonged breast-feeding was associated with a marked increase in plasma
      prolactin concentrations to levels similar to those in lactating Gaing but higher
      than those in lactating Scottish women; ovulatory menstrual cycles and pregnancy
      occurred during frequent lactation; in lactating menstruating women there was an
      inverse correlation between fat weight and months post-partum. These data suggest
      that other factors as well as suckling account for the effects of lactation on
      fecundity.

PMID- 1737814
TI  - Breast-feeding in London, 1905-19.
AB  - Medical Officer of Health reports for London boroughs, 1900-19, are analysed to
      determine the incidence of neonatal breast-feeding, duration of lactation,
      reasons for early supplementation and premature weaning, and their relationship
      with infant mortality. In a sample of 222,989 infants, breast-feeding rates were
      very high. Over 90% were breast-fed in the first month, almost 80% at 3 months,
      and over 70% at 6 months. The poorest boroughs had the highest rates of neonatal
      breast-feeding, but also a higher incidence of early supplementation and
      premature weaning. There was a significant positive correlation between breast
      feeding and infant mortality due to poor maternal diet and health, poor
      nutritional quality of supplementary and substitute foods, and the use of an
      unhygienic feeding bottle. Energetic campaigns to counteract these problems
      probably contributed to the fall of infant mortality in this period.

PMID- 1737815
TI  - Seasonal patterns of spontaneous abortion.
AB  - The presence of a seasonal pattern of spontaneous abortion in the United States
      was found using data from the two most recent cycles of the National Survey of
      Family Growth (USA). The pattern was bimodal with peaks in March and August.

PMID- 1737816
TI  - Response reliability of demographic data: a longitudinal study in Sri Lanka.
AB  - Response consistency was examined by linking the records of women interviewed in
      the 1982 Sri Lanka Contraceptive Prevalence Survey with records from the same
      individuals followed up 3 years later. Seventy-eight percent of women reported
      identical year of birth in the two surveys, but only 58% were consistent for age
      at marriage. Data on sterilisation and number of children born were highly
      reliable, but wives' reports on husband's age and education were relatively weak.
      Multivariate analysis of the effects of socioeconomic factors on consistency in
      age reporting confirms that education is the most influential factor related to
      consistency, followed by religion and husband's occupation.

PMID- 1737817
TI  - Correlation between subsequent lengths of postpartum amenorrhoea in a prospective
      study of breast-feeding women in rural Bangladesh.
AB  - The relationship between subsequent lengths of lactational amenorrhoea for
      individual women in a prospective study of breast-feeding women in Bangladesh was
      studied. The data indicate that previous length of amenorrhoea has significant
      predictive value for the subsequent length of amenorrhoea. Information on
      previous experience with lactational amenorrhoea should be therefore incorporated
      into guidelines for the introduction of family planning during lactation.

PMID- 1737818
TI  - Effect of son mortality on contraceptive practice in Bangladesh.
AB  - This study based on the 1975-76 Bangladesh Fertility Survey showed that the
      mortality of sons, and not daughters, was associated with a lower rate of female
      contraceptive initiation of use and a higher rate of discontinuation.

PMID- 1737819
TI  - Fertility and suicide rates: a time series analysis in the United States.
AB  - In a time series study of the USA from 1933 to 1984, fertility rates were
      associated with the suicide rates of those aged 15-44. The higher the fertility
      rate the lower the suicide rate for these age groups, for both whites and non
      whites, and for both men and women. The results were seen as supporting
      Durkheim's theory of suicide.

PMID- 1737820
TI  - Turning bad luck into good. The alchemy of Willem Kolff, the first successful
      artificial kidney, and the artificial heart.

PMID- 1737821
TI  - Starch strikes back.

PMID- 1737822
TI  - A patient who got darker on zidovudine therapy.

PMID- 1737823
TI  - Management of aortic dissection after coronary artery bypass.

PMID- 1737824
TI  - Pain and lumps in the female breast.

PMID- 1737825
TI  - In the best interests of Helga Wanglie.

PMID- 1737826
TI  - Squamous cell carcinoma of the skin.

PMID- 1737827
TI  - Psychosexual disorders in children and adolescents.

PMID- 1737828
TI  - The sexual abuse of male children and adolescents: a review of current research.
AB  - Inevitably, in a wide ranging review, there will be some important omissions. The
      main difficulties in assessing the available information have been the lack, in
      so many studies, of analysis along gender lines, the lack of control groups, and,
      in many instances, too small sample size. Despite these limitations there has,
      over the past decade, been an upsurge of interest in and awareness of the
      significance of the sexual abuse of boys. It permits us to identify a number of
      important trends and to draw certain conclusions. Firstly, the scale of the
      sexual abuse of boys is much greater than was believed 10 years ago. There is no
      reason to think this is simply an artifact of definition, or information
      gathering, or indeed of an increased willingness to recognize abusive behaviour
      between children, even though these will all have an effect. Whilst the trend is
      clear, the actual prevalence rate is difficult to determine, with a reported
      range of between 3% and 31%. A current 'best guess' suggests contact abuse in the
      range of 2-5% in the male population. As each study controls for its own
      definition of abuse, the narrowing in the ratio of boys to girls abused can be
      accepted as quite reliable, and additional evidence of a delayed recognition
      effect. Retrospective community evidence shows 1 boy is abused for every 2-4
      girls abused. In contrast, the highest clinical ratios are for 1 boy to every 4
      girls. Those who work with runaways, male child prostitutes, or child and
      adolescent psychiatric inpatient units appear particularly likely to encounter
      abused boys. Secondly, a variety of explanations have been advanced to explain
      the apparent under-reporting or under-detection of the sexual abuse of boys.
      Prominent among them have been the boy's fears of disbelief and of being labelled
      homosexual. Police patterns of reporting extra-familial abuse may mask its extent
      from protection or health agencies, which is important because extra-familial
      abuse does appear to be more common in boys, especially older boys, than girls.
      Although there has been some diminution of the cultural denial that girls can be
      abused, a parallel decrease of denial regarding boys has lagged behind. This is
      particularly true of father-son and of the much less common mother-son abuse. It
      is plausible that certain 'alertors' are more relevant for boys. The recent
      development of aggressive behaviour, homophobic anxiety, co-abuse of a sibling
      and abusing behaviour in particular deserve consideration.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1737829
TI  - Childhood temperament.

PMID- 1737830
TI  - Early-onset anorexia nervosa and related eating disorders.

PMID- 1737831
TI  - The underlying nature of specific language impairment.

PMID- 1737832
TI  - Autoimmune anti-HIV-1gp120 antibody with antiidiotype-like activity in sera and
      immune complexes of HIV-1-related immunologic thrombocytopenia.
AB  - Autoimmune antiidiotype-like antibody (Ab2) directed against anti-HIV-1gp120
      (Ab1) was found in high titer in the sera of 10 consecutive homosexual and 11
      narcotic addict HIV-1-related immunologic thrombocytopenia (HIV-1-ITP) patients,
      was barely detectable in 10 nonthrombocytopenic HIV-1 sero-positive individuals,
      and was not detectable in 5 normal subjects by use of a solid-phase RIA.
      Reactivity of autologous Ab2 for Ab1 was 4-120-fold greater than Ab2 for
      homologous Ab1. Affinity-purified Ab2 did not block the binding of affinity
      purified Ab1 to its HIV-1gp120 epitopes on immunoblot, indicating the absence of
      "internal image" antiidiotype. Both Ab1 and Ab2 are precipitable from sera with
      polyethylene glycol (PEG) and present in a macromolecular complex that is
      excluded by gel filtration on G200 and contains IgG, IgM, C3, and the anti
      F(ab')2 antiidiotype-like complex. PEG-precipitable complexes bind to platelets
      in a saturation-dependent manner. Neither affinity-purified Ab1 nor Ab2 binds to
      platelets. However, the combination of Ab1 and Ab2 (preincubated for 2 h at 22
      degrees C) binds to platelets in a saturation-dependent manner at an optimum
      ratio range of 10-20:1. Ab2 reactivity correlates with serum PEG-precipitable
      immune complex level (r = 0.91; P less than 0.001) and with thrombocytopenia (r =
      0.89; P less than 0.001). We suggest that the anti-HIV-1gp120 antiidiotype-like
      complex contributes to the markedly elevated platelet Ig and C3 level of HIV-1
      ITP patients and propose that this may contribute to their thrombocytopenia.

PMID- 1737833
TI  - Lipoprotein lipase increases low density lipoprotein retention by subendothelial
      cell matrix.
AB  - Lipoprotein lipase (LPL), the rate-limiting enzyme for hydrolysis of plasma
      lipoprotein triglycerides, is a normal constituent of the arterial wall. We
      explored whether LPL affects (a) lipoprotein transport across bovine aortic
      endothelial cells or (b) lipoprotein binding to subendothelial cell matrix
      (retention). When bovine milk LPL was added to endothelial cell monolayers before
      addition of 125I-labeled LDL, LDL transport across the monolayers was unchanged;
      but, at all concentrations of LDL tested (1-100 micrograms), LDL retention by the
      monolayers increased more than fourfold. 125I-labeled LDL binding to
      extracellular matrix increased when LPL was added directly to the matrix or was
      added to the basolateral side of the endothelial cell monolayers. Increased LDL
      binding required the presence of LPL and was not associated with LDL aggregation.
      LPL also increased VLDL, but not HDL, retention. Monoclonal anti-LPL IgG
      decreased both VLDL and LDL retention in the presence of LPL. Lipoprotein
      transport across the monolayers increased during hydrolysis of VLDL triglyceride
      (TG). In the presence of LPL and VLDL, VLDL transport across the monolayers
      increased 18% and LDL transport increased 37%. High molar concentrations of oleic
      acid to bovine serum albumin (3:1) in the medium increased VLDL transport
      approximately 30%. LDL transport increased 42% when oleic acid was added to the
      media. Therefore, LPL primarily increased retention of LDL and VLDL. A less
      remarkable increase in lipoprotein transport was found during hydrolysis of TG
      containing lipoproteins. We hypothesize that LPL-mediated VLDL and LDL retention
      within the arterial wall potentiates conversion of these lipoproteins to more
      atherogenic forms.

PMID- 1737834
TI  - Feedback inhibition of insulin gene expression by insulin.
AB  - To examine the possible involvement of insulin and glucose in regulation of
      pancreatic islet gene expression, hyperinsulinemic (insulin infusion 4.1 mU/kg
      per min) clamps were performed for 12 h in rats at two different levels of
      glycemia (either 3 or 8 mM). A control group received a saline infusion for 12 h.
      At the end of the 12-h study period, pancreatic RNA was extracted, proinsulin and
      amylin mRNAs were measured on total RNA, and glucokinase and glucose transporter
      (GLUT-2) mRNAs were measured on poly(A)+ RNA by dot blot analysis. In insulin
      infused hypoglycemic rats, there was a 58% decrement in proinsulin mRNA (P less
      than 0.01) relative to levels in controls, with no change in amylin, glucokinase,
      or islet GLUT-2 mRNAs. In insulin-infused hyperglycemic rats, there was a
      comparable decrement (44%, P less than 0.01) in proinsulin mRNA and a smaller
      decrement in GLUT-2 mRNA (32%, P less than 0.05), with no change in amylin or
      glucokinase mRNAs relative to levels in control animals. These studies suggest
      that insulin has a negative feedback inhibitory effect on its own synthesis. The
      mechanism of inhibition is unknown. It could be a direct effect of insulin on its
      own transcription, or alternatively an indirect effect mediated by humoral or
      neural factors. Sustained hyperinsulinemia may lead to suppression of normal
      islet beta cells and may contribute to the ultimate hypoinsulinemia of noninsulin
      dependent diabetes mellitus.

PMID- 1737835
TI  - Noradrenergic inhibition of canine gallbladder contraction and murine pancreatic
      secretion during stress by corticotropin-releasing factor.
AB  - Gastrointestinal secretory and motor responses are profoundly altered during
      stress; but the effects of stress and its mediator(s) on the two major gut
      functions, exocrine pancreatic secretion and gallbladder motility, are unknown.
      We therefore developed two animal models that allowed us to examine the effects
      of acoustic stress on canine gallbladder contraction and restraint stress on rat
      exocrine pancreatic secretion. Acoustic stress inhibited cholecystokinin-8 (CCK)-
      and meal-induced gallbladder contraction, and restraint stress inhibited basal
      and CCK/secretin-stimulated pancreatic secretion. These inhibitory responses were
      mimicked by cerebral injection of corticotropin-releasing factor (CRF) and
      abolished by the CRF antagonist, alpha-helical CRF-(9-41). The effects of stress
      and exogenous CRF were simulated by intravenous infusion of norepinephrine but
      prevented by ganglionic, noradrenergic, and alpha-adrenergic but not beta
      adrenergic receptor blockade. Vagotomy, adrenalectomy, and--in rats-
      hypophysectomy did not alter the effects produced by stress and CRF. These
      results indicate that endogenous CRF released in response to different stressors
      in distinct species inhibits canine gallbladder contraction and murine exocrine
      pancreatic secretion via activation of sympathetic efferents. Release of
      norepinephrine appears to be the final common pathway producing inhibition of
      biliary and pancreatic digestive function during stress mediated by cerebral CRF.

PMID- 1737836
TI  - Diagnostic value of a synthetic peptide derived from Echinococcus granulosus
      recombinant protein.
AB  - A specific monoclonal antibody (MAb; EG 02 154/12) directed against a protein
      epitope of Echinococcus granulosus antigen 5 was used to screen a cDNA library
      constructed from E. granulosus protoscoleces RNA. One clone designated Eg14 was
      selected and shown to code for an amino acid sequence partially homologous to
      that of the clone Eg6 previously identified with the same MAb. Hydrophobic
      cluster analysis showed that both recombinant antigens may adopt a similar alpha
      helical organization and share a common conformational epitope. A synthetic
      peptide (89-122) mimicking the conformational site of Eg6 and Eg14 was
      constructed and demonstrated to be able to inhibit binding of the MAb and human
      hydatid sera to the Eg6 fusion protein (FP6) or to native hydatid antigens. To
      assess the diagnostic value of the peptide 89-122, we tested sera from patients
      infected with different parasites for their antibody reactivity with this peptide
      in ELISA. A high binding sensitivity and specificity of IgG-A-M antibodies were
      obtained with E. granulosus-infected patient sera. Moreover, the peptide 89-122
      was found to be specifically recognized by IgE antibodies from patients with
      hydatid disease. These results indicate the particular interest of this synthetic
      peptide as a standardized antigen in diagnosis and treatment surveillance of
      hydatidosis.

PMID- 1737837
TI  - Molecular basis of lactase levels in adult humans.
AB  - The molecular basis of adult human "lactase deficiency" has long been a subject
      of controversy. To address this issue, small intestinal biopsies from orienta,
      black, and white patients were analyzed. Adjacent samples were assayed for
      lactase and sucrase specific activities and the sucrase/lactase ratio (high ratio
      signifies lactase deficiency), and the results were compared to lactase steady
      state mRNA levels detected in Northern blots probed with a human lactase mDNA.
      All oriental patients had high ratios and no detectable lactase mRNA. Four black
      patients had a similar pattern; two with low ratios had detectable mRNA. The
      group of white patients displayed a range of findings, from high ratio/no mRNA to
      low ratio/considerable mRNA. Elevated levels of lactase mRNA always correlated
      with the presence of elevated levels of lactase enzyme activity, suggesting that
      the difference in levels of adult human intestinal lactase activity among racial
      groups may be regulated at the level of gene transcription.

PMID- 1737838
TI  - Fibroblasts modulate intestinal secretory responses to inflammatory mediators.
AB  - Cultured colonic epithelial cells and fibroblasts were used to examine the
      interaction between these cell types during intestinal secretion. Secretory
      responses of T84 colonic epithelial cells, measured as changes in the short
      circuit current in modified Ussing chambers to bradykinin, serotonin, hydrogen
      peroxide, and histamine, were enhanced in the presence of fibroblasts, either in
      cocultures or when separate cultures of fibroblasts were acutely juxtaposed with
      the T84 cultures. This effect was abolished by pretreatment with indomethacin and
      the fibroblasts were found to release prostaglandin E2 in response to these
      inflammatory mediators. Fibroblasts may exert a paracrine regulation on the
      secretory response of intestinal epithelial cells via the generation and release
      of cyclooxygenase products in response to inflammatory mediators. These studies
      suggest a novel function for the intestinal fibroblastic sheath: that of
      amplification of the inflammatory response through mesenchymal/epithelial
      interaction.

PMID- 1737839
TI  - Exacerbation of ischemic dysfunction by angiotensin II in red cell-perfused
      rabbit hearts. Effects on coronary flow, contractility, and high-energy phosphate
      metabolism.
AB  - We studied the effects of angiotensin II during low-flow ischemia and reperfusion
      using red cell-perfused isovolumic rabbit hearts. Under baseline conditions where
      coronary perfusion pressure (CPP) was 100 mm Hg and left ventricular end
      diastolic pressure (LVEDP) was set at 10 mm Hg, 10(-8) M angiotensin II caused a
      mild increase in LV developed pressure (+12%) and decrease in coronary flow (
      8%). Low-flow ischemia was imposed by reducing CPP to 15 mm Hg for 30 min
      followed by 30 min of reperfusion. During ischemia, the angiotensin II group
      showed a gradual further reduction in coronary flow in association with a greater
      depression of LV developed pressure and increase in LVEDP relative to the no-drug
      group. To separate the effect of angiotensin II on coronary flow from a direct
      myocardial effect, the angiotensin II group was compared with an additional no
      drug group with a matched progressive reduction in coronary flow during ischemia.
      In these groups, the ischemic depression of LV developed pressure, myocardial ATP
      levels, and lactate production were similar. However, the ischemic rise in LVEDP
      was greater (42.0 +/- 5.4 vs. 19.9 +/- 1.3 mm Hg, P less than 0.01) and recovery
      was incomplete in the angiotensin II group. These observations suggest that
      angiotensin II exerts a direct adverse effect on LV diastolic relaxation during
      low-flow ischemia and recovery.

PMID- 1737840
TI  - Two different allelic mutations in the lecithin-cholesterol acyltransferase gene
      associated with the fish eye syndrome. Lecithin-cholesterol acyltransferase
      (Thr123----Ile) and lecithin-cholesterol acyltransferase (Thr347----Met).
AB  - We have elucidated the genetic defect in a 66-yr-old patient with fish eye
      syndrome (FES) presenting with severe corneal opacities and
      hypoalphalipoproteinemia. The patient's plasma concentration of high density
      lipoprotein (HDL) cholesterol was reduced at 7.7 mg/dl (35.1-65.3 mg/dl in
      controls) and the HDL cholesteryl ester content was 31% (60-80% in controls);
      however, total plasma cholesteryl esters were similar to normal (60% of total
      cholesterol vs. a mean of 66% in controls). The patient's plasma cholesterol
      esterification rate was slightly reduced at 51 nmol/ml per h (control subjects:
      61-106 nmol/ml per h), whereas lecithin-cholesterol acyltransferase (LCAT)
      activity, assayed using a HDL-like exogenous proteoliposome substrate, was
      virtually absent (0.9 nmol/ml per h vs. 25.1-27.9 nmol/ml per h in control
      subjects). DNA sequence analysis of the proband's LCAT gene revealed two separate
      C to T transitions resulting in the substitution of Thr123 with Ile and Thr347
      with Met. The mutation at codon 347 created a new restriction site for the enzyme
      Nla III. Analysis of the patient's polymerase chain reaction-amplified DNA
      containing the region of the Thr347 mutation by digestion with Nla III confirmed
      that the proband is a compound heterozygote for both defects. The patient's
      daughter, who is asymptomatic despite a 50% reduction of LCAT activity, is
      heterozygous for the Thr123----Ile mutation. Our data indicate that the regions
      adjacent to Thr123 and Thr347 of LCAT may play an important role in HDL
      cholesterol esterification, suggesting that these regions may contain a portion
      of the LCAT binding domain(s) for HDL.

PMID- 1737841
TI  - Prevention of diabetes in BB/Wor rats by intrathymic islet injection.
AB  - The objective of this study was to determine whether the intrathymic injection of
      islets can prevent the development of diabetes in BB/Wor rats. Evidence suggests
      that a failure to induce islet thymic tolerance may be an etiological factor in
      the development of the disease. It was theorized that the introduction of islets
      into the thymus might directly induce islet tolerance and thus prevent disease.
      Islets from diabetes-resistant BB/Wor rats were injected into the thymuses of 23
      young diabetes-prone BB/Wor rats; 25 sham-operated animals served as controls.
      Results showed that 22 of the 25 control rats became diabetic while only 8 of the
      23 experimental rats became diabetic (P less than 0.0002). The specific lysis of
      islet cells by spleen cells from nondiabetic experimental and control rats was
      comparable and less than the lysis induced by spleen cells from diabetic rats.
      These data demonstrate that the intrathymic injection of islets into diabetes
      prone BB/Wor rats is an effective method for preventing the development of
      autoimmune type I diabetes.

PMID- 1737842
TI  - Tubular antigen-binding proteins repress transcription of type IV collagen in the
      autoimmune target epithelium of experimental interstitial nephritis.
AB  - We have been studying immune interactions with somatic cells using a tubular
      antigen-binding protein (ThF) secreted by helper T lymphocytes harvested from
      mice that have an autoimmune form of interstitial nephritis called anti-tubular
      basement membrane disease. This ThF, although characterized originally because of
      its ability to induce effector T cells, additionally recognizes the nephritogenic
      3M-1 antigen expressed by its target renal tubular epithelium. We believe these
      proteins, in general, may modulate directly some homeostatic functions in organ
      derived cells, and now report that our ThF represses specifically the cellular
      transcription and secretion of basement membrane type IV collagen in tubular
      epithelium. These in vitro findings of reduced levels of mRNA encoding type IV
      collagen correlate well with in situ hybridization studies performed on kidneys
      expressing early autoimmune lesions, and predict a progressive drop in the
      expression of type IV collagen in the interstitium. Such a novel and unexpected
      repression of transcription of type IV collagen might easily impart or facilitate
      permanent change in the infrastructure of kidney architecture during autoimmune
      injury and, perhaps, contributes to the process of tubular atrophy attendant to
      prolonged renal inflammation.

PMID- 1737843
TI  - Regulation of intestinal lactase in adult hypolactasia.
AB  - Relative deficiency of intestinal lactase activity during adulthood, adult
      hypolactasia, is a common condition worldwide. We studied the regulation of
      lactase-phlorizin hydrolase in normal and adult hypolactasic subjects by
      correlating transcript abundance in intestinal biopsies with relative synthetic
      rates for the protein in cultured intestinal explants. After metabolic labelling
      studies in six subjects, precursor lactase-phlorizin hydrolase was identified in
      amounts directly proportional to the enzyme-specific activity suggesting that
      levels of intestinal lactase are regulated by synthetic rate. Total intestinal
      RNA was extracted from biopsies of these subjects and three hypolactasic adults
      who had participated in previous biosynthesis studies. Transcript levels were
      markedly reduced in deficient subjects who demonstrated diminished lactase
      phlorizin hydrolase synthesis. The sequence of 1 kb of 5'-flanking region of the
      lactase-phlorizin hydrolase gene was determined in two hypolactasic subjects and
      two controls. No sequence variability was identified to account for differences
      in mRNA levels or biosynthetic rates between the two groups. A single
      hypolactasic subject previously characterized as demonstrating delayed
      posttranslational processing, showed message levels intermediate between other
      deficients and controls. These results suggest that in the majority of our
      subjects, pretranslational mechanisms account for the predominate regulatory
      control of lactase-phlorizin hydrolase expression in the proximal intestine.

PMID- 1737844
TI  - Calcium and potassium are important regulators of barrier homeostasis in murine
      epidermis.
AB  - Topical solvent treatment removes lipids from the stratum corneum leading to a
      marked increase in transepidermal water loss (TEWL). This disturbance stimulates
      a variety of metabolic changes in the epidermis leading to rapid repair of the
      barrier defect. Using an immersion system we explored the nature of the signal
      leading to barrier repair in intact mice. Initial experiments using hypotonic to
      hypertonic solutions showed that water transit per se was not the crucial signal.
      However, addition of calcium at concentrations as low as 0.01 mM inhibited
      barrier repair. Moreover, both verapamil and nifedipine, which block calcium
      transport into cells, prevented the calcium-induced inhibition of TEWL recovery.
      Additionally, trifluoroperazine or N-6-aminohexyl-5-chloro-1
      naphthalenesulfonamide, which inhibit calmodulin, prevented the calcium-induced
      inhibition of TEWL recovery. Although these results suggest an important role for
      calcium in barrier homeostasis, calcium alone was only modestly effective in
      inhibiting TEWL recovery. Potassium alone (10 mM) and phosphate alone (5 mM) also
      produced a modest inhibition of barrier repair. Together, however, calcium and
      potassium produced a synergistic inhibition of barrier repair (control 50%
      recovery vs. calcium + potassium 0-11% recovery in 2.5 h). Furthermore, in
      addition to inhibiting TEWL recovery, calcium and potassium also prevented the
      characteristic increase in 3-hydroxy-3-glutaryl CoA reductase activity that
      occurs after barrier disruption. Finally, the return of lipids to the stratum
      corneum was also blocked by calcium and potassium. These results demonstrate that
      the repair of the epidermal permeability barrier after solvent disruption can be
      prevented by calcium, potassium, and phosphate. The repair process may be
      signalled by a decrease in the concentrations of these ions in the upper
      epidermis resulting from increased water flux leading to passive loss of these
      ions.

PMID- 1737845
TI  - Thromboerythrocytes. In vitro studies of a potential autologous, semi-artificial
      alternative to platelet transfusions.
AB  - In an attempt to overcome the limitations and drawbacks of using fresh platelets
      for transfusion therapy of thrombocytopenic patients, we have performed in vitro
      experiments on an autologous, semi-artificial alternative to platelet
      transfusions. Based on our previous studies of the interactions of unactivated
      and activated platelets with beads coated with peptides of various lengths, all
      of which contained the arginine-glycine-aspartic acid (RGD) cell recognition
      sequence, the peptide Ac-CGGRGDF-NH2 was chosen for covalent coupling to
      erythrocytes. A heterobifunctional crosslinking reagent (N-maleimido-6
      aminocaproyl ester of 1-hydroxy-2-nitrobenzene-4-sulfonic acid) was used to
      crosslink via the peptide's free sulfhydryl group and the erythrocyte's surface
      amino groups. Approximately 0.5-1.5 x 10(6) peptide molecules bound per
      erythrocyte after 2 h of incubation, and most of the peptides appeared to
      crosslink to glycophorin A. The resulting cells, termed thromboerythrocytes,
      interacted selectively with activated platelets to form mixed aggregates. Studies
      with fluid phase RGD peptides and monoclonal antibodies indicated that the RGD
      peptides on the thromboerythrocytes interacted with the GPIIb/IIIa receptors on
      activated platelets. Thromboerythrocytes could also bind to platelets adherent to
      collagen. There was minimal erythrocyte hemolysis during the formation of
      thromboerythrocytes and studies of thromboerythrocyte osmotic fragility and
      cellular deformability showed no significant changes from control erythrocytes.
      Whereas there is a 20:1 ratio of erythrocytes to platelets in the circulation of
      normal individuals, the erythrocytes from as little as 50 ml of blood could be
      transformed into the equivalent of 2 U of platelets by numbers (equivalent to 18
      U of platelets by mass), and reinfused into the same individual within several
      hours. These data encourage us to proceed to in vivo studies to assess the
      hemostatic efficacy of thromboerythrocytes in thrombocytopenic animals.

PMID- 1737846
TI  - Human immunodeficiency virus infection induces both polyclonal and virus-specific
      B cell activation.
AB  - Peripheral blood lymphocytes (PBL) were obtained from HIV-1-infected patients at
      different stages of disease. The absolute number of IgM-, IgG-, and IgA-producing
      lymphocytes per 10(6) PBL was increased 2.8-, 3.4-, and 1.9-fold, respectively,
      compared with normal controls. 2-17% of IgG-secreting patient cells reacted with
      the gp160 envelope glycoprotein of HIV-1 (a 737-fold increase over background),
      while 1-9% reacted with p24 (140-fold over background). In addition to this HIV
      specific B cell activation, the number of lymphocytes reactive with nonviral
      antigens such as DNA, myosin, actin, trinitrophenylated keyhole limpet
      hemocyanin, and ovalbumin was increased by a mean of 17.9-fold. Evidence suggests
      that the latter changes reflect an HIV-induced polyclonal B cell activation
      unrelated to the production of anti-HIV antibodies. For example, the proportion
      of IgG anti-gp160- and anti-p24-secreting lymphocytes declined in patients with
      advanced disease, whereas the number of B cells producing antibodies to non-HIV
      antigens rose. Moreover, CD4 cell count and T4/T8 ratio showed a significant
      inverse correlation with the degree of polyclonal activation but not with anti
      HIV responsiveness. These observations demonstrate that both quantitative and
      qualitative changes in B cell activation accompany (and may be predictive of)
      disease progression in HIV-infected individuals.

PMID- 1737847
TI  - An osteopenic nonfracture syndrome with features of mild osteogenesis imperfecta
      associated with the substitution of a cysteine for glycine at triple helix
      position 43 in the pro alpha 1(I) chain of type I collagen.
AB  - Mutations affecting the pro alpha 1(I) or pro alpha 2(I) collagen genes have been
      identified in each of the major clinical types of osteogenesis imperfecta. This
      study reports the presence of a heritable connective tissue disorder in a family
      with an osteopenic syndrome which has features of mild osteogenesis imperfecta
      but was considered idiopathic osteoporosis in the proband. At age 38, while still
      premenopausal, she was found to have osteopenia, short stature, hypermobile
      joints, mild hyperelastic skin, mild scoliosis, and blue sclerae. There was no
      history of vertebral or appendicular fracture. Hip and vertebral bone mineral
      density measurements were consistent with marked fracture risk. Delayed reduction
      SDS-PAGE of pepsin-digested collagens from dermal fibroblast cultures
      demonstrated an anomalous band migrating between alpha 1(I) and alpha 1(III).
      This band merged with the normal alpha-chains upon prereduction, indicating an
      unexpected cysteine residue. Cyanogen bromide peptide mapping suggested that the
      mutation was in the smaller NH2-terminal peptides. cDNA was reverse transcribed
      from mRNA and amplified by the polymerase chain reaction. A basepair mismatch
      between proband and control alpha 1(I) cDNA hybrids was detected by chemical
      cleavage with hydroxylamine:piperidine. The cysteine substitution was thus
      localized to alpha 1(I) exon 9 within the cyanogen bromide 4 peptide. Nucleotide
      sequence analysis localized a G----T point mutation in the first position of
      helical codon 43, replacing the expected glycine (GGT) residue with a cysteine
      (TGT). The prevalence of similar NH2-terminal mutations in subjects with this
      phenotype which clinically overlaps idiopathic osteoporosis remains to be
      determined.

PMID- 1737848
TI  - Molecular studies on primary lipoprotein lipase (LPL) deficiency. One base
      deletion (G916) in exon 5 of LPL gene causes no detectable LPL protein due to the
      absence of LPL mRNA transcript.
AB  - We have systematically investigated a genetic defect resulting in a primary
      lipoprotein lipase (LPL) deficiency in a proband TN and his affected brother SN,
      both manifesting familial hyperchylomicronemia. Neither LPL activity nor
      immunoreactive LPL mass was detected in postheparin plasma from the two patients.
      Immunocytochemical and biosynthetic studies on the proband's monocyte-derived
      macrophages with rabbit anti-human LPL antiserum revealed that no
      immunochemically detectable LPL protein was found in either the cells or culture
      medium, whereas LPL having a molecular mass of 61 kD was detected in normal
      cells. No detectable LPL mRNA was identified from poly(A)+RNA of the proband's
      macrophages by Northern blot analysis, and grossly visible LPL gene rearrangement
      was not observed by Southern blot analysis. Sequence analysis of polymerase chain
      reaction-amplified LPL gene exons detected one base deletion of G (first position
      of Ala221) at base 916 in exon 5 which leads to a premature termination by a
      frameshift. This mutation, designated as LPLArita and resulting in the loss of an
      AluI restriction enzyme site, was newly identified. We further analyzed the LPL
      gene from the two patients and their family members by digestion with AluI. Both
      patients were homozygous for LPLArita allele, while their spouses did not have
      this mutation. As genetically expected, their children were all heterozygous for
      LPLArita. We conclude that primary LPL deficiency in the proband was caused by a
      lack of enzyme synthesis due to the absence of LPL mRNA resulting from one base
      deletion of G in exon 5, and that heterozygous LPLArita deficient subjects show
      almost half value of control LPL mass.

PMID- 1737849
TI  - Molecular cloning of the human Goodpasture antigen demonstrates it to be the
      alpha 3 chain of type IV collagen.
AB  - To characterize the autoantigen of Goodpasture's (anti-glomerular basement
      membrane) disease, a molecule of 26-kD reactive with autoantibodies from
      patients' sera was purified from collagenase digests of sheep glomerular basement
      membrane. Short internal amino acid sequences were obtained after tryptic or
      cyanogen bromide cleavage, and used to deduce redundant oligonucleotides for use
      in the polymerase chain reaction on cDNA derived from sheep renal cortex.
      Molecules of 175 bp were amplified and found to come from two cDNA sequences. One
      was identical to that of a type IV collagen chain (alpha 5) cloned from human
      placenta and shown to be expressed in human kidney. The other was from a type IV
      collagen chain with close similarities to alpha 1 and alpha 5 chains, and was
      used to obtain human cDNA sequences by cDNA library screening and by further
      polymerase chain reaction amplifications. The correspondence of the derived amino
      acid sequence of the new chain with published protein and cDNA sequences shows it
      to be the alpha 3 chain of type IV collagen. Its gene, COL4A3, maps to 2q36-2q37.
      The primary sequence and other characteristics of this chain confirm that it
      carries the Goodpasture antigen.

PMID- 1737850
TI  - Defective insulin response of phosphorylase phosphatase in insulin-resistant
      humans.
AB  - Insulin-stimulated glycogen synthase activity in human muscle is reduced in
      insulin-resistant subjects. Insulin regulation of human muscle glycogen synthase
      may require activation of a type-1 protein phosphatase (PP-1). We investigated
      the change of phosphorylase phosphatase and glycogen synthase activities in
      muscle biopsies obtained during a 2-h hyperinsulinemic euglycemic clamp in 12
      insulin-sensitive (group S) and 8 insulin-resistant (group R) subjects. Fasting
      phosphorylase phosphatase activity was lower in group R than in group S, and did
      not increase significantly with insulin infusion in group R until 20 min. In
      group S, phosphorylase phosphatase was significantly stimulated by 10 min,
      remaining significantly higher than in group R at all time points. The insulin
      mediated changes in phosphatase activities were not decreased by 3 nM okadaic
      acid but were completely inhibited by 1 microM okadaic acid, thereby verifying
      that insulin-stimulated phosphorylase phosphatase is accounted for by a PP-1.
      Subcellular fractionation demonstrated reduced fasting PP-1 activities in both
      the glycogen and cytosolic fractions of muscle obtained from subjects in group R
      compared to those in group S. These results suggest that insulin activation of PP
      1 could contribute to the stimulation of glycogen synthase by this hormone in
      human muscle. Lower fasting PP-1 activity in cytosol and glycogen fractions plus
      lower insulin-stimulated PP-1 activity could explain, in part, reduced insulin
      stimulated glycogen synthase in skeletal muscle of insulin-resistant subjects.

PMID- 1737851
TI  - Pathobiology of cast nephropathy from human Bence Jones proteins.
AB  - Renal failure is a common accompaniment of multiple myeloma and is usually due to
      cast nephropathy, or "myeloma kidney." To understand this lesion, four human
      Bence Jones proteins (BJP) were purified from the urine of volunteers who had
      either no evidence of renal dysfunction (BJP1) or renal failure from cast
      nephropathy (BJP2, BJP3, BJP4). When infused directly into the rat nephron in
      vivo, BJP2, BJP3, and BJP4 produced intraluminal obstruction by precipitating in
      the distal nephron; protein casts were never identified before the tip of the
      loop of Henle. Obstruction was related to the concentration of BJP in the
      perfusate. Addition of furosemide to the perfusate augmented obstruction in a
      concentration-dependent fashion. Pretreatment of rats with colchicine completely
      prevented obstruction and cast formation of perfused nephrons; beta
      lumicolchicine did not prevent obstruction. Tamm-Horsfall glycoprotein purified
      from beta-lumicolchicine-treated and untreated rats coaggregated with BJP3 in
      vitro. Tamm-Horsfall glycoprotein from colchicine-treated rats did not contain
      sialic acid and did not aggregate with BJP3 in vitro. Thus, cast-forming human
      BJP coaggregated with Tamm-Horsfall glycoprotein and obstructed the rat distal
      nephron. Intranephronal obstruction was aggravated by decreasing extracellular
      fluid volume or adding furosemide. Finally, by decreasing secretion and altering
      the carbohydrate moiety of Tamm-Horsfall glycoprotein, colchicine prevented
      intraluminal cast formation and obstruction of the rat nephron.

PMID- 1737852
TI  - Hereditary and acquired p53 gene mutations in childhood acute lymphoblastic
      leukemia.
AB  - The p53 gene was examined in primary lymphoblasts of 25 pediatric patients with
      acute lymphoblastic leukemia by the RNase protection assay and by single strand
      conformation polymorphism analysis in 23 of 25 cases. p53 mutations were found to
      occur, but at a low frequency (4 of 25). While all four mutations were identified
      by single strand conformation polymorphism, the comparative sensitivity of RNase
      protection was 50% (2 of 4). Heterozygosity was retained at mutated codons in 3
      of 4 cases. One pedigree was consistent with the Li-Fraumeni syndrome, and bone
      marrow from both diagnosis and remission indicated a germline G to T transversion
      at codon 272 (valine to leucine). Although members of another family were
      affected with leukemia, a 2-bp deletion in exon 6 was nonhereditary. The other
      two nonhereditary p53 mutations included a T to G transversion at codon 270
      (phenylalanine to cysteine) and a G to C transversion at codon 248 (arginine to
      proline). These data support the role of both hereditary and acquired p53
      mutations in the pathogenesis and/or progression of some cases of childhood acute
      lymphoblastic leukemia.

PMID- 1737853
TI  - Binding of nonmucoid Pseudomonas aeruginosa to normal human intestinal mucin and
      respiratory mucin from patients with cystic fibrosis.
AB  - Lung infections due to Pseudomonas aeruginosa and Pseudomonas cepacia are common
      in patients with cystic fibrosis. Initial colonization is due to nonmucoid P.
      aeruginosa, while later mucoid variants emerge and are associated with chronic
      infection. P. cepacia colonization tends to be more prevalent in older patients.
      The present study was conducted to discover whether highly purified mucins (from
      cystic fibrosis sputum and control intestinal secretions) exhibited specific
      binding of nonmucoid P. aeruginosa. In vitro solid phase microtiter binding
      assays (with or without a blocking agent) as well as solution phase assays were
      conducted. Bacteria bound to both mucins via bacterial pili, but no differences
      in binding capacity were noted between the mucins. Unlike P. cepacia (described
      in the accompanying manuscript) there was also no preferential binding of P.
      aeruginosa to mucins versus bovine serum albumin, casein, gelatin, or a host of
      structurally unrelated proteins and glycoproteins. Carbohydrate hapten inhibition
      studies did not suggest the existence of specific mucin carbohydrate receptors
      for P. aeruginosa. In solid phase assays a low concentration (0.05 M) of
      tetramethylurea abolished P. aeruginosa bacterial binding to both mucins as well
      as to BSA, whereas in solution phase assays mucin binding to bacteria was not
      completely disrupted by tetramethylurea. Specific monoclonal antipilus antibodies
      did not inhibit binding to a greater extent than did Fab fragments of normal
      mouse IgG. Binding of strains PAO1 and PAK (and isolated PAK pili) to buccal
      epithelial cells was not influenced by the presence of mucin in binding assay
      mixtures. Our findings do not support the widely held notion that specific mucin
      receptors are responsible for the attachment of P. aeruginosa pili, nor do they
      support the idea that there is a competitive interference by mucins of bacterial
      binding to respiratory cells. In patients with cystic fibrosis, it would seem
      unlikely therefore that initial colonization of the lungs by P. aeruginosa is due
      to a 'selective tropism' of these bacteria for respiratory mucin.

PMID- 1737854
TI  - Recovery of energy metabolism in rat brain after carbon monoxide hypoxia.
AB  - Carbon monoxide (CO) may inhibit mitochondrial electron transport in the brain
      and increase the toxic effects of the gas. This hypothesis was investigated in
      anesthetized rats during CO exposure and recovery at either normobaric or
      hyperbaric O2 concentrations. During exposure and recovery, we measured the
      oxidation level of cerebrocortical cytochrome c oxidase by differential
      spectroscopy and biochemical metabolites known to reflect aerobic energy
      provision in the brain. CO exposure (HbCO = 71 +/- 1%) significantly decreased
      blood pressure and cytochrome oxidation level. Cerebral ATP was maintained while
      lactate/pyruvate, glucose, and succinate rose, and phosphocreatine (PCr) fell,
      relative to control (P less than 0.05). Intracellular pH (pHi) calculated from
      the PCr equilibrium also declined during the exposures. During recovery, HbCO
      fell more rapidly at hyperbaric than at normobaric O2 levels, but returned to 10%
      or less in both groups by 45 min. Cytochrome oxidation state improved to 80% of
      control after 90 min at normobaric O2, but recovered completely after hyperbaric
      O2 (P less than 0.05). In normobaric O2, PCr and pHi continued to fall for 45 min
      after CO exposure and did not recover completely by 90 min. PCr and pHi in
      animals after hyperbaric O2 improved within 45 min, but also remained below
      control at 90 min. These data indicate that intracellular uptake of CO can impair
      cerebral energy metabolism, despite the elimination of HbCO from the blood.

PMID- 1737855
TI  - Molecular basis for membrane rigidity of hereditary ovalocytosis. A novel
      mechanism involving the cytoplasmic domain of band 3.
AB  - Hereditary ovalocytic red cells are characterized by a marked increase in
      membrane rigidity and resistance to invasion by malarial parasites. The
      underlying molecular defect in ovalocytes remained a mystery until Liu and
      colleagues (N. Engl. J. Med. 1990. 323:1530-38) made the surprising observation
      that the ovalocytic phenotype was linked to a structural polymorphism in band 3,
      the anion transporter. We have now defined the mutation in band 3 gene and
      established the biophysical sequelae of this mutation. This mutation involves the
      deletion of amino-acids 400-408 in the boundary between the cytoplasmic and the
      first transmembrane domains of band 3. The biophysical consequences of this
      mutation are a marked decrease in lateral mobility of band 3 and an increase in
      membrane rigidity. Based on these findings, we propose the following model for
      increased membrane rigidity. The mutation induces a conformational change in the
      cytoplasmic domain of band 3, leading to its entanglement in the skeletal protein
      network. This entanglement inhibits the normal unwinding and stretching of the
      spectrin tetramers necessary for membrane extension, leading to increased
      rigidity. These findings imply that the cytoplasmic domain of an integral
      membrane protein can have profound effects on membrane material behavior.

PMID- 1737856
TI  - Congenital erythropoietic porphyria: identification and expression of exonic
      mutations in the uroporphyrinogen III synthase gene.
AB  - Congenital erythropoietic porphyria (CEP), an inborn error of heme biosynthesis,
      results from the deficient activity of uroporphyrinogen III synthase (URO
      synthase). This autosomal recessive disorder is heterogeneous; patients with
      severe disease are often transfusion dependent, while milder patients primarily
      have cutaneous involvement. To investigate this phenotypic heterogeneity, exonic
      point mutations in the URO-synthase gene were identified in unrelated CEP
      patients. Four missense mutations were identified: (a) an A to G transition of
      nucleotide (nt) 184 that predicted a Thr to Ala substitution at residue 62
      (designated T62A); (b) a C to T transition of nt 197 that encoded an Ala to Val
      replacement at residue 66 (A66V); (c) a T to C transition of nt 217 that
      predicted a Cys to Arg substitution at residue 73 (C73R); and (d) a C to T
      transition of nt 683 that resulted in a Thr to Met replacement at residue 228
      (T228M). In addition, a G to A transition of nt 27 that did not change the
      encoded amino acid (A9A) was detected in an African patient. The T62A, C73R, and
      T228M alleles did not express detectable enzymatic activity, while the A66V
      allele expressed residual, but unstable activity. The C73R allele was present in
      eight of 21 unrelated CEP patients (21% of CEP alleles). In three patients,
      identification of both alleles permitted genotype-phenotype correlations; the
      A66V/C73R, T228M/C73R, and C73R/C73R genotypes had mild, moderately severe, and
      severe disease, respectively. These findings provide the first genotype-phenotype
      correlations and permit molecular heterozygote detection in this inherited
      porphyria.

PMID- 1737857
TI  - Restoration of insulin responsiveness in skeletal muscle of morbidly obese
      patients after weight loss. Effect on muscle glucose transport and glucose
      transporter GLUT4.
AB  - A major defect contributing to impaired insulin action in human obesity is
      reduced glucose transport activity in skeletal muscle. This study was designed to
      determine whether the improvement in whole body glucose disposal associated with
      weight reduction is related to a change in skeletal muscle glucose transport
      activity and levels of the glucose transporter protein GLUT4. Seven morbidly
      obese (body mass index = 45.8 +/- 2.5, mean +/- SE) patients, including four with
      non-insulin-dependent diabetes mellitus (NIDDM), underwent gastric bypass surgery
      for treatment of their obesity. In vivo glucose disposal during a euglycemic
      clamp at an insulin infusion rate of 40 mU/m2 per min was reduced to 27% of
      nonobese controls (P less than 0.01) and improved to 78% of normal after weight
      loss of 43.1 +/- 3.1 kg (P less than 0.01). Maximal insulin-stimulated glucose
      transport activity in incubated muscle fibers was reduced by approximately 50% in
      obese patients at the time of gastric bypass surgery but increased twofold (P
      less than 0.01) to 88% of normal in five separate patients after similar weight
      reduction. Muscle biopsies obtained from vastus lateralis before and after weight
      loss revealed no significant change in levels of GLUT4 glucose transporter
      protein. These data demonstrate conclusively that insulin resistance in skeletal
      muscle of mobidly obese patients with and without NIDDM cannot be causally
      related to the cellular content of GLUT4 protein. The results further suggest
      that morbid obesity contributes to whole body insulin resistance through a
      reversible defect in skeletal muscle glucose transport activity. The mechanism
      for this improvement may involve enhanced transporter translocation and/or
      activation.

PMID- 1737858
TI  - Apolipoprotein E prevents the progression of atherosclerosis in Watanabe
      heritable hyperlipidemic rabbits.
AB  - Apo E plays an important role in plasma lipoprotein metabolism through its high
      affinity binding to cell surface LDL receptor. In the present study, we studied
      the effects of apo E on the atherogenic process in Watanabe heritable
      hyperlipidemic rabbits which are deficient in LDL receptor and an animal model
      for familial hypercholesterolemia. We isolated apo E from plasma of 1%
      cholesterol-fed rabbits and administered 10 mg of purified apo E intravenously
      into five Watanabe heritable hyperlipidemic rabbits three times a week from their
      age of 2.5 months to 11 months for 8.5 months. After sustained administration to
      apo E, we found a significant reduction in the accumulation of cholesterol ester
      in aortae (1.55 +/- 0.07 mg/g tissue) as compared to control rabbits (4.32 +/-
      0.61 mg/g tissue). Supporting this, the percentage of the surface area of the
      aorta with macroscopic plaque was remarkably decreased in apo E-treated animals
      (18.8 +/- 5.1% vs. 38.8 +/- 8.0% in control). Thus, apo E definitely prevented
      the progression of atherosclerosis in Watanabe heritable hyperlipidemic rabbits.

PMID- 1737860
TI  - Retraction.

PMID- 1737859
TI  - Are cysteine-rich and COOH-terminal domains of dystrophin critical for
      sarcolemmal localization?
AB  - It has been hypothesized that the tight localization of dystrophin at the muscle
      membrane is carried out by its cysteine-rich and/or carboxyl domains. We report
      the results of biochemical and immunocytochemical investigations of dystrophin in
      muscle from a 1-yr-old patient with a large deletion that removes the distal part
      of the dystrophin gene, thus spanning the exons coding for the cysteine-rich and
      the carboxy-terminal domains, and extends beyond the glycerol kinase and
      congenital adrenal hypoplasia genes. Immunological analysis of muscle dystrophin
      shows that the deletion results in the production of a truncated, but stable,
      polypeptide correctly localized at the sarcolemma. These data indicate that
      neither the cysteine-rich domain, nor the carboxyl domain, are necessary for the
      appearance of normal dystrophin sarcolemmal localization.

PMID- 1737861
TI  - Are we creating socially responsible dental professionals?

PMID- 1737862
TI  - Instructional and information technology initiatives: the potential for delivery.
AB  - An attempt has been made to discuss some of the issues and opportunities which
      lie ahead as dental educators, their institutions, and our national associations
      prepare for the expected growth in the instructional and informational
      technologies that curriculum reform and technological advances will promote. The
      issues stem from a perceived need to collectively deliver products, as well as
      discuss issues, within our associations. While most national professional
      associations are well equipped to focus on questions of policy rather than the
      production of specific products, I believe there is a real potential for the
      successful pursuit of both within dental education.

PMID- 1737863
TI  - Using patient-instructors to teach and evaluate interviewing skills.
AB  - The teaching and evaluation of clinical interviewing skills is a continuing
      challenge for medicine and dentistry. The use of patient-instructors who provide
      consistency in presenting scenarios has recently been pioneered in dental
      education. This program focused primarily on teaching and used patient
      instructors to give individual feedback from the patient's perspective to
      students after each of five scenarios. Feedback was constructive and behaviorally
      oriented so that it could be applied immediately to succeeding scenarios. Rating
      instruments assessed both process and content skills. Results indicated that
      students improved significantly in interpersonal interviewing skills as they
      progressed through the exercise. Content skills improved only slightly. Student
      and faculty reaction was positive. The program is an effective and time efficient
      means of teaching history taking and interviewing skills as well as an effective
      evaluation tool.

PMID- 1737864
TI  - A survey of instructional technology in dental education.
AB  - Little is known about current use of hardware and non-hardware instructional
      technologies in dental education. To address this area, the investigators
      designed a questionnaire to assess support for the development of instructional
      technology and determine the extent to which different instructional technologies
      are used in North American dental schools. Responses were received from 59 of 65
      dental schools (91 percent). Respondents at most schools judged the
      administration at their school to be supportive of the development of
      instructional technology, but in general, did not feel faculty were enthusiastic
      about or rewarded for developing innovative methods. The most common computer
      based application involves testing and record keeping, which is used extensively
      in about half the dental schools. Individualized instruction and paper and pencil
      simulations are used in at least some courses at a majority of dental schools.
      Schools with available support services apply certain technologies to a
      significantly greater extent than schools without available support services.

PMID- 1737865
TI  - Attitudes of dental hygiene students toward individuals with AIDS.

PMID- 1737866
TI  - Current teaching of proximal retention grooves for Class II amalgam preparations.

PMID- 1737867
TI  - A dental school sponsored, pre-paid dental plan for college students.

PMID- 1737868
TI  - Implementation of a team concept of patient care.

PMID- 1737869
TI  - The willed future: thoughts garnered from the Cheshire cat.

PMID- 1737870
TI  - The effect of postdoctoral general dentistry programs on specialization.

PMID- 1737871
TI  - Hearing protection against high-level shooting impulses in relation to hearing
      damage risk criteria.
AB  - The earmuff attenuation of acoustic impulses produced by large-caliber weapons
      was measured with a high-speed microcomputer controlled unit. The estimated
      accuracy was +/- 1 dB in peak sound-pressure level measurements. The peak levels
      outside earmuffs were 184 dB for the heavy bazooka and 172 dB for the hand-held
      bazooka (re: 20 microPa). Heavy bazooka impulse peak levels were attenuated from
      7 to 19 dB by the earmuffs depending on the mass and volume of the measured three
      types of earmuffs. Hand-held bazooka impulse peak levels were attenuated by the
      earmuffs from 9 to 15 dB. The risk limits for hearing loss from a single impulse
      were exceeded in spite of the use of earmuffs when the criteria of CHABA (USA) or
      Pfander (Germany) were applied. The unexpectedly low attenuation was due to the
      low-frequency waveform of the high-level impulses. The earmuffs were found to
      prolong the impulse duration, which may reduce the benefit otherwise achieved by
      attenuation of the peak levels.

PMID- 1737872
TI  - Short-term poststimulatory response characteristics of the human acoustic
      stapedius reflex: monotic and dichotic stimulation.
AB  - Two experiments were performed to study short-term poststimulatory response
      characteristics of the human acoustic stapedius reflex in the time and intensity
      domains. In experiment 1, monotic magnitude-intensity functions (MIFs) were
      obtained for a 20-ms test stimulus preceded by a conditioning stimulus varying in
      duration (20, 50, 100, 500 ms) and level (-10, 0, +10 dB re: stapedius-reflex
      threshold) and temporally separated from the test stimulus by various
      interstimulus intervals (ISIs) (0, 20, 50, 100, 500 ms). Experiment 2 was similar
      in design except that conditioner and test stimuli were presented dichotically
      and fewer ISIs were used. Both experiments demonstrated that a prior conditioning
      stimulus produced significant increases in test-stimulus response magnitude.
      These poststimulatory effects were characterized by complex interactions among
      stimulus variables (conditioner duration, conditioner level, and interstimulus
      interval) with similar interactions occurring for both monotic and dichotic
      stimuli. A simple superposition effect of the responses to the conditioner and
      test stimulus does not account for the effect of prior stimulation since
      responses often exceeded the sum of the responses to the conditioner and the test
      stimulus alone.

PMID- 1737873
TI  - Responses to amplitude-modulated tones in the auditory nerve of the cat.
AB  - Sinusoidally amplitude-modulated (AM) tones are frequently used in psychophysical
      and physiological studies, yet a comprehensive study on the coding of AM tones in
      the auditory nerve is lacking. AM responses of single auditory-nerve fibers of
      the cat are studied, systematically varying modulation depth, frequency, and
      sound level. Synchrony-level functions were nonmonotonic with maximum values that
      were inversely correlated with spontaneous rate (SR). In most fibers, envelope
      phase-locking showed a positive gain. Modulation transfer functions were
      uniformly low pass. Their corner frequency increased with characteristic
      frequency (CF), but changed little for CFs above 10 kHz. The highest modulation
      frequencies to which phase locking occurred were more than 0.8 oct lower than the
      highest frequencies to which phase locking to pure tones occurs. Cumulative, or
      unwrapped, phase increased linearly with modulation frequency: The slope was
      inversely related to CF, and slightly higher than group delays reported for pure
      tones. High SR, low CF fibers showed the poorest envelope phase locking. In some
      low CF fibers, phase locking increased at high levels, associated with "peak
      splitting" phenomena. Changes in average rate due to modulation were small, and
      could be enhancement or suppression.

PMID- 1737874
TI  - Modeling the identification of concurrent vowels with different fundamental
      frequencies.
AB  - Human listeners are better able to identify two simultaneous vowels if the
      fundamental frequencies of the vowels are different. A computational model is
      presented which, for the first time, is able to simulate this phenomenon at least
      qualitatively. The first stage of the model is based upon a bank of bandpass
      filters and inner hair-cell simulators that simulate approximately the most
      relevant characteristics of the human auditory periphery. The output of each
      filter/hair-cell channel is then autocorrelated to extract pitch and timbre
      information. The pooled autocorrelation function (ACF) based on all channels is
      used to derive a pitch estimate for one of the component vowels from a signal
      composed of two vowels. Individual channel ACFs showing a pitch peak at this
      value are combined and used to identify the first vowel using a template matching
      procedure. The ACFs in the remaining channels are then combined and used to
      identify the second vowel. Model recognition performance shows a rapid
      improvement in correct vowel identification as the difference between the
      fundamental frequencies of two simultaneous vowels increases from zero to one
      semitone in a manner closely resembling human performance. As this difference
      increases up to four semitones, performance improves further only slowly, if at
      all.

PMID- 1737875
TI  - Intensity and frequency resolution: masking of absolute identification and fixed
      and roving discrimination.
AB  - Auditory intensity and frequency resolution were studied in three paradigms under
      masking conditions. Absolute identifications of single stimuli (one-interval
      paradigm) and 2IFC judgments of fixed- and roving-level pairs of stimuli (two
      interval paradigm) were obtained from the same experienced observers. Judgments
      were made under optimal (no mask) conditions, in the presence of a broadband
      noise mask (simultaneous mask), and when the stimulus(i) to be judged were either
      preceded (forward mask) or followed (backward mask) by a broadband noise mask.
      Substantial masking of intensity resolution was found in all mask conditions.
      Only a simultaneous mask affected frequency resolution. In the no mask condition,
      performance was best for fixed-level (or frequency) 2IFC discrimination, followed
      by roving-level (frequency) 2IFC, and finally absolute identification. These
      differences were maintained under masking for frequency resolution, but not for
      intensity resolution. The results are discussed in terms of the Braida and
      Durlach (1988) model of intensity resolution. A similar model is suggested for
      frequency resolution with differences suggested by the differences in neural
      coding of sound intensity and frequency.

PMID- 1737876
TI  - Auditory filter shapes at low center frequencies in young and elderly hearing
      impaired subjects.
AB  - Auditory filter shapes were measured for two groups of hearing-impaired subjects,
      young and elderly, matched for audiometric loss, for center frequencies (fc) of
      100, 200, 400, and 800 Hz using a modified notched-noise method [B. R. Glasberg
      and B. C. J. Moore, Hear. Res. 47, 103-138 (1990)]. Two noise bands, each 0.4fc
      wide, were used; they were placed both symmetrically and asymmetrically about the
      signal frequency to allow the measurement of filter asymmetry. The overall noise
      level was either 77 or 87 dB SPL. Stimuli were delivered monaurally using
      Sennheiser HD424 earphones. Although auditory filters for the hearing-impaired
      subjects were generally broader than for normally hearing subjects [Moore et al.,
      J. Acoust. Soc. Am. 87, 132-140 (1990)], some hearing-impaired subjects with mild
      losses had normal filters. The filters tended to broaden with increasing hearing
      loss. There were not any clear differences in filter characteristics between
      young and elderly hearing-impaired subjects. The signal-to-noise ratios at the
      outputs of the auditory filters required for threshold (K) tended to be lower
      than normal for the young hearing-impaired subjects, but were not significantly
      different from normal for the elderly hearing-impaired subjects. The lower K
      values for the young hearing-impaired subjects may occur because broadened
      auditory filters reduce the deleterious effects on signal detection of
      fluctuations in the noise.

PMID- 1737877
TI  - Signal detection in temporally modulated and spectrally shaped maskers.
AB  - The first part of this paper presents several experiments on signal detection in
      temporally modulated noise, yielding a general approach toward the concept of
      comodulation masking release (CMR). Measurements were made on masked thresholds
      of both long- and short-duration, narrow-band signals presented in a 100%
      sinusoidally amplitude-modulated (SAM) noise masker (modulation frequency 32 Hz),
      as a function of masker bandwidth from 1/3 oct up to 13/3 octs, while the masker
      band was geometrically centered at signal frequency. With the short-duration
      signals placed in the valley of the masker, a substantial CMR (i.e., a decrease
      of masked threshold with increasing masker bandwidth) was found, whereas for the
      long-duration signals CMR was smaller. Furthermore, investigations were carried
      out to determine whether CMR changes when the bandwidth of the signals,
      consisting of bandpass impulse responses, is increased. The data indicate that
      substantial CMR remains even when all masker bands contain a signal component,
      thus minimizing across-channel differences. This finding is not in line with
      current models accounting for the CMR phenomenon. The second part of this paper
      concerns signal detection in spectrally shaped noise. Also investigated was
      whether release from masking occurs for the detection of a pure-tone signal at a
      valley or a peak of a simultaneously presented masking noise with a sinusoidally
      rippled power spectrum, when this masker was preceded and followed by a second
      noise (temporal flanking burst) with an identical spectral shape as the on-signal
      noise. Similar to CMR effects for temporal modulations, the data indicate that
      coshaping masking release (CSMR) occurs when the signal is placed in a valley of
      the spectral envelope of the masker, whereas no release from masking is found
      when the signal is placed at a peak of the spectral envelope of the masker. The
      implications of these experiments for measures of spectral and temporal
      resolution are discussed.

PMID- 1737878
TI  - The role of frequency selectivity in measures of auditory and vibrotactile
      temporal resolution.
AB  - The purpose of this study was to compare the role of frequency selectivity in
      measures of auditory and vibrotactile temporal resolution. In the first
      experiment, temporal modulation transfer functions for a sinusoidally amplitude
      modulated (SAM) 250-Hz carrier revealed auditory modulation thresholds
      significantly lower than corresponding vibrotactile modulation thresholds at SAM
      frequencies greater than or equal to 100 Hz. In the second experiment, auditory
      and vibrotactile gap detection thresholds were measured by presenting silent gaps
      bounded by markers of the same or different frequency. The marker frequency F1 =
      250 Hz preceded the silent gap and marker frequencies after the silent gap
      included F2 = 250, 255, 263, 310, and 325 Hz. Auditory gap detection thresholds
      were lower than corresponding vibrotactile thresholds for F2 markers less than or
      equal to 263 Hz, but were greater than the corresponding vibrotactile gap
      detection thresholds for F2 markers greater than or equal to 310 Hz. When the
      auditory gap detection thresholds were transformed into filter attenuation
      values, the results were modeled well by a constant-percentage (10%) bandwidth
      filter centered on F1. The vibrotactile gap detection thresholds, however, were
      independent of marker frequency separation. In a third experiment, auditory and
      vibrotactile rate difference limens (RDLs) were measured for a 250-Hz carrier at
      SAM rates less than or equal to 100 Hz. Auditory RDLs were lower than
      corresponding vibrotactile RDLs for standard rates greater than 10 Hz.
      Combination tones may have confounded auditory performance for standard rates of
      80 and 100 Hz. The results from these experiments revealed that frequency
      selectivity influences auditory measures of temporal resolution, but there was no
      evidence of frequency selectivity affecting vibrotactile temporal resolution.

PMID- 1737879
TI  - Discrimination of interaural envelope correlation and its relation to binaural
      unmasking at high frequencies.
AB  - Listeners' sensitivity to interaural correlation of the envelope of high
      frequency waveforms and whether such sensitivity might account for detectability
      in a masking-level difference paradigm were assessed. Thresholds of interaural
      envelope decorrelation (from a reference correlation of 1.0) were measured for
      bands of noise centered at 4 kHz and bandwidths ranging from 50-1600 Hz.
      Decorrelation of the envelope was achieved by "mixing" two independent narrow
      band noises. Separately, with the same listeners, NoSo and NoS pi detection
      thresholds were measured for maskers of the same center frequency and bandwidths.
      For bandwidths of noise up to about 400 Hz, listeners were similarly sensitive to
      interaural decorrelation in both types of task. However, for bandwidths greater
      than 400 Hz or so, while sensitivity in the discrimination task was unaffected,
      sensitivity was reduced in the NoS pi conditions. Additional data suggested that
      listeners were able to maintain their sensitivity independent of bandwidth in the
      discrimination task by focusing on binaural information within select spectral
      regions of the stimuli.

PMID- 1737880
TI  - Spectral integration of broadband signals in diotic and dichotic masking
      experiments.
AB  - The method of Gassler [Acustica 4, 408-414 (1954)] was used to measure the
      audibility of multicomponent signals as a function of their bandwidth against a
      broadband, white-noise masker. Test signals were composed of 1 to 41 sinusoids
      with a spectral spacing of 10 Hz and were always spectrally centered around 400
      Hz. Masker duration was 400 ms and the 300-ms signals were centered within the
      noise intervals. A three-interval forced-choice procedure with adaptive level
      adjustment was applied. NoSo, NoSm, NoS pi, and N pi So masked thresholds were
      obtained for four subjects. A comparison of the diotic and the three dichotic
      conditions yields no significant difference in the bandwidth dependence and
      suggests equal integration bandwidths for all conditions. However, the original
      results of Gassler could not be replicated: Neither were the overall levels of
      signals with a bandwidth below the critical bandwidth constant nor were the
      results for broadband signals in accordance with a single-band model of
      detection. The narrow-band data are much better described by calculating the
      overall signal level at the output of a rounded exponential filter [Patterson et
      al., J. Acoust. Soc. Am. 72, 1788-1803 (1982)] with an equivalent rectangular
      bandwidth of 65 Hz. For broader signal bandwidths, the signal level at threshold
      increases as predicted by a multiband model.

PMID- 1737881
TI  - Effects of temporal separation and masker level on binaural analysis in forward
      masking.
AB  - In the present study detection under diotic (NoSo) and dichotic (NoS pi)
      listening conditions in a forward masking paradigm was investigated. Both the
      level of a noise masker and the temporal separation between the masker and a 250
      Hz tone burst served as independent variables. Results showed that most of the
      variance in the data could be accounted for by the amount of masking in the NoSo
      condition, independent of the value of the temporal parameter, which itself
      accounted for only 1.4% of the variance that remained. Once the data were
      corrected for NoSo masking effectiveness, the MLD was found to decrease by only
      1.4 dB as temporal separation increased from 5-100 ms, which is consistent with a
      very long time constant for the binaural system. Consistent with this finding, it
      was shown that slope changes of the growth of masking functions, for simultaneous
      as compared to forward masking, were similar for both the NoSo and NoS pi
      conditions.

PMID- 1737882
TI  - Frequency dependence of binaural performance in listeners with impaired binaural
      hearing.
AB  - Binaural performance was measured as a function of stimulus frequency for four
      impaired listeners, each with bilaterally symmetric audiograms. The subjects had
      various degrees and configurations of audiometric losses: two had high-frequency,
      sensorineural losses; one had a flat sensorineural loss; and one had multiple
      sclerosis with normal audiometric thresholds. Just noticeable differences (jnd's)
      in interaural time, interaural intensity, and interaural correlation as well as
      detection thresholds for NoSo and NoS pi conditions were obtained for narrow-band
      noise stimuli at octave frequencies from 250-4000 Hz. Performance of the impaired
      listeners was generally poorer than that of normal-hearing listeners, although it
      was comparable to normal in a few instances. The patterns of binaural performance
      showed no apparent relation to the audiometric patterns; even the two subjects
      with similar degree and configuration of hearing loss have very different
      binaural performance, both in the level and frequency dependence of their
      performance. The frequency dependence of performance on individual tests is
      irregular enough that one cannot confidently interpolate between octaves. In
      addition, it appears that no subset of the measurements is adequate to
      characterize the performance in the rest of the measurements with the exception
      that, within limits, interaural correlation discrimination and NoS pi detection
      performance are related.

PMID- 1737883
TI  - Effects of noise on detection of amplitude increments of sinusoidal vibration of
      the skin.
AB  - Vibrotactile thresholds for detecting a 300-Hz signal in the presence of both a
      300-Hz sinusoidal pedestal and a background noise were measured as a function of
      the amplitudes of the pedestal and noise. Threshold increased monotonically as a
      function of the amplitude of the noise, but was a nonmonotonic function of the
      amplitude of the sinusoidal pedestal. Negative masking, in which the pedestal
      facilitated detection of the test stimulus, was observed in the absence of
      background noise and in the presence of subthreshold background noise when the
      pedestal was near or below threshold. Negative masking disappeared when the
      experiment was conducted in the presence of moderately intense to intense
      background noise. The results are consistent with a peripheral high-energy
      threshold for taction.

PMID- 1737884
TI  - Potential benefits of adaptive frequency-gain characteristics for speech
      reception in noise.
AB  - Some current single-microphone hearing aids employ techniques for adaptively
      varying the frequency-gain characteristics in an attempt to improve speech
      reception in noise. The potential benefit of this strategy depends on the
      spectral spread of masking and the degree to which it can be reduced by changing
      the frequency-gain characteristic. In this study these benefits were examined for
      subjects with normal hearing under static listening conditions. In the
      unprocessed condition, subjects were presented with nonsense syllables in an
      octave-band noise centered on 0.5, 1, or 2 kHz. The frequency-gain characteristic
      was then modified with the goal of reducing the intensity of the frequency region
      containing the octave-band noise. This processing resulted in increases as large
      as 60 percentage points in consonant-correct scores with the low- and mid
      frequency octave noise bands, and a small increase with the high-frequency noise.
      Masking patterns produced by the octave noises were also measured and were
      related to the intelligibility results via an analysis based on Articulation
      Theory. The Articulation Index was also used to compare the effectiveness of
      three adaptive rules. A simple multiband volume control is expected to provide
      much of the benefit of more sophisticated systems without the need for separate
      estimation of input speech and noise spectra.

PMID- 1737885
TI  - Fundamental frequency declination is not unique to human speech: evidence from
      nonhuman primates.
AB  - In human speech, declination of the fundamental frequency (F0) of the voice spans
      coherent units of an utterance and, therefore, signals where units begin and end.
      A rapid final fall at the end of an utterance provides a further indication of an
      utterance's ending. The occurrence of declination is sufficiently widespread
      across languages that several investigators have suggested it as a language
      universal. Language universals may be universal because they are part of a
      species-specific specialization for language or, alternatively, they may
      constitute conventionalizations of natural dispositions of the vocal tract that
      may serve a communicative function. Evidence is offered favoring the latter
      account for declination and the final fall by showing that vocal productions of
      vervet monkeys (Cercopithecus aethiops) and rhesus macaques (Macaca mulatta) show
      declination, and vervets show clear evidence of a final fall. Interestingly, the
      fall in F0 may serve some communicative role in the vocal exchanges of vervets
      and rhesus, analogous to its signalling function in human language.

PMID- 1737886
TI  - Talker and listener effects on degree of perceived foreign accent.
AB  - Four experiments were carried out to examine listener- and talker-related factors
      that may influence degree of perceived foreign accent. In each, native English
      listeners rated English sentences for degree of accent. It was found that degree
      of accent is influenced by range effects. The larger the proportion of native (or
      near-native) speakers included in a set of sentences being evaluated, the more
      strongly accented listeners judged sentences spoken by non-native speakers to be.
      Foreign accent ratings were not stable. Listeners judged a set of non-native
      produced sentences to be more strongly accented after, as compared to before,
      they became familiar with those sentences. One talker-related effect noted in the
      study was the finding that adults' pronunciation of an L2 may improve over time.
      Late L2 learners who had lived in the United States for an average of 14.3 years
      received significantly higher scores than late learners who had resided in the
      United States for 0.7 years. Another talker-related effect pertained to the age
      of L2 learning (AOL). Native Spanish subjects with an AOL of five to six years
      were not found to have an accent (i.e., to receive significantly lower scores
      than native English speakers), whereas native Chinese subjects with an average
      AOL of 7.6 years did have a measurable accent. The paper concludes with the
      presentation of several hypotheses concerning the relationship between AOL and
      degree of foreign accent.

PMID- 1737887
TI  - On the sufficiency of compound target specification of isolated vowels and vowels
      in /bVb/ syllables.
AB  - It has been suggested [e.g., Strange et al., J. Acoust. Soc. Am. 74, 695-705
      (1983); Verbrugge and Rakerd, Language Speech 29, 39-57 (1986)] that the temporal
      margins of vowels in consonantal contexts, consisting mainly of the rapid CV and
      VC transitions of CVC's, contain dynamic cues to vowel identity that are not
      available in isolated vowels and that may be perceptually superior in some
      circumstances to cues which are inherent to the vowels proper. However, this
      study shows that vowel-inherent formant targets and cues to vowel-inherent
      spectral change (measured from nucleus to offglide sections of the vowel itself)
      persist in the margins of /bVb/ syllables, confirming a hypothesis of Nearey and
      Assmann [J. Acoust. Soc. Am. 80, 1297-1308 (1986)]. Experiments were conducted to
      test whether listeners might be using such vowel-inherent, rather than
      coarticulatory information to identify the vowels. In the first experiment,
      perceptual tests using "hybrid silent center" syllables (i.e., syllables which
      contain only brief initial and final portions of the original syllable, and in
      which speaker identity changes from the initial to the final portion) show that
      listeners' error rates and confusion matrices for vowels in /bVb/ syllables are
      very similar to those for isolated vowels. These results suggest that listeners
      are using essentially the same type of information in essentially the same way to
      identify both kinds of stimuli. Statistical pattern recognition models confirm
      the relative robustness of nucleus and vocalic offglide cues and can predict
      reasonably well listeners' error patterns in all experimental conditions, though
      performance for /bVb/ syllables is somewhat worse than for isolated vowels. The
      second experiment involves the use of simplified synthetic stimuli, lacking
      consonantal transitions, which are shown to provide information that is nearly
      equivalent phonetically to that of the natural silent center /bVb/ syllables
      (from which the target measurements were extracted). Although no conclusions are
      drawn about other contexts, for speakers of Western Canadian English
      coarticulatory cues appear to play at best a minor role in the perception of
      vowels in /bVb/ context, while vowel-inherent factors dominate listeners'
      perception.

PMID- 1737888
TI  - The effect of accentuation and word duration on the naturalness of speech.
AB  - In this study the effect of appropriate word duration and correct (pitch)
      accentuation on the naturalness of speech was investigated. In the stimulus
      material, the information value of the target word determined the correctness of
      accentuation ([new, +accent] and [old, -accent] were defined as correct).
      Appropriate word duration was defined as either "in agreement with accentuation"
      ([long, +accent] and [short, -accent]) or "in agreement with information value"
      ([long, new] and [short, old]). Listeners were asked to give naturalness
      judgments along a scale from 1 (very unnatural) to 10 (very natural) on fragments
      consisting of two sentences. Duration and accentuation of the target word, which
      always occurred in the second sentence, were manipulated separately and in
      combinations. Judgments show that accentuation that is not in agreement with
      information value causes a significant decrease of naturalness. When accentuation
      is in agreement with information value but duration is inappropriate for both
      factors, the perceived naturalness decreases significantly. However, listeners
      were unable to give consistent naturalness judgments on the manipulated word
      durations in fragments with incorrect accent distributions. Based on these
      results and the findings of an earlier production study [W. Eefting, J. Acoust.
      Soc. Am. 89, 412-424 (1991)], which showed that duration is not involved in the
      realization of pitch accent, the following is suggested. Speakers adapt both
      accentuation and word duration in order to indicate that a word contains relevant
      information. Presence of an accent distinguishes the word from its (less
      relevant) environment. A longer duration provides the listener with the extra
      time that is needed in order to process the word's content adequately.

PMID- 1737889
TI  - Speech reception in quiet and in noisy conditions by individuals with noise
      induced hearing loss in relation to their tone audiogram.
AB  - Tone thresholds and speech-reception thresholds were measured in 200 individuals
      (400 ears) with noise-induced hearing loss. The speech-reception thresholds were
      measured in a quiet condition and in noise with a speech spectrum at levels of
      35, 50, 65, and 80 dBA. The tone audiograms could be described by three principal
      components: hearing loss in the regions above 3 kHz, from 1 to 3 kHz and below 1
      kHz; the speech thresholds could be described by two components: speech reception
      in quiet and speech reception in noise at 50-80 dBA. Hearing loss above 1 kHz was
      related to speech reception in noise; hearing loss at and below 1 kHz to speech
      reception in quiet. The correlation between the speech thresholds in quiet and in
      noise was only R = 0.45. An adequate predictor of the speech threshold in noise,
      the primary factor in the hearing handicap, was the pure-tone average at 2 and 4
      kHz (PTA2,4, R = 0.72). The minimum value of the prediction error for any tone
      audiometric predictor of this speech threshold was 1.2 dB (standard deviation).
      The prediction could not be improved by taking into account the critical ratio
      for low-frequency noise nor by its upward spread of masking. The prediction error
      is due to measurement error and to a factor common to both ears. The latter
      factor is ascribed to cognitive skill in speech reception. Hearing loss above 10
      to 15 dB HL (hearing level) already shows an effect on the speech threshold in
      noise, a noticeable handicap is found at PTA2,4 = 30 dB HL.

PMID- 1737890
TI  - Method to measure acoustic impedance and reflection coefficient.
AB  - A frequency-domain based system for measuring acoustic impedance and reflection
      coefficient is described. The calibration procedure uses a least-mean-squares
      approximation to the Thevenin parameters describing the source and receiver
      characteristics in which the data measured on closed, cylindrical tubes are
      matched to a viscothermal tube model. The system is intended for use in
      acoustical measurement in human ear canals, in which the cross-sectional area of
      the ear canal at the point of insertion is imprecisely known. This area is
      acoustically estimated from the impedance data, and the reflection coefficient is
      calculated in terms of this area and the impedance data. Measurements on a
      variety of closed tubes show the method is accurate over the frequency range
      investigated (less than 10.7 kHz). The time-domain reflection function is
      evaluated by transforming the reflection coefficient from the frequency domain,
      but the finite bandwidth of the measured data limits the accuracy of time-domain
      response measurements. The method is well suited for frequency-domain
      measurements in human ear canals.

PMID- 1737891
TI  - Relative ear advantage and element duration.
AB  - Lauter [J. Acoust. Soc. Am. 71, 701-707 (1982)] reported that although the
      magnitude and direction of the absolute ear advantage for speech and nonspeech
      sound sets presented dichotically varies considerably among listeners, consistent
      patterns of a relative ear advantage (EArel) across sound sets are preserved from
      listener to listener. She further claimed that EArel appeared to be related to
      the duration of elements that composed a sequence. The existence of EArel is
      investigated for four sound sets: CV nonsense syllables and pitch patterns that
      were composed of 50-, 80-, or 120-ms tones. The paradigm was target monitoring, a
      Yes/No task in which listeners attended to only one ear and listened for the
      presence of a target signal. The results failed to confirm that listeners have a
      consistent relative ear advantage related to element duration for nonspeech sound
      sets.

PMID- 1737892
TI  - Ultrasonic heating of lung tissue.
AB  - Tests with mice show that lung tissue is not selectively heated in comparison
      with other soft tissues and that lung has an efficient mechanism for dissipating
      that heat which is produced. Temperatures measured with a fine thermocouple
      placed at the outer surface of the mouse lung show approximately 1 degree C total
      rise in temperature in the living animal for an incident intensity of 1 W/cm2 (4
      MHz, unfocused sound field).

PMID- 1737893
TI  - Temperature dependences of the acoustic nonlinearity parameter B/A of aqueous
      solutions of amino acids.
AB  - A differential technique for evaluating the molar increments of the nonlinearity
      parameter B/A has been employed for investigations of aqueous solutions of the
      amino acids glycine, alanine, norvaline, norleucine, arginine monohydrochloride,
      and lysine monohydrochloride in the temperature range 18 degrees C-45 degrees C.
      Some regularities of temperature dependencies of the nonlinearity parameter B/A
      of hydration shells of charged and aliphatic groups have been found.
      Contributions of these groups to the value of B/A molar increments of solute
      versus temperature have been estimated.

PMID- 1737894
TI  - 41st annual scientific session of the American College of Cardiology. Dallas,
      Texas, April 12-16, 1992. Abstracts.

PMID- 1737895
TI  - Putting nutrition on the grocery store shelf.

PMID- 1737896
TI  - Shaping a success story: dietetics in Taiwan.

PMID- 1737897
TI  - Obesity treatment: worshiping the "scale god".

PMID- 1737898
TI  - Trigeminal neuralgia: can one case report support a treatment recommendation?

PMID- 1737899
TI  - Nutrition screening initiative: development and implementation of the public
      awareness checklist and screening tools.

PMID- 1737900
TI  - Public health nutrition practices to prevent low birth weight in eight
      southeastern states.
AB  - This study was conducted to identify current public health nutrition practices
      for the prevention and treatment of low-birth-weight (LBW) infants in eight
      southeastern states. Nutrition personnel (n = 1,054) were mailed a 51-item
      questionnaire with three parts that sought information on the respondents'
      professional backgrounds and employment status and on practice and standards of
      care for women before and during pregnancy and of LBW infants. Results based on a
      62% response rate indicated 73% had worked in public health nutrition for 2 to 9
      years, 56% were direct care providers, and 51% had bachelor's degrees. Only 40%
      of respondents indicated that their agencies had prepregnancy nutrition
      intervention protocols, whereas 89% indicated that they had high-risk pregnancy
      screening protocols and 91% indicated that they had high-risk treatment
      protocols. More than 91% indicated that their treatment protocols included
      guidelines for weight gain, preparation of nutrition care plans, and assessment
      of dietary and biochemical factors, health behavior, and obstetric history. Only
      73% indicated inclusion of assessment of educational level. Nutritionists saw
      high-risk pregnant women (or those at risk for preterm labor) slightly more
      frequently during pregnancy than they saw low-risk women; however, the range (0.9
      to 3.8 vs 0.5 to 2.3) and average (2.0 vs 1.2) number of visits for both groups
      differed only slightly. Nutritionists counseled women and charted in the medical
      record more frequently than they used nutrition care plans. To reduce LBW,
      nutritionists should implement treatment protocols and monitor high-risk women
      closely. The relationship between pre-pregnancy nutrition interventions and birth
      weight should be investigated.

PMID- 1737901
TI  - Food intake of very obese persons: quantitative and qualitative aspects.
AB  - To document the caloric intake of very obese persons and investigate the food
      choices and dietary composition that maintain severe obesity, we studied the self
      selected food intake required to maintain stable weight in two groups of very
      obese subjects: 11 inpatients with a mean weight 181% above desirable body weight
      and 35 outpatients with a mean weight 125% above desirable body weight.
      Qualitative and quantitative food intake were evaluated using records obtained on
      the hospital metabolic ward for the inpatients and using self-recorded food
      records for the outpatients. Absolute caloric intake in both groups was greater
      in proportion to the degree of obesity (deviation from desirable body weight);
      caloric intake per unit of lean body mass (kilocalories per gram urinary
      creatinine) was constant regardless of the degree of obesity and was essentially
      the same as that of normal nonobese persons. Food records indicated that the
      obese subjects maintained their high caloric intake by consuming mostly foods of
      high caloric density, with occasional binge eating. They largely avoided foods of
      low intrinsic energy density and modified-calorie foods, ie, foods with decreased
      fat, nonnutritive sweeteners, or fillers. By substituting foods of lower caloric
      density for usual food choices from the same food group, obese persons could
      decrease caloric intake by 20% and increase potential for notable weight loss.

PMID- 1737902
TI  - Building a strategic forecasting system for hospital foodservice operations.
AB  - Forecasting, which involves the manipulation of operational data, is a critical
      task in foodservice management. We propose a strategic forecasting system for
      foodservice management, which may be expedited by using decision support systems.
      The most notable potential for improved forecast performance and decision
      flexibility may rest with increasing forecasting information. This article
      provides a framework for building a strategic forecasting system that can help
      managers select and use appropriate forecasting models for foodservice
      operations.

PMID- 1737903
TI  - Hemochromatosis and dietary iron supplementation: implications from US mortality,
      morbidity, and health survey data.
AB  - Trends in the mortality rates, morbidity rates, and hematologic screening
      parameters for hemochromatosis in the United States over the past 20 years were
      examined to assess whether dietary iron supplementation is a precipitating factor
      for hemochromatosis. From 1968 through 1987, there was an increase in the overall
      hemochromatosis mortality rates attributable to white women. From 1979 through
      1987, the hospitalization rates for hemochromatosis ranged from 4 to 13 per
      100,000 persons in Medicaid data (1984) and the National Hospital Discharge
      Survey (1979-1987) and are similar to estimates in the literature from 1955.
      Although the iron nutritional status of persons under 55 years of age increased
      from the first to the second National Health and Nutrition Examination Survey,
      there was no corresponding increase at the 95th percentile in the hemochromatosis
      screening parameters--serum iron concentration and transferrin saturation. A
      hypothetical scenario was used to examine the progression from homozygous gene
      frequency to phenotypic expression. It is concluded that clinical hemochromatosis
      is rarer than prevalence estimates of 100 to 500 per 100,000 persons predicted by
      gene frequency. In addition, there is no strong evidence of an increase in
      hemochromatosis from mortality, morbidity, or health survey data, which implies
      that dietary iron supplementation begun in 1940 has not accelerated
      manifestations of hemochromatosis. Any increase in hemochromatosis since iron
      fortification can probably be attributed to accuracy in diagnosis and enhanced
      awareness of the disease by physicians rather than to environmental factors.

PMID- 1737904
TI  - Effect of maternal employment on the quality of young children's diets: the CSFII
      experience.

PMID- 1737905
TI  - Using early weight gain and other nutrition-related risk factors to predict
      pregnancy outcomes.

PMID- 1737906
TI  - Reliability of direct observation of schoolchildren's consumption of bag lunches.

PMID- 1737907
TI  - Recruitment and retention of volunteers in a dietary methodology study.

PMID- 1737908
TI  - Teaching computer-aided nutrition assessment via self-instructional modules.

PMID- 1737909
TI  - Immunosuppressive therapy for primary biliary cirrhosis.

PMID- 1737910
TI  - Hepatitis B virus reinfection after orthotopic liver transplantation. Serological
      and clinical implications.
AB  - The implications of hepatitis B virus (HBV) reinfection after liver
      transplantation were studied in 29 patients followed for 1.7-15 years. Of 20
      patients with HBV infection alone, nine were HBeAg and HBV DNA seronegative and
      11 had evidence of HBV replication as measured by HBeAg or HBV DNA
      seropositivity. Nine patients had co-existing HBV and delta virus (HDV)
      infection. Five patients became HBsAg seronegative after transplantation (four
      immediately and one after an hepatitic episode). Of the 20 patients with HBV
      infection alone, 17 had evidence of viral replication after transplantation with
      markedly increased HBV DNA levels. Five patients with HDV infection had HBV DNA
      in serum, but in significantly lower amounts than in those with HBV infection
      alone. Twenty-five episodes of graft dysfunction attributed to recurrent HBV
      infection occurred in 19 patients (65.5%). Thirteen episodes (in 12 patients)
      were self-resolving acute hepatitic illnesses. Six patients had a rapidly
      progressive illness leading to graft loss within 6 weeks, with the distinctive
      histological features termed fibrosing cholestatic hepatitis (FCH). Liver
      function tests in these patients showed markedly abnormal serum bilirubin and
      prothrombin times, but only modest increases in serum transaminase levels. An
      additional six patients lost their graft as a consequence of HBV recurrence
      through various pathogenetic mechanisms including possible (but unproven) FCH,
      chronic active hepatitis or late-onset hepatic failure. Co-existing HDV infection
      appeared to confer some medium-term protection from graft loss.

PMID- 1737911
TI  - Mechanism of bile acid-induced HCO3-(-)rich hypercholeresis. An analysis based on
      quantitative acid-base chemistry.

PMID- 1737912
TI  - Endoscopic management of biliary tract obstruction in the 1990s.

PMID- 1737913
TI  - Serial determination of type III procollagen amino propeptide serum levels in
      patients with histologically progressive and non-progressive primary biliary
      cirrhosis.
AB  - We examined the value of serum procollagen III amino propeptide (PIIIP) for
      predicting the histological progression of primary biliary cirrhosis (PBC).
      Serial PIIIP measurements were obtained for nine patients with histologically
      progressive PBC and nine patients with histologically stable early disease,
      assessed by repeated liver biopsies and followed for up to 13 years. The means of
      the follow-up PIIIP concentrations were elevated in 39% of the cases; moreover,
      PIIIP levels were elevated at least once during follow-up in 72% of the cases.
      Mean follow-up PIIIP concentrations did not differ significantly between
      progressive and non-progressive patients. In addition, in the progressive group,
      histological progression was not reflected by PIIIP levels. No difference was
      found between the serum PIIIP levels corresponding to the histological stages I,
      II and III. The individual coefficients of the correlation between serum PIIIP
      and biochemical variables (bilirubin, alkaline phosphatase, ASAT, albumin) and
      histology showed a wide distribution without a consistent trend towards positive
      or negative. Treatment with cyclosporin A or cyclosporin A combined with
      prednisone did not influence serum PIIIP levels. Treatment with penicillamine
      combined with prednisone, however, resulted in a significant decrease in PIIIP
      concentrations (p less than 0.05). We conclude that serum PIIIP measurements are
      of no value for predicting the histological progression of PBC.

PMID- 1737914
TI  - Uptake of organic anions by isolated rat hepatocytes. A classification in terms
      of ATP-dependency.
AB  - Uptake of organic anions into isolated rat hepatocytes was studied to examine
      their ATP dependency. In the presence of rotenone (0.2 microM), the initial
      velocity of the uptake (Vo) of dibromosulfophthalein (DBSP; 10 microM), 1-anilino
      8-naphthalenesulfonate (ANS; 10 microM) and benzylpenicillin (PCG; 0.02 microM)
      was reduced to 60-70% of the control value, while that of bromosulfophthalein
      (BSP; 10 microM), rose bengal (RB; 10 microM) and bromophenol blue (BPB; 10
      microM) was not affected. Furthermore, we examined the inhibitory effect of
      rotenone on the uptake at equilibrium of non-metabolizable ligands (DBSP, BPB and
      RB). The uptake of these ligands reached equilibrium at 30 min with a cel-to
      medium concentration ratio (C/M ratio) of 75, 37 and 126, respectively. The C/M
      ratio at equilibrium of DBSP was reduced by rotenone to approx. 60% of the
      control value, while that of BPB and RB was not reduced. Other metabolic
      inhibitors such as sodium azide (10 mM) and carbonylcyanide-p
      trifluoromethoxyphenylhydrazone (FCCP; 10 microM) also reduced the Vo of DBSP and
      PCG, while the uptake of BSP and RB was not reduced by these inhibitors. These
      results indicate that organic anions can be classified into two groups according
      to whether they are taken up by hepatocytes in an ATP-dependent manner, i.e., via
      active transport or in an ATP-independent manner, i.e., via facilitated
      diffusion. DBSP, PCG and ANS belong to the former group, whereas BSP, BPB and RB
      belong to the latter.

PMID- 1737915
TI  - Autoantibodies in experimental autoimmune hepatitis.
AB  - Experimental autoimmune hepatitis (EAH) can be induced in mice by immunization
      with syngeneic soluble liver antigens in complete Freund's adjuvant. It has
      previously been shown that autoreactive T cells play an important role in this
      animal model of autoimmune hepatitis. We have studied the occurrence of liver
      autoantibodies in EAH. Characteristic autoantibodies appeared several weeks after
      disease induction and antibody titres continued to rise when histological and
      biochemical signs of disease activity had already regressed. Autoantibodies in
      EAH seemed to recognize autoantigens other than those present in autoimmune
      chronic active hepatitis patients. We conclude that autoantibodies arise in
      experimental autoimmune hepatitis but that these autoantibodies do not play a
      critical role in the pathogenesis of the disease.

PMID- 1737916
TI  - Utilization of ATP-depleted cells in the analysis of taurocholate uptake by
      isolated rat hepatocytes.
AB  - The usefulness of ATP-depleted rat hepatocytes in transport studies was examined.
      ATP-depleted hepatocytes were prepared by incubating cell suspensions with 30
      microM rotenone. In ATP-depleted hepatocytes, plasma membrane permeability was
      increased and mitochondrial membrane potential decreased, while both
      intracellular volume and pH remained normal. Furthermore, in the presence of
      valinomycin, the initial uptake rates of 3H-tetraphenyl phosphonium (TPP+) with
      varied medium concentrations of potassium were predicted according to the Goldman
      Hodgkin-Katz equation, which demonstrated that a potassium diffusion potential
      could be produced in this system. Using the thus-characterized ATP-depleted
      cells, the uptake mechanism of taurocholate was investigated. In the presence of
      an inwardly directed Na gradient, the taurocholate uptake was markedly stimulated
      and bile acid was transiently accumulated at a concentration 3-times higher than
      at equilibrium ('overshoot') in ATP-depleted cells. No overshoot was observed in
      viable cells, however, which suggests that in ATP-depleted cells the Na gradient,
      a driving force for taurocholate uptake, decreased with time. In both viable and
      ATP-depleted cells, the relationship between medium concentrations of Na and the
      Na-dependent initial uptake rate were sigmoidal, and the Hill coefficients were
      close to 2. The Na-dependent initial uptake rate of taurocholate was stimulated
      by a valinomycin-induced inside negative potassium-diffusion potential in ATP
      depleted cells, and the movement of a 'one plus' (as a net) charge was revealed
      by fitting the data to the Goldman-Hodgkin-Katz equation. These results support
      the hypothesis that sodium-coupled hepatic uptake of taurocholate occuthrough an
      electrogenic process with the stoichiometry of 2 Na: 1 taurocholate, although
      this issue is controversial. In the presence of an outwardly directed sodium
      gradient, efflux of taurocholate from ATP-depleted cells was not stimulated.
      Consequently, the physiological transport vector of taurocholate from blood to
      cell is not only due to the direction of the sodium gradient (blood to cell) but
      also to membraneous orientation of transport carriers. In conclusion, kinetic
      analysis using ATP-depleted hepatocytes allowed the formulation of a new approach
      to clarify the as yet unresolved issues concerning transport stoichiometry and
      the mechanism for vectorial transport of taurocholate.

PMID- 1737917
TI  - Effect of the terpenic compound epomediol on biliary secretion and bile
      composition in the rat.
AB  - The aim of the present investigation was to define the role of the synthetic
      terpenoid epomediol on biliary secretion in rats recovered from anaesthesia, in
      stabilized conditions and receiving an intravenous infusion of Na+ taurocholate
      (120 or 240 nmol.min-1 per 100 g body wt.) or physiologic saline (NaCl 0.16 M).
      Epomediol was administered at the rate of 20 and 50 mg.kg-1 per h, through a
      second syringe connected to the same vein catheter. Bile flow was increased up to
      67% according to the model. The effect of epomediol is dose-dependent, associated
      with enhanced Na+ transport into bile and with an increased anionic gap. The
      extent of epomediol action also changes according to the different rates of bile
      acid secretion. At low secretory rates a greater choleretic action was observed
      with epomediol. The effect was negligible for a secretion of bile acids above 350
      nmol.min-1 per 100 g body wt. Excretion into bile of the epomediol glucuronide
      was not hampered by high Na+ taurocholate output. This suggests that there is no
      competition of the two anions for a common excretory pathway at the studied
      rates. The effect of epomediol seems due to a mechanism of action both
      independent and additive to the mechanism for bile acids. The presence of
      additivity of the two choleretic mechanisms at low flow and bile acid secretion
      and the loss of action at high secretory rates, suggests that the maximal
      capacity of passage for water into bile was reached.

PMID- 1737918
TI  - Experimental dissolution of pigment gallstone material using alkaline EDTA and
      adjuvant bile salts/non-bile salt detergents, thiols and urea, with respect to
      local chemolitholysis.
AB  - In order to enhance the dissolution capacity and the kinetics of topical solvents
      used in local pigment chemolitholysis, a series of dissolution experiments was
      performed with intact brown and black pigment stones and with standardized
      solutes such as pigment stone powder and compressed powder (static disc method).
      The basic dissolution medium was a 0.1 M boric acid/sodium carbonate buffer (pH
      9.5), and the basic lytic agent was EDTA-4Na, working satisfactorily at 1-3 g/dl.
      It could be demonstrated that the dissolution efficiency of this basic solvent
      was enhanced significantly in the presence of a detergent (surfacant) and of
      urea. Among the detergents the zwitterionic (e.g., Sulfobetain-12) and the
      nonionic types (e.g., a polyoxyethylene ether like Lubrol PX) proved to be most
      effective. The adjuvant effect of the investigated thiols was disappointing. Only
      dithioerythritol/dithiothreitol and N-acetylcysteine showed any moderate, if
      consistent, lytic activity. The highest dissolution rates in dissolving
      compressed powder standards (disc method) were achieved with the ternary solvent
      (1% w/v EDTA/80 mM Lubrol PX/1 M urea, pH 9.5). Intact black pigment stones, well
      known as problematic candidates for chemolitholysis, could be largely dissolved
      up to approximately 70% of their initial weight. This was not merely a physical
      disintegration, but a chemical process.

PMID- 1737919
TI  - Higher levels of serum aminoterminal type III procollagen peptide, and laminin in
      alcoholic than in nonalcoholic cirrhosis of equal severity.
AB  - In vitro models have shown that metabolites of ethanol (acetaldehyde and lactate)
      stimulate collagen synthesis, thereby, suggesting that they may be important as
      fibrogenic mediators. The relevance of these findings for fibrogenesis in the
      human liver in vivo, however, has not as yet been demonstrated. Serum markers for
      collagen (PIIINP, using radioimmunoassays employing polyclonal antibodies and Fab
      fragments (PIIINP-Fab), respectively) and basement membrane (laminin) metabolism
      were therefore investigated in 25 alcoholic cirrhotics (Pugh-Score: 6.7 +/- 1.9
      S.D.) and in 19 comparable nonalcoholic cirrhotics (Pugh-Score: 6.3 +/- 1.5,
      n.s.) with only slight evidence for inflammation: GOT 28 +/- 22 vs. 24 +/- 21
      U/l; GPT 24 +/- 23 vs. 31 +/- 28 U/l; gamma-globulins 24 +/- 8 vs. 22 +/- 5%,
      respectively (all n.s.). Severity of the disease was assessed by quantitative
      liver function tests. Levels of PIIINP, PIIINP-Fab and laminin measured by RIA
      were 21 +/- 19 micrograms/l, 90 +/- 42 micrograms/l and 2.5 +/- 0.8 U/ml in
      alcoholic cirrhosis and 10 +/- 6 micrograms/l, 61 +/- 10 micrograms/l and 1.9 +/-
      0.4 U/ml in nonalcoholic cirrhosis, respectively (all p less than 0.01).
      Differences on PIIINP and PIIINP-Fab remained significant even after accurate
      matching for galactose elimination capacity, aminopyrine breath test and hepatic
      sorbitol clearance. Laminin levels were higher in alcoholic cirrhosis only after
      matching for the hepatic sorbitol clearance (p less than 0.01). The higher levels
      of serum markers for collagen and basement membrane metabolism in alcoholic vs.
      nonalcoholic patients with cirrhosis at equal severity of the disease and with
      only minimal signs of inflammation may be the clinical reflection of a specific
      fibrogenic effect of ethanol metabolites.

PMID- 1737920
TI  - The effect of an eucaloric high carbohydrate diet on circulating levels of
      glucose, fructose and non-esterified fatty acids in patients with cirrhosis.
AB  - Twelve cirrhotic patients and six controls were fed an eucaloric high
      carbohydrate (CHO) diet for 3 days. Fasting serum triglyceride (TG), non
      esterified fatty acids (NEFA), glucose, insulin and glycerol were estimated
      daily. On the 3rd day of the study we measured NEFA, glucose, insulin, and
      fructose every 45 min from 07:45 h until 19:45 h, and then every 4 h until 07:45
      h the next day. The patients were divided into two groups of six on the basis of
      plasma lecithin-cholesterol acyltransferase (LCAT) activity: group A cirrhotics
      (with good liver function--LCAT activity: 40.6-65.7 nmol.ml-1.h-1; mean 48.5),
      and group B (poor liver function--LCAT: 23.7-32.3; mean 27.4). On the high CHO
      diet there was an increase in the fasting serum TG with a peak after 2 or 3 days.
      The increase in serum TG in controls was greater (p less than 0.01) than in
      either group of cirrhotics. In the controls and in group A most of the extra TG
      was carried in VLDL; in group B only 39% of the TG increment was found in VLDL.
      Fasting NEFA fell with 3 days of CHO feeding in the control group (p less than
      0.01); they were unchanged in group A, and rose in group B to a significantly
      higher level than in controls (p less than 0.01). During day 3 when a high CHO
      diet was fed plasma NEFA levels fell in cirrhotics, and for most of the day the
      mean NEFA concentration in group B patients was significantly (p less than 0.05)
      lower than in normals. On day 3 glucose and fructose levels rose after each meal-
      much more in cirrhotics than in controls (and more in group B than in group A),
      and for most of the day they were significantly higher in group B patients as
      compared to the controls (glucose p less than 0.01, fructose p less than 0.001).
      Our results supported the hypothesis that plasma NEFA would be lower following
      high CHO meals in cirrhotics than in controls. This suggests that a high NEFA
      utilisation, which occurs in fasting cirrhotics, is not present throughout the
      day. Following a CHO meal, we suggest that tissues derive energy directly from
      the dietary sugars which are present in high concentration during the period of
      absorption and that this reduces the post prandial requirement for NEFA.

PMID- 1737921
TI  - Hepatic haemodynamics and microvascular architecture after portal venular
      embolization in the rat.
AB  - To clarify the relationship between hepatic damage and alterations of hepatic
      microvascular architecture and haemodynamics following portal venule occlusion,
      the present study was performed in rats which had been injected into the portal
      vein with 700,000 plastic beads (30-35 microns in diameter). When the occluded
      segment of the portal venule was short, infarction did not occur because of the
      prompt development of vascular channels bypassing the obstructed venules. On the
      other hand, when the occluded segment was long, infarction usually occurred. In
      this case, formation of collateral vascular channels began as dilatation of the
      sinusoids in the vicinity of the occluded portal venules and increased in
      diameter and developed into new portal venules in 5 days. Increased portal
      vascular resistance after embolization was normalized after 5 days in parallel
      with the progression of reconstruction of vascular channels. Reduced bile
      production returned to a normal level 3 days after embolization. Necrotic tissue
      was resorbed completely and replaced by fibroblasts 5 days after embolization.
      These findings indicate that the development of infarct following portal venule
      occlusion depends on the length of the occluded segment, and that hepatic
      microvasculature has a great capacity for adaptation and rapid reconstruction of
      vascular channels which leads to speedy recovery from hepatic circulatory
      disturbances and resulting hepatic damage.

PMID- 1737922
TI  - The effects of alcohol use on rebleeding and mortality in patients with alcoholic
      cirrhosis following variceal haemorrhage.
AB  - The effect of continued alcohol intake on prognosis in alcoholic cirrhotics who
      have already bled from varices is controversial. To investigate the effect of
      alcohol intake on prognosis we studied 189 consecutive alcoholic cirrhotics
      admitted, for the first time, to the Royal Free Hospital with variceal bleeding.
      Sixty-six died within 30 days of admission and 23 were excluded from the study
      for other reasons. Of the 100 remaining 15 remained 'probably abstinent' over
      long-term follow-up, 29 drank occasionally and 56 continued to misuse/abuse
      alcohol. The percentage survival probability at 2 years was 66% in the probable
      abstainers, 68% in the occasional drinkers and 63% in the alcohol abuse/misuse
      group. There were no significant differences in either mortality or rebleeding
      rates between the three groups. A rebleeding index (designed to take account of
      the number of rebleeds per patient and the total length of follow-up) also failed
      to show any significant difference between the three groups. The Cox proportional
      hazard model was used to study the effect of the following factors on rebleeding
      and mortality; age, sex, alcohol use, Pugh's score, acute treatment received for
      initial variceal bleed and long-term treatment received for prevention of
      recurrent variceal haemorrhage. Pugh's score was significantly related to risk of
      death during follow-up (p = 0.0122), but none of the other factors was
      significantly related to risk of rebleeding or mortality. Using conventional
      methods to determine alcohol use we were unable to demonstrate significant
      effects of alcohol intake on rebleeding or mortality in alcoholic cirrhotics who
      had bled from oesophageal varices.

PMID- 1737923
TI  - Interaction of antigenic peptides with MHC class I molecules on living cells
      studied by photoaffinity labeling.
AB  - Using a direct binding assay based on photoaffinity labeling, we have studied the
      interaction of antigenic peptides with murine MHC class I molecules on living
      cells. Photoreactive derivatives were prepared by N-terminal amidation with iodo,
      4-azido salicylic acid of the Kd restricted Plasmodium berghei circumsporozoite
      (P.b. CS) peptide 253-260 (YIPSAEKI) and the Db-restricted Adenovirus 5 early
      region 1A (Ad5 E1A) peptide 234-243 (SGPSNTPPEI). As assessed in functional
      competition experiments, both peptide derivatives retained the specific binding
      activity of the parental peptides for Kd or Dd, respectively. The P.b. CS
      photoprobe specifically labeled Kd molecules on P815 (H-2d) cells, but failed to
      label RMA (H-2b) cells. Conversely, the Ad5 E1A photoprobe specifically labeled
      Db molecules on RMA cells, but failed to label P815 cells. When the two
      photoprobes were tested on a panel of Con A-activated spleen cells expressing 10
      different H-2 haplotypes, significant photoaffinity labeling was observed only on
      H-2d cells with the P.b. CS photoprobe and on H-2b cells with the Ad5 E1A
      photoprobe. Labeling of cell-associated Kd or Db molecules with the photoprobes
      was specifically inhibited by antigenic peptides known to be presented by the
      same class I molecule. Photoaffinity labeling of Kd with the P.b. CS photoprobe
      was used to study the dynamics of peptide binding on living P815 cells. Binding
      increased steadily with the incubation period (up to 8 h) at 37 degrees C and at
      ambient temperature, but was greatly reduced (greater than 95%) at 0 to 4 degrees
      C or in the presence of ATP synthesis inhibitors. The magnitude of the labeling
      was twofold higher at room temperature than at 37 degrees C. In contrast, binding
      to isolated Kd molecules in solution rapidly reached maximal binding,
      particularly at 37 degrees C. Dissociation of the photoprobe from either cell
      associated or soluble Kd molecules was similar, with a half time of approximately
      1 h at 37 degrees C, whereas the complexes were long-lived at 4 degrees C in both
      instances.

PMID- 1737924
TI  - The class II MHC-restricted presentation of endogenously synthesized ovalbumin
      displays clonal variation, requires endosomal/lysosomal processing, and is up
      regulated by heat shock.
AB  - LB27.4 cells (a B lymphoblastoid APC) were transfected with a plasmid containing
      an OVA cDNA. Functional analysis of six independent clones yielded three patterns
      of MHC-restricted presentation of the endogenously synthesized OVA. A clone
      displayed either: 1) strong class I and class II-restricted presentation, 2)
      strong class I but little or no class II-restricted presentation or, 3) only a
      modest class I-restricted presentation. There was no clonal variation in class II
      restricted presentation of exogenous Ag or in the amount of surface class I or II
      molecules. Heat shock increased the presentation of endogenous but not exogenous
      Ag with class II. These results indicate that an endogenously synthesized Ag both
      constitutively and during heat shock can gain access to the class II, MHC
      restricted, presentation pathway. The amount of OVA synthesized by a cell
      correlated with whether OVA-class II complexes were detected. However, the amount
      of OVA secreted into the extracellular fluid was not sufficient to sensitize APC,
      which suggests that endogenously synthesized OVA enters the class II pathway of
      Ag presentation by an intracellular route rather than by an
      extracellular/reuptake route. Also, the functional and quantitative analysis of
      the clones suggests that endogenously synthesized OVA was presented more
      efficiently with class I as compared to class II-MHC molecules. Leupeptin and
      chloroquine inhibited the class II-restricted presentation of endogenously
      synthesized OVA. Together these results indicate that endogenously synthesized
      OVA can gain access to an endosomal/lysosomal compartment via an intracellular
      route and be processed and presented in association with class II-MHC molecules.

PMID- 1737925
TI  - A toxic shock syndrome toxin-1 peptide that shows homology to mycobacterial heat
      shock protein 18 is presented as conventional antigen to T cells by multiple HLA
      DR alleles.
AB  - We observe that PBMC from most adults (16 of 18 subjects tested) show a small but
      significant in vitro proliferative response to a 30-amino acid-long peptide
      (peptide 2, amino acids 34-63) derived from toxic shock syndrome toxin. By
      contrast, PBMC from newborn blood and thymocytes do not proliferate to this
      peptide, and furthermore, peptide 2 did not displace the binding of radiolabeled
      TSST-1 to MHC class II positive cells, nor did it induce IL-1 beta mRNA in
      monocytes, indicating that this peptide does not behave as a superantigen.
      Proliferation of PBMC to peptide 2 could be blocked by anti-HLA-DR, but not by
      anti-HLA-DP or DQ mAb, suggesting that HLA-DR molecules are the restriction
      elements for the recognition of this peptide by T cells. This premise was further
      confirmed by demonstrating that mouse L cells transfected with human HLA-DR, but
      not HLA-DP or DQ molecules, supported the proliferation of purified T cells to
      peptide 2. Studies with subjects of known HLA-DR types showed that all types
      tested are capable of responding to this peptide, PBMC from adults exposed to
      mycobacterial Ag showed significantly better proliferative response to peptide 2
      than unexposed adults. Studies with truncations of this peptide suggest that a
      "core" region of eight amino acids that is conserved between low m.w. heat shock
      proteins and peptide 2 may be critical to T cell recognition of this peptide. The
      universal presentation of peptide 2 by HLA-DR molecules may contribute to the
      widespread natural immunity observed against toxic shock syndrome toxin.

PMID- 1737926
TI  - Human peripheral blood lymphocytes transplanted into SCID mice constitute an in
      vivo culture system exhibiting several parameters found in a normal humoral
      immune response and are a source of immunocytes for the production of human
      monoclonal antibodies.
AB  - Human PBL from vaccinated healthy blood donors, which was transplanted i.p. into
      mice with severe combined immunodeficiency (SCID), exhibited an Ag-dependent
      humoral Ir against tetanus toxoid. This Ir was dose dependent and was completely
      abrogated by immunizing with large amounts of Ag, suggesting a high dose
      tolerization of the B cells. A dose-dependent selection of specific, high
      affinity B clonotypes was also suggested, since immunization with low
      concentrations of tetanus toxoid produced antisera with higher avidity than
      immunizations using a high dose of Ag. The production of human Ig and the clonal
      outgrowth of normal human B cells in the SCID mouse was strongly down-regulated
      by human NK cells. Human immune B lymphocytes were also recovered from immunized
      SCID mice and transformed with EBV, yielding lymphoblastoid cell lines producing
      high affinity antitetanus human IgG antibodies. These results suggest that SCID
      mice, repopulated with human PBL, can constitute a functional model of several
      parameters of a normal human humoral Ir and can provide a source of immune B
      cells for the production of human mAb.

PMID- 1737927
TI  - Allogeneic chimerism in scid mice after neonatal transfer of bone marrow.
AB  - Allogeneic chimeras are valuable tools for studies of complex immune cell
      interactions in vivo. Mice with severe combined immune deficiency (scid) should
      be ideal hosts for chimerism with allogeneic bone marrow cells as these animals
      lack mature T and B lymphocytes capable of reacting against donor alloantigens.
      However, it has been difficult to achieve full reconstitution of adult scid mice
      even using coisogenic bone marrow grafts without prior irradiation of the
      recipient. We explored ways to generate complete reconstitution of scid mice with
      allogeneic bone marrow. Unirradiated adult scid recipients of allogeneic bone
      marrow were only marginally reconstituted. Adult scid mice pretreated with 250 R
      were reconstituted with allogeneic bone marrow as measured by serum IgM
      concentration, peripheral lymphoid cellularity, and mitogen responses, but a
      potentially important immunologic deficit was found in these mice: 250 R caused a
      70% loss of scid macrophages and dendritic cells which persisted at least 5
      months. By contrast, when scid mice were injected i.p. with allogeneic bone
      marrow within the first 24 h after birth, rapid and complete reconstitution of
      both T and B cell lineages was achieved, and the animals had APC that were both
      donor and host in origin. Considering the extent and duration of engraftment (43
      wk) by allogeneic cells in neonatally transplanted scid mice, it was anticipated
      that their bone marrow would be chimeric. However, the bone marrow contained very
      few donor-derived cells, suggesting that lymphopoiesis may be taking place in
      other organs in these chimeras.

PMID- 1737928
TI  - Transforming growth factor-beta enhances the M-CSF and GM-CSF-stimulated
      proliferation of macrophages.
AB  - Transforming growth factor-beta (TGF-beta) has been shown to regulate the
      proliferation and function of several different cell types in the immune system.
      We have examined the effect of TGF-beta on the proliferation of murine
      macrophages in liquid culture. TGF-beta by itself did not induce proliferation of
      differentiated (7 days in culture) bone marrow-derived macrophages (BMM). In the
      presence of M-CSF, TGF-beta enhanced the proliferation of differentiated BMM and
      elicited peritoneal macrophages but had an inhibitory effect on the proliferation
      of nonadherent BMM (3 days in culture). The effect of TGF-beta was not restricted
      to M-CSF-dependent proliferation but was also observed for GM-CSF-dependent
      proliferation. The autocrine production of TGF-beta appeared to contribute to the
      proliferation of BMM. The addition of antibody against TGF-beta inhibited M-CSF-
      and GM-CSF-dependent proliferation 32% and 28%, respectively. In bone marrow, TGF
      beta may be an important negative regulator of macrophage proliferation; whereas,
      in the tissues, TGF-beta may enhance macrophage proliferation.

PMID- 1737929
TI  - Transforming growth factor-beta 1 and IL-4 regulate the adhesiveness of Peyer's
      patch high endothelial venule cells for lymphocytes.
AB  - The adhesion of lymphocytes to endothelial cells lining the postcapillary high
      endothelial venules (HEV) is the first step in their emigration from the
      bloodstream into lymph nodes and Peyer's patches (PP). We have recently shown
      that the adhesiveness of cultured rat lymph node and PP HEV cells for thoracic
      duct lymphocytes can be increased significantly by pretreatment with TNF-alpha,
      IFN-gamma, and IL-4. In the present study we investigated the role of
      transforming growth factor-beta 1 (TGF-beta) on the adhesiveness of nonstimulated
      and cytokine-stimulated PP HEV cells for rat lymphocytes. The results indicated
      that at picomolar concentrations, TGF-beta significantly (p less than 0.001)
      decreased the ability of PP HEV cells to adhere 51Cr-labeled rat lymphocytes.
      Maximal inhibition was observed with a TGF-beta dose of 0.5 ng/ml and an
      incubation time of 6 to 12 h. TGF-beta did not affect the morphology of HEV cells
      and had no adverse effect on their viability. Moreover, the decrease in HEV
      adhesiveness by TGF-beta was reversible, with lymphocyte binding returning to
      control level 24 h after removal of the cytokine. The specificity of TGF-beta was
      confirmed by the ability of neutralizing anti-TGF-beta 1 antibody, but not
      control serum, to abolish the inhibitory properties of the cytokine. In addition,
      TGF-beta completely abrogated the increased adhesiveness of PP HEV cells normally
      induced by TNF-alpha or IFN-gamma. In contrast, TGF-beta had no effect on the
      stimulating effects of IL-4. Moreover, preincubation of PP HEV cells with TGF
      beta did not alter the ability of these cells to respond to IL-4. Importantly,
      the adhesion of rat lymphocytes to IL-4-stimulated PP HEV cells can be blocked by
      pretreatment of lymphocytes with the PP-homing receptor-specific 1B.2.6 antibody
      whereas pretreatment of human mononuclear cells with anti-very late activation
      antigen-4 alpha antibody inhibited only partially the binding of these cells to
      the IL-4-stimulated PP HEV monolayers. Taken together, these findings strongly
      suggest that TGF-beta and IL-4 play important regulatory roles in lymphocyte-HEV
      adhesion and that the stimulatory effect of IL-4 is mediated at least in part
      through the increased expression of organ-specific ligands on HEV cells.

PMID- 1737930
TI  - Human IL-3 induction of c-jun in normal monocytes is independent of tyrosine
      kinase and involves protein kinase C.
AB  - We have used normal human monocytes as a model system to begin elucidating the
      signal transduction mechanism associated with the IL-3R. Normal human monocytes
      deprived of human serum and CSF become quiescent in vitro. Stimulation of these
      cells with rIL-3 induces expression of the c-jun protooncogene, as detected by
      Northern blotting of total monocyte RNA. This protooncogene is also induced in
      these cells by phorbol ester through direct stimulation of protein kinase C.
      Concentrations of the protein kinase C inhibitor I-(5-isoquindinyl-sulfonyl)-2
      methylpiperazine (H-7) between 30 and 100 microM (5-20 x Ki) inhibit this
      induction by phorbol ester. The same concentration-range of H-7 completely
      inhibited the induction of c-jun by human IL-3. A structural analog of H-7
      designated HA-1004 preferentially inhibits cyclic nucleotide-dependent protein
      kinase rather that protein kinase C. HA-1004 at 5 to 20 x Ki did not inhibit IL-3
      induced c-jun mRNA accumulation. Further 30 microM genistein that is an effective
      inhibitor of cellular tyrosine kinases did not inhibit IL-3-induced c-jun
      expression. Immunoprecipitation of lysates from [32P]orthophosphate labeled cells
      with antiphosphotyrosine polyclonal antibody showed that IL-3-stimulated
      phosphorylation of a 70-kDa protein and a 110-kDa protein on tyrosine, and that
      these protein phosphorylations were completely inhibited by 30 microM genistein.
      As further confirmation that IL-3 is stimulating protein kinase C in human
      monocytes we have found that IL-3 stimulates phosphorylation of the unique
      protein kinase C substrate myristoylated alanine-rich C kinase substrate in these
      cells. It is therefore likely that the interaction of IL-3 with its receptor
      generates diacylglycerol and stimulates the Ca2+/phospholipid-dependent protein
      kinase C.

PMID- 1737931
TI  - IL-10 inhibits human T cell proliferation and IL-2 production.
AB  - Human IL-10 has been reported previously to inhibit the secretion of IFN-gamma in
      PBMC. In this study, we have found that human IL-10 inhibits T cell proliferation
      to either mitogen or anti-CD3 mAb in the presence of accessory cells. Inhibited T
      cell growth by IL-10 was associated with reduced production of IFN-gamma and IL
      2. Studies of T cell subset inhibition by human IL-10 showed that CD4+, CD8+,
      CD45RA high, and CD45RA low cells are all growth inhibited to a similar degree.
      Dose response experiments demonstrated that IL-10 inhibits secretion of IFN-gamma
      more readily than T cell proliferation to mitogen. In addition, IL-2 and IL-4
      added exogenously to IL-10 suppressed T cell cultures reversed completely the
      inhibition of T cell proliferation, but had little or no effect on inhibition of
      IFN-gamma production. Thus, in addition to its previously reported biologic
      properties, IL-10 inhibits human T cell proliferation and IL-2 production in
      response to mitogen. Inhibition of IFN-gamma production by IL-10 appears to be
      independent of the cytokine effect of IL-2 production.

PMID- 1737933
TI  - HLA-Bw22: a family of molecules with identity to HLA-B7 in the alpha 1-helix.
AB  - Various HLA-B molecules exhibit serologic cross-reactions with HLA-B7, including
      HLA-B27, B40, Bw42, and Bw22. Of this group, primary structures for the three
      serologic subdivisions of HLA-Bw22, HLA-Bw54, Bw55, and Bw56, have yet to be
      determined. Here, we describe the nucleotide sequences of five distinctive HLA
      Bw22 alleles isolated from cells of different ethnic origins typed either for
      Bw54, Bw55, or Bw56. Heterogeneity in molecules typed as Bw55 and Bw56 was
      defined. The five HLA-Bw22 alleles form a closely related family that appears to
      have evolved by a series of simple gene conversion events, all of which alter the
      antigen recognition site of the encoded proteins. Of note, HLA-Bw54 is the
      product of a gene conversion between HLA-B and C alleles. All the Bw22 alleles
      encode an alpha 1-helix identical in amino acid sequence to that of HLA-B7 and
      Bw42, a feature almost certainly responsible for the serologic cross-reactivity
      of these molecules. Shared substitutions in the alpha 1-helix can also explain
      the cross-reactivity of Bw22 and B7 with B27. Patterns of amino acid substitution
      in the alpha 2-domain of Bw22 heavy chains correlate with certain antibody and T
      cell cross-reactivities, thereby implicating particular amino acids in their
      target epitopes.

PMID- 1737932
TI  - Chimeric and humanized antibodies with specificity for the CD33 antigen.
AB  - L and H chain cDNAs of M195, a murine mAb that binds to the CD33 Ag on normal and
      leukemic myeloid cells, were cloned. The cDNAs were used in the construction of
      mouse/human IgG1 and IgG3 chimeric antibodies. In addition, humanized antibodies
      were constructed which combined the complementarity-determining regions of the
      M195 antibody with human framework and constant regions. The human framework was
      chosen to maximize homology with the M195 V domain sequence. Moreover, a computer
      model of M195 was used to identify several framework amino acids that are likely
      to interact with the complementarity-determining regions, and these residues were
      also retained in the humanized antibodies. Unexpectedly, the humanized IgG1 and
      IgG3 M195 antibodies, which have reshaped V regions, have higher apparent binding
      affinity for the CD33 Ag than the chimeric or mouse antibodies.

PMID- 1737934
TI  - Expression of human IL-1 beta in Salmonella typhimurium. A model system for the
      delivery of recombinant therapeutic proteins in vivo.
AB  - The feasibility of using Salmonella typhimurium aroA mutant (SL3261) to deliver
      protein therapeutic agents was investigated in a murine model system. We have
      constructed an Escherichia coli expression plasmid designed to express the human
      protein IL-1 beta. This plasmid expresses IL-1 beta to high levels (greater than
      30% total cell protein) in E. coli. In Salmonella the IL-1 beta is expressed
      constitutively to about 10% total cell protein, as verified by Western blotting
      analysis using polyclonal rabbit anti-IL-1 beta antibody. The protein is produced
      in a soluble and biologically active form. BALB/c mice administered orally or
      i.v. with S. typhimurium aroA mutants carrying the plasmid produced highly
      significant antibody responses against human IL-1 beta as determined by a solid
      phase RIA. Furthermore, mice injected with the construct were significantly
      protected against lethal gamma-irradiation (850 rad). This study therefore
      demonstrates that the vaccine strain of Salmonella mutants can also be used
      effectively to deliver therapeutic proteins in vivo.

PMID- 1737935
TI  - Stimulus-response coupling in monocytes infected with Leishmania. Attenuation of
      calcium transients is related to defective agonist-induced accumulation of
      inositol phosphates.
AB  - Mononuclear phagocytes infected with Leishmania have been shown to have defective
      responses to extracellular stimuli. To investigate the potential relationship of
      these findings to alterations in calcium-dependent signaling pathways, the
      regulation of [Ca2+]i concentrations was examined in human peripheral blood
      monocytes infected with amastigotes of Leishmania donovani. Measurements of
      [Ca2+]i in fura-2-loaded monocytes were made at the single cell level by
      microfluorimetry. In normal monocytes, resting [Ca2+]i was 56 +/- 2 nM (mean +/-
      SEM). In contrast, in monocytes infected with Leishmania there was an
      approximately twofold increase in basal [Ca2+]i (122 +/- 5 nM, p less than 0.01
      vs control). Treatment of cells with pertussis toxin before infection did not
      abrogate infection-induced increases in basal [Ca2+]i, suggesting that this
      effect was not mediated via the activation of a G protein coupled to
      phospholipase C. However, elevated resting [Ca2+]i did correlate with increased
      rates of 45Ca2+ uptake by infected monocytes. As expected, in response to
      treatment with 10(-7) M FMLP, control monocytes showed rapid net increases in
      [Ca2+]i of 303 +/- 19 nM. In contrast, net transients of [Ca2+]i in infected
      monocytes in response to FMLP were attenuated to only 137 +/- 9 nM (p less than
      0.01 vs control). This result was not related to excess buffering of [Ca2+]i in
      infected cells as both control and infected monocytes showed equivalent
      transients of [Ca2+]i in response to the calcium ionophore A23187. Rather,
      inhibition of agonist-induced calcium release in infected cells appeared related
      to defective generation of second messenger because compared to control cells
      labeled with myo-[2-3H]inositol, little accumulation of inositol 1,4,5
      trisphosphate was detected in infected monocytes. Attenuation of inositol
      phosphate accumulation and calcium release in response to chemotactic peptide
      correlated with decreased FMLP-induced superoxide and hydrogen peroxide
      production by infected monocytes. These results provide direct evidence for
      defective regulation of [Ca2+]i and calcium-dependent signaling in Leishmania
      infected monocytes and provide a basis for understanding abnormalities in
      activation-related responses that involve signaling through Ca(2+)-regulated
      pathways.

PMID- 1737936
TI  - Two regions of the H-2 Dd promoter are responsive to dimethylsulfoxide in line 1
      cells by a mechanism distinct from IFN-gamma.
AB  - The line 1 lung carcinoma is a spontaneous BALB/c tumor deficient in class I Ag
      expression at the protein and mRNA levels. Exposure of line 1 cells to 3% DMSO or
      IFN-gamma increases class I Ag protein and mRNA dramatically. We have examined
      the regulation of class I Ag induction by DMSO in line 1 cells. We found DMSO
      induces class I Ag expression in line 1 cells by a mechanism distinct from IFN,
      because the kinetics of class I Ag induction by these agents were dramatically
      different, 7 days vs 3 days, and DMSO did not act through an IFN second
      messenger. At the molecular level, class I H chain transcription in line 1 cells
      was low. Treatment with 3% DMSO or IFN-gamma increased H chain transcription four
      fold and sevenfold, respectively, indicating that class I H chain expression is
      regulated at the level of transcription in line 1 cells. Using reporter gene
      constructs, we mapped the regions in the Dd H chain promoter that increase H
      chain expression after DMSO treatment of line 1 cells. Two regions of the Dd
      promoter, D1, from -210 to -133 bp, and D2, from -125 to -61 bp, were found to be
      independently responsive to DMSO. These regions were also responsive to IFN-gamma
      in line 1 cells. However, consistent with our cellular results, DMSO and IFN
      induction of class I H chain expression differed at the molecular level as
      determined by D1 point mutations that diminished IFN-gamma responsiveness but did
      not alter induction by DMSO. Thus, DMSO appears to regulate class I transcription
      through multiple regions of the class I H chain promoter in line 1 cells by a
      mechanism distinct from IFN-gamma.

PMID- 1737937
TI  - Analysis of the AP-1 sites in the IL-2 promoter.
AB  - We have investigated the role of the two AP-1 sites, located at approximately 
      150 and -180 bp relative to the transcription start site, in induction of the IL
      2 promoter through the TCR/CD3 complex. We show that only the proximal (-150 bp)
      AP-1 site is functional in vitro, as judged by its ability to bind nuclear
      proteins from T cells stimulated with Ag or anti-CD3 epsilon. The inducible
      nuclear proteins binding to this site have the characteristics of AP-1, as judged
      by their kinetics of induction, the ability to compete and be competed
      efficiently by a metallothionein AP-1 site oligonucleotide, and their reaction
      with antibodies to Fos and Jun proteins. Mutations in the proximal AP-1 site
      greatly diminish or abrogate induction of the IL-2 promoter, indicating that the
      site is also functional in vivo. Although the distal (-180 bp) AP-1 site is
      incapable of direct binding to nuclear proteins from activated T cells, a
      mutation in this site diminishes IL-2 promoter induction, suggesting that this
      site may also be functional in vivo. Cotransfection of a 5' IL-2-chloramphenicol
      acetyltransferase plasmid with c-Fos and/or c-Jun enhances the induction of IL-2
      chloramphenicol acetyltransferase activity, confirming that the IL-2 promoter
      contains a functional AP-1 site. Both AP-1 sites may be targets for c-Fos action,
      as inferred from the results of experiments in which c-Fos was cotransfected with
      internal deletion mutants of the IL-2 promoter lacking either AP-1 site. Northern
      analysis indicates that mRNAs for at least six members of the Fos/Jun family (c
      fos, fosB, fra-1, c-jun, junB, and junD) are expressed in activated Ar-5 cells;
      thus the AP-1 sites of the IL-2 promoter may bind different dimeric Fos/Jun
      complexes at different times after T cell activation, perhaps mediating both
      positive and negative regulation of the IL-2 promoter.

PMID- 1737938
TI  - Characterization of complementary DNA clones encoding the rabbit IL-8 receptor.
AB  - IL-8 is a proinflammatory cytokine that functions as a chemoattractant for
      neutrophils. Recently, cDNA clones encoding the human neutrophil IL-8R were
      isolated by an expression cloning strategy. The amino acid sequence of the human
      IL-8R was sufficiently similar to a published sequence for an isoform of the
      rabbit FMLP receptor that we considered the possibility that the rabbit sequence
      might bind IL-8 as well. In order to establish its ligand specificity, we have
      isolated and characterized cDNA clones encoding the rabbit receptor. These cDNA
      clones, when expressed in mammalian cells, confer high affinity IL-8 binding (Kd
      = 3.6 nM), lack detectable binding of FMLP, and produce a transient increase in
      the intracellular Ca2+ concentration in response to IL-8 but not to FMLP. These
      data demonstrate that the reported rabbit FMLP receptor is the rabbit IL-8R, not
      an isoform of the FMLP receptor. In addition, the amino acid sequence of the
      rabbit IL-8R encoded by these cDNA clones differs at 23 amino acids (of 355) from
      that previously published.

PMID- 1737939
TI  - Differential expression of related HLA class II DQ beta genes caused by
      nucleotide variation in transcriptional regulatory elements.
AB  - HLA class II genes comprise a large multigene family with intra- and interlocus
      variation in structure and expression. Within this family of related genes, the
      HLA-DX alpha and beta loci (HLA DQA2 and DQB2) are highly homologous to
      functional HLA-DQ loci (HLA DQA1 and DQB1) but are frequently termed pseudogenes
      because DX gene transcription has not been observed, even in cells expressing HLA
      DQ. Analysis of upstream transcriptional regulatory elements for the DX beta and
      DQ beta genes identified a high degree of nucleotide homology, consistent with
      their derivation from a common ancestral class II gene. However, transient
      expression assays with plasmids utilizing promoter elements from the DX beta gene
      had no activity in transfected human B cells, in contrast to homologous DQ beta
      sequences. Reciprocal exchange of specific sequences from the DQ beta gene with
      those of the DX beta gene restored expression to wild-type DQ beta levels, as did
      mutagenesis of only three DX-specific nucleotides in the upstream regulatory
      region. These three nucleotides mark two binding sites for distinct nuclear DNA
      binding proteins that differentially recognize DQ beta and DX beta sequences.
      Transcription of these genes is critically dependent on interactions between
      these two upstream regulatory region sites which distinguish DX beta from its
      closely related homologue, DQ beta.

PMID- 1737940
TI  - Monocyte chemotactic cytokine gene transfer modulates macrophage infiltration,
      growth, and susceptibility to IL-2 therapy of a murine melanoma.
AB  - Tumor-derived chemotactic factors have been identified and suggested to play a
      role in the regulation of macrophage infiltration in neoplastic tissues. The
      present study was designed to assess the in vivo relevance of a tumor-derived
      chemotactic factor molecularly identified as monocyte chemotactic protein (MCP;
      alternative designations are JE and MCAF) by gene transfer in a murine melanoma.
      After gene transfer, MCP-producing melanoma clones showed a marked (twofold)
      increase in the percentage of tumor-associated macrophages compared with control
      clones and with the parent line: for instance, the percentage of tumor-associated
      macrophages was 20.9 +/- 1.5, 29.4 +/- 2.3, and 47.6 +/- 2.5 for the parent line,
      the control V14 clone, and the MCP-producing L12 clone, respectively. MCP
      producing cells were tumorigenic but exhibited a slower growth rate in vivo
      (e.g., doubling time of 2.9 and 6.6 days for the control V14 and the MCP
      producing L12 clone, respectively) with a prolongation of survival time. The in
      vitro growth rate of melanoma clones was unaffected by MCP gene transfer. The
      same difference between MCP-producing and control cells, in terms of macrophage
      infiltration and growth rate, was detected after implantation in athymic mice.
      Whereas the in vivo growth rate of MCP-expressing tumors was slower, after i.m.
      inoculation of small cell numbers (10(2) cells) MCP-producing cells were
      slightly, but significantly, more tumorigenic. Local administration of IL-2 had
      modest, but definite, antitumor activity in this model; MCP-producing cells were
      less susceptible to local IL-2 immunotherapy. These results demonstrate that a
      tumor-derived chemotactic cytokine can indeed play a role in the regulation of
      mononuclear phagocyte recruitment in neoplastic tissues and emphasize how tumor
      associated macrophages can exert a dual influence in tumor-host interactions.

PMID- 1737942
TI  - On being a doctor at the year's beginning.

PMID- 1737941
TI  - A stromal cell-specific monoclonal antibody augments the stromal cell-dependent B
      lymphopoiesis.
AB  - We produced the mAb R25 against the stromal cell line ST2, which could support B
      lymphopoiesis in vitro. R25 enhanced the ability of ST2 to support B
      lymphopoiesis and precipitated molecules of 110 and 120 kDa (p110/120) from ST2
      cell lysates. p110/120 were also expressed on other stromal and fibroblast cell
      lines but not on freshly isolated bone marrow hematopoietic cells, spleen cells,
      and lymphoid cell lines. However, R25 had no or weak effect on the stromal cell
      dependent myelopoiesis. Even under conditions in which bone marrow cells were
      separated from stromal cells with a membrane filter, R25 could augment the
      stromal cell-dependent B lymphopoiesis. However, R25 did not induce the increase
      of IL-7 mRNA of ST2 cells. Taken together, these findings suggest that the
      stromal cell surface molecules p110/120 are involved in the stromal cell
      dependent B lymphopoiesis and that certain soluble factors distinct from IL-7 may
      contribute to the p110/120-mediated B cell generation.

PMID- 1737943
TI  - Cost to society high for bogus DME orders.

PMID- 1737944
TI  - Push and pull: a look at the 1992 Georgia General Assembly.

PMID- 1737945
TI  - Medicare rip-off: DME fraud bleeds the system.

PMID- 1737947
TI  - Rescuing tort reform.

PMID- 1737946
TI  - Surgical treatment of spontaneous dissection of the internal carotid artery: case
      report and review.

PMID- 1737949
TI  - AMA provides AIDS guidelines for physicians.

PMID- 1737948
TI  - Diagnostic and therapeutic considerations in the management of atrial
      fibrillation.

PMID- 1737950
TI  - American Medical Association battles five threats to public health.

PMID- 1737951
TI  - AIDS and HIV testing.

PMID- 1737952
TI  - Different effects of the antiprogesterone RU486 on progesterone secretion by the
      corpus luteum of rats with 4- and 5-day oestrous cycles.
AB  - Administration of the antiprogesterone RU486 (2 mg/day) for 14 days to rats with
      a 5-day reproductive cycle resulted in an increase in both ovarian and pituitary
      weight in contrast with rats with a 4-day oestrous cycle. Luteal progesterone
      production decreased earlier in 4-day than in 5-day cyclic rats. Treatment of 5
      day cyclic rats with antiprogesterone from the day of metoestrus onwards resulted
      in the advancement of the preovulatory prolactin surge by 24 h. Progesterone
      production by the corpus luteum was, however, not affected, indicating that in 5
      day cyclic rats the corpora lutea are still functionally active at the time of
      the preovulatory surge of prolactin. They become, therefore, stimulated both in
      size and progesterone production. In contrast, the corpora lutea in 4-day cyclic
      rats are functionally inactive at the time of the preovulatory surge of
      prolactin, and prolactin acts luteolytically. In conclusion, the advancement of
      the preovulatory surge of prolactin by 24 h accounts, at least in part, for the
      increase in ovarian weight in 5-day cyclic rats after treatment with
      antiprogesterone. The results of these experiments do not agree with a direct
      effect of the antiprogesterone RU486 on progesterone secretion by the corpus
      luteum.

PMID- 1737953
TI  - Translational status of the insulin-like growth factor-I mRNAs in liver of
      protein-restricted rats.
AB  - Dietary protein restriction in young rats decreases serum insulin-like growth
      factor-I (IGF-I) concentrations and the amount of liver IGF-I mRNA, suggesting
      that regulation for the liver IGF-I gene expression in this model occurs at a
      pretranslational level. To determine whether there is also translational control,
      we assessed the association of the liver IGF-I mRNA transcripts with polysomes in
      livers of normally fed (15% dietary protein) versus protein-restricted (5%
      dietary protein) rats. One week of dietary protein restriction reduces serum IGF
      I concentrations by 54% and the amount of liver IGF-I mRNA by 35%, with the 7.5
      kb size-class of IGF-I mRNA being the most affected (-48%). Protein restriction
      reduces the amount of the polysomal IGF-I mRNAs by 30%, a value in close
      agreement with the changes in total IGF-I mRNAs. Protein restriction is not
      associated with changes in the distribution of IGF-I mRNAs between the polysomal
      and non-polysomal fractions. All major size-classes of IGF-I mRNA transcripts
      (7.5, 4.7, 1.7, 0.9-1.2 kb) are associated with the polysomes in both dietary
      groups, suggesting involvement in the initiation phase of the IGF-I translation.
      We conclude that no untranslatable pool of IGF-I mRNAs is present in the liver of
      protein-restricted animals. Protein restriction, however, decreases slightly the
      mean size of polysomes. This decrease in ribosomal number associated with the IGF
      I mRNA could decrease translational efficiency. Our data suggest that dietary
      protein restriction does not impair the initiation of IGF-I mRNA translation.

PMID- 1737954
TI  - Relaxin increases the firing rate of supraoptic neurones and increases oxytocin
      secretion in the rat.
AB  - In urethane-anaesthetized ovariectomized rats, injection of porcine relaxin (7.5
      and 15 micrograms/kg, i.v.) caused a sustained increase in circulating plasma
      oxytocin and vasopressin concentrations; 10 micrograms relaxin/rat i.v. produced
      a smaller but significant increase in plasma oxytocin concentration in conscious
      ovariectomized rats. A significant increase in oxytocin concentration and
      inhibition of the spontaneous milk-ejection reflex was also seen in anaesthetized
      (ovary intact) lactating rats following injection of relaxin (7.5 micrograms/kg,
      i.v.). To investigate whether relaxin acts by increasing the electrical activity
      of oxytocin neurones or by facilitating stimulus-secretion coupling in the
      pituitary, the electrical activity of neurones in the supraoptic nucleus was
      recorded in urethane-anaesthetized lactating rats and in ovariectomized rats.
      Porcine relaxin (10 micrograms/rat, i.v.) increased the firing rate of both
      oxytocin and vasopressin neurones in the supraoptic nucleus in lactating rats.
      The response to relaxin was unaffected by subsequent injection of naloxone (1
      mg/kg, i.v.). Oxytocin neurones were also activated by injection of relaxin (10
      micrograms/rat) into ovariectomized rats. Combining the electrophysiological
      data, the neuronal activation following relaxin was significantly correlated with
      the level of spontaneous activity prior to relaxin injection. The results show
      that relaxin acts centrally to increase circulating plasma oxytocin and
      vasopressin concentrations by an opioid-independent mechanism.

PMID- 1737955
TI  - Release of proinsulin from the human fetal beta cell.
AB  - beta cells in the human fetal pancreas are immature in that they release little
      or no insulin in response to nutrients, such as glucose. The aim of this study
      was to examine further the immaturity of these cells, specifically regarding the
      storage and release of the precursor of insulin, proinsulin. Explants of human
      fetal pancreas were cultured in vitro for 3 weeks. Levels of proinsulin remained
      relatively constant throughout at 0.04 +/- 0.002 (S.E.M.) pmol/mg per day with a
      molar ratio of proinsulin to insulin of 2.2 +/- 0.11%. This low ratio was
      slightly greater than that observed in culture medium conditioned by adult human
      islets (0.3 +/- 0.1%), but similar to that found in acid-ethanol extracts of
      cultured explants (1.4 +/- 0.3%). Passaging of human fetal pancreas for 3 months
      in diabetic nude mice, which should have caused some maturation of the fetal beta
      cell, did not change the proportion of proinsulin present. Culture of explants in
      the presence of 12-O-tetra-decanoylphorbol-13-acetate resulted in some inhibition
      of proinsulin release, but much less than that for insulin, so that the molar
      ratio increased to 15.4 +/- 1.6% from the control 3.5 +/- 0.3%. Static
      stimulation of cultured explants with 10 mmol Ca2+/l, 10 mmol theophylline/l, and
      these two agents together caused 15-, 4- and 10-fold enhancement respectively of
      proinsulin release; glucose, leucine, arginine and KCl had no effect. In
      contrast, all these agents caused significant insulin release, the last four to a
      much smaller extent (less than or equal to three fold) than the first three (10-,
      19- and 65-fold respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737956
TI  - Seasonal changes in plasma androgens, glucocorticoids and glucocorticoid-binding
      proteins in the marsupial sugar glider Petaurus breviceps.
AB  - An investigation spanning two breeding seasons was carried out to examine
      endocrine changes associated with reproduction in a wild population of the
      marsupial sugar glider Petaurus breviceps, a small arboreal gliding possum. Using
      techniques of equilibrium dialysis and polyacrylamide gel electrophoresis at
      steady-state conditions, a high-affinity, low-capacity glucocorticoid-binding
      protein was demonstrated in the plasma of Petaurus breviceps. Equilibrium
      dialysis at 36 degrees C using cortisol gave a high-affinity binding constant of
      95 +/- 5.2 litres/mumol for a presumed corticosteroid-binding globulin (CBG)
      while the binding constant for the cortisol-albumin interaction was 3.5 +/- 0.4
      litres/mmol. There was no difference between the sexes in the affinity of binding
      of cortisol to CBG; however, the cortisol-binding capacity underwent seasonal
      variation in both sexes. Progesterone was bound strongly to the presumed CBG
      while neither oestradiol nor aldosterone appeared to be bound with high affinity
      to P. breviceps plasma. In the males, peaks in the plasma concentration of
      testosterone coincided with the July-September breeding season in both years. A
      significant inverse relationship was shown to exist between the plasma
      testosterone concentration and the CBG-binding capacity. In both sexes an
      increase occurred in the plasma concentration of free cortisol during the first
      breeding season, a pattern which was not repeated in the subsequent breeding
      season, possibly due to a lower population density in that year.

PMID- 1737957
TI  - Gonadal steroids effect similar regulation of gonadotrophin subunit mRNA
      expression in both male and female rats.
AB  - Gonadal steroids can act both indirectly via gonadotrophin-releasing hormone
      (GnRH) and directly on the pituitary to regulate gonadotrophin subunit gene
      expression. Recent studies to assess a possible direct action at the pituitary
      have shown that testosterone, when given to males in the absence of endogenous
      GnRH action, selectively increases FSH-beta mRNA concentrations. Conversely, in
      females, oestradiol appears to regulate gonadotrophin subunit mRNAs primarily via
      GnRH. The present study was designed to determine whether these differing results
      reflect specific actions of the gonadal steroids themselves or different
      responses of the pituitary gonadotroph cells in males and females. Rats which had
      been castrated 7 days earlier were given silicone elastomer implants (s.c.)
      containing oestradiol (plasma oestradiol 68 +/- 4 ng/l) in males or testosterone
      (plasma testosterone 3.5 +/- 0.3 micrograms/l) in females in the absence or
      presence of a GnRH antagonist. Seven days later pituitaries were removed and
      steady-state mRNA concentrations measured by dot-blot hybridization. In males,
      oestradiol reduced LH-beta and FSH-beta but not alpha mRNA. The antagonist
      reduced levels of all three subunit mRNAs in males and the addition of oestradiol
      had no further effect, suggesting that oestradiol regulates gonadotrophin subunit
      gene expression in males by suppressing GnRH secretion. In females, testosterone
      reduced all three subunit mRNAs though FSH-beta remained threefold higher than in
      intact animals. The GnRH antagonist was as effective as testosterone alone and
      reduced alpha and LH-beta to levels found in intact animals.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1737958
TI  - Comparison of the galactopoietic response to pituitary-derived and recombinant
      derived variants of bovine growth hormone.
AB  - Two studies were designed to examine the differences in galactopoietic potency of
      molecular variants of pituitary- and recombinant-derived bovine GH (bGH). The
      recombinant bGH molecules included amino-terminal and position-127 amino acid
      substitutions which are representative of two of the four natural pituitary
      variants or of partially degraded bGH molecules. Amino-terminal variants of bGH
      included methionine (Met1), alanine (Ala1), serine (Ser1) or deletion of four
      amino acids (delta 1-4). The delta 1-4 variants were representative of
      degradation products previously isolated in pituitary bGH preparations. In the
      first study, 54 lactating Holstein cows received i.m. injections of a buffer
      solution (control), pituitary-derived bGH, or recombinant-derived [Met1,Leu127]
      bGH, [Met1,Val127]-bGH, [Ala1,Leu127]-bGH, or [Ala1,Val127]-bGH. Cows received 25
      mg bGH/day for 21 days. Substitution of the amino-terminal alanyl residue with
      methionine did not affect milk response. GH variants with Val127 elicited a
      greater milk response (8.5 kg/day) than Leu127 bGH variants (6.5 kg/day). The
      average milk response to the four recombinant bGH variants was 7.5 kg/day greater
      than controls compared with 4.4 kg/day for pituitary-derived bGH. In contrast,
      blood bGH concentrations were equivalent for pituitary and recombinant bGH
      treatments, approximately 20 micrograms/l more than control levels at 3 h after
      injection. Blood free fatty acid concentrations were increased, but insulin and
      glucose levels were unaffected by bGH treatment. In the second study, 54
      lactating Holstein cows received i.m. injections of a buffer control solution or
      recombinant-derived [Met1,Leu127]-bGH, [Ser1,Leu127]-bGH, [Ser1,Val127]-bGH,
      [delta 1-4,Leu127]-bGH or [delta 1-4,Val127]-bGH. Cows received 25 mg bGH/day for
      28 days. The milk response to full-length bGH variants was 6.6 kg/day greater
      than the response to the amino-terminal deletion variants (P less than 0.05).
      Substitution of valine for leucine did not affect milk response to either the
      deletion (delta 1-4) or full-length (Met1 or Ser1) bGH molecules. In conclusion,
      the lowered galactopoietic potency of pituitary bGH preparations was
      demonstrated, at least in part, to be due to the presence of amino-terminal amino
      acid deletions rather than differences in amino acid sequences of recombinant
      bGH. Ala1 bGH variants with valine at position 127 elicited a greater milk
      response than Leu127 variants.

PMID- 1737959
TI  - Release of corticotrophin-releasing factor-41, arginine vasopressin and oxytocin
      from rat fetal hypothalamic cells in culture: response to activation of
      intracellular second messengers and to corticosteroids.
AB  - The effects of the activation of protein kinase A (PKA), protein kinase C (PKC)
      and corticosteroids were investigated on the release of corticotrophin-releasing
      factor-41 (CRF), arginine vasopressin (AVP) and oxytocin from rat fetal
      hypothalamic cells in culture. Both forskolin and PMA (phorbol 12-myristate 13
      acetate) increased CRF, AVP and oxytocin release, while dexamethasone and
      aldosterone only reduced basal secretion of CRF. Both steroids also inhibited
      forskolin-induced CRF, AVP and oxytocin responses to PMA. These data provide
      direct evidence for a role for both PKC- and PKA-mediated mechanisms in the
      regulation of CRF, AVP and oxytocin release and for differential effects of both
      glucocorticoids and mineralocorticoids on PKA- and PKC-stimulated responses.

PMID- 1737960
TI  - Effects of cytokines on rat insulinoma INS-1 cells.
AB  - To investigate further the role of cytokines in the pathogenesis of type I
      insulin-dependent diabetes mellitus, the effects of interleukin-1 beta (IL-1),
      tumour necrosis factor-alpha (TNF) and gamma-interferon (IFN) were tested on rat
      insulinoma INS-1 cells. Whereas TNF and IFN had, respectively, a minor or no
      effect on insulin production, IL-1 caused a time- and dose-dependent decrease in
      insulin release and lowered the insulin content as well as the preproinsulin mRNA
      content of INS-1 cells. Both IL-1 and TNF exerted a cytostatic effect, estimated
      by a decrease in [3H]thymidine incorporation, while only IL-1 decreased cell
      viability as measured by the colorimetric 3-(4,5-dimethylthiazol-2-yl)-2,5
      diphenyltetrazolium bromide (MTT) test. The glutathione content of INS-1 cells
      was shown to be modulated by the presence of 2-mercaptoethanol in the culture
      medium, but was not affected by IL-1 or TNF. In conclusion, INS-1 cell culture is
      considered to be a useful model for studying the effect of cytokines on insulin
      producing cells. The differentiated features of these cells will permit several
      questions to be addressed regarding the mechanism of action of IL-1 and
      eventually other cytokines, both at the level of gene expression and of
      intracellular signalling.

PMID- 1737961
TI  - Osmoregulatory adaptation in pregnancy and its disorders.
AB  - The physiological osmoregulatory adaptations of pregnancy include decreased
      thresholds for both thirst and AVP secretion and increased MCR for AVP. The
      combined effects of these changes may unmask subclinical DI. In view of the
      altered relationship between serum osmolality and thirst, caution is required in
      investigating thirst and polyuria in pregnancy lest an erroneous diagnosis of
      psychogenic polydipsia be made.

PMID- 1737962
TI  - Arachidonic acid-induced LH release is ATP-independent and insensitive to N-ethyl
      maleimide.
AB  - The mechanism of arachidonic acid (AA)-induced LH release was characterized using
      sheep pituitary cells in primary culture permeabilized with Staphylococcal alpha
      toxin. In intact cells, exogenous AA evoked release of LH in a manner which was
      partially dependent on extracellular Ca2+. At similar concentrations, AA also
      caused cell permeabilization as monitored by efflux of [3H]2-deoxyglucose
      metabolites. In alpha-toxin-permeabilized cells where cytosolic Ca2+ was clamped
      at resting levels, AA retained its ability to cause LH release. Unlike the
      stimulation of exocytosis produced by Ca2+, phorbol ester or cyclic AMP, AA
      evoked release was independent of ATP and was not inhibited by pretreatment with
      N-ethyl maleimide. These findings indicated that exogenous AA does not cause LH
      release by Ca2+ influx or mobilization or by activating protein kinase C. The
      results suggest that LH release induced by exogenous AA is probably due to its
      detergent-like properties, and does not represent true exocytosis.

PMID- 1737963
TI  - Expression of an abundant alpha-class glutathione S-transferase in bovine and
      human adrenal cortex tissues.
AB  - Bovine adrenal cortex tissue expresses high levels of glutathione S-transferase
      (GST) from each of the alpha, mu and pi gene families. We describe the
      purification and characterization of an abundant alpha-class GST from this tissue
      that has not been identified previously because of its failure to bind to S
      hexylglutathione-Sepharose 6B (S-hexG-Ag). This enzyme has been affinity purified
      on glutathione-Sepharose 6B (GSH-Ag) and was obtained in a highly purified form
      by employing S-hexG-Ag to remove the bulk of GST before chromatography on GSH-Ag.
      The purified GST eluted from GSH-Ag was found to exhibit marked peroxidase and
      delta 5-ketosteroid isomerase activities (19.2 and 1.67 U/mg respectively). The
      bovine enzyme also showed high GST activity towards 4-hydroxynonenal (5.09 U/mg).
      Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis
      revealed that the bovine GST contains two distinct polypeptides, one with an Mr
      of 25,900 and the other with an Mr of 26,500. An abundant alpha-class GST was
      also purified from human adrenal cortex that possessed properties which were
      similar to the bovine alpha-class GST described above; however, unlike the bovine
      enzyme, the corresponding human alpha-class GST bound to S-hexG-Ag. As with the
      bovine enzyme, the purified human GST displayed marked peroxidase and isomerase
      activities (27 and 4.02 U/mg respectively). Further analysis on SDS-PAGE (Mr
      25,800) and reverse-phase high-performance liquid chromatography established that
      this abundant alpha-class GST in human adrenal cortex is equivalent to the human
      liver GST B1B1 enzyme. As both human and bovine adrenal cortex contain high
      levels of alpha-class GST with similar catalytic properties, we discuss the
      possible functions of these enzymes in this tissue.

PMID- 1737964
TI  - Preferential release of tri-iodothyronine following stimulation by thyrotrophin
      or thyrotrophin-releasing hormone in sheep of different ages.
AB  - The influence of TRH and TSH injections on plasma concentrations of tri
      iodothyronine (T3) and thyroxine (T4) was investigated in neonatal (injection
      within 0.5 h after delivery) and growing lambs and in normal, pregnant and
      lactating adult ewes (all 2 years old and originating from Suffolk, Milksheep and
      Texal crossbreeds). Neonatal lambs had higher levels of T3, T4 and GH compared
      with all other groups, whereas prolactin and TSH were higher in lactating ewes.
      In all animals, injections of TRH increased plasma concentrations of prolactin
      and TSH after 15 min but not of GH at any time. Small increases in T3 and T4 were
      observed in neonatal lambs, without any effect on the T3 and T4 ratio, after
      prolactin administration, whereas prolactin did not influence plasma
      concentrations of T3 or T4 in all other experimental groups. Similar results for
      thyroid hormones were obtained after TRH or TSH injections. It was therefore
      concluded that the effects observed after TRH challenge were mediated by the
      release of TSH. With the possible exception of neonatal lambs, plasma
      concentrations of T3 after administration of TRH or TSH were always increased
      before those of T4; the increase in T3 occurred within 0.5-1 h compared with 2-4
      h for T4 in all experimental groups. This resulted in an increased ratio of
      plasma T3 to T4 up to 4 h after injection. It is concluded that, in sheep, TRH
      and TSH preferentially release T3 from the thyroid gland probably by a
      stimulatory effect of TSH on the intrathyroidal conversion of T3 to T4.

PMID- 1737965
TI  - Hyperkeratosis and colposcopy.

PMID- 1737966
TI  - Streptococci, sore throats, and uncertainty.

PMID- 1737967
TI  - The effect of aspirin on niacin-induced cutaneous reactions.
AB  - BACKGROUND: Niacin (nicotinic acid) is one of the first-line agents recommended
      for the treatment of hyperlipidemia. Bothersome cutaneous reactions (flushing,
      feeling of warmth, itching, and tingling), however, often limit patient
      acceptability and tolerability. The National Cholesterol Education Program
      recommends giving aspirin or another nonsteroidal anti-inflammatory drug before
      administering niacin. Lack of scientific data supporting this recommendation,
      however, led to this randomized, double-blind, placebo-controlled trial to
      evaluate the efficacy of 80 mg of aspirin and 325 mg of aspirin in reducing these
      cutaneous reactions. METHODS: Thirty-one healthy subjects were randomized into
      one of four groups. Each group completed four different treatment regimens
      (placebo-placebo; 80 mg of aspirin-500 mg of niacin; 325 mg of aspirin-500 mg of
      niacin; and placebo-500 mg of niacin). Subjects received one of each of the four
      treatment regimens on separate visits that were at least 24 hours apart.
      Intensity and tolerability of cutaneous reactions were evaluated by an intensity
      rating scale and a visual analog scale. RESULTS: Results indicate that 325 mg of
      aspirin is significantly better than 80 mg of aspirin in decreasing
      intolerability to niacin. Aspirin reduced the incidence of warmth and flushing
      associated with niacin, but not the itching and tingling. CONCLUSIONS: It appears
      from this pilot study that preceding niacin with 325 mg of aspirin will decrease
      the warmth and flushing associated with niacin.

PMID- 1737968
TI  - Obstetric ultrasound by family physicians.
AB  - Obstetric ultrasound examination is a useful diagnostic procedure for family
      physicians who select appropriate equipment, observe indications, understand
      limitations, and work toward performance mastery. The knowledge obtained during
      an examination assists clinical decision making and reduces liability. This is
      particularly true for rural and underserved communities where family physicians
      provide the majority of prenatal and comprehensive perinatal care. Mastery of
      obstetric ultrasound techniques can also lead to developing amniocentesis skills
      and serve as an aid to external cephalic version. The equipment does not require
      extensive maintenance and is available at all hospitals. Many offices and group
      practices have found purchase of this equipment to be cost effective. Based on
      clinical experience in family practice and a review of the medical literature, an
      approach to skill acquisition and quality assurance is described.

PMID- 1737969
TI  - Angioedema after long-term enalapril use.
AB  - A case of life-threatening angioedema occurring after 13 months of enalapril
      therapy is reported. Clinicians should be aware that such severe reactions can
      occur, even after long-term therapy. Patients who take angiotensin-converting
      enzyme inhibitors should be carefully questioned during each follow-up
      examination concerning angioedema symptoms.

PMID- 1737970
TI  - A criterion-based review of preventive health care in the elderly. Part 1.
      Theoretical framework and development of criteria.
AB  - The magnitude of health care resources devoted to care for the elderly is
      increasing; however, little is known about the efficacy of the services purchased
      with those resources. This is especially true in the area of preventive health
      care. In the absence of a consistent and comprehensive definition of health for
      the elderly population, it has been difficult either to establish criteria for
      evaluating preventive services or to assess the impact of those services. This
      article extends criterion-based review to the assessment of preventive services
      for the elderly. Health in the elderly can be defined by three related factors:
      the absence of disease, the maintenance of optimal function, and the presence of
      an adequate support system. Based on this definition of health, goals for
      preventive care should include compression of morbidity in addition to prevention
      of disease, and will require that quality of life be measured to completely
      assess the value of services. Unfortunately, existing measures of quality of life
      are difficult to apply to the elderly population, and there are no consistent
      societal values on which to base a new definition for quality of life. Because
      existing sets of criteria for the evaluation of preventive services do not
      address the distinctive health issues affecting the elderly, we have constructed
      a set of six criteria designed specifically for the well elderly population. In a
      companion article, we will apply these criteria to candidate preventive services
      for the elderly population to develop a geriatric health maintenance protocol for
      use in clinical practice.

PMID- 1737971
TI  - A new measure of substance abuse treatment. Initial studies of the treatment
      services review.
AB  - This paper describes the development and initial testing of the Treatment
      Services Review (TSR). The TSR is a 5-minute, technician-administered interview
      that provides a quantitative profile of the number and types of treatment
      services received by patients during alcohol and drug abuse rehabilitation. Test
      retest studies indicated satisfactory reliability administered either in person
      or over the phone. Tests of concurrent validity showed the ability to
      discriminate different levels of treatment services and good correspondence with
      independent measures of treatment provided. While additional studies are still
      needed with this instrument, the data collected thus far suggest that the TSR may
      serve two types of needs. First, at the programmatic level, the TSR may prove
      useful in describing and comparing programs in terms of the nature and number of
      services actually delivered to patients. At the individual patient level, the TSR
      may offer a means of evaluating the "match" between a patient's needs and the
      services actually provided.

PMID- 1737972
TI  - The Harvard Trauma Questionnaire. Validating a cross-cultural instrument for
      measuring torture, trauma, and posttraumatic stress disorder in Indochinese
      refugees.
AB  - There are no valid and reliable cross-cultural instruments capable of measuring
      torture, trauma, and trauma-related symptoms associated with the DSM-III-R
      diagnosis of posttraumatic stress disorder (PTSD). Generating such standardized
      instruments for patients from non-Western cultures involves particular
      methodological challenges. This study describes the development and validation of
      three Indochinese versions of the Harvard Trauma Questionnaire (HTQ), a simple
      and reliable screening instrument that is well received by refugee patients and
      bicultural staff. It identifies for the first time trauma symptoms related to the
      Indochinese refugee experience that are associated with PTSD criteria. The HTQ's
      cultural sensitivity may make it useful for assessing other highly traumatized
      non-Western populations.

PMID- 1737973
TI  - Koro epidemics in Guangdong, China. A questionnaire survey.
AB  - Koro epidemics, characterized by panic due to fear of genital retraction,
      involving more than 2000 victims, mainly young men, occurred in Hainan Island and
      Leizhou Peninsula of Guangdong Province, China, in 1984-85 and 1987. A
      questionnaire survey of 214 victims of these epidemics was conducted in 1988. The
      survey focused on symptom manifestation, personality profile, life problems, and
      folk belief. The results of the "koro" group were compared with those of a
      "clinic" group with minor psychiatric disorder and a "control" group from the non
      clinical, non-koro episode population in the epidemic area. The results revealed
      that the victims of the koro epidemics were characterized by low intellectual
      endowment and strong acceptance of koro-related folk beliefs. The results support
      the hypotheses that: a) a koro attack is a psychologically induced anxiety-panic
      condition; b) the presence of an intensive belief in the culturally related
      concept of koro makes the subject vulnerable to the attack; and c) social crisis
      or tension serves as a trigger for the occurrence of the epidemic.

PMID- 1737974
TI  - Behavior of children with seizures. Comparison with norms and effect of seizure
      type.
AB  - Scores for 112 children aged 6 to 12 years, with well-controlled seizures and of
      average or higher IQ, were compared for problem behavior with established norms.
      As assessed on the Conners' Teacher Rating Scale, the group with seizures was
      comparable to the normative group on two subscales and superior on two others. In
      contrast, parents of children in the seizure group rated them as significantly
      worse on all six subscales of the Revised Behavior Problem Checklist. In a larger
      group of 133 children with seizures, from which this sample was selected, the
      relationship of age, sex, and seizure type to behavior problems was examined.
      Subjects with partial seizures were rated as slightly more aggressive and
      antisocial than those with generalized seizures. Findings were discussed in
      regard to differences in perception of behavior by parents and teachers and the
      possible relevance of seizure type to the expression of behavior problems.

PMID- 1737975
TI  - Blepharospasm and obsessive-compulsive disorder.
AB  - Although essential blepharospasm is considered to be a form of focal dystonia,
      many patients with blepharospasm have been noted to have concomitant depression,
      anxiety, phobias, hypochondriasis, and other emotional and behavioral disorders,
      suggesting a psychiatric component to the disease that is phenomenologically
      similar to obsessive-compulsive disorder (OCD) in terms of the repetitive,
      perseverative, and persistent nature of the symptoms. The Maudsley OCD
      questionnaire was administered to 21 patients with blepharospasm and 19 normal
      controls. The blepharospasm patients scored significantly higher than the
      controls (p less than .01). Although preliminary, the current study does support
      at least a phenomenological link between OCD and blepharospasm.

PMID- 1737976
TI  - Mixed handedness and features of schizotypal personality in a nonclinical sample.
AB  - Using a nonclinical, noncollege sample, this study set out to confirm and extend
      previous findings of a relationship between the cognitive-perceptual features of
      schizotypal personality and mixed handedness using the Schizotypal Personality
      Questionnaire (SPQ). Based on previous findings of relationships between
      nondextrality and thought disorder in schizophrenia, it was predicted that the
      odd speech subscale of the SPQ would have the strongest relationship with mixed
      handedness. Mixed-handed adults did have significantly higher scores than right
      handed and left-handed adults on the cognitive-perceptual factor and its subscale
      of odd speech. Similar trends were also observed for the cognitive-perceptual
      subscales of suspiciousness, eccentric behavior, and unusual perceptual
      experiences. These results support and extend previous findings, and are broadly
      consistent with the association between thought disorder and nondextrality in
      schizophrenia.

PMID- 1737977
TI  - Critical importance of stimulus unawareness for the production of subliminal
      psychodynamic activation effects. An attributional model.
AB  - This paper describes a new theoretical model of subliminal psychodynamic
      activation (SPA) effects. The model conceptualizes subliminal-supraliminal
      differences in SPA effects as being due to differences in subjects' attributions
      for the changes in anxiety level that are produced by subliminal versus
      supraliminal SPA stimuli. Changes in anxiety level produced by supraliminal SPA
      stimuli can be attributed by subjects to the experimental procedures, diminishing
      the impact of these messages on subjects' responses. In contrast, subjects cannot
      attribute changes in anxiety level produced by subliminal SPA stimuli to the
      experimental procedures. Therefore, no "discounting" (i.e., situational)
      attributions for subliminally induced changes in anxiety levels are available to
      subjects, and subliminal SPA messages produce significantly stronger effects on
      responding than do supraliminal SPA messages. The attributional model of SPA
      effects is discussed in the context of other long-term research programs
      investigating subliminal phenomena. The implications of this model for clinical
      treatment and empirical research utilizing the SPA paradigm are discussed.

PMID- 1737978
TI  - Cognitive bias in the articulated thoughts of depressed and nondepressed
      psychiatric patients.
AB  - Beck's cognitive theory of depression postulates several types of cognitive bias
      among depressed patients. Empirical studies supporting this hypothesis have
      usually used questionnaire "endorsement" measures of cognition, which may suggest
      responses to subjects. We used the articulated thoughts during simulated
      situations (ATSS) method of cognitive assessment in comparing cognitive processes
      of 15 outpatients with major depression with those of 15 nondepressed psychiatric
      outpatients in three simulated situations. Depressed patients exceeded
      nondepressed patients in cognitive bias only in the negative (not the neutral or
      positive) simulated situation. Discussion centered on the possible utility of
      ATSS for research on cognition in stressful situations.

PMID- 1737979
TI  - Microprocesses in perception and personality.
AB  - This paper utilizes an ontogenetically validated personality test, the Meta
      Contrast Technique (MCT). The instrument focuses on the microdevelopment of
      perception (percept genesis) reflecting the process of individual adaptation to
      and construction of reality. Empirical evidence for the adequacy of the MCT
      paradigm in neuropsychological personality research is presented. In all, 45
      patients were tested; thirty-three patients with various forms of supratentorial
      brain tumors were examined and compared with a group of 12 cerebrovascular
      disease (CVD) patients. Without the examiner's knowledge of degree of tumor
      malignancy, the MCT results allowed differentiation among tumors of various
      histological types. Uninformed of the final diagnosis, patients with highly
      malignant gliomas showed panic-related anxiety and schizoid-like regressions, in
      contrast both to patients with low and nonmalignant brain tumors and to the group
      of CVD patients.

PMID- 1737980
TI  - Attention/information-processing factors in psychotic disorders. Replication and
      extension of recent neuropsychological findings.
AB  - The scores of attention/information-processing measures derived from
      neuropsychological testing of 34 chronic psychotic, primarily schizophrenic
      patients were subjected to a principal components analysis. Measures were chosen
      a priori on the basis of a previous factor-analytic study by A.F. Mirsky (1987,
      Behavioral and psychophysiological markers of disordered attention, Environmental
      Health Perspectives 74:191-199). The factor pattern in the present study was
      strikingly similar to that reported by Mirsky on a largely nonpsychotic sample.
      In both studies, four factors emerged that may be identified as: a) perceptual
      motor speed; b) mental control (numerical-mnemonic); c) flexibility; and d)
      vigilance. This replication provides support for previously postulated types of
      attention and suggests that schizophrenic and other psychotic disorders are not
      associated with atypical organization of attention/information-processing
      dimensions. The authors discuss questions raised by Mirsky's previous results in
      light of the present findings. In particular, it was concluded that the
      flexibility factor requires further clarification. Implications of the findings
      for clinical evaluation and research in schizophrenia are discussed as well.

PMID- 1737981
TI  - Disturbances of person identification in Alzheimer's disease. A retrospective
      study.
AB  - Person identification disturbances in Alzheimer's disease (AD) add to the
      suffering of both patients and caregivers. We assessed the prevalence of person
      identification disturbances in the records of 217 outpatients with AD. These
      disturbances occurred in 25.4% (N = 55) and included transient misidentifications
      of familiar persons (N = 34), the Capgras syndrome (N = 11), misidentification of
      themselves in mirrors (N = 5), prosopagnosia (N = 3), misidentification of
      unfamiliar persons as familiar (N = 1), and misidentification of another person
      as oneself (N = 1). Transient misidentifications were easily corrected
      misperceptions, and the Capgras syndrome and mirror difficulties were associated
      with suspiciousness/paranoia and delusions. In AD, these findings suggest that
      misidentifications of familiar persons result from misinterpretations due to
      cognitive impairments, and the Capgras syndrome and mirror difficulties ensue
      when these misinterpretations are elaborated by paranoid delusions.

PMID- 1737982
TI  - On the mechanism of ouabain-induced release of acetylcholine from synaptosomes.
AB  - Ouabain (5 x 10(-8)-5 x 10(-4) M) was confirmed to cause a dose-dependent
      increase in [3H]acetylcholine ([3H]ACh) release, cytosolic free Ca2+
      concentration ([Ca2+]i), and 22Na+ uptake in cerebrocortical synaptosomes of rats
      in the presence of extracellular Ca2+. Ouabain also caused a dose-dependent
      decrease in membrane potential. In a low-Na+ (10 mM) medium, ouabain failed to
      increase [3H]ACh release and [Ca2+]i. Tetrodotoxin (10(-6) M) had no effect on
      the ouabain-induced increase in both [3H]ACh release and [Ca2+]i but abolished
      the increase in 22Na+ uptake and partially inhibited the depolarizing effect.
      Verapamil (10(-6)-5 x 10(-4) M) inhibited the ouabain-induced increase in both
      [3H]ACh release and [Ca2+]i in a dose-dependent manner. Removal of extracellular
      Ca2+ abolished the effect of ouabain on [Ca2+]i but not on [3H]ACh release and
      22Na+ uptake, regardless of the presence or absence of EGTA. In the absence of
      extracellular Ca2+, 10 mM Mg2+ blocked ouabain-induced [3H]ACh release, which was
      resistant to verapamil. These results suggest that ouabain can increase ACh
      release from synaptosomes without the preceding increases in intracellular Ca2+
      and/or Na+ content. It seems likely that the removal of extracellular Ca2+
      unmasks mechanisms of ouabain action different from those operating in the
      presence of Ca2+.

PMID- 1737983
TI  - 1-Methyl-4-(2'-ethylphenyl)-1,2,3,6-tetrahydropyridine-induced toxicity in PC12
      cells is enhanced by preventing glycolysis.
AB  - The effects of 1-methyl-4-(2'-ethylphenyl)-1,2,3,6-tetrahydropyridine (2'Et
      MPTP), 1-methyl-4-(2'-ethylphenyl)pyridinium (2'Et-MPP+), and the classic complex
      1 inhibitor, rotenone, on toxicity as well as on rates of glucose use and lactate
      production were studied using the pheochromocytoma PC12 cell line. PC12 cells are
      neoplastic in nature and have a high rate of glycolysis accompanied by a large
      production of lactate and a low use of glucose carbon through the Krebs cycle. 1
      Methyl-4-phenylpyridinium (MPP+) and analogues such as 2'Et-MPP+ are actively
      accumulated by mitochondrial preparations in vitro and block NADH dehydrogenase
      of complex 1. This blockade results in biochemical sequelae that are ultimately
      cytotoxic. In this study, untreated PC12 cells used glucose and concomitantly
      accumulated lactate in a time-dependent manner at all concentrations of glucose
      studied. Treatment with 50 microM 2'Et-MPP+ or 50 nM rotenone increased both
      rates significantly, indicating a shift toward increased glycolysis. Cell death
      caused by the neurotoxins was also time and concentration dependent and markedly
      enhanced by glucose depletion in the medium. The increase in 2'Et-MPTP-induced
      toxicity in low glucose-supplemented cells was not due to an increase in
      pyridinium formation from the tetrahydropyridine, but rather to the lack of
      glucose for glycolysis. Moreover, inhibition of glycolysis with 2-deoxyglucose or
      iodoacetic acid also enhanced the lethality of the neurotoxins to the cells. The
      data in this study provide additional support to the hypothesis that 2'Et-MPP+ or
      related analogues act to kill cells by inhibiting mitochondrial
      respiration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737984
TI  - Characterization of mono- and polyclonal antibodies against highly purified
      choline acetyltransferase: a monoclonal antibody shows reactivity in human brain.
AB  - Choline acetyltransferase (ChAT) from porcine brain was purified by
      immunoaffinity chromatography, and the highly purified enzyme was subsequently
      used for immunization of mice and rabbits. After fusion of mouse spleen cells, 32
      cultures producing monoclonal antibodies directed against ChAT were detected by
      an enzyme-linked immunosorbent assay (ELISA) with immunoaffinity-purified ChAT.
      Of these original 32, the most active 11 cultures were cloned and used for
      ascites production. The 11 clones generated monoclonal antibodies of the
      immunoglobulin (Ig) M class (three), the IgG1 subclass (seven), and the IgG2b
      subclass (one). The isoelectric points of the antibodies of the IgG class were
      different in each case. The monoclonal antibodies exhibited different binding
      characteristics in the above ELISA and on western blots. Two monoclonal
      antibodies demonstrated excellent immunohistological results with neurons of rat
      brain and spinal cord. One of them reacted well immunohistochemically with
      neurons of human brain and also recognized partially purified human placenta ChAT
      in the ELISA.

PMID- 1737986
TI  - Bicuculline- and baclofen-insensitive gamma-aminobutyric acid binding to rat
      cerebellar membranes.
AB  - Up to 60% of gamma-[3H]aminobutyric acid ([3H]GABA) bound specifically to rat
      cerebellar membranes in the absence of Ca2+ was insensitive to the GABAA
      antagonist bicuculline and to the GABAB agonist baclofen. This indicates that a
      significant component of specifically bound [3H]GABA is associated with non
      GABAA, non-GABAB binding sites. The presence of this binding component appeared
      seasonal, peaking in the month of September (early spring) each year over a 4
      year period. The calcium independence and bicuculline and baclofen insensitivity
      of the binding indicate that this binding is not to the classical GABAA and GABAB
      binding sites. High concentrations of muscimol and isoguvacine inhibited non
      GABAA, non-GABAB binding. Scatchard analysis of the non-GABAA, non-GABAB binding
      sites indicated two kinetic components: KD1 = 42 nM and KD2 = 9.2 microM; Bmax1 =
      1.6 pmol/mg of protein and Bmax2 = 28 pmol/mg of protein.

PMID- 1737985
TI  - Tumor necrosis factor modulates the inactivation of catecholamine secretion in
      cultured sympathetic neurons.
AB  - Cytokines exert multiple effects on cellular functions. We studied the effects of
      cytokines on the calcium-dependent release of catecholamines in cultured neurons
      from neonatal rat superior cervical ganglia. Incubation of sympathetic neurons
      with recombinant human interleukin-1 beta (0.14-0.7 nM) or recombinant human
      tumor necrosis factor-alpha (1 nM) for 24-48 h had no effect on the baseline
      spontaneous release and the initial K(+)-evoked [3H]norepinephrine release,
      compared with untreated cells. A repeat K(+)-induced depolarization after 6 min
      resulted in a decrease of [3H]norepinephrine secretion to 69 +/- 5.8% (n = 11) of
      the initial secretion in recombinant human tumor necrosis factor-treated cells,
      but not in control cells. The secretory response was restored when the interval
      between the two K+ challenges was increased to 10 min. We conclude that the
      diminished secretory response to a repeat stimulus in recombinant human tumor
      necrosis factor-treated superior cervical ganglia neurons is due to a prolonged
      recovery from inactivation of secretion in these cells.

PMID- 1737987
TI  - Isolation and identification of methylarginines from bovine brain.
AB  - Methylarginines in free form were identified in bovine brain. Three compounds
      were isolated from the basic aliphatic amino acid fraction of bovine brain with
      several ion-exchange chromatographies. They showed the same Rf values in paper
      and thin-layer chromatographies as those of authentic NG-monomethylarginine,
      NG,NG-dimethylarginine, and NG,N'G-dimethylarginine. The migration distance of
      the isolated compounds in high-voltage paper electrophoresis and the retention
      times in ion-exchange HPLC were also identical to those of the above authentic
      methylarginines. We concluded that these three compounds are the methyl
      derivatives of arginine described above. The amount of these three compounds
      isolated from 1,090 g of bovine brain was 0.3 mumol of NG-monomethylarginine, 0.1
      mumol of NG,NG-dimethylarginine, and 0.5 mumol of NG,N'G-dimethylarginine. The
      occurrence of these free methylarginines may have an important role in regulating
      the signal transduction through the nitric oxide system.

PMID- 1737988
TI  - Bradykinin stimulates arachidonic acid release through the sequential actions of
      an sn-1 diacylglycerol lipase and a monoacylglycerol lipase.
AB  - In cultured dorsal root ganglion (DRG) neurons prelabeled with [3H]arachidonic
      acid [( 3H]AA), bradykinin (BK) stimulation resulted in increased levels of
      radioactive diacylglycerol, monoacylglycerol, and free AA. The transient
      increases in content of radioactive diacylglycerol and monoacylglycerol preceded
      the increase in level of free AA, suggesting the contribution of a diacylglycerol
      lipase pathway to AA release. An analysis of the molecular species of
      diacylglycerols in unstimulated cultures revealed the presence of two primary
      [3H]AA-containing species, 1-palmitoyl-2-arachidonoyl and 1-stearoyl-2
      arachidonoyl diacylglycerol. BK stimulation resulted in a preferential increase
      in content of 1-stearoyl-2-arachidonoyl diacylglycerol. When DRG cultures were
      labeled with [3H]stearic acid, treatment with BK increased the amount of label in
      diacylglycerol and free stearic acid, but not in monoacylglycerol. This result
      suggested that AA release occurred through the successive actions of an sn-1
      diacylglycerol lipase and monoacylglycerol lipase. Other data supporting a
      diacylglycerol lipase pathway was the significant inhibition of [3H]AA release
      and consequent accumulation of diacylglycerol by RG 80267, which preferentially
      inhibits diacylglycerol lipase. Analysis of the molecular species profiles of
      individual phospholipids in DRG neurons indicated that phosphoinositide
      hydrolysis may account for a significant portion of the rapid increase in content
      of 1-stearoyl-2-arachidonoyl diacylglycerol. We were unable to obtain evidence
      that the phospholipase A2 pathway makes a significant contribution to BK
      stimulated AA release in DRG cultures. Under our assay conditions there were no
      BK-stimulated increases in levels of radioactive lysophosphatidylinositol,
      lysophosphatidylcholine, or lysophosphatidylethanolamine in cultures prelabeled
      with [3H]inositol, [3H]choline, or [3H]-ethanolamine, respectively.

PMID- 1737989
TI  - Normal and heat-induced patterns of expression of heme oxygenase-1 (HSP32) in rat
      brain: hyperthermia causes rapid induction of mRNA and protein.
AB  - Most cells possess a variety of mechanisms, such as high levels of glutathione,
      that guard against cytotoxic free radicals, which are suspected in the etiology
      of various neurological deficits. Neurons, however, are deficient in this
      antioxidant source. The list of other potent antioxidants includes the bile
      pigments biliverdin and bilirubin. Heme oxygenase (HO) isozymes, HO-1 (HSP32) and
      HO-2, catalyze the rate-limiting step in the only biological pathway by which
      bile pigments are produced. In this study, heat shock is identified as the only
      stimulus reported to date that can alter expression in brain HO-1 of protein and
      mRNA in vivo. Using a HO-1 cDNA probe, we examined the level of HO-1 mRNA in
      normal rat brain and in brain 1 and 6 h following heat shock. Exposure of male
      rats to 42 degrees C for 20 min caused a 20-fold increase in brain HO-1 1.8-kb
      mRNA within 1 h after treatment. Quantification of brain HO-1 protein by HO-1
      radioimmunoassay revealed a fourfold increase at 6 h posttreatment. In normal
      brain, HO-1 protein was sparsely expressed in few select neuronal and nonneuronal
      cell populations in forebrain, diencephalon, cerebellum, and brainstem regions.
      Six hours following heat shock, an intense increase in HO-1 protein in glia
      throughout the brain, ependyma lining the ventricles of the brain,
      paraventricular nucleus, Purkinje cell layer of the cerebellum, and cochlear
      nucleus of brainstem was observed. We suggest that increases in HO-1 transcript
      and protein reflect a means to elevate levels of antioxidants in cells with
      compromised defense mechanisms caused by stress.

PMID- 1737990
TI  - DM-20 mRNA is expressed during the embryonic development of the nervous system of
      the mouse.
AB  - We used both the polymerase chain reaction (PCR) and in situ hybridization to
      search for the presence of proteolipid protein (PLP) gene transcripts in the
      developing mouse. Total brain RNA extracted from 13-19-day embryos, analyzed by
      PCR, demonstrated the presence of a single transcript that was unambiguously
      identified with the DM-20 mRNA. RNA samples from postnatal day 2 animals also
      showed a signal corresponding to the PLP transcript, in addition to the DM-20
      message. By in situ hybridization of 10-day embryos using a DM-20 antisense cRNA
      probe, we showed that the localization of the DM-20 message was restricted to the
      diencephalic basal plate. On the same embryo sections, in addition to the brain
      localization, an intense hybridizing signal was also detected in the trigeminal
      and spinal ganglia, the vagal glossopharyngeal ganglion, and the sympathetic
      ganglion chain. The demonstration of transcription of the PLP gene, long before
      the beginning of the myelination process, suggests that in addition to a
      structural function in myelin compaction, some of the products of the PLP gene
      (DM-20) may have a role during the compartmentalization and differentiation of
      the neural tube.

PMID- 1737991
TI  - Kinetic analysis of the chloride dependence of the neuronal uptake of dopamine
      and effect of anions on the ability of substrates to compete with the binding of
      the dopamine uptake inhibitor GBR 12783.
AB  - The specific binding of [3H]1-[2-(diphenyl-methoxy)ethyl]-4-(3-phenyl-2
      propenyl)piperazine ([3H]GBR 12783) to the dopamine (DA) neuronal carrier present
      in membranes prepared from rat striatum was not affected when Cl- was replaced by
      either Br- or NO3-. In media containing Cl-, Br-, or NO3-, d-amphetamine and DA
      competed with the radioligand in a monophasic manner with Hill coefficients of
      close to 1 (0.94-1.12). Replacement of Cl- by Br- impaired the ability of some
      substrates (d-amphetamine, DA, p-hydroxyamphetamine, and m-tyramine) to compete
      with [3H]GBR 12783. The potency of Br- to decrease the affinity of substrates for
      the specific binding site was significantly correlated (t = 7.07, p less than
      0.001) with their affinity for this binding site. These results suggest that the
      various substrates tested could bind to recognition sites in which Cl- is
      differently involved; as a consequence, substrates could bind to the neuronal
      carrier by means of partly different links. In experiments dealing with the
      specific uptake of [3H]DA, F-, NO3-, isethionate-, or acetate- was unable to
      substitute for Cl-, whereas Br- was quite a total substitute. Replacement of Cl-
      by equimolar concentrations of either NO3- or isethionate- resulted in inhibition
      curves of DA specific uptake with Hill coefficients of close to 1 (0.77 and 1.04
      respectively); this indicates that both NO3- and isethionate- are devoid of
      inhibitory effects on neuronal uptake and are quite ineffective substitutes for
      Cl-.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1737992
TI  - Vesamicol binding to subcellular membranes that are distinct from
      catecholaminergic vesicles in PC12 cells.
AB  - We have examined PC12 cells for the localization of binding sites for vesamicol
      [l-2-(4-phenylpiperidino) cyclohexanol], a compound that has previously been
      shown to bind to cholinergic vesicles and to inhibit the uptake of acetylcholine.
      Initial studies presented in this article demonstrate the existence of a
      specific, saturable vesamicol binding site in PC12 cells. Subsequent experiments
      show that these binding sites reside in a membrane population that is distinct
      from catecholamine-containing compartments with respect to density and antigenic
      composition. In particular, vesamicol binding compartments have a lower density
      than catecholaminergic vesicles and, unlike these latter vesicles, do not appear
      to contain the vesicle-specific proteins synaptophysin and SV2 as part of the
      same membrane. These results suggest that vesicular transport proteins for
      acetylcholine and catecholamines are differentially sorted to distinct membrane
      compartments in PC12 cells.

PMID- 1737993
TI  - Rat hippocampal lactate efflux during electroconvulsive shock or stress is
      differently dependent on entorhinal cortex and adrenal integrity.
AB  - The role of the entorhinal cortex and the adrenal gland in rat hippocampal
      lactate formation was assessed during and after a short-lasting immobilization
      stress and electroconvulsive shock (ECS). Extracellular lactate was measured on
      line using microdialysis and enzyme reactions (a technique named lactography); in
      some rats, unilateral lesions of the entorhinal cortex were made or the bilateral
      adrenal glands were removed. The stress-evoked increase in hippocampus lactate
      was not altered either ipsi- or contralateral to an entorhinal cortex lesion. The
      response to ECS was attenuated only in the hippocampus ipsilateral to the
      entorhinal cortex lesion. Removal of bilateral adrenal glands caused some delay
      in the increase in hippocampal lactate after ECS and a major reduction in the
      stress-evoked lactate response. These results indicate that (1) the entorhinal
      cortex is activated by ECS, thereby activating hippocampal lactate efflux and
      presumably metabolism, and (2) the adrenal gland is essential in the response to
      stress and, to a minor extent, in the ECS-altered hippocampal metabolism.

PMID- 1737994
TI  - Nuclear magnetic resonance spectroscopy study on energy metabolism, intracellular
      pH, and free Mg2+ concentration in the brain of transgenic mice overexpressing
      human ornithine decarboxylase gene.
AB  - We have generated a transgenic mouse line strikingly overexpressing the human
      ornithine decarboxylase (ODC) gene in their brain. Brain ODC activity was
      increased in the transgenic animals by a factor of 70 in comparison with their
      nontransgenic littermates. The content of brain putrescine, the product of ODC,
      was greater than 60 mumol/g of tissue in the transgenic mice, whereas in the
      normal animals it was below the level that could be detected by an HPLC method.
      The concentrations of the higher polyamines (spermidine and spermine) were not
      significantly different from control values. 31P nuclear magnetic resonance (31P
      NMR) spectroscopy analyses revealed a significantly reduced (40%) free Mg2+
      concentration as calculated from the chemical shift differences of the nucleoside
      triphosphate alpha and beta peaks in the brains of the transgenic animals. The
      lower free Mg2+ concentration in the brains of ODC transgenic mice was not a
      consequence of altered intracellular pH or changes in cellular high-energy
      metabolites. 1H NMR showed no differences in brain choline/N-acetylaspartate and
      total creatine/N-acetylaspartate ratios between the two animal groups. These ODC
      transgenic animals may serve as models in vivo for studies on cerebral
      postischemic events and on epilepsy, as polyamines are supposed to be involved in
      these processes.

PMID- 1737995
TI  - Uptake and metabolism of choline by rat brain after acute choline administration.
AB  - The present study is concerned with the uptake and metabolism of choline by the
      rat brain. Intraperitoneal administration of choline chloride (4-60 mg/kg) caused
      a dose-dependent elevation of the plasma choline concentration from 11.8 to up to
      165.2 microM within 10 min and the reversal of the negative arteriovenous
      difference (AVD) of choline across the brain to positive values at plasma choline
      levels of greater than 23 microM. Net choline release and uptake were linearly
      dependent on the plasma choline level in the physiological range of 10-50 microM,
      whereas the CSF choline level was significantly increased only at plasma choline
      levels of greater than 50 microM. The bolus injection of 60 mg/kg of [3H]choline
      chloride caused the net uptake of greater than 500 nmol/g of choline by the brain
      as calculated from the AVD, which was reflected in a minor increase of free
      choline level and a long-lasting increase of brain phosphorylcholine content,
      which paralleled the uptake curve. Loss of label from phosphorylcholine 30 min to
      24 h after choline administration was accompanied by an increase of label in
      phosphatidylcholine, an indication of a delayed transfer of newly taken-up
      choline into membrane choline pools. In conclusion, homeostasis of brain choline
      is maintained by a complex system that interrelates choline net movements into
      and out of the brain and choline incorporation into and release from
      phospholipids.

PMID- 1737996
TI  - Reserpine-induced processing of chromogranin A in cultured bovine adrenal
      chromaffin cells.
AB  - The effect of reserpine on the processing of the secretory granule protein
      chromogranin A (CgA) in isolated bovine adrenal chromaffin cells was investigated
      using two radioimmunoassays employing site-specific antisera. The two antisera
      were directed against closely associated regions of the CgA molecule which would
      be exposed by specific processing: antiserum L331 was raised against the C
      terminus of the regulatory peptide pancreastatin, and the second antiserum, L300,
      was raised against the synthetic peptide [Tyr0]CgA306-313 (YLSKEWEDA), a sequence
      that lies immediately C-terminal to pancreastatin and adjacent to a dibasic amino
      acid cleavage site. Chronic reserpine treatment of chromaffin cells produced a
      time- and dose-dependent increase in processing, as demonstrated by an increase
      in pancreastatin- and YLSKEWEDA-immunoreactivity (ir). The reserpine-induced rise
      in pancreastatin-ir was due predominantly to an increase in pancreastatin 1-47,
      whereas the rise in YLSKEWEDA-ir was due to increases in three polypeptides: a 51
      kDa YLSKEWEDA-ir polypeptide, CgA297-313, and CgA248-313. The latter
      predominated. The action of reserpine on both pancreastatin- and YLSKEWEDA-ir was
      found to be largely inhibited by the protein synthesis inhibitor cycloheximide.
      The results show that treatment of isolated chromaffin cells with reserpine
      induces both the selective proteolytic processing and peptidyl-glycine amidation
      of CgA and its derived fragments. As reserpine has a similar effect on
      proenkephalin in chromaffin cells, the results suggest that reserpine induces a
      general increase in the activity of the processing enzymes, partially by an
      increase in protein synthesis.

PMID- 1737997
TI  - A highly sensitive assay for histamine using ion-pair HPLC coupled with
      postcolumn fluorescent derivatization: its application to biological specimens.
AB  - A simple and highly sensitive method for the determination of histamine (HA) was
      developed using ion-pair, reversed-phase HPLC coupled with postcolumn o
      phthalaldehyde derivatization fluorometry, and it was applied to the unpurified
      extracts of human and rat plasma, and brains of rats and mice. The HA
      concentrations both in the plasma and brains determined by the present method
      were well consistent with the values obtained by cation-exchange HPLC with
      postcolumn fluorescent derivatization currently in use. The present method was
      more advantageous than the assay using cation-exchange HPLC: (1) it was three to
      four times more sensitive (the detection limit was 0.5 pg of HA), and (2) it
      enabled the measurement of HA in samples containing (R)alpha-methylhistamine, a
      potent and specific H3-receptor agonist, which could not be separated from HA by
      cation-exchange chromatography. Using the present method coupled with
      intracerebral microdialysis, we found in the rat hypothalamus that (R)alpha
      methylhistamine (5 mg/kg i.p.) markedly decreased the extracellular concentration
      of HA with a maximal effect (83% reduction) during 30-60 min after injection,
      suggesting that most of HA in the microdialysate fraction is neuronal in origin.

PMID- 1737998
TI  - Brain transfer coefficients for 67Ga: comparison to 55Fe and effect of calcium
      deficiency.
AB  - The transfer coefficients (Kin) for the uptake of gallium-67 (67Ga) into brain
      and CSF were determined in unanesthetized male Fischer-344 rats fed either a
      normal or a low-Ca diet. Kin for 67Ga was also compared with transfer
      coefficients for the uptake of iron-55 (55Fe) and 125I-albumin in control
      animals. The value of CSF 67Ga Kin was 3 x 10(-7) ml.g-1.s-1 and was 50% larger
      in low-Ca animals. Brain regional Kin values for 67Ga were 3-9 x 10(-7) ml.g-1.s
      1 with no differences in Kin between normal and low-Ca rats. CSF Kin values for
      55Fe were 40% and those for albumin were 15% of Kin for 67Ga. For brain, Kin
      values for 55Fe were 15-40% smaller than for 67Ga, but for albumin the Kin values
      were 85% less than for 67Ga. 67Ga was found to be 99% bound to plasma proteins,
      whereas 55Fe was 99.9% bound. The results indicate that metals that are primarily
      bound to transferrin enter the CSF and brain very slowly. Uptake of both metals
      was faster than albumin, which may indicate that metal bound to small chelates
      contributes significantly to brain uptake. In addition, Ca deficiency does not
      enhance entry of Ga into the brain.

PMID- 1737999
TI  - Dissimilar aluminum and gallium permeation of the blood-brain barrier
      demonstrated by in vivo microdialysis.
AB  - Aluminum (Al) and gallium (Ga) permeations of the blood-brain barrier (BBB) were
      assessed in rats. Unbound extracellular Al and Ga concentrations were ascertained
      at the two potential sites of BBB permeation, cerebral capillaries and choroid
      plexuses, by implantation of microdialysis probes in the frontal cortex and
      lateral ventricle, respectively. A microdialysis probe implanted in the jugular
      vein revealed unbound blood Al or Ga concentrations. Al or 67Ga citrate was
      administered via the femoral vein. Peak Al and Ga concentrations were seen within
      the first 10 min at all three sites. Area under the curve (concentration vs. time
      to final sample) values were calculated using RSTRIP. Within-rat overall frontal
      cortical/blood and lateral ventricular/blood ratios [brain/blood ratios (oBBRs)]
      were calculated from area under the curve values. Aluminum frontal cortical oBBRs
      were significantly higher than those for the lateral ventricle. Ga oBBRs were not
      significantly different between the two sites. Al and Ga oBBRs were significantly
      different in the lateral ventricle. These results suggest that the primary site
      of A1 permeation across the BBB is at cerebral capillaries, whereas Ga permeation
      across the BBB does not significantly differ between cerebral capillaries and
      choroid plexuses. The use of Ga as a model to study Al pharmacokinetics may not
      be appropriate in the elucidation of the site or mechanism of Al entry into the
      brain.

PMID- 1738000
TI  - Quantitative examination of tissue concentration profiles associated with
      microdialysis.
AB  - Spatial solute concentration profiles resulting from in vivo microdialysis were
      measured in rat caudate-putamen by quantitative autoradiography. Radiolabeled
      sucrose was included in the dialysate, and the tissue concentration profile
      measured after infusions of 14 min and 61.5 min in an acute preparation. In
      addition, the changes in sucrose extraction fraction over time were followed in
      vivo and in a simple in vitro system consisting of 0.5% agarose. These
      experimental results were then compared with mathematical simulations of
      microdialysis in vitro and in vivo. Simulations of in vitro microdialysis agreed
      well with experimental results. In vivo, the autoradiograms of the tissue
      concentration profiles showed clear evidence of substantial differences between
      14 and 61.5 min, even though the change in extraction fraction was relatively
      small over that period. Comparison with simulated results showed that the model
      substantially underpredicted the observed extraction fraction and overall amount
      of sucrose in the tissue. A sensitivity analysis of the various model parameters
      suggested a tissue extracellular volume fraction of approximately 40% following
      probe implantation. We conclude that the injury from probe insertion initially
      causes disruption of the blood-brain barrier in the vicinity of the probe, and
      this disruption leads to an influx of water and plasma constituents, causing a
      vasogenic edema.

PMID- 1738001
TI  - Magnesium-dependent enhancement of endogenous agonist binding to A1 adenosine
      receptors: a complicating factor in quantitative autoradiography.
AB  - Quantitative autoradiography was used to investigate the effects of Mg2+ on
      agonist and antagonist binding to A1 receptors in rat striatum. A1 receptors were
      labelled with the selective agonist N6-[3H]cyclohexyladenosine ([3H]CHA) or the
      selective antagonist 1,3-[3H]dipropyl-8-cyclopentylxanthine ([3H]DPCPX). Mg2+ had
      no significant effect on equilibrium binding constants for [3H]CHA [control: KD
      (95% confidence interval) of 0.34 (0.15-0.80) nM and Bmax of 267 +/- 8 fmol/mg of
      gray matter; with 10 mM Mg2+: KD of 0.8 (0.13-4.9) nM and Bmax of 313 +/- 8.9
      fmol/mg of gray matter] or [3H]DPCPX [control: KD of 0.54 (0.30-0.99) nM and Bmax
      of 256 +/- 2.3 fmol/mg of gray matter; with 10 mM Mg2+: KD of 1.54 (0.2-11.0) nM
      and Bmax of 269 +/- 35.7 fmol/mg of gray matter]. In contrast, Mg2+ slowed the
      apparent association rate for both ligands; this was observed as a shift from a
      one-component to a two-component model for [3H]DPCPX. Mg2+ also affected the
      dissociation rates of both ligands; for [3H]CHA, dissociation in the presence of
      Mg2+ was not detected. Mg2+ produced a concentration-dependent inhibition of
      [3H]CHA binding only prior to equilibrium. HPLC was performed on untreated
      sections, sections preincubated with adenosine deaminase (ADA), and sections
      preincubated with ADA and incubated with ADA in the absence or presence of Mg2+.
      Adenosine was found in measurable quantities under all conditions, and the
      concentration was not influenced by Mg2+ or by the inclusion of GTP in the
      preincubation medium. From these data, we conclude the following: (a) adenosine
      is present and may be produced continuously in brain sections; (b) ADA is not
      capable of completely eliminating the produced adenosine; (c) Mg2+ apparently
      does not influence adenosine production or elimination; (d) A1 receptor-guanine
      nucleotide binding protein coupling is maximal in this preparation; and (e) Mg2+
      decreases the dissociation rate of bound endogenous adenosine from A1 receptors,
      thus limiting the access of [3H]CHA and [3H]DPCPX to the receptors. Thus,
      enhancement of endogenous adenosine binding to A1 receptors by Mg2+ is a
      complicating factor in receptor autoradiography and may be so in other
      preparations as well.

PMID- 1738002
TI  - Biochemical and pharmacological characterization of serotonin-O
      carboxymethylglycyl[125I]iodotyrosinamide, a new radioiodinated probe for 5-HT1B
      and 5-HT1D binding sites.
AB  - There is a lack of radioactive probes, particularly radioiodinated probes, for
      the direct labeling of serotonin-1B (5-HT1B) and serotonin-1D (5-HT1D) binding
      sites. Serotonin-O-carboxymethylglycyltyrosinamide (S-CM-GTNH2) was shown
      previously to be specific for these two subtypes; we, therefore, linked a 125I to
      its tyrosine residue. Biochemical and pharmacological properties of S-CM
      G[125I]TNH2-binding sites were studied by quantitative autoradiography on rat and
      guinea pig brain sections. S-CM-G[125I]TNH2 binding is saturable and reversible
      with a KD value of 1.3 nM in the rat and 6.4 nM in the guinea pig. Binding is
      heterogeneous, paralleling the anatomical distribution of 5-HT1B sites in the rat
      and of 5-HT1D sites in the guinea pig. The binding of 0.02 nM S-CM-G[125I]TNH2
      was inhibited by low concentrations of 5-HT, S-CM-GTNH2, CGS 12066 B, 5
      methoxytryptamine, and tryptamine in both species. Propranolol inhibited the
      radioligand binding with a greater affinity in the rat than in the guinea pig.
      Conversely, 8-hydroxy-2-(di-n-propylamino)tetralin inhibited S-CM-G[125I]TNH2
      binding with a greater affinity in the guinea pig than in the rat. Other
      competitors, specific for 5-HT1C, 5-HT2, 5-HT3, and adrenergic receptors,
      inhibited S-CM-G[125I]TNH2 binding in rat and guinea pig substantia nigra and in
      other labeled structures known to contain these receptors, but only at high
      concentrations. S-CM-G[125I]TNH2 is then a useful new probe for the direct study
      of 5-HT1B and 5-HT1D binding sites.

PMID- 1738003
TI  - Detection of mobile proteins by proton nuclear magnetic resonance spectroscopy in
      the guinea pig brain ex vivo and their partial purification.
AB  - Proton nuclear magnetic resonance (1H NMR) spectroscopy was used to study
      metabolites of the brain cortex ex vivo. The superfused brain cortex preparation
      was judged to be metabolically viable on the basis of the 31P NMR spectrum
      (intracellular pH of 7.23 +/- 0.03 and phosphocreatine/ATP ratio of 1.21 +/-
      0.09). Using 1H NMR a group of previously unidentified signals was detectable at
      0.94, 1.22, and 1.40 ppm with a water-suppressed spin-echo sequence. These
      signals had shorter spin-spin relaxation times (51-54 ms) than N-acetylaspartate
      and lactate (84-93 ms) and also smaller saturation factors, an indication of
      shorter spin-lattice relaxation times than the latter two low-molecular-weight
      metabolites. The unidentified signals also displayed homonuclear coupling to
      other spins in the methine region of the spectrum. Acid extraction of the brain
      slices or cortex from animals that were killed yielded a mixture of proteins that
      exhibited NMR properties matching the 1H NMR signals in the brain cortex. The
      molecular mass of these thermoresistant, "mobile" proteins, which contained
      proline plus hydroxyproline (9-16% of all amino acids), ranged between 8 and 40
      kDa. These "new" assignments of 1H NMR-detectable compounds may influence
      interpretation of NMR data of some metabolites, as their signals are in the
      vicinity of the -CH3 1H NMR peaks of lactate and alanine.

PMID- 1738004
TI  - Characterization of neutral proteinases from Alzheimer-affected and control brain
      specimens: identification of calcium-dependent metalloproteinases from the
      hippocampus.
AB  - Three neutral proteinases from human hippocampal tissue have been identified and
      partially characterized using substrate gel electrophoresis. The proteinases
      showed activity when gelatin was used as the substrate, but had no detectable
      activity against casein. Based on the results of inhibition studies and the
      calcium requirements, it was concluded that the activities were due to calcium
      dependent metalloproteinases. The apparent molecular weights were 130,000 (MP
      130), 100,000 (MP-100), and 70,000 (MP-70). Half-maximal activities were observed
      with 20 microM Ca2+ for MP-130, 40 microM Ca2+ for MP-100, and 800 microM Ca2+
      for MP-70. In the presence of Ca2+, Zn2+ reestablished the activities of the
      three metalloproteinases at a lower concentration than did either Co2+ or Mn2+.
      One millimolar Al3+ inhibited 67% of the MP-70 activity, but did not affect the
      MP-100 and MP-130 activities. An analysis of Alzheimer-affected hippocampal and
      control samples showed that the specific activity (in units per milligram of
      sodium dodecyl sulfate-soluble protein) of MP-70 varied less than the activities
      of MP-100 and MP-130 between the two groups. Although p-amino-phenylmercuric
      acetate (p-APMA) increased the activities of MP-70 by 70% in both groups of
      specimens, the resulting activities from Alzheimer samples were greater than
      those from control samples (p less than 0.01). A wide range of MP-100 specific
      activity was observed in both groups, and its mean activity was higher in
      Alzheimer-affected samples (p less than 0.05). Treatment with p-APMA increased
      the activity of MP-100 only 25% in both groups of tissue samples. MP-130 activity
      was detected predominantly in Alzheimer-affected hippocampal specimens, and
      treatment with p-APMA failed to increase its activity in both the control and the
      Alzheimer-affected specimens. The results demonstrate an elevated level of
      metalloproteinase activities, capable of degrading tissue matrix components, in
      the hippocampus from postmortem Alzheimer patients.

PMID- 1738005
TI  - Synapses on motoneuron dendrites in the brachial section of the frog spinal cord:
      a computer-aided electron microscopic study of cobalt-filled cells.
AB  - Cobalt-labelled motoneuron dendrites of the frog spinal cord at the level of the
      second spinal nerve were photographed in the electron microscope from long series
      of ultrathin sections. Three-dimensional computer reconstructions of 120 dendrite
      segments were analysed. The samples were taken from two locations: proximal to
      cell body and distal, as defined in a transverse plane of the spinal cord. The
      dendrites showed highly irregular outlines with many 1-2 microns-long 'thorns'
      (on average 8.5 thorns per 100 microns 2 of dendritic area). Taken together, the
      reconstructed dendrite segments from the proximal sites had a total length of
      about 250 microns; those from the distal locations, 180 microns. On all segments
      together there were 699 synapses. Nine percent of the synapses were on thorns,
      and many more close to their base on the dendritic shaft. The synapses were
      classified in four groups. One third of the synapses were asymmetric with
      spherical vesicles; one half were symmetric with spherical vesicles; and one
      tenth were symmetric with flattened vesicles. A fourth, small class of asymmetric
      synapses had dense-core vesicles. The area of the active zones was large for the
      asymmetric synapses (median value 0.20 microns 2), and small for the symmetric
      ones (median value 0.10 microns 2), and the difference was significant. On
      average, the areas of the active zones of the synapses on thin dendrites were
      larger than those of synapses on large calibre dendrites. About every 4 microns 2
      of dendritic area received one contact. There was a significant difference
      between the areas of the active zones of the synapses at the two locations.
      Moreover, the number per unit dendritic length was correlated with dendrite
      calibre. On average, the active zones covered more than 4% of the dendritic area;
      this value for thin dendrites was about twice as large as that of large calibre
      dendrites. We suggest that the larger active zones and the larger synaptic
      coverage of the thin dendrites compensate for the longer electrotonic distance of
      these synapses from the soma.

PMID- 1738006
TI  - The logistic modeling of sensitivity, specificity, and predictive value of a
      diagnostic test.
AB  - A method is described for modeling the sensitivity, specificity, and positive and
      negative predictive values of a diagnostic test. To model sensitivity and
      specificity, the dependent variable (Y) is defined to be the dichotomous results
      of the screening test, and the presence or absence of disease, as defined by the
      "gold standard", is included as a binary explanatory variable (X1), along with
      variables used to define the subgroups of interest. The sensitivity of the
      screening test may then be estimated using logistic regression procedures.
      Modeled estimates of the specificity and predictive values of the screening test
      may be similarly derived. Using data from a population-based study of peripheral
      arterial disease, the authors demonstrated empirically that this method may be
      useful for obtaining smoothed estimates of sensitivity, specificity, and
      predictive values. As an extension of this method, an approach to the modeling of
      the relative sensitivity of two screening tests is described, using data from a
      study of screening procedures for colorectal disease as an example.

PMID- 1738007
TI  - The "Intervention Index": insufficient information.

PMID- 1738008
TI  - Ischemic heart disease prevention: estimating the impact of interventions.
AB  - The potential impact of ischemic heart disease intervention programs has usually
      been assessed using the dichotomy between those programs targeted to high risk
      groups and those that are population based, but this distinction does not
      adequately describe the spectrum of possibilities. Using data from the National
      Health and Nutrition Examination Survey Epidemiologic Follow-up Study (NHEFS), we
      assessed the effect of a spectrum of 27 potential interventions on mortality
      reduction and on an Intervention Index (defined as the number of persons whose
      risk must change to prevent one death). Using combinations of cholesterol
      reductions of 20% and decreases in the prevalence of smoking and hypertension of
      50%, reductions in mortality varied from 1 to 27% and the Intervention Index
      varied from 26 to 520. A number of potential interventions were equivalent in
      their mortality reduction of their Intervention Indexes, despite their affecting
      differing proportions of the population. The Intervention Index provides some
      measure of the relative efficiency of programs and points to the comparability of
      different interventive approaches. In addition, this analysis suggests that the
      potential impact of intervention programs on mortality will be modest, but that a
      focus on certain subgroups, such as those aged 40-59 years, can achieve
      substantial results within those groups, even though the population effect would
      be minimal.

PMID- 1738009
TI  - A randomized controlled trial of dietary fat reduction: the retention of subjects
      and characteristics of drop outs.
AB  - We have examined the feasibility of carrying out a randomized controlled trial of
      dietary fat reduction in women at increased risk for breast cancer. The
      randomization was either to a control group who were taught the principles of
      balanced nutrition, but were not counselled to change their fat intake, or to an
      intervention group who were taught to reduce their dietary fat intake to 15% of
      total calories from a baseline average of 35% of calories. Potentially eligible
      subjects were women attending a breast diagnostic clinic who had the mammographic
      pattern of dysplasia. Subjects were recruited by letter from their referring
      surgeon followed by a telephone call. Subjects interested in participating in the
      study then entered by one of two phases. In Phase I, the study was explained,
      informed consent sought and willing subjects randomized to the intervention or
      control group. Using this procedure 227 subjects were randomized and 48 (21%)
      dropped out of the study in the 12 months following randomization. (A drop out
      was defined as a subject who persistently failed to keep appointments and provide
      nutrient data.) Of these drop outs, 30 (63%) occurred at or soon after
      randomization. A modified procedure of entry was then adopted in which subjects
      interested in the study were first taught the procedures involved, including
      keeping food records and clinic appointments, and were then asked to provide
      consent and randomized. Two hundred and eighty subjects were enrolled using this
      modified procedure and 25 (9%) have dropped out in the 12 months following
      randomization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738010
TI  - Relationships of site of infarction and history of previous infarction with short
      and long-term prognosis after acute myocardial infarction in Japan.
AB  - We studied the outcome in 308 patients with acute myocardial infarction (MI)
      admitted to the coronary care unit of Kobe General Hospital. Short-term outcome
      (within 28 days after MI) and long-term outcome (more than 28 days) were examined
      with survival curves to find any relationship with a history of previous MI and
      with the site of the MI. In the short term, 38 of the 308 patients died of
      cardiac causes. The group with anterior MI tended to have higher mortality than
      the group of patients with inferior MI, and among patients without a previous MI,
      patients with anterior MI had significantly higher mortality (p = 0.01). In
      multivariate analysis by the logistic regression model, the site of the MI was
      found to be independently associated with the short-term outcome. In the long
      term, with a mean follow-up of 3.4 years, 23 of the 308 patients died of cardiac
      causes. Different sites of the MI did not result in different outcomes in
      patients with or without a previous MI. Of patients with anterior or inferior MI,
      those with a previous MI tended to have higher mortality, and of patients with an
      inferior MI, the difference was significant (p = 0.001). In multivariate analysis
      by the proportional hazards model, a history of MI was more predictive than the
      site of the MI. In conclusion, the site of the MI was associated more with the
      short-term outcome than with the long-term outcome, and a history of MI was
      associated more closely with the long-term outcome.

PMID- 1738011
TI  - Prognosis in long-term immunosuppressive treatment of refractory chronic
      inflammatory demyelinating polyradiculoneuropathy.
AB  - Treatment of chronic inflammatory demyelinating polyneuropathy (CIDP) frequently
      includes use of immunosuppressive agents. Controlled treatment trials
      demonstrating efficacy are available only for prednisone and therapeutic plasma
      exchange (TPE). When these fail to achieve lasting chemical improvement after
      reduction or cessation of therapy, subsequent regimens are empiric, often leading
      to prolonged immunosuppression. It is not possible to predict who will respond to
      which agent and when. Administered individually, immunosuppressive agents may
      pose an acceptable risk, but cumulative effects of multiple agents in refractory
      patients may suppress the immune system and contribute to increased morbidity and
      mortality. Treatment difficulties with refractory CIDP patients have not been
      emphasized, and long-term effects of immunosuppression have focused on the risk
      of malignancy. In reviewing our clinical experience treating over 100 CIDP
      patients we identified approximately 20 patients who could be considered
      refractory to multiple immunosuppressive therapies and dependent upon long-term
      intermittent TPE. Two of these patients exemplify the morbidity associated with
      CIDP and its associated treatment. Our review of the clinical course of these
      patients raised issues about the use of multiple immunosuppressive agents, long
      term goals, and long-term prognosis in CIDP.

PMID- 1738012
TI  - An analysis of symptoms in patients with permanent ventricular pacemakers.
AB  - The prevalence and severity of symptoms of the "pacemaker syndrome" were
      investigated in 64 patients with VVI pacemakers and compared, in the same
      patients, to a series of control symptoms, unrelated to pacemaker function.
      Symptoms were also compared in patient groups unlikely to have the "pacemaker
      syndrome" (atrial fibrillation), most likely to have such symptoms (retrograde
      atrial activation) and in an intermediate group (competitive paced and sinus
      rhythms). There was a linear relationship between the frequency and severity of
      "pacemaker" symptoms and control questions in all groups and no preponderance of
      "pacemaker" symptoms in any group. The study provides an estimate of the number
      and severity of symptoms in patients with VVI pacemakers, demonstrates the non
      specificity of the "pacemaker syndrome" and shows no evidence of a sub-clinical
      "pacemaker syndrome" in the patients observed.

PMID- 1738013
TI  - The psychological and physical health of family members caring for an elderly
      person with dementia.
AB  - Most elderly persons with dementia are cared for at home, usually by the spouse
      or an adult child. The objective of the present study was to determine whether
      there is an excess of psychological and physical health problems among family
      caregivers (CGs) of elderly persons with dementia. Data were obtained by
      interview from close family members of dementia patients (CGs), and from a
      comparison group made up of close family members of patients undergoing cataract
      surgery (non-caregivers, NCGs). CGs had significantly higher levels of depression
      and physical symptoms than NCGs. The association between caregiving and the
      health variables was stronger among subjects who were the patient's spouse than
      among those who were the patient's child. Furthermore, greater behavioral
      disturbance in the demented patient was associated with higher levels of
      morbidity in the CG. The results suggest that CGs might benefit from careful
      monitoring of their health status, and from greater access to specialized support
      services.

PMID- 1738014
TI  - Evaluation of the properties and reliability of a clinical severity scale for
      acute asthma in children.
AB  - The inter-observer agreement (reliability) and validity of a clinical asthma
      severity scale (ASS) derived from separate scores of wheeze, heart rate and
      accessory muscle use (each on a 4-point scale) were studied in 60 children aged
      between 6 months and 17 years (mean 5.4 years). Independent assessments of these
      clinical parameters were made by two paediatricians, and they also rated patients
      as having a mild, moderate, severe or very severe acute episode (clinical
      judgement rating, CJR). Oxygen saturation (SaO2) was measured concurrently by a
      Biox 3700 pulse oximeter and readings were categorized as mild (SaO2 greater than
      or equal to 94%), moderate (91-93%) and severe (less than 91%). Agreement between
      clinicians was assessed by the weighted kappa statistic (kappa W). Agreement for
      the ASS score compared to the severity grade obtained from SaO2 was slight (kappa
      W = 0.34) and compared to CJR the kappa W was 0.55. An ASS score of moderate or
      worse (greater than 3) had sensitivity of 97% and specificity of 50% for
      prediction of admission. The maximum frequency and duration of nebulizer therapy
      following admission were significantly greater for severe patients than for
      moderate patients. Length of hospital stay did not reflect the ASS score in the
      emergency department but total duration of functional disability increased with
      ASS score. The substitution of an adjusted heart rate score for the raw heart
      rate score used in ASS detracted from scale performance. The ASS is an imprecise
      but reasonable quantitative measure of the severity of an acute episode of
      asthma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738015
TI  - Gender differences in platelet count and its association with cigarette smoking
      in a large cohort in Israel.
AB  - Cigarette smoking has an effect on platelet function and aggregation although the
      sensitivity of platelet count in reflecting this phenomenon is not known. The
      association of platelet count with smoking habits was examined in a cohort of
      5017 Israeli industrial workers aged 20-64 years. Males had a significantly lower
      age-adjusted mean platelet count than females (225,600 vs 247,800/microliters; p
      less than 0.001). Female smokers had lower platelet counts than non-smokers
      (231,000 for heavy vs 252,000 for never smokers) with a strong dose-response
      relationship (p less than 0.0001), whereas among males platelet count was
      slightly higher in smokers (224,000 for non-smokers vs 227,000 for heavy smokers;
      p = 0.243). The difference in platelet count between the sexes remained almost
      identical after controlling for smoking status and hematocrit. In multiple
      regression analysis, the negative association between smoking and platelet count
      in women remained highly significant (p less than 0.001) after controlling for
      ethnic origin, alcohol consumption, body mass, hematocrit, cholesterol and HDL
      cholesterol, whereas for males the slight positive association was not
      significant. The reduced platelet count observed in males compared with females
      and in female smokers, suggests that platelet count may reflect sex differences
      in hemostasis and the effects of smoking on the hemostatic system. This may have
      implications for the mechanisms underlying the pathogenesis of ischemic heart
      disease and should be explored further.

PMID- 1738016
TI  - What price perfection? Calibration and discrimination of clinical prediction
      models.

PMID- 1738017
TI  - Clinical epistemology of sensitivity and specificity.

PMID- 1738018
TI  - Long-term results after lateral canthal advancement for unilateral coronal
      synostosis.
AB  - The procedure of lateral canthal advancement was carried out to correct
      unilateral coronal synostosis in 39 consecutive patients at The Hospital for Sick
      Children during a 20-year period. Thirty-seven children were available for follow
      up study, and results were considered to be good or excellent in 81% of them.
      Liberation of the supraorbital margin and release of stenotic skull base sutures
      are crucial for a successful result. The severity of the process and the age of
      the patient were not restrictive factors in regard to indication for this
      procedure. Some patients showed a continuous improvement with time. Morbidity was
      minimal. It is suggested that lateral canthal advancement is the procedure of
      choice for unilateral coronal synostosis.

PMID- 1738019
TI  - Three-dimensional computerized tomography angiography in the diagnosis of
      cerebrovascular disease.
AB  - Computer-generated three-dimensional reconstruction of the intracranial vascular
      system obtained by contrast-enhanced computerized tomography (CT) has been used
      in the diagnosis of 20 patients with known or suspected intracranial
      cerebrovascular disease. This technique allows visualization of the intracranial
      vasculature without exposing patients to the risks associated with intra-arterial
      angiography. The color prints and videotape images generated have been used to
      diagnose the presence of intracranial aneurysms, arteriovenous malformations, and
      venous angiomas. They have also been used to rule out structural abnormalities in
      patients with suspected intracranial vascular pathology and to screen patients
      with a strong family history of intracranial aneurysm. In 11 patients who
      underwent both three-dimensional CT angiography and intra-arterial angiography,
      the diagnostic correlation was 100%. No complications from the procedures or from
      incorrect diagnosis have been encountered. Although this technique requires
      further development and clinical evaluation, the authors' early experience with
      three-dimensional CT angiography suggests that this may become a valuable tool in
      the diagnosis of patients with cerebrovascular disease.

PMID- 1738020
TI  - The relationship of blood flow velocity fluctuations to intracranial pressure B
      waves.
AB  - Intracranial pressure (ICP) and continuous transcranial Doppler ultrasound
      signals were monitored in 20 head-injured patients and simultaneous synchronous
      fluctuations of middle cerebral artery (MCA) velocity and B waves of the ICP were
      observed. Continuous simultaneous monitoring of MCA velocity, ICP, arterial blood
      pressure, and expired CO2 revealed that both velocity waves and B waves occurred
      despite a constant CO2 concentration in ventilated patients and were usually not
      accompanied by fluctuations in the arterial blood pressure. Additional recordings
      from the extracranial carotid artery during the ICP B waves revealed similar
      synchronous fluctuations in the velocity of this artery, strongly supporting the
      hypothesis that blood flow fluctuations produce the velocity waves. The ratio
      between ICP wave amplitude and velocity wave amplitude was highly correlated to
      the ICP (r = 0.81, p less than 0.001). Velocity waves of similar characteristics
      and frequency, but usually of shorter duration, were observed in seven of 10
      normal subjects in whom MCA velocity was recorded for 1 hour. The findings in
      this report strongly suggest that B waves in the ICP are a secondary effect of
      vasomotor waves, producing cerebral blood flow fluctuations that become amplified
      in the ICP tracing, in states of reduced intracranial compliance.

PMID- 1738021
TI  - The relationship of ventricular drainage to aneurysmal rebleeding.
AB  - Given the widespread use of continuous external ventricular drainage in patients
      with aneurysmal subarachnoid hemorrhage (SAH), this investigation was undertaken
      to define the relationship of ventricular drainage to aneurysmal rebleeding. A
      historical cohort study of 128 patients with confirmed aneurysmal SAH was
      performed using a multivariate stepwise logistic regression analysis to examine
      the relationship between aneurysmal rerupture and ventricular drainage, while
      controlling for important clinical and radiological independent variables. The
      variables for ventricular drainage selected in the regression analysis were
      clinical grade, aneurysm size, and presence of hydrocephalus. The rate of
      rerupture was significantly higher in cases with ventricular drainage (odds ratio
      5.31:1, p less than 0.05), poor clinical grade (odds ratio 4.90:1, p less than
      0.02), and large aneurysm size (odds ratio 11.25:1, p less than 0.01). The
      significant effect of ventricular drainage was limited to patients with
      hydrocephalus. The increased risk of aneurysmal rebleeding in patients undergoing
      ventricular drainage may result from both: 1) a rise in aneurysmal transmural
      pressure, since intracranial pressure is lowered by ventricular drainage; and 2)
      an association between ventricular drainage and a more severely disrupted
      aneurysm which is more prone to rebleed as part of its natural history. This
      study found an increased risk of aneurysmal rebleeding among patients undergoing
      ventricular drainage, particularly in the presence of hydrocephalus.

PMID- 1738022
TI  - Oligodendrogliomas: the Mayo Clinic experience.
AB  - Eighty-one patients with pure supratentorial oligodendrogliomas underwent surgery
      alone (19 patients) or surgery plus postoperative radiation therapy (63 patients)
      between the years 1960 and 1982. The median survival time and the 5-, 10-, and 15
      year survival rates for these 82 patients were 7.1 years, 54%, 34%, and 24%,
      respectively; these values were significantly different from those for an age-
      and sex-matched normal reference population. Univariate and multivariate survival
      analyses were performed on 13 possible prognostic factors including: patient age
      and sex; presence of seizures; site, size, side, computerized tomography (CT)
      enhancement, grade, and calcification of the tumor; and treatment (extent of
      surgical resection, lobectomy, radiation dose, and radiation field). Of these
      factors, tumor grade as classified by the Kernohan and St. Anne-Mayo methods was
      most strongly associated with survival. Patients with Grade 1 or 2 tumors by
      either grading method had a median survival time and 5- and 10-year survival
      rates of approximately 9.8 years. 75%, and 46%, respectively, compared to 3.9
      years, 41%, and 20% for those with Grade 3 or 4 tumors. The extent of surgical
      resection was also associated with survival. The 19 patients who underwent gross
      total resection of their tumor had a median survival time and 5- and 10-year
      survival rates of 12.6 years, 74%, and 59%, compared to 4.9 years, 46%, and 23%,
      respectively, for the 63 who had subtotal resection. When comparing the 19
      patients who underwent surgery alone with the 63 who had surgery plus
      postoperative radiation therapy, there did not appear to be a survival benefit to
      be gained from the addition of postoperative radiation therapy. However, the
      patients who had surgery alone tended to have gross total resections and lower
      tumor grades. Analysis of the subset of 63 patients who underwent subtotal
      resection alone or with radiation therapy showed that the median survival time
      and 5- and 10-year survival rates were: 2 years, 25%, and 25% for the eight
      patients with subtotal resection alone; 4.5 years, 39%, and 20% for the 26
      patients with surgery and low-dose (less than 5000 cGy) radiation therapy; and
      7.9 years, 62%, and 31% for the 29 patients receiving surgery and high-dose
      radiation therapy (greater than or equal to 5000 cGy), respectively.

PMID- 1738023
TI  - Early seizures after mild closed head injury.
AB  - The authors review the seizure incidence in 4232 adult patients with mild closed
      head injury who did not receive prophylactic anticonvulsant agents. One hundred
      patients (2.36%) experienced seizures within 1 week after head injury; 43 of
      these (1.02% of the series) had seizures within 24 hours after trauma. Most of
      the seizures (84%) that developed during the 1st week after injury were of the
      generalized tonic-clonic type. The incidence of generalized tonic-clonic seizures
      was higher than that of partial seizures with motor symptoms both within 24 hours
      (91% vs. 9%) and during the Day 2 to 7 period (79% vs. 21%). No definite
      intracranial pathological findings were detected by computerized tomography (CT)
      in 53% of patients with early posttraumatic seizures; six patients had
      intracranial hemorrhage without intracranial parenchymal damage (three with
      epidural hematoma and three with subarachnoid hemorrhage). The most common
      positive CT findings in the early posttraumatic-seizure group were intracerebral
      hemorrhage (24%), followed by acute subdural hematoma with intracerebral
      hemorrhage (17%). Intracerebral parenchymal damage could be identified on CT
      scans in 41 (48.8%) of 84 patients with generalized tonic-clonic seizures and
      five (31%) of 16 patients with partial seizures with motor symptoms. The
      intracerebral parenchymal damage was most commonly detected in the frontal lobe
      (21%) and the temporal lobe (19%). Seven patients with early posttraumatic
      seizures received emergency craniotomy to remove an intracranial hematoma
      (epidural in three, subdural and intracerebral in four) because the mass effect
      resulted in significant midline shift as seen on CT scans. This review suggests
      that early posttraumatic seizures after mild closed head injury have a high
      incidence (53%) in patients with normal CT scan findings. Although the
      possibility of surgically correctable intracranial hemorrhage is low (7%), the
      condition may be devastating if not treated properly.

PMID- 1738024
TI  - Surgical stabilization of cervical spinal fractures using methyl methacrylate.
      Technical considerations and long-term results in 52 patients.
AB  - This study analyzes the long-term outcome of 52 consecutively treated patients
      with acute cervical spinal fracture/dislocation who underwent posterior surgical
      stabilization using methyl methacrylate in the absence of bone grafting. The
      patients ranged in age from 15 to 93 years. In 40 patients the injury was located
      in the lower cervical spine; for these a previously described surgical format was
      employed. In 12 patients the fracture involved C-1 or C-2, and the modification
      used for these injuries is presented. The postoperative period of evaluation
      ranged from 6 months to 12 years. There was one case of infection, which
      eventually required removal of the acrylic, but there were no instances of new
      neurological injury or of operative mortality. Failure of stabilization occurred
      in two previously reported patients treated early in the series. Comparison of
      the patient outcome in this study with that of certain other reports suggests
      that at least four technical factors are important for the success of methyl
      methacrylate stabilization: 1) the acrylic inlay must be provided with an anchor
      to bone; 2) the anchor must be of a type that does not easily erode through bone;
      3) the inclusion of wire must be done in a manner that allows each strand to be
      completely encased in the acrylic; and 4) the cross-sectional area of the inlay
      is critical.

PMID- 1738025
TI  - Stereotactic radiosurgical treatment of brain metastases.
AB  - In a series of 33 patients with reasonably controlled primary cancers,
      stereotactic radiosurgery was used to treat 52 brain metastases. After a mean
      radiological follow-up time of 5.5 months, six lesions (12%) had stabilized in
      size, 26 (50%) were significantly reduced, and 15 (29%) had disappeared. One
      large melanoma metastasis progressed relentlessly despite treatment. Five lesions
      (9%) had decreased in size slightly before enlarging. In two of these lesions,
      biopsy revealed only necrosis. In almost all cases, treatment was associated with
      decreased peritumoral edema. However, a group of patients with large metastases
      and extensive prior brain irradiation has been identified in whom prolonged
      symptomatic cerebral edema poses a problem. It is concluded that radiosurgery is
      a viable alternative to surgical resection for some cases of brain metastasis.

PMID- 1738026
TI  - Diffuse brain swelling in severely head-injured children. A report from the NIH
      Traumatic Coma Data Bank.
AB  - In this study, data were prospectively collected from 753 patients (111 children
      and 642 adults) with severe head injury and examined for evidence of diffuse
      brain swelling and its association with outcome. Diffuse brain swelling occurred
      approximately twice as often in children (aged 16 years or younger) as in adults.
      A high mortality rate (53%) was found in these children, which was three times
      that of the children without diffuse brain swelling (16%). Adults with diffuse
      brain swelling had a mortality rate (46%) similar to that of children, but only
      slightly higher than that for adults without diffuse brain swelling (39%). When
      the diagnosis of diffuse brain swelling was expanded to include patients with
      diffuse brain swelling plus small parenchymal hemorrhages (less than 15 cu cm),
      these mortality rates were virtually unchanged.

PMID- 1738027
TI  - Aneurysms arising from the proximal (A1) segment of the anterior cerebral artery.
      A study of 38 cases.
AB  - This study reviews aneurysms of the proximal segment (A1) of the anterior
      cerebral artery in 38 patients (23 men and 15 women) and their surgical,
      angiographic, and clinical management. Thirty-seven aneurysms were saccular and
      one was fusiform. The incidence of A1 aneurysms among a total of 4295 aneurysm
      cases treated was 0.88%. Multiple aneurysms occurred in 17 patients (44.7%) of
      the 38 cases; in 10 (58.8%), there was bleeding from the A1 aneurysm. The
      aneurysms were classified into five categories according to the mode of origin of
      the aneurysm in relation to the A1 segment: in 21 cases, aneurysms originated
      from the junction of the A1 segment and a perforating artery; in eight, from the
      A1 segment directly; in six, from the proximal end of the A1 fenestration; and in
      two, from the junction of the A1 segment and the cortical branch. One patient had
      a fusiform aneurysm. Computerized tomography (CT) of these aneurysms revealed
      bleeding extending to the septum pellucidum similar to that of anterior
      communicating artery aneurysms. When performing radical surgery it is very
      important to recognize the characteristics of A1 aneurysms, including
      multiplicity, a high incidence of vascular anomalies (especially A1
      fenestration), and their similarity to anterior communicating artery aneurysms on
      CT.

PMID- 1738028
TI  - Intraforaminal repair of plexus spinal nerves by a posterior approach: an
      experimental study.
AB  - Many spinal nerve roots injured due to stretch or other types of lesions are not
      reparable. Some spinal nerves might be repaired if they could be exposed in their
      intraforaminal course. A posterior subscapular approach for a more lateral
      exposure of the brachial plexus was combined with a facetectomy to expose
      intraforaminal nerves in a series of Macaca rhesus monkeys. This approach exposed
      a 6- to 10-mm segment of spinal nerve not approachable by a more classic anterior
      operation. Sural grafts were placed from the dural exit of the spinal nerves to
      the cord level of the plexus. Nine surviving animals were followed for 36 to 54
      months and observed for clinical evidence of return of function. In each animal
      at least one electromyogram (EMG) was performed. The plexus was then re-exposed
      and intraoperative nerve action potentials were recorded across graft sites.
      Evoked muscle action potential and cortical potentials were recorded in six
      animals. Despite the proximal level of repair, adequate regeneration was shown by
      clinical, electrical, and histological studies. Functional return was best to the
      supraspinatus and biceps muscles and to wrist and finger flexors. Clinical
      recovery was present, but less effective, for deltoid, wrist, and finger
      extensors and intrinsic muscles of the hand, despite evidence on EMG of
      reinnervation. Recovery of the infraspinatus muscle was poor. Nerve action
      potentials could be recorded across each graft site. Reinnervational activity was
      recorded by EMG and evoked muscle action potential studies in most of the muscles
      studied, despite the persistence of some denervational changes 3 years or more
      after injury and repair. Histological studies confirmed the presence of a large
      number of axons of moderate size and myelination even at the forearm level.

PMID- 1738029
TI  - Transient glucose hypermetabolism after acute subdural hematoma in the rat.
AB  - Ischemic brain damage occurs in most patients with acute subdural hematoma, yet
      many aspects of the distribution and extent of this damage remain unexplained.
      Previous studies in rat model, which produces a region of infarction under the
      hematoma, have implicated an "excitotoxic" mechanism, suggesting that high
      concentrations of excitatory amino acids may exacerbate ischemic damage. A study
      is described in which local glucose utilization is measured 2 or 4 hours after
      induction of acute subdural hematoma in the rat. These changes are compared to
      those produced by introducing the same volume of inert silicone gel into the
      subdural space. Massive increases (up to 142%) in glucose utilization occurred
      throughout both hippocampi and in a variable zone around the ischemic core, but
      these had normalized by 4 hours after blood injection. Hippocampal
      hypermetabolism was not seen after introduction of the silicone mass, suggesting
      that diffusible substances from the clotted blood may be responsible for these
      changes. This transient hypermetabolism accords with an excitotoxic process,
      which may amplify brain damage after acute subdural hematoma.

PMID- 1738030
TI  - Perfusion pressure breakthrough threshold of cerebral autoregulation in the
      chronically ischemic brain: an experimental study in cats.
AB  - A study was designed to investigate hyperperfusion syndrome after the restoration
      of normal cerebral blood flow in a chronically cerebral ischemic state resulting
      from high-flow arteriovenous malformations or severe carotid stenosis. A fistula
      between the left distal common carotid artery and the jugular vein was created
      and the left vertebral artery was simultaneously occluded in 44 cats to produce a
      chronic cerebral ischemic state. For control experiments, 10 cats underwent
      occlusion of the left common carotid and vertebral arteries. Six weeks later,
      pial arterial behavior, disruption of the blood-brain barrier (BBB), and cerebral
      histological changes were investigated using three experimental methods. In the
      first, in which a fistula was occluded under normal conditions, pial arteries
      contracted to some 80% of the resting state; however, no BBB disruption or
      histological changes were observed. In the second experiment, in which a 20
      minute occlusion of the left middle cerebral artery was performed in the cats
      with a patent fistula, a 30% to 40% dilated state of the pial arteries continued
      after recirculation, and BBB disruption-induced cerebral edema and infarction
      were observed. These findings were more prominent in the cats that underwent
      occlusion of the fistula. On the other hand, in the control group, the pial
      arteries returned to resting size within 40 minutes, and no BBB disruption or
      histological changes were observed. In the third experiment, in which moderate
      hypertension was induced for 1 hour, the pial arteries dilated much more
      remarkably; BBB disruption and cerebral edema were revealed to be more extensive
      in the cases of fistula occlusion than within those with a patent fistula. In the
      control group, however, the pial arteries contracted 10% during hypertension,
      while BBB disruption and histological changes were not evident. The results
      indicate that the perfusion pressure breakthrough threshold in the chronically
      ischemic brain may not be reduced by the restoration of normal blood flow, but
      may be decreased by the addition of new ischemic insults or hypertension.

PMID- 1738031
TI  - Effect of mannitol on local cerebral blood flow after temporary complete cerebral
      ischemia in rats.
AB  - The effects of pretreatment with mannitol on local cerebral blood flow (CBF)
      after permanent or temporary global cerebral ischemia were evaluated with 14C
      iodoantipyrine autoradiography in rats under halothane-N2O endotracheal
      anesthesia. Blood pressure, pulse rate, arterial blood gas levels, and
      electroencephalographic (EEG) tracings were monitored throughout the experiments.
      After permanent occlusion of the basilar artery and both external carotid and
      pterygopalatine arteries, severe global ischemia was induced by permanent
      occlusion of the common carotid arteries (CCA's) or by a 30-minute temporary CCA
      occlusion followed by 5 minutes of reperfusion. Intravenous mannitol (25%, 1
      gm/kg) or saline solution was administered 5 minutes before occlusion of the
      CCA's. Cerebral blood flow was measured in 24 anatomical regions. The EEG
      tracings flattened within 2 to 3 minutes after the onset of ischemia, and no
      recovery was observed during reperfusion. In the mannitol-treated rats and the
      saline-treated controls, autoradiographic studies after permanent occlusion
      showed no CBF in the forebrain or cerebellum, although brain-stem and spinal cord
      CBF values were normal. After 5 minutes of reperfusion, CBF in the cortex, basal
      ganglia, and white matter was 100% to 200% higher in mannitol-treated rats and
      50% to 100% higher in saline-injected rats than in the nonischemic anesthetized
      control group. Heterogeneously distributed areas of no-reflow were seen in all
      saline-injected rats but were observed in none of the mannitol-treated rats.
      Pretreatment with mannitol prevented postischemic obstruction of the
      microcirculation during 5 minutes of recirculation after 30 minutes of severe
      temporary ischemia, but the EEG signals did not recover. Further studies of the
      functional and morphological responses to longer periods of postischemic
      recirculation are needed to verify the extent to which these mannitol-induced
      effects are protective.

PMID- 1738032
TI  - Time course of the impairment of cerebral autoregulation during chronic cerebral
      vasospasm after subarachnoid hemorrhage in primates.
AB  - The time course of the impairment of cerebral autoregulation during chronic
      cerebral vasospasm after subarachnoid hemorrhage was studied in 18 monkeys.
      Changes in cerebral blood flow (CBF) at the regional level and central conduction
      times during either graded hypo- or hypertension were evaluated in these animals
      at three stages (3, 7, and 14 days) following the introduction of an autologous
      blood clot around the right middle cerebral artery (MCA). Angiograms revealed a
      reduction in vessel caliber (compared to the baseline level in the involved MCA)
      of 30% at 3 days, 50% at 7 days, and 10% at 14 days. At all stages, CBF remained
      constant at mean arterial blood pressures (MABP) of 60 to 160 mm Hg in the
      noninvolved hemisphere. In contrast, at the 3- and 7-day stages, there was an
      impairment of autoregulation in the involved hemisphere at MABP of 40 to 180 mm
      Hg. The right hemispheric CBF was significantly (p less than 0.05) lower than
      that in the left throughout the period of investigation at MABP below 120 mm Hg,
      but rose to exceed the left CBF at MABP above 180 mm Hg at the 7-day stage and
      160 mm Hg at the 14-day stage. The right-sided central conduction time showed
      significant (p less than 0.05) prolongation at MABP below 60 mm Hg at the 3-day
      stage and 40 mm Hg at the 7-day stage. It is suggested that these results may
      help to develop guidelines for hemodynamic therapy for vasospasm in its various
      stages.

PMID- 1738033
TI  - Treatment of murine primary brain tumors with systemic interleukin-2 and tumor
      infiltrating lymphocytes.
AB  - Methods have recently been described for the isolation and expansion of
      lymphocytes that have trafficked into animal and human tumors. These CD8-positive
      tumor-infiltrating lymphocytes (TIL's) have exceptional trafficking ability to,
      and efficacy against, tumor targets in extracranial sites. Prior to Phase I
      clinical trials for patients with gliomas, adoptive immunotherapy with TIL's was
      studied in a mouse model of primary brain tumors to determine if intracerebral
      tumors have a similar response. Glioma 261 (GL261) tumors were grown in the
      subcutaneous space of C57BL/6 mice. After enzymatic digestion, the cells were
      incubated in vitro with interleukin-2 (IL-2) until a confluent population of T
      lymphocytes was present. The in vitro efficacy of these TIL's was tested against
      fresh GL261 targets with a chromium release assay; the in vivo efficacy was
      tested against GL261 tumors in the liver and against irradiated and nonirradiated
      GL261 tumors in the brain. Mice received one of the following: intraperitoneal
      saline; intraperitoneal IL-2 (7500 to 50,000 U three times daily for 5 days); IL
      2 plus intravenous TIL's (1 to 3 x 10(7) cells); 10 Gy cranial irradiation;
      irradiation plus IL-2; or irradiation plus IL-2 plus TIL's. The TIL preparation
      killed 77% of tumor targets in 4 hours at an effector:target ratio of 100:1. In
      animals with GL261 tumors in the liver, at 2 weeks there were 93 +/- 37, 128 +/-
      45, and 21 +/- 14 liver metastases in the control, IL-2, and IL-2 plus TIL
      groups, respectively. However, in animals with GL261 tumors in the brain, no
      treatment group had an increased survival rate compared to the control group. It
      is concluded that, although TIL and IL-2 immunotherapy can be used effectively to
      treat brain tumors in vitro and at sites outside the central nervous system, it
      is ineffective against the same type of tumor in the brain. Different methods of
      delivery or different combinations of these immunomodulators may be more
      effective; however, based on these findings, treatment of patients with IL-2 and
      TIL cannot be recommended until efficacy has been demonstrated in an animal
      model.

PMID- 1738034
TI  - Direct approach to a traumatic giant internal carotid artery aneurysm associated
      with a carotid-cavernous fistula. Case report.
AB  - The case is reported of a giant intracranial internal carotid artery aneurysm
      associated with a carotid-cavernous fistula following a closed head injury. The
      aneurysm and the fistula disappeared after only the neck of the aneurysm was
      clipped. This is the first case in which a direct surgical approach was
      successful in sparing the internal carotid flow. Reports of similar cases are
      reviewed.

PMID- 1738035
TI  - Intramedullary epidermoid cysts of the spinal cord. Case report.
AB  - Epidermoid cysts are tumors familiar to neurosurgeons, but intramedullary
      epidermoid cysts are rare. The authors report the case of a 6-year-old girl
      presenting with progressive paraparesis. A midthoracic intramedullary mass was
      revealed on myelography and magnetic resonance (MR) imaging and confirmed as an
      intramedullary epidermoid cyst at surgery, at which time the cyst was removed.
      This is the fourth report documenting a purely intramedullary epidermoid cyst
      occurring in a child. The pathology and etiology, epidemiology, clinical
      features, radiology (including MR image characteristics), and surgical treatment
      of such rare intramedullary benign tumors are discussed. Magnetic resonance
      imaging reduces the delay in diagnosis of spinal cord tumors but should be guided
      by clinical judgment.

PMID- 1738036
TI  - Ligamentum flavum hematoma. Report of two cases.
AB  - Two patients presenting with signs and symptoms suggestive of nerve root
      compression secondary to extradural masses were found to have ligamentum flavum
      hematomas. Both patients had neurological deficits preoperatively and regained
      normal function postoperatively. There was no significant antecedent injury in
      either case. The symptom course was longer than that for spontaneous epidural
      hematoma. In one case, there was remodeling of bone, initially suggesting either
      infection or tumor.

PMID- 1738037
TI  - Cerebral protection during aneurysm surgery with isoflurane anesthesia. Technical
      note.
AB  - A strategy for intraoperative cerebral protection is described in which
      intraoperative electroencephalography is used to titrate the level of inspired
      isoflurane given for anesthesia to obtain isoelectricity prior to temporary
      vessel occlusion during repair of difficult aneurysms. During temporary vessel
      occlusion, arterial blood pressure is maintained or increased with an inotropic
      or vasopressor agent. After clipping of the aneurysm, the concentration of
      isoflurane is reduced to allow the patient to awaken in the operating room for
      early postoperative neurological examination. The combination of a high
      concentration of isoflurane, temporary vessel occlusion, and maintenance of
      arterial blood pressure may be a useful protective regimen during neurovascular
      procedures.

PMID- 1738038
TI  - A portable traction device for cervical fractures. Technical note.
AB  - A lightweight and completely self-contained traction device is described. It has
      been used to immobilize the cervical spine during radiographic evaluation and
      treatment of patients with cervical fracture, and for therapeutic traction in
      patients with a ruptured disc. Other applications are possible, but have not yet
      been investigated.

PMID- 1738039
TI  - End-to-side anastomosis of small vessels using an Nd:YAG laser with a
      hemispherical contact probe. Technical note.
AB  - A new technique is described which enables the surgeon to perform an end-to-side
      anastomosis between arteries with little (less than 2 minutes) or no occlusion of
      the recipient artery. The technique was developed in rabbits, but has recently
      been successfully used in a patient in whom an anastomosis between the
      superficial temporal artery and a proximal branch of the middle cerebral artery
      was created.

PMID- 1738040
TI  - Two examples of ancient skull surgery.
AB  - The author, while a research illustrator at the Smithsonian Institution National
      Museum of Natural History, studied two ancient skulls from the Incan period in
      Peru, both with trephination. Her conclusions and illustrations of the skulls are
      included in this paper.

PMID- 1738041
TI  - Brain tolerance to radiosurgery.

PMID- 1738042
TI  - Complications of radiosurgery for brain AVM's.

PMID- 1738043
TI  - Instrumentation for spinal trauma.

PMID- 1738044
TI  - Myelotomy in spinal spasticity.

PMID- 1738045
TI  - Prediction tree for severely head-injured patients.

PMID- 1738046
TI  - Efficiency of stereopsis in random-dot stereograms.
AB  - The statistical efficiency of stereopsis was investigated by measurement of the
      discriminability d' of a step edge in depth in a random-dot stereogram and its
      comparison with d' calculated for an ideal observer model. Efficiencies of
      approximately 20% were found for stimuli with very few (less than 30) dots. As
      the number of dots was increased, efficiency fell markedly to 2% and below. Over
      the ranges explored in this study, there was little variation in efficiency with
      changes in dot density (with dot number constant) or stimulus size. Efficiency
      loss was also found to be almost entirely due to incomplete use of the available
      information rather than to intrinsic observer variance. Results were compared
      with two simple models that implemented possible detection strategies.

PMID- 1738047
TI  - Experimental test of an analytical model of aberration in an oil-immersion
      objective lens used in three-dimensional light microscopy.
AB  - Oil-immersion microscope objective lenses have been designed and optimized for
      the study of thin, two-dimensional object sections that are mounted immediately
      below the coverslip in a medium that is index matched to the immersion oil. It
      has been demonstrated both experimentally and through geometrical- and physical
      optics theory that, when the microscope is not used with the correct coverslip or
      immersion oil, when the detector is not located at the optimal plane in image
      space, or when the object does not satisfy specific conditions, aberration will
      degrade both the contrast and the resolution of the image. In biology the most
      severe aberration is introduced when an oil-immersion objective lens is used to
      study thick specimens, such as living cells and tissues, whose refractive indices
      are significantly different from that of the immersion oil. We present a model of
      the three-dimensional imaging properties of a fluorescence light microscope
      subject to such aberration and compare the imaging properties predicted by the
      model with those measured experimentally. The model can be used to understand and
      compensate for aberration introduced to a microscope system under nondesign
      optical conditions so that both confocal laser scanning microscopy and optical
      serial sectioning microscopy can be optimized.

PMID- 1738048
TI  - Color changes in red and white projections at low luminance.
AB  - In previous studies photographic projections containing only mixtures of red and
      white light produced a wide variety of hues. In the present experiment similar
      patterns were produced on a color monitor. Squares with four combinations of red
      and white light were studied at two mean luminances. Subjects reported that a
      chromaticity that appeared pink at our higher luminance appeared yellow at low
      luminance.

PMID- 1738049
TI  - Visual instrument image quality metrics and the effects of coma and astigmatism.
AB  - We examine subjective contrast and edge sharpness discrimination in the presence
      of different amounts of coma, astigmatism, and combinations of these two
      aberrations. We also examine the correlation between subjective results and
      objective image quality measures. These include the integral of the modulation
      transfer function (MTF) across the frequency range of interest (MTFa), the Strehl
      ratio, the variance of the wave-front aberration, and the radius of 84% encircled
      energy of the point-spread function (R84). For the target orientation that is
      most affected by the aberrations, we find that the MTFa and R84 give good
      correlation, while the Strehl ratio and the variance do not. In addition, we find
      that the MTFa correlates with subjective results for all target orientations. We
      discuss the implications of the results on the automated assessment of the image
      quality of visual instruments.

PMID- 1738050
TI  - Size of saccade and fixation duration of eye movements during reading:
      psychophysics of Japanese text processing.
AB  - The size of saccadic eye movements and eye fixations during Japanese text reading
      (written in both hirakana phonograms and kanji ideograms) were analyzed. Hirakana
      is sound based, i.e., it consists of symbols for syllables, but such text was
      processed differently from English text in terms of saccadic eye movements and
      fixations. In experiment 1 the reader was asked to read three types of text
      (hirakana only, kanji-hirakana mixed, and English) in a natural reading manner.
      The results show that kanji-hirakana-mixed text, which has picturelike symbols,
      requires shorter eye fixations and longer saccades than those required by
      hirakana text. The findings show that kanji and hirakana are processed
      differently. Logographlike kanji text greatly facilitated text processing and
      understanding during reading. In experiment 2 we found that kanji-based text had
      a wider perceptual span of reading than did hirakana text. The wider span is
      consistent with the longer saccade length for kanji-based text found in
      experiment 1. In experiment 3 we studied the convenient viewing position, i.e.,
      the position within a word where the eye should fixate first for the isolated
      word to be recognized most quickly. A convenient viewing position was confirmed
      to exist both for hirakana- and kanji-based words, but for hirakana words the
      position changed as word length changed, as was expected from the results of
      experiment 2. In experiment 4 we measured lexical access time for hirakana- and
      kanji-based words and found that the reaction time to kanji-based words was
      faster than the reaction time to words written with hirakana.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1738051
TI  - Molecular and biochemical aspects of nematode collagens.
AB  - Collagens are major structural proteins of nematode cuticles and basement
      membranes (basal laminae). The collagen proteins that form these structures
      differ in their biochemical and physical properties and are encoded by distinct
      gene families. Nematode basement membrane collagens are large proteins that show
      strong homology to basement membrane collagens of vertebrates. There appear to be
      2 nonidentical basement membrane collagen genes in nematodes. Cuticle collagens
      are about one-sixth the size of basement membrane collagens and are encoded by a
      large family of 20-150 nonidentical genes. Cuticle collagens can be subdivided
      into 4 families based upon certain structural features in the proteins. The
      mature, extracellular forms of both types of collagen proteins are extensively
      cross-linked by disulfide bonds and are largely insoluble in the absence of a
      thiol-reducing agent. Cuticle collagens also are cross-linked by nonreducible
      covalent bonds that involve tyrosine residues. The experimental studies that have
      led to our current understanding of the structures of basement membrane and
      cuticle collagens are reviewed. Some previous questions about the physical
      properties of these proteins are reexamined in light of the primary sequence
      information now available for the proteins.

PMID- 1738052
TI  - Excretory-secretory products of Echinostoma paraensei sporocysts mediate
      interference with Biomphalaria glabrata hemocyte functions.
AB  - Miracidia of Echinostoma paraensei were cultured in medium containing 14C-labeled
      amino acids, allowed to transform into sporocysts, and their excretory/secretory
      products (E-S) were collected and characterized by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and autoradiography. Effects of E-S on
      hemocytes of Biomphalaria glabrata were also assessed. E-S collected during day 1
      of culture (E-S1) contained several polypeptides, none of which were labeled,
      suggesting that E-S1 are largely preformed. E-S1 significantly depressed the
      ability of hemocytes to phagocytose sheep red blood cells (SRBC), but otherwise
      had little effect on hemocyte structure or behavior. E-S released by sporocysts
      in day-2 cultures (E-S2) and in older cultures generally were similar and also
      contained several polypeptides, many of which were labeled, indicating active
      synthesis of E-S in vitro. E-S2 strongly inhibited hemocyte uptake of SRBC. Also,
      hemocytes pretreated with E-S2 assumed a spherical shape and failed to spread
      normally. E-S obtained through 10 days of culture mediated this effect. Active
      components of E-S2 were greater than 100 kDa in their native configuration, were
      heat- and trypsin-labile, and were bound by anti-E-S antibodies. Both greater
      than 200- and 80-kDa bands were prominent in anti-E-S immunoprecipitates.
      Hemocytes derived from snails of the 13-16-R1 strain of B. glabrata (a strain
      resistant to infection with Schistosoma mansoni), when pretreated with E-S2,
      bound to sporocysts of S. mansoni but lost their ability to damage such
      sporocysts. E-S2 interfered with hemocyte functions in ways inferred from earlier
      classic in vivo studies of trematode-snail interactions.

PMID- 1738053
TI  - Sarcocystis falcatula of opossums: transmission by cockroaches with fatal
      pulmonary disease in psittacine birds.
AB  - Old World psittacines experienced an acute fatal illness in outdoor breeding
      collections in South Florida. Toxoplasma-like organisms were found histologically
      in pulmonary capillaries and elsewhere. Because the organisms underwent
      schizogony and could not be transmitted to mice, we looked for a cause other than
      Toxoplasma gondii. An opossum was trapped on the premises of 1 facility and was
      found to be shedding sporocysts similar to Sarcocystis falcatula in its feces.
      Cockroaches were prevalent and suspected as transport hosts. Cockroaches that had
      ingested opossum feces and subsequently were fed to cockatoos induced an
      identical fatal illness. Obstruction of pulmonary capillaries by developing
      schizonts and pulmonary edema were the most important pathologic findings. The
      epidemic was stopped by biological insect control employing flightless chickens
      to reduce cockroach populations and by an electric fence restricting access of
      opossums to these outdoor psittacine breeding facilities.

PMID- 1738054
TI  - Effects of albendazole on Gnathostoma spinigerum in mice.
AB  - Mice were infected with 5 advanced third-stage larvae of Gnathostoma spinigerum
      and, beginning on the 28th day postinfection, were treated orally with
      albendazole. In the first experiment, infected mice each received albendazole
      once a day (30, 60, or 90 mg/kg/day) for 21 consecutive days. In the second
      experiment, they received albendazole twice a day (30 and 30, 60 and 60, or 90
      and 90 mg/kg/day) for the same length of time. All mice were killed 28 days after
      cessation of treatment and the carcasses were examined for parasites. With both
      regimens, the administration of albendazole significantly reduced the number of
      larvae. However, a complete larvicidal effect was obtained only with albendazole
      at the dosage of 90 mg/kg twice daily.

PMID- 1738055
TI  - Formation of the capsule around Filicollis anatis (Acanthocephala) in its
      intermediate host.
AB  - Morphogenesis of the capsule around larvae of Filicollis anatis was studied by
      electron microscopy. The capsule is formed at early, middle, and late acanthella
      development. The inner layer is formed at the late acanthella stage apparently
      from material secreted via a system of hypodermal canals. The central layer of
      the capsule is formed mainly of detached microvilli of the acanthella. The source
      and mechanism of formation of the outer layer, which appears during the early
      acanthella stage, are unclear.

PMID- 1738056
TI  - Cold-hardiness in Pelecitus fulicaeatrae (Nematoda: Filarioidea), a parasite of
      the ankles of Fulica americana (Aves).
AB  - The filarioid nematode Pelecitus fulicaeatrae (Diesing, 1861) is considered cold
      hardy. Adults and microfilariae became motile when placed in saline at 22 C after
      having been removed from thawed carcasses of their host, the American coot
      (Fulica americana Gmelin) (Aves: Gruiformes). Adult nematodes from 5 of 12
      carcasses became active as did microfilariae from 4 of 5 carcasses. Carcasses had
      been frozen at an undetermined temperature below 0 C for an initial 14 days and
      then at -21 to -24 for 100-159 days.

PMID- 1738057
TI  - The use of the polymerase chain reaction to identify porcine isolates of
      Trichinella.
AB  - A method was developed to identify domestic isolates of Trichinella using the
      polymerase chain reaction. Oligonucleotide primers, based on the repetitive DNA
      sequence (pPRA) from the P1 isolate of Trichinella, were used to amplify genomic
      DNA from 13 domestic isolates and tested against sylvatic isolates of
      Trichinella. Pattern differences were observed among domestic isolates,
      indicating divergence of this repetitive sequence. The primers were specific for
      domestic Trichinella as no amplification was detected for sylvatic isolates or
      Trichinella pseudospiralis. It was possible to identify an isolate from a single
      larva following digestion or in situ in muscle tissue.

PMID- 1738058
TI  - Experimental Caryospora bigenetica (Apicomplexa: Eimeriidae) infections in swine
      (Sus scrofa).
AB  - Two Hampshire-Landrace crossbred pigs were found to contain developmental stages
      of Caryospora bigenetica following oral inoculation with 1 x 10(8) oocysts. One
      pig was given intramuscular injections of methylprednisolone acetate. Both pigs
      displayed clinical signs of dermal coccidiosis from 3 to 10 days after
      inoculation, including swollen jowls and hocks, bilateral ocular discharges,
      generalized erythema, and lethargy. Meronts and gamonts were observed
      histologically in numerous tissues including jowl, ear, footpad, tongue, and lung
      at 10 days postinoculation. The present study is the first report of C.
      bigenetica infections in swine.

PMID- 1738059
TI  - Isolation of Toxoplasma gondii from a naturally infected beef cow.
AB  - Toxoplasma gondii was isolated from the intestinal wall of an adult shorthorn
      cow. The cow had an antibody titer of 1:1,600 in the T. gondii agglutination test
      using formalin-fixed whole tachyzoites. The strain of the parasite designated CT
      1 was lethal to mice. This is the first report of the recovery of viable T.
      gondii from a naturally infected cow in the United States.

PMID- 1738060
TI  - Psoroptes sp. in two llamas (Lama glama) in Washington.
AB  - Psoroptes sp. mites were isolated from two llamas (Lama glama), a 4-mo-old male
      and its dam, in Washington. Mites were restricted to the ears and were
      responsible for head-shaking and incoordination. Infestations were treated
      successfully with a subcutaneous injection of ivermectin at 0.2 mg/kg of body
      weight and with 2 drops of ivermectin diluted in saline given topically in each
      ear. This is the first known report of Psoroptes sp. in llamas in the United
      States.

PMID- 1738061
TI  - How effective is the agar plate method for Strongyloides stercoralis?
AB  - The sensitivity of the agar plate method for the diagnosis of Strongyloides
      stercoralis was studied experimentally. Results demonstrated that this method was
      sensitive enough to detect S. stercoralis even when only a few worms were
      present.

PMID- 1738062
TI  - Survival of Onchocerca volvulus in nodules implanted in immunodeficient rodents.
AB  - Onchocerca volvulus is an obligate human parasite, and its study has been
      difficult due to an inability to maintain it outside the human host. We report
      the successful transplantation of onchocercomata containing living adult O.
      volvulus worms into immunodeficient C.B.-17.scid/scid (scid) mice or athymic
      rnu/rnu (nude) rats. Living, motile worms containing viable microfilariae were
      present in onchocercomata recovered from scid mice or nude rats for up to 20 wk,
      establishing a novel animal model for future investigation of O. volvulus.

PMID- 1738063
TI  - Helminth parasites of the raccoon (Procyon lotor) from north-central Arkansas.
AB  - Twenty-three species of helminths (4 trematodes, 2 cestodes, 14 nematodes, and 3
      acanthocephalans) were found in the gastrointestinal tract, lungs, pancreas,
      tongue, urinary bladder, and subcutaneous tissues of 30 live-trapped or hunter
      shot raccoons from north-central Arkansas between November 1989 and April 1990.
      Helminths were not detected in the brain, diaphragm, gallbladder, heart, liver,
      reproductive system, or trachea. Each raccoon examined was infected with 3 or
      more of the following helminths: Brachylaima virginiana, Eurytrema procyonis,
      Fibricola cratera, Pharyngostomoides procyonis, Atriotaenia procyonis,
      Mesocestoides spp., Arthrocephalus lotoris, Capillaria aerophila, Capillaria
      plica, Capillaria procyonis, Capillaria putorii, Crenosoma goblei, Cruzia
      americana, Dirofilaria tenuis, Dracunculus insignis, Enterobius sp., Gnathostoma
      procyonis, Molineus barbatus, Physaloptera rara, Trichinella spiralis,
      Centrorhynchus wardae, Macracanthorhynchus ingens, and Oligacanthorhynchus
      tortuosa. All helminths collected with the exception of D. insignis constitute
      new geographic distribution records. Occurrences of C. aerophila, C. wardae, and
      O. tortuosa are new host records. One nymphal pentastome, Porocephalus crotali,
      was found in the liver of 1 raccoon, constituting a new host record.

PMID- 1738064
TI  - Identification of Dirofilaria immitis-infected dogs with a coagglutination assay.
AB  - The presence of Dirofilaria immitis excretory-secretory (ES) products was
      detected in the urine of infected dogs using a coagglutination assay. Urine
      samples from 30 naturally infected dogs were positive. Seventeen of them were
      microfilaremic, whereas 13 had become amicrofilaremic after receiving 2 courses
      of diethylcarbamazine. Urine samples from 20 dogs infected with other parasites,
      Dipetalonema reconditum (7), Toxocara canis (5), and Ancylostoma caninum (8), and
      urine samples from 20 healthy dogs were negative. The assay detected 200 ng/ml or
      more of ES products. This assay is simple, easy to perform with minimum training,
      and requires no equipment. Therefore it should be useful to detect canine
      filariasis under field conditions.

PMID- 1738065
TI  - Enzymes of the tricarboxylic acid cycle in Ancylostoma ceylanicum and
      Nippostrongylus brasiliensis.
AB  - Enzymes of the tricarboxylic acid (TCA) cycle and glyoxylate pathway were
      investigated in adults and infective larvae of Ancylostoma ceylanicum and
      Nippostrongylus brasiliensis, and their activities were compared with those
      obtained in rat liver. A complete sequence of enzymes of the TCA cycle, with most
      of them showing activities quite similar to those in the rat liver homogenate,
      was detected in adults of both species. All the enzymes except fumarase and
      malate dehydrogenase were located predominantly in mitochondria where they showed
      a variable distribution of activities between the soluble and the membranes
      fractions. Malate dehydrogenase and fumarase were found in both the mitochondria
      and the 9,000-g supernatant fraction. Succinyl CoA synthetase, which was present
      in minimum activity, appeared rate limiting. Enzymes of the glyoxylate pathway,
      particularly isocitrate lyase, seemed to aid the functioning of the Krebs cycle
      by allowing the formation of succinate from isocitrate. The infective larvae of
      both species also were found equipped with all the enzymes of the Krebs cycle.
      Nonetheless, only isocitrate lyase of the glyoxylate pathway could be detected in
      these parasites.

PMID- 1738066
TI  - Redescription of Hebesoma violentum Van Cleave, 1928 (Acanthocephala:
      Neoechinorhynchidae).
AB  - Hebesoma violentum Van Cleave, 1928, is redescribed from 155 paratypes from Van
      Cleave's original 1921 and 1923 collections in China. The present distribution of
      H. violentum in China and the Soviet Union is reported and the uncertain status
      of Hebesoma derosum Gupta and Jain, 1973, examined.

PMID- 1738067
TI  - Description and pathology of Neoechinorhynchus idahoensis n. sp. (Acanthocephala:
      Neoechinorhynchidae) in Catostomus columbianus from Idaho.
AB  - Neoechinorhynchus idahoensis is described from Catostomus columbianus caught in
      the Salmon River, Stanley Basin, Idaho. The new species is closest to
      Neoechinorhynchus venustus Lynch, 1936, but is distinguished from it by its
      smaller and variably structured eggs, anterio-dorsal trunk hump, bent and
      posteriorly notched proboscis receptacle, and larger proboscis, proboscis
      receptacle, and hooks. It is distinguished also from 2 other species of
      Neoechinorhynchus with proboscis hooks in middle and anterior circles about
      equally large and from 7 other species having lemnisci greatly unequal in length.
      Histopathology of host tissue showed limited host response exemplified by
      epithelial damage and hemorrhaging at point of proboscis attachment with
      subsequent macrophage and other phagocytic cell migration. The proboscis extended
      through the host epithelium into the submucosa with limited hemorrhaging at the
      point of attachment. Unorganized collagenous fibers were present. The lumen of
      the host intestine was obstructed, and compressed villi were present. The trunk
      of the worm damaged intestinal epithelium near the crypts, causing localized
      inflammation. The caryophyllaeid cestode Isoglaridacris calentinei Mackiewicz,
      1974, was present in concurrent infections of C. columbianus.

PMID- 1738068
TI  - Biological tags for stock separation in Pacific herring Clupea harengus pallasi
      in California.
AB  - A survey of the parasites of Pacific herring (Clupea harengus pallasi) off
      northern California identified 1 species of Acanthocephala, 1 species of Cestoda,
      2 species of Copepoda, 1 species and 1 family of Digenea, 3 species of Nematoda,
      and 3 species of Protozoa. From this survey, Lacistorhynchus dollfusi (Cestoda),
      Parahemiurus merus (Digenea), and Anisakis simplex, Contracaecum sp.,
      Hysterothylacium sp. (Nematoda) were selected as potential tags. Herring were
      collected in Tomales, San Francisco, and Monterey bays for the following 9 yr and
      examined for these select parasites. The results suggest that these parasites can
      be used to distinguish the spawning stocks of San Francisco and Tomales bays. The
      distribution of the definitive hosts of the respective parasites suggests that
      the Tomales Bay fish are offshore during the nonbreeding season and the San
      Francisco Bay fish onshore. The similarity in parasitism between San Francisco
      Bay and the nonspawning population in Monterey Bay suggests that these 2
      populations represent a single stock.

PMID- 1738069
TI  - Pattern of cercarial emergence of Schistosoma curassoni from Niger and comparison
      with three sympatric species of schistosomes.
AB  - The emergence pattern of Schistosoma curassoni cercariae from Bulinus
      umbilicatus, whose adult worms parasitize bovine, caprine, and ovine ungulates in
      Niger, is of a circadian type with a mean emission time at 0855 hr +/- 1 hr 6
      min, characteristic of the schistosome species parasitizing domestic or wild
      cattle. The comparison of this cercarial emergence pattern with those of the
      other 3 sympatric species of schistosomes (Schistosoma haematobium, Schistosoma
      bovis, and Schistosoma mansoni) shows a significant difference between the
      chronobiology of the cercariae infective for human and those infective for bovine
      hosts. This difference may improve epidemiological surveys based on snail
      prevalences by allowing the distinction between bulinids infected with human and
      bovine parasites.

PMID- 1738070
TI  - Use of confidence ellipses to detect effects of parasites on the growth of yellow
      perch, Perca flavescens.
AB  - Determining the causes of mortality in populations of fish is inherently
      difficult. To simplify the determination of whether parasite-induced mortality
      occurs, parasitologists have relied on 3 types of subjective analyses of graphs.
      Peaked host age-parasite intensity curves concomitant with a decrease in the
      degree of dispersion (measured by variance-to-mean ratio) of parasites in older
      age-classes of fishes, a slope of less than 2.0 for a log-log graph of variance
      versus mean intensity of infection, and differences between truncated and
      nontruncated forms of a theoretical frequency distribution for the parasite are
      considered indicators of parasite-induced mortality in fishes. The nematode
      Raphidascaris acus causes significant parasite-induced mortality in natural
      populations of yellow perch (Perca flavescens) in Dauphin Lake, Manitoba, Canada.
      Using this fish-parasite system we present a comparison of some of the graphical
      techniques used by parasitologists to detect parasite-induced mortality and show
      how confidence ellipses based on the parameters beta 0 and beta 1 of a linear
      model for growth of yellow perch (weight = beta 0 + beta 1 x age) can be used to
      compare many growth curves simultaneously. When plotted in a bivariate fashion
      (beta 0 vs. beta 1), vertical displacement of confidence ellipses along the
      ordinate (beta 1) are due to sublethal effects on growth of fishes in response to
      parasites, whereas lateral shifts along the abscissa (beta 0) are suggestive of
      parasite-induced mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738071
TI  - Factors affecting the survival of Neospora caninum bradyzoites in murine tissues.
AB  - Studies were conducted to determine factors that influence the survival of
      bradyzoites of Neospora caninum within tissue cysts in the brains of
      experimentally inoculated mice. Viable tissue cysts were detected in the brains
      of mice inoculated 13 mo previously with either of 2 isolates (NC-1 or NC-2) of
      N. caninum. Bradyzoites within tissue cysts of the NC-2 isolate survived for at
      least 14 days at 4 C in refrigerated brain homogenates. Bradyzoites within tissue
      cysts of the NC-2 isolate also survived in the intact brain of a mouse carcass
      refrigerated at 4 C for 7 days. Bradyzoites within tissue cysts of the NC-3
      isolate were killed by freezing at -20 C for 1 day.

PMID- 1738072
TI  - Relative susceptibility of Giardia muris trophozoites to killing by mouse
      antibodies of different isotypes.
AB  - The aim of this work was to examine the ability of mouse IgA, IgG, and IgM anti
      Giardia antibodies to kill Giardia muris trophozoites in the presence and absence
      of complement. Using a 2-color flow cytometry assay, binding of antibody to
      trophozoites was assessed with fluorescein-conjugated anti-mouse immunoglobulin,
      and percentages of killed trophozoites were quantified by staining with propidium
      iodide. Trophozoites were killed in the presence of complement by IgG3 and IgM
      anti-trophozoite monoclonal antibodies. Anti-trophozoite IgA, obtained from the
      intestinal lumen of G. muris-infected BALB/c mice, became bound to trophozoites
      in vitro but did not kill these organisms in the presence or absence of
      complement. The results suggest that clearance of G. muris infection by
      intestinal IgA directed against G. muris trophozoites does not involve antibody
      dependent killing of trophozoites in the intestinal lumen.

PMID- 1738073
TI  - Effects of immunization of rabbits on establishment, survival, and reproductive
      biology of the tick Hyalomma anatolicum anatolicum.
AB  - Four antigenic preparations, viz. salivary gland antigen (SG Ag), whole tick
      extract antigen (WTE Ag) and 30,000-g supernatant fraction, and pellet of WTE Ag
      (TES Ag and TEP Ag, respectively), were made from partially fed adult female
      Hyalomma anatolicum anatolicum. Four groups of 5 rabbits each were immunized with
      the antigens, and a fifth group was kept as control. Following challenge with
      adult H. a. anatolicum, a significant decrease in engorgement weight and egg mass
      weight and an increase in engorgement period and preoviposition period were
      observed in WTE Ag-immunized rabbits. Similar results were observed with TES Ag
      and SG Ag, except that change in the engorgement period was insignificant.
      However, none of the tick parameter measurements showed significant changes with
      TEP Ag. None of the antigens produced significant changes in the percentage of
      engorgement or oviposition period of the challenged ticks. Thus, WTE Ag was the
      most effective in altering tick performances.

PMID- 1738074
TI  - Electrophoretic and immunologic characterization of proteins of merozoites of
      Eimeria acervulina, E. maxima, E. necatrix, and E. tenella.
AB  - Merozoites of Eimeria acervulina, Eimeria maxima, Eimeria necatrix, and Eimeria
      tenella were compared by gel electrophoresis, western-blotting with chicken
      antiserum, indirect fluorescent antibody reactions, and antiserum neutralization.
      Merozoites from the 4 species had dissimilar patterns of proteins and antigens in
      soluble and membrane fractions. Coomassie blue staining of SDS-PAGE gels revealed
      16-22 protein bands depending on the species of merozoite but only 3 bands per
      species in the membrane fractions. Homologous and heterologous antisera
      recognized 5-12 soluble fraction bands and 3-7 membrane fraction bands on
      immunoperoxidase-stained western blots, depending on the species. When antisera
      from infected chickens were used in an indirect fluorescent antibody reaction,
      the merozoites of E. tenella and E. necatrix had a strong reaction with
      homologous and heterologous antisera. Merozoites of E. acervulina and E. maxima
      reacted with homologous antisera but had a weak or no reaction with heterologous
      antisera. Chicken antiserum against E. tenella had no effect on the viability of
      E. tenella merozoites when they were inoculated into chicken embryos.

PMID- 1738075
TI  - Vector specificity of Trypanosoma catostomi and its infectivity to freshwater
      fishes.
AB  - Trypanosoma catostomi was found in 36.2% of 558 white suckers (Catostomus
      commersoni) from Ontario, Canada. The abundance of Actinobdella inequiannulata
      was 35% (68 leeches/197 suckers examined for leeches). The susceptibility of 3
      species of leeches (Hemiclepsis marginata, Desserobdella phalera, and A.
      inequiannulata) and 7 species of fishes (C. commersoni, Amia calva, Anguilla
      rostrata, Ictalurus nebulosus, Oncorhynchus mykiss, Perca flavescens, and Esox
      lucius) to infection with T. catostomi was examined. Metatrypanosomes were found
      in the crop and proboscis sheath of 13 of 21 A. inequiannulata and in the crop of
      10 of 12 H. marginata and 1 of 21 D. phalera. Only flagellates from A.
      inequiannulata were infective to C. commersoni. Cultured T. catostomi infected C.
      commersoni and A. calva but not any other fish species. Laboratory-reared C.
      commersoni were more susceptible than wild-caught specimens. Cultured Trypanosoma
      phaleri did not infect its natural host, A. calva. Host specificity should be
      established experimentally before a specific diagnosis is made. Cultures may be
      useful in simulating factors that affect development in the vector.

PMID- 1738076
TI  - Role of synganglion in oogenesis of the tick Ornithodoros parkeri (Acari:
      Argasidae).
AB  - The role of the synganglion in oocyte development in Ornithodoros parkeri was
      investigated by ligation and transplantation experiments. Ligation between legs 2
      and 3 to isolate the synganglion from the ovary and ligation between legs 1 and 2
      to keep both the synganglion and the ovary in the posterior ends were performed
      on mated females on different days after feeding. Results show that
      vitellogenesis was inhibited significantly if the synganglion was separated from
      the ovary within the first few days after feeding. However, transplantation of
      synganglia from 3 kinds of donors (unfed virgin, fed virgin, and fed mated
      females) into the synganglionless posterior portions induced vitellogenesis and
      oocyte development to final maturation. The supra- and subesophageal parts of the
      synganglion showed a similar gonadotropic activity after each was transplanted
      separately into the ligated synganglionless posterior portions. These results
      indicate that the synganglion produces an egg development stimulation factor
      (EDSF) that possibly is present in a storage form in unfed and/or fed virgin
      females in which vitellogenesis has not progressed and is released in females
      after feeding and mating. However, the characterization of EDSF and precise sites
      of production and storage await further investigation.

PMID- 1738077
TI  - Growth, development, pathogenicity, and transplantation of Echinostoma caproni
      (Trematoda) on the chick chorioallantois.
AB  - Excysted metacercariae of Echinostoma caproni were cultivated on the
      chorioallantoic membrane (CAM) of 6-day-old domestic chick embryos for 2-13 days
      postinoculation. There was no significant difference in the body area of fixed
      and stained preovigerous worms from the CAM versus those grown in domestic
      chicks. However, ovigerous worms from the CAM were significantly smaller than
      those from chicks. Worm development, i.e., gonadal differentiation, uterine
      curling, vitellinogenesis, ovigerousness, and oviposition, took 1 day longer on
      the CAM than in the chick. Histopathologic studies of worms attached to the CAM
      were done on cryostat and paraffin sections stained with hematoxylin and eosin.
      Some worms attached to the CAM by their collar spines and acetabulum, whereas
      others penetrated the chorionic epithelium and encapsulated in the mesenchyme.
      Pathogenicity to the CAM included hyperplasia of the chorionic epithelium,
      hemorrhagia, reduced fibrocytes and blood vessels, but increased lymphocytes and
      eosinophils in the mesenchyme. Attempts to transplant 11-day-old CAM worms to new
      CAMs were unsuccessful.

PMID- 1738078
TI  - Medical care costs of intravenous drug users with AIDS in Brooklyn.
AB  - This article reports on a study of medical costs of intravenous drug users
      (IVDUs) with acquired immune deficiency syndrome (AIDS) in Brooklyn, NY, U.S.A.
      Sociodemographic and clinical data as well as information on medical resource use
      was gathered for 38 IVDUs with AIDS, all of whom belonged to minority
      racial/ethnic groups and were covered by Medicaid insurance. Data obtained
      through patient interviews and review of medical records indicated that the
      sample had mean annual medical charges of $33,002 per patient per year. Average
      inpatient charges were $24,171, with an average of 1.13 hospitalizations and 38.5
      days of in-hospital care. Significantly more in-hospital care and higher
      inpatient charges on average were noted among patients who did not have a stable
      housing environment. Outpatient charges averaged $8,831, with 80% for
      pharmaceuticals. This estimate of medical charges and resource use, one of the
      first developed in a cohort of nonwhite individuals with i.v. drug use as a risk
      factor for human immunodeficiency virus infection, is about one third less than
      recent estimates reported from studies of cohorts of white homosexual men.

PMID- 1738079
TI  - Circumstantial evidence of HIV transmission via breast milk.

PMID- 1738080
TI  - Design of active control equivalence trials.

PMID- 1738081
TI  - HIV transmission in simulated conditions of sharing hypodermic equipment.

PMID- 1738082
TI  - A low prevalence of HTLV-I/-II infection among eight population groups from
      Merida Yucatan, Mexico.

PMID- 1738084
TI  - HIV-1 and HIV-2 seroprevalence rates in mother-child pairs living in The Gambia
      (west Africa).
AB  - A seroepidemiological study was conducted, during 1988 and 1989, of mother-child
      pairs living in The Gambia (West Africa) in order to determine the distribution
      of the human immunodeficiency viruses type 1 (HIV-1) and type 2 (HIV-2).
      Specimens were obtained from 931 children (age range, 14-17, months) and 923
      mothers (age range, 14-17 years) using village-based cluster samples; the
      children are participating in The Gambia Hepatitis Intervention Study (GHIS), a
      large-scale HBV vaccination program. Large numbers of indeterminate Western blot
      patterns were observed among the mothers, mainly for HIV-1 antibodies; HIV-1
      infected subjects were not found, whereas an HIV-2 seroprevalence rate of 0.75%
      was observed. The children born to the seven HIV-2 positive women were
      seronegative for HIV-2 antibodies, and none of the children showed HIV-2 or HIV-1
      seropositively.

PMID- 1738083
TI  - Determinants of HTLV-1 seroprevalence in Miyazaki Prefecture, Japan: a cross
      sectional study.
AB  - To evaluate determinants of the prevalence of human T-cell leukemia virus type I
      (HTLV-I) antibody positivity in an endemic region, Miyazaki Prefecture, Japan,
      demographic and serologic data were collected on 7,055 individuals consecutively
      seen at Miyazaki City Health Promotion Center between September 1983 and December
      1984. The overall HTLV-I seroprevalence was 8.5%; age and gender distributions of
      HTLV-1 antibody positivity were consistent with previous findings for endemic
      populations. The prefecture could be divided into two geographic areas based on
      seroprevalence: high prevalence (12.1%) in the southwest and medium prevalence
      (6.6%) for the rest of the prefecture. Current occupation in fishing, forestry,
      or livestock raising significantly correlated with HTLV-1 seropositivity
      [relative risk (RR) = 3.0, 2.5, 2.0, respectively]; farming also was associated
      but only in the medium prevalence region (RR = 1.3; p = 0.06). For a subset of
      157 HTLV-I-positives and 175 negative controls screened for antibodies to the
      toxoplasmosis organisms, toxoplasma exposure was not significantly associated
      with HTLV-I infection. In this endemic Japanese population, both geographic and
      sociologic factors characterized the distribution of HTLV-I seroprevalence,
      reflecting transmission patterns and historical duration of the infection.

PMID- 1738085
TI  - Lack of evidence of vertical transmission of human immunodeficiency virus type 2
      in a sample of the general population in Bissau.
AB  - Twenty-nine human immunodeficiency virus type 2 (HIV-2) seropositive women
      identified in a cross-sectional study in Bissau in 1987 participated in a follow
      up study in 1988, where each was matched for age and marital status with two HIV
      2 seronegative women. Detailed information about all pregnancies was obtained.
      The HIV-2 seropositive women and their controls had similar mean numbers of
      pregnancies, live children, children who died, and abortions. The HIV-2
      seropositive women did not have a greater risk of having had an abortion or a
      child who died than did the HIV-2 seronegative women. No difference in survival
      was seen between children born to HIV-2 seropositive and HIV-2 seronegative
      women. The H/S-ratios and CD4 numbers were lower in the seropositive group, but
      none had values lower than 0.4 and 0.4 x 10(9)/L, respectively. Seven
      prospectively observed children born to HIV-2 seropositive mothers showed no sign
      of infection. The lack of evidence of transmission of HIV-2 from mother to child
      is suggested to be due to the absence of marked immunodeficiency in this random
      sample of the general population.

PMID- 1738086
TI  - HLA-B35 is associated with accelerated progression to AIDS.
AB  - To investigate the influence of HLA specificities on the rate of progression and
      outcome of human immunodeficiency virus (HIV) infection, we performed (a) a case
      control study in 1989-1990 of HIV-seropositive individuals stratified by both
      risk behavior and ethnic background, (b) a longitudinal cohort study of HIV
      infected male homosexuals enrolled in 1981-1982, and (c) an analysis of
      individuals with a diffuse infiltrative CD8 lymphocytosis syndrome. In the case
      control study, there was a significantly higher frequency of HLA-B35 among
      intravenous drug users, but not homosexuals, who developed illnesses meeting the
      case definition for AIDS compared with asymptomatic HIV-positive controls,
      regardless of ethnic status. In the longitudinal study, HLA-B35-positive
      homosexuals had a significantly increased rate of progression to AIDS and
      decreased survival over a 7-year period compared with those without this
      specificity. Finally, there was a significantly decreased frequency of HLA-B35 in
      individuals with the diffuse infiltrative lymphocytosis syndrome, a clinically
      and genetically distinctive disorder occurring in HIV infection in which a low
      rate of progression to opportunistic infections was found. The high rate of
      salivary and lacrimal gland lymphoma in this group suggests that there is
      dissociation between the presence of HLA-B35 and the development of particular
      AIDS-defining conditions. We conclude that HLA-B35 is a risk factor for more
      rapid progression to AIDS, particularly opportunistic infections and Kaposi's
      sarcoma, operating in groups with high rates of newly acquired HIV infections
      such as New York City male homosexuals in 1981-1982, and intravenous drug users
      in 1989-1990.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738087
TI  - Decrease in HIV provirus in peripheral blood mononuclear cells during zidovudine
      and human rIL-2 administration.
AB  - Quantification of human immunodeficiency virus (HIV) proviral DNA in peripheral
      blood mononuclear cells (PBMC) was performed in 13 HIV-seropositive asymptomatic
      individuals during 10-24 months by polymerase chain reaction amplification of
      multiple half-log dilutions of cellular DNA. At enrollment, subjects had a
      geometric mean titer of 100 copies of HIV provirus per 10(6) PBMC (mean +/- SD, 2
      +/- 0.9 log10). In four untreated individuals there was no significant change in
      provirus levels during a mean period of 13.3 months. In eight patients treated
      with zidovudine (ZDV) and human recombinant interleukin 2 (rIL-2), HIV provirus
      copies declined to 13 per 10(6) cells (1.1 +/- 0.8 log10) at the end of the first
      course of ZDV and rIL-2 at week 20 (p less than 0.01), and to 40 per 10(6) cells
      (1.6 +/- 0.9 log10) after 12 months of treatment (p less than 0.04). Subsequent
      courses, which included 12 weeks of ZDV alone or 4 weeks of IL-2 alone, did not
      significantly change the already depressed provirus copy numbers. Proviral copy
      number also remained depressed during drug-free "washout periods" between
      courses. Finally, we observed a return to a geometric mean of 400 copies per
      10(6) cells (2.6 +/- 0.3 log10) a mean of 7.9 months after discontinuation of
      therapy. Measurement of changes in HIV provirus should provide a direct marker
      for defining antiviral activity of drugs, biologics, and combination therapy.

PMID- 1738088
TI  - A comparison of HIV-1 antibody classes, titers, and specificities in paired semen
      and blood samples from HIV-1 seropositive men.
AB  - Twenty-eight paired blood and semen samples obtained from human immunodeficiency
      virus type 1 (HIV-1) seropositive men at various stages of disease progression
      were evaluated for titer and immunoglobulin (Ig) class by an enzyme-linked
      immunosorbent assay (ELISA). Blood antibody titers ranged from 40,000 to
      4,000,000 with a median of 40,000. Semen titers ranged from 400 to 40,000 with a
      median of 400. HIV-1 antibody titers in matched semen and blood samples showed a
      strong positive correlation (r = 0.963). The ratio of semen:blood titers ranged
      from 1:1000 to 1:10 with a median of 1:100. There was no correlation between
      blood or semen antibody titer and stage of disease of the patients. However,
      there was a trend toward higher (greater than or equal to 4000) semen antibody
      titers in men with evidence of genital tract inflammation greater than 10(6)
      white blood cells/ml semen; 3/5 versus 5/23, p greater than 0.1 Fisher exact
      test). All HIV-1 antibodies detected were of the IgG class; no IgA or IgM class
      antibodies of titers greater than or equal to 40 were found in either blood or
      semen. Thirteen paired blood and semen samples from individual patients were
      analyzed for antibody specificity by Western blot. In some cases antibody
      profiles in semen were different from those in blood; strong antibody reactivity
      against the gp160 viral coat antigen band was consistently detected in semen and
      blood, whereas the prevalence of detectable antibody reactivity against the p55
      and p17 HIV-1 antigen bands was significantly reduced in semen.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1738089
TI  - Premarital HIV-1 testing in New Jersey.
AB  - To answer questions related to the usefulness of premarital testing for human
      immunodeficiency virus type 1 (HIV-1), two "blinded" or "nonlinked" HIV-1
      serosurveys were done in New Jersey, a state with a high incidence of AIDS, on
      blood specimens submitted for a premarital serologic test for syphilis. The first
      survey involved premarital blood specimens submitted to the New Jersey Department
      of Health laboratory for the year starting September 1987. The second survey
      involved premarital specimens submitted to five private or hospital clinical
      laboratories in the spring of 1989, of which approximately 1,000 consecutive
      premarital specimens from each laboratory were sent to the Department of Health
      laboratory for HIV-1 testing. Of 4,247 specimens tested in the 1987-1988 survey,
      21 (0.49%) were positive for antibodies to HIV-1, while among 4,696 specimens in
      the 1989 survey, 29 (0.62%) were positive. When the survey results were weighted
      by the number of marriages by geographic regions of the state, the weighted
      premarital HIV-1 seroprevalence was 0.55% for the 1987-1988 survey and 0.62% for
      the 1989 survey. The male/female ratio of positive tests was 2.7:1 in 1987-1988
      and 1.6:1 in 1989. Of the 8,943 specimens in both surveys, 5 (0.06%) gave an
      indeterminate immunoblot result, compared with 50 positive results. These
      percentages of premarital HIV-1 infections are much higher than earlier estimates
      and reports and are of the same magnitude as recently reported blinded premarital
      HIV-1 testing elsewhere. Results of this magnitude support a recommendation in
      New Jersey of voluntary HIV-1 counseling and testing for marriage applicants.

PMID- 1738090
TI  - Activity of CD4-Pseudomonas exotoxin against cells expressing diverse forms of
      the HIV and SIV envelope glycoproteins.
AB  - CD4(178)-PE40 is a genetically engineered hybrid toxin containing a portion of
      human CD4 linked to the translocation and ADP-ribosylation domains of Pseudomonas
      exotoxin A. In vitro, the molecule has been shown to selectively kill cells
      expressing the envelope glycoproteins of human immunodeficiency virus (HIV) or
      simian immunodeficiency virus (SIV), and to inhibit HIV spread. In this report we
      examine the activity of the hybrid toxin against cells expressing diverse forms
      of the HIV and SIV envelope glycoproteins, encoded by recombinant vaccinia virus
      vectors. The activity of CD4(178)-PE40 was found to be unaffected by mutations in
      the HIV-1 or HIV-2 envelope glycoprotein genes, which prevent normal proteolytic
      processing of the corresponding gp160 precursor molecules. Cells expressing a
      mutant HIV-1 envelope glycoprotein lacking most of the cytoplasmic tail of the
      gp41 transmembrane subunit were also sensitive to the hybrid toxin. Most
      interestingly, HIV-1, HIV-2, and SIVmac envelope glycoprotein molecules known to
      have widely differing affinities for CD4 were found to be comparably effective at
      mediating sensitivity to CD4(178)-PE40. By virtue of its ability to kill infected
      cells, the hybrid toxin inhibited the spread of SIVmac in vitro. These results
      indicate that CD4(178)-PE40 is active against cells expressing HIV and SIV
      envelope glycoproteins with a diverse array of structural differences.

PMID- 1738091
TI  - Contribution of disulfide bonds in the carboxyl terminus of the human
      immunodeficiency virus type I gp120 glycoprotein to CD4 binding.
AB  - The carboxyl half of the HIV-1 gp120 glycoprotein, which has been implicated in
      binding to the CD4 receptor, contains two disulfide bonds linking cysteine
      residues 378-445 and 385-418. To examine the necessity of these disulfide bonds
      for the formation and/or maintenance of a gp120 glycoprotein competent for CD4
      binding, we created mutants of a soluble form of gp120 in which combinations of
      these cysteine residues were altered. The mutant glycoproteins were examined for
      export from the expressing cell and for CD4 binding ability. Mutant gp120
      molecules lacking both disulfide bonds were not stably expressed or exported.
      However, mutants for which either disulfide bond could form were exported and
      were fully competent for CD4 binding. In some cases, the presence of one of the
      pair of linked cysteines exerted more detrimental effects on export or CD4
      binding than did alteration of both cysteines. Thus, the evaluation or the
      contribution of a particular disulfide bond to a phenotype should include studies
      in which both cysteines involved in the bond are simultaneously altered.

PMID- 1738092
TI  - HIV-1 infection of human fetal thymocytes.
AB  - Some neonates with congenital human immunodeficiency virus type 1 (HIV-1)
      infection exhibit immune dysregulation. This suggests that fetal CD4+ cells,
      possibly thymocytes, may be infected during gestation. If thymocytes are
      infected, this may result in a disruption of T-cell differentiation. To examine
      this hypothesis, normal human fetal thymocytes were established in tissue
      culture, characterized, and then exposed to HIV-1. On initial isolation, fetal
      thymocytes were analyzed for phenotypic markers by flow cytometry and assessed
      for T-cell function by mitogen-stimulated thymidine incorporation. The thymocytes
      comprised greater than 70% double positive (CD4+, CD8+) cells and responded to T-
      but not to B-cell mitogens. Thereafter, thymocytes were incubated in either
      tissue culture medium containing infectious HIV-1 or in control (HIV-free)
      medium. Infection of fetal thymocytes was determined by light and electron
      microscopy in combination with immunocytochemistry, molecular hybridization, and
      an infectious cell center (ICC) assay. After 1 week in culture, the thymocytes
      exposed to HIV-1 were positive by immunocytochemistry for the HIV-1-associated
      protein gp41. In addition, the presence of HIV-1 DNA was detected by molecular
      hybridization confirming infection of these cells. The ICC assay demonstrated the
      production of infectious HIV-1 particles and budding of mature virions was
      observed by electron microscopy. These studies demonstrate that human fetal
      thymocytes can be infected with HIV-1 in vitro and that this infection results in
      production of infectious virions. These results support the hypothesis that
      vertical transmission of HIV-1 in vivo may result in the infection of fetal
      thymocytes, which may contribute to postnatal HIV-1-associated pathologic
      conditions.

PMID- 1738093
TI  - Age-dependent gentamicin experimental nephrotoxicity.
AB  - The nephrotoxic potential of gentamicin was compared in adult (2-month-old) and
      old (24-month-old) female Sprague-Dawley rats in a model of short-term infusion.
      Animals were infused over a 12-hr period with saline or with gentamicin achieving
      steady-state serum levels of 56.1 +/- 11.7 (n = 18) and 59.8 +/- 14.7 (n = 17)
      micrograms/ml +/- S.D. (N.S.) in the adult and the old rats, respectively.
      Animals were sacrificed 2 hr (day 0), 4 days and 8 days after the end of the
      infusion. The renal cortical levels of gentamicin at day 0 (2 hr after the end of
      the infusion) were 1161 +/- 120 and 1125 +/- 275 micrograms/g of tissue +/- S.D.
      (N.S.) in the adult and the old rats, respectively. Tissue levels of gentamicin
      were lower in both gentamicin-treated groups on day 4 and 8 as compared with day
      0 (P less than .05). The sphingomyelinase activity (measure of the lysosomal
      phospholipidosis) was significantly inhibited in the renal cortex of the adult
      and the old rats, but no significant difference was observed between these two
      groups. The in vivo [3H]thymidine incorporation into DNA, expressed as the
      percentage of the values measured in each age-matched control group, was
      significantly lower in the old animals as compared with that measured in the
      adult rats (P less than .05). No significant difference was observed in the renal
      function of adult rats, but a significant increase in the serum creatinine levels
      was measured in the old rats on day 4 of the experiment (248% of the control
      value, P less than .01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738094
TI  - Renal and antihypertensive effects of a novel eukalemic diuretic, ICI 207,828.
AB  - ICI 207,828, an aminomethylphenol pyrazine derivative, produces water diuretic
      effects with only minimal alterations in kaliuresis in dogs and rats after oral
      and parenteral administration. In the dog, ICI 207,828 reached maximum activity
      at a dose of 10 mg/kg, p.o. This was comparable to that of hydrochlorothiazide
      (HCTZ) at a dose of 5 mg/kg, p.o. or higher. In the rat, a dose of 30 mg/kg, p.o.
      of ICI 207,828 was comparable to the maximum of water diuretic and saluretic
      response obtained with HCTZ at a dose of 10 mg/kg, p.o. Based upon studies using
      in vitro amphibian models of the mammalian nephron, ICI 207,828 appeared to act
      on both the thick ascending limb of the loop of Henle and the late distal
      nephron. In the toad bladder preparation, ICI 207,828 inhibited Na+ transport
      when placed on either the mucosal (amiloride-like) or serosal (thiazide-like or
      loop diuretic-like) sides. This compound also inhibited Cl- transport in the toad
      cornea preparation (loop diuretic-like). ICI 207,828 did not change plasma K+
      significantly in dogs dosed for 14 days at doses having diuretic effects (5 and
      10 mg/kg, p.o., daily). In contrast, HCTZ consistently decreased plasma K+,
      whereas amiloride increased it significantly. ICI 207,828 demonstrated
      antihypertensive effects in spontaneously hypertensive rats. At 30 mg/kg, p.o.,
      b.i.d., ICI 207,828 and HCTZ produced approximately equal antihypertensive
      activities during a 3 1/2-day treatment period. The pharmacological profile of
      ICI 207,828 indicates that this compound is a potent eukalemic diuretic and
      antihypertensive agent in animals.

PMID- 1738095
TI  - Evaluation of the renal site of action of a novel, eukalemic diuretic, ICI
      207,828.
AB  - ICI 207,828 is a novel eukalemic diuretic in animals that is comparable in effect
      to hydrochlorothiazide. We used micropuncture and microperfusion techniques to
      determine the site(s) of action of this compound in the rat nephron. Either
      furosemide (FUR) or ICI 207,828 were perfused through the loop of Henle in situ.
      Both compounds caused significant reduction in water and electrolyte reabsorption
      by the loop. The effect of ICI 207,828 was significantly less than that of FUR.
      Both amiloride and ICI 207,828 were perfused, in situ, through the superficial
      distal tubule. ICI 207,828 had an effect similar to amiloride. Sodium and water
      reabsorption and potassium secretion were inhibited. In free-flow micropuncture
      studies, ICI 207,828, infused continuously i.v., had little effect on electrolyte
      and water reabsorption by the superficial proximal tubule. This compound
      significantly inhibited water and electrolyte reabsorption by the loop of Henle.
      Distal tubule secretion of potassium was inhibited. In addition, fractional
      potassium reabsorption beyond the superficial, late distal tubule was inhibited
      by ICI 207,828. From these results, we conclude that ICI 207,828 significantly
      inhibits electrolyte and water transport by the loop of Henle and distal tubule,
      and at sites beyond the superficial distal tubule such as either the collecting
      duct system or juxtamedullary nephrons. The reduction in distal potassium
      secretion, in concert with reduced loop of Henle and postdistal reabsorption,
      results in no net potassium loss in the urine, thus rendering this compound
      eukalemic.

PMID- 1738096
TI  - Effect of chronic ethanol diet on expression of gonadotropin genes in the male
      rat.
AB  - The present study elucidates further the defect in the function of hypothalamic
      pituitary-gonadal axis in the male rat after a 6% ethanol diet for 5 weeks. The
      body, testis, prostate and seminal vesicle weights of the ethanol-treated animals
      did not differ from those of the pair-fed controls. However, the weights of the
      ethanol and pair-fed groups were significantly lower than in untreated controls
      (P less than .001). The pituitary luteinizing hormone beta mRNA level of ethanol
      treated rats was significantly higher (P less than .05) but the follicle
      stimulating hormone beta mRNA level was lower (P less than .05) than those of the
      diet control group. Additionally, the follicle-stimulating hormone beta mRNA
      level of the diet controls was higher than that of the untreated controls (P less
      than .05). There were no significant differences in the levels of common-alpha
      subunit or prolactin mRNA between the groups. The serum and testicular
      testosterone concentrations of the ethanol and diet control groups did not
      differ, but both were significantly lower than in untreated controls (P less than
      .01). The serum luteinizing hormone of ethanol rats was significantly higher than
      that of diet controls (P less than .01), but the pituitary luteinizing hormone,
      the serum and pituitary follicle-stimulating hormone and the prolactin of ethanol
      and diet control animals did not differ.

PMID- 1738097
TI  - H+ coupled active transport of bestatin via the dipeptide transport system in
      rabbit intestinal brush-border membranes.
AB  - Bestatin [(2S,3R)-3-amino-2-hydroxy-4-phenylbutanoyl-L-leucine], a dipeptide
      containing an unusual amino acid, has been used clinically as an anticancer agent
      in p.o. dosage form. We examined the transport characteristics of [3H]bestatin by
      rabbit intestinal brush-border membrane vesicles. Bestatin uptake was stimulated
      by an inward H+ gradient (overshoot phenomenon) and by an interior-negative
      membrane potential. About half of the apparent bestatin uptake at 1 mM by brush
      border membrane vesicles was estimated as binding to the membranes. The affinity
      constant for the bestatin transport was 0.52 mM. The uptake of bestatin by brush
      border membrane vesicles was inhibited by p.o. cephalosporins and dipeptides, but
      not by amino acids. In vesicles preloaded with either bestatin, cephradine or
      glycylsarcosine, the uptake of [3H]bestatin was stimulated markedly
      (countertransport effect). These results indicate that bestatin is transported
      via the H+/dipeptide transport system in rabbit intestinal brush-border
      membranes.

PMID- 1738098
TI  - Pharmacokinetics/pharmacodynamics of ketoconazole-prednisolone interaction.
AB  - Ketoconazole is commonly used in patients with fungal infections during
      immunosuppressive therapy with prednisolone. Ketoconazole inhibits mixed function
      oxidases, enzymes responsible for the catabolism of prednisolone, and might, by
      that mechanism, increase prednisolone concentrations and thus, the
      immunosuppressive effect of prednisolone. On the other hand, ketoconazole has
      been found to bind to the glucocorticoid receptor and, thereby, to function as a
      glucocorticoid antagonist in cultured cell preparations. In order to establish
      whether ketoconazole enhances or attenuates the immunosuppressive effect of
      prednisolone, the influence of ketoconazole on the kinetics of prednisolone and
      on the delayed hypersensitivity response was assessed in mice. Ketoconazole
      increased prednisolone concentrations, measured by high pressure liquid
      chromatography, in mice given a single dose of prednisolone or a continuous
      prednisolone treatment for 17 days. At four different doses of prednisolone
      administered for 17 days, the glucocorticoid therapy-associated inhibition of the
      delayed hypersensitivity response to keyhole limpet hemocyanin was enhanced by
      ketoconazole. Thus, coadministration of ketoconazole with prednisolone increases
      the exposure to the steroid and enhances the immunosuppressive effect.

PMID- 1738099
TI  - Effect of benzylpenicillin on the disposition of cefodizime in rats: no net
      effect on total clearance due to decreased hepatobiliary clearance and increased
      renal clearance.
AB  - Effect of benzylpenicillin (PCG) on the disposition of [14C]cefodizime (CDZM), a
      nonmetabolizable analog of cefotaxime, was studied in rats. Rats were divided
      into two groups to receive i.v. injection of [14C]CDZM (15 mg/kg) alone and
      during the infusion of PCG. Although the total concentration of [14C]CDZM in
      plasma vs. time data were almost the same between the groups, the unbound
      concentration of [14C]CDZM was increased 2-fold by the treatment with PCG.
      Hepatobiliary excretion of [14C]CDZM was reduced by the treatment with PCG,
      indicating that PCG inhibits the transport of CDZM across the sinusoidal and/or
      bile canalicular membrane(s). Further support for this hypothesis is the finding
      that the uptake of [14C]CDZM by the isolated hepatocytes in vitro was via an
      active transport process that was reduced by PCG. Furthermore, pharmacokinetic
      analysis of the data obtained from in vivo and in vitro experiments indicated
      that PCG reduced the permeability of [14C]CDZM across the sinusoidal and bile
      canalicular membranes to 32% and 40% of the control value, respectively. The
      urinary excretion of [14C]CDZM was principally via the glomerular filtration
      process and was not affected by the treatment with PCG. Because of the 2-fold
      rise in the unbound fraction of [14C]CDZM in the treated rats, the renal
      clearance for total [14C]CDZM was increased 2-fold by the treatment with PCG. The
      increase in the renal clearance compensated for the decrease in the hepatic
      clearance. The net effect of the alterations in these pharmacokinetic parameters
      resulted in no change in the time profiles of [14C]CDZM concentration in plasma
      between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738100
TI  - Reduced glomerular hypertrophy by somatostatin analog, SMS 201-995, in the
      subtotal nephrectomized rats fed high-protein meals.
AB  - The chronic effects of SMS 201-995 (SMS), a long-acting somatostatin analog, on
      the progression of renal failure in 3/4 subtotal nephrectomized rats (NPX) fed
      high protein meals (40% protein) were investigated. Rats were divided into four
      groups, [i.e., normal control (C) (n = 6), NPX control (NPX-C) (7), NPX treated
      with SMS 1.0 micrograms/day (SMS-1.0) (7) and SMS-10.0 (7)]. SMS was continuously
      administered s.c. via an osmotically driven pump for 8 weeks. SMS had no
      significant changes in either body weight or hematocrit levels for NPX groups.
      Systolic blood pressure in NPX rats showed similar elevations, but SMS had no
      distinct effect on it for them. Significant changes in urine volume, creatinine
      clearance, and urinary protein excretion were not obtained among the NPX rats. No
      significant changes of glomerular sclerosis index was found among the NPX rats.
      Mean planar area of glomeruli in NPX rats was significantly larger than in normal
      control rats. NPX treated with both 1.0 and 10.0 micrograms/day SMS had
      statistically smaller values compared with NPX control rats. It was concluded
      that the chronic administration of SMS reduced glomerular hypertrophy without
      altering renal functions in this experimental model.

PMID- 1738101
TI  - Mechanisms of vomiting induced by serotonin-3 receptor agonists in the cat:
      effect of vagotomy, splanchnicectomy or area postrema lesion.
AB  - The locations of serotonin-3 (5-HT3) receptors involved in initiating vomiting
      (emesis) were assessed by cutting visceral afferents or lesioning the area
      postrema. The 5-HT3 receptor agonists phenylbiguanide (PBG) and 2-methyl-5-HT
      were shown to induce vomiting and related prodromal signs (e.g., licking,
      swallowing) in nonoperated cats. Two-methyl-5-HT, but not PBG, also usually
      produced defecation and sometimes urination. Most studies were conducted using
      PBG, which induced vomiting in 40/49 (82%) cats at doses of 8.0 mg/kg i.p. or
      less (thresholds ranged from 2-8 mg/kg, median 5 mg/kg). Latencies to the first
      episode ranged from 4 to 21 min (median 7.5 min). PBG-induced vomiting was
      blocked by the 5-HT3 receptor antagonist MDL 72222. Lesions of the area postrema
      had no apparent effect on vomiting induced by PBG or by electrical stimulation of
      abdominal vagal afferents. In contrast, the threshold of PBG-induced vomiting was
      increased by supradiaphragmatic vagotomy and greatly increased by splanchnic
      nerve section. Thus, abdominal visceral afferents, but not the area postrema,
      play an important role in mediating vomiting induced by i.p. injection of the 5
      HT3 receptor agonist PBG. The mechanisms by which vomiting is induced by PBG as
      compared to the cancer chemotherapeutic drug cisplatin are discussed.

PMID- 1738102
TI  - Time-dependent protective effects of calcium channel blockers on anoxia- and
      hypoxia-induced proximal tubule injury.
AB  - The effects of anoxia or hypoxia on Ca++ uptake and lactic dehydrogenase (LDH)
      release were examined in freshly isolated rat proximal tubules (rPT). Both Ca++
      uptake and LDH release were increased above control after only 10 min of either
      anoxia or hypoxia in rPT. The increase in Ca++ uptake was through voltage
      sensitive, slow Ca++ channels, because pretreatment with chemically dissimilar
      calcium channel blockers (CCB), either verapamil or flunarizine, prevented the
      increased Ca++ uptake and reduced the LDH release from the anoxic and hypoxic
      rPT. After 20 min of hypoxia, however, verapamil pretreatment did not
      significantly reduce the high Ca++ uptake rate, thus, suggesting that this
      increase in Ca++ permeability was occurring through pathways other than the slow
      Ca++ channels. The increase in LDH release was only slightly decreased by
      verapamil after 20 min of hypoxia. After 20 min of anoxia in rPT, Ca++ uptake was
      no longer increased, but the increased LDH release persisted. These effects of
      anoxia were unaltered by verapamil. These results, thus, suggest that early
      membrane injury to isolated rPT in suspension, which is associated with 10 min of
      either anoxia or hypoxia, involves increased cellular Ca++ uptake through voltage
      sensitive Ca++ channels and protection is afforded by CCB. In contrast, after 20
      min of anoxia or hypoxia, rPT membrane damage persisted and was only partially
      reversed by CCB. The rPT injury induced by 20 min of O2 deprivation, thus,
      involves factors independent of voltage-sensitive Ca++ channels.

PMID- 1738103
TI  - Effects of fluoxetine on convulsions and on brain serotonin as detected by
      microdialysis in genetically epilepsy-prone rats.
AB  - Fluoxetine, an antidepressant and inhibitor of serotonin reuptake, was evaluated
      as an anticonvulsant in genetically epilepsy-prone rats (GEPRs) because seizure
      predisposition in GEPRs is partially dependent on deficits in brain serotonin.
      Fluoxetine produced dose-dependent reductions in sound-induced convulsion
      intensity in both moderate seizure GEPRs and severe seizure GEPRs with the peak
      anticonvulsant effect occurring 4 hr after i.p. administration. A subchronic
      study in severe seizure GEPRs demonstrated that the ED50 after 28 days of dosing
      (8.2 mg/kg) was lower than the acute ED50 (15.9 mg/kg) so that there was no
      apparent development of tolerance. The lower ED50 after subchronic administration
      apparently resulted from accumulation of fluoxetine and its metabolite
      norfluoxetine in brain. Brain microdialysis studies showed that acute fluoxetine
      administration resulted in a significant increase in extracellular serotonin
      concentration in the thalamus. The increase in serotonin concentration in the
      dialysate corresponded temporally with the anticonvulsant effect produced by
      fluoxetine. Intrathalamic administration of fluoxetine via the dialysis probe
      caused an increase in serotonin concentration in the dialysate, suggesting that
      the effect of fluoxetine was on nerve terminals. Fluoxetine could be dialyzed
      from thalamus after its i.p. administration. Fluoxetine concentration in the
      thalamic dialysate was similar to the concentration found in plasma. We conclude
      that fluoxetine is an effective anticonvulsant in GEPRs and that the
      microdialysis results strongly suggest a relationship between the effects of
      fluoxetine on serotonergic neurons and the anticonvulsant effect produced by this
      drug.

PMID- 1738104
TI  - Endothelium-dependent nonadrenergic, noncholinergic neural relaxation in guinea
      pig pulmonary artery.
AB  - The presence and the possible mechanism of action of the inhibitory
      nonadrenergic, noncholinergic nerve system (i-NANC) were investigated in guinea
      pig pulmonary artery (PA) precontracted with U44069 (a thromboxane analog). In
      the presence of alpha adrenergic blockage, electrical field stimulation induced a
      frequency-dependent, tetrodotoxin-sensitive relaxation. This relaxation was
      reduced by 9.1 +/- 1.9 and 19.4 +/- 2.8% by atropine (1 microM) and combined
      atropine and propranolol (both 1 microM), indicating that the main component is
      mediated by i-NANC neural mechanisms. In the branch PA rings, this i-NANC
      relaxation was unaffected by pretreatment with a cyclooxygenase inhibitor
      (indomethacin, 10 microM), 5-lipoxygenase inhibitor (A63162, 1 microM) or
      substance P desensitization, but was inhibited markedly by the P2y-purinoceptor
      antagonist reactive blue 2 (30 microM) and slightly potentiated by the peptidase
      alpha-chymotrypsin (2 U/ml). L-NG-monomethyl-arginine(L-NMMA), a nitric oxide
      synthesis inhibitor, caused a concentration-dependent inhibition of the i-NANC
      relaxation (53.9 +/- 4.1% at 100 microM), but had no effect on equivalent
      nitroprusside-induced relaxation. The inhibitory effect of L-NMMA was reversed
      completely by L-arginine (300 microM), but not by D-arginine (300 microM).
      Removal of vascular endothelium greatly reduced the i-NANC relaxation in the
      branch PA rings, but had no effect on i-NANC relaxation in main PA rings. Both in
      vivo capsaicinization and in vitro desensitization with capsaicin (1 microM)
      caused a significant reduction of the i-NANC relaxation in main PA, but had no
      significant effect in the branch PA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738105
TI  - Effect of endothelin-1 on guinea pig gallbladder smooth muscle in vitro.
AB  - The purpose of this study was to investigate the pharmacological activity of
      endothelin-1 (ET-1) on guinea pig gallbladder smooth muscle. Guinea pig
      gallbladder muscle strips were mounted in 10-ml siliconized organ baths
      containing Krebs' solution. After 1 hr of equilibration, ET-1 was added
      cumulatively. ET-1 induced slow-developing and long-duration contractile
      responses. The EC50 was approximately 10 nM. ET-1 was 5 times less potent than
      cholecystokinin (EC50, 2 nM), but 20 and 40 times more potent than carbachol
      (EC50, 200 nM) and histamine (EC50, 400 nM), respectively. The concentration
      response curve to ET-1 was not affected by tetrodotoxin (0.1 microM) or by the
      muscarinic antagonist, atropine (10 microM). The neuronal N-type calcium channel
      blocker, omega-conotoxin (0.1 microM), had no significant effect on the ET-1
      concentration-response curve. In contrast, the contractile effect to ET-1 was
      reduced markedly by removal of extracellular calcium or by the voltage-dependent
      calcium channel blockers nicardipine and diltiazem. Substitution of strontium (an
      inhibitor of intracellular calcium release) for Ca++ significantly reduced the
      response to ET-1. The cyclooxygenase inhibitor indomethacin had no significant
      effect on the contractile activity of ET-1. These finding suggest that ET-1 is a
      potent contractile stimulant of guinea pig gallbladder and that it acts directly
      on the smooth muscle. The activity depends on extracellular Ca++, suggesting
      involvement of Ca++ influx via the voltage-dependent Ca++ channel and on
      intracellular calcium.

PMID- 1738106
TI  - Role of electronic factors in binding and reduction of azo dyes by hepatic
      microsomes.
AB  - The factors which regulate the binding and reduction of azo dyes by rat liver
      microsomes have been investigated. Azo dyes having both electron-donating and 
      withdrawing substituents were reduced more readily both enzymically and
      chemically (dithionite) than those containing electron-donating substituents
      alone, which is consistent with less negative oxidation-reduction potentials of
      the former. A linear correlation between Vmax and Km was seen for substrates
      having only electron-donating substituents, suggesting a possible inverse
      relation between binding affinity and rate of reduction. This relationship was
      not apparent for substrates having both electron-donating and -withdrawing
      substituents. A lower Km was seen with substrates having a greater number of
      heteroatoms bearing nonbonding electrons in either electron-donating or 
      withdrawing groups. Furthermore, more basic dyes, which have a higher density of
      nonbonding electrons, showed an inverse correlation with both Vmax and Km. The
      requirement of nonbonding electrons was also observed with the binding of the
      fully reduced amine metabolites to microsomal cytochrome P-450. Type II binding
      spectra were observed for both aniline and 4-chloroaniline, but not with aniline
      derivatives bearing electron-withdrawing substituents such as methyl anthranilate
      and methyl-4-aminobenzoate. Electron-withdrawing substituents increase
      delocalization of nonbonding electrons on the amino residue; consequently, these
      are no longer available for binding to the enzyme. The binding constant of the
      reduced metabolite, aniline (36 microM), relative to the Km values of substrate
      azo dyes (range 0.31-1.73 microM) implies that the more weakly bound amine
      metabolites are readily released from the binding/catalytic site.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1738107
TI  - Heroin, 6-acetylmorphine and morphine effects on threshold for rewarding and
      aversive brain stimulation.
AB  - Studies investigating the reinforcing and analgesic activity of heroin and
      morphine have found that heroin is a more potent compound. The rapid
      deacetylation of heroin to 6-acetylmorphine and morphine raises questions
      concerning the underlying mechanism responsible for this difference in potency.
      The present series of experiments addressed this issue by examining, in the rat,
      the relative potency of heroin and its active metabolites, 6-acetylmorphine and
      morphine, to lower the threshold for rewarding stimulation of the medial
      forebrain bundle and raise the threshold for aversive stimulation of the
      mesencephalic reticular formation. Reward and escape thresholds were determined
      by using a modification of the psychophysical method of limits. Heroin was found
      to be approximately 40 times more potent than morphine in lowering the reward
      threshold and approximately 6.5 times more potent in raising the escape
      threshold. 6-Acetylmorphine and heroin were approximately equipotent in producing
      significant effects on the threshold for both rewarding and aversive brain
      stimulation. These findings suggest that heroin's increased potency when compared
      to morphine may be due, in part, to the activity of 6-acetylmorphine.

PMID- 1738108
TI  - Cocaine and metabolite concentrations in the fetal guinea pig after chronic
      maternal cocaine administration.
AB  - To determine the disposition of cocaine (COC) and metabolites after chronic COC
      exposure in the late gestation guinea pig, six time-bred Dunkin-Hartley guinea
      pigs were given 10 daily 6 mg/kg COC s.c. injections from day 50 of gestation.
      Maternal blood and urine, fetal cord blood, and brain and amniotic fluid were
      collected 1 hr after the last injection. There was no difference between maternal
      and fetal plasma COC concentrations. This may be due to the combined effect of
      lower protein binding and ion trapping of COC in the fetus. Benzoylecgonine was
      higher in maternal plasma, but benzoylnorecgonine was higher in fetal plasma. COC
      brain-to-plasma ratios were similar in the dam and fetus. Benzoylecgonine was the
      only metabolite that could be detected in the brain, but levels were too low to
      quantitate. COC accumulated 3 to 4 times plasma concentrations in the amniotic
      fluid and was directly proportional to fetal plasma COC concentrations.
      Benzoylnorecgonine in amniotic fluid accumulated to 2 times fetal plasma levels.
      The in vitro half-life of COC in amniotic fluid was 30 times longer than plasma
      elimination half-life in vivo. The high level and long duration of COC in
      amniotic fluid serve as a reservoir for prolonged fetal COC exposure.

PMID- 1738109
TI  - Purinergic relaxation and hyperpolarization in guinea pig and rabbit coronary
      artery: role of the endothelium.
AB  - Purinergic relaxation and hyperpolarization was investigated in the isolated
      guinea pig coronary artery (GPCA) and compared to purinergic relaxation in the
      rabbit coronary artery (RCA). Vessels were contracted with the histamine H1
      receptor agonist 2-(2-aminoethyl)pyridine (AEP) and the actions of adenosine,
      AMP, ATP, 2-chloroadenosine (CIAD),2-methylthioATP (MeATP) and beta,gamma
      methylene ATP compared. The order of potency with P1 agonists in GPCA was CIAD
      greater than adenosine = AMP and for P2y agonists it was MeATP greater than ATP
      greater than beta,gamma-methylene ATP. Both ATP and CIAD produced less relaxation
      of GPCA segments contracted with K+ (36-100 mM) than with AEP. The IC50 for CIAD,
      but not ATP, was increased in the GPCA with 8(p-sulfophenyl)theophylline (100
      microM). Relaxations with ATP and CIAD were not different in endothelium-denuded
      GPCA. Methylene blue (50 microM) increased AEP contractile amplitude by 33% and
      increased the IC50 values for both CIAD and ATP. A similar shift in potency to
      purines was seen by varying AEP concentration. ATP, CIAD and MeATP also relaxed
      RCA. These responses were not different in endothelium-denuded vessels. Pressure
      application of ATP, MeATP, adenylylimidodiphosphate and to a lesser extent
      beta,gamma methATP transiently hyperpolarized cells in the GPCA, whereas CIAD did
      not. ATP hyperpolarization was enhanced in the presence of AEP and abolished
      after endothelium removal. The results indicate that purinergic relaxation in the
      GPCA and RCA is mediated by both P1 and P2y receptors located on the smooth
      muscle cells. In the GPCA, P1 receptors appear limited to the muscle, whereas P2y
      receptors are present on both muscle and endothelium.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1738110
TI  - Evidence of significant absorption of antipyrine from urinary bladder of rats.
AB  - We examined the in vivo absorption and pharmacokinetics of antipyrine, a base
      that is unionized at physiologic pH, from the urinary bladder of adult female
      Fischer rats. The clearance of an i.v. dose of antipyrine (25 mg/kg) was found to
      vary considerably between animals, which is consistent with the literature data.
      Therefore, it was necessary to simultaneously determine drug clearance and
      bladder absorption in the same animal. This was accomplished by giving
      concomitantly an i.v. dose of [14C]antipyrine (2.5 muCi, about 90 micrograms/kg)
      via a jugular vein catheter and an intravesical dose of unlabeled antipyrine (33
      mg/kg) via a urethral catheter. Unlabeled antipyrine was detected in plasma,
      indicating the absorption of antipyrine into systemic circulation. The
      bioavailability of the intravesical dose was calculated using the clearance of
      [14C]antipyrine and the plasma concentrations of unlabeled antipyrine. The
      intravesical dose was withdrawn through the urethral catheter after 90 min. To
      minimize mechanical manipulation and damage, the bladder was not rinsed. This may
      have caused the incomplete recovery of the unabsorbed dose; about 65 +/- 18%
      (mean +/- S.D.) of the dose was recovered at 90 min. Maximal plasma
      concentrations were achieved at 10 to 48 min after removal of the intravesical
      dose, which is consistent with a continued absorption of the residual dose. The
      intravesical bioavailability was variable between animals, with an average of
      11.6 +/- 6.4% (mean +/- S.D.; range, 4.1-19.2%). In conclusion, these data
      demonstrate that neutral drugs such as antipyrine are absorbed from the bladder,
      that the extent of absorption is variable and that the urinary bladder may be a
      site of significant re-entry of drugs into the systemic circulation.

PMID- 1738111
TI  - Characterization of 5-hydroxytryptamine1B receptors in rat spinal cord via
      [125I]iodocyanopindolol binding and inhibition of [3H]-5-hydroxytryptamine
      release.
AB  - The aim of the present study in rat spinal cord synaptosomes was to compare the
      pharmacological characteristics of the serotonin (5-HT)1B receptor defined by
      [125I]iodocyanopindolol [( 125I] ICYP) binding and the 5-HT autoreceptor defined
      by inhibition of [3H]-5-HT release. In Percoll gradient Fractions 3 and 4 of
      spinal cord synaptosomes, a single saturable binding site for [125I]ICYP with a
      maximum binding of 70 and 134 fmol/mg, respectively, was demonstrated in the
      presence of 30 microM isoproterenol. The Kd of 0.16 nM did not vary between
      fractions. Competition for [125I]ICYP binding by various 5-HT agonists and
      antagonists also indicated a single site model based on a Hill coefficient of
      approximately 1.0. The most potent compounds at displacing [125I]ICYP binding
      were RU 24969 (5-methoxy-3-[1,2,3,6-tetrahydropyridin-4-yl]-1H-indole), 5
      carboxyamidotryptamine HCl, 5-methoxytryptamine, 5-HT and CGS 12066B (7
      trifluoromethyl-4(4 methyl-1-pyrolo[1,2-a]-quinoxaline malate). [125I]ICYP
      binding was not altered by compounds with activity at 5-HT1A, 5-HT1C, 5-HT2, 5
      HT3 or alpha-2 receptor sites. Similar to the pharmacological characteristics of
      the 5HT1B site defined by [125I]ICYP, compounds most active at inhibiting 15 mM
      K(+)-stimulated release of [3H]-5-HT were RU24969 = 5-carboxyamidotryptamine HCl
      = CGS 12066B greater than 5-methoxytryptamine greater than 5-HT. Compounds with
      activity at 5-HT1A, 5-HT1C, 5-HT2 or 5-HT3 sites were inactive. A correlation
      analysis of selective 5-HT1B compounds comparing the pKD for displacement of
      [125I]ICYP vs. the IC50 for inhibition of [3H]-5-HT release demonstrated the
      pharmacological similarity of the presynaptic inhibitory 5-HT autoreceptor and
      the 5-HT receptor site defined by [125I]ICYP binding in spinal cord synaptosomes
      (r = 0.791, P = .0193). Although [125I]ICYP binding was unaltered, alpha-2
      agonists such as clonidine, norepinephrine and UK 14304 [5-bromo-6-[2-imidazolin
      2-ylamino]-quinoxaline) as well as the alpha-2 antagonists rauwolscine and
      yohimbine also decreased the K(+)-stimulated release of [3H]-5-HT and
      phentolamine, an alpha-2 antagonist increased release. The action of these alpha
      2 compounds to alter [3H]-5-HT release suggests the presence of heteroreceptors
      localized on 5-HT terminals in the spinal cord. These results point out that
      [125I]ICYP identifies the 5-HT1B receptor, and affinity of compounds for this
      site predicts action at the 5-HT1B autoreceptor.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1738112
TI  - Coronary blood flow in rats is dependent on the release of vascular nitric oxide.
AB  - The present study evaluated the role of nitric oxide (NO) in determining basal
      coronary vascular tone and the mechanism by which NO regulates coronary blood
      flow. Sprague-Dawley rats were anesthetized and instrumented for recording
      arterial pressure (AP), heart rate (HR) and coronary blood flow (CBF; Doppler).
      In rats without ventricular pacing, N-nitro-L-arginine methyl ester (LNAME) (10
      mumol/kg, i.v.), an inhibitor of NO synthesis, produced an increase in AP and a
      decrease in HR. The LNAME-induced bradycardia was inhibited by sinoaortic
      denervation. LNAME also produced a reduction in left anterior descending (LAD)
      CBF. When the same dose of LNAME was administered to a separate group of rats
      measuring CBF in the right coronary artery (RCA), the decrease in CBF was found
      to be more prominent in the LAD compared to the RCA. Removal of the sympathetic
      innervation to the heart and adrenal demedullation did not alter the decrease in
      CBF, indicating that the effects of LNAME were not centrally mediated. To
      determine if the effect of LNAME on CBF was due to a direct action on the
      coronary vasculature or was secondary to the change in HR, dose-response curves
      were performed for LNAME (0.3-300 mumol/kg, i.v.) in rats with ventricular
      pacing. Under these conditions, LNAME still produced an increase in AP and a
      decrease in CBF, resulting in an increase in coronary vascular resistance.
      Administration of L-arginine (100-300 mg/kg, i.v.) resulted in a reversal of the
      cardiovascular effects of LNAME with the reversal being sustained for 1 to 5
      min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738113
TI  - Acetylated endothelin-1 is a constrictor in guinea pig lung vasculature but not
      in isolated vascular strips.
AB  - We examined the relative importance of the two amino groups of endothelin-1 in
      mediating pulmonary vasoconstrictor activity. Complete acetylation of prefolded
      endothelin-1 (fAcET-1[AcK9]) yielded a product with vasoconstrictor properties
      (EC50 = 0.52 +/- 0.04 nM) in isolated Ringer-perfused guinea pig lungs similar to
      native endothelin-1 (EC50 = 0.31 +/- 0.05 nM). However, fAcET-1[AcK9] exhibited a
      marked reduction in potency when assessed by contraction of isolated guinea pig
      pulmonary artery strips or by contraction of carotid artery or aortic strip
      preparations. fAcET-1[AcK9] at concentrations up to 100 nM failed to induce
      appreciable contraction of any vascular strip preparation. In contrast,
      endothelin-1 had an EC50 of 1.46 +/- 0.32 to 1.88 +/- 0.19 nM in various vessel
      preparations. The differences in response to fAcET-1[AcK9] in the intact lung vs.
      strip preparation suggest different receptor populations in the two preparations.
      The importance of specific amino groups for contractile activity in the vascular
      strip preparation was explored by acetylation of individual sites (amino terminus
      or lysine sidechain) or both sites during peptide synthesis to produce AcET-1, ET
      1[AcK9], and AcET-1[AcK9], respectively. The order of potency was endothelin-1
      much greater than ET-1[AcK9] greater than AcET-1 greater than AcET-1[AcK9]. These
      results suggest that chemical modifications (e.g., biotinylation) should be made
      preferentially at the lysine-9 sidechain in order to retain maximal biological
      activity in vascular strip preparations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738114
TI  - Regional variation in acute vascular homologous tachyphylaxis.
AB  - The development of tachyphylaxis or desensitization in a tissue upon repeated
      application of an agonist is a well-established phenomenon. To investigate the
      possible basis of vascular homologous tachyphylaxis, vasomotor responses in
      isolated cerebral and peripheral blood vessels from the cat, dog and rabbit upon
      repeated application of several agonists were examined using in vitro tissue bath
      techniques. Tachyphylaxis to vasodilator responses developed to repeated
      application of vasoactive intestinal polypeptide (VIP) but not to beta adrenergic
      agonist, forskolin, 8-bromo-cyclic AMP, sodium nitroprusside or 8-bromo-cyclic
      GMP in feline cerebral arteries. The tachyphylaxis to VIP-induced responses
      varied among regions and was greatest in the internal carotid artery (ICA),
      followed by the middle cerebral artery and least in the basilar artery (BA).
      Cerebral arteries also developed significant tachyphylaxis to constriction
      induced by repeated applications of neuropeptide Y (NPY), alpha-1 adrenergic
      agonist, but not to alpha-2 adrenergic agonist, acetylcholine (ACh) or KCl. The
      tachyphylaxis to constrictions induced by repeated application of neuropeptide Y
      (NPY) also varied among regions, but was different from that induced by VIP; it
      was greatest in the BA, followed by the middle cerebral artery and least in the
      ICA. Similar results were obtained in arteries without endothelial cells. The
      density of regional innervation of NPY-immunoreactive fibers, which is densest in
      ICA and sparsest in BA, parallels that of VIP-immunoreactive fibers in these
      three regions. There is no positive correlation between density of catecholamine
      fluorescence fibers and degree of tachyphylaxis to noradrenaline-induced
      constriction in cat ICA, dog saphenous arteries and rabbit ear arteries
      either.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738115
TI  - Conversion of nitroglycerin to nitric oxide in microsomes of the bovine coronary
      artery smooth muscle is not primarily mediated by glutathione-S-transferases.
AB  - The pharmacological action of organic nitrate vasodilators [e.g., nitroglycerin
      (NTG)] is thought to be mediated through metabolic conversion to nitric oxide
      (NO); conversion leads to vasodilatation, whereas diminished conversion in
      chronic therapy may lead to pharmacological tolerance. The biochemical nature of
      this process, however, is poorly understood. Glutathione-S-transferases (GST)
      have been shown to metabolize organic nitrates in the liver, but it is not known
      whether these enzymes are involved in this pharmacologically relevant process.
      We, therefore, compared the activities of conversion of NTG to NO vs. those of
      GST in microsomal suspensions of bovine coronary artery smooth muscle tissue. A
      classical GST substrate, 1-chloro-2,4-dinitrobenzene, inhibited NO production in
      microsomes, suggesting possible involvement of GST in organic nitrate activation.
      However, GST activity derived from microsomes exhibited a different heat lability
      profile compared to that of NO generation. Known inhibitors of GST (viz.,
      indomethacin and bromosulfophthalein) did not alter the NO-generating activity in
      microsomes. Glutathione was a critical cofactor for GST, but not for NO
      generation from NTG, and thiols other than glutathione (e.g., N-acetyl-L-cysteine
      and thiosalicylic acid) also could facilitate NO production. Moreover, comparison
      to a commercially available purified liver GST preparation showed that, at the
      same GST activity toward 1-chloro-2,4-dinitrobenzene, the microsomal incubation
      produced about 8 times more NO than the purified liver GST. Radiation
      inactivation analysis of the functional molecular sizes of GST and the NO
      producing enzyme(s) suggested that the enzymes were of different molecular
      weights (54 kD and 160 kD, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738116
TI  - Identification of multiple muscarinic binding site subtypes in cat and human
      cerebral vasculature.
AB  - The binding characteristics of the nonselective muscarinic antagonist [3H]N
      methyl scopolamine ([3H]NMS) have been studied in membrane fractions of cat and
      human cerebral blood vessels. A computer-fitting method was used to analyze the
      data obtained from association/dissociation, saturation and competition
      experiments. Specific binding of [3H]NMS to membrane preparations from cat and
      human pia-arachnoid vessels was found to be saturable (respective Bmax values of
      98 +/- 15 and 67 +/- 7 fmol/mg protein) and of high affinity (KD values of 165 +/
      28 and 125 +/- 12 pM, respectively). Competition studies, in the presence of
      various well-characterized M1, M2 or M3 putative muscarinic antagonists,
      performed against the binding of [3H]NMS, revealed the heterogeneity of
      muscarinic binding sites in these vascular tissues. A population of M1 sites was
      clearly identified in both human and cat pial vessel membranes and accounted for
      approximately 40 (human) and 20% (cat) of the total population of cerebrovascular
      muscarinic binding sites labeled with [3H]NMS. Such observation was further
      supported by saturation studies of [3H]NMS binding performed under M1 blocking
      conditions (75 nM pirenzepine). Competition and saturation (in the presence of M2
      antagonists) studies suggested the presence of M2 sites (approximately 35% of
      total sites) in cat pial vessels. However, under the same conditions, no M2
      binding sites could be detected in human cerebrovascular membranes. A small
      population of M3 sites (approx. 20%) was found in both human and cat
      cerebrovascular membranes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738117
TI  - Cardioprotection and attenuation of endothelial dysfunction by organic nitric
      oxide donors in myocardial ischemia-reperfusion.
AB  - The effects of two nitric oxide (NO) donors were evaluated in a 6-h model of
      feline myocardial ischemia-reperfusion. After 80 min of a 90-min ischemic period,
      SIN-1 or C87-3754 or their respective controls (i.e., 0.9% NaCl or C88-3934, a
      control compound which does not release NO) were given i.v. as a bolus (0.1
      mg/kg) and infused at 1 mg/kg/h for the entire 4.5-h reperfusion period.
      Administration of the active NO donors significantly decreased the necrotic
      area/area-at-risk ratio from 29 +/- 3% in the vehicle group to 9 +/- 2 and 11 +/-
      5% in the SIN-1 and C87-3754 groups, respectively (P less than .001). The
      inactive NO donor C88-3934 failed to reduce infarct size (31 +/- 3%). Neither NO
      donor reduced the accumulation of neutrophils in the necrotic area when compared
      to their respective control groups, but both agents significantly attenuated
      coronary endothelial dysfunction as shown by a vasorelaxation to acetylcholine of
      62 +/- 2 and 64 +/- 3% in the SIN-1- and C87-3754-treated arteries, as compared
      to only a 27 +/- 3 and 34 +/- 4% vasorelaxation in the vehicle and inactive NO
      donor groups, respectively (P less than .001). Our studies show that SIN-1 and
      C87-3754 exert beneficial effects in a 6-h model of myocardial ischemia
      reperfusion. Both NO donors decreased myocardial necrosis and decreased the
      reperfusion-induced endothelial dysfunction without significantly altering the
      pressure-rate index (i.e., an index of myocardial oxygen demand).

PMID- 1738118
TI  - Blockade of the ATP-sensitive K+ channel by 5-hydroxydecanoate in guinea pig
      ventricular myocytes.
AB  - Effects of a novel antiarrhythmic agent, 5-hydroxydecanoate (5-HD), were
      investigated on the electrical activity of the guinea pig ventricular myocytes.
      The shortening of action potential duration induced by applying iodoacetate (IAA)
      for 5 to 10 min was reversed completely by 5-HD (100 microM) in the papillary
      muscle. The single channel current recording in the cell-attached configuration
      revealed both activation of the ATP-sensitive K+ channel during the treatment
      with IAA and after depression of the channel by the additional application of 100
      microM 5-HD. The quick rundown of the ATP-sensitive K+ channel activity
      interfered the analysis of the drug effect in the usual inside-out patch
      configuration. The channel activity in the isolated patch was partially recovered
      and stabilized by applying a tissue extract, which was prepared from guinea pig
      ventricle. Under this condition relationship between the 5-HD concentration and
      the K+ channel open probability was characterized with a K1/2 of 0.16 microM and
      a Hill coefficient of 0.88. The open- and close-time analysis revealed a decrease
      of the mean duration of the bursting channel opening and an increase of the
      interburst time under the effect of 5-HD. The inward-rectifier K+ channel,
      responsible for the resting K+ conductance, was not affected by 5-HD. It was
      concluded that the curative effect of 5-HD on the shortened action potential in
      the IAA-treated myocytes is mediated by the depression of the ATP-sensitive K+
      channel.

PMID- 1738119
TI  - Pharmacologic evaluation of A23187-induced contractions of three distinct
      preparations of guinea pig lung parenchymal strips.
AB  - The present investigation examined the pharmacologic profiles of three distinct
      guinea pig lung parenchymal strips (LPS): intact LPS, denuded LPS (devoid of any
      lung pleura) and pleural surface strips. All three preparations responded
      similarly to increasing concentrations of KCl, whereas maximum contractile
      responses of the intact LPS and pleural surface strips to histamine, LTD4 and
      U46619, a thromboxane A2 mimetic, were significantly greater (P less than 0.001)
      than those elicited by the denuded LPS. Moreover, concentration-response curves
      for intact LPS and pleural surface strips to ovalbumin and ionophore A23187
      challenges were equivalent to each other, which were significantly (P less than
      0.001) higher in magnitude than that for the denuded LPS. The net contractile
      response of the denuded LPS to A23187 was significantly reduced by 35% in the
      presence of 1 x 10(-5) M A-64077, a 5-lipoxygenase inhibitor, and nearly
      abolished with the addition of 1 x 10(-6) M pyrilamine and 4 x 10(-6) M
      indomethacin. In contrast, the maximum contractile responses of the intact LPS
      and pleural surface strips were reduced by 40 and 30%, respectively, in the
      presence of all three inhibitors. On the other hand, morphometric analysis
      revealed that the density of mast cells in the smooth muscle of lung pleura was
      as high as that found in the bronchiolar area (2.35 +/- 0.31 vs. 2.62 +/- 0.28
      per 0.05 mm2). In contrast, mast cells were scarcely identified in the alveolar
      parenchyma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738120
TI  - Affinity of different local anesthetic drugs and catecholamines for the
      contraluminal transport system for organic cations in proximal tubules of rat
      kidneys.
AB  - To study the cellular uptake of [3H]tetraethylammonium (TEA) and its inhibition
      by different local anesthetic drugs and catecholamines, the capillary stopped
      flow microperfusion method was used. [3H]TEA concentration in the peritubular
      capillaries decreased in a time and concentration-dependent manner. This cellular
      uptake of [3H]TEA could be described by a facilitated diffusion model (Jmax =
      0.57 +/- 0.08 pmol sec-1 cm-1, Km = 0.28 +/- 0.01 mmol/l). Between the pKa values
      of the local anesthetic drugs (range, 2.8-8.9) and their apparent Ki values, a
      significant correlation was found (r = -0.916, n = 12). In the case of
      catecholamines, hydrophobic substitution in the form of an alkyl chain in the
      alpha-position or at the nitrogen increased the inhibitory potency, whereas
      hydroxyl substitution in the beta-position decreased the affinity. Except for the
      catecholamines with complex substitutions at the benzene ring (--CH2OH,--NHCONH2,
      -OOCN[CH3)2, --Cl, --NH2) the apparent Ki values of the catecholamines were
      directly correlated with the hydrophobicity. It is concluded that hydrophobicity
      and pKa are two important physicochemical parameters which influence the affinity
      of a molecule for the transport system for organic cations at the contraluminal
      side of renal proximal tubules.

PMID- 1738121
TI  - Beneficial effects of TCV-309, a novel potent and selective platelet activating
      factor antagonist in endotoxin and anaphylactic shock in rodents.
AB  - Pharmacological profiles of a novel specific platelet activating factor (PAF)
      antagonist, TCV-309 (3-bromo-5-[N-phenyl-N-[2-[2- (1,2,3,4-tetrahydro-2
      isoquinolycarbonyloxy)ethyl] carbamoyl]ethyl] carbamoyl]-1-propylpyridinium
      nitrate] and its beneficial effects in shock were examined. TCV-309 specifically
      inhibited PAF-induced aggregation of rabbit and human platelets, and [3H]PAF
      binding to rabbit platelet microsomes with IC50 values of 33, 58 and 27 nM,
      respectively. It was as potent as WEB 2086 and more potent than CV-6209 and CV
      3988. TCV-309 did not cause hemolysis in human or rat blood due to a detergent
      like action. In rats, TCV-309 selectively inhibited the PAF-induced hypotension,
      hemoconcentration and death with ED50 values of 2.7, 6.4 and 1.7 micrograms/kg
      (i.v.), respectively. TCV-309 most potently protected mice from death induced by
      PAF and due to anaphylactic shock with ED50 values of 2.1 and 2.6 micrograms/kg
      (i.v.), respectively, when compared with CV-3988, CV-6209, WEB 2086 (i.v.) and L
      652731 (p.o.). TCV-309 also reversed PAF-induced hypotension and endotoxin
      induced hypotension in rats with ED50 values of 3.3 and 1.2 micrograms/kg (i.v.),
      respectively. There was a significant linear relationship between the ability
      (ED50 value) of these PAF antagonists to prevent death induced by PAF and death
      due to anaphylactic shock in mice, and between their reversing ability (ED50
      value) for the hypotension induced by PAF and endotoxin in rats. TCV-309 (100
      micrograms/kg i.v.) protected rats from death induced by endotoxin. Thus, PAF may
      be a lethal mediator in anaphylactic shock and a hypotensive mediator in
      endotoxin shock in rodents.

PMID- 1738122
TI  - Comparative study of the effects of furosemide, ethacrynic acid and bumetanide on
      the lithium clearance and diluting segment reabsorption in humans.
AB  - The effect of intravenous administration of the loop diuretics bumetanide,
      furosemide and ethacrynic acid on lithium (Li) clearance (CLi) and diluting
      segment reabsorption was studied in seven healthy water-loaded men. According to
      the increments in minimal urine osmolality (Uosm), ethacrynic acid (which
      increased Uosm from 59 +/- 4 to 233 +/- 3 mOsmol/kg) had the strongest inhibiting
      effect on diluting segment reabsorption, whereas that of furosemide and
      especially bumetanide was significantly less pronounced (rise in Uosm from 56 +/-
      3 to 222 +/- 4 and 56 +/- 4 to 192 +/- 2 mOsmol/kg, respectively). In contrast,
      ethacrynic acid induced a significantly smaller rise in CLi (approximately 14% of
      the filtered load of Li) than furosemide and bumetanide, which increased Li
      excretion by approximately 23% and approximately 24% of its filtered load. The
      observation that the loop diuretic with the most pronounced inhibiting effect in
      the diluting segment had the smallest effect on CLi makes is unlikely that the
      increase in CLi induced by loop diuretics is predominantly effected in Henle's
      loop.

PMID- 1738123
TI  - A role for phospholipid-derived inflammatory mediators in intestinal anaphylaxis
      in the rat.
AB  - This study investigated the role of phospholipid-derived inflammatory mediators
      in electrolyte transport in the normal rat jejunum and during intestinal
      anaphylaxis to a food protein in a rat model. In a standard Ussing chamber
      preparation, the leukotrienes (LTs) C4 and D4 both significantly stimulated an
      increase in short-circuit current in a concentration-dependent manner. The
      responses to both LTC4 and LTD4 were significantly reduced by the LTD4 receptor
      antagonist, MK-571. The 5-lipoxygenase products, LTB4, 5-hydroxyeicosatetraenoic
      acid and 5-hydroperoxyeicosatetraenoic acid did not significantly alter short
      circuit current. The thromboxane mimetic, U-46619, had a small, but significant
      stimulatory effect on short-circuit current. Platelet-activating factor (PAF)
      caused a significant, concentration-dependent increase in short-circuit current,
      with effects at concentrations as low as 2 nM and with a maximum effect of 69 +/-
      14 microA/cm2. The stimulatory effect of 0.2 microM PAF was significantly reduced
      by the PAF receptor antagonist WEB 2086. Exposure of sensitized jejunum to
      ovalbumin caused a biphasic increase in short-circuit current which was reduced
      by pretreatment with the 5-lipoxygenase inhibitor, L651,392, and the PAF receptor
      antagonist, WEB 2086. The response to ovalbumin was not significantly affected by
      pretreatment of the tissue with the LTD4 receptor antagonist, MK-571, at
      concentrations which inhibited the responses to exogenous LTC4 and LTD4. The
      thromboxane/endoperoxide receptor antagonist, L670,596, had no significant effect
      on the short-circuit current response to ovalbumin.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1738124
TI  - Effect of yohimbine on renal sympathetic nerve activity and renal norepinephrine
      spillover in anesthetized rabbits.
AB  - The function of presynaptic alpha-2 adrenergic autoinhibition of norepinephrine
      release was studied in anesthetized rabbits (alfadolone + alfaxalone) with
      uninterrupted sympathetic impulse traffic. The animals received a tracer infusion
      of [3H]norepinephrine i.v. Arterial and renal venous concentrations of endogenous
      norepinephrine and [3H]norepinephrine, the firing rate of the renal sympathetic
      nerves and renal blood flow were determined. The results were used to calculate
      the renal fractional [3H]norepinephrine extraction, the renal removal and
      spillover of norepinephrine, the total body [3H]norepinephrine clearance and
      total body norepinephrine spillover. Sodium nitroprusside (10-80 micrograms kg-1
      min-1 i.v.), which was infused to modulate sympathetic activity through the
      baroreceptors, caused hypotension and increased the renal sympathetic firing rate
      and the renal as well as total body norepinephrine spillover. Increases of total
      body norepinephrine spillover were much higher than increases of renal spillover.
      Yohimbine (1 mg kg-1 + 0.2 mg kg-1 hr-1 i.v.) caused slight central
      sympathoexcitation. In addition, it enhanced the renal and total body spillover
      of norepinephrine at any given firing rate of the renal sympathetic nerves. The
      distinguishing feature of this study is the measurement of sympathetic firing
      rate and norepinephrine spillover in one and the same organ, the kidney. The
      results demonstrate that the alpha-2 adrenergic autoinhibition of norepinephrine
      release normally operates in the kidney with intact sympathetic impulse traffic.
      They also suggest its operation in other peripheral sympathetically innervated
      tissues.

PMID- 1738125
TI  - Involvement of nitric oxide in nerve-mediated inhibition and action of vasoactive
      intestinal peptide in colonic smooth muscle.
AB  - Neurally mediated relaxation of canine colonic smooth muscle is associated with
      an increase in the resting membrane potential and is blocked by inhibition of
      nitric oxide synthesis. N omega-nitro-L-arginine completely prevented nerve
      mediated relaxation, an effect that was reversed by L-arginine but not D
      arginine. Vasoactive intestinal peptide (VIP) also relaxed canine colonic smooth
      muscle. Part of this relaxation was due to activation of inhibitory nerves and
      this effect was mediated by nitric oxide. In addition to the neurally mediated
      effect, VIP affected smooth muscle directly. This relaxation was associated with
      a reduction of the plateau phase of the slow-wave type action potential, without
      an effect on the resting membrane potential. This action of VIP was similar to
      that of forskolin which suggests that VIP increases intracellular cyclic AMP. In
      summary, nitric oxide mediates inhibitory innervation to smooth muscle as well as
      activation of inhibitory nerves by VIP. The electrophysiological mechanism by
      which VIP directly affects smooth muscle is described, an effect not mediated by
      nitric oxide.

PMID- 1738126
TI  - Biochemical and pharmacological activities of SR 26831, a potent and selective
      elastase inhibitor.
AB  - SR 26831 ([[5-(2-chloro-benzyl-2-(terbutyloxycarbonyl)]-4,5,6,7-
      tetrahydrothieno(3,2-c)pyridine]N-oxide) is the first member of a new class of
      human leukocyte elastase inhibitors. SR 26831 inhibited in a dose-dependent
      manner elastases from human leukocytes or pancreas with IC50 values of 80 +/- 2.6
      nM and 4.8 +/- 0.12 microM, respectively. Steady-state studies revealed that SR
      26831 behaved like a noncompetitive, irreversible inhibitor of both types of
      enzymes. SR 26831 inhibited in a dose-dependent manner degradation of [3H]elastin
      and [3H]collagens (types I and IV) by human leukocyte elastase (IC50 values were
      between 1.2 and 1.8 microM). In this respect, SR 26831 was 3- to 20-fold more
      active than alpha-1-antitrypsin. SR 26831 was also highly selective for elastases
      inasmuch as it did not inhibit pepsin, collagenase, trypsin, alpha-chymotrypsin,
      factor Xa, plasmin, kallikrein, cathepsins B, C, D and G and thrombin. In the
      rabbit, SR 26831 was cleared rapidly from blood after i.v. injection, but
      affected intracellular leukocyte elastase activity shortly after either i.v. or
      p.o. administration. In the rat, i.v. or p.o. administration of SR 26831
      prevented in a dose-dependent manner acute lung injury induced by intratracheal
      instillation of human leukocyte elastase. SR 26831 (1 mg/kg) was still efficient
      when it was administered 90 min before elastase instillation and was also able to
      limit further hemorrhage development in response to elastase, after it had begun.
      SR 26831 may therefore be of therapeutic value in the treatment of diseases such
      as rheumatoid arthritis or pulmonary emphysema thought to be due to the
      destructive action of leukocyte elastase.

PMID- 1738127
TI  - Thromboxane A2 accounts for bronchoconstriction but not for platelet
      sequestration and microvascular albumin exchanges induced by fMLP in the guinea
      pig lung.
AB  - When injected i.v. to guinea pigs, the granulocyte secretagog N-formyl-L
      methionyl-L-leucyl-L-phenylalanine (fMLP) induces bronchoconstriction (BC), lung
      platelet sequestration and increased transendothelial albumin exchanges in lungs.
      We evaluated BC and the variations of the lung contents in radiolabeled
      platelets, erythrocytes and extravascular albumin, as measurements of platelet
      lung entrapment, reduction of lung blood volume and increase of transendothelial
      albumin exchanges, respectively. Trimetoquinol, a thromboxane A2 (TXA2)
      endoperoxide receptor antagonist, inhibited BC and platelet entrapment by lungs
      induced by fMLP, but protection was nonspecific because it also suppressed BC by
      histamine. The specific TXA2 synthetase inhibitor/endoperoxide receptor
      antagonist ridogrel suppressed BC and reduced lung platelet entrapment, but
      failed to prevent the increase of extravascular albumin and the decrease of
      erythrocyte lung contents due to fMLP. Consequently, the fMLP-induced increase of
      vascular albumin exchanges and reduction of lung blood volume are TXA2
      independent. Aspirin prevented BC, but failed to suppress lung platelet
      entrapment by fMLP, indicating that in vivo platelet activation is not TXA2
      dependent, even though the levels of circulating TXB2, the stable metabolite of
      TXA2, were increased after fMLP concomitantly with that of 6-keto-prostaglandin
      (PG)F1 alpha, the stable metabolite of PGI2. The ridogrel-treated animals showed
      reduced blood level of TXB2 and increased levels of 6-keto-PGF1 alpha after fMLP
      challenge. Blocking the cyclooxygenase pathway with aspirin prevented ridogrel
      induced protection against lung platelet sequestration after fMLP, supporting the
      concept that rechanneling of arachidonate metabolism toward protective
      prostaglandins accounts for protection by ridogrel.

PMID- 1738128
TI  - Hemoglobin adduct and hepatic- and urinary bladder-DNA adduct levels in rapid and
      slow acetylator Syrian inbred hamsters administered 2-aminofluorene.
AB  - The levels of covalently bound arylamine-hemoglobin and DNA adduct formation were
      used as dosimeters to measure the effect of acetylator genotype and sex on the
      metabolic conversion of the carcinogen, 2-aminofluorene, to reactive
      intermediates. A single high dose of 2-aminofluorene (60 mg/kg b.wt. i.p.) was
      administered to male and female homozygous rapid (Patr/Patr) acetylator hamsters
      (MHA/SsLaK) and homozygous slow (Pats/Pats) acetylator hamsters (Bio. 82.73/H).
      By using 32P-postlabeling assay methodology, a sole nonacetylated DNA adduct,
      which cochromatographed with authentic N-(deoxyguanosin-8-yl)-2-aminofluorene was
      detected at 3, 6, 12, 18 or 24 hr postdosing in liver and urinary bladder DNA of
      both rapid and slow acetylator hamsters. The highest levels were detected at 18
      hr post 2-aminofluorene injection at which time the average levels of hepatic 2
      aminofluorene-DNA adducts were similar between male and female rapid and slow
      acetylators. By comparison, the levels of 2-aminofluorene-DNA adducts in the
      urinary bladder at 18 hr were about 4-fold lower than in the liver, and were
      significantly greater in homozygous rapid than in homozygous slow acetylator
      counterparts (P less than .01). In both the liver and urinary bladder, the levels
      of 2-aminofluorene-DNA adducts were independent of sex. In contrast to the DNA
      adduct data, the levels of 2-aminofluorene-hemoglobin adducts, evaluated by
      capillary gas chromatography-mass spectrometry, were significantly higher in the
      homozygous slow acetylators than in homozygous rapid acetylators. However, there
      again were no differences between males and females.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1738129
TI  - Genetic covariation in low alcohol-sensitive and high alcohol-sensitive selected
      lines of rats: behavioral and electrophysiological sensitivities to the
      depressant effects of ethanol and the development of acute neuronal tolerance to
      ethanol in situ at generation eight.
AB  - Phenotypic differences in behavioral and initial neuronal sensitivities to acute
      ethanol (EtOH) administration were examined and compared among replicate lines of
      rats, which were selectively bred for low and high EtOH sensitivity. The eighth
      generation of HAS (EtOH-sensitive) and LAS (EtOH-insensitive) rats were
      significantly different in terms of sensitivity both to EtOH-induced loss of
      righting response (sleep time) and to EtOH-induced depressions of cerebellar
      Purkinje neuron firing rates. This study provides the first evidence for a
      significant correlation between behavioral and electrophysiological EtOH
      sensitivities among individual animals and between replicate selected rodent
      lines. These data support the hypothesis that a genetic correlation exists
      between these two phenotypes. In addition, the LAS rats expressed a significantly
      higher incidence of acute cellular tolerance to the depressant neuronal effects
      of repeated local applications of EtOH over a period of a few minutes. We have
      characterized this response and concluded that it may contribute to EtOH
      sensitivity. However, our data also suggest that the EtOH insensitivity of
      cerebellar Purkinje neurons in LAS rats is not only a consequence of acute
      neuronal tolerance to EtOH, but also due to low initial EtOH sensitivity of these
      neurons. Both behavioral and electrophysiological EtOH phenotypes of LAS and HAS
      rats have diverged with the application of selection pressure for behavioral EtOH
      sensitivity; these data suggest that the mechanisms underlying neuronal
      sensitivity and acute neuronal tolerance to EtOH are important in determining the
      behavioral EtOH sensitivities of these animals.

PMID- 1738130
TI  - Electrophysiological effects of ethanol on hippocampal and cerebellar neurons
      cografted with locus coeruleus in oculo: role of the noradrenergic circuitry.
AB  - Nucleus locus coeruleus (LC) was sequentially transplanted with hippocampus or
      cerebellum from rat fetuses to the anterior eye chamber of adult rat hosts.
      Histological, electrophysiological and pharmacological studies indicate that the
      LC neurons survive and functionally innervate neurons in hippocampal and
      cerebellar cografts. Ethanol, when superfused over the double transplants in
      urethane-anesthetized hosts, caused excitations of hippocampal neuronal activity
      at doses between 1 and 30 mM, whereas applications above 30 mM depressed the
      activity of grafted hippocampal neurons. Similar results were observed in
      cerebellar Purkinje neurons cografted in oculo, except that cerebellar neurons
      were more sensitive to both the excitatory and the depressant effects of ethanol.
      The excitations caused by lower ethanol doses in double grafts were prevented by
      the cosuperfusion of 0.5 to 1.0 microM clonidine, a treatment which effectively
      removed the inhibitory influence of the LC neurons from the grafted neuronal
      circuit by depressing the LC neuronal activity. Ethanol-induced excitations were
      also not observed in single grafts of hippocampus, which lack a catecholamine
      innervation. Furthermore, in double grafts, when the noradrenergic inhibition was
      blocked postsynaptically with the alpha adrenergic antagonist phentolamine,
      ethanol-induced excitations were prevented, although ethanol did not alter the
      postsynaptic actions of norepinephrine. Our data suggest that the ethanol-induced
      excitations in the cerebellar and hippocampal grafts appear to be disinhibitions
      mediated by an ethanol-induced depression of the inhibitory noradrenergic input
      to these target tissues from LC cografts. Indeed, the doses of ethanol that
      induced neuronal excitations in hippocampal transplants also elicited marked
      depressions of LC neurons.

PMID- 1738131
TI  - Brief transient ischemia induces long-term depletion of norepinephrine without
      affecting the aromatic amino acid decarboxylase and monoamine oxidase activities
      in the rat kidney.
AB  - Renal artery occlusion (RAO) for 30, 60 or 90 sec was found to reduce
      norepinephrine tissue levels in both the cortex and medulla of the rat,
      respectively, by 2 to 5%, 56 to 65% and 92 to 97%, but no significant change in
      dopamine tissue levels was found to occur. Similar effects were obtained with
      occlusion of the aorta proximally to the renal arteries for 90 sec.
      Administration of superoxide dismutase (40 mg/kg) immediately before RAO resulted
      in a marked protection of the norepinephrine depletion effect as caused by
      transient ischemia. The sodium-dependent formation of dopamine and 3,4
      dihydroxyphenylacetic acid, the deaminated metabolite of dopamine, in renal
      slices loaded with L-3,4-dihydroxyphenylalanine (50 microM) was found to be
      similar in denervated and control kidneys. Type A and B monoamine oxidase
      activities were measured with the deamination of two specific substrates,
      respectively, [3H]-5-hydroxytryptamine and [14C]-beta-phenylethylamine, in
      homogenates of the renal cortex and renal medulla; neither type of monoamine
      oxidase, A or B, was found to be affected by denervation. The renal tissues
      collected for morphological observation were those in which RAO was performed for
      90 sec. The general structure of the renal cortex was not affected by RAO, being
      similar in the control and the denervated kidney. In conclusion, the results
      presented suggest that the tissue damaging effect produced by RAO appears to be
      selective for the renal sympathetic innervation and seems to involve the
      generation of some reactive oxygen species, namely superoxide.

PMID- 1738132
TI  - That was then: elderly survivors of incest.
AB  - 1. Psychosocial ramifications of incest last a lifetime for some and may be of
      crucial importance in treating patients in the later developmental stages of
      life. 2. Nursing assessments that include current and past history of violence
      are important for understanding presenting symptomology and interpersonal
      dynamics, but they are often neglected. 3. There is a need for nursing research
      that looks at all facets of elderly incest survivors, including incidence, late
      life symptomology, and special treatment needs.

PMID- 1738133
TI  - Preventing spiritual distress in the dying client.
AB  - 1. Nurses want to provide holistic care to all clients. Viewing spiritual
      development as a part of human growth and development is appropriate and
      essential to nursing practice. 2. Nursing care that is effective in maintaining
      the spiritual integrity of clients nearing death can be effective if placed
      within a theoretical framework. 3. Levels of spiritual development coupled with
      the transitional phases of the dying process lead to accurate assessments of
      clients. In turn, nursing strategies that are selected as a result of such
      theoretically based assessments are likely to be effective in preventing
      spiritual distress.

PMID- 1738134
TI  - Inpatient practice. An integrated framework.
AB  - A framework for practice that integrates nursing concepts and processes with
      system concepts has distinct advantages. Nursing concepts provide direction for
      nursing care; the nursing process provides the structure in which nursing care is
      delivered and evaluated. Application of system concepts enables the CNS to
      navigate and negotiate the larger institutional context. Inpatient practice is
      not just the delivery of quality patient care; it also involves managing the
      system so it is possible to deliver care. An integrated framework has been
      offered as a guide to inpatient practice. Although further use and testing are
      indicated, so far it has proved useful in the practice of a CNS.

PMID- 1738135
TI  - How will the trend toward biological psychiatry affect the future role of the
      psychiatric mental health nurse?

PMID- 1738136
TI  - Comments on public sector nursing.

PMID- 1738137
TI  - Psychiatric nursing in the 1990s & beyond.
AB  - In the decade of the '90s, psychiatric mental health nursing will need to take
      stock of itself--its practice, its education, and its research--if it is to
      successfully prepare for the changes in care of the mentally ill. Like
      psychiatrists, we will need to rethink our agendas in light of new science and
      technology and rationalize the mental health delivery system and our role in it
      through systematic research and advocate for a system that provides quality care
      for the chronically ill and the poor. In the next century, we will need to
      rethink the basics of nursing care and the leadership roles of nurses as
      hospitals and the doctor's role within them changes. Psychiatric mental health
      nurses will need to be at the forefront in advocating for a delivery system that
      listens to patients and families, that humanizes the dehumanizing experience of
      hospitalization. The challenges before us are formidable.

PMID- 1738139
TI  - Structure and DNA binding activity of analogues of 1,5-bis(4
      amidinophenoxy)pentane (pentamidine)
AB  - The DNA binding properties of a series of 39 bisbenzamidines related to the
      clinically used antipneumocystis drug pentamidine (1) were studied. Changes in
      the thermal denaturation temperature of calf thymus DNA (delta Tm) showed that
      all the compounds have significant affinity for DNA. A comparison of delta Tms
      for the series with delta Tms of base-pair-specific DNA-binding compounds, using
      homopolymers poly(dA).poly(dT) and poly(dG-dC).poly(dG-dC), indicated that the
      compounds show moderate specificity for AT base pairs. Lack of DNA helix
      extension, measured by viscometric titration with sonicated calf thymus DNA,
      indicated that the compounds do not bind to DNA by intercalation. Analogues of 1
      with an odd number of methylenes connecting the benzamidine rings had a higher
      affinity for DNA and homopolymers than analogues with an even number of
      methylenes. All of the compounds containing an amidino group meta to the linking
      chain showed lower polynucleotide affinity. These results suggest that the shape
      of the molecules was important for DNA binding. Molecular modeling studies showed
      a correlation between the DNA binding and the radius of curvature of molecular
      mechanics models of the molecules. Monosubstitution on the benzamidine rings or
      replacement of the amidino group with the cyclic imidazolino group had no
      influence on the DNA-binding affinity of the compounds. Substitution of NH for
      the ether oxygen connecting group of 1 had no effect on the DNA binding or base
      pair specificity. Methylation of either of the nitrogen atoms of the imidazolino
      group to provide an analogue of 1 with N-methylimidazolino groups decreased DNA
      affinity considerably. GC vs AT base-pair specificity as measured by delta Tm
      does not correlate with the radius of curvature. The experimental and modeling
      results are consistent with DNA minor-groove binding.

PMID- 1738140
TI  - alpha-Keto amide inhibitors of aminopeptidases.
AB  - The design and synthesis of 3-amino-2-oxo-4-phenylbutanoic acid amides (alpha
      keto amides), a new class of aminopeptidase inhibitor, are described. These
      compounds, illustrated by the Phe-Leu analogue 2, are effective inhibitors of
      arginyl aminopeptidase (Ki = 1.5 microM), cytosol aminopeptidase (Ki = 1.0
      microM), and microsomal aminopeptidase (Ki = 2.5 microM). The ketone carbonyl of
      the alpha-keto amide was found to hydrate readily in an aqueous DMSO solution,
      due to the electron-withdrawing effect of the neighboring amide group. A
      mechanism of inhibition is proposed for the alpha-keto amides that is similar to
      that proposed for the structurally related aminopeptidase inhibitor bestatin and
      its analogues, wherein the inhibitor may interact with the S1'-S2' subsite of the
      enzyme rather than the S1-S1' subsite. Like bestatin, the alpha-keto amides are
      slow-binding inhibitors of all three enzymes.

PMID- 1738138
TI  - Adenosine receptors: pharmacology, structure-activity relationships, and
      therapeutic potential.

PMID- 1738141
TI  - Potent, orally active aldose reductase inhibitors related to zopolrestat:
      surrogates for benzothiazole side chain.
AB  - A broad structure-activity program was undertaken in search of effective
      surrogates for the key benzothiazole side chain of the potent aldose reductase
      inhibitor, zopolrestat (1). A structure-driven approach was pursued, which
      spanned exploration of three areas: (1) 5/6 fused heterocycles such as
      benzoxazole, benzothiophene, benzofuran, and imidazopyridine; (2) 5-membered
      heterocycles, including oxadiazole, oxazole, thiazole, and thiadiazole, with
      pendant aryl groups, and (3) thioanilide as a formal equivalent of benzothiazole.
      Several benzoxazole- and 1,2,4-oxadiazole-derived analogues were found to be
      potent inhibitors of aldose reductase from human placenta and were orally active
      in preventing sorbitol accumulation in rat sciatic nerve, in an acute test of
      diabetic complications. 3,4-Dihydro-4-oxo-3-[(5,7-difluoro-2-benzoxazolyl)methyl]
      1- phthalazineacetic acid (124) was the best of the benzoxazole series (IC50 =
      3.2 x 10(-9) M); it suppressed accumulation of sorbitol in rat sciatic nerve by
      78% at an oral dose of 10 mg/kg. Compound 139, 3,4-dihydro-4-oxo-3-[[(2
      fluorophenyl)-1,2,4- oxadiazol-5-yl]methyl]-1-phthalazineacetic acid, with IC50
      less than 1.0 x 10(-8) M, caused a 69% reduction in sorbitol accumulation in rat
      sciatic nerve at an oral dose of 25 mg/kg. The thioanilide side chain featured in
      3-[2-[[3-(trifluoromethyl)phenyl]amino]-2-thioxoethyl]-3,4-dihydro - 4-oxo-1
      phthalazineacetic acid (195) proved to be an effective surrogate for
      benzothiazole. Compound 195 was highly potent in vitro (IC50 = 5.2 x 10(-8) M)
      but did not show oral activity when tested at 100 mg/kg. Additional structure
      activity relationships encompassing a variety of heterocyclic side chains are
      discussed.

PMID- 1738142
TI  - 3-Carboxy-5-methyl-N-[4-(trifluoromethyl)phenyl]-4-isoxazolecarboxamide, a new
      prodrug for the antiarthritic agent 2-cyano-3-hydroxy-N-[4
      (trifluoromethyl)phenyl]-2-butenamide.
AB  - The title compound 3-carboxyisoxazole 3 was synthesized by cycloaddition of
      carbethoxyformonitrile oxide to N-[4-(trifluoromethyl)phenyl]-3-pyrrolidino-2
      butenamide (6) with spontaneous elimination of pyrrolidine followed by hydrolysis
      of the ethyl ester. Compound 3 was shown to be absorbed intact after oral
      administration to rats. Over 24 h, the compound was metabolized to yield plasma
      concentrations of the antiinflammatory agent 2-cyano-3-hydroxy-N-[4
      (trifluoromethyl)phenyl]-2-butenamide (2), similar to those obtained following an
      equivalent dose of the established prodrug of 5-methyl-N-[4
      (trifluoromethyl)phenyl]isoxazole-4-carboxamide (1).

PMID- 1738143
TI  - Synthesis and cytotoxic activity of C-glycosidic nicotinamide riboside analogues.
AB  - The C-glycosidic nicotinamide riboside analogue (2) was prepared by reaction of
      ribonolactone 24 with the lithiated oxazoline 19 followed by triethylsilane
      reduction to 26 and deprotection. Selective phosphorylation to the
      pseudonucleotide 34 was effected via the isopropylidene compound 33. In contrast
      to the benzoic acid riboside (28) the benzamide riboside (2) showed extremely
      high cytotoxicity at nanomolar concentrations to S49.1 lymphoma cells but only
      slightly increased dexamethasone toxicity.

PMID- 1738144
TI  - Fluoronaphthyridines as antibacterial agents. 4. Synthesis and structure-activity
      relationships of 5-substituted-6-fluoro-7-(cycloalkylamino)-1,4-dihydro-4-oxo-1,8
      naphthyridine-3-carboxylic acids.
AB  - A series of 5-substituted-6-fluoro-7-(cycloalkylamino)-1,4-dihydro-4-oxo-1,8-
      naphthyridine-3-carboxylic acids have been prepared and tested for their in vitro
      and in vivo antibacterial activities. The 5-methyl group gave better in vitro
      activity with the 1-cyclopropyl appendage, but poorer activity with the 1-tert
      butyl moiety. With the 1-(2,4-difluorophenyl) substitution, the influence of the
      7-cycloalkylamino group was determinant: a (3S)-3-amino-pyrrolidine was shown to
      enhance greatly the in vitro and in vivo activity of the 5-methyl derivative.
      Compound 33 (BMY 43748) was selected as a promising candidate for an improved
      therapeutic agent.

PMID- 1738145
TI  - Synthesis and anti-HIV activity of 4'-thio-2',3'-dideoxynucleosides.
AB  - A series of 2',3'-dideoxy-4'-thionucleoside analogues of purines and pyrimidines,
      including 4'-thioddI (17), 4'-thioddC (27), and 4'-thioAZT (34), were synthesized
      and evaluated for their inhibitory activity against human immunodeficiency virus
      (HIV). A stereospecific synthesis of the 2,3-dideoxy-4-thioribofuranosyl
      carbohydrate precursor 11 starting with L-glutamic acid is described. 2',3'
      Dideoxy-4'-thiocytidine (27) displayed significant, but modest activity in vitro
      against human immunodeficiency virus.

PMID- 1738146
TI  - Synthesis and biological activity of certain alkyl 5-(alkoxycarbonyl)-1H
      benzimidazole-2-carbamates and related derivatives: a new class of potential
      antineoplastic and antifilarial agents.
AB  - A series of methyl and ethyl 5-(alkoxycarbonyl)-1H-benzimidazole-2-carbamates (7
      19) and methyl 5-carbamoyl-1H-benzimidazole-2-carbamates (24-34) have been
      synthesized via the reaction of an appropriate alcohol or amine with the acid
      chloride derivatives 6a or 6b at room temperature. Reaction of an alcohol with
      acid chloride 6a at reflux temperature afforded transesterified products 20-23 in
      good yield. Treatment of methyl 5-amino-1H-benzimidazole-2-carbamate with
      substituted benzoyl chlorides furnished the methyl 5-benzamido-1H-benzimidazole-2
      carbamates (36-38). Compounds 9, 16, 20, and 22 demonstrated significant growth
      inhibition in L1210 cells with IC50's less than 1 microM. Growth inhibition by
      this series of compounds appears to be associated with mitotic spindle poisoning.
      All the compounds tested, 9, 10, 19, 20, 22, and 23, caused significant
      accumulation of L1210 cells in mitosis. Compounds 7, 9, 19, 25, 26, 27, and 36
      showed significant in vivo antifilarial activity against adult worms of Brugia
      pahangi, Litomosoides carinii, and Acanthocheilonema viteae in experimentally
      infected jirds.

PMID- 1738147
TI  - alpha-Methylated analogues of triiodothyroalkanoic acids: synthesis and
      biological activity.
AB  - Three novel thyroid hormone analogues: alpha-methyl-3,5,3'-triiodothyroacetic
      acid, alpha-methyl-3,5,3'-triiodothyropropionic acid, and alpha-methyl-3,5,3',5'
      tetraiodothyropropionic acid were synthesized. The hepatic thyroid receptor
      affinity of these analogues was compared to that other available thyroid
      analogues. The ability of these compounds to increase the activity of two hepatic
      enzymes and to lower blood cholesterol was compared to that of L
      triiodothyronine. alpha-Methyl-3,5,3'-triiodothyroacetic acid was shown to have
      less nuclear binding affinity, less enzyme inducing ability, but more blood
      cholesterol lowering ability than triiodothyroacetic acid. alpha-Methyl-3,5,3',5'
      tetraiodothyropropionic acid showed less nuclear binding affinity and less enzyme
      inducing activity than alpha-methyl-3,5,3'-triiodothyropropionic acid.

PMID- 1738148
TI  - Renin inhibitory pentols showing improved enteral bioavailability.
AB  - Incorporation of a C-terminal pentahydroxy functionality led to potent, low
      molecular weight hydrophilic renin inhibitors lacking the P1' side chain. As
      these compounds are easy to synthesize and have sufficient water solubility, they
      were chosen for further study. Compound 33 was transported across rabbit
      intestinal brush border membrane vesicles and yielded a hypotensive effect in
      sodium-depleted rhesus monkeys which lasted for 90 min when dosed at 2 mg/kg id.

PMID- 1738149
TI  - Base-catalyzed isomerization of retinoic acid. Synthesis and differentiation
      inducing activities of 14-alkylated all-trans-, 13-cis-, and 20,14-retro-retinoic
      acids.
AB  - Retinoic acid (1) is isomerized regioselectively by excess amounts of lithium
      diisopropylamide (LDA) to give 20,14-retro-retinoic acid (3). Alkylation of the
      intermediate dianion of retinoic acid gave 14-alkylated derivatives of 3. By
      isomerization of the alkylated retro isomers under basic conditions, several 14
      alkyl-all-trans- and -13-cis-retinoic acids were synthesized. The retinoidal
      activities of these derivatives were examined, based on the ability to induce
      differentiation of human promyelocytic leukemia cell line HL-60. 20,14-retro
      Retinoic acid (3) is 1/50 as active as retinoic acid (1). Although 14-methyl
      20,14-retro-retinoic acid (4) is as active as 3, the introduction of a 14-methyl
      group into all-trans- and 13-cis-retinoic acid resulted in decreased activity.
      Introduction of bulkier alkyl groups at the C-14 position caused the
      disappearance of the activity.

PMID- 1738150
TI  - Multivariate analysis by the minimum spanning tree method of the structural
      determinants of diphenylethylenes and triphenylacrylonitriles implicated in
      estrogen receptor binding, protein kinase C activity, and MCF7 cell
      proliferation.
AB  - The response profiles of 36 para-substituted diphenylethylenes (DPEs) and
      triphenylacrylonitriles (TPEs) have been compared by multivariate analysis. The
      responses measured were (a) relative binding affinity (RBA) for the cytosol
      estrogen receptor (ER), (b) ability to promote the growth of the human MCF7
      breast cancer cell-line, (c) cytotoxicity in MCF7 cells, and (d) ability to
      stimulate or inhibit protein kinase C (PKC) III activity under three different
      conditions of enzyme activation. The prime object of the analysis was to observe
      the simultaneous influence of diverse combinations of substituents on all these
      in vitro responses. To do this, the minimum spanning tree (MST) method was used
      to organize the molecules into a network in which proximate molecules are closely
      related with regard to their responses whereas remote molecules are distinct. The
      MST of this population of molecules had four main branches. E2 and its TPE mime
      were located in a central position within the trunk whereas the tips of the
      branches tended toward molecules of different specificity, i.e., cytotoxic
      molecules that bind to ER and interfere with PKC, noncytotoxic molecules that
      also bind to ER and interfere with PKC but promote cell growth, molecules only
      active on PKC, and molecules active on all parameters except PKC stimulation. A
      parallel MST analysis of the relationships among the response parameters
      themselves confirmed previous conclusions: For this population of molecules, RBAs
      for ER are fairly closely related to ability to promote MCF7 cell growth and only
      little to cytotoxicity (Bignon et al. J. Med. Chem. 1989, 32, 2092). Cytotoxicity
      is much more clearly correlated with inhibition of diacylglycerol-stimulated PKC
      activity than with RBAs for ER. PKC inhibition differs substantially depending
      upon whether the substrate is H1 histone or protamine sulfate.

PMID- 1738151
TI  - QSAR analyses of the substituted indanone and benzylpiperidine rings of a series
      of indanone-benzylpiperidine inhibitors of acetylcholinesterase.
AB  - QSAR analyses have been performed on the substituted indanone and
      benzylpiperidine ring substructures of a set of acetylcholinesterase, AChE,
      inhibitors of which 1-benzyl-4-[(5,6-dimethoxy-1-oxoindan-2-yl)methyl]piperidine
      hydrochloride is a potent in vitro and ex vivo inhibitor. The method of molecular
      decomposition-recomposition was used to define the sets of molecular
      substructures and corresponding in vitro inhibition databases. A QSAR involving
      the magnitude of the dipole moment, the highest occupied molecular orbital (HOMO)
      energy, and a specific pi-orbital wave function coefficient of the substituted
      indanone ring substructure was constructed and found to be significant. The
      absence of any molecular-shape or bulk term in the QSAR, coupled with some of the
      relatively large substituents used to construct the QSAR, suggests considerable
      space is available around the indanone ring during the inhibition process. A set
      of QSARs were constructed and evaluated for substituents on the aromatic ring of
      the benzylpiperidine substructure. The most significant QSAR involves a
      representation of molecular shape, the largest principal moment of inertia, and
      the HOMO of the substituted aromatic ring. It appears that upon binding the
      receptor "wall" is closely fit around the benzyl ring, especially near the para
      position. Overall, the QSAR analysis suggests inhibition potency can be better
      enhanced by substitution on the indanone ring, as compared to the aromatic sites
      of the benzylpiperidine ring. Moreover, inhibition potency can be rapidly
      diminished, presumably through steric interactions with the receptor surface of
      AChE, by substitution of moderate to large groups on the benzyl ring,
      particularly at the para position.

PMID- 1738152
TI  - Conformational analyses and molecular-shape comparisons of a series of indanone
      benzylpiperidine inhibitors of acetylcholinesterase.
AB  - Conformational analyses and molecular-shape comparisons were carried out on an
      analogue series of indanone-benzylpiperidine inhibitors of acetylcholinesterase
      (AChE). It was possible to define an active conformation with respect to the
      flexible geometry of the benzylpiperidine moiety, as well as an active
      conformation of the indanone ring-piperidine ring substructure for analogues
      having a single spacer group between these rings. No active conformation could be
      postulated for analogues having two or three spacer units between the indanone
      and piperidine conformation could be postulated for analogues having two or three
      spacer units between the indanone and piperidine rings. Still, a receptor binding
      model can be constructed for all indanone and piperidine ring substructures. The
      postulated active conformation for 1-benzyl-4-[(5,6-dimethoxy-1-oxoindan-2
      yl)methyl]piperidine hydrochloride (1a), a potent AChE inhibitor, is close to the
      crystal structures of 1a with respect to the indanone-piperidine substructure,
      but differs from the crystal structures for the benzylpiperidine moiety. However,
      the crystal conformations and the postulated active conformation of the
      benzylpiperidine portion of the AChE inhibitor are estimated to be about equally
      stable. A trans-decalin analogue of 1a can adopt the postulated active
      conformation as shown by calculation and as seen in its crystal structure. The
      inactivity of this analogue is explained by the added steric size of the decalin
      unit and/or the time-average valence geometry behavior at the spiro junction to
      the indanone ring.

PMID- 1738153
TI  - A novel class of enkephalinase inhibitors containing a C-terminal sulfo group.
AB  - A new series of sulfonic acids were synthesized and tested for their
      enkephalinase inhibitory activity. Among them, the most potent was N-(2-benzyl-3
      mercaptopropionyl)metanilic acid 10i with an IC50 value of 0.27 nM. Several other
      analogues (10a,b,j,n,o,gg,hh) showed the inhibitory activity comparable to or
      greater than thiorphan (IC50 = 2.6 nM), a C-terminal carboxyl-containing
      inhibitor of enkephalinase. Thus compounds containing a C-terminal sulfo group,
      instead of the C-terminal carboxyl group, were found to show a remarkably high
      level of inhibition of enkephalinase. The analgesic activity of 10b, (S)-10b, and
      (R)-10b was also evaluated by the phenylbenzoquinone writhing test.

PMID- 1738154
TI  - Electron microscopy of the actin-myosin head complex in the presence of ATP.
AB  - The structure of the actin-myosin head complex during the ATPase cycle has been
      studied by electron microscopy of negatively stained acto-heavy-meromyosin. In
      the absence of ATP, heavy meromyosin molecules generally showed a regular, angled
      appearance, with both heads attached to the actin filament. In the presence of
      ATP, attached molecules showed a less ordered structure, often with only one head
      attached. We conclude that configurations other than the rigor structure occur
      during the actomyosin cross-bridge cycle.

PMID- 1738155
TI  - Genetic and functional analysis of the basic replicon of pPS10, a plasmid
      specific for Pseudomonas isolated from Pseudomonas syringae patovar savastanoi.
AB  - The sequence of a 1823 base-pair region containing the replication functions of
      pPS10, a narrow host-range plasmid isolated from a strain of Pseudomonas
      savastanoi, is reported. The origin of replication, oriV, or pPS10 is contained
      in a 535 base-pair fragment of this sequence that can replicate in the presence
      of trans-acting function(s) of the plasmid. oriV contains four iterons of 22 base
      pairs that are preceded by G+C-rich and A+T-rich regions. A dnaA box located
      adjacent to the repeats of the origin is dispensable but required for efficient
      replication of pPS10; A and T are equivalent bases at the 5' end of the box.
      repA, the gene of a trans-acting replication protein of 26,700 Mr has been
      identified by genetic and functional analysis. repA is adjacent to the origin of
      replication and is preceded by the consensus sequences of a typical sigma 70
      promoter of Escherichia coli. The RepA protein has been identified, using the
      minicell system of E. coli, as a polypeptide with an apparent molecular mass of
      26,000. A minimal pPS10 replicon has been defined to a continuous 1267 base-pair
      region of pPS10 that includes the oriV and repA sequences.

PMID- 1738156
TI  - Crystal structure of the alkaline proteinase Savinase from Bacillus lentus at 1.4
      A resolution.
AB  - Savinase (EC3.4.21.14) is secreted by the alkalophilic bacterium Bacillus lentus
      and is a representative of that subgroup of subtilisin enzymes with maximum
      stability in the pH range 7 to 10 and high activity in the range 8 to 12. It is
      therefore of major industrial importance for use in detergents. The crystal
      structure of the native form of Savinase has been refined using X-ray diffraction
      data to 1.4 A resolution. The starting model was that of subtilisin Carlsberg. A
      comparison to the structures of the closely related subtilisins Carlsberg and
      BPN' and to the more distant thermitase and proteinase K is presented. The
      structure of Savinase is very similar to those of homologous Bacillus
      subtilisins. There are two calcium ions in the structure, equivalent to the
      strong and the weak calcium-binding sites in subtilisin Carlsberg and subtilisin
      BPN', well known for their stabilizing effect on the subtilisins. The structure
      of Savinase shows novel features that can be related to its stability and
      activity. The relatively high number of salt bridges in Savinase is likely to
      contribute to its high thermal stability. The non-conservative substitutions and
      deletions in the hydrophobic binding pocket S1 result in the most significant
      structural differences from the other subtilisins. The different composition of
      the S1 binding loop as well as the more hydrophobic character of the substrate
      binding region probably contribute to the alkaline activity profile of the
      enzyme. The model of Savinase contains 1880 protein atoms, 159 water molecules
      and two calcium ions. The crystallographic R-factor [formula; see text].

PMID- 1738157
TI  - Crystallization and preliminary X-ray analysis of complexes of peptide inhibitors
      with human recombinant and mouse submandibular renins.
AB  - Inhibitor-complexed crystals of mouse and human renins suitable for X-ray
      analysis have been prepared. The mouse renin is complexed with a non-hydrolysable
      decapeptide analogue of rat angiotensinogen containing a hydroxyethylene isostere
      in place of the scissile bond. The crystals are monoclinic, space group P2(1)
      with cell dimensions a = 78.3 A, b = 117.8 A, c = 85.9 A, beta = 101.18 degrees
      containing four molecules per asymmetric unit. The human renin is fully
      glycosylated and complexed with a tetrapeptide containing norstatine. The complex
      crystallises in the cubic space group P2(1)3 with a = 143.1 A and has two
      molecules in the asymmetric unit. The rotation function of the mouse renin
      complex indicates pseudo 222 symmetry while that of human renin indicates a
      pseudo 2-fold axis. Full structural analyses of the two complexes are underway.

PMID- 1738158
TI  - Investigations on the dynamic structures of adenine- and thymine-containing DNA.
AB  - The structures of poly(dA-dT), poly(dA-dBr5U) and of poly(dA).poly(dT) have been
      investigated in solution and in fibers, by Raman spectroscopy. Both the
      alternating poly(dA-dT), poly(dA-dBr5U) and non-alternating poly(dA).poly(dT)
      exhibit, in the region of sugar phosphate backbone vibrations, two bands of
      almost equal intensity at about 841 cm-1 and 817 cm-1. The analysis of the
      characteristic bands of thymine residues that are sensitive to sugar puckers
      gives indication of a significant displacement from the C(2')-endo conformer
      suggesting the adoption of alternative conformers such as O(4')-endo. In
      contrast, the diagnostic Raman bands for the sugar pucker of adenine residues
      suggest, instead, predominant adoption of C(2')-endo conformations. These Raman
      results are compatible with rapid dynamic changes of sugar puckers between C(2')
      endo and O(4')-endo for the thymidine (and uridine) residues, whereas in adenine
      residues the sugar puckers fluctuate around the C(2')-endo pucker in all
      synthetic DNA molecules studied. Molecular dynamics simulations, performed on six
      different starting models using two distance-dependent dielectric functions
      epsilon(r) = 4 r and a sigmoidal dependence), all gave similar dynamic behavior
      in agreement with these Raman data and their interpretation. The mean calculated
      pseudorotation phases of the adenine residues are systematically higher (around
      C(2')-endo) than those of the thymine residues (close to O(4')-endo-C(1')-exo).
      Besides, the mean lifetimes of the thymine residues are 1.5 to 2.0-fold higher in
      the O(4')-endo than in the C(2')-endo domain, while those of the adenine residues
      are two to threefold higher in the C(2')-endo than in the O(4')-endo domain. In
      the Raman spectra of the alternating poly(dA-dBr5U), the splitting of a band into
      two components arising from the two contributions of ApBr5U and Br5UpA provides
      strong evidence for a repeating dinucleotide structure in solution. The
      calculated twist values averaged over the simulation runs are also systematically
      higher in the 5'T-A3' step (39 degrees) than in the 5'A-T3' step (33 degrees).
      Simultaneously, the calculated roll values are positive in the 5'T-A3' step (6
      degrees) and negative in the 5'A-T3' step (-9 degrees), while the propeller twist
      values are about the same (-11 degrees to -16 degrees). On the other hand, in the
      homopolymer, the average twist value is close to 36 degrees with the roll angle
      close to 0 degrees and large propeller twist values (-20 degrees).

PMID- 1738160
TI  - Energy-optimized structure of antifreeze protein and its binding mechanism.
AB  - A combination of Monte Carlo simulated annealing and energy minimization was
      utilized to determine the conformation of the antifreeze protein from the fish
      winter flounder. It was found from the energy-optimized structure that the
      hydroxyl groups of its four threonine residues, i.e. Thr2, Thr13, Thr24, Thr35,
      are aligned on almost the same line parallel to the helix axis and separated
      successively by 16.1, 16.0 and 16.2 A, respectively, very close to the 16.6 A
      repeat spacing along [0112] in ice. Based on such a space match, a zipper-like
      model is proposed to elucidate the binding mechanism of the antifreeze protein to
      ice crystals. According to the current model, the antifreeze protein may bind to
      an ice nucleation structure in a zipper-like fashion through hydrogen bonding of
      the hydroxyl groups of these four Thr residues to the oxygen atoms along the
      [0112] direction in ice lattice, subsequently stopping or retarding the growth of
      ice pyramidal planes so as to depress the freeze point. The calculated results
      and the binding mechanism thus derived accord with recent experimental
      observations. The mechanistic implications derived from such a special antifreeze
      molecule might be generally applied to elucidate the structure-function
      relationship of other antifreeze proteins with the following two common features:
      (1) recurrence of a Thr residue (or any other polar amino acid residue whose side
      chain can form a hydrogen bond with water) in an 11-amino-acid period along the
      sequence concerned; and (2) a high percentage of Ala residue component therein.
      Further experiments are suggested to test the ice binding model.

PMID- 1738159
TI  - Three-dimensional structure of the bifunctional enzyme phosphoribosylanthranilate
      isomerase: indoleglycerolphosphate synthase from Escherichia coli refined at 2.0
      A resolution.
AB  - The three-dimensional structure of the monomeric bifunctional enzyme N-(5'
      phosphoribosyl)anthranilate isomerase:indole-3-glycerol-phosphate synthase from
      Escherichia coli has been refined at 2.0 A resolution, using oscillation film
      data obtained from synchrotron radiation. The model includes the complete protein
      (452 residues), two phosphate ions and 628 water molecules. The final R-factor is
      17.3% for all observed data between 15 and 2 A resolution. The root-mean-square
      deviations from ideal bond lengths and bond angles are 0.010 A and 3.2 degrees,
      respectively. The structure of N-(5'-phosphoribosyl)anthranilate isomerase:
      indole-3-glycerol-phosphate synthase from E. coli comprises two beta/alpha-barrel
      domains that superimpose with a root-mean-square deviation of 2.03 A for 138 C
      alpha-pairs. The C-terminal domain (residues 256 to 452) catalyses the PRAI
      reaction and the N-terminal domain (residues 1 to 255) catalyses the IGPS
      reaction, two sequential steps in tryptophan biosynthesis. The enzyme has the
      overall shape of a dumb-bell, resulting in a surface area that is considerably
      larger than normally observed for monomeric proteins of this size. The active
      sites of the PRAI and the IGPS domains, both located at the C-terminal side of
      the central beta-barrel, contain equivalent binding sites for the phosphate
      moieties of the substrates N-(5'-phosphoribosyl) anthranilate and 1-(o
      carboxyphenylamino)-1-deoxyribulose-5-phosphate. These two phosphate binding
      sites are identical with respect to their positions within the tertiary structure
      of the beta/alpha-barrel, the conformation of the residues involved in phosphate
      binding and the hydrogen-bonding network between the phosphate ions and the
      protein. The active site cavities of both domains contain similar hydrophobic
      pockets that presumably bind the anthranilic acid moieties of the substrates.
      These similarities of the tertiary structures and the active sites of the two
      domains provide evidence that N-(5'-phosphoribosyl)anthranilate isomerase:indole
      3-glycerol-phosphate synthase from E. coli results from a gene duplication event
      of a monomeric beta/alpha-barrel ancestor.

PMID- 1738161
TI  - Molecular dynamics simulation of the DNA triplex d(TC)5.d(GA)5.d(C+T)5.
AB  - A molecular dynamics simulation of the DNA triple helix d(TC)5.d(GA)5.d(C+T)5 is
      described (C+ represents a protonated cytosine residue). The simulation has been
      performed using the program AMBER 3.1 and includes counterions and explicit
      solvent under periodic boundary conditions. Both the dynamic and time-averaged
      behaviour of the system has been analysed. Considerable deviations from the fibre
      diffraction model for DNA triple helix structure are observed, including the
      repuckering of the purine strand sugars that has been identified in some nuclear
      magnetic resonance (n.m.r.) studies. The simulation suggests that this
      conformational change may be driven by the possibility of improved interactions
      between the phosphate groups of this strand and both the solvent and counterions.
      Several examples of a particular conformational transition are observed,
      involving correlated changes in the backbone angles alpha and gamma. These
      transitions provide a possible explanation for some unusual n.m.r. data that have
      been reported. The structure of the triple helix major groove also suggests an
      explanation for the observed stabilization of DNA triplexes by polyvalent
      cations, and their ability to interact with drugs that bind in the minor groove
      of DNA duplexes.

PMID- 1738162
TI  - beta-Trefoil fold. Patterns of structure and sequence in the Kunitz inhibitors
      interleukins-1 beta and 1 alpha and fibroblast growth factors.
AB  - Previous crystallographic analyses of the Kunitz inhibitors from soybean.
      Erythrina caffra and wheat, the interleukins-1 beta and 1 alpha and the acidic
      and basic fibroblast growth factors have shown that they contain a most unusual
      fold. It is formed by six two-stranded hairpins. Three of these form a barrel
      structure and the other three are in a triangular array that caps the barrel. The
      arrangement of the secondary structures gives the molecules a pseudo 3-fold axis.
      Although the different proteins have very similar structures, many of their
      sequences have no significant similarities overall. The structural determinants
      of this fold are described and discussed in this paper. The barrels in the
      different proteins have the same geometrical features: six strands tilted at 56
      degrees to the barrel axis; a barrel diameter of 16 A, and the beta-sheet
      hydrogen bonded so that it is staggered with a shear number of 12. These features
      fit McLachlan's equations for ideal barrels formed by beta-sheets. The wide
      diameter of the barrels is filled by layers of residues that, while not identical
      in the different proteins, are, in almost all cases, large. The structure of the
      triangular array of hairpins is determined by the coiling of the strands and the
      packing of hairpin residues against each other and against residues from the
      interior of the barrel. The major sequence requirements of this fold are large or
      medium hydrophobic residues at 18 buried sites. In the different structures the
      total volume of these residues is 3000 (+/- 120) A. The polyhedron model of
      protein architecture is used to demonstrate that the main, and in particular the
      symmetrical, features of this fold arise from the ideal and equal packing of six
      hairpins, modified only slightly to form hydrogen bonds between the hairpins.

PMID- 1738163
TI  - Dissociation of a native dimer to a molten globule monomer. Effects of pressure
      and dilution on the association equilibrium of arc repressor.
AB  - The monomer-dimer association reaction of Arc repressor was studied by pressure
      induced dissociation and by dilution. The dissociation was measured by the
      decrease (red shift) in the average energy of emission of the tryptophan
      fluorescence. Pressure dissociation also promoted a decrease in the excited-state
      lifetime of the single tryptophanyl residue, Trp14. These observations suggest
      that Trp14 becomes exposed to an aqueous environment following dissociation. The
      pressure-dissociation curves were concentration dependent, with p1/2 (half
      dissociation pressure) shifting to higher pressures as the concentration
      increased. The dissociation constant (KdO) obtained by extrapolating the pressure
      dissociation curves to atmospheric pressure was similar to that determined from
      the dilution curve (KdO = 30 nM). An anomalous steepness of dissociation in
      response to dilution was observed, suggesting that conformational changes occur
      as a result of dissociation of Arc repressor. Binding of bis(8-anilinonaphthalene
      1-sulfonate) to Arc repressor was not significantly affected by pressure
      dissociation, whereas thermal or urea denaturation was accompanied by a dramatic
      decrease in binding. These results suggest that the conformational changes that
      follow dissociation induced by pressure are more limited than those following
      denaturation. The tryptophan anisotropy decreased by about one-half, suggesting
      the dissociation of a globular dimer to a compact monomer. On the other hand,
      denaturation by urea promoted an increase in anisotropy, as expected for a random
      coil conformation. Dissociated Arc has the hydrodynamic properties of a folded
      monomer. On the other hand, dissociated Arc has a high degree of exposure of
      hydrophobic side-chains, and the distribution of conformations is much broader
      than that in the folded dimer. These features suggest that the dissociated
      subunit is a molten globule. The subunit interaction was substantially increased
      by a single amino acid substitution (Pro8----Leu), and the free energy of
      stabilization amounted to -2.9 kcal/mol. This increased stability suggests that
      residue 8 is located in the dimer interface and that part of the tertiary and
      most of the quaternary structure constraints result from the interaction between
      the intersubunit beta-strands.

PMID- 1738164
TI  - Crystal structure of the complex between carboxypeptidase A and the biproduct
      analog inhibitor L-benzylsuccinate at 2.0 A resolution.
AB  - The X-ray crystal structure of the carboxypeptidase A-L-benzylsuccinate complex
      has been refined at 2.0 A resolution to a final R-factor of 0.166. One molecule
      of the inhibitor binds to the enzyme active site. The terminal carboxylate forms
      a salt link with the guanidinium group of Arg145 and hydrogen bonds with Tyr248
      and Asn144. The second carboxylate group binds to the zinc ion in an asymmetric
      bidentate fashion replacing the water molecule of the native structure. The zinc
      ion moves 0.5 A from its position in the native structure to accommodate the
      inhibitor binding. The overall stereochemistry around the zinc can be considered
      a distorted tetrahedron, although six atoms of the co-ordinated groups lie within
      3.0 A from the zinc ion. The key for the strong inhibitory properties of L
      benzylsuccinate can be found in its ability both to co-ordinate the zinc and to
      form a short carboxyl-carboxylate-type hydrogen bond (2.5 A) with Glu270.

PMID- 1738166
TI  - Breast cancer and taxol top press and public interest: "the" cancer stories of
      1991.

PMID- 1738165
TI  - Two crystal forms of the lentil lectin diffract to high resolution.
AB  - The legume lectins are an important class of polysaccharide-binding proteins with
      a wide range of biochemical and immunological applications. Two high-resolution
      crystal forms are obtained for the lentil (Lens culinaris) lectin: a monoclinic
      P21 and an orthorhombic P212121. The unit cell dimensions for the monoclinic form
      are a = 58.0 A, b = 56.0 A, c = 82.1 A, beta = 104.4 degrees, while for the
      orthorhombic form a = 56.4 A, b = 74.6 A, c = 124.9 A. The asymmetric unit
      contains one dimer in both cases. The crystals diffract to 1.7 A resolution using
      synchrotron radiation. Preliminary data have been collected to 2.3 A on both
      crystal forms using a conventional X-ray source.

PMID- 1738167
TI  - Prevention centers planned for U.S., France.

PMID- 1738168
TI  - Drug development link between U.S. and Europe yielding results.

PMID- 1738169
TI  - Breast cancer surveillance: on increasing its effectiveness while reducing its
      negative psychological effects.

PMID- 1738170
TI  - Psychological distress and surveillance behaviors of women with a family history
      of breast cancer.
AB  - Women with a family history of breast cancer are at increased risk for developing
      the disease. This study investigated the beliefs of women at high risk for breast
      cancer (one or more first-degree relatives with breast cancer) about their breast
      cancer risk and the impact of this information on their surveillance behaviors
      and psychological distress. The Health Belief Model and the Fear Arousing
      Communications Theory were used in this study. Two hundred and seventeen women,
      enrolled in a breast protection program, completed a questionnaire regarding
      health beliefs and behaviors, social support, and psychological distress. While
      94% came in for regularly scheduled mammograms, only 69% came in for regular
      clinical breast examinations. A discriminant function analysis revealed that
      increased cancer anxiety decreased regular clinical examinations (coefficient = 
      .65). Only 40% performed breast self-examination monthly, 10% never performed
      breast self-examination, and 50% did not perform breast self-examination
      regularly. High breast self-examination performance prior to coming to the
      program was the best predictor of current breast self-examination, and high
      anxiety predicted poor adherence to monthly breast self-examination (multiple R =
      .61). More than 27% of the women at high risk were defined as having a level of
      psychological distress consistent with the need for counseling. Women reporting
      more barriers to screening, fewer social supports, and low social desirability
      had more psychological distress (multiple R = .75). Higher anxiety was directly
      related to poor attendance at a clinical breast examination and poor adherence to
      monthly breast self-examination.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738171
TI  - Suramin, an active nonhormonal cytotoxic drug for treatment of prostate cancer:
      compelling reasons for testing in patients with hormone-refractory breast cancer.

PMID- 1738172
TI  - Inhibition of breast cancer growth by suramin.
AB  - In this study, the polyanionic compound suramin was shown to be a potent in vitro
      growth inhibitor of both hormone-insensitive, estrogen receptor-negative human
      breast cancer cells (MDA MB231 and SK-BR-3) and hormone-responsive, estrogen
      receptor-positive human breast cancer cells (ZR 75-1, T47D, and MCF7). The
      inhibitory effect of suramin was dose dependent, with a median effective dose
      varying from 7 microM for MDA MB231 cells to 50 microM for MCF7 cells. This
      result indicated that estrogen receptor-negative cells were more sensitive to the
      drug. In MCF7 cells, not only did suramin block the mitogenic action of growth
      factors such as epidermal growth factor (EGF) and insulin-like growth factors I
      and II (IGF-I and IGF-II, respectively), but it also totally abolished the
      increase in cell proliferation induced by the steroid hormone 17 beta-estradiol
      (E2). Maximal inhibition was obtained after 5 days of suramin treatment, and
      inhibition either was partially reversed by E2, IGF-I, and IGF-II or was not
      reversible by EGF following removal of drug. In addition, suramin significantly
      decreased synthesis and secretion of the lysosomal enzyme cathepsin D, which was
      shown to be associated with a high risk of breast tumor metastasis. These results
      therefore suggest that, because of its effects on growth and cathepsin D
      secretion, suramin might be a helpful additional therapeutic tool for breast
      cancer patients, especially for patients with estrogen receptor-negative tumors
      which are insensitive to antihormonal strategies.

PMID- 1738173
TI  - Effect of vitamin A, C, and E supplementation on rectal cell proliferation in
      patients with colorectal adenomas.
AB  - Studies suggest that cell proliferation abnormalities of the colorectal mucosa
      are associated with risk of neoplasia, and most cancers of the large bowel are
      thought to arise from adenomas. The results of other studies suggest that
      vitamins A, C, and E have chemopreventive efficacy against colon cancer in animal
      models. This study evaluates the effect of dietary vitamin supplementation on
      cell kinetics in uninvolved rectal mucosa in patients with colorectal adenomas.
      Twenty patients with colorectal adenomas were given vitamins A, C, and E for 6
      months after complete polypectomy, and 21 patients with adenomas received
      placebo. In each patient, six biopsy specimens were taken from normal-appearing
      rectal mucosa before treatment and after 3 and 6 months of treatment and were
      incubated with tritiated thymidine ([3H]thymidine), and the [3H]thymidine-labeled
      cells were counted by use of autoradiography. Two parameters of cell
      proliferation were evaluated: 1) the ratio of the number of labeled cells to the
      total number of cells (thymidine labeling index) and 2) the ratio of the number
      of labeled cells in the upper 40% of the crypt to the total number of labeled
      cells in the crypt (phi h). The latter index reflects abnormal expansion of the
      proliferative compartment and is thought to be an intermediate biomarker of
      cancer risk. In patients receiving vitamins, phi h decreased progressively from
      baseline values, with increasing statistical significance (P less than .05 after
      3 months, P less than .01 after 6 months). There was a statistically significant
      decrease in the thymidine labeling index in the 40% of the crypt near the mucosal
      surface, but the variation in the overall labeling index was not statistically
      significant. In the placebo group, we observed no statistically significant
      change in cell kinetics. These findings suggest that vitamin A, C, and E
      supplementation is effective in reducing abnormalities in cell kinetics that may
      indicate a precancerous condition. Before larger trials on chemoprevention of
      colorectal adenoma recurrence are conducted, additional studies are needed (a) to
      validate that cell kinetics is an intermediate biomarker, (b) to determine active
      agents, optimal dosage, and the relative efficacy of agents given alone and in
      combination, and (c) to test toxicity.

PMID- 1738175
TI  - Tamoxifen: tablet dosage.

PMID- 1738174
TI  - Ovarian cancer and older women: is treatment less aggressive?

PMID- 1738176
TI  - Isn't skin cancer preventable?

PMID- 1738177
TI  - First antisense drug trials planned in leukemia.

PMID- 1738178
TI  - Mutagens in meat under fire.

PMID- 1738179
TI  - Late effects of childhood cancer treatment can be life threatening.

PMID- 1738180
TI  - Is cisplatin a human carcinogen?
AB  - Traditionally, cisplatin has not been regarded among chemotherapeutic drugs as a
      carcinogenic risk to humans because it is not a classical alkylating agent. A
      review of recently published experimental data indicates that cisplatin is
      mutagenic, clastogenic, capable of inducing cell transformation, able to act as
      an initiator in classical mouse skin initiation/promotion experiments, and
      carcinogenic in laboratory animals. Notably, it causes myeloid leukemia in BD IX
      rats. These observations demonstrate that cisplatin should be considered a potent
      carcinogen in experimental settings. A review of the literature identified 65
      instances of subsequent cancer in patients receiving cisplatin-based chemotherapy
      for an initial malignancy. The majority of second cancers were acute
      nonlymphocytic leukemias or myelodysplasia. In only one instance was cisplatin
      the sole antineoplastic drug given to patients. The routine use of cisplatin in
      conjunction with other known or suspected human carcinogens makes it impossible
      to use these anecdotal reports as a basis for assessing cisplatin's
      carcinogenicity in humans. Two quantitative epidemiologic studies have addressed
      this question: One suggested that the combination of cisplatin and doxorubicin is
      leukemogenic in humans, while the other implicated etoposide rather than
      cisplatin as the leukemogen. Formal epidemiologic studies of appropriate cohorts
      of cisplatin-treated patients are needed to resolve the question of its
      carcinogenicity in humans.

PMID- 1738181
TI  - Trends in cancer mortality in 15 industrialized countries, 1969-1986.
AB  - BACKGROUND: Assessing trends in cancer provides a means for gauging progress
      against the disease, estimating future demands for care and treatment, and
      suggesting clues about shifting causal factors that may account for the more
      recent changes. PURPOSE: This study was designed to evaluate trends in the major
      sites of cancer associated with high mortality rates in 15 industrialized
      countries. To highlight differences among regions, we grouped these countries
      into six geographic areas: United States, Eastern Europe, Western Europe, East
      Asia, Oceania, and Nordic countries. In addition, cancer mortality trends in
      these regions were compared with incidence patterns in the United States.
      METHODS: Data provided by the World Health Organization were used to evaluate age
      specific mortality trends from 1969 through 1986 for lung, breast, prostate,
      stomach, and colorectal cancers and for all other sites considered as a group. We
      also assembled and analyzed data from the Surveillance, Epidemiology, and End
      Results (SEER) Program of the National Cancer Institute for the same sites and
      age groups from 1973 through 1986. RESULTS: Over the period 1969 through 1986,
      recorded cancer mortality in persons aged 45 years and older in the six regions
      studied has increased for lung, breast, and prostate cancers in most age groups,
      while the decline in stomach cancer mortality is substantial. The increase in
      lung cancer deaths in men aged 45-54 years has slowed greatly or reversed in all
      areas except Eastern Europe and East Asia. Trends for intestinal cancer vary by
      age and region. For all other sites considered as a group, increases have
      occurred for persons older than 64 years in most regions. In Eastern Europe,
      there are disturbingly high rates and rapid increases for several of the major
      forms of cancer in persons aged 45-54 years. In general, trends for cancer
      incidence in the United States parallel those for mortality. For intestinal
      cancer, however, incidence has increased while mortality has declined.
      CONCLUSIONS: The trends we report cannot be explained solely by changes in
      cigarette smoking or aging. Other causes of changes in cancer incidence and
      mortality need to be determined. IMPLICATIONS: The increasing and decreasing
      trends in mortality from and incidence of cancer that we found are important for
      health care planning and may also suggest opportunities for research in cancer
      prevention.

PMID- 1738182
TI  - Fluorouracil combined with the pure (6S)-stereoisomer of folinic acid in high
      doses for treatment of patients with advanced colorectal carcinoma: a phase I-II
      study.
AB  - BACKGROUND: Potentiation of the antitumor activity of fluorouracil (5-FU) by
      folinic acid has been demonstrated in patients with colorectal adenocarcinoma.
      Modulation is due to the interaction of thymidylate synthase, fluorodeoxyuridine
      monophosphate, and methylene tetrahydrofolate, which leads to the formation of a
      stable ternary complex with concomitant enzyme inactivation. Folinic acid
      consists of a mixture of equal parts of two stereoisomers differing in chirality
      at the C-6 carbon of the pteridine ring. Only the levorotatory (6S)-stereoisomer
      of folinic acid is transformed into active folate cofactors. However, the (6R)
      stereoisomer of folinic acid is not inert; it was shown to interfere with the
      (6S) form at the cellular level. PURPOSE: The possibility of a deleterious effect
      of the unnatural stereoisomer on the modulation of 5-FU led us to carry out a
      phase I-II study of 5-FU combined with the (6S)-stereoisomer of folinic acid
      given in high doses for treatment of patients with advanced colorectal carcinoma.
      We also determined the plasma pharmacokinetics of folates after intravenous (IV)
      injection of (6S)-folinic acid at the dose used in this study. METHODS: Treatment
      consisted of 5-FU (350-550 mg/m2 per day by IV infusion for 2 hours) and (6S)
      folinic acid (100 mg/m2 per day by IV bolus injection) given for 5 consecutive
      days; the treatment was repeated every 21 days. Twenty-five patients with
      advanced colorectal carcinoma, who had had no prior chemotherapy, were evaluated
      for antitumor activity. The quantity of folates in plasma was measured using a
      microbiological assay. RESULTS: The median follow-up time was 9 months (range,
      3.5-15.2 months). The response rate was 52% (complete response, 12%; partial
      response, 40%). The median time to disease progression for responding patients
      was 9.2 months (range, 5.9-15+ months). The estimated probability of survival at
      12 months was 73%. Palliative improvement in quality of life was achieved in most
      patients who had symptoms due to the tumor before the start of treatment. The
      dose-limiting toxic effects were grade 3 diarrhea, dermatitis, and oral
      mucositis. Grade 4 toxicity did not occur. Myeloid toxicity was minor. After IV
      injection, (6S)-folinic acid was rapidly cleared from plasma (mean half-lives:
      alpha = 7.2 minutes and beta = 126 minutes). The mean concentration of the
      unchanged compound 2 hours after injection was 5.8 mumol/L. CONCLUSION: The (6S)
      form of folinic acid potentiates the antitumor effect of 5-FU given
      concomitantly. IMPLICATION: Our results justify a more complete exploration of
      the pure active stereoisomer as a modulator of the fluoropyrimidines.

PMID- 1738183
TI  - Long-term therapy with low-dose isotretinoin for prevention of basal cell
      carcinoma: a multicenter clinical trial. Isotretinoin-Basal Cell Carcinoma Study
      Group.
AB  - BACKGROUND: High-dose isotretinoin has been reported to have a prophylactic
      effect on nonmelanoma skin cancer, although it is associated with significant
      toxicity. PURPOSE: To test the effectiveness of the long-term administration of
      low-dose isotretinoin in reducing the occurrence of basal cell carcinoma at a new
      site in patients with previously treated basal cell carcinomas and to measure the
      toxicity associated with this regimen, we conducted a clinical trial at eight
      cancer centers. METHODS: Nine hundred and eighty-one patients with two or more
      previously confirmed basal cell carcinomas were randomly assigned to receive
      either 10 mg of isotretinoin or a placebo daily. Patients were followed for 36
      months and monitored at 6-month intervals for skin cancer and toxic effects.
      RESULTS: After 36 months of treatment, no statistically significant difference in
      either the cumulative percent of patients with an occurrence of basal cell
      carcinoma at a new site or the annual rate of basal cell carcinoma formation
      existed between patients receiving isotretinoin and those receiving the placebo.
      Elevated serum triglycerides, hyperostotic axial skeletal changes, and
      mucocutaneous reactions were more frequent in the group receiving isotretinoin
      than in the control group, and these differences were all statistically
      significant (P less than .001). CONCLUSION: This low-dose regimen of isotretinoin
      not only is ineffective in reducing the occurrence of basal cell carcinoma at new
      sites in patients with two or more previously treated basal cell carcinomas but
      also is associated with significant adverse systemic effects. IMPLICATION: The
      toxicity associated with the long-term administration of isotretinoin, even at
      the low dose used in this trial, must be weighted in planning future prevention
      trials.

PMID- 1738184
TI  - Delayed tumor onset in transgenic mice fed a low-folate diet.
AB  - BACKGROUND: Transgenic mice carrying the human T-lymphotropic virus type 1 tax1
      (transactivator) gene develop peripheral nerve sheath tumors with well
      characterized times of onset and tissue involvement. PURPOSE AND METHODS: To
      evaluate the effect of dietary folic acid on age at tumor onset and on the
      concentration of folate in tissues and tumors, we bred heterozygous transgenic
      mice and systematically assigned their offspring at weaning (within litters) to a
      2 x 2 x 2 factorial arrangement. The three variables studied were 1) the tax1
      gene (presence or absence), 2) gender (male or female), and 3) dietary level of
      folic acid (0.11 or 11.34 mumol folic acid per kilogram of controlled amino acid
      based diet). Blood and tissues were collected from tumor-bearing transgenic mice
      (prior to cachexia) and from nontransgenic littermates, matched whenever possible
      for gender and diet. RESULTS: Transgenic mice fed a diet containing 0.11 mumol of
      folic acid per kilogram developed tumors significantly later (92.8 +/- 6.4 days)
      than did those fed a diet containing 11.34 mumol of folic acid per kilogram (71.9
      +/- 3.9 days). Folate concentrations in tumors of mice fed the low-folate diet
      were approximately one third those in tumors of mice fed the higher folate diet.
      Brain folate concentrations in mice fed the low-folate diet were less than one
      half those in mice fed the higher folate diet. CONCLUSION: Results show that the
      onset of spontaneous tumors can be delayed by feeding mice the lowest level of
      folate adequate to meet nutritional requirements for normal growth. IMPLICATION:
      Transgenic animal models of human disease offer great potential for evaluating
      the role of micronutrients in human carcinogenesis.

PMID- 1738185
TI  - Detection of messenger RNA from O6-methylguanine-DNA methyltransferase gene MGMT
      in human normal and tumor tissues.
AB  - BACKGROUND: The level of the DNA repair protein O6-methylguanine-DNA
      methyltransferase is an important determinant of the response of tumor cells in
      culture to alkylating nitrosoureas. In these cells, the abundance of messenger
      RNA (mRNA) is directly correlated with repair activity. PURPOSE: Our purpose was
      to compare transferase mRNA levels with the repair activity in primary human
      tumors. METHODS: Human transferase mRNA was measured in tissue samples from brain
      tumors, normal lung, lung tumors, ovarian tumors, and normal human liver by use
      of an RNA protection assay with an antisense probe prepared from the cloned gene.
      RESULTS: Normal and tumor tissue samples from the same patient had similar
      transferase activity levels, but transferase expression varied widely among
      tissue samples from different patients. Brain and lung samples, on average, had
      transferase mRNA levels closer to those in liver samples than their transferase
      activity levels. In two cases, tissue samples which were transferase deficient by
      the activity assays were found to lack transferase mRNA. CONCLUSIONS:
      Deficiencies in transferase activity are due to reduced or absent mRNA
      transcription or processing. In brain and lung, there may be post-transcriptional
      control of mRNA expression. The wide interindividual variation in transferase
      expression is also seen at the transcription level. IMPLICATIONS: These are among
      the first measures of transferase mRNA expression in primary human tissue. More
      samples should be examined to extend these observations.

PMID- 1738186
TI  - Microculture-based chemosensitivity testing: a feasibility study comparing
      freshly explanted human melanoma cells with human melanoma cell lines.
AB  - BACKGROUND: The culture of cancer cells has many applications in chemosensitivity
      testing and new drug development. PURPOSE: Our goal was to adapt simple
      semiautomated microculture methods for testing the chemosensitivity of melanoma
      cells freshly recovered from patients' tumors. METHODS: Cells were cultured on a
      substrate of agarose and exposed continuously to cytotoxic drugs, the effects of
      which were measured by determining the uptake of [3H]thymidine 4-7 days later.
      RESULTS: Immunocytochemical staining of cells cultured with 5-bromo-2'
      deoxyuridine demonstrated that tumor cells were responsible for the measured
      thymidine incorporation. The effects of cytotoxic drugs were calculated as
      logarithmic 50% inhibitory concentrations and expressed as divergences from the
      mean in a log-mean graph. The inhibitory effects of amsacrine, etoposide,
      doxorubicin, cisplatin, mitomycin C, and fluorouracil were tested. Tumors
      differed widely in their sensitivity to these drugs, although sensitivity to the
      three topoisomerase-II-directed agents was highly correlated. Cells from two non
      neoplastic hematopoietic progenitor cell lines (FT and 32D) showed
      chemosensitivity patterns distinct from those in the melanoma cells, indicating
      tissue selectivity. Two established melanoma cell lines, MM-96 and FME, were
      tested under the same conditions and showed sensitivity typical of at least some
      fresh specimens. CONCLUSIONS: These results support the validity of melanoma cell
      lines as models of freshly resected melanoma cells. If successfully applied to
      other tumor types, such semiautomated approaches could find wide application in
      routine hospital laboratories for the chemosensitivity testing of patients' tumor
      cells.

PMID- 1738187
TI  - Optimal mastectomy timing.

PMID- 1738188
TI  - Reduced oral etoposide bioavailability in patients with advanced cancer of the
      head and neck.

PMID- 1738189
TI  - Soft-laser therapy for iatrogenic mucositis in cancer patients receiving high
      dose fluorouracil: a preliminary report.

PMID- 1738190
TI  - Prostate cancer incidence in cimetidine users.

PMID- 1738191
TI  - Extracellular Tax1 protein stimulates tumor necrosis factor-beta and
      immunoglobulin kappa light chain expression in lymphoid cells.
AB  - The human T-cell leukemia virus type I tax1 gene product is responsible for the
      increased expression of several cytokine and cellular genes that contain NF-kappa
      B regulatory sequences. Our laboratory has previously demonstrated that purified,
      extracellular Tax1 protein induced the nuclear accumulation of NF-kappa B binding
      activity in lymphoid cells. Since HTLV-I infection causes increased levels of
      lymphotoxin tumor necrosis factor-beta [TNF-beta] and immunoglobulin secretion,
      we have studied the interaction of NF-kappa B proteins from Tax1-stimulated cells
      with the TNF-beta and immunoglobulin kappa (Ig kappa) light chain genes. Tax1
      induction of NF-kappa B occurred in the presence of cycloheximide, and Tax1
      stimulation did not result in increased levels of NF-kappa B or c-rel RNA. These
      results indicate that new synthesis of NF-kappa B proteins was not required for
      induction of NF-kappa B-binding activity. With use of the Ig kappa NF-kappa B
      binding site as a probe, two distinct NF-kappa B gel shift complexes were induced
      by the Tax1 protein. A slower-migrating complex, C1, was inhibited by the
      addition of purified I kappa B. In contrast, the faster-migrating C2 complex was
      not inhibited by I kappa B, but C2 was increased by detergent treatment of
      cytoplasmic extracts, suggesting that its binding activity was also regulated by
      an inhibitor. The Tax1-stimulated proteins that interacted with the NF-kappa B
      binding sites in the Ig kappa and TNF-beta promoters were distinct. A 75-kDa
      protein preferentially associated with the Ig kappa NF-kappa B-binding site. In
      contrast, a 59-kDa protein associated with the TNF-beta NF-kappa B-binding site.
      Tax1 stimulation led to increased levels of TNF-beta and Ig kappa mRNA, as
      measured by reverse transcription and polymerase chain reaction analysis. These
      results represent the first experimental evidence that extracellular Tax1 can
      regulate the expression of endogenous cellular genes.

PMID- 1738192
TI  - Alpha interferon inhibits early stages of the human immunodeficiency virus type 1
      replication cycle.
AB  - In this study, we have analyzed the effect of human alpha interferon (IFN-alpha)
      on a single replication cycle of human immunodeficiency virus type 1 (HIV-1)
      infection in the lymphocytic cell line CEM-174, which is highly sensitive to the
      antiviral effects of IFN. Pretreatment of cells with 50 to 500 U of recombinant
      human IFN-alpha per ml resulted in a marked reduction in viral RNA and protein
      synthesis. The effect of IFN-alpha was dose dependent and was amplified in
      multiple infection cycles. IFN-induced inhibition of viral protein synthesis
      could be detected only when cells were treated with IFN-alpha prior to infection
      or when IFN-alpha was added up to 10 h postinfection, but not if IFN-alpha was
      added at the later stages of HIV-1 replication cycle or after the HIV-1 infection
      was already established. Analysis of the integrated HIV-1 provirus showed a
      marked decrease in the levels of proviral DNA in IFN-treated cells. Thus, in
      contrast to the previous studies on established HIV-1 infection in T cells, in
      which the IFN block appeared to be at the posttranslational level, during de novo
      infection, IFN-alpha interferes with an early step of HIV-1 replication cycle
      that occurs prior to the integration of the proviral DNA. These results indicate
      that the early IFN block of HIV-1 replication, which has been previously observed
      only in primary marcophages, can also be detected in the IFN-sensitive T cells,
      indicating that the early IFN block is not limited to macrophages.

PMID- 1738193
TI  - Identification of a novel gene, Vin-1, in murine leukemia virus-induced T-cell
      leukemias by provirus insertional mutagenesis.
AB  - The BL/VL3 radiation leukemia virus is a nondefective retrovirus which induces
      clonal or oligoclonal T-cell leukemia in mice. To study the role of provirus
      insertional mutagenesis in the development of these neoplasias, we searched for
      common provirus integration sites in BL/VL3 radiation leukemia virus-induced
      tumors. Using cellular sequences flanking a provirus cloned from one of these
      thymomas, we found that the viral genome was integrated into a common region,
      designated Vin-1, in a low percentage (5%) of these tumors. The proviruses found
      in this locus were integrated in the same orientation, close to a CpG-rich
      island, at proximity of a transcriptional unit encoding a 6-kb RNA. Vin-1 RNA was
      detected in several organs of the adult mouse. Vin-1 RNA levels were high in
      tumors having a provirus inserted within the Vin-1 region but were also high in
      some other tumors whose Vin-1 region was not found to be rearranged. Vin-1 was
      found to be well conserved among mammalian species and was mapped to mouse
      chromosome 6, between raf and K-ras-2. Vin-1 appears to be a novel gene which may
      be involved in tumor development.

PMID- 1738194
TI  - Biological phenotype of human immunodeficiency virus type 1 clones at different
      stages of infection: progression of disease is associated with a shift from
      monocytotropic to T-cell-tropic virus population.
AB  - The composition of human immunodeficiency virus type 1 (HIV-1) clonal populations
      at different stages of infection and in different compartments was analyzed.
      Biological HIV-1 clones were obtained by primary isolation from patient
      peripheral blood mononuclear cells under limiting dilution conditions, with
      either blood donor peripheral blood lymphocytes or monocyte-derived macrophages
      (MDM) as target cells, and the biological phenotype of the clones was analyzed.
      In asymptomatic individuals, low frequencies of HIV-1 clones were observed. These
      clones were non-syncytium inducing and preferentially monocytotropic. In
      individuals progressing to disease, a 100-fold increase in frequencies of
      productively HIV-1-infected cells was observed as a result of a selective
      expansion of nonmonocytotropic clones. In a person progressing to AIDS within 19
      months after infection, only syncytium-inducing clones were detected, shifting
      from MDM-tropic to non-MDM-tropic over time. From his virus donor, a patient with
      wasting syndrome, only syncytium-inducing clones, mostly non-MDM-tropic, were
      recovered. Parallel clonal analysis of HIV-1 populations in cells present in
      bronchoalveolar lavage fluid and peripheral blood from an AIDS patient revealed a
      qualitatively and quantitatively more monocytotropic virus population in the lung
      compartment than in peripheral blood at the same time point. These findings
      indicate that monocytotropic HIV-1 clones, probably generated in the tissues, are
      responsible for the persistence of HIV-1 infection and that progression of HIV-1
      infection is associated with a selective increase of T-cell-tropic,
      nonmonocytotropic HIV-1 variants in peripheral blood.

PMID- 1738195
TI  - Ribozymes which cleave arenavirus RNAs: identification of susceptible target
      sites and inhibition by target site secondary structure.
AB  - The development of safe and effective antiviral agents has been a slow process,
      largely because of the difficulty in distinguishing between virus and host
      functions; materials toxic to the virus are frequently harmful also to the host
      in which the agent resides. Recently, techniques which target nucleic acid
      sequences as a means of reducing gene expression have emerged. This antisense
      armamentarium includes ribozymes, RNA enzymes which cleave other RNA molecules in
      a sequence-specific manner. We wish to assess the ability of ribozymes to control
      animal virus infection. Reasoning that the viruses most vulnerable to ribozyme
      intervention will be those whose complete life cycle is based on RNA (with no DNA
      stage), we have begun to develop ribozymes directed toward lymphocytic
      choriomeningitis virus (LCMV), the prototype of the arenavirus family. Using
      ribozymes of the hammerhead variety, we have identified several sites on the LCMV
      genome which can be efficiently cleaved in trans. The efficiency of cleavage is
      site dependent, and we demonstrate that secondary structure at the target site
      can abolish ribozyme cleavage. Computer-assisted analysis indicates that much of
      the LCMV genome may be involved in base pairing, which may render it similarly
      resistant to ribozyme attack. The few remaining open regions of LCMV lack a GUC
      target site, on which most studies to date have relied. Here we show that AUC,
      CUC, and AUU are alternative sites which can be cleaved by trans-acting
      ribozymes. This finding is important given the aforementioned restriction of
      available sites, imposed by secondary structure.

PMID- 1738196
TI  - Tacaribe arenavirus RNA synthesis in vitro is primer dependent and suggests an
      unusual model for the initiation of genome replication.
AB  - A Tacaribe virus in vitro system for RNA synthesis was established and found in
      large part to faithfully reproduce RNA synthesis in vivo. Similar to influenza
      virus and bunyavirus in vitro systems, this system was also highly dependent on
      added oligonucleotides. Of the eight tested, only three were active, in the order
      GpC greater than CpG greater than ApApC. Determination of the 5' ends of the
      transcripts suggested that the oligonucleotides were acting as primers. In
      particular, whereas stimulation with CpG (complementary to positions +1 and +2 of
      the template) led to RNAs whose 5' ends were at position +1 as expected, GpC
      stimulation led to transcripts whose 5' ends were at position -1 rather than at
      position +2, as GpC is complementary to positions +2 and +3 of the template. This
      finding suggests a model for the initiation of genome replication in which pppGpC
      is first made on the template at positions +2 and +3 but slips backwards on the
      template so that the 5' end is at position -1 before elongation can continue.

PMID- 1738197
TI  - Rapid resolution of duck hepatitis B virus infections occurs after massive
      hepatocellular involvement.
AB  - A study was carried out to determine some of the factors that might distinguish
      transient from chronic hepadnavirus infection. First, to better characterize
      chronic infection, Pekin ducks, congenitally infected with the duck hepatitis B
      virus (DHBV), were used to assess age-dependent variations in viremia, percentage
      of DHBV-infected hepatocytes, and average levels of DNA replication intermediates
      in the cytoplasm and of covalently closed circular DNA in the nuclei of infected
      hepatocytes. Levels of viremia and viral DNA were found to peak at about the time
      of hatching but persisted at relatively constant levels in chronically infected
      birds up to 2 years of age. The percentage of infected hepatocytes was also
      constant, with DHBV replication in virtually 100% of hepatocytes in all birds.
      Next, we found that adolescent ducks inoculated intravenously with a large dose
      of DHBV also developed massive infection of hepatocytes with an early but low
      level viremia, followed by rapid development of a neutralizing antibody response.
      No obvious quantitative or qualitative differences between transiently and
      chronically infected liver tissue were detected in the intracellular markers of
      viral replication examined. However, in the adolescent duck experiment, DHBV
      infection was rapidly cleared from the liver even when up to 80% of hepatocytes
      were initially infected. In all of these ducks, clearance of infection was
      accompanied by only a mild hepatitis, with no evidence that massive cell death
      contributed to the clearance. This finding suggested that mechanisms in addition
      to immune-mediated destruction of hepatocytes might make major contributions to
      clearance of infections, including physiological turnover of hepatocytes in the
      presence of a neutralizing antibody response and/or spontaneous loss of the
      capacity of hepatocytes to support virus replication.

PMID- 1738198
TI  - LRV1 viral particles in Leishmania guyanensis contain double-stranded or single
      stranded RNA.
AB  - The 32-nm-diameter spherical viral particles found in the cytoplasm of Leishmania
      guyanensis CUMC1-1A sediment at 130S and have a buoyant density of approximately
      1.4 g/ml in cesium chloride gradients. These particles contain a 5.3-kb double
      stranded RNA, while single-stranded RNA that corresponds to the viral positive
      strand is associated with less-dense particles. These results suggest a
      conservative and sequential mode of LRV1 viral RNA replication that is
      exemplified by the ScV L-A virus of yeast.

PMID- 1738199
TI  - Identification of membrane antigen C33 recognized by monoclonal antibodies
      inhibitory to human T-cell leukemia virus type 1 (HTLV-1)-induced syncytium
      formation: altered glycosylation of C33 antigen in HTLV-1-positive T cells.
AB  - We isolated four monoclonal antibodies (MAbs), M38, M101, M104, and C33, which
      were capable of inhibiting syncytium formation induced in a human T-cell line,
      MOLT-4-#8, by coculture with human T-cell leukemia virus type 1 (HTLV-1)-positive
      human T-cell lines. The MAbs had, however, no inhibitory activity on syncytium
      formation induced in a human osteosarcoma line, HOS, by HTLV-1-positive T-cell
      lines. They also did not inhibit syncytium formation induced in MOLT-4-#8 by
      human immunodeficiency virus type 1-positive MOLT-4. All MAbs reacted with
      various human cell lines of lymphoid and nonlymphoid origins, including HTLV-1
      positive T-cell lines. Furthermore, they all reacted with a murine A9 clone
      containing human chromosome 11 fragment q23-pter. Two MAbs, M104 and C33,
      immunoprecipitated a membrane antigen with the same molecular size. The antigen
      (henceforth called C33 antigen) was about 40 to 55 kDa in HTLV-1-negative Jurkat,
      CEM, MOLT-4, and normal peripheral blood CD4-positive human T cells and about 40
      to 75 kDa in HTLV-1-positive C91/PL, TCL-Kan, MT-2, and in fresh HTLV-1
      transformed CD4-positive human T-cell lines. Pulse-chase experiments revealed
      that C33 antigen was synthesized as a 35-kDa precursor that was then processed to
      41 to 50 kDa in MOLT-4 and to 44 to 70 kDa in C91/PL. In the presence of
      tunicamycin, a 28-kDa protein was synthesized. The conversion from 35 kDa to 41
      to 50 kDa in MOLT-4 and to 44 to 70 kDa in C91/PL was inhibited by monensin.
      Treatment with N-glycanase alone, but not with sialidase and O-glycanase in
      combination, completely removed the sugar moiety of C33 antigen from both HTLV-1
      negative Jurkat and HTLV-1-positive C91/PL. Therefore, C33 antigen has only N
      linked carbohydrates, the modification of which appears to be substantially
      altered in the presence of the HTLV-1 genome.

PMID- 1738200
TI  - Functional characterization of a U5 ribozyme: intracellular suppression of human
      immunodeficiency virus type 1 expression.
AB  - We have designed a ribozyme that cleaves human immunodeficiency virus type 1 (HIV
      1) RNA in U5 (at nucleotide +115). This ribozyme was tested in vitro and was
      found to give efficient and specific digestion of RNA containing the HIV-1 U5
      sequence. When the U5 ribozyme was placed into the HIV-1 genome, virus
      replication was suppressed in tissue culture. Introduction of this ribozyme into
      cells by using an amphotropic retrovirus vector significantly reduced expression
      of U5-containing RNA in cells chronically infected with HIV-1. Naive T cells were
      cocultivated with packaging cells that produce defective amphotropic retroviruses
      containing the U5 ribozyme. These lymphocytes were found to be partially
      protected from HIV-1 infection.

PMID- 1738201
TI  - Differential expression of Hz-1 baculovirus genes during productive and
      persistent viral infections.
AB  - Hz-1 viral RNA transcription was studied during productive and persistent
      infections. The RNAs were localized to 10- to 30-kb regions within the viral
      genome, and the timing of their expression was determined. During productive
      infections, we detected 101 virus-specific transcripts that could be grouped into
      three categories by time of appearance. At 2 h postinoculation (p.i.), a total of
      34 virus-specific transcripts were detected. An additional 51 and 16 virus
      specific transcripts appeared between 4 and 6 h p.i. and at 8 h p.i.,
      respectively. After 8 h, no new transcripts were found. Under conditions of
      persistent infection, we detected only one viral persistency-associated
      transcript (PAT1). The region of the viral DNA which encodes PAT1 was cloned.
      During productive infections, three transcripts were derived from this region.
      Each had the same polarity as PAT1. One of them was of the same size as PAT1 and
      had similar, if not identical, 3' and 5' ends. This report provides detailed and
      very useful information concerning sequentially expressed transcripts of the Hz-1
      baculovirus.

PMID- 1738202
TI  - Structure and assembly of hemagglutinin mutants of fowl plague virus with
      impaired surface transport.
AB  - Five temperature-sensitive mutants of influenza virus A/FPV/Rostock/34 (H7N1),
      ts206, ts293, ts478, ts482, and ts651, displaying correct hemagglutinin (HA)
      insertion into the apical plasma membrane of MDCK cells at the permissive
      temperature but defective transport to the cell surface at the restrictive
      temperature, have been investigated. Nucleotide sequence analysis of the HA gene
      of the mutants and their revertants demonstrated that with each mutant a single
      amino acid change is responsible for the transport block. The amino acid
      substitutions were compared with those of mutants ts1 and ts227, which have been
      analyzed previously (W. Schuy, C. Will, K. Kuroda, C. Scholtissek, W. Garten, and
      H.-D. Klenk, EMBO J. 5:2831-2836, 1986). With the exception of ts206, the changed
      amino acids of all mutants and revertants accumulate in three distinct areas of
      the three-dimensional HA model: (i) at the tip of the 80-A (8-nm)-long alpha
      helix, (ii) at the connection between the globular region and stem, and (iii) in
      the basal domain of the stem. The concept that these areas are critical for HA
      assembly and hence for transport is supported by the finding that the mutants
      that are unable to leave the endoplasmic reticulum at the nonpermissive
      temperature do not correctly trimerize. Upon analysis by density gradient
      centrifugation, cross-linking, and digestion with trypsin and endoglucosaminidase
      H, two groups can be discriminated among these mutants: with ts1, ts227, and
      ts478, the HA forms large irreversible aggregates, whereas with ts206 and ts293,
      it is retained in the monomeric form in the endoplasmic reticulum. With a third
      group, comprising mutants ts482 and ts651 that enter the Golgi apparatus,
      trimerization was not impaired.

PMID- 1738203
TI  - In vitro resolution of poxvirus replicative intermediates into linear
      minichromosomes with hairpin termini by a virally induced Holliday junction
      endonuclease.
AB  - Available evidence suggests that one or more late viral gene products are
      involved in processing poxvirus replicative intermediates into mature progeny
      hairpin-terminated genomes. Cloned versions of the Shope fibroma virus (SFV)
      replicated telomere in the inverted repeat configuration were used as substrates
      to assay lysates from poxvirus-infected cells for protein fractions that
      participate in the resolution of the circular substrate plasmid into a linear
      minichromosome with viral hairpin termini. An activity in a crude protein
      fraction obtained from vaccinia virus-infected cells at late times during the
      replicative cycle was capable of accurately resolving all poxviral inverted
      repeat replicative intermediates tested. The resolved linear products are
      identical to the products of in vivo resolution and possessed symmetrical nicks
      which mapped at the borders of the inverted repeat sequence. Strand-specific
      nicks were also identified, which mapped within the telomere resolution target
      sequence known to be required for telomere resolution in vivo. The resolving
      activity that we have identified is specific to virus-infected cells at late
      times during replication and cleaves cloned poxviral telomeric substrates in a
      fashion expected of a classic Holliday junction-resolving enzyme in addition to
      possessing a telomere resolution target-specific nicking activity. Although a
      Holliday junction-resolving activity would also be expected to play a role in the
      recombination induced by poxvirus infection, the appearance of the activity
      described here only after the commencement of viral late protein synthesis
      suggests that it functions strictly at late times. Other non-viral Holliday
      junction analogs can also be cleaved by this extract, suggesting that this
      component of the resolution activity may also play a role in other viral
      processes that require cleavage of a branched DNA structure. Thus, we have
      identified a poxviral activity that may be a part of a protein complex which
      resolves concatemeric replicative intermediates of viral DNA as well as
      participate in general recombination late during infection.

PMID- 1738204
TI  - Identification and characterization of an extracellular envelope glycoprotein
      affecting vaccinia virus egress.
AB  - Sequence analysis of the vaccinia virus strain Western Reserve genome revealed
      the presence of an open reading frame (ORF), SalL4R, which has the potential to
      encode a transmembrane glycoprotein with homology to C-type animal lectins (G. L.
      Smith, Y. S. Chan, and S. T. Howard, J. Gen. Virol. 72:1349-1376, 1991). Here we
      show that the SalL4R gene is transcribed late during infection from a TAAATG
      motif at the beginning of the ORF. Antisera raised against a TrpE-SalL4R fusion
      protein identified three glycoprotein species of Mr 22,000 to 24,000 in infected
      cells. Immunogold electron microscopy demonstrated that SalL4R protein is present
      in purified extracellular enveloped virus particles but not in intracellular
      naked virus (INV). A mutant virus was constructed by placing a copy of the SalL4R
      ORF downstream of an isopropyl-beta-D-thiogalactopyranoside (IPTG)-inducible
      vaccinia virus promoter within the thymidine kinase locus and subsequently
      deleting the endogenous SalL4R gene. The growth kinetics of this virus
      demonstrated that SalL4R was nonessential for the production of infectious INV
      but was required for virus dissemination. Consistent with this finding, the
      formation of wild-type-size plaques by this mutant was dependent on the presence
      of IPTG. Electron microscopy showed that without SalL4R expression, the inability
      of the virus to spread is due to a lack of envelopment of INV virions by Golgi
      derived membrane, a morphogenic event required for virus egress.

PMID- 1738205
TI  - Persistent infection of normal mice with human immunodeficiency virus.
AB  - In this article, we report the establishment of persistent HIV type 1 infection
      of normal Swiss mice after a single intraperitoneal injection with high-producing
      HIV-infected U937 cells. Anti-HIV antibodies were found more than 500 days after
      the original injection, and p24 antigenemia was detected in approximately 50% of
      the mice. By polymerase chain reaction (PCR) techniques, HIV-specific gag and env
      sequences were detected in DNA samples from peripheral blood mononuclear cells
      (PBMC) and peritoneal cells of seropositive mice 300 to 500 days after
      inoculation with HIV-infected cells. These DNA samples did not contain human DNA
      sequences, as determined by PCR analysis using primers and the probe for the HLA
      DQ alpha gene. Low levels of p24 and detectable human reverse transcriptase
      activity were found in cultures of PBMC and peritoneal macrophages. Cocultivation
      of PBMC, peritoneal cells, and spleen cells with human uninfected U937 or CEM (a
      T lymphoma cell line) cells resulted in HIV infection of the target cells, as
      determined by PCR analysis and/or p24 assays. The intravenous injection of
      untreated Swiss mice with the PBMC from PCR-positive mice resulted in the
      development of an increasing antibody response to HIV in the recipient animals.
      Together these results indicate that cells from seropositive Swiss mice were
      persistently infected with HIV and were capable of producing infectious virus.
      The development of persistent HIV infection in an immunocompetent mouse may
      represent the starting point for further studies aimed at defining the host
      mechanisms involved in the restriction of virus replication, defining the
      pathogenesis of HIV infection, and testing antiviral compounds and vaccines.

PMID- 1738206
TI  - Binding of a host cell nuclear protein to the stem region of human
      immunodeficiency virus type 1 trans-activation-responsive RNA.
AB  - Human immunodeficiency virus type 1 (HIV-1) transcription is regulated by both
      viral and host cell factors. Although the viral trans-activator protein, Tat, and
      its cis-responsive element, trans-activation-responsive (TAR) RNA, have been
      identified and characterized, the mechanism of HIV-1 transcriptional regulation
      has not been satisfactorily described. Whereas Tat is necessary to activate
      transcription, additional factors, derived from the host cell, are important in
      regulating HIV-1 transcription. To identify such host cell-specific factors, we
      used an RNase protection mobility shift assay and UV cross-linking to detect a
      140-kDa HeLa cell nuclear protein that binds specifically to TAR RNA. By
      extensive mutational analysis, we determined that the binding of this protein is
      dependent on both the sequence and the structure of the TAR RNA stem region.
      Other groups have shown that the production of prematurely terminated transcripts
      from the HIV-1 promoter is also dependent on the sequence and structure of the
      TAR RNA stem. This correlation with our results suggests that the TAR RNA stem
      binding protein is involved in the production of prematurely terminated
      transcripts from the HIV-1 promoter and in the regulation of HIV-1 gene
      expression.

PMID- 1738207
TI  - Irreversible modification of measles virus RNA in vitro by nuclear RNA-unwinding
      activity in human neuroblastoma cells.
AB  - The matrix (M) gene of a measles virus (MV) variant passaged in IMR-32 human
      neuroblastoma cells displays numerous uridine-to-cytosine transitions called
      biased hypermutation. Using an in vitro assay, we show that IMR-32 cells contain
      high levels of an activity which unwinds and irreversibly alters the base pairing
      of double-stranded RNA synthesized from the M gene of MV. This activity is found
      exclusively in the cellular nucleus and is present at a lower level in African
      green monkey kidney Vero cells. Experiments with mixed cell extracts suggest that
      the low activity in Vero cells is not due to inhibitory factors. These findings
      support the hypothesis that this RNA-modifying and -unwinding activity is
      responsible for biased hypermutation of MV strains that infect the central
      nervous system. Possible functions of this neural cell activity and implications
      for central nervous system disorders are discussed.

PMID- 1738208
TI  - A chimera of EBNA1 and the estrogen receptor activates transcription but not
      replication.
AB  - DNA replication from the plasmid origin of replication of Epstein-Barr virus
      requires one viral protein, EBNA1. This protein also acts as a transcriptional
      activator. Mutational analyses of EBNA1 have led to the conclusion that it
      supports transcription and DNA replication similarly. Such analyses have not
      probed the DNA-binding domain of EBNA1. To test whether domains of EBNA1
      specifically required for either transcription or replication lie within its DNA
      binding domain, we constructed a functional transcriptional activator by placing
      the EBNA1 DNA-binding domain in the context of the activation domains of the
      estrogen receptor. This hybrid protein did not support DNA replication, which
      indicates that the DNA-binding domain does not contain a replication-specific
      domain that can function along with heterologous transcriptional activating
      domains.

PMID- 1738209
TI  - Mutational analysis of conserved N-linked glycosylation sites of human
      immunodeficiency virus type 1 gp41.
AB  - Amino acid substitutions were introduced into four conserved N-linked
      glycosylation sites of the human immunodeficiency virus type 1 envelope
      transmembrane glycoprotein, gp41, to alter the canonical N-linked glycosylation
      sequences. One altered site produced a severe impairment of viral infectivity,
      which raises the possibility that N-linked sugars at this site may have an
      important role in the human immunodeficiency virus type 1 life cycle.

PMID- 1738211
TI  - Effect of short-chain fatty acids on colonic function and structure.
AB  - Short-chain fatty acids (SCFA), fermentation products of fiber, are believed to
      play a role in intestinal adaptation. Although the administration of fiber or the
      infusion of SCFA has been shown to cause colonic growth, studies have been done
      primarily in enterally fed animals. In addition, the effects of SCFA on
      absorptive function have not been determined. Adult male rats were maintained on
      total parenteral nutrition (TPN) and, in addition, received either 150 mmol/L of
      saline or 150 mmol/L of SCFA mixture (60:25:15, acetate:propionate:butyrate) into
      the proximal colon. One week later, the in vivo absorption of water,
      electrolytes, and 20 mmol/L of butyrate was measured. After the rats were killed,
      parameters of colonic mass were determined. SCFA infusion into the colon had no
      significant effect on absorptive function. However, significantly greater mucosal
      height (p less than .01) and mucosal DNA (p less than .05), were observed.
      Although SCFA has a modest effect on colonic structure, they do not influence
      absorptive function in TPN rats.

PMID- 1738210
TI  - Efficient replication of human immunodeficiency virus type 1 requires a threshold
      level of Rev: potential implications for latency.
AB  - The Rev protein of human immunodeficiency virus type 1 (HIV-1) is essential for
      the expression of the structural genes of HIV-1. To determine whether a
      functional threshold level of Rev is required to allow efficient HIV-1
      replication, CD4-positive HeLa cells, constitutively expressing a Rev-deficient
      provirus, were transfected with various quantities of a Rev-expressing plasmid.
      Compared with the quantity of the Rev-producing plasmid transfected, HIV-1
      replication was distinctly nonlinear as measured by HIV-1 p24 antigen and HIV-1
      specific RNA production. A quantitative RNA polymerase chain reaction (PCR)
      demonstrated that Rev mRNA expression was linearly correlated with the quantity
      of Rev-expressing plasmid which was transfected into these cells. These data
      suggest that a critical threshold of Rev is required for a highly productive HIV
      1 infection. This threshold level of Rev may be involved in the generation and
      maintenance of HIV-1 proviral latency.

PMID- 1738212
TI  - Nutritional and metabolic response to acute spinal-cord injury.
AB  - The metabolic response to complete spinal cord injury was prospectively studied
      in 10 patients with Frankel class A spinal cord injury. Weekly excretory and
      balance studies profile the changes in nitrogen, calcium, and 3-methylhistidine
      excretion in relation to body weight and metabolic rate. The initial resting
      energy expenditures were 10% below what was predicted, and body weight decreased
      by 10%. Nitrogen excretion paralleled the changes in body weight. Calcium
      excretion increased for 3 weeks and reached a plateau 150% above baseline. Our
      results chronicle the magnitude of metabolic response to spinal shock. Comparison
      with reported values shows this response exceeds that seen in immobilized
      patients. Nitrogen excretion rose to levels seen in highly stressed patients and
      must be considered in the management of patients with acute spinal-cord injury.

PMID- 1738213
TI  - Effect of intravenous fat on cholecystokinin secretion and gallbladder motility
      in man.
AB  - During total parenteral nutrition (TPN) gallbladder bile stasis and hypomotility
      have been well documented. Little is known, however, about the effect of the
      separate components of TPN on gallbladder motor function. Inasmuch as fat,
      administered intraduodenally, is a potent stimulus of cholecystokinin (CCK)
      secretion and gallbladder contraction we have investigated whether intravenous
      (IV) fat affects gallbladder motility. Six healthy volunteers were studied on two
      separate occasions, during infusion of Intralipid 10%, 200 mL/h or saline
      infusion (control) for 3 hours, to evaluate the effect of IV infusion of fat on
      (1) plasma CCK concentration and gallbladder volume and (2) CCK-induced
      gallbladder emptying. Intravenous infusion of Intralipid resulted in significant
      increases in serum triglycerides from 0.9 +/- 0.1 to 5.1 +/- 1.3 mmol/L (at 90
      min). During fat infusion no significant changes in plasma CCK and gallbladder
      volume were noted when compared with basal values or to the control experiment.
      During IV fat, concomitant infusion of 0.25, 0.5, and 1.0 Ivy dog unit (IDU) per
      kilogram per hour of CCK-33 resulted in a significant reduction in gallbladder
      volume from 26 +/- 6 cm3 (basal) to 15 +/- 4 cm3 (p less than .05), 6 +/- 2 cm3
      (p less than .05) and 2.5 +/- 1 cm3 (p less than .05), respectively. No
      significant differences in CCK-induced gallbladder emptying were observed between
      IV fat and saline infusion (control). It is concluded that, in contrast to
      intraduodenal fat, IV infusion of fat does not affect (1) basal plasma CCK and
      gallbladder volume and (2) CCK-induced gallbladder contraction.

PMID- 1738214
TI  - Comparison of tolerance and nutritional outcome between a peptide and a standard
      enteral formula in critically ill, hypoalbuminemic patients.
AB  - Dipeptides have been reported to be more efficiently absorbed from the
      gastrointestinal tract than free amino acids. The objective of this study was to
      compare prospectively a peptide enteral formula (PEF) with a standard enteral
      formula (SEF) for tolerance and nutritional outcome in acutely injured,
      hypoalbuminemic (less than 3.0 g/dL) patients who require enteral nutrition
      support. The prevalence of diarrhea and elevated gastric residuals was assessed
      daily. Prealbumin, transferrin, colloid oncotic pressure, Prognostic Nutritional
      Index, and nitrogen balance were measured on days 0, 5, and 10 of enteral
      nutrition support. Forty-one patients received 345 days of enteral nutrition
      support. Prevalences of diarrhea and elevated gastric residuals were similar
      between groups. Prealbumin increased and the Prognostic Nutritional Index
      decreased significantly from baseline at day 10 in both groups. Transferrin
      increased in both groups, but not significantly. Colloid oncotic pressure
      increased significantly from baseline at days 5 and 10 in the SEF group and day
      10 in the PEF group. Nitrogen balance increased significantly from baseline at
      days 5 and 10 in each group. The only significant difference between groups was
      for nitrogen balance at day 10, which was higher in the SEF group. We conclude
      based upon our selected measurements of tolerance and nutritional outcome PEF
      seems to offer no advantage over SEF in acutely injured, hypoalbuminemic
      patients.

PMID- 1738215
TI  - Protein malnutrition alone and in combination with endotoxin impairs systemic and
      gut-associated immunity.
AB  - Because protein-malnourished or endotoxemic patients are at an increased risk of
      developing nosocomial infections, this study was performed to investigate the
      effects of protein malnutrition and endotoxemia, alone and in combination, on
      systemic and intestinal immunity. Protein malnutrition was created by feeding the
      animals a solid diet containing 0.03% protein. Subgroups of these protein
      malnourished mice were killed after being challenged with saline or endotoxin on
      days 0, 7, 14, or 21. At death, the animals were weighed, tissues were harvested
      for histologic analysis (ileum, mesenteric lymph node [MLN], liver, and spleen),
      mitogen responsiveness (MLN, Peyer's patches, and spleen), and xanthine oxidase
      measurements (ileum and cecum). Separate groups were evaluated for survival. Both
      the saline and endotoxin-challenged mice had lost about 30% of their body weight
      after 21 days on the low-protein diet. The protein-malnourished mice were more
      susceptible to endotoxin-induced mortality (70% at 21 days) than the normally
      nourished mice (0%) (p less than .001). The mitogen responsiveness of the protein
      malnourished mice to the T-cell mitogens (PHA and Con-A) progressively decreased
      the longer the mice were protein malnourished, and this decreased in blastogenic
      responsiveness was associated with histologic evidence of lymphoid atrophy. In
      contrast, the blastogenic response to the primarily B-cell mitogen, PWM, was
      largely preserved. The endotoxin challenge further depressed the immune state of
      mice tested after 0, 7, or 14 (but not 21) days of protein malnutrition. Thus,
      both protein malnutrition and endotoxin impaired systemic and gut-associated
      immune responsiveness to mitogens. However, in the protein-malnourished mice, the
      degree of immune suppression did not correlate with endotoxin-induced mortality.

PMID- 1738216
TI  - Use of even-numbered carbon atom dicarboxylic salts in parenteral nutrition as
      fuel substrate.
AB  - Sebacic acid (C10), a saturated, straight-chain dicarboxylic acid with 10 carbon
      atoms in disodic salt form, was given intravenously to two groups of healthy male
      volunteers in order to evaluate its possible use in total parenteral nutrition.
      The first group, composed of six subjects, received 1000 mg of sebacate as a
      bolus; six other subjects (second group) received 10 g of sebacate dissolved in
      500 mL of double-distilled water at an infusion rate of 3.33 g/h over 3 hours.
      The serum sebacate data for each subject were analyzed by computer, using
      biexponential fit corresponding to a 2-compartment open model. The distribution
      half-life (t1/2) was 0.34 +/- 0.06 hour and the elimination phase was rather
      rapid (Ke = 2.10 +/- 0.38/h); the volume of the central compartment was 2.79 +/-
      0.54 L and the volume of tissue compartment 3.72 +/- 0.14 L. These data showed a
      good tissue fixation of sebacate. The plasma clearance was evaluated to be 5.96
      +/- 2.19 L/h and the renal clearance was 19.22 +/- 10.69 L/h, indicating that a
      tubular secretion of C10 takes place. The serum concentration of sebacate raised
      to the maximal value at the end of the infusion (180 minutes), corresponded to
      480.50 +/- 43.02 micrograms/mL. Respiratory and metabolic parameters were
      evaluated by indirect calorimetry from the beginning of the infusion for 210
      minutes. The O2 consumption (VO2 mL/min per square meter) remained essentially
      unchanged throughout the experiment (from 154.3 +/- 28.3 at 0 to 155.3 +/- 39.5
      at time 180 minutes).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738217
TI  - Effect of rate of enteral nutrient supply on gut mass.
AB  - Early enteral feeding after injury is important for maintenance of gut integrity.
      However, enteral nutrients are frequently administered at low rates because of
      decreased gastrointestinal motility. These low rates are said to "maintain the
      gut." This study was performed to evaluate the effect of rate of enteral nutrient
      delivery on gut mass. Six male Sprague-Dawley rats had no surgery and served as
      controls (ad libitum rat chow diet). Twenty-four male Sprague-Dawley rats
      underwent abdominal surgery for placement of gastroduodenal feeding tubes (tip
      located 2 cm into intestine from pylorus) and were randomized (n = 6 per group)
      to ad libitum rat chow, 1/2 strength peptide diet (Reabilan HN, RHN) at 1 mL/h
      (1/2RHN-1 mL), full-strength peptide diet at 2 mL/h (RHN-2 mL), or full-strength
      peptide diet at 4 mL/h (RHN-4 mL). These diets supplied approximately 30%, 13%,
      50%, and 100% of rat recommended daily allowances. The control animals gained
      weight (38 +/- 3 g over 5 days) whereas all postsurgery animals lost weight.
      Weight loss was greatest in the 1/2 RHN-1 mL (-55 +/- 3 g over 5 days) and RHN-2
      mL (-52 +/- 6 g over 5 days) groups compared with the RHN-4 mL animals (-41 +/- 5
      g over 5 days). All animals fed liquid enteral diets had reduced gut weights
      compared with chow-fed animals. Gut weights did not differ between control and
      postsurgery ad libitum chow animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738218
TI  - Effect of short-chain fatty acids on the human colonic mucosa in vitro.
AB  - Fermentable dietary fiber components are known to stimulate colonic crypt
      proliferation. As these compounds are rapidly degraded to short-chain fatty acids
      (SCFAs) by the anaerobic microflora, the hypothesis was tested that this trophic
      effect of fiber may be mediated by SCFAs. Biopsies were taken from normal cecal
      mucosa of 45 individuals during routine colonoscopy. They were incubated for 3
      hours with sodium salts of SCFAs at physiological concentrations (three SCFAs =
      acetate 60 mmol/L + propionate 25 mmol/L + butyrate 10 mmol/L; acetate 60 mmol/L;
      propionate 25 mmol/L; butyrate 10 mmol/L) or equimolar NaCl (control). Cell
      proliferation was measured autoradiographically by subsequent pulse labeling with
      [3H]thymidine (1 hour). The labeling index (number of labeled cells divided by
      the total number of cells) was computed for the crypt as a whole and for five
      equal crypt compartments (compartment 1 = crypt base, compartment 5 = crypt
      surface). Cecal crypt proliferation was raised significantly in all incubation
      experiments with SCFAs. Butyrate (10 mmol/L, increase + 89%) and propionate (25
      mmol/L, + 70%) were as effective in stimulating proliferation as the combination
      of three SCFAs (+103%), although the effect of acetate (+31%) was minor.
      Increasing the butyrate concentration to 25 mmol/L or 60 mmol/L did not result in
      a further increase of cell labeling. SCFAs stimulated proliferation in the basal
      three crypt compartments only. An expansion of the proliferative zone to
      compartments 4 and 5 was not observed. SCFAs, especially butyrate and propionate,
      are luminal trophic factors for the cecal epithelium.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1738219
TI  - Concurrent administration of albumin with total parenteral nutrition in sick
      newborn infants.
AB  - The effects of concurrent administration of albumin with total parenteral
      nutrition were studied in 12 premature newborns (birth weight 1.26 +/- 0.1 kg
      [mean +/- SEM] and gestational age 30 +/- 0.8 weeks [mean +/- SEM]) compared with
      a control group of 12 premature newborns (birth weight 1.17 +/- 0.2 kg and
      gestational age 29 +/- 0.1 weeks) who received total parenteral nutrition. All
      newborns had a plasma albumin level below 3 g/dL and were in cardiorespiratory
      distress requiring assisted ventilation. Albumin supplementation of total
      parenteral nutrition resulted in a sustained increase in serum albumin
      concentration as well as increased mean arterial blood pressures in the study
      group. Slow albumin infusion had no observed effect on the severity of
      respiratory distress. Study group infants regained birth weight earlier than
      control group infants. These data suggest that the concurrent administration of
      albumin may be clinically beneficial in critically ill newborn infants.

PMID- 1738220
TI  - Glucose metabolism and thermogenesis during glucose and insulin infusion in
      severely underweight patients.
AB  - This study investigates the effects of gross loss of body weight on glucose
      disposal (GD), storage (GS), oxidation (GO), and the thermogenic response (TR)
      during hyperinsulinemic euglycemic glucose infusion in 9 underweight but
      nourished patients (UP) and in 3 of the patients after weight gain (WGP). In UP,
      baseline metabolic rate (MR) was 4.1 +/- 0.2 kJ/min and respiratory exchange
      ratio (RER) 0.97 +/- 0.02. During the final 30 minutes of hyperinsulinemia MR
      rose by 0.32 +/- 0.07 kJ/min (p less than .01) and RER rose to 1.09 +/- 0.03 (p
      less than .01). GD was 61 +/- 3 mumol/kg per minute, GO 35 +/- 1 mumol/kg per
      minute, and GS 26 +/- 4 mumol/kg per minute. The energy cost of glucose storage
      as glycogen was 0.15 kJ/min, and as lipid was 0.2 kJ/min. In WGP baseline MR was
      4.5 +/- 0.4 kJ/min and RER was 0.91 +/- 0.03. During hyperinsulinemia MR rose by
      0.63 +/- 0.2 kJ/min, RER rose to 0.93 +/- 0.02, GD was 53 +/- 4 mumol/kg per
      minute, GO was 30 +/- 3 mumol/kg per minute, and GS was 23 +/- 1 mumol/kg per
      minute. The energy cost for this glucose storage was 0.22 kJ/min. Therefore,
      during hyperinsulinemia in UP, GD, and TR are similar, but GO is greater and GS
      is less than previously reported in healthy subjects. However, this TR is
      entirely accounted for by the energy cost of glucose storage with no evidence of
      facultative thermogenesis. In WGP, all responses were similar to those in healthy
      subjects, and the TR was in excess of that required of the energy cost of glucose
      storage.

PMID- 1738221
TI  - Platelet glutathione peroxidase activity in long-term total parenteral nutrition
      with and without selenium supplementation.
AB  - Selenium (Se) is not routinely included in total parenteral nutrition (TPN)
      solution; thus, patients receiving long-term TPN may be at risk of Se deficiency,
      which may cause fatal cardiomyopathy. Platelet glutathione peroxidase (GSH-Px)
      activity, as well as Se levels and GSH-Px activity in plasma and erythrocytes
      during prolonged TPN, was measured in six patients with chronic gastrointestinal
      disease. During the time course of TPN, Se administration was discontinued for 12
      weeks, and then resupplemented for another 12 weeks. Before the study period, all
      Se indices had been maintained within the normal range. After discontinuation of
      Se supplementation, a significant decrease in platelet GSH-Px activity was
      observed after 1 week (from 64 +/- 7 [mean +/- SD] to 39 +/- 5 U/g of protein).
      After resupplementation, it increased after 1 week (from 44 +/- 9 to 65 +/- 10
      U/g of protein). Plasma Se indices significantly changed within 3 weeks after
      withdrawal and reintroduction of Se (Se: from 136 +/- 28 to 75 +/- 14 and from 61
      +/- 22 to 125 +/- 33 micrograms/L; GSH-Px: from 236 +/- 50 to 140 +/- 36 and from
      128 +/- 32 to 220 +/- 64 U/L). Erythrocyte Se indices showed no significant
      changes during the study period. The results demonstrate that platelet GSH-Px
      activity is the most sensitive index of Se status in TPN patients.

PMID- 1738222
TI  - Equal aspiration rates from postpylorus and intragastric-placed small-bore
      nasoenteric feeding tubes: a randomized, prospective study.
AB  - Postpylorus delivery of enteral feeding is perceived by many experts to be safer
      than intragastric delivery. To test this assumption, patients with similar
      Glasgow Coma Scores were given identical enteral formulas continuously via a 10
      French nasoenteric tube, placed into the stomach or beyond the second portion of
      the duodenum. Observations were made for attainment of desired nutrition, bowel
      changes, and clinical signs of aspiration. Radiographs of the chest and abdomen
      were obtained every 3 days. If a tube migrated out of a chosen location, it was
      replaced. Thirty-three patients were studied. Seventeen patients were fed into
      the stomach and 16 patients were fed postpylorus. The mean duration of enteral
      feeding was 11.8 days for the gastric group and 10.9 days for the postpylorus
      group (p = NS). The time to deliver the desired kilocalories was 3.33 and 2.77
      days (p = NS) for gastric and postpylorus-fed patients. Tubes displaced similarly
      in each group, gastric 0.647, postpylorus 0.750 per duration of feeding (p = NS).
      Chest radiographs met the criteria for aspiration pneumonia in 31.3% of gastric
      and 40% of postpylorus-fed patients (p = NS). Together, these data indicate that
      complications from enterally fed patients are equally common whether the distal
      port of the feeding tube is in the stomach or beyond the second portion of the
      duodenum.

PMID- 1738223
TI  - Emulsion stability in total nutrient admixtures containing a pediatric amino acid
      formulation.
AB  - Emulsion stability of total nutrient admixtures containing TrophAmine amino acid
      injection admixed with Intralipid, Nutrilipid, and Liposyn II was studied. High
      and low electrolyte concentrations were added to each total nutrient admixture
      before storage at 4 degrees C for 48 hours then at 20-22 degrees C for 24 hours.
      Stability studies were also performed on total nutrient admixtures containing
      higher concentrations of fat emulsion and total nutrient admixtures with added
      cysteine hydrochloride and carnitine. High electrolyte concentrations only were
      added to these total nutrient admixtures before being stored refrigerated for 24
      hours then at room temperature for 24 hours. Visual assessment, pH determination,
      and particle size analysis were performed immediately after compounding and after
      refrigerated and room temperature storage. Particle size was assessed by
      measuring the mean diameter of the fat emulsion and the percent of oil volume in
      particles greater than 5 microns. Repeated-measures analyses of variance were
      used to determine significance of type or concentration of fat emulsion,
      electrolyte concentrations, or time on mean diameter or percent particles greater
      than 5 microns. There were minimal changes in pH values over time. Creaming was
      observed in all total nutrient admixtures at all sampling times except time zero.
      This was reversible upon agitation. Results of particle size analysis over time
      indicated little change in mean diameter or percent particles greater than 5
      microns. These minimal changes did not seem to be clinically significant. It is
      concluded that total nutrient admixtures prepared with this pediatric amino acid
      formulation are stable when prepared and stored as reported.

PMID- 1738224
TI  - Effects of various enteral feeding products on postprandial blood glucose
      response in patients with type I diabetes.
AB  - These studies were performed to evaluate the postprandial blood glucose responses
      to a variety of differently formulated enteral feeding products in patients with
      type I diabetes. Eleven subjects with type I diabetes were evaluated in three
      studies, all using a Biostator (artificial endocrine pancreas) that delivered a
      small, basal amount of insulin and measured blood glucose levels. Subjects
      consumed 20 mL of the assigned formula every 15 minutes for the 240 minutes of
      the study. Study 1 evaluated the response to each of five products: Glucerna,
      Enrich, Ensure HN, Pulmocare, and Compleat Modified. When the postprandial blood
      glucose response to Glucerna was greater than when its research formulation (EN
      8715) had been tested in 1988, studies 2 and 3 were undertaken to assess why this
      discrepancy occurred. Study 2 compared stored EN-8715 to Glucerna and study 3
      compared frozen and thawed vs nonfrozen EN-8715, because of a concern that the
      original product had been frozen during shipping. In study 1 the glucose response
      (assessed as area under the glucose curve) correlated with the grams of
      carbohydrate present in the enteral feeding formula (r = .58, p = .002). The
      presence or absence of fiber, in the form of soy polysaccharide, did not affect
      the glucose response. Glucerna produced a significantly lower blood glucose
      response than did Enrich, Ensure HN, or Compleat Modified, although this response
      was greater than the response to EN-8715 in 1988. However, in study 2 no
      differences were found between stored EN-8715 and Glucerna and in study 3,
      freezing and thawing was not found to significantly alter the glucose
      response.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738225
TI  - Spontaneous partial fracture of the catheter of a totally implantable
      subcutaneous infusion port.
AB  - A totally implantable subcutaneous infusion port was inserted via the left
      subclavian vein with peel-away sheath in a 45-year-old male patient receiving
      home parenteral nutrition. Sixteen months after implantation, the patient noted
      pain in his left clavicular region during home infusion. This was found to be due
      to the leakage of infusion fluid resulting from partial fracture of the catheter
      at the level where the catheter passed between the clavicle and first rib.
      Because the fracture was partial, the catheter did not embolize to the heart or
      large vessels. Although subcutaneous infusion ports afford patients greater
      freedom and the ability to lead a more active life than do external catheters, it
      is emphasized that there may be the risk of spontaneous catheter fracture in
      patients using subcutaneous infusion ports.

PMID- 1738226
TI  - The Prognostic Inflammatory and Nutritional Index in traumatized patients
      receiving enteral nutrition support.

PMID- 1738227
TI  - Total parenteral nutrition and tumor metastases.

PMID- 1738228
TI  - Composition of fat in enteral diets can influence outcome in experimental
      peritonitis.

PMID- 1738229
TI  - Special report from ASCN/A.S.P.E.N. Working Group on Standards for Aluminum
      Content of Parenteral Nutrition Solutions.

PMID- 1738230
TI  - Phenytoin and enteral feeding.

PMID- 1738231
TI  - Search for anti-metastatic therapy: effects of phenytoin on B16 melanoma
      metastasis.
AB  - The ability to metastasize requires that tumor cells be able to degrade matrix.
      Nontoxic compounds that inhibit matrix digestion might be useful as anti
      metastatic agents. We have investigated whether phenytoin, a drug commonly used
      in clinical practice that inhibits the production of collagenase by some cells,
      inhibits metastases in a standard animal model of metastasis: In vitro, phenytoin
      inhibited the proliferative response of B16 F10 melanoma cells to serum
      containing media (75% inhibition at 25 micrograms/ml) but had no effect on their
      ability to degrade a type I collagen gel (1-100 micrograms/ml). Treatment of
      these cells with phenytoin prior to inoculation in vivo did not inhibit tumor
      growth, implantation in a surgical wound, or incidence of spontaneous metastases
      from a primary tumor growing in the foot. Pretreatment of mice with phenytoin
      (15, 40, and 75 mg/kg/day) diminished pulmonary metastases following tail vein
      injection in a minimal but dose dependent fashion; mean number of pulmonary
      colonies 4.6 +/- 3.1 (75/mg/kg/day) vs. 10.2 +/- 9.9 (control). However, tumor
      growth, implantation, and spontaneous metastases were not inhibited by
      pretreating the mice with the same doses of phenytoin. It is concluded that
      phenytoin has an insignificant inhibitory effect on tumor growth and metastasis.

PMID- 1738232
TI  - Marginal mandibulectomy for carcinoma of the floor of the mouth.
AB  - Resection of primary tumors of the floor of the mouth mandates consideration of
      the management of the mandible which may be either involved by direct invasion or
      by close proximity. Segmental mandibulectomy can usually be performed when the
      tumor is either massive or directly invading the mandible. However, the cosmetic
      and functional results of segmental mandibulectomy are unsatisfactory. Whenever
      the tumor is close to the mandible or adherent to the periosteum, consideration
      should be given to marginal mandibulectomy. Over a period of 8 years, we have
      treated 65 patients with carcinoma of the floor of the mouth. Of these, 22
      underwent marginal mandibulectomy. The number of patients staged T1, T2, and T3
      were 4, 13, and 5, respectively. Most had oblique marginal mandibulectomy
      including the resection of the upper rim and medial cortex of the mandible.
      Vertical or horizontal mandibulectomy was rarely used. In each patient the
      preoperative workup included dental X-rays, panoramic films, and computerized
      tomography (CT) scan of the head and neck. The decision as to the extent of
      mandibulectomy was made primarily based on the clinical judgement. Seven patients
      underwent marginal mandibulectomy through the open mouth. However, in the
      remaining 15 patients, the cheek flap approach was utilized. The defect following
      marginal mandibulectomy was reconstructed either with split thickness skin graft,
      tongue flap, or myocutaneous flap. Small defects were left open to heal by
      granulation and secondary intention. Split thickness skin grafts healed very well
      over the surface of resected mandibles. Good local tumor control was achieved at
      the primary site and the functional and cosmetic results were excellent.

PMID- 1738233
TI  - Intravenous nitrogen mustard given immediately after mastectomy: possible effect
      on local recurrence.
AB  - A small group of patients with Stage I and II ductal breast carcinomas were
      treated with intravenous nitrogen mustard the day of mastectomy and the first two
      postoperative days. Long term follow-up revealed that only one patient developed
      isolated local recurrence, a rate much lower than usually reported. It is
      possible that early use of chemotherapy could reduce local recurrences in the
      recently traumatized tissue.

PMID- 1738234
TI  - Carcinoid tumors and inflammatory bowel disease.
AB  - Three cases are described in which carcinoid tumors arose in previously
      established inflammatory bowel disease: two were in the ileum in cases of Crohn's
      disease, and one was in the rectum in a case of ulcerative colitis. Review of
      this association in the literature suggests that it may be more than fortuitous.

PMID- 1738235
TI  - Distribution of histologic subtypes and sex ratio in various primary sites of
      lymphocytic lymphoma.
AB  - To examine the distribution of histologic subtypes and sex ratio in each primary
      site of lymphoma, 1,169 histologically proven cases of lymphocytic lymphoma were
      analyzed. The location of tumor was nodal in 615(53%) and extranodal in 517(44%),
      patients with the gastrointestinal tract being the most common. The incidence was
      predominantly in males for all histologic types and in nodal and extranodal
      sites, except for a predominance of females in extranodal lymphoplasmacytic(Lp
      cytic), lymphoplasmacytoid(Lp-cytoid) tumors. Frequency of the Lp-cytic/Lp-cytoid
      type among all types of lymphoma in females was about 2.7 times more frequent in
      extranodal than in nodal sites. The most striking example was thyroid lymphoma in
      which the frequency of Lp-cytic/Lp-cytoid type was 36% in female and 0% in male
      patients. Including this type of lymphoma, frequency of low grade lymphoma in
      females was higher in extranodal sites than in nodal sites.

PMID- 1738236
TI  - Merkel cell carcinoma: report of two cases and clinical considerations.
AB  - We present the clinical and pathological features of two cases of facial Merkel
      cell carcinoma (MCC) and a critical reappraisal of the literature on this
      subject. Among patients with this presentation of a rare neoplasm, the disease is
      very often localized (local or locoregional growth, without distant metastases).
      Radiotherapy seems to be highly effective in obtaining local control and possibly
      cure, even when used as the sole treatment method; prompt regression of the
      neoplastic masses has been observed in both the cases we treated. One of them,
      and many of those reported in the literature and treated with radiotherapy alone
      or combined with surgery, achieved long-term survival.

PMID- 1738237
TI  - Malignant granular cell tumor of the breast.
AB  - A primary malignant granular cell tumor (MGCT) in the breast is presented. The
      tumor showed mitoses, pleomorphism, necrosis and regional lymph node spread.
      While local excision is the best form of treatment, MGCT can spread rapidly to
      lymph nodes, lungs, liver, and bone. This lesion is an uncommon primary
      malignancy of breast with only 4 other cases reported.

PMID- 1738238
TI  - The value of prognostic factors in selecting node-negative breast cancer patients
      for adjuvant therapy.

PMID- 1738239
TI  - Cancer control in developing countries.

PMID- 1738240
TI  - Elevated CA19-9 as the most significant prognostic factor in advanced colorectal
      carcinoma.
AB  - Tumor markers such as carcinoembryonic antigen (CEA) and CA19-9 were analyzed as
      response indicators and prognostic factors in advanced colorectal carcinoma.
      Eighty-five patients participated in a phase II chemotherapy study from October
      1984 to July 1990. A three-drug schedule was administered including low dose
      epirubicin and sequential methotrexate 5-fluorouracil, followed by leucovorin
      rescue. Serum specimens for CEA and CA19-9 were obtained prior to the initiation
      of chemotherapy, and subsequently at 4-6 weeks' intervals. In univariate analysis
      Karnofsky, the site of the primary tumor, the extent of metastases, the presence
      of abdominal or liver metastases, serum CEA (cut-off of 20 micrograms/l), and
      CA19-9 levels correlated with survival. In stepwise multivariate analysis an
      elevated CA19-9 level, a poor Karnofsky, and the presence of liver metastases
      were independent adverse prognostic factors. Tumors originating from the left
      colon had a better prognosis than the others. This was related to a higher
      response rate in this patient group. Serum CA19-9 level was the most significant
      prognostic factor whether it was entered as a continuous or as a dichotomized
      variable into the model. The median survival of patients with a normal CA19-9
      level was 30.0 months (lower 95% confidence interval: 16.4 months; upper limit
      was not calculable), and with an elevated CA19-9 value 10.3 months (8.0-12.6
      months, 95% confidence interval). Five of 85 patients had a complete response and
      20 a partial response, the overall response rate being 29%. When compared with
      tumor shrinkage, "CEA response" and "CA19-9 response" had a sensitivity of 84%
      and 88% and specificity of 77% and 67%, respectively. In conclusion, serum CEA
      value seems to be the best tumor marker for response prediction, while CA19-9
      level is one of the best available prognostic indicators in advanced colorectal
      carcinoma.

PMID- 1738241
TI  - Increased drug resistance of cultured human cancer cell lines in three
      dimensional cellular growth assay using collagen gel matrix.
AB  - We have conducted a three-dimensional cellular growth assay using collagen gel
      matrix with an endpoint of the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H
      tetrazolium bromide (MTT) assay, on four human gastric and colonic cancer cell
      lines. Three-dimensionally growing cells in collagen gel matrix were 2- to 180
      fold more resistant to mitomycin C, doxorubicin, 5-fluorouracil, and cisplatin
      than those in monolayer culture, and these resistances were increased further
      when the cells increased their three-dimensionality. Furthermore, the influence
      of fibroblasts in the collagen gel matrix on the chemosensitivity of cancer cells
      was less than that in monolayer culture. Since this new assay using collagen gel
      matrix with an endpoint of the MTT assay was able to detect the increase of drug
      resistance of human cancer cell lines by three-dimensional cellular growth using
      a simple and convenient procedure, it was considered to be more useful than
      conventional monolayer cultures for evaluating the chemosensitivity of cancer
      cells.

PMID- 1738242
TI  - Total gastrectomy: nutritional status after different reconstruction techniques.
      An experimental study.
AB  - The authors report their experimental studies on early nutritional changes in 30
      gastrectomized rats where intestinal continuity was restored by three different
      reconstruction methods, i.e., exclusion of the duodenum from alimentary transit
      (Sweet-Allen method), or duodenal recanalization (Longmire method) or double
      duodenal and jejunal recanalization (Moricca method). Ten sham operated rats were
      used as controls. Results showed that the group of rats which underwent
      Longmire's reconstruction presented better nutritional parameters (body weight
      gain, daily food intake, feeding efficiency, albuminemia) than the Moricca and
      Sweet-Allen reconstruction groups. These results became statistically significant
      when follow up was extended to 18 months by using an actuarial method. However,
      perioperative mortality rate was highest in the Longmire reconstruction group.

PMID- 1738244
TI  - Patents in biotechnology.

PMID- 1738243
TI  - Fifteen years of research of bioactive alkaloids.

PMID- 1738245
TI  - Heterotrimeric GTP-binding proteins: an expanding family of signal transducers.

PMID- 1738246
TI  - [New view on rehabilitation procedures promises major economic and humanitarian
      benefits].

PMID- 1738247
TI  - [Valuable tests for students with foreign preclinical education].

PMID- 1738248
TI  - [Information-based adjustment of sex education clinics for adolescents].

PMID- 1738249
TI  - [Do not reduce the competence level of the general psychiatric public care].

PMID- 1738250
TI  - [Sick-listed but active].

PMID- 1738251
TI  - [Weak hands demand specially adjusted drug packages].

PMID- 1738252
TI  - [Adenotomy is of certain significance in recurrent otitis].

PMID- 1738253
TI  - [Cognitive psychotherapy in the elderly with anxiety depressive disorders is
      effective].

PMID- 1738254
TI  - [Time pressure is a problem for a sex education project].

PMID- 1738255
TI  - [For how long have rheumatic diseases existed? Pictorial art as evidence].

PMID- 1738256
TI  - [Considerable variations in diagnostic and therapeutic routines. Medical
      education on asthma treatment should be improved as a study from emergency
      departments indicates].

PMID- 1738257
TI  - [Transplantation of the small intestine can be suitable in patients with pseudo
      obstruction].

PMID- 1738258
TI  - [The largest institution for patients with tuberculosis in Sweden had its own
      cemetery for the victims of the disease].

PMID- 1738259
TI  - [A commentary on vision-threatening retinal changes in diabetes. Consensus
      conferences should be continued. They are valuable for all participants].

PMID- 1738260
TI  - [Physicians and writers in Scandinavia. Emil Aarestrup--poet of love and death].

PMID- 1738261
TI  - [Sclerotherapy in bleeding stomach ulcers--an effective therapeutic method].

PMID- 1738262
TI  - [Inconsistent on amalgam].

PMID- 1738263
TI  - [Difficult to understand criticism against curettage-cryosurgery in basalioma].

PMID- 1738264
TI  - [Impermeable equipment should be used for intravenous infusions of
      nitroglycerin].

PMID- 1738265
TI  - [Knowledge about metabolic capacity is important in drug therapy].
AB  - Genetic polymorphisms are common and are also found for drug metabolising enzymes
      such as acetyltransferase and two distinct cytochrome P-450 isoenzymes that
      catalyse the oxidative metabolism of the model drugs debrisoquine and S
      mephenytoin respectively. Thus, individual metabolic activity can be categorised
      as slow or rapid. The metabolism of a number of drugs has been shown to
      cosegregate with that of either of these substrates. In subjects with slow
      metabolism of a certain drug, its effects might be enhanced due to increased
      concentrations either of the drug itself or of its active metabolite(s). In
      practice, knowledge of a patient's debrisoquine metabolic phenotype is an
      advantage when prescribing tricyclic antidepressants and neuroleptics, as the
      drug concentration will be considerably higher in slow metabolisers than in the
      average patient. Codeine has no analgesic effect in slow metabolisers of
      debrisoquine, probably due to deficient metabolism to morphine. Pharmacogenetic
      data can also be utilised as an aid in interpreting the drug concentrations
      obtained in therapeutic drug monitoring programmes. The metabolism of diazepam,
      omeprazol, and proguanil is associated with the capacity to oxidise S
      mephenytoin. Proguanil requires metabolic activation before it has any effect on
      the malaria parasite and this reaction seems severely impaired in slow
      metabolisers of S-mephenytoin. So far, no unequivocal relationship has been
      established as existing between drug oxidation phenotypes and spontaneous disease
      manifestations. The potential clinical importance of polymorphic metabolic drug
      elimination needs to be taken into consideration in assessing drugs.

PMID- 1738266
TI  - [Significant difference in sterilization frequency in different counties 15 years
      after the introduction of the new legislation].

PMID- 1738267
TI  - [A functioning classification system for primary health care now exists].

PMID- 1738268
TI  - [The physician Linne. A far-seeing observer--the first practitioner of
      occupational medicine in Sweden].

PMID- 1738269
TI  - [Hyperhomocysteinemia--a new risk factor for vascular diseases?].

PMID- 1738270
TI  - [Hyponatremia can indicate tuberculous meningitis].

PMID- 1738271
TI  - [Unreasonable regulations on issuing of death certificates].

PMID- 1738272
TI  - [Forensic examination of HIV-infected persons: knowledge of risk factors can
      prevent suicide].

PMID- 1738273
TI  - [159 cases of renal adenocarcinoma. Good prognosis with nephrectomy if the tumor
      is intracapsular].

PMID- 1738274
TI  - [We have much to learn about the treatment and prevention of post-traumatic
      stress].

PMID- 1738275
TI  - [Experiences of the Stockholm County Council. Concentration on education in
      psychological and social disaster planning is a good investment].

PMID- 1738276
TI  - [Insufficient documentation is a serious problem for quality assurance of nursing
      care].

PMID- 1738277
TI  - [A special study helps to find hidden shortages of health services to the
      patients].

PMID- 1738278
TI  - [Physicians and writers in Scandinavia. Paal-Helge Haugen--the literary
      composer].

PMID- 1738279
TI  - Age-related changes in oral sensation.
AB  - Oral sensation (including two-point discrimination, oral stereognosis,
      vibrotactile detection, somesthetic sensitivity, proprioception, and thermal
      sensitivity) was studied in 60 healthy adults in five age categories: 20 to 34,
      35 to 49, 50 to 64, 65 to 79, and 80 years and above. Thermal and somesthetic
      sensitivity as well as proprioception did not change with age. Ability to
      differentiate tactile and vibratory sensation on the lip decreased after age 80
      (P less than .01), but vibration detection on the soft palate did not change.
      Stereognostic ability remained good up to age 80, and then declined for four of
      the nine shapes tested (P less than .01). Two-point discrimination deteriorated
      on the upper lip (P less than .01), on the cheeks (P less than .02), and on the
      lower lip (P less than .06). Two-point discrimination on the tongue and palate
      did not change. It was noted that oral sensation remained good with aging,
      showing only a slight decline in function after age 80.

PMID- 1738280
TI  - The relationship between the nasal cycle and mucociliary clearance.
AB  - Nasal airway resistances were measured bilaterally on subjects at 30-minute
      intervals over 6 hours using anterior rhinomanometry. The first 10 subjects found
      to exhibit alternating congestion and decongestion of the nasal mucosa (i.e., the
      nasal cycle) were included in the study. Using the saccharin method, nasal
      mucociliary clearance was determined for each subject in both the congested and
      decongested phases of the cycle. The results were statistically significant at
      the P less than .09 level, highly suggestive of a difference in nasal mucociliary
      clearance between the two phases of the cycle, with the congested phase having
      the more rapid clearance. However, when compared to the mucociliary clearance
      times in disease states, the difference in transport times between the two phases
      is probably not clinically significant.

PMID- 1738281
TI  - Stapedectomy techniques in residency training.
AB  - The KTP-532 laser has decreased the technical difficulty involved in teaching and
      performing a stapedectomy in our residency program. Use of this laser has
      resulted in improved hearing and a decreased number of major and minor
      complications compared to an equal number of large fenestra stapedectomies
      performed with hand-held instruments. The major disadvantages of the KTP-532
      laser are its cost and limited availability, and the inconvenience of a
      micromanipulator. The laser should not be relied upon entirely in performing a
      stapedotomy on a thick footplate. The University of Texas Medical Branch
      experience in training residents in both large and small fenestra stapedectomy is
      reported.

PMID- 1738282
TI  - Hearing preservation in acoustic neuroma surgery.
AB  - With advances in imaging, intracanalicular acoustic neuromas are identified
      readily in patients including, oftentimes, those with serviceable hearing.
      Fourteen patients were operated on in an attempt to preserve hearing. Hearing was
      retained in 10 (71%) of the 14. Serviceable hearing was present in 7 (50%),
      borderline serviceable hearing in 2 (14%), and nonserviceable hearing in 1 (7%).
      The problems, advantages, and disadvantages of the differing approaches are
      discussed.

PMID- 1738283
TI  - Temporal bone fractures: longitudinal or oblique? The case for oblique temporal
      bone fractures.
AB  - Classical descriptions and illustrations of temporal bone fractures are
      misleading. Both oblique and longitudinal fractures produce a similar fracture
      line in the middle cranial fossa; however, externally, they are different.
      Oblique fractures cross the petrotympanic fissure while longitudinal fractures
      run within it. In a study of 150 temporal bone fractures, the majority were
      oblique. An array of fracture planes accounts for most of the fractures observed.
      Depending on the direction of trauma, fracture planes rotate around an
      anteroposterior axis. When they approach the horizontal (axial) plane, they
      result in oblique fractures. True longitudinal fractures are rare. They are
      vertical and perpendicular to the oblique planes.

PMID- 1738284
TI  - The prevalence of migraine in Meniere's disease.
AB  - This study attempted to determine the prevalence of migraine in unilateral
      classic Meniere's disease and vestibular Meniere's disease. Diagnostic criteria
      for these three entities were identified and charts of patients with episodic
      vertigo were reviewed. A questionnaire was designed to assess the prevalence of
      migraine using criteria established previously by other authors. Questionnaires
      were mailed to patients with classic Meniere's disease, patients with vestibular
      Meniere's disease, and a normal control group. The response rates from the
      questionnaires in the three groups were 75%, 70%, and 36%. The percentages of the
      respondents who met the predetermined criteria for migraine in the three groups
      were 22%, 81%, and 33%. The significant difference in migraine prevalence between
      classic and vestibular Meniere's disease suggests the possibility of different
      etiologies for the two entities.

PMID- 1738285
TI  - Dysphonia in the aging: physiology versus disease.
AB  - A chart review from 151 dysphonic patients over the age of 60 was done to define
      aging related voice disorders. Overwhelmingly, patients suffered from dysphonia
      due to disease processes associated with aging rather than to physiologic aging
      alone. These include: 1. central neurological disorders affecting laryngeal
      function (e.g., stroke, Parkinson's disease, essential tremor, Alzheimer's
      disease); 2. benign vocal fold lesions (e.g., Reinke's edema, benign and
      dysplastic epithelial lesions); 3. inflammatory disorders (e.g., laryngitis
      sicca, medication effect); 4. laryngeal neoplasia; and 5. laryngeal paralysis.
      Typical laryngeal findings of vocal fold bowing and breathiness consistent with
      presbylarynges were present in only six patients. Presbylarynges is not a common
      disorder and should be a diagnosis of exclusion made only after careful medical
      and speech evaluation.

PMID- 1738286
TI  - Surgery for recurrent and residual cholesteatoma.
AB  - One hundred twelve patients (116 ears) were treated for recurrent and residual
      cholesteatoma. A retrospective review revealed that 66% had undergone canal wall
      down mastoidectomy at the previous surgery. The surgical procedure at revision
      was selected on the basis of an intraoperative assessment of the extent of
      disease, and clinical prediction of eustachian tube function. The average period
      of follow-up was 3.4 years. Revision surgery was successful in providing the
      patient with a safe, dry ear in 105 (91%) of 116 cases. Surgical principles and
      hearing results are presented.

PMID- 1738287
TI  - Early experience with percutaneous tracheotomy.
AB  - Early reports of a percutaneous dilatational technique for tracheotomy tube
      placement have been encouraging. This method uses a needle for placement into the
      trachea, a J-tipped guidewire, and progressively larger dilators to widen the
      stoma for insertion of a tracheotomy tube. A prospective study was undertaken to
      assess the efficacy of this percutaneous tracheotomy technique. Serious
      complications were encountered, including difficulty with dilatation, excessive
      bleeding, false passage of the tracheotomy tube, and death. Because of this
      unacceptable morbidity, the study was terminated after enrollment of only seven
      patients. Percutaneous tracheotomy is a dangerous procedure with potential for
      catastrophic complications. These complications were encountered by third- and
      fourth-year surgical residents performing the procedure under close supervision.
      If the puncture technique is further popularized and attempted by untrained
      physicians, these authors predict many disasters.

PMID- 1738288
TI  - Abductor laryngeal dystonia: a series treated with botulinum toxin.
AB  - Abductor laryngeal dystonia (LD) is characterized by a hoarse voice quality which
      is broken up by breathy or whispered portions. Botulinum toxin injection (Botox)
      has been a safe and effective treatment for adductor laryngeal dystonia and is
      currently accepted medical therapy. As an extension of the established treatment
      program, in 1989 treatment of abductor LD was initiated. Thirty-two patients have
      been treated by sequential percutaneous electromyogram-guided (EMG) injections of
      the posterior cricoarytenoid (PCA) muscles. Most patients required treatment of
      both PCA muscles and improved to an average of 70% of normal voice. Patients who
      had a preexisting tremor, evidence of dystonia in other muscle groups, vocal
      tremor, or respiratory dysrhythmia had less improvement. Ten patients also
      required injection of the cricothyroid muscles and/or type I laryngoplasty.

PMID- 1738289
TI  - Oncofetal antigen expression in head and neck carcinoma.
AB  - Oncofetal antigens (OFA) are proteins expressed during periods of embryonal/fetal
      development and on malignant cells. Previous investigations detected the presence
      of phase-specific 44- and 200-kd OFA, using a monoclonal antibody (MoAb 115).
      This study will determine if primary head and neck squamous cell carcinomas
      express the 44-kd OFA, and will assess the possible role of OFA in oncogenesis.
      Fifteen primary human head and neck squamous cell carcinomas (HNSCC) and six
      HNSCC cell lines were tested for OFA expression. Thirteen primary cancers and
      three cell lines demonstrated various degrees of OFA positivity. Oncofetal
      antigens are proposed to represent a proto-oncogene active during fetal
      development and malignant growth in head and neck squamous cell carcinomas.

PMID- 1738290
TI  - Influence of middle ear immune response on the immunological state and function
      of the inner ear.
AB  - According to clinical experience, a causative correlation between otitis media
      and sensorineural hearing loss is likely. During an otitis media, inflammatory
      mediators should be released and diffuse through the round window membrane to
      cause an immune response of the inner ear. Using 20 guinea pigs, an
      immunologically caused otitis media was induced. Auditory evoked potentials were
      registered by means of electrocochleography and electric response audiometry from
      day 0 to day 7. Each time, before and after starting the immune response serum,
      middle ear effusion and perilymph were sampled and the concentration of
      interleukin-2 (IL-2) analyzed. Decalcified temporal bones were examined
      immunohistochemically. In this study, IL-2 was found in the middle ear effusion
      and perilymph, and there was evidence of an immune response of the inner ear
      during an otitis media. Histological results were in close correlation with this
      event. Electrophysiological data showed conduction deafness and signs of
      sensorineural hearing loss with a maximum at day 3.

PMID- 1738291
TI  - Spontaneous and evoked otoacoustic emissions in preterm neonates.
AB  - Spontaneous (SOEs) and evoked otoacoustic emissions (EOEs) were recorded in a
      group of preterm neonates (N = 134 ears) in order to study the basic properties
      of SOEs and EOEs as a function of gestational age. In the study, it was found
      that: 1. EOEs were recorded in 93% of the tested ears; 2. SOEs were recorded in
      61% of the tested ears; 3. there were no statistically significant variations of
      EOE amplitude with gestational age; 4. EOE spectrum did not vary with age; and 5.
      the two main factors influencing EOE amplitude were the SOE presence and the fast
      Fourier transform spectrum, especially the lower limit of the spectrum. Thus, the
      maturation of outer hair cell properties appears to be complete at 32 weeks of
      gestational age. Because a number of infants at risk for hearing loss are preterm
      babies, screening for EOEs, an objective, rapid, and nontraumatic technique, may
      prove useful in evaluating peripheral auditory dysfunction in preterm neonates.

PMID- 1738292
TI  - Compound action potentials recorded from the exposed eighth nerve in patients
      with intractable tinnitus.
AB  - Compound action potentials (CAP) were recorded directly from the exposed
      intracranial portion of the eighth nerve in 19 patients undergoing microvascular
      decompression (MVD) of the eighth nerve for intractable tinnitus. The waveform of
      the CAPs recorded in patients with tinnitus varied from normal to highly
      abnormal, but only in 1 patient were there distinct abnormalities in the waveform
      of the CAP that could not be attributed to the patient's hearing loss. The mean
      values of the latencies of the N1 and N2 peaks in the CAPs recorded from the
      exposed eighth nerve in patients with tinnitus and high-frequency hearing loss
      were virtually indistinguishable from the latencies obtained in patients with
      similar hearing loss but no tinnitus. There was no statistically significant
      difference between the latency of peak III in the brainstem auditory evoked
      potentials (BAEPs) in these two groups of patients, but the latency of peak V was
      slightly shorter (statistically significant) in the patients with tinnitus than
      it was in the patients without tinnitus.

PMID- 1738293
TI  - Endoscopic pituitary tumor surgery.

PMID- 1738294
TI  - Maxillary removal and reinsertion for improved access to anterior cranial base
      tumors.
AB  - Portions or all of the maxillae are oftentimes removed solely to provide access
      to certain cranial base tumors rather than because they are involved directly
      with disease. The purpose of this report is to describe an approach that involves
      removal of one or both maxillae to improve tumor exposure with subsequent
      reinsertion as free bone grafts which are stabilized with titanium craniofacial
      fixation plates. The titanium permits postoperative imaging studies and
      radiotherapy. Eleven patients ranging from 10 to 69 years of age have undergone
      12 operations using this technique for resection of 4 benign and 8 malignant
      tumors at The Ohio State University. Seven of the 8 patients with malignancies
      underwent postoperative radiation therapy. There have been no permanent
      complications and no evidence of bone resorption in this group after follow-up of
      up to 15 months.

PMID- 1738295
TI  - Additional exposure during translabyrinthine surgery.

PMID- 1738296
TI  - Endothelin-1- and endothelin-3-induced vasorelaxation via common generation of
      endothelium-derived nitric oxide.
AB  - The vasorelaxant effects by endothelin-1 (ET-1) and endothelin-3 (ET-3), and
      their mechanisms of action were studied in isolated porcine pulmonary arterial
      strips. ET-1 and ET-3 dose-dependently (10(-9) - 10(-8) M) relaxed vascular
      strips precontracted with norepinephrine only in the presence of endothelium. The
      maximal vasorelaxant effect by ET-1 was about 70% of that by ET-3. The ET-1- and
      ET-3- induced vasorelaxation was blocked by NG-nitro-L-arginine, an inhibitor of
      nitric oxide synthesis, and methylene blue, an inhibitor of soluble guanylate
      cyclase. The present data suggest that vascular smooth muscle relaxation induced
      by ET-1 and ET-3 is mainly ascribed to synthesis and release of nitric oxide from
      L-arginine in endothelium.

PMID- 1738297
TI  - Prediction of tertiary structures in 'scorpion-toxin' type proteins.
AB  - In the three-dimensional architecture of macromolecules, the structural stability
      and proper folding manifest due to cooperative packing interaction of various
      segments. Hydrophobicity is the major factor stabilizing protein-protein
      associations. In the disulfide-containing proteins, S-S bonds are integral part
      of structural motifs and large part of the protein-folding problem can be reduced
      to identifying and understanding motifs and subdomains of these proteins.
      Identifying such a motif with S-S bonds in 'scorpion-toxin' type proteins, and
      from model-building studies, five tertiary structural models for these type of
      proteins can be proposed. These canonical structural models can be refined by
      regular minimum energy and computer simulation methods to arrive at the final
      tertiary structures. Such 'models' can be of considerable use i) in understanding
      the biochemical reaction mechanisms in the structure-function relationships, ii)
      structure determination by X-ray methods (molecular replacement method), iii)
      drug design etc.

PMID- 1738298
TI  - Inhibitory effects of endothelin-1 and endothelin-3 on prolactin release:
      possible involvement of endogenous endothelin isopeptides in the rat anterior
      pituitary.
AB  - Spontaneous prolactin release from the isolated rat anterior pituitary was
      inhibited by endothelin-1 in a dose-dependent manner (10(-8)-10(-6) M).
      Endothelin-3 also inhibited spontaneous prolactin release with an almost
      identical dose-response relationship as endothelin-1. These inhibitory effects
      were unaffected by application of a dopamine D2-receptor antagonist, YM-09151-2
      (10(-7) M). Rat anterior and posterior pituitary glands were abundant in both
      endothelin-1 and endothelin-3, as compared with other regions of the brain. The
      present results suggest that endogenous endothelin-1 and endothelin-3 in the
      anterior and posterior pituitary are involved in the inhibitory regulation of
      prolactin secretion as autocrine or paracrine factors.

PMID- 1738299
TI  - Prolonged increase of corticosterone secretion by chronic social stress does not
      necessarily impair immune functions.
AB  - The influence of a chronic social stress upon immunity was investigated in Wistar
      rats, submitted for four weeks to two different behavioral situations, balanced
      in a factorial design: housing with three females and membership rotation. The
      combination of these two factor led to adrenal enlargement (43.3%), thymus
      involution (39.5%) and increased basal corticosterone levels, all indices of
      activation of the hypothalamic-hypophysis-adrenal axis. However, neither natural
      killer cell activity, splenocyte reactivity to mitogen nor the rate of
      spontaneous development of antibodies against Mycoplasma pulmonis, a common
      pathogen of the respiratory tract, were changed in the endocrine activated
      animals. Analysis of the data on kinetics of stress at 1, 7 and 28 days after the
      initial mixing of the animals gave the same results. These data question the
      immunosuppressant activity usually conferred to corticosteroids, at least when
      adrenal hyperactivity is induced by chronic environmental stressors.

PMID- 1738300
TI  - Secretory cholinesterase of Ancylostoma ceylanicum: effect of tubulin binding
      agents and benzimidazole anthelmintics.
AB  - Ancylostoma ceylanicum, the human hookworm parasite, exhibited significant
      secretion of cholinesterase when maintained in vitro in RPMI-1640 medium.
      Secretion of the enzyme was linear up-to 4 hours of incubation. About 40 percent
      of the total cholinesterase activity was localized in the soluble fraction, while
      remaining activity was associated with the particulate fraction of the nematode.
      Exposure of the hookworms to colchicine in vitro caused significant inhibition in
      secretion of the enzyme by the parasite with concomitant accumulation of
      cholinesterase within the adult worms. Vinblastine did not show noticeable effect
      on the enzyme secretion as well as activity within the parasite. Incubation of
      hookworms with some benzimidazole anthelmintics viz., mebendazole or albendazole
      significantly reduced the capacity of the worms to secrete cholinesterase and
      increase in enzyme activity within the parasite. Adult worms recovered from
      mebendazole treated hamsters exhibited about 3 fold greater activity of
      cholinesterase as well as significantly lower capacity to secrete cholinesterase
      in vitro as compared to the worms recovered from untreated animals. These
      observations indicate role of microtubules in the secretion of cholinesterase by
      hookworms and as a target for the action of benzimidazole anthelmintics.

PMID- 1738301
TI  - Criminal penalties for maternal substance abuse.

PMID- 1738302
TI  - Helping families say good-bye.

PMID- 1738303
TI  - Unit-based family-support groups: a reminder.

PMID- 1738304
TI  - Communicating with addicted women in labor.

PMID- 1738305
TI  - Infant cardiopulmonary resuscitation for expectant and new parents.

PMID- 1738306
TI  - Teaching parents infant CPR--lecture or audiovisual tape?

PMID- 1738307
TI  - Shoulder dystocia: when to use suprapubic or fundal pressure.
AB  - "The delivery of the head with or without forceps may have been quite easy, but
      more commonly there has been a little difficulty in completing the extension of
      the head. The hairy scalp slides out with reluctance. When the forehead has
      appeared it is necessary to press back the perineum to deliver the face ... time
      passes. The child's head becomes suffused. It endeavors unsuccessfully to
      breathe. Abdominal efforts by the mother or by her attendants produce no advance;
      gentle head traction is equally unavailing. Usually equanimity forsakes the
      attendants. They push, they pull. Alarm increases. Eventually by greater strength
      of muscle or by some infernal juggle, the difficulty appears to be overcome, and
      the shoulders and trunk of a goodly child are delivered. The pallor of its body
      contrasts with the plum-colored cyanosis of the face, and the small quantity of
      freshly expelled meconium about the buttocks. It dawns upon the attendants that
      their anxiety was not ill-founded, the baby lies limp and voiceless, and too
      often remains so despite all efforts at resuscitation".

PMID- 1738308
TI  - The RU 486 story: the French experience.

PMID- 1738309
TI  - From failures to major learning experiences.

PMID- 1738310
TI  - Haemolysin-derived synthetic peptides with pore-forming and haemolytic activity.
AB  - Escherichia coli haemolysin (Hlya) is a pore-forming protein which belongs to the
      family of 'Repeat-toxins' (RTX) (Lo et al., 1987; Lally et al., 1989; Kraig et
      al., 1990). A model for the pore-forming structure of HlyA has been proposed
      (Ludwig et al., 1991) which consists of eight transmembrane segments all present
      in this hydrophobic region of HlyA. We report here that two synthetic peptides of
      10 and 8 amino acids in length (Pep1 and Pep2, respectively), which are derived
      from transmembrane segment V, are able to form pores in an artificial lipid
      bilayer. In addition, Pep1 exhibits strong haemolytic activity when tested on
      human red blood cells (HRBCs). The haemolytic activity of Pep1 and of E. coli
      haemolysin is completely inhibited by antibodies raised against Pep1.

PMID- 1738311
TI  - Bacillus subtilis chemotaxis: a deviation from the Escherichia coli paradigm.
AB  - In Escherichia coli, chemotactic sensory transduction is believed to involve
      phosphoryl transfer for excitation, and changes in receptor methylation for
      adaptation. In Bacillus subtilis, changes in degree of receptor methylation do
      not bring about adaptation. Novel methylation reactions are believed to be
      involved in excitation in B. subtilis. The main chemotaxis proteins of E. coli-
      CheA, CheB, CheR, CheW and CheY--are present in B. subtilis but play somewhat
      different roles in the two organisms. Several unique chemotaxis proteins are also
      present in B. subtilis. Some of the properties of B. subtilis chemotaxis are also
      seen in Halobacterium halobium, suggesting that there may be a similar underlying
      mechanism that predates the evolutionary separation of the bacteria from the
      archaea and eucarya.

PMID- 1738312
TI  - On the evolution of functional secondary metabolites (natural products).
AB  - It is argued that organisms have evolved the ability to biosynthesize secondary
      metabolites (natural products) because of the selectional advantages they obtain
      as a result of the functions of the compounds. The clustering together of
      antibiotic biosynthesis, regulation, and resistance genes implies that these
      genes have been selected as a group and that the antibiotics function in
      antagonistic capacities in nature. Pleiotropic switching, the simultaneous
      expression of sporulation and antibiotic biosynthesis genes, is interpreted in
      terms of the defence roles of antibiotics. We suggest a general mechanism for the
      evolution of secondary metabolite biosynthesis pathways, and argue against the
      hypothesis that modern antibiotics had prebiotic effector functions, on the basis
      that it does not account for modern biosynthetic pathways.

PMID- 1738313
TI  - spbA locus ensures the segregational stability of pTH1030, a novel type of gram
      positive replicon.
AB  - The replication region of the plasmid pHT1030 of Bacillus thuringiensis was
      previously mapped to a 2.9 kb DNA fragment. The DNA sequence was analysed and it
      was shown that the minimal replicon resides within a 1 kb fragment of DNA
      carrying no potential protein coding sequence. Moreover, no production of single
      stranded DNA intermediates was detected in the plasmid-containing cells. pHT1030
      therefore belongs to a class of replicons not previously described in Gram
      positive bacteria. Examination of the segregational stability of deletion
      derivatives of pHT1030 in bacilli defined two stability regions. One is located
      within the minimal replicon of pHT1030, whereas the second (spbA) is not required
      for replication. spbA encodes a 15 kDa protein and ensures the segregational
      stability of the plasmid. This effect of spbA is particularly highlighted in
      sporulation. The absence of the spbA locus gives rise to plasmid-free spores at
      high frequency, whereas the spbA+ plasmids are stably maintained. The stability
      of the plasmids during sporulation seems to be correlated with an unequal
      division of the cell by the sporulation septum.

PMID- 1738314
TI  - Membrane topology of the integral membrane components, OppB and OppC, of the
      oligopeptide permease of Salmonella typhimurium.
AB  - The oligopeptide permease of Salmonella typhimurium is a periplasmic binding
      protein-dependent transport system. Five gene products, OppABCDF, are required
      for the functioning of this transporter, two of which (OppB and OppC) are highly
      hydrophobic, integral membrane proteins and are responsible for mediating passage
      of peptides across the cytoplasmic membrane. OppB and OppC are each predicted,
      from their sequences, to span the membrane many times. In this paper we describe
      experimental evidence confirming these predictions using a combination of
      biochemical, immunological and genetic procedures. Each of these two proteins is
      shown to span the membrane six times, with the N- and C-termini both being
      located at the cytoplasmic face of the membrane. Opp is apparently a typical
      member of the ABC (ATP-binding cassette) superfamily of transporters. These
      findings, therefore, have general implications for the organization and function
      of other ABC transporters, including the human multidrug resistance protein and
      the product of the cystic fibrosis gene.

PMID- 1738315
TI  - Pseudomonas aeruginosa AlgB, which modulates the expression of alginate, is a
      member of the NtrC subclass of prokaryotic regulators.
AB  - The Pseudomonas aeruginosa exopolysaccharide alginate is an important virulence
      factor in chronic pulmonary infections of cystic fibrosis patients. We determined
      the nucleotide sequence of the gene, algB, which regulates the level of
      exopolysaccharide produced by mucoid P. aeruginosa. The predicted amino acid
      sequence of AlgB revealed a high degree of similarity to the regulatory proteins
      in the NtrC subclass of 'two-component regulatory systems'. AlgB expression in
      Escherichia coli minicells showed a molecular weight of approximately 50,000 Da,
      comparable to that of the inferred amino acid sequence (49,318 Da). We show that
      algB is transcriptionally active in mucoid strains of P. aeruginosa and regulates
      the expression of the alginate biosynthetic gene, algD, thereby resulting in
      increased expression of alginate in mucoid P. aeruginosa.

PMID- 1738316
TI  - Isolation and characterization of sporulation-specific promoters in the yeast
      Saccharomyces cerevisiae.
AB  - A library of random yeast genomic DNA:lacZ fusions has been constructed using an
      episomal yeast-Escherichia coli shuttle vector (pCS1). Plasmid pCS1 requires
      insertion of a promoter and an in frame ATG codon upstream of its resident
      truncated lacZ gene to regulate expression in yeast. Yeast genomic DNA fragments
      of 4-6 kb were generated by partial digestion with Sau3A and ligated into the
      unique BamHI site of plasmid pCS1 to generate a library of 5 x 10(4) individual
      E. coli transformants. This library was screened to identify promoter-lacZ
      fusions that were expressed uniquely during sporulation. Of 342 yeast
      transformants that exhibited beta-galactosidase activity, two were found to
      express the lacZ gene in a sporulation-specific manner. This paper presents the
      characterization of two genomic yeast DNA fragments containing promoters that
      control lacZ expression during the sporulation process. Expression from the
      promoter present in plasmid pJC18 occurred from 11-21 hours into the sporulation
      process, while the promoter in plasmid pJC217 was active from 4-14 hours.
      Staining of nuclear DNA to correlate nuclear morphology with timing of gene
      expression showed when each of these promoters was active in terms of the
      morphological stages of sporulation.

PMID- 1738317
TI  - Pullulanase secretion in Escherichia coli K-12 requires a cytoplasmic protein and
      a putative polytopic cytoplasmic membrane protein.
AB  - The previously uncharacterized third and fourth genes (pulE and pulF) of the
      pullulanase secretion gene operon of Klebsiella oxytoca strain UNF5023 are,
      respectively, predicted to encode a 55 kDa polypeptide with a putative nucleotide
      binding site, and a highly hydrophobic 44 kDa polypeptide that probably spans the
      cytoplasmic membrane several times. Expression of pulE in minicells or under the
      control of a strong bacteriophage T7 promoter resulted in the production of a c.
      58 kDa cytoplasmic protein. A representative PulE-beta-galactosidase hybrid
      protein created by Tnlac mutagenesis was also found mainly in the cytoplasm.
      These results are in line with the predicted absence from PulE of a region of
      sufficient hydrophobicity to function as a signal sequence. The PulF polypeptide
      could not be detected either in minicells or when the gene was transcribed from
      the T7 promoter, but the acquirement of three pulF-lacZ gene fusions that encoded
      hybrid proteins with relatively high levels of beta-galactosidase activity
      indicates that this gene can be transcribed and translated. Gene disruption
      experiments indicated that both pulE and pulF are required for pullulanase
      secretion in Escherichia coli K-12. Both proteins exhibit considerable homology
      throughout their entire lengths with other proteins involved in protein
      secretion, pilin assembly, conjugation and transformation competence in a variety
      of bacteria. In addition, PulE protein has consensus sequences found in a wide
      variety of nucleotide-binding proteins. This study completes the initial
      characterization of the pullulanase secretion gene operon, which comprises 13
      genes that are all essential for the transport of pullulanase across the outer
      membrane.

PMID- 1738318
TI  - Child injury prevention.

PMID- 1738319
TI  - Metastatic liver cancer: no cause for nihilism.

PMID- 1738320
TI  - Tuberculosis in Australia--a forgotten disease.

PMID- 1738321
TI  - Childhood pedestrian injuries in the Perth metropolitan area.
AB  - OBJECTIVE: To examine the characteristics of childhood pedestrian injuries in the
      Perth metropolitan area from 1980 to 1989. DESIGN: Retrospective descriptive
      study. SETTING: Perth metropolitan area, Western Australia. PARTICIPANTS: Child
      pedestrians aged 0 to 14 years who were injured during the period 1 January 1980
      to 31 December 1989. MAIN OUTCOME MEASURES: An extensive database which reported
      fatal and non-fatal motor vehicle collisions was used to obtain details on the
      child pedestrian, the vehicle involved in the collision, and the environmental
      factors related to these injuries. RESULTS: A total of 1282 child pedestrian
      injuries were reported in the 10 year period. Children aged between 5 and 9
      years, and were overrepresented among those injured. This study also demonstrated
      a similar proportion of injuries involving the 10-14 year age group. Injuries
      frequently occurred mid block, on local urban roads, between the hours of 3 p.m.
      and 7 p.m., and a greater than expected proportion of drivers involved in these
      collisions were in the under-21 age category. To describe the pattern of
      childhood pedestrian injuries we calculated both age-specific injury rates, and
      injury rates based on the number of registered motor vehicles. The latter
      revealed a greater than 20-fold variation between local government areas.
      CONCLUSIONS: Further analytical research, incorporating a measure of the child
      pedestrian's exposure to roads and traffic is required to identify those features
      in the individual and the environment which have a significant influence on the
      likelihood of a collision. Such research is required to institute effective
      preventive measures.

PMID- 1738322
TI  - Childhood poisoning--a changing profile with scope for prevention.
AB  - OBJECTIVES: To study the pattern of poisoning in children admitted to the
      Children's Hospital between 1983 and 1988; to compare this pattern with the last
      study of poisoning in childhood from this institution, done in 1956; and to
      survey knowledge of a sample of general practitioners and pharmacists about
      common childhood poisonings. DESIGN: A retrospective review of 407 medical
      records of children admitted after poisoning and a postal questionnaire to 150
      randomly selected pharmacists and 150 randomly selected general practitioners.
      RESULTS: Poisoning accounted for one in 200 admissions to the Children's
      Hospital. The pattern of poisoning has changed since 1956 when the main agents
      were kerosene, pesticides, aspirin and digoxin. Now they are the benzodiazepines,
      iron preparations, paracetamol and anticonvulsants. There were four deaths due to
      the ingestion of quinine, caustic soda, ferrous sulphate and an arsenic-based
      weed killer respectively. Five per cent of the admissions resulted in significant
      morbidity. Sixty-five per cent of general practitioners and 45% of pharmacists
      responded to the questionnaire. The high toxicity of quinine, anticonvulsants,
      iron preparations and digoxin was not widely appreciated by over 50% of the
      general practitioners while over 60% of the pharmacists were not aware of the
      high toxicity of anticonvulsants and paracetamol. CONCLUSIONS: Although the
      pattern of childhood poisoning has changed, it remains a significant but largely
      preventable cause of mortality and morbidity.

PMID- 1738323
TI  - Survey of neonatal meningitis in Australia: 1987-1989.
AB  - OBJECTIVE: To identify incidence, bacterial aetiology, outcome after treatment
      and risk factors for poor outcome of neonatal meningitis. DESIGN: Retrospective
      survey of neonatal meningitis occurring in Australia between January 1987 and
      December 1989. Data were obtained from Medical Records and Microbiology
      Departments of hospitals with neonatal nurseries. SETTING: Neonatal nurseries
      throughout Australia. PATIENTS: 116 infants under 6 weeks of age with bacterial
      or fungal meningitis. RESULTS: The minimum incidence was 0.17 per 1000 live
      births. Traditional neonatal pathogens were responsible for 60% of cases (group B
      streptococci, 35%; Escherichia coli, 22%), childhood meningeal pathogens for 10%
      and opportunistic pathogens for 30%. Risk factors for meningitis, including
      prematurity, were more common among those with meningitis due to E. coli or
      opportunistic pathogens than among those with infections due to group B
      streptococci, Listeria monocytogenes or the childhood pathogens (46/60 v. 11/55;
      P less than 0.0001). Meningitis was more likely to be due to Gram-negative
      bacteria in premature infants (less than 36 weeks gestation) than in full-term
      infants (19/30 v. 20/86; P = 0.0002). The mortality overall was 26% but was
      higher in extremely premature infants (less than 29 weeks) (6/9 v. 24/107; P =
      0.009) and among 13 patients who were judged to have had inappropriate initial
      therapy (7/13 v. 21/97; P = 0.04). Long-term sequelae occurred in at least 23% of
      survivors, but were more common in those with Gram-negative meningitis (6/10 v.
      13/76; P = 0.012). CONCLUSIONS: Initial therapy with penicillin or amoxycillin
      plus cefotaxime is appropriate for most infants with bacterial meningitis. Since
      some less common Gram-negative bacteria isolated in this survey were resistant to
      cefotaxime, an aminoglycoside should be added, initially, in Gram-negative
      meningitis.

PMID- 1738324
TI  - Climatic temperature and variation in the incidence of sudden infant death
      syndrome between the Australian states.
AB  - OBJECTIVE: To describe the relationship between climatic temperature and the
      incidence of sudden infant death syndrome (SIDS) for the Australian States and
      examine the extent to which differences in climatic temperature might explain the
      regional variation of SIDS in Australia. DESIGN: Case series study. A generalised
      linear model was used to model the association between monthly average
      temperature and the incidence of SIDS. SETTING: The report is population based.
      Data are available from all Australian States. SUBJECTS: Cases of SIDS from birth
      to less than 12 months of age occurring in Queensland (1981-1987), New South
      Wales (1981-1987), Victoria (1984-1987), Tasmania (1975-1989), South Australia
      (1980-1989), and Western Australia (1980-1988). RESULTS: Every one degree Celsius
      decrease in average monthly temperature within the range 9 degrees C to 25
      degrees C is associated with a 10.6% (95% confidence interval, 9.6%-11.7%)
      increase in the incidence of SIDS. Climatic temperature accounts for 84% of the
      interstate variation in the rate of SIDS. After controlling for the effect of
      temperature, a significant overall difference in SIDS incidence remains (P less
      than 0.0001) for the Australian States. CONCLUSION: Climatic temperature accounts
      for most but not all of the regional variation of SIDS incidence in the
      Australian States. The remaining variation may reflect differences in the
      maternal and infant characteristics of the State populations.

PMID- 1738325
TI  - Sudden infant death syndrome: factors contributing to the difference in incidence
      between Victoria and Tasmania.
AB  - OBJECTIVE: To examine how much of the difference in incidence of sudden infant
      death syndrome (SIDS) between Tasmania and Victoria could be accounted for by the
      effect of differing climatic temperature and the effect of the differing
      prevalence of maternal and infant characteristics in the two State populations.
      DESIGN: A two population ecological comparison. Two previously published
      predictive models were applied to quantify the contribution of several factors to
      the higher incidence of SIDS in Tasmania compared with Victoria. SETTING: A
      population based study involving the two Australian States of Tasmania and
      Victoria. PATIENTS: The characteristics of the 1985 to 1987 live birth cohorts of
      Tasmania and Victoria were examined. Cases were defined as all infants dying in
      1985 to 1987 whose cause of death was stated as SIDS. RESULTS: The rate of SIDS
      for Tasmania and Victoria 1985 to 1987 was 3.76 per 1000 live births and 2.18 per
      1000 live births respectively. Adjustment of the Tasmanian rate for the effect of
      the interstate difference in climatic temperature resulted in a lower Tasmanian
      rate of 2.92 per 1000 live births. Adjustment for the effect of interstate
      differences in maternal age, birthweight, infant sex, month of birth and
      intention to breast-feed at hospital discharge decreased the Tasmanian rate to
      2.47 per 1000 live births. CONCLUSION: Approximately 82% of the interstate
      difference in SIDS incidence between Tasmania and Victoria from 1985 to 1987 can
      be accounted for by differences in climatic temperature, maternal age, birth
      weight, infant sex, month of birth and feeding intention at hospital discharge.

PMID- 1738326
TI  - General practice. Research in general practice. Establishing a rural research
      network.

PMID- 1738327
TI  - Teaching the students. Teaching communication skills in small groups.

PMID- 1738328
TI  - Diagnosis and treatment of confirmed and suspected snake bite. Implications from
      an analysis of 46 paediatric cases.
AB  - OBJECTIVE: To identify reliable predictors of envenomation in suspected snake
      bite and to examine the current standard of treatment in envenomed patients.
      DESIGN: Retrospective cohort analysis of children presenting with suspected or
      confirmed snake bite in southern mainland Australia. Detection of snake venom in
      urine or blood was taken as proof of envenomation. SETTING: Intensive Care Unit,
      Royal Children's Hospital, Melbourne. PATIENTS: Forty-six children presenting
      between 1979 and 1990. MAIN OUTCOME MEASURES: Positive and negative clinical
      evidence, venom tests, and coagulation tests. RESULTS: Twenty-seven children
      (59%) had suspected bites; 10 (22%) were bitten but not envenomed; 9 (19%) were
      envenomed. Two died of coagulopathy. Headache, abdominal pain or vomiting were
      moderately predictive of envenomation (positive predictive values of 63%, 57% and
      64% respectively). Coagulopathy was a highly sensitive, specific and reliably
      predictive (100%) indicator of envenomation. The pressure-immobilisation bandage
      was used in 28% of cases at the scene of the bite and in 41% on contact with
      medical or paramedical services. Twelve patients received antivenom; of these,
      six received adrenaline as premedication. CONCLUSION: Headache, abdominal pain,
      nausea or vomiting, or abnormal coagulation tests accurately predict envenomation
      by snakes in southern mainland Australia. More or better education on first aid
      and clinical management of snake bite is needed.

PMID- 1738329
TI  - Analgesia for day surgery.
AB  - OBJECTIVE: To review current and potential analgesic techniques in day surgery,
      with particular regard to their pharmacology. DATA SOURCES: Recent articles on
      analgesia for surgery and day surgery were retrieved from Index Medicus for 1988
      1990. Pharmacokinetic data were collated from recent textbooks and articles. DATA
      SYNTHESIS: The reviewed information is integrated with a pharmacological approach
      and personal experience with the use of postoperative analgesia. CONCLUSIONS:
      Combination analgesia therapy is the best approach for postoperative analgesia
      for day surgery. The usefulness of preoperative blockade of the pain sensation
      which limits activation of the central pain pathway and decreases analgesic
      requirements, is also emphasised. Examples of measures for relief of mild,
      moderate and severe pain are given.

PMID- 1738330
TI  - Augmentin-induced jaundice with a fatal outcome.
AB  - OBJECTIVE: To report a case of death due to Augmentin-induced cholestatic
      hepatitis and discuss a possible drug interaction between Augmentin and
      oestrogenic steroids. CLINICAL FEATURES, INTERVENTION AND OUTCOME: An 81-year-old
      man, on oestrogen therapy for prostatic malignancy, presented with obstructive
      jaundice one week after completing a four-week course of Augmentin for recurrent
      urinary tract infection. Liver biopsy showed features of a drug-induced
      cholestatic hepatitis with bile duct injury. His clinical course was marked by
      progressive deterioration with increasing jaundice and the development of hepatic
      encephalopathy. A course of prednisolone did not result in any improvement and he
      died nine weeks after the onset of jaundice. CONCLUSIONS: The cholestatic
      hepatitis induced by Augmentin is usually reversible but may be progressive,
      leading to death. The concurrent administration of ethinyloestradiol, a
      potentially cholestatic agent, may have altered the susceptibility and/or course
      of the reaction in this patient.

PMID- 1738331
TI  - Mycobacterium bovis (BCG) vaccination. Progressive disease in a patient
      asymptomatically infected with the human immunodeficiency virus.
AB  - OBJECTIVE: To report a case of progressive disease caused by Mycobacterium bovis
      after BCG vaccination in a patient asymptomatically infected with the human
      immunodeficiency virus (HIV). CLINICAL FEATURES: A 34-year-old white man about to
      commence employment as a developmental care worker had a BCG vaccination. Five
      months later, he had a positive result to a serological test for HIV antibody.
      Nine months after BCG vaccination, he presented with fever (38.7 degrees C), a
      large left axillary lymph node and a small left pleural effusion. The lymph node
      was biopsied and acid-fast bacilli observed in Ziehl-Neelsen stained smears.
      Culture grew Mycobacterium bovis (BCG). TREATMENT AND OUTCOME: He was
      successfully treated with isoniazid, rifampicin and ethambutol for a period of
      nine months. CONCLUSION: BCG vaccination of asymptomatic HIV-positive patients is
      not recommended. The detection of those at risk for HIV infection before
      vaccination administration is essential. Self-exclusion based on information
      supplied to all potential recipients is likely to be the most effective method.

PMID- 1738332
TI  - An epidemiological study of snake bite envenomation in Papua New Guinea.

PMID- 1738333
TI  - Can infant death from child abuse be prevented?

PMID- 1738334
TI  - Teaching medical students about violence.

PMID- 1738335
TI  - Acute psychosis after withdrawal of vigabatrin.

PMID- 1738336
TI  - Cholestasis with ticarcillin-potassium clavulanate (Timentin)

PMID- 1738337
TI  - General practitioner databases in Australia.

PMID- 1738338
TI  - Karitane Mothercraft Society.

PMID- 1738339
TI  - Lead: subtle forms and new modes of poisoning.

PMID- 1738341
TI  - Defibrillators on Qantas aircraft.

PMID- 1738340
TI  - Treatment of recurrent staphylococcal furunculosis.

PMID- 1738342
TI  - The battle of the couches and the rats.

PMID- 1738343
TI  - Psychotherapy: from Freud to cognitive science.

PMID- 1738344
TI  - Quadrivalent meningococcal vaccine for use after splenectomy.

PMID- 1738345
TI  - The battle of the couches and the rats.

PMID- 1738346
TI  - Increasing the numbers of general practitioners who provide smoking cessation
      advice.

PMID- 1738347
TI  - Information provided in Australia about the size of standard drinks.

PMID- 1738348
TI  - Cardiac risk factor management.

PMID- 1738349
TI  - Haemopoietic toxicity and low-dose methotrexate.

PMID- 1738350
TI  - Inflammatory terminology.

PMID- 1738351
TI  - Geriatric suicide.

PMID- 1738352
TI  - Geriatric suicide.

PMID- 1738353
TI  - Has the Missouri State Board of Registration for the Healing Arts gone too far?

PMID- 1738354
TI  - Bronchopulmonary lavage for pulmonary alveolar proteinosis.
AB  - In summary, total-lung bronchopulmonary lavage was performed five times on two
      patients under general anesthesia with controlled ventilation using a Robert-Shaw
      double lumen ETT. One lavage was complicated by a hydrothorax that was treated
      without untoward sequelae. No significant hypoxemia, circulatory impairment or
      leakage of lavaged fluid into the opposite lung was noted on any occasion. The
      average time of all procedures was 108 minutes (range 80-150 minutes), and
      patients were extubated on all occasions 2 to 5 hours after the treatment.
      Patients were discharged 24 to 36 hours after the last lavage with improvement,
      though not resolution, of the alveolar infiltrates radiographically. The ABG
      analysis revealed minimal improvement in oxygenation in Case No.1 from a
      preoperative paO2 of 60 mmHg on room air to a paO2 of 74 mmHg on the day of
      discharge. However, the patient was able to resume his normal activity level. In
      Case No.2, the patient's resting paO2 did not improve significantly from the
      preoperative value of 82 mmHg. Subjectively, however, the patient noted marked
      improvement. Prior to bronchopulmonary lavage, this patient's SaO2 decreased from
      97% to 81% after walking 800 feet. Approximately a week and a half after
      discharge, the patient reported being able to run without symptoms and generally
      was feeling well. With careful attention to detail and the coordination of
      resources from the departments of anesthesia, pulmonary medicine, respiratory
      therapy and nursing services, bronchopulmonary lavage can be performed safely and
      efficiently in order to curtail the progressive hypoxemia which often develops in
      patients with PAP.

PMID- 1738355
TI  - Massive gastric hemorrhage due to small vessel erosion (the Dieulafoy lesion).

PMID- 1738356
TI  - Racial differences in cardiovascular disease mortality and risk factors.

PMID- 1738357
TI  - Advance directives: beginning the process.

PMID- 1738358
TI  - Outbreak of influenza A in a nursing home--New York, December 1991-January 1992.
AB  - During December 1991 and January 1992, an outbreak of influenza A occurred among
      residents of a nursing home in New York. From mid-October through mid-November
      1991, influenza vaccine was administered to 295 (88%) of the 337 residents of the
      nursing home. The residents shared common dining and recreational areas; the mean
      age of residents was 83 years (range: 51-103 years); 256 (76%) were female. The
      prevalence of underlying illness in vaccinated and unvaccinated patients was not
      determined.

PMID- 1738359
TI  - Viscerotropic leishmaniasis in persons returning from Operation Desert Storm-
      1990-1991.
AB  - From November 1990 through December 1991, seven men among the approximately
      500,000 military personnel from the United States who participated in Operation
      Desert Storm had leishmaniasis involving internal organs diagnosed at Walter Reed
      Army Medical Center. In at least five of the cases, the species of the infecting
      parasite was Leishmania tropica (previously known as L. tropica minor), a
      parasite more commonly associated with cutaneous than with visceral
      leishmaniasis.

PMID- 1738360
TI  - Cholera associated with an international airline flight, 1992.

PMID- 1738361
TI  - Childbearing and contraceptive-use plans among women at high risk for HIV
      infection--selected U.S. sites, 1989-1991.
AB  - From September 1990 through August 1991, 2655 (49%) of the 5457 women reported
      with acquired immunodeficiency syndrome (AIDS) in the United States had been
      injecting-drug users (IDUs), and 1136 (21%) had had sexual intercourse with men
      who were IDUs (1). During the same period, 413 (56%) of the 735 children (aged
      less than 13 years) reported with AIDS were born to mothers who were either IDUs
      (38%) or sex partners of IDUs (18%) (1). Even though messages and services
      regarding prevention of human immunodeficiency virus (HIV) infection and
      pregnancy planning for women at high risk for HIV infection should be tailored to
      their specific needs, information regarding pregnancy history, plans for
      childbearing, and contraceptive use among such women is limited. This report
      characterizes the childbearing and contraceptive-use plans of women at high risk
      for HIV infection interviewed during 1989-1991 in three settings--methadone
      maintenance programs, drug-free outpatient programs, and detention facilities--in
      Florida, New Jersey, New York, and Pennsylvania.

PMID- 1738362
TI  - NIOSH Alert: Preventing electrocutions during work with scaffolds near overhead
      power lines.

PMID- 1738363
TI  - Lactoferrin in the mouse uterus: analyses of the preimplantation period and
      regulation by ovarian steroids.
AB  - Uterine expression of lactoferrin (LF) during the preimplantation period and its
      regulation by the ovarian steroids estradiol (E2) and/or progesterone (P4) in
      ovariectomized adult mice were examined. Immunoblot detection of LF in uterine
      cell lysates demonstrated the presence of this protein from days 1-8 of pregnancy
      [day 1 (D1) = day of vaginal plug]. Immunoprecipitation of 35S pulse-labeled
      uterine proteins showed that the relative rate of LF synthesis was high on D1,
      but below the level of detection by D4. Immunolocalization of LF in uterine
      sections showed intense luminal and glandular epithelial staining on D1 and D2,
      and progressively decreased staining through D4. Immunoreactive protein was also
      detected in cells, primarily concentrated in the stroma. The relative number of
      these cells was greatest on D1 and decreased progressively to a low number by D4.
      These cells were morphologically similar to neutrophils, which are known to
      contain LF protein, but little or no LF mRNA. Northern blotting showed that
      uterine LF mRNA levels were very high on D1 and D2 of pregnancy and decreased to
      low, but detectable, levels by D4. In situ hybridization to uterine sections
      showed that LF mRNA was highly abundant only in glandular and luminal epithelial
      cells, and followed the same pattern as immunolocalization on D1-D4 in epithelial
      cells. These results document two sources of LF in the preimplantation mouse
      uterus: neutrophils and epithelial cells. The synthesis of LF in the uterus
      reflects the abundance of epithelial LF mRNA, which is high on the first 2 days
      of pregnancy. Neutrophils that contain LF are also abundant in the uterine stroma
      during this time. E2 and/or P4 regulation of uterine LF was examined. LF mRNA was
      rapidly induced by E2 in ovariectomized adult mice, and this mRNA was localized
      exclusively to epithelial cells. P4 had little effect on uterine LF mRNA levels,
      but antagonized the prolonged induction of this gene by E2. E2 induced the
      accumulation of immunoreactive LF in uterine epithelial cells and the appearance
      of numerous immunopositive neutrophils distributed throughout the uterine stroma.
      P4 also antagonized these effects. Thus, E2 regulates LF gene expression in
      uterine epithelial cells and causes the recruitment of neutrophils into the
      uterus. These results suggest that LF may play an important role in early
      pregnancy and that uterine LF gene expression is regulated by a balance between
      estrogen and P4.

PMID- 1738364
TI  - Induction of cytoskeletal gene expression by insulin.
AB  - Insulin has rapid pleiotropic effects on cellular metabolism. In certain cell
      types, insulin can cause morphological changes by inducing rearrangements of
      cytoskeletal components, but the regulation of cytoskeletal gene expression by
      insulin has not been previously described. In the present work insulin was found
      to rapidly, but transiently, increase transcription of the cytoskeletal beta
      actin and alpha-tubulin genes in rat H4IIE hepatoma cells. Insulin-induced
      transcription of beta-actin mRNA was evident within 5 min and was maximal by 10
      15 min at 1000% above control levels. beta-Actin transcription was induced at
      insulin concentrations as low as 5 x 10(-12) M insulin and was maximal at 5 x 10(
      9) M. Transcription of the alpha-tubulin gene was also rapidly stimulated by
      physiological concentrations of insulin, but only to 300-400% above basal levels.
      For both the beta-actin and alpha-tubulin genes, the induction of transcription
      was transient, with a return to basal levels by 60-120 min. Transcription of
      neither the skeletal or cardiac alpha-actin gene nor the beta-tubulin gene was
      altered by insulin administration. Messenger RNA levels for the beta-actin and
      alpha-tubulin genes increased, but to a lesser extent than transcription, since
      these mRNAs were abundant and stable before the transient induction of
      transcription. Inhibitors of protein synthesis, in the presence or absence of
      insulin, also acutely stimulated transcription of these genes.

PMID- 1738365
TI  - Hormone- and phorbol ester-activated protein kinase C isozymes mediate a
      reorganization of the actin cytoskeleton associated with prolactin secretion in
      GH4C1 cells.
AB  - TRH regulates PRL secretion and synthesis in GH4C1 rat pituitary cells. TRH
      responses are associated with activation of protein kinase C (PKC) isozymes and
      elevation of cytosolic calcium. To determine which PKC isozymes are involved in
      TRH-directed responses, we evaluated the effect of TRH on GH cell alpha-, beta-,
      delta-, and epsilon-PKC isozymes. Immunoblot analysis demonstrated that TRH
      caused rapid redistribution of all isozymes to a Triton X-100-insoluble (i.e.
      cytoskeletal) fraction. Corollary immunocytofluorescence studies demonstrated
      that redistributed PKCs accumulate in cell peripheries. Exocytosis involves
      reorganization of the cytoskeleton, therefore, each of the GH cell PKCs is
      appropriately located to phosphorylate proteins important for cytoskeleton
      organization. To determine the relative contributions of calcium and PKC signal
      transduction pathways in mediating TRH responses, the effects of potassium
      depolarization (which increases cytosolic calcium) and phorbol dibutyrate (which
      activates all PKC isozymes without increasing calcium) were compared. The data
      indicate that TRH-mediated reorganization of vinculin proceeds via a calcium
      mediated pathway, whereas fragmentation of actin filaments proceeds via a PKC
      dependent pathway. Selective down-modulation of epsilon-PKC with prolonged TRH
      treatment was used to demonstrate that epsilon-PKC is not necessary for certain
      TRH-stimulated biological responses.

PMID- 1738366
TI  - Comparison of the 90-kilodalton heat shock protein interaction with in vitro
      translated glucocorticoid and estrogen receptors.
AB  - The rat glucocorticoid receptor is a 795-amino acid protein with the hormone
      binding domain located in the C-terminal portion of the molecule. In the absence
      of hormone, this domain displays a protein inactivation activity that represses
      the nuclear localization, DNA binding, and transcriptional regulatory activities
      of the receptor. This inactivation activity, which appears to be mediated by the
      90-kilodalton heat shock protein (HSP90), is stronger in the glucocorticoid
      receptor than the corresponding activity of the estrogen receptor hormone binding
      domain. In order to analyze these differences, we have directly compared in vitro
      translated glucocorticoid and estrogen receptors in terms of their interaction
      with HSP90 by a coimmunoprecipitation assay employing two monoclonal antibodies,
      AC88 and 8D3, which react with different regions of the HSP90 molecule. Intact
      forms of both the glucocorticoid receptor and the estrogen receptor
      coimmunoprecipitated with endogenous HSP90 in reticulocyte lysates, indicating
      that both receptors were capable of binding to HSP90 when translated in vitro. By
      assaying a series of receptor deletion mutants, we found that the sequences
      required for HSP90 binding mapped to a similar region within the hormone binding
      domain of both receptors. While the hormone binding domain was found to be the
      only structural requirement for HSP90 binding to the glucocorticoid receptor,
      additional sequences N-terminal to the hormone binding domain were shown to be
      required for HSP90 binding to the estrogen receptor. These results are consistent
      with a postulate that differences in the protein inactivation activities of the
      glucocorticoid and estrogen receptor hormone binding domains may be secondary to
      differences in the interactions of these domains with HSP90.

PMID- 1738367
TI  - Transforming growth factor-beta 1 overproduction in prostate cancer: effects on
      growth in vivo and in vitro.
AB  - We found previously that transforming growth factor-beta 1 (TGF beta 1) mRNA
      levels are markedly elevated in rat prostate cancer (Dunning R3327 sublines)
      compared to levels in normal prostate. Our goal was to determine whether elevated
      expression of TGF beta 1 is biologically relevant to prostate cancer growth in
      vivo. We chose as our model the R3327-MATLyLu prostate cancer epithelial cell
      line, which produces metastatic anaplastic tumors when reinoculated in vivo. Our
      approach was to stably transfect MATLyLu cells with an expression vector that
      codes for latent TGF beta 1 and to isolate subclones of cells that over-expressed
      TGF beta 1 mRNA. We also isolated a subclone of MATLyLu cells transfected with a
      control vector lacking the TGF beta 1 cDNA insert. We then studied the growth of
      these cells in vivo and in vitro. Twenty days after sc inoculation of 10(6) cells
      in vivo, TGF beta 1-overproducing MATLyLu tumors were 50% larger, markedly less
      necrotic, and produced more extensive metastatic disease (lung metastases in 73%
      of all lobes and lymph node metastases in 88% of animals) compared to control
      MATLyLu tumors (lung metastases, 21%; lymph node metastases, 7%). Thus, TGF beta
      1 produced in vivo is biologically active and can promote prostate cancer growth,
      viability, and aggressiveness, perhaps via effects on the host and/or on the
      tumor cells themselves. When followed in vitro, TGF beta 1-overproducing cells
      became growth inhibited, but this effect was transient as cells subsequently
      resumed proliferating. Growth inhibition was due to TGF beta, because it could be
      prevented by TGF beta-neutralizing antibody. Therefore, prostate cancer cells can
      activate and respond to secreted latent TGF beta 1, and although the cells are
      transiently inhibited in vitro, there is no net inhibition of growth. The ability
      of the cells to respond to endogenously produced TGF beta 1 suggests that TGF
      beta 1 overexpression enhances tumor growth in vivo at least in part via an
      effect of TGF beta 1 on the tumor cells themselves.

PMID- 1738368
TI  - The origin of nuclear receptor proteins: a single precursor distinct from other
      transcription factors.

PMID- 1738369
TI  - The rat prolactin gene is expressed in brain tissue: detection of normal and
      alternatively spliced prolactin messenger RNA.
AB  - Previous work by our laboratory has described the presence and widespread
      distribution of a PRL-like immunoreactive protein in brain. The persistence of
      this PRL in brain after hypophysectomy provided substantial evidence that brain
      PRL represented the product of a synthetic pool separate from that of the
      anterior pituitary PRL. To pursue this concept of independent synthesis further,
      we sought to determine whether brain tissue expressed PRL mRNA. Although we were
      easily able to detect a single species of PRL mRNA in pituitary by Northern
      hybridization, we could not visualize message in hypothalamus or
      extrahypothalamic brain by this technique. Therefore, we performed the polymerase
      chain reaction on cDNAs from anterior pituitary, hypothalamus, discrete
      extrahypothalamic brain regions, and other tissues. Hypothalamus and
      extrahypothalamic brain parts, including the cerebellum, caudate, brain stem,
      amygdala, thalamus, cortex, and hippocampus, were all positive to varying
      degrees. Lung and liver were negative, and anterior pituitary was consistently
      positive. All positive tissues, including anterior pituitary, expressed two
      hybridization signals: the expected amplified product and another smaller one.
      The smaller amplified product is presumably the result of an alternatively
      spliced transcript that is missing part of the PRL gene. Hypophysectomized
      animals did not express PRL message in brain, but expression was restored in
      hypophysectomized animals treated with testosterone. Transcripts for Pit-1 (GHF
      1), a transcription factor important in regulation of pituitary PRL, were not
      detected in hypothalamus or any of the extrahypothalamic brain parts. The finding
      of testosterone stimulation of brain PRL message and undetectable levels of Pit-1
      (GHF-1) in hypothalamic and extrahypothalamic brain regions indicates that the
      transcriptional regulation of PRL in the brain is different from that in the
      anterior pituitary.

PMID- 1738370
TI  - Thyrotropin (TSH)-releasing hormone-responsive elements in the rat TSH beta gene
      have distinct biological and nuclear protein-binding properties.
AB  - Two TRH-responsive elements have been identified in the rat TSH beta gene by
      deletion/mutation analysis of the 5'-flanking region of the gene and transfection
      of TSH beta-luciferase constructs into the GH3 pituitary cell line. Biological
      responsiveness was confirmed by inserting synthetic oligonucleotides next to the
      heterologous viral thymidine kinase (tk) promoter in tk luciferase (tkLUC)
      constructs. Both DNA regions, termed TSH A (at -274 to -258 bp) and TSH C (-402
      to -385 bp), have a high level of sequence similarity to binding sites for the
      POU domain pituitary transcription factor Pit-1/GHF-1. In transfection assays,
      the TSH A region had no basal enhancer activity, but did confer 3- to 6-fold TRH-
      and PMA-stimulated transcriptional responses to the tk promoter. The TSH C region
      conferred basal enhancer activity (3- to 10-fold above control tkLUC) as well as
      a 2- to 3-fold TRH or PMA response. Combinations of TSH A and TSH C elements
      conferred both enhancer activity and a TRH- or PMA-stimulated response, but more
      than two copies of the regions resulted in no further stimulatory effect. Both
      TSH beta gene regions bound to nuclear proteins from GH3 cells, as determined by
      gel retardation analysis. The TSH A region DNA formed three prominent DNA-protein
      complexes, ranging from slowly to rapidly migrating bands and with calculated
      affinities of 32, 0.5, and 208 nM, respectively. The TSH C region formed two
      major complexes, which corresponded on the basis of mobility to the most slowly
      and rapidly migrating complexes formed by TSH A, but with calculated affinities
      of 3.1 and 33 nM. TSH C also formed a rapidly migrating minor complex unique for
      this gene region. The more rapidly migrating complexes appeared to be specific to
      nuclear proteins from GH3 cells. Treatment of cells with TRH did not
      significantly alter the affinity of protein binding. Mutation of TSH A and TSH C
      DNA by T to G substitutions abolished the ability of the DNA to confer a TRH
      response and severely inhibited the ability of the DNA to bind to GH3 nuclear
      proteins. Thus, transcriptional regulation of the rat TSH beta gene by TRH is
      correlated with the ability of the two TRH-sensitive elements to bind nuclear
      proteins. The differences noted in basal enhancer activity or the degree of TRH
      responsiveness may be related to some unique proteins bound to each DNA or to the
      differences in affinity of binding of the proteins common to both elements.

PMID- 1738371
TI  - Transcriptional and posttranscriptional regulation of type 1 plasminogen
      activator inhibitor and tissue-type plasminogen activator gene expression in HTC
      rat hepatoma cells by glucocorticoids and cyclic nucleotides.
AB  - We have reported previously that incubation of HTC rat hepatoma cells with the
      synthetic glucocorticoid dexamethasone causes a 90% decrease in tissue-type
      plasminogen activator (tPA) activity secondary to a 4-fold increase in
      plasminogen activator inhibitor-1 (PAI-1) mRNA accumulation. Dexamethasone also
      induces a modest and transient increase in tPA mRNA. The cyclic nucleotide analog
      8-bromo-cAMP (cA) causes a greater than 50-fold increase in PA activity, the
      result of a 90% decrease in PAI-1 and a sustained 2-fold increase in tPA mRNA
      accumulation. Dexamethasone and cA in combination cause a 150-fold increase in PA
      activity, the result of an 80% decrease in PAI-1 and a synergistic 15-fold
      increase in tPA mRNA. To determine the mechanism of this complex hormonal
      regulation, we have examined rates of synthesis and decay of PAI-1 and tPA mRNAs.
      Here we report that dexamethasone induces a 5-fold increase in PAI-1 gene
      transcription and does not significantly alter PAI-1 message decay; PAI-1 mRNA
      has a half-life of about 4 h in both untreated and dexamethasone-treated cells.
      In contrast, cA regulates PAI-1 mRNA by both decreasing the rate of PAI-1 gene
      transcription by 60% and accelerating the rate of PAI-1 message decay. Regulation
      of tPA by cA, both alone and in combination with dexamethasone, occurs primarily
      at the level of transcription. Dexamethasone and cA-induced tPA mRNA has a half
      life of 2.75 h; tPA mRNA degradation is significantly inhibited by either
      cycloheximide or actinomycin-D.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738372
TI  - Epinephrine inhibits lipoprotein lipase gene expression in rat adipocytes through
      multiple steps in posttranscriptional processing.
AB  - Previous studies have demonstrated that in vitro treatment of adipocytes with
      catecholamines results in a decrease in the activity of the enzyme lipoprotein
      lipase (LPL). To examine the mechanism of this effect, primary cultures of rat
      adipocytes were cultured in the presence of various concentrations of epinephrine
      (10(-9)-10(-5) M). Epinephrine yielded a dose-dependent decrease in LPL activity;
      heparin-releasable LPL activity was reduced to 66% of control values after
      exposure to 10(-5) M epinephrine for 2 h. However, there was no effect of
      epinephrine on LPL immunoreactive mass, as measured by enzyme-linked
      immunosorbent assay. When cells were pulse labeled with [35S]methionine, there
      was a rapid and dose-dependent decrease in immunoprecipitable LPL. In spite of
      the decrease in LPL translation, neither epinephrine nor other catecholamines
      altered the level of LPL mRNA or the rate of LPL transcription. To further
      examine LPL posttranslational processing, cells were pulse labeled with
      [35S]methionine in the absence of epinephrine and then chased with unlabeled
      methionine in the presence of epinephrine. Cells exposed to epinephrine during
      the chase demonstrated a decrease in LPL secretion into the medium as well as a
      decrease in LPL degradation. The addition of epinephrine during LPL
      posttranslational processing did not alter the sensitivity of the newly
      synthesized LPL protein to endo-beta-N-acetylglucosaminidase-H. Thus, epinephrine
      had multiple effects on adipocyte LPL. Although there was a rapid decrease in LPL
      synthesis that was not due to changes in LPL mRNA, the level of LPL protein was
      unchanged under these conditions due to a decrease in LPL degradation and
      secretion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738373
TI  - Structural organization of the follicle-stimulating hormone receptor gene.
AB  - We have characterized a series of rat genomic clones that code for the FSH
      receptor (FSHR) gene and approximately 14.8 kilobases of DNA up-stream of the
      transcriptional start sites. Southern blot analysis indicated that there was only
      a single gene for the FSHR. Primer extension and S1 nuclease experiments revealed
      the presence of two major transcriptional start sites at positions -80 and -98
      relative to the translational start site. Transient expression studies of a
      fusion gene containing 830 basepairs of DNA 5' to the translational start site
      linked to the reporter gene chloramphenicol acyltransferase have shown that this
      portion of the gene is capable of acting as a transcriptional promoter in rat
      Sertoli cells. The FSHR gene contained 10 exons and nine introns. The first nine
      exons encoded the extensive amino-terminal domain of the receptor, while the last
      exon encoded the transmembrane-spanning and cytoplasmic domains. A repeated motif
      similar to that observed in the leucine-rich glycoprotein family was delineated
      within exons 2-9. Comparison of the FSHR gene to the LH receptor gene revealed a
      number of striking similarities which clearly indicate that these receptors
      evolved through gene duplication. The ancestral gene for these receptors
      presumably arose from a series of tandem duplications of the leucine-rich motif,
      which when combined with the common ancestral gene of the G-protein-coupled
      receptor family led to the current gene structure of the glycoprotein hormone
      receptors.

PMID- 1738374
TI  - Chicken progesterone receptor is phosphorylated by a DNA-dependent protein kinase
      during in vitro transcription assays.
AB  - We have reported previously that chicken progesterone receptor (PR) is
      phosphorylated in vivo in response to progesterone administration. Three
      phosphorylation sites have been reported, two of which show increased
      phosphorylation in response to hormone and one which is phosphorylated only in
      response to hormone administration. We found previously that PR lacking the
      hormone-dependent phosphorylation is active in an in vitro transcription assay.
      Since the source of general transcription factors is a HeLa nuclear extract which
      contains many kinases, we have analyzed the receptor for phosphorylation during
      the in vitro transcription assay. We report here that the receptor is rapidly and
      efficiently phosphorylated on new sites, causing a change in receptor mobility on
      sodium dodecyl sulfate-gels. This phosphorylation is strictly dependent upon the
      presence of double stranded DNA. A DNA-activated protein kinase with similar
      properties has been isolated previously from HeLa cell nuclei. We find that
      phosphorylation of PR with this purified enzyme mimics the phosphorylation
      observed in the transcription assay. These data suggest that a previously
      undetected additional series of DNA-dependent phosphorylations may be required
      for activation of the PR.

PMID- 1738375
TI  - Gonadotrope-specific expression of the human follicle-stimulating hormone beta
      subunit gene in pituitaries of transgenic mice.
AB  - The molecular basis for the cell-specific and hormonal regulation of the
      pituitary gonadotropin beta-subunit genes is unknown. To identify the essential
      DNA regulatory elements of the human FSH beta (hFSH beta) gene, we introduced a
      10-kilobase cloned fragment encompassing the gene into the germline of transgenic
      mice. We showed by a combination of Northern blot hybridization, RIA, and
      immunofluorescence histochemistry that the hFSH beta gene was expressed
      exclusively in mouse pituitary gonadotropes. Human FSH beta was actively
      secreted, presumably as an interspecies heterodimer, with mouse alpha-subunit,
      and no free hFSH beta was detected in serum. Male transgenic mice consistently
      had higher basal pituitary expression and secretion of hFSH beta than the female
      transgenic mice. Castration combined with testosterone replacement caused a
      marked reduction in hFSH beta gene expression in transgenic males, but had no
      effect on the pituitary levels of FSH in normal male mice. These experiments
      demonstrate that the essential DNA regulatory elements and gonadotrope
      transcription factors required for cell-specific expression of the FSH beta gene
      must be conserved between human and mouse. There appear to be important
      differences in the hormonal regulation of the gene between species, however.

PMID- 1738376
TI  - Nosocomial transmission of hepatitis B virus associated with the use of a spring
      loaded finger-stick device.
AB  - BACKGROUND AND METHODS: From June 1989 through March 1990, 26 patients, of whom
      23 had diabetes, contracted acute hepatitis B virus (HBV) infection in a hospital
      in California. All 26 patients and one HBV carrier (also a diabetic) had been
      admitted to a single medical ward during the six months before the case patients
      became infected with HBV. To determine the source of the infection, we conducted
      a retrospective cohort study of the 72 patients with diabetes who had been
      admitted to the ward from January through December 1989 and a case-control study
      comparing the 3 nondiabetic patients who contracted hepatitis with 20 nondiabetic
      controls. RESULTS: The retrospective cohort study of all the patients with
      diabetes who were admitted to the ward during 1989 found that those who underwent
      capillary blood sampling by finger stick with a spring-loaded lancet device were
      more likely to contract HBV infection than those who did not have finger sticks
      (attack rate, 42 percent vs. 0 percent; P = 0.08). In addition, a dose-response
      relation was observed between the number of finger sticks received and the
      frequency of hepatitis B (P = 0.002). The case-control study found that all 3 of
      the nondiabetic patients who contracted hepatitis underwent finger-stick blood
      sampling with the device, as compared with none of the 20 nondiabetic controls (P
      = 0.0006). A review of nursing procedures indicated that the platform of the
      device was not routinely changed after each use; this finding suggested that
      contamination of the platform by HBV-infected blood was the mechanism of
      percutaneous transmission of HBV. CONCLUSIONS: Proper use of finger-stick devices
      as well as strict adherence to universal precautions to avoid contamination by
      blood are required to decrease the possibility of transmission of blood-borne
      pathogens among hospitalized patients.

PMID- 1738377
TI  - Transmission of human immunodeficiency virus type 1 from a seronegative organ and
      tissue donor.
AB  - BACKGROUND: Since 1985, donors of organs or tissues for transplantation in the
      United States have been screened for human immunodeficiency virus type 1 (HIV-1),
      and more than 60,000 organs and 1 million tissues have been transplanted. We
      describe a case of transmission of HIV-1 by transplantation of organs and tissues
      procured between the time the donor became infected and the appearance of
      antibodies. The donor was a 22-year-old man who died 32 hours after a gunshot
      wound; he had no known risk factors for HIV-1 infection and was seronegative.
      METHODS: We reviewed the processing and distribution of all the transplanted
      organs and tissues, reviewed the medical histories of the donor and HIV-1
      infected recipients, tested stored donor lymphocytes for HIV-1 by viral culture
      and the polymerase chain reaction, and tested stored serum samples from four
      organ recipients for HIV-1 antigen and antibody. RESULTS: HIV-1 was detected in
      cultured lymphocytes from the donor. Of 58 tissues and organs obtained from the
      donor, 52 could be accounted for by the hospitals that received them. Of the 48
      identified recipients, 41 were tested for HIV-1 antibody. All four recipients of
      organs and all three recipients of unprocessed fresh-frozen bone were infected
      with HIV-1. However, 34 recipients of other tissues--2 receiving corneas, 3
      receiving lyophilized soft tissue, 25 receiving ethanol-treated bone, 3 receiving
      dura mater treated with gamma radiation, and 1 receiving marrow-evacuated, fresh
      frozen bone--tested negative for HIV-1 antibody. Despite immunosuppressive
      chemotherapy, HIV-1 antibody appeared between 26 and 54 days after
      transplantation in the three organ recipients who survived more than four weeks.
      CONCLUSIONS: Although rare, transmission of HIV-1 by seronegative organ and
      tissue donors can occur. Improvements in the methods used to screen donors for
      HIV-1, advances in techniques of virus inactivation, prompt reporting of HIV
      infection in recipients, and accurate accounting of distributed allografts would
      help to reduce further this already exceedingly low risk.

PMID- 1738378
TI  - The risk of subarachnoid and intracerebral hemorrhages in blacks as compared with
      whites.
AB  - BACKGROUND: Stroke is an important cause of death among blacks, and intracerebral
      and subarachnoid hemorrhages account for nearly half of all early deaths from
      stroke. The present study investigates whether blacks and whites differ in their
      risk of having either intracerebral or subarachnoid hemorrhage. METHODS: We
      reviewed the medical records, autopsy reports, and CT scans of all patients
      suspected of having had an intracerebral or subarachnoid hemorrhage during 1988
      among the nearly 1.3 million people in the Greater Cincinnati metropolitan area.
      RESULTS: There were 221 cases of first spontaneous intracranial hemorrhage among
      1,086,462 whites (159 intracerebral and 62 subarachnoid hemorrhages), and 45
      cases among 171,718 blacks (27 intracerebral and 18 subarachnoid hemorrhages).
      Blacks had 2.1 times the risk of subarachnoid hemorrhage of whites (95 percent
      confidence interval, 1.3 to 3.6) and 1.4 times the risk of intracerebral
      hemorrhage (95 percent confidence interval, 0.9 to 2.1). In those under the age
      of 75, the risk of intracerebral hemorrhage among blacks was 2.3 times that of
      whites (95 percent confidence interval, 1.5 to 3.6), whereas the risk among
      blacks 75 or older was one fourth that of whites (95 percent confidence interval,
      0.1 to 0.8). Deaths within 30 days of intracerebral or subarachnoid hemorrhage
      accounted for 1.9 years of life lost per 1000 blacks under 65 years of age, as
      compared with 0.5 year per 1000 whites. CONCLUSIONS: Young and middle-aged blacks
      have a substantially higher risk of subarachnoid or intracerebral hemorrhage than
      whites of similar age. These types of stroke are important causes of excess
      mortality among young and middle-aged blacks.

PMID- 1738379
TI  - Allopurinol in the treatment of American cutaneous leishmaniasis.
AB  - BACKGROUND: Pentavalent antimony, the generally accepted treatment for
      leishmaniasis, is given parenterally, and it is expensive and not readily
      available in developing countries. An inexpensive, orally administered compound
      would be a substantial advance in treatment. Previous studies in vitro have shown
      synergism between allopurinol and pentavalent antimony in tissue-culture systems.
      We designed this clinical study to determine whether synergism could be
      demonstrated in patients. METHODS: We performed a randomized, controlled study of
      the efficacy of allopurinol plus meglumine antimoniate (Glucantime), as compared
      with meglumine antimoniate alone, in patients with cutaneous leishmaniasis, who
      were recruited from a village in southeastern Colombia. In addition, those who
      declined injections were treated with allopurinol alone, and those who declined
      any treatment were considered controls. All the patients were followed for one
      year after the completion of treatment. Lesions that healed completely at three
      months and remained healed during follow-up were considered to be cured. RESULTS:
      The cure rate for patients treated with meglumine antimoniate was 36 percent; the
      addition of allopurinol increased the rate to 74 percent (P less than 0.001).
      Treatment with allopurinol alone yielded a cure rate of 80 percent (P less than
      0.001). There were no cures among the untreated patients. There was no
      significant difference between the cure rate with allopurinol plus meglumine
      antimoniate and that with allopurinol alone. No major toxic effects were
      observed. CONCLUSIONS: For the treatment of American cutaneous leishmaniasis, the
      combination of allopurinol and meglumine antimoniate is significantly more
      effective than meglumine antimoniate alone, probably because of the efficacy of
      allopurinol alone, which appears to be as good as the combination.

PMID- 1738380
TI  - Surgical management of spastic diplegia in cerebral palsy.

PMID- 1738381
TI  - Bladder cancer--field versus clonal origin.

PMID- 1738382
TI  - The challenge of intracellular pathogens.

PMID- 1738383
TI  - Carotid endarterectomy.

PMID- 1738384
TI  - Carotid endarterectomy.

PMID- 1738385
TI  - Carotid endarterectomy.

PMID- 1738386
TI  - Carotid endarterectomy.

PMID- 1738387
TI  - Carotid endarterectomy.

PMID- 1738388
TI  - Skin cancer and HLA antigens.

PMID- 1738389
TI  - Skin cancer and HLA antigens.

PMID- 1738390
TI  - Alcohol in mother's milk.

PMID- 1738391
TI  - Alcohol in mother's milk.

PMID- 1738392
TI  - Pericarditis caused by a sewing needle.

PMID- 1738393
TI  - Insurance coverage for preventive immunizations in childhood.

PMID- 1738394
TI  - Changing the consent rules for Desert Storm.

PMID- 1738395
TI  - To end an epidemic. Lessons from the history of diphtheria.

PMID- 1738396
TI  - Uremic pruritus: a review.

PMID- 1738397
TI  - Hypoglycemia with hyperinsulinemia in a chronic hemodialysis patient following
      parathyroidectomy.
AB  - We report a chronic hemodialysis patient with severe hyperparathyroidism who
      developed hypoglycemia with inappropriate hyperinsulinemia following
      parathyroidectomy. An abrupt fall in parathyroid hormone level and administration
      of large amounts of calcitriol may have resulted in increased insulin release and
      enhanced tissue sensitivity to insulin producing sustained hypoglycemia in this
      patient.

PMID- 1738398
TI  - Acute decline in renal function as a consequence of ovarian hyperstimulation
      syndrome.
AB  - Two cases of severe ovarian hyperstimulation syndrome following ovulation
      induction are described, one of them following in vitro fertilization and embryo
      transfer, and the other after conventional ovarian stimulation. This condition
      was associated with an acute reversible decline in renal function. The treatment
      and the possible pathophysiological mechanisms are discussed.

PMID- 1738399
TI  - Renal insufficiency due to bilateral primary renal lymphoma.
AB  - Diffusely enlarged nonhydronephrotic kidneys on ultrasound and computer
      tomographic examination in a case of progressive preterminal renal insufficiency
      were very suggestive of extensive lymphomatous infiltration. Diffuse infiltration
      of the kidney by centrocytic/centroblastic non-Hodgkin lymphoma was confirmed
      upon renal biopsy. No other localizations of lymphoma could be found. After four
      courses of CHOP chemotherapy there was a complete remission of this primary renal
      non-Hodgkin lymphoma, with complete recovery of renal function.

PMID- 1738400
TI  - Acute effect of erythropoietin on plasma renin activity and aldosterone levels in
      end-stage renal disease.

PMID- 1738401
TI  - Sex chromosome abnormality in chronic renal failure.

PMID- 1738402
TI  - Retinitis pigmentosa and aortic regurgitation in a patient with adult polycystic
      kidney disease.

PMID- 1738403
TI  - Cadmium, hypertension and smoking.

PMID- 1738404
TI  - Administration of Triton WR 1339 aggravates chronic aminonucleoside nephrosis.

PMID- 1738405
TI  - Intravenous Fe-gluconate-Na for iron-deficient patients on hemodialysis.

PMID- 1738406
TI  - Acute interstitial nephritis during continuous intravenous administration of low
      dose interleukin-2.

PMID- 1738407
TI  - Gordon's syndrome--hypertension and hyperkalemia associated with normal
      glomerular filtration rate.

PMID- 1738408
TI  - Interaction of fluconazole with ciclosporin A.

PMID- 1738409
TI  - Metabolic study in dysmorphic hematuria.

PMID- 1738410
TI  - Serum erythropoietin levels in the immediate kidney-posttransplant period.
AB  - Following successful kidney transplantation, renal anemia is gradually corrected
      during the first 3-4 months. Serum erythropoietin (EPO) levels are increased
      after the first postoperative day following grafting. In this study, the serum
      EPO levels in the early posttransplant phase were investigated in 8 living-donor
      and 7 cadaveric-kidney transplant recipients with special emphasis on the first
      24 h. Despite a considerable difference in cold ischemic time of the graft in the
      two groups the increase in serum EPO levels was noticed at about the same time (8
      h) in both groups and the first peak of serum EPO, which was observed after 24 h,
      reached the same level in both groups. After 9-11 days, serum EPO reached levels
      which usually are observed during the first months following transplantation. The
      EPO response seems to be blunted in relation to the degree of anemia in the early
      posttransplant phase.

PMID- 1738411
TI  - Infusion of peripheral blood mononuclear cell products from nephrotic children
      increases albuminuria in rats.
AB  - Supernatants of peripheral blood mononuclear cell culture from children with
      minimal change nephrotic syndrome (MCNS) and focal segmental glomerulosclerosis
      (FSGS) were tested for their ability to increase glomerular basement membrane
      (GBM) permeability and for effects on anionic sites in the GBM. Supernatants from
      cultures of concanavalin A-stimulated peripheral blood mononuclear cells from
      patients with MCNS, those with FSGS and normal controls were infused into the
      renal arteries of normal rats. Infusion of the supernatants from patients with
      MCNS and FSGS caused a significant reduction of anionic sites in the GBM (p less
      than 0.001) and a significant increase in urinary albumin excretion (p less than
      0.05), whereas infusion of supernatants in control cases did not reduce anionic
      sites nor increase urinary albumin excretion. These findings show that
      stimulation of peripheral blood mononuclear cells from MCNS and FSGS with
      concanavalin A results in liberation of soluble substances which reduce
      polyanions in the GBM and increases GBM permeability.

PMID- 1738412
TI  - Inhibition of urea tubular reabsorption by PGE1 infusion in man.
AB  - We have shown that the inhibition of prostaglandin (PG) synthesis in man
      decreases the fractional clearance of urea (FCurea). To understand the
      mechanism(s) by which PG affect the renal handling of urea, 6 normal volunteers
      were randomly studied in maximal antidiuresis (by water deprivation and by
      administering 1-desamino-8-D-arginine vasopressin) before and during PGE1
      infusion, in two separate occasions: (A) after 7 days of normal protein (1 g/kg
      b.w./day) and water intake (10 ml/kg b.w./day), and (B) after 7 days of low
      protein intake (0.5 g/kg b.w./day) and high water intake (80 ml/kg b.w./day) to
      lower the corticomedullary osmotic gradient. During infusion of PGE1 at rates of
      0.01, 0.05 and 0.1 micrograms/min/kg, randomly administered, the urinary fluid
      losses were replaced by infusing equal volumes of hypotonic NaCl (80 mmol/l). To
      evaluate the time effects of this protocol, control studies were performed in an
      other 8 subjects receiving vehicle infusion without PGE1. In study A, FCurea rose
      by 23% (p less than 0.01) at the lowest PGE1 infusion rate (0.01
      micrograms/min/kg), in the absence of any simultaneous change in water and salt
      output, Uosm, PAH and inulin clearance. Higher PGE1 infusion rates (0.05 and 0.1
      micrograms/min/kg) were associated with a progressive increase of FCurea (50%, p
      less than 0.001 and 91%, p less than 0.001, respectively), fractional clearance
      of water and salt output, inulin and PAH clearance and reduced Uosm from 1,005
      (22 SEM; basal value) to 772 (38 SEM; minimum value) mosm/kg (p less than
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738413
TI  - Effect of thrombocytopenia on the onset of immune complex glomerulonephritis.
AB  - The effect of platelets on the development of immune complex glomerulonephritis
      (GN) was examined using bovine serum albumin (BSA) GN with platelet depletion. To
      clarify the role of platelets in the initial stage of BSA GN, thrombocytopenia
      was induced before BSA infusion. In 18 New Zealand white rabbits, BSA was
      intravenously injected twice after the presensitization. Eight of these BSA GN
      rabbits were injected daily with goat anti-rabbit platelet antiserum to induce
      thrombocytopenia, and platelet counts were maintained below 5 x 10(4)/microliters
      throughout the experiment. In the thrombocytopenic group, the degree of
      proteinuria was significantly decreased compared to the control group. Glomerular
      polymorphonuclear leukocyte infiltration, mononuclear cell proliferation,
      exudation and glomerular enlargement were significantly suppressed in the
      thrombocytopenic group. The results suggest that platelets may be quite important
      in the initiation and development of immune complex GN.

PMID- 1738414
TI  - Increased lipid peroxidation in patients on maintenance hemodialysis.
AB  - Lipid peroxidation products, lipid hydroperoxide and malonaldehyde were measured
      in the serum of patients on maintenance hemodialysis and compared with values
      obtained from a group of healthy controls. Dialysis patients had significantly
      elevated levels of lipid peroxidation products (12.9 +/- 1.9 vs. 9.3 +/- 1.3
      nmol/ml, mean +/- SD, patients vs. controls, p less than 0.0001). In contrast,
      the serum transferrin level was significantly lower in the dialysis patients (217
      +/- 71 vs. 290 +/- 50 mg/dl, patients vs. controls, p less than 0.0002). Compared
      to normal controls HDL cholesterol was lower (40 +/- 11 vs. 53 +/- 8, p less than
      0.0001) and triglycerides were higher (206 +/- 103 vs. 142 +/- 64, p less than
      0.007) in the patient group. The patient group was then divided on the basis of
      using polysulfone or cupraphane dialyzers. Patients using polysulfone dialyzers
      had lower levels of 2-thiobarbituric acid-reactive substances (12.3 +/- 0.9 vs.
      13.6 +/- 2.1, polysulfone vs. cupraphane, p = 0.05), and higher transferrin
      concentrations (248 +/- 84 vs. 194 +/- 37, p = 0.03). Thus, in patients on
      maintenance hemodialysis there was evidence for accelerated lipid peroxidation.
      This abnormality was more marked in patients using traditional cupraphane
      dialyzers. The mechanism for this observation remains unclear.

PMID- 1738415
TI  - Control of predialytic hyperphosphatemia by oral calcium acetate and calcium
      carbonate. Comparable efficacy for half the dose of elemental calcium given as
      acetate without lower incidence of hypercalcemia.
AB  - Since Mai et al. found, with the intestinal lavage technique, that the same dose
      of elemental calcium given as acetate (Ca Ac) complexed in the gut of uremic
      patients twice as much phosphate as calcium carbonate (CaCO3) while inducing a
      rather low calcium absorption, we wanted to see if half the dose of elemental
      calcium given as Ca Ac could control, on medium term, the predialysis plasma
      phosphate as well as CaCO3 while inducing less frequent hypercalcemia. This was
      evaluated in a cross-over study of 3 periods of 10 weeks according to the
      sequence Ca Ac, CaCO3 and Ca Ac, in 12 compliant patients on chronic dialysis
      previously treated by CaCO3. Because of poor tolerance of Ca Ac during the first
      period, 4 patients were excluded and the results were assessed only on the 8
      patients who completed the study. For half the doses of elemental calcium (620 +/
      250 mg versus 1,310 +/- 560 mg versus 710 +/- 200 mg/day), Ca Ac allowed the
      same control of predialytic hyperphosphatemia (1.67 +/- 0.34; 1.74 +/- 0.32; 1.75
      +/- 0.38) with paradoxically comparable normal mean plasma calcium concentration
      (2.61 +/- 0.14; 2.56 +/- 0.13; 2.55 +/- 0.14 mmol/l). Plasma alkaline
      phosphatases and intact PTH concentrations remained also stable during the 3
      periods. The frequency of hypercalcemia greater than 2.75 mmol/l (12; 9; 20%) and
      of hyperphosphatemia greater than 2 mmol/l (17; 22; 27%) were comparable with the
      2 treatments. In conclusion, Ca Ac controls predialytic hyperphosphatemia as
      efficiently as CaCO3 for half the dose of elemental calcium without, however,
      decreasing the frequency of hypercalcemia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738416
TI  - Prognostic indicators in childhood IgA nephropathy.
AB  - A number of clinical, laboratory and pathologic parameters were assessed for
      their prognostic significance in 200 children aged less than 15 years with IgA
      nephropathy, who had shown normal renal function at the time of initial biopsy
      and were followed for more than 2 years thereafter. After a mean follow-up period
      of 5.0 years from the initial biopsy, 93 patients had no demonstrable
      abnormality, 76 had minor urinary abnormalities, 21 had persistent heavy
      proteinuria and 10 had developed chronic renal impairment. A poor outcome was
      found to be correlated with heavy proteinuria at biopsy, diffuse mesangial
      proliferation, a high proportion of glomeruli showing sclerosis, crescents or
      capsular adhesions, the presence of moderate or severe tubulointerstitial
      changes, and the presence of subepithelial electron-dense deposits and lysis of
      the glomerular basement membrane by electron microscopy. The percentage of
      glomeruli displaying crescents, sclerosis and adhesions appeared to be the most
      reliable prognostic indicator. Nine of the 27 patients (33%) in whom greater than
      or equal to 30% of glomeruli showed crescents, sclerosis and adhesions developed
      chronic renal impairment, and only 14% of these patients had normal urine at
      follow-up. In contrast, only 1 of the 173 patients in whom less than 30% of
      glomeruli showed such lesions developed chronic renal impairment (p less than
      0.001) and 51% of these patients showed complete remission at follow-up (p less
      than 0.001). These results demonstrate that an accurate prediction of the outcome
      based on the initial renal biopsy findings is possible early in the course of
      children with IgA nephropathy.

PMID- 1738417
TI  - Study on chronic renal injuries induced by carbon tetrachloride: selective
      inhibition of the nephrotoxicity by irradiation.
AB  - Carbon tetrachloride (CCl4) was intraperitoneally injected into Balb/c mice 4
      times at biweekly intervals, and the morphological changes of the liver and
      kidney were examined during 12 weeks after the last injection. The renal injuries
      progressed in spite of cessation of CCl4 treatment; microcysts with tubular-cell
      degeneration were manifest on day 42 after the last injection of CCl4. At the end
      of the experiment, however, interstitial fibrosis with inflammatory cell
      infiltration was much more prominent. Glomerular changes with IgG deposits also
      developed following the tubulointerstitial changes. The CCl4 treatment induced
      liver damage as well, but it promptly subsided without formation of cirrhosis.
      The CCl4 nephrotoxicity was completely inhibited by whole body irradiation (200
      rad) exposed at each injection of CCl4. In contrast, the hepatic damage was not
      changed by irradiation. These results seem to indicate etiologic independence of
      renal and hepatic events induced by CCl4 treatment. It is also suggested that
      chronic CCl4 nephrotoxicity is mediated, at least in part, by radiosensitive
      responses of the mice themselves.

PMID- 1738418
TI  - Plasma profiles and dialysis kinetics of oxalate in patients receiving
      hemodialysis.
AB  - Regular dialysis treatment (RDT) does not obviate hyperoxalemia of chronic renal
      failure (CRF). However, there is emerging evidence suggesting that current
      dialysis prescription is not always associated to progressive oxalate
      accumulation. In view of the controversy still concerning this issue, we have
      investigated on plasma profiles and dialysis kinetics of oxalate in patients on
      RDT. Oxalate was determined by ion chromatography on serum ultrafiltrates and on
      the whole dialyzate in 23 stable patients on RDT for end-stage renal failure
      unrelated to primary hyperoxaluria. Nine patients were on traditional
      hemodialysis (HD) and 14 on soft hemodiafiltration (HDF). Dialysis prescription
      was set so as to obtain similar KT/V of urea. Mean dialyzer clearance of oxalate
      (KdOx) was calculated by standard procedures and was compared to urea (KdUrea)
      and creatinine (KdCr) clearances. Oxalate removal was measured on the whole spent
      dialyzate. Distribution volume of oxalate (VOx) was estimated by assuming a
      single-pool model and was used to estimate the oxalate appearance rate (OxAR).
      Plasma profiles showed that dialysis patients were virtually always
      hyperoxalemic. However, the threshold of supersaturation for calcium oxalate was
      exceeded in only 13 of 138 (9.4%) assayed ultrafiltrates, 13% on HD and 7.1% on
      HDF. Dialysis reduced plasma oxalate by more than 60%. There was a postdialysis
      oxalate rebound averaging 9.6% at 30 min from the end of dialysis. Plasma oxalate
      predialysis was independent of sex, age and time on dialysis. KdOx was mildly
      higher on HDF than on HD, and was lower than both KdUrea and KdCr, irrespective
      of the dialysis technique.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738419
TI  - Intraglomerular proteinase activity in adriamycin-induced nephropathy.
AB  - Adriamycin (ADR)-induced nephropathy is characterized by focal and segmental
      glomerulosclerosis and is supposed to be an ideal model of chronic progressive
      renal disease. The aim of our study was to investigate whether there might be an
      altered activity of glomerular proteinases in ADR nephropathy, thereby
      aggravating glomerular protein accumulation as an important initiating hallmark
      of glomerulosclerosis. In fact, we could demonstrate significantly enhanced
      levels of intraglomerular protein and DNA content in the experimental animals at
      week 7, 12 and 22 after administration of ADR. When relating intraglomerular
      proteinase activity, which was measured in ultrasonically destroyed isolated
      glomeruli, obtained by differential sieving techniques, to the intraglomerular
      protein and DNA content, this enzyme activity was significantly reduced
      throughout the observation period. Based on these data, we suggest that this
      relatively decreased proteinase activity in glomeruli exposed to ADR might play a
      pathogenetic role in the development of glomerular hypertrophy, an important
      harbinger of glomerulosclerosis.

PMID- 1738420
TI  - Increases in levels of collagen types I and IV messenger ribonucleic acid in
      murine kidneys after treatment with ciclosporin.
AB  - We investigated changes in the levels of mRNA transcripts encoding types I and IV
      collagen in the kidney following the administration of ciclosporin (CS) in mice.
      Daily doses of CS increased the levels of mRNAs encoding collagen types I and IV
      in whole kidneys harvested 4 weeks after treatment. At this time point, neither a
      reduction of renal function detected by serum creatinine, nor histologic evidence
      of interstitial damage were present. Elevated levels of serum creatinine as well
      as mild interstitial changes did develop, however, 12 weeks after daily treatment
      with CS. Collagen type I transcripts were almost normal after 12 weeks, whereas
      levels of type IV mRNA were still elevated. Our findings indicate that increases
      in transcripts encoding collagens precede a deterioration in renal function and
      the development of interstitial changes in this murine model of chronic CS
      nephrotoxicity.

PMID- 1738421
TI  - Induction of irreversible glomerulosclerosis in the rat by repeated injections of
      a monoclonal anti-Thy-1.1 antibody.
AB  - The present experiment demonstrated that an irreversible glomerulosclerosis could
      be induced in the rat through repeated intravenous administrations of OX-7 (a
      monoclonal anti-Thy-1.1 antibody). Rats were injected with 0.2 mg of affinity
      purified OX-7 at 1-week intervals for a period of 4 weeks. Glomerular damage was
      periodically examined at light-microscopic level. Thirty-five days after the
      initial injection (7 days after the final injection), capillary aneurysms and
      expansion of the mesangial areas with hypercellularity were frequently observed.
      Similar glomerular damage was also observed in rats 7 days after they received a
      single injection of either 1.0 or 0.2 mg of OX-7. After repeated injections, 112
      days from the initial administration (84 days after the final injection),
      approximately 60% of the glomeruli had expanded mesangial areas with an apparent
      increase in the mesangial matrix. The result contrasts sharply with that obtained
      from a single injection of OX-7 in that more than 85% of the glomeruli showed no
      abnormalities 84 days after the injection. This chronic model, as a result of
      repeated injections of the antibody, could serve as a potential for further
      investigation of the mechanisms involved in the development of chronic
      glomerulonephritis.

PMID- 1738422
TI  - [Magnetic resonance imaging in diffuse brain injury].
AB  - Forty cases diagnosed as diffuse brain injury (DBI) were studied by magnetic
      resonance imaging (MRI) performed within 3 days after injury. These cases were
      divided into two groups, which were the concussion group and diffuse axonal
      injury (DAI) group established by Gennarelli. There were no findings on
      computerized tomography (CT) in the concussion group except for two cases which
      had a brain edema or subarachnoid hemorrhage. But on MRI, high intensity areas on
      T2 weighted imaging were demonstrated in the cerebral white matter in this group.
      Many lesions in this group were thought to be edemas of the cerebral white
      matter, because of the fact that, on serial MRI, they were isointense. In mild
      types of DAI, the lesions on MRI were located only in the cerebral white matter,
      whereas, in the severe types of DAI, lesions were located in the basal ganglia,
      the corpus callosum, the dorsal part of the brain stem as well as in the cerebral
      white matter. As for CT findings, parenchymal lesions were not visualized
      especially in mild DAI. Our results suggested that the lesions in cerebral
      concussion were edemas in cerebral white matter. In mild DAI they were non
      hemorrhagic contusion; and in severe DAI they were hemorrhagic contusions in the
      cerebral white matter, the basal ganglia, the corpus callosum or the dorsal part
      of the brain stem.

PMID- 1738423
TI  - [Clinical course in poor grade patients with ruptured intracranial aneurysms and
      extensive subarachnoidal clot].
AB  - Three hundred and eight cases with ruptured intracranial aneurysms and variable
      amounts of subarachnoidal clot were evaluated clinically with special emphasis on
      the natural course of poor grade patients. Clinical severity was classified
      according to the Glasgow Coma Scale (GCS); severe cases (score 3-8) and mild
      cases (score 9-15). Patients were further divided into four groups based on the
      preoperative clinical course, and on whether radical surgery was performed or
      not. Group A, severe cases without radical surgery (17 patients, mean GCS score
      4.2); group B, severe cases (which had undergone) radical surgery (24 cases, mean
      GCS score 5.5); group C, patients considered as severe cases on admission that
      had improved to mild cases before radical surgery (3 patients, mean GCS score
      11.7); group D, mild cases which had undergone radical surgery (254 cases, mean
      GCS score 14.3). CT findings after their last bleeding episode were evaluated in
      each group using subarachnoid hemorrhage (SAH) score from "0"-"3" according to
      the severity of SAH. In addition, the SAH-B (brainstem) score ("0"-"9") was also
      evaluated. In this score, the amount of SAH in each perimesencephalic cistern (a.
      prepontine or interpeduncular cistern, b. ambient cistern, c. quadrigeminal
      cistern) was considered with a possible score of "0"-"3" for each cistern. (No
      patient had a concurrent intracerebral or intraventricular hematoma causing a
      mass effect on CT scan). All cases in group A died except one patient that
      remained in a vegetative state. All of them had severe subarachnoidal clot (mean
      SAH score 2.9, SAH-B score 8.2). In group B, in patients with same scores (mean
      SAH score 2.8, mean SAH-B score 7.3), the outcome was as follows: 6 patients
      (33.3%) had full recovery or were capable of self-management, 6 patients (33.3%)
      were partially or fully dependent, and 12 patients (50%) were either in
      vegetative state or died. Patients in groups C and D with good outcome had
      significantly less amount of SAH, especially in the perimesencephalic cistern
      (group C--mean SAH score 2.3, mean SAH-B score 3.7, group D--mean SAH score 1.9,
      mean SAH-B score 3.3). It is concluded that duration and level of unconsciousness
      in the cases of SAH without concurrent hematoma causing mass effect, has a good
      correlation with the severity of SAH in the perimesencephalic cisterns.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1738424
TI  - [Study of meningeal carcinomatosis: diagnosis and treatment].
AB  - Thirty-four patients with meningeal carcinomatosis were treated at The Center for
      Adult Diseases, Osaka, from 1984 through 1990. The major origin of meningeal
      carcinomatosis was carcinoma of the lung (14 cases) and breast (8 cases). The
      most frequent histological type of carcinoma was adenocarcinoma (23 cases).
      Twenty cases still had active lesions and/or primary lesions in the lung, liver
      or bone at the time of diagnosis of the meningeal carcinomatosis. The primary
      lesions were treated surgically in 22 cases, with chemotherapy in 4 cases and
      with radiotherapy in 2 cases. Metastatic brain tumors were treated by surgical
      removal followed by chemo-radiotherapy in 12 cases, and with radiotherapy alone
      in 2 cases. The interval from the time of diagnosis of the primary lesion to the
      time of diagnosis of the meningeal carcinomatosis varied from one month to eight
      years, and the interval between surgical removal of metastatic brain tumors and
      the diagnosis of meningeal carcinomatosis ranged from 0 to 3 years. With regard
      to the diagnosis of meningeal carcinomatosis, positive cytology was seen in
      initial standard lumbar puncture in 32 of the 34 patients. CT scan showed
      abnormal findings in 28 of the 34 patients, including ventricular dilatation only
      (12 cases), and small enhancing lesions along the CSF space (12 cases). The EEG
      showed abnormal patterns in 14 of 15 cases. Intrathecal chemotherapy with
      methotrexate alone or combined methotrexate with cytosine arabinoside via the
      Ommaya reservoir or standard lumbar puncture alternately with or without
      radiation therapy was successful as treatment, and 22 of 29 treated patients
      showed symptomatic improvement of the meningeal irritation.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1738425
TI  - [Study on the extent of peritumoral edema in glioma: its correlation with the
      proliferative potential and tumor-infiltrating mononuclear cells].
AB  - The correlation between the extent of peritumoral edema and the proliferative
      potential or the infiltration of mononuclear cells was studied in 17 gliomas. The
      peritumoral edema was evaluated on contrast enhanced CT scan as the ratio of the
      low density area around the tumor to the enhanced high density area. The
      proliferative potential and the infiltration of mononuclear cells into the tumor
      were investigated immunohistochemically using monoclonal antibody (MAb) against
      DNA polymerase alpha and anti-Leu MAb's respectively. There was a significant
      correlation between the extent of the peritumoral edema and the percentage of DNA
      polymerase alpha positive cells. The degree of the infiltration of mononuclear
      cells into the tumor tissue also correlated with the extent of peritumoral edema.
      In gliomas with high proliferative potential and/or severe infiltration of
      mononuclear cells, the peritumoral edema may be aggravated by disruption of the
      blood-brain-barrier and increased vascular permeability.

PMID- 1738426
TI  - [Two cases of von Recklinghausen's disease with multiple brain and spinal
      tumors].
AB  - The authors reported two cases of von Recklinghausen's disease with multiple
      brain tumors and multiple spinal tumors. The first case, a 21-year-old man who
      had a past history of optic gliomas was admitted because of gait disturbance.
      Computed tomography (CT) and magnetic resonance imaging (MRI) showed
      calcification of the basal ganglia, bilateral C-P angle tumors, cystic cerebellar
      tumor and arachnoid cyst in the quadrigeminal cistern. Myelography and MRI
      revealed multiple spinal tumors. Surgical management was performed and cerebellar
      tumor was histologically confirmed to be a pilocytic astrocytoma. Spinal tumors
      were also astrocytomas. The second patient, a 56-year-old woman suffered from
      right iliac pain, right hemiparesis and motor aphasia. CT revealed two round
      tumors in the left cerebral hemisphere and bilateral C-P angle tumors.
      Myelography and MRI demonstrated multiple intradural-extramedullary spinal
      tumors. Histologically, supratentorial tumors were transitional meningiomas and
      spinal tumors were neurinomas. It is well known that von Recklinghausen's disease
      is often associated with brain or spinal tumors. But, in the literature, only 22
      cases of von Recklinghausen's disease combined with multiple brain tumors with
      different histological types and multiple spinal tumors have been reviewed. With
      our two cases, the average age of these 24 cases was 28.6 years old, nine cases
      were male and 15 cases were female. All patients had C-P angle tumors and 23
      cases were combined with intracranial meningiomas. In this paper, the clinical
      features and diagnostic aspects were discussed.

PMID- 1738427
TI  - [Radiosensitive malignant meningioma presenting Garcin's syndrome: a case
      report].
AB  - A 58-year-old woman with Garcin's syndrome caused by malignant meningioma is
      reported. She first noticed left facial hypesthesia followed by left visual
      disturbance with exophthalmos. CT scan showed an enhanced mass extending from the
      left cavernous sinus to the left orbit. Cranial x-ray revealed bone deformity
      around the orbit. The tumor was subtotally resected and its histological type was
      shown to be anaplastic meningioma. After the initial surgery the patient was left
      with hyposmia, mild ptosis and incomplete 6th cranial nerve palsy on the left
      side. After one and half years, not only palsy of those cranial nerves but also
      that of other unilateral cranial nerves became progressively apparent due to
      tumor regrowth. In total, 11 nerves (2nd-12th) were affected by the tumor,
      without long tract signs or symptoms of increased intracranial pressure.
      Radiation therapy carried out after the 2nd surgery was extremely effective and
      resulted in the recovery of lower cranial nerve function. The tumor was founded
      to have disappeared completely on the 2-year follow-up CT.

PMID- 1738428
TI  - [A case of hypothalamic astrocytoma with precocious puberty].
AB  - A case of hypothalamic astrocytoma with precocious puberty is presented. In July
      1989, a 2-year-old girl was admitted to our hospital because of vaginal bleeding
      and enlargement of breasts. Breast development was Tanner's stage 3 and no pubic
      hair was present. Endocrinological evaluation revealed a slightly high level of
      LH, but the responses of LH and FSH to LH-RH test resulted in exceedingly high
      values similar to those in adults. Plain CT scan showed an isodense mass in the
      suprasellar cistern which was not enhanced following administration of contrast
      medium. MR imaging revealed the precise location of the mass attached to the
      posterior hypothalamus between the pituitary stalk and the mamillary bodies in
      sagittal view. The signal intensity of the mass was homogenous and isointense
      relative to the gray matter on T1 weighted image. But on T2 weighted image, it
      showed high signal intensity compared with the normal brain parenchyma. A right
      fronto-temporal craniotomy was performed and the tumor was partially removed.
      Histological examination disclosed moderate hypercellularity of glial cells but
      no neurons were visible. This appeared to be astrocytoma grade II. In the
      literature, CT and MRI behaviour of hypothalamic hamartomas are almost similar to
      our case. Therefore we think it is not possible at the present time to
      differentiate a low grade astrocytoma from hamartoma when using CT and MRI alone.
      In this case, the mechanism of development of precocious puberty seemed to be due
      to hypothalamic compression by the tumor.

PMID- 1738429
TI  - [Two cases of lateral approach for thoraco-lumbar junctional lesions: experiment
      of Kaneda's device].
AB  - Case 1: a 32-year-old woman was admitted to our hospital with major complaints of
      gait disturbance and urinary incontinence. The tendon reflex was markedly
      increased in the bilateral lower extremities, and both Babinski's reflex and
      clonus were strongly positive. Myelography revealed complete block in the 10th
      thoracic vertebral level. On April 15, 1989, a tumor in the vertebral region was
      exposed and excised via a right posterolateral approach. Kaneda's device was used
      for internal fixation. The tumor was diagnosed as myeloma histologically. The
      postoperative course was uneventful. Postoperatively, the patient became capable
      of walking by herself. Case 2: an 18-year-old woman was admitted because of burst
      fractures of the 1st and 2nd lumbar vertebrae due to a traffic accident in
      January of 1989. The fractured bones had been manually repositioned and fixed
      with plaster. However, the patient still had gait disturbance (intermittent
      claudication). Myelography revealed a complete block in the 2nd lumbar vertebral
      region. On May 7, the vertebral foramen was opened via a left anterolateral
      approach, and internal fixation was performed using Kaneda's device.
      Postoperatively, the patient recovered full ability to walk, and returned to
      normal social activity. From our experience, it is thought to be useful to employ
      a right posterolateral approach to the thoracic vertebrae, and a left
      anterolateral approach to the lumbar vertebrae. We used Kaneda's device for
      internal fixation, successfully. However, this device has the following
      disadvantages; (1) there are few plates designed for females, whose vertebrae are
      small, (2) it is difficult to preserve the arteries of Adamkiewicz and (3)
      postoperative MRI becomes impossible.

PMID- 1738430
TI  - [Postoperative intracranial hemorrhage due to vitamin K deficiency: report of two
      cases].
AB  - Vitamin K deficient hemorrhagic diathesis is well known as a cause of infantile
      intracranial hemorrhage. Its occurrence, however, as a post-surgical complication
      is rare and has never been reported previously. Two cases are presented here
      which illustrate the existence of such a hazard. Case 1. A 73-year-old woman
      admitted with subarachnoid hemorrhage (WFNS IV) underwent microsurgical
      exploration of a left internal carotid aneurysm, and neck clipping of the
      aneurysm was performed. She had an uneventful postoperative course, but her
      neurological condition deteriorated suddenly on the fifth postoperative day. CT
      scan revealed a large epidural hematoma. Case 2. A 6-year-old boy was admitted
      due to the dysfunction of a ventriculo-peritoneal shunt system that had
      previously been placed for hydrocephalus. This dysfunction was thought to be
      caused by meningitis. Twelve days after ventricular drainage and antibiotic
      therapy, sudden intraventricular hemorrhage occurred. In both cases, PT and APTT
      were markedly prolonged, FDP slightly increased and fibrinogen slightly
      decreased. SFMC was positive in case 2. After the administration of vitamin K, PT
      and APTT were immediately normalized. Recent reports emphasize the adverse effect
      of antibiotics that leads to vitamin K deficient hemorrhagic diathesis,
      especially, in patients in a cachectic state. In these two cases, such a
      cachectic condition was not observed. We presume that the cause of vitamin K
      deficiency would be, along with the administration of antibiotics, a preliminary
      condition of disseminated intravascular coagulation which is encountered in some
      neurological disorders including subarachnoid hemorrhage. We conclude that
      attention should be paid for these pitfalls in perioperative neurosurgical care.

PMID- 1738431
TI  - [Histological diagnosis of brain tumors: (19). Medulloblastoma].

PMID- 1738432
TI  - [CT findings in "fresh" cerebral paragonimiasis].
AB  - There are few reports on CT findings in "fresh" cerebral paragonimiasis. We have
      experienced four cases of "fresh" cerebral paragonimiasis examined by CT scan.
      Three patients were children aged 7, 9, and 14 years, and one was an adult aged
      25 years. Three patients were examined by CT scan 2 to 6 months after the onset
      of high grade fever, convulsion and focal deficit signs, and a patient was
      examined one month after his progressive visual disturbance. The unique CT
      findings are multilocular cystic lesions in temporo-occipital or in temporo
      parietal lobes with extensive brain edema. Two cases were also associated with
      "soap-bubble" calcifications. The cysts were more dense than CSF and enhanced by
      contrast media. The histopathological specimen showed that the eggs of
      paragonimus were in the abscess cavity, of which the wall was composed with
      highly vascular gliomesenchymal capsule and numerous cell infiltration. Three
      patients underwent craniotomy for removal of abscess and decompression. Bitionol
      were administered and all patients recovered well. We also discussed the
      differential diagnosis of cerebral parasitic granulomas.

PMID- 1738433
TI  - Thyroid hormones regulate the formation of inositol phosphate in response to
      thyrotropin-releasing hormone in rat anterior pituitaries.
AB  - The effects of thyroid hormones on TSH secretion and inositol phospholipid
      hydrolysis in response to thyrotropin-releasing hormone (TRH) in rat anterior
      pituitaries were examined. Experimental hypothyroidism caused a significant
      increase in [3H]inositol phosphate ([3H]IP) formation in response to TRH in rat
      anterior pituitaries with a concomitant elevation of blood TSH. In contrast,
      administration of thyroxine (T4) to hypothyroid rats resulted in a complete
      restoration of blood TSH and TRH-stimulated [3H]IP formation to the euthyroid
      control value. Furthermore, in vitro pre-treatment of anterior pituitaries with
      triiodothyronine (T3) produced a dose-dependent decrease in both TSH secretion
      and the formation of [3H]IP in response to TRH. These results indicate that
      thyroid hormones regulate TRH receptor-linked inositol phospholipid hydrolysis in
      the rat anterior pituitary, suggesting that negative feedback action of thyroid
      hormone occurs at post receptor event in the rat anterior pituitary, which may,
      to a certain extent, be responsible for the underlying mechanism of T3 inhibition
      of TSH secretion.

PMID- 1738434
TI  - Effect of diabetes on the levels of two forms of Met-enkephalin in plasma and
      peripheral tissues of the rat.
AB  - Levels of native and cryptic or peptidase-derivable (after being digested with
      trypsin and carboxypeptidase) Met-enkephalin were measured by a specific
      radioimmunoassay method in plasma, anterior and neurointermediate lobes of
      pituitary and various peripheral tissues of streptozotocin (STZ) diabetic rats.
      The results show that the highest concentration of native and cryptic Met
      enkephalin were found in the neurointermediate lobe of pituitary. Streptozotocine
      induced diabetes alters the concentration of either or both forms of Met
      enkephalin in plasma, the anterior and neurointermediate lobes of the pituitary,
      heart, lung, spleen, liver, seminal vesicle, vas deferens, kidney, bladder
      detrusor, and duodenum. One of the most pronounced effects of diabetes observed
      in this study is seen in the seminal vesicles where native Met-enkephalin was
      depleted to less than 10% of the control value. The uneven distribution of Met
      enkephalin in peripheral tissues may suggest that these tissues process and/or
      metabolize Met-enkephalin to different degrees. Our data also suggest that STZ
      induced diabetes alters the enkephalinergic activity in some of these tissues. It
      is suggested that some of the peripheral pathophysiological symptoms associated
      with diabetes may be attributed, in part, to altered activity of enkephalinergic
      systems.

PMID- 1738435
TI  - Cavernous sinus hemangiomas: a series, a review, and an hypothesis.
AB  - Cavernous sinus hemangiomas represent 3% of all benign cavernous sinus tumors.
      They are dangerous tumors because of the risk of excessive bleeding, but they are
      easier to dissect from surrounding structures than meningiomas because of the
      presence of a pseudocapsule. Three cases where total excision was achieved with
      minimal blood loss, without stroke, and with preservation of cranial nerve
      function in 2 cases are reported, and 50 cases from the literature are reviewed.
      Hemangiomas can be distinguished preoperatively from over one-half of meningiomas
      by their marked hyperintensity on T2-weighted magnetic resonance imaging. They
      arise within the cavernous sinus and extend laterally by dissecting between the
      two layers of dura lining the floor of the middle fossa. Cranial nerves III, IV,
      and V remained stretched over the tumor surface within the overlying dura,
      whereas cranial nerve VI is found within the tumor and is the most difficult
      cranial nerve to preserve. Principles for successful and safe excision include
      preoperative assessment of the safety of temporary or permanent carotid artery
      occlusion, obtaining early proximal carotid artery control, carefully developing
      the plane between the dura and the tumor pseudocapsule, early devascularization
      of the tumor, and avoiding "piecemeal" tumor resection. A few cases demonstrated
      tumor shrinkage with radiation therapy which should be considered for patients
      with incomplete tumor excision or who are too ill to undergo surgery.

PMID- 1738436
TI  - Spontaneous spinal epidural hematoma causing paraplegia: resolution and recovery
      without surgical decompression.
AB  - Spontaneous spinal epidural hematomas are well-recognized but rare entities. The
      standard treatment for these hematomas has been prompt surgical evacuation. The
      authors report a case of a 76-year-old man who precipitously became paraplegic
      secondary to a spontaneous spinal epidural hematoma and then experienced the
      complete resolution of his neurological deficit and the hematoma. We conclude
      that conservative (nonoperative) management of spontaneous spinal epidural
      hematomas may be appropriate in those instances in which there is early and
      sustained neurological recovery confirmed by radiological resolution of the
      lesion.

PMID- 1738437
TI  - Postlaminectomy lumbar pseudomeningocele: report of four cases.
AB  - Pseudomeningocele formation is unusual after a lumbar discectomy. Four patients
      who developed a pseudomeningocele after lumbar disc surgery are reported. The
      pseudomeningocele was symptomatic in three patients. The diagnosis of a
      pseudomeningocele was made by computed tomography in conjunction with myelography
      in three patients and magnetic resonance imaging in the fourth. All patients
      underwent surgery for the pseudomeningocele with primary closure of the dural
      defect (the patient whose meningocele was asymptomatic also had an excision of an
      extruded disc), and postoperative results were gratifying.

PMID- 1738438
TI  - Spinal intramedullary subependymomas: case report and review of the literature.
AB  - A cervical spinal intramedullary subependymoma in a 53-year-old man is reported,
      and the relevant literature is reviewed. Spinal cord subependymomas seem to
      follow a benign course. Radiotherapy should not be administered to these
      patients. Magnetic resonance imaging, even with enhancement, is not able to
      distinguish between a subependymoma and the more common ependymoma.

PMID- 1738439
TI  - Intramedullary epidermoid associated with an intramedullary spinal abscess
      secondary to a dermal sinus.
AB  - Intramedullary spinal abscesses are rare and potentially devastating lesions. A
      heightened clinical awareness of patients at risk is essential for an early
      diagnosis and intervention to improve the prognosis of these patients. The first
      case of spinal abscess was described in 1830, and only 63 cases have been
      reported subsequently. Intraspinal epidermoids also are unusual lesions. These
      tumors were reported first in 1829 and represent less than 1% of all intraspinal
      tumors. We present a case of a 2-year-old girl who had rapidly progressive
      paraplegia with urinary and bowel retention and was found to have an
      intramedullary epidermoid and an intramedullary abscess as a result of a dermal
      sinus. The association of an intramedullary abscess and epidermoid tumor, two
      rare lesions, has not been reported previously. We also review the literature
      related to both intramedullary epidermoids and intramedullary abscesses of the
      spinal cord. Advances in sectional imaging as described should help lead to an
      early and safe diagnosis of these rare but often debilitating lesions. This case
      illustrates the importance of a complete neurological assessment of all patients
      with a congenital dermal sinus because of the potential for intradural extension
      and the frequent association with other dysraphic abnormalities. Prophylactic
      surgery is indicated in many cases to prevent dangerous and recurrent infections
      of the central nervous system.

PMID- 1738440
TI  - Prophylactic hypervolemia without calcium channel blockers in early aneurysm
      surgery.
AB  - Delayed ischemic neurological deficit (DIND) remains a major unsolved problem in
      the management of aneurysmal subarachnoid hemorrhage (SAH). For many years, the
      complications reported with acute aneurysm surgery caused surgeons to operate
      late after SAH. In a 42-month-period, we managed 146 patients with aneurysm
      and/or SAH. Forty-seven patients were characterized by the following: Hunt and
      Hess Grades I through III after an aneurysmal SAH; 2) clipping of their aneurysm
      within 72 hours of their SAH; and (3) prophylactic hypervolemia with a pulmonary
      artery catheter to optimize their fluid management. Forty of 47 (85%) had an
      excellent or good outcome, and 3 of 47 (6%) died. All of those who died had DIND.
      Nine of 47 (19%) patients developed DIND. There were 20 complications, primarily
      pulmonary edema, in 16 patients and one death related to prophylactic
      hypervolemia. It is not clear from our experience, when compared with results
      from other series, that hypervolemia provides any additional benefit to the
      patient as measured by a reduction in the risk of DIND or improved outcome.
      Despite aggressive volume expansion to the point of cardiovascular compromise, as
      evidenced by our high rate of pulmonary edema, we had no appreciable decrease in
      neurological morbidity and mortality when compared with results from recent
      reports.

PMID- 1738441
TI  - Intramedullary abscess associated with a spinal cord ependymoma: case report.
AB  - Intramedullary spinal cord abscesses are relatively uncommon. We report the first
      case of an intramedullary spinal cord abscess in a preexisting spinal cord
      ependymoma. The clinical features and pathogenesis are discussed. Salient
      features of the management of intramedullary spinal cord abscesses are outlined.

PMID- 1738442
TI  - Traumatic spondylolisthesis of the lower cervical spine: case report.
AB  - A case of traumatic spondylolisthesis of C6 and C7 is presented. The mechanism of
      injury and the therapeutic implications are discussed.

PMID- 1738443
TI  - Spinal cord compression in Scheuermann's kyphosis: case report.
AB  - Compression of the spinal cord secondary to disc disorders in Scheuermann's
      kyphosis is rare. This review reports an unusual case emphasizing mechanisms of
      compression of the spinal cord from this disc disorder. Contrasts and comparisons
      with previously published cases are included.

PMID- 1738444
TI  - Video endoscopic sympathectomy using a fiberoptic CO2 laser to treat palmar
      hyperhidrosis.
AB  - Palmar hyperhidrosis is a common disorder among orientals. A new therapeutic
      technique for this disorder has been designed by combining a computer compact
      disc video endoscopic system with a fiberoptic CO2 surgical laser unit. The
      operation is performed under general anesthesia with alternating one-lung
      ventilation. There are three important aids in localizing the correct sympathetic
      segment: 1) direct visualization of its magnified image on the television
      monitor; 2) identification with an electrode probe palpation at its presumed
      location; and 3) monitoring the microvasomotor changes on the skin of the finger
      resulting from electrical stimulation of the sympathetic trunk. Subsequently, the
      confirmed sympathetic target is vaporized using a low power CO2 laser under
      direct vision on the television monitor. The laser is delivered to the target by
      a small optical fiber passing through a throacoscope, which is introduced into
      the thoracic cavity via the intercostal space between the second and third ribs
      at the midclavicular line. Fourteen palmar hyperhidrosis patients were
      successfully treated by this method. No complications, such as Horner's syndrome,
      bleeding, or intercostal neuralgia, were encountered. Although the number of
      cases treated was small, and the follow-up period was short, the evidence
      indicates that a definite sympathectomy on a confirmed segment under magnified
      vision is possible with this procedure, and could warrant a definite and long
      lasting therapeutic effect. Based on our experience, the method is considered a
      relatively minor and safe procedure, causing minimal discomfort and almost
      invisible scars. The operation time and hospital stay were remarkably shortened
      in comparison with other conventional sympathectomy procedures.

PMID- 1738445
TI  - Partial callosal resection for pericallosal aneurysms.
AB  - The surgical treatment of aneurysms that arise at the origin of the pericallosal
      artery is technically difficult. This report describes a technique that improves
      the exposure of the proximal vasculature during a craniotomy for pericallosal
      aneurysms. A portion of the corpus callosum was resected in two patients before
      the manipulation of their aneurysms. The resection provided excellent exposure of
      the A2 segment of the anterior cerebral artery, and both aneurysms were clipped
      safely. Neither patient exhibited signs of hemispheric disconnection. The authors
      conclude that partial callosal resection improves access to the proximal vessels
      during procedures for pericallosal aneurysms.

PMID- 1738446
TI  - A simple and reliable technique to monitor intracranial pressure in the rat:
      technical note.
AB  - A technique for intracranial pressure (ICP) monitoring in the rat that uses a
      permanent cisterna magna cannula is described. The cannula is placed into the
      subarachnoid space through the atlanto-occipital membrane with the operating
      microscope and is secured with cement. The distal end is connected to a pressure
      transducer and a polygraph recorder. To study the consistency of this technique,
      12 anesthetized adult rats were subjected to baseline ICP measurements 2 days
      after placement of the cannula. Baseline pressures ranged between 1.0 and 10.0 cm
      H2O, with a mean of 5.6 cm H2O. Respiratory variations were detected in all
      tracings, and manual abdominal compressions (Valsalva maneuver) correlated with
      immediate transient rises in ICP in all rats. While CSF pressure was being
      continuously monitored, rats were subjected to subarachnoid hemorrhage induced by
      transclival basilar artery puncture. Of the 12 rats, 10 showed a moderate
      transient rise in cerebrospinal fluid pressure, which peaked approximately 2
      minutes after subarachnoid hemorrhage (mean peak change, 10.5 cm H2O; range, 0
      32.5 cm H2O). Reliable pressure tracings were obtained in three of five animals
      examined 3 days after subarachnoid hemorrhage (ICP range, 4.0-4.5 cm H2O; mean,
      4.2 cm H2O). We conclude that this cannula is easy and inexpensive to construct
      and that it provides reliable ICP tracings during experimental procedures in the
      rat.

PMID- 1738447
TI  - Complete temporal lobectomy for surgical resuscitation of patients with
      transtentorial herniation secondary to unilateral hemisphearic swelling.

PMID- 1738448
TI  - Transplantation of adrenal medulla and omentum to the putamen by a transinsular
      pathway for Parkinson's disease.

PMID- 1738449
TI  - Prolonged lumbar spinal drainage after the resection of tumors of the skull base:
      a cautionary note.

PMID- 1738450
TI  - Role of prostaglandins in delayed cerebral ischemia after subarachnoid
      hemorrhage.
AB  - Prostaglandin E2, thromboxane B2, and 6-oxo-prostaglandin F1 alpha were assayed
      in blood and cerebrospinal fluid samples from patients after subarachnoid
      hemorrhage (SAH) and from a control population. The levels found in samples
      obtained from patients after SAH were compared with those found in controls and
      were also correlated with a number of clinical and radiological variables, many
      of which are either significantly associated with or represent evidence of
      cerebral ischemia. The levels of prostaglandin E2, thromboxane B2, and 6-oxo
      prostaglandin F1 alpha in blood samples from patients after SAH and from controls
      were below the level of sensitivity of the assays. Levels of prostaglandin E2,
      thromboxane B2, and 6-oxo-prostaglandin F1 alpha in cerebrospinal fluid from
      patients after SAH were significantly elevated when compared with those found in
      control samples. There was no significant correlation, however, between the level
      of each prostaglandin measured and the following variables: clinical grade on
      admission as assessed by the Glasgow Coma Score and the World Federation of
      Neurological Surgeons grading system; the amount of subarachnoid blood seen on
      computed tomographic scan; the occurrence of ischemic deterioration; the
      occurrence of low density change on computed tomographic scan; the presence of
      vasospasm on angiography; clinical outcome as assessed by the Glasgow Coma Score
      3 months after the ictus; and the incidence of ischemia as a cause of death or
      disability as assessed 3 months after the ictus. A primary role for
      prostaglandins in the etiology of delayed cerebral ischemia after SAH is not
      therefore confirmed.

PMID- 1738451
TI  - Neuropsychological assessment outcomes of nonacquired immunodeficiency syndrome
      patients with primary central nervous system lymphoma before and after blood
      brain barrier disruption chemotherapy.
AB  - The risk of neurotoxicity was evaluated in eight consecutive patients with non
      acquired immunodeficiency syndrome (AIDS) primary central nervous system lymphoma
      who had survived disease free for more than 1 year after completion of treatment
      with osmotic opening of the blood-brain barrier and chemotherapy (methotrexate,
      cytoxan, procarbazine, and decadron). Trends in neuropsychological assessment
      results between baseline and follow-up (1 to 7 years) were analyzed for all eight
      nonradiated survivors. This serial assessment design addressed the specific issue
      of neurotoxic risk potential of treatment, when confounding factors of tumor
      persistence/recurrence and cranial irradiation were ruled out. Follow-up results
      of an extensive battery of tests to assess higher cortical function provided
      evidence of the safety of chemotherapy protocol with the blood-brain barrier
      disruption. These findings stand in contrast to well-known cognitive risks
      associated with cranial radiotherapy. Long-term follow-up suggests that
      chemotherapy can be given in conjunction with osmotic opening of the blood-brain
      barrier in nonradiated patients without cognitive manifestations of
      neurotoxicity.

PMID- 1738452
TI  - Quantitative study of blood-brain barrier permeability changes after experimental
      whole-brain radiation.
AB  - Basic mechanisms underlying the tolerance and reaction of the central nervous
      system to ionizing radiation are not known precisely. We investigated the
      possibility of a change in blood-brain barrier (BBB) function as a causative
      factor for early delayed whole-brain radiation-induced cerebral dysfunction. Rats
      were exposed to conventional fractionation (200 cGy/d, 5 d/wk; total dose, 4000
      cGy). BBB changes were assessed by means of the quantitative 14C-alpha
      aminoisobutyric acid technique and electron microscopy. Studies of the passage of
      horseradish peroxidase across the BBB permitted comparative quantitative
      isotopical and qualitative morphological data. Experiments were carried out 2 to
      3 weeks after the completion of the radiation exposure. The transport of 14C
      alpha-aminoisobutyric acid across the BBB increased significantly in cerebral
      cortex and cerebellar gray matter, averaging 1.3 to 1.5 times over the normal
      values. Electron microscopy disclosed an intense vesicular response of the
      cortical microvascular endothelium that occurred without the opening of the tight
      junctions and resulted in an intense transport of HRP across the intact
      endothelium. The present data indicate that moderate doses of whole-brain
      radiation induce well-defined changes in BBB function, which possibly are
      involved in the pathogenesis of radiation-induced cerebral dysfunction in humans.

PMID- 1738453
TI  - Intradural extramedullary cysts of the spinal canal: clinical presentation,
      radiographic diagnosis, and surgical management.
AB  - Fourteen patients with intradural extramedullary cysts of the spinal canal are
      described. Histological classification included 11 arachnoid, 2 epithelial, and 1
      ependymal cyst. There were 9 thoracic, 3 cervical, and 2 lumbar cysts. The most
      common clinical presentation was a slowly progressive myelopathy. Twelve patients
      (85%) had objective neurological findings at the time of diagnosis. Radiographic
      diagnosis was made by a combination of myelography, computed tomographic scan
      with myelography, and magnetic resonance imaging. Complete surgical resection was
      accomplished for 8 dorsal cysts, and 6 ventral cysts were widely fenestrated into
      the subarachnoid space. Overall results were considered excellent or good in 9
      patients, fair in 3, and poor in 2. There was one recurrence, which required a
      second operation. We conclude that the majority of intradural spinal cysts can be
      successfully managed surgically with a favorable clinical outcome.

PMID- 1738454
TI  - Myelographic and enhanced computed tomographic appearance of acute traumatic
      spinal cord avulsion.
AB  - The neuroradiological findings that revealed spinal cord transection/laceration
      in 6 patients with acute, blunt spinal trauma are described. Four patients
      suffered cervical spine injuries, and two had thoracic injuries. Initially, all
      patients had complete neurological deficit at the level of injury. The deficit
      improved in only 1 patient. On the basis of clinical history and spinal
      radiographs, spinal hyperflexion with distraction was the predominant mechanism
      of injury in our patients. Computed tomography with intrathecal contrast was
      performed on all patients and was always diagnostic. Visualization of intrathecal
      contrast material accumulating within the cord or the absence of cord shadow
      within the contrast column established the diagnosis in all cases. A dural tear
      was noted in 3 patients. Thoracic myelography was performed in 2 patients and, in
      both, demonstrated contrast pooling within the spinal cord at the level of the
      laceration. Magnetic resonance imaging was obtained in 1 patient and revealed an
      irregular, low-signal-intensity, intramedullary region extending to the cord
      surface on T1-weighted axial images. The myelographic and enhanced computed
      tomographic appearances of acute, traumatic spinal cord avulsion/laceration,
      which have been infrequently reported in the literature, are described.

PMID- 1738455
TI  - Microvascular decompression for hemifacial spasm: analyses of operative findings
      and results in 310 patients.
AB  - The operative findings and results of microvascular decompression (MVD) on 310
      Chinese patients with hemifacial spasm are analyzed in this report. The
      operations were performed at the Neurological Institute of the Veterans General
      Hospital-Taipei between January 1983 and June 1990. The length of follow-up
      ranged from 6 months to 8 years (mean, 4.3 years); 273 patients (88%) had
      complete relief of spasm within 3 days after one MVD, and the remaining 37
      patients (12%) showed no immediate postoperative improvement. Sixteen (5.2%) of
      these 37 initially unresponsive patients subsequently experienced complete
      relief, which occurred from 4 days to 22 months (median, 21 days) after one MVD;
      13 others (4.2%) had complete relief immediately after the second MVD; another 3
      (1%) had delayed complete relief 6, 9, and 11 months after the second MVD,
      respectively; and the remaining 5 (1.6%) only had delayed partial relief, which
      occurred 2 to 9 weeks after one MVD. Late recurrence occurred in three patients
      (1%). These immediate and long-term results lend support to the conclusion that
      the timing of reoperation can be postponed for a period of 3 to 4 weeks in the
      event of an initial failure to get improvement, and that a second MVD may be of
      value.

PMID- 1738456
TI  - Benign cerebellar astrocytomas of childhood.
AB  - Benign cerebellar astrocytomas of childhood are potentially surgically curable
      lesions. Histologically, these neoplasms can be divided into pilocytic and
      diffuse astrocytomas. Whether there is a difference in the recurrence rate
      between these two tumor types after a surgical resection is not clear. In
      addition, the role of immediate postoperative imaging in predicting a recurrence
      has not been established. To answer these questions, we have reviewed the charts
      of 23 patients with benign cerebellar astrocytomas treated at Childrens Hospital
      of Los Angeles over a 10-year period (1977-1987). Of the 23 tumors, 15 were
      pilocytic and 8 were diffuse. All patients underwent an attempted gross total
      surgical removal of the tumor, and all patients had a postoperative computed
      tomographic (CT) scan with and without intravenously administered contrast
      material performed within 72 hours of the operation. Based on the postoperative
      CT scan, 12 patients had residual tumors. Seven of the subtotally resected tumors
      were pilocytic (7 of 15), and 5 were diffuse (5 of 8). Interestingly, the surgeon
      believed that a gross total resection had been obtained in 9 of these patients.
      There have been 4 recurrences in these 23 patients, with a mean follow-up of 4.9
      years. All recurrences were in patients with subtotal resections. Of the 11
      patients with a total resection of the tumor, 7 developed a small rim of
      enhancement on subsequent scans an average of 5 months after the
      operation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738457
TI  - Dissemination of supratentorial malignant gliomas via the cerebrospinal fluid in
      children.
AB  - Of 100 children with supratentorial gliomas (excluding gliomas of the anterior
      visual pathways) treated at the Children's Hospital of Pittsburgh from 1980 to
      1990, 34 had malignant gliomas. Follow-up was adequate in 33 of these patients,
      and an antemortem diagnosis of dissemination of the malignant glioma via the
      cerebrospinal fluid (CSF) was made in 11. Of these 11, 8 were boys and 3 were
      girls; they ranged in age from 17 months to 16 years at the time of diagnosis of
      the primary glioma. The distribution of histological types was as follows:
      glioblastoma multiforme, 4; malignant oligodendroglioma, 3; anaplastic
      astrocytoma, 2; malignant mixed glioma, 1; and malignant ependymoma, 1. The
      interval between diagnosis and CSF dissemination ranged from 1 week to 59 months
      (median, 8 months). Survival after dissemination ranged from 3 weeks to 11 months
      (median, 4 months). Two patients were alive 5 and 3 months after diagnosis of
      dissemination, respectively. These 11 patients were compared with the other 22
      patients who did not have CSF dissemination. The risk factors for dissemination
      suggested by our data were male sex, ventricular operative entry, multiple
      resections, and malignant oligodendroglioma. Because of the high incidence (33%)
      of CSF dissemination, postoperative evaluation of the craniospinal axis with
      gadolinium-enhanced magnetic resonance imaging should be performed on all
      children with supratentorial malignant gliomas. Moreover, since the mortality is
      extremely high once dissemination has occurred, craniospinal irradiation should
      be considered in children with one or more of the above risk factors, even before
      symptoms or definite radiological evidence of CSF dissemination emerge.

PMID- 1738458
TI  - Minor leak before rupture of an intracranial aneurysm and subarachnoid hemorrhage
      of unknown etiology.
AB  - Of 312 consecutive patients who were admitted to an emergency hospital because of
      subarachnoid hemorrhage (SAH), data on premonitory minor leaks were available on
      303. Patients with an aneurysmal SAH had significantly (P less than 0.05) more
      frequently (100 of 273, or 37%) a history of symptoms consistent with a previous
      minor leak than those with a hemorrhage of unknown etiology (4 of 30, or 13%).
      Aneurysmal SAH was associated with a poorer prognosis, more frequent occurrence
      of repeated bleeding and cerebral ischemia compared with SAH of unknown etiology,
      even in the good grade patients. The possible occurrence of a minor leak in poor
      grade patients may be even more frequent because the history obtained from family
      members was quite often uncertain. The outcome did not differ according to the
      evidence of previous minor leaks, but those who were admitted before a major
      rupture had a good outcome. The median time between a minor leak and major
      rupture was 14 days (range, 1 day to 4 mo). The correct diagnosis of a minor leak
      is important because early diagnosis and management can improve the overall
      outcome of this disastrous disease.

PMID- 1738459
TI  - Intraoperative monitoring of the dorsal sacral roots: minimizing the risk of
      iatrogenic micturition disorders.
AB  - In 31 children (age, 2-17 years) and 1 adult, individual dorsal root action
      potentials (DRAPs) from the S1-S3 roots were recorded intraoperatively after
      electrical stimulation of the dorsal penile or clitoral nerves, in preparation
      for surgery within the cauda equina. In most patients, pudendal afferent activity
      was present in S2 and S3 bilaterally; in some, the afferent activity was confined
      to a single root bilaterally, and in one, to a single root on one side. Dorsal
      root action potentials of small amplitude were recorded from S1 in 15 patients,
      although in no patient was S1 the primary carrier of these afferents. No lesion
      of the roots or rootlets carrying significant afferent activity was created
      during the rhizotomy, and no dysfunction in micturition resulted. We propose that
      the neurophysiological identification of roots and rootlets carrying afferent
      activity from the penile or clitoral nerves allows for rhizotomy of the S2 roots
      with the least possible risk of postoperative micturition and sexual dysfunction.

PMID- 1738460
TI  - The effect of graded spinal cord injury on the extrapyramidal and pyramidal motor
      evoked potentials of the rat.
AB  - This study investigated the differential effects of graded spinal cord injury on
      the rat extrapyramidal motor evoked potential (exp-MEP) and pyramidal motor
      evoked potential (pyr-MEP) and the prognostic value of these effects in
      predicting postinjury motor performance in the rat model. In 20 rats subjected to
      graded spinal injury (10-100 g-cm), there was a differential injury threshold for
      ablation of exp-MEP and pyr-MEP. All peaks of the pyr-MEP were extinguished in
      the animals subjected to impact forces of 50 g-cm and above (n = 12). In
      contrast, the exp-MEP was completely abolished in only two animals at injuries of
      80 g-cm or above. A residual exp-MEP response persisted in the remaining 18
      animals. Motor performance was monitored in 16 additional animals for up to 1
      week after spinal injury. The pyr-MEP was abolished in 100% of the rats subjected
      to a 50-g cm injury (n = 7), whereas the exp-MEP persisted up to the highest
      impact forces (80 g-cm). Hind leg paralysis was present in the five rats where
      the pyr-MEP was extinguished but with persistence of the exp-MEP. An 80%
      reduction in the amplitude of the pyr-MEP in four animals resulted in mild ataxia
      with motor improvement at the end of a week. An increase or a 70% loss in pyr-MEP
      peak amplitude resulted in no clinical motor deficits (n = 5).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1738461
TI  - Influence of some anesthetic agents on muscle responses to transcranial magnetic
      cortex stimulation: a pilot study in humans.
AB  - The effects of some commonly used intravenous and inhalational anesthetic agents
      on the motor evoked responses to transcranial magnetic cortex stimulation were
      assessed in 17 subjects. Compound motor action potentials (CMAPs) of the abductor
      digiti minimi muscle were recorded. Baseline values (12 stimulations/subject)
      were established before anesthesia was induced with a single agent administered
      in steps up to a maximal dose (MaxDose). Cortical stimulation was performed and
      depth of anesthesia was assessed according to Guedel after each dose. A common
      feature was the marked intra- and interindividual variability of baseline values
      of CMAPs in those patients not premedicated, those premedicated, and the
      anesthetized patients. The average amplitude of CMAPs was related to the depth of
      anesthesia in a given subject, whereas onset latencies of CMAPs did not
      systematically change. CMAPs were markedly reduced or abolished after
      administration of potent sedative drugs such as midazolam (MaxDose, 0.4 mg/kg
      body weight), pentothal (MaxDose, 8 mg/kg), propofol (MaxDose, 2 mg/kg), and
      isoflurane (MaxDose, 1.9 and 3.7 vol %), as soon as patients reached Stage II and
      Stage III anesthesia. When fentanyl (MaxDose, 8 micrograms/kg) or nitrous oxide
      (MaxDose, 79%) was used, the subjects reached Stages I and II, but not Stage III.
      With these drugs, reliable recording of CMAPs was possible even with the maximal
      administered dose.

PMID- 1738463
TI  - Intracerebral schwannoma: case report.
AB  - A case of intraparenchymal schwannoma is presented. The neuroradiological
      findings of reported intraparenchymal schwannomas, including the case reported
      here, are discussed. The specific tumor characteristics are emphasized. This
      report appears to be the only documentation as a result of magnetic resonance
      imaging of this specific tumor.

PMID- 1738462
TI  - Late manifestations of esthesioneuroblastomas in the central nervous system:
      report of two cases.
AB  - Two patients with esthesioneuroblastomas that disseminated in the central nervous
      system (CNS) and elsewhere are reported. The latest recurrences in the CNS were
      19 years after the diagnosis in patient and 9 years after the diagnosis in the
      other. Because the treatment of patients with such late recurrences is
      complicated by previous surgical procedures and radiation therapy, we review
      therapeutic options for these patients. The literature has not previously
      stressed the occurrence of late metastases, including those to the CNS, after
      prolonged disease-free intervals.

PMID- 1738464
TI  - Cerebral blood flow correlates of word monitoring in sentences: influence of
      semantic incoherence. A spect study in normals.
AB  - The aim of this study was to assess the cerebral blood flow (CBF) changes induced
      by the semantic incoherence of sentences whose words were to be monitored by the
      subjects. According to Marslen-Wilson and Tyler, word processing would be
      parallel (global) in semantically coherent sentences, and serial (local) in
      semantically incoherent ones. We hypothesized that, in comparison with the
      parallel mode, the serial mode of word processing would result in a preponderant
      activation of the frontal lobes and/or of the left hemisphere, hence in a flow
      increase in these regions. In addition, one could assume that the increase in
      task complexity resulting from the breaking of semantic coherence would reinforce
      the functional links between hemispheres. Furthermore, as interactions between
      the processing of semantically coherent vs incoherent of verbal materials and the
      processing of imageable vs non-imageable stimuli was recently suspected, we
      designed a study combining coherent vs incoherent sentences and imageable vs non
      imageable words. The results we obtained in 12 normal volunteers by measuring
      regional cerebral blood flow by SPECT and IV injection of Xenon 133 during the
      four experimental conditions, did not allow us to firmly establish our
      hypotheses. Indeed, we failed to demonstrate any significant CBF changes across
      conditions and there was no interaction between coherent vs incoherent and
      imageable vs non-imageable conditions. However, the analysis of the inter
      regional correlations pointed to an increase in the functional links between the
      hemispheres in the incoherent conditions, whatever the imageability.

PMID- 1738465
TI  - Auditory attention in early Parkinson's disease: an impairment in focused
      attention.
AB  - Focused attention in the auditory modality was studied in a group of Parkinson
      patients and compared to matched controls using a Dichotic monitoring task.
      Parkinson patients detected more phonemic distractors on the unattended input
      than the normal controls, despite a high level of ipsilateral responses for
      target detection and target discrimination. This impairment in focused attention
      may be attributed to degenerative changes in the ascending monoamine pathways
      which have been implicated in the role of auditory attention.

PMID- 1738466
TI  - The measurement of handedness: a cross-cultural comparison of samples from
      England and Papua New Guinea.
AB  - Handedness was compared in 125 English children and 185 young people from Papua
      New Guinea (PNG). Many of the latter were unfamiliar with implements such as
      pencils and spoons. The PNG subjects showed strong hand preferences, usually for
      the right, and on some items were more consistent in hand use than the English
      subjects. However, they had smaller hand differences on peg-moving and tapping
      than the English children. A factor analysis identified one factor with high
      loadings from items involving precise motor control, and another with positive
      loadings from only card-dealing, block-building and threading. The first factor
      was impervious to cultural influences, whereas the second showed considerable
      cultural variation.

PMID- 1738467
TI  - Distributions of hand preference and hand skill asymmetry in preschool children:
      theoretical implications.
AB  - We describe the distributions of hand skill asymmetry for the Peg-moving task and
      the Graphic test among 765 preschool children. A single normal component was
      observed for the Peg-moving task, but two normal components for the Graphic test,
      which corresponded primarily to the right- and left-handed children. Hand
      Preference and Graphic test hand skill asymmetry were age-dependent, but there
      was no age effect on the PMT hand skill asymmetry. Results are discussed in
      relation to the Annett's Right Shift theory.

PMID- 1738468
TI  - Spatial ability as a predictor of math achievement: the importance of sex and
      handedness patterns.
AB  - In accordance with major theories of handedness and brain organization,
      differential predictors for math achievement were found as a function of sex and
      handedness subgroups among eighth graders. Although there was no difference in
      absolute levels of performance as a function of either sex or handedness,
      predictive structures did differ. Regression analyses showed that spatial ability
      predicts math achievement for: (1) girls with anomalous dominance (non-right
      handers and right-handers with non-right-handed relatives), and (2) all boys
      (independent of handedness group). In contrast, for the standard dominance girls
      who are right-handed with all right-handed relatives (considered strongly left
      hemisphere dominant for language), spatial ability did not predict for math
      achievement. These findings occurred, even when scholastic aptitude and verbal
      achievement factors were controlled. It was concluded that further studies of sex
      differences in math achievement should consider subgroup differences within the
      sexes, based on handedness patterns.

PMID- 1738469
TI  - Hemispheric specialization for skilled perceptual organization by chessmasters.
AB  - The right cerebral hemisphere may be relatively specialized for parsing simple
      visual stimuli according to default rules, such as the Gestalt laws of perceptual
      organization, whereas the left cerebral hemisphere may be relatively specialized
      for overriding such default rules. We extend this model to 'semantically rich
      domains' by performing a divided-visual-field experiment on 16 chessmasters. Such
      subjects are able to recall and recognize complex chess positions by chunking the
      basic elements of the stimuli--the chess pieces--into meaningful groupings
      according to certain rules that are specific to the semantic structure of the
      chess domain. We show that the right hemisphere is superior to the left at
      parsing according to the default rules of chess chunking, but that the left
      hemisphere is superior to the right at grouping pieces together in violation of
      those rules. These results suggest that the right hemisphere is better able to
      acquire and apply new sets of default parsing rules for specific contexts. We
      conclude, consistent with other neuropsychological evidence, that the right
      hemisphere is critical for chess skill.

PMID- 1738470
TI  - Spatial recognition and spatial order memory in patients with dementia of the
      Alzheimer's type.
AB  - Patients diagnosed as having mild or moderate primary degenerative dementia of
      the Alzheimer's type (PDDAT), and normal elderly subjects were tested for spatial
      order and a spatial recognition memory. Results for spatial order memory
      indicated that compared to normal elderly subjects, patients with mild PDDAT
      showed an impaired memory only for the last serial positions. In contrast, with
      respect to spatial recognition memory, patients with mild PDDAT showed an
      impaired memory only for the early serial positions. Patients with moderate PDDAT
      were impaired on all serial positions for both spatial order and spatial
      recognition memory. Based on comparable deficit patterns seen in animals and
      patients with hippocampal and parietal cortex lesions, it is suggested that
      memory deficits displayed by PDDAT patients might be a function of underlying
      pathology in the hippocampus and parietal cortex.

PMID- 1738471
TI  - Impulsivity, risk-taking, and the ability to synthesize fragmented information
      after frontal lobectomy.
AB  - Patients with unilateral frontal- or temporal-lobe excisions and control subjects
      performed a cognitive risk-taking task in which target items (line-drawings or
      words) had to be guessed on the basis of partial-information clues. For each
      item, subjects chose to guess with either one, two, three, or all four clues, for
      a possible reward of 30, 20, 10, or 5 points, respectively. Two clue-presentation
      conditions were used to allow the differentiation of risk-taking from
      impulsivity. Whereas no group obtained high risk-taking scores, patients with
      frontal-lobe lesions demonstrated impulsive behaviour when manual responses were
      required. Only the left frontal-lobe group was impaired at solving the clues.

PMID- 1738472
TI  - Reversed laterality of cerebral functions in a non-right-hander:
      neuropsychological and spect findings in a case of 'atypical' dominance.
AB  - A 54-year-old non-right-handed man with positive familial sinistrality showed a
      pure right hemisphere syndrome following a left hemisphere stroke. Severe right
      side hemineglect, transcortical motor dysprosodia, spatial dysgraphia and visuo
      constructive impairments were observed. At no time were the expected left
      hemisphere abnormalities such as aphasia, alexia, right-left disorientation or
      finger agnosia noted. A left fronto-temporal subcortical lesion was documented on
      CT scan. A Tc-99m HM-PAO SPECT study revealed no cerebral blood flow changes in
      the right hemisphere while in the left hemisphere a fronto-temporo-parietal
      cerebral blood flow reduction was evident. This case of a complete reversed
      laterality of cognitive functions argues for a distinction to be made between
      'anomalous' cerebral dominance and 'atypical' cerebral dominance.

PMID- 1738473
TI  - The effects of intensity and irrelevant location of a tactile stimulation in a
      choice reaction time task.
AB  - Simon and his colleagues have demonstrated that the location of a stimulus in the
      sensory field, even if it is irrelevant for the task, may critically affect
      reaction time. This so-called 'Simon effect' is a general phenomenon that
      encompasses all sensory modalities. The experiment reported here showed that the
      tactile version of the Simon effect was additive on reaction time with the
      respective effects of stimulus intensity and of the within-hand/between-hand
      composition of the repertoire of fingers devoted to the task. In light of recent
      theoretical developments, the present data suggest that the locus of the Simon
      effect is stimulus identification, a perceptual stage which follows stimulus
      encoding and precedes stimulus-response translation.

PMID- 1738474
TI  - Clustering strategies on tasks of verbal fluency in Parkinson's disease.
AB  - The verbal output of patients with Parkinson's disease (PD) was analyzed for
      semantic and phonemic clusters on tasks of verbal fluency. One task required cued
      retrieval by semantic category (i.e. animals), and one required non-cued
      retrieval by initial letter (e.g. words beginning with 'F'). Nondemented PD
      patients (N = 25) produced significantly fewer words on the cued semantic
      retrieval task than age-, gender- and education-matched normal control subjects
      (N = 22), but were not impaired on the non-cued letter retrieval task. However,
      overall, PD patients were able to form more semantic clusters than phonemic
      clusters. These results are discussed in light of other studies of verbal fluency
      deficits in patients with PD.

PMID- 1738475
TI  - Working as an international nurse executive.

PMID- 1738476
TI  - Nursing administration that is international is broad and outward, not narrow and
      inward.

PMID- 1738477
TI  - Challenges to nursing from the World Health Organization and the International
      Council of Nurses.

PMID- 1738478
TI  - International nursing administration.

PMID- 1738479
TI  - Nursing in Malawi: challenges to nurses in leadership positions.

PMID- 1738480
TI  - King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

PMID- 1738481
TI  - Saudi Arabian culture.

PMID- 1738482
TI  - International nursing recruitment: a personal perspective.

PMID- 1738483
TI  - Nurse development program.

PMID- 1738485
TI  - Quality assurance on a roller coaster.

PMID- 1738484
TI  - Toward effective intercultural teaching.

PMID- 1738486
TI  - Culturally responsive nursing management in an international health care setting.

PMID- 1738487
TI  - Educational strategies in a transcultural setting.

PMID- 1738488
TI  - After war: long-term effects on people, their health, and the health system.

PMID- 1738489
TI  - Initiating a volunteer program at KFSH.

PMID- 1738490
TI  - Patient classification in the Groote Schuur Hospital region, Republic of South
      Africa.

PMID- 1738491
TI  - Nursing administration trends in Brazil.

PMID- 1738492
TI  - Health and nursing services in Pakistan: problems and challenges for nurse
      leaders.

PMID- 1738493
TI  - Nursing and health services in Austria.

PMID- 1738494
TI  - Polish nursing in action.

PMID- 1738495
TI  - Development of nursing services in the Basque Autonomous Region, Spain.

PMID- 1738497
TI  - Nursing administration in Korea.

PMID- 1738496
TI  - Nursing in India.

PMID- 1738498
TI  - Health and nursing services in Cameroon: challenges and demands for nurses in
      leadership positions.

PMID- 1738499
TI  - Homing in.

PMID- 1738500
TI  - Quality of care.

PMID- 1738501
TI  - Ensuring quality for ostomists.

PMID- 1738502
TI  - Determining the standards.

PMID- 1738503
TI  - Accident and emergency audit.

PMID- 1738504
TI  - A nursing concern.

PMID- 1738505
TI  - There is a better way.

PMID- 1738507
TI  - CIS sponsor debate flawed.

PMID- 1738506
TI  - Publishitis.

PMID- 1738508
TI  - Renal unit nurses under pressure.

PMID- 1738509
TI  - Unqualified care.

PMID- 1738510
TI  - The quest for quality.

PMID- 1738511
TI  - The Bethesda classification for squamous intraepithelial lesions: histologic,
      cytologic, and viral correlates.
AB  - In applying the Bethesda System of classification to cervical squamous lesions,
      we evaluated the Papanicolaou smears, cervical biopsies, and human papillomavirus
      (HPV) DNA status of 76 clinic patients. The biopsy specimens and concurrent
      Papanicolaou smears were analyzed using criteria for low-grade and high-grade
      squamous intraepithelial lesions, and the biopsies were analyzed for HPV DNA by
      in situ hybridization. Two independent observers produced good agreement in both
      cytologic (kappa = 0.62) and histologic (kappa = 0.71) diagnoses. Predictive
      values of high-grade cytology (for high-grade histology) were high (0.95 for
      reviewer 1; 0.97 for reviewer 2), and both high-grade cytology and histology
      correlated strongly with certain "high-risk" HPV types. In contrast, the
      predictive value of low-grade cytology for either low-grade histology or HPV
      types other than "high risk" was poor. This study supports the use of certain
      histologic criteria for distinguishing squamous intraepithelial lesions into two
      grades. Limitations in cytologic-histologic correlation appear to reflect the
      absence of cytologic criteria for distinguishing well-differentiated precursor
      lesions associated with high-risk HPV types.

PMID- 1738512
TI  - Adenocarcinoma of the cervix treated with radiation alone: prognostic
      significance of S-100 protein and vimentin immunostaining.
AB  - Fifty-nine patients with adenocarcinoma of the cervix were treated with radiation
      alone (eight stage I, 15 stage II, 25 stage III, and 11 stage IV patients). The
      disease-free 5-year survival rates for each stage were 63, 58, 30, and 9%,
      respectively. The incidence of vimentin-positive cancer cells in 20 women with
      adenosquamous carcinoma was significantly higher than that in 34 with
      endocervical adenocarcinoma (25 versus 6%; P less than .05). The outcome of stage
      III patients with S-100 protein-positive dendritic cells (Langerhans cells) or
      without vimentin-positive cancer cells was significantly better than that of
      women negative for S-100 protein or positive for vimentin (P less than .025 and P
      less than .05, respectively). These findings indicate that, along with clinical
      stage, Langerhans cell infiltration and the vimentin negativity of cancer cells
      are favorable prognostic factors in stage III adenocarcinoma of the cervix
      treated with radiation alone.

PMID- 1738513
TI  - The association of occult amniotic fluid infection with gestational age and
      neonatal outcome among women in preterm labor.
AB  - To evaluate the relationships between gestational age, neonatal outcome, and
      amniotic fluid (AF) bacteria, we obtained AF from women with intact membranes in
      idiopathic preterm labor. Positive cultures were obtained from 20 (19%) of 105
      women. The frequency of positive cultures was inversely related to gestational
      age: 23-26 weeks, nine of 20; 27-30 weeks, four of 24; and 31-34 weeks, seven of
      61 (chi2 for trend, P less than .001). Fusobacterium nucleatum, Bacteroides
      ureolyticus, and Ureaplasma urealyticum were the most common isolates.
      Facultative and anaerobic bacteria were more commonly isolated from women at less
      than 30 weeks' gestation, and Ureaplasma urealyticum was commonly isolated at
      greater than 30 weeks' gestation. Forty percent of the patients identified as
      having positive AF facultative and anaerobic cultures by the research laboratory
      had negative cultures in the clinical laboratory. Clinical characteristics and
      maternal white blood cell count and differential did not differ between women
      with and without positive cultures. Elevated C-reactive protein levels and a
      positive AF Gram stain were the two most sensitive and specific methods to
      predict positive AF cultures. Women with positive cultures delivered a median of
      1.0 day after enrollment, compared with 28.5 days for women with negative
      cultures. The median gestational age at delivery for women with positive cultures
      was 27.5 weeks, and the median birth weight was 866 g. Positive AF cultures were
      associated with respiratory distress syndrome, bronchopulmonary dysplasia, and
      neonatal death. If occult AF infection among women in preterm labor is a
      treatable cause of preterm birth, then treatment could markedly reduce both
      perinatal morbidity and mortality.

PMID- 1738514
TI  - Assessment of a rapid latex agglutination test for group B streptococcal
      colonization of the genital tract.
AB  - OBJECTIVE: The purpose of this study was to determine the reliability of a rapid
      enzyme extraction-latex agglutination test in detecting intrapartum colonization
      of the maternal genital tract by group B streptococci. METHODS: Swabs of vaginal
      secretions were obtained from 314 patients in labor with either ruptured or
      intact membranes. Four tests were performed on each specimen: 1) qualitative
      culture on blood agar, 2) semiquantitative culture on blood agar, 3) culture in
      selective Todd-Hewitt broth, and 4) latex agglutination preceded by enzyme
      extraction. RESULTS: The prevalence of positive cultures was 29%. When compared
      with culture in Todd-Hewitt broth, the latex agglutination test had a sensitivity
      of 30%, specificity 93%, positive predictive value 64%, and negative predictive
      value 76%. In patients with heavy colonization the test had a sensitivity of 76%,
      compared with 17% in patients with light growth (P less than .001). The lower
      limit of sensitivity of the test was 4 x 10(5) cfu/mL. The performance of the
      test was not affected by rupture of the membranes. CONCLUSION: Although the latex
      agglutination test is reasonably sensitive in detecting heavy colonization, low
      overall performance combined with technical difficulties in assessment of
      particle agglutination make the test unsuitable for general screening.

PMID- 1738515
TI  - Human immunodeficiency virus infection in pregnant women under care at AIDS
      clinical trials centers in the United States.
AB  - The federal government supports a nationwide network of medical centers to
      evaluate promising therapies against the human immunodeficiency virus (HIV) and
      the opportunistic infections and cancers that characterize AIDS. Forty-five
      obstetricians from the 49 medical centers receiving federal research support for
      the conduct of AIDS-related clinical trials, in preparation for a meeting,
      provided summary information about the number and clinical status of the known
      HIV-infected pregnant women under their care and the prenatal screening policies
      for HIV infection at their institutions. In the 12-month period before December
      1989, an estimated 1000-1801 HIV-infected women delivered at these centers. The
      majority (82%) were asymptomatic, 12% were symptomatic, and 6% had AIDS. Routine
      T-cell testing of infected women was done as part of prenatal care in only 30 of
      45 centers. Pneumocystis carinii pneumonia was reported in 35 women. Zidovudine
      was administered during pregnancy in 29 women. Formal prenatal screening policies
      have been implemented at the majority (43 of 45) of the medical centers. Most of
      the infected women identified at these centers chose to continue the pregnancy.
      With the increasing incidence of HIV infection in women, information concerning
      the clinical and immunologic state of pregnant infected women and the present use
      of antiretroviral and other related therapeutics during pregnancy can guide the
      approach to women's health care and is crucial to the design and implementation
      of AIDS clinical trials.

PMID- 1738516
TI  - The relationship of hydrogen peroxide-producing lactobacilli to bacterial
      vaginosis and genital microflora in pregnant women.
AB  - Lactobacilli provide an important microbial defense against genital colonization
      by pathogens. The role of hydrogen peroxide (H2O2) in the control of genital
      microflora was explored in a cross-sectional study of 275 women in the second
      trimester of pregnancy. Vaginal cultures were obtained for detection of H2O2
      positive and H2O2-negative lactobacilli and other members of the genital
      microflora. Compared with women with H2O2-negative lactobacilli, women colonized
      by H2O2-positive lactobacilli were less likely to have bacterial vaginosis,
      symptomatic candidiasis, and vaginal colonization by Gardnerella vaginalis,
      Bacteroides, Peptostreptococcus, Mycoplasma hominis, Ureaplasma urealyticum, and
      viridans streptococci (P less than or equal to .05 for each comparison). In
      addition to the above organisms, women without vaginal lactobacilli were more
      likely than those women with H2O2-positive lactobacilli to have Chlamydia
      trachomatis, and less likely to be colonized by Enterococcus or coagulase
      negative staphylococci (P less than .05 for each comparison). Vaginal
      colonization by group B streptococci or Escherichia coli was not related to the
      presence of H2O2-positive lactobacilli. These data suggest that the presence of
      H2O2-positive lactobacilli in the vagina is inversely correlated with infection
      by some genital pathogens in pregnant women.

PMID- 1738517
TI  - An intravaginal controlled-release prostaglandin E2 pessary for cervical ripening
      and initiation of labor at term.
AB  - The purpose of this randomized, double-blind study was to evaluate the efficacy
      and safety of a new controlled-release hydrogel pessary for ripening the cervix
      and initiating labor. Subjects had an entry Bishop score of 4 or less and
      gestational age of 37 or more weeks. One hundred fourteen women received a
      placebo pessary and 101 received the hydrogel pessary, containing 10 mg of
      prostaglandin (PG) E2. Compared with the placebo group, those given the PGE2
      pessary were more likely to have an increase in Bishop score of 3 or more (60 or
      59% versus 21 or 18%; P less than .0001), change to a Bishop score of 6 or higher
      (59 or 58% versus 18 or 16%; P less than .0001), and active labor (68 or 67%
      versus 15 or 13%; P less than .0001). Including the crossover study, uterine
      hyperstimulation (28 of 182, 15%) and fetal heart rate abnormalities (18 of 182,
      10%) in PGE2-treated subjects were reversed on removal of the pessary with no
      apparent harm to the mother or fetus. These temporary adverse effects appeared
      while the pessary was in place and after the onset of active labor. Oxytocin was
      unnecessary in 89 of 182 (49%) of the PGE2-treated cases and was used more often
      to augment than to induce labor. We conclude that the described controlled
      release PGE2 vaginal pessary induces appreciable cervical ripening and frequently
      initiates active labor with little or no need for oxytocin. The pessary may cause
      uterine hyperstimulation or fetal heart rate abnormalities, but these would be
      expected to reverse on removal of the pessary.

PMID- 1738518
TI  - Maternal transport of patients with advanced cervical dilatation--to fly or not
      to fly?
AB  - Emergency maternal transport of women in advanced preterm labor often involves
      difficult decisions about whether to transport or not. A retrospective review of
      maternal transports performed in northern Arizona by Samaritan Air Evac covered a
      21-month period. Of the 1080 patients transported for preterm labor, 54 calls for
      transport (5%) were received when the patient was 7 cm or more dilated. Five
      women were delivered at the referring hospital and 49 were transported, none of
      whom delivered en route. Only 21 (39%) of them delivered in the first hour after
      arrival at the tertiary center. The decision to transport patients in advanced
      preterm labor should be based on such factors as distance between hospitals, time
      required to cover that distance, personnel on the transport, facilities available
      at the transporting hospital, gestational age, and speed with which labor has
      progressed.

PMID- 1738519
TI  - Fetomaternal hemorrhage in threatened abortion.
AB  - In this study, we compared the incidence of fetomaternal hemorrhage between
      patients with threatened abortion and a control population of similar gestational
      age. The study population comprised pregnant patients at less than 20 weeks'
      gestation who presented to our emergency room with a history of vaginal bleeding
      without cervical dilatation or passage of tissue. The control population
      consisted of women presenting for elective pregnancy termination; they were
      excluded from the study if they gave a history of any antepartum bleeding. The
      amount of fetomaternal hemorrhage was evaluated using the Kleihauer-Betke acid
      elution assay. A positive result in our laboratory, as determined by a
      nonpregnant control group, was a value of 0.07% or more fetal cells. Using this
      criterion, 11% of the study population had a positive Kleihauer-Betke test,
      compared with 4% in the pregnant control group. Rho(D) immunoglobulin may be
      indicated in Rho(D)-negative patients who present with threatened abortion.

PMID- 1738520
TI  - Relation of mild idiopathic polyhydramnios to perinatal outcome.
AB  - The relation between clinically obvious polyhydramnios and poor perinatal outcome
      has been described. Much less is known about mild, unexplained polyhydramnios,
      which usually is initially suggested by sonographic examination late in
      gestation. The purpose of the present investigation was to relate mild idiopathic
      polyhydramnios to perinatal outcome. Mild polyhydramnios was defined
      sonographically as an amniotic fluid index of 24.1-39.9 during fetal biophysical
      testing. All subjects had singleton gestations not complicated by conditions
      known to predispose to polyhydramnios. We diagnosed mild polyhydramnios in 97 of
      1177 patients (8.2%) undergoing fetal testing at 26-42 gestational weeks.
      Premature delivery, intrapartum complications, and neonatal depression were no
      more frequent in the pregnancies complicated by mild, unexplained polyhydramnios
      than in a comparable control group with normal fluid volume. The mild
      polyhydramnios group showed a significantly higher incidence of birth weight
      greater than 4000 g than did the control group (18.6 versus 8.6%; P less than
      .05). We conclude that mild idiopathic polyhydramnios in late gestation is
      relatively common. Except for a higher incidence of large for gestational age
      fetuses, this condition by itself is not associated with an increased risk of
      adverse perinatal outcomes.

PMID- 1738521
TI  - The severely anemic and hydropic isoimmune fetus: changes in fetal hematocrit
      associated with intrauterine death.
AB  - Hydrops caused by isoimmune hemolytic anemia is frequently associated with fetal
      death following intrauterine intravascular transfusion. To identify possible
      predictors of procedure-related fetal death, we examined changes in fetal blood
      volume and hematocrit resulting from the initial transfusion performed on 19
      severely anemic, hydropic fetuses. Seven fetuses (36.8%) died at 24-72 hours
      after transfusion, but in no case was the procedure associated with fetal
      distress. There were no significant differences between fetuses who died and
      those who survived in terms of total volume of blood transfused, volume
      transfused as a percentage of total fetoplacental blood volume, hematocrit of
      transfused blood, post-transfusion hematocrit, umbilical vein pH, or gestational
      age at transfusion. Significant differences were noted between hydropic fetuses
      who died compared with those who survived in the mean pretransfusion hematocrit,
      6.7% (+/- 2.0) versus 8.7% (+/- 1.6) (P = .03), and the relative increase in post
      over pre-transfusion hematocrit, 5.5-fold (+/- 1.4) versus 3.5-fold (+/- 0.8) (P
      = .001). Stepwise logistic regression analysis confirmed that only the relative
      increase in hematocrit was predictive of fetal loss. Moreover, six of seven fetal
      deaths occurred when the relative increase in hematocrit was greater than
      fourfold, whereas ten of 12 surviving fetuses had relative increases of less than
      fourfold. We conclude that large, acute increases in fetal hematocrit following
      intrauterine transfusion are associated with substantial mortality in hydropic
      fetuses.

PMID- 1738522
TI  - Comparison of cord purine metabolites to maternal and neonatal variables of
      hypoxia.
AB  - Umbilical arterial concentrations of purine metabolites were evaluated
      prospectively as markers of hypoxia. The results suggest that hypoxanthine
      accumulates in association with fetal acidosis and reduced levels of buffer base
      (P less than .01). Acute hypoxemia defined by umbilical arterial oxygen pressure
      was accompanied by elevation of uric acid concentrations (P less than .01). Fetal
      heart rate tracings with characteristics classically associated with fetal stress
      correlated with increased concentrations of hypoxanthine and xanthine (P less
      than .01). Therefore, intrapartum events may occur that are not documented by
      standard markers of perinatal hypoxia at delivery.

PMID- 1738523
TI  - Placental compressibility: implications for indirect diagnosis of posterior
      placenta previa.
AB  - A number of problems beset the indirect diagnosis of posterior placenta previa
      using transabdominal ultrasound. We add a new potential complicating factor. In
      128 pregnancies at or beyond 30 weeks' gestation, measurements were taken from
      the fetal skull to the maternal sacrum before and after compression. Up to 69%
      compressibility of the placenta was found in vivo and in vitro. Modified fetal
      skull to maternal sacrum measurement criteria were devised from the results.
      Placenta previa is highly unlikely if the measurement from the fetal skull to
      maternal sacrum is less than 10 mm before compression or less than 7 mm after
      compression. Placenta previa is probable if the measurement is greater than 20 mm
      before compression or greater than 15 mm after compression. In 40% of the cases,
      posterior placenta previa could not be excluded. We conclude that placental
      compressibility is an additional confounding problem for indirect ultrasound
      assessment of posterior placenta previa and that indirect assessment should be
      attempted only if maneuvers to image the lower uterine segment directly are
      unsuccessful.

PMID- 1738524
TI  - Endothelin transfer and endothelin effects on water transfer in human fetal
      membranes.
AB  - Although endothelin-1 is synthesized by human amnion, its physiologic role and
      its ability to be transferred to myometrium for oxytocic action remain unclear.
      We investigated the transfer of endothelin-1 itself and the effects of endothelin
      1 on the transfer of tritiated water across human amnion or
      amnion/chorion/decidua in vitro with an Ussing chamber technique. Permeability
      coefficients (mean +/- standard error) for 3H2O across amnion/chorion/decidua in
      the fetal to maternal direction were 1.26 +/- 0.21 and 1.25 +/- 0.10 x 10(-4)
      cm/second (N = 6) and in the maternal to fetal direction 0.90 +/- 0.07 and 0.98
      +/- 0.15 x 10(-4) cm/second (N = 5) in the absence or presence, respectively, of
      10(-9) mol/L endothelin-1 in the fetal reservoir. Comparable values were found in
      either direction with 10(-9) mol/L endothelin-1 in the maternal reservoir.
      Apparent permeability coefficients for 125I endothelin-1 in the fetal to maternal
      direction were 3.34 +/- 0.79 and 2.43 +/- 0.68 x 10(-5) cm/second (N = 5) for
      amnion or amnion/chorion/decidua. However, appreciable trapping of 125I
      endothelin-1 by the fetal membranes was apparent. Endothelin-1 does not appear to
      affect water movement across the human fetal membranes, and only a small
      proportion of endothelin-1 itself is transferred across the membranes.

PMID- 1738525
TI  - Cerebral-umbilical Doppler ratio as a predictor of adverse perinatal outcome.
AB  - Using a 3.5-MHz duplex Doppler system, 45 normal-growth and 45 growth-retarded
      fetuses were studied between 30-41 weeks' gestation. Velocity recordings were
      obtained from the middle cerebral artery and umbilical artery to calculate the
      ratio between the two pulsatility indexes. The cerebral-umbilical Doppler ratio
      is usually constant during the last 10 weeks of gestation. Therefore, a single
      cutoff value (1.08) was used, above which velocimetry was considered normal and
      below which it was considered abnormal. The cerebral-umbilical Doppler ratio
      provided a better predictor of small for gestational age newborns and adverse
      perinatal outcome than either the middle cerebral artery or umbilical artery
      alone. In fact, in predicting those newborns who were small for gestational age,
      the cerebral-umbilical ratio had a 70% diagnostic accuracy [(true positive + true
      negative)/total number of cases], compared with 54.4% for the middle cerebral
      artery and 65.5% for the umbilical artery. The results were more encouraging for
      prediction of adverse perinatal outcome; diagnostic accuracy for the cerebral
      umbilical ratio was 90%, compared with 78.8% for the middle cerebral artery and
      83.3% for the umbilical artery.

PMID- 1738526
TI  - Selected intrapartum external cephalic version of the second twin.
AB  - After delivery of twin A, external cephalic version was attempted on 30
      malpositioned second twins (12 transverse and 18 breech). Version was successful
      and resulted in subsequent vertex vaginal delivery for 11 of the 12 transverse
      presentations and 16 of 18 breech presentations. Successful version was not
      associated with parity or with birth weight. Among the 30 attempted versions,
      only one infant had a 1-minute Apgar score below 7. There were not enough cases
      to determine an association of delivery interval between twins and poor neonatal
      outcome. External cephalic version in selected twin gestations is useful for
      management of the second twin with abnormal presentation. Technique refinement
      and greater experience may improve the overall success rate with external version
      of the second twin. Although external cephalic version cannot yet be recommended
      as the method of choice, the procedure seems safe, and routine cesarean delivery
      may not always be indicated.

PMID- 1738527
TI  - Factors that influence weight loss in the puerperium.
AB  - A study group of 795 women was followed with frequent weight measurements and
      questionnaires about their activities for 6 months postpartum. The mean (+/- SD)
      net weight gain from the first prenatal visit to 6 months postpartum was 1.4 +/-
      4.8 kg. Weight gain during prenatal care was the variable most highly correlated
      to weight loss. Return to work outside the home, parity, and smoking also
      correlated significantly to weight loss. Breast-feeding, exercise, season of the
      year, age, and marital status were not correlated. Route of delivery was related
      to weight loss at 2 and 6 weeks, but not at 6 months. Counseling women about
      weight gain during pregnancy and weight loss requires an understanding of these
      variables with a long-term perspective of at least 6 months.

PMID- 1738528
TI  - Oral contraceptive use and risk of uterine fibroids.
AB  - The association between oral contraceptive (OC) use and the risk of uterine
      fibroids was analyzed in a case-control study conducted between 1986-1990. The
      subjects were 390 patients under 55 years of age with histologically confirmed
      fibroids and 1136 controls in hospitals for a spectrum of acute conditions (other
      than gynecologic, hormonal, or neoplastic) apparently unrelated to OC use. A
      total of 78 cases (20%) and 200 controls (18%) reported OC use. Compared with
      never-users, the multivariate relative risk for ever-users was 1.1 (95%
      confidence interval [CI] 0.8-1.5). No direct relationship emerged with duration
      of use, the estimated relative risk being 1.3 (95% CI 0.9-2.0) in users of OCs
      for less than 3 years and 0.8 (95% CI 0.5-1.3) in users for 3 years or more. The
      risk of fibroids was apparently (though not significantly) greater with longer
      recency of use: The estimated relative risks were 0.9 and 1.5, respectively, in
      women reporting last OC use less than 10 years before and 10 or more years before
      diagnosis of the disease. No relationship emerged with latency of use. There was
      no noteworthy interaction regarding risk of fibroids between OC use and potential
      covariates. These findings suggest that fibroids are unrelated to the use of OCs.

PMID- 1738529
TI  - Treatment options for human immunodeficiency virus-infected pregnant women.
      Obstetric-Gynecologic Working Group of the AIDS Clinical Trials Group of the
      National Institute of Allergy and Infectious Diseases.
AB  - The increasing seroprevalence of human immunodeficiency virus (HIV) among women
      of reproductive age and the risks of vertical transmission of HIV have led to
      recommendations for routine prenatal HIV counseling and testing. The incentive to
      undergo such testing is related not only to fetal concerns, but also to the
      potential benefit of early and comprehensive therapy for women. Treatments that
      should be considered for use during pregnancy include the antiretroviral agent
      zidovudine and prophylactic agents to prevent Pneumocystis carinii pneumonia, the
      most common opportunistic infection seen in patients progressing to AIDS.
      Assessment of the risks and benefits of these treatments during pregnancy is
      complex and requires discussions between physician and patient. This paper
      reviews current information and provides recommendations for incorporating
      therapies into obstetric practice.

PMID- 1738530
TI  - Transvaginal mobilization and utilization of the anterior bladder wall to repair
      vesicovaginal fistulas involving the urethra.
AB  - Repair of vesicovaginal fistulas resulting from obstetric trauma remains a major
      challenge to surgeons worldwide. Large defects that result in partial or total
      urethral loss are especially difficult to repair. Even when closure of such
      fistulas is accomplished, return of normal urogenital function is often impaired,
      underscoring the need to improve existing surgical procedures. Transvaginal
      urethral and bladder neck reconstruction using mobilized anterior bladder wall
      was helpful in closing 18 of 20 vesicovaginal fistulas with urethral involvement
      caused by obstetric trauma. This method involves advancement of an anterior
      bladder wall flap into the vagina, where it is rolled into a neo-urethra or
      connected to whatever remnant of urethral tissue exists. Complications included
      stress incontinence requiring further surgery (four), small bladder capacity with
      detrusor instability (two), urethral stenosis requiring dilatation (two),
      postoperative hemorrhage (one), and vaginal stenosis (one). Continued
      modification of this procedure holds promise for many patients considered
      inoperable in the past.

PMID- 1738531
TI  - The utility of the TDx test in the assessment of fetal lung maturity.
AB  - Accurate assessment of fetal lung maturity is essential in the management of high
      risk obstetric patients. New rapid techniques have been developed to supplement
      time-consuming chromatographic methods. We compared one of these newer methods,
      the TDx-FLM, to the standard tests for fetal pulmonary maturity. There was an
      excellent correlation between the TDx and the lecithin-sphingomyelin ratio (r =
      0.78). Although a TDx value of 70 or greater is considered mature, we found a
      value of 50 or greater predictive of fetal lung maturity in 100% of cases, and
      have chosen to redefine a mature value as 50 or greater in our institution. This
      value has greatly enhanced the clinical applicability of the test, allowing use
      of a large number of specimens from the previously poorly understood and often
      disregarded borderline category.

PMID- 1738532
TI  - Continuous monitoring of fetal temperature by noninvasive probe and its
      relationship to maternal temperature, fetal heart rate, and cord arterial oxygen
      and pH.
AB  - The human fetus is normally warmer than its mother. The principal route of fetal
      heat dissipation is through the placental circulation. We developed a technique
      that is noninvasive to the fetus to record the fetal skin and maternal uterine
      wall temperatures, from which we derived the temperature difference. We have
      established a range of normal values (mean temperature difference 0.24C) and
      present some preliminary data. The results show a correlation between changing
      temperature and baseline fetal heart rate (r = 0.628, P less than .001) and the
      influence of contractions and epidural analgesia on these measurements.
      Measurement of the fetal-maternal temperature difference during labor may help
      detect abnormal umbilical-placental blood flow, resulting in fetal distress, and
      may help distinguish sinister from iatrogenic fetal tachycardias. Our technique
      provides the first simple means of recording this basic fetal variable.

PMID- 1738533
TI  - Diagnosis and management of chronic hypertension in pregnancy.

PMID- 1738534
TI  - Court-ordered treatment in obstetrics: the ethical views and legal framework.

PMID- 1738535
TI  - Court-ordered treatment in obstetrics: the ethical views and legal framework.

PMID- 1738536
TI  - [Burnout or daily motivation].

PMID- 1738537
TI  - [Nursing: profession or calling? A transition from "nursing as a calling" to
      "nursing as a profession" is necessary and in the end it is up to us nurses to
      give to our profession a direction, satisfactory to ourselves].

PMID- 1738538
TI  - [Expectations and reality in nursing].

PMID- 1738539
TI  - [Strategies for the enhancement of motivation. Motivation--the key to success?].

PMID- 1738540
TI  - [Nursing diploma--the beginning or the end?].

PMID- 1738541
TI  - [Position of the Austrian Nurses Federation towards the article: Socialminister
      Hesoun is looking for 2500 nurses].

PMID- 1738542
TI  - Prevalence of post-headshake nystagmus in patients with caloric deficits and
      vertigo.
AB  - Post-headshake nystagmus (PHN) has recently been described as a clinically useful
      physical sign implying uncompensated asymmetric input from the vestibular end
      organs. A rapid 20-second headshake and sudden stop produces a jerk nystagmus of
      5- to 20-second duration in certain individuals with symptoms suggestive of a
      peripheral vestibulopathy. This retrospective review of 214 patient evaluations
      was undertaken to study the associations between post-headshake nystagmus,
      caloric deficits after bithermal binaural irrigation, and the presence of
      vertigo. Both clinical observation of the nystagmus with eyes open (PHN-OBS) and
      routine EOG recording with eyes closed (PHN-EOG) were used. In patients with
      unilateral caloric deficits, 42% (18 of 43) had PHN-EOG, compared with 18% (3 of
      17) in patients with bilateral dysfunction and 15% (23 of 154) in patients with
      normal calorics (p less than 0.001). In similar fashion, 26% (32 of 124) of
      patients with vertigo (recent or past) had PHN-EOG compared to 13% (12 of 90) of
      patients without vertigo (p less than 0.03). Finally, of 110 cases with both PHN
      EOG and PHN-OBS performed, 45% (9 of 20) with PHN-EOG also had PHN-OBS, as
      opposed to only 4% (4 of 90) without PHN-EOG displaying PHN-OBS (p less than
      0.0001). We conclude that the prevalence of post-headshake nystagmus is increased
      in patients with either a unilateral caloric deficit or a history of true
      vertigo, and is best detected in the absence of vision.

PMID- 1738543
TI  - Meningiomas of the jugular foramen.
AB  - Meningiomas of the jugular foramen manifest the same signs and symptoms as glomus
      jugulare tumors. They arise from arachnoid cells lining the jugular bulb and grow
      slowly, infiltrating the temporal bone and posterior fossa. These lesions,
      however, are more clinically treacherous than glomus tumors. Meningiomas
      infiltrate surrounding bone and nerve tissue and require wide margins of
      resection to prevent recurrence. Eight of these lesions have been managed in the
      past 5 years at the House Ear Clinic using modern imaging and skull base
      techniques. Two have recurred after "total" microsurgical removal. Presentation,
      radiologic evaluation, and management guidelines are reviewed.

PMID- 1738544
TI  - The efficacy of perioperative antibiotic therapy on recovery following
      tonsillectomy in adults: randomized double-blind placebo-controlled trial.
AB  - One hundred and one adult patients undergoing tonsillectomy for chronic/recurrent
      tonsillitis completed a prospective, randomized, double-blind, placebo-controlled
      study in which ticarcillin disodium and clavulanate potassium (Timentin) or
      placebo was administered intravenously at the time of surgery and for 12 hours
      postoperatively. The patients than received oral amoxicillin and clavulanate
      potassium (Augmentin) therapy or placebo for an additional seven days. Each
      patient kept a daily log to assess the incidence and severity of postoperative
      symptoms. Tonsillar core tissue at the time of surgery, as well as tonsillar
      fossa cultures after 7 days of treatment, were obtained. Those patients who
      received antibiotics fared consistently better in the immediate postoperative
      period compared with the placebo group. Specifically, patients in the antibiotic
      group experienced significantly less mouth odor, were able to tolerate a regular
      diet sooner, and resumed their normal activities earlier than did patients who
      received placebo. Patients who received antibiotics experienced fewer days with
      mouth odor (p = 0.004). In addition, on postoperative days 3 to 5, the antibiotic
      group was eating a regular diet (p = 0.05) and had returned to their routine
      activities earlier (p = 0.045) when compared with the placebo group.
      Perioperative antibiotic therapy was well tolerated and was effective in
      minimizing symptoms after tonsillectomy.

PMID- 1738545
TI  - Airway changes in relationship to mandibular posturing.
AB  - Comparison of posterior airway space was evaluated radiographically on patients
      with sleep apnea in a mandibular reposed position vs. a mandibular protruded
      position. This was performed at the Santa Barbara Sleep Disorders Medical Center
      to simulate the effect of anterior orthotic appliances on these patients. The
      overall effect of forward mandibular posturing was a mean increase of posterior
      airway space (PAS) by approximately 56%, but wide variations were seen.

PMID- 1738546
TI  - Head and neck squamous cell carcinoma cell line-induced suppression of in vitro
      lymphocyte proliferative responses.
AB  - Tumour-infiltrating lymphocytes (TILs) are often difficult to expand in vitro. In
      some cases this has been attributable to immunosuppression mediated by the
      elaboration of prostaglandins by either tumor cells or tumor-infiltrating
      monocytes. In this laboratory, freshly prepared TILs containing single-cell
      suspensions of head and neck tumors displayed both poor proliferation as well as
      minimal responsiveness to indomethacin-mediated reversal of immunosuppression. In
      order to investigate tumor-mediated immunosuppression further, a system was
      developed whereby a new cell line of head and neck squamous cell carcinoma was
      used to suppress allogeneic peripheral blood mononuclear cell proliferation in
      response to phytohemagglutinin (PHA) and Interleukin-2 (IL-2). Tumor cells were
      able to suppress peripheral blood mononuclear cell (PBMNC) proliferation up to
      95%. This suppressive effect was dependent on tumor cell number and was
      reversible by the use of higher concentrations of PHA, but not by increased
      concentrations of IL-2. Suppression was immediate when IL-2 was used as the
      stimulus for proliferation, but required extended lymphocyte/tumor cell contact
      when PHA was used. Flow cytometric analysis of tumor-exposed and PHA-stimulated
      PBMNCs revealed a decrease in both the number of cells expressing IL-2 receptors
      as well as the density of IL-2 receptors per cell. This pattern of suppression,
      as well as the reversibility of suppression by indomethacin, implicates
      prostaglandins in the mechanisms by which these tumor cells mediate
      immunosuppression.

PMID- 1738547
TI  - Basaloid-squamous carcinoma of the palate.
AB  - Basaloid-squamous carcinoma is a rare, nonsquamous cell tumor presenting in the
      head and neck that has recently been described. The clinical and histopathologic
      features of basaloid-squamous carcinoma derived from the 12 reported cases in the
      literature, including our case resembling an arteriovenous malformation, are
      described. The important interaction of the operating surgeon with the surgical
      pathologist in guiding the extent of the resection is emphasized.

PMID- 1738548
TI  - Cricopharyngeal dysfunction.
AB  - The aim of the study was to determine the manometric patterns in dysphagic
      patients with radiologic evidence of upper esophageal sphincter (UES)
      dysfunction. Nineteen patients with radiographic abnormalities of the UES
      underwent measurement of several parameters of UES tonic pressure and
      pharyngoesophageal water swallow dynamics. At least two UES tonic pressures were
      elevated in six subjects, compared with a control group of 67 healthy volunteers.
      No patients had UES achalasia. The cricopharyngeal impression in the remaining
      patients may represent muscular hypertrophy or deficiency of UES opening, despite
      manometric relaxation, but its relationship to the patient's symptoms remains
      unknown. Cricopharyngeal myotomy appears to be a reasonable treatment for
      patients with manometric UES hypertonicity.

PMID- 1738549
TI  - The effects of bolus flow on vertical pharyngeal pressure measurement in the
      pharyngoesophageal segment: clinical significance.
AB  - Measurement of pressures in the pharyngeal esophageal segment (P-E segment) is
      complicated by the vertical motion and by the rapidly changing pressures in the
      segment. The sensors move superiorly and inferiorly with respect to the P-E
      segment during the swallow. This study examines the validity of manofluorographic
      measurements taken in the P-E segment by using a catheter with sensors spaced at
      1 cm intervals. Seven normal volunteers were tested. Measurements were similar
      using one sensor and using an average of five sensors. During the time of bolus
      passage, the P-E segment is open and the bolus itself equalizes pressures
      measured within the bolus.

PMID- 1738550
TI  - Effects of vestibular rehabilitation on dizziness and imbalance.
AB  - Vestibular rehabilitation is a specific approach to physical therapy aimed at
      reducing dizziness and imbalance by facilitating central nervous system
      compensation for peripheral vestibular dysfunction. This article reports
      preliminary results of studies concerning the relative effectiveness of
      vestibular rehabilitation, general conditioning exercises, and vestibular
      suppressant medication on dizziness and imbalance in patients with chronic
      vestibular symptoms of at least 6 months duration. Patients with positional
      and/or movement-related dizziness and abnormal posturography were randomly
      assigned to the three treatment groups. Preliminary results suggest that although
      all three treatment approaches reduce dizziness, only vestibular rehabilitation
      also improves balance. This study takes the first step toward determining the
      efficacy of a specific exercise approach for reducing dizziness and imbalance in
      patients with chronic peripheral vestibular disorders.

PMID- 1738551
TI  - Characterization of the immune barrier in human olfactory mucosa.
AB  - Immunologic defense factors in the human olfactory mucosa were localized
      immunohistochemically. Olfactory epithelium was identified with an antiserum to
      olfactory marker protein, specific for olfactory receptor neurons. Constituents
      of the secretory immune system, including IgA, IgM, secretory component, and J
      chain, were localized in the acinar and duct cells of Bowman's glands and in the
      mucociliary complex. In addition, B lymphocytes in the lamina propria near
      Bowman's glands displayed immunoreactivity for IgA, IgM, and J chain.
      Immunostaining also localized other humoral factors. Immunoreactivity for IgG was
      present throughout the stroma and in B lymphocytes in the lamina propria.
      Antibody to IgD stained numerous B lymphocytes clustered below the basement
      membrane. Antibody to IgE stained similarly distributed cells; toluidine blue
      staining demonstrated that many were mast cells. In addition, antibodies to IgD
      and IgE stained occasional intraepithelial B lymphocytes or mast cells. Two
      antimicrobial proteins, lactoferrin and lysozyme, were localized in Bowman's
      glands and the mucociliary complex. Thus, the human olfactory mucosa, which
      provides a direct neural route for pathogens to the brain, is a site for
      synthesis and secretion of immune and other defense factors.

PMID- 1738552
TI  - Complications of secondary tracheoesophageal puncture: the Cleveland Clinic
      Foundation experience.
AB  - One hundred forty-six secondary tracheoesophageal puncture (TEP) procedures were
      performed on 132 patients at the Cleveland Clinic Foundation in the past 10
      years. The complications of these procedures are reviewed, along with assessment
      of potential risk factors such as irradiation, esophageal/hypopharyngeal
      stricture, alcoholism, diabetes, or chronic obstructive pulmonary disease. Among
      the subgroups studied, only stricture dilation was associated with an increased
      incidence of postsurgical complications. The majority of these, however, were
      immediate, and were probably related to the esophagoscopy or dilation itself. The
      incidence of TEP-related complications in all groups of patients may be higher
      than previously suspected.

PMID- 1738553
TI  - Ventilation tubes and prophylactic antibiotic eardrops.
AB  - Insertion of ventilation tubes has successfully remedied chronic otitis media
      with effusion in millions of children, but the procedure has been complicated by
      secondary infections and otorrhea in as many as 34% of the cases. Because
      infection at the time of surgery was suspected as the primary cause of these
      postoperative complications, short-term prophylaxis with antibiotic eardrops was
      proposed for averting secondary infections. To evaluate this hypothesis, we
      conducted a 6-month prospective study in which 200 children had bilateral tube
      insertions. Antibiotic eardrops were administered to patients' right ears
      intraoperatively and for 3 days after surgery; left ears received no eardrops and
      served as controls. The prophylactic strategy did not significantly decrease the
      incidence of postoperative otorrhea in treated right ears compared with controls.

PMID- 1738554
TI  - Immunohistochemical analysis of otic capsule osteogenesis in the Palmerston North
      autoimmune mouse.
AB  - Autoimmunity and the immune complex disease associated with it have been
      hypothesized to be the cause of several idiopathic diseases of the inner ear-
      including the new bone formation associated with otic capsule osteogenesis and
      otosclerosis. The Palmerston North (PN) autoimmune mouse strain, which exhibits
      both spontaneous systemic autoimmune disease and otic capsule bone formation, has
      been proposed as a model relating these two disease processes. To investigate the
      potential role of immunopathologic processes in PN otic capsule lesion formation,
      inner ears from PN mice were immunostained for the presence of IgG and complement
      (C3), two immunologic markers involved in the development of the vascular and
      perivascular changes associated with immune complex deposition. Both systemic
      autoimmune disease and otic capsule bony lesions were confirmed in all animals.
      However, immunohistochemical analyses did not establish a direct relationship
      between the two conditions as complement was absent in all lesions and IgG
      stained positive in only one instance. These results suggest that immune complex
      deposition is not directly involved in the otic capsule lesions of the PN mouse,
      and alternate mechanisms relating autoimmune disease and otic capsule
      osteogenesis must be explored.

PMID- 1738555
TI  - Parosteal osteosarcoma.

PMID- 1738556
TI  - Neuroleptic malignant syndrome during perphenazine treatment in a patient with
      head and neck cancer: a case report.

PMID- 1738557
TI  - Two unusual locations of osteoradionecrosis.

PMID- 1738558
TI  - Pinnochio travels to Oz.

PMID- 1738560
TI  - RBRVS enactment prompts new E/M codes.

PMID- 1738559
TI  - Legislative grand rounds: 1991.

PMID- 1738561
TI  - An open letter to Magic Johnson.
AB  - The last installment in this series dealt with post-test counseling of a person
      whose HIV test was negative. The plan was to provide counseling for an HIV
      infected person in this installment. NBA basketball star Magic Johnson's surprise
      announcement on November 7, 1991, of his infection with HIV has provided an
      unexpected opportunity to counsel a well-known person through an "open letter."

PMID- 1738562
TI  - State Medical Board considering HIV/HBV policy.

PMID- 1738563
TI  - Recouping past-due charges. The Health Care Group.

PMID- 1738564
TI  - Grappling with managed care: where does medical education fit?
AB  - While the effects of managed care on access and quality have been extensively
      debated, the implications of these efforts on medical education have not been
      widely explored. Because managed care will increasingly impact upon medical
      education, now is an opportune time to examine its effect and to discuss the need
      for medical students to be aware of managed care principles.

PMID- 1738565
TI  - Learning generics.
AB  - The growing use of generic drug substitution may have important implications on
      quality of care. This study was conducted to determine resident physicians'
      knowledge of restrictive prescribing policies at the hospitals where they
      primarily practice.

PMID- 1738567
TI  - No quick-fix solutions for medicine.

PMID- 1738566
TI  - Update: Medicare patient records in physicians' offices.
AB  - We have become aware of a growing concern among physicians who are under the
      impression that review of Medicare patients' records in physicians' offices is
      imminent. Our current activity of reviewing care provided by health maintenance
      organizations (HMOs) may have caused some physicians to believe that such review
      had already started. HMO review may, at times, include a request for office
      records, but such requests are made to the HMO. The review does not take place at
      the physician's office.

PMID- 1738568
TI  - The primate dorsal spinothalamic tract: evidence for a specific termination in
      the posterior nuclei (Po/SG) of the thalamus.
AB  - The spinothalamic tract in primates and other mammals arises primarily from cells
      in lamina I of the dorsal horn, from lamina V cells and to a lesser extent from
      other laminae. Most of the neurons of lamina I respond only to noxious mechanical
      or thermal stimuli. Spinothalamic tract (STT) cells of lamina V tend to respond
      to both innocuous and noxious stimuli. Recent studies have suggested that the
      classical STT in the anterolateral quadrant (ALQ) contains primarily the axons of
      lamina V cells and that the axons of lamina I cells travel more dorsally in the
      dorsolateral quadrant (DLQ) to constitute the dorsal spinothalamic tract (DSTT).
      Using the anterograde transport of wheat germ agglutinin conjugated to
      horseradish peroxidase (WGA-HRP) injected into the spinal cord in conjunction
      with a contralateral anterolateral cordotomy, we have found there is a
      substantial projection of the DSTT to the posterior nuclei of the caudal-ventral
      thalamus, designated Po/SG. This projection is almost entirely abolished when the
      lesion includes the area of spinal cord white matter at the level of the
      denticulate ligament. Larger lesions that destroy the ALQ and much of the lateral
      column white matter, but that spare the dorsolateral column white matter in the
      region of the corticospinal tract, abolish all transport of WGA-HRP to the
      thalamus. We conclude that the spinothalamic pathway in the non-human primate
      encompasses a continuous fiber bundle that extends dorsally to include the region
      of lateral column white matter opposite the denticulate ligament and that the
      more dorsal aspect of this pathway projects primarily to Po/SG of thalamus.

PMID- 1738569
TI  - Morphine blocks descending pain inhibitory controls in humans.
AB  - In man, heterotopic painful thermal conditioning stimuli induce parallel
      decreases in the spinal nociceptive flexion (RIII) reflex and the concurrent
      sensation of pain elicited by electrical stimulation of the sural nerve at the
      ankle. Such phenomena may be related to the diffuse noxious inhibitory controls
      (DNIC) which were initially described in the rat and subsequently documented in
      humans. In 9 subjects in the present study, a 2 min application of a moderately
      noxious temperature (46 degrees C) to the contralateral hand strongly depressed
      the RIII reflex elicited in the biceps femoris muscle by electrical stimulation
      of the sural nerve at 1.2 times the reflex threshold. These depressive effects
      were maximal during the second min of the conditioning period, showing a 80%
      inhibition of the RIII reflex which gradually recovered to its baseline value 7
      min after the end of the conditioning period. Such inhibitory effects were
      completely blocked 15-26 min after administration of a low dose of morphine
      hydrochloride (0.05 mg/kg, i.v.). The lifting of the inhibitions was compatible
      with an action at the opioid receptors since the inhibitions were re-observed 5
      16 min after naloxone injection (0.006 mg/kg, i.v.). During all the experimental
      sessions, heart and respiratory rates remained stable at their control levels.
      Since it has been shown previously that such a dose of morphine could not have a
      direct effect within the spinal cord (Willer 1985), it is concluded that this
      opiate blocks, in a naloxone-reversible fashion, those bulbo-spinal controls
      which are triggered by heterotopic nociceptive events. Possible implications for
      hypoalgesia based on the principles of counter-irritation are discussed.

PMID- 1738570
TI  - Calcitonin in phantom limb pain: a double-blind study.
AB  - Salmon calcitonin (s-CT) has been shown to be a valuable analgesic in phantom
      limb pain (PLP) in several case reports. To evaluate these findings a double
      blind crossover comparison of s-CT treatment versus placebo was initiated. Twenty
      one out of 161 patients who had undergone major amputations and developed severe
      PLP 0-7 days after surgery were included in the study. For each patient a matched
      pair of infusions was prepared containing either 200 IU of s-CT or placebo. Group
      I (n = 11) was first given s-CT and group II (n = 10) placebo. When PLP reached a
      level of more than 3 on a numeric analogue scale (NAS) the first infusion was
      administered. The second infusion (crossover) or more infusions were given when
      the pain level again exceeded more than 3 on NAS. Using s-CT infusion, PLP was
      eased from a median of 7 to 4 on NAS in both groups (P less than 0.001),
      regardless of whether s-CT or placebo was given first. Placebo, however, did not
      change pain scores (median 7 on NAS, P greater than 0.1). In the s-CT group, but
      not in the placebo group, 4 individuals remained pain free without a second
      infusion. Any further treatment was performed with s-CT. One week after the first
      PLP treatment 19 patients (90%) had pain relief of more than 50%, 16 (76%) were
      completely pain free, and 15 (71%) never experienced PLP again. One year later 8
      out of the 13 surviving patients (62%) still had more than 75% PLP relief. After
      2 years PLP exceeded 3 on NAS in 5 individuals (42%), and the remaining 12
      patients presented the same PLP as after 1 year. In conclusion, s-CT is a
      valuable treatment for PLP in the early postoperative period.

PMID- 1738571
TI  - Amitriptyline versus maprotiline in postherpetic neuralgia: a randomized, double
      blind, crossover trial.
AB  - Amitriptyline (AT) relieves some patients with postherpetic neuralgia (PHN). Many
      patients suffer side effects and better therapies are necessary. The aim of this
      study was to evaluate the efficacy of maprotiline (MT) (noradrenergic) compared
      to AT (mixed noradrenergic and serotonergic) in this disorder. Thirty-five
      patients entered a randomized, double-blind, crossover trial of these two agents.
      We found that MT relieved PHN in many patients but was not as effective as AT.
      Side effects were troublesome with both agents. Relief of steady pain, brief pain
      and pain on tactile stimulation occurred. Four groups of responses were
      identified. Some patients reported relief with both agents, some with neither
      agent and others with only one of the drugs. Most patients were not depressed and
      analgesia was observed to occur without change in depression ratings in most
      patients who responded. This result provides evidence that in some patients AT
      may act via a selective noradrenergic mechanism in relieving PHN and that
      individuals may differ in the balance and type of neurotransmitters inhibiting
      pain. Selective noradrenergic agents may be effective if AT fails.

PMID- 1738572
TI  - Hyperalgesia and expanded receptive fields.

PMID- 1738573
TI  - Patterns of normal personality structure among chronic pain patients.
AB  - Fifty-nine chronic pain patients satisfying one of four previously identified
      pain group classifications were evaluated using the NEO Personality Inventory
      (NEO-PI), a standardized measure of normal adult personality structure. Minnesota
      Multiphasic Personality Inventory (MMPI) pain subgroups differed with respect to
      level of NEO-PI Neuroticism. In particular, emotionally overwhelmed pain patients
      as defined by multiple MMPI scale elevations had higher NEO-PI Neuroticism
      scores. Post hoc analyses revealed higher levels of depression, anxiety,
      vulnerability, and hostility in emotionally overwhelmed subjects. None of the
      remaining groups differed from each other on NEO-PI Neuroticism. Additionally,
      none of the other NEO-PI domains discriminated pain subgroups. NEO-PI profiles
      for pain patients (except for Neuroticism in emotionally overwhelmed patients)
      yielded t scores in the average range, suggesting that chronic pain patients
      present with a relatively normal underlying personality structure.

PMID- 1738574
TI  - Assessment of acute pediatric pain: do child self-report, parent ratings, and
      nurse ratings measure the same phenomenon?
AB  - The purpose of this study was to determine the factors that are associated with
      child, parent, and nurse ratings of acute pediatric pain and distress during
      venipuncture. The behavior of eighty-five pediatric cancer patients during
      venipuncture was recorded by trained raters, and their observations were compared
      with ratings of pain and distress obtained from parents, pediatric patients, and
      pediatric nurses. Regression analyses indicated that ratings made by the child,
      parent, and nurse reflect different perspectives. Nurses' ratings were based upon
      overt distress, parents' ratings reflected their subjective perception of the
      child's pain, and the child's self-report was associated with the child's
      chronologic age.

PMID- 1738575
TI  - Stimulation of craniofacial muscle afferents induces prolonged facilitatory
      effects in trigeminal nociceptive brain-stem neurones.
AB  - Stimulation of small-diameter afferents supplying deep tissues has been shown to
      increase the excitability of spinal cord neurones responding to cutaneous
      afferent inputs. This facilitation has been implicated as integral central
      mechanisms of deep pain that may contribute to the tenderness and spread and/or
      referral of pain following injury of deep tissues. In view of the recent
      documentation of deep craniofacial afferent inputs, as well as cutaneous afferent
      inputs to the trigeminal (V) spinal tract nucleus, we wished to determine the
      effects of deep inputs excited by the small-fibre irritant mustard oil on
      trigeminal nociceptive neurones. The extracellular activity of single brain-stem
      neurones was recorded in subnuclei caudalis and oralis of the V spinal tract
      nucleus of anaesthetized rats. The neurones were classified as low-threshold
      mechanosensitive (LTM), wide dynamic range (WDR) and nociceptive specific (NS) on
      the basis of their cutaneous mechanoreceptive field properties and their
      responses evoked by electrical stimulation of their cutaneous afferent inputs.
      Injection of 5% mustard oil (2-5 microliters) into the deep masseter muscle
      produced a facilitatory effect in 12 of 27 nociceptive neurones tested in
      caudalis and in 5 of 12 nociceptive neurones in oralis. This effect was reflected
      in an expansion of the cutaneous mechanoreceptive field, an increase in
      spontaneous activity or an increase in responsivity to electrical stimulation of
      cutaneous afferent inputs to the neurones. The facilitation was reversible and
      typically became apparent within 3-5 min of the injection, reached its peak at 5
      10 min, and lasted for 20-30 min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738576
TI  - Benzodiazepines and pain: effects of midazolam on the activities of nociceptive
      non-specific dorsal horn neurons in the rat spinal cord.
AB  - The high density of GABA-benzodiazepine receptors in the superficial dorsal horn
      suggests a possible involvement of benzodiazepines (BZs) in the modulation of
      spinal pain processes. In this electrophysiological study we have examined the
      effects of midazolam (MZ), a water-soluble short-acting BZ, on the activities of
      57 nociceptive non-specific dorsal horn cells, one in each animal. Recordings
      were performed at lumbar level in unanesthetized decerebrate spinal rats before
      and following intravenous injection of MZ (1, 2 or 5 mg/kg). The spontaneous
      activity was weakly and significantly but not dose dependently reduced by MZ. For
      the total neuronal population MZ induced no significant effect on C-fiber evoked
      responses, whatever the dose used. More precise analysis shows that for 45/55
      neurons the responses were slightly depressed, but this effect was not dose
      dependent. In contrast, A delta-fiber evoked responses were markedly and dose
      dependently depressed. These effects of MZ were reversed by intravenous
      administration of the antagonist flumazenil (FZ). Despite the fact that MZ
      displays a very weak effect on responses due to C-fiber stimulation, the possible
      involvement of BZs in the modulation of nociceptive transmission at the level of
      the dorsal horn is discussed on the basis of clinical and experimental findings,
      taking into account the role of GABAergic mechanisms in sensory events.

PMID- 1738577
TI  - A limited arthritic model for chronic pain studies in the rat.
AB  - Freund's adjuvant induced polyarthritis in rats has been used extensively to
      study pain processes of long duration. There are limitations of this model for
      chronic studies of pain/arthritis since the severe systemic changes provoke
      ethical concerns and also affect behaviour, physiology and biochemistry. Attempts
      to limit adjuvant-induced arthritis by plantar injection of the inoculum have
      been made. In this model, however, the process evolved to produce widespread
      polyarthritis if followed for the 6-plus-weeks necessary for chronic studies.
      Therefore, although it offers the researcher a reliable limited model of
      inflammation and nociception at the outset, for longer studies it may have all
      the disadvantages of the polyarthritic rat. The purpose of the present study was
      to produce a limited arthritic process in rats, stable over 6 weeks and suitable
      for behavioural and neurochemical studies of various chronic pain treatment
      methods. Injection (0.05 ml) of complete adjuvant containing 300 micrograms
      Mycobacterium butyricum in the tibio-tarsal joint produces a predictable
      monoarthritis, stable clinically and behaviourly from weeks 2 through 6 post
      injection. As revealed by clinical observations and X-ray examinations, the
      arthritis produced was limited anatomically, pronounced, prolonged and stable. A
      marked increase in sensitivity to paw pressure was seen in the affected limb.
      Animals gained weight and remained active, indicating little systemic disturbance
      as opposed to polyarthritic rats. We propose this limited model of arthritis as a
      suitable alternative to the polyarthritic rat for prolonged studies.

PMID- 1738578
TI  - Met-enkephalin and beta-endorphin are not involved in the analgesic action of
      transcutaneous vibratory stimulation.
AB  - Although the analgesic effects observed during the application of vibration may
      be attributable to neuronal inhibition of the pain pathways, this does not
      account for the fact that pain relief sometimes persists for a long time after
      the end of vibration treatment. Two experiments were carried out in order to
      determine whether pain relief might involve the release of endogenous opioids. In
      the first experiment, we studied the effects of injecting either a morphine
      antagonist, naloxone (0.4 mg), or a placebo, on the analgesia resulting from
      vibratory stimulation in 12 patients suffering from acute or chronic pain. In the
      second experiment, the Met-enkephalin and beta-endorphin levels were determined
      before and after 30 min vibratory stimulation in the cerebrospinal fluid of 8
      patients suffering from chronic pain and 1 control subject, all of whom had been
      fitted with a ventriculo-peritoneal drain which made it possible to collect
      samples of cerebrospinal fluid painlessly. The results of these experiments show,
      on the one hand, that the effects of naloxone on the vibration-induced analgesia
      did not differ from those of the placebo and, on the other hand, that no increase
      in the Met-enkephalin or beta-endorphin levels occurred concomitantly with pain
      relief. It will therefore be necessary to investigate other mechanisms as
      possible means of explaining the post-vibratory analgesic effects.

PMID- 1738579
TI  - The representation of prolonged and intense, noxious somatic and visceral stimuli
      in the ventrolateral orbital cortex of the cat.
AB  - The responses of single neurones in the ventrolateral orbital (VLO) cortex to
      noxious pinch, heating of the skin, twisting of the joints and distension of the
      gall bladder were studied in cats anaesthetized with halothane. Of 60 neurones
      studied, 44 responded to prolonged (greater than 10 sec) stimuli that were well
      within the noxious range. Neurones were relatively unresponsive to innocuous
      stimuli or to the transient application of noxious stimuli. Many single neurones
      responded to a variety of modalities of noxious stimuli (e.g., skin heating and
      gall bladder distension). Many neurones studied showed a fluctuating level (5-15
      Hz) of ongoing spontaneous activity. Neurones responded with either an increased
      frequency of spikes (excitation) or an inhibition of spontaneous discharge,
      irrespective of the source of noxious stimulation. Noxious stimuli delivered
      simultaneously to two different tissues (e.g., skin and visceral) sometimes
      produced excitation of the neurone under study, to levels above that produced by
      the application a noxious stimulus to only one of the tissues. Receptive fields
      were often large involving both contralateral and ipsilateral areas of the body,
      as well as both fore and hind limbs. No evidence of somatotopic organization was
      obtained. The responses of some neurones outlasted the application of the stimuli
      by many minutes. It is concluded that single neurones in the ventrolateral
      orbital cortex respond to the prolonged application of intensely noxious stimuli
      to a variety of body tissues, in a manner that is in keeping with the involvement
      of this cortical area in both the physiological, autonomic and experiential
      components of the affective-motivational aspect of pain. Furthermore, from the
      consequences of lesion studies in man and animals, it is proposed that the
      activation of cells in the orbital cortex by a variety of noxious stimuli
      reflects its more general role in the development and maintenance of behaviour in
      response to negative reinforcement of both social and physical origins.

PMID- 1738580
TI  - Trends in physiologic and pharmacologic interventions in pediatric nuclear
      medicine.

PMID- 1738581
TI  - Pediatric body CT.

PMID- 1738582
TI  - Magnetic resonance imaging in the pediatric patient.
AB  - Magnetic resonance imaging is an excellent technique for evaluation of pediatric
      pathology. When combined with other imaging modalities, MRI represents a powerful
      addition to the radiologist's diagnostic armamentarium. Magnetic resonance
      imaging has demonstrated great potential for noninvasively characterizing
      physical and chemical properties of various tissues and in some cases has
      provided information not available by any other technique. Future developments
      may result in much faster scan times, better biochemical characterization
      (magnetic resonance spectroscopy), and improved images. Certainly, the full
      potential of this extraordinary imaging technique has not been reached. As
      prospective studies of MRI evolve, this technique will play an increasing role in
      assessing pediatric disease.

PMID- 1738583
TI  - Pediatric diagnostic imaging: to see or not to see.

PMID- 1738584
TI  - Perspectives on pediatric imaging: 1992.

PMID- 1738585
TI  - Pediatric ultrasound in the 1990s.

PMID- 1738586
TI  - Diagnostic sonography of the fetus: a guide to the evaluation of the neonate.

PMID- 1738587
TI  - Inhibition of DNA synthesis at the hemimethylated pBR322 origin of replication by
      a cell membrane fraction.
AB  - The replication of both ColE1-type plasmids and plasmids bearing the origin of
      replication of the Escherichia coli chromosome (oriC) has been shown to be
      inhibited by hemimethylation of adenine residues within GATC sequences. In the
      case of oriC plasmids, this inhibition was previously shown to be mediated by the
      specific affinity of the hemimethylated origin DNA for an outer cell membrane
      fraction. Here, we suggest that a similar mechanism is operating in the case of
      the ColE1-like plasmid pBR322 as (i) a hemimethylated DNA fragment carrying the
      promoter for the RNA which primes DNA synthesis (RNAII) is specifically bound by
      the same membrane fraction and, (ii) the addition of the membrane fraction to a
      soluble assay of pBR322 replication results in preferential inhibition of
      initiation on the hemimethylated template. We suggest that membrane sequestration
      of hemimethylated origin DNA and/or associated replication genes following
      replication may be a common element restricting DNA replication to precise
      moments in the cell cycle.

PMID- 1738588
TI  - A CT promoter element binding protein: definition of a double-strand and a novel
      single-strand DNA binding motif.
AB  - Numerous genes contain promoter elements that are nuclease hypersensitive. These
      elements frequently possess polypurine/polypyrimidine stretches and are usually
      associated with altered chromatin structure. We have previously isolated a clone
      that binds a class of CT-rich promoter elements. We have further characterized
      this clone, termed the nuclease-sensitive element protein-1, or NSEP-1. NSEP-1
      binds both duplex CT elements and the CT-rich strand of these elements in a
      'generic' sequence specific manner and has overlapping but distinct single-and
      double-strand DNA binding domains. The minimal peptide region sufficient for both
      duplex and single-strand DNA binding includes two regions rich in basic amino
      acids flanking an RNP-CS-1 like octapeptide motif. Deletion analysis shows that
      the single-strand DNA binding activity is mediated by the RNP-CS-1 like
      octapeptide motif and is the key peptide region necessary for single-strand
      binding. NSEP-1's affinity for CT rich promoter elements with strand asymmetry in
      addition to its double- and single-strand DNA binding properties suggests that it
      may be a member of a class of DNA binding proteins that modulate gene expression
      by their ability to recognize DNA with unusual secondary structure.

PMID- 1738589
TI  - Human calcitonin gene regulation by helix-loop-helix recognition sequences.
AB  - Human calcitonin (CT) gene transcription is regulated by proximal 5' flanking
      sequences which mediate cAMP-induced expression, and by a distal basal enhancer
      region. Using transient expression of CT-CAT constructs, we showed that the basal
      enhancer is active in a CT-producing small cell lung cancer cell line (DMS53) and
      the thyroid C cell derived tumor line, TT, but is inactive in non-CT-producing
      cell lines. In deletional and direct mutational analyses of the distal enhancer
      region, disruption of two elements resembling recognition sequences for the helix
      loop-helix (HLH) family of transcriptional regulatory proteins resulted in a
      significant loss of basal transcriptional enhancer action. These results suggest
      that HLH recognition motifs may mediate a significant portion of constitutive CT
      gene transcriptional activity in these cells. Nuclear protein extracts from DMS53
      cells formed specific binding complexes with oligonucleotides containing two of
      these candidate enhancer sequences. However, proteins capable of binding to these
      CT gene HLH consensus recognition sites were not restricted to CT-producing
      cells. We conclude that members of the HLH protein family, some expressed
      ubiquitously and some expressed or activated in a tissue-restricted fashion, may
      combine to enhance CT gene transcription in tumor cells of neuroendocrine
      derivation.

PMID- 1738590
TI  - EGF-induced jun B-expression in transfected P19 embryonal carcinoma cells
      expressing EGF-receptors is dependent on Jun D.
AB  - The TPA-inducible transcription factor AP-1, consisting of homo- or hetero-dimers
      of members of the Jun- and Fos-families, regulates transcription of a wide
      variety of genes containing the TPA response element (TRE). In P19 embryonal
      carcinoma (EC) cells, Jun D is the only component of AP-1 expressed, while in
      these cells until now none of the members of the jun- and fos-families have been
      found to be inducable by external stimuli. Here we demonstrate that Jun B is the
      only member of the Jun- and Fos-families that is induced by Epidermal Growth
      Factor (EGF) in transfected murine P19 EC cells, expressing functional human EGF
      receptors (hEGF-Rs). Induction of jun B can be mimicked in wild type P19 EC cells
      by the synergistic action of the phorbol ester TPA and the calcium ionophore
      A23187, through activation of signal transduction pathways, that are activated
      simultaneously by EGF. The EGF induced jun B expression in the hEGF-R expressing
      P19 EC cells is mediated by an inverted repeat (IR) sequence in the jun B
      promoter, previously shown to be responsive to both PKC and PKA signal
      transduction. Transactivation of the IR sequence by EGF can be blocked completely
      by prior expression of antisense Jun D, but not by antisense c-Jun. These studies
      therefore implicate Jun D in the regulation of immediate early gene expression by
      external stimuli.

PMID- 1738591
TI  - A simple method for global sequence comparison.
AB  - A simple method of sequence comparison, based on a correlation analysis of
      oligonucleotide frequency distributions, is here shown to be a reliable test of
      overall sequence similarity. The method does not involve sequence alignment
      procedures and permits the rapid screening of large amounts of sequence data. It
      identifies those sequences which deserve more careful analysis of sequence
      similarity at the level of resolution of the single nucleotide. It uses observed
      quantities only and does not involve the adoption of any theoretical model.

PMID- 1738592
TI  - Sequence and base modifications of two phenylalanine-tRNAs from Thermus
      thermophilus HB8.

PMID- 1738593
TI  - Differential detection of multiple DNA-binding complexes using dissimilar
      polyanion competitors.

PMID- 1738594
TI  - Characterization of (CA)n microsatellites with degenerate sequencing primers.

PMID- 1738595
TI  - Non-fusion proteins expressed in E. coli: detection by alpha-complementation
      (blue/white selection).

PMID- 1738596
TI  - PCR using a thermostable polymerase with 3' to 5' exonuclease activity generates
      blunt products suitable for direct cloning.

PMID- 1738597
TI  - Nonisotopic SSCP and competitive PCR for DNA quantification: p53 in breast cancer
      cells.

PMID- 1738598
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 1738599
TI  - Structural features in TAR RNA of human and simian immunodeficiency viruses: a
      phylogenetic analysis.
AB  - A comparative analysis of TAR RNA structures in human and simian immunodeficiency
      viruses reveals the conservation of certain structural features despite the
      divergence in sequence. Both the TAR elements of HIV-1 and SIV-chimpanzee can be
      folded into relatively simple one-stem hairpin structures. Chemical and RNAase
      probes were used to analyze the more complex structure of HIV-2 TAR RNA, which
      folds into a branched hairpin structure. A surprisingly similar RNA conformation
      can be proposed for SIV-mandrill, despite considerable divergence in nucleotide
      sequence. A third structural presentation of TAR sequences is seen for SIV
      african green monkey. These results are generally consistent with the
      classification of HIV-SIV viruses in four subgroups based on sequence analyses
      (both nucleotide- and amino acid-sequences). However, some conserved TAR
      structures were detected for members of different virus subgroups. It is
      therefore proposed that RNA structure analysis might provide an additional tool
      for determining phylogenetic relationships among the HIV-SIV viruses.

PMID- 1738601
TI  - Expression of active iron regulatory factor from a full-length human cDNA by in
      vitro transcription/translation.
AB  - Iron regulatory factor (IRF), also called iron responsive element-binding protein
      (IRE-BP), is a cytoplasmic RNA-binding protein which regulates post
      transcriptionally transferrin receptor mRNA stability and ferritin mRNA
      translation. By using the polymerase chain reaction (PCR) and the sequence
      published by Rouault et al. (1990) a probe was derived which permitted the
      isolation of three human IRF cDNA clones. Hybridization to genomic DNA and mRNA,
      as well as sequencing data indicated a single copy gene of about 40 kb specifying
      a 4.0 kb mRNA that translates into a protein of 98,400 dalton. By in vitro
      transcription of a assembled IRF cDNA coupled to in vitro translation in a wheat
      germ extract, we obtained full sized IRF that bound specifically to a human
      ferritin IRE. In vitro translated IRF retained sensitivity to sulfhydryl
      oxidation by diamide and could be reactivated by beta-mercaptoethanol in the same
      way as native placental IRF. An IRF deletion mutant shortened by 132 amino acids
      at the COOH-terminus was no longer able to bind to an IRE, indicating that this
      region of the protein plays a role in RNA recognition. Placental IRF has
      previously been shown to migrate as a doublet on SDS-polyacrylamide gels. After
      V8 protease digestion the heterogeneity was located in a 65/70 kDa NH2-terminal
      doublet. The liberated 31 kDa COOH-terminal polypeptide was found to be
      homogeneous by amino acid sequencing supporting the conclusion of a single IRF
      gene.

PMID- 1738602
TI  - In vitro cleavage of double- and single-stranded DNA by plasmid RSF1010-encoded
      mobilization proteins.
AB  - We have used purified RSF1010 mobilization proteins to reproduce in vitro a
      strand-specific nicking at the plasmid origin of transfer, oriT. In the presence
      of Mg2+, the proteins MobA (78-kDa form of RSF1010 DNA primase), MobB, and MobC
      and supercoiled or linear duplex oriT DNA form large amounts of a cleavage
      complex, which is characterized by its sensitivity to protein-denaturant
      treatment. Upon addition of SDS to such a complex, a single strand break is
      generated in the DNA, and MobA is found linked to the 5' nick terminus,
      presumably covalently. The double-strand nicking activity of MobA requires, in
      addition to Mg2+, the presence of MobC and is stimulated by the presence of MobB.
      The nick site has been shown by DNA sequencing to lie at the position cleaved in
      vivo during transfer, between nucleotides 3138/3139 in the r strand of RSF1010.
      We have found that MobA will also cleave DNA at sites other than oriT if the DNA
      is present in single-stranded form. Breakage in this case occurs in the absence
      of denaturing conditions, and after prolonged incubation, reclosure can be
      demonstrated.

PMID- 1738603
TI  - Retinoblastoma susceptibility genes contain 5' sequences with a high propensity
      to form guanine-tetrad structures.
AB  - Retinoblastoma susceptibility genes contain significant runs of oligoguanine at
      their 5' ends. Oligonucleotides having these sequences underwent complex
      formation in the presence of sodium ions, in which there was association of four
      strands. Formation of this structure was completely prevented if guanine was
      replaced by 7-deazaguanine, indicating the importance of guanine N7 in the
      formation of the complex. Complex formation lead to protection of guanine N7
      against methylation by dimethyl sulphate, but thymine bases located between
      oligoguanine blocks were reactive to osmium tetroxide. There was also some
      sensitivity to S1 nuclease to the 5' side of the oligoguanine block. The results
      show that the G-rich regions of the mouse and human retinoblastoma susceptibility
      genes have a propensity to undergo tetraplex formation of the kind demonstrated
      in the immunoglobulin switch region.

PMID- 1738604
TI  - 7-Deazapurine containing DNA: efficiency of c7GdTP, c7AdTP and c7IdTP
      incorporation during PCR-amplification and protection from endodeoxyribonuclease
      hydrolysis.
AB  - The enzymatic synthesis of 7-deazapurine nucleoside containing DNA (501 bp) is
      performed by PCR-amplification (Taq polymerase) using a pUC18 plasmid DNA as
      template and the triphosphates of 7-deaza-2'-deoxyguanosine (c7Gd), -adenosine
      (c7Ad) and -inosine (c7Id). c7GdTP can fully replace dGTP resulting in a
      completely modified DNA-fragment of defined size and sequence. The other two 7
      deazapurine triphosphates (c7AdTP) and (c7IdTP) require the presence of the
      parent purine 2'-deoxyribonucleotides. In purine/7-deazapurine nucleotide
      mixtures Taq polymerase prefers purine over 7-deazapurine nucleotides but accepts
      c7GdTP much better than c7AdTP or c7IdTP. As incorporation of 7-deazapurine
      nucleotides represents a modification of the major groove of DNA it can be used
      to probe DNA/protein interaction. Regioselective phosphodiester hydrolysis of the
      modified DNA-fragments was studied with 28 endodeoxyribonucleases. c7Gd is able
      to protect the DNA from the phosphodiester hydrolysis in more than 20 cases, only
      a few enzymes (Mae III, Rsa I, Hind III, Pvu II or Taq I) do still hydrolyze the
      modified DNA. c7Ad protects DNA less efficiently, as this DNA could only be
      modified in part. The absence of N-7 as potential binding position or a geometric
      distortion of the recognition duplex caused by the 7-deazapurine base can account
      for protection of hydrolysis.

PMID- 1738600
TI  - Compilation of vertebrate-encoded transcription factors.

PMID- 1738605
TI  - The expression of the amyloid precursor protein (APP) is regulated by two GC
      elements in the promoter.
AB  - The structure of the promoter of the human APP gene resembles that of
      housekeeping genes, with the presence of a GC-rich region and the lack of a
      canonical TATA box. Since analysis of the expression of the APP gene, especially
      at the transcriptional level, might reveal factors or elements, which influence
      amyloid formation in Alzheimer's disease, a 5' deletion analysis of the APP
      promoter was performed, leading to the identification of an activating DNA
      fragment (Ac), acting also on a heterologous promoter. DNaseI-footprint analysis
      revealed three protected regions on the Ac fragment. Further gene transfer
      experiments showed, that at least two elements, designated A and C, confer
      transcriptional activity in HeLa cells. Whereas the proximal element A is a 19bp
      long GC-rich DNA sequence, the distal element C is a GC-palindrome with the
      sequence 5'GCGGCGCCGC.

PMID- 1738606
TI  - Identification of the template binding polypeptide in the pea chloroplast
      transcriptional complex.
AB  - We have identified the template-binding polypeptide in the pea chloroplast
      transcriptional complex by photoaffinity labelling. This polypeptide has an
      apparent molecular weight of about 150 kDa and binds to both, chloroplast
      ribosomal (16S rRNA) and messenger (psbA) promoters. The 16S rRNA and psbA
      promoters were amplified from chloroplast DNA by the polymerase chain reaction
      and labelled with a photoactive analogue of TTP, 5-bromodeoxy UTP, as well as
      with alpha-32P-dCTP. Using the filter-binding assay, the conditions for binding
      of the RNA polymerase complex to chloroplast promoters were optimized. The
      polypeptide directly interacting with the template was photo-crosslinked to it
      and resolved by denaturing gel electrophoresis. The photoaffinity labelling of
      the 150 kDa polypeptide was dependent on photoactivation by UV irradiation, and
      the presence of chloroplast promoters. Competition experiments showed that the
      protein formed a strong interaction with the plastid promoters which could not be
      displaced by lambda-phage DNA or synthetic polynucleotides. The photo-crosslinked
      and nuclease-treated promoter-polypeptide complex was resistant to further
      digestion with DNase and RNase, but could be hydrolyzed by Proteinase K. Binding
      of the promoters by the 150 kDa polypeptide could not be surpressed by
      transcription inhibitors like rifampicin and alpha-amanitin. However, heparin
      (0.001%) inhibited the formation of the enzyme-promoter complex, and interfered
      with the photoaffinity labelling of the 150 kDa polypeptide. The extent of
      photoaffinity labelling of 150 kDa polypeptide exhibits some degree of
      correlation to total transcriptional activity under various salt concentrations.
      The results demonstrate that the 150 kDa polypeptide is a functional template
      binding polypeptide of the pea chloroplast transcription complex.

PMID- 1738607
TI  - Processing of chimeric introns in dicot plants: evidence for a close cooperation
      between 5' and 3' splice sites.
AB  - Splice sites of vertebrate introns are generally not recognized in plant cells.
      Several lines of evidences have led to the proposal that the mechanism of 3'
      splice site selection differs in plants and animals (K. Wiebauer, J.J. Herrero,
      and W. Filipowicz, Mol. Cell. Biol. 8:2042-2051, 1988). To gain a better insight
      into the mechanistic differences between plant and animal splicing, we
      constructed chimeric introns consisting partly of dicotyledonous plant and partly
      of animal intron sequences. Splicing of these chimeric introns was analyzed in
      transiently transfected tobacco protoplasts. The results show that there are no
      principal sequence or structural differences between the 3' splice regions of
      plants and animals. Furthermore, evidence is provided that cooperation between 5'
      and 3' splice sites takes place and influences their mutual selection.

PMID- 1738609
TI  - Chlamydomonas reinhardtii telomere repeats form unstable structures involving
      guanine-guanine base pairs.
AB  - Unusual DNA structures involving four guanines in a planar formation (guanine
      tetrads) are formed by guanine-rich (G-rich) telomere DNA and other G-rich
      sequences (reviewed in (1)) and may be important in the structure and function of
      telomeres. These structures result from intrastrand and/or interstrand Hoogsteen
      base pairs between the guanines. We used the telomeric repeat of Chlamydomonas
      reinhardtii, TTTTAGGG, which contains 3 guanines and has a long interguanine A +
      T tract, to determine whether these sequences can form intrastrand and
      interstrand guanine tetrads. We have found that ss (TTTTAGGG)4 can form
      intrastrand guanine tetrads that are less stable than those formed by more G-rich
      telomere sequences. They are not only more stable, but also more compact, they
      are more stable in the presence of K+ than they are in the presence of Na+. While
      ds oligonucleotides with ss 3' overhangs of (TTTTAGGG)2 can be observed to
      associate as dimers, formation of this interstrand guanine tetrad structure
      occurs to a very limited extent and requires very high G-strand concentration,
      high ionic strength, and at least 49 hours of incubation. Our results suggest
      that, if telomere dimerization occurs in vivo, it would require factors in
      addition to the TTTTAGGG telomere sequence.

PMID- 1738608
TI  - Sensitive detection of RNAs in single cells by flow cytometry.
AB  - A rapid and sensitive fluorescent in situ hybridization method has been developed
      to probe RNA contents of individual cells by flow cytometry. Fixed cells in
      suspension were hybridized with 5' end-fluorophore-labeled oligodeoxynucleotides
      complementary to defined regions of the RNA of interest and analyzed by flow
      cytometry. With this method, we monitored combinations of histone H4 mRNA, 18S
      rRNA and 28S rRNA levels in synchronized HeLa S3 cells by multicolor analysis. A
      fluorescence signal equivalent to 1800 copies of histone H4 mRNA per cell was
      detected with signal-to-background ratio of 5.4. If non-specific binding of the
      fluorophore-labeled probe can be reduced, as few as 100 copies of mRNA of the
      size of H4 could be detected in individual cells by flow cytometry.

PMID- 1738610
TI  - Caring in its "proper place": race and benevolence in Charleston, SC, 1813-1930.

PMID- 1738611
TI  - "Half a loaf is better than no bread": public health nurses and physicians in
      Ontario, 1920-1925.

PMID- 1738612
TI  - An historical perspective of Confederate nursing during the Civil War, 1861-1865.

PMID- 1738613
TI  - Nurses under attack: the Lewes Riot and the Society of St. Margaret.

PMID- 1738614
TI  - The nature of history: meditations on Clio's craft.

PMID- 1738615
TI  - The changing face of nursing.

PMID- 1738616
TI  - Aspirations unattained: the story of the Illinois Training School's search for
      university status.

PMID- 1738617
TI  - The spirituality of Florence Nightingale.

PMID- 1738618
TI  - Watchful vigilance: nursing care, technology, and the development of intensive
      care units.

PMID- 1738619
TI  - Research and reform: community nursing and the Framingham Tuberculosis Project,
      1914-1923.

PMID- 1738620
TI  - A worry lifted.

PMID- 1738621
TI  - Stillbirth rites.

PMID- 1738622
TI  - Media watch.

PMID- 1738624
TI  - The value of nursing. Telling stories, telling moments.

PMID- 1738623
TI  - Two cheers for matron.

PMID- 1738625
TI  - Finding the right words.

PMID- 1738626
TI  - One from the heart.

PMID- 1738627
TI  - The value of nursing. Prove your worth.

PMID- 1738628
TI  - Encouraging research.

PMID- 1738630
TI  - The stigma of infertility.

PMID- 1738629
TI  - Making sense of surgical flaps.

PMID- 1738631
TI  - Grading practice.

PMID- 1738632
TI  - A very personal problem.

PMID- 1738633
TI  - General practice viewed from A&E.

PMID- 1738634
TI  - Visiting hours in intensive care units.

PMID- 1738635
TI  - Dressing ability after stroke.

PMID- 1738636
TI  - Primary nursing. Network for change.

PMID- 1738637
TI  - Primary nursing. Whose plan is it anyway?

PMID- 1738638
TI  - Allowing for loss.

PMID- 1738639
TI  - Birth of ill health.

PMID- 1738640
TI  - Pass the hat.

PMID- 1738641
TI  - No place to go.

PMID- 1738642
TI  - Road safety.

PMID- 1738643
TI  - Proceeding with caution.

PMID- 1738644
TI  - Foundation for success.

PMID- 1738645
TI  - Drugs update. Stopping the drugs trolley.

PMID- 1738647
TI  - Record recovery.

PMID- 1738646
TI  - Simon's nursing assessment.

PMID- 1738648
TI  - Hungarian research.

PMID- 1738649
TI  - Visiting time.

PMID- 1738650
TI  - Putting parents in the picture.

PMID- 1738651
TI  - Action replay?

PMID- 1738652
TI  - The value of nursing. Sound judgments.

PMID- 1738653
TI  - Systems of life. Bone and bones. 2.

PMID- 1738654
TI  - Changes in the year before death 1969-87.

PMID- 1738655
TI  - A support group for care providers.

PMID- 1738656
TI  - Diagnosing change in job structures.

PMID- 1738657
TI  - Practising research-based teaching.

PMID- 1738658
TI  - How to use questioning in the classroom.

PMID- 1738659
TI  - Nutrition, Dehydration before death.

PMID- 1738661
TI  - Open learning programme. P5: client assessment. Part (i): Assessment in context
      [continuing education credit].

PMID- 1738660
TI  - Parenteral nutrition.

PMID- 1738662
TI  - Prejudiced treatment. Interview by Peter Mason.

PMID- 1738663
TI  - Homeless and healthless.

PMID- 1738664
TI  - Bedding down.

PMID- 1738666
TI  - Looking after junior.

PMID- 1738665
TI  - An end to glue ear?

PMID- 1738667
TI  - What price tranquillity?

PMID- 1738668
TI  - Death with dignity. Christianity.

PMID- 1738669
TI  - Infection control. Protecting the patient at risk.

PMID- 1738670
TI  - Open learning. Building a career.

PMID- 1738671
TI  - Safe as houses.

PMID- 1738672
TI  - The value of nursing. Professional demands.

PMID- 1738673
TI  - Evaluating syringe drivers.

PMID- 1738674
TI  - Training in the twenties.

PMID- 1738675
TI  - Compression healing of venous ulcers.

PMID- 1738676
TI  - Parents' responses to a child's hospitalisations.

PMID- 1738677
TI  - Does nose blowing help hearing in glue ear?

PMID- 1738678
TI  - Canadian competence.

PMID- 1738679
TI  - Elderly people in A&E.

PMID- 1738680
TI  - Computing in practice: information management & technology. Informed choice.

PMID- 1738681
TI  - Professional development module. P6: facilitating learning. Part (I): Learning
      and communication.

PMID- 1738682
TI  - Suggested shift changes threaten ability to provide patient care.

PMID- 1738683
TI  - Room service.

PMID- 1738684
TI  - Stoma care?

PMID- 1738685
TI  - Lost rights.

PMID- 1738686
TI  - Places for dying?

PMID- 1738687
TI  - Up to standard.

PMID- 1738688
TI  - Balancing acts.

PMID- 1738689
TI  - Body politic. Class struggle.

PMID- 1738690
TI  - Families and HIV. Rebels at risk.

PMID- 1738691
TI  - Families and HIV. United we stand.

PMID- 1738692
TI  - Health and social services.

PMID- 1738693
TI  - Companions in casualty.

PMID- 1738694
TI  - Mental health--blyth spirits.

PMID- 1738695
TI  - Death with dignity--Jehovah's Witnesses.

PMID- 1738696
TI  - Positive progress--care study.

PMID- 1738697
TI  - Where did you get that cap?

PMID- 1738698
TI  - Drinking safely.

PMID- 1738699
TI  - The role of the nurse on the consultant's ward round.

PMID- 1738700
TI  - Too many tests?

PMID- 1738701
TI  - Continence--breaking point.

PMID- 1738702
TI  - Continence--feeling off-colour.

PMID- 1738703
TI  - Anterior dislocations of the hip. Femoral head indentation fracture.

PMID- 1738704
TI  - Radiologic case study. Giant synovial cysts.

PMID- 1738705
TI  - Wu's bunionectomy.

PMID- 1738707
TI  - Gross polyethylene failure in total knee arthroplasty.
AB  - A total of 12 total knee replacements in nine patients with evidence of gross
      polyethylene failure at the time of revision surgery were identified. There were
      nine tibial and three patellar component failures. The average time from index to
      revision arthroplasty was 6 years (range: 0.75 to 9.63). A retrospective cohort
      group was identified based on date of operation. The average patient weight of
      the initial group was 89.6 kg (range: 76 to 104 kg), compared with 74.8 kg
      (range: 47 to 108 kg) (P = .045) in the control group. There was a male sex
      preponderance in the failure group (P = .045). The average height of the study
      group was 176 cm, compared to 161 cm for the control group (P = .003). Using the
      modified OASDI scale, the failure group had a higher activity level (P = .023).
      Pre-revision limb alignment in patients with failed TKA was statistically
      different from controls and served as an indication of polyethylene failure (P =
      .04). The selection of modular prosthetic component systems that allow for easy
      polyethylene revision is indicated in the high risk patient group identified.
      Close follow up is needed to minimize the sequela of polyethylene failure.

PMID- 1738706
TI  - Total hip arthroplasty for protrusio acetabuli: a 3- to 9-year follow up of the
      Heywood technique.
AB  - Thirty-five total joint arthroplasties (34 patients) were performed in patients
      who had protrusio acetabuli. Twenty-nine percent of the patients had acetabular
      protrusio of grade I, while 71% had grade II and grade III protrusio. The mean
      follow up was 4 years (range: 3 to 9). Cemented acetabular components were used
      in 11 hips; 24 hips received an uncemented porous coated acetabular component.
      The patient evaluations included preoperative and postoperative Harris Hip
      Ratings and standard radiographs. In all cases, the medial wall defect was
      reconstructed with the solid autogenous femoral head as described by Heywood. The
      mean preoperative Harris Hip Rating was 45 (range: 30 to 60 points), and the
      postoperative mean was 85 (range: 70 to 100 points). Radiographically, the
      preoperative protrusio measured a mean of 8.8 mm (range: 6 to 18 mm), and the
      mean postoperative placement of the femoral head was 10 mm lateral to Kohler's
      line (range: 6 to 13 mm). There were no acetabular component failures and no
      acetabular bone graft resorptions. All autogenous grafts were incorporated to the
      host radiographically by 1 year post-surgery. This study corroborates previous
      work which suggests that medial-placed bone grafting is not resorbed and
      consolidates with the host bone. We find this technique extremely useful in
      dealing with this technical problem.

PMID- 1738708
TI  - The meniscus.
AB  - Abnormalities and injuries of the meniscus have been studied for decades. An
      expanded knowledge of knee biomechanics and the advent of arthroscopy have
      changed the diagnosis and treatment of meniscal pathology over the past decade.
      This review highlights some of the relevant literature concerning the meniscus.

PMID- 1738709
TI  - Three-dimensional CT reconstruction for assessment of Pipkin fracture
      dislocations of the hip.

PMID- 1738710
TI  - Intraosseous lipoma of the humerus.

PMID- 1738711
TI  - Vascular injury during cementless total hip arthroplasty.

PMID- 1738712
TI  - Analysis of the discoid meniscus in Koreans.
AB  - Discoid meniscus is a relatively common disorder of the knee in Koreans. Its
      arthroscopic treatment is one of the most technically demanding procedures of
      this field. The purposes of this study were to define the clinical features of
      the discoid meniscus in Koreans and to suggest an adequate arthroscopic
      technique. We performed arthroscopic meniscectomy on 37 knees with a lateral
      discoid meniscus. The average length of follow up was 21 months. The presence of
      synovial hypertrophy in the knee with discoid was significantly higher than that
      with a non-discoid meniscal lesion. A medial midpatellar portal for the
      arthroscope is advisable for clean arthroscopic surgery in this situation. We
      obtained satisfactory results through the partial resection of the discoid
      meniscus, leaving the normal semilunar-shaped meniscus intact as much as
      possible.

PMID- 1738713
TI  - The relationship between the treatment of congenital dislocation of the hip and
      avascular necrosis.
AB  - The most important complication following the treatment of congenital dislocation
      of the hip is avascular necrosis. The potential sequelae that may arise after the
      onset of avascular necrosis are worse than if the hip remained dislocated. We
      evaluated 38 hips in which avascular necrosis developed after reduction. The
      average patient age at the time of reduction was 4.3 years, with a follow up of 6
      to 15 years. Twelve hips had closed reduction and 26 had open reduction.
      Following reduction, 8 hips had Type I, 6 had Type II, 9 had Type III, and 15 had
      Type IV avascular necrosis. In this article, we evaluate our cases and review
      current literature on the subject. Close follow up and timely interventions can
      reduce potential sequelae to a minimum.

PMID- 1738714
TI  - Chronic lateral ankle instability--inversion sprains: Part I.

PMID- 1738715
TI  - Human immunodeficiency virus: occupational risk for surgeons.

PMID- 1738716
TI  - Prophylactic cerclage: a method of preventing femur fracture in uncemented total
      hip arthroplasty.
AB  - The incidence of femur fracture in non-cemented hip arthroplasty has been
      reported to be between 4.1% and 27.8%. To quantitate the hoop stress generated
      during insertion of a femoral broach in total hip arthroplasty and determine the
      effect of cerclage with both braided cable and wire, we harvested 14 pairs of
      embalmed cadaver femurs. These were reamed and broached to duplicate the surgical
      technique of inserting a straight non-cemented femoral component. Group one
      consisted of eight matched cadaver femurs which were tested using a single 2.0 mm
      chrome-cobalt cable placed around the calcar of one femur, with the other serving
      as a control. Group two consisted of five matched cadaver femurs which were
      tested using a single 18 gauge cerclage wire in the same manner. In group one,
      the femurs serving as controls were found to have a mean microstrain of (1425.00
      +/- 1180.19). The eight femurs tested with a 2 mm cable were determined to have a
      mean microstrain of (4179 +/- 2853.89). In group two, the femurs serving as
      controls were found to have a mean microstrain of (962.60 +/- 956.78). The five
      femurs in group two tested with a cerclage wire were determined to have a mean
      microstrain of (1112.00 +/- 975.66). Using a paired t-test, statistical
      significance was achieved with a confidence level of P less than or equal to .01
      in group one. Prophylactic wiring of the proximal femur with 2 mm cable increases
      the hoop stress resistance and, therefore, should decrease the incidence of
      intraoperative femur fractures in uncemented total hip arthroplasty.

PMID- 1738717
TI  - The usefulness of MRI in evaluating menisci after meniscus repair.
AB  - We reviewed magnetic resonance imaging (MRI) scans of 15 asymptomatic patients at
      6 months to 1 year following meniscal repair procedures. All of the patients were
      found to have persistent MRI signals in the region of the repair. Nine of the 17
      meniscal repairs in the 15 patients had persistent grade 3 signals. Arthrograms
      were performed on six patients (eight meniscal repairs). Seven of these
      postoperative menisci showed grade 3 signals on MRI. Only one meniscus was shown
      to have a complete tear by arthrogram. There were no false negative scans. The
      overall accuracy, defined as the percentage of postoperative menisci correctly
      diagnosed by MRI, was 38% (3/8). MRI is a useful preoperative diagnostic study
      following knee injury. This report demonstrates, however, that present MRI
      modalities are unable to distinguish between scar tissue of healed meniscal
      repairs and meniscal tears. Therefore, it is not a useful diagnostic tool in
      evaluating reinjury following successful meniscal repair.

PMID- 1738718
TI  - Operative treatment of bicondylar intraarticular fractures of the distal humerus.
AB  - Orthopedists' lack of consensus on treatment regimens for bicondylar fractures of
      the distal humerus warrants further review of this uncommon fracture. We present
      a series of 17 bicondylar fractures of the distal humerus that had a minimum
      follow up of 2 years. Of these fractures, the 13 that were treated exclusively
      with internal fixation had 92% excellent or good results. The operative technique
      we describe is modified from the technique recommended by the AO group. We have
      found it helpful to use the radial column as the site of primary fixation with a
      3.5 mm dynamic compression plate in the sagittal plane. Additional fixation is
      provided by a reconstruction plate placed posteriorly on the ulnar column in the
      coronal plane. This system of dual plates in perpendicular planes provides
      rigidity for early motion which, when supervised, is beneficial to a satisfactory
      outcome.

PMID- 1738719
TI  - A comparison of epidural and non-epidural anesthesia and analgesia in total hip
      or knee arthroplasty patients.
AB  - This retrospective study explores a number of variables encountered with the use
      of either epidural or non-epidural anesthesia and analgesia. Postoperative
      mobility, amount of narcotic used, incidence of blood transfusion, length of
      stay, and presence of urinary retention, pruritus, nausea and vomiting, or
      respiratory depression were compared in a group of 101 consecutive patients
      scheduled for total hip or knee arthroplasty. Fifty-two patients received
      epidural anesthesia and analgesia; the remaining 49 received non-epidural
      anesthesia, followed by standard IM/IV postoperative analgesia. Epidural patients
      required significantly less narcotic than the non-epidural group. There were
      significantly fewer blood transfusions in the epidural group; however, epidural
      patients had significantly increased incidence of urinary retention and pruritus.
      The use of epidural anesthesia and analgesia for total hip and knee arthroplasty
      patients has definite merit, but is most safely administered in a monitored,
      skilled nursing unit.

PMID- 1738720
TI  - Evaluation of the cervical spine in the emergency setting: who does not need an X
      ray?

PMID- 1738721
TI  - Polymethylmethacrylate-antiblastic drug compounds: an in vitro study assessing
      the cytotoxic effect in cancer cell lines--a new method for local chemotherapy of
      bone metastasis.
AB  - An in vitro study was performed assessing the pharmacologic properties of
      polymethylmethacrylate (PMMA)-antiblastic agent (doxorubicin and cisplatinum)
      mixtures in normal and neoplastic cell lines cultures. The study's aim was to
      analyze the polymerization capacity of PMMA in the presence of doxorubicin and
      cisplatinum, the release of drug from the mixture, the kinetics of release, and
      the effect of the released drugs in normal and neoplastic cell cultures. Our data
      show that even at high concentrations neither doxorubicin nor cisplatinum inhibit
      the polymerization of PMMA. Moreover, mixtures in vitro can release the
      antiblastic drug which maintains its pharmacologic activity on sensitive
      neoplastic cells. Therefore, the PMMA-antiblastic drug mixtures, along with
      current anti-cancer therapy (systemic chemotherapy and radiation therapy), may
      provide better local control of the metastatic lesion and of some bone tumors.

PMID- 1738722
TI  - Isolated bilateral tarsal navicular fracture-dislocation.

PMID- 1738723
TI  - Complex dorsal dislocation of the interphalangeal joint of the great toe.

PMID- 1738724
TI  - Triceps avulsion fracture in a weightlifter.

PMID- 1738725
TI  - Fusobacterium nucleatum pyomyositis.

PMID- 1738726
TI  - Fixation screws of the acetabular component in hip replacement.

PMID- 1738727
TI  - Arthroscopic capsular suture for anterior instability of the shoulder.
AB  - We assessed the results of arthroscopic transglenoid capsular suture in eight
      recurrent traumatic unidirectional anterior dislocations. At an average follow up
      of 11 months, ranging from eight to 18 months, assessment by Rowe's scoring
      system were excellent or good in all shoulders. There were no redislocations and
      all patients achieved near full, painless range of motion. There were no
      complications. We propose a new classification of anterior capsular lesions
      (Bankart lesion) and we describe the details of the arthroscopic suture
      technique. We conclude that arthroscopic suture is an effective method with low
      surgical morbidity and low cost in the treatment of recurrent anterior
      dislocation of the shoulder.

PMID- 1738728
TI  - Salvage of infected total hip replacement: use of antibiotic/PMMA spacer.

PMID- 1738729
TI  - Total ankle joint replacement: a clinical follow up.
AB  - The TPR total ankle joint replacement system (Smith & Nephew Richards) was
      implanted in 30 ankles in 25 patients. Twenty-three ankles in 18 patients were
      followed; 21 had rheumatoid arthritis and two had osteoarthritis. The average age
      at surgery was 62 years (range: 37 to 77), and the average follow up was 59
      months (range: 37 to 89). The improvement was especially obvious with respect to
      pain and function. The average walking distance improved from 260 m
      preoperatively to 975 m postoperatively. Even though there was some improvement
      with respect to pain and function, the results of the study are disappointing in
      comparison to studies of ankle arthrodesis.

PMID- 1738730
TI  - Chronic lateral ankle instability--inversion sprains: Part II.

PMID- 1738731
TI  - Radiologic case study. MRI and sports injuries.

PMID- 1738732
TI  - Giant cell arteritis and polymyalgia rheumatica.
AB  - The close relationship between giant cell arteritis and polymyalgia rheumatica
      has not been clearly explained. These disorders affect the same patient
      population and often coexist in the same person. Monitoring of the erythrocyte
      sedimentation rate is a useful tool in both diagnosis and treatment. Management
      with varying doses of prednisone has proved effective in resolving symptoms.

PMID- 1738733
TI  - Rational treatment of gout. Stopping an attack and preventing recurrence.
AB  - The most definitive method of diagnosis for acute gouty arthritis is aspiration
      of the affected joint and examination of the fluid for the characteristic needle
      shaped monosodium urate crystals. Treatment is aimed at promptly stopping the
      attack and reversing complications. Colchicine and various nonsteroidal anti
      inflammatory drugs are effective for both treatment and prophylaxis.
      Antihyperuricemic therapy may be indicated in patients who have had several
      attacks in a year.

PMID- 1738734
TI  - Exercise and the heart. Good, benign, or evil?
AB  - The risks and benefits of regular aerobic exercise have been studied extensively.
      Because of the potential risks, we believe that sedentary persons over age 40 who
      have cardiac risk factors, as well as patients with coronary artery disease
      (CAD), should have a complete physical examination and probably an exercise
      electrocardiogram before starting a vigorous exercise program. In general,
      however, regular exercise has proven to be extra-ordinarily safe and the
      theoretical and proven benefits appear to greatly outweigh the risks in most
      people, including those with CAD, those with severe left ventricular dysfunction,
      and the elderly.

PMID- 1738736
TI  - Father and son.

PMID- 1738735
TI  - Acute renal failure in a patient with prostatic carcinoma. A case of benign
      uropathy.
AB  - Obstructive uropathy and renal insufficiency are often associated with cancer.
      However, in the case described here, a patient with carcinoma of the prostate had
      acute renal failure due to benign obstructive uropathy. Precise, prompt diagnosis
      and treatment resulted in complete reversal of renal symptoms.

PMID- 1738737
TI  - Obsessive-compulsive disorder. Characteristic features, pharmacologic management.
AB  - Obsessive-compulsive disorder is a fascinating and troubling clinical problem
      that is now believed to be relatively common. New approaches to research are
      beginning to unlock its secrets and explore its biological underpinnings. Drugs
      such as fluoxetine hydrochloride (Prozac) and clomipramine hydrochloride
      (Anafranil) now offer hope for improvement in the lives of affected persons.

PMID- 1738738
TI  - Acute poisoning emergencies. Resolving the gastric decontamination controversy.
AB  - As in all medical emergencies, in acute poisoning the cornerstone of management
      is good supportive care. Aggressive support of the cardiovascular, respiratory,
      and central nervous systems, along with appropriate gastric decontamination,
      greatly reduces morbidity and mortality and improves patient outcome. Ipecac is
      generally reserved for home use, where it can be given to induce emesis
      immediately after ingestion of toxins, and it is given only in cases of mild or
      moderate toxicity. Activated charcoal should replace ipecac in the emergency
      department for cases of mild or moderate toxicity. Gastric lavage and
      administration of activated charcoal should be considered in cases with life
      threatening potential. A cathartic should be considered after activated charcoal
      has been administered, but only in cases where it will not have a detrimental
      effect.

PMID- 1738739
TI  - Travel to the Persian Gulf. Medical guidelines for visitors.
AB  - The disease, destruction, and destitution created by the recent conflicts in the
      Persian Gulf have resulted in increased international travel to affected
      countries for relief and reconstruction. Such travel involves more than minimal
      health risks, but effective preparation of travelers by primary care physicians
      can help, as discussed by the authors.

PMID- 1738740
TI  - Surgery in the elderly. Lowering risks by understanding special needs.
AB  - Elderly patients should be evaluated closely before surgery. Problems commonly
      found in these patients (ie, hypertension, diabetes, and cardiac and pulmonary
      disease) should be sought with special care and treated before surgery is
      undertaken. Also, wound healing may be compromised, drug clearance and metabolism
      impaired, and nutritional status abnormal. However, if these and other age
      related problems are anticipated, surgery is usually successful and recovery
      uneventful.

PMID- 1738741
TI  - Heart disease after mediastinal radiotherapy.
AB  - The greatest risk for most cancer patients is inadequate treatment of their
      disease. Although mediastinal radiotherapy is a safer procedure than it was 20
      years ago, it still may damage the thoracic viscera, including the heart.
      Cardiovascular problems tend to present subtly years later, when the patient may
      not recall the prior radiation or may not deem it significant. An awareness of
      this long latency period and of the wide spectrum of heart disease that may
      result from radiotherapy is essential for management of these patients.

PMID- 1738742
TI  - Premalignant lesions of the gastrointestinal tract. Surveillance regimens for
      three treatable disorders.
AB  - Barrett's esophagus, ulcerative colitis, and adenomatous colorectal polyps have
      been proven to be precursors of cancer. Early treatment and appropriate
      esophagoscopic or colonoscopic surveillance for recurrence or disease progression
      in these patients can save lives. Dr Schuman discusses typical regimens and
      special considerations in follow-up of these disorders.

PMID- 1738743
TI  - Pernicious anemia. Early identification to prevent permanent sequelae.
AB  - Pernicious anemia can be confidently diagnosed in a patient who has megaloblastic
      hematopoiesis, low serum cobalamin level, and impaired vitamin B12 absorption
      correctable by administering intrinsic factor. Recent studies suggest that
      neurologic disorders in patients with pernicious anemia are less severe than in
      the past, highly responsive to therapy, and seen in the absence of anemia and
      macrocytosis. A low serum cobalamin level in the absence of anemia, particularly
      in a patient with a neurologic disorder, should not be ignored.

PMID- 1738744
TI  - Superficial fungal infections. Topical and oral treatment of common types.
AB  - Superficial fungal infections are common dermatologic conditions, and patients
      often visit primary care physicians for evaluation. Diagnosis can be established
      with direct microscopic examination, fungal culture, and Wood's light
      examination. Some infections (eg, tinea corporis, tinea cruris, tinea pedis,
      pityriasis versicolor) are often successfully treated with a topical antifungal
      alone. Others (eg, tinea capitis, onychomycosis) require use of a systemic
      antifungal. Physicians should be familiar with available agents and their adverse
      effects and closely follow patients receiving long-term antifungal therapy.

PMID- 1738745
TI  - Acute pyelonephritis. Preventing complications through prompt diagnosis and
      proper therapy.
AB  - The diagnosis of pyelonephritis is based on clinical and laboratory criteria that
      include fever, flank pain or tenderness, leukocytosis, pyuria, and confirmatory
      urine culture. A Gram stain of unspun urine can provide an important early clue
      regarding the etiologic agent. At least 85% of cases are caused by Escherichia
      coli, but clinicians need to be aware of other potentially aggressive organisms
      as well. Elderly, diabetic, or immunocompromised hospitalized patients and
      patients subject to instrumentation present a more complex diagnostic challenge
      and require more intense parenteral treatment. Prompt diagnosis and proper
      therapy decrease the risk of serious complications.

PMID- 1738746
TI  - Pericarditis and myocarditis. Which is benign and which isn't?
AB  - Pericarditis and myocarditis are inflammatory diseases that are often initiated
      by common viruses. Pericarditis rarely causes serious long-term disability,
      whereas myocarditis may lead to chronic congestive cardiomyopathy and permanent
      disability. The pathogenesis of both is proposed to be bimodal, with an early
      stage characterized by viral replication and a later stage by infiltration of
      lymphocytes and necrosis of cells secondary to an autoimmune process. Treatment
      of pericarditis is usually symptomatic. Myocarditis requires bed rest and
      conventional therapy for congestive heart failure. Efficacy of immunosuppressive
      therapy for myocarditis is currently being tested in an international multi
      center clinical trial.

PMID- 1738747
TI  - Oral anticoagulant therapy. Newer indications and an improved method of
      monitoring.
AB  - Oral anticoagulants remain time-tested therapeutic agents. A number of new
      indications for use of these drugs have recently emerged, especially nonvalvular
      atrial fibrillation. New information on the factors associated with adverse
      reactions to oral anticoagulants is available, along with improved knowledge on
      how to evaluate and treat such complications. A major advance in the safer use of
      these drugs in North America will accompany increased application of the
      International Normalized Ratio in reporting prothrombin time.

PMID- 1738748
TI  - $8,334 Concorde flights, bypass surgery, and MRIs.

PMID- 1738749
TI  - Sorting out the cephalosporins.
AB  - How can you choose the best cephalosporin to prescribe out of an array that is
      vast and quickly growing? Dr Brogan simplifies the process by describing the
      specific advantages as well as the shortcomings of individual agents. He also
      makes general recommendations based on his experience.

PMID- 1738750
TI  - Medical school loans.

PMID- 1738751
TI  - Rethinking the therapeutic pyramid for rheumatoid arthritis. When are NSAIDs
      alone not enough?
AB  - A large number of agents that compare quite favorably to nonsteroidal anti
      inflammatory drugs in terms of toxicity and efficacy are available to physicians
      for the treatment of rheumatoid arthritis. Primary care physicians need to
      familiarize themselves with the use of these drugs and consider prescribing them
      early in the course of the disease, when they may be of greatest benefit.

PMID- 1738752
TI  - Nonarticular pain syndromes. Differentiating generalized, regional, and localized
      disorders.
AB  - Nonarticular pain syndromes, although not inherently crippling, can have
      significant impact on patients' comfort, daily activities, and job performance.
      These syndromes include fibromyalgia, bursitis, tendinitis, and localized
      myofascial pain syndromes. Although differentiating these conditions from one
      another may be difficult, early diagnosis and follow-up are important for
      determining appropriate treatment. Depending on the diagnosis, treatment may
      include use of nonsteroidal anti-inflammatory drugs, analgesics, or
      corticosteroid injections; trigger-point desensitization therapy; physical
      therapy; and patient education.

PMID- 1738753
TI  - Prostanoids as local modulators of reflex micturition.
AB  - Surge of interest about the possible role of prostanoids in the regulation of
      urinary bladder function can be traced back to the early 1970s, after the
      demonstration that prostaglandin-like material is released in the circulation
      during or immediately after bladder distension. The discovery that even a mild
      form of tissue stimulation, such as stretch of smooth muscle cells, releases
      significant amounts of prostanoids prompted the speculation that locally
      generated prostaglandins (PGs) might aid the receptive functions of hollow
      organs, such as the stomach and the urinary bladder, thereby allowing
      accommodation of their physiological content. While the latter interpretation
      turned out to be incorrect for the urinary bladder, these earlier studies
      attracted the attention of many investigators on the possible role of prostanoids
      as local modulators of micturition. This topic has been the subject of some
      recent reviews addressing the effect of prostanoids in regulating motility, blood
      flow, defence against infection and carcinogenesis in the urinary bladder. The
      aim of this short review is to re-address the topic of prostanoid modulation of
      reflex micturition with particular emphasis on a target for prostanoid action in
      the urinary bladder (i.e. sensory nerves) which, until recently, has been somehow
      neglected.

PMID- 1738754
TI  - Fractal dimension in pharmacology.

PMID- 1738755
TI  - Membrane antiperoxidative activities of D-propranolol, L-propranolol and dimethyl
      quaternary propranolol (UM-272).
AB  - With the isolated sarcolemmal membrane model, the antiperoxidative activities of
      D-propranolol, L-propranolol and the non-beta-blocker analogue UM-272 (dimethyl
      quaternary propranolol) were compared. Membrane lipid peroxidation induced by the
      Fe-catalysed, hydroxyl radical producing system (dihydroxyfumarate + Fe3+) was
      assessed by MDA formation. In the range of 10-200 microM, both D- and L
      propranolol exhibited identical concentration-dependent inhibitory effects (20
      70%), whereas UM-272 was about 2/3 as active as propranolol. In contrast,
      lignocaine (lidocaine), a well known membrane stabilizer, did not produce any
      effect. When purified rat hepatic microsomes were peroxidized by NADPH + Fe3+,
      comparable antiperoxidative effects were produced by the propranolol enantiomers
      and the dimethyl analogue. Thus, the antioxidant activities of these agents are
      related to their intrinsic chemical properties which might contribute to the
      reported beneficial effects of propranolol and UM-272 in models of
      ischaemia/reperfusion injury.

PMID- 1738756
TI  - Influence of cetiedil on erythrocyte membrane microviscosity and
      acetylcholinesterase activity.
AB  - Since one of the cellular targets of cetiedil, a vaso-erythroactive drug, is
      likely to be the erythrocyte membrane, we have studied the influence of this drug
      on erythrocyte membrane microviscosity and acetylcholinesterase activity. No
      effect was evidenced on microviscosity, as measured by fluorescence polarization
      of light emitted by DPH or TMA-DPH labelling of the lipid bilayer. Cetiedil,
      however, did lower acetylcholinesterase activity, but it did not directly inhibit
      this enzyme activity. It can therefore be considered as an amphiphilic drug that
      perturbs membrane properties without affecting the physical state of the
      erythrocyte membrane.

PMID- 1738757
TI  - Debrisoquine oxidation in an Italian population: a study in healthy subjects and
      in schizophrenic patients.
AB  - The debrisoquine oxidation phenotype was assessed in 137 healthy Italian
      volunteers and in 41 drug-free schizophrenic patients. A bimodal distribution of
      the urinary debrisoquine/4-hydroxydebrisoquine metabolic ratio was observed in
      healthy volunteers. Ten subjects were identified as poor metabolizers, yielding a
      frequency of 7.3% which is similar to that reported in other European countries.
      The prevalence of the poor metabolizer phenotype was 9.8% among schizophrenic
      patients. This indicates that there is no association between polymorphic drug
      oxidation and schizophrenic disorder. Treatment with chlorpromazine (100 or 150
      mg daily) significantly increased the debrisoquine metabolic ratio in nine
      patients (P less than 0.01). These results confirm that neuroleptics of the
      phenothiazine class inhibit the oxidative metabolism of debrisoquine.

PMID- 1738758
TI  - Hepatic uptake and biliary secretion of bile acids in the perfused rat liver.
AB  - Hepatic uptake and biliary secretion have been evaluated in the isolated perfused
      rat liver for cholic, chenodeoxycholic, ursodeoxycholic acid, both free and
      taurine-conjugated; the physicochemical properties of the bile acids have also
      been calculated and related to these experimental parameters. Cholic acid
      disappearance rate from the perfusate was the fastest, followed by that of
      ursodeoxycholic and chenodeoxycholic; it was also faster for taurine-conjugated
      bile acids than for their respective unconjugated forms. The recovery in bile was
      higher for conjugated than for unconjugated bile acids, and among each class, was
      higher for cholic than for chenodeoxycholic and ursodeoxycholic. The hepatic
      uptake correlated negatively (r = -0.99) with the bile acid lipophilicity, while
      the biliary secretion correlated with the solubility of the molecules. These
      results show the effect of the physicochemical properties of BA on their hepatic
      handling, at the physiological concentration of BA in the portal blood.

PMID- 1738759
TI  - Treatment with low dose metformin in patients with peripheral vascular disease.
AB  - Low dose metformin (500 mg b.i.d.) was tested in 11 patients with symptomatic
      peripheral vascular disease (PVD) in an open design. At -1, 0, 1, 4, 7 months the
      major lipid and lipoprotein parameters, arterial function, and fibrinolytic
      activity were monitored. Arterial function changes were similar to those found
      with a high dose (850 mg t.i.d.) metformin but plasma lipids did not change to an
      appreciable extent. Post-ischaemic blood flow, by plethysmography, rose 30%; the
      exercise capacity, evaluated by treadmill test, also increased significantly by
      105.7% for relative and 53.3% for absolute claudication. Total fibrinolytic
      activity did not change during the treatment but the antigens of two of the major
      components of the fibrinolytic system, i.e. t-PA and PAI-1, were significantly
      reduced at the end of the study. This study gave results quite consistent with
      those obtained with higher metformin doses, associated with a potentially higher
      risk of lactic acidosis.

PMID- 1738760
TI  - Electrophysiological actions of a new antiarrhythmic drug, bisaramil, on isolated
      heart preparations.
AB  - Electrophysiological effects of bisaramil--a new antiarrhythmic drug under
      clinical trial--were investigated on isolated heart preparations, at a
      concentration range of 2.3-23 x 10(-6) M. Bisaramil dose dependently decreased
      the maximum rate of depolarization (Vmax), action potential amplitude (APA) and
      overshoot (OS) both in auricle and in papillary muscle of guinea-pig heart. There
      was no significant and obvious effect on the duration of the action potential and
      the resting membrane potential was also unchanged. Bisaramil slowed the
      spontaneous frequency of pacemaker cells in rabbit sinus node preparation due to
      its inhibitory effect on slow diastolic depolarization (SDD). Bisaramil was able
      to inhibit slow Ca(2+)-action potentials induced by isoprenaline on K(+)
      depolarized papillary muscle. Results obtained with transmembrane current
      measurements revealed that bisaramil inhibited both fast Na(+)-current and slow
      Ca(2+)-current in frog sinoauricular fibres at the same concentration. Bisaramil
      with a mixed mode of the action seems to be a very promising drug.

PMID- 1738761
TI  - Reproducibility of Wolfe's classification of mammographic parenchymal patterns.
AB  - BACKGROUND: Inadequate reproducibility of Wolfe's classification of mammographic
      parenchymal patterns may explain its limited use in clinical and screening
      practice. If the misclassification of mammographic parenchymal pattern categories
      is substantial, inconsistencies in study results will occur, which could at least
      partially explain the frequent inability to replicate Wolfe's findings in studies
      of breast cancer. In this article, results of a study to determine whether
      consensus to resolve inconsistencies between raters would improve the level of
      concordance in mammographic parenchymal pattern categorization and thus help
      reduce misclassification are presented. METHODS. One hundred consecutive
      mammograms from a large screening clinic in New York City were classified
      independently by two expert mammographers on two separate occasions, 8 days
      apart. Coding was repeated in two consensus conferences several weeks later.
      Reliability was estimated by computing intraclass correlation coefficients.
      RESULTS: Initially, the average intraobserver reliability for the four patterns
      was 0.68 and the interobserver reliability was 0.65. After consensus, reliability
      improved markedly to 0.88. CONCLUSION: It is concluded that the added
      complication and cost of consensus ratings will be more than offset by a
      substantial increase in precision.

PMID- 1738762
TI  - Mental retardation associated with parental smoking and alcohol consumption
      before, during, and after pregnancy.
AB  - METHODS: In an epidemiologic study, parental alcohol consumption and smoking
      before, during, and after pregnancy were studied as possible risk factors for
      mental retardation in offspring. The parents of 306 mentally retarded children
      (cases) and 322 physically handicapped children (referents) were interviewed
      about their lifestyle habits from 3 months preconception to 6 months postnatal.
      RESULTS: Odds ratios with 95% confidence intervals were calculated as risk
      indicators. For fathers who smoked a pipe or cigars, an odds ratio of 2.4 (95%
      CI: 1.2-5.1) was observed. Maternal alcohol consumption was increased among the
      case mothers with risk ratios ranging from 1.7 (95% CI: 1.2-2.3) preconception to
      1.4 (95% CI:1.0-2.0) during the fetal period. These risks were more pronounced
      for the mothers who consumed greater than or equal to 3 drinks/day once or twice
      a week. CONCLUSIONS: This study suggests that paternal smoking and maternal
      alcohol consumption are risk factors for mental retardation in offspring.

PMID- 1738763
TI  - Physical activity in Minnesota physicians.
AB  - METHODS: A survey inquiring about physical activity was mailed to a random sample
      of 500 physicians who were current members of the Minnesota Medical Association.
      RESULTS: Overall, 65.6% of the 393 respondents reported performing regular
      exercise, while 38.2% participated in exercise vigorous enough to be of
      cardiovascular benefit (at least three times per week, at least 15-30 min per
      session, and strenuous enough to cause sweating or shortness of breath). Men
      reported a significantly higher prevalence of regular exercise and cardiovascular
      exercise than did women. There was no significant relationship between the
      prevalence of either regular exercise or cardiovascular exercise and age,
      specialty, the percentage of primary care performed, the number of patients seen
      per day, or the number of hours worked per week. CONCLUSIONS: The prevalence of
      physical activity was higher among physicians in this survey compared with levels
      reported for the general population.

PMID- 1738764
TI  - Leisure time physical activity: are there black/white differences?
AB  - BACKGROUND: Behavioral risk factor surveillance survey data collected during 1984
      and 1985 in South Carolina were analyzed. METHODS: This article is based on
      telephone interviews conducted with 2,005 individuals (431 black, 1574 white),
      mean age, 45.1 years, selected by random-digit dialing. Information on the type,
      frequency, and duration of leisure time physical activity was used to estimate
      leisure time energy expenditure (kcal/week) averaged over the previous month. The
      median level of leisure time energy expenditure differed significantly (all P
      less than 0.001) by gender (men = 741, women = 421), age (six categories;
      youngest, 18-29 years = 780; oldest, 70+ = 301), annual household income (four
      categories; lowest, less than or equal to $10,000 = 300; highest, greater than
      $35,000 = 870), body mass index (kg/m2, less than or equal to 24.1 = 601, greater
      than or equal to 30.1 = 180), and race (black = 301, white = 601). RESULTS:
      Leisure time energy expenditure generally decreased with increasing age and body
      mass index and increased with increasing levels of education and income among all
      race/gender groups. Logistic regression analyses revealed that after adjustment
      for gender (if applicable), age, income, and body mass index, the variable race
      made a statistically significant contribution to the model, in the total sample
      (P less than .03) and for women P less than .001), but not for men. CONCLUSIONS:
      Our results suggest that blacks living in the South, particularly black women,
      have lower levels of leisure time physical activity compared with their white
      counterparts after control for several important confounders.

PMID- 1738765
TI  - Social status and coronary heart disease: results from the Scottish Heart Health
      Study.
AB  - Social status has frequently been found to be associated with the prevalence of
      coronary heart disease. Currently, in developed countries, it seems that the
      least advantaged social groups are at the greatest risk. This article addresses
      this issue in the Scottish population, using a cross-sectional sample of 10,359
      men and women. Four measures of social status are used: level of education, years
      of education, housing tenure, and the Office of Population Censuses and Surveys'
      definition of social class based on occupation. By each of these four criteria,
      and for both sexes, the least advantaged have a significantly higher coronary
      heart disease prevalence (P less than 0.01). The odds ratios for housing tenure
      are highest, being 1.63 and 1.55 for men and women, respectively, comparing those
      who live in rented accommodation with owner-occupiers. After adjustment for a
      number of coronary heart disease risk factors, which are possible confounding
      variables, most, if not all, of the significant effect of education and
      occupation on coronary heart disease is removed. Housing tenure is still highly
      significant (P less than 0.001), with odds ratios of 1.48 and 1.45 for men and
      women, respectively. Smoking and fibrinogen are the most important confounding
      variables for men, and body mass index, high-density lipoprotein cholesterol, and
      triglyceride levels, the most important for women. When relationships among the
      social factors themselves are investigated, housing tenure is found to remove the
      significant effects of education and occupation in men, and of education in
      women. No other social factor removes the significant effect of housing tenure (P
      less than 0.001). Housing tenure in Scotland is thus found to be the most
      discriminatory measure of social status in relation to coronary heart disease.

PMID- 1738766
TI  - The Heart Smart cardiovascular school health promotion: behavior correlates of
      risk factor change.
AB  - BACKGROUND: A growing awareness of health promotion and positive lifestyle
      change, coupled with the knowledge that cardiovascular risk has its origins in
      childhood, has led to the development of health promotion programs in the
      elementary school. While most school-based programs target specific behaviors or
      enlist singular intervention modalities, the Heart Smart cardiovascular school
      health promotion targeted the total school environment with a multidisciplinary
      approach to prompt the school's varied institutions to implement changes in
      curriculum, school lunch, and physical education. METHODS: Components of the
      Heart Smart environmental intervention included: (a) a school lunch program
      providing cardiovascular healthful food choices, reduced in fat by 30% and in
      sodium and sugar by 50%; (b) a physical education program promoting personal
      fitness and aerobic conditioning; and (c) cardiovascular risk factor screening,
      measuring fasting lipids and lipoproteins, anthropometrics, and blood pressure.
      Changes in cardiovascular risk factor status, school lunch selections, and
      exercise performance were compared. RESULTS: Screening participants showed
      greater improvement in health knowledge than nonparticipants. School lunch
      choices were successfully altered, and children whose lunch choices were
      cardiovascular healthful evidenced the greatest cholesterol reduction.
      Improvements in run/walk performance were related in predicted directions to the
      overall cardiovascular risk profile. Increases in high-density lipoprotein
      cholesterol were observed at intervention schools. CONCLUSION: Observations
      indicate a relationship between behavior change and physiologic changes achieved
      in a total school health promotion to reduce cardiovascular risk.

PMID- 1738767
TI  - Does a reduced fat diet cause retardation in child growth?
AB  - BACKGROUND: A diet low in saturated fat and cholesterol is strongly recommended
      by the American Heart Association and the National Cholesterol Education Program
      as a way to prevent coronary heart disease. In addition, the National Cancer
      Institute has suggested that dietary fat restriction may also prevent the
      development of some cancers. However, the American Academy of Pediatrics reviewed
      the same evidence in relation to children and concluded that that major dietary
      changes recommended for adults should not be prescribed for children. METHODS: In
      this article, we review the evidence for the detrimental consequences associated
      with dietary fat restriction for children. Evidence from studies on secular
      trends, migration, and vegetarian communities suggests minor effects of dietary
      fat restriction upon growth. In addition, there is some evidence indicating that
      children who are placed on severe dietary restriction during growth periods may
      experience growth stunting. Virtually all of the published studies have serious
      methodological limitations. CONCLUSION: We conclude that dietary fat restriction
      may have some small, but measurable, effects upon growth.

PMID- 1738768
TI  - Primary prevention of cardiovascular disease: 3-year intervention results in boys
      of 12 years of age.
AB  - BACKGROUND: The intervention group comprised 477 children at the age of 11.8 +/-
      0.11 years. The reference group comprised 528 children aged 11.9 +/- 0.12 years.
      Both groups were drawn on the basis of the selected examination of children from
      two Moscow districts. The criteria for risk factors involved the upper 5% of the
      distribution curve for blood pressure, the upper 10% of the distribution curve
      for cholesterol and triglycerides, the upper 15% of the distribution curve for
      the Quetelet index, and a positive response to the question on smoking, "Smoke at
      least once per week or more frequently?" METHODS: The intervention was carried
      out both among the entire sample population and more intensively among persons
      with risk factors. It included counseling for children and their parents on
      rational diet, physical activity, and smoking hazards. Relevant material on
      health education was disseminated. Follow-up examinations were carried out at 1
      and 3 years following baseline measures. RESULTS: The examination at 1 year
      showed that the children of the intervention district had attained a greater
      reduction in their levels of total cholesterol, triglycerides, and systolic blood
      pressure than those of the reference district. High-density lipoprotein
      cholesterol levels decreased equally in both districts. After 3 years, the effect
      was retained for cholesterol and systolic blood pressure; the level of high
      density lipoprotein cholesterol showed a greater reduction in district 2. After 1
      year, the increase in the Quetelet index among the intervention sample (district
      1) became less. After 3 years of intervention, the smoking accretion rate had
      decreased by 8.9% in district 1 (intervention) compared with that in district 2
      (reference).

PMID- 1738769
TI  - Cotinine in an ultrafiltrate of saliva.
AB  - BACKGROUND: We have developed a device for the simplified collection of a
      prepurified sample of saliva in the mouth. METHOD: The device is based on the
      principle of an osmotic pump and accumulated about 1.2 ml of an ultrafiltrate of
      saliva within 8 min. We have investigated the ultrafiltrate for its utility as a
      biological medium in the evaluation of cigarette smoking status. RESULTS: (a) In
      58 matched samples from 13 subjects, the correlation coefficient for the cotinine
      concentration in the saliva and the ultrafiltrate was 0.95; (b) in matched plasma
      and ultrafiltrate samples from 27 smokers, the correlation coefficient for the
      cotinine concentrations was 0.96 with plasma containing 1.2 times the
      ultrafiltrate mean; (c) in a nonsmoker, elevated cotinine levels could be
      detected in the ultrafiltrate more than 24 hr after smoking 2 cigarettes, and the
      pattern of rise and decrease reflected that in whole saliva; and (d) in a
      habitual smoker; the mean cotinine concentration in the ultrafiltrate was 157
      ng/ml (SD +/- 25.7 ng/ml) during a period of smoking 15 cigarettes per day and
      dropped to a mean of 47 ng/ml (SD +/- 10.5) when smoking was reduced to 5
      cigarettes per day; after cessation of smoking, detectable concentrations of
      cotinine persisted for up to 5 days. CONCLUSION: The device facilitated the
      aesthetic, noninvasive collection of a biological sample useful in the validation
      of smoking status.

PMID- 1738770
TI  - National TV smoking cessation program and contest in Finland.
AB  - BACKGROUND: In the fall of 1986 the North Karelia Project in cooperation with
      Finnish TV 2 arranged an eight-part nationwide smoking cessation TV program. The
      Project, also arranged a smoking cessation contest coinciding with the TV program
      in cooperation with four major voluntary public health organizations and the
      national health service. The TV program featured two studio groups of local
      volunteers: one from Turku (southwestern Finland) and the other from North
      Karelia, where there was more intensive community support for the activity.
      RESULTS: Based on a national survey of a representative population sample, the
      reported viewing rates (at least one part) of the working-age population (15-64
      years, smokers and nonsmokers) were 64% in North Karelia, 45% in Turku, and 46%
      nationally (P less than 0.001). Among smokers who had watched at least one
      session of the TV program, 7.7% reported to have tried to quit smoking in North
      Karelia, 4.1% in Turku, and 7.5% nationally. Altogether, 16,089 smokers
      participated in the contest; again the highest participation rate was in North
      Karelia. The 6-month success rate among the smokers who participated in the
      contest was 22% in North Karelia, 18% in Turku, and 17% nationally (P less than
      0.05). Men were more likely to succeed in quitting: among men the 6-month success
      rate was 22% and among women 15% (P less than 0.001). CONCLUSIONS: The results
      and experiences indicate high viewing and participation and a beneficial cost
      effect ratio. They also stress the importance of community support activities in
      enhancing the effects of a media-based health promotion program.

PMID- 1738771
TI  - Mammography knowledge and intentions among insured women.
AB  - METHOD. A survey was conducted among 1,113 randomly selected insured state
      university employees to evaluate knowledge of the American Cancer Society
      mammography guidelines, awareness of insurance coverage for screening mammograms,
      previous guideline adherence, and future mammography intentions. RESULTS: The
      survey, which included two mailings with follow-up phone cells of nonresponders,
      had a refusal rate of 6%. Respondents were relatively more likely to know the
      guideline for older age groups; 77% knew the guidelines for women 50+. Over one
      third of the responders were not aware that their insurance policy covered
      screening mammograms. For women who had never had a mammogram, insurance
      knowledge was significantly related to intentions to have a mammogram in the
      future. Previous screening adherence, as well as future intentions, was
      positively related to the age of the respondent. The results are contrasted with
      those of previous studies, and the implications for the content of future breast
      cancer screening campaigns are discussed.

PMID- 1738772
TI  - An iterative technique for identifying smoking deceivers with application to the
      Scottish Heart Health Study.
AB  - BACKGROUND: The study population consists of 3,977 self-declared nonsmokers for
      whom complete data on smoking biochemistry were available. Data were obtained
      from the Scottish Heart Health Study, a random cross-sectional population sample
      of 40- to 59-year-old men and women. METHODS: Three biochemical markers of
      smoking (expired-air carbon monoxide, serum thiocyanate, and serum cotinine) are
      used together to derive optimum cut-points for distinguishing true nonsmokers
      from self-declared nonsmokers who are smoking deceivers, using an iterative
      procedure via a computer program. RESULTS: The cut-points derived are, for carbon
      monoxide, 6 ppm (sensitivity, 0.81, and specificity, 0.94, when compared with the
      other two biochemical markers combined), for thiocyanate, 63.4 mumol/liter
      (sensitivity, 0.75; specificity, 0.92), and, for cotinine, 17.5 ng/ml
      (sensitivity, 0.77; specificity, 0.98). These cut-points are generally lower than
      those reported previously, primarily because other studies have taken self
      reported smoking status to be the truth. The presence of deceivers among declared
      nonsmokers would tend to raise the biochemical levels of this group and hence of
      the cut-points. CONCLUSION: The prevalence of smoking deception in the Scottish
      population is low: the frequency of those at or above all three cut-points is
      1.2%, at or above two or more (the preferred definition of a smoking deceiver) is
      2.2%, and at or above at least one is 16.4%.

PMID- 1738773
TI  - A comparison of risk assessment models for term and preterm low birthweight.
AB  - BACKGROUND: Most epidemiological research dealing with the assessment of risk for
      low birthweight has focused on all low birthweight births. Studies that have
      attempted to distinguish between term and preterm low birthweights have tended to
      examine preterm low birthweight, since the risk of perinatal mortality and
      morbidity is greatest for this group of infants. METHOD: This study uses data
      from 25,408 singleton births in a 20-county region in North Carolina to identify
      and compare risk factors for term and preterm low birthweights, and also examines
      the usefulness of separate multivariate risk assessment systems for term and
      preterm low birthweights that could be used in the clinical setting. RESULTS:
      Risk factors that overlap as significant predictors of both types of low
      birthweight include race, no previous live births, smoking, weight under 100 lb,
      and previous preterm or low birthweight birth. Age also is a significant
      predictor of both types of low birthweight, but in opposite directions. Younger
      age is associated with reduced risk of term low birthweight and increased risk of
      pattern low birthweight. CONCLUSION: Comparison of all risk factors indicates
      that different multivariate models are needed to understand the epidemiology of
      preterm and term low birthweights. In terms of clinical value, a general risk
      assessment model that combines all low birthweight births is as effective as the
      separate models.

PMID- 1738774
TI  - Prescriptions should come with full information.

PMID- 1738775
TI  - Setting up an 'EPO' system. Management of patients receiving recombinant human
      erythropoietin.
AB  - As more people with end stage renal disease are treated with erythropoietin for
      their anaemia, a well-coordinated system is essential to monitor their response
      to treatment. This is best achieved by keeping management of the system in the
      hands of one or two people.

PMID- 1738776
TI  - How am I doing and where am I going? Individual performance review in staff
      appraisal.

PMID- 1738777
TI  - Handwashing: a process of judgement and effective decision-making.
AB  - It is well-known that regular handwashing is an effective way of reducing cross
      infection. Healthcare professionals need to be encouraged to evaluate their
      practice in the light of research-based evidence of their patients' needs, so
      improvements can be made.

PMID- 1738778
TI  - A force to promote bonding and wellbeing. Therapeutic touch and massage.

PMID- 1738779
TI  - A dynamic role that improves the service. Combining triage and nurse practitioner
      roles in A&E.
AB  - Increasing attendance in A&E departments has many negative knock-on effects.
      These can be reduced by introducing a triage system combined with a nurse
      practitioner role.

PMID- 1738780
TI  - Sensitivity can break the taboo. Female sexual problems and treatment approaches.

PMID- 1738781
TI  - Professional development brings specialist knowledge. The role of the diabetes
      specialist nurse: the Manchester model.
AB  - People with diabetes are at risk of a range of complications, but this risk can
      be significantly reduced by effective management of their condition. A
      multidisciplinary team approach ensures all aspects of their care, management and
      education are covered.

PMID- 1738782
TI  - Data systems can boost nursing care. Nurse management information systems in
      resource management.
AB  - Resource management aims to improve patient care by matching resources with
      patient needs. Nurse management information systems provide data on skill mix,
      rostering requirements, ward costs and patient dependency levels, enabling a
      nursing strategy to be planned for the ward.

PMID- 1738783
TI  - An informed approach may prevent loss. New perspectives on cot death.
AB  - Cot death can be devastating for both parents and healthcare professionals,
      causing feelings of helplessness and loss. Recent research, however, has
      identified some contributory factors, which nurses and midwives can bring to
      parents' attention.

PMID- 1738784
TI  - Innovation encourages a broader view. District nurse involvement in student nurse
      training.
AB  - As Project 2000 becomes established, district nurses will need to expand their
      teaching role. Students on community placements can find it difficult to become
      involved in this one-to-one nursing role, but adequate planning and use of
      teaching aids can ensure they get valuable insights.

PMID- 1738785
TI  - A lost world within the shadows.

PMID- 1738786
TI  - Do autoreceptors mediate dopamine agonist--induced yawning and suppression of
      exploration? A critical review.
AB  - The hypothesis that stimulation of dopamine autoreceptors is the mechanism by
      which dopamine agonists induce yawning and suppression of exploration is
      critically examined. It is shown that the relation between reduced extracellular
      dopamine levels, assessed by microdialysis, and behavioural effects of dopamine
      agonists, a dopamine synthesis inhibitor and a granule storage blocker is highly
      inconsistent. The time-course and duration of the behavioural effects of dopamine
      agonists differ from the reduction of extracellular dopamine. Amphetamine
      cotreatment is shown to increase dopamine levels, while yawning and suppression
      of exploration can still be induced. The data strongly indicate that
      autoreceptors are not the mediators of these behavioural effects. It is proposed
      that postsynaptic receptors mediate dopamine agonist induced yawning and
      suppression of exploration. Evidence is also presented showing that yawning and
      suppression of exploration are not functionally equivalent.

PMID- 1738787
TI  - Effects of diazepam on behavioural and antinociceptive responses to the elevated
      plus-maze in male mice depend upon treatment regimen and prior maze experience.
AB  - Recent studies have shown that brief exposure to an elevated plus-maze (EPM)
      produces non-opioid antinociception in male mice. The present experiments were
      designed to assess the effects of diazepam on this phenomenon. When acutely
      administered, low doses (0.5-1.0 mg/kg) of diazepam failed to produce an
      anxiolytic profile and exerted rather inconsistent effects on EPM-induced
      elevations in tail-flick latencies. In EPM-experienced mice, chronic treatment
      with higher doses of diazepam (2-4 mg/kg, 8 days) produced a weak anxiolytic
      action and inhibited the early phase of EPM antinociception only. However, in EPM
      naive mice, 8-day diazepam pretreatment exerted a marked anxiolytic effect and
      completely eliminated the antinociceptive response to the maze. Together, these
      data support the view that anxiety is a key factor in certain forms of adaptive
      pain inhibition and suggest a possible mediational role for benzodiazepine
      receptors. Our findings also show that prior exposure to the EPM, rather than
      chronic handling/injection, greatly reduces the anti-anxiety effect of diazepam.
      Furthermore, since re-exposure to the maze, per se, decreased time spent on the
      open arms and central platform, a shift in behavioural baseline ("retest
      anxiogenesis") may have contributed to the weak behavioural effects of diazepam
      in test-experienced animals. Importantly, as chronic treatment with diazepam did
      not influence this anxiogenic-like retest profile, our data suggest that a single
      prior experience of the EPM may radically alter the nature of the anxiety
      reaction provoked by this test.

PMID- 1738788
TI  - Different effects of serotonin (5-HT) uptake blockers in caudate nucleus and
      hippocampus of the rabbit: role of monoamine oxidase in dopaminergic terminals.
AB  - Slices of rabbit hippocampus or caudate nucleus were incubated with [3H]-5-HT
      (0.1 microM, 60 min) or with [3H]-DA. In hippocampal tissue, the 5-HT uptake
      blockers chlorimipramine, fluvoxamine, and 6-nitroquipazine (0.1, 1, 10 microM)
      reduced the percentage content of [3H]-5-HT in a concentration dependent manner.
      The degree of inhibition of [3H]-5-HT content produced by the 5-HT uptake
      inhibitors was not affected by the MAO inhibitors pargyline or amezinium (which
      by themselves enhanced [3H] loading) or the catecholamine uptake inhibitor
      nomifensine (which by itself did not affect [3H] loading). In caudate nucleus
      tissue, however, the [3H]-5-HT accumulation was reduced only at the highest
      concentration of the 5-HT uptake blockers (10 microM). In the additional presence
      of the MAO inhibitors or nomifensine (which by themselves increased or
      diminished, respectively, the [3H] labelling) the 5-HT uptake inhibitors became
      more potent in reducing the percentage [3H]-5-HT accumulation of caudate nucleus
      slices. These results indicate (1) that a false labelling of [3H]-5-HT into
      dopaminergic terminals in the caudate nucleus can be prevented by nomifensine,
      (2) that the 5-HT uptake blockers seem to accumulate within the dopaminergic
      terminals, where they may display a MAO inhibitory property. The 5-HT uptake
      blockers were ineffective on the percentage tritium accumulation of caudate
      nucleus slices incubated with [3H]-DA, regardless of the presence of pargyline or
      nomifensine. Tritiated DA and deaminated [3H]-metabolites were separated in the
      superfusate of [3H]-DA-release experiments in caudate nucleus tissue.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1738789
TI  - Effect of peripheral administration of cinnarizine and verapamil on the
      abstinence syndrome in diazepam-dependent rats.
AB  - The effects of two calcium channel blockers (verapamil and cinnarizine) were
      evaluated on diazepam withdrawal symptoms. Rats were made diazepam dependent by
      chronic treatment with daily injections of the drug, 20 mg/kg IP for 3 weeks. On
      abrupt termination of the drug, animals showed withdrawal hyperactivity that was
      assessed by autonomic, behavioural and motor signs. The peak effect was seen 3
      days after the withdrawal of diazepam. On IP administration, verapamil and
      cinnarizine (10, 20 and 40 mg/kg) given on eight occasions at an interval of 12 h
      reversed the withdrawal-induced increase in spontaneous motor activity.
      Cinnarizine in higher doses (20 and 40 mg/kg) was found to be effective in
      suppressing the behavioural signs but verapamil did not show any protective
      effect against startle response and irritability. These results suggest that
      modulation of the calcium influx in the CNS might influence withdrawal.

PMID- 1738790
TI  - Noradrenergic receptor mechanisms in neophobia.
AB  - We have previously demonstrated that depletion of forebrain norepinephrine (NE)
      led to an attenuation of neophobia in a novel environment, as defined by a
      greater preference for novel food over familiar food. To study further the role
      of forebrain NE in neophobia we chronically infused noradrenergic receptor
      ligands or forskolin into the lateral ventricles of sham and 6-hydroxydopamine
      dorsal bundle lesioned rats. Chronic NE infusions into lesioned animals reversed
      the lesion-induced shift in relative food preference. The beta receptor agonist
      isoproterenol had moderate effects similar to those of NE in lesioned and sham
      animals. Phenylephrine, an alpha-1 agonist, was without effect. Forskolin, an
      adenylate cyclase activator, mimicked the effects of NE infusions. These data
      suggest a role for noradrenergic stimulation of adenylate cyclase in neophobia.

PMID- 1738791
TI  - Effects of four non-cholinergic cognitive enhancers in comparison with tacrine
      and galanthamine on scopolamine-induced amnesia in rats.
AB  - Amnesia can be induced in rats in the passive avoidance paradigm by
      administration of scopolamine, a central muscarinic receptor antagonist. Tacrine
      or galanthamine, inhibitors of acetylcholinesterase, given in conjunction with
      scopolamine partially reversed the scopolamine-induced deficit in passive
      avoidance performance. Four so-called cognitive enhancers, all widely used for
      the treatment of the symptoms associated with mental aging, cerebral
      insufficiency and senile memory disorder, were investigated in this paradigm.
      Piracetam, an extract of Ginkgo biloba, dihydroergocristine and a combination of
      raubasine with dihydroergocristine, all attenuated the amnesia induced by
      scopolamine. In contrast, nicergoline had no significant effect. Raubasine alone
      also failed to significantly attenuate scopolamine-induced amnesia, although some
      doses of raubasine had a non-significant tendency (P less than 0.10) to reduce
      the amnesia.

PMID- 1738792
TI  - Twenty-four-hour monitoring of heart rate, motor activity and smoking behavior
      including comparisons between smokers and nonsmokers.
AB  - The present study was an attempt to monitor continuously and in parallel
      cigarette consumption, heart rate, and physical activity under field conditions.
      In a first experiment the test-retest reliability of the recording devices was
      evaluated with a small number of nonsmoking students on days with similar
      schedules. The intraday development of heart rate and activity revealed a
      remarkable intraindividual stability, and the test-retest reliability
      coefficients calculated between the totals of heart rate and activity revealed
      values of 0.73 and higher for heart rate and 0.47 and higher for activity on
      comparable days. The second experiment was done with housewives as subjects to
      see whether heart rate and/or activity might differentiate smokers from
      nonsmokers in subjects who are less strictly bound to a fixed daily work program.
      The smoker/nonsmoker comparisons revealed significantly higher heart rates for
      smokers but almost identical activity readings. In a third experiment it was
      tested whether partial smoking abstinence in the morning might differentiate the
      morning and afternoon heart rates in smokers. Heart rate but not activity was
      significantly decreased during the abstinence period. Taken together, the
      simultaneous monitoring of heart rate and activity might be a valuable instrument
      in smoking research, since it is sensitive enough to detect manipulations of the
      smoking behavior under natural conditions.

PMID- 1738793
TI  - Effects of nicotine on hunger and eating in male and female smokers.
AB  - We tested whether the inverse relationship between smoking and body weight may be
      due in part to nicotine's acute effects on reducing hunger and eating. On four
      mornings, male and female smokers (n = 10 each), abstinent overnight from smoking
      and food, received one of three nicotine doses (7.5, 15, and 30 micrograms/kg) or
      placebo (0) via nasal spray every 30 min for 2 h. Self-reported hunger and
      satiety ("fullness") and craving for cigarettes were obtained after each dose
      presentation. Subjects subsequently ate ad lib from a large array of food items
      varying in sweet taste and fat content. For both males and females, nicotine had
      no effect on self-reported hunger, but cigarette craving was decreased. Rather
      than being decreased, caloric intake during the meal was unexpectedly increased
      following nicotine compared with placebo. Cigarette craving increased after the
      meal, and this increase was unaffected by nicotine dose. There were virtually no
      differences between males and females in any effects of nicotine. These results
      indicate that nicotine may not acutely suppress appetite in fasting smokers and
      suggest that other actions of nicotine or smoking may account for the lower body
      weights of smokers.

PMID- 1738794
TI  - Smokeless tobacco abstinence effects and nicotine gum dose.
AB  - There were two experiments on abstinence from smokeless tobacco. The purpose of
      the first experiment was to determine abstinence effects from smokeless tobacco.
      The purpose of the second experiment was to examine the effects of different
      doses of nicotine gum on smokeless tobacco abstinence effects. The subjects were
      male Copenhagen smokeless tobacco users who underwent 3 days of baseline
      measurement while continuing to use smokeless tobacco ad libitum, and 5 days of
      the experimental condition. In the first experiment, the subjects were assigned
      randomly to one of two groups and compared: continuous smokeless tobacco users (n
      = 10), and deprivation plus no nicotine gum (n = 10). In the second experiment,
      subjects were assigned randomly and in a double-blind fashion to one of three
      groups and compared: (1) deprivation plus 0 mg nicotine gum (n = 20); (2)
      deprivation plus 2 mg nicotine gum (n = 20); and (3) deprivation plus 4 mg
      nicotine gum (n = 20). The first experiment showed significant increases upon
      abstinence for the following variables: (1) craving; (2) difficulty
      concentrating; (3) restlessness; (4) excessive hunger; (5) eating; (6) reaction
      time; (7) variability of reaction time and (8) total withdrawal scores for both
      the self-rated and the observer-rated forms. The second experiment showed that
      nicotine gum failed to significantly reduce smokeless tobacco abstinence effects,
      although those with high cotinine levels may receive some benefit from nicotine
      gum.

PMID- 1738795
TI  - Low doses of oxytocin facilitate social recognition in rats.
AB  - Social recognition of juveniles by adult male residents has been shown to be
      modulated by neurohypophyseal hormones. The decrease of social investigation
      behavior during a second encounter with the same juvenile serves as index for
      social recognition. In the present study it was found that low doses (0.09-6.0
      ng.kg-1) of oxytocin (OXT) given subcutaneously dose dependently facilitated
      social recognition. The effect of OXT appeared specific, since no change in
      social investigation was found when a novel juvenile was tested during the second
      encounter. No disturbances of social recognition by the low doses of OXT could be
      detected, in contrast to higher doses of this hormone. Other neurohypophyseal
      hormones, vasopressin and vasotocin, did not facilitate social recognition when
      tested in the same range of low doses.

PMID- 1738796
TI  - The McCollough effect as a measure of central cholinergic activity in man.
AB  - The McCollough Effect (ME) is an orientation contingent colour after-effect which
      has been proposed as an indicator of central neurotransmitter activity. Shute
      (1979) suggested that the ME could reflect a hippocampal "forgetting" mechanism
      which should be inhibited by GABAergic neurones and stimulated by cholinergic
      neurones. The purpose of the present study was to demonstrate that the ME is in
      fact sensitive to cholinergic and anticholinergic drugs and to compare its
      sensitivity to more conventional tests of psychomotor and cognitive function. Ten
      healthy subjects received single doses of physostigmine (0.75 mg SC), hyoscine
      (1.2 mg), temazepam (20 mg), flecainide (200 mg) or placebo in a double-blind
      double-dummy presentation. Subjects were tested on a battery of psychomotor and
      cognitive function tests at baseline and 1 h, and adapted to the ME at 1.5 h.
      Visual analogue rating scales and conventional tests of psychomotor function and
      saccadic eye movements indicated that both subjective and objective measures of
      arousal were impaired by temazepam. The subjective, but not the objective,
      measures of arousal were also impaired by both hyoscine and physostigmine, but
      not by flecainide. Initial strength and duration of the ME were decreased by
      physostigmine and increased by hyoscine and temazepam, relative to placebo (P
      less than 0.01). Thus, the ME is capable of detecting cholinergic,
      anticholinergic and GABA mimetic drug effects in man, in therapeutic doses.

PMID- 1738797
TI  - Effects of single and repeated doses of theophylline on aspects of performance,
      electrophysiology and subjective assessments in healthy human subjects.
AB  - The effects of both single and repeated doses of theophylline were evaluated on a
      battery of nine performance tests, the EEG, the EMG and on subjective assessments
      of mood and side-effects. The subjects were 20 healthy adults who participated in
      both phases of this randomized, double-blind, placebo controlled, crossover
      study. The single dose of 400 mg and the repeated doses of 300 mg b.d. for 4
      weeks were intended to attain therapeutic serum concentrations. The Sternberg
      Additive Factors Method for assessing information processing revealed enhanced
      performance in both phases of this study, while the Horizontal Addition Test
      showed improved performance in the single dose phase only. The remaining seven
      performance tests failed to show significant differences between theophylline and
      placebo. Single doses of theophylline did not significantly alter mood, but
      marked adverse effects were encountered in the repeated dose phase, possibly
      related to unpleasant side-effects. Both EEG and EMG findings indicative of
      stimulation were associated with a single dose of theophylline, but substantial
      tolerance developed during 4 weeks of therapy. These findings demonstrate CNS
      stimulation by both single and repeated doses of theophylline with the occurrence
      of adverse side-effects during repeated administrations.

PMID- 1738798
TI  - Panic disorder--a national problem, a federal response.

PMID- 1738799
TI  - HIV-infected men's practices in notifying past sexual partners of infection risk.
AB  - The researchers studied the self-reported practices of men infected with the
      human immunodeficiency virus (HIV) in Los Angeles concerning notifying past
      sexual partners of their risk of infection. The sample of 111 men consisted of 87
      Hispanics, 14 whites, 9 blacks, and 1 Asian. Ninety-three percent identified
      themselves as homosexual or bisexual, and 13 percent reported having injected a
      nonprescription drug. Seventy-five percent had tested HIV seropositive within the
      previous 8 months. Subjects were asked about notifying sexual partners with whom
      they had contact in the 12-months before the subject tested HIV seropositive. Of
      the 111 subjects, 39 (35 percent) reported that they had attempted to inform 1 or
      more past partners. Of those who attempted, 30 subjects (76.9 percent) reported
      notifying at least 1 partner. Overall, the 111 subjects reported a total of 926
      individual sexual partners during the 12 months; 51 partners (5.5 percent) were
      informed of their risk by the subjects. A multivariate logistic regression
      analysis indicated that those with the most past sexual partners were least
      likely to attempt to notify any partner. The same inverse relationship was
      obtained for actual notification and may stem in part from the greater frequency
      of nonidentifiable partners among those reporting many encounters. The extent and
      quality of posttest counseling regarding partner notification was not assessed.
      However, rates of attempted notification were nonsignificantly higher among those
      who received private professional counseling, who belonged to a support group, or
      who received social support from family or friends. The data suggest that without
      concerted and culturally appropriate counseling, many HIV infected persons do not
      attempt to notify past sexual partners of their risk.

PMID- 1738800
TI  - Pilot study of AIDS risk in the general population.
AB  - This study evaluated a methodology for obtaining information on the prevalence of
      risk behaviors for human immunodeficiency virus infection (HIV) in the general
      population. From two census tracts in an upper midwestern urban community, 334
      households were identified at random. One adult between the ages of 18 and 55
      years in each household was asked to complete a confidential questionnaire about
      knowledge and attitudes toward acquired immunodeficiency syndrome (AIDS) and risk
      behaviors for HIV infection. Half the responders were also asked to provide a
      blood sample for HIV serotesting. Response rates to the behavior questionnaire
      were high (85 to 90 percent). However, only 72 percent of those asked to provide
      a blood sample agreed to do so. Survey results showed low rates of HIV risk
      behavior in this population sample. The median number of lifetime sexual partners
      was five for men and three for women, and most reported contacts exclusively with
      persons of the opposite sex. Eleven percent of the men and 5 percent of the women
      reported having had sexual partners of the same sex during their lifetime. Seven
      percent of men and 3 percent of women reported same sex partners in the last 12
      months. Very few reported extremely high-risk behaviors (that is, only one man
      reported multiple sexual partners with anal intercourse in the previous year).
      About one in five survey respondents reported having changed his or her behavior
      because of the AIDS epidemic, usually by being more selective about and reducing
      the number of sexual partners. Success of the methodology employed in this survey
      gives reason for optimism that population-based surveys of behavioral risks for
      HIV infection are feasible.

PMID- 1738801
TI  - Public health week: marketing the concept of public health.
AB  - The Public Health Programs and Services (PHP&S) Branch of the Los Angeles County
      Department of Health Services began a strategic planning effort in January 1986
      to meet new disease trends, curb rising health care costs, consolidate limited
      resources, and handle shifting demographics. A strategic plan was designed to
      assess the opportunities and challenges facing the agency over a 5-year horizon.
      Priority areas were recognized, and seven strategic directives were formulated to
      guide PHP&S in expanding public health services to a changing community. Health
      promotion was acknowledged as a critical target of the strategic planning
      process. Among the most significant results of the health promotion directive was
      the establishment of an annual Public Health Week in Los Angeles County.
      Beginning in 1988, 1 week per year was selected to enhance the community's
      awareness of public health programs and the leadership role PHP&S plays in
      providing these programs to nearly 9 million residents of Los Angeles County.
      Events in Public Health Week include a professional lecture series and the
      honoring of an outstanding public health activist and a media personality who has
      fostered health promotion. Other free community activities such as mobile
      clinics, screenings, and health fairs are held throughout the county. With
      intensive media coverage of Public Health Week, PHP&S has been aggressive in
      promoting its own services and accomplishments while also educating the community
      on vital wellness issues. The strategic methodology employed by PHP&S, with its
      emphasis on long-range proactive planning, is receiving national recognition and
      could be adopted by similar agencies wishing to enhance their image and develop
      unique health promotion projects in their communities.

PMID- 1738802
TI  - Use of restraint devices to prevent collision injuries and deaths among welfare
      supported children.
AB  - Evidence that death and injury rates for young children involved in automobile
      collisions could be reduced if children were restrained prompted the State of
      Tennessee to pass the nation's first child passenger law, a law that became
      effective in January 1978. Although similar laws have now been enacted throughout
      the United States, usually restraint devices are not provided to low-income
      groups who may have difficulty affording them. Few studies have examined the use
      of such devices by welfare recipients. A total of 56 black women, receiving
      Medicaid and residing in inner city Memphis, were interviewed about their use of
      passenger restraints during automobile travel for their children ages 0-3 years.
      About two-thirds of the mothers interviewed said they rarely or never used child
      passenger restraint devices when transporting their child. Children age 3 years
      were significantly less likely to be transported in child restraint devices than
      younger children. Women who had received welfare payments for 3 years or more or
      who made fewer than one automobile trip a week with their child were
      significantly less likely to use child passenger restraints. These results
      suggest that, in spite of child passenger laws, automobile restraint devices are
      not used for a high percentage of children ages 0-3 years receiving medical care
      under State and Federal Medicaid programs. Since treatment costs are paid under
      these programs when children are injured in collisions, program administrators
      may have strong incentives to increase the proportion of these children being
      restrained while traveling in motor vehicles.

PMID- 1738803
TI  - Developing cancer control capacity in state and local public health agencies.
AB  - In 1986, the National Cancer Institute began a major grant program to enhance the
      technical capabilities of public health departments in cancer prevention and
      control. This effort, commonly referred to as "capacity building" for cancer
      control, provided funding to support eight State and one local health department.
      The program focused on developing the knowledge and skills of health department
      personnel to implement intervention programs in such areas as smoking cessation,
      diet modification, and breast and cervical cancer screening. The grants ranged
      from 2 to 5 years in length, with funding of $125,000 to $1.6 million per grant.
      The total for the program was $7.4 million. While the priorities set for these
      grants were nominally similar, their capacity building activities in cancer
      prevention and control evolved into unique interventions reflecting the
      individual needs and priorities of each State or locality. Their experiences
      illustrate that technical development for planning, implementing, and evaluating
      cancer prevention and control programs is a complex process that must occur at
      multiple levels, regardless of overall approach. Factors found to contribute to
      successful implementation of technical development programs include* commitment
      of the organization's leadership to provide adequate support for staff and
      activities and to keep cancer prevention and control on the organizational
      agenda,* the existence of appropriate data to monitor and evaluate programs,*
      appropriately trained staff,* building linkages with State and community agencies
      and coalitions to guide community action,* an established plan or process for
      achieving cancer control objectives,* access to the advice of and participation
      of individual cancer and health experts,* an informed State legislature,*
      diffusion of cancer prevention and control efforts,and* the ability to obtain
      funds needed for future activities.

PMID- 1738804
TI  - A million dollar measles outbreak: epidemiology, risk factors, and a selective
      revaccination strategy.
AB  - Between February 8 and April 4, 1986, an outbreak of measles occurred in the
      State of Arkansas. A total of 489 suspected measles cases were reported from 53
      counties; 86 schools statewide reported suspected measles cases. There were 284
      cases confirmed in 18 counties; 23.6 percent among students in one university and
      41.2 percent among students in kindergarten through 12th grade in 32 schools. An
      epidemiologic investigation was carried out to evaluate risk factors for vaccine
      failure and to assess the effectiveness of a selective revaccination strategy in
      the outbreak setting. A cohort study conducted at a junior high school showed
      that, compared with students vaccinated against measles at ages 15 months or
      older, those vaccinated at ages 12-14 months had a three-fold increased risk of
      measles (relative risk 3.2, 95 percent confidence interval 1.5, 6.9). For schools
      reporting measles, the Arkansas Department of Health and the Department of
      Education jointly required reimmunization of students vaccinated at ages younger
      than 15 months and the exclusion of students not vaccinated at ages 15 months or
      older until they were vaccinated or until 2 weeks after the last rash onset. To
      implement these recommendations, more than 100,000 doses of combined measles
      mumps-rubella vaccine were distributed at a cost greater than $1 million.

PMID- 1738805
TI  - Healthy children ready to learn: an essential collaboration between health and
      education.
AB  - The "Healthy Children Ready to Learn" initiative starts with the underlying
      concept that health is a critical partner to optimum education. All children have
      a right to be healthy. At a minimum, this right assumes promoting optimum use of
      available and effective preventive measures, such as ensuring compliance with
      immunization recommendations; promoting measures to prevent injuries; ensuring
      opportunities to identify disease and disabilities early; and providing prompt
      treatment when needed. Families must receive the support and assistance they need
      to raise healthy and educated children. Activities directed toward National
      Education Goals and the related National Health Promotion and Disease Prevention
      Objectives can advance progress toward school readiness, focus attention and
      available resources on needed programs and services, and thus help the nation in
      achieving its goal of having all children arriving at school each day healthy,
      well nourished, and ready to learn. To realize these goals and objectives, the
      two critical systems of greatest importance to children, those providing health
      services and education, need to collaborate, not only among themselves, but also
      with social services. A range of critical health problems will require our
      attention if the goals are to be met, such as availability of prenatal care,
      infant mortality, inadequate nutrition during pregnancy or early childhood, or
      both, disease prevention by immunization, infants who have been exposed to drugs,
      fetal alcohol syndrome, and the emotional and mental disorders of early
      childhood, to name a few. At any one time, any family may be in need of
      appropriate services. To address the health and well-being of their young
      children, a continuum of appropriate, accessible services must be available in
      the community. The first steps toward successful achievement of the readiness
      goal will require the identification of health, education, and social service
      programs that serve young children and their families, and the creation of a
      climate that fosters innovative and effective collaboration between programs at
      the Federal and State levels, especially as it pertains to the community.
      Policies and programs should be built around the needs of families. In this
      regard, the critical role that parents play in shaping a healthy environment
      conducive to school readiness must be recognized as a key element in shaping the
      strategies that should help in achieving the readiness goal. Similarly important
      is the need to engage professional organizations and other private sector groups
      involved with health, education, and other children's issues to work with
      government and families to achieve the school readiness goal and its related
      health objectives.

PMID- 1738806
TI  - The role of data-driven planning and coalition development in preventing
      cardiovascular disease.
AB  - Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in
      the United States. Effective programs for the prevention and control of CVD need
      to include data-based planning and evaluation at the State and local levels. The
      authors describe the development of data-driven planning and intervention
      strategies in Missouri. Statewide planning activities have resulted in the
      formation of an advisory committee and development of a State plan, a resource
      directory, and training courses. Analysis of mortality data revealed an unusual
      concentration of CVD deaths in the southeast portion of the State. Local
      coalitions are being developed in each of six counties in this region to reduce
      the prevalence of CVD risk factors. A regional behavioral risk factor survey of
      1,006 adults identified key risk factors that will be addressed by the
      coalitions. These data suggested that physical inactivity, obesity, and
      hypertension are especially acute problems in the area. Key components of the
      local coalition development included providing localized data and obtaining the
      strong commitment of the local health departments. Expanded use of chronic
      disease surveillance data for planning and evaluation will increase the
      probability that localities, States, and the nation will achieve Year 2000 Health
      Objectives. The data-based planning process is described as a possible model for
      use by other States and localities.

PMID- 1738807
TI  - Geriatric education centers address medication issues affecting older adults.
AB  - Serious problems have been identified in the prescribing of medications for
      elderly patients and use of prescription and nonprescription drugs by older
      persons. Overuse, underuse, and inappropriate use of drugs by the elderly have
      been widely documented, and the harmful consequences have been described. This
      paper reviews information concerning the need for action to improve health
      professionals' knowledge and skills with respect to drugs and the elderly and
      activities being undertaken by geriatric education centers (GECs) to enhance
      these capacities. Grant support for the centers from the Health Resources and
      Services Administration, a Public Health Service component agency, began in 1983.
      In fiscal year 1992 there are 31 centers operating in 26 States. The centers are
      multi-institutional and conduct four types of educational activities. These
      include review of pharmacological issues for multidisciplinary groups,
      specialized training for pharmacists, discipline-specific programs focusing on
      medication issues, and activities aimed at educating the public. Examples of the
      GECs' educational activities are given.

PMID- 1738808
TI  - Some current factors influencing the prescribing and use of psychiatric drugs.
AB  - A reprise of selected known factors about the influences affecting the
      prescribing and use of drugs, and some new developments in the drug marketplace,
      are the basis for this summary and observations about future expectations
      regarding psychotherapeutic agents. This information can be used to assist in
      formulating or updating, or both, conceptualizations and hypotheses for future
      policy and research planning in this area.

PMID- 1738809
TI  - A comparison of low birth weight among Medicaid patients of public health
      departments and other providers of prenatal care in North Carolina and Kentucky.
AB  - Matching of Medicaid and health department patients' files to birth certificates
      was used as a means of evaluating the effect of prenatal care given by public
      health departments on the birth weights of babies of women in Medicaid. Three
      years of live birth data from North Carolina and 2 years of birth data from
      Kentucky were used in the analysis. After controlling for other low birth weight
      risk factors (including the quantity of prenatal care) with logistic regression,
      women in Medicaid who received prenatal care outside public health departments
      were found to be substantially more likely than those who received care at health
      departments to have low weight infants. This association was especially strong
      for births under 1,500 grams. The authors suggest that the comprehensive prenatal
      care that is provided by the public health departments, which includes various
      nonmedical support services, may be responsible for this difference. These
      findings have important implications for proposed expansions of the Medicaid
      Program to cover more pregnant women in poverty.

PMID- 1738810
TI  - Factors associated with rates of participation in WIC by eligible pregnant women.
AB  - The relationship between sociodemographic, biological, and prenatal care
      characteristics, and participation rates of pregnant women in the Special
      Supplemental Food Program For Women, Infants, and Children (WIC) was studied by
      interviewing 200 postpartum patients in a Buffalo, NY, hospital between October
      1988 and January 1989. Among the 136 women eligible for the program, 94 (69
      percent) participated during their index pregnancies. WIC participation was found
      to be highly associated with source of prenatal care and having made more
      frequent prenatal visits. WIC was related to having fewer children and earlier
      initiation of prenatal care. Multivariate analysis showed that program
      participation remained highly associated with the source of prenatal care and the
      number of prenatal visits, when combined with other factors considered, such as
      age, education, marital status, number of living children, and timing of initial
      prenatal visit. The results suggest the need for a WIC enrollment effort directed
      to providers of prenatal care, who would be urged to encourage women to seek
      early and adequate prenatal care through the program.

PMID- 1738811
TI  - Smoking during pregnancy among northwest Native Americans.
AB  - There is little available information on the smoking habits of Native Americans.
      The authors used data from the Washington State birth certificate to determine
      the prevalence of smoking during pregnancy among Native American mothers in
      Washington State. From 1984 through 1988, 39.8 percent of all Native Americans
      smoked during their pregnancy. Smoking patterns during pregnancy differed
      markedly between Native Americans and whites according to maternal age and
      marital status. The smoking prevalence in Native Americans, adjusted for maternal
      age and marital status, was 1.3 times higher than that found in Washington State
      white women. This is the first analysis of statewide smoking rates during
      pregnancy among Native Americans. The birth certificate can serve as a readily
      accessible and low cost surveillance system for populations such as Native
      Americans, who are otherwise difficult to study. Smoking intervention programs
      need to be targeted at Native Americans, and how their smoking patterns differ
      from those of the general population needs to be recognized.

PMID- 1738812
TI  - The multilingual videotape project: community involvement in a unique health
      education program.
AB  - The large number of Southeast Asian, Hispanic, and Portuguese immigrants in Rhode
      Island face formidable language and cultural barriers in gaining access to the
      health care that they need. As the funding for refugee-specific programs
      diminishes, the focus is on programs that encourage self-sufficiency, assist in
      gaining access to mainstream health care, and involve a collaboration among
      service agencies and the communities they serve. On behalf of a coalition of
      health care and community agencies, Women and Infants Hospital of Rhode Island
      received a private foundation grant to produce nine multilingual videotapes that
      would educate immigrants and refugees about health issues specific to them and
      help them access the health care system. The project was structured to maximize
      the involvement of the various communities and to "empower" community members in
      working with mainstream service agencies. Coalition and other community members
      provided input into topic selection, script content, and presentation methods for
      the videotapes that would be culturally appropriate. During the 2-year project,
      nine videotapes were produced with narration in seven languages. Copies of the
      videotapes were distributed free of charge to coalition members.

PMID- 1738813
TI  - Simulating smokers' acceptance of modifications in a cessation program.
AB  - Recent research has underscored the importance of assessing barriers to smokers'
      acceptance of cessation programs. This paper illustrates the use of computer
      simulations to gauge smokers' response to program modifications which may produce
      barriers to participation. It also highlights methodological issues encountered
      in conducting this work. Computer simulations were based on conjoint analysis, a
      consumer research method which enables measurement of smokers' relative
      preference for various modifications of cessation programs. Results from two
      studies are presented in this paper. The primary study used a randomly selected
      sample of 218 adult smokers who participated in a computer-assisted phone
      interview. Initially, the study assessed smokers' relative utility rating of 30
      features of cessation programs. Utility data were used in computer-simulated
      comparisons of a low-cost, self-help oriented program under development and five
      other existing programs. A baseline version of the program under development and
      two modifications (for example, use of a support group with a higher level of
      cost) were simulated. Both the baseline version and modifications received a
      favorable response vis-a-vis comparison programs. Modifications requiring higher
      program costs were, however, associated with moderately reduced levels of
      favorable consumer response. The second study used a sample of 70 smokers who
      responded to an expanded set of smoking cessation program features focusing on
      program packaging. This secondary study incorporate in-person, computer-assisted
      interviews at a shopping mall, with smokers viewing an artist's mock-up of
      various program options on display. A similar pattern of responses to simulated
      program modifications emerged, with monetary cost apparently playing a key role.
      The significance of conjoint-based computer simulation as a tool in program
      development or dissemination, salient methodological issues, and implications for
      further research are discussed.

PMID- 1738814
TI  - Serum cholesterol concentrations among Navajo Indians.
AB  - Navajo Indians have been reported by earlier investigators to have low
      concentrations of serum lipids and a low prevalence of hyperlipidemia, as well as
      low rates of ischemic heart disease. However, no data on serum lipid
      concentrations among Navajos have been reported for more than two decades. The
      authors conducted a study to determine the distribution of concentrations of
      serum total cholesterol (TC), high density lipoprotein cholesterol, low density
      lipoprotein cholesterol, and triglyceride among persons 25-74 years old living in
      a representative community on the Navajo Indian reservation. Data are reported
      for 255 subjects, 105 men and 150 women, ages 25-74 years. The authors compared
      these data to those for the general population as determined by the second
      National Health and Nutrition Examination Survey (NHANES II). TC concentrations
      among Navajo men were similar to those from NHANES II. TC concentrations among
      younger Navajo women were similar to those for women younger than 55 years from
      NHANES II, but were significantly lower among older Navajo women. While 27.6
      percent of men ages 25-74 years studied in NHANES II had TC concentrations
      greater than 240 milligrams per deciliter, 33.8 percent of Navajo men had
      similarly elevated TC. However, the prevalence of serum TC concentrations greater
      than 240 milligrams per deciliter among Navajo women (17.5 percent) was about
      half that among women studied in NHANES II (32.9 percent). A similar pattern was
      found for low density lipoprotein cholesterol. The researchers concluded that
      Navajo Indians are no longer characterized by low serum lipid concentrations,
      that increased cholesterol concentrations may be a harbinger of increasing rates
      of atherosclerotic coronary heart disease among Navajos, and that attention
      should be directed to primary prevention of hyperlipidemia in Navajo Indian
      communities.

PMID- 1738815
TI  - Can B-cell signalling be understood?

PMID- 1738816
TI  - Effects of stress on the growth of a fibrosarcoma in nu/nu and conventional mice.
AB  - BALB/c mice subjected to water stress twice daily, between 3 and 7 min at each
      exposure 3 days before, 5 days after, or 3 days before and 5 days after
      intradermal Meth A tumour transplantation, showed an increase of tumour size and
      tumour growth rate compared with that of home cage control (HCC) mice. However,
      BALB/c mice subjected to water stress 3 days before and 6 days after tumour
      transplantation showed a decrease of tumour size and tumour growth rate compared
      with HCC mice. BALB/c mice subjected to 2 min of handling stress daily on days 1
      through 5, but not BALB/c mice subjected to handling stress on days 1 through 7
      or on days 6 through 7 of tumour growth, showed an increased in tumour size
      relative to HCC mice. On the other hand, BALB/cBy mice handling stressed on days
      1 through 7, but not BALB/cBy mice handling stressed on days 1 through 5 or days
      6 through 7 after tumour transplantation, showed a decreased tumour size compared
      with HCC mice. No effect of stress could be observed when nu/nu BALB/c mice were
      subjected to water stress 3 days before and 6 days after tumour transplantation.
      However, BALB/c nu/nu mice pre-injected intraperitoneally with spleen cells from
      conventional mice had a decreased tumour size and growth rate of the tumour when
      stressed 3 days before and 6 days after tumour transplantation.

PMID- 1738817
TI  - The complete amino acid sequence of bovine serum amyloid protein A (SAA) and of
      subspecies of the tissue-deposited amyloid fibril protein A.
AB  - Bovine serum amyloid A (SAA) was isolated from the acute phase high density
      lipoprotein (HDL) fraction of a cow suffering from acute mastitis. The elucidated
      primary structure revealed a protein consisting of 112 amino acid residues.
      Compared with SAA proteins from other species, the bovine protein was shown to
      have an insertion of nine amino acid residues between positions 69 and 70. No
      microheterogeneity could be observed in the protein. Amyloid fibrils extracted
      from the kidneys were found to contain at least three subspecies of protein AA,
      consisting of 68, 81 and about 110 amino acid residues. The amino acid sequences
      established for the protein AA subspecies revealed no microheterogeneity, and
      were identical to that elucidated for protein SAA.

PMID- 1738818
TI  - Interferon-gamma production by African swine fever virus-specific lymphocytes.
AB  - Peripheral blood mononuclear cells (PBMC) from inbred pigs that were immunized
      with autologous macrophages infected with the African swine fever (ASF) virus
      BA71V, a nonvirulent virus isolate, proliferated and produced interleukin-2 in
      response to homologous and heterologous isolates of the ASF virus. They produced,
      however, interferon (IFN) only when challenged in vitro with homologous or
      attenuated isolates of the ASF virus, but not with heterologous or virulent
      isolates. The IFN was pH 2 labile and was neutralized by specific serum to
      porcine recombinant IFN gamma.

PMID- 1738819
TI  - [Glucocorticoids and infection].
AB  - Glucocorticosteroids are the most commonly used immunosuppressive agents. In the
      following review important mechanisms of action of glucocorticoids on the
      immunological network are summarized, the relationship between duration of
      therapy, daily dose and incidence of infections is analysed, and evidence is
      presented that in some infectious diseases glucocorticoids may even be
      beneficial. The association between corticosteroid therapy and subsequent
      infections was calculated by pooling the data from 73 controlled clinical trials
      (meta-analysis). The rate of infectious complications was not increased in
      patients given a daily dose of less than 10 mg or a cumulative dose of less than
      700 mg prednisone. With increasing doses the occurrence rate of infectious
      complications increased in patients given corticosteroids as well as in patients
      given placebo, a finding which suggests that not only the corticosteroid but also
      the underlying disease state accounts for the steroid-associated infectious
      complications observed in clinical practice. To analyze the effect of
      glucocorticoids prescribed as adjuvants in patients with infectious diseases, an
      analysis of the controlled trials was performed. Some patients with pulmonary
      tuberculosis or constrictive pericarditis have a better outcome when they are
      given prednisone. On the other hand, there is no evidence that patients with
      septic shock or ARDS derive advantage from glucocorticoid therapy. At present
      there is controversy as to whether patients with bacterial meningitis should be
      treated with glucocorticosteroids. Patients with hepatitis B should not be
      treated with glucocorticoids, whereas elderly patients less frequently show
      postherpetic neuralgia when given glucocorticosteroids. Patients with cerebral
      malaria should not be given glucocorticosteroids. Aids patients with pneumocystis
      carinii pneumonia have a higher survival rate when treated with
      glucocorticosteroids than with placebo.

PMID- 1738820
TI  - [Addison's disease in the framework of poly-glandular autoimmune syndromes: 3
      case reports].
AB  - Case reports of three patients with idiopathic Addison's disease combined with
      other associated autoimmune endocrine and non-endocrine disorders are presented.
      In the first patient, a young man with a long-standing history of mucocutaneous
      candidiasis, latent Addison's disease was discovered by diagnostic screening
      tests. In the two other patients, women aged 39 and 20 respectively, overt
      Addison's disease combined with primary hypothyroidism was diagnosed. One of them
      also had a pre-existing ovarian failure. The polyglandular autoimmune syndromes
      with Addison's disease are classified into two different subtypes, on the basis
      of characteristic patterns of disease combinations and on different modes of
      inheritance. Patients with autoimmune Addison's disease are at relatively high
      risk for other endocrine disorders or non-endocrine autoimmune diseases.
      Therefore, these patients--and in some instances also their relatives--need
      lifelong supervision and advice to ensure timely recognition of any associated
      diseases.

PMID- 1738821
TI  - [Toxic shock syndrome in infection due to Streptococcus pyogenes].
AB  - Acute infections with group A beta-hemolytic streptococcus normally take a
      favourable course under therapy with penicillin. Only in a few cases has a
      completely different manifestation been described with multisystem failure
      similar to toxic shock syndrome induced by Staphylococcus aureus. We report on 4
      patients (1990/91) who showed this manifestation in spite of immediate antibiotic
      therapy. In 3 patients the suspected portal of entry was the skin, in 1 patient
      it was unknown. Group A streptococci were grown from blood cultures from all 4
      patients. Without an underlying immune deficiency all 4 patients (age 22, 24, 38
      and 51) went into septic shock with high fever, hepatic and renal impairment,
      diarrhea, DIC and cerebral confusion. 2 patients died within a few days after
      developing acute respiratory distress syndrome and cerebral edema. All strains
      isolated from the patients were penicillin-sensitive, group A streptococci. 3 of
      them were M-type 1, which are known to be more invasive. The bacteremia by itself
      is not sufficient to explain all complications and the high mortality rate. It is
      probable that streptococcal toxins, such as pyrogenic exotoxin A, streptolysin O,
      or a new unknown one, play a decisive role.

PMID- 1738822
TI  - [Pericardectomy and acute infectious pericarditis].
AB  - Between 1980 and 1990 12 patients (5 male, 7 female) were operated on for acute
      infectious pericarditis at a mean age of 42 years. The infections were 6
      bacterial (purulent 4, abscess 2), 4 tuberculous, 1 viral and 1 Candida.
      Pericarditis resulted from contiguous spread of infection from bilateral
      pneumonia in 3 patients, from subphrenic abscess in 2 and followed bacteremia in
      1. Clinical signs were: tamponade/shock in 9, elevated jugular venous pressure in
      11, edema in 6, hepatomegaly in 6, ascites in 1, and pericardial friction rub in
      3. A preoperative pericardiocentesis in 9 patients allowed only 4 positive
      microbiological diagnoses and was an insufficient drainage in all cases. The
      preoperative mean NYHA class was 3.3. The pericardectomy was total in 9 patients
      and partial in 3. Total mortality was 1/12 patients (8%) with one late death due
      to recurrent tuberculous pericarditis. No patient with purulent pericarditis
      died. Another recurrence occurred 6 months after acute viral pericarditis. Atrial
      fibrillation in one patient was the only postoperative complication. After a mean
      follow-up period of 48.5 months no cardiac constriction had occurred in 11
      surviving patients Actuarial survival after pericardectomy is 100% after 1 month
      and remains 91% after 5 years. The mean NYHA class has significantly improved to
      1.2 (p less than 0.05) at the end of the follow-up. We conclude that
      pericardectomy combined with a specific antimicrobial therapy is a safe treatment
      for acute infectious and especially purulent pericarditis with low mortality and
      excellent longterm results. Early pericardectomy allows rapid decompression of
      the heart, removal of intrapericardial adhesions and infected tissue and prevents
      late constriction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738823
TI  - [Severe accidental hypothermia with cardiopulmonary arrest: prolonged
      resuscitation without extracorporeal circulation].
AB  - We describe a case of severe hypothermia in a 32-year-old patient who fell into a
      crevasse. Three hours later he was rescued and flown to a district hospital. On
      arrival he was apparently dead, with cadaveric skin, dilated and fixed pupils,
      pulseless and in respiratory arrest. His rectal temperature was 26 degrees C. On
      the ECG monitor there was first ventricular fibrillation, then, after several
      unsuccessful attempts at defibrillation, the heart became asystolic.
      Cardiopulmonary resuscitation was begun with orotracheal intubation and external
      cardiac compression, which eventually lasted 4 hours and continuously required a
      team of 6 persons. Only at a temperature of 32.5 degrees C could the patient be
      defibrillated with success. In the absence of extracorporeal circulation (ECC)
      the victim was rewarmed by warm-air breathing and by instillation of warm saline
      in peritoneum, stomach and bladder. In this way the rewarming velocity was 1.8
      degrees C/hour. The postacute course was characterized by severe rhabdomyolysis
      (CK of 100,000 U/L) with non-oliguric renal failure, which necessitated several
      sessions of hemodialysis. Four months later the asymptomatic patient returned to
      work. Our case shows that a severely hypothermic patient can successfully be
      treated in a primary hospital not equipped with an ECC, provided that there is a
      sufficiently large team. Further, uninterrupted external cardiac compression
      guarantees efficient circulation even over several hours. Electric defibrillation
      in a hypothermic patient is ineffective unless normal body temperature has been
      reached. Lastly, every effort to continue resuscitation must be made in the still
      hypothermic patient whose absence of clinical response may obscure the real
      possibility of complete recovery.

PMID- 1738824
TI  - [Concerning "Trainee in internal medicine. Does the future general internist need
      participation in sciences?" by P.W. Straub (Schweiz. med. Wschr. 1991; 121: 1435
      1438)].

PMID- 1738825
TI  - [Medicine and animal experiments--some thoughts and facts].

PMID- 1738826
TI  - [New procedures for resin-metal bonds. A comparative in-vitro study].
AB  - Since 1984 it has been possible to create a chemical bond between dental alloys
      and composite resins resembling the metallo-ceramic bond. Modern systems based on
      silanization (Rocatec, Silicoater MD, and Spectralink), in connection with the
      specific resins used in these systems (VisioGem, Dentacolor, and SR-Isosit-N),
      were tested for their bond strength to 9 common dental alloys (of 7 different
      types) with regard to shear strength, the topography of the fracture surfaces,
      and metallographic microstructure transformations. No major structural
      transformations were observed for any of the systems tested. A notable degree of
      interdependence was seen in the Silicoater MD system whose bond strength to non
      precious alloys (among others) was the lowest in the test. The Rocatec system, on
      the other hand, showed a superior bond to all types of alloys, especially to pure
      titanium.

PMID- 1738827
TI  - Morphological and labeling evidence supporting and extending a modern theory of
      tooth eruption.
AB  - As the interest in biological mechanisms of tooth eruption has recently been
      revived by a new eruption theory, the present study was an attempt to contribute
      new data to this problem. Four male Macaca fascicularis monkeys, two infant
      (about 13 months old) and two juvenile (about 44 months old), were labeled either
      by sequential fluorochrome or by single 3H-proline injections and then served for
      studying the bone apposition patterns around erupting premolars and molars. About
      100 microns thick ground sections cut either in the mesiodistal or bucco-oral
      direction and the corresponding micrographs, microradiographs and
      autoradiographs, as well as fluorescence micrographs were used. In the
      multirooted teeth studied, bone apposition was most prominent and fast in the
      inter-radicular region, while at the fundus of the alveoli, bone apposition was
      slight or negligible. Around maxillary premolars and molars, bone apposition
      pointed in the mesial as well as in the axial direction. This was true for the
      intraosseous and the supraosseous phase of tooth eruption. Using these
      observations in addition to preliminary data calculated for the rates of bone
      apposition in the inter-radicular, apical and crestal regions, and for the rate
      of root elongation, the new eruption hypothesis could be extended. It is
      suggested that eruption of multirooted teeth, in the presence of corresponding
      coronal resorption, is entirely explained by forces generated through inter
      radicular bone apposition and that their dental follicle is in a stimulating mode
      inter-radicularly but neutral apically at the bottom of the alveolar fundus.

PMID- 1738828
TI  - [The optimization of dentin bonding in mixed Class-V cavities].
AB  - A new functional bonding agent was tested in the placement of mixed class V in
      vitro restorations. Variable insertion procedures of the composite material were
      also evaluated. One of the procedures was the direct filling technique, the other
      were direct immediate composite inlays, cemented with light, chemically or dual
      cured composite cements. The quantitative SEM marginal analysis results showed a
      significant superiority (p less than 0.05) of the adhesive inlay restorative
      procedure over the direct filling technique. Dye penetration confirmed these
      findings. Among the inlay groups, postcuring and the curing method of the
      composite cement were crucial for the success.

PMID- 1738829
TI  - [Bristle anchoring and bristle end-rounding in adults' toothbrushes].
AB  - Scanning electron microscopic study of bristle heads of 8 toothbrush brands
      commercially available in the Federal Republic of Germany and Switzerland has
      shown qualitative variations in the rounding of bristle ends. The percentage of
      acceptable end rounding of the bristles was for 4 brands above 75% and for 2
      brands 55-56%. For 2 products, the percentage was below 40%. The new method of
      welding bristle bundles at their base into the head of the toothbrush was used
      only by one producer.

PMID- 1738830
TI  - [Tooth-colored inlays/overlays. Tooth-colored adhesive inlays and overlays:
      materials, principles and classification].

PMID- 1738831
TI  - [The discovery of accessory root canals].

PMID- 1738832
TI  - [Formaldehyde and paraformaldehyde allergy. Allergic reactions to formaldehyde
      and paraformaldehyde after tooth root treatments].

PMID- 1738833
TI  - Chronic fatigue syndrome.

PMID- 1738834
TI  - Alar: the aftermath.

PMID- 1738835
TI  - Alar: the aftermath.

PMID- 1738836
TI  - Science budget: selective growth.

PMID- 1738837
TI  - Sequencing venture sparks alarm.

PMID- 1738838
TI  - Stepping up the pressure on indirect costs.

PMID- 1738839
TI  - Sarin indicted.

PMID- 1738840
TI  - Zagury in the clear.

PMID- 1738841
TI  - Molecular design gets into a hole.

PMID- 1738842
TI  - "African Eve" backers beat a retreat.

PMID- 1738843
TI  - Boring in on beta-amyloid's role in Alzheimer's.

PMID- 1738844
TI  - On the probability of matching DNA fingerprints.
AB  - Forensic scientists commonly assume that DNA fingerprint patterns are infrequent
      in the general population and that genotypes are independent across loci. To test
      these assumptions, the number of matching DNA patterns in two large databases
      from the Federal Bureau of Investigation (FBI) and from Lifecodes was determined.
      No deviation from independence across loci in either database was apparent. For
      the Lifecodes database, the probability of a three-locus match ranges from 1 in
      6,233 in Caucasians to 1 in 119,889 in Blacks. When considering all trios of five
      loci in the FBI database, there was only a single match observed out of more than
      7.6 million comparisons. If independence is assumed, the probability of a five
      locus match ranged from 1.32 x 10(-12) in Southeast Hispanics to 5.59 x 10(-14)
      in Blacks, implying that the minimum number of possible patterns for each ethnic
      group is several orders of magnitude greater than their corresponding population
      sizes in the United States. The most common five-locus pattern can have a
      frequency no greater than about 10(-6). Hence, individual five-locus DNA profiles
      are extremely uncommon, if not unique.

PMID- 1738845
TI  - Reversal of integration and DNA splicing mediated by integrase of human
      immunodeficiency virus.
AB  - In retroviral integration, the viral integration protein (integrase) mediates a
      concerted DNA cleavage-ligation reaction in which the target DNA is cleaved and
      the resulting 5' ends of target DNA are joined to the 3' ends of viral DNA.
      Through an oligonucleotide substrate that mimics the recombination intermediate
      formed by this initial cleavage-ligation reaction, the purified integrase of
      human immunodeficiency virus was shown to promote the same reaction in reverse, a
      process called disintegration. Analysis of a set of structurally related
      substrates showed that integrase could promote a range of DNA cleavage-ligation
      reactions. When the viral DNA component of the disintegration substrate was
      single-stranded, integrase could mediate a DNA splicing reaction analogous to RNA
      splicing.

PMID- 1738846
TI  - Potentially amyloidogenic, carboxyl-terminal derivatives of the amyloid protein
      precursor.
AB  - The 39- to 43-amino acid amyloid beta protein (beta AP), which is deposited as
      amyloid in Alzheimer's disease, is encoded as an internal peptide that begins 99
      residues from the carboxyl terminus of a 695- to 770-amino acid glycoprotein
      referred to as the amyloid beta protein precursor (beta APP). To clarify the
      processing that produces amyloid, carboxyl-terminal derivatives of the beta APP
      were analyzed. This analysis showed that the beta APP is normally processed into
      a complex set of 8- to 12-kilodalton carboxyl-terminal derivatives. The two
      largest derivatives in human brain have the entire beta AP at or near their amino
      terminus and are likely to be intermediates in the pathway leading to amyloid
      deposition.

PMID- 1738847
TI  - Processing of the amyloid protein precursor to potentially amyloidogenic
      derivatives.
AB  - The approximately 120-kilodalton amyloid beta protein precursor (beta APP) is
      processed into a complex set of 8- to 12-kilodalton carboxyl-terminal derivatives
      that includes potentially amyloidogenic forms with the approximately 4-kilodalton
      amyloid beta protein (beta AP) at or near their amino terminus. In order to
      determine if these derivatives are processed in a secretory pathway or by the
      endosomal-lysosomal system, (i) deletion mutants that produce the normal set of
      carboxyl-terminal derivatives and shortened secreted derivatives were analyzed
      and (ii) the effect of inhibitors of endosomal-lysosomal processing was examined.
      In the secretory pathway, cleavage of the beta APP occurs at a single site within
      the beta AP to generate one secreted derivative and one nonamyloidogenic carboxyl
      terminal fragment, whereas, in the endosomal-lysosomal system, a complex set of
      carboxyl-terminal derivatives is produced that includes the potentially
      amyloidogenic forms.

PMID- 1738848
TI  - Chondroitin sulfate as a regulator of neuronal patterning in the retina.
AB  - Highly sulfated proteoglycans are correlated with axon boundaries in the
      developing central nervous system which suggests that these molecules affect
      neural pattern formation. In the developing mammalian retina, gradual regression
      of chondroitin sulfate may help control the onset of ganglion cell
      differentiation and initial direction of their axons. Changes induced by the
      removal of chondroitin sulfate from intact retinas in culture confirm the
      function of chondroitin sulfate in retinal histogenesis.

PMID- 1738849
TI  - Human origins and analysis of mitochondrial DNA sequences.

PMID- 1738850
TI  - Financing health services in Sub-Saharan Africa: options for decision makers
      during adjustment.
AB  - The financing of health services has become an increasingly critical and urgent
      issue in many developing countries particularly in Sub-Saharan Africa. This paper
      analyses options available to policy makers. The possible effects and side
      effects of strategies are described based on the experience from different
      countries. The dangers of simplistic solutions are discussed. A cautious approach
      is recommended taking into consideration the lessons learned in other regions
      accompanied by a careful ongoing evaluation especially regarding the ability to
      pay of the poorer sections of the population. Providing for equity in health care
      should be an important guiding principle. It therefore appears to be necessary to
      find an appropriate mix of public and private sector interventions with elements
      of cost-sharing for services and drugs, insurance schemes and more efficient use
      of available resources.

PMID- 1738851
TI  - Effect of the Holocaust on coping with cancer.
AB  - The aim of the study was to investigate whether surviving stressful life
      threatening situations influences coping with new stressful life threatening
      situations. The study group, therefore, was composed of 53 cancer patients
      (present life threatening situation) who had survived the Holocaust (past life
      threatening situation). They were compared to 53 cancer patients who had not gone
      through the Holocaust, matched for sociodemographic and medical background. The
      Holocaust survivors were unable to mobilize partial denial (had significantly
      higher scores on the Impact of Events Scale) and their psychological distress was
      much higher (significantly higher scores on the Brief Symptom Inventory). Their
      functioning however (as reported along the Psychosocial Adjustment to Physical
      Illness Scale) did not significantly differ from that of the comparison group.
      The possible mechanisms for these long term effects of past trauma are discussed
      as well as the need to regard traumatized persons as 'high risk' psychologically
      when they have to cope with new life threatening situations.

PMID- 1738852
TI  - Time and energy costs of distance in rural life space of Zimbabwe: case study in
      the Chiduku Communal Area.
AB  - Time cost of distance (TCD) and energy cost of distance (ECD) devoted to routine
      activities for supporting the basic human requirements of rural households have
      become a major source of concern because of the high proportion of the daylight
      TCDs and ECDs expended on such tasks in most rural areas of Sub-Saharan Africa.
      The high burden of TCDs and ECDs on members of the rural household has
      constrained daylight time available for food production and health maintenance.
      This case study in a Communal Area (CA) of Zimbabwe, examines the total and
      comparative magnitudes of TCDs and ECDs on trips for domestic chores, social
      services and tertiary functions (markets, central services, transport and
      communication), as well as the gender and age differences in the absorption of
      TCDs and ECDs for these activities. The findings indicate excessive uses of the
      time and energy budget on walking trips to accomplish basic household necessities
      in which domestic chores consume by far the largest portion of this budget with
      the highest burden falling on the female members of the household.

PMID- 1738853
TI  - Explanation of vigorous physical activity during two years using social learning
      variables.
AB  - This study examined determinants of vigorous physical activity in a community
      sample of adults over a 24-month period. Social learning theory predicts that
      causal relationships between determinants and behavior are bidirectional, and
      both the behavior and its influences are subject to change over time. Thus,
      dynamic variables were expected to account for more variance in exercise change
      than static baseline variables. Over 86% of respondents to the baseline mail
      survey completed follow-up surveys 24 months later, yielding a final sample of
      1739. Two physical activity change indices were constructed that were adjusted
      for baseline exercise and demographic variables, so that the effects of social
      learning variables could be isolated. In a two-step hierarchical regression
      analysis, physical activity measures were regressed onto 21 static and six
      dynamic independent variables. Baseline self-efficacy was a significant predictor
      of exercise change for both dependent variables. Four dynamic social learning
      variables were significantly associated with both exercise change measures: self
      efficacy, perceived barriers, family support, and friend support. Social learning
      variables accounted for 12.3-15.5% of the variance in exercise change over 24
      months. The results provide strong support for bidirectional causation between
      behavior and determinants and suggest hypotheses to be tested in experimental
      studies.

PMID- 1738854
TI  - Is magnitude of co-payment effect related to income? Using census data for health
      services research.
AB  - This study: (1) describes and evaluates a method for estimating household income
      using home addresses in conjunction with census data, and (2) uses this method in
      a study designed to determine if the introduction of copayments caused primary
      care office visit rates to decrease more for lower income enrollees than for
      higher income enrollees of a large health maintenance organization (HMO). Each
      step in the process of linking income estimates for small census units (block
      groups) to specific home addresses is described and the validity and precision of
      these estimates is assessed through comparisons of estimated income with self
      reported income for residents of the Puget Sound area of Washington state.
      Although subject to considerable measurement error, this approach provided valid
      income estimates. This method was then used to estimate the incomes of over
      20,000 households of HMO enrollees in a controlled study of the relationship
      between copayment effect on visit rates and enrollee income. Copayments were
      found to have a similar effect on higher and lower income enrollees.

PMID- 1738855
TI  - Alcohol problems and sense of coherence among older adults.
AB  - The relation between alcohol problems and sense of coherence (SOC), a salutogenic
      model developed by Antonovsky, was assessed on a sample of 952 older members of a
      health maintenance organization. Data on alcohol problems (5-item index) and SOC
      (9-item scale) were obtained from mailed questionnaires. Multiple regression
      analyses indicated that SOC was a significant negative predictor of alcohol
      problems while controlling for alcohol consumption level, frequency of
      drunkenness and demographic characteristics. In addition, SOC scores were
      significantly higher for a subsample of lighter drinkers who reported no alcohol
      problems in the last year and had not been drunk in the last year (n = 419) as
      compared to heavier drinkers who reported at least one alcohol problem in the
      last year, and reported being drunk at least once in the last year (n = 107).
      These findings emphasize the importance of assessing factors which contribute to
      healthier behaviors as opposed to focusing exclusively on predictors of
      pathogenic outcomes.

PMID- 1738856
TI  - Prevalence of self-reported poor sleep in a healthy population aged 50-65.
AB  - Many population-based surveys have reported that the prevalence of poor sleep
      increases with age. Despite the uniformity of findings, it remains unclear to
      what extent age-related declines in overall physical health are related to those
      results. One approach to this problem has been to adjust for such confounding
      variables multivariately. Some prior studies using this approach have not shown
      the expected age-related increases in the prevalence of poor sleep. Another
      approach has been the study of sleep in carefully screened, healthy populations.
      The current study reports the prevalence of disturbed sleep in a population, ages
      50-65, carefully screened for physical health as part of an ongoing study of
      exercise and cardiovascular function. The prevalence of self-reported trouble
      falling asleep every night or almost every night (1.1% M, 2.6% F), trouble
      awakening and returning back to sleep (4.4% M, 3.3% F), and use of hypnotic
      medication at least twice a week (1.6% M, 2.6% F) were consistently lower than in
      nearly all previous population-based studies of individuals of comparable age.
      This implies that when overall physical health factors are taken into account a
      decline in sleep quality is not necessarily an inevitable component of aging per
      se. As has been shown in other studies, there were small but statistically
      significant relationships between self-reported depression and poor sleep.
      Despite the low prevalence of poor sleep, about a third of the population
      reported feeling not well-rested and/or not getting the sleep they required. The
      individuals in this study also reported obtaining significantly less sleep
      relative to normative data from 30 years ago.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738857
TI  - Medical specialists' choice of location: the role of geographical attachment in
      Norway.
AB  - The relation between current place of work (area of the country) and factors that
      might possibly represent doctors geographical attachments was studied in a sample
      of 322 Norwegian medical specialists. Location of hospital residency, age and
      geographical origin of spouse were associated with current location. Geographical
      attachment seems to influence doctors' locational choices from start of medical
      school until the end of their residency. The probability that a doctor shall
      locate in peripheral areas may increase from less than 10% to more than 50% if
      the doctor has the residency training in the periphery. Hence, favoring entrance
      to medical schools of students from the underserved areas, and location of
      graduate and postgraduate medical training in the underserved areas, as far as it
      is feasible while still maintaining medical standards, is suggested by the study.

PMID- 1738858
TI  - African women and AIDS: negotiating behavioral change.
AB  - Trends in the incidence of HIV/AIDS infection among women in Sub-Saharan Africa
      suggest this population is increasingly at risk. Many of the same factors that
      have predisposed rural African women to ill health in the past now increase their
      vulnerability to AIDS, including poverty and malnutrition, uncontrolled
      fertility, and complications of childbirth. As men travel out from rural
      communities to urban centers in search of employment, their sexual contacts
      multiply; many will acquire the HIV virus and carry it back to infect wives at
      home. Women, too, are leaving rural areas for the promise of a better life in
      cities and commercial centers along the way. Their struggle for economic survival
      and personal autonomy has led many to form relationships with new sexual
      partners, with a consequent increase in HIV seroprevalence among women once
      considered at low risk of infection. This paper argues that AIDS prevention
      campaigns have not yet taken into account the cultural, social, and economic
      constraints on most African women's ability to comply with advice to limit
      partners and use condoms. The author proposes a research agenda to explore the
      meaning of AIDS and AIDS prevention in the sociocultural context of women's
      lives. A better understanding of how women, themselves, perceive and respond to
      current attempts to prevent the transmission of AIDS is an increasingly critical
      factor in the intervention process. Most important, it is a necessary first step
      toward their effective participation with men in the development of culturally
      relevant strategies for protecting themselves and their families.

PMID- 1738859
TI  - Prostitutes and their clients: a Gambian survey.
AB  - The social backgrounds and working behaviour of 248 prostitutes in urban and
      rural areas of The Gambia were investigated. Prostitutes were found to be highly
      mobile, moving frequently between a number of working locations in The Gambia and
      neighbouring Senegal, from which most of them originated. The educational level
      of prostitutes and the standard of living of their natal families were above
      average. Prostitutes worked on average four days a week and had between two and
      three clients a night. Condoms were used in up to 80% of contacts. 795 clients of
      prostitutes were interviewed and found to be on average of low educational and
      occupational status. Half were non-Gambian and most were currently travelling or
      living away from home.

PMID- 1738860
TI  - Older widow mortality in rural Bangladesh.
AB  - Prospective data from rural Bangladesh are used to explore the adverse impact of
      widowhood on old age female mortality. The results indicate that widows aged 45
      and above have significantly higher mortality than their currently married
      counterparts. Controlling for age and disability status, much of this excess
      mortality risk can be accounted for by patterns of living arrangements and
      household assets. An analysis of older widows suggests that the presence of adult
      male kin in the household (primarily sons), and to a lesser extent household
      headship (both of which may be interpreted as reflecting individual access to
      resources in this society) have a substantial impact on mortality risks for this
      group of women.

PMID- 1738861
TI  - Evaluation of a mobile branch surgery in a rural area.
AB  - Access to the family doctor at his or her surgery is a problem for many people
      living in rural Britain. The service provided by a caravan used as a general
      practice mobile branch surgery in a rural part of Norfolk was evaluated using a
      survey of residents and examination of practice records. In a village where the
      mobile surgery replaced a conventional branch surgery, consultation rates
      increased slightly during the first year of operation. In a village where the
      mobile surgery was a new facility, consultation rates increased substantially in
      the first year. Replies from residents indicated that although the limitations of
      the mobile surgery were recognised, the service reduced the problems of physical
      access in remote villages to the level of those in the village where the main
      surgery is situated.

PMID- 1738862
TI  - Forensic anthropology and the concept of race: if races don't exist, why are
      forensic anthropologists so good at identifying them?
AB  - Most anthropologists have abandoned the concept of race as a research tool and as
      a valid representation of human biological diversity. Yet, race identification
      continues to be one of the central foci of forensic anthropological casework and
      research. It is maintained in this paper that the successful assignment of race
      to a skeletal specimen is not a vindication of the race concept, but rather a
      prediction that an individual, while alive was assigned to a particular socially
      constructed 'racial' category. A specimen may display features that point to
      African ancestry. In this country that person is likely to have been labeled
      Black regardless of whether or not such a race actually exists in nature.

PMID- 1738863
TI  - Forensic archaeology as mortuary anthropology.
AB  - This paper argues that forensic anthropology is more than just physical
      anthropology, but should incorporate several subdisciplinary perspectives into a
      framework of mortuary anthropology. The advantage of this holistic approach is to
      provide context for the primary roles of physical anthropologists; identification
      of victims, and assessing manner of death. Mortuary anthropology provides
      information on processes of disposal and site formation, including the
      regularity, sequencing, and timing of events, which is complementary to the
      traditional roles of physical anthropologists. A call is made for more widespread
      application of this perspective.

PMID- 1738864
TI  - Racial identification in the context of prehistoric-historic biological continua:
      examples from South Asia.
AB  - The practice of 'racial palaeontology' disappeared 50 years ago with the fall of
      the biological race concept in systematics and population genetics. However,
      certain ethnic minorities claim close biological affinities with extinct
      (sometimes Pleistocene) populations. Forensic anthropologists may be involved in
      this issue through analyses of prehistoric and modern populations in
      circumstances where a biological continuum may exist. Skeletal evidence from
      South Asia is discussed.

PMID- 1738865
TI  - Forensic diagnosis of race--general race vs specific populations.
AB  - Commonly used methods of diagnosing racial affinity from the skull may give
      paradoxical results. This may be due to using single populations to represent
      large geographical areas, and to the use of measurements unduly subject to local
      variation. It is suggested that a more flexible approach, using appropriate local
      populations and selected measurements, would be entirely practical with the use
      of modern small computers.

PMID- 1738866
TI  - Physicians and the state in the U.S.A. and Israel.
AB  - The paper focuses on two patterns of policy-making: a professional pattern in
      which physicians dominate, and a political pattern in which state authorities
      take the lead. It looks into the causes of the emergence of each of these
      patterns and their consequences, in terms of the equity of the health services
      and their efficiency. The U.S.A. and Israel provide examples for the professional
      and political patterns of health policy making. The causes for the development of
      the political pattern in the U.S.A. are grounded in the social salience of
      medical care, in physicians' economic power, and in the individualistic political
      culture. The politicization of health services in Israel came about owing to the
      low placement of health on the social agenda, the proletarianization of
      physicians, and the hierarchical administrative culture. Analysis of the results
      indicates that Israel portrays more equity in health services. However, in terms
      of efficiency results are mixed. In both countries, changes are taking place in
      opposite directions: more politicization in the U.S.A.; less in Israel.

PMID- 1738867
TI  - Psychiatric diagnosis and racial bias: empirical and interpretative approaches.
AB  - Understanding of psychiatric illness among Britain's Black and ethnic minority
      population has shifted from an emphasis on cultural difference to one on racism
      within psychiatric theory and practice. In spite of this apparent turn, the
      explanations put forward remain within an empirical framework of methodological
      individualism, reflecting the background and training of British psychiatrists
      themselves. How racism may be actually demonstrated in individual clinical
      practice remains elusive. The standard hypotheses are examined here through a
      conventional clinical vignette study: this suggests medical education does not in
      itself now involve any specific racist psychiatric assumptions. Fuller
      understanding of the exercise of social power within this particular domain
      requires not only more complex interactive studies, preferably derived from a
      variety of clinical and social contexts, but a more developed interpretation of
      psychiatric practice and ideology within the social system.

PMID- 1738868
TI  - Ethnicity, morbidity and health service utilization in two Labrador communities.
AB  - This paper compares total outpatient health care utilization of residents of the
      Labrador community of Sheshatshit, a predominantly native Innu settlement, with
      those for the adjacent and predominantly caucasian community of Northwest River
      for 1986. In lieu of a community survey, these data provide an approximation of
      the morbidity patterns within the populations. Findings indicate that the native
      population experiences proportionately more infectious diseases (39.3% of all
      visits compared to 12.5% of all visits for the non-native community). While
      residents of the Innu community utilize health services primarily for curative
      care, residents of Northwest River sought services for both curative and
      preventive care. It is concluded that inequalities in material wellbeing may
      underlie the morbidity in Sheshatshit. While desirable in light of the WHO Ottawa
      Charter, any modification of the health services on account of these morbidity
      patterns will have only modest effect until policy-based initiatives to reduce
      material inequalities are implemented.

PMID- 1738869
TI  - Child health outcomes among Central American refugees and immigrants in Belize.
AB  - The purpose of this study was to investigate the effect of international
      migration, including refugee status, upon child health outcomes. Data were drawn
      from a survey conducted in 1989 in three settlements in Belize, Central America,
      that have a high proportion of refugees and economic immigrants living side-by
      side with the local population. In two of the settlements, the entire population
      of mothers with children under 6 was interviewed; in the third settlement a two
      thirds random sample was interviewed. Health history data were obtained for 255
      children of 134 mothers, from whom sociodemographic data were also collected. The
      majority of children were born to Salvadoran or Guatemalan mothers, but native
      and naturalized Belizeans in the survey communities were included for comparison
      purposes. Migration, the exposure variable, was characterized by mother's
      residency/refugee legal status, nationality, and duration of time in country.
      Socioeconomic and proximate control variables were included as suggested by the
      Mosley-Chen framework. Despite normal birthweight averaging 3374 g, a large
      proportion of children are at the lowest percentiles of the weight-for-age curves
      (44% below the tenth percentile for the international reference population). A
      high incidence of diarrheal and respiratory illnesses (30% and 47% of children,
      respectively, having frequent episodes), and 50% of children with measles
      vaccination appropriate for age, indicate a population with high potential
      morbidity. Logistic regression was used to model the effects of migration on
      weight-for-age and frequency of diarrheal and respiratory tract episodes
      independent of socioeconomic and proximate factors, as suggested by the Mosley
      Chen framework.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1738870
TI  - Pursuing health for all in Britain--an assessment.
AB  - In 1977 the World Health Organisation adopted the strategic goal "Health For All
      by the Year 2000". The Regional Office for Europe of the World Health
      Organisation has taken important steps toward the attainment of the goal, with
      the formulation in 1980 of a common health policy and the adoption by the
      Regional Committee in 1984 of 38 wide-ranging targets. The targets represent a
      common view of what could be Health For All in Europe and constitute a major
      challenge which the 33 member states in the European Region have set for
      themselves. Thus, the targets offer a different way or approach to the building
      of a local strategy. This paper reviews the extent to which Health For All and
      its associated targets constitute part of the planning process at district level.
      At the core of the paper is the results of a survey of health authorities and
      boards in the United Kingdom which sought details on the extent to which health
      planners and policy makers have embraced the concept of Health For All in
      applying it to a local setting. The findings of the survey are discussed within
      the context of whether or not Health For All should be a centrally driven or
      locally derived policy. And how the experience in Britain could be of value to
      others embarking on such a venture.

PMID- 1738871
TI  - Elasticity of demand for water in Khartoum, Sudan.
AB  - A survey of the quantities of water purchased from vendors in the squatter areas
      of Khartoum, Sudan, was used to assess the effect of the price charged for water
      and of household income on domestic water consumption. Households in two squatter
      communities--Meiyo and Karton Kassala--were studied by observation and by
      interview. In spite of the substantially higher charges, water consumption in
      Karton Kassala was as high as that in Meiyo. Households within these communities
      showed no tendency to use less water when paying a higher price for it, or when
      their income was below average. In other words, no price elasticity or income
      elasticity was detectable. This was all the more striking in view of the high
      proportion of income that was spent on water; 17% in Meiyo, and 56% in Karton
      Kassala. One consequence of this lack of elasticity is that the poorest
      households devote the greatest percentage of their income to the purchase of
      water, although the only major item in their household budget which can be
      sacrificed to make this possible is food. The high price of water in urban Sudan
      is probably a major cause of the malnutrition prevalent in the squatter areas.
      Another consequence is that a low-income household's consumer surplus for
      domestic water is very high, amounting to a substantial proportion of its total
      income. This has important consequences for the economic appraisal of urban water
      supply schemes. It also follows that wealthier households with private
      connections would be willing to pay at least as much for water as that currently
      paid by the poor.

PMID- 1738872
TI  - Preventive health behavior among black and white women in urban and rural areas.
AB  - The relationship of race to preventive health behavior among women is examined
      using data from the 1985 National Health Interview Survey. We find that black
      women are less likely to engage in primary prevention behaviors such as
      exercising, non-smoking and maintaining a favorable weight. However, black women
      are more likely to engage in secondary prevention behaviors such as receiving a
      Pap test or a breast exam. These findings are surprising as they indicate a
      change in secondary prevention behavior among black women. The racial differences
      in exercising, maintaining a favorable weight and receiving a Pap test or a
      breast exam cannot fully be explained by the differing levels of socio-economic
      status, measured by education and income. However, the higher percentage of
      smoking among black women is due to their lower levels of education. Urban/rural
      residence modifies the effect of race on smoking and receiving a Pap test. Black
      women in urban areas are most likely to be smokers. Almost no difference exists
      between white women in urban and rural areas concerning their likelihood of
      receiving a Pap test, we find that black women in urban areas are much more
      likely to be screened for cervical cancer than black women in rural areas.

PMID- 1738873
TI  - Eosinophilic meningitis beyond the Pacific Basin: the global dispersal of a
      peridomestic zoonosis caused by Angiostrongylus cantonensis, the nematode
      lungworm of rats.
AB  - The principal etiologic agent of human eosinophilic meningitis, Angiostrongylus
      cantonensis, was first detected in rats in Canton, China in 1933. The first human
      case was detected on Taiwan in 1944. Epidemic outbreaks were noted on Ponape (E.
      Caroline Is.) from 1944 to 1948. The disease may present as transient meningitis
      or a more severe disease involving the brain, spinal cord and nerve roots, with a
      characteristic eosinophilia of the peripheral blood and CSF. Since 1961 it has
      been known that human infections are usually acquired by purposeful or accidental
      ingestion of infective larvae in terrestrial mollusks, planaria and fresh-water
      crustacea. There is no effective specific treatment. The African land snail,
      Achatina fulica played an important role in the panpacific dispersal of the
      organism: it will be important in Africa in the future as well. Rats were, and
      will continue to be the principal agents of expansion of the parasite beyond the
      Indopacific area. During and just after WWII the parasite was introduced, and/or
      spread passively from South and Southeast Asia into the Western Pacific islands
      and eastward and southward through Micronesia, Melanesia, Australia and into
      Polynesia, sequestered in shipments of war material and facilitated by post-war
      commerce. In the 1950s numerous cases were identified for the first time on
      Sumatra, the Philippines, Taiwan, Saipan, New Caledonia, and as far east as
      Rarotonga and Tahiti. Then cases were detected in Vietnam, Thailand, Cambodia,
      Java, Sarawak, the New Hebrides, Guam and Hawaii during the 1960s. Subsequently
      in the Pacific Basin the disease has appeared on Okinawa, other Ryukyu islands,
      Honshu, Kyushu, New Britain, American Samoa and Western Samoa, Australia, Hong
      Kong, Bombay, India, Fiji and most recently in mainland China. The parasite in
      rats now occurs throughout the Indopacific Basin and littoral. Beyond the
      Indopacific region, the worm has been found in rodents in Madagascar (ca 1963),
      Cuba (1973), Egypt (1977), Puerto Rico (1984), New Orleans, Louisiana (1985) and
      Port Harcourt, Nigeria (1989). Human infections have now been detected in Cuba
      (1973), Reunion Island (1974) and Cote d'Ivoire (1979) and should be anticipated
      wherever infected rats of mollusks have been introduced. Caged primates became
      infected in zoos in Hong Kong (1978) and New Orleans and Nassau, Bahamas (1987).
      The use of mollusks and crustacea as famine foods, favored delicacies and
      medicines has resulted in numerous outbreaks and isolated infections. Economic
      and political instability, illicit trade, unsanitary peridomestic conditions and
      lack of health education promote the local occurrence and insidious global
      expansion of parasitic eosinophilic meningitis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1738874
TI  - Why clinical trials fail: the hidden assumptions of clinical trials.

PMID- 1738875
TI  - First-order prevention and second-order treatment: health care in the developed
      world is too long on the latter.

PMID- 1738876
TI  - Psychologic sequelae of chronic toxic waste exposure.
AB  - Exposure to toxic industrial substances has been a topic of increasing concern to
      environmentalists, government agencies, industrial engineers, and medical
      specialists. Our study focuses on the psychologic symptom responses of a
      community to perceived long-term exposure to toxic waste products. We compared
      their symptom clusters, as shown by their responses to questions on the Hopkins
      Symptom Checklist-90 Item (SCL-90) and the Social Adjustment Scale (SAS), with
      symptom levels of normal and depressed subjects. Issues of media coverage,
      litigation, and potential for compensation complicate the psychiatric
      epidemiology of the subject.

PMID- 1738877
TI  - Drug therapy in the elderly.
AB  - The segment of the population older than 65 accounts for about 25% of the total
      drug expenditures in developed countries. This figure is predicted to reach 40%
      by the year 2030. Drug therapy in the elderly can be complicated by many factors.
      The pharmacokinetic processes of absorption, distribution, metabolism, and
      elimination are altered by the physiologic changes of aging involving body
      composition and organ function. While the extent of drug absorption is not
      affected by age, few drugs have delayed rates of absorption after oral
      administration. Changes in body composition, protein binding, and blood flow do
      affect the concentrations of free unbound drug, the volume of distribution, and
      elimination half-life of a number of drugs. The primary goal of drug therapy in
      the elderly is to improve the quality of life. When medical therapy is required,
      the physician must be aware of the potential effect of age and disease on
      pharmacokinetics and pharmacodynamics and of the possible ramifications for
      adverse drug reactions or interactions. By increasing our knowledge of the action
      and effects of drugs in the elderly, and by enhancing communication and
      understanding between physician and patient, we can significantly improve the
      overall quality of care for the elderly patient.

PMID- 1738878
TI  - Antineutrophil cytoplasmic antibodies: clinical characteristics of 10 patients
      with the perinuclear pattern of immunofluorescence on ANCA testing.
AB  - Antineutrophil cytoplasmic antibodies (ANCA) have recently been described in
      association with necrotizing glomerulonephritis, systemic vasculitis, and other
      autoimmune-mediated connective tissue diseases, including systemic lupus
      erythematosus (SLE) and polychondritis. At least two distinct classes of ANCA
      have been described, differentiated by characteristic immunofluorescence patterns
      using neutrophils as substrate for indirect immunofluorescence assay (IFA). A
      focal, centrally accentuated, finely granular cytoplasmic staining pattern (c
      ANCA) is both sensitive and specific for Wegener's granulomatosis (WG) and is
      thus a useful clinical adjunct in the diagnosis and monitoring of disease
      activity in WG. The second class of ANCA, defined by a perinuclear
      immunofluorescent staining pattern (p-ANCA) on standardized IFA, has not been
      studied as extensively. It appears to occur in a variety of connective tissue
      diseases, most often necrotizing glomerulonephritis other than WG, systemic
      vasculitis with renal involvement, and SLE. In screening more than 2000 serum
      samples received in our rheumatology laboratory for ANA testing, we found p-ANCA
      in 10 patients. All 10 had evidence of systemic autoimmune disease, though with
      wide variation in extent and severity of disease. All 10 had other
      autoantibodies, most frequently ANA (60%). Our studies suggest that p-ANCA define
      a heterogeneous patient population with a spectrum of autoimmune disease, most
      frequently necrotizing glomerulonephritis and systemic vasculitis. Future studies
      will establish the role of p-ANCA in clinical medicine and broaden our
      understanding of the origin and possible pathogenesis of ANCA and autoantibodies
      in general.

PMID- 1738879
TI  - Transplacentally transmitted autoimmune disorders of the fetus and newborn:
      pathogenic considerations.
AB  - Autoimmune diseases affect a significant number of women in their childbearing
      years. This group of disorders constitutes a heterogeneous spectrum with a common
      basis involving the presence of autoantibodies often of the IgG type.
      Transplacental transfer of autoantibodies is not uncommon, and autoantibodies can
      be readily demonstrated in newborn serum. Only a small proportion of infants with
      circulating autoantibodies exhibit clinical symptoms. The transient neonatal
      manifestations of maternal autoimmune disease disappear over a time course
      consistent with the catabolism of IgG, providing no permanent damage occurs. Thus
      the pathogenic role of transferred autoantibodies seems well established.
      However, maternal-autoantibody-mediated tissue damage appears to depend on
      factors other than the mere passage of the antibody to the fetal compartment.
      This review details putative factors that are likely to modulate the clinical
      expression of the fetal antigen-autoantibody reaction in offspring of mothers
      with autoimmune disorders. The importance of amount, type, and specificity of
      autoantibodies is described. The possible significance of fetal and maternal
      immunogenetics is briefly discussed, as well as the limited knowledge currently
      available on the fetal development of fetal antigenic sites at target organs.
      These and other as yet unidentified factors may help explain the rarity of
      clinical manifestations in infants exposed to potentially pathogenic maternal
      autoantibodies.

PMID- 1738880
TI  - Topical pharmacotherapy for allergic rhinitis: new agents.
AB  - The advantages of topical (as opposed to systemic) therapy for allergic rhinitis
      include the avoidance of undesirable systemic effects and the concentration of
      therapeutic effect on the target organ. Successful topical therapy requires
      establishment of a proper diagnosis, followed by effective delivery of the
      medication to the nasal mucosa. In addition to currently available preparations
      such as cromolyn sodium and various corticosteroids, several other topical nasal
      preparations for the treatment of allergic rhinitis are under investigation.
      These include antihistamines (eg, levocabastine), anti-inflammatory/mast cell
      stabilizing drugs (eg, nedocromil), new corticosteroids (eg, triamcinolone,
      budesonide, fluocortin, fluticasone), anticholinergics (eg, ipratropium), and
      miscellaneous agents (eg, HEPP [IgE pentapeptide]).

PMID- 1738881
TI  - Cone biopsy in premenopausal women: why was outpatient management abandoned?
AB  - In a 2-year retrospective study, I reviewed the records of 180 premenopausal
      patients who had had cone biopsy. The purpose of this study was to determine the
      indications for the procedure in the view of the practicing clinician and to
      determine whether these young women might have received better treatment as
      outpatients. In this series, positive findings on endocervical curettage (ECC) in
      patients with otherwise satisfactory results of colposcopy was by far the leading
      reason for cone biopsy, and positive findings on ECC did not correlate with
      occult disease in the canal when the cone specimen was examined. Also, a
      significant number of women had cone biopsy solely for severe dysplasia, though
      the literature clearly shows the effectiveness of outpatient management in these
      cases (eg, using proper cryotherapeutic methods). If ECC is done routinely
      despite satisfactory results of colposcopic examination and unexpectedly positive
      results are obtained, I recommend repeat colposcopy with aggressive use of an
      endocervical speculum and a careful, adequate ECC before abandoning outpatient
      management. Proper histologic interpretation of ECC in light of all clinical data
      is essential to avoid unnecessary morbidity.

PMID- 1738882
TI  - Automatic implantable cardioverter-defibrillator: early experience at Wilford
      Hall USAF Medical Center.
AB  - Fifteen patients with malignant ventricular arrhythmias were treated with the
      automatic implantable cardioverter-defibrillator (AICD) over a 22-month period.
      The cause of the arrhythmia was coronary artery disease in 13 of the patients
      (87%), sarcoid cardiomyopathy in one (7%), and a primary electrical abnormality
      in one (7%). The mean ejection fraction was 29%, with a range of 15% to 70%.
      Fourteen of the patients had inducible ventricular tachycardia using program
      stimulation. Defibrillating and rate-sensing leads were inserted through a
      lateral thoracotomy in 13 patients and through a median sternotomy in two
      patients in conjunction with other cardiac procedures. The generators were
      positioned in a subcutaneous pocket beneath the left costal cartilage. There was
      one early and one late death, both due to congestive heart failure. Neither was
      related to a ventricular tachyarrhythmia, and in each patient the AICD was
      functioning properly at the time of death. The mean follow-up period was 11.5
      months, with five patients receiving a total of 17 shocks. We conclude that the
      AICD is a highly effective, low-risk treatment for malignant ventricular
      tachyarrhythmias.

PMID- 1738883
TI  - Lesions of the nasal radix in pediatric patients: diagnosis and management.
AB  - Lesions involving the nasal radix are not extremely uncommon in the pediatric
      population. Such lesions may represent inflammatory or infectious processes,
      neoplasia, traumatic sequelae, or developmental anomalies, but faulty
      embryogenesis is considered the most common cause. During my surgical experience,
      I have encountered nasal dermoids, nasal gliomas, and nasal encephaloceles
      resulting in lesions at the root of the nose. Each of these has unique features
      that will affect therapy.

PMID- 1738884
TI  - Theoretic orientations and folk medicine research in the Appalachian South.

PMID- 1738885
TI  - Antineutrophil cytoplasmic antibody associated with pulmonary hemorrhage:
      Wegener's granulomatosis?
AB  - Antineutrophil cytoplasmic antibodies have been described mainly in patients with
      Wegener's granulomatosis. It has proven useful for both diagnosis and follow-up
      in these patients. We have described a patient with diffuse pulmonary hemorrhage
      in whom the suspicion of Wegener's granulomatosis was raised by the
      identification of antineutrophil cytoplasmic antibodies.

PMID- 1738886
TI  - Miliary tuberculosis: unusual cause of abdominal pain in pregnancy.
AB  - We have described a case of miliary tuberculosis, with symptoms primarily due to
      hepatic involvement during pregnancy. Liver biopsy showed granulomatous
      hepatitis, and subsequent cultures of sputum, urine, and gastric aspirate were
      positive for Mycobacterium tuberculosis. Although this patient was seronegative
      for HIV, an increased incidence of extrapulmonary and disseminated tuberculous
      infection has recently been noted in patients with HIV infection. Given the
      increasing incidence of HIV in the general population, we may therefore
      anticipate a corresponding rise in the incidence of extrapulmonary tuberculosis.
      Since an increasing number of gravidas will be immunocompromised by HIV
      infection, renewal of knowledge regarding diagnosis of miliary tuberculosis in
      pregnancy is valuable.

PMID- 1738887
TI  - Lyme arthritis with subarticular cyst formation in metacarpal and metatarsal
      bones.
AB  - A young woman was treated for seronegative rheumatoid arthritis for more than 9
      years, without clinical improvement, before the diagnosis of chronic Lyme
      arthritis of the metacarpal and metatarsal phalangeal joints was made.
      Roentgenograms showed subarticular cyst formation in the metacarpal and
      metatarsal bones. The patient's response to treatment with a 2-week course of
      ceftriaxone was dramatic.

PMID- 1738888
TI  - Listeria monocytogenes causing endovascular infection.
AB  - Listeria monocytogenes is an uncommon cause of mycotic aneurysms, endocarditis,
      and other endovascular infections. When they occur, these infections usually
      involve patients with relatively normal host defenses, but with abnormal vascular
      intima or cardiac valves. We have reported a Listeria monocytogenes infection at
      the site of a posttraumatic aortic aneurysm.

PMID- 1738889
TI  - Adrenal insufficiency and stage D carcinoma of the prostate.
AB  - A patient with stage D prostatic cancer but in reasonably good general health was
      discovered to have adrenal failure and tumor destruction of the adrenal glands.
      Because prostatic cancer is common and compatible with prolonged survival, we
      surveyed other patients with stage D prostatic cancer. On initial screening with
      the cosyntropin test, we found that 5 of 14 patients failed to respond with an
      increase in serum cortisol of 10 micrograms/dL, suggesting an adrenal failure
      incidence of 36%. Retesting, however, indicated that probably all of these were
      false-positive results.

PMID- 1738890
TI  - Azathioprine: effective steroid-sparing therapy for generalized lichen planus.

PMID- 1738891
TI  - Infantile gastrointestinal hemangioma as a cause of chronic anemia.
AB  - Gastrointestinal hemangiomas, though rare, can be an important source of GI
      bleeding in infants. In the past, diagnosis has been hampered by a lack of
      reliable methods. With the recent advent of selective mesenteric angiography, the
      suspected diagnosis can be readily confirmed. Surgical resection remains the
      definitive therapy; steroid therapy has produced conflicting results.

PMID- 1738892
TI  - Cushing's syndrome with cranial and pulmonary lesions: necessity for tissue
      diagnosis.
AB  - This report describes two cases of Cushing's syndrome associated with radiologic
      abnormalities in the lung and brain. In both cases, the pathologic diagnosis of
      the intracranial lesion was unsuspected and prompted changes in management. These
      cases illustrate that the etiology of pulmonary and central nervous system mass
      lesions in patients with Cushing's syndrome may not be predicted on clinical
      grounds or by conventional radiologic methods. A tissue diagnosis is essential as
      a guide to appropriate management, and biopsies of such lesions are indicated.

PMID- 1738893
TI  - Cholesterol microembolization and stable renal function with continued
      anticoagulation.
AB  - Cholesterol microembolization as a sequela of oral anticoagulant therapy has been
      reported to cause infarction of virtually any organ, often resulting in death.
      Until recently, discontinuance of anticoagulant therapy has been recommended, as
      this cessation has been shown to slow or halt further tissue infarction. I have
      described a patient with a prosthetic heart valve in whom the purple toes
      syndrome developed. Stable renal function followed the initiation of high-dose
      subcutaneous heparin therapy.

PMID- 1738894
TI  - EDTA-induced pseudothrombocytopenia.
AB  - A 45-year-old man was admitted to the hospital because of unstable angina
      pectoris. During the wait for coronary artery bypass surgery, the platelet count
      gradually decreased from 154,000 to 20,000/mm3, without hemorrhagic
      manifestations. Medications were discontinued and surgery was postponed. Direct
      blood smear revealed a normal number of platelets, establishing the diagnosis of
      pseudothrombocytopenia. The mechanism of the development of
      pseudothrombocytopenia is not clear.

PMID- 1738895
TI  - Pancytopenia caused by unsuspected pernicious anemia complicating sickle cell
      beta-thalassemia.
AB  - We have described a a 23-year-old black woman with sickle cell beta-thalassemia
      who had a urinary tract infection and who was incidentally found to be
      pancytopenic. Although her anemia was categorized as "normocytic, normochromic"
      by an electronic particle counter, evaluation of the pancytopenia confirmed
      unsuspected pernicious anemia. Greater vigilance and a higher index of suspicion
      are crucial for early diagnosis of pernicious anemia in patients with other known
      hemoglobinopathies.

PMID- 1738896
TI  - Transvaginal intra-abdominal impalement injury.
AB  - Impalement injuries due to sexual activity are highly unusual and variable. We
      have described a case of transvaginal impalement injury of the rectum, bladder,
      omentum, and mesentery manifested by vaginal bleeding. The patient could not
      recount how she had been injured. Management of such an injury requires extensive
      initial evaluation and a multidisciplinary approach to therapy.

PMID- 1738897
TI  - Drug interactions with oral contraceptives.

PMID- 1738898
TI  - The future of CME.

PMID- 1738899
TI  - Prolonged recrudescence of Plasmodium falciparum.

PMID- 1738900
TI  - Medicine--business or profession?

PMID- 1738902
TI  - Angiotensin-converting enzyme inhibitor therapy.

PMID- 1738901
TI  - Vitamin A, childhood mortality, foresight and epidemiology.

PMID- 1738903
TI  - Telling patients the truth.

PMID- 1738904
TI  - Listeria monocytogenes meningitis at King Edward VIII Hospital, Durban. A 10-year
      experience, 1981-1990.
AB  - Nine cases, 3 adults and 6 children, with Listeria monocytogenes meningitis were
      seen over a 10-year period at King Edward VIII Hospital, Durban. These cases
      accounted for 0.8% (3/374) and 0.6% (6/1,210) of all culture-positive cases of
      acute bacterial meningitis in adults and children, respectively, and represented
      2.9% (4/136) of all culture-positive cases in the neonatal age group and 5.7%
      (3/53) of culture-positive cases in adults 50 years and older. The patients had
      positive blood and cerebrospinal fluid (CSF) cultures. All isolates were
      sensitive to ampicillin, chloramphenicol, sulphamethoxazole-trimethoprim
      combination and gentamicin. One isolate in an 11-month-old child was resistant to
      penicillin and 2 isolates in the adult patients displayed intermediate
      sensitivity to this antibiotic. The adults were over 50 years of age and
      presented with an abrupt onset of a pyrexial illness, meningitis and focal
      neurological signs; only 1 survived. Only 1 8-week-old infant of the paediatric
      cases survived. A polymorphonuclear leucocytosis, low serum glucose and elevated
      protein values were common findings in the CSF and the features in some patients
      mimicked tuberculous or viral meningitis. The fulminant course of the disease and
      the fact that penicillin and not ampicillin is the first-line antibiotic makes it
      essential to consider listeriosis as a possible diagnosis, particularly in the
      very ill patient.

PMID- 1738905
TI  - Information yield from routine pre-operative chest radiography and
      electrocardiography.
AB  - Studies in First-World settings suggest that routine pre-operative investigations
      are of minimal usefulness. A retrospective study of 797 case records determined
      the yield of significant information from routine chest radiography and ECG in a
      provincial general hospital serving a broad socio-economic sector. The results
      were in agreement with those of other studies, viz. that routine investigation
      may be worthwhile only in older patients. Routine chest radiographs showed an
      overall positive yield of 6%; 17% in those over 60 years but only 2% in those
      under 60 years. Routine ECGs showed a positive yield of 7% overall; 7.4% in those
      older than 40 years and 4.5% in those under 40 years. Investigations indicated by
      history or physical examination had a significantly greater yield: 34% for chest
      radiography and 31% for ECGs. Positive results of indicated investigations were
      more evenly spread across the age groups. The pre-eminence of clinical skills in
      determining which patients require special investigations is reaffirmed.

PMID- 1738906
TI  - Occupational diseases in South African mines--a neglected epidemic?
AB  - A major difficulty in assessing incidence and prevalence of occupational diseases
      among the workforce employed on South African mines is the lack of
      epidemiological data. Published and unpublished data were collated and analysed
      for the period 1915-1988 in order to provide insights into occupational disease
      trends. Using proxies for incidence rates, it was demonstrated that the rates of
      silicosis and tuberculosis were likely to be high. In the case of silicosis among
      black miners, disease was contracted in a relatively short period on average. The
      stabilisation of the black workforce on the mines, which started in 1975 and
      continues, is an important factor likely to lead to an increase in occupational
      disease rates. Recommendations for improved data reporting and research are made,
      in particular the need to identify occupational groups at high risk and the
      calculation of prevalences.

PMID- 1738907
TI  - Infant and child mortality in the Elim District, northern Transvaal, 1976-1986,
      and a comparison of trends.
AB  - Childhood mortality rates among rural blacks in South Africa are currently not
      based on a reliable registration system. National childhood mortality statistics
      rely on mortality extrapolations and population estimates. This study attempts to
      provide further information on infant and child mortality among rural blacks in
      the northern Transvaal, using a direct method. Currently available obstetric
      histories from hospital and clinic records of the Elim Hospital Health Ward were
      reviewed, covering the years 1976-1988 and approximately 28,000 pregnancies. The
      mean infant mortality rate was 88/1,000 live births, and did not change
      significantly over 10 years, in contrast to other populations in South Africa
      with documented decreases. Components of the infant mortality rate were also
      calculated. There was a 1 in 10 risk of death among children less than 5 years of
      age over this period, although the risk had declined slightly over 10 years.
      Mortality among boys was higher than that among girls in all age groups studied.
      Conclusions include that small but measurable changes have occurred in rural
      South African black childhood mortality rates, although there has been no
      discernible change in infant mortality, and that a simple direct method can
      illustrate levels as well as trends in mortality. This has implications for
      health policy.

PMID- 1738908
TI  - Vaccination status of children aged 12-23 months in the Northern Transvaal Health
      Region.
AB  - A vaccination coverage survey was done between October and December 1989 in the
      Northern Transvaal Health Region, as the first phase in the region's contribution
      to the National Measles Strategy. The aim of the study was to evaluate the
      vaccination status of children in this region aged 12-23 months. The study
      population was divided into four strata, a black and a white urban stratum and
      two rural black strata, one in the north-western and the other in the south
      eastern part of the region (self-governing and independent territories excluded).
      The Expanded Programme on Immunisation (EPI)-recommended cluster sampling
      technique was used in each stratum. The data were collected by nursing staff
      working in the area, after they had received special training. A questionnaire
      was used to obtain data from randomly selected households. The following
      conclusions can be made from the results: (i) in all strata percentages of fully
      vaccinated children were well below the EPI-recommended target of 60-70% to be
      reached by the developing countries by 1990; (ii) a danger of measles outbreaks
      exists in most communities, because the levels of measles vaccination were less
      than 70% in three out of the four strata; (iii) the children with the highest
      risk of developing measles complications were not being vaccinated early enough;
      and (iv) the very high drop-out rates for subsequent vaccinations in the rural
      areas warrant urgent attention.

PMID- 1738909
TI  - Protein energy malnutrition and its recognition in outpatient departments in
      Venda hospitals.
AB  - Between April and June 1988 the number of children under 5 years old attending
      outpatient departments of Venda hospitals who had protein energy malnutrition
      (PEM) was determined, the proportions at 3 Venda hospitals were compared, and
      what percentage of these children was detected by attendant health workers was
      determined. Approximately 6% had severe PEM; this finding was consistent for all
      3 hospitals. The rates for mild PEM were 22% for Tshilidzini and Donald Fraser
      Hospitals and 33% for Siloam Hospital. This statistically significant difference
      has not been explained. Health workers failed to recognise about 25% of children
      with severe PEM and 50% of children with mild PEM. It is suggested that certain
      interventions and activities are essential if PEM is to be adequately managed:
      these are efficient monitoring; pre-employment and in-service education for
      health workers; a breast-feeding and weaning survey; and an investigation of the
      variation of malnutrition among Venda hospitals.

PMID- 1738910
TI  - Child health in farm workers' communities.
AB  - Black women who had borne one or more children in the 5 years preceding the study
      and who were resident on white-owned farms were sampled in a multistage cluster
      procedure from the population of two magisterial districts of the southern
      Transvaal, Ventersdorp and Balfour. The purpose of this study was to determine
      mothers' knowledge and behaviour regarding the health of their children, to
      correlate this with personal and social characteristics of the mothers, and to
      document aspects of their physical environment. Only 50% of mothers had completed
      4 or more years of formal education. One in three had experienced the death of at
      least 1 of her children. Water and sanitation facilities were inadequate for
      most. Little was known about oral rehydration solution preparation or about
      growth monitoring. Most children were breast-fed. Between 50% and 63% of the
      children had vaccinations appropriate for their ages, depending on whether
      evidence from clinic cards or from mothers' memories was taken as valid. The
      single most important determinant of the appropriate knowledge and behaviour of
      mothers was education. Basic living and social conditions of farm workers require
      improvement and the health services must be re-orientated to deliver
      comprehensive primary care.

PMID- 1738911
TI  - Changes in penile skin blood flow following intracavernosal injection of
      papaverine.
AB  - Marked changes in penile skin blood flow following intracavernosal injection of
      papaverine were observed in 14 subjects. Increased flow was more pronounced in
      those patients who failed to achieve erection or had poor erection than in those
      who responded with adequate erection. This observation may explain in part why
      papaverine fails in subjects responding to prostaglandin E1. It raises the
      suspicion of a corporal cutaneous shunt, which may influence the choice between
      the use of an external vacuum device and venous surgery in certain cases of
      venogenic impotence.

PMID- 1738912
TI  - Weskoppies Hospital, founded 1892--the early years.
AB  - The Krankzinnigengesticht te Pretoria (Pretoria Lunatic Asylum) was established
      in 1892 as the first and only psychiatric institution in the Zuid-Afrikaansche
      Republiek (now the Transvaal). The asylum was later renamed Weskoppies Hospital.
      The first 10 years of the hospital's history, including the turbulent years of
      the Anglo-Boer War, are described. Attention is given to the institution's
      management, the diagnosis and treatment of patients and the effectiveness of such
      treatment. The hospital's medical director followed an enlightened approach to
      caring for the mentally ill, in line with the policies of psychiatric hospitals
      in contemporary Europe. However, his ideals of no restraint and minimal
      confinement of patients could not be maintained during the war years owing to
      insufficient accommodation and a lack of suitably trained attendants. It is
      concluded that the humane care of the institutionalised psychiatric patient was
      (and is) not guaranteed by enlightened policies, but depends on sufficient
      resources to put such policies into practice.

PMID- 1738913
TI  - A simple urinary screening test to differentiate between upper and lower urinary
      tract haematuria.

PMID- 1738914
TI  - Causes of perinatal death.

PMID- 1738915
TI  - Causes of perinatal death.

PMID- 1738916
TI  - Immunological status of children with Kawasaki syndrome.

PMID- 1738917
TI  - Inhibition of host-versus-graft and graft-versus-host responses after small bowel
      transplantation in rats by rapamycin.
AB  - The effect of rapamycin (RAPA) on both host-versus-graft (HVG) and graft-versus
      host (GVH) immune responses was examined in small bowel transplant models using
      strongly histoincompatible donor-recipient combinations. Normal Wistar Furth
      (WFu; RT-1u) recipients rejected Buffalo (BUF; RT-1b) small bowel allografts
      within a mean survival time (MST) of 10.5 +/- 0.5 days. Administration of RAPA
      (0.8 mg/kg) by continuous intravenous infusion for 14 days via an osmotic pump
      prolonged graft survival to 25.0 +/- 4.6 days (P = 0.01). In a second strain
      combination, the 12.5 +/- 2.2 day survival of Brown Norway (BN; RT-1n) small
      bowel allografts in Lewis (RT-1l) recipients was prolonged to 21.6 +/- 2.0 and
      28.5 +/- 2.8 days by 14 days of i.v. RAPA at doses of 0.8 and 1.6 mg/kg,
      respectively. In this model RAPA is five times more effective than cyclosporine,
      which at 4.0 mg/kg prolongs BN small bowel allografts in Lewis recipients to 21.6
      +/- 6.3. To isolate HVG and GVH immune responses, (BN x Lewis)F1 hybrid rats
      served as the graft donor or host, respectively. In the HVG model, (BN x Lewis)F1
      small bowel allografts, which were rejected by normal Lewis recipients at 12.2 +/
      3.6 days, were prolonged to 40.8 +/- 5.8 days (P = 0.001) by RAPA (0.8 mg/kg x
      14 days). In the GVH model, the ability of Lewis small bowel allografts to
      produce severe GVH disease in untreated (BN x Lewis)F1 recipients at 12.3 +/- 2.8
      days was delayed to 21.3 +/- 5.2 days by 0.8 mg/kg RAPA (P = 0.025). Thus, RAPA
      protects small bowel allografts more effectively against HVG than GVH immune
      responses.

PMID- 1738918
TI  - Intestinal function following allogeneic small intestinal transplantation in the
      rat.
AB  - This study tests the hypothesis that small bowel transplantation alters the
      function of the intestine. The function of the small intestine was investigated
      after syngeneic (BN----BN or Lew----Lew) and fully allogeneic (BN----Lew)
      orthotopic total small intestinal transplantation (SIT) using a two-stage model.
      All animals were treated with cyclosporine A throughout the 60-day study period.
      Syngeneic transplantation reduced weight gain in the (BN----BN) rats, but not in
      the (Lew----Lew) animals. Allogeneic transplantation caused a reduction in weight
      gain for the first 30 days posttransplantation, which may have been associated
      with graft-versus-host disease. Thereafter, the rate of growth of allogeneic SIT
      animals was normal. Dietary fat absorption was reduced in all groups of
      transplanted animals. Intestinal permeability to mannitol and polyethylene glycol
      400 (PEG-400) was increased by syngeneic transplantation in all groups, with
      further permeability increases to mannitol, lactulose, PEG-400, and 51Cr-EDTA
      after allogeneic SIT. The glucose-stimulated intestinal short circuit current was
      reduced by both syngeneic and allogeneic SIT, but the maximal active transport
      rate for glucose uptake was increased, as was the passive uptake of fatty acids.
      These functional alterations were not associated with changes in intestinal
      morphology or evidence of rejection. These findings demonstrate that: (1) SIT
      results in significant changes in the transport characteristics of the bowel, but
      these have a minimal impact on the well-being of the animal overall; (2) SIT
      induces an increase in intestinal permeability to mannitol and PEG-400, with a
      further increase in permeability to all markers following allogeneic SIT; (3)
      following SIT, and the immune events associated with allogeneic SIT, significant
      adaptation of the transplanted intestine occurs. We suggest that denervation of
      the small intestine after SIT is the underlying cause of the changes observed.

PMID- 1738919
TI  - Effects of cotransplanted fetal liver on fetal pancreas isografts.
AB  - Ricordi et al. described a hepatotrophic effect mediated by pancreatic islets on
      cotransplanted hepatocytes. We found a reciprocal salutary effect of fetal liver
      (FL) on fetal pancreas (FP) in the intramural small bowel (ISB) site. To further
      investigate this intriguing finding, composite FP/FL isografts were transplanted
      to the conventional renal subcapsular (RSC) site and the accessible but
      historically inhospitable intramuscular site in streptozotocin-diabetic Lewis
      rats. A comparison of recipients of FP/FL and FP alone found the proportion
      rendered normoglycemic was site dependent. All recipients of either composite
      FP/FL grafts or FP alone transplanted in the ISB site became normoglycemic. The
      proportion of normoglycemic recipients was lower in the RSC site (71% FP and 40%
      FP/FL) and the i.m. site (14% FP and 67% FP/FL). Importantly, regardless of site,
      normoglycemia was established with an accelerated time course in recipients of
      FP/FL versus FP alone (24 +/- 8 vs. 67 +/- 43 days; P = 0.001). Normal (or more
      rapid) glucose clearance after challenge was achieved in all normoglycemic
      recipients except those transplanted in the RSC site. On histological examination
      of excised FP/FL grafts, hepatocytes were present in association with islets.
      Cyclosporine-induced islet toxicity could not be overcome in 6 recipients of FP
      alone, but 6 of 8 recipients of FP/FL became normoglycemic (P less than 0.01). To
      assess the effect of FP on hepatocytes, allografts (Wistar donors) of FP or FP/FL
      were cotransplanted in the ISB of enzyme-deficient jaundiced Gunn rats.
      Immunosuppression consisted of rapamycin (0.8 mg/kg/day) infused intravenously
      for 4 weeks. In the FP/FL group (n = 4), the mean serum bilirubin level decreased
      from 8.6 to 4.9 mg/dl at 6 weeks after transplantation. This was a significant
      difference as compared with the increased mean serum bilirubin from 6.9 to 7.8
      mg/dl (P less than 0.05; paired Student's t test) in recipients of FL alone (n =
      4). In conclusion, we found a mutual paracrine effect on islets and hepatocytes
      transplanted as a composite FP/FL graft. FL hastened the establishment of
      normoglycemia following transplantation of FP in diabetic rats, and FP enhanced
      FL transplant function in Gunn rats.

PMID- 1738920
TI  - Long-term survival of donor-specific pancreatic islet xenografts in fully
      xenogeneic chimeras (WF rat----B10 mouse).
AB  - We recently reported that reconstitution of lethally irradiated B10 mouse
      recipients with 40 x 10(6) untreated WF rat bone marrow cells resulted in stable
      fully xenogeneic chimerism (WF rat----B10 mouse). In these animals, the tolerance
      induced for skin xenografts was highly MHC specific in that donor-specific WF rat
      skin grafts were significantly prolonged while MHC-disparate third-party
      xenografts were rapidly rejected (median survival time [MST] = 9 days). We have
      now examined whether islet cell xenografts placed under the renal capsule of
      chimeras rendered diabetic with streptozotocin would be accepted and remain
      functional to maintain euglycemia. Animals were prepared, typed for chimerism at
      6 weeks, and diabetes induced with streptozotocin. Donor-specific WF (Rt1Au)
      islet cell xenografts were significantly prolonged (MST greater than 180 days) in
      WF----B10 chimeras, while MHC-disparate third-party F344 rat (Rt1A1) grafts were
      rejected with a time course similar to unmanipulated B10 mice (MST = 8 days). The
      transplanted donor-specific islet cells were functional to maintain euglycemia,
      since removal of the grafts at from 100 to 180 days in selected individual
      chimeras uniformly resulted in return of the diabetic state. These data suggest
      that donor-specific islet cell xenografts are accepted and remain functional in
      mice rendered tolerant to rat xenoantigens following bone marrow transplantation.

PMID- 1738921
TI  - Prolongation of cardiac allograft survival in rats by anti-TNF and cyclosporine
      combination therapy.
AB  - Cyclosporine is well known to have many adverse side effects. However, while
      decreasing the dosage of CsA can reduce its toxicity, this also lowers its
      immunosuppressive effectiveness. Additionally, anti-tumor necrosis factor has
      been demonstrated to have immunosuppressive activity and been shown to prolong
      cardiac allograft survival. This current study therefore investigated the
      efficacy of a combined therapy of anti-TNF with low-dose CsA in a rat heterotopic
      cardiac transplant model utilizing Brown-Norway donors and Lewis recipients.
      Control transplant recipients received no immunotherapy. Experimental animals
      received single-dose anti-TNF intraperitoneally on posttransplant days 0, 3, or 5
      and/or low-dose CsA (1.5 mg/kg/day) intramuscularly from days 0 to 14 after
      transplantation. Rejection was determined by the lack of contractions in the
      transplanted heart. No animal received any other form of immunosuppression. Graft
      survival was significantly prolonged with combination CsA and anti-TNF therapy,
      suggesting a synergistic effect against acute cardiac allograft rejection,
      possibly from CsA and anti-TNF interacting at different levels of the recipient
      immune response. This form of combination therapy may hold promise for future
      immunosuppressive techniques.

PMID- 1738922
TI  - Limitations of heart preservation by cold storage.
AB  - Clinical heart preservation is currently limited to only 4-6 hr, while the
      kidney, liver, and pancreas can tolerate 24-48 hr of cold ischemia. A fundamental
      difference between these organs is that the heart is contractile, containing
      large quantities of actin and myosin, and is susceptible to contracture-induced
      injury caused by energy deprivation. We have quantified and correlated the onset
      of contracture with levels of ATP and glycogen during cold storage in rabbit
      hearts flushed with UW solution, with and without 1 mM calcium (Ca), or 3 mM
      iodoacetate (IAA). A fluid-filled left ventricular balloon was used to generate
      pressure-volume curves (compliance) at 1, 6, 12, 18, and 24 hr of cold storage.
      Onset of contracture occurred in UW stored hearts at 18 hr, contracture in hearts
      exposed to Ca occurred between 6 and 12 hr. Compliance was significantly less in
      hearts exposed to Ca at 12, 18, and 24 hr (P less than .01) than in hearts
      without Ca. ATP levels were well maintained for up to 18 hr in the hearts
      preserved in UW solution (78%), but fell more rapidly in the presence of Ca at 12
      hr (P less than .005), 18 hr (P less than .005), and 24 hr (P less than .05). In
      comparison, the ATP supply of the liver and kidney was exhausted by only 4 hr of
      cold storage. Onset of myocardial contracture correlated with a decrease in ATP
      to less than 80% of control, and contracture accelerated ATP decline 3-6-fold.
      IAA caused nearly complete myocardial contracture and ATP depletion within 2 hr.
      Isolated heart function was 77% and 73% at 6 and 12 hr of storage, but fell to
      54% and 42% at 18 and 24 hr, respectively, coinciding with development of
      contracture. We conclude that ischemic contracture in this model is a major cause
      of myocardial damage during cold storage, and is accelerated by the presence of
      Ca. Other organs can be successfully stored despite exhaustion of ATP reserves.
      Thus successful cold-storage of the heart is highly ATP-dependent. Since cold
      storage inevitably leads to ATP depletion, extension of myocardial ischemic
      tolerance will depend on either reversible inhibition of ATP hydrolysis during
      storage, reversible uncoupling of contracture development from ATP depletion, or
      maintaining ATP production by continuous hypothermic perfusion.

PMID- 1738923
TI  - Beneficial effects of cyclosporine on postischemic liver injury in rats.
AB  - The discovery of cyclosporine has had a significant impact on preventing the
      rejection of transplanted organs in humans. In this study, we present another
      positive aspect of cyclosporine. Rats were pretreated with cyclosporine (10
      mg/kg, i.v.), or untreated. After 2-hr ischemia or 1 hr of reperfusion following
      2-hr ischemia, livers were isolated and liver adenine nucleotide concentrations
      were determined. Liver mitochondria were prepared and their function was
      estimated polarographically. Leakage of AST, ALT, LDH, and adenine nucleotides
      into the hepatic vein just after reperfusion was also measured. Cyclosporine
      treatment did not affect ischemia-induced mitochondrial dysfunction, nor did it
      prevent the associated decrease in adenosine triphosphate concentration. However,
      treatment with cyclosporine accelerated the recovery of mitochondrial function
      and of tissue adenosine triphosphate concentrations. Cyclosporine treatment also
      mitigated leakage of AST, ALT, LDH, and adenine nucleotides after reperfusion.
      These results indicate that cyclosporine shows a potent protective effect on
      ischemia-reperfusion-related liver injury.

PMID- 1738924
TI  - Duodenal mucosal pH as a reperfusion indicator in pancreatic-duodenal
      transplantation in the pig.
AB  - We have studied differences in reperfusion between the pancreas and the duodenum
      after 6 hr of cold storage in a porcine whole-organ pancreaticoduodenal allograft
      transplantation model. Two different flush-out and storage solutions, Perfadex
      and EuroCollins, were compared. Graft duodenal mucosal pH (pHi) was measured as
      an indicator of duodenal mucosal reperfusion. Pancreatic reperfusion was
      estimated indirectly using a ratio between the release of immunoreactive cationic
      trypsin (irCT) to serum 10 and 60 min following reperfusion. Twelve pigs
      (Perfadex n = 6, EuroCollins n = 6) were transplanted and all showed preserved
      endocrine and exocrine function postoperatively. Our data support the concept
      that reperfusion of a pancreaticoduodenal graft can be estimated using duodenal
      pHi and that the ratio of irCT at 10 and 60 min gives an indirect estimate of
      pancreatic reperfusion. The results also show that grafts stored in EuroCollins
      reperfuse more slowly than grafts stored in Perfadex.

PMID- 1738925
TI  - Renal transplant function after ten years of cyclosporine.
AB  - Although the nephrotoxic side effects of cyclosporine are well known, the impact
      of long-term CsA on renal transplant function is uncertain. We studied 5-10-year
      renal function in 347 CsA-treated patients, and in 64 randomly selected non-CsA
      treated patients who had a minimum of 55 months of graft function. Non-CsA
      patients had a lower creatinine (Cr) level at one year than CsA patients (P =
      .001), with no change in renal function over time (P = .6). In CsA-treated
      patients there was also no suggestion of progressive renal damage, as evidenced
      by no change in Cr or 1/Cr. Simple linear regression models of 1/Cr vs. time for
      the first 10 years posttransplant were fit to the data for each patient. Analysis
      of the Y-intercept estimates from these regressions showed that age (P = .001),
      sex (P = .001), cyclosporine toxicity (P = .024), and initial cyclosporine dosage
      (P = .016) significantly affected the one-year serum Cr. Variables not affecting
      one-year Cr included donor source, early rejection episodes, late rejection
      episodes, ATN, diabetes, transplant number, HLA ABDR mismatch (for cadaver
      transplants), maximum PRA, and PRA at transplant. Analysis of the slope estimates
      from the regressions revealed that only age (P = .001) and late rejection
      episodes (P = .001) significantly affected the rate of change in 1/Cr over time.
      We conclude that, in long-term renal transplant patients, there is no evidence of
      progressive deterioration in renal function due to CsA nephrotoxicity.

PMID- 1738926
TI  - The incidence and impact of early rejection episodes on graft outcome in
      recipients of first cadaver kidney transplants.
AB  - The objective of this study was to define the incidence and significance of acute
      rejection occurring in the first year following transplantation. The influence of
      contemporary induction immunosuppression on rejection, as well as the effect of
      rejection on graft and patient loss, renal function, and maintenance
      immunosuppression during the first year in 110 recipients of first cadaver renal
      transplants were analyzed. All patients received CsA, Aza, and prednisone for 30
      days with withdrawal of Aza at 30 days and then prednisone at 105 days; 57
      patients were prospectively randomized to receive ALG (Merieux) until serum
      creatinine was less than 300 mumol/L. Short-term ALG administration did not
      influence the incidence, severity, nature, or outcome of rejection episodes.
      Fifty-five (50%) patients had at least 1 rejection in the first 90 days. All
      patients with delayed graft function and 7/8 (88%) sensitized patients (current
      PRA greater than 50%) had at least 1 rejection episode; 71% (n = 35) of all
      rejection episodes occurred in the first 30 days posttransplant. Patients
      rejection free at 90 days remained rejection free the entire first year. Graft
      loss was 18% for rejections in the first month, 13% for rejections occurring
      later (P = NS); 20% (n = 11) of patients had a second rejection and 1% (n = 2)
      had a third rejection. The risk of graft loss was 9% with a first rejection, 38%
      with a second rejection, and 50% with a third rejection. Of 12 (22%) rejections
      that were steroid resistant, 10 (83%) were reversed with OKT3. One-year graft
      survival for patients without rejection, with steroid-sensitive rejection, and
      with steroid-resistant rejection was 96%, 88% (P = ns), and 58% (P less than
      0.001), respectively; 1 year SCr was 168 +/- 93, 196 +/- 77 (P = ns), and 268 +/-
      96 microMol/L (P less than 0.05), respectively. Patients free of rejection and
      with stable renal function continued to do well on maintenance CsA monotherapy,
      and they were more likely to be on CsA monotherapy than those with rejection
      episodes (P less than 0.01).

PMID- 1738927
TI  - Enisoprost in renal transplantation. The Enisoprost Renal Transplant Study Group.
AB  - Prostaglandins of the E-series (PGE) mediate a wide variety of physiologic
      processes and have been shown to have regulatory roles in cell immunity. Previous
      animal and human trials have shown lower incidence of acute rejection when
      prostaglandins are administered in conjunction with standard immunosuppressives.
      This study evaluated the effects of the PGE analogue, enisoprost (EP), in a
      multicenter (39 centers) prospective, randomized, double-blind trial in 374
      patients undergoing renal transplantation. Groups were placebo, enisoprost 50
      micrograms p.o. q.i.d. (EP-50 micrograms), and enisoprost 100 micrograms p.o.
      q.i.d. (EP-100 micrograms). Patients received cyclosporine, azathioprine,
      corticosteroids, and Minnesota antilymphocyte globulin or OKT3 according to each
      center's protocol. Prophylactic antibody therapy (MALG or OKT3) was not
      randomized. Two hundred fifty-five patients completed the 8-week study period. Of
      the 119 patients who were withdrawn, 73 did so because of an adverse event.
      Rejection episodes occurred in 98 of 374 patients (26%). There was no
      statistically significant difference in the incidence of rejection between
      placebo- and EP-treated patients (P = 0.782). There was no significant difference
      in episodes of cyclosporine nephrotoxicity between placebo- and EP-treatment
      groups (P = 0.883). There was also no difference between incidence of acute
      tubular necrosis, duration of initial hospitalization, or need for
      rehospitalization between placebo- and EP-treated groups. Administration of EP
      was associated with frequent adverse events including elevation of body
      temperature, dyspepsia, and diarrhea. Antibody-treated patients had a higher
      percentage of black recipients, higher mean body weight, greater cold ischemic
      times, fewer living-related donors, and higher panel reactivity. Patients not
      receiving antibody prophylaxis were better matched immunologically than those
      receiving either MALG or OKT3. Despite these immunologic differences, there was
      no significant difference in the incidence of rejection in patients who did or
      did not receive antibody prophylaxis. Cyclosporine toxicity was more common in
      MALG-treated patients (P = 0.02). Renal function was worse in antibody-treated
      patients. There was no detectable effect of enisoprost on the incidence of acute
      rejection, renal function, or hospitalization in a multicenter prospective,
      randomized, double-blind trial in 374 patients undergoing renal transplantation.

PMID- 1738929
TI  - The impact of HLA frequency differences in races on the access to optimally HLA
      matched cadaver renal transplants. The Medical Advisory Committee.
AB  - We examined the donor/recipient HLA match of 448 consecutive cadaver renal
      transplants to determine if donor race had an impact on the quality of HLA match
      that was achieved. Eighty (17.9%) kidneys from black donors and 368 (82.1%) from
      nonblack donors (87.8% caucasians) were distributed to the blood type compatible
      and crossmatch negative recipients on the basis of a local variance of the United
      Network for Organ Sharing (UNOS) point system. There were 278 (62%) nonblack and
      170 (38%) black recipients, numbers close to those of nonblacks and blacks on the
      waiting list (59% and 41%, respectively). Kidneys from nonblack donors
      represented 86% (240/278) of transplants for nonblack and 75% (128/170) of
      transplants for black recipients. The best matches, i.e., zero-A,B,DR, zero-A,B,
      zero-B,DR, and 1-A,B,DR mismatches, for nonblack recipients were solely derived
      from the nonblack donors, and the few well-matched kidneys from black donors were
      distributed to black recipients. Black recipients with zero mismatches were few
      (3, 2%) compared with nonblacks (21, 8%). Kidneys received by black recipients
      were more likely to be poorly matched (5-6 mismatches) if coming from nonblack
      donors (57/128, 44%) than black donors (11/42, 26%), P = 0.035. It was also
      observed from HLA frequency comparisons that well-matched kidneys from nonblack
      donors were rarely distributed to black patients with HLA phenotypes unique to or
      more common in blacks who represented a sizeable portion of blacks on the waiting
      list. We conclude that better donor/recipient HLA matches are achieved when both
      donors and recipients are of the same race. Thus a larger number of black donors
      are needed to improve the quality of HLA matching for potential black kidney
      transplant recipients.

PMID- 1738928
TI  - The ability of pretransplant test-dose pharmacokinetic profiles to reduce early
      adverse events after renal transplantation.
AB  - Pretransplant test-dose pharmacokinetic profiles were used to determine
      individual cyclosporine drug bioavailability and clearance rates in renal
      transplant patients. Assuming a linear relation between dose and area under the
      concentration curve (AUC), starting i.v. and p.o. CsA doses were computed from
      the test-dose results. Target values were 400 ng/ml steady-state concentration
      (Css) during continuous intravenous infusion, and 500 ng/ml average drug
      concentration (Cavss = AUC/dosing interval) after oral administration, based upon
      measurements with the specific monoclonal antibody 3H-tracer radioimmunoassay.
      The outcomes after dose individualization with a 1-(n = 32), 2-(n = 38), or 3-(n
      = 41) hr i.v. infusion test dose and a p.o. test dose (n = 111) were compared
      with 228 historical control patients who received a uniform protocol of CsA i.v.
      at 2.5 mg/kg/day and p.o. at 14 mg/kg/day. The observed Css after i.v. CsA was
      within 10% of the target concentration in 73% of recipients tested with the 3-hr
      protocol, a significantly greater fraction than achieved with either the uniform
      dose (14%), or the 1-(34%) and 2-(25%) hr protocols. Patients in the 3-hr
      protocol group showed reduced incidences of delayed graft function, early graft
      loss, and rejection episodes, and a lower mean serum creatinine value,
      particularly at 7 but also at 30 days posttransplantation. Administration of the
      predicted oral dose produced a peak concentration of greater than or equal to 700
      ng/ml drug absorption in 60% of recipients at 3 days, 90% at 5 days, and 98% at 7
      days. The test-dose method less effectively predicted the appropriate oral CsA
      dose to produce target Cssav and failed to reduce the 90-day rejection incidence.
      Despite its limitations with the more-complicated p.o. route, the test-dose
      method successfully predicts i.v. CsA doses, thereby reducing the incidence of
      early adverse events.

PMID- 1738930
TI  - The large center variation in half-lives of kidney transplants.
AB  - Based on a log-linear model for analyzing multiple effects, center variation in
      the UCLA Transplant Registry is the most influential factor in early renal graft
      survival. Among 68 active centers accounting for 70% of all transplants between
      1985 and 1989, the 1-year graft survival (adjusted for 15 covariates) varied from
      60 to 90%. The long-term graft survival, as measured by the half-lives of the
      first cadaver donor transplants at these centers, based on a minimum of 4 years
      of follow-up data, varied from 3 to 26 years. Although there was some correlation
      (r = 0.24) of half-life with the 1-year graft survival rate at each center, in
      many instances, excellent centers had poor half-lives and average centers had
      excellent half-lives. From a Cox regression analysis on data from 6752 first
      cadaver-donor renal transplants surviving beyond 1 year (submitted to the UNOS
      data base), white female recipients of 0 HLA-AB-mismatched kidneys not requiring
      dialysis in the first week posttransplant had projected half-lives of 14.1 years,
      whereas black male recipients of 4 HLA-AB-mismatched kidneys requiring
      therapeutic dialysis had half-lives of 2.3 years. However, adjustment for these
      factors could only remove 17% of the total variability in the centers' half
      lives. Consequently, any algorithm intended to judge a center's renal transplant
      capabilities should include, even after adjustment for covariates, some function
      of both 1-year graft survival and half-life beyond 1 year.

PMID- 1738931
TI  - The effect of erythropoietin and blood transfusions on highly sensitized patients
      on a single cadaver renal allograft waiting list.
AB  - The effects of EPO on transfusion requirements and HLA allosensitization were
      studied in a group of 145 sensitized patients on a single cadaveric renal
      allograft waiting list. All patients included in the study had PRA levels greater
      than 40% and at least six months of follow-up after the general availability of
      EPO. A total of 108 (74%) of these patients received EPO during the study period
      while 37 (26%) did not. The EPO patients had a much higher incidence of prior
      transfusions than the non-EPO patients (64% vs. 39% P less than 0.05). During the
      follow-up period, there was a marked reduction in transfusion incidence in the
      patients who received EPO from 64% to 14% (P less than 0.05). A lesser and
      nonsignificant reduction in incidence of transfusions was seen in the non-EPO-EPO
      patients. Analysis of PRA levels in the EPO and non-EPO groups demonstrated a
      reduction in PRA levels over time but there was no difference between the two
      groups. When the patients were divided by the need for transfusions in the follow
      up period, a comparison of these two groups demonstrated significant differences.
      At the six-month follow-up point, patients in the nontransfused group had a
      significantly lower mean PRA than the transfused patients (49% vs. 62%,
      respectively, P less than 0.05). Furthermore, a greater number of patients in the
      nontransfused group had PRA declines greater than or equal to 15% compared with
      the nontransfused group (56/46% vs. 4/15%, respectively; P = .007). Stepwise
      logistic regression analysis of possible risk factors for persistent high PRA
      levels demonstrated that continued transfusion was the only significant factor.
      This study suggests that the institution of EPO therapy in sensitized patients on
      a single cadaveric waiting list can result in substantial reduction in the need
      for on-going transfusions. However, the decline in PRA levels appears to be more
      closely tied to the avoidance of transfusion rather than to the specific
      institution of EPO therapy.

PMID- 1738932
TI  - Cadaveric small bowel and small bowel-liver transplantation in humans.
AB  - Five patients had complete cadaveric small bowel transplants under FK506
      immunosuppression, one as an isolated graft and the other 4 in continuity with a
      liver. Three were children and two were adults. The five patients are living 2-13
      months posttransplantation with complete alimentation by the intestine. The
      typical postoperative course was stormy, with sluggish resumption of
      gastrointestinal function. The patient with small intestinal transplantation
      alone had the most difficult course of the five, including two severe rejections,
      bacterial and fungal translocation with bacteremia, renal failure with the
      rejections, and permanent consignment to renal dialysis. The first four patients
      (studies on the fifth were incomplete) had replacement of the lymphoreticular
      cells in the graft lamina propria by their own lymphoreticular cells. Although
      the surgical and after-care of these patients was difficult, the eventual uniform
      success suggests that intestinal transplantation has moved toward becoming a
      practical clinical service.

PMID- 1738933
TI  - The use of marginal donors for liver transplantation. A retrospective study of
      365 liver donors.
AB  - A total of 365 donor hepatectomies performed between May 1985 and March 1990 were
      reviewed and analyzed retrospectively to identify risk factors associated with
      poor graft function and to study the outcome of grafts retrieved from "marginal"
      donors. The donor mean age was 27.1 years (8-69 years). Mean ICU donor stay was
      2.7 days (range 0 to 18 days), and the mean ischemic time was 8.6 hr (range 3 to
      22 hr). The pancreas was retrieved in 39 donors. Donor's weight above 100 kg was
      the only variable found to be associated with both significantly increased 3
      month graft loss (P less than 0.01) and early hepatocellular damage--AST or ALT
      greater than 2000 U/ml, 1st day posttransplant (P less than 0.02). Prolonged stay
      in the ICU (greater than 3 days), although associated with a significantly
      increased rate of hepatocellular damage (P less than 0.05), did not affect early
      graft survival. A systolic blood pressure less than 90 mmHg despite the use of
      high-dose dopamine (greater than 15 micrograms/mg/min), but not each of these
      variables itself, was also associated with a significantly increase rate of
      hepatocellular damage (P less than 0.001). All other variables, including age
      greater than 50, ischemic time greater than 12 hr, combined liver-pancreas
      procurement, and liver function test abnormalities, did not affect the outcome.
      We conclude that extending our limits to accept donors of the higher age group
      and those who have moderately abnormal liver function tests or a prolonged
      ischemic time will not jeopardize our results. It is suggested to perform liver
      biopsy in overweight donors during the retrieval to prevent using grafts with
      severe fatty infiltration. It is hypothesized that hormonal changes, starvation,
      and increased risk to develop infection might jeopardize the outcome of grafts
      from donors with a prolonged ICU stay. Although 70% of the early hepatocellular
      injuries are reversible, the remaining 30% result in graft failure.

PMID- 1738934
TI  - Biliary complications in pediatric liver transplantation. A comparison of reduced
      size and whole grafts.
AB  - One of the major changes in liver transplantation has been the application of
      reduced-size liver transplants(RLT). RLT has the great advantage of expanding the
      donor pool up to ten times the weight of the recipient, thereby decreasing
      pretransplant mortality in the pediatric age group. It has been suggested that
      RLT is a risk factor for biliary complications. To analyze the role of RLT and
      biliary complications, the results of 213 consecutive liver transplants in 164
      pediatric patients over a 6-year period will were reviewed. These included 113
      whole-liver transplants and 100 reduced-size liver transplants (49 reduced
      cadaveric liver transplants (RCLT), 38 split-liver transplants (SLT) and 13
      living-related liver transplants (LRLT). The average weight and age were
      significantly higher in recipients receiving whole-size grafts (average weight
      18.4 mg, average age 4.9 years) than in those receiving reduced size grafts
      (average age 2.3 years, average weight 11.1 kg). Biliary reconstruction consisted
      of Roux-en-Y, cholangiojejunostomy (n = 203) or choledochocholedochostomy (n =
      10). There were 29 total biliary complications, (13.6%) with no significant
      difference in the complication rate between the whole (n = 13, 11.5%) or reduced
      livers (n = 16, 16%). Biliary leakage was the most common complication (n = 20),
      and it occurred at the biliary enteric anastomoses (n = 10), the roux limb (n =
      7), or at the cut edge (n = 3). Of the leaks occurring at the biliary enteric
      anastomoses, 50% were caused by hepatic artery thrombosis. Biliary obstruction
      accounted for their remaining complications (n = 9) or 4.2%. Actuarial survival
      from 6 years to a minimum of two months of follow-up was 73% in the whole-size
      and 70% in reduced-size liver transplants. This series demonstrates that the
      incidence of biliary complications is similar in reduced-size and full-size
      grafts. No grafts were lost to biliary complications in the absence of hepatic
      artery thrombosis.

PMID- 1738935
TI  - Hepatic artery thrombosis in infants. A comparison of whole livers, reduced-size
      grafts, and grafts from living-related donors.
AB  - Hepatic artery thrombosis (HAT) is a major cause of patient morbidity and graft
      loss in pediatric liver transplantation (OLT). Although some grafts may be
      salvaged by arterial thrombectomy and reconstruction, many patients require
      retransplantation. Patient survival is reduced by HAT. It has been suggested that
      the incidence of HAT may be altered by the use of reduced-size grafts (RSG). We
      analyzed our series of infants receiving OLT to determine the frequency of HAT in
      full-size OLT, cadaveric RSG, and living-related RSG. The role of arterial
      anastomotic technique in the development of HAT was also examined. Between
      10/1/84 and 12/7/90 433 liver transplants were performed. During this period 100
      patients between 3 months and 2 years of age (mean 13 months) received 134 liver
      grafts. The mean weight at the time of transplant was 7.9 kg. (range: 1.9-15 kg).
      Of the 134 grafts, 60 were whole livers, 61 were cadaveric RSGs, and 13 were
      living-related RSGs. The cadaveric RSGs were 9 right lobe grafts, 21 left lobe
      grafts, and 31 left lateral segment grafts. Twenty-seven of the cadaveric RSGs
      were from split livers, while the other 34 were simple reductions. All 13 living
      related RSGs were left lateral segments. HAT occurred in 15 of 60 (25%) whole
      livers, 9 of 61 (15%) cadaveric RSGs, and 3 of 13 (23%) of the living-related
      donor RSGs (P = NS). Subdividing the cadaveric RSGs revealed that HAT occurred in
      3 of 9 (33%) right lobe grafts, 3 of 21 (14%) left lobe grafts, and 3 of 31 (10%)
      left lateral segment grafts (P = NS). The site of the arterial anastomosis in the
      recipient correlated with the incidence of HAT (hepatic artery 21/86 [24%],
      celiac axis 1/9 [11%], aorta 2/32 [6%], P = 0.06). In conclusion, it appears that
      use of a cadaveric left lobe or left lateral segment graft and an aortic arterial
      anastomosis reduces the risk of hepatic artery thrombosis in liver transplant
      recipients less than 2 years of age.

PMID- 1738936
TI  - Human islet isolation and allotransplantation in 22 consecutive cases.
AB  - This report provides our initial experience in islet isolation and intrahepatic
      allotransplantation in 21 patients. In group 1, 10 patients underwent combined
      liver-islet allotransplantation following upper-abdominal exenteration for
      cancer. In group 2, 4 patients received a combined liver-islet allograft for
      cirrhosis and diabetes. One patients had plasma C-peptide greater than 3 pM and
      was therefore excluded from analysis. In group 3, 7 patients received 8 combined
      cadaveric kidney-islet grafts (one retransplant) for end-stage renal disease
      secondary to type 1 diabetes mellitus. The islets were separated by a
      modification of the automated method for human islet isolation and the
      preparation were infused into the portal vein. Immunosuppression was with FK506
      (group 1) plus steroids (groups 2 and 3). Six patients in group 1 did not require
      insulin treatment for 5 to greater than 16 months. In groups 2 and 3 none of the
      patients became insulin-independent, although decreased insulin requirement and
      stabilization of diabetes were observed. Our results indicate that rejection is
      still a major factor limiting the clinical application of islet transplantation
      in patients with type 1 diabetes mellitus, although other factors such as steroid
      treatment may contribute to deteriorate islet engraftment and/or function.

PMID- 1738937
TI  - Whence the lungs? A study to assess suitability of donor lungs for
      transplantation.
AB  - Efforts at clinical lung transplantation have been hampered by an insufficient
      donor pool. To estimate the number of potential suitable lung donors, we
      conducted a UNOS-sponsored survey of organ procurement organizations and
      collected data with respect to possible lung donation from human cardiac donors.
      Contact with OPOs was made by telephone after cardiac donors were identified by
      UNOS. Of 150 cardiac donors, 7 were utilized for lung or heart-lung
      transplantation. By our criteria, however, 47 additional donors had lungs that
      may have been suitable for transplantation but were not utilized, and frequently
      were not offered for transplantation for a variety of reasons. This survey
      implies that approximately 25% of cardiac donors likely have lungs that may be
      suitable for transplantation.

PMID- 1738938
TI  - Social rehabilitation and return to work after cardiac transplantation--a
      multicenter survey.
AB  - As the medical results of heart transplantation steadily improve, the social
      rehabilitation of patients, in particular, their ability to return to some form
      of employment, is becoming increasingly important. Two-hundred fifty patients
      were therefore surveyed at 7 heart transplant centers (5 of which were Medicare
      certified) from different geographic regions in the U.S.A. Over all, 45% were
      employed, 36% were unemployed, 13% were medically disabled, and 6% were retired.
      Of those employed, 87% had returned to their previous employment, and only 13%
      had secured new employment. Of the unemployed, 16% had made job applications, and
      no fewer than 63% had no current plan to seek employment. Factors found to
      negatively influence a return to work included the following: (1) length of
      medical disability prior to transplantation; (2) a patient's self-perception of
      being physically unable to work; and (3) the potential loss of health insurance
      and/or disability income. At 2 centers, where there was a definite policy of not
      supporting a patient's claim for medical disability in the absence of an absolute
      indication, there were significantly increased numbers who (1) secured new
      employment and (2) planned to seek employment. More serious attention must be
      paid to aspects of employment if heart transplant recipients are to become fully
      productive members of the community.

PMID- 1738939
TI  - HLA in human serum--quantitation of class I by enzyme immunoassay.
AB  - A solid-phase, enzyme-linked immunoassay was used to quantitate the soluble
      fraction of HLA-class I. The sera of 318 individuals were studied, as well as the
      urine of six individuals with normal renal function. The stability of blood
      concentrations of the soluble HLA was also evaluated. The data justify the
      following six conclusions. (1) All normal people have circulating HLA (mean = 357
      ng/ml). (2) The population can be divided into one group of low secretors (mean =
      162.4 +/- 65.2 ng/ml) and another group of high secretors (mean = 540.7 +/- 185.9
      ng/ml) (P less than 0.01). (3) Blood levels in each individual are reasonably
      consistent over short (days) and long (years) periods of time. (4) The mean
      concentration of soluble HLA-class I in all renal failure patients was 590 ng/ml,
      significantly higher than normal (P = less than 0.05); it was highest in patients
      on peritoneal dialysis (mean = 683 ng/ml) in spite of substantial chronic loss in
      peritoneal dialysate. (5) Renal allograft recipients with stable allograft
      function also had mean values greater than normal at 554 ng/ml (P less than
      0.05). (6) Soluble HLA-class I was not detected in the urine of individuals with
      normal renal function.

PMID- 1738940
TI  - Intragraft cytokine profile during human liver allograft rejection.
AB  - Forty-three human liver allograft biopsies and normal liver were directly
      analyzed for inflammatory and immunoregulatory cytokine gene expression by
      polymerase chain reaction (PCR). IL-5 gene expression was predominantly present
      in biopsies from liver allografts with histopathological evidence of acute
      rejection. IL-2 gene expression was rarely observed in rejecting allografts or
      allografts without evidence of rejection. In contrast, IL-4 message was readily
      detectable in the majority of liver allografts regardless of clinical status. The
      inflammatory mediators IL-1 beta, TNF-alpha, and IL-6 were detected with similar
      frequency in rejecting allografts and allografts without evidence of rejection.
      These findings suggest that inflammatory and immunoregulatory cytokines are
      produced within the allograft. Moreover, IL-5 may play a role in the local
      mechanisms of liver allograft rejection.

PMID- 1738941
TI  - Assessment of the in vivo immunosuppressive activity of the major cyclosporine
      metabolite by leukemia allograft rejection.
AB  - AM1 (M17) is the major metabolite of cyclosporine found in the blood of human
      transplant recipients, and trough levels of this derivative exceed those of the
      parent compound approximately two-fold. Studies performed in vitro indicate that
      AM1 retains only 10-20% of the biological activity of the parent compound, but
      very little is known about its in vivo immunosuppressive effects. We therefore
      developed a rapid and sensitive method, based on the rejection of allogeneic
      L1210 (H-2d) leukemia cells by C57BL/6 (H-2b) mice, to assess the
      immunosuppressive activity of AM1 in vivo. Rejection of the leukemia allograft
      was determined by analyzing the spleens from mice injected intravenously with
      10(5) L1210 cells for the presence of H-2Kd-positive cells by flow cytometry
      using an FITC-conjugated monoclonal anti-H-2Kd antibody. Nonimmunosuppressed mice
      rejected the allogeneic cells and survived indefinitely. Spleens from these mice
      were virtually free of H-2Kd-positive cells (0.51 +/- 0.21%) by day 7. In
      contrast, C57BL/6 mice treated with 10 mg/kg/day s.c. of CsA all died from the
      L1210 challenge (mean survival time of 9 +/- 1 days). Spleens from mice treated
      in this manner contained 11.02 +/- 3.31% H-2Kd-positive cells on day 7. There was
      a direct correlation between the dose of CsA administered (7.5-50 mg/kg/day) and
      the percentage of H-2Kd-positive cells in the spleen. We then compared the
      immunosuppressive activity of AM1 and CsA in this model. AM1 was purified from
      the urine of CsA-treated renal allograft recipients by a combination of
      preparative adsorption-desorption chromatography and preparative elution high
      performance liquid chromatography. AM1 at a dose of 10 mg/kg/day exhibited no
      demonstrable immunosuppressive effect, and trough levels of AM1 on day 7 were
      only 36 +/- 4 ng/ml. Increasing the dose of AM1 to 50 mg/kg/day resulted in only
      1.05 +/- 0.16% H-2Kd-positive cells in the spleens (P = NS) and a mean trough
      level of 221 +/- 27 ng/ml. In contrast, mice treated with 50 mg/kg/day of CsA
      exhibited 17.7 +/- 2.9% H-2Kd-positive cells in their spleens and a mean trough
      CsA level of 3036 +/- 277 ng/ml. The half-life of a single subcutaneous dose of
      10 mg/kg of AM1 (4.6 hr) was significantly shorter than that of CsA (9.7 hr) in
      mice. Compared with CsA, the lack of immunosuppressive effect of AM1 in vivo
      therefore appears to be due to a combination of decreased immunosuppressive
      activity and increased rate of clearance in mice.

PMID- 1738942
TI  - Skin xenograft rejection in Xenopus--immunohistology and effect of thymectomy.
AB  - Immunohistology, using the T-lineage-specific monoclonal antibody XT-1 and an
      anti-IgM mAb, illustrates differences in the cellular basis of skin allograft and
      xenograft destruction displayed by control froglets (X. laevis). Thus T cells
      predominate within allografts, whereas B-lineage cells accumulate under
      xenografts (from X. tropicalis). The possibility that T cells do not play a
      central role in mediating xenograft rejection is consistent with the finding that
      early thymectomy (at 7 days) has minimal effect on rejection end points of X.
      tropicalis transplants. However, rejection of skin from a "phylogenetically less
      distant" xenogeneic species (X. borealis) is shown here to be impaired in early
      thymectomized X. laevis. Differences in the extent to which the thymus has been
      shown to influence skin xenograft rejection in Xenopus are discussed.

PMID- 1738943
TI  - Comparison of UW and Euro-Collins solutions in paired cadaveric kidneys.

PMID- 1738944
TI  - Whole-organ transplant of an annular pancreas.

PMID- 1738945
TI  - Recurrent variceal bleeding after liver transplantation--persistent left-sided
      portal hypertension.

PMID- 1738946
TI  - A major difference in the mechanisms of neonatally induced tolerance and
      cyclophosphamide-induced tolerance.

PMID- 1738947
TI  - Hemostasis at the time of renal transplantation for bleeding following core
      biopsy.

PMID- 1738948
TI  - [Mandatory ambulatory labor].

PMID- 1738949
TI  - [The main obstetrical problems].
AB  - Development og antenatal care and obstetrics in Denmark during the past decades
      has been carried out by distribution of advisory guiding principles from the
      Ministry of the Interior (Ministry of Health) and the Board of Health, most
      recently in 1985. On the basis of a review of the current problems in obstetrics,
      reassessment of the guiding principles is suggested, particularly development of
      obstetrics on the basis of well controlled assessments of new possibilities. As
      possibilities for improving the results of obstetrics, the problems concerning
      preconceptional examination, alternative methods, mini-centre arrangements, care
      of sick pregnant women in their own homes, employment of ultrasound and
      cardiotocography are described. Modern furnishing of maternity departments,
      improved midwifery and better cooperation between the staff groups involved are
      considered necessary to ensure that maternity care in Denmark can become even
      better than it is at present.

PMID- 1738950
TI  - [The course of postpartum period after mandatory ambulatory labor].
AB  - Mandatory early discharge for all normal multiparae was introduced as a trial
      arrangement in the County of Ringkobing from 1.1.1990. A total of 113 early
      discharged women and 90 patients who remained in hospital participated in a
      questionnaire investigation comprising 41 questions about problems and need for
      support during the first postpartum period and about satisfaction with the
      postpartum period. A total of 64% of all the multiparae were early discharged and
      were discharged 4.2 hours after the delivery. On the whole, the women were
      satisfied with the postpartum period and only few problems in infants or mothers
      occurred. The early discharged group, however, as compared with the control
      group, stated that they had received less satisfactory support concerning breast
      feeding (p less than 0.005) and that, in general, they had received less support
      from friends (p less than 0.01) and hospital staff (p = 0.04). The group of early
      discharged felt that they had received less satisfactory information (p less than
      0.005) and, on the whole, they were less satisfied with the postpartum period (p
      less than 0.005). In addition, the group who were early discharged had 67% more
      telephone conversations with and 127% more visits from the midwife, health nurse
      or practitioner.

PMID- 1738951
TI  - [Strategy for delivery in breech presentations. A retrospective study].
AB  - A six-year material of 236 singleton breech deliveries at term was evaluated
      retrospectively. Infants who were small for the gestational ages at birth were
      excluded. Vaginal delivery proved successful in 41.1% of the material. The
      vaginal success rate was 61.8. Low parity and age and high birth weight reduced
      the vaginal success rate. The route of delivery did not affect the outcome in
      terms of infantile morbidity or mortality. Nevertheless, an increased number of
      neonates with congenital disorders was observed. It is concluded that trial of
      vaginal delivery may be employed in a selected group of pregnant women with
      breech presentations without increasing the risk of adverse effects of the
      neonate.

PMID- 1738952
TI  - [Xerostomia caused by radiotherapy of patients with head and neck cancer].
AB  - Xerostomia causes great inconvenience in patients treated with irradiation for
      cancer of the head and neck. For all practical purposes, salivary gland tissue
      becomes irreversibly incapable of functioning after doses of 40 Gy (standard
      fractioning). Curative doses are 60-70 Gy and, therefore, xerostomia can only be
      limited by attempting to involve as little as possible of salivary gland tissue
      in the irradiation fields. The limits of the tumour should be diagnosed as
      exactly as possible so that the irradiation fields are not made any larger than
      necessary "for safety". Therapeutic techniques which involve salivary gland
      tissue on only one side should be elected when this is justifiable. It is
      important to inform the patient about caries prohylaxis and the patient's own
      dentist should be involved in the problem as early as possible. Prophylatic
      fluorine treatment should be offered to alle of the patients.

PMID- 1738953
TI  - [Self assessment of the functional level in a group of psychiatric patients on
      admission and discharge. Aspects of the reliability of the Sickness Impact
      Profile].
AB  - A comparison was undertaken between a method of personal assessment of the
      functional level and the health related quality of life, the Sickness Impact
      Profile (SIP) and a method based on observers, the Nurses' Observation Scale for
      Inpatient Evaluation, in a little group of mentally ill patients. This revealed
      good sensitivity as regards the registered effect of treatment and fairly good
      agreement between the results. SIP has gradually been demonstrated to be a well
      proved and widely employed method within many medical specialties with both
      internal and external validity.

PMID- 1738954
TI  - [Differential diagnosis in acute chest pain and suspected myocardial infarction.
      A pilot study].
AB  - In half of the patients admitted with chest pain on suspicion of an acute
      myocardial infarction (AMI), this diagnosis is not confirmed (non-AMI). Both AMI
      and non-AMI patients have a mortality which exceeds the mortality of the
      background population in the years following discharge based on a high incidence
      of cardiac death. As a pilot investigation, a comprehensive investigation
      programme was tested in 32 consecutive non-AMI patients. The possible organic
      causes of acute chest pain were thus illustrated systematically in each
      individual patient. In ten of the patients, a definitive diagnosis was
      established within the first 24 hours of admission and no further investigation
      was thus performed. The remaining 22 patients participated in the planned
      investigation programme. In 30 of the patients (94%) a probable organic cause for
      the chest pain was found. This investigation demonstrates that the investigation
      programme is employable and it suggests that the cause of chest pain in non-AMI
      patients usually can be placed in one of the three main groups: 1) IHS, 2)
      oesophageal disease and 3) physiurgic conditions.

PMID- 1738955
TI  - [Formaldehyde in textiles as a possible cause of arthritis and angioedema].
AB  - A case of arthritis and angioedema which developed on occupational exposure to
      formaldehyde in textiles is described. Possible pathological mechanisms are
      discussed. The suspicion that an unknown immunological reaction may be the cause
      is raised.

PMID- 1738956
TI  - [Pyomyositis].
AB  - Pyomyositis (PM) is characterized by bacterial infection and suppuration of
      striated muscle. It is very rarely encountered in temperate climates. Only five
      cases have hitherto been reported in Denmark. Two cases of PM are presented. Both
      of these demonstrate the difficulty of establishing early diagnosis and the
      severe complications of PM.

PMID- 1738957
TI  - [Crisis intervention--a task for the district psychiatry?].

PMID- 1738958
TI  - Coxarthrosis on the island of Gotland. Increased prevalence in a rural
      population.
AB  - On the island of Gotland and in the city of Malmo, the prevalence of coxarthrosis
      was calculated using the hip projections in colon roentgen examinations. The
      prevalence of coxarthrosis among the Gotland islanders was about twice that of
      the Malmo urbanites, and the condition became obvious earlier in life. The
      population of the local Gotland city of Visby did not contribute to this
      difference; the difference was entirely due to an increased incidence in the
      rural population of the island. Heavy labor in conjunction with farming is
      believed to be the cause of the deviation.

PMID- 1738959
TI  - Uptilting osteotomy of the lateral tibial plateau for a knee deformity. A case
      report.
AB  - A middle-aged woman had had anterior poliomyelitis at 11 years of age that had
      left her with residual weakness in both legs. She gradually developed a
      recurvatum and valgus deformity in both knees, which caused pain and instability.
      A technique to restore the top of the tibia by means of a rotational osteotomy of
      the lateral tibial plateau is presented. This operation resulted in painless,
      asymptomatic knees and improved function.

PMID- 1738960
TI  - Posttraumatic ulnar translation of the carpus. A case report.
AB  - A 24-year-old miner sustained wrist trauma in a car accident. The initial
      radiographs showed a dorsal rim fracture of the radius without any dislocation of
      the wrist. Fourteen days later, radiography revealed a total ulnar translation of
      the carpus. Open reduction was performed with a good clinical and radiographic
      result.

PMID- 1738961
TI  - Simultaneous occurrence of trapezium-scaphoid-trapezoid dislocation and multiple
      carpometacarpal fracture dislocations. A case report.

PMID- 1738962
TI  - Mixing does not improve mechanical properties of all bone cements. Manual and
      centrifugation-vacuum mixing compared for 10 cement brands.
AB  - Contemporary mixing methods--centrifugation, vacuum mixing with or without
      precompression--were compared with manual mixing by testing strength
      characteristics in accordance with a proposed revision of the international
      standard for bone cements as applied to 10 cement brands. Simplex brands and low
      viscosity cements were the strongest, and were not improved by any of the vacuum
      mixing procedures. Centrifuging was found unsuitable for low-viscosity cements.
      Without attaining the strength of the former, the cements best suited for
      auxiliary mixing methods were CMW-1 and Palacos brands, which improved 6-11
      percent by either of the methods. The Sterivac system was generally found
      unacceptable, because about 20 percent of a cement package was retained in the
      mixing gear, and the application of precompression had no additional effect on
      compressive and bending strengths.

PMID- 1738963
TI  - Cefuroxime for prevention of postoperative coxitis. One versus three doses tested
      in a randomized multicenter study of 2,651 arthroplasties.
AB  - Infection prophylaxis in hip replacement with one perioperative dose of
      cefuroxime was evaluated in a randomized controlled multicenter study using a
      three-dose regimen as a control. All the operations were performed in
      conventionally ventilated operating theaters. Of the 2,796 hip replacements
      entered in the study, 145 replacements were excluded because of protocol
      violations. The remaining 2,651 hip replacements were analyzed: 1,327 and 1,324
      in the one- and the three-dose group, respectively. There were no differences
      between the one-dose and the three-dose groups as regards the incidence of
      postoperative wound-healing problems, and urinary tract or other distant
      infections. The use of additional antibiotics after the perioperative prophylaxis
      did not differ between the treatment groups. After a mean follow-up period of 13
      months, joint sepsis was diagnosed in 11 of the patients in the one-dose group
      (0.83 percent) and in 6 of the patients in the control group (0.45 percent). This
      difference was not significant. Because the estimated difference between the one
      dose and the three-dose group was 0.38 percent, we could not confirm that the
      efficacy of one dose was equal to three doses. An extended follow-up study, with
      more cases of joint sepsis, may provide more conclusive data. Until then, a three
      dose regimen is recommended.

PMID- 1738964
TI  - The irritable hip. Scintigraphy in 192 children.
AB  - Over a 4-year period, 192 patients with a typical transient synovitis syndrome
      underwent radionuclide scintigraphy shortly after presentation. Three different
      patterns were found suggesting that all the cases may not be of the same
      etiology. Fifteen patients had evidence of ischemia of the femoral head, but only
      4 patients went on to develop the typical radiographic features of Perthes'
      disease. The other 11 patients are thought to represent a minor, radiographically
      silent form of Perthes' disease.

PMID- 1738965
TI  - Femoral anteversion in normal adults. Ultrasound measurements in 50 men and 50
      women.
AB  - The femoral anteversion (AV) angles were measured by ultrasound in a normal group
      of 100 adult subjects to find the normal range of anteversion, to determine the
      normal left/right difference, to assess the interobserver variation, and to find
      the correlation between AV angle and clinical hip rotation. All the ultrasound
      measurements were performed independently by 2 observers. The mean AV angle was
      18 degrees in the women and 14 degrees in the men. The mean left/right difference
      in AV was 3.8 degrees, and the upper normal limit of side difference (mean +/- 2
      SD) was 9.8 degrees. The mean (SD) interobserver variation was only 1.9 degrees
      (1.3 degrees). The correlations between AV angles and internal and external hip
      rotation were significant, but not very high (r = 0.49 and -0.49, respectively).
      We conclude that ultrasound is appropriate for measurement of femoral
      anteversion. Our results could be used as a basis when evaluating patients with
      clinically suspected rotational disorders of the femur.

PMID- 1738966
TI  - The displacement of the femoral head by rotational acetabular osteotomy. A
      radiographic study of 97 subluxated hips.
AB  - To determine the limits of medial and inferior displacement of the subluxated
      femoral head by rotational acetabular osteotomy, we studied the acetabular
      coverage and position of the femoral head radiographically before and after
      surgery in 97 hips. The median age of the patients at the time of surgery was 33
      (18-54) years. The position of the femoral head was represented by its center and
      medial and upper borders. The average increase and decrease in the CE and the AC
      angle were 39 degrees and 27 degrees, respectively. The average medial
      displacement of the head was 8 (-12 to +19) mm measured from its center, and 7 (
      10 to +21) mm measured from its medial border. The average inferior displacement
      was 5 (-6 to +19) mm from its center and 4 (-10 to +15) mm from the upper border.
      These results indicate that concentric reduction by rotational acetabular
      osteotomy is limited and that medial displacement of the subluxated femoral head
      is within similar ranges obtained by other conventional pelvic osteotomies.

PMID- 1738967
TI  - Osteonecrosis of the femoral head in spontaneously hypertensive rats. Relation to
      ossific nuclei during growth.
AB  - We observed the distribution of the ossific nuclei and the occurrence of
      osteonecrosis in the femoral capital epiphysis of spontaneously hypertensive
      rats. In 270 femoral heads, the ossific nuclei were seen in the following sites
      of the epiphysis: Type 1, the lateral portion in 150 femoral heads; Type 2, the
      central portion in 5 heads; Type 3, both lateral and central portions in 12
      heads; and Type 4, throughout the epiphysis in 62 heads. The number of femoral
      heads with osteonecrosis in Types 1-4 was 61, 0, 5, and 17, respectively.

PMID- 1738968
TI  - Oral cefadroxil prophylaxis in hip fracture surgery. Serum concentrations studied
      in 17 patients.
AB  - Serum concentration-time curves were determined in seventeen 82 (60-90) year-old
      patients undergoing trochanteric hip fracture surgery after receiving 1 g of
      cefadroxil per os. All the patients attained a serum level of antibiotic high
      enough to inhibit the growth of Staphylococcus aureus and S. epidermidis. When
      orally administered, cefadroxil should be given within 2 hours before surgery.

PMID- 1738969
TI  - Uppsala screws or Hansson pins for internal fixation of femoral neck fractures? A
      prospective study of 180 cases.
AB  - In a prospective randomized trial, two methods of internal fixation of femoral
      neck fractures were compared. Totally, 179 patients with 180 fractures were
      treated with either two Uppsala screws (n 96) or two Hansson pins (n 84). In all,
      130 fractures were primarily displaced (Garden stages III and IV), whereas 88
      percent of the fractures in both groups were well reduced. The patients were
      followed clinically and radiographically for 1 year. Thirty-six patients died
      within 12 months after the operation. The functional results and the incidence of
      segmental collapse and nonunion did not differ between the groups. However, at
      the 4-month follow-up, 2 of 59 of the Garden's stages III and IV in the Uppsala
      screw group were found displaced, whereas the corresponding result in the Hansson
      pin group was 9 of 52 (P = 0.03).

PMID- 1738970
TI  - Implant holding power of the femoral head. A cadaver study of fracture screws.
AB  - The holding power against axial pull-out forces of eight different screws
      implanted in the femoral heads of cadavers was tested. The Olmed screw had the
      greatest resistance to pull-out forces followed by the recently designed Ullevaal
      screw with long threads, and the von Bahr screw. There were substantial
      differences in the holding power in the four sectors of the femoral head. The
      holding power was strongly correlated with the logarithm of the moment of inertia
      of the screw threads, which is a function of the area and number of the threads
      (r = 0.94, P = 0.0002).

PMID- 1738971
TI  - Fractures of the femoral shaft in children treated with an AO-compression plate.
      Report of 12 cases followed until adulthood.
AB  - Thirteen femoral shaft fractures in 12 children aged 0-15 years were each treated
      with an AO-compression plate. The mean age at operation was 11 (6-14) years, and
      all the patients were followed until closure of the growth plates. No deep
      infections occurred, and all the fractures healed without angulation of rotation.
      The mean overgrowth was 7 (-9-25) mm. All the patients had unrestricted movement
      in the hip and knee, and had no complaints at the follow-up examinations. We
      conclude that plate osteosynthesis of femoral shaft fractures in children is a
      safe and reliable method for internal fixation when use of traction is not
      possible.

PMID- 1738972
TI  - Retrofascial pyogenic iliac fossa abscess. 20 cases studied by ultrasonography.
AB  - Twenty patients with a pyogenic iliac fossa abscess were analyzed. The main
      clinical signs were fever, limp, pain, and flexion deformity of the hip.
      Ultrasonography was a reliable diagnostic test.

PMID- 1738973
TI  - Treatment of 84 cases of femoral nonunion.
AB  - Eighty-four femoral nonunions were treated with Kuntscher nailing, Grosse-Kempf
      locked nailing, plating, and Huckstep nailing, and were followed-up for a median
      of 34 months. Kuntscher nailing and locked nailing were superior, with fewer
      complications, less operation time, and less blood loss. A Kuntscher nail was
      preferred for the isthmic region when there was no shortening of the bone, and a
      locked nail was preferred above or below this region or when lengthening was
      indicated.

PMID- 1738974
TI  - Effects of intramedullary reaming and nailing on blood flow in rat femora.
AB  - The right femur in 40 rats was reamed, and in 40 others it was additionally
      nailed. Analysis of bone blood flow was performed by the distribution of
      radiolabeled microspheres at different postoperative time intervals. Blood-flow
      measurements were accompanied by analyses of hydroxyproline and calcium contents.
      Immediately after reaming, the blood flow of the diaphyseal part of the femur was
      reduced to approximately one third of that of the intact femur, whereas the
      contents of hydroxyproline and calcium were reduced by 10 percent. Within 1 week,
      the blood flow was normal. This study provides evidence that the presence of a
      nail does not interfere with the restoration of bone blood flow. Restoration of
      blood flow in bone apparently is a rapid process. The replacement of
      hydroxyproline and calcium contents seemed to be linked to flow, as no increase
      in these constituents were found until the blood flow had approximated the level
      of the intact femur.

PMID- 1738975
TI  - Biodegradable guide for bone regeneration. Polyurethane membranes tested in
      rabbit radius defects.
AB  - Segmental, 1-cm osteoperiosteal defects were produced in both radii of 10
      rabbits. One defect was covered with a biodegradable polyurethane membrane formed
      as a tube. The contralateral defect served as an untreated control. Healing was
      analyzed by radiographic and histologic studies after 5 weeks. Nine out of 10
      control defects displayed nonunion, whereas membrane-treated defects consistently
      healed by forming callus external to the membrane fusing the bone fragments.
      Loose connective tissue was predominant in the bone gap underneath the membrane.
      Presumably, the membrane has served as a scaffold for regenerating periosteum.

PMID- 1738976
TI  - Renal function not impaired by hip arthroplasty. A prospective study of 26
      patients.
AB  - To evaluate the importance of various changes during major surgery, 26 patients,
      electively chosen for total hip replacement (THR), were investigated for renal
      function preoperatively and postoperatively. In most of the patients, surgery was
      performed ad modum Charnley (n 25), and anesthesia was given mainly by continuous
      administration of bupivacaine or mepivacaine through an epidural catheter.
      Postoperatively, there was an improvement in glomerular filtration rate (GFR) and
      a reduction in renal concentrating ability (RCA), but no change in diurnal
      albumin excretion. No correlation was found between the change in GFR and, e.g.,
      the degree of peroperative hypotension, bleeding, transfusions, or volume of
      infusions. There was a correlation between the impairment of RCA and the lowering
      of serum albumin concentration. In 3 patients the GFR was slightly impaired. The
      risk of contracting severe, acute renal failure seems low in THR performed on
      patients with reduced or normal kidney function.

PMID- 1738977
TI  - Effects of function on rat femora.
AB  - We evaluated the mechanical effects of different degrees of function and weight
      bearing on intact rat femora. Thirty rats were allocated to either an exercising,
      a nonweight-bearing, or a control group. The exercising rats were trained on a
      treadmill with a 6 weeks' running program of progressive intensity and duration.
      In the nonweight-bearing group, the left achilles tendon was severed at its
      insertion. The control rats were allowed normal activity. After 6 weeks, the
      animals were killed. The maximum bending moment and bending rigidity were
      increased in the exercised rats, whereas no differences were found between the
      control and nonweight-bearing rats. Bone weight and bone dimensions did not
      differ in the three groups. In the nonweight-bearing group, the maximum bending
      moment and bending rigidity were higher in the nonoperated on limb, as well as
      the outer and inner bone dimensions and the area moment of inertia. Our results
      indicate that exercise improves the mechanical characteristics of bone.

PMID- 1738978
TI  - Patellar complications after knee arthroplasty. A prospective study of 56 cases
      using the Kinematic prosthesis.
AB  - A prospective study on 56 knees was performed to analyze the incidence and cause
      of patellar complications following total knee arthroplasty with the Kinematic
      prosthesis inserted with the Universal Instrumentation system. Patellar
      complications occurred in 23 cases: 15 had anterior knee pain. There was 1 case
      of patellar fracture. Subluxation of the patella occurred in 13 cases, of which 6
      were painful. Although the mechanical alignment was correctly reconstructed to
      neutral in all but 2 cases, the instrumentation tended to allow malpositioning of
      the components into excessive femoral valgus and compensatory excessive tibial
      varus that predisposed to patellar subluxation. With this prosthesis and
      instrumentation, patellar stability is hindered by a very short anterior femoral
      flange, a shallow patellar groove, and insertion of the components at 3 degrees
      to the mechanical axis. It should be ensured that the components are correctly
      positioned, that patellar stability is carefully checked before closing the
      capsule, and that lateral release is performed more often.

PMID- 1738979
TI  - Laxity and graft fixation after reconstruction of the anterior cruciate ligament.
      A roentgen stereophotogrammetric analysis of 11 patients.
AB  - The sagittal laxity of the knee was measured in 11 consecutive patients with
      chronic anterior cruciate ligament deficiency before and 1 year after ligament
      reconstruction with a free bone-tendon-bone graft from the patellar tendon
      (modified Clancy technique). Tantalum markers were implanted in the femur, in the
      tibia, and in the graft for roentgen stereophotogrammetric analysis (RSA) of the
      sagittal laxity and the migration of the bony ends of the graft. The precision in
      measurements of total anterior-posterior displacement (+/- 2 SD of the
      differences between repeated measurements) was 2.2 mm. A decrease in total
      anterior-posterior displacement from 12 mm before reconstruction of 5 mm 1 year
      postoperatively using a stress load of 150 N was found. The bony ends of the free
      graft migrated maximally 0.7 mm, implying adequate fixation.

PMID- 1738980
TI  - Postoperative complications of distal humeral fractures. 27/96 adults followed up
      for 6 (2-10) years.
AB  - Of 96 adult patients with a distal intercondylar, intraarticular fracture of the
      humerus treated operatively during a 10-year period, 27 patients suffered a local
      complication, while the total number of individual complications were 34. There
      were six postoperative infections, 12 neural injuries, and 16 fixation failures.
      Because of the complication, a reoperation was performed in 12 of the 27
      patients. The final outcome was assessed at a reexamination after a mean follow
      up period of 6 (2-10) years. Three patients had a permanent dysfunction of the
      ulnar nerve. In another 3 patients, failure of the fixation had resulted in an
      established nonunion of the distal humerus. It appeared that the possibilities of
      internal fixation in several cases had been overestimated.

PMID- 1738981
TI  - Sympathetically mediated anterior knee pain. Scintigraphy and anesthetic blockade
      in 19 patients.
AB  - Nineteen patients with anterior knee pain without the classical features of
      reflex sympathetic dystrophy (RSD) were investigated by local anesthetic
      sympathetic blockade. Scintigraphy was performed before the sympathetic blockade
      in all the cases, and the scintigraphic appearances were correlated with the
      clinical response. Eleven patients responded to the blockade (9 good and 2 fair).
      Only 1 out of 10 patients with increased scintigraphic uptake failed to respond,
      whereas 7 out of 9 patients with normal uptake failed to respond. Our study
      suggests that a sympathetically mediated component may exist in patients with
      anterior knee pain without RSD, and that scintigraphy is useful in identifying
      those patients for whom sympathetic blockade may be helpful.

PMID- 1738982
TI  - A case of multifocal liposarcoma?
AB  - A 53-year-old man presented with a grade 2 liposarcoma in his left thigh and
      grade III liposarcomas in the mediastinum and omentum. Later, a grade 2 tumor was
      discovered in the musculature of his right thigh. In addition to recurrences, he
      developed lesions that were considered metastatic. He died 3 years later of
      multiple lesions. The case may represent a multifocal liposarcoma, which has been
      previously reported in only 35 cases.

PMID- 1738983
TI  - Blunt upper abdominal trauma: evaluation by CT.
AB  - CT is the technique of choice for initial examination of hemodynamically stable
      patients after blunt abdominal trauma. It is highly sensitive, specific, and
      accurate for use in detecting the presence or absence of injury and defining its
      extent. Nonoperative management of many posttraumatic injuries, particularly in
      the liver, spleen, and kidney, is possible in part because of the diagnostic
      usefulness of CT. CT can be used effectively to visualize the progression of
      liver and spleen injuries in those patients chosen for conservative management.
      CT helps in treatment decisions in patients with renal injury by defining the
      character and extent and distinguishing minor from severe renal trauma.
      Posttraumatic injuries to the pancrease, bowel, and mesentery can be detected
      with CT. In these areas, however, signs may be subtle, and a significant injury
      may be missed on an initial examination.

PMID- 1738984
TI  - Acute adrenal injury after blunt abdominal trauma: CT findings.
AB  - During a 32-month period, adrenal injuries were diagnosed in 20 (2%) of 1120
      patients who had abdominal CT for assessment of blunt force trauma. Injuries were
      unilateral in 17 patients (12 right-sided and five left-sided) and bilateral in
      three (23 total adrenal injuries) and were accompanied by concurrent ipsilateral
      thoracic or abdominal injuries in all but one patient. Nineteen (83%) of the
      adrenal injuries appeared as discrete round to oval hematomas expanding the
      adrenal gland, two (9%) appeared as diffuse irregular hemorrhage obliterating the
      gland, and two (9%) appeared as uniform swelling of the adrenal gland. Associated
      CT findings included "stranding" of the periadrenal fat caused by blood in 14
      cases (61%) and posterior pararenal hemorrhage mimicking a thickened
      diaphragmatic crus in nine cases (39%). In general, these injuries had no
      significant medical sequelae, but acute adrenal insufficiency developed in one
      patient with bilateral lesions; in another patient with an adrenal hematoma
      compressing the inferior vena cava, caval thrombosis developed. The potential for
      delayed bleeding or infection within the hemorrhagic gland exists, but these did
      not occur in any of our patients. Our experience indicates that adrenal injury
      resulting from blunt trauma is more common than suggested by previous reports and
      emphasizes the importance of careful inspection of the adrenal glands in patients
      in whom lower thoracic or upper abdominal injuries are detected by CT.

PMID- 1738985
TI  - Efficacy of digital radiography for the detection of pneumothorax: comparison
      with conventional chest radiography.
AB  - As part of our continuing evaluation of the clinical applicability of digital
      radiography, we compared the abilities of radiologists to detect pneumothoraces
      on conventional chest radiographs with their performances when using three
      formats of digitally obtained images. Twenty-three frontal-view chest radiographs
      with pneumothoraces and 22 other chest radiographs, either normal or showing
      miscellaneous abnormalities, were interpreted by five experienced radiologists in
      each of four formats: conventional film-screen chest radiographs, small-format
      (17.8 x 21.6 cm) computed radiographs, large-format (35.6 x 43.1 cm) computed
      radiographs, and digital images viewed on an interactive electronic workstation.
      The receiver-operating-characteristic curve areas for each observer for the four
      types of images were compared by a z test on a critical ratio, and the mean
      sensitivity and specificity values were compared by the sign rank test. The mean
      areas under the receiver-operating-characteristic curves ranged from 0.869 for
      the digital workstation to 0.915 for film-screen images. The differences observed
      among formats were not statistically significant. Mean specificities also were
      not significantly different, ranging from 0.90 for large-format computed
      radiographs to 0.96 for the digital workstation. Mean sensitivity ranged from
      0.65 for the digital workstation to 0.82 for film-screen images. Radiologists
      interpreting digital workstation images were significantly less sensitive in
      detecting pneumothoraces than with film-screen and small-format computed images
      (p = .06). In this study, radiologists detected pneumothoraces equally well on
      conventional film-screen radiographs and digital images printed on film; however,
      they detected pneumothoraces less well on electronic viewing consoles. This
      latter finding reflects an important practical difference in the working behavior
      of radiologists interacting with a digital workstation.

PMID- 1738986
TI  - Bronchiolitis obliterans organizing pneumonia with migratory pulmonary
      infiltrates.

PMID- 1738987
TI  - The art of learning medicine.

PMID- 1738988
TI  - Pulmonary hemorrhage complicating systemic lupus erythematosus: role of MR
      imaging in diagnosis.

PMID- 1738989
TI  - Economic issues in screening mammography.
AB  - The issues surrounding screening mammography present apparent conflicts:
      conflicting guidelines for screening; an oversupply of facilities, yet inadequate
      access to mammography for some groups of women; increased medicolegal
      vulnerability as participation in screening is promoted; disparate results from
      studies of cost-effectiveness; wide variations in delivery modes and practice
      patterns of facilities, yet an evolution toward a single set price for
      mammography by payers for screening. This review does not claim to offer
      solutions to these conflicts, rather it attempts to carry forward a discussion of
      the issues. With these conflicts, screening mammography may be only a microcosm
      of similar economic issues in general health care delivery. Our health care
      system has room for variety, if access and quality are improved at an affordable
      cost. Screening for breast cancer with mammography will not reach its full
      potential to reduce mortality until many of these issues can be resolved.

PMID- 1738990
TI  - The frequency and significance of small (less than or equal to 15 mm) hepatic
      lesions detected by CT.
AB  - The purpose of our study was to determine the frequency of detection of small
      hepatic lesions (less than or equal to 15 mm) in outpatients who had abdominal CT
      and to assess the significance of these lesions in the presence or absence of
      known malignant tumors. Contrast-enhanced abdominal CT scans in 1454 patients
      were reviewed. In 254 patients (17%), hepatic lesions 15 mm or smaller were
      detected. In 51% of these patients, lesions were judged benign on the basis of
      other imaging studies, biopsy results, or stability for at least 6 months as
      shown by CT. Lesions were judged malignant on the basis of progression seen on
      radiologic studies or biopsy in 22%. The other 27% of the patients had lesions
      that could not be classified. The majority of patients with small hepatic lesions
      (82%) were known to have a malignant tumor; in 51% of these patients, lesions
      were diagnosed as benign. No patient without a known malignant tumor had a small
      hepatic lesion that was determined to be malignant. Multiple small lesions were
      more likely to represent malignant disease than were single small lesions. We
      conclude that small hepatic lesions are common (seen in 17% of our patients), and
      that there is a high probability that hepatic lesions smaller than 15 mm are
      benign, even in patients known to have an extrahepatic malignant tumor.

PMID- 1738991
TI  - Massive upper gastrointestinal hemorrhage with normal findings on arteriography:
      value of prophylactic embolization of the left gastric artery.
AB  - During a 5-year period, 13 patients who presented with massive upper
      gastrointestinal hemorrhage had normal findings on arteriography. Seven had
      prophylactic embolization of the left gastric artery, and six had conservative
      therapy. Normal angiographic findings were associated with clinical cessation of
      bleeding in 12 of 13 patients. Lesions not treated by embolization or other
      invasive therapy had a high rate of massive recurrent hemorrhage (four of six).
      Of lesions subsequently found to be supplied by the left gastric artery, two of
      four cases not treated by embolization or surgery had clinically significant
      recurrent hemorrhage, whereas none of six cases treated by embolization had
      recurrent hemorrhage. Prophylactic embolization of the left gastric artery
      appears warranted when (1) there is definite prior identification of a lesion in
      the left gastric artery territory or (2) there is no prior localization of a
      lesion but the patient is at risk for multiorgan failure if bleeding recurs.

PMID- 1738992
TI  - Hemorrhagic colitis caused by Escherichia coli preceding hemolytic-uremic
      syndrome: radiologic features.

PMID- 1738993
TI  - Diagnosis of primary hyperaldosteronism: importance of correlating CT findings
      with endocrinologic studies.
AB  - Twenty patients with primary hyperaldosteronism had endocrinologic and radiologic
      studies to distinguish aldosterone-producing adenoma from idiopathic
      hyperaldosteronism due to bilateral micro- or macronodular hyperplasia of the
      adrenal cortex. In addition to examination for changes in the plasma level of
      aldosterone associated with postural changes and measurement of the plasma level
      of 18-hydroxycorticosterone, all 20 patients had CT examination of the adrenal
      glands. In three patients with normal adrenal glands on CT and three patients
      with CT evidence of two solitary nodules, one in each adrenal gland, a diagnosis
      of idiopathic hyperaldosteronism was confirmed by endocrinologic findings (five
      patients) or 131I-6 beta-iodomethyl-19-norcholesterol (NP-59) adrenal
      scintigraphy (one patient). In nine patients with a solitary adrenal nodule on
      CT, a diagnosis of aldosterone-producing adenoma was confirmed by surgery (seven
      patients) or hormone sampling via the adrenal veins (two patients). However, in
      three patients with a solitary adrenal nodule on CT, a diagnosis of idiopathic
      hyperaldosteronism was suggested by endocrinologic findings (three patients) and
      confirmed by the results of NP-59 scintigraphy (two patients) or adrenal venous
      sampling (one patient). In addition, in two patients with CT evidence of three
      adrenal nodules (two in one gland, one in contralateral gland), a diagnosis of
      aldosterone-producing adenoma was suggested by endocrinologic findings in both
      patients and confirmed by surgery in one. Although high-resolution CT is highly
      accurate for the detection of aldosterone-producing adenoma, significant
      diagnostic errors can occur in patients with primary hyperaldosteronism if CT
      findings are not correlated with results of endocrinologic studies.

PMID- 1738994
TI  - MR imaging in adenocarcinoma of the prostate: interobserver variation and
      efficacy for determining stage C disease.
AB  - Patients with adenocarcinoma of the prostate confined to the gland (stage B) are
      candidates for a potentially curative surgical procedure (radical retropubic
      prostatectomy). However, patients with adenocarcinoma that penetrates the capsule
      or invades the seminal vesicles (stage C) are no longer considered good
      candidates for surgical cure of their disease. The purpose of this study was to
      compare the ability of four radiologists to detect stage C disease on MR images
      and to evaluate interobserver variability. One hundred consecutive MR studies of
      the prostate were reviewed independently by four radiologists to determine
      whether the cancer was stage C (capsule penetration or seminal vesicle invasion
      by tumor). A radical prostatectomy was performed in each case, and careful
      histologic assessment was made of the prostatic capsule and seminal vesicles for
      any evidence of stage C disease. The sensitivity, specificity, and accuracy (true
      positive + true-negative/100 patients) in detecting stage C disease were
      calculated for each of the four readers. Four receiver-operating-characteristic
      curves were generated and compared by means of the univariate z score. Percentage
      agreement was calculated for five specific areas of the prostate on MR images,
      and observations made by the best reader were compared with the other three to
      help determine interreader variability. The results showed that the sensitivity
      and specificity of MR imaging in detecting stage C disease ranged from .24 to .61
      (mean, .48) and .49 to .79 (mean, .66), respectively. The accuracy of MR imaging
      ranged from .47 to .61 (mean, .55). The univariate z score test showed that one
      of the readers significantly differed from the other three. The average
      percentage agreement between that reader and the other three was 70% for the five
      separate anatomic regions. This study shows that considerable interobserver
      variation exists in the interpretation of MR images for staging cancer of the
      prostate. The average accuracy among four radiologists in determining the
      presence of stage C adenocarcinoma of the prostate from MR images was only
      slightly above a chance guess at .55.

PMID- 1738995
TI  - Myometrial invasion by endometrial carcinoma: assessment by MR imaging.
AB  - In patients with early-stage endometrial cancer, preoperative knowledge of
      myometrial tumor extension has important prognostic and therapeutic implications.
      The purpose of this prospective study was to determine the sensitivity and
      specificity of MR imaging for assessing the depth of myometrial invasion in
      patients with endometrial cancer that clinically was thought to be confined to
      the uterine corpus. Sixty-five consecutive patients were included in the study.
      All patients had MR imaging before radical surgery. MR imaging findings were
      compared with microscopic pathologic findings in all cases. On MR images and at
      histologic analysis, myometrial invasion was classified as absent (tumor confined
      to the endometrium), superficial (less than 50% of myometrial thickness), or deep
      (50% or more of myometrial thickness). At histologic examination, tumor limited
      to the endometrium was proved in 14 cases, superficial myometrial invasion by
      tumor was present in 34 cases, and deep tumor invasion was demonstrated in 17
      cases. In determining the presence of tumor confined to the endometrium, MR
      imaging had a sensitivity of 57% and a specificity of 96%. In the assessment of
      tumor with superficial myometrial invasion, MR imaging had a sensitivity and a
      specificity of 74%, whereas in assessing deep myometrial penetration, the
      sensitivity and specificity of MR were 88% and 85%, respectively. Errors in MR
      interpretation when determining myometrial tumor spread were more frequently
      overestimations rather than underestimations. Our results indicate that MR
      imaging is useful for the preoperative assessment of myometrial invasion in
      patients with proved endometrial cancer.

PMID- 1738996
TI  - Renal lymphoma.

PMID- 1738997
TI  - Renal tuberculosis: diagnosis with sonographically guided aspiration cytology.
AB  - Sonographically guided fine-needle aspiration cytology was performed in 19
      patients suspected to have renal tuberculosis. This procedure enabled a diagnosis
      of renal tuberculosis to be made in six of seven patients with urine cultures
      consistently negative for acid-fast bacilli and confirmed the diagnosis in nine
      patients with focal renal lesions on sonography and urine cultures positive for
      acid-fast bacilli. The fine-needle aspiration cytologic samples were positive for
      acid-fast bacilli in seven (44%) of the 16 confirmed cases, and acid-fast bacilli
      were present in 80% of the samples containing necrotic material. Epithelioid
      granulomas were present in 15 (94%) of 16 patients diagnosed with renal
      tuberculosis. One patient had no evidence of acid-fast bacilli or epithelioid
      granulomas, but seminal fluid ultimately grew acid-fast bacilli. Two patients
      (13%) with evidence of tuberculosis had minor self-limiting complications from
      the fine-needle aspiration: one perirenal hematoma and one abdominal wall
      intramuscular hematoma. Sonographically guided fine-needle aspiration cytology is
      useful as a means of diagnosing renal tuberculosis in patients with urine
      cultures negative for acid-fast bacilli, and is of value in defining the
      granulomatous nature of sonographically visible lesions in patients with positive
      urine cultures.

PMID- 1738998
TI  - CT findings in tuboovarian abscess.
AB  - Pelvic inflammatory disease with tuboovarian abscess can cause a wide range of
      radiologic abnormalities. Although the diagnosis of tuboovarian abscess is
      usually straightforward and is based on clinical and sonographic findings,
      unusual or unsuspected cases may be confused with other pelvic or abdominal
      diseases. The purpose of this essay is to illustrate the CT findings in
      tuboovarian abscess.

PMID- 1738999
TI  - MR imaging of extraabdominal desmoids: differentiation from other neoplasms.
AB  - A retrospective review of MR images of 36 patients with histologically proved
      extraabdominal desmoids was done to define the MR characteristics of these tumors
      and to determine if MR could be used to differentiate desmoids from other benign
      and malignant soft-tissue neoplasms. The desmoids evaluated included eight
      primary and 30 recurrent lesions. Our study was conducted in parallel with
      another study in which the MR appearance of 95 benign and malignant soft-tissue
      masses was evaluated, and the MR images of these masses were compared with our
      findings. The four desmoids from that study are included in our data. The signal
      intensity of the tumor on T1- and T2-weighted images was graded relative to the
      intensities of muscle and fat. Homogeneity, margin, neurovascular and bone
      involvement, and fibrosis (low-signal regions within the tumor on both T1- and T2
      weighted images) were evaluated. On MR imaging, the desmoids showed inhomogeneous
      signal (97%), poor margination (89%), neurovascular involvement (58%), and bone
      involvement (37%). Fibrosis was present in 88% of primary desmoids and 90% of
      recurrent ones, and intermediate signal (greater than that of muscle and less
      than that of fat) was present in 75% and 50% of these, respectively. Our results
      show that the MR features of desmoids have characteristics that are commonly
      found in malignant tumors (inhomogeneous signal, poor margination, and
      neurovascular involvement). MR features of desmoids that distinguish them from
      malignant neoplasms are the presence of fibrosis and intermediate signal in the
      regions of the tumor.

PMID- 1739000
TI  - MR diagnosis of meniscal tears of the knee: value of axial three-dimensional
      Fourier transformation GRASS images.
AB  - Axial MR images of 40 knees in 37 patients with clinically suspected meniscal
      tears were obtained by using a three-dimensional (3-D) Fourier transform,
      gradient-refocused acquisition in the steady state (GRASS) pulse sequence. All
      knees also were examined in both coronal and sagittal planes with a two
      dimensional (2-D) Fourier transform, spin-echo pulse sequence for T1-weighted
      images and a multiplanar GRASS pulse sequence for T2*-weighted images
      (conventional 2-D pulse sequences). Arthroscopic confirmation was available in
      all cases and was used as the gold standard. In these 40 knees, 32 of 33 meniscal
      tears and 45 of 47 normal menisci were correctly identified with axial 3-D
      imaging, yielding a sensitivity of 97% and specificity of 96%. Conversely, the
      sensitivity was 82% and the specificity was 100% for the 2-D technique in the
      diagnosis of meniscal tears. A combination of both techniques yielded 100%
      sensitivity, 100% specificity, and 100% accuracy in the evaluation of the
      menisci. Seven discrepancies between the findings of the two techniques were
      found in the evaluation of 33 arthroscopically proved torn menisci; six of the
      seven represented false-negative 2-D images and one was a false-negative axial 3
      D image. Of 47 normal menisci, only two false-positives occurred with axial 3-D
      imaging and none with 2-D imaging. Despite the lack of a statistically
      significant difference, these preliminary findings suggest that the sensitivity
      in the diagnosis of meniscal tears can be improved by adding thin-sliced axial
      images with the 3-D GRASS pulse sequence to conventional 2-D imaging.

PMID- 1739001
TI  - CT and MR evaluation of the labral capsular ligamentous complex of the shoulder.
AB  - Stability of the glenohumeral articulation is dependent on the integrity of the
      rotator cuff, labrum, glenohumeral ligaments, capsular elements, and bony
      glenoid. The importance of the soft-tissue elements in maintaining stability has
      been well documented in the surgical literature but has only recently been
      introduced into the radiologic literature. The purpose of this essay is to
      illustrate the normal labrum, capsular complex, and glenohumeral ligaments,
      including common congenital variations as depicted by CT arthrography and MR
      imaging, and to describe the pathologic findings leading to shoulder instability.

PMID- 1739002
TI  - Radiation-induced insufficiency fractures of the pelvis: evaluation with 99mTc
      methylene diphosphonate scintigraphy.
AB  - 99mTc-methylene diphosphonate (99mTc-MDP) bone scans in 80 patients, 30-80 years
      old (average, 62 years old) with uterine cancer who received high doses of
      radiation (10-60 Gy; average, 46 Gy) were reviewed retrospectively to evaluate
      the frequency of pelvic insufficiency fractures caused by radiotherapy and to
      study the appearance of the fractures on bone scans. Bone scans in 29 of 80
      patients showed abnormalities in the pelvis: insufficiency fractures were
      identified in 27 patients (34%) and osseous metastases were found in two patients
      (3%). The fractures and metastases were diagnosed by CT and were confirmed by
      observing the patients' clinical courses. Fractures were identified in 27 (39%)
      of 69 postmenopausal women and in none of 11 premenopausal patients (p greater
      than .05). Fractures were found in 21 (84%) of 25 patients who had pelvic pain
      and in six (11%) of 55 patients who were asymptomatic (p greater than .001).
      Scintigrams in patients with fractures showed more than one fracture in most
      patients (85%), and fractures were often symmetric (67%). Scintigrams in two
      patients with osseous metastases showed increased activity in an iliac wing that
      was outside the radiation field. Our results suggest that a marked increase in
      insufficiency fractures occurs after radiation therapy, especially in
      postmenopausal patients. A symmetric area of increased uptake of radionuclide is
      a characteristic scintigraphic appearance of an insufficiency fracture.

PMID- 1739003
TI  - Musculoskeletal infections in patients with AIDS: CT findings.
AB  - The CT appearances of various musculoskeletal infections found in patients with
      AIDS are illustrated. Recognition of these infections is important for management
      of patients, but conventional laboratory tests may be inadequate in screening for
      infection or confirming the response of the host to therapy. As a screening
      examination for patients with AIDS, CT can suggest or confirm the presence of
      musculoskeletal infections even when infection has not been suspected.

PMID- 1739004
TI  - An unusual epiphyseal osteoid osteoma.

PMID- 1739005
TI  - The normal and abnormal scrotum in children: evaluation with color Doppler
      sonography.
AB  - The use of color Doppler sonography to evaluate the symptomatic testes in
      children with scrotal pain or swelling was prospectively studied with a fourth
      generation color sonographic unit with a 7-MHz linear transducer. The 32 patients
      were 1 day to 18 years old (mean age, 8.6 years). Results were correlated with
      scintigraphic findings in 23 patients, with the final diagnosis established by
      surgery in 12 patients, and with clinical follow-up in all patients. Eight cases
      of testicular torsion, including two of acute torsion and six of late torsion,
      were correctly detected by color Doppler sonography and confirmed surgically. In
      the remaining patients, perfusion of the testis was correctly detected by color
      Doppler examination. The final diagnoses in these patients included torsion of
      the appendix testis (15 patients), epididymitis (five patients), epididymo
      orchitis (one patient), yolk sac tumor of the testis (one patient), hydrocele
      (one patient), and local reaction to an insect bite (one patient). The ability to
      detect blood flow in the normal contralateral testis was also evaluated in 28
      patients. Blood flow was demonstrated in normal testes larger than 1 cm3.
      Detection of flow in the very small normal prepubertal testis was often
      difficult, and no flow was identified in one testis. Flow was identified in
      central arteries in only six of 13 testes smaller than 1 cm3. We conclude that
      color Doppler sonography is helpful in the initial evaluation of pediatric
      testes, providing accurate evaluation of the involved hemi-scrotum in our
      patients and also providing the benefit of both structural and flow information.
      Until our sensitivity to low-velocity flow improves, we would not suggest the
      exclusive use of color Doppler sonography in the evaluation of testicular
      perfusion in the prepubertal patient. We advocate the addition of testicular
      scintigraphy to corroborate the presence of testicular perfusion when flow in
      intratesticular arteries cannot be established with certainty by color Doppler
      sonography.

PMID- 1739006
TI  - Plain film diagnosis of intussusception: prevalence of the target sign.
AB  - We describe a feature of intussusception seen on plain abdominal films that to
      our knowledge has not been previously described. The abnormality, termed the
      "target sign," consists of two concentric, circular, radiolucent lines to the
      right of the spine superimposed on the kidney. Four observers examined 280 plain
      abdominal films; 180 were of 94 patients who had had 100 episodes of
      intussusception and 100 films were of 80 control subjects. The target sign was
      observed by three or four observers on plain films in 24 (26%) of 94 patients
      with intussusception and on 4% of radiographs of control subjects. There was no
      concordance between observers on false-positive findings seen in the control
      subjects. Our experience suggests that circular radiolucent lines superimposed on
      the right kidney on plain abdominal radiographs (target sign) constitute a useful
      diagnostic feature of intussusception.

PMID- 1739007
TI  - Thoracic outlet syndrome: evaluation of the subclavian vessels by color duplex
      sonography.
AB  - Changes in flow in the subclavian artery and vein resulting from the use of a
      hyperabduction maneuver during Doppler sonography in 20 volunteers were compared
      with retrospective findings in 16 patients clinically suspected of having
      thoracic outlet syndrome. Significant compression of the subclavian artery showed
      in the Doppler waveform as at least a doubling of peak systolic velocity or
      complete cessation of flow with hyperabduction; significant compression of the
      subclavian vein was diagnosed by complete cessation of blood flow or loss of
      atrial and respiratory dynamics in the waveform of the subclavian vein with
      hyperabduction. In volunteers, asymptomatic compression of the subclavian vein
      with arm abduction was seen in two (10%) and asymptomatic compression of the
      subclavian artery was seen in four (20%). Of the 16 patients, thrombosis of the
      subclavian vein was found in seven, compression of the subclavian vein with
      hyperabduction was found in six, and diagnoses other than thoracic outlet
      syndrome were established as the cause of pain in three. When duplex sonography
      was compared with venography, which was performed in 10 patients, one false
      negative case was found because a subclavian vein thrombus had not been detected.
      The subclavian artery was examined in five of the six patients with positional
      compression of the subclavian vein; compression of the subclavian artery was
      found in three. The clinical significance of compression of the subclavian artery
      cannot be determined from our data because of the small number of patients
      involved. When the sonographic criteria of subclavian vein clot or compression
      resulting in a complete loss of normal venous phasicity with arm abduction and
      the clinical criterion of subsequent improvement in symptoms after curative
      surgery are used, color Doppler sonography is 92% sensitive and 95% specific for
      the diagnosis of thoracic outlet syndrome. This preliminary study shows that
      Doppler sonography has potential in the evaluation of thoracic outlet syndrome.

PMID- 1739008
TI  - Arterial injury from penetrating trauma: evaluation with single-acquisition fat
      suppressed MR imaging.

PMID- 1739009
TI  - Combined saccular aneurysm and proximal interruption of the inferior vena cava
      associated with Budd-Chiari syndrome.

PMID- 1739010
TI  - Catheter-induced pulmonary artery pseudoaneurysm: the halo sign on CT.

PMID- 1739011
TI  - Temno biopsy needle: evaluation of efficacy and safety in 165 biopsy procedures.

PMID- 1739012
TI  - Detection of residual or recurrent meningioma after surgery: value of enhanced vs
      unenhanced MR imaging.
AB  - The enhanced and unenhanced MR examinations obtained after surgery for meningioma
      in 38 patients were reviewed to determine the value of enhanced vs unenhanced MR
      imaging for the detection of residual or recurrent tumor. Enhanced images
      improved delineation of the extent of tumor in seven of 13 cases in which
      meningioma was identified on unenhanced images and allowed more definitive
      detection or exclusion of residual or recurrent meningioma in 18 of 21 cases with
      equivocal findings on unenhanced images. In addition, enhanced images were
      helpful for detecting small recurrences, identifying en plaque growth, and
      showing subtle progression on serial studies. Enhanced MR imaging also allowed
      detection of two morphologic patterns of dural enhancement adjacent to the
      surgical bed: (1) thin and smooth, which was seen in patients both with and
      without residual or recurrent tumor, and (2) thick and nodular, which was seen
      only in patients with findings indicative of, or at least suggestive of, residual
      or recurrent meningioma. Unenhanced images failed to detect, or poorly detected,
      these dural abnormalities. Unenhanced sequences were necessary for accurate
      interpretation of the enhanced images (e.g., identification or exclusion of
      hemorrhage). The combination of unenhanced and enhanced MR imaging is recommended
      for the detection of residual or recurrent meningioma after surgery.

PMID- 1739013
TI  - Sequence of enhancement of various portions of the pituitary gland on gadolinium
      enhanced MR images: correlation with regional blood supply.
AB  - In an effort to study the blood supply of the pituitary gland, we determined the
      sequence in which various portions of the gland enhanced on MR images obtained
      after administration of gadopentetate dimeglumine in seven healthy volunteers.
      The pituitary gland has a unique blood supply: the pars nervosa is supplied by
      the inferior hypophyseal arteries; the infundibular stem is supplied by the
      superior hypophyseal arteries, which are more distal than the inferior
      hypophyseal arteries; and the pars distalis is supplied indirectly by portal
      systems from the infundibular stem. Therefore, the expected sequence of contrast
      enhancement of the pituitary gland is: the pars nervosa first, the infundibular
      stem second, and the pars distalis last. However, it is difficult to evaluate the
      temporal sequence of contrast enhancement with "slow" conventional MR techniques,
      such as routine enhanced images acquired minutes after contrast administration.
      Accordingly, we used rapid enhanced gradient-echo sequences (14 sec/image) and
      the region-of-interest method to determine contrast enhancement for various
      portions of the gland. Enhancement-time curves were then plotted for each portion
      and compared to determine the sequence of enhancement. Our results show that the
      timing of contrast enhancement of various parts of the pituitary gland as
      demonstrated on MR imaging correlates closely with the expected perfusion
      sequence based on knowledge of regional vascular anatomy. Normal enhancement-time
      curves of different portions of the pituitary gland were established. This
      technique and baseline data can be used to evaluate patients with hypopituitarism
      caused by ischemia.

PMID- 1739014
TI  - MR imaging of the stellate ganglion: normal appearance.
AB  - The stellate ganglion has not previously been identified by imaging techniques.
      MR imaging shows the stellate ganglion at the thoracic inlet adjacent to the neck
      of the first rib, lateral to the longus colli muscle and posterior to the
      vertebral artery. Although its shape varies somewhat, it can be identified
      consistently in normal persons.

PMID- 1739015
TI  - MR appearance of osteogenic sarcoma of the calvaria.

PMID- 1739016
TI  - Monitoring heart rate and oxygen saturation with a fiber-optic pulse oximeter
      during MR imaging.

PMID- 1739017
TI  - Comparison of iohexol 300 and diatrizoate meglumine 60 for body CT: image
      quality, adverse reactions, and aborted/repeated examinations.
AB  - Six hundred patients were prospectively randomized and given either diatrizoate
      meglumine 60 or iohexol 300 during dynamic contrast-enhanced body CT in order to
      compare image quality, contrast reactions, and the number of aborted studies or
      studies in which images had to be repeated. Three hundred two patients received
      iohexol 300, and 298 patients received diatrizoate meglumine 60. Thirty-nine
      percent (119/302) of the patients given iohexol 300 and 63% (188/298) of the
      patients given diatrizoate meglumine 60 had at least one adverse reaction thought
      to be related to contrast material during, or within 24 hr of, the body CT scan.
      When reactions of discomfort (heat or warmth, flushing, bad taste) were excluded,
      16% (48/302) of the patients who received iohexol and 33% (99/298) of the
      patients who were given diatrizoate meglumine 60 had at least one adverse
      reaction. The differences in both types of reactions between the two agents were
      significant (p less than .001). Among scans evaluated for study quality, 71%
      (214/302) of the iohexol 300 group and 62% (184/298) of the diatrizoate meglumine
      60 group had optimal enhancement (p = .02). However, when the optimal and
      adequate categories were combined, 301 of 302 patients given iohexol 300 and 292
      of 298 patients given diatrizoate meglumine 60 had diagnostic-quality studies (no
      statistical difference). Studies were not terminated nor were images repeated in
      97% (292/302) of the patients given iohexol 300 and in 94% (280/298) of those
      given diatrizoate meglumine 60. The CT study was repeated because of movement
      during the contrast injection or aborted because of contrast-related reactions in
      0.7% of the patients given iohexol 300 and in 3.0% of the patients given
      diatrizoate meglumine 60. This difference was statistically significant (p =
      .04). Our results suggest that the difference in image quality, number of adverse
      reactions, and number of aborted/repeated CT scans performed with iohexol 300 or
      diatrizoate meglumine 60 are not sufficiently different to warrant conversion to
      nonionic agents for body CT scans.

PMID- 1739018
TI  - Hypercard coding system for the ACR Index for Radiological Diagnoses.
AB  - We describe a computer version of the Index for Radiological Diagnoses of the
      American College of Radiology (ACR). This system combines a graphics interface
      with a search mechanism while preserving the hierarchical structure of the Index.
      The graphics interface allows easy selection of an anatomic part, while the
      search mechanism provides the code numbers associated with an entered term. The
      computer system and the paperback version of the ACR Index were compared by
      having 52 volunteers (21 radiology faculty members, 21 radiology residents, and
      10 medical students) each code 30 cases with the book and a matched set of 30
      cases with the computer. The average time to code cases was shorter when the
      computer was used (52.2 vs 64.5 sec; p less than .0001). Accuracy was higher when
      the computer was used (96.4% vs 90.4%; p less than .0001). The average confidence
      in the computer diagnosis was also higher (9.73 vs 9.51, on a scale of 1-10; p =
      .0016). This system demonstrates the ability of a computer program to outperform
      an analogous noncomputerized system.

PMID- 1739019
TI  - Radiologic application of a microcomputer-based three-dimensional imaging system.

PMID- 1739020
TI  - Radiology summit meeting--1991: Solutions through synectics.

PMID- 1739021
TI  - Western Neuroradiological Society, 23rd annual meeting: October 1991.

PMID- 1739022
TI  - Ruptured pulmonary hydatid cyst and folded membrane on CT.

PMID- 1739023
TI  - Pneumopyopericardium after penetrating chest injury.

PMID- 1739024
TI  - Positive predictive values for mammographically detected carcinomas.

PMID- 1739025
TI  - Mammographic appearance of coumadin-induced fat necrosis.

PMID- 1739026
TI  - Latex retention balloon for barium enemas.

PMID- 1739027
TI  - Visceral calcifications in AIDS.

PMID- 1739028
TI  - Ewing sarcoma manifested as acute abdomen.

PMID- 1739029
TI  - Sonography vs MR imaging in children who are candidates for liver
      transplantation.

PMID- 1739030
TI  - The looking-down view for pelvic MR imaging.

PMID- 1739031
TI  - Leiomyoma of the urethra: appearance on transvaginal sonography.

PMID- 1739032
TI  - Accessory occipital ventricle.

PMID- 1739033
TI  - Insomnia in the elderly.

PMID- 1739034
TI  - The term 'egg' and contraception.

PMID- 1739035
TI  - Nicardipine-induced hyperglycemia.

PMID- 1739036
TI  - Cracking down on 'neck cracking'.

PMID- 1739037
TI  - CPT coding changes: another progeny of Medicare reimbursement.

PMID- 1739038
TI  - Update on breast implants.

PMID- 1739039
TI  - Competency and the routine discussion of advance directives.

PMID- 1739040
TI  - Medicare hassles and family physicians.

PMID- 1739041
TI  - Diary from a week in practice.

PMID- 1739042
TI  - Osteoarthritis.
AB  - Osteoarthritis is a frequent cause of physical impairment in the elderly. The
      disease has a slow, progressive course that ends with joint failure and
      subsequent disability. The hands and the large weight-bearing joints are most
      commonly affected. The cause of osteoarthritis is unknown. The strongest risk
      factor is age, but age alone does not cause the disease. Clinically,
      osteoarthritis is manifested by joint pain and stiffness. Radiographs reveal
      joint space narrowing, subchondral sclerosis, osteophytes and, later, subchondral
      cysts and intra-articular osseous bodies. Biochemically, the cartilage in
      osteoarthritis differs from normal cartilage in elderly patients. The goals of
      treatment are to control pain, maintain function through strengthening and range
      of-motion exercises, protect the joint and limit iatrogenic injury by selecting
      treatment options that minimize complications. Even when cure is not possible,
      appropriate medical care can improve the patient's functioning and well-being.

PMID- 1739043
TI  - Infection of fetal scalp electrode monitoring sites.
AB  - Complications caused by placement of a fetal scalp electrode include trauma,
      hemorrhage and infection. Infections are usually localized and self-limited, but
      they can occasionally lead to serious complications, such as osteomyelitis,
      sepsis and death. The recommended treatment for a scalp abscess is incision and
      drainage, followed by appropriate antibiotic therapy. If a serious infection is
      suspected, the infant should be hospitalized, blood cultures obtained and
      intravenous antibiotic therapy initiated.

PMID- 1739044
TI  - Occupational repetitive strain injury.
AB  - Repetitive strain injuries include a group of disorders that most commonly
      develop in workers using excessive and repetitious motions of the neck and upper
      extremity. A careful occupational history, physical examination and specific
      diagnostic maneuvers can help distinguish these musculoskeletal injuries from
      rheumatologic diseases, psychologic disorders, acute joint or tendon inflammation
      from other causes and single-event traumatic sprains and strains. Repetitive
      strain injury may be manifested by cervical syndrome, tension neck syndrome,
      thoracic outlet syndrome and frozen shoulder syndrome. Common injuries involving
      the elbow, wrist and hand include epicondylitis, carpal tunnel syndrome and ulnar
      nerve entrapment. Conservative treatment consisting of rest, application of ice
      or heat and anti-inflammatory drugs is usually effective, but the injury may take
      weeks or months to resolve. Modifications in the workplace can prevent many of
      these injuries and may be required to prevent reinjury after the patient returns
      to work.

PMID- 1739045
TI  - An approach to nutrition screening for older Americans.
AB  - The Nutrition Screening Initiative suggests an adaptable, tiered approach to
      screening for poor nutritional status in older Americans. The first level of
      screening is a checklist to be completed by elderly individuals or their
      caregivers. This checklist, which will be widely disseminated, describes the
      warning signs of poor nutritional status. It is anticipated that individuals will
      approach their physicians on the basis of scores on this checklist. Also included
      are two screening tests designed to help clinicians more easily detect poor
      nutritional status, or risk factors for poor nutrition, in their patients. The
      level I screen is to be completed by a social service or health care
      professional, or by other trained personnel. The level II screen focuses on
      additional information to be obtained following referral to a physician or other
      qualified health care professional.

PMID- 1739046
TI  - Acute rheumatic fever: an update.
AB  - The incidence of acute rheumatic fever is increasing in the United States, but
      many physicians are now unfamiliar with the diagnosis and treatment of this
      disease. The revised Jones criteria provide guidance for the diagnosis of
      rheumatic fever; two major criteria or one major and two minor manifestations are
      required to make the diagnosis. Salicylates are usually the initial treatment of
      choice for the arthritis of rheumatic fever. Penicillin remains the recommended
      prophylactic agent for secondary prevention.

PMID- 1739047
TI  - Recognizing an index case of type 1 neurofibromatosis.
AB  - Neurofibromatosis is a relatively common autosomal dominant disorder with
      variable penetrance. The disorder usually presents in childhood. Hallmarks of
      type 1 neurofibromatosis are cafe-au-lait macules and neurofibromas. Neurologic
      complications include mental retardation, learning disabilities and seizures.
      Tumors of the eighth cranial nerve, as well as other intracranial and spinal
      neoplasms, are the typical lesions in type 2 neurofibromatosis. Both forms of
      neurofibromatosis have a highly variable course and may result in progressive
      neurologic deterioration, disfigurement and impingement syndromes. In the 50
      percent of cases that represent new mutations, diagnosis may be delayed if the
      physician is not familiar with the salient features of the disorder. Thorough
      initial evaluation, genetic counseling and close follow-up are important aspects
      of management.

PMID- 1739048
TI  - Klippel-Feil syndrome.
AB  - The triad of short neck, low posterior hairline and severe restriction of
      cervical motion is a classic definition of Klippel-Feil syndrome. The anatomic
      and clinical expressions of this syndrome vary widely, ranging from mild cosmetic
      deformity to severe disability. The diagnosis is usually apparent on lateral
      cervical radiographs.

PMID- 1739049
TI  - Thrombolytic therapy in acute myocardial infarction.
AB  - Multiple clinical trials have demonstrated that thrombolytic treatment early in
      the course of acute myocardial infarction significantly reduces mortality.
      Patients under 75 years of age who have had chest pain for no longer than six
      hours and who demonstrate ST-segment elevation on electrocardiogram are the best
      candidates for this therapy. Recent studies suggest that there is little
      difference in effectiveness among streptokinase, alteplase and anistreplase.
      However, streptokinase is 10 times less expensive than the other agents and
      causes fewer intracranial bleeds, the major serious adverse effect of
      thrombolytic therapy. An advantage of anistreplase is that it can be given in a
      five-minute bolus injection, compared with a one-hour infusion for streptokinase
      and a three-hour infusion for alteplase. Thrombolytic therapy is contraindicated
      in patients with known pregnancy, active internal bleeding, uncontrolled
      hypertension, aortic dissection, intracranial neoplasm or a history of
      hemorrhagic stroke. Heparin should be administered with both alteplase and
      streptokinase. Aspirin, beta blockers, nitrates and lidocaine are useful
      adjunctive therapies in the setting of an acute myocardial infarction.

PMID- 1739050
TI  - Contrast sensitivity vision testing: new screening technology for family
      physicians.
AB  - Contrast sensitivity vision testing is the new technology in visual screening.
      Easy to administer and quick to perform, contrast sensitivity vision testing
      appears to be cost-effective for use by family physicians. It is a more sensitive
      indicator of ocular disease than traditional Snellen acuity testing and may
      detect ocular pathology at an early stage when Snellen acuity is still normal.

PMID- 1739051
TI  - Foreign-body granuloma due to an unsuspected wooden thorn.
AB  - Foreign bodies occasionally cause a chronic granulomatous reaction that may be
      mistaken for a plantar wart or even a skin malignancy. This possibility should be
      considered when lesions on the foot become progressively larger and more tender.
      Diagnosis may require surgical excision.

PMID- 1739052
TI  - Exercise stress testing for the family physician: Part II. Interpretation of the
      results.
AB  - Information gained from exercise stress testing includes the heart rate and blood
      pressure response, the presence of symptoms or dysrhythmias, functional aerobic
      capacity and evidence of myocardial ischemia. Certain ST-segment patterns
      correlate with various degrees of ischemia. Overall, stress testing has a
      sensitivity and a specificity of about 70 and 75 percent, respectively, but the
      results are even more useful than this when considered in light of the pre- and
      post-test probability of coronary artery disease. Use of the exercise test score
      and decision-tree algorithms is helpful in clinical decision making.

PMID- 1739053
TI  - Treatment of exacerbations of COPD.
AB  - Chronic obstructive pulmonary disease (COPD) affects approximately 14 million
      Americans. Treatment of COPD includes bronchodilators, corticosteroids and
      antibiotics. The most common bacterial isolates during exacerbations of COPD are
      Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis.

PMID- 1739054
TI  - A guide to the new office evaluation and management codes for 1992.
AB  - The new office evaluation and management codes require an understanding of
      definitions that have been recently created by the Current Procedural Terminology
      (CPT) Editorial Panel. Code selection is based on seven components; the three key
      components are the history, the physical examination and medical decision making.
      Office visit codes are divided into five levels of visits, based on service. New
      patient office visits require all three key components for any level visit;
      established-patient office visits require only two of the three components. The
      new office code descriptions were created to assist physicians in code
      selections. Only when counseling or coordination of care dominates the visit
      (e.g., more than 50 percent) is time to be considered a controlling factor.
      Physicians are urged not to code only from time descriptors. The 1992 CPT book
      will list only the new evaluation and management codes, deleting the old level-of
      service codes. Physicians are encouraged to contact local insurance carriers to
      ensure that they will also be using the new codes in 1992.

PMID- 1739055
TI  - Cosmetic breast surgery.
AB  - Appropriate follow-up care, including early postoperative serial mammography, is
      essential for women receiving cosmetic breast surgery. Common procedures include
      augmentation or reduction mammoplasty and breast reconstruction following
      mastectomy for cancer. Postoperative complications include infection, poor wound
      healing and pain. Hypertrophic scar formation, which may disrupt the normal
      breast contour, may be reduced by gentle and frequent massage of the scar.
      Avoiding sun exposure and using sun screens may prevent hyperpigmentation of the
      scar. Reduction mammoplasty is associated with sensory loss, which is
      occasionally permanent. Special complications associated with augmentation
      mammoplasty include diffusion of silicone through the implant and unfavorable
      breast appearance secondary to capsular contracture. Capsular contracture may be
      prevented by regular implant exercises. Preoperative and early postoperative
      serial mammograms are essential to differentiate surgical from malignant changes.

PMID- 1739056
TI  - Practical approach to the treatment of hypothyroidism.
AB  - Hypothyroidism most commonly is the result of primary thyroid failure due to
      autoimmune thyroiditis, but also may follow treated Graves' disease or may occur
      as transient hypothyroidism. Laboratory evaluation of thyroid function has been
      refined by the development of ultrasensitive thyroid-stimulating hormone
      determinations, allowing accurate diagnosis of primary hypothyroidism and
      assessment of treatment response. Determining whether therapy is appropriate for
      patients with subclinical hypothyroidism or euthyroid sick syndrome requires
      clinical judgment in addition to laboratory evaluation. Thyroid hormone
      replacement for hypothyroidism is best accomplished with levothyroxine. Factors
      that may affect serum thyroxine levels include thyroid binding globulin levels,
      drug interactions and variations in thyroxine absorption and clearance.

PMID- 1739057
TI  - Hydrocephalus in infancy and childhood.
AB  - Hydrocephalus is marked by the excessive accumulation of cerebrospinal fluid
      within the ventricles. The disorder is characterized by an imbalance in the
      production and reabsorption of cerebrospinal fluid. Congenital hydrocephalus is
      usually the result of an intrauterine infection or maldevelopment of the aqueduct
      of Sylvius. Acquired hydrocephalus can be caused by infection, neoplasm or
      hemorrhage. In infants, hydrocephalus usually presents as progressive head
      enlargement. The presenting symptoms in children are irritability, headache,
      nausea, vomiting and lethargy. Diagnosis is made with ultrasonography, computed
      tomography or magnetic resonance imaging. The majority of patients are treated
      with cerebrospinal fluid shunt procedures, most commonly the placement of
      ventriculoperitoneal or lumboperitoneal shunts. The outcome of hydrocephalus is
      determined by the etiology, the presence or absence of associated anomalies, and
      the timeliness of diagnosis and treatment.

PMID- 1739058
TI  - Assessing patient competence for medical decision making.
AB  - Competence frequently becomes an issue when a patient refuses a recommended
      surgical procedure or medication, refuses a placement option such as a nursing
      home or threatens to leave the hospital against medical advice. Physicians often
      struggle to balance the patient's right to self-determination and informed
      consent with their own mission to provide patients with optimal treatment. At
      present, few guidelines exist to assist physicians in making competence
      determinations. Legal precedents and conceptual issues in evaluating competence
      are reviewed. A protocol for assessing competence is presented.

PMID- 1739059
TI  - Alternatives to physical and pharmacologic restraints in long-term care.
AB  - The most effective programs for reducing the use of restraints involve facility
      policy initiatives that are strongly supported by the medical director, the
      administrator and the director of nursing. The physician and nursing home staff
      must recognize that physical and pharmacologic restraints have different
      purposes. Implementing alternatives to restraints requires a careful examination
      of the source of the problem behavior and an individualized approach.
      Alternatives to medication should be stressed. When a medication is necessary, it
      should be prescribed for a limited time, with a definite date for
      discontinuation. Family physicians can actively participate in restraint
      reduction programs, whether by initiating the process or by providing support and
      counseling to staff.

PMID- 1739060
TI  - Orofacial pain: diagnosis and treatment.
AB  - Orofacial pain can have an inflammatory, neurologic or musculoskeletal cause.
      Inflammatory diseases include dental abscess, sinusitis, temporal arteritis,
      sialolithiasis and infections of the parotid gland. Common neurologic diseases
      that cause facial pain are trigeminal neuralgia, glossopharyngeal neuralgia,
      paratrigeminal neuralgia and cluster headaches. Musculoskeletal causes include
      temporomandibular joint syndrome and myofascial pain dysfunction syndrome. A
      clear understanding of pertinent anatomy and an organized approach to diagnosis
      will facilitate the evaluation of patients with orofacial pain.

PMID- 1739061
TI  - Treatment of accidental hypothermia.
AB  - Hypothermia is an underreported cause of death in the United States. The clinical
      presentation of hypothermia may include neurologic, cardiovascular and metabolic
      abnormalities. In severely hypothermic patients, evaluation may reveal no signs
      of life until the patient is rewarmed. Treatment is directed at restoring normal
      body temperature and attending to fluid resuscitation, electrolyte disorders,
      cardiac arrhythmias and associated disease states or conditions. Groups at
      particular risk for hypothermia include outdoor workers, the homeless, trauma
      victims and the very young or very old. Also at risk are persons with preexisting
      serious illnesses and those who are taking medications or abusing drugs. Cardiac
      arrest, hypotension, unresponsiveness and severe hyperkalemia portend a poorer
      prognosis.

PMID- 1739062
TI  - Clozapine: a novel antipsychotic.
AB  - Clozapine is the first truly new antipsychotic drug introduced in the last 40
      years. Compared to traditional neuroleptic agents, clozapine appears to have a
      stronger effect on most schizophrenic symptoms. Thus, it seems to be more
      effective than other agents in severely ill, treatment-resistant patients.
      Clozapine rarely causes extrapyramidal symptoms such as pseudoparkinsonism or
      akathisia. To date, no confirmed cases of tardive dyskinesia have been attributed
      to the drug. Despite these advantages, the usefulness of clozapine is limited by
      its potentially life-threatening side effects, which include agranulocytosis and
      respiratory depression.

PMID- 1739063
TI  - NIH releases statement on depression in the elderly.

PMID- 1739064
TI  - Clinical application of the ACCO appliance. Part 1.
AB  - Difficult Class II, Division 1 malocclusions can be successfully treated with a
      combination of fixed and removable appliances. The clinical application of the
      Margolis ACCO appliance is demonstrated in a variety of malocclusions through the
      use of before-treatment progress, and posttreatment records.

PMID- 1739065
TI  - Patterns of incisor root resorption before and after orthodontic correction in
      cases with anterior open bites.
AB  - External root resorption is a frequent iatrogenic consequence of orthodontic
      treatment, particularly in the maxillary anterior teeth. Since resorption also
      occurs is a normal function of aging and since altered behaviors such as bruxism
      and chronic nailbiting accelerate resorption even in the absence of treatment, it
      was hypothesized that the long-term orthopedic forces of tongue thrusting leading
      to anterior open bites would also enhance the rates of clastic activity. In a
      series of 32 adolescents with open bites, the roots of permanent maxillary
      central incisors were significantly shorter and exhibited higher modal grades of
      periapical resorption than a matched series with deep bites before treatment. The
      open bite group also had less facial bony support for these teeth. Both series
      experienced discernible resorption during full-banded treatment but to comparable
      extents so that, after active treatment, the open bite series continued to
      possess significantly greater degrees of resorption. Consequently, the oral
      forces leading to apertognathia are themselves destructive of root integrity and
      merit early recognition and interception.

PMID- 1739066
TI  - Controlled retraction of maxillary incisors.
AB  - The force characteristics inherent in the prefabricated PG retraction spring have
      been shown to be efficient for controlled movement of canines. In the present
      investigation, this spring was analyzed with regard to its applicability for
      controlled retraction of the maxillary incisors. A description of the required
      system of moments and horizontal and vertical forces, acting at both the active
      (alpha) and reactive (beta) units, is presented. The three-dimensional force
      system generated by specific modifications of the spring was registered in a
      bench testing device mounted with strain gauges, and the resultant data presented
      in a graphic. It is concluded that the PG retraction spring can be used as a
      module for controlled retraction of both canines and incisors. The magnitude of
      horizontal and vertical forces is kept within the anticipated physiologic limits
      and can be identified by the shape of the activated spring. Variability of the
      distance between the anterior and the posterior points of force attack has no
      significant influence on the horizontal and vertical forces produced. Only minor
      clinical adjustments are needed to modify the retraction spring from canine-to
      incisor retraction.

PMID- 1739067
TI  - Lower arch crowding in the young adult.

PMID- 1739068
TI  - Comparison of the shear bond strength of a light-cured glass ionomer and a
      chemically cured glass ionomer for use as an orthodontic bonding agent.
AB  - Light-cured glass ionomers with an initial set of 20 seconds may produce higher
      initial bond strengths, as well as decreased sensitivity to moisture
      contamination and desiccation, than chemically cured glass ionomers making them
      attractive for use as orthodontic bonding agents. The purpose of this study was
      to determine and compare the shear bond strength of stainless steel orthodontic
      attachments to enamel with a light-cured glass ionomer (Zionomer) tested at 60
      minutes and 24 hours, and a rapidly setting chemically cured glass ionomer (Ketac
      Bond) tested at 60 minutes and 24 hours. Fifty-two recently extracted human
      premolars were randomly divided into four groups--1-hour and 24-hour light-cured
      glass ionomer groups and 1-hour and 24-hour chemically cured glass ionomer
      groups. Stainless steel lingual buttons were bonded to prepared enamel surfaces,
      and the samples were placed in a water bath at 37 degrees C until ready for
      testing. The shear bond strength of each sample was determined with a universal
      testing instrument. Results from the study conclude: (1) The mean shear bond
      strength of the light-cured glass ionomer is greater than that of the chemically
      cured glass ionomer at 1 and 24 hours. (2) The mean shear bond strength of both
      glass ionomers increases from 1 to 24 hours. (3) The mean shear bond strength of
      the light-cured glass ionomer is not significantly different from 1 to 24 hours,
      but the shear bond strength of the chemically cured glass ionomer cement is
      different.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1739069
TI  - An example of regional variation in the tempos of tooth mineralization and hand
      wrist ossification.
AB  - Two groups of adolescent orthodontic patients, one from the Midwest and one from
      the Midsouth, were compared to test the clinical impression that the permanent
      teeth of southern children form and erupt at significantly later ages. Indeed, a
      marked difference is documented, with the Midsouth series achieving
      mineralization stages at least 1 1/2 years later on average. This suggests that
      regional differences are appreciably greater than previously suspected. Clinical
      consequences revolve on the use of conventional (generally Northeast-based) norms
      for tooth formation and eruption and predictive models of facial growth. In
      contrast, the analysis of rates of hand-wrist development (bone age) of these
      same subjects disclosed no difference; this further confirms the essential
      independence of development of the dental and osseous tissue systems.

PMID- 1739070
TI  - Impacted maxillary canines: a review.
AB  - An overview of the incidence and sequelae, as well as the surgical, periodontal,
      and orthodontic considerations in the management, of impacted canines is
      presented. The clinician needs to be familiar with the differences in the
      surgical management of the labially and palatally impacted canines, the best
      method of attachment to the canine for orthodontic force application, the
      advantages of one-arch versus two-arch treatment, and the implications of canine
      extraction. The various factors that influence all these decisions are discussed.

PMID- 1739071
TI  - The first direct bonding in orthodontia, revisited.

PMID- 1739072
TI  - First direct bonding in orthodontia.

PMID- 1739073
TI  - Risk preclusion.

PMID- 1739074
TI  - Comments on vertical growth patterns.

PMID- 1739075
TI  - Comments on increase in arch perimeter.

PMID- 1739076
TI  - Abnormal urate transport in patients with intracranial disease.
AB  - Based on our demonstration of a high incidence of hypouricemia, tubular urate
      transport abnormality, and cerebral atrophy in patients with acquired
      immunodeficiency syndrome (AIDS), we performed prospective renal clearance
      studies in 29 consecutive neurosurgical patients with intracranial diseases of
      multiple etiologies to test our hypothesis that patients with intracranial
      disorders had defective tubular urate transport. Similar studies were performed
      in 21 age-matched controls. None of the subjects had serum creatinine greater
      than 123.8 mumol/L (1.4 mg/dL), sickle cell or liver diseases, or received
      intravenous fluid or uricosuric drugs at the time of study. Seven patients had no
      surgical procedures, 12 were studied after a neurosurgical procedure, and 10 had
      preoperative and postoperative studies. Ten had more than one postoperative
      study. Twelve had 24-hour urine collections. We found that 18 of 29 patients had
      elevated fractional excretion (FE) of urate greater than 10%. There was no
      difference in preoperative and postoperative FE urate by nonpaired t test for all
      patients and by paired t test in the 10 patients who had preoperative and
      postoperative studies performed. Seven patients had hypouricemia, defined as
      serum urate less than or equal to 0.18 mmol/L (3 mg/dL). Only one had
      hyponatremia (serum sodium less than 130 mmol/L). Urate excretion averaged 3.6 +/
      0.32 mmol (603 +/- 52.7 mg)/24 h, suggesting that the hypouricemia was not due
      to decreased urate production. None of the medications or surgical procedures
      could be considered to have caused the urate transport abnormality, nor was it
      associated with any specific intracranial location or type of disease.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1739077
TI  - Potassium homeostasis with indomethacin therapy in normal subjects.
AB  - In an attempt to delineate effects of prostaglandin (PG) synthesis inhibition on
      potassium metabolism in normal subjects, we challenged 13 young, healthy
      volunteers with a potassium chloride infusion before and after a 4-day course of
      indomethacin (25 mg orally, three times a day). The plasma potassium level was
      monitored at 10-minute intervals throughout the 50-minute infusion and for a
      total of 180 minutes. The maximal increment in plasma potassium level was 0.82 +/
      0.07 mmol/L (mEq/L) in the untreated state, and 0.86 +/- 0.08 mmol/L with
      indomethacin treatment. The basal potassium level before infusion was higher in
      the indomethacin-treated than the control state (3.83 +/- 0.07 v 3.68 +/- 0.07
      mmol/L; P less than 0.01). Urinary potassium excretion over the 3-hour study
      period equalled the potassium load administered, and was unaffected by
      indomethacin therapy. Indomethacin did not alter insulin or aldosterone levels
      during the study. PGE2 excretion over the 3 hours was lower in the indomethacin
      than the control phase, although it was higher than normal in both phases. In an
      additional experiment, the comparative effects of a saline versus saline
      potassium infusion on PG excretion were studied. No differences were seen between
      the excretion patterns of PGE2 or 6-keto-PGF1a with the two infusions. We
      conclude that (1) although basal serum potassium level is slightly higher in
      healthy young people during indomethacin treatment, there is little effect on
      handling of an acute potassium load; (2) the aldosterone response to hyperkalemia
      is PG-independent; (3) urinary PG excretion increases in response to a saline
      based infusion, but the effect is not enhanced by acute potassium loading.

PMID- 1739078
TI  - Expression of differentiation antigens and growth-related genes in normal kidney,
      autosomal dominant polycystic kidney disease, and renal cell carcinoma.
AB  - Cellular differentiation and mRNA levels of genes involved in kidney growth were
      investigated in normal kidney cells, cyst-lining epithelial cells of polycystic
      kidney disease, and renal carcinoma cells (RCC). All cells comparatively studied
      exhibited an antigenic phenotype of proximal tubular cells as shown by the
      expression of a panel of brush border membrane enzymes and kidney-associated cell
      surface antigens. The epithelial developmental antigen Exo-1 was expressed in 50%
      to 80% of cyst-lining epithelia in polycystic kidney tissue and in 20% to 30% of
      polycystic kidney cells cultured in vitro. Normal kidney cells and RCC were
      negative under identical culture conditions. The expression of antigen Exo-1 is
      associated with hyperproliferation in an epithelial tissue compartment composed
      of cells which have not yet reached their terminal differentiation state.
      Increased amounts of mRNA of the growth factor receptor system of epidermal
      growth factor (EGF) receptor and its ligand transforming growth factor (TGF)
      alpha were associated with the malignant phenotype of RCC. Increased expression
      of EGF receptor and TGF-alpha, although less prominent, were also observed in
      polycystic kidney cells compared with normal kidney cells. In conclusion, the
      expression of Exo-1 in cyst-lining epithelial cells of autosomal dominant
      polycystic kidney disease (ADPKD) and the altered regulation of TGF-alpha and EGF
      receptor in these cells contribute to the hypothesis that hyperproliferation is
      an underlying pathogenic mechanism of ADPKD.

PMID- 1739079
TI  - Solute clearances with high dialysate flow rates and glucose absorption from the
      dialysate in continuous arteriovenous hemodialysis.
AB  - The purpose of this study was to determine the effects of high inlet dialysate
      flow rates (IDFR) on the clearances of urea and creatinine and to measure the
      absorption of glucose through the dialyzer in continuous arteriovenous
      hemodialysis (CAVHD). Ten anuric acute renal failure patients in the intensive
      care unit were studied. Increasing the IDFR from 0 to 33.3 mL/min (0 to 2 L/h)
      produced linear increments in the clearances of urea and creatinine, whereas
      further increases in the IDFR from 33.3 to 66.7 mL/min (2 to 4 L/h) produced less
      important, but still significant, increases in the clearances. At 66.7 mL/min,
      the clearances for urea and creatinine were 48.5 +/- 3.4 and 42.2 +/- 2.5 mL/min,
      respectively. Using a dialysate with a glucose concentration of 25.3 mmol/L (0.5
      g/dL), the net transfer of glucose through the dialyzer did not change
      significantly, from 16.7 to 66.7 mL/min of IDFR. Increasing the inlet dialysate
      glucose concentration from 25.3 to 75.8, 126.3, and 214.6 mmol/L (0.5 to 1.5,
      2.5, and 4.25 g/dL) at a fixed IDFR of 16.7 mL/min produced linear increments in
      the net glucose transferred to the patient, from 0.12 +/- 0.02 to 0.67 +/- 0.05,
      1.25 +/- 0.06 and 2.30 +/- 0.14 mmol/min, respectively (21.4, 121.0, 225.7, and
      414.5 mg/min). No significant changes in the ultrafiltration and plasma flow
      rates through the dialyzer were recorded at these different IDFR or inlet
      dialysate glucose concentrations. Ten patients were treated for 4 days or more
      with 16.7 mL/min (1 L/h) IDFR CAVHD with excellent control over kidney function
      parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1739080
TI  - Outpatient vascular access surgery: impact of a dialysis unit-based surgical
      facility.
AB  - The present report describes a novel approach to vascular access surgery based on
      the philosophy that a readily available operating room, staffed by nurses
      familiar with the unique problems of dialysis patients and their therapy, would
      reduce dialysis delays and maintain the quality of surgical care. Based on a 28
      month experience with more than 1,000 access cases, we conclude that a
      traditional surgical setting is not necessary for either quality access graft
      placement or the management of access complications.

PMID- 1739081
TI  - The Thomas shunt revisited.
AB  - During a 10-year period, 57 external Thomas femoral shunts (TS) were placed in 43
      patients for chronic hemodialysis access. Median shunt survival was 28 months
      (range, 0.5 to 132). Sixty-three percent (36/57) of shunts are presently
      functional or functioned until the time of patient death from unrelated cause or
      removal after renal transplantation. The remaining 37% (21/57) failed after a
      mean duration of 18 months (range, 2 to 40). Causes of failure were thrombosis
      (57%), refractory infection (24%), and failure during surgical revision (19%).
      There were no shunt-related deaths. Race, sex, the presence of diabetes mellitus
      or hypertension, and prior surgical revision of access did not adversely affect
      shunt survival. These results support the TS as a viable means of chronic
      vascular access for hemodialysis patients who cannot receive further upper arm
      accesses.

PMID- 1739082
TI  - Clinical experience with short-time hemodialysis.
AB  - After at least 6 months on conventional hemodialysis (cellulosic dialyzers,
      acetate dialysate, and a 3- to 4-hour treatment time), 56 patients were changed
      to short-time hemodialysis (less than 180 minutes) using polysulfone dialyzers
      and bicarbonate-containing dialysate. Treatment time decreased (191 +/- 5 v 147
      +/- 5 min; P = 0.001), while Kt/V (1.22 +/- 0.04 v 1.29 +/- 0.06; P = NS) and
      normalized protein catabolic rate (pcr) (1.10 +/- 0.05 v 1.10 +/- 0.07 g/kg/d; P
      = NS) remained constant. When compared with the conventional period, 30 months of
      short-time hemodialysis resulted in no changes in predialysis blood pressure (BP)
      (151 +/- 2/84 +/- 1 v 151 +/- 2/86 +/- 1 mm Hg), postdialysis BP (144 +/- 2/81 +/
      1 v 143 +/- 3/84 +/- 1 mm Hg), interdialytic weight gain (2.4 +/- 0.1 v 2.7 +/-
      0.2 kg), or blood urea nitrogen (BUN) (26.1 +/- 0.71 v 25.3 +/- 1.07 mmol/L [73
      +/- 2 v 71 +/- 3 mg/dL]). Shorter treatment times were not associated with an
      increase in intradialytic complications. Actually, the frequency (%) of dialysis
      treatments associated with nausea (5.94 +/- 1.33 v 2.21 +/- 0.52), vomiting (3.12
      +/- 0.87 v 0.54 +/- 0.14; P less than 0.05), headaches (5.60 +/- 1.13 v 2.03 +/-
      0.52; P less than 0.05), and back pain (0.91 +/- 0.25 v 0.05 +/- 0.05; P less
      than 0.05) was decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1739083
TI  - Comparisons of the effects of calcium carbonate and calcium acetate on zinc
      tolerance test in hemodialysis patients.
AB  - Because aluminum hydroxide, as a phosphate binder, lowered intestinal zinc
      absorption, we studied the effects of calcium carbonate (CaCO3) and calcium
      acetate (CaAc), two other phosphate binders, on intestinal Zn absorption in nine
      patients on hemodialysis and in 11 controls by measuring 1- and 2-hour serum Zn
      levels after oral administration of 50 mg of elemental Zn as Zn gluconate with or
      without concomitant administration of 2 g CaCO3 (800 mg elemental Ca) or 3 g CaAc
      (750 mg elemental Ca). Fasting serum Zn levels were not different between
      patients and controls (14.0 +/- 2.3 v 14.1 +/- 1.2 mumol/L [91.8 +/- 14.9 v 92.3
      +/- 8.0 micrograms/dL]), but the area under the curve of serum Zn increment (AUC)
      2 hours after an oral Zn challenge without or with either of two of phosphate
      binders used was significantly smaller in patients than in controls (P less than
      0.05). The AUC after concomitant administration of Zn with CaCO3 did not differ
      from that of Zn alone in either patients or controls, but it was significantly
      less in Zn with CaAc than in Zn alone or in Zn with CaCO3 in both groups. The
      results demonstrate that intestinal Zn absorption after an oral Zn challenge
      decreased in patients on hemodialysis and concomitant administration of CaAc, but
      CaCO3 did not decrease intestinal Zn absorption in either group.

PMID- 1739084
TI  - Long-term benefits of therapy with cyclophosphamide and prednisone in patients
      with membranous glomerulonephritis and impaired renal function.
AB  - Long-term follow-up data are provided for a previously reported study of patients
      with membranous glomerulonephritis (MGN), nephrotic syndrome, and renal function
      impairment. Nine patients were treated with cyclophosphamide (1 to 2 mg/kg) and
      six of these received concurrent prednisone; they are compared with 17 concurrent
      controls (14 of whom had received prednisone at some time). The mean follow-up is
      83 +/- 13 months in the treated patients and 64 +/- 7 months in the controls. Of
      the nine treated patients, four achieved a complete remission from the nephrotic
      syndrome (proteinuria less than 0.5 g/d), and five a partial remission
      (proteinuria decreased by at least 50% and to less than 3.5 g/d). One of the nine
      treated patients and 10 of the 17 controls have reached end-stage renal disease
      (ESRD) (P less than 0.05). Nine of the controls reaching ESRD had persistent
      nephrotic syndrome, whereas of the seven controls who have not yet reached ESRD,
      only two have persistent nephrotic syndrome (chi 2, P less than 0.02). There have
      been four relapses in three treated patients, and three of the four have
      responded to repeat therapy. One patient refused full therapy and remains
      nephrotic. Life-table analysis demonstrates significantly increased survival from
      ESRD in treated patients as compared with controls (P = 0.04).

PMID- 1739085
TI  - Treatment of membranous glomerulonephropathy.

PMID- 1739086
TI  - Should the urine PCO2 or the rate of excretion of ammonium be the gold standard
      to diagnose distal renal tubular acidosis?
AB  - A high rate of excretion of ammonium (NH4+) during chronic metabolic acidosis
      should rule out the diagnosis of distal renal tubular acidosis (RTA). Bearing
      this in mind, the purpose of this report is to demonstrate that a low urine minus
      blood PCO2 difference in alkaline urine (U-B PCO2) is a less reliable indicator
      of the diagnosis of distal RTA. The patient who is the subject of this report
      sniffs glue on a chronic, but intermittent basis. He presented with metabolic
      acidosis (pH 7.20; bicarbonate, 10 mmol/L) and an anion gap in plasma of 20
      mEq/L. The urine anion gap (-14 mEq/L) and osmolal gap (185 mmol/L [mOsm/kg] H2O)
      suggested that there was a high, rather than a low, rate of excretion of NH4+.
      This was confirmed by direct measurement of NH4+ in the urine (101 mumol/min).
      The high rate of excretion of NH4+ suggested that the metabolic acidosis was due,
      in large part, to an abnormally high rate of production of acid (hippuric acid,
      because the rate of excretion of hippurate was 76 mumol/min). The U-B PCO2 was
      low (10 mm Hg) on the second hospital day, after the acidosis was corrected.
      Potential reasons for the discrepancy between the high rate of excretion of NH4+
      and the low U-B PCO2 are discussed.

PMID- 1739087
TI  - Acute renal failure in hepatitis B virus-related membranous nephropathy with
      mesangiocapillary transition and crescentic transformation.
AB  - We report the first case of hepatitis B virus (HBV)-related membranous
      nephropathy (MN) that progressed to crescentic transformation superimposed on a
      mixed membranous and mesangiocapillary glomerulonephritis. The patient developed
      acute renal failure, which partially responded to pulse methylprednisolone
      therapy, and subsequently recovered after plasma exchange.

PMID- 1739088
TI  - Fatal destructive cervical spondyloarthropathy in two patients on long-term
      dialysis.
AB  - Two patients with fatal cervical cord compressive myelopathy are described, both
      of whom had been on dialysis for more than 15 years. Destructive changes were
      noted in mid and upper cervical regions, with soft tissue mass in the atlanto
      occipital region in one patient. Clinical and radiographic findings suggest both
      amyloid and hyperparathyroidism as possible etiologies for these destructive
      spinal changes. Clinicians should be aware that the full picture of quadriparesis
      may be associated with destructive spondyloarthropathy (DSA) in long-term
      dialysis patients.

PMID- 1739089
TI  - An unusual case of renal failure after pregnancy.

PMID- 1739090
TI  - Surgery in the management of autosomal dominant polycystic kidney disease.

PMID- 1739091
TI  - Effect of androgen administration on the action of exogenous erythropoietin in
      hemodialysis patients.

PMID- 1739092
TI  - Pheochromocytoma in a renal failure patient treated by hemodialysis.

PMID- 1739093
TI  - Human mesangial cells are resistant to productive infection by multiple strains
      of human immunodeficiency virus types 1 and 2.
AB  - Human immunodeficiency virus-associated nephropathy (HIVAN) is a recognized
      clinical entity of unknown pathogenesis. A role for viral infection of renal
      cells in the initiation of this process at present is an intriguing but untested
      hypothesis. Studies in primate models of acquired immunodeficiency syndrome
      (AIDS) suggest that injury to the mesangial cell may be central to the sclerosing
      glomerular lesion characteristic of HIVAN. We therefore tested the infectibility
      of human mesangial cells (HMC) in vitro by a variety of strains of HIV chosen to
      include a spectrum of tropisms for different cell types. Productive infection of
      mesangial cells could not be demonstrated using any of the virus strains.
      Nonetheless, HIV infection of intrinsic renal cells remains an attractive area of
      inquiry for understanding the natural history of HIVAN.

PMID- 1739094
TI  - Effect of renal replacement therapy on viscosity in end-stage renal disease
      patients.
AB  - Viscosity, an important determinant of microcirculatory hemodynamics, is related
      to hematocrit (HCT), and may be altered by renal failure or its treatment. To
      assess these factors, we studied the effect of dialysis on the viscosity of whole
      blood, plasma, and reconstituted 70% HCT blood of eight continuous ambulatory
      peritoneal dialysis (CAPD) and nine hemodialysis (HD) patients under steady shear
      flow conditions at different shear rates, before and after dialysis, compared
      with nine normal subjects. The density of the red blood cells (RBCs), a marker of
      cell hydration, was measured in HD patients by a nonaqueous differential
      floatation technique. Whole blood viscosity was higher in controls than patients,
      and correlated with HCT before treatment (P less than 0.05) at shear rates of
      11.5 to 230 s-1) in HD patients, and 23 to 230 s-1 in all end-stage renal disease
      (ESRD) patients. In contrast, whole blood viscosity correlated with HCT in CAPD
      patients only at the lowest shear rates (2.3 and 5.75 s-1, P less than 0.05).
      Plasma viscosity was higher in CAPD patients than both HD patients before
      treatment and controls (P less than 0.05, analysis of variance [ANOVA]), despite
      lower plasma total protein, albumin, and similar fibrinogen concentration
      compared with HD patients. When all samples were reconstituted to 70% HCT, CAPD
      patients had higher whole blood viscosity than control subjects'. The high HCT
      blood viscosity of the ESRD patients was higher than control subjects' at
      capillary shear rates, suggesting increased RBC aggregation and decreased RBC
      deformability in patients with renal disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1739095
TI  - Silicon accumulation in dialysis patients.
AB  - Plasma silicon measurements have been obtained in patients with end-stage renal
      disease on chronic dialysis therapy. The mean +/- SE values for normal plasma
      silicon concentrations are .15 +/- .02 mg/L. All dialysis groups showed marked
      elevations in their plasma silicon that correlated with the silicon content of
      their respective dialysis fluids. The values of two different hemodialysis groups
      and a peritoneal dialysis group were 4.6 +/- .4, 2.5 +/- .2, and 1.9 +/- 1.2
      mg/L, respectively. The silicon content of their respective dialysis fluids were
      4.0 +/- .7, 0.5 +/- .4, and 0 +/- .1 mg/L. The ultrafiltrability of plasma
      silicon through Cuprophane membranes was 79 +/- 2%. Hemodialysis patients
      drinking high-silicon well water showed significantly higher plasma silicon
      levels than patients drinking lower silicon municipal water. It is concluded that
      use of dialysis fluid with elevated silicon levels and the consumption of water
      containing high concentrations of silicon are two important determinants of
      silicon levels in a dialysis population. We observed no overt effects of silicon
      accumulation on the health status of our dialysis patients.

PMID- 1739096
TI  - Serum bactericidal activity for Yersinia enterocolitica in hemodialysis patients:
      effects of iron overload and deferoxamine.
AB  - Human serum has been shown to be bactericidal for most strains of Yersinia
      enterocolitica. Systemic Y enterocolitica infections have been reported in iron
      overloaded hemodialysis patients treated with deferoxamine. Both iron and
      deferoxamine are known to enhance the growth of Y enterocolitica. We inoculated
      sera from 12 hemodialysis patients whose serum ferritin levels ranged from 26 to
      6,855 micrograms/mL (ng/mL), as well as three controls, with Yersinia organisms.
      After latencies of 0 to 24 hours, inoculated sera were then plated on blood agar.
      Bactericidal activity was demonstrated in all sera and the degree of activity did
      not correlate with ferritin levels. Bactericidal activity was also demonstrated
      in sera from three deferoxamine treated patients. We conclude that in vitro, sera
      of end-stage renal failure patients, with and without iron overload, are as
      bactericidal as control sera for Y enterocolitica and that deferoxamine therapy
      does not interfere with that bactericidal activity.

PMID- 1739097
TI  - Serum calcium increases the incidence of arrhythmias during acetate hemodialysis.
AB  - We investigated the occurrence of arrhythmias during maintenance acetate
      hemodialysis (HD) using a 24-hour continuous electrocardiogram recording system.
      Three of 22 patients showed augmented increases in both ventricular premature
      beats and supraventricular premature beats during HD. When we changed the
      dialysate from one with a Ca2+ concentration of 1.75 mmol/L (3.5 mEq/L), to one
      with a Ca2+ concentration of 1.25 mmol/L (2.5 mEq/L), the elevation of serum Ca2+
      concentration during HD was abolished and the increases in both ventricular
      premature beats and supraventricular premature beats were significantly
      decreased. The elevation of serum Ca2+ concentration during HD might induce
      either extracellular or intracellular increase in Ca2+ concentration in the heart
      and elicit either reentry- or triggered-activity types of arrhythmias during HD.
      The present results indicate that the dialysate with a lower Ca2+ concentration
      is advisable to use in patients with underlying cardiac diseases.

PMID- 1739098
TI  - A comparison of reported sleep disorders in patients on chronic hemodialysis and
      continuous peritoneal dialysis.
AB  - There are few data about the prevalence and characteristics of reported sleep
      disorders in chronic dialysis patients and, although insomnia is often used as a
      marker of uremia, there are few data relating complaints of sleep to adequacy of
      dialysis. We therefore surveyed 48 hemodialysis (HD) patients, 22 continuous
      peritoneal dialysis (PD) patients, and 41 healthy control subjects about
      disordered sleep. The questionnaire included demographic data, questions
      characterizing the reported sleep problems, and linear analogue scales
      quantitating the severity of the sleep disturbance and feelings of anxiety,
      worry, and sadness. Kt/V determinations were also made for each dialysis patient.
      Fifty-two percent of the HD, 50% of the PD, and 12% of the control subjects
      reported problems sleeping (P less than 0.001, all dialysis patients v controls).
      No differences between HD and PD in characteristics of sleep problems were seen.
      Sleep severity scale results confirmed sleep disorders (7.2 in those with v 0.95
      in those without sleep disorders, where 0 = sleep a little problem and 10 = a big
      problem, P less than 0.001). Caffeine intake (P less than 0.05) and worry (P less
      than 0.004) were the only factors associated with reported sleep disturbances.
      Kt/V values (1.4 +/- 0.3) did not predict reported sleep problems. Mean reported
      hours of sleep per night (5.5 +/- 2 v 5.8 +/- 1.4) and desired hours of sleep per
      night (8.3 +/- 2 v 7.6 +/- 1.3) were similar among dialysis patients and controls
      reporting sleep problems. Dialysis patients and controls without self-reported
      sleep disorders slept a mean of 7.1 +/- 2.4 and 7 +/- 1.1 h/night,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1739099
TI  - Polymicrobial peritonitis in patients on continuous peritoneal dialysis.
AB  - Little data are available about the characteristics, outcome, and risk factors
      for polymicrobial peritonitis in patients on continuous peritoneal dialysis. We
      therefore reviewed the 43 episodes of polymicrobial peritonitis that occurred in
      39 of our patients over the 11.5 years of our program. Polymicrobial peritonitis
      represented 9% (43/492) of all peritonitis episodes. Only three episodes of
      polymicrobial peritonitis were associated with an enteric source. Sixteen percent
      (7/43) of the polymicrobial peritonitis episodes were associated with catheter
      infections. Staphylococcus aureus was one of the cultured organisms in 33% of the
      polymicrobial peritonitis episodes. Patients with polymicrobial peritonitis had
      higher rates of tunnel infection (0.28/yr v 0.18/yr) and overall peritonitis
      (1.23/yr v 0.81/yr) than patients with single-organism peritonitis. Black
      patients were more likely to have polymicrobial peritonitis (12/56 v 27/338
      whites, chi 2 = 9.8, P less than 0.005). Patient age, gender, time on peritoneal
      dialysis, insulin dependence, and cause of end-stage renal disease had no
      influence on polymicrobial peritonitis. Significantly more catheters were removed
      for polymicrobial peritonitis than for single-organism peritonitis (17/42 v
      89/420, chi 2 = 7.05, P less than 0.01), but in 60% of the episodes, the
      polymicrobial peritonitis was successfully treated without catheter removal.
      Polymicrobial peritonitis often occurs without gram-negative organisms and
      extension of catheter infection may be involved in some cases. For unclear
      reasons, black patients are at higher risk of polymicrobial peritonitis.

PMID- 1739100
TI  - Effect of pregnancy on long-term function of renal allografts.
AB  - Pregnancy in renal allograft recipients is associated with hyperfiltration with
      the potential for glomerular damage and adverse effects on long-term graft
      prognosis. We have undertaken a case-controlled study of posttransplant follow-up
      for a mean of 12 years (range, 4 to 23) in 36 female renal allograft recipients,
      18 who became pregnant and 18 controls (matched to underlying disease and renal
      function) who did not. Assessments included plasma creatinine (PCr), glomerular
      filtration rate (GFR) by infusion clearance of inulin (Cin), mean arterial
      pressure (MAP), and documentation of antihypertensive therapy. By the end of
      follow-up, PCr in the pregnancy group (112 +/- 73 mumol/L [1.26 +/- 0.83 mg/dL])
      and controls (127 +/- 52 mumol/L [1.44 +/- 0.59 mg/dL]) had increased by 19% and
      8%, respectively, and GFR in the pregnancy group (58 +/- 29 mL/min) and controls
      (56 +/- 32 mL/min) had decreased by 18% and 7%, respectively. Graft loss or
      chronic rejection occurred in two patients in each group and there was a death in
      the pregnancy group 9 years after the second of two successful pregnancies. MAP
      in the pregnancy group (96 +/- 12 mm Hg) had decreased by 1%, and in the controls
      (101 +/- 9 mm Hg) had increased by 5%. Two patients in the index group and three
      in the control group commenced antihypertensive therapy during follow-up. There
      was, therefore, no evidence of an adverse effect of pregnancy in renal allograft
      recipients on long-term renal function or development of hypertension.

PMID- 1739101
TI  - Pregnancy in the renal transplant patient.

PMID- 1739102
TI  - Hyperlipidemia associated with alpha-mercaptopropionylglycine therapy for
      cystinuria.
AB  - Treatment of cystinuria with alpha-mercaptopropionylglycine has been associated
      with fewer side effects than traditional therapy with D-penicillamine. In this
      report, we describe a patient who developed hyperlipidemia secondary to alpha
      mercaptoproprionylglycine therapy. This abnormality resolved after the therapy
      was discontinued and did not recur with lower dose therapy. Patients treated with
      alpha-mercaptoproprionylglycine should be monitored closely for the development
      of lipid abnormalities.

PMID- 1739103
TI  - B-cell lymphoma presenting as infiltrative renal disease.
AB  - Acute renal failure is rarely the presenting manifestation of non-Hodgkin's
      lymphoma. Of the reported cases of renal insufficiency secondary to diffuse renal
      infiltration with lymphoma, few have presented with acute renal failure. We
      present a patient with acute renal failure secondary to diffuse bilateral renal
      infiltration by a B-cell non-Hodgkin's lymphoma. The findings of an elevated
      serum lactate dehydrogenase (LDH), lymphopenia, and homogenous bilateral renal
      enlargement on computed tomographic (CT) imaging were important in suggesting the
      diagnosis of primary renal lymphoma. Renal biopsy with immunohistochemical and
      ultrastructural analysis was instrumental in confirming this diagnosis.

PMID- 1739104
TI  - Immunotactoid (microtubular) glomerulopathy: an entity distinct from fibrillary
      glomerulonephritis?
AB  - Immunotactoid glomerulopathy (IT), or alternatively, microtubular glomerulopathy,
      is a term that has been used by some investigators to encompass those
      glomerulopathies characterized by the presence of fibrillar or microtubular
      deposits which are distinguished from amyloid principally by their larger size
      and lack of reactivity with the Congo red reagent. A case is presented here of IT
      as it was initially described. The present case, and a review of the literature,
      suggest that the diagnosis of IT be restricted to those glomerulopathies
      associated with large, at times organized, microtubular deposits. Terms such as
      fibrillary glomerulonephritis, or alternatively Congo red-negative amyloidosis
      like glomerulopathy, could then be used to describe those patients with smaller,
      fibrillar glomerular deposits having an appearance closely resembling amyloid. We
      believe it is possible to separate the entities fibrillary glomerulonephritis and
      IT on morphological grounds. This is a potentially useful distinction that
      identifies patients who are likely to have or develop clinical evidence of a
      lymphoplasmacytic disorder or dysproteinemia, which are associated with deposits
      of IT, and distinguishes them from patients with fibrillary glomerulonephritis,
      of whom only a single case has been linked to such clinical findings.

PMID- 1739105
TI  - Contribution of urinary titratable acid to acid-base homeostasis.

PMID- 1739107
TI  - Undercover nursing.

PMID- 1739106
TI  - Musculoskeletal complications after renal transplantation: pathogenesis and
      treatment.
AB  - Renal transplantation is associated with several abnormalities of function and
      structure of the musculoskeletal system. Some of these skeletal problems result
      from incomplete resolution of abnormalities of bone and mineral metabolism
      present at the time of transplantation. In this regard, persistent
      hyperparathyroidism, diabetes mellitus type 1, and accumulation of beta 2
      microglobulin may lead to residual skeletal effects despite excellent function of
      the allograft. Persistent hyperparathyroidism may accelerate bone loss and
      increase the risk for osteonecrosis, as well as cause hypercalcemia and
      hypophosphatemia; some patients with severe hyperparathyroidism require
      parathyroid surgery. Osteonecrosis is the most debilitating skeletal complication
      after transplantation and frequently requires surgical therapy. Although
      osteomalacia associated with aluminum overload generally resolves after
      transplantation, bone complications due to dialysis amyloidosis and diabetes
      mellitus type 1 often fail to improve. Alternatively, skeletal abnormalities can
      be acquired after transplantation. Most of the new derangements of bone and
      mineral metabolism are due to the immunosuppressive medications. Toxic effects of
      glucocorticoids on bone contribute to the pathogenesis of osteonecrosis, increase
      the risk for fractures by decreasing cancellous bone mass and synthesis of bone
      matrix, and dampen the linear growth response in pediatric recipients. Whether
      cyclosporine independently causes appreciable toxic effects on bone metabolism is
      not yet clear, but use of this drug increases the prevalence of gout and dental
      problems. Osteonecrosis, osteopenia, and short stature remain important skeletal
      complications in recipients of renal allografts. Therapeutic efforts should be
      directed toward alleviating pretransplant bone disease and attenuating bone loss
      after transplantation.

PMID- 1739108
TI  - New roles for interferon-alpha?

PMID- 1739109
TI  - Healthy reform or exacerbated status quo?

PMID- 1739110
TI  - More on hospice six.

PMID- 1739111
TI  - Steroidphobia and the pulmonary patient.

PMID- 1739112
TI  - Why give corticosteroids for Pneumocystis carinii pneumonia?

PMID- 1739113
TI  - Use a decision tree to choose wound dressings.

PMID- 1739114
TI  - MRSA: Pandora's box for hospitals.

PMID- 1739115
TI  - Job focus. Rehab: 'primary nursing as it was meant to be.'.

PMID- 1739116
TI  - NMS: rare and dangerous drug reaction.

PMID- 1739117
TI  - Job focus. Your guide to nursing opportunities on the West Coast.

PMID- 1739118
TI  - The staph that eats hospitals.

PMID- 1739119
TI  - Pointing out medication errors.

PMID- 1739120
TI  - Eggs mean murder.

PMID- 1739121
TI  - Casein kinase II alteration precedes tau accumulation in tangle formation.
AB  - Previous studies have shown altered casein kinase II (CK-II) in Alzheimer's
      disease (AD). For the present study, the authors analyzed CK-II immunoreactivity
      at various stages of tangle formation using quantitative laser confocal
      microscopy and immunoelectron microscopy. AD hippocampal pyramidal cells without
      neurofibrillary tangles (NFTs) displayed 15% more anti-tau immunoreactivity (P
      less than 0.01) and 43% more anti-CKII immunolabeling than controls (P less than
      0.001). In AD, tangle-bearing hippocampal neurons with strong anti-tau
      immunoreactivity (threefold increase from controls) showed a significant 22%
      increase in anti-CKII immunolabeling (P less than 0.01), compared with those
      without NFTs. Neurons with early neurofibrillary changes showed diffuse anti-CKII
      immunostaining in their cytoplasm and cell processes. In tangle-bearing neurons,
      in which a higher level of tau immunoreactivity was detected, anti-CKII
      immunolabeling was distributed along a fibrillar meshwork in cell bodies and
      processes. Linear regression analysis of anti-CKII and anti-tau immunoreactivity
      in AD showed a positive correlation (r = 0.53, P less than 0.001). At the
      ultrastructural level, anti-CKII was immunolocalized to the paired helical
      filaments (PHF) of the tangle-bearing neurons, as well as to PHF in neuropil
      threads and some dystrophic neurites in plaques. These results suggest a possible
      role for CK-II in tangle formation.

PMID- 1739122
TI  - Beta protein immunoreactivity is found in the majority of neurofibrillary tangles
      of Alzheimer's disease.
AB  - The presence of dystrophic neurites in most extracellular neurofibrillary tangles
      (E-NFT) suggests a factor promoting neurite growth in E-NFT. Although the beta
      protein detected in E-NFT may fill that role, reports that only 2-10% of E-NFT
      contain beta-protein whereas 80-100% contain dystrophic neurites suggested that
      beta-protein does not play an important role. In this study, the authors used two
      antisera and one monoclonal antibody to beta-protein to establish the effects of
      tissue preparation and formic acid enhancement on the detection of beta-protein
      in E-NFT. We found that beta-protein epitopes in E-NFT are sensitive to
      formaldehyde fixation and are best enhanced by 50% formic acid, whereas beta
      protein in senile plaques is best enhanced at higher formic acid concentrations.
      After treatment with 50% formic acid, beta-protein was found in all E-NFT.
      Interestingly, after treatment with 10% formic acid, half of intraneuronal-NFT (I
      NFT) also contained beta-protein immunoreactivity. The finding that beta-protein
      immunoreactivity in senile plaques, E-NFT and I-NFT is increased at different
      formic acid concentrations suggests that beta-protein in each location is in a
      different conformation. In contrast, no beta-protein immunoreactivity could be
      found in E-NFT of the brain stem, an area in which dystrophic neurites do not
      infiltrate E-NFT. These findings indicate a correlation between neuritic
      infiltration and presence of beta-protein in E-NFT and suggests the two are
      linked in Alzheimer's disease for E-NFT as well as senile plaques.

PMID- 1739123
TI  - Macrophage colony-stimulating factor mRNA and protein in atherosclerotic lesions
      of rabbits and humans.
AB  - In this study, the authors demonstrate the expression of mRNA and the presence of
      protein for macrophage colony-stimulating factor (MCSF) in atherosclerotic
      lesions from humans and rabbits. In situ hybridization of serial sections of
      human fatty streaks demonstrated expression of MCSF mRNA by cells dispersed
      throughout the lesions. Immunocytochemical staining with a panel of MCSF-specific
      antibodies showed extensive cell-associated staining of all of the cell types in
      the lesions. Immunocytochemical studies of atherosclerotic lesions from Watanabe
      heritable hyperlipidemic (WHHL) and cholesterol-fed rabbits demonstrated a
      similar cell-associated pattern of staining. There was no MCSF-specific staining
      of aortas from normal rabbits or of cultured aortic smooth muscle cells from
      either humans or rabbits. Macrophage-derived foam cells (MFC) were isolated from
      the aortas of ballooned, cholesterol-fed rabbits. A Northern blot demonstrated
      that RNA isolated from the MFC hybridized with a human cDNA probe for MCSF. RNA
      from alveolar macrophages isolated simultaneously from the same rabbits did not
      hybridize with the MCSF probe. Conditioned media from an 18- to 24-hour
      incubation of the MFC contained colony-stimulating activity as demonstrated in a
      mouse bone marrow culture assay. Most of this colony-stimulating activity was
      neutralized by preincubating the conditioned media with an MCSF-specific
      antibody.

PMID- 1739124
TI  - Macrophage colony-stimulating factor gene expression in vascular cells and in
      experimental and human atherosclerosis.
AB  - The infiltration of monocytes into the vascular wall and their transformation
      into lipid-laden foam cells characterizes early atherogenesis. Macrophages are
      also present in more advanced human atherosclerotic plaques and can produce many
      mediators that may contribute to lesion formation and progression. Macrophage
      colony-stimulating factor (MCSF) enhances the proliferation and differentiation
      of monocyte progenitors and is required for the survival and activation of mature
      monocytes and macrophages. The authors therefore examined the expression of the
      MCSF gene in cultured human vascular endothelial (EC) and smooth muscle cells
      (SMC) as well as in atheromatous lesions from rabbits and humans. Growth arrested
      EC and SMC contain a low level of MCSF mRNA. Bacterial lipopolysaccharide (LPS),
      recombinant human interleukin-1 alpha (IL-1 alpha) or tumor necrosis factor alpha
      (TNF alpha) induced MCSF mRNA accumulation in a concentration-dependent manner in
      both EC and SMC. These stimuli induced large increases in MCSF mRNA with peak
      induction between 4-8 hours after treatment. LPS, IL-1 alpha, and TNF alpha
      stimulated EC and SMC also showed increased fluorescent antibody staining for
      MCSF protein and released immunoreactive MCSF in a time-dependent manner. In
      contrast, phorbol 12-myristate 13-acetate (PMA) was a less potent inducer of MCSF
      gene expression and iron-oxidized low-density lipoproteins (ox-LDL) did not
      increase consistently MCSF mRNA or the synthesis and secretion of immunoreactive
      protein. Northern analysis of mRNA isolated from the atheromatous aorta of
      rabbits fed a 1% cholesterol diet for 10 weeks showed elevated MCSF mRNA compared
      with controls. Immunostaining of atheromatous arterial lesions of rabbits
      demonstrated MCSF protein in association with intimal SMC as well as macrophages.
      Furthermore, polymerase chain reaction (PCR) analysis of MCSF mRNA in human
      atheromata showed higher levels than found in nonatherosclerotic arteries and
      veins. Since the authors found no mRNA for the MCSF receptor, c-fms, in cultured
      EC or SMC macrophages are likely the primary target for MCSF within atheromatous
      vessels. The authors therefore investigated the effects of MCSF on monocyte
      functions related to foam cell development. Treatment of cultured human monocytes
      with recombinant human MCSF (10(3) U/ml, 72 hr) led to the accumulation of mRNA
      for the acetyl-LDL (scavenger) receptor and apolipoprotein E (apo E). These
      studies establish that vascular EC and SMC produce substantial MCSF in response
      to a variety of stimuli. The local production of MCSF during atherogenesis may
      contribute to macrophage survival and proliferation or activate specific
      macrophage functions such as expression of the scavenger receptor and secretion
      of apo E.

PMID- 1739125
TI  - Histologic findings after in vivo placement of small intestine submucosal
      vascular grafts and saphenous vein grafts in the carotid artery in dogs.
AB  - A small caliber vascular graft from porcine small intestine submucosa (SIS) was
      implanted in a canine carotid artery (n = 24) and compared with an autogenous
      saphenous vein graft that was implanted in the contralateral carotid artery. In
      this study, four grafts were evaluated at the following times after surgery: 2,
      7, 14, 28, 90, and 180 days. One SIS graft thrombosed at 2 days, two SIS and two
      saphenous vein grafts were thrombosed at 90 days, and one SIS and one saphenous
      vein graft were thrombosed at 180 days. At 2 days after implant, the luminal
      surface of the SIS graft was covered by a thin (30 mu) fibrin meshwork. By 14
      days after surgery, endothelial cells on the fibrin meshwork were staining for
      FVIII-related antigen. Smooth muscle cells were observed in the new intima
      (fibrin meshwork) by 28 days. At 90 days, both types of graft had arterialized
      with an intima covered by endothelium, a smooth muscle media, and marked
      adventitial fibrosis. Similar histology was observed at 180 days. These results
      indicate that this SIS graft was similar to saphenous vein graft in the dog.

PMID- 1739126
TI  - Malaria mimicry with tumor necrosis factor. Contrasts between species of murine
      malaria and Plasmodium falciparum.
AB  - Because Plasmodium berghei ANKA induces cerebral malaria and P. vinckei does not,
      the former has often been studied as a model for human falciparum malaria. It
      lacks, however, many of the systemic changes seen in the human disease. Because
      both of these murine models and the human disease have now been defined in terms
      of excess tumor necrosis factor (TNF) production, the authors have more closely
      examined the two murine models in this light to see which provides the better
      overall model for falciparum malaria. Administering TNF to malaria-infected mice
      did not cause cerebral symptoms nor breakdown of the blood-brain barrier, which
      is the hallmark of P. berghei ANKA cerebral malaria and is generally absent in
      human cerebral malaria. Tumor necrosis factor did, however, induce hypoglycemia
      and liver injury, pathology that is seen in terminal P. vinckei and falciparum
      malaria, but is absent in terminal P. berghei ANKA malaria. Plasma TNF and
      interleukin-6 (IL-6) also were found to be consistently higher in infections
      caused by P. vinckei than in those caused by P. berghei ANKA. The pathology of P.
      vinckei malaria is thus consistent with raised systemic levels of TNF and other
      cytokines, as is falciparum malaria. The authors therefore conclude that P.
      vinckei malaria, although lacking a cerebral component, is the better model for
      the human disease.

PMID- 1739127
TI  - Detection of intratumoral aromatase in breast carcinomas. An immunohistochemical
      study with clinicopathologic correlation.
AB  - The expression of aromatase was evaluated in 38 breast carcinomas by an
      immunohistochemical method (ABC) using an specific polyclonal antibody against
      human placental aromatase. Fifteen tumors (40%) showed significant
      immunoreactivity, as defined by cytoplasmic positivity of moderate intensity
      present in at least 15% of the cells. The results were correlated with the
      estrogen and progesterone hormone receptor status and several clinicopathologic
      parameters such as age, tumor size, lymph node status, and stage of the disease.
      There was a significant, but inverse, correlation between the aromatase activity
      and the estrogen receptor status (P = 0.04), indicating the likelihood of
      negative estrogen if substantial aromatase activity was present. No statistically
      significant correlation was found between the presence of intratumoral aromatase
      and the rest of the parameters studied (P greater than 0.7). Nor was there a
      correlation between the aromatase content of the tumors and the menopausal
      status. The degree of intratumoral heterogeneity of the aromatase content was
      minimal in six cases where multiple samples from each tumor were analyzed. This
      is the first study reporting the detection of aromatase in archival material from
      breast carcinomas using immunohistochemical techniques. The lack of biologic
      significance of its presence in breast cancer reported here and by others using
      biochemical assays should be validated in larger series with longer follow-up.
      The method described can be readily used for that objective.

PMID- 1739128
TI  - Accumulation of alpha B-crystallin in central nervous system glia and neurons in
      pathologic conditions.
AB  - Alpha B-crystallin, a major protein of the vertebrate lens, is found in the
      central nervous system (CNS) and is a major protein component of Rosenthal fibers
      (RF), intracytoplasmic inclusions within astrocytes. Its level of expression in
      the normal CNS is low and appears to be confined to glial cells, both astrocytes
      and oligodendrocytes. A number of human brains displaying a variety of pathologic
      changes were examined by immunohistochemistry with an anti-alpha B-crystallin
      antiserum and increased immunoreactivity was found in astrocytes and
      oligodendrocytes without the formation of RFs. Furthermore, some neurons in
      neurodegenerative disorders were also immunolabeled with the anti-alpha B
      crystallin antiserum. Thus, the accumulation of alpha B-crystallin appears to be
      part of the repertoire of reactive processes of CNS glial cells and some neurons
      in pathologic conditions.

PMID- 1739129
TI  - Extracellular matrix protein gene expression in atherosclerotic hypertensive
      pulmonary arteries.
AB  - Lobar pulmonary arteries from patients with unexplained pulmonary hypertension
      were obtained at the time of single-lung transplantation to determine the
      response of large elastic vessels to increased intraluminal pressure.
      Specifically, human pulmonary arteries were examined to determine if remodeling
      remained active at the time of surgery and whether remodeling was similar to
      previously reported remodeling observed in several animal models. Grossly, the
      hypertensive vessels appeared atherosclerotic. Histochemical stains revealed a
      thick, diffuse neointima in hypertensive vessels compared with normal vessels.
      Immunohistochemistry demonstrated elastin protein in the neointima and in situ
      hybridization studies demonstrated tropoelastin mRNA largely in the neointima.
      Similarly, immunohistochemistry and in situ hybridization detected cellular
      fibronectin, thrombospondin and type I collagen protein and mRNA within the
      thickened intima from hypertensive vessels. These studies provide evidence that
      hypertensive vessels in patients with severe chronic pulmonary hypertension are
      actively remodeling but that the pattern of remodeling is different from
      previously described animal models.

PMID- 1739130
TI  - Cytokine-induced gene expression of interleukin-8 in human transitional cell
      carcinomas and renal cell carcinomas.
AB  - Chemotactic cytokines play a critical role in recruiting leukocytes to sites of
      tissue injury. Interleukin-8 (IL-8) is a chemotactic cytokine secreted by a
      variety of cells (eg, monocytes, endothelial cells, fibroblasts) during the
      inflammatory response. In this report, the authors demonstrate that human
      transitional cell carcinomas and renal cell carcinomas have the capacity to
      elaborate IL-8 in response to the inflammatory mediators IL-1 beta and tumor
      necrosis factor (TNF)-alpha. All cell lines expressed high levels of IL-8 mRNA on
      stimulation with either IL-1 beta or TNF-alpha, but not lipopolysaccharide; one
      expressed the gene constitutively. The authors selected one transitional cell
      carcinoma cell line (UM-UC-9) and one renal cell carcinoma cell line (UM-RC-5)
      for further study. Both displayed a time- and dose-dependent increase in steady
      state levels of IL-8 mRNA in response to IL-1 beta and TNF-alpha. Specific mRNA
      was detectable by 1 hour after stimulation. Secretion of antigenic IL-8 measured
      by enzyme-linked immunosorbent assay into culture supernatants reflected the
      kinetics of mRNA expression. Because heat-inactivated TNF-alpha failed to induce
      synthesis of IL-8 mRNA, and cycloheximide augmented TNF-alpha-induced synthesis,
      IL-8 expression appears to be a stimulus-specific primary induction phenomenon.
      As with other inflammatory mediators whose mRNA contains a 3' AU-rich sequence
      (eg, IL-2, TNF-alpha), the half-life of IL-8 mRNA was short, less than 1 hour.
      Our data suggest that secretion of IL-8 by malignant cells may partly account for
      the inflammatory infiltrates associated with some malignant neoplasms.

PMID- 1739131
TI  - Immunopathologic analysis of human urinary bladder cancer. Characterization of
      two new antigens associated with low-grade superficial bladder tumors.
AB  - The authors have further characterized the normal human tissue distribution and
      tumor expression of two highly restricted tumor-associated antigens, detected by
      mouse monoclonal antibodies M344 and 19A211, which are primarily expressed on low
      grade superficial urinary bladder tumors. This study was conducted using
      immunohistochemical staining of frozen and deparaffinized sections of human
      normal and tumor tissues. The antigens are stable and well preserved on
      deparaffinized tissue sections. M344 antibody identifies a high-molecular-weight
      determinant on a cytosolic protein component of over 300,000 Mr. This antigen was
      not detected on any normal tissue analyzed, including 14 specimens of normal
      urothelium and 22 cases of cystitis; however, M344 was positive in 74.5% of Ta-T1
      tumors and 11% of T3-T4 tumors. 19A211 antibody identifies a sialylated epitope
      on a cytoplasmic protein complex of 100,000 to 200,000 Mr. This antigen also was
      expressed preferentially on low-grade superficial bladder tumors (77% Ta-T1) and
      less frequently on deeply infiltrating tumors (10% T3-4). 19A211 was negative on
      all normal cells tested, with the exception of umbrella cells, in approximately
      25% of the normal urothelium and cystitis specimens studied. Either one or both
      of these tumor-associated antigens are detected in approximately 80% of low-grade
      papillary superficial tumors and carcinoma in situ of the urinary bladder. The
      expression of these antigens on a subset of low-grade bladder tumors, known to
      progress in only about 10% of cases, suggests that phenotypic differences may
      reflect biologic potential. Beyond their possible biologic significance,
      antibodies M344 and 19A211 may provide clinically useful probes for early
      detection and stratification of urinary bladder tumors.

PMID- 1739132
TI  - Expression and function of heterotypic adhesion molecules during differentiation
      of human skeletal muscle in culture.
AB  - The infiltration of skeletal muscle by leukocytes occurs in a variety of
      myopathies and frequently accompanies muscle degeneration and regeneration. The
      latter involves development of new myofibers from precursor myoblasts, and so
      infiltrating cells may interact with muscle at all stages of differentiation. The
      authors have investigated the surface expression of ligands for T-cell adhesion
      during the differentiation of human skeletal muscle in vitro. Myoblasts expressed
      low levels of ICAM-1 (CD54), which remained constant during muscle cell
      differentiation and could be induced by cytokines such as gamma-interferon. It is
      therefore likely that ICAM-1 is involved in the invasive accumulation of
      lymphocytes during skeletal muscle inflammation. In contrast, LFA-3 (CD58) was
      expressed at higher levels than ICAM-1 on myoblasts, decreased significantly
      during myogenesis, and was unaffected by immune mediators. Both ICAM-1 and LFA-3
      were able to mediate T cell binding to myoblasts, whereas adhesion to myotubes
      was independent of the LFA-3 ligand. Although expressed throughout myogenesis,
      human leukocyte antigen class I and CD44 did not appear to mediate T cell
      binding. The expression of ligands that facilitate interaction of myogenic cells
      with lymphocytes may have important implications for myoblast transplantation.

PMID- 1739133
TI  - Porcine von Willebrand disease and atherosclerosis. Influence of polymorphism in
      apolipoprotein B100 genotype.
AB  - The relationship of apolipoprotein-B genotype (Lpb) to diet-induced
      hypercholesterolemia and atherosclerosis was studied in von Willebrand disease
      (vWD) and normal pigs. Von Willebrand and normal pigs developed comparable levels
      of hypercholesterolemia (respectively, 757.9 +/- 49.4 versus 772.8 +/- 47.9
      mg/dl, P = 0.95). Pigs with Lpb1/5 and Lpb5/8 genotypes, however, developed
      significantly higher serum cholesterol levels than those with other Lpb genotypes
      (866.1 +/- 64.0 mg/dl, P = 0.0343). Coronary and aortic atherosclerosis, measured
      by computer-assisted automated image analyzer, were not significantly different
      between vWD and normal pigs. Pigs with an Lpb5 allele developed significantly
      more atherosclerosis than those with the Lpb3/8 or Lpb8/8 genotypes or the rare
      Lpb1 allele (r greater than or equal to 0.434, P less than or equal to 0.05).
      Polymorphism in apolipoprotein B100 genotype, then, significantly influenced the
      severity of diet-induced hypercholesterolemia and atherosclerotic plaque
      formation in vWD and normal swine without regard to the vWD genotype.

PMID- 1739134
TI  - Vascular expression of glucose transporter in experimental brain neoplasms.
AB  - Vascular abnormalities in brain neoplasms are important to tumor biology and
      therapy. Glucose transporter (GLUT1) expression is a differentiated property of
      normal cerebral microvessels typically associated with expression of the blood
      brain barrier. We investigated the relationship of GLUT1 expression to other
      vascular characteristics in F98, 9L, and C6 gliomas and Walker 256 carcinomas
      implanted into adult rat brains. The percentages of microvessels with
      immunohistochemically detectable GLUT1 were 95.5 +/- 3.9 in F98, 60.9 +/- 3.9 in
      9L, 45.4 +/- 5.6 in C6, and 1.2 +/- 0.3 in Walker 256 (mean +/- SEM). The
      percentage of GLUT1-positive vessels in F98 was not statistically different from
      that in normal brain. GLUT1 expression was not dependent on restricted
      permeability as all tumors were highly permeable to Evans blue. GLUT1 expression
      was unrelated to vascular density, vascular morphology, and parenchymal GFAP
      expression. The expression of GLUT1, a marker of cerebral endothelial
      differentiation, is a newly described property of glial tumor vessels that may
      have diagnostic and prognostic significance.

PMID- 1739135
TI  - Characterization of uterine epithelium apoptotic cell death kinetics and
      regulation by progesterone and RU 486.
AB  - The authors show here that progesterone suppresses apoptosis, and its antagonist
      RU 486 induces it in rabbit uterine epithelium, as assessed by morphologic and
      biochemical studies. The authors' studies demonstrate that internucleosomal DNA
      fragments are identifiable as early as 24 hours after ovariectomy of
      pseudopregnant rabbits, and become undetectable 6 days after ovariectomy. Maximal
      levels of DNA fragmentation (about 74% of total isolated DNA) were observed 36
      hours after ovariectomy. The number of apoptotic cells appeared to increase
      parallel to the increased DNA breakdown, and accounted for approximately 26% of
      the uterine epithelial cells at 48 hours after ovariectomy. Levels of
      progesterone in serum dropped precipitously 6 hours after ovariectomy and
      remained very low for several days. Administration of progesterone, more than any
      other steroid hormone, to pseudopregnant ovariectomized rabbits, prevented the
      increase in apoptotic cell death. By contrast, administration of the anti
      progestin RU 486 to pseudopregnant rabbits triggered apoptosis, which attained
      levels similar to those observed in ovariectomized animals. The authors' findings
      establish that uterine epithelium apoptosis occurs in a time-dependent fashion
      and provides strong evidence that the actions of progesterone in that tissue are
      not only to stimulate cell proliferation and differentiation, but also to
      suppress apoptosis.

PMID- 1739136
TI  - Protection of human umbilical vein endothelial cells by glycine and structurally
      similar amino acids against calcium and hydrogen peroxide-induced lethal cell
      injury.
AB  - Cultured human umbilical vein endothelial cells treated with either the calcium
      ionophore, ionomycin, or ionomycin plus cyanide-m-chlorophenylhydrazone had
      immediate severe depletion of adenosine triphosphate, (ATP) and increases of
      cytosolic free calcium (Caf) and then sustained lethal cell injury as manifested
      by release of lactate dehydrogenase and failure to exclude vital dyes within 15
      minutes. Inclusion of glycine in the experimental medium prevented the enzyme
      leakage for at least 60 minutes without altering the ATP depletion or increases
      of Caf. The physiologic glycine concentration of 0.25 mmol/l gave 50% protection,
      and protection was complete at 1 mmol/l. Several other small neutral amino acids,
      L- and D-alanine, beta-alanine, 1-aminocyclopropane-1-carboxylate, alpha
      aminoisobutyrate, and L-serine, had effects similar to glycine, but other amino
      acids and metabolic substrates did not. The endothelial cells were relatively
      resistant to damage from hydrogen peroxide, but sensitivity could be increased by
      preloading with Fe2+. In both non-loaded and Fe(2+)-loaded cells, hydrogen
      peroxide-induced lactate dehydrogenase (LDH) release developing over 180 minutes
      was prevented by glycine in a fashion analogous to that seen with ionomycin
      damage. Mn2+ also partially protected against hydrogen peroxide injury but was
      not required for glycine's effects. These data demonstrate that striking
      modulatory effects of glycine and structurally similar amino acids that have
      previously been characterized in most detail using kidney tubule cells are
      strongly expressed in human umbilical vein endothelial cells and are involved in
      their response to Ca2+ and oxidant-mediated damage. These amino acid effects must
      be considered in the design of in vitro studies of endothelial cell injury and
      may contribute to endothelial cell pathophysiology in vivo.

PMID- 1739137
TI  - Establishment and characterization of five new human renal tumor xenografts.
AB  - Ten different human renal cell carcinoma (RCC) primary tumors were xenografted
      into BALB/c nu/nu mice. Five of the tumors (NU-10, NU-12, NU-20, NU-22, and NU
      28) gave rise to serially transplantable tumors that were further characterized.
      Histology, DNA index, immunohistochemical characteristics, growth rate, and
      clonogenic potential were followed from primary tumor to the 5th to 15th
      transplant passage. Only one of the tumors (NU-20) showed remarkable instability
      for all tested parameters in the first five transplant passages. Histology of the
      other tumors was essentially the same to the histology of the primary tumors,
      although differences between human and host-derived vessels were apparent. DNA
      index values in general showed a trend toward an aneuploid character of the
      xenografts. Immunohistochemical analyses showed a loss of intensity of staining
      but a concomitant rise in the fraction of positively staining cells with
      antibodies against cytokeratins, vimentin, tumor-associated antigens, and human
      leukocyte antigen (HLA) class I antigens. Human leukocyte antigen class II
      antigen expression showed a loss of intensity as well as a decrease in the
      fraction of positive cells. Tumor doubling time was lowest in transplant passage
      number 0, and stable growth was noticed in transplant passages 1 through 4.
      Clonogenic potential of four of the lines was higher for the xenografts than for
      the primary tumors. The authors conclude that, on xenografting, histologic
      characteristics of the primary tumor are essentially conserved. Progression in
      the first transplant passages, however, results in tumors with a more aggressive
      character.

PMID- 1739138
TI  - Tissue eosinophilia and eosinophil degranulation in syndromes associated with
      fibrosis.
AB  - Eosinophilia has long been associated with endomyocardial fibrosis, but the
      involvement of the eosinophilia in fibrosis of other organs is unclear. To
      investigate this question, the authors tested whether tissue eosinophilia and
      eosinophil degranulation are present in syndromes associated with fibrosis. The
      authors used an indirect immunofluorescent technique to localize eosinophil
      granule major basic protein (MBP) in formalin-fixed, paraffin-embedded tissue
      specimens from 50 patients. Thirty-four specimens were obtained from patients
      with inflammatory fibrosis: 12 with idiopathic retroperitoneal fibrosis, seven
      with sclerosing mediastinitis, four with sclerosing cholangitis, and 11 with
      pulmonary fibrosis. The remaining 16 specimens were obtained from patients with
      noninflammatory fibrous proliferations: four with keloids, six with scars, three
      with Dupuytren's contracture and three with dense stromal fibrosis of the breast.
      Eosinophil infiltration and/or extracellular MBP deposition were observed in 28
      of the 34 specimens (82%) from patients with inflammatory fibrosis, including 11
      of the 12 cases of retroperitoneal fibrosis, five of the seven cases of
      sclerosing mediastinitis, all four cases of sclerosing cholangitis, and 8 of the
      11 cases of pulmonary fibrosis. In contrast, eosinophil infiltration and MBP
      deposition were not observed in specimens from the 16 patients with
      noninflammatory fibrous proliferation (P less than 0.001). These results indicate
      that eosinophil infiltration and release of a granule protein, namely MBP,
      commonly occur in inflammatory fibrotic lesions.

PMID- 1739139
TI  - Women health workers: past and present.

PMID- 1739140
TI  - Men who have sex with men: continued challenges for preventing HIV infection and
      AIDS.

PMID- 1739141
TI  - Prevention: the cost-effectiveness of the California Diabetes and Pregnancy
      Program.
AB  - BACKGROUND: The California Diabetes and Pregnancy Program is a new preventive
      approach to improving pregnancy outcomes through intensive diabetes management
      preconception and early in pregnancy. METHODS: Hospital charges and length of
      stay data were collected on 102 program enrollees and 218 control cases. Ninety
      program enrollees and 90 control cases were matched on mother's age. White's
      classification, and race. Regression models controlled for these variables in
      addition to MediCal status, birth weight, and enrollment in the program. RESULTS:
      Hospital charges were about 30% less for program participants and days in the
      hospital were roughly 25% less. The program effects were larger for women that
      enrolled before 8 weeks gestation. More serious diabetics were also found to have
      larger reductions in charges and days. CONCLUSION: After adjusting for inflation
      and differences in charges across hospitals, $5.19 is saved for every dollar
      spent on the program.

PMID- 1739142
TI  - Maternal smoking and the risk of polyhydramnios.
AB  - BACKGROUND: Washington State birth certificates were used to conduct a population
      based case-control study to assess the possible association of maternal smoking
      with polyhydramnios. METHODS: All singleton births complicated by polyhydramnios
      (n = 557) were identified from the vital records for the years 1984 to 1987. For
      comparison, 1671 records were randomly selected for the same years from singleton
      births uncomplicated by polyhydramnios. RESULTS: Women who reportedly smoked
      prenatally were found to be at increased risk for polyhydramnios (relative risk
      [RR] = 1.7, 95% confidence interval [CI] = 1.5-2.1, adjusted for marital status,
      maternal age, and parity). When women with conditions known to be associated with
      polyhydramnios were excluded, the risk for those who smoked prenatally remained
      elevated (RR = 1.8, 95% CI = 1.1-2.3). CONCLUSION: Overdistention of the uterus
      from polyhydramnios may cause a variety of pregnancy complications. The observed
      association of smoking with polyhydramnios may be a further indication for public
      health interventions aimed at preventing smoking during pregnancy.

PMID- 1739143
TI  - A cost-effectiveness analysis of three staffing models for the delivery of low
      risk prenatal care.
AB  - BACKGROUND: Health care costs are increasing at more than twice the rate of
      inflation, thus, public officials are seeking safe and economic methods to
      deliver quality prenatal care to poor pregnant women. This study was undertaken
      to determine the relationship between the cost and effectiveness of three
      prenatal clinic staffing models: physician based, mixed staffing, and clinical
      nurse specialist with physicians available for consultation. METHODS: Maternal
      and neonatal physiological outcome data were obtained from the hospital clinical
      records of 156 women attending these clinics. The women were then interviewed
      concerning their satisfaction with their prenatal care clinic. The financial
      officer from each clinic provided data on the clinic staffing costs and hours of
      service. RESULTS: There were no differences in outcomes for the maternal-neonatal
      physiological variables, although newborn admission to the Neonatal Intensive
      Care Unit (NICU) approached significance among the clinics. The clinic staffed by
      clinical nurse specialists had the greatest client satisfaction and the lowest
      cost per visit. CONCLUSIONS: The use of clinical nurse specialists might
      substantially reduce the cost of providing prenatal care while maintaining
      quality, and might thereby save valuable resources.

PMID- 1739144
TI  - Medicaid prenatal care: a comparison of use and outcomes in fee-for-service and
      managed care.
AB  - BACKGROUND: To control rising costs, state Medicaid agencies are enrolling
      recipients in managed care health plans (MCPs). We performed this study to assess
      this policy's impact on accessibility and outcomes of Medicaid-funded prenatal
      care. METHODS: We performed a retrospective, controlled study with three cohorts:
      a study group of 1106 Medicaid recipients enrolled in three MCPs, a matched
      comparison group of 4830 recipients receiving care in the fee-for-service (FFS)
      system, and a second matched comparison group of 4434 non-Medicaid enrollees of
      the same MCPs. Data on prenatal care use and birth outcomes were obtained through
      linkage of claims and discharge files with birth certificate files. RESULTS:
      Medicaid recipients enrolled in MCPs used prenatal care similarly to those in the
      FFS system and showed equal or modestly improved birth-weight distributions.
      However, Medicaid MCP enrollees showed poorer use of prenatal care and birth
      outcomes compared with non-Medicaid enrollees of the same plans. CONCLUSIONS:
      Enrollment in MCPs has a neutral or small beneficial effect on the prenatal care
      received by the Medicaid population. However, providing financial access and
      modifying the system of care for this population did not result in parity with
      the general population.

PMID- 1739145
TI  - Attitudes about infertility interventions among fertile and infertile couples.
AB  - BACKGROUND: There has been marked progress in the development of infertility
      interventions. This paper reports attitudes about 11 interventions for
      infertility. METHODS: Face-to-face interviews were conducted with each member of
      185 infertile and 90 presumed fertile couples in southeastern Michigan. RESULTS:
      Seven of these interventions were generally viewed favorably and four were
      generally viewed negatively, regardless of the couple's fertility status.
      Infertile couples viewed all interventions, except for adoption, more favorably
      than did fertile couples. Multidimensional scaling was used to cluster the
      interventions according to similarity in endorsement. These clusters form a
      continuum from interventions that allow only one member of the couple to be a
      biological parent to the most noninvasive techniques. All clusters remain roughly
      equidistant from adoption, in which neither member of the couple is a biological
      parent. CONCLUSIONS: Interventions that produce a child who is biologically
      related to only one member of the couple were viewed most negatively. Members of
      couples who were receiving fertility treatment made finer discriminations among
      infertility interventions than did individuals who had not received treatment.

PMID- 1739146
TI  - Nonclinical factors associated with surgery received for treatment of early-stage
      breast cancer.
AB  - BACKGROUND: Women diagnosed with early breast cancer have had the opportunity to
      receive breast-conserving surgical treatment, which reduces the physical and
      psychological morbidity heretofore associated with breast removal. METHODS:
      Nonclinical factors associated with women receiving partial mastectomies with
      radiation (P + R) compared with modified radical mastectomies without radiation
      (MOR) were examined in 2238 Black and White women diagnosed, in 1985 through
      1987, with early-stage breast cancer in the metropolitan Detroit area. RESULTS:
      Age at diagnosis and size of hospital were the strongest predictors of type of
      surgery received, with younger women (less than 55 years of age) and women
      treated in larger hospitals (more than 500 beds) more than twice as likely to
      receive P + R. Stratifying on race, age at diagnosis remained the strongest
      predictor for White women, followed by hospital size. Among Black women, hospital
      size was more strongly associated with surgery received than was age.
      CONCLUSIONS: Younger women and women undergoing treatment at large hospitals are
      more likely to receive the breast-conserving P + R. Black women treated in small
      hospitals appear to be particularly unlikely to receive P + R.

PMID- 1739147
TI  - Breast cancer screening practices among users of county-funded health centers vs
      women in the entire community.
AB  - BACKGROUND: Breast cancer screening rates tend to be lower among women with lower
      income and/or education. METHODS: Telephone surveys of random samples of women
      aged 50 to 75 who had visited five health centers (n = 795) and women in the same
      age group residing in the entire community (n = 404) were conducted in 1988.
      RESULTS: Despite the significantly lower socioeconomic level, a higher proportion
      of minority women, and a poorer knowledge of mammography, screening rates in the
      health center group were not lower than in the community sample. About half or
      more of the health center respondents had ever had a mammogram regardless of
      income, education, age, and ethnic group. Of the community respondents, 49% had
      ever had a mammogram, but the proportion varied significantly by income and
      education. Within the subgroup of women having annual incomes below $15,000,
      mammography use was actually higher among health center women; that is, 50% of
      health center vs 35% of community women reported ever having a mammogram and 31%
      vs 14%, respectively, reported having a mammogram in the past year. CONCLUSION:
      The findings demonstrate the importance of publicly funded health centers in
      achieving screening rates among the socioeconomically disadvantaged that are
      comparable to (or even higher than) those in the general population.

PMID- 1739149
TI  - Vaginal douching among women of reproductive age in the United States: 1988.
AB  - BACKGROUND: Vaginal douching has been associated with pelvic inflammatory disease
      (PID) in several epidemiologic studies. METHODS: To determine the extent to which
      douching is practiced and to describe the population subgroups in which it is
      most prevalent, we analyzed data from the 1988 National Survey of Family Growth,
      which is based on a nationally representative sample of 8450 United States women
      between the ages of 15 and 44 years. RESULTS: Thirty-seven percent of the sample
      reported douching; 18% douched at least once a week. The variable most strongly
      and consistently associated with douching was race: two thirds of Black women,
      but only one third of White women, reported douching. The practice was least
      frequent among 15- to 19-year-olds (31%) and most frequent among 20- to 24-year
      olds (41%). Douching was more common among women who lived in poverty (50%) than
      among those who did not (28%). Seventy percent of Black women living in poverty
      reported douching. Women with less than a high school education were almost four
      times more likely to report douching as those with 16 or more years of schooling
      (56% vs 16%). Women with only 1 partner and those with 10 or more partners were
      less likely to douche than others. Sixteen percent of women who reported
      douching, compared with 10% of those who did not, also reported a history of PID.
      CONCLUSIONS: Douching may be a modifiable risk factor for PID, it should be a
      high priority for future etiologic research.

PMID- 1739148
TI  - Geographic and socioeconomic variation in the onset of decline of coronary heart
      disease mortality in white women.
AB  - BACKGROUND: Regional, metropolitan, and socioeconomic factors related to the
      onset of decline of coronary heart disease (CHD) mortality among White women are
      reported. Such studies are important for planning population-level interventions.
      METHODS: Mortality data for 1962 to 1978 were used, to estimate the year of onset
      of decline. Ecological analyses of socioeconomic data from the US census were
      used to emphasize structural and organizational aspects of changes in disease,
      rather than as a substitute for an individual-level design. RESULTS: Onset of
      decline of CHD mortality among White women was estimated to have occurred by 1962
      in 53% of 507 state economic areas (SEAs), ranging from 79% in the Northeast to
      39% in the South. Metropolitan areas experienced earlier onset of decline than
      did nonmetropolitan areas. Average income, education, and occupational levels
      were highest in early onset areas and declined across onset categories.
      CONCLUSIONS: The results provide additional evidence for previously observed
      geographic and social patterns of CHD decline. Emphasis on structural economic
      factors determining the shape of the CHD epidemic curve does not detract from the
      medical importance of risk factors, but underscores the importance of community
      development to public health improvements. The results are consistent with the
      idea that the course of the CHD epidemic in the United States has been strongly
      influenced by socioeconomic development.

PMID- 1739150
TI  - Employment status and heart disease risk factors in middle-aged women: the Rancho
      Bernardo Study.
AB  - BACKGROUND: In recent years, an increasing number of women have been entering the
      labor force. It is known that in men, employment is related to heart disease
      risk, but there are few studies examining this association among women. METHODS:
      The relation between employment status and heart disease risk factors including
      lipid and lipoprotein levels, systolic and diastolic blood pressure, fasting and
      postchallenge plasma glucose and insulin levels, was examined in 242 women aged
      40 to 59 years, who were participants in the Rancho Bernardo Heart and Chronic
      Disease Survey. At the time of a follow-up clinic visit between 1984 and 1987,
      46.7% were employed, primarily in managerial positions. RESULTS: Employed women
      smoked fewer cigarettes, drank less alcohol, and exercised more than unemployed
      women, but these differences were not statistically significant. After adjustment
      for covariates, employed women had significantly lower total cholesterol and
      fasting plasma glucose levels than unemployed women. Differences on other
      biological variables, although not statistically significant, also favored the
      employed women. CONCLUSIONS: Results of this study suggest that middle-aged women
      employed in managerial positions are healthier than unemployed women.

PMID- 1739151
TI  - AIDS in bisexual men in the United States: epidemiology and transmission to
      women.
AB  - BACKGROUND: Homosexual and bisexual men with acquired immunodeficiency syndrome
      (AIDS) differ, and bisexual men play an important role in the sexual transmission
      of human immunodeficiency virus (HIV) to women. METHODS: To describe AIDS in
      these groups, we examined AIDS cases reported nationally through June 1990.
      RESULTS: Among 65 389 men who reported having had sex with men since 1977, 26%
      were bisexual. More Black (41%) and Hispanic men (31%) than White men (21%)
      reported bisexual behavior. Bisexual men were twice as likely to report
      intravenous drug use (20%) as were homosexual men (9%), regardless of race or
      ethnicity. Among 3555 women with heterosexually acquired AIDS, 11% reported
      sexual contact with a bisexual man and no other risk factor, although in some
      states approximately half reported such contact. In 1989, the AIDS rate due to
      sex with a bisexual man was three and five times higher among Hispanic and Black
      women, respectively, than among White women. CONCLUSIONS: Differences between
      bisexual and homosexual men with AIDS and the relative importance of AIDS in
      women due to sexual contact with bisexual men should be considered in the
      development of HIV prevention programs.

PMID- 1739152
TI  - Knowledge and attitudes about AIDS among corporate and public service employees.
AB  - BACKGROUND: We examined the relationship between workplace AIDS education efforts
      and workers' knowledge about HIV transmission and their attitudes toward
      coworkers with AIDS. METHODS: Questionnaires were mailed to corporate and public
      service workers at 12 work sites to ascertain the extent of their knowledge about
      AIDS and their attitudes toward coworkers with AIDS. Each work site had offered
      an AIDS education program. The average response rate was 40%; 3460 workers
      returned questionnaires. RESULTS: Respondents' knowledge was largely consistent
      with available scientific evidence. However, a substantial minority still believe
      HIV infection can be transmitted through casual contact. Over 30% endorse the
      screening of new employees for AIDS, and 23% would fear contagion from an
      infected coworker. Thirty percent of the respondents expressed skepticism about
      the veracity of information from government sources and the scientific community.
      Work site comparisons show that where educational programs are minimal, employees
      know less about HIV transmission and hold more negative attitudes. CONCLUSION:
      Comprehensive workplace AIDS education programs can reinforce workers' knowledge
      about HIV transmission, thereby fostering more favorable views toward coworkers
      with AIDS.

PMID- 1739153
TI  - Workplace compliance with a no-smoking law: a randomized community intervention
      trial.
AB  - BACKGROUND: Compliance with state and local laws restricting smoking in public
      places and workplaces has not been systematically evaluated. METHODS: We assessed
      workplace compliance with a comprehensive no-smoking law adopted in Brookline,
      Mass, and tested whether mailing information to businesses increased awareness of
      and compliance with the law. We conducted a random sample telephone survey of 299
      businesses (87% response rate). Self-reported compliance was validated by direct
      observations. RESULTS: One year after its adoption, the law was popular with
      businesses. The prevalence of smoking restrictions, smoking policies, and no
      smoking signs was 80%, 59%, and 40%, respectively. One third of businesses banned
      smoking. Full compliance with the law was low, however, because few businesses
      posted a copy of their smoking policy as required. The mailing increased
      employers' awareness of the law. Employers sent the mailing also reported better
      compliance, but this was not confirmed by direct observations. CONCLUSIONS: The
      law was popular and contributed to a high prevalence of workplace smoking
      restrictions. Different interpretations of the law by policymakers and businesses
      seemed to explain why formal compliance was low. The mailing increased awareness
      of, but not compliance with, the law.

PMID- 1739154
TI  - Attitudes toward genetic testing of Amish, Mennonite, and Hutterite families with
      cystic fibrosis.
AB  - BACKGROUND: We had the unique opportunity to study families with cystic fibrosis
      (CF) from an interrelated Amish-Mennonite kindred and from an isolated Hutterite
      kindred. METHODS: While obtaining blood for DNA linkage analysis to help find the
      CF gene, we asked family members to answer a questionnaire about attitudes and
      feelings toward genetic testing. The questionnaire was also administered to
      families receiving care at the University of Rochester. After DNA-based CF
      carrier testing was developed, we asked the families whether they wanted to know
      the results. RESULTS: Each cultural group felt differently about many issues.
      Between 31% and 78% approved of CF-carrier testing and 14% to 78% approved of
      prenatal diagnosis. The majority (59%) of Hutterite parents and siblings were
      opposed to carriers marrying carriers and most (82%) of the CF families wanted to
      know the results of carrier testing. CONCLUSIONS: Cultural differences need to be
      understood before genetic services are offered. Also, most CF mutations and their
      clinical correlates (phenotypes) will need to be defined. There are as few as
      three CF mutations in the Hutterite population. It will be possible to offer them
      the option to choose accurate genetic counseling. It will be difficult to offer
      genetic services to other populations with more heterogeneous attitudes and many
      more identified and yet-to-be-identified CF mutations.

PMID- 1739155
TI  - The accuracy of Medicare's hospital claims data: progress has been made, but
      problems remain.
AB  - BACKGROUND: Health care databases provide a widely used source of data for health
      care research, but their accuracy remains uncertain. We analyzed data from the
      1985 National DRG Validation Study, which carefully reabstracted and reassigned
      ICD-9-CM diagnosis and procedure codes from a national sample of 7050 medical
      records, to determine whether coding accuracy had improved since the Institute of
      Medicine studies of the 1970s and to assess the current coding accuracy of
      specific diagnoses and procedures. METHODS: We defined agreement as the
      proportion of all reabstracted records that had the same principal diagnosis or
      procedure coded on both the original (hospital) record and on the reabstracted
      record. We also evaluated coding accuracy in 1985 using the concepts of
      diagnostic test evaluation. RESULTS: Overall, the percentage of agreement between
      the principal diagnosis on the reabstracted record and the original hospital
      record, when analyzed at the third digit, improved from 73.2% in 1977 to 78.2% in
      1985. However, analysis of the 1985 data demonstrated that the accuracy of
      diagnosis and procedure coding varies substantially across conditions.
      CONCLUSIONS: Although some diagnoses and all major surgical procedures that we
      examined were accurately coded, the variability in the accuracy of diagnosis
      coding poses a problem that must be overcome if claims-based research is to
      achieve its full potential.

PMID- 1739156
TI  - Cancer anxiety and attitudes toward mammography among screening attenders,
      nonattenders, and women never invited.
AB  - A mailed questionnaire survey was conducted among the following groups: 179 women
      who screened false positive at a free mammography screening; a random sample of
      250 women who screened negative; 670 nonattenders of the screening; and a random
      population sample of 250 women who lived in another city and were not invited,
      but were otherwise comparable. The most frequently reported reason for
      nonattendance was not having the opportunity. Furthermore, only 18% of the
      nonattenders reported anxiety about breast cancer compared with 33% of the
      population sample (P less than .05). Ninety-nine percent of the women who
      attended indicated a positive attitude toward mammography that had not been
      adversely affected by screening experiences.

PMID- 1739157
TI  - Medicaid coverage of screening tests for breast and cervical cancer.
AB  - Although most women receive periodic Papanicolaou smear (Pap) those who do not
      are more likely to be of lower socioeconomic status. Similarly, for the many
      women who do not receive periodic mammography for early diagnosis of breast
      cancer, cost has often been cited as a reason. Medicaid provides health benefits
      to roughly 9.4 million women of the appropriate ages for Pap tests and roughly
      3.3 million women of the appropriate ages for mammography. The decision to
      provide such coverage is made on the state level. Of the 50 states and the
      District of Columbia, 49 provide some level of coverage for Pap smears, 39 for
      screening mammography. Knowing the extent of coverage allows public health
      professionals to take advantage of this funding source to provide services for
      lower-income women and may help initiate coverage in those states where it is not
      currently available.

PMID- 1739158
TI  - Distribution of HIV type 1 infection in childbearing women in California.
AB  - The incidence of acquired immunodeficiency syndrome (AIDS) is increasing among
      California heterosexuals and children. To assess human immunodeficiency virus
      (HIV)-1 infection in childbearing women, we conducted a blinded serosurvey of
      newborns. Dried blood specimens taken from 99% of California births during the
      third quarter of 1988 (n = 135,808) and linked only to maternal demographic
      categories were tested for HIV-1 antibody by enzyme immunoassay and confirmed by
      Western blot. Period prevalence of HIV-1 infection was 7.4 per 10,000
      childbearing women. Prevalence was highest for Black women and was also elevated
      for Hispanic and San Francisco Bay Area women. Findings suggest that California
      Hispanic women will make up an increasing proportion of new AIDS cases.

PMID- 1739159
TI  - Cesarean section rates in Italy by hospital payment mode: an analysis based on
      birth certificates.
AB  - The study, based on birth certificate data from 1985 through 1987, investigated
      cesarean section (CS) rates in the Lazio region of Italy and their relationship
      with mode of hospital care payment. Use of abdominal delivery increased from
      22.3% in 1985 to 24.3% in 1987. CS rates were highest (34.7%) in private
      hospitals. A marked variation in the use of CS was associated with mode of
      hospital care payment independently from other predictors of abdominal delivery.

PMID- 1739160
TI  - Professional relationships between midwives and physicians: collaboration or
      conflict?
AB  - This study examines the professional relationships between midwives and
      physicians providing obstetrical care in Washington State. Four hundred ninety
      six randomly sampled family physicians and obstetrician-gynecologists and 211
      certified nurse, licensed, and lay midwives were surveyed to learn more about
      midwife/physician consulting relationships. Only certified nurse midwives have
      forged mutually satisfactory relationships with the physician community.
      Increased hospital-based training and practice opportunities are needed before
      licensed midwives can improve their professional relationships with physicians.

PMID- 1739161
TI  - Factors associated with artificial feeding in Shanghai.
AB  - Factors associated with artificial feeding were analyzed for 3285 infants in
      Shanghai. Boys, those from more highly educated families, and those born by
      assisted delivery or by cesarean section were more likely to be artificially fed
      than were girls, those from less educated families, and those born by spontaneous
      delivery. Infants whose birth weight was around 3750 g had the lowest probability
      of artificial feeding; higher and lower birth weights were positively associated
      with artificial feeding.

PMID- 1739162
TI  - Smoking-related behavior, beliefs, and social environment of young black women in
      subsidized public housing in Chicago.
AB  - Survey data indicate that young Black female smokers living in public housing are
      heavier smokers and have weaker motivation to quit, health beliefs and social
      environment less conducive to cessation, and less knowledge of where to get help
      to quit than other young Black female smokers in metropolitan Chicago. Compared
      with White women, the latter, other Black women smoke fewer cigarettes daily and
      have a stronger desire to quit and more concern about health reasons for
      quitting, but have a weaker belief in the risk of lung cancer from smoking,
      greater concern about quitting difficulties, and less knowledge of where to get
      help to quit. Low education, not race, is associated with higher smoking
      prevalence and less social pressure to quit or support for quitting.

PMID- 1739163
TI  - Smoking initiation and cessation in relation to body fat distribution based on
      data from a study of Swedish women.
AB  - In a representative sample of Swedish women, smokers were significantly less
      obese than nonsmokers. However, a smoker was likely to have significantly more
      upper-body fat than a nonsmoker of similar body mass index. Women who quit
      smoking experienced less upper-body fat deposition than would be expected by
      their accompanying weight gain, suggesting that weight gained as a consequence of
      smoking cessation is not preferentially deposited in the region associated with
      increased cardiovascular risk.

PMID- 1739164
TI  - Surveillance of occupational lead exposure in New Jersey: 1986 to 1989.
AB  - Between January 1986 and June 1989, 1916 New Jersey workers were identified
      through a surveillance system for occupational lead exposure. The average annual
      proportion of workers with a blood lead level above 2.42 mumol/L was 12%.
      Industries with the highest proportion of workers with blood lead levels above
      2.42 mumol/L were special trade construction (35%) and industries dealing with
      scrap and waste materials (27%).

PMID- 1739165
TI  - Inaccuracies in certification of nonmelanoma skin cancer deaths.
AB  - Nonmelanoma skin cancer is the most common cancer site in the United States, yet
      mortality from this cause is poorly understood. We sought medical records of the
      16 reported deaths during 1979 through 1987 from this cause (International
      Classification of Diseases, 9th version [ICD-9], code 173) among Rhode Island
      residents to evaluate the accuracy of the reported cause of death. Of the 110
      cases for which the cause of death could be classified as correct or incorrect,
      59 (54%) were misclassified, 49 (83%) of which were mucous-membrane, squamous
      cell carcinomas of the head and neck. For most of these, the written death
      certificate diagnosis was squamous-cell carcinoma of the head and neck, which was
      coded 173.4. Other problematic diagnoses were cancer of the head and neck and
      malignant fibrous histiocytoma. In response to a mailed survey, most health
      departments replied that squamous-cell carcinoma of the head and neck was coded
      under rubric 173 and malignant fibrous histiocytoma was coded under rubric 171,
      but there was no unanimity. The misclassification of other causes of death to ICD
      9 rubric 173 is substantial. The vast majority were coded to rubric 173.4 and
      were due to a small number of diagnoses that are recognizable on examination of
      the death certificate.

PMID- 1739166
TI  - Provider compliance with recommended dietary fluoride supplement protocol.
AB  - Proper dosage of dietary fluoride supplements is important for children without
      access to optimally fluoridated water to balance dental caries prevention and
      risks of dental fluorosis. Subsequent to water fluoride assay, compliance by
      physicians and dentists with the recommended dietary fluoride supplement dosage
      schedule was determined for 446 children. Approximately one third of child
      patients and 42% of siblings did not receive the recommended supplement dosage.

PMID- 1739167
TI  - Condom use in multi-ethnic neighborhoods of San Francisco: the population-based
      AMEN (AIDS in Multi-Ethnic Neighborhoods) Study.
AB  - We examined the prevalence and correlates of condom use in a community-based
      sample of unmarried heterosexual and gay/bisexual Whites, Blacks, and Hispanics
      (aged 20 to 44 years) in San Francisco (n = 1229). Only 9% of heterosexual males
      reported always using condoms, and fewer of those with multiple sexual partners
      (6%) reported always using condoms compared with those in monogamous
      relationships (12%). Much higher proportions of gay/bisexual men reported always
      using condoms (48%). Racial differences in condom use were observed only among
      women. Sexual communication and the sexual enjoyment value of condoms were
      consistent correlates of condom use across gender and sexual orientation, while
      other condom-related beliefs were significant predictors of condom use only for
      men. In general, condom promotion programs should build sexual communication
      skills, teach people how to enhance enjoyment with condoms, and reduce
      psychological barriers to condom acquisition and use.

PMID- 1739168
TI  - Women healers of the middle ages: selected aspects of their history.
AB  - The stellar role of women as healers during the Middle Ages has received some
      attention from medical historians but remains little known or appreciated. In the
      three centuries preceding the Renaissance, this role was heightened by two
      roughly parallel developments. The first was the evolution of European
      universities and their professional schools that, for the most part,
      systematically excluded women as students, thereby creating a legal male monopoly
      of the practice of medicine. Ineligible as healers, women waged a lengthy battle
      to maintain their right to care for the sick and injured. The 1322 case of
      Jacqueline Felicie, one of many healers charged with illegally practicing
      medicine, raises serious questions about the motives of male physicians in
      discrediting these women as incompetent and dangerous. The second development was
      the campaign--promoted by the church and supported by both clerical and civil
      authorities--to brand women healers as witches. Perhaps the church perceived
      these women, with their special, often esoteric, healing skills, as a threat to
      its supremacy in the lives of its parishioners. The result was the brutal
      persecution of unknown numbers of mostly peasant women.

PMID- 1739169
TI  - Mum's the word: the Supreme Court and family planning.
AB  - On May 23, 1991, the US Supreme Court upheld federal regulations that prohibit
      federally funded family planning programs from counseling about or referring for
      abortion. As a result, government benefits may now entail substantial costs. The
      regulations changed the nature of government-assisted family planning from
      comprehensive care and counseling to limited services and government-prescribed
      information. The reasoning in Rust v Sullivan allows government to limit freedom
      of speech in federally funded programs. The decision may have been influenced by
      antiabortion sentiment, but it does not affect the legality of abortion. Instead,
      it sets a precedent for government control of whether and how health care can be
      discussed wherever government pays some of the bills.

PMID- 1739170
TI  - Mammography outreach program.

PMID- 1739171
TI  - A statewide early intervention program for HIV-infected people.

PMID- 1739172
TI  - A randomized prospective clinical trial to determine the efficacy of interferon
      gamma in severely injured patients.
AB  - Many aspects of the normal immune response are depressed after severe injury.
      Reduced monocyte human leukocyte antigen-DR (HLA-DR) levels have closely
      correlated with the development of major infection. After a pilot study with
      recombinant interferon-gamma (rIFN-gamma) showed restoration of depressed HLA-DR
      levels after major injury, a multicenter, prospective, randomized, double-blind
      trial was conducted. Two hundred thirteen trauma patients who were at high risk
      of infection received either placebo or rIFN-gamma (100 micrograms)
      subcutaneously each day for 10 days after admission. One hundred ninety-three
      patients were evaluable with respect to primary end points. Patients treated with
      rIFN-gamma were older (p = 0.10) and had more severe modes of injury (p = 0.02).
      By the third day, both monocyte HLA-DR antigen expression and outcome predictive
      score were significantly better in the rIFN-gamma-treated group than in the
      placebo group (p = 0.0001 and p = 0.0006, respectively). Nine deaths occurred in
      patients treated with rIFN-gamma compared with 12 deaths in the placebo group (p
      = 0.46). Major infections requiring surgical drainage or debridement occurred in
      17 patients treated with rIFN-gamma compared with 22 treated with placebo. No
      difference between treatment arms was noted in overall major or minor infection
      rates, but there were fewer severe infections that required reoperation or
      computer tomographic-guided drainage in patients receiving IFN-gamma. While these
      results suggest that rIFN-gamma may be useful in some aspects of infection in the
      patient with severe trauma, a larger trial with longer treatment will be needed
      to prove the comprehensive value of rIFN-gamma.

PMID- 1739173
TI  - Pelvic abscess or pseudoaneurysm: diagnostic and therapeutic dilemma following
      iliac arterial trauma.
AB  - Intra-abdominal abscesses often complicate operations for abdominal trauma and
      are particularly dangerous in patients whose injuries involve major vessels. We
      report our experience with 10 patients who developed pelvic abscesses among 75
      survivors of iliac arterial injuries. Pseudoaneurysms of primarily repaired iliac
      arteries occurred in 8 of these 10 patients. Emergency operations were required
      for acute arterial thrombosis or hemorrhage in four patients; massive hemorrhage
      that complicated the drainage of pelvic abscesses led to the recognition of the
      pseudoaneurysms in the other four patients. Three of the eight patients with
      pseudoaneurysm died of postoperative complications; ischemic extremity sequelae
      occurred in all five survivors. The association of pelvic abscesses with the
      complications iliac arterial repairs has not been previously emphasized. The
      integrity of an arterial repair should be arteriographically confirmed before
      proceeding with drainage of a pelvic abscess that developed after iliac arterial
      trauma.

PMID- 1739174
TI  - Augmentation of the immune response of the murine liver by levamisole.
AB  - Murine hepatic nonparenchymal cells (NPC) were studied following in vivo
      treatment with levamisole. This agent was found to increase the cytolytic action
      of these cells against YAC-1 and P815 target cells. An increase in the cytostatic
      activity against liver-derived murine colon adenocarcinoma 38 tumor cells was
      also observed. Treatment with levamisole also augmented the proliferation of the
      hepatic NPC. Supernatants generated by these cells contained an agent capable of
      stimulating the proliferation of bone marrow cells from the same mice. The effect
      of levamisole on different subsets of NPC derived from the liver in this model is
      discussed.

PMID- 1739175
TI  - Postprandial augmentation of portal hepatic inflow after prosthetic H-graft
      portacaval shunt.
AB  - Encephalopathy after portasystemic shunting generally occurs after eating. After
      partial portal decompression, encephalopathy is uncommon, presumably because of
      associated portal hemodynamics. However, after partial shunting, the changes in
      portal venous hemodynamics that occur with eating are unknown. With this in mind,
      11 nonencephalopathic adults were studied more than 1 year after 8-mm H-graft
      portacaval shunt (PCS). The studies utilized color flow duplex ultrasound to
      determine the changes in portal vein (PV) and inferior vena cava blood flow that
      occur with eating a standardized meal. Following H-graft PCS, there is increased
      blood flow in the inferior vena cava after eating, particularly cephalad to the H
      graft PCS, implying increased flow through the prosthetic shunt. Eating also
      increases hepatopedal blood flow in the PV distal to the H-graft PCS.
      Postprandial increases in hepatopedal portal blood flow may play an important
      role in avoiding encephalopathy after H-graft PCS.

PMID- 1739176
TI  - Internal pancreatic fistula.
AB  - Internal pancreatic fistulae are well-recognized complications of inflammatory
      pancreatic disease. From 1963 to 1990, 50 patients with either pancreatic ascites
      (34), pancreatic ascites and pleural effusion (7), or pancreatic pleural effusion
      (9) were treated. Initial therapy was conservative, consisting of
      gastrointestinal rest, serosal apposition with paracentesis or thoracentesis,
      with or without the administration of anti-secretagogues. This therapy was
      successful in 21 of 42 patients, but 5 deaths occurred. Operative therapy was
      performed in 24 patients. There was one surgical failure and two deaths early in
      the experience. Ten of our final 16 patients underwent liver biopsy, and all 10
      were found to have cirrhosis. All patients, even those with documented cirrhosis,
      should have routine amylase and albumin determinations on ascitic or pleural
      fluid. Internal pancreatic fistulae should be treated initially nonoperatively;
      if this is ineffective, operative therapy has an acceptably low morbidity and
      mortality.

PMID- 1739177
TI  - Precholecystectomy endoscopic cholangiography and stone removal is not superior
      to cholecystectomy, cholangiography, and common duct exploration.
AB  - Thirty-four patients with suspected common bile duct stones were randomized to
      undergo endoscopic cholangiography and stone removal prior to open
      cholecystectomy or to have open cholecystectomy, operative cholangiography, and
      common bile duct exploration. Sixteen underwent the first protocol, and 18 the
      second. Analysis of the ability to clear stones from the common bile duct,
      morbidity, mortality, hospital stay, length of operation, and hospital cost
      showed no difference in outcome between patients treated by either method. These
      data suggest there is neither an advantage nor a disadvantage to treating
      patients with suspected duct stones by precholecystectomy endoscopic
      cholangiography and stone removal.

PMID- 1739178
TI  - Improvement in survival of mice with proximal small bowel obstruction treated
      with octreotide.
AB  - Small bowel obstruction is a common disorder in surgical practice. The major
      morbidity of bowel obstruction relates to intestinal distension and ischemia. We
      hypothesized that octreotide, a potent inhibitor of gut secretion, would reduce
      mortality in a mouse model of lethal small bowel obstruction. C57 mice were
      anesthetized with urethane and prepared with either proximal jejunal or distal
      ileal obstruction. After 8 hours, surviving mice were randomized to receive
      either octreotide (100 micrograms/kg) or saline subcutaneously every 8 hours.
      Octreotide significantly improved survival in mice with proximal obstruction by
      life table analysis. Mean survival increased from 31 +/- 3 to 41 +/- 4 hours. In
      distal obstruction, octreotide treatment resulted in a trend towards improved
      survival; however, this trend failed to reach statistical significance by life
      table analysis. The improvement in survival in this mouse model suggests that
      octreotide may be a valuable adjunct in the treatment of patients with small
      bowel obstruction.

PMID- 1739179
TI  - Comparative efficacy of topical hemostatic agents in a rat kidney model.
AB  - The efficacies of four topical hemostatic agents were compared in a rat model
      employing a standardized renal injury. The materials used to effect hemostasis
      were oxidized cellulose, microfibrillar collagen powder, positively charged
      modified collagen, and single donor heterologous fibrin glue. Animals that were
      treated only with surgical gauze served as controls. Hemostasis was achieved by
      application of one of the topical hemostatic agents plus moderate digital
      pressure. The time necessary to achieve complete hemostasis was recorded for each
      animal. Control animals bled profusely and suffered an increased postoperative
      mortality rate compared with the experimental animals. Microscopic studies
      demonstrated progressive healing of the injuries with varying degrees of
      inflammation and scar formation. Fibrin glue was by far the most effective agent
      in controlling hemostasis. The collagen materials, though effective, required a
      longer time to control bleeding and did not differ statistically in their
      activity from one another.

PMID- 1739180
TI  - Surgical treatment of primary carcinoma of the gallbladder based on the
      histologic analysis of 48 surgical specimens.
AB  - During the past 5 years, extended cholecystectomy and/or more radical procedures,
      including pancreatoduodenectomy and extended hepatic lobectomy, were performed on
      48 patients with carcinoma of the gallbladder in an attempt to cure the disease.
      It was retrospectively proven from microscopic analysis of the surgical specimens
      taken from the 48 patients that 28 patients had received curative resections. The
      28 consisted of all 4 patients with stage I carcinoma, all 9 with stage II, 6 of
      8 with stage III, and 9 of 27 with stage IV. We reached the following
      conclusions: (1) extended cholecystectomy with resection of the bile duct in the
      hepatoduodenal ligament is the optimum procedure for patients with stage I and
      stage II carcinomas, and (2) for patients with stage III carcinoma, more radical
      procedures, including pancreatoduodenectomy and/or wider resection of the liver,
      might result in curative resection of the disease. For some patients with stage
      IV tumors, such as duodenal invasion or direct invasion of the liver, curative
      resection may be achieved by pancreatoduodenectomy or extended hepatic lobectomy.

PMID- 1739181
TI  - Hepatic resections for primary and metastatic tumors using the ultrasonic
      surgical dissector.
AB  - We have previously described the development of new hepatic surgical techniques
      using the ultrasonic surgical dissector. With 10 years' experience, we have found
      that major liver resections have been simplified and that the technique is
      repeatable in hands other than our own. Thirty-three patients had 37 tumors,
      averaging 5.65 cm in size, resected with an average blood loss of only 1,020 mL
      per case, which included 5 right trisegmentectomies, 12 lobectomies, 15 segmental
      resections, and 4 subsegmental resections. Twenty-two patients had metastatic
      colorectal cancer. Blood transfusion requirements averaged only 2.24 units in
      long-term survivors, which was significantly less than the 3.5 units received by
      patients who have since died (p = 0.092). There were no operative deaths. The
      median survival of these 22 patients was 56 months, and the 5-year actuarial
      survival rate was 35%. All of the early deaths occurred in patients with more
      than four tumors, and no patient with less than four tumors died before 42 months
      with recurrent disease. Six patients had bilateral tumors, and the fact that
      patients survived into the fourth and fifth post-resectional year indicates that
      resection was worthwhile. All these patients had Dukes' C primary tumors, but we
      found no statistical difference in survival between patients with Dukes' B and
      Dukes' C lesions. The results indicate that hepatic resection with the ultrasonic
      surgical dissector decreases blood loss, requires few transfusions, is safe to
      perform, and is associated with excellent long-term survival.

PMID- 1739182
TI  - Can general surgeons perform colonoscopy safely?
AB  - The purpose of the current study was to review the safety of colonoscopy
      performed by nonfellowship-trained general surgeons. To address this issue, we
      reviewed more than 1,000 consecutive diagnostic and therapeutic colonoscopies and
      recorded the complications. This was a multi-institutional study involving seven
      general surgeons, none of whom had had formal fellowship endoscopic training.
      Perforation was confirmed by laparotomy, bleeding was defined as that requiring
      hospitalization and/or transfusion, and cardiopulmonary arrest was self
      explanatory. There was one perforation in the diagnostic group and none in the
      therapeutic group, for a rate of 0.10% overall and 0.12% in diagnostic
      colonoscopy. There were no instances of bleeding or cardiac arrest. This
      complication rate of 1 per 1,025 colonoscopic procedures by general surgeons
      compares favorably with that previously reported by other specialties (p less
      than 0.001). We conclude that postgraduate endoscopy fellowship is not necessary
      for general surgeons to become safe colonoscopists.

PMID- 1739183
TI  - Biliary tract reconstruction after injury of the main hepatic duct.

PMID- 1739184
TI  - Risks of precut papillotomy and the management of patients with duodenal
      perforation.

PMID- 1739185
TI  - Intra-abdominal procedures in pregnant women.

PMID- 1739186
TI  - Management of exercise-induced asthma.

PMID- 1739187
TI  - Asthma during pregnancy: interrelationships and management.

PMID- 1739188
TI  - Adverse reactions to cocaine.

PMID- 1739189
TI  - Cat scratch disease and nontuberculous mycobacterial disease: diagnostic
      usefulness of PPD-Battey, PPD-T and cat scratch skin test antigens.

PMID- 1739190
TI  - Forced oscillation technique. Reference values for total respiratory resistance
      obtained with the Siemens Siregnost FD5.
AB  - Total respiratory resistance (Rrs) was measured by the application of a sine wave
      of airflow to the mouth at an oscillation frequency of 10 Hz. The instrument used
      was the Siemens Siregnost FD5. The Rrs data were correlated with height, age,
      sex, and weight in 73 patients and 29 healthy subjects. The patients took part in
      a rehabilitation program for restoration of their locomotion function. Both
      groups had normal lung function (VC, FEV1) and no signs of pulmonary disease. The
      only important determining factor for the value of the Rrs was height. The mean
      Rrs of 102 subjects was 0.29 +/- 0.08 kPa.1-1.s. Other studies gave values
      between 0.23 +/- 0.05 and 0.32 +/- 0.10 kPa.1-1.s.

PMID- 1739191
TI  - Superficial nasal mucosal blood flow and nasal patency following topical
      oxymetazoline hydrochloride.
AB  - The objective of this study was to evaluate the effect of 60 micrograms
      oxymetazoline on nasal mucosal blood flow (NMBF) measured by laser Doppler
      velocimetry. Nasal airflow (measured by anterior rhinomanometry) and subjectively
      perceived airflow (measured by visual analog scales) were also evaluated. A
      reduction of NMBF (mL/100 g tissue/min) was observed following local application
      of 60 micrograms oxymetazoline that was not observed after the vehicle was
      applied. For example, NMBF at baseline was measured at 78.8 +/- 10.3 mL/100 g
      tissue/min (mean +/- SEM). During the five minutes following vehicle application,
      mean values remained at 81.8 +/- 8.8 mL/100 g tissue/min. Five minutes after
      topical oxymetazoline treatment, NMBF was reduced 49% to 38.3 +/- 10.2 mL/100 g
      tissue/min. Nasal airflow (mL/sec), which was measured before and after LDV probe
      placement, was not significantly increased in either the ipsilateral (281.4 +/-
      33.1 to 314.3 +/- 31.6) or contralateral nostril (335.7 +/- 26.9 to 262.1 +/-
      36.4), probably due to the limited surface application of drug. Subjective
      assessments of congestion by both the investigator and the subject showed
      significant improvements in the ipsilateral nostril. We conclude that, under the
      conditions of our study, localized application of 60 micrograms oxymetazoline
      significantly reduces superficial nasal blood flow and provides subjectively
      perceived improvements in nasal stuffiness.

PMID- 1739192
TI  - Evaluation of a generic albuterol metered-dose inhaler: importance of priming the
      MDI.
AB  - Since the patent on albuterol metered-dose inhalers (MDI) expired in 1989,
      several manufacturers have developed generic products. In order to determine
      whether one generic albuterol MDI is equivalent to a reference product (Ventolin
      MDI), we compared the relative efficacy of two puffs (180 micrograms) of each
      inhaler in 17 intermittent or mild chronic adult asthmatics (FEV1 48% to 77%
      predicted) in a randomized, single-blind, crossover manner. The test dose was the
      first two puffs out of each canister. Pulmonary function was measured before each
      test dose and at frequent intervals over eight hours. Baseline FEV1 values on
      both study days were within 20%. The mean +/- SD peak effect was 80.5 +/- 15.5%
      of maximum achievable improvement in FEV1 after the generic compared with 92.2 +/
      8.8% after Ventolin (P = .006). The area under the curve (AUC) for this same
      measurement during the first four hours was 242 +/- 75%.hr-1 after the generic
      compared with 297 +/- 40%.hr-1 after Ventolin, a mean difference of 19% (P =
      .002). The study was then repeated with the MDI primed prior to the test dose
      (ie, two puffs were first discharged into a waste basket) in subjects willing to
      return for re-study (n = 11). There was no significant difference in AUC in the
      second study: 215 +/- 77%.hr-1 after generic and 228 +/- 82%.hr-1 after Ventolin
      (P = .65); however, there was only a 35% chance of detecting a 20% difference in
      AUC with this sample size. These data indicate that, without priming, an MDI may
      deliver less drug, and thereby less therapeutic effect.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1739193
TI  - Combined effect of nifedipine and diltiazem on methacholine-induced
      bronchoconstriction in asthmatic patients.
AB  - Calcium blockers alter airway hyperreactivity. We studied the effect of either 60
      mg diltiazem or 20 mg nifedipine and their combination on the airway response to
      methacholine-induced bronchoconstriction. Compared with placebo or diltiazem,
      nifedipine significantly raised the PC20. When diltiazem was given alone, it had
      no effect on the airway but, when given with nifedipine, it significantly raised
      the PC20 to methacholine. The effect was superior to any of the other treatments
      given. This study supports the concept of combining two different calcium
      blockers in the treatment of bronchial asthma.

PMID- 1739194
TI  - Increasing asthma mortality in Denmark 1969-88 not a result of a changed coding
      practice.
AB  - We have studied asthma mortality in Denmark from 1969 to 1988. Age standardized
      mortality rates calculated in three age groups, 10-34, 35-59, and greater than or
      equal to 60 years, disclosed similar trends. Increasing mortality from asthma in
      the mid-1970s to 1988 was seen in all three age groups with higher mortality in
      1979-88 as compared with 1969-78 of 95%, 55%, and 69%, respectively. Since the
      eighth revision of the International Classification of Diseases (ICD8) was used
      in Denmark over the entire 20-year period, changes in coding practice due to
      change of classification system cannot explain the findings.

PMID- 1739195
TI  - Hemorrhagic infarct conversion in experimental stroke.
AB  - STUDY OBJECTIVE: This study investigated the relations between hemorrhagic
      infarction and occlusion, release, levels of glycemia, brain energy state, and
      lactate content after cerebrovascular occlusion. DESIGN: Prospective, controlled
      laboratory investigation. TYPE OF PARTICIPANTS: One hundred six pentobarbital
      anesthetized cats. INTERVENTIONS: The middle cerebral artery was occluded with a
      Yasargil clip transorbitally either temporarily (0.5, four, and eight hours) or
      permanently. Normoglycemic and hyperglycemic animals were closely monitored for
      eight hours. Brain pathology was assessed after two weeks' survival or at the
      time of spontaneous animal death. Topographic brain metabolite studies were
      carried out after four hours of middle cerebral artery occlusion. MEASUREMENTS
      AND MAIN RESULTS: Morphometric quantitation of cerebral hemorrhage and infarction
      and fluorometric determinations of blood and brain tissue, glucose, glycogen,
      lactate, adenosine triphosphate, and phosphocreatine from 16 topographic brain
      sites were carried out. Twenty-one of 82 (25.6%) animals evaluated
      neuropathologically showed hemorrhagic infarcts. Occluding the artery in
      hyperglycemic animals caused fivefold more frequent and 25-fold more extensive
      hemorrhage into infarcts than in normoglycemic animals. Temporary occlusion with
      clip release after four hours in hyperglycemic animals caused the most extensive
      hemorrhage into infarcts. Most hemorrhages into infarcts (81%) took place in
      animals that died within a few hours after they experienced ischemia and that
      showed infarction and marked edema of the entire middle cerebral artery
      territory. Linear regression analyses demonstrated a close relation between
      hemorrhage into infarcts and near-total energy depletion (adenosine triphosphate,
      less than 0.3 microM/g; phosphocreatine, less than 0.5 microM/g) in brain sites
      that showed extremely high tissue lactate concentrations (more than 30 microM/g).
      The biochemical changes that correlated with hemorrhage into infarcts were more
      marked than those with infarcts without hemorrhage. CONCLUSION: Hyperglycemia and
      restoration of blood flow to ischemic territories were strong risk factors for
      hemorrhagic infarct conversion. Concomitant tissue metabolic changes suggest that
      marked tissue energy depletion accompanied by acidosis damages brain vessels and
      renders them penetrable for edema fluid and, ultimately, red blood cell
      extravasation.

PMID- 1739196
TI  - Plasma catecholamine levels after intraosseous epinephrine administration in a
      cardiac arrest model.
AB  - STUDY OBJECTIVE: To measure plasma catecholamine levels and the cardiovascular
      response after administering epinephrine by the intraosseous (IO) route in an
      animal cardiac arrest model. MODEL: Eighteen anesthetized swine (weight, 12 to 15
      kg) subjected to five minutes of electrically induced ventricular fibrillation
      followed by 25 minutes of chest compression and ventilation. INTERVENTIONS:
      Animals were anesthetized with 30 mg/kg IM ketamine and 75 mg/kg IV a-chloralose,
      intubated, placed on a respirator, and surgically instrumented. Ventricular
      fibrillation was induced. After five minutes of cardiac arrest, mechanical chest
      compressions were initiated and continued until the end of the experiment.
      Animals received 0.01 mg/kg IO epinephrine (five) or 0.1 mg/kg IO epinephrine
      (five) at ten and 20 minutes. The eight controls did not receive epinephrine.
      MEASUREMENTS AND MAIN RESULTS: Plasma epinephrine levels increased from 1.0 to
      approximately 40 to 85 ng/mL with the initiation of CPR. Epinephrine (0.01 mg/kg)
      increased plasma epinephrine levels to 222 +/- 72 ng/mL at 12 minutes after
      arrest but did not increase diastolic or mean blood pressure. Epinephrine (0.1
      mg/kg) increased plasma epinephrine levels to 1,103 +/- 157 ng/mL at 12 minutes
      after arrest and increased diastolic and mean arterial blood pressures.
      CONCLUSION: IO epinephrine is rapidly transported to the central circulation but
      requires larger than currently recommended doses to produce a significant change
      in blood pressure.

PMID- 1739197
TI  - Failure of countershock-type pulses in vitro to adversely alter mitochondrial
      oxidative phosphorylation.
AB  - STUDY OBJECTIVE: The aim of the study was to investigate a potential mechanism of
      myocardial injury after DC countershock. The effect of countershock-type
      electrical discharges on rabbit heart mitochondrial oxygen consumption was
      measured in vitro using a novel respiration cell. MEASUREMENTS AND MAIN RESULTS:
      Mitochondria were isolated from the hearts of adult Dutch and New Zealand White
      rabbits. Single rectangular shocks (voltage gradients 20 to 80 V/cm; 5 ms
      duration) caused no significant changes in state 3 oxygen consumption in standard
      incubation medium. Single and multiple defibrillator shocks (critically damped
      sine waveform; 5 ms duration) with peak voltage gradients of 242 to 659 V/cm
      similarly had no significant effect on state 3 oxygen consumption. CONCLUSION: At
      voltage gradients similar to and greater than those causing myocardial cell
      injury and necrosis, electrical discharges do not directly depress mitochondrial
      function. Therefore, the reduction in mitochondrial oxygen consumption observed
      following transthoracic shocks in vivo may invoke other mechanisms (eg,
      intracellular calcium influx, high circulating noradrenaline, or free radical
      formation in the intact heart).

PMID- 1739198
TI  - Regional cerebral blood flow with manual internal cardiac massage versus direct
      mechanical ventricular assistance.
AB  - STUDY HYPOTHESIS: Previous studies have not discerned the best method for
      generating regional cerebral blood flow during internal cardiac massage. We
      hypothesized that regional cerebral blood flow generated by a mechanical method-
      direct mechanical ventricular assistance (DMVA)--would be superior to manual
      internal cardiac massage (MAN). STUDY POPULATION: Twelve adult Yucatan minipigs
      weighing more than 44 kg each were studied. METHODS: Swine were instrumented for
      regional cerebral blood flow measurements using tracer microspheres. After 15
      minutes of ventricular fibrillation, swine were randomized to receive either MAN
      or DMVA. Regional cerebral blood flow was measured during normal sinus rhythm and
      at one minute (VF-1) and six minutes (VF-2) after initiation of circulatory
      support. Regional cerebral blood flow values were compared using a Wilcoxon rank
      sum test. RESULTS: During VF-1, there was a tendency for DMVA to produce greater
      regional cerebral blood flow than MAN, although these differences were not
      statistically significant (DMVA vs MAN as mL/min/100 g): cerebral cortex, 28
      versus 11; cerebellum, 49 versus 22; midbrain, 43 versus 16; pons, 55 versus 18;
      medulla, 55 versus 19; and spinal cord, 33 versus 10. During VF-2, DMVA produced
      greater regional cerebral blood flows than were produced by MAN: cerebral cortex,
      39 versus 12 (P less than .06); cerebellum, 58 versus 20 (P less than 0.5);
      midbrain, 50 versus 18 (P less than .05); pons, 52 versus 22 (P less than .06);
      medulla, 53 versus 20 (P less than .05); and spinal cord, 31 versus 12 (P less
      than .05). CONCLUSION: DMVA produces greater regional cerebral blood flow than is
      produced during MAN after 15 minutes of ventricular fibrillation. DMVA is
      effective at maintaining regional cerebral blood flow after a prolonged cardiac
      arrest.

PMID- 1739199
TI  - Validity of a disposable end-tidal CO2 detector in verifying endotracheal tube
      placement in infants and children.
AB  - STUDY OBJECTIVE: To examine the validity of a disposable, colorimetric end-tidal
      CO2 detector in verifying endotracheal tube (ETT) placement in infants and
      children. DESIGN: The detector was studied prospectively in 151 intubations.
      SETTING: Operating room, ICU, and emergency department of a children's hospital.
      PARTICIPANTS: One hundred thirty-seven children undergoing endotracheal
      intubation for anesthesia (52), respiratory support (76), or CPR (23).
      INTERVENTIONS: After endotracheal intubation, tube position was verified, the
      detector was attached, and readings were obtained. MEASUREMENTS AND RESULTS: The
      detector correctly identified tube position (trachea, 124; esophagus, four) in
      all 120 patients who were not in cardiac arrest (P less than .01). In the cardiac
      arrest setting, all six esophageal intubations were correctly identified, but two
      of the 17 tracheal intubations were incorrectly interpreted as esophageal
      intubations (P less than .01). CONCLUSION: The detector accurately identifies ETT
      position in children with spontaneous circulation who weigh more than 2 kg.
      During CPR, a positive test correctly indicates that the ETT is in the airway,
      but a negative result (suggesting esophageal placement) requires an alternate
      means of confirming ETT position.

PMID- 1739200
TI  - Pediatric bacterial meningitis: is prior antibiotic therapy associated with an
      altered clinical presentation?
AB  - STUDY HYPOTHESIS: The clinical features of children treated with oral antibiotics
      before the diagnosis of bacterial meningitis differ from those who receive no
      antibiotics. DESIGN: Retrospective case series. SETTING: University medical
      center. PARTICIPANTS: Two hundred fifty-eight children 24 months old or younger
      with bacterial meningitis hospitalized during a 12-year period. Eighty-three
      children were treated with oral antibiotics before the diagnosis of meningitis,
      and 175 children were not. INTERVENTIONS: None. METHODS: The emergency department
      chart and hospital records were reviewed for presenting demographic, historical,
      physical examination, and laboratory features. Clinical features of pretreated
      and untreated patients were compared. RESULTS: Pretreated children demonstrated
      less frequent temperature of 38.3 C or higher, altered mental status and a longer
      duration of symptoms before diagnosis, with more frequent vomiting; ear, nose,
      and throat infections; and physician visits in the week before detection of
      meningitis (P less than .05 for all comparisons). There was no difference in
      incidence of upper respiratory symptoms, seizures, nuchal rigidity, Kernig's and
      Brudzinski's signs, focal neurologic signs, mortality, and length of
      hospitalization between groups. CONCLUSION: Clinical features of children who
      have taken antibiotics before the detection of meningitis differ significantly
      from those who have not undergone antibiotic therapy. Physicians should be aware
      of these differences when evaluating young children on antibiotics for the
      possibility of meningitis.

PMID- 1739201
TI  - The relationship of poison center contact and injury in children 2 to 6 years
      old.
AB  - STUDY OBJECTIVE: To determine if children from households that call a poison
      center are at increased risk of nonpoisoning injury. DESIGN: A blinded and
      controlled telephone survey of two groups of households with children between 2
      and 6 years old: case households identified by a poison center as having
      requested information regarding a possible poisoning in a child in this age group
      in 1989, and control households that did not contact the poison center. The
      control group was matched by telephone area code and prefix; the last four digits
      were chosen by random digit dialing. TYPES OF PARTICIPANTS: Children from 2 to 6
      years old. MEASUREMENTS AND MAIN RESULTS: One hundred twenty-nine households
      identified by the poison center and 136 control households completed the
      telephone interview. The number of children 2 to 6 years old in these households
      was 190 in the 129 poison control households and 209 in the 136 nonpoison control
      households. There were 45 injuries among the 190 children in the poison control
      group and 31 injuries among 209 children in the nonpoison control group. The
      annual rate of injuries per child was significantly greater in the poison control
      group (23.7%) than in the nonpoison control group (14.8%) (P less than .025; odds
      ratio, 1.6; 95% confidence interval, 1.1 to 2.4). CONCLUSION: Children 2 to 6
      years old in households that contact a poison center for a possible poison
      exposure in a child in this age group are at increased risk of injury.

PMID- 1739202
TI  - Re-evaluation of the tympanic thermometer in the emergency department.
AB  - STUDY OBJECTIVE: A study was undertaken to re-evaluate tympanic temperatures
      using a commonly used portable infrared tympanic thermometer. DESIGN:
      Temperatures were recorded sequentially at two body sites using an electronic
      digital thermometer and an infrared tympanic thermometer. The tympanic
      thermometer was set to the core equivalency setting. SETTING: The emergency
      department of a Level 2 trauma center. TYPE OF PARTICIPANTS: Seventy-nine
      pediatric patients presenting to the ED. MEASUREMENTS AND MAIN RESULTS: Mean
      temperatures in the tympanic and rectal temperature groups were 38.5 +/- 1.08 C
      and 38.8 +/- 1.02 C, respectively (P greater than .05). The overall correlation
      of rectal and tympanic temperatures was 0.93 (P much less than .001). Stratifying
      the data by age resulted in a weakened correlation for patients 3 months of age
      and younger. For all strata, the sensitivity, specificity, positive predictive
      value, and negative predictive value of the tympanic thermometer for predicting
      fever were 96.6%, 100%, 100%, and 90.1%, respectively; for patients more than 3
      months of age, the values were 100% in all categories. CONCLUSION: Our findings
      indicate that the First Temp infrared tympanic thermometer accurately detected
      fever in a pediatric population more than 3 months old. Results were inconclusive
      in patients less than 3 months old.

PMID- 1739203
TI  - Plasma cocaine and tetracaine levels following application of topical anesthesia
      in children.
AB  - STUDY OBJECTIVES: To measure plasma cocaine and tetracaine levels in children
      after standardized application of a solution of tetracaine 0.5%, epinephrine
      0.05%, and cocaine 11.8% (TAC) to lacerations requiring suture repair. DESIGN:
      Nonrandomized, controlled trial over a five-month period. SETTING: University
      hospital emergency department. TYPE OF PARTICIPANTS: Stable children less than 16
      years of age with uncomplicated lacerations. MEASUREMENTS AND MAIN RESULTS: Blood
      was obtained at either 15 or 20 minutes (early; 32) or 45 or 60 minutes (late;
      45) for measurement of plasma cocaine and tetracaine levels. Analysis for cocaine
      and tetracaine concentrations was performed using gas chromatography-mass
      spectroscopy with a limit of detection for both assays of 0.5 ng/mL. Serum
      cocaine levels were low but measurable at both times in 75% of children. No
      tetracaine was measurable. Median cocaine levels were 1 ng/mL (range, 0 to 112
      ng/mL) for the early group and 2 ng/mL (range, 0 to 274 ng/mL) for the late group
      (P = NS). Only two children had levels of more than 100 ng/mL. No significant
      correlation between patient or laceration characteristics and cocaine levels was
      detected. No significant change in heart rate or blood pressure was detected.
      Children who required additional local anesthesia had nonfacial lacerations and
      lower cocaine levels than children with facial lacerations. CONCLUSION:
      Application of 3 mL of standard TAC solution for 15 minutes results in low but
      measurable plasma cocaine levels in 75% of children.

PMID- 1739204
TI  - Emergency medicine & injury control.

PMID- 1739205
TI  - Trauma systems development.

PMID- 1739206
TI  - Emergency medicine, "where are ye?".

PMID- 1739208
TI  - Use of statistical tests.

PMID- 1739207
TI  - Opportunity knocks. What will we do?

PMID- 1739209
TI  - An academic status report for emergency medicine.

PMID- 1739210
TI  - The use of external, noninvasive pacing for the termination of ventricular
      tachycardia in the emergency department setting.
AB  - STUDY OBJECTIVE: To determine the potential usefulness of external cardiac pacing
      for the termination of sustained ventricular tachycardia in the emergency
      department setting. TYPE OF PARTICIPANTS: Five men and one woman (mean age, 57
      years) who presented to the ED with a wide-complex, hemodynamically stable
      tachycardia that was later proven to be ventricular in origin. INTERVENTION: Each
      patient underwent external overdrive pacing using a modified external pacemaker
      at a pulse amplitude of 120 mA and a rate of 200 pulses per minute. RESULTS: In
      all six patients, external cardiac pacing was able to successfully terminate
      tachycardia without complication. CONCLUSION: We conclude that external
      noninvasive pacing may be an effective means of terminating ventricular
      tachycardia in the ED setting.

PMID- 1739211
TI  - Pseudometabolic acidosis caused by underfill of Vacutainer tubes.
AB  - STUDY OBJECTIVES: To determine how serum bicarbonate and anion gap are affected
      by sample size in a 10-mL red-top (clot) Vacutainer tube at the fixed sample
      volumes of 10, 3, and 1 mL. DESIGN: Venous phlebotomy on consecutive emergency
      department patients; three tubes drawn in random order. The first 20 patients had
      unvented tubes, and the last ten had the tubes vented within one minute of the
      draw. SETTING: University hospital ED. PARTICIPANTS: Thirty ED patients.
      INTERVENTIONS: All blood samples had electrolytes determined within one hour of
      phlebotomy. To approximate the ED setting, the time to analysis was not
      controlled, but each triple draw had simultaneous analysis. MEASUREMENTS AND MAIN
      RESULTS: Mean bicarbonate in mmol/L (with sample size) was 21.7 (10 mL), 19.4 (3
      mL), and 16.3 (1 mL) (r2 = .86, P = .0001). Anion gap in mmol/L was 16.7 (10 mL),
      17.5 (3 mL), and 19.1 (1 mL) (r2 = .84, P = .0077). Venting of Vacutainer tubes
      did not significantly change these results. CONCLUSION: Underfill of 10-mL
      Vacutainer tubes causes a significant decline in bicarbonate and an increase in
      anion gap that may be mistaken for a metabolic acidosis. To correct for these
      effects, the bicarbonate should be increased by 0.5 to 0.6 mmol/L, and the anion
      gap should be decreased by 0.2 to 0.3 mmol/L for every milliliter of air above
      the sample in a 10-mL Vacutainer tube. Venting the tubes will not correct this
      effect. All tubes should be filled completely to avoid creating a pseudometabolic
      acidosis.

PMID- 1739212
TI  - A model research curriculum for emergency medicine.

PMID- 1739213
TI  - The place of emergency medicine in the academic community.

PMID- 1739214
TI  - Setting the national agenda for injury control in the 1990s.

PMID- 1739215
TI  - The antiphospholipid antibody syndrome in the emergency department setting-
      livedo reticularis and recurrent venous thrombosis.
AB  - We present the case of a 26-year-old man with an exacerbation of apparent chronic
      asthma with chronic peripheral vascular disease due to recurrent venous
      thrombosis. Localized livedo reticularis, new cutaneous infarctions, severe
      venous insufficiency, thrombocytopenia, renal failure, and cerebral
      supratentorial dysfunction were noted. During hospital admission, antibodies to
      phospholipids in high titer were present by three different testing methods.
      Renal biopsy demonstrated significant renal vasculature abnormalities
      characteristic of hemolytic endovasculopathy, and magnetic resonance imaging
      showed multiple cerebral infarctions. This case exemplifies the spectrum of
      presentations and management of the primary antiphospholipid antibody syndrome.
      The clue to its presence in this patient was the livedo reticularis rash, a
      cutaneous marker for this syndrome that was evident in the emergency department.

PMID- 1739216
TI  - The emergency management of moray eel bites.
AB  - As human encounters with hazardous marine life increase, emergency physicians are
      more frequently confronted with the management of resultant injuries. We present
      three cases involving hand injuries inflected by moray eels. Each was managed
      with local wound care and subsequent outpatient treatment with either oral
      ciprofloxacin or cefuroxime. One patient had mild residual hand dysfunction, and
      no patient developed wound infection. To better assess the bacteriology of such
      injuries, oral cultures were taken from captive moray eels and surrounding
      aquarium water. Culture and sensitivity analyses showed Vibrio and Pseudomonas to
      be the predominant species, both sensitive to ciprofloxacin, cefuroxime,
      tetracycline, and trimethoprim-sulfamethoxazole. We conclude that moray eel bites
      can be managed successfully with aggressive, local wound care and antibiotic
      coverage that targets Vibrio and Pseudomonas species.

PMID- 1739217
TI  - Ascariasis mimicking an acute abdomen.
AB  - Infection with the roundworm Ascaris lumbricoides is common in children and may
      mimic an acute abdomen. The cases of two pediatric patients who presented to the
      emergency department with signs and symptoms of a surgical abdomen are presented
      to highlight the presentation of this infection. Both cases were diagnosed by
      physical examination and radiographs and were treated successfully without
      surgical intervention. These cases illustrate the need for heightened awareness
      by the emergency physician of ascariasis in the differential diagnosis of acute
      abdomen.

PMID- 1739218
TI  - Retrograde intubation of the pharynx: an unusual complication of emergency
      cricothyrotomy.
AB  - Retrograde, translaryngeal intubation of the pharynx, a previously unreported and
      potentially fatal complication of emergency cricothyrotomy, is described. Methods
      of avoiding this complication are discussed. Reports in the literature of related
      technical errors following successful surgical incision of the cricothyroid
      membrane are discussed.

PMID- 1739219
TI  - Tonic status epilepticus: an unusual presentation of unresponsiveness.
AB  - We report an unusual cause of unresponsiveness in a 73-year-old woman seen in the
      emergency department. Extensive evaluation, including an emergency EEG that
      demonstrated rhythmic, high-voltage spike-and-wave discharges characteristic of
      convulsive activity, confirmed the diagnosis of generalized tonic status
      epilepticus. The patient's persistent subclinical seizures terminated after the
      IV administration of diazepam. Varying presentations of generalized tonic status
      epilepticus have been described in the neurology literature, with EEG
      confirmation of this diagnosis. Review of the emergency medicine literature does
      not describe a similar presentation of altered mental status in the adult
      population. This case illustrates one necessary role for ED EEG in the
      identification of occult status epilepticus causing altered mental status.

PMID- 1739220
TI  - Orthostatic vital signs.

PMID- 1739221
TI  - Pharmacotherapy of pregnancy--related SVT.

PMID- 1739222
TI  - Using ACE-inhibitors.

PMID- 1739223
TI  - The evolution of continence following total colectomy.

PMID- 1739224
TI  - How can general surgery survive?

PMID- 1739225
TI  - Acute limited normovolemic hemodilution can be safely used in a malnourished
      model.
AB  - This study investigates the effects of acute limited normovolemic hemodilution
      (ALNH) on intestinal healing in a malnourished animal model. Twenty rabbits were
      randomized into three Groups: Group 1 = control; Group 2 = ALNH (removal 35%
      blood volume and maintenance of normovolemia with 3:1 crystalloid infusion)
      followed by retransfusion (RT) after small bowel anastomosis (ANA). Group 3 had a
      restricted diet for 3 weeks preoperatively to cause a 15 percent to 20 percent
      weight loss. A six cm segment of small bowel (SB) was resected and anastomosed
      (ANA) in all animals. Blood pressure (BP), transserosal oxygen tension (TsPao2),
      hematocrit (Hct), colloid oncotic pressure (COP), wet-to-dry weight ratios
      (WW/DW), hydroxyproline (OH-Pro) content, and tensile strength (TS) of the ANA
      and a segment of adjacent SB were determined. BP did not change from baseline
      (BL) in Group 2 during ALNH; however, it rose significantly after RT (P less than
      0.05). BP decreased significantly during ALNH in Group 3 (P less than 0.05) and
      did not rise above baseline after RT. There was no significant change in TsPao2
      from BL within groups during the experiment. The Hct and COP decreased
      significantly after ALNH in Groups 2 and 3 after ALNH compared to BL (P less than
      0.05). After RT the Hct and COP increased and by Day 8 the Hct had risen to BL
      values in Group 3 but not in Group 2 (P less than 0.05), whereas COP values were
      not significantly different from BL in either group. There was no difference in
      WW/DW or TS between or among the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1739226
TI  - Peritoneal neutrophil chemotaxis is impaired in biliary obstruction.
AB  - Previous studies have shown impaired reticuloendothelial function in biliary
      obstruction. The chemotactic response of polymorphonuclear leukocytes from
      peripheral blood and peritoneal fluid of jaundiced rats (Group 1) was compared to
      that of sham operated controls (Group 2) and normal rats (Group 3). Male Sprague
      Dawley rats underwent bile duct ligation or sham celiotomy. Studies were
      performed from 1 to 3 weeks after surgery. Mean serum bilirubin was 6.8 mg
      percent in Group 1 and normal in Groups 2 and 3. Peritoneal neutrophils were
      induced by intraperitoneal injection of 10 ml of 10 percent peptone broth 16
      hours before the study, harvested from peritoneal fluid and peripheral blood, and
      isolated on Ficoll-Hypaque. F-met-leu-phe (FMLP) chemoattractant (10(-7) M) was
      used to induce migration of neutrophils across 3 mu filters. The filters were
      removed, mounted on slides, stained, and counts averaged for five oil immersion
      fields for each of three wells. Data were expressed as number of neutrophils per
      oil immersion field. Peritoneal neutrophil chemotaxis was significantly decreased
      in Group 1 (10.3 +/- 8.1) compared with Groups 2 (17.0 +/- 7.3) and 3 (20.2 +/-
      6.4). A similar trend was noted in polymorphonuclear leukocytes from peripheral
      blood (Group 1: 13.1 +/- 7.8, Group 2: 18.2 +/- 6.7, Group 3: 17.4 +/- 5.9; P =
      0.1). This impairment in neutrophil chemotaxis may contribute to the high rate of
      septic complications observed in the jaundiced host.

PMID- 1739227
TI  - Pericardiotomy improves left ventricular compliance during sepsis-induced
      pulmonary artery hypertension.
AB  - Sepsis-induced pulmonary artery hypertension (SIPAH) causes an increase in right
      ventricular (RV) afterload, dilatation of the RV, leftward shift of the
      interventricular septum (IVS), and therefore decreases left ventricular
      compliance (LVC). This study was designed to evaluate the role of pericardiotomy
      during SIPAH as an alternative to vasodilators (which cause a detrimental
      increase in shunt fraction) to improve LVC. Systemic and pulmonary hemodynamics,
      pulmonary function, RV, and LVC were acquired at baseline (BL), during SIPAH with
      closed pericardium (PAHCP) and after opening the pericardium (PAHOP). Systemic
      hemodynamics and pulmonary function did not change significantly during the
      experiment. The infusion of live bacteria induced a significant rise in mean
      pulmonary artery pressure from 16 +/- 5.3 at BL to 36.8 +/- 3.3 and 35.0 +/- 6.4
      mm Hg during PAHCP and PAHOP, respectively, (P less than 0.05). Pulmonary
      vascular resistance index and right ventricular stroke work index (RVSWI)
      displayed a similar rise in response to SIPAH (P less than 0.05 vs BL).
      Pericardiotomy did not affect pulmonary hemodynamics or RVSWI. Right ventricular
      contractility did not increase following pulmonary hypertension while the
      pericardium was closed (440 +/- 78 vs 410 +/- 125, P less than 0.05); however, it
      rose, although not significantly, to 615 +/- 326 after pericardiotomy. RV time
      tension index displayed a rise during SIPAH with the pericardium intact and
      returned to baseline values after pericardiotomy; however, these changes were not
      significant. RVC did not change significantly throughout the experiment. In
      contrast, LVC decreased significantly after SIPAH and significantly improved
      after pericardiotomy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1739228
TI  - Treatment priorities in patients with traumatic rupture of the thoracic aorta.
AB  - Autopsy studies reveal that 90 percent of patients with traumatic rupture of the
      thoracic aorta (TRTA) die at the scene of the accident and 25 percent of those
      reaching the hospital do not survive their injuries. Treatment priorities in
      patients with TRTA and associated life-threatening head and intra-abdominal
      injuries have not been adequately studied. The authors reviewed their experience
      with 57 consecutive patients sustaining TRTA to establish treatment priorities in
      these multiply injured patients. The mean age of the population was 35 years (43
      men, 14 women). Hospital mortality was 24 percent; the most common cause of death
      was hemorrhage. Fully 95 percent of the patients had associated injuries
      requiring operative intervention. Abdominal injuries requiring laparotomy were
      present in 20 patients (35%): 14 splenic injuries, 8 liver injuries, 3 pancreatic
      injuries, and 3 mesenteric lacerations. Twenty-eight patients (49%) had
      orthopaedic injuries requiring operative fixation. Maxillofacial injuries
      requiring surgical repair occurred in 20 patients (35%). Fifteen patients (26%)
      sustained significant closed head injuries, but only 1 required craniotomy for
      hemorrhage. Nine hemodynamically unstable patients with intra-abdominal
      hemorrhage underwent immediate laparotomy for control of bleeding followed by
      aortography and aortic repair (2 deaths, 22%). Seven hemodynamically stable
      patients had aortography followed by laparotomy for control of intra-abdominal
      hemorrhage with subsequent thoracotomy (1 death, 14%). Thirty stable patients
      underwent aortography followed by immediate thoracotomy; 22 required no further
      procedures, while 8 required an additional operation (7 death, 23%).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1739229
TI  - Computed tomography and diagnostic peritoneal lavage. Complementary roles in
      blunt trauma.
AB  - Viewpoints regarding the use of computed tomography (CT) and diagnostic
      peritoneal lavage (DPL) in the evaluation of stable blunt abdominal trauma
      patients remain polarized and their respective roles are ill-defined. To further
      clarify their independent and combined value, the authors report the results of a
      prospective study of their use in adult patients satisfying the entry criteria of
      major blunt torso trauma, hemodynamic stability, equivocal and unreliable
      abdominal examination, and absence of both before abdominal surgery and unstable
      pelvic fractures. The 116 patients admitted to the study over an 11-month period
      were first submitted to a CT scan using a 9800 series GE scanner (General
      Electric Medical Systems; Milwaukee, WI). After its review with the faculty CT
      radiologist, the surgeon recorded his decision as to the need for the laparotomy.
      All patients were then subjected to DPL and the results recorded as recommending
      laparotomy based on finding aspiration of greater than 10 cc of blood or greater
      than or equal to 100,000 RBC/mm3 greater than W 500 WBC/mm3, or positive gram
      stain. A final decision was then formulated based on information gained from both
      studies. Actual need for operation or observation was recorded based on ultimate
      outcome in observed patients or upon findings at laparotomy. Initial laparotomy
      was performed in 22 patients; yet only 17 had injuries requiring repair.
      Unnecessary laparotomy was recommended by DPL in 15.5 percent of patients vs 0.8
      percent by CT (P greater than .01), while inappropriate observation was
      recommended by DPL in 1.7% vs 6.9% by CT (P less than .01).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1739230
TI  - Prostaglandin E2 in duodenal ulcer complications.
AB  - Prostaglandins are presumed to have cytoprotective properties and may play a role
      in the pathogenesis of duodenal ulcer and its complications. To evaluate this
      hypothesis, 35 patients with either duodenal ulcer bleeding (18 patients) or
      gastric outlet obstruction (17 patients) were investigated. Biopsies were taken
      from gastroduodenal tissues and secretions for prostaglandin E2 (PGE2) levels.
      These levels were compared to those taken from the same areas during a later
      endoscopy. A correlation was found between the severity of the clinical
      endoscopic findings and PGE2 levels. Increased levels of PGE2 were found in the
      quiescent phase and decreased levels found during the deteriorated phase. These
      differences of PGE2 levels were found to be of significant value (P less than
      0.002). Furthermore, the patients in which the PGE2 levels were decreased at
      second endoscopy needed surgery. PGE2 may, thus, be a factor in duodenal ulcer
      pathogenesis and its complications, and be used as a prognostic marker and guide.

PMID- 1739231
TI  - Primary aortoenteric fistulas.
AB  - Aortoenteric fistulas were first reported in 1822. Primary aortoenteric fistulas
      are uncommon (less than 200 cases reported). Secondary aortoenteric fistulas are
      a well-recognized complication of prosthetic grafts (incidence from 0.4 to 2.4%).
      Atherosclerosis, gallstones, foreign bodies, carcinomas, and diverticular disease
      are the most common etiologies. Diagnosis is difficult with most studies being
      nondiagnostic. A high incidence of suspicion is required to successfully
      diagnosis preoperatively. Surgical repair is required for survival of the
      patients and should consist of the following: 1) primary closure of the
      intestinal defect, 2) either primary anatomical repair with a prosthetic graft or
      extra-anatomical vascular reconstruction, depending upon the presence or absence
      of infection, and 3) treatment with appropriate antibiotics. One of the largest
      series of primary aortoenteric fistulas from a single institution consisting of
      three cases secondary to aneurysmal and granulomatous disease is discussed.

PMID- 1739232
TI  - Phytobezoar obstruction of a Meckel's diverticulum.

PMID- 1739233
TI  - The carpal tunnel syndrome: Part I.
AB  - The carpal tunnel syndrome is a compression of the median nerve within the carpal
      tunnel with very specific signs and symptoms. Anatomical dissection of 156 wrists
      is presented and then the authors compare their findings with the findings of
      other investigators. The purpose of this article is not to present results but
      rather to discuss the anatomic entities involved with the syndrome and to present
      the open treatment modality.

PMID- 1739234
TI  - Increased sympathetic nervous activity and the effects of its inhibition with
      clonidine in alcoholic cirrhosis.
AB  - OBJECTIVE: To study disturbances in sympathetic nervous system function in
      patients with alcoholic cirrhosis and the effect of clonidine on such
      disturbances. DESIGN: Cross-sectional physiologic and neurochemical evaluation of
      patients with cirrhosis and of healthy controls; an uncontrolled trial of
      intravenous clonidine in the cirrhotic patients. PATIENTS: Forty-four
      hospitalized patients with biopsy-proven alcoholic cirrhosis and 31 healthy
      controls. INTERVENTIONS: Intravenous clonidine. MAIN OUTCOME MEASURES:
      Radiotracer-derived measures of norepinephrine release to plasma, central
      hemodynamics, wedge hepatic vein pressure, and measures of renal function. MAIN
      RESULTS: In patients with cirrhosis, clonidine reduced previously elevated
      norepinephrine overflow rates for the whole body, kidneys, and hepatomesenteric
      circulation. This sympathetic inhibition was accompanied by the following
      potentially clinically beneficial effects: the lowering of renal vascular
      resistance (median reduction, 24%; 95% CI, 14% to 31%), the elevation of
      glomerular filtration rate (median increase, 27%; CI, 14% to 39%), and the
      reduction of portal venous pressure (median reduction, 25%; CI, 18% to 32%). The
      norepinephrine and hemodynamic responses to graded clonidine dosing (1, 2, and 3
      micrograms/kg body weight intravenously) indicated that the sympathetic outflow
      to the hepatomesenteric circulation was more sensitive to pharmacologic
      suppression with clonidine than was the sympathetic outflow to the systemic
      circulation. CONCLUSIONS: The sympathetic nerves to the kidneys, heart, and
      hepatomesenteric circulation are stimulated in patients with cirrhosis. Clonidine
      inhibits these activated sympathetic outflows differentially, which could
      possibly provide a basis for the selective pharmacologic treatment of portal
      hypertension in patients with cirrhosis.

PMID- 1739235
TI  - The natural history of electrocardiographic preexcitation in men. The Manitoba
      Follow-up Study.
AB  - OBJECTIVE: To examine the natural history of preexcitation occurring on the
      routine electrocardiogram (ECG). DESIGN: A longitudinal cohort study of 3983
      originally healthy men followed prospectively for 40 years. SETTING: Free-living
      (community-dwelling) study members residing predominantly in Canada.
      PARTICIPANTS: Nineteen male study members with preexcitation occurring during
      routine examination in the 40-year follow-up of the Manitoba Follow-up Study.
      MEASUREMENTS: Routinely requested clinical examinations and ECGs, supplemented by
      information supplied by the study member or his physician. MAIN RESULTS: Ten
      study members were found to have preexcitation at enrollment, for a prevalence of
      2.5 per 1000 (95% CI, 1.2 to 4.6). A delta wave was first detected during follow
      up in an additional nine study members. Seventeen of 19 study members did not
      have the delta wave at some later time, and preexcitation was intermittently
      present in most of these members. Over time there was a loss of preexcitation,
      with 15 of 19 study members no longer exhibiting a delta wave by the end of
      follow-up. Five of 11 study members with symptoms had physician confirmation of
      an arrhythmia. Fourteen study members remain alive, and none of the five deaths
      was attributed to preexcitation. CONCLUSIONS: Preexcitation found on routine ECG
      in our originally healthy male study group did not confer excess morbidity or
      mortality, even in those study members who developed symptomatic arrhythmias.
      Most preexcitation was intermittent and disappeared over time.

PMID- 1739236
TI  - Acetazolamide in the treatment of acute mountain sickness: clinical efficacy and
      effect on gas exchange.
AB  - OBJECTIVE: To determine the efficacy of acetazolamide in the treatment of
      patients with acute mountain sickness and the effect of the drug on pulmonary gas
      exchange in acute mountain sickness. DESIGN: A randomized, double-blind, placebo
      controlled trial. SETTING: The Denali Medical Research Project high-altitude
      research station (4200 m) on Mt. McKinley, Alaska. PARTICIPANTS: Twelve climbers
      attempting an ascent of Mt. McKinley (summit, 6150 m) who presented to the
      medical research station with acute mountain sickness. INTERVENTION: Climbers
      were randomly assigned to receive acetazolamide, 250 mg orally, or placebo at 0
      (baseline) and 8 hours after inclusion in the study. MAIN OUTCOME MEASURES: An
      assessment of acute mountain sickness using a symptom score and pulmonary gas
      exchange measurements was done at baseline and at 24 hours. MAIN RESULTS: After
      24 hours, five of six climbers treated with acetazolamide were healthy, whereas
      all climbers who received placebo still had acute mountain sickness (P = 0.015).
      Arterial blood gas specimens were obtained from three of the six acetazolamide
      recipients and all of the placebo recipients. The alveolar to arterial oxygen
      pressure difference (PAO2-PaO2 difference) decreased slightly over 24 hours in
      the acetazolamide group (-0.8 +/- 1.2 mm Hg) but increased in the placebo group
      (+3.3 +/- 2.3 mm Hg) (P = 0.024). Acetazolamide improved PaO2 over 24 hours (+2.9
      +/- 0.8 mm Hg) when compared with placebo (-1.3 +/- 2.8 mm Hg) (P = 0.045).
      CONCLUSION: In established cases of acute mountain sickness, treatment with
      acetazolamide relieves symptoms, improves arterial oxygenation, and prevents
      further impairment of pulmonary gas exchange.

PMID- 1739237
TI  - Treatment of Mycobacterium avium complex bacteremia in AIDS with a four-drug oral
      regimen. Rifampin, ethambutol, clofazimine, and ciprofloxacin. The California
      Collaborative Treatment Group.
AB  - OBJECTIVE: To determine the quantitative microbiologic response and the clinical
      response of patients with Mycobacterium avium complex bacteremia and AIDS to an
      oral antimycobacterial regimen. DESIGN: A phase II, multicenter clinical trial.
      SETTING: Four university-affiliated medical centers. PATIENTS: Forty-one patients
      with HIV infection who had at least two consecutive blood cultures positive for
      M. avium complex and who had not received previous antimycobacterial therapy were
      enrolled in the study. Thirty-one patients were evaluable with regard to the
      efficacy of the oral regimen. INTERVENTIONS: Patients received a combination of
      orally administered rifampin (600 mg), ethambutol (15 mg/kg body weight),
      clofazimine (100 mg once daily), and ciprofloxacin (750 mg twice daily) for 12
      weeks. Parenterally administered amikacin, 7.5 mg/kg daily for 4 weeks after the
      first 4 weeks of oral therapy, was used at the discretion of the individual
      investigator. MEASUREMENTS: Clinical symptoms, Karnofsky scores, and adverse
      events were monitored. Colony counts for M. avium complex were determined. MAIN
      RESULTS: The mean logarithmic (log) baseline colony count decreased from 2.1 to
      0.7 after 4 weeks of oral therapy (P less than 0.001). Suppression of bacteremia
      was sustained throughout therapy. Thirteen patients (42%) became culture negative
      during therapy. The mean duration of treatment was 9.7 weeks. Nineteen evaluable
      patients (61%) completed 12 weeks of therapy. Adverse reactions to one or more
      agents were common. CONCLUSIONS: A rapid reduction in symptoms and bacteremia can
      be achieved as early as week 2 of therapy using an oral regimen of rifampin,
      ethambutol, clofazimine, and ciprofloxacin. Colony counts rose dramatically after
      therapy was discontinued, suggesting that more prolonged periods of therapy are
      necessary to eradicate systemic infection.

PMID- 1739238
TI  - Conjugal Graves disease.

PMID- 1739239
TI  - Career differences between primary care and traditional trainees in internal
      medicine and pediatrics.
AB  - OBJECTIVE: To assess the relation of Primary Care Residency Training to career
      choice, board certification, and practice location of internists and
      pediatricians. DESIGN: Cohort study with up to 8 years of follow-up. SETTING: The
      United States. PARTICIPANTS: The 17,933 residents trained in all internal
      medicine (13,750) and pediatrics (4,183) residency programs between 1977 and 1982
      were studied using information from the National Resident Matching Program, the
      AMA Physician Masterfile, the Area Resource File, and a telephone survey.
      MEASUREMENTS: Career choice, board certification, and practice location were
      studied in relation to five explanatory variables: type of residency (primary
      care or traditional track), gender, year of medical school graduation,
      educational orientation of the teaching hospital, and medical school prestige.
      MAIN RESULTS: Graduates of primary care residency training programs chose careers
      in generalist primary care significantly more often than did graduates of
      traditional tracks in both internal medicine (72% compared with 54%) and
      pediatrics (88% and 81%, respectively; P less than 0.001 for both values). Board
      certification rates in internal medicine were statistically higher for graduates
      of primary care training programs (80%) than for graduates of traditional
      programs (76%, P = 0.002) but were not statistically significant for both groups
      of pediatric graduates. Graduates of primary care programs in pediatrics and
      internal medicine practiced in medically less served communities more often than
      did graduates of traditional programs. CONCLUSION: Graduates of primary care
      residency training programs in internal medicine and pediatrics differ from
      graduates of traditional residency programs in career choices, board
      certification rates, and practice locations.

PMID- 1739240
TI  - Wegener granulomatosis: an analysis of 158 patients.
AB  - OBJECTIVE: To prospectively study the clinical features, pathophysiology,
      treatment and prognosis of Wegener granulomatosis. DESIGN: Of the 180 patients
      with Wegener granulomatosis referred to the National Institute of Allergy and
      Infectious Diseases during the past 24 years, 158 have been followed for 6 months
      to 24 years (a total of 1229 patient-years). MEASUREMENTS: Characteristics of
      clinical presentation, surgical pathology, course of illness, laboratory and
      radiographic findings, and the results of medical and surgical treatment have
      been recorded in a computer-based information retrieval system. SETTING: The
      Warren Magnuson Clinical Center of the National Institutes of Health. MAIN
      RESULTS: Men and women were equally represented; 97% of patients were white, and
      85% were more than 19 years of age. The mean period of follow-up was 8 years. One
      hundred and thirty-three patients (84%) received "standard" therapy with daily
      low-dose cyclophosphamide and glucocorticoids. Eight (5.0%) received only low
      dose cyclophosphamide. Six (4.0%) never received cyclophosphamide and were
      treated with other cytotoxic agents and glucocorticoids. Ten patients (6.0%) were
      treated with only glucocorticoids. Ninety-one percent of patients experienced
      marked improvement, and 75% achieved complete remission. Fifty percent of
      remissions were associated with one or more relapses. Of 99 patients followed for
      greater than 5 years, 44% had remissions of greater than 5 years duration.
      Thirteen percent of patients died of Wegener granulomatosis, treatment-related
      causes, or both. Almost all patients had serious morbidity from irreversible
      features of their disease (86%) or side effects of treatment (42%). CONCLUSIONS:
      The course of Wegener granulomatosis has been dramatically improved by daily
      treatment with cyclophosphamide and glucocorticoids. Nonetheless, disease- and
      treatment-related morbidity is often profound. Alternative forms of therapy have
      not yet achieved the high rates of remission induction and successful maintenance
      that have been reported with daily cyclophosphamide treatment. Despite continued
      therapeutic success with cyclophosphamide, our long-term follow-up of patients
      with Wegener granulomatosis has led to increasing concerns about toxicity
      resulting from prolonged cyclophosphamide therapy and has encouraged
      investigation of other therapeutic regimens.

PMID- 1739241
TI  - The health transition in developing countries: a role for internists from the
      developed world.
AB  - Demographic and epidemiologic changes that have occurred in the past five decades
      in many developing countries provide new opportunities for internists from
      developed countries to contribute to improvements in international health. These
      changes, called the "health transition," are characterized by major growth in the
      number and proportion of middle-aged and elderly persons and in the frequency of
      the chronic diseases that occur in these age groups. The health transition is the
      result of concentrated national and international efforts to improve maternal and
      child health by emphasizing primary care and community-organized outreach
      services. In many developing countries, such efforts have been responsible for a
      decrease in the birth rate; reduced maternal mortality; improved preventive
      services; and a vigorous therapeutic approach to infantile diarrhea and
      respiratory infection, which, in turn, have resulted in the reduced infant
      mortality and the increased life expectancy that defines the health transition.
      These changes, often accompanied by increasing urbanization and
      industrialization, are creating health problems similar to those seen in the
      "developed" world but are occurring in countries that have far fewer resources.
      Internists interested in working in developing countries can therefore bring
      their skills, experience, and perspective to bear on these problems, primarily by
      working within well-structured programs, the aim of which is to strengthen the
      capacity of the organizations and institutions within these countries to cope
      with the rising tide of chronic adult diseases.

PMID- 1739242
TI  - Increasing utilization of allogeneic bone marrow transplantation. Results of the
      1988-1990 survey.
AB  - OBJECTIVE: To determine the pattern and frequency of allogeneic bone marrow
      transplantation from related and unrelated donors from 1988 to 1990. DESIGN AND
      SETTING: Survey of 342 institutions in 47 countries. MEASUREMENTS: Numbers of
      patients receiving bone marrow transplantation for specific disease categories at
      institutions with active allogeneic bone marrow transplant programs. MAIN
      RESULTS: Patients (14,745) received allogeneic bone marrow transplantation
      between 1988 and 1990; of these, 1153 (8%) were from unrelated donors. Reasons
      for transplantation were acute leukemia (47%), chronic myelogenous leukemia
      (27%), lymphoma and other malignancies (10%), severe aplastic anemia (9%), and
      other nonmalignant diseases (7%). The number of allogeneic bone marrow
      transplants per million persons differed among countries, averaging 7.7 per
      million in North America and 5.7 per million in western Europe. CONCLUSIONS: The
      use of allogeneic bone marrow transplantation continued to increase at a rate of
      more than 600 additional patients and 25 new transplant teams annually. This rise
      is due in part to increasing use of unrelated volunteers as donors. Resources
      allocated for transplants vary widely among countries.

PMID- 1739243
TI  - Training primary care physicians.

PMID- 1739244
TI  - Clonidine for portal hypertension: a sympathetic solution?

PMID- 1739245
TI  - Anemia of chronic disease: a misnomer?

PMID- 1739246
TI  - Anemia of chronic disease: a misnomer?

PMID- 1739247
TI  - Anemia of chronic disease: a misnomer?

PMID- 1739248
TI  - Regional variations in plasma fibrinogen.

PMID- 1739249
TI  - Hyperprolactinemia, galactorrhea, and atenolol.

PMID- 1739250
TI  - Cefotetan-induced singultus.

PMID- 1739251
TI  - Augmented Valsalva maneuver for supraventricular tachycardia in the young.

PMID- 1739252
TI  - Does low total creatine kinase rule out myocardial infarction?

PMID- 1739253
TI  - Does cerebral toxoplasmosis therapy protect against pneumocystitis in AIDS?

PMID- 1739254
TI  - Does radiation increase survival in nonresectable lung cancer?

PMID- 1739255
TI  - Laser surgery for the treatment of larynx carcinomas: indications, techniques,
      and preliminary results.
AB  - The authors have developed four different types of endolaryngeal laser resections
      for the treatment of larynx carcinomas. These new techniques are based on
      traditional concepts employed in partial larynx resections. From 1986 onward, 110
      patients with laryngeal cancers were treated by endoscopic laser surgery. One
      hundred six patients were operated on for cure and 4 for palliation. In 9 cases
      of T3 tumor, complete removal of the tumor was not possible, requiring total
      laryngectomy. In all T2 cancers of the glottis and subglottis (n = 36), a total
      resection was possible. Additional staged neck dissection was performed in 16
      cases, and postoperative radiotherapy in 10 cases. Follow-up investigations of
      the patients treated for cure (n = 106) cover a period of 3 to 42 months (mean,
      22 months). These revealed 6 recurrences in the larynx, which were treated by
      laryngectomy. Recurrences in the cervical nodes were seen in 2 patients following
      resection of a supraglottic tumor and a subglottic tumor, respectively. Seven
      patients could not be followed up, 4 patients died of intercurrent disease, and
      87 patients are alive and free of tumor. At present the number of recurrences and
      the rate of survival show no significant difference from those previously
      reported after conventional surgery. The phonatory function is not always
      predictable and still remains to be investigated. The authors believe that laser
      surgery may obviate the need for total laryngectomies in selected cases of
      laryngeal cancer, especially in T2 tumors. However, T3 tumors should not be
      treated by endolaryngeal laser surgery.

PMID- 1739256
TI  - Characteristics of late responses to superior laryngeal nerve stimulation in
      humans.
AB  - To characterize human thyroarytenoid and cricothyroid muscle responses to
      stimulation of the internal (sensory) and external (motor) branches of the
      superior laryngeal nerve (SLN), three awake subjects were studied at rest and
      during muscle activation with stimulation at different current levels. When only
      the external branch was stimulated, direct cricothyroid muscle responses were
      obtained without responses in either thyroarytenoid muscle. When only the
      internal branch was stimulated, no cricothyroid responses were obtained, but two
      late thyroarytenoid responses occurred (R1 and R2). The R1 response was usually
      ipsilateral and had a mean onset latency of 18 milliseconds, while the R2
      response was bilateral and occurred between 66 and 70 milliseconds. Both
      responses tended to decrease in latency and increase in amplitude with increased
      stimulation level. The similarity of R1 to the adductor response and R2 to other
      late responses is discussed.

PMID- 1739257
TI  - Pediatric transbronchial lung biopsy.
AB  - A retrospective review of 25 transbronchial lung biopsies in 19 pediatric
      patients is reported. Nineteen of these procedures used a rigid ventilating
      bronchoscope and a small cup biopsy forceps. The indications included diffuse
      pulmonary infiltrates in the immunocompromised patient, severe hyaline membrane
      disease, tumor, and lung transplant. In 84% of the procedures, adequate tissue
      was obtained. There was a 12.5% incidence of pneumothorax and no significant
      pulmonary hemorrhage.

PMID- 1739258
TI  - Dysphagia following various degrees of surgical resection for oral cancer.
AB  - Postoperative swallowing problems were investigated in 20 patients who had
      undergone various degrees of surgical resection for oral cancer. The swallowing
      problems were evaluated on the basis of type of food, degree of aspiration, and
      duration of postoperative nasogastric tube feeding. Two patients with tongue
      cancer who had had hemiglossectomy without reconstruction ate normal food without
      aspiration within a week after operation. Eight patients who had undergone two-
      to three-quarter glossectomy for tongue cancer ate gruel with no or occasional
      liquid aspiration. Among 4 patients who had had near-total or total glossectomy
      for tongue cancer, 3 ate thin gruel or liquid with occasional aspiration. The
      other could not eat orally because of consistent severe aspiration. One patient
      with mouth floor cancer underwent resection of the mouth floor in combination
      with hemiglossectomy and she ate gruel without aspiration. Among 5 patients with
      mouth floor cancer who had had surgical removal accompanied by near-total or
      total glossectomy, 3 ate gruel with no or occasional liquid aspiration, 1 ate
      thin gruel with no aspiration, and the other could not eat orally. A diagnosis of
      T4 lesions, extensive removal of the tongue base, removal of the geniohyoid and
      mylohyoid muscles, and removal of the lateral pharyngeal wall were significantly
      related to poor swallowing function.

PMID- 1739259
TI  - Voice analysis of patients with endoscopically treated early laryngeal carcinoma.
AB  - Endoscopic laser resection of early (T1) laryngeal carcinoma has been advocated
      as an alternative to radiotherapy. Heretofore, the voice characteristics
      following this procedure have been addressed in only one review, which included
      patients treated by irradiation and laser resection. We present the first review
      of voice findings in 22 patients treated only by endoscopic laser resection of
      their vocal cord carcinomas. Laser resection of selected vocal cord carcinomas
      produced voice function results acceptable to the patients and was rated by them
      to be normal to almost normal. Speech pathologists rated the voices to be near
      normal to mildly abnormal. Voices after laser resection of vocal carcinoma
      exhibited a slightly higher fundamental frequency, a decrease in intensity and
      phonatory duration, and markedly higher laryngeal airway resistance. The
      percentage of voicing showed little deviation from normal, as did mean percentage
      of perturbations.

PMID- 1739260
TI  - Open tube versus flexible esophagoscopy in adult head and neck endoscopy.
AB  - Open tube esophagoscopy is the mainstay of otolaryngic esophageal examination.
      Over the last 30 years flexible endoscopes have become popular and are
      challenging the open tube esophagoscope for use in otolaryngic practice. This
      study examines all open tube esophagoscopies performed on adult patients at the
      University of Pennsylvania over an 8-year period for the diagnosis and treatment
      of foreign bodies, strictures, functional disorders, and carcinoma. Open tube
      esophagoscopy is most useful for foreign body extraction, examination of the
      cervical esophagus, and dilation of pliable strictures. For most other
      indications flexible esophagoscopy provides improved visualization with lower
      morbidity. For patients with squamous cell carcinoma of the head and neck we
      found a 1.4% incidence of secondary esophageal malignancies and a 28% incidence
      of false-negative barium swallow studies. We recommend esophagoscopy for all
      patients with carcinoma of the upper aerodigestive tract. The otolaryngologist
      should be adept at both flexible and open tube esophagoscopy in order to allow
      optimal examination of and therapeutic intervention in the upper aerodigestive
      tract.

PMID- 1739261
TI  - Histopathologic correlates of acute laryngeal allograft rejection in a rat model.
AB  - This study used both clinical and histopathologic criteria to define the sequence
      and time parameters of rejection in histoincompatible vascularized rat laryngeal
      allografts. Clinical onset of rejection was characterized at 1 week by graft
      edema. Pathologic examination at this time revealed arterial wall thickening and
      a diffuse lymphocytic and macrophage mucosal infiltrate. At 14 days, the graft
      was encased in an inflammatory exudate with no visible cartilaginous structure.
      This correlated microscopically with a lymphocytic infiltrate of the lamina
      propria, loss of minor salivary glands, and squamous metaplasia of the surface
      respiratory epithelium. Arterial thrombosis was always correlated with tissue
      necrosis, but venous occlusion, occurring more than 2 days after transplantation,
      was not an independent determinant of graft viability. Definition of the time
      sequence and histopathology of rejection will allow future determination of the
      efficacy of various immunosuppressive regimens.

PMID- 1739262
TI  - Herpes zoster oticus: treatment with acyclovir.
AB  - Herpes zoster oticus produces facial paralysis with a low recovery rate.
      Acyclovir, a specific virostatic drug, was given intravenously in five herpes
      zoster oticus patients, and in three of them was followed by oral therapy. In
      follow-ups of 1 to 24 months, one patient had grade I recovery, three patients
      grade II, and one grade III. These good results encourage the use of acyclovir in
      herpes zoster oticus patients.

PMID- 1739263
TI  - Elastin at the hinge portion of the eustachian tube cartilage in specimens from
      normal subjects and those with cleft palate.
AB  - The density of elastin in the intermediate portion between the lateral lamina and
      the medial lamina of human eustachian tube (ET) cartilage was examined in six
      normal adults, seven normal children, and six children with cleft palate (CP) in
      order to obtain information about how the physical properties of the ET cartilage
      differ as a function of age and presence of CP. Cross sections of the
      midcartilaginous portions of the ETs that had been stained with Weigert's elastin
      stain were photographed at uniform magnification, the area for study was
      projected, and the meshlike are of the ET cartilage that stained elastin-positive
      was represented on paper by lines. A digitizer was used to measure the total
      length of all the lines representing elastin in each photomicrograph, and the
      mean was determined for each of the three groups. The mean density of elastin was
      significantly greater in normal adults than in normal children (Student's t test,
      t = 2.781; p less than .02). It was also significantly greater in normal children
      than in CP children (Wilcoxon t = 24.0; p less than .05). These results appear to
      indicate that CP children have poorer elasticity in this area of the ET
      cartilage, which might cause functional obstruction (floppiness) of the ET in
      those children.

PMID- 1739264
TI  - Cochlear blood flow and microvascular resistance changes in response to
      hypertonic glycerol, urea, and mannitol infusions.
AB  - The effect of hyperosmotic agents on cochlear blood flow (CBF) was tested in
      normal guinea pigs and in guinea pigs having prior unilateral operations to
      ablate the endolymphatic duct. Laser-Doppler-measured CBF was normalized to
      remove apparent changes related directly to systemic blood pressure. Hyperosmotic
      fluids were given via venous infusion: glycerol (20% and 40% solutions), urea
      (10%, 30%, and 40% solutions), and mannitol (40% solution). All agents were
      dissolved in 0.9% saline and the mixtures were given at a rate of 0.3 to 0.6
      mL/min for 5 minutes. Control infusions were of 0.9% saline and isotonic dextran
      70 (Pharmacia). All hyperosmotic infusions resulted in similar increases in
      normalized cochlear blood flow (nCBF) that extended to a maximum of 300% of the
      baseline value in a dose-dependent way during the infusion time period. Within
      approximately 30 minutes following infusions, nCBF had returned to baseline
      levels. Saline infusion alone had little effect on nCBF, but isotonic dextran 70
      gave a sustained increase to 122% of the baseline levels. There was no difference
      between the responses of nCBF in hydropic and normal cochleas for either control
      or hyperosmotic solutions. Measurements of systemic hematocrit at time intervals
      during and following the infusions showed that transient reductions of up to
      approximately 8% (for the maximum osmotic challenge) occurred during the
      infusion. It is concluded that the hyperosmotic treatments tested here are
      equally effective for short-term enhancements of nCBF in both normal and hydropic
      cochleas. The basis of the flow increase is partially rheologic and partially due
      to a local vasodilation.

PMID- 1739265
TI  - Chronic perilymph fistula in the guinea pig with implications in the human.
AB  - To improve understanding of the pathophysiology of perilymph fistulas, a
      predictable animal model of a chronic fistula was developed. Our findings suggest
      that guinea pig fistulas do not remain patent for prolonged periods. By
      extrapolating these findings to humans, we postulate that the symptoms and signs
      of perilymph fistula are possibly due not to one prolonged constant fistula, but
      rather a series of "blowouts" from an inherent congenital or posttraumatic weak
      spot in either the round or oval window. We feel that a diagnosis of perilymph
      fistula must be considered in any patient presenting with a Meniere's-like
      symptom set concomitant with a congenital inner ear deformity or a history of
      inner ear trauma.

PMID- 1739266
TI  - Chondrosarcoma of the larynx.

PMID- 1739267
TI  - Fine-needle aspiration of salivary glands: its utility and tissue effects.
AB  - Any diagnostic procedure requires a circumspect decision on its clinical utility.
      Otherwise, it risks being only an additional evaluation that is not cost
      effective. In the case of fine-needle aspiration biopsy of lesions of salivary
      glands, there are unquestioned clinical indications; none, however, merit its
      inclusion as part of a systematic evaluation. Attention is also called to the
      possible negation of a histopathologic diagnosis because of the tissue effects of
      the fine-needle aspiration.

PMID- 1739268
TI  - The three bellies of the canine cricothyroid muscle.
AB  - The cricothyroid muscle is capable of multiple functions, including vocal cord
      elongation and adduction. In addition, the cricothyroid can lengthen the glottis
      as well as provide posture to the cricothyroid joint. The purpose of the present
      study is to demonstrate that the many functional capabilities of the cricothyroid
      are a reflection of the existence of separate bellies within the muscle.
      Microdissection revealed three distinct muscle bellies within the cricothyroid:
      rectus, oblique, and horizontal. These differ in fiber orientation (rectus 79
      degrees, oblique 48 degrees, horizontal 7 degrees) and are separated by fascial
      planes. Histochemistry showed that these three bellies are composed of different
      percentages of slow twitch fibers (rectus 31.3%, oblique 43.3%, horizontal
      39.6%). Finally, electromyography demonstrated differences in the electrical
      activity patterns of the three bellies. It is concluded that the cricothyroid
      muscle is composed of three distinct muscle bellies that probably play separate
      roles in the complex function of this muscle.

PMID- 1739269
TI  - Hemoglobin and 2,3-diphosphoglycerate levels in transfused dialysis patients with
      myocardial infarction.
AB  - Thirty frequently transfused patients on long term hemodialysis were studied and
      a similar number of age and sex-matched patients who were infrequently transfused
      were used as a control group to ascertain the influence of a previous myocardial
      infarction (MI) on transfusion requirements. The frequency of previous MI on
      electrocardiogram (ECG) in the transfused and control groups was similar (40
      percent and 37 percent, respectively). In frequently transfused dialysis patients
      with MI, the hemoglobin level (transfusion trigger) at which these patients were
      transfused was higher than that of frequently transfused patients without MI (8.3
      +/- 1.5 g per dl vs. 6.9 +/- 1 g per dl, p less than 0.01) which indicated that
      patients without MI tolerated a greater degree of anemia than those with MI. The
      2,3-diphosphoglycerate (2,3-DPG) levels were significantly elevated in all
      transfused patients when compared to matched controls. However, levels of 2,3-DPG
      were significantly higher in MI patients receiving frequent transfusions than in
      other transfused patients, suggesting oxygen demands may not have been fully met
      despite the frequent transfusions. The results suggest levels of 2,3-DPG deserve
      further study in relation to the adequacy of tissue oxygenation in anemic
      dialysis patients.

PMID- 1739270
TI  - Conversion of a qualitative screening test to a quantitative measurement of
      urinary cystine and homocystine.
AB  - Qualitative urinary screening procedures were converted to quantitative methods
      for urinary cystine and homocystine based on the reactions between these amino
      acids and cyanide-nitroprusside reagents. Cystine and homocystine are quantified
      by the measurement of absorbances at 521 and 524 nm, respectively. Cyanide
      nitroprusside reacts with both cystine and homocystine. However, in the presence
      of silver nitrate, only homocystine reacts to produce a magenta color. Following
      the cyanide-nitroprusside reaction, absorbance must be read within three minutes
      for cystine and immediately for homocystine. The stability of the absorption
      spectra has no apparent effect on these quantitative assays. Amino acid
      concentrations are expressed as ratios to creatinine, which tends to eliminate
      false negative results in dilute urine specimens. The normal urine value for
      cystine and homocystine combined is 66.8 +/- 52 (n = 50) mg per g creatinine. The
      normal value for homocystine alone is 29.9 +/- 16.8 (n = 24) mg per g creatinine.
      The simplicity of these procedures allows these quantitative methods to be used
      as screening tests for cystinuria and homocystinuria.

PMID- 1739271
TI  - Evaluation of the SonoClot Analyzer for the measurement of platelet function in
      whole blood.
AB  - A viscoelastometer, the SonoClot Coagulation Analyzer, has been proposed for use
      in the evaluation of platelet function. The purpose of this study was to evaluate
      systematically this instrument when used with whole blood. Under laboratory
      conditions, the coefficient of variation (cv) of determinations of whole blood
      activated clotting time (ACT) on the instrument was approximately 7.0 percent. In
      contrast, the cv of measurements on whole blood related to the graphic events
      associated with clot formation ranged from 9.2 to 41.7 percent. Because of the
      large and variable cvs associated with these measurements of clotting, the
      SonoClot Analyzer cannot presently be recommended for use in studies designed to
      examine quantitatively the clotting function in whole blood.

PMID- 1739272
TI  - Hypertension and vascular dementia.
AB  - Postmortem surveys on patients treated for chronic hypertension often fail to
      demonstrate significant vessel changes. Nevertheless, hypertensive alterations in
      the brain can include infarcts and hemorrhages. Autopsies in a primary care
      hospital have shown that hypertension can affect arteries, arterioles, and
      capillaries in various patterns and degrees in the brain. These vascular lesions
      may be associated with large and small infarcts and hemorrhages in isolated or
      diffuse patterns. Widespread cerebral edema can occur with rapidly progressive
      hypertension. Atherosclerosis, arterial and arteriolar fibrinoid necrosis, and
      micro-aneurysms may be observed. Chronic hypertensive encephalopathy causes
      vascular dementia and can be associated with subcortical arterial and arteriolar
      leukoencephalopathy, leukoaraiosis and/or Binswanger's disease. Epidemiologic
      evaluations based on complete autopsy studies need to be correlated with
      compliance of therapy, appropriate diagnosis of hypertension, and its long-term
      effects on the nervous system. Although persistent poorly controlled hypertension
      is known to damage the brain both acutely and chronically, the effects of
      intermittent hypertension remain to be defined.

PMID- 1739273
TI  - Ionized calcium buffering in the transfused anhepatic patient: Ab initio
      calculations of calcium ion concentrations.
AB  - Homeostatic control of ionized calcium can be volatile during liver
      transplantation, particularly during the anhepatic stage. Recently, an
      opportunity arose to evaluate an 11-year-old girl who developed persistent ionic
      hypocalcemia during a prolonged anhepatic period subsequent to the failure and
      removal of the graft. The patient was remarkable for having survived a 34-hour
      anhepatic interval before a second and successful orthotopic liver transplant.
      Ionic hypocalcemia (ionized calcium less than 1 mmol per L) coexisted with
      significant hypercalcemia (total calcium greater than 5 mmol per L) during this
      anhepatic interval. The discrepancy was due to high concentrations of citrate,
      which accumulated from the multiple transfusions of citrated blood, and the
      inability to metabolize citrate in the anhepatic state. Using a mathematical
      model to solve for free calcium ion concentration in the presence of multiple
      ligands, it is demonstrated that prolonged hypercitricemia markedly alters the
      calcium ion buffering properties of blood, and these changes must be recognized
      in order to prevent adverse clinical consequences of ionic hypocalcemia.

PMID- 1739274
TI  - The informative abstract.

PMID- 1739275
TI  - Alopecia by a different name. A matter of splitting hairs.

PMID- 1739276
TI  - Search for Streptococcus.

PMID- 1739277
TI  - Tender periungual nodules. Myrmecia (deep palmoplantar warts).

PMID- 1739278
TI  - Persistent painful plantar masses. Epithelioma cuniculatum.

PMID- 1739279
TI  - Pruritic pigmented papules posing permanent problems. Urticaria pigmentosa (UP)
      with secondary anetoderma.

PMID- 1739280
TI  - Acyclovir in the prevention of severe aphthous ulcers.

PMID- 1739281
TI  - Pseudocysts around the interphalangeal joints as a manifestation of calcinosis
      cutis in a patient with lupus nephritis undergoing hemodialysis.

PMID- 1739282
TI  - Complement-fixing activity to melanin-producing cells preceding the onset of
      vitiligo in a patient with type 1 polyglandular failure.

PMID- 1739283
TI  - Pharmacologic doses of lovastatin do not predictably affect the course of
      psoriasis.

PMID- 1739284
TI  - Radiation therapy as an alternate therapy for locally recurrent acral lentiginous
      malignant melanoma.

PMID- 1739285
TI  - The role of streptococcal infection in the initiation of guttate psoriasis.
AB  - BACKGROUND AND DESIGN: Although the association between streptococcal infection
      and guttate psoriasis is well known, to date there has been little information on
      whether only limited groups and/or serotypes of beta-hemolytic streptococci are
      involved. One hundred eleven patients with a sudden onset or deterioration of
      psoriasis were investigated for evidence of streptococcal infection. Of these
      patients, 34 had acute guttate psoriasis, 30 had a guttate flare of chronic
      psoriasis, 37 had chronic plaque psoriasis, and 10 had other types of psoriasis.
      RESULTS: Serologic evidence of recent streptococcal infection was present in 19
      (58%) of 33 patients with acute guttate psoriasis compared with seven (26%) of 27
      patients with guttate exacerbations of chronic psoriasis. Streptococcus pyogenes
      was isolated from 19 (17%) of all 111 patients (9 [26%] of 34 with acute guttate
      psoriasis, four [13%] of 30 with guttate exacerbations of chronic psoriasis, and
      five [14%] of 37 patients with chronic psoriasis) compared with seven (7%) of 101
      of a control population of patients being seen for treatment of viral warts.
      Other beta-hemolytic streptococci were found with equal frequency in the study
      and control populations. Thirteen isolates of 10 different streptococcal
      serotypes were obtained from the 64 patients with guttate psoriasis. These
      serotypes were similar in distribution and prevalence to those present in the
      local community. CONCLUSIONS: This study confirms the strong association between
      prior infection with S pyogenes and guttate psoriasis but suggests that the
      ability to trigger guttate psoriasis is not serotype specific.

PMID- 1739286
TI  - Burn depth estimation using indocyanine green fluorescence.
AB  - Expedient primary excision of deep dermal and full-thickness burn wounds with
      subsequent skin grafting is the standard of care in most burn institutions, but
      differentiating full-thickness from partial-thickness burns is often difficult.
      Because accurate early assessment of burn depth may improve care, a variety of
      technical methods have attempted to measure burn depth but these methods have had
      limited success. We describe a new technique to determine burn depth that uses
      infrared (840- to 850-nm) fluorescence emission from intravenously administered
      indocyanine green following excitation with infrared (780 nm) and UV light (369
      nm). Full-thickness and partial-thickness burns in hairless rat skin were
      distinguished based on the infrared-induced and UV-induced fluorescence intensity
      ratios relative to normal, unburned skin immediately after the burn and on post
      burn days 1 through 3 and 7. Dual-wavelength excitation of indocyanine green
      infrared fluorescence can delineate full-thickness from partial-thickness burns
      at an early date, allowing prognosis, surgical planning, and early primary
      excision and grafting.

PMID- 1739287
TI  - Immunopathology of toxic epidermal necrolysis. Keratinocytes, HLA-DR expression,
      Langerhans cells, and mononuclear cells: an immunopathologic study of five cases.
AB  - BACKGROUND: Toxic epidermal necrolysis is a potentially severe mucocutaneous
      affliction whose cause is usually drug related. To further characterize the
      nature of the dermal mononuclear infiltrate as well as the epidermal alterations
      observed by standard microscopy, we studied five cases of toxic epidermal
      necrolysis using labeled monoclonal antibodies. RESULTS: On clinically involved
      areas of skin, the following occurs: (1) the dermal infiltrate is composed mainly
      of activated T lymphocytes, with a predominant helper phenotype; (2) the number
      of Langerhans cells is decreased; and (3) keratinocytes express HLA-DR molecules,
      normally absent on their surface. CONCLUSIONS: These findings, although not
      specific, are consistent with an immune cellular reaction, but they could also be
      linked to an inflammatory reaction initiated by epidermal damages whatever its
      primary mechanism.

PMID- 1739288
TI  - Identification of cicatricial pemphigoid antigens.
AB  - The nature of skin antigens defined by antibodies in patients with cicatricial
      pemphigoid was studied with use of the 1 mol/L of sodium chloride split skin
      technique and Western immunoblot analysis. Antibodies in the serum samples of
      three of seven patients with cicatricial pemphigoid reacted to the epidermal side
      of 1 mol/L of sodium chloride split skin, and antibodies in the serum sample of
      one patient reacted to the dermal side. With Western immunoblot analysis, three
      patients had antibodies to antigens in the epidermal extracts of skin. The
      antibodies reacted in all patients to a 160-kd antigen and in one patient to an
      additional 230-kd antigen. These two antigens are similar in molecular weight to
      the 230-kd major bullous pemphigoid antigen and to the 160-kd minor bullous
      pemphigoid antigen. However, while the basement membrane zone antibodies present
      in cicatricial pemphigoid were most often directed to the 160-kd antigen, those
      present in 38 patients with bullous pemphigoid reacted most often (in 34 patients
      [89%]) to the 230-kd antigen. None of the serum samples reacted to antigens in
      dermal extracts that contained the epidermolysis bullosa acquisita antigen. These
      results indicate that the basement zone membrane antibodies present in
      cicatricial pemphigoid are directed in part to epidermal antigens that are
      similar in molecular weight to bullous pemphigoid antigens. However, the
      frequency of reactions to different basement membrane zone antigens differs in
      the two diseases, which may account for the clinical differences between the two
      conditions.

PMID- 1739289
TI  - Role of excision repair in UVB-induced depletion and recovery of human epidermal
      Langerhans cells.
AB  - Skin exposure to UVB radiation deprives the antigen-presenting function and OKT6
      monoclonal antibody-binding characteristics of Langerhans cells. Decrease of
      Langerhans cell population could be relevant to immune surveillance disturbance
      in the UV-exposed skin. Patients with xeroderma pigmentosum exhibit a
      thousandfold higher risk for sunlight-induced skin cancers than patients with
      normal skin, and also have various defects in cellular immunity. Therefore,
      studies of numerical and structural changes in epidermal Langerhans cells of
      patients with xeroderma pigmentosum after UVB irradiation compared with normal
      subjects may contribute to understanding the role of antigen-presenting cells in
      photocarcinogenesis. The effect of UVB radiation on OKT6+ Langerhans cells was
      studied in epidermal sheets obtained from irradiated normal subjects (36 and 49
      years old) and subjects with xeroderma pigmentosum complementation group A (21
      years old), complementation group D (32 years old), and variant (35 and 60 years
      old). Langerhans cell densities in chronically sunlight-exposed skin were
      remarkably reduced in patients with xeroderma pigmentosum group A but only
      slightly in those with xeroderma pigmentosum variant and in normal subjects
      compared with covered skin. Structural changes were substantial in Langerhans
      cells of chronically exposed patients with xeroderma pigmentosum group A but
      fewer in subjects with other xeroderma pigmentosum groups and in normal subjects.
      A single irradiation of three times the minimal erythema dose induced a large
      reduction of Langerhans cells from 3 to 7 days in all subjects. However,
      subsequent reappearance and return to preirradiated levels was delayed more in
      patients with xeroderma pigmentosum group A than in those with xeroderma
      pigmentosum variant and normal subjects. These results indicate (1) an essential
      role for excisional repair in the UVB-induced depletion, recovery, and
      maintenance of the epidermal Langerhans cell population, and (2) a possible, but
      not confirmed, relationship between depletion of Langerhans cells and earlier
      photocarcinogenesis in xeroderma pigmentosum.

PMID- 1739290
TI  - The follicular degeneration syndrome in black patients. 'Hot comb alopecia'
      revisited and revised.
AB  - BACKGROUND: The history, physical examination, and histologic findings in 10
      black women with a common, distinctive form of scarring alopecia (formerly called
      hot comb alopecia) were retrospectively studied. A detailed history of hair care
      habits was obtained, and scalp biopsy specimens were examined after both vertical
      and transverse sectioning. OBSERVATIONS: Poor correlation is noted between the
      usage of a hot comb and the onset or progression of disease. The earliest
      observable histologic abnormality is the premature desquamation of the inner root
      sheath. In severely affected follicles this is followed by a chain of histologic
      events leading to complete follicular degeneration. CONCLUSIONS: The term
      follicular degeneration syndrome (FDS) is proposed for this clinically and
      histologically distinct form of scarring alopecia. Historical information is
      incompatible with the hypothesis that hot comb usage causes the alopecia. It
      remains unclear whether the use of any of a variety of hair care products and
      techniques plays a role in the pathogenesis of this condition. Premature
      desquamation of the inner root sheath serves as a histologic marker for FDS
      follicular degeneration syndrome, and may be an important pathogenetic factor.

PMID- 1739291
TI  - Cutaneous leishmaniasis acquired during military service in the Middle East.
AB  - BACKGROUND: Cutaneous leishmaniasis is endemic in much of the Middle East.
      Personnel from more than 55 nations are currently participating in Middle East
      peacekeeping and military activities. OBSERVATIONS: Twenty-three Fijian members
      of a military observational force in Sinai, Egypt, acquired cutaneous
      leishmaniasis. They were treated successfully with 1-month courses of
      ketoconazole. CONCLUSIONS: Soldiers who acquire cutaneous leishmaniasis may
      return home to nations where cutaneous leishmaniasis is unknown or rarely
      diagnosed. Cutaneous leishmaniasis, caused by Leishmania major, may be treated
      with ketoconazole rather than antimonials.

PMID- 1739292
TI  - Middermal elastolysis in an elderly man with evidence of elastic fiber
      phagocytosis.
AB  - BACKGROUND: Middermal elastolysis is a clinically and histologically distinct
      entity. This idiopathic loss of dermal elastic fibers has mostly been reported in
      younger adults. To our knowledge, the present case, which has been followed up
      for 4 years, is the first to occur in an elderly man. OBSERVATIONS: Two years
      after the onset of progressive wrinkling of the upper aspect of the thorax, the
      patient underwent a biopsy. Histologic examination of the specimens confirmed
      previous findings of middermal elastolysis. Examination of extracutaneous elastic
      tissue showed normal findings. Electron microscopy demonstrated elastic fibers
      embraced by macrophages, which is suggestive of elastic fiber phagocytosis. For
      the following 4 years, the patient has remained in stable clinical condition.
      CONCLUSIONS: Middermal elastolysis is probably more common than has been assumed
      so far. It does not affect nondermal elastic tissue. After progressive loss of
      dermal elasticity in a circumscribed area, a benign course follows, with a stable
      condition over several years. Electron microscopic findings indicate that elastic
      fiber phagocytosis is operative in the disappearance of the middermal elastic
      tissue.

PMID- 1739293
TI  - Disseminated histoplasmosis in patients receiving low-dose methotrexate therapy
      for psoriasis.
AB  - BACKGROUND: Low-dose methotrexate sodium therapy used for nonmalignant disease
      has been associated with a variety of opportunistic infections with pathogens
      occurring in patients with defective cellular immunity. This article describes
      the unusual development of disseminated histoplasmosis as a probable complication
      of immunosuppression resulting from use of methotrexate. OBSERVATIONS: We report
      the cases of three patients in whom disseminated histoplasmosis developed while
      receiving low-dose methotrexate therapy for psoriasis. Disease manifestations
      were unusually severe in two of the three patients. All three cases were
      disseminated, and two cases resulted in illnesses requiring intensive medical
      treatment. Each patient responded appropriately to antifungal treatment, although
      one patient has required long-term suppressive treatment because of persistent
      Histoplasma antigenuria. These cases illustrate the risk for opportunistic fungal
      infections in patients receiving low-dose methotrexate therapy for nonmalignant
      diseases. CONCLUSIONS: Histoplasma should be added to the list of pathogens to be
      suspected in patients receiving such therapy.

PMID- 1739294
TI  - Necrobiotic xanthogranuloma.
AB  - We reviewed 32 cases of necrobiotic xanthogranuloma and 16 cases from the world
      literature. Necrobiotic xanthogranuloma is a destructive dermal and subcutaneous
      xanthogranuloma that most frequently involves the face (periorbital region) and
      trunk. Monoclonal gammopathy is common (IgG-kappa in 23 cases and IgG-lambda in
      nine cases), and cryoglobulins have also been found. Low complement levels,
      anemia, and leukopenia are frequently present. Bone marrow examination shows
      plasma cell proliferation and, rarely, true myeloma. We describe mucosal, muscle,
      and systemic lesions, including xanthogranulomatous myocardial lesions. The
      clinical course is chronic and often progressive. Low-dose chlorambucil treatment
      is safe and effective, but individual patients have responded to treatment with
      corticosteroids, melphalan, local radiation, and plasma exchange.

PMID- 1739295
TI  - Basement membrane and fibroblast aberration in blisters at the donor, graft, and
      spontaneously healed sites in patients with burns.
AB  - BACKGROUND AND DESIGN: Blisters that developed on spontaneously healed wounds and
      grafts in 13 patients with burns were analyzed by light, fluorescence, and
      electron microscopy. RESULTS: Blisters developed on the dermal side of the
      dermoepidermal junction and occurred more frequently in donor site and healed
      mesh graft than in split-thickness sheet graft. The four major components of the
      basement membrane zone (bullous pemphigoid antigen, laminin, type IV collagen,
      and epidermolysis bullosa acquisita antigen) were reduced in quantity and
      irregularly deposited at blister sites. Immediately adjacent to the blisters,
      epidermolysis bullosa acquisita antigen appeared normal in quantity, while
      laminin, type IV collagen, and bullous pemphigoid antigen levels appeared
      slightly reduced. Mononuclear infiltrates and autoantibodies were not detected by
      light microscopy or direct-indirect immunofluorescence, respectively.
      Ultrastructurally, adjacent dermal fibroblasts demonstrated swollen rough
      endoplasmic reticulum and vacuolization. CONCLUSIONS: We speculate that blister
      development in patients with burns is related to defective reorganization of the
      basement membrane zone in association with dermal fibroblast aberration during
      wound healing.

PMID- 1739296
TI  - Natural history of sensitizations in atopic dermatitis. A 3-year follow-up in 250
      children: food allergy and high risk of respiratory symptoms.
AB  - BACKGROUND AND DESIGN: The aim of the study was to define the natural history of
      sensitization in atopic dermatitis (AD) through cross-sectional (comparison of
      three age classes) and longitudinal study: 250 children with minor (32.5%),
      moderate (32.5%), and severe (35%) AD were examined for aeroallergen and food
      hypersensitivity (skin tests, clinical scoring after allergen elimination, and
      food challenges). RESULTS: The allergic screening was negative in minor AD and
      positive in 33% of cases of moderate AD that were concerned with aeroallergen
      sensitizations with only limited respiratory involvement. This suggests that
      nonspecific cutaneous hyperreactivity remains an almost exclusive precipitating
      factor in moderate or minor AD. Severe AD was characterized by a positive
      allergologic assessment in 100% of patients: food allergens were incriminated as
      flare factors in 96% of patients, with associated aeroallergen sensitization in
      36%. Even at a young age (less than or equal to 2 years), the severe AD group is
      marked by an extreme frequency of food sensitization (93%) that persists in 73%
      of children younger than 7 years and 67% younger than 16 years. From the
      comparison of three age classes, the sequence of food and respiratory
      sensitization seems to be part of the natural course of AD. Prospective study in
      29 children of group 1 (less than 2 years) with a 3-year follow-up confirms the
      data of the cross-sectional study since 27 had development of aeroallergen
      sensitization, with respiratory symptoms as early as age 3 years in 23 of these
      children. CONCLUSION: The detection of food allergy in a child presenting with AD
      is likely to indicate a prognosis of severe AD and should be considered by
      dermatologists as a potentially important predictor of further respiratory
      symptoms.

PMID- 1739297
TI  - Cutaneous histopathologic, immunohistochemical, and clinical manifestations in
      patients with hemophagocytic syndrome. Military Medical Consortium for Applied
      Retroviral Research (MMCARR).
AB  - BACKGROUND AND DESIGN: The hemophagocytic syndrome (HPS) is characterized by
      fever, wasting, generalized lymphadenopathy, hepatosplenomegaly, and
      pancytopenia, often with associated coagulopathy. The most common cutaneous
      manifestations are panniculitis and purpura. Cytophagic histiocytic panniculitis
      fits within the spectrum of HPS, and the most consistent histopathologic feature
      in HPS is a proliferation of mature histiocytes that exhibit prominent
      erythrophagocytosis and cytophagocytosis. The clinical spectrum, the underlying
      causes, and the histopathologic features found in HPS are broad. The
      characteristic phagocytic histiocytes seen in HPS have been confused with
      malignant histiocytes in the past, but are now known to be reactive. The clinical
      findings, histologic, and immunohistochemical features of 10 cases of HPS with
      cutaneous lesions were reviewed. Immunohistochemical markers included KP-1, beta
      F-1, UCHL-1, L-26, MAC-387, factor XIIIa, and S100 protein. RESULTS: The HPS was
      associated with T-cell lymphoma and/or viral infection. Most biopsy specimens
      showed edema and hemorrhage with a lymphohistiocytic infiltrate and prominent
      histiocytic cells showing erythrophagocytosis and, in some cases,
      cytophagocytosis. The histiocytic cells showed positive reactions for KP-1 and
      negative reactions for the lymphoid markers. In all cases the lymphoid cells
      showed a mixed pattern with most cells positive for beta F-1 and UCHL-1, and a
      small percentage positive for L-26. CONCLUSION: In HPS, the prominent phagocytic
      histiocytes are reactive and are stimulated by T-cell lymphocytes, either
      neoplastic or in response to viral infection. Many of the findings in the HPS may
      also be due directly or indirectly to cytokines produced by proliferating T-cell
      lymphocytes and/or reactive phagocytic histiocytes.

PMID- 1739298
TI  - Peripheral blood mononuclear cell subsets in patients with severe inherited forms
      of epidermolysis bullosa.
AB  - BACKGROUND AND DESIGN: Epidermolysis bullosa (EB) is a group of inherited
      disorders in which slight trauma to the skin results in blister formation.
      Patients with severe types of EB suffer cutaneous infections that sometimes
      progress to septicemia and cutaneous and gastrointestinal carcinomas that are
      locally aggressive and frequently metastasize. Previous studies have shown
      deficits in natural killer (NK) cell activity as well as in lymphokine and
      monokine production in patients with severe forms of EB. Alterations in
      peripheral blood mononuclear cells, however, which may reflect on immune
      functions in patients with EB, have received little attention. A prospective
      study was designed to ascertain if differences existed between subsets of
      peripheral blood mononuclear cells in patients with severe forms of EB vs healthy
      control subjects. Thirty patients with clinical and histologic diagnoses of EB
      and 30 healthy volunteers were studied. Flow cytometric analysis of labeled cells
      was performed. RESULTS: Absolute numbers of CD3+, CD2+, CD4+, CD19+, NK+, CD29+,
      and CD45R+ cells were lower in patients with severe types of EB in comparison
      with controls. The T cells showed decreased numbers of interleukin 2 receptors.
      An increase in numbers of CD20+, CD4+ CD8+, and CD4-CD8- cells was also observed
      in patients with severe types of EB. CONCLUSION: Alterations in monocyte and
      lymphocyte subsets known to affect host immune response were observed in patients
      with severe forms of EB. Quantitative changes relative to controls included
      decreased total numbers of T cells with greater decreases in helper cells,
      decreased NK cells, and a diminished number of interleukin 2 receptors. Such
      changes have been associated previously with a lower resistance to infections and
      to neoplasia. The changes in subsets correlated with the severity of the
      cutaneous and extracutaneous disease in the patients with EB.

PMID- 1739299
TI  - The protective effect of vitamin E on the hemolysis associated with dapsone
      treatment in patients with dermatitis herpetiformis.
AB  - OBJECTIVE: This study looked at whether oral vitamin C and vitamin E would
      protect the erythrocyte from oxidant damage caused by dapsone in patients with
      dermatitis herpetiformis. DESIGN: Fifteen consecutive patients with dermatitis
      herpetiformis taking dapsone therapy received, in addition, 800 U/d of vitamin E
      for 4 weeks; then 1000 mg of vitamin C per day for 4 weeks, and, finally,
      combined vitamin E and vitamin C therapy for 4 weeks. Hemolysis indexes were
      assessed at baseline and after each 4-week period. RESULTS: Statistical analysis
      of the results suggests that oral administration of 800 units of vitamin E daily
      for 4 weeks confers partial protective effect against dapsone-induced hemolysis
      in patients with dermatitis herpetiformis. CONCLUSION: Partial protection against
      dapsone-induced hemolysis by orally administered vitamin E, if confirmed as being
      clinically relevant by further trials, may allow clinicians to continue dapsone
      therapy orally in patients who develop significant hemolysis. Prophylactic
      vitamin E to minimize potential hemolysis at the initiation of dapsone therapy
      may also be appropriate.

PMID- 1739300
TI  - Immunofluorescence abnormalities in lichen planopilaris.
AB  - BACKGROUND: Lichen planopilaris is believed to be a variant of lichen planus
      because both diseases have similar histologic features. However, as the clinical
      features of the two diseases differ, we conducted immunofluorescence studies to
      examine the relation between the two conditions more closely. OBSERVATIONS:
      Direct immunofluorescence was performed on scalp lesions of seven patients with
      lichen planopilaris. All had abnormal linear deposits of Ig restricted to the
      basement membrane zone of hair follicles. The deposits consisted of only IgG or
      IgA in five patients (70%) and of IgG in combination with other Igs in two
      patients (30%). Basement membrane zone deposits of fibrin were present in only
      one patient (14%) and were linear in appearance. There was no staining of ovoid
      bodies. These immunofluorescence abnormalities differ from those associated with
      lichen planus where basement membrane zone deposits of fibrin are present in
      almost all patients, where the basement membrane zone deposits are fibrillar in
      appearance, and where the deposits of Ig over ovoid bodies are common.
      CONCLUSIONS: The different appearance and composition of abnormal deposits of
      immunoreactants in lichen planopilaris and lichen planus suggest that the two
      conditions are different diseases.

PMID- 1739301
TI  - Molluscum contagiosum. Ultrastructural evidence for its presence in skin adjacent
      to clinical lesions in patients infected with human immunodeficiency virus type
      1. Military Medical Consortium for Applied Retroviral Research.
AB  - BACKGROUND AND DESIGN: Molluscum contagiosum in acquired immunodeficiency
      disease, although not life threatening, is often a marker of late-stage disease
      and may lead to disfiguring cutaneous lesions. Although most current therapy
      results in at least temporary clearing of individual lesions, lesions frequently
      recur and new lesions arise. Examination of hematoxylin-eosin-stained histologic
      sections in two patients showed changes suggestive of viral infection in the
      epidermis 0.5 cm and 1 cm lateral to obvious clinical lesions. These areas were
      clinically free of any lesions. Both routine histopathologic examination and
      ultrastructural examination were performed in two patients infected with human
      immunodeficiency virus type 1 (HIV-1) and three non-HIV-1-infected patients.
      RESULTS: All patients showed histologic changes diagnostic of molluscum
      contagiosum. In addition, the sections from HIV-1-infected patients showed areas
      of acanthosis, hyperkeratosis, and nuclear atypia. Electron microscopy of these
      areas revealed rare viral organisms in these areas. Similar acanthotic,
      hyperkeratotic areas were not seen in the biopsy specimens from the non-HIV-1
      infected patients and no viral particles were found in the epidermis around the
      lesions. CONCLUSION: Viral structures consistent with molluscum contagiosum are
      present within the clinically normal epidermis around lesions of molluscum
      contagiosum in some HIV-1-infected patients. This may explain the large number of
      lesions seen in these patients and the difficulty in controlling the spread and
      recurrence of molluscum contagiosum in HIV-1-infected patients.

PMID- 1739302
TI  - Restrictive dermopathy. Report of two affected siblings and a review of the
      literature.
AB  - BACKGROUND: Restrictive dermopathy is a lethal genetic disorder consisting of
      abnormally tight skin, generalized joint contractures, distinctive facies, and
      pulmonary hypoplasia. Autosomal recessive inheritance has been suggested based on
      multiply affected siblings and some reports of parental consanguinity. This
      article describes two siblings with the restrictive dermopathy syndrome and
      reviews previously reported cases. OBSERVATIONS: Eight other cases have been
      reported in the literature as restrictive dermopathy. These cases have shared
      striking similarities in their clinical histories and phenotypes. The skin in
      these infants has been described as rigid and tense, with skin biopsy specimens
      showing a thick epidermis, thin dermis, abnormally arranged collagen bundles, and
      poorly developed appendages. Other prominent features are flexion contractures
      and craniofacial and pulmonary abnormalities. The genetic and/or developmental
      defects leading to the restrictive dermopathy syndrome are presently not known.
      CONCLUSIONS: The restrictive dermopathy syndrome is distinct and is easily
      differentiated from other congenital diseases such as the icthyoses and also from
      the clinical conditions of sclerema neonatorum and subcutaneous fat necrosis of
      the newborn. Recognition of this syndrome is important for determining the
      prognosis of affected infants and for recommending genetic counseling to affected
      families.

PMID- 1739303
TI  - Restrictive dermopathy in two brothers.
AB  - BACKGROUND: Restrictive dermopathy is an autosomal recessive phenotype
      characterized by universal tautness of skin resulting in fetal akinesia and death
      during the neonatal period. The clinical signs and symptoms of this uncommon
      disease are described in two brothers, and evidence is provided that fetal biopsy
      specimens obtained during the 20th week of gestational age are nondiagnostic.
      OBSERVATIONS: The first patient was a growth-retarded preterm boy suffering from
      generalized desquamation, marked joint contractures, and facial hypoplasia.
      Prominent light microscopic findings were hyperorthokeratosis intermingled with
      parakeratosis and absence of the elastic fibers in a thinned dermis. Electron
      microscopic examination of the epidermis revealed a lack of keratin filaments and
      an abnormal globular shape of the keratohyalin granules. The child died 4 days
      after birth. A following pregnancy resulted in birth of a preterm boy who died of
      the same disease within 2 hours. In the 20th week of gestational age, fetal
      biopsy specimens were obtained, but light and electron microscopy failed to
      reveal any abnormalities. CONCLUSIONS: Restrictive dermopathy is a genuine skin
      disease resulting in fetal akinesia that precludes a normal intrauterine
      development. The clinical features of this disorder are so distinctive that an on
      the-spot diagnosis can be established. In view of the data obtained in this case,
      the feasibility of prenatal diagnosis should be regarded with great caution.

PMID- 1739304
TI  - Perianal pseudoverrucous papules and nodules in children.
AB  - BACKGROUND: Pseudoverrucous papules and nodules were originally described as a
      reaction to irritation in association with urostomies. These changes have not
      been described as occurring on the perianal skin or around colostomies.
      OBSERVATIONS: Five children had remarkably similar-appearing papules and nodules
      of the perianal and suprapubic skin. The rash consisted of more than a dozen 2-
      to 8-mm shiny, smooth, red, moist, flat-topped, round lesions. This peculiar and
      striking reaction appears to be the result of encopresis or urinary incontinence.
      Biopsy specimens reveal reactive acanthosis or psoriasiform spongiotic
      dermatitis. The lesions regress when the irritating factor is removed.
      CONCLUSIONS: Recognition of this entity is important because pseudoverrucous
      papules and nodules may mimic more serious dermatoses and unnecessary workup may
      be initiated. Although this reaction involving perianal skin has not been
      reported previously, we believe it is not uncommon.

PMID- 1739305
TI  - The delayed postburn blister. A commonplace but commonly overlooked phenomenon.

PMID- 1739306
TI  - Immunodermatopathology.

PMID- 1739307
TI  - Spider bite with lymphangitic streaking. Brown or violin spider bite with
      atypical features.

PMID- 1739308
TI  - Indurated telangiectatic plaques. Malignant angioendotheliomatosis (MAE).

PMID- 1739309
TI  - Peristomal atrophic papules. Degos' disease (malignant atrophic papulosis).

PMID- 1739310
TI  - The incidence of malignant melanoma in New South Wales.

PMID- 1739311
TI  - Limitations of direct immunofluorescence.

PMID- 1739312
TI  - Delayed reaction to bed bug bites.

PMID- 1739313
TI  - Pseudomonas mesophilica cutaneous infection in an immunocompetent patient.

PMID- 1739314
TI  - Incidence of allergic reactions to hydrocortisone-17-butyrate in standard patch
      test series.

PMID- 1739315
TI  - Autofluorescence of clothing as an adjunct in the diagnosis of apocrine
      chromhidrosis.

PMID- 1739316
TI  - Cutis verticis gyrata and pachydermoperiostosis: demonstration with computed
      tomography.

PMID- 1739317
TI  - Lack of efficacy of the Q-switched ruby laser in the treatment of vitiligo.

PMID- 1739318
TI  - Parathyroid hormone-related protein in patients with malignant melanoma.

PMID- 1739319
TI  - Failure to prevent nicotine addition in young people with diabetes.
AB  - The habit of smoking is usually acquired at a young age and it is particularly
      undesirable in individuals with diabetes. A study was carried out to assess
      objectively the prevalence of smoking in young patients with diabetes and whether
      younger age at onset of diabetes (implying exposure to health education) reduced
      the incidence of smoking. Ninety nine young adults with diabetes attending the
      routine clinic were studied using a structured interview and assay of a urinary
      nicotine metabolite (cotinine). Forty eight percent of the cohort were smoking
      (raised urinary cotinine), although only 31% admitted to smoking. Thirty eight
      percent of the patients with childhood onset diabetes, 56% of the adolescent
      onset, and 47% of the young adult onset patients were smoking. Smoking was not
      related to glycaemic control or body mass index. In conclusion, smoking is common
      in young patients with diabetes and is often denied. Conventional health
      education does not appear to prevent children and adolescents with diabetes from
      starting to smoke. Anti-smoking policies and health education must therefore be
      reinforced and improved.

PMID- 1739320
TI  - Do doctors recognise eating disorders in children?
AB  - The aim of this study was to determine whether doctors recognise eating disorders
      in children, in particular anorexia nervosa. A group of paediatricians, general
      practitioners, and school medical officers was approached to participate in the
      study. Each was sent a questionnaire including two case vignettes of children
      with anorexia nervosa and questions about diagnosis and management. The response
      rate was 64.5%. Of 97 different diagnosis suggested, only one quarter were
      psychiatric or psychological. One third of the paediatricians mentioned anorexia
      nervosa within their differential diagnosis in both cases compared with 2% of
      primary care physicians. These results suggest that doctors' awareness of
      childhood onset eating disorders remains limited. A delay in appropriate
      treatment has potentially adverse consequences for prognosis.

PMID- 1739321
TI  - Trial of intensive compared with weekly speech therapy in preschool children.
AB  - Forty two preschool children referred to a speech therapy department were
      randomly allocated to receive intensive individual speech therapy or the more
      traditional once weekly approach. Boys and minority ethnic groups were referred
      most frequently. Speech therapy improved expression more than comprehension, as
      measured on Reynell scales. The mean improvements were 0.5 SDs (95% confidence
      intervals (CI) 0.3 to 0.7) and 0.3 (95% CI 0.1 to 0.5) respectively. There was a
      greater improvement in children receiving intensive compared with weekly therapy
      in the expression scores (0.8 SDs (95% CI 0.5 to 1.1) v 0.2 SDs (95% CI -0.1 to
      0.5]. White and non-white children had similar improvements in comprehension
      scores but white children had greater improvement in expression scores (1.1 SDs v
      0.3 SDs). This difference was seen in both therapy groups. Randomised trials are
      useful in the evaluation of speech therapy in children.

PMID- 1739322
TI  - Home parenteral nutrition in chronic intestinal failure.
AB  - In children with severe failure of intestinal function, intravenous nutrition is
      at present the only treatment able to maintain adequate nutrition for prolonged
      periods of time. Over the last five years we have discharged 10 patients home on
      parenteral nutrition for a total of 25 patient years and here the outcome of
      these children is presented. Of the 10 patients, one has discontinued home
      parenteral nutrition (HPN), seven patients remain well, one patient has recently
      moved to the USA, and one patient has died after major abdominal surgery. All
      children had either normal or an accelerated rate of growth on HPN and
      developmentally all have progressed well. All the children over 5 years attend
      normal schools. The major complication of treatment was line sepsis with an
      overall rate of one episode in 476 days and a total of nine central lines (five
      patients) have required replacement giving an average line life of 680 days. For
      those children unfortunate enough to suffer from severe intestinal failure, HPN
      is preferable to prolonged hospital treatment and offers the chance of a good
      quality of life with prolonged survival.

PMID- 1739323
TI  - A biotinidase Km variant causing late onset bilateral optic neuropathy.
AB  - A patient with a newly recognised variant of biotinidase deficiency presented
      with acute loss of vision at the age of 10 years. Progressive bilateral optic
      neuropathy, spastic paraparesis, and a predominantly motor type neuropathy
      developed over the next five years. Metabolic investigations revealed biotin
      depletion causing multiple carboxylase deficiency. The basic defect was a biotin
      recycling disorder due to a mutant biotinidase with residual activity of 4.4%
      assayed routinely. Biocytin excretion in urine was only slightly increased.
      Further investigations on plasma biotinidase revealed biphasic kinetics with two
      different reduced values for maximum reaction velocity (Vmax) and two for the
      Michaelis constant (Km), one being almost normal and the other considerably
      raised. In contrast to this patient, two age matched children with partial
      biotinidase deficiency (2.8% and 2.9% of normal), but with a normal Km for
      biocytin, remained asymptomatic. After six months of oral substitution with 10 mg
      biotin per day the coecocentral and peripheral scotomata regressed, the pyramidal
      signs in the lower limbs disappeared, and further progression of the motor
      neuropathy arrested. We conclude that the differential diagnosis of unexplained
      bilateral optic neuropathy of juvenile onset, particularly when associated with
      upper and lower motor neuron disease, should include biotinidase deficiency.

PMID- 1739324
TI  - Beta glucuronidase and hyperbilirubinaemia in breast fed infants of diabetic
      mothers.
AB  - A prospective study was performed comparing bilirubin concentrations in 10 breast
      fed term infants of diabetic mothers (IDM) to those of 10 breast fed normal term
      infants. The beta-glucuronidase concentrations in serum and breast milk were
      assayed in the respective mothers. Significantly higher bilirubin concentrations
      were noted in the IDM group. Serum and breast milk beta-glucuronidase
      concentrations were significantly higher in diabetic mothers as compared with
      those of non-diabetic mothers. We suggest that the high concentration of beta
      glucuronidase in breast milk of diabetic mothers is an additional important cause
      leading to hyperbilirubinaemia in their breast fed infants.

PMID- 1739325
TI  - Axillary and rectal temperature measurements in infants.
AB  - Rectal and axillary temperatures were measured during the daytime in 281 infants
      seen randomly at home and 656 at hospital under 6 months old, using mercury-in
      glass thermometers. The normal temperature range derived from the babies at home
      was 36.7-37.9 degrees C for rectal temperature and 35.6-37.2 degrees C for
      axillary temperature. Rectal temperature was higher than axillary in 98% of the
      measurements. The mean (SD) difference between rectal and axillary temperatures
      was 0.7 (0.5) degrees C, with a range of 3 degrees C. When used in hospital to
      detect high temperature, axillary temperature had a sensitivity of 73% compared
      with rectal temperature. This is too insensitive for accurate detection of an
      infant's high temperature. Rectal temperature measurement is safer than
      previously suggested: perforation has occurred in less than one in two million
      measurements. If an infant's temperature needs to be taken, rectal temperature
      should be used.

PMID- 1739326
TI  - Streptococcus associated toxic shock.
AB  - In the past few years, there appears to have been a change in the spectrum of
      disease caused by group A beta-haemolytic streptococcus (GABHS), and a toxic
      shock-like syndrome caused by this organism has recently been described in
      adults. We report four children with an acute illness characterised by rapid
      progression of shock, erythematous rash, multisystem organ involvement,
      electrolyte derangements, and desquamation who fulfil the previously established
      diagnostic criteria for toxic shock syndrome. Three of the children had extensive
      cutaneous and soft tissue infection and the fourth had peritonitis. All four
      developed bacteraemia. Treatment included aggressive cardiovascular resuscitation
      and antibiotic therapy. Although no patient died, they suffered multiple and
      severe complications requiring prolonged treatment and hospitalisation.
      Streptococcal toxic shock syndrome is a separate and clearly defined entity
      occurring in previously healthy children.

PMID- 1739327
TI  - Implantable intravenous access device.
AB  - The use of a fully implantable device for venous access is described in two
      infants with transfusion dependent haemolytic anaemia. This device is a possible
      improvement in the treatment of infants needing long term venous access, although
      doctors should be aware of the infrequent complications.

PMID- 1739328
TI  - Paediatric psychotherapy: a service in a general outpatient clinic.
AB  - The service of paediatric psychotherapy to a general paediatric outpatient clinic
      is described. Using techniques developed to suit paediatric patients a median of
      nine patients each clinic were treated. Referral symptoms resolved in a median
      time of four months after a median of seven sessions. This model for the
      management of paediatric patients with emotional and behavioural difficulties may
      allow an effective and efficient use of psychotherapy time.

PMID- 1739329
TI  - Coeliac disease and lymphangiectasia.
AB  - Two out of 74 children with coeliac disease demonstrated severe intestinal
      protein loss. In both children a serial small bowel biopsy specimen showed
      intestinal lymphangiectasia to be also present. Intestinal lymphangiectasia is
      another disorder that may be associated with coeliac disease.

PMID- 1739330
TI  - Positive end expiratory pressure via a portable system in thoracic dystrophy.
AB  - The provision of positive end expiratory pressure, via a unique portable system,
      in the long term management of a child with thoracic dystrophy is reported. The
      system uses low gas flow enabling a reduction in equipment and simplification of
      the circuit as compared with a standard continuous positive airways pressure
      system.

PMID- 1739331
TI  - HIV infection in children.

PMID- 1739332
TI  - Medium chain acyl-CoA dehydrogenase deficiency.
AB  - From 65 reported cases of medium chain acyl-CoA dehydrogenase deficiency, we
      found an average presenting age of 13.5 months and a mean age at death of 18.5
      months. One quarter of patients died of a Reye-like syndrome and/or sudden infant
      death. In half the cases there had been at least one sibling death. Asymptomatic
      cases were not uncommon (12% of cases). The crises were generally induced by a
      prolonged fast and after a viral prodromal phase in three quarters of cases. The
      crises consisted of somnolence progressing to lethargy which could lead to coma.
      Vomiting was frequent (60% of cases). Seizures, which were found in 29% of cases,
      represented a bad prognosis. The physical examinations revealed frequently a
      variable and regressive anicteric hepatomegaly. Blood and urine analysis revealed
      in most instances hypoglycaemia (96% of cases) with hypoketonuria and sometimes
      metabolic acidosis. Hepatic and muscular cytolytic enzymes were frequently
      raised, as were plasma ammonia, urea, and uric acid. Plasma total or free
      carnitine concentrations, especially non-fasting, were diminished in most cases.
      Plasma saturated medium chain fatty acids and particularly unsaturated cis-4
      decenoate were on the other hand raised during the crises or during fasting.
      Urinary organic acid analysis revealed a characteristic profile of medium chain
      aciduria: C6-C10 dicarboxylic acids, hydroxy acids, glycine conjugates, and
      carnitine conjugates. Oral loading tests with carnitine or phenylpropionate allow
      a precise diagnosis. The diagnosis is confirmed by specific assays in various
      tissues. Avoidance of prolonged fasting seems to be the mainstay of treatment.

PMID- 1739333
TI  - Lower oesophageal pH monitoring--a useful clinical tool.

PMID- 1739334
TI  - Statistics from the inside. 3. Estimation.

PMID- 1739335
TI  - Accidents on hospital wards.

PMID- 1739336
TI  - Hazard from the exposed terminals of a battery driven transport incubator.

PMID- 1739337
TI  - Antenatal diagnosis of inborn errors of metabolism.

PMID- 1739338
TI  - Parenteral lipids and free radicals in preterm infants.

PMID- 1739339
TI  - Treating neonatal jaundice with phenobarbitone: the inadvertant administration of
      significant doses of ethyl alcohol.

PMID- 1739340
TI  - Transient gluten intolerance.

PMID- 1739341
TI  - Psoriasis in childhood.

PMID- 1739342
TI  - Co-morbidity associated with fabricated illness (Munchausen syndrome by proxy).
AB  - Fifty six children who had been victims of fabricated illnesses and 82 of their
      103 siblings were studied. In addition to the index fabrication, 64% of index
      children had had other illnesses fabricated by their mothers. Twenty nine per
      cent of the index children had a history of failure to thrive and 29% a history
      of non-accidental injury, inappropriate medication, or neglect. Seventy three per
      cent of the index children had been affected by at least one of these additional
      problems. Eleven per cent of the siblings had died in early childhood, the cause
      of death not being identified. Thirty nine per cent of siblings themselves had
      had illnesses fabricated by their mothers, and 17% had been affected by either
      failure to thrive, non-accidental injury, inappropriate medication, or neglect.

PMID- 1739343
TI  - Comparison of BCG vaccination at birth and at third month of life.
AB  - Tuberculosis is an important health problem in developing countries and the BCG
      vaccine plays an important part in preventing the disease. There are different
      reports about the preventive value of BCG. Some of them claim that it is
      satisfactory while others suggest that it provides little protection. There are
      also varying ideas about the optimum time to vaccinate babies, some studies
      suggesting that late vaccination confers a high degree of protection. This
      prospective controlled study has been undertaken to evaluate the value of BCG
      vaccine given to babies during their first three days of life versus its value
      when given in their third month of life. Evaluation was measured by the results
      of tests with purified protein derivative (PPD), by vaccine scars, that by the
      complications of the vaccine. It was found that BCG given at the end of the third
      month provides a higher rate of response and fewer complications than when given
      during the first three days of life.

PMID- 1739344
TI  - Conditions accounting for substantial time spent in hospital in children aged 1
      14 years.
AB  - To identify the clinical conditions associated with substantial time spent in
      hospital by children aged 1-14 years, records of children admitted to hospital in
      1975, 1979, and 1984 were studied. Analysis was by linkage of abstracts of
      routine records of hospital inpatient care in six districts in southern England
      covered by the Oxford record linkage study. The total time spend in hospital in
      the acute specialties each year was calculated by summing the lengths of stay of
      all episodes of care for each child in each year. First, admissions with long
      median times in hospital per child admitted were identified. These included,
      notably, fracture of femur and, in the later years, leukaemia, other malignant
      neoplasms, and congenital disorders of metabolism. Second conditions were
      identified which accounted for large numbers of children with lengths of stay of
      five days or more. These included, in particular, congenital anomalies, asthma,
      and appendicitis. Third, conditions were identified which accounted for the
      largest numbers of bed days used. These included congenital anomalies,
      hypertrophy of tonsils and adenoids, asthma, otitis media, appendicitis, and head
      injury. Median time spent in hospital per child admitted declined for most
      conditions but increased for leukaemia, other malignant neoplasms, and congenital
      disorders of metabolism. Admission rates for children who spent five days or more
      in hospital each year declined for all common conditions except asthma which
      increased. Total numbers of beds used increased for asthma and otitis media but
      declined for all other common conditions.

PMID- 1739345
TI  - Congenital hypothyroidism detected by neonatal screening: relationship between
      biochemical severity and early clinical features.
AB  - The relationships between biochemical severity of hypothyroidism (as judged by
      plasma thyroxine) and the clinical and radiographic findings at diagnosis were
      evaluated in 449 infants born in 1982-4 with congenital hypothyroidism identified
      by neonatal screening. Details of pregnancy, delivery, and the neonatal period
      were also examined and compared with the findings in a normal population of
      36,727 infants born in 1988. Infants with plasma thyroxine values of 30 nmol/l or
      less had a significantly higher incidence of prolonged jaundice, feeding
      difficulties, lethargy, umbilical hernia and macroglossia, showed more severe
      delay of bone maturation on a knee radiograph, and had a higher proportion of
      thyroid agenesis on isotope scan. In contrast, an ectopic or hypoplastic gland
      was more common in infants with plasma thyroxine values above 30 nmol/l.
      Prevalence of illness in pregnancy and mode of delivery was not related to
      severity of hypothyroidism and were similar to figures for the normal population.
      Induction of labour, gestation over 40 weeks, and birth weight above 3500 g were
      significantly more common in the hypothyroid infants. Perinatal illness and
      congenital malformations were more common in the infants with low plasma
      thyroxine values at diagnosis.

PMID- 1739346
TI  - Relationship between urinary and serum growth hormone and pubertal status.
AB  - Urinary growth hormone (uGH) excretion and serum growth hormone concentrations
      have been compared in three groups of children. Group 1 consisted of 21 children
      who had had cranial irradiation as part of their treatment for acute
      lymphoblastic leukaemia; group 2, 18 normal children; and group 3, 12 boys with
      constitutional delay in growth and puberty who were in early puberty. Children in
      groups 1 and 2 each had a 24 hour serum growth hormone profile (sampling every 20
      minutes) and concurrent urine collection. The 12 boys in group 3 had a total of
      21 profiles (sampling every 15 minutes for 12 hours) and concurrent urine
      collections. In the prepubertal children (n = 17), in both groups 1 and 2, there
      was a significant correlation between mean serum growth hormone and total uGHng/g
      creatinine. There were also significant correlations between total uGHng/g
      creatinine and both peak serum growth hormone and mean amplitude of the pulses in
      the growth hormone profile. In the pubertal children (n = 22), in groups 1 and 2,
      whether combined or in separate groups, there was no significant correlation
      between total uGHng/g creatinine and mean serum growth hormone, peak serum growth
      hormone, or mean amplitude of the pulses in the growth hormone profile. In group
      3 there were significant correlations between total uGHng/g creatinine and both
      the mean serum growth hormone and mean amplitude of the pulses in the profile.
      Therefore uGH estimations appear to correlate well with serum growth hormone
      profiles in children who are prepubertal or in early puberty, but not in those
      further advanced in pubertal development. These results may reflect a variation
      in the renal handling of growth hormone during pubertal development. uGH
      estimation may be an unreliable screening investigation for growth hormone
      sufficiency in mid to late puberty.

PMID- 1739347
TI  - Limited joint mobility in subjects with insulin dependent diabetes mellitus:
      relationship with eye and kidney complications.
AB  - Three hundred and fifty seven subjects (178 males and 179 females) with insulin
      dependent diabetes mellitus were evaluated for the presence of limited joint
      mobility of the interphalangeal joints. Sixty six subjects (19%) had stage 1 and
      26 subjects (7%) had stage 2 involvement of their interphalangeal joints. The
      presence of contractures was significantly related to mean longitudinal glycated
      haemoglobin (HbA1) concentrations, duration of diabetes, age of onset, mean
      longitudinal cholesterol concentrations and blood pressure. Limited joint
      mobility was also significantly associated with early diabetic retinopathy and
      raised albumin excretion rates. Limited joint mobility remained a significant
      factor in the logistic regression model for albuminuria and grade of retinopathy
      when controlled for smoking, cholesterol concentrations, duration of diabetes,
      age, gender, and blood pressure. However, limited joint mobility was only
      significantly associated with diabetic retinopathy when the effect of HbA1
      concentrations was included in the multivariate model.

PMID- 1739348
TI  - Substandard monitoring of warfarin in North America. Time for change.

PMID- 1739349
TI  - Shepherding the patient's right to self-determination. The physician's dawning
      role.

PMID- 1739350
TI  - Who needs a preoperative electrocardiogram?

PMID- 1739351
TI  - A votre sante.

PMID- 1739352
TI  - Guidelines for medical practice and the future of medicine.

PMID- 1739353
TI  - Availability of primary care health personnel. The States speak out.
AB  - The adequacy of the supply of health personnel, and primary care personnel in
      particular, has been assessed at the aggregate national level and the
      disaggregate or regional/state perspective. While Federal programs have been
      successful in expanding the Nation's supply of health care practitioners and
      alleviating aggregate national shortages in some occupations and specialties,
      problems of geographic distribution remain. In an effort to obtain information on
      the adequacy of the supply of health care personnel within each state and
      jurisdiction, the chief executives were asked to assess their most pressing
      personnel supply concerns. The two occupations most often cited as being in short
      supply were primary care physicians and registered nurses. The state assessment
      of shortages of registered nurses is in concert with national assessments. In
      contrast, the supply of primary care physicians appears to be adequate if not in
      excess at the national level, implying that aggregate assessments may camouflage
      significant regional and state shortages. Disaggregate assessments are essential
      to derive an appropriate picture of national supply adequacy.

PMID- 1739354
TI  - Reliance on prothrombin time ratios causes significant errors in anticoagulation
      therapy.
AB  - BACKGROUND: The intensity of warfarin anticoagulation in the United States may be
      inappropriate if the international normalized ratio (INR) is not used, or if the
      international sensitivity index (ISI) of the thromboplastin is outside the range
      of 2.2 to 2.6. METHODS: Fifty-three hospital laboratories provided data on the
      sensitivity of their thromboplastin and whether they reported INR values.
      Additional data on thromboplastin sensitivity were obtained from 140 laboratories
      involved in the Stroke Prevention in Atrial Fibrillation study. The three major
      manufacturers of thromboplastin confirmed the range of thromboplastin sensitivity
      reported by the laboratories. RESULTS: Of 53 laboratories surveyed, 16 (30%)
      could not provide ISI data and only 11 (21%) reported INR results. Unlabeled
      thromboplastin was being used by 20% to 24% of laboratories, and only 8% to 20%
      were using thromboplastins with an ISI of 2.2 to 2.6. At the time the three
      manufacturers were contacted, they reported marketing thromboplastins with ISI
      values from 1.2 to 2.8, but none of the thromboplastins at that time had ISI
      values between 2.2 and 2.6. CONCLUSION: Warfarin therapy in the United States is
      managed inappropriately because most laboratories do not report INRs and the
      variability in thromboplastin sensitivity produces misleading prothrombin time
      ratio results. Additionally, recent research may require reexamination if INR or
      ISI data were not provided.

PMID- 1739355
TI  - A comparison of imipenem to ceftazidime with or without amikacin as empiric
      therapy in febrile neutropenic patients.
AB  - BACKGROUND: Neutropenic patients with cancer are traditionally treated with
      empiric antibiotic combinations when they become febrile. The availability of
      broad-spectrum antibiotics such as ceftazidime and imipenem has made it possible
      to initiate therapy with a single agent (monotherapy). The objectives of this
      trial were to compare ceftazidime and imipenem as single agents for the therapy
      of febrile episodes in neutropenic patients and to ascertain whether the addition
      of an aminoglycoside (amikacin) to either of these agents would provide an
      advantage. METHODS: A prospective clinical trial was conducted in which eligible
      neutropenic patients with cancer were randomized to one of four treatment arms:
      ceftazidime alone; imipenem alone; ceftazidime plus amikacin; and imipenem plus
      amikacin. Efficacy analysis was done for 750 assessable episodes. A multivariate
      logistic-regression analysis was also performed to examine the unique
      contribution of various prognostic factors. RESULTS: The overall response rates
      were 76% with imipenem plus amikacin, 72% with imipenem, 71% with ceftazidime
      plus amikacin, and 59% with ceftazidime alone. Single-organism gram-positive
      infections occurred in 101 of 750 episodes. Without a change in antibiotics, the
      response rates were 50% with imipenem, 40% with imipenem plus amikacin, 39% with
      ceftazidime plus amikacin, and 38% with ceftazidime. Most responded to vancomycin
      or other antibiotics, and the mortality associated with gram-positive infections
      was only 5%. Regardless of the antibiotic regimen, the majority of uncomplicated
      gram-negative infections responded to therapy and the majority of complicated
      gram-negative infections failed to respond. Multivariate logistic-regression
      analysis showed that recovery of the neutrophil count was the most favorable
      prognostic factor in a patient's response to infection, whereas the presence of
      gram-positive infection, acute leukemia, pulmonary or enteric infection, and
      therapy with ceftazidime were unfavorable factors. CONCLUSIONS: Single-agent
      therapy with imipenem is as effective as more conventional combination antibiotic
      therapy for the empirical treatment of febrile episodes in neutropenic patients
      with cancer.

PMID- 1739356
TI  - Durable power of attorney for health care. A survey of senior center
      participants.
AB  - Fifty-nine healthy senior center participants were interviewed to determine how,
      when, and why the durable power of attorney for health care is being used. The 21
      users of the durable power of attorney for health care executed a form for the
      expected reasons; however, a majority had not given a copy of the form to their
      physician and few had discussed details of their preferences with the proxy. Of
      the 38 nonusers, the most frequent reasons for not executing a durable power of
      attorney for health care were: lack of awareness of the form, procrastination,
      and difficulty choosing a proxy. The new Patient Self-Determination Act requiring
      hospitals to inform patients of advance directives will help to overcome some of
      the obstacles in use of the durable power of attorney for health care; however,
      community education must still be encouraged.

PMID- 1739357
TI  - Moderate and heavy alcohol consumption have no favorable effect on lipid values.
AB  - Moderate alcohol consumption has been reported to provide protection against
      coronary heart disease. We studied serum lipid values in 380 men, including 184
      controls (37 teetotalers and 147 moderate drinkers), 90 heavy drinkers, and 106
      alcoholics. Total cholesterol values were significantly lower among alcoholics
      than controls (mean +/- SEM, 5.43 +/- 0.15 mmol/L [210 +/- 5.8 mg/dL] vs 6.01 +/-
      0.08 mmol/L [232 +/- 3.1 mg/dL]), but their high-density lipoprotein (HDL)
      cholesterol values were higher (1.66 +/- 0.07 mmol/L [64 +/- 2.7 mg/dL] vs 1.14
      +/- 0.02 mmol/L [44 +/- 0.8 mg/dL]). Accordingly, there was a highly significant
      difference in the HDL/total cholesterol ratio (0.32 +/- 0.13 vs 0.19 +/- 0.01).
      Heavy drinkers had significantly higher total cholesterol values than controls
      (6.30 +/- 0.13 mmol/L [244 +/- 5.0 mg/dL] vs 6.01 +/- 0.08 mmol/L [232 +/- 3.1
      mg/dL]); the same was true of HDL cholesterol values (1.25 +/- 0.07 mmol/L [48 +/
      2.7 mg/dL] vs 1.14 +/- 0.02 mmol/L [44 +/- 0.8 mg/dL]). No significant
      difference was found in the HDL/total cholesterol ratio between controls and
      heavy drinkers or between teetotalers and moderate drinkers. Therefore, moderate
      alcohol intake apparently does not change HDL/total cholesterol ratio; if
      moderate drinking is protective against coronary heart disease, the mechanism is
      probably not via lipids.

PMID- 1739358
TI  - The utility of preoperative electrocardiograms in the ambulatory surgical
      patient.
AB  - To determine the utility of preoperative screening electrocardiograms (ECGs)
      among ambulatory surgery patients, we reviewed the charts of 751 consecutive
      adult patients who underwent ambulatory surgery. Data were collected on
      demographic characteristics, coexisting medical problems, American Society of
      Anesthesiologists physical status score, preoperative ECG results, adverse
      intraoperative cardiovascular events, and postoperative cardiovascular
      complications. In our study population of relatively healthy outpatients,
      preoperative ECGs were abnormal in 42.7% of patients. Age, increased physical
      status score, and male gender were associated with a greater incidence of
      abnormal preoperative ECGs. There were 12 adverse cardiovascular perioperative
      events among the 751 patients (1.6%), and the preoperative ECG may have been
      clinically useful in six of these 12 patients. Neither preoperative ECGs nor
      results of preoperative screening questionnaires were predictive of adverse
      cardiovascular perioperative events. These findings question the utility of
      preoperative ECGs in the ambulatory surgery setting, especially among younger,
      relatively healthy patients.

PMID- 1739359
TI  - Identification of severe coronary artery disease using simple clinical
      parameters.
AB  - The purpose of our study was to examine the ability of clinical and resting
      electrocardiographic variables to provide useful estimates of the probability of
      three-vessel or left-main coronary artery disease. The study group consisted of
      680 patients with symptomatic coronary artery disease who underwent exercise
      equilibrium radionuclide angiography and coronary angiography within 6 months.
      Sixteen clinical and electrocardiographic variables were examined by logistic
      regression analysis. The independently predictive variables were then used to
      develop convenient graphic estimates of the probability of three-vessel or left
      main disease and to classify patients into high-risk (greater than 35%),
      intermediate-risk (15-35%), or low-risk (less than 15%) groups. Five variables
      were independently predictive of left-main or three-vessel disease: age, typical
      angina, diabetes, gender, and both history and electrocardiographic evidence of a
      prior myocardial infarction. A single graph was constructed that displayed the
      probability of severe coronary artery disease as a function of a five-point
      cardiac risk scale, which incorporated these variables. Two hundred sixty-two
      patients (39% of the study group) were classified as high risk; 127 of these
      patients (48%) had three-vessel or left-main disease. An additional 96 patients
      were classified as low risk; nine of these patients (9%) had three-vessel or left
      main disease. Five clinical variables that were obtained on an initial patient
      assessment can provide useful estimates of the likelihood of severe coronary
      disease.

PMID- 1739360
TI  - Antithrombin III level, fibrinogen level, and platelet count changes with
      adjuvant tamoxifen therapy.
AB  - Adjuvant therapy for breast cancer with tamoxifen is suggested to be of benefit
      to both women with negative and women with positive axillary nodes, and treatment
      lasting several years is currently being investigated. Venous thrombophlebitis
      may complicate tamoxifen treatment at a rate of approximately one per 800
      treatment-years. To explore the possible mechanisms of this effect, we evaluated
      changes in antithrombin III levels, fibrinogen levels, and platelet counts in 140
      postmenopausal women with surgically resected breast cancer who were disease free
      and participating in a double-blind, placebo-controlled, randomized toxicity
      study of tamoxifen. Antithrombin III levels, elevated at baseline evaluation,
      decreased in tamoxifen-treated subjects at 6 months, but no subject exhibited a
      drop to clinically significant levels. Fibrinogen levels decreased 15% (0.4 g/L)
      in tamoxifen-treated subjects at 6 months. Platelet counts decreased 7% to 9%
      from baseline to evaluations at 3, 6, 12, 18, and 24 months in tamoxifen-treated
      subjects. While these changes do not explain the possible small thrombophlebitis
      promoting effect of tamoxifen, the decrease in fibrinogen levels might be
      expected to be associated with a decreased risk of arterial thrombosis.

PMID- 1739361
TI  - Severity of pulmonary asbestosis as classified by International Labour
      Organisation profusion of irregular opacities in 8749 asbestos-exposed American
      workers. Those who never smoked compared with those who ever smoked.
AB  - The profusion of irregular opacities on chest roentgenograms by International
      Labour Organisation pneumoconiosis criteria was used to assess the severity of
      asbestosis in 8749 asbestos-exposed active and retired American workers. Seventy
      eight percent had no asbestosis (category 0/0 or 0/1), 18.6% had slight
      asbestosis (1/0 to 1/2), 3% had moderate asbestosis (2/1 to 2/3), and 0.3% had
      advanced disease (3/2 or greater). Significantly more current smokers had
      asbestosis than did those who had never smoked, and their average profusion of
      opacities was higher. The mean age of current smokers with asbestosis was 60
      years, whereas subjects with the disease who had never smoked had a mean age of
      64 years, a significant difference. Cigarette smoking and asbestosis appear to
      act synergistically to produce irregular opacities on chest roentgenograms of
      asbestos-exposed American workers.

PMID- 1739362
TI  - Recently acquired syphilis in the elderly population.
AB  - Despite the dramatic rise in syphilis incidence in the United States, studies on
      recently acquired syphilis in persons more than 60 years of age remain rare.
      Thirty-five cases of primary, secondary, and early latent syphilis in individuals
      60 years and older were identified in the city of Hartford, Conn, between 1985
      and 1990. There were no cases of early syphilis in the elderly reported from 1985
      to 1986, whereas there were 23 cases reported from 1989 to 1990. Thirty-three
      cases occurred in men and two cases occurred in women; 25 patients were black,
      five were white, and five were Hispanic. Ten men reported having more than one
      sexual partner within 2 months of their diagnosis; five of these 10 had sexual
      relations with a prostitute. Physicians who care for the elderly should perform a
      complete sexual history and counsel patients regarding high-risk sexual
      practices.

PMID- 1739363
TI  - Delirium. The occurrence and persistence of symptoms among elderly hospitalized
      patients.
AB  - We evaluated the occurrence and persistence of delirium in 325 elderly patients
      admitted to a teaching hospital from either a defined community or a long-term
      care facility. Of the study participants, 34 (10.5%) had Diagnostic and
      Statistical Manual of Mental Disorders, Third Edition--defined delirium at
      initial evaluation; of the remaining patients, 91 (31.3%) developed new-onset
      delirium. An additional 110 patients also experienced individual symptoms of
      delirium without meeting full criteria. Preexisting cognitive impairment and
      advanced age were associated with increased risk of incident delirium in the
      community sample but not the institutional one. Delirium was not associated with
      an increased risk of mortality, but it was associated with a prolonged hospital
      stay and an increased risk of institutional placement among community-dwelling
      elderly. Only five patients (4%) experienced resolution of all new symptoms of
      delirium before hospital discharge, and only 20.8% and 17.7%, respectively, had
      resolution of all new symptoms by 3 and 6 months after hospital discharge. These
      data suggest that delirium is a common disorder that may be substantially less
      transient than currently believed and that incomplete manifestations of the
      syndrome may be frequent.

PMID- 1739364
TI  - Factors associated with veterans' decisions about living wills.
AB  - Most states have adopted legislation that allows patients to designate by advance
      directives the type of health care they would like to receive if they should
      become incompetent while suffering from a terminal illness. The living will is
      one of the most common of these legal instruments. Unlike most studies that have
      examined very sick or hospitalized patients' preferences regarding life
      sustaining treatments, our study explores the concerns of 70 ambulatory veterans
      from a general medical clinic regarding living wills. Before the interview, 43%
      of patients reported never having heard of living wills. At interview, 4% of the
      patients had a living will, 33% intended to sign a living will but had not done
      so (INTEND), 54% were undecided about living wills (UNDECIDED), and 9% did not
      want a living will. Compared with UNDECIDED patients, all other patients did not
      differ in the use of health care services during the previous year or in
      diagnoses. INTEND patients, however, were significantly more likely to be white,
      to express poorer health status, to know someone with a living will, and to have
      previously discussed the topic. UNDECIDED patients were more likely than INTEND
      patients to report that religious beliefs about living wills affected their
      decision. Virtually all (91%) of the respondents believed that signing a living
      will would not affect their treatment. These data suggest that many patients may
      not know that they can have a living will and that discussions with those who
      already have a living will may be helpful in educational programs designed to
      promote informed patient decision-making.

PMID- 1739365
TI  - Effect of buspirone on withdrawal symptoms associated with smoking cessation.
AB  - BACKGROUND: Preliminary information suggests that buspirone hydrochloride
      ameliorates symptoms of nicotine withdrawal. In a double-blind, randomized,
      placebo-controlled trial, we determined the effects of buspirone on the
      withdrawal symptoms associated with smoking cessation in 40 long-term cigarette
      smokers. METHODS: Subjects were randomized to 4 weeks of treatment with either
      buspirone (n = 20) or placebo (n = 20). Subjects were instructed to maintain
      their usual cigarette intake during the first 21 days of treatment and to cease
      smoking on day 22 of treatment. Withdrawal symptoms were subjectively rated
      before and during smoking cessation. RESULTS: Before smoking cessation, there
      were no significant differences in the intensity of any withdrawal symptom
      between the buspirone- and placebo-treated subjects, with the exception of a
      significantly higher rating for drowsiness in the buspirone group. During the
      smoking cessation period, the ratings for craving, anxiety, irritability,
      restlessness, and sadness were significantly lower in the buspirone group than
      the placebo group. There were no significant differences between the groups in
      their ratings for hunger, inability to concentrate, or drowsiness. Fifteen
      buspirone-treated subjects and nine placebo-treated subjects were able to abstain
      from cigarettes during the entire 7-day smoking cessation period. No subject
      dropped out of the study for perceived drug side effects. Eight buspirone-treated
      subjects and five placebo-treated subjects reported side effects, all of which
      were mild. CONCLUSIONS: Buspirone ameliorated most of the short-term withdrawal
      symptoms associated with smoking cessation. Further controlled studies will be
      needed to define the benefit in smoking cessation.

PMID- 1739366
TI  - Mupirocin treatment of nasal staphylococcal colonization.
AB  - The effectiveness and safety of mupirocin calcium ointment applied to the
      anterior part of the nares for 5 days in the eradication of nasal carriage of
      Staphylococcus aureus was investigated in a placebo-controlled, double-blind
      study. Subjects were healthy medical center staff who had two positive cultures
      of the anterior nares for S aureus. Antimicrobial susceptibility, phage typing,
      and restriction endonuclease analysis of plasmid DNA were used to monitor the
      identity of relapsing and persisting strains. Mupirocin eliminated 74% of S
      aureus at early follow-up and 91% of original strains. At 4 weeks, 78% of the
      original strains were eradicated, whereas all of the placebo group remained
      colonized. Recolonization with mupirocin-resistant strains occurred in six
      patients, but these were of different phage and plasmid types from the original
      isolates. None of the subjects had serious adverse effects. Applied intranasally
      for 5 days, a calcium preparation of mupirocin in a paraffin base is effective in
      eliminating S aureus nasal carriage and is well tolerated.

PMID- 1739367
TI  - Borderline-low serum thyrotropin level is correlated with increased fasting
      urinary hydroxyproline excretion.
AB  - BACKGROUND: Recent studies suggest that even mildly supraphysiologic thyroid
      hormonal status accelerates bone loss. In hyperthyroidism, increased bone
      resorption is the predominant mechanism for bone loss. We postulated that the
      changes in thyroid hormone status as reflected by low-normal and minimally
      subnormal serum thyrotropin level would have an effect on bone turnover and could
      be detected by a simple, noninvasive marker of bone resorption, fasting urinary
      total hydroxyproline-creatinine excretion (THP/Cr). METHODS: We retrospectively
      identified ambulatory patients with a restricted range of diagnoses who had had
      measurements of thyrotropin and THP/Cr performed within +/- 21 days. RESULTS: Of
      the 86 patients, 47 had thyrotropin levels greater than 1.0 mU/L. In these
      patients, no correlation was evident for thyrotropin and THP/Cr. Of the other 39
      patients, 11 had suppressed thyrotropin levels (less than 0.1 mU/L) and showed
      clearly elevated values for THP/Cr, as expected from previous studies of
      hyperthyroidism. For 28 patients with thyrotropin in the borderline and low
      normal range of 0.1 to 1.0 mU/L, a significant negative correlation with THP/Cr
      was found. The THP/Cr was positively correlated with serum alkaline phosphatase
      level, as expected with increased bone turnover. CONCLUSIONS: These results add
      further support to the hypothesis that even a minimal excess of thyroid hormones
      increases bone turnover and may contribute to accelerated bone loss.

PMID- 1739368
TI  - Cardiovascular responses to phlebotomy and sitting in middle-aged and elderly
      subjects.
AB  - BACKGROUND: Responding appropriately to hypotensive challenges is an important
      determinant of health and functional independence in elderly individuals.
      Cardiovascular responses to phlebotomy and postural change were evaluated using a
      large database developed in a study designed to establish the safety of blood
      donation by older individuals. METHODS: The groups studied included 464 subjects
      aged 65 years and younger (range, 52 to 65 years) and 532 subjects more than 65
      years old (range, 66 to 78 years old). Blood pressure and pulse rate measurements
      were followed by the withdrawal of 500 mL of blood. These measurements were
      repeated, first in the supine and then in the sitting position. RESULTS: Nearly
      all individuals studied remained hemodynamically stable after these two
      challenges. Age was not an independent predictor of blood pressure change after
      either phlebotomy or postural change. Large decreases in diastolic blood pressure
      were equally rare in both age groups. However, more older subjects (15.2%)
      exhibited a decline of 20 mm Hg or more in systolic blood pressure following
      phlebotomy, compared with the middle-aged group (6.9%). These age-related
      differences did not persist after controlling for the higher initial systolic
      blood pressures observed in the older subjects. Postphlebotomy postural change to
      the sitting position had little additional effect. CONCLUSIONS: These results
      indicate that the ability to respond to hypovolemia and postural change remains
      relatively intact in healthy elderly individuals. The higher prevalence of a
      significant drop in systolic blood pressure after phlebotomy, orthostasis, and
      possibly other homeostatic challenges in older subjects is probably due to the
      presence of higher basal blood pressure readings, including hypertension. In
      spite of these differences, blood donation is appropriate and should be
      encouraged in healthy elderly individuals in this age group.

PMID- 1739369
TI  - Differences in urinary albumin excretion rate between normotensive and
      hypertensive, white and nonwhite subjects.
AB  - Eighty-one normotensive and 61 hypertensive white and nonwhite subjects were
      studied cross-sectionally to determine the prevalence and determinants of
      elevated urinary albumin levels. Twenty-four-hour urinary albumin excretion was
      determined by radioimmunoassay. The prevalence of elevated urinary albumin level
      (greater than or equal to 15 mg/24 h) was significantly greater in hypertensive
      than in normotensive subjects (31.1% and 8.6%). Among hypertensive subjects, a
      much greater proportion of whites than nonwhites had urinary albumin levels of 15
      mg/24 h or greater (39.5% and 17.4%). The independent association of blood
      pressure with urinary albumin level was affirmed by logistic regression analyses
      for white normotensive and hypertensive subjects combined, and for hypertensive
      subjects alone. Furthermore, among hypertensive subjects, whites were five times
      as likely as nonwhites to have elevated urinary albumin levels. Thus, blood
      pressure and ethnicity were the important determinants of urinary albumin
      excretion among hypertensive subjects.

PMID- 1739370
TI  - Return to work after an initial myocardial infarction and subsequent emotional
      distress.
AB  - We examined how return to work predicted subsequent change in emotional distress
      in 143 patients who had been employed at the time of initial myocardial
      infarction. Ninety patients (63%) returned to work by 4 months and remained
      employed at 12 months. There were no differences in mental health at baseline
      between those who returned to work and those who did not, but emotional distress
      decreased significantly between 4 and 12 months only in the group who returned to
      work. Emotional distress declined after resuming work even when employees
      returned to jobs with which they reported dissatisfaction at the time of the
      myocardial infarction. The relationship between return to work and decreasing
      emotional distress remained after controlling for initial physical and
      psychological adjustment as well as sociodemographic and social support
      characteristics. The improvements in mental health associated with return to work
      should reassure clinicians who emphasize the emotional as well as economic value
      of work after an initial myocardial infarction.

PMID- 1739371
TI  - Amantadine-resistant influenza A in a nursing facility.
AB  - Rapid index case treatment and amantadine prophylaxis were implemented in two
      nursing homes exposed to influenza A. Facility A had no isolation of cases, and
      18 of 22 cases occurred after amantadine hydrochloride therapy was initiated.
      Three patients exhibited amantadine-resistant virus. Facility B had day 1
      isolation of the index case. A facility-wide outbreak did not occur. The
      experience of these facilities suggests that concurrent amantadine treatment and
      prophylaxis without adequate case isolation may promote further influenza A
      infection in a nursing facility.

PMID- 1739372
TI  - Multiple-dose charcoal and whole-bowel irrigation do not increase clearance of
      absorbed salicylate.
AB  - BACKGROUND: This study assesses whether oral multiple-dose charcoal therapy (MDC)
      or whole-bowel irrigation (WBI) enhances the excretion of previously absorbed
      salicylate. METHODS: A controlled, randomized, three-limbed crossover protocol
      was used in nine humans who ingested aspirin. Salicylate levels were measured in
      serial serum specimens and 32-hour urine collections and kinetic parameters were
      calculated. RESULTS: There were no differences among the control (CTL), MDC, or
      WBI groups for area under the serum concentration vs time curve (CTL, 2320 +/-
      501 mg/L.h MDC, 2040 +/- 454 mg/L.h; WBI, 2093 +/- 418 mg/L.h) or for urinary
      salicylates (CTL, 54.9% +/- 9.4%; MDC, 50.9% +/- 8.0%, WBI, 52.4% +/- 13.7% of
      ingested dose). CONCLUSIONS: Our data do not support the use of either MDC or WBI
      to enhance the excretion of previously absorbed salicylate in poisoned patients.
      In patients with drug overdoses, a clear rectal effluent remains as the endpoint
      for WBI.

PMID- 1739373
TI  - HIV antibody testing in young, urban adults.
AB  - We surveyed men and women aged 21 to 34 years to determine the rates of human
      immunodeficiency virus (HIV) antibody testing in blacks and whites of diverse
      education levels in four US cities. Responses to the anonymous, mailed
      questionnaire were received from 90% of 777 white women, 64% of 734 black women,
      79% of 677 white men, and 48% of 541 black men. The percentages reporting HIV
      testing for these four race-gender groups were 29%, 22%, 30%, and 38%,
      respectively. The percentages reporting testing that was voluntarily sought (ie,
      not in connection with blood donation, military service) were 16%, 14%, 18%, and
      22%, respectively. In each race-gender group, roughly half of those who had not
      been tested said they "might have a blood test for the AIDS virus in the future".
      Education level was not correlated with HIV-testing frequency. Blacks were
      significantly less likely than whites to be aware of "a blood test that can
      detect the AIDS virus infection" (58% vs 77%), but blacks who knew of the test
      were more likely than whites to have been tested (47% vs 37%). Eleven percent of
      subjects reported at least one major risk factor for HIV infection. In these
      people, HIV testing was most common among homosexually active men (56% tested;
      52% voluntarily sought), intermediate among injection drug users (40% tested; 31%
      voluntarily sought), and least common among the sexual partners of injection-drug
      users (21% tested; 11% voluntarily sought). Health education programs need to
      communicate the availability of, and need for, anonymous HIV testing.

PMID- 1739374
TI  - Fluconazole in the treatment of hepatosplenic candidiasis.
AB  - Hepatosplenic candidiasis has increased in frequency among immunocompromised
      hosts. Risk factors include hematologic malignancy, intensive chemotherapy,
      prolonged neutropenia, and treatment with broad-spectrum antibiotics. Patients
      most commonly present with abdominal pain, persistent fevers despite antibiotic
      therapy, and an elevated alkaline phosphatase level that is out of proportion to
      other hepatic enzyme levels. Gastrointestinal mucosal damage secondary to
      intensive chemotherapy may allow colonization with Candida species and subsequent
      seeding of the portal vein. Treatment has consisted of prolonged courses of
      amphotericin B, with mortality rates approaching 50%. We report a case of
      hepatosplenic candidiasis in a patient with acute myelogenous leukemia who had
      clinical and radiographic improvement during fluconazole therapy. Fluconazole may
      be an efficacious and less toxic alternative to amphotericin B.

PMID- 1739375
TI  - An acquired hemorrhagic disorder from long-acting rodenticide ingestion.
AB  - A 62-year-old man who presented with gross hematuria was found to have a severe
      and prolonged coagulopathy. The workup involved mixing studies, which suggested
      an acquired factor deficiency, and specific factor assays, which demonstrated
      isolated defects in vitamin K-dependent factors. With vitamin K deficiency
      excluded, and serum warfarin levels undetectable, so-called superwarfarin
      ingestion was suspected. This diagnosis was subsequently proved by biochemical
      evidence (an increase in the serum vitamin K epoxide-vitamin K ratio) and
      compatible history. This case illustrates how a logical workup can lead to a
      diagnosis of superwarfarin ingestion, even without a history of such an
      ingestion. New serum assays for specific superwarfarins are also mentioned. This
      case report should increase clinicians' awareness of long-acting rodenticide
      ingestions.

PMID- 1739376
TI  - Anxiety disorders and hyperventilation.

PMID- 1739377
TI  - Vancomycin-induced cytopenias.

PMID- 1739378
TI  - Lowering cholesterol and death due to accidents, suicides: unresolved issues.

PMID- 1739379
TI  - The intensive care unit--industrial complex.

PMID- 1739380
TI  - A proposed mechanism of the inflammatory attacks in familial Mediterranean fever.

PMID- 1739381
TI  - Availability of zirconium in topical antiperspirants.

PMID- 1739382
TI  - National health policy without rationing?

PMID- 1739384
TI  - Medical database finalized.

PMID- 1739383
TI  - Renal cell carcinoma following prolonged testosterone therapy.

PMID- 1739385
TI  - IgA nephropathy: preliminary results of low-antigen-content diet treatment.

PMID- 1739386
TI  - Morphological and contractile characteristics of rat aortae perfused for 3 or 6
      days in vitro.
AB  - We studied the morphological and contractile characteristics of rat thoracic
      aortic segments perfused for 3 or 6 days under pulsatile conditions. Light
      microscopic examination of the segments revealed the presence of an unchanged
      tunica media. However, the intimal surface was mostly devoid of endothelial
      cells. The perfused aortic segments showed a dramatic increase in spontaneous
      tone when compared to fresh and sham-treated aortic segments. Maximum responses
      to potassium and norepinephrine were reduced after 3 days of perfusion (20-40%
      reduction), while maximum responses to 5-hydroxytryptamine and angiotensin II
      were not significantly different. After 6 days of perfusion, maximum responses to
      all agonist were reduced (50-60%). Sensitivity to norepinephrine was not affected
      by the treatment, while sensitivity to 5-hydroxytryptamine was reduced. The
      perfused aortic segments relaxed well in response to isoproterenol. Our system
      provides a useful experimental model for short-term studies of hypertension- and
      atherosclerosis-related vascular changes. Further refinement and characterization
      could improve the performance of the system for longer-term studies.

PMID- 1739387
TI  - Effects of diazepam (Valium) on aortic atherogenesis and plasma lecithin:
      cholesterol acyltransferase activity in cockerels fed an atherogenic diet.
AB  - Blood plasma LCAT (lecithin: cholesterol acyltransferase, EC 2.3.1.43) was
      studied in cockerels fed an atherogenic diet to determine if attenuation of
      aortic atherogenesis, as a result of simultaneous treatment of the birds with
      diazepam, might be related to modulation of enzyme activity by the drug.
      Administration of diazepam (0.6 mg/kg) did not influence LCAT. It was observed
      that no relationship could be established between enzyme activity and the extent
      of aortic atherogenesis. In contrast, addition of diazepam in vitro to cockerel
      plasma caused a concentration-dependent inhibition of LCAT activity. The effect
      was most pronounced when diazepam was present at a concentration of 50-200
      microM, where inhibition of enzyme activity was 25-65%. Thus, pharmacologic doses
      of diazepam do not appear to affect LCAT in vivo. It is concluded that diazepam
      attenuates aortic atherogenesis in cockerels fed an atherogenic diet by a
      mechanism independent of LCAT.

PMID- 1739388
TI  - Treatment of diabetic ketoacidosis and non-ketotic hyperosmolar diabetic coma.
AB  - Although mortality of diabetic ketoacidosis (KA) has decreased during the past 20
      yr to 1-2%, hyperosmolar non-ketotic coma (HNC) is still lethal in 20-30% of
      cases due to severe underlying conditions or to complications. The most frequent
      causes of death are infections and thromboembolic disorders. The strategies of
      initial treatment of KA and HNC are similar; in KA, insulin, fluid and
      electrolyte replacement have first priority. In HNC, rehydration and electrolyte
      administration are of primary importance. It is now generally recognized that
      insulin therapy is best performed using low doses (4-8 units/h); after
      institution of insulin treatment and rehydration there are rapid changes of fluid
      and electrolytes from the extra- into the intravascular space. In this situation
      it is a major therapeutic challenge to avoid complications due to hypokalaemia,
      hypophosphataemia, hypomagnesaemia and hypovolaemia. These complications should
      be avoided by adequate replacement, and particularly by regular clinical and
      laboratory monitoring. When blood glucose concentrations decrease below 14
      mmols/l, blood glucose concentrations should initially be maintained at this
      level because rapid lowering below this level may increase the risk of brain
      oedema. Too-vigorous fluid replacement with crystalline solutions also increases
      the risk that brain oedema or complications like the adult respiratory distress
      syndrome will develop. If hypovolaemia persists in spite of adequate crystalloid
      solutions, colloid-containing fluids such as albumin should be administered. It
      is not established whether replacements of phosphate and magnesium have clinical
      benefits. Nevertheless, it is probably justified to administer phosphate and
      magnesium when their serum concentrations are below the normal range,
      particularly if the clinical situation is critical. Mortality from diabetic coma
      in industrialized countries may only be decreased by prophylaxis, i.e. by
      education of all diabetic patients and physicians to detect metabolic
      decompensation early.

PMID- 1739389
TI  - Endocrine emergencies.

PMID- 1739390
TI  - Disorders of water balance--hyponatraemia and hypernatraemia.
AB  - Plasma sodium concentration depends on water balance, and is normally maintained
      in a narrow range by an integrated system involving the precise regulation of
      water intake via thirst mechanism and control of water output via vasopressin
      secretion. Anything that interferes with the full expression of either
      osmoregulatory function exposes the patient to the hazards of abnormal decreases
      or increases in plasma sodium level. Hyponatraemia is almost always due to a
      defect in water excretion. Increased intake may contribute to the problem but is
      rarely, if ever, a sufficient cause. Hypernatraemia is almost always due to
      deficient water intake; excessive water losses may contribute to the problem, but
      they are never a sufficient cause. The most dangerous and usually the most
      blatant clinical effects of the disturbed water balance are those involving the
      central nervous system. Complex adaptive mechanisms have been developed to
      mitigate the impact of both hypo- and hypernatraemia on brain cells. However, the
      same protective changes render the brain more susceptible to severe
      neuropathology that may arise from inappropriate treatment of these disorders.

PMID- 1739391
TI  - Management of disorders of calcium homoeostasis.
AB  - Severe hypercalcaemia may be life-threatening and requires prompt management.
      Whatever the cause, the aim of therapy should obviously be to eradicate the
      source of hypercalcaemic factors. After rehydration, which is an essential first
      step in the management strategy, and after evaluation of the prevailing
      pathogenetic mechanism, the acute treatment will be aimed at increasing urinary
      Ca excretion and inhibiting bone resorption. Among the various pharmacological
      agents, bisphosphonates appear to be the drugs of first choice, because of their
      efficacy and their virtual absence of side-effects. The decision to treat
      hypocalcaemia is determined by the extent of the symptoms and the risk of
      complications. The treatment of acute hypocalcaemia comprises the parenteral
      administration of Ca or magnesium, when magnesium deficiency can be suspected.
      Then, chronic hypocalcaemia may require the use of 1,25-dihydroxyvitamin D, once
      the replenishments of vitamin D stores have been assured.

PMID- 1739392
TI  - Phaeochromocytoma: diagnosis and management.
AB  - The incidence, symptoms, signs and differential diagnosis of phaeochromocytoma
      have been discussed in detail. Current methods of biochemical diagnosis and
      anatomical localization of the tumour have been reviewed, the appropriate
      pharmacotherapy and other aspects of medical management have been outlined. Also
      detailed herein are anaesthetic management and surgical approach, the pitfalls of
      drug administration in known or suspected phaeochromocytoma, and particular
      considerations when phaeochromocytoma is malignant or when it coexists with
      pregnancy. Three decades ago, the diagnosis and management of phaeochromocytoma
      was succinctly summarized as follows: 'think of it, confirm it, find it and
      remove it' (Manger and Gifford, 1977; Ross, 1962). Despite the availability of
      sophisticated diagnostic tests and the significant progress in management, where
      phaeochromocytoma is concerned, a high index of suspicion ('thinking of it')
      remains the physician's most valuable tool.

PMID- 1739393
TI  - Endocrine emergencies in pregnancy.
AB  - A number of endocrine conditions and emergencies have unique characteristics when
      present in the pregnant woman. Often the abnormal endocrine state affects both
      mother and fetus and the various diagnostic and therapeutic approaches have to be
      altered to avoid harming the fetus. Furthermore, the pregnant state itself may
      alter the natural course of the underlying endocrine condition. Prolactinomas may
      enlarge due to the hormonal milieu of pregnancy, causing mass effects and even
      apoplexy. Anticipation of this possibility and prompt recognition may prevent
      disastrous consequences. This stimulatory state may extend to the normal
      pituitary, resulting in Sheehan's syndrome. An acute form of Sheehan's may go
      unrecognized, leading to unnecessary maternal deaths. Autoimmune endocrine
      disorders may sometimes be exacerbated and at other times be ameliorated during
      pregnancy. Witness the development of lymphocytic hypophysitis during pregnancy,
      a condition best left alone if it can be diagnosed without surgery. Graves's
      disease usually improves during pregnancy but it may occasionally flare,
      resulting in potentially lethal thyroid storm. The various therapeutic
      alternatives for hyperthyroidism are very much affected by effects on the fetus.
      Cushing's syndrome has very bad consequences for the fetus and must be diagnosed
      and treated urgently, if not emergently. Phaeochromocytomas are always endocrine
      emergencies requiring urgent and sometimes emergent treatment.
      Hyperparathyroidism is usually mild, but severe hypercalcaemia can be a true
      endocrine emergency. Recognition of the interactions of these endocrine
      conditions and their specific treatments with the complicated maternal-fetal unit
      makes their diagnosis and treatment simultaneously both difficult and extremely
      rewarding.

PMID- 1739394
TI  - Paediatric endocrine and metabolic emergencies.

PMID- 1739395
TI  - Endocrine emergencies. Hypoglycaemia.
AB  - Hypoglycaemia is possibly the most frequent metabolic emergency, in that insulin
      induced hypoglycaemia is a common side-effect of treatment of a common disease.
      The symptoms are partly sympathetic and related to the release of catecholamines.
      These symptoms include sweating, tremor, palpitations, sensation of hunger,
      restlessness and anxiety. Other symptoms are caused by an insufficient supply of
      glucose to the brain, resulting in neuroglucopenia with symptoms like blurred
      vision, weakness, slurred speech, vertigo and difficulties in concentration.
      Symptom recognition is the primary and most effective defence against cerebral
      dysfunction which is the ultimate consequence of hypoglycaemia. Even in insulin
      treated diabetic patients symptom failure might occur. Patients who experience
      severe episodes of hypoglycaemia do not constitute a special subgroup of
      patients. However, near-normalization of blood glucose levels have resulted in an
      increase in the incidence of severe hypoglycaemia. Moreover, the threshold for
      hormonal counter-regulatory responses in adrenaline, growth hormone and cortisol
      is lowered after a period of strict metabolic control in insulin-dependent
      diabetic patients. The glucose level at which the patients become subjectively
      aware of hypoglycaemia is correspondingly reduced. Other reasons for
      hypoglycaemia to occur are oral hypoglycaemic agents, especially sulfonylureas
      which may be potentiated by other drugs. Prolonged hypoglycaemia may be seen
      after first-order sulfonylureas, and may indicate glucose infusion as treatment.
      Next to insulin and sulfonylurea, ethanol is the most common cause of
      hypoglycaemia. In non-diabetics, hypoglycaemia will typically develop 6-24 h
      after a moderate or heavy intake of ethanol by a person who has had an
      insufficient intake of food for 1 or 2 days. Insulin-producing tumours,
      insulinomas and non-islet cell tumours may also be reasons for hypoglycaemia in
      non-diabetics. Treatment of mild episodes of hypoglycaemia is intake of fast
      absorbing carbohydrates. Severe episodes can be treated with either i.v. dextrose
      or glucagon injected i.m. or i.v. The glycaemic response and recovery of a normal
      level of consciousness is 1-2 min slower after glucagon than after glucose.

PMID- 1739396
TI  - Endocrine emergencies. Disorders of the adrenal cortex.
AB  - Adrenal crisis represents the major endocrine emergency with a fatal outcome if
      not properly recognized and correctly treated. It can present as the first
      manifestation of acute or chronic primary adrenal failure. Secondary adrenal
      insufficiency with usually less dramatic manifestations can cause mental
      disturbances, electrolyte or metabolic disorders severe enough to warrant prompt
      correction and therapeutic intervention. This is particularly true in cases of
      abrupt cessation of steroid treatment, pituitary apoplexy and Sheehan's syndrome.
      Hyperfunction of the adrenal cortex, be it hypercorticism or
      hypermineralocorticism, can also require rapid treatment of electrolyte disorders
      and hypertension. The symptoms and differential diagnosis of these entities are
      described as well as their proper treatment. In order to confirm later the
      diagnosis, the need to secure biological samples for hormone determination before
      starting treatment is emphasized.

PMID- 1739397
TI  - Pituitary gland emergencies.
AB  - Emergencies in pituitary disease are not common. They can result from the failure
      of the pituitary gland to secrete one or more pituitary hormones, or from neuro
      ophthalmological symptoms due to the mass effect of an expanding hypothalamic
      pituitary tumour. Loss of hormone secretion, particularly ACTH and, to a lesser
      extent, TSH, can rapidly become life-threatening and requires urgent replacement
      therapy. Acute severe hypopituitarism should be vigorously treated as an
      emergency with a glucocorticoid preparation. Neuro-ophthalmological symptoms such
      as visual impairment, sudden onset of severe headache and alteration of the level
      of consciousness should prompt appropriate radiological investigations, since
      this may well call for emergency surgery.

PMID- 1739398
TI  - Thyroid emergencies.
AB  - Thyroid storm is a rapid decompensation of severe hyperthyroidism which can best
      be described by the three criteria of hyperthermia, tachycardia and altered
      mental state with severe agitation. There has to be a precipitating factor such
      as infection, iodine contamination, surgery or even I-131 treatment. Severe
      hyperthyroidism not fulfilling the criteria of thyroid storm can also be an
      indication for emergency treatment, particularly in the elderly with heart
      disease. Suppressed serum TSH and elevated free T4 levels are essential to
      confirm the diagnosis. When rapidly available, radioiodine uptake of the thyroid
      can be useful. Therapy aims at rapidly reducing the active circulating hormone
      pool, hypermetabolic state, tachycardia, and finally hormone synthesis. Thyroid
      secretion can be blocked by ioipanoic acid or ipodate while hypermetabolic state
      can be reduced with beta-blockers or calcium channel-blockers. Treatment of
      hyperthyroidism in patients with iodine contamination is a real therapeutic
      challenge. Myxoedema coma, a complication of severe hypothyroidism, is defined by
      hypothermia (rectal temperature less than 36 degrees C), bradycardia, slow
      mentation, precipitating factor such as infection or drug overdose, and increased
      serum creatine phosphokinase levels. Diagnosis of severe hypothyroidism should be
      confirmed by serum measurements of TSH and free T4. Treatment consists of general
      supporting measures including rewarming, correction of serum electrolyte
      disturbances, and adequate alimentation. Thyroid hormone treatment should
      initially be aggressive using either 300-400 micrograms of T4 or 20-40 micrograms
      of T3 intravenously. Cortisone therapy may be added. Patients should be under
      close monitoring as arrhythmias and myocardial infarction are frequent
      complications of myxoedema coma and/or its treatment with thyroid hormones.

PMID- 1739399
TI  - Emergency treatment of Graves' ophthalmopathy.
AB  - The ocular emergencies encountered in Graves' ophthalmopathy, namely optic
      neuropathy, corneal ulceration, subluxation of the globe, and severe periorbital
      oedema with chemosis have been discussed. Evaluation of the clinical signs and
      symptoms of these conditions, as well as their treatment, have been outlined. Of
      particular concern is the complaint of 'blurry vision' that may indicate the
      presence of optic neuropathy. Early recognition of this entity, with prompt
      referral to an ophthalmologist is important because there is an inverse
      relationship between duration of visual loss and efficacy of treatment. The
      ophthalmological evaluation of a patient with optic neuropathy may demonstrate
      decreased visual acuity, impaired colour perception, or an afferent pupillary
      defect. In addition, a visual field examination may be a helpful adjunctive test.
      Available therapy for optic neuropathy includes high-dose corticosteroids,
      supervoltage X-irradiation and orbital decompressive surgery. We have reviewed
      the literature concerning these modalities and outlined our approach to the
      treatment of optic neuropathy. In general, we recommend orbital decompression at
      an early stage for this condition. Another worrisome complaint is of 'eye pain'.
      In this case, distinction must be made between the causes that include ocular
      inflammation, corneal keratitis and corneal ulceration. The corneal ulceration is
      characterized by extreme eye pain and erythema, and may require surgical
      intervention. Severe ocular inflammation may respond well to a course of high
      dose steroids. A combination of these ocular emergencies in a patient with
      Graves' ophthalmology necessitates careful consideration of the available
      treatment options.

PMID- 1739400
TI  - Studies on the activation of rat liver microsomal glutathione transferase in
      isolated hepatocytes.
AB  - The mechanism of activation of microsomal glutathione transferase in isolated
      liver cells by diisapropylidene acetone (phorone) was investigated. Phorone (1
      mM) causes a time-dependent increase (up to 2.6-fold) in the glutathione
      transferase activity of microsomes isolated from treated hepatocytes. Since
      phorone reacts with sulfhydryl groups, the possibility that this compound
      activated microsomal glutathione transferase directly was studied. It was found
      that neither the activity of the purified enzyme nor that in isolated microsomes
      is affected by phorone. It has been suggested [Masukawa T and Iwata H, Biochem
      Pharmacol 35: 435-438, 1986] that activation of microsomal glutathione
      transferase by phorone in vivo is mediated through thiol-disulfide interchange
      involving oxidized glutathione (GSSG). It is shown here that the glutathione
      transferase activity of isolated microsomes, which was increased by the addition
      of 10 mM GSSG, can be decreased to the basal level with 0.1 M dithioerythritol.
      Dithioerythritol, on the other hand, only marginally decreases the glutathione
      transferase activity in microsomes isolated from phorone-treated hepatocytes.
      This finding argues against a role for thiol-disulfide interchange in the
      activation of the enzyme by phorone. Furthermore, the glutathione depletion
      caused by phorone does not seem to be responsible for activation per se, since
      other thiol depletors [e.g. diethylmaleate (DEM)] do not affect the activity of
      the enzyme. Immunoblot analysis of microsomes isolated from phorone-treated
      hepatocytes did not reveal any partial proteolysis which might have accounted for
      the activation. It is suggested that activation of microsomal glutathione
      transferase by phorone proceeds through a mechanism which might reflect an in
      vivo regulation of this enzyme. Additional compounds which have been shown to
      activate the microsomal glutathione transferase in vivo were also tested and
      significant activation was obtained with 1,2-dibromoethane (1.4-fold) but not
      with DEM or carbon tetrachloride. Activation was also obtained with 1-chloro-2,4
      dinitrobenzene (CDNB) (1.6-fold) and to a small extent with t-butyl hydroperoxide
      (1.2-fold). The activation by 1,2-dibromoethane and CDNB is probably mediated
      through covalent binding, considering the known alkylating properties of these
      compounds. CDNB is the first substrate shown to activate the microsomal
      glutathione transferase implying that electrophilic compounds which are
      substrates can increase the rate of their own elimination by reacting with this
      enzyme. In addition, activation by t-butyl hydroperoxide indicates that oxidative
      stress can activate microsomal glutathione transferase.

PMID- 1739401
TI  - 1H NMR studies of reactions of copper complexes with human blood plasma and
      urine.
AB  - Reactions of the copper complexes Cu(II)Cl2, [Cu(II)(EDTA)]2-, [Cu(II)2(DIPS)4]
      and [Cu(I)(DMP)2]+ (where DIPS is 3,5-diisopropylsalicylate and DMP is 2,9
      dimethylphenanthroline) with human blood plasma and urine have been studied by
      500 MHz 1H NMR spectroscopy, and CD spectroscopy has been used to monitor the
      transfer of Cu(II) onto albumin in plasma. The rate of transfer of Cu(II) from
      [Cu(II)(EDTA)]2- onto albumin as measured by CD (T1/2 26 min, 0.5 mM Cu, 21
      degrees), was similar to the rate of Cu(II) binding to amino acids and citrate,
      and to the rate of formation of [Ca(II)(EDTA)]2- in plasma. Reactions of
      Cu(II)Cl2 and [Cu(II)2(DIPS)4] in plasma followed a similar course, but were more
      rapid. The latter complex also appeared to give rise to the displacement of
      lactate from protein binding. Reactions of copper complexes in plasma therefore
      involve a range of low Mr ligands as well as albumin, and the ligands play a
      major role in determining the kinetics of the reactions. These factors, as well
      as the partitioning of both complexes and displaced ligands into lipoproteins,
      are likely to play important roles in the molecular pharmacology of copper
      containing drugs. In urine, His and formate were involved in EDTA and DIPS
      displacement from their respective copper complexes, and peaks for free DIPS and
      [Ca(II)(EDTA)]2- were observed. The complex (Cu(I)(DMP)2]+ appeared to be
      relatively stable in both plasma and urine.

PMID- 1739402
TI  - Protective action of seven natural phenolic compounds against peroxidative damage
      to biomembranes.
AB  - The effects of seven phenolic compounds isolated from Salvia miltiorrhiza on
      peroxidative damage to liver microsomes, hepatocytes and erythrocytes of rats
      were studied. The results show that the seven compounds inhibited lipid
      peroxidation of rat liver microsomes induced by iron/cysteine and Vitamin
      C/NADPH. The hemolysis of rat erythrocytes induced by hydrogen peroxide was also
      inhibited. The degree of inhibition varied with different compounds. Among the
      seven compounds, the action of salvianolic acid A (Sai A) was the most potent.
      Therefore, the protective action of Sai A against peroxidative damage to isolated
      rat hepatocytes and their plasma membranes was evaluated further. Malondialdehyde
      (MDA) production and bleb of the surfaces of rat hepatocytes induced by
      iron/cysteine were prevented by Sai A. The production of MDA and the consumption
      of NADPH of the plasma membrane during lipid peroxidation initiated by
      iron/cysteine and Vitamin C/NADPH were also inhibited. The results strongly
      suggest that several phenolic compounds like Sai A have a protective action
      against peroxidative damage to biomembranes.

PMID- 1739403
TI  - Lactational transfer of 3,3',4,4'-tetrachloro- and 2,2',4,4',5,5'
      hexachlorobiphenyl induces cytochrome P450IVA1 in neonates. Evidence for a
      potential synergistic mechanism.
AB  - On the first day of lactation, material rats were treated with a single low dose
      of 5 mg/kg body weight of 3,3',4,4'-tetrachlorobiphenyl (TCB) or 2,2',4,4',5,5'
      hexachlorobiphenyl (HCB) or with a combination of both congeners. Lactational
      transfer of these polychlorinated biphenyls (PCBs) was found in neonates and
      significant increases in microsomal cytochrome P450, cytochrome b5 and in
      glutathione-S-transferase activity were observed. Treatment with HCB did not
      increase neonatal ethoxyresorufin-O-de-ethylation (EROD) activities whereas a
      more than 26-fold increase in EROD activity was noted in response to exposure to
      TCB. However, EROD activities were increased more than 65-fold in response to the
      combined exposure to TCB and HCB. Exposure via milk to TCB caused a significant
      reduction in the N-demethylation of aminopyrine, but the combined exposure to TCB
      and HCB produced a significant reduction in the N-demethylation of
      dimethylnitrosamine. Lactational transfer of either TCB or HCB reduced marginally
      peroxisomal enzyme activities; however, exposure to a combination of TCB and HCB
      resulted in the highly significant reduction in KCN-insensitive palmitoyl-CoA
      oxidation and acetyl-CoA oxidation. Contrary to the reduction of these enzyme
      activities, the specific concentrations of CYP4A1 were significantly increased
      when neonates were exposed to either TCB or HCB. The largest induction, however,
      was observed in response to the combined exposure to both PCBs. Evidence is
      presented to suggest an induction of CYP4A1 which may be independent of the
      molecular substitution pattern of the two PCBs used in our studies but on a
      possible mode of synergistic interaction.

PMID- 1739404
TI  - Cytotoxicity of ortho-phenylphenol in isolated rat hepatocytes.
AB  - The effects of ortho-phenylphenol (OPP) and its metabolites, phenyl-hydroquinol
      (PHQ) and phenyl-benzoquinone (PBQ), on isolated rat hepatocytes were
      investigated. Addition of OPP (0.5-1.0 mM) to cells caused a dose-dependent cell
      death accompanied by the depletion of intracellular levels of ATP, glutathione
      (GSH) and protein thiols. GSH loss correlated with the formation of oxidized GSH.
      In addition, PHQ and especially PBQ (both at 0.5 mM) resulted in acute cell death
      with rapid depletion of ATP, GSH and protein thiols, and further low doses of PBQ
      (10-50 microM) elicited serious impairment of mitochondrial functions related to
      oxidative phosphorylation and Ca fluxes in isolated liver mitochondria. These
      results indicate that mitochondria are a target for these compounds and that OPP
      is itself toxic to hepatocytes even when metabolism is inhibited. The loss of
      cellular GSH and protein thiols accompanied by the impairment of mitochondrial
      function may be the main mechanisms of cytotoxicity induced by OPP and its
      metabolites.

PMID- 1739405
TI  - Enzymology of the reduction of the potent benzotriazine-di-N-oxide hypoxic cell
      cytotoxin SR 4233 (WIN 59075) by NAD(P)H: (quinone acceptor) oxidoreductase (EC
      1.6.99.2) purified from Walker 256 rat tumour cells.
AB  - 3-Amino-1,2,4-benzotriazine-1,4-dioxide (SR 4233; WIN 59075) is a highly
      selective hypoxic cell cytotoxin soon to enter phase I clinical trial. The
      compound is thought to exert its action through a toxic one-electron reduced free
      radical intermediate. Preliminary data have suggested that SR 4233 may be
      metabolized by DT-diaphorase [NAD(P)H: (quinone acceptor) oxidoreductase (EC
      1.6.99.2)] to both two- and four-electron reduced products and that this route of
      biotransformation may represent a bioprotection pathway. In this study, a highly
      purified enzyme preparation was employed in order to investigate further the
      metabolism of SR 4233 by DT-diaphorase and to examine the mechanism of reduction
      in more detail. Spectrophotometric analysis showed that SR 4233 underwent
      reduction by DT-diaphorase with an apparent Km of 1.23 +/- 0.27 mM and Vmax of
      8.55 +/- 1.67 nmol/min/microgram protein. This reaction was inhibited completely
      by dicoumarol (100 microM) and partially by an antiserum raised against the
      purified enzyme. Characterization of the products of SR 4233 reduction by reverse
      phase HPLC confirmed that both two- (SR 4317) and four- (SR 4330) electron
      reduction products were generated, the latter being the predominant metabolite,
      particularly in prolonged incubations. Further experiments showed that the four
      electron reduction product, but not the two-electron reduction product, was also
      a substrate for DT-diaphorase with an apparent Km of 1.14 mM and a Vmax of 57.12
      nmol/min/micrograms protein. The results presented confirm that SR 4233 is indeed
      a substrate for DT-diaphorase and that a mixture of two-, four- and six-electron
      reduced products may be formed. The possible toxicological and pharmacodynamic
      significance of this metabolism is discussed.

PMID- 1739406
TI  - Medium chain length fatty acids stimulate triacylglycerol synthesis in tissue
      culture cells.
AB  - In the presence of undecanoic acid (C11) or lauric acid (C12) the synthesis of
      triacylglycerols was stimulated up to 10-fold both in tumor cell lines and in
      normal cell lines. Monocarboxylic acids of shorter or longer chain length either
      had no effect at all or were less effective. The increased triacylglycerol
      production was demonstrated, on the one hand, by the incorporation of
      radiolabeled glycerol into triacylglycerols and, on the other, by the
      incorporation of radiolabeled monocarboxylic acids, the incorporation of all (1
      14C)-labeled monocarboxylic acids (C6, C12, C16, C18) regardless of their chain
      length, being preferentially enhanced by C11 and C12. C12 stimulated the de novo
      synthesis of triacylglycerols to such a degree that a 7-fold increase in the
      total amount of triacylglycerols per cell was observed during the first 10 hr of
      incubation. After removal of C12 from the tissue culture medium levels of
      triacylglycerols reach initial values again within 6 hr, indicating that the
      stimulatory effect of C12 is dependent on its continued presence. This led to the
      speculation that medium chain length monocarboxylic acids might be involved in
      the control of triacylglycerol synthesis.

PMID- 1739407
TI  - Inhibition of melanogenesis by BMY-28565, a novel compound depressing tyrosinase
      activity in B16 melanoma cells.
AB  - The mechanism of a novel melanin synthesis inhibitor, BMY-28565, was studied
      using mouse B16 melanoma cells. This compound was active in depressing the
      intracellular accumulation of melanin with an IC50 of 5 microM. At dose levels
      causing no cytotoxicity, the melanolytic effect of this compound was correlated
      strongly with depression of the enzymatic activity of tyrosinase (monophenol
      oxygenase, EC 1.14.18.1), the key enzyme in the melanin synthesis pathway.
      Transcription of the tyrosinase gene was not inhibited by BMY-28565, as
      determined by RNA blotting analysis. BMY-28565 and three other active derivatives
      of this compound caused increased glycosylation of proteins in B16 melanoma
      cells, as assessed by radioactive mannose incorporation. It is, thus, suggested
      that the mechanism of inhibition of tyrosinase might be related to modifications
      of the sugar moiety of this enzyme or of a protein(s) that is essential for the
      expression of its enzymatic activity.

PMID- 1739408
TI  - Substrate specificity of human deoxycytidine kinase toward antiviral 2',3'
      dideoxynucleoside analogs.
AB  - Deoxycytidine (dCyd) kinase has been purified to homogeneity from human leukemic
      spleen, and the capacity of the enzyme to phosphorylate 2',3'-dideoxynucleoside
      (ddN) analogs that are clinically effective inhibitors of human immunodeficiency
      virus (HIV) replication was evaluated. Cytosine-containing ddN analogs, such as
      2',3'-dideoxycytidine, 2',3'-dideoxy-2',3'-dehydrocytidine, and cytallene, were
      efficiently phosphorylated by dCyd kinase, while no phosphorylation of purine
      containing ddN analogs was detected. dCyd kinase was completely inactive toward
      2',3'-dideoxyadenosine (ddAdo), 2',3'-dideoxyinosine, 2',3'-dideoxyguanosine, and
      adenallene, although it was capable of phosphorylating both 2'-deoxyadenosine
      (dAdo) and 2'-deoxyguanosine (dGuo). The abilities of wild type and mutant human
      T lymphoblastoid CEM cells to accumulate ddAdo in situ and in vitro were also
      ascertained. Comparison of the abilities of intact wild type CEM cells and
      derivatives deficient in nucleoside transport, dCyd kinase, and/or adenosine
      (Ado) kinase to accumulate [3H]ddAdo-derived radioactivity revealed no
      significant differences among the wild type and mutant strains. However, ddAdo
      phosphorylating activity was decreased in extracts from Ado kinase-deficient
      cells but not in lysates prepared from cells genetically deficient in dCyd kinase
      activity. In comparative growth rate experiments, wild type, nucleoside transport
      deficient, and dCyd kinase-deficient CEM cells were equally sensitive to ddAdo
      toxicity, while, interestingly, a deficiency in Ado kinase correlated with a 5
      fold decreased growth sensitivity to the purine ddN. Insertion of an adenine
      phosphoribosyltransferase deficiency into the CEM cell lines did not influence
      ddAdo toxicity or incorporation rate. These results imply that Ado kinase may be
      an important factor in ddAdo phosphorylation by CEM cells. Furthermore, these
      studies demonstrate that cytosine- and purine-containing ddNs are transported and
      activated by independent pathways and, therefore, have important implications for
      anti-HIV therapy in that pyrimidine and purine ddNs might be used in combination
      for the treatment of acquired immunodeficiency syndrome.

PMID- 1739409
TI  - Enzymic N-demethylation reaction catalysed by red blood cell cytosol.
AB  - Red blood cell cytosol promotes enzymic N-demethylation reactions which display
      typical Michaelis-Menten kinetics with respect to N-methylaniline as substrate.
      The demethylase activity is linked with hemoglobin (Hb) and is enhanced in the
      presence of NADH and the NADH-methemoglobin reductase system. It has been adduced
      that Hb in its oxygenated form is involved in the reaction.

PMID- 1739410
TI  - Interaction of phomopsin A with porcine brain tubulin. Inhibition of tubulin
      polymerization and binding at a rhizoxin binding site.
AB  - Phomopsin A is an antimitotic cyclic peptide containing a 13-member ring
      including an ether linkage. It was isolated from the fungus Phomopsis
      leptostromiformis as the causal agent of lupinosis. Phomopsin A strongly
      inhibited microtubule assembly (IC50: 2.4 microM). Our study using radiolabeled
      phomopsin A, prepared biosynthetically by feeding L-[U-14C]isoleucine to the
      culture of P. leptostromiformis, indicated that at least two binding sites of
      phomopsin A exist on tubulin on the basis of a Scatchard analysis; i.e. the
      dissociation constants of a high affinity site (Kd1) and a low affinity site
      (Kd2) at 37 degrees were determined to be 1 x 10(-8) and 3 x 10(-7) M,
      respectively. Phomopsin A inhibited the binding of radiolabeled rhizoxin to
      tubulin with an inhibition constant (Ki) of 0.8 x 10(-8) M. This showed that the
      high affinity site of phomopsin A is identical to the rhizoxin binding site. The
      binding of the radiolabeled phomopsin A was also inhibited by rhizoxin and
      ansamitocin P-3, with an inhibition constant of 10(-7) M, and to a lesser extent
      by vinblastine. Phomopsin A had no inhibitory effect on colchicine binding to
      tubulin.

PMID- 1739411
TI  - Biotransformation of caffeine and theophylline in mammalian cell lines
      genetically engineered for expression of single cytochrome P450 isoforms.
AB  - Primary steps in the metabolism of caffeine and theophylline are cleavage of
      methyl groups and/or hydroxylation at position 8, mediated by cytochromes P450.
      V79 Chinese hamster cells genetically engineered for stable expression of single
      forms of rat cytochromes P450IA1, P450IA2 and P450IIBI and human P450IA2 and rat
      liver epithelial cells expressing murine P450IA2 were used to overcome problems
      arising in the proper allocation of metabolic pathways to specific isoforms by
      conventional techniques. These cell lines were exposed to caffeine and/or
      theophylline, and concentrations of metabolites formed in the medium were
      determined by HPLC. Caffeine was metabolized by human, rat and murine P450IA2,
      resulting in the formation of four primary demethylated and hydroxylated
      metabolites. However, there were differences in the relative amounts of the
      metabolites. The human and the mouse P450IA2 isoforms predominantly mediated 3
      demethylation of caffeine. The rat cytochrome P450IA2 mediated both 3
      demethylation and 1-demethylation of caffeine to a similar extent. Theophylline
      was metabolized mainly via 8-hydroxylation. All cell lines tested were able to
      carry out this reaction, with highest activities in cell lines expressing rat or
      human P450IA2, or rat P450IA1. These results support the hypothesis that caffeine
      plasma clearance is a specific in vivo probe for determining human P450IA2
      activity.

PMID- 1739412
TI  - Enhancement of ethanol-induced lipid peroxidation in rat liver by lowered
      carbohydrate intake.
AB  - In order to investigate the effect of carbohydrate intake on ethanol-induced
      lipid peroxidation and cytotoxicity, rats were maintained on four different test
      diets, a medium-carbohydrate (carbohydrate intake, 8.4 g/day/rat on average), a
      low-carbohydrate (carbohydrate intake, 2.8 g/day/rat on average), an ethanol
      containing medium-carbohydrate (carbohydrate and an ethanol intake, 8.4 and 2.9
      g/day/rat on average, respectively), and an ethanol-containing low-carbohydrate
      diet (2.8 and 2.9 g/day/rat on average, respectively). Ethanol and the low
      carbohydrate diet each increased the liver malondialdehyde content, but the
      combined effect of both (ethanol-containing low-carbohydrate diet) was much more
      prominent than either alone. The degree of increase in malondialdehyde content
      almost paralleled the activity of the microsomal ethanol oxidizing system. Both
      the low-carbohydrate and the ethanol-containing low-carbohydrate diets decreased
      the liver glutathione content, but ethanol combined with the medium-carbohydrate
      diet had no effect on the content. Ethanol treatment increased the liver
      triglyceride content only when combined with the low-carbohydrate diet. The rate
      of NADPH-dependent microsomal malondialdehyde formation was much higher in
      microsomes from rats maintained on the ethanol-containing low-carbohydrate diet
      than in those from rats on the ethanol-containing medium-carbohydrate diet,
      indicating that lowered carbohydrate intake augments ethanol-induced
      malondialdehyde accumulation in the liver by enhancing the rate of lipid
      peroxidation. In addition, when incubated with red blood cells in the presence of
      NADPH, microsomes from rats fed the ethanol-containing low-carbohydrate diet
      caused marked hemolysis, which was prevented by the addition of 5 mM glutathione
      to the incubation system. Furthermore, addition of 50 mM ethanol to the reaction
      system greatly accentuated the hemolysis. These results suggest that lowered
      carbohydrate intake at the time of ethanol consumption potentiates ethanol
      cytotoxicity by enhancing ethanol-induced lipid peroxidation.

PMID- 1739413
TI  - A comparative study on the contribution of cytochrome P450 isozymes to metabolism
      of benzene, toluene and trichloroethylene in rat liver.
AB  - The contribution of P450IIE1, P450IIC11/6, P450IIB1/2 and P450IA1/2 to the
      formation of chloral hydrate (CH) from trichloroethylene (TRI) was investigated
      in microsomes from control, ethanol-, phenobarbital (PB)- and 3
      methylcholanthrene (MC)-treated rats using monoclonal antibodies (MAbs) to the
      respective P450 isozymes, and compared with their roles in benzene and toluene
      metabolism. Anti-P450IIE1 inhibited the formation of CH from TRI more strongly in
      microsomes from ethanol-treated rats than in microsomes from control rats at low
      concentration of TRI when net inhibition was compared. Anti-P450IIC11/6 inhibited
      CH formation in microsomes from control and PB-treated rats at high, not low,
      concentration of TRI, but the net inhibition in control microsomes was less than
      that due to anti-P450IIE1. Anti-P450IIB1/2 and anti-P450IA1/2 also inhibited CH
      formation from TRI in microsomes from PB- and MC-treated rats, respectively,
      stronger at high substrate concentration than at low concentration. These results
      indicate that P450IIE1, P450IIC11/6, P450IIB1/2 and P450IA1/2 are involved in the
      metabolic step from TRI to CH, and the first isozyme may be a low-Km TRI oxidase
      and the others high-Km one. Comparing the contributions of four isozymes to
      benzene, toluene and TRI metabolism, all four acted in the metabolism of these
      compounds, but P450IIE1 did not catalyse o-cresol formation nor P450IA1/2 benzyl
      alcohol formation from toluene, suggesting regioselectivity of toluene metabolism
      in the action of these two isozymes. The contribution of P450IIE1 in benzene and
      TRI oxidation was greater than that of P450IIC11/6, but the reverse was seen with
      respect to benzyl alcohol formation from toluene, indicating that P450IIC11/6 is
      relatively inactive towards benzene and TRI oxidation, but is primarily involved
      in toluene metabolism. P450IIB1/2 and P450IIC11/6 attacked all the metabolic
      positions studied, but only in the side-chain metabolism of toluene was their
      contribution significant, suggesting that these two isozymes are quite similar in
      function.

PMID- 1739414
TI  - Selective modulation of glutathione in mouse brain regions and its effect on
      acrylamide-induced neurotoxicity.
AB  - Selective modulation of brain glutathione (GSH) may assist the elucidation of the
      role of GSH in the central nervous system. Subcutaneous administration of diethyl
      maleate (DEM) depleted both cerebral and hepatic GSH in a dose- and time
      dependent manner. While hepatic GSH levels returned to control levels 6 hr after
      DEM administration, brain GSH levels remained significantly lowered for up to 12
      hr after administration of DEM. However, intrathecal administration of DEM
      resulted in a selective lowering of brain GSH without altering hepatic levels.
      Intrathecal administration of L-buthionine sulfoximine (L-BSO; 1.0 mmol/kg body
      wt) also depleted the GSH content of the brain and the levels remained low 24 hr
      after L-BSO administration. The extent of GSH depletion varied in different
      regions of the brain; maximal depletion was observed in the brainstem, followed
      by the cerebellum, striatum, cortex and hippocampus. Intrathecal administration
      of L-2-oxothiazolidine 4-carboxylate (OTC) resulted in a marginal elevation of
      GSH levels in the brain. There was considerable regional variation. A maximal
      elevation of 134% was seen in the hippocampus, 6 hr following the intrathecal
      administration of 8.0 mmol of OTC/kg body wt. The effect of the modulation of
      brain GSH levels on acrylamide (ACR)-induced neurotoxicity was examined.
      Depletion of GSH by pretreatment of mice with L-BSO or DEM (administered
      intrathecally) enhanced the toxicity of ACR as measured by the inhibition of
      brain glyceraldehyde-3-phosphate dehydrogenase (GAPDH) activity. The inhibition
      of GAPDH by ACR was attenuated by pretreatment of animals with OTC. Thus, brain
      GSH may play an important role in the detoxification of xenobiotics, in situ
      within the central nervous system.

PMID- 1739415
TI  - The effect of budesonide and triamcinolone acetonide on hepatic microsomal
      testosterone metabolism in the rat.
AB  - The hepatic microsomal metabolism of testosterone was studied in male rats after
      treatment with either budesonide or triamcinolone acetonide for 13 weeks. The in
      vitro metabolism was determined using a testosterone concentration of 35 nM which
      is comparable to the levels found in plasma. It was shown that the total
      microsomal testosterone metabolism was decreased in budesonide-treated rats and
      increased in rats treated with triamcinolone acetonide. The testosterone
      metabolites produced were measured and thus it was revealed that budesonide
      treatment brought about its effect through a 50% decrease in the activity of
      steroid 5 alpha-reductase, but did not affect other reductive enzymes, or the
      oxidation of testosterone. Triamcinolone acetonide treatment decreased steroid 5
      alpha-reductase activity by 95% and also decreased the activities of steroid 3
      alpha- and 3 beta-reductases by more than 90%. In addition, treatment with
      triamcinolone acetonide caused a 50% increase in the oxidative metabolism of
      testosterone, which resulted in the observed increase in total testosterone
      metabolism. The presence of 0.1 microM budesonide in the microsomal incubations
      was without effect on testosterone metabolism. However, 0.1 microM triamcinolone
      acetonide inhibited testosterone oxidation by 65%, without affecting the
      reductive pathway of testosterone metabolism.

PMID- 1739416
TI  - The mechanism of action and mode of inhibition of dihydroorotate dehydrogenase. A
      quantum chemical study.
AB  - Semiemperical quantum chemical calculations have been applied to study the
      reaction mechanism and mode of inhibition of dihydroorotate dehydrogenase. The
      structure of substrate, intermediate, product and various inhibitors of
      dihydroorotate dehydrogenase were optimized using MNDO method and the geometry,
      heat of formation and the net atomic partial charges of optimized molecules, as
      well as the energy of the reaction path were calculated. This study shows that
      the carbanion intermediate of this reaction is rather stable (heat of formation =
      -134.5 kcal) and readily forms upon nucleophilic attack by groups such as
      hydroxyl ion. There is good correlation between electronic properties and the
      biological activities of various inhibitors of this enzyme and the geometry of
      the most active inhibitor resembles closely that of the intermediate of the
      reaction. Therefore, it is concluded that the enzymatic oxidation of
      dihydroorotate dehydrogenase proceeds via formation of an intermediate and the
      inhibitors bind to the active site of this enzyme in the place of this
      intermediate.

PMID- 1739417
TI  - Effect of anthelmintics on the antioxidant system of Nippostrongylus
      brasiliensis.
AB  - To understand the mode of anthelmintic action of thiabendazole and methyl-[5-[[4
      (2-pyridinyl)-l-piperazinyl]carbonyl]-1H-benzimidazole- 2-yl] carbamate (C.D.R.I.
      compound 81/470) against Nippostrongylus brasiliensis, their effect on the
      metabolism of reactive oxygen species in the parasite as well as in rat intestine
      was examined. Both drugs produced a significant depression in the levels of
      superoxide dismutase (SOD) and reduced glutathione (GSH) of the parasite. Release
      of antioxidant enzymes by the drug-treated worms was also found to be appreciably
      lowered. Both thiabendazole and compound 81/470 induced a depression in the
      levels of all five constituents of the antioxidant system of rat intestine but
      significant alterations were detected only in the GSH content of infected and the
      SOD activity of normal intestine. The production of O2- by treated intestine was,
      on the other hand, markedly enhanced. Increased formation of O2- by the host
      intestine accompanied with the reduced level of SOD and GSH in N. brasiliensis
      appear to have a deleterious effect on the parasite. Consequently, the drug
      treated worms are unable to retain themselves in situ and are ultimately
      expelled. The greater effect produced on these parameters by thiabendazole
      compared to compound 81/470 is consistent with the relative efficacy of these
      anthelmintics.

PMID- 1739418
TI  - Irreversible inhibition of thromboxane (TX) A2 synthesis by Y-20811, a selective
      TX synthetase inhibitor.
AB  - As Y-20811, sodium (+-)-4-[alpha-hydroxy-5-(1-imidazolyl)-2-methylbenzyl]-3,5
      dimethylb+ ++ enzoic acid, has been reported to inhibit serum thromboxane (TX) A2
      production with a long duration of action, its mechanism of action was
      investigated. When [3H]Y-20811 (3 mg/kg) was administered orally to rats, the
      peak platelet concentration of Y-20811 was obtained 1 hr after the
      administration, and the T1/2 was 43 hr. The peak plasma concentration of Y-20811
      was also obtained 1 hr after administration, but the elimination of Y-20811 from
      plasma was faster (T1/2 alpha = 1.5 hr, T1/2 beta = 15 hr) than that observed in
      platelets. Serum TXA2 (estimated as TXB2) production was inhibited significantly
      from 1 to 72 hr after the oral administration of unlabeled Y-20811 (3 mg/kg),
      which temporally resembled the change of the platelet Y-20811 concentration. In
      platelet-rich plasma, [3H]Y-20811 completely inhibited TXA2 production at about
      1500 pg/10(9) platelets, and the IC50 level was about 600 pg/10(9) platelets,
      which was similar to values obtained in ex vivo studies. In addition, inhibition
      of TXA2 production by Y-20811 still remained after washing the drug-pretreated
      microsomes, whereas that of dazoxiben completely disappeared. A similar
      irreversible inhibition of TXA2 production was observed with aspirin. These
      results suggest that Y-20811 may firmly combine with platelet TX synthetase and
      may irreversibly inhibit TXA2 production.

PMID- 1739419
TI  - Inhibition of a type B monoamine oxidase inhibitor, (E)-2-(4-fluorophenethyl)-3
      fluoroallylamine (MDL-72974A), on semicarbazide-sensitive amine oxidases isolated
      from vascular tissues and sera of different species.
AB  - (E)-2-(4-Fluorophenethyl)-3-fluoroallylamine hydrochloride (MDL-72974A) has been
      discovered recently to be a very potent and highly selective type B monoamine
      oxidase inhibitor. We have found that this inhibitor is also capable of
      inhibiting semicarbazide-sensitive amine oxidases (SSAOs) obtained from vascular
      tissues and sera of different species. The inhibition of SSAO by MDL-72974A was
      irreversible and time dependent. It was competitive without preincubation of the
      enzyme with the inhibitor and demonstrated a mixed-type of inhibition when the
      enzyme was preincubated with the inhibitor. The IC50 values were estimated to be
      2 x 10(-9) M, 5 x 10(-9) M, 8 x 10(-8) M and 2 x 10(-8) M for SSAO from dog
      aorta, rat aorta, bovine aorta and human umbilical artery, respectively. SSAO
      obtained from bovine serum was relatively insensitive to MDL-72974A (IC50 = 3 x
      10(-7) M. Following intraperitoneal administration of MDL-72974A, rat brain MAO-B
      was inhibited with the ED50 value being about 0.2 mg/kg. Rat aorta SSAO was also
      inhibited and to a similar extent by the same dose. MDL-72974A is the most potent
      SSAO inhibitor that has been described thus far.

PMID- 1739420
TI  - Purification of the human blood platelet thromboxane A2/prostaglandin H2 receptor
      protein.
AB  - The human platelet thromboxane A2/prostaglandin H2 receptor has been purified
      6100-fold to apparent homogeneity by a three-step chromatographic procedure with
      an overall yield of 6%. A 6-fold purification of the receptor was first achieved
      by chromatography of 3-[(3-cholamidopropyl)dimethyl-ammonio]-1-propanesulfonate
      (CHAPS)-solubilized membrane proteins from human platelets on a diethylaminoethyl
      (DEAE)-Sepharose column. The DEAE eluate fractions containing receptor activity
      were then applied to a newly developed affinity column using the cyclohexyl
      derivative of SQ30,741 (SQ31,491) as the immobilized ligand. Elution of the
      receptor from the affinity column with BM13.177 yielded a further purification of
      1700-fold. An additional 4-fold receptor purification from the affinity column
      eluate was achieved by HPLC using GPC 500 and GPC 100 columns connected in
      tandem. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and silver
      staining of the HPLC eluate containing purified receptor revealed a single,
      distinct band with a molecular weight of 55,000. The receptor binding activity
      was detected with [3H]SQ29,548 using a newly developed binding assay which
      involved immobilization of the receptor on polyethyleneimine-treated glass fiber
      filters. The binding of [3H]SQ29,548 to the purified receptor was time dependent,
      saturable, reversible and highly specific. Unlabeled SQ29,548, BM13.505, and
      U46619 (but not thromboxane B2 or 6-keto prostaglandin F1 alpha) competed for
      [3H]SQ29,548 binding to the purified receptor in a concentration-dependent
      manner. Scatchard analysis of [3H]SQ29,548 binding to the purified receptor
      revealed the presence of a single class of high-affinity binding sites, with a Kd
      of 4 nM and a Bmax of 17 nmol/mg protein.

PMID- 1739421
TI  - Effect of etomoxiryl-CoA on different carnitine acyltransferases.
AB  - The effects of etomoxiryl-CoA on purified carnitine acyltransferases and on
      carnitine acyl-transferases of rat heart mitochondria and rat liver microsomes
      were determined. At nanomolar concentrations, the data agreed with that of other
      investigators who have shown that etomoxiryl-CoA must be binding to a high
      affinity site with specific inhibition of mitochondrial carnitine
      palmitoyltransferase (CPTo). Micromolar amounts of etomoxiryl-CoA inhibited both
      short- and long-chain carnitine acyltransferases. The concentrations of
      etomoxiryl-CoA required for 50% inhibition of the different carnitine
      acetyltransferases and microsomal and peroxisomal carnitine octanoyltransferase
      were in the low micromolar range. Mixed-type and uncompetitive inhibition
      kinetics were obtained, depending on the source of purified enzyme. When purified
      rat heart CPT was incubated with etomoxiryl-CoA, it increased the K0.5 and
      decreased the Hill coefficient for acyl-CoA. Both proteins and phospholipids of
      mitochondria and microsomes formed covalent adducts of [3H]etomoxir, with the
      predominant labeling in phospholipids. None of the purified enzymes formed
      covalent adducts when incubated with [3H]etomoxiryl-CoA, in contrast to intact
      mitochondria or microsomes. The major 3H-labeled protein for rat heart
      mitochondria had a molecular weight of 81,000 +/- 4000, and the major proteins
      from microsomes had a molecular weight of 51,000-57,000. Malonyl-CoA prevented
      most of the tritum incorporation into the 81,000 Da protein of mitochondria, but
      it had little effect on incorporation of tritiated etomoxir into the 51,000
      57,000 Da proteins of microsomes. When 50 microM etomoxiryl-CoA was added to
      microsomes and to mitochondria that had been incubated with radioactive
      etomoxiryl-CoA, much of the radioactive etomoxir disappeared from the major
      microsomal proteins, but virtually none was displaced from the mitochondrial
      protein. Thus, at least two different types of covalent etomoxir complexes were
      formed. This pulse-chase experiment showed that the mitochondrial protein
      etomoxir complex was not turned over, consistent with other data showing that
      etomoxir inhibited carnitine palmitoyltransferase. In contrast, the major protein
      etomoxir complex in microsomes was turned over during the pulse-chase experiment.

PMID- 1739422
TI  - Biochemical characterization of coumarin 7-hydroxylase activity in chick embryo
      liver microsomes.
AB  - Coumarin occurs naturally in the diet and can induce and inhibit cytochrome P450
      enzymes. Hepatic coumarin 7-hydroxylase activity is the major pathway for
      coumarin metabolism in humans but not in rats, most strains of mice, or other
      laboratory animals. Coumarin 7-hydroxylase activity and the effects of chemical
      inhibitors and inducers on this activity were studied in 19-day-old chick embryo
      liver microsomes. Activity was between 35 and 75 nmol/mg protein/hr which is
      approximately 2-fold higher than reported for human liver microsomes. The pH
      optimum was 7.8 and the Km determined by both an ether extraction and a high
      performance liquid chromatography method was 7.3 +/- 0.9 (+/- SD) microM.
      Substrate inhibition was evident at coumarin concentrations above 250 microM
      (activities at 1000 and 4000 microM coumarin were 84 and 40% of Vmax,
      respectively). The Ki values (+/- SD) for inhibitors of microsomal coumarin 7
      hydroxylase activity in vitro were: alpha-naphthoflavone, 46.9 +/- 19.8 nM;
      metyrapone, 0.8 +/- 0.9 microM; aniline, 12.3 +/- 8.2 microM; cimetidine, 70.9 +/
      27.9 microM; N-nitrosodimethylamine, 0.7 +/- 0.9 mM; and dimethyl sulfoxide, 7.9
      +/- 1.9 mM. Treatment of chick embryos with pyrazole (40 mumol) increased
      coumarin 7-hydroxylase by 50% at 24 hr, but this activity was unaffected by
      treatment of embryos with 3-methylcholanthrene (2 mumol) or glutethimide (8
      mumol). Thus, hepatic coumarin 7-hydroxylase activity in 19-day-old chick embryos
      is higher than in most laboratory animals and has similar biochemical properties
      as the enzyme in humans and mice. The chick embryo liver may be a useful system
      for studies on the biochemical effects of coumarin and the regulation of
      cytochrome P450-dependent coumarin 7-hydroxylase.

PMID- 1739423
TI  - Increased sterigmatocystin-induced mutation frequency in Saccharomyces cerevisiae
      expressing cytochrome P450 CYP2B1.

PMID- 1739424
TI  - In vitro inhibition studies of the glucuronidation of 3'-azido-3'-deoxythymidine
      catalysed by human liver UDP-glucuronosyl transferase.

PMID- 1739425
TI  - B-G: we know what it is, but what does it do?
AB  - B-G molecules are polymorphic cell surface proteins that are encoded by the
      chicken MHC. Here, Jim Kaufman and Jan Salomonsen briefly summarize developments
      in the molecular genetics, the structure and the tissue distribution of B-G
      molecules, and discuss possible functions of this intriguing multigene family.

PMID- 1739426
TI  - The immune system evolved to discriminate infectious nonself from noninfectious
      self.
AB  - Here, Charles Janeway argues that the requirement for two signals to initiate the
      adaptive immune response may reflect the evolutionary history of host defences.
      Early phases of host defence involve receptors and ligands that may have
      controlled immune responses prior to the development of clonally-distributed
      receptors encoded in rearranging genes. The former receptors persist in
      contemporary vertebrates both to trigger innate or nonclonal responses and to
      signal to lymphocytes that a particular antigen is associated with a
      microorganism.

PMID- 1739427
TI  - Germinal centres in T-cell-dependent antibody responses.
AB  - For more than a century follicles have been recognized as a site of intense cell
      proliferation and cell death. At last the significance of this activity is
      beginning to emerge: antigen-driven B-cell proliferation, somatic mutation,
      positive and negative selection, and memory and plasma cell development all
      appear to take place within the follicle.

PMID- 1739428
TI  - Helix-loop-helix proteins in the regulation of immunoglobulin gene transcription.
AB  - Transcriptional control of the Ig heavy chain and kappa light chain is dominated
      by single enhancers located within the body of each gene. These enhancers bind
      distinct, yet overlapping, sets of cell-type-specific and ubiquitous nuclear
      proteins. This review focuses on one particular subclass of enhancer-binding
      protein, termed helix-loop-helix (HLH) proteins, describing their role in the
      establishment of cell-type-specific transcription and suggesting how they may be
      regulated during B-cell maturation.

PMID- 1739429
TI  - Science training for European journalists.

PMID- 1739430
TI  - HIV and idiotypic T-cell regulation: another view.

PMID- 1739431
TI  - Progress in primary immunodeficiency.
AB  - Clinically, primary immunodeficiencies can be grouped into several well-defined
      syndromes. This consistent clinical picture, however, belies the enormous
      complexity of lymphocyte maturation and activation, and it has long been
      suspected that numerous distinct underlying defects give rise to primary
      immunodeficiencies. At a recent workshop, the molecular and genetic
      characterization of a handful of such defects provided tacit support for such
      suspicions.

PMID- 1739432
TI  - Primary structure and characterization of the precursor to human pituitary
      adenylate cyclase activating polypeptide.
AB  - Human cDNAs encoding the precursor to pituitary adenylate cyclase activating
      polypeptide (PACAP) were cloned from human testis and cerebral cortex cDNA
      libraries. Nucleotide sequencing revealed that cDNA from the testis library
      encoded the entire precursor for PACAP, while cDNA from the brain library
      represented only the carboxy-terminal half of the precursor. The predicted human
      PACAP precursor consisted of 176 amino acid residues and was very similar to the
      ovine one (82%). Both human and ovine precursors contained both PACAP and another
      peptide, PACAP-related peptide (PRP), having 29 amino acids. PACAP and PRP were
      preceded and followed by paired basic amino acids, recognized as important for
      post-translational processing. The PACAP precursor resembles the vasoactive
      intestinal peptide (VIP) precursor, which contains VIP and peptide histidine
      methionine/isoleucine amide (PHM/PHI). Structurally, PRP had some similarity to
      PHM/PHI, growth hormone-releasing hormone (GRH) and PACAP. Northern blot analysis
      indicated that a 3.0-kb transcript was expressed in the ovine hypothalamus.
      Tissue distribution of PACAP mRNA was also clarified in the rat. Southern blot
      analysis of human genomic DNA gives single bands with six restriction enzymes,
      indicating that a single copy of the PACAP gene is contained in a haploid genome.
      The cDNA for human PACAP precursor was expressed using COS-7 and Chinese hamster
      ovary (CHO) cells. Immunoreactive PACAP was secreted into the culture media of
      both transfected cell lines.

PMID- 1739433
TI  - The mouse intestinal fatty acid binding protein gene: nucleotide sequence,
      pattern of developmental and regional expression, and proposed structure of its
      protein product.
AB  - The rat intestinal fatty acid binding protein (I-FABP) gene has been used as a
      model to study temporal and spatial differentiation of the gut epithelium while
      its protein product has been used as a model for examining the atomic details of
      noncovalent fatty acid-protein interactions. We have isolated the mouse I-FABP
      gene (Fabpi) and determined its nucleotide sequence. Comparisons of the
      orthologous mouse, rat, and human I-FABP genes revealed three conserved domains
      in their otherwise divergent 5' nontranscribed sequences. RNA blot hybridization
      and multilabel immunocytochemical methods were used to compare the developmental
      stage-specific patterns of activation of the rat and mouse genes. In addition,
      Fabpi expression in enterocytes was examined as a function of their
      differentiation along the crypto-to-villus and duodenal-to-colonic axes of the
      small intestine. Based on the similar temporal and geographic patterns of mouse
      and rat I-FABP expression described here and the results of our earlier studies
      of transgenic mice containing rat Fabpi/human growth hormone fusion genes, we
      propose that one of the conserved domains, spanning nucleotides -500 to -419 in
      mouse Fabpi, and/or a 14-bp element, are necessary for establishing and
      maintaining its region-specific expression along the duodenal-to-colonic axis of
      the perpetually renewing gut epithelium. Finally, predictions of the structure of
      mouse I-FABP using the refined 2.0 A model of rat I-FABP, suggest that a proline
      found at position 69 of the mouse, but not rat, protein may affect its ligand
      binding properties.

PMID- 1739434
TI  - Primary structure of the ribosomal DNA intergenic spacer from the mosquito, Aedes
      albopictus.
AB  - We have determined the primary structure of a 4.7-kb portion of the ribosomal DNA
      intergenic spacer from cultured cells of the mosquito, Aedes albopictus.
      Immediately upstream from the 18S rRNA gene was a 753-bp sequence containing two
      regions similar to known RNA polymerase I promoters, each preceded by potential
      transcription termination signals. Upstream from this putative promoter region
      was a 3.15-kb tandem array of 17 direct repeats with a consensus sequence length
      of 201 bp. The 201-bp repeats contained imperfect antisense duplications of 11-bp
      core domain regions in the putative RNA polymerase I promoters, and sequences of
      possible significance in recombination. Farthest upstream of the 18S rRNA gene
      was an 803-bp region containing two copies each of 34-, 48-, and 64-bp elements
      separated by apparently unique sequence. This first detailed structural analysis
      of a ribosomal DNA intergenic spacer from a member of the lower Diptera has
      revealed features similar to those described for the higher Diptera as well as
      conserved motifs presumably critical to rRNA transcription.

PMID- 1739435
TI  - Isolation and characterization of eft-1, an elongation factor 2-like gene on
      chromosome III of Caenorhabditis elegans.
AB  - A gene (eft-1) encoding an elongation factor 2-like protein was isolated from a
      region adjacent to the polyubiquitin gene, ubq-1, of Caenorhabditis elegans.
      Sequence analysis of genomic and cDNA clones revealed that the deduced amino acid
      sequence of the protein (EFT-1) is 38% identical to that of mammalian and
      Drosophila elongation factor 2 (EF-2). The entire eft-1 gene is approximately 3.8
      kb in length and contains 5 exons separated by short introns of 46-75 bp. The
      2,547-bp open reading frame predicts a protein of 849 amino acid residues
      (calculated Mr, 96,151). Conserved sequences shared among a variety of GTP
      binding proteins including EF-2 are found in the amino-terminal third of EFT-1.
      The carboxy-terminal half contains regions with 40-57% similarity (including
      conservative changes) with segments characteristic of EF-2 and its prokaryotic
      homolog, EF-G. However, the histidyl residue target for ADP-ribosylation of EF-2
      by diphtheria toxin is replaced by tyrosine in EFT-1. Southern and Northern blot
      analyses indicate that eft-1 is a single-copy gene that is expressed at all
      stages of nematode development. Amplification of fragments encoding highly
      conserved regions of EF-2 using the polymerase chain reaction led to the
      isolation of a fragment encoding the modifiable histidyl residue and which likely
      represents part of the C. elegans EF-2 gene (eft-2). This suggests that EFT-1 is
      not the C. elegans homolog of EF-2, but a closely related protein.

PMID- 1739436
TI  - An improved CAT assay for promoter analysis in either transgenic mice or tissue
      culture cells.
AB  - We have developed an improved method for determining CAT activity directed by
      stably (transgenic mice) or transiently (tissue culture cell lines) introduced
      CAT reporter gene constructs. The procedure is based on the use of a new buffer
      system which considerably increases the stability of the CAT enzyme during the
      preparation of the crude cell extracts. When compared to other procedures, our
      method enables an increase of up to 100-fold in the sensitivity of the assay,
      depending on the transgenic tissue tested. Furthermore, a strong increase (up to
      23-fold) was also observed with various promoter/CAT constructs transiently
      transfected in established tissue culture cell lines. This increase in
      sensitivity provides a significant reduction in the time required to perform the
      CAT assay when strong promoters are studied (from 18 to 1 hr) and is also very
      useful for the analysis of CAT gene expression driven by weak promoters.

PMID- 1739437
TI  - Lymphedema 30 years after radical mastectomy.
AB  - Lymphedema is a common and often distressing consequence of the management of
      breast cancer. This is the first report of new onset lymphedema 30 yr after
      radical mastectomy for the management of breast cancer. The patient's swelling
      began 10 days after commencing daily finger sticks to follow blood sugar,
      stemming from a recent diagnosis of diabetes mellitus. If proper precautions had
      been observed, swelling may not have developed. The patient had marked reduction
      of her edema with appropriate use of graded compression garments and self
      administered massage therapy, after early recognition and prompt intervention
      into her problem. This case highlights efforts that need to be made to prevent
      the development of edema.

PMID- 1739438
TI  - A prospective study of the menstrual cycle and spinal cord injury.
AB  - Sixty seven menstrual cycles were studied prospectively in a nonclinical sample
      of 20 women who had suffered a traumatic spinal cord injury (quadriplegia n = 13;
      paraplegia n = 7) at least 1 yr before assessment. Level of injury did not
      influence cycle length (mean +/- SE = 28.7 +/- 3 days), duration of menses (4.6
      +/- 1 days) or serum concentrations of gonadotropins and ovarian hormones.
      Midluteal phase serum progesterone values were consistent with ovulation
      (progesterone = greater than 5 ng/ml) in 93% of the cycles in which endocrine
      measures were obtained; but the ability of basal body temperature pattern to
      predict serum progesterone was low (43%). Cyclic dysmenorrhea was reported by 13
      women with injuries ranging from C5 to T12. These findings suggest that ovulatory
      menstrual cycles are common in women after traumatic spinal cord injury and
      support the need for contraception by those wishing to avoid pregnancy. Basal
      body temperature charts revealed potential problems in applying the symptothermal
      method of natural family planning to a population of women at risk for oral
      contraceptives.

PMID- 1739439
TI  - Electromyographic and nerve conduction studies in the mdx mouse.
AB  - Electromyographic responses to needle-electrode insertion and repetitive indirect
      stimulation were recorded from gastrocnemius, soleus and cranial tibialis muscles
      of normal and dystrophic (mdx) mice at 20-154 days. Recordings from myotonic
      (ADRmto) mice served as controls for "true" myotonia. Complex repetitive
      discharges were observed in muscles of mdx mice but no complex repetitive
      discharges or other abnormalities were observed in muscles of normal control
      mice. Complex repetitive discharges in mdx muscles did not resemble the
      prolonged, abnormally repetitive discharges observed in myotonic mouse muscles.
      Neuromuscular blockade with tubocurarine and nerve transection had no effect on
      observed electromyographic abnormalities in the mdx mice. Nerve conduction and
      repetitive stimulation studies also revealed no abnormalities in mdx mice. These
      findings indicate that the mdx condition is a nonmyotonic, primary myopathy. No
      signs of myotonia or impaired neuromuscular transmission were found in mdx mice.

PMID- 1739440
TI  - Factor analysis. A methodology for data reduction in nerve conduction studies.
AB  - Analyzing multiple nerve conduction study parameters individually is
      statistically problematic. The goal of this study was to develop a useful factor
      analysis scheme for assessment of nerve conduction study abnormalities in
      diabetic neuropathy. Hypotheses were: (1) factor analysis produces a few
      physiologically meaningful factors, (2) there are associations between factors
      and markers of diabetic severity and (3) clinical impressions are related to
      factor scores. We studied 165 Japanese-American men: 52 nondiabetic, 66 diabetic
      and 47 with impaired glucose tolerance. One author (W.C.S.) obtained 28 nerve
      conduction study parameters in all subjects and factor analysis extracted five
      factors from these parameters. These factors were related to conduction
      velocities (factor 1), distal ulnar function (factor 2), sensory amplitudes
      (factor 3), distal median function (factor 4) and distal peroneal function
      (factor 5); together, they explain 57% of the variability in the total data.
      Diabetic factor scores were significantly (P less than 0.05) below that of the
      controls and correlations with fasting blood sugar were significant at the P less
      than or equal to 0.001 level. Use of this technique promises to permit sensible
      analysis of large amounts of data in clinical studies of diabetic and other types
      of polyneuropathy.

PMID- 1739441
TI  - Hypothyroidism producing reversible dementia. A challenge for medical
      rehabilitation.
AB  - The evaluation of dementia for reversible causes should not be overlooked.
      Hypothyroidism is a reversible cause for dementia. Mental status is one of the
      important factors to be assessed prospectively to determine whether a patient is
      likely to benefit from intensive inpatient rehabilitation. Because of the
      negative effect of dementia on the learning process during intensive inpatient
      medical rehabilitation, it alone may be a sufficient reason to consider
      alternatives to intensive inpatient rehabilitation. On our rehabilitation unit,
      hypothyroidism causing confusion was recognized and corrected in two patients.
      The thyroid-stimulating hormone test is suggested as a screening tool.

PMID- 1739442
TI  - Functional loading augments the initial tensile strength and energy absorption
      capacity of regenerating rabbit Achilles tendons.
AB  - The biomechanical effect of functional loading was studied in surgically
      tenotomized, repaired and immobilized right Achilles tendons of 34 rabbits.
      Beginning from the 5th day after surgery, loading was initiated by removing the
      immobilization casts of the animals to permit unrestricted weight-bearing to
      tolerance. At each of 12, 18 and 21 days after surgery, functionally loaded
      tendons and their corresponding nonloaded controls were excised and compared for
      differences in tensile strength, tensile stress and energy absorption capacity.
      Functional loading induced a twofold increase in the tensile strength (P less
      than 0.05) and energy absorption capacity (P less than 0.05) of the tendons, at
      both 12 and 18 days after surgery. No statistically significant differences were
      observed in the tensile strength and energy absorption capacity of the tendons at
      21 days after surgery. Statistically significant differences in tensile stress
      were not observed at any time period throughout the study. These findings
      demonstrate that functional loading augments the tensile strength and energy
      absorption capacity of experimentally tenotomized tendons without promoting re
      rupture, but only during the very early stages of healing. Even though the
      healing process of rabbit tendons may differ from healing of human tendons, these
      results suggest that similar beneficial effects may be attained if repaired human
      Achilles tendon ruptures are carefully loaded during the very early rather than
      later stages of healing.

PMID- 1739443
TI  - Mechanism of unexpected death in a patient with C2 quadriplegia ventilated by aid
      of a phrenic nerve stimulator. Brief report.

PMID- 1739444
TI  - Clinical trial of a low-temperature plastic anterior ankle foot orthosis.
AB  - The modification of a new design in orthosis usually has its clinical indication.
      In this study, a low-temperature thermoplastic ankle foot orthosis (AFO) was
      designed in anterior leaf type, called anterior AFO, to meet the need of indoor
      barefoot walking in Taiwan. It could be easily molded and remolded to fit the
      foot, as well as to adjust the position of the foot and ankle. Sixty-eight
      patients with acute hemiplegia were fitted with this anterior AFO during
      ambulation training: 46 had good fitting (67.6%), 15 had fair fitting (22.1%) and
      7 had poor fitting (10.3%). Two patients were observed to have ankle clonus, and
      four patients experienced breakage or tear of the AFO within 4 wk. The gait
      characteristics were measured in six chronic hemiplegia patients to compare the
      effect of anterior AFO with posterior AFO (Teufel style). Their gait pattern did
      improve by AFO fitting, especially from the foot pressure distribution, but no
      significant difference between the two types of AFO was found.

PMID- 1739445
TI  - Evaluation of somatic and autonomic small fibers neuropathy in diabetes.
AB  - The relationship between somatic and autonomic neuropathy was assessed in the
      feet of 30 diabetic patients. Somatic small fiber function was evaluated by the
      thermal threshold test for cold (A delta fibers) and warmth (C fibers).
      Telethermography and transcutaneous oxygen tension were used to investigate the
      autonomic control of peripheral circulation. Autonomic neuropathy caused the
      opening of arteriovenous anastomosis, which was revealed through an elevation of
      the feet's temperature and a low transcutaneous oxygen tension. The association
      of the opening of the arteriovenous anastomosis and the perturbation of the
      thermal threshold test established a relationship between the dysfunction of the
      autonomic and the somatic fibers.

PMID- 1739446
TI  - Intrathecal baclofen. Effects on nocturnal leg muscle spasticity.
AB  - Electromyographic activity was recorded from tibialis anterior during nocturnal
      polysomnography in six patients with severe spasticity of spinal origin. The
      patients had a baclofen reservoir system implanted subcutaneously into their
      lumbar subarachnoid space and were studied for two nights in a double-blind,
      placebo controlled, crossover design. Tibialis anterior electromyographic
      activity per hour of sleep was reduced on the night of baclofen infusion. In
      particular, less electromyographic activity occurred after arousal from sleep.

PMID- 1739447
TI  - Improving the efficiency of patient selection for continuing rehabilitation in a
      general hospital: the Stroke Option Rehabilitation Team. A commentary.

PMID- 1739448
TI  - Setting the national agenda for injury control in the 1990s: rehabilitation of
      persons with injuries. Special report from the Third National Injury Control
      Conference.

PMID- 1739449
TI  - Medical economics of PM&R. III. Categories of physician activities in the
      rehabilitation setting.

PMID- 1739450
TI  - Social competence: an important construct in mental retardation.

PMID- 1739451
TI  - Interpersonal cognitive problem-solving among children with mild mental
      retardation.
AB  - In this study we sought to determine whether interpersonal cognitive problem
      solving skills could distinguish adjusted from nonadjusted classroom behavior
      among children with mild mental retardation. Discriminant analyses indicated
      that, irrespective of age or IQ, adjusted children had a larger number of
      relevant solutions to common problems as well as a higher ratio of aggressive
      solutions. Findings suggest that cognitive interpersonal skills may be as
      important, if not even more important, for this population as for youngsters
      without mental retardation.

PMID- 1739452
TI  - Assessment of loneliness at school among children with mild mental retardation.
AB  - This study was designed to determine whether children with mild mental
      retardation understand the concept of loneliness, whether their feelings of
      loneliness at school can be reliably assessed, and whether there are differences
      in loneliness between children with and without mental retardation. Results from
      a sample of 62 students with mild mental retardation and 62 students without
      retardation, ages 8 through 13, indicated that (a) high percentages of both
      groups understood what loneliness means, (b) a loneliness questionnaire yielded
      satisfactory internal reliability with both groups, and (c) boys but not girls
      with mental retardation reported significantly more loneliness than did children
      without mental retardation. Suggestions were made for future research on
      loneliness in school settings.

PMID- 1739453
TI  - Differences in adolescents' self-concept as a function of academic level,
      ethnicity, and gender.
AB  - The relations of dimensions of self-concept of adolescents with their academic
      level, ethnicity, and gender were investigated. A self-concept inventory
      assessing 11 aspects of self-concept was administered to a sample of 1,140 eight
      grade students stratified with regard to academic level (regular class,
      educationally marginal, learning handicapped), ethnicity (white, black, and
      Hispanic), and gender. Results showed that regular class students had higher
      levels of self-concept on most scales than did students who were educationally
      marginal or learning handicapped; the latter two groups showed few differences.
      Black students had higher self-concept ratings than did white and Hispanic
      students on most scales. An interaction on two academically related dimensions of
      self-concept revealed that white students who were educationally marginal had the
      lowest level of academic and verbal self-concept. Implications of the results for
      theories of self-concept formation were discussed.

PMID- 1739454
TI  - Toward defining and measuring social skills in employment settings.
AB  - Although it is clear that appropriate social skills are related to job success,
      little agreement has been reached on how to define and measure social skills. In
      this article a definition of social skills was proposed that will begin to
      identify the components that need to be considered when teaching social skills to
      individuals with mental retardation in employment settings. In addition, three
      measurement approaches were discussed that further operationalize these
      components. Current social skills training research in employment settings was
      reviewed and discussed with respect to the measurement approaches proposed in
      this article.

PMID- 1739455
TI  - Social evaluation of behaviors comprising three social skills and a comparison of
      the performance of people with and without mental retardation.
AB  - We evaluated whether behaviors commonly taught to persons with mental retardation
      as part of three important social skills (following instructions, accepting
      criticism, and negotiating to resolve conflicts) were responded to favorably by
      other people. People with mental retardation who lived in the community and other
      people from the community participated in videotaped role plays involving each of
      the social skills. The performances of participants were scored according to
      behavioral checklists. Participants with mental retardation scored as well as
      other participants on following instructions and accepting criticism but lower on
      negotiating. Community members were asked to evaluate how well the participants
      did in the videotaped role-play situations. There were high positive correlations
      between the scores derived from the behavioral checklists and the evaluations of
      community members for both groups of participants.

PMID- 1739456
TI  - Social support networks of adults with mental retardation who live at home.
AB  - The social support networks of 418 adults with mental retardation who live at
      home were found to be large, durable, active, and diverse in their composition.
      Family members predominated as members of these support networks. Differences
      were found in many network characteristics based on the gender and level of
      mental retardation of the adults. Males and those with the most severe mental
      retardation were found to be at risk for social isolation. Contrasts with the
      social support networks of adults in nonfamily settings were discussed.

PMID- 1739457
TI  - Reconsidering the construct of mental retardation: implications of a model of
      social competence.
AB  - A historical overview of efforts to integrate social competence into a definition
      of mental retardation was provided. The existing AAMR definition was criticized
      for its incorporation of a muddled construct of adaptive behavior, which over
      emphasizes psychopathology and underemphasizes social intelligence. A model of
      general competence was presented, and mental retardation was reconceptualized as
      a condition characterized by deficits in social, practical, and conceptual
      intelligence. Although such a conceptualization would be an improvement on the
      current definition, we argued that a definition of mental retardation based on
      social competence outcomes (i.e., need for support in playing critical social
      roles) would be preferable to a definition that is still tied too closely to
      psychometric criteria.

PMID- 1739458
TI  - Signaling pathways in odorant detection.
AB  - The application of molecular genetic techniques has led to the identification of
      olfactory-specific proteins that represent each component in a second messenger
      cascade. Our current understanding of signaling in the olfactory system suggests
      that receptor proteins of a large family, responsible in part for the specificity
      of the system, converge on a relatively small number of second messenger systems.
      The ability to express these elements in heterologous systems should allow for
      the reconstitution of the signaling cascade and provide insight into the
      specificity of ligand binding, pathway activation, and signal termination.

PMID- 1739459
TI  - Neuronal precursor cells in the rat hippocampal formation contribute to more than
      one cytoarchitectonic area.
AB  - We have tested the hypothesis that cell lineage restriction boundaries define the
      borders between cytoarchitectonic areas in the cerebral cortex. Clonally related
      cells were identified using a retroviral marking technique, and the dispersion of
      neuronal clones was examined with respect to the transitions between cortical
      areas. We chose to study the hippocampal formation because we found that clones
      of hippocampal neurons, unlike those in neocortex, are compact and readily
      identifiable in the adult and that transitions between areas in the hippocampus
      are sharp relative to the spread of a typical clone. We conclude, contrary to the
      hypothesis, that clones of neurons transgress the boundaries between areas in the
      hippocampal formation, that border-crossing clones are observed as frequently as
      would be expected if clones spread freely over the hippocampus with no constraint
      imposed by area borders, and that different types of pyramidal neurons,
      characteristic of different areas, may appear to a single clone. different areas,
      may appear in a single clone.

PMID- 1739460
TI  - The role of interactions in determining cell fate of two identified motoneurons
      in the embryonic zebrafish.
AB  - The role of cellular interactions in determining the fates of two identified
      motoneurons in the embryonic zebrafish was investigated by transplanting
      individual motoneurons from labeled donor embryos to unlabeled hosts. The results
      suggest that although these cells normally adopt different fates, they form an
      equivalence group in which one fate is primary and the other is secondary. Both
      cells are able to adopt the primary fate. A cell that has adopted the secondary
      fate can be induced to switch to the primary fate by ablating the cell that has
      adopted the primary fate, even many hours after axogenesis. Although interactions
      between the two cells appear to regulate which cell adopts the secondary fate,
      these interactions seem to be independent of neuromuscular activity.

PMID- 1739461
TI  - Genes necessary for directed axonal elongation or fasciculation in C. elegans.
AB  - The outgrowth of single axons through different cellular environments requires
      distinct sets of genes in the nematode C. elegans. Three genes are required for
      the pioneering circumferential outgrowth of identified motor neuron axons between
      the lateral hypodermal cell membrane and the basal lamina. Three other genes are
      required for the longitudinal outgrowth of these axons along preexisting axon
      bundles as well as for the fasciculation of axons within these neuron bundles.
      Five additional genes are required for circumferential outgrowth, longitudinal
      outgrowth, and fasciculation; mutations in three of these genes disrupt axon
      ultrastructure, suggesting that they function in axon formation rather than in
      axon guidance.

PMID- 1739462
TI  - Molecular characterization of the Schwann cell myelin protein, SMP: structural
      similarities within the immunoglobulin superfamily.
AB  - The Schwann cell myelin protein (SMP), previously defined in quail and chick by a
      monoclonal antibody, is in vivo exclusively expressed by myelinating and
      nonmyelinating Schwann cells and oligodendrocytes. The isolation of the complete
      nucleotide sequence of SMP is reported here. The predicted polypeptide chain
      reveals that SMP is a transmembrane molecule of the immunoglobulin superfamily
      showing sequence similarities with several surface glycoproteins expressed in the
      nervous and immune systems. In spite of a 43.5% overall sequence identity between
      rat myelin-associated glycoprotein (MAG) and quail SMP, SMP does not seem to be
      the avian homolog of MAG, since their expression, regulation, and functions are
      significantly different. Unusual sequence arrangements shared by SMP, MAG, and
      two lymphoid antigens suggest the existence of a particular subgroup in the
      immunoglobulin superfamily.

PMID- 1739463
TI  - Interaction of free and synaptic vesicle-bound synapsin I with F-actin.
AB  - Synapsin I is a neuron-specific phosphoprotein that binds to small synaptic
      vesicles and F-actin in a phosphorylation-dependent fashion. We have found that
      dephosphorylated synapsin I induces a dose-dependent increase in the number of
      actin filaments, which at high ionic strength is abolished by synapsin I
      phosphorylation. The increase in filament number appears to be due to a
      nucleating effect of synapsin I and not to a barbed-end capping/severing
      activity. Synaptic vesicle-bound synapsin I was as effective as free synapsin I
      in increasing the number of filaments. These data support the view that synapsin
      I is involved in the regulation of the dynamics of the actin-based network during
      the exo-endocytotic cycle.

PMID- 1739464
TI  - The challenge of quality versus quantity in echocardiography.

PMID- 1739465
TI  - Diagnosis of aortic transection by transesophageal echocardiography.
AB  - Transesophageal echocardiography (TEE) offers spectacularly detailed images of
      thoracic aortic anatomy and blood flow; however, its utility for diagnosis of
      aortic trauma is unknown. Our case underscores the ability of TEE to diagnose
      aortic transection. The speed, mobility, and accuracy of TEE makes it an
      attractive means of diagnosing aortic trauma in the critically ill.

PMID- 1739466
TI  - Health Care Financing Administration release of final physician payment reform
      regulation.
AB  - The Health Care Financing Administration has released final regulations
      concerning physician payment reform. The new method will significantly affect
      global, technical, and professional reimbursement. The American Society of
      Echocardiography is preparing response to these regulations.

PMID- 1739467
TI  - Pseudocolor displays in B-mode imaging applied to echocardiography and vascular
      imaging: an update.
AB  - Cardiac and vascular ultrasound systems incorporting colorized gray-scale display
      options to supplement the standard B-mode gray-scale image have recently
      reappeared on the market from several manufacturers. As yet, the clinical benefit
      of this "new" technology is unknown, and recommendations and protocols for its
      best application are not available. This article reviews the limitations of the
      gray-scale displays currently used, the rationale of the color-supplemented B
      mode image, and some of the potential applications to cardiac and vascular
      ultrasound.

PMID- 1739468
TI  - A computer-aided approach for the quantitation of regional left ventricular
      function using two-dimensional echocardiography.
AB  - Quantitation of regional left ventricular function is becoming increasingly
      important in this era of interventional cardiology. In this article we describe a
      computer-assisted approach for the assessment of regional left ventricular
      function that integrates three features. First, it measures left ventricular wall
      thickening and endocardial motion and curvature during an entire systolic
      contraction sequence. Second, it allows us to easily define endocardial and
      epicardial borders without actually having to manually trace the entire border.
      Third, it displays complex data in a simple format for easy assimilation. We
      believe that this approach is practical and comprehensive and can be used to
      quantitate regional left ventricular function with two-dimensional
      echocardiography.

PMID- 1739469
TI  - Echocardiographic indexes of allograft rejection in pediatric cardiac transplant
      recipients.
AB  - To determine the usefulness of echocardiographic indexes of left ventricular (LV)
      function as possible predictors of cardiac rejection, 12 transplant recipients
      (ages 3 to 17 years) underwent a total of 52 serial echocardiographic
      examinations and cardiac biopsies. The results were compared to those of 12
      normal children (ages 2 to 17 years). Biopsies were graded as no rejection (n =
      23), mild rejection (cellular infiltrate, n = 13), and moderate rejection
      (myocyte necrosis, n = 16). LV dimensions, percent shortening fraction, indexed
      LV mass, and ejection fraction were measured from M-mode and two-dimensional
      echocardiography. From the mitral valve Doppler tracing, the following
      measurements were made: isovolumic relaxation time, peak E and peak A velocities,
      and the fraction of filling under the E and A waves as well as in the first third
      of diastole. Compared with normal subjects, transplant recipients with no
      rejection had higher heart rates (95 +/- 15 vs 80 +/- 17 beats/min), longer
      isovolumic relaxation time (68.8 +/- 11.2 vs 51.5 +/- 13.6 msec), decreased first
      third area fraction (0.48 +/- 0.10 vs 0.57 +/- 0.10), and similar shortening
      fraction, LV mass, and peak E and A velocities (p less than 0.03). Compared with
      transplant recipients with no rejection, patients in whom mild rejection
      developed also had decreased shortening fraction (31% +/- 10% vs 37% +/- 8%) and
      decreased peak E velocity (0.68 +/- 0.19 vs 0.88 +/- 0.15 m/s) (p less than
      0.03). From mild to moderate rejection, no further changes were noted in any
      echocardiographic indexes measured.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1739470
TI  - Pulmonic valve endocarditis as an underdiagnosed disease: role of transesophageal
      echocardiography.
AB  - Pulmonic valve endocarditis is a rare clinical entity. In spite of an increase in
      the frequency of right-sided endocarditis, primarily it is the tricuspid valve
      that is involved. Two-dimensional transthoracic echocardiography has improved our
      ability to diagnose infective endocarditis but has not identified many cases of
      pulmonic valve endocarditis. With the use of transesophageal echocardiography,
      three recent cases of pulmonic valve endocarditis were diagnosed by our
      laboratory. Each of these patients had clinical evidence of right-sided
      endocarditis, yet routine transthoracic echocardiograms failed to identify any
      pulmonic valve abnormalities. The true incidence of pulmonic valve endocarditis
      may be higher than previously reported, and the transesophageal echocardiogram is
      the preferred method for identifying and evaluating pulmonic valve endocarditis
      in adults.

PMID- 1739471
TI  - Exclusion of atrial thrombus by transesophageal echocardiography.
AB  - To determine whether transesophageal echocardiography (TEE) is useful in ruling
      out the presence of atrial thrombus, we performed TEE in 20 patients immediately
      before valve replacement or valve repair and within 3 days of an autopsy in one
      patient. Mitral stenosis was the predominant lesion in three patients, mitral
      regurgitation was seen in 11 patients, five patients had mitral prosthesis
      malfunction, one patient had a tricuspid prosthesis malfunction, and one patient
      had aortic stenosis. Eight patients were in atrial fibrillation. Four patients
      demonstrated spontaneous contrast in the associated atria. Nine patients were
      receiving oral anticoagulation. Mean left atrial diameter was 5.3 +/- 1.3 mm. TEE
      revealed no evidence for atrial thrombus in 18 of the 21 patients; this finding
      was confirmed by careful inspection of the atria including the appendages. TEE
      demonstrated a left atrial thrombus in two patients and a right atrial thrombus
      in another (confirmed at the time of surgery or at autopsy). In all cases
      transthoracic echocardiography was negative. Our data suggest that TEE is useful
      in ruling out atrial thrombus, and therefore may be a useful test preceding
      interventions associated with an increased risk of embolism from the atria such
      as cardioversion, mitral valvuloplasty, or valve replacement.

PMID- 1739472
TI  - Comparison of transesophageal color flow Doppler imaging of normal mitral
      regurgitant jets in St. Jude Medical and Medtronic Hall cardiac prostheses.
AB  - Transesophageal color flow Doppler imaging of mitral mechanical prostheses is now
      widely used. This method eliminates the frequent problems of acoustic shadowing
      and flow masking that are commonly seen with a transthoracic Doppler study of
      mechanical mitral prostheses. Transesophageal color flow Doppler imaging was
      performed postoperatively in seven patients who had received St. Jude Medical
      mitral prostheses (St. Jude Medical, Inc., St. Jude, Minnesota) and in six
      patients who received Medtronic Hall mitral valves (Medtronic, Inc., Minneapolis,
      Minnesota). Maximal systolic regurgitant jet length and area determinations were
      obtained in all patients. A comparison of maximal jet lengths and areas for each
      type of mechanical prosthesis demonstrated that the Medtronic Hall prostheses
      produced longer maximal jet lengths (p = 0.0001) and larger jet areas (p =
      0.0009) than those produced by the St. Jude Medical mitral valves. Medtronic Hall
      prostheses produce a large centrally directed jet, whereas St. Jude Medical
      prostheses typically generate three smaller jets. Recognition of these
      differences in transesophageal color flow Doppler images in these commonly used
      cardiac valve prostheses is necessary to avoid misinterpretation of the normally
      large systolic regurgitant jet of the Medtronic Hall prosthesis as representing
      prosthetic dysfunction.

PMID- 1739473
TI  - Echocardiographic design of a multicenter investigation of free-living elderly
      subjects: the Cardiovascular Health Study.
AB  - The Framingham study has shown by M-mode echocardiography that left ventricular
      hypertrophy is a powerful, independent predictor for the development of coronary
      heart disease and that increased left atrial dimension has been associated with
      an increased risk of stroke. No previous population-based study has evaluated the
      risk factor correlates and predictive value for coronary heart disease and stroke
      of two-dimensional and Doppler, as well as M-mode, echocardiography. The
      Cardiovascular Health Study is a multi-year prospective epidemiologic study of
      5201 men and women older than 65 recruited from four geographic sites in the
      United States. The main objectives of incorporating echocardiography were to
      determine whether echocardiographic indices, or changes in these indices, are (1)
      correlated with traditional risk factors for coronary heart disease and stroke;
      and (2) independent predictors of morbidity and mortality for coronary heart
      disease and stroke. Echocardiographic measurements of interest include those
      related to global and segmental left ventricular systolic and diastolic structure
      and function and left atrial size. For each subject, a baseline echocardiogram
      was recorded in super-VHS tape using a standard protocol and equipment. All
      studies were sent to a reading center where images were digitized and
      measurements were made using customized computer algorithms. Calculated data and
      images were stored on optical disks to facilitate retrieval and future
      comparisons in longitudinal studies. A second echocardiogram is scheduled in year
      7, with a goal of determining whether changes in cardiac anatomy or function over
      a 5-year period are important predictors of morbidity or mortality from coronary
      heart disease and stroke. Quality control measures included standardized training
      of echocardiography technicians and readers, technician observation by a trained
      echocardiographer, periodic blind duplicate readings with reader review sessions,
      phantom studies, and quality control adults.

PMID- 1739474
TI  - Denver shunt causing abnormal right atrial mass: noninvasive determination of
      shunt patency by color-coded Doppler shuntography.
AB  - An unusual floating mass was detected in the right atrium of a 71-year-old man
      with liver cirrhosis and intractable ascites using two-dimensional
      echocardiography. The mass was caused by the venous tip of a Denver
      peritoneovenous shunt. Shunt patency could be assessed easily by compression of
      the pump body; this maneuver resulted in a laminar or turbulent flow that was
      recorded at the tip of the shunt in the right atrium by color-coded Doppler
      echocardiography. We are reporting the first case demonstrating the value of
      echocardiography in diagnosing a Denver shunt in the heart and shunt patency by
      color-coded Doppler shuntography.

PMID- 1739475
TI  - Right-to-left shunt through a patent foramen ovale caused by severe tricuspid
      regurgitation detected with color Doppler echocardiography.
AB  - We describe a 65-year-old patient with moderate combined mitral disease and
      severe tricuspid regurgitation, in whom the tricuspid regurgitant jet was
      oriented toward the interatrial septum. Color flow and pulsed Doppler
      demonstrated a late-systolic to mid-diastolic, right-to-left shunting of the
      tricuspid regurgitant jet through the foramen ovale. This finding was
      subsequently confirmed with transesophageal echocardiography.

PMID- 1739476
TI  - Two-dimensional and color Doppler echocardiographic diagnosis of penetrating
      missile wounds of the heart: chronic complications from intracardiac course of a
      bullet.
AB  - Two-dimensional echocardiography has gained a role in the management of the acute
      complications of penetrating cardiac trauma and in precisely localizing retained
      bullet fragments within the heart. We report the case of an 8-year-old boy with
      chronic symptoms after a bullet wound. In this case, traumatic mitral
      regurgitation caused by mitral leaflet perforation and retention of the bullet in
      the tricuspid annulus occurred because of an unusual intracardiac course of the
      projectile. The diagnosis was made by transthoracic echocardiography. The ability
      of two-dimensional echocardiography to delineate the true location of the foreign
      body within the heart and Doppler ultrasound to identify mitral valve perforation
      helped guide a prompt, efficient, and successful surgical procedure.

PMID- 1739477
TI  - Pulsed Doppler echocardiographic and color flow imaging detection of retrograde
      filling of anomalous left coronary artery from the pulmonary artery.
AB  - We report a case in which pulsed wave Doppler echocardiography and color flow
      imaging of blood flow direction in an anomalous coronary artery from the
      pulmonary artery assisted in the correct diagnosis and confirmed the adequacy of
      the surgical correction. Low-velocity color scales were used to show retrograde
      filling of the left coronary artery before surgery and antegrade filling of the
      left coronary artery after surgery. Detecting direction of blood flow in coronary
      arteries should increase the accuracy of the noninvasive diagnosis of anomalous
      left coronary artery from the pulmonary artery.

PMID- 1739478
TI  - Echocardiographic diagnosis of left ventricular outflow tract obstruction after
      mitral valvuloplasty with a flexible Duran ring.
AB  - We report on a patient in whom left ventricular outflow obstruction developed
      after mitral valve repair with a flexible Duran ring. This complication has been
      reported in 4.5% to 21% of patients when a rigid Carpentier ring was used but was
      thought to be eliminated with the use of flexible rings.

PMID- 1739479
TI  - Complementary role of two-dimensional and Doppler echocardiography in the
      diagnosis of left ventricular free-wall rupture.
AB  - We describe a case of left ventricular free-wall rupture of the heart in which
      the use of two-dimensional and Doppler echocardiography provided the diagnosis.
      The echocardiographic findings in this condition are discussed and a previously
      unreported finding is described.

PMID- 1739480
TI  - Identification of Chiari's network with transesophageal echocardiography.
AB  - A prominent Chiari's network may be difficult to distinguish from pathologic
      right atrial masses on transthoracic echocardiography. We report a 38-year-old
      woman who had a cerebrovascular accident. Transthoracic echocardiogram revealed
      an atrial septal aneurysm and a mobile right atrial mass. This mass was correctly
      identified as Chiari's network on the basis of the transesophageal
      echocardiographic findings of a broad base of attachment in the right atrium and
      filamentous nature of the mass. These findings were confirmed at surgery.

PMID- 1739481
TI  - Overseas dentists training scheme.

PMID- 1739482
TI  - Aspiration in dental local anaesthesia.
AB  - When injecting into a blood vessel (for example during intravenous sedation) it
      is essential to aspirate blood into the syringe prior to drug administration to
      ensure that the tip of the needle is lying within a vein. By the same token, when
      the injection is intended to be extravascular it would appear to be wise to
      ensure that no blood is aspirated into the syringe before drug delivery. This
      procedure is employed routinely by medical and nursing staff, but is not
      universally accepted by dentists prior to the administration of dental local
      anaesthetics.

PMID- 1739483
TI  - Recollected in tranquillity. A profile of Ernest Matthews. Interview by Colin
      Davis.
AB  - Emeritus Professor Ernest Matthews, living in happy retirement in a delightful,
      small nineteenth century house in Petersfield, looks about 70 years old, and is
      in fact 17 years older. He has made many contributions to the advancement of
      dentistry, and we asked him, as he looked back over the years, how he saw the
      dental world today compared with 60 years ago when he qualified.

PMID- 1739485
TI  - The education and training of personnel auxiliary to dentistry.

PMID- 1739484
TI  - Cause for concern.

PMID- 1739486
TI  - 'Orthodontic aspects of vocational training'.

PMID- 1739487
TI  - 'Orthodontic aspects of vocational training'.

PMID- 1739488
TI  - Meetings that matter.

PMID- 1739489
TI  - 'Equipment malfunction'.

PMID- 1739490
TI  - Recovery of transplanted tooth after root filling.

PMID- 1739491
TI  - 'A primary double molar tooth in a child with Russell-Silver syndrome'.

PMID- 1739492
TI  - 'After the contract ... which way now?'.

PMID- 1739493
TI  - 'Maxillofacial surgery should become a specialty of medicine'.

PMID- 1739494
TI  - 'Increased anterior crowding in the dentition'.

PMID- 1739495
TI  - 'Do you treat HIV positive patients?'.

PMID- 1739496
TI  - 'An urgent remedy needed'.

PMID- 1739497
TI  - 'Changes in the community periodontal index of treatment needs (CPITN) after
      periodontal treatment in a general dental practice'.

PMID- 1739498
TI  - 'Do you treat HIV positive patients?'.

PMID- 1739499
TI  - 'Is digit sucking of significance?'.

PMID- 1739500
TI  - Setting the record straight.

PMID- 1739501
TI  - A dental health education programme, including home visits, for nursery school
      children.
AB  - The aim of this study was to measure the effectiveness of three preventive
      programmes by measuring changes in oral hygiene, gingivitis and the uptake of
      dental care of nursery school and young primary school children living in areas
      of urban deprivation. The oral hygiene and gingivitis of a group of children who
      brushed their teeth daily at school improved during the study, but deteriorated
      during the summer holiday. A second group of children also brushed their teeth at
      school, and in addition their parents were given dental health education by a
      dental hygienist at home. Parents of a third group of children were given dental
      health education only at home. The oral hygiene and gingivitis of both the second
      and third groups improved and was maintained during the school holiday. The
      preventive programmes had little effect on the uptake of dental care in any of
      the study groups.

PMID- 1739502
TI  - The management of a plastic bullet injury to the mandible.
AB  - A patient hit by a plastic bullet sustained severe facial contusion and a
      comminuted fracture of the mandible with bone loss. There was a non-union of the
      fracture. The injury and the restoration of the defect are described and the use
      of plastic bullets is discussed.

PMID- 1739503
TI  - DNA fingerprinting of oral bacteria.
AB  - This elective study was conducted at the Dental School, University of Wales
      College of Medicine and at the University of Wales College of Cardiff School of
      Pure and Applied Biology. The student's interest in oral microbiology and desire
      to contribute to the work being performed in the field of oral microbiology, led
      him to concentrate his study on developing a DNA fingerprinting method to
      evaluate the putative new species of the genus Capnocytophaga. The genus
      Capnocytophaga, which contains Gram-negative, capnophilic fusiform-shaped
      bacteria, has been implicated in juvenile periodontitis and prepubertal
      gingivitis. However, the genus is also part of the normal oral flora. The student
      believed that there was an implication of the existence of both pathogenic and
      non-pathogenic strains of Capnocytophaga and developed a method of DNA
      fingerprinting to distinguish Capnocytophaga strains from clusters identified by
      Khwaja et al. The student felt that the study allowed insight into the tremendous
      potential of molecular techniques for furthering the understanding of dental
      disease and confirmed his ambition to pursue a career in academic oral
      microbiology. This area of study allows new associations to be made between
      specific bacteria and diseases, aiding the possibility of rapid and early
      diagnosis.

PMID- 1739504
TI  - Western Asia--a college visit.
AB  - The first newspaper for a fortnight is always read avidly by any homeward bound
      traveller. So it was for the passengers on Flight KL872 on Monday, November 4
      after a Conference in Pakistan and India with the Royal College of Surgeons of
      England. It was not long before Guardian readers had found the article 'In the
      ruins of the Raj' by Mark Tully.* Uncannily, it recounted the splendour and
      majesty of the countries we had visited and yet, at the same time, expressed our
      fears for the future of these delightfully hospitable and intelligent people who
      had been our hosts in Pakistan and India for two weeks.

PMID- 1739505
TI  - Problems of the Pakistani dental education system.

PMID- 1739506
TI  - The clinical performance of a glass polyalkenoate (glass ionomer) cement used in
      a 'sandwich' technique with a composite resin to restore Class II cavities.
AB  - The use of glass polyalkenoate (GPA) cement in conjunction with composite resin
      using an acid etch technique is now well known and a 'sandwich' of tooth/GPA
      cement/composite resin has been recommended to form the cervical seal at the base
      of approximal boxes in Class II cavities. This paper reports on the 2-year
      results of a controlled clinical trial using a commercial GPA lining cement. The
      trial was designed to evaluate the efficacy of this 'sandwich' technique. Sixty
      four restorations in the mouths of 22 patients were evaluated during the 2.5 year
      period of the trial. The composite resin component of the restorations performed
      well. Five restorations failed, all in the region of the approximal box. Four
      failures were related to the exposed GPA cement component of the 'sandwich'.
      Failure was probably related to placement difficulties of the technique. The use
      of GPA cement laminated with composite resin when the GPA cement was enclosed
      within the final restoration appeared to be a successful technique.

PMID- 1739507
TI  - Permanent damage to inferior alveolar and lingual nerves during the removal of
      impacted mandibular third molars. Comparison of two methods of bone removal.
AB  - Injuries to the inferior alveolar or lingual nerve are recognised complications
      of third molar surgery. In a prospective study, permanent damage was found to be
      significantly related to bone removal using a surgical drill. The Howarth
      periosteal elevator may not provide adequate protection to the lingual nerve when
      a surgical drill is used.

PMID- 1739508
TI  - A practical gloving and handwashing regimen for dental practice.
AB  - The debate concerning the re-use of gloves in dental practice continues, despite
      the fact that recent guidelines on cross-infection control recommend that a new
      pair of gloves should be used for each patient. Whichever policy for glove use is
      adopted, it is important to take the maximum possible precautions in hand care.
      This paper presents a practical regimen for hand/glove washing which is simple,
      quick and effective. The importance of establishing a hand-care regimen in dental
      practice is emphasised.

PMID- 1739509
TI  - A unique natural tooth-supported partial denture.

PMID- 1739510
TI  - Tongue piercing: a new fad in body art.

PMID- 1739511
TI  - 'Computers in dentistry'.

PMID- 1739512
TI  - A severe case of amelogenesis imperfecta reported in a twin.

PMID- 1739513
TI  - Low-energy lasers in dentistry.

PMID- 1739514
TI  - Experience, skill and knowledge gained by newly qualified dentists during their
      first year of general practice.
AB  - This study was commissioned by the Department of Health in 1988 for the
      assessment of the preparation of newly qualified dentists for general practice
      and the effect of the Vocational Training Schemes on their development. Newly
      qualified dentists working either as VTS trainees or associates were assessed in
      three ways. During the third and the twelfth months of practice they were asked
      to keep a one-week clinical diary record. They were also asked to complete a
      questionnaire to give a subjective assessment of their skill and knowledge
      related to general practice. Similar questionnaires were completed by their
      trainers or principals in order to provide an objective assessment. An indication
      of the volume of treatment they provided was also obtained from DPB records. The
      results showed that associates saw more patients and provided more treatment than
      VTS trainees during their first year. The difference between the two groups was
      greater at 3 months than at 12 months; however, wide variations were found,
      especially in the VTS group. The results from the questionnaires suggest that,
      with the exception of practice administration, oral surgery, orthodontics,
      anaesthesia and sedation, the undergraduate course provides adequate preparation
      for the initial demands of general practice. However, initially both groups were
      judged to be unprepared for independent practice. The results suggest that during
      the first year of practice the support and guidance of a more experienced
      colleague is essential, together with the provision of adequate and varied
      clinical experience.

PMID- 1739515
TI  - Preventing moral distress: our ethical obligation.

PMID- 1739516
TI  - Quality of information and extent of the transformation within organizations.

PMID- 1739517
TI  - RBRVS: a primer for nurse executives.

PMID- 1739518
TI  - Torsade de pointes: chaos, sixteen years on?

PMID- 1739519
TI  - Provision of services for the diagnosis and treatment of heart disease. Fourth
      report of a Joint Cardiology Committee of the Royal College of Physicians of
      London and the Royal College of Surgeons of England.
AB  - The principal conclusions of the fourth report of the Joint Cardiology Committee
      are: 1 Cardiovascular disease remains a major cause of death and morbidity in the
      population and of utilisation of medical services. 2 Reduction in the risk of
      cardiovascular disease is feasible, and better co-ordination is required of
      strategies most likely to be effective. 3 Pre-hospital care of cardiac
      emergencies, in particular the provision of facilities for defibrillation, should
      continue to be developed. 4 There remains a large shortfall in provision of
      cardiological services with almost one in five district hospitals in England and
      Wales having no physician with the appropriate training. Few of the larger
      districts have two cardiologists to meet the recommendation for populations of
      over 250,000. One hundred and fifty extra consultant posts (in both district and
      regional centres) together with adequate supporting staff and facilities are
      urgently needed to provide modest cover for existing requirements. 5 The
      provision of coronary bypass grafting has expanded since 1985, but few regions
      have fulfilled the unambitious objectives stated in the Third Joint Cardiology
      Report. 6 The development of coronary angioplasty has been slow and haphazard.
      All regional centres should have at least two cardiologists trained in coronary
      angioplasty and there should be a designated budget. Surgical cover is still
      required for most procedures and is best provided on site. 7 Advances in the
      management of arrhythmias, including the use of specialised pacemakers,
      implantable defibrillators, and percutaneous or surgical ablation of parts of the
      cardiac conducting system have resulted in great benefit to patients. Planned
      development of the emerging sub-specialty of arrhythmology is required. 8
      Strategies must be developed to limit the increased exposure of cardiologists to
      ionising radiation which will result from the expansion and increasing complexity
      of interventional procedures. 9 Supra-regional funding for infant cardiac surgery
      and transplantation has been successful and should be continued. 10 Despite
      advances in non-invasive diagnosis of congenital heart disease the amount of
      cardiac catheterisation of children has risen due to the increase in number of
      interventional procedures. Vacant consultant posts in paediatric cardiology and
      the need for an increase in the number of such posts cannot be filled from
      existing senior registrar posts. All paediatric cardiac units should have a
      senior registrar and in the meantime it may be necessary to make proleptic
      appointments to consultant posts with arrangements for the appointees to complete
      their training. 11 Provision of care for the increasing number of adolescent and
      adult survivors of complex congenital heart disease is urgently required. The
      management of these patients is specialised, and the committee recommends that it
      should ultimately be undertaken by either adult or pediatric cardiologists with
      appropriate additional training working in supra-regionally funded centers
      alongside specially trained surgeons. 12 Cardiac rehabilitation should be
      available to all patients in the United Kingdom. 13 New recommendations for
      training in cardiology are for a total of at least five years in the specialty
      after general professional training, plus a year as senior registrar in general
      medicine. An additional year may be required for those wishing to work in
      interventional cardiology and adequate provision must be made for those with an
      academic interest. 14 It is essential that both basic and clinical research is
      carried out in cardiac centres but these activities are becoming increasingly
      limited by the lack of properly funded posts in the basic sciences and
      restriction in the number of honorary posts for clinical research workers. 15 A
      joint audit committee of the Royal College of Physicians and the British Cardiac
      Society has been established to coordinate audit in the specialty. All district
      and regional cardiac centres should cooperate with the work of the committee, in
      addition to their participation in local audit activities.

PMID- 1739520
TI  - Vagaries of acceleration dependent aberration.

PMID- 1739521
TI  - Antiarrhythmic drug treatment: need for continuous vigilance.
AB  - Any physician treating cardiac arrhythmias should be aware of a possible
      worsening of the arrhythmia (so-called arrhythmogenesis) after the start of
      antiarrhythmic drug treatment. To facilitate the recognition of that complication
      the type and possible mechanisms of arrhythmogenesis are reviewed. Recognition
      also requires an understanding of (a) the time of appearance of arrhythmogenic
      effects after different drugs, (b) the value of non-invasive and invasive tests,
      and (c) the profile of the patient most likely to develop this problem.
      Guidelines are given to reduce the incidence of the arrhythmogenic effects of
      antiarrhythmic drugs and a plea is made that the physician should be always on
      the alert for this complication.

PMID- 1739522
TI  - Is there chaos in cardiology?

PMID- 1739523
TI  - Progress in familial hypertrophic cardiomyopathy: molecular genetic analyses in
      the original family studied by Teare.

PMID- 1739524
TI  - Electrical restitution in the endocardium of the intact human right ventricle.
AB  - OBJECTIVE: To characterise electrical restitution in the intact human heart.
      PATIENTS AND METHODS: A series of monophasic action potential electrical
      restitution curves were constructed from a single right ventricular endocardial
      site in eight patients (three men) without structural heart disease aged 52-68
      (mean 55 years). A combination pacing/monophasic action potential electrode was
      used to pace and record monophasic action potentials at drive cycle lengths of
      from 350 ms to 1500 ms. Ventricular extrastimuli were delivered at 20 cycle
      intervals and decreased from the longest coupling interval attainable without
      escape beats. RESULTS: Restitution curves shifted downward and towards the left;
      steady state action potential duration shifted from the restitution plateau and
      descended the curve, the amount of shift being linearly related to drive cycle
      length in two patients in whom the relation could be assessed; the amount of
      monophasic action potential shortening was a function of the degree of
      prematurity and that relation was unaffected by drive rate; the magnitude of
      restitution and the time constant of the restitution curve were not changed
      significantly by altered drive cycle length. CONCLUSION: In the intact heart in
      vivo, electrical restitution (of the monophasic action potential) has similar
      characteristics to those (of the transmembrane action potential) in cellular
      preparations in vitro. Thus the alteration of action potential plateau currents
      by instantaneous rate change or drug effects, which can be directly observed by
      techniques available to the cellular electrophysiologist, may be indirectly
      assessed in vivo by characterisation of the effect of these on electrical
      restitution.

PMID- 1739525
TI  - Value of ambulatory ST segment monitoring in patients with chronic stable angina:
      does measurement of the "total ischaemic burden" assist with management?
AB  - OBJECTIVE: To assess the prognostic significance of transient ischaemic episodes
      during daily activities in patients with stable angina. PATIENTS AND METHODS: 172
      patients with stable angina attending the cardiac outpatients departments of
      Hillingdon Hospital (n = 155) and the National Heart Hospital (n = 17) were
      prospectively studied by exercise testing and 48 hours of ambulatory ST segment
      monitoring, and followed for prognostic purposes for up to 39 months (mean 24.5
      months). Patient inclusion depended on a clinical diagnosis of stable coronary
      artery disease which necessitated outpatient review (and antianginal treatment in
      94% of patients). It was not dependent on objective evidence of reversible
      ischaemia. Events recorded during the follow up period included death, non-fatal
      myocardial infarction, unstable angina, and the requirement for
      revascularisation. RESULTS: 72 patients (42%) had transient ischaemic episodes
      during daily activities, and 104 patients (60.5%) had an ischaemic response to
      exercise. 63 patients (36%) had evidence of ischaemia on both investigations;
      with 59 (34%) having no documented ischaemia on either investigation. There were
      27 patient events (15.7%) recorded over a mean 24.5 month follow up, including
      five deaths (2.9%) (three cardiac related (1.7%)), six non-fatal myocardial
      infarctions (3.5%), six admissions with unstable angina (3.5%), and 10
      revascularisation procedures (5.8%). Of the nine "hard" or objective end points
      (cardiac death and non-fatal myocardial infarction), only two had evidence of
      transient ischaemia on ambulatory ST segment monitoring at initial investigation,
      with 10 of the 25 patients (38.5%) with any cardiac event having such episodes.
      CONCLUSIONS: The outcome in patients with chronic stable angina receiving
      standard medical treatment was good over a mean two year follow up period. For
      the purpose of assessing prognosis over this time scale, there was no advantage
      to performing ambulatory ST segment monitoring in such patients.

PMID- 1739526
TI  - Dr Dennis M Krikler: editor of the British Heart Journal 1981-91.

PMID- 1739527
TI  - Limited value of the resting electrocardiogram in assessing patients with recent
      onset chest pain: lessons from a chest pain clinic.
AB  - OBJECTIVE: To evaluate a clinic set up specifically to assess patients with
      recent onset chest pain, particularly those presenting with a normal resting
      electrocardiogram. DESIGN: Retrospective review of case notes. SETTING: Cardiac
      department of a tertiary referral cardiothoracic centre. PATIENTS: 250
      consecutive patients with recent onset chest pain seen within 24 hours of general
      practitioner referral. OUTCOME MEASURES: Clinical diagnosis and management.
      RESULTS: 40% of patients were seen within seven days of the onset of symptoms.
      Twenty seven per cent had non-cardiac symptoms and could be discharged while 60%
      were considered to have cardiac pain. Sixty six patients (26%) were admitted
      directly from the clinic and 48 of these underwent coronary angiography within
      three weeks. Seventy patients (28%) have so far undergone intervention
      (angioplasty or coronary artery surgery), 22 within one month of presentation.
      One hundred and nine patients (44%) presented with a normal resting
      electrocardiogram, 21 of whom were considered to have unstable angina. Forty one
      of these patients were investigated of whom 37 were found to have significant
      coronary disease and 26 have undergone intervention. CONCLUSIONS: This experience
      highlights the inadequacy of a routine electrocardiogram reporting service in
      patients with recent onset of chest pain. An alternative facility offering
      immediate and complete cardiac assessment produced patient benefit with early
      diagnosis and intervention. Investigation of these patients, however, accounted
      for 5% of cardiac catheterisation laboratory throughput; this was a significant
      additional and unscheduled workload.

PMID- 1739528
TI  - "Subclinical" pacemaker syndrome: a randomised study of symptom free patients
      with ventricular demand (VVI) pacemakers upgraded to dual chamber devices.
AB  - OBJECTIVE: To determine whether symptom free patients with single chamber
      pacemakers benefit from dual chamber pacing. DESIGN: A randomised double blind
      crossover comparison of ventricular demand (VVI), dual chamber demand (DDI), and
      dual chamber universal (DDD) modes after upgrading from a VVI device. SETTING:
      Cardiology outpatient department. PATIENTS: Sixteen patients aged 41-84 years who
      were symptom free during VVI mode pacing for three or more years. INTERVENTION:
      Pacemaker upgrade during routine generator change. MAIN OUTCOME MEASURES: Change
      in subjective (general health perception, symptoms) and objective (clinical
      assessment, treadmill exercise, and radiological and echocardiographic indices)
      results between pacing modes before and after upgrading. RESULTS: 75% preferred
      DDD, 68% found VVI least acceptable with 12% expressing no preference. Perceived
      general well-being and exercise capacity (p less than 0.01) and treadmill times
      (p less than 0.05) were improved in DDD mode but VVI and DDI modes were similar.
      Clinical, echocardiographic, radiological, and electrophysiological indices
      confirmed the absence of overt pacemaker syndrome, although mitral and tricuspid
      regurgitation was greatest in VVI mode (p less than 0.01). CONCLUSIONS: Most
      patients who were satisfied with long term pacing in VVI mode benefited from
      upgrading to DDD mode pacing suggesting the existence of "subclinical" pacemaker
      syndrome in up to 75% of such patients. The DDI mode offered little subjective or
      objective benefit over VVI mode in this population and should be reserved for
      patients with paroxysmal atrial arrhythmias. VVI mode pacing should be used only
      for patients with very intermittent symptomatic bradycardia or atrial
      fibrillation with a good chronotropic response during exercise.

PMID- 1739529
TI  - Pacemaker electrode implantation in patients with persistent left superior vena
      cava.
AB  - Four out of 661 consecutive patients with permanent endocardial VVI pacing had
      the pacing lead introduced through a persistent left superior vena cava. It was
      difficult to introduce the lead from the right atrium into the right ventricle
      because the tip of the lead tended to be deflected away from the tricuspid
      orifice. This difficulty was overcome by shaping the lead into a pigtail with 3-4
      cm wide loop. This avoided the risk of entering a branch of the coronary sinus in
      order to reach the right atrium. This technique made it easier to position the
      lead in the right ventricular apex. There were no complications in these four
      patients during a mean follow up of three years.

PMID- 1739530
TI  - Catheter ablation by low energy DC shocks for successful management of atrial
      flutter.
AB  - OBJECTIVE: To assess the effects of low energy ablation of the substrate for
      atrial flutter. DESIGN: Initial retrospective analysis of patients undergoing low
      energy ablation of the atrioventricular node for refractory atrial flutter (group
      1) was followed by a prospective assessment of low energy ablation in the
      posterio-inferior right atrium for the same condition (group 2). SETTING:
      Tertiary referral centre for management of cardiac arrhythmias. PATIENTS: Seven
      men (aged 50-67 years) with refractory atrial flutter. INTERVENTIONS: Multiple (3
      10) low energy DC shocks with a cumulative energy of 100-245 J in the region of
      the atrioventricular node in group 1 and 12-15 low energy DC shocks (cumulative
      energy 110-235 J) guided by the anatomical landmarks of the triangle of Koch and
      applied directly to the atrial wall. MAIN OUTCOME MEASURE: Freedom from
      recurrence of atrial flutter. RESULTS: In group 1 despite initial complete
      atrioventricular block in three patients, atrioventricular conduction had resumed
      in all by one month. All four, however, were in sinus rhythm at follow up six to
      13 months later. Two of the three patients in group 2 were free of atrial flutter
      at follow up three to four months after ablation. CONCLUSION: Ablation of the
      atrial flutter substrate with low energy DC shocks is feasible. Precise
      electrophysiological mapping is not necessary.

PMID- 1739531
TI  - Early and late arrhythmias after the Fontan operation: predisposing factors and
      clinical consequences.
AB  - OBJECTIVE: To study the incidence, predisposing factors, and clinical
      significance of arrhythmias early and late after the Fontan operation for
      congenital heart disease. PATIENTS AND METHODS: All 104 consecutive patients
      undergoing Fontan repair from 1975 to 1988 were studied retrospectively. Hospital
      records were reviewed for perioperative arrhythmia. Clinical information and
      annual electrocardiograms were available for all 78 hospital survivors during a
      follow up of up to 13 years (mean 3.7 years). Ambulatory electrocardiographic
      monitoring was performed in 67 patients (81%). RESULTS: Eleven patients (10.6%)
      developed a perioperative tachycardia (eight, atrial flutter; three, His bundle
      tachycardia). Multivariate analysis showed that raised preoperative mean
      pulmonary artery pressure and low aortic saturation were significant risk factors
      for the development of atrial flutter (r2 = 0.32, p = 0.0001) but not for His
      bundle tachycardia. Despite intensive medical treatment 10 of these 11 patients
      died. At the last visit 72 (92%) of the 78 patients were in sinus rhythm on their
      standard 12 lead electrocardiogram. Junctional rhythm was present in three
      patients, two patients had atrial flutter, and one had a paced rhythm. Ambulatory
      monitoring did not show important bradycardia or ventricular arrhythmias.
      Actuarial survival free of supraventricular arrhythmia was 82% at eight years
      after operation. Multivariate analysis identified older age, increased right
      atrial size, and raised mean preoperative pulmonary artery pressure as risk
      factors for arrhythmia during intermediate follow-up (r2 = 0.46, p less than
      0.001). Late tachycardias, in contrast to those occurring in the perioperative
      period, were not associated with an increased mortality. CONCLUSIONS: Except for
      his bundle tachycardia in the perioperative period, early and late arrhythmias
      after a Fontan operation seem to be a consequence of adverse preoperative and
      postoperative haemodynamic function. The perioperative outcome is therefore poor
      even when the patient can be restored to sinus rhythm. Medical and surgical
      modifications to improve the haemodynamic disturbances associated with
      arrhythmias are therefore indicated.

PMID- 1739532
TI  - Atrial flutter in the fetus and young infant: an association with accessory
      connections.
AB  - OBJECTIVE: To highlight the association between atrial flutter and accessory
      connections in the fetus and young infant. DESIGN: A retrospective review from
      January 1985 to January 1990. PATIENTS: Fetuses, neonates, and young infants with
      atrial flutter. RESULTS: Four fetuses and five infants presented with atrial
      flutter. In two fetuses and one infant sinus rhythm returned spontaneously. The
      other six required cardioversion. Three of them developed orthodromic
      atrioventricular re-entry tachycardia and each had evidence of an accessory
      connection. CONCLUSIONS: Because atrial flutter in the fetus and neonate is rare,
      the high incidence of accessory connections in this group points to a possible
      aetiology of "idiopathic" atrial flutter in this age group.

PMID- 1739533
TI  - Normal relation between heart rate and cardiac repolarisation in sudden infant
      death syndrome.
AB  - OBJECTIVE: To determine whether there was a difference in the relation between
      heart rate and RT intervals in infants who later died of sudden infant death
      syndrome (SIDS) and controls. DESIGN: A blinded, computer analysis of
      prospectively acquired physiological data on SIDS cases and controls. SETTING:
      Physiological data obtained from infants at home (collaborative analysis National
      Heart and Lung Institute and Exeter University). PARTICIPANTS: Nine fullterm
      infants who subsequently died of SIDS and 10 surviving controls matched for age
      and birth weight. INTERVENTIONS: 24 hour tape recordings of the electrocardiogram
      at home between three and 11 weeks of age. MAIN OUTCOME MEASURES: Mean value of
      the constant b, which relates by linear regression the log of each RT interval to
      the log of its proceeding RR interval, and any difference between SIDS cases and
      controls. RESULTS: The mean (2SEM) values for b were 0.20 (0.03) for the 10
      controls and 0.19 (0.03) for the nine SIDS infants. Cyclical correlations between
      RT and RR intervals of varying strength were identified in both SIDS infants and
      controls. CONCLUSIONS: Infants who subsequently died of SIDS did not show an
      impaired ability to modify RT intervals in response to change in heart rate.

PMID- 1739534
TI  - Myocardial dysfunction in treated adult hypopituitarism: a possible explanation
      for increased cardiovascular mortality.
AB  - OBJECTIVE: To assess cardiac structure and function in patients with treated
      hypopituitarism and to determine their relation to the degree of growth hormone
      deficiency and body composition pattern. DESIGN: 26 patients with treated
      hypopituitarism were studied by cross sectional and Doppler echocardiography and
      by exercise testing. The results were analysed and their relation to the degree
      of growth hormone deficiency and body composition determined. SETTING: All tests
      were performed in the department of cardiology and the unit of metabolic medicine
      at a tertiary referral centre. PATIENTS: Patients with hypopituitarism referred
      for endocrine assessment. MAIN OUTCOME MEASURES: Left ventricular mass, left
      ventricular diastolic function, and exercise capacity in patients with
      hypopituitarism and their relation to growth hormone deficiency. RESULTS: Mean
      (SD) serum concentration of insulin-like growth factor 1 (IGE-1), a measure of
      growth hormone deficiency, was 82.4 (45) micrograms/l. Lean body mass calculated
      by measuring total body potassium was 50 (9) kg. All patients had a normal left
      ventricular mass index and a normal left ventricular ejection fraction. Eight
      patients had abnormal left ventricular diastolic function. There was a
      significant correlation between IGF-1 and left ventricular mass (r = 0.45, p less
      than 0.02). Lean body mass was also significantly correlated with left
      ventricular mass (r = 0.78, p less than 0.0001) and left ventricular diastolic
      function (r = -0.63, p less than 0.01). The mean exercise duration was 8.6 (3.6)
      minutes. There was a significant correlation between serum IGF-1 and the rate
      pressure product on exercise (r = 0.47, p less than 0.01). Seven patients had
      planar ST segment depression greater than 0.1 mV during exercise testing. In five
      of these patients there was rapid resolution of ST segment depression immediately
      after exercise. Two patients developed considerable ST segment depression, and
      subsequent coronary angiography showed normal coronary arteries. Exercise-induced
      ST segment depression was not related to the severity or duration of growth
      hormone deficiency or serum cholesterol concentration. CONCLUSIONS: This study
      suggests that left ventricular mass and the rate-pressure product are related to
      the degree of growth hormone deficiency, that left ventricular diastolic
      dysfunction is frequently seen in hypopituitarism, and that these patients may
      have ischaemic-like ST segment changes during exercise testing. These findings
      may explain the increased cardiovascular mortality in patients with
      hypopituitarism and may also have implications for growth hormone replacement
      therapy in adults.

PMID- 1739535
TI  - Recurrent ventricular arrhythmias complicating myocardial infarction in the
      presence of phaeochromocytoma.
AB  - After an acute myocardial infarction a 49 year old man developed late recurrent
      severe ventricular arrhythmias coincident with transient hypertensive episodes. A
      phaeochromocytoma was diagnosed on the basis of the urinary concentration of
      catecholamines and computerised tomography of the adrenal glands. After
      stabilisation of his cardiac rhythm and blood pressure with alpha and beta
      adrenergic blockade and anti-arrhythmic treatment the right adrenal gland, which
      contained the tumour, was successfully resected. The diagnosis of a
      phaeochromocytoma should be considered when recurrent ventricular arrhythmias are
      associated with intermittent hypertension after myocardial infarction.

PMID- 1739536
TI  - Impact of catheter and surgical ablation on arrhythmia treatment in a tertiary
      referral centre.
AB  - Invasive cardiac electrophysiology studies began as diagnostic studies. The past
      decade has seen the introduction of several new treatments which have broadened
      the scope of invasive electrophysiology studies. In particular, the development
      of catheter ablation techniques increasingly allows curative treatment to be
      delivered in the catheter laboratory. The workload of electrophysiological
      procedures has steadily increased in our tertiary referral centre. Over 1000
      patients have been treated in the past 20 years and it is projected that 219 new
      patients will be treated in 1991 and 342 procedures will be carried out. Over 25%
      of patients now receive either catheter or surgical ablation and almost 80% of
      these are cured permanently without the need for further drug treatment. The
      development of safer techniques for catheter ablation has led to its increased
      use and a decline in surgical ablations. Because catheter ablation is a much
      simpler and less traumatic procedure than surgical ablation there are great
      advantages both for the patient and in terms of cost-effectiveness.
      Antitachycardia pacing, relatively common in 1985, has now largely been
      supplanted by ablation and implantation of defibrillators. As the tendency to non
      pharmacological treatment increases and evidence mounts that cost-effectiveness
      is greater for electrophysiological treatments, the implications for the funding
      of electrophysiology services grow. The initially high cost of curative treatment
      needs to be balanced against the longer term and potentially higher costs of
      palliative drug treatment. The potential to cure patients with catheter
      procedures may lead to a greater demand for this expertise and a need for an
      increase in training and facilities.

PMID- 1739537
TI  - A proactive resolution.

PMID- 1739538
TI  - Nursing assessment of the elderly for dermatologic procedures.
AB  - The fastest growing group of Americans are senior citizens. The elderly patient
      is more at risk due to age, general health, chronic disease, and drugs. A good
      nursing assessment will help the nurse identify health problems that may affect
      the surgical outcome.

PMID- 1739539
TI  - The role of the histotechnician in Mohs surgery.
AB  - Critical elements of Mohs micrographic surgery are performed by the
      histotechnician in the frozen section laboratory. This article provides an
      overview of the essential role of the histotechnician as a member of the
      micrographic surgical team.

PMID- 1739540
TI  - Assessment of the photosensitive patient.
AB  - Photosensitivity is an abnormal cutaneous response to photosensitizing substances
      and sunlight or artificial light. Proper assessment of the photosensitive patient
      is important in defining photosensitive diseases and reactions.

PMID- 1739541
TI  - Redefining identity when appearance is altered.
AB  - Alteration in appearance, impacting on identity, can occur when cancer or other
      chronic illness strikes. Patients and families need assistance in coping with
      changes and redefining a sense of self during treatment and beyond. This article
      examines some common effects of therapy and disease on appearance and outlines a
      nursing plan of care to assist the patient in regaining acceptance in the outer
      world.

PMID- 1739542
TI  - [Technology, the client, the nurse and her resources].

PMID- 1739543
TI  - Retirement to renal failure: the management of the elderly dialysis patient.

PMID- 1739544
TI  - Patient assessment in acute hemodialysis.

PMID- 1739545
TI  - Early tracheal intubation with thiopentone in elective surgery.
AB  - We have studied tracheal intubating conditions within 30 s of administration of
      thiopentone in 24 patients and compared this with our usual method of tracheal
      intubation, which involves 3 min of manual ventilation in 29 patients. All
      patients received papaveretum 10 mg 3 min before induction and alcuronium at
      induction of anaesthesia. Satisfactory intubating conditions were observed in 83%
      of patients in both groups. There were no difficult or failed intubations and no
      patient had laryngospasm. The duration of laryngoscopy in the control group was
      14.1 (SD 8.6) s (range 7-50 s), compared with 12.4 (3.1) s (range 6-20 s), in the
      early intubation group (ns). In the control group there was a significant
      decrease in systolic pressure before tracheal intubation and a significant
      increase in heart rate after intubation, compared with baseline values. The
      average systolic pressure in the early intubation group increased only minimally:
      from a pre-intubation value of 143.3 (21.2) mm Hg to 145.5 (25.1) mm Hg after
      intubation. Our results demonstrate that early tracheal intubation under
      thiopentone supplemented with an opioid and a non-depolarizing neuromuscular
      block is feasible, associated with minimal changes in arterial pressure and not
      accompanied by an increased incidence of side effects.

PMID- 1739546
TI  - Delayed presentation of an extradural abscess complicating thoracic extradural
      analgesia.
AB  - Extradural abscess is a rare but recognized complication of extradural
      anaesthesia. Previous reports have been associated with a short time interval
      between extradural catheterization and presentation. We report a patient with
      rheumatoid arthritis, receiving steroid therapy, in whom an extradural abscess
      did not present until 23 days after the insertion of a thoracic extradural
      catheter to provide postoperative analgesia.

PMID- 1739547
TI  - Clonidine in the treatment of alcohol withdrawal in the intensive care unit.
AB  - We present two cases of patients with a past history of alcohol abuse admitted to
      the Intensive Care Unit (ICU) for treatment of respiratory problems, after
      multiple trauma and after sub-total colectomy, respectively. In both patients,
      features of alcohol withdrawal were prominent after sedation had been
      discontinued. Both were treated successfully with an infusion of clonidine.

PMID- 1739548
TI  - Retrograde intubation using the subcricoid region.
AB  - The applied anatomy of the cricothyroid and cricotracheal region of the neck and
      a retrograde method of tracheal intubation using the subcricoid region are
      described. This approach has several advantages, including absence of bleeding
      complications, as there are no major blood vessels on the cricotracheal membrane,
      and reduction in the possible development of subglottic oedema and stenosis.

PMID- 1739549
TI  - Management of carboxyhaemoglobinaemia.

PMID- 1739550
TI  - Management of carboxyhaemoglobinaemia.

PMID- 1739551
TI  - Analysis of effects of drug combinations.

PMID- 1739552
TI  - Iatrogenic foreign body after laryngoscopy.

PMID- 1739553
TI  - Gastric emptying in pregnancy.

PMID- 1739554
TI  - Propofol sedation for outpatient upper gastrointestinal endoscopy.

PMID- 1739555
TI  - Extradural haematoma after continuous extradural anaesthesia.

PMID- 1739556
TI  - Difficult laryngoscopy.

PMID- 1739557
TI  - Extradurals and balanced analgesia.

PMID- 1739558
TI  - Failed tracheal intubation at caesarean section and the laryngeal mask.

PMID- 1739559
TI  - Reported significant observations during anaesthesia: a prospective analysis over
      an 18-month period.
AB  - We describe a prospective analysis, in one hospital, of reported significant
      observations involving unsafe practices and working conditions during
      anaesthesia. Of the 549 significant observations reported voluntarily during a
      period of 18 months, 82% involved occurrences which were considered preventable
      and 27% could have been fatal if they had not been recognized and corrected.
      Ninety-three percent of incidents did not lead to a negative outcome. Human error
      was responsible for 411 (75%) reports. Lack of vigilance and failure to check
      were the most frequently reported factors associated with human error.
      Significant observations involving errors in drugs administration were the most
      frequent. Forty-five percent of all reported significant observations were made
      during maintenance of anaesthesia.

PMID- 1739560
TI  - Effect of oxygen therapy on late postoperative episodic and constant hypoxaemia.
AB  - As constant hypoxaemia itself may trigger development of apnoea and periodic
      breathing, we have studied the effect of oxygen therapy on the occurrence of late
      postoperative episodic hypoxaemia. Thirty-five patients without cardiopulmonary
      disease and undergoing elective total hip replacement were monitored with a pulse
      oximeter on the second night after operation (23:00 to 07:00), receiving either
      21% or 37% oxygen by face mask in a randomized double-blind design. Mean oxygen
      saturation was greater in the group receiving 37% oxygen than in those having 21%
      oxygen (96% vs 92%, P less than 0.01). There was a weak correlation between mean
      oxygen saturation and the total number of hypoxaemic episodes (rs = -0.62, P less
      than 0.001), explained partly by the calculated (non-mechanistic) reduction in
      mean saturation by the episodes of hypoxaemia. There was no significant
      difference between the groups in the total number of sudden decreases in oxygen
      saturation, the duration of the events or number of patients with events to more
      or less than 80% oxygen saturation, although there was a trend towards fewer
      patients having events to less than 80% in the 37% oxygen group (nine of 17
      patients vs five of 18 patients (ns); 95% confidence limits of median difference:
      -6 to 56%). We conclude that postoperative oxygen therapy with 37% oxygen by face
      mask increases mean oxygen saturation, but does not influence the basic mechanism
      leading to episodic hypoxaemia.

PMID- 1739561
TI  - Postoperative hypoxaemia after major abdominal vascular surgery.
AB  - We have studied the severity and duration of nocturnal hypoxaemia before
      operation and for the first five nights after operation after elective major
      abdominal vascular surgery. Oxygen supplementation was almost 100% effective in
      keeping oxygen saturation greater than 90% during the early postoperative period;
      however, 50% of patients spent prolonged periods with an SpO2 less than 85%
      during at least one night after operation. The risk of severe hypoxaemia persists
      well beyond the current prescription of supplementary oxygen in these high risk
      patients. A significant association exists between the mean preoperative
      overnight saturation value and the nocturnal saturation observed subsequently in
      the later postoperative period.

PMID- 1739562
TI  - Effects of i.v. midazolam on upper airway resistance.
AB  - We have measured changes in supraglottic airway resistance (Rsg) produced by
      midazolam. Ten subjects were studied on two occasions, receiving in a random
      order either midazolam 0.1 mg kg-1 or placebo. Supraglottic pressures were
      measured using a balloon-tipped catheter and air flow with a pneumotachograph.
      Rsg were calculated at a flow rate of 0.3 litre s-1 during inspiration. No
      changes in Rsg and no apnoeic events were noted following placebo injection. Mean
      Rsg increased from 0.23 (SEM 0.07) kPa litre-1 s to 1.29 (0.38) kPa litre-1 s 5
      min after injection of midazolam (P less than 0.01), and remained increased
      significantly for 20 min. Twenty-two apnoeic events were recorded in six
      subjects, including 11 obstructive events. We conclude that midazolam in sedative
      doses increases Rsg markedly and induces central apnoea during the first few
      minutes after i.v. administration and this is followed by obstructive apnoea.

PMID- 1739563
TI  - Paediatric day-case surgery.

PMID- 1739564
TI  - Effects of posture, phonation and observer on Mallampati classification.
AB  - We have studied the effects of phonation and posture on the Mallampati
      classification of view of the pharyngeal structures. Differences between
      observers were allowed for by the experimental design and log-linear modelling.
      Sixty-four patients were assessed on the ward, sitting upright, with and without
      phonation, by each of two observers. Another 64 patients were assessed without
      phonation, but both upright and supine, again by both observers. Phonation (the
      patient saying "Ah") produced a marked, systematic improvement of view; moving to
      the supine posture produced a small, systematic, non-significant worsening of the
      view. Differences between observers were non-systematic but substantial. About
      25% of patients phonated spontaneously. It is recommended that anaesthetists make
      their own assessments of Mallampati classification, with the patient in either of
      the postures but always either with or without phonation, and thereby gradually
      "calibrate" their assessments against the degree of difficulty encountered in
      intubation.

PMID- 1739565
TI  - A high flow semi-open system for preoxygenation: an evaluation.
AB  - We have compared an alternative breathing system for preoxygenation comprising a
      Hudson face mask with high oxygen inflow (48 litre min-1) and a Mapleson A
      breathing system (100 ml kg-1 min-1). The study consisted of two parts: the first
      involved adult volunteers (10 male, seven female) and the second part used a lung
      model for spontaneous ventilation with a sinusoidal ventilatory wave pattern. In
      the volunteers, preoxygenation was achieved at mean times of 138 (SD 31.3) s and
      164 (SD 36.7) s with the high flow semi-open and Mapleson A systems,
      respectively. In the lung model, at peak inspiratory flow rates of 30 and 40
      litre min-1, the preoxygenation times were 139 and 120 s, respectively, with the
      semi-open system and 167 and 156 s with the Mapleson A system. The high flow semi
      open system may be an alternative for current techniques, provided peak
      inspiratory flows are not excessive.

PMID- 1739566
TI  - Fresh gas requirements of an enclosed afferent reservoir breathing system during
      controlled ventilation in children.
AB  - An enclosed afferent reservoir breathing system (EAR) designed by Ohmeda was
      evaluated during anaesthesia with controlled ventilation in 104 healthy children.
      Carbon dioxide production and arterial carbon dioxide tension were measured in 12
      children in order to determine the proportion of fresh gas (VF) involved in gas
      exchange. When the ratio of minute volume ventilation to fresh gas flow (VE:VF)
      exceeded 1.5, fractional utilization of fresh gas with the EAR was 0.92. This
      value and values of carbon dioxide production obtained from 43 children were used
      to derive a simple formula relating fresh gas flow requirements to body weight.
      The formula, VF = 0.6 x weight 0.5, was assessed in 49 children weighing 10-70
      kg. The mean end-tidal partial pressure of carbon dioxide in these patients was
      4.5 kPa (range 3.8-5.2 kPa). We conclude that the EAR has an efficiency of 92% in
      the use of fresh gas during controlled ventilation in healthy children, provided
      the VE:VF ratio is greater than 1.5. Under these conditions, normocapnia to mild
      hypocapnia was produced accurately using the formula VF = 0.6 x weight 0.5.

PMID- 1739567
TI  - Sighs and their effect on the breathing of patients anaesthetized with infusions
      of propofol.
AB  - Twenty-one spontaneous sighs were analysed from records of the breathing of 10
      patients anaesthetized for 22-42 (mean 28.7) min with propofol infusions. Sighs
      occurred in eight patients, the rate varying between once in 29 min and four
      times in 26 min. There was no pattern in breaths preceding sighs, but the
      succeeding breaths were altered. On the first succeeding breath, tidal volume was
      reduced by a mean of 32% (95% confidence limits 19-44%; P less than 0.01) and
      inspiratory time by a mean of 15% (95% confidence limits 8-22%; P less than 0.01)
      of the means of the preceding breaths. These effects lasted on average at least
      10 breaths. Expiratory time was usually slightly prolonged after a sigh, but this
      effect was less clear, less consistent and less prolonged. Sighs in patients
      anaesthetized with propofol reduce the ventilatory drive (in terms of mean
      inspiratory flow), and alter the timing, of succeeding breaths.

PMID- 1739568
TI  - Maternal and fetal haemodynamic effects of spinal and extradural anaesthesia for
      elective caesarean section.
AB  - Serial haemodynamic investigations were performed in 32 women who were allocated
      randomly to receive either spinal or extradural anaesthesia for elective
      Caesarean section. Cardiac output was measured by Doppler and cross-sectional
      echocardiography at the aortic valve. Doppler flow velocity waveforms were
      recorded also from the umbilical artery. Preloading with Ringer lactate solution
      1 litre increased cardiac output in both groups. After injection of bupivacaine,
      cardiac output remained increased in the extradural group, but decreased in the
      spinal group. This was associated with an increase in umbilical artery
      pulsatility index in the spinal group. Umbilical artery pH was less in the spinal
      group (7.22 vs 7.27), although no neonate was depressed at birth. The maximum
      percentage change in cardiac output and umbilical artery pulsatility index
      correlated with umbilical artery pH (r = 0.54, r = 0.72, respectively). There was
      no significant correlation with change in arterial pressure.

PMID- 1739569
TI  - First-time coronary artery bypass grafting: the anaesthetist as a risk factor.
AB  - We have investigated the contribution of the anaesthetist and surgeon to outcome
      after 1301 consecutive coronary artery bypass grafting operations (first
      operation). The mean + 1 SD aspartate amino transferase concentration on the day
      after surgery (AST-D1) was 134 u litre-1 (or, after logarithmic transformation,
      94 u litre-1). Twenty patients were selected at random from each of three groups
      having AST-D1 less than 100 u litre-1, 100-134 u litre-1 or greater than 134 u
      litre-1; positive ECG diagnoses of perioperative myocardial infarction were
      significantly more frequent with AST-D1 values greater than 100 u litre-1 than
      with smaller values, but no more frequent with AST-D1 greater than 134 u litre-1.
      Because several deaths occurred before AST-D1 could be measured, an "adverse
      outcome" was defined as either hospital death or AST-D1 greater than 100 u litre
      1. Univariate analysis implicated both anaesthetist and surgeon as significant
      predictors of adverse outcome but, after allowing for 12 patient-related factors,
      only cardiopulmonary bypass time (or ischaemic cross-clamp time) (P less than
      0.01) and anaesthetist (P = 0.05) were associated significantly with outcome.

PMID- 1739570
TI  - Induction dose-response of propofol in unpremedicated children.
AB  - The induction dose requirements of propofol were compared in three age groups in
      300 unpremedicated healthy Chinese children: group A, younger than 2 yr (n = 48);
      group B, 2-5 yr (n = 117); group C, 6-12 yr (n = 135). Patients in each group
      were allocated randomly to receive one of eight doses of propofol (1.2, 1.4, 1.6,
      1.8, 2.0, 2.2, 2.4 and 2.6 mg kg-1). ED50 and ED95 for loss of eyelash reflex
      (LER) and acceptance of face mask (AFM) were determined using probit analysis.
      ED50 and ED95 for both LER and AFM were greatest in group A, less in B and
      smallest in C; ED95 (AFM) for groups A, B and C were 2.88 (2.55-3.36), 2.53 (2.31
      2.86), and 2.20 (2.02-2.46) mg kg-1, respectively. This probably represented
      their effective induction dose. The incidence of apnoea was dose related, but not
      pain on injection.

PMID- 1739571
TI  - Effect of addition of hyaluronidase to bupivacaine during axillary brachial
      plexus block.
AB  - We have studied in 22 patients the effect of adding hyaluronidase to bupivacaine
      during axillary brachial plexus block (BPB) in a double-blind design. Patients
      received BPB using bupivacaine 2 mg kg-1 with adrenaline 1 in 200,000, either
      with or without hyaluronidase 3000 iu, in a volume of 0.5 ml per 2.54 cm of the
      patient's height. The use of hyaluronidase did not increase the speed of onset of
      anaesthesia or reduce the incidence of inadequate nerve block. Hyaluronidase
      produced a significant reduction in the duration of anaesthesia. Changes in grip
      strength and skin temperature were useful in assessing the onset and progress of
      BPB.

PMID- 1739572
TI  - In vitro contracture tests in patients with various neuromuscular diseases.
AB  - In order to investigate the relationship between neuromuscular disease and
      malignant hyperthermia (MH) susceptibility, the caffeine and halothane in vitro
      contracture test (European Malignant Hyperthermia Group Protocol) were performed
      in 60 patients who underwent muscle biopsy for investigation of a clinically
      suspected neuromuscular disorder. Two test results were classified as MH
      susceptible, 10 as MH equivocal and 48 MH negative. The large number of equivocal
      results is thought to indicate the lack of specificity of the individual
      components of this test in patients with clinical or histological evidence of
      neuromuscular disease. The increased in vitro sensitivity to the drugs tested may
      nevertheless provide some explanation for several in vivo "MH-like reactions"
      reported frequently in these patients. These reactions, however, are likely to be
      based on pathophysiological mechanisms different from those responsible for a
      true MH crisis.

PMID- 1739573
TI  - Treatment of postoperative pain with diclofenac in uvulopalatopharyngoplasty.
AB  - Diclofenac sodium suppositories 150-200 mg day-1 were compared with placebo in a
      double-blind study during the first 3 days after uvulopalatopharyngoplasty in 40
      patients with habitual snoring or obstructive sleep apnoea syndrome. Consumption
      of rescue analgesics (paracetamol suppositories) and pain assessed by a visual
      analogue scale were significantly less in the diclofenac group. Bleeding time
      (modified Ivy's test) and reported side effects did not differ between the two
      groups.

PMID- 1739574
TI  - MAC-awake of isoflurane, enflurane and halothane evaluated by slow and fast
      alveolar washout.
AB  - End-tidal anaesthetic concentrations at first eye opening in response to a verbal
      command during recovery from anaesthesia (MAC-awake), were measured for
      isoflurane (n = 16), enflurane (n = 16) and halothane (n = 14). MAC-awake was
      measured during either slow or fast alveolar washout. Slow washout was obtained
      by decreasing anaesthetic concentrations in predetermined steps of 15 min,
      assuming equilibration between brain and alveolar partial pressures. Fast
      alveolar washout was obtained by discontinuation of the inhalation anaesthetic,
      which had been maintained at 1 MAC for at least 15 min. Mean MAC-awake obtained
      with slow alveolar washout was similar for isoflurane (0.25 (SD 0.03) MAC), and
      enflurane (0.27 (0.04) MAC) and significantly greater than values obtained by
      fast alveolar washout (isoflurane: 0.19 (0.03) MAC; enflurane: 0.20 (0.03) MAC).
      The MAC-awake of isoflurane and enflurane was significantly less than that of
      halothane, which was 0.59 (0.10) MAC as evaluated by the slow and 0.50 (0.05) MAC
      as evaluated by the fast alveolar washout method. Recovery time from anaesthesia
      with fast alveolar washout was 8.8 (4.0) min for halothane, which was not
      different from isoflurane (15 (2.5) min), but significantly shorter than for
      enflurane (22 (10) min), reflecting differences in the anaesthetic concentration
      gradient between MAC and MAC-awake values. These data do not support the
      hypothesis of a uniform ratio between MAC and MAC-awake values.

PMID- 1739575
TI  - Recognition and management of difficult airway problems.

PMID- 1739576
TI  - Sedation after cardiac bypass surgery: comparison of propofol and midazolam in
      the presence of a computerized closed loop arterial pressure controller.
AB  - Forty patients who had undergone coronary artery graft surgery and who required
      vasodilator therapy for postoperative hypertension were given infusions of either
      propofol (2,6,di-isopropylphenol) or midazolam, together with an infusion of
      morphine for analgesia while ventilation was controlled artificially. Sodium
      nitroprusside was administered to patients in both groups using a computer
      controlled closed loop system. Both agents produced good quality of sedation.
      Overall times to spontaneous ventilation and tracheal extubation were shorter in
      the propofol group, but this was not statistically significant. Ease of control
      of arterial pressure was satisfactory clinically with both agents, although
      propofol appeared to be associated with a statistically greater incidence of
      hypotension.

PMID- 1739577
TI  - The specific dermatoses of pregnancy: the British perspective.

PMID- 1739578
TI  - Acoustic microscopy: can you hear the diagnosis?

PMID- 1739579
TI  - Advances in vulvar disease: lichen sclerosus et atrophicus et al.

PMID- 1739580
TI  - Prenatal diagnosis of severe dermatologic diseases.
AB  - It is obvious that the nature of prenatal diagnosis of severe or lethal skin
      conditions is rapidly evolving. New molecular, enzymatic, and ultrastructural
      markers will become available. The biochemical base of many of these disorders
      will become known and the accuracy and utility of in utero diagnosis will
      improve. We wish to make one point again. The field is rapidly outpacing the
      ability of review articles to keep current. We urge you to refer to a genetic
      center for information when you are dealing with a situation in which prenatal
      diagnosis may be an issue.

PMID- 1739581
TI  - Advances in alopecia areata and androgenetic alopecia.

PMID- 1739582
TI  - Topical product design and extemporaneous compounding in dermatology.

PMID- 1739583
TI  - Phototherapy and photochemotherapy.

PMID- 1739584
TI  - Update on chemical peels.
AB  - The area of chemical peeling has seen an explosion of growth and interest in the
      last 5 years. The use of peeling for the therapy of pigmentary dyschromias,
      actinic keratoses and rhytides, depressed scarring, and in selected cases,
      irradiation dermatitis, is amplified by the discovery of new wounding agents and
      new variations in technique. Appropriate growth in the objective evaluation of
      these agents and techniques is dependent on the demonstrative histology and the
      sharing of knowledge of both excellent results and significant complications in
      the dermatologic surgical literature.

PMID- 1739585
TI  - Superficial anatomy and cutaneous surgery of the hand.

PMID- 1739586
TI  - Keratinocyte cytokines.
AB  - It is now clear that keratinocytes produce a wide range of cytokines that can be
      regarded as important mediators of intercellular communication. A major emphasis
      has been placed on IL-1 because of its relationships with other cytokines and
      other differentiated tissues. Dysregulation of IL-1, IL-1 receptor, and
      inhibitory factors for IL-1 may cause imbalance of skin biology, leading to
      perpetuation of immune and inflammatory events. Interaction of IL-1 with other
      cytokines in vivo is also important in the understanding of the pathophysiology
      of skin diseases. More fundamental questions regarding the homeostatic
      significance of IL-1 in keratinocytes still remain to be answered.

PMID- 1739587
TI  - Imaging of the temporal bone.
AB  - High-resolution CT remains the imaging modality of choice for investigation of
      the temporal bone, especially if there is suspicion of bony involvement. The
      advances in two- and three-dimensional reconstruction are helpful for visualizing
      complex osseous structures. Nevertheless, the most exciting advances regarding
      imaging of the temporal bone were achieved in MR imaging. Improvement of surface
      coil technology, application of gadopentetate dimeglumine, and development of new
      imaging sequences led to an increasing importance for MR imaging, especially in
      inflammatory diseases. Soft tissue structures in neoplastic diseases in the
      temporal bone are better depicted on MR imaging. Therefore, in some cases, both
      modalities are used to detect soft tissue and bony abnormalities of the temporal
      bone, especially for cases using surgical management.

PMID- 1739588
TI  - Imaging of the nasal cavity and paranasal sinuses.
AB  - The CT examination in the coronal plane is the optimal imaging modality to
      evaluate the nasal cavity and the paranasal sinuses, especially for evaluating
      chronic inflammatory disease. This modality affords optimal display of the
      osteomeatal channels and best defines the extent of mucoperiosteal disease.
      Updated parameters for scanning afford a significant reduction of radiation. MR
      imaging supersedes CT in its ability to distinguish between inflammatory and
      neoplastic pathology and appears to be the optimal imaging modality for diagnosis
      of fungal sinusitis.

PMID- 1739589
TI  - Imaging of the salivary glands.
AB  - Salivary gland diseases are very common disorders and require radiologic
      evaluation. Several radiologic methods are used for assessment of these diseases.
      Conventional films of the parotid and submandibular glands demonstrate opaque
      stones in the duct system, whereas sialography depicts nonopaque stones, provides
      additional information on the position of the stones, and differentiates it from
      other calcific densities near the duct system, as well as providing information
      concerning ectasia of the ducts. CT has been used for evaluating mass lesions and
      extraglandular inflammatory disease, including abscesses. CT also depicts stones
      that may not be visible on conventional films. MR imaging has become an important
      modality in the diagnosis and definition of benign and malignant tumors and cysts
      and it will probably replace CT as the primary imaging modality for the
      assessment of these lesions. Gadolinium may be used in the examination,
      especially if a malignant tumor is suspected (because of irregularity and
      intraglandular extension).

PMID- 1739590
TI  - Imaging of the larynx.
AB  - In the past year, most of the new developments in imaging the larynx have
      concerned MR imaging. Some early results with the use of gadolinium are very
      promising. The superiority of new imaging techniques (CT and MR imaging) for the
      evaluation of deep structures of the larynx is now widely accepted and there is
      now enough background to assess the impact of new imaging methods on treatment.
      Also, prognostic factors are now emerging in laryngeal cancer. CT and MR imaging
      appear to be of great interest for evaluating recurrent diseases. Interest in
      plain film studies still remains especially for emergency situations. In
      pediatric patients, ultrasound and ultrafast CT of the larynx have been
      investigated.

PMID- 1739591
TI  - Diagnostic procedures in nasopharyngeal illness.
AB  - The nasopharynx contains a wide variety of different cell types. Therefore, many
      kinds of lesions can occur in this area, ranging from embryologic abnormalities
      to benign and malignant neoplasms. The challenge to the radiologist is to
      describe the extent and localization of inflammation, benign, and malignant
      tumors. The diagnostic procedures in these cases include flexible or rigid
      fiberoptic clinical examinations. Pantomography and plain film studies are
      usually done as part of the initial examination, and CT replaces pluridirectional
      tomography for all questions about compact bone. Soft tissue extent of lesions is
      better shown on MR imaging. New scientific experiences in diagnosing lesions of
      the area of the nasopharynx are presented.

PMID- 1739592
TI  - Magnetic resonance techniques and artifacts.
AB  - One area in which MR imaging can use improvement is the reduction of artifacts
      due to various physiologic motions during imaging. These artifacts degrade images
      and can cause misleading interpretations. This paper reviews some of the recent
      technical advances directed to remove these artifacts, as well as other
      techniques that improve MR imaging quality in general.

PMID- 1739593
TI  - Imaging of the thyroid and parathyroid.
AB  - The radiologic armamentarium for imaging of thyroid and parathyroid diseases
      includes scintigraphy, ultrasonography, CT, and MR imaging. Continued refinements
      of these diagnostic tools have been made during the past year. This paper reviews
      those recent advancements in the fields of parathyroid and thyroid imaging.

PMID- 1739594
TI  - Temporomandibular joint imaging.
AB  - Pain and discomfort caused by internal derangement of the temporomandibular joint
      are frequent in our society. Patients can present with very divergent complaints,
      not always clearly related to the temporomandibular joint. Good imaging studies
      of the temporomandibular joint that can show the presence or absence of a problem
      and give an idea as to type of disease and its seriousness are, therefore,
      necessary. The choice of which imaging study to use largely depends on whether MR
      imaging is easily available. Ongoing investigations show that MR imaging of the
      temporomandibular joint not only depicts the soft tissue derangements very well,
      but also shows the associated bony changes. However, the exact significance of
      disk displacement is not always clear because anterior displacement is also seen
      in asymptomatic volunteers and after clinically successful treatment.

PMID- 1739595
TI  - Neuroradiology.

PMID- 1739596
TI  - Head and neck.

PMID- 1739597
TI  - Imaging of normal anatomy and anomalies of the brain.
AB  - Magnetic resonance imaging permits better delineation of many anatomic structures
      not resolved with other imaging modalities and, by permitting the behavior of
      these structures to be observed at different pulse sequences, allows their
      tissues to be characterized. The literature of the year 1990 to 1991 includes
      many descriptive reports of normal anatomy, some of which are accompanied by
      explanations for the MR signal appearance. Familiarity with normal central
      nervous system structures and with normal MR signal characteristics is essential
      to avoid mistaking them for pathologic variants.

PMID- 1739598
TI  - Imaging of pediatric and congenital brain disease.
AB  - The etiology of hemiplegic cerebral palsy has been elucidated by surveys of
      affected children using CT. MR imaging has contributed to the more exact
      diagnosis of the nature and extent of hypoxic ischemic damage and allows the
      accurate estimation of the time of the insult. Serial MR imaging and MR
      spectroscopy may be useful for predicting the prognosis for cerebral palsy and
      neurodevelopmental delay. The damage caused by intrauterine infection is best
      appreciated on MR imaging, though CT is important in showing calcification.
      Similar considerations apply to tuberous sclerosis, and new observations may
      facilitate MR imaging diagnosis. Gadolinium-enhanced MR imaging is the most
      accurate modality for detection of tumor recurrence and metastatic spread.
      Enhancement due to reactions to and complications of surgery can usually be
      distinguished. The reliability of MR imaging in showing many congenital anomalies
      provides evidence of the incidence of these lesions and contributes to
      understanding the disordered embryology. Most of the changes described in
      inherited metabolic disorders are nonspecific, but they may suggest a particular
      diagnosis, and MR imaging is the most sensitive modality for monitoring progress.
      Lifesaving intervention for arteriovenous malformations involving the vein of
      Galen requires detailed noninvasive imaging for selecting the most effective
      approach. Technical developments in diffusion and in flow imaging promise to
      further increase our diagnostic capabilities and to limit the application of
      invasive techniques.

PMID- 1739599
TI  - Magnetic resonance imaging contrast agents.
AB  - Intravenous contrast enhancement has assumed a prominent position in clinical MR
      imaging, particularly for studies of the head and spine. New chelates such as
      gadoteridol are likely to be approved in the near future; gadopentetate
      dimeglumine is the only agent approved for clinical use in the United States.
      Clinical applications have rapidly expanded for the gadolinium chelates with
      extracellular distribution. Within the next decade, approval is anticipated for a
      variety of additional agents that may help assess tissue function.

PMID- 1739600
TI  - Imaging of metabolic diseases of the brain.
AB  - Increasing interest in metabolic diseases of the brain has revealed more specific
      patterns of disease, permitting us to make more accurate diagnoses or to suggest
      a more limited differential list of considerations. MR imaging is also useful in
      monitoring the course of the disease in processes for which treatment is
      available.

PMID- 1739601
TI  - Imaging of infections of the central nervous system.
AB  - Acquired immunodeficiency syndrome (AIDS) and AIDS-related infection of the brain
      constitute a large fraction of the most recent research into central nervous
      system infection. Two major areas of controversy discussed in the past year's
      literature were the neuroradiologic and neurologic manifestations of early human
      immunodeficiency virus infection in the central nervous system and
      differentiation of toxoplasmosis from lymphoma. Other non-AIDS related infections
      discussed included infectious aneurysms, bacterial abscesses, tuberculosis,
      cysticercosis, fungal infections, and zoster myelitis.

PMID- 1739602
TI  - Imaging of tumors of the central nervous system.
AB  - Research in diagnosing and understanding brain tumors in neuroradiology is
      influenced by the investigative tools available to neuroradiologists. CT has
      represented the gold standard for the past two decades. The role of angiography
      has become complementary; relevant in the therapeutic phase of embolization of
      meningiomas or base of the skull tumors or in intra-arterial chemotherapy for
      gliomas. In 1991, the MR imaging revolution continues to provide new insights in
      the diagnosis, classification, and understanding of the biology of brain tumors.
      Interest has been focused mainly on information provided by MR imaging and MR
      spectroscopy. Spectroscopy is being used in a more systematic way and in large
      series with different histologic tumor types. Spectra from tumors are definitely
      different from those of normal brain, although no specific patterns for
      histologic types were found, with the possible exception of meningiomas.
      Comparison with positron emission tomography is considered to be useful. Analysis
      of rare tumors using MR imaging allows better understanding, classification,
      diagnosis, and surgical therapy of lesions such as central neurocytomas,
      hamartomatous tumors, and lymphomas. An attempt at a better classification for
      brain tumors was proposed and may prove to be very useful for systematization and
      communication.

PMID- 1739603
TI  - Imaging of degenerative processes of the spine.
AB  - Because MR imaging provides accurate, clear, and noninvasive imaging for diseases
      of the spine and spinal cord, it has become the primary imaging modality in
      patients with spinal pathology. Degenerative processes of the spine are frequent,
      including disk degeneration and herniations, spondylosis, spinal canal stenoses,
      calcifications, and ossifications of the spinal ligaments. Several papers have
      been published recently on MR imaging in degenerative processes of the spine.

PMID- 1739604
TI  - Ischemic brain disease, vascular brain disease, and magnetic resonance
      angiography.
AB  - Rapid, accurate diagnosis and successful implementation of new stroke therapies
      will depend on the refinement and skilled use of neuroimaging. Because a variety
      of MR techniques offer information on local brain biochemistry, blood flow,
      perfusion, vascular integrity, ischemia, edema or free water, infarction, and
      hemorrhage, there is intense interest in their application to cerebrovascular
      disease. This review highlights recent advances in MR technology as they relate
      to conventional MR imaging, MR angiography, and basic MR research into the use of
      diffusion, perfusion, and spectroscopic techniques.

PMID- 1739605
TI  - Imaging of neurodegenerative diseases.
AB  - Neuroimaging of degenerative brain disorders has continued to advance, primarily
      with MR imaging, single-photon emission CT, and positron emission tomography.
      Information gained from these morphologic and functional imaging studies provides
      insight into the pathologic and pathophysiologic changes associated with these
      diseases. Recent papers relating to various neurodegenerative disorders such as
      Alzheimer's disease, vascular dementias, acquired immunodeficiency syndrome
      related dementia, Pick's disease, Huntington's disease, progressive supranuclear
      palsy, and others are reviewed and discussed.

PMID- 1739606
TI  - Physiologic imaging of the brain.
AB  - Advances in imaging hardware for positron emission tomography and single-photon
      emission CT, coupled with a wide variety of radiopharmaceutical agents, have
      allowed these techniques to be used in the evaluation of neoplasm, stroke,
      epilepsy, and dementia. Cerebral perfusion agents continue to be the mainstay of
      single-photon emission CT imaging but, in addition to the evaluation of ischemia,
      it has seen an increasing role in the study of dementia, neuropsychiatric
      disorders, and seizures. Positron emission tomography scanning has had similar
      applications but it is playing a greater part in the evaluation of neoplasms,
      including primary gliomas and pituitary adenomas. Stable-xenon CT has shown value
      in the study of ischemia associated with meningitis, sickle cell disease, chronic
      subdural hematomas, and cerebral arteriovenous malformations. MR diffusion
      imaging shows promise in the evaluation of white matter pathology and some
      tumors.

PMID- 1739607
TI  - Selectivity and potency; are we doing the right things to find anti-cancer agents
      with these properties?

PMID- 1739608
TI  - The management of locally advanced breast cancer.

PMID- 1739609
TI  - Lessons from 20 years of curative therapy of childhood acute leukaemia.
AB  - The past 20 years of curative therapeutics of childhood acute leukaemia has been
      largely a period of consolidation of gains, refinement of techniques and
      dissemination of expertise and technology. However, certain lessons have been
      learned. First, cure can be permanent but the complexity and cost of curative
      treatment currently restricts its accessibility; prevention or simple curative
      treatment is needed. Secondly, cure of the child demands that the risk of adverse
      sequelae of treatments be carefully balanced with known therapeutic benefits.
      Thirdly, preventive meningeal irradiation is no longer required. Fourth,
      treatment intensification is self-limiting. Adverse reactions can cancel out or
      exceed therapeutic benefits, resulting in a lower cure rate or a similar cure
      rate with lower quality of cure. Finally, morphology, immunophenotype and
      genotype of acute leukaemia are important criteria for selecting and scheduling
      drug therapy. Genotype may be the most important since leukaemia is a genetic
      disorder for which morphology and immunophenotype are mere reflections. However,
      none of these features, individually or together, are sufficient to explain all
      the difference in outcome among children on a given treatment plan or to
      completely fulfill the need of criteria for selection of treatment. Acute
      leukaemia remains an unsolved problem demanding considerably more basic and
      clinical research to meet the need for prevention and simple dependable curative
      treatment.

PMID- 1739610
TI  - Enhancement of transforming growth factor-alpha synthesis in multicellular tumour
      spheroids of A431 squamous carcinoma cells.
AB  - Multicellular tumour spheroids are cellular aggregates that can be prepared from
      many types of tumour cells. These three-dimensional structures provide a model
      for analysing the effects of cell-cell contact and intercellular
      microenvironments on phenomena such as autocrine regulation of growth factor
      synthesis. Autoregulation of the synthesis of transforming growth factor-alpha
      (TGF-alpha) was investigated at the message and protein levels in spheroid and
      monolayer cultures prepared from the A431 human squamous carcinoma cell line. The
      epidermal growth factor receptor (EGF-R) of these monolayer A431 cells had an
      average surface density of 2.2 x 10(6)/cell. Constitutive expression of TGF-alpha
      mRNA was an average of 3-fold greater in A431 spheroids than in monolayers, even
      for densely packed, confluent monolayers. This effect did not depend on hypoxic
      stress within the spheroids. TGF-alpha protein synthesis was enhanced in
      comparison with that in monolayer culture, reaching a value of up to 2-fold
      greater on a per cell basis. These results are discussed in the context of a TGF
      alpha/EGF-R autocrine loop operating within cells that produce high local
      concentrations of TGF-alpha in the three-dimensional architecture of a spheroid.

PMID- 1739611
TI  - Changes in tissue fatty acid composition in murine malignancy and following
      anticancer therapy.
AB  - We studied the mouse NC tumour, a subcutaneously transplanted adenocarcinoma
      originally of mammary origin. Measurements per g tissue were made of 17 fatty
      acids (FAs), the combined amounts of n-3, n-6, saturated, unsaturated, and total
      FAs, and of various FA ratios in the tumour, mammary tissue, spleen, liver and
      plasma. Compared with mammary tissue from normal mice, tumours of vehicle-treated
      controls had less of seven of the FAs and more of two FAs. Mice bearing the NC
      tumour often had changed (usually decreased) amounts of FAs in the 'normal'
      spleen, liver and plasma, but not in mammary tissue. Treatment with methotrexate
      (MTX) was studied alone and with indomethacin which can potentiate MTX
      cytotoxicity. Indomethacin 1.25 mg kg-1 (INDO) increased the amounts of 3/17
      tumours FAs and the unsaturated FAs, but reduced 9/17 FAs, the saturated and the
      unsaturated FAs in 'normal' mammary tissue, and usually had no effect on the FAs
      of other tissues. MTX 2 or 4 mg kg-1 (MTX 2 or 4 mg) +/- INDO in general partly
      restored (increased) the amounts of tumour FAs, and reduced the
      saturated/unsaturated FA ratio. In the 'normal' spleen and plasma also, but not
      in the liver, MTX 2 mg generally somewhat restored the FA composition. However,
      as in the liver, the spleen 20:4 and 22:6 (which form prostaglandins and lipid
      peroxides) did not increase in the presence of INDO. With MTX 4 mg, some of the
      plasma and liver FAs decreased, in contrast to the tumour. There was generally no
      evidence of MTX potentiation by INDO. These results are discussed in relation to
      carcinogenesis, cachexia, and the response to treatment.

PMID- 1739612
TI  - The inhibition of DNA synthesis in chronic lymphocytic leukaemia cells by
      chlorambucil in vitro.
AB  - The inhibition of 3H-thymidine incorporation into the DNA of mitogen-stimulated
      lymphocytes from patients with chronic lymphocytic leukaemia by chlorambucil was
      measured in vitro and the results related to clinical drug resistance. The assay
      proved to be both sensitive and specific showing a clear separation of those
      patients with responsive disease from those with disease resistant to treatment.
      There was evidence of primary drug resistance in untreated patients. In almost
      all patients who received treatment this led to increasing resistance to
      chlorambucil in vitro. The assay is predictive of clinical responsiveness and
      provides a potential means whereby new therapeutic agents and treatment modifiers
      may be investigated.

PMID- 1739613
TI  - Divergent responses to epidermal growth factor in hormone sensitive and
      insensitive human prostate cancer cell lines.
AB  - The present study was undertaken to compare the relationship between response to
      exogenous epidermal growth factor (EGF) and the expression of the EGF-receptor
      (EGF-R) in an androgen sensitive (LNCaP) and insensitive (DU145) prostate cancer
      cell line. Although both cell lines demonstrated a single EGF-R binding site of
      similar high affinities (mean dissociation constant (Kd) +/- S.D. for DU145 = 1.0
      +/- 0.6 nmol l-1; LNCaP = 2.8 +/- 2.2 nmol l-1) the number of binding sites (RT)
      for the hormone insensitive DU145 cells (mean +/- S.D. = 2.5 +/- 1.0 x 10(5)
      sites/cell) and 10-fold greater than that expressed in the androgen responsive
      LNCaP cell line (mean +/- S.D. = 2.0 +/- 1 x 10(4) sites/cell). Additionally
      exogenous EGF only minimally affected the growth and DNA synthesis of DU145 cells
      whereas LNCaP cells showed a significant response which was dose dependent. The
      autologous production of EGF-like molecules by DU145 cells is believed to reduce
      the cells needs for exogenous mitogens, thereby rendering the cells
      autostimulatory. Treatment of LNCaP cells with Mibolerone--a synthetic androgen-
      did not affect either the expression of the EGF receptor or the proliferative
      response observed with EGF. Western blot analysis, using monoclonal antibodies
      directed against the EGF receptor revealed a band of approximately 170 kD with
      DU145 cell lysates but the LNCaP EGF receptor was not detected using this
      technique.

PMID- 1739614
TI  - Novobiocin-induced anti-proliferative and differentiating effects in melanoma
      B16.
AB  - The antibiotic drug novobiocin was evaluated for its anti-tumour properties in
      B16 melanoma cells. Novobiocin is shown to inhibit melanoma B16 cell
      proliferation. The anti-proliferative effect was gradually reversible upon
      removal of novobiocin from the culture medium. Growth inhibition by novobiocin
      was accompanied by phenotypic alterations, that included morphological changes,
      lipid accumulation and marked increases in the activities of NADPH cytochrome c
      reductase and gamma glutamyl transpeptidase. In vivo administration of repeated
      i.p. doses of novobiocin, to mice implanted with B16 melanoma cells resulted in
      growth retardation. The combined treatment of the B16 melanoma cells with
      novobiocin and other chemical inducers of differentiation was examined in a cell
      growth assay. Novobiocin and sodium butyrate inhibited cell growth in a near
      additive manner, while combination of novobiocin with the GTP-depleting agents,
      tiazofurin or mycophenolic acid resulted in a synergistic decrease in cell
      growth. Our results support the contention further that novobiocin and other
      differentiating agents might be of potential value in melanoma therapy.

PMID- 1739615
TI  - Epidermal growth factor receptor levels are lower in carcinomatous than in normal
      colorectal tissue.
AB  - A series of 24 paired samples of colorectal carcinoma and the respective normal
      colorectal mucosa were analysed for Epidermal Growth Factor Receptor (EGFR)
      content by means of a standardised ligand binding assay. We, for the first time,
      found that EGFR levels are statistically significantly higher in normal
      colorectal mucosa biopsy samples than they are in colorectal carcinoma biopsy
      samples, the median EGFR levels being 77.5 fmol mg-1 of membrane protein (range
      35-239), against 46 fmol mg-1 of membrane protein (range 22-81), respectively, P
      less than 0.001. In addition, we found that there are significant regional
      differences in EGFR expression in the normal human colon mucosa. The EGFR levels
      were significantly higher in samples from the proximal part of the colon than
      they were in samples from the distal part, the median EGFR levels being 124 fmol
      mg-1 of membrane protein (range 70-239) vs 55 fmol mg-1 membrane protein (range
      35-156), P less than 0.05. The EGFR levels of the colorectal carcinoma samples
      did not show any regional variation.

PMID- 1739616
TI  - Type III collagen metabolism in soft tissue sarcomas.
AB  - Sera of 85 patients with benign soft tissue lesions or sarcomas of soft tissues
      were investigated for a collagen metabolite, the aminoterminal propeptide of type
      III procollagen (PIIINP). Patients were divided into three groups: benign soft
      tissue lesions (n = 39), localised (n = 29) and metastatic (n = 18) soft tissue
      sarcomas (STS). Values of PIIINP above the reference range were found in 15%, 28%
      and 50% of the respective groups. The difference in the concentration of PIIINP
      was statistically significant between the benign lesions and the localised
      sarcomas; P = 0.05, and between the benign lesions and the metastatic sarcomas; P
      less than 0.001. In localised sarcomas there was a correlation between PIIINP and
      bone-involvement (r = 0.61, P = 0.002) and in metastatic disease between PIIINP
      and liver metastases (r = 0.77, P less than 0.001). In localised sarcomas the
      overall survival for patients with a value of PIIINP above the reference range
      was significantly poorer (P = 0.03) than for patients with values within the
      reference range, even after stratification for the histological malignancy grade
      of the tumours (P = 0.04).

PMID- 1739617
TI  - Human/mouse chimeric antibodies show low reactivity with human anti-murine
      antibodies (HAMA).
AB  - Human anti-murine antibody (HAMA) response is a serious problem in the repeated
      infusion of murine monoclonal antibodies (MoAbs). HAMA positive sera were
      obtained from seven patients with colorectal cancer, pancreas cancer, malignant
      melanoma or myocardial infarction who had previously received radiolabelled
      MoAbs. The nature of HAMA was analysed using size exclusion high performance
      liquid chromatography (HPLC) after incubating with radiolabelled MoAbs including
      IgG, Fab or human/mouse chimeric Abs. Immune complexes composed of HAMA and MoAbs
      were formed. The percentage of radioactivity with a high molecular weight was
      related to HAMA levels determined by enzyme linked immunosorbent assay. Most
      radioactivity present in immune complex shifted to the antibody fraction after
      the addition of normal murine serum. All of seven sera were reactive with all
      four murine IgGs and this suggests that HAMA in these patients recognised the
      constant region of MoAbs. In one patient, HAMA was considered to recognise the
      variable region and to be anti-idiotypic. There was no significant binding with
      human/mouse chimeric Abs in any HAMA positive serum, although five out of seven
      patients were reactive with murine MoAb Fab, indicating that HAMA was composed of
      Abs responsive to the CH1 or CL region of murine IgG. These results suggest that
      (1) HAMA was composed of Ab responsive to Fc portion and/or CH1 or CL region of
      murine IgG, and (2) human/mouse chimeric Abs look promising in the repeated
      infusion of MoAb in HAMA positive patients.

PMID- 1739618
TI  - Production and characterisation of a monoclonal antibody (Cx-99) against cervical
      carcinoma.
AB  - An IgG1 monoclonal antibody (MAb Cx-99) has been established which recognises a
      surface antigen on epithelial cells, but not on fibroblastic or hematopoietic
      cells. Immunohistochemical studies showed that this antigen was present in all 37
      squamous cell carcinomas (SCC) including 33 cervical SCC, and 30 of the 32
      adenocarcinomas examined; most of the 33 cervical SCC were stained extensively.
      It was also detected in the culture medium of cervical cancer cell lines. In the
      normal cervix, this antigen was restricted to the undifferentiated basal cells.
      This observation suggests that the widespread expression of the antigen was
      triggered by oncogenesis. The MAb Cx-99 recognised an epitope on an asialyted
      glycoprotein which has an apparent molecular weight of 37 kilodaltons (kD) (and 2
      minor proteins at 18 and 27 kD) and an isoelectric point (pI) of 5.3. It may have
      potential for studies on differentiation and oncogenesis and for diagnostic
      applications.

PMID- 1739619
TI  - Inactivation of p53 gene in human and murine osteosarcoma cells.
AB  - We examined structure and expression of the p53 and Rb genes in a C3HOS
      transplantable mouse model of osteosarcoma. The results were compared to
      analogous studies conducted with five human osteosarcoma cell lines. The p53 gene
      was found rearranged in the mouse tumour. The rearrangement mapped to the first
      intron region of the p53 gene and as a result, no p53 expression could be
      detected in C3HOS tumours. Using p53 genomic probes, we have detected the same
      rearrangement in the original radiation-induced tumour and the various clones
      that were isolated from it. Deletion and rearrangement of the p53 gene were also
      found in three out of five of the human osteosarcoma cell lines (MG-63, G-292,
      Saos-2). No p53 expression could be detected in these three cell lines. In the
      affected human osteosarcoma cell lines, the rearrangement involved the first
      intron region. In addition, the mouse tumor was analysed for structural and
      expression changes in the Rb and the c-myc genes. Normal expression of both genes
      were detected in the murine tumour. Only one (Saos-2) human osteosarcoma cell
      line exhibited gross structural alteration in the retinoblastoma gene. The
      results suggest that the inactivation of p53 may be an important step in the
      development of osteosarcomas, and that a rearrangement affecting the first intron
      is common in osteosarcomas.

PMID- 1739620
TI  - Sensitivity and specificity of CA242 in gastro-intestinal cancer. A comparison
      with CEA, CA50 and CA 19-9.
AB  - A serological assay for the quantitative determination of the novel tumour
      associated epitope CA242 was developed and used for determination of sensitivity
      and specificity of CA242 in gastrointestinal cancer. The CA242 assay showed a
      better tumour specificity than CA50 (and CA 19-9). This was most noticeable in
      benign hepatobiliary disease. The sensitivity at 90% specificity cut-off level
      was approximately three times higher for CA242 compared to CA50 in colo-rectal
      cancer Dukes A, B and C, while in pancreatic cancer the sensitivity of CA242 and
      CA50 was similar. CA242 was expressed independently of CEA, and the combination
      of CEA and CA242 gave in colo-rectal cancer considerably higher sensitivity than
      the use of only one of the markers. This was most pronounced in Dukes A and Dukes
      B patients. CA242 is a novel tumour marker of potential clinical use,
      particularly in colo-rectal cancer.

PMID- 1739621
TI  - Generation of adherent lymphokine activated killer (A-LAK) cells from patients
      with acute myelogenous leukaemia.
AB  - Successful generation of adherent lymphokine-activated killer (A-LAK) cells,
      highly-enriched in CD3-CD56+ antitumour effector cells, from the peripheral blood
      of ten patients with acute myelogenous leukaemia (AML) is described. The AML
      patients were either untreated or in remission. In vitro proliferation of A-LAK
      cells in patients with AML was generally poor, unless the cells were cocultured
      with irradiated concanavalin A (ConA)--prestimulated allogeneic PBL or selected
      lymphoblastoid cell lines (LCL) as feeder cells. Using this method, the median
      fold proliferation was 290 for A-LAK cells cultured with ConA-activated feeders
      and 291 for those grown with LCL, both significantly higher (both P less than
      0.001) than the median of 2-fold expansion observed in cultures without feeders.
      A-LAK cultures generated in the presence of feeders consistently showed good
      enrichment (up to 90%) in CD3-CD56+ NK cells. Although NK activity was not
      significantly increased on a per cell basis in A-LAK cells grown with feeder
      cells, total lytic activities against both NK-sensitive target, K562, and NK
      resistant target, Daudi, were significantly greater (P less than 0.02 for ConA
      PBL feeders and P less than 0.005 for LCL feeders) as compared to those in paired
      cultures without feeders. In the presence of irradiated allogeneic feeder cells,
      7/10 AML patients generated A-LAK cultures characterised by good proliferation
      and increased purity as well as cytotoxic activity.

PMID- 1739622
TI  - In vitro and in vivo studies on the combination of Brequinar sodium (DUP-785; NSC
      368390) with 5-fluorouracil; effects of uridine.
AB  - Brequinar sodium (DUP-785; Brequinar) is a potent inhibitor of the pyrimidine de
      novo enzyme dihydroorotate dehydrogenase (DHO-DH), leading to a depletion of
      pyrimidine nucleotides, which could be reversed by uridine. In in vitro studies
      we investigated the effect of different physiological concentrations of uridine
      on the growth-inhibition by Brequinar, the effect of the nucleoside transport
      inhibitor, dipyridamole, and the combination of Brequinar and 5-fluorouracil
      (5FU). Uridine at 1 microM slightly reversed the growth inhibition by Brequinar,
      while the effect of 5-500 microM was greater. However, at Brequinar
      concentrations greater than 30 microM, uridine could not reverse the growth
      inhibitory effects. Addition of dipyridamole could only partially prevent the
      reversing effects of uridine. The combination of Brequinar and 5FU was more than
      additive in the absence of uridine in the culture medium, but not in the presence
      of uridine. The combination of Brequinar and 5FU was tested in vivo in two murine
      colon tumour models, Colon 26 and Colon 38. Scheduling of both compounds appeared
      to be very important. In Colon 38 no potentiating effect of Brequinar could be
      observed. In contrast in Colon 26 a more than additive effect could be observed.
      Since uridine concentrations are considerably different in these tumours (higher
      in Colon 38), it was concluded from both the in vitro and in vivo experiments
      that uridine is an important determinant in combinations of Brequinar and 5FU.

PMID- 1739623
TI  - Molecular and functional characterisation of a fusion protein suited for tumour
      specific prodrug activation.
AB  - A fusion protein consisting of the humanised Fab fragment of the anti CEA MAb BW
      431 and the human beta-glucuronidase was expressed in BHK cells. Functional
      testing revealed that the specificity and avidity of the humanised V region was
      similar to the original murine MAb BW 431. Furthermore, the enzymatic activity,
      pH sensitivity and stability of the human beta-glucuronidase in the fusion
      protein was comparable to the activity of recombinant human beta-glucuronidase.
      Using anti-idiotype affinity chromatography, two molecules of a molecular weight
      of 125 kDa or 250 kDa could be visualized under nonreducing conditions in SDS
      PAGE. Reducing conditions revealed a 25 kDa light and 100 kDa heavy chain. Due to
      its suitable biological characteristics this fusion protein might be an
      appropriate molecule allowing a site specific antibody directed enzyme prodrug
      therapy (ADEPT) in vivo.

PMID- 1739624
TI  - Detection of bone marrow abnormalities in patients with Hodgkin's disease by T1
      mapping of MR images of lumbar vertebral bone marrow.
AB  - Pixel by pixel T1 mapping of MR images has been used in conjunction with image
      analysis techniques to study the lumbar vertebral bone marrow of 20 patients with
      refractory or relapsed Hodgkin's disease prior to salvage chemotherapy, or high
      dose chemotherapy with autologous bone marrow rescue. Compared to 18 age matched
      controls, seven patients had significantly abnormal lumbar vertebral marrow T1
      histograms with median, 5% and 95% centile T1 values that lay outside a three
      dimensional 95% probability region obtained for the normals. Six of these
      patients had increased areas of high T1 consistent with bone marrow involvement
      with lymphoma; although, only in two of them had Hodgkin's disease been detected
      by bilateral iliac crest bone marrow biopsy. Post-treatment studies were
      performed in four patients who had abnormal areas of high T1 in the lumbar
      vertebral bone marrow. All showed normalisation of the T1 histogram, with a
      reduction of T1 values to within the normal range as defined by the studies of
      age matched controls. T1 mapping of bone marrow offers potential for detecting
      bone marrow infiltrates in patients with lymphoma, and also for the assessment of
      treatment response.

PMID- 1739625
TI  - Adjuvant tamoxifen for male breast cancer (MBC).
AB  - A study was started in 1976 whereby patients with Stage II and operable Stage III
      MBC were given adjuvant Tamoxifen for 1 year, increasing to 2 years from 1988.
      All patients had axillary nodal involvement. Primary treatment consisted of a
      radical mastectomy or simple mastectomy with radiotherapy. The rarity of the
      disease precluded a randomised trial. Thirty-nine patients are available for
      analysis at a median follow-up of 49 months. The actuarial survival of the
      Tamoxifen treated patients is 61% (range 42-80%) at 5 years compared to 44%
      (range 35-53%) for historical controls (P = 0.006). Disease-free survival was 56%
      (37-75%) vs 28% (17-33%) at 5 years (P = 0.005). There were no serious side
      effects recorded. The conclusion from this, the first reported series on adjuvant
      Tamoxifen therapy for MBC, is that significant improvement in disease-free
      survival can be achieved with minimal upset to the patients. Recruitment to the
      study continues.

PMID- 1739626
TI  - Familial testicular cancer: a report of the UK family register, estimation of
      risk and an HLA class 1 sib-pair analysis.
AB  - Forty-two families with two or more cases of testicular cancer have been reported
      to the UK Register for Familial Testicular Cancer, comprising two pairs of
      identical twins, 27 sets of other brothers (25 pairs, two triples), nine father
      son pairs, two pairs of first cousins and two uncle-nephew pairs. In total 91
      testicular tumours are described in 86 individuals (42 (46%) pure seminoma, 49
      (54%) other germ cell tumours). The median age at diagnosis in these patients was
      significantly younger than that in a comparable series of non-familial patients
      (29 c.f. 32.5 years, P less than 0.01). In a case-control comparison of 794
      testicular cancer patients, eight patients (1.0%) had a brother and four patients
      (0.5%) had a father with a previous diagnosis of testicular cancer at the time of
      their own diagnosis (and these families are all included in this report). Two out
      of 794 controls (0.3%) had a first degree relative with testicular cancer. The
      cumulative risk to a brother of a patient for developing testicular cancer by the
      age of 50 years was estimated to be 2.2% (95% C.I. 0.6-3.8%) which results in a
      relative risk of 9.8 (95% C.I. 2.8-16.7) in comparison with the general
      population. HLA Class I typing of 21 affected sib-pairs demonstrated four (19%)
      sharing two haplotypes, 13 pairs (62%) sharing one and four pairs (19%) sharing
      none. This did not differ significantly from the expected proportions of
      25%/50%/25%. It is unlikely, therefore, that there is a major gene associated
      with testicular cancer predisposition within or closely linked to the major
      histocompatibility gene complex on chromosome 6.

PMID- 1739627
TI  - A case-control study of cancers of the gastric cardia in Italy.
AB  - In a case-control study of gastric cancer (GC) in high-risk and low-risk areas in
      Italy, 923 GCs were reviewed by one pathologist and classified according to
      anatomic site. There were 68 (7.4%) cancers occurring in the gastric cardia.
      Compared to other GCs, cardia cancer tended to occur more often in males (sex
      ratio 2.8 vs 1.7) and as intestinal or unclassified histologic types. Nutritional
      factors for cardia tumours resembled those of other GCs, showing inverse
      associations with the consumption of raw vegetables, citrus and other fresh
      fruit, and ascorbic acid, and positive associations with the intake of
      traditional soups and meat, protein and cholesterol, and preference for salty
      foods. Cigarette smoking and wine consumption were unrelated to cardia cancer
      risk, and there was only a weak association with total alcohol intake. Cardia
      tumours showed a greater familial occurrence of GC than did other sites, with a 7
      fold increase in risk for those reporting two first-degree relatives with GC. The
      authors discuss these findings in view of the rising incidence of adenocarcinomas
      of the cardia and lower oesophagus that has been reported in some western
      countries.

PMID- 1739628
TI  - A phase I study on the reversal of multidrug resistance (MDR) in vivo: nifedipine
      plus etoposide.
AB  - Multidrug resistance (MDR) is one of the mechanisms of resistance to multiple
      cytotoxic drugs and is mediated by the expression of a membrane pump called the P
      glycoprotein. Nifedipine is one of the calcium channel blocking agents which
      reverses MDR in vitro. Fifteen patients with various malignancies received
      nifedipine at three dose levels: 40 mg, 60 mg and 80 mg orally twice daily for 6
      days. Etoposide was administered intravenously on day 2 in a dose of 150-250 mg m
      2 and orally 150-300 mg twice daily on days 3 and 4. Cardiovascular effects of
      nifedipine were dose limiting and the maximum tolerated dose was 60 mg bid. Mean
      area under the plasma concentration curve (AUC0-00) and plasma half-life (beta)
      of nifedipine and its major metabolite MI at the highest dose level were 7.87
      microM.h, 7.97 h and 4.97 microM.h, 14.0 h respectively. Nifedipine did not
      interfere with the pharmacokinetics of etoposide.

PMID- 1739629
TI  - A randomised study comparing standard dose carboplatin with chlorambucil and
      carboplatin in advanced ovarian cancer.
AB  - A total of 161 previously untreated patients with FIGO stage III or IV epithelial
      ovarian cancer were randomised after surgery to receive six courses of either
      carboplatin 400 mg m-2 alone (Arm A) or carboplatin 300 mg m-2 with chlorambucil
      10 mg day-1 for 7 days (Arm B). The median progression free survival (PFS) was
      similar: arm A: 45 weeks; arm B: 61 weeks (P = 0.830). Multivariate Cox
      regression analysis showed that the extent of residual disease and performance
      status were the most important prognostic factors for PFS. Fifty-two per cent of
      patients received dose escalations based on nadir blood counts, and 89% of all
      dose adjustments were made according to protocol. Failure to achieve a
      significant degree of leucopenia was associated with worse progression free
      survival (P less than 0.001). A total of 29.4% of patients fall into this
      category. The median survival was similar in both arms, i.e. 75 weeks. It is
      unlikely that there is any major clinical advantage to adding chlorambucil to
      single agent carboplatin for the management of advanced ovarian cancer, but
      whether used in combination or a single agent, the dose of carboplatin should be
      sufficient to cause at least grade I leucopenia. This may best be achieved by
      determining the initial dose based on renal function, and then adjusting
      subsequent doses according to nadir blood counts.

PMID- 1739630
TI  - Prognostic impact of chromosome aberrations in ovarian cancer.
AB  - Clinico-cytogenetic correlations were assessed in 88 patients with malignant
      ovarian tumours. Cytogenetic analysis of the primary tumours yielded normal
      karyotype (N) in 33 patients and abnormal karyotypes (A) in 55 patients. Within
      the A group, seven tumours had simple abnormalities (AS), i.e., numerical changes
      only or a single structural aberration, and 48 had karyotypes with complex
      aberrations (AC). A correlation analysis between groups N and A revealed that
      cytogenetic abnormalities were more often found among seropapillary tumours, and
      that cases with abnormal karyotypes on average were of higher stage and more
      often had residual tumour mass after initial surgery (P less than 0.05 for all
      variables). When the three groups N, AS, and AC were compared, they were found to
      be significantly different with regard not only to the three parameters mentioned
      above, but now tumour grade also appeared to correlate with karyotypic pattern (P
      = 0.001), with poorly differentiated tumours having the most complex karyotypes.
      In a correlation analysis between karyotypic pattern and survival, group A
      patients had shorter survival than group N (P = 0.049). In the corresponding
      analysis between groups N, AS, and AC, the differences were also significant (P =
      0.039), with shorter survival in group AC than in groups N and AS. Stage, grade,
      residual tumour after primary surgery, and performance status also correlated
      with survival time. A multivariate analysis identified abnormal karyotype as
      being independently associated with short survival in advanced clinical stages (P
      = 0.030) of ovarian carcinoma. We conclude that cytogenetic analysis of tumour
      cells may be of clinical value in the assessment of prognosis in patients with
      malignant ovarian tumours.

PMID- 1739631
TI  - Phase I trial of temozolomide (CCRG 81045: M&B 39831: NSC 362856).
AB  - Temozolomide (CCRG 81045: M&B 39831: NSC 362856) is an analogue of mitozolomide
      displaying similar broad spectrum activity in mouse tumours, but showing
      considerably less myelosuppression in the toxicology screen. Temozolomide was
      initially studied intravenously at doses between 50-200 mg m-2 and subsequently
      was given orally up to 1,200 mg m-2. A total of 51 patients were entered on the
      single dose schedule. Temozolomide exhibits linear pharmacokinetics with
      increasing dose. Myelotoxicity was dose limiting. Experimentally, temozolomide
      activity was schedule dependent and therefore oral administration was studied as
      a daily x 5 schedule between total doses of 750 and 1,200 mg m-2 in 42 patients.
      Myelosuppression was again dose limiting. The recommended dose for Phase II
      trials is 150 mg m-2 po for 5 days (total dose 750 mg m-2) for the first course,
      and if no major myelosuppression is detected on day 22 of the 4 week cycle, the
      subsequent courses can be given at 200 mg m-2 for 5 days (total dose 1 g m-2) on
      a 4 week cycle. Mild to moderate nausea and vomiting was dose related but readily
      controlled with antiemetics. Clinical activity was detected using the 5 day
      schedule in four (2CR, 2PR; 17%) out of 23 patients with melanoma and in one
      patient with mycosis fungoides (CR lasting 7 months). Two patients with recurrent
      high grade gliomas have also had partial responses. Temozolomide is easy to use
      clinically and generally well tolerated. In the extended Phase I trial
      temozolomide only occasionally exhibited the unpredictable myelosuppression seen
      with mitozolomide.

PMID- 1739632
TI  - Serum ceruloplasmin and the risk of cancer in Finland.
AB  - The relationship between serum ceruloplasmin level and cancer incidence was
      investigated in a case-control study nested within a longitudinal study of 39,268
      Finns participating in the Social Insurance Institution's Mobile Clinic Health
      Examination Survey carried out in 1968-1972. During a median follow-up of 8
      years, 766 cancer cases were identified. Ceruloplasmin levels were determined
      from stored serum samples collected at the baseline from these cancer cases and
      from two matched controls per case. The overall incidence of cancer was
      positively associated with serum ceruloplasmin level. The association was
      strongest for lung cancer and other cancers related to smoking and, consequently,
      in males. The smoking-adjusted relative risk of lung cancer among men was 4.3
      (95% confidence interval (CI) = 1.8-10.6) in the highest quintile of serum
      ceruloplasmin as compared with that in the lowest quintile. The corresponding
      relative risks for cancers related to smoking combined, and for cancers not
      related to smoking were 3.9 (CI = 1.9-8.4) and 0.9 (CI = 0.6-1.5), respectively.
      The elevated risk of lung cancer at high concentrations of serum ceruloplasmin
      persisted after further adjustment for several potential confounding factors such
      as serum levels of vitamins A and E and selenium. The risk was stronger during
      the first 6 years of follow-up than later, and strongest during the first 2
      years. The most likely explanation of the present results thus is that high serum
      ceruloplasmin levels in lung cancer are mainly due to occult cancer.

PMID- 1739633
TI  - Neuron-specific enolase--a serum tumour marker in seminoma?
AB  - The clinical significance of neuron-specific enolase (NSE) as a tumour marker was
      evaluated in 54 patients with seminoma. Before orchiectomy NSE was elevated in
      six out of 21 patients with stage I seminoma and 11 out of 16 patients with
      metastases. After orchiectomy NSE normalised in all evaluated stage I cases, but
      was still elevated in six out of 12 patients with metastatic disease. NSE
      monitored the effect of cisplatin-based chemotherapy in patients with metastases.
      In some patients, increased serum NSE was found together with raised levels of
      human choriogonadotropin (HCG) and lactate dehydrogenase (LDH), while in others
      only NSE was elevated. No false positive NSE values were observed. NSE seems to
      be a clinically worthwhile serum tumour marker for monitoring seminoma patients,
      with a sensitivity and specificity of the same order as HCG.

PMID- 1739634
TI  - An evaluation of the prognostic significance of alpha-1-antitrypsin expression in
      adenocarcinomas of the lung: an immunohistochemical analysis.
AB  - Expression of alpha-1-antitrypsin (AAT) in tumour cells of 102 surgically
      resected lung adenocarcinomas was examined by immunohistochemical method using
      anti-AAT antiserum. While only 13 cases (13%) were negative for AAT expression,
      89 cases (87%) contained AAT at varying degrees. The degree of AAT-positive
      tumour cells was significantly higher in advanced cases than in early cases.
      Clinical follow-up study of the patients, particularly in stage I, showed that
      strongly AAT-positive cases have poor prognosis than weak-to-moderately AAT
      positive or AAT-negative cases. Thus, AAT expression status in tumour cells of
      lung adenocarcinoma may be a biological marker of prognostic significance in
      regard to tumour growth.

PMID- 1739635
TI  - Dacarbazine (DTIC), human recombinant interferon alpha 2a (Roferon) and 5
      fluorouracil for disseminated malignant melanoma.

PMID- 1739636
TI  - Beta-hCG expression by bladder cancers.

PMID- 1739637
TI  - School nursing: more than a mother substitute. Interview by Daniel Allen.

PMID- 1739638
TI  - Practice nursing--an auspicious future.

PMID- 1739639
TI  - Operation clean-up. Cleaning up our act.

PMID- 1739640
TI  - Operation clean-up. Cleaning up.

PMID- 1739641
TI  - Operation clean-up. The real cost.

PMID- 1739642
TI  - Operation clean-up. Hands up for cleanliness.

PMID- 1739643
TI  - Children with cancer: supporting the family.

PMID- 1739644
TI  - Psychiatry. Hospital closure: a personal experience.

PMID- 1739645
TI  - Cleaner hospitals.

PMID- 1739646
TI  - Psychiatry. Nurses' reactions to hospital closure.
AB  - The second article dealing with the effects of psychiatric hospital closure
      explores how the transition from the role of hospital nurse to community nurse
      occasioned by closure is proving an extremely difficult process. Some of the
      feelings evoked resemble the grief experienced after the death of a loved one.
      This article focuses on the reactions of 22 nurses to the closure of a large
      mental hospital. Nurses with many years' experience were found to be suffering a
      bereavement reaction which threatened their emotional and physical wellbeing. The
      author suggests that this 'institutional loss' has important implications for the
      successful rehabilitation of large numbers of mentally ill patients.

PMID- 1739647
TI  - Continuing education: who meets the cost?

PMID- 1739648
TI  - Linking students with ambulance teams.

PMID- 1739650
TI  - Attitude towards the care of elderly people.

PMID- 1739649
TI  - Time to end the violence.

PMID- 1739651
TI  - Professional conduct: left out in the Code?

PMID- 1739652
TI  - Ethics: upward accountability.

PMID- 1739653
TI  - A day in the life: a job at holidaymakers.

PMID- 1739655
TI  - Pleasure time?

PMID- 1739654
TI  - Spare us the yuppie nurse.

PMID- 1739656
TI  - Mental health: a nurse for all reasons.

PMID- 1739657
TI  - Ethics: grass on patients?

PMID- 1739658
TI  - Quality care: abusing drug users.

PMID- 1739659
TI  - Nurse leaders: Hunt at the helm. Interview by Norah Casey.

PMID- 1739660
TI  - Continuing education: leading from the front. Interview by Norah Casey.

PMID- 1739661
TI  - Operation clean-up. Sweeping changes.

PMID- 1739662
TI  - Absorption and function of iron.

PMID- 1739663
TI  - Operation clean-up. Urinary catheters: patient management.

PMID- 1739664
TI  - Educating nurses for practice in Europe.

PMID- 1739665
TI  - Implications of fetal cell transplantation.

PMID- 1739666
TI  - Supporting bereaved relatives in A&E.

PMID- 1739667
TI  - State of hospitals in the United Kingdom.

PMID- 1739668
TI  - Ethics: measuring life in pounds.

PMID- 1739669
TI  - Operation clean-up. Hygiene--your legal rights.

PMID- 1739670
TI  - Equal opportunities: artificial sexuality.

PMID- 1739671
TI  - Whistleblowing: the case for confidentiality.

PMID- 1739672
TI  - Shift patterns: a hard day's night.

PMID- 1739673
TI  - Practice: individual and unique?

PMID- 1739674
TI  - Inward rectification in Limulus ventral photoreceptors.
AB  - We examined inward rectification in Limulus ventral photoreceptors using the two
      microelectrode voltage clamp. Hyperpolarization in the dark induced an inward
      current whose magnitude was distinctly dependent on extracellular K+
      concentration, [K+0]. The [K+0] dependence resembled the characteristic [K+0]
      dependence of other inward rectifiers. The inward current was not dependent on
      extracellular Ca2+ or Na+, and it was unaffected by intracellular injection of Cl
      . The hyperpolarization induced currents had two phases, an early nearly
      instantaneous phase and a slowly developing late phase. The currents were
      sensitive to extracellular barium and cesium. In voltage-pulse experiments, the
      magnitudes of the inwardly rectifying currents were variable from cell to cell,
      with some cells exhibiting negligible inward currents. Large hyperpolarizations
      (to membrane potentials more negative than about -140 mV) caused unstable inward
      current recordings, irreversible desensitization, and irreversible elevation of
      intracellular Ca2+ concentration. The inward rectifier provides negative feedback
      by tending to depolarize the cell (with inward current) in response to
      hyperpolarization. We suggest that the inward rectifier reduces the amount of
      hyperpolarization that would otherwise be generated by electrogenic processes.
      This feature would restrict the dynamic voltage range of the photoreceptors at
      very hyperpolarized potentials.

PMID- 1739675
TI  - Foveal dark adaptation, photopigment regeneration, and aging.
AB  - Foveal dark adaptation in 58 subjects and photopigment regeneration in 60
      subjects from 10-78 years of age exhibit parallel slowing of recovery rate with
      increasing age, with significant correlation of the two functions among
      individuals. The data are suggestive of an initial slight decline in rate before
      age 50, followed by a greater decline occurring at different ages in different
      individuals. Longitudinal data for one subject from age 40-65 show an increase in
      pigment regeneration time constant consistent with this idea. Foveal sensitivity
      and photopigment density both decrease with increasing age and are significantly
      correlated among individuals, although sensitivity declines more with age than
      does photopigment density. In contrast to earlier proposals based upon the
      Rushton-Dowling equation, we found no universal constant of proportionality to
      relate log relative threshold to photopigment within our population.

PMID- 1739676
TI  - Development of lateral interactions in the infant visual system.
AB  - The development of lateral inhibitory interactions in the infant visual system,
      as reflected by the visual-evoked potential (VEP), was studied using a radial,
      asymmetrical windmill-dartboard stimulus. This contrast-reversing stimulus
      generates VEP responses with a strong fundamental frequency component and an
      attenuated second harmonic component (relative to that obtained using a
      symmetrical stimulus). These two harmonic components reflect distinct phenomena,
      and appear to be the result of short-range (the fundamental) and long-range
      (attenuated second harmonic) lateral inhibitory interactions elicited by
      differential luminance-modulation of contiguous spatial regions. We studied the
      development of the short- and long-range interactions at 100% and 30% contrast in
      human infants using both VEP amplitude and phase measures. Attenuation of the
      second harmonic (long-range interactions) was adult-like by 8 weeks of age while
      the strength of the fundamental (short-range interactions) was adult-like by 20
      weeks suggesting a differential development of long-range and short-range
      interactions. In contrast, corresponding phase data indicated significant
      immaturities at 20 weeks of age for both the short- and long-range components.

PMID- 1739677
TI  - Localization of phototransduction in Limulus ventral photoreceptors: a
      demonstration using cell-free rhabdomeric vesicles.
AB  - Second messengers are involved in a number of cellular responses to a variety of
      stimuli. Diffusion of these second messengers likely will determine the speed and
      efficiency of such responses. Localization, particularly in large cells, would
      enhance the efficiency of such transduction systems by restricting the volume in
      which this diffusion takes place and thereby limiting the diffusion of soluble
      messengers. Phototransduction in Limulus ventral photoreceptors involves second
      messenger systems; the volume of this cell is quite large, but the effect of a
      single photoexcited rhodopsin molecule is exerted over light-dependent channels
      localized within a very small area of the plasma membrane. In order to
      investigate localization of phototransduction in these photoreceptors, we have
      compared the light responses of small vesicles (photoballs) excised from these
      cells with those of the intact photoreceptors. We found that the basic kinetics
      of excitation and adaptation of the photoballs are essentially identical to those
      of the intact cell. This indicates that all of the necessary machinery for
      phototransduction is present and intact in the photoball and that any diffusion
      of second messengers that affect the normal light response of the cell must occur
      within a region at least as small as our photoballs (on the order of 1 micron3).

PMID- 1739678
TI  - Transfer of contrast sensitivity in linear visual networks.
AB  - Contrast sensitivity is a useful measure of the ability of an observer to
      distinguish contrast signals from noise. Although usually applied to human
      observers, contrast sensitivity can also be defined operationally for individual
      visual neurons. In a model linear neuron consisting of a filter and noise source,
      this operational measure is a function of filter gain, noise power spectrum,
      signal duration, and a performance criterion. This definition allows one to
      relate the sensitivities of linear neurons at different levels in the visual
      pathway. Mathematical formulae describing these relationships are derived, and
      the general model is applied to the specific problem of relating the
      sensitivities of parvocellular LGN neurons and cortical simple cells in the
      primate.

PMID- 1739679
TI  - Acid phosphatase localization in endocytosed horizontal cell gap junctions.
AB  - Gap junction (GJ) endocytosis appears to be part of a cycle of GJ renewal in
      horizontal cells of the teleost fish retina. At least three stages of GJ
      endocytosis in these neurons have been identified using conventional electron
      microscopy (EM): invagination of GJ membranes (GJ blebs); free GJ vesicles; and
      GJ vesicle fusion with mature lysosomes (Vaughan & Lasater, 1990a). In the
      present study, EM-level acid phosphatase (AP) histochemistry of white bass retina
      was used to determine at what stage enzymatic degradation of endocytosed GJs
      begins. Electron-dense AP reaction product was observed within the trans face of
      the Golgi apparatus, mature lysosomes, and occasional, internal GJ vesicles. In
      contrast, GJ blebs, peripheral GJ vesicles, and most internal GJ vesicles lacked
      AP reaction product. These results support the idea that at least some of the GJ
      vesicles observed within these retinal neurons arise from endocytosis, are on a
      degradative pathway, and can be termed GJ "endosomes." Furthermore, GJ vesicles
      appear to be initially free of AP, but some later acquire it (presumably from
      transport vesicles bearing degradative enzymes). It is still unclear whether our
      previous report of GJ vesicle fusion with mature lysosomes is a subsequent step
      in GJ degradation or part of a different degradative pathway altogether.

PMID- 1739680
TI  - Light-dependent delay in the falling phase of the retinal rod photoresponse.
AB  - Using suction electrodes, photocurrent responses to 100-ms saturating flashes
      were recorded from isolated retinal rods of the larval-stage tiger salamander
      (Ambystoma tigrinum). The delay period (Tc) that preceded recovery of the dark
      current by a criterion amount (3 pA) was analyzed in relation to the flash
      intensity (If), and to the corresponding fractional bleach (R*0/Rtot) of the
      visual pigment; R*0/Rtot was compared with R*s/Rtot, the fractional bleach at
      which the peak level of activated transducin approaches saturation. Over an
      approximately 8 ln unit range of I(f) that included the predicted value of
      R*s/Rtot, Tc increased linearly with ln I(f). Within the linear range, the slope
      of the function yielded an apparent exponential time constant (tau c) of 1.7 +/-
      0.2 s (mean +/- S.D.). Background light reduced the value of Tc measured at a
      given flash intensity but preserved a range over which Tc increased linearly with
      ln I(f); the linear-range slope was similar to that measured in the absence of
      background light. The intensity dependence of Tc resembles that of a delay (Td)
      seen in light-scattering experiments on bovine retinas, which describes the
      period of essentially complete activation of transducin following a bright flash;
      the slope of the function relating Td and ln flash intensity is thought to
      reflect the lifetime of photoactivated visual pigment (R*) (Pepperberg et al.,
      1988; Kahlert et al., 1990). The present data suggest that the
      electrophysiological delay has a similar basis in the deactivation kinetics of
      R*, and that tau c represents TR*, the lifetime of R* in the phototransduction
      process. The results furthermore suggest a preservation of the "dark-adapted"
      value of TR* within the investigated range of background intensity.

PMID- 1739681
TI  - American Society of Regional Anesthesia, annual meeting. Tampa, Florida, March 26
      29, 1992. Abstracts.

PMID- 1739682
TI  - The vascular factor in low tension glaucoma: alchemists' gold?

PMID- 1739683
TI  - A primate model for age related macular drusen.
AB  - A closed colony of semi-free-ranging rhesus monkeys maintained in isolation since
      1938 by the Caribbean Primate Research Center (CPRC) is being studied as a model
      for age related macular drusen. Of examined colony animals 57.7% of the monkeys
      and 47.3% of their eyes have drusen. The prevalence and severity of drusen are
      linearly related to increasing age and are significantly higher in specific
      maternal lineages (matrilines). An electrophysiological estimate indicates loss
      of function associated with drusen. Prevalence of drusen in CPRC females is
      almost twice that of males, while the prevalence among CPRC animals in general
      appears to be several times that of monkeys from continental US facilities.
      Evidence suggests that the frequency of endstage lesions is also similar to that
      in human populations. The CPRC matriline monkeys appear to provide the best model
      yet reported for human age related macular drusen.

PMID- 1739684
TI  - Surgically induced necrotising sclerokeratitis (SINS)--precipitating factors and
      response to treatment.
AB  - The clinical features, treatment, and visual outcome of 52 eyes from 43 patients
      who developed scleritis following surgery were reviewed. In all patients the
      scleral inflammation developed adjacent to a surgical wound. Ninety six per cent
      had necrotising disease and 23% also had evidence of secondary posterior
      scleritis. Many different types of ocular surgery were implicated and the
      majority (75%) of the patients had two or more surgical procedures before the
      onset of the scleritis. Although cataract extraction through a limbal incision
      resulted in the largest subgroup, scleritis also followed glaucoma, strabismus,
      and retinal detachment surgery. The latent period between surgery and the
      appearance of inflammation was short (mean 9 months) except for a small group in
      whom scleritis occurred many years after squint surgery. Sixty three per cent of
      patients had evidence of a systemic disease. Early diagnosis and aggressive
      medical treatment significantly improved the visual outcome. The precipitating
      factors, pathogenesis, and course of this condition are discussed.

PMID- 1739685
TI  - Finger blood flow in patients with low tension glaucoma and primary open-angle
      glaucoma.
AB  - Finger blood flow was studied by means of laser Doppler flowmetry in 12 patients
      with low tension glaucoma (LTG), 12 patients with primary open-angle glaucoma
      (POAG) and 12 normal subjects. Baseline flow, flow after immersion of the hand in
      warm water (+40 degrees C), and flow after exposure of the hand in cold water (+4
      degrees C) were measured. Statistically significant differences were not found in
      each flow between the three groups of the patients (p greater than 0.05).
      Vasospastic response to warm and cold water was observed in 25% of LTG patients,
      17% of POAG patients, and 25% of normal subjects. There was no significant
      difference between LTG, POAG, and normal subjects in finger blood flow.

PMID- 1739686
TI  - Is there a genetic basis for Fuchs' heterochromic uveitis? Discordance in
      monozygotic twins.
AB  - One pair, and probably two pairs, of monozygotic twins are reported with
      discordance for Fuchs' heterochromic uveitis (FHU). Regular Mendelian inheritance
      of this disease is now proved to be impossible. The heritability of FHU is low
      and may be zero. The possibility of any genetic predisposition to the disease and
      its association with 'simple' heterochromia are discussed.

PMID- 1739687
TI  - Autofluorescence of the crystalline lens in early and late onset diabetes.
AB  - Blue/green autofluorescence (excitation around 420 to 430 nm, emission around 520
      nm) of the crystalline lens has been studied by an in vivo photographic method in
      two populations of diabetics and controls. The populations consisted of a
      geographically based survivor group of 161 mixed early and late onset diabetics
      (and 133 non-diabetic controls) and a second group of 104 early onset insulin
      dependent diabetics (and 138 non-diabetic controls), the latter all with non
      cataractous lenses. Powerful associations (p less than 10(-6) were found between
      the presence of diabetes and increased lenticular autofluorescence in both
      populations. Among the mixed diabetics diabetic type was a significant factor
      after accounting for the effects of age and diabetic duration. In the early onset
      group (clear lenses) a powerful association existed between autofluorescence and
      diabetic duration (p = 0.000011) after allowing for the effect of age, while in a
      subgroup of late onset diabetics with clear lenses this effect was modest (p =
      0.015). In the early onset diabetic group diabetic retinopathy (p = 0.0064) was
      associated with increased lenticular autofluorescence after allowing for the
      effects of age and diabetic duration. In addition a powerful interaction between
      diabetic duration and the presence of diabetic retinopathy (p less than 10(-6)
      was found in this subgroup. Among the geographically based population of
      diabetics, increased nuclear brunescence was powerfully associated (p less than
      10(-6) with increased autofluorescence after allowing for the effects of age,
      diabetic duration, and type of diabetes. This association was not found in the
      non-diabetic population. Non-enzymatic glycosylation of lens proteins should be
      considered as a possible mechanism of production of the fluorogen with emission
      around 520 nm.

PMID- 1739688
TI  - Modelling of changes in the corneal endothelium after cataract surgery and
      penetrating keratoplasty.
AB  - Long term changes in endothelial cell density were monitored in three groups of
      patients after surgery. One group underwent uncomplicated cataract surgery, one
      group complicated cataract surgery which eventually progressed to corneal
      decompensation, and one group penetrating keratoplasty. A mathematical model is
      presented which describes endothelial cell loss after surgery as an exponential
      decay process towards an asymptote with constant rate of cell loss over time.
      When fitted to the data from the three groups there is excellent agreement in
      each case. Discriminant analysis techniques were applied to model predictions to
      assess the likelihood of late corneal decompensation after surgery. From
      measurements of endothelial cell density before and after surgery we were able to
      correctly assign patients undergoing cataract surgery to decompensation or non
      decompensation groups in 85.7% and 92.7% of cases respectively.

PMID- 1739689
TI  - Survey of the contamination of eyedrops of hospital inpatients and
      recommendations for the changing of current practice in eyedrop dispensing.
AB  - Topical ophthalmic medications used on the ward and from the outpatient area have
      been taken and cultured for potential bacterial contamination in the laboratory.
      We examined 143 bottles used by patients who had had routine cataract surgery and
      trabeculectomy. We also examined for bacterial contamination 216 bottles of
      eyedrops used in the outpatient area of the hospital. No contamination was found
      in the postoperative eyedrops, but five bottles were contaminated from the
      outpatient area (2.3%). The bacterial growth from outpatient drops was of the
      same order of magnitude as in previous studies. The practice in the UK for
      postoperative eyedrops to be discarded and fresh, separate bottles to take home
      is discussed. We recommend that this practice be changed so that the
      postoperative drops used for 72 hours or less are taken home.

PMID- 1739690
TI  - Spontaneous congenital non-pigmented epithelial cysts of the iris stroma.
AB  - Histopathological and immunohistochemical findings in 11 patients with
      spontaneous congenital non-pigmented epithelial cysts of the iris stroma were
      studied. The cysts were lined by stratified squamous to unilayered cuboidal non
      pigmented epithelium. Goblet cells were present in nine cysts, indicating a
      similarity to conjunctival epithelium. The demonstration of higher-molecular
      weight keratins and absence of S-100 protein, by monoclonal and polyclonal
      antibodies, argues for surface ectodermal rather than neuroectodermal origin of
      the cysts. Theories of embryogenesis have been conflicting, but our results
      support the theory that they arise from surface ectoderm, displaced probably at
      the time of lens vesicle formation. The finding of normally sited subepithelial S
      100 positive melanocytes may suggest that ectopic conjunctival epithelium can
      induce normal patterns of migration of neural crest cells.

PMID- 1739691
TI  - The optical spacer--a simple device which extends the scope of indirect
      ophthalmoscopy.
AB  - A simple device is described which both facilitates and significantly extends the
      scope of indirect ophthalmoscopy.

PMID- 1739692
TI  - Orbital lymphoproliferative disorders.

PMID- 1739693
TI  - Dedifferentiated chondrosarcoma arising in the orbit.
AB  - Orbital chondrosarcomas are extremely rare and are usually an extension of
      tumours involving the paranasal sinuses. A unique case of dedifferentiated
      chondrosarcoma arising solely within the orbit is presented.

PMID- 1739694
TI  - Periorbital necrobiosis lipoidica.
AB  - Necrobiosis lipoidica is a granulomatous skin condition typically occurring on
      the legs. A patient with this condition presented with gross bilateral induration
      of the eyelids sufficient to close both eyes.

PMID- 1739695
TI  - A clinicopathological study of ocular involvement in primary hyperoxaluria type
      I.
AB  - We performed a clinicopathological study on the eyes of a 3-year-old girl with
      primary hyperoxaluria type I. An examination one year before death disclosed a
      slightly diminished visual acuity in both eyes with black, geographic central
      macular, subretinal patches. Calcium oxalate was deposited predominantly in the
      retinal pigment epithelium of the posterior pole, where these cells were markedly
      hyperplastic and hypertrophied round foci of oxalate crystals. Oxalate crystals
      were exceedingly sparse in other ocular structures and when present were not
      associated with an apparent tissue reaction in these other locations. A
      collagenous layer was evident between parts of the retinal pigment epithelium and
      the neurosensory retina, which contained occasional perivascular clumps of
      melanin laden cells. The predominant deposition of oxalate in the retinal pigment
      epithelium, with the exuberant response of these cells around the crystals, gives
      a clue to the pathogenic mechanisms of primary hyperoxaluria.

PMID- 1739696
TI  - Vitelliform macular degeneration associated with mitochondrial myopathy.
AB  - A patient with mitochondrial myopathy is described. Examination of his fundus
      revealed bilateral vitelliform degeneration of the maculae. This lesion is a
      focal abnormality of the retinal pigment epithelium and may be a manifestation of
      the underlying mitochondrial disease.

PMID- 1739697
TI  - Penetrating keratoplasty for keratoconus.

PMID- 1739698
TI  - Trachoma still undefeated.

PMID- 1739699
TI  - Diabetic radiation morbidity.

PMID- 1739700
TI  - Hyperopic shift and the use of masking agents in excimer laser superficial
      keratectomy.

PMID- 1739701
TI  - Treatable blindness in temporal arteritis.

PMID- 1739702
TI  - Phenotypes of conjunctival inflammatory cells in sarcoidosis.
AB  - Phenotypes of the infiltrating mononuclear cells of the lower fornix conjunctiva
      of nine patients with sarcoidosis and six controls were studied using monoclonal
      antibodies and a modified immunoperoxidase method. Four patients had sarcoidosis
      of recent onset (duration of 2 years or less) and five patients had a chronic
      disease (duration of 3 or more years). The inflammatory cells in the sarcoid
      conjunctival specimens were predominantly T lymphocytes, the vast majority of
      which were of T helper/inducer subtype expressing Leu-3a + 3b positivity. The
      ratio of T helper/inducer cells to T suppressor/cytotoxic cells was 3.9 on
      average but only 0.9 in controls. Epithelioid cell granulomas were seen in three
      specimens in one case of recent onset and in two chronic cases comprising a
      marked amount (more than 15 cells/visual field) of cells bearing phenotypes of
      macrophages, T cells, T helper/inducer cells and HLA-DR antigen, and in smaller
      quantities of T suppressor/cytotoxic cells. The mean number of all
      immunocompetent cell subtypes of specimens from newly diagnosed patients exceeded
      that of specimens from chronic patients. We believe that the sarcoid immune
      reaction in the conjunctiva is a dynamic process in which proliferation of
      immunocompetent mononuclear cells precedes the stage of granuloma formation.

PMID- 1739703
TI  - Endothelin: a new vasoactive ocular peptide.

PMID- 1739704
TI  - Exudative retinal detachment and posterior scleritis associated with massive
      scleral thickening and calcification treated by scleral decompression.
AB  - A 66-year-old man presented with massive bilateral scleral thickening and
      calcification associated with a unilateral exudative retinal detachment which did
      not respond to systemic anti-inflammatory agents including steroids and
      cyclophosphamide but improved with scleral resection. This patient shows the
      features of both posterior scleritis and the uveal effusion syndrome, providing
      further evidence for the role of a thickened sclera and interference with the
      trans-scleral flow of fluid in the formation of such an exudative retinal
      detachment.

PMID- 1739705
TI  - Transient loss of peripheral vision as the presentation of left atrial myxoma.
AB  - A 42-year-old man developed transient loss of vision in both eyes. On
      echocardiography to investigate a systolic murmur and determine the potential
      source of emboli, a large left atrial myxoma was diagnosed. This was removed
      successfully leaving no visual or neurological deficit.

PMID- 1739706
TI  - Delleman syndrome: a case report and review.
AB  - A case of oculocerebrocutaneous syndrome is presented, to our knowledge the first
      to be reported in West Bank and Gaza. The child was of consanguinous parents. The
      clinical features of orbital cyst, periorbital cutaneous malformations, and
      cerebral malformations are described, together with a brief review of previous
      reports. The need for neurological follow-up of these cases is emphasised.

PMID- 1739707
TI  - Pituitary adenoma presenting as the Foster-Kennedy syndrome.
AB  - A 27-year-old man presented to the casualty department with visual failure.
      Clinically he demonstrated the Foster-Kennedy syndrome. Computed tomography
      revealed a large space-occupying lesion which was subsequently shown to be a
      pituitary adenoma. The literature is reviewed and possible mechanisms of the
      Foster-Kennedy syndrome are discussed.

PMID- 1739708
TI  - Premalignant melanosis of the conjunctiva and the cornea in xeroderma
      pigmentosum.
AB  - Xeroderma pigmentosum is a rare autosomal recessive dermatosis. The neoplastic
      changes in sunlight-exposed areas of the skin and eyes may be related to the
      impaired replication of ultraviolet radiation-damaged DNA. A 38-year-old Greek
      woman is reported with a mild form of xeroderma pigmentosum and primary acquired
      melanosis with atypia of her right limbal conjunctiva and cornea. The development
      of this precursor of conjunctival malignant melanoma in a xeroderma pigmentosum
      patient may support the putative role of sunlight exposure in malignant
      transformation of conjunctival melanocytes.

PMID- 1739709
TI  - Resection of intraocular squamous cell carcinoma.
AB  - A patient with recurrent squamous cell carcinoma of the conjunctiva was referred
      with 20/20 vision in an eye with obvious intraocular extension. A modified
      iridocyclochoroidectomy was performed and the tumour was removed. Three and a
      half years later the patient's vision is 20/30 and there is no recurrence. This
      is the first case in which an eye has been successfully salvaged with documented
      intraocular squamous cell carcinoma of the conjunctiva.

PMID- 1739710
TI  - Keratitis in Reiter's syndrome.

PMID- 1739711
TI  - Statistical standards.

PMID- 1739712
TI  - Amblyopia.

PMID- 1739713
TI  - Cataract surgery.

PMID- 1739714
TI  - Dominant cone dystrophy starting with blue cone involvement.

PMID- 1739715
TI  - Cause of blindness in the Central African Republic.

PMID- 1739716
TI  - Prospects for day-case vitreoretinal surgery.

PMID- 1739717
TI  - Cataracts in children with uveitis.

PMID- 1739718
TI  - Evaluation of outpatient experience with vitreoretinal surgery.
AB  - The experience of 55 consecutive individuals undergoing outpatient vitreoretinal
      surgery was evaluated. Objective variables, including preoperative and
      intraoperative information, subjective postoperative pain, and discomfort were
      measured with a previously validated 100 mm visual analogue scale. Patients also
      ranked the overall experience. Average pain and discomfort scores in the recovery
      room were 21.8 and 22.6 and overnight were 26.7 and 30.4 (scale 0 to 100),
      respectively. Eighty eight per cent of subjects were satisfied with the
      experience. Elevated pain and discomfort scores were statistically correlated
      with scleral buckling, prolonged surgical or recovery room time, requirement for
      parenteral pain medications, and high intraocular pressure on the first
      postoperative visit. None of the patients needed further hospital treatment. This
      study suggests that vitreoretinal surgery in an appropriately selected population
      does not require routine inpatient care.

PMID- 1739719
TI  - Lensectomy for complicated cataract in juvenile chronic iridocyclitis.
AB  - Experience with the removal of complicated cataract by lensectomy in patients
      with juvenile chronic iridocyclitis (JCI) has so far been limited. The results of
      lensectomy were reviewed retrospectively in 131 patients with JCI (187 eyes). The
      mean follow up period was 5 years 4 months. The main operative complication was
      accidental loss of lens material into the vitreous cavity. The postoperative
      complications were glaucoma (23 eyes, 15%), phthisis (14 eyes, 8%), secondary
      pupillary membranes (11 eyes, 6%), and retinal detachment (six eyes, 3%). The
      incidence of postoperative phthisis was related to the level of intraocular
      pressure (IOP) at the time of surgery. Twenty four per cent of hypotonous eyes
      and 4% of eyes with normal or elevated IOP became phthisical. Visual acuity was
      improved in 77%, was worse in 13%, and unchanged in 10% of eyes. The main causes
      of a postoperative visual acuity of 6/60 or less were glaucoma, amblyopia, and
      phthisis. Lensectomy did not appear to alter the course of uveitis.

PMID- 1739720
TI  - An experimental model of oculorespiratory reflex.
AB  - An experimental study of the oculorespiratory reflex (ORR) was conducted on 20
      albino rabbits using a square wave (SW) type of stimulus. The ORR could be
      elicited in 100% of animals. The medial rectus was observed to be most
      reflexogenic for ORR. The frequency and pattern of ORR was not affected by
      bilateral vagotomy, intravenous atropine or glycopyrrolate, but could be
      completely abolished by retrobular block.

PMID- 1739721
TI  - Blood-ocular barrier permeability in monkeys.
AB  - The permeability of the blood-ocular barrier was investigated in five monkeys
      using vitreous fluorophotometry (VFP). Inward permeability (Pin) of the blood
      retinal barrier was calculated by a computer simulation method. Kinetic VFP was
      performed after intravitreal injection of fluorescein (F) or fluorescein
      monoglucuronide (FG). The estimated mean value of Pin (x10(-6) cm/min) was 4.8
      (SD 1.2). The mean rates of loss (per hour) of F from the anterior chamber (Ka)
      and the vitreous (Kv) were 0.11 (SD 0.01) and 0.13 (SD 0.03), respectively, which
      were approximately three and four times greater than those of FG (0.04 (SD 0.01)
      and 0.03 (SD 0.01), respectively). Probenecid administered intraperitoneally
      decreased both the Ka and the Kv of F significantly but had no effect on the Ka
      or the Kv of FG, suggesting that F was excreted from the eye with the aid of the
      active transport mechanism. The results of comparative studies of the rates of
      loss of F from the anterior chamber (Ka) and from the vitreous (Kv) suggested
      that active transport was more predominant in the blood-retinal barrier than in
      the blood-aqueous barrier.

PMID- 1739722
TI  - A comparison of 141 polymacon (Iogel) and 140 poly(methyl methacrylate)
      intraocular lens implants.
AB  - In a prospective controlled trial 290 consecutive patients were randomly
      allocated a polymacon or a poly(methyl methacrylate) (PMMA) intraocular lens.
      Early Treatment of Diabetic Retinopathy Study (ETDRS) acuity charts gave similar
      results with both lenses. However Pelli-Robson contrast sensitivity charts gave a
      better result with PMMA lenses. Polymacon lenses appeared to remain free of any
      adhesions after implantation raising the question of long term stability. Four
      patients experienced problems related to this, three involved total lens
      dislocation. Seven patients developed early 'fibrin' membranes coating the
      polymacon lens, of which three were florid.

PMID- 1739723
TI  - Improved iodine-125 plaque design in the treatment of choroidal malignant
      melanoma.
AB  - The use and development of iodine-125 plaque therapy for choroidal malignant
      melanoma are described. Since 1975 experience has led to changes in plaque design
      and insertion techniques. Twenty-one patients were irradiated with local
      episcleral iodine-125 plaques. Three patients required a second plaque for tumour
      recurrence. Four eyes were enucleated because of continued tumour growth and a
      further eye was removed because of glaucoma secondary to radiation retinopathy.
      Two patients (9.5%) died of metastases. The remaining 19 patients are alive and
      clinically clear of metastases, with a mean follow up time of 73.1 months (range
      43-142 months).

PMID- 1739724
TI  - Periocular migration of hard contact lenses.
AB  - Six cases are presented in which hard contact lenses have migrated into the
      periocular soft tissues, four into the eyelid, one into the orbit and one which
      spontaneously reappeared on the cornea 12 years after the patient had last worn
      contact lenses. Some possible mechanisms of this phenomenon and a review of the
      literature are presented.

PMID- 1739725
TI  - Occurrence of pseudoexfoliation following penetrating keratoplasty for
      keratoconus.
AB  - The occurrence of pseudoexfoliation (PSX) following penetrating keratoplasty for
      keratoconus is reported in three eyes of two patients. The patients' ages at
      keratoplasty were 37, 40, and 31 years, and PSX was first observed 5, 4, and 6
      years following keratoplasty. The donor age was 76, 81, and 81 years. Possible
      explanations for the occurrence of PSX after keratoplasty include mere
      coincidence, some sort of non-specific reaction to surgery or to postoperative
      medication, an immunogenic reaction to transplanted foreign corneal tissue, and
      the hypothetical speculation that PSX might be a transmissible disease.

PMID- 1739726
TI  - Effects of NO2-modification of Tyr83 on the reactivity of spinach plastocyanin
      with cytochrome f.
AB  - We have investigated the electron transfer (ET) reactions between turnip
      cytochrome f, and the native and NO2-Tyr83-modified forms of spinach plastocyanin
      (PCu) at 10.0 degrees C and ionic strength 0.200 M(NaCl), in both directions as a
      function of pH. The PCu(II)/cytochrome f(II) rate constants in the pH-range 4-6.8
      reflect active and remote binding site protonation. At higher pH, NO2-Tyr83 and
      positively charged residues on cytochrome f are deprotonated, and both native and
      NO2-modified PCu exhibit a composite rate constant variation in this pH range.
      When framed by ET theory this pattern is fully understandable in terms of
      variations in reduction potentials and electrostatic interactions, caused by the
      protonation equilibria. The rate constant ratio knitro/knative is, however, only
      1.04 for the PCu(II)/cytochrome f(II) reactions in spite of a 18 mV higher
      reduction potential for NO2-Tyr83-modified PCu. This is much lower than the value
      of 1.42 expected from ET theory solely on the basis of such a reduction potential
      effect. A similar effect is seen for PCu(I)/cytochrome f(III) for which the low
      pH knitro/knative ratio is 0.51. Notable but smaller effects are also observed
      for the small reaction partners [Fe(CN)6]3-/4- and [Co(phen)3]3+/2+. The effect
      of NO2-modification in addition to the reduction potential effect can be resolved
      into a small reorganization energy increase around the copper atom and a smaller
      electronic transmission coefficient for ET through the Cu/Cys84/Tyr83 sequence.
      The former effect dominates in the reactions with the small reaction partners,
      while the electronic effects contribute significantly for PCu/cytochrome f,
      supporting the concept that the PCu/cytochrome f ET is at the remote PCu binding
      site.

PMID- 1739727
TI  - Differential permeability for lipophilic compounds in uncoupler-resistant cells
      of Escherichia coli.
AB  - The acrA strain AS-1 of Escherichia coli is more sensitive than its parent W3110
      to growth inhibition by Methylene blue, sodium dodecyl sulfate and novobiocin. UR
      3 is an uncoupler-resistant strain isolated from AS-1 which is resistant to
      growth inhibition by carbonylcyanide m-chlorophenylhydrazone (CCCP), 3,3',4',5
      tetrachlorsalicylanilide (TCS) and tributyltin chloride, while remaining
      sensitive to the first group of compounds. A revertant of AS-1 acquired
      resistance to Methylene blue and sodium dodecyl sulfate but remained sensitive to
      uncouplers. In contrast to AS-1, proline uptake in UR-3 was resistant to
      uncouplers. Strain UR-3 grown in the presence of uncoupler incorporated
      elongation factor Tu to high levels in the outer membrane of the cell. A role for
      the outer membrane in the acquisition of uncoupler-resistance by UR-3 is
      suggested by the behaviour of the mutant to the fluorescence probe N-phenyl-1
      naphthylamine. The fluorescence intensity of this probe was quenched by membrane
      energization in the wild-type strain W3110 but not in AS-1. UR-3 behaved like
      W3110, suggesting that an outer membrane barrier to neutral lipophilic compounds
      like N-phenyl-1-naphthylamine (NPN) and uncouplers had been restored in UR-3. By
      contrast, AS-1 and UR-3 both allowed energized uptake of the fluorescent
      lipophilic cation 2-(dimethylaminostyryl)-1-ethylpyridinium (DMP+). It is
      concluded that lipophilic materials must permeate the outer membrane of E. coli
      by at least two different routes. However, uncoupler-resistance in UR-3 appears
      to be more complex than the provision of an outer membrane barrier to uncouplers.
      Thus, uncouplers readily discharged a pH gradient established in both AS-1 and UR
      3 by addition of HCl to cell suspensions.

PMID- 1739728
TI  - Mechanism of energization of uptake of the fluorescent dye 2-(4
      dimethylaminostyryl)-1-ethylpyridinium cation [DMP+] into an acrA strain of
      Escherichia coli.
AB  - The mechanism of uptake of the fluorescent dye 2-(4-dimethylaminostyryl)-1
      ethylpyridinium cation (DMP+) into cells and vesicles of the acrA strain AS-1 of
      Escherichia coli was examined. Uptake was energized by substrate oxidation and
      discharged by uncouplers. Uptake was enhanced by the presence of
      tetraphenylphosphonium cation, tetraphenylboron anion and tributyltin chloride,
      which may inhibit the efflux system for DMP+. Uptake was inhibited by 5
      methoxyindole-2-carboxylic acid (MIC). By the use of ionophores with right-side
      out vesicles loaded with monovalent cations it was shown that DMP+ uptake could
      be driven both by the establishment of a membrane potential across the vesicle
      membrane and by a H+/DMP+ antiport system. Attempts to demonstrate the latter
      mechanism in everted membrane vesicles were unsuccessful.

PMID- 1739729
TI  - The fluorescence yield of Rhodopseudomonas viridis in relation to the redox state
      of the primary electron donor.
AB  - The fluorescence yield of bacteriochlorophyll (BChl) b in membranes of
      Rhodopseudomonas viridis was measured immediately and at a variable time-interval
      after a saturating laser flash to bring about charge separation. At 4 K a
      decrease of the yield by 28% was observed immediately after the flash. This yield
      recovered mono-exponentially with a time constant of 6.3 +/- 0.4 ms to
      approximately the original level. The same time constant was observed for the re
      reduction of the primary electron donor, indicating that the fluorescence
      quenching can be ascribed to the oxidation of the primary donor. The extent of
      quenching decreased with increasing temperature and reversed to a fluorescence
      increase at temperatures above 50 K. These results may be explained by the
      presence of long-wavelength absorbing BChls b in the antenna which at low
      temperature transfer their excitation energy more efficiently to the oxidized
      than to the reduced primary donor, in support of a similar hypothesis used to
      explain the quenching of fluorescence by 'oxidized' reaction centers in
      heliobacterium chlorum (Deinum, G., Kramer, H., Aartsma, T.J. Kleinherenbrink,
      F.A.M. and Amesz, J. (1991) Biochim. Biophys. Acta 1058, 339-344).

PMID- 1739730
TI  - Characterisation of photoinduced breakdown of the D1-polypeptide in isolated
      reaction centres of Photosystem II.
AB  - When the isolated reaction centre of Photosystem II, reconstituted with the
      quinone, 2,5-dibromo-3-methyl-6-isopropyl-p-benzoquinone (DBMIB), is exposed to
      photoinhibitory illumination, a D1-polypeptide breakdown product of 24 kDa is
      detected by immunoblotting. In addition, weaker bands are also detected at 17, 13
      and 10 kDa. It is suggested that the 24 kDa D1-polypeptide breakdown product is
      the same as that first observed in vivo by Greenberg et al. (1987) EMBO J. 6,
      2865-2869. Its appearance in isolated Photosystem II reaction centres requires
      the presence of an electron acceptor, but occurs under both aerobic and anaerobic
      conditions. In our in vitro experimental system the photoinduced degradation of
      the D1-polypeptide to the 24 kDa fragment was related to the functional activity
      of the reaction centre and the enzymatic nature of the proteolysis was
      characterised by a pH optimum of about 8.0 and by inhibition with proteinase
      inhibitors, especially the serine-type soybean trypsin inhibitor. The results
      support our earlier findings (Shipton and Barber (1991) Proc. Natl. Acad. Sci.
      USA 88, 6691-6695) that the appearance of the light-induced D1-polypeptide
      breakdown pattern of fragments occurs as a consequence of donor side
      photoinhibition when highly oxidising species accumulate in the reaction centre
      and bring about pigment oxidation and degradation. We suggest that it is this
      selective loss of pigments that induces a conformational change in the D1
      polypeptide which triggers its autoproteolytic cleavage.

PMID- 1739731
TI  - Mediation of glycosylated and partially-deglycosylated glucose oxidase of
      Aspergillus niger by a ferrocene-derivatised detergent.
AB  - A ferrocene-derivatised detergent, (11-ferrocenylundecyl) trimethylammonium
      bromide (FTMAB), when oxidised to the corresponding ferricinium ion, was found by
      electrochemical studies to be an effective electron acceptor for reduced glucose
      oxidase of Aspergillus niger (EC 1.13.4) and thus acts as a electron-transfer
      mediator between glucose oxidase and a working electrode held at a potential
      sufficiently positive to reoxidise reduced FTMAB. An increase in mediating
      activity was produced when FTMAB was present in concentrations above its critical
      micelle concentration. An 'enzyme electrode' was formed by adsorption of glucose
      oxidase and FTMAB surfactant on a graphite rod. The electrode functioned as an
      amperometric biosensor for glucose in phosphate-buffered saline solution. A mixed
      micelle of glucose oxidase and FTMAB, probably adsorbed on the electrode surface,
      appears to be advantageous for the amperometric determination of glucose.
      Additionally, glucose oxidase was treated with alpha-mannosidase. When this
      partially-deglycosylated glucose oxidase was incorporated in an enzyme electrode,
      a 100-fold increase in the second-order rate constant (k) for electron transfer
      between the enzyme and FTMAB was observed, together with increased current
      densities, with respect to the equivalent values for FTMAB and commercial glucose
      oxidase. The use of deglycosylated enzymes in biosensors is suggested.

PMID- 1739732
TI  - Beta-alanine transaminase activity in black and suppressor of black mutations of
      Drosophila melanogaster.
AB  - An assay for beta-alanine transaminase activity in extracts of Drosophila
      melanogaster has been developed. By use of this assay, the levels of beta-alanine
      transaminase activity in several strains of flies has been examined as a function
      of developmental age. The black mutation shows elevated levels of activity
      compared to wild type, while suppressor of black strains show decreased levels
      compared to wild type.

PMID- 1739733
TI  - Effect of oxygen tension and lactate concentration on keratan sulphate and
      chondroitin sulphate biosynthesis in bovine cornea.
AB  - Calf cornea slices were incubated with [U-14C]glucose, in varying pO2 or lactate
      concentrations. Acid glycosaminoglycans were separated by ion-exchange
      chromatography after papain digestion. The percentage radioactivity incorporated
      into keratan sulphate increased markedly with decreased oxygen tension, whereas a
      concomitant relative decrease of the biosynthesis of glycosaminoglycuronans
      occurred. Similar results were obtained with increased lactate concentration. Our
      findings support the idea that keratan sulphate is a functional substitute for
      chondroitin sulphate in conditions of oxygen lack (Scott, J.E. and Haigh, M.
      (1988) J. Anat. 158, 95-108).

PMID- 1739734
TI  - Photosensitization of aqueous model systems by hypericin.
AB  - Absorption and fluorescence measurements of purified hypericin (HY) were made in
      various media. Photosensitization of two aqueous systems was investigated:
      resealed red blood cell membranes (ghosts) and hen lysozyme (Lys). Solubilization
      of HY by ghost membranes was shown by means of diffuse reflectance spectroscopy.
      Visible light irradiation of the ghosts incorporating HY led to lipid
      peroxidation with evidence of singlet oxygen involvement. A binding model
      applicable for insoluble ligands is indicative of strong HY binding to HSA. The
      HY-HSA complex photosensitized inactivation of Lys. The pseudo-first-order
      reaction kinetics with protection by azide ion are consistent with a Type II
      mechanism mediated by singlet oxygen. The results are discussed in the context of
      the HY photodynamic and antiretroviral activities.

PMID- 1739735
TI  - Influence of glucogenic amino acids on the hepatic metabolism of threonine.
AB  - The supplementation of a low-protein diet with L-threonine leads to a marked
      accumulation of threonine in plasma and liver, whereas increasing dietary protein
      generally leads to an induction of threonine dehydratase in the liver, hence
      depressed availability for extrasplanchnic tissues. The aim of the present study
      was, thus, to further investigate the factors which control the utilization of
      threonine by the liver. Increasing the dietary supply of threonine led to
      parallel increases in the afferent and hepatic concentrations and in the rate of
      utilization by the liver; however, the fractional extraction tended to decrease.
      It appears that the addition of a mixture of glucogenic amino acids to the diet
      prevented the accumulation of threonine in plasma induced by exogenous threonine.
      The glucogenic amino acids increased the fractional hepatic uptake of threonine,
      and counteracted its accumulation in the liver. These effects reflect the fact
      that the glucogenic amino acids elicited a potent induction of the threonine
      dehydratase, whereas threonine alone was uneffective. Our results suggest that,
      besides the well-established effect of glucogenic conditions, the availability of
      some glucogenic amino acids is an important factor in the control of threonine
      catabolism.

PMID- 1739736
TI  - N3-haloacetyl derivatives of L-2,3-diaminopropanoic acid: novel inactivators of
      glucosamine-6-phosphate synthase.
AB  - N3-Haloacetyl derivatives of L-2,3-diaminopropanoic acid, novel glutamine
      analogs, were shown to be strong inhibitors of glucosamine-6-phosphate synthase
      from bacteria and Candida albicans. The inhibition was competitive with respect
      to glutamine and non-competitive with respect to D-fructose-6-phosphate. In the
      absence of glutamine, the tested compounds inactivated glucosamine-6-phosphate
      synthase from C. albicans with Kinact = 0.5 microM, 0.55 microM and 18.5 microM
      for bromoacetyl-, iodoacetyl- and chloroacetyl derivatives of L-2,3
      diaminopropanoic acid, respectively. The inactivation obeyed the criteria for
      active site-directed modification.

PMID- 1739737
TI  - In vivo insulin responsiveness for glucose uptake and production at eu- and
      hyperglycemic levels in normal and diabetic rats.
AB  - Whole body glucose uptake (BGU) and hepatic glucose production (HGP) at maximal
      plasma insulin concentrations (+/- 5000 microU/ml) were determined by eu- (EC) (6
      mM) and hyperglycemic (HC) (20 mM) clamps (120 min), combined with [3-3H]glucose
      infusion, in normal and streptozotocin-treated (65 mg/kg) 3-day diabetic,
      conscious rats. In normal rats, during EC, BGU was 12.4 +/- 0.4 mg/min and during
      HC, when urinary glucose loss was 0.54 +/- 0.09 mg/min, BGU was 25.5 +/- 1.6
      mg/min. However, throughout the final 60 min of HC, glucose infusion rate (GIR)
      was not constant but a linear decline in time (r = -0.99) of 17%, P less than
      0.0001, was observed indicating a hyperglycemia-induced desensitization process.
      In diabetic rats, during EC, BGU was 7.7 +/- 0.3 mg/min and during HC, BGU was
      15.5 +/- 1.4 mg/min. Throughout the final 60 min of HC, GIR was constant,
      suggesting that the hyperglycemia-induced desensitization process was already
      completed. In normal and diabetic rats, HGP was similar: during EC 0.2 +/- 0.5
      mg/min and 0.1 +/- 0.5 mg/min, and during HC 0.4 +/- 0.4 mg/min and 0.5 +/- 0.6
      mg/min, respectively. In vitro adipocyte and muscle insulin receptor studies
      showed normal to increased receptor number and increased receptor
      autophosphorylation in diabetic compared to normal rats. IN CONCLUSION: (i) 3-day
      diabetic rats show, at maximal plasma insulin concentrations, insulin resistance
      to BGU, but not to HGP. The resistance to BGU is equally present (reduction of
      38%) at eu- and hyperglycemic levels as compared to normal rats. (ii) 3-day
      diabetic rats reveal no defect in adipocyte and muscle insulin receptor function.
      These data indicate that the diabetes induced insulin resistance for BGU is at
      the post-receptor level and due to a decreased maximal capacity (Vmax) for
      glucose uptake, with no change in affinity, or Km.

PMID- 1739738
TI  - Parallel stranded DNA under the scanning tunnelling microscope.
AB  - Using scanning tunnelling microscopy, we have directly observed parallel stranded
      DNA helixes of 43 nucleotides in length. The double helix is right-handed and has
      an average spacing, 17.43 A (+/- 1 S.D.: 2.30 A), and an average apparent depth,
      4.79 A (+/- 1 S.D.: 1.04 A) for each groove. The average pitch of the helical
      turn is 34 A (+/- 1 S.D.: 3.35 A) and consists of no more than ten base pairs.
      The diameter of the helix is approx. 17-20 A. Our results provide direct evidence
      for the existence of a parallel structure of DNA in vitro and some details of its
      fine structure.

PMID- 1739739
TI  - Differential and coordinate responses of the human genes encoding the heat stable
      alkaline phosphatases to cAMP and sodium butyrate in the choriocarcinoma line JEG
      3.
AB  - Human heat stable alkaline phosphatases are encoded by two closely related genes:
      the PLAP-1, which specifies the term placental enzyme, and the PLAP-2, which is
      expressed primarily in germ cells. In the choriocarcioma line JEG-3, 8-Br-cAMP
      induced the accumulation of the mRNA of both genes, while sodium butyrate induced
      the accumulation of PLAP-2 transcripts only. Each agent increased the
      transcription rate of one or both of the genes, as assayed by run-on
      transcription. In transfection of JEG-3 cells with PLAP promoters fused to the
      firefly luciferase gene, the activity of the PLAP-2 promoter (but not PLAP-1) was
      induced with sodium butyrate, while both promoters were induced by 8-Br-cAMP.
      Inducibility of the PLAP-2 promoter by 8-Br-cAMP was still observed when the
      promoter was shortened to -103, leaving intact a sequence resembling a cAMP
      response element. The extent of transcriptional activation by either agent was
      not sufficient to explain the accumulation of PLAP mRNA. These studies suggest
      that both transcriptional and posttranscriptional processes are involved in the
      induction of the PLAP-1 and PLAP-2 gene in JEG-3 cells.

PMID- 1739740
TI  - TRH-related peptides in the rabbit prostate complex during development.
AB  - The novel peptide, pyroglutamylglutamylprolineamide (pGlu-Glu-ProNH2), has
      recently been isolated and characterized from the rabbit prostate complex. The
      tripeptide is present in high concentrations in the prostate complex and semen,
      together with a 40-50 residue polypeptide which contains a TRH-immunoreactive
      fragment at its C-terminus. The present study investigates changes in the levels
      of these TRH-related peptides in rabbits aged 11 weeks, 4 months, 7 months, 13
      months and 2 years. For each age group the peptides were extracted from the
      prostate complex, separated by gel exclusion chromatography, and located by TRH
      radioimmunoassay. The TRH-immunoreactive fragment was released from the
      polypeptide by trypsin digestion prior to radioimmunoassay. Very low
      concentrations of TRH-immunoreactive peptides were present at 11 weeks of age,
      but considerable levels of both peptides were found in all the other age groups.
      Anion exchange chromatography, under conditions which resolve TRH and pGlu-Glu
      ProNH2, showed that the majority of the low molecular weight TRH immunoreactivity
      co-eluted with synthetic pGlu-Glu-ProNH2. The remaining TRH immunoreactivity,
      which had not bound to the anion resin, also failed to bind to a cation exchange
      column at pH 2.0, indicating that it was not authentic TRH. Dissection of the
      prostate complex into its four constitutive regions (vesicular gland, coagulating
      gland, prostate and bulbourethral gland) followed by extraction, chromatography
      and TRH radioimmunoassay of each region showed that the TRH-related peptides were
      located in the prostate.

PMID- 1739741
TI  - Identification of superoxide dismutase in rat liver peroxisomes.
AB  - In this paper we have investigated whether or not superoxide dismutase is
      localized in peroxisomes from rat liver. Using an improved method to prepare
      peroxisomes from clofibrate induced rat livers, we identified superoxide
      dismutase activity in peroxisomes. This activity was found to be predominantly of
      the copper-zinc type. The finding of superoxide dismutase activity in peroxisomes
      makes sense since peroxisomes also contain superoxide generating enzyme
      activities such as xanthine oxidase.

PMID- 1739742
TI  - Insect glycolipids.
AB  - Systematic elucidations of the chemical structures of glycosphingolipids from
      members of the phyla Arthropoda (class:insecta) of the Protostomia have shown
      several characteristic differences to those of the Deuterostomia, e.g., the
      Vertebrata. The ceramide constituents of the arthropod sphingolipids are C14:1-
      and C16:1-sphingoid and a majority of saturated C18-, C20-, C22- and C24-fatty
      acids. The GSL of the dipteran insects, L. caesar and C. vicina, consist of a
      series of homologous compounds of increasing sugar chain length. The carbohydrate
      moieties of these arthropod GSL are all derived from one unique neutral sugar
      core sequence, the arthro-series. The longest member known, an
      arthrononaosylceramide has the structure Gal beta,3GalNAc beta,3GlcNAc beta,3Gal
      beta,3GalNAc alpha,4GalNAc beta,4GlcNAc beta,3Man beta,4Glc beta Cer. Three
      pentahexosylceramides have been characterized that differ in their nonreducing
      terminus, i.e., IV4GalNAc alpha-Ap4Cer, IV3Gal alpha-Ap4Cer and IV3Gal beta
      Ap4Cer. A large repertoire of structural variations of the arthro-series GSL is
      created by two types of derivatisations of the neutral carbohydrate core:
      addition of a zwitterionic 2-aminoethylphosphate group in phosphodiester linkage
      to the 6-position of the III-N-acetylglucosamine of the arthrotriaosylceramide
      core and/or substitution of a terminal galactose in 3-position by a glucuronic
      acid residue. The latter acidic arthro-series GSL were given the name
      arthrosides. Preliminary results have indicated that the blowfly GSL component
      distribution is strongly organ specific. GSL of various larval organs are
      distinguished by the length of their neutral core carbohydrate chain, as well as,
      the degree of PEtn- and GlcA-substitutions. Normal human sera contain antibodies
      that recognize epitopes on arthro-series GSL. Thereby, sites of the neutral
      carbohydrate chain, as well as, the zwitterionic and acidic epitopes are involved
      in the immune recognition. In a pathological condition, a M-protein of patients
      with autoallergic demyelinating peripheral neuropathy was found to react strongly
      with a glucuronic acid-containing molecular structure on arthrosides. Some
      indication was obtained for a possible functional role of glucuronic acid in
      dipteran-cell adhesion by using a mouse monoclonal antibody, mAb CAF-I. This
      antibody, directed against an arthroside epitope involving glucuronic acid, could
      induce an in vitro detachment of insect cells from one another or from their
      substratum. Obviously, present research on the GSL of insects is only at an early
      stage. Nevertheless, from the results available so far it was become increasingly
      apparent that a new chapter in our knowledge of GSL structures has been
      opened.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1739743
TI  - A defect in the sterol:steryl ester interconversion in a mutant of the yeast,
      Saccharomyces cerevisiae.
AB  - A culture cycle dependent interconversion of sterols and steryl esters is
      disturbed in a mutant of Saccharomyces cerevisiae. Independent extragenic
      suppressors to this mutant return the mutant's pleiotropic phenotype to that of
      the parental wild type. Concomitant with the alterations in interconversion,
      modifications were found in the yeast proteins that antigenically react with
      antibodies elicited against mammalian apolipoproteins. Suppressor mutations
      returned the aberrant immunoblot banding pattern of the mutant to that of the
      wild type in apolipoprotein B.

PMID- 1739744
TI  - Hepatic and nonhepatic sterol synthesis and tissue distribution following
      administration of a liver selective HMG-CoA reductase inhibitor, CI-981:
      comparison with selected HMG-CoA reductase inhibitors.
AB  - Since cholesterol biosynthesis is an integral part of cellular metabolism,
      several HMG-CoA reductase inhibitors were systematically analyzed in in vitro, ex
      vivo and in vivo sterol synthesis assays using [14C]acetate incorporation into
      digitonin precipitable sterols as a marker of cholesterol synthesis. Tissue
      distribution of radiolabeled CI-981 and lovastatin was also performed. In vitro,
      CI-981 and PD134967-15 were equipotent in liver, spleen, testis and adrenal,
      lovastatin was more potent in extrahepatic tissues than liver and BMY21950,
      pravastatin and PD135023-15 were more potent in liver than peripheral tissues. In
      ex vivo assays, all inhibitors except lovastatin preferentially inhibited liver
      sterol synthesis; however, pravastatin and BMY22089 were strikingly less potent
      in the liver. CI-981 inhibited sterol synthesis in vivo in the liver, spleen and
      adrenal while not affecting the testis, kidney, muscle and brain. Lovastatin
      inhibited sterol synthesis to a greater extent than CI-981 in the spleen, adrenal
      and kidney while pravastatin and BMY22089 primarily affected liver and kidney.
      The tissue distribution of radiolabeled CI-981 and lovastatin support the changes
      observed in tissue sterol synthesis. Thus, we conclude that a spectrum of liver
      selective HMG-CoA reductase inhibitors exist and that categorizing agents as
      liver selective is highly dependent upon method of analysis.

PMID- 1739745
TI  - Plasma lipid transport in the preruminant calf, Bos spp: primary structure of
      bovine apolipoprotein A-I.
AB  - The preruminant calf (Bos spp.) is a model of considerable interest with regard
      to hepatic and intestinal lipoprotein metabolism (Bauchart et al., J. Lipid Res.
      (1989) 30, 1499-1514 and Laplaud et al., J. Lipid Res. (1990) 31, 1781-1792). As
      a preliminary step towards future experiments dealing with HDL metabolism in the
      calf, we have purified apoA-I from this animal and determined its complete amino
      acid sequence. Thus, approx. 10% of calf apoA-I was shown to contain a
      propeptide, with the sequence Arg-His-Phe-Trp-Gln-Gln. Enzymatic cleavage of apoA
      I resulted in 10 proteolytic peptides. The complete apoA-I sequence was obtained
      after alignment of peptides on the basis of their homologies with those from
      rabbit apoA-I. Thus calf apoA-I consists of 241 amino acid residues, and exhibits
      high sequence homology with all mammalian apoA-I's studied to date. The bovine
      protein contained 10 hydrophobic amphipathic helical regions, occurring between
      residues 43-64, 65-86, 87-97, 98-119, 120-141, 142-163, 164-184, 185-206, 207-217
      and 218-241. A computer-constructed phylogenetic tree showed that bovine apoA-I
      was more closely related to its dog counterpart, including the presence of a
      single methionine, than to the corresponding macaque and human proteins.
      Comparative predictions of the respective antigenic structures of human and
      bovine apoA-I's using the Hopp-Woods algorithm indicated similar positions for
      all 13 detectable antigenic sites, among which 7 were of identical, or closely
      related, amino acid composition. This finding was confirmed by demonstration of
      partial immunological identity between the two proteins upon immunodiffusion
      analysis, a result obtained using a monospecific rabbit antiserum against bovine
      apoA-I. Finally, comparison of sequence homology between bovine apoA-I and the
      lecithin:cholesterol acyl transferase (LCAT) activating region of human apoC-I
      suggests that several LCAT activating domains may be present in calf apoA-I.

PMID- 1739746
TI  - Effect of beta-lactoglobulin on the activity of pregastric lipase. A possible
      role for this protein in ruminant milk.
AB  - The interaction of bovine beta-lactoglobulin with palmitic and oleic acids has
      been studied by a partition equilibrium method. Bovine beta-lactoglobulin
      displays only one high affinity binding site for fatty acids whose association
      constants for palmitic and oleic acids are 4.2 x 10(6) and 2.3 x 10(6) M-1,
      respectively. However, other binding sites with low affinity are also present.
      The existence of one high affinity binding site is in accordance with the amount
      of fatty acids naturally bound to beta-lactoglobulin isolated from milk. The
      effect of beta-lactoglobulin on ruminant pregastric lipases from a pharyngeal
      extract has been assayed. The activity of pharyngeal lipase on a triglyceride
      emulsion is increased about 200%, 250% and 190% in the presence of 10 mg/ml, 20
      mg/ml and 40 mg/ml of beta-lactoglobulin, respectively, the last concentration
      representing that found physiologically in colostrum. Albumin, another ligand
      binding protein, increases the activity of this enzyme to a lesser extent and
      high levels tend to inhibit enzyme action. These results indicate that beta
      lactoglobulin could participate in the digestion of milk lipids during the
      neonatal period by enhancing the activity of pregastric lipase through removal of
      the fatty acids that inhibit this enzyme.

PMID- 1739747
TI  - Purification and NH2-terminal amino acid sequences of human and rat kidney fatty
      acid omega-hydroxylases.
AB  - A cytochrome P-450 (P-450), designated P-450HK omega, has been isolated and
      purified from human kidney microsomes to a specific content of 13 nmoles of P
      450/mg of protein. P-450HK omega showed an apparent molecular weight of 52,000 on
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Absolute
      spectra of the oxidized form indicated that this P-450 was largely in the low
      spin state and partly in the high-spin state. It catalyzed the omega- and (omega
      1)-hydroxylation of fatty acids such as laurate, myristate, and palmitate, with
      no activity toward prostaglandin A1, benzphetamine, 7-ethoxycoumarin, or 7
      ethoxyresorufin. The first 35 NH2-terminal amino acid sequence of P-450HK omega
      had about 70% homology with those of rabbit kidney fatty acid omega-hydroxylases
      of the P-450 IVA gene subfamily, P-450ka-1, P-450ka-2, and P-450kd, except for
      four undetermined residues. Moreover, Western blot and immuno-inhibition studies
      showed that P-450HK omega reacted with an antibody against the rabbit kidney
      fatty acid omega-hydroxylase. The results suggest that P-450HK omega is a member
      of the same P-450 gene family (IVA subfamily) as the rabbit enzymes. In addition,
      the terminal sequence of P-450HK omega also showed 54% homology with that of P
      450k-2, a fatty acid omega-hydroxylase from rat kidney microsomes. To our
      knowledge, this is the first time that a P-450 specific for fatty acid omega
      hydroxylase activity has been isolated to homogeneity from human tissues.

PMID- 1739748
TI  - Effects of clofibrate feeding on essential fatty acid desaturation and oxidation
      in isolated rat liver cells.
AB  - The effects of clofibrate feeding on the metabolism of polyunsaturated fatty
      acids were studied in isolated rat hepatocytes. Administration of clofibrate
      stimulated the oxidation and particularly the peroxisomal beta-oxidation of all
      the fatty acids used. The increase in oxidation products was markedly higher when
      n-3 fatty acids were used as substrate, indicating that peroxisomes contribute
      more to the oxidation of n-3 than n-6 fatty acids. The whole increase in
      oxidation could be accounted for by a corresponding decrease in acylation in
      triacylglycerol while the esterification in phospholipids remained unchanged. A
      marked stimulation of the amounts of newly synthesized C16 and C18 fatty acids
      recovered, was observed when 18:2(n-6), 20:3(n-6), 18:3 (n-3) and 20:5(n-3), but
      not when 20:4(n-6) and 22:4(n-6) were used as substrate. This agrees with the
      view that extra-mitochondrial acetyl-CoA produced from peroxisomal beta-oxidation
      is more easily used for fatty acid new synthesis than acetyl-CoA from
      mitochondrial beta-oxidation. The delta 6 and delta 5 desaturase activities were
      distinctly higher in cells from clofibrate fed rats indicating a stimulating
      effect.

PMID- 1739749
TI  - UV-treated lipoproteins as a model system for the study of the biological effects
      of lipid peroxides on cultured cells. 4. Calcium is involved in the cytotoxicity
      of UV-treated LDL on lymphoid cell lines.
AB  - In lymphoid cells pulsed with 'cytotoxic' concentrations of UV-treated LDL, the
      study of the variations of free cytosolic calcium concentration, of the influence
      of extracellular calcium and of the protective effect of calcium chelators
      suggests that both intra- and extracellular calcium could play a major role in
      the genesis of cell injury leading to cell death. (1) A dramatic sustained rise
      of cytosolic free calcium (the level of free cytosolic calcium was higher than
      500 nmol/l for 6 h or more) occurred several hours after the beginning of the
      pulse with UV-treated LDL (lag period between 6 and 12 h). (2) The rise of the
      free cytosolic calcium and the 'cytotoxicity' induced by UV-treated LDL were
      largely dependent on the concentration of extracellular calcium which has an
      effect on the uptake of UV-treated LDL and on the expression of the
      'cytotoxicity' at the cellular level. (3) The study of the sequence of
      intracellular events showed that the cellular oxidative stress generated by
      oxidized LDL was followed by the rise of free cytosolic calcium and later by the
      rise of 'cytotoxicity' indexes. (4) The intracellular calcium chelators, BAPTA/AM
      and EGTA/AM, were able to partially protect lymphoid cells against the
      'cytotoxicity' of oxidized LDL. The supposed mechanisms of the free cytosolic
      calcium rise and the respective role of calcium or/and other factors (for
      instance direct lesions of the plasma membrane by the oxidative stress due to
      oxidized LDL) in the genesis of cellular lesions leading to cell death are
      discussed.

PMID- 1739750
TI  - Inhibition of prostaglandin synthesis in human endothelial cells treated with
      metabolic inhibitors.
AB  - Endothelial cell injury is often associated with increased synthesis of
      prostaglandin (PG)I2. We observed, however, that endothelial cells treated with
      metabolic inhibitors which reduce cellular ATP content develop an injury pattern
      characterized by reduced PGI2 synthesis. This study examined the relationship
      between cell injury, arachidonic acid metabolism and ATP content in human
      umbilical vein endothelial cells treated with 2-deoxyglucose (2DG), a glycolytic
      inhibitor, and oligomycin (OG), a respiratory chain inhibitor. Either inhibitor
      alone significantly reduced cellular ATP concentrations, but only OG reduced
      basal PG synthesis. The combination of 2DG and OG, however, was more effective
      than either agent alone in reducing cellular ATP content (greater than or equal
      to 50% of control) and inhibiting basal and agonist-stimulated PGI2 synthesis.
      This reduced PGI2 synthesis preceded 51chromium release, lactic dehydrogenase
      release and was not associated with a net release of arachidonic acid from cell
      membranes. Histamine, A23187 and bradykinin stimulated PGI2 synthesis in
      untreated but not in 2DG and OG treated cells. Exogenous arachidonic acid
      increased PGI2 synthesis to a similar extent in both 2DG and OG treated and
      untreated cells. Therefore, reduced PG synthesis in 2DG and OG treated
      endothelial cells is not due to inhibition of cyclooxygenase. Furthermore,
      reduced PG synthesis in these cells occurs prior to cell injury and is not
      strictly associated with cellular ATP depletion.

PMID- 1739751
TI  - Down-regulation of hepatic lipase gene expression and activity by fenofibrate.
AB  - The influence of the hypolipidemic drug, fenofibrate, on hepatic lipase (HL) gene
      expression and activity was investigated in the rat. Fenofibrate treatment
      provoked a dose-dependent decrease in HL mRNA levels. At a dose of 0.5% (w/w), HL
      mRNA levels were reduced to nearly 50% the levels in untreated controls. This
      decrease was parallelled by a comparable reduction in liver HL activity. The
      decrease in HL mRNA levels was already observed after 1 day of fenofibrate
      treatment. Whole liver perfusion experiments showed that the heparin-releasable
      HL activity in fenofibrate-treated livers dropped to 10% the activity in control
      livers. In conclusion, treatment with fenofibrate decreases HL gene expression,
      leading to a lowered activity of endothelium bound HL in fenofibrate-treated
      livers.

PMID- 1739752
TI  - 36th annual meeting of the GTH (German Thrombosis and Hematology Society).
      Heidelberg, 9-12 February 1992. Abstracts.

PMID- 1739753
TI  - Sensitivity of CFU-E to exogenous erythropoietin in benzene-treated mice.
AB  - Normal as well as hypertransfused BDF1 mice were exposed to 300 ppm of benzene, 6
      h/day, 5 days per week for 2, 4, and 6 weeks respectively. Erythroid-committed
      hematopoietic progenitor cells CFU-E were determined in the bone marrow, and 59Fe
      incorporation was measured in the peripheral blood 48 h after its injection, as
      an indicator of active erythroid cell production. CFU-E numbers were reduced in
      benzene-exposed mice at all intervals, as was 59Fe incorporation in the
      peripheral blood after 2 weeks of exposure. In hypertransfused mice the CFU-E
      suppression, caused primarily by the hypertransfusion, was aggravated by benzene.
      After injection of 1 IU Ep 4 days before killing the CFU-E numbers and the 59Fe
      incorporation increased in controls as well as in benzene-exposed animals, but
      the difference persisted. After nine consecutive Ep injections the difference
      concerning the femur disappeared after 2 and 6 weeks of benzene exposure but was
      still present in the peripheral blood. These results suggest that chronic benzene
      exposure has a negative effect on early erythroid-committed, Ep-responsive
      hematopoietic cells.

PMID- 1739754
TI  - Recombinant human erythropoietin for the treatment of anemia in the
      myelodysplastic syndromes: a clinical and erythrokinetic assessment.
AB  - The clinical and ferrokinetic effects of escalating doses of subcutaneously
      administered recombinant human erythropoietin (rh-EPO) were studied in ten
      patients with myelodysplastic syndromes and severe transfusion-dependent anemia.
      Red blood cell transfusion requirements diminished in four patients, and one of
      the patients eventually became transfusion independent with an EPO-induced rise
      of Hb from 7.7 g/dl to 12.3 g/dl. Endogenous serum levels of EPO were
      significantly increased in all patients (100-5700 mU/ml), but three of four
      responders had a relatively low baseline level. The effective red cell iron
      turnover (RCIT) improved in two responding patients and even normalized in one
      patient. This increase in RCIT was accompanied with a decline in the ineffective
      red cell iron turnover (IIT). The other responding patients had a relatively
      preserved RCIT before EPO treatment. EPO therapy further increased the fraction
      of IIT in the latter patients. Red cell survival time did not increase during EPO
      therapy, even in the responding patients. One transient and one maintained
      increase in platelet count were observed. Disease progression with a sustained
      increase in blast cells in one patient and a transient elevation of blasts in
      another patient was seen. No other side effects of EPO therapy were observed.
      These results suggest that anemic MDS patients with low serum EPO levels and
      relatively spared effective erythropoiesis as measured by ferrokinetic studies
      may be the best candidates for treatment with recombinant human EPO.

PMID- 1739755
TI  - The contribution of DNA analysis to carrier detection and prenatal diagnosis of
      hemophilia A and B.
AB  - Developments in DNA technology have provided a novel means of carrier detection
      and prenatal diagnosis of hemophilia A and B. The collection of a large set of
      data has enabled us to evaluate the present feasibility and reliability of a
      diagnosis at the gene level and its contribution to methods already available.
      Since 1984, 533 potential and obligate carriers belonging to 170 families with
      hemophilia have been referred to us. By the combined use of pedigree analysis,
      coagulation assays, and DNA (RFLP) analysis, certainty about the carrier status
      has been markedly increased for the potential carriers. Although RFLP analysis
      revealed the possible origin of the mutation in many families with an isolated
      patient, uncertainty remained for quite a number of their female relatives
      because of the possible occurrence of germline mosaicism. Forty-one women
      requested prenatal diagnosis during one or more pregnancies. The short time
      interval between pregnancies, even after abortion of an affected fetus, proved
      that first-trimester prenatal diagnosis has become an acceptable option for women
      at risk. Recently, efficient methods for direct identification of mutations have
      been developed, and they may allow a definite diagnosis for all families with
      hemophilia in the near future.

PMID- 1739756
TI  - Iron stores in 1359, 30- to 60-year-old Danish women: evaluation by serum
      ferritin and hemoglobin.
AB  - Iron status, including serum (S-)ferritin and hemoglobin (Hb), was assessed in a
      population survey comprising 1359 nonpregnant Danish women in age cohorts of 30,
      40, 50, and 60 years. S-ferritin levels were similar in 30- and 40-year-old
      women; they displayed a significant increase in 50-year-old women and a further
      significant increase in 60-year-old women. In the 30- and 40-year-old women,
      median S-ferritin was 38 micrograms/l, 5-95 percentile 6-135 micrograms/l; 17.2%
      had values less than 15 micrograms/l (i.e., depleted iron stores), 22.7% values
      from 15 to 30 micrograms/l (i.e., small iron stores), and 60.1% values greater
      than 30 micrograms/l (i.e., replete iron stores). In the 50-year-old women,
      median S-ferritin was 54 micrograms/l, 5-95 percentile 10-164 micrograms/l; 10.3%
      had values less than 15 micrograms/l, 16.5% values from 15 to 30 micrograms/l,
      and 73.2% values greater than 30 micrograms/l. For the 60-year-old women, median
      S-ferritin was 84 micrograms/l, 5-95 percentile 25-249 micrograms/l; 1.6% had
      values less than 15 micrograms/l, 8.6% values from 15 to 30 micrograms/l, and
      89.8% values greater than 30 micrograms/l. Blood donors (n = 180) had lower S
      ferritin than nondonors in all age-groups (p less than 0.001). In the entire
      series, Hb levels were similar in 30- and 40-year-old women, median 137
      milligrams (8.5 mmol/l), 5-95 percentile 121-152 milligrams (7.5-9.4 mmol/l), and
      higher in 50- and 60-year-old women, median 140 milligrams (8.7 mmol/l), 5-95
      percentile 123-158 milligrams (7.6-9.8 mmol/l) (p less than 0.0001). Hb values
      less than 121 milligrams (7.5 mmol/l) were observed in 3.8% of the women. Women
      with S-ferritin less than 15 micrograms/l (n = 161) had lower Hb, median 134
      milligrams (8.3 mmol/l), than those with S-ferritin greater than or equal to 15
      micrograms/l, median 139 milligrams (8.6 mmol/l) (p less than 0.001). Iron
      deficiency anemia (S-ferritin less than 15 micrograms/l and Hb less than 121
      milligrams) was seen in 2.3% of 30- and 40-year-old women, and in 1.1% of 50- and
      60-year-old women.

PMID- 1739757
TI  - The relevance of cultures of catheter-drawn blood and heparin-lock fluid to
      diagnose infection in hematologic patients.
AB  - The results of bacteriologic cultures of blood and heparin-lock fluid, both drawn
      from the central venous catheters of 54 consecutive oncohematologic patients,
      have been used to determine their value for the diagnosis of systemic and
      catheter-associated infection. In 30 patients with clinical signs of infection
      (bacteremia or septicemia), 74 of 1000 (7.4%) heparin-lock fluid cultures, 114 of
      542 (21%) catheter-drawn blood cultures, and 36 of 134 (26%) venipuncture blood
      cultures became positive, whereas in 24 patients without clinical signs of
      infection the respective values were 5 of 700 (0.7%), one of 220 (0.4%), and none
      of ten cultures. Comparison of the results of cultures sampled on the same day
      reveals that the positive and negative predictive values for catheter-drawn blood
      cultures, with the venipuncture blood cultures taken as the standard for
      bacteremia, are 82% and 95% respectively. The results of heparin-lock fluid are
      indicative for clinically relevant colonization of the catheter. Three or more
      positive heparin-lock fluid cultures, sampled on subsequent days, were correlated
      with the occurrence of bacteremia or septicemia with a positive predictive value
      of 100%. The conclusions are supported by the results of scanning electron
      microscopy.

PMID- 1739758
TI  - Acute parvovirus B19 infection mimicking myelodysplastic syndrome of the bone
      marrow.
AB  - A 36-year-old, previously healthy woman was referred to our institution with
      pancytopenia and splenomegaly for suspected acute leukemia. Bone marrow
      aspiration showed marked dysplastic changes, excess of blasts, and only spurious
      red blood cell precursors. Action was taken to prepare allogeneic bone marrow
      transplantation from an HLA identical sibling for myelodysplastic syndrome.
      Repeat cytological examination of the bone marrow revealed striking hyperplasia
      of the red cell line with presence of abnormal giant proerythroblasts. Acute
      parvovirus B19 infection was suspected and confirmed by detection of anti-B19 IgM
      and B19 DNA. The underlying disease for this transient aplastic crisis was a
      formerly unknown hereditary spherocytosis.

PMID- 1739759
TI  - A 53-year-old man with shock and arthritis 1 month after consolidation
      chemotherapy for acute myeloid leukemia.

PMID- 1739760
TI  - Defining the cost of health care.

PMID- 1739761
TI  - Creatively speaking.

PMID- 1739762
TI  - Family violence Part I. Hidden secrets: elder abuse.

PMID- 1739763
TI  - Commission sends a clear message: no more business as usual.

PMID- 1739764
TI  - Watch your language.

PMID- 1739765
TI  - The price of integrity.

PMID- 1739766
TI  - [Experiences with digital luminescence radiography (DLR) in pediatric radiology].
AB  - X-ray examinations represent a variety of indications with different demands on
      exposure latitude, spatial and contrast resolution of screen-film-system
      combinations in paediatric radiography. The value of digital luminescent
      radiography (DLR) was compared to conventional x-ray examinations carried out
      with screen-film-systems, speed class 200, by analysing matched digital and
      conventional exposures in 200 abdominal, 600 skeletal and 300 chest examinations.
      The exposure of DLR was reduced to 50% of conventional exposure. Analysing the
      results in abdominal and skeletal radiography, DLR proved to be diagnostically
      equivalent to conventional radiography despite the reduction in exposure dose.
      DLR of the newborn chest compared to conventional x-ray studies was not always
      sufficient due to lower digital spatial resolution.

PMID- 1739767
TI  - [MR angiography in neuropediatric problems: the technic and the clinical
      results].
AB  - 31 children aged between 6 months and 14 years with various neurovascular
      abnormalities were examined by MR angiography in a prospective study. In order to
      test the sensitivity and specificity of the MR results, these were compared in 8
      cases with the findings of digital subtraction angiography or conventional
      angiography. In 24 patients arterial MR angiography was performed; in 17 these
      showed anomalies or abnormalities of the intracranial vascular system. In 7
      patients venous MR angiography was performed and demonstrated the presence of
      sinus thrombosis in 6 of these. Comparison between MR angiography and DSA showed
      agreement in 7 cases; in one patient the degree of a stenosis was exaggerated by
      MR. The results of this study indicate that arterial and venous MR is of great
      value as an additional study in paediatric neurovascular problems.

PMID- 1739768
TI  - [MR angiography of the vertebrobasilar circulatory area: the potential uses of
      the saturation technic to determine the direction of the flow].
AB  - MR angiography (MRA) combined with selective saturation techniques has proved to
      be a reliable method for the determination of flow direction and vascular supply
      at the level of the circle of Willis. We describe its application to the
      vertebrobasilar system (VBS) in ten volunteers and five patients with abnormal
      findings. In one patient with postsurgical stenosis of the brachiocephalic
      artery, reverse flow of the vertebral artery (VA) was demonstrated. Collateral
      blood flow from the anterior circulation over the posterior communicating
      arteries was shown in three patients with bilateral vertebral or proximal basilar
      artery occlusion. Due to increase of pressure during contrast injection into the
      contralateral VA, DSA showed reverse flow of a dissected VA in one patient. MR
      flow determination as well as TCD proved antegrade flow. All results correlated
      with both DSA and transcranial Doppler (TCD). The technique is little time
      consuming and is a promising add-on examination to conventional and MRA imaging
      of the VBS.

PMID- 1739769
TI  - [Color-coded Doppler sonography of the thyroid: an advance in carcinoma
      diagnosis?].
AB  - There are several papers suggesting that colour-coded Doppler sonography is a
      useful diagnostic tool for the differentiation of malignant and benign lesions of
      the thyroid gland. This hypothesis (hypervascularization of malignant nodules) is
      reconsidered by preoperative examination of 65 patients by using colour-coded
      Doppler sonography and scintigraphy. Among these patients 21 carcinomas and 2
      malignant lymphomas of the thyroid gland were found histologically. Colour-coded
      Doppler sonography was true positive in 10 cases, true negative in 28 cases,
      false positive in 14 cases and false negative in 13 cases. Our conclusion is that
      colour-coded Doppler sonography cannot be used unconditionally for the detection
      of carcinoma of the thyroid gland.

PMID- 1739770
TI  - [The signal behavior of parathyroid adenomas in MRT--the contrast ratio of the
      thyroid and fatty tissue].
AB  - A quantitative analysis of signal relationships using T1, proton and T2 weighted
      spin echo sequences was carried out using 20 parathyroid adenomas demonstrated by
      MRI. T1 weighted sequences from 15 adenomas were also examined following
      intravenous injection of Gd-DTPA. No typical signal relationship could be
      defined. In 4 cases the administration of contrast medium markedly increased the
      contrast between the adenoma and the thyroid gland. In 12 cases the tumour could
      be examined histologically following removal. In 2 cases there was oedema of the
      tumour and corresponding increased intensity of the T2 weighted sequences; in
      none of the other cases was there any clear correlation between the signals and
      the histology.

PMID- 1739771
TI  - [Cervical lymph node metastases. The sonographic demonstration of malignancy].
AB  - The value of sonography for demonstrating cervical lymph node metastases has been
      studied, using longitudinal and transverse measurements as criteria for
      malignancy. A transverse/longitudinal quotient greater than 2 indicates the
      presence of metastases with a 96% assurance. Using only longitudinal measurements
      lymph node metastases can be excluded with only a 36% assurance. The sensitivity
      of both methods also differs (95% for the maximal transverse quotient as against
      90% for longitudinal measurements). The use of the maximal transverse quotient
      increases specificity from 36 to 96%. This gives sonography an accuracy of 95%.

PMID- 1739772
TI  - [The findings of color Doppler sonography in breast tumors].
AB  - 72 histologically confirmed tumours of the breast--37 carcinomas and 35 benign
      tumours--for which mammograms were also available were examined by colour Doppler
      sonography. Vascularisation of benign processes showed at most 2 vessels (with
      the exception of 3 sarcoma phylloides and one proliferative mastopathy).
      Vascularisation clearly in excess of benign processes was observed in only 15 of
      the 37 carcinomas. In 33 of the carcinomas there was no doubt concerning the
      diagnosis preoperatively, in the remaining 4 the high vascularity was taken as an
      indication for surgery. CONCLUSION: In rare cases colour Doppler sonography can
      provide additional information in the presence of 'vascular' tumours. It is not
      possible to differentiate between poorly vascularised carcinomas and benign
      tumours.

PMID- 1739773
TI  - [Intravascular ultrasound (IVUS): the assessment of tumor infiltration into the
      vascular wall].
AB  - The demonstration or exclusion of tumour infiltration into a vessel wall is made
      possible by IVUS. This was performed 25 times in 23 patients using a 20 MHz probe
      where there was suspicion of tumour infiltration on the basis of CT, MRI or
      angiography. IVUS proved very suitable for clarifying the situation, making
      direct intravascular evaluation of the affected vessel possible. In 10 cases
      where surgery was performed, the demonstration or exclusion of tumour
      infiltration into a vein was confirmed operatively in every case. Further
      experience is necessary before the value of the method for diagnosing early
      arterial infiltration can be judged.

PMID- 1739774
TI  - [The extension of MR diagnosis in dissecting aortic aneurysms by means of FLASH
      and snapshot-FLASH sequences].
AB  - Using a combination of T1 weighted snapshot-flash sequences and intravenous
      contrast bolus it was possible to demonstrate intraluminal signal differences in
      a period of seconds. 5 confirmed aortic lesions were studied; 2 old aortic
      dissections (with differentiation between the true and false lumen), 1 acute
      aortic dissection and a partially thrombosed thoracic aortic aneurysm were
      demonstrated. The advantage of this technique lies in its simplicity and
      reproducibility. Difficulties in interpreting the intraluminal phases arising
      from spin echo and flash techniques are made easier by interpreting the available
      signals from this method.

PMID- 1739775
TI  - [The diagnosis of spinal trauma: the indication for CT and myelo-CT on the day of
      the injury].
AB  - During a period of 24 months, 211 patients were investigated in our radiological
      clinic by emergency CT of the spine on the day of the injury. In 128 (61%) a
      traumatic lesion could be demonstrated. Most frequently involved were the
      transitional zones of the spine (occipito-atlanto-axial segment, cervico-thoracic
      and thoracolumbar segments). In 68% of these patients, conventional radiographs
      of the spine of these critical zones proved to be inadequate. 20% of the lesions
      demonstrated by CT could not be seen on conventional radiographs and 41% were
      shown incompletely. In 61% of cases CT provided additional information when
      compared with conventional radiography.

PMID- 1739776
TI  - ["Surgical projection" in the gadolinium-DTPA (Gd-DTPA)-supported NMR tomographic
      diagnosis of lateral lumbar disk prolapse].
AB  - In a group of 25 patients the coronal views of plain and Gd-DTPA-enhanced MRI
      studies were correlated with CT and operative findings. All series included
      sagittal, transverse and coronal FLASH sequences (GE 500/6, flip angle 70
      degrees), sagittal proton density-(SE 2500/15) and T2-(SE 2500/70) weighted
      images. MR diagnosis proved to be correct in all cases. Compared to CT and axial
      MRI herniated disk material in the lateral intravertebral space and its
      relationship to nerve roots was demonstrated more clearly on coronal views.

PMID- 1739777
TI  - [A comparison of the value of magnetic resonance tomography and computed
      tomography in Nelson syndrome patients].
AB  - The hypophyses of 13 patients with Nelson syndrome following bilateral
      adrenalectomy were examined by MRI and CT. Diffuse enlargement of the hypophysis
      was demonstrated in 8 patients by CT and in 9 by MRI. Compared with CT, MRI
      provides better demonstration of tumour development, such as abnormal convexity
      of the cranial margin of the hypophysis (MRI 4/13, CT 1/13), displacement of the
      infundibulum (MRI 4/13, CT 0/13) or optic chiasm (MRI 2/13, CT 0/13). MRI also
      provides diagnostically important differentiation between scar tissue and
      recurrence of tumour following hypophysectomy (MRI 1/3, CT 0/3) and more accurate
      demonstration of infiltration of the cavernous sinus (MRI 4/13, CT 2/13). CT is
      superior only in showing the floor of the sella. MRI is the method of choice for
      imaging in cases of Nelson syndrome.

PMID- 1739778
TI  - [Gas-forming infections of the extremities].
AB  - A variety of cases of gas-forming infections has been collected and the
      radiological appearances due to the gas formation are described. In the context
      of the clinical situation the development of gas gangrene can be distinguished
      from other gas-forming infections which are mostly due to B. coli or cellulitis
      due to anaerobic streptococci. In addition to describing the pathology and
      clinical course, the possible forms of treatment are discussed.

PMID- 1739779
TI  - Diagnostic accuracy of ultrasound-guided fine-needle pancreatic biopsy.
AB  - We reviewed the results of 187 consecutive ultrasound-guided fine-needle biopsies
      of the pancreas in 171 patients to assess the diagnostic accuracy of the method.
      The final diagnosis obtained at operation, autopsy or follow-up were:
      adenocarcinoma (n = 83), metastatic cancer (n = 11), cystadenocarcinoma (n = 2),
      lymphoma (n = 2), malignant gastrinoma (n = 1), pseudocyst (n = 25), cyst (n =
      13), chronic pancreatitis (n = 9), normal pancreas (n = 10), abscess (n = 7),
      benign islet-cell tumour (n = 5), cystadenoma (n = 3). Sufficient cytologic
      material was obtained in 95.3% of biopsies and the overall accuracy in
      distinguishing benign from malignant disease was 85.4%. False negative results
      were obtained in 12 patients (13.1%). Inconclusive results (CIII) were found in
      aspirates from one cyst and two islet cell tumours. There were no false-positive
      results. The only complication was a post-biopsy haematoma around the head of
      pancreas, which resolved spontaneously. Ultrasound-guided pancreatic fine-needle
      biopsy is a safe method and allows of a high degree of diagnostic accuracy. It
      has a high specificity. Its sensitivity in the detection of malignancy improves
      if biopsies are repeated in doubtful cases. It further permits tumours to be
      graded and allows complications of pancreatitis to be diagnosed.

PMID- 1739780
TI  - [Transcatheter embolization of tumors of the muscular and skeletal systems].
AB  - The value of transcatheter embolisation of tumours of the musculoskeletal system
      is discussed on the basis of 26 cases. All procedures were performed following
      diagnostic angiography (DSA). By preoperative vascular occlusion it was possible
      to prevent major blood loss during surgery, provided the operation was carried
      out within three days of embolisation. Reduction in size of some large inoperable
      metastases before radio-iodine therapy is another indication for embolisation. As
      a palliative measure, vascular occlusion can be used for reducing otherwise
      untreatable skeletal pain and for the management of arteriovenous malformations.
      Bleeding from a tumour can be controlled by vascular occlusion. Our results
      indicate that transcatheter embolisation is an effective and reliable technique.

PMID- 1739781
TI  - [The radiation loading of the crystalline lens and thyroid during high-resolution
      computed tomography of the teeth].
AB  - The radiation dose to the ocular lens and thyroid gland during high resolution CT
      of the jaw was measured in a head phantom and in 9 patients. The dose for the
      lens and thyroid gland resulting from 10 cuts was 0.7 and 0.9 mGy, respectively.
      By shielding the thyroid gland against scatter a reduction of 20% is possible.
      Radiation exposure is considerably higher than during conventional dental x-ray
      examinations. Compared with CT examinations of the head and neck region,
      radiation exposure of both organs is about the same.

PMID- 1739782
TI  - [The tracheal bronchus as the cause of chronic recurrent pneumonias].

PMID- 1739783
TI  - [An unusual complication following the osteosynthesis care of a clavicular
      fracture].

PMID- 1739784
TI  - Computed tomography of retroperitoneal ganglioneuroma. Case report.

PMID- 1739785
TI  - [Progressive kidney failure due to cholesterol embolization. A complication
      following arteriography].

PMID- 1739786
TI  - [Myositis ossificans progressiva. A case report for the differential diagnosis of
      ectopic ossification of the cervical spine].

PMID- 1739787
TI  - Medical abortion.

PMID- 1739788
TI  - Ocular injuries from boxing.

PMID- 1739790
TI  - Fiddling with medical negligence.

PMID- 1739789
TI  - Swimming and grommets.

PMID- 1739791
TI  - NHS reforms: the first six months.

PMID- 1739792
TI  - Aneurin Bevan on the NHS.

PMID- 1739793
TI  - AIDS now a health risk in Sri Lanka.

PMID- 1739794
TI  - Childhood mortality after a high dose of vitamin A in a high risk population.
AB  - OBJECTIVES: To determine whether a single high dose of vitamin A given to all
      children in communities with high mortality and malnutrition could affect
      mortality and to assess whether periodic community wide supplementation could be
      readily incorporated into an ongoing primary health programme. DESIGN:
      Opportunistic controlled trial. SETTING: Jumla district, Nepal. SUBJECTS: All
      children aged under 5 years; 3786 in eight subdistricts given single dose of
      vitamin A and 3411 in remaining eight subdistricts given no supplementation. MAIN
      OUTCOME MEASURES: Mortality and cause of death in the five months after
      supplementation. RESULTS: Risk of death for children aged 1-59 months in
      supplemented communities was 26% lower (relative risk 0.74, 95% confidence
      interval 0.55 to 0.99) than in unsupplemented communities. The reduction in
      mortality was greatest among children aged 6-11 months: death rate (deaths/1000
      child years at risk) was 133.8 in supplemented children and 260.8 in
      unsupplemented children (relative risk 0.51, 0.30 to 0.89). The death rate from
      diarrhoea was also reduced (63.5 supplemented v 97.5 unsupplemented; relative
      risk 0.65, 0.44 to 0.95). The extra cost per death averted was about $11.
      CONCLUSION: The results support a role for Vitamin A in increasing child
      survival. The supplementation programme was readily integrated with the ongoing
      community health programme at little extra cost.

PMID- 1739795
TI  - Stability of essential drugs during shipment to the tropics.
AB  - OBJECTIVE: To determine whether present methods of international transport of
      essential drugs by sea adversely affect their quality. DESIGN: Controlled
      longitudinal study of drug shipments sent by sea from Unicef in Copenhagen to
      Lagos; to Mombasa and by land to Kampala; and to Bangkok. 11 essential drugs were
      stored in four locations on board the ships. SETTING: Main shipping routes from
      Unicef, Copenhagen, to tropical countries. MAIN OUTCOME MEASURES: Temperature and
      relative humidity in the test packs during the journey. Amount of active
      ingredient in the drugs before and after shipment. RESULTS: Temperatures recorded
      within the test packs range from -3.5 degrees C to 42.4 degrees C and were 3-12
      degrees C higher than the ambient temperature. Relative humidity within the packs
      ranged from 20% to 88%. Differences between the locations on board were
      negligible. Ergometrine injection, methylergometrine injection, and retinol
      capsules lost 1.5-5.8% of their activity. Ampoules of ergometrine showed a large
      variation in the amount of active ingredient after shipment, with three of 80
      samples having concentrations 60% below those stated. Ampicillin,
      benzylpenicillin, phenoxymethylpenicillin, and tetracycline were not affected by
      transport. CONCLUSIONS: Drugs were exposed to a much higher temperature and
      humidity than is recommended by the manufacturer, especially in tropical harbours
      and during inland transport. Except for ergometrine and methylergometrine the
      transport would not affect clinical effectiveness.

PMID- 1739796
TI  - Mortality and occupational exposure to radiation: first analysis of the National
      Registry for Radiation Workers.
AB  - OBJECTIVE: To study cause specific mortality of radiation workers with particular
      reference to associations between fatal neoplasms and level of exposure to
      radiation. DESIGN: Cohort study. SETTING: United Kingdom. SUBJECTS: 95,217
      radiation workers at major sites of the nuclear industry. MAIN OUTCOME MEASURE:
      Cause of death. RESULTS: Most standardised mortality ratios were below 100: 83
      unlagged, 85 with a 10 year lag for all causes; 84 unlagged, 86 lagged for all
      cancers; and 80 for all known other causes, indicating a "healthy worker effect."
      The deficit of lung cancer (75 unlagged, 76 lagged) was significant at the 0.1%
      level. Standardised mortality ratios were significantly raised (214 unlagged, 303
      lagged) for thyroid cancer, but there was no evidence for any trend with external
      recorded radiation dose. Dose of external radiation and mortality from all
      cancers were weakly correlated (p = 0.10), and multiple myeloma was more strongly
      correlated (p = 0.06); for leukaemia, excluding chronic lymphatic, the trend was
      significant (p = 0.03; all tests one tailed). The central estimates of lifetime
      risk derived from these data were 10.0% per Sv (90% confidence interval less than
      0 to 24%) for all cancers and 0.76% per Sv (0.07 to 2.4%) for leukaemia
      (excluding chronic lymphatic leukaemia). These are, respectively, 2.5 times and
      1.9 times the risk estimates recommended by the International Commission on
      Radiological Protection, but 90% confidence intervals are large and the
      commission's risk factors fall well within the range. The positive trend with
      dose for all cancers, from which the risk estimate was derived, was not
      significant. The positive association between leukaemia (except chronic lymphatic
      leukaemia) was significant and robust in subsidiary analyses. This study showed
      no association between radiation exposure and prostatic cancer. CONCLUSION: There
      is evidence for an association between radiation exposure and mortality from
      cancer, in particular leukaemia (excluding chronic lymphatic leukaemia) and
      multiple myeloma, although mortality from these diseases in the study population
      overall was below that in the general population. The central estimates of risk
      from this study lie above the most recent estimates of the International
      Commission on Radiological Protection for leukaemia (excluding chronic lymphatic
      leukaemia) and for all malignancies. However, the commission's risk estimates are
      well within the 90% confidence intervals from this study. Analysis of combined
      cohorts of radiation workers in the United States indicated lower risk estimates
      than the commission recommends, and when the American data are combined with our
      analysis the overall risks are close to those estimated by the commission. This
      first analysis of the National Registry for Radiation Workers does not provide
      sufficient evidence to justify a revision in risk estimates for radiological
      protection purposes.

PMID- 1739797
TI  - Detection of functional iron deficiency during erythropoietin treatment: a new
      approach.

PMID- 1739798
TI  - Health promotion in the general practice consultation: a minute makes a
      difference.
AB  - OBJECTIVE: To see whether extending appointment length from seven and a half
      minutes or less to 10 minutes per patient would increase health promotion in
      general practice consultations. DESIGN: Controlled trial of 10 minute
      appointments. Consultations were compared with control surgeries in which the
      same doctors booked patients at their normal rate (median six minutes per
      patient). SETTING: 10 general practices in Nottinghamshire. SUBJECTS: 16 general
      practitioners were recruited. Entry criteria were a booking rate of eight or more
      patients an hour, a wish for longer consultations, and plans to increase
      appointment length. MAIN OUTCOME MEASURES: Duration of consultations; recording
      of blood pressure, weight, and cervical cytology in the medical record; recording
      of advice about smoking, alcohol, diet, exercise, and immunisation in the medical
      record; reporting of the above activities by patients. RESULTS: Mean consultation
      times were 8.25 minutes in the experimental sessions and 7.04 and 7.16 minutes in
      the control sessions. Recording of blood pressure, smoking, alcohol consumption,
      and advice about immunisation was significantly more frequent in the experimental
      sessions, and the proportion of consultations in which one or more items of
      health education were recorded in the medical notes increased by an average of
      over 6% in these sessions. Patients more often reported discussion of smoking and
      alcohol consumption and coverage of previous health problems in the experimental
      sessions. There was little change in discussion of exercise, diet, and weight or
      cervical cytology activity. CONCLUSIONS: Shortage of time is a major factor in
      general practitioners' failure to realise their potential in health promotion.
      General practice should be organised so that doctors can run 10 minute
      appointment sessions.

PMID- 1739799
TI  - Managing change in general practice: a step by step guide.

PMID- 1739800
TI  - Quality management in the NHS: the doctor's role--I.

PMID- 1739801
TI  - Prescribing in Europe--forces for change.

PMID- 1739802
TI  - Swimming--the hazards of taking a dip.

PMID- 1739803
TI  - ABC of vascular diseases. Late complications of arterial grafts.

PMID- 1739804
TI  - A patient's charter for laboratories.

PMID- 1739805
TI  - Prescribing at the hospital--general practice interface.

PMID- 1739806
TI  - Auditing necropsies.

PMID- 1739807
TI  - Communication of results of necropsies.

PMID- 1739808
TI  - Hormonal manipulation of prostatic cancer.

PMID- 1739809
TI  - Vision screening in preschool children.

PMID- 1739810
TI  - Vision screening in preschool children.

PMID- 1739811
TI  - Auditing audits.

PMID- 1739812
TI  - The EPIC study.

PMID- 1739813
TI  - Lessons of Chernobyl.

PMID- 1739814
TI  - Understanding Marfan's syndrome.

PMID- 1739815
TI  - Health of the nation: personality disorder.

PMID- 1739816
TI  - Nursing comes of age.

PMID- 1739817
TI  - Disposal of clinical waste.

PMID- 1739818
TI  - First among women.

PMID- 1739819
TI  - Randomized clinical trials in general practice.

PMID- 1739820
TI  - Reducing risks in the sudden infant death syndrome.

PMID- 1739821
TI  - Relabelling blood.

PMID- 1739822
TI  - What mentally ill offenders need.

PMID- 1739823
TI  - Airs, waters, places, and doctors.

PMID- 1739824
TI  - Systemic vasculitis.

PMID- 1739825
TI  - Junior doctors on the warpath.

PMID- 1739826
TI  - Thermal environment and sudden infant death syndrome: case-control study.
AB  - OBJECTIVE: To compare the thermal environment of infants who died of the sudden
      infant death syndrome with that of age matched control infants. DESIGN: Case
      control study. Infants who died were matched with two controls, one for age and
      one for age and birth weight. Thermal measurements were conducted at the death
      scene for cases and at the scene of last sleep for control infants, who were
      visited unexpectedly within four weeks of the index infant's death on a day of
      similar climatic conditions. A follow up questionnaire was administered to
      parents of cases and controls. SETTING: The geographical area served by the
      professional Tasmanian state ambulance service, which includes 94% of the
      Tasmanian population. SUBJECTS: 41 infants died of the sudden infant death
      syndrome at home; thermal observations at death scene were available for 28
      (68%), parental questionnaire data were available for 40 (96%). 38 controls
      matched for age and 41 matched for age and birth weight. RESULTS: Cases had more
      excess thermal insulation for their given room temperature (2.3 togs) than
      matched controls (0.6 togs) (p = 0.009). For every excess thermal insulation unit
      (tog) the relative risk of the sudden infant death syndrome was 1.26 (95%
      confidence interval 1.05 to 1.52). The average thermal bedding value calculated
      from parental recall was similar to that observed by attendant ambulance officers
      (mean difference = 0.4 tog, p = 0.39). Cases were more likely to have been found
      prone (odds ratio 4.58; 1.48 to 14.11). Prone sleeping position was not a
      confounder or effect modifier of the relation between excess thermal insulation
      and the syndrome. CONCLUSIONS: Overheating and the prone sleeping position are
      independently associated with an increased risk of the sudden infant death
      syndrome. Further work on infant thermal balance and sudden infant death is
      required and guidelines for appropriate infant thermal care need to be developed.

PMID- 1739827
TI  - Can the fall in Avon's sudden infant death rate be explained by changes in
      sleeping position?
AB  - OBJECTIVE: To examine the impact of changing practice with regard to infant
      sleeping position on mortality from the sudden infant death syndrome. DESIGN: A
      population based study of all infants dying suddenly and unexpectedly during
      February 1990 to July 1991, and two groups of controls; one comprising every
      125th baby born to Avon residents and the other comprising pairs of infants
      matched to each index case for age, neighbourhood, and date of study. Information
      about sleeping position was collected at home visits soon after the index baby's
      death or, for the population based controls, on several occasions in the first
      six months of life. The design was comparable to that of an earlier study of the
      same population. SETTING: County of Avon. SUBJECTS: 35 infants who died suddenly
      and unexpectedly (32 of the sudden infant death syndrome), 70 matched controls,
      and 152 population based controls. RESULTS: The prevalence of prone sleeping in
      the matched controls was much lower than that found in an earlier study in Avon
      (28% (18/64) 1990-1 v 58% (76/131) 1987-9; p less than 0.001) and was comparable
      with the prevalence in population based controls (29%). This would be expected to
      lead to a reduction in the incidence of the sudden infant death syndrome to
      2.0/1000 live births (95% confidence interval 1.8/1000 to 2.5/1000). The actual
      mortality fell from 3.5/1000 in 1987-9 to 1.7/1000. CONCLUSION: The fall in
      mortality can be almost entirely accounted for by the reduction in prone
      sleeping, suggesting a causal relation exists between them. Side and supine
      positions confer protection but the side position is unstable and the infant may
      roll prone. We therefore recommend supine as the safest sleeping position for
      babies.

PMID- 1739828
TI  - Increased risk of death from measles in children with a sibling of opposite sex
      in Senegal.
AB  - OBJECTIVE: To examine whether contracting measles from a sibling of the opposite
      sex affects mortality. DESIGN: Prospective registration during 15-20 years of all
      births and deaths, including 243 measles related deaths. Measles infection was
      not registered; however, as in fatal cases measles was probably contracted from a
      maternal sibling the risk of dying during measles outbreaks was examined in
      families with two boys, two girls, or a boy and a girl. SETTING: 31 small
      villages in two rural areas of eastern Senegal. SUBJECTS: 766 children living in
      families with two children aged under 10 years during outbreaks of measles, 107
      (14%) of whom died of measles. MAIN OUTCOME MEASURE: Deaths from measles, size of
      village, age and sex of maternal siblings. RESULTS: The interval between
      outbreaks in the same village was greater than 10 years. The risk of dying of
      measles was significantly related to age, increasing with the age difference
      between siblings and decreasing with the size of village. In a multiple logistic
      regression analysis adjusting for these background factors, children in families
      with a boy and a girl had a significantly higher mortality than children in
      families with two boys or two girls (odds ratio = 1.81, 95% confidence interval
      1.17 to 2.82). The increase in risk was the same for boys and girls in families
      with two children one of whom was a boy and one a girl. CONCLUSION: Cross sexual
      transmission may be an important determinant of severity of measles infection.

PMID- 1739829
TI  - Geriatric visiting hours: lessons for the general wards?

PMID- 1739830
TI  - Establishment of pregnancy after removal of sperm antibodies in vitro.

PMID- 1739831
TI  - Uncomfortable prescribing decisions: a critical incident study.
AB  - OBJECTIVE: To explore the discomfort experienced by general practitioners in
      relation to decisions about whether or not to prescribe. DESIGN: Focused
      interviews of general practitioners about prescribing decisions that made them
      uncomfortable. Analysis based on the critical incident technique. SETTING: One
      family practitioner committee area in the north of England. RESPONDENTS: 69
      principals and five trainee general practitioners. MAIN OUTCOME MEASURES: Drugs
      and clinical problems associated with prescribing discomfort. Reasons given by
      doctors for making the prescribing decisions they did and reasons for feeling
      uncomfortable. RESULTS: Antibiotics, tranquillisers, hypnotics, and symptomatic
      remedies were most often associated with discomfort, but any prescribable item
      could be associated with discomfort. Respiratory diseases, musculoskeletal
      problems, and anxiety were most often associated with discomfort, but again any
      condition could be associated. The main reasons given for the decisions made were
      patient expectation, clinical appropriateness, factors related to the doctor
      patient relationship, and precedents. The main reasons given for feeling
      uncomfortable were concern about drug toxicity, failure to live up to the general
      practitioner's own expectations, concern about the appropriateness of treatment,
      and ignorance or uncertainty. CONCLUSIONS: Many considerations, including
      medical, social, and logistic ones, influence the decision to prescribe in
      general practice. The final action taken depends on a complex interaction of
      these disparate influences.

PMID- 1739832
TI  - Re-examining the fundamental principles of the NHS.

PMID- 1739833
TI  - Environmental radiation: a cause for concern?

PMID- 1739834
TI  - Quality management in the NHS: the doctor's role--II.

PMID- 1739835
TI  - Occupational causes of disorders in the upper limb.

PMID- 1739836
TI  - Hazards of pharmacological tests of growth hormone secretion.

PMID- 1739837
TI  - Searching published reports.

PMID- 1739838
TI  - Hazards of pharmacological tests of growth hormone secretion.

PMID- 1739839
TI  - Failed hip replacements.

PMID- 1739840
TI  - Voice after laryngectomy.

PMID- 1739841
TI  - Voice after laryngectomy.

PMID- 1739842
TI  - Voice after laryngectomy.

PMID- 1739843
TI  - Overheads for clinical research.

PMID- 1739844
TI  - Deciding whether to be a doctor.

PMID- 1739845
TI  - High potency factor VIII concentrates.

PMID- 1739846
TI  - Impact resistance of drinking glasses.

PMID- 1739847
TI  - Diazoxide no longer marketed.

PMID- 1739848
TI  - Post-comatose unawareness?

PMID- 1739849
TI  - Developmental levels of social cognition in head-injury patients.
AB  - Ten adults, who had sustained a closed head injury, were interviewed regarding
      their self-understanding, concepts of persons, and interpersonal negotiation
      strategies. Responses were evaluated in terms of developmental levels of social
      cognition. Levels of interpersonal negotiation strategies were significantly
      lower than levels of self-understanding, descriptions of psychological
      characteristics of self were at a significantly higher level than descriptions of
      active and physical characteristics of self. Within interpersonal conflict
      situations, proposed solutions were at a significantly lower level than the
      justifications offered for the solutions. In general, developmental levels of
      social cognition were comparable to levels exhibited by non-clinical samples of
      adolescents. The two areas in which the head-injury patients appeared to perform
      at a significantly higher level than adolescents were their justifications for
      their proposed solutions to the interpersonal conflict situations and their
      ability to express the emotional consequences of interpersonal conflict.

PMID- 1739850
TI  - Premorbid emotional and behavioural adjustment in children with mild head
      injuries.
AB  - This study investigated the hypothesis that children sustaining a mild closed
      head injury have a higher prevalence of premorbid behavioural problems than
      children in the general community. The prevalence of emotional and behavioural
      problems among children with a mild closed head injury was compared with the
      prevalence of problems in children with a severe closed head injury, children in
      the general community, and children referred to a psychiatric outpatient clinic.
      The results showed that the children with a mild head injury did not have
      significantly more premorbid emotional and behavioural problems than other
      children in the community. The children with a mild head injury also had
      significantly fewer emotional and behavioural problems than children referred to
      a psychiatric outpatient clinic. The results suggest that the common assumption
      that children with a mild closed head injury have a higher prevalence of
      premorbid emotional and behavioural problems than other children in the general
      community may not be correct.

PMID- 1739851
TI  - Language abilities of mildly closed head injured (CHI) children 10 years post
      injury.
AB  - The language functioning of a group of 14 children who had sustained a mild
      closed head injury (CHI) at least 10 years previously was assessed. The subjects
      were administered a battery of language assessments including an overall language
      test, and specific language skills assessments. Performance of the head-injured
      group was compared with that of a group of non-neurologically impaired accident
      victims matched for age, sex and educational level. Overall language performance
      of the experimental group did not differ significantly from the controls.

PMID- 1739852
TI  - Long-term neuropsychological outcome after severe head injury with good recovery.
AB  - The quality of outcome after severe closed head injury has become of increasing
      concern to neurosurgeons. The assessment of residual deficits in patients who
      have recovered from closed head injury can be very difficult. Many patients are
      classified as having a good recovery according to the Glasgow Outcome Scale
      (GOS), but this may be insufficiently focused or sensitive to demonstrate mental
      deficits objectively. We investigated 33 patients with severe closed head injury
      who subsequently were diagnosed as having made a good recovery according to the
      GOS. The severity of the injury was determined by the Glasgow Coma Scale (GCS)
      and by the presence of a midline shift in the preoperative CT scans. There was a
      minimal interval of 15 months (means = 1080.5 days, SD = 491 days) between injury
      and time of neuropsychological testing. Their performance was compared with that
      of 15 orthopaedic cases. Residual neuropsychological deficits can be demonstrated
      on the majority of measures in a group of patients who have achieved good
      recovery on the GOS. Midline shift in preoperative CT scans is not of prognostic
      value for long-lasting neuropsychological deficits.

PMID- 1739853
TI  - Rehabilitation staff stress as it relates to patient acuity and diagnosis.
AB  - Significant concern exists regarding occupational stress among nurses; the
      present study explored the ways in which nurses' clinical symptoms and coping
      styles may relate to their working on a brain injury unit or a general
      rehabilitation unit within an acute physical rehabilitation hospital. A
      comparison of rehabilitation nurses' responses with those of physical therapists
      within the same setting was also completed. Staff members completed
      questionnaires related to job stress and satisfaction, coping (Ways of Coping
      Checklist) and adjustment (Symptom Checklist-90). Staff groups differed with
      regard to symptomatology. Brain injury nurses reported higher psychological
      distress than physical therapists on subscales including depression,
      interpersonal sensitivity and the global severity index. While brain injury
      nurses' distress in several areas was higher than other staff groups and than a
      normal non-patient sample, it did not approach the levels reported by a
      psychiatric outpatient normative group. Although the three staff groups did not
      differ notably with regard to most styles of coping, data suggest that work with
      brain injury patients may foster use of a problem-solving style. Lower physical
      and cognitive functioning of brain patients as compared with general
      rehabilitation patients may influence the greater psychological distress reported
      by brain injury nurses. Job stress appears to relate specifically to the
      perceived stressfulness of cognitive behavioural aspects of care for all staff
      groups. Implications of these findings, particularly with regard to support
      interventions, are discussed.

PMID- 1739854
TI  - Executive and compensatory memory retraining in traumatic brain injury.
AB  - A controlled treatment outcome study was conducted comparing the efficacy of
      memory remediation treatment with no treatment on traumatic brain-injury
      patients. The memory remediation treatment consisted of both compensatory and
      executive training skills and was delivered 6 hours weekly over a 2 1/2-week
      period. Six subjects in the treatment group and 6 subjects in the control group
      were matched on WAIS-R FSIQ scores, pre-test memory scores and age. Pre- and post
      test measures were obtained for both groups on a paragraph memory task. A
      significant difference was demonstrated between the treatment and control post
      test memory scores. The experimental group significantly improved memory scores
      beyond that of the control group, suggesting that memory remediation is effective
      for head-injury patients with memory deficits. Discussion of findings and
      suggestions for further investigation are presented.

PMID- 1739855
TI  - Late improvement in closed head injury with a low-pressure valve shunt.

PMID- 1739856
TI  - Problems in magnetic resonance imaging of patients with severe brain injury and a
      solution to one of them.
AB  - A number of difficulties have been encountered in carrying out MRI scans with
      severely brain-injured subjects. One of the problems is maintenance of head
      position for the 30 minutes' duration of the scan. The use of a vacuum cushion
      has proved a low-cost solution to this problem.

PMID- 1739857
TI  - Use of AA and NA in the treatment of chemical dependencies of traumatic brain
      injury survivors.
AB  - Alcoholics Anonymous and Narcotics Anonymous have been under-utilized in the
      treatment of chemical dependency in traumatic brain injury survivors. Both offer
      a social support network and a self-help recovery programme. The fellowships can
      be viewed as three progressive levels focusing on behavioural, cognitive and
      gestalt issues. Finally observations and suggestions are offered which may help
      in incorporating this therapeutic modality which is the most widespread treatment
      of individuals with chemical dependencies.

PMID- 1739858
TI  - Coping strategies and locus of control following traumatic brain injury:
      relationship to long-term outcome.
AB  - Cluster-analytic techniques were used to categorize coping strategies (CS)
      measured by the Ways of Coping--Revised Scale, and locus of control (LOC) beliefs
      measured by the Multidimensional Health Locus of Control Scale in 53 male
      traumatically brain-injured (TBI) persons. A cluster characterized by
      comparatively higher use of self-controlling and positive reappraisal CS and
      lower external LOC was associated with significantly lower mood disturbance and
      physical difficulties and a trend to be less depressed. The age of the
      neurologically injured patient and Taylor's (1983) cognitive adaptation theory
      may be important aspects of recovery from TBI and other neurological conditions.

PMID- 1739859
TI  - Coma arousal intervention.

PMID- 1739860
TI  - British Society for Rheumatology, spring meeting. Southampton, 26-27 March 1992.
      Abstracts.

PMID- 1739861
TI  - Advances in innovative oncology: biomodulation, chemoimmunotherapy, and selected
      Phase II drugs. Proceedings of The Chemotherapy Foundation. November 7-8, 1991,
      New York City, USA. Abstracts.

PMID- 1739862
TI  - Physical and biochemical factors in bone metabolism.

PMID- 1739863
TI  - Effect of calcitonin on bone histomorphometry and bone metabolism in rheumatoid
      arthritis.
AB  - Twenty-four women (mean age +/- SD 49 +/- 13 years) with classical or definite
      rheumatoid arthritis (disease duration 15 +/- 8 years) were treated with
      synthetic salmon calcitonin (SCT) nasal spray 200 IU three times a week for 3
      months. Bone biopsies from the iliac crest were taken before and after SCT
      treatment. Histomorphometrical quantification of undecalcified bone sections was
      made using the manual point-counting method. SCT decreased the resorption surface
      of trabecular bone (ES/BS) significantly (P less than 0.001). There was also a
      significant increase (P less than 0.05) in trabecular bone volume (BV/TV) after 3
      months of treatment, whereas no statistically significant changes were found in
      osteoid parameters. There were no significant changes in biochemical analyses of
      bone metabolism. We conclude that SCT might be useful in the prevention of bone
      loss in RA.

PMID- 1739864
TI  - Cross-cultural association between dietary animal protein and hip fracture: a
      hypothesis.
AB  - Age-adjusted female hip fracture incidence has been noted to be higher in
      industrialized countries than in nonindustrialized countries. A possible
      explanation that has received little attention is that elevated metabolic acid
      production associated with a high animal protein diet might lead to chronic bone
      buffering and bone dissolution. In an attempt to examine this hypothesis, cross
      cultural variations in animal protein consumption and hip fracture incidence were
      examined. When female fracture rates derived from 34 published studies in 16
      countries were regressed against estimates of dietary animal protein, a strong,
      positive association was found. This association could not plausibly be explained
      by either dietary dietary calcium or total caloric intake. Recent studies suggest
      that the animal protein-hip fracture association could have a biologically
      tenable basis. We conclude that further study of the metabolic acid-osteoporosis
      hypothesis is warranted.

PMID- 1739865
TI  - Influence of body weight on rates of change in bone density of the spine, hip,
      and radius in postmenopausal women.
AB  - Interrelationships between percent of ideal body weight (%IBW), serum estrogen
      levels, and change in bone mineral density (delta BMD) and bone mineral content
      (delta BMC) were studied in 288 postmenopausal women aged 41-71 years who
      participated in a 2-year calcium supplement trial. The spine (L2-L4) and femoral
      neck were measured by dualphoton absorptiometry, and the radius was measured by
      single-photon absorptiometry. Years since menopause, calcium intake, and initial
      BMD or BMC were included as independent variables in two-phase regressions of
      delta BMD and delta BMD on %IBW. Increased %IBW protected against loss of spine
      BMD [regression slope estimate = 0.05, 95% C.I.: (0.03, 0.26)] and BMC in women
      up through about 106 %IBW but not in heavier women. Increased %IBW was not
      significantly related to delta BMD or delta BMC at the femoral neck or radius.
      Women above 106 %IBW had significant gains in spine and femoral neck area (P less
      than 0.05). Serum estrone and estradiol were positively correlated with delta BMD
      and delta BMC at the femoral neck only.

PMID- 1739866
TI  - Sex differences in geometry of the femoral neck with aging: a structural analysis
      of bone mineral data.
AB  - The greater hip fracture rate among elderly women is generally ascribed to
      differences in femoral neck strength between the sexes. Strength of a given bone
      is a function of both its material properties and the magnitudes of mechanical
      stresses within it. This study examined the hypothesis that these apparent
      strength differences between the sexes are due to dissimilarities in the
      restructuring of the femoral neck with age, which result in higher stresses in
      elderly women. Using Hip Strength Analysis, a computer program developed by the
      authors, femoral neck cross-sectional geometric properties for stress analyses
      were derived from bone mineral image data of 409 community living, white subjects
      ranging from 19 to 93 years of age. Though both sexes show declines in femoral
      neck bone mineral density (BMD) and cross-sectional area with age, only females
      show a decline in the cross-sectional moment of inertia (CSMI, a geometric index
      of bone rigidity). The lack of decline in male CSMI appears to be a result of a
      small but significant increase in femoral neck girth. Similar age-related changes
      have been observed in the femoral shaft by others. The net effect of these
      observed changes is that mechanical stresses in the femoral neck of females
      appear to increase at three times the rate per decade of those of males. These
      results lend support to the hypothesis that the higher fracture rate in elderly
      women is due, at least in part, to elevated levels of mechanical stress,
      resulting from a combination of greater bone loss and less compensatory geometric
      restructuring with age.

PMID- 1739867
TI  - Discriminatory ability of bone mass measurements (SPA and DEXA) for fractures in
      elderly postmenopausal women.
AB  - We investigated the discriminatory ability of forearm bone mineral content
      (BMCarm) measured by single photon absorptiometry (SPA) and spinal bone mineral
      density (BMDspine) measured by dual-energy X-ray absorptiometry (DEXA) in 387
      elderly postmenopausal women. Of these, 22 had never sustained a fracture
      (normal), 91 had had less than three vertebral wedge fractures (mild), 51 had
      experienced a peripheral fracture (moderate), and 24 had had more than three
      vertebral wedge or compression fractures (severe). BMCarm exceeded BMDspine
      slightly in the ability to discriminate the mild and moderate groups (P less than
      0.01-0.001), whether calculations were performed on raw values or the Z-scores
      compared with premenopausal women. Receiver operating (ROC) analysis showed that
      at every cutoff level BMCarm had a similar ability as BMDspine to discriminate
      between the vertebral fracture (mild and severe) groups and healthy premenopausal
      and nonfractured postmenopausal women (normal), whereas BMCarm had a
      significantly higher discriminatory ability of peripheral fractures (P less than
      0.05) (moderate) group compared with premenopausal women. We conclude that SPA
      and DEXA are equally capable as diagnostic procedures in women with established
      osteoporosis.

PMID- 1739868
TI  - Osteogenesis imperfecta: a clinical study of the first ten years of life.
AB  - One hundred twenty-seven children with osteogenesis imperfecta (O.I.) were
      studied during the first 10 years of life. According to Sillence, 40 patients
      were assigned to type I, 39 to type III, and 48 to type IV O.I. Centiles for
      height, weight, and the annual number of fractures could be established for the
      different types of O.I. The development of the skeletal changes could be
      documented for the different forms of the disease. At birth, the skeletal changes
      were significantly more severe in type III than in type IV patients. During the
      first 10 years of life the number of fractures, extent of skeletal deformities,
      and growth retardation did not differ between types III and IV. Only fracture
      nonunion, dentinogenesis imperfecta, and congenital cardiac malformations were
      more frequent in type III than in type IV. Papillary calcifications of the kidney
      and kidney stones were diagnosed in 4 type III and 2 type IV patients.
      Hemihypertrophy of the body developed in 2 type I patients. Although types III
      and IV patients suffered from severe short stature, serum insulin-like growth
      factor (IGF) I was in the normal range.

PMID- 1739869
TI  - Characterization of very young mineral phases of bone by solid state 31phosphorus
      magic angle sample spinning nuclear magnetic resonance and X-ray diffraction.
AB  - The properties of bone mineral change with age and maturation. Several
      investigators have suggested the presence of an initial or "precursor" calcium
      phosphate phase to help explain these differences. We have used solid state 31P
      magic angle sample spinning (MASS) nuclear magnetic resonance (NMR) and X-ray
      radial distribution function (RDF) analyses to characterize 11- and 17-day-old
      embryonic chick bone and fractions obtained from them by density fractionation.
      Density fractionation provides samples of bone containing Ca-P solid-phase
      deposits even younger and more homogeneous with respect to the age of mineral
      than the calcium phosphate (Ca-P) deposits in the whole bone samples. The
      analytical techniques yield no evidence for any distinct phase other than the
      poorly crystalline hydroxyapatite phase characteristic of mature bone mineral. In
      particular, there is no detectable crystalline brushite [DCPD, CaHPO4 2H2O less
      than 1%] or amorphous calcium phosphate (less than 8-10%) in the most recently
      formed bone mineral. A sizeable portion of the phosphate groups exist as HPO4(2-)
      in a brushite (DCPD)-like configuration. These acid phosphate moieties are
      apparently incorporated into the apatitic lattice. The most likely site for the
      brushite-like configuration is probably on the surface of the crystals.

PMID- 1739870
TI  - Biphasic dose-response curves of cortisol effects on rat diaphyseal bone
      biomechanics.
AB  - Doses of 8, 16 (low), 32, 48, 64 (medium), and 150 (high) mg/kg/day of cortisol
      were administered to groups of 8 growing rats each during 16 days, and their
      femurs were then submitted to 3-point bending tests at low strain rate. Low doses
      had no effect. Medium doses, previously shown to improve calcium (Ca) balance and
      weight gain in the species, augmented diaphyseal elastic and ultimate strength,
      stiffness, and plastic-to-elastic deformation ratio with respect to untreated
      controls. This effect was achieved either by enhancing bone mass (volume,
      sectional moment of inertia, wall/lumen ration) without changes in material
      quality parameters (32 mg/kg/day) or, conversely, by increasing bone tissue
      mechanical properties (stress, modulus of elasticity) not affecting bone geometry
      (48 and 64 mg/kg/day). The highest dose, known to depress Ca balance and weight
      gain, impaired diaphyseal mechanical performance in controls by substantially
      reducing bone mass without major variation in bone material properties, that is,
      developing a true osteopenic state in mechanical terms. The energy elastically
      absorbed per unit volume (proportional to the risk of comminute fractures) was
      greater with the highest dose because of enhanced deformability and diminished
      bone mass. The biphasic dose-response curves obtained, grossly parallel to those
      previously demonstrated for metabolic actions of cortisol in the same species,
      showed that biomechanical repercussion of this treatment on bone depends on
      different, dose-dependent effects which vary independently in temporal course,
      intensity, and sign.

PMID- 1739871
TI  - Vertebral fracture or vertebral deformity.

PMID- 1739872
TI  - Effect of membrane cholesterol on calcium phosphate formation in aqueous
      suspensions of anionic liposomes.
AB  - The present study examined the effect of membrane cholesterol on liposome
      mediated calcium phosphate precipitation in metastable aqueous solutions (2.25 mM
      Ca2+ and 1.5 mM inorganic phosphate) at 22 degrees C, pH 7.4 and 240 mOsm. The
      liposomes were prepared from 7:2:X molar mixtures of phosphatidylcholine,
      dicetylphosphate, and cholesterol (x = 0, 1, 5, or 9) and contained either 0 or
      50 mM encapsulated phosphate. The membranes were made permeable to Ca2+ by
      addition of the cationophore, X-537A. Changes in external Ca2+ concentration were
      used as the principal monitor of the course of precipitation. Without
      encapsulated phosphate, 7:2:X liposomes (with or without ionophore) induced no
      precipitation. With 50 mM encapsulated phosphate and in the presence of
      ionophore, precipitation significantly depended on the cholesterol level in the
      membrane. At 0 and 10 mole% cholesterol, precipitate developed rapidly both
      within and outside the liposomes. At 35 and 50 mole% cholesterol, no observable
      intraliposomal precipitation occurred, and extraliposomal precipitation started
      only after an induction period of 24 hours. Delayed extraliposomal precipitation
      also took place in PO4-containing liposomes without added ionophore. In this
      latter case, however, cholesterol was essential for this precipitation to occur
      with the optimum level being around 10 mole%. Suppression of ionophore-mediated
      intraliposomal precipitation at higher cholesterol levels could be related to the
      inflexible cholesterol molecules making the membrane more rigid, thereby
      restricting Ca-ionophore transport. This restriction could be reversed with
      ethanol. Delayed extraliposomal precipitation in the absence of added ionophore
      (or at higher cholesterol levels in its presence) could be explained by seeding
      from low, unobserved levels of intraliposomal precipitate formed during slow,
      unfacilitated Ca2+ leakage into the liposomal interior.

PMID- 1739873
TI  - Three-year calcitonin combination therapy for postmenopausal osteoporosis with
      crush fractures of the spine.
AB  - Forty-five postmenopausal osteoporotic women with at least one osteoporotic
      vertebral crush fracture were randomized into three treatment groups. Each
      patient was on calcitonin, 50 U, on alternate days for 2 weeks monthly (350
      U/month), and 500 mg/day oral calcium supplementation. In group II, this therapy
      was supplemented with phosphate (750 mg/day), and in group III, norandrostenolone
      decanoate (50 mg/month) was added to the calcitonin+calcium therapy. Bone mineral
      content, by single photon absorptiometry, of the radius midshaft and distal site
      (3 cm), as well as the lumbar and metacarpal radiomorphometrical indices were
      estimated seminannually. The therapeutic trial lasted 36 months except in the
      phosphate supplementation group, where, due to unfavorable results, treatment was
      discontinued after 24 months. Calcitonin practically prevented further bone loss
      for 24 months even in this relatively small and intermittent dosage. Phosphate
      supplementation was without benefit; however, according to the majority of the
      examined parameters, combination of calcitonin with the anabolic steroid
      norandrostenolone decanoate extended efficacy up to 36 months. This latter
      combination seems to be a promising, relatively inexpensive therapeutic regimen
      in the treatment of established postmenopausal osteoporosis.

PMID- 1739874
TI  - Osteonal remodeling and mechanical properties of the femoral cortex in rabbits
      treated with 24R,25(OH)2D3.
AB  - The increase of bone mass by therapeutics does not always mean the enhancement of
      bone quality. The purpose of this study is to clarify the changes of osteonal
      remodeling and the mechanical properties of femoral cortex in rabbits treated
      with 24R,25(OH)2D3. Fifteen NZW rabbits (3 kg B.W.) were divided into three
      groups of 5 animals each. Groups 1, 2, and 3 were given vehicle, 10
      micrograms/kg, and 100 micrograms/kg 24R,25(OH)2D3, respectively, daily for 8
      weeks. At the end of the experiment, the left femur was removed and bone mineral
      content (BMC) was measured with single photon absorptiometry. Serum 24,25(OH)2D
      concentrations reached levels of approximately 15 and 200 times that of the
      controls in groups 2 and 3, respectively. Neither 25(OH)D nor 1,25(OH)2D level
      showed any significant change in either group. Group 3 showed significant
      increase in mineral content and density in the epimetaphyseal regions, but the
      increase at the diaphyseal region did not reach a statistically significant
      level. Mechanical test for torsion was conducted for mid-cortical regions. After
      the test, bone pieces were bonded together with adhesive to reconstruct the
      original form, and undecalcified cross-sectional sections were made at the
      diaphyses. Fluorescent microscopy disclosed a marked reduction of remodeling in
      secondary osteonal bone area. The numbers for double-labeled osteons for groups
      1, 2, and 3 were 2.47 +/- 0.819, 1.14 +/- 1.02* and 0.137 +/- 0.307* N/mm2,
      respectively, and the numbers for osteons with resorption lacunae were 1.37 +/-
      0.721, 0.412 +/- 0.370* and 0.268 +/- 0.339** N/mm2, respectively. However,
      neither structural stiffness nor strength correlated with the indices of osteonal
      remodeling; instead, they were significantly correlated with bone mineral
      contents.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1739876
TI  - Effect of fluoride dosage on bone density, sonic velocity, and longitudinal
      modulus of rabbit femurs.
AB  - Relationships between the fluoride dosage administered to weanling New Zealand
      white male rabbits and some mechanical properties of the compact bone were
      investigated for a wide range of dosages. The measured quantities were density,
      longitudinal sonic velocity in the radial direction, and fluoride ion
      concentration in compact bone. The longitudinal elastic modulus was estimated
      from the product of the density and the square of the sonic velocity. The
      relative static load stress was estimated from the ratio of the final body weight
      to the cross-sectional area of the femur. These measurements and derived
      quantities provide quantitative measures of bone quality. A slight peak (2%
      greater than reference) was determined for the density and a slightly larger peak
      (5% above reference) for the longitudinal sonic velocity at a dosage of
      approximately 20 mg/kg/day. The longitudinal elastic modulus exhibited a
      substantial peak, 14% greater than reference. The relative static load stress
      showed a very slight peak as a function of dosage and also as a function of
      fluoride concentration in the bone. When plotted against the elastic modulus, a
      nonlinear monotonic increase was observed with modulus, showing that the cross
      sectional area of the bone is responsive to the stiffness of the tissue. Stiffer
      tissue produces a smaller cross section, whereas a more compliant tissue requires
      a marked increase in the area.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1739875
TI  - Production of new trabecular bone in osteopenic ovariectomized rats by
      prostaglandin E2.
AB  - Serum chemistry and bone morphometry of the proximal tibial metaphysis were
      performed in 3-month-old double fluorescent-labeled, female Sprague-Dawley rats
      subjected to bilateral ovariectomy or sham surgery for 4 months prior to
      treatment with 0, 0.3, 1, 3, or 6 mg of prostaglandin E2 (PGE2)/kg/day
      subcutaneously for 30 days. The 4-month postovariectomized rats possessed an
      osteopenic proximal tibial metaphysis with 7% trabecular area compared with
      controls (19%). PGE2 treatment elevated osteocalcin levels and augmented proximal
      tibial metaphyseal bone area in ovariectomized and sham-operated rats.
      Osteopenic, ovariectomized rats treated with 6 mg PGE2/kg/day for 30 days
      restored bone area to levels of age-matched sham-operated rats. Morphometric
      analyses showed increased woven and lamellar bone area, fluorescent-labeled
      perimeter (osteoblastic recruitment), mineral apposition rate (osteoblastic
      activity), bone formation rate (BFR/BV), and longitudinal bone growth. These
      dramatic bone changes were all significantly increased at the dose-response
      manner. This study showed that in vivo PGE2 is a powerful activator of bone
      remodeling, it increases both bone resorption and bone formation, and produces an
      anabolic effect by shifting bone balance to the positive direction. Furthermore,
      PGE2-induced augmentation of metaphyseal bone area in ovariectomized rats was at
      least two times greater than in sham-operated rats.

PMID- 1739877
TI  - Characterization of osteoblast-like cells from normal adult rat femoral
      trabecular bone.
AB  - Osteoblast-like cell cultures have been established from the trabecular surfaces
      of normal adult rat femoral trabecular bone. The cultured cells responded to
      stimulation by parathyroid hormone (rPTH), with a rise in intracellular cAMP in
      excess of 25-fold while failing to respond to incubation with sCT. Furthermore,
      the osteoblast-like cells exhibited a high level of alkaline phosphatase
      expression, both histochemically and biochemically. Incubations with 1,25(OH)2
      vitamin D3 increased the alkaline phosphatase activity by 50% and stimulated bone
      Gla-protein (BGP) synthesis. When the cell layers were supplemented with both 50
      micrograms/ml ascorbic acid and 10 mM beta-glycerophosphate and allowed to grow
      past confluency for 3 weeks, they formed calcified ridges and multilayered
      nodules. Confirmation of the mineralization of an extracellular matrix was made
      by von Kossa staining. This simple isolation technique now facilitates the
      availability of normal adult rat osteoblastic cells for investigation of bone and
      mineral metabolism.

PMID- 1739878
TI  - Sodium fluoride does not increase human bone cell proliferation or protein
      synthesis in vitro.

PMID- 1739879
TI  - Compact bone and fracture risk.

PMID- 1739880
TI  - Management of xerostomia.
AB  - Xerostomia (dry mouth) is an unpleasant condition that is common after
      radiotherapy to the head and neck, although it may have other causes. A review of
      the management of xerostomia, as well as the prevention and management of the
      oral soft tissue and dental complications resulting from xerostomia, is provided.

PMID- 1739881
TI  - The base metal alloy question in removable partial dentures--a review of the
      literature and a survey of alloys in use in Alberta.
AB  - Base metal alloys have been used for over 60 years to cast removable partial
      denture frameworks. Among other elements, these alloys principally contain
      nickel, chromium and cobalt, and may be divided into the nickel-containing and
      nickel-free alloys. Because of the potential biocompatibility hazard created by
      these and other elements found in the alloys, this group of materials has come
      under ever increasing scrutiny in the literature. This paper reviews pertinent
      literature and reports on the findings of a survey on the base metal alloys used
      in Alberta for the casting of removable partial denture frameworks.

PMID- 1739882
TI  - Computerized databases: privacy issues in the development of the nursing minimum
      data set.
AB  - Nursing leaders promoting the development and use of computerized databases such
      as the Nursing Minimum Data Set (NMDS) have not adequately addressed the complex
      ethical issues involved with computerized information systems. The purpose of
      this article is to describe the privacy issues involved with the NMDS. Moral
      considerations and principles guiding resolution of ethical issues concerning
      violations of patient privacy are discussed. A paradigm case is used to
      demonstrate the significance of privacy violations in computerized databases. Two
      security systems currently being considered in other disciplines are included for
      their relevance to the development of the NMDS. The broader implications
      concerning the impact of technology on preservation of human dignity and the
      quality of life are addressed.

PMID- 1739883
TI  - Computer-supported versus manually-generated nursing care plans: a comparison of
      patient problems, nursing interventions, and AIDS patient outcomes.
AB  - The number and type of activated patient problems and the number of nursing
      interventions in computer-supported and manually-generated nursing care plans for
      Human Immunodeficiency Virus (HIV) infected patients hospitalized for
      Pneumocystis carinii pneumonia (PCP) were compared. There were significantly more
      activated patient problems (p = 0.005) and nursing interventions (p = 0.002)
      listed using the computer-supported care planning system. The top ranked problems
      in both systems were reflective of the clinical presentation of acute PCP. The
      problem, potential for increased risk of infection, was activated more frequently
      using the computer-supported care plan. There were no significant differences in
      patient outcome as measured by functional status and patients' self-ratings of
      physical condition at hospital discharge.

PMID- 1739884
TI  - A computer-based AIDS education program for nursing students.
AB  - A multidisciplinary team has developed a computer-based software program for
      educating nursing students and other college students about six sexually
      transmitted diseases (STDs). The program for educating about Acquired Immune
      Deficiency Syndrome (AIDS) is the first of the six "Smartbooks" to be completed,
      using the Hypercard Expert System shell on the Macintosh computer. Information is
      organized within a framework known as a concept map, and the student user
      progresses through the program in a self-directed way by "clicking" on the
      portion of the concept map that is of interest. Thus, the knowledge base can be
      accessed in many different ways, and is not restricted to a linear format.
      Comparative quantitative analysis using a control program shows consistently
      better student retention of information presented within the program that
      features concept maps. Qualitative results indicate that students find the
      conceptually-arranged knowledge base implicitly easy to understand, "fun" to use,
      and interesting to explore. Educational theory suggests that the success of such
      a format may be related to the schematic nature of memory.

PMID- 1739885
TI  - X.

PMID- 1739886
TI  - Noviceware: a model for learning the software development process.
AB  - Students and nursing faculty without formal computer science training can
      collaborate within an independent study structure to assist the student in
      gaining experience with the fundamentals of software development. The systems
      development life cycle approach provides an essential map to structure such
      independent studies. This article describes the development within an academic
      setting of a computerized research management system. The software builds a
      database of research case demographic data and data from a 65-item tool used in
      scoring videotapes of caregiver-infant interactions. For students and faculty
      contemplating similar projects, recommendations about planning software
      development experiences and securing hardware, software, and expert resources are
      provided.

PMID- 1739887
TI  - Implementing a computer system: issues for nurse administrators.
AB  - Because more and more health care agencies are becoming computerized, nursing
      administrators need to increase their knowledge about computer systems.
      Specifically, they must have at least some basic knowledge regarding the
      purchase, implementation, and maintenance of systems, because they and their
      staff are ultimately affected by them. This article describes how one agency
      managed the implementation of a new computer system and the issues that the nurse
      administrator faced during this process.

PMID- 1739888
TI  - Aortoenteric fistula 24 years after aortic endarterectomy.
AB  - Aortoenteric fistula is a well-recognized and potentially catastrophic
      complication of aortic surgery. It usually follows aortic graft placement and
      removal of the prosthesis. Extra-anatomic bypass is the treatment generally
      recommended. The authors report the case of a 74-year-old woman who presented
      with an aortoenteric fistula 24 years after aortic endarterectomy. The fistula
      was managed with an anatomically placed Dacron graft. The radiologic findings and
      approach to management of this uncommon problem are discussed.

PMID- 1739889
TI  - Spontaneous gastric decompression of pancreatic pseudocyst.
AB  - Spontaneous resolution of pancreatic pseudocysts is being reported with
      increasing frequency. Although many mechanisms have been proposed one that is not
      frequently recognized is spontaneous decompression into the gastrointestinal
      tract. This case report demonstrates the mechanism of spontaneous resolution of a
      traumatic pancreatic pseudocyst, several weeks after injury, through
      fistulization between the pseudocyst and the stomach. Spontaneous resolution of a
      pancreatic pseudocyst after a transient episode of diarrhea should suggest the
      mechanism of gastrointestinal decompression of the pseudocyst.

PMID- 1739890
TI  - The surgeon's dilemma: fibrocystic "dis" "ease" of the breast.

PMID- 1739891
TI  - Retention sutures: are they really necessary?

PMID- 1739892
TI  - Gauze roll padding for retention sutures.

PMID- 1739893
TI  - Field triage--help or hindrance?
AB  - Field triage protocols have potential benefits in urban trauma systems, but for
      optimal effect they must be tailored to local needs and tested in each system for
      sensitivity and specificity. They should be implemented only by experienced
      physicians and surgeons who can monitor and adjust the protocol when necessary.

PMID- 1739894
TI  - Air versus land transport of the critically injured patient.
AB  - Trauma patients frequently require transport from the hospital to which they are
      admitted initially to a trauma unit for further assessment and management.
      Canada's geography and demography provide unique challenges when transporting the
      severely injured patient by air or land. The author describes and compares air
      and land transport for the trauma patient. These complementary modes of transport
      are an integral part of a comprehensive trauma system.

PMID- 1739895
TI  - Airway management in the blunt trauma patient: how important is the cervical
      spine?
AB  - Emergency airway management in the patient with blunt trauma is a clinical
      dilemma. Many of these patients require immediate airway management, but each
      method carries its own set of risks and benefits. At the heart of the issue is
      the long-standing belief that oral intubation is hazardous in the presence of an
      unstable injury to the cervical spine. In this article, the issues surrounding
      selection of an appropriate technique for airway management are reviewed
      critically. Recommendations are made for management of the airway in this high
      risk group of patients with injury to the cervical spine.

PMID- 1739896
TI  - Small-volume resuscitation.
AB  - Small-volume resuscitation with hypertonic saline is an attractive modality but
      is still at an early stage of experimental and clinical investigation. Aggressive
      resuscitation from traumatic, hypovolemic shock could be facilitated during the
      prehospital phase, but hypotension remains a physiological and beneficial
      compensatory mechanism to minimize active bleeding until definitive care is
      provided. Despite encouraging results, the author concludes that, at present,
      hypertonic saline cannot be considered a truly "magic potion" for resuscitation
      of the trauma patient.

PMID- 1739897
TI  - Traumatic intracranial mass lesions: how soon for evacuation?
AB  - The purpose of this paper is to identify, by simple clinical parameters, those
      patients who are at particular risk for traumatic intracranial hematomas
      following accidental injury and to review the effects of delays in treatment on
      death from head injury. The findings indicate that vehicle occupants 30 years of
      age or younger are significantly (p less than 0.001) more likely to suffer from a
      "diffuse" head injury and serious truncal injury than they are to suffer a
      traumatic intracranial mass lesion. Conversely, older patients (60 years of age
      or older) injured in falls are more likely to have operable intracranial mass
      lesions without significant injury to the torso (p less than 0.001).
      Recommendations concerning early diagnosis and treatment of accident victims are
      made from these data.

PMID- 1739898
TI  - Age-related breast diagnosis.
AB  - Of the three commonest symptoms found in 3294 patients referred to a specialty
      breast clinic--mass, nodularity and pain--only nodularity was age related. Only
      30% of the patients had a clinically localized abnormality, and only 19% of these
      abnormalities were suggestive of carcinoma. The majority of suggestive lesions
      were in women over 55 years of age. Of the patients seen because of a breast
      lump, 46% were found to have a significant mass. Most abnormalities were found in
      patients presenting with a mass or nipple discharge, and the significance was age
      related. Symptoms associated with the lowest rate of positive biopsies were
      nodularity, pain and skin or nipple changes. The biopsy and cancer rates were
      significantly age related. The cancer rate in women 40 years of age and under was
      0.8%, between 41 and 55 the rate was 5%, and in those over 55 it was 21%. The
      predominant finding in young women was a fibroadenoma. In the middle age range
      fibrocystic change was most common, and in postmenopausal women most of the
      lesions were malignant.

PMID- 1739899
TI  - Tisseel in hypospadias repair.
AB  - Tisseel (Immuno AG, Vienna, Austria), a fibrin sealant, adhesive and hemostatic
      agent made up of sterilized human and bovine components, was used in hypospadias
      repairs. The incidence of fistula and significant edema and the duration of
      hospitalization were all reduced in 30 patients who underwent modified Mustarde
      repairs in which Tisseel was used when compared with a matched group of 30
      repairs without Tisseel. In addition, the rate of complications in fistula
      repairs and complex revisions was reduced when Tisseel was used on urethral
      suture lines and under all skin flaps.

PMID- 1739900
TI  - [Heart-skin syndrome and cardiac myxoma: presentation of a case and clinical
      experience of 17 years].
AB  - Between 1971 and 1988, cardiac myxoma was identified in 13 (0.003%) of 4000
      patients who underwent open-heart surgery at the hopital du Sacre-Coeur in
      Montreal. One patient with multiple right atrial tumours also had abnormal
      cutaneous pigmentation compatible with the recently identified syndrome of
      "Carney's complex." This syndrome has also been associated with endocrine
      abnormalities such as primary nodular adrenal hyperplasia, with or without
      Cushing's syndrome. The authors review the literature and compare the findings
      with their experience in the surgical treatment of cardiac myxomas.

PMID- 1739901
TI  - Hemodynamic and temperature changes after aortocoronary bypass grafting.
AB  - Perioperative hemodynamic and temperature changes were reviewed in 58 patients
      who underwent aortocoronary bypass grafting. Core temperature showed an immediate
      decline postoperatively, secondary to core temperature cooling during bypass.
      Subsequent rewarming occurred over the next 8 to 12 hours, with the temperature
      often increasing above normal. The reason for this pyrexial response is
      discussed. The cardiac index was depressed immediately postoperatively, again
      with substantial recovery within 8 hours. This improvement over time occurred not
      only because of recovery of intrinsic function but also because of reduction in
      myocardial work due to falling systemic vascular resistance. The latter was high
      immediately postoperatively and then consistently fell during the rewarming
      phase. During the first 8 hours postoperatively there were significant changes in
      temperature and cardiac and systemic vascular resistance indices. The hemodynamic
      data correlated strongly with changes in temperature. Falling systemic vascular
      resistance required the institution of alpha-agonist therapy in 25% of patients.

PMID- 1739902
TI  - Subendocardial abscess as a complication of prolonged central venous access for
      parenteral nutrition.
AB  - Patients with chronic gastrointestinal diseases may require long-term parenteral
      nutrition. The authors describe a case in which a subendocardial abscess
      developed in the right atrium in association with staphylococcal septicemia. The
      patient, a 15-year-old boy, had a malpositioned Silastic catheter, the tip of
      which was in his right atrium. Staphylococcal abscess of the heart has been
      described previously after cardiac surgery, but the authors believe this is the
      first reported case related to a central venous catheter.

PMID- 1739903
TI  - Surgical management of perforated benign gastric ulcer in high-risk patients.
AB  - The authors compared the outcome in 40 high-risk patients who had a perforated
      benign gastric ulcer with respect to management by omental patch closure (OPC) or
      partial gastrectomy (PG). The patients were considered to be at high risk because
      of the presence of one or more of the following factors: age more than 70 years;
      initial hypotension; delay from presentation to operation of more than 12 hours;
      and significant premorbid illness. OPC was performed in 22 patients and PG in 10;
      the other 8 patients were initially managed nonoperatively (NonOp). Death rates
      were 40% overall--36% for patients in the OPC group, 30% for those in the PG
      group and 63% for those in the NonOp group. The hospital stay was more than 12
      days for 57% of the OPC group, 86% of the PG group and 67% of the NonOp group.
      Sixty-eight percent of patients in the OPC group, 90% in the PG group and 89% in
      the NonOp group had complications. There was no significant difference in death
      rates between those treated with OPC and PG. There was a trend to lower death
      rates in patients over 70 years of age who underwent PG (1 of 6) compared with
      those who underwent OPC (7 of 12). The authors concluded that partial
      gastrectomy, a definitive surgical treatment for gastric ulcer disease, is not
      contraindicated in high-risk patients who have a perforated benign gastric ulcer.

PMID- 1739904
TI  - Causes of oral tongue cancer treatment failures. Analysis of autopsy cases.
AB  - Eighty-three autopsy cases of squamous cell carcinoma of the oral tongue were
      reviewed to identify retrospectively the causes of treatment failure. The cure
      rate for the primary cancers at autopsy was 48.2% (40 of 83). Regional lymph node
      metastases were found in 71.1% (59 of 83). Regional metastases and/or
      juxtaprimary recurrence frequently spread continuously and diffusely, forming
      bulky neck tumors in 38.6% (32 of 83). The incidence of distant lymph node
      metastasis (below the clavicle) and hematogenous metastasis was 35.4% (29 of 82)
      and 58.5% (48 of 82), respectively. The lung was the most common site of
      hematogenous metastases (52.4%, 43 of 82). Hematogenous metastasis occurred more
      frequently in the younger age group (less than 40 years of age; P = 0.03).
      Distant lymph node metastases were identified in the lung hilar, bifurcation, and
      paratracheal nodes in 89.7% (26 of 29) and had a statistically significant
      association with lung hematogenous metastasis. Univariate analysis revealed that
      gross appearance, tumor stage, clinical stage, presence of cervical lymph node
      metastasis, and interval from N0 to NX were significant predictors of survival
      time (duration from initial treatment to death). Rupture of the neck vessels was
      fatal in eight patients (9.6%), and hypercalcemia was seen in six (7.2%).
      Pulmonary infection was the direct cause of death in 33.7% of patients (28 of
      83). Secondary malignant lesions occurred in 22.9% (19 of 83).

PMID- 1739905
TI  - Histopathologic characteristics of early stage esophageal carcinoma. A
      comparative study with gastric carcinoma.
AB  - Unlike the stomach, the esophageal mucosal layer has abundant vessels. To study
      the histopathologic character of cancer of the esophagus in comparison with that
      of stomach, the histologic findings (such as vascular or lymphatic permeation and
      lymph nodal involvement of cancer) were surveyed in 52 lesions of superficial
      esophageal carcinoma in which carcinoma invasion was limited to the submucosal
      layer, 448 cases of so-called early gastric carcinoma in which the carcinoma
      invasion was limited to the submucosal layer, and 109 cases of gastric carcinoma
      invading the proper muscle layer (PM-carcinoma). With respect to lymph node
      metastasis and lymphatic and vascular permeation, there was a particularly high
      incidence of carcinoma extending to the submucosal layer (SM-carcinoma) of the
      esophagus and a similar high incidence of PM-carcinoma of the stomach. Carcinoma
      limited to the mucosal epithelium and mucosal layer of the esophagus (MM
      carcinoma) has an incidence similar to carcinoma in the mucous membrane and SM
      carcinoma of the stomach, respectively. Thus, the cases in which carcinoma
      invasion was limited to the muscle layer of the mucosa of the esophagus were
      shown to have a prognosis similar to that of so-called early carcinoma of the
      stomach.

PMID- 1739906
TI  - Serial histologic investigation of squamous epithelial dysplasia associated with
      carcinoma of the esophagus.
AB  - Esophageal dysplasia and carcinoma were reviewed in the surgical specimens
      obtained from 37 patients with squamous cell carcinoma and 4 with adenocarcinoma;
      special attention was paid to the continuity of both lesions. Two hundred forty
      dysplasias and 113 carcinomas in situ (CIS) were recognized in the squamous cell
      carcinoma cases and 2 dysplasias and no CIS in the adenocarcinoma cases. The CIS
      often was accompanied continuously by severe dysplasia rather than mild or
      moderate dysplasia, suggesting some relationship between the CIS and the severity
      of dysplasia. However, many dysplastic lesions were located separately from the
      carcinoma. The frequency of appearance of the dysplasia near the CIS was low
      (11%), demonstrating a negative dysplasia-CIS sequence in many of the esophageal
      cancers. Lymphocytic infiltration was investigated further beneath the dysplasia
      or CIS. The degree of lymphocytic infiltration with lymphoid follicles correlated
      with the severity of dysplasia and was the highest in CIS.

PMID- 1739907
TI  - Low-dose rate telecobalt therapy as a boost against esophageal carcinomas.
AB  - The results of treating 54 esophageal carcinomas with low-dose rate telecobalt
      therapy (LDRT) as a boost were compared with those of treating 97 esophageal
      carcinomas with conventionally fractionated irradiation alone (CFI). The LDRT
      (100 cGy/hr, 500 to 700 cGy/day, a total dose of 1400 to 2000 cGy) was boosted at
      10 days after 6000 cGy of the CFI dose. Although the LDRT group included more
      advanced cases than the CFI group, local effects and survival rates in the former
      group were slightly better than in the latter group. Late complications were more
      severe in the LDRT group. However, they were acceptable when the total dose
      administered to this group was less than 8000 cGy. Using LDRT as a boost against
      esophageal carcinomas was found to be satisfactory therapeutically.

PMID- 1739908
TI  - HLA-DR antigen expression in intestinal-type and diffuse-type gastric carcinoma.
AB  - The expression of the HLA-DR antigen, a Class II HLA antigen, was analyzed in 41
      cases of gastric carcinoma (23 intestinal-type and 18 diffuse-type according to a
      modified Lauren classification) using a monoclonal antibody that is reactive to
      this antigen in routinely formalin-fixed, paraffin-embedded tissue sections.
      Seventeen cases of intestinal-type gastric carcinoma and two cases of diffuse
      type gastric carcinoma were positive for the HLA-DR antigen. The staining in
      intestinal-type carcinoma generally was stronger and more extensive than in
      diffuse-type carcinoma, which showed only weak and focal staining. The difference
      in the frequency and pattern of staining between intestinal and diffuse-type
      gastric carcinoma supports the concept that these are two distinct subtypes of
      gastric carcinoma.

PMID- 1739909
TI  - Hereditary nonpolyposis colorectal cancer (Lynch syndrome II). Diploid
      malignancies with prolonged survival.
AB  - DNA flow cytometry was performed on 44 paraffin blocks from 16 specimens of 11
      lesions in five patients from two families identified as probably having the
      dominant gene of the Lynch Type II syndrome. All but one specimen showed
      diploidy, although two such specimens were metastases and one a recurrence. The
      one aneuploid gastric biopsy was followed by a resection with diploidy in all 13
      blocks from the malignancy and may represent a superficial change without
      clinical significance. The prolonged survival after discovery of malignancy in
      such families may be explained in part by diploidy of the lesions.

PMID- 1739910
TI  - High incidence of ras gene mutation in intrahepatic cholangiocarcinoma.
AB  - The DNA sequences around codons 12, 13, and 61 of the ras gene were analyzed by
      polymerase chain reaction and direct sequencing in 18 intrahepatic
      cholangiocarcinomas. The ras gene mutations were found in 9 of 18 (50%): 6 in K
      ras codon 12, 1 in K-ras codon 13, 1 in K-ras codon 61, and 1 in N-ras codon 12.
      The incidence of mutations was higher in the hilar type of intrahepatic
      cholangiocarcinomas, especially when these tumors were large. The incidence and
      spectrum of the mutations were almost the same as those reported in colon
      cancers, possibly indicating similar etiologic agent(s) in the carcinogenesis of
      both cancers.

PMID- 1739911
TI  - Lymphoma in inflammatory bowel disease.
AB  - Nine patients with lymphoma occurring in association with inflammatory bowel
      disease were admitted to The Mount Sinai Hospital between 1960 and 1983. Five
      (two men and three women) occurred among 1156 patients (0.43%) with ulcerative
      colitis (UC) and four (men), among 1480 patients (0.27%) with Crohn's disease
      (CD), a strong male preponderance in the latter group. In all four of the
      patients with CD and in four of the five patients with UC, the lymphomas were
      extraintestinal. The mean age of onset of UC in these patients was late (46
      years, 19 years older than in our overall series), with lymphomas occurring a
      mean of only 12 years later. By contrast, patients with CD had bowel disease much
      younger (mean age, 26 years), and their lymphomas appeared after a longer disease
      duration (mean, 24 years). The risk factors for the one patient with colonic
      lymphoma were similar to those with colitis-associated colorectal carcinoma:
      extensive and long-standing colitis and relatively young age when malignant
      disease developed. Four of the patients with lymphoma had associated colonic
      carcinoma; in three of them, the carcinoma appeared within the first decade of
      colitis, an unusual occurrence. A second malignant lesion also occurred in three
      patients with UC.

PMID- 1739912
TI  - Primary biphasic lymphoplasmacytic lymphoma of the lung. A mucosa-associated
      lymphoid tissue lymphoma with compartmentalization of plasma cells in the lung
      and lymph nodes.
AB  - A primary mucosa-associated lymphoid tissue lymphoma of the lung in a 27-year-old
      man was found. The tumor was composed mainly of centrocyte-like cells and plasma
      cells. These two components were demarcated sharply from each other, resulting in
      a zoning or biphasic pattern. This characteristic pattern also was present in the
      involved regional lymph nodes. Monoclonality of tumor cells was shown
      immunohistochemically and by in situ hybridization techniques. This article also
      highlights the use of in situ hybridization in detecting light chain mRNA in
      paraffin sections.

PMID- 1739913
TI  - T-cell chronic lymphocytic leukemia. T-cell function and lymphokine secretion.
AB  - The leukemic T-cells of the six patients with T-cell chronic lymphocytic leukemia
      (T-CLL), four with CD4 and CD45R-positive (CD4+ CD45R*) T-CLL and two with CD8
      and CD45R-positive (CD8+ CD45R+) T-CLL phenotype were studied for detailed
      immunologic phenotypic and functional characteristics. The levels of soluble
      interleukin-2 receptors were elevated significantly in the serum of all four
      patients with CD4+ CD45R+ T-CLL. Moreover, the CD4+ CD45R+ T-CLL patients' T
      cells, after in vitro stimulation with phytohemagglutinin and concanavalin A,
      expressed elevated percentages of interleukin-2 receptors on cells and secreted
      high interleukin-2 activity. The B-cell growth factor (BCGF) activity from three
      patients with CD4+ CD45R+ T-CLL was enhanced, but B-cell differentiation factor
      (BCDF) activity of the all T-CLL patients was decreased. Reduced BCGF and BCDF
      activity of the leukemic T-cells was one possible mechanism of
      hypogammaglobulinemia detected in two patients with T-CLL. All T-CLL patients'
      leukemic T-cells had diminished immunoregulatory functional activity in
      allogeneic mixed lymphocyte reactions. These observations suggest that leukemic T
      cells from T-CLL patients have many immunologic functional defects that may be
      important in their proliferative potential.

PMID- 1739914
TI  - Skin melanoma of the head and neck. Prognostic factors and recurrence-free
      survival in 512 patients.
AB  - The clinicopathologic and therapeutic data of 512 patients, with clinical Stage I
      invasive head and neck melanoma of the skin were retrospectively evaluated. There
      were 287 females and 225 males. Median age at primary surgery was 65 years
      (range, 18 to 96 years). Median observation period was 5 years (range, 1 month to
      25 years). Site of first recurrence was local in 7% (38 of 512), regional in 13%
      (67 of 512) and distant in 6% (31 of 512). Sex, age, ulcerated tumor, and tumor
      thickness were found to act as independent risk factors to recurrence-free
      survival by Cox multivariate regression analysis. In addition, size of excision
      margin was found to be of no significance to survival without relapse when
      adjusting for the independent risk factors.

PMID- 1739915
TI  - Relationship between immune response to melanoma vaccine immunization and
      clinical outcome in stage II malignant melanoma.
AB  - The authors investigated whether there was a relationship between the induction
      of a delayed-type hypersensitivity (DTH) response to melanoma vaccine
      immunization and disease recurrence. They studied prospectively 94 evaluable
      patients with surgically resected Stage II malignant melanoma who were immunized
      to a partially purified, polyvalent, melanoma antigen vaccine. The DTH response
      to skin tests to the vaccine was measured before treatment and at the fourth
      vaccine immunization. Vaccine treatment induced a strong DTH response in 29 (31%)
      patients, an intermediate response in 24 (25%), and no response in 41 (44%). The
      median disease-free survival (DFS) of patients with a strong, intermediate, and
      no DTH response to vaccine immunization was more than 72 months, 24 months, and
      15 months, respectively. The relationship between an increase in the DTH response
      and a prolonged DFS was statistically significant (P = 0.02); clinically
      meaningful (the median DFS of patients with a strong DTH response was 4.7 years
      longer than that of nonresponders); and, by multivariate analysis, independent of
      disease severity or overall immune competence. These findings suggest, but do not
      prove, that vaccine treatment can slow the progression of melanoma in some
      patients.

PMID- 1739916
TI  - Expression of cell adhesion molecules in human melanoma cell lines and their role
      in cytotoxicity mediated by tumor-infiltrating lymphocytes.
AB  - The role of cell adhesion molecules (CAM) LFA1, ICAM-1, LFA3, VLA1, VLA4, CD29,
      CD44, and CD56 in tumor-infiltrating lymphocyte (TIL) and natural killer cell
      (NK)-mediated killing of target cells was studied. Melanoma cell lines and
      autologous TIL were derived from seven patients with metastatic melanoma, and
      cytotoxicity assays were done in the presence and absence of monoclonal
      antibodies (MoAb) to CAM expressed on melanoma cells or TIL. The melanoma cell
      lines analyzed were all positive for CD29 and LFA3 expression, negative for LFA1
      expression, but showed variable expression of ICAM-1, VLA1, VLA4, CD44, and CD56.
      The effects of anti-CAM antibodies on TIL-mediated melanoma killing fell into
      three categories: (1) consistent inhibition of TIL-mediated killing was observed
      when melanoma cells were pretreated with anti-ICAM1 and anti-LFA-3 MoAb or when
      TIL were pretreated with anti-LFA1; (2) no effect was observed when melanoma
      cells were pretreated with anti-CD56; or (3) a discreet, but significant,
      inhibition was observed when target cells were pretreated with anti-CD29, anti
      VLA1, anti-VLA4, and anti-CD44. Cytotoxicity was significantly enhanced by
      pretreatment of target cells with gamma-interferon (gamma-IFN), although gamma
      IFN did not augment surface expression of the CAM studied. The NK-mediated
      killing of K562 cells was blocked by anti-LFA1, anti-CD18, and anti-ICAM, and
      partially inhibited by anti-CD44 MoAb. Together, these results suggest that
      several accessory CAM may play a role in regulating cellular cytotoxicity.
      Because cytotoxicity generally correlated with the level of expression of CAM in
      melanoma cells, weak CAM surface expression may provide a means for melanomas to
      escape immune surveillance.

PMID- 1739917
TI  - Estrogen receptor immunohistochemistry in carcinoma in situ of the breast.
AB  - Although estrogen receptor (ER) content and its clinical significance have been
      extensively evaluated in invasive breast cancer, ER expression in carcinoma in
      situ (CIS) of the breast and its correlates are less well understood. Thus, using
      an indirect immunoperoxidase technique and paraffin-embedded tissue, the authors
      studied ER expression in 100 breast tumors containing CIS with or without
      invasive carcinoma. The percentages of positive and of strongly positive nuclei
      were compared among histologic categories of CIS and between CIS and invasive
      carcinoma. The relationships between histologic features of CIS (cell size,
      nuclear pleomorphism, necrosis, extent of CIS) the patient's age, and the ER
      status of CIS also were evaluated. ER expression in pure CIS was compared with
      that of CIS with adjacent invasive carcinoma. Significant differences were
      observed between comedo CIS, which was frequently ER negative, and non-comedo and
      lobular CIS, which usually were positive. A predominance of large cells,
      independently from other features, was the best morphologic predictor of ER
      negative status in CIS. ER in CIS correlated with ER in invasive carcinoma in 98%
      of cases (r2 = 0.677). CIS without invasive carcinoma was more frequently ER weak
      or negative than CIS associated with invasive carcinoma. There was no difference
      in the overall percentage of nuclear staining in CIS of women of premenopausal
      versus postmenopausal age; however, a higher proportion of strongly positive
      cells occurred in the postmenopausal group. The authors conclude that the ER
      expression in CIS correlates with pathologic features of differentiation and is
      similar to that of invasive carcinoma.

PMID- 1739918
TI  - Immunohistochemical demonstration of elevated expression of epidermal growth
      factor receptor in the neoplastic changes of cervical squamous epithelium.
AB  - To evaluate epidermal growth factor (EGF) receptor expression in the neoplastic
      process of squamous cell epithelium of the uterine cervix, normal, premalignant,
      and malignant cervical tissues were examined for the presence of EGF receptor by
      the avidin-biotin immunoperoxidase techniques with a monoclonal antibody to EGF
      receptor. Although normal cervical epithelium did not show appreciable staining
      for EGF receptor, predominant staining for the receptor was observed in most
      dysplastic epithelia and carcinomas in situ. In invasive squamous carcinoma,
      there was a great difference in the immunohistochemically detected levels of EGF
      receptor among the histologic cell types. Large cell nonkeratinizing carcinoma
      and its keratinizing counterpart contained high levels of EGF receptor; small
      cell nonkeratinizing carcinoma lacked immunostainable EGF receptor. These results
      suggest that the elevated expression of EGF receptor may be involved in the
      initial stage of tumorigenesis of cervical squamous epithelium and that EGF
      receptor expression may be related to the differentiation or dedifferentiation of
      cervical squamous carcinoma cells.

PMID- 1739919
TI  - Augmenting effect of sizofiran on the immunofunction of regional lymph nodes in
      cervical cancer.
AB  - The immunomodulating effect of sizofiran on regional lymph nodes (RLN) was
      studied in cervical cancer and benign gynecologic tumors comparatively between
      treated patients (sizofiran intramuscularly (1) 1 day (20 mg) before and (2) 8
      days (20 mg) and 1 day (20 mg) before surgery; n = 34) and untreated patients (n
      = 21). The RLN (internal iliac lymph nodes) were dissected surgically, and
      freshly obtained mononuclear (MN) cells were studied to observe interleukin-2 (IL
      2) production and lymphokine-activated killer cell and natural-killer cell
      activities. The infiltration of surface phenotype of MN cells into RLN was
      determined semiquantitatively by immunohistochemistry. Sizofiran augmented IL-2
      production of RLN, which was accompanied by a marked increase in the number of
      cells stained with anti-Leu-3a and IL-2 receptor. This effect was found more
      often in Stage Ib disease than in Stage 0, and it was not observed in benign
      tumors. These results suggest that stimulation with some antigens (e.g., cancer
      antigen in the current study) is necessary to induce immunoaugmentation by
      sizofiran which has no antigenicity. The augmenting effect was seen even in lymph
      nodes involved by advanced cervical cancer. Therefore, sizofiran was found to be
      a potent biologic response modifier in patients with cervical cancer.

PMID- 1739920
TI  - Abrogation of the invasion of human bladder tumor cells by using protease
      inhibitor(s).
AB  - It was shown previously that invasive human transitional cell carcinoma cell line
      EJ, but not the noninvasive RT4 cells, can degrade basement membrane laminin and
      that the degradation of basement membrane laminin was a result of a
      redistribution of activated cysteine proteinase cathepsin B to the plasma
      membrane of the invasive EJ cells. Using a modified Boyden chamber and an
      artificial basement membrane, it was found first that cysteine proteinase
      inhibitor E-64 can abolish the ability of the EJ cells to invade through the
      artificial basement membrane to the underside of the filter. Second, E-64 can
      prevent the degradation of purified human basement membrane laminin by the plasma
      membrane fraction of invasive EJ cells. Third, E-64 does not affect the ability
      of the EJ cells to attach to the extracellular matrix nor is the inhibitory dose
      toxic to the cells when assayed with trypan-blue dye exclusion. However, E-64
      does affect the ability of the EJ cells to respond to autocrine motility factor
      induced motility. Finally, in an in vivo model, E-64 was not toxic to the animals
      tested and may have limited the blood-borne metastatic ability of invasive EJ
      cells in the treated animals. It was concluded that proteinase cathepsin B may be
      involved in human bladder tumor invasion, in both extracellular matrix
      degradation and factor-induced cellular motility, and the authors suggested that
      the use of inhibitor(s) to cysteine proteinases may limit the invasive potential
      of human bladder cancer cells.

PMID- 1739921
TI  - Prognostic factors for survival and tumor control in cervical lymph node
      metastases from head and neck cancer. A multivariate study of 492 cases.
AB  - A multivariate analysis was carried out in 492 patients with metastatic neck
      disease from squamous cell carcinoma to determine the influence of clinical and
      therapeutic factors on survival, local and regional control, and distant
      metastases. After radiation treatment with radical intent, recurrence at the
      primary site was the most frequent site of treatment failure (20% of cases),
      followed by distant metastases (14% of the cases), whereas isolated neck
      recurrences occurred in only 7% of the patients. The most significant factors
      influencing survival were primary tumor site, node fixation, N-stage, T-stage,
      and number of lymphatic chains. The most significant factors influencing local
      control were primary site, T-stage, and node fixation. Significant factors
      influencing regional control were radiation therapy volume, primary tumor site,
      node fixation, and node location (upper and lower neck). Significant factors
      influencing distant control were N-stage, number of nodes, and number of involved
      lymphatic chains.

PMID- 1739922
TI  - Coronary artery disease mortality in patients treated for Hodgkin's disease.
AB  - The authors conducted a follow-up study of the association between mediastinal
      irradiation, chemotherapy, and mortality from coronary artery disease in 4665
      patients treated for Hodgkin's disease. Study subjects were followed after the
      diagnosis of Hodgkin's disease until death or the closing date of the study. The
      average duration of follow-up was 7 years; 2415 patients died, and 124 cases of
      coronary artery disease were identified from death certificates, including 68
      cases of acute myocardial infarction. The age-adjusted relative risks (RR) of
      death with any coronary artery disease after mediastinal irradiation and after
      chemotherapy were 1.87 (95% confidence interval [CI], 0.92 to 3.80) and 1.28 (CI,
      0.77 to 2.15), respectively. A significantly increased risk of death in the
      subcategory myocardial infarction was observed after mediastinal irradiation (RR,
      2.56; CI, 1.11 to 5.93) but not after chemotherapy (RR, 0.97; CI, 0.53 to 1.77).
      These results support the hypothesis that radiation therapy to the mediastinum
      increases the risk of coronary artery disease.

PMID- 1739923
TI  - Blood eosinophilia in Hodgkin's disease. A follow-up of 25 cases in Venezuela.
AB  - Twenty-five patients with Hodgkin's disease and high eosinophil counts were
      observed for an average of 90 months. Fluctuations in the levels of eosinophils
      were important in the course of observation. No relation with stages, histologic
      type, or evolution was noticed. Steroid-containing regimens and severe premortem
      conditions seemed to lower the counts. Relapse-free survival was shorter in our
      25 patients than in a control group of 50 patients with Hodgkin's disease and no
      eosinophilia who had approximately the same stage, histologic type, and treatment
      of disease. However, the overall survival was somewhat better for the
      eosinophilic patients with stages IIIB and IV (0.1 greater than P greater than
      0.05).

PMID- 1739924
TI  - Hodgkin's disease and non-Hodgkin's lymphoma containing Reed-Sternberg-like giant
      cells in Taiwan. A clinicopathologic analysis of 50 cases.
AB  - Hodgkin's disease (HD) is uncommon in Taiwan. In reviewing the clinicopathologic
      features of 50 cases, the authors found that the diagnosis of HD was complicated
      with non-Hodgkin's lymphoma (NHL). Fourteen cases were reclassified as NHL
      containing Reed-Sternberg (RS) giant cells, mostly peripheral T-cell lymphoma
      (PTL), and 34 cases as classic HD, which included 8 cases of lymphocyte
      predominance, 10 of nodular sclerosis, 12 of mixed cellularity, and 4 of
      lymphocyte depletion. For cases of HD, there was a bimodal age-incidence
      distribution with peaks at the third and fifth decades; 61.8% manifested Stage B
      symptoms and 80.6% had Stage III/IV disease. The group of patients with NHL,
      compared with those with classic HD, was found to be older (mean age, 41.4 years
      versus 33.1 years; P less than 0.05), to have more extranodal disease (35.7%
      versus 8.8%, P less than 0.05), less complete remission rate (25% versus 67.9%, P
      less than 0.05), and shorter median survival (29 months versus 90 months). Most
      of the NHL patients originally were diagnosed as having atypical or unclassified
      HD. Thus, the authors conclude that the previous observation of a predominance of
      mixed cellularity HD in Asian regions may be attributable to the inclusion of
      PTL, which may mimic HD in histology. Because there is a marked difference in
      clinical behavior and prognosis, it is important to distinguish between HD and
      NHL containing RS giant cells in an area with a high incidence of PTL.

PMID- 1739925
TI  - Clinicopathologic and therapeutic aspects of angioimmunoblastic lymphadenopathy
      related lesions.
AB  - The clinicopathologic features of 14 patients with angioimmunoblastic
      lymphadenopathy (AIL)-related lesions were analyzed. Lymph node biopsy specimens
      from all the patients showed a diffuse obliteration of lymph node architecture,
      prominent vascular proliferation, a polymorphous cellular infiltrate, including
      immunoblasts, and varying degrees of clear cell proliferation. The patients were
      eight males and six females, with a median age of 58.5 years. All but one were in
      an advanced stage at the time of diagnosis. Bone marrow involvement was observed
      in eight patients. Thirteen patients had a negative serologic reaction for
      antibody to human T-cell leukemia virus type I (HTLV-I), and one patient was
      considered to be a HTLV-I carrier. Polyclonal hypergamma-globulinemia was
      observed in 6 patients, and 6 of the 12 patients showed elevated IgE levels.
      Immunophenotyping of the involved lymph nodes revealed a preponderance of T-cells
      in all the patients. Eleven of these patients showed a predominance of CD4+ over
      CD8+ T-cells, and only one patient showed a predominance of CD8+ over CD4+ T
      cells. Two of five patients whose gene analysis was carried out showed clonal
      rearrangement of the T-cell receptor beta chain gene without rearrangement of the
      immunoglobulin heavy chain genes. Twelve patients received doxorubicin-containing
      combination chemotherapy; of these, 7 patients achieved complete response, and
      the other 5 had partial response. Nine patients are still alive with a median
      follow-up period of 21 months, and five patients died during the follow-up
      period. Progression to high-grade T-cell lymphoma with systemic infiltration was
      ascertained in two of three cases for which autopsy was performed. From our
      experience, we recommend doxorubicin-containing combination chemotherapy as
      initial therapy for AIL-related lesions.

PMID- 1739926
TI  - Megestrol acetate in cancer anorexia and weight loss.
AB  - High-dose megestrol acetate has been associated with increased appetite and
      weight. To examine the effects of high-dose megestrol acetate in the treatment of
      anorexia and weight loss in patients with advanced hormone-insensitive malignant
      lesions, a randomized double-blind placebo-controlled trial was conducted.
      Patients receiving megestrol acetate for 1 month reported a significant
      improvement in appetite and adequacy of food intake compared with those receiving
      placebo. A three-item scale measuring appetite, adequacy of food intake, and
      concern about weight revealed a higher improvement with megestrol acetate than
      with placebo. Patients who worsened while receiving placebo had similar favorable
      changes after the cross over to megestrol acetate. These data indicate that
      megestrol acetate may improve appetite and food intake in patients with advanced
      cancer.

PMID- 1739927
TI  - Patterns and risks of cancer in farmers in Alberta.
AB  - Data on occupations and life styles of patients with cancer have been collected
      since 1983. To investigate cancer patterns and risks in farmers in Alberta, all
      farmers were abstracted and compared with nonfarmers in the data base, using case
      control analysis. Controls were patients with cancer at any site except the index
      site. Significantly elevated odds ratio (OR), adjusted for age and smoking, were
      found among the farmers for cancers of the lip (OR = 3.22, 95% confidence
      interval [CI] = 2.14 to 4.84) and prostate (OR = 1.31, 95% CI = 1.11 to 1.55).
      Crude risk for lung cancer was significantly lower in farmers, but statistical
      significance disappeared when risk was adjusted for smoking (OR = 0.81, 95% CI =
      0.65 to 1.02). Farmers were at considerably lower risk of malignant melanoma of
      the skin, compared with nonfarmers (OR = 0.57, 95% CI = 0.36 to 0.91).

PMID- 1739928
TI  - Familial occurrence of infantile myofibromatosis.
AB  - Two brothers with multicentric infantile myofibromatosis (IM) are reported. In
      both, tumors were present at birth; the tumors regressed spontaneously, but new
      lesions developed throughout the follow-up periods of 15 and 8 years.
      Immunohistochemically, the nodules were found to be positive for vimentin and
      actin, but negative for desmin and S-100 protein; these findings support the
      myofibroblastic nature of IM. A literature review revealed nine additional
      families with IM in more than one family member. Although the occurrence of IM in
      eight sets of siblings, with consanguinity in two of them, favors an autosomal
      recessive mode of inheritance, the disorder also has been well documented in half
      sisters and in successive generations, which makes autosomal dominant inheritance
      a more plausible explanation.

PMID- 1739929
TI  - Childhood cancer registry of the Province of Torino, Italy. Survival, incidence,
      and mortality over 20 years.
AB  - Incident childhood cancers in the Province of Torino, Italy (population aged 0 to
      14 years averaging 0.5 million) have been registered since 1967. Four population
      based exhaustive surveys have been done to collect cases diagnosed during the
      periods 1967 to 1969, 1970 to 1975, 1976 to 1981, and 1982 to 1986. For each
      registered child, vital status on June 30, 1988 was assessed. This article
      reports incidence, mortality, and survival rates over a 20-year period. A
      statistically significant trend toward an increased incidence of soft tissue
      sarcomas was identified. Statistically insignificant trends included an increased
      incidence of brain tumors (probably reflecting improved diagnostic procedures)
      and a decreased incidence of thyroid tumors. Incidence rates of leukemias in the
      first year of life tended to decrease. As expected, survival rates of some
      childhood cancers dramatically improved throughout the 20-year period; this
      occurred in leukemias, brain tumors, soft tissue sarcomas, and renal tumors.
      Survival rates are compared with observations in comparable population-based
      series.

PMID- 1739930
TI  - DNA content and other prognostic features in childhood medulloblastoma. Proposal
      of a scoring system.
AB  - The authors reviewed clinical features, surgical extent of resection, histologic
      parameters, and DNA content in 55 children with medulloblastomas and found that
      complete or near total resection, absence of tumor dissemination, tumor DNA
      aneuploidy, and low proliferative index correlated with a favorable clinical
      outcome. A scoring system was developed based upon these features to identify
      patients who, in the future, may benefit from more aggressive or novel
      therapeutic regimens. Patient age and sex and adjuvant chemotherapy did not
      significantly correlate with long-term survival. The data also suggest that
      tumors that have been designated as cerebellar neuroblastomas may be a distinct
      group of posterior fossa tumors, which may have a better prognosis.

PMID- 1739931
TI  - Home care of HIV/AIDS.

PMID- 1739932
TI  - The "new" profession.

PMID- 1739933
TI  - The Manitoba nurses' strike--win, lose or draw?

PMID- 1739934
TI  - Strikes by nurses.

PMID- 1739936
TI  - The right place.

PMID- 1739935
TI  - The power of self-help.

PMID- 1739937
TI  - Monitoring the path of nursing.

PMID- 1739938
TI  - Creating your own conceptual framework.

PMID- 1739939
TI  - Checking the fit.

PMID- 1739940
TI  - Political action. Choice or obligation?

PMID- 1739941
TI  - [Hospital at home, a reality].

PMID- 1739942
TI  - [Education, key to successful integration].

PMID- 1739943
TI  - Piperine, a plant alkaloid of the piper species, enhances the bioavailability of
      aflatoxin B1 in rat tissues.
AB  - Piperine is known to modify the biotransformation of drugs. The effect of
      piperine on the metabolic activation and distribution of [3H]-aflatoxin B1 (AFB1)
      in rats has been described. Piperine markedly inhibited liver microsome-catalysed
      [3H]AFB1 binding to calf thymus DNA in vitro, in a dose dependent manner. Rats
      pretreated with piperine accumulated considerable [3H]AFB1 radioactivity in
      plasma and in the tissues examined as compared to the controls. However, piperine
      had no influence on hepatic [3H]AFB1-DNA binding in vivo, which could possibly be
      due to the null effect of piperine on liver cytosolic glutathione (GSH) 5
      transferase activity. Piperine-treated rat liver microsomes demonstrated a
      tendency to enhance [3H]AFB1 binding to calf thymus DNA in vivo. The effect of
      piperine on AFB1 metabolism thus closely resembles the mode of action of SKF 525
      A on biotransformation of foreign compounds.

PMID- 1739944
TI  - Immunoquantitation of von Willebrand factor (factor VIII-related antigen) in
      vinyl chloride exposed workers.
AB  - Angiosarcoma of the liver is a rare malignant tumor which has been associated
      with occupational exposure to vinyl chloride (VC). We have determined by ELISA
      the level of von Willebrand factor (vWf) in the serums of 107 VC-exposed workers,
      active or retired, and of 133 blood donors used as controls. The vWf level was
      slightly but significantly higher in the VC-exposed group than in the control
      group (P = 0.035). Seventeen VC-exposed workers exhibited a raised level of vWf,
      with no biochemical sign of hepatic disturbance, nor any evidence of illness;
      only one of them exhibited elevated alkaline phosphatase and gamma-glutamyl
      transpeptidase values. The vWf serum level of 3 patients with hepatic
      angiosarcoma associated to VC-exposure was markedly elevated. These increased
      levels of vWf in VC-exposed workers most likely reflect an increased activity of
      liver endothelial cells; whether an elevated level of vWf could be associated
      with increased risk of developing liver angiosarcoma remains to be determined.

PMID- 1739945
TI  - Differences in metabolic activation of dibenzo[a,e]fluoranthene characterized by
      32P-postlabeling in two mouse fibroblast models.
AB  - The formation of DNA adducts was investigated in mouse fibroblasts from two
      different tissues--embryos and adult lung--after incubation with
      dibenzo[a,e]fluoranthene (DBF) or its major proximate metabolites. The nuclease
      P1 modification of the 32P-postlabeling method was adapted for detection of DBF
      DNA adducts. Quantitative and qualitative differences were observed in the
      metabolic activation mediated by the two cell types. DBF-DNA adducts generated
      three major spots reproducibly, and more than ten spots of medium or weak
      importance. The highest level of DNA binding occurred via the DBF-bay region
      vicinal dihydrodiol epoxide but with significant differences in the quantitative
      distribution of adducts. Striking qualitative differences were observed when lung
      fibroblasts were incubated with the DBF-pseudo bay region dihydrodiol (DBF-12,13
      DHD). The spots representing adducts induced in embryo fibroblasts by DBF-3OH
      12,13-DHD, a further metabolite of DBF-12,13-DHD, were totally absent from
      chromatograms of lung cells. These results show that both embryo and lung
      fibroblasts can activate DBF but that different cytochrome P-450 forms and
      substrate affinities are involved. The finding that different activation systems
      may be present in subcategories of the same tissue, may provide a partial
      explanation for the wide variations in sensitivity to carcinogens among species,
      organs and tissues.

PMID- 1739946
TI  - Gamma-interferon and retinoic acid synergize in inhibiting the growth of human
      neuroblastoma cells in nude mice.
AB  - We have investigated the effects of retinoic acid (RA), human recombinant gamma
      interferon (gamma-IFN), and the association of both agents on the growth of human
      neuroblastoma (NB) cells in [CD1(nu/nu)] nude mice. Two human NB cell lines,
      namely LAN-5 and GI-LI-N, were previously adapted to grow in syngeneic animals
      for 7 consecutive passages. At the eighth passage, only animals which developed
      10-mm diameter tumors within 40 days from xenograft were admitted to the study.
      RA and/or gamma-IFN were administered subcutaneously 3-5 days per week for 3
      consecutive weeks. The number of days necessary for each tumor mass to grow up to
      20 mm diameter (in vivo doubling time, ivDT) was then evaluated. Tumor growth was
      significantly inhibited in gamma-IFN (P less than 0.005) and RA (P less than
      0.05) treated mice grafted with GI-LI-N. The combination of the two agents did
      not further enhance ivDT. The tumor growth inhibition was not statistically
      significant in LAN-5 bearing mice treated with RA or gamma-IFN alone, while a
      synergistic effect between the two drugs was observed (P less than 0.05). We
      conclude that parenteral combined administration of RA and gamma-IFN may prove to
      be useful in inhibiting the growth of tumors derived from human NB cells
      resistant to single inducers.

PMID- 1739947
TI  - Changes in alanine transport in plasma membrane vesicles from rat liver during
      the early stages of diethylnitrosamine-induced hepatocarcinogenesis.
AB  - The transport of L-alanine, a natural substrate of system A, across liver plasma
      membrane vesicle preparations was modified during the early stages of rat DENA
      hepatocarcinogenesis. Kinetic studies indicated an increase of the Vmax, with
      normal Km values, at 30 h in rats undergoing a partial hepatectomy. Normal Vmax
      and drastically reduced Km values were present using membrane preparations from
      liver tissue showing enzyme-altered hyperplastic foci and/or preneoplastic
      nodules. The results suggest that alanine transport is differently affected by
      initiating and promoting stimuli during rat DENA hepatocarcinogenesis. The
      changes of the Vmax could be related to the promoting effect of partial
      hepatectomy on cell proliferation whereas the changes of the affinity constant
      (Km) could be the result of intrinsic modifications of the transporter in
      initiated cells.

PMID- 1739948
TI  - The enzymatic activities of branched-chain amino acid catabolism in tumour
      bearing rats.
AB  - Rats bearing the Walker-256 carcinosarcoma showed significant changes in branched
      chain amino acid metabolism as compared with their non-tumour-bearing controls.
      In vitro measurement of branched-chain amino acid transaminase and branched-chain
      2-oxo acid dehydrogenase showed significant increases in the skeletal muscle of
      tumour-bearing animals. In addition, the circulating concentration of leucine was
      increased in the tumour-bearing group. It can be concluded that the metabolism of
      branched-chain amino acids in the host is profoundly altered by the presence of a
      tumour and this may well be one of the main factors contributing to the so-called
      cancer cachexia.

PMID- 1739949
TI  - Cystatins and stefins in ascites fluid from ovarian carcinoma.
AB  - Cysteine proteinase inhibitors (CpI) of all three families were found in ascites
      fluid from patients with ovarian carcinoma. CPIs were isolated by affinity
      chromatography on carboxymethylated papain Sepharose, followed by gel filtration,
      anti-stefin-Sepharose and ion exchange chromatography. The highest apparent
      inhibition against cathepsin B (Cat B) was found in the low molecular mass (LMM)
      CPI fraction. Immunochemical analysis of this fraction revealed the presence of
      cystatin C and both stefins A and B while the high molecular mass (HMM) CPI
      fraction contained kininogens. We demonstrated that CPIs were not completely
      associated with cysteine proteinases (CPs): about 20% of HMM CPIs and 50% of LMM
      CPIs were free in native ascites fluid. Affinity chromatography on anti-Cat B
      Sepharose revealed that the major LMM CPI, associated with Cat B in native
      ascites fluid, was the full length form of cystatin C, pI 9.3, and not its
      truncated form, pI 7.85. The latter was isolated and found to inhibit Cat B in
      vitro with apparent Ki 0.18 +/- 0.2 nM. Stefin A was isolated from alkaline
      activated ascites fluid in its two isoforms, pI 4.6 and 4.9. In native ascites,
      the pI 4.9 isoform was mostly associated with Cat B. Ki for Cat B was 3.55 +/-
      1.7 nM, not significantly different from the Ki values measured for stefin A,
      isolated from other human tissues and biological fluids.

PMID- 1739950
TI  - Monitoring of urinary excretion of modified nucleosides in cancer patients using
      a set of six monoclonal antibodies.
AB  - Monoclonal antibodies were produced and characterized in order to allow the
      monitoring of the urinary excretion of six modified nucleosides. The specificity
      of each antibody was determined and competitive solid-phase enzyme-linked
      immunoassays were designed, the sensitivity of which lay in the pmol range.
      Detection and quantitation of 5-methylcytidine (5-MeCyd), 4-acetylcytidine (4
      AcCyd), 1-methylinosine (1-MeIno), 1-methyladenosine (1-MeAdo), 7-methylguanosine
      (7-MeGuo) and pseudouridine (psi-Urd) can be performed in small volumes (70
      microliters) of untreated urine. Results can be obtained from as many as 20
      different samples, for one molecule, within 3 h. With this technique, values
      observed for three commonly measured nucleosides in urine from healthy subjects
      (psi-Urd, 1-MeAdo and 1-MeIno) are in good agreement with those reported by other
      authors after analysis by high performance liquid chromatography. Results
      obtained in urine from cancer patients show significantly increased levels of the
      six haptens quantitated by this immunoassay.

PMID- 1739951
TI  - Fractionated treatment of CaD2 tumors in mice sensitized with aluminium
      phthlocyanine tetrasulfonate.
AB  - CaD2 mammary carcinomas transplanted into the feet of mice were treated with
      tetrasulfonated phthalocyanine (AlPcS4) and laser light at 680 nm. A light dose
      of 135 J/cm2 was either given as continuous radiation (15 min) or fractionated
      with 15 s exposure, 15 s darkness, 15 s exposure and so on for 30 min. The CaD2
      tumors were found to respond better to a fractionated exposure than to the same
      energy given in one exposure. The reason for this is assumed to be a
      relocalization of the dye upon illumination, seen as a rapid decrease in
      fluorescence. When the laser light was turned off, the fluorescence returned to
      almost the initial value.

PMID- 1739952
TI  - The right ventricle.

PMID- 1739953
TI  - Anatomy and pathology of the right ventricle (including acquired tricuspid and
      pulmonic valve disease).
AB  - With the increased availability of various imaging techniques to assess right
      ventricular structure and function, there has been a greater appreciation of the
      importance of right ventricular performance in the setting of left ventricular
      dysfunction as well as intrinsic ventricular diseases. This article discusses the
      pathology of the right ventricle, tricuspid valve, and pulmonic valve and
      concentrates on the major acquired and congenital conditions that manifest in an
      adult population.

PMID- 1739954
TI  - The right ventricle in pulmonary disease.
AB  - Abnormal pulmonary function that causes pulmonary artery hypertension increases
      right ventricular work. To compensate, the right ventricle enlarges, and cor
      pulmonale develops. Right ventricular failure occurs when these adaptive
      mechanisms cannot compensate for the hemodynamic burden. The various pulmonary
      diseases that are associated with right ventricular overload and the physiologic
      responses of the right ventricle to increased afterload are discussed in this
      article.

PMID- 1739955
TI  - Endovascular infections arising from right-sided heart structures.
AB  - Endovascular infections that involve the right side of the heart present their
      own unique etiologies, pathophysiologies, clinical manifestations, and
      therapeutic issues. The pathology of the vegetations of right-sided endocarditis
      is identical to that of left-sided endocarditis. These vegetations are irregular,
      friable masses of varying size the contain platelets, fibrin, RBCs, and
      microorganisms. These lesions serve as a nidus for deep-seated infection and
      produce sustained bacteremia. Right-sided endocarditis occurs in 5% to 10% of all
      cases of endocarditis. The most common predisposing factors are IV drug abuse and
      congenital heart disease. S. aureus is the most common pathogen. The clinical
      manifestations include fever, chills, rigor, dyspnea, pleuritic pain, productive
      cough, and hemoptysis. The cardiac manifestations can be notably absent early in
      the course of the disease, with only 20% of patients initially showing a
      significant murmur on physical examination. Peripheral embolic lesions can be
      seen. Echocardiography is helpful in identifying vegetations on the tricuspid
      valve in a significant proportion of patients. The chest radiograph is
      characteristic, showing features typical of multiple septic pulmonary emboli. The
      radiograph shows multiple, small, fuzzy, patchy, peripherally located densities
      that can change rapidly on serial films. Complications of right-sided
      endocarditis include pulmonary infarction, pulmonary abscess, progressive right
      sided heart failure, and renal abnormalities. The treatment of right-sided
      endocarditis includes prolonged therapy, with high doses of IV bactericidal
      antibiotics. Four weeks of antibiotic therapy is generally required, but newer
      regimens using combination antibiotic therapy can be successful in sensitive
      strains of viridans group streptococci and S. aureus. Surgical resection of the
      tricuspid valve is recommended for organisms that do not respond to initial
      antibiotic therapy, fungal endocarditis, resistant relapsing organisms, or
      coexistent infection with S. aureus and P. aeruginosa. The prognosis of right
      sided endocarditis is generally favorable when compared with left-sided
      endocarditis. The prognosis is especially favorable in IV drug abusers infected
      with S. aureus. Patients infected with fungal organisms, Pseudomonas or Serratia,
      have a worse prognosis. The presence of significant right-sided heart failure
      also imparts a worse prognosis.

PMID- 1739956
TI  - Tachycardias of right ventricular origin.
AB  - Ventricular tachycardia arising from the right ventricle usually has a left
      bundle branch morphology and occurs in a variety of disorders. Uhl's anomaly and
      right ventricular dysplasia may represent a spectrum of one disorder and are a
      cause of right heart dilatation, failure, and premature sudden death due to
      ventricular arrhythmias. Familial forms of the disorder may account for focal
      clustering in some geographic areas. Management should involve aggressive
      stratification of arrhythmia risk and may include medical, surgical, or device
      therapy. In contrast, the syndrome of right ventricular outflow tract
      tachycardia, including nonischemic exercise-induced and repetitive monomorphic
      ventricular tachycardia, is a more benign entity. Management often involves beta-
      and calcium channel blocking drugs or type IC antiarrhythmic drugs. Catheter
      ablation of the arrhythmia focus in the right ventricular outflow tract has been
      used in selected patients. In this syndrome the right ventricle is normal, and
      noninvasive testing as well as electrophysiologic studies can be helpful in
      distinguishing it from the more malignant right ventricular dysplasia.
      Ventricular arrhythmias may also be seen after right ventricular incision, as in
      surgical repair of tetralogy of Fallot and ventricular septal defects.
      Significant ventricular ectopy associated with an abnormal right ventricle
      (enlarged or depressed systolic function) is associated with an increased risk
      for sustained arrhythmia and sudden cardiac death in this group. The optimal
      indicator(s) of highest risk in these patients remains under investigation but
      will likely include electrophysiologic testing. Bifascicular block occurs
      commonly after repair of tetralogy of Fallot, but is usually benign. Isolated
      right ventricular infarction is rare. Most right ventricular arrhythmias
      associated with ischemia occur in the setting of iatrogenic catheter manipulation
      for pacing or hemodynamic monitoring. In conclusion, right ventricular
      arrhythmias involve an unusual and interesting group of clinical entities and
      appear to span the spectrum of arrhythmias mechanisms. A macroreentrant
      activation ring around the ventriculotomy scar may account for the arrhythmias
      following repair of tetralogy of Fallot. Microreentry at sites of morphologic
      abnormalities results in the arrhythmias associated with right ventricular
      dysplasia and ischemia. Triggered activity related to DADs or, less likely,
      abnormal automaticity, produce repetitive monomorphic ventricular tachycardia and
      nonischemic exercise-induced ventricular tachycardia, both of which usually
      originate from the right ventricular outflow tract. Iatrogenic ventricular
      tachycardia associated with catheter manipulation is especially likely to occur
      in the presence of right ventricular ischemia and infarction. It is important to
      recognize these clinical entities because treatment is specific.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1739957
TI  - The right ventricle in disorders causing pulmonary venous hypertension.
AB  - The right ventricle is frequently affected by pulmonary arterial hypertension of
      postcapillary obstructive origin. The disorders that cause states of pulmonary
      venous hypertension arise in the left ventricle, left atrium, or pulmonary veins.
      Biochemical factors, the pericardium, interventricular septum, and pulmonary
      arterial system combine to communicate the effects of these disorders to the
      right ventricle. Although not ideally suited to pressure loading, the right
      ventricle undergoes a series of structural and hemodynamic adaptations that allow
      for chronic compensation until failure supervenes, with characteristic clinical
      findings. Exercise may serve to magnify the abnormalities of right ventricular
      function. Correction of left-sided heart lesions with improvement in pulmonary
      venous hypertension is associated with favorable effects on the right ventricle.
      In states of left-sided heart failure, the level of right ventricular function
      may provide important prognostic information.

PMID- 1739958
TI  - Right ventricular assist devices and the surgical treatment of right ventricular
      failure.
AB  - Treatment of patients with severe right ventricular dysfunction follows a
      continuum of progressive therapies. If optimization of volume status and
      inotropic support do not adequately improve right ventricular function, higher
      levels of mechanical circulatory support are required. A right-sided intraaortic
      balloon pump has been helpful in such circumstances. The centrifugal pump and the
      artificial ventricle provide the most effective long-term circulatory support for
      patients with right ventricular or biventricular failure after cardiopulmonary
      bypass, myocardial infarctions, or as a bridge to cardiac transplantation. All of
      these support measures still carry a high morbidity and mortality. Survival in
      approximately one third of these high-risk patients can be expected with the use
      of right ventricular assist devices. Cardiopulmonary bypass has also been
      effective for circulatory support of patients with massive pulmonary emboli.

PMID- 1739959
TI  - Assessment of right ventricular function. Role of nuclear imaging techniques.
AB  - Due to the complex geometry of the right ventricle, contrast angiography is not
      ideally suited for determining its volumes and for carrying out volume-based
      analyses. Nuclear cardiological techniques, being free from this limitation, have
      played an important role in understanding the right ventricular performance in
      various disease conditions. This technique is currently in clinical use and can
      be applied for assessing the role of right ventricular function in various
      cardiopulmonary diseases.

PMID- 1739960
TI  - Hemodynamics of the right ventricle in normal and disease states.
AB  - The physiology and hemodynamic functions of the right ventricle in normal and
      disease states differ considerably from those of the left ventricle. To
      illuminate these differences, the right ventricle's essential functions in the
      normal circulation are reviewed, its functional anatomy and blood supply are
      described, principles and methods of systolic function assessment are discussed,
      and hemodynamic adaptations to selected diseases causing chronic right-side
      volume and pressure overload are highlighted.

PMID- 1739961
TI  - Right ventricular infarction.
AB  - Right ventricular myocardial infarction, long unrecognized because of a lack of
      diagnostic methods and unsupported beliefs regarding the dispensability of the
      right ventricle, may now be diagnosed using well-accepted criteria. Right
      ventricular infarction is clearly associated with anterior left ventricular
      infarction as well as inferior infarction. It may occur in 30% to 40% of patients
      with inferior infarction, although a much smaller percentage experience
      hemodynamic instability on the basis of right ventricular infarction.
      Pathophysiologically, right ventricular systolic and diastolic dysfunction are
      exacerbated by pericardial restraint and concomitant left ventricular
      dysfunction, accounting for the characteristic findings of cardiogenic shock and
      marked preload dependence in many patients. Right ventricular infarction may be
      suspected on the grounds of clinical presentation, physical examination, and
      enzymatic findings, and is confirmed using well-defined electrocardiographic,
      radionuclide, echocardiographic, and hemodynamic criteria. Once diagnosed, right
      ventricular infarction requires specific hemodynamic and pharmacologic
      management, including the judicious use of volume expansion and inotropic
      support. Several forms of mechanical and surgical intervention are of therapeutic
      value in treating hemodynamic disturbances and recognized complications. With
      appropriate management, the prognosis for patients with right ventricular
      infarction is generally favorable.

PMID- 1739962
TI  - Facts about the National Center for Nursing Research.

PMID- 1739963
TI  - More is better: activators and repressors from the same gene.

PMID- 1739964
TI  - Multiple extracellular activities in Drosophila egg perivitelline fluid are
      required for establishment of embryonic dorsal-ventral polarity.
AB  - Twelve maternal effect genes (the dorsal group and cactus) are required for the
      establishment of the embryonic dorsal-ventral axis in the Drosophila embryo.
      Embryonic dorsal-ventral polarity is defined within the perivitelline compartment
      surrounding the embryo by the ventral formation of a ligand for the Toll
      receptor. Here, by transplantation of perivitelline fluid we demonstrate the
      presence of three separate activities present in the perivitelline fluid that can
      restore dorsal-ventral polarity to mutant easter, snake, and spatzle embryos,
      respectively. These activities are not capable of defining the polarity of the
      dorsal-ventral axis; instead they restore structures according to the intrinsic
      dorsal-ventral polarity of the mutant embryos. They appear to be involved in the
      ventral formation of a ligand for the Toll protein. This process requires serine
      proteolytic activity; the injection of serine protease inhibitors into the
      perivitelline space of wild-type embryos results in the formation of dorsalized
      embryos.

PMID- 1739965
TI  - The Drosophila learning and memory gene rutabaga encodes a Ca2+/Calmodulin
      responsive adenylyl cyclase.
AB  - Four putative adenylyl cyclase genes from Drosophila melanogaster were identified
      by virtue of their extensive sequence homology with mammalian cyclases. One
      corresponds to the learning and memory gene rutabaga and is most similar to the
      mammalian brain Ca2+/calmodulin (CaM)-responsive cyclase. In a mammalian
      expression system, rutabaga cyclase activity was stimulated approximately 5-fold
      by the presence of Ca2+/CaM. A point mutation, identified at this locus in rut1
      mutant flies, resulted in loss of detectable adenylyl cyclase activity. New P
      element insertion-induced rutabaga mutations mapped to within 200 nucleotides of
      the 5' end of the rutabaga cDNA. These data confirm the identity of the rutabaga
      locus as the structural gene for the Ca2+/CaM-responsive adenylyl cyclase and
      show that the inactivation of this cyclase leads to a learning and memory defect.

PMID- 1739966
TI  - L. monocytogenes-induced actin assembly requires the actA gene product, a surface
      protein.
AB  - The intracellular pathogenic bacterium L. monocytogenes can spread directly from
      cell to cell without leaving the cytoplasm. The mechanism of this movement,
      generated through bacterially induced actin polymerization, is not understood. By
      analyzing an avirulent Tn917-lac mutant defective for actin polymerization, we
      have identified a bacterial component involved in this process. The transposon
      had inserted in actA, the second gene of an operon. Gene disruption of downstream
      genes and transformation of the mutant strain with actA showed that the actA gene
      encodes a surface protein necessary for bacterially induced actin assembly. Our
      results indicate that it is a 610 amino acid protein with an apparent molecular
      weight of 90 kd.

PMID- 1739967
TI  - The nontransmembrane tyrosine phosphatase PTP-1B localizes to the endoplasmic
      reticulum via its 35 amino acid C-terminal sequence.
AB  - We report the first intracellular characterization of an endogenous
      nontransmembrane protein tyrosine phosphatase (PTP). Using affinity-purified
      polyclonal antibodies, we have identified PTP-1B as a 50 kd serine phosphoprotein
      in immunoprecipitation and immunoblotting assays. Surprisingly, indirect
      immunofluorescence experiments indicate that PTP-1B is localized predominantly in
      the endoplasmic reticulum (ER). Subcellular fractionation is consistent with this
      localization and establishes that PTP-1B is tightly associated with microsomal
      membranes, with its phosphatase domain oriented towards the cytoplasm. The C
      terminal 35 amino acids of PTP-1B are both necessary and sufficient for targeting
      to the ER. The finding of a tyrosine phosphatase on the ER suggests new
      possibilities for cellular events controlled by tyrosine phosphorylation.

PMID- 1739968
TI  - Phosphorylation of initiation factor 2 alpha by protein kinase GCN2 mediates gene
      specific translational control of GCN4 in yeast.
AB  - We show that phosphorylation of the alpha subunit of eukaryotic translation
      initiation factor 2 (eIF-2) by the protein kinase GCN2 mediates translational
      control of the yeast transcriptional activator GCN4. In vitro, GCN2 specifically
      phosphorylates the alpha subunit of rabbit or yeast eIF-2. In vivo,
      phosphorylation of eIF-2 alpha increases in response to amino acid starvation,
      which is dependent on GCN2. Substitution of Ser-51 with alanine eliminates
      phosphorylation of eIF-2 alpha by GCN2 in vivo and in vitro and abolishes
      increased expression of GCN4 and amino acid biosynthetic genes under its control
      in amino acid-starved cells. The Asp-51 substitution mimics the phosphorylated
      state and derepresses GCN4 in the absence of GCN2. Thus, an established mechanism
      for regulating total protein synthesis in mammalian cells mediates gene-specific
      translational control in yeast.

PMID- 1739969
TI  - Short peptide domains target proteins to plant vacuoles.

PMID- 1739970
TI  - The leucine-Lrp regulon in E. coli: a global response in search of a raison
      d'etre.

PMID- 1739971
TI  - Antigen analog-major histocompatibility complexes act as antagonists of the T
      cell receptor.
AB  - A novel mechanism for inhibition of T cell responses is described. Using the
      recognition of the influenza hemagglutinin (HA) 307-319 peptide in the context of
      DR1 class II major histocompatibility complex molecules, we have found that
      nonstimulatory analogs of the HA peptide preferentially inhibit HA-specific T
      cells in inhibition of antigen presentation assays. This antigen-specific effect
      could be generalized to another DR1-restricted peptide, Tetanus toxoid 830-843.
      Direct binding and cellular experiments indicated that the mechanism responsible
      was distinct from competition for binding to DR1 molecules. Likewise, negative
      signaling and induction of T cell tolerance could also be excluded as effector
      mechanisms. Thus, the most likely mechanism for this effect is engagement of
      antigen-specific T cell receptors by DR1-peptide analog complexes, which results
      in antigen-specific competitive blocking of T cell responses by virtue of their
      capacity to compete with DR1-antigen complexes for binding to the T cell
      receptor.

PMID- 1739972
TI  - Introduction of intersubunit disulfide bonds in the membrane-distal region of the
      influenza hemagglutinin abolishes membrane fusion activity.
AB  - Influenza virus hemagglutinin (HA) mediates viral entry into cells by a low pH
      induced membrane fusion event in endosomes. A number of structural changes occur
      throughout the length of HA at the pH of fusion. To probe their significance and
      their necessity for fusion activity, we have prepared a site-directed mutant HA
      containing novel intersubunit disulfide bonds designed to cross-link covalently
      the membrane-distal domains of the trimer. These mutations inhibited the low pH
      induced conformational changes and prevented HA-mediated membrane fusion;
      conditions that reduced the novel disulfide bonds restored membrane fusion
      activity. We conclude that structural rearrangements in the membrane distal
      region of the HA are required for membrane fusion activity.

PMID- 1739973
TI  - A two-component regulatory system for self/non-self recognition in Ustilago
      maydis.
AB  - In U. maydis the multiallelic b locus controls sexual and pathogenic development.
      In the b locus a gene coding for a regulatory protein had been identified, and it
      was suggested that the interaction of two b polypeptides specified by different
      alleles programs sexual development in this fungus. We now demonstrate the
      existence of a second regulatory gene in the b locus. We term this gene bW and
      refer to the former as the bE gene. Both genes exist in many alleles. Although
      unrelated in primary sequence, both genes are similar in their overall
      organization. The gene products display allele-specific variability in their N
      terminal domains, show a high degree of sequence conservation in the C-terminal
      domains, and contain a homeodomain-related motif. Genetic evidence is provided to
      show that the pair of bE and bW polypeptides encoded by different b alleles is
      the key regulatory species.

PMID- 1739974
TI  - Caveolin, a protein component of caveolae membrane coats.
AB  - Caveolae have been implicated in the transcytosis of macromolecules across
      endothelial cells and in the receptor-mediated uptake of 5
      methyltetrahydrofolate. Structural studies indicate that caveolae are decorated
      on their cytoplasmic surface by a unique array of filaments or strands that form
      striated coatings. To understand how these nonclathrin-coated pits function, we
      performed structural analysis of the striated coat and searched for the molecular
      component(s) of the coat material. The coat cannot be removed by washing with
      high salt; however, exposure of membranes to cholesterol-binding drugs caused
      invaginated caveolae to flatten and the striated coat to disassemble. Antibodies
      directed against a 22 kd substrate for v-src tyrosine kinase in virus-transformed
      chick embryo fibroblasts decorated the filaments, suggesting that this molecule
      is a component of the coat. We have named the molecule caveolin. Caveolae
      represent a third type of coated membrane specialization that is involved in
      molecular transport.

PMID- 1739975
TI  - Mechanism of specificity in the Fos-Jun oncoprotein heterodimer.
AB  - Fos and Jun, the protein products of the nuclear proto-oncogenes c-fos and c-jun,
      associate preferentially to form a heterodimer that binds to DNA and modulates
      transcription of a wide variety of genes in response to mitogenic stimuli. Both
      Fos and Jun contain a single leucine zipper region. Previous studies have shown
      that the leucine zippers of Fos and Jun are necessary and sufficient to mediate
      preferential heterodimer formation. The leucine zipper regions from Fos and Jun
      are also known to fold autonomously, most likely as two-stranded, parallel coiled
      coils. We show here that 8 amino acids from Fos and from Jun are sufficient to
      mediate preferential heterodimer formation in a background of the GCN4 leucine
      zipper sequence. Using pH titration and amino acid replacements, we also show
      that destabilization of the Fos homodimer by acidic residues provides a major
      thermodynamic driving force for preferential heterodimer formation.

PMID- 1739976
TI  - Ssn6-Tup1 is a general repressor of transcription in yeast.
AB  - The homeodomain protein alpha 2 and the SRF-like protein Mcm1 are required to
      establish cell type in the yeast Saccharomyces cerevisiae. Together, these
      regulatory proteins recognize a specific DNA operator, marking a set of genes for
      transcriptional repression. In this paper, we show that occupancy of the operator
      by alpha 2-Mcm1 is not sufficient to bring about repression. Rather, repression
      is effected only when Ssn6 (a TPR protein) and Tup1 (a beta-transducin repeat
      protein) are also present in the cell. We show that Ssn6 represses transcription
      when brought to a promoter by a bacterial DNA-binding domain and that Tup1 is
      required for this repression. Based on these and other results, we propose that
      Ssn6-Tup1 is a general repressor of transcription in yeast, recruited to target
      promoters by a variety of sequence-specific DNA-binding proteins.

PMID- 1739977
TI  - Yeast and human TFIID with altered DNA-binding specificity for TATA elements.
AB  - TFIID is the highly conserved, but species-specific, component of the RNA
      polymerase II transcription machinery that binds specifically to the TATA element
      (consensus TATAAA). Using a genetic selection, we isolated an altered specificity
      derivative of yeast TFIID that permits transcription from promoters containing a
      mutated TATA element (TGTAAA). Biochemical analysis indicates that this TFIID
      derivative has specifically gained the ability to bind TGTAAA efficiently. The
      mutant protein contains three substitutions within a 12 amino acid region; two of
      these are necessary and primarily responsible for the altered specificity. An
      analogous version of human TFIID, generated by introducing the same amino acid
      substitutions in the corresponding region of the protein, can support basal and
      GCN4-activated transcription in yeast cells from a TGTAAA-containing promoter.
      These results define a surface of TFIID that directly interacts with the TATA
      element, and they indicate that human TFIID can respond to acidic activator
      proteins in conjunction with the other components of the yeast transcription
      machinery.

PMID- 1739978
TI  - A far upstream estrogen response element of the ovalbumin gene contains several
      half-palindromic 5'-TGACC-3' motifs acting synergistically.
AB  - We have identified an estrogen-responsive enhancer element (DH3 ERE) in the
      estrogen-induced DNAase I-hypersensitive region III of the chicken ovalbumin
      gene, which is located approximately 3.3 kb upstream from the mRNA start site and
      does not contain palindromic ERE. Four TGACC half-palindromic motifs, separated
      from each other by more than 100 bp, are responsible for conferring estrogen
      inducibility either to the proximal ovalbumin gene promoter or to heterologous
      promoters. Thus, widely spaced half-palindromic ERE motifs can act
      synergistically. Each half-palindromic motif was shown to bind the estrogen
      receptor (ER) with a low efficiency in vitro. However, two widely spaced half
      palindromic motifs bound the ER cooperatively, much more efficiently than
      expected from binding to isolated half-ERE motifs. The ovalbumin promoter half
      palindromic ERE motif located close to the TATA box was required for the activity
      of the distal DH3 ERE, but could be replaced by the binding sites of other
      transactivators.

PMID- 1739979
TI  - U5 snRNA interacts with exon sequences at 5' and 3' splice sites.
AB  - U5 snRNA is an essential pre-mRNA splicing factor whose function remains
      enigmatic. Specific mutations in a conserved single-stranded loop sequence in
      yeast U5 snRNA can activate cleavage of G1----A mutant pre-mRNAs at aberrant 5'
      splice sites and facilitate processing of dead-end lariat intermediates to mRNA.
      Activation of aberrant 5' cleavage sites involves base pairing between U5 snRNA
      and nucleotides upstream of the cleavage site. Processing of dead-end lariat
      intermediates to mRNA correlates with base pairing between U5 and the first two
      bases in exon 2. The loop sequence in U5 snRNA may therefore by intimately
      involved in the transesterification reactions at 5' and 3' splice sites. This
      pattern of interactions is strikingly reminiscent of exon recognition events in
      group II self-splicing introns and is consistent with the notion that U5 snRNA
      may be related to a specific functional domain from a group II-like self-splicing
      ancestral intron.

PMID- 1739980
TI  - Promoter-selective activation domains in Oct-1 and Oct-2 direct differential
      activation of an snRNA and mRNA promoter.
AB  - The promoter specificity of transcriptional activators is generally thought to be
      conferred by the specificity of the DNA-binding domain, which brings the
      activation domain to the appropriate promoter sequence. We show here, however,
      that Oct-1 and Oct-2 can differentially activate transcription not through DNA
      binding specificity but instead through the use of promoter-selective activation
      domains. These distinct activation domains lead to stimulation of the U2 small
      nuclear RNA promoter by Oct-1 and an mRNA promoter by Oct-2. An Oct-2 variant,
      called Oct-2B, differs from Oct-2 by an Oct-1-related C-terminal extension that
      results from alternative splicing. This variant gains the ability to activate the
      U2 small nuclear RNA promoter. Thus, the promoter selectivity of a
      transcriptional activator can be changed, in this case by alternative splicing,
      without affecting its DNA binding specificity.

PMID- 1739981
TI  - Articular chondrocytes secrete IL-1, express membrane IL-1, and have IL-1
      inhibitory activity.
AB  - Previous work from our laboratory has shown that rabbit articular chondrocytes,
      like macrophages, produce reactive oxygen intermediates, express Ia antigen, and
      can mediate immunologic functions such as antigen presentation and induction of
      mixed and autologous lymphocyte reactions. We were interested in seeing if these
      cells could secrete interleukin-1 (IL-1) or express membrane form of IL-1 (mIL
      1). Using the standard C3H/HeJ thymocyte assay, neither secreted IL-1 nor mIL-1
      activity was detected in untreated or LPS-treated chondrocytes. However, the
      D10.G4.1 proliferation assay showed that chondrocytes, stimulated with LPS,
      secrete IL-1 and express the mIL-1 in a dose- and time-dependent manner. The IL-1
      activity in LPS-stimulated chondrocyte supernatant and on fixed cells could be
      inhibited by anti-IL-1 antibodies. Sephadex G-75 chromatography of pooled,
      concentrated LPS culture supernatant resolved into two peaks of IL-1 activity at
      13-17 and at 45-70 kDa, respectively. The bioactivity of chromatographic
      fractions were similar using both the thymocyte and D10.G4.1 bioassays. Western
      blot analysis of chondrocyte supernatant detects 17-kDa IL-1 beta; no processed
      17-kDa IL-1 alpha was seen but IL-1 alpha-specific reactivity was observed at 64
      kDa. Immunoblot analysis of chondrocyte lysates shows that cell-associated IL-1
      is IL-1 alpha and is 37 kDa in size. PCR analysis shows the presence of mRNA for
      IL-1 beta and IL-1 alpha in LPS-treated cells; IL-1 beta mRNA was detected in
      untreated chondrocytes. The inability to detect IL-1 by the thymocyte assay is
      due to the presence of a chondrocyte inhibitor of IL-1 that can be demonstrated
      in cell sonicates, supernatants, and on paraformaldehyde-fixed chondrocytes.
      Chromatography of LPS-stimulated supernatant showed a peak of IL-1 inhibitory
      activity at 21-45 kDa. Chondrocytes which secrete IL-1 and express mIL-1 could
      play a critical role in maintaining chronic inflammation in rheumatoid arthritis.
      Therefore, the ability of chondrocytes to produce both IL-1 and an inhibitor to
      IL-1 is important in interpreting the mechanism of cartilage matrix maintenance
      and degradation.

PMID- 1739982
TI  - Control of experimental autoimmune uveoretinitis by low dose T cell vaccination.
AB  - Autoimmune T lymphocytes can be used under appropriate conditions to induce
      resistance to the specific autoimmune disease that they usually produce. This
      practice, termed T cell vaccination, was found to be effective with the injection
      of a low (subpathogenic) number of autoaggressive T line lymphocytes. We report
      here that T cell vaccination produced marked resistance to the expression of
      experimental autoimmune uveoretinitis (EAU) in Lewis rats. In addition,
      vaccination led to the appearance of lymphoid cells in the vaccinated rats that
      demonstrated proliferative responses against idiotypic and ergotypic
      specificities of the injected T cells. This is the first report demonstrating the
      effector T lymphocytes specific for ocular antigens may be used as agents to
      modulate immunopathogenic responses responsible for EAU.

PMID- 1739983
TI  - Corticosteroids inhibit the delivery of short-term activational pulses of phorbol
      ester and calcium ionophore to human peripheral T cells.
AB  - Although there is evidence that corticosteroids inhibit receptor-ligand-induced
      phospholipid hydrolysis, the immunosuppressive effects of these agents downstream
      of protein kinase C (PK-C) activation and cytosolic Ca2+ mobilization is unclear.
      Previous studies indicated that T cell proliferative activation could be achieved
      with simultaneous short-term (e.g., 15-120 min) exposure to agents activating PK
      C and elevating cytosolic Ca2+. In the studies reported here, similar procedures
      were utilized for determining whether corticosteroids alter T cell activation
      signals downstream of second messenger events. Dexamethasone interfered with T
      cell activation induced by short-term exposure to phorbol 12,13-dibutyrate (PDBu)
      and the calcium ionophore, ionomycin. The inhibitory effect was evident with as
      little as 15 min of exposure to dexamethasone and T cell activating agents,
      making mechanisms involving de novo protein synthesis unlikely. Dexamethasone's
      effects in this system were blocked by the steroid receptor antagonist RU-486,
      indicating that the inhibition was mediated through the glucocorticoid receptor.
      The inclusion of recombinant interleukin-2 (IL-2) only partially overcame the
      dexamethasone inhibitory effect. Long-term (i.e., 48 hr) direct stimulation of PK
      C with either PDBu or the non-tumor-promoting PK-C activator, bryostatin 1, also
      substantially overcame dexamethasone's effects, resulting in a recovery of IL-2
      production and significant restoration of the T-cell proliferative response.
      These observations suggest that treatment with a PK-C-activating agent such as
      bryostatin 1 could reduce glucocorticosteroid-induced immunosuppression.

PMID- 1739984
TI  - Differential regulation of IgA production by TGF-beta and IL-5: TGF-beta induces
      surface IgA-positive cells bearing IL-5 receptor, whereas IL-5 promotes their
      survival and maturation into IgA-secreting cells.
AB  - Transforming growth factor beta (TGF-beta) and IL-5 have been shown to augment
      IgA production by LPS-stimulated murine B cells. We investigated the effect of
      TGF-beta on the expression of surface Ig-isotype and IL-5 receptor on LPS
      stimulated B cells. TGF-beta increased the proportion of both surface IgA
      positive (sIgA+) B cells and sIgG2b+ B cells and enhanced IgA and IgG2b
      production by LPS-stimulated B cells. TGF-beta synergized with IL-5 only for IgA
      production of the seven Ig-isotypes and in combination with IL-5 caused a
      significant increase in the proportion of sIgA+ B cells up to 17.4%. In contrast,
      IL-5 decreased the proportion of sIgG2b+ B cells and sIgG3+ B cells and inhibited
      the production of IgG2b and IgG3 by LPS-stimulated B cells. About 50% of sIgA+
      cells induced by TGF-beta expressed IL-5 receptor. They secreted peak levels of
      IgA and seemed to maintain long viability in the presence of IL-5; whereas TGF
      beta had the opposite effects on sIgA+ B cells and down-regulated the IL-5
      receptor expression. These results indicate that TGF-beta increases the number of
      sIgA(+)- and IL-5 receptor-positive B cells which respond to IL-5 giving rise to
      IgA-secreting cells and also support the notions that TGF-beta preferentially
      induces switching to sIgA+ B cells and IL-5 induces the maturation of postswitch
      sIgA+ B cells into IgA-secreting cells in a stepwise fashion.

PMID- 1739985
TI  - Induction of macrophage interleukin-1 production by Listeria monocytogenes
      hemolysin.
AB  - Listeriolysin O produced by a hemolytic strain of Listeria monocytogenes was
      purified from the ammonium sulfate precipitate of a culture supernatant through
      the steps of ion-exchange chromatography and gel filtration. The purified
      hemolysin finally gave a single band on sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis with a molecular weight of 58,000. When peritoneal exudate
      macrophages were stimulated with purified hemolysin, we found a high level of IL
      1 activity as determined by thymocyte costimulator assay in the culture
      supernatant. Cell-associated and intracellular IL-1 activity was also detected.
      The activity in the supernatant or membrane was blocked by polyclonal antibody to
      murine IL-1 alpha. Moreover, IL-1-specific mRNA expression could be detected in
      the macrophages stimulated with listeriolysin O by Northern blot analysis.
      Possible contamination by LPS of the listeriolysin O preparation did not seem to
      contribute to the induction of macrophage IL-1 production.

PMID- 1739986
TI  - Mechanisms involved in NK resistance induced by interferon-gamma.
AB  - Human tumor cell lines were treated with interferon-gamma (IFN-gamma) and then
      used as target cells in NK assays to measure their ability to form conjugates and
      stimulate the production of NK cytotoxic factors (NKCF) and to determine their
      susceptibility to NKCF lysis. K562 and cell lines RS1, RS3, RS7, CAC, and CAP2,
      obtained from solid brain tumors, were used as targets, and peripheral blood
      lymphocytes (PBL) from normal donors were used as effector cells. IFN-gamma
      treated cell lines had a decreased susceptibility to NKCF lysis and a decreased
      ability to induce the release of these factors without affecting target-effector
      cell binding. These results were not due to changes in HLA class I antigen
      expression, given that the level of HLA class I antigens on the tumor cell lines
      was not affected, the only exception being K562. In an attempt to further clarify
      the possible influence of HLA class I expression on K562, IFN-gamma-pretreated
      K562 cells were separated into HLA class I positive and HLA class I negative
      subsets for the NK assays. The results showed that both populations behaved
      similarly upon target-effector conjugate formation, whereas the HLA class I
      positive population showed a reduced susceptibility to lysis by NK cells and
      NKCF. Thus, these results establish that NK resistance induced by IFN-gamma is
      mediated by blocking the target cell's ability to activate NK cell triggering and
      release of NKCF and by blocking its susceptibility to lysis by these factors.
      This analysis helps to clarify not only the NK process but also the controversial
      regulatory effect of IFN in NK lysis.

PMID- 1739987
TI  - Antigen recognition and IL-2 receptor gene expression as evidence against clonal
      deletion in mice with neonatally induced transplantation tolerance.
AB  - Neonatal transplantation tolerance was induced in B10.A mice by the injection of
      spleen and bone marrow cells from semiallogeneic [C57BL/10(B10) x B10.A] F1
      donors. The neonatally treated mice accepted skin grafts from B10 donors. Spleen
      cells from tolerant animals did not respond by proliferation to tolerated B10
      antigens in vitro. However, spleen cells from tolerant mice recognized specific
      (B10) antigens and synthesized mRNA for the inducible 55-kDa interleukin-2
      receptor (IL-2R) as did cells from normal animals. Maintenance of this early
      phase of cell activation upon contact with tolerated antigens is direct evidence
      against clonal deletion as a mechanism, in this particular model of neonatally
      induced transplantation tolerance.

PMID- 1739988
TI  - Protective immunity and granulomatous inflammation is mediated in vivo by T cells
      reactive to epitopes common to avirulent and listeriolysin-negative mutants of
      Listeria monocytogenes.
AB  - The ability of several listeriolysin O-negative mutants of the EGD and NCTC 7973
      strains of Listeria monocytogenes to activate specific T cell responses in vitro
      and in vivo was determined. T cell lines from different inbred mouse strains and
      derived T cell clones elicited by L. monocytogenes, strain EGD, which are able to
      adoptively transfer protection and granuloma formation were examined. Specificity
      testing revealed no differences between listeriolysin-positive and -negative
      strains to induce proliferation of the T cell lines and clones. Similar results
      were obtained when we examined CD4+ T cell-mediated granuloma formation in the
      livers of mice previously immunized with viable bacteria of the virulent strain.
      Granulomatous inflammation could be elicited by iv application of heat-killed
      bacteria of listeriolysin-positive and of -negative bacteria. Protective immunity
      to listerial infections and granulomatous inflammation therefore appears to be
      mediated by T cells recognizing epitopes on listerial antigens that are shared by
      both pathogenic and nonpathogenic Listeria strains.

PMID- 1739989
TI  - Inhibition of the anti-CD3-induced T cell proliferation by crosslinking of
      stimulatory antibodies in the presence of PMA and interleukin-2.
AB  - Anti-CD3 antibodies are directed to the nonpolymorphic part of the T cell
      receptor complex and may activate human peripheral T cells. Under some
      circumstances crosslinked anti-CD3 has been described to augment the
      proliferative response. Here we demonstrate that crosslinking of stimulatory anti
      CD3 antibodies by anti-IgG in cell suspension abolishes their effect on
      proliferation of human resting peripheral T cells in the presence of PMA and/or
      IL-2. This effect was observed within a wide range of anti-CD3 concentrations (1
      ng/ml to 1 microgram/ml) independent of the presence of monocytes. The inhibition
      was not due to the induction of cell death, since cells remained propidium iodide
      negative after treatment. Protein-tyrosine phosphorylation after anti-CD3
      crosslinking was more pronounced than in the presence of noncrosslinked anti-CD3.
      This indicates that the signal was transmitted after anti-CD3 crosslinking,
      however, it was unable to induce T cell proliferation. Reduced IL-2 receptor
      expression after anti-CD3 crosslinking and the inability of exogenous IL-2 to
      restore the proliferative response might indicate a reduced susceptibility to IL
      2 as a reason for the described phenomenon.

PMID- 1739990
TI  - [Color vision in pseudophakia].
AB  - The authors compare colour differentiation of 30 phakic and 30 pseudophakic eyes,
      using the Farnsworth-Munsell 100-hue test. No significant difference was found
      between the two groups as regards differentiation of colours although
      theoretically it could be expected that colour differentiation will be better in
      eyes with a synthetic intraocular lens. The factor which has the greatest
      influence on colour sense is the subject's age.

PMID- 1739991
TI  - [Changes in color differentiation using the 100-Hue Test. I. The total score on
      the test in relation to age].
AB  - The authors investigated colour differentiation, using the FM 100-hue test in
      healthy subjects without hypertension and diabetes and with a normal
      ophthalmological finding and normal functions. They examined 120 subjects, i.e.
      240 eyes--120 male eyes and 120 female eyes in six decades from 21-80 years. The
      examination revealed a significant diminution of colour differentiation with
      advancing age but no difference in colour differentiation between men and women.
      The tests can be considered at the same time a basic orientation standard for
      evaluation of colour differentiation.

PMID- 1739992
TI  - [Hamartomas of the optic disc and adjacent retina].
AB  - The authors discuss some formations on the optic disk and close neighbourhood
      resembling tumours. They originate from various cellular elements in that area
      and are described as hamartomas. A progressive growth was recorded only in
      vascular hamartomas after unsuccessful therapeutic intervention, the remainder
      were stationary during observation periods of various lengths.

PMID- 1739993
TI  - [Changes in color differentiation using the 100-Hue Test. II. The score for basic
      colors of the spectrum in relation to age].
AB  - The author investigated changes of colour sensitivity of red, green and blue,
      using the FM 100-hue test. For examination healthy subjects without hypertension
      and diabetes and with a normal ophthalmological finding and normal functions were
      selected. In six age groups (21-80 years) 240 male and female eyes were examined.
      In the youngest age group there was greatest proportion of errors in the blue
      area, less in the green area and the least in the red area. A more detailed
      analysis revealed that the greatest rate of errors was in the blue-green area.
      With advancing age the number of errors in the areas of the basic colours
      increase and at the same time differences between differentiation of red, green
      and blue decrease. In the age group above 71 years no differences were found in
      the score of errors in the area of basic colour.

PMID- 1739994
TI  - [Clinical index for prediction of visual acuity after cataract surgery--personal
      experience].
AB  - The authors are giving an account of their own experience with the clinical index
      for prediction of the visual acuity after cataract surgery. The index uses the
      following data - age, visual acuity before operation, number of regularly taken
      drugs and frequency of reading before operation. In 171 eyes of patients operated
      on account of cataract by different techniques (the patients were not specially
      selected and some suffered from other eye diseases), the authors found a close
      agreement between the vision predicted by means of the clinical index and the
      final visual acuity after operation. Agreement was recorded in 68%. The authors
      recommend the clinical index for more extensive clinical tests.

PMID- 1739995
TI  - [Calculations for intraocular lenses].
AB  - The authors deal with the postoperative dioptric deviation from the calculated
      optic potency of the emetropic intraocular lens, using formulae SRK II, SRK/T and
      Holladay's formula. Within the range +/- 1.5 D the deviation varied in 84% of the
      operated eyes where the intraocular lens was assessed according to formula SRK
      II; in 76% when formula SRK/T was used and in 74% when Holladay's formula was
      used. The authors give also an account of possible sources of errors during
      measurement, calculation and evaluation of results.

PMID- 1739996
TI  - [Objective evaluation of the success of treatment in exudative diabetic
      maculopathy].
AB  - The effectiveness of pharmacological and laser treatment of diabetic maculopathy
      was evaluated so far according to the change of visual acuity and the
      ophthalmoscopic picture. Computer comparison of the size of the photographic
      picture of the circinata before treatment and in the course of treatment makes
      objective evaluation of treatment of exudative diabetic maculopathy possible.

PMID- 1739997
TI  - [Thrombolysis of arterial retinal occlusion using urokinase].
AB  - The authors present an account on possible aimed thrombolytic treatment of
      occlusion of the retinal artery by urokinase. Aimed thrombolysis can be performed
      at ophthalmological departments with an available radiodiagnostic department,
      which performs angiographies of carotid arteries. The authors discuss the
      necessary dose of 200,000 to 300,000 i.u. of urokinase. One-hour infusion with an
      initial booster dose is best. Early administration of the preparation is
      considered most important by the authors. The authors present the case-history of
      a 34-year-old patient with complete occlusion of the central retinal artery with
      haemodynamically severe aortal stenosis with a congenital background. Urokinase
      was administered six hours after occlusion of the artery. Gradually reperfusion
      of the retina occurred and improvement of the visual acuity from 0.01 to 0.17
      with a residual relative wedge-shaped loss of the visual field and paleness of
      the disc of the optic nerve.

PMID- 1739998
TI  - [Ocular changes in Alport's syndrome].
AB  - In a group of 17 patients with Alport's syndrome changes on the ocular fundus
      were detected in 35.3% without influence on the central visual acuity. At the
      same time a statistically significant reduction of sensitivity to contrast was
      proved. ERG examination revealed statistically significant changes in the a and b
      wave as regards steepness and in the b wave also as regards amplitude.

PMID- 1739999
TI  - [Changes in the visual field after laser coagulation in type I diabetics].
AB  - The authors examined 41 eyes of 22 compensated type I diabetics 1 - 2 years after
      laser photocoagulation, using an automatic static perimeter Peritest. One fifth
      of the investigated patients had marked changes - DR20. The patients are not
      aware of the diminution of the visual field. Even the most extensive diminution
      of the visual field in this group did not restrict the ability to drive motor
      vehicles.

PMID- 1740000
TI  - [Treatment of chronic uveitis with long-term administration of penicillin].
AB  - The authors followed up a group of 20 patients with chronic uveitis (10 men and
      10 women), mean age 36.5 years. Despite treatment of the foci, they suffered on
      average from seven relapses of the disease, frequently several times in the
      course of one year. From the anamnestic aspect there was a significantly high
      number of spells of tonsillitis, respiratory infections and arthralgia. Half the
      cases of uveitis, mainly anterior, were bilateral. The patients suffered from
      dysimmunoglobulinaemia with low values of FW, ASLO, Latex. HLA B 27 was positive
      in five subjects. After one-year of Pendepon or Penclen administration (in half
      the patients with NORG) 18 patients did not develop a relapse for a period of 2-3
      years. The method is simple, cheap, easy to use in field practice, in particular
      in junior patients. The clinical effect of treatment justifies the use of this
      method as an alternative of intermittent immunosuppression.

PMID- 1740001
TI  - [Keratoplasty in children].
AB  - The authors report anatomical and functional results of 24 keratoplasties in
      children aged 7 months to 15 years, incl. analysis of peroperative and
      postoperative complications. A total of 24 keratoplastics were performed on 20
      eyes of 20 children. The mean follow up period was 2.1 years. Nineteen times the
      first operation was involved, three times the first, twice the second
      rekeratoplasty. The most frequent postoperative complication was an immunological
      reaction of the disk which occurred in 33%. It caused turbidity of five disks.
      After keratoplasty 11 disks remained transparent (45.8%), 10 disks became turbid
      (41.7%) and three disks semitransparent (12.5%). A visual acuity of 6/12 or
      better was recorded in 7 eyes (39%) and 6/60 and better in 6 eyes (30%). The
      cause of reduced visual acuity beneath 6/12 with a clear disk was in three
      instances amblyopia, in one case nystagmus.

PMID- 1740002
TI  - [Diseases of the pupil].

PMID- 1740003
TI  - Transgeneration transmission of carcinogenic risk.

PMID- 1740004
TI  - 2-Aminofluorene-DNA adducts in mouse urinary bladder: effect of age, sex and
      acetylator phenotype.
AB  - Formation of urinary bladder DNA-2-aminofluorene adducts in inbred and acetylator
      congenic mice was measured 3 h after a 60 mg/kg dose of the arylamine carcinogen.
      The sensitivity of 32P-postlabeling with HPLC analysis permitted quantitation of
      adducts in individual mouse bladders. Acetylator phenotype was a significant
      determinant of DNA damage in female mice as slow acetylators had higher levels of
      bladder DNA adducts than rapids. This correlation is the reverse of that seen
      with hepatic DNA. Age was also a significant determinant of DNA damage as older
      mice (20-23 weeks) formed more bladder DNA adducts than young (7 week) mice. The
      age-related increase in bladder adduct formation was seen in both sexes of all
      mouse lines. Male B6 mice exposed to 2-aminofluorene at 20-23 weeks of age showed
      a 26-fold higher level of bladder DNA adducts than males exposed at 7 weeks. In
      addition to the large increase in total adduct level, the older male B6 mice
      produced significant amounts of an unidentified, early-eluting adduct peak that
      had chromatographic properties similar to an aminofluorene-DNA adduct produced
      through peroxidative activation. These results indicate that age, sex and
      acetylator phenotype are all important determinants of aromatic amine-bladder DNA
      adduct formation in mice.

PMID- 1740005
TI  - Cytochrome P450IA expression in adult and fetal human liver.
AB  - A monoclonal antibody has been produced that recognizes the cytochrome P450 form,
      cytochrome P450IA1, but not cytochrome P450IA2 in rats and recognizes a single
      protein band of similar mol. wt on immunoblots of human liver microsomes.
      Immunohistochemical studies have been carried out with this antibody to
      investigate the localization and distribution of cytochrome(s) P450 of the P450IA
      family in human liver. Cytochrome P450IA was identified in both adult and fetal
      liver and in each case it was localized predominantly to hepatocytes. In adult
      liver there was a heterogeneous distribution of cytochrome P450IA
      immunoreactivity with cytochrome P450IA mainly present in zone 3 hepatocytes of
      the liver acinus. Within fetal liver there was a uniform distribution of
      cytochrome P450IA immunoreactivity with no apparent zonal distribution. Bile duct
      epithelium did not show definite immunostaining for cytochrome P450IA in either
      adult or fetal liver.

PMID- 1740006
TI  - Enhanced induction of epidermal ornithine decarboxylase activity in C57BL/6
      compared to DBA/2 mice by protein kinase C-activating skin tumor promoters:
      relevance to genetically mediated differences in promotion susceptibility.
AB  - Previous work from our laboratory demonstrated that 12-O-tetradecanoylphorbol-13
      acetate (TPA) or a synthetic diacylglycerol induced significantly higher
      epidermal ornithine decarboxylase (ODC) activity in C57BL/6 than in DBA/2 mice.
      To understand further the genetic basis for this strain difference, two tumor
      promoters were evaluated for their effects on epidermal ODC activity: teleocidin,
      which activates protein kinase C (PKC); and 1,8-dihydroxyl-3-methyl-9-anthrone
      (chrysarobin), which does not. In addition, the ODC induction response in B6D2F1
      offspring and BXD recombinant inbred (RI) strains was examined following multiple
      treatments with TPA. A single topical application of teleocidin to mouse dorsal
      skin led to the hyperinduction of epidermal ODC activity in C57BL/6 mice. In
      contrast, while chrysarobin induced epidermal ODC activity, no significant
      differences in the magnitude of this response were observed in SENCAR, DBA/2 or
      C57BL/6 mice. Consistent with our previous findings, the magnitude of ODC
      induction by teleocidin in these three mouse lines (C57BL/6 greater than SENCAR
      greater than DBA/2) did not correlate with their susceptibility to tumor
      promotion by TPA (SENCAR greater than DBA/2 greater than C57BL/6). ODC activity
      induced by multiple application of TPA in B6DF1 mice, whose susceptibility to
      phorbol ester tumor promotion is inherited as an incomplete dominant trait, was
      comparable to that induced in C57BL/6 mice at all the doses examined. Cluster
      analysis of TPA-induced ODC activity in BXD RI strains allowed us tentatively to
      group them into four or five phenotypes and to estimate a minimum of two genetic
      loci controlling TPA-induced ODC activity. Furthermore, in BXD RI strains, there
      was no apparent relationship between the magnitude of ODC induction and
      responsiveness to tumor promotion or sustained hyperplasia. Collectively, these
      results suggest that hyperinducibility of ODC in response to PKC-activating tumor
      promoters is inherited as an autosomal dominant trait, and that genetic
      determinants for ODC induction, at least in C57BL/6 and DBA/2 mice, appear
      completely independent of those controlling tumor promotion susceptibility.

PMID- 1740007
TI  - UVC modulation of epidermal growth factor receptor number in HeLa S3 cells.
AB  - Induction of transforming growth factor alpha (TGF alpha) in human cell lines by
      254 nm ultraviolet radiation (UVC) suggests that TGF alpha may have an autocrine
      role in UV-induced tumorigenesis. Binding of TGF alpha to epidermal growth factor
      receptor (EGFR) is an important initial step in transducing the signal for cell
      division. Experiments reported herein were designed to determine whether, in
      addition to inducing TGF alpha, UVC might also induce changes in the levels of
      EGFR on HeLa S3 cells [125I]EGF binding to HeLa S3 cells was inhibited 8 h after
      exposure to 7 J/m2 UVC radiation followed by increased [125I]EGF binding 16-32 h
      after irradiation. Scatchard analysis of EGF binding at 28 h indicated that
      irradiated cells had 60% more receptors with no differences in apparent binding
      affinities (56,300 +/- 5494 receptors versus 34,900 +/- 1899 receptors in sham
      irradiated cells). Cell cycle analysis at 8 h post-UVC indicated that cells had
      slowed traverse of S-phase, but by 24 and 48 h, times at which increases in
      [125I]EGF were evident, cell cycle distributions were essentially back to normal.
      These results indicate that UVC modulates EGFR numbers in HeLa S3 cells and
      suggest that solar radiation may modulate EGFR numbers in keratinocytes or other
      cells in the skin. The presence of UV-induced growth factors such as TGF alpha
      and increased levels of EGFR may result in sustained cell proliferation by
      autocrine or paracrine mechanisms. These populations of cycling cells would then
      be at risk for subsequent mutational events that result in transformation to a
      tumorigenic state.

PMID- 1740008
TI  - JB6 murine epidermal cell lines sensitive and resistant to 12-O
      tetradecanoylphorbol-13-acetate (TPA)-induced transformation exhibit differential
      arachidonic acid metabolism in response to TPA and the calcium ionophore A23187.
AB  - In a study of arachidonic acid metabolism in murine epidermal JB6 cells, promoter
      sensitive (P+) and promoter-resistant (P-) variants, labeled with [3H]arachidonic
      acid, were treated successively with 12-O-tetradecanoylphorbol-13-acetate (TPA)
      and the calcium ionophore A23187. Released radiolabel was separated by HPLC and
      identified by coelution of standards. Prostacyclin release was then quantified by
      radioimmunoassay for 6-keto prostaglandin (PG)F1 alpha. A23187 alone resulted in
      a small but significant enhanced release of radiolabel from both cell variants
      (0.7 +/- 0.2% for P- and 0.6 +/- 0.3% for P+ cells; mean +/- SD). Treatment with
      TPA and subsequent treatment with A23187 resulted in a synergistically enhanced
      release of radiolabel from both cell variants (4.1 +/- 0.8% for P- and 3.4 +/-
      0.9% for P+ cells) relative to that with either agent alone. Although the
      predominant product for each treatment regimen was prostaglandin E2 (PGE2), the
      TPA-resistant cells (P-) released significantly more 6-keto PGF1 alpha, a stable
      breakdown product of PGI2, than did the TPA-sensitive (P+) cells. These results
      indicate differential arachidonic acid metabolism between JB6 cell variants
      resistant and sensitive to TPA-induced transformation.

PMID- 1740009
TI  - Investigation of the covalent binding of styrene-7,8-oxide to DNA in rat and
      mouse.
AB  - Styrene-7,8-oxide (SO), the main intermediate metabolite of styrene, induces
      hyperkeratosis and tumors in the forestomach of rats and mice upon chronic
      administration by gavage. The aim of this study was to investigate whether DNA
      binding could be responsible for the carcinogenic effect observed. [7-3H]SO was
      administered by oral gavage in corn oil to male CD rats at two dose levels (1.65
      or 240 mg/kg). After 4 or 24 h, forestomach, glandular stomach and liver were
      excised, DNA was isolated and its radioactivity determined. At the 4 h time
      point, the DNA radioactivity was below the limit of detection in the forestomach
      and the liver. Expressed in the units of the covalent binding index, CBI = (mumol
      adduct/mol DNA nucleotide)/(mmol chemical administered/kg body wt), the DNA
      binding potency was below 2.6 and 2.0 respectively. In the glandular stomach at 4
      h, and in most 24 h samples, DNA was slightly radiolabeled. Enzymatic degradation
      of the DNA and separation by HPLC of the normal nucleotides showed that the DNA
      radioactivity represented biosynthetic incorporation of radiolabel into newly
      synthesized DNA. The limit of detection of DNA adducts in the glandular stomach
      was 1.0. In a second experiment, [7-3H]SO was administered by i.p. injection to
      male B6C3F1 mice. Liver DNA was analyzed after 2 h. No radioactivity was
      detectable at a limit of detection of CBI less than 0.6. In agreement with the
      relatively long half-life of SO in animals, the chemical reactivity of SO appears
      to be too low to result in a detectable production of DNA adducts in an in vivo
      situation. Upon comparison with the DNA-binding of other carcinogens, a purely
      genotoxic mechanism of tumorigenic action of SO is unlikely. The observed
      tumorigenic potency in the forestomach could be the result of strong tumor
      promotion by high-dose cytotoxicity followed by regenerative hyperplasia.

PMID- 1740010
TI  - Contributions of human liver cytochrome P450 enzymes to the N-oxidation of 4,4'
      methylene-bis(2-chloroaniline).
AB  - 4,4'-Methylene-bis(2-chloroaniline) (MOCA) can produce tumors in rodents and dogs
      and an increased incidence of bladder tumors has been reported in exposed
      workers. It is therefore of interest to identify the human cytochrome P450 (P450)
      enzymes involved in MOCA N-oxidation, the primary reaction involved in the
      formation of an electrophilic product. Human liver microsomes were fractionated
      and MOCA N-oxidation activity was monitored through the procedure. The most
      active enzyme fraction corresponded to P450 3A4, as determined by immunochemical
      assays and N-terminal amino acid sequence analysis. Yeast recombinant P450 3A4
      also had MOCA N-oxidation activity. Purified human liver P450 2A6 showed
      catalytic activity; however, anti-P450 2A6 inhibited less than 20% of the
      microsomal activity while anti-P450 3A4 inhibited up to 75%. Levels of marker
      activities of both P450 3A4 (nifedipine oxidation) and P450 2A6 (coumarin 7
      hydroxylation) were measured in a set of human liver microsomes and both were
      correlated with MOCA N-oxidation rates. Gestodene and troleandomycin inhibited up
      to half of the microsomal MOCA N-hydroxylation activity but 7,8-benzoflavone
      showed only slight inhibition. Anti-P450 3A4 inhibited (up to 80% of) the
      microsomal transformation of MOCA to a product genotoxic as judged by bacterial
      SOS response. The work indicates that P450 3A4 makes a major contribution to
      human liver microsomal MOCA N-oxidation, and P450 2A6 has a minor role. P450 1A2,
      which catalyzes the hydroxylation of many arylamines, does not contribute to a
      great extent.

PMID- 1740011
TI  - Mutagenicity in V79 cells of N-nitrosobis(2-hydroxypropyl)amine and N
      nitrosobis(2-oxopropyl)amine activated by tissues from hamsters fed low and high
      fat diets.
AB  - Hepatocytes and pancreas duct tissues from male Syrian hamsters fed high-fat
      (HFD) and low-fat (LFD) diets were used to activate N-nitrosobis(2
      hydroxypropyl)amine (BHP) and N-nitrosobis(2-oxopropyl)amine (BOP) in the V79
      cell mutagenicity assay. V79 DNA alkylation by BHP and BOP was also measured.
      There was a 3.5-fold increase in BHP mutagenicity but only a 1.4-fold increase in
      BOP mutagenicity when hepatocytes from HFD-fed hamsters were used over the
      mutagenicity when hepatocytes from LFD-fed hamsters were used. When pancreas duct
      tissue was the activating system there was a 2-fold increase in BHP and BOP
      mutagenicity. O6-Methylguanine levels in V79 DNA rose 4-fold when hepatocytes
      from HFD-fed hamsters were used to activate BOP but they declined when BHP was
      the alkylating agent.

PMID- 1740012
TI  - Endogenous glutathione levels modulate both constitutive and UVA
      radiation/hydrogen peroxide inducible expression of the human heme oxygenase
      gene.
AB  - Induction of the expression of the mammalian heme oxygenase gene appears to be a
      general response to oxidant stress. In view of the role of glutathione in
      protecting cells against solar UVA radiation and other forms of oxidant stress,
      we have investigated the relationship between intracellular glutathione levels
      and the inducibility of the human heme oxygenase gene after treatment of
      populations of cultured skin fibroblasts with either UVA radiation or hydrogen
      peroxide. We observe a clear relationship between cellular glutathione status and
      both the constitutive and oxidant-inducible accumulation of heme oxygenase mRNA.
      Glutathione depletion may lead to enhanced gene expression either as a result of
      the potentiated accumulation of active oxygen intermediates or as a result of the
      direct influence of glutathione on a critical target involved in signal
      transduction.

PMID- 1740013
TI  - Investigation on the carcinogenic effects of coal tar pitch in rat respiratory
      tract by intratracheal instillations.
AB  - The effects of coal tar pitch (CTP) on the tracheobronchial mucosa of Wistar rats
      were studied. Three groups of animals received 10 weekly intratracheal
      instillations of CTP at the cumulative doses of 6.48, 136.56 and 200 mg
      respectively. The control group of rats received 10 weekly intratracheal
      instillations of charcoal powder at a cumulative dose of 20 mg. The study in
      which the animals were killed serially revealed that CTP had conspicuous damage
      on the respiratory system of rats, especially on the bronchiolo-alveolar areas.
      The lesions induced by CTP ranged from hyperplastic, metaplastic and dysplastic
      changes to extensive cancers. These lesions were usually multifocal, and were
      more severe in the rats receiving higher dosages of CTP. The deposition of CTP
      particles within or adjacent to these lesions could be readily identified. Lung
      cancers occurred in 12.5% (4/32) and 25% (10/40) of the rats treated with 136.56
      and 200 mg of CTP, whereas no tumors were found in control rats and the rats that
      received 6.48 mg of CTP. The overall cancer incidence significantly related to
      the cumulative dose of CTP. The histological types of lung cancers consisted of
      squamous cell carcinomas (10 out of the 14 lung cancers), adenocarcinoma (1/14),
      and combined squamous and adenocarcinomas (3/14). The development of CTP-induced
      rat lung cancers appears to derive from the hyperplasias of bronchiolo-alveolar
      epithelium, and processing stages of squamous metaplasias and/or dysplasias to
      carcinomas. The present results confirmed the carcinogenic effects of CTP on the
      respiratory system of rats, and provided experimental evidence for human lung
      carcinogenesis, particularly in those occupationally exposed to coal tars or tar
      products.

PMID- 1740014
TI  - Adenylate cyclase activity in crude liver membranes during chemical
      hepatocarcinogenesis in portacaval shunted rats.
AB  - Hepatocarcinogenesis was initiated in rats with diethylnitrosamine (DEN) followed
      by a selection with 2-acetylamino-fluorene (2-AAF). Portacaval shunt was then
      performed in order to promote tumor development. Control rats were not submitted
      to the initiation--selection protocol and were sham-operated. In control rats,
      adenylate cyclase activity from crude liver membranes was stimulated 7- to 8-fold
      by maximal doses of glucagon (10(-6) M) or guanyl-5'-yl-imidophosphate [Gpp(NH)p]
      (10(-3) M), and 17-fold by a maximal (10(-5) M) dose of forskolin. Guanosine-5'-O
      (2-thiodiphosphate) inhibited the response to forskolin (-38%) and to low doses
      of glucagon (-50%). The initiation--selection protocol increased the activity in
      basal conditions and in response to various stimuli. The portacaval shunt did not
      modify the activity of the enzyme with respect to basal activity or the response
      to glucagon. It significantly decreased the response to Gpp(NH)p (-45%) and to
      forskolin (-27%). The initiation--selection protocol increased the basal activity
      of the enzyme (+150%) and its response to Gpp(NH)p (+300%). When tumors
      developed, the activity of the cyclase further increased (+200%) and an
      inhibitory effect of GTP on the hormone-stimulated enzyme appeared (-40%). From
      these results, it is concluded that the promotion of hepatocarcinogenesis by
      portacaval shunt is coupled with modifications in the activity of adenylate
      cyclase in response to glucagon and guanylnucleotides.

PMID- 1740015
TI  - Induction of 8-hydroxydeoxyguanosine in Ah-responsive mouse liver by iron and
      Aroclor 1254.
AB  - Treatment of Ah-responsive C57BL/10ScSn mice with iron greatly sensitizes them to
      induction of hepatic porphyria and tumour formation by the polychlorinated
      biphenyl mixture Aroclor 1254. In the present studies, male C57BL/10ScSn mice
      received a single dose of iron-dextran (600 mg Fe/kg) and were fed a diet
      containing 0.01% Aroclor 1254 for 1, 3 and 5 weeks. By use of HPLC with
      electrochemical detection, 8-hydroxydeoxyguanosine (8-OHdG) was then measured in
      liver DNA as a marker for oxidative damage. Treatments with iron or Aroclor alone
      did not result in a significant increase in 8-OHdG except at 3 weeks following
      iron treatment. At 1 and 3 weeks 8-OHdG levels were induced approximately 3- and
      5-fold above control groups respectively in iron- and Aroclor-treated animals.
      Although there was an apparent 5- to 10-fold increase in the level of 8-OHdG at 5
      weeks, this was partially attributed to the in vitro effects of porphyrins,
      levels of which were massively elevated in liver at this time point. The
      iron/Aroclor-induced synergistic elevation of 8-OHdG at 1 and 3 weeks was
      concluded to be due to in vivo damage, thus suggesting the importance of DNA
      oxidation in the early events of carcinogenesis in this system.

PMID- 1740016
TI  - Differential sensitivities of transplacentally initiated newborn mouse epidermal
      cells to different tumor promoters.
AB  - Epidermal cells isolated from newborn mice and cultured in low Ca2+ (0.02 mM)
      medium showed typical basal cell morphology and proliferated as monolayer. An
      increase in the medium Ca2+ concentration to normal level (1.8 mM) induced
      terminal differentiation of epidermal cells. Epidermal cells obtained from
      newborn mice transplacentally initiated with 7,12-dimethylbenz[a]anthracene
      (DMBA) produced a small number of rapidly growing cellular foci with epidermal
      morphology when the medium Ca2+ concentration was raised to normal level. The
      number of these Ca(2+)-induced differentiation-resistant colonies increased with
      increasing doses of DMBA, indicating that the differentiation-resistant colonies
      are the cells initiated by DMBA. Three differentiation-resistant colonies were
      cloned and designated as WY-1, WY-18 and WY-20 cells. All of these cell lines
      grew rapidly in the normal Ca2+ medium but not in the low Ca2+ medium. A potent
      skin tumor promoter, 12-O-tetradecanoyl-phorbol-13-acetate (TPA), and other TPA
      type second-stage tumor promoters such as mezerein and 12-O-retinoylphorbol-13
      acetate, stimulated the growth of WY-18 and WY-20 cells in the low Ca2+ medium,
      but did not stimulate the growth of WY-1 cells. TPA stimulated DNA synthesis and
      ornithine decarboxylase induction in WY-18 and WY-20 cells but not in WY-1 cells.
      A non-TPA-type tumor promoter, okadaic acid, failed to stimulate the growth of
      these three cell lines. Another non-TPA-type tumor-promoting agent, 7-bromo
      methylbenz[a]anthracene, also failed to stimulate the growth of WY-1 and WY-20
      cells but stimulated the growth of WY-18 cells. WY-18 and WY-20 cells formed
      colonies in soft agar but WY-1 cells did not form colonies. When these cell lines
      were injected s.c. into nude mice, WY-1 cells produced fast-growing tumors,
      whereas WY-18 and WY-20 cells produced relatively slow-growing tumors. Our
      present results indicate that each initiated cell has different sensitivities for
      different types of tumor promoters, and each type of promoter acts on
      corresponding types of initiated cells.

PMID- 1740017
TI  - Expression of ribosomal phosphoprotein PO is induced by antitumor agents and
      increased in Mer- human tumor cell lines.
AB  - We initiated this study to determine whether three structurally related
      bifunctional alkylating agents could induce the expression of a presumptive human
      DNA repair gene. The gene chosen for this study is known to encode the ribosomal
      phosphoprotein PO, but ironically may also share functions related to DNA repair.
      We now show by Northern analysis that PO is induced by L-phenylalanine mustard, 4
      hydroperoxycyclophosphamide and mechlorethamine, which are DNA-damaging agents
      commonly used as chemotherapeutic antitumor agents. In further support of its
      involvement in DNA repair is the finding of a 30- to 50-fold constitutive
      overexpression of the PO gene in human tumor cell lines that are Mer-, cells
      which lack O6-methylguanine methyltransferase activity, when compared to Mer+
      cell lines. This constitutively elevated level of PO in Mer- cell lines, which
      are thus DNA repair defective for O6-alkyguanine lesions, was not observed for
      other genes tested, including the human ribosomal gene S17 whose mRNA steady
      state levels were uniformly the same in both Mer- and Mer+ cells. Taking these
      data together, it appears that increased levels of PO are somehow linked to DNA
      repair, and increased expression of PO may compensate for the decreased O6
      methylguanine DNA methyltransferase activity in Mer- cells. Furthermore, the PO
      gene has also been shown to be overexpressed in colorectal tumors and polyps and
      the sera of some systemic lupus erythematosus patients contain antibodies against
      PO. The titer of the anti-PO antibodies rises significantly during lupus
      psychosis.

PMID- 1740018
TI  - Loss of peroxisomal enzyme expression in preneoplastic and neoplastic lesions
      induced by peroxisome proliferators in rat livers.
AB  - Immunohistochemical staining of enoyl CoA hydratase (ECH), a key peroxisomal
      enzyme, revealed that the putative preneoplastic lesions induced in livers by
      administration of the peroxisome proliferator (PP) clofibrate (0.3% in diet) to
      rats for 60 weeks or more, lacked this enzyme so that they could be detected as
      ECH-negative foci. ECH and other peroxisomal enzymes such as acyl CoA oxidase,
      catalase and carnitine-dependent acetyltransferase were also either not or only
      weakly expressed in most hepatic hyperplastic nodules and hepatomas induced by
      ciprofibrate (0.025% in diet), Wy-14,643 (0.1%) or BR-931 (0.2%), while being
      strongly induced in surrounding hepatocytes. These results indicate that the
      expression of ECH and other peroxisomal enzymes is repressed in putative
      preneoplastic and neoplastic lesions induced by PPs in rat livers and that these
      peroxisomal enzymes might therefore be used as negative markers.

PMID- 1740019
TI  - Rat pituitary changes observed with magnetic resonance imaging following removal
      of estrogen stimulus: correlation with histopathology and immunohistology.
AB  - The effect of estrogen withdrawal on pituitary glands of rats treated with
      estradiol-17 beta for various lengths of time was monitored by magnetic resonance
      imaging (MRI) and histological examination. Estrogen pellets were removed at
      seven different time points ranging from 4 to 206 days after pellet implantation.
      High-resolution mid-sagittal MR images of the rat head were made 1 day before
      pellet implantation, immediately following pellet withdrawal, and 14 and 28 days
      after pellet withdrawal. Twenty-eight days after pellet withdrawal pituitary
      glands were fixed and processed for histological examination. Enlarged
      pituitaries were detected by MRI from 16 days after implantation and onwards.
      Twenty-eight days after estrogen withdrawal the typical triangular shape of the
      normal pituitary had returned and pituitary morphology was indistinguishable from
      that of normal pituitaries in all rats that had been treated with estrogen for up
      to 114 days. Pituitaries of rats that had received estrogen for 186 days had a
      normal MR image 28 days after estrogen withdrawal, but microscopic examination
      revealed multifocal hyperplasias of prolactin-positive cells throughout the pars
      distalis. MRI of rats treated for 206 days showed tumorously enlarged
      pituitaries. There was no evidence of tumor regression in these rats 28 days
      after pellet removal. It was concluded that hypertrophic pituitaries regained a
      normal size, shape and morphology after estrogen withdrawal, except for a
      remarkable type of hyperplasia following estrogen treatment for 186 days and a
      recovery period of 28 days. In tumorous pituitaries no regression of lesions was
      noticed.

PMID- 1740020
TI  - Enhancement by nickel(II) and L-histidine of 2'-deoxyguanosine oxidation with
      hydrogen peroxide.
AB  - Conversion of the 2'-deoxyguanosine (dG) residues in calf thymus DNA to 8-hydroxy
      2'-deoxyguanosine (8-OH-dG) was achieved at physiological pH by treating the DNA
      with hydrogen peroxide (H2O2) in the presence of nickel(II) chloride (NiCl2). The
      effectiveness of this reaction was enhanced by L-histidine (His) which forms the
      Ni(II)-His2 complex. Similar effects of NiCl2 and His were observed on
      hydroxylation of pure dG with H2O2. The rate of pure dG conversion to 8-OH-dG at
      37 degrees C (100 mM phosphate buffer) depended on combination and concentration
      of the reagents and on pH. Following 24 h incubation at pH 7.4 of 0.75 mM dG with
      30 mM H2O2 and 1 mM NiCl2, dG was converted into 8-OH-dG to the extent of 0.05%
      in the absence of His and 0.45% in the presence of 2 mM His. After 24 h
      incubation at pH 7.4 of 0.5 mg/ml DNA with 7.5 mM H2O2 and 0.1 mM NiCl2, 0.18% of
      the dG moiety was converted into 8-OH-dG in the absence of His and 0.42% in the
      presence of 0.2 mM His. Interestingly, a mixture of H2O2 with His was also
      capable of oxidizing dG to 8-OH-dG even in the absence of NiCl2, albeit less
      effectively than in the presence of NiCl2. This effect was not suppressed after
      treatment of dG, His and the buffer with Chelex to remove divalent metal
      contaminants, if any. The exact chemistry of the observed phenomena remains to be
      determined. Since the Ni(II)-His2 complex is the major low mol. wt nickel carrier
      in mammalian organisms, the observed redox properties of this complex, reported
      here for the first time, may be crucial for the toxicity and carcinogenicity of
      nickel.

PMID- 1740021
TI  - The time-dependent increase in the binding of benzo[a]pyrene to DNA through (+)
      anti-benzo[a]pyrene-7,8-diol-9,10-epoxide in primary rat hepatocyte cultures
      results from induction of cytochrome P450IA1 by benzo[a]pyrene treatment.
AB  - The proportion and amount of benzo[a]pyrene (B[a]P) that binds to DNA through the
      carcinogenic (+)-anti-benzo[a]pyrene-7,8-diol-9,10-epoxide [(+)-anti-BPDE]
      increases with time of exposure to B[a]P in cell cultures derived from a number
      of species. Pretreatment of primary rat hepatocyte cultures for 12 h with 1
      microgram B[a]P/ml medium increased the subsequent metabolism of [3H]B[a]P by 47%
      and [3H]B[a]P-DNA binding by 53% compared with acetone-pretreated hepatocytes.
      The amount of (+)-anti-BPDE bound to DNA in the B[a]P-pretreated hepatocytes
      increased 175%. B[a]P pretreatment also increased DNA-binding 2-fold in
      hepatocytes treated with [3H]7,8-dihydroxy-7,8-dihydro-B[a]P but had no effect on
      DNA binding in cells treated with anti-B[a]P-7,8-diol-9,10-epoxide. Western
      blotting showed that cytochrome P450IA1, which was not detectable prior to B[a]P
      treatment, was selectively increased by B[a]P treatment. A monoclonal antibody
      that specifically inhibits cytochrome P450IA1 reduced the binding of B[a]P to DNA
      by greater than 90% in microsomal preparations from B[a]P-pretreated hepatocytes.
      These results indicate that the time-dependent increase in the formation of (+)
      anti-BPDE-DNA adducts results from an increase in the amount and proportion of
      B[a]P metabolized to this ultimate carcinogen by P450IA1 that is induced by the
      B[a]P treatment. The importance of P450IA1 induction by the B[a]P for its
      activation to this ultimate carcinogenic metabolite suggests that long-term
      exposure of cells to B[a]P could result in activation of a higher proportion of
      the B[a]P to the carcinogenic (+)-anti-BPDE.

PMID- 1740022
TI  - Increased cytogenetic damage in smokers deficient in glutathione S-transferase
      isozyme mu.
AB  - Reduced expression of the mu-isozyme of glutathione S-transferase (GST; EC
      2.5.1.18) has been associated with increased lung cancer risk. We studied the
      association between GST-mu expression and DNA damage as measured by sister
      chromatid exchanges (SCE) in healthy male smokers. SCE levels were higher in the
      71 GST-mu-deficient smokers compared to the 83 non-deficient smokers (5.24 versus
      4.97 SCE/lymphocyte; P = 0.09). In smokers having high plasma cotinine levels
      (greater than median of 315 ng/ml), this mu-related difference was more
      pronounced (5.50 versus 4.97; P = 0.01), whereas it was absent in smokers having
      low cotinine levels (4.95 versus 4.97; P = 0.92). Increased cytogenetic damage in
      GST-mu-deficient heavy smokers may thus explain the association between GST-mu
      expression and lung cancer.

PMID- 1740023
TI  - Defining conditions for the efficient in vitro cross-linking of proteins to DNA
      by chromium(III) compounds.
AB  - The formation of cross-links between bovine serum albumin and DNA in the presence
      of chromium(III) chloride was found to be highly pH dependent. In vitro, such
      lesions were only formed at acidic values of pH, but were not detected at neutral
      pH. Complexes of chromium(III) and GSH/GSSG similarly failed to induce DNA
      protein cross-links at physiological values of pH. Our findings indicate that the
      cross-links generated in vitro at acidic pH may not be directly relevant to the
      observed formation of such lesions in cultured cells and that a physiologically
      relevant in vitro model for the efficient cross-linking of proteins to DNA has
      yet to be devised.

PMID- 1740024
TI  - Repeated exposure to Opisthorchis viverrini and treatment with the antihelminthic
      Praziquantel lacks carcinogenic potential.
AB  - The effects of repeated Praziquantel administration, subsequent to infection and
      reinfection with Opisthorchis viverrini (OV), on lesion development in the Syrian
      hamster liver were investigated. Five applications of the antihelminthic drug
      were made (300 mg/kg body wt, i.g.), each time approximately 5 weeks after dosing
      with 60-80 OV metacercariae at weeks 0, 8, 16, 24 and 32. The animals were then
      maintained until week 40 when they were killed; histopathological investigation
      revealed no significant development of either hepatocellular of cholangiocellular
      preneoplastic/neoplastic lesions. The results indicate that repeated exposure to
      Praziquantel at levels sufficient for successful removal of parasite infestation
      does not itself carry carcinogenic risk.

PMID- 1740025
TI  - Changing the way we do business.

PMID- 1740026
TI  - Socializing nursing students into professional activities.

PMID- 1740027
TI  - Primary malignant localized fibrous tumours of the pleura: clinical, radiological
      and pathological features.
AB  - Localized fibrous tumours of the pleura are rare primary pleural tumours that may
      exhibit malignant behaviour in approximately 20% of cases. The clinical,
      radiological and pathological features of five patients with malignant localized
      fibrous tumours of the pleura are presented. Clinical symptoms included chest
      pain, breathlessness and cough. Hypertrophic pulmonary osteoarthropathy (HPOA)
      occurred in one patient. Chest radiographs and thoracic computed tomography (CT)
      demonstrated large necrotic masses, with focal calcification and compressive
      atelectasis of the underlying lung. Histological features were variable and
      resulted in designation of these tumours as localized fibrous tumours of the
      pleura of low or high grade malignancy. The grading of malignancy did not
      correlate with final outcome, adequacy of surgical excision being the most
      important factor. These tumours have been referred to as benign pleural fibromas
      or localized mesotheliomas, but these names are inaccurate and the term localized
      fibrous tumour of the pleura is to be preferred. This term should also include
      tumours such as malignant fibrous histiocytoma of the pleura.

PMID- 1740028
TI  - Complications attributable to the formation of the track in patients undergoing
      percutaneous nephrolithotomy.
AB  - Reported complication rates of percutaneous nephrolithotomy vary considerably. In
      our own experience of 110 percutaneous nephrolithotomies performed by an
      experienced interventional radiologist, the complication rate for the entire
      procedure was 3.6%, and for the formation of the nephrostomy track 0.9%. This
      compares favourably with the reports from the major centres. Radiation dose to
      the operator was monitored and our results confirm that with meticulous attention
      to technique, dosages may be kept very low. We conclude that prior training in
      interventional techniques is a major factor in reducing both the morbidity
      associated with percutaneous nephrolithotomy and the radiation dose to the
      operator.

PMID- 1740029
TI  - Intracranial extension of orbital pseudotumour.
AB  - Radiologically demonstrable intracranial extension of orbital pseudotumour is
      rare, and only four cases appear to have been reported previously in the
      literature. A review of the computed tomographic (CT) images of 90 biopsy proven
      cases of orbital pseudotumour seen over a 10 year period revealed eight cases
      with intracranial meningeal spread.

PMID- 1740030
TI  - Infratemporal pneumatocele arising from maxillary sinus.
AB  - Pneumatocele of the infratemporal fossa caused by herniation of air through a
      break in the wall of the aerated maxillary sinus is rare. Two cases are reported:
      one arising from a maxillary pneumocele with a defect in the wall of the
      zygomatic recess and one associated with maxillary radionecrosis with
      pathological fracture complicated by infection. Computed tomography can clearly
      demonstrate the extent of the pneumatocele, and can show the maxillary pathology
      and the causative bony defect in the sinus. Treatment depends on the clinical
      conditions of the patient, the pathology and the size of the bony defect.

PMID- 1740031
TI  - The involvement of the maxillary antrum by odontogenic keratocysts.
AB  - The involvement of the maxillary antrum by an odontogenic keratocyst is an
      unusual presentation of this important lesion which shows a tendency to recur
      following surgery when it arises in the mandible. The clinical presentation and
      radiological appearance in five patients are described. The differential
      diagnosis of this lesion is briefly reviewed.

PMID- 1740032
TI  - Technical report: interventional sialography--balloon dilatation of a Stensen's
      duct stricture using digital subtraction sialography.

PMID- 1740033
TI  - Technical report: a 'new' tube providing rapid insertion for the small bowel
      enema.
AB  - Small bowel enteroclysis (SBE) is considered to be diagnostically superior to the
      conventional barium follow through examination (Sanders and Ho 1976; Maglinte et
      al., 1982; Herlinger, 1982) and would be more generally acceptable if jejunal
      intubation could be undertaken rapidly with minimum fluoroscopy and patient
      discomfort. Using a modified Merck 'Coresafe' tube 75 out of 80 patients referred
      for SBE were intubated, with considerably reduced fluoroscopic and intubation
      times. No tube related difficulty was encountered and patient tolerance was good.

PMID- 1740034
TI  - Case report: multiple hepatic and pulmonary haemangioblastomas--a new
      manifestation of von Hippel-Lindau disease.
AB  - Capillary haemangioblastomas rarely occur outside the central nervous system and
      have not been described previously in the lung or liver. We describe such lesions
      developing in a patient with von Hippel-Lindau complex who previously had
      cerebellar and spinal haemangioblastomas resected.

PMID- 1740035
TI  - Pelvic radiation disease.

PMID- 1740036
TI  - Case report: the air crescent sign in pulmonary leukaemic infiltrate.
AB  - Localized pulmonary infiltrates in leukaemic patients were until recently almost
      synonymous with superinfection. This case illustrates that true leukaemic
      pulmonary involvement should always be considered in these patients when a high
      peripheral blast count is present. We believe this to be the first description of
      cavitation in a proven leukaemic infiltrate.

PMID- 1740037
TI  - Case report: replacement lipomatosis of the kidney--unusual CT features.
AB  - A case of replacement lipomatosis of the kidney (RLK) diagnosed on computed
      tomography (CT) is presented. CT demonstrated an infiltrating fatty mass
      surrounding a scarred kidney with a central staghorn calculus. Infiltration of
      the retroperitoneal muscles and an abscess within the erector spinae were also
      seen. The most important feature of this case is a mass effect causing
      displacement of the aorta and spleen, which is enlarged. This is usually only
      seen with malignant masses and has not been previously reported with RLK. The
      literature and radiological features of RLK are reviewed.

PMID- 1740038
TI  - Case report: deep venous thrombosis following iopamidol venography.
AB  - A case of deep venous thrombosis following iopamidol venography is presented.
      This complication has not previously been reported.

PMID- 1740039
TI  - Case report: broken intracholedochal stent.
AB  - Decompression of biliary obstruction by an internal stent is well accepted in
      patients with malignant strictures. Less frequent is the use of this technique
      for the management of benign disorders. In the latter situation the biliary stent
      may be left in place for a very long period. We report a rare complication of a
      broken intracholedochal stent which had been inserted for a benign post-operative
      stricture.

PMID- 1740040
TI  - Orbital pseudotumour.

PMID- 1740041
TI  - Hepatic and splenic calcification due to amyloidosis.

PMID- 1740042
TI  - The value of negative needle biopsy in suspected operable lung cancer.

PMID- 1740043
TI  - Polyamide--the evolution of a synthetic membrane for renal therapy.

PMID- 1740044
TI  - Basic features of the polyamide membranes.
AB  - Progress in membrane and membrane process development have contributed to the
      continuous improvement of the extracorporeal treatment of renal failure during
      the last 40 years. Today membranes can be adapted to the specific needs required
      by their clinical application. Synthetic structures like the polyamide membranes
      offer a wide range of possibilities in performance and hemocompatibility, due to:
      (1) the use of block polymers or polymer blends and mixtures, and (2)
      modification of membrane structure, pore size and porosity, due to changes of the
      preparation process. However, further improvements are still required to achieve
      the ultimate goal of matching the performance of biological membranes.

PMID- 1740045
TI  - High-flux hemodialysis with a polyamide dialyzer.

PMID- 1740046
TI  - Continuous renal replacement therapies of acute renal failure and the polyamide
      membrane.

PMID- 1740047
TI  - Dialysis-related amyloidosis and high-flux membranes.

PMID- 1740048
TI  - Removal of high-molecular-weight toxins.

PMID- 1740049
TI  - Biocompatibility of the polyamide membranes.

PMID- 1740050
TI  - Pyrogen retention by the polyamide membranes.

PMID- 1740051
TI  - Hemofiltration in the past and present.

PMID- 1740052
TI  - Hemofiltration: predilution versus postdilution.

PMID- 1740053
TI  - Hemodiafiltration: technical aspects.

PMID- 1740054
TI  - The polyamide membrane in hemodiafiltration.

PMID- 1740055
TI  - Mastitis: why is it so hard to cure?

PMID- 1740056
TI  - Bovine endometritis: the burden of proof.

PMID- 1740057
TI  - A comparison of end-tidal halothane concentrations measured at proximal and
      distal ends of the endotracheal tube in the horse.
AB  - Measurements (n = 126) of end-tidal halothane concentrations were taken from 21
      horses anesthetized for routine and emergency surgery. One hundred five paired
      values allowed comparison of gas samples taken near the oral end of the
      endotracheal tube (Y1) to samples obtained at the cuffed end of the endotracheal
      tube (Y2). Twenty-one paired readings were assessed to compare samples taken 25
      cm beyond the cuffed end of the tube (Y3) to samples from Y1. Measurements were
      made at all locations at 15-minute intervals starting 30 minutes after beginning
      halothane. All measurements were made in triplicate at end-expiration, and both
      sites were sampled within 1 minute of each other. Halothane concentration was
      measured by rapid infrared analysis with a gas sampling rate of 150 ml/min and
      displayed as a digital reading. Calibration of the machine was checked regularly.
      The difference between readings (Y1-Y2 or Y1-Y3 = Sdif) was tested using general
      linear models and a significance level of p less than 0.05 was used. The variable
      Sdif was analyzed with respect to time, mode of ventilation, and type of
      recumbency; no effects of these variables were detected. The mean values (+/- SD)
      of 105 readings for Y1 and Y2 were 2.41 vol% (+/- 0.49) and 2.39 vol% (+/- 0.49)
      respectively, and the Pearson's correlation coefficient (Y1 vs Y2) was 0.96. The
      mean values (+/- SD) of 21 measurements for Y1 and Y3 were 2.31 vol% (+/- 0.27)
      and 2.32 vol% (+/- 0.28) respectively and the Pearson's correlation coefficient
      (Y1 vs Y3) was 0.98.

PMID- 1740058
TI  - Mastitis due to Mycoplasma in the state of New York during the period 1972-1990.
AB  - Between January 1972 and December 1990, bulk-tank (n = 721) and cow (n = 9,163)
      milk samples from dairy herds in New York State were examined by bacteriologic
      procedures for Mycoplasma. The organism was found in 165 herds in 42 counties,
      and in 2.3 and 11.7% of the tank and cow samples, respectively. Mycoplasma bovis
      was isolated in 164 herds, M. californicum was isolated in 1. Highest incidence
      of mycoplasmal clinical mastitis occurred during the winter. The disease resulted
      in culling of 30-70% of the cows in several herds. Eighty-six of the positive
      herds were located in the western part of the state. This area had more large
      herds (greater than 200 cows) compared to the rest of the state; however, herd
      size was not a risk factor. Purchased animals added to herds without quarantine,
      poor hygiene during mastitis treatment, and personnel in contact with mastitic
      cows or infected milk were involved in outbreaks and disease transmission.

PMID- 1740059
TI  - Characterization of Sarcocystis neurona from a thoroughbred with equine protozoal
      myeloencephalitis.
AB  - Morphological information is presented for syntype material of the etiologic
      agent of equine protozoal myeloencephalitis, Sarcocystis neurona. A clinical
      description of the horse from which the organism was isolated and the methodology
      used to immunosuppress the horse in an attempt to increase parasite numbers are
      also given. The description includes microscopic details observed both with light
      and transmission electron microscopy. Mainly stages from tissue are illustrated,
      but information is also presented on the development of the organism after
      inoculation onto monolayers of bovine monocytes. It is believed that the large
      numbers of organisms observed in this horse were due to its having not received
      prior treatment with trimethoprimsulphonamide and the large amounts of
      corticosteroids that were administered in order to facilitate isolation of the
      pathogen.

PMID- 1740060
TI  - Nonsteroidal management of canine pruritus with amitriptyline.
AB  - Thirty-one dogs with nonlesional pruritus were treated with amitriptyline (1
      mg/kg orally q12h) to determine its efficacy in the management of canine allergic
      pruritus. Seventeen dogs were known to be atopic, 8 were presumed to be atopic,
      and 6 had pruritus of undetermined etiology. Pruritus was virtually eliminated in
      5 (16.1%) dogs, reduced by approximately 50% in another 5 (16.1%) dogs, and not
      changed in the remaining 21 dogs. Side effects were uncommon.

PMID- 1740061
TI  - Attempted reinnervation of the equine larynx using a muscle pedicle graft.
AB  - Laryngeal hemiplegia was induced in 4 ponies via a left recurrent laryngeal
      neurectomy. Reinnervation of the denervated left cricoarytenoideus dorsalis
      muscle was then attempted using a muscle pedicle graft from the right
      cricoarytenoideus dorsalis muscle. In 3 ponies there was no return of abductor
      function and failure of graft survival. In the fourth pony there was return of
      abductor function along with survival of the muscle bridge, however, there was
      evidence of reinnervation across the neurectomy site. Muscle-to-muscle
      neurotization of the paralyzed equine larynx, utilizing the cricoarytenoideus
      dorsalis muscle, does not appear to be a clinically useful technique.

PMID- 1740062
TI  - Serum concentrations of cefepime (BMY-28142), a broad-spectrum cephalosporin, in
      dogs.
AB  - Serum concentrations of cefepime (BMY-28142) were determined for four dosing
      regimes, 10 mg/kg or 20 mg/kg, given as single subcutaneous (SC) or intramuscular
      injections (IM) to dogs. Serial serum samples were analyzed for the presence of
      cefepime by high-performance liquid chromatography. In experiment 1, the overall
      mean (+/- SEM) serum concentration (for a 12-hour period) after a dose of 20
      mg/kg for SC and IM routes (4.9 +/- 0.74 micrograms/ml and 5.5 +/- 0.63
      micrograms/ml, respectively) was twice that for the 10 mg/kg dose given either SC
      or IM (2.2 +/- 0.31 micrograms/ml and 2.8 +/- 0.47 micrograms/ml, respectively).
      There was no significant difference (p greater than 0.05) in mean serum
      concentrations for SC and IM routes of administration at the same dosage. In
      subsequent experiments, 5 doses of cefepime (20 mg/kg) were administered IM at 12
      hour (experiment 2) or 24-hour (experiment 3) intervals. The mean (+/- SEM) peak
      serum concentration was 12.1 +/- 1.59 micrograms/ml, 2 hours after the 2nd
      injection in experiment 2. In experiment 3, the mean (+/- SEM) peak serum
      concentration was 10.9 +/- 1.34 micrograms/ml, 4 hours after the 1st injection.
      Mean trough concentrations in experiment 2 were greater than or equal to 0.5
      microgram/ml and less than or equal to 0.5 in experiment 3. Multiple IM doses
      produced transient edema at the injection site and mild lameness in all dogs.
      Cefepime was highly active against single canine isolates of Staphylococcus
      intermedius, Pseudomonas aeruginosa and Escherichia coli, with minimum inhibitory
      concentrations of 0.125 microgram/ml, 1 microgram/ml and 0.3 microgram/ml,
      respectively.

PMID- 1740063
TI  - Equine coxofemoral luxations: 17 cases (1975-1990).
AB  - The medical records of 17 horses with coxofemoral luxation were examined. Ponies
      and miniature horses were overrepresented. The mean age at the time of diagnosis
      was 7 years (range 1 month to 25 years). Seventy percent were female. Severe
      trauma, such as a fall or being kicked by another horse, was a common etiology.
      Thirty-five percent had other orthopedic injuries associated with the luxation.
      Closed reduction, with the use of a mechanically assisted calving device, was
      attained in 5 cases but reluxation occurred shortly afterward in 4 of these.
      Varying surgical techniques were used in 3 cases but none were successful in
      maintaining reduction. Ponies and miniature horses are better able to handle
      chronic lameness and therefore had a better long-term survival rate than horses
      with a chronically luxated coxofemoral joint.

PMID- 1740064
TI  - Hematuria and weight loss in a mare with pancreatic adenocarcinoma.
AB  - This clinical report describes an 11-yr-old Thoroughbred mare that presented with
      clinical signs of weight loss and hematuria. History and clinical findings
      suggested the mare had neoplasia of the urogenital system. Although ultrasound
      guided biopsy of the perirenal mass did not yield abnormal cells, large irregular
      cells were isolated from the thoracic and peritoneal fluid. At necropsy, multiple
      firm nodules were disseminated throughout the peritoneal cavity. Histological
      examination of the nodules revealed cells that were consistent with a pancreatic
      exocrine adenocarcinoma. This is the first report of pancreatic adenocarcinoma
      causing dysfunction of the urogenital system.

PMID- 1740065
TI  - Prospective, randomized trial of inpatient vs. outpatient bowel preparation for
      elective colorectal surgery.
AB  - A prospective, randomized trial of inpatient vs. outpatient bowel preparation for
      elective colorectal surgery was performed in 100 consecutive patients. Bowel
      preparation was standardized for both groups and consisted of 4 liters of Colyte
      (Reed & Carnrick, Piscataway, NJ) and oral neomycin and Flagyl (G. D. Searle &
      Co., Skokie, IL) the day before surgery. Patients were randomized into four
      subcategories: ileocolostomy, colocolostomy, abdominal perineal resection, and
      other. Tap water enemas were administered on the morning of surgery to ensure and
      adequate mechanical preparation. Ninety-six percent of the inpatient group and 97
      percent of the outpatient group were able to drink three-fourths or more of the
      oral lavage preparation (P = 0.789, Fisher's exact text). A mean of 2.26 tap
      water enemas was required to achieve clear returns for the inpatient group,
      compared with 2.28 tap water enemas for the outpatient group (P = 0.221, Fisher's
      exact test). The adequacy of the bowel preparation as graded by the primary
      surgeon was good (84 percent), fair (12 percent), and poor (4 percent) in the
      outpatient group (P = 0.673, Fisher's exact test). Wound infection developed in 4
      percent of the inpatient group and 4 percent of the outpatient group (P = 1.0,
      Fisher's exact test). Anastomotic leak of intra-abdominal abscess was seen in one
      patient in each group (P = 1.0, Fisher's exact test). We conclude that outpatient
      bowel preparation is as effective as inpatient bowel preparation for elective
      colorectal surgery and offers the advantage of cost savings and shorter
      hospitalization.

PMID- 1740066
TI  - Clinical conundrum of solitary rectal ulcer.
AB  - A retrospective study of 80 patients with biopsy-proven solitary rectal ulcer
      (SRU) was conducted to review its clinical spectrum. The median follow-up was 25
      months. The female-to-male ratio was 1.4:1.0, and the mean age was 48.7 years
      (range, 14-76 years). Principal symptoms were bowel disturbances (74 percent) and
      rectal bleeding (56 percent). Twenty-one patients (26 percent) were asymptomatic
      and required no treatment. A previous "wrong" diagnosis was made in 25 percent.
      Rectal prolapse was identified in 28 percent (full-thickness, 15 percent;
      mucosal, 13 percent). The macroscopic appearance of the lesion seen in SRU varied
      widely and included polypoid lesions in 44 percent (the predominant finding in
      the asymptomatic group), ulcerated lesions in 29 percent (always symptomatic),
      and edematous, nonulcerated, hyperemic mucosa in 27 percent. Anorectal manometry
      provided little helpful information in the patients in whom it was performed.
      Management by bulk laxatives and bowel retraining led to symptomatic improvement
      in 19 percent of cases. In 29 percent of cases, symptoms persisted despite
      endoscopic healing of the lesion. Intractability of symptoms led to surgery in
      only 27 (34 percent) patients. Depending on the presence or absence of rectal
      prolapse, rectopexy or a conservative local procedure (such as local excision),
      respectively, appeared to be the optimal surgical treatment. The polypoid variety
      tended to respond to therapy more favorably than non-polypoid varieties. Thus,
      the macroscopic appearance of SRU has a significant bearing on the clinical
      course, and most cases do not require surgery.

PMID- 1740067
TI  - Videoproctography in selecting patients with constipation for colectomy.
AB  - The results of colectomy for constipation based only on evidence of delayed
      colonic markers have been disappointing. The operation may fail because these
      patients are unable to evacuate the rectum owing to outlet obstruction. In the
      present study, we have used a combination of videoproctography and transit marker
      studies in an attempt to predict patients who will have a favorable outcome after
      colectomy by excluding patients with outlet obstruction. Videoproctography was
      performed in 228 patients referred for consideration of surgery for constipation.
      Only 111 (38 percent) had a normal proctogram with complete evacuation of liquid
      barium. Of these 111 patients, 21 (19 percent) had delayed colonic marker
      studies. Colectomy and ileorectal anastomosis were performed in 18 of these 21
      patients; two years later, 16 were symptom free, with a median daily bowel
      frequency of four (range, two to six). The remaining two patients failed to
      respond to surgery. These data suggest that true idiopathic, slow-transit
      constipation is uncommon, but, when identified on the basis of delayed markers
      and the ability to expel liquid on proctography, an excellent result can be
      anticipated from colectomy and ileorectal anastomosis.

PMID- 1740068
TI  - Malignant cells are collected on circular staplers.
AB  - Anastomotic recurrence after resection of colorectal carcinoma has been
      attributed to insufficient clearance, migration of tumor cells into lymphatics,
      or implantation of exfoliated malignant cells during anastomosis. We studied 10
      patients submitting to low anterior resection for cancer 6 to 16 cm (mean, 12.6
      cm) from the anal verge. The anastomosis was performed with a circular stapler
      introduced transanally into the rectum using the established technique. No lavage
      of the rectal stump with a cytotoxic agent was conducted before the anastomosis
      was performed. Having completed the anastomosis, the stapler and the doughnuts
      were washed with saline, which was collected for cytologic examination. The
      doughnuts were then examined histologically; all were tumor free. In 9 of the 10
      cases, malignant cells were identified in the centrifuged saline. It may be that
      malignant cells collected by the stapler are implanted during anastomosis and
      cause subsequent anastomotic recurrence.

PMID- 1740069
TI  - Chronic constipation with encopresis persisting beyond 15 years of age.
AB  - Childhood constipation with encopresis is a common malady. Previous reports
      suggest that essentially all patients either respond to standard treatments or
      have spontaneous recovery before 16 years of age. In this paper, we describe the
      results of anorectal function studies and treatment outcome in four patients in
      whom constipation and encopresis persisted beyond 15 years of age. Abnormalities
      in the ability to defecate water-filled balloons, in external sphincter
      relaxation with straining, in rectal sensation and development of the urge to
      defecate, and in maximum anal resting pressure were seen in some or all of these
      patients. In addition, two patients had impaired voluntary squeeze strength. Two
      patients responded to standard therapy; a colostomy was needed in one; and one
      failed therapy and has become a recluse.

PMID- 1740070
TI  - Colorectal cancer risk after jejunoileal bypass: dysplasia and DNA content in
      longtime follow-up of patients operated on for morbid obesity.
AB  - Jejunoileal bypass (JIB) has been a widespread operation for treatment of morbid
      obesity. Bile acids are regarded as cofactors in the carcinogenesis of the colon,
      and, since intestinal bypass involves increased exposure of bile acids to the
      large intestinal mucosa, JIB has been postulated to increase the risk for
      colorectal carcinoma. In experimental studies on animals, the results have
      indicated an increased frequency of induced carcinomas, but in clinical series
      only one patient with colon carcinoma has been reported. Thirty women, operated
      on with JIB 11 to 17 years earlier, were examined by colonoscopy with multiple
      biopsies, systematically taken for histologic evaluation and flow cytometric DNA
      analysis. In only one patient, low-grade dysplasia was detected in an initial
      adenomatous lesion but was not visible macroscopically. No DNA aneuploidy was
      found. In a control group of 11 patients examined for non-neoplastic disease,
      neither dysplasia nor aneuploidy was diagnosed. Within 17 years postoperatively,
      we have, by these methods, not been able to verify any colorectal malignant
      transformation in patients operated on with JIB. However, since carcinogenesis is
      a long process, further surveillance will be demanded before an increased risk
      for colorectal carcinoma can be excluded.

PMID- 1740071
TI  - Fibrin glue improves the healing of irradiated bowel anastomoses.
AB  - Many surgeons are reluctant to construct a bowel anastomosis with irradiated
      intestine. Previous studies have demonstrated diminished tensile strength of rat
      small bowel anastomoses that have been irradiated intraoperatively. To determine
      whether fibrin glue, a known tissue adhesive, improves the healing of these
      anastomoses, 69 male Sprague-Dawley rats were randomized into three anastomotic
      groups: Group 1, sutured ileal anastomosis without radiation or fibrin glue;
      Group 2, irradiated sutured ileal anastomosis without fibrin glue; and Group 3,
      irradiated ileal anastomosis with fibrin glue added to the suture line. Groups 2
      and 3 received a single dose of 2,000 R intraoperatively. At seven days, the rats
      were sacrificed and the anastomotic segment was tested for breaking (tensile)
      strength. Anastomotic collagen content was evaluated using a hydroxyproline
      assay. Tensile strength results demonstrated that Group 2 was significantly
      weaker than Groups 1 and 3 (P = 0.001) and that the hydroxyproline content of
      Group 3 was significantly greater than that of Group 2 (P = 0.015). These results
      show that the addition of fibrin glue to an intraoperatively irradiated small
      bowel anastomosis improves healing, as demonstrated by both tensile strength and
      hydroxyproline content studies.

PMID- 1740072
TI  - Can Hemoccult-II replace colonoscopy in surveillance after radical surgery for
      colorectal cancer and after polypectomy?
AB  - Surveillance after colorectal carcinoma and adenoma includes colonoscopy, which
      is a demanding procedure for the patient, doctor, and society. Therefore, it was
      investigated whether a simple fecal occult blood test could replace colonoscopy.
      Hemoccult-II (H-II) was performed before 1,244 colonoscopies in patients with
      previous cancer and before 328 colonoscopies in an adenoma surveillance program.
      The H-II test was positive in 3 of 9 patients with local recurrence, in 2 of 13
      with metachronous cancer, and in 31 of 186 with adenomas. The test was positive
      more often in patients with large and multiple adenomas, sigmoid adenomas, and
      adenomas with villous elements and moderate-to-severe dysplasia, but the
      sensitivity did not reach more than 25 to 40 percent. It was concluded that
      markers more sensitive than H-II are needed to detect metachronous cancers and
      new adenomas. In the meantime, colonoscopy has to be used with intervals of
      several years, but not for detection of local recurrent cancer, which in most
      cases may be found by simpler means.

PMID- 1740073
TI  - Carcinoma of the rectal pouch following restorative proctocolectomy. Report of a
      case.
AB  - A case of adenocarcinoma developing in the pouch following restorative
      proctocolectomy is presented. This seems to be the third reported in the
      literature. The carcinoma developed from the remnants of precancerous rectal
      mucosa left in the muscular rectal cuff. The patient had been suffering from
      ulcerative colitis for 17 years prior to the development of the malignancy. He
      presented with features of subacute intestinal obstruction. Diagnosis was by
      sigmoidoscopic examination of the pouch and biopsy. He was treated with
      abdominoperineal resection of the pouch and rectum, followed by chemotherapy.

PMID- 1740074
TI  - Malignant histiocytosis of the intestine simulating Crohn's disease. Report of a
      case.
AB  - We report a case of malignant histiocytosis of the intestine (MHI) in which
      clinical and small bowel barium examination led to an initial diagnosis of
      Crohn's disease. The patient's symptoms and radiologic features improved
      dramatically with steroid therapy, and the patient remained free of severe
      symptoms for five years; at this stage, massive rectal bleeding occurred and
      segmental ileal resection was performed. Pathology findings of the resected
      specimen revealed nonspecific ulceration of the ileum. The correct diagnosis,
      MHI, became apparent six months after surgical intervention, on the appearance of
      multiple lymphadenopathy.

PMID- 1740075
TI  - Spontaneous perforating hematoma of the rectum. Report of a case.
AB  - Intramural hematomas of the intestine most often occur in the setting of blunt
      abdominal trauma. However, spontaneous hematomas can occur secondary to either
      hematologic disorders, or use of anticoagulant therapy. There has been no clearly
      documented report of a spontaneous rectal hematoma. We describe the novel
      treatment of a patient with a spontaneous intramural hematoma of the rectum which
      presented as an abdominal catastrophe.

PMID- 1740076
TI  - Leon Ginzburg 1899-1988. The road to regional enteritis. 1974.

PMID- 1740077
TI  - Practice parameters for antibiotic prophylaxis to prevent infective endocarditis
      or infected prosthesis during colon and rectal endoscopy. The American Society of
      Colon and Rectal Surgeons.

PMID- 1740078
TI  - Practice parameters for antibiotic prophylaxis--supporting documentation. The
      Standards Task Force. American Society of Colon and Rectal Surgeons.

PMID- 1740079
TI  - Data on hepatic metastases.

PMID- 1740080
TI  - Progress in the development of the Canadian Society of Colon and Rectal Surgeons.

PMID- 1740081
TI  - The prevalence of confusion in the definition of hemorrhoids.

PMID- 1740082
TI  - Common nursing diagnoses for pulmonary alveolar edema patients.
AB  - PAE can occur as a consequence of heart failure. Depending upon the extent of
      left ventricular failure, pulmonary edema can vary widely in severity. To
      anticipate potential health care needs and, ultimately, to treat PAE, the
      critical care nurse identifies common nursing diagnoses. Once the nurse
      understands the physiologic or psychological mechanisms for the particular
      nursing diagnoses, he or she can serve as a reference point to identify expected
      nursing outcomes.

PMID- 1740083
TI  - Effectiveness of coping strategies among critical care nurses.
AB  - Although research on job stress has focused on the extent or causes of stress in
      critical care, few studies have focused on the effects of stress reduction
      strategies by the critical care staff. The results of a study that examined the
      strategies critical care nurses used to manage job stress and the effectiveness
      of these techniques are described.

PMID- 1740084
TI  - The ethical case analysis: heroic measures for patients with chronic problems.
      Part I: The ethical case.

PMID- 1740085
TI  - The ethical case analysis: heroic measures for patients with chronic problems.
      Part II: Ethical analysis.

PMID- 1740086
TI  - Nursing outcomes: focusing on results.

PMID- 1740087
TI  - Durable power of attorney: nursing implications.
AB  - Written, witnessed advance directives such as Durable Powers of Attorney and
      Living Wills communicate patients' care preferences. The critical care nurse must
      be knowledgeable about these legal documents to be able to effectively uphold the
      specific care requests. The authors define advance directives and outline the
      role of the nurse in execution of these directives.

PMID- 1740088
TI  - Self-care assessment: key to teaching and discharge planning.
AB  - Patient education research supports the premise that the nurse must consider the
      patient's perspective before attempting to provide an educational program for
      implementing the therapeutic regimen. This article describes how a self-care
      assessment instrument can help the nurse to develop an individualized teaching
      plan for the cardiac patient.

PMID- 1740089
TI  - Imagery: helping ICU patients control pain and anxiety.
AB  - As healthcare providers strive for holistic approaches to modern problems, the
      use of imagery and relaxation is gaining popularity. Relaxation and imagery can
      be used effectively in critical care areas to help patients cope with their
      symptoms, treatments, and/or the critical care environment.

PMID- 1740090
TI  - Assessing congenital heart defects in the cocaine-exposed neonate.
AB  - An estimated 100,000 "crack babies" are born each year in the United States.
      Because in addition to a variety of other congenital anomalies, neonatal cardiac
      defects have recently been linked to maternal cocaine use, the critical care
      nurse needs to conduct a detailed cardiac status assessment on all cocaine
      exposed infants.

PMID- 1740091
TI  - Prevalence of symptoms of systemic lupus erythematosus (SLE) and of fluorescent
      antinuclear antibodies associated with chronic exposure to trichloroethylene and
      other chemicals in well water.
AB  - Criteria for the recognition of systemic lupus erythematosus (SLE) were applied
      to 362 subjects exposed to trichloroethylene, trichloroethane, inorganic
      chromium, and other chemicals in water obtained from wells in an industrially
      contaminated aquifer in Tucson, Arizona. Their antinuclear autoantibodies were
      measured by fluorescence (FANA) in serum. Ten patients with clinical SLE and/or
      other collagen-vascular diseases were considered separately. Results were
      compared to an Arizona control group, to published series, and to laboratory
      controls. Frequencies of each of 10 ARA symptoms were higher in exposed subjects
      than in any comparison group except those with clinical SLE. The number of
      subjects than in any comparison group except those with clinical SLE. The number
      of subjects with 4 or more symptoms was 2.3 times higher compared to referent
      women and men. FANA titers greater than 1:80 was approximately 2.3 times higher
      in women but equally frequent in men as in laboratory controls. ARA score and
      FANA rank were correlated with a coefficient (cc) of .1251, r2 = .0205 (p less
      than 0.036) in women and this correlation was almost statistically significant in
      men cc = .1282, r2 = .0253 (p less than 0.059). In control men and women neither
      correlation was significant. Long-term low-dose exposure to TCE and other
      chemicals in contaminated well water significantly increased symptoms of lupus
      erythematosus as perceived by the ARA score and the increased FANA titers.

PMID- 1740092
TI  - Activation of cerebral dopaminergic systems by noise and whole-body vibration.
AB  - To clarify the involvement of the central nervous system in responses of
      organisms to noise and whole-body vibration, the activity of dopamine (DA) neuron
      systems was estimated by examining DA turnover rates in various discrete regions
      of the brains of rats exposed to noise (broad band, 102 dB) or whole-body
      vibration (20 Hz, 4G) for 90 min. Plasma corticosterone level (COR) was
      determined simultaneously as an index of stress-induced autonomic-nervous and
      endocrine functions. Noise and whole-body vibration increased both COR and DA
      turnover rates (shown by an increase of homovanillic acid (HVA) and/or HVA/DA
      ratio) in the frontal cortex (FC) and the nucleus accumbens (NAc). Only noise
      increased the DA turnover rate in the amygdala (AMY). Furthermore, strong
      positive correlations of the HVA/DA ratios in the FC and the NAc with COR were
      observed in rats exposed to noise or vibration. These results suggest that the
      responses of organisms to noise and whole-body vibration may be critically
      mediated by cerebral DA systems, in particular by the mesocortical DA system,
      indicating that change of DA in the AMY can be considered a specific response to
      noise.

PMID- 1740093
TI  - The reversibility of tributyltin-induced toxicity in vitro as a function of
      concentration and duration of exposure (C x T).
AB  - The toxicity exhibited by murine erythroleukemic cells (MELC) exposed to
      tributyltin (TBT) is a function of both concentration (C) and duration of
      exposure (T). At or above a critical C x T product value (CPV) (e.g., 0.5-1.0
      microM TBT, 6 hr), exposed MELC exhibit severe, irreversible toxicity: decreased
      membrane integrity (viability, measured by propidium iodide [PI] exclusion),
      grossly perturbed cell-cycle distributions, and fixation of the plasma
      membrane/cytoplasm complex. Below the CPV, exposed cells exhibit retention of
      carboxyfluorescein (CF) fluorescence (indicative of decreased plasma membrane
      permeability) and decreased cell proliferation, a result of retardation of
      progression into, through, and out of the S (DNA synthetic) phase of the cell
      cycle. However, following washout and recovery, mean CF fluorescence, cell
      proliferative capacity, and cell-cycle kinetics return to control levels. These
      results suggest that the toxic changes induced by TBT exposure may be reversible
      if exposure conditions do not exceed the CPV. To assess whether the CPV has been
      exceeded, a multiparameter flow cytometric analysis of membrane integrity and
      cell-cycle kinetics is useful.

PMID- 1740094
TI  - Effects of manganese forms on biogenic amines in the brain and behavioral
      alterations in the mouse: long-term oral administration of several manganese
      compounds.
AB  - This work has identified the relative toxicity of four forms of manganese, using
      biogenic amine levels, tissue retention, weight gain, and activity scores as
      criteria. Male mice were chronically treated with four forms of manganese
      administered orally, mixed with the diet, for 12 months. The food intake for the
      control mice and the mice exposed to manganese was similar, but the manganese
      treatment reduced normal weight gain in the mice. The Mn levels were higher in
      some parts of brain after feeding insoluble salts than after the soluble salts.
      The concentration of manganese was significantly increased in the liver and
      spleen of the manganese carbonate-exposed group, compared with the concentration
      in the control group. Manganese dioxide feeding lowered dopamine and increased
      homovanilic acid. Since manganese dioxide is a powerful oxidizing agent in
      organic chemistry, it possibly enhanced the oxidative metabolite of dopamine.
      Accumulation of manganese in the brain correlated with reduced hypothalamic
      dopamine levels in the manganese acetate-exposed group; and the amount of
      manganese accumulated correlated with the intensity of suppression of motor
      activity. These findings indicate that manganese dioxide is more toxic than
      divalent manganese. Of the divalent manganese compounds, manganese acetate seemed
      to have the greatest toxic effect.

PMID- 1740095
TI  - Morphometric, structural, and ultrastructural studies of tench (Tinca tinca L.)
      hepatocytes after copper sulfate administration.
AB  - A structural, ultrastructural, and morphometric study was made of the liver
      parenchyma of 12 adult tench (Tinca tinca, L.) subjected to acute experimental
      copper sulfate poisoning. The lesions observed were characterized by the
      accumulation in the cytoplasm of large amounts of hemoglobinemic pigment produced
      by intense hemolysis, initially in Kupffer cells and by the last stage of the
      experiment in hepatocytes. This process became increasingly severe, and
      culminated in the massive necrosis of large areas of liver parenchyma, which led
      to the death of tench 12 days after the start of the experiment.

PMID- 1740096
TI  - Ultrastructural changes induced by benzo[a]pyrene in sea bass (Dicentrarchus
      labrax) liver and intestine: importance of the intoxication route.
AB  - The ultrastructural effects of benzo[a]pyrene (BaP) on sea bass (Dicentrarchus
      labrax) liver and intestine were studied after experimental intoxication by two
      different routes: intraperitoneal injection and force-feeding. In both
      hepatocytes and enterocytes, the main structural perturbations concerned a large
      development of both rough and smooth endoplasmic reticulum and a great increase
      in the number of vacuoles and lysosomes in BaP-treated fish. After 17 days of
      contamination, some nuclear changes were observed, indicating the high reactivity
      of BaP metabolites which form covalent adducts with DNA and the long-term
      toxicity of this compound. However, in the intestine, after force-feeding
      intoxication, more perturbations were seen, particularly concerning the
      mitochondria. Both organs were altered in a different way with respect to the
      intoxication route. In BaP intraperitoneal injected fish, the liver was the first
      injured organ and presented heavier injuries than intestine. In force-feeding
      treated fish, the intestinal epithelium was the first concerned tissue and it was
      highly modified after BaP intoxication. The importance of the intoxication
      pathway in the effects of BaP on liver and intestine was discussed with special
      reference to their role in BaP uptake, metabolism, and distribution in the
      organism.

PMID- 1740097
TI  - Interactions of plant zinc and plant species on the bioavailability of plant
      cadmium to Japanese quail fed lettuce and spinach.
AB  - Many cadmium-contaminated environments contain high levels of zinc. The effects
      of plant Zn and plant species on plant Cd bioavailability were tested in Japanese
      quail fed lettuce and spinach. Four groups of birds received 10% of their diets
      as lettuce or spinach leaves intrinsically labeled with 109Cd and containing low
      or high intrinsic Zn. Two other groups were fed control diets containing 109Cd as
      CdSO4 and low or high Zn as ZnCO3. Cadmium concentrations in diets ranged from
      0.857 to 1.05 micrograms/g dry wt. Zinc concentrations in low-Zn diets ranged
      from 21.2 to 22.8, and in high-Zn diets from 56.0 to 63.3 micrograms/g dry wt.
      Increased lettuce and spinach Zn decreased plant Cd retention in kidney, liver,
      and jejunum-ileum of Japanese quail. Spinach Cd was less absorbed than lettuce Cd
      at both Zn levels. Inorganic Zn produced a lesser decrease in Cd retention in
      kidney, liver, and jejunum-ileum than did plant Zn. We conclude that (1) crops
      that transport Zn and Cd readily into edible tissues show lower Cd
      bioavailability when grown in Zn-Cd contaminated environments than in Cd-only
      polluted sites, (2) plant species differ in Cd bioavailability for identical
      concentrations of Zn and Cd in edible tissues, and (3) toxicological studies with
      animals exposed to Cd salts and Zn supplements do not assess Cd bioavailability
      of Zn-Cd contaminated crops.

PMID- 1740098
TI  - Characteristics of the inhibition of interferon-alpha/beta production after
      crystalline nickel sulfide exposure.
AB  - Murine L-929 cells were treated with crystalline nickel sulfide (NiS), washed,
      and then exposed to polyriboinosinic-polyribocytidylic acid (Poly I:C) to induce
      interferon-alpha/beta (IFN-alpha/beta). Addition of crystalline NiS at different
      time points, from 24 hr prior to IFN induction (pretreatment) up to 12 hr after
      IFN induction, resulted in significant inhibition of IFN-alpha/beta production.
      In addition, 24-hr pretreatment of L-929 cells with crystalline NiS resulted in
      significantly decreased production of IFN-alpha/beta even 120 hr after addition
      of IFN inducer. IFN-alpha/beta at a known concentration was titered by means of a
      viral plaque reduction assay in crystalline NiS-treated L-929 cell cultures.
      Crystalline NiS did not show a significant inhibitory effect on the antiviral
      activity of IFN on L-929 cells as compared to controls. The results described
      here suggest that NiS has a rapid and a long-lasting inhibitory activity on the
      production of IFN-alpha/beta.

PMID- 1740099
TI  - In vitro effect of mercury on enzyme activities and its accumulation in the first
      trimester human placenta.
AB  - The effect of incubating young placental explants with HgCl2 on the activities of
      aryl hydrocarbon hydroxylase (AHH) (a phase I enzyme), quinone reductase (QR),
      catecholamine-O-methyltransferase (COMT) (both phase II enzymes), and glucose-6
      phosphate dehydrogenase (G-6-PD) is described. Mercury (Hg) at low doses
      significantly elevated placental phase I and phase II enzyme activities, but
      decreased the activity of G-6-PD. The increase in activities, which was time- and
      dose-dependent, was higher in explants incubated for 24 hr than in those
      incubated for 6 hr. The decrease in placental G-6-PD activity was drastic at low
      Hg dose levels but at higher levels the inhibitory effect was milder for both
      incubation periods. Placental explants accumulated Hg in amounts proportional to
      its concentration in the incubation medium and this accumulation was greater in
      explants incubated for 24 hr. The data suggest that contamination with low Hg
      levels from the environment during pregnancy may affect placental enzymatic
      activity. The accumulation of Hg during short incubation indicates a strong
      placental cell affinity for Hg, which could affect its other metabolic functions.
      The system used in sensitive, as it shows alteration in enzyme activity even with
      relatively low concentrations of the metal and the response is dose-related.

PMID- 1740100
TI  - Behavioral and molecular analyses suggest that circadian output is disrupted by
      disconnected mutants in D. melanogaster.
AB  - Mutations in the disconnected (disco) gene act to disrupt neural cell patterning
      in the Drosophila visual system. These mutations also affect adult locomotor
      activity rhythms, as disco flies are arrhythmic under conditions of constant
      darkness (DD). To determine the state of the circadian pacemaker in disco
      mutants, we constructed with pers double mutants (a short period allele of the
      period gene) and assayed their behavioral rhythms in light-dark cycles (LD), and
      their biochemical rhythms of period gene expression under both LD and DD
      conditions. The results demonstrate that disco flies are rhythmic, indicating
      that they have an active circadian pacemaker that can be entrained by light. They
      also suggest that disco mutants block or interfere with elements of the circadian
      system located between the central pacemaker and its outputs that mediate overt
      rhythms.

PMID- 1740101
TI  - Coordinate genetic control of yeast fatty acid synthase genes FAS1 and FAS2 by an
      upstream activation site common to genes involved in membrane lipid biosynthesis.
AB  - A systematic search for upstream controlling elements necessary for efficient
      expression of the yeast fatty acid synthase genes FAS1 and FAS2 revealed
      identical activation sites, UASFAS, in front of both FAS genes. The individual
      element confers, in a heterologous yeast test system, an approximately 40-fold
      stimulation of basal gene expression. The UASFAS motifs identified have the
      consensus sequence TYTTCACATGY and function in either orientation. The same
      sequence motif is found in the upstream regions of all so far characterized yeast
      genes encoding enzymes of phospholipid biosynthesis. In gel retardation assays, a
      protein factor, Fbf1 (FAS binding factor), was identified which interacted with
      UASFAS. The UASFAS motif proved to be an inositol/choline responsive element
      (ICRE) conferring strict repression by exogenous inositol and choline on a
      heterologous reporter gene. Its core sequence perfectly matches the CANNTG motif
      typical of basic helix-loop-helix DNA-binding proteins. In contrast to the
      individual UASFAS element, the intact yeast FAS promoters are not significantly
      influenced by inositol and choline, and thus allow nearly constitutive fatty acid
      synthase production. Available evidence suggests that additional cis- and trans
      acting elements, other than UASFAS and Fbf1, are involved in this constitutive
      FAS gene expression.

PMID- 1740102
TI  - Regulation of transcription of immunoglobulin germ-line gamma 1 RNA: analysis of
      the promoter/enhancer.
AB  - Antibody class switching is achieved by recombinations between switch (S) regions
      which consist of tandemly repeated sequences located 5' to Ig heavy chain
      constant (CH) region genes. RNA transcripts from specific unrearranged or germ
      line Ig CH genes are induced in IgM+ B cells prior to their undergoing class
      switch recombination to the same CH genes. Thus, the antibody class switch
      appears to be directed by induction of accessibility, as assayed by transcription
      of germ line CH genes. For example, IL-4 induces transcripts from the mouse germ
      line C gamma 1 and C epsilon genes to which it also directs switch recombination.
      We report here that the 150 bp region upstream of the first initiation site of
      RNA transcribed from the murine germ-line C gamma 1 gene, contains promoter and
      enhancer elements responsible for basal level transcription and inducibility by
      anti-Ig phorbol myristate acetate (PMA) and for synergy of these inducers with IL
      4 in a surface IgM+ B cell line, L10A6.2 and a surface IgG2a+ B cell line, A20.3.
      Linker-scanning mutations demonstrated that multiple interdependent elements are
      required for inducibility by PMA and also for synergy with IL-4. Within the 150
      bp region are several consensus sequences that bind known or putative
      transcription factors, including a C/EBP binding site--IL-4 responsive element,
      four CACCC boxes, a PU box, a TGF beta inhibitory element (TIE), an alpha beta
      interferon response element (alpha beta-IRE) and an AP-3 site. The relationship
      between transcription regulated by these elements and the regulation of
      endogenous germ-line gamma 1 transcripts and switching to IgG1 is discussed.

PMID- 1740103
TI  - The TATA box promoter region of maize Adh1 affects its organ-specific expression.
AB  - We have isolated two lineage-related Mutator (Mu3) transposon-induced Adh1
      promoter mutants in maize: Adh1-3F1124 carries a duplicated TATA box and its
      revertant, Adh1-3F1124r17, bears a deleted TATA box. Both alterations lead to
      unique patterns of organ-specific ADH1 enzyme expression. Enzyme activity in Adh1
      3F1124 sporophytic organs (scutellum and roots) is greatly reduced, while
      activity levels remain normal in the male gametophyte (pollen). Conversely,
      enzyme activity in Adh1-3F1124r17 roots and scutellum is partially restored, but
      is concomitantly reduced in pollen. Transcript analysis suggests (i) that the
      TATA box region of the Adh1 gene influences post-transcriptional processes in the
      male gametophyte but not in roots and (ii) that organ-specific transcription
      signals in the promoter are distinct from the previously identified anaerobic
      environment-specific cis-acting transcription signals. Different organs appear to
      provide surrogate TATA function in different ways, leading to organ-specific
      differences in the length of the Adh1 message 5' leader.

PMID- 1740104
TI  - A missense mutation in the vasopressin-neurophysin precursor gene cosegregates
      with human autosomal dominant neurohypophyseal diabetes insipidus.
AB  - Familial neurohypophyseal diabetes insipidus in humans is a rare disease
      transmitted as an autosomal dominant trait. Affected individuals have very low or
      undetectable levels of circulating vasopressin and suffer from polydipsia and
      polyuria. An obvious candidate gene for the disease is the vasopressin
      neurophysin (AVP-NP) precursor gene on human chromosome 20. The 2 kb gene with
      three exons encodes a composite precursor protein consisting of the neuropeptide
      vasopressin and two associated proteins, neurophysin and a glycopeptide. Cloning
      and nucleotide sequence analysis of both alleles of the AVP-NP gene present in a
      Dutch ADNDI family reveals a point mutation in one allele of the affected family
      members. Comparison of the nucleotide sequences shows a G----T transversion
      within the neurophysin-encoding exon B. This missense mutation converts a highly
      conserved glycine (Gly17 of neurophysin) to a valine residue. RFLP analysis of
      six related family members indicates cosegregation of the mutant allele with the
      DI phenotype. The mutation is not present in 96 chromosomes of an unrelated
      control group. These data suggest that a single amino acid exchange within a
      highly conserved domain of the human vasopressin-associated neurophysin is the
      primary cause of one form of ADNDI.

PMID- 1740105
TI  - The characterization of the promoter of the gene encoding the p50 subunit of NF
      kappa B indicates that it participates in its own regulation.
AB  - In order to characterize the regulation of the gene encoding the p50 subunit of
      the transcription factor NF-kappa B, we have isolated a human genomic clone, and
      sequenced the promoter of this gene. By in situ hybridization we have mapped the
      gene encoding the p50 subunit of NF-kappa B to the 4q23-4q25 region of the human
      genome and the H1-H3 region of the murine chromosome 3. The p50 promoter lacks
      TATA and CAAT elements, but contains NF-kappa B, AP-1 and HIP-1 binding sequence.
      The kappa B motif binds NF-kappa B, KBF1, and heterodimers of p50 and c-rel,
      suggesting that the gene is regulated by members of this family. Co-transfection
      experiments demonstrate that the p50 promoter can be activated by either of the
      two subunits of NF-kappa B (p50 and p65), and more strongly by the combination of
      both. The promoter of p50 can be activated by phorbol esters and tumor necrosis
      factor alpha but not by forskolin and these responses are mediated through the NF
      kappa B binding sequence. The involvement of NF-kappa B in the regulation of the
      p50 gene is also supported by the inhibition of the PMA activation of the
      promoter by an NF-kappa B transdominant negative mutant, as well as the product
      of the v-rel oncogene.

PMID- 1740106
TI  - A novel complex between the p65 subunit of NF-kappa B and c-Rel binds to a DNA
      element involved in the phorbol ester induction of the human urokinase gene.
AB  - The NF-kappa B subunits, p50 and p65, have extensive sequence homology with the c
      rel proto-oncogene and the Drosophila morphogen dorsal. It has recently been
      shown that in vitro translated c-Rel can bind to DNA and form a complex with p50.
      However, the conditions for DNA binding of c-Rel in vivo and its DNA sequence
      specificity have not been established. Here we report the identification a novel
      heterodimeric complex that binds to a kappa B-like, phorbol ester (TPA)
      responsive DNA sequence, 5'-GGGAAAGTAC-3', in the 5' flanking region of the human
      urokinase (uPA) gene. This sequence was shown to bind two protein complexes, LC
      and UC. LC was indistinguishable from NF-kappa B as it reacted with antibodies
      recognizing the p50 subunit of NF-kappa B, and was shown by UV crosslinking to
      contain the p50 and p65 subunits of NF-kappa B. UC, on the other hand, strongly
      reacted with anti-v-Rel, but not with the anti-p50 antibodies, and was shown by
      crosslinking to contain 75 kDa and 85 kDa protein-DNA adducts. The 75 kDa and the
      85 kDa adducts could be immunoprecipitated only by anti-p65 and anti-c-Rel
      antibodies, respectively, showing that c-Rel formed a heterodimer with p65. Both
      protein complexes were present in inactive forms in HeLa cell cytosol, and their
      nuclear translocation was induced by TPA. DNA binding of UC and LC could,
      furthermore, be inhibited by I kappa B-alpha.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740107
TI  - Biochemical and genetic analysis of operator contacts made by residues within the
      beta-sheet DNA binding motif of Mnt repressor.
AB  - Residues 2, 6, 8 and 10 of Mnt repressor are the major determinants of operator
      DNA binding and recognition. Here, we investigate the interaction of wild-type
      Mnt and mutants bearing the Arg2----Lys, His6----Ala, Asn8----Ala and Arg10---
      Lys mutations with operator DNA modified by methylation or by symmetric base
      substitutions. The wild-type pattern of methylation interference is altered in
      specific ways for each of the mutant proteins. In addition, some of the mutant
      proteins show a 'loss of contact' phenotype with specific mutant operators. Taken
      together, these and previous results predict the following contacts between side
      chains in the Mnt tetramer and operator DNA: Arg2 recognizes the guanines at
      operator positions 10 and 12; His6 contacts the guanines at operator positions 5
      and 17; Asn8 contacts operator positions 4, 7, 15 and 18; Arg10 contacts the
      guanines at operator positions 8 and 14. The proposed contacts can be
      accommodated in a structural model in which the anti-parallel beta-sheet motifs
      of Mnt dimers lie in the major grooves of each operator half-site, centered over
      pseudo-symmetry axes that are 5.5 bp from the central dyad axis of the operator.

PMID- 1740108
TI  - Recombination of constant and variable modules alters DNA sequence recognition by
      type IC restriction-modification enzymes.
AB  - EcoR124 and EcoDXXI are allelic type I restriction-modification (R-M) systems
      whose specificity genes consist of common structural elements: two variable
      regions are separated by a constant, homologous region containing a number of
      repetitive sequence elements. In vitro recombination of variable and constant
      elements has led to fully active, hybrid R-M systems exhibiting new and
      predictable target site specificities. Methylation of synthetic DNA sequences
      with purified, hybrid modification methylases was used to confirm the proposed
      recognition sequences. The results clearly demonstrate the correlation between
      protein domains and target site specificity. Our data suggest that a bacterial
      population may switch the recognition sequences of its type I R-M system by
      single recombination events and thus is able to maintain a prokaryotic analogue
      of the immune system of variable specificity.

PMID- 1740109
TI  - Characterization of a zinc finger DNA-binding protein expressed specifically in
      Petunia petals and seedlings.
AB  - In Petunia, the expression of the 5-enolpyruvylshikimate-3-phosphate synthase
      gene (EPSPS) is tissue-specific and developmentally regulated. Nuclear extracts
      from Petunia petal contain a factor that interacts with the 5' upstream region of
      EPSPS. DNase I footprinting experiments revealed four strong binding sites (EP1
      EP4) and several weaker sites that appear to bind the same factor. We have
      isolated a cDNA clone (EPF1) encoding a DNA-binding protein that has similar
      binding activity to that of the nuclear factor. The deduced amino acid sequence
      shows that the encoded protein, EPF1, contains two repeats of a Cys2/His2 zinc
      finger motif. EPF1 and the factor detected in nuclear extracts appear to differ
      in their molecular weight and Zn2+ requirements. Nevertheless, Northern blot
      analyses showed that the expression pattern of EPF1 is remarkably similar to that
      of EPSPS. In addition, as determined by translational fusion of the EPF1 upstream
      region to the beta-glucuronidase reporter gene, the cell specific expression
      pattern of EPF1 in flower and seedling is nearly identical to that of EPSPS.
      Taken together with the results of cis-element analyses, these observations
      suggest that EPF1 may be one of the factors involved in the activation of EPSPS.

PMID- 1740110
TI  - Targeted alterations of the Caenorhabditis elegans genome by transgene instructed
      DNA double strand break repair following Tc1 excision.
AB  - Excision of a Tc1 transposon of Caenorhabditis elegans is thought to leave a DNA
      double strand break. We report here that sequence polymorphisms in a transgenic
      DNA template are copied into the corresponding chromosomal gene upon excision of
      Tc1 from the chromosome. This shows that the double strand DNA break resulting
      from Tc1 excision is repaired with the extrachromosomal DNA as template and that
      sequences flanking the break can be replaced by sequences from the transgene.
      Transgene instructed break repair provides a method for the targeted introduction
      of precise alterations into the Caenorhabditis elegans genome.

PMID- 1740111
TI  - Xwnt-8 modifies the character of mesoderm induced by bFGF in isolated Xenopus
      ectoderm.
AB  - In Xenopus, growth factors of the TGF-beta, FGF and Wnt oncogene families have
      been proposed to play a role in generating embryonic pattern. In this paper we
      examine potential interactions between the bFGF and Xwnt-8 signaling pathways in
      the induction and dorsal-ventral patterning of mesoderm. Injection of Xwnt-8 mRNA
      into 2-cell Xenopus embryos does not induce mesoderm formation in animal cap
      ectoderm isolated from these embryos at the blastula stage, but alters the
      response of this tissue to mesoderm induction by bFGF. While animal cap explants
      isolated from non-injected embryos differentiate to form ventral types of
      mesoderm and muscle in response to bFGF, explants from Xwnt-8 injected embryos
      form dorsal mesodermal and neural tissues in response to the same concentration
      of bFGF, even if the ectoderm is isolated from the prospective ventral sides of
      embryos or from UV-ventralized animals. Our results support a model whereby dorso
      ventral mesodermal patterning can be attained by a single mesoderm inducing
      agent, possibly bFGF, which is uniformly distributed across the prospective
      dorsal-ventral axis, and which acts in concert with a dorsally localized signal,
      possibly a Wnt protein, which either alters the response of ectoderm to induction
      or modifies the character of mesoderm after its induction.

PMID- 1740112
TI  - Roles of U4 and U6 snRNAs in the assembly of splicing complexes.
AB  - A series of U4 and U6 snRNA mutants was analysed in Xenopus oocytes to determine
      whether they block splicing complex assembly or splicing itself. All the U4 and
      U6 mutants found to be inactive in splicing complementation resulted in defects
      in assembly of either U4/U6 snRNP or of splicing complexes. No mutants were found
      to separate the entry of U5 and U6 snRNAs into splicing complexes and neither of
      these RNAs was able to associate with the pre-mRNA in the absence of U4. In the
      absence of U6 snRNA, however, U4 entered a complex containing pre-mRNA as well as
      the U1 and U2 snRNAs. U6 nucleotides whose mutation resulted in specific blockage
      of the second step of splicing in Saccharomyces cerevisiae are shown not to be
      essential for splicing in the oocyte assay. The results are discussed in terms of
      the roles of U4 and U6 in the assembly and catalytic steps of the splicing
      process.

PMID- 1740113
TI  - Reconstituted mammalian U4/U6 snRNP complements splicing: a mutational analysis.
AB  - We have developed an in vitro complementation assay to analyse the functions of
      U6 small nuclear RNA (snRNA) in splicing and in the assembly of small nuclear
      ribonucleoproteins (snRNPs) and spliceosomes. U6-specific, biotinylated 2'-OMe
      RNA oligonucleotides were used to deplete nuclear extract of the U4/U6 snRNP and
      to affinity purify functional U4 snRNP. The addition of affinity purified U4
      snRNP together with U6 RNA efficiently restored splicing activity, spliceosome
      assembly and U4/U5/U6 multi-snRNP formation in the U4/U6-depleted extract.
      Through a mutational analysis we have obtained evidence for multiple sequence
      elements of U6 RNA functioning during U4/U5/U6 multi-snRNP formation, spliceosome
      assembly and splicing. Surprisingly, the entire 5' terminal domain of U6 RNA is
      dispensable for splicing function. In contrast, two regions in the central and 3'
      terminal domain are required for the assembly of a functional U4/U5/U6 multi
      snRNP. Another sequence in the 3' terminal domain plays an essential role in
      spliceosome assembly; a model is strongly supported whereby base pairing between
      this sequence and U2 RNA plays an important role during assembly of a functional
      spliceosome.

PMID- 1740114
TI  - The 2.2 A resolution crystal structure of influenza B neuraminidase and its
      complex with sialic acid.
AB  - Influenza virus neuraminidase catalyses the cleavage of terminal sialic acid, the
      viral receptor, from carbohydrate chains on glycoproteins and glycolipids. We
      present the crystal structure of the enzymatically active head of influenza B
      virus neuraminidase from the strain B/Beijing/1/87. The native structure has been
      refined to a crystallographic R-factor of 14.8% at 2.2 A resolution and its
      complex with sialic acid refined at 2.8 A resolution. The overall fold of the
      molecule is very similar to the already known structure of neuraminidase from
      influenza A virus, with which there is amino acid sequence homology of
      approximately 30%. Two calcium binding sites have been identified. One of them,
      previously undescribed, is located between the active site and a large surface
      antigenic loop. The calcium ion is octahedrally co-ordinated by five oxygen atoms
      from the protein and one water molecule. Sequence comparisons suggest that this
      calcium site should occur in all influenza A and B virus neuraminidases. Soaking
      of sialic acid into the crystals has enabled the mode of binding of the reaction
      product in the putative active site pocket to be revealed. All the large side
      groups of the sialic acid are equatorial and are specifically recognized by nine
      fully conserved active site residues. These in turn are stabilized by a second
      shell of 10 highly conserved residues principally by an extensive network of
      hydrogen bonds.

PMID- 1740115
TI  - Identification and characterization of an Escherichia coli gene required for the
      formation of correctly folded alkaline phosphatase, a periplasmic enzyme.
AB  - Tn5 insertion mutations of Escherichia coli were isolated that impaired the
      formation of correctly folded alkaline phosphatase (PhoA) in the periplasm. The
      PhoA polypeptide synthesized in the mutants was translocated across the
      cytoplasmic membrane but not released into the periplasmic space. It was
      susceptible to degradation by proteases in vivo and in vitro. The wild-type
      counterpart of this gene (named ppfA) has been sequenced and shown to encode a
      periplasmic protein with a pair of potentially redox-active cysteine residues.
      PhoA synthesized in the mutants indeed lacked disulfide bridges. These results
      indicate that the folding of PhoA in vivo is not spontaneous but catalyzed at
      least at the disulfide bond formation step.

PMID- 1740116
TI  - Interconversion of three differentially modified and assembled forms of BiP.
AB  - The immunoglobulin heavy chain binding protein BiP/GRP78 is post-translationally
      modified by phosphorylation and ADP ribosylation. In cells induced to synthesize
      higher levels of BiP, either due to the accumulation of nontransported proteins
      or to glucose starvation, both BiP phosphorylation and ADP ribosylation are
      reduced. BiP bound to other proteins is unmodified, suggesting that both
      phosphorylation and ADP ribosylation are restricted to the unbound BiP pool. In
      the present study, both modifications were further characterized in terms of
      their stability, the pool of BiP that harbored these modifications, and the
      relationship between the modified and unmodified forms of BiP. While levels of
      BiP synthesis vary according to the physiological state of a cell, we found that
      both induced and uninduced cells contain similar amounts of free BiP. However,
      free BiP in uninduced cells was found primarily in an aggregated state, whereas
      in cells that accumulate nontransported proteins, it was predominantly monomeric.
      Both phosphorylation and ADP ribosylation were restricted to the aggregated form
      of free BiP. These post-translational modifications occurred upon release of BiP
      from associated proteins, and could be reversed upon induction of BiP synthesis.
      Therefore, BiP exists either (1) complexed to other proteins, (2) as a free
      unmodified monomer, or (3) as free modified aggregates. Our data suggest that BiP
      can be interconverted from one state to another, and that the various forms are
      functionally distinct.

PMID- 1740117
TI  - Involvement of the chaperonin dnaK in the rapid degradation of a mutant protein
      in Escherichia coli.
AB  - The ability of Escherichia coli rapidly to degrade abnormal proteins is inhibited
      by mutations affecting any of several heat shock proteins (hsps). We therefore
      tested whether a short-lived mutant protein might become associated with hsps as
      part of its degradation. At 30 degrees C, the non-secreted mutant form of
      alkaline phosphatase, phoA61, is relatively stable, and very little phoA61 is
      found associated with the hsp dnaK. However, raising the temperature to 37
      degrees C or 41 degrees C stimulated the degradation of this protein, and up to
      30% of cellular phoA61 became associated with dnaK, as shown by
      immunoprecipitation and Western blot analysis. Also found in complexes with
      phoA61 were the hsps, protease La and grpE (but no groEL, or groES). The rapid
      degradation of phoA61 at 37 degrees C and 41 degrees C is in part by protease La,
      since it decreased by 50% in lon mutants. This process also requires dnaK, since
      deletion of this gene prevented phoA61 degradation almost completely (unless a
      wild-type dnaK gene was introduced). In contrast, the missense mutation, dnaK756,
      enhanced phoA61 degradation. The dnaK756 protein also was associated with phoA61,
      but this complex, unlike that containing wild-type dnaK could not be dissociated
      by ATP addition. Furthermore, in a grpE mutant, the degradation of phoA61 and the
      amount associated with dnaK increased, while in a dnaJ mutant, phoA61 degradation
      and its association with dnaK decreased. Thus, complex formation with dnaK
      appears essential for phoA61 degradation by protease La and some other cell
      proteases, and a failure of the dnaK to dissociate normally may accelerate
      proteolytic attack.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740118
TI  - Insertion and assembly of the precursor of subunit II into the photosystem I
      complex may precede its processing.
AB  - The biogenesis and assembly of subunit II of photosystem I (PSI) (psaD gene
      product) were studied and characterized. The precursor and the mature form were
      produced in vitro and incubated with intact plastids or isolated thylakoids.
      Following import of the precursor into isolated plastids, mostly the mature form
      of subunit II was found in the thylakoids. However, when the processing activity
      was inhibited only the precursor form was present in the membranes. The precursor
      was processed by a stromal peptidase and processing could occur before or after
      insertion of the precursor into the thylakoids. Following insertion into isolated
      thylakoids, both the precursor and the mature form of subunit II were confined to
      the PSI complex. Insertion of the mature form of subunit II was much less
      efficient than that of the precursor. Kinetic studies showed that the precursor
      was inserted into the membrane. Only at a later stage, the mature form began to
      accumulate. These results suggest that in vivo the precursor of subunit II is
      inserted and embedded in the thylakoids, as part of the PSI complex. Only later,
      it is processed to the mature form through the action of a stromal peptidase.

PMID- 1740119
TI  - Casein kinase II phosphorylation increases the rate of serum response factor
      binding site exchange.
AB  - Recombinant baculoviruses were used to express wild-type serum response factor
      (SRF) and a mutant, SRF.CKIIA, which lacks all four serine residues in the major
      casein kinase II (CKII) site at residues 77-90. Purified recombinant SRF binds
      DNA with an affinity and specificity indistinguishable from that of HeLa cell
      SRF, and activates transcription in vitro. Comparative phosphopeptide analysis of
      the wild-type and mutant proteins demonstrated that the wild-type protein is
      phosphorylated at the major CKII site in insect cells. Dephosphorylation of
      recombinant SRF does not affect its affinity for the c-fos SRE, and results in
      only a 3-fold reduction in binding to the synthetic site ACT.L. However,
      dephosphorylation does cause a large decrease in the rates of association with
      and dissociation from either site. These effects are due solely to
      phosphorylation at the major CKII site: the binding properties of the SRF.CKIIA
      mutant are identical to those of dephosphorylated wild-type SRF, and CKII
      phosphorylation in vitro converts dephosphorylated wild-type SRF from a slow
      binding to a fast-binding form without significantly changing binding affinity.
      CKII phosphorylation thus acts to potentiate SRF-DNA exchange rates rather than
      alter equilibrium binding affinity.

PMID- 1740120
TI  - cis-diol dehydrogenases encoded by the TOL pWW0 plasmid xylL gene and the
      Acinetobacter calcoaceticus chromosomal benD gene are members of the short-chain
      alcohol dehydrogenase superfamily.
AB  - In the aerobic degradation of benzoate by bacteria, benzoate is first
      dihydroxylated by a ring-hydroxylating dioxygenase to form a cis-diol (1,2
      dihydroxycyclohexa-3,4-diene carboxylate) which is subsequently transformed to a
      catechol by an NAD(+)-dependent cis-diol dehydrogenase. The structural gene for
      this dehydrogenase, encoded on TOL plasmid pWW0 of Pseudomonas putida (xylL) and
      that encoded on the chromosome of Acinetobacter calcoaceticus (benD), were
      sequenced. They encode polypeptides of about 28 kDa in size. These proteins are
      similar to each other, exhibiting 58% sequence identity. They are also similar to
      other proteins of at least 20 different functions, which are members of the short
      chain alcohol dehydrogenase family. The alignment of these proteins suggest two
      amino acids, lysine and tyrosine, as catalytically important residues.

PMID- 1740121
TI  - Expression of the Saccharomyces cerevisiae Kex2p endoprotease in inset cells.
      Evidence for a carboxy-terminal autoprocessing event.
AB  - The pheromone-processing Kex2p endoprotease of Saccharomyces cerevisiae has been
      difficult to characterize due to its low level of expression in yeast cells. To
      overcome this problem, we have overexpressed Kex2p using the baculovirus/insect
      cell expression system. Spodoptera frugiperda Sf9 insect cells infected with a
      recombinant baculovirus, containing the complete KEX2 gene which encodes the
      Kex2p protease (814 amino acids), accumulate an 120-kDa functional form of the
      enzyme. The inhibition profile of the insect-cell-derived endoprotease is similar
      to that of the yeast enzyme. The recombinant infected insect cells also secrete
      into the medium about half of the total Kex2p activity produced. Deleting the
      carboxyl-terminal tail and the transmembrane domain of Kex2p (Kex2 delta p, 666
      amino acids) does not measurably interfere with the enzyme characteristics and
      results in the secretion of up to 90% of the total enzyme activity. The truncated
      form, Kex2 delta p, of the endoprotease accumulates in the cell supernatant to
      6.7 x 10(5) U/l. The molecular mass of the secreted forms for both the wild-type
      Kex2p and Kex2 delta p is the same (70 kDa) and is 50-kDa lower than the
      intracellular form. This result implicates a processing event which gives rise to
      shorter extracellular forms of both the wild-type Kex2p and Kex2 delta p and
      which trims their carboxy termini upsteam of amino acid 666. This processing
      event requires the integrity of the Ser385 of the Kex2p active site.

PMID- 1740122
TI  - Interaction of Prodan with tubulin. A fluorescence spectroscopic study.
AB  - The compound 6-propionyl-2-(N,N-dimethyl)-aminonaphthalene (Prodan), an efficient
      fluorescent probe for proteins, is shown to bind to tubulin. Detailed experiments
      on fluorescence enhancement, anisotropy and energy transfer were carried out to
      unravel the nature of Prodan-tubulin interaction and the Prodan-binding site on
      tubulin. It was found that Prodan binds to tubulin at a rigid site, with a
      stoichiometry of 1:1 and a dissociation constant of 20 microM. Competition
      experiments using 1,8-[3H]anilinonaphthalenesulfonate ([3H]ANS) indicated that
      the three aminonaphthalenes, ANS, bis(1,8-anilinonaphthalenesulfonate) and Prodan
      probably bind to a common region on the tubulin molecule.

PMID- 1740123
TI  - Structure of the Clostridium thermocellum gene licB and the encoded beta-1,3-1,4
      glucanase. A catalytic region homologous to Bacillus lichenases joined to the
      reiterated domain of clostridial cellulases.
AB  - The nucleotide sequence of the Clostridium thermocellum gene licB, coding for a
      thermoactive beta-1,3-1,4-glucanase, has been determined. The gene is located
      downstream, but in opposite orientation to the beta-glucosidase gene bglA. A
      coding region of 1002 bp is flanked by canonical promoter and transcription
      terminator sequences. The primary translation product of the licB gene has a
      predicted molecular mass of 37,896 Da. The protein sequence can be divided into
      several discrete segments: an N-terminal signal peptide, a catalytic region, a
      segment rich in Pro and Thr residues and a C-terminal reiterated domain. The
      catalytic region shows close similarity to lichenases of bacilli (52-58%
      identity) and Fibrobacter succinogenes (35% identity), but is unrelated to barley
      beta-1,3-1,4-glucanases. It consists of two domains, which in the case of the F.
      succinogenes lichenase are arranged in reversed order to that of C. thermocellum
      and Bacillus lichenases. The C-terminal reiterated domain of C. thermocellum
      lichenase is homologous to the duplicated non-catalytic domain of endo-beta-1,4
      glucanases and xylanase Z from the same organism. This domain is considered a
      characteristic feature of clostridial cellulases organized as multienzyme complex
      (cellulosome). The beta-1,3-1,4-glucanase encoded by the licB gene might
      therefore be an additional enzyme component of the C. thermocellum cellulosome.

PMID- 1740124
TI  - Sequence-specific NMR assignments of the trp repressor from Escherichia coli
      using three-dimensional 15N/1H heteronuclear techniques.
AB  - Sequence-specific 15N and 1H assignments for the trp holorepressor from
      Escherichia coli are reported. The trp repressor consists of two identical 107
      residue subunits which are highly helical in the crystal state [Schevitz, R.,
      Otwinowski, Z., Joachimiak, A., Lawson, C. L. & Sigler, P. B. (1985) Nature 317,
      782-786]. The high helical content and the relatively large size of the protein
      (Mr = 25,000) make it difficult to assign even the main-chain resonances by
      conventional homonuclear two-dimensional NMR methods. However, we have now
      assigned the main-chain resonances of 94% of the residues by using three
      dimensional 15N/1H heteronuclear experiments on a sample of protein uniformly
      labelled with 15N. The additional resolution obtained by spreading out the
      signals into three dimensions proved indispensable in making these assignments.
      In particular, we have been able to resolve signals from residues in the N
      terminal region of the A helix for the first time in solution. The observed NOE
      results confirm that the repressor is highly helical in solution, and contains no
      extended chain conformations.

PMID- 1740125
TI  - Isolation and structural determination of three peptides from the insect Locusta
      migratoria. Identification of a deoxyhexose-linked peptide.
AB  - We have isolated three novel peptides from the aqueous extract of the pars
      intercerebralis of male and female adults of the insect Locusta migratoria. After
      extensive HPLC purification, the peptides were characterised by automated Edman
      degradation and electrospray mass spectrometry: one is a 35-residue peptide
      (3752.3 +/- 1.1 Da) containing six cysteines involved in three intramolecular
      disulfide bridges, the second is a 36-residue peptide (3919.2 +/- 0.9 Da), also
      cross-linked by three intramolecular disulfide bridges. This second peptide is
      post-translationally modified by a single fucose moiety, which was identified by
      gas chromatography coupled to mass spectrometry. These two peptides show a strong
      sequence similarity. Additionally, they were also found in larger amounts in the
      fat body of Locusta; this finding raises the question of their exact site of
      synthesis. The third peptide (5776.3 +/- 0.9 Da), a 54-residue peptide cross
      linked by six intramolecular disulfide bridges, is structurally related to the
      two other peptides, but to a lesser extent. Mass spectrometry has shown that all
      the cysteines within these three peptides are involved in intramolecular
      disulfide bridges; however, the location of these bridges is not yet established
      and is currently being investigated. A computer search of sequence data banks did
      not reveal any significant similarity of these three peptides with other known
      proteins.

PMID- 1740126
TI  - Studies on the variants of the protein toxins ricin and abrin.
AB  - This study elucidates some structural and biological features of galactose
      binding variants of the cytotoxic proteins ricin and abrin. An isolation
      procedure is reported for ricin variants from Ricinus communis seeds by using
      lactamyl-Sepharose affinity matrix, similar to that reported previously for
      variants of abrin from Abrus precatorius seeds [Hegde, R., Maiti, T. K. & Podder,
      S. K. (1991) Anal. Biochem. 194, 101-109]. Ricin variants, subfractionated on
      carboxymethyl-Sepharose CL-6B ion-exchange chromatography, were characterized
      further by SDS/PAGE, IEF and a binding assay. Based on the immunological cross
      reactivity of antibody raised against a single variant of each of ricin and
      abrin, it was established that all the variants of the corresponding type are
      immunologically indistinguishable. Analysis of protein titration curves on an
      immobilized pH gradient indicated that variants of abrin I differ from other
      abrin variants, mainly in their acidic groups and that variance in ricin is a
      cause of charge substitution. Detection of subunit variants of proteins by two
      dimensional gel electrophoresis showed that there are twice as many subunit
      variants as there are variants of holoproteins, suggesting that each variant has
      a set of subunit variants, which, although homologous, are not identical to the
      subunits of any other variant with respect to pI. Seeds obtained from polymorphic
      species of R. communis showed no difference in the profile of toxin variants, as
      analyzed by isoelectric focussing. Toxin variants obtained from red and white
      varieties of A. precatorius, however, showed some difference in the number of
      variants as well as in their relative intensities. Furthermore, variants analyzed
      from several single seeds of A. precatorius red type revealed a controlled
      distribution of lectin variants in three specific groups, indicating an
      involvement of at least three genes in the production of Abrus lectins. The
      complete absence or presence of variants in each group suggested a post
      translational differential proteolytic processing, a secondary event in the
      production of abrin variants.

PMID- 1740127
TI  - 31P-NMR assignment and conformational study of NADPH bound to Lactobacillus casei
      dihydrofolate reductase based on two-dimensional 1H-31P-heteronuclear and 1H
      detected 1H-31P-shift-correlation experiments.
AB  - For any detailed NMR conformational study of a protein-ligand complex it is
      essential to have specific resonance assignments. We have now assigned the
      pyrophosphate 31P resonances in spectra of NADPH bound to Lactobacillus casei
      dihydrofolate reductase (DHFR) by using a combination of 1H-31P-heteronuclear
      shift-correlation (HETCOR), 1H-31P-heteronuclear multiple-quantum-coherence
      correlation spectroscopy (HMQC-COSY), 1H-1H COSY, homonuclear Hartmann-Hahn
      (HOHAHA) and NOE spectroscopy (NOESY) experiments. The nicotinamide pyrophosphate
      phosphorus, P(n), has been unequivocally assigned to a signal (-14.07 ppm) which
      shows a large 3JP-O-C-H coupling constant. Such a coupling constant when combined
      with the appropriate Karplus relationship provides conformational information
      about the P-O-C-H torsion angle. The torsion angle changes by 65 degrees +/- 10
      degrees for the binary complex compared with the value in free NADPH. The
      observed coupling constants for the binary (DHFR--NADPH) and ternary (DHFR--NADPH
      -methotrexate) complexes (12.3 and 10.5 +/- 0.6 Hz, respectively) indicate that
      the pyrophosphate group has a similar conformation in the two complexes.

PMID- 1740128
TI  - Effects of ions on the intrinsic activities of c-H-ras protein p21. A comparison
      with elongation factor Tu.
AB  - The influence of the ionic environment on the intrinsic GTPase activity and the
      guanine-nucleotide interaction of Ha-ras protein p21 were studied in various
      experimental conditions and compared with the behaviour of elongation factor (EF)
      Tu. To this purpose, nucleotide-free p21 was prepared, which is much more stable
      than by any other reported method. Specific differences between p21 and EF-Tu
      were found in the action of divalent anions which strongly enhance the
      dissociation rate of p21.GDP without affecting that of EF-Tu. Unlike EF-Tu, the
      GTPase activity of p21 is only slightly dependent on the presence and
      concentration of monovalent cations. The concentrations of Mg2+ influencing the
      dissociation rate of the p21.GDP complex are much higher than for the intrinsic
      GTPase activity, an effect also observed for EF-Tu. These results point to two
      distinct roles of Mg2+: as a conformational regulator of the interaction with the
      substrate and as a key element for the hydrolysis of GTP. The GTPase activity of
      p21 is not affected by changes in pH over the range 6-9.2, different from that of
      EF-Tu. However, stabilization by kirromycin confers a pH independence to the
      GTPase of EF-Tu in the pH range 6.5-10, suggesting that the bell-shaped behaviour
      of this activity in the absence of the antibiotic is due to denaturation. This
      implies similar properties in the catalytic mechanism of these two guanine
      nucleotide-binding proteins.

PMID- 1740129
TI  - Action pattern of xylo-oligosaccharide hydrolysis by Schizophyllum commune
      xylanase A.
AB  - The endo-1,4-beta-xylanase of the basidiomycete Schizophyllum commune, designated
      xylanase A, was studied to determine its action pattern, rates of reaction and
      bond-cleavage frequencies on xylo-oligomer and xylo-alditol substrates ranging in
      degree of polymerization (Dp) from xylotriose (X3) to xyloheptaose (X7). An HPLC
      method using a Dionex HPLC and Carbopac PA1 ion-exchange column with pulsed
      amperometric detection was developed to quantify both substrate loss and increase
      of products. Xylanase A had no detectable activity on xylobiose (X2) and low
      activity on xylotriose and xylotetraose (X4) but cleaved X5-X7 rapidly with X2
      and X3 as major products. Initial rate data from hydrolyses of individual
      oligomers at 25 degrees C and pH 5.81 indicated that the Michaelis constant (Km)
      decreased with increasing chain length (n) of oligomer. Turnover number (kcat)
      increased with chain length up to n = 7 suggesting that the specificity region of
      xylanase A spans about seven xylose units. Bond-cleavage frequencies obtained
      from xylanase A hydrolysis of xylo-alditols indicated a strong preference for
      internal linkages of the xylose chain. The action pattern of xylanase A on
      reduced substrates suggests that the catalytic site is located assymetrically
      within the binding cleft of the enzyme.

PMID- 1740130
TI  - Cytoplasmic high-level expression of a soluble, enzymatically active form of the
      Escherichia coli penicillin-binding protein 5 and purification by dye
      chromatography.
AB  - High-level expression of a soluble form of penicillin-binding protein 5 (PBP5),
      called PBP5s, and translocation across the cytoplasmic membrane results in lysis
      of Escherichia coli cells. The detrimental effect of increased amounts of this
      D,D-carboxypeptidase on the stability of murein polymer can be avoided by
      accumulation of the overexpressed protein in the cytoplasm. The signal peptide of
      the structural gene dacAs, coding for PBP5s was deleted by creating a BamHI site
      at the site of processing and the truncated gene dacAsc was cloned under the
      control of the lambda PR promoter. Temperature induction resulted in a 200-fold
      overproduction of the mature PBP5s in the cytosol (PBP5sc) which is no longer
      harmful to the cells. PBP5sc could quantitatively be recovered in the soluble
      fraction after disrupting the cells. The protein retained full enzymatic activity
      as measured by the release of D-alanine from bisacetyl-L-Lys-D-Ala-D-Ala and
      formation of [14C]penicillin-protein complex at a 1:1 stoichiometry. A one-step
      purification procedure using the immobilized dye Procion rubine MX-B resulted in
      homogeneous preparations of both wild-type and mutated forms of PBP5sc.

PMID- 1740131
TI  - Use of influenza C virus for detection of 9-O-acetylated sialic acids on
      immobilized glycoconjugates by esterase activity.
AB  - An overlay and a solid-phase assay are presented which allow the specific
      detection of 9-O-acetylated sialic acids on sialoglycoconjugates immobilized on
      microtiter plates, nitrocellulose or separated on thin-layer chromatograms. The
      assay takes advantage of two different biological properties of influenza C
      virus, its high-affinity binding to 9-O-acetylated sialic acids and its sialate 9
      O-acetylesterase that is used for detection of bound virus with fluorogenic or
      chromogenic substrates. Though simple and rapid, the assay is highly sensitive
      with a detection limit of 65 fmol 9-O-acetylated sialic acid in 9-O-acetylated
      ganglioside GD1a. Influenza C virus is able to bind to a wide spectrum of
      sialoglycoconjugates like mucins, serum glycoproteins or gangliosides containing
      naturally or synthetically O-acetylated sialic acids. 9-O-Acetyl-N
      glycoloylneuraminic acid can also function as a high-affinity receptor
      determinant for influenza C virus. While the acetyl ester at the 9 position is
      essential for virus binding in all cases, a 4-O-acetyl group is not recognized.
      In addition to alpha(2.3) or alpha(2.6) bonds, 9-O-acetyl-N-acetylneuraminic acid
      in alpha(2.8) linkage to N-acetylneuraminic acid is also functionally active.

PMID- 1740132
TI  - Cross-species comparison of the sequence of the leukaemia inhibitory factor gene
      and its protein.
AB  - Leukaemia inhibitory factor (LIF) is a pleiotropic growth factor active in
      diverse cell systems in both the adult and the embryo. The LIF gene from a number
      of mammalian species is highly conserved. The ovine and porcine LIF genes were
      cloned, sequenced and compared to the previously published murine and human LIF
      gene sequences. While the coding regions of the LIF gene are highly conserved,
      the non-coding regions are largely non-conserved. In a region of approximately
      340 bp, the 5' end of the translational initiation codon is highly conserved
      (84%). This region includes four conserved TATA boxes, two transcriptional start
      sites identified in the murine gene and the minimal region required to function
      as the LIF promoter. A sequence in the murine gene adjacent to this highly
      conserved region which appears to contain a negative control element is, however,
      poorly conserved between the four species compared, except for a sequence of 16
      conserved nucleotides. Within the largely non-conserved first intron, there is a
      block of approximately 150 nucleotides which is highly conserved between all four
      species (approximately 72%). However, a sequence in intron 1 of the murine LIF
      gene which corresponds to an alternative exon of a putative variant LIF
      transcript is very poorly conserved between species, with only relics of this
      exon evident in the other three species. A comparison of the five LIF protein
      sequences available (murine, rat, human, ovine and porcine) revealed that the
      protein displays a high degree of similarity, ranging from 74% between mouse and
      sheep to 92% between rat and mouse. Several large blocks of absolutely conserved
      amino acid sequence were identified. The ovine LIF gene was modified to allow
      production of recombinant ovine LIF in yeast cells, which was shown to be
      biologically active on murine cells.

PMID- 1740133
TI  - Structure of the capsular polysaccharide of Actinobacillus pleuropneumoniae
      serotype 5b.
AB  - The capsular polysaccharide of Actinobacillus pleuropneumoniae serotype 5b
      (strain L20) was found to be a high molecular mass polymer composed of 2
      acetamido-2-deoxy-D-glucose, D-glucose, and 3-deoxy-D-manno-octulosonic acid
      (KDO). Methylation analysis, partial hydrolysis and a combination of homonuclear
      and 1H-detected heteronuclear shift-correlated nuclear magnetic resonance
      experiments showed the polysaccharide to be a branched polymer of a trisaccharide
      repeating unit, having the structure: [formula; see text]

PMID- 1740134
TI  - Membrane protein acylation. Preference for exogenous myristic acid or endogenous
      saturated chains in Acholeplasma laidlawii.
AB  - Mycoplasmas are small bacteria without a cell wall, often found as surface
      parasites on eukaryotic cells. Of the more than 200 membrane proteins from
      Acholeplasma laidlawii resolved by two-dimensional PAGE, 23 were covalently
      modified with acyl chains. These acyl proteins had lower pI values than average
      and were all labelled by different exogenously supplied radioactive fatty acids
      attached by O-ester bonds. The fatty acids were selectively incorporated in the
      order myristic acid (14:0) greater than palmitic acid (16:0) greater than stearic
      acid (18:0) greater than oleic acid (18:1). However, endogenously synthesised
      saturated fatty acids, most of which were 16:0, were preferred over the supplied
      ones. A fraction of the exogenous 14:0 was elongated to 16:0. Absence of
      saturated fatty acids increased the incorporation of 18:1. The maximum extent of
      modification was one acyl chain for protein T2, on the exterior surface and two
      acyl chains for protein D12, spanning them membrane. Exogenously supplied fatty
      acids were incorporated into membrane lipids in proportion to their occurrence.
      However, the acylated proteins always contained 8-10 times more saturated chains
      than did the lipids. When exogenously supplied, all A. laidlawii polar membrane
      lipids could donate acyl chains to the acylated proteins but the neutral fraction
      (fatty acids and diacylglycerol) was most efficient. An incorporation into the
      acylated proteins of labelled cysteine, but not glucose or glycerol, was
      observed. Acylated proteins with different chains interacted similarly with a
      Triton X-114 detergent phase, and no full-size proteins (or acylated fragments)
      were released from cells by proteolytic enzymes. The results indicate an
      anchoring with peptide segments in addition to the acyl chains. Both 14:0 and
      16:0 were attached at one end of both T2 and D12, but the N-terminal methionine
      of T2 was not acylated. The extent of modification and preference for saturated
      chains in the A. laidlawii membrane acylated proteins is more similar to
      eukaryotic than to eubacterial proteins.

PMID- 1740135
TI  - Characterization of a recombinant bifunctional enzyme, galactose
      dehydrogenase/bacterial luciferase, displaying an improved bioluminescence in a
      three-enzyme system.
AB  - The two structural genes encoding galactose dehydrogenase (Pseudomonas
      fluorescens) and the beta subunit of luciferase (Vibrio harveyi) were fused in
      frame in order to prepare and subsequently characterize an artificial
      bifunctional enzyme complex. This hybrid enzyme exhibited both galactose
      dehydrogenase activity and bioluminescence when expressed in Escherichia coli
      together with the alpha subunit of luciferase. The purified conjugate was used to
      study possible proximity effects in a sequential three-enzyme reaction with the
      bifunctional enzyme catalyzing the first and the last reaction. The intermediate
      enzyme, diaphorase, was added separately. The engineered enzyme system,
      comprising the galactose dehydrogenase/luciferase conjugate, could display a
      twofold higher bioluminescence in the overall enzyme reaction compared to a
      corresponding reference system with separate native enzymes. The increased
      bioluminescence obtained for the engineered enzyme system is proposed to be due
      to an improved organization of the enzyme in solution.

PMID- 1740136
TI  - Redox control of catalysis in ATP-citrate lysate from rat liver.
AB  - In thiol redox buffers at pH 8.0, rat liver ATP-citrate lyase is in equilibrium
      between an oxidised inactive form and a reduced active form. The reduced enzyme
      is inactivated by oxidised glutathione (GSSG) at a rate of 45 min-1.M-1 and the
      oxidised enzyme is activated by reduced glutathione (GSH) at a rate of 3.2 min
      1.M-1. At redox equilibrium, the enzyme activity depends on the ratio
      [GSH]2/[GSSG]. The inactivation involves formation of a protein-protein
      disulphide rather than a protein-glutathione complex. This reaction has Keq = 78
      +/- 7 mM for the oxidative reaction. Activity can therefore be controlled by the
      redox state of the cell, being more active in the fed state than in the
      oxidatively stressed state. This redox process is also important in the in vitro
      enzyme assay, where ATP-citrate lyase is in redox equilibrium with oxygen and
      either dithiothreitol or 2-mercaptoethanol. Reduction is a two-step process,
      requiring high concentrations of reductant for full activation (30 mM
      dithiothreitol or 200 mM 2-mercaptoethanol). The enzyme inhibitor, Medica-16
      raises the redox equilibrium constant to greater than 400 mM. It binds more
      tightly to the oxidised form of the enzyme, with Ki less than 40 microM compared
      to 180 microM for the reduced form.

PMID- 1740137
TI  - Channelling can decrease pool size.
AB  - It is widely considered that a possible advantage of metabolite channelling, in
      which a product of an enzyme is transferred to the next enzyme in a metabolic
      pathway without being released to the 'bulk' solution, is that channelling can
      decrease the steady-state concentrations of 'pool' intermediates. This then
      spares the limited solvent capacity of the cell, and reduces the loss of pathway
      flux due to leakage or instability of the free intermediate. Recently, however,
      based on simulations of a particular model of a 'dynamic' channel, Cornish-Bowden
      ["Failure of channelling to maintain low concentrations of metabolic
      intermediates" (1991) Eur. J. Biochem. 195, 103-108] has argued that this is not
      in fact the case; his simulations indicated that the channel was rather
      ineffective at decreasing the concentration of the pool intermediate, and in some
      cases actually increased it. However, although his simulations were restricted to
      very specific thermodynamic and kinetic parameters, he generalised his
      conclusions, arguing that "channelling has no effect on the free concentration of
      a channelled intermediate in a pathway". By showing that, for a number of kinetic
      cases, the concentration of the pool intermediate did decrease substantially with
      increased channelling, we demonstrate here that the conclusion of Cornish-Bowden
      is not correct. In particular, if the reaction catalysed by the enzymes forming
      the channel has an equilibrium constant K higher than 1, and if the enzyme
      removing the product of the channel reaction is kinetically competent,
      channelling in the model system studied by Cornish-Bowden (1991) can decrease the
      steady-state concentration of the pool by a factor of 1000, independently of the
      mechanism of the terminal reaction and under conditions of essentially constant
      overall flux. If the channel is a 'static' channel, the decrease in the pool can
      be to arbitrarily low levels. This conclusion also holds for a system in which
      other reactions may consume the pool intermediate. Thus, channelling can maintain
      metabolite concentrations at low levels.

PMID- 1740138
TI  - Repair of transcriptionally active and inactive genes during S and G2 phases of
      the cell cycle.
AB  - To study the effect of ultraviolet irradiation on S and G2 phases of the cell
      cycle, BB88 mouse cells synchronized by a double thymidine block were exposed to
      ultraviolet light, and rates of DNA synthesis and mitotic indexes were determined
      at regular intervals. It was found that with increasing ultraviolet dose,
      semiconservative DNA synthesis decreased and the sharp mitotic wave observed in
      the unirradiated cells gradually degenerated. To study repair, semiconservative
      DNA replication was inhibited with hydroxyurea at different time intervals after
      releasing cells from the block and the DNA synthesized as a result of repair of
      the ultraviolet damage was labeled with 5'-bromodeoxyuridine (BrdU). The newly
      repaired DNA was separated from bulk DNA by immunoprecipitation with monoclonal
      anti-BrdU antibody, labeled with 32P and hybridized to nine different gene and
      oncogene probes dot-blotted in excess on nylon membranes to determine their
      abundance in the repaired DNA. The results showed that: (a) the most actively
      repaired segment was a 211-bp sequence adjacent to the promotor region of the
      beta-actin gene; (b) all transcriptionally active genes were repaired at similar
      and constant rates throughout S and G2 phases; (c) the nontranscribed genes were
      repaired at much lower rates in early S phase, but later in S phase and
      especially in G2 phase, their repair rates increased and approached those of the
      transcribed genes.

PMID- 1740139
TI  - Pharmacological and biochemical characterization of cholecystokinin/gastrin
      receptors in developing rat pancreas. Age-related expression of distinct receptor
      glycoforms.
AB  - Cholecystokinin/gastrin receptors in the pancreas of newborn (3-day-old) rats are
      of type A, as in control mature rats, revealed by pharmacological analysis of
      specific 125I-Bolton-Hunter-reagent-labelled [Thr34,Ahx37]cholecystokinin(31-39)
      (Ahx, aminohexanoic acid) binding. Also, by 1 day post-partum, pancreatic
      cholecystokinin receptors were shown to be coupled to guanine-nucleotide-binding
      regulatory (G) proteins. Scatchard analysis of 125I-Bolton-Hunter-reagent
      labelled [Thr34,Ahx37]cholecystokinin(31-39) binding to pancreatic membranes from
      rats at different times after birth showed a slight increase in the binding
      capacity of cholecystokinin receptors between days 3 and 14 and a sixfold
      increase in 21-day-old rats, with no change in receptor affinity during
      development. SDS/PAGE analysis of pancreatic membranes affinity labelled with the
      photoactivable ligand 125I-[2-(p-azidosalicylamido)-1,3'-dithiopropionate]
      labelled [Thr34,Ahx37]cholecystokinin-(31-39) identified cholecystokinin
      receptors of 100-135 kDa in 3-day-old rats, 96-130 kDa in 7-day-old rats, 90-125
      kDa in 10-day-old rats and 85-100 kDa in 14-day-old and 21-day-old rats, as found
      in control adult rats. Endo-beta-N-acetylglucosaminidase F treatment yielded a
      core protein of 42 kDa in all developmental stages. These findings are consistent
      with an age-related postnatal expression of distinct glycoforms of pancreatic
      cholecystokinin receptors. Furthermore, it was observed that the period 2-3 weeks
      after birth, characterized by stabilization of the mass of the cholecystokinin
      receptor, precedes the dramatic increase in the receptor number.

PMID- 1740140
TI  - Role of the beta subunit of casein kinase-2 on the stability and specificity of
      the recombinant reconstituted holoenzyme.
AB  - Recombinant human alpha subunit from casein kinase-2 (CK-2) was subjected, either
      alone or in combination with recombinant human beta subunit, to high temperature,
      tryptic digestion and urea treatment. In all three cases, it was shown that the
      presence of the beta subunit could drastically reduce the loss of kinase
      activity, strongly suggesting a protective function for the beta subunit.
      Assaying different peptides for specificity toward the recombinant alpha subunit
      and the recombinant reconstituted enzyme, showed that the presence of the beta
      subunit could modify the specificity of the catalytic alpha subunit. Therefore, a
      dual function for the beta subunit is proposed which confers both specificity and
      stability to the catalytic alpha subunit within the CK-2 holoenzyme complex. The
      peptide DLEPDEELEDNPNQSDL, reproducing the highly acidic amino acid 55-71 segment
      of the human beta subunit, counteracts the stimulatory effect of the beta subunit
      on the alpha subunit activity and partially substitutes the beta subunit in
      conferring thermal stability to the alpha subunit. No such effect is induced by
      the peptide MSSSEEVSW, reproducing the N-terminal segment of the beta subunit
      including the autophosphorylation site. It is suggested that the acidic domain of
      the beta subunit, encompassing residues 55-71, plays a role in the interactions
      between the beta and alpha subunits.

PMID- 1740142
TI  - ADP-ribosylation of actins by arginine-specific ADP-ribosyltransferase purified
      from chicken heterophils.
AB  - We reported the purification and characterization of an arginine-specific ADP
      ribosyltransferase and acceptor protein p33 in granules of chicken peripheral
      polymorphonuclear leukocytes (heterophils) [Mishima, K., Terashima, M., Obara,
      S., Yamada, K., Imai, K. & Shimoyama, M. (1991) J. Biochem. (Tokyo) 110, 388
      394]. In the present study, we obtained evidence that chicken non-muscle
      beta/gamma-actin, skeletal muscle alpha-actin and smooth-muscle gamma-actin were
      ADP ribosylated by the heterophil ADP-ribosyltransferase. The stoichiometry of
      ADP-ribose incorporation into these actins was 1.2 mol, 1.0 mol and 2.0 mol ADP
      ribose/mol of beta/gamma-actin, alpha-actin and gamma-actin, respectively. The
      optimal pH for the ADP ribosylation was at pH 8.5, with the respective actin. Km
      values for NAD were calculated to be 30 microM with beta/gamma-actin, 35 microM
      with alpha-actin and 20 microM with gamma-actin. The Km values for the actin
      isoforms were 15 microM for beta/gamma-actin, 2.5 microM for alpha-actin and 10
      microM for gamma-actin. ADP ribosylation of actin inhibited its capacity to
      polymerize, as determined by the increase in fluorescence intensity with N-(1
      pyrenyl)iodoacetamide-labelled actin. Filamentous actin (F-actin) polymerized
      with the respective actin isoform was also ADP ribosylated, although the extent
      of the modification of F-actin was lower than that of globular actin (G-actin).
      In situ ADP ribosylation of beta/gamma-actin was evidenced with chicken
      peripheral heterophils permeabilized with saponin. Thus, the endogenous ADP
      ribosylation of actin in the heterophils may be involved in the cellular
      processes such as phagocytosis, secretion and migration.

PMID- 1740141
TI  - Purification and characterization of maize seedling casein kinase IIB, a
      monomeric enzyme immunologically related to the alpha subunit of animal casein
      kinase-2.
AB  - Casein kinase IIB (CKIIB), a protein kinase related to animal casein kinase-2
      (CK2), has been purified to homogeneity. It appears to be a monomeric enzyme,
      composed by an individual 39 kDa subunit, homologous to the alpha/alpha' subunits
      of animal CK2 and devoid of the autophosphorylatable 25-kDa alpha subunit of
      animal CK2, which display an heterotetrameric alpha 2 beta 2/alpha alpha' beta 2
      structure. Such a conclusion is supported by the following lines of evidence: (1)
      CKIIB displays an apparent 39,000 Mr by gel filtration on Ultrogel AcA 34 and it
      gives rise to a single prominent protein band of similar Mr (38,000) upon
      SDS/PAGE; (2) upon incubation of the enzyme with [32P]ATP, no radiolabeled bands
      are detectable which might be attributable to either canonical or atypical beta
      subunits; (3) the 39-kDa band immunoreacts with antisera that recognize the alpha
      subunit of rat and chicken CK2; (4) conversely, no component immunologically
      related with the beta subunit could be detected in CKIIB by Western-blot analyses
      with antisera that recognize animal beta subunits; (5) the recombinant beta
      subunit of human CK2 is readily phosphorylated by CKIIB, the reaction being
      prevented, rather than stimulated, by polylysine, a behaviour typical of animal
      CK2 autophosphorylation. While the responsiveness of CKIIB to either heparin
      inhibition or polylysine stimulation are reminiscent of those of animal CK2, its
      peptide substrate specificity is significantly different and its thermolability
      is increased. Altogether these data would indicate that maize seedling CKIIB
      represents a naturally occurring monomeric form of CK2 devoid of non-catalytic
      subunits. Its properties, compared to those of animal CK2, suggest that the beta
      subunits of animal CK2 may be responsible for structural modifications conferring
      an altered specificity and an increased stability to the catalytic subunit.

PMID- 1740143
TI  - H-NMR studies on d(GCTTAAGC)2 and its complex with berenil.
AB  - Two-dimensional (2D) 1H-NMR spectroscopy has been used to analyze the structure
      of d(GCTTAAGC)2 and its interaction with berenil in solution. Nuclear Overhauser
      enhancement connectivities enabled sequential assignments of nearly all proton
      resonances in the self-complementary octamer duplex and demonstrated that the
      oligonucleotide is primarily in a B-type conformation. No major conformational
      changes were observed by the addition of berenil, but proton resonances of the
      two adenosine nucleotides shifted substantially. Intermolecular nuclear
      Overhauser effects between berenil and the DNA duplex revealed that the drug
      binds via the minor groove of d(GCTTAAGC)2 in the A.T-base-pair region. At 18
      degrees C the twofold symmetry of the duplex is preserved on berenil binding.
      However, strongly shifted proton resonances broadened significantly. A model is
      proposed for the berenil-d(GCTTAAGC)2 complex involving fast exchange of berenil
      between two equivalent symmetry-related binding sites, which span the 5'-TAA-3'
      region and are asymmetrically disposed with respect to the dyad axis of the
      duplex. These results are compared with previous studies on the berenil
      d(GCAATTGC)2 complex.

PMID- 1740144
TI  - 1H-NMR structural determination of the N-linked carbohydrate chains on
      glycopeptides obtained from the bean lectin phytohemagglutinin.
AB  - Phytohemagglutinin, the lectin of the common bean Phaseolus vulgaris, is a N
      linked glycoprotein with one high-mannose-type and one xylose-containing
      oligosaccharide side chain per polypeptide. The high-mannose-type glycan is
      attached to Asn12 and the complex-type glycan to Asn60 [Sturm, A. & Chrispeels,
      M. J. (1986) Plant Physiol. 81, 320-322]. The structures of the oligosaccharides
      were elucidated from two glycopeptides obtained from the lectin by Pronase
      digestion, affinity chromatography on concanavalin-A--Sepharose and gel
      filtration chromatography on a column of BioGel P-4. The N-linked glycan
      structures were investigated by 500-MHz 1H-NMR spectroscopy and were established
      to be: [formula; see text]

PMID- 1740145
TI  - A supramolecular light-harvesting complex from chloroplast photosystem-II
      membranes.
AB  - In this study, we report on the composition of a photosystem-II antenna
      preparation which contains three chlorophyll-a/b proteins (CP), CP29, CP24 and
      light-harvesting complex (LHC) II obtained from Zea mays grana membranes as
      previously described [Dainese, P. & Bassi, R. (1991) J. Biol. Chem. 266, 8136
      8142]. We demonstrate that the three chlorophyll proteins are present in the
      preparation with a 3:3:9 molar ratio and that they form a supramolecular antenna
      complex which represents one third of the photosystem-II antenna system.
      Phosphorylation experiments show that this complex is involved in the mechanism
      of regulation of excitation-energy distribution between photosystems:
      phosphorylation of the membranes induces dissociation of the LHCII moiety from
      the CP29-CP24 moiety and changes in the aggregation state of LHCII components of
      the CP29-CP24-LHCII complex. The LHCII subpopulations of the complex are shown to
      be distinct from the total LHCII population by isoelectrofocusing analysis. On
      the basis of these data and in the light of the stoichiometry of photosystem-II
      chlorophyll-binding proteins, we propose a model for the organization of
      photosystem-II antenna system.

PMID- 1740146
TI  - Evidence for a selective destabilization of an integral membrane protein, the
      cytochrome b6/f complex, during gametogenesis in Chlamydomonas reinhardtii.
AB  - We studied the process of photosynthetic inactivation during gametogenesis of the
      unicellular green alga Chlamydomonas reinhardtii. We show that it is caused by
      the selective destabilization of a single transmembrane protein complex, the
      cytochrome b6/f complex, which is initially accumulated in the thylakoid
      membranes of vegetative cells. This protein destabilization is controlled by the
      intracellular energy sources available in the gametes, i.e. the coupled electron
      flow in the mitochondria and the amount of starch accumulated in the chloroplast.
      It nevertheless requires the expression of gamete-specific proteins. The loss of
      cytochrome b6/f complexes during gametogenesis is prevented by the addition of
      cycloheximide, but is chloramphenicol insensitive. Therefore, it is likely to
      involve some translation product of nuclear origin, specifically expressed during
      gametogenesis. Among the new polypeptides specifically found in the gametes, we
      detected a soluble polypeptide M alpha (approximate molecular mass of 63 kDa),
      which shared common epitopes with cytochrome f. Its synthesis displays an
      antibiotic sensitivity typical of a nuclear-encoded polypeptide and is controlled
      by the same intracellular signals which control the destabilization of the
      cytochrome b6/f complexes in the thylakoid membranes.

PMID- 1740147
TI  - Oxidoreduction of butanol in deermice (Peromyscus maniculatus) lacking hepatic
      cytosolic alcohol dehydrogenase.
AB  - In view of conflicting information in the literature regarding enzyme systems
      responsible for alcohol oxidation in deermice previously reported to lack hepatic
      alcohol dehydrogenase (ADH) activity, the reversibility of butanol oxidation was
      studied in vivo and in liver-perfusion systems. Mixtures of [1,1-2H2]ethanol and
      butanol were given intraperitoneally to deermice lacking (ADH-) or possessing
      (ADH+) ADH activity, followed by analysis of alcohols in blood by GC/MS. 2H
      exchange between the two alcohols was seen in all experiments. In ADH- deermice,
      the 2H excess of butanol increased steadily and reached 18 +/- 5% after 2.5 h. In
      ADH+ deermice, butanol was rapidly eliminated and the 2H excess was about 7%
      after 0.5 h. In similar experiments with rats, the 2H excess was about 40% for 2
      h. Perfusions of livers from ADH- deermice with mixtures of unlabelled and 1
      [2H]butanol showed significant but slow intermolecular hydrogen transfer at C1,
      indicating oxidoreduction catalyzed by a dehydrogenase. Slow reduction of butanal
      was observed in mitochondria from ADH- deermice. ADH activity with a pH optimum
      of 10 and Km for ethanol of 6 mM was detected in the inner mitochondrial
      membranes from rats and deermice. However, low rates of oxidation observed in
      experiments carried out with perfused livers and in vitro suggest that this
      enzyme system does not contribute significantly to alcohol oxidation in vivo.
      Thus, perfused liver from ADH- deermice appears to be a useful system for studies
      of ADH-independent oxidation of alcohols. The 2H exchange between the alcohols
      seen in vivo indicates that both ethanol and butanol are substrates for a common
      extrahepatic dehydrogenase in ADH- deermice.

PMID- 1740148
TI  - Mechanism of the stimulatory effect of a potassium-rich medium on the
      phosphorylation of glucose in isolated rat hepatocytes.
AB  - We have investigated the mechanism by which the replacement of a Na(+)-rich
      medium by a K(+)-rich medium causes an increase in the apparent affinity of
      glucokinase (hexokinase IV or D) for glucose in isolated hepatocytes [Bontemps,
      F., Hue, L. & Hers, H. G. (1978) Biochem. J. 174, 603-611]. The stimulatory
      effect of a K(+)-rich medium on the rate of glucose phosphorylation, as assessed
      by the release of tritium from [2-3H]glucose, was only partially additive with
      the effect of fructose, suggesting that it was also due to a decrease in the
      inhibition exerted on glucokinase by its regulatory protein. Measurements of
      metabolites indicated that the effect of the K(+)-rich medium was neither due to
      the formation of fructose 1-phosphate, nor to changes in the concentrations of
      fructose 6-phosphate or Pi, two other effectors of the regulatory protein.
      Replacement of Na+ by K+ in the medium resulted in a time-dependent and dose
      dependent increase in cell volume that paralleled the changes in the rate of
      detritiation observed at 5 mM glucose. The water and chloride contents, estimated
      using radiolabelled compounds, were threefold and tenfold higher, respectively,
      in K+ cells than in Na+ cells, and the intracellular Cl- concentration about
      threefold higher (94 versus 29 meq/l). The effects of the K(+)-rich medium on
      cell volume, Cl- concentration and rate of detritiation were greatly reduced by
      including 80 mM trehalose or sucrose in the medium at the start of the
      incubation. Addition of trehalose to cells incubated for 45-50 min in the K(+)
      rich medium caused an immediate decrease in cell volume whereas the rate of
      detritiation and the Cl- concentration underwent a transient increase followed by
      a decrease. Replacement of KCl by KBr, potassium acetate or potassium
      trichloroacetate in the K(+)-rich medium resulted in different relationships
      between cell volume and the rate of detritiation, in agreement with the
      differential effect of these salts on the activity of purified glucokinase
      assayed in the presence of regulatory protein. From these results we conclude
      that the increase in the activity of glucokinase induced by a KCl-rich medium is
      at least partly due to an increase in the concentration of Cl-, which relieves
      the inhibition exerted by the regulatory protein on purified glucokinase.

PMID- 1740149
TI  - Characterisation of a cysteine protease from bloodstream forms of Trypanosoma
      congolense.
AB  - A cysteine protease (trypanopain-Tc) with cathepsin-L-like properties has been
      purified from Trypanosoma congolense. The enzyme has an apparent molecular mass
      of 31-32 kDa by SDS/PAGE and 66 kDa by gel chromatography. It has a pI 7.4 and a
      high affinity for concanavalin A. Trypanopain-Tc catalyses the limited
      proteolysis of a variety of protein substrates such as fibrinogen, serum albumin
      and trypanosome variant-surface glycoprotein. It has minimal or no activity
      against casein or elastin. A variety of peptidyl amidomethylcoumarins and
      peptidyl diazomethanes were used to test the specificity of trypanopain-Tc. The
      better substrates had Arg or Lys in P1 and hydrophobic amino acids in P2 and P3.
      The best substrate found for trypanopain-Tc was Z-Phe-Arg-NHMec (Z,
      benzyloxycarbonyl; NHMec, 7-amido-4-methylcoumarin). The kinetic constants for
      the hydrolysis of Z-Phe-Arg-NHMec were kcat = 17.4 s-1, Km = 4.4 microM, kcat/Km
      = 4.0 microM-1.s-1, which are very similar to those of cathepsin L with this
      substrate. The specific substrates for cathepsin B (Z-Arg-Arg-NHMec) and
      cathepsin H (Arg-NHMec) were not hydrolysed by trypanopain-Tc under the
      conditions tested. The pH optimum of trypanopain-Tc against Z-Phe-Arg-NHMec was
      pH 6.0 but it showed a broad peak of activity extending well into the alkaline
      region. The enzyme was activated by low-molecular-mass thiol compounds and
      inhibited by cystatin, L-trans-epoxysuccinyl-4-guanidinobutane (E-64) and a
      variety of peptidyl diazomethanes. The most effective diazomethane inhibitors (Z
      Leu-Leu-Met-CHN2, Z-Leu-Met-CHN2 and Z-Leu-Lys-CHN2, were inhibitory at nanomolar
      concentrations and were trypanocidal in vitro after 24-48 h incubation in greater
      than or equal to 20 microM [inhibitor]. However, it is not clear whether the
      trypanocidal activity of these inhibitors is a consequence of the inhibition of
      trypanopains or of some other essential proteolytic activities within the
      parasites.

PMID- 1740150
TI  - Purification and characterization of cathepsin J from rat liver.
AB  - Cathepsin J has been partially purified [Liao, J. C. R. & Lenney, J. F. (1984)
      Biochem. Biophys. Res. Commun. 124, 909-916], but its detailed properties are
      still unknown. In this study, we have purified cathepsin J completely and
      characterized it. It was purified to homogeneity from the mitochondrial-lysosomal
      fraction of rat liver by acid treatment, followed by ammonium sulfate
      precipitation (20-65%), and chromatographies on S-Sepharose, ConA-Sepharose, Affi
      gel 501, HPLC DEAE-5PW and HPLC TSK G3000SW. Cathepsin J was found to be a
      lysosomal high-molecular-mass cysteine protease of about 160 kDa consisted of two
      different subunits. One subunit (alpha subunit) was a glycoprotein with a
      molecular mass of 19-24 kDa which was reduced to 19 kDa by treatment with
      endoglycosidase F. It has the amino acid sequence LPESWDWRNVR at its N-terminus,
      which was very similar to those at the N-termini of rat cathepsins B, H and L.
      The other subunit (beta subunit) was a glycoprotein with a molecular mass of 17
      kDa, which was reduced to 14 kDa by treatment with endoglycosidase F. It had
      DTPANETYPDLLG at its N-terminus, which had no similarity with the N-terminal
      sequences of other cathepsins. Cathepsin J showed strong affinity for synthetic
      substrates such as N-benzyloxycarbonyl-phenylalanyl-arginine 4-methyl-coumaryl-7
      amide and glycyl-arginine beta-naphthylamide. It was activated by thiol reagents
      and chloride ion and was inhibited by cysteine protease inhibitors. However, its
      initial inhibition constant Ki(initial) by N-(L-3-trans-carboxyoxirane-2
      carbonyl)-L-leucine-3- methylbutylamide (E-64-c) was 1800 nM, which was 100-500
      times those of cathepsins B and L. Many properties of cathepsin J were similar to
      those of cathepsin C (dipeptidylaminopeptidase I) reported as a lysosomal
      cysteine protease with dipeptidyl-aminopeptidase activity [McDonald, J. K.,
      Reilly, T. J. & Ellis, S. (1964) Biochem. Biophys. Res. Commun. 16, 135-140].
      Furthermore, antiserum against rat liver cathepsin C reacted with rat liver
      cathepsin J. These findings suggested that cathepsin J is identical with
      cathepsin C.

PMID- 1740151
TI  - 6-Deoxyerythronolide-B synthase 2 from Saccharopolyspora erythraea. Cloning of
      the structural gene, sequence analysis and inferred domain structure of the
      multifunctional enzyme.
AB  - Sequencing of the eryA region of the erythromycin biosynthetic gene cluster from
      Saccharopolyspora erythraea has revealed another structural gene (ORF B), in
      addition to the previously characterised ORF A, which appears to encode a
      component of 6-deoxyerythronolide-B synthase, the enzyme that catalyses the first
      stage in the biosynthesis of the polyketide antibiotic erythromycin A. The
      nucleotide sequence of ORF B, which lies immediately adjacent to ORF A, has been
      determined. The predicted gene product of ORF B is a polypeptide of 374417 Da
      (3568 amino acids), which is highly similar to the product of ORF A and which
      likewise contains a number of separate domains, each with substantial amino acid
      sequence similarity to components of known fatty-acid synthases and polyketide
      synthases. The order of the predicted active sites along the chain from the N
      terminus is 3-oxoacyl-synthase--acyltransferase--acyl-carrier-protein-- 3-oxoacyl
      synthase--acyltransferase--dehydratase--enoylreductase-- oxoreductase--acyl
      carrier-protein. The position of the dehydratase active site has been pinpointed
      for the first time for any polyketide synthase or vertebrate fatty-acid synthase.
      The predicted domain structure of 6-deoxyerythronolide-B synthase is strikingly
      similar to that previously established for vertebrate fatty-acid synthases. This
      analysis of the sequence supports the view that the erythromycin-producing
      polyketide synthase contains three multienzyme polypeptides, each of which
      accomplishes two successive cycles of polyketide chain extension. In this scheme,
      the role of the ORF B gene product is to accomplish extension cycles 3 and 4.

PMID- 1740152
TI  - CecC, a cecropin gene expressed during metamorphosis in Drosophila pupae.
AB  - Cecropins are antibacterial peptides, induced in insects in response to bacterial
      infections. In Drosophila, three cecropin genes have previously been
      characterized, CecA1, CecA2, and CecB, in a dense cluster at 99E on the third
      chromosome. From the same locus, we now describe a fourth member of the cecropin
      gene family, CecC, which is mainly expressed at the early pupal stage. In situ
      hybridization to immunized pupae show that CecC is induced in the anterior end of
      the larval hindgut and in other larval tissues that are undergoing histolysis.
      Within these other tissues it is often expressed in distinct foci that may
      correspond to hemocytes. A similar pattern of expression in the metamorphosing
      pupa is also observed for the CecA and CecB genes. Comparing the DNA sequences of
      the cecropin genes, a conserved region is observed about 30 bp upstream of the
      TATA box. It consists of three shorter motifs, two of which are reminiscent of a
      putative promoter element in immune protein genes from the cecropia moth.

PMID- 1740153
TI  - The phosphorylated and/or sulfated structure of the carbohydrate-protein-linkage
      region isolated from chondroitin sulfate in the hybrid proteoglycans of
      Engelbreth-Holm-Swarm mouse tumor.
AB  - The structure of the linkage region of chondroitin sulfate chains attached to the
      hybrid proteoglycans of the Engelbreth-Holm-Swarm mouse tumor was investigated.
      The peptidoglycan fraction which contains oversulfated chondroitin sulfate rich
      in the GlcA beta 1-3GalNAc-4,6-diO-sulfate unit and undersulfated heparan sulfate
      rich in GlcA beta 1-4GlcNAc and GlcA beta 1-4GlcN-2N-sulfate units was isolated
      after exhaustive protease digestion of the acetone powder of the tumor tissue,
      (GlcA, glucuronic acid; GalNAc, 2-deoxy-2-N-acetylamino-D-galactose).
      Glycosaminoglycans were released by beta-elimination using NaB3H4 and digested
      with chondroitinase ABC. The linkage region fraction was separated from heparan
      sulfate by gel filtration and fractionated by HPLC on an amine-bound silica
      column. Six radiolabeled compounds (L1-L6) were obtained and structurally
      analyzed by cochromatography with authentic hexasaccharide alditols recently
      isolated by us from the linkage region, and by digestion using chondroitinase
      ACII, alkaline phosphatase and beta-galactosidase in conjugation with HPLC. These
      compounds shared the conventional hexasaccharide backbone structure: delta GlcA
      beta 1-3GalNAc beta 1-4GlcA beta 1-3Gal beta 1-3Gal beta 1-4Xyl-ol, (delta GlcA,
      delta 4.5-GlcA or D-gluco-4-enepyranosyluronic acid). L1 was not sulfated or
      phosphorylated. L2 and L4 were monosulfated at C-6 and C-4 of the GalNAc residue,
      respectively. Upon alkaline phosphatase digestion, L3, L5 and L6 were converted
      to L1, L2 and L4, respectively. Analysis of the periodate oxidation products
      indicated that the phosphate group in L3, L5 and L6 is located at C-2 of Xyl-ol.
      These results suggest that Xyl-2-O-phosphate is associated with both 4-O-sulfated
      and 6-O-sulfated GalNAc units and does not directly determine the sulfation
      pattern of chondroitin sulfate.

PMID- 1740154
TI  - Zonation of cytochrome P450 isozyme expression and induction in rat liver.
AB  - The regional expression of six different cytochrome P450 (CYP) forms in rat liver
      under constitutive and induced conditions was compared using immunological
      techniques. Immunostaining of consecutive thin sections from control liver
      revealed that the same hepatocytes, forming a 6-8 cells thick layer surrounding
      the terminal hepatic venules, were stained for CYP2B1/2, CYP2E1 and CYP3A1.
      Staining of CYP2A1 extended further into the midzonal region, whereas all cells
      of the acinus stained for CYPEtOH2. These results were supported by Western blot
      analysis of cell lysates from the periportal or perivenous region obtained by
      zone-restricted digitonin treatment during in situ perfusion. The data suggest
      three distinct patterns of constitutive P450 expression: perivenous-restricted
      (CYP2B1/2, CYP2E1 and CYP3A1); perivenous-dominated (CYP2A1) and panacinar
      (CYPEtOH2). Chronic exposure to ethanol caused induction of CYP2E1 in the same
      cells already being constitutively expressed, whereas CYPEtOH2 was more induced
      in the periportal area. The relative induction of CYP2B1/2, CYP3A1 and CYPEtOH2
      after treatment with phenobarbital was stronger in periportal hepatocytes,
      resulting in levelling out of the initial perivenous dominance of CYP2B1/2 and
      CYP3A1, whereas CYPEtOH2 became periportal-dominated. Acetone induced CYP2E1,
      CYP2C11 and CYP3A1 selectively in the perivenous area. These studies indicate
      that a particular P450 isozyme is generally induced in the same cells where it is
      constitutively expressed, and that this regional selectivity is independent of
      the kind of inducer. The data suggest that, during maturation, the hepatocytes
      acquire various phenotypes in the periportal and perivenous region, to respond
      differently to endogenous and exogenous signals in the control of P450
      expression.

PMID- 1740155
TI  - The molecular and genetic analysis of mouse development.
AB  - This review describes some recent advances in the molecular-genetic analysis of
      mouse development. Reversed genetics and gene assignment have been used to
      isolate genes affected in developmental mutations. The establishment of a high
      density molecular-genetic map promises to facilitate cloning of additional genes
      with developmental functions. Based on molecular, biochemical or other biological
      criteria many mouse genes that code for transcriptional regulators, growth-factor
      like molecules and their receptors have been isolated. The role of these genes
      during development can be analysed in vivo after producing targeted mutations.
      Mutations can be generated by homologous recombination in the genome of embryonic
      stem cells and can then be introduced into the mouse germ line by means of germ
      line chimaeras. Additional approaches employing stem cells to identify and mutate
      putative developmental genes are coming into use.

PMID- 1740156
TI  - Analysis of genes involved in the biosynthesis of lantibiotic epidermin.
AB  - The structural gene of the lanthionine-containing peptide antibiotic epidermin is
      located on a 54-kb plasmid of Staphylococcus epidermidis [Schnell et al. (1988)
      Nature 333, 276-278]. A 13.5-kb DNA region neighbouring the epidermin structural
      gene (epiA) was subcloned and its sequencing revealed five additional open
      reading frames. Three of these reading frames, epiB, epiC and epiD shared no
      homology with previously described proteins stored in data bases. They were
      located 3' adjacent to epiA. Using epiB as a probe, a 5-kb mRNA was identified
      indicating that three or all four reading frames are transcribed as an operon.
      Additionally, a 0.3-kb mRNA specific for epiA was identified. Two open reading
      frames (epiP and epiQ) were located 3' to epiA, epiB, epiC and epiD, but in the
      reverse orientation. The epiQ gene product shows similarity to the positive
      regulatory factor PhoB. This might indicate a regulatory function of epiQ in
      epidermin biosynthesis. The epiP gene product shows striking similarity to
      several serine proteases which makes epiP a likely candidate for processing the
      epidermin prepeptide. Heterologous epidermin synthesis in the non-producing
      organism Staphylococcus carnosus finally proved that these reading frames are
      necessary for epidermin biosynthesis.

PMID- 1740157
TI  - Anthracycline binding to DNA. High-resolution structure of d(TGTACA) complexed
      with 4'-epiadriamycin.
AB  - Crystallographic methods have been applied to determine the high-resolution
      structure of the complex formed between the self-complementary oligonucleotide
      d(TGTACA) and the anthracycline antibiotic 4'-epiadriamycin. The complex
      crystallises in the tetragonal system, space group P4(1)2(1)2 with a = 2.802 nm
      and c = 5.293 nm, and an asymmetric unit consisting of a single DNA strand, one
      drug molecule and 34 solvent molecules. The refinement converged with an R factor
      of 0.17 for the 2381 reflections with F greater than or equal to 3 sigma F in the
      resolution range 0.70-0.14 nm. Two asymmetric units associate such that a
      distorted B-DNA-type hexanucleotide duplex is formed incorporating two drug
      molecules that are intercalated at the TpG steps. The amino sugar of 4'
      epiadriamycin binds in the minor groove of the duplex and displays different
      interactions from those observed in previously determined structures.
      Interactions between the hydrophilic groups of the amino sugar and the
      oligonucleotide are all mediated by solvent molecules. Ultraviolet melting
      measurements and comparison with other anthracycline-DNA complexes suggest that
      these indirect interactions have a powerful stabilising effect on the complex.

PMID- 1740158
TI  - The amino acid sequence of glutamate decarboxylase from Escherichia coli.
      Evolutionary relationship between mammalian and bacterial enzymes.
AB  - The amino acid sequence of glutamate decarboxylase from Escherichia coli was
      solved by a combination of automated Edman degradation of peptide fragments
      derived by proteolytic and chemical cleavage and sequencing of DNA. Correct
      alignment of three peptides, for which no peptide overlaps were available, was
      achieved by sequencing a 1.1-kbp fragment of DNA produced by a polymerase-chain
      reaction using primers corresponding to sequences known to be in amino-terminal
      and carboxy-terminal regions of the protein. Sequence similarity (24% identity)
      with mammalian glutamate decarboxylase was found to be limited to a 55-residue
      sequence around the lysine residue that binds the coenzyme. Stronger similarity
      (38% identity), again confined to the same region, is seen with bacterial
      pyridoxal-phosphate-dependent histidine decarboxylase.

PMID- 1740159
TI  - The piscine plasma retinol-binding protein. Purification, partial amino acid
      sequence and interaction with mammalian transthyretin of rainbow trout
      (Oncorhynchus mykiss) retinol-binding protein.
AB  - 1. Retinol-binding protein (RBP) has been isolated from the pooled plasma or
      rainbow trouts (Oncorhinchus mykiss) by gel filtration, hydrophobic interaction
      chromatography and ion-exchange chromatography. By this procedure two forms of
      the protein, both with a molecular mass (approximately 20 kDa) similar to that of
      mammalian RBP, were purified to homogeneity. Five amino acid substitutions have
      been found in the partial (about 60%) sequences of the two forms of trout RBP,
      which are presumably acetylated at their N terminus. The apparent participation
      of six conserved cysteines in the formation of disulphide bridges, as in human
      RBP, and the similarity (about 60%) of the amino acid sequence of trout and
      mammalian RBPs, indicate the existence of a similar overall structure
      organization in evolutionary distant RBPs. 2. Although the two forms of trout RBP
      are not physiologically involved in the formation of any protein--protein complex
      in plasma, they are capable of interacting with mammalian transthyretin, albeit
      with a binding affinity (K'd = 15-40 microM) considerably lower than that of
      mammalian RBP. Our data indicate that the two forms of trout RBP also possess the
      region that in mammalian RBP has the functional role of binding transthyretin. It
      is suggested that transthyretin (or a homologous protein) was modified, during
      phylogenetic development of the non mammalian vertebrates, to acquire a binding
      site for such a region of the RBP molecule.

PMID- 1740160
TI  - [Review: development of the spontaneously epileptic rat].

PMID- 1740161
TI  - [Number of animals used in experiments in 1990--results of a survey--JALAS
      Working Group for Laboratory Animal Data Bank, Tokyo and Life Science Research
      Information Section, The Institute of Physical and Chemical Research, Saitama].
AB  - A survey on the number of animals used in experiments including bioassay,
      diagnosis, education and preparation of biological agents such as vaccine between
      April 1990 and March 1991 was conducted. Out of 849 universities, institutes,
      testing laboratories and companies, 607 replies were received. The distribution
      of the number of animals is shown in the following tables. [tables; see text]

PMID- 1740162
TI  - [Changes in rhythmicity of ambulatory and drinking activities produced by
      presentation of short time lightings during dark period in rats].
AB  - It is well known that the lighting conditions affect many physiological
      phenomenon of laboratory animals. However, lighting conditions are frequently
      disturbed by investigators themselves. In this study, behavioral (ambulation and
      drinking) rhythmicities of rats were investigated after irregular lighting; i. e.
      presentation of short time lighting at 21:00, 24:00 and 3:00 for 12 min during
      dark period (18:00-6:00). Vaginal smear was taken and sexual cycle was observed
      everyday. Ambulatory and drinking activities were measured by Gundai type Ambulo
      drinkometer. The irregular lighting produced the following changes in the
      rhythmicities: 1) increase in the ambulatory activity during 15:00-18:00
      immediately before dark period 2) decrease in ambulatory activity before
      ovulation 3) disappearance of inhibitory phenomenon of drinking activity which
      was usually observed before ovulation 4) increase in the drinking activity during
      6:00-9:00 immediately after dark period 5) the changes in rhythmicities of the
      behavioral activities lasted for more than 1 month after replacement to the
      regular lighting condition.

PMID- 1740163
TI  - Dotted white--a plumage color mutant in Japanese quail (Coturnix coturnix
      japonica).
AB  - A plumage color mutant, dotted white (DTW), of Japanese quail is described in
      this paper. The adult DTW mutant shows white plumage with a small colored spot on
      the head and/or back. The pigmented spots invariably appear on the dorsal region
      and never on the ventral region of the body. Some birds lack colored spots and
      show pure white plumage. The chick of the DTW mutant shows cream yellow plumules
      similar to those of the White Leghorn chick. Colored spots also exist as in
      adults, and its coloration is diluted light brown. The feathers on colored spots
      of the adult show diluted pigmentation as compared with wild-type feathers. In
      addition, the wheat-straw colored shaft streak is extremely narrow and the
      transversal bars are missing. The DTW mutant is thought to be genetically
      different from previously reported similar mutants, brown-splashed white, panda,
      and recessive white. Genetic analyses revealed that the DTW mutant plumage is
      controlled by an autosomal recessive gene. The gene symbol dtw is provisionally
      proposed, since there remains a possibility that the DTW character may be allelic
      to some of the similar mutant characters mentioned above.

PMID- 1740164
TI  - [Fertilizing ability in vitro of golden hamster spermatozoa after acute
      testicular X-irradiation].
AB  - The present study is concerned with the effect of radiation to the testis on
      fertilizing ability in vitro using golden hamster spermatozoa. Male hamsters at 6
      and 8 weeks of age were given acute testicular X-irradiation (200 kVp, 20 mA,
      0.47-0.48 Gy/min). Spermatozoa were collected from the cauda epididymides at
      different times after irradiation and then they were suspended in fertilization
      medium. After preincubation for 4-5 hr, the spermatozoa were cultured with the
      eggs collected from mature hamsters treated with PMSG-hCG. Fertilized eggs were
      examined for incidence of sperm penetration and formation of pronuclei at 4-5 hr
      after insemination. The fertilization rate (47.7%) at the 6th week after
      irradiation with a dose of 2 Gy was much lower in comparison with the control
      value (92.6%). However, the fertilization rates at the 3rd and 9th weeks after
      irradiation were 97.7 and 90.6%, respectively. In these period, no difference was
      found between the irradiated groups and the control groups. From the changes in
      sperm concentration after irradiation with a dose of 2 Gy, it was found that the
      fertilization rate was the lowest at the 6th week. The sensitive stage to
      radiation during spermatogenesis with reference to the reduction of fertilizing
      ability after irradiation coincides with that of decrease in the sperm
      concentration and sperm motility. The results of fertilization rate at the 6th
      week after different doses of X-irradiation (0.25-6 Gy) indicated that the
      reduction of fertilization rate is nearly expressed as a dose-response
      relationship.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740165
TI  - A method to eliminate odor from recirculating air in the animal house.
AB  - A new method to eliminate odors from air recirculating in an animal house is
      described. The new system consists of an ozonizer and titania silica ozone
      decomposition catalyst in the terminal of a recirculating ventilation system. The
      principle underlying the elimination of odors is the oxidative reaction of
      malodorous components on the surface of the catalyst caused by coupling with
      ozonolysis. This method appeared superior in terms of its durability, efficiency
      and lack of resistance to air flow.

PMID- 1740166
TI  - Turnover rates of hypothalamic dopamine associated with the two types of
      prolactin surges during pseudopregnancy in rats.
AB  - Two surges of prolactin (PRL) are observed daily during pseudopregnancy (PSP) in
      the rat: the nocturnal (N) surge at dawn and the diurnal (D) surge in the
      evening. In order to clarify differences in the controlling mechanisms of the two
      types of PRL surges, we attempted to examine the turnover rates of dopamine (DA)
      and norepinephrine (NE) in the preoptic-anterior hypothalamus (PAH) and mid
      posterior hypothalamus (MPH) on day 5-6 of PSP. The turnover rates of DA in the
      hypothalamus were inversely correlated with the serum PRL levels at the D surge
      when a significant increase in serum PRL was accompanied by not only a marked
      decrease in turnover rates of DA in the PAH, but also a slight decrease in
      turnover rates of the amine in the MPH. Contrarily, no significant decrease
      occurred in the turnover rates of DA in the hypothalamus at the N surge. There
      was no obvious correlation between the turnover rates of NE in the hypothalamus
      and the serum PRL levels at either PRL surge. These findings suggest that
      decreased turnover rates of DA in the hypothalamus are involved in the D surge,
      and it is most probable that the N PRL surge occurs under the control of another
      factor such as the hypothalamic PRL-releasing factor.

PMID- 1740167
TI  - Pathology and angiographical studies on urogenital organ system induced by
      idiopathic hemorrhage in male E1 mice.
AB  - Urogenital organ system induced by idiopathic hemorrhage in sudden died male E1
      mice were investigated macro- and histopathologically and angiographically. The
      mortality of the male E1 mice with brief life span was 85% during observation
      period for 33 weeks, and about half of the male E1 mice died between 10-week-old
      and 20-week-old. In all dead mice, urine retention was prominent, and the seminal
      vesicle or the coagulating gland, especially the bulbocavernosus muscle had
      severe hemorrhage. There was coagulated blood mass in the urethral lumen and the
      lumen of the seminal vesicle and the coagulating gland. Further, in pars
      spongiosa, coagulated blood mass occupied the most area of the corpus spongiosum
      penis and corpus cavernosum penis with severe hemorrhage. Angiographically, the
      penile artery in not affected male E1 mice was thinner than that in control mice.

PMID- 1740168
TI  - [The application of industrial endoscope to observation of the ocular-fundus in
      small laboratory animals].
AB  - Observation and recording methods of the ocular-fundus in small laboratory
      animals were studied using the industrial endoscope and VTR systems,
      respectively. The ocular-fundus was observed widely, brightly and clearly in the
      usual animal facility. In addition, the ocular-fundus was recorded easily and it
      was possible to examine the ocular-fundus recorded by the VTR systems.

PMID- 1740169
TI  - Effects of atherogenic diet on young farm pigs.
AB  - This study was designed to assess the usefulness of young farm pigs as an
      experimental model for hypercholesterolemia. In order to test this, we
      investigated both serologic and electrocardiographic effects of atherogenic diet.
      Four-week-old pigs were fed an atherogenic diet for 8 weeks. No arrhythmia was
      observed on ECG in all animals. There were no significant difference between
      control and atherogenic diet group on the values of ECG parameters. However,
      plasma lipids values of atherogenic diet group were significantly (p less than
      0.05) higher than those of control diet group. Thus, hypercholesterolemia was
      induced in young farm pigs by feeding atherogenic diet in a relatively short
      time. This fact suggests that young farm pigs may be an useful model for further
      studies of the effect of hypercholesterolemia on cardiovascular function and the
      early pathogenesis of atherosclerosis.

PMID- 1740170
TI  - Effects of naloxone and naltrexone on receptive and proceptive behaviors in
      female rats.
AB  - The sexual receptive and proceptive behaviors induced by opiate antagonists,
      naloxone and naltrexone in estrogen-primed ovariectomized rats were observed
      under the presence of sexually active males. The females were treated
      intraperitoneally with naloxone or naltrexone at doses ranging from 0.5 to 4.0
      mg/kg and the sexual behavior of females was tested before and after the
      injection of drug. The results obtained suggest that the opiate antagonists play
      a role in the regulation of lordosis behavior, but not proceptive behavior in
      female rats.

PMID- 1740171
TI  - [Spontaneous cleft palate in CF#1/Ohu mice].
AB  - We found a spontaneous cleft palate in a mouse of CF#1/Ohu (Ohu University,
      Japan). Further, the frequency of the spontaneous cleft palate in strains of
      CF#1/Jms (Institute of Medical Science, University of Tokyo, Japan) and CF#1/Jah
      (National Institute of Animal Health, Japan) were about 3%, respectively. The
      frequency and the types of spontaneous cleft palate in CF#1 were clearly
      different from those in A/J and CL/Fr strains which were used as model animals of
      lip and cleft palate. We think that CF#1 is the new animal models to analyze a
      cleft palate genetically and biochemically.

PMID- 1740172
TI  - [Improvement of pituitary homograft under the kidney capsule in mice].
AB  - The model of hyperprolactinemia induced by pituitary homografts under the kidney
      capsule has been used mainly in the field of reproductive physiology. The authors
      report an improved method for pituitary grafting in mice. The procedure was as
      follows: 1. The male pituitary glands with normal saline were aspirated into a
      polyethylene tube. 2. Two incisions were made in the kidney capsule. 3. The
      polyethylene tube with pituitary glands was inserted via a large incision. 4.
      Blowing air into the tube, the pituitary glands were left under the kidney
      capsule and normal saline streamed out of a small incision. Using this method,
      all pituitary grafted mice became pseudopregnant.

PMID- 1740173
TI  - Changes in rhythmicities of ambulatory and drinking activities after
      hypophysectomy in rats.
AB  - Effects of hypophysectomy on circadian rhythms of ambulatory and drinking
      activities in adult male rats were automatically recorded and investigated with a
      Gundai-type ambulodrinkometer. The rats were maintained under LL conditions
      following an LD condition. When free-running rhythms had stabilized, the rats
      were hypophysectomized. The rhythmicities of both activities became indistinct
      over the 2-4 weeks following surgery, and then gradually recovered. At this time
      phase shifts (phase advance) were observed in the hypophysectomized rats, while
      these changes were not observed in sham-operated rats. All rats entrained to
      lighting when kept under LD conditions again. These results suggest that the
      pituitary does not play an essential role in maintaining circadian rhythms, but
      does function as an important subordinal oscillator.

PMID- 1740174
TI  - Trypanosoma cruzi: stage expression of calmodulin-binding proteins.
AB  - The subcellular distribution of calmodulin-binding proteins in three life stages
      of Trypanosoma cruzi was analyzed by a [125I]calmodulin gel overlay procedure
      under conditions where proteolysis was kept to a minimum. It was found that T.
      cruzi contains a complex profile of calcium-dependent calmodulin-binding proteins
      and that several of these polypeptides were differentially expressed at specific
      stages of development. The majority of these stage-specific polypeptides was
      found in the particulate fractions of the replicative stages of the parasite,
      i.e., epimastigote and amastigote. These studies suggest that calcium and
      calmodulin may play an important central role in the growth and differentiation
      of this parasite. We have also assessed the calmodulin content of the various
      life stages by immunoblot analysis. These studies identified a 14-kDa
      immunoreactive peptide present at equivalent levels in epi-, trypo-, and
      amastigote stages (extracellular).

PMID- 1740175
TI  - Plasmodium chabaudi: association of reversal of chloroquine resistance with
      increased accumulation of chloroquine in resistant parasites.
AB  - The effects of tricyclic antidepressants, desipramine and imipramine, and
      phenothiazines, chlorpromazine and trifluoperazine, on chloroquine (CQ)-resistant
      and CQ-sensitive lines of P. chabaudi were examined in vivo. In mice that
      received daily injections of these drugs the growth of CQ-resistant and CQ
      sensitive parasites was unaffected or affected very slightly, if at all. A
      combination of CQ and each drug suppressed the growth of CQ-resistant parasites
      in a dose-dependent manner. In addition, in CQ-sensitive parasites each drug also
      increased the susceptibility to CQ. Measurements of CQ levels by high-performance
      liquid chromatography showed that CQ accumulated in sensitive parasites to more
      than twice the level in resistant parasites at 2 to 4 hr after an injection of
      CQ. Verapamil and desipramine substantially increased CQ levels in both CQ
      resistant and CQ-sensitive parasites. These results suggest that not only Ca2+
      antagonists but tricyclic antidepressants reverse CQ resistance in CQ-resistant
      parasites and enhance the inhibitory effect in sensitive parasites by increasing
      CQ levels in those parasites. The effects of Ca2+ antagonists, tricyclic
      antidepressants, and phenothiazines on a pyrimethamine-resistant line of P.
      chabaudi were also studied. None of the Ca2+ antagonists (verapamil, nicardipine,
      and diltiazem) affected the growth of the parasite in combination with 20 mg/kg
      pyrimethamine. Tricyclic antidepressants and phenothiazines suppressed
      pyrimethamine-resistant parasites to some extent. However, the extent of this
      suppression was less pronounced as compared with that of suppression of CQ
      resistance by the same drugs.

PMID- 1740176
TI  - Schistosoma japonicum: excretory-secretory products of the eggs during miracidial
      development.
AB  - The release pattern of excretory-secretory (E-S) products of Schistosoma
      japonicum eggs was investigated using eggs cultured in a chemically defined
      medium (MEMSE-J) for 16 days. The amount of protein released in culture
      supernatants was greater in 0- to 4-day and 12- to 16-day cultures than in 4- to
      12-day cultures. The protein composition of E-S products and soluble extracts of
      newly laid eggs (N-SEA) and in vitro matured eggs (M-SEA) was analyzed by SDS
      PAGE. Silver staining patterns of N-SEA and M-SEA were found to be similar except
      for the band at approximately 66 kDa, which appeared in highest concentrations in
      N-SEA. Western blot analysis with human infected sera showed antibody recognition
      of a 140- to 160-kDa antigen present in E-S products from mature eggs, while E-S
      products from immature eggs were unreactive. When either [35S]methionine or
      [3H]glucosamine was added to the culture medium, newly synthesized proteins or
      glycoproteins of the SEA and E-S products were labeled. Incorporation of both
      isotopes into SEA appears to correlate with developmental activity of the eggs.
      In contrast, release of E-S proteins and glycoproteins is more apparent as the
      miracidium matures. These results suggested that the source of E-S products from
      immature eggs is likely to be the collapsing vitelline cells and that of E-S
      products from mature eggs to be mainly miracidial secretions.

PMID- 1740177
TI  - Loss of Lyme disease spirochetes from Ixodes ricinus ticks feeding on European
      blackbirds.
AB  - To determine whether blackbirds (Turdus merula), the most abundant and most
      abundantly tick-infested ecotonal bird of Central Europe, may contribute to the
      transmission of the Lyme disease spirochete (Borrelia burgdorferi), we compared
      the infectivity to ticks of naturally as well as experimentally infected
      blackbirds and rodents. European blackbirds experience intense exposure to Ixodes
      ricinus ticks and to the pathogens that they transmit. In nature, subadult I.
      ricinus ticks found feeding on these birds generally contain no spirochetes,
      although infection is universal in those found on black-striped mice (Apodemus
      agrarius). Those found on yellow-necked mice (A. flavicollis) are less frequently
      infected. Ticks lose infection in the course of feeding on blackbirds and fail to
      infect them. Subadult I. ricinus ticks readily feed on blackbirds, black-striped
      mice, and jirds (Meriones unguiculatus), but engorge less fully on the bird than
      on the rodents. Although birds may burden human health by establishing new
      infestations of I. ricinus ticks, our observations indicate that particular birds
      may benefit health by locally diminishing transmission of the Lyme disease
      spirochete.

PMID- 1740178
TI  - Leishmania amazonensis infection: a comparison of in vivo leishmanicidal
      mechanisms between immunized and naive infected BALB/c mice.
AB  - In vitro studies have shown that both macrophage activation and destruction of
      parasitized macrophages lead to leishmania destruction. The relative role played
      by such mechanisms in vivo have not been properly evaluated. We took advantage of
      the model of intravenous immunization with solubilized leishmanial antigen which
      renders partially resistant the otherwise highly susceptible BALB/c mice to
      address this issue avoiding the interference of different genetic backgrounds.
      Leishmania destruction occurred in three situations: destruction of the
      parasitized macrophage, which were in close contact with lymphocytes or
      eosinophils; extracellular damage, always surrounded by small foci of
      granulocytes; and parasite damage inside activated macrophages. Destruction of
      the parasitized macrophages was frequently seen in immunized and protected
      animals. Our observations suggest that destruction of parasite-loaded macrophages
      is an important mechanism of host protection in experimental cutaneous
      leishmaniasis.

PMID- 1740179
TI  - Leishmania donovani: antagonistic effect of S-adenosyl methionine on
      ultrastructural changes and growth inhibition induced by sinefungin.
AB  - Sinefungin, an antifungal and antiparasitic nucleoside antibiotic, is a very
      potent antileishmanial agent in vitro and in vivo (Bachrach et al. 1980, FEBS
      Letters 121, 287-291; Neal et al. 1985, Transactions of the Royal Society of
      Tropical Medicine and Hygiene 79, 85-122). It was previously shown that this
      molecule is a competitive inhibitor of AdoMet for transmethylases (Paolantonacci
      et al. 1986, Molecular and Biochemical Parasitology 21, 47-54; Avila et al. 1987,
      Molecular and Biochemical Parasitology 26, 69-76) and that it induces shape
      changes of Leishmania donovani promastigotes as observed by light microscopy
      (Lawrence and Robert-Gero 1990; Bulletin de la Societe Francaise de Parasitologie
      8, 13-18). In the present work the effect of the antibiotic on the ultrastructure
      was analyzed by electron microscopy. The main changes induced at sublethal
      concentrations (0.26 microM sinefungin for 16 hr) were progressive rounding,
      decreased motility, enlargement of the flagellar pocket, and shortening and loss
      of the external part of the flagellum. The comparison with control cells showed
      shorter Golgi saccules and fragmentation of the trans-Golgi network into
      vesicles, indicating a stimulated Golgi apparatus activity. This result,
      associated with the enlarged flagellar pocket, suggests an unbalanced cytoplasmic
      exchange between exocytosis and endocytosis. These effects are quite different
      from those induced by tunicamycin (Dagger et al. 1984, Biology of the Cell 50;
      173-180) or paromomycin. In addition, other nucleoside and nonnucleoside growth
      inhibitors failed to induce similar changes. AdoMet antagonized the sinefungin
      induced shape changes and ultrastructural modifications but had no effect with
      respect to other growth inhibitors. This suggests that the sinefungin activity at
      the cellular level is specifically related to competition with AdoMet. A
      comparative study of N-methylation and carboxylmethylation of proteins in
      sinefungin-treated promastigotes showed that the antibiotic preferentially
      inhibits the latter, catalyzed by protein-O-methyltransferases. These enzymes are
      known to regulate the function of various proteins involved in secretion. Overall
      the results suggest that one of the main targets of sinefungin in exponentially
      growing cells is the protein carboxylmethylation involved in membrane transport.

PMID- 1740180
TI  - Biochemical characterisation of the enzyme responsible for "activated L-serine
      sulphydrase" activity in nematodes.
AB  - The biochemical properties of the enzyme responsible for nematode "activated L
      serine sulphydrase" activity (L-cysteine + R-SH----cysteine thioether + H2S) have
      been investigated using primarily the gastro-intestinal nematodes Nippostrongylus
      brasiliensis and Haemonchus contortus. The activated L-serine sulphydrase enzyme
      was found to be cytosolic in origin and exhibited maximal activity at pH 9.0.
      Enzyme activity was widely distributed amongst the major tissues of adult female
      Ascaris suum but was particularly abundant in longitudinal muscle. The enzyme
      appeared to have a rigid specificity for L-cysteine as the primary thiol
      substrate, but was capable of utilising a number of sulphur amino acids (and
      derivatives) and nonphysiological thiols as second substrates. The best second
      thiol substrates were nonphysiological, hydroxyl-containing thiols that showed
      some structural similarity to the standard second substrate, 2-mercaptoethanol.
      Kinetic analyses revealed that the enzyme operates by a sequential catalytic
      mechanism, and the absolute Michaelis constants were: KL-cysteine = 0.21 +/- 0.02
      mM and K2-mercaptoethanol = 5.58 +/- 0.59 mM. The enzyme was relatively
      insensitive to inhibition by a variety of substrate analogues and known
      inhibitors of pyridoxal 5'-phosphate dependent enzymes, whilst plant phenols
      caused significant levels of inhibition. The most potent inhibitors discovered
      were the anthelmintics bithionol, dichlorophene and hexachlorophene. Further
      characterisation revealed that hexachlorophene was a parabolic competitive
      inhibitor of the activated L-serine sulphydrase enzyme.

PMID- 1740181
TI  - Theileria annulata: alterations in phosphoprotein and protein kinase activity
      profiles of infected leukocytes of the bovine host, Bos taurus.
AB  - The phosphoprotein profiles of T. annulata-infected and uninfected leukocyte cell
      lines were compared by both in vivo and in vitro labeling assays. Three
      phosphoproteins were unique to T. annulata-infected cells, while a further two
      were quantitatively increased relative to uninfected cells. In addition, two
      proteins were present and phosphorylated only in the uninfected cell lines,
      suggesting either a repression of these proteins or their dephosphorylation upon
      infection of the host cell by the parasite. In order to determine if alterations
      in protein kinase activity may be responsible for these differences, as opposed
      to levels of available substrate, an in situ electrophoretic protein kinase assay
      was developed. This assay allowed a crude separation of protein kinases and
      revealed alterations in the protein kinase profile of Theileria-infected cells
      which reflected the differences observed in phosphoprotein profiles. Two protein
      kinases were unique to infected cells, a further two were more active in infected
      cells while one was more active in uninfected cells.

PMID- 1740182
TI  - Plasmodium fragile: cytoadherence of parasitized rhesus monkey erythrocytes to
      human endothelial cells under shear flow conditions.

PMID- 1740183
TI  - Molecular characterization of cDNA sequences encoding glutathione S-transferases
      of Fasciola hepatica.

PMID- 1740184
TI  - Proteases as biological regulators. Introductory remarks.

PMID- 1740185
TI  - Proteolysis in protein import and export: signal peptide processing in eu- and
      prokaryotes.
AB  - Numerous proteins in pro- and eukaryotes must cross cellular membranes in order
      to reach their site of function. Many of these proteins carry signal sequences
      that are removed by specific signal peptidases during, or shortly after, membrane
      transport. Signal peptidases have been identified in the rough endoplasmic
      reticulum, the matrix and inner membrane of mitochondria, the stroma and
      thylakoid membrane of chloroplasts, the bacterial plasma membrane and the
      thylakoid membrane of cyanobacteria. The composition of these peptidases varies
      between one and several subunits. No site-specific inhibitors are known for the
      majority of these enzymes. Accordingly, signal peptidases recognize structural
      motifs rather than linear amino acid sequences. Such motifs have become evident
      by employing extensive site-directed mutagenesis to investigate the anatomy of
      signal sequences. Analysis of the reaction specificities and the primary
      sequences of several signal peptidases suggests that the enzymes of the
      endoplasmic reticulum, the inner mitochondrial membrane and the thylakoid
      membrane of chloroplasts all have evolved from bacterial progenitors.

PMID- 1740187
TI  - Proteases and proteolysis in the lysosome.
AB  - Proteins sequestered by a non-selective bulk process within the lysosomes turn
      over with an apparent half-life of about 8 minutes and this rapid lysosomal
      proteolysis is initiated by endopeptidases, in particular by the cathepsins D and
      L. We describe also the cathepsins B and H which show mainly exopeptidase and
      only low endopeptidase activity. Especially cathepsin H is most probably the only
      lysosomal aminopeptidase in many cell types. Additionally, the properties of
      other mammalian lysosomal endo- and exopeptidases are compared. Finally, we
      discuss some of the conditions for the action of lysosomal proteases as the low
      intralysosomal pH, the high part of lysosomal thiol groups and the absence of
      intralysosomal proteinase inhibitors.

PMID- 1740189
TI  - Genetic analysis of ubiquitin-dependent protein degradation.
AB  - Selective degradation of cellular proteins serves to eliminate abnormal proteins
      and to mediate the turnover of certain short-lived proteins, many of which have
      regulatory functions. In eukaryotes a major pathway for selective protein
      degradation is ATP-dependent and is mediated by the ubiquitin system. This
      pathway involves substrate recognition by components of a ubiquitin-protein
      ligase system, covalent attachment of ubiquitin moieties to proteolytic
      substrates, and subsequent degradation of these conjugates by a multicatalytic
      protease complex. Recent genetic evidence suggests that the remarkable
      selectivity of this process is largely controlled at the level of substrate
      recognition by the ubiquitin ligase system. In Saccharomyces cerevisiae,
      ubiquitin-conjugating enzymes UBC1, UBC4 and UBC5 have been identified as key
      components of this highly conserved degradation pathway. Genetic analysis
      indicates that ubiquitin-dependent proteolysis is essential for cell viability
      and that UBC4 and UBC5 enzymes are essential components of the eukaryotic stress
      response.

PMID- 1740186
TI  - The early and late processing of lysosomal enzymes: proteolysis and
      compartmentation.
AB  - Lysosomal enzymes are subjected to a number of modifications including
      carbohydrate restructuring and proteolytic maturation. Some of these reactions
      support lysosomal targeting, others are necessary for activation or keeping the
      enzyme inactive before being segregated, while still others may be adventitious.
      The non-segregated fraction of the enzyme is secreted and can be isolated from
      the medium. It is considered that the secreted lysosomal enzymes fulfill certain
      physiological and pathophysiological roles. By comparing the secreted and the
      intracellular enzymes it is possible to distinguish between the reactions that
      occur before and after the segregation. In this review the reactions that may
      influence the segregation are referred to as the early processing and those
      characteristic for the enzymes isolated from lysosomal compartments as the late
      processing. The early processing is characterized mainly by modifications of
      carbohydrate side chains. In the late processing, proteolytic fragmentation
      represents the most conspicuous changes. The review focuses on the
      compartmentation of the reactions and the proteolytic fragmentation of lysosomal
      enzyme precursors. While a plethora of proteolytic reactions are involved, our
      knowledge of the proteinases responsible for the particular maturation reactions
      remains very limited. The review points also to work with cells from patients
      affected with lysosomal storage disorders, which contributed to our understanding
      of the lysosomal apparatus.

PMID- 1740188
TI  - Autophagy and other vacuolar protein degradation mechanisms.
AB  - Autophagic degradation of cytoplasm (including protein, RNA etc.) is a non
      selective bulk process, as indicated by ultrastructural evidence and by the
      similarity in autophagic sequestration rates of various cytosolic enzymes with
      different half-lives. The initial autophagic sequestration step, performed by a
      poorly-characterized organelle called a phagophore, is subject to feedback
      inhibition by purines and amino acids, the effect of the latter being potentiated
      by insulin and antagonized by glucagon. Epinephrine and other adrenergic agonists
      inhibit autophagic sequestration through a prazosin-sensitive alpha 1-adrenergic
      mechanism. The sequestration is also inhibited by cAMP and by protein
      phosphorylation as indicated by the effects of cyclic nucleotide analogues,
      phosphodiesterase inhibitors and okadaic acid. Asparagine specifically inhibits
      autophagic-lysosomal fusion without having any significant effects on autophagic
      sequestration, on intralysosomal degradation or on the endocytic pathway.
      Autophaged material that accumulates in prelysosomal vacuoles in the presence of
      asparagine is accessible to endocytosed enzymes, revealing the existence of an
      amphifunctional organelle, the amphisome. Evidence from several cell types
      suggests that endocytosis may be coupled to autophagy to a variable extent, and
      that the amphisome may play a central role as a collecting station for material
      destined for lysosomal degradation. Protein degradation can also take place in a
      'salvage compartment' closely associated with the endoplasmic reticulum (ER). In
      this compartment unassembled protein chains are degraded by uncharacterized
      proteinases, while resident proteins return to the ER and assembled secretory and
      membrane proteins proceed through the Golgi apparatus. In the trans-Golgi network
      some proteins are proteolytically processed by Ca(2+)-dependent proteinases;
      furthermore, this compartment sorts proteins to lysosomes, various membrane
      domains, endosomes or secretory vesicles/granules. Processing of both endogenous
      and exogenous proteins can occur in endosomes, which may play a particularly
      important role in antigen processing and presentation. Proteins in endosomes or
      secretory compartments can either be exocytosed, or channeled to lysosomes for
      degradation. The switch mechanisms which decide between these options are subject
      to bioregulation by external agents (hormones and growth factors), and may play
      an important role in the control of protein uptake and secretion.

PMID- 1740193
TI  - Progestins, breast cancer, and the limitations of epidemiology.

PMID- 1740192
TI  - Progestins and breast cancer: an epidemiologic review.
AB  - OBJECTIVE: To provide a worldwide review of all studies that have examined the
      relationship between progestins, as contained in both contraceptive and
      postmenopausal replacement therapies, and breast cancer risk. An overview of
      utilization patterns for progestins, as well as a review of possible biological
      mechanisms for progestins' action on breast tissue, are also presented. DATA
      IDENTIFICATION: All major epidemiologic studies conducted since 1980 have been
      identified through MEDLINE searches through the published literature and personal
      communications with prominent researchers in the area. STUDY SELECTION: Only
      studies that specifically examined the effects of progestin use are discussed
      here; these include investigations of progestins, in combination or singularly,
      as the main hypothesis or a subgroup analysis. RESULTS: The majority of studies
      have examined combination estrogen and progestin products (oral contraceptives),
      and subgroup analyses of progestins have been impeded by low statistical power
      and the fact that each progestin possesses different types of pharmacological
      activity. Only a few studies of long-acting injectable progestins exist,
      confirming a general lack of specific information on the progesterone-breast
      cancer relationship. Investigations of the effect on breast cancer of the
      addition of progestins to postmenopausal replacement therapy have also produced
      inconsistent results. CONCLUSIONS: To date, there is no consistent evidence of an
      association between progestins and breast cancer. There is need for further
      study, particularly of patients in potentially high-risk groups, including those
      with (1) extended hormone exposure before age 25 and/or first full term pregnancy
      and (2) exposure in the postmenopausal period.

PMID- 1740190
TI  - Proteases and protein degradation in Escherichia coli.
AB  - In E. coli, protein degradation plays important roles in regulating the levels of
      specific proteins and in eliminating damaged or abnormal proteins. E. coli
      possess a very large number of proteolytic enzymes distributed in the cytoplasm,
      the inner membrane, and the periplasm, but, with few exceptions, the
      physiological functions of these proteases are not known. More than 90% of the
      protein degradation occurring in the cytoplasm is energy-dependent, but the
      activities of most E. coli proteases in vitro are not energy-dependent. Two ATP
      dependent proteases, Lon and Clp, are responsible for 70-80% of the energy
      dependent degradation of proteins in vivo. In vitro studies with Lon and Clp
      indicate that both proteases directly interact with substrates for degradation.
      ATP functions as an allosteric effector promoting an active conformation of the
      proteases, and ATP hydrolysis is required for rapid catalytic turnover of peptide
      bond cleavage in proteins. Lon and Clp show virtually no homology at the amino
      acid level, and thus it appears that at least two families of ATP-dependent
      proteases have evolved independently.

PMID- 1740194
TI  - Cytokine levels in follicular fluid of polycystic ovaries in patients treated
      with dexamethasone.
AB  - OBJECTIVE: To assess the levels of cytokines in the follicular fluid of
      stimulated ovaries. DESIGN: The study included two groups of four patients with
      polycystic ovarian disease. These were diagnosed by clinical and ultrasonic
      features and characteristic hormonal profiles, treated with gonadotropin
      releasing hormone-analogue and human menopausal gonadotropin. One group received
      dexamethasone (DEX). MAIN OUTCOME: Dexamethasone is capable of directly affecting
      granulosa and immune cells. It was also expected to affect cytokine production of
      granulosa and immune cells of the ovary. RESULTS: This study demonstrates that FF
      from patients treated with DEX has reduced tumor necrosis factor (TNF) activity
      and elevated colony-stimulating factor levels. Regardless of the treatment with
      DEX, the follicles with high levels of TNF contained minimal concentrations of
      estradiol. Interleukin-6 did not differ between the FF samples. CONCLUSIONS:
      These results suggest a role for cytokines in the process of folliculogenesis and
      ovarian maturation. Modification of cytokines by DEX might explain the beneficial
      effect of fertility.

PMID- 1740191
TI  - The role of proteolytic processing in the morphogenesis of virus particles.
AB  - Proteinases are encoded by many RNA viruses, all retroviruses and several DNA
      viruses. They play essential roles at various stages in viral replication,
      including the coordinated assembly and maturation of virions. Most of these
      enzymes belong to one of three (Ser, Cys or Asp) of the four major classes of
      proteinases, and have highly substrate-selective and cleavage specific
      activities. They can be thought of as playing one of two general roles in viral
      morphogenesis. Structural proteins are encoded by retroviruses and many RNA
      viruses as part of large polyproteins. Their proteolytic release is a
      prerequisite to particle assembly; consequent structural rearrangement of the
      capsid domains serves to regulate and direct association and assembly of capsid
      subunits. The second general role of proteolysis is in assembly-dependent
      maturation of virus particles, which is accompanied by the acquisition of
      infectivity.

PMID- 1740195
TI  - Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term
      follow-up focusing on natural history and circulating hormones.
AB  - OBJECTIVE: To determine if the hormonal imbalance in women with polycystic ovary
      syndrome (PCOS) continues into and after menopause and to analyze factors
      constituting an increased risk for developing metabolic disorders. DESIGN: The
      study was a transectional retrospective cohort follow-up of patients with PCOS.
      SETTING: The women with PCOS were recruited from hospital clinics, and referents
      were randomized from a population study of women. PARTICIPANTS: Thirty-three
      women ages 40 to 59 years with ovarian histopathology typical of PCOS at wedge
      resection 22 to 31 years previously; 132 age-matched referents were analyzed.
      MAIN OUTCOME MEASURES: Clinical data were collected via a questionnaire
      supplemented with an interview in connection to a clinical examination that also
      included fasting venous sampling. RESULTS: Infertility, hirsutism, and
      oligomenorrhea were more common among the subjects with PCOS, but there was a
      considerable spontaneous restitution of cyclic regularity with time. Women with
      PCOS were more often hysterectomized and entered menopause later compared with
      referents. The hormone data show a typical profile for PCOS. Compared with
      referents women with PCOS showed marked increase in prevalence of central
      obesity, higher basal serum insulin concentrations, and a higher prevalence of
      diabetes mellitus and hypertension. CONCLUSION: Perimenopausal women with PCOS
      have an increased morbidity in hypertension and diabetes mellitus that adds to
      the classic symptoms, such as anovulation, hirsutism, and infertility.

PMID- 1740196
TI  - CA-125 levels in human uterine fluid.
AB  - OBJECTIVE: To measure uterine fluid CA-125 concentration and to determine if any
      menstrual cycle phase dependent changes exist in its level. Serum levels are
      measured for comparison. DESIGN: CA-125 levels in uterine fluid were measured
      during the follicular and luteal phases of the menstrual cycle. In a sequential
      study, paired uterine fluid and serum samples were obtained once in both
      midfollicular and midluteal phases of the same menstrual cycle. RESULTS: CA-125
      in uterine fluid during the follicular phase (n = 14) ranged from 16.4 x 10(3) to
      616.5 x 10(3) U/mL, and from 6.2 x 10(3) to 567.3 x 10(3) U/mL in the luteal
      phase (n = 11). In the paired sequential uterine fluid and serum samples, (1) the
      means (+/- SEM) CA-125 in uterine fluid were 81.5 x 10(3) +/- 37.9 x 10(3) U/mL
      and 91.4 x 10(3) +/- 56.8 x 10(3) U/mL in the midfollicular and midluteal phases,
      respectively (P = 0.75); (2) the CA-125 levels in serum increased in the
      midluteal phase (P less than 0.05); and (3) compared with serum, uterine fluid
      levels were greater with a wider range. CONCLUSIONS: When compared with serum CA
      125, uterine fluid contains high concentrations varying over a wide range without
      fluctuation between the follicular and luteal phases of the menstrual cycle.

PMID- 1740197
TI  - Hysterosalpingography and selective salpingography in the differential diagnosis
      of chemical intrauterine versus tubal pregnancy.
AB  - OBJECTIVE: To determine the validity of hystersalpingography (HSG) and/or
      bilateral selective salpingography in the differential diagnosis of early
      (biochemical) intrauterine versus intratubal abortions. DESIGN: The study design
      involved the performance of HSG and selective salpingography in sequential
      patients with low declining beta-human chorionic gonadotropin (beta-hCG) values.
      SETTING: Medical School-affiliated Infertility Center. PARTICIPANTS: Four
      sequential pregnant infertility patients who demonstrated declining beta-hCG
      levels before pregnancy could be confirmed by ultrasound (chemical pregnancies).
      RESULTS: Three of four patients demonstrated a characteristic tubal opacification
      pattern in conjunction with a normally appearing endometrial cavity, considered
      diagnostic of an early tubal pregnancy. In contrast, a missed intrauterine
      pregnancy (IUP) demonstrated a characteristically abnormal endometrial cavity.
      CONCLUSIONS: Some early (chemical) pregnancy losses are intratubal rather than
      intrauterine. The correct differential diagnosis of early missed IUPs versus
      intratubal pregnancies is important because of its prognostic significance.

PMID- 1740198
TI  - Intrauterine insemination outperforms intracervical insemination in a randomized,
      controlled study with frozen, donor semen.
AB  - OBJECTIVE: To assess the efficacy of intrauterine insemination (IUI) in a donor
      insemination program. DESIGN: Prospective randomized clinical trial. SETTING:
      Donor insemination program. PATIENTS, PARTICIPANTS: Women undergoing insemination
      were randomly assigned to receive either IUI or intracervical insemination for a
      maximum of six cycles. INTERVENTIONS: None. MAIN OUTCOME MEASURE(S): Cycle
      fecundity rates between the two routes were compared. RESULTS: The monthly
      fecundity rate for intracervical insemination was 5.1% compared with 23% by IUI.
      By life table analysis, pregnancy rates for IUI were significantly higher than
      intracervical insemination (P = 0.02). CONCLUSIONS: Intrauterine insemination
      with quarantined donor sperm is superior to intracervical insemination.

PMID- 1740199
TI  - An epidemiologic study of smoking and primary infertility in women.
AB  - OBJECTIVE: To determine the relationship between cigarette smoking and primary
      female infertility. DESIGN: Retrospective, case-control study. SETTING:
      Population-based and randomly selected from eight geographic areas in the United
      States. PARTICIPANTS: Women, 20 to 54 years of age, who were randomly selected to
      serve as the control group of the Cancer and Steroid Hormone Study were used for
      this study. Within this group, there were 483 women who were classified as having
      experienced primary infertility and 2,231 women eligible to serve as controls.
      Primary infertility, defined as 24 consecutive months of unprotected intercourse
      without conception, was documented from a calendar of each women's reproductive
      and contraceptive history. RESULTS: Smoking one pack of cigarettes per day (odds
      ratio = 1.36) and starting to smoke before 18 years of age (odds ratio = 1.30)
      were significantly associated with increased risk of infertility. Life table and
      proportional hazards analysis indicated that smoking did not significantly
      increase the time required to conceive among infertile women. CONCLUSIONS: Number
      of cigarettes smoked and age when the women began smoking contributed to
      infertility in this study. It is reasonable, therefore, to recommend that women
      stop smoking when they are attempting to become pregnant.

PMID- 1740200
TI  - Cyclic changes in the concentration of glucose and fructose in human cervical
      mucus.
AB  - OBJECTIVE: To determine a possible cyclic change in the concentration of glucose
      and fructose in the aqueous phase of human cervical mucus (CM). DESIGN:
      Concentrations of glucose and fructose were longitudinally determined in the
      aqueous phase of CM of normal cycling women using enzymatic techniques, modified
      for small quantities. SETTING: Patients visiting a fertility clinic were
      selected. PATIENTS: Nine healthy women with regular menstrual cycles of 28 +/- 3
      days that appeared to be ovulatory, demonstrated by sonographic follicle immaging
      and serum progesterone (P) measurements. INTERVENTIONS: Cervical mucus samples
      were longitudinally collected preovulatory, postovulatory, and premenstrual in
      ovulatory cycles, monitored by ultrasound and blood estradiol and P measurements.
      MAIN OUTCOME MEASURES: The study was designed to measure glucose and fructose
      longitudinally on three different points during one cycle. RESULTS: The
      preovulatory glucose concentrations in CM were lower than postovulatory and
      premenstrual. The preovulatory fructose concentrations were lower than
      premenstrual. The glucose concentration correlated with the blood P level.
      CONCLUSION: There is a consistent change in the glucose concentration measured in
      human CM in three phases of the menstrual cycle. The preovulatory and
      premenstrual fructose concentrations differ significantly. Knowledge of the
      carbohydrate metabolism in human cervical mucus may contribute in illuminating
      the possible role of the carbohydrate metabolism in sperm migration at midcycle
      and implantation in the luteal phase.

PMID- 1740201
TI  - Chlamydial antibodies and deoxyribonucleic acid in patients with ectopic
      pregnancy.
AB  - OBJECTIVE: To evaluate the importance of previous and persisting chlamydial
      infection for ectopic pregnancy (EP). DESIGN: A prospective study of women with
      EP. SETTING: Hospitalized patients. PATIENTS AND CONTROLS: Eighty-six women with
      EP with (group I; n = 35) or without (group II; n = 51) risk factors for EP and
      chlamydial infection. Age-matched normally pregnant women served as controls.
      INTERVENTIONS: Blood samples were drawn from patients and controls for antibody
      determination. MAIN OUTCOME MEASURES: The frequency of immunoglobulin G
      antibodies was compared between patients and controls, and the polymerase chain
      reaction (PCR) was used to detect chlamydial deoxyribonucleic acid (DNA) in tubal
      tissue from 33 patients (70 specimens). RESULTS: Immunoglobulin G antibodies
      (titer greater than or equal to 32) were significantly more common among patients
      than in controls (51% versus 31%, P less than 0.025). The difference was more
      pronounced between group I and controls (69% versus 31%, P less than 0.005).
      Chlamydial DNA was not detected in any tubal specimen. CONCLUSIONS: An
      association was found between previous chlamydial infection (serologically) and
      EP, especially in women with risk factors, but no evidence of persisting
      chlamydial infection in the tubes could be demonstrated using PCR.

PMID- 1740202
TI  - Psychological aspects of donor insemination: evaluation and follow-up of
      recipient couples.
AB  - OBJECTIVE: To evaluate the utility of psychological screening for couples
      entering a donor insemination program. DESIGN: Each spouse completed
      questionnaires. A psychologist reviewed them and rated the psychological fitness
      of the couple for participation in the program. Follow-up questionnaires were
      sent to each couple at a mean of 11 months after entry into the program. SETTING:
      Applicants for donor insemination were studied in an infertility program in a
      large, tertiary referral center. PATIENTS, PARTICIPANTS: Consecutive applicants
      to enter the donor insemination program were required to participate in the
      initial evaluation. INTERVENTIONS: Couples judged by the psychologist to be at
      risk for a poor psychological outcome had an assessment and counseling interview
      with the psychologist before proceeding with insemination. MAIN OUTCOME MEASURES:
      Initially, the Stress and Infertility Questionnaire measured specific anxieties
      related to donor insemination, marital and sexual impact, and attitudes about
      confidentiality; the Brief Symptom Inventory measured psychological distress; and
      the Dyadic Adjustment Inventory assessed marital satisfaction. At follow-up, 48%
      of couples returned a modified version of the Stress and Infertility
      Questionnaire and the other two questionnaires. RESULTS: The psychologist's
      rating was predictive of pregnancy rates (59% for excellent candidates, 41% for
      acceptable couples, and 14% for couples psychologically at risk). At-risk couples
      were more likely to drop out of the program (50% versus only 20% of other
      couples). Sexual problems were reported by 59% of women and 53% of men. Couples
      believed that a child should not be told of the donor insemination (74% of wives
      and 80% of husbands). Initially, 64% of wives and 70% of husbands chose total
      secrecy with families or friends, and these attitudes shifted little over time.
      CONCLUSION: This screening procedure is cost-effective and suggests that
      psychological intervention should be attempted with at-risk couples.

PMID- 1740203
TI  - Utility of zona pellucida drilling in cases of severe semen alterations in man.
AB  - OBJECTIVE: To evaluate the utility of zona drilling for human severe sperm
      alterations in in vitro fertilization (IVF). DESIGN: A prospective randomized
      study was conducted according to random assignment of collected oocytes to a
      control or zona drilling procedure. SETTING: Reproductive Biology Laboratory,
      University Hospital of Nantes, France. PATIENTS: Twenty infertile couples with
      severe semen defects and previous IVF failure. INTERVENTIONS: Ultrasound-guided
      transvaginal follicular aspiration. RESULTS: Fertilization rates were compared to
      assess the advantages of zona drilling: 93% (80/86) drilled oocytes survived and
      18.75% (15) were fertilized, whereas only 3% (3/100) control oocytes were
      fertilized. The polyspermy rate for fertilized drilled oocytes was high (10/15;
      66.6%). The normal fertilization rate after zona drilling remained very low
      (5/86; 5.8%) and was not statistically different from that of control oocytes
      (3/100; 3%). One implantation occurred after replacement of five drilled embryos
      in three patients but resulted in early miscarriage. Replacement of the single
      control embryo led to a progressive pregnancy and normal male birth. CONCLUSIONS:
      This study indicates that zona drilling does not improve IVF results in cases of
      severe semen alterations.

PMID- 1740204
TI  - The impact of long-term gonadotropin-releasing hormone analogue treatment on
      preclinical abortions in patients with severe endometriosis undergoing in vitro
      fertilization-embryo transfer.
AB  - OBJECTIVE: To examine the relationship between endometriosis and preclinical
      abortions and to evaluate the effect of gonadotropin-releasing hormone analogue
      (GnRH-a) therapy on these pregnancies. DESIGN AND PATIENTS: Of 67 women with
      severe endometriosis referred to us for in vitro fertilization-embryo transfer
      (IVF-ET), 32 underwent ovarian stimulation for oocyte retrieval with menotropins
      (protocol A), whereas the other 35 were admitted for the procedure after a 6
      month period of hormonal suppression with a GnRH agonist (protocol B). The
      clinical impact of the preclinical and clinical pregnancies in both treatment
      protocols were evaluated on the basis of oocyte classification and embryo quality
      score. SETTING: All patients were treated in our IVF Unit. MAIN OUTCOME MEASURE:
      Clinical pregnancy was used as our main outcome measure of success. RESULTS: A
      significantly higher number of preclinical pregnancies (P less than 0.0001)
      occurred in patients treated by protocol A. After GnRH-a treatment, the
      preclinical pregnancy rate declined significantly (P less than 0.0001), whereas
      the clinical pregnancy rate per cycle and per transfer rose significantly (P less
      than 0.0001 and P less than 0.0001, respectively). Furthermore, clinical
      pregnancies had a significantly better mean embryo quality score in comparison
      with preclinical pregnancies (P less than 0.0001). CONCLUSIONS: It is concluded
      that combining GnRH-a therapy before IVF-ET provides an improved treatment
      modality for preclinical abortions and infertility associated with severe
      endometriosis.

PMID- 1740205
TI  - Leuprolide acetate-prepared in vitro fertilization-gamete intrafallopian transfer
      cycles: efficacy versus controls and cost analysis.
AB  - OBJECTIVE: To evaluate the effect of gonadotropin-releasing hormone agonist (GnRH
      a) when given through stimulation with gonadotropins versus stopping it as
      stimulation was initiated versus a control group unprepared in this manner. Also,
      to construct a cost analysis for this type of therapy in an in vitro
      fertilization-gamete intrafallopian transfer program (IVF-GIFT). DESIGN:
      Prospective, consecutive, randomized, with a control group. SETTING: An out
      patient IVF-GIFT program. PATIENTS: One hundred new patients entering an IVF-GIFT
      program. INTERVENTIONS: In vitro fertilization or GIFT cycles with or without
      preparation (pituitary suppression) by GnRH-a administration in which suppression
      was continued or halted as gonadotropins were begun. MAIN OUTCOME MEASURES:
      Cancellation rates, ampules, and days of gonadotropin use, costs, estradiol (E2)
      level, egg numbers and quality, and pregnancy rates. RESULTS: Stopping GnRH-a
      (leuprolide acetate) therapy as stimulation was begun did not lessen the
      suppressive effect in reduction of spontaneous luteinizing hormone surge as seen
      with continued use of agonist. In contrast, the control group had a 30.3%
      cancellation rate before ovum retrieval. The E2 and egg data among the groups
      were similar, but as expected, agonist use led to the need for more and longer
      duration of gonadotropin stimulation. Pregnancy rates were not different by
      group. Costs were approximately even by the third initiated cycle.

PMID- 1740206
TI  - After superovulation-intrauterine insemination fails: the prognosis for treatment
      by gamete intrafallopian transfer/pronuclear stage transfer.
AB  - OBJECTIVE: To determine the prognosis for gamete intrafallopian transfer
      (GIFT)/pronuclear stage transfer (PROST) treatment after prior superovulation
      intrauterine insemination (IUI). DESIGN: Matched, retrospective. SETTING:
      Outpatient university endocrine-infertility program. PATIENTS, PARTICIPANTS: One
      hundred forty-four women matched for infertility factors and age were studied
      according to the following three treatment groups: superovulation-IUI only,
      GIFT/PROST only, or GIFT/PROST after superovulation-IUI. MAIN OUTCOME MEASURES:
      Per cycle and cumulative pregnancy rates (PRs) were compared utilizing life table
      analysis. RESULTS: Cumulative PRs (0.408) for superovulation-IUI only were lower
      than initial (0.469) and cumulative (0.802) cycle fecundity of GIFT/PROST (P =
      0.002). Per cycle and cumulative PRs did not differ between GIFT/PROST only
      versus GIFT/PROST after superovulation-IUI. CONCLUSIONS: Gamete intrafallopian
      transfer/PROST may be cost-effective when compared with superovulation-IUI. The
      prognosis for GIFT/PROST success is not negatively affected by earlier
      superovulation-IUI treatment failure.

PMID- 1740207
TI  - Relationship of follicle number and other factors to fecundability and multiple
      pregnancy in clomiphene citrate-induced intrauterine insemination cycles.
AB  - OBJECTIVE: To determine characteristics associated with pregnancy and multiple
      gestation after clomiphene citrate (CC)-intrauterine insemination (IUI). DESIGN:
      Prospective study of all patients undergoing CC-IUI between January 1, 1983 and
      December 31, 1989. SETTING: Private fertility clinic. PATIENTS: Eight hundred
      forty-nine patients undergoing 1,974 cycles of CC-IUI. MAIN OUTCOME MEASURES:
      Relationship between number and size of preovulatory follicles, age, additional
      infertility diagnosis, medication, and initial semen quality to fecundity, birth,
      and multiple gestation. RESULTS: Uncorrected, per cycle fecundity was 7.2%. The
      number of follicles greater than or equal to 12 mm (r = 0.055, P less than 0.05)
      was and the number greater than or equal to 15, 18, and 21 mm was not correlated
      with fecundity. Endometriosis with (P = 0.013) or without (P less than 0.0005)
      tubal adhesions and tubal adhesions alone (P = 0.005), decreased fecundability by
      50%. Initial semen quality did not affect fecundity, unless semen concentration
      was less than 5 x 10(6)/mL or motility was less than 20%. Multiple pregnancy was
      not associated with the dose of CC, use of human chorionic gonadotropin, or
      number of follicles. CONCLUSIONS: Multiple pregnancy was unrelated to follicle
      numbers or to CC dose. The highest birth rates after CC-IUI occurred when initial
      sperm concentration was greater than or equal to 5 x 10(6)/mL, motility was
      greater than or equal to 20%, and no endometriosis or adhesions were present.

PMID- 1740208
TI  - Performance of cryopreserved pre-embryos obtained in in vitro fertilization
      cycles with or without a gonadotropin-releasing hormone agonist.
AB  - OBJECTIVE: To evaluate the viability and potential for pregnancy of
      cryopreserved/thawed pre-embryos obtained after ovarian stimulation using
      gonadotropin-releasing hormone agonist (GnRH-a) adjunct therapy. DESIGN:
      Retrospective clinical evaluation of all patients receiving a gonadotropin
      ovarian stimulation protocol (follicle-stimulating hormone/human menopausal
      gonadotropin [FSH/hMG]) with/without GnRH-a. SETTING: Academic tertiary clinical
      care unit. PATIENTS: Patients receiving leuprolide acetate (LA)/FSH/hMG (n = 136:
      LA in the luteal phase; long protocol) were compared with patients receiving
      FSH/hMG alone (n = 130) within the same time-frame in our program (April 1987
      through October 1989). INTERVENTIONS: All patients had both a cycle in which pre
      embryos were transferred fresh and a cycle of thaw of cryopreserved pre-embryos
      (frozen at the pronuclear stage in a slow freeze-thaw protocol using 1,2
      propanediol) transferred in monitored natural cycles. MAIN OUTCOME MEASURES:
      Groups were similar in age, etiology of infertility, and cycle day 3 serum FSH
      levels; a significantly higher (P less than 0.001) number of preovulatory oocytes
      was recovered in the GnRH-a group. Both groups of patients were transferred an
      equal number of pre-embryos at the time of IVF. Cycles with frozen/thawed pre
      embryos were evaluated based on the analysis of the three main variables that
      demonstrate cryopreservation efficiency: survival rate, implantation rate, and
      term pregnancy rate (PR). RESULTS: Non-GnRH-a group (113 transfers): pre-embryo
      survival, 71.5%; PR/transfer, 24.7%; implantation rate, 16.0%; GnRH-a group (125
      transfers): pre-embryo survival 71.6%; PR/transfer, 32.8%; implantation rate,
      12.0% (no significant differences). CONCLUSIONS: The use of GnRH-a produced pre
      embryos of equal aptitude for development after cryopreservation at the
      pronuclear stage when compared with a similar gonadotropin stimulation treatment
      without GnRH-a.

PMID- 1740209
TI  - The relationship between embryo quality and the occurrence of multiple
      pregnancies.
AB  - OBJECTIVE: To study the relationship between the quality of the transferred
      embryos and the occurrence of multiple pregnancies. Embryo quality was defined by
      the cleavage rate and by morphological parameters such as blastomere size and the
      presence or absence of anucleate fragments. DESIGN: A retrospective analysis of
      1,915 consecutive transfers of fresh embryos between January 1986 and December
      1989. SETTING: All the embryo transfers (ETs) were performed in patients from the
      in vitro fertilization program of the Center for Reproductive Medicine, Vrije
      Universiteit Brussel, Brussels, Belgium. RESULTS: We confirmed the relationship
      between the number of embryos transferred and the pregnancy rate (PR): 11.9% of
      the single, 19.0% of the double, and 34.1% of the triple ETs were successful.
      Thirty-one percent of these triple embryo replacements resulted in a multiple
      gestation. At the time of transfer (44 to 48 hours after insemination), we
      observed that embryos that had undergone at least two mitotic divisions implanted
      better than two-cell embryos of comparable morphological appearance (implantation
      rate per transferred embryo: 21.3% versus 12.3%, P less than 0.001) and that
      heavily fragmented embryos did not implant as well as embryos without or with
      fewer anucleate fragments (1.5% versus 14.1%, P less than 0.001). The PR,
      implantation rate, and the incidence of multiple pregnancies increased
      significantly with the number of good quality embryos that were transferred.
      CONCLUSIONS: Our study indicated that embryo quality based on morphological
      observations could predict the occurrence of multiple pregnancies.

PMID- 1740210
TI  - Discordant secretion of pregnancy specific beta 1-glycoprotein and human
      chorionic gonadotropin by human pre-embryos cultured in vitro.
AB  - OBJECTIVE: To study and compare the secretion of pregnancy specific beta 1
      glycoprotein (SP1) and human chorionic gonadotropin (hCG) by human pre-embryos,
      cultured in vitro, with their respective morphological development. DESIGN: Spare
      human pre-embryos from randomly selected women participating in a program of in
      vitro fertilization (IVF) were studied prospectively. SETTING: Pre-embryos were
      cultured, and hormone release was determined in academic research laboratories.
      PATIENTS, PARTICIPANTS: Pre-embryos (n = 108) cultured for 14 days after
      fertilization in Ham's F-10 medium (GIBCO Ltd., Paisley, Scotland) were observed,
      and hCG and SP1 were measured in the culture media at regular intervals. MAIN
      OUTCOME MEASURES: Discordant secretion of SP1 and hCG. RESULTS: Of the 98
      bipronucleate pre-embryos, 53.6% formed blastocysts, 17.3% of which hatched.
      Human chorionic gonadotropin was detected from day 7 after fertilization
      concomitantly with blastocyst formation, thereafter showing a logarithmic
      increase (maximum 10,650 mIU) until the first signs of embryonic disintegration.
      Pregnancy-specific beta 1-glycoprotein release started 3 to 4 days after
      fertilization independently of the morphological development and the future
      production of hCG, thereafter displaying a nonlogarithmic increase (maximum 41
      ng). CONCLUSIONS: Hormone secretion and morphological development are unique for
      each pre-embryo. Human chorionic gonadotropin and SP1 seem to have different
      biochemical and physiological regulation.

PMID- 1740211
TI  - Immunosuppressive activity and alpha interferon concentrations in human embryo
      culture media as an index of potential for successful implantation.
AB  - OBJECTIVE: To evaluate potential correlations between establishment of pregnancy
      and immunosuppressive activity secreted by the preimplantation embryo. DESIGN: To
      evaluate immunosuppressive activity, supernatants from preimplantation embryos
      were assessed for their ability to inhibit lymphocyte proliferation.
      Additionally, alpha interferon concentrations were also measured in these
      supernatants. We compared these parameters from embryo culture supernatants of
      women who did and did not achieve pregnancy after in vitro fertilization (IVF).
      Immunosuppression was assessed using a lymphocyte proliferation assay with
      concanavalin A (Con A) and phytohemagglutinin (PHA) as mitogens. SETTING: In
      vitro fertilization program at the University of Utah Medical Center.
      PARTICIPANTS: Couples less than 40 years of age, with normal semen quality and
      bilateral tubal obstruction. RESULTS: Immunosuppression calculated using the
      stimulation index (mean +/- SEM) in pregnant and nonpregnant women, respectively,
      were: Con A: 43.9 +/- 3.9 versus 19.1 +/- 10.1, P less than 0.04. PHA: 23.6 +/-
      5.6 versus 12.5 +/- 12.8, P less than 0.02. Alpha interferon levels (mean +/- SD)
      in pregnant and nonpregnant women were not significantly different: 23.98 +/- 9.6
      U/mL versus 24.79 +/- 2.5 U/mL. CONCLUSIONS: We conclude that pre-embryos with
      the capacity for successful implantation secrete greater amounts of
      immunosuppressive factors than those destined not to implant, as measured by Con
      A and PHA lymphocyte proliferation assays. Refinement of assay techniques and
      identification of the substances involved could have significant impact on IVF
      programs.

PMID- 1740212
TI  - An improved medium for long-term culture of human embryos overcomes the in vitro
      developmental block and increases blastocyst formation.
AB  - OBJECTIVE: To determine if a culture medium, designated CZB after the authors who
      first described it, which is supplemented with 0.11 mM ethylenediaminetetraacetic
      acid, 1.0 mM glutamine, 31.30 mM lactate, and 0.27 mM pyruvate and is lacking
      glucose for the initial stages of culture that overcomes the in vitro two-cell
      block of mouse embryos, can improve the rate of blastocyst formation of human
      embryos in long-term cultures and increase the pregnancy rate (PR) when used in a
      clinical in vitro fertilization (IVF) program. DESIGN: The study is in two parts.
      Initially, excess oocytes from IVF and gamete intrafallopian transfer patients
      were fertilized in vitro and then placed in long-term culture of either CZB plus
      10% heat-inactivated human serum (32 zygotes) or Earle's balanced salt solution
      (EBSS) supplemented with 0.45 mM pyruvate plus 10% human serum (28 zygotes) to
      determine if CZB medium could enhance in vitro development and increase
      blastocyst formation when compared with EBSS. Subsequently, CZB or EBSS medium
      was used for short-term cultures of embryos in a clinical IVF program to
      determine if the use of CZB could increase the clinical IVF PR. SETTING: Private
      practice of one author (M.D.). PATIENTS: The excess oocytes were donated by
      couples not wishing to have cryopreservation. In the clinical trial, 49 couples
      presenting with tubal or male factor infertility and who had three or more
      fertilized zygotes were randomly assigned to one of the culture media being used.
      RESULTS: In long-term cultures, embryos were observed at 42, 66, 90, 114, and 138
      hours after fertilization and scored for blastomere number, degree of
      fragmentation, and developmental arrest. When CZB- and EBSS-cultured embryos were
      evaluated over 138 hours, there was a significant increase in the number of CZB
      cultured embryos reaching the blastocyst stage (56% versus 20%; P less than
      0.009) and less fragmentation of CZB-cultured embryos (18.8% versus 50%; P less
      than 0.01). In short-term cultures, pronuclear stage embryos from patients
      undergoing IVF were cultured in CZB or EBSS for 24 hours, graded, and then used
      in embryo transfers. Of the 28 patients assigned to EBSS, 6 became pregnant
      (21.4%), and of the 21 assigned to CZB, 5 attained pregnancy (23.8%). These
      results were not significantly different. CONCLUSIONS: The use of CZB for the
      long-term culture of human embryos is highly beneficial and increases the rate of
      blastocyst formation, but its use in an IVF program does not increase the
      clinical PR.

PMID- 1740213
TI  - Accuracy and precision of computer-aided sperm analysis in multicenter studies.
AB  - STUDY OBJECTIVES: To develop methods of instrument calibration and
      standardization that enable the use of computer-aided sperm analysis (CASA)
      technology in multicenter studies of sperm motility. SETTING: Clinical semen
      evaluation for the andrology laboratory and in vitro fertilization programs.
      PATIENTS: Semen specimens were selected from the videotape archives of the
      University of California at Davis Andrology Laboratory and used to produce a
      videotape reference standard for CASA instrument testing and calibration. Four
      identical CASA instruments, two each at two sites, were used to analyze the
      videotape. Machine accuracy was verified by manual analysis of the videotape.
      RESULTS: The coefficient of variation (CV) for repeated measures was between 1%
      and 8% for each variable on all CASA instruments. Mean values for CASA parameters
      varied as a function of the digitization threshold. A minimum CV was obtained at
      a particular threshold setting, suggesting an optimum for each machine. Because
      of high within-machine precision, slight differences in mean values between
      machines were statistically significant for some variables and some specimens;
      such differences are probably not biologically significant. CONCLUSION:
      Multicenter standardization of CASA instrumentation is possible, but threshold
      settings are one source of variation that must be controlled using CVs or another
      means of objective calibration. One method is to adjust the threshold of each
      instrument until the count obtained by CASA equals the count obtained by the
      manual method used to determine the dilution requirements for neat semen.

PMID- 1740214
TI  - Effect of volumetric mixtures of peritoneal and follicular fluid from the same
      woman on sperm motility and acrosomal reactivity in vitro.
AB  - OBJECTIVE: To study the effect of peritoneal (PF) and follicular fluids (FF from
      the same woman) as well as of given volumetric combinations thereof on sperm
      motility and acrosomal reactivity. DESIGN: Prospective. Peritoneal fluid and FF
      were incubated separately or in given volumetric combinations (PF/FF = 100/0,
      75/25, 50/50, 25/75, 0/100; vol/vol) with swim-up sperm suspensions. SETTING: In
      vitro fertilization and general infertility clinic and laboratories. PATIENTS,
      PARTICIPANTS: Women participants of the gamete intrafallopian transfer program
      (motility study, n = 20; acrosomal reaction study, n = 14). Sperm donors of the
      artificial insemination program and men with given sperm parameters.
      INTERVENTIONS: Hormonal stimulation. Laparoscopy. MAIN OUTCOME MEASURES:
      Progressive velocity and percentage of motile gametes measured with multiple
      exposure photography. Acrosomal reactivity measured by an immunofluorescent
      technique. RESULTS: Follicular fluid always influenced progressive motility and
      also sustained the number of motile gametes, as function of time, better than PF
      or the PF/FF mixtures (P less than 0.05). The acrosomal reactivity of sperm
      incubated in the various PF/FF combinations was low; after 5 hours only the FF
      sperm suspensions showed a significant enhancement of acrosomally reacted
      gametes. CONCLUSION: At ovulation, FF transmit positive (motility- and acrosomal
      reactivity-enhancing) signals to sperm, whereas PF may transmit positive,
      neutral, or negative signals (noise signals). The volumetric combination of FF
      and PF in the tubal environment, which may differ from cycle to cycle and from
      woman to woman, could therefore result in synergic (or antagonistic) effects on
      the sperm fertility potential.

PMID- 1740215
TI  - The axonemal ultrastructure of spermatozoa from men with asthenospermia.
AB  - OBJECTIVE: To determine with the use of transmission electron microscopy (TEM)
      the proportion of patients with the semen pattern of severe asthenospermia (less
      than 20% motility) that have an abnormality of sperm axonemal structure as the
      basis for this disorder. DESIGN: Transverse sections of sperm tail axonemes were
      quantitatively analyzed, and the mean frequency per axoneme of the doublet
      microtubules, central pair, outer dynein arms, inner dynein arms, and radial
      spokes were determined. SETTING: Patients were being investigated for male
      infertility at the Reproductive Medicine Clinic at Monash Medical Centre
      (Melbourne). Semen samples were processed for and analyzed by TEM in the
      university laboratory. PATIENTS: Ten asthenospermic patients in whom repeated
      semen analysis demonstrated a percentage of sperm motility less than 20% were
      selected. MAIN OUTCOME MEASURE(S): The main measure was the quantitative analysis
      of sperm axonemes. The hypothesis that a reduction of axonemal components causes
      lowered motility derived from the results. RESULTS: Individual asthenospermic
      patients demonstrated significant reductions in at least three axonemal
      structures when compared with the normal mean. Statistical analysis of the
      grouped data showed that all axonemal components were significantly lower than
      the normal mean. CONCLUSIONS: The consistent reduction of axonemal components
      strongly suggests that axonemal deficiencies are the cause of lowered motility in
      asthenospermic patients.

PMID- 1740216
TI  - Chronic suppression of testicular function by constant infusion of gonadotropin
      releasing hormone agonist and testosterone supplementation in the bonnet monkey
      (Macaca radiata).
AB  - OBJECTIVE: To study the efficacy of long-term buserelin acetate infusion to
      desensitize pituitary and block testicular function in adult male monkeys (Macaca
      radiata). ANIMALS: Proven fertile male monkeys exhibiting normal testicular
      function. PROTOCOL: Each of the control (n = 5) and experimental monkeys (n = 10)
      received a fresh miniosmotic pump every 21 days, whereas pumps in controls
      delivered vehicle of experimentals released 50 micrograms buserelin acetate every
      24 hours. On day 170 (renewed every 60 days) a silastic capsule containing
      crystalline testosterone (T) was implanted in the experimental monkeys. At the
      end of 3 years, treatment was stopped, and recovery of testicular function and
      fertility monitored. RESULTS: (1) Treatment resulted in marked reduction of
      nocturnal but not basal serum T; (2) the pituitary remained desensitized to
      buserelin acetate throughout the 3-year period; (3) animals were largely
      azoospermic with occasional oligospermia exhibited by two monkeys; and (4)
      withdrawal of treatment restored testicular function, with 70% of animals
      regaining fertility. CONCLUSION: Long-term infertility (but restorable) can be
      induced in male monkeys by constant infusion of buserelin acetate and T.

PMID- 1740217
TI  - An intact zona pellucida is not necessary for successful mouse embryo
      cryopreservation.
AB  - OBJECTIVE: To determine the developmental potential of mouse embryos that
      underwent cryopreservation after micromanipulation of the zona pellucida. DESIGN:
      Gaps were produced in the zona pellucida of mouse oocytes or two-cell embryos by
      zona drilling with acid Tyrode's solution. Zona-drilled oocytes were fertilized
      in vitro and cultured to the two-cell stage. Two-cell embryos were frozen,
      thawed, and cultured to the expanded blastocyst stage. RESULTS: There was no
      difference in the rate of embryo survival post-thaw (248/318, 77% versus 288/345,
      83.4%), or in the rate of development to the expanded blastocyst stage (91/248,
      36.7% versus 88/288, 30.6%), between embryos that were zona drilled as oocytes
      and unmanipulated controls. Similarly, there was no difference in the rate of
      cryosurvival (206/217, 94.9% versus 168/187, 89.8%) or development to the
      blastocyst stage (154/206, 74.7% versus 132/168, 78.6%) between embryos that were
      fertilized in vivo and zona drilled at the two-cell stage and embryos that were
      unmanipulated. CONCLUSIONS: These findings indicate that small gaps in the zona
      pellucida, such as those that result from micromanipulation, do not significantly
      alter the ability of embryos to withstand cryopreservation.

PMID- 1740218
TI  - Pharmacokinetics of methotrexate after local tubal injection for conservative
      treatment of ectopic pregnancy.
AB  - Methotrexate peak level after intratubal injection was found to be significantly
      lower than the accepted toxic level. After IM injection, MTX peak level and the
      AUC were found to be similar to the levels observed after intratubal injection.
      The advantage of tubal injection over IM injection is challenged.

PMID- 1740219
TI  - Incidence of bilateral adnexal disease in severe endometriosis (revised American
      Fertility Society [AFS], stage IV): should a stage V be included in the AFS
      classification?
AB  - Studying the incidence of bilateral adnexal disease and dense adhesions, two
      groups of patients with severe endometriosis were distinguished, suggesting that
      a stage V needs to be considered in the AFS classification.

PMID- 1740220
TI  - Contralateral tubal pregnancy after gamete intrafallopian transfer.
AB  - A case of EP after GIFT into the contralateral tube is presented. Hydrotubation
      with Earle's medium immediately before the GIFT cannot be excluded as a possible
      cause of gamete migration. The complete demise of the CL also demonstrates that
      trophoblast can implant and develop without steroidal support.

PMID- 1740221
TI  - Controlled micromanipulation of human sperm in three dimensions with an infrared
      laser optical trap: effect on sperm velocity.
AB  - Individual human sperm can be micromanipulated in three dimensions using a 1.06
      microns Nd:YAG laser trap. Single sperm swimming with velocities in the range of
      65 to 85 microns/sec can be trapped with 40 mW of power through 120 seconds
      without a deleterious effect on velocity. Even though it will be necessary to
      further evaluate the effects of laser light on specific functions of sperm, our
      data suggest that decreasing the time of manipulation to a minimum will increase
      the safety of the micromanipulation procedures. Laser traps may play a role in
      assisted reproductive technology by facilitating the selective transport of
      individual sperm.

PMID- 1740222
TI  - Ultrastructure sperm defects in addicts.
AB  - Addiction is a major problem confronting the whole world today. Disruption of
      interpersonal relationships, economic loss, and crimes against property are
      frequent consequences. Harm to the individual himself extends to all
      physiological systems. In the present study, we examined semen samples of six
      addicts by light and electron microscopy. Oligoasthenospermia was demonstrated in
      five patients, and necrospermia was observed in one patient. Severe degenerative
      changes of the sperm heads were noted. Granular condensation of the chromatin
      with nuclear vacuoles was demonstrated. Persistent cytoplasmic droplets were
      frequently observed. Degenerated tails showing fragmentation of the plasma
      membranes and numerical aberrations of the 9 + 2 configuration were also present,
      together with thickened and disorganized fibrous sheaths. These results confirm
      the deleterious effects of addiction on the entire sperm structure.

PMID- 1740223
TI  - Smoking and corpus luteum function.

PMID- 1740224
TI  - Tumor necrosis factor-alpha and sperm function?

PMID- 1740225
TI  - Clomiphene citrate and cervical mucus.

PMID- 1740226
TI  - Pre- and postweaning excretion of puberty-influencing chemosignals in house mice.
AB  - Pre- and postweaning excretion of urinary chemosignals that influence puberty in
      female house mice were tested. The dependent variable used to assess the
      effectiveness of urine samples collected from donor mice was the age of first
      vaginal estrus in young female mice. Preweaning excretion of the puberty-delaying
      chemosignal by females was affected by litter sex composition; this effect
      interacted with the age of the young donor females. In litters of all females,
      the substance occurred from about the age of 9 days and in litters with 6 females
      and 2 males the delay substance was released from about the age of 17 days.
      Grouping dams during gestation but not prior to conception resulted in excretion
      of the puberty-delaying substance in the female progeny from the age of 17 days
      or possibly earlier. Young male mice do not excrete the puberty-accelerating
      chemosignal prior to the age of puberty. However, giving young males injections
      of testosterone resulted in an earlier first excretion of the acceleratory
      signal, suggesting that the machinery for chemosignal production is operative
      prior to the time of sexual maturity. Caging young males with an adult female
      prior to puberty resulted in earlier excretion of the puberty-accelerating
      substance, while caging young males with adult males retarded excretion of the
      substance. The findings are discussed in terms of early hormone effects on
      behavior and with regard to consequences for the chemosignal systems in house
      mice.

PMID- 1740227
TI  - Contextual determinants of auditory learning in bobwhite quail embryos and
      hatchlings.
AB  - This study examined the ability of bobwhite quail embryos and hatchlings to learn
      an individual bobwhite maternal call. Results revealed that embryos could learn
      an individual maternal call and remember that call for at least 24 hr following
      exposure. In contrast, hatchlings reared socially in groups of same-age chicks
      during postnatal exposure to a maternal call did not demonstrate a preference for
      that familiar call at 24 hr following exposure. However, individual auditory
      recognition was exhibited by hatchlings reared in social isolation, suggesting
      that the perceptual and social complexity of the postnatal situation can disrupt
      or interfere with early auditory learning. Additional support for this view was
      the finding that embryos exposed to unusually early visual stimulation during
      prenatal exposure to a maternal call also failed to prefer that familiar maternal
      call in subsequent choice tests. The idea that early auditory learning capacity
      is determined more by context and experience rather than the organism's specific
      age or stage of development is discussed.

PMID- 1740228
TI  - Organization of the stretch response to milk in the rat fetus.
AB  - Intraoral infusion of milk reliably elicits a stretch response in the rat fetus.
      The fetal stretch response appears isomorphic to the stereotypic behavior
      exhibited postnatally by suckling rat pups during milk ejection. Using a
      procedure that permits direct fetal observation, milk infusions were delivered to
      rat fetuses on Day 20 or 21 of gestation. Infusion of milk promoted systematic
      changes in fetal behavior that culminated in expression of the stretch response
      nearly 3 min later. Interruption of this behavioral sequence prevented
      stretching, suggesting that a period of behavioral reorganization after milk
      infusion is necessary but not sufficient for the stretch response to occur. The
      behavioral sequence initiated by the fetal rat's first exposure to milk is
      remarkably similar to the behavior exhibited by experienced infant rats at the
      nipple.

PMID- 1740229
TI  - Developmental constraints on the expression of behavioral and heart-rate
      orienting responses: II. The role of ambient temperature.
AB  - The effect of ambient temperature on the expression of behavioral and heart-rate
      orienting responses to a novel olfactory stimulus was examined in rats 1-18 days
      of age. There was no effect of ambient temperature on the behavioral orienting
      responses at any age. Ambient temperature did influence the expression of the
      heart-rate orienting response and did so differentially as a function of age. The
      implications of these findings for developmental models of attention and
      cognition are discussed.

PMID- 1740230
TI  - Consensus conference on research funding.

PMID- 1740231
TI  - Does it make you see red?: on the use of color in slides.

PMID- 1740232
TI  - Experimental gastric mucosal injury: laboratory models reveal mechanisms of
      pathogenesis and new therapeutic strategies.
AB  - Gastric ulcer is a multifaceted, pluricausal illness. Knowledge of the
      pathophysiology of gastric ulcer disease remains incomplete. Current
      pharmacological management of gastric ulceration is directed primarily at the
      reduction or neutralization of gastric acid secretion despite evidence that
      patients with this disease often exhibit normal gastric secretory activity.
      Attempts have been made to prevent or reduce gastric mucosal injury by
      cytoprotective agents without diminishing gastric acidity. We review several
      alternate explanations for the cause of gastric ulcers by examining various
      experimental models of gastric mucosal damage, including ethanol-, stress-, and
      nonsteroidal antiinflammatory drug-induced gastric lesions. We also discuss
      possible new strategies for the treatment of ulcer disease, particularly novel
      pharmacological targets arising from research conducted with these models.
      Growing realization that factors other than gastric secretion contribute
      significantly to the development of gastric ulcer disease prompts the conclusion
      that these same factors represent viable treatment alternatives.

PMID- 1740233
TI  - Molecular mimicry: a mechanism for autoimmune injury.
AB  - Many mechanisms may account for immune-mediated pathology after viral infections.
      Although several means have been hypothesized to play a role in disease, a widely
      accepted mechanism for viral-induced autoimmunity is molecular mimicry. It is
      thought that damage could result from an immune response to similar regions
      shared between virus and the host. Using computer-aided analysis, many sequence
      homologies have been identified between virus and host antigens. Using peptides
      corresponding to these regions, immunologic cross-reactivity has been found. In
      some cases, monoclonal antibodies to peptides of these regions have been shown to
      directly induce or augment disease in animal models. Using this approach to
      identify similar regions, it is possible to associate a known autoantigen with an
      infectious agent in autoimmune diseases in which there is no known etiologic
      agent. Conversely, it would also be possible to associate a known viral
      constituent with an unknown host antigen. Furthermore, identification of disease
      inducing regions of autoantigens or viral proteins may lead to immunotherapeutic
      approaches to establish tolerance or anergy to such disease-inducing regions.

PMID- 1740234
TI  - Diversity of structure, signaling and regulation within the family of muscarinic
      cholinergic receptors.
AB  - Acetylcholine signals through two types of unrelated membrane receptors referred
      to as nicotinic (nAChR) and muscarinic (mAChR) acetylcholine receptors. Nicotinic
      acetylcholine receptors were the first neurotransmitter receptors to be purified,
      cloned, and sequenced, and much is known about these proteins. In contrast, until
      5 years ago relatively little was known about the muscarinic receptors. Since
      then there has been an explosion of information concerning the structure,
      signaling, and regulation of what is now known to be a family of muscarinic
      receptors. This review discusses the five identified members of the mAChR family
      and their coupling to the multiple G proteins that allow mAChRs to modulate many
      different types of signal transduction pathways. The five members of this family
      that have been identified so far have striking homology in their hydrophobic
      membrane domains but possess distinct cytoplasmic domains between the fifth and
      sixth membrane-spanning regions. These cytoplasmic domains appear to contain
      important determinants for receptor/G protein interaction and are likely to
      contain phosphorylation sites that regulate these interactions. mAChR agonists
      have been shown to induce phosphorylation of mAChR in intact cells, and the
      evidence that suggests that receptor phosphorylation may play a role in the
      regulation of receptor function is discussed.

PMID- 1740235
TI  - Electric power, pineal function, and the risk of breast cancer.
AB  - Breast cancer is the leading cause of cancer death in women in the industrialized
      world, and the rates of breast cancer incidence are rising. Although risk is high
      in industrialized societies, it is low in nonindustrialized areas. The search for
      the causes of breast cancer has not yet yielded a convincing explanation for the
      geographic and temporal patterns in the occurrence of breast cancer. Generation
      of electric power is a hallmark of industrialization, and two products of
      electric power, light-at-night (LAN) and electromagnetic fields (EMF), may affect
      breast cancer risk. Exposure to either LAN or EMF can decrease production of
      melatonin by the pineal gland. Melatonin, in turn, has been shown to suppress
      mammary tumorigenesis in experimental animals. Moreover, recent epidemiological
      findings indicate an increased risk of breast cancer in workers occupationally
      exposed to EMF. On the basis of these considerations, it is proposed that the use
      of electrical power accounts, in part, for the higher risks of breast cancer in
      industrialized societies.

PMID- 1740236
TI  - Proteoglycans: many forms and many functions.
AB  - Proteoglycans are produced by most eukaryotic cells and are versatile components
      of pericellular and extracellular matrices. They belong to many different protein
      families. Their functions vary from the physical effects of the proteoglycan
      aggrecan, which binds with link protein to hyaluronan to form multimolecular
      aggregates in cartilage; to the intercalated membrane protein CD44 that has a
      proteoglycan form and is a receptor and a cell-binding site for hyaluronan; to
      heparan sulfate proteoglycans of the syndecan and other families that provide
      matrix binding sites and cell-surface receptors for growth factors such as
      fibroblast growth factor (FGF). One feature that recurs in proteoglycan biology
      is that their structure is open to extensive modulation during cellular
      expression. Examples of protein changes are known, but a major source of
      structural variation is in the glycosaminoglycan chains. The number of chains and
      their length can vary, as well as their pattern of sulfation. This may result in
      the switching of different chain types with different properties, e.g.,
      chondroitin sulfate and heparan sulfate, and it may also result in the selective
      expression of sulfated chain sequences that have specific functions. The control
      of glycosaminoglycan structure is not well understood, but it does appear to be
      used to change the properties of proteoglycans to suit different biological
      needs. Proteoglycan forms of proteins are thus important modifiers of the
      organization of the pericellular and extracellular matrices and modulators of the
      processes that occur there.

PMID- 1740237
TI  - Bone structure: from angstroms to microns.
AB  - Bone has a complex hierarchical structure, which despite much investigation, is
      still not well understood. Here we bring together pieces of this complicated
      puzzle, albeit from different sources, to present a tentative overview of bone
      structure. The basic building blocks are the extremely small plate-shaped
      crystals of carbonate apatite, just hundreds of angstroms long and wide and some
      20-30 A thick. They are arranged in parallel layers within the collagenous
      framework. At the next hierarchical level these mineral-filled collagen fibrils
      are ordered into arrays in which the fibril axes and the crystal layers are all
      organized into a 3-dimensional structure that makes up a single layer or lamella
      of bone a few microns thick. The orientations of the collagen fibrils and the
      crystal layers in alternating lamellae of rat bone differ such that in the
      thinner lamellae, the fibrils and the crystal layers are parallel to the lamellar
      boundaries. In the thicker lamellae the fibrils are parallel to the boundary, but
      the crystal layers are rotated out of the plane of the boundary. In many bones
      these alternating lamellae are organized into even larger ordered structures to
      produce what is truly a remarkably ordered material, all the way from the
      molecular scale to the macroscopic product.

PMID- 1740238
TI  - Relationship of resistance to oxygen free radicals to CuZn-superoxide dismutase
      activity in transgenic, transfected, and trisomic cells.
AB  - Although CuZn-superoxide dismutase (CuZnSOD) has been shown to reduce oxidative
      damage in several systems, the quantitative relationship between the degree of
      protection and CuZnSOD activity has not been well investigated. Therefore, the
      ability of cells to tolerate superoxide toxicity was assessed as a function of
      endogenous CuZnSOD activity in several mouse and human cell lines with
      progressively higher levels of CuZnSOD activity. In five lines of fetal
      fibroblasts derived from SOD1-transgenic mice, with CuZnSOD activities of 1.7- to
      7.1-fold the nontransgenic level and no changes in the cellular glutathione
      peroxidase (GSHPx) activity, a direct relationship (r = 0.97) between the LD50 to
      paraquat and enzyme activity was observed, suggesting that CuZnSOD activity is
      the single most important factor in determining the paraquat LD50. Mouse trisomy
      16 fetal fibroblasts and human trisomy 21 lung fibroblasts, both expressing a 1.5
      fold increase in CuZnSOD activity, were 1.5-fold more tolerant to paraquat than
      were their diploid counterparts. Furthermore, the protective effect of CuZnSOD at
      the DNA level, as shown by reduced thymine glycol generation, was demonstrated in
      paraquat-treated transgenic fibroblasts. A direct relationship (r = 0.78) of
      paraquat LD50 and CuZnSOD activity was also observed with a panel of six lines of
      SOD1- transfected HeLa cells with 1.6- to 7.3-fold the basal CuZnSOD activity.
      Moreover, there was no correlation between resistance to paraquat toxicity and
      the cellular GSHPx and/or catalase activity. Taken together, these results
      demonstrate a consistently protective effect of endogenous CuZnSOD against
      superoxide toxicity in both primary and transformed cell lines.

PMID- 1740239
TI  - Interleukin 1 protects hair follicles from cytarabine (ARA-C)-induced toxicity in
      vivo and in vitro.
AB  - ImuVert, a biologic response modifier, and interleukin 1 (IL 1) have been shown
      to protect the young rat from alopecia induced by cytarabine (ARA-C). In the
      present study the inhibition by ARA-C of DNA synthesis in hair follicles (HFs)
      and the protective effect of ImuVert and IL 1 were investigated in vivo and in
      vitro. Both ImuVert and IL 1 were equally effective in protecting rats from ARA-C
      induced alopecia. DNA synthesis in HFs isolated from ARA-C-treated animals was 10
      20% of untreated controls. Follicles isolated from animals given either ImuVert
      or IL 1 before ARA-C exhibited normal DNA synthesis. In vitro, the incubation of
      normal rat HF with ARA-C resulted in 80% inhibition of [3H]-thymidine uptake.
      Preincubation of the follicles for 1 hr with IL 1 before the addition of ARA-C
      completely blocked the inhibition. Preincubation with imuVert, however, was less
      effective in blocking the inhibition from ARA-C.

PMID- 1740240
TI  - Volatile anesthetics gate a chloride current in postnatal rat hippocampal
      neurons.
AB  - A volatile anesthetic-gated current was characterized in patch-clamped cultured
      postnatal rat hippocampal neurons. In this preparation, the major volatile
      anesthetics, isoflurane, halothane, and enflurane, open an anion-selective
      conductance. This volatile anesthetic-gated current exhibits anion selectivity
      with a chloride-to-acetate permeability ratio of 15, shows outward rectification
      well described by the constant field equation, and is activated in a dose
      dependent fashion with half-maximal response to isoflurane at 0.8 mM (0.032 atm).
      The current persists in the absence of external Ca2+ and is not blocked by
      strychnine, a glycine antagonist. However, the gamma-aminobutyric acidA (GABAA)
      antagonists, bicuculline and picrotoxinin, and the nonspecific anion channel
      blocker, 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS), completely
      block the response. These observations suggest that volatile anesthetics, like
      several other general anesthetics such as barbiturates, steroids, and etomidate,
      have a GABA-mimetic effect on vertebrate central neurons in culture. It is not
      clear whether this GABAA-gating property is a prerequisite for all general
      anesthetics. However, under normal physiological conditions of low intracellular
      Cl-, it is likely that drugs with both direct GABA agonist and GABA modulatory
      properties will produce overall depression of the central nervous system by
      increasing the normal inhibitory synaptic influence and by directly
      hyperpolarizing neurons.

PMID- 1740241
TI  - Role of [Ca2+]i in induction of c-fos, c-jun, and c-myc mRNA in rat PTE after
      oxidative stress.
AB  - Oxidative stress plays an important role in various types of cell injury and
      tumor promotion. Cells respond to oxidative stress in many ways including changes
      in membrane organization, ion movements, and altered gene expression, all of
      which contribute to the subsequent fate of affected cells. In this study, we
      investigated the expression of the proto-oncogenes c-fos, c-myc, and c-jun, which
      play a key role in proliferation and differentiation, using primary cultures of
      rat proximal tubular epithelium exposed to oxidative stress generated by the
      xanthine/xanthine oxidase system. This system generates superoxide and H2O2 in
      the extracellular space stimulating the release of active oxygen species from
      inflammatory cells. c-fos mRNA was expressed within 15 min, peaked at 30 min, and
      returned to constitutive levels by 3 h. c-jun mRNA began to rise after 30 min,
      peaked at 120 min, and remained above the constitutive levels up to 180 min. c
      myc mRNA expression was less affected by the treatment, with levels increasing
      gradually over the 180 min period. The expression of c-fos was inhibited by
      superoxide dismutase but not by catalase and was super-induced by cycloheximide.
      H2O2 alone did not induce any c-fos mRNA in this system. Chelation of
      extracellular ionized calcium by EGTA or of intracellular ionized calcium by Quin
      2/AM resulted in a marked decrease of c-fos expression. Two protein kinase C
      inhibitors, H-7 and staurosporine, partly diminished the expression of c-fos,
      whereas a third, 2-aminopurine, which has a broader spectrum of inhibiting
      protein kinases, almost completely abolished it. A poly ADP-ribosylation
      inhibitor, 3-aminobenzamide, had no effect on c-fos expression in this system.
      Our results show that oxidative stress provokes sequential expression of c-fos, c
      jun, and c-myc, mRNA in this order. This c-fos expression appears to be largely
      controlled by calcium ion movement, which could include protein kinase C
      activation. Another protein kinase or kinases also appear to play an important
      role.

PMID- 1740242
TI  - Advances and controversies in blood coagulation: a 50-year retrospective.

PMID- 1740243
TI  - Federation of American Societies for Experimental Biology. 1992 FASEB meeting.
      Anaheim, California, April 5-9, 1992. Abstracts. Part I.

PMID- 1740244
TI  - 1992 FASEB meeting. Anaheim, California, April 5-9, 1992. Abstracts.

PMID- 1740245
TI  - Oral status and resident well-being in a skilled nursing facility population.
AB  - We studied the relationship between oral status and well-being in dentate and
      edentulous institutionalized residents through interviews with and dental
      examinations on 58 men and women. Oral status (measured by oral function, dental
      problem self report, soft tissue anomalies, and dry mouth) and well-being
      (measured by affect balance, self-esteem, health status, and nurse's ratings)
      were similar for dentate and edentulous subjects. Multiple regression analyses
      indicated oral status was significantly related to well-being. Unexpectedly, the
      extent of caries and plaque was also positively related to well-being, suggesting
      complex relationships between oral status markers and well-being in institutional
      settings.

PMID- 1740246
TI  - Psychosocial needs and care in nursing homes: comparison of views of social
      workers and home administrators.
AB  - Nursing home social workers (n = 152) and administrators (n = 231) were asked to
      rate the relative importance of resident and family psychosocial needs and the
      frequency of functions performed by or expected to be performed by social workers
      to meet these needs. Overall, administrators rated 19 of 28 psychosocial needs
      higher in importance than did social workers. The two groups both rated as very
      important the needs of support during the transition to the nursing home, help in
      dealing with loss, and help with relatedness and intimacy issues, though the
      groups rated high-frequency functions somewhat differently.

PMID- 1740247
TI  - Reconsidering the life review: the social construction of talk about the past.
AB  - The ostensible natural propensity of the elderly to talk about the past is
      reconsidered from a social constructionist perspective, offering a sociological
      alternative to Robert Butler's life review interpretation. Data from life
      narrative interviews with 30 near-centenarians are used to illustrate the
      importance of situated narrative challenges for initiating the construction and
      communication of life stories. Life stories are presented as social constructions
      made necessary and shaped by the demands of specific social situations.

PMID- 1740248
TI  - Psychiatric consultation to a continuing care retirement community.
AB  - Life care communities provide a continuum of residential services to the elderly.
      This report describes the provision of on-site psychiatric consultations to 82
      individuals residing in one such community. Dementia and major depression were
      the most common diagnoses made.

PMID- 1740249
TI  - "Ideal" SCU not so ideal.

PMID- 1740250
TI  - Unblocking hospital beds.

PMID- 1740251
TI  - Aged heterogeneity: fact or fiction? The fate of diversity in gerontological
      research.
AB  - Studies examining age-related changes typically report findings as age-based
      generalizations that neglect the phenomenon of variability in gerontological
      research. This paper examines the degree of attention given in 185 studies to
      individual differences and the empirical patterns of variability reported in
      those studies that present measures of dispersion. Measures of dispersion were
      reported in 43% of the gerontological studies reviewed and in 24% of the
      developmental studies. Overall, a majority of all gerontological studies
      presenting data reported increases in variability with increasing age (65%). This
      pattern was more pronounced in longitudinal studies than in cross-sectional ones.

PMID- 1740252
TI  - Service use among low-income minority elderly: strategies for overcoming
      barriers.
AB  - The 1987 amendments to the Older Americans Act mandate a special effort to serve
      low-income minority elderly persons. A literature review showed that "practice
      oriented" research on service use has focused primarily on identifying barriers
      with much less attention to identification of strategies for overcoming the
      barriers. This paper identifies and describes strategies used throughout Texas.
      Strategies addressing the "lack of knowledge" barrier included use of influential
      groups, working with significant individuals, and the media. Strategies
      addressing the "lack of access" barrier included transportation, affordability,
      and availability. Strategies addressing the "lack of intent" barrier focused on
      cultural differences, making services attractive, and overcoming negative
      attitudes toward service use.

PMID- 1740253
TI  - Predicting the volume of health and social services: integrating cognitive
      impairment into the modified Andersen framework.
AB  - This investigation examined cognitive impairment as a predictor of the volume of
      community services used by older adults. Predictors of service volume were
      selected according to the modified Andersen framework and tested with 97 health
      care and 246 social service clients of a large multiservice agency. Results for
      health care clients showed that the effects of four predictors differ depending
      on clients' level of cognitive impairment; living arrangement, presence of
      secondary caregivers, client depression and task burden of the primary caregiver.
      No differences in predictor of social service use were observed for cognitively
      impaired and lucid clients.

PMID- 1740254
TI  - Veteran interstate migration and VA health service use.
AB  - Resource allocations within the VA health care system are based in part on the
      number of veterans in an area plus the number of veterans expected to move into
      the area. This paper examines the relative importance of geographic mobility as a
      factor affecting the use of VA health services by the older veteran population in
      the U.S. Using a variety of secondary data sources, we found that the variation
      in state VA health service admission rates is better explained primarily by the
      characteristics of the resident nonmobile veteran population and the
      characteristics of veterans migrating to the state, not just by their numbers.
      Health care demand projections should take these findings into account.

PMID- 1740255
TI  - Efficacy of nursing home preadmission screening.
AB  - This study evaluates the efficacy of four state nursing home preadmission
      screening instruments. Using data from three community-based services
      demonstration experiments, the screens were compared on measures of sensitivity,
      specificity, and proportions of false negatives and false positives. Results
      indicate that the more restrictive screens tended to have lower sensitivity but
      higher specificity, and to generate a higher proportion of false negative
      decisions than the more liberal screens. Overall rates of correct prediction were
      higher for the more restrictive screens. Results highlight differences in
      eligibility restrictiveness across states as well as possible tradeoffs of cost
      containment and access in designing a preadmission screen.

PMID- 1740256
TI  - Differential effects of daughters' marital status on their parent care
      experiences.
AB  - This study compared the parent care experiences of five groups of daughters (N =
      492) (married, remarried, separated/divorced, widowed, and never married). Data
      include demographic characteristics and measures of depression, positive affect,
      personality strength, health, social support, relationship quality, caregiving
      burden, caregiving mastery, and caregiving satisfaction. Women with husbands had
      more socio-emotional and instrumental support, much higher incomes, less
      financial strain from caregiving, and less depression. They felt their own
      particular marital status made caregiving easier than did the three groups of not
      married women.

PMID- 1740257
TI  - Status transitions and future outlook as determinants of conflict: the
      caregiver's and care receiver's perspective.
AB  - This study examined the effects of status transitions and future outlook on
      conflict from the perspective of both caregiver and care receiver. As predicted,
      future outlook had a powerful association with dyadic conflict. Other strong
      predictors of conflict for care receivers were current state of happiness and
      changes in the relationship over a 3-year period. For caregivers, conflict was
      associated with care receivers' lack of social participation with family and
      friends, and changes in dyadic relationship.

PMID- 1740258
TI  - Retirement intentions among black professionals: implications for practice with
      older black adults.
AB  - This study examined the preretirement intentions of black professionals. The
      sample consisted of 234 blacks and was stratified by gender, age, and
      professional status. Based on a model developed for predicting the retirement
      intentions and attitudes of a sample of white professionals, six categories of
      independent variables (sociocultural, work history, alienation, leisure and
      social activities, financial planning, and plans for retirement life) were
      included in the analysis. Professionals who were highly committed to their work,
      had few financial investments, and socialized primarily with co-workers tended to
      avoid planning for retirement. These results have important implications for
      practitioners concerned with more effectively meeting the preretirement and
      retirement needs of older black adults.

PMID- 1740259
TI  - Availability of personal transportation in households of elders: age, gender, and
      residence differences.
AB  - Using data from the 1% Public Use Microdata Sample of the 1980 Census of
      Population and Housing, we examined correlates of the availability of personal
      transportation in the households of elders. Results indicate that the
      availability of vehicles decreases with age, is highest for rural farm and lowest
      for central city residents, and is lower for women. Only 1.3% of rural farm men
      65-74 lack access to a vehicle, but 57.8% of central city women 85 + are without
      personal transportation in their households.

PMID- 1740260
TI  - Age differences and correlates of worrying in young and elderly adults.
AB  - A cross-sectional investigation compared worry and its correlates in elderly
      people (N = 89) and in college students (N = 74). Consistent with prediction, the
      elderly adults expressed significantly fewer worries than the college students
      about finances and social events. Both groups were equally worried about health
      issues. The elderly scored higher on the Bradburn Affect Balance Scale, scored in
      the external direction on the Nowicki-Strickland Locus of Control Scale, and were
      more oriented toward the past and present than the future. Worry in the elderly
      was related to less favorable attitudes toward the future, and among college
      students worry was related to negative attitudes toward the present. For both age
      groups, an external locus of control was associated with higher worry scores.

PMID- 1740261
TI  - Factors influencing hospital patients' preferences in the utilization of life
      sustaining treatments.
AB  - Ninety-seven elderly hospitalized patients were asked about their preferences for
      several treatments under three hypothetical levels of future cognitive
      functioning: intact, confused, and unconscious. Levels of cognitive functioning
      and depression were also assessed. Sixty-six percent of the patients were more
      likely to want treatment if they expected to be cognitively intact than when a
      future condition involved impaired cognition; 36% did not want any treatment in
      at least 75% of the conditions; and 16% wanted treatment in at least 75% of the
      conditions studied. A minority (12%) did not show any pattern in their
      preferences. The absence of a definite pattern was related to lower levels of
      education and to higher levels of depressive symptoms. Patients self-reported
      their preferences for treatments being influenced most by their personal values,
      religion, and by experiences with illnesses of others.

PMID- 1740262
TI  - Decisional control in moving to a nursing home: postadmission adjustment and well
      being.
AB  - Five hundred and two skilled nursing facility residents were measured with a
      multidimensional assessment instrument within 4 weeks of admission, and then at 3
      and 12 months following baseline, to determine the impact of deciding and wanting
      to make the move on well-being and adjustment. Dependent variables included
      measures of physical, social, and psychological functioning, social interaction,
      activity, satisfaction with services, and discharge. Regression analyses suggest
      an interactive effect on ADL change at 3 months.

PMID- 1740263
TI  - The molecular revolution--coming your way soon.

PMID- 1740264
TI  - Longitudinal study of gall stone prevalence at necropsy.
AB  - A prospective study of the prevalence of gall stone disease at necropsy in a
      stable population has been undertaken over a 10 year period up to June 1988. In
      women, the prevalence of gall stone disease remained static but in men aged 50-59
      years it rose from 7% (n = 148) in the first three years to 18% (n = 138) in the
      last three years (p less than 0.01) and in men aged 60-69 it rose from 12% (n =
      370) to 20% (n = 366, p less than 0.01). In the latter age group the female: male
      ratio fell from 2:1 to 0.8:1. The proportion of deaths from coronary heart
      disease in men fell slightly in those over 70 during the study period. There was
      a fall in deaths from coronary heart disease in all age groups in women. Men with
      gall stones were less likely to have had a cholecystectomy than women, and
      overall 88% of gall stones remained in situ. In a parallel clinical study, the
      number of cholecystectomies carried out in the same district fell by 18% over the
      10 years without any apparent change in the provision of resources.
      Cholecystectomy remained almost three times more frequent in women. National data
      indicate that there have been major changes in the average diet before and during
      the period of study in favour of reducing coronary heart disease. There has been
      no change in mortality from coronary heart disease in young men but if the
      observed increase in the prevalence of gall stones in men and the decrease in
      deaths from coronary heart disease in women are real phenomena, it seems likely
      that they are diet related.

PMID- 1740265
TI  - High incidence of oesophageal and gastric cancer in Kashmir in a population with
      special personal and dietary habits.
AB  - Over a three year period (1 July 1986 to 30 June 1989) all newly diagnosed and
      histologically proved cases of oesophageal and gastric cancer were recorded
      prospectively. Some 1515 cases of oesophageal cancer (1050 men and 465 women) and
      966 cases of gastric cancer (789 men and 177 women) were registered. Seven
      patients had simultaneous oesophageal and gastric cancer. Age standardised
      incidence rates for oesophageal cancer were: men 43.6/100,000 per year; women
      27.9/100,000 per year. The rates for gastric cancer were: men 36.7/100,000 per
      year, women 9.9/100,000 per annum. These figures were three to six times higher
      than those recorded by cancer registries in Banglore, Madras, and Bombay. The
      incidence rates for oesophageal and gastric cancer in Islamabad (southern
      district of Kashmir) were 4.1 to 5.4 times higher in men and 1.5 to 2.0 times
      higher in women than those for Kupwara (northern district of Kashmir). The
      incidence rates for oesophageal and gastric cancer in Muslims, Hindus, and Sikhs
      were different. The epidemiology of oesophageal cancer in Kashmir was similar to
      that found in the 'Asian oesophageal cancer belt'. At the same time Kashmir also
      had an unprecedented high incidence of gastric cancer. Kashmiries have special
      personal and dietary habits. Further studies are needed to define the relation
      between these habits and the occurrence of oesophageal and gastric cancer.

PMID- 1740266
TI  - Alternative method of positioning the pH probe for oesophageal pH monitoring.
AB  - The most reliable method of positioning a pH probe for oesophageal pH monitoring
      is to use manometry to determine the upper margin of the lower oesophageal
      sphincter and to place the probe 5 cm above this point. Manometry is expensive,
      however, requires special equipment and training, and is not widely available. An
      alternative cheaper way of determining the site of the lower oesophageal
      sphincter has been evaluated. A fine bore nasogastric tube with a latex balloon
      at its tip was inserted transnasally into the stomach. The balloon was inflated
      with 10 ml of water and the tube withdrawn until resistance was met. The distance
      from the nose (in cm) was noted and compared with the upper margin of the lower
      oesophageal sphincter as determined by oesophageal manometry. The manometric
      distance agreed closely with the balloon distance minus 1 cm (bias 0.29 cm; 95%
      CI of bias, 0.03 to 0.55 cm; 2 SD, limits of agreement, 1.58 cm). We conclude
      that where oesophageal manometry is not available, balloon localisation is a
      suitably accurate way of identifying the lower oesophageal sphincter.

PMID- 1740267
TI  - Comparison of aspiration and scintigraphic techniques for the measurement of
      gastric emptying rates of liquids in humans.
AB  - A comparison was made of two techniques to measure the rate of gastric emptying.
      A noninvasive scintigraphic technique using a gammacamera and an invasive
      aspiration technique based on dye dilution were performed simultaneously. Seven
      healthy male volunteers each consumed two different liquid meals on two separate
      occasions. Scintigraphic measurements were performed continuously with aspiration
      every 10 minutes for a total of one hour. Gastric emptying rates were expressed
      as slope values after semilog linearisation of the emptying curves. Agreement
      between the two methods was assessed from the individual differences and mean of
      the two techniques, as well as from the geometric mean, including 95% limits of
      agreement. The scintigraphic technique gave a 70% slower emptying rate than the
      dye dilution technique. However, the 95% limits of agreement are large (1.56 to
      0.30), reflecting the small sample size and the large coefficient of variation in
      the techniques used.

PMID- 1740268
TI  - Intestinal lymphangiectasia associated with angiofollicular lymph node
      hyperplasia (Castleman's disease).
AB  - A patient presenting with predominantly gastrointestinal symptoms and a history
      of myocardial infarction was found to have ascites, hepatosplenomegaly, para
      aortic lymphadenopathy, thrombocytosis, and a paraproteinaemia. A jejunal biopsy
      specimen showed lymphangiectasia and histology of the spleen and lymph nodes
      showed angiofollicular hyperplasia or Castleman's disease of the hyaline vascular
      type. This association has not previously been described and, moreover, systemic
      symptoms are unusual in this variant of Castleman's disease.

PMID- 1740269
TI  - Rectal lymphoma after colectomy for ulcerative colitis.
AB  - Primary colonic lymphoma is an increasingly recognised complication of ulcerative
      colitis. We report the first known case of rectal lymphoma occurring after
      colectomy and ileorectal anastomosis in ulcerative colitis.

PMID- 1740270
TI  - Can Crohn's disease be diagnosed at laparotomy?
AB  - The typical macroscopic features of Crohn's disease have been well described and
      are widely regarded as sufficient to diagnose the disease at laparotomy. We
      report six patients undergoing laparotomy for symptomatic Crohn's disease, shown
      radiologically, who were found to have macroscopically normal small bowel despite
      careful examination of the bowel by an experienced surgeon. In four cases
      resection was deferred, but all subsequently deteriorated and required further
      surgery. Minor abnormalities found by balloon examination of the terminal ileum
      prompted resection in two further patients. Histology showed an unusually
      superficial distribution of inflammation, which could explain the negative
      findings at laparotomy. We conclude that normal laparotomy findings alone do not
      exclude a diagnosis of clinically important small bowel Crohn's disease. Crohn's
      disease should be considered in patients with persisting symptoms after negative
      laparotomy.

PMID- 1740271
TI  - Intestinal metaplasia and Helicobacter pylori: an endoscopic bioptic study of the
      gastric antrum.
AB  - To study the relationship between intestinal metaplasia and Helicobacter pylori
      infection, 2274 gastroscopic antral biopsies taken from 533 patients were
      examined. Overall, intestinal metaplasia was found in 135 patients (25.3%) and H
      pylori in 289 patients (54.2%). The prevalence of intestinal metaplasia and H
      pylori was age related, being more common in patients greater than or equal to 50
      years compared with patients less than 50 years (intestinal metaplasia, p less
      than 0.001 and H pylori, p less than 0.05). Intestinal metaplasia was found more
      often in H pylori positive patients compared with H pylori negative patients
      (33.9% v 15.2%, p less than 0.001). The mean age of intestinal metaplasia
      positive patients who were also H pylori positive was 64 (13.3) years, whereas
      the mean age of intestinal metaplasia positive patients who were H pylori
      negative was 72 (14.7) years (p less than 0.005). The extent of intestinal
      metaplasia was not statistically different in the latter two groups. Although our
      data do not prove a causal relationship between H pylori infection and the
      histogenesis of intestinal metaplasia it is suggested that H pylori infection is
      an important factor in the development of intestinal metaplasia, which is
      generally recognised as a precursor lesion of intestinal type gastric carcinoma.

PMID- 1740272
TI  - Gastric emptying of liquid in children suffering from acute rotaviral
      gastroenteritis.
AB  - Nausea and vomiting commonly occur in children suffering from rotaviral
      diarrhoea. Gastric emptying was studied in 10 children (age six to 12 months)
      suffering from acute diarrhoea caused by rotavirus using a dye dilution double
      sampling technique. The test meal was 5% dextrose in water and this test was
      repeated 12 weeks after recovery. The median (range) of the percentages of the
      liquid meal remaining in the stomach at 5, 10, 20, 40, and 60 minutes after
      instillation of the meal were 82 (79-90), 70 (61-86), 51 (38-76), 26 (14-53), and
      13 (2-35) respectively in the acute stage, whereas after the recovery period the
      values were 76 (70-79), 58 (49-63), 33 (24-40), 11 (2-26), and 3 (0-7). The
      differences were statistically significant. The half time of gastric emptying
      (t1/2) was 19.5 (14-30) minutes in acute stage, and 13.1 (10-15) minutes during
      follow up (p less than 0.01). Rotaviral gastroenteritis is accompanied by
      abnormal gastric motor function, as manifested by delayed emptying of a liquid
      meal.

PMID- 1740273
TI  - Cysteamine protects gastric epithelial cell monolayers against drug induced
      damage: evidence for direct cellular protection by sulphydryl compounds.
AB  - The sulphydryl containing drug cysteamine protects gastric mucosa in vivo against
      acute injury. It is not known whether this protection includes a direct effect on
      gastric cells. Using gastric epithelial cell monolayers derived from a well
      differentiated human cell line, we evaluated whether cysteamine protects against
      taurocholate or indomethacin induced damage in conditions which completely
      exclude the influence of vascular, hormonal, and neural factors. The effect of
      cysteamine on prostaglandin production by monolayer cells in vitro was also
      assessed. Cysteamine decreased damage brought about by sodium taurocholate and
      indomethacin by 40% (p less than 0.01) and 50% (p less than 0.01) respectively.
      The sulphydryl blocker iodoacetamide prevented the protective effect of
      cysteamine. Pretreatment with indomethacin, which inhibited prostaglandin E2
      output by 60%, did not prevent protection by cysteamine; incubation with
      cysteamine decreased prostaglandin E2 production by cultured cells. We conclude
      that (i) cysteamine directly protected gastric epithelial cells in vitro (ii)
      this protection occurred with indomethacin, which interferes with cellular
      metabolism of prostaglandins, and taurocholate, whose damaging action at neutral
      pH is unrelated to interference with prostanoid metabolism, (iii) cysteamine
      protection in vitro is unrelated to endogenous prostaglandins and is probably
      mediated by endogenous sulphydryl compounds.

PMID- 1740274
TI  - Production of epithelial cell growth factors by lamina propria mononuclear cells.
AB  - The effects of lamina propria mononuclear cell culture supernatant on epithelial
      cell DNA synthesis were studied using cells isolated from patients with
      inflammatory bowel disease and normal controls. Supernatants from resting and
      phytohaemagglutinin stimulated cells were studied and supernatants that strongly
      promoted DNA synthesis were pooled, and growth factor activity partially
      characterised. The effects of recombinant interleukins-1 beta,2,3,interferon
      gamma, and granulocyte macrophage colony stimulating factor were tested in the
      same system. Resting lamina propria mononuclear cells produce factors that
      increase DNA synthesis. Production of these factors is increased by
      phytohaemagglutinin stimulation. No significant differences were found in
      production of these factors between patients with inflammatory bowel disease and
      normal controls. The molecular weight of the active factor(s) lies in the region
      31-48 kD. Chromatofocusing produced two peaks of activity, one in the region pk
      5.5 and one around pk 6.4. The activity was heat and acid pH labile. Activity was
      not destroyed, however, by 0.05% trypsin. Recombinant granulocyte macrophage
      colony stimulating factor was a weak stimulus to epithelial DNA synthesis,
      interleukin-1 beta was weakly inhibitory but other cytokines tested did not have
      any effect. Granulocyte macrophage colony stimulating factor is probably
      important in controlling epithelial cell growth.

PMID- 1740275
TI  - Oral submucosal fibrosis--a preventable disease.

PMID- 1740276
TI  - Effect of intrajejunal elemental diet perfusion on jejunal secretion of
      immunoglobulins, albumin, and hyaluronan in man.
AB  - The aim of this work was to study the jejunal secretion of immunoglobulins (Ig),
      albumin, and hyaluronan in response to jejunal perfusion of an elemental diet. A
      four lumen tube with a proximal occluding balloon at the angle of Treitz was used
      for jejunal perfusion in seven healthy volunteers (mean age 23 years). The length
      of the test segment was 40 cm. The jejunum was successively perfused with a
      control electrolyte solution for 80 minutes and with an elemental diet
      (containing 20.5 milligrams of free amino acids and 104.2 milligrams of
      oligosaccharides) for 100 minutes. The jejunal fluid concentrations of albumin,
      IgG, monomeric IgA (m-IgA), polymeric IgA (p-IgA), IgM, secretory component, and
      hyaluronan were measured and their jejunal outputs calculated. Within 20 minutes
      of starting perfusion with the elemental diet there was a significant increase in
      the secretion rates of albumin (x3.3), IgG (x5), M-IgA (x3.7), p-IgA (x2), IgM
      (x2), and secretory component (x1.6), but the hyaluronan secretion rate was not
      changed. The increase in m-IgA, p-IgA, IgM, and secretory component output
      suggests that intestinal perfusion of an elemental diet results in stimulation of
      secretory immunity. The increase in albumin and IgG output probably reflects a
      nutrient induced leakage from the plasma compartment.

PMID- 1740277
TI  - Mr 40,000 human colonic epithelial protein expression in colonic mucosa and
      presence of circulating anti-Mr 40,000 antibodies in cotton top tamarins with
      spontaneous colitis.
AB  - Saguinus oedipus, Callithrix jacchus, and Saguinus fuscicollis are three species
      of New World monkeys which develop a form of colitis that is similar to human
      ulcerative colitis. Only S oedipus, however, develop colon cancer. We examined
      intestinal tissues from these animals for the presence of an antigen cross
      reacting to the Mr 40,000 human colonic epithelial protein that acts as an
      autoantigen in ulcerative colitis. Using an anti-Mr 40,000 monoclonal antibody
      (7E12H12, IgM isotype), by an immunoperoxidase assay we showed that all colon
      specimens from S oedipus reacted with 7E12H12; however, the colonic tissue from C
      jacchus and S fuscicollis did not. In immunotransblot analysis eluted IgG
      antibody bound to human ulcerative colitis colon (CCA-IgG) reacted with Mr 40,000
      protein(s) present in the extracts of colon from S oedipus animals and humans.
      Small intestinal tissue reacted neither with 7E12H12 nor with CCA-IgG. In S
      oedipus, the Mr 40,000 protein was localised exclusively to colonic epithelial
      cells. Preincubation of seven S oedipus colon specimens with eight of 10 sera
      from animals with acute or chronic colitis and 0 of four sera from animals
      without colitis almost completely inhibited the binding of 7E12H12 to the colonic
      epithelium. Four of these 10 sera inhibited the binding of 7E12H12 to the
      autologous colon. These results show the presence of circulating autoantibodies
      in S oedipus with colitis against an epitope(s) on Mr 40,000 protein shared by
      human and S oedipus colon.

PMID- 1740278
TI  - Increased concentrations of interleukin 1 beta, interleukin-2, and soluble
      interleukin-2 receptors in endoscopical mucosal biopsy specimens with active
      inflammatory bowel disease.
AB  - Concentrations of interleukin-1 beta (IL-1 beta), interleukin-2 (IL-2), and
      soluble IL-2 receptors (sIL-2R) were determined by enzyme linked immunosorbent
      assays (ELISA) in supernatants of sonicated endoscopical mucosal biopsy specimens
      from 31 patients with inflammatory bowel disease and 19 controls. IL-1 beta was
      detected in 53% of the patient supernatants (p = 0.0001), IL-2 in 35% (p =
      0.0031), compared with none of the controls. Soluble IL-2R was present in 55% and
      26% of the specimens, respectively (p = 0.07). The concentrations of IL-1 beta (p
      = 0.00015), IL-2 (p = 0.0019), and sIL-2R (p = 0.0073) were highest in the most
      inflamed biopsy specimens, compared with less inflamed specimens and controls.
      There were no significant differences in IL-1 beta, IL-2, and sIL-2R
      concentrations between ulcerative colitis (16) and Crohn's disease patients (15).
      The results suggest that enhanced cellular immunity operates in vivo at the
      mucosal level in active inflammatory bowel disease.

PMID- 1740280
TI  - Distribution of collagenous colitis: utility of flexible sigmoidoscopy.
AB  - We investigated the distribution of the collagen band in 33 patients with
      collagenous colitis to estimate the likelihood of the disease being diagnosed in
      biopsy specimens from the left side of the colon, such as those obtained using
      flexible sigmoidoscopy. To be included in this study patients had a subepithelial
      collagen band greater than or equal to 10 microns, an increase in chronic
      inflammatory cells in the same specimen, and diarrhoea for which there was no
      other apparent cause. In 17 patients undergoing full colonoscopy with a thickened
      collagen band, collagenous colitis was frequently patchy, even though overall the
      thickened collagen band was almost equally distributed throughout the colon.
      Rectal biopsy specimens showed a normal collagen band in 73% of patients, while a
      thickened collagen band was found in 82% of patients in at least one specimen
      from the left side of the colon. Three patients had a thickened collagen band
      only in the caecum. In three of eight rectal biopsy specimens with a normal
      collagen band there was no mucosal inflammation to raise the possibility of
      proximal disease, although all but one specimen with a normal collagen band from
      the sigmoid and descending colon were inflamed. Rectal biopsy alone is therefore
      a relatively poor method of making the diagnosis. Flexible sigmoidoscopy with
      multiple biopsy specimens from several sites is a reasonable initial
      investigation but not sufficient to exclude collagenous colitis when based on the
      presence of a thickened collagen band alone. Should left sided biopsy specimens
      show a normal collagen band but an inflamed mucosa, total colonoscopy with
      multiple specimens including the caecum may be required to establish the
      diagnosis.

PMID- 1740279
TI  - Salicylates used in inflammatory bowel disease and colchicine impair interferon
      gamma induced HLA-DR expression.
AB  - Colonic epithelial cells express HLA-DR in inflammatory bowel disease. The effect
      of drugs used in the treatment of inflammatory bowel disease and colchicine on
      interferon-gamma (IFN-gamma) induced DR expression has been investigated. HT-29
      cells were cultured in 25 cm2 flasks. At 48 hours interferon-gamma (0, 50, or 100
      U/ml) +/- drug were added. At 120 hours the cells were stained for HLA-DR and
      analysed by flow cytometry. 10(-2) M 5ASA reduced DR expression induced by 50
      U/ml interferon-gamma from 62 (12)% of cells (mean SD) to 29 (20)% (p less than
      0.005). Corresponding figures for 10(-2) M N-acetyl 5ASA were 68 (16)% to 39
      (17)% (p less than 0.05); for 10(-2) M 4ASA, 61 (4)% to 57 (4)% (p = 0.6); for
      10(-2) M N-acetyl 4ASA, 60 (12)% to 35 (13)% (p less than 0.05); for 10(-2) M
      olsalazine, 72 (9)% to 3 (1)% (p less than 0.001); for 10(-3) M olsalazine, 72
      (9)% to 16 (10)% (p less than 0.001); for 10(-6) M colchicine, 62 (13)% to 5 (3)%
      (p less than 0.001); and for 10(-7) M colchicine, 62 (13)% to 10 (3)%. Similar
      results were obtained when DR was induced by 100 U/ml of interferon-gamma except
      with 10(-2) M 4ASA which reduced expression from 77 (4)% to 68 (3)% (p less than
      0.05). Sulphapyridine, prednisolone, indomethacin and cyclosporin A had no
      effect. Concurrent staining with propidium iodide showed that these results were
      unchanged when viable cells alone were analysed. Prior incubation of cells with
      drug, followed by washing, had no effect on interferon-gamma induced DR
      expression. 5ASA, N-acetyl 5ASA, 4ASA, N-acetyl 4ASA, olsalazine and colchicine
      reduce interferon-gamma induced HLA-DR expression. In inflammatory bowel disease
      these compounds may impair antigen presentation by the colonic epithelium.

PMID- 1740281
TI  - Oesophageal clearance of small amounts of equal or less than one millilitre of
      acid.
AB  - The oesophageal acid clearance time was evaluated in 10 healthy volunteers of
      'small' boluses of 0.5 and 1 ml and 'minute' boluses of 0.05 and 0.1 ml 0.1 N
      HCl, as well as 0.1 and 1 ml 0.01 and 0.001 N HCl. Swallow rate was normalised at
      q 60 seconds. For 0.1 ml 0.1 N HCl, acid clearance time was also measured for
      swallow intervals of q 30 and 120 seconds. Acid clearance time to restore pH to
      4.0 was significantly longer (p less than 0.01) for the 0.5 and 1 ml 0.1 N HCl
      (210 and 273 seconds, respectively) than for the 0.05 and 0.01 ml acid boluses
      (83 and 94 seconds, respectively). The minimum acid clearance time was 18 seconds
      (0.05 ml 0.1 N HCl). Acid clearance time for 0.1 N HCl was less than one minute
      on only two occasions. The acid clearance times were comparable when the subjects
      sat upright. A longer interswallow interval--that is, 120 seconds, resulted in a
      significantly longer acid clearance time than shorter swallow intervals (p less
      than 0.05). Oesophageal acid clearance time for small acid volumes averaged more
      than three minutes and for minute acid volumes was generally more than one
      minute; and acid clearance times were comparable for the supine and upright
      postures, while gastrooesophageal reflux episodes causing pH drops to 3-4 may
      last for less than 15 seconds, substantial oesophageal pH drops to less than or
      equal to 1.5 that persists less than 15 seconds are difficult to be attributed to
      true gastrooesophageal reflux.

PMID- 1740282
TI  - Measurement of in vivo proliferation in human colorectal mucosa using
      bromodeoxyuridine.
AB  - In vivo bromodeoxyuridine (BrdUrd) labelling of the human large bowel was
      performed and a detailed histochemical localisation of label in sections of
      crypts was undertaken using a monoclonal antibody to BrdUrd containing DNA. Flow
      cytometric studies on extracted nuclei were also performed (data presented
      elsewhere). The average crypt in the human large bowel (excluding the rectum) was
      82 cells in height and 41 cells in circumference, with a total of about 2000
      cells (assuming a topographical correction factor of 0.6). Ten per cent of the
      cells were replicating their DNA--that is, were in the S phase of the cell cycle-
      and 0.4% were in mitosis. The median position for the labelling index versus cell
      position frequency plot is at the 20th cell position--at a quarter of the crypt
      height. The lower and upper limits of the cell proliferation are given by the 5th
      and 95th percentiles at cell positions 4 and 43 respectively. The peak labelling
      index is about 30% and it occurs at cell position 15. The labelling index at the
      crypt base, the probable stem cell zone, is about 14%, suggesting that these
      cells have a longer cell cycle. Taking a value of 8.6 hours for the duration of
      the S phase (deduced from the flow cytometric data) and assuming a growth
      fraction of 1.0 for the mid-crypt, these data provide an estimate of about 30
      hours for the cell cycle time. The rectal crypts are about the same size but
      contain about 30% fewer S phase cells. The data also yielded a per cent BrdUrd
      labelled mitosis curve.

PMID- 1740283
TI  - Oesophageal motility, luminal pH, and electrocardiographic-ST segment analysis
      during spontaneous episodes of angina like chest pain.
AB  - The relation between oesophageal motility, luminal pH, and spontaneous pain
      events in 47 patients with recurrent angina like pain and normal coronary
      arteries was investigated. Preliminary investigation by conventional station pull
      through manometry (SPTM), was followed by a 24 hour period of ambulatory
      oesophageal motility and luminal pH monitoring. Computerised analysis of motility
      and pH data recorded during chest pain was then compared with pre-elected control
      samples taken before and after symptoms. Concurrent real time
      electrocardiographic (ECG)-ST segment analysis was performed to catalogue any ECG
      STT wave changes indicative of myocardial ischaemia. SPTM showed a high group
      percentage incidence of simultaneous contractions (mean (SD) 11.1 (2.3)%) and a
      raised lower oesophageal sphincter tone (57.4 (15.2) mm Hg). During ambulatory
      monitoring, 35 patients experienced one or more episode of angina, providing a
      total of 59 pain events, although no significant change in group motility and
      reflux parameters peculiar to episodes of chest pain were found. Ischaemic ECG
      changes were detected in 10 (21%) patients, but were accompanied by pain in only
      two. Independent analysis of the ECG traces corresponding to these purported
      ischaemic ECG events determined them unequivocal in three patients and probable
      in a further two. No apparent correlation was noted, however, between these ECG
      events and corresponding patterns of motility or reflux.

PMID- 1740284
TI  - Estimation of total hepatic blood flow by duplex ultrasound.
AB  - The volume flow rate of blood in the portal vein and the hepatic artery was
      measured using a duplex ultrasound system. Two sections of the hepatic artery
      were studied; the common hepatic artery where measurements were made just after
      the bifurcation of the coeliac axis to splenic and hepatic arteries and the
      hepatic artery itself, where measurements were made just proximal to the porta
      hepatis in a straight stretch of artery overlying the portal vein. Total hepatic
      blood flow was taken as the sum of hepatic artery and portal vein flows. A group
      of 10 normal healthy volunteers in the fasting state was studied. The mean (SD)
      volume blood flow in the vessels was measured to be: hepatic artery 3.5 (45%)
      ml/min/kg, common hepatic artery 6.9 (30%) ml/min+/kg, portal vein 13.5 (21%)
      ml/min/kg, total hepatic flow 17.0 (16%) ml/min/kg.

PMID- 1740285
TI  - Coagulation factor V and VIII/V ratio as predictors of outcome in paracetamol
      induced fulminant hepatic failure: relation to other prognostic indicators.
AB  - The value of coagulation factor V and VIII/V levels as prognostic indicators was
      assessed in 27 patients with fulminant hepatic failure and compared with other
      predictive indices. Admission factor V levels were significantly reduced in 22
      patients with paracetamol induced hepatic failure compared with a healthy control
      group (median 9.5% v 103%, respectively; p less than 0.001) and with lower values
      in non-A non-B hepatitis (median 2.7%). Values in the seven patients who died
      after paracetamol overdose, considered together with the four who underwent liver
      transplantation (group median 5.1%), were significantly lower than in the 11 who
      survived (median 11.8%; p less than 0.01). Median admission factor VIII was
      higher in those who died or received a transplant than in those who survived
      (298% v 162%; p less than 0.05), with both results higher than in healthy
      volunteers (median 104%; p less than 0.01) but lower than in non-A non-B
      hepatitis (median 340%). The ratio of factor VIII/V on admission was less than 30
      in all patients who survived paracetamol overdose (median 17) with corresponding
      values greater than 30 in 10 of 11 of those who died (median 39). A factor V
      result less than or equal to 10% on admission predicted an adverse outcome in 10
      of 11 fatal cases, a 91% sensitivity which was greater than for the previously
      defined indicator of an arterial blood pH less than 7.30 on admission
      (sensitivity 82%). Prothrombin time at admission or on day 4 did not usefully
      predict outcome in our series. Predictive accuracy was 73% and 82% for factor V
      and admission acidosis respectively and 95% for factor V in conjunction with
      admission coma grade III or IV and factor VIII (ratio > 30). These criteria may
      be useful in selecting patients with paracetamol induced fulminant hepatic
      failure for transplantation.

PMID- 1740286
TI  - Tracking personal spending on health care.

PMID- 1740287
TI  - Clinical quality initiatives: the search for meaningful--and accurate--measures.
AB  - At times, it seems as though every hospital, hospital association, philanthropic
      foundation and major corporation in the United States is involved in the quality
      movement in health care. The explosion of quality measurement initiatives that
      began in the 1980s is continuing apace, with earlier programs being expanded,
      enhanced, modified and replicated throughout the country in a variety of
      settings. This cover story looks at the broad efforts to develop clinical quality
      measurement tools from four different perspectives. First, we provide an update
      on the Maryland Quality Indicator Project and its ongoing use as a role model for
      many of the newer clinical indicator projects now being developed. Part two looks
      at the Joint Commission on Accreditation of Healthcare Organizations and its
      Agenda for Change project, as well as other large-scale quality measurement
      programs under way in the private sector that are attempting to determine what
      indicators are meaningful to use. Part three examines the growing role of
      corporate payers in pushing hospital-comparison and other assessment programs
      forward. And in the final section, we look at the federal government's role in
      developing practice guidelines and outcomes research.

PMID- 1740288
TI  - Two largest national alliances fine-tune strategies as health care environment
      changes. Interview by Howard J. Anderson.
AB  - The nation's two largest alliances of not-for-profit hospitals and systems are
      refining their roles for the 1990s. American Health Care Systems (AmHS) and
      Voluntary Hospitals of America (VHA) are moving away from strategies designed for
      competition in the marketplace of the 1980s, and toward helping their members
      change the way they deliver health care in their communities. While AmHS is
      promoting its health care reform proposal, VHA sees its existing 29 regional
      organizations of hospitals as a potential infrastructure for the development of
      community-based, integrated networks of care as envisioned in the AHA's reform
      plan. Experts add that the alliances clearly have to go beyond group purchasing
      to serve the changing needs of their members.

PMID- 1740289
TI  - Pharmaceutical prices continue to drive up supply costs.
AB  - The 1992 purchasing outlook from the Joint Purchasing Corp. (JPC), New York City,
      forecasts a difficult winter followed by a mild economic recovery beginning in
      the spring or early summer. Pharmaceuticals, however, are forecast to undergo
      significant price increases, due in part to hospital pharmaceutical price hikes
      associated with the ramifications of the 1990 Medicaid drug rebate legislation
      passed by Congress.

PMID- 1740290
TI  - Survey: CEOs cite flaws in departmental IS.

PMID- 1740291
TI  - Hospitals use research to build physician links.

PMID- 1740292
TI  - Home care PPS demonstration edges forward.

PMID- 1740293
TI  - Hospitals face few problems with new OSHA vaccine rule.

PMID- 1740294
TI  - TQM: best antidote for MD practice problems.

PMID- 1740295
TI  - Pathology trainee attrition: a new variable in the manpower equation.

PMID- 1740296
TI  - Immunopathologic and molecular studies as an aid to the diagnosis of malignant
      mesothelioma.

PMID- 1740297
TI  - Myxoid heart disease: an assessment of extravalvular cardiac pathology in severe
      mitral valve prolapse.
AB  - Because of the microscopic features of the affected leaflets in mitral valve
      prolapse (MVP), myxoid degeneration of the valve is a common pathologic
      designation applied to this condition. We undertook this study as a means of
      gaining an insight into the occurrence and prevalence of extravalvular cardiac
      alterations in hearts with severe MVP. Tissues of 24 hearts with severe
      myxomatous transformation of the mitral valve as the sole cardiac abnormality
      were examined. Eighteen of the 24 subjects with severe MVP died suddenly. Only
      two of these had pathologic evidence of severe mitral insufficiency. Twenty-four
      normal hearts served as controls. The two groups of hearts came from victims of
      homicide, suicide, accident, or natural death. Sections of the mitral valve,
      working myocardium, conduction system, and cardiac nerves and ganglia were
      studied by routine and special connective tissue and proteoglycan stains. Similar
      to the findings in severely affected mitral valves, prominent deposits of
      proteoglycans in neural and conduction tissue readily distinguished hearts with
      myxomatous valve changes from the control hearts. We conclude that the commonly
      recognized local derangement of valvular tissue in MVP is but one specific
      reflection of a more general myxomatous alteration in cardiac connective tissue.

PMID- 1740298
TI  - Incidental myocarditis with intravenous drug abuse: the pathology,
      immunopathology, and potential implications for human immunodeficiency virus
      associated myocarditis.
AB  - Human immunodeficiency virus (HIV)-associated myocarditis is well reported. Many
      of these patients are also intravenous (IV) drug abusers. This study examined
      sudden death victims from the Office of the Chief Medical Examiner, State of
      Maryland, for active myocarditis. A group of HIV-negative drug abusers is
      compared with a group of HIV-negative victims without any known risk factors for
      the acquired immunodeficiency syndrome. Using modified Dallas criteria combined
      with an avidin-biotin-labeled immunoperoxidase procedure, the cases were
      classified as active, borderline, or absent myocarditis. Serologic analysis for
      circulating antimyocardial antibody was performed along with phenotypic analysis
      of the infiltrate. Of the 15 IV drug abuse cases examined, none were positive for
      HIV (enzyme-linked immunosorbent assay and Western blot). With IV drug abuse as
      the primary risk factor, five cases demonstrated active myocarditis, while five
      others had borderline myocarditis. Only one of 10 low-risk patients had a
      lymphocytic infiltrate consistent with borderline myocarditis. Drug abuse-related
      myocarditis was associated with cardiac pathology resulting in sudden death in
      only one case. Antimyocardial antibodies were positive in four of the 15 IV drug
      abuse cases, including patients with active, borderline, and absent myocarditis.
      The phenotypic expression of the lymphocytic infiltrates was similar to the
      findings reported for idiopathic and HIV-related myocarditis (Am J Pathol
      137:1365-1371, 1990). Toxicology studies did not implicate any particular drug of
      abuse, but the increased frequency of myocarditis observed may reflect
      complications of cocaine or the combined effects of opiates and cocaine.
      Intravenous drug abuse is an independent risk factor for myocarditis and must be
      taken into consideration in studies of HIV-associated myocarditis.

PMID- 1740299
TI  - Infrequent detection of Toxoplasma gondii genome in toxoplasmic lymphadenitis: a
      polymerase chain reaction study.
AB  - The diagnosis of toxoplasmic lymphadenitis is currently established by histologic
      evaluation with confirmation by serologic studies. We used a sensitive and
      specific polymerase chain reaction methodology for the identification of
      toxoplasmic genomes previously reported by others to investigate whether this
      technology could contribute to the diagnosis. We were able to reliably detect
      toxoplasmic genomes in paraffin-embedded tissues of toxoplasmic encephalitis and
      myocarditis, and serial dilution studies indicated a high degree of sensitivity.
      Nonetheless, we identified toxoplasmic genomes in frozen tissue from only one of
      nine cases of toxoplasmic lymphadenitis. In the one positive case, only one of
      three frozen samples from the lymph node biopsy was positive, indicating a focal
      infection within the lymph node. It is concluded that polymerase chain reaction
      studies, at their current level of sensitivity, are not of great use in
      contributing to the evaluation of cases of suspected toxoplasmic lymphadenitis,
      which continues to be best diagnosed by accurate histopathologic examination.

PMID- 1740300
TI  - Primary (granulomatous) angiitis of the central nervous system: a
      clinicopathologic analysis of 15 new cases and a review of the literature.
AB  - The clinical and pathologic features of 15 new cases of the uncommon primary or
      granulomatous angiitis of the central nervous system (PACNS) are described. To
      date, only 108 such cases have been reported in the English literature.
      Clinically, most PACNS patients have been young or middle-aged (mean age, 45
      years; range, 3 to 96 years), with men outnumbering women slightly by a ratio of
      4 to 3. The most frequent presenting complaints are headache, weakness, and
      confusion; less common complaints are aphasia, dysphasia, nausea or vomiting,
      loss of memory, and seizure disorder. There is usually no evidence of a systemic
      disease; the erythrocyte sedimentation rate is almost invariably normal, and
      there are no diagnostic laboratory tests. The cerebral angiogram usually shows
      multifocal, segmental stenosis or irregularity of small and medium-sized
      leptomeningeal and intracranial blood vessels, often with a beading or aneurysmal
      appearance, and alterations in blood flow in the affected regions. Anatomically,
      the angiitis is focal and segmental in distribution. An isolated negative biopsy,
      therefore, does not rule out the disease. Histologically, PACNS may be
      granulomatous, necrotizing, or lymphocytic in character, and mixed morphologic
      types often occur. Large- and small-vessel thrombosis is common. Acute lesions
      frequently coexist with healing or healed lesions. Involvement of extracranial
      blood vessels occurs only rarely. Past or current herpes zoster infection and
      Hodgkin's lymphoma are the most noteworthy clinical associations of PACNS, but
      whether they are causally related remains uncertain.

PMID- 1740301
TI  - Antigenic phenotypes of hairy cell leukemia and monocytoid B-cell lymphoma: an
      immunohistochemical evaluation of 66 cases.
AB  - Using a large panel of antibodies on multi-tumor block sections of routinely
      processed, paraffin-embedded fixed tissue, we compared the antigenic phenotype of
      42 clinically, morphologically, and immunologically well-characterized cases of
      hairy cell leukemia (HCL) with 24 cases of monocytoid B-cell lymphoma (MBCL)
      selected from the Monocytoid B-Cell Lymphoma Registry at the City of Hope
      National Medical Center. The predominant antigenic phenotype of hairy cells was
      CD45 (leukocyte common antigen)+, CD45Ra (4KB5, MB1, MT2)+, L26+, CDw75 (LN1)+,
      CD74 (LN2)+, LN3+, MB2+, CD45RO (UCHL1)-, MT1-, CD15 (Leu-M1)-, neuron-specific
      enolase (NSE)-, epithelial membrane antigen-, and CD30 (Ber-H2)-. The
      immunophenotype of neoplastic monocytoid B lymphocytes was essentially identical
      to that of the hairy cells, with one exception: the neoplastic monocytoid B
      lymphocytes were stained by epithelial membrane antigen in seven cases. An
      interesting observation was the staining by anti-muscle-specific actin of the
      neoplastic cells of MBCL in 53% of cases, but of none of the cases of HCL. The
      results of our study (1) indicate that HCL and MBCL can be immunophenotyped
      reliably on fixed tissue samples, (2) further confirm the proposed lineage
      relationship between these two lymphoproliferative disorders, and (3) indicate
      that decalcification of bone marrow biopsies does not adversely affect the
      immunoreactivity of hematopoietic-associated antigens.

PMID- 1740302
TI  - Autopsy analysis in patients with vascular diseases.
AB  - An analysis of autopsy findings in 68 patients who died with vascular surgical
      disorders was performed. Incorrect diagnoses and therapy were evaluated. It was
      found that complications of the primary disease or its treatment were frequently
      missed clinically (41%). Septic complications and severe hemorrhage were common
      in examinations of morbidity and mortality. In 13% of cases a treatment error
      with adverse impact on survival was detected. It is concluded that postmortem
      examination is a valuable tool in the final evaluation of patient care in a
      vascular surgical unit. A repeated plea for the autopsy is supported by this
      study.

PMID- 1740303
TI  - Herpes simplex virus hepatitis in pregnancy: a clinicopathologic study of three
      cases.
AB  - Herpes simplex virus (HSV) hepatitis is rare in adults, usually occurring in
      immunocompromised individuals and in otherwise healthy women in the third
      trimester of pregnancy. Three cases of HSV hepatitis occurring in pregnant women
      were diagnosed at our institution between 1981 and 1990. This diagnosis was not
      suspected clinically, and in each case was made on the basis of histology,
      immunoperoxidase studies, and viral cultures of liver tissue. Clinically, the
      patients had severe anicteric liver failure with markedly elevated serum
      aspartate aminotransferase and alanine aminotransferase levels; two of the three
      patients died. None had mucocutaneous lesions at the time of diagnosis.
      Histologically, two distinct patterns of necrosis and inflammation were seen. Two
      of the cases had well-demarcated foci of necrosis scattered randomly throughout
      the lobules with neutrophilic infiltration, giving the impression of abscess
      formation. Hepatocytes at the periphery of these areas of necrosis had enlarged
      nuclei with "ground-glass" inclusions; however, no Cowdry type A inclusions were
      seen. Rare multinucleated cells were present. Immunoperoxidase staining using
      antibodies to HSV was positive primarily in the hepatocytes with inclusions. The
      third case had diffuse, almost total hepatic necrosis with no viral inclusions
      and virtually no inflammatory response. This histologic pattern is similar to
      that seen in neonates with HSV infection. Immunoperoxidase studies in this case
      were negative; however, viral cultures were positive. While HSV hepatitis may be
      suspected or diagnosed on the basis of histology alone, viral cultures are an
      important adjunct since viral inclusions may be absent. Prompt diagnosis is
      important since antiviral therapy is now available.

PMID- 1740304
TI  - Primary pulmonary hypertension and human immunodeficiency virus infection in a
      non-hemophiliac man.
AB  - We describe clinical and postmortem findings in a 44-year-old man with pulmonary
      hypertension and infection with the human immunodeficiency virus (HIV-1).
      Plexogenic angiopathy and veno-occlusive lesions were present, in addition to a
      mild, patchy pulmonary interstitial lymphoid infiltrate. The clinical data for 14
      previously reported cases of HIV-associated primary pulmonary hypertension are
      summarized. We speculate that these vascular changes may be due to damage from a
      specific immune response to HIV.

PMID- 1740305
TI  - Necrobiotic xanthogranuloma with myocardial lesions and nodular transformation of
      the liver.
AB  - A 73-year-old woman with a history of necrobiotic xanthogranuloma (NXG) with
      paraproteinemia died suddenly while hospitalized for bronchitis and congestive
      heart failure. At postmortem examination, myocardial lesions histologically
      typical of NXG were found. This is the fifth reported autopsy of a patient with
      NXG. In all five autopsied cases, and in two additional surgical cases,
      necrobiotic granulomas of internal viscera were present, and in three cases the
      myocardium was involved. In addition, our patient had nodular transformation of
      the liver, a rare lesion that was also reported in one of the previous autopsy
      cases with NXG.

PMID- 1740306
TI  - Peripheral biphasic adenocarcinoma of the lung: light microscopic and
      immunohistochemical findings.
AB  - We report two cases of peripheral biphasic adenocarcinoma primary in the lung. To
      our knowledge, peripheral adenocarcinoma of the lung with a spindle-cell
      component has not been described previously. Diffuse positive cytokeratin and
      negative vimentin immunostaining of the spindle-cell components support an
      epithelial differentiation of the malignant spindle cells. Although study of
      additional cases is needed, our initial findings suggest that immunohistochemical
      staining pattern may help distinguish these neoplasms from other biphasic
      neoplasms primary or secondary to the lung, such as carcinosarcoma or malignant
      mesothelioma.

PMID- 1740308
TI  - Identification of titanium in human tissues.

PMID- 1740307
TI  - Ossifying fibromyxoid tumor of soft parts: evidence supporting Schwann cell
      origin.
AB  - Immunohistochemical and ultrastructural studies of an ossifying fibromyxoid tumor
      of soft parts have been performed. Immunoreactivity of neoplastic cells for S-100
      protein and glial fibrillary acidic protein, lack of immunoreactivity for type II
      collagen, and presence of basal lamina indicate that the tumor is of Schwann cell
      and not cartilaginous origin.

PMID- 1740309
TI  - Identification of titanium in human tissues.

PMID- 1740310
TI  - The fates of the new properties: intellectual workproducts.

PMID- 1740311
TI  - Quality control methods for data entry in pathology using a computerized data
      management system based on an extended data dictionary.
AB  - In pathology, computerized data management systems have been used increasingly to
      facilitate a more efficient supply of information. Since data entry precedes data
      utilization, the reliability of the information stored strongly depends on the
      quality of data input. Despite its potential capability, most personal computer
      based database software does not provide versatile and user-friendly data
      validation procedures. Therefore, we developed a data dictionary-driven data
      management system that enables the user to perform extensive validation routines
      without the need for hard programming. Using examples from an existing database
      for endometrial carcinomas, different types of data errors and their error traps
      are explained. It is pointed out that data type definitions, defaults, templates,
      or picture clauses are suitable means to avoid formal errors. Validations on data
      domains and ranges test whether data fall into a predefined scope. Relational
      checks control data validity within a context of different data items, whereas
      process routines provide automatic data computation, thereby circumventing user
      input. By exploiting the facilities of an extended data dictionary, a powerful
      tool is made available to secure various aspects of data integrity simultaneously
      with input. In this way, computerized data quality control can improve the
      efficiency and reliability of data management tasks in pathology.

PMID- 1740312
TI  - Cytogenetics of human oocytes, zygotes, and embryos after in vitro fertilization.
AB  - Chromosome errors, inherited or arising de novo during gametogenesis and
      transmitted at fertilization to the conceptus, may be a major cause of embryonic
      mortality. The in vitro fertilization and embryo transfer (IVF/ET) procedure
      provides extra material--oocytes, zygotes, and embryos--to investigate the
      contribution of chromosomal abnormality to implantation failure. This paper
      reviews the results of cytogenetic studies on such material. Estimates from a
      total of 1120 oocytes from 11 studies give an overall proportion of chromosomal
      abnormality of 35%. Single and multiple nullisomies and disomies are found,
      involving nonrandom chromosome gain or loss. Hypohaploid complements are more
      frequent than hyperhaploid complements. The higher rate of chromosome loss of
      hypohaploid karyotypes was found to be largely artifactual. The estimated overall
      frequency of aneuploidy is 13%. In embryos the level of chromosomal abnormality
      is 23%-40%. Errors of fertilization are responsible for a substantial number of
      triploid embryos, many of which develop into mosaics. Factors extrinsic to the
      conceptus, such as infertility, advanced maternal age, and ovarian
      hyperstimulation, may increase the level of chromosomal abnormality. More refined
      methods for accurately recognizing and selecting chromosomally normal embryos for
      transfer are needed to improve the success rate of this reproductive technology.

PMID- 1740313
TI  - Maternal origin of deletion 15q11-13 in 25/25 cases of Angelman syndrome.
AB  - About half of the cases of Angelman syndrome arise from deletions of chromosome
      band 15q12. In 25 cases we have been able to determine the parental origin of the
      deletion and, in line with other reported cases, we have found the deletion to be
      of maternal origin. There were no exceptions. The parental origin was determined
      using cytogenetic markers in 13 of the cases, in nine by using the pattern of
      inheritance of restriction fragment length polymorphisms, and in three using both
      techniques.

PMID- 1740314
TI  - Molecular analysis of aberrations of Xp and Yq.
AB  - Three cases of Y chromosomal aberrations were studied using a panel of Y-specific
      DNA sequences from both Yp and euchromatic Yq. One case was a phenotypic male
      fetus with a Y-derived marker chromosome. The short arm of this chromosome was
      intact, but most of its long arm was missing. The second case had a 46,XYq-
      karyotype with portions of euchromatic Yq, including the spermatogenesis region,
      missing. The third case was a phenotypic female with a 46,XXp+ karyotype. The
      extra material on the Xp+ chromosome was derived from the heterochromatic, and
      part of the euchromatic, portion of Yq. Application of X-specific DNA sequences
      demonstrated that the distal portion of the short arm of the translocation X
      chromosome was deleted (Xpter-p22.3). The three examples demonstrate the
      importance of diagnostic DNA analysis in cases of marker chromosomes, and X and Y
      chromosomal aberrations. In addition, the findings in the patients facilitate
      further deletion mapping of euchromatic Yq.

PMID- 1740315
TI  - Influence of HLA genotype on birth weight of patients with Turner syndrome.
AB  - Growth failure starting before birth is a common characteristic in Turner
      syndrome, and its pathogenesis is still not completely explained. Experiments
      performed in mice and rats to test whether a genetic disparity between mothers
      and offspring and maternal immunological status have any influence on litter size
      have demonstrated that allogenic litters are significantly larger in size than
      genetically compatible ones. Studies in humans have given contrasting results,
      but some authors have found that heterozygosity at enzyme loci and in blood
      groups is positively correlated with intrauterine growth. HLA class I and II
      polymorphisms were defined in 53 patients with Turner syndrome and in their
      parents, and lymphocytotoxic antibody detection was performed in 36 mothers.
      These data were related to the patients' birth weight. The frequency of the HLA
      B16 allele in patients with a birth weight greater than 10th centile was
      significantly higher in comparison with those less than 10th centile. HLA antigen
      sharing was present in 43 couples (81.1%). Mean birth weight was 2934 +/- 472 g
      in patients without HLA antigen parental sharing and 2721 +/- 529 g in those
      whose parents shared HLA antigens. The mean birth weight of the 10 patients whose
      parents do not share HLA antigens was significantly higher than that of the
      patients with parental HLA-B+ DR sharing (P less than 0.05) and not significantly
      highe than in those patients with parental HLA sharing at other HLA loci.
      Patients whose parents shared B+DR antigens also had significantly smaller birth
      weights than those with B and A+B+DR sharing (P less than 0.025 and P less than
      0.025). No significant difference in mean birth weight was found in relation to
      other parameters, such as mother-child histocompatibility, HLA homozygosity and
      lymphocytotoxic production in the mothers.

PMID- 1740316
TI  - Cytogenetic and molecular characterization of marker chromosomes in patients with
      mosaic 45,X karyotypes.
AB  - Cytogenetic and molecular techniques were employed to determine the origin of
      marker chromosomes in five patients with mosaic 45,X karyotypes. The markers were
      shown to be derived from the X chromosome in three female patients and from the Y
      chromosome in one female and one male. One of the female patients, with a very
      small, X-derived ring chromosome, had additional phenotypic abnormalities not
      typically associated with Turner syndrome. In this patient, both the ring and the
      normal X chromosomes replicated early; perhaps the unusual phenotype is the
      result of both chromosomes remaining transcriptionally active. These studies
      illustrate the power of resolution and utility of combined cytogenetic and
      molecular approaches to some clinical cases.

PMID- 1740317
TI  - Molecular characterization of beta-thalassemia in Czechoslovakia.
AB  - We have identified different beta-thalassemia mutations in 93 members of 34
      families of Czech or Slovakian descent using gene amplification, hybridization
      with specific 32P-labeled oligonucleotide probes, sequencing of amplified DNA,
      and gene mapping. The G----A mutation at IVS-I-1 was found in 18 families; other
      Mediterranean mutations were IVS-II-1 (G----A), IVS-II-745 (C----G), IVS-I-110 (G
      ---A), and codon 39 (C----T); these were present in 9 additional families. The G-
      --T mutation at codon 121, known to cause Heinz-body beta-thalassemia, was
      present in 3 families, and the frameshift at codons 82/83 (-G), first described
      in the Azerbaijanian population, in 2 families. A newly discovered allele was a
      frameshift at codons 38/39 (-C). One beta-thalassemia allele was incompletely
      characterized. We observed in 2 families a T----C mutation at position +96 UTR
      (untranslated region) relative to the termination codon; this mutation likely is
      a rare polymorphism. alpha-Thalassemia was rare; only one person carried the 
      alpha 3.7 heterozygosity, and one other had a yet to be identified alpha
      thalassemia-1, while seven had the alpha alpha alpha anti 3.7 triplication.

PMID- 1740318
TI  - The role of the sex-determining region of the Y chromosome (SRY) in the etiology
      of 46,XX true hermaphroditism.
AB  - The syndrome of 46,XX true hermaphroditism is a clinical condition in which both
      ovarian and testicular tissue are found in one individual. Both Mullerian and
      Wolffian structures are usually present, and external genitalia are often
      ambiguous. Two alternative mechanisms have been proposed to explain the
      development of testicular tissue in these subjects: (1) translocation of
      chromosomal material encoding the testicular determination factor (TDF) from the
      Y to the X chromosome or to an autosome, or (2) an autosomal dominant mutation
      that permits testicular determination in the absence of TDF. We have investigated
      five subjects with 46,XX true hermaphroditism. Four individuals had a normal
      46,XX karyotype; one subject (307) had an apparent terminal deletion of the short
      arm of one X chromosome. Genomic DNA was isolated from these individuals and
      subjected to Southern blot analysis. Only subject 307 had Y chromosomal sequences
      that included the pseudoautosomal boundary, SRY (sex-determining region of Y),
      ZFY (Y gene encoding a zinc finger protein), and DXYS5 (an anonymous locus on the
      distal short arm of Y) but lacked sequences for DYZ5 (proximal short arm of Y)
      and for the long arm probes DYZ1 and DYZ2. The genomic DNA of the other four
      subjects lacked detectable Y chromosomal sequences when assayed either by
      Southern blotting or after polymerase chain reaction amplification. Our data
      demonstrate that 46,XX true hermaphroditism is a genetically heterogeneous
      condition, some subjects having TDF sequences but most not. The 46,XX subjects
      without SRY may have a mutation of an autosomal gene that permits testicular
      determination in the absence of TDF.

PMID- 1740319
TI  - Identification of factor IX mutations in haemophilia B: application of polymerase
      chain reaction and single strand conformation analysis.
AB  - The molecular characterization of two haemophilia B defects, Calgary 1 and
      Calgary 2, was carried out using polymerase chain reaction (PCR) amplification
      and direct dideoxy sequencing. It had been previously shown that the Calgary 1
      mutation affects the 5' TaqI restriction site of exon VIII, whereas Calgary 2
      involves the loss of the 3' TaqI site of exon VIII of the factor IX gene.
      Sequencing data has now revealed that each of these alterations involves a C-to-T
      transition within a CpG dinucleotide. In each instance an arginine residue is
      replaced by a stop codon. These cases represent the recurrence of each particular
      alteration, both of which are predicted to result in the production of a
      truncated protein lacking a significant part of the catalytic region. A recently
      developed technique that reveals base substitutions as single-strand conformation
      polymorphisms (SSCP) was adapted for modelling in the detection of point
      mutations. Referred to here as single-strand conformation (SSC) analysis, this
      procedure, used in association with PCR, provided a reliable and sensitive system
      for molecular diagnosis in each of the cases presented. Computer-generated
      secondary structure predictions demonstrated a strong correlation with
      experimental results and the technique was used to screen 11 additional patients
      in the same region. A change detected by SSC analysis in one patient was
      localized to 55 base pairs, sequenced, and identified as a conservative amino
      acid substitution. This patient is now referred to as Calgary 3.

PMID- 1740320
TI  - Chromosome 1 in human colorectal tumors. Cytogenetic research on structural
      changes and their significance.
AB  - The significance of short and long arm anomalies of chromosome 1 was investigated
      in 55 colorectal tumors comprising 41 carcinomas and 14 adenomas. The tumors were
      at various stages of transformation from adenoma to carcinoma. Our investigation
      was prompted by the observation of a p32-pter deletion on the short arm of
      chromosome 1 in a case of benign tubulovillous adenoma with mild dysplasia, as
      well as by frequent reports that chromosome 1 is involved in many neoplastic
      processes. Long arm anomalies were found in seven of the 41 carcinomas, six of
      which were in stage B2, and short arm anomalies in ten carcinomas at various
      stages. Three of the adenomas exhibited chromosome 1 anomalies, which in one case
      comprised a 1p32-pter deletion only. Overall, short arm anomalies especially
      concerned the p32-36 region. These results suggest that the cytogenetic anomalies
      respectively located on the short and long arms of chromosome 1 should be
      considered separately. Damage to the long arm might constitute a late non
      specific event, whereas damage to the p32-pter region of the short arm might be
      involved in triggering colorectal tumor development.

PMID- 1740321
TI  - Polymorphisms in the apolipoprotein (apo) AI-CIII-AIV gene cluster: detection of
      genetic variation determining plasma apo AI, apo CIII and apo AIV concentrations.
AB  - We have examined the associations between levels of plasma apolipoprotein (apo)
      AI, apo CIII and apo AIV and genetic variation in the apo AI-CIII-AIV gene
      cluster in 162 boys and young men from Belgium aged from 7 to 23 years. Genotypes
      were determined for six restriction enzymes XmnI, PstI, SstI, PvuIIA-CIII, PvuIIB
      AIV and XbaI, and for the G to A substitution at -75 bp in the 5' region of the
      apo AI gene. The polymorphism most strongly associated with apo AI levels was the
      G to A substitution (P = 0.025, R2 x 100 = 3.6%) confirming previous
      observations. The polymorphism most strongly associated with apo CIII levels was
      that of PvuIIA-CIII (P = 0.023, R2 x 100 = 2.9%) in the apo CIII gene. This novel
      association must be interpreted with caution until it has been confirmed in an
      independent sample. The polymorphism associated with the largest effect on apo
      AIV levels was that detected with XbaI in the apo AIV gene, but this association
      was not statistically significant. Previously reported associations between the
      SstI polymorphism and triglyceride levels, and between the PstI polymorphism and
      apo AI levels, were weakly detected in the present sample. Our results show that
      variation associated with some of the polymorphisms in the apo AI-CIII-AIV
      cluster makes a small, but statistically significant, contribution to the
      determination of apo AI and apo CIII levels in this sample of young men and boys.
      These observations may, in part, explain reported associations between
      polymorphisms in this gene cluster, differences in plasma lipid and lipoprotein
      levels, and prevalence of coronary artery disease.

PMID- 1740322
TI  - Sperm chromosome complements from two human reciprocal translocation
      heterozygotes.
AB  - Using the hamster oocyte/human sperm fusion technique, we studied sperm
      chromosome complements in two male reciprocal translocation heterozygotes,
      46,XY,t(11;17)(p11.2;q12.3) and 46,XY,t(1;11) (p36.3;q13.1). For the t(11;17)
      carrier, 202 sperm chromosome complements were obtained, but 18 karyotypes were
      not included in the segregation data because of multiple breaks and
      rearrangements. The alternate and adjacent I types, adjacent II, and 3:1
      segregations accounted for 38.6%, 32.1%, 26.6%, and 2.7% of the sperm analyzed
      from the t(11;17) carrier. A total of 575 sperm chromosome complements was
      obtained using sperm from the t(1;11) heterozygote, and 27 karyotypes were
      excluded from the segregation data because of multiple breaks and rearrangements.
      For the t(1;11) carrier, the alternate and adjacent I types, adjacent II, and 3:1
      segregations were responsible for 31.4%, 42.9%, 15.9%, and 8.0% of the analyzed
      sperm chromosome complements. Chromosomal abnormalities unrelated to the
      translocation, particularly the conservative estimate of aneuploidy frequency,
      were within the range observed in normal men. Hence, there was no evidence for an
      interchromosomal effect causing meiotic nondisjunction, despite the large sample
      sizes studied.

PMID- 1740323
TI  - Rapid generation of chromosome-specific alphoid DNA probes using the polymerase
      chain reaction.
AB  - Non-isotopic in situ hybridization of chromosome-specific alphoid DNA probes has
      become a potent tool in the study of numerical aberrations of specific human
      chromosomes at all stages of the cell cycle. In this paper, we describe
      approaches for the rapid generation of such probes using the polymerase chain
      reaction (PCR), and demonstrate their chromosome specificity by fluorescence in
      situ hybridization to normal human metaphase spreads and interphase nuclei.
      Oligonucleotide primers for conserved regions of the alpha satellite monomer were
      used to generate chromosome-specific DNA probes from somatic hybrid cells
      containing various human chromosomes, and from DNA libraries from sorted human
      chromosomes. Oligonucleotide primers for chromosome-specific regions of the alpha
      satellite monomer were used to generate specific DNA probes for the
      pericentromeric heterochromatin of human chromosomes 1, 6, 7, 17 and X directly
      from human genomic DNA.

PMID- 1740324
TI  - Transferrin subtypes in 51 Danish patients with hereditary haemochromatosis and
      in 847 normal subjects.
AB  - Transferrin (TF) subtypes were determined by isoelectric focusing in 51 unrelated
      Danish patients with hereditary haemochromatosis (HH) and in 847 normal subjects.
      The following TF phenotype frequencies were observed in HH patients and controls,
      respectively: TF*C1, 70.6% vs. 58.8%; TF*C2, 5.9% vs. 2.4%; TF*C3, 0% vs. 0.4%;
      TF*C1-2, 11.8% vs. 24.7%; TF*C1-3, 5.9% vs. 9.7%; TF*C2-3, 3.9% vs. 2.2%; TF*B
      C1, 2.0% vs. 1.5%; TF*B-C2, 0% vs. 0.4%. None of these differences were
      statistically significant. There was no relationship between the TF subtypes and
      the clinical or paraclinical expression of disease in HH patients.

PMID- 1740325
TI  - A possible mosaic form of delayed centromere separation and aneuploidy.
AB  - On average, a "normal" centromere separation sequence was seen in 3 neonates with
      trisomy 18 and in their parents. When evaluating individual mitoses, unusually
      late separating chromosomes 18 were found in a few cells of one of the parents in
      each family. A possible germline mosaicism of delayed separation in the parent
      may account for trisomy in the offspring.

PMID- 1740326
TI  - The unbalanced offspring of the male carriers of the 11q;22q translocation:
      nondisjunction at meiosis II in a balanced spermatocyte.
AB  - Carriers of the standard translocation t(11;22) (q23.3;q11.2) produce only one
      type of unbalanced offspring, a tertiary trisomy resulting into the karyotype
      47,XX or XY, +der(22)t(11;22)(q23.3;q11.2), usually derived from the mother. The
      exception is one single patient 47,XY,t(11;22)(q23.3;q11.2), +der(22)t(11;22)
      (q23.3;q11.2)pat. We report a second case with the same karyotype, also of
      paternal origin. Thus, the rare unbalanced offspring of a carrier father (only 5
      cases known) may receive a supernumerary der(22), as a consequence of tertiary
      trisomy, but also as a consequence of nondisjunction at meiosis II of a balanced
      spermatocyte.

PMID- 1740327
TI  - Further characterization of the new marker at DXS115 with regard to carrier
      detection in hemophilia A.

PMID- 1740328
TI  - A genetic linkage map of human chromosome 20 composed entirely of microsatellite
      markers.
AB  - Twenty-six (CA)n polymorphic microsatellites were isolated from a flow-sorted
      chromosome 20 library. To reduce the number of sequencing gels, these
      microsatellites were genotyped on 15 CEPH families using a procedure derived from
      the multiplex sequencing technique of G. M. Church and S. Kieffer-Higgins (1988,
      Science 240:185-188). A primary map with a strongly supported order was
      constructed with 15 (CA)n markers. Regional localizations for the 11 other
      microsatellites were obtained with regard to the primary map. The 26 loci span
      approximately 160 cM. Regional localizations for a set of index markers (D20S4,
      D20S6, D20S16, and D20S19) and for other markers from the CEPH Public Database
      (D20S5, D20S15, D20S17, and D20S18) have also been determined. The total map
      spans a genetic distance of approximately 195 cM extending from the (CA)n marker
      IP20M7 on 20p to D20S19 on 20q. The density of microsatellite markers is markedly
      higher in the pericentromeric region, with an average distance of 3 to 4 cM
      between adjacent markers over a distance of 43 cM. Two-thirds of these randomly
      isolated microsatellites are clustered in that region between D20S5 and D20S16
      representing approximately one-fourth of the linkage map. This might suggest a
      nonrandom distribution of (CA)n simple sequence repeats on this chromosome.

PMID- 1740329
TI  - Genomic organization, nucleotide sequence, and cellular distribution of a Shaw
      related potassium channel gene, Kv3.3, and mapping of Kv3.3 and Kv3.4 to human
      chromosomes 19 and 1.
AB  - Genomic and cDNA clones encoding a novel Shaw-related potassium channel gene have
      been isolated from mice and humans. The mouse-Kv3.3 gene encodes a protein of 679
      amino acids. Unlike the vertebrate Shaker-related genes that have intronless
      coding regions, mouse Kv3.3 is encoded by at least two exons separated by 3 kb of
      intervening sequence. The amino-terminal 212 amino acids are encoded by a single
      exon, and the hydrophobic core of the protein beginning at the S1 transmembrane
      segment is contained in a separate exon. Multiple Kv3.3-hybridizing transcripts
      are visible in the mouse brain, liver, thymus, and heart. Using probes derived
      from a human genomic clone containing the 3' exon of human Kv3.3 (KCNC3), we have
      localized the gene to human chromosome 19. The related gene, human Kv3.4 (KCNC4),
      was localized to human chromosome 1.

PMID- 1740330
TI  - Structural organization and complete nucleotide sequence of the gene encoding
      human acid sphingomyelinase (SMPD1).
AB  - Acid sphingomyelinase (ASM; HGMW-approved symbol, SMPD1) is the lysosomal
      phosphodiesterase that hydrolyzes sphingomyelin to ceramide and phosphocholine.
      The deficient activity of this enzyme results in Types A and B Niemann-Pick
      disease (NPD). The full-length cDNA encoding human ASM has been isolated and
      characterized (E. H. Schuchman, M. Suchi, T. Takahashi, K. Sandhoff, and R. J.
      Desnick (1991) J. Biol. Chem. 66:8531-8539), and the ASM gene has been localized
      to chromosomal region 11p15.1-p15.4 (L. V. Pereira, R. J. Desnick, D. Adler, C.
      M. Disteche, and E. H. Schuchman (1991) Genomics 9:229-234). Using the cDNA as a
      probe, a genomic clone containing the ASM genomic region was isolated and the
      complete nucleotide sequence of the human ASM gene, including 1116 and 468
      nucleotides upstream and downstream from the ASM coding region, respectively, was
      determined. This housekeeping gene contained six exons ranging in size from 77 to
      773 bp and five introns ranging in size from 153 to 1059 bp. Exon 2 was unusually
      large and encoded 258 amino acids, or about 44% of the mature ASM polypeptide.
      The alternatively spliced 172-bp type 1-specific sequence was encoded by exon 3,
      whereas the type 2-specific sequence was located at the 5' end of intron 2. An
      analysis of the intron/exon junctions revealed that there was a weak donor splice
      site (AAA gtgagg) at the exon 3/intron 3 junction which occasionally leads to
      alternative splicing of exon 3 and the occurrence of the type 2 and 3 ASM
      transcripts. A single Alu1 element in the reverse orientation was in intron 2,
      immediately downstream from the type 2-specific sequence.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1740331
TI  - Generation of a panel of somatic cell hybrids containing fragments of human
      chromosome 12P by X-ray irradiation and cell fusion.
AB  - We have employed an irradiation and fusion procedure to generate somatic cell
      hybrids containing various fragments of the short arm of human chromosome 12
      using a 12p-only hybrid (M28) as starting material. For the initial
      identification of hybrids retaining human DNA, nonradioactive in situ
      hybridization was performed. Seventeen cell lines appeared to contain detectable
      amounts of human material. Detailed characterization of these hybrids by Southern
      blot analysis and chromosomal in situ suppression hybridization (chromosome
      painting), using hybrid DNAs as probes after Alu element-mediated PCR, resulted
      in a hybrid panel encompassing the entire chromosome 12p arm. This panel will
      provide a valuable resource for the rapid isolation of region-specific DNA
      markers. In addition, this panel may be useful for the characterization of
      chromosome 12 aberrations in, e.g., human germ cell tumors.

PMID- 1740332
TI  - Mapping of the gene family for human heat-shock protein 90 alpha to chromosomes
      1, 4, 11, and 14.
AB  - The HSP90 family of heat-shock proteins (encoded by genes for HSP90 alpha and
      beta) constitutes one of the major groups of proteins that are synthesized at
      increased rates in response to heat and other forms of stress. We previously
      isolated two distinct cDNA clones for HSP90 alpha from human peripheral blood
      lymphocytes and from HeLa cells transfected with the adenovirus E1A gene,
      respectively. To determine the organization of this complex multigene family in
      the human genome, we used three complementary approaches: Southern analysis of a
      panel of human/hamster somatic cell hybrids, molecular cloning of the cosmid
      HSP90 alpha clones from libraries prepared with DNAs from human lymphoblastoid
      cells, and in situ hybridization to human chromosomes. We demonstrate here that
      nucleotide sequences that encode HSP90 alpha map to human chromosomes 1q21.2-q22,
      4q35, 11p14.1-p14.2, and 14q32.3. The chromosomal mapping of the loci, HSPCAL1,
      HSPCAL2, HSPCAL3, HSPCAL4, and the characterization of the respective genes
      should facilitate clarification of the organization of this gene family and lead
      to a better understanding of the biological functions of the gene product.

PMID- 1740333
TI  - Genetic variation at five trimeric and tetrameric tandem repeat loci in four
      human population groups.
AB  - Trimeric and tetrameric short tandem repeats (STRs) represent a rich source of
      highly polymorphic markers in the human genome that may be studied with the
      polymerase chain reaction (PCR). We report the analysis of a multilocus genotype
      survey of 97-380 chromosomes in U.S. Black, White, Mexican-American, and Asian
      populations at five STR loci located on chromosomes 1, 4, 11, and X. The
      heterozygote frequencies of the loci ranged from 0.36 to 0.91 and the number of
      alleles from 6 to 20 for the 20 population and locus combinations. Relative
      allele frequencies exhibited differences between populations and unimodal,
      bimodal, and complex distributions. Although deviations were noted at some locus
      population test combinations, genotype data from the loci were consistent overall
      with Hardy-Weinberg equilibrium by three tests. Population subheterogeneity
      within each ethnic group was not detected by two additional tests. No mutations
      were detected in a total of 860 meioses for two loci studied in the CEPH kindreds
      and five loci studied in other families. An indirect estimate of the mutation
      rates gave values from 2.3 x 10(-5) to 15.9 x 10(-5) for the five loci. Higher
      mutation rates appear to be associated with greater numbers of tandem repeats in
      the core motif. The most frequent genotype for all five loci combined appears to
      have a frequency of 7.59 x 10(-4). Together, these results suggest that trimeric
      and tetrameric STR loci are useful markers for the study of new mutations and
      genetic linkage analysis and for application to personal identification in the
      medical and forensic sciences.

PMID- 1740334
TI  - High-resolution localization of 69 potential human zinc finger protein genes: a
      number are clustered.
AB  - In this study, we describe the identification and partial characterization of 101
      potential human zinc finger protein genes (ZnFPs). These sequences were isolated
      by hybridization of cosmids, obtained from mouse-human cell lines enriched for
      chromosome 11p, with an oligonucleotide specific for the "link" sequence between
      contiguous zinc fingers. Sixty-nine of these cosmids were regionally localized to
      human prometaphase chromosomes by in situ hybridization. The localization of
      these cosmids suggests that a number of finger protein genes occur in linked
      clusters. Their assignment to chromosomes 3p, 11p, 19p, 19qter, 20p, and 21q
      makes them valuable as markers or "candidate" genes for diseases associated with
      these chromosome regions.

PMID- 1740335
TI  - Distribution of moderately repetitive sequences pTR5 and LF1 in Xq24-q28 human
      DNA and their use in assembling YAC contigs.
AB  - Xq24-q28 DNA, from a hamster/human hybrid cell containing only that portion of
      the human X chromosome, was found to contain 56 TaqI restriction fragments that
      hybridized to the moderately repetitive sequence pTR5. Using the pTR5 sequence as
      a probe in colony hybridization, 136 cognate yeast artificial chromosome (YAC)
      clones were detected among a collection of 820 containing about three genomic
      equivalents of the Xq24-q28 DNA. The YACs were then grouped into 48 contigs and
      single clones containing one or more of the TaqI fragments. Overlaps were
      confirmed both by fingerprinting YACs with AluI and L1 probes and by additional
      information. A less complete analysis was also carried out with a second
      moderately repetitive sequence, LF1, and some smaller contigs were merged into
      larger ones. Moderately repetitive sequences can thus be used as probes for
      multiple loci in single hybridization experiments and can help to organize and
      confirm YAC overlaps during the development of maps with long-range contiguity.

PMID- 1740336
TI  - Structure and sequence of the human alpha-L-fucosidase gene and pseudogene.
AB  - Fucosidosis is a rare lysosomal storage disease resulting from a nearly complete
      deficiency of alpha-L-fucosidase enzyme activity. Previously, cDNA encoding human
      fucosidase was cloned and sequenced. Here we report the determination of the
      human fucosidase gene structure and sequence as well as the sequence of the
      fucosidase pseudogene. The gene encoding fucosidase is composed of eight exons
      spanning 23 kb of DNA. Analysis of the sequence 5' of the open reading frame
      indicates the presence of multiple transcription factor binding sites but no TATA
      box. Northern blot analysis has confirmed an mRNA size of 2.3 kb in human
      lymphoblasts, testis, and epithelial cells. We have also sequenced the processed
      pseudogene of fucosidase. The sequence of the pseudogene is 80% identical to that
      of fucosidase cDNA but does not contain an open reading frame.

PMID- 1740337
TI  - Variable (dG-dT)n.(dC-dA)n sequences in the porcine genome.
AB  - One of the more widely studied simple repeat sequences in the mammalian genome is
      the (dG-dT)n.(dC-dA)n dinucleotide repeat sequence. As these repeats are highly
      polymorphic and fairly evenly distributed in diverse mammalian genomes, they
      constitute a very powerful tool for genetic mapping in a wide variety of species.
      So far, the knowledge about repeat sequences in the porcine genome is sparse and
      only a few areas of this genome have been sequenced. We have isolated and
      characterized 108 porcine (dG-dT)n.(dC-dA)n sequences and studied the
      distribution of these, both by investigating random clones and by performing in
      situ hybridization. A remarkable correlation between humans and pigs was found
      with respect to the structure, to the number of repeat blocks, and to the
      chromosomal distribution.

PMID- 1740338
TI  - Analysis of the human regulators of complement activation (RCA) gene cluster with
      yeast artificial chromosomes (YACs).
AB  - The human regulators of complement activation gene cluster (RCA cluster) have
      been partially characterized with yeast artificial chromosomes (YACs). While the
      data confirm many points previously elucidated, the finer resolution of YAC
      mapping has allowed the discovery and/or localization of partial gene
      duplications, the determination of gene orientations, and the measurement of gaps
      between known genes. Here nine overlapping YACs that encompass a genomic region
      of 800 kb, encoding four RCA genes and three gene-like elements, are described.
      The encoded genes and two of the gene-like elements share the same orientation
      and are ordered (5' to 3') DAF, CR2, CR1, MCP-like, CR1-like, and MCP. A C4bp
      like region lies upstream from DAF and is likely to correspond to one recently
      observed by F. Pardo-Manuel, J. Rey-Campos, A. Hillarp, B. Dahlback, and S.
      Rodriguez de Cordoba (1990, Proc. Natl. Acad. Sci. USA 87: 4529-4533). MCP-like,
      a new genetic element, was discovered and found to be homologous to the 5'
      portion of the MCP gene. Two large gaps of 85 kb (between CR2 and DAF) and 110 kb
      (between DAF and the C4bp-like element) could carry additional RCA genes. The
      arrangement of CR1, MCP-like, CR1-like, and MCP, in that order, strongly suggests
      that this region was generated by a single duplication of neighboring CR1/CR1
      like and MCP/MCP-like forerunners. The RCA YACs will now serve as convenient DNA
      sources for the subcloning and further characterization of this region.

PMID- 1740339
TI  - Detecting single base substitutions as heteroduplex polymorphisms.
AB  - We have developed a sensitive technique for detecting single base substitutions
      in polymerase chain reaction (PCR) products from individuals heterozygous for
      polymorphisms or new mutations. This technique takes advantage of the formation
      of heteroduplexes in the PCR between different alleles from heterozygous
      individuals. These heteroduplexes can be detected on polyacrylamide gels because
      they migrate slower than their corresponding homoduplexes. Using PCR, we have
      generated a series of point mutations in a defined region of DNA in the equine
      infectious anemia virus (EIAV). Each mutation is the result of a single base
      substitution. By mixing the PCR products amplified from these mutations with one
      another, as well as with wildtype PCR products, we can generate heteroduplexes in
      which the identity of the mismatched bases is known. We detected eight of nine
      point mutations using this technique. We have also modified the electrophoretic
      conditions to optimize the detection of these heteroduplexes. In addition, the
      usefulness of this technique is demonstrated by its ability to detect a mutation
      in the cystic fibrosis gene that is the result of a single base substitution.
      This technique should prove useful for rapidly screening large numbers of
      individuals for new mutations or polymorphisms.

PMID- 1740340
TI  - PCR amplification of chromosome-specific DNA isolated from flow cytometry-sorted
      chromosomes.
AB  - We have established a method for amplifying and obtaining large quantities of
      chromosome-specific DNA by linker/adaptor ligation and polymerase chain reaction
      (PCR). Small quantities of DNA isolated from flow cytometry-sorted chromosomes 17
      and 21 were digested with MboI, ligated to a linker/adaptor, and then subjected
      to 35 cycles of PCR. Using this procedure, 20 micrograms of chromosome-specific
      DNA can be obtained. Southern blot analysis using several DNA probes previously
      localized to chromosomes 17 and 21 indicated that these gene sequences were
      present in the amplified chromosome-specific DNA. A small quantity of the
      chromosome-specific DNA obtained from the first round of PCR amplification was
      used to amplify DNA for a second, third, and fourth round of PCR (30 cycles), and
      specific DNA sequences were still detectable. Fluorescence in situ hybridization
      using these chromosome-specific DNA probes clearly indicated the hybridization
      signals to the designated chromosomes. We showed that PCR-amplified chromosome 17
      specific DNA can be used to detect nonrandom chromosomal translocation of
      t(15;17) in acute promyelocytic leukemia by fluorescence in situ hybridization.

PMID- 1740341
TI  - A polymorphic (CA)n repeat element maps the human glucokinase gene (GCK) to
      chromosome 7p.
AB  - A compound imperfect dinucleotide repeat element,
      [CA]4TTTGT[CT]7[CA]9AA[CA]4CCACATA[CA]3, was found approximately 10 kb 3' to the
      human glucokinase gene (GCK) from analysis of contiguous genomic DNA obtained
      from a bacteriophage lambda chromosome walk. Direct human genomic sequencing
      revealed the source of polymorphism to be variable numbers of CT and CA repeats.
      Altogether six alleles that range in length from +10 to -15 nucleotides compared
      to the most common (Z) allele have been identified. Alleles Z, Z + 2, and Z + 4
      were present in American Blacks, Pima Indians, and Caucasians, with somewhat
      varied frequencies among the groups. Two alleles, Z + 10 and Z - 15, appear to be
      unique to American Blacks, while a Z + 6 allele was observed only in the
      Caucasian population studied. Observed heterozygosity of the polymorphism in the
      CEPH reference pedigree collection is 44% and the PIC 0.44. The polymorphism is
      assayed by PCR amplification and resolution of 32P-end-labeled products (ranging
      in length from 180 to 205 bp) on denaturing polyacrylamide sequencing gels. Using
      the PCR assay, the human glucokinase gene was physically localized to chromosome
      7 in a panel of rodent/human somatic cell lines. Genetic analysis in CEPH
      pedigrees placed the dinucleotide repeat element, and thereby the human
      glucokinase gene, on chromosome 7p between TCRG and a RFLP locus D7S57. The
      glucokinase dinucleotide repeat genetic marker can now be used to assess the role
      of the glucokinase gene in diabetes by population association studies. In
      addition, this repeat marker and others flanking it on chromosome 7 can be used
      in linkage studies with families segregating the disorder.

PMID- 1740342
TI  - A 2-cM genetic linkage map of human chromosome 7p that includes 47 loci.
AB  - A new high-resolution genetic linkage map for human chromosome 7p has been
      constructed. The map is composed of 47 loci (54 polymorphic systems), 19 of which
      are uniquely placed with odds of at least 1000:1. Four genes are represented,
      including glucokinase (GCK, ATP:D-hexose-6-phosphotransferase, EC 2.7.1.2) which
      was mapped via a (CA)n dinucleotide repeat polymorphism. The sex-average map
      measures 94.4 cM and the male and female maps measure 73.2 and 116.1 cM,
      respectively. We believe that the genetic map extends nearly the full length of
      the short arm of chromosome 7 since a centromere marker has been incorporated,
      and the most distal marker, D7S21, has been cytogenetically localized by in situ
      hybridization to 7p22-pter. The average marker spacing is 2 cM, and the largest
      interval between uniquely placed markers is 13 cM (sex-average map). Overall,
      female recombination was observed to be about 1.5 times that of males, and a
      statistically significant sex-specific recombination frequency was found for a
      single interval. The map is based on genotypic data gathered from 40 CEPH
      reference pedigrees and was constructed using the CRI-MAP program package. The
      map presented here represents a combined and substantially expanded dataset
      compared to previously published chromosome 7 maps, and it will serve as a
      "baseline" genetic map that should prove useful for future efforts to develop a 1
      cM map and for construction of a contiguous clone-based physical map for this
      chromosome.

PMID- 1740343
TI  - Genetic variability of the murine creatine kinase B gene locus and related
      pseudogenes in different inbred strains of mice.
AB  - The role of genetic variation in isoenzyme gene families is often poorly
      appreciated. We report here on the determination of DNA sequences and typing of
      genetic variability in four creatine kinase B (CKB) gene loci in different inbred
      strains of mice. The unique functional murine CKB gene was found to be nearly
      identical to the previously characterised rat and human sequences in both size
      and exon-intron structure. In this gene, approximately 0.5% allelic nucleotide
      positions as well as the lengths of simple A-rich and [TG]n repetitive elements
      located at the 5' and 3' sides of the transcribed segment, differed between
      inbred strains of mice. Preliminary experiments suggest that this sequence
      divergence is of importance for design of gene targeting strategies involving
      homologous DNA recombination. The three additional CKB-like gene loci in mice all
      had the characteristics of processed pseudogenes. By Southern blot analysis we
      could demonstrate that both the type and number of pseudogenes differed between
      inbred strains. Analysis of the CKB gene sequences enabled us to speculate about
      the evolutionary history of this highly polymorphic subfamily of genes.

PMID- 1740344
TI  - Assignment of rat linkage group V to chromosome 19 by single-strand conformation
      polymorphism analysis of somatic cell hybrids.
AB  - The rat provides a number of important models of human genetic disease; however,
      the rat genetic map has not been extensively developed. Although most rat
      chromosomes carry several gene assignments, some major linkage groups (LG) remain
      to be mapped. To determine the chromosome location of the largest unmapped
      linkage group in the rat (LG V containing multiple carboxylesterase loci), we
      used single-strand conformation polymorphism analysis to identify the rat
      esterase-10 gene in a panel of rat x mouse somatic cell hybrids. We found that
      the carboxylesterase gene family and hence LG V are located on rat chromosome 19.
      We have also confirmed the assignment of the angiotensinogen gene to rat
      chromosome 19 and have used a large set of recombinant inbred strains to map two
      anonymous variable number of tandem repeat (VNTR) markers to this chromosome. The
      current findings bring the total number of genes assigned to rat chromosome 19
      from 3 to 19 and provide further evidence of substantial homology between this
      chromosome and chromosome 8 in the mouse.

PMID- 1740345
TI  - Rps4 maps near the inactivation center on the mouse X chromosome.
AB  - RPS4Y, a Y-linked gene in humans, appears to encode an isoform of ribosomal
      protein S4. A homologous locus on the human X chromosome, RPS4X, lies close to
      the X-inactivation center but fails to undergo X-inactivation. We have isolated a
      genomic clone from the mouse Rps4 locus, the homolog of human RPS4X. We derived
      an intron probe that hybridizes to the functional Rps4 locus but does not cross
      hybridize to related sequences elsewhere in the mouse genome. Genetic mapping
      utilizing interspecific mouse backcrosses and the intron-specific probe
      demonstrates that Rps4 maps close to the Phka locus on the mouse X chromosome and
      in the vicinity of the X-inactivation center. The gene order Ccg-1-Rps4/Phka-Xist
      Pgk-1 is conserved between mouse and human.

PMID- 1740346
TI  - Use of Alu-PCR to characterize hybrids containing multiple fragments and to
      generate new Xp21.3-p22.2 markers.
AB  - Irradiation fragment hybrids potentially provide highly enriched sources of
      region-specific human DNA. However, such hybrids often contain multiple human
      pieces, not all of which can be easily detected. To develop specific resources
      for rapidly generating markers from Xp21.3-p22.2, we have single cell cloned two
      previously constructed irradiation hybrids that contain markers in this region
      and have achieved segregation of the different known fragments originally
      retained. Alu-PCR products were generated from subclones positive or negative for
      Xp21.3-p22.2 markers, and comparison of the ethidium bromide patterns between
      sister subclones facilitated identification of bands likely to map to particular
      regions; in contrast, subclones that shared markers but were derived from
      independent lines showed no overlap in ethidium bromide pattern. All Alu-PCR
      products from one subclone, 50K-19E, in which only three closely linked markers
      were detected (DXS41, DXS208, DXS274) were mapped back to their region of origin.
      Of 28 products, 15 mapped to Xp21.2-p22.2, and these make up a new set of
      regionally assigned markers. However, the mapping data identified four separate
      Xp fragments in 50K-19E, only one of which had been picked up by marker analysis.
      Mapping back gel-isolated Alu-PCR products from an irradiation hybrid prior to
      any cloning or screening generates a comprehensive profile of the human DNA
      retained and permits rapid selection of sequences derived only from the region of
      interest.

PMID- 1740347
TI  - Mapping of locus for X-linked congenital stationary night blindness (CSNB1)
      proximal to DXS7.
AB  - A recombinant chromosome in a male affected with X-linked congenital stationary
      night blindness (CSNB1) provides new information on the location of the CSNB1
      locus. A four-generation family with five males affected with X-linked CSNB was
      analyzed with five polymorphic markers for four X-chromosome loci spanning the
      region OTC (Xp21.1) to DXS255 (Xp11.22). Four of the males inherited the same X
      chromosome; one male inherited a chromosome that from OTC to DXS7, inclusive, was
      derived from the normal X chromosome of his unaffected grandfather and that from
      a location between DXS7 and DXS426 proximally was derived from the chromosome
      carrying the CSNB1 locus. This recombinant maps the CSNB1 locus in this family to
      a region on the short arm of the X chromosome proximal to the DXS7 locus.

PMID- 1740348
TI  - Alkaline phosphatase activity is expressed only in B lymphocytes committed to
      proliferation.
AB  - Alkaline phosphatase (APase) activity was measured in murine splenic lymphocytes
      stimulated with the T lymphocyte mitogens phytohemagglutinin (PHA) and
      Concanavalin A (Con A) and the B lymphocyte mitogens lipopolysaccharide (LPS) and
      anti-immunoglobulin (anti-Ig). APase activity was found to be enhanced
      specifically in mitogen-stimulated B lymphocytes, but not in T lymphocytes. This
      enhancement starts around 8 h after stimulation with a mitogen. With soluble anti
      Ig it was observed that the B cells enter G1 phase as assessed by RNA synthesis
      and blast transformation. However, these cells fail to synthesize DNA and also do
      not show any increase in APase activity. When the same anti-Ig coupled to
      Sepharose was used as a stimulator, cells synthesized DNA and also showed
      significant increase in APase activity. When hydroxyurea was added, the
      enhancement in APase activity by the mitogen was not diminished although the
      cells failed to synthesize DNA. These observations indicate that APase activity
      is enhanced only in activated B cells committed to proliferation.

PMID- 1740349
TI  - Development of an antibody that binds sulfur mustard.
AB  - An antibody that binds bis(2-chloroethyl) sulfide (sulfur mustard) was developed.
      The immunizing antigen was prepared from the hapten 4-(2-chloroethyl)benzoic acid
      covalently bound to keyhole limpet hemocyanin (KLH). The antibody was monitored
      by a solid phase enzyme-linked immunosorbent assay (ELISA). The test antigen
      consisted of a second hapten, 8-chlorocaprylic acid, covalently bound to bovine
      serum albumin (BSA). The test antigen was absorbed to the wells of 96-well
      plates. The immunizing and test antigens contain a common chloroethyl moiety.
      Thiodiglycol, the principal hydrolysis product of sulfur mustard, does not react
      with the antibody. This antibody, because of its specificity, has the potential
      to be a valuable tool for mustard research and forensic detection.

PMID- 1740350
TI  - Association of recombinant soluble IL-6-signal transducer, gp130, with a complex
      of IL 6 and soluble IL-6 receptor, and establishment of an ELISA for soluble
      gp130.
AB  - IL-6 mediates its pleiotropic functions through two membrane proteins, a ligand
      binding molecule (IL-6 receptor, IL-6R) and a non-ligand-binding signal
      transducer (gp130). Starting with a previously isolated cDNA clone encoding human
      gp130, recombinant soluble gp130 (sgp130) lacking the transmembrane and
      cytoplasmic regions was expressed in COS7 cells or CHO cells. sgp130 could
      associate with a complex of IL-6 and soluble IL-6R (sIL-6R), also lacking
      transmembrane and cytoplasmic regions. This indicated that extracellular region
      of gp130 was responsible for the association with IL-6R which was occupied by IL
      6. An enzyme-linked immunosorbent assay (ELISA) for the quantitation of sgp130
      was established, which was based on the interaction of sgp130 with the complex of
      IL-6 and sIL-6R and could detect sgp130 as low as 1 ng/ml.

PMID- 1740351
TI  - Monoclonal antibodies against soman: characterization of soman stereoisomers.
AB  - Hybridomas were produced which expressed monoclonal anti-soman antibodies as
      determined by microtiter enzyme-linked-antibody immunoassay (EIA). Each of these
      antibodies was titrated using a competitive inhibition enzyme immunoassay (CIEIA)
      with a variety of test ligands. The ligands used included soman (a racemic
      mixture), sarin, tabun, and each of the four stereoisomers of soman (C+ P+, C+ P
      , C-P+ and C-P-). In all cases the antibodies tested exhibited IC50 values of 10(
      4)-5 x 10(-6) M for soman. When sarin or tabun was used as a ligand, the
      antibodies exhibited no cross reactivity. All of the antibodies cross reacted
      with the four soman stereoisomers. A second group of hybridomas were produced
      which expressed monoclonal antibodies against CsPs-soman. These antibodies were
      used to make preliminary absolute chiral assignments to the four soman
      stereoisomers.

PMID- 1740352
TI  - Potentiation of the humoral response of intravenous antigen by splenotropic
      liposomes.
AB  - We have recently described that large liposomes composed of egg
      phosphatidylcholine (PC), cholesterol (chol) and monosialoganglioside GM1 show
      elevated accumulation in the red pulp of the spleen when they are i.v.
      administered into mice. Up to 50% of the injected dose was found in spleen at 4 h
      post injection. In this report, we have investigated the potential application of
      such liposomes in the stimulation of anti-lysozyme response in mice. Lysozyme
      entrapped in the splenotropic liposomes composed of PC/chol/GM1 showed higher
      efficiency in potentiating the humoral response than that of either free lysozyme
      or lysozyme entrapped in hepatotropic liposomes composed of PC/chol. The results
      demonstrate that high levels of i.v. antigen delivery by liposomes to the splenic
      macrophage instead of the liver Kupffer cells is important in the liposomal
      adjuvanticity. The antibody elicited by the liposome entrapped antigen was mainly
      IgG1 subtype.

PMID- 1740353
TI  - Perforin is expressed in CTL populations generated in vivo.
AB  - Immunization of C57BL/6 mice with syngeneic tumor cells, MBL-2, resulted in the
      generation of antitumor effector cells in vivo. The immunized C57BL/6 mice
      permanently rejected viable MBL-2 lymphoma cells, but not B16 melanoma cells.
      Cytotoxic T cells obtained from MBL-2-immunized mouse peritoneal cells (PEC)
      showed specific cytotoxicity against MBL-2, but not to YAC-1, RDM-4 and Meth A
      cells. By sorting with FACStar, the specific CTL were characterized as TCR alpha
      beta+ CD8+ T cells. Moreover, the cytoplasm of in vivo-induced CTL was stained
      with a monoclonal antibody against perforin. The localization of perforin in
      cytoplasmic granules of CTL was demonstrated by electron microscope analysis.
      This experiment presented the first evidence that in vivo-induced CD8+ CTL
      against syngeneic tumor cells expressed significant amounts of perforin.

PMID- 1740354
TI  - Specific functions of human NK cells.
AB  - Since natural killer (NK) cells lack both CD3/TCR molecules and surface Ig, it is
      generally thought that they are unable to recognize antigens. However, CD3-CD16+
      cells were found to respond in MLC against irradiated allogeneic mononuclear
      cells and to lyse normal PHA blasts derived from the stimulating donor, but not
      autologous cells or cells derived from most allogeneic donors. A similar pattern
      was obtained with cloned NK cells, thus indicating that the ability to
      specifically recognize given normal allogeneic cells is a clonally distributed
      function. Moreover, analysis of NK clones for their ability to lyse either tumor
      cells or normal PHA blasts (both derived from individual cancer patients)
      indicated that the two phenomena are distinct. Analysis of a large number of NK
      clones derived from a given individual for their ability to lyse a panel of
      allogeneic donors allowed the identification of at least four groups of clones
      characterized by unique patterns of reactivity ("specificities"). We further
      studied the mode of inheritance of the various NK-defined specificities: all the
      characters "susceptibility to lysis" by NK clones (displaying one or another
      specificity) segregated independently, were inherited in an autosomic recessive
      manner and were carried by chromosome 6. The finding of clonally distributed
      specific functions in NK cells suggested the existence of clonally distributed
      receptor molecules. Along this line mAbs were raised against NK clones, and
      screened for their ability to trigger the immunizing clones: two mAbs (termed
      GL183 and EB6) were directed against a novel family of 58-kDa surface
      molecules.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740355
TI  - The effects of complement depletion on corneal inflammation in rats.
AB  - There are indications that complement activation may be involved in inflammatory
      processes of the cornea. To investigate the role of the complement system in
      experimental keratitis, rats were depleted of their plasma complement by
      treatment with cobra venom factor (CVF). intraperitoneal injection of CVF
      resulted in undetectable complement serum activity for 6 days when measured by a
      hemolytic assay. The corneal inflammatory response, induced by a single
      intracorneal injection of heterologous serum into nonsensitized CVF-treated rats,
      was suppressed significantly. The onset of the clinical symptoms of keratitis was
      delayed, and the severity was reduced. In addition, analysis of the serum
      antibody titers showed impaired antibody synthesis in the CVF-treated group. When
      keratitis was induced by an intracorneal antigen challenge in sensitized rats, no
      difference was observed when comparing the clinical signs of keratitis of CVF
      treated animals with sham-treated animals. In addition, CVF treatment did not
      alter the course of lipopolysaccharide (LPS)-induced corneal inflammation. These
      findings suggest that the role of plasma complement activation in antigen- and
      LPS-induced keratitis appears to be limited. The implications for the
      immunopathologic mechanisms underlying keratitis are discussed.

PMID- 1740356
TI  - Distributional change of fodrin in the wound healing process of the corneal
      epithelium.
AB  - Distribution of fodrin, F-actin, and E-cadherin in the wound healing process of
      the mouse corneal epithelium was examined by immunolabeling techniques. In the
      normal epithelium, fodrin, F-actin, and E-cadherin were observed only in the cell
      periphery. After wounding, however, fodrin was observed diffusely in the basal
      cell cytoplasm. Distribution of the other two proteins was not changed. Fodrin in
      the upper cell layers did not show cytoplasmic labeling. The distributional
      change of fodrin in the basal cell was seen not less than 1 mm apart from the
      wound edge and as early as 5 min after the wounding, lasted for about 12 hr, and
      then gradually disappeared. The change in fodrin localization is one of the
      earliest phenomena which occur in the corneal epithelium after wounding. Because
      fodrin is an actin-binding protein and is believed to interact with E-cadherin,
      this change may be important in modulating the cytoskeleton and the intercellular
      junction before cell migration occurs.

PMID- 1740357
TI  - The large-conductance potassium ion channel of rabbit corneal epithelium is
      blocked by quinidine.
AB  - Basal layers of the rabbit corneal epithelium contain a large-conductance
      potassium ion (K+) selective channel (160-170 pS in 150 mM KCl). This channel
      previously was shown to be blocked by cesium and barium ions applied to its outer
      surface. By direct patch clamp experiments, it is shown that the channel also is
      blocked by quinidine in the 0.1-1 mM range when applied either to the outside or
      inside of membrane patches containing these channels. This additional
      pharmacologic tool should aid in identifying the individual currents that compose
      the macroscopic currents from corneal epithelial cells and eventually should help
      to provide a detailed assessment of their function.

PMID- 1740358
TI  - Induction of corneal epithelial cytochrome P-450 arachidonate metabolism by
      contact lens wear.
AB  - Two biologically active cytochrome P-450 arachidonate metabolites previously were
      characterized: 12(R)-hydroxy-5,8,10,14-eicosatetraenoic acid (12(R)-HETE) and
      12(R)-hydroxy-5,8,14-eicosatrienoic acid (12(R)-DH-HETE), which are endogenously
      formed in the corneal epithelium. The functional activity of these novel
      metabolites mimics changes observed in hypoxic corneas. Therefore, the effect of
      hypoxic stress was examined on metabolite formation in rabbits fitted with
      polymethylmethacrylate contact lenses. Although applied lenses fit tightly to the
      rabbit cornea, mechanical irritation also may contribute to the ocular response.
      Contact lens-induced hypoxic stress stimulated endogenous formation of both 12(R)
      HETE (a sodium, potassium adenosine triphosphatase inhibitor) and 12(R)-DH-HETE
      (a vasodilatory, chemotactic, and angiogenic factor) in a time-dependent manner.
      After 4 hr of contact lens wear, a 21-fold increase in endogenous 12(R)-HETE
      formation concomitant with an increase in corneal thickness was observed. After
      prolonged contact lens wear (144 hr), a 23-fold increase in endogenous 12(R)-DH
      HETE formation was found, corresponding with the appearance of a marked
      conjunctival inflammation characterized by corneal neovascularization. The
      increased formation of these compounds was associated with time-dependent changes
      in corneal endothelial morphology. The ability of 12(R)-HETE and 12(R)-DH-HETE to
      mediate the clinical signs of corneal hypoxia suggest these metabolites may be
      potential mediators of contact lens complications that followed conditions of
      hypoxic stress and possibly mechanical irritation in this model.

PMID- 1740359
TI  - Collagen shields as a vehicle for collecting and studying migratory cells on
      human corneas.
AB  - Collagen shields have been studied in the enhancement of the initial healing of
      epithelial defects, as an adjunct in the treatment of dry eye, and as a reservoir
      and delivery system for topical ocular medications. The authors used collagen
      shields to collect information on the numbers and types of free cells populating
      the normal and postoperative ocular surface. In addition, correlative microscopic
      techniques were used to study details of the mechanisms responsible for the
      dissolution of the shields when applied to the human eye. Collagen shields were
      applied as a bandage lens on the eyes of patients who underwent extracapsular
      cataract extraction (n = 10) or penetrating keratoplasty (n = 10) and on normal
      volunteers (n = 10). The shields were collected at the 1-day postoperative
      examination and fixed in aldehyde mixtures. Specimens then were processed for
      correlative light (LM), transmission (TEM), and scanning (SEM) microscopy. Cell
      accumulation was shown by SEM on both anterior and posterior shield surfaces.
      Cell adherence occurred primarily on the posterior shield periphery for
      approximately 2 mm, with the central zone relatively clean. Both LM and TEM
      evaluation revealed cell counts ranging from 0.066 cells/10(4) microns2 (standard
      deviation, +/- 0.256) in healthy eyes compared with shields placed on
      postoperative eyes (194.25 +/- 7.32 cells/10(4) microns2). Various correlative
      microscopy techniques revealed that most cells were polymorphonuclear leukocytes
      with a low number of other hematogenous (lymphocytes and monocytes) and
      exfoliated epithelial cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740360
TI  - Adhesion complex formation after small keratectomy wounds in the cornea.
AB  - The adhesion complex of the corneal epithelium consists of the hemidesmosome and
      its associated structures, such as anchoring filaments, lamina densa of the
      basement membrane, and anchoring fibrils. It contributes to the adhesion of the
      corneal epithelium to Bowman's layer. To understand the adhesion complex better,
      an electron microscopic and immunofluorescence analysis was done of the
      reformation of the adhesion complex in small (1 mm) keratectomy wounds in the
      guinea pig cornea. In these wounds, the epithelium, hemidesmosomes, basal lamina,
      anchoring fibrils, and anterior stroma were removed. The wound bed was
      epithelialized completely by 24 hr after wounding. Immunofluorescence analyses
      involved the use of antibodies against plaque components of the hemidesmosome, an
      antibody against laminin, and an antibody against the collagen VII component of
      anchoring fibrils. At 18 hr after wounding, there was no morphologic evidence of
      hemidesmosomes at the epithelial-stromal interface. At 24 hr, hemidesmosomes were
      observed, with or without subjacent lamina densa. Furthermore, plaque components
      were detected by immunofluorescence in those cells in contact with the wound bed.
      In contrast, no type VII collagen was detected. On day 7, collagen VII, laminin,
      and bullous pemphigoid autoantibody markers colocalized along the wound bed as
      determined by immunofluorescence. However, at the ultrastructural level, even
      though the lamina densa of the basal lamina was observed primarily where
      hemidesmosomes were present, it remained incomplete. In this study, the precise
      temporal sequence in which components are incorporated into the assembling
      adhesion complex was described during wound healing. Furthermore, the possibility
      that the hemidesmosomal plaque nucleates the formation of the underlying basal
      lamina was discussed.

PMID- 1740361
TI  - Reduced epithelial adhesion after extended contact lens wear correlates with
      reduced hemidesmosome density in cat cornea.
AB  - Reduced epithelial adhesion in cat corneas after continuous wear of thick
      hydrogel contact lenses has been reported previously. To investigate the
      mechanism(s) underlying this observed loss of epithelial adhesion further, the
      corneas of both eyes of cats that had worn low-oxygen-transmissible thick
      parallel-design hydrogel contact lenses only in one eye for 8-121 days were
      examined using both light and transmission electron microscopy (TEM). Contact
      lens wear induced many changes in the epithelium, including a decrease in the
      number of cell layers and appearance of cuboidal rather than columnar basal cell
      shapes. In addition, TEM revealed that the number of hemidesmosomes (HDs) per
      micrometer of basement membrane was reduced significantly after contact lens
      wear. Anchoring fibrils in lens-wearing corneas appeared normal, and the
      reduction in epithelial adhesion occurred without obvious epithelial edema.
      Decreased epithelial adhesion after contact lens wear appears to be directly
      related to the reduced numbers of HDs. Possible reasons for decreased HD density,
      such as loss of basal cell shape and chronic epithelial hypoxia after contact
      lens wear, are discussed.

PMID- 1740362
TI  - Embryonic corneal epithelial actin alters distribution in response to laminin.
AB  - In the current study, laser scanning confocal image analysis was used to
      investigate the actin distribution in whole-mount preparations of freshly
      isolated and cultured corneal epithelia. Actin staining defined the cell borders
      and microvilli of the periderm cells. The actin was prominent as an organized
      network at the interface between the basal and periderm cells and in the basal
      compartment of the basal cells (actin cortical mat) when isolated with the basal
      lamina (BL). In epithelia isolated without BL, the actin in the periderm cells
      and the network at the periderm-basal cell interface was the same as in epithelia
      isolated with BL. However, the actin in the basal compartment of the basal cells
      was localized in the cellular blebs that projected from the basal cell surface.
      Epithelia isolated without BL and cultured in the presence of laminin reorganized
      the actin cortical mat within 2 hours. However, epithelia isolated without BL and
      cultured without BL proteins continued to have basal cell projections, sometimes
      into the pores of the filter. Treatment of epithelia with 2 microM cytochalasin D
      prevented the reorganization of the actin by laminin. In conclusion, the use of
      confocal analysis increased our understanding of actin distribution in the
      epithelial sheets. These results confirmed and extended previous studies using
      electron microscopy to determine that corneal epithelial cells respond to
      extracellular matrix molecules by an actin-dependent mechanism.

PMID- 1740363
TI  - Functional loss in age-related Bruch's membrane change with choroidal perfusion
      defect.
AB  - During a prospective study of age-related macular degeneration, evidence of
      diffuse Bruch's membrane disease was sought using fluorescein angiographic
      evidence of a prolonged choroidal filling phase. Dark-adapted static perimetry
      was done on eight eyes with this angiographic sign and on six eyes with a similar
      number of drusen but no manifest choroidal perfusion abnormality. Scotopic
      threshold was measured using the Humphrey automated perimeter and fine matrix
      mapping. In eyes without delayed choroidal perfusion, no discrete areas of
      increased threshold were found compared with the background sensitivity. By
      contrast, in seven of the eight eyes with fluorescein angiographic evidence of
      prolonged choroidal filling, discrete areas of scotopic threshold elevation (up
      to 3.4 log units) were recorded; these corresponded closely to regions of
      choroidal perfusion abnormality. It was postulated that diffuse deposits of
      abnormal material might account for both the perfusion abnormality and functional
      loss by acting as a diffusion barrier between the choriocapillaris and the
      retinal pigment epithelium.

PMID- 1740364
TI  - Temporal expression of the transthyretin gene in the developing rat eye.
AB  - Transthyretin (TTR) is a 55-kilodalton tetrameric protein that plays an important
      role in the plasma transport of thyroxine and retinol. Plasma TTR is synthesized
      in the liver, but major sites of synthesis also have been described in the
      choroid plexus (CP) epithelium, the visceral yolk sac, and the eye. Recently, the
      retinal pigment epithelium (RPE) was identified as the specific site of TTR
      synthesis in the rat eye, and it was suggested that this established a functional
      homology between the RPE and the CP epithelium. In this study, the temporal
      pattern of TTR mRNA expression was investigated in the rat eye and brain during
      development (embryonic day 10 [e10]-postnatal day 7 [P7]) by in situ
      hybridization and quantitative densitometry. The TTR mRNA was present in
      abundance in the primordial CP before organogenesis (e10-12), but in the eye, TTR
      mRNA first was detected at considerably lower levels after organogenesis (e16)
      and only in a subset of RPE cells in the equatorial region. The relative
      abundance of TTR mRNA in RPE rose gradually until e21, but on the first day of
      life a surge was seen, followed by stabilization at adult levels by P7. These
      findings suggest that the requirement for TTR in CP and RPE, and possibly its
      function, may differ during development. The postnatal surge in RPE TTR message
      levels raises the possibility that transcription of the TTR gene in the newborn
      animal may be responsive to newly encountered environmental stimuli in the
      perinatal period, such as incident light.

PMID- 1740365
TI  - Interocular differences in macular pigment density.
AB  - Interocular differences in the optical density of macular pigment were examined.
      Foveal and parafoveal sensitivities to lights of 460 and 530 nm were measured by
      heterochromatic flicker photometry for both eyes of ten subjects. These two
      wavelengths represent the maximum and minimum absorbance for macular pigment.
      Taking the difference in log sensitivity to the 460 nm light for the fovea and
      parafovea, after normalizing with respect to 530 nm, yields a measurement of the
      optical density of the macular pigment. Consistent interocular differences in
      macular pigment density were found for only two subjects, and these differences
      were less than 0.1. Other subjects frequently showed significant interocular
      differences on a given day but showed no consistent differences over the course
      of many days. In general, the amount of macular pigment measured for one eye was
      found to be essentially the same as that for the other eye. When measurements
      were averaged for the two eyes of each subject, significant differences in
      macular pigment density among subjects were found.

PMID- 1740366
TI  - Total retinal volumetric blood flow rate in diabetic patients with poor glycemic
      control.
AB  - Total retinal volumetric blood flow rate was measured in 12 normal subjects and
      18 poorly controlled diabetic patients with background diabetic retinopathy.
      Maximum or center-line erythrocyte velocity (Vmax) was assessed by bidirectional
      laser Doppler velocimetry in four to five major retinal veins of one eye of each
      subject. Venous diameter (D) was measured from monochromatic fundus photographs.
      Total venous cross-section and measured total retinal volumetric blood flow in
      the diabetic patients were significantly larger than normal (P = 0.001 and P =
      0.02, respectively). A positive linear correlation was found between Vmax and D
      in normal and diabetic eyes. Volumetric blood flow rate, Q, varied with D at a
      power of 2.87 in normal eyes. Total volumetric blood flow correlated with total
      venous cross-section. It was found that Q in the temporal retina was
      significantly larger than in the nasal retina in normal subjects (P = 0.0008) and
      diabetic patients (P = 0.0002). A significant difference in Q was observed
      between the superior and inferior retina in diabetic patients (P = 0.03) but not
      in normal subjects. The retinal vascular regulatory response to 100% oxygen
      breathing was reduced (P = 0.019) in diabetic patients and correlated with the
      level of background diabetic retinopathy. A close estimate of total volumetric
      blood flow may be obtained from blood flow measurement in one major retinal vein
      and the determination of total venous cross-section. This may be important for
      clinical studies in which measurements of all individual retinal veins may not be
      feasible.

PMID- 1740367
TI  - Xyloside-induced disruption of interphotoreceptor matrix proteoglycans results in
      retinal detachment.
AB  - Unique domains of the retinal interphotoreceptor matrix (IPM), termed cone matrix
      sheaths, are composed largely of chondroitin 6-sulfate proteoglycan in most
      higher mammalian species. Recent investigations suggest that cone matrix sheaths
      participate in the maintenance of normal retinal attachment. To investigate the
      potential functional roles of IPM proteoglycans further, the synthesis of cone
      matrix sheath chondroitin 6-sulfate proteoglycan was perturbed in vivo.
      Intravitreal injections of p-nitrophenyl-beta-D-xylopyranoside (xyloside), a
      sugar that inhibits chondroitin sulfate proteoglycan synthesis, were administered
      to Yucatan micropigs. Their eyes were examined funduscopically and
      electroretinographically. At selected times, the eyes were enucleated and
      examined histochemically and immunohistochemically with various probes directed
      against cone photoreceptor cells and cone matrix sheaths. The IPM was affected
      selectively after xyloside administration; no inner retinal pathology or
      dysfunction was detected morphologically or electroretinographically. The degree
      of xyloside-induced perturbation was dependent on the duration of xyloside
      exposure and dose. It was classified into three stages, based on morphologic and
      histochemical criteria. Although all three stages could be observed in a given
      retina, a single stage typically predominated, depending on the particular dosage
      regimen. The early stage was characterized by IPM disruption, as evidenced by
      disorganization of chondroitin 6-sulfate and peanut agglutinin (PNA)-binding
      glycoconjugates. Cone photoreceptor cell outer segment degeneration and markedly
      decreased chondroitin 6-sulfate immunoreactivity distinguished the middle stage.
      During the late stage, there was a near complete absence of both immunoreactive
      chondroitin 6-sulfate and PNA-binding glycoconjugates in the IPM. Shallow retinal
      detachments that appeared funduscopically as patches of retinal whitening
      frequently were observed after moderate durations of xyloside exposure; these
      progressed peripherally with continued xyloside exposure. Histologically, the
      areas of retinal whitening corresponded to regions in which cone matrix sheaths
      were split transversely (ie, in a plane perpendicular to the longitudinal axes of
      the photoreceptor cell outer segments) or were separated completely from cone
      outer segments. Similar effects were not observed in control eyes. These results
      suggest that adhesion between the neural retina and retinal pigmented epithelium
      may be dependent, in part, on continuous synthesis of cone matrix sheath
      associated proteoglycans and, potentially, other IPM proteoglycans. In addition,
      these proteoglycans appear to be necessary for the maintenance of cone
      photoreceptor cell outer segment integrity.

PMID- 1740368
TI  - Ultracytochemical localization of the erythrocyte/HepG2-type glucose transporter
      (GLUT1) in cells of the blood-retinal barrier in the rat.
AB  - The blood-retinal barrier is part of the blood-ocular barrier. Retinal pigment
      epithelial cells connected by tight junctions serve as an outer blood-retinal
      barrier, and the nonfenestrated endothelial cells of blood vessels sealed by
      tight junctions serve as an inner blood-retinal barrier. Using antibodies
      specific for the erythrocyte/HepG2-type glucose transporter (GLUT1), one isoform
      of facilitated-diffusion glucose transporters, it was found, by ultrastructural
      cytochemical examination, that GLUT1 in the rat was localized at both the apical
      and basolateral plasma membranes of retinal pigment epithelial cells. The
      fenestrated endothelial cells of the underlying choriocapillaries were negative
      for GLUT1. In the inner retina, GLUT1 was found at both the luminal and
      contraluminal plasma membranes of endothelial cells. These observations show that
      GLUT1 is concentrated at the critical plasma membranes of the blood-retinal
      barrier and may serve as the machinery for glucose transport across the barrier.

PMID- 1740369
TI  - Ocular infection with a murine neurovirulent retrovirus does not cause retinal
      degeneration.
AB  - The developing eyes of CFW/D mice inoculated at birth with a neurovirulent mutant
      (ts1) of Moloney murine leukemia virus (MoMuLV), nonneurovirulent wild type (wt)
      MoMuLV, and conditioned virus-free medium were studied comparatively by
      immunohistochemistry, lectin histochemistry and light microscopy. Cellular
      targets for viral antigen expression in the eye were identical in both ts1 and wt
      MoMuLV-infected mice. Viral antigen first was observed in endothelial cells of
      the retina and subsequently spread in a spatial and temporal pattern consistent
      with normal vascularization of the developing retina. The virus also was observed
      in (1) epithelial cells of the bulbar and palpebral conjunctiva, ora ciliaris
      retinae, and lacrimal gland; (2) endothelial cells of the ciliary body, iris,
      choroid, and sclera; (3) amacrine cells of the retina; and (4) smooth muscle
      cells and endothelia of the periocular muscle. Although ts1 MoMuLV induced a
      spongiform encephalopathy in the brain and spinal cord, structural lesions were
      not observed in the retina or other ts1 MoMuLV-infected ocular structures;
      differentiation of the retina was normal. The lectin Ricinus communis agglutinin
      I (RCA-I) labeled (1) endothelial cells of the hyaloid vessels, tunica vasculosa
      lentis, retina, ciliary body, iris, choroid, and sclera; (2) epithelial cells of
      the cornea, bulbar and palpebral conjunctiva, ora ciliaris retinae, and lacrimal
      gland; (3) smooth muscle cells and endothelia of the periocular muscle; (4) inner
      segments of the photoreceptor layer; and (5) amacrine cells of the
      retina.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740370
TI  - Electrode comparison in pattern electroretinography.
AB  - In recent years, there has been great interest in recording the pattern
      electroretinogram (PERG) in glaucomatous and diabetic populations. The Dawson,
      Trick, and Litzkow thread electrode (DTLTE) and the gold foil electrode (GFE),
      commonly used for recording PERGs, were compared for variations in amplitude of
      response, test-retest variability, and patient comfort. Two study centers
      collected data on a total of 32 normal subjects. The subjects from the London
      center showed a slight (but not significant) preference for the DTLTE, and the
      Houston subjects also found the DTLTE to be significantly more comfortable (chi
      square = 39, P less than 0.001). In both study groups, the GFE was found to
      produce a statistically larger amplitude of response than that obtained with the
      DTLTE. Significant differences were found regardless of the slow (transient, 3.1
      Hz; F = 6.24; P = 0.0192) or fast (steady state, 8.3 Hz; F = 18.38; P = 0.0001)
      stimulus-presentation rate. Larger differences between the two electrodes
      occurred under steady-state conditions. Although there is no consensus as to the
      optimum recording conditions to obtain the subtle PERG, it appears the the GFE
      records larger responses than the DTLTE. However, test-retest data confirmed that
      the GFE records twice the amplitude of the DTLTE, and it also produced twice the
      variability (average percent difference over time for GFE, 15%; for DTLTE, 8%).

PMID- 1740371
TI  - Boron neutron capture therapy of anterior chamber melanoma with p
      boronophenylalanine.
AB  - Boron neutron capture therapy (BNCT) is a form of radiation therapy that requires
      selective uptake of boron by the tumor and irradiation with thermal neutrons.
      Phenylalanine is an amino acid precursor of melanin and when boronated (p
      boronophenylalanine [BPA]) was found to be selectively taken up by Greene
      melanoma cells in the anterior chamber of rabbits. This tumor model was
      irradiated 24 hr after oral administration of BPA and was used for
      biodistribution studies that compared BPA and sodium pentaborate. Three groups
      were irradiated: group 1 (11 rabbits) received BPA followed by thermal neutron
      irradiation, group 2 (9 rabbits) received thermal neutron irradiation only, and
      group 3 (9 rabbits) served as unirradiated, undrugged control animals. Eight of
      the 11 tumors in group 1 were treated successfully; all tumors in groups 2 and 3
      grew. Histopathologic examination did not reveal vascular or retina damage in
      group 1. These preliminary experiments confirm that newer boronated compounds,
      such as BPA, used in BNCT and improved neutron beams can provide selective
      irradiation of ocular melanomas.

PMID- 1740372
TI  - Hyperthermia reduces the occurrence of proliferative vitreoretinopathy in a
      rabbit model.
AB  - The effects of hyperthermia on experimental proliferative vitreoretinopathy (PVR)
      in rabbits were studied. Heat treatment (42.4 degrees C for 30 min) of the
      retinal surface (as estimated from temperature measurement of the retrobulbar
      space) 2 to 3 hr after fibroblast injection reduced the occurrence of traction
      retinal detachment compared with control rabbits (P less than 0.02), but the
      incidence of pucker formation plus traction detachment was not significantly
      different between the two groups. In a separate experiment, heat treatment
      applied to normal rabbit eyes showed only reversible elongation in the latency of
      the electroretinographic b-wave without affecting the amplitude. Histologic
      examination revealed no significant changes in the heat-treated normal rabbit
      retina. Hyperthermia may be used as a new therapeutic tool for PVR.

PMID- 1740373
TI  - In situ measurements of lens fluorescence and its interference with visual
      function.
AB  - Irradiation of the primate lens by near-ultraviolet wavelengths results in a blue
      fluorescence, which can be an intraocular source of veiling glare. This study
      quantitated the fluorescence intensity as a function of exciting intensity and
      wavelength. As the exciting wavelength was increased from 360 to 430 nm, the
      decreasing fluorescence intensity (for equal radiant exposures) was partially
      offset by a shift in the fluorescence spectrum to wavelengths of greater luminous
      efficiency so the luminance of the lens fluorescence remained approximately
      constant. The measured luminance of the lens fluorescence was high enough to
      imply degradation of visual function as a result of reduced contrast of the
      retinal image. To obtain an objective measure of visual deficit associated with
      the fluorescent glare, the visual evoked potential (VEP) elicited by
      counterphased sine-wave gratings was recorded while the subject eye was
      continuously exposed to the 413 nm emission from a krypton laser. The VEP
      amplitude was reduced in the presence of the exciting laser even at levels
      defined as "safe" (ie, where exposure levels are insufficient to induce an acute
      ocular lesion). Because the direct glare effect of the exciting radiation was
      negligible in this experiment, the VEP response loss is attributed to the effect
      of the lens fluorescent glare.

PMID- 1740374
TI  - Effects of pilocarpine and tropicamide on blood-aqueous barrier permeability in
      man.
AB  - The time courses of changes in the effects of topical pilocarpine and tropicamide
      on the index of the blood-aqueous barrier permeability to plasma protein (Pin)
      were determined in normal volunteers. Before and after drug instillation in one
      eye, protein concentration in the anterior chamber (Ca) was determined from
      aqueous flare intensity with a laser flare-cell meter and from aqueous flow by
      fluorophotometry. The Pin was calculated from the Ca, plasma protein
      concentration, and aqueous flow. One percent pilocarpine produced a maximum
      increase of 21 +/- 10% in the Ca (mean +/- SEM, n = 10), no significant change in
      the aqueous flow (n = 5), and a maximum increase of 29 +/- 10% in the Pin (n =
      10). Three percent pilocarpine produced a maximum increase of 55 +/- 11% in the
      Ca (n = 8), a maximum increase of 34 +/- 13% in the aqueous flow (n = 5), and a
      maximum increase of 74 +/- 18% in the Pin (n = 8). Tropicamide (0.4%) produced a
      maximum decrease of 17 +/- 7% in the Ca (n = 8), a maximum decrease of 15 +/- 11%
      in the aqueous flow (n = 8), and a maximum decrease of 24 +/- 13% in the Pin (n =
      8). The results indicated that pilocarpine increased the blood-aqueous barrier
      permeability to plasma protein in a dose-dependent manner and that tropicamide
      reduced it.

PMID- 1740375
TI  - Localization of smooth muscle and nonmuscle actin isoforms in the human aqueous
      outflow pathway.
AB  - alpha-Smooth muscle actin is the isoform of actin restricted to vascular smooth
      muscle, pericytes, myofibroblasts and, certain other cells that are of myoid
      origin. We investigated the distribution of alpha-smooth muscle actin and
      nonmuscle specific filamentous actin in the human aqueous outflow system by
      immunohistochemical methods. Filamentous actin was observed in all cellular
      constituents of the outflow pathway, while distribution of alpha-smooth muscle
      actin was restricted to the ciliary muscle, to specific cells throughout the
      trabecular meshwork, and to cells adjacent to the outer wall and the collector
      channels. The ciliary muscle extended deep into the corneoscleral meshwork, far
      anterior to the scleral spur. These findings agree with our previous study
      localizing the distribution of smooth muscle myosin in the human aqueous outflow
      pathway. Although functionality of the immunoreactive cells needs to be
      demonstrated, our data show that a potentially contractile apparatus exists in a
      subpopulation of trabecular meshwork cells and in certain cells of the more
      distal components of the outflow system.

PMID- 1740376
TI  - Visual evoked potentials after photostress in patients with primary open-angle
      glaucoma and ocular hypertension.
AB  - Visual evoked potentials (VEPs) were assessed in basal condition and after
      photostress in normal subjects, in subjects with ocular hypertension (OHT), and
      in subjects with primary open-angle glaucoma (POAG). The VEPs recorded in basal
      condition showed that in patients with OHT and POAG a latency of the P100 peak
      was higher than in controls. The amplitudes were reduced in POAG patients but not
      in OHT patients. In all eyes, the VEPs recorded 20 s after photostress showed an
      increase in latency and a decrease in amplitude. In the control eyes, the
      functional recovery was complete after 80 s. In the eyes with OHP and in the eyes
      with POAG, the parameters of VEP after photostress underwent greater changes than
      in the control eyes. VEPs were superimposable on the basal condition (recovery
      time) at 73.2 s in OHT patients and at 113.2 s in POAG patients. The longer VEP
      recovery time after photostress observed in OHT and POAG patients could be
      attributed to the reduced functionality of the outer layers or the inner retinal
      layers of the central retina, or both. This test may be useful in the clinical
      evaluation for early diagnosis of glaucoma.

PMID- 1740377
TI  - Apparent accommodation in pseudophakic eyes as measured with visually evoked
      potentials.
AB  - We measured apparent accommodation with pattern reversal visually evoked cortical
      potentials in 27 pseudophakic eyes after the implantation of posterior chamber
      intraocular lenses. The patients ranged in age from 47-83 years. The amplitude of
      accommodation was not significantly different between pseudophakic eyes and
      normal phakic eyes. Apparent accommodation was inversely proportional to the
      pupillary diameter and was significantly correlated with corneal astigmatism. No
      significant relationship was noted between apparent accommodation and age of
      patients, corrected visual acuity, or refractive error.

PMID- 1740378
TI  - Partially deficient glutamate dehydrogenase activity and attenuated oscillatory
      potentials in patients with spinocerebellar degeneration.
AB  - Glutamate dehydrogenase (GDH, EC 1.4.1.2) catalyzes the synthesis and degradation
      of glutamate, an excitatory neurotransmitter in the retina. Recently, two forms
      of GDH, a soluble heat-stable form and a particulate heat-labile form, have been
      demonstrated to be deficient in some types of spinocerebellar degeneration (SCD).
      We measured these forms of GDH activity in leukocyte homogenate from patients
      with SCD (n = 22) and normal subjects (n = 20) who were examined
      ophthalmoscopically and electrophysiologically. Seven patients with SCD showed
      attenuated oscillatory potentials (OPs) on electroretinography. The heat-labile
      GDH activity in these seven patients (78 +/- 51 nmol/mg protein/h) was
      significantly lower than that of 15 patients with normal OPs (367 +/- 189) and
      the normal subjects (397 +/- 1720 (P less than 0.001). Our results indicated that
      patients with SCD could be separated into two groups electrophysiologically, one
      with normal OPs and one with attenuated OPs. Also indicated was that a deficiency
      of heat-labile GDH might affect some functions of neural elements in the retina
      that are responsible for the generation of OPs.

PMID- 1740379
TI  - Comparison of prednisolone and RMI-1068 in the ocular irritative response in
      dogs.
AB  - Ocular inflammation was induced in 36 dogs by performing an anterior capsulotomy
      with a Nd:YAG laser. All dogs were pretreated with topical atropine. Dogs were
      then divided into three groups: (1) control, with no other pretreatment; (2)
      pretreatment with the topical dual cyclooxygenase/lipoxygenase inhibitor RMI
      1068; and (3) pretreatment with topical prednisolone acetate. Dogs were studied 1
      3 hours after lasering. RMI-1068 maintained mydriasis and raised intraocular
      pressure compared to the control and prednisolone groups. An ocular
      fluorophotometer used to measure anterior chamber fluorescence after IV injection
      of sodium fluorescein showed that RMI-1068 decreased anterior chamber fluorescein
      concentration compared to the control and prednisolone groups. RMI-1068 decreased
      PGF2 alpha concentrations in the aqueous at 1 and 3 hours compared to the control
      and prednisolone groups. Prednisolone decreased PGF2 alpha concentrations
      compared to the control group at 1 h. Concentrations of LTB4 in the aqueous at 1
      hour were lower in the RMI-1068 group than in the control and prednisolone
      groups.

PMID- 1740380
TI  - Enhanced induction of a 72 kDa heat shock protein in cultured retroocular
      fibroblasts.
AB  - Fibroblasts in the retroocular connective tissue appear to play a central role in
      the pathogenesis of Graves' ophthalmopathy (GO). We hypothesize that specific
      attributes, differentiating normal from GO retroocular fibroblasts, may render
      the latter more vulnerable to the ongoing immunopathological process in GO. We
      investigated whether GO fibroblasts differ from normal fibroblasts with respect
      to their sensitivity and capacity to express the inducible 72 kDa heat shock
      protein (HSP) in response to stressful environmental stimuli. Cultured
      retroocular fibroblasts derived from patients with GO and normal individuals were
      exposed to various changes in the culture medium that may simulate conditions in
      the affected retroocular space in vivo. HSP 72 reactivity was determined using
      sodium dodecyl sulfate polyacrylamide-gel electrophoresis of cellular extracts,
      followed by immunoblotting with a mouse monoclonal anti-HSP 72 antibody and
      quantitative scanning densitometry. In addition, indirect immunofluorescence was
      performed on parallel fibroblast monolayers. Following exposure to heat and
      acidic pH, deprivation from nutrients, and high monolayer density, GO fibroblasts
      expressed HSP 72 with significantly greater sensitivity and in significantly
      higher abundance than did normal fibroblasts. These results demonstrate that
      changes in the physiological environment induce HSP 72 expression in cultured
      fibroblasts. The enhanced sensitivity and capacity of GO retroocular fibroblasts
      to express the inducible HSP 72 in response to stressful stimuli may play a role
      in the autoimmune process affecting the retroocular space in GO.

PMID- 1740381
TI  - Monoclonal antibody specific for the cellular receptor of echoviruses.
AB  - Cell lines of primate origin carry membrane receptors which are specific for
      echoviruses (EV). The present report describes isolation and characterization of
      a monoclonal antibody (Mab 143) reacting with the membrane of KB cells. The Mab
      was selected for its protection of different cell lines from primate origin
      against the CPE of EV-11. This protection was found to extend to most EV
      serotypes and to coxsackievirus A9, while the replication of several other
      picornaviruses was not affected. The fluorecein isothiocyanate labelled Mab did
      not react with cell lines from bovine, canine, or rabbit origin, but bound
      specifically to the cell lines from human or simian origin. These results suggest
      that a unique receptor site is used by most EV serotypes for binding onto and
      penetration into susceptible cells.

PMID- 1740382
TI  - Properties of the Mentha strain of lychnis ringspot virus.
AB  - A hordeivirus isolated from horsemint (Mentha longifolia Huds.) was designated as
      the mentha strain of lychnis ringspot virus (LRSV-M) on the basis of serological
      relationship with the type strain (LRSV-T) and similarities in nucleotide
      sequence and properties of genomic and replicative RNAs of the two strains. Four
      ssRNAs in addition to the three genomic RNAs were encapsidated by LRSV-M coat
      protein. No genomic sequence similarity was detected between LRSV-M and either
      barley stripe mosaic or poa semilatent viruses under high stringency conditions,
      confirming that the hordeiviruses are a group of morphologically similar, but
      genomically distinct viruses.

PMID- 1740383
TI  - Isolation and characterization of the measles virus strains with low
      hemagglutination activity.
AB  - Six measles virus strains were isolated from clinical specimens. They differed
      from a prototype strain in being incapable to grow in cell lines derived from
      monkey kidney and having a slower electrophoretic mobility of the hemagglutinin
      protein and a very low hemagglutination activity.

PMID- 1740384
TI  - Isolation and characterization of a portal protein-DNA complex from dsDNA
      bacteriophage.
AB  - A portal protein-DNA complex was isolated from bacteriophage disrupted in 70%
      acetic acid. This treatment dissociated most of the phage structural proteins,
      while the portal protein ring remained attached to the highly condensed naked
      DNA. In the absence of a headful of DNA, the portal ring was not protected.
      Purification of the portal ring-DNA complex by density gradient centrifugation
      showed that a dsDNA fragment of about 40 bp was protected from DNase digestion by
      this association, suggesting it was internalized within the 140 A long, 20-40 A
      in diameter T4 apical channel of the ring dodecamer. A portal ring-DNA complex
      could be isolated from a number of phages (T4, T7, Phi29), and the end(s) of
      phage T7 DNA was (were) found to be preferentially associated with the ring
      complex.

PMID- 1740385
TI  - Absence of a gene dosage effect during bacteriophage T3- and T7-coded RNA
      polymerase synthesis.
AB  - The rates of synthesis of phage-coded RNA polymerase upon infection of
      Escherichia coli by bacteriophages T3 or T7 were measured at different MOIs under
      permissive and non-permissive conditions. At MOIs from 1 to 15, these rates did
      not vary appreciably, at MOIs of about 20 there was a slight depression in the
      synthesis rate. The reason for this absence of a positive gene dosage effect is
      unknown.

PMID- 1740386
TI  - Comparison of health expenditures in U.S. and Hawaii economies.

PMID- 1740387
TI  - America's pharmaceutical research companies: keeping the cost of health care
      down. Pharmaceutical Manufacturers Association.

PMID- 1740388
TI  - Hereditary anemias in Hawaii: an update.

PMID- 1740389
TI  - Maintaining the supply and monitoring the quality of the blood bank.

PMID- 1740390
TI  - Does improved depth dose characteristics and treatment planning correlate with a
      gain in therapeutic results? Evidence from past clinical experience using
      conventional radiation sources.
AB  - Experience with the use of external beam conventional radiation over a period of
      several decades has shown that in every instance where there has been a major
      advance in the physical delivery of radiation to the tumor (beam energy and
      characteristics and precise tumor dose delivery) there has been a corresponding
      major improvement in the treatment results. The advent of megavoltage sources
      following the invention and use of Cobalt 60 and medical linear accelerator units
      during the late 1940's and early 1950's and their major impact on tumor control
      and patient survival in solid tumors such as carcinoma of the prostate, Hodgkin's
      Disease, head and neck tumors and cancer of the cervix are being discussed. Most
      recently, the use of computerized tomography and computer systems for treatment
      planning is likely to show a further improvement in the therapeutic results.

PMID- 1740391
TI  - Normal tissue complication probabilities: variable dose per fraction.
AB  - Because of the large amount of data generated by 3D treatment planning, new tools
      are being developed for the evaluation and optimization of the plans. Estimates
      of the probability of local control of the tumor and for the probability of
      specific normal tissue complications are among the new tools. The normal tissue
      complication probability (NTCP) is based on clinical estimates of the tolerance
      doses for specific tissues/organs. These tolerance doses are assumed to apply for
      uniform partial and full volume irradiations delivered at 2 Gy per fraction and 5
      fractions per week. A different tolerance dose may apply when the dose is
      delivered at a different dose per fraction and over a different period of time.
      This study evaluates the maximum change expected in the NTCP when the normal
      structure receives the dose at a different dose per fraction than the target
      volume due to different choices in the delivery of the daily fraction.

PMID- 1740392
TI  - New imaging technologies: prospects for target definition.
AB  - Developments in medical imaging over the past 2 decades are providing significant
      improvement in tumor definition. Improvements in soft tissue visualization with
      tumor specific contrast combined with direct 3D data acquisition and millimetre
      spatial resolution set new standards in tumor definition. Such precision in tumor
      imaging provides a new level of challenge for precision radiation treatment.
      Significant further improvement over the next decade in geographic definition is
      unlikely. The challenge for imaging research is that of extracting tissue
      specific information about tumors such as perfusion and response to therapy
      rather than simply anatomical clarity.

PMID- 1740393
TI  - Charged particle radiotherapy of paraspinal tumors.
AB  - Between 1976 and 1987, 52 patients with tumors adjacent to and/or involving the
      cervical, thoracic, or lumbar spinal cord were treated with charged particles at
      the University of California Lawrence Berkeley Laboratory. The histologies
      included chordoma and chondrosarcoma (24 pts), other bone and soft tissue sarcoma
      (14 pts), and metastatic or unusual histology tumors (14 pts). Radiation doses
      ranged from 29 to 80 Gray-equivalent (GyE), with a median dose of 70 GyE. Twenty
      one patients received a portion of their treatment with photons. Median followup
      was 28 months. For 36 previously untreated patients, local control was achieved
      in 21/36 patients and the 3-year actuarial survival was 61%. Of 16 patients
      treated for recurrent disease, 7/16 were locally controlled and the 3-year
      actuarial survival was 51%. For patients treated for chordoma and chondrosarcoma,
      probability of local control was influenced by tumor volume (less than 100 cc or
      greater than 150 cc) and whether disease was recurrent or previously untreated.
      Complications occurred in 6/52 patients, including one spinal cord injury, one
      cauda equina and one brachial plexus injury, and three instances of skin or
      subcutaneous fibrosis. Charged particle radiotherapy can safely deliver high
      tumor doses to paraspinal tumors with good local control.

PMID- 1740394
TI  - Conformal radiotherapy for unresectable retroperitoneal soft tissue sarcoma.
AB  - Local tumor control remains a continuing challenge in the treatment of
      retroperitoneal soft tissue sarcoma. Though complete resection by means of wide
      excision or excisional biopsy can be performed in a minority of patients only,
      aggressive surgical approach remains the treatment of choice. Unresectable
      sarcoma can rarely be controlled by conventionally applied radiotherapy--only a
      few percent of patients survive. A superior dose distribution of external
      radiation is demanded in order to spare healthy tissue. The presumably greatest
      advantage will occur when radiotherapy is used preoperatively. The possible
      clinical gain of superior dose distribution is demonstrated by results of the
      dynamic, 3-D conformal pion radiotherapy at PSI. Between April 1983 and June 1988
      a total of 21 patients were treated with high doses (greater than or equal to 30
      Gy) for unresectable retroperitoneal soft tissue sarcoma. The follow-up time is
      13-74 months, median 24. Fifteen patients were treated with 20 fx, and 19
      patients were treated with fraction sizes of 150 or 165 cGy. Except for one
      patient with thrombocytopenia after chemotherapy, no treatment interruption was
      necessary. Five patients developed late reactions, caused also by surgery and
      chemotherapy: two intestinal obstructions, one liver abscess, one leg edema, and
      one superficial skin necrosis. Nine patients had laparotomy after pion
      irradiation, five for resection of the previous unresectable tumor; 3/5 sarcoma
      were completely resected. Morbidity rate after post-pion laparotomy did not
      increase. Three patients had local tumor progression, 1/3 inside the treatment
      volume. The actuarial five-year local tumor control rate of these unresectable
      retroperitoneal sarcoma is 60%, the actuarial five-year survival rate is 33%. Out
      of the 21 patients, 15 are alive, two have died from local progression, one from
      peritoneal progression, and three from metastases.

PMID- 1740395
TI  - Potential improvement in the results of irradiation for prostate carcinoma using
      improved dose distribution.
AB  - Results for radiation treatment of prostate carcinoma indicate that nearly one
      third of Stage C patients fail locally. This number will likely increase as
      occult failures are discovered by monitoring serum prostate specific antigen
      levels. Thus, there is need for techniques that would increase the local control
      of prostatic carcinoma. Using cross-sectional imaging and 3-dimensional treatment
      planning, dose distributions for photon irradiation can be created that conform
      more closely to the shape of the prostate and seminal vesicles, sparing
      additional dose to portions of bladder and rectum. A dose escalation trial is
      underway to investigate whether these techniques will lead to increased local
      control without unacceptable increases in bladder and rectal complications. While
      zero local failures is probably an unattainable goal, reduction in local failure
      in prostate cancer would likely increase the overall cure rate in this disease.

PMID- 1740396
TI  - The proton treatment center at Loma Linda University Medical Center: rationale
      for and description of its development.
AB  - Proton radiation, a continuation of radiation oncology's historic search for an
      optimum dose distribution, offers superior characteristics for clinical radiation
      therapy. A complete facility for clinical proton radiation therapy has been
      designed for and constructed at Loma Linda University Medical Center. To bring
      about this achievement, a consortium of engineers, physicists, and physicians
      interested in the clinical applications of protons was necessary. The
      accelerator, the beam transport and delivery systems, the building, and the
      personnel who operate the system were all brought together to fully exploit the
      properties of protons for patient treatments, which are now underway.

PMID- 1740397
TI  - Three dimensional vector analysis of the spatial components and voltage
      magnitudes of the P300 response during different attentional states and stimulus
      modalities.
AB  - The spatial orientation and vector magnitude of the P300 event related potential
      (ERP) were investigated under both passive and active attentional states using
      stimuli presented to two sensory modalities. Three orthogonal electrode pairs
      were used to establish a tri-axial reference frame. By combining the separate
      single channel data recordings into a Cartisian coordinate system, both the
      spatial orientation and the vector magnitude of the P300 response could be
      derived and described as a hypothetical dipole. Results suggested that changes in
      amplitudes, recorded with individual electrode pairs, can be attributed largely
      to changes in the spatial orientation of a rotating P300 response dipole, and not
      simply to the altered magnitude of the response. The combined-axes P300 response
      occurs in two separate spatial domains, depending on stimulus modality and
      attentional state.

PMID- 1740398
TI  - The influence of monocular viewing on heart period variability.
AB  - Monocular viewing seems to differentially activate the cerebral hemispheres.
      Viewing with only one eye is accompanied by a relatively greater activation of
      the contralateral hemisphere. In this study heart periods were measured during
      binocular, left and right monocular viewing in 29 right-handed males. Power
      spectral analysis of heart period variability showed that the amount of heart
      rate fluctuations in the 0.07-0.13 Hz frequency range (the mid-frequency peak of
      the spectrum) depends on the viewing eye. Only viewing with the left eye produced
      a significant increase of the mid-frequency peak. It is known that sympathetic
      activity contributes strongly to the mid-frequency component of the heart rate.
      Therefore, it is concluded that the effects of left monocular viewing result in
      an increased sympathetic influence on the sinoatrial node.

PMID- 1740399
TI  - Psychophysiological indices of cerebral maturation.
AB  - Maturation (1-21 yr) trajectories for quantitative electroencephalographic (QEEG)
      frequency spectra are presented for four regions of the human brain. The results
      show that all four regions exhibited discontinuous maturation rates: five stages
      were identified. The stages were synchronous across regions during the first 10
      1/2 years of life. Thereafter, the four maturation trajectories became
      independent of one another. Interestingly, a major maturational advance was
      recorded from the frontal regions, during late adolescence. The relationships
      between these findings to maturation rates in skull volume, cortical thickness,
      cortical volume and nerve cell density measurements was discussed. These
      converging results indicate that the observed QEEG stages can reliably be
      interpreted as landmarks in cerebral maturation.

PMID- 1740400
TI  - Thinking with images or thinking with language: a pilot EEG probability mapping
      study.
AB  - This pilot EEG mapping study was designed to explore thinking processes using
      complex mental imagery and thought processes. EEG was recorded with 19 electrodes
      (10/20 system against averaged ear lobe signals) while volunteers (n = 42)
      performed two separate tasks: visualization of an abstract concept and
      interpretation of a painting. Average spectral parameters such as amplitude,
      local and interhemispheric coherences were computed for five frequency bands
      (theta, alpha, beta 1, 2 and 3). Results indicate that the frontal regions are
      strongly involved during these tasks as evidenced by coherence changes. Changes
      are also present in temporal, parietal and occipital regions and are discussed in
      relation to information processing with the frontal regions considering the
      different cognitive functions required by the tasks.

PMID- 1740401
TI  - Stimulus rise time, intensity and the elicitation of unconditioned cardiac and
      electrodermal responses.
AB  - In recent discussions on the differentiation of orienting, startle and defense
      responses, the importance of stimulus rise time for the elicitation of different
      cardiac response patterns was re-emphasized. Especially, it has been claimed that
      phasic accelerative heart rate (HR) responses-interpreted as indicators of
      startle-might not only be evoked by auditory stimuli with instantaneous rise
      times and high intensities, but also by low to moderate stimulus intensities with
      sudden onsets. The present study examined this question by manipulating rise time
      (instantaneous vs. 50 ms) and intensity (60 vs. 95 dB). Subjects (N = 120) were
      randomly assigned to one of the four independent groups. They performed a
      habituation experiment in which 12 tones of 1000 Hz with a constant interstimulus
      interval of 90 s were presented. On trial 13, a change in rise time was
      introduced by reversing the rise time condition in each group (i.e., from
      instantaneous to 50 ms and vice versa). Examination of HR changes across 4
      poststimulus seconds, of maximal HR deceleration and acceleration, as well as
      examination of magnitude of skin conductance responses (SCRs) indicated clear
      intensity effects. Rise time, on the other hand, had no effects on HR and SC that
      could be interpreted as indicative of startle. Thus, it could neither be observed
      that instantaneous rise time led to stronger accelerative HR responses nor that
      the combination of instantaneous rise time and high intensity elicited anything
      but a dominant accelerative response pattern. These findings were also obtained
      when the first four trials were analyzed separately. As a consequence of stimulus
      change, larger SCRs as well as larger decelerative HR responses were observed
      without, however, being affected by the direction of the change in rise time. In
      sum, the present study suggests that the role attributed to rise time with
      respect to eliciting qualitatively different cardiac response patterns has been
      exaggerated. The consequences for the differentiation of different unconditioned
      responses are briefly addressed.

PMID- 1740402
TI  - The law of initial values: a four factor theory.
AB  - The effects of four factors, measurement error, skewness, floor/ceiling effects,
      and reactivity, on the correlation between change and initial level were studied
      using computer simulations. A total of 24 conditions were simulated: the four
      factors being examined together with variations in the direction of change, level
      of measurement error and/or strength of effect. In each condition ten random
      samples of 50 cases were generated by SPSSX, and compute functions were used to
      model the effects of interest. Three factors were capable of producing a negative
      correlation (the Law of Initial Values, LIV): measurement error, skewness, and
      floor/ceiling effects. Two factors yielded a positive correlation (anti-LIV
      effect): reactivity and skewness. The issue of how to determine which factor is
      operating in a given situation is discussed.

PMID- 1740403
TI  - Identification and standardization of bilateral electrodermal parameters of
      learning abilities and disabilities.
AB  - Data are presented for identified and standardized bilateral electrodermal
      parameters of normal subjects with learning abilities and those with learning
      disabilities during cognitive workload in three different sessions. The
      electrodermal parameters are presented in terms of specific mumhos and represent
      the first identification and standardization of human abilities and disabilities.
      It was found that normal subjects had an electrodermal activity level which
      ranged between 6.5-8.5 mumhos bilaterally. Furthermore, 15 sub-groups of subjects
      with learning disabilities were identified based on their Left and Right
      electrodermal activity levels. They could be grouped under three main categories:
      (1) those subjects with lower than 5.01 mumhos Left and/or Right electrodermal
      activity level; (2) those with higher than 10.1 mumhos Left and/or Right activity
      level; and (3) those with mixed electrodermal activity having lower than 5.01
      mumhos Left and/or Right activity in one session and higher than 10.1 mumhos
      activity in another session. These identified and standardized parameters have
      clinical implications and applications for the electrophysiological evaluation
      and psychophysiological treatment of learning disabilities.

PMID- 1740404
TI  - Responsiveness patterns and handedness differences in bilateral electrodermal
      asymmetry.
AB  - The aim of the present study was to examine the relationship between subjects'
      handedness and electrodermal asymmetry when subjects were divided according to
      their electrodermal Responsiveness Patterns, obtained during a stimulus-free
      period. Skin conductance was bilaterally recorded in a sample of 48 subjects (24
      dextrals and 24 sinistrals) during the performance of two tasks (watching a film
      and listening to neutral tones). Subjects were divided into four groups of 12
      subjects each (dextral right-hand responders, dextral left-hand responders,
      sinistral right-hand responders and sinistral left-hand responders). No
      differences were found between dextral and sinistral subjects. Orientation of
      electrodermal asymmetry in each Responsiveness Patterns remained constant
      throughout the two conditions: right-hand responders showed higher electrodermal
      activity on their right hand, while left-hand responders showed higher
      electrodermal activity on their left hand. In addition, left-hand responders
      showed a slower habituation rate on their left hand than on their right hand,
      whereas right-hand responders showed no significant differences between hands.

PMID- 1740405
TI  - The effects of stress-anxiety and coping styles on heart rate variability.
AB  - This study explored the effects of a naturally occurring stressor on the
      amplitudes of the respiratory sinus arrhythmia and Traube-Hering-Mayer bands of
      the power spectra of cardiac interbeat intervals of 15 Highly Anxious, 15 Truly
      Low Anxious and 15 Repressor women. Interbeat interval samples were obtained from
      4.5 min tachygraph records while the subjects sat quietly 2 weeks before (2W),
      the day before (DB) and 1 week following (WA) their oral comprehensive
      examinations. Subjects also reported their state anxiety on each occasion.
      Repeated measures ANOVA indicated that subjects' state anxiety was greater on the
      DB than on the other two occasions. Heart rates were faster for the DB than for
      the 2W and WA occasions. Truly Low Anxious women had slower heart rates, across
      all occasions, than did Repressors or Highly Anxious women. Although respiratory
      sinus arrhythmia amplitudes did not differ across occasions, RSA amplitudes were
      smaller for individuals with high trait anxiety (Repressors and Highly Anxious)
      than for subjects with low trait anxiety (Truly Low Anxious). Traube-Hering-Mayer
      amplitudes were smaller on the DB than the 2W or WA occasions for all subjects
      and were smaller for Repressors or Highly Anxious women than for Truly Low
      Anxious women across occasions.

PMID- 1740406
TI  - Cardiovascular reactivity assessment: effects of choice of difficulty on
      laboratory task responses.
AB  - This laboratory study of cardiovascular reactivity was designed to examine how a
      choice of difficulty element in a mental arithmetic task would affect
      cardiovascular responses. 20 healthy male subjects were tested on a computer
      controlled mental arithmetic task, designed to standardize performance across
      subjects by keeping constant the proportion of correct responses. This was
      achieved by automatic adjustment of problem difficulty according to ongoing
      performance. Subjects were led to believe that they could take either a
      'difficult' or an 'easy' version of the mental arithmetic task and were asked to
      make a choice; in fact, all subjects were given the same task. Subjects who chose
      the 'difficult' mental arithmetic task (N = 10) showed significantly greater
      increases in myocardial contractility, cardiac output and systolic blood pressure
      during task performance than those who chose 'easy' (N = 10). However, subjects
      who chose 'difficult' were presented with more difficult problems presumably due
      to their exerting greater levels of effort during the task. The differences in
      cardiovascular responses associated with choice of difficulty were absent during
      testing on four subsequent tasks which did not incorporate any choice options
      (reaction-time, speech, mirror trace, cold pressor). These findings are
      interpreted as being provocative, rather than in any way conclusive.
      Nevertheless, they are suggestive of the possibility that choice of difficulty in
      laboratory tasks may be one strategy for improving the ecological validity of
      laboratory reactivity assessment procedures.

PMID- 1740407
TI  - Protein disulfide isomerase. A multifunctional protein resident in the lumen of
      the endoplasmic reticulum.

PMID- 1740408
TI  - Cloning and functional expression of a mammalian Na+/nucleoside cotransporter. A
      member of the SGLT family.
AB  - Complementary DNAs encoding seven different proteins related to the rabbit
      intestinal Na+/glucose cotransporter, SGLT1, were isolated from a rabbit renal
      cDNA library at relatively high stringency. The messages for RK-B to RK-F were
      single mRNA species at 2.3 kilobases (kb) in heart and kidney. The message for RK
      A was 4 kb and was found in brain, lung, intestine, liver, and kidney. RK-I mRNA
      was approximately 3 kb and was found in all tissues tested. The most abundant
      clone, RK-C, constituted nucleotides 66-2150 of the sodium-nucleoside
      cotransporter, SNST1. The 672-amino acid protein encoded by SNST1 is 61%
      identical and 80% similar in sequence to SGLT1. Expression of SNST1c in Xenopus
      oocytes resulted in nucleoside-stimulated 22Na uptake and sodium-dependent
      [3H]uridine uptake. The uptake of [3H]uridine was inhibited by a range of
      nucleosides, including the anti-human immunodeficiency virus drug,
      dideoxycytidine. The results of this study show that there is a family of SGLT1
      related proteins found in a wide variety of tissues and that one of these is a
      Na+/nucleoside cotransporter.

PMID- 1740409
TI  - The cytoplasmic domain of tissue factor is phosphorylated by a protein kinase C
      dependent mechanism.
AB  - Tissue factor (TF) is an integral membrane glycoprotein that serves as a cellular
      receptor and cofactor for the activation of the plasma protease factor VII. TF
      activity in both monocytes and endothelial cells is regulated by various
      cytokines and mitogens, including the protein kinase C (PKC) activator phorbol 12
      myristate 13-acetate (PMA). Three TF constructs (full-length human, a cytoplasmic
      domain deletion mutant, and a human-rat TF chimera), expressed in a human kidney
      cell line, were used to examine the in vivo phosphorylation state of TF after PMA
      treatment. The cytoplasmic domains of both rat and human TF were rapidly
      phosphorylated after cells were treated with 10-100 nM PMA. This response was
      completely abolished by preincubating cells with staurosporine, the potent PKC
      inhibitor, prior to PMA treatment. Localization of the phosphorylation site(s) to
      the cytoplasmic domain was demonstrated using a deletion mutant of TF and by CNBr
      digestion at the single methionine residue (Met-210) in the TF sequence. The rat
      TF cytoplasmic domain was phosphorylated to a higher specific activity than the
      human TF cytoplasmic domain. Phosphoamino acid analysis of the chimeric TF
      revealed both phosphothreonine and phosphoserine, whereas human TF contained only
      phosphoserine. Thus both potential phosphoacceptor sites are phosphorylated in
      the rat TF cytoplasmic domain. Alignment of TF cDNA sequences of mouse, rat,
      rabbit, and man revealed that the phosphoacceptor site (X-S*/T*-P-X, where
      asterisk indicates the phosphorylated residue) in the cytoplasmic domain has been
      conserved through evolution.

PMID- 1740410
TI  - Triiodothyronine (T3) decreases binding to DNA by T3-receptor homodimers but not
      receptor-auxiliary protein heterodimers.
AB  - Thyroid hormone receptors (TRs) are ligand-dependent transcription factors that
      bind to thyroid hormone response elements (TREs) to mediate positive and negative
      regulation of transcription of thyroid hormone-responsive genes. TR binding to
      TREs can be enhanced by interaction with a nuclear protein, triiodothyronine (T3)
      receptor auxiliary protein (TRAP). There are two major isoforms of thyroid
      hormone receptors, TR alpha-1 and TR beta-1, which are encoded on two separate
      genes. We studied the binding of TR alpha-1 and TR beta-1 to several TREs: the
      chick lysozyme TRE (F2), which is positively regulated by T3; rabbit beta-myosin
      heavy chain TRE, which is negatively regulated by T3; and an idealized inverted
      palindrome, TRElap. We demonstrate the formation of homodimers, TR alpha/TR beta
      dimers, and TR/TRAP heterodimers when receptor is bound to these DNA sequences.
      Surprisingly, we found that T3 decreased TR alpha-1 and TR beta-1 homodimer
      binding in a dose-dependent manner to these TREs as well as TR alpha/TR beta
      dimer binding to F2. In contrast, T3 did not affect TR/TRAP heterodimer binding
      to TREs suggesting that this heterodimer may be the stable complex occupying TREs
      in the presence of ligand.

PMID- 1740411
TI  - Fibronectin fragments cause chondrolysis of bovine articular cartilage slices in
      culture.
AB  - Elevated fibronectin (Fn) and Fn fragment concentrations are found in the
      synovial fluid of osteoarthritic and rheumatoid arthritic patients. Fn has been
      shown to affect expression of chondrocytic matrix proteins, and Fn fragments have
      been shown to elevate gene expression of neutral proteinases in synoviocytes. For
      these reasons, we tested the effects of Fn fragments on protease release and
      resultant proteoglycan release from cartilage in serum-free bovine articular
      cartilage explant cultures. We have found that 1 microM amino-terminal 29- and 50
      kDa gelatin-binding Fn fragments caused over a 50-fold enhancement of
      gelatinolytic and collagenolytic proteinase release with a 23-fold enhancement of
      proteoglycan (PG) release. Release was significant at fragment concentrations as
      low as 20 nM. An integrin-binding 140-kDa fragment mixture was the least active
      fragment, whereas native Fn had little activity. The relative activities of the
      fragments correlated with their relative abilities to bind to cartilage. The RGDS
      integrin-recognition peptide also caused release, although sequence mutants did
      not. PG release was blocked by actinomycin D, cycloheximide, and deoxyglucose. Fn
      fragment-mediated PG release was decreased in 10% serum by over 10-fold but was
      still 2-fold greater than in controls. In the presence of insulin-like growth
      factor-1, PG release was as great as without serum. We suggest that Fn fragments,
      as found in diseased synovial fluid, may contribute to protease-mediated damage
      to cartilage.

PMID- 1740412
TI  - Activation of protein kinase C by oleic acid. Determination and analysis of
      inhibition by detergent micelles and physiologic membranes: requirement for free
      oleate.
AB  - Sodium oleate is able to activate soluble protein kinase C (Murakami, K., Chan,
      S. Y., and Routtenberg, A. (1986) J. Biol. Chem. 261, 15424-15429) but is unable
      to activate membrane-bound enzyme (El Touny, S., Khan, W., and Hannun, Y. (1990)
      J. Biol. Chem. 265, 16437-16443). Because physiologic interactions of fatty acids
      with protein kinase C occur in the presence of membranes, the following studies
      were conducted to evaluate the effects of surfaces (detergent micelles or
      platelet membranes) on the activation of protein kinase C by oleate. At
      concentrations at or above the critical micellar concentration (CMC) of Triton X
      100, oleate was present primarily in Triton X-100/oleate-mixed micelles, as
      determined by gel permeation chromatography and equilibrium dialysis binding
      studies. At concentrations slightly below the CMC for Triton X-100, the presence
      of oleate caused the formation of a limited number of mixed micelles. Studies of
      the dose-dependent activation of purified platelet protein kinase C by sodium
      oleate in the presence of different concentrations of Triton X-100 indicated that
      only unbound oleate was able to activate protein kinase C. Platelet protein
      kinase C was resolved into two major isoenzymes (types II (beta) and III (alpha))
      which displayed nearly identical interaction with oleate. Activation of protein
      kinase C by oleate in a physiologic setting employing platelet substrates and
      endogenous platelet protein kinase C was investigated. Oleate potently activated
      protein kinase C in the cytosolic compartment. In platelet homogenates as well as
      in a reconstituted platelet cytosol and membrane system, the dose dependence of
      protein kinase C on oleate showed a significant shift to the right. Approximately
      30% of oleate was associated with platelet cytosol and 70% was associated with
      platelet membranes. Partitioning of oleate into the two platelet compartments
      showed little change with pH, temperature, or duration of incubation. When
      corrected for free oleate concentration, activation of protein kinase C by oleate
      showed identical dose dependence in cytosol and homogenate. Arachidonate, a
      potential physiologic activator of protein kinase C, showed similar behavior as
      oleate although only 30% of arachidonate partitioned into platelet membranes with
      the majority of arachidonate (70%) remaining in the cytosolic fraction.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1740413
TI  - Role of thrombin exosites in inhibition by heparin cofactor II.
AB  - We determined the role of specific thrombin "exosites" in the mechanism of
      inhibition by the plasma serine proteinase inhibitors heparin cofactor II (HC)
      and antithrombin (AT) in the absence and presence of a glycosaminoglycan by
      comparing the inhibition of alpha-thrombin to epsilon- and gamma T-thrombin
      (produced by partial proteolysis of alpha-thrombin by elastase and trypsin,
      respectively). All of the thrombin derivatives were inhibited in a similar manner
      by AT, either in the absence or presence of heparin, which confirmed the
      integrity of both heparin binding abilities and serpin reactivities of epsilon-
      and gamma T-thrombin compared to alpha-thrombin. Antithrombin activities of HC in
      the absence of a glycosaminoglycan with alpha-, epsilon, and gamma T-thrombin
      were similar with rate constants of 3.5, 2.4, and 1.2 x 10(4) M-1 min-1,
      respectively. Interestingly, in the presence of glycosaminoglycans the maximal
      inhibition rate constants by HC with heparin and dermatan sulfate, respectively,
      were as follows: 30.0 x 10(7) and 60.5 x 10(7) for alpha-thrombin, 14.6 x 10(7)
      and 24.3 x 10(7) for epsilon-thrombin, and 0.017 x 10(7) and 0.034 x 10(7) M-1
      min-1 for gamma T-thrombin. A hirudin carboxyl-terminal peptide, which binds to
      anion-binding exosite-I of alpha-thrombin, dramatically reduced alpha-thrombin
      inhibition by HC in the presence of heparin but not in its absence. We analyzed
      our results in relation to the recently determined x-ray structure of D-Phe-Pro
      Arg-chloromethyl ketone-alpha-thrombin (Bode, W., Mayr, I., Baumann, U., Huber,
      R., Stone, S. R., and Hofsteenge, J. (1989) EMBO J. 8, 3467-3475). Our results
      suggest that the beta-loop region of anion-binding exosite-I in alpha-thrombin,
      which is not present in gamma T-thrombin, is essential for the rapid inhibition
      reaction by HC in the presence of a glycosaminoglycan. Therefore, alpha-thrombin
      and its derivatives would be recognized and inhibited differently by HC and AT in
      the presence of a glycosaminoglycan.

PMID- 1740414
TI  - Incorporation of [32P]orthophosphate into long chains of inorganic polyphosphate
      within lysosomes of human fibroblasts.
AB  - When isolated human fibroblast lysosomes are incubated with 4 microM
      [32P]phosphate at pH 7.0, orthophosphate is transported into lysosomes and is
      rapidly incorporated into low and high molecular weight products. We have
      characterized the high molecular weight (HMW) lysosomal material into which
      [32P]phosphate is incorporated and have found it to consist of long chains of
      inorganic polyphosphate based on the following observations. 1) greater than 97%
      of HMW 32P-lysosomal material is converted to [32P]orthophosphate when incubated
      with 1 N HCl for 20 min at 100 degrees C. 2) Incubation of HMW 32P-lysosomal
      material at pH 7.0 and 65 degrees C for 96 h results in the formation of
      [32P]trimetaphosphate, which is known to be produced only from linear chains of
      polyphosphate under these conditions. 3) HMW 32P-lysosomal material is resistant
      to degradation by proteinase K, ribonuclease, and deoxyribonuclease and extracts
      into the aqueous phase during phenol/chloroform extractions. 4) HMW 32P-lysosomal
      material displays heterogeneous mobility on polyacrylamide gels with most chains
      ranging in length from 100 to at least 600 phosphate residues. 5) HMW 32P
      lysosomal material is partially hydrolyzed under alkaline conditions to yield a
      continuous ladder of polyphosphate species differing by one or several residues
      in length on polyacrylamide gels.

PMID- 1740415
TI  - Distinct oxidoresistance phenotype of human T47D cells transfected by rat
      glutathione S-transferase Yc expression vectors.
AB  - We have investigated the role of a glutathione S-transferase (GST) with inherent
      peroxidase activity in the cellular defense against lipid peroxidation and free
      radical-mediated oxidative damage. Stable transfectants of human T47D cells were
      generated which express recombinant rat GST-Yc from a human cytomegalovirus
      promoter-based expression vector. Among several GST-Yc transfectants
      characterized, two of them contained, respectively, 2- and 3-fold higher GST
      activity than parental cells or control transfectants and, respectively, 4-5- and
      8-10-fold higher selenium-independent glutathione peroxidase activity. Cellular
      growth kinetics and rates of [3H]thymidine incorporation showed that both
      transfectants were more resistant to oxidative shocks mediated by cumene
      hydroperoxide or singlet oxygen generated by photosensitized rose bengal than
      were T47D cells and control transfectants. In contrast, a T47D transfectant,
      which expressed high levels of recombinant selenoglutathione peroxidase and
      showed enhanced resistance to cumene hydroperoxide (Mirault, M.-E., Tremblay, A.,
      Beaudoin, N., and Tremblay, M. J. (1991) J. Biol. Chem. 266, 20752-20760), was as
      sensitive as parental cells to singlet oxygen. No difference was found in growth
      sensitivity to 1-h shock treatments with the quinonoid drug daunomycin,
      irrespective of GST-Yc or selenoglutathione peroxidase overexpression in these
      cells.

PMID- 1740416
TI  - Multinuclear NMR studies of intracellular cations in perfused hypertensive rat
      kidney.
AB  - We have investigated hypertension-associated alterations in intracellular cations
      in the kidney by measuring intracellular pH, free Mg2+, free Ca2+, and Na+
      concentrations in perfused normotensive and hypertensive rat (8-14 weeks old)
      kidneys using 31P, 19F, and double quantum-filtered (DQ) 23Na NMR. The effects of
      both anoxia and ischemia on the 23Na DQ signal confirmed its ability to detect
      changes in intracellular Na+. However, there was a sizable contribution of the
      extracellular Na+ to the 23Na DQ signal of the kidney. The intracellular free
      Ca2+ concentration, measured using 19F NMR and 5,5'difluoro-1,2-bis(2
      aminophenoxy)ethane N,N,N',N'-tetraacetic acid, also increased dramatically
      during ischemia; the increase could be partly reversed by reperfusion. No
      significant differences were found between normotensive and hypertensive kidneys
      in the ATP level, intracellular pH, intracellular free Mg2+, and the 23Na DQ
      signal or in the extent of the extracellular contribution to the 23Na DQ signal.
      Oxygen consumption rates were also similar for the normotensive (5.02 +/- 0.46
      mumol of O2/min/g) and hypertensive (5.47 +/- 0.42 mumol O2/min/g) rat kidneys.
      The absence of a significant difference in intracellular pH, Na+ concentration,
      and oxygen consumption between normotensive and hypertensive rat kidneys suggests
      that an alteration in the luminal Na+/H+ antiport activity in hypertension is
      unlikely. However, a highly significant increase (64%, p less than 0.01) in free
      Ca2+ concentration was found in perfused kidneys from hypertensive rats (557 +/-
      48 nM, blood pressure = 199 +/- 5 mmHg, n = 6) compared with normotensive rats
      (339 +/- 21 nM, blood pressure = 134 +/- 6, n = 4) indicating altered renal
      calcium homeostasis in essential hypertension. An increase in intracellular free
      Ca2+ concentration without an accompanying change in the intracellular Na+
      suggests, among many possibilities, that the Ca2+/Mg(2+)-ATPase may be inhibited
      in the hypertensive renal tissue.

PMID- 1740417
TI  - Point mutational analysis of the hamster dihydrofolate reductase minimum
      promoter.
AB  - We have shown previously that 48 base pairs (bp) of 5'-flanking sequence are
      necessary for correct initiation at the major transcriptional start site of the
      Chinese hamster dihydrofolate reductase (dhfr) gene (Ciudad et al., 1988). As an
      upstream element, this sequence alone confers 25% of maximum promoter activity.
      The 5' half of this sequence is particularly well conserved among mammalian
      species; it contains one Sp1 binding site (GC box) and one CAA element. In the
      present work, we have analyzed the role of this region by extensive point
      mutational analysis. Twenty-three dhfr minigene constructs containing 1- or 2
      base substitutions in this region of the promoter were tested by measuring their
      ability to transfect DHFR-deficient Chinese hamster ovary cells to a DHFR+ growth
      phenotype. Eight mutants, all in or near the GC box, exhibited reduced
      transfection efficiency. Promoter disfunction in these mutants was confirmed by
      RNase protection analysis of stable transfectants. Gel retardation experiments
      showed that mutants affected in the consensus sequence for Sp1 binding were
      deficient in binding a protein found in nuclear extracts of Chinese hamster ovary
      cells. Purified human transcription factor Sp1 was also unable to bind a promoter
      sequence bearing one of these single base substitutions, suggesting that Sp1
      itself is involved in dhfr transcription in vivo. We conclude that most single
      base mutations in the GC box severely cripple or eliminate promoter function by
      inhibiting binding of transcription factors to this regulatory sequence and that
      Sp1 is likely to be involved in dhfr transcription in vivo. We also found that
      the well conserved CAA element is not absolutely necessary for transcription.

PMID- 1740418
TI  - Epidermal growth factor enhances a microsomal 12-lipoxygenase activity in A431
      cells.
AB  - 12-Hydroxyeicosatetraenoic acid (12-HETE) is formed from arachidonic acid either
      by 12-lipoxygenase or by a cytochrome P450 monooxygenase. 12-Lipoxygenase is
      generally localized in the soluble cytosolic fraction, and the cytochrome P450
      monooxygenase is a microsomal enzyme. In this study, 12-HETE biosynthesis and the
      regulation of 12-HETE biosynthesis by epidermal growth factor (EGF) in A431 cells
      were investigated. 12-HETE was biosynthesized from arachidonic acid by the
      microsomal fraction of A431 cells, but not by the cytosolic fraction. The
      formation of 12-HETE was inhibited by 5,8,11,14-eicosatetraynoic acid,
      nordihydroguaiaretic acid, and caffeic acid. Nordihydroguaiaretic acid at 10(-4)
      M and 5,8,11,14-eicosatetraynoic acid at 10(-5) M almost completely inhibited its
      formation. However, the formation of 12-HETE was not affected by the presence of
      an NADPH-generating system, carbon monoxide, or SKF 525A. The biosynthetic 12
      HETE was analyzed by chiral stationary phase high performance liquid
      chromatography and was highly enriched in (12S)-HETE. We therefore concluded that
      the enzyme responsible for the formation of (12S)-HETE in the microsomes of A431
      cells is a 12-lipoxygenase. The microsomal 12-lipoxygenase of A431 cells belongs
      to the "leukocyte-type" enzyme as determined by substrate specificity and enzyme
      kinetics studies. The microsomal 12-lipoxygenase oxygenated linoleic acid much
      faster than the cytosolic platelet 12-lipoxygenase and is a "self-catalyzed
      inactivation" enzyme. Treatment of cells with 50 ng/ml EGF significantly induced
      microsomal 12-lipoxygenase activity. The lag period for the expression of the
      stimulatory effect of EGF on 12-lipoxygenase activity was approximately 10 h. The
      stimulatory effect of EGF on 12-lipoxygenase activity was completely blocked by
      treatment with 35 microM cycloheximide, indicating a requirement for de novo
      protein biosynthesis. Furthermore, the presence of the endogenous inhibitor of 12
      lipoxygenase (which masked (12S)-HETE biosynthesis in intact cells) was
      identified in the cytosolic fraction of A431 cells. The putative inhibitor was
      enzyme-selective. It inhibited the leukocyte-type 12-lipoxygenase, but not the
      "platelet-type" enzyme.

PMID- 1740419
TI  - Ionic interactions in the nitrogenase complex. Properties of Fe-protein
      containing substitutions for Arg-100.
AB  - A series of Azotobacter vinelandii strains have been constructed in which the
      nitrogenase Fe-protein (Av2) was altered by substitutions for Arg-100. This
      invariant residue is a likely partner in a salt bridge with the MoFe-protein and,
      in some species, is the site of reversible regulation by ADP-ribosylation (Pope,
      M. R., Murrell, S. A., and Ludden, P. W. (1985) Proc. Natl. Acad. Sci. U. S. A.
      82, 3173-3177). Although we find that arginine is the optimum amino acid, other
      residues in this position could support diazotrophic growth. These results were
      surprising because Klebsiella pneumoniae Fe-protein substituted by His-100 had
      been reported to be inactive (Lowery, R. G., Chang, C. L., Davis, L. C., McKenna,
      M.-C., Stevens, P. J., and Ludden, P. W. (1989) Biochemistry 28, 1206-1212). Two
      altered Fe-proteins (Av2-R100Y, the tyrosyl form, and Av2-R100H, the histidyl
      form) were isolated and, in contrast to this earlier report, we found that both
      had some activity in acetylene reduction. However, both altered proteins
      exhibited a decreased maximum velocity (35 and 3% of wild type, respectively) and
      were strongly inhibited by excess MoFe-protein. These adverse activity parameters
      were also manifest in the increased sensitivity of the altered proteins to
      inhibition by salts. Indeed, the salt sensitivity of Av2-R100H is so significant
      that its activity is masked in the normal assay and is easily missed. In
      addition, for Av2-R100H, substrate reduction is substantially uncoupled from
      MgATP hydrolysis. These results suggest that substitutions for Arg-100 may
      decrease the affinity of the Fe-protein for the MoFe-protein prior to electron
      transfer but increase affinity after electron transfer. Hence, the role of Arg
      100 may be to provide the optimum balance in stabilities of these two complexes
      for maximum efficiency in substrate reduction.

PMID- 1740420
TI  - Incorporation and distribution of epoxyeicosatrienoic acids into cellular
      phospholipids.
AB  - The different regioisomers of epoxyeicosatrienoic acids derived from cytochrome P
      450 monooxygenase are readily esterified into phospholipids of mastocytoma cells.
      Incorporation of 14,15-epoxyeicosatrienoic acid was concentration-dependent, with
      Km = 1.1 microM and Vmax = 36 pmol/min/10(7) cells. Half-maximal incorporation
      occurred in 30 min, reaching a steady-state concentration of 470 pmol/10(6)
      cells. This was slightly lower than the values for arachidonic acid (665
      pmol/10(6) cells) or 5-hydroxyeicosatetraenoic acid (554 pmol/10(6) cells). The
      distribution of 14,15-epoxyeicosatrienoic acid was preferential in the order
      phosphatidylethanolamine greater than phosphatidylcholine greater than
      phosphatidylinositol greater than phosphatidyl serine much greater than neutral
      lipids plus fatty acids. This contrasted with 5(S)-hydroxyeicosatetraenoic acid,
      which was distributed primarily into phosphatidylcholine. Fast atom
      bombardment/tandem mass spectrometry facilitated identification of molecular
      species containing epoxyeicosatrienoic acids without relying on radioisotopes.
      Phosphatidylethanolamine plasmalogens with 16:1 or 18:2 at the sn-1 position, or
      an 18:0 acyl group, and phosphatidylcholine with 16:0 alkyl ether or an acyl
      group at the sn-1 position incorporated all possible epoxyeicosatrienoic acid
      regioisomers. Under basal conditions, cells eliminated 14,15-cis
      epoxyeicosatrienoic acid slowly with a half-life of 34.9 +/- 7 h. Cells
      stimulated with calcium ionophore A23187 eliminated 14,15-epoxyeicosatrienoic
      acid rapidly. It was notable that its rate of release from phosphatidylcholine
      and phosphatidylinositol exceeded that for arachidonic acid. A coenzyme A
      independent transacylase also catalyzed the transfer of epoxyeicosatrienoic acids
      from mastocytoma cell membranes into 1-palmitoyl-2-lysophosphatidylcholine. The
      cellular incorporation, release, and distribution of epoxyeicosatrienoic acids is
      distinctive and contrasts with most other eicosanoids, suggesting that these
      compounds may have both autocoid and nonautocoid functions.

PMID- 1740421
TI  - Natural bovine osteogenin and recombinant human bone morphogenetic protein-2B are
      equipotent in the maintenance of proteoglycans in bovine articular cartilage
      explant cultures.
AB  - Osteogenin and related bone morphogenetic proteins are members of the
      transforming growth factor-beta superfamily, and were isolated by their ability
      to induce cartilage and bone formation in vivo. The influence of osteogenin,
      purified from bovine bone, and of recombinant human bone morphogenetic protein-2B
      (BMP-2B) has been examined in bovine articular cartilage explants. Both
      differentiation factors stimulated in a dose-dependent manner the synthesis of
      proteoglycans and decreased their rate of degradation. At a dose of 30 ng/ml,
      proteoglycan synthesis was increased to levels observed with either 20 ng/ml
      insulin-like growth factor I, 10 ng/ml transforming growth factor-beta, or 20%
      fetal bovine serum. This increase of biosynthetic rates above basal medium levels
      was observed in young, adolescent, and adult tissues. Analysis of the size of the
      newly synthesized proteoglycans, the glycosaminoglycan chain size, and the
      glycosaminoglycan type of explants treated with osteogenin or BMP-2B were very
      comparable to each other, and to proteoglycans isolated from cartilage treated
      with either insulin-like growth factor I or fetal bovine serum. These results
      demonstrate that osteogenin and BMP-2B alone are capable of stimulating and
      maintaining the chondrocyte phenotype in vitro.

PMID- 1740422
TI  - Domain 3 of kininogens contains a cell-binding site and a site that modifies
      thrombin activation of platelets.
AB  - High and low molecular weight kininogens (HK and LK) are able to bind to
      platelets to inhibit thrombin binding to and activation of platelets. The heavy
      chain domain on the kininogens that contains these functions has been determined.
      Domain 3 (D3) but not domains 1 or 2, completely inhibited 125I-HK binding to
      platelets (Ki = 24 +/- 7 nM, n = 4). 125I-D3 specifically bound to unstimulated
      platelets and human umbilical vein endothelial cells. On platelets, it was
      blocked by unlabeled D3 and HK but not prekallikrein, factor XII, C1s, or C1
      inhibitor. Further, one monoclonal antibody (HKH13) directed to kininogens' D3
      blocked 125I-HK and 125I-D3 binding to platelets. The binding of 125I-D3 to
      platelets was fully reversible by addition of 35 molar excess of unlabeled D3. D3
      binding to platelets was saturable with an apparent Kd of 39 +/- 8 nM (n = 4) and
      1227 +/- 404 binding sites/platelet. D3, like HK and LK, inhibited thrombin
      induced platelet activation by preventing thrombin binding to platelets. Another
      monoclonal antibody (HKH12), directed to D3, which did not block HK binding to
      platelets, reduced HK's ability to inhibit 125I-alpha-thrombin binding. This
      result suggests that the region on D3 that inhibits 125I-alpha-thrombin binding
      to platelets is different from that which directly binds to platelets. These
      studies indicate that D3 of the kininogens contains both a binding region for
      platelets and endothelial cells and another region that inhibits thrombin-induced
      platelet activation.

PMID- 1740423
TI  - In vivo mutational analysis of the NGFI-A zinc fingers.
AB  - NGFI-A is a mammalian transcription factor that contains zinc fingers similar to
      those observed in several other proteins, including NGFI-C and Krox-20. To define
      precisely the DNA binding domain of NGFI-A, we selected mutants using a chimeric
      transcriptional activator that contains the NGFI-A zinc finger domain sandwiched
      between the lexA DNA binding domain and the GAL4 transcriptional activating
      domain. Expression of this lexA-NGFI-A-GAL4 (LAG) trimeric protein in yeast
      significantly retarded their growth, unlike an activator containing only the lexA
      and GAL4 components. This suggested that LAG inappropriately regulates genes in
      yeast that contain NGFI-A binding sites. Yeast that contained LAG reverted to
      wild-type growth at high frequency by inactivation of LAG. The mutations
      recovered from these revertants were specifically limited to the 83-residue NGFI
      A zinc finger domain by requiring that the lexA and GAL4 portions of the LAG
      chimera remain functional. Nearly all of the 93 mutants obtained contained single
      missense mutations that mapped within the zinc fingers to residues thought to be
      important for zinc finger function. Deletion analysis of native NGFI-A verified
      that residues distant from the zinc fingers do not influence DNA binding, thus
      establishing the minimal functional DNA binding domain. Interestingly, many zinc
      finger residues ascribed specific functions by x-ray crystallography were never
      mutated in yeast, implying that the identity of these residues is not critical.
      Surprisingly, not all of the mutations tested significantly impaired NGFI-A
      specific DNA binding, suggesting that the function of these zinc fingers is more
      diverse than previously recognized.

PMID- 1740424
TI  - Factor IXa enhances reconstitution of factor VIIIa from isolated A2 subunit and
      A1/A3-C1-C2 dimer.
AB  - Heterotrimeric factor VIIIa was reconstituted from isolated A2 subunit and A1/A3
      C1-C2 dimer of thrombin-activated human factor VIII in a reaction that was
      sensitive to pH. Maximal levels of reconstituted factor VIIIa at pH 6.0 were as
      much as 20-fold greater than were values observed at pH 7.5. The presence of
      factor IXa and phospholipid resulted in a marked increase in factor VIIIa
      reconstituted at physiologic pH. However, the resultant factor VIIIa was unstable
      due to slow proteolysis of the A1 subunit. Factor IXa modified by the active site
      specific reagent dansyl-glutamyl-glycyl-arginyl-chloromethyl ketone (DEGR-IXa)
      increased the level of factor VIIIa reconstituted from subunits to a similar
      extent as was observed for unmodified factor IXa and yielded stable factor VIIIa.
      This enhancement was saturated above a 1:1 molar ratio of DEGR-IXa to factor
      VIIIa subunits and could be blocked by an anti-factor IX antibody, suggesting
      that the DEGR-IXa-dependent increase in factor VIIIa reconstitution correlated
      with assembly of the factor X-ase complex. At a saturating amount of DEGR-IXa,
      the level of factor VIIIa reconstitution at pH 7.5 approached values obtained at
      pH 6.0. Fluorescence polarization measurements indicated that factor VIIIa
      altered binding of DEGR-IXa to phospholipid. However, neither the A2 subunit nor
      the A1/A3-C1-C2 dimer alone produced this effect. This result suggested that both
      A2 and A1/A3-C1-C2 were necessary for association of the cofactor with factor
      IXa. These results suggest a model in which assembly of the intrinsic factor X
      ase complex stabilizes factor VIIIa through inhibition of subunit dissociation.

PMID- 1740425
TI  - Carbonic anhydrase in Escherichia coli. A product of the cyn operon.
AB  - The product of the cynT gene of the cyn operon in Escherichia coli has been
      identified as a carbonic anhydrase. The cyn operon also includes the gene cynS,
      encoding the enzyme cyanase. Cyanase catalyzes the reaction of cyanate with
      bicarbonate to give ammonia and carbon dioxide. The carbonic anhydrase was
      isolated from an Escherichia coli strain overexpressing the cynT gene and
      characterized. The purified enzyme was shown to contain 1 Zn2+/subunit (24 kDa)
      and was found to behave as an oligomer in solution; the presence of bicarbonate
      resulted in partial dissociation of the oligomeric enzyme. The kinetic properties
      of the enzyme are similar to those of carbonic anhydrases from other species,
      including inhibition by sulfonamides and cyanate. The amino acid sequence shows a
      high degree of identity with the sequences of two plant carbonic anhydrases. but
      not with animal and algal carbonic anhydrases. Since carbon dioxide formed in the
      bicarbonate-dependent decomposition of cyanate diffuses out of the cell faster
      than it would be hydrated to bicarbonate, the apparent function of the induced
      carbonic anhydrase is to catalyze hydration of carbon dioxide and thus prevent
      depletion of cellular bicarbonate.

PMID- 1740426
TI  - Shuffling of amino acid sequence: an important control in synthetic peptide
      studies of nucleic acid-binding domains. Binding properties of fragments of a
      conserved eukaryotic RNA binding motif.
AB  - We have used synthetic peptides to study a conserved RNA binding motif in yeast
      poly(A)-binding protein. Two peptides, 45 and 44 amino acids in length,
      corresponding to amino and carboxyl halves of a 90-amino acid RNA-binding domain
      in the protein were synthesized. While the amino-terminal peptide had no
      significant affinity for nucleic acids, the carboxyl-terminal peptide-bound
      nucleic acids with similar characteristics to that for the entire 577 residue
      yeast poly(A)-binding protein. In 100 mM NaCl, the latter peptide retained over
      50% of the intrinsic binding free energy of the protein, as well as, similar RNA
      versus DNA binding specificity. However, shuffling of the sequence of this 44
      residue peptide had surprisingly little effect on its nucleic acid binding
      properties suggesting the overriding importance of amino acid composition as
      opposed to primary sequence. Deletion studies on the 44 residue peptide with the
      "correct" sequence succeeded in identifying amino acids important for conferring
      RNA specificity and for increasing our understanding of the molecular basis for
      nucleic acid binding by synthetic peptides. The shuffled peptide study, however,
      clearly indicates that considerable caution must be exercised before
      extrapolating results of structure/function studies on synthetic peptide
      analogues to the parent protein.

PMID- 1740427
TI  - Carnitine stimulation of glucose oxidation in the fatty acid perfused isolated
      working rat heart.
AB  - The effects of L-carnitine on myocardial glycolysis, glucose oxidation, and
      palmitate oxidation were determined in isolated working rat hearts. Hearts were
      perfused under aerobic conditions with perfusate containing either 11 mM [2-3H/U
      14C]glucose in the presence or absence of 1.2 mM palmitate or 11 mM glucose and
      1.2 mM [1-14C]palmitate. Myocardial carnitine levels were elevated by perfusing
      hearts with 10 mM L-carnitine. A 60-min perfusion period resulted in significant
      increases in total myocardial carnitine from 4376 +/- 211 to 9496 +/- 473 nmol/g
      dry weight. Glycolysis (measured as 3H2O production) was unchanged in carnitine
      treated hearts perfused in the absence of fatty acids (4418 +/- 300 versus 4547
      +/- 600 nmol glucose/g dry weight.min). If 1.2 mM palmitate was present in the
      perfusate, glycolysis decreased almost 2-fold compared with hearts perfused in
      the absence of fatty acids. In carnitine-treated hearts this drop in glycolysis
      did not occur (glycolytic rates were 2911 +/- 231 to 4629 +/- 460 nmol glucose/g
      dry weight.min, in control and carnitine-treated hearts, respectively. Compared
      with control hearts, glucose oxidation rates (measured as 14CO2 production from
      [U-14C]glucose) were unaltered in carnitine-treated hearts perfused in the
      absence of fatty acids (1819 +/- 169 versus 2026 +/- 171 nmol glucose/g dry
      weight.min, respectively). In the presence of 1.2 mM palmitate, glucose oxidation
      decreased dramatically in control hearts (11-fold). In carnitine-treated hearts,
      however, glucose oxidation was significantly greater than control hearts under
      these conditions (158 +/- 21 to 454 +/- 85 nmol glucose/g dry weight.min, in
      control and carnitine-treated hearts, respectively). Palmitate oxidation rates
      (measured as 14CO2 production from [1-14C]palmitate) decreased in the carnitine
      treated hearts from 728 +/- 61 to 572 +/- 111 nmol palmitate/g dry weight.min.
      This probably occurred secondary to an increase in overall ATP production from
      glucose oxidation (from 5.4 to 14.5% of steady state myocardial ATP production).
      The results reported in this study provide direct evidence that carnitine can
      stimulate glucose oxidation in the intact fatty acid perfused heart. This
      probably occurs secondary to facilitating the intramitochondrial transfer of
      acetyl groups from acetyl-CoA to acetylcarnitine, thereby relieving inhibition of
      the pyruvate dehydrogenase complex.

PMID- 1740428
TI  - Analysis of a kinetic model for melanin biosynthesis pathway.
AB  - The kinetic behavior of the melanin biosynthesis pathway from L-tyrosine up to
      dopachrome has been studied from experimental and simulation assays. The reaction
      mechanism proposed is based on a single active site of tyrosinase. The
      diphenolase and monophenolase activities of tyrosinase involve one single
      (oxidase) and two overlapped (hydroxylase and oxidase) catalytic cycles,
      respectively. The stoichiometry of the pathway implies that one molecule of
      tyrosinase must accomplish two turnovers in the hydroxylase cycle for each one in
      the oxidase cycle. Furthermore, the steady-state rates of dopachrome production
      and O2 consumption from tyrosine and L-dopa, also fulfill the stoichiometry of
      the pathway: VO2T/VDCT = 1.5 and VO2T/VDCD = 1.0, where T represents L-tyrosine,
      DC represents dopachrome, and D represents L-dopa. It has been ascertained by
      high performance liquid chromatography that in the steady-state, a quantity of
      dopa is accumulated ([D]ss) which fulfills the constant ratio [D]ss = R[T]0.
      Taking this ratio into account, an analytical expression has been deduced for the
      monophenolase activity of tyrosinase. In this expression kcatT congruent to
      (2/3)k3(K1/K2)R, revealing that kcatT is not a true catalytic constant, since it
      also depends on equilibrium constants and on the experimental R = 0.057. This low
      value explains the lower catalytic efficiency of tyrosinase on tyrosine than on
      dopa, (VmaxT/KmT)/(VmaxD/KmD) congruent to (2/3)R, since a significant portion of
      tyrosinase is scavenged from the catalytic turnover as dead-end complex EmetT in
      the steady-state of the monophenolase activity of tyrosinase.

PMID- 1740429
TI  - Acylpeptide hydrolase: inhibitors and some active site residues of the human
      enzyme.
AB  - Acylpeptide hydrolase may be involved in N-terminal deacetylation of nascent
      polypeptide chains and of bioactive peptides. The activity of this enzyme from
      human erythrocytes is sensitive to anions such as chloride, nitrate, and
      fluoride. Furthermore, blocked amino acids act as competitive inhibitors of the
      enzyme. Acetyl leucine chloromethyl ketone has been employed to identify one
      active site residue as His-707. Diisopropylfluorophosphate has been used to
      identify a second active site residue as Ser-587. Chemical modification studies
      with a water-soluble carbodiimide implicate a carboxyl group in catalytic
      activity. These results and the sequence around these active site residues,
      especially near Ser-587, suggest that acylpeptide hydrolase contains a catalytic
      triad. The presence of a cysteine residue in the vicinity of the active site is
      suggested by the inactivation of the enzyme by sulfhydryl-modifying agents and
      also by a low amount of modification by the peptide chloromethyl ketone
      inhibitor. Ebelactone A, an inhibitor of the formyl aminopeptidase, the bacterial
      counterpart of eukaryotic acylpeptide hydrolase, was found to be an effective
      inhibitor of this enzyme. These findings suggest that acylpeptidase hydrolase is
      a member of a family of enzymes with extremely diverse functions.

PMID- 1740430
TI  - Myocardial triglyceride turnover during reperfusion of isolated rat hearts
      subjected to a transient period of global ischemia.
AB  - Triglyceride turnover in reperfused/ischemic rat hearts was investigated. Hearts
      were initially perfused under aerobic conditions for a 1-h "pulse" perfusion with
      1.2 mM [1-14C]palmitate to label the endogenous lipid pools, followed by a 30-min
      period of no-flow ischemia or a 10-min period of retrograde perfusion (control).
      Hearts were then reperfused under aerobic conditions with buffer containing 1.2
      mM [9,10-3H]palmitate. All buffers contained 11 mM glucose and 500 microunits/ml
      insulin. Rates of endogenous triglyceride lipolysis and synthesis were measured
      during reperfusion, whereas rates of exogenous palmitate oxidation were measured
      both prior to ischemia and during reperfusion following ischemia. During
      reperfusion of ischemic hearts, a 20% increase in exogenous fatty acid oxidation
      rates was seen compared with pre-ischemic rates. Despite an initial burst of
      endogenous fatty acid oxidation, no acceleration of steady state endogenous
      triglyceride lipolysis was seen compared with their nonischemic hearts. In
      contrast, a significant increase in triglyceride synthesis was observed.
      Triglyceride turnover was also measured in a series of hearts reperfused
      following ischemia in the absence of exogenous fatty acids. A significant
      enhancement of functional recovery was seen compared with hearts reperfused with
      1.2 mM palmitate. In addition, a significant increase in fatty acid oxidation
      from endogenous triglyceride lipolysis was observed. We conclude that the heart
      quickly recovers its ability to oxidize exogenous fatty acids during reperfusion
      and that although triglyceride lipolysis is not accelerated during reperfusion of
      ischemic hearts in the presence of 1.2 mM palmitate, a significant increase in
      triglyceride synthesis does occur.

PMID- 1740431
TI  - Active-site structural comparison of streptococcal NADH peroxidase and NADH
      oxidase. Reconstitution with artificial flavins.
AB  - The apoproteins of the streptococcal NADH peroxidase (H2O2----2H2O) and NADH
      oxidase (O2----2H2O) stabilize the neutral forms of 6-hydroxy- and 6-mercapto
      FAD, respectively. The redox behavior of the 6-hydroxy-FAD peroxidase closely
      mimics that of the native enzyme with both dithionite and NADH. Both oxidase and
      peroxidase preferentially stabilize the N(1)-protonated p-quinonoid species of 8
      mercapto-FAD, and the 8-position of the bound flavin is accessible to solvent in
      both proteins. The 8-mercapto-FAD peroxidase yields an EH2 spectrum on reduction
      virtually identical to that seen with 8-mercapto-FAD glutathione reductase, but
      no distinct EH2.NADH form appears. The dramatic decreases in reactivity at the
      flavin 2- and 4-positions for both the peroxidase and the oxidase, assessed with
      the reconstituted 2- and 4-thio-FAD enzymes, suggest that these positions are
      buried by elements of both protein structures. Furthermore, reconstitution of the
      peroxidase with the higher potential 2- and 4-thioflavins yields enzyme forms
      which are fully reducible with 1.4 eq of NADH/FAD, giving rise to stable thio
      FADH2.NAD+ complexes. This behavior closely mimics that of the native NADH
      oxidase and provides further evidence supporting the hypothesis that a major
      functional distinction between the two structurally related proteins is
      determined by the redox potential and/or NADH reactivity of the bound flavin
      coenzyme.

PMID- 1740432
TI  - An analysis of the side chain requirement at position 177 within the lactose
      permease which confers the ability to recognize maltose.
AB  - In previous work (Brooker, R. J., and Wilson, T. H. (1985) Proc. Natl. Acad. Sci.
      U. S. A. 82, 3959-3963), lactose permease mutants were isolated which possessed
      an enhanced recognition for maltose. In some of these mutants, the wild-type
      alanine residue at position 177 was changed to valine or threonine. To gain
      further insight into the side chain requirement at position 177 that confers
      maltose recognition, further substitutions of isoleucine, leucine, phenylalanine,
      proline, and serine have been made via site-directed mutagenesis. Permeases
      containing alanine or serine exhibited poor maltose recognition whereas those
      containing isoleucine, leucine, phenylalanine, proline, or valine showed moderate
      or good recognition. As far as galactosides are concerned, the Val-177, Pro-177,
      and Ser-177 mutants were able to transport lactose as well as, or slightly better
      than, the wild-type strain. The other mutants displayed moderately reduced levels
      of lactose transport. For example, the Phe-177 mutant, which was the most
      defective, showed a level of downhill transport which was approximately 20% that
      of the wild-type strain. In uphill transport assays, all of the position 177
      mutants were markedly defective in their ability to accumulate beta-D
      thiomethylgalactopyranoside against a concentration gradient. Finally, the
      position 177 mutants were analyzed for their ability to catalyze an H+ leak.
      Interestingly, even though the wild-type permease does not leak H+ across the
      bacterial membrane, all of the position 177 mutants were shown to transport H+ in
      the absence of sugars. For most of the mutants, this H+ leak was blocked by the
      addition of beta-D-thiodigalactoside. Overall, these results are discussed with
      regard to the effects of position 177 substitutions on the sugar recognition site
      and H+ transport.

PMID- 1740433
TI  - Identification of novel members of the serum amyloid A protein superfamily as
      constitutive apolipoproteins of high density lipoprotein.
AB  - A novel serum amyloid A protein (SAA) has been identified as a normal
      apolipoprotein component of non-acute phase high density lipoprotein. This novel
      SAA has been designated "constitutive" SAA (C-SAA) to distinguish it from "acute
      phase" SAA (A-SAA). C-SAA was partially sequenced, and immunochemical analyses
      indicated that it constitutes a distinct subclass of apolipoproteins within the
      SAA superfamily. A C-SAA cDNA clone was isolated from a human liver library and
      sequenced. The clone predicts a pre-C-SAA molecule of 130 residues from which an
      18-residue leader peptide is cleaved. The 112-residue mature molecule is 8
      residues longer than human A-SAA; the size difference is due to the presence of
      an octapeptide between positions 70 and 77 that is not found in the corresponding
      region of human A-SAA. Paradoxically, octapeptides of similar composition are
      found at similar positions in the A-SAAs of a number of other species. The C-SAA
      octapeptide specifies the first two residues of a NSS tripeptide, the only
      potential N-linked glycosylation site in the molecule. Studies indicate that
      approximately 50% of these sites are glycosylated, thereby giving rise to two
      size classes, 14 and 19 kDa, of C-SAA in vivo. Human acute phase liver contains
      little C-SAA mRNA relative to the levels of A-SAA mRNA, and the treatment of
      PLC/PRF/5 hepatoma cells with monocyte-conditioned medium does not induce C-SAA
      mRNA concentrations to detectable levels, in contrast to the massive induction of
      A-SAA mRNA observed. C-SAA is therefore not a major acute phase reactant.

PMID- 1740434
TI  - Multiple endoglycosidase (Endo) F activities expressed by Flavobacterium
      meningosepticum. Endo F1: molecular cloning, primary sequence, and structural
      relationship to Endo H.
AB  - A full-length insert for the endo-beta-N-acetylglucosaminidase (Endo) F1 gene was
      located on a 2,200-base pair EcoRI fragment of genomic DNA and cloned into the
      plasmid vector Bluescript. Transformed Escherichia coli cells expressed Endo F1
      activity very well, but the enzyme apparently was not processed and secreted into
      the medium as it normally is in Flavobacterium meningosepticum. DNA sequencing
      revealed an open reading frame of 1,017 nucleotides encoding a putative 50-amino
      acid signal sequence, and a mature protein (31,667 Da) of 289 amino acids. The
      deduced amino acid sequence was verified by direct Edman microsequencing of 88%
      of the purified protein as tryptic and V8 protease peptides. Alignment of Endo F1
      (289 amino acids) with the established amino acid sequence of Streptomyces
      plicatus Endo H (271 amino acids) revealed a 32% structural identity over the
      entire sequence and a high degree of conservative replacements. Potential
      catalytic domains identified in other proteins that hydrolyze the beta 1,4
      glycosidic linkage between N-acetylglucosamine residues are also conserved for
      amino acid identity and relative spacing in Endo F1.

PMID- 1740435
TI  - Expression of rat liver glutamine transporters in Xenopus laevis oocytes.
AB  - As a first step in attempting to isolate the Na(+)-dependent System N transporter
      from rat liver we have investigated the use of prophase-arrested oocytes from
      Xenopus laevis for the functional expression of rat liver glutamine transporters.
      Individual oocytes, defolliculated by collagenase treatment, were injected with
      50 nl of a 1 mg.ml-1 solution of poly(A)+ RNA (mRNA) isolated from rat liver. 50
      microM L-[3H]glutamine uptake was measured 1-5 days post-injection: after 48 h,
      poly(A)+ RNA-injected oocytes showed a 60 +/- 12% increase in Na(+)-dependent
      glutamine uptake compared to controls. This increased uptake showed
      characteristic features of hepatic System N: that is, it tolerated Li(+)-for-Na+
      substitution and was inhibited by the System N substrate L-histidine (5 mM) in Li
      medium, unlike endogenous Na(+)-dependent glutamine transport. In subsequent
      experiments rat liver poly(A)+ RNA, size-fractionated by density gradient
      fractionation, was injected into oocytes. Injection of poly(A)+ RNA of 1.9-2.8
      kilobases (kb) in size resulted in a significant stimulation of Na(+)-dependent
      glutamine transport to 0.362 +/- 0.080 pmol.min-1/oocyte from 0.178 +/- 0.060
      pmol.min-1/oocyte in vehicle-injected oocytes (p less than 0.01). A lighter
      fraction, with poly(A)+ RNA of less than 1.9 kilobases size resulted in a similar
      increase in Na(+)-dependent glutamine uptake which was largely Li(+)-tolerant:
      Li(+)-stimulated glutamine uptake in oocytes injected with this fraction
      increased to 0.230 +/- 0.070 pmol.min-1/oocyte from 0.098 +/- 0.029 pmol.min
      1/oocyte in controls (p less than 0.05). This enhanced rate of Li(+)-stimulated
      glutamine uptake was inhibited 28 and 70%, respectively, by 1 and 5 mM L
      histidine. Na(+)-independent uptake of glutamine rose by 72 +/- 12% in oocytes
      injected with poly(A)+ RNA of 2.8-3.6 kb (p less than 0.001). These results
      demonstrate that glutamine transporters, with characteristics associated with
      hepatic Systems N, L, and A (or ASC), can be expressed in X. laevis oocytes
      injected with specific size fractions of rat liver mRNA.

PMID- 1740436
TI  - Identification of an essential tyrosine residue in the catalytic site of a
      chitinase isolated from Zea mays that is selectively modified during inactivation
      with 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide.
AB  - Chitinase isolated from Zea mays seeds is inactivated by 1-ethyl-3-(3
      dimethylaminopropyl)carbodiimide (EDC) in the absence of exogenous nucleophiles.
      Oligomers of N-acetylglucosamine,N,N',N",N"'-tetra-N-acetylchitotetraose
      (GlcNAc4), and to a lesser extent, N,N',N"-tri-N-acetylchitotriose (GlcNAc3) and
      N,N'-di-N-acetylchitobiose (GlcNAc2) provide partial protection against
      inactivation by the reagent. An examination of the concentration dependence of
      the protection afforded by GlcNAc4 revealed direct competition between the
      substrate analog and the reagent for the same binding sites on the enzyme.
      Isolation and Edman degradation of a "new" tryptic fragment, observed after
      inactivation of chitinase with EDC, revealed the sequence G-P-L-Q-I-S-W-N-*-N-Y-G
      P-A-G-R, where the asterisk represents a cycle in which no amino acid was
      detected, presumably as a consequence of derivatization with EDC. In basic
      chitinases from dicotyledonous plants such as Arabidopsis thaliana, Phaseolis
      vulgaris (bean), Nicotiana tabacum (tobacco), and Solanum tuberosum (potato), as
      well as in the chitinase isolated from the monocotyledonous plant Hordeum vulgare
      (barley), this position is invariably occupied by a tyrosine. However, in the
      Oryza sativa (rice) basic chitinase, this position is occupied by a
      phenylalanine. The following additional evidence supports identification of this
      residue as tyrosine in Z. mays chitinase. (a) Inactivation of chitinase with EDC
      is reversible by treatment with hydroxylamine. (b) Liquid secondary ion mass
      spectrometric analysis of the isolated derivatized peptide revealed the presence
      of a molecular ion with a mass to charge ratio consistent with the peptide
      containing a derivatized tyrosine residue. These results provide evidence for an
      essential tyrosine residue at or near the catalytic site of chitinase that is
      selectively modified during inactivation with EDC.

PMID- 1740437
TI  - Molecular cloning of the major cell surface heparan sulfate proteoglycan from rat
      liver.
AB  - We have used an antiserum raised against a purified heparan sulfate proteoglycan
      (HSPG) preparation isolated from rat liver to screen a lambda gt11 expression
      library and have obtained overlapping cDNA clones that contain the full-length
      coding sequence of an HSPG core protein capable of spanning the plasma membrane.
      The open reading frame of the rat cDNA encodes a protein of 211 amino acids. The
      predicted protein sequence (23 kDa) has a high degree of homology with the
      published partial sequence of the human lung fibroblast HSPG, fibroglycan. The
      deduced protein sequence contains a 24-amino acid transmembrane domain and a 33
      amino acid cytoplasmic domain, both of which are identical with the corresponding
      regions of human fibroglycan and are highly homologous to the human, hamster, and
      mouse epithelial HSPG, syndecan. The putative ectodomain, which has 85% homology
      to fibroglycan, contains three possible glycosaminoglycan attachment sites that
      may be occupied by heparan sulfate chains. The major 49-kDa core protein in the
      liver HSPG preparation was found to be reactive to an antibody that specifically
      recognizes the cytoplasmic domain of fibroglycan. We have used the full-length
      cDNA clone to analyze the expression of this transmembrane core protein gene in
      whole tissues and several epithelial and fibroblastoid cell lines. It hybridizes
      to three mRNA species in all cell and tissue types examined, but in liver,
      isolated hepatocytes, and kidney, an additional 0.8-kilobase mRNA was detected.
      The three common messages arise from differential use of alternative
      polyadenylation sites, whereas the fourth tissue-restricted RNA species
      represents a related gene transcript. The rat equivalent of human fibroglycan
      therefore appears to be the major transmembrane proteoglycan in liver, and its
      widespread expression in many diverse tissues and cells suggests that it plays an
      important role in cellular interactions.

PMID- 1740438
TI  - Sex-specific, growth hormone-regulated transcription of the cytochrome P450 2C11
      and 2C12 genes.
AB  - Growth hormone (GH) differentially regulates the expression of several male
      specific and female-specific liver cytochrome P450 mRNAs as a function of its sex
      dependent ultradian secretory pattern. Pulsatile GH release stimulates expression
      of the male-specific P450 2C11, while a continuous GH secretion pattern
      suppresses expression of 2C11 and stimulates the expression of the female
      specific P450 2C12. To help define the level at which GH regulates the expression
      of 2C11 and 2C12 mRNA, liver nuclear RNA samples isolated from rats differing in
      GH status were analyzed for 2C11 and 2C12 hnRNAs by hybridization to 2C11 and
      2C12 gene-specific exonic oligonucleotide probes, as well as exon/intron junction
      probes. The 2C11 and 2C12 hnRNAs were found to be responsive to circulating GH
      profiles in a manner indistinguishable from the corresponding mature, cytoplasmic
      mRNAs, with no 2C12 mRNA precursors found in untreated male or hypophysectomized
      female liver nuclei, and no 2C11 mRNA precursors in untreated female or
      hypophysectomized male liver nuclei. Thus, transport of 2C11 and 2C12 RNA to the
      cytoplasm and cytoplasmic mRNA stability are unlikely to be important GH
      regulated control points for sex-specific P450 RNA expression. Run-on
      transcription analysis further established that GH regulates the sex-specific
      expression of the 2C11 and 2C12 genes at the level of transcript initiation.
      Transcription was also shown to be the major step for regulation of the male
      specific P450 2A2 RNA, whose expression, unlike 2C11, is not obligatorily
      dependent on pulsatile GH release. In vitro footprinting analysis of 2C11 and
      2C12 promoter fragments incubated with liver nuclear proteins isolated from rats
      differing in GH status revealed several sex- and GH-dependent differences in
      DNase cleavage patterns ("hypersensitivity sites"), demonstrating that GH can
      regulate specific protein-DNA interactions in the 5'-flanking sequences of these
      two genes. In vitro transcription assays driven by 2C11 and 2C12 5'-flanking DNA
      sequences fused to TATAA box-G-less cassette template constructs did not,
      however, faithfully mimic the sex-specific transcription of the 2C11 and 2C12
      genes, indicating that additional cis-elements or trans-acting factors may be
      required to achieve the transcriptional regulation of these genes that occurs in
      vivo.

PMID- 1740439
TI  - Sex-dependent expression and clofibrate inducibility of cytochrome P450 4A fatty
      acid omega-hydroxylases. Male specificity of liver and kidney CYP4A2 mRNA and
      tissue-specific regulation by growth hormone and testosterone.
AB  - The induction of liver cytochrome P450 4A-catalyzed fatty acid omega-hydroxylase
      activity by clofibrate and other peroxisome proliferators has been proposed to be
      causally linked to the ensuing proliferation of peroxisomes in rat liver. Since
      female rats are less responsive than males to peroxisome proliferation induced by
      clofibrate, the influence of gender and hormonal status on the basal and
      clofibrate-inducible expression of the 4A P450s was examined. Northern blot
      analysis using gene-specific oligonucleotide probes revealed that in the liver,
      P450 4A1 and 4A3 mRNAs are induced to a much greater extent in male as compared
      to female rats following clofibrate treatment, whereas P450 4A2 mRNA is
      altogether absent from female rat liver. Male-specific expression of P450 4A2
      mRNA was also observed in kidney. Western blot analysis indicated that a similar
      sex dependence characterizes both the basal expression and the clofibrate
      inducibility of the corresponding P450 4A proteins. This suggests that the lower
      responsiveness of female rats to clofibrate-induced peroxisome proliferation may
      reflect the lower inducibility of the P450 4A fatty acid hydroxylase enzymes in
      this sex. Investigation of the contribution of pituitary-dependent hormones to
      the male-specific expression of 4A2 revealed that this P450 mRNA is fully
      suppressed in liver following exposure to the continuous plasma growth hormone
      profile that characterizes adult female rats; in this and other regards liver
      P450 4A2 is regulated in a manner that is similar, but not identical to, P450
      3A2, a male-specific testosterone 6 beta-hydroxylase. In contrast, kidney 4A2
      expression, although also male-specific, was not suppressed by continuous growth
      hormone treatment, but was regulated by pathways that, in part, involve
      testosterone as a positive regulator. The male-specific expression of liver and
      kidney P450 4A2 is thus under the control of distinct pituitary-dependent
      hormones acting in a tissue-specific manner.

PMID- 1740440
TI  - Myristoylation of proteins in the yeast secretory pathway.
AB  - Protein myristoylation was investigated in the yeast secretory pathway.
      Conditional secretory mutations were used to accumulate inteRmediaries in the
      pathway between the endoplasmic reticulum and Golgi (sec 18, 20), within the
      Golgi (sec 7), and between the Golgi and plasma membrane (sec 1, 3, 4, 5, 6, 8,
      9). The accumulation of vesicles was paralleled by the enrichment of a defined
      subset of proteins modified either via ester or amide linkages to myristic acid:
      Myristoylated proteins of 21, 32, 49, 56, 75, and 136 kDa were enriched between
      the endoplasmic reticulum and Golgi; proteins of 21, 32, 45, 56, 75, 136 kDa were
      enriched by blocks within the Golgi; and proteins of 18, 21, 32, 36, 49, 68, and
      136 kDa were trapped in a myristoylated form by blocks between the Golgi and
      plasma membrane. This enrichment of myristoylated proteins was reversed upon
      returning the cells to the permissive temperature for secretion. The fatty acid
      was linked to the 21-kDa protein via a hydroxylamine-resistant amide linkage (N
      myristoylation) and to the proteins of 24, 32, 49, 56, 68, 136 kDa via
      hydroxylamine-labile ester linkage (E-myristoylation). In addition, myristoylated
      proteins of 21, 56, and 136 kDa were glycosylated via amino linkages to
      asparagine. This suggests they are exposed to the lumen of the secretory pathway.
      Three proteins (24, 32, and 56) were E-myristoylated in the presence of protein
      synthesis inhibitors, indicating this modification can occur posttranslationally.
      After using cycloheximide to clear protein passengers from the secretory pathway
      the 21-, 32-, and 56-kDa proteins continued to accumulate in a myristoylated form
      when vesicular transport was blocked between the Golgi and plasma membrane. These
      data suggest that myristoylation occurs on a component of the secretory machinery
      rather than on a passenger protein.

PMID- 1740441
TI  - Demonstration of a calcium requirement for secretory protein processing and
      export. Differential effects of calcium and dithiothreitol.
AB  - HepG2 cells were employed as model system to investigate potential relationships
      between early protein processing and Ca2+ storage by the endoplasmic reticulum.
      Ca2+ was required for glycoprotein processing and export by intact cells. The
      processing and export of alpha 1-antitrypsin and the secretion of complement
      factor 3, which are glycosylated proteins, were inhibited by the Ca2+ ionophore
      ionomycin whereas the export of albumin, a non-glycoprotein, was little affected.
      Ionomycin blocked processing of alpha 1-antitrypsin at the conversion from the
      high mannose to the complex glycosylated form without affecting ATP or GTP
      contents. Pre-existing inhibition of intracellular processing of alpha 1
      antitrypsin by ionomycin was fully reversible upon removal of the ionophore with
      fatty acid-free bovine serum albumin. This reversal required Ca2+. After reversal
      the arrested form of alpha 1-antitrypsin was fully converted to the mature form
      and exported to the medium. Inhibitions of alpha 1-antitrypsin processing and
      complement factor 3 secretion by the metalloendoprotease antagonist Cbz-Gly-Phe
      NH2 (where Cbz is benzyloxycarbonyl) were strongest at low extracellular Ca2+ but
      were reduced or prevented by high extracellular Ca2+. Processing and secretion of
      alpha 1-antitrypsin were reduced upon incubation in low Ca2+ medium. Exposure to
      dithiothreitol reduced albumin export while affecting alpha 1-antitrypsin export
      minimally. Suppression of amino acid incorporation into total cellular proteins
      of HepG2 cells accompanied inhibitions of protein processing by agents depleting
      sequestered Ca2+ stores or by dithiothreitol. Putative control of rates of
      translational initiation by the endoplasmic reticulum through linkage to rates of
      early protein processing is discussed.

PMID- 1740442
TI  - rab GTP-binding proteins with three different carboxyl-terminal cysteine motifs
      are modified in vivo by 20-carbon isoprenoids.
AB  - p21ras and several other ras-related GTP-binding proteins are modified post
      translationally by addition of 15-carbon farnesyl or 20-carbon geranylgeranyl
      isoprenoids to cysteines within a conserved carboxyl-terminal sequence motif,
      Caa(M/S/L), where a is an aliphatic amino acid. Proteins ending with M or S are
      substrates for farnesyltransferase, whereas those ending with L are modified
      preferentially by geranylgeranyltransferase. We recently reported that GTP
      binding proteins encoded by rab1B (GGCC), rab2 (GGCC), and rab5 (CCSN) are
      modified by 20-carbon isoprenyl derivatives of [3H]mevalonate when translated in
      vitro, despite having carboxyl-terminal sequences distinct from the Caa(M/S/L)
      motif. We now show that these proteins function as specific acceptors for
      geranylgeranyl in vitro and are modified by 20-carbon isoprenyl groups in COS
      cells metabolically labeled with [3H]mevalonate. Proteins encoded by rab4 and
      rab6, with yet another distinct carboxyl-terminal motif (xCxC), are similarly
      modified by 20-carbon isoprenoids in vitro and in vivo. The geranylgeranyl
      modification of rab5 protein (CCSN) is catalyzed by an enzyme in brain cytosol
      but not by a purified geranylgeranyltransferase that modifies GTP-binding
      proteins with the CaaL motif. Unlike the prenylation of proteins with Caa(M/S/L)
      termini, the prenylation of rab5 protein is not inhibited by a synthetic peptide
      based on its carboxyl-terminal sequence (TRNQCCSN). When cellular isoprenoid
      synthesis is blocked by treatment of cells with lovastatin, rab proteins that are
      normally localized in membranes of the endoplasmic reticulum, Golgi apparatus,
      and endosomes accumulate in the cytosol. This change in rab protein localization
      is reversed by providing cells with mevalonate. These findings suggest that
      geranylgeranyl modification underlies the ability of rab GTP-binding proteins to
      associate with intracellular membranes, where they are postulated to function as
      mediators of vesicular traffic.

PMID- 1740443
TI  - Extracellular autoprocessing of a metalloprotease from Streptomyces cacaoi.
AB  - We have previously demonstrated that the extracellular neutral metalloprotease
      (Npr) of Streptomyces cacaoi is synthesized as a 60-kDa preproenzyme (P60), then
      processed to the 35-kDa mature form (P35) (Chang, P. C., Kuo, T.-C., Tsugita, A.,
      and Lee, Y.-H. W. (1990) Gene (Amst.) 88, 87-95). In this study, we investigated
      the active site and the mechanism involved in the maturation of the protease.
      Site-specific mutations at the putative zinc-binding ligands and active site of
      Npr at His202, Glu203, His206, and Glu240 led to complete abolishment of Npr
      activity and concomitant accumulation of a 57-kDa inactive protein (P57) which
      was secreted. Sequence analysis of the NH2 terminus indicated that P57 was
      derived from P60 after removal of the signal peptide and represented the
      proenzyme form of Npr (pro-Npr). Analysis of the zinc content of purified mutant
      P57 proteins revealed a dramatic loss of zinc atom as compared with the wild-type
      P35 protein. In vitro with the aid of exogenous active Npr, the mutant P57
      protein could be converted to the mature inactive P35 with an identical NH2
      terminal sequence and a molecular mass the same as that of the wild-type P35.
      From these studies, we conclude that these highly conserved residues (His202,
      Glu203, His206, and Glu240) are indispensable for zinc binding and protease
      activity, as well as processing of Npr. In addition, we have clearly demonstrated
      that maturation of Npr occurs extracellularly via an autocatalytic cleavage of
      the pro-Npr propeptide. This is the first report of such a maturation mechanism
      for an extracellular protease in streptomycetes which can serve as a model for
      further studies on the mechanism of secretion and processing of proteases from
      Gram-positive bacteria.

PMID- 1740444
TI  - Alternative splicing of fructose 1,6-bisphosphate aldolase transcripts in
      Drosophila melanogaster predicts three isozymes.
AB  - The genes that encode fructose 1,6-bisphosphate aldolase of Drosophila
      melanogaster have been isolated and characterized. These genes exist in a single
      copy 8-kilobase pair locus in the Drosophila genome which is located at
      cytogenetic position 97A-B. The nucleotide sequence and transcript mapping
      suggest that three overlapping protein isozyme genes may be encoded at this
      locus. These isozyme genes all share a single promoter, a 5'-untranslated first
      exon, and two other protein coding exons. The isozyme-specific carboxyl-terminal
      amino acids are encoded by one of three alternatively utilized fourth exons: 4A,
      4B, or 4C by alternative splicing. The transcript containing exon 4C, whose
      sequence has been reported previously, is abundant throughout development and has
      a developmental profile similar to other glycolytic gene transcripts; however, it
      shows developmental specificity in the alternative use of two polyadenylation
      signals which result in a 2.4-kilobase and a 1.9-kilobase transcript. The
      transcript containing exon 4B is 1.6 kilobases in size and is most abundant
      during the larval stages and during the time of eclosion. The transcript
      containing exon 4A is in low abundance and found only during the adult stage.
      Sequence comparisons of the alternative fourth exons indicate that the
      duplication leading to the multiple exons is quite old and preceded the origin of
      the genus Drosophila.

PMID- 1740445
TI  - A novel 40-kDa membrane-associated EF-hand calcium-binding protein in Plasmodium
      falciparum.
AB  - A 40-kDa sexual stage radiolabeled surface protein of Plasmodium falciparum,
      Pfs40, was previously identified as a potential target antigen of transmission
      blocking immunity by an immunogenetic approach. Synthetic oligonucleotide
      "guessmers," based on microsequenced tryptic peptides of Pfs40 purified by two
      dimensional gel electrophoresis, were used to clone the full length cDNA and
      genomic DNA encoding Pfs40. The deduced amino acid sequence predicted an integral
      membrane protein containing five EF-hand calcium-binding domains. The biological
      activity of one or more of these domains was confirmed by binding of 45Ca to both
      native and recombinant Pfs40. Antisera to recombinant Pfs40 immunoprecipitated
      the native radiolabeled 40-kDa surface protein. The predicted noncytosolic
      membrane-associated localization of Pfs40 is unique within the EF-hand calcium
      binding protein superfamily.

PMID- 1740446
TI  - Translocation of ATP into the lumen of rough endoplasmic reticulum-derived
      vesicles and its binding to luminal proteins including BiP (GRP 78) and GRP 94.
AB  - Rat liver and canine pancreas rough endoplasmic reticulum-derived vesicles, which
      were sealed and of the same topographical orientation as in vivo, were used in a
      system in vitro to demonstrate translocation of ATP into their lumen.
      Translocation of ATP is saturable (apparent Km: 3-4 microM and Vmax: 3-7
      pmol/min/mg of protein) and protein mediated because treatment of intact vesicles
      with Pronase, N-ethylmaleimide, or 4,4'-diisothiocyanostilbene-2,2'-disulfonic
      acid inhibit transport. The entire ATP molecule is being translocated; this was
      shown by high performance liquid chromatography analysis and the use of a
      nonhydrolyzable analog. Control experiments rule out that translocation of ATP
      attributed to rough endoplasmic reticulum-derived vesicles is due to
      contamination by mitochondria and Golgi vesicles. Following translocation of ATP
      into the lumen of the vesicles, binding to luminal proteins including BiP
      (immunoglobulin heavy chain-binding protein-glucose-regulated protein 78) and
      glucose-regulated protein 94 was observed. This binding appeared to be specific
      because similar experiments with GTP were negative. These studies strongly
      suggest that translocation of ATP into the rough endoplasmic reticulum lumen may
      serve as a mechanism for making ATP available in proposed energy requiring
      reactions within the lumen.

PMID- 1740447
TI  - Structural relationships between two forms of DNA polymerase epsilon from calf
      thymus.
AB  - We previously reported purification of two forms of DNA polymerase epsilon from
      calf thymus (Crute, J. J., Wahl, A. F., and Bambara, R. A. (1986) Biochemistry
      25, 26-36). We have now used the "polymerase trap" photolabeling method to
      identify the polypeptides containing the polymerase active site in each enzyme
      preparation. The molecular mass of these polypeptides are 210 and 145 kDa for the
      polymerases now designated epsilon and epsilon*, respectively. Renaturation of
      polymerase activity from denaturing gel electrophoresis corroborates the
      polymerase trap results. Photolabeling of polymerase fractions suggests that the
      smaller subunit is derived by proteolysis of the larger subunit during
      purification. Native sedimentation coefficient measurements of polymerase
      containing column fractions further suggest a precursor/product relationship
      between the two polymerases. Response of polymerization activity to a battery of
      inhibitors normally used to distinguish mammalian nuclear DNA polymerases was
      found to be essentially identical for polymerases epsilon, epsilon*, and the
      epsilon* generated in fractions initially containing epsilon. These latter
      results demonstrate that the loss of the protease-sensitive domain of the active
      site subunit does not affect catalytic function as measured in a standard DNA
      polymerase assay. The sole apparent functional difference observed here between
      the epsilon and epsilon* forms is evidence that only the full-length epsilon form
      can be directly photocrosslinked to dATP, independent of DNA synthesis.
      Photolabeling of the post-microsomal supernatant fraction from thymus glands
      obtained from fetal calves reveals the presence of both the epsilon and epsilon*
      polypeptide.

PMID- 1740448
TI  - Molecular cloning and characterization of the structural gene coding for the
      developmentally regulated lysosomal enzyme, alpha-mannosidase, in Dictyostelium
      discoideum.
AB  - The gene coding for the Dictyostelium discoideum lysosomal enzyme, alpha
      mannosidase, has been cloned and sequenced. To accomplish this, the mature 60-
      and 58-kDa subunits of the enzyme were purified and subjected to liquid-phase N
      terminal amino acid sequencing. Sequence information was obtained for both of the
      mature subunits, and a 48-mer oligonucleotide was synthesized based on the
      determined amino acid sequence of the 58-kDa subunit. Using this oligonucleotide
      as a probe, an 8-kilobase HindIII fragment of genomic DNA was isolated and
      subjected to Sanger dideoxy DNA sequencing. The first 4400 nucleotides contained
      the complete alpha-mannosidase gene and 1100 nucleotides of 5'-flanking DNA.
      Primer extension analysis indicated that transcription begins at multiple sites 
      48 to -64 nucleotides upstream of the first nucleotide of the predicted
      translation initiation codon. A single open reading frame (ORF) of 3015
      nucleotides was found that was interrupted by a single intron and that contained
      the amino acid sequences of the N termini of the two mature alpha-mannosidase
      subunits; a polyadenylation signal was also found just downstream of the
      termination codon. A potential cleavable signal sequence was identified in the
      first 22 amino acids of the predicted precursor protein, and two propeptide
      regions (Pro I and II) were identified that were immediately upstream of the N
      termini of the 60- and 58-kDa mature subunits, respectively. These propeptide
      regions are not present in the mature protein and are therefore predicted to be
      proteolytically removed as the membrane associated 140-kDa precursor is
      transported to lysosomes and processed to the soluble 60- and 58-kDa mature forms
      of the enzyme. In fact, potential proteolytic cleavage sites were identified
      flanking the Pro I and Pro II regions. Pro I, which immediately follows the
      signal sequence, consists of 18 amino acids, most of which are highly charged and
      hydrophilic residues, while Pro II, found in the central portion of the
      precursor, is very hydrophobic. While no obvious transmembrane regions were
      identified, several short hydrophobic amino acid stretches were found to be
      localized in and around the Pro II region, and these may be responsible for
      attachment of precursors to membranes.

PMID- 1740449
TI  - Alternative splicing and endoproteolytic processing generate tissue-specific
      forms of pituitary peptidylglycine alpha-amidating monooxygenase (PAM).
AB  - The pituitary is a rich source of peptidylglycine alpha-amidating monooxygenase
      (PAM). This bifunctional protein contains peptidylglycine alpha-hydroxylating
      monooxygenase (PHM) and peptidyl-alpha-hydroxyglycine alpha-amidating lyase (PAL)
      catalytic domains necessary for the two-step formation of alpha-amidated peptides
      from their peptidylglycine precursors. In addition to the four forms of PAM mRNA
      identified previously, three novel forms of PAM mRNA were identified by examining
      anterior and neurointermediate pituitary cDNA libraries. None of the PAM cDNAs
      found in pituitary cDNA libraries contained exon A, the 315-nucleotide (nt)
      segment situated between the PHM and PAL domains and present in rPAM-1 but absent
      from rPAM-2. Although mRNAs of the rPAM-3a and -3b type encode bifunctional PAM
      precursors, the proteins differ significantly. rPAM-3b lacks a 54-nt segment
      encoding an 18-amino acid peptide predicted to occur in the cytoplasmic domain of
      this integral membrane protein; rPAM-3a lacks a 204-nt segment including the
      transmembrane domain and encodes a soluble protein. rPAM-5 is identical to rPAM-1
      through nt 1217 in the PHM domain; alternative splicing generates a novel 3'
      region encoding a COOH-terminal pentapeptide followed by 1.1 kb of 3'
      untranslated region. The soluble rPAM-5 protein lacks PAL, transmembrane, and
      cytoplasmic domains. These three forms of PAM mRNA can be generated by
      alternative splicing. The major forms of PAM mRNA in both lobes of the pituitary
      are rPAM-3b and rPAM-2. Despite the fact that anterior and neurointermediate
      pituitary contain a similar distribution of forms of PAM mRNA, the distribution
      of PAM proteins in the two lobes of the pituitary is quite different. Although
      integral membrane proteins similar to rPAM-2 and rPAM-3b are major components of
      anterior pituitary granules, the PAM proteins in the neurointermediate lobe have
      undergone more extensive endoproteolytic processing, and a 75-kDa protein
      containing both PHM and PAL domains predominates. The bifunctional PAM precursor
      undergoes tissue-specific endoproteolytic cleavage reminiscent of the processing
      of prohormones.

PMID- 1740450
TI  - Genomic organization of mouse J kappa recombination signal binding protein (RBP-J
      kappa) gene.
AB  - We have isolated a cDNA clone (RBP-2) for the protein (RBP-J kappa) which binds
      to immunoglobulin recombination signals with 23-base pair spacers (Matsunami, N.,
      Hamaguchi, Y., Yamamoto, Y., Kuze, K., Kangawa, K., Matsuo, H., Kawaichi, M., and
      Honjo, T. (1989) Nature 342, 934-937). During further screening of a cDNA library
      from the same mouse pre-B cell line (38B9), we have isolated a second cDNA clone
      (RBP-2N) which differs from RBP-2 in its 5' sequence. RNase protection assays
      indicated that the RBP-2N type mRNA was produced in 10-20 times the quantity as
      RBP-2 mRNA. To elucidate the relationship between these two mRNAs, we analyzed
      the genomic organization of the RBP-J kappa gene. Southern hybridization of mouse
      genomic DNA detected at least 7 EcoRI fragments hybridizing to an RBP-2 cDNA
      probe, suggesting a complex structure for the RBP-J kappa gene. Cloning of each
      EcoRI fragment revealed one functional RBP-J kappa gene and three related genes.
      The functional gene was composed of 11 exons and spanned at least 50 kilobase
      pairs. The sequence of exon 1 and its 5'-flanking region contained a GC-rich
      promoter-like region but no apparent TATA box. The initiation site of
      transcription was heterogeneous, and the two types of mRNA are produced from the
      same exon by transcription initiation at different sites and by different usage
      of splice signals. Two of the three related genes were processed pseudogenes with
      scattered stop codons. The other was also a processed gene with a sequence
      exactly the same as that of RBP-2, except that this gene lacked the sequence
      corresponding to the first exon of the functional gene.

PMID- 1740451
TI  - Coordinated leading- and lagging-strand synthesis at the Escherichia coli DNA
      replication fork. I. Multiple effectors act to modulate Okazaki fragment size.
AB  - The coordinated action of many enzymatic activities is required at the DNA
      replication fork to ensure the error-free, efficient, and simultaneous synthesis
      of the leading and lagging strands of DNA. In order to define the essential
      protein-protein interactions and model the regulatory pathways that control
      Okazaki fragment synthesis, we have reconstituted the replication fork of
      Escherichia coli in vitro in a rolling circle-type DNA replication system. In
      this system, in the presence of the single-stranded DNA binding protein, the
      helicase/primase function on the lagging-strand template is provided by the
      primosome, and the synthesis of DNA strands is catalyzed by the DNA polymerase
      III holoenzyme. These reconstituted replication forks synthesize equivalent
      amounts of leading- and lagging-strand DNA, move at rates comparable to those
      measured in vivo (600-800 nucleotides/s at 30 degrees C), and can synthesize
      leading strands in the range of 150-500 kilobases in length. Using this system,
      we have studied the cycle of Okazaki fragment synthesis at the replication fork.
      This cycle is likely to have several well defined decision points, steps in the
      cycle where incorrect execution by the enzymatic machinery will result in an
      alteration in the product of the reaction, i.e. in the size of the Okazaki
      fragments. Since identification of these decision points should aid in the
      determination of which of the enzymes acting at the replication fork control the
      cycle, we have endeavored to identify those reaction parameters that, when
      varied, alter the size of the Okazaki fragments synthesized. Here we demonstrate
      that some enzymes, such as the DnaB helicase, remain associated continuously with
      the fork while others, such as the primase, must be recruited from solution each
      time synthesis of an Okazaki fragment is initiated. We also show that variation
      of the concentration of the ribonucleoside triphosphates and the
      deoxyribonucleoside triphosphates affects Okazaki fragment size, that the control
      mechanisms acting at the fork to control Okazaki fragment size are not fixed at
      the time the fork is assembled but can be varied during the lifetime of the fork,
      and that alteration in the rate of the leading-strand DNA polymerase cannot
      account for the effect of the deoxyribonucleoside triphosphates.

PMID- 1740452
TI  - Coordinated leading- and lagging-strand synthesis at the Escherichia coli DNA
      replication fork. II. Frequency of primer synthesis and efficiency of primer
      utilization control Okazaki fragment size.
AB  - To investigate the role of the priming apparatus at the replication fork in
      determining Okazaki fragment size, the products of primer synthesis generated in
      vitro during rolling-circle DNA replication catalyzed by the DNA polymerase III
      holoenzyme, the single-stranded DNA binding protein, and the primosome on a
      tailed form II DNA template were isolated and characterized. The abundance of
      oligoribonucleotide primers and the incidence of covalent DNA chain extension of
      the primer population was measured under different reaction conditions known to
      affect the size of the products of lagging-strand DNA synthesis. These analyses
      demonstrated that the factors affecting Okazaki fragment length could be
      distinguished by either their effect on the frequency of primer synthesis or by
      their influence on the efficiency of initiation of DNA synthesis from primer
      termini. Primase and the ribonucleoside triphosphates were found to stimulate
      primer synthesis. The observed trend toward smaller fragment size as the
      concentration of these effectors was raised was apparently a direct consequence
      of the increased frequency of primer synthesis. The beta subunit of the DNA
      polymerase III holoenzyme and the deoxyribonucleoside triphosphates did not alter
      the priming frequency; instead, the concentration of these factors influenced the
      ability of the lagging-strand DNA polymerase to efficiently utilize primers to
      initiate DNA synthesis. Maximum utilization of the available primers correlated
      with the lowest mean value of Okazaki fragment length. These data were used to
      draw general conclusions concerning the temporal order of enzymatic steps that
      operate during a cycle of Okazaki fragment synthesis on the lagging-strand DNA
      template.

PMID- 1740453
TI  - Coordinated leading- and lagging-strand synthesis at the Escherichia coli DNA
      replication fork. V. Primase action regulates the cycle of Okazaki fragment
      synthesis.
AB  - Replication forks formed during rolling-circle DNA synthesis supported by a
      tailed form II DNA substrate in the presence of the primosome, the single
      stranded DNA binding protein, and the DNA polymerase III holoenzyme (Pol III HE)
      that had been reconstituted from the purified subunits, beta, tau, and the
      gamma.delta complex, at limiting (with respect to nucleotide incorporation)
      concentrations of the Pol III core (alpha, epsilon, and theta) produced
      aberrantly small Okazaki fragments, while the synthesis of the leading strand was
      unperturbed. These small Okazaki fragments were not arrayed in tandem along the
      lagging-strand DNA template, but were separated by large gaps. Similarly
      structured synthetic products were not manufactured by replication forks
      reconstituted with higher, saturating concentrations of the Pol III core.
      Replication forks producing these small fragments could respond, by modulating
      the size of the Okazaki fragments produced, to variations in the concentration of
      NTPs or the primase, conditions that affect the frequency of priming on the
      lagging strand, but not to variation in the concentration of dNTPs, conditions
      that affect the frequency of utilization of the primers. Significantly longer
      Okazaki fragments (greater than 7 kilobases) could be produced in the presence of
      a limiting amount of Pol III core at low concentrations of the primase. These
      observations indicated that the production of small Okazaki fragments was not a
      result of a debilitated lagging-strand Pol III core, but rather a function of the
      time available for nascent strand synthesis during the cycle of events that are
      required for the manufacture of an Okazaki fragment and that it was the
      association of primase with the replication fork that keyed this cycle.

PMID- 1740454
TI  - Chromogranin B (secretogranin I), a secretory protein of the regulated pathway,
      is also present in a tightly membrane-associated form in PC12 cells.
AB  - Chromogranin B (CgB, also called secretogranin I) is a secretory protein sorted
      to secretory granules in a wide variety of endocrine cells and neurons.
      Unexpectedly, after stimulation of regulated secretion in the neuroendocrine cell
      line PC12, a fraction of the exocytosed CgB was not released into the medium but
      remained associated with the plasma membrane. The addition of exogenous CgB to
      unstimulated cells did not result in the appearance of cell surface CgB,
      suggesting that the presence of cell surface CgB could not be accounted for by
      adsorption of released CgB to the cell surface. Upon further incubation of
      stimulated PC12 cells, the surface CgB was internalized by the cells and largely
      degraded. The surface CgB was not released by exposure to pH 11, yet it
      partitioned in the aqueous phase upon Triton X-114 phase separation. Subcellular
      fractionation and differential extraction studies showed that the membrane
      associated CgB constituted at least 10% of the total cellular CgB. These
      observations suggest that (a) the appearance of CgB at the cell surface is due to
      fusion of secretory granules with the plasma membrane and (b) a fraction of CgB
      is present in tight association with the secretory granule membrane. We propose a
      model in which membrane-associated CgB, by virtue of its ability to interact in a
      homophilic manner with soluble CgB, plays a key role in the sorting and targeting
      of CgB to the regulated pathway.

PMID- 1740455
TI  - COQ2 is a candidate for the structural gene encoding para
      hydroxybenzoate:polyprenyltransferase.
AB  - Coenzyme Q functions as a lipid-soluble electron carrier in eukaryotes. In
      Saccharomyces cerevisiae, the enzymes responsible for the assembly of the
      polyisoprenoid side chain and subsequent transfer to para-hydroxybenzoate (PHB)
      are encoded by the nuclear genes COQ1 and COQ2, respectively. Yeast mutants
      defective in coenzyme Q biosynthesis are respiratory defective and provide a
      useful tool to study this non-sterol branch of the isoprenoid biosynthetic
      pathway. We isolated a 5.5-kilobase genomic DNA fragment that was able to
      functionally complement a coq2 strain. Additional complementation analyses
      located the COQ2 gene within a 2.1-kilobase HindIII-BglII restriction fragment.
      Sequence analyses revealed the presence of a 1,116-base pair open reading frame
      coding for a predicted protein of 372 amino acids and a molecular mass of 41,001
      daltons. The amino acid sequence exhibits a typical amino-terminal mitochondrial
      leader sequence and six potential membrane-spanning domains. Primer extension and
      Northern analyses indicate the gene is transcriptionally active. Transformation
      of a coq2 strain with the 2.1-kilobase HindIII-BglII genomic restriction fragment
      on a multicopy plasmid restores PHB:polyprenyltransferase activity to wild-type
      levels. Disruption of the chromosomal COQ2 gene indicates the gene is not
      essential for viability, yet is required for PHB:polyprenyltransferase activity
      and respiratory function. In addition, the deduced amino acid sequence of
      PHB:polyprenyltransferase contains a putative allylic polyprenyl diphosphate
      binding site. The presence of this aspartate-rich domain in a number of
      functionally distinct proteins which utilize polyprenyl diphosphate substrates is
      reported.

PMID- 1740456
TI  - Evidence for separate networks of classical and novel basement membrane collagen.
      Characterization of alpha 3(IV)-alport antigen heterodimer.
AB  - The COOH-terminal non-collagenous domains (NC1) of type IV collagen from
      glomerular basement membranes (GBM), lens capsule basement membranes, and
      Descemet's membrane varied in the distribution of their NC1 subunits. All of
      these basement membranes (BMs) contained both classical (alpha 1(IV) and alpha
      2(IV)) and novel collagen chains (alpha 3(IV), alpha 4(IV) and the Alport
      antigen). Whereas GBM had a predominance of disulfide-bonded subunits, the lens
      capsule and Descemet's membrane were primarily monomeric, differences that are
      likely related to the functional and structural diversity of collagen in various
      tissues. A heterodimer formed from monomeric subunits of alpha 3(IV) and the
      Alport antigen exists in human and bovine GBM. This dimer represents an important
      cross-link of the NC1 domain of novel collagen. Additionally, immunoaffinity
      methodology showed that the novel BM collagen hexamers segregate into populations
      containing only novel BM subunits without the participation of the classical
      subunits (alpha 1(IV) and alpha 2(IV)). These data provided evidence for the
      presence of two separate networks of BM collagen: one containing alpha 1(IV) and
      alpha 2(IV), and the other consisting of the novel collagen chains.

PMID- 1740457
TI  - Isolation of a novel human alpha (1,3)fucosyltransferase gene and molecular
      comparison to the human Lewis blood group alpha (1,3/1,4)fucosyltransferase gene.
      Syntenic, homologous, nonallelic genes encoding enzymes with distinct acceptor
      substrate specificities.
AB  - Biochemical and genetic evidence indicates that the human genome may encode four
      or more distinct GDP-fucose:beta-D-N-acetylglucosaminide 3-alpha-L
      fucosyltransferase (alpha(1,3)fucosyltransferase) activities. Genes encoding two
      of these activities have been previously isolated. These correspond to an
      alpha(1,3/1,4)fucosyltransferase thought to represent the human Lewis blood group
      locus and an alpha(1,3)fucosyltransferase expressed in the myeloid lineage. We
      report here the molecular cloning and expression of a third human
      alpha(1,3)fucosyltransferase gene, homologous to but distinct from the two
      previously reported human fucosyltransferase genes. When expressed in transfected
      mammalian cells, this gene determines expression of a fucosyltransferase capable
      of using N-acetyllactosamine to form the Lewis x epitope, and alpha(2,3)sialyl-N
      acetyllactosamine to construct the sialyl Lewis x moiety. This enzyme shares 91%
      amino acid sequence identity with the human Lewis blood group
      alpha(1,3/1,4)fucosyltransferase, yet exhibits only trace amounts of
      alpha(1,4)fucosyltransferase activity. Polymerase chain reaction analyses were
      used to demonstrate that the gene is syntenic to the Lewis locus on chromosome
      19. These analyses also excluded the possibility that this DNA segment represents
      an allele of the Lewis locus that encodes alpha(1,3)fucosyltransferase but not
      alpha(1,4)fucosyltransferase activity. These results are consistent with the
      hypothesis that this gene encodes the human "plasma type"
      alpha(1,3)fucosyltransferase, and suggest a molecular basis for a family of human
      alpha(1,3)fucosyltransferase genes.

PMID- 1740458
TI  - Covalent binding of C3b to C4b within the classical complement pathway C5
      convertase. Determination of amino acid residues involved in ester linkage
      formation.
AB  - C5 convertase of the classical complement pathway is a protein complex consisting
      of C4b, C2a, and C3b. Within this complex C3b binds to C4b via an ester linkage.
      We now present evidence that the covalent C3b-binding site on human C4b is Ser at
      position 1217 of C4. We also show that formation of the covalently linked C4b.C3b
      complex occurs in the mouse complement system and that the C3b-binding site on
      mouse C4b is Ser at position 1213 which is homologous to Ser-1217 of human C4.
      Therefore, covalent binding of C3b to a single specific site on C4b within the
      classical pathway C5 convertase is likely a common phenomenon in the mammalian
      complement system. Specific noncovalent association of metastable C3b with C4b
      would occur first, leading to reaction of the thioester with a specific hydroxy
      group. This is supported by two lines of experimental evidence, one which shows
      that a mutant C4 that does not make a covalent linkage with C3b is still capable
      of forming C5 convertase and a second in which the C4b.C3b complex has been
      demonstrated by cross-linking erythrocytes bearing this C5 convertase.

PMID- 1740459
TI  - C1 repressor of phage P1 is inactivated by noncovalent binding of P1 Coi protein.
AB  - The temperate phage P1 encodes two genes whose products antagonize the action of
      the phage's C1 repressor of lytic functions, namely a distantly linked
      antirepressor gene, ant, and a closely linked c1 inactivator gene, coi. Starting
      with an inducible coi-recombinant plasmid, Coi protein was overproduced and
      purified to near homogeneity. By using a DNA mobility shift assay we demonstrate
      that Coi protein inhibits the operator binding of the C1 repressors of the
      closely related P1 and P7 phages. Coi protein (Mr = 7,600) exerts its C1
      inactivating function by forming a complex with the C1 repressor (Mr = 32,500) at
      a molar ratio of about 1:1, as shown by density gradient centrifugation and gel
      filtration. C1 repressor and Coi protein are recovered in active form from the
      complex, suggesting that noncovalent interactions are the sole requirements for
      complex formation. The interplay of repressor and antagonists operating in the
      life cycle of P1 is discussed.

PMID- 1740460
TI  - Deletion analysis of recombinant human factor V. Evidence for a
      phosphatidylserine binding site in the second C-type domain.
AB  - Human coagulation factor V is an integral component of the prothrombinase
      complex. Rapid activation of prothrombin is dependent on the interactions of this
      nonenzymatic cofactor with factor Xa and prothrombin in the presence of calcium
      ions and a phospholipid or platelet surface. Factor V is similar structurally and
      functionally to the homologous cofactor, factor VIII, which interacts with factor
      IXa to accelerate factor X activation in the presence of calcium and
      phospholipids. Both of these cofactors, when activated, possess homologous heavy
      and light chains. Binding to anionic phospholipids is mediated by the light
      chains of these two cofactors. In bovine factor Va, a phosphatidylserine-specific
      binding site has been localized to the amino-terminal A3 domain of the light
      chain. In human factor VIII, on the other hand, a region within the carboxyl
      terminal C2 domain of the light chain has been shown to interact with anionic
      phospholipids. We have constructed a series of recombinant deletion mutants
      lacking domain-size fragments of the light chain of human factor V (rHFV). These
      mutants are expressed and secreted as single-chain proteins by COS cells.
      Thrombin and the factor V activator from Russell's viper venom process these
      deletion mutants as expected. The light chain deletion mutants possess
      essentially no procoagulant activity, nor are they activated by treatment with
      factor V activator from Russell's viper venom. Deletion of the second C-type
      domain results in essentially complete loss of phosphatidylserine-specific
      binding whereas the presence of the C2 domain alone (rHFV des-A3C1, which lacks
      the A3 and C1 domains of the light chain) results in significant
      phosphatidylserine-specific binding. The presence of the A3 domain alone (rHFV
      des-C1C2) does not mediate binding to immobilized phosphatidylserine. Increasing
      calcium ion concentrations result in decreased binding of recombinant human
      factor V and the mutant rHFV des-A3C1 to phosphatidylserine, similar to previous
      studies with purified plasma factor V and phospholipid vesicles. These results
      indicate that human factor V, similar to human factor VIII, possesses a
      phosphatidylserine-specific binding site within the C2 domain of the light chain.

PMID- 1740461
TI  - Putative three-stranded DNA pairing intermediate in recA protein-mediated DNA
      strand exchange: no role for guanine N-7.
AB  - As an early step in DNA strand exchange reactions, the recA protein aligns
      homologous sequences within two DNA molecules to form a putative triple-stranded
      intermediate. In virtually all models for three-stranded DNA proposed to date,
      hydrogen bonds involving the N-7 position of guanine have played a prominent
      structural role. To determine whether the N-7 position of guanine is required for
      triple helix and heteroduplex formation in the recA protein-mediated DNA pairing
      reaction, guanine was completely replaced by the base analog 7-deazaguanine in
      both strands of the duplex DNA substrate using polymerase chain reaction. This
      modified double-strand DNA was reacted with unmodified single-strand DNA in
      vitro. The 7-deazaguanine-substituted DNA functioned as well as the unsubstituted
      DNA in recA protein-mediated DNA three-strand exchange reactions. Strand exchange
      reactions involving four strands also proceeded normally when three of the four
      strands contained 7-deazaguanine rather than guanine. In fact, the rate of strand
      exchange improved somewhat when the modified DNA substrates were used. This
      indicates either that the N-7 position of guanine is not essential for the
      formation of the putative triple-stranded DNA pairing intermediate, or that a
      three-stranded (or four-stranded) structure is not an obligate intermediate in
      recA protein-mediated DNA strand exchange.

PMID- 1740462
TI  - The intracellular targeting and membrane topology of 3-hydroxy-3-methylglutaryl
      CoA reductase.
AB  - We present evidence that the amino-terminal 39 residue region of 3-hydroxy-3
      methylglutaryl- (HMG) CoA reductase, which includes the putative first
      transmembrane span, is a signal sequence for targeting HMG-CoA reductase to the
      endoplasmic reticulum. This evidence is based upon fractionation, endoglycosidase
      H sensitivity and protease protection assays on an in vitro
      transcription/translocation system programmed with a mutant cDNA of HMG-CoA
      reductase that is deleted for sequences coding for all of the putative
      transmembrane spans except the first. We show that the protein product of this
      mutant cDNA is associated with microsomes, glycosylated, or protected from
      proteolysis only in the presence of Signal Recognition Particle. Also, we present
      evidence for a topological model of HMG-CoA reductase that consists of eight
      transmembrane spans. This evidence is based upon a concanavalin A binding assay
      for in vivo glycosylation of an engineered glycosylation site in each of a series
      of mutants of the fusion protein, HMGal (Skalnik, D. G., Narita, H., Kent, C.,
      and Simoni, R. D. (1988) J. Biol. Chem. 263, 6836-6841). This series of mutants
      was designed such that for each linker segment between transmembrane spans, a
      mutant was constructed with an engineered glycosylation site introduced into that
      linker segment. We show that only the mutants with glycosylation sites in the
      linker segments between transmembrane spans 1 and 2, 3 and 4, and 5 and 6 are
      glycosylated. These results support an eight transmembrane span model for the
      topology of HMG-CoA reductase and are inconsistent with a seven-transmembrane
      span model.

PMID- 1740463
TI  - The role of the membrane domain in the regulated degradation of 3-hydroxy-3
      methylglutaryl coenzyme A reductase.
AB  - We have constructed a series of mutations in the membrane and linker domains of
      Syrian hamster 3-hydroxy-3-methylglutaryl-(HMG) CoA reductase in order to
      determine the regions critical for the regulated degradation of the enzyme. In
      transfected Chinese hamster ovary cells, we have expressed a fusion protein,
      HMGal, which consists of the membrane and linker domains of the Syrian hamster
      HMG-CoA reductase fused to beta-galactosidase. Using this fusion protein, we have
      determined that a deletion of 64 amino acids from the central region of the
      membrane domain causes the protein to be degraded extremely rapidly. In addition,
      deletion of PEST sequences has little effect on degradation, but deletion of the
      linker domain makes the protein's degradation insensitive to sterols and
      mevalonate. In addition to deletion mutations, we have systematically replaced
      each hydrophobic, putative membrane spanning region of the membrane domain with
      the first transmembrane sequence from bacteriorhodopsin. Replacement of span 4
      has no effect on degradation. Replacements of spans 5 or 6 result in a protein
      which has a normal basal rate of degradation, but this rate of degradation is not
      accelerated by mevalonate, low density lipoprotein, or 25-hydroxycholesterol.
      Replacement of span 3 results in a protein whose degradation is similarly not
      accelerated by sterols or mevalonate, but since this protein might be
      mislocalized, these results are inconclusive. Replacement of span 7 yields a
      short-lived protein which is degraded more rapidly in response to mevalonate but
      not in response to exogenous sterols. Replacement of span 8 extends both the
      basal and mevalonate-accelerated half-life about 5-fold. This work begins to
      define the critical regions for regulated degradation within the membrane domain
      of HMG-CoA reductase.

PMID- 1740464
TI  - Fine mapping of the high molecular weight kininogen binding site on blood
      coagulation factor XI through the use of rationally designed synthetic analogs.
AB  - Using immunological and chemical cleavage techniques, we have previously
      identified a domain contained within residues Phe56-Ser86 in the first tandem
      repeat (A1) of the heavy chain of factor XI which binds high Mr kininogen
      (Baglia, F. A., Jameson, B. A., and Walsh, P. N. (1990) J. Biol. Chem. 265, 4149
      4154). We have now chemically synthesized peptides from corresponding homologous
      regions in the second (A2), third (A3), and fourth (A4) tandem repeats of the
      heavy chain (A2: Asn145-Ala176; A3: Asn235-Arg266; and A4: Gly326-Lys357). These
      peptides had no effect on the binding of factor XI to high Mr kininogen. Because
      of a lack of detailed structural information for the A1 domain, a molecular model
      of this region was constructed. This hypothetical model made distinct and
      testable predictions regarding potential surfaces and concomitant secondary
      structure. Specifically, the resulting structure depicted two juxtaposed beta
      stranded stem-loops that, in conjunction with biological information, constitute
      a candidate surface for contact with high Mr kininogen. The hypothetical A1 model
      was, consequently, used as a predictive template in the rational design of two
      synthetic peptides (Val59-Arg70 and Asn72-Lys83). When both these peptides were
      added together and the binding of factor XI to high Mr kininogen was examined, a
      synergistic inhibitory effect was observed compared with each peptide added
      individually. Our data are consistent with the notion that the sequence of amino
      acids from Val59-Lys83 of the heavy chain of factor XI contains two antiparallel
      beta-strands connected by beta-turns that together comprise a continuous surface
      utilized for the binding of high Mr kininogen.

PMID- 1740465
TI  - Refinement of the structure of recombinant rat intestinal fatty acid-binding
      apoprotein at 1.2-A resolution.
AB  - The three-dimensional structure of the 131-residue rat intestinal fatty acid
      binding protein, without bound ligand (apoI-FABP), has been refined with x-ray
      diffraction data to a nominal resolution of 1.19 A. The final model has a
      conventional crystallographic R-factor of 16.9% for 34,290 unique reflections [a
      root mean square (r.m.s.) deviation for bond length of 0.012 A and a r.m.s.
      deviation of 2.368 degrees for bond angles]. Ninety-two residues are present as
      components of the protein's 10 anti-parallel beta-strands while 14 residues are
      part of its two short alpha-helices. The beta-strands and alpha-helices are
      organized into two nearly orthogonal beta-sheets. Particular attention has been
      placed in defining solvent structure and the structures of discretely disordered
      groups in this protein. Two hundred thirty-seven solvent molecules have been
      identified; 24 are located within apoI-FABP. The refined model includes alternate
      conformers for 228 protein atoms (109 main-chain, 119 side-chain) and 63 solvent
      molecules. We have found several aromatic side-chains with multiple conformations
      located near, or in, the protein's ligand binding site. This observation, along
      with the fact that these side-chains have a temperature factor that is relatively
      higher than that of other aromatic residues, suggests that they may be involved
      in the process of noncovalent binding of fatty acid. The absence of a true
      hydrophobic core in I-FABP suggests that its structural integrity may be
      maintained primarily by a hydrogen bonding network involving protein and solvent
      atoms.

PMID- 1740466
TI  - Brefeldin A: insights into the control of membrane traffic and organelle
      structure.

PMID- 1740467
TI  - Identification of a subdomain of CENP-B that is necessary and sufficient for
      localization to the human centromere.
AB  - We have combined in vivo and in vitro approaches to investigate the function of
      CENP-B, a major protein of human centromeric heterochromatin. Expression of
      epitope-tagged deletion derivatives of CENP-B in HeLa cells revealed that a
      single domain less than 158 residues from the amino terminus of the protein is
      sufficient to localize CENP-B to centromeres. Centromere localization was
      abolished if as few as 28 amino acids were removed from the amino terminus of
      CENP-B. The centromere localization signal of CENP-B can function in an
      autonomous fashion, relocating a fused bacterial enzyme to centromeres. The
      centromere localization domain of CENP-B specifically binds in vitro to a subset
      of alpha-satellite DNA monomers. These results suggest that the primary mechanism
      for localization of CENP-B to centromeres involves the recognition of a DNA
      sequence found at centromeres. Analysis of the distribution of this sequence in
      alpha-satellite DNA suggests that CENP-B binding may have profound effects on
      chromatin structure at centromeres.

PMID- 1740468
TI  - Dynamic organization of DNA replication in mammalian cell nuclei: spatially and
      temporally defined replication of chromosome-specific alpha-satellite DNA
      sequences.
AB  - Five distinct patterns of DNA replication have been identified during S-phase in
      asynchronous and synchronous cultures of mammalian cells by conventional
      fluorescence microscopy, confocal laser scanning microscopy, and immunoelectron
      microscopy. During early S-phase, replicating DNA (as identified by 5
      bromodeoxyuridine incorporation) appears to be distributed at sites throughout
      the nucleoplasm, excluding the nucleolus. In CHO cells, this pattern of
      replication peaks at 30 min into S-phase and is consistent with the localization
      of euchromatin. As S-phase continues, replication of euchromatin decreases and
      the peripheral regions of heterochromatin begin to replicate. This pattern of
      replication peaks at 2 h into S-phase. At 5 h, perinucleolar chromatin as well as
      peripheral areas of heterochromatin peak in replication. 7 h into S-phase
      interconnecting patches of electron-dense chromatin replicate. At the end of S
      phase (9 h), replication occurs at a few large regions of electron-dense
      chromatin. Similar or identical patterns have been identified in a variety of
      mammalian cell types. The replication of specific chromosomal regions within the
      context of the BrdU-labeling patterns has been examined on an hourly basis in
      synchronized HeLa cells. Double labeling of DNA replication sites and chromosome
      specific alpha-satellite DNA sequences indicates that the alpha-satellite DNA
      replicates during mid S-phase (characterized by the third pattern of replication)
      in a variety of human cell types. Our data demonstrates that specific DNA
      sequences replicate at spatially and temporally defined points during the cell
      cycle and supports a spatially dynamic model of DNA replication.

PMID- 1740469
TI  - Mechanisms responsible for F-actin stabilization after lysis of polymorphonuclear
      leukocytes.
AB  - While actin polymerization and depolymerization are both essential for cell
      movement, few studies have focused on actin depolymerization. In vivo,
      depolymerization can occur exceedingly rapidly and in a spatially defined manner:
      the F-actin in the lamellipodia depolymerizes in 30 s after chemoattractant
      removal (Cassimeris, L., H. McNeill, and S. H. Zigmond. 1990. J. Cell Biol.
      110:1067-1075). To begin to understand the regulation of F-actin
      depolymerization, we have examined F-actin depolymerization in lysates of
      polymorphonuclear leukocytes (PMNs). Surprisingly, much of the cell F-actin,
      measured with a TRITC-phalloidin-binding assay, was stable after lysis in a
      physiological salt buffer (0.15 M KCl): approximately 50% of the F-actin did not
      depolymerize even after 18 h. This stable F-actin included lamellar F-actin which
      could still be visualized one hour after lysis by staining with TRITC-phalloidin
      and by EM. We investigated the basis for this stability. In lysates with cell
      concentrations greater than 10(7) cells/ml, sufficient globular actin (G-actin)
      was present to result in a net increase in F-actin. However, the F-actin
      stability was not solely because of the presence of free G-actin since addition
      of DNase I to the lysate did not increase the F-actin loss. Nor did it appear to
      be because of barbed end capping factors since cell lysates provided sites for
      barbed end polymerization of exogenous added actin. The stable F-actin existed in
      a macromolecular complex that pelleted at low gravitational forces. Increasing
      the salt concentration of the lysis buffer decreased the amount of F-actin that
      pelleted at low gravitational forces and increased the amount of F-actin that
      depolymerized. Various actin-binding and cross-linking proteins such as
      tropomyosin, alpha-actinin, and actin-binding protein pelleted with the stable F
      actin. In addition, we found that alpha-actinin, a filament cross-linking
      protein, inhibited the rate of pyrenyl F-actin depolymerization. These results
      suggested that actin cross-linking proteins may contribute to the stability of
      cellular actin after lysis. The activity of crosslinkers may be regulated in vivo
      to allow rapid turnover of lamellipodia F-actin.

PMID- 1740470
TI  - Mechanism of centrosome positioning during the wound response in BSC-1 cells.
AB  - Locomoting cells are characterized by a pronounced external and internal anterior
      posterior polarity. One of the events associated with cell polarization at the
      onset of locomotion is a shift of the centrosome, or MTOC, ahead of the nucleus.
      This position is believed to be of strategic importance for directional cell
      movement and cell polarity. We have used BSC-1 cells at the edge of an in vitro
      wound to clarify the causal relationship between MTOC position and the initiation
      of cell polarization. We find that pronounced cell polarization (the extension of
      a lamellipod) can take place in the absence of MTOC repositioning or
      microtubules. Conversely, MTOCs will reposition even after lamellar extension and
      cell polarization have occurred. Repositioning requires microtubules that extend
      to the cell periphery and is independent of selective detyrosination of
      microtubules extending towards the cell front. Significantly, MTOCs maintain, or
      at least attempt to maintain, a position at the cell's centroid. This is most
      clearly demonstrated in wounded monolayers of enucleated cells where the MTOC
      closely follows the centroid position. We suggest that the primary response to
      the would is the biased extension of a lamellipod, which can occur in the absence
      of microtubules and MTOC repositioning. Lamellipod extension leads to a shift of
      the cell's centroid towards the wound. The MTOC, in an attempt to maintain a
      position near the cell center, will follow. This will automatically put the MTOC
      ahead of the nucleus in the vast majority of cells. The nucleus as a reference
      for MTOC position may not be as meaningful as previously thought.

PMID- 1740471
TI  - Meiotic spindle assembly in Drosophila females: behavior of nonexchange
      chromosomes and the effects of mutations in the nod kinesin-like protein.
AB  - Mature Drosophila oocytes are arrested in metaphase of the first meiotic
      division. We have examined microtubule and chromatin reorganization as the
      meiosis I spindle assembles on maturation using indirect immunofluorescence and
      laser scanning confocal microscopy. The results suggest that chromatin captures
      or nucleates microtubules, and that these subsequently form a highly tapered
      spindle in which the majority of microtubules do not terminate at the poles.
      Nonexchange homologs separate from each other and move toward opposite poles
      during spindle assembly. By the time of metaphase arrest, these chromosomes are
      positioned on opposite half spindles, between the metaphase plate and the spindle
      poles, with the large nonexchange X chromosomes always closer to the metaphase
      plate than the smaller nonexchange fourth chromosomes. Nonexchange homologs are
      therefore oriented on the spindle in the absence of a direct physical linkage,
      and the spindle position of these chromosomes appears to be determined by size.
      Loss-of-function mutations at the nod locus, which encodes a kinesin-like
      protein, cause meiotic loss and nondisjunction of nonexchange chromosomes, but
      have little or no effect on exchange chromosome segregation. In oocytes lacking
      functional nod protein, most of the nonexchange chromosomes are ejected from the
      main chromosomal mass shortly after the nuclear envelope breaks down and
      microtubules interact with the chromatin. In addition, the nonexchange
      chromosomes that are associated with spindles in nod/nod oocytes show excessive
      poleward migration. Based on these observations, and the structural similarity of
      the nod protein and kinesin, we propose that nonexchange chromosomes are
      maintained on the half spindle by opposing poleward and anti-poleward forces, and
      that the nod protein provides the anti-poleward force.

PMID- 1740472
TI  - The desmoplakin carboxyl terminus coaligns with and specifically disrupts
      intermediate filament networks when expressed in cultured cells.
AB  - Specific interactions between desmoplakins I and II (DP I and II) and other
      desmosomal or cytoskeletal molecules have been difficult to determine in part
      because of the complexity and insolubility of the desmosome and its constituents.
      We have used a molecular genetic approach to investigate the role that DP I and
      II may play in the association of the desmosomal plaque with cytoplasmic
      intermediate filaments (IF). A series of mammalian expression vectors encoding
      specific predicted domains of DP I were transiently expressed in cultured cells
      that form (COS-7) and do not form (NIH-3T3) desmosomes. Sequence encoding a small
      antigenic peptide was added to the 3' end of each mutant DP cDNA to facilitate
      immunolocalization of mutant DP protein. Light and electron microscopical
      observations revealed that DP polypeptides including the 90-kD carboxy-terminal
      globular domain of DP I specifically colocalized with and ultimately resulted in
      the complete disruption of IF in both cell lines. This effect was specific for IF
      as microtubule and microfilament networks were unaltered. This effect was also
      specific for the carboxyl terminus of DP, as the expression of the 95-kD rod
      domain of DP I did not visibly alter IF networks. Immunogold localization of COS
      7 cells transfected with constructs including the carboxyl terminus of DP
      demonstrated an accumulation of mutant protein in perinuclear aggregates within
      which IF subunits were sequestered. These results suggest a role for the DP
      carboxyl terminus in the attachment of IF to the desmosome in either a direct or
      indirect manner.

PMID- 1740473
TI  - Mutants in the S. cerevisiae PKC1 gene display a cell cycle-specific osmotic
      stability defect.
AB  - The PKC1 gene of Saccharomyces cerevisiae encodes a homologue of the Ca(2+)
      dependent isozymes of mammalian protein kinase C (Levin, D.cE., F. O. Fields, R.
      Kunisawa, J. M. Bishop, and J. Thorner. 1990. Cell. 62:213-224). Cells depleted
      of the PKC1 gene product display a uniform phenotype, a behavior indicating a
      defect in the cell division cycle (cdc). These cells arrest division after DNA
      replication, but before mitosis. Unlike most cdc mutants, which continue to grow
      in the absence of cell division, PKC1-depleted cells arrest growth with small
      buds. We created conditional alleles of PKC1 to explore the nature of this
      unusual cdc defect. In contrast to PKC1-depleted cells, all of the conditional
      pkc1 mutants isolated were suppressed by the addition of CaCl2 to the medium,
      suggesting that the mutant enzymes could be activated by Ca2+. Arrest of growth
      and cell division in the conditional mutants was accompanied by cessation of
      protein synthesis, rapid loss of viability, and release of cellular material into
      the medium, suggesting cell lysis. This conclusion was supported by the
      observation that a pkc1 deletion mutant was capable of proliferation in
      osmotically stabilized medium, but underwent rapid cell lysis when shifted to
      hypo-osmotic medium. We have incorporated these observations into a model to
      explain the cdc-specific arrest of pkc1 mutants.

PMID- 1740474
TI  - The plus ends of stable microtubules are the exclusive nucleating structures for
      microtubules in the axon.
AB  - Microtubules (MTs) in the axon have a uniform polarity orientation that is
      recapitulated during recovery from episodes of MT depolymerization (Heidemann, S.
      R., M. A. Hamborg, S. J. Thomas, B. Song, S. Lindley, and D. Chu. 1984. J. Cell
      Biol. 99:1289-1295). This tight regulation of their organization indicates that
      axonal MTs are spatially regulated by discrete nucleating structures comparable
      in function to the centrosome. Several authors have proposed that an especially
      stable class of MTs in the axon may serve as these nucleating structures. In a
      previous report (Baas, P. W., and M. M. Black. 1990. J. Cell Biol. 111:495-509),
      we determined that the axons of cultured sympathetic neurons contain two classes
      of MT polymer, stable and labile, that differ in their sensitivity to nocodazole
      by roughly 35-fold. The stable and labile polymer represent long-lived and
      recently assembled polymer, respectively. We also determined that these two
      classes of polymer can be visually distinguished at the immunoelectron
      microscopic level based on their content of tyrosinated alpha-tubulin: the labile
      polymer stains densely, while the stable polymer does not stain. In the present
      study, we have taken advantage of these observations to directly identify MT
      nucleating structures in the axon. Neuron cultures were treated with nocodazole
      for 6 h to completely depolymerize the labile polymer in the axon, and
      substantially shorten the stable polymer. The cultures were then rinsed free of
      the drug, permitted to reassemble polymer for various periods of time, and
      prepared for immunoelectron microscopic localization of tyrosinated alpha
      tubulin. Serial reconstruction of consecutive thin sections was undertaken to
      determine the spatial relationship between the stable MTs and the newly assembled
      polymer. All of the new polymer assembled in direct continuity with the plus ends
      of stable MTs, indicating that these ends are assembly competent, and hence
      capable of acting as nucleating structures. Our results further indicate that no
      self-assembly of MTs occurs in the axon, nor do any MT nucleating structures
      exist in the axon other than the plus ends of stable MTs. Thus the plus ends of
      stable MTs are the exclusive nucleating structures for MTs in the axon.

PMID- 1740475
TI  - Incorporation of protein into spore coats is not cell autonomous in
      Dictyostelium.
AB  - At maturity, the spores of Dictyostelium are suspended in a viscous fluid
      droplet, with each spore being surrounded by its own spore coat. Certain
      glycoproteins characteristic of the spore coat are also dissolved in this fluid
      matrix after the spore coat is formed. To determine whether any proteins of the
      coat reside in this fluid phase earlier during the process of spore coat
      assembly, pairs of strains which differed in a spore coat protein carbohydrate
      marker were mixed and allowed to form spore coats in each other's presence. We
      reasoned that proteins belonging to an early, soluble, extracellular pool would
      be incorporated into the spore coats of both strains. To detect trans
      incorporation, spores were labeled with a fluorescent antibody against the
      carbohydrate marker and each spore's fluorescence was analyzed by flow cytometry.
      Several proteins of both the outer and inner protein layers of the coat appeared
      to be faithfully and reciprocally trans-incorporated and hence judged to belong
      to a soluble, assembly-phase pool. Western blot analysis of sorted spores, and EM
      localization, confirmed this conclusion. In contrast, one outer-layer protein was
      not trans-incorporated, and was concluded to be insoluble at the time of
      secretion. Three classes of spore coat proteins can be described: (a) Insoluble
      from the time of secretion; (b) present in the early, soluble pool but not the
      late pool after spore coat formation; and (c) present in the soluble pool
      throughout spore coat assembly. These classes may, respectively: (a) Nucleate
      spore coat assembly; (b) comprise a scaffold defining the dimensions of the
      nascent spore coat; and (c) complete the assembly process by intercalation into
      the scaffold.

PMID- 1740476
TI  - Clinical review 31: Anabolic-androgenic steroids and athletes: what are the
      issues?

PMID- 1740477
TI  - New biomarkers of bone resorption.

PMID- 1740478
TI  - Urinary pyridinium cross-links as markers of bone resorption in tumor-associated
      hypercalcemia.
AB  - Osteoclastic activity is increased in tumor-associated hypercalcemia, which,
      thus, constitutes an excellent opportunity to assess new markers of the bone
      resorption rate. We have measured the fasting urinary excretion of the pyridinium
      cross-links pyridinoline (Pyr) and deoxypyridinoline (D-Pyr) in 36 hypercalcemic
      cancer patients (mean +/- SD, 3.2 +/- 0.4 mmol/L for total serum Ca and 1.66 +/-
      0.24 mmol/L for Ca2+). Thirty-two of them were reevaluated after treatment with
      iv bisphosphonates. Urinary Pyr and D-Pyr levels were higher than those in
      healthy controls (130 +/- 62 vs. 40 +/- 19 nmol/mmol creatinine for Pyr and 20 +/
      15 vs. 6 +/- 3 nmol/mmol creatinine for D-Pyr; P less than 0.001 for both). This
      represented a mean 3.3-fold increase over the normal mean compared to 5.8- and
      3.4-fold increases for fasting urinary Ca and hydroxyproline, respectively.
      Individual values were elevated in 83% and 75% of the cases for Pyr and D-Pyr
      compared to 97% and 83% for urinary Ca and hydroxyproline, respectively. The
      levels of Pyr and D-Pyr tended to be higher in patients with head and neck tumors
      than in patients with breast cancer. Urinary Pyr and D-Pyr correlated with each
      other (r = 0.72; P less than 0.001) and were highly correlated with
      hydroxyproline (r = 0.68 and 0.83, respectively; P less than 0.001 for both), but
      poorly correlated with urinary Ca (r = 0.21; P = NS and r = 0.42; P = 0.01,
      respectively), suggesting that these markers reflect different events of bone
      resorption. Similarly, after bisphosphonate therapy, urinary Pyr and D-Pyr levels
      fell by 31% and 50%, respectively, compared to 38% for hydroxyproline and 76% for
      urinary Ca. There was a significant correlation between posttreatment D-Pyr and
      serum Ca levels (r = 0.43; P less than 0.05). In summary, we found that the
      urinary excretion of Pyr and D-Pyr was markedly increased in hypercalcemic cancer
      patients and was adequately lowered by bisphosphonate therapy. The urinary
      excretion of the pyridinium cross-links, especially D-Pyr, should be helpful to
      specifically quantitate bone matrix resorption and monitor the inhibition of bone
      resorption in cancer patients receiving antiosteolytic drugs.

PMID- 1740479
TI  - Marked diurnal variation in urinary excretion of pyridinium cross-links in
      premenopausal women.
AB  - To investigate whether bone resorption exhibits a diurnal variation in healthy
      premenopausal women, we measured urinary excretion of pyridinoline and
      deoxypyridinoline cross-links (U-Pyr/Cr and U-D-Pyr/Cr) every 3 h over a 24-h
      period in 12 healthy premenopausal women (mean +/- 1 SD age, 32 +/- 5 yr). To
      study diurnal variation, U-Pyr/Cr and U-D-Pyr/Cr are the best available markers
      of bone resorption for a diurnal variation study, as they are not influenced by
      diet. Plasma osteocalcin and serum alkaline phosphatase (markers of bone
      formation) were also measured. A marked diurnal rhythm was observed in U-Pyr/Cr
      and U-D-Pyr/Cr, with the peak between 0500-0800 h and the nadir between 1400-2300
      h. The fluctuation was 2-fold over the 24-h period, with a mean fall of 25-35%
      between 0800-1100 h. This study demonstrates a marked diurnal variation in the
      new biochemical markers of bone resorption, U-Pyr/Cr and U-D-Pyr/Cr, in
      premenopausal women. Furthermore, this study emphasizes the importance of
      regulating the time of the urine sample taken for measuring urinary pyridinium
      cross-links for clinical investigations as well as in clinical practice.

PMID- 1740480
TI  - Urinary hydroxypyridinium cross-links of collagen in primary hyperparathyroidism.
AB  - Urinary concentrations of the collagen cross-links, pyridinoline (PYD) and
      deoxypyridinoline (DPD), were determined in 87 patients with untreated or
      surgically treated primary hyperparathyroidism (PHPT). Eighty-four healthy
      individuals, matched for age and sex, constituted the control group for the
      excretion of pyridinium cross-links. In addition, a subgroup of 25 patients with
      PHPT was followed longitudinally for up to 2 yr after successful
      parathyroidectomy. Mean urinary excretion of PYD (46.8 +/- 2.7 nmol/mmol
      creatinine) and DPD (17.6 +/- 1.3 nmol/mmol creatinine) was significantly higher
      in patients with untreated PHPT than in normal subjects (P less than 0.001). In
      the group undergoing successful parathyroidectomy, mean urinary concentrations of
      PYD (34 +/- 2.5) and DPD (9.4 +/- 0.8) were similar to those in normal controls
      and significantly lower than those in the untreated patient population (P less
      than 0.001). The urinary concentration of both cross-links was significantly
      correlated with serum levels of both alkaline phosphatase and PTH. Mean urinary
      concentrations of both cross-link compounds decreased significantly within 6
      months in patients followed longitudinally and as early as 2 weeks after surgery
      in individual patients compared to presurgical baseline values. These changes
      preceded the reduction in serum alkaline phosphatase and hydroxyproline by
      approximately 6 months. The results demonstrate that urinary hydroxypyridinium
      cross-links of collagen are useful indices in the clinical assessment of bone
      involvement in PHPT.

PMID- 1740481
TI  - Abnormalities in circadian patterns of bone resorption and renal calcium
      conservation in type I osteoporosis.
AB  - We compared changes over 24 h in 15 postmenopausal normal women (mean [+/- SD]
      age, 64 +/- 7 yr) with those in 15 postmenopausal women with type I osteoporosis
      and vertebral fractures (mean age, 64 +/- 5 yr). The serum osteocalcin
      concentration, a sensitive index of bone formation, increased by about 5% at
      night in both groups. Urinary deoxypyridinoline excretion, a sensitive index of
      bone resorption, increased by 48% at night (P less than 0.01) in the normal
      women, whereas in the osteoporotic women it was 62% higher overall (P less than
      0.05), and the increase persisted into the morning. At night, urinary fractional
      excretion of calcium decreased by 20% (P less than 0.001) in the normal women,
      but was unchanged in the osteoporotic women; this circadian pattern differed
      between groups (P less than 0.05). The serum ionized calcium concentration did
      not change at night in either group. There was a trend (P = 0.07) for blunting of
      the nocturnal increase in the serum intact PTH level in osteoporotic women. Thus,
      the nocturnal serum ionized calcium level is maintained by decreased urinary
      calcium excretion and increased bone resorption in postmenopausal normal women,
      but almost entirely by increased resorption in postmenopausal osteoporotic women.
      This greater dependence on bone resorption during the nocturnal fast may account
      in part for the greater bone loss in osteoporotic women.

PMID- 1740482
TI  - Understanding the genetics of autoimmune thyroid disease--still an illusive goal!

PMID- 1740483
TI  - Genetics of autoimmune thyroid disease: lack of evidence for linkage to HLA
      within families.
AB  - Clinical and epidemiologic observations, including the association of Graves'
      disease (GD) and Hashimoto's thyroiditis (HT) with the HLA gene complex, support
      a role for specific disease-related genes in the development of autoimmune
      thyroid disease (AITD). The combination of HLA and immunoglobulin heavy chain
      allotypes (Gm) has previously been reported to be predictive of AITD in multiply
      affected Japanese families. We have investigated the immunogenetics of AITD in
      families in the United States. Twenty-seven pedigrees including 15 with GD, 8
      with HT, and 4 with both HT and GD were immunogenetically typed and analyzed for
      population and within family disease associations. The majority of families (63%)
      were multiplex for AITD. HLA-DR3 was increased in affected family members with GD
      and HLA-DR5 was increased in affected family members with HT. Formal linkage
      analysis was applied to test for coinheritance of disease with the HLA locus
      within families. The LIPED computer program was used to calculate the probability
      of linkage in terms of the lod score. Evidence from linkage analysis was
      consistently against linkage of either GD or HT to the HLA region under various
      penetrances and different modes of inheritance. The combination of HLA and Gm was
      not found to be predictive of disease in 7 selected multiplex families with
      multigenerational instances of AITD. T cell function was also examined in 3 pairs
      of siblings genetically identical for HLA and Gm but discordant for disease
      expression. We found no evidence of a global T cell defect in the small number of
      patients examined. We conclude that whereas there is an association of AITD with
      the HLA region, our linkage analysis demonstrates that alleles of the HLA region
      are not cosegregating with either GD or HT within these families. Thus, whereas
      HLA may increase susceptibility to AITD, as shown by the existence of an HLA
      association, the major genetic influence on the inheritance of AITD must be at
      another locus.

PMID- 1740484
TI  - Analysis of the preproPTH gene by denaturing gradient gel electrophoresis in
      familial isolated hypoparathyroidism.
AB  - Familial isolated hypoparathyroidism (FIH) is an inherited metabolic disorder
      characterized by hypocalcemia and hyperphosphatemia due to deficient secretion of
      biologically active PTH. We used denaturing gradient gel electrophoresis to
      screen for mutations in exon 1 and the coding region of the preproPTH gene. Exons
      1, 2, and 3 of the preproPTH gene and flanking intronic regions were amplified by
      polymerase chain reaction using primers that were designed employing the MELT-MAP
      program. One oligonucleotide from each primer pair was synthesized with a 5'-GC
      clamp. Screening of amplified DNA from normal subjects and patients with FIH
      revealed two single base changes that altered migration of amplified preproPTH
      gene fragments through denaturing gels: 1) an A----G transition in intron 1; 10
      nucleotides upstream of exon 2; and 2) a C----A transversion in exon 3 that
      conserves the arginine residue at codon 52 (CGA----AGA). By contrast, we did not
      detect pathogenic mutations in amplified regions of the preproPTH genes of 18
      affected members of 5 FIH kindreds. The two polymorphisms occur frequently, and
      were therefore used to perform linkage analysis in 5 multiplex FIH families.
      Linkage analysis was inconclusive in 2 families and showed discordance between
      hypoparathyroidism and any of the preproPTH gene alleles in 2 other families. In
      another family, analysis was suggestive of linkage between hypoparathyroidism and
      inheritance of a specific preproPTH gene allele. These results indicate that
      denaturing gradient gel electrophoresis can be used to identify mutations in
      defined regions of the preproPTH gene, and to examine linkage of specific
      preproPTH alleles and inherited disorders of mineral metabolism.

PMID- 1740485
TI  - Hypothalamo-hypophyseal thyroid and gonadal function before and after
      erythropoietin therapy in dialysis patients.
AB  - We examined the effects of administration of two hypothalamic neurohormones, TRH
      and GnRH, for 3 days in five anemic male dialysis patients and five age-matched
      normal male volunteers. Patients on chronic hemodialysis have abnormal
      hypothalamo-hypophyseal thyroid and gonadal functions, including blunted TSH
      response to TRH, hyperprolactinemia, elevated basal levels of LH with exaggerated
      response to GnRH, and depressed FSH secretory response to GnRH. After correction
      of anemia with exogenous erythropoietin, these dialysis patients were given a
      single injection of the same hypothalamic hormones. The repeat studies after the
      correction of anemia showed normalization of 1) the TSH response to TRH, 2) basal
      GH and PRL levels, and 3) the FSH response to GnRH. Although these patients
      appear to have biochemical evidence of testicular failure, the gonadotropin
      response (FSH) to GnRH was not exaggerated. In addition, there was no increase in
      total T4 and free T4 after TRH administration. Although a free T3 response to TRH
      was present, it was remarkably blunted compared to that of controls. At the
      present time, it is not known whether these hormonal responses after the
      correction of anemia are due to better oxygenation or a trophic action of the
      erythropoietin.

PMID- 1740486
TI  - The modulation of circulating parathyroid hormone immunoheterogeneity in man by
      ionized calcium concentration.
AB  - Twenty normal individuals received 2-h iv infusions of CaCl2 and Na2
      ethylenediamine tetra-acetate, with sampling every 15 min. PTH was measured by
      means of an intact hormone assay (I) and two carboxylterminal assays structured
      to react mostly with mid (M) or late (L) carboxylterminal fragments. A
      mathematical model was used to fit the sigmoidal relationship between ionized
      calcium (CA++) and PTH values. The influence of Ca++ on circulating PTH
      immunoheterogeneity was assessed via changes in L/I, M/I, and M/L ratios. Results
      are reported as means +/- SD. Response to hypocalcemia was highest with M (57.8
      +/- 26.4 pmol/L, P less than 0.005 vs. L or I) and higher with L (20.1 +/- 5.6
      pmol/L; P less than 0.0005 vs. I) than with I (14.1 +/- 6.4 pmol/L). L/I, M/I,
      and M/L decreased from 2.43 +/- 0.56 to 1.54 +/- 0.19 (P less than 0.0005), 8.44
      +/- 2.38 to 4.36 +/- 4.07 (P less than 0.0005), and 3.49 +/- 0.71 to 2.86 +/-
      0.76 (P less than 0.005), respectively, during Na2 ethylenediamine tetra-acetate
      infusion. Nonsuppressible PTH was again higher with M (13.7 +/- 4.8 pmol/L; P
      less than 0.0005 vs. L or I) and higher with L (2.8 +/- 0.7 pmol/L, P less than
      0.0005 vs. I) than with I (0.5 +/- 0.3 pmol/L). L/I, M/I, and M/L ratios
      increased from 2.47 +/- 0.97 to 5.35 +/- 2.09 (P less than 0.0005), 8.90 +/- 3.10
      to 29.56 +/- 14.89 (P less than 0.0005), and 3.62 +/- 0.90 to 5.30 +/- 1.91 (P
      less than 0.005) during CaCl2 infusion. The set-point for PTH stimulation by
      calcium was similar for M (1.15 +/- 0.035 mmol/L) and L (1.175 +/- 0.041 mmol/L)
      but significantly higher with the I assay (1.184 +/- 0.31 mmol/L; P less than
      0.0005 vs. M). The M/I, L/I, and M/L ratio set-points were similar at 1.28 +/-
      0.01, 1.27 +/- 0.01, and 1.29 +/- 0.02 mmol/L. Thus, even if proportionately more
      intact PTH and less carboxylterminal fragments are produced and secreted during
      hypocalcemia, the latter still predominate in the circulation. Furthermore, at
      high calcium values, secretion of fragments is less well inhibited than that of
      intact hormone. The lower secretion and higher ratio set-points suggest that the
      secretion and intracellular degradation of PTH have different sensitivities to
      inhibition by calcium.

PMID- 1740487
TI  - Identification of a 27-kilodalton protein with the properties of type I
      iodothyronine 5'-deiodinase in human thyroid gland.
AB  - N-Bromoacetyl-[125I]T4(BrAc[125I]T4) was used as affinity label to identify type
      I 5'-deiodinase (5'-D) in human thyroid glands. Affinity labeled proteins were
      analyzed by autoradiography after sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. Human thyroid microsomes labeled with BrAc[125I]T4 showed the
      most prominent radiolabeled band of protein at a mol wt of approximately 27,000
      (p27). BrAc[125I]T4 incorporations into p27 were significantly higher in both
      Graves' and follicular adenomas than in normal thyroids. On the other hand, four
      cases out of five carcinomas were lower than the least value of normal thyroids.
      Furthermore, an excellent correlation was observed between 5'-D activities and
      quantities of p27 in all cases (r = 0.96; P less than 0.001). Labeling of p27 was
      strongly inhibited by preferred type I 5'-D substrate rT3, but to a lesser extent
      by poor substrate T4 or T3, and the type I 5'-D inhibitor, propylthiouracil and
      iopanoic acid, also inhibited the p27 labeling in normal and various diseases. In
      addition, the rate of enzyme inactivation by BrAcT4 equaled the rate of p27
      labeling. These data suggest that p27 may be a type I 5'-D itself or at These
      data suggest that p27 may be a type I 5'-D itself or at least the substrate
      binding subunit of this enzyme in human thyroid, and that both Graves' and
      follicular adenoma thyroids contain larger amounts of it, and papillary
      adenocarcinoma thyroids smaller than normal amounts.

PMID- 1740488
TI  - Insulin-like growth factor-I (IGF-I) may not be essential for ovarian follicular
      development: evidence from IGF-I deficiency.
AB  - Insulin-like growth factor-I (IGF-I) stimulates growth and differentiation in
      follicular granulosa cells (GC). To examine whether this effect is prerequisite
      to human folliculogenesis, a patient with Laron-type dwarfism (IGF-I deficiency
      secondary to GH receptor abnormality) was examined while undergoing in vitro
      fertilization treatment. Despite low levels of IGF-I in serum and follicular
      fluid (less than 3 and less than 2 nmol/L) and very high levels of IGF-I-binding
      protein, the patient developed normal ovarian follicles. After the administration
      of GnRH analog (GnRHa) and human menopausal gonadotropin in a dose similar to
      that used in normovulatory women, estradiol (E2) levels reached above 5000 pmol/L
      on the day of hCG administration, and mature fertilizable oocytes were retrieved
      during ovum pickup. The patient's GC E2 production, tested in a primary culture,
      did not respond to IGF-I after 4 days of incubation, while control cultures
      showed a significant increase. Only after a priming period of 7 days did IGF-I
      have a significant effect on E2 production, as observed in the patient's GC
      culture. This delayed response suggests that the patient's GC were not exposed in
      vivo to IGF-I. Our data support the view that IGF-I is not required for normal
      follicular development, but is, rather, a nonessential modulator of FSH action.

PMID- 1740489
TI  - Salt-wasting congenital adrenal hyperplasia: detection and characterization of
      mutations in the steroid 21-hydroxylase gene, CYP21, using the polymerase chain
      reaction.
AB  - We have characterized mutations in the steroid 21-hydroxylase gene (CYP21) in
      salt-wasting congenital adrenal hyperplasia (SW-CAH) subjects, healthy control
      subjects, and affected sibling pairs with SW-CAH. To identify point mutations in
      CYP21, we have used an improved polymerase chain reaction methodology that allows
      analysis of the entire CYP21 gene. In addition, we have used polymerase chain
      reaction to search for abnormally spliced mRNAs resulting from putatively
      abnormal CYP21 genes transfected into COS1 cells. We found that all 26 SW-CAH
      subjects from whom DNA could be completely analyzed, had mutations that could
      account for the 21-hydroxylase enzyme deficiency. These mutations included CYP21
      gene deletion, conversion to the inactive CYP21P form, point mutations leading to
      amino acid substitutions or stop codons, small gene deletions, and a point
      mutation in intron-2 that leads to an abnormally spliced mRNA. The point mutation
      in intron-2 was directly shown to activate a cryptic splice site 19 basepairs
      from exon-3 of CYP21 and thereby cause a reading frame mutation. This CYP21
      mutation was frequently found in our white SW-CAH subjects, while the frequency
      of this mutation was extremely low in a racially matched control population.
      Furthermore, affected sibling pairs shared this mutation in all cases examined.
      The results presented should have important applications for the prenatal
      diagnosis of CAH.

PMID- 1740490
TI  - Robustness of the male lactotropic axis to the hyperprolactinemic stimulus of
      primary thyroidal failure.
AB  - Primary hypothyroidism is a presumptive proximate basis for increased serum PRL
      concentrations. However, most studies to date have been performed in females and
      do not address the possible effect of sex differences. In the present study we
      investigated the 24-h patterns of pulsatile PRL release in 10 hypothyroid men (24
      h mean +/- SEM: total T4, 35 +/- 8 nmol/L; TSH, 55 +/- 10 mU/L) by sampling blood
      at 10-min intervals for 24 h. The study was repeated in 5 men, 5-7 months and
      again 14-36 months after treatment with levothyroxine. The control group
      consisted of 7 normal age-matched euthyroid men. The mean 24-h serum PRL
      concentration of 4.9 +/- 0.6 micrograms/L in 10 hypothyroid men was not
      significantly different from the value of 4.9 +/- 0.5 micrograms/L found in the
      normal group (P greater than 0.5). Pulsatile features of PRL release were
      evaluated by Cluster analysis, which revealed normal mean PRL peak frequency
      (12.6 +/- 0.7 vs 13.4 +/- 0.6 pulses/24 h; P greater than 0.5), maximal peak
      amplitude (6.1 +/- 0.7 vs. 6.7 +/- 0.6 micrograms/L; P greater than 0.5), peak
      increment (2.2 +/- 0.3 vs. 2.6 +/- 0.3 micrograms/L; P = 0.3), mean valley (4.2
      +/- 0.6 vs. 4.4 +/- 0.4 micrograms/L; P greater than 0.5), and prepeak nadir (3.6
      +/- 0.5 vs. 3.6 +/- 0.4 micrograms/L; P greater than 0.5) PRL concentrations.
      Five to 7 months of T4 therapy in 5 hypothyroid men caused significant decreases
      in the mean 24-h (2.9 +/- 0.5 vs. 6.1 +/- 1.2 micrograms/L; P less than 0.05),
      interpulse valley (2.5 +/- 0.4 vs. 5.2 +/- 1.1 micrograms/L; P less than 0.05),
      and prepeak nadir (2.3 +/- 0.3 vs. 4.6 +/- 1.0 micrograms/L; P less than 0.05)
      PRL concentrations. These values returned to normal after 14-36 months of
      treatment. Cosinor analysis revealed preserved circadian PRL rhythmicity during
      hypothyroidism, with a normal circadian mesor (mean), amplitude, and acrophase.
      In summary, we have demonstrated normal mean 24-h serum PRL concentrations as
      well as normal pulsatile and circadian patterns of PRL release in men with
      primary hypothyroidism. These results stand in contrast to previous reports of
      increased serum PRL concentrations observed predominantly in hypothyroid
      premenopausal women. The foregoing disparity suggests the possibility of a role
      for estrogen in enhancing the effect of hypothyroidism on PRL release.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1740491
TI  - Evidence for a critical role of progesterone in the regulation of the midcycle
      gonadotropin surge and ovulation.
AB  - Serum concentrations of progesterone begin to rise just before the midcycle
      gonadotropin surge that leads to ovulation. To examine the role of progesterone
      in the regulation of these events, we evaluated the effects of a low dose (1
      mg/day, orally) of the antiprogesterone RU 486 on the timing of the gonadotropin
      surge and ovulation in normally cycling women. The drug or a placebo was given
      for 5 or 15 days, starting when the dominant follicle reached 14-16 mm. RU 486
      consistently delayed the timing of the midcycle gonadotropin surge and the
      subsequent collapse of the dominant follicle, despite rising estradiol
      concentrations and normal follicular development. Unexpectedly, RU 486 also
      delayed the emergence of the periovulatory progesterone rise. The addition of
      progesterone (5-10 mg/day, im, for 2 days) to a 5-day course of RU 486 after the
      emergence of a mature follicle readily induced LH and FSH surges and completely
      reversed the effects of RU 486 at midcycle. Our results suggest that RU 486
      delays the midcycle gonadotropin surge and ovulation by suppressing or
      antagonizing an ovarian progestational signal. Progesterone may, thus, represent
      the ultimate ovarian signal to the estrogen-primed hypothalamic-pituitary unit to
      trigger the gonadotropin surge that leads to ovulation.

PMID- 1740492
TI  - Defective ring A reduction of cortisol as the major metabolic error in the
      syndrome of apparent mineralocorticoid excess.
AB  - Impaired peripheral metabolism of cortisol in the syndrome of apparent
      mineralocorticoid excess is currently understood to be causally related to the
      severe but otherwise unexplained manifestations of mineralocorticoid excess. A
      normally ambivalent mineralocorticoid receptor responding equally well to
      glucocorticoids and mineralocorticoids requires prereceptor inactivation of
      glucocorticoids to elicit a specific mineralocorticoid effect. The failed
      inactivation step in the form of the syndrome of apparent mineralocorticoid
      excess first described (type 1) involves the 11 beta-hydroxydehydrogenation of
      cortisol to cortisone. In another form of the syndrome (type 2) this conversion
      occurs normally in the face of otherwise similar clinical and biochemical
      features. Markedly decreased cortisol metabolic clearance in the type 2 form
      suggested impairment of a major component of that clearance, ring A reduction. A
      noninvasive method was developed for measuring the conversion of cortisol to
      tetrahydrocortisol and allotetrahydrocortisol, and this step was found to be
      profoundly decreased in both type 1 and type 2 forms. Thus, the major abnormality
      in the peripheral metabolism of cortisol common to both forms involved ring A
      reduction, not 11 beta-hydroxydehydrogenation. Since ring A reduction was better
      correlated with the manifestation of mineralocorticoid excess in both forms of
      the syndrome, this step might also be a normal major prereceptor mechanism
      conferring mineralocorticoid specificity.

PMID- 1740493
TI  - Hypothalamic gonadotropin-releasing hormone secretion and follicle-stimulating
      hormone dynamics during the luteal-follicular transition.
AB  - To define the precise neuroendocrine characteristics of the luteal-follicular
      transition, 11 normal women underwent 12 frequent sampling studies at 10-min
      intervals for 48 h at various points during the transition from one cycle to the
      next. Daily blood samples captured both the preceding and subsequent LH surges,
      so that studies could be characterized in relation to the preceding LH peak
      (LH+), the subsequent LH peak (LH-), and menses (M). In the frequent sampling
      study, LH and FSH were measured in all samples, and estradiol (E2) and
      progesterone (P) were measured in 2-h pools. The frequency of pulsatile LH
      secretion increased 4.5-fold over an 8-day period spanning the luteal-follicular
      transition. This increase in LH pulse frequency was strongly related to the
      preceding LH peak (r = 0.82; P less than 0.00001), but was not at all related to
      the onset of menses. When the temporal markers (i.e. LH+, LH-, and M) were
      removed from the analysis, LH pulse frequency was inversely related to the log of
      serum P (r = 0.50; P less than 0.005), but not E2. FSH levels increased both
      within the individual studies (P less than 0.005) and in the group as a whole
      over the duration of the luteal-follicular transition. Mean FSH rose 3.5-fold
      compared to less than a 2-fold increase in mean LH. As with LH pulse frequency,
      the increase in FSH was most strongly related to the preceding LH peak, but was
      also significantly associated with the subsequent LH peak and the onset of
      menses. The relationship between FSH and the number of days from the preceding LH
      peak is even better fit by a second degree polynomial, which revealed an abrupt
      increase in LH beginning at LH+11. With the temporal markers excluded, the
      increase in FSH related only to LH pulse frequency (r = 0.62; P less than 0.001).
      FSH was not statistically related to the decreases in P or E2, which are also key
      variables at this stage of the menstrual cycle. We reached the following
      conclusions. 1) A dramatic increase in LH pulse frequency, and by inference GnRH
      pulse frequency, accompanies the selective rise in FSH levels during the luteal
      follicular transition of the normal menstrual cycle. 2) Both the increase in GnRH
      pulse frequency and the rise in FSH levels during this transition are strongly
      related to the preceding LH peak, while the clinical marker of menses is a
      relatively poor indicator of these events.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1740494
TI  - Cortisol resistance in acquired immunodeficiency syndrome.
AB  - This study concerns 9 iv drug abusers with acquired immunodeficiency syndrome
      (AIDS) who developed hypercortisolism without the clinical signs or metabolic
      consequences of hypercortisolism. All patients were characterized by an
      Addisonian picture (weakness, weight loss, hypotension, hyponatremia, and intense
      mucocutaneous melanosis). An acquired form of peripheral resistance to
      glucocorticoids was suspected. We, therefore, examined glucocorticoid receptor
      characteristics on mononuclear leukocytes by measuring [3H]dexamethasone binding
      and the effect of dexamethasone on [3H]thymidine incorporation, which is one of
      the effects of glucocorticoid receptor activation. Glucocorticoid receptor
      density was increased in AIDS patients with an Addisonian picture (group 1; 16.2
      +/- 9.4 fmol/million cells) compared to values in 12 AIDS patients without an
      Addisonian picture (group 2; 6.05 +/- 2.6 fmol/million cells; P less than 0.01)
      and sex- and age-matched controls (3.15 +/- 2.3 fmol/million cells; P less than
      0.01). The affinity of glucocorticoid receptors (Kd) was strikingly decreased
      (9.36 +/- 3.44 nM in group 1; 3.2 +/- 1.5 nM in group 2; 2.0 +/- 0.8 nM in
      controls; P less than 0.01). [3H]Thymidine incorporation was decreased dose
      dependently by dexamethasone in controls and patients; the effect was
      significantly blunted (P less than 0.05) in group 1 patients, which suggests that
      activation of glucocorticoid receptor is impaired as a result of the
      glucocorticoid receptor abnormality. In conclusion, AIDS patients with
      hypercortisolism and clinical features of peripheral resistance to
      glucocorticoids are characterized by abnormal glucocorticoid receptors on
      lymphocytes. Resistance to glucocorticoids implies a complex change in immune
      endocrine function, which may be important in the course of immunodeficiency
      syndrome.

PMID- 1740495
TI  - Function of DR-positive thyrocytes from patients with Graves' disease:
      quantitative analysis of thyroid peroxidase content by fluorescent photometry.
AB  - A considerable number of thyrocytes in patients with autoimmune thyroiditis
      ectopically express HLA-DR antigen. Furthermore, it has been reported that
      interferon-gamma-induced DR-positive thyrocytes in vitro secrete less thyroid
      hormone in response to TSH stimulation compared with DR-negative ones. However,
      the function of the intrinsically DR-positive thyrocytes is unknown. To evaluate
      their function, we stained by immunofluorescence for both DR antigen and thyroid
      peroxidase (TPO) in thyroid epithelial cells from patients with Graves' disease.
      We also measured the quantity of DR antigen and TPO using fluorescent photometry.
      The content of TPO was not significantly reduced in DR-positive thyrocytes
      compared with that in DR-negative thyrocytes. The TPO content is one measure of
      thyrocyte function. There was no significant difference between DR-positive and
      DR-negative thyrocytes. In conclusion, the function of DR-positive thyrocytes in
      vivo was not suppressed compared with that of DR-negative thyrocytes.

PMID- 1740496
TI  - Low urinary growth hormone values in patients with Turner's syndrome.
AB  - Short stature is one of the major symptoms in Turner's syndrome (TS). The cause
      of short stature is not clearly known at present. In this study we initially
      assessed GH secretory status in TS by determinations of urinary human (h) GH
      excretion for 2 consecutive days. Secondly, the therapeutic dose of hGH used for
      treatment of short stature in TS was evaluated by measurements of urinary hGH
      after recombinant hGH (r-hGH) injections. Twenty-four-hour urinary hGH excretion
      for the 2 days combined was significantly lower in patients with TS than in
      normal children [2.3 +/- 1.8 ng/day (n = 7) vs. 13.4 +/- 3.2 (n = 16); P less
      than 0.001], although four of seven patients with TS had normal GH responses to
      the provocative tests. The mean level of urinary hGH in TS after 2 days was
      comparable to that in complete GH deficiency (1.9 +/- 0.9 ng/day; n = 14) that we
      previously reported. Treatment with daily sc injections of 1.0 IU (0.37
      mg)/kg.week r-hGH, given in seven divided doses, normalized urinary hGH excretion
      and induced remarkable catch-up growth in all patients with TS. These results
      indicate that the 24-h endogenous GH secretion in seven patients with TS is
      impaired. The measurement of 24-h urinary hGH excretion may prove to be useful as
      a marker to assess the abnormal GH secretion and the adequacy of treatment with
      hGH in patients with TS. The therapeutic dose of hGH in TS is approximately 0.37
      mg/kg.week, given in seven divided doses. To convert international units of r-hGH
      to milligrams, divide by 2.7.

PMID- 1740497
TI  - Enhanced transdermal delivery of testosterone across nonscrotal skin produces
      physiological concentrations of testosterone and its metabolites in hypogonadal
      men.
AB  - None of the current or experimental androgen treatment modalities for male
      hypogonadism has been reported to produce physiological concentrations or
      circadian variations in testosterone (T) and its metabolites, dihydrotestosterone
      (DHT) and estradiol (E2). This investigation describes a novel transdermal dosage
      form designed to enhance the delivery of native T across nonscrotal skin. The
      main objective was to determine whether the nightly application of two
      experimental transdermal patches to different sites on the body (e.g. back,
      chest, arms, etc.) would result in normal plasma levels of T, DHT, and E2 for men
      and mimic the normal circadian variation. Six hypogonadal males (aged 24-66 yr)
      were studied 4 weeks after stopping T ester treatment. After single application
      of two patches, T levels increased from a pretreatment baseline of 5.8 +/- 0.94
      nmol/L (mean +/- SE; 167 +/- 27 ng/dL) to an average peak concentration of 44.1
      +/- 4.8 nmol/L (1273 +/- 138 ng/dL) 5.7 +/- 0.6 h after application and reached a
      24-h level of 16.9 +/- 2.9 nmol/L (488 +/- 85 ng/dL). DHT and E2 levels exhibited
      parallel variations within the normal reference ranges. During 4 weeks of daily
      evening application to various sites on the torso, the mean delivery of T from
      two patches was 5.2 +/- 0.1 mg/day (approximately 20% of the patch content), and
      morning T levels were within the normal limits. On day 28 of treatment, the 24-h
      plasma profiles of T, DHT, and E2 (obtained with two patches on the back)
      approximately mimicked the normal circadian variations reported in healthy young
      men. The time-averaged T level was 21.8 +/- 2.9 nmol/L (629 +/- 84 ng/dL), and
      the plasma concentration ratios of DHT/T (0.07 +/- 0.01) and E2/T (0.005 +/-
      0.001) were within the normal range. SHBG concentrations were not significantly
      altered over the 4 weeks of treatment. The patches were well tolerated, except
      for one patient who developed a local reaction to an excipient during the third
      week of treatment. Two of the patients (one with Klinefelter's syndrome)
      completed several months of continuous therapy. T, DHT, and E2 have remained in
      the range of normal, and plasma LH levels in the patient with Klinefelter's
      syndrome became normal. Subjective improvement in symptoms has continued, and
      tolerability has been good in both patients. These results indicate that the
      enhanced transdermal delivery of T across nonscrotal skin is a patient-friendly
      androgen replacement modality and produces physiological concentrations of T and
      its metabolites, which are unattainable with other treatment modalities.

PMID- 1740498
TI  - Induction and superinduction of messenger ribonucleic acid specific for aromatase
      cytochrome P-450 in cultured human skin fibroblasts.
AB  - Aromatase cytochrome P-450 (cytochrome P-450AROM) catalyzes the formation of
      aromatic C18 estrogenic steroids from C19 androgens. Several studies indicate
      that cytochrome P-450AROM activity is induced by glucocorticoids such as
      dexamethasone (DEX) and superinduced by DEX plus cycloheximide (CHX). We have
      used cultured human skin fibroblasts as a model system to investigate the
      regulation of aromatase gene expression. Whereas Northern blot analysis of total
      cellular RNA or poly (A)+ RNA from untreated strains of normal human skin
      fibroblasts failed to demonstrate any hybridization with a specific human
      placental cytochrome P-450AROM complementary DNA, analysis of RNA from cells
      treated with DEX demonstrated hybridization of the cytochrome P-450AROM
      complementary DNA to two transcripts of about 2.5 and 3.0 kilobases. Incubation
      of cells with DEX plus CHX resulted in a further increase in levels of cytochrome
      P-450AROM messenger RNA (mRNA) when compared to cells treated with DEX alone,
      suggesting that inhibition of protein synthesis superinduces transcription of the
      cytochrome P-450AROM gene. By contrast, levels of beta-actin mRNA were not
      affected by treatment with DEX and CHX. Treatment of cells with CHX alone did not
      produce a change in either aromatase activity or levels of cytochrome P-450AROM
      mRNA transcripts. These results indicate that aromatase activity is regulated by
      changes in the concentration of cytochrome P-450AROM mRNA, and imply that control
      of cytochrome P-450AROM gene expression is at the level of gene transcription. We
      conclude that the cytochrome P-450AROM gene is regulated by a complex mechanism
      that includes both positive and negative transcription factors.

PMID- 1740499
TI  - Effect of glycemic control on the overnight dexamethasone suppression test in
      patients with diabetes mellitus.
AB  - Because many of the clinical features associated with Cushing's syndrome are
      frequently found in patients with diabetes mellitus, diabetic patients are often
      evaluated for Cushing's syndrome. The initial test for Cushing's syndrome is the
      1 mg overnight dexamethasone suppression test (DST), but its value as a screening
      test in diabetic subjects, especially those with poor glycemic control, has been
      questioned. To address this issue, an overnight DST was administered to 100
      subjects with diabetes. Only 7 patients failed to suppress their plasma cortisol
      to less than 140 nmol/L (5.0 micrograms/dL), achieving a specificity of 93%.
      There was no relation between acute glycemic control (as measured by the mean of
      4 serum glucose values obtained before receiving dexamethasone) or chronic
      glycemic control (as measured by glycohemoglobin) and false positive responses to
      the 1 mg overnight DST. The mean of the measures of acute glycemic control of the
      7 subjects who had false positive results, 14.4 +/- 2.8 mmol/L, was not
      significantly different than that of the 93 subjects with normal responses, 13.2
      +/- 3.3 mmol/L. Similarly, the mean glycohemoglobin of the subjects with false
      positive results, 12.8 +/- 2.4%, was not significantly different than that of the
      subjects with normal responses, 12.9 +/- 2.5%. There was no correlation between
      plasma cortisol after dexamethasone and glycohemoglobin (r = 0.05), and only a
      weak correlation with the mean serum glucose (r = 0.21). We conclude that the 1
      mg overnight DST is a valid screening test for Cushing's syndrome in patients
      with diabetes, regardless of glycemic control.

PMID- 1740500
TI  - A prospective study of lymphocyte-initiated immunosuppression in normal
      pregnancy: evidence of a T-cell etiology for postpartum thyroid dysfunction.
AB  - Immune function in normal pregnancy and the postpartum period remains poorly
      defined. We hypothesized that a comparative study between pregnant women with
      normal and abnormal immune function would further our understanding of the immune
      mechanisms of pregnancy. We chose to study a cohort of pregnant women at risk for
      the development of postpartum thyroid dysfunction (PPTD) as well as a group of
      normal controls. We chose PPTD as the model for abnormal immune function because
      of the relative ease of monitoring disease development and the relatively high
      prevalence for PPTD reported in earlier studies. Five hundred and fifty-two women
      were screened for the presence of thyroid autoantibodies in the first trimester
      of pregnancy. Thirty-three thyroid autoantibody-positive women and 28 thyroid
      autoantibody-negative women were followed prospectively throughout pregnancy and
      6 months into the postpartum period. Lymphocyte subset analyses, thyroid function
      tests, and thyroid autoantibodies (antihuman thyroglobulin and antithyroid
      peroxidase) were performed at defined intervals. All patients were HLA serotyped.
      Normal pregnancy was principally characterized by decreased CD4+ T-cells and
      increasing CD8+ T-cells, causing a significant fall in the CD4+/CD8+ ratio in
      late pregnancy and into the postpartum period. Women who developed PPTD had 1) a
      higher CD4+/CD8+ ratio (P = 0.04), 2) activation of T-cells in the postpartum
      period (P = 0.02), and 3) significantly higher thyroid autoantibody titers
      (antihuman thyroglobulin, P = 0.02; antithyroid peroxidase, P = 0.0018). We found
      an overall incidence for PPTD of 8.8%. These data demonstrated that women who
      were thyroid autoantibody positive in the first trimester of pregnancy had a one
      in three chance of developing PPTD. We observed a significant fall in the T-cell
      helper/suppressor ratio in normal pregnant women, which was associated with
      distinct T-cell subset changes. This pregnancy-initiated T-cell regulation
      reflected an overall suppression of immune function. The development of PPTD was
      a frequent postpartum event in our population and was associated with a triad of
      immune markers: a reduction in the normal immune suppression of pregnancy (as
      indicated by higher T-cell helper/suppressor ratios), enhanced postpartum T-cell
      activation, and elevated thyroid autoantibodies. The reduction in the degree of
      immune suppression was, therefore, a major factor in the development of PPTD. Our
      results define immunological changes that occur in normal pregnancy and distinct
      immunological abnormalities necessary for the development of PPTD.

PMID- 1740501
TI  - Hypothalamo-pituitary axis by magnetic resonance imaging in isolated growth
      hormone deficiency patients born by normal delivery.
AB  - Magnetic resonance imaging was performed using a 1.5 Tesla magnet in 22 children
      (14 boys and 8 girls) between 5-20 yr of age with isolated GH deficiency (IGHD),
      born by normal vaginal delivery without any birth asphyxia or trauma. A total of
      22 children (10 boys and 12 girls) without short stature and endocrine disease
      were evaluated as controls. The IGHD group had a height velocity less than 4
      cm/yr and delayed bone age. The peak GH levels were less than 10 micrograms/L
      (mean, 2.4 micrograms/L). The height of the pituitary gland ranged from 3-7.5 mm
      in controls. An intact stalk was observed in 21 children with IGHD, with
      nonvisualization in 1. An apparently thin stalk was seen in 6. The posterior lobe
      identified by the hyperintensity signal, had a mean diameter of 1.84 mm and was
      located in a normal position in 21 children. An ectopic posterior pituitary
      hyperintensity was present in 1 patient. The anterior pituitary was hypoplastic
      in 17 children, with partial empty sella in 13. A total of 5 children had
      associated brain anomalies, such as Arnold Chiari malformation, craniovertebral
      malformation with basilar impression, degenerative plaques around posterior horn
      of lateral ventricle and parietal area, and infarcts in caudate nucleus and
      putamen. These findings suggest that IGHD was not related to transection or
      compression of the stalk.

PMID- 1740502
TI  - Evidence for increased liver glycogen in patients with noninsulin-dependent
      diabetes mellitus after a 3-day fast.
AB  - In order to assess hepatic glycogen stores in patients with noninsulin dependent
      diabetes mellitus (NIDDM) after a 3-day fast, the incremental glucose response to
      1.0 mg iv glucagon (glucose area under the curve, glucoseAUC) was assessed in 19
      obese diabetic subjects after an overnight (14 h) fast and again after a 3-day
      (64 h) fast. Results were compared to those of lean (n = 6) and obese (n = 15)
      nondiabetic subjects. During the fast, plasma glucose fell significantly in the
      lean (4.9 +/- 0.2 to 3.9 +/- 0.2 mmol/L), obese (5.1 +/- 0.1 to 4.2 +/- 0.2
      mmol/L), and diabetic (14.7 +/- 0.7 to 10.3 +/- 1.0 mmol/L) subjects. However, in
      contrast to the fall in glucoseAUC observed in the lean (92.4 +/- 15.4 to 39.9 +/
      8.1 mmol min-1 L-1, P less than 0.02) and obese (64.4 +/- 11.1 to 48.4 +/- 9.4
      mmol min-1 L-1) subjects, the glucoseAUC increased in diabetic subjects from 81.6
      +/- 8.6 to 103.9 +/- 8.8 mmol min-1 L-1 during the fast, and was significantly
      greater than that of either the lean (P less than 0.001) or obese (P less than
      0.001) nondiabetic subjects after the 64-h fast. Evidence that the glucose
      response to glucagon after a 64-h fast represents glycogenolysis and not
      gluconeogenesis was provided by studies in 10 additional subjects (5 obese
      nondiabetic subjects and 5 patients with NIDDM). Overall hepatic glucose output
      calculated from glucose kinetic data [( 3-3H]glucose) increased in diabetic and
      nondiabetic subjects during the first 30 min after glucagon administration and
      fell progressively thereafter. However, no increase in alanine gluconeogenesis
      (14C-alanine incorporation into glucose) was observed after glucagon
      administration in either subject group. The paradoxical accumulation of glycogen
      in the patients with NIDDM during the fast occurred despite basal rates of
      hepatic glucose output on the third day of the fast which were greater than those
      of obese nondiabetic subjects (9.0 +/- 1.2 vs. 5.6 +/- 0.5 mumol kg-1 min-1, P
      less than 0.05). A glycogen sparing action of increased gluconeogenesis is
      proposed as the explanation for the preservation of liver glycogen in patients
      with NIDDM.

PMID- 1740503
TI  - Compound heterozygous mutations (Arg 239----stop, Pro 342----Thr) in the CYP17
      (P45017 alpha) gene lead to ambiguous external genitalia in a male patient with
      partial combined 17 alpha-hydroxylase/17,20-lyase deficiency.
AB  - 17 alpha-Hydroxylase deficiency is characterized by defects in either or both the
      17 alpha-hydroxylase/17,20-lyase activities. We have, for the first time,
      elucidated the molecular basis of the deficiency in a male pseudohermaphrodite
      with ambiguous external genitalia resulting from partial combined deficiency of
      both activities. The patient is found to be a compound heterozygote, carrying two
      different inherited mutant alleles in the cytochrome P45017 alpha (CYP17) gene.
      One allele, from his mother, contains a stop codon (TGA) in place of arginine
      (CGA) at amino acid position 239 in exon 4. Because this occurs at the N-terminal
      side of the heme binding sequence, the putative resultant truncated protein is
      nonfunctional. The second allele, from his father, contains a missense mutation
      encoding the substitution of proline (CCA) by threonine (ACA) at position 342 in
      exon 6. Reconstruction of this mutation by site-directed mutagenesis into human
      P45017 alpha cDNA followed by expression in COS 1 cells leads to the same amount
      of immunodetectable P45017 alpha protein as found with expression of the normal
      P45017 alpha cDNA, although both the 17 alpha-hydroxylase and 17,20-lyase
      activities are found to be reduced to 40-45% of those of the normal enzyme. The
      presence of ambiguous external genitalia in this 46 XY individual indicates that
      greater than 20% of the total normal 17,20-lyase activity is required for
      complete virilization in the male.

PMID- 1740504
TI  - Mechanisms of hepatic and peripheral insulin resistance during acute infections
      in humans.
AB  - To examine mechanisms of insulin resistance, nine patients (age 33 +/- 4 yr, body
      mass index 22 +/- 1 kg/m2) with acute bacterial or viral infections and in six
      matched normal subjects were studied. Endogenous glucose appearance (Ra), glucose
      disappearance (Rd), and recycling, the percentage of plasma lactate originating
      from plasma glucose, total glucose oxidation, and whole body and forearm muscle
      Rd were measured after an overnight fast in the basal state and during
      physiological hyperinsulinemia (serum insulin approximately 215 pmol/L). Basally
      Ra, Rd, glucose recycling, and oxidation were similar in both groups. During
      hyperinsulinemia, insulin stimulated plasma Rd approximately 35% less (17.6 +/-
      1.3 vs. 26.8 +/- 3.6 mumol/kg.min, P less than 0.01, patients vs. normal
      subjects), and inhibited endogenous Ra less in the patients (from 13.3 +/- 0.8 to
      5.3 +/- 0.8 mumol/kg.min) than in the normal subjects (from 12.8 +/- 1.0 to 2.1
      +/- 1.2 mumol/kg.min, P less than 0.01). The decrease in whole body Rd was
      largely explained by a approximately 75% reduction in muscle Rd (5.6 +/- 1.5 vs.
      20.8 +/- 3.3 mumol/kg muscle.min, P less than 0.01, patients vs. normal
      subjects). The defect in Rd was confined to nonoxidative (4.8 +/- 1.1 vs. 11.0 +/
      3.0 mumol/kg.min, P less than 0.01, patients vs. normal subjects) but not to
      oxidative glucose metabolism. The percentage of plasma lactate derived from
      plasma glucose during hyperinsulinemia averaged 63 +/- 6% in the patients and 79
      +/- 5% in the normal subjects, indicating that glycogenolysis did not excessively
      dilute glycolytic carbons in the patients. We conclude that during natural
      infections in humans, abnormal glucose metabolism is confined to the insulin
      stimulated state and involves a marked defect in muscle glucose uptake and
      glycogen synthesis, as well as a less marked hepatic defect.

PMID- 1740505
TI  - Evidence for the presence of differently glycosylated forms of prorenin in the
      plasma of anephric man.
AB  - Previously, we unexpectedly observed that plasma inactive renin (trypsin
      activatable renin) in bilaterally nephrectomized rats is not prorenin. To
      determine whether plasma inactive renin in anephric man is prorenin, we examined
      the immunological and biochemical properties of plasma inactive renin from five
      anephric patients. There were significant concentrations of inactive renin (5.33
      +/- 2.08 ng/L.s) in plasma of anephric patients, while active renin was
      negligible (0.06 +/- 0.01 ng/L.s). The inactive renin from anephric patients
      could be immunoprecipitated 97 +/- 1% by specific antiserum against the
      prosegment portion of prorenin. Specific antimature renin serum completely
      inhibited the angiotensin-I-generating activity of inactive renin induced by
      trypsin treatment. The molecular mass of inactive renin from anephric patients
      (49.0 +/- 0 kDa), estimated by gel permeation high performance liquid
      chromatography, was similar to that of normal human plasma prorenin (48.2 +/- 0.8
      kDa). These results indicate that plasma inactive renin in anephric man is
      prorenin, findings different from our previous observations obtained in anephric
      rats. Concanavalin-A chromatography separated inactive renin from anephric
      patients into three forms, including the column-unbound form, the loosely bound
      form, and the tightly bound form. Thus, in anephric man, differently glycosylated
      multiple forms of prorenin are released into the circulation from an extrarenal
      organ(s).

PMID- 1740506
TI  - Reduction in size of a thyrotropin- and gonadotropin-secreting pituitary adenoma
      treated with octreotide acetate (somatostatin analog).
AB  - TSH as well as alpha-subunit, secretion has been shown to decrease after the
      administration of the somatostatin analog octreotide acetate (SMS 201-995). We
      have studied a 59-yr-old, male patient with a TSH- and gonadotropin-secreting
      tumor who, because of severe cardiomyopathy, was treated with long-term
      somatostatin analog rather than surgical resection of the pituitary tumor.
      Thirteen weeks of treatment with thrice daily sc injection of 100 micrograms
      octreotide acetate resulted in decreased TSH and alpha-subunit secretion, normal
      serum thyroid hormone levels, reduction in LH and testosterone level, and
      significant tumor size reduction. Long-term treatment for 51 weeks has not been
      associated with any significant side effects. We have shown that octreotide
      acetate may be a therapeutically valuable modality for certain patients with
      neoplastic inappropriate secretion of TSH (NIST). A probable effect of octreotide
      acetate on neoplastic gonadotropes, as evidenced by the reduction of the LH level
      with a concomitant decrease in testosterone level, is, likewise, suggested.

PMID- 1740507
TI  - Utility of an oral diffusion sink (ODS) device for quantification of saliva
      corticosteroids in human subjects.
AB  - Measurement of cortisol by assay of single blood or saliva samples is inherently
      imprecise due to the episodic secretion of cortisol. In addition, assay of blood
      usually quantifies total cortisol, rather than separating free hormone, which is
      proportionately the much smaller fraction. Furthermore, the free fraction may be
      disproportionately higher in hypercortisolism. Urinary free cortisol is one
      measure that provides both a time integral and a focus on the free fraction, but
      it is inconvenient and prone to collection error in unsupervised ambulatory
      subjects. The Oral Diffusion Sink (ODS) apparatus takes up corticosteroids from
      saliva according to first-order kinetics and may provide a practical alternative.
      We assessed the utility of the ODS in a study of seven healthy volunteers
      admitted to the CRC for three days. Data on day two from 0700-1100 h and 1100
      1500 h were compared between the ODS and three other means of assessing cortisol:
      urinary free cortisol (UFC), blood, and saliva. The subjects all tolerated
      wearing the ODS device without any complaint. High correlations were observed
      between ODS values vs. data for UFC, plasma, and saliva determinations. In
      summary, the ODS device was well tolerated and collected reliable corticosteroid
      data, and thus provides a new, non-invasive methodology for studies of HPA
      function in health and disease.

PMID- 1740508
TI  - Diagnosing fungal infections in immunocompromised hosts.

PMID- 1740509
TI  - Parenchymatous thyroid nodules: a histocytological study of 31 cases from a
      goitrous area.
AB  - AIMS: To analyse the benefits and limitations of fine needle aspiration in the
      cytological differentiation of parenchymatous nodular goitres from follicular
      tumours in an endemic area. METHODS: Cytological smears of fine needle aspirates
      from 31 parenchymatous nodular goitres were studied. A sample from the punctured
      nodules was fixed in formalin and stained with haematoxylin and eosin for
      histological analysis. RESULTS: All nodules occurred in a multinodular gland,
      were well circumscribed, did not compress surrounding thyroid tissue, and for the
      most part, were unencapsulated. Two cases showed cytological features of nodular
      goitre, two of colloid cysts; the remaining 27 were cytologically
      indistinguishable from follicular lesions. CONCLUSIONS: Most of the
      parenchymatous nodules studied had features suggestive of follicular lesions or
      neoplasia, but surgical treatment should only be considered after hormone
      treatment has proved unsuccessful, and when they are not suspected as malignant
      clinically. Fine needle aspiration is useful as a diagnostic and screening aid,
      but the results should be interpreted with caution to prevent unnecessary
      surgery.

PMID- 1740510
TI  - Association of Helicobacter pylori with HLA-DR antigen expression in gastritis.
AB  - AIMS: To assess the association between Helicobacter pylori-associated gastritis
      and HLA-DR antigen (class II antigen) expression. METHODS: Fifty endoscopic
      gastric biopsy specimens were studied for the presence of H pylori, degree and
      type of inflammation, and for HLA-DR antigen expression in the epithelium. The
      cases were chosen to represent different categories: inflamed gastric mucosa with
      (n = 13) and without (n = 20) H pylori, and non-inflamed mucosa (n = 17).
      RESULTS: The antigen was aberrantly expressed in the antral mucosal epithelium in
      11 of 12 cases (92%) with acute-on-chronic gastritis when H pylori was also
      present. It was present in the antrum in only seven of 18 H pylori negative cases
      (39%) with acute-on-chronic/chronic gastritis. One of three cases of acute
      gastritis and three of seven cases of chronic gastric erosions (non-inflamed
      category) showed positive staining. Generally, there was more staining in the
      antral than body mucosa and in the surface/foveolar epithelium than in the
      glands. No aberrant HLA-DR antigen expression was found in the 10 cases of normal
      gastric mucosa examined. CONCLUSIONS: These findings suggest that H pylori may
      have a role in the induction of class II HLA antigen expression in chronic
      gastritis and lend support to the view that these organisms may be responsible
      for part of the inflammatory response.

PMID- 1740511
TI  - Salmonella bacteraemia in England and Wales, 1981-1990.
AB  - AIMS: To report the incidence of nontyphoidal salmonellas in England and Wales
      and identified in the Division of Enteric Pathogens, London between 1981 and
      1990. METHODS: Strains were serotyped and phage typed for Salmonella typhimurium,
      S enteritidis, and S virchow, using established methods. RESULTS: Overall, less
      than 2% of nontyphoidal salmonellas isolated from humans were from blood culture.
      The highest numbers of bloodstream isolates were from infections caused by S
      enteritidis and S typhimurium, but the highest incidence of septicaemias was
      attributable to infections with S cholerae-suis, S dublin, and S virchow. 2.2% of
      S typhimurium isolates phage type 204C were from blood culture; likewise, 5.5% of
      S virchow phage type 19. This could be a cause for concern as most isolates of
      both these phage types are multiresistant to antimicrobial drugs. CONCLUSIONS:
      Salmonella septicaemia is rare in England and Wales in other than a few serotypes
      of limited epidemiological importance.

PMID- 1740512
TI  - Enzyme immunoassay for anti-treponemal IgG: screening or confirmatory test?
AB  - AIMS: To review the performance of the Venereal Diseases Research Laboratory
      (VDRL) test and the Treponema pallidum haemagglutination assay (TPHA) as a
      combined screen for syphilis to provide a baseline for assessing screening by
      anti-treponemal IGG EIA. METHODS: Between 1980 and 1987 all serum samples were
      screened by both VDRL and TPHA tests. The FTA-ABS test was also used in suspected
      early primary syphilis, or when one of the other tests was positive. A positive
      result in a screening test was confirmed by quantitative testing. From 1988 all
      specimens were screened with an enzyme immunoassay (Captia Syph G) as a single
      screening test. RESULTS: Of the 44 primary, 47 secondary, and 38 early latent
      cases of syphilis, the VDRL and TPHA detected 32 (73%) and 31 (71%) of the
      primary cases; the combination detected 37 (84%). All 85 cases of cases of
      secondary and early latent infection were reactive in the TPHA test, whereas the
      VDRL was reactive in only 68 (80%). EIA had a reported sensitivity of 82% for
      primary infection. CONCLUSIONS: EIA can be used as a single screening test for
      detecting early syphilis because its results are comparable with those of the
      combined VDRL and TPHA tests. The conventional VDRL test should not be used as a
      single screening test.

PMID- 1740513
TI  - Evaluation of enzyme linked immunosorbent assay for screening urinary tract
      infection in elderly people.
AB  - AIMS: To evaluate the Uristat test, an indirect enzyme linked immunosorbent assay
      for the qualitative detection of antibodies in urine, as a screening, and in the
      diagnosis of urinary tract infection in the elderly. METHODS: Semiquantitative
      culture was compared with conventional microscopy, dipstick analysis and the
      ELISA. In the ELISA, 371 urine samples were examined for antibodies to an antigen
      mixture of six common urinary pathogens. RESULTS: The sensitivity was 91% and the
      specificity 25% for the ELISA. The negative predictive value was 81% and the
      positive predictive value was 43%. CONCLUSIONS: In its present form the Uristat
      test has no clear advantages over conventional bacteriological techniques for
      screening urine samples for infection in an elderly population.

PMID- 1740514
TI  - Screening tests for pathogenic corynebacteria.
AB  - AIM: To provide simple tests that would help in the identification of
      corynebacteria that produce diphtheria toxin. METHODS: A collection of 99 freshly
      isolated corynebacteria was assembled and the cultures identified by conventional
      tests confirmed by an identification kit. Modifications were made to procedures
      for preparation of the culture medium for the Elek test and to the test for
      detection of pyrazinamidase (pyrazine carboxylamidase) activity. These two
      together with an indicator medium for cystinase activity were applied to the
      collection of organisms. RESULTS: Cystinase was detected in all 61 members of the
      toxigenic species and none produced pyrazinamidase. In contrast, all but two of
      the 38 representatives of non-toxigenic species yielded pyrazinamidase and none
      formed cystinase. Of the 61 cystinase producing cultures (which were also
      pyrazinamidase negative), 21 gave a positive Elek test with the modified culture
      medium. A total of 30 of these 61 were tested for toxigenicity in guinea pigs and
      the results of the animal and plate tests concorded. At least seven cultures
      could have been reported as non-toxigenic if Elek tests based on media prepared
      in the conventional way had been the only test available. CONCLUSION: The three
      procedures described go some way towards meeting the needs of diagnostic
      laboratories for efficient procedures for distinguishing pathogenic
      corynebacteria.

PMID- 1740515
TI  - Bacterial toxins: a possible cause of cot death.
AB  - AIM: To test the hypothesis that sudden infant death syndrome (SIDS) may be
      caused by toxins of commonly occurring bacteria in infants lacking developed
      immunity. METHODS: Nasopharyngeal microbial isolates from 22 pairs of SIDS cases
      and healthy infants matched for age (by month), sex, and sampling time (by month)
      were compared for lethal toxigenicity. Crude toxin preparations were made from
      isolates cultured on dialysis membrane overlaid on agar, and these preparations
      were then tested for lethality by intravenous injection into 11 day old chick
      embryos. RESULTS: Fifteen (68%) of the SIDS cases were each found to have at
      least one lethally toxigenic organism in their nasopharyngeal flora; only eight
      (36%) of the flora of normal infants included a lethally toxigenic species.
      CONCLUSION: Infants who have died of SIDS have a significantly higher (p less
      than 0.05) probability than matched healthy infants of having a lethally
      toxigenic bacterial species in their nasopharyngeal flora.

PMID- 1740516
TI  - Plasma viscosity in inflammatory bowel disease.
AB  - AIMS: To assess the relation of plasma viscosity to disease activity in patients
      with inflammatory bowel disease. METHODS: Crohn's disease (n = 60) and ulcerative
      colitis (n = 71) were diagnosed on the basis of typical histological or
      radiological features. Active Crohn's disease was defined as a Crohn's disease
      activity index of 150 or over. Active ulcerative colitis was defined as a liquid
      stool passed three times a day or more with blood. Blood samples were assessed
      for haemoglobin concentration, total white cell count, platelets, plasma
      viscosity, erythrocyte sedimentation rate, serum albumin, and C-reactive protein.
      RESULTS: Plasma viscosity was higher in those with active Crohn's disease
      compared with those with inactive Crohn's disease or active ulcerative colitis.
      Plasma viscosity correlated significantly with erythrocyte sedimentation rate, C
      reactive protein, and platelet count in patients with Crohn's disease. In
      ulcerative colitis plasma viscosity correlated only with serum C-reactive
      protein. Plasma viscosity showed a low sensitivity for detecting active Crohn's
      disease, with 48% of those with active disease having a plasma viscosity within
      the laboratory reference range. CONCLUSIONS: Plasma viscosity is related to
      disease activity in Crohn's disease, but is insufficiently sensitive for it to
      replace erythrocyte sedimentation rate as a measure of the acute phase response
      in Crohn's disease.

PMID- 1740517
TI  - Assessment of value of calibrated lyophilised plasmas to determine International
      Sensitivity Index for coagulometers.
AB  - An attempt was made to correct for the effects of coagulometers on the
      International Sensitivity Index (ISI) in a series of collaborative studies.
      Modified ISI were derived from the prothrombin time results with coagulometer
      systems using a range of calibrated plasmas. Two alternative approaches to
      correction of the ISI were evaluated. The first relied on the consensus
      orthogonal regression slopes of the prothrombin times for each coagulometer
      system plotted against the consensus manual results; the second depended on the
      local individual slope of the prothrombin times for each instrument. The two
      procedures were compared with the currently recommended method where
      International Normalised Ratios (INR) are derived from the manual ISI of the
      thromboplastin. The recommended method gave a significant bias from the manual
      results with most coagulometers. In contrast, the local correction procedure gave
      no significant biases, whereas the consensus method did so in a few instances.
      Both these correction procedures seem more reliable than the recommended method
      of INR derivation, but the local correction is more accurate and offers a more
      practical solution by allowing laboratories to determine their own corrected ISI
      on a range of calibrated plasmas.

PMID- 1740518
TI  - Early clinical pathologists 4: Rudolf Virchow (1821-1902).

PMID- 1740519
TI  - Increased serum concentrations of tumour necrosis factor in beta thalassaemia:
      effect of bone marrow transplantation.
AB  - AIMS: Serum concentrations of tumour necrosis factor-alpha (TNF) were determined
      in beta thalassemic patients before and after bone marrow transplantation (BMT)
      to evaluate whether changes in TNF concentrations after BMT were related to
      immune mediated complications. METHODS: Serum TNF concentrations were determined
      by enzyme linked immunoassay (EIA) in paired samples from 71 patients with beta
      thalassemia before and after BMT. Serial samples from 13 patients were also
      studied for up to six months after BMT. Forty one normal healthy children matched
      for sex and age were studied as controls. RESULTS: beta thalassemic patients had
      high serum TNF concentrations before transplantation compared with controls.
      These were not related to sex, age, duration of disease, number of blood
      transfusions, transferrin concentrations or splenectomy. DQw1 positive patients
      showed significantly lower TNF concentrations than non-DQw1 cases. Patients with
      severe liver fibrosis had significantly higher TNF concentrations. No correlation
      was found between TNF values and BMT outcome before transplantation but TNF alpha
      values fell significantly after BMT. The decrease persisted only in patients with
      successful engraftment. In serial samples studied for up to six months after BMT,
      TNF values decreased but in four out of five patients with graft rejection and in
      all five with acute graft versus host disease (GVHD) sharp increases occurred at
      the time of clinical symptoms. No correlation was found between the degree of
      GVHD and serum TNF-alpha concentrations nor between TNF-alpha concentrations
      after BMT and the presence of bacterial, viral, and fungal infections.
      CONCLUSIONS: About 50% of beta thalassemic patients have increased serum TNF, and
      the changes after BMT are related to the occurrence of immune mediate
      complications. The persistence of low TNF concentrations after successful
      engraftment may be due to the preparative regimen and the lack of adverse immune
      reactions.

PMID- 1740520
TI  - Classical complement activation induced by pregnancy: implications for management
      of connective tissue diseases.
AB  - AIMS: To determine the effect of pregnancy on C4d concentrations and to assess
      whether C4d remains a useful disease activity marker in the management of
      connective tissue diseases during pregnancy. METHODS: Plasma C3, C4, and C4d
      concentrations were measured in 83 women at various stages of normal pregnancy
      and compared with those in 80 non-pregnant controls. RESULTS: C3 concentrations
      in the pregnant women were significantly raised (p = 0.0001) and the C4
      concentrations were reduced (p = 0.0007), and accompanied by a significant
      increase in C4d (p = 0.0001). The C4d:C4 ratio was higher in the pregnant women
      (p = 0.0001). CONCLUSIONS: Pregnancy induces activation of the classical
      complement pathway. C4d concentrations cannot be used to monitor disease activity
      in patients with connective tissue diseases during pregnancy.

PMID- 1740521
TI  - Evaluation of two new methods for routine measurement of alkaline phosphatase
      isoenzymes.
AB  - AIMS: To evaluate the performance of two new methods for the analysis of alkaline
      phosphatase (ALP) isoenzymes designed for use in the routine chemical pathology
      laboratory: pre-incubation with neuraminidase before agarose electrophoresis; and
      selective precipitation of the bone isoenzyme with wheat germ agglutinin (WGA).
      METHODS: Serum samples from 39 patients were analysed. Seventeen were from
      patients with liver disease, eight from patients with bone disease, and 14 from
      patients with normal ALP activity and no evidence of liver or bone disease. The
      two new methods were compared with the established method, wheat germ agglutinin
      affinity electrophoresis. RESULTS: There was good correlation between the
      neuraminidase and WGA electrophoretic methods. The WGA precipitation method
      showed negative interference in the measurement of bone isoenzyme activity in
      samples containing biliary alkaline phosphatase. Both the new methods had
      advantages of speed and simplicity over the existing method, but cost per test
      was considerably higher. CONCLUSIONS: The neuraminidase electrophoretic method is
      a satisfactory alternative to the WGA affinity electrophoretic method, although
      it is more expensive. The WGA precipitation method cannot be recommended for use
      with serum samples from patients with suspected liver disease.

PMID- 1740522
TI  - Experience of a quality assessment scheme for non-laboratory glucose meters.
AB  - In late 1989 a quality assessment scheme was introduced for glucose meters at 12
      non-laboratory sites in a unit of management. The overall monthly imprecision of
      the meters varied from 3.4% to 17.1%, the highest coefficients of variation being
      recorded for glucose concentrations outside the range 3-20 mmol/l. In the same
      period 37% of results fell outside +/- 10% of laboratory set target limits; 13%
      fell outside +/- 20% of these limits. Participants have been advised of the
      unreliability of results outside the range 3-20 mmol/l. The main benefit of the
      scheme has been the improved confidence of users in the results obtained.

PMID- 1740523
TI  - Audit of catheter urine culture requests.
AB  - An audit to assess the appropriateness of catheter urine culture requests was
      carried out for a period of one month. The requests were followed up by members
      of the Infection Control Team at ward level. The laboratory report had no impact
      on the removal of the catheter in asymptomatic or symptomatic patients, although
      the reports did aid antibiotic prescribing in symptomatic patients.

PMID- 1740524
TI  - Transitional cell carcinoma: a case for collaboration.
AB  - Urine samples from the greatest proportion of the numerical workload of most
      clinical microbiology laboratories. During the screening by microscopy, atypical
      cells were detected which did not conform to the normal cellular morphology found
      in urinary deposits. These specimens were referred to the Department of
      Cytopathology for a second opinion. From these referrals a small but significant
      number of previously undiagnosed transitional cell carcinomas were detected.

PMID- 1740525
TI  - Symptomatic zinc deficiency in experimental zinc deprivation.
AB  - An evaluation of indices of poor zinc status was undertaken in five male subjects
      in whom dietary zinc intake was reduced from 85 mumol d-1 in an initial phase of
      the study to 14 mumol d-1. One of the subjects developed features consistent with
      zinc deficiency after receiving the low zinc diet for 12 days. These features
      included retroauricular acneform macullo-papular lesions on the face, neck, and
      shoulders and reductions in plasma zinc, red blood cell zinc, neutrophil zinc and
      plasma alkaline phosphatase activity. Alcohol induced hepatitis, which was
      suspected in this subject, may have caused a predisposition to altered zinc
      metabolism and possible zinc deficiency which was exacerbated by subsequent zinc
      deprivation. The report supports the value of neutrophil zinc concentration as an
      indicator of poor zinc status.

PMID- 1740526
TI  - Notes on necropsy.
AB  - From the above it can be seen that autopsy is not a grotesque, macabre procedure
      performed for peculiar and disreputable reasons in a remote corner of the
      hospital. On the contrary, it is a scientific study designed to forward our
      knowledge of health and disease by the three primary methods of service, teaching
      and research. The examination of a dead body is always an emotional procedure.
      The pathologist and those concerned with frequent performance of autopsies become
      accustomed to it. To witness an autopsy may cause considerable emotional reaction
      in inexperienced people. As part of the learning experience, it can be very
      useful and appropriate staff are welcome to attend by arrangement. As proper
      protection garments are required and the suitability of viewing certain autopsies
      may arise, a formal request to the responsible pathologist is necessary. Whatever
      one's religious beliefs, it may be helpful to think of the deceased person's body
      as something which he or she has used during life, but which is no longer in any
      real way the persons once life has departed. The decreased body must be treated
      with dignity and respect as representing the remains of what was a human being
      and because of the natural desire of the next of kin that the remains of their
      relative should so be treated; it is not the person who used the body during
      life.

PMID- 1740527
TI  - Comparison of two simple microaerobic atmospheres for cultivation of thermophilic
      campylobacters.
AB  - A comparison of a modification of the spirit burn method and one based on the
      Fortner principle was carried out on 3474 faecal samples from patients with
      diarrhoea. Of the 96 isolates of Campylobacter, 47 showed equal abundance of
      growth, regardless of the method used. By using the spirit burn method, however,
      growth of 33 isolates was significantly increased, and 18 out of those 33
      isolates grew only in the spirit burn method atmosphere. The spirit burn method
      is more effective than the one based on the Fortner principle, it is easy to
      perform, quick, and cheap.

PMID- 1740528
TI  - Association between mast cells and myelomonocytes.

PMID- 1740529
TI  - Distribution of type IV collagen immunoreactivity to assess questionable early
      stromal invasion.
AB  - AIMS: To determine if the immunocytochemical delineation of subepithelial
      basement membrane can be used in the assessment of questionable early invasive
      cervical carcinoma. METHODS: The distribution of immunoreactive type IV collagen
      was examined in 15 cervical biopsy specimens in which the reporting pathologist
      had specifically described difficulty in assessing or excluding early invasion of
      subepithelial stroma associated with cervical intraepithelial neoplasia (CIN).
      The results were compared with those from biopsy specimens showing CIN III (N =
      8), carcinoma with definite early stromal infiltration (FIGO stage 1a1) (n = 6),
      and more advanced invasive squamous tumours (FIGO stages 1a2 to 3) (n = 8). In
      all cases the immunocytochemical findings were assessed in relation to serial
      sections stained with haematoxylin and eosin. RESULTS: Six of the 15
      diagnostically problematic biopsy specimens were considered, on review, to show
      early infiltration of subepithelial tissue and putative invasive foci were
      consistently absent in basement membrane. A similar pattern was observed in the
      "definite" early invasive cases. Eight problematic biopsy specimens were
      considered to show only in situ neoplasia; five of these had intact though
      occasionally attenuated basement membrane, three showed focal type IV collagen
      defects. In the remaining case biopsy trauma precluded further assessment.
      Basement membrane defects were identified in five of eight cases of CIN III,
      while three of eight squamous carcinomas showed partial retention of type IV
      collagen immunoreactivity around invasive tumour cell nests. CONCLUSIONS: Defects
      in subepithelial basement membrane occur in in situ and invasive neoplasia in the
      uterine cervix. Immunocytochemical staining for type IV collagen is of limited
      diagnostic value in the assessment of biopsy specimens with questionable early
      stromal invasion.

PMID- 1740530
TI  - Reconstruction of fetuses after dissection.

PMID- 1740531
TI  - MacPharmacology: a series of computerized study and review programs.

PMID- 1740532
TI  - Excess synthroid ingestion presenting as congestive heart failure.

PMID- 1740533
TI  - Effects of chronic amantadine hydrochloride ingestion on its and acetaminophen
      pharmacokinetics in young adults.
AB  - The authors studied the effect of chronic amantadine ingestion on its own
      disposition and that of acetaminophen in five healthy young adults. The half-life
      of amantadine after 42 days ingestion was 15.1 +/- 2.3 hours and was not
      different from 14.8 +/- 4.4 hours after an acute ingestion (mean +/- SD).
      However, chronic amantadine ingestion was associated with an increased apparent
      volume of distribution for acetaminophen, 1.1 +/- 0.1 L/kg compared with 0.9 +/-
      0.1 L/kg, when the two drugs were concurrently ingested after a 2-week washout
      period. This difference in kinetic distribution was not reflected in terminal
      acetaminophen half-life, 149 +/- 54 versus 151 +/- 55 minutes for chronic and
      acute amantadine ingestion, respectively. Plasma acetaminophen clearance with
      chronic amantadine ingestion (5.8 +/- 2.6 mL/min/kg) was not different from that
      determined after acute coingestion of both drugs (4.3 +/- 1.1 mL/min/kg). Thus,
      no change in recommended dose is necessary when these two drugs are coingested.

PMID- 1740534
TI  - Clinical pharmacokinetics of albendazole in patients with brain cysticercosis.
AB  - Albendazole pharmacokinetics were studied in eight patients who were receiving
      albendazole in doses of 15 mg/kg per day for 8 days as treatment of brain
      cysticercosis. Albendazole was not detected in plasma, but its main metabolite
      albendazole sulphoxide could be measured. Maximum plasma levels for albendazole
      sulphoxide ranged from 0.45 to 2.96 micrograms/mL. The half-life of albendazole
      sulphoxide was between 10 and 15 hours. A double peak was found in three
      patients. Mean residence time values were from 14 to 20 hours. Plasma levels of
      albendazole sulphoxide at the steady state showed great intraindividual
      variability. The results suggest that albendazole can be administered twice daily
      rather than three times as is currently done.

PMID- 1740535
TI  - Marine bioactive compounds: stereospecific anti-inflammatory activity of natural
      and synthetic cordiachromene A.
AB  - A new synthesis is proposed for cordiachromene A (CCA), a bioactive component of
      the ascidian Aplidium antillense Gravier, using a method producing a racemic
      mixture. The anti-inflammatory activities of a natural extract and a chemically
      synthetic form of CCA were assessed in vivo by carrageenan-induced rat-paw edema.
      The activity of synthetic CCA was confirmed by a test on kaolin-induced granuloma
      in the rat. Strong activities were measured for both CCA, but comparison of
      results of the first test suggests that only the natural optically active isomer
      has an anti-inflammatory effect. CCA is similar to indomethacin in its effect on
      carrageenan-induced rat-paw edema and ten times as active as phenylbutazone.

PMID- 1740536
TI  - The pharmacokinetics of flurbiprofen in younger and elderly patients with
      rheumatoid arthritis.
AB  - The pharmacokinetics of flurbiprofen (Ansaid Tablets, Upjohn Company of Canada,
      Don Mills, Ontario) were evaluated in both younger (40 to 60 years) and elderly
      (65 to 83 years) rheumatoid arthritic patients after both a 100-mg single-dose
      administration and at steady state during a 100-mg twice-a-day dosage regimen.
      Both flurbiprofen plasma concentration-time profiles and the urinary excretion of
      flurbiprofen and its major metabolites were evaluated. The results indicate that
      the pharmacokinetics of flurbiprofen are linear in both age groups based on only
      minor changes between single-dose and steady-state parameter determinations and
      the agreement between calculated and predicted accumulation values in plasma
      concentrations. Only minor differences in the pharmacokinetic parameters were
      observed between the younger and elderly patients. Only free flurbiprofen
      clearance was found to have a significant but variable correlation to patient
      age. The effect of flurbiprofen on the urinary excretion of two prostaglandins
      were also evaluated throughout this study. In both age groups, the maximum
      decrease in urinary excretion was observed after the first dose, and this effect
      was maintained throughout the remainder of the study. Percent decreases from
      baseline in urinary excretion during drug administration were similar for both
      age groups. Similar side-effect profiles were observed between age groups.

PMID- 1740537
TI  - Pharmacokinetics of tranexamic acid in patients with ulcerative colitis and in
      healthy volunteers after the single instillation of 2 g rectally.
AB  - Topically applied antifibrinolytic drugs may be of value in the control of
      bleeding in active ulcerative colitis. Any impairment of systemic fibrinolysis in
      this condition, however, is potentially harmful. Since pharmacokinetic data after
      the rectal administration of tranexamic acid are non-existent, plasma
      concentration and recovery in the urine were recorded after a single dose of 2 g
      tranexamic acid given rectally to five patients with ulcerative colitis and to
      five healthy volunteers. The median area under the curve was, for the volunteers,
      7.64 mg/L x hr (range: 4.43-11.56) and, for the patients, 13.84 mg/L x hr (range:
      9.32-50.22) (P less than .05). The median 24-hour recovery in the urine was 0.8%
      (0.3-1.1) and 2.7% (1.1-4.0), respectively (P less than .05). The median peak
      plasma concentration was, for the volunteers, 0.40 mg/L (range: 0.20-0.69) 6
      hours after administration and, for the patients, 1.10 mg/L (range: 0.53-2.90) 5
      hours after administration (P less than .05). The plasma concentrations and
      recovery in the urine that were observed in the patients and volunteers were low
      compared with those seen after oral intake of the same dose. The plasma
      concentrations did not reach levels that were considered liable to impair
      systemic fibrinolysis.

PMID- 1740538
TI  - Antihypertensive and metabolic effects of single and combined atenolol regimens.
AB  - The antihypertensive and metabolic effects of placebo (PL), a fixed combination
      of hydrochlorothiazide (25 mg) and triamterene (50 mg) (HCTZ/TRI), atenolol (25
      mg) (Atc-25), atenolol (50 mg) (Ate-50) and their combination with HCTZ/TRI given
      once daily, were tested on 256 patients with mild-to-moderate essential
      hypertension. After 3 weeks of PL monotherapy, 43 patients were randomized to PL
      (group 1), 41 patients to HCTZ/TRI (group 2), 44 patients to Ate-25 (group 3), 42
      patients to Ate-50 (group 4), 43 patients to Ate-25/HCTZ/TRI (group 5), and 43
      patients to Ate-50/HCTZ/TRI (group 6) in a double-blind parallel design study and
      were followed for 4 weeks. At the end of week 7, those patients who were
      randomized to groups 5 and 6 were allowed to continue for an additional 12 weeks,
      if their arterial pressure was satisfactorily controlled. Complete blood counts,
      blood chemistries, urinalyses, and electrocardiograms were done initially and
      during the study. Monotherapy with HCTZ/TRI, Ate-25, and Ate-50 had significant
      and equal antihypertensive effects compared with placebo. (P less than .01).
      However, the combination of Ate-25/HCTZ/TRI and Ate-50/HCTZ/TRI resulted in
      further reduction of arterial pressure with the effect being greatest with Ate
      50/HCTZ/TRI (P less than .001). Patient groups 3 through 6 had also slower heart
      rates compared with groups 1 and 2 (P less than .01). Mild, but statistically
      significant, increases in BUN, glucose, triglycerides, and uric acid were noted
      in groups 2, 5, and 6 (P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740539
TI  - Transcranial Doppler to evaluate the effects of antihypertensive medication on
      cerebral blood flow velocity.
AB  - The effect of oral nifedipine on cerebral blood flow velocity was studied in six
      elderly hypertensive patients using transcranial Doppler. Serial measurements of
      blood pressure (BP), middle cerebral artery (MCA) flow velocity and nifedipine
      serum concentrations were obtained over an 8-hour period. The authors found a
      significant inverse relationship between MCA velocities and nifedipine
      concentrations, independent of BP changes. These results are consistent with a
      direct vasodilatory effect of nifedipine on cerebral vessels and support the use
      of TCD in pharmacodynamic investigations of the cerebral vasculature.

PMID- 1740540
TI  - Evaluation of quinapril on regional blood flow and cardiac function in patients
      with congestive heart failure.
AB  - Quinapril, a nonsulfhydryl ACE inhibitor, was evaluated in ten New York Heart
      Association (NYHA) functional class (FC) II-III CHF patients to determine its
      effects on regional blood flow [effective renal plasma flow (ERPF), renal blood
      flow (RBF), renal vascular resistance (RVR), hepatic blood flow (HBF), hepatic
      vascular resistance (HVR), segmental limb pressure (SLP), creatinine clearance
      (CRCL)] and cardiac function [left ventricular ejection fraction (LVEF)].
      Previous vasodilator therapy was withdrawn 2 weeks before baseline measurements.
      Stable regimens of digoxin and diuretics were continued throughout the study.
      ERPF was assessed using p-aminohippurate (PAH), HBF by indocyanine green (ICG)
      clearance, and LVEF by radionuclide scintography. Segmental limb pressures were
      measured by Doppler flow detection. Measurements were performed at baseline (B)
      and after 4 weeks of quinapril therapy (10 mg BID). Quinapril increased renal (P
      less than 0.05) and hepatic blood flow (P = 0.06) and significantly reduced renal
      and hepatic vascular resistance. Glomerular filtration rate and left ventricular
      ejection fraction were unchanged. Mean arterial pressure and brachial segmental
      pressures decreased without change in heart rate. Noninvasive cardiovascular
      assessments indicate that quinapril improves regional blood flow while exhibiting
      no change in left ventricular ejection fraction, in patients with NYHA FC II-III
      CHF.

PMID- 1740541
TI  - Pharmacodynamic and pharmacokinetic evaluation of a new transdermal delivery
      system with a time-dependent release of glyceryl trinitrate.
AB  - The pharmacokinetics of glyceryl trinitrate (GTN) and its main metabolites as
      well as the hemodynamic effects of a new transdermal delivery system (TDS) were
      investigated in ten healthy male volunteers using a single blind, placebo
      controlled study design with an application period of active drug of 4 successive
      days. The adhesive-type matrix system contains 20-mg GTN and released about 75%
      in a time-dependent manner. The plasma concentrations of GTN and its metabolites
      1-2- and 1-3 glyceryl dinitrate reflected the time-dependent release with higher
      plasma concentrations during the first 12 hours than during the second 12 hours.
      Continuous administration of the TDS, which released 15 mg GTN/day, caused an
      accumulation of GTN in the plasma (about 70% greater AUC at the fourth day in
      comparison with the first day). The total effect per dose on the a/b-ratio of the
      digital pulse (height of the peak of the systolic wave divided by height of the
      peak of the dicrotic wave) and the reflex tachycardia were diminished by about
      50% and 37%, respectively, at the fourth treatment day. The effect on systolic
      blood pressure measured under orthostatic conditions was blunted already 8 hours
      after the first application. The effect of sublingually administered GTN on
      digital pulse was attenuated during administration and also 1 hour after removal
      of the last TDS. The effect was restored 8 to 12 hours after removal of the TDS.
      Thus, the discontinuous release of GTN from the new system does not prevent the
      decline of hemodynamic efficacy during continuous therapy.

PMID- 1740542
TI  - Effect of cimetidine administration on the pharmacokinetics of pirmenol.
AB  - The potential for a drug-drug interaction between pirmenol, an extensively
      metabolized antiarrhythmic agent, and cimetidine, an inhibitor of hepatic drug
      metabolizing enzymes, was evaluated in eight healthy adults. A single 150-mg oral
      dose of pirmenol was administered on study days 1 and 8 and oral cimetidine, 300
      mg QID, was administered on study days 4 through 11. Plasma and urine samples
      were collected after each pirmenol dose for determination of pirmenol
      concentration. Mean pirmenol concentration-time curves and pharmacokinetic
      parameters, including elimination rate constant, were not significantly altered
      by concomitant administration of cimetidine.

PMID- 1740543
TI  - Development of the olfactory nerve in the clawed frog, Xenopus laevis: II.
      Effects of hypothyroidism.
AB  - Quantitative and morphological data were obtained on developing olfactory axons
      in normal and hypothyroid larvae of the African clawed frog Xenopus laevis.
      Hypothyroid larvae were produced by rearing the animals, beginning at stage 48,
      in a 0.01% solution of propylthiouracil (PTU), a treatment that blocks synthesis
      of thyroid hormone. These PTU-treated larvae were compared to their age-matched
      siblings when these siblings reached stage 52 (premetamorphic larvae; prior to
      synthesis of thyroid hormone), stage 57 (late premetamorphic larvae; after the
      onset of thyroid hormone synthesis), or stage 58 (larvae at the onset of
      metamorphic climax; thyroid hormone levels continue to rise). The number of
      olfactory axons did not differ between stage 52 control animals and the age
      matched, PTU-treated animals, but there were only about half the number of axons
      in the PTU-treated animals that were age-matched to the stage 57 or 58 controls.
      Thus, PTU had no effect on olfactory axon number prior to the normal rise in
      thyroid hormone levels. But PTU significantly reduced the normal increase in
      olfactory axon number compared to stage 58 control larvae, whose thyroid hormone
      levels are high. While PTU also produced some changes in several other body
      measurements, the effect on the olfactory axons was the most consistent and
      prominent. The results presented here support our previous findings that thyroid
      hormone plays a significant role in the development of the olfactory system in
      Xenopus.

PMID- 1740544
TI  - Spatio-temporal patterns of retinal ganglion cell death during Xenopus
      development.
AB  - During development of the retina in mammals and birds, most retinal ganglion
      cells (RGC) that are produced are eliminated later in development by cell death.
      In lower vertebrates, however, such massive cell death has not been observed;
      total ganglion cell number increases linearly during most of development. Using
      3H-thymidine or 5-bromodeoxyuridine labeling of retinal cell nuclei, we have been
      able to identify postmitotic RGC populations in Xenopus central retina at
      different developmental stages and follow their fate during development to
      postmetamorphic stages. RGC populations that become postmitotic between embryonic
      stages 32 and 49, during the initial stages of retinal growth, lose 40-77% of
      their cells during metamorphosis (approximately 4,000-5,000 cells). Twenty
      percent of the RGC present at stage 54, which later disappear, represent the same
      population of dying RGC that were present at stage 49. This suggests that the
      ganglion cells that became postmitotic between stage 49 and 53/54 show no
      apparent decline in numbers during metamorphosis. Since thyroxine is known to
      stimulate an increase in RGC number as well as the extent of fiber projection on
      the tectum, we suggest that this reduction in RGC numbers is not due to thyroxine
      induced neuronal cell death. After stage 54, however, binocular vision develops
      in Xenopus (Keating, '74) and ipsilateral fibers begin to grow into thalamic
      visual neuropils (Hoskins and Grobstein, '85). We suggest, therefore, that as in
      mammals, in which RGC elimination correlates with binocular segregation of
      contralateral and ipsilateral retinal axons in visual centers, a similar process
      may occur in the frog among those RGC projecting to thalamic visual neuropils.

PMID- 1740545
TI  - Immunohistochemical evidence for transient expression of fibronectin in the
      developing dorsal lateral geniculate nucleus of the ferret.
AB  - In recent years, the important role of the extracellular matrix in neural
      development has been increasingly recognized. In order to begin to examine what
      role might be played by the extracellular matrix in the developing dorsal lateral
      geniculate nucleus (dLGN), the present study used immunocytochemistry to assess
      the distribution of a recognized extracellular matrix molecule, fibronectin (FN),
      during postnatal development of the ferret dLGN. Prior to the segregation of cell
      layers, no clear pattern of FN distribution can be distinguished within the dLGN.
      By P16, when layers A and A1 are separated by an interlaminar space, FN is
      localized in that space. By P24, FN is present not only between layers A and A1,
      but also within layers A and A1 as bands parallel to the laminar borders. These
      bands appear to correspond spatially and temporally to the development of
      sublaminar boundaries in the ferret (Hahm and Sur, Neurosci Abstr 14:460, 1988).
      By the end of the first postnatal month, immunoreactivity is diminished but still
      present. FN is no longer present at P44 or in the adult. Adjacent sections were
      incubated with antiserum to glial fibrillary acid protein (GFAP). When a laminar
      pattern of GFAP can be distinguished, it coincides with the interlaminar
      distribution of FN. The findings described here are consistent with a role for FN
      in the development of a laminar organization in the dLGN.

PMID- 1740546
TI  - Functional and anatomical organization of cardiovascular pressor and depressor
      sites in the lateral hypothalamic area: I. Descending projections.
AB  - The present study describes the anatomical organization of projections from
      functionally defined cell groups of the lateral hypothalamic area. Cardiovascular
      pressor and depressor sites were identified following microinjection (5-50 nl) of
      0.01-1.0 M L-glutamate or D,L-homocysteate into the anesthetized rat. Subsequent
      injections of Phaseolus vulgaris-leucoagglutinin (PHA-L) or wheat germ agglutinin
      horseradish peroxidase (WGA-HRP) were made into pressor or depressor sites and
      their connections with the brainstem and spinal cord were traced. Decreases in
      blood pressure (10-45 mmHg) and heart rate (20-70 bpm) were elicited from tuberal
      (LHAt) and posterior (LHAp) regions of the lateral hypothalamic area (LHA).
      Depressor neurons in the LHAt have descending projections to the central gray,
      dorsal and median raphe nuclei, pedunculopontine tegmental nucleus, pontine
      reticular formation, medial and lateral parabrachial nuclei, laterodorsal
      tegmental region, and medullary reticular formation including the region of the
      lateral tegmental field, nucleus ambigous, and rostrocaudal ventral lateral
      medulla. In contrast, descending projections from depressor neurons in the LHAp
      have dense terminal fields in the rostral, middle, and commissural portions of
      the nucleus of the solitary tract and the lateral tegmental field as well as the
      ventrolateral central gray, pedunculopontine tegmental nucleus, and medial and
      lateral parabrachial nuclei. Both the LHAt and LHAp have light projections to the
      intermediate region of the cervical and thoracic spinal cord. Increases in blood
      pressure (10-40 mmHg) and heart rate (20-70 bpm) were elicited almost exclusively
      from neurons located medial to the LHAt and LHAp in a region surrounding the
      fornix, termed the perifornical area (PFA). Pressor cells in the PFA have
      descending projections to the central gray, dorsal and median raphe nuclei,
      laterodorsal tegmental nucleus, and Barrington's nucleus as well as a light
      projection to the commissural portion of the nucleus of the solitary tract and
      the intermediate region of the cervical and thoracic spinal cord. The retrograde
      labeling observed in the WGA-HRP studies indicates that cells in most terminal
      fields have reciprocal projections to the pressor and depressor regions of the
      LHA. The results demonstrate that groups of neurons in the lateral hypothalamus
      with specific cardiovascular function have differential projections to the brain
      stem.

PMID- 1740547
TI  - Response of retinal terminals to loss of postsynaptic target neurons in the
      dorsal lateral geniculate nucleus of the adult cat.
AB  - We have used the neurotoxin kainic acid to produce rapid degeneration of neurons
      in the dorsal lateral geniculate nucleus (dLGN) of the adult cat. This
      degeneration mimics the rapid loss of geniculate neurons seen after visual cortex
      ablation in the neonate. Subsequent anterograde transport of horseradish
      peroxidase injected into the eye was used to reveal the projection patterns of
      retinal ganglion cell axons at different survival periods after the kainic acid
      injection. The density of retinal projections to the degenerated regions of the
      geniculate was reduced considerably at 4 and 6 months survival, but at 2 months
      was not significantly different from normal. The laminar pattern of projections
      to degenerated regions of the geniculate did not change in any animals studied,
      even when an adjacent lamina contained surviving cells. Electron microscopic
      examination of degenerated dLGN revealed intact retinal (RLP) and RSD terminals
      at all survival times, although the density of terminals appeared much reduced
      when compared to controls. Some RLP terminals exhibited the "dark reaction" of
      degeneration and these degenerating terminals were most numerous at 2 months
      survival. These findings demonstrate that, in response to degeneration of their
      usual target cells, mature retinal ganglion cells with withdraw their axon
      terminals from these regions of degeneration. We conclude that mature retinal
      ganglion cells continue to be dependent on target integrity for the maintenance
      of a normal axonal arborization.

PMID- 1740548
TI  - Immunocytochemical localization of luteinizing hormone-releasing hormone (LHRH)
      in the nervus terminalis and brain of the big brown bat, Eptesicus fuscus.
AB  - Little is known about the immunohistochemistry of the nervous system in bats.
      This is particularly true of the nervus terminalis, which exerts strong influence
      on the reproductive system during ontogeny and in the adult. Luteinizing hormone
      releasing hormone (LHRH) was visualized immunocytochemically in the nervus
      terminalis and brain of juvenile and adult big brown bats (Eptesicus fuscus). The
      peripheral LHRH-immunoreactive (ir) cells and fibers (nervus terminalis) are
      dispersed along the basal surface of the forebrain from the olfactory bulbs to
      the prepiriform cortex and the interpeduncular fossa. A concentration of
      peripheral LHRH-ir perikarya and fibers was found at the caudalmost part of the
      olfactory bulbs, near the medioventral forebrain sulcus; obviously these cells
      mediate between the bulbs and the remaining forebrain. Within the central nervous
      system (CNS), LHRH-ir perikarya and fibers were distributed throughout the
      olfactory tubercle, diagonal band, preoptic area, suprachiasmatic and supraoptic
      nuclei, the bed nuclei of stria terminalis and stria medullaris, the anterior
      lateral and posterior hypothalamus, and the tuber cinereum. The highest
      concentration of cells was found within the arcuate nucleus. Fibers were most
      concentrated within the median eminence, infundibular stalk, and the medial
      habenula. The data obtained suggest that this distribution of LHRH
      immunoreactivity may be characteristic for microchiropteran (insectivorous) bats.
      The strong projections of LHRH-containing nuclei in the basal forebrain
      (including the arcuate nucleus) to the habenula, may indicate close functional
      contact between these brain areas via feedback loops, which could be important
      for the processing of thermal and other environmental stimuli correlated with
      hibernation.

PMID- 1740549
TI  - A morphological correlate of target recognition by regenerating motor axons in
      the cockroach.
AB  - A specific cell recognition process during regeneration of severed axons of
      identified cockroach motor neurons eventually leads to the reformation of the
      original innervation pattern of target muscles in the leg. This occurs even
      though, at early times after nerve crush, the multiple branches of each
      regenerating axon grow into both appropriate and inappropriate muscles. In this
      study, we sought to examine whether there are any structural differences between
      regenerating axon branches in appropriate and inappropriate muscles that could
      lead to an understanding of why only those in inappropriate muscles are
      eliminated. A neuron subset-specific monoclonal antibody, NSS-2A, which labels
      the inhibitory motor neurons, was used to make their axon branches visible at
      various times after nerve crush. In inappropriate muscles, these axons grow
      primarily parallel to the muscle fibers and are later eliminated. In the
      appropriate muscles, these axon branches initially also grow parallel to the
      muscle fibers, but subsequently grow many interstitial collaterals. The formation
      of the collateral branches is a morphological correlate of the specific
      interaction of a neuron with its appropriate muscle. The simultaneous occurrence
      of axonal elimination and collateral sprouting supports the idea that the two
      processes are causally related, as suggested by the sibling neurite bias
      hypothesis.

PMID- 1740550
TI  - Radiopacity and physical properties of titanium-polymethacrylate composite.
AB  - Titanium-polymethacrylate composite was prepared as an x-ray-opaque filler for
      composite core materials. The base monomers of the composite were 2,2-bis [4-(3
      methacryloyloxy-2-hydroxypropoxy) phenyl] propane (Bis-GMA) and triethyleneglycol
      dimethacrylate (TEGDMA). Pure titanium powder was used as a radiopaque element.
      Two functional methacrylates--isopropyl dimethacryloyl isostearoyl titanate (KR
      7) and 4-methacryloyloxyethyl trimellitate anhydride (4-META)--were adopted as
      couplers of titanium powder. The radiopacity of composites was determined in
      terms of their equivalent thickness of aluminum per unit thickness of material.
      Compressive and transverse strengths of the composites were measured by use of
      coupled and untreated titanium fillers. The composites that contained 70% and 80%
      titanium by weight showed more radiopacity than enamel and less than amalgam.
      Radiopacity was controlled by the content of titanium filler in the composite.
      The decrease in compressive and transverse strengths of the composites was 0.7 to
      15.9% and 43.7 to 52.9%, respectively, after one year's immersion in water. The
      decrease in transverse strength was remarkable; however, this deterioration was
      diminished by use of both KR-7 and 4-META as couplers for titanium. Thus,
      prepared titanium-polymethacrylate composite may be used as a radiopaque
      composite filler for self-curing composite core materials.

PMID- 1740551
TI  - The effect of carbamide-peroxide gel on the shear bond strength of a microfil
      resin to bovine enamel.
AB  - Cylinders of a visible-light-cured microfil resin were formed on, and bonded to,
      the flattened labial enamel surfaces of young bovine incisor teeth which had
      previously been subjected to four different treatments: (1) immersion in 10%
      carbamide-peroxide gel, pH 4.7, for three h; (2) immersion in 10% carbamide
      peroxide gel, pH 4.7, for six h; (3) immersion in 10% carbamide-peroxide gel, pH
      7.2, for three h; and (4) immersion in 10% carbamide-peroxide gel, pH 7.2, for
      six h. For each experimental group, a control group of resin-bonded to saline
      immersed teeth was prepared. In addition, two groups, prepared according to
      treatment 4, were leached in distilled water for one and seven d, respectively,
      prior to resin application. Specimens were stored in distilled water at 37
      degrees C for seven d prior to shear-bond-strength testing. A total of 90 teeth
      was tested. Statistical analysis of the results indicated that there was a highly
      significant reduction in the shear bond strength to carbamide-peroxide-treated
      enamel as compared with that to saline-treated enamel. The effects of duration of
      peroxide treatment and pH, as well as the interaction term, were not
      statistically significant. Leaching of the peroxide-treated enamel in water for
      either one or seven d prior to resin application restored the adhesiveness of the
      enamel. Scanning electron microscopic examination of randomly selected, fractured
      test specimens indicated that the peroxide-induced reduction in enamel
      adhesiveness was related to alterations in both attachment-surface area at the
      resin-enamel interface and resin quality.

PMID- 1740552
TI  - The effect of sucrose on plaque pH in the primary and permanent dentition of
      caries-inactive and -active Kenyan children.
AB  - The hypothesis that the Stephan pH responses of dental plaque would be different
      in caries-active and -inactive individuals was tested in 20 seven-year-old and 19
      14-year-old Kenyan children. In each age group, half the children had greater
      than or equal to 2 dentin cavities; the other half had no such lesions. With a
      palladium-touch microelectrode, interdental plaque pH was monitored between m1/m2
      in each quadrant in the primary dentition and in the four molar/premolar regions
      in the permanent dentition. pH was also monitored in caries cavities in the
      occlusal surfaces of lower first molars and on the tongue. pH was measured before
      and up to 60 min after the children rinsed with 10 mL of 10% sucrose. Caries
      status of the individual was unrelated to plaque pH in comparable non-carious
      sites in both of the age groups. The pH minimum in the maxilla was about 0.5 pH
      units lower than that in the mandible. Active occlusal caries lesions had a
      resting pH value of about 5.5, about 1 pH unit lower than that of sound surfaces.
      The pH dropped to about 4.5 in caries lesions and recovered slowly. In sound
      occlusal sites, a pH drop to about 6.0 was followed by a relatively rapid return
      to the resting value. Thus, when the mean values were considered, the classic
      Stephan curve response was evident. However, when the pH changes at single sites
      were considered at various time intervals, a substantial, erratic fluctuation was
      observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740553
TI  - The effect of chlorhexidine varnish treatment on salivary mutans streptococcal
      levels in child orthodontic patients.
AB  - A chlorhexidine dental varnish was applied to the teeth of 26 children, ten to 17
      years of age, in an attempt to limit the increase in colonization by mutans
      streptococci that normally accompanies the placement of fixed orthodontic
      appliances and to assess the acceptance of the application procedure. Despite the
      insertion of the appliances in the month following the varnish application, the
      numbers of detectable salivary mutans streptococci in the children were found to
      remain significantly lower than baseline values for seven months (p less than
      0.01). Among the 26 children, 16 exhibited high counts (greater than 2.5 x 10(5)
      cfu/mL saliva) at baseline, but none exhibited such counts until three months
      post-treatment, when one child did. By seven months, eight children had high
      counts. No significant difference in effectiveness was observed between varnish
      formulations containing 10% or 20% chlorhexidine acetate, or between children of
      different ages or past caries experience. The lack of drop-outs and the results
      of a questionnaire indicated that acceptance of the treatment by the children was
      excellent. The study indicates that chlorhexidine varnish therapy was acceptable
      to the children and was effective in suppressing oral mutans streptococcal levels
      for long periods, even when used prior to the placement of fixed orthodontic
      appliances.

PMID- 1740554
TI  - Expression of type I collagen pro-alpha 2 chain mRNA in adult human permanent
      teeth as revealed by in situ hybridization.
AB  - The expression of the gene COL1A2, coding for the pro-alpha 2 chain of type I pro
      collagen, was analyzed in fully developed human permanent teeth. The teeth were
      fixed with formalin, demineralized with EDTA for about ten weeks, and embedded in
      paraffin. Pro-alpha 2(I) mRNA was localized in the sections by in situ
      hybridization, with use of [35S)]-labeled single-stranded RNA probes. The amount
      of mRNA for pro-alpha 2(I) collagen chain, as indicated by the relative densities
      of silver grains and the grain counts per cell in autoradiography, was high in
      odontoblasts, whereas in pulpal fibroblasts it was low. High levels of pro-alpha
      2(I)mRNA expression were also present in those odontoblasts which had elaborated
      new dentin matrix in response to dental caries. Expression in the periodontal
      ligament, including the cementoblast layer, was slightly stronger than that in
      odontoblasts. The intense expression of pro-alpha 2(I) mRNA in odontoblasts of
      adult teeth suggests that even after the completion of primary dentin formation,
      they continue to synthesize heterotrimeric type I collagen molecules. Cell type
      specific differences in the expression of pro-alpha 2(I) mRNA imply that type I
      collagen probably plays a major role in the regulation of the structure and
      function of dental tissues. Finally, in situ hybridization enabled pro-alpha 2(I)
      collagen mRNA to be detected in tissue sections even after prolonged
      demineralization, and thus it proved to be a valuable technique for analysis of
      gene expression in adult dental tissues, as shown here for COL1A2.

PMID- 1740555
TI  - Fatty acids of healthy and periodontally diseased root substance in human teeth.
AB  - In this comparative study, samples of root substance from healthy and
      periodontally diseased human teeth were analyzed for fatty acids by means of a
      gas-chromatographic technique. The sample preparation procedure allowed specimens
      from individual teeth to be analyzed. The content of the fatty acids C16:0,
      C16:1, C18:0, and C18:1 in the superficial layer of the periodontally diseased
      teeth was significantly higher than that of healthy teeth. In the inner layer,
      there was no such difference. Four different 3-hydroxy fatty acids (3-OH C14:0, 3
      OH C15:0, 3-OH C16:0, and 3-OH C17:0) were identified by combined gas
      chromatography/mass-spectrometry in the tooth substance of periodontally diseased
      teeth. This indicates the presence of lipid A, which is the toxic component of
      bacterial lipopolysaccharides.

PMID- 1740556
TI  - Electromyographic heterogeneity in the human masseter muscle.
AB  - The complex, pennate architecture of the human masseter muscle points to a
      functional division into more than the commonly distinguished deep and
      superficial parts. In this study, the possible existence of regional differences
      in activation was examined. EMG activity was registered in three deep and three
      superficial regions with the use of bipolar fine-wire electrodes. Recordings were
      made during different static bite tasks, in specified directions, and with a
      specified bite-force magnitude. A linear bite-force/EMG relationship was
      observed. Furthermore, it appeared that muscle regions showed a different pattern
      of change in activity as a function of bite-force direction. Heterogeneity was
      nearly absent in anteriorly-, anteriomedially-, and medially-directed bites, but
      became increasingly obvious in the other bite-force directions. The posterior
      deep region showed the most aberrant activation pattern, which was almost
      opposite that from the other regions. This part was fully active in
      posterolaterally-directed bites. The posterior superficial region showed the
      largest variability in activity as a function of bite-force direction. The
      results point to a functional partition of the masseter muscle in at least three
      parts: anterior deep, posterior deep, and superficial. A further subdivision of
      the superficial portion might be present, but was not as obvious as the division
      of the deep masseter.

PMID- 1740557
TI  - A light and electron microscopic anterograde WGA-HRP tracing study on the sensory
      innervation of junctional and sulcular epithelium in the rat molar.
AB  - The sensory innervation of junctional and oral sulcular epithelium was
      investigated by use of anterograde transport of wheat-germ agglutinin-horseradish
      peroxidase from the trigeminal ganglion. By light microscopy, labeled intra
      epithelial nerve fibers were observed forming a dense plexus in the apical two
      thirds of the junctional epithelium, with some fibers located near the enamel
      space. Occasional fibers extended coronally to the sulcus bottom. By electron
      microscopy, labeled intra-epithelial axon terminals or varicosities were
      demonstrated to be in close contact with both junctional epithelial cells and
      neutrophils. These varicosities, which were occasionally surrounded by the
      cytoplasmic processes of epithelial cells or neutrophils, frequently contained
      large granular and small clear vesicles. In contrast to the junctional
      epithelium, the oral sulcular epithelium was sparsely innervated, except for the
      transition region between the oral sulcular epithelium and the junctional
      epithelium, where a dense innervation by labeled intraepithelial fibers was
      found. These fibers extended as far as the stratum spinosum. Electron microscopy
      revealed mitochondria-filled profiles of varicosities between epithelial cells.
      This study shows differences in the distribution and ultrastructure of sensory
      nerves between the junctional and oral sulcular epithelia, and further provides
      morphological evidence that sensory nerves in the junctional epithelium come into
      contact not only with epithelial cells but also with neutrophils.

PMID- 1740558
TI  - Factors affecting blood mercury concentrations in practicing dentists.
AB  - It has been suggested that mercury vapor may be transformed into highly toxic
      organomercury compounds by micro-organisms in the oral cavity and
      gastrointestinal tract. If this hypothesis is correct, practicing dentists might
      be expected to have concentrations of organic mercury in their blood higher than
      that found in non-dentists. Blood mercury concentrations of practicing dentists
      and non-dentists were determined by means of cold-vapor atomic absorption
      spectrophotometry. Potential sources of mercury exposure were identified in both
      dentists and non-dentists through a questionnaire completed at the time of
      sampling. Concentrations of total and inorganic blood mercury were significantly
      higher in dentists than in non-dentists. The organomercury concentrations of the
      two groups were not statistically different (p greater than or equal to 0.05).
      The high concentration of inorganic mercury in the blood of dentists was not
      related to the organomercury level, suggesting that biotransformation of
      inorganic mercury to organomercury does not occur in vivo. However, the
      concentration of blood organomercury was positively correlated with the frequency
      of fish consumption. There was no correlation between the number of amalgam
      restorations and the concentration of inorganic blood mercury for both groups.
      Accidental mercury spills in the dental operatory may contribute most to the
      concentration of inorganic blood mercury in the blood of dentists.

PMID- 1740559
TI  - An in vitro model for assessment of fluoride uptake from glass-ionomer cements by
      dentin and its effect on acid resistance.
AB  - This investigation presents an experimental model for studying interactions of
      glass-ionomer cements (GICs) with bovine dentin slabs. Fluoride incorporation was
      studied with five serial abrasion biopsies, each being approximately 10 microns
      thick. The time of interaction was a very important parameter, indicating
      continuous fluoride release from the GIC and diffusion into dentin over a 30-day
      period. Expressed in mass per volume (mg F/cm3), the fluoride incorporation
      reached 12.0 mg at the first and 2.5 mg at the fifth layer, several times greater
      than the baseline of 0.27 mg/cm3 in bovine dentin. A subsequent test of acid
      resistance in a lactic acid buffer (pH 4.0), followed by microradiography of
      lesions, showed a characteristic 40-microns-wide acid-resistant zone on surfaces
      exposed to the GICs. In contrast, the untreated control surfaces had lesions
      demineralized evenly from the surface to the intact tissue, without the higher
      density zone at the surface of the lesion. The model seems promising for
      screening fluoride incorporation into dentin from fluoride-releasing dental
      materials.

PMID- 1740560
TI  - Dental school admission and graduation requirements.

PMID- 1740561
TI  - Educational goals and research directions in endodontics.

PMID- 1740562
TI  - Treatment of glabellar frown lines with C. botulinum-A exotoxin.
AB  - Eighteen patients with glabellar frown lines were treated with C. botulinum-A
      exotoxin. Sixteen of the 17 patients followed showed improvement for periods
      ranging from 3 months to 11 months. Side-effects were minimal and transient.
      Because C. botulinum-A exotoxin therapy of glabellar frown lines treats the
      underlying cause of these lines, it is more effective than soft tissue
      augmentation although this improvement is temporary. Treatment with C. botulinum
      A exotoxin is a simple, safe procedure.

PMID- 1740563
TI  - Clinical predictors of malignant pigmented lesions. A comparison of the Glasgow
      seven-point checklist and the American Cancer Society's ABCDs of pigmented
      lesions.
AB  - Reducing morbidity and mortality from malignant melanoma is the greatest
      challenge facing dermatology today. We present a comparison of the Glasgow seven
      point checklist and the American Cancer Society's ABCDs of pigmented lesions for
      detecting early melanomas. Logistic regression analysis showed that the Glasgow
      checklist (N = 205 lesions) contained two significant variables (irregular
      outline, P = .001, relative odds = 10.9; diameter greater than 1 cm, P = .005,
      relative odds = 6.7) for differentiating benign from malignant pigmented lesions
      whereas a three-point version of the ABCDs (N = 192 lesions) had three
      significant variables (irregular outline, P = .001, relative odds = 9.3; diameter
      greater than 6 mm, P = .008, relative odds = 5.5; variegation, P = .05, relative
      odds = 3.7). All six melanomas scored 3 out of 3 on the ABCD scale for a
      sensitivity of 1.00 and specificity of 0.98 at a threshold of 3 out of 3.
      Patients rarely sought dermatologic consultation because of these predictors but
      often sought help for nonsignificant reasons such as inflammation (P = .93),
      color change (P = .84), itch (P = .72), and increasing size (P = .38). The
      simpler three-point scale at a threshold of two had equal specificity (0.88
      versus 0.94) and better sensitivity (0.73 versus 0.44) than the Glasgow seven
      point checklist at the recommended threshold of three out of seven. We therefore
      recommend that the American public be better educated about the ABCDs to help
      increase self-referral so that early melanomas can be found and eradicated.

PMID- 1740564
TI  - The ice-saline-Xylocaine technique. A simple method for minimizing pain in
      obtaining local anesthesia.
AB  - Prior to skin surgery, localized cryoanesthesia is initially obtained utilizing
      Cryogel packs before local anesthesia injection, minimizing or abolishing pain
      from the piercing of the skin by the injection needle. The surgical field is then
      infiltrated with benzyl alcohol-containing normal saline, a painless solution
      producing moderate local anesthesia. Subsequently, a stronger anesthetic
      containing a vasoconstrictor or other desired additives can be infiltrated
      without significant patient discomfort. This simple three-step method has
      resulted in excellent patient acceptance, and is potentially useful for a wide
      range of surgical procedures and medical specialties.

PMID- 1740565
TI  - Microsurgical treatment of nasolabial and glabellar wrinkles.
AB  - Nasolabial and glabellar wrinkles have been treated using a new microsurgical
      technique. This technique consists of two steps, both performed under a
      microscope: 1) microsurgical peeling of tissue surrounding the wrinkle, and 2)
      direct excision of the wrinkle. This procedure was performed on approximately 30
      patients. All results showed effective diminishing of the treated wrinkle with
      almost no conspicuous scarring.

PMID- 1740566
TI  - Varicose veins--primary treatment with sclerotherapy. A personal appraisal.
AB  - Varicose veins are a very common condition that presents in a variety of forms.
      Treatment modalities are variant and beneficial. The author reports on an
      experience of 25 years treating 20,000 patients using surgery and sclerotherapy
      with particular results using morrhuate sodium.

PMID- 1740567
TI  - Postsclerotherapy hyperpigmentation. The role of serum ferritin levels and the
      effectiveness of treatment with the copper vapor laser.
AB  - Cutaneous pigmentation is a common complication of sclerotherapy of dilated lower
      limb veins. Histologic examination has shown that the pigment is due to
      hemosiderin deposition predominantly in the superficial dermis. Optimal technique
      will reduce the incidence of pigmentation but it is likely that patient factors
      such as total body iron storage may explain why some patients are more prone to
      develop pigmentation. Traditional exfoliation therapies have not given reliable
      reproducible results and there is need to develop an effective treatment without
      adverse sequelae. In this study 16 patients with refractory postsclerotherapy
      pigmentation were treated with the copper vapor laser. Within 3 months of
      treatment 11 (69%) had significant clearing of the pigmentation. Four (25%) had
      slight improvement and one patient had no discernible improvement. No adverse
      sequelae were reported or observed. The treated patients and 16 matched control
      patients who had not developed pigmentation were investigated with serum iron,
      ferritin and transferrin levels. There was a trend towards higher serum iron and
      ferritin levels and lower transferrin levels in the patients who developed
      pigmentation compared with those who did not develop this sequela. This trend was
      statistically significant for ferritin levels in patients 50 years of age and
      younger. The results indicate that serum ferritin may be a good indicator of
      susceptibility to postsclerotherapy pigmentation.

PMID- 1740568
TI  - Ambulant minisurgical phlebectomy.

PMID- 1740569
TI  - Office varicose vein surgery under local anesthesia.
AB  - Varicose veins of any size (except telangiectasia) and in any site of the lower
      limb (except the saphenofemoral junction) can be avulsed through multiple 0.5-mm
      (or larger) incisions under local infiltration anesthesia (Muller's technique).
      When necessary, high ligation, division, and stripping of the proximal long
      saphenous vein can also be performed under local anesthesia. It is thus possible
      to treat even the most complex varicose cases with outpatient office-based
      surgery.

PMID- 1740570
TI  - Posterior composite restorations.

PMID- 1740571
TI  - Air-driven handpieces and air emphysema. Council on Dental Materials, Instruments
      and Equipment; American Association of Oral and Maxillofacial Surgeons.

PMID- 1740572
TI  - Oral candidal infection and denture stomatitis: a comprehensive review.
AB  - Denture stomatitis rarely occurs without at least one predisposing factor that
      lowers patient resistance. A new disinfection technique for dentures and oral
      tissue may eliminate topical or anti-fungal drug use.

PMID- 1740573
TI  - Oral health of patients with Alzheimer's disease.
AB  - Generally healthy, unmedicated patients with Alzheimer's disease have few but
      significant changes in their oral health. Study results reinforce preventive oral
      hygiene for these patients.

PMID- 1740574
TI  - Patient maintenance of esthetic restorations.
AB  - There are probably as many ways to maintain esthetic restorations as there are
      restorations. After esthetic treatment is completed, schedule a mandatory
      postoperative appointment to make certain that whatever technique the patient
      uses is effective. At the postoperative visit, it should be apparent that the
      patient's tissue is healthy. If the tissue has not healed, some change in home
      care or additional periodontal or restorative treatment may be necessary. There
      are virtually hundreds, perhaps even thousands of home plaque removal devices.
      The ones mentioned here have worked for us and are therefore discussed. It isn't
      the type of device that is critical, however, but patient compliance. The
      described regimens have worked effectively for us in overcoming this obstacle of
      compliance. Appropriate recall visits with the hygienist should be made at one-
      to six-month intervals. In the final analysis, your success with esthetic
      restorations may well depend on your patients' success with esthetic maintenance.

PMID- 1740575
TI  - Reasons for local anesthesia failures.
AB  - U.S. dental practitioners administer about 4,000,000 local anesthetic blocks and
      infiltrations annually. The failure rate to achieve adequate anesthesia for the
      procedure is estimated to be 5 percent to 15 percent. This article describes five
      different categories of failures and suggest ways to troubleshoot them.

PMID- 1740576
TI  - Why do most GPs shun periodontics?

PMID- 1740577
TI  - Diagnosing and managing oral candidiasis.
AB  - The red to white lesions of oral candidiasis are easily treated with any of
      several antifungal medications. But predisposing systemic conditions, such as
      diabetes mellitus or human immunodeficiency virus infection, should be ruled out
      as contributing factors.

PMID- 1740578
TI  - It's time for action on licensure.

PMID- 1740579
TI  - Firing an employee, how to make the process easier and stay out of court.

PMID- 1740580
TI  - Dental fees and inflation: good news or bad news?

PMID- 1740581
TI  - The effect of aerosol distribution on airway responsiveness to inhaled
      methacholine in patients with asthma.
AB  - It has been demonstrated that airway deposition of inhaled aerosols is more
      heterogeneous in patients with asthma than in normal subjects. Nevertheless, the
      influence of abnormal airway deposition on responses to bronchoactive aerosols is
      poorly understood. We altered bronchopulmonary deposition heterogeneity of
      methacholine aerosol in nine asymptomatic patients with asthma by controlling
      inspiratory flow at high (approximately 60 L/min) versus low (approximately 12
      L/min) rates on 2 study days and determined the effect on the provocative dose of
      methacholine causing a 20% fall in FEV1 (PD20) (often used as a measure of airway
      responsiveness). Deposition uniformity was quantified from gamma-camera scans of
      the lungs in terms of the distribution of a technetium-labeled aerosol that was
      inhaled rapidly or slowly before the inhalation of methacholine. Increased
      deposition in an inner (large, central airways) versus an outer (peripheral
      airways and alveoli) zone of the right lung (inner/outer ratio, greater than 1)
      and higher values of skew (an index of deposition asymmetry) and kurtosis (an
      index of deposition range) indicated enhanced heterogeneity of deposition. Mean
      (+/- SD) inner/outer ratio was significantly higher during rapid inspiration
      compared to slow inspiration with 2.91 +/- 0.51 and 1.84 +/- 0.30, respectively
      (p less than 0.01). Mean skew and kurtosis were also significantly higher after
      rapid inspiration, with 1.12 +/- 0.35 and 3.86 +/- 1.25, respectively, compared
      to 0.74 +/- 0.36 and 2.64 +/- 0.77 after slow inhalation (p less than 0.01).
      Geometric mean PD20 methacholine was significantly reduced when the aerosol was
      inhaled rapidly, with 5.9 cumulative methacholine units compared to 15.7 units
      after slow inhalation (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740582
TI  - Quantitative IgE- and IgG-subclass responses during and after long-term ragweed
      immunotherapy.
AB  - We studied the quantitative responses of short ragweed (RW)-pollen-specific serum
      antibodies in 22 patients with RW immunotherapy (IT) and in a different set of 31
      patients, 16 of whom stopped RW IT after more than 5 years of treatment. Serum
      was assayed before and after season, 1 year before and 1 and 2 years after
      starting IT, and 1 year and 2 years after stopping IT. RW pan-IgG, RW IgG1, and
      RW IgG4 were measured by ELISA, and RW IgE by RAST. Absolute quantities of RW
      IgG1 and RW IgG4 in reference sera were estimated by least-squares multiple
      regression analysis of 223 sera with the equation RW pan-IgG = RW IgG1 + RW IgG4.
      IgG1 is dominant in the early immune response of IT and disappears relatively
      slowly when IT is stopped. In contrast, IgG4 appears in significant quantities
      only after prolonged IT and disappears rapidly when IT is stopped. The apparent
      average half-life of RW IgG4 (9 months) was significantly shorter than that of RW
      IgG1 (29 months) (p less than 0.001). Before IT, mean RW IgE rose 180% (p less
      than 0.01) during the RW pollination season (August to November). This seasonal
      rise in RW IgE was ablated after IT from 1 year up to 8 years, but returned the
      year after IT was stopped. After 2 years of IT, the RW IgG1 and IgG4 levels were
      significantly correlated with RW IgE (r = 0.94 and 0.81; p = 0.0001 and 0.005).

PMID- 1740583
TI  - Immunotherapy with honeybee venom and yellow jacket venom is different regarding
      efficacy and safety.
AB  - Venom immunotherapy (VIT) for Hymenoptera allergy is accepted as safe and
      effective. However, widely varying success rates and frequencies of side effects
      are reported. Differences between various Hymenoptera species could account for
      these diverging results. We therefore analyzed 205 patients with a history of
      systemic allergic reactions to either honeybee (148 patients) or yellow jacket
      stings (57 patients) during VIT. All patients had a positive skin test to the
      respective venom before VIT, were monitored for side effects of VIT, and
      submitted to a sting challenge while they were receiving VIT. Patients with
      honeybee-venom allergy had a higher sensitivity in both skin tests (p less than
      0.05) and RAST (p less than 0.001) than patients with yellow jacket-venom
      allergy. They developed systemic side effects to VIT injections significantly
      more often (41% versus 25%; p less than 0.01) and also reacted more frequently to
      the sting challenge (23% versus 9%; p less than 0.01) than patients with yellow
      jacket-venom allergy. We conclude that results obtained from studies on the
      allergy to one Hymenoptera venom cannot be extrapolated to allergies to other
      Hymenoptera venoms.

PMID- 1740584
TI  - Benzyl benzoate moist powder: investigation of acaricidal [correction of
      acarical] activity in cultures and reduction of dust mite allergens in carpets.
AB  - Despite advances in the understanding of dust mites, it remains difficult to
      control exposure to mite allergens, and it is particularly difficult to reduce
      mites in fitted carpets or sofas. Several chemicals have been demonstrated to
      kill mites or denature mite allergens, and some of these chemicals have been
      investigated in carpets. Benzyl benzoate (BB), which has been widely used to kill
      scabies mites and is known to kill mites of the genus Dermatophagoides, has been
      used as a method of treating carpets. The present article describes experiments
      in the laboratory and in houses in testing two preparations of BB, a moist powder
      and a foam. The moist powder is composed of two ingredients, a wetted "inert"
      cellulose, which is designed to act as a cleaning agent, and the active BB
      adsorbed onto silicates. The active powder kills 90% of mites in culture within
      12 hours and 100% in 24 hours, whereas the cellulose is not acaricidal. The moist
      powder preparation was highly effective at killing D. farinae and D.
      pteronyssinus mites in the laboratory. In carpets the moist powder, applied for
      12 hours with repeated brushing, was demonstrated to reduce the concentrations of
      group I and group II dust mite allergens in dust recovered at 1 month. This
      decrease in concentration could, in part, be explained by a persistent increased
      recovery of dust caused by residual white powder. However, when the recovery of
      group II allergens was calculated as the total allergen recovered, the decrease
      was highly significant at 2 weeks and 4 weeks after treatment (p less than
      0.001). Application of the powder to carpets for 4 hours or of the foam to sofas
      was less effective. After 2 months the effect on mite antigen in carpets was
      still present, but some increase was apparent, suggesting that repeat application
      after 2 or 3 months would be necessary to control mite-allergen levels.

PMID- 1740585
TI  - Activation of the coagulation pathway during ongoing allergic cutaneous reactions
      in humans.
AB  - The levels of histamine, fibrinopeptide A (FPA), and IgG were determined in
      chamber fluids overlying sites of antigen versus buffer incubation for up to 7
      hours in seven atopic and four antigen-nonreactive subjects. Significant
      increases in histamine were observed at antigen versus buffer sites in the atopic
      subjects throughout the 7-hour period. FPA and IgG levels were higher in antigen
      than in buffer sites from 0 to 5 hours in the atopic subjects. Furthermore, FPA
      levels correlated with the magnitude of induration at 6 hours after antigen
      injection in atopic subjects. There were no differences in the levels of
      histamine, FPA, or IgG at antigen versus buffer sites in the skin test-negative
      subjects. We suggest that the combination of vascular leakage of proteins,
      induced by vasoactive mediator release, and activation of these proteins during
      ongoing cutaneous reactions is responsible for fibrin formation that contributes
      to the pathophysiology of late-phase allergic responses in the skin.

PMID- 1740586
TI  - Passive cigarette smoke-challenge studies: increase in bronchial hyperreactivity.
AB  - Degree and duration of bronchial hyperreactivity (BHR) after environmental
      tobacco smoke (ETS) inhalation was assessed in 31 smoke-sensitive subjects with
      asthma who exhibited lower airway symptoms on ETS exposure (group I) and 39 smoke
      sensitive subjects without asthma who manifested only upper airway symptoms on
      cigarette-smoke exposure (group II). Subjects were challenged with ETS for 4
      hours in a static-test chamber. The atmosphere was continuously monitored for
      airborne particulate levels (800 cpm), total suspended particulates (1266 +/- 283
      micrograms/m3), and airborne nicotine levels (226 +/- 49 micrograms/m2).
      Methacholine challenges were performed before and serially after cigarette-smoke
      exposure, and the provocative dose causing a 20% fall in FEV1 was determined.
      Five of the 31 smoke-sensitive subjects with asthma and none of the smoke
      sensitive subjects without asthma reacted to cigarette-smoke challenge (greater
      than or equal to 20% fall from baseline FEV1). Thirty-two percent (10/31) of the
      subjects with asthma demonstrated increased BHR at 6 hours, 29% (9/31) at 24
      hours, and 13% (4/31) up to day 14 after ETS challenge. Of the subjects without
      asthma, 18% (7/39) demonstrated increased BHR at 6 hours, 10% (4/39) at 24 hours,
      and 8% (3/39) at 3 weeks. These studies demonstrated an increase in BHR after
      cigarette-smoke challenge in a number of study subjects (although they were
      clinically asymptomatic) and suggest that prolonged subclinical airway
      inflammation can occur in the absence of demonstrable change in airway caliber on
      exposure to ETS.

PMID- 1740587
TI  - Comparison of human nasal mucosal secretion in vivo and in vitro.
AB  - The secretion of proteins from the human nasal mucosa induced by histamine, alpha
      adrenergic, beta-adrenergic, and cholinergic agonists was studied in vivo and in
      vitro. Glandular secretion of lactoferrin, lysozyme (in vivo only), and
      respiratory glycoconjugates (RGCs) was measured. Vascular permeability was
      determined in vivo by albumin secretion in relationship to the other proteins.
      Muscarinic stimulation by methacholine induced significant glandular secretion
      (lactoferrin, lysozyme and/or RCGs) both in vivo and in vitro, confirming that
      muscarinic receptors are stimulated directly. Histamine induced predominantly
      vascular permeability in vivo but caused some glandular secretion as well.
      However, in vitro, histamine had no effect on glandular secretion, suggesting
      that histamine acts predominantly on the nasal vascular bed and only affects
      glandular secretion through reflex actions. Phenylephrine, an alpha-adrenergic
      agonist, selectively stimulated lysozyme release in vivo, and both RGCs and
      lactoferrin release in vitro. Thus, alpha-adrenergic stimulation has some direct,
      albeit minimal, capacity to stimulate mucosal glands. beta-Adrenergic agonists
      had no effect on glandular secretion or vascular permeability either in vivo or
      in vitro. Therefore, glandular secretion is directly stimulated by alpha
      adrenergic and cholinergic agonists, but not by beta-adrenergic agonists. The
      stimulation of glandular secretion by histamine is indirect and mediated through
      the action of neural reflexes.

PMID- 1740588
TI  - HLA-DR4-associated nonresponsiveness to mountain-cedar allergen.
AB  - We did human lymphocyte antigen (HLA)-DR and DQ typing on 37 subjects with
      mountain-cedar (MC) pollinosis as defined by history and a positive skin test. Of
      these 37 subjects, 31 were subdivided into 18 subjects with a single positive
      skin test (SPST) and 13 subjects with multiple positive skin tests (MPSTs). We
      also typed 51 subjects without MC sensitivity or atopy as defined by history and
      negative skin tests to a battery of aeroallergens. We also typed 116 subjects in
      whom MC sensitivity had not been determined. Total IgE, Mc-specific
      immunoglobulin E (sIgE), and MC-sIgE binding bands by immunoblot were also
      determined on the subjects with SPSTs and MPSTs. No significant differences were
      found between the subjects with SPSTs and MPSTs for HLA type, total IgE, MC sIgE,
      or bands bound by MC sIgE by immunoblot. There was a strong negative relationship
      between HLA-DR4 and subjects with MC pollinosis; chi-square, 14.857; p = 0.0096;
      and odds ratio, 0.139. These findings suggest that there is no difference in
      genetic immunoregulation between subjects with SPSTs and MPSTs but that the
      presence of the DR4 gene product is associated with a decreased risk of an IgE
      response to MC and protection from MC pollenosis.

PMID- 1740589
TI  - Changes in bronchial responsiveness following nasal provocation with allergen.
AB  - The relationship between upper airway inflammation and asthma is controversial.
      In the current study, we sought to investigate the relationship between allergic
      rhinitis and lower airway dysfunction by performing double-blind, randomized
      nasal challenges with allergen or placebo. Subjects were selected for a prior
      history of asthma exacerbations after the onset of seasonal allergic rhinitis
      symptoms. After the induction of a marked nasal-allergic reaction (with a
      technique of nasal provocation that limited allergen delivery to the nose), there
      were no changes in FEV1, specific conductance, or lung volumes either 30 minutes
      or 4 1/2 hours after nasal allergen challenge, nor any changes in peak flow rates
      followed hourly until the next day. However, nasal provocation with allergen
      resulted in a relative increase in bronchial responsiveness to methacholine
      compared with that to placebo (p = 0.011 at 30 minutes and p = 0.0009 at 4 1/2
      hours after challenge). Our study suggests that, although a nasal-allergic
      response does not induce airflow limitation of the lower airways, it can alter
      bronchial responsiveness.

PMID- 1740590
TI  - Is there a role for cyclosporine in asthma?

PMID- 1740591
TI  - Suffocating odor and asthma after Acarosan-powder carpet treatment.

PMID- 1740592
TI  - Evidence of mast cell involvement in a clinical syndrome mimicking toxic shock
      syndrome.

PMID- 1740593
TI  - Ambulatory monitoring of sleep-wakefulness patterns in healthy elderly males and
      females (greater than 88 years): the "Senieur" protocol.
AB  - OBJECTIVE: The study was designed to investigate sleep-wake patterns in healthy
      elderly men and women (greater than 88 years) using ambulatory recording
      techniques. DESIGN: Cross-sectional observations on 2 consecutive days. METHODS:
      Two consecutive 24-hour recordings were made. Each 30-second period of the
      recording was scored as characteristic of wakefulness, REM, and non-REM sleep
      (stages 1-4). SETTING: Interviews and recordings were done in the home of the
      elderly, not interfering with the habitual routine. PARTICIPANTS: Among eligible
      members of the "Senieur" protocol, screened for wellness, seven females (88-102
      years) and seven males (88-98 years) volunteered to participate. MAIN OUTCOME
      MEASURES: Organization of sleep, sleep structure, and daytime mapping. RESULTS:
      There was no difference between the first and second night recording. Important
      gender differences were observed: males had significantly less total sleep,
      shorter REM latency, more transitions to wake from REM, less NREM 3 sleep, and
      virtually no NREM 4. Daytime napping, REM amount, and distribution did not show
      sex differences. Although the variability in the amount of napping was
      considerable, it occupied less than 10 percent of the total sleep time in both
      women and men. Daytime napping was unrelated to sleep characteristics.
      CONCLUSIONS: Ambulatory sleep-wake recordings allow an objective and critical
      evaluation of sleep function in normal aging. Interesting findings include a
      shift of REM sleep to the first part of the sleep period an increased cycle
      variability, and non-correlation of night-time sleep with daytime napping. In
      contrast to earlier findings in elderly persons, a polygraphic and subjective
      first-night effect was lacking.

PMID- 1740594
TI  - Viral respiratory infections in the institutionalized elderly: clinical and
      epidemiologic findings.
AB  - OBJECTIVE: To prospectively evaluate the incidence and impact of viral
      respiratory infection in the institutionalized elderly during a winter season.
      DESIGN: Prospective descriptive study, without intervention. METHOD: Patients
      with respiratory illnesses were evaluated by a directed history and physical
      examination. Nasopharyngeal secretions for viral culture were obtained, and acute
      and convalescent serum samples were obtained for analysis. Serologic evidence of
      infection with respiratory syncytial virus (RSV) and parainfluenza were
      determined by enzyme immunoassay (EIA), and influenza by hemagglutination
      inhibition assay and EIA. SETTING: A 591-bed nursing home. PARTICIPANTS:
      Residents with signs or symptoms of acute respiratory illness (nasal congestion,
      pharyngitis, cough, wheezing, or respiratory difficulty) were eligible for study.
      RESULTS: A viral etiology was documented in 62 out of 149 illnesses (42%). RSV
      was the most common virus associated with illness; it was documented in 27% of
      respiratory illnesses, followed by rhinovirus (9%), parainfluenza (6%), and
      influenza (1%). RSV was associated with significantly more severe disease when
      compared with rhinovirus. Clustering of specific viral infections occurred,
      suggesting nosocomial transmission. CONCLUSIONS: Viruses are an important cause
      of acute respiratory infections in the institutionalized elderly during the
      winter months.

PMID- 1740595
TI  - Positron emission tomography and familial Alzheimer's disease: a pilot study.
AB  - OBJECTIVE: Local cerebral metabolic rates for glucose were compared between
      patients with familial Alzheimer's disease (FAD), sporadic Alzheimer's Disease
      (SAD), and normal controls (NC) to determine if FAD is associated with a unique
      pattern of brain metabolism. DESIGN: Case-control study matched to convenience
      sample of FAD. METHODS: Subjects in the three diagnostic groups were scanned
      using fluorodeoxyglucose and the Positron Emission Tomographic (PET) technique.
      The criterion standard of a detailed clinical history and examination were
      compared to scan results. SETTING: Patients in a university hospital. SUBJECTS:
      Ambulatory controls and Alzheimer's patients, both sporadic (n = 8) and familial
      (n = 7). The two groups were similar in severity of cognitive dysfunction.
      RESULTS: FAD and SAD patients did not significantly differ in terms of local
      cerebral metabolic rates for glucose.

PMID- 1740596
TI  - Hearing loss prevalence and management in nursing home residents.
AB  - OBJECTIVES: To determine the prevalence and management of hearing loss and
      hearing handicap among non-demented nursing home residents. DESIGN: Descriptive
      study of total population of two nursing homes. PARTICIPANTS: All 121 eligible
      residents. SETTINGS: Two nursing homes. MINI OUTCOME MEASURES: Audiometry,
      questionnaires of nurses and subjects regarding perceived hearing handicap, and
      documentation in medical records of hearing loss. RESULTS: 77% had at least a
      mild (greater than or equal to 26 dB Hearing Level) hearing loss in the better
      ear, and 51% had a moderate to severe loss (greater than or equal to 41 dB HL).
      Self-assessments of hearing handicap by residents, together with audiometric
      findings and expressed interest in a hearing aid, were more useful guides for
      aural rehabilitation needs than were nurses' assessments of residents' handicaps.
      Medical records failed to identify 48% of residents with moderate to severe
      hearing losses. Fifty-eight percent of residents with severe hearing loss
      currently had hearing aids, and 38% more would like to have an aid. CONCLUSIONS:
      Residents should have hearing evaluations with documentation of results on
      admission and periodically under the direction of a nurse trained as a hearing
      specialist. Environmental modifications of the NH plus use of hearing aids can
      improve hearing.

PMID- 1740597
TI  - The effects of patterned urge-response toileting (PURT) on urinary incontinence
      among nursing home residents.
AB  - OBJECTIVE: To test an individualized form of habit training for urinary
      incontinence (UI) among long-stay cognitively and/or physically impaired elderly
      nursing home residents over time. DESIGN: Randomization of subjects occurred by
      nursing home unit. Baseline wet checks were done hourly for one 24-hour period at
      3-week intervals over 12 weeks followed by 72 hours of continuous electronic
      monitoring to establish precise voiding patterns for each subject. The 12-week
      intervention period was administered by indigenous staff after they attended a 4
      hour UI educational program. Subjects were followed an additional 12 weeks to
      determine the extent of maintenance of the intervention among staff and subjects.
      SETTING: Four non-profit nursing homes; west, mid-west, east coast. PATIENTS:
      Consent was obtained from 154 (71%) who met primary inclusion criteria. Forty-one
      failed the secondary inclusion criteria leaving 113 who entered the 37-week
      study. Eighty-eight completed the study (experimental = 51, control = 37); all
      were physically and/or mentally impaired, averaged age 85, and had either urge or
      urge/stress UI. RESULTS: UI was significantly decreased during the 3-month period
      (P less than 0.001). Eighty-six percent showed improvement over baseline while
      one-third improved 25% or more over their baseline UI rate. The control group's
      UI increased during the same period of time. The volume of UI among the
      experimental group also decreased (P less than 0.005) while the control group's
      UI volume increased. CONCLUSIONS: The training program was effective in reducing
      UI though compliance among nursing staff averaged only 70% of the prescribed
      toileting times. The success of this approach is similar to other recently
      described behavioral programs but achieved the reduction using only regular
      nursing staff. This individualized approach supports the recent regulatory thrust
      to individualize care to promote and maintain functional abilities and autonomy.

PMID- 1740598
TI  - The impact of pacemaker implantation on cognitive functioning in elderly
      patients.
AB  - OBJECTIVE: To describe and quantify the impact of pacemaker implantation on
      cognitive functioning in the elderly. DESIGN: Prospective case-control, non
      randomized trial. Data were collected from clinical and family interviews and
      from a psychological test battery. SETTING: Pacemaker clinic in a tertiary care
      hospital. PARTICIPANTS: Nineteen elderly (65+ years) patients undergoing new or
      replacement pacemaker implantation for dysrhythmias and volunteer controls
      matched for age, sex, and short Mental Status Questionnaire test results, without
      dysrhythmia or intervention. MAIN OUTCOME MEASURES: Subjective and clinical
      impressions based on family interviews; results of psychological test battery
      before and 6-12 months after pacemaker implantation. RESULTS: Prior to pacemaker
      implantation, three patients met DSM-III criteria for dementia and two for
      delirium. Paced patients demonstrated deficiency in immediate memory, language,
      memory for less structured information, and learning of abstract materials. These
      deficits were due primarily to the poor performance of patients with complete
      heart block. Despite clinical and subjective impressions of improvement, there
      was no change in psychologic test performance subsequent to pacemaker
      implantation. CONCLUSIONS: Impaired cognitive functioning is not always
      clinically apparent but appears common in patients with cardiac dysrhythmias; it
      is not altered 6-12 months after pacemaker implantation.

PMID- 1740599
TI  - Diabetes support groups improve health care of older diabetic patients.
AB  - OBJECTIVE: To assess whether knowledge or psychosocial and glycemic benefits of a
      diabetes education program are enhanced by a support group for older patients.
      DESIGN: A partially randomized controlled trial involving two groups of patients:
      Group A, subjects who received an education program followed by 18 months of
      support group sessions; Group B, only the diabetes education program. A third
      convenience sample, Group C, received neither intervention. Groups A and B were
      assessed before and immediately after the education program, and all groups were
      assessed 2 years after the education program. SETTING: Diabetes clinic at a
      Veterans Affairs Medical Center. PATIENTS: All subjects were male (mean age = 68
      +/- 1.3 years, range = 57-82 years; duration of diabetes = 10 +/- 2 years, range
      3-16). Sample sizes were 11 in Group A, 13 in Group B, and 8 in Group C.
      INTERVENTION: The education program consisted of six weekly sessions covering
      aspects of diabetes self-care. The support group consisted of 18 monthly sessions
      for continuing education, discussion, and structured social activities. OUTCOME
      MEASURES: Diabetes knowledge, psychosocial factors (self-care-related quality of
      life, stress, family involvement in care, and social involvement), depression,
      and glycemic control. RESULTS: Group A scored better (at least P less than 0.05)
      on knowledge, quality of life, and depression than the other groups. Groups A and
      B showed less stress, greater family involvement, better glycemic control, but
      less involvement in social activities than Group C. CONCLUSION: Diabetes
      education programs can have long term benefits on knowledge, psychosocial
      functioning, and glycemic control for older diabetic patients. The addition of
      support groups enhances diabetes knowledge and psychosocial functioning.

PMID- 1740600
TI  - Body composition in elderly men: effect of dietary modification during strength
      training.
AB  - OBJECTIVE: To assess how dietary change affects gain in strength and muscle mass
      during heavy resistance training of elderly men. DESIGN: Randomized controlled
      trial. INTERVENTION: During 12 weeks of resistance training of knee extensors and
      flexors, a daily supplement of 560 +/- 16 kcal/day (17% energy from protein, 43%
      from carbohydrate, 40% from fat) was randomly assigned to six men (S) while five
      men (U) received no supplement. Food intake, strength, whole body composition,
      and midthigh composition by CT scan were assessed before training and at 6 and 12
      weeks. SETTING: The men were outpatients but lived in a Metabolic Research Unit
      during the three assessments. PARTICIPANTS: Eleven healthy men aged 61 to 72
      years. RESULTS: Densitometry showed no change over time in fat or fat-free mass.
      However, the S men increased (P less than 0.05) weight, skinfold thickness at six
      sites, subcutaneous midthigh fat, and creatinine excretion; in all men, changes
      in these values and in midthigh muscle were proportional to changes in reported
      energy intake (P less than 0.05). There was midthigh muscle hypertrophy in both
      groups, but it was greater in S than U (P less than 0.01). Both groups gained
      strength (P less than 0.001) with no effect of diet. CONCLUSIONS: During physical
      rehabilitation of the elderly, dietary intake may influence the increase in lean
      as well as adipose tissue without altering strength gain. These preliminary
      findings should be confirmed by a larger study with sedentary controls.

PMID- 1740601
TI  - Reduced infectivity of cold-adapted influenza A H1N1 viruses in the elderly:
      correlation with serum and local antibodies.
AB  - OBJECTIVE: To compare young and elderly adults in terms of their immune responses
      and rates of infection following intranasal vaccination with a live attenuated
      influenza virus. DESIGN: Time series, comparing outcomes in young and elderly
      convenience sample. METHOD: Retrospective laboratory analysis of serum and nasal
      wash specimens collected during prior studies in which young or elderly
      volunteers had been inoculated with cold-adapted influenza A/Kawasaki/86 (H1N1)
      reassortant virus. SETTING: Johns Hopkins Center for Immunization Research.
      PARTICIPANTS: Healthy young and elderly adults with pre-vaccination serum
      hemagglutination inhibition (HAI) antibody titers less than or equal to 1:8.
      OUTCOME MEASUREMENTS: Antibody responses in serum and nasal washes. MAIN RESULTS:
      The proportion of vaccinees who developed any serum or local antibody response
      was higher in young compared with elderly subjects (20/20 vs 5/14, P less than
      0.0005). Resistance to infection with cold-adapted virus correlated with pre
      vaccination levels of serum immunoglobulin G (IgG), serum IgA, and nasal wash IgA
      antibody to whole virus antigen. Age was highly correlated with a lack of
      response to vaccine by simple regression, but not when data were adjusted for pre
      existing antibody levels. CONCLUSIONS: Cold-adapted reassortant influenza A H1N1
      viruses achieve lower rates of infection in elderly than young adults, primarily
      due to age-related differences in preexisting levels of immunity which may not be
      reflected by HAI titer.

PMID- 1740602
TI  - Time dependency of cognitive recovery with cobalamin replacement: report of a
      pilot study.
AB  - OBJECTIVE: To examine the effects of cobalamin repletion on cognition in elderly
      subjects with low serum cobalamin and evidence of cognitive dysfunction. DESIGN:
      Time series data collected in an open trial of parenteral cobalamin therapy.
      SETTINGS: Outpatient geriatric assessment centers, inpatient geropsychiatry unit,
      and tertiary care university hospital. PARTICIPANTS: Twenty-two subjects with low
      serum cobalamin (less than 150 pmol/L) and evidence of cognitive dysfunction were
      entered consecutively over an 8-month period of time. Eighteen subjects completed
      the study. INTERVENTIONS: Subjects received 1000 micrograms of cyanocobalamin
      intramuscularly daily for 1 week, then weekly for 1 month, then monthly
      thereafter for a minimum of six months. OUTPATIENT MEASURE: The Mattis Dementia
      Rating Scale (DRS) was administered both before and at least 6 months after full
      cobalamin replacement therapy. The hypothesis that cognitive improvement was
      dependent on the duration of cognitive symptoms was formulated a posteriori.
      RESULTS: After a minimum of 6 months of cobalamin therapy, 11 of 18 patients
      showed cognitive improvement. There was a striking correlation between duration
      of cognitive symptoms and response to therapy. Patients symptomatic for less than
      12 months gained an average of twenty points on the DRS (paired t test P =
      0.0076), whereas patients symptomatic greater than 12 months lost an average of
      three points (paired t test P = .34). Two patients symptomatic for only 3 months
      normalized their DRS scores, gaining 31 and 28 points, respectively. CONCLUSION:
      There may be a time-limited window of opportunity for effective intervention in
      patients with cognitive dysfunction and low serum cobalamin.

PMID- 1740603
TI  - Study of strategies for the recruitment of elders including the use of community
      volunteers.
AB  - OBJECTIVES: The primary objective was to compare study participation when first
      contact was made by telephone versus an unscheduled visit to the household. The
      secondary objective was to compare study participation when three differing modes
      of questionnaire presentation were used. DESIGN: The residents of 300 randomly
      selected households were contacted by community volunteers and asked to
      participate in a study of the etiology of cancer and other chronic diseases. Two
      methods of first contact were used, a telephone call to schedule a home visit and
      an unscheduled visit to the household. Three modes of questionnaire presentation
      were used. PARTICIPANTS: Residents of a retirement community in Arizona who were
      aged 50 or over. MAIN OUTCOME MEASURES: Agreement to participate, defined as
      acceptance of and agreement to complete the study questionnaires. Participation
      in the study, defined as acceptance and completion of the study questionnaires.
      RESULTS: No difference was observed in participation when first contact was made
      by telephone (46%) as compared with an unscheduled visit to the household (45%)
      (P = 0.83). Similarly, no difference in the participation was observed between
      three modes of presentation of the questionnaire to the householders (P = 0.13).
      Agreement to participate was, however, significantly higher when first contact
      was made by visiting the home (81% vs 55%) (P less than 0.001). CONCLUSIONS:
      Neither the strategy used for first contact nor mode of questionnaire
      presentation affected participation.

PMID- 1740604
TI  - Tuberculosis in aging adults.

PMID- 1740605
TI  - Advances in Alzheimer's disease.

PMID- 1740606
TI  - Oral cancer: to screen or not to screen?

PMID- 1740607
TI  - Effects of strength training in elderly women.

PMID- 1740608
TI  - Alarm devices instead of restraints?

PMID- 1740609
TI  - The clinical importance of environmental lighting to the elderly.
AB  - 1. Nurses need to be aware of the effects of artificial lights on the aged
      because the aged spend a greater amount of time under these lights than do
      younger people. 2. Although the aged require more light than younger people to
      see, bright lights may cause glare. The use of indirect lighting is recommended
      to reduce problems with glare. 3. The aged see best under artificial lighting
      that simulates natural sunlight. 4. Nurses who work in institutional settings
      should be sensitive to the need for individualized light-dark cycles.

PMID- 1740610
TI  - Education in the elderly. Adapting and evaluating teaching tools.
AB  - 1. The patient's Bill of Rights documents the rights of patients to be informed
      of their illness, health, and treatment. 2. The use of appropriate teaching tools
      can significantly increase learning, especially if the tools are modified to
      accommodate normal aging changes. 3. An appropriate teaching tool is a critical
      component to the learning success of the elderly. 4. With aging changes that
      result in loss of short-term memory, a teaching tool may make the difference
      between short-term learning and long-term success.

PMID- 1740611
TI  - Releasing restraints in the nursing home: it can be done.
AB  - 1. The value of physical restraints for nursing home residents has not been
      documented, yet they have been used almost universally for at least 50 years. 2.
      The use of physical restraints for confused patients produces numerous negative
      outcomes. 3. Nursing homes can create environments that are restraint-free for
      all residents, and demonstration trials have proven the feasibility of restraint
      free care. 4. A restraint-free environment produces a dramatic decrease in
      agitation and mobility problems.

PMID- 1740612
TI  - The relationship of anxiety to development of postoperative delirium.
AB  - 1. Although patients who experience unplanned, unanticipated surgery were not
      more anxiety prone than patients undergoing planned surgery, they did experience
      higher levels of state anxiety and a higher incidence of delirium
      postoperatively. 2. Nurses should be alert to an increased risk of negative
      outcomes among patients with little or no opportunity for psychological
      preparation prior to surgery, and especially among patients undergoing
      unanticipated orthopedic surgery. 3. State anxiety scores among patients
      undergoing unplanned surgery declined postoperatively rather than rose. This
      indicates that the critical period for nursing intervention may be in the
      preoperative period. 4. Delirium is not associated with anxiety in a direct or
      linear way. Patients who experience delirium postoperatively do not experience
      greater state anxiety, nor are they more anxiety prone than patients who do not
      exhibit delirium.

PMID- 1740613
TI  - The music therapy assessment tool in Alzheimer's patients.
AB  - 1. Empirical research is needed to evaluate immediate and sustained
      physiological, psychological, and psychosocial therapeutic effects, if any, of
      music therapy on behavioral patterns of elderly institutionalized Alzheimer's
      patients. 2. The Music Therapy Assessment Tool (MTAT) was specifically designed
      and developed to assess the effects of music therapy on behavioral patterns of
      Alzheimer's disease patients. 3. Preliminary testing of the MTAT suggests that it
      has fairly high internal consistency and inter-rater reliability and warrants
      consideration as a research tool. 4. Musical intervention included familiar music
      to facilitate communication and socialization, ethnic and nostalgic music to
      stimulate reminiscence, and melodies with distinctive rhythmic patterns to
      enhance movement and behavioral repatterning.

PMID- 1740614
TI  - Implementation of a urinary continence program.
AB  - 1. Meaningful involvement of staff supports the tenet that staff must not only
      participate in making decisions that they perceive as being important to them,
      but that they also perceive that their participation has an impact. 2. Urinary
      incontinence accompanies dementia of the Alzheimer's type because the person
      forgets how to locate the bathroom, is unable to communicate the need to void,
      and has an impaired central inhibition of elimination. Regular toileting
      schedules help promote continence. 3. Strategies that encourage staff
      participation in a new program include the deliberate use of wording, anonymous
      written input on select forms, and ongoing support and recognition. Staff members
      must feel respected for their knowledge, ideas, and experience.

PMID- 1740615
TI  - The challenge of caring: behavioral management.

PMID- 1740616
TI  - Blood shortage.

PMID- 1740617
TI  - Health policy commission sees no easy answers. Interview by Bob Carlson.

PMID- 1740618
TI  - New Medicare formula: RVU x GAF x CF = ?

PMID- 1740620
TI  - ISMA lobbying team plays offense, defense.

PMID- 1740619
TI  - Gallup Poll reflects Indiana attitudes on health care.

PMID- 1740621
TI  - New alternatives in gallstone treatment.
AB  - Within the past few years, a number of new treatment modalities for gallbladder
      stones have become available. Laparoscopic cholecystectomy has proved as safe as
      traditional surgical cholecystectomy, without the discomfort and lengthy
      recuperation associated with a large abdominal incision. Several other new
      treatments also have been investigated, including percutaneous
      cholecystolithotomy, peroral drug chemolysis, extracorporeal shock wave
      lithotripsy, and methyl-tert-butyl ether lavage. The relative merits and
      disadvantages of these treatments, compared to each other and to standard
      cholecystectomy, are described herein.

PMID- 1740622
TI  - Echoes in the halls: thoughts on double publication.

PMID- 1740623
TI  - What molecular biology has taught us about fibrinolysis.

PMID- 1740624
TI  - Fibrinogen deposition and macrophage-associated fibrin formation in malignant and
      nonmalignant lymphoid tissue.
AB  - Nonmalignant lymphoid tissue and tissue from patients with nodular sclerosis,
      Hodgkin's disease, and large cell lymphocytic lymphoma was examined by
      immunohistochemical techniques for the occurrence in situ of components of
      coagulation and fibrinolysis reaction pathways. Staining for material interpreted
      as fibrinogen was observed in abundance in both malignant and reactive lymphoid
      tissue. Fibrin also occurred to a variable extent but focally in all tissues.
      Components of coagulation pathways, including tissue factor, factor VII, factor
      X, and factor XIII ("a" subunit), were restricted to tissue macrophages. Double
      labeling techniques revealed fibrin in direct apposition to tissue macrophages.
      We conclude that fibrinogen and fibrin occur in both benign and malignant
      lymphoid tissue and that the transformation of fibrinogen to fibrin is
      attributable to macrophage-initiated thrombin formation. We postulate that both
      systemic and local hypercoagulability associated with these disorders may be
      attributable to macrophage activation resulting in expression of procoagulant
      activity.

PMID- 1740625
TI  - Fibrin coating of bladder tumor cells (T24) is not protective against LAK cell
      cytotoxicity.
AB  - Certain evidence indicates that tumor cells in the circulation may be enshrouded
      with a coat of fibrin. It has been suggested that this fibrin coat protects tumor
      cells from attack by the immune system. This study compared the interaction of
      lymphokine activated killer (LAK) cells with tumor cells alone and with fibrin
      coating. LAK cell killing of cultured human bladder tumor cells (T24) was
      measured by a 4-hour chromium release assay. Tumor cells (3 x 10(6] were
      incubated with Na51CrO4 for 2 hours at 37 degrees C and 5% CO2 in serum-free
      medium. After washing, one half of the cells were coated with fibrin by exposure
      to recalcified platelet-poor plasma. Fibrin coating was confirmed by
      immunofluorescence with anti-human-fibrinogen-fluorescein-conjugated antibodies.
      LAK cells were prepared from peripheral blood lymphocytes by incubation with
      interleukin-2 at a concentration of 1000 units of interleukin-2/1 ml serum-free
      medium/1 million cells for 5 days at 37 degrees C, 5% CO2. Five thousand tumor
      cells with or without fibrin were incubated with varying concentrations of either
      LAK or peripheral blood lymphocytes (10,000 to 100,000 cells). After 4 hours the
      supernatants were harvested and counted in a gamma counter for 1 minute. Over a
      range of effector-to-target cell ratios of 10:1 to 100:1 (LAK to T24), no
      difference was seen in percentage of specific lysis for T24 alone versus fibrin
      coated T24 cells. At a ratio of 100:1 (LAK to T24), percentage of specific lysis
      was 83.3% versus 87.7% for uncoated and coated T24 cells, respectively. This
      suggests that fibrin coating of tumor cells is insufficient to provide protection
      from LAK cell killing.

PMID- 1740626
TI  - Stimulation of growth of neuroblastoma cells by ferritin in vitro.
AB  - Among children with advanced neuroblastoma, serum concentrations of the iron
      storage protein ferritin correlate inversely with prognosis. To determine whether
      ferritin stimulates tumor cell growth, the effects of graded concentrations on
      cell number were studied for each of three neuroblastoma cell lines (CHP-126, CHP
      100, IMR-32) plated in serum-free tissue culture medium. Ferritin extracted from
      human liver, spleen, or CHP-126 cells (150 ng/ml, final concentration) but not
      from human heart (150-300 ng/ml) resulted in 1.4-fold +/- 0.2-fold increases in
      cell numbers over 72 hours as measured spectrophotometrically after reduction of
      a tetrazolium dye. Higher concentrations of isoferritins (up to 1000 ng/ml) did
      not further increase cell number, but stimulation was abrogated by rabbit
      immunoglobulin G antiferritin. Although specific receptors for iodine 125-labeled
      ferritin could not be demonstrated on the two cell lines tested, deoxyribonucleic
      acid (DNA) synthesis, measured by incorporation of 3H-thymidine, also increased
      after addition of ferritin, by approximately 25%. We conclude that ferritin has
      mitogenic activity for human neuroblastoma cells in vitro which may explain the
      clinical correlation between levels of that protein and prognosis. Possible
      implications for therapy are discussed.

PMID- 1740627
TI  - Improved maintenance of platelet in vivo viability during storage when using a
      synthetic medium with inhibitors.
AB  - We report on the storage of platelet concentrates and the effects on in vivo and
      in vitro platelet function tests of adding the platelet inhibitors prostaglandin
      E1 and theophylline to a plasma-free synthetic medium and storage in containers
      with reduced surface-to-volume ratio. Paired in vivo studies on platelets labeled
      with indium 111 after 14-day storage demonstrated higher recoveries (mean +/- SD)
      of 23% +/- 9% and longer survivals of 109 +/- 59 hours for the test group versus
      8% +/- 10% and 19 +/- 22 hours, respectively (p less than 0.01), for the control
      group (synthetic medium with no inhibitors and use of standard containers). The
      improved viability was associated with a significantly lower glycolytic rate;
      better maintenance of other in vitro parameters including respiratory activity,
      adenosine triphosphate levels, hypotonic shock response, surface glycoprotein Ib
      (by flow cytometry); and improved preservation of morphologic integrity (p less
      than 0.05). In particular, a strong inverse correlation (r = -0.91) was observed
      between in vivo recoveries and the fraction of platelets negative for
      glycoprotein Ib. We conclude that avoidance of platelet activation by a
      combination of inhibitors, plasma removal, and reduced container surface improves
      platelet respiratory activity, adenosine triphosphate and glycoprotein Ib levels,
      and posttransfusion viability of platelet concentrates stored for 14 days.

PMID- 1740628
TI  - Modification of platelet and lymphocyte calcium handling and blood pressure by
      dietary sodium and calcium in genetically hypertensive rats.
AB  - Abnormal cellular calcium handling has been postulated to be involved in the
      pathogenesis of hypertension. To determine whether the blood pressure response to
      dietary manipulation of sodium level (as the chloride salt) and calcium level is
      associated with changes in cellular cation metabolism, the interactive effects of
      both dietary components on blood pressure and intracellular free calcium
      concentration [( Ca2+]i) in blood platelets and thymic lymphocytes, erythrocyte
      sodium content, and blood ionized calcium were examined in stroke-prone
      spontaneously hypertensive rats. Rats were fed low (0.3%) or high (3.1%) sodium
      and low (0.2%) or high (2.0%) calcium diet for 6 weeks. With the rats receiving
      the high sodium-low calcium diet, systolic blood pressure was higher than with
      other diets, among which no difference was detected. Both basal [Ca2+]i and
      ionomycin (50 and 150 nmol/L) stimulated [Ca2+]i in platelets, and in
      lymphocytes, were higher with the high sodium-low calcium diet than with the
      others. Thus the high sodium diet elevated blood pressure and increased [Ca2+]i
      in the resting and stimulated state in both cell lines with the low-calcium but
      not the high-calcium diet. The high-sodium diet was associated with increased
      sodium content of erythrocytes, whereas manipulations of dietary calcium level
      had no effect on erythrocyte sodium content. Dietary calcium level had more of an
      effect on blood ionized calcium than did dietary sodium level. In combined diet
      groups, blood pressure was positively, significantly correlated with basal and
      ionomycin-induced [Ca2+]i in platelets (r = 0.64 and 0.67, respectively) and in
      lymphocytes (r = 0.53 and 0.60, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740629
TI  - Plasma elastase alpha 1-antitrypsin and lactoferrin in sepsis: evidence for
      neutrophils as mediators in fatal sepsis.
AB  - Increased vasopermeability and vasodilation, presumably the result of endothelial
      perturbation, are considered among the basic pathogenetic mechanisms in septic
      shock. Neutrophils have been implicated as a source for mediators in endothelial
      injury. We measured elastase-alpha 1-antitrypsin (alpha 1AT) complexes and
      lactoferrin as markers for release of neutrophil granule contents in plasma from
      patients with sepsis on admission to the Intensive Care Unit, and we delineated
      the relationship of neutrophil activation to other inflammatory parameters and to
      hemodynamic and biochemical parameters. Levels of elastase-alpha 1AT and
      lactoferrin significantly correlated with each other (r = 0.58; p less than
      0.008), and were increased (greater than 3.33 and 5 nmol/L, respectively) in 96%
      and 71% of the patients, respectively. Lactoferrin, but not elastase-alpha 1AT,
      correlated with the number of white blood cells (r = 0.38; p = 0.008). Elastase
      alpha 1 AT levels were significantly higher (p = 0.008), whereas white blood cell
      counts were lower (p = 0.015) in patients with shock when compared with patients
      without abnormal blood pressure. Both elastase-alpha 1AT and lactoferrin levels
      correlated with lactate levels (r = 0.33; p = 0.024 and r = 0.30; p = 0.04),
      suggesting a role for neutrophil activation in the pathogenesis of
      hypoxygenation. In addition, elastase-alpha 1AT correlated with the
      concentrations of interleukin 6 (IL-6) (r = 0.46; p = 0.001) and C3a (r = 0.38; p
      = 0.009), suggesting that cytokines and complement may contribute to the
      degranulation of neutrophils in sepsis. Elastase-alpha 1AT complexes were
      inversely related to C1-inhibitor (r = -0.33; p = 0.028) and to platelet numbers
      (r = -0.42; p = 0.003). Levels of elastase-alpha 1AT complexes in plasma appeared
      to be of prognostic significance; levels were higher in 27 patients who died than
      in 21 patients who survived (p = 0.01). The mortality in 27 patients with
      concentrations below 10 nM was 37%, whereas it was 81% in 21 patients with higher
      levels. The overall mortality in this study was 56%. These results provide
      further evidence that activation and degranulation of neutrophils, induced by
      multiple agonists, are involved in the development of fatal complications in
      patients with sepsis.

PMID- 1740630
TI  - Degradation of rat lung collagens by cathepsin B.
AB  - The lysosomal proteinase cathepsin B degrades purified insoluble collagen in
      vitro. To determine whether the enzyme degrades collagens present in normal
      extracellular matrices, we quantitated release of hydroxyproline-containing
      peptides during incubation of rat lung explants with bovine spleen cathepsin B.
      Incubation of explants with cathepsin B at pH 5.9 caused significant release of
      hydroxyproline, indicating collagen degradation, without apparent injury to lung
      parenchymal cells, as determined by release of lactate dehydrogenase. Release of
      hydroxyproline was completely inhibited by E-64, a specific inhibitor of cysteine
      proteinases. Cathepsin B demonstrated significant collagenolytic activity over a
      range of pH values from 4.0 to 6.5. Little activity was present at pH 7.0 or
      above. The findings indicate that cathepsin B is capable of degrading collagens
      embedded in the complex extracellular matrix of the lung and suggest that the
      enzyme may contribute to collagen degradation in vivo.

PMID- 1740631
TI  - Effects of extraerythrocytic hemoglobin and its components on mononuclear cell
      procoagulant activity.
AB  - Earlier studies performed in rabbits in this laboratory showed that human
      hemoglobin causes leukocyte infiltration into heart and lung tissues and
      coagulation abnormalities including thrombosis. Since stimulation of peripheral
      blood mononuclear cells induces procoagulant activity, we investigated the
      possibility that isolated peripheral blood mononuclear cells from humans and
      rabbits were stimulated by hemoglobin to produce a procoagulant activity
      response. Stroma-free hemoglobin and its purified components were assayed for
      their stimulatory effect on peripheral blood mononuclear cells. The added effect
      of endotoxin contamination was also explored. A significant dose-dependent effect
      of stroma-free hemoglobin on procoagulant activity was found with both human and
      rabbit peripheral blood mononuclear cells, but rabbit cells were found to be 50
      fold more sensitive than human cells. Hematin, methemoglobin, and purified
      hemoglobin Ao elicited procoagulant activity effects with human peripheral blood
      mononuclear cells, but isolated globin did not. We also studied the effects of
      these compounds on activation of complement, a known mediator of the procoagulant
      activity response. Stroma-free hemoglobin, hematin, purified hemoglobin Ao, and
      methemoglobin were all found to cleave complement fraction C3 to C3a but at
      concentrations much higher than those required for procoagulant activity. The
      data suggest that heme itself may be responsible for the procoagulant effect of
      stroma-free hemoglobin solutions.

PMID- 1740632
TI  - Time course of serum protein changes after strenuous exercise of the forearm
      flexors.
AB  - The time course of changes in serum proteins and other blood constituents after
      eccentric exercise of the forearm flexors by six nonweight-trained female
      subjects (age, 19.7 +/- 1.9 years) was investigated. Eccentric muscle actions are
      those in which the muscle lengthens as it exerts force, as when a person lowers a
      weight. Serum levels of creatine kinase, lactate dehydrogenase, aspartate
      aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl
      transpeptidase, myoglobin, as well as urea nitrogen, uric acid, creatinine,
      calcium, and phosphorus were examined before and for 6 days after exercise.
      Creatine kinase increased dramatically (peak value ranged from 6740 to 24,200
      U/L) and aspartate aminotransferase, lactate dehydrogenase, alanine
      aminotransferase, and myoglobin followed the same time course as creatine kinase,
      but their peak values were lower. These proteins did not increase significantly
      until 48 hours after exercise and reached peak values 3 to 5 days after exercise.
      Alkaline phosphatase, gamma-glutamyl transpeptidase, uric acid, urea nitrogen,
      creatinine, calcium, and phosphorus showed no change. There is either a delay in
      muscle protein release by damaged muscle fibers, or the proteins are unable to
      leave the interstitial area for the 24 to 48 hour period after exercise. Because
      of the long delay, care should be taken when blood protein levels are interpreted
      in persons who have exercised strenuously (even if only for a short period of
      intense effort) several days before any diagnostic tests are performed.

PMID- 1740633
TI  - Pharmacologic properties of an unfractionated heparin butyryl derivative with
      long-lasting effects.
AB  - This article reports on the pharmacologic properties of an O-acylated butyryl
      derivative (C4-UH) of unfractionated heparin (UH). In a purified system, the
      ability of C4-UH to catalyze the inhibition of thrombin and of factor Xa in the
      presence of antithrombin III was similar to that of UH. Addition of albumin (10
      mg/ml) to the reagents reduced the antithrombin and antifactor Xa catalytic
      potency of C4-UH 68-fold and 20-fold, respectively, and did not alter those of
      UH. As judged from the prolongation of the activated partial thromboplastin time
      and the thrombin clotting time, the anticoagulant activities of C4-UH were two
      times weaker than those of UH. After calibration against UH, the antifactor Xa
      specific and antithrombin-specific activities were two and 6.6 times lower,
      respectively. After bolus intravenous injection into rabbits, the apparent
      clearances of C4-UH were reduced 2.4 (antifactor Xa activity) and 3.2 times
      (antithrombin activity) in comparison with those of UH. This property accounted
      for the higher plasma concentrations generated during a constant infusion of the
      same dose. In the Wessler thromboplastin model, the minimum doses providing the
      maximum antithrombotic effect after bolus injection were equivalent for both
      compounds when expressed as antifactor Xa units; the duration of the
      antithrombotic effect of this derivative was prolonged, whereas the hemorrhagic
      potential was unaffected. This study opens a new concept for heparin derivatives
      having lower clearances and long-lasting effects. These properties could be
      linked to nonspecific binding of C4-UH to plasma proteins, thereby reducing the
      amount of free compound available to interact with antithrombin III.

PMID- 1740634
TI  - LD: the next 25 years.

PMID- 1740635
TI  - Reflections on Barsch's perspectives, and a few of my own.

PMID- 1740636
TI  - Learning disabilities: the changing landscape.

PMID- 1740637
TI  - Historical perspectives on dyslexia.
AB  - This article begins with an historical overview of the neurological aspects of
      dyslexia, which was originally seen as a member of the family of aphasias. That
      overview is followed by a brief review of familial and genetic factors in
      developmental dyslexia. The article then presents psycholinguistic models of
      dyslexia as they relate to the neurological concepts. Finally, the author reviews
      briefly the evolution of methods that have been successful in the remediation of
      dyslexia.

PMID- 1740638
TI  - Children with language disorders: natural history and academic success.
AB  - Children with developmental language disorders pose specific and unique problems
      for educators. This article addresses the continuing academic vulnerability of
      these children during the school years. We advance the position that their
      academic vulnerability results from the lifelong need to acquire language, to
      learn with language, and to apply language knowledge for academic learning and
      social development. Issues are addressed that relate to persistence of language
      deficits and learning in school.

PMID- 1740639
TI  - Perspectives on learning disabilities: the vectors of a new convergence.

PMID- 1740640
TI  - Predictors of self-esteem: the roles of parent-child perceptions, achievement,
      and class placement.
AB  - This study examined the relative influence on children's self-esteem of academic
      achievement, maternal self-esteem, maternal acceptance, and children's perception
      of their parents' acceptance of them. Subjects were students with learning
      disabilities in a self-contained class (n=31), similarly diagnosed students in
      resource room (n=35), students in compensatory education (n=30), and nondisabled
      students (n=30) from Grades 3 through 6. Results showed that for the self
      contained group, a child's perception of maternal and paternal acceptance plus
      the child's academic achievement score accounted for 58% of the variance in the
      child's self-esteem. None of the independent variables accounted for a
      significant proportion of the variance in the compensatory education and regular
      class groups. The self-esteem of the regular class students was significantly
      higher than that of the resource room students and the compensatory education
      students, but not significantly higher than that of the self-contained students.

PMID- 1740641
TI  - Neutrophil-induced immunoglobulin binding to erythrocytes involves proteolytic
      and oxidative injury.
AB  - Neutrophil-induced alterations in feline erythrocytes were studied to better
      understand the pathogenesis of erythrocyte destruction associated with
      inflammatory diseases. As in previous studies, addition of superoxide
      dismutase/catalase to a coculture of erythrocytes and activated neutrophils
      attenuated neutrophil-induced immunoglobulin G (IgG) binding. However, incubation
      of erythrocytes with hydrogen peroxide or neutrophil-derived anuclear cytoplasts
      (neutroplasts) failed to induce IgG binding. Addition of phenylmethylsulfonyl
      fluoride, a serine protease inhibitor, to the erythrocyte-neutrophil coculture
      attenuated IgG binding. These observations suggest that neutrophil-derived serine
      protease activity is involved in IgG binding to erythrocytes. Further, incubation
      of erythrocytes with serine proteases, but not metalloproteases or sulfhydryl
      proteases, induced immunoglobulin binding. Freeze-fracture replicas of the
      erythrocyte membrane failed to demonstrate clustering of band 3 protein,
      suggesting that spatial rearrangement of band 3 protein was not the cause of the
      IgG binding. Neutrophil-induced IgG binding due to the combined action of
      proteases and oxidants may explain the accelerated destruction of erythrocytes in
      inflammatory diseases.

PMID- 1740642
TI  - Characterization of bilirubin transport system by human peripheral blood
      mononuclear cells.
AB  - Decreased immune responses have been observed in hyperbilirubinemic patients.
      This study investigates bilirubin transport into human peripheral blood
      mononuclear cells (PBMNCs). In vitro incubation of PBMNCs at 37 degrees C with 0
      12 mg/dl bilirubin in solution with a fixed bovine serum albumin (BSA)
      concentration (3.0 g/dl) resulted in a dose-dependent increase of intracellular
      bilirubin in both monocytes and lymphocytes. Bilirubin uptake in monocytes was
      significantly higher (up to 2.7 times) than in lymphocytes under the same culture
      conditions. When PBMNCs were incubated with varying concentrations of bilirubin
      (0-16 mg/dl) in fixed BSA (3.0 g/dl) solution or at a fixed bilirubin/albumin
      molar ratio (0.4), the initial velocity of uptake in both cell fractions was
      proportional to the free (unbound to albumin) bilirubin concentration rather than
      the total bilirubin concentration. Bilirubin uptake by both cell fractions was
      significantly inhibited by treatment with metabolic inhibitors. Bilirubin uptake
      by monocytes continued to increase in parallel with incubation temperature from 0
      degrees C to 40 degrees C, whereas uptake by lymphocytes reached a maximal level
      at 20 degrees C and remained constant thereafter. These results suggest that
      monocytes and lymphocytes incorporate bilirubin in proportion to the free
      bilirubin concentration and this function may rely on different energy-dependent
      mechanisms.

PMID- 1740643
TI  - Characterization of immunosuppressive functions of murine peritoneal macrophages
      induced with various agents.
AB  - Murine peritoneal macrophages (M phi s), induced with stimuli such as
      thioglycollate, zymosan A, OK-432, bacille Calmette-Guerin (BCG), or live
      Mycobacterium intracellulare, showed varying levels of inhibitory activity
      against the concanavalin A (Con A) blastogenic response of splenic T cells. All
      test M phi s significantly inhibited the interleukin 2 (IL-2)-producing ability
      of T cells but this inhibition was not enough to explain the observed reduction
      in T cell Con A mitogenesis. In contrast, they markedly inhibited IL-2-reactive T
      cell generation, and the inhibition was sufficient to cause the reduction in T
      cell mitogenesis. A general relationship was observed between immunosuppressive
      activity of a given M phi and its active oxygen-producing ability (measured in
      terms of chemiluminescence) in response to phorbol myristate acetate triggering
      (r = .84, P less than .005). However, the suppressor activity of test M phi s was
      not reduced by superoxide dismutase and catalase, indicating that active oxygen
      radicals themselves did not mediate the expression of the immunosuppressive
      activity of these M phi s. On the other ahnd, indomethacin (an inhibitor of
      prostaglandin synthesis) caused a partial reduction in their immunosuppressive
      activity. The suppressor activity of M phi s induced with intraperitoneal
      injection of recombinant interferon gamma (IFN-gamma) was markedly reduced in the
      presence of myoglobin, a scavenger for nitric oxide radical (NO.). Tumor necrosis
      factor alpha (TNF alpha) failed to affect Con A mitogenesis of splenic T cells,
      even in combination with IFN-gamma. On the other hand, unsaturated long-chain
      fatty acids including oleic, linoleic, linolenic, and arachidonic acids markedly
      reduced the T cell function. These findings suggest some important roles of
      prostaglandins, NO., and long-chain unsaturated fatty acids as mediators of the
      expression of immunosuppressive function of the peritoneal M phi s.

PMID- 1740644
TI  - Absence of interleukin 1 alpha radioprotection in tumor-bearing animals: elevated
      plasma levels of prostaglandin E versus a preexisting primed marrow.
AB  - Recombinant human interleukin 1 (IL-1) administered as a "priming" agent 24 h
      prior to hematopoietically lethal doses of total body irradiation (TBI) confers
      radioprotection to normal C57B1/6 (B6) mice, but not to B6 tumor-bearing animals
      (TBAs) known to have altered hematopoietic steady states. Using the Lewis lung
      tumor (LLca) in the B6 mouse, studies were carried out to determine whether the
      failure of IL-1 to radioprotect the LLca TBA was related to a preexisting
      "primed" hematopoietic state in the TBA or resulted from inhibition of
      myelopoietic activity associated with the production of prostaglandin E (PGE) by,
      or in response to, the tumor. Both normal B6 and LLca B6 TBAs were injected
      (every 24 h x 1-5) with 100 micrograms of indomethacin (IND) prior to the
      administration of IL-1. A single treatment with IND was sufficient to reduce the
      elevated levels of PGE found in the plasma of the TBAs. After five treatments,
      IND reduced the PGE level to below that of controls. Neither the acute nor the
      protracted IND treatment, however, affected the expansion of the stem and
      progenitor cell compartments of the marrow in the LLca TBA. Furthermore, no
      evidence of restoration of the radioprotective properties of IL-1 was observed in
      TBAs pretreated with IND. Collectively, these data suggest that the failure of IL
      1 to provide radioprotection to the LLca TBA is not a direct result of the
      elevated plasma PGE levels associated with growth of the LLca tumor. In addition,
      these studies provide insight into the importance of examining in vivo effects of
      biological molecules in altered, as well as normal, physiological states.

PMID- 1740645
TI  - Fibronectin fragments stimulate tumor necrosis factor secretion by human
      monocytes.
AB  - Fibronectin (Fn) is a high molecular-weight glycoprotein that can influence many
      aspects of monocyte function. The purpose of this study was to determine whether
      Fn could stimulate monocyte tumor necrosis factor (TNF) secretion. Monocytes were
      isolated from the peripheral blood of healthy volunteers by density gradient
      centrifugation and adherence to plastic (2 h). Plasma Fn was purified from the
      blood by gelatin-Sepharose affinity chromatography. Monocytes were stimulated
      with Fn for 18 h and the supernatants were assayed for TNF activity using the
      L929 bioassay. Intact Fn stimulated the secretion of TNF in a dose-dependent
      manner. Intact Fn-induced TNF secretion by monocytes was inhibited (50%) but not
      eliminated by the addition of the R-G-D-containing peptide GRGDSP. Limited
      proteolysis of the Fn molecule using insoluble chymotrypsin resulted in a
      fragment preparation that was dramatically more stimulatory than the intact Fn
      preparation. High-performance liquid chromatographic (HPLC) purification of the
      fragments demonstrated that at least two fragments were capable of stimulating
      TNF secretion. Further purification by affinity chromatography and HPLC localized
      the stimulatory activity to the 120-kd cell-binding fragment. The possibility
      that the stimulatory activity was the result of endotoxin contamination was ruled
      out using macrophages from C3H/Hej mice. These results suggest that Fn fragments
      are potentially important molecules for activation of monocytes and may stimulate
      monocyte cytotoxic activity.

PMID- 1740646
TI  - Differential immunocompetence of macrophages derived using macrophage or
      granulocyte-macrophage colony-stimulating factor.
AB  - Macrophages derived in vitro from bone marrow progenitors (bone marrow-derived
      macrophages, BMDMs) using either macrophage colony-stimulating factor (CSF-1) or
      granulocyte-macrophage colony-stimulating factor (GM-CSF) as the myelopoietic
      stimulus display differential functional, morphological, and mRNA phenotypes. The
      data presented here demonstrate further that CSF-1- and GM-CSF-derived BMDMs
      differ in immunologic capacity. GM-CSF-derived BMDMs, when compared to CSF-1
      derived BMDMs, showed greater cytolytic activity against tumor necrosis factor
      alpha (TNF-alpha)-resistant, but not TNF-alpha-sensitive, tumor targets. In
      contrast, CSF-1-derived BMDMs produced nitrite in response to lipopolysaccharide
      (LPS) alone, whereas GM-CSF-derived BMDMs required interferon gamma plus LPS
      treatment. The two BMDM populations also showed differential sensitivities to LPS
      for secretion of TNF-alpha and nitrite, but the maximal inducible amounts of
      these factors and prostaglandin E2 were similar between the BMDM populations.
      Lastly, GM-CSF-derived but not CSF-1-derived BMDMs showed an L-arginine-dependent
      listeriacidal activity. These results show that the functional heterogeneity of
      CSF-1- and GM-CSF-derived macrophages is limited and appears to result largely
      from differences in the activational signals required by each BMDM population to
      elicit a given function.

PMID- 1740647
TI  - Mouse T cell clones against Mycobacterium avium: identification of clones that
      modify resistance against atypical mycobacteria infection.
AB  - Mouse T cell clones against live Mycobacterium avium were generated from the
      spleens of BALB/c mice infected with M. avium TMC 702. Eighth clones were of the
      L3T4+ subset, whereas two were of Lyt2+ subset. Six of the L3T4+ T cell clones
      were of the TH1 subset whereas two were of the TH2 subset, judged on the profile
      of cytokine release. One of the Lyt2+ clones exhibited significant cytotoxicity
      against M. avium-infected mouse macrophages. Transfer of clones to nude BALB/c
      mice infected with M. avium was associated with insignificant changes in
      resistance for seven clones. One clone, of the L3T4+/TH2 subset, transferred
      significant resistance to the infection, also associated with infusion of
      supernatants from the clone, which was fully inhibited by neutralizing with anti
      interleukin 4. By contrast, infusion of one TH1 clone and the cytolytic Lyt2+ led
      to increased microbial growth in the spleens and livers of infected mice, which
      was not apparent on infusion with supernatants. Application of clones'
      supernatants on infected macrophages had marginal effects on M. avium growth and
      was not correlated with protective or suppressive activity. Overall, these
      results suggest that T cells may influence M. avium growth in vivo in a
      bidirectional manner and also suggest that interleukin 4 may be an important
      factor in host resistance to M. avium.

PMID- 1740648
TI  - Heterogeneity in the mobilization of cytoplasmic calcium by human
      polymorphonuclear leukocytes in response to fMLP, C5a and IL-8/NAP-1.
AB  - The visible excitation and emission wave-lengths of the recently developed
      fluorescent Ca2+ indicator fluo-3 permit analysis of the intracellular Ca2+
      concentration, [Ca2+]i, in flow cytometry with a 488-nm argon laser. The role of
      [Ca2+]i in human polymorphonuclear leukocyte heterogeneity was investigated in
      response to formyl-methionyl-leucyl-phenylalanine (fMLP), C5a, and interleukin
      8/neutrophil attractant/activation protein 1 (IL-8/NAP-1) by flow cytometry. The
      [Ca2+]i changes in different subpopulations within a heterogeneous cell
      suspension were resolved upon stimulation with fMLP. Using an anti-CD16
      phycoerythrin-conjugated antibody and fluo-3 simultaneously, neutrophils affected
      and nonaffected in Ca2+ mobilization were distinguished in two patients suffering
      from glycogen storage disease type 1b. In normal neutrophils, a different time
      course of Ca2+ mobilization of neutrophil subpopulations immediately after
      stimulation with fMLP was detected. In addition, after stimulation with a low
      concentration of IL-8/NAP-1 (10(-10) M) two subsets of neutrophils appeared; one
      of them showed an increase in [Ca2+]i, while the other did not. These results
      indicate heterogeneity in the neutrophil signal transduction process involved in
      Ca2+ mobilization. Therefore, flow cytometric analyses can resolve changes in
      single-cell [Ca2+]i distribution patterns, which is important for the
      understanding of [Ca2+]i in neutrophil heterogeneous activation processes.

PMID- 1740649
TI  - Role for the cervical sympathetic trunk in regulating anaphylactic and endotoxic
      shock.
AB  - This study tests the hypothesis that spinal nerves projecting down the cervical
      sympathetic trunk contribute to the regulation of systemic immune responses.
      Decentralization or ablation (ganglionectomy) of the superior cervical ganglia
      (SCG), which receive innervation from spinal segments C8-T8, were found to reduce
      the pulmonary inflammatory response consequent to induction of anaphylaxis in
      rats sensitized to the nematode Nippostrongylus brasiliensis. Furthermore, the
      hypotensive responses to IV endotoxin were attenuated in sensitized rats by these
      operations, whereas decentralization without ganglionectomy protected against
      endotoxic shock in normal (unsensitized) rats. These results suggest that
      systemic inflammatory events are regulated by the cervical sympathetic nervous
      system at a level superior to the superior cervical ganglia. Further studies are
      warranted to investigate the role of the cervical and thoracic sympathetic nerves
      in the regulation of systemic immunological function.

PMID- 1740650
TI  - Differences in treatment history with manipulation for acute, subacute, chronic
      and recurrent spine pain.
AB  - Preference for treatment protocols used in the care of spine disorders are based
      more upon clinical impressions than upon systematic study of the pathology or
      treatment efficacy. As social emphasis moves to cost containment strategies,
      quantitative data is necessary to give guidance for rational policy decisions.
      This study sets a description of the clinical experience obtained in a group
      practice, teaching clinic engaged in management of spine disorders. The same
      subjects were separately reported as being broadly representative of those seen
      in private using a cash payment policy. Clinical characteristics were quantified
      on 241 patients. A total of 149 volunteered to complete follow up evaluations.
      The total number of treatment sessions were tallied to case resolution on all 241
      patients and were evaluated by stratifying them according to chronicity of the
      chief complaint. The range of treatment for all cases was 1-22. Chronic
      complaints required the most care, with a mean of 8.2 sessions (F = 2.833, p =
      .014). Thoracic disorders required approximately half the care as lordotic spine
      regions (F = 2.372, p = .04). No differences were observed based upon descriptive
      classifications of entrapment, mechanical or muscular pain. All but 25 cases
      reached resolution well within 6 wk, requiring a mean of 3.8 (range 1-11)
      additional treatment sessions.

PMID- 1740651
TI  - The evolution and importance of spinal and chiropractic research.
AB  - From its discovery in 1895 to its current status, in which the World Federation
      of Chiropractic Meeting may be considered a prestigious international scientific
      conference, the evaluation of chiropractic can be viewed as a compression of the
      phases which medical and scientific evolution have followed over a much longer
      period. Chiropractic theory started primarily as a vitalistic philosophy
      justifying its treatment while the medical scientific community was rejecting
      vitalism. Both chiropractic and medical spine specialists went through a period
      of speculative theory in the first half of this century based upon either
      perceived neurological or pathological observations. There was a period of single
      theory preoccupation by chiropractors (the subluxation) and medical specialists
      (disc herniation) which brought these professions into conflict. The past decade
      has led to greater scientific exploration by both professions, with more national
      scientific discussion of the causes and treatment of spinal problems. The next
      decade, however, appears likely to require greater emphasis on social research
      into clinical effectiveness of treatments, prevention of back pain, patient
      satisfaction and quality assurance. This evolution should be considered the
      normal maturation of a health care profession.

PMID- 1740652
TI  - Pathoanatomic studies and clinical significance of lumbosacral zygapophyseal
      (facet) joints.
AB  - Low back pain, with or without pain referred to the leg, affects up to 85% of the
      population at some time during their lives, which places an enormous economic
      burden upon many world communities and costs the United States in excess of $13
      billion per year. The role of the lumbosacral zygapophyseal (facet, interlamina)
      joints in the low back "facet" syndrome is briefly discussed, including the
      clinical symptomatology. The main purpose of this article is to provide
      preliminary morphological findings of histological studies of human cadaveric
      lower lumbosacral spines, which show some examples of how the zygapophyseal
      joints may be involved in dysfunction of mechanical origin. Statistical analysis
      of the frequency of these findings will be published when the histological study
      currently under way is completed. While it is not possible to correlate
      morphological changes in cadavers with pain, it appears that the zygapophyseal
      joints and their associated soft tissues could be a source of low back pain of
      mechanical origin, with or without referred pain to the leg.

PMID- 1740653
TI  - The reflex effects of spinal somatic nerve stimulation on visceral function.
AB  - This paper studies somatovisceral reflex responses in the cardiovascular organ,
      gastrointestinal tract, urinary bladder and adrenal medulla in anesthetized
      animals after eliminating emotional factors following somatic sensory
      stimulations. Various somatic sensory stimulations, including cutaneous, muscle
      and articular sensory stimulations, can produce differing autonomic reflex
      responses, depending on which visceral organs and somatic afferents are
      stimulated. Some responses have dominant sympathetic efferent involvement,
      whereas others have dominant parasympathetic efferent involvement. Some responses
      have propriospinal and segmental characteristics, while others have supraspinal
      and generalized characteristics in their reflex nature. These somatovisceral
      reflex responses may be functioning during spinal manipulative therapy in
      conscious humans.

PMID- 1740654
TI  - The effects of compression on the physiology of nerve roots.
AB  - The spinal roots connect the central and peripheral nervous systems. In doing so,
      the nerve roots pass through the spinal column, where they are located in narrow
      spaces, close to vertebrae and intervertebral discs. At these locations, nerve
      roots can be subjected to mechanical compression in association with, for
      example, disc herniation, spinal stenosis and spine trauma. In this article,
      basic aspects of the anatomy and physiology of nerve roots are reviewed. Nerve
      fiber arrangements, connective tissue layers and blood supply are described. The
      effects of compression on nerve root structure and function are summarized, based
      on experimental studies involving analyses of nerve function, nutrition,
      including blood flow, and edema formation in the nerve root. Pain mechanisms in
      nerve root compression are reviewed in relation to various clinical conditions.

PMID- 1740655
TI  - The anatomical basis for cervicogenic headache.
AB  - The neuroanatomical basis for cervicogenic headache is convergence in the
      trigeminocervical nucleus between nociceptive afferents from the field of the
      trigeminal nerve and the receptive fields of the first three cervical nerves.
      Only structures innervated by C1-C3 have been shown to be capable of causing
      headache. These are the muscles, joints and ligaments of the upper three cervical
      segments, but also include the dura mater of the spinal cord and posterior
      cranial fossa and the vertebral artery.

PMID- 1740656
TI  - Studies on the biomechanical effect of a spinal adjustment.
AB  - Manual treatment of spinal disorders is perhaps the most well-studied remedy for
      spine-related disorders. Clinical description and controlled studies provide only
      limited advances in knowledge because so little is known scientifically about
      manual treatment methods or the disorders to which they are directed. The common
      factor for all manual methods is that they apply an external load to the spine
      and its surrounding tissues. Merging of efforts by basic scientists, engineers
      and clinician-scientists can resolve some of the underlying scientific ambiguity
      surrounding these issues. This report reviews the seminal efforts in biomechanics
      that are emerging to describe and understand the treatment, the spinal disorder
      for which it is used and the physiological effects of the treatment.

PMID- 1740657
TI  - A nephritogenic rat monoclonal antibody to mouse aminopeptidase A. Induction of
      massive albuminuria after a single intravenous injection.
AB  - Antibodies directed against antigens present on renal epithelial cells can cause
      membranous glomerulonephritis in experimental animals, which closely resembles
      the human form of this disease. However, most antibodies produced so far fail to
      cause the persistent and severe proteinuria that is seen in humans. In our search
      for new antibodies of this kind, we have now produced a monoclonal antibody (mAb)
      against mouse aminopeptidase A, a hydrolase that is present in the mouse kidney.
      The mAb (ASD-4) was prepared by fusion of mouse myeloma cells with splenocytes of
      Lou rats immunized with brush border (BB) membranes from mouse kidneys. ASD-4 is
      of the IgG1 subclass and reacts with a 140-kD protein as demonstrated by
      immunoprecipitation on radiolabeled BB membranes. In indirect immunofluorescence
      and immunoelectronmicroscopy of normal mouse kidneys, ASD-4 was diffusely present
      on the BB of the S1 and S2 segments of the proximal tubules, and on the cell
      membranes of the glomerular visceral epithelia. It also bound to cell membranes
      of nonglomerular endothelia, smooth muscle cells of arteries, and juxtaglomerular
      cells. After injection of ASD-4 into normal mice, an immediate homogeneous
      binding to the capillary wall was seen that gradually changed into a fine
      granular pattern after 1 d. This glomerular binding was followed by binding to
      the BB and basolateral membranes of the convoluted proximal tubules. Immediately
      after injection of ASD-4, a dose-dependent albuminuria occurred that lasted for
      at least 16 d. ASD-4 is thus a new rat mAb against a well-defined renal
      epithelial antigen that causes not only membranous glomerulonephritis after a
      single injection in the mouse, but also severe albuminuria.

PMID- 1740658
TI  - Glucocorticoid receptor-mediated suppression of the interleukin 2 gene expression
      through impairment of the cooperativity between nuclear factor of activated T
      cells and AP-1 enhancer elements.
AB  - The immunosuppressant hormone dexamethasone (Dex) interferes with T cell-specific
      signals activating the enhancer sequences directing interleukin 2 (IL-2)
      transcription. We report that the Dex-dependent downregulation of 12-O
      tetradecanoyl-phorbol-13-acetate (TPA) and calcium ionophore-induced activity of
      the IL-2 enhancer are mediated by glucocorticoid receptor (GR) via a process that
      requires intact NH2- and COOH-terminal and DNA-binding domains. Functional
      analysis of chloramphenicol acetyltransferase (CAT) vectors containing internal
      deletions of the -317 to +47 bp IL-2 enhancer showed that the GR-responsive
      elements mapped to regions containing nuclear factor of activated T cells protein
      (NFAT) (-279 to -263 bp) and AP-1 (-160 to -150 bp) motifs. The AP-1 motif binds
      TPA and calcium ionophore-induced nuclear factor(s) containing fos protein. TPA
      and calcium ionophore-induced transcriptional activation of homo-oligomers of the
      NFAT element were not inhibited by Dex, while AP-1 motif concatemers were not
      stimulated by TPA and calcium ionophore. When combined, NFAT and AP-1 motifs
      significantly synergized in directing CAT transcription. Such a synergism was
      impaired by specific mutations affecting the trans-acting factor binding to
      either NFAT or AP-1 motifs. In spite of the lack of hormone regulation of
      isolated cis elements, TPA/calcium ionophore-mediated activation of CAT vectors
      containing a combination of the NFAT and the AP-1 motifs became suppressible by
      Dex. Our results show that the IL-2-AP-1 motif confers GR sensitivity to a
      flanking region containing a NFAT element and suggest that synergistic
      cooperativity between the NFAT and AP-1 sites allows GR to mediate the Dex
      inhibition of IL-2 gene transcription. Therefore, a Dex-modulated second level of
      IL-2 enhancer regulation, based on a combinatorial modular interplay, appears to
      be present.

PMID- 1740659
TI  - Expression of the Qa-2k phenotype encoded by the Q5k gene on the surface of tumor
      cells derived from H-2k mice.
AB  - Immunological and biochemical characteristics of the Qa-2 murine nonclassical
      histocompatibility class 1 antigen expressed on tumor cells derived from H-2k (Qa
      2-) mice were studied. It was found that the Qa-2 antigen on normal H-2b
      lymphocytes reacted with Qa-2-specific monoclonal antibodies (mAbs) 34-1.2, 59
      (both specific to the alpha 1/alpha 2 region) and 141-15.8 (specific to the alpha
      3 domain), and the Qa-2 antigen on H-2k tumor cells (Qa-2k antigen) reacted with
      mAbs 59 and 141-15.8, but not with 34-1.2. The normal Qa-2 antigen was
      susceptible to treatment with phosphatidylinositol-specific phospholipase C, but
      the Qa-2k antigen was insensitive to it. By Northern hybridization, polymerase
      chain reaction (PCR) studies on cDNA, Southern hybridization, Western blotting,
      and nucleotide sequence analysis, the Q5k gene was identified as the gene
      encoding the Qa-2k antigen expressed on BW5147 lymphoma cells derived from a
      mouse of AKR strain (H-2k, Qa-2-). The nucleotide sequence of PCR-amplified
      BW5147 Q5k cDNA showed complete agreement with the reported sequence of exons 1-5
      of the Q5k gene of C3H/He. It also showed complete deletion of the region
      corresponding to exons 6 and 7, and a very short coding region in exon 8,
      resulting in very short cytoplasmic domain of the product compared with regular
      class 1 antigens. These characteristics were expected from the reported Q5k
      genomic sequence. These results revealed that the Qa-2k antigen was distinct from
      the normal Qa-2 antigen expressed on H-2b lymphocytes although it cross-reacted
      with some Qa-2-specific mAbs.

PMID- 1740660
TI  - Targeting autoantigen to B cells prevents the induction of a cell-mediated
      autoimmune disease in rats.
AB  - Immunization protocols that induce high levels of delayed-type hypersensitivity
      are often associated with low levels of antibody production, whereas alternative
      immunization strategies can produce the opposite effect. This reciprocal
      relationship appears to depend, at least in part, on the fact that T cell-derived
      lymphokines that are predominantly involved in one type of response inhibit the
      development of those T cells that promote the alternative one. Such a regulatory
      mechanism is likely to be bistable in that whenever one form of response is
      established, spontaneous development of the alternative one will be inhibited. We
      have applied this concept to the control of a cell-mediated autoimmune disease in
      rats. By covalently linking the autoantigen to anti-IgD antibody, we have
      targeted it to B cells for presentation to antigen-specific T cells. This form of
      presentation favors antibody production and may be expected to antagonize the
      cell-mediated disease-inducing response to the same antigen. To test this
      hypothesis, use was made of the fact that experimental allergic encephalomyelitis
      (EAE), when induced with the encephalitogenic peptide of guinea pig myelin basic
      protein, is purely a cell-mediated disease. The experiments show that Lewis rats,
      immunized with the peptide in its encephalitogenic form, were protected from
      disease when simultaneously injected with the peptide coupled to anti-IgD
      monoclonal antibodies. Control experiments showed that neither peptide nor anti
      IgD alone were protective, and the peptide covalently coupled to irrelevant
      antibodies also failed to protect. Spleen cells from animals protected from
      disease by the anti-IgD-peptide conjugate, when activated in vitro with the
      encephalitogen, were able to transfer EAE to naive recipients. The results
      demonstrate that a cell-mediated immune response can be controlled by appropriate
      targeting of the specific antigen without inducing T cell anergy and suggest a
      potential strategy for preventing autoimmune diseases that are essentially cell
      mediated in type.

PMID- 1740661
TI  - Polymorphisms in the tumor necrosis factor alpha (TNF-alpha) gene correlate with
      murine resistance to development of toxoplasmic encephalitis and with levels of
      TNF-alpha mRNA in infected brain tissue.
AB  - Murine resistance to development of toxoplasmic encephalitis (TE) has recently
      been mapped to the D region of the major histocompatibility complex (H-2). Since
      the gene for tumor necrosis factor alpha (TNF-alpha) is located 5' of the D
      region and TNF-alpha has been implicated as playing a role in neurological
      diseases, we were interested in determining the relationship of TNF-alpha
      production to TE resistance. We have demonstrated that resistance to TE in inbred
      mice can be correlated with specific restriction fragment length polymorphisms
      and microsatellite variants in the TNF-alpha gene. Mice that are susceptible to
      TE express elevated levels of TNF-alpha mRNA in brain tissue 6 wk after infection
      with the ME49 strain of Toxoplasma gondii. Resistant mice and all mice that are
      uninfected show no detectable TNF-alpha mRNA expression in brain tissue.
      Differences in the TNF-alpha gene between susceptible and resistant mice have
      been localized to the first intron, the promoter, and the 3' end of the TNF-alpha
      gene. These data implicate differences in regulation of TNF-alpha production in
      brain tissue as contributing to differences in susceptibility to development of
      TE.

PMID- 1740662
TI  - Activation events during thymic selection.
AB  - During their differentiation in the mouse thymus, CD4+8- cells undergo several of
      the sequential changes observed upon normal activation of mature, peripheral CD4+
      lymphocytes. Expression of CD69, an early activation marker, is first observed on
      a minority of cells at the T cell receptor (TCR)lo/med double-positive stage, is
      maximal (50-90%) on heat-stable antigen (HSA)hi TCRhi double-positive, HSAhi
      TCRmed CD4+8lo, and HSAhi TCRhi CD4+8- cells, and is downmodulated at the mature
      HSAlo CD4+8- stage. In contrast, CD44, a late activation marker, is selectively
      expressed at the HSAlo stage. The set of lymphokines that CD4+8- thymocytes can
      produce upon stimulation also characteristically expands from mainly interleukin
      2 (IL-2) at the HSAhi stage, to IL-2 and very large amounts of IL-4, IL-5, IL-10,
      and interferon gamma (IFN-gamma) at the HSAlo stage. 1 in 30 HSAlo CD4+8- adult
      thymocytes secrete IL-4 upon stimulation through their TCR. This frequency is 25%
      of the frequency of IL-2 producers, about 100-fold above that of peripheral
      (mainly resting) CD4+ T cells. With time after their generation in organ culture,
      CD4+8- thymocytes lose their capacity to secrete IL-4, IL-5, and IFN-gamma, but
      not IL-2. Similarly, the frequency of IL-4, but not of IL-2, producers
      progressively decreases after emigration to the periphery as judged by direct
      comparison between thymic and splenic CD4+ cells in newborns, or by following the
      fate of intrathymically labeled CD4+8- cells in adults after their migration to
      the spleen. This sequence suggests that thymic selection results from an
      activation process rather than a simple rescue from death at the double-positive
      stage, and shows that the functional changes induced after intrathymic
      activation, although transient, are still evident after export to the periphery.

PMID- 1740663
TI  - Induction of monocytic differentiation and NF-kappa B-like activities by human
      immunodeficiency virus 1 infection of myelomonoblastic cells.
AB  - The effects of human immunodeficiency virus 1 (HIV-1) infection on cellular
      differentiation and NF-kappa B DNA binding activity have been investigated in a
      new model of myeloid differentiation. PLB-985 cells represent a bipotential
      myelomonoblastic cell population capable of either granulocytic or monocytic
      differentiation after induction with appropriate inducers. By virtue of the
      presence of CD4 on the cell surface, PLB-985 cells were chronically infected with
      HIV-1 strain IIIB. PLB-IIIB cells clearly possessed a more monocytic phenotype
      than the parental myeloblasts, as determined by differential staining, increased
      expression of the myeloid-specific surface markers, and transcription of the c
      fms proto-oncogene. NF-kappa B binding activity was inducible by tumor necrosis
      factor and phorbol myristate acetate in PLB-985. However, in PLB-IIIB cells,
      constitutive expression of a novel NF-kappa B complex was detected, composed of
      proteins ranging between 70 and 110 kD. These proteins interacted specifically
      with the symmetric NF-kappa B site from the interferon beta (IFN-beta) promoter.
      Mutations affecting the 5' guanine residues of the kappa B site were unable to
      compete for these NF-kappa B-related proteins. Inducibility of endogenous IFN
      beta and IFN-alpha RNA was also increased in PLB-IIIB cells. These studies
      indicate that HIV-1 infection of myelomonoblastic cells may select for a more
      mature monocytic phenotype and that unique subunit associations of NF-kappa B DNA
      binding proteins may contribute to differential NF-kappa B-mediated gene
      expression.

PMID- 1740664
TI  - Intraepithelial airway dendritic cells: a distinct subset of pulmonary dendritic
      cells obtained by microdissection.
AB  - Dendritic cells (DC), in general, and pulmonary DC, in particular, are a
      heterogeneous population of cells, their phenotype and function being dependent
      on their anatomic location, their state of activation, and the regulatory effect
      of locally secreted cytokines. Using a novel microdissection technique, the
      epithelium from the trachea and entire airway system was harvested, and the
      contained DC isolated at greater than 90% purity. The phenotype and function of
      these airway DC (ADC) was compared to DC isolated, at greater than 90% purity,
      from the parenchyma of the same lung. In contrast to lung DC (LDC), ADC did not
      express intercellular adhesion molecule 1 (ICAM-1) in situ, the amount of immune
      associated antigen (Ia) expressed was less (as determined by immunoperoxidase
      staining and immunopanning), and greater than 50% of ADC displayed Fc receptors
      (FcR). The majority of LDC were ICAM-1+, less than 5% expressed FcR, and all were
      intensely Ia+. Airway DC were most numerous in tracheal epithelium, but they were
      also present in small numbers in the epithelium of the most distal airways. Their
      numbers increased in all segments of the tracheobronchial epithelium in response
      to the administration of IFN-gamma. ADC were consistently more effective than LDC
      in presenting soluble (hen egg lysozyme) and particulate (heat-killed Listeria
      monocytogenes) antigens to antigen-sensitized T cells. By contrast, LDC were
      significantly more efficient in stimulating the proliferation of nonsensitized T
      cells in an autologous mixed leukocyte reaction. These data suggest that in
      normal animals, intraepithelial DC of airways share many attributes with
      Langerhans cells of the skin. Interstitial LDC, by contrast, reside in an
      environment where they may be exposed to a different set of regulatory factors
      and where they have progressed to a more advanced stage of differentiation than
      ADC. Both groups of DC are, however, heterogeneous, reflecting the continuous
      turnover that these cells undergo in the lung.

PMID- 1740665
TI  - Genetic analysis of self-associating immunoglobulin G rheumatoid factors from two
      rheumatoid synovia implicates an antigen-driven response.
AB  - Although much has been learned about the molecular basis of immunoglobulin M
      (IgM) rheumatoid factors (RFs) in healthy individuals and in patients with mixed
      cryoglobulinemia and rheumatoid arthritis, little is known about the genetic
      origins of the potentially pathogenic IgG RFs in the inflamed rheumatoid synovia
      of patients. Recently, we generated from unmanipulated synovium B cells several
      hybridomas that secreted self-associating IgG RFs. To delineate the genetic
      origins of such potentially pathogenic RFs, we adapted the anchored polymerase
      chain reaction to rapidly clone and characterize the expressed Ig V genes for the
      L1 and the D1 IgG RFs. Then, we identified the germline counterparts of the
      expressed L1 IgG RF V genes. The results showed that the L1 heavy chain was
      encoded by a Vh gene that is expressed preferentially during early ontogenic
      development, and that is probably located within 240 kb upstream of the Jh locus.
      The overlap between this RF Vh gene and the restricted fetal antibody repertoire
      is reminiscent of the natural antibody-associated Vh genes, and suggests that at
      least part of the "potential pathogenic" IgG RFs in rheumatoid synovium may
      derive from the "physiological" natural antibody repertoire in a normal immune
      system. Indeed, the corresponding germline Vh gene for L1 encodes the heavy chain
      of an IgM RF found in a 19-wk-old fetal spleen. Furthermore, the comparisons of
      the expressed RF V genes and their germline counterparts reveal that the L1 heavy
      and light chain variable regions had, respectively, 16 and 7 somatic mutations,
      which resulted in eight and four amino acid changes. Strikingly, all eight
      mutations in the complementarity determining regions of the V gene-encoded
      regions were replacement changes, while only 6 of 11 mutations in the framework
      regions caused amino acid changes. Combined with L1's high binding affinity
      toward the Fc fragment, these results suggest strongly that the L1 IgG RF must
      have been driven by the Fc antigen.

PMID- 1740666
TI  - Restoration of a tumorigenic phenotype by beta 2-microglobulin transfection to EL
      4 mutant cells.
AB  - It has frequently been suggested that loss of beta 2-microglobulin (beta 2m) in
      tumor cells may lead to malignant progression due to escape from immunological
      recognition. Here, we directly tested the role of beta 2m expression in
      tumorigenicity. A beta 2 m loss mutant (C4.4-25-), selected from the murine
      lymphoma EL-4, showed a marked reduction in tumorigenicity as compared with EL-4
      in normal C57B1/6 (B6) mice. The reduced tumorigenicity was directly related to
      beta 2 m expression. Transfection of an intact murine beta 2m gene markedly
      increased the tumorigenic potential. The reduced tumorigenicity of C4.4-25-
      compared with beta 2m transfected cells was observed also in athymic B6 nu/nu
      mice, but was abolished in B6 mice depleted of natural killer (NK) 1.1-positive
      cells. These results show that restoration of beta 2m expression can promote
      tumorigenicity and demonstrate for the first time that induction of major
      histocompatibility complex class I expression by transfection can lead to escape
      from NK cells in vivo.

PMID- 1740667
TI  - The AP-1 site at -150 bp, but not the NF-kappa B site, is likely to represent the
      major target of protein kinase C in the interleukin 2 promoter.
AB  - Stimulation of T cells with antigen results in activation of several kinases,
      including protein kinase C (PKC), that may mediate the later induction of
      activation-related genes. We have examined the potential role of PKC in induction
      of the interleukin 2 (IL-2) gene in T cells stimulated through the T cell
      receptor/CD3 complex. We have previously shown that prolonged treatment of the
      untransformed T cell clone Ar-5 with phorbol esters results in downmodulation of
      the alpha and beta isozymes of PKC, and abrogates induction of IL-2 mRNA and
      protein. Here we show that phorbol ester treatment also abolishes induction of
      chloramphenicol acetyltransferase activity in Ar-5 cells transfected with a
      plasmid containing the IL-2 promoter linked to this reporter gene. The IL-2
      promoter contains binding sites for nuclear factors including NFAT-1, Oct, NF
      kappa B, and AP-1, which are all potentially sensitive to activation of PKC. We
      show that induction of a trimer of the NFAT and Oct sites is not sensitive to
      phorbol ester treatment, and that mutations in the NF-kappa B site have no effect
      on inducibility of the IL-2 promoter. In contrast, mutations in the AP-1 site
      located at -150 bp almost completely abrogate induction of the IL-2 promoter, and
      appearance of an inducible nuclear factor binding to this site is sensitive to
      PKC depletion. Moreover, cotransfections with c-fos and c-jun expression plasmids
      markedly enhance induction of the IL-2 promoter in minimally stimulated T cells.
      Our results indicate that the AP-1 site at -150 bp represents a major, if not the
      only, site of PKC responsiveness in the IL-2 promoter.

PMID- 1740668
TI  - A thyroxine-containing peptide can induce murine experimental autoimmune
      thyroiditis.
AB  - A synthetic peptide based on a sequence containing thyroxine at position 2553 in
      thyroglobulin (Tg), and already shown to be recognized by two clonotypically
      distinct murine Tg autoreactive T cell hybridomas, can trigger primed lymph node
      cells to transfer thyroiditis to naive recipients. Donor lymph node cells could
      be prepared from mice immunized either with intact mouse Tg or with this peptide
      itself. After a second exposure to the priming antigen in vitro, both these
      populations induced 100% thyroiditis in recipient animals. The importance of the
      T4 residue in the development of disease was demonstrated by the failure of Tg
      tryptic peptides depleted of T4 to stimulate pathogenic effectors in vitro, even
      when the lymph node cells had been taken from mice primed with whole Tg. We
      conclude that this T4-containing 12mer sequence is a major thyroiditogenic
      epitope in CBA/J mice although we cannot exclude the possibility that there are
      other pathogenic epitopes present in the whole Tg molecule.

PMID- 1740669
TI  - Modification of potassium channel kinetics by amino group reagents.
AB  - We have examined the actions of several amino group reagents on delayed rectifier
      potassium channels in squid giant axons. Three general classes of reagents were
      used: (1) those that preserved the positive charge of amino groups; (2) those
      that neutralize the charge; and (3) those that replace the positive with a
      negative charge. All three types of reagents produced qualitatively similar
      effects on K channel properties. Trinitrobenzene sulfonic acid (TNBS) neutralizes
      the peptide terminal amino groups and the epsilon-amino group of lysine groups.
      TNBS (a) slowed the kinetics of macroscopic ionic currents; (b) increased the
      size of ionic currents at large positive voltages; (c) shifted the voltage
      dependent probability of channel opening to more positive potentials but had no
      effect on the voltage sensitivity; and (d) altered several properties of K
      channel gating currents. The actions of TNBS on gating currents suggest the
      presence of multiple gating current components. These effects are not all
      coupled, suggesting that several amino groups on the external surface of K
      channels are important for channel gating. A simple kinetic model that considers
      the channel to be composed of independent heterologous subunits is consistent
      with most of the modifications produced by amino group reagents.

PMID- 1740670
TI  - Virus-induced obesity in mice: association with a hypothalamic lesion.
AB  - In an earlier study we found that a substantial percentage of mice surviving
      infection with canine distemper virus (CDV) slowly developed a morbid obesity
      syndrome. In the present study we wished to explore the role of the virus in the
      development of this syndrome. The distribution of viral antigen(s) in brains of
      pre-obese animals shortly after intracerebral infection was mapped using
      immunocytochemical procedures. A distinctive pattern of cell labeling was found,
      extending from the anterior periventricular hypothalamus ventrally and caudally
      toward the posterior hypothalamus. The heaviest concentration of labeled cells
      was found in the arcuate-ventromedial area. Viral antigen-containing cells were
      not found in obese brain specimens. However, the latter revealed, by glial
      fibrillary acidic protein immunostaining, a gliotic lesion of the hypothalamus
      that approximated topographically the pattern of virus tropism. Examination of
      the arcuate area revealed a significant reduction in tyrosine hydroxylase
      immunoreactive and pro-opiomelanocortin mRNA positive perikarya. We suggest that
      the loss of critical populations of hypothalamic neurons as a result of an
      antecedent viral infection led ultimately to the development of morbid obesity.

PMID- 1740671
TI  - Expression of various NCAM isoforms in human embryonic muscles: correlation with
      myosin heavy chain phenotypes.
AB  - Neural cell adhesion molecules (NCAM) are known to play a pivotal role in
      regulating cell-cell interactions in various tissues. The diversity of NCAM is
      made by alternative splicing of a single gene and by post-translational
      modifications. The spatio-temporal expression of the various isoforms is
      developmentally regulated and may modulate cell interactions. We investigated the
      expression of NCAM isoforms, in particular polysialylated and
      phosphatidylinositol-anchored isoforms, in developing psoas and quadriceps human
      muscle from 15 weeks of gestation to term. In parallel, we examined the
      expression of the myosin heavy chain phenotype (another developmentally regulated
      system) to determine whether polysialylated-NCAM molecules (the so-called
      embryonic NCAM) and developmental myosin heavy chains are coexpressed. Our
      results showed an expression of polysialylated-NCAM and phosphatidylinositol
      anchored isoforms during the early stages of myotube maturation. The expression
      of polysialylated-NCAM on developing myotube was always associated with the
      expression of developmental myosin heavy chains. However, the loss of
      polysialylated-NCAM from maturing myotubes was not correlated with the
      disappearance of the developmental myosin heavy chains, but rather with the
      appearance of an adult myosin heavy chain phenotype. The relationship between
      polysialylated-NCAM and myosin heavy chain phenotype was similar in psoas and in
      quadriceps muscles. We observed that maturation of quadriceps muscle takes place
      earlier than psoas. Biochemical analysis showed that phosphatidylinositol
      anchored molecules were never polysialylated; this indicates different roles of
      these isoforms in muscle development.

PMID- 1740672
TI  - Pathology of HIV-1 infection of the central nervous system. A review.

PMID- 1740673
TI  - Occurrence of oligodendrocytes within astrocytes in demyelinating lesions.
AB  - We investigated the fine structural details of the presence of apparently newly
      formed oligodendrocytes within reactive astrocytes in white matter lesions
      obtained by biopsy from seven cases (3 multiple sclerosis (MS); 3 progressive
      multifocal leukoencephalopathy (PML); 1 with nonspecific reactive changes next to
      a sarcoid granuloma). Intact oligodendrocytes were found within astrocytic
      cytoplasm in two acute MS lesions and also in the reactive white matter lesion.
      The internalized cells appeared to lie within membrane-bound vacuoles. Formation
      of rudimentary junctions was observed between the internalized cells and host
      astrocytes. Sometimes more than one oligodendrocyte was seen in the same
      astrocyte. Our study suggests that this newly recognized interaction between
      astrocytes and oligodendrocytes is not restricted to acute MS lesions and
      probably represents emperipolesis rather than phagocytosis. This apparently
      nonspecific finding may be expected in any lesion with a proliferation of
      astrocytes and oligodendrocytes. The precise mechanism of this phenomenon or its
      functional significance is not entirely clear.

PMID- 1740674
TI  - The twitcher mouse: immunocytochemical study of Ia expression in macrophages.
AB  - The cells expressing immune response associated antigen (Ia) were investigated in
      the nervous system of the twitcher mouse (an authentic murine model of globoid
      cell leukodystrophy in humans). With immunocytochemistry using a monoclonal
      antibody against Mac-1 antigen, many Mac-1 immunoreactive cells (Mac-1 positive
      cells) were detected in the central as well as the peripheral nervous systems
      (CNS and PNS). In the CNS, Mac-1 positive cells in the gray matter showed
      cellular morphology of ramified microglia with delicate cellular processes, while
      in the white matter Mac-1 positive cells were more plump in shape. Ia expressing
      cells (Ia positive cells) were also largely confined to the white matter. About
      10% of the Mac-1 positive cells were Ia positive. The Ia and Mac-1 positive cells
      were slender and spindle shaped, and morphologically similar to Ia positive cells
      in the peripheral nerves while the cells expressing Mac-1 only were more plump in
      shape. With immunoelectron microscopy, however, both slender Ia positive and
      plump Ia negative and Mac-1 positive cells revealed electron lucent cytoplasmic
      vacuoles containing characteristic tubular inclusions of globoid cell
      leukodystrophy. The results suggest that Ia positive cells are a subset of
      macrophages in the CNS. Whether Ia expression was induced to "endogenous"
      microglia or whether Ia expressing cells were exogenous cells infiltrated in the
      CNS in response to pathological lesions is yet to be determined.

PMID- 1740675
TI  - Kunitz protease inhibitor-containing amyloid beta protein precursor
      immunoreactivity in Alzheimer's disease.
AB  - The amyloid beta protein (beta/A4) that is deposited in senile plaques and in
      cerebral vessels in Alzheimer's disease (AD) is derived from a larger membrane
      associated glycoprotein, the amyloid beta protein precursor (APP). The gene
      encoding APP produces at least four major transcripts. Three of the four
      transcripts contain an alternatively-spliced exon encoding a Kunitz protease
      inhibitor domain (KPI). We now report the results of a series of experiments
      using novel immunohistochemical reagents to anatomically localize beta/A4, APP,
      and KPI-containing forms of APP (APP-KPI) in the hippocampal formation and
      temporal neocortex. A new monoclonal antibody against beta/A4 recognized senile
      plaques and vascular amyloid, but no cellular elements. Anti-APP and anti-KPI
      monoclonal antibodies stained neurons, including proximal axons and dendrites.
      The neuritic component of some plaques in patients with AD and in elderly control
      individuals were also immunoreactive for both APP and APP-KPI. Quantitative
      assessment of senile plaques in temporal neocortex showed that, on average, about
      one-third of beta/A4 immunoreactive plaques stained with either anti-APP or anti
      KPI. Amyloid beta protein precursor and APP-KPI immunoreactivity were also found
      in the white and grey matter vessels of both AD patients and control individuals.
      These results suggest that KPI-containing forms of APP are present in dystrophic
      neurites of senile plaques, and normally in neurons, neuronal processes, and in
      the vascular compartment in the brain. Thus, APP-KPI is in a position to be
      intimately associated with beta/A4 deposition in the neuropil, in plaques and in
      amyloid angiopathy.

PMID- 1740676
TI  - Lumpectomy and radiation: improving the outcome.

PMID- 1740677
TI  - Extended-field radiotherapy is superior to MOPP chemotherapy for the treatment of
      pathologic stage I-IIA Hodgkin's disease: eight-year update of an Italian
      prospective randomized study.
AB  - PURPOSE: To compare the effectiveness of chemotherapy (CHT) with extended-field
      radiotherapy (RT) in the treatment of early-stage Hodgkin's disease (ESHD), we
      report an 8-year updated analysis of a study in which treatment with six cycles
      of mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) CHT was
      randomly compared with extended-field RT. PATIENTS AND METHODS: From August 1979
      to December 1982, 89 adult patients with pathologic stage I-IIA Hodgkin's disease
      (HD) were randomly allocated to receive either RT with mantle field followed by
      periaortic irradiation (n = 45) or six monthly courses of MOPP CHT (n = 44).
      RESULTS: All patients in the RT arm and 40 of 44 in the CHT arm achieved complete
      remission. Twelve relapses occurred in each group. Eight patients treated with
      MOPP and two of the RT arm died of HD. Three other patients of the CHT group died
      because of a second cancer. With a median follow-up greater than 8 years, the
      overall survival rate is significantly higher in the RT than in the CHT group
      (93% v 56%; P less than .001), whereas the rates of freedom from progression and
      relapse-free survival (RFS) were similar in the two groups (76% v 64% and 70% v
      71%, respectively). Of the 12 patients relapsing after RT, 11 (92%) achieved a
      second CR, compared with only six of the 12 (50%) in the MOPP group. Analysis of
      the response rate to salvage treatments showed that the type of relapse in the
      MOPP group was a prognostic indicator for the achievement of a second CR, whereas
      in the RT group, a second CR was obtained regardless of the characteristics of
      the relapses. At 80 months, the probability of survival of relapsing patients
      calculated from time of relapse was 85% and 15% in the RT and CHT groups,
      respectively (P = .02). CONCLUSION: We conclude that RT alone is the treatment of
      choice for adult patients with ESHD with favorable prognostic factors.

PMID- 1740678
TI  - Effect of recombinant human granulocyte-macrophage colony-stimulating factor in
      patients with Hodgkin's disease: a phase I/II study.
AB  - PURPOSE: As bone marrow toxicity is the major limitation of the optimal
      administration of chemotherapy, we investigated whether recombinant human
      granulocyte-macrophage colony-stimulating factor (rhGM-CSF) could prevent
      myelotoxicity or accelerate hematopoietic recovery after mechlorethamine,
      vincristine, procarbazine, and prednisone (MOPP) chemotherapy. PATIENTS AND
      METHODS: Twenty-four previously untreated patients with Hodgkin's disease were
      included in a phase I/II study in which standard MOPP chemotherapy was followed
      by 5 days of GM-CSF at every other cycle. Patients were entered sequentially to
      receive one of four dosc levels (2, 4, 8, and 16 micrograms/kg of glycoprotein;
      1.4, 2.8, 5.5, and 11.0 micrograms/kg of protein) and were randomly allocated to
      either 24-hour continuous intravenous (IV) infusion or twice daily subcutaneous
      (SC) injection of rhGM-CSF. RESULTS: WBC counts (mainly neutrophils, eosinophils,
      and monocytes) were significantly higher in cycles with rhGM-CSF than in cycles
      with MOPP alone. The total number of days of leukopenia (WBC count less than or
      equal to 2.0 x 10(9)/L) and neutropenia (absolute neutrophil count [ANC] less
      than or equal to 1.0 x 10(9)/L) was reduced in cycles with rhGM-CSF from 6.3 to
      0.8 days and from 5.4 to 1.0 days, respectively. All dose levels of rhGM-CSF were
      effective in increasing the ANC, but only at the dose levels of 8 and 16
      micrograms/kg did this significantly affect the scheduling of chemotherapy. Mild
      and reversible adverse reactions included low-grade fever, chest/bone pain,
      myalgias, erythemia, headache, fatigue, and periorbital edema. CONCLUSIONS: rhGM
      CSF can be administered safely to patients with Hodgkin's disease and results in
      improved hematologic recovery after MOPP. Full-dose chemotherapy can be
      administered on time, resulting in an increase in the overall tolerated dose of
      myelosuppressive drugs when compared with historical controls. SC administration
      proved to be at least as effective as continuous IV infusion and should be
      preferred.

PMID- 1740679
TI  - Treatment of chronic myelogenous leukemia in accelerated and blastic phases with
      daunorubicin, high-dose cytarabine, and granulocyte-macrophage colony-stimulating
      factor.
AB  - PURPOSE: The study was undertaken to improve the results of intensive
      chemotherapy in chronic myelogenous leukemia (CML) in accelerated (CML-AP) and
      blastic phases (CML-BP) by the addition of granulocyte-macrophage colony
      stimulating factor (GM-CSF) as supportive therapy. PATIENTS AND METHODS: Forty
      eight patients were treated with daunorubicin 120 mg/m2 intravenously on day 1,
      cytarabine (ara-C) 1.5 g/m2/d by continuous infusion over 24 hours for 4 days,
      and Solu-Medrol (methylprednisolone; The Upjohn Co, Kalamazoo, MI) 100 mg/d for 5
      days, followed on day 5 by GM-CSF 125 micrograms/m2/d over 6 hours until recovery
      of granulocyte count above 2.0 x 10(3)/microliters. Twenty-four patients had CML
      BP, and 24 had CML-AP. RESULTS: During remission induction, 45 patients (94%)
      developed febrile episodes (fever of unknown origin, 23 patients [48%];
      documented infections, 22 patients [46%]). The median time to recovery of
      granulocyte count above 0.5 x 10(3)/microliters was 29 days and to platelet count
      above 30 x 10(3)/microliters, 28 days. Overall, 14 of 48 patients (29%) achieved
      a complete hematologic remission (CHR), and seven (15%) reverted to a second
      chronic phase. CHR was noted in eight of 24 patients with CML-BP (33%), and in
      six of 24 patients with CML-AP (25%). Cytogenetic responses were observed in 11
      patients (23%), but were transient. Sixteen patients developed either fluid
      retention, hypotension, pleuropericardial effusions, or pericarditis, or a
      combination of these side effects. These side effects were severe in four
      patients and are likely to be disease-associated, as a similar regimen of
      intensive chemotherapy and GM-CSF at the same dose and schedule in acute
      lymphocytic leukemia was not associated with these side effects. CONCLUSIONS: The
      results pertinent to remission rates, induction mortality, myelosuppression
      profile and related complications, and overall survival were not significantly
      improved compared with previous experience. In summary, the results of intensive
      chemotherapy in CML-transformed phases remain poor, despite the addition of GM
      CSF as a supportive measure.

PMID- 1740680
TI  - Gemcitabine in leukemia: a phase I clinical, plasma, and cellular pharmacology
      study.
AB  - PURPOSE: Phase I clinical and in vitro studies of gemcitabine (2',2'
      difluorodeoxycytidine; dFdC) have demonstrated that the accumulation rate of dFdC
      5'-triphosphate (dFdCTP) in mononuclear and leukemia cells is saturated when
      plasma or extracellular dFdC levels exceed 15 to 20 mumol/L. Thus, we designed a
      phase I study to maximize the accumulation of dFdCTP by leukemia cells by
      administering dFdC at 10 mg/m2/min, a dose rate calculated to produce steady
      state plasma dFdC levels that exceed 15 to 20 mumol/L. PATIENTS AND METHODS: The
      treatment intensity was increased in patients (n = 22) with relapsed or
      refractory acute leukemia or chronic myelogenous leukemia (CML) in blast crisis
      by prolonging the infusion duration but maintaining the same rate. Doses of dFdC
      between 1,200 mg/m2 and 6,400 mg/m2 were administered weekly for 3 weeks.
      RESULTS: The maximum-tolerated dose was 4,800 mg/m2 infused over 480 minutes. The
      mean steady-state dFdC level in plasma of all infusions was 26.5 +/- 9 mumol/L (n
      = 19). The accumulation rates of dFdCTP in circulating leukemia cells varied
      greatly among patients but remained linear in eight patients infused for 120 to
      240 minutes, and up to or beyond 360 minutes in five of eight additional
      patients. Elimination of dFdCTP was significantly related to its cellular
      concentration: blasts with greater than 450 mumol/L dFdCTP exhibited biphasic
      elimination, whereas blasts with lower dFdCTP concentrations exhibited linear
      kinetics. Biphasic elimination was associated with higher dFdCTP areas under the
      concentration-times-time curve (AUCs) and greater inhibition of DNA synthesis.
      CONCLUSION: Studies of the cellular pharmacology and pharmacodynamics of dFdC may
      be useful in optimizing protocol designs for leukemia.

PMID- 1740681
TI  - Prognostic significance of S-phase fraction in good-risk, node-negative breast
      cancer patients.
AB  - PURPOSE: Formalin-fixed, paraffin-embedded tissues from axillary node-negative
      breast cancer patients were analyzed by flow cytometry to determine the
      prognostic significance of DNA ploidy and S-phase fraction (SPF). PATIENTS AND
      METHODS: All patients were registered on a good-risk control arm of an intergroup
      clinical trial. They had small- to intermediate-sized (less than 3 cm), estrogen
      receptor (ER)-positive tumors and received no adjuvant therapy after modified
      radical mastectomy or total mastectomy with low axillary-node sampling. The
      median follow-up was 4.8 years. RESULTS: Assessable ploidy results were obtained
      from 92% of the 298 specimens studied (51% diploid, 49% aneuploid), and SPFs were
      assessable for 83% of the tumors. SPFs for diploid tumors ranged from 0.7% to
      11.9% (median, 3.6%), compared with a range of 1.2% to 26.7% (median, 7.6%) for
      aneuploid tumors (P less than .0001). No significant differences in disease-free
      or overall survival were observed between patients with diploid and aneuploid
      tumors. Using different SPF cutoffs by ploidy status (4.4% for diploid, 7.0% for
      aneuploid), patients with low SPFs had significantly longer disease-free survival
      rates than patients with high SPFs (P = .0008). The actuarial 5-year relapse
      rates were 15% and 32% for patients with low (n = 142) and high SPFs (n = 105),
      respectively. Similar relationships between SPF and clinical outcome were
      observed for patients with diploid tumors (P = .053) and for patients with
      aneuploid tumors (P = .0012). CONCLUSION: S-phase fraction provides additional
      prognostic information for predicting disease-free survival for axillary node
      negative breast cancer patients with small, ER-positive tumors.

PMID- 1740682
TI  - Carboplatin: an active drug in metastatic breast cancer.
AB  - PURPOSE: The study was undertaken to assess the antitumor activity of carboplatin
      400 mg/m2 intravenously every 4 weeks in metastatic breast cancer (MBC). PATIENTS
      AND METHODS: Thirty-four MBC patients without any prior exposure to chemotherapy
      entered the study. All patients had measurable disease in at least one site and
      were assessable for response and toxicity. RESULTS: Of 34 assessable patients, 12
      obtained a complete (one) or partial (11) response to carboplatin, resulting in
      an overall response rate of 35% (95% confidence interval, 19.8% to 53.5%). The
      median duration of response was 8 months (range, 2+ to 12 months). Responses were
      seen in lymph nodes (four of six), lung (five of nine), skin and soft tissues
      (four of nine), breast (two of eight), and liver (three of 11), but not in
      measurable lytic lesions of the bone. Toxicity was mild, mainly consisting of
      emesis (81% of the patients; 66% of the courses), leukopenia of World Health
      Organization (WHO) grade 1 to 2 (47% of the patients; 18% of the courses), and
      thrombocytopenia (12% of the patients; 3% of the courses). There were no cases of
      life-threatening toxicity, although one patient developed grade 4
      thrombocytopenia without bleeding. Of 22 patients who did not respond to
      carboplatin, 18 received salvage therapy with cyclophosphamide, doxorubicin, and
      fluorouracil (CAF; 15 patients); cyclophosphamide, methotrexate, and fluorouracil
      (CMF; one patient); or hormones (two patients). Objective responses to CAF and
      hormonal therapy were seen in 11 of 15 and two of two patients, respectively. The
      remaining patient did not respond to CMF salvage chemotherapy. Overall, the
      response rate to either first-line carboplatin or second-line salvage therapy was
      73.5% (25 of 34 patients). After a median follow-up time of 22 months, the median
      survival was 19 months. CONCLUSIONS: Carboplatin is an active drug in MBC
      patients without previous exposure to chemotherapy. In our study, the use of an
      experimental drug as first-line single-agent treatment in MBC did not have a
      negative influence on patient survival, as the majority of the carboplatin
      nonresponding patients could be salvaged with a conventional therapeutic regimen.

PMID- 1740683
TI  - Aromatase activity and estradiol in human breast cancer: its relationship to
      estradiol and epidermal growth factor receptors and to tumor-node-metastasis
      staging.
AB  - PURPOSE: The present report attempts to clarify whether there is a relationship
      between aromatase activity (ARAC) and estradiol (E2), hormonal receptors, E2
      receptor (ER), and epidermal growth factor receptor (EGFR), as well as with tumor
      stage and histopathology in human breast cancers. MATERIALS AND METHODS: We
      studied 225 breast carcinomas, 67 of which were premenopausal and 158
      postmenopausal. In each sample, ARAC, EGFR, ER, and E2 were quantified. ARAC was
      quantified by Thompson and Siiterii's method, EGFR was quantified with a two
      point assay method using radioactive iodine (125I)-EGF as ligand, and ER was
      measured by the Scatchard method using 3H-E2. E2 was quantified by
      radioimmunoassay in the diethylether tumor extract. RESULTS: ARAC was found in
      64% of the cancers studied. There is a strong direct association between ARAC and
      tumor size in postmenopausal patients (P = .001). In the postmenopausal group,
      the proportion of ARAC-positive (ARAC+) tumors is significantly higher among ER
      positive (ER+) than ER-negative (ER-) ones (P less than .001). ER+ tumors also
      have significantly higher levels of E2 than do ER- ones (P less than .0001);
      similarly, ARAC+ tumors have significantly higher levels of E2 than do ARAC- ones
      (P less than .0001). There is a significant multiple linear correlation between
      the log of the levels of ARAC, ER, and EGFR and the log of tumor E2 (P less than
      .0001). The correlation coefficients obtained show that ARAC and ER have a
      positive effect on tumor E2. CONCLUSION: The results obtained suggest the
      importance of tumor ARAC in the tumoral levels of E2 and reinforce the possible
      biologic significance of tumor ARAC, especially in postmenopausal breast
      carcinoma patients.

PMID- 1740684
TI  - Pulmonary function tests after whole-lung irradiation and doxorubicin in patients
      with osteogenic sarcoma.
AB  - PURPOSE: Because of the scarcity of information regarding long-term follow-up of
      pulmonary function after whole-lung irradiation, a prospective study was started
      at the University of Florida in 1979 to evaluate pulmonary function after
      treatment with whole-lung irradiation and doxorubicin in patients with osteogenic
      sarcoma. PATIENTS AND METHODS: Between 1979 and 1984, 57 osteogenic sarcoma
      patients with no evidence of metastatic disease at diagnosis received adjuvant
      therapy consisting of whole-lung irradiation (with the heart shielded) followed
      by Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH). The whole-lung
      irradiation schema was 1,600 cGy in 10 fractions with 8-MV x-rays via anterior
      and posterior fields. This was followed by five cycles of Adriamycin for a total
      dose of 450 mg/m2. Pulmonary function tests (PFTs) consisting of spirometry, lung
      volumes, and diffusing capacity were obtained before the whole-lung irradiation,
      at 6 and 12 months after irradiation, and at yearly intervals thereafter.
      RESULTS: At the time of analysis, 28 of the 57 patients were available for study,
      with a mean follow-up of 42 months (range, 6 to 77 months). Follow-up pulmonary
      function testing revealed decreased forced vital capacity (FVC) and forced
      expiratory volume at 1 second (FEV1) during the first 6 to 12 months after whole
      lung irradiation. These values returned to baseline during the second-year
      posttherapy and remained at baseline throughout the remainder of the follow-up
      period. Changes in lung volumes demonstrated a similar early trend, with
      significant decreases in total lung capacity (TLC) and functional residual
      capacity (FRC) at 6 to 12 months. These changes, however, did not improve
      significantly during the remainder of the follow-up period. Diffusing capacity of
      the lungs for carbon monoxide (DLCO) also reached a nadir at 6 to 12 months after
      whole-lung irradiation, with resolution by 2 years and maintenance of at least
      baseline values for the remainder of the follow-up period. CONCLUSIONS: Treatment
      with whole-lung irradiation and Adriamycin, as given in this study, caused no
      significant sequelae, as demonstrated by pulmonary function testing during the
      mean follow-up period of 42 months, although a mild, transient restrictive
      ventilatory defect occurred at 6 to 12 months after treatment.

PMID- 1740685
TI  - Sequential cycles of high-dose carboplatin administered with recombinant human
      granulocyte-macrophage colony-stimulating factor and repeated infusions of
      autologous peripheral-blood progenitor cells: a novel and effective method for
      delivering multiple courses of dose-intensive therapy.
AB  - PURPOSE: The trial was undertaken to study the effect of administering
      granulocyte-macrophage colony-stimulating factor (GM-CSF) with and without
      peripheral-blood progenitor cells (PBPC) on the hematologic and nonhematologic
      toxicity observed with multiple cycles of high-dose carboplatin chemotherapy.
      PATIENTS AND METHODS: Eighteen patients with a variety of solid tumors received a
      total of 40 cycles of carboplatin, 1,200 mg/m2 per cycle, administered by
      continuous infusion over 96 hours. All 40 courses were administered with a daily
      4-hour intravenous (IV) infusion of either 5 or 10 micrograms/kg/d of recombinant
      human Escherichia coli-derived GM-CSF. The first 20 courses were administered
      without PBPC support (treatment A). Because of severe neutropenia and
      thrombocytopenia, the next 20 courses of therapy were administered with GM-CSF,
      PBPC, and oral antibiotic prophylaxis (treatment B). RESULTS: The addition of
      PBPC support led to a significant reduction in the duration of neutropenia (10.5
      v 7.5 days; P = .027) and thrombocytopenia (12.4 v 5.2 days; P = .001), number of
      RBC transfusions (six v three; P = .01) and platelet transfusions (10.3 v 3.7; P
      = .013), number of hospital days (12.6 v 2.9; P = .01), and days of IV
      antibiotics (11.8 v 2.4; P = .007) per cycle. Significant increases in the weekly
      dose intensity (206 v 285 mg/m2/wk; P = .014) and total dose (2,287 v 3,600
      mg/m2; P = .018) of carboplatin delivered were also observed with treatment B.
      The overall response rate in this study was 70%, with 11 of 16 assessable
      patients achieving either a complete (three patients) or partial (eight patients)
      remission. CONCLUSION: This combination of GM-CSF and PBPC infusion represents an
      effective method for delivering multiple cycles of high-dose carboplatin
      chemotherapy and may serve as a model for the administration of high-dose
      chemotherapy in future trials.

PMID- 1740686
TI  - Irradiated blood products to prevent graft-versus-host disease.

PMID- 1740687
TI  - The dissonance mutation at the no-on-transient-A locus of D. melanogaster:
      genetic control of courtship song and visual behaviors by a protein with putative
      RNA-binding motifs.
AB  - Genetic and molecular results are here presented revealing that the dissonance
      (diss) courtship song mutation is an allele of the no-on-transient-A (nonA) locus
      of Drosophila melanogaster. diss (now called nonAdiss) was originally isolated as
      a mutant with aberrant pulse song, although it was then noted to exhibit defects
      in responses to visual stimuli as well. The lack of transient spikes in the
      electroretinogram (ERG) and optomotor blindness associated with nonAdiss are
      shown to be similar to the visual abnormalities caused by the original nonA
      mutations. nonAdiss failed to complement either the ERG or optomotor defects
      associated with four other nonA mutations. However, all four of these nonA
      mutants--which were isolated on visual criteria alone--sang a normal courtship
      song. nonAdiss complemented at least three of the nonA mutations with regard to
      the singing phenotype, as assessed by a new method for temporal analysis of the
      male's pulse song. Both visual and song abnormalities caused by nonAdiss were
      rescued by P-element-mediated transformation with overlapping 11 and 16 kilobase
      (kb) fragments of genomic DNA (originally cloned from the nonA locus by Jones and
      Rubin, 1990). Analysis of behavioral phenotypes in transformed flies carrying
      mutagenized versions of the 11 kb genomic fragment (in a nonAdiss genomic
      background) localized the rescuing DNA to a region containing an open reading
      frame that encodes a polypeptide (NONA) with similarity to a family of RNA
      binding proteins. Immunohistochemical determination of NONA's spatial and
      temporal expression revealed that it is localized to the nuclei of cells in many
      neural and non-neural tissues, at all stages of the life cycle after very early
      in development. Genetic connections between the control of two quite different
      behaviors--reproductive and visual--are discussed, along with precedences for
      generally expressed gene products playing roles in specific behaviors.

PMID- 1740688
TI  - Color selectivity of neurons in the inferior temporal cortex of the awake macaque
      monkey.
AB  - We tested the color selectivity of neurons in the inferior temporal (IT) cortex
      of two awake macaque monkeys. A color stimulus was presented at the center of the
      visual field while the animal performed a fixation task. The responses of single
      units to various colors were recorded and were plotted in a color space. The
      color space was based on the CIE (Commission Internationale de l'Eclairage)
      chromaticity diagram. Quantitative analysis of the color selectivity was
      performed using a standard set of colors that were evenly distributed in the
      color space. Sixty-five neurons recorded from eight guide tubes implanted in
      anterior part of IT cortex were tested quantitatively, and their color
      selectivity was statistically evaluated. Forty-six of them (71%) were classified
      as color selective. Color-selective cells responded to some colors but not to
      others, and we called the responsive region in the color space the "color field."
      The location and the size of a cell's color field were largely independent of the
      luminance of the stimulus. About 80% of the color-selective neurons had color
      fields consisting of a single responsive region that were restricted in some part
      of the color space, and the remaining cells had more than one responsive region
      within the color space. Preferred hues of the color-selective neurons differed
      from cell to cell. The population of cells together covered nearly all of the
      color space. There was a tendency for more color-selective cells to be less
      sensitive to white and desaturated cyans. Some of the cells with color fields
      that consisted of more than one responsive region were more sensitive to
      saturation of the stimulus than to its hue. Although previous
      electrophysiological studies in IT cortex emphasized the pattern selectivity of
      the neurons, our results suggest that color is an important factor in the role
      that IT cortex plays in the object recognition.

PMID- 1740689
TI  - Cooperative regulation of calcitonin gene-related peptide levels in rat sensory
      neurons via their central and peripheral processes.
AB  - Calcitonin gene-related peptide (CGRP) is present in both motor and sensory
      neurons and transported in the somatofugal direction. CGRP levels in sensory
      neurons are assumed to be regulated by NGF supplied from their peripheral
      targets. In cultured sensory neurons, however, a basal level of CGRP persists
      even without NGF. This suggests that some additional factors may be involved in
      regulation of CGRP levels of sensory neurons. The present study shows that
      chronic section of the sciatic nerve in the rat reduces CGRP levels in the lumbar
      dorsal root ganglia (DRG), whereas section of dorsal roots increases CGRP levels
      in the DRG. This increased CGRP level by dorsal rhizotomy was associated with
      enhancement of the CGRP mRNA expression in the DRG. Thus, CGRP expression in DRG
      appears to be regulated reciprocally via their central and peripheral processes.
      When the sciatic nerve had been cut 1 week previously, however, dorsal rhizotomy
      no longer increased CGRP levels in the lumbar DRG. Therefore, stimulation of CGRP
      synthesis in the DRG by dorsal rhizotomy may require the integrity of the
      peripheral processes. When NGF had been infused into the central stump of the cut
      sciatic nerve, dorsal rhizotomy again increased CGRP levels in the DRG, despite
      prior section of the peripheral processes. We conclude that CGRP expression in
      sensory neurons may be regulated by cooperative action of some factors derived
      via their central processes and NGF supplied from the peripheral targets.

PMID- 1740690
TI  - Distinct spatial and temporal expression patterns of K+ channel mRNAs from
      different subfamilies.
AB  - Different types of K+ channels play important roles in many aspects of
      excitability. The isolation of cDNA clones from Drosophila, Aplysia, Xenopus, and
      mammals points to a large multigene family with several distinct members encoding
      K+ channels with unique electrophysiological and pharmacological properties.
      Given the pivotal role K+ channels play in the fine tuning of electrical
      properties of excitable tissues, we studied the spatial and temporal basis of K+
      channel diversity. We report the isolation of two putative K+ channels that
      define two new subfamilies based upon amino acid sequence similarities with other
      known K+ channels. Northern blot and in situ hybridization studies revealed
      differences in the spatial and temporal expression patterns for these two new
      clones along with mRNAs from other K+ channel subfamilies. Two of the K+ channels
      studied are predominantly expressed in the brain. One of the "brain-specific" K+
      channels is first expressed after about 2 weeks of postnatal cerebellar
      development and remains at levels about 10-fold higher in the cerebellum than in
      the rest of the brain.

PMID- 1740691
TI  - Changes in the activity of units of the cat motor cortex with rapid conditioning
      and extinction of a compound eye blink movement.
AB  - Patterns of spike activity were measured in the pericruciate cortex of conscious
      cats before and after development of a Pavlovian conditioned eye blink response.
      Unit activity was tested with presentations of a click conditioned stimulus (CS)
      and a hiss discriminative stimulus (DS) of similar intensity to the click. Unit
      discharge in response to the CS increased after conditioning, but not after
      backward conditioning when conditioned reflexes (CRs) were not performed. Rates
      of spontaneous, baseline discharge were not increased after conditioning with
      respect to rates of discharge measured in the naive state. It appeared that an
      increase in the ratio of CS-elicited discharge to background activity, together
      with an increase in the number of units responding to the CS after conditioning,
      supported discrimination of the CS from the DS and performance of the conditioned
      blink response. This is the first detailed characterization of patterns of a
      rapidly conditioned Pavlovian response. Activation of units by the CS preceded
      the onset of the CR, supporting the hypothesis that the activity played a role in
      initiating the conditioned eye blink movement. Extinction with retention of
      performance of the CR was associated with perseverance of the increased unit
      discharge in response to the CS. Extinction with substantially reduced
      performance of the CR was associated with diminution of the unit response to the
      CS below levels found with conditioning. Averages of patterns of spike activity
      elicited by the CS after conditioning showed components of discharge with onsets
      of 8-40 msec (alpha 1), 40-72 msec (alpha 2), 72-112 msec (beta), and greater
      than 112 msec (gamma), corresponding to each of four separate excitatory EMG
      components of the compound blink CR. Each component increased in magnitude after
      conditioning, relative to levels found in the naive state. The finding that long-
      as well as short-latency components of unit activation increased after
      conditioning supported the hypothesis that generation of both long- and short
      latency blink CRs in normal animals may depend significantly on neural circuitry
      and mechanisms within the motor cortex.

PMID- 1740692
TI  - Increases in excitability of neurons of the motor cortex of cats after rapid
      acquisition of eye blink conditioning.
AB  - Measurements were made of resting potentials, input resistance, and excitability
      to intracellularly applied, depolarizing current pulses in neurons of the
      pericruciate cortex of conscious cats before and after acquisition of a rapidly
      conditioned eye blink reflex (CR). Neuronal excitability increased after
      conditioning, and an increased input resistance was found to be correlated with
      the increased level of excitability. No associated changes were found in resting
      potentials as a consequence of conditioning. When cells were divided into groups
      according to the latency of spike activity elicited by a click conditioned
      stimulus (CS) in relation to four separate excitatory EMG components of the
      compound blink CR, excitability increases were found in cells with increased
      spike activity at alpha 1 (8-40 msec), alpha 2 (40-72 msec), beta (72-112 msec),
      and gamma (112-160 msec) latencies after delivery of the CS. Also, the proportion
      of cells with high excitability (less than 0.7 nA required for spike elicitation)
      was increased at each latency period after conditioning. Increases in later
      components of spike discharge could also be found in the cells with increases in
      earlier components of discharge and increased excitability. The findings
      suggested that excitability increases facilitated a responsiveness to the CS that
      supported production of long- as well as short-latency components of the blink
      CR. Many of the changes in neuronal properties found after rapid eye blink
      conditioning, such as the increases in excitability and resistance and in the
      proportion of CS-excitable cells, resembled changes found earlier after
      acquisition of a slowly developing Pavlovian blink CR, using the same click CS
      and tap unconditioned stimulus without addition of a hypothalamic stimulus. The
      possibility should be considered that the (10-100 times) more rapidly acquired
      form of eye blink conditioning does not represent a different form of
      conditioning, but instead a change in the rate of conditioning supported by the
      more rapid production of increases in neural excitability.

PMID- 1740693
TI  - Transforming growth factor alpha, but not epidermal growth factor, promotes the
      survival of sensory neurons in vitro.
AB  - Transforming growth factor alpha (TGF alpha) is a mitogenic polypeptide that is
      structurally homologous to epidermal growth factor (EGF) and appears to bind to
      the same receptor in all systems tested previously. In the present study, TGF
      alpha was found to enhance survival and neurite outgrowth of cultured neonatal
      rat dorsal root ganglion (DRG) neurons in a dose-dependent manner. This effect
      was observed with TGF alpha concentrations as low as 17.8 pM. By contrast, EGF at
      concentrations up to 83 nM was ineffective. Moreover, EGF did not antagonize the
      TGF alpha survival-promoting effect unless present in large excess (500-fold the
      concentration for which TGF alpha is effective); even in this case, only partial
      antagonism was achieved. Survival of neurons from nodose, trigeminal, and
      sympathetic ganglia was not increased by TGF alpha. Both a subpopulation of DRG
      neurons and of macrophages in the cultures bound iodinated TGF alpha. This
      binding was inhibited by excess unlabeled TGF alpha but not EGF. Our data are
      consistent with the possibilities that the actions of TGF alpha on DRG neurons
      occur indirectly via unidentified neurotrophic molecules other than NGF as well
      as directly on the neurons themselves. Thus, TGF alpha, in contrast to EGF, may
      act as a survival or maintenance factor for a subset of rat sensory neurons.
      Mediation of this neurotrophic effect appears to occur via a new form of TGF
      alpha receptor.

PMID- 1740694
TI  - Cerebellar target neurons provide a stop signal for afferent neurite extension in
      vitro.
AB  - The contributions of cell-cell interactions to the establishment of specific
      patterns of innervation within target brain regions are not known. To provide an
      experimental analysis of the regulation of afferent axonal growth, we have
      developed an in vitro assay system, based on the developing mouse cerebellum, in
      which afferent axons from a brainstem source of mossy fiber afferents, the
      basilar pontine nuclei, were cocultured with astroglia or granule neurons
      purified from the cerebellum. In the absence of cells from the cerebellum,
      pontine explants produced axons that fasciculated and extended rapidly on a
      culture surface treated with poly-lysine or laminin. When pontine neurites grew
      onto cerebellar astroglial cells, outgrowth was more abundant than on substrates
      alone, suggesting that glial cells provide a positive signal for axon extension.
      Time-lapse video microscopy indicated that the rate of neurite extension
      increased from less than 50 microns/hr to more than 100 microns/hr when axonal
      growth cones moved from the culture substratum onto an astroglial-cell surface.
      Acceleration of neurite extension was also observed as pontine neurites grew onto
      other pontine neurites. By contrast, when pontine neurites grew on granule
      neurons, the appropriate targets of mossy fibers, the length of pontine neurites
      was greatly reduced. As growing axons terminated on granule neurons, the target
      cells appeared to provide a "stop-growing signal" for axon extension. The length
      of pontine neurites decreased with increasing granule neuron density. Two lines
      of evidence suggested that the stop signal was contact mediated. First, video
      microscopy showed that pontine growth cones stopped extending after contacting a
      granule neuron. Second, the length of afferent axons was not reduced when pontine
      neurites grew at a distance from granule neurons. Competition experiments where
      both astroglia and granule neurons were plated together suggested that the growth
      arrest signal provided by granule neurons could override the growth-promoting
      signal provided by astroglial cells. These results suggest that specific cell
      cell interactions regulate the growth of pontine afferent axons within their
      cerebellar target, with axoaxonal and axoglial interactions promoting axon
      extension and axon-target cell interactions interrupting axon extension.

PMID- 1740695
TI  - Transient calbindin-D28k-positive systems in the telencephalon: ganglionic
      eminence, developing striatum and cerebral cortex.
AB  - Calbindin-D28k (calbindin) is a member of the superfamily of calcium-binding
      proteins implicated in the regulation of intracellular calcium. In the mature
      brain, calbindin is widely expressed in neurons of the forebrain and the
      hindbrain, and in the telencephalon calbindin-like immunoreactivity is
      particularly strongly expressed by medium-sized neurons of the striatum and by
      certain other neurons in the cortex and subcortex. We have traced the development
      of calbindin expression in the forebrain of the rat, and report here that in
      addition to the steady development of these calbindin-positive neuronal systems,
      transient waves of calbindin expression occur in cells of the ventricular zones
      of the basal ganglia and cortex and in cells of the telencephalic regions derived
      from these ventricular zones including radial glia of the developing striatum. In
      the striatum and its ventricular zone (the ganglionic eminence, or GE) we
      identified four transient calbindin-positive systems in the perinatal period.
      First, calbindin-immunoreactive cells began to appear in the GE by embryonic day
      (E)18, and by E20 an extensive dorsal and lateral part of the GE was marked by
      dense calbindin-like immunoreactivity in the ventricular zone. This calbindin
      system peaked at postnatal day (P)0-P3 and disappeared by P15. Its presence
      suggests that the GE is divisible on a molecular basis into lateral and medial
      districts that may correspond to derivatives of the lateral and medial
      ventricular ridges. Second, a system of calbindin-positive processes appeared in
      the dorsal and lateral caudoputamen with temporal and spatial distributions
      matching the germinal zone system. Many of these processes could be traced from
      calbindin-positive cells in the ventricular zone of the GE, including processes
      stretching across the full width of the dorsal caudoputamen. Double-staining
      experiments demonstrated that these radial processes were Rat.401-positive,
      suggesting that they form a subset of radial glia in the developing
      telencephalon. These findings demonstrate that during development calbindin is
      expressed in glial as well as neural cells. They further suggest that the radial
      glia associated with the GE form heterogeneous populations, the transient
      calbindin-positive radial glia being associated with the lateral ridge of the GE
      and its derivatives. Third, a scattered population of calbindin-positive cells
      with morphologies different from the common medium-sized calbindin-immunoreactive
      neurons of the striatum appeared in the dorsal and lateral striatum from about
      E20 to P15. Some of these cells were close to the transient calbindin-positive
      radial processes in the same region, but others were not.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1740696
TI  - Agreement states still chafing under NRC compatibility.

PMID- 1740697
TI  - Positron emission tomography using fluorine-18-fluorodeoxyglucose in malignant
      lymphoma: a comparison with proliferative activity.
AB  - To evaluate the relationship between PET using 18F-fluorodeoxyglucose (FDG) and
      pathological findings and to compare indices obtained by FDG-PET, FDG-PET was
      performed in 23 patients with untreated malignant lymphoma. Three indices
      obtained by FDG-PET, tumor-to-normal contrast ratio (TCR), distribution
      absorption ratio (DAR), k1k2/(k2 + k3), correlated with proliferative activity
      which was pathologically estimated both by mitotic count and by proportion of
      cells in all phases of the cell cycle. The relationship did not significantly
      change according to which of the three indices was chosen. FDG-PET, which shows
      the proliferative activity of tumors, is considered to be a useful method for
      managing tumors.

PMID- 1740698
TI  - Clinical applications of positron emission tomography in cancer: the good, the
      bad and the ugly.

PMID- 1740699
TI  - Quantitating tumor glucose metabolism with FDG and PET.

PMID- 1740700
TI  - Validation of gallium-67-citrate single-photon emission computed tomography in
      biopsy-confirmed residual Hodgkin's disease in the mediastinum.
AB  - In a retrospective study of a series of 30 adult patients during restaging of
      Hodgkin's disease after therapy, computed tomography (CT) and biopsy results were
      correlated with 67Ga SPECT in order to determine the value of SPECT imaging in
      monitoring recurrent mediastinal Hodgkin's disease. SPECT had an overall accuracy
      of 93% (28/30) and correctly identified active disease in 24 of 25, 96% of
      histopathologically proven recurrent Hodgkin's disease. Thus in this post-therapy
      setting, we have confirmed the high sensitivity of 67GA SPECT scans in patients
      selected for biopsy. Gallium-67 may prove particularly useful in detecting
      residual disease activity in patients in whom biopsy was positive but the
      interpretations of the CT scans were uncertain in regard to presence of tumors
      [8/30 (27%)]. In this group of patients, we found SPECT particularly helpful. A
      larger prospective series is under way to assess this possibility.

PMID- 1740701
TI  - Bone scintigraphy in preschool children with lower extremity pain of unknown
      origin.
AB  - Small children often cannot describe the location of bone pain for parents or
      physicians. Bone scans were performed in 56 children under five years of age with
      lower extremity pain and/or gait abnormalities of unknown etiology. Patients with
      fever, and those known to have infection, child abuse, malignancy, and/or
      radiographic abnormalities were excluded. Thirty patients had abnormal bone
      scans. Abnormalities included evidence of hip synovitis (4), femoral head
      avascularity (2), various proximal femoral abnormalities (3), knee synovitis (3),
      toddler's fracture (1), various tibial or fibular abnormalities (4), and various
      abnormalities of the tarsal bones (16). Tarsal bone abnormalities included four
      with abnormal calcaneal uptake and nine with abnormal uptake in or adjacent to
      the cuboid bone. Correlative imaging studies were available for 26 sites, and
      focal bone findings were noted at only five locations. Tarsal bone abnormalities
      accounted for over half of the scintigraphic abnormalities in these preschool
      children with gait abnormalities. Abnormal uptake in/or adjacent to the cuboid
      bone was common and probably represented stress injury.

PMID- 1740702
TI  - Effects of dipyridamole infusion on human renal function observed using
      technetium-99m-DTPA.
AB  - Our observation that a prolonged dipyridamole infusion reduced or eliminated
      blood clearance of Gd-DTPA in dogs led us to investigate if dipyridamole, infused
      intravenously at rates comparable to those used in thallium myocardial perfusion
      tests, would alter renal filtration in humans. Renal filtration was assessed
      using a bolus injection of 10 mCi of 99mTc-DTPA in five males (19-63 yr old) with
      normal serum urea and creatinine. Twenty minutes following the bolus injection a
      10-min intravenous infusion of either dipyridamole (0.14 mg/kg/min) or saline
      sham was given. Four to 10 min following the start of the dipyridamole infusion,
      a paradoxical rise in counts in the kidney region of interest was observed and
      persisted for 10 to 27 min. During this time, a 13% to 52% (mean +/- s.d., 40% +/
      16%, p less than 0.007) reduction in the exponential slope defining the
      clearance of counts from the cardiac region of interest occurred (implying a
      reduction of glomerular filtration rate), mean heart rate increased 27 +/- 5 bpm,
      p less than 0.002 and mean diastolic pressure decreased 12.9 +/- 6.4 mmHg, p less
      than 0.028. This finding indicates that renal clearance of tracers such as
      thallium or contrast agents such as Gd-DTPA is reduced during dipyridamole
      infusion.

PMID- 1740703
TI  - The frequency of asymptomatic and electrically silent exercise-induced regional
      myocardial ischemia during first-pass radionuclide angiography with upright
      bicycle ergometry.
AB  - The presence of asymptomatic (silent) myocardial ischemia during provocative
      testing may limit the detection of ischemic heart disease, unless sensitive
      indicators of ischemia are utilized. Exercise ventricular function studies are
      well suited for ischemia detection since segmental dysfunction is an early
      pathophysiologic event in the ischemic cascade. In this study, we examined the
      rest and stress first-pass radionuclide angiographic studies of 104 patients with
      coronary artery disease and exercise-induced regional wall motion abnormalities.
      Asymptomatic ischemia was observed in 83 patients, while only 21 patients were
      symptomatic. Clinical variables were not different between the two groups, except
      for a higher frequency of a prior anginal history in the symptomatic group. The
      peak heart rate and pressure-rate product were significantly higher in the silent
      ischemia group, as these patients are not limited by symptoms. Wall motion
      scores, resting and exercise ejection fractions were similar in the two groups.
      The frequency of an ischemic electrocardiographic ST-segment response was low,
      and was not significantly different between groups. These data indicate that
      electrically and symptomatically silent myocardial ischemia are frequent
      occurrences with upright bicycle ergometry. Without adjunctive cardiac imaging,
      this mode of exercise may not be appropriate for the evaluation of ischemic heart
      disease.

PMID- 1740704
TI  - Diagnostic value of technetium-99m radionuclide angiography for detecting
      thrombosis in left atrial appendage.
AB  - In mitral valve disease, it is important to know whether thrombi are present in
      the left atrium when deciding upon a course of treatment. The left atrial
      thrombus usually locates in the left atrial appendage. In most cases of mitral
      valve disease, the left atrial appendage is clearly demonstrated by radionuclide
      angiography using 99mTc-labeled red blood cells and it can be speculated that the
      cases in which left atrial appendage are not demonstrated by RNA have left atrial
      thrombi. On the basis of this hypothesis, the diagnostic accuracy of radionuclide
      angiography to detect left atrial thrombi was evaluated retrospectively in 60
      patients with mitral valve disease who had undergone surgery. The sensitivity of
      first-pass and equilibrium radionuclide angiography to detect left atrial thrombi
      was 83% and 67%, the specificity 79% and 54%, and the accuracy 80% and 57%,
      respectively. Although there were two false-negative cases in which the left
      atrial thrombi did not locate in the appendage and 10 false-positive cases in
      which left atrial appendages were not dilated, the negative predictive value was
      so high that a clearly demonstrated left atrial appendage can be translated into
      the absence of left atrial thrombi.

PMID- 1740705
TI  - Radiation-induced inhibition of tumor growth as monitored by PET using L-[1
      11C]tyrosine and fluorine-18-fluorodeoxyglucose.
AB  - The potential use of PET to monitor radiotherapeutic effects on tumors has been
      evaluated with L-[1-11C]tyrosine and 18FDG. Single x-ray doses of 10, 30, or 50
      Gy have been applied to rhabdomyosarcoma tumors growing in the flank of rats.
      Dose-dependent reductions of tracer uptake were registered by PET 4 and 12 days
      after treatment. These later effects on tracer uptake appeared to correlate with
      changes in tumor volume. Therefore, PET using L-[1-11C]tyrosine and 18FDG is
      suitable to monitor kinetics of tumor growth and tumor regression after
      radiotherapy. Direct effect on tracer uptake was not observed within 8 hr after
      irradiation. This indicates that, using PET, early predictions on the outcome of
      radiotherapy are not possible. When combining a radiation treatment with
      hyperthermia, radiation-induced inhibition of tumor growth was clearly enhanced.
      Tracer uptake remained at the pretreatment value, possibly due to invasion of
      host cells. From these experiments, it can be concluded that it is difficult to
      monitor a combined treatment of radiation and hyperthermia by PET.

PMID- 1740706
TI  - Dosimetry at the cellular level of Kupffer cells after technetium-99m-sulphur
      colloid injection.
AB  - The radiation dose to Kupffer cells was estimated at the cellular level after
      intravenous injection of 99mTc labeled sulphur colloids in rats. The results were
      then compared with those obtained using macroscopic dosimetry. From the
      microscopy appearance observed using a "track" microautoradiographic method
      (MAR), it was shown that only 0.2% of the Kupffer cells were actually involved in
      the pinocytosis of radioactive colloids. For each electronic emission from 99mTc
      (Auger and internal conversion), the fraction of the emitted energy actually
      absorbed within the Kupffer cell was calculated using the values provided by
      Berger. About 15% of the total energy emitted by electrons was absorbed in 0.2%
      of the Kupffer cells. If these results are extrapolated to humans, the dose
      absorbed by the labeled cells can be estimated to be between 0.5 and 0.9 Gy/MBq.
      This represents about 15,000 times the average electron dose to the liver as
      estimated from macrodosimetric methods. In cases such as this one where an
      important distribution heterogeneity is expected, dosimetric estimations at a
      cellular level may be particularly useful.

PMID- 1740707
TI  - Does nonuniformity of dose have implications for radiation protection?

PMID- 1740708
TI  - Biodistribution and kinetics of radiolabeled proteins in rats with focal
      infection.
AB  - The purpose of this study was to evaluate the role of both protein and
      radionuclide in the accumulation of 111In-labeled human immunoglobulin G (IgG) in
      infectious foci. In rats with a calf muscle infection, biodistribution was
      determined 2, 6, 24, and 48 hr after injection of a radiopharmaceutical. For IgG,
      human serum albumin (HSA) and human immunoglobulin A (IgA), all labeled with
      111In, target-to-background (T/B) ratios were similar throughout the study.
      However, absolute abscess uptake of 111In-IgA was significantly lower. For IgG
      labeled with 111In, 123I, or 99mTc, similar T/B ratios were found up to 24 hr.
      After 48 hr, the T/B ratio of 111In-IgG was significantly higher than the T/B
      ratio of 123I-IgG. The absolute abscess uptake of 111In-IgG was higher than that
      of 99mTc-IgG at 24 hr and 123I-IgG at 48 hr. In conclusion, the radionuclide
      appears to be of major importance in the accumulation of radiolabeled proteins in
      infectious foci. Protein mainly influences blood clearance and distribution in
      organs. The Fc-gamma receptor is not crucial for accumulation in infectious foci.

PMID- 1740709
TI  - Targeted proteins for diagnostic imaging: does chemistry make a difference?
AB  - The Oyen et al. study is valuable in that it systematically evaluates several of
      the factors involved in radiolabeled protein uptake and retention in infectious
      foci. The role of particular proteins and their receptor specific interactions
      seems to be inconsequential in agreement with the findings of other. However, the
      role of the radiolabel was shown to be important and significant differences were
      delineated from comparisons of the radionuclides and their associated
      chemistries. The conclusion implicating radionuclide chemistry and associated
      linkages underscores the need to optimize the attachment and labeling chemical
      modifications of protein carriers. Evaluation criteria should include serum
      stability, determination and assessment of the effect of molar substitution
      ratio, and potential for improving blood clearance without reducing the target-to
      non-target ratio. Important areas for future study include characterization of
      radioactive metabolites and the design and synthesis of new ligands which direct
      the disposition of metabolites reducing retention in normal organs or
      accelerating renal excretion. Additionally, intracellular processing of
      radiolabel, compartmental distribution and strategies for augmenting
      internalization and retention within the target cell merit detailed exploration.
      For each radionuclide of interest, 111In, radioiodines, 99mTc and others,
      improved chemical moieties exist for controlling radiolabel fate. When carrying
      out mechanistic and evaluative studies, clear-cut conclusions will only be
      reached when defined and controlled chemistry is used. Having established a "gold
      standard," simplifications in radiolabeling and other chemical refinements can
      then be pursued with a quantitative understanding of the trade-offs in targeting
      agent performance versus other considerations such as cost reduction, simplicity,
      and convenience.

PMID- 1740710
TI  - Polymeric microspheres for radionuclide synovectomy containing neutron-activated
      holmium-166.
AB  - Poly-L-lactic acid (PLA) microspheres containing neutron-activated 166Ho were
      investigated as potential agents for radionuclide synovectomy. Stable 165Ho,
      complexed to acetylacetone (AcAc), was incorporated into PLA spheres by the
      solvent evaporation technique. Spheres prepared with the optimal mean particle
      size of 7.2 microns (range 2-13 microns) containing 25.4% 165Ho-AcAc (9.1% 165Ho)
      were irradiated in a high neutron flux to produce 31.1-36.0 mCi 166Ho. In vitro
      human plasma studies showed that the irradiated spheres retained 99.0 +/- 0.01%
      of the 166Ho at 314 hr. In-vivo retention studies were conducted by administering
      irradiated PLA spheres with 257-591 microCi 166Ho into the joint space of normal
      rabbits (n = 6). Biodistribution analysis and gamma camera analysis showed 166Ho
      retention in the joint space after 120 hr of 97.7% +/- 0.8% and 98.2% +/- 2.4%,
      respectively, with no uptake by the lymph nodes. The ease with which the PLA
      spheres can be made in the optimal size range for later irradiation and their
      ability to retain the 166Ho make them attractive agents for radionuclide
      synovectomy.

PMID- 1740711
TI  - Experimental study on radioactive pathways of hypodermically injected technetium
      99m.
AB  - The objective of this study was to investigate the biological substrate of
      radioactive pathways of migration of hypodermically injected 99mTc into points of
      low electrical resistance. Sixteen anesthetized adult male beagles were used.
      Control and test points were defined by comparing their electrical resistance to
      that of the pinna. Seventy-three experiments of three different types were
      performed: (1) separate hypodermic injections of [99mTc] sodium pertechnetate,
      201Tl-chloride, 131INa and 99mTc-rhenium sulfide into control and test points;
      (2) simultaneous injections of [99mTc]sodium pertechnetate and 201Tl chloride
      into control and test points; and (3) intravascular injections of 99mTcO4 into
      blood vessels underlying test points. Only the hypodermic injection of 99mTc into
      points of low electrical resistance gave rise to a specific radioactive pathway
      characterized by rapid and longitudinal migration, clearly independent of
      background activity. The specific radioactive pathway detected is not the result
      of diffusion of the radiotracer through nerves, veins or lymphatic vessels, but
      its trajectory coincides with that described for one of the acupuncture meridians
      in the dog.

PMID- 1740712
TI  - Anatomic divisions.

PMID- 1740713
TI  - Synthesis, rodent biodistribution, dosimetry, metabolism, and monkey images of
      carbon-11-labeled (+)-2 alpha-tropanyl benzilate: a central muscarinic receptor
      imaging agent.
AB  - Muscarinic cholinergic receptors (mAChR) are abundant in the brain, and the mAChR
      system mediates many aspects of brain function. There is evidence of alterations
      in muscarinic binding in degenerative brain disorders. A muscarinic receptor
      radioligand, carbon-11-(+)-2 alpha-tropanyl benzilate ([11C]TRB), has been
      prepared through N-[11C]methylation of N-desmethyl TRB, and evaluated in rodents
      and primates. Full body biodistribution in rats has been determined and the
      expected human dosimetry calculated. Comparisons with [11C]scopolamine in rats
      showed 2-6 times greater brain uptake of [11C] TRB. Highly specific and saturable
      binding of [11C]TRB in the striatum and cortex was demonstrated by greater than
      85% blockade of uptake following QNB or scopolamine pretreatment.
      Striatum/cerebellum ratios in mice at 60 min exceeded 12.6. TLC analysis of rat
      tissues showed the absence of 11C-metabolites in brain and heart, and a rapid
      solid phase C-18 Sep-Pak method found that unmetabolized plasma [11C]TRB in
      monkeys fell from 81% at 5 min to 48% at 80 min. Finally, brains of living
      primates have been imaged using PET and [11C]TRB; regional localization was
      consistent with muscarinic receptor distribution. These results represent
      intermediate steps in the development of [11C]TRB for quantification of central
      muscarinic receptors in man.

PMID- 1740714
TI  - Identification and differentiation of congenital gallbladder abnormality by
      quantitative technetium-99m IDA cholescintigraphy.
AB  - Failure to visualize the gallbladder in its usual location along the right
      inferior hepatic border suggests many possibilities including acute
      cholecystitis. The case described here reveals the importance of proper protocol
      for hepatobiliary imaging with 99mTC-IDA agents, the necessity of quantification
      of function as an integral part of imaging to enable proper differential
      diagnosis. A case of bilobed gallbladder presenting as a Valentine heart in an
      unusual location in the liver is described. The measurement of the CCK-8 induced
      gallbladder ejection fraction for each lobe facilitated proper diagnosis.

PMID- 1740715
TI  - Radiographic and neuro-SPECT imaging in an immature third ventricle teratoma:
      case report.
AB  - We report a case of an immature teratoma of the third ventricle, which was
      preoperatively thought to be a choroid plexus papilloma. The diagnosis was made
      by biopsy since the radiographic (CT, MRI), angiographic and scintigraphic
      findings ([99mTc]pertechnetate, 99mTc-DTPA, 99mTc-HMPAO brain SPECT) were
      nonspecific. Disruption of the blood-brain barrier is the mechanism for
      radionuclidic and contrast tumoral uptake and is demonstrated by marked contrast
      enhancement on CT and focal concentration on [99mTc]pertechnetate and 99mTc-DTPA
      images. No suppression of [99mTc]pertechnetate tumor uptake was observed
      following the administration of potassium perchlorate. Increased concentration of
      tumor protein is suggested by the increased signal on the T1-weighted magnetic
      resonance images and high [99mTc]pertechnetate uptake. The tumor's detection on
      the 99mTc-HMPAO brain SPECT was due to its intraventricular location. A number of
      potential mechanisms for brain tumor localization of 99mTc-HMPAO are discussed.

PMID- 1740716
TI  - Comparison of independent aura, ictal and interictal cerebral perfusion.
AB  - Technetium-HMPAO cerebral SPECT was performed interictally, immediately after an
      independent aura and ictally in a patient with complex partial seizures.
      Interictally there was a left inferior frontoparietal region of decreased
      perfusion. Ictally there were a number of foci of increased perfusion. The aura
      study showed focal hyperperfusion in the left frontal region and decreased
      perfusion in the adjacent cortex posteriorly, suggesting a zone of suppression.
      This may be the cause or effect of the nonprogression of the aura. The case
      raises the possibility that cerebral perfusion studies performed immediately
      after independent auras may localize seizure foci if ictal studies are nonfocal.

PMID- 1740717
TI  - Application of a continuous ventricular function monitor with miniature cadmium
      telluride detector to patients with coronary artery bypass grafting.
AB  - A continuous ventricular function monitor with a miniature cadmium telluride
      detector was evaluated and applied to patients with coronary bypass surgery
      (CABG). Ejection fraction (EF) at rest and change in EF from rest to exercise and
      postexercise (Y) measured with the device correlated with that of the gamma
      camera (X) (Y = 0.86x + 6.8(%), r = 0.87, n = 110, p less than 0.001, and Y =
      0.96x + 0.4(%), r = 0.90, n = 37, p less than 0.001 respectively). Left
      ventricular function during and after supine ergometer exercise was monitored in
      54 patients before and after CABG. The EF change from baseline to peak exercise
      improved from -5.9% +/- 8.9% before CABG to 7.2% +/- 7.9% after CABG (p less than
      0.001). In all patients but two, a rapid EF increase just after exercise over
      baseline EF was observed. This EF "overshoot" during recovery increased from
      11.5% +/- 6.5% to 16.4% +/- 6.0% (p less than 0.001) after CABG. The time from
      the cessation of exercise to EF overshoot decreased from 153 +/- 80 sec to 76 +/-
      49 sec (p less than 0.001) after CABG. The continuous ventricular function
      monitor with a miniature cadmium telluride detector is able to measure EF
      reliably. Following successful aortocoronary bypass, EF response during exercise
      improved and the EF overshoot in the recovery phase became faster and higher.

PMID- 1740718
TI  - Nuclear probes in cardiology.

PMID- 1740719
TI  - An evaluation of maximum likelihood-expectation maximization reconstruction for
      SPECT by ROC analysis.
AB  - A ROC study was performed in order to evaluate whether the maximum likelihood
      expectation maximization (ML-EM) reconstruction algorithm improves diagnostic
      performance compared to the conventional filtered backprojection method in SPECT.
      Several implementations of the algorithm were tested including 25 and 50
      iteration stopping points, with and without nonuniform attenuation compensation,
      and with and without Metz filtering. Filtered backprojection was with Metz filter
      and without attenuation compensation. The test data were computer simulated to
      model cardiac 201Tl SPECT. The data incorporated the effects of nonuniform
      attenuation, distance-dependent collimator response, and scatter. Patient CT
      images provided realistic anatomy and attenuation information for the data
      simulation. Four observers each viewed 120 images for each of the reconstruction
      methods. Lesion detectability with ML-EM increased with Metz filtering and
      decreased with nonuniform attenuation compensation. The best MIL-EM
      implementation, 50 iterations with Metz filtering and without attenuation
      compensation, was not statistically better than filtered backprojection.

PMID- 1740720
TI  - Three-dimensional presentation of the Fourier amplitude and phase: a fast display
      method for gated cardiac blood-pool SPECT.
AB  - The routine clinical use of gated SPECT is inhibited by sophisticated, time
      consuming processing techniques. The present paper describes a new technique for
      the simultaneous three-dimensional presentation of the amplitude and phase of the
      first Fourier harmonics, with the aim of obtaining detailed information about the
      ventricular motion in a relatively short time, from each angle of view of three
      dimensional space. The method is simple and robust, and processing is automatic.
      It does not need carefully elaborated techniques for surface determination,
      because the cardiac surface is merely used as a reference skeleton onto which the
      functional information of amplitude and phase is mapped. The Fourier analysis
      before reconstruction results in running times shorter than 15 min and may
      further open the way for the routine use of gated SPECT.

PMID- 1740721
TI  - The importance of a delayed scan in thallium imaging.

PMID- 1740722
TI  - Incorrect naming of a carbon-11-labeled reagent.

PMID- 1740723
TI  - Providing support for preceptors in a community hospital.
AB  - An inexpensive support system for preceptors centered around monthly inservice
      programs is described. This approach has resulted in improved documentation of
      the preceptee's progress and greater consistency in how preceptors implement
      their role. In addition, preceptors believe their concerns are heard. During a
      nursing shortage, many hospitals may benefit from implementing a similar support
      system for their preceptors.

PMID- 1740724
TI  - Partnership between education and service for psychiatric staff education.
AB  - Economic restraints and limited resources have made partnerships between nursing
      service and nursing education a growing imperative. Although economics are a
      major consideration in establishing partnerships, there can be other professional
      advantages to the institution and the community.

PMID- 1740725
TI  - A study of nurses who completed a hospital-based reentry program.
AB  - This article describes a survey of nurses who completed a reentry program. The
      study resulted in information about demographics, job history, career
      development, and career satisfaction. Findings reveal that the reentry program
      was successful in assisting inactive nurses to return to the work force.

PMID- 1740726
TI  - A model combining centralized and decentralized staff development.
AB  - Traditionally, most nursing staff development departments are either
      decentralized or centralized. This article presents the advantages and
      disadvantages of each of these organizational systems and describes a model used
      at the National Institutes of Health that combines elements of both. Strategies
      to control for the disadvantages are outlined. This organizational structure may
      enable staff development educators to better meet the educational needs of nurses
      in today's health care settings.

PMID- 1740727
TI  - A comparison of four nursing documentation systems.
AB  - Nurses must be able to keep charts effectively and efficiently while providing
      high-quality care. Often, nurse educators are responsible for finding a workable
      system for a particular institution. This article reviews four nursing
      documentation systems that can be used in a variety of health care settings:
      Problem Centered, PIE (Problem Intervention Evaluation), Focus, and Charting by
      Exception.

PMID- 1740728
TI  - Implementing a neonatal resuscitation program.
AB  - This experience with the implementation of the neonatal resuscitation program has
      been positive. Collaborative planning between nursing staff education and nursing
      management has resulted in an efficient and rewarding certification process.

PMID- 1740729
TI  - Mandatory nurse assistant training for more competent caregivers.

PMID- 1740730
TI  - Designing quality brochures.
AB  - Many formulas may be used to create a brochure. The main goal is to entice people
      to read the material. Designing and preparing brochures in house offers a great
      deal of flexibility and is generally less expensive than having them designed
      outside. Brochures can be produced very creatively, and they give the education
      department yet another opportunity to develop professionally.

PMID- 1740731
TI  - Getting started--overview of the educational design series.

PMID- 1740732
TI  - Knowledge retention and clinical application after continuing education.
AB  - The authors investigate the knowledge retention and clinical application of
      physical assessment skills by nurses who participated in a required continuing
      education workshop. Tools were developed to measure the specific application of
      workshop concepts. Results support the underlying objectives of nursing staff
      development, which are to increase knowledge and improve skills.

PMID- 1740733
TI  - The early effects of joint immobilization on medial collateral ligament healing
      in an ACL-deficient knee: a gross anatomic and biomechanical investigation in the
      adult rabbit model.
AB  - In this study, the short-term effects of immobilization on joint damage and
      medial collateral ligament (MCL) healing were investigated in unstable, anterior
      cruciate ligament (ACL)-deficient knees in rabbits. Forty-six 12-month-old female
      New Zealand white rabbits were separated into three groups. Animals from each
      group had surgery on their right knees: group I, sham controls (n = 9); group II,
      complete transection of the ACL and removal of a 4 mm segment (gap injury) of MCL
      midsubstance with no immobilization of the limb (n = 19); and group III, same
      injuries to the ACL and MCL (as group II) but with immobilization of the limb (n
      = 18). No surgical repair of disrupted ligaments was performed. Left knees served
      as unoperated contralateral controls. All animals were allowed unrestricted cage
      activity until sacrifice in subgroups at 3, 6, and 14 weeks of healing when
      biomechanical properties of all MCLs were measured. All knee joints were
      systematically examined for gross evidence of damage to articular cartilage,
      menisci, and periarticular soft tissues. To monitor relative in vivo loads on
      injured limbs during healing, hindlimb weight bearing was assessed at biweekly
      intervals. Results indicated that animals in both groups II and III bore
      relatively lower loads (compared to preinjury values) on their injured hindlimbs.
      Mechanical testing of MCLs showed only minor changes in sham controls, while
      group II and III healing MCLs demonstrated significantly lower force and stress
      at MCL complex failure compared to contralateral controls. In specific
      comparisons of group III to group II animals, we noted that immobilization
      prevented joint damage over the early intervals studied. In addition,
      immobilization resulted in MCL laxity similar to contralateral control values but
      inhibited development of structural strength and stiffness in healing MCLs. These
      results suggest that in the rabbit, short-term immobilization of an ACL-deficient
      knee offers some advantages to the joint and to certain low load behaviors of the
      healing MCL, but it also results in a smaller quantity of scar tissue that is
      less able to resist higher loads. Longer-term studies involving remobilization
      are necessary before the effects of brief immobilization on joint damage and MCL
      healing in this ACL-deficient model can be fully defined.

PMID- 1740734
TI  - Strain in the anteromedial bundle of the anterior cruciate ligament under
      combination loading.
AB  - Strain within the anteromedial bundle (AMB) of the anterior cruciate ligament
      (ACL) was measured in 13 human knee specimens in order to determine the
      combination of external loads most likely to cause injury. Using a load
      application system that allowed 5 df with the flexion angle being fixed, pure
      loads of anterior/posterior force, medial/lateral force, varus/valgus torque, and
      internal/external axial torque were applied at three flexion angles: 0 degrees,
      15 degrees, 30 degrees. Combined loads were applied in pairs at two flexion
      angles: 0 degrees and 30 degrees. Liquid mercury strain gauges were used to
      measure strain in the ACL. Anterior tibial force was the primary determinant of
      strain in the anteromedial bundle. This strain was significantly larger at 30
      degrees flexion than at 0 degrees. The strain sensitivity of the AMB to medial
      force was approximately one-half that to pure anterior force. The effect of
      anterior and medial forces was additive when applied in combination. Neither pure
      axial torque nor pure varus/valgus torque was observed to strain significantly
      the AMB at any of the flexion angles investigated. However, valgus torque in
      combination with anterior force resulted in a significantly larger strain than
      pure anterior force. Internal axial torque in combination with anterior force
      also resulted in a larger strain than pure anterior force.

PMID- 1740735
TI  - Effect of tension and placement of a prosthetic anterior cruciate ligament on the
      anteroposterior laxity of the knee.
AB  - We wished to determine the optimal tension required to restore normal joint
      laxity to anterior cruciate ligament (ACL)-deficient knees using a braided
      polyethylene ACL prosthesis (PACL). In 10 cadaveric specimens, we measured the
      anteroposterior (AP) laxity of the intact knee at 10 degrees, 30 degrees, 60
      degrees, and 90 degrees of flexion. The ACL was then removed and replaced with
      the PACL using tunnel-tunnel (T-T) and "over-the-top" (OTT) placement techniques.
      In both positions, the PACL was initially tensioned to 0, 9, 18, and 27 N with
      the knee flexed to 30 degrees. AP joint laxity was then measured at each flexion
      angle. With an increase in initial tension, there was a corresponding decrease in
      AP laxity. At 30 degrees and 90 degrees of flexion, AP laxity was not
      significantly different from normal using T-T placement and an initial tension of
      0 N. At 90 degrees of flexion, AP laxity was not significantly different from
      normal using OTT placement at 0 or 9 N of initial tension. For both positions,
      all other tension levels and flexion angles constrained AP laxity. No laxity
      differences were detected between the OTT and T-T positions at any flexion angle.
      The variability in AP laxity of the T-T position was significantly greater than
      OTT. With a 150-N anterior shear force applied to the proximal tibia, the maximum
      tensions developed in the PACL were not significantly different between the two
      positions except at 90 degrees. The results suggest that implantation of the PACL
      is best performed using OTT positioning with an initial tension of 0 N applied at
      30 degrees of knee flexion.

PMID- 1740736
TI  - Tensile properties of the inferior glenohumeral ligament.
AB  - The tensile properties of the inferior glenohumeral ligament have been determined
      in 16 freshly frozen cadaver shoulders. The inferior glenohumeral ligament was
      divided into three anatomical regions: a superior band, an anterior axillary
      pouch, and a posterior axillary pouch. This yielded 48 bone-ligament-bone
      specimens, which were tested to failure in uniaxial tension. The superior band
      was consistently the thickest region, averaging 2.79 mm. The thickness of the
      inferior glenohumeral ligament decreased from antero-superiorly to postero
      inferiorly. The resting length of all three anatomical regions was not
      statistically different. Total specimen strain to failure for all bone-ligament
      bone specimens averaged 27%. Variations occurred between the three regions, with
      the anterior pouch specimens failing at a higher strain (34%) than those from the
      superior band (24%) or the posterior pouch (23%). Strain to failure for the
      ligament midsubstance (11%) was found to be significantly less than that for the
      entire specimen (27%). Thus, larger strain must occur near the insertion sites of
      the inferior glenohumeral ligament. Stress at failure was found to be nearly
      identical for the three regions of the ligament, averaging 5.5 MPa. These values
      are lower than those reported for other soft tissues, such as the anterior
      cruciate ligament and patellar tendon. The anterior pouch was found to be less
      stiff than the other two regions, perhaps suggesting that it is composed of more
      highly crimped collagen fibers. Three failure sites were seen for the inferior
      glenohumeral ligament: the glenoid insertion (40%), the ligament substance (35%),
      and the humeral insertion (25%). In addition, significant capsular stretching
      occurred before failure, regardless of the failure mode.

PMID- 1740737
TI  - Biochemically discrete zones of canine flexor tendon: evaluation of properties
      with a new photographic method.
AB  - We describe a photographic method that we have found useful for studying small
      strain fields within a larger zone of interest. We have used this method to
      document differences in material properties which correlate with zones of
      different biochemical makeup in the canine flexor digitorum profundus tendon.
      This method may be useful in analysis of experimental injury and wound healing in
      this model and may have application in evaluating material properties of soft
      tissue in other models as well.

PMID- 1740738
TI  - Physicochemical properties of the aging and diabetic sand rat intervertebral
      disc.
AB  - Hydration, fixed charge density, (FCD) and hydration under various osmotic
      pressures were compared in young, old, and young diabetic sand rats. This rat is
      a desert animal that may develop diabetes when fed a regular diet; it is also
      known to have radiographic and histologic evidence of intervertebral disc (IVD)
      disease. Forty-five rats and 180 IVD were used in this study; they were divided
      into three equal groups: young healthy, old healthy, and young diabetics. IVD,
      cancellous bone, and muscle were sampled from distal lumbar spines. The young
      diabetic rats (YD) were considerably heavier than the age-matched controls, had
      higher insulin and glucose levels, and all YD had cataracts. The discs of the
      young diabetic animals demonstrated decreased hydration, FCD and ability to
      resist compression under osmotic pressures as compared with the young and healthy
      discs and were more similar to the discs from old rats. The IVD is the most
      affected musculoskeletal connective tissue in sand rats with aging and diabetes.
      The aged and diabetic discs in the sand rat demonstrated changes similar to human
      changes with regard to lower hydration, FCD, and ability to resist osmotic
      pressure. Therefore, the sand rat may be a suitable animal model for studying the
      pathogenesis of disc degeneration.

PMID- 1740739
TI  - Spinal mobility and posture in 8- to 16-year-old children.
AB  - Spinal mobility and posture were measured in 294 8-16-year-old boys and girls,
      divided into five age groups. The upper thoracic sagittal alignment was more
      vertical among girls, but the postural curves showed no significant age-related
      differences for either sex. Among both boys and girls thoracic extension, lateral
      flexion, and rotation decreased significantly between the ages of 12 and 13, but
      with the exception of extension they returned to the previous level by age 16.
      Girls were significantly different from boys at 13 years of age. In the thoracic
      spine, girls had less kyphosis, and were stiffer in forward and lateral flexion,
      with more rotation to the right than to the left. In the lumbar spine, lateral
      flexion increased after the age of 10 in both sexes. Between the ages of 8 and 14
      lumbar lateral flexion was significantly greater among girls than among boys,
      whereas extension and rotation was greater only at the ages of 8 and 10 years.
      With increasing age, a shift from left to right dominance in lumbar lateral
      flexion was found in girls only.

PMID- 1740740
TI  - Trunk positioning accuracy in children 7-18 years old.
AB  - Trunk proprioception was measured in 253 healthy children 7-18 years of age using
      infrared markers placed on the back of the head and on the skin over the T1, T8,
      and S1 spinous processes. The children were tested for their accuracy in sensing
      return of the head and trunk to a centered, neutral position in the frontal
      plane. Whole-body sway was also quantified during 10 s of relaxed standing by
      measuring mean amplitudes of trunk marker and foot center of pressure (CP)
      movements. The results show that trunk positioning accuracy improved
      significantly with age (p = 0.000). Subjects could position their trunk in the
      frontal plane to within a mean (+/- SD) of 2.5 (+/- 1.1) and 0.9 (+/- 0.6)
      degrees of the neutral position at ages 7 and 18 years, respectively. No
      statistically significant gender differences were found. At every age trunk
      positioning accuracy was diminished in the presence of a continuous external
      trunk moment (equivalent to 0.01 x body weight x height), although not
      significantly so. Neither mean trunk sway nor CP amplitudes were significantly
      correlated with age or sex. The overall results suggest that spine decompensation
      is only abnormal when it exceeds 20 mm in healthy children and adolescents.

PMID- 1740741
TI  - Pattern analysis of electromyographic linear envelopes exhibited by subjects with
      uninjured and injured knees during free and fast speed walking.
AB  - We wished to determine whether anterior cruciate ligament (ACL) injury caused
      changes in patterns of activity of individual or groups of muscles that control
      the knee joint. The electromyographic (EMG) patterns of six muscles in 26
      individuals with uninjured knees and 20 individuals with ruptured ACL were
      studied during free and fast speed walking. A previously developed clustering
      technique was used for analysis. This technique involves making the Fourier
      transform of the average linear envelope (LE) of each muscle for each subject and
      using the amplitude and phase angles of the lower frequency harmonics as features
      to describe a pattern. These features are then grouped to subdivide the
      population of EMG patterns into different types. The results of analyses on
      single muscles showed that there exists a typical or "normal" pattern for each
      muscle which most uninjured and some injured subjects exhibit as well as several
      atypical patterns which mostly injured subjects exhibit, and that the atypical
      patterns are much more evident at fast walking speed. The characteristics of
      atypical patterns with respect to normal include time shifts in the peak of major
      phases of activity, the absence of a second phase of activity, and the existence
      of additional phases of activity. Synergy analysis showed that if one muscle has
      an atypical pattern, then several do; i.e., ACL injury induces major changes in
      the control strategy of the knee. The implications are that for rehabilitation
      programs one must focus on the training and strengthening of more than one
      muscle, and that for reconstructive procedures the changes in mechanics of the
      joint can possibly induce a significant change in its control strategy.

PMID- 1740742
TI  - Mechanical properties of microcallus in human cancellous bone.
AB  - Until now, the mechanical properties of the microcalluses that form in human
      cancellous bone have been unexplained. We measured the microhardnesses of
      microcalluses in cancellous bone, of the trabeculae within the microcalluses, of
      the trabeculae adjacent to microcalluses, and of trabeculae lacking microcalluses
      in a human tibia and femur. We observed no important differences between
      materials at the four different sites. Because the microhardness of bone is very
      closely related to its stiffness, this finding indicates that microcalluses are
      likely to stiffen the trabeculae in which they are formed, even though they may
      surround unhealed fractures of the cancellous trabeculae.

PMID- 1740743
TI  - Comparison of asymmetrical and symmetrical pulse waveforms in electromagnetic
      stimulation.
AB  - Pulsing electromagnetic field (PEMF) stimulation is a noninvasive therapeutic
      modality that has been successfully used to stimulate healing of surgically
      resistant human bone fracture nonunions. Asymmetry of the stimulus pulse waveform
      was thought to be necessary for therapeutic effectiveness, but asymmetrical
      pulses require significant electrical energy that constrains clinical delivery
      systems to suboptimal designs. Development of low-energy consuming stimuli will
      enable clinical device improvements and may provide additional information about
      the interaction of electromagnetic fields with tissues. The objectives of this
      study were (a) to determine if asymmetry of the stimulus pulse waveform is needed
      for efficacy and (b) to determine if symmetrical pulse waveform stimuli also can
      produce a beneficial therapeutic response. The rabbit fibular osteotomy model was
      used to answer these questions and to identify which components of the clinically
      used asymmetrical PEMF produce the therapeutic response. The results suggest that
      asymmetry is not necessary and that a narrow pulse width, symmetrical square wave
      signal can also stimulate stiffness increases in this model. The data also
      suggest that the high-amplitude, narrow-pulse portion of the asymmetrical PEMF is
      the principal component of the signal pulse that is responsible for the clinical
      therapeutic effect.

PMID- 1740744
TI  - The microstructural tensile properties and biochemical composition of the bovine
      distal femoral growth plate.
AB  - The tensile properties of distal femoral growth plates from 12-month-old cows
      were determined on uniformly prepared straight bone-growth plate-bone specimens
      (7 x 7 mm2 in cross-section) from predetermined anatomical sites on the physis.
      Each specimen was distracted to failure using a computer-controlled servo
      hydraulic testing machine at a strain rate of 0.004 s-1. It was found that the
      exponential constitutive law, using finite deformation formulation for strain,
      provides an excellent description of the stress-strain behavior of all the
      specimens up to the point of failure. The ultimate stress and both tangent moduli
      (i.e., the toe region tangent modulus and the tangent modulus calculated at 75%
      of ultimate strain) varied with anatomical site. The anterior region was the
      strongest, followed by the posterior/lateral. The anterior and posterior/lateral
      regions were also the stiffest, whereas the posterior/medial and center regions
      were the weakest and most compliant. The bone-growth plate-bone specimen
      exhibited a low ultimate strain (13.8% +/- 6%) that did not vary significantly
      throughout the growth plate. This result suggests that disruption of the physis
      may occur in vivo even at the lower distractions currently recommended for the
      clinical chondrodiatasis procedure for leg lengthening. The biochemical
      composition of the growth plate in the anatomical regions correlated well with
      the tensile properties. There was a greater collagen content in the regions that
      were the stiffest and strongest. The gross morphology of the growth plate of the
      bovine distal femur is also described in this study. There is a regular pattern
      to the undulations of the physis at several dimensional levels. Histologic
      findings showed that orientation of the hypertrophic cell columns and
      transphyseal septa are aligned nearly parallel to the longitudinal axis of the
      diaphyseal shaft. This column orientation is not affected by the undulation of
      the primary contour of the physis, which at certain locations may be inclined as
      much as 60 degrees relative to the diaphyseal axis. The orientation of the
      hypertrophic cell columns appears to be one of the dominant microstructural
      features influencing the tensile behavior of the bone-growth plate-bone
      specimens.

PMID- 1740745
TI  - Influence of continuous infusion of interleukin-1 alpha on the core protein and
      the core protein fragments of the small proteoglycan decorin in cartilage.
AB  - Decorin, a collagen-binding small proteoglycan, is considered to have a specific
      function in the organization or stability of the collagen network. Therefore,
      alteration of its molecular properties may be of pathophysiological relevance
      during the development of cartilage damage. It is shown here that normal
      cartilage from rabbit knee-joint contains glycosaminoglycan chain-bearing core
      protein fragments of 39, 23, and 18 kDa, each one amounting to approximately 5-6%
      of the intact decorin core protein. Continuous infusion of human recombinant
      interleukin-1 alpha for 14 days (200 ng/day) into a knee-joint led in condylar
      cartilage to a reduction in the amount of intact core protein from 2
      micrograms/mg wet tissue to about 1.1 micrograms/mg. The increase in its quantity
      found after infusion of heat-inactivated interleukin-1 was not statistically
      significant. The concentration of all three core protein fragments became reduced
      to a similar extent as the intact core protein under the influence of the
      cytokine, and additional fragments were not found. Surprisingly, there was a much
      smaller response to interleukin-1-treatment in patellar cartilage.

PMID- 1740746
TI  - Fixation stability of femoral components in a canine hip replacement model.
AB  - A canine hip replacement model was used to compare fixation stability in cemented
      and cementless femoral components. Parameters of comparison were the load-induced
      positional changes of each prosthesis relative to its proximal femoral cortex,
      hereafter called relative displacements. Identical femoral components, with the
      proximal third of their stem porous-coated, were implanted in the right femurs of
      10 large, mixed-breed dogs. Five were tightly fit to allow porous ingrowth, and
      five were cemented into the medullary canal. Four months after implantation, all
      femurs were harvested. A prosthesis was implanted in the left (normal) femur of
      each dog ex vivo with fixation identical to the contralateral limb to simulate
      acute postoperative fixation. Eddy current transducers measured relative
      displacements under application of static loads, serially applied in the axial,
      mediolateral, and craniocaudal directions. Thereafter, the femurs were
      transversely sectioned and morphologically analyzed to correlate bony apposition
      at the implant surface with relative displacements. We observed no difference in
      relative displacements between acute and 4-month-cemented groups (e.g., 0.0059 +/
      0.0021 vs. 0.0060 +/- 0.0048 mm, respectively, for 100-N axial loading measured
      at midstem). With cementless implantation, relative displacements of the acute
      group were significantly larger (p = 0.007) than those of the 4-month group
      (e.g., 0.236 +/- 0.257 vs. 0.097 +/- 0.129 mm, respectively, for 100-N axial
      loading measured at midstem). Cementless components implanted for 4 months were
      not significantly different than cemented components, but a trend suggested that
      they were still not as stable as cemented components, particularly for
      craniocaudal loads. Relative displacements of the 4-month, porous ingrowth group
      were approximately proportional to the percentage of bony apposition raised to
      the -1.44 power (r = 0.94).

PMID- 1740747
TI  - Comparative study of factors relating to HIV risk level of black homeless women.
AB  - A comparative study was conducted to assess factors that relate to level of HIV
      risk of black homeless women. The study examined whether 460 black women
      categorized as high, moderate, or low risk for HIV infection differed in
      environmental, demographic, and personal factors; appraisal of threat; resources;
      coping responses; and health outcome. Multivariate analyses of variance revealed
      high-risk homeless women reported statistically significant and greater concerns,
      appraisal of threat, emotion-focused coping, depression, and emotional distress,
      as well as less self-esteem and sense of coherence than moderate- and low-risk
      homeless women. Discriminant analyses revealed that women at high risk for HIV
      infection were best differentiated from moderate- and low-risk women by greater
      use of emotion-focused coping, greater severity of concerns, greater depression,
      and less self-esteem. An understanding of psychosocial factors most predictive of
      groups at highest risk for HIV infection provides impetus for interventional
      programs focused on altering the course of the disease in this population.

PMID- 1740748
TI  - Central nervous system manifestations in human immunodeficiency virus infection
      without AIDS.
AB  - To characterize neurological and neuropsychological findings associated with
      human immunodeficiency virus type-I (HIV) infection, 77 seropositive homosexual
      or bisexual males with no or minor symptoms of HIV were compared prospectively to
      44 HIV seronegative men by observers blinded to serological status of the
      subjects. Neurological symptoms and examination findings were not significantly
      different between seropositives and seronegatives except for cranial nerve
      findings, predominantly mild hearing impairment. Mean performance scores for a 15
      test neuropsychological battery were within an unimpaired range for both groups,
      although for five tests, mean scores were significantly poorer in seropositives.
      After adjustment for vocabulary score, and demographic and psychosocial
      variables, the mean score of seropositives was significantly worse only for the
      Benton Visual Retention Test. Magnetic resonance (MR) images of brain were
      abnormal in 14 (27%) of 52 seropositives and one of 10 seronegatives (value was
      not significant). HIV was isolated from cerebrospinal fluid (CSF) in 31 (61%) of
      51 seropositives. The only clinical or laboratory difference between CSF culture
      positives and negatives was a higher CSF immunoglobulin synthesis rate in the
      former subjects (medians of 10.3 versus 0.1 mg/day; p = 0.03). An additional 13
      seropositive subjects had immunologic evidence of central nervous system HIV
      infection, defined by a serum-to-CSF HIV antibody ratio of less than 5.5.
      Intracranial abnormalities on MR imaging were associated with CSF immunologic
      responses to HIV. Nervous system involvement occurred in the vast majority of men
      with early HIV infection, but clinically significant impairment was uncommon.

PMID- 1740749
TI  - Pharmacokinetics of single and chronic dose zidovudine in two HIV positive
      patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
AB  - The effect of continuous ambulatory peritoneal dialysis (CAPD) on zidovudine
      (ZDV) elimination was studied in two HIV-positive men. Serum and dialysate
      samples were collected after a single oral dose of 200 mg (patient 1) or 100 mg
      (patient 2) of ZDV, and again on at least one occasion during chronic therapy
      (100 mg every 8 h). Concentrations of ZDV and its glucuronide metabolite (GZDV)
      were measured by radioimmunoassay. ZDV serum half-lives on day 1 were 7.9 h
      (patient 1) and 2.6 h (patient 2). The apparent GZDV half-lives on day 1 were
      19.9 h (patient 1) and 7.1 h (patient 2), with resultant accumulation of
      metabolite (up to 36 micrograms/ml) during chronic therapy. At 14 h following
      single dose, 8.2 +/- 0.4% of dose was recovered in dialysate as GZDV; ZDV
      accounted for less than 0.6% of dose recovered in dialysate after both single and
      multiple dose. After the initial dwell (tau) following single dose, peritoneal
      clearances of ZDV were 4.3 ml/min (tau = 4 h, patient 1) and 5.9 ml/min (tau = 5
      h, patient 2), and GZDV clearances were 6.7 and 5.1 ml/min, respectively. ZDV
      serum protein binding was less than 10%. The small amount of unchanged ZDV
      removed by CAPD suggests that no supplemental doses are needed in HIV patients
      undergoing CAPD.

PMID- 1740750
TI  - Identification of HIV-1 envelope glycoprotein in the serum of AIDS and ARC
      patients.
AB  - Binding of the human immunodeficiency virus type 1 (HIV-1) external envelope
      glycoprotein (gp120) has been reported to alter the function and surface antigen
      expression of lymphocytes and monocytes in vitro. To determine whether these in
      vitro findings could be relevant in vivo, we searched for the presence of this
      antigen in the serum of patients with AIDS and the AIDS-related complex (ARC).
      Using an antigen capture enzyme-linked immunosorbent assay (ELISA) with
      polyclonal anti-gp120 antibody, we detected envelope antigens (gp160/120) in
      serum of 22 of 32 AIDS patients. In contrast, an ELISA using solid-phase
      recombinant CD4 to capture gp160/120 failed to detect any positives. A
      modification of the anti-gp120-based ELISA identified gp160/120-IgG immune
      complexes in all of 11 AIDS patients tested and in 4 ARC patients who were
      negative for gp160/120 antigen. We conclude that gp160/120, predominantly in the
      form of immune complexes, can be identified as circulating antigen in patients
      with AIDS. The potential pathogenic consequences of this antigenemia, its
      relation to soluble CD4 therapy, and its application as a clinical marker of
      disease merit further study.

PMID- 1740751
TI  - The completeness of AIDS surveillance.
AB  - AIDS surveillance data are widely used in setting HIV intervention policies, and
      the effectiveness of these data depend on their completeness. We reviewed studies
      conducted by state and local health departments on the completeness of AIDS
      reporting. These studies identified AIDS cases through alternate data sources,
      such as death certificates, hospital discharge records, disease registries, or
      medication records. In most instances greater than 80% of AIDS cases detected
      through these studies had been reported, although lower levels of reporting were
      found in some outpatient settings. A comparison of vital records and AIDS
      surveillance confirmed that AIDS surveillance is identifying 70-90% of all HIV
      related deaths in men 25-44 years of age. Historically, AIDS surveillance has
      emphasized reporting from hospitals. Efforts to maintain current levels of
      reporting, or to improve reporting, are challenged by the growth of the epidemic
      and by the increasing role of outpatient diagnosis of AIDS.

PMID- 1740752
TI  - A model for the AIDS epidemic in Mexico: short-term projections.
AB  - As in many developing countries, the AIDS epidemic in Mexico has become a major
      public health problem. Given the competition for scarce health resources in
      Mexico, where hospitals are overcrowded and care for AIDS patients is often
      unavailable, planning depends on accurate estimates of the incidence of AIDS and
      the prevalence of HIV-1 infection. This article presents estimates of AIDS
      incidence in Mexico corrected for delays in reporting and short-term projections
      based on the corrected AIDS incidence. Trends in incidence cannot be assessed
      without such correction because only about 50% of AIDS cases are reported within
      4 months of diagnosis. In addition to information on AIDS incidence, short-term
      projections also require estimates of the latency distribution between infection
      with HIV-1 and onset of AIDS. Latency periods with medians of 8 and 10 years lead
      to estimates that 22,000 and 24,000 new AIDS cases infected before June 1989 will
      be diagnosed between 1989 and 1994.

PMID- 1740753
TI  - Polymerase chain reaction in detecting HIV infection among seropositive infants:
      relation to clinical status and age and to results of other assays.
AB  - The polymerase chain reaction (PCR) for human immunodeficiency virus (HIV) was
      evaluated using coded blood specimens from infants whose clinical status is now
      known. A micromethod for the efficient isolation of mononuclear cells from small
      volumes of blood, and definitions of PCR positivity that took into account the
      number and purity of these mononuclear cells, were established in an attempt to
      define parameters for quality assurance. Results of HIV culture, p-24 antigen,
      and HIV-specific IgA obtained on the same specimens were compared to PCR results.
      PCR had a specificity of 100% among 83 specimens from 50 babies known to be
      uninfected. Sensitivity among 26 HIV-infected infants older than 3 months was 98%
      (44 of 45 specimens); the one negative specimen, which had also been culture
      negative, gave a positive PCR result on the remaining aliquot when tested after
      decoding. Among infected infants less than 3 months old, which is an age when
      diagnosis by other assays is most problematic, PCR identified 10 of 10 patients
      (10 of 11 specimens) including two younger than one month. Viral culture showed
      the best concordance with PCR; however, in three infants, positive PCR results
      were observed several months before positive results were observed by viral
      culture.

PMID- 1740754
TI  - Characteristics associated with HIV-1 infection in pregnant women in Brazzaville,
      Congo.
AB  - Maternal human immunodeficiency virus type 1 (HIV-1) infection in sub-Saharan
      Africa is a major public health concern because of the high prevalence among
      women of childbearing age and the poor prognosis for perinatally infected
      children. Characteristics associated with HIV seroprevalence were studied in a
      population of 1,833 pregnant women seen in two large mother-child clinics in
      Brazzaville, Congo. The prevalence of HIV infection was 3.9% (95% confidence
      interval, 3.0-4.9%) and differed significantly according to the district of
      residence, marital status, duration of the relationship with the current partner,
      number of sexual partners in the year prior to pregnancy, number of living and
      dead children, and history of blood transfusion and/or hospitalization. Logistic
      regression analysis identified six significant factors independently associated
      with seropositivity; age, history of blood transfusion and/or hospitalization,
      district of residence, duration of the relationship, number of living children,
      and number of decreased children. However, the predictive value of the model was
      poor: while 80% of the truly positive women were correctly predicted positive by
      the model, 50% of the truly negative women were misclassified. Among pregnant
      women attending these clinics it is therefore difficult to identify a subgroup at
      risk toward which specific actions could be targeted.

PMID- 1740755
TI  - Improved detection of HIV-2 DNA in clinical samples using a nested primer-based
      polymerase chain reaction.
AB  - A two-step polymerase chain reaction (PCR), with four double (nested) primer
      pairs, used for the detection of HIV-2 in clinical samples is described. With
      these four nested primer pairs we could detect HIV-2 DNA in 17 of 17 virus
      isolates and in blood mononuclear cell samples from 31 of 37 (83.7%) seropositive
      individuals after ethidium bromide staining of the amplified DNA. The nested
      primer PCR was also compared with a single primer pair-based PCR followed by
      hybridization. The sensitivities of the two methods were almost equal, but the
      nested primer PCR offered obvious technical advantages.

PMID- 1740756
TI  - Autologous HIV-1 neutralizing antibodies: emergence of neutralization-resistant
      escape virus and subsequent development of escape virus neutralizing antibodies.
AB  - The capacity of consecutive human sera to neutralize sequentially obtained
      autologous virus isolates was studied. HIV-1 was isolated three times over a 48
      164-week period from three individuals immediately after seroconversion and from
      two individuals in later stages of infection. Development of neutralizing
      antibodies to the primary virus isolates was detected 13-45 weeks after
      seroconversion. Emergence of escape virus with reduced sensitivity to
      neutralization by autologous sera was demonstrated. The patients subsequently
      developed neutralizing antibodies against the escape virus but after a delay.
      Titers of neutralizing antibodies against late virus isolates were generally low
      compared to initial neutralizing titers against primary virus isolates. The delay
      in appearance of neutralizing antibodies to the dominant viral strain at any time
      in the patient and the emergence of neutralization resistant escape virus may be
      part of the explanation of the apparent failure of the immune system to control
      HIV infection.

PMID- 1740757
TI  - An amino-terminal amino acid affects the electrophoretic mobility of the HIV-1
      nef protein.
AB  - The nef protein of the BH8 clone derived from the IIIB isolate of human
      immunodeficiency virus 1 (HIV-1) has a molecular weight of 27,000, whereas that
      produced by a clone of the BRU strain of HIV-1 appears to have a molecular weight
      of 24,800. To determine the basis for this difference in molecular weight, a
      series of recombinant nef genes were made in which segments of the BH8 and BRU
      nef coding sequences were exchanged. The region of amino acids 35-74 caused
      mobility shift. In this region, the BH8 and BRU proteins differ by a single amino
      acid at position 54. Residue 54 of BH8 nef is an aspartic acid, whereas that of
      BRU is alanine. Reciprocal changes in the sequences of BH8 and BRU nef were made
      by site-directed mutagenesis. The results show that substitution of aspartic acid
      at residue 54 of BH8 to alanine results in a protein that has a molecular weight
      of 25,000, and substitution of the alanine at position 54 of BRU to aspartic acid
      results in synthesis of a 27-kDa protein. These results show that a change in
      amino acid 54 of the HIV-1 nef protein dramatically affects the electrophoretic
      mobility of the protein. Nef proteins that contain an aspartic acid at residue 54
      migrate as 27-kDa proteins, whereas those that contain alanine at residue 54
      migrate as 25-kDa proteins.

PMID- 1740758
TI  - Instability of HIV sequences in high copy number plasmids.
AB  - Plasmid proviral molecular clones of the LAI isolate of HIV-1 and the ROD isolate
      of HIV-2 were originally prepared in moderate copy number plasmids derived from
      pBR322, which contains the colE1 origin of replication. In these plasmid vectors,
      the HIV sequences are stable to continuous passage in bacteria. However, when the
      colE1 origin was replaced by the mutant origin from pUC18, pGEM, or pBluescript
      plasmids, which replicates to much higher copy numbers in bacteria, then
      deletions of HIV sequences occurred even in RecA defective strains. Deletions
      occurred in two different media, at room temperature and 37 degrees C, and with
      or without plasmid amplification in the presence of chloramphenicol. These
      results raise a cautionary note when cloning immunodeficiency viral sequences
      into plasmid vectors containing a high copy number origin of replication.

PMID- 1740759
TI  - Prevalence of HIV infection among prostitutes in Benin (West Africa)

PMID- 1740760
TI  - HIV-2 infection in Cameroon: no evidence of indigenous cases.

PMID- 1740761
TI  - Natural disease--unnatural cause.

PMID- 1740762
TI  - A health hazard assessment in school arts and crafts.
AB  - Unlike the cautious attitude being exercised toward generic chemicals, an off
      guard behavior is often observed toward the same chemicals once they are
      recognized as a "common daily item." Students and instructors of arts and crafts
      classes alike are often unaware of the potential risks from exposure to some of
      the arts and crafts materials they use due to either the false security of
      "common daily item" or the lack of specific knowledge of the hazardous
      ingredients in those products. This unawareness of potential health hazards could
      lead to improper handling of these materials and result in unnecessary health
      risk during their use. A three-year study of college arts and crafts class
      students indicates a high incidence of allergic reactions among attending
      students for exposure of less than 70 hours within a period of 7 weeks. A self
      evaluation method is developed to identify and minimize these health hazards
      associated with arts and crafts classes. This checklist of 15 pertinent
      parameters covers identifiable hazardous areas and situations in arts and crafts
      classrooms. Record keeping and promotion of student awareness are also addressed,
      so that instructors and students in an arts and crafts class can more readily
      recognize actual or potential hazards and act to prevent them.

PMID- 1740763
TI  - Health hazards associated with the cyanotype printing process.

PMID- 1740764
TI  - Industrial hygiene survey in a university art department.
AB  - Analysis of air samples indicated that concentrations of respirable free silica
      from sandblasting equipment used inside an unventilated painting room greatly
      exceeded the current OSHA standard and NIOSH recommended criteria. Lack of
      ventilation in the design materials studio resulted in excessive wood dust
      concentrations; levels averaged 29 mg/m3 which was well above the evaluation
      criteria of 5 mg/m3. Noise levels measured in the woodworking area of the design
      materials studio, and near the melting furnace located in the foundry of the
      ceramics studio, exceeded the 100-dBA limit recommended by NIOSH for a 2 hr
      continuous exposure. Lack of proper ventilation in the design materials painting
      room and in the printmaking darkroom resulted in exposures to toxic
      concentrations of toluene (from spray painting) and methyl cellosolve acetate
      (from KPR photo etching chemicals). Results of atmospheric sampling indicate that
      exposure to wood dust, crystalline silica, methyl cellosolve acetate, and toluene
      were excessive, and capable of producing both acute and long term health effects.

PMID- 1740765
TI  - The first art hazards course.

PMID- 1740766
TI  - A waste disposal program for a university art department.
AB  - With the introduction of hazardous waste regulations on May 19, 1980, many of the
      wastes generated and disposed of by university art departments are now considered
      hazardous wastes by law. Pollution Control, an operational department within
      Southern Illinois University, Carbondale, charged with the environmental
      compliance of the University, has developed a hazardous waste management program
      for the safe and proper disposal of these wastes. Wastes that can pose a threat
      not only to the artist, but also to the disposer of the wastes and the
      environment, are included in this program to prevent haphazard or indiscriminate
      disposal. Major functions of the program include identification of such wastes,
      collection, storage, treatment, and, finally, environmentally safe disposal of
      the waste.

PMID- 1740767
TI  - Hepatocellular injury induced by chronic low-dose CCl4 in spontaneous and renal
      hypertensive rats: a correlation to the reversal of experimental rat hypertensive
      models.
AB  - Renal hypertension has been reduced to normal levels in the rat with subcutaneous
      injections of carbon tetrachloride (CCl4). Previous light microscopic evaluation
      of liver sections demonstrated varying degrees of hepatocellular and hepatic
      parenchymal injury secondary to CCl4 administration. In normotensive rat
      populations, saline injections have been shown not to cause hypertension, and the
      treatment of normal rats with subcutaneous CCl4 did not change their blood
      pressure over that of noninjected controls. In this study we compare the extent
      of blood pressure reduction with the degree of CCl4-induced liver injury in the
      renal-induced, spontaneous hypertensive rat (SHR), and normotensive rat.
      Statistically significant blood pressure reduction followed CCl4 injection of
      renal (p less than .01) and SHR (p less than .001) hypertensive animals. The
      morphological liver injury appeared most sensitively reflected in hepatocellular
      nuclear atypia. The SHR animals were the most resistant to CCl4 liver damage by
      chronic CCl4 treatment. There was no measurable effect of CCl4 treatment on the
      animals as assessed by their activity, rate of development and weight gain. The
      degree of blood pressure reduction due to CCl4 treatment in the SHR animals was
      similar to that previously reported in DOCA and renal-induced hypertensive
      animals.

PMID- 1740768
TI  - Protective and therapeutic efficacies of protein A on 7,12
      dimethylbenz(alpha)anthracene-induced rat mammary adenocarcinoma.
AB  - Protein A of Staphylococcus aureus Cowan I is a powerful immunostimulating agent.
      Female Swiss Portan rats fed 7,12-dimethylbenz(alpha)anthrancene (DMBA) exhibited
      increased serum alkaline phosphatase activity, which returned to normal levels
      following eight weeks of treatment with 12 micrograms protein A subcutaneously.
      Protein A reduced the potential of tumor induction by DMBA as observed by the
      noninduction of tumors until three months after discontinuation of protein A
      administration. The total leukocyte count was not affected. Protein A treatment
      for six weeks of DMBA-induced mammary adenocarcinoma-bearing rats caused the
      increased serum alkaline phosphatase activity to decrease but not to normal
      levels, indicating regression but no disappearance of the tumors. The total
      leukocyte count of the tumor bearers was stimulated by protein A and increased 24
      hours after protein A administration; however, in the fourth week of treatment it
      returned to normal levels. The leukocytosis suggests that protein A could cause
      tumor necrosis by an inflammatory reaction, edema, and cell destruction and thus
      tumor regression.

PMID- 1740769
TI  - The biosynthesis of polyketide-derived mycotoxins.
AB  - The biosynthesis of a few representative polyketide-derived mycotoxins is
      reviewed: patulin, citrinin, diplosporin, ochratoxin A, maltoryzine,
      xanthomegnin, cytochalasans, ergochromes, zearalenone, citreoviridin, and the
      aflatoxins. Particular attention is given to the biosynthetic sequence: acetate--
      -averufin----versiconal acetate----versicolorin A----sterigmatocystin---
      aflatoxin B1.

PMID- 1740770
TI  - Detoxification of aflatoxin-polluted peanut cakes with monomethylamine/Ca(OH)2:
      pilot industrial application, nutrition experiments, toxicity evaluation.
AB  - The process described has been studied up to an industrial pilot scale. In this
      article this article we summarize the basic knowledge on the process and the
      technological conditions of pilot application for detoxifying peanut cakes
      polluted by up to 3,500 ppb Aflatoxine (2,300 ppb B1). The nutritional
      experiments carried out on rats and other mammals are described, and the
      toxicological and biochemical evaluation of the cakes on Bacillacea are reported
      and discussed. The data collected show that the MMA/Ca(OH)2 process offers
      promising possibilities for industrial application on the basis of technological
      and economic criteria, as well as from the point of view of efficiency and
      safety.

PMID- 1740772
TI  - Desert Storm 1991: orthopaedic related surgical injuries.

PMID- 1740771
TI  - Lead poisoning from art restoration and pottery work: unusual exposure source and
      household risk.
AB  - Two cases of lead poisoning following exposures in the arts and crafts
      environment are presented. The first illustrates the impact of an unusual
      exposure source experienced by a female art conservator while restoring an
      antique Peruvian tapestry from the Chancay Period (A.D. 1000-1500). The second
      demonstrates the extension to the artist's family members of a lead hazard
      associated with pottery work. Noted were a wide spectrum of clinical and
      biochemical abnormalities, ranging from severe neurological and gastrointestinal
      symptoms to subtle alterations in the biosynthetic pathway of heme. Marked
      elevation of the blood lead level (up to 130 mcg/100 mL) was found in the most
      severe case of lead poisoning. The cases illustrate the need for industrial
      hygiene measures in this type of work in order to prevent lead intoxication, both
      in the adult artist and children in the household. However, in some instances of
      increased lead absorption in persons with lead-related hobbies, sources other
      than those associated with arts and crafts should be investigated. This
      alternative is illustrated by a third case, in which firearms training was the
      more likely source of excessive exposure. Multiple occupational factors must
      occasionally be considered in evaluating increased lead absorption.

PMID- 1740773
TI  - Re: Below-knee amputee gait with dynamic elastic response prosthetic feet: a
      pilot study.

PMID- 1740774
TI  - Design and evaluation of a sensory feedback system that provides grasping
      pressure in a myoelectric hand.
AB  - Providing accurate sensory information to the individual with a myoelectric limb
      is of great importance for improving device use in a wide variety of tasks. A
      number of feedback systems presently being investigated rely on either
      vibrotactile or electrotactile skin stimulation, which does not provide sensory
      patterns similar to those in a natural grasping hand. A prototype system was
      developed to enhance sensory information transfer by using a technique in which
      the feedback modality (pressure) was the same as the grasping pressure. The
      present study compared the developed system (pressure) with vibrotactile
      feedback, vision, and compounds of these three modes. It was found that the
      pressure-pressure concept reduced grasping pressure replication errors and error
      variability.

PMID- 1740775
TI  - A portable insole plantar pressure measurement system.
AB  - To analyze plantar pressures during activities of daily living, one needs a fully
      portable system capable of measuring many steps over extended periods. This paper
      presents an inexpensive, reliable, portable plantar pressure acquisition system
      which we have developed. It allows the long-term recording (up to 2 hours) of
      pressure-time data from 14 pressure sensors within insoles. The sensor chosen is
      an inexpensive, conductive polymer sensor that is only 0.25 mm thick yet able to
      withstand sudden overloads. The portable, battery-powered, microprocessor-based
      data acquisition system has a memory space of 480 kbytes for data storage. It can
      collect pressure data from 14 insole sensors at a 20 Hz sample frequency for 5
      seconds every minute over a 2-hour period. It enables the long-term measurement
      of plantar pressures during normal activities in a natural unrestricted
      environment. The design and development of this portable insole plantar pressure
      measurement system is described.

PMID- 1740776
TI  - Development of an automated wheelchair guided by a magnetic ferrite marker lane.
AB  - An automated wheelchair with a guide sensor, guided by a magnetic ferrite marker
      that is resistant to the presence of dirt, is described. The wheelchair permits
      the severely disabled, as well as the older population, to move about freely,
      both indoors and outdoors. This is due to the simple operation involved (pushing
      a button), and a magnetic ferrite marker lane which is minimally influenced by
      dirt or other nonmagnetic materials. For increased comfort, a nonlinear signal
      processing circuit and pulse-steering drive method have been developed to provide
      a smooth running operation. In addition, a function that provides for stopping at
      desired destinations has been added for convenience, and a collision prevention
      function using infrared sensors has been added for safety.

PMID- 1740777
TI  - Safety studies with the University of Melbourne multichannel electrotactile
      speech processor.
AB  - Results of safety investigations conducted as an integral part of the development
      of a multichannel electrotactile speech processor (Tickle Talker) are reported.
      Electrical parameters of the stimulus waveform, design of the electrode handset
      and cabling, and the electrical circuitry of the speech processor/stimulator and
      programming interface have been analyzed for potential risks. Constant current
      biphasic square pulses delivered to electrodes positioned on the skin surface
      over the digital nerve bundles were chosen to optimize the safety, comfort, and
      function of the electrotactile stimulus. The device was battery-powered, and the
      user circuit was isolated from earth-referenced sources. Each electrode was
      isolated by capacitive coupling, preventing DC leakage of current to the user
      circuit. Studies of finger temperature showed slight cooling of the skin on the
      fingers of both stimulated and unstimulated hands for individual subjects
      following electrotactile stimulation through the Tickle Talker. Subsequent
      analysis of finger and hand vascular circulation in five subjects showed slight
      reductions in hand blood flow in some individuals. The results did not
      demonstrate a significant mean decrease in hand or finger blood flow following
      electrotactile stimulation. No evidence of sympathetic involvement was found, nor
      were any changes in vascular structure of the hand such as those associated with
      Raynaud's disease found. Evidence suggests that the decrease in temperature found
      in the initial study may be due to a change in the ratio of blood flow between
      arteriovenous anastomoses and nutritive capillary beds. Studies of: 1) changes in
      mean threshold and comfortable pulse widths over time; and, 2) changes in tactual
      sensitivity as measured by hot/cold, sharp/dull, and two-point difference limen
      discrimination, did not detect any systematic change in peripheral nervous system
      function following electrotactile stimulation. Analysis of electroencephalogram
      (EEG) recordings taken during electrotactile stimulation, and after relatively
      long periods of experience with the device did not show any pathological changes
      which might be associated with epileptic foci. In summary, no contraindications
      to long-term use of the Tickle Talker were detected in the studies performed.

PMID- 1740778
TI  - Speech recognition performance on a modified nonsense syllable test.
AB  - A modification of the City University of New York nonsense syllable test (CUNY
      NST) has been developed in which (a) the several subtests of the original test
      are replaced with a 22-item consonant-vowel (CV) subtest and a 16-item vowel
      consonant (VC) subtest; and, (b) the response choices for each target syllable
      include all 22 initial and all 16 final consonants, respectively. In addition,
      the test tokens are presented as isolated syllables without a carrier phrase.
      These changes enable the resolution of confusions not possible on the original
      NST, and also the construction of a single confusion matrix each for CVs and VCs,
      respectively. The modified nonsense syllable test (MNST) provides results that
      compare favorably to those of the original NST.

PMID- 1740779
TI  - Effect of functional bracing, quadriceps and hamstrings on anterior tibial
      translation in anterior cruciate ligament insufficiency: a preliminary study.
AB  - Anterior tibial translation was measured in six patients with anterior cruciate
      ligament insufficiency. The tests were done in 15, 45, and 90 degrees of knee
      flexion, partly with activated quadriceps or hamstrings, and partly with subjects
      wearing a 4-point functional DonJoy brace. The translation was evaluated with a
      computerized electrogoniometer (Acufex KSS). The anterior tibial translation was
      significantly reduced by use of the hamstrings in all three degrees of knee
      flexion. The effect of the 4-point brace was only significant in 15 and 45
      degrees of flexion. The quadriceps did not reduce the anterior tibial
      translation.

PMID- 1740780
TI  - Epithelial respiratory cells from cystic fibrosis patients do not possess
      specific Pseudomonas aeruginosa-adhesive properties.
AB  - Nasal polyp cells in primary culture from cystic fibrosis (CF) and non-CF
      patients were compared for the ability to bind Pseudomonas aeruginosa cells and
      for the presence of sulphated glycoconjugates at the epithelial cell surface.
      Quantitation of bacterial adhesion, by scanning electronmicroscopy, showed no
      significant difference between the cells cultured from CF and non-CF patients.
      Micro-organisms associated with ciliated cells were mainly aggregated, in
      contrast with those from non-ciliated cells. Sulphated glycoconjugates were
      identified on cells cultured from both CF and non-CF patients, regardless of
      whether or not these cells had attached bacteria. A matrix-like material that
      surrounded the aggregated bacteria was more prominent on cells cultured from CF
      patients than on those from non-CF patients. The interaction of aggregated P
      aeruginosa cells with polyp cells cultured from both CF and non-CF patients
      appeared to occur by means of this matrix material. Our findings suggest that
      chronic colonisation of the airways of CF patients cannot be explained by an
      increased affinity between the P. aeruginosa cells and the respiratory cell
      surface receptors in the CF patient. Nevertheless, the in-vitro observation that
      the matrix surrounding the bacteria reacted with a monoclonal antibody against
      respiratory mucins allows us to speculate that increased mucin secretion by cells
      from CF patients might, in vivo, play a decisive role in the interaction between
      P. aeruginosa and the respiratory epithelium.

PMID- 1740781
TI  - The protective activity of immunostimulants against Listeria monocytogenes
      infection in mice.
AB  - The function of peritoneal macrophages induced by intraperitoneal (i.p.)
      injection of attenuated Streptococcus pyogenes (OK-432), Bacillus Calmette Guerin
      (BCG), protein-bound polysaccharide preparation isolated from Coriolus vesicolor
      (PSK) or Lactobacillus casei was examined. The PMA-triggered respiratory burst
      (production of O2- and H2O2) of macrophages induced by OK-432, BCG or Lac. casei
      was greater than that of resident or thioglycollate-stimulated macrophages and
      was similar to that of BCG-activated macrophages. PSK failed to enhance the
      production of O2- or H2O2 by macrophages. Alkaline phosphodiesterase (APD)
      activity was reduced in macrophages induced by OK-432, BCG or Lac. casei
      injection and in BCG-activated macrophages. The APD activity of macrophages
      obtained 7 and 13 days after i.p. injection of PSK was elevated, as with
      thioglycollate-stimulated macrophages. Listericidal activity in vitro was
      enhanced in macrophages obtained in 13 and 7 days, but suppressed in macrophages
      obtained 2 days after OK-432, BCG or Lac. casei injection. Lac. casei
      administered either 2 or 13 days before infection with Listeria monocytogenes was
      protective but OK-432, BCG (0.1 mg) and PSK were not, even though they were able
      to stimulate macrophage function.

PMID- 1740782
TI  - Congenital bacterial sepsis in very preterm infants.
AB  - The results of body fluid and surface cultures from 148 preterm infants less than
      33 weeks gestational age obtained routinely on admission to a neonatal intensive
      care unit were reviewed. The aim was to determine the occurrence of congenital
      bacterial sepsis in this population and to examine whether surface cultures
      yielded information helpful in management. Gastric aspirate and umbilical, nasal
      and ear swabs were cultured and the results were compared to those of blood
      cultures. Nine infants (5.4%) had congenital bacterial sepsis diagnosed by
      positive blood cultures. Only the results of microscopy of gastric aspirate were
      available within hours of birth and before the results of blood culture.
      Microscopy of gastric aspirate, demonstrating pus cells, alone had a sensitivity
      of 0.86 in predicting congenital sepsis but a specificity of 0.49; the
      specificity, however, rose to 0.80 if both organisms and pus cells were observed
      on microscopy. Thus, only this combination was a useful pre-indicator of
      congenital sepsis. In infants who did not develop septicaemia, treatment was
      modified only if Streptococcus agalactiae was cultured from surface sites; in all
      such cases, the organism was grown from the ear swab. Our results demonstrate
      that congenital bacterial sepsis is common amongst very preterm infants admitted
      for neonatal intensive care but routine screening of surface cultures should be
      restricted to an ear swab only.

PMID- 1740783
TI  - Diagnostic significance of circulating immune complexes in patients with
      pulmonary tuberculosis.
AB  - A polyethylene glycol (PEG) precipitation method was used to examine sera of
      patients with active pulmonary tuberculosis (PT), leprosy and non-tuberculous
      pulmonary diseases and of healthy control subjects for immune complexes (ICs).
      Mycobacterium tuberculosis antigen 5 was detected in the ICs in 80% of patients
      with PT by the indirect (sandwich) enzyme-linked immunosorbent assay (ELISA).
      Detection of mycobacterial antigen in ICs has diagnostic potential as an adjunct
      in the laboratory diagnosis of PT, particularly when repeated bacteriological
      investigations for M. tuberculosis in clinical specimens are negative. Levels of
      ICs tend to decrease with the duration of anti-tuberculosis chemotherapy and
      their detection can also be used to assess the clinical response to therapy in
      patients with PT.

PMID- 1740784
TI  - Factors affecting production of the group A streptococcus bacteriocin SA-FF22.
AB  - Factors influencing the production of streptococcin A-FF22 (SA-FF22) in liquid
      media were examined. Despite good growth of the producer strain, no SA-FF22 was
      detected during incubation at 40 degrees C, at pH 7, in Brain Heart Infusion
      Broth or in Mg(2+)-supplemented media. Optimal SA-FF22 production occurred at 32
      degrees C, at pH 6.7, in cultures in Tryptic Soy Broth supplemented with glucose
      2.25% and yeast extract 1%. Under these conditions SA-FF22 remained cell
      associated but could be extracted with acid.

PMID- 1740785
TI  - Use of antibiotics in veterinary practice.

PMID- 1740786
TI  - An experimental evaluation of the pharmacokinetics of fusidic acid in peritoneal
      dialysis.
AB  - Fusidic acid, an antimicrobial agent with activity against coagulase-positive and
      coagulase-negative staphylococci, has considerable potential for the management
      of staphylococcal peritonitis associated with continuous ambulatory peritoneal
      dialysis (CAPD). Whether fusidic acid reaches therapeutic levels in the dialysate
      once therapeutic serum levels have been achieved is not known. An animal model of
      CAPD that reproduced essential features of the clinical procedure was used to
      investigate this issue. Although oral administration was the preferred route,
      fusidic acid is not absorbed from the gastrointestinal tract of laboratory rats,
      and a subcutaneous injection of diethanolamine fusidate was used to achieve serum
      levels of the agent equivalent to those achieved clinically in man. In this
      model, fusidic acid concentrations up to 28 times the MIC for staphylococci were
      found in the dialysate when therapeutic levels of the agent were reached in the
      serum. The data provide support for continued experimental and clinical
      evaluation of the role of fusidic acid in CAPD-associated peritonitis.

PMID- 1740787
TI  - Induction of the SOS gene (umuC) by 4-quinolone antibacterial drugs.
AB  - Induction by the 4-quinolone group of antibacterial drugs of the umuC gene, the
      SOS function most involved in error-prone DNA repair (together with umuD), was
      assessed in a strain of Escherichia coli harbouring a umuC::lacZ gene fusion. All
      4-quinolones tested induced this umuC::lacZ fusion, with maximum induction at 4
      quinolone concentrations close to their minimum inhibitory concentrations for
      this strain, and the SOS Inducing Potential (SOSIP) was closely related to
      antibacterial activity. Mitomycin C, a known mutagen, was a slightly better
      inducer (in terms of SOSIP) than any of the quinolones. In contrast, induction by
      4-quinolones of the sfiA (sulA) gene, an SOS function involved in cell division
      inhibition, was better than induction by mitomycin C in an E. coli strain
      harbouring an sfiA::lacZ gene fusion. The umuC gene fusion was induced at lower
      concentrations of 4-quinolone than was the sfiA gene fusion.

PMID- 1740788
TI  - Incidence of an aminoglycoside 6'-N-acetyltransferase, ACC(6')-1b, in amikacin
      resistant clinical isolates of gram-negative bacilli, as determined by DNA-DNA
      hybridisation and immunoblotting.
AB  - Seventy amikacin-resistant clinical isolates of gram-negative bacteria belonging
      to nine genera were examined by immunoblotting and by DNA-DNA hybridisation for
      the presence of ACC(6')1b enzyme, previously called AAC(6')-4, or its encoding
      gene aacA1b. The organisms mostly had resistance profiles compatible with AAC(6')
      production and were from South and North America, the Far East and Europe.
      Polyclonal (rabbit) anti-AAC(6')-1b antisera and an intragenic aacA1b (aacA4)
      probe derived from the multiresistance plasmid pAZ007 were used. The aacA1b gene
      was found to be widespread. Positive hybridisation, and immunologically cross
      reactive proteins, were observed in 44% of the isolates examined. They were
      present most frequently (greater than or equal to 70%) in isolates of Klebsiella,
      Escherichia and Enterobacter spp., but less often (less than or equal to 25%) in
      Serratia, Citrobacter, Acinetobacter and Pseudomonas spp. The strains that
      reacted with the probe produced enzymes that varied in their apparent mol. wts
      between c. 24,000 and 26,000. The existence of multiple electrophoretic forms of
      amikacin-acetylating enzymes of the ACC(6')-1b type may be useful in
      epidemiological surveys of AAC(6')-mediated amikacin resistance.

PMID- 1740789
TI  - An investigation of beta-lactamases from clinical isolates of Bacteroides
      species.
AB  - Among a group of 116 clinically significant isolates of Bacteroides spp., 24
      exhibited beta-lactamase activity greater than the basal level characteristic of
      most Bacteroides strains. Investigation of specific enzyme activity, iso-electric
      point and enzyme inhibition profiles revealed that the beta-lactamases involved
      could be divided into four groups, some showing similarity to those described in
      previous studies. Seven of the enzymes were able to hydrolyse cefoxitin,
      latamoxef or imipenem, and eight enzymes degraded penicillin in the presence of
      clavulanic acid. Five strains showed reduced susceptibility to cefoxitin,
      latamoxef or imipenem which was not associated with beta-lactamase activity.

PMID- 1740790
TI  - The rectal mucosa-associated microflora in patients with ulcerative colitis.
AB  - The rectal mucosa-associated flora (MAF) of patients with ulcerative colitis has
      been studied in 25 patients with newly diagnosed disease, 20 with relapse of
      existing disease, and 44 who were in remission. Patients with active disease were
      re-examined twice during treatment. The MAF was simpler and less dense than the
      microflora of faeces. Obligate anaerobes usually predominated in the MAF although
      the ratio of obligate anaerobes to facultative species was lower than that found
      in faeces. Viable counts of the total flora and of its constituent genera varied
      considerably between patients. Counts of the total flora, of obligate anaerobes
      (including bifidobacteria, eubacteria and clostridia), and facultative organisms
      and micro-aerobes (enterobacteria and lactobacilli) were reduced in patients with
      active disease compared with those with inactive disease; corresponding carriage
      rates were also lower. Counts and carriage rates increased during treatment and
      approached those found in quiescent disease. The alterations in the MAF were
      especially marked in patients experiencing their first attack of ulcerative
      colitis. The relationship between these alterations and the aetiology and
      pathogenesis of this disease remains unclear.

PMID- 1740791
TI  - Percutaneous tracheostomy after trauma and critical illness.
AB  - A method of percutaneous tracheostomy (PT) using a tracheostome, which permits
      insertion of a full-sized cuffed tracheostomy tube, was evaluated in 61
      critically ill or injured patients (89% had trauma). Of the 54 trauma patients,
      65% had brain injuries, 14% had injuries to the cervical spinal cord, 33% had
      face or jaw injuries, and 15% had lung injuries. The indications for PT were coma
      (46%), acute airway obstruction (5%), face or jaw injury (20%), pneumonitis
      (39%), adult respiratory distress syndrome (12%), and sepsis (21%). Tracheostomy
      was done in 51% of all cases specifically for managing pulmonary secretions, in
      37% for prolonged intubation, and in 25% for neurologic lesions. The tracheostomy
      was done as an emergency in 5%, as urgent in 28%, and electively in 77%.
      Percutaneous tracheostomy was successful in 90% of the cases, and in 8% it was
      converted to a surgical tracheostomy after an initial percutaneous attempt. In
      46% it was performed at the bedside, in 46% in the operating room, and in 7% in
      the emergency suite. A full-sized tracheostomy tube (#6 to #8) was used in all
      cases and was considered optimal or larger than needed in 87% of cases. With
      three exceptions the complications of PT were minor, but 30% of the patients died
      of their primary disease. In one case death occurred because of bronchospasm and
      cardiac arrest during the PT, but appeared to be independent of the type of
      tracheostomy. Healing after in-hospital removal (37%) was excellent in 95% of
      cases and 97% of physicians indicated that they would use the device again.

PMID- 1740792
TI  - A study of the relationship among survival, gut-origin sepsis, and bacterial
      translocation in a model of systemic inflammation.
AB  - Several factors, including uncontrolled inflammation, gut barrier failure, and
      sepsis, have been implicated in the development of multiple organ failure. To
      investigate the relative importance and interrelationships among some of these
      factors, increasing doses of the inflammatory agent zymosan were used to induce a
      systemic inflammatory state in mice. At nonlethal doses (0.1 and 0.5 mg/g body
      weight), zymosan caused injury to the intestinal mucosa, increased intestinal
      xanthine oxidase activity, and promoted bacterial translocation in a dose
      dependent fashion. Inhibition or inactivation of xanthine oxidase activity was
      effective in reducing mucosal injury and bacterial translocation when zymosan was
      injected at 0.1 mg/g but not at 0.5 mg/g body weight. At a dose of 1 mg/g, the
      lethal effects of zymosan appeared to be related to gut-origin sepsis, since
      cefoxitin (1 mg/g) reduced the seven-day mortality rate from 100% to 20% (p less
      than 0.01). However, at a zymosan dose of 2 mg/g, antibiotics did not improve
      survival. Zymosan thus induced gut barrier failure and systemic infection in a
      dose-dependent fashion. Additionally, the mechanism of zymosan-induced bacterial
      translocation and the relationship of gut-origin sepsis to survival appeared to
      be related to the magnitude of the inflammatory insult (the dose of zymosan).

PMID- 1740793
TI  - Bacterial translocation and multiple system organ failure in bowel ischemia and
      reperfusion.
AB  - Forty dogs were divided randomly into four groups. The portal circulation was
      reduced to 50%-60% for one hour by partially occluding the superior mesenteric
      artery (SMA) for the purpose of determining the relationship between the
      reperfusion injury, bacterial translocation, and multiple system organ failure.
      Escherichia coli 0111 B4 (1 x 10(10)/kg) was fed to each animal 12 hours before
      operation. Group I constituted the controls, in which a sham operation was done.
      The experimental procedure was completed in all the animals of the other three
      groups. The group-II animals received no further manipulation. Rubia yunnanensis,
      an antioxidant, was given to the animals in group III. Amikacin was given to the
      animals in group IV. The results showed that the animals in group II developed
      bacteremia, hypoxemia, and hypotension compared with the animals in group I. The
      levels of superoxide dismutase (SOD) in whole blood were markedly lowered in
      group-II animals, with malondialdehyde (MDA) values significantly elevated after
      reperfusion when compared with group I. Plasma levels of anaphylatoxin C5a and
      thromboxane B2 (TXB2) were significantly raised in group-II animals beginning
      from reperfusion when compared with the animals in group I, group III, and group
      IV. Pathologic changes in the intestine, liver, and lung were marked only in the
      group-II animals, including acute necrosis of the intestinal mucosa, granulocyte
      infiltration, and bacterial invasion of the liver and lung. These results
      suggested that bowel ischemia and reperfusion may promote gut barrier failure and
      bacterial translocation, then contribute to the development of MSOF by allowing
      bacteria or endotoxin normally contained within the gut to reach the portal and
      systemic circulations, where it fuels the septic process. Oxygen free radicals,
      anaphylatoxin, and thromboxane may be potential factors in the development of gut
      barrier failure and MSOF.

PMID- 1740794
TI  - Ibuprofen lowers body temperature and metabolic rate of humans with burn injury.
AB  - A group of 15 burned children and young adults with large burns (mean, 41% +/-
      15% BSA) were administered ibuprofen (40 mg/kg for 3 days). Each patient served
      as his or her own control in this crossover study (with and without ibuprofen).
      Paired calorimetric and temperature studies and urinary nitrogen measurements
      were performed. No nitrogen-sparing effect was identified for this dose of
      ibuprofen. However, patients demonstrated a statistically significant reduction
      in average rectal temperature (0.67 degrees C decreases) (p less than 0.01) and
      in metabolic rate (11.4% decreases) (p less than 0.01) while taking ibuprofen.
      Linear regression analysis of the reduction in temperature versus the reduction
      in metabolic rate yielded a statistically significant correlation (p less than
      0.01) with a slope of 13.6% reduction in metabolic rate per degree centigrade
      reduction in the 72-hour average rectal temperature. These results support the
      hypothesis that ibuprofen attenuates the hypermetabolic response to thermal
      injury by blunting the temperature elevation that is usually seen.

PMID- 1740795
TI  - Left ventricular performance in patients with thermal injury or multiple trauma:
      a clinical study with echocardiography.
AB  - Left ventricular (LV) contractile and diastolic performance was evaluated in
      patients with thermal injury or multiple trauma using precordial and
      transesophageal echocardiography. Thirty-nine patients were divided into four
      groups: group B1 (within 24 hours after thermal injury); group B2 (from 24 to 72
      hours after thermal injury); group M (multiple trauma); and a control group
      (outpatients). Left ventricular contractile indices, including ejection fraction,
      mean velocity of circumferential fiber shortening, and the ratio of systolic
      blood pressure to LV end-systolic dimension, were not impaired in any of the
      experimental groups. The ratio of LV filling volume during rapid filling to
      stroke volume, obtained from M-mode echocardiography as an index of LV
      distensibility, was significantly decreased in groups B1 (44.5% +/- 8.8%) and B2
      (46.8% +/- 8.5%) compared with controls (61.9% +/- 7.4%) (p less than 0.05). The
      ratio of the peak velocity in the atrial contraction phase to that in the rapid
      filling phase, obtained using pulsed Doppler echocardiography, also showed
      significant impairment of LV distensibility in groups B1 (1.08 +/- 0.12) and B2
      (1.09 +/- 0.07) compared with controls (0.71 +/- 0.12) (p less than 0.01). Group
      M showed no significant impairment of these diastolic indices. A profound
      depression of LV diastolic function thus occurs following thermal injury but not
      following multiple trauma.

PMID- 1740796
TI  - External fixation of fractures with a new frame in managing patients with
      multiple trauma.
AB  - The use of a new modular frame with the AO tubular fixator in managing the cases
      of severely injured patients is reported. The simplicity in design, the
      versatility, and the ease of insertion make this frame very useful in managing a
      patient with multiple injuries in the emergency department when stable fixation
      of a variety of fractures is needed. Our clinical experience with 23 patients,
      all with an ISS of 16 or greater, is reported and four representative cases are
      described.

PMID- 1740797
TI  - Blade-plating of closed displaced supracondylar fractures of the distal femur
      with the AO system.
AB  - We reviewed a series of 42 closed and displaced supracondylar and intercondylar
      fractures of the distal end of the femur that were treated over a 7-year period
      by open reduction and internal fixation using the AO system (blade-plate). A
      strict rating scale incorporating subjective data and objective motion of the
      involved knee was used for the results. At a mean follow-up of 5 years, the
      results in eight patients were rated excellent, the results in 14 were rated as
      good, the results in 11 as fair, and the results in nine as poor. Complications
      were found in 15 patients (37.5%). Complications included postoperative
      osteomyelitis in two; nonunions in three; malunions in two; delayed unions in
      two; marked loss of knee motion in four; and superficial infection and wound
      hematoma in one patient each.

PMID- 1740798
TI  - Necrotizing fasciitis of the extremities.
AB  - Necrotizing fasciitis is a limb- and life-threatening soft-tissue infection.
      Eighteen patients with necrotizing fasciitis of the extremities were reviewed.
      These infections occurred most commonly after minor trauma. Associated chronic
      debilitating diseases were present in 13 patients. All but two infections were
      polymicrobial. The overall mortality rate was 33%. Death was caused by persistent
      wound sepsis in three and systemic septic complications in spite of apparent
      local infection control in three. At the admission physical examination the
      condition may resemble a benign, low-grade cellulitis. Three of four patients
      died because of a delay in surgical debridement for more than 24 hours after
      admission. Multiple radial debridements of the involved skin, fat, and fascia are
      essential to control progressive necrosis. Our results suggest that early
      diagnosis and prompt surgical debridement of necrotizing fasciitis are essential
      for survival.

PMID- 1740799
TI  - Anterior compartment syndrome of the thigh in athletes--indications for
      conservative treatment.
AB  - Anterior compartment syndrome of the thigh resulting from blunt contusion without
      an accompanying fracture is rare. The treatment advocated for it by most authors
      has been surgical. However, because wound infection rates are high and loss of
      knee range of motion is frequent, we considered conservative treatment in
      selected patients. Six athletes who developed an anterior thigh compartment
      syndrome shortly after sustaining a blunt contusion to the quadriceps with an
      accompanying massive hematoma were studied prospectively. Tissue pressure, renal
      function, and creatinine phosphokinase (CPK) levels were closely monitored.
      Fasciotomy was not performed, despite sustained pressure elevations above 50 mm
      Hg. Neurologic function was not affected. At follow-up examination 1 year later,
      no limitation of joint motion nor weakness of the quadriceps were observed. Thus
      in selected young patients in whom an isolated anterior compartment syndrome of
      the thigh occurs, conservative treatment yielded results superior to fasciotomy.

PMID- 1740800
TI  - Emergency department record keeping and the potential for injury surveillance.
AB  - Successful design of injury prevention measures relies on understanding the
      occurrence and circumstances of injuries, which, in turn, necessitates that good
      quality data be collected about injured persons. The emergency department (ED) is
      an important source of injury information. This paper reports the results of a
      survey of all 129 hospital emergency departments in North Carolina to examine
      record-keeping practices and determine what information is collected and stored
      in the EDs. The findings demonstrate that there is considerable variability in
      the types of data that would be available to a researcher attempting to use ED
      records. Of special note is the absence of information about the external cause
      of injury.

PMID- 1740801
TI  - The effect of hypothermia on liver adenosine triphosphate (ATP) recovery
      following combined shock and ischemia.
AB  - During both hemorrhagic shock and ischemia, adenosine triphosphate (ATP)
      concentrations fall in liver tissue. Incomplete recovery of ATP correlates with
      cell death and subsequent organ dysfunction. Changes in liver ATP levels were
      evaluated in paired groups of rats subjected to combined hemorrhagic shock and
      ischemia. A second set of paired animals was studied over time with shock alone.
      One animal in each pair was maintained at 28 degrees C and the other at 37
      degrees C. Ischemia was produced by occluding inflow to the left half of the
      liver, and tissue was obtained from this area in all animals studied. Adenosine
      triphosphate levels fell in warm and cold animals subjected to both shock and 60
      minutes of ischemia but recovered more completely during reperfusion in the cold
      animals. Shock alone caused a steady fall in ATP levels in the warm, but not the
      cold rats. These biochemical changes may indicate a beneficial effect of moderate
      hypothermia in the management of severe liver hemorrhage requiring temporary
      occlusion of blood flow.

PMID- 1740802
TI  - Results of a multi-institutional outcome assessment: results of a structured peer
      review of TRISS-designated unexpected outcomes.
AB  - The utility of TRISS as a component of trauma center quality assurance (QA) was
      evaluated. TRISS survival probabilities were estimated for a total of 2,023
      consecutive trauma patients admitted to three level-I trauma centers during a 6
      month period. A structured peer review was performed of the 50 patients (2.1%)
      having statistically unexpected outcomes. For 23 (18 survivors, five deaths)
      TRISS-designated outcomes were sustained in peer review. In 27 cases (one
      survivor, 26 deaths) TRISS-designated outcomes were not sustained by peer review
      and TRISS. Limitations were identified in each case. Peer review of unexpected
      outcomes identified by TRISS provided a consistent and objective QA methodology.
      An understanding of TRISS as an objective component of the trauma center QA
      process is essential in blending it with what is, at present, a largely
      subjective process in many hospitals. Use of TRISS standardizes the peer review
      process, resulting in a more reliable base for development and improvement of
      trauma center QA programs.

PMID- 1740803
TI  - Use of skin staplers in experimental gastrointestinal injuries.
AB  - Undocumented reports exist concerning use of skin staplers to close small
      perforations of the gut. This study examined use of this device in experimental
      gastrointestinal injuries in dogs. In 18 anesthetized mongrel dogs, matching
      uniform perforations were made with a sterile leather punch; one perforation of
      each pair was closed with 3-0 silk and the other with a skin stapler. A total of
      80 stomach, 238 small intestine, and 140 colon perforations were created. Hole
      sizes progressed from 1.9 to 5.0 mm. Unrepaired intestinal wounds leaked and were
      lethal. No leaks were identified in wounds closed with either sutures or staples
      provided that closure was complete. Speed of staple closure was faster than that
      of suture closure (1.2 vs. 16.0 seconds), but ease of closure was similar. It is
      concluded that skin staplers are safe for repair of small wounds, created under
      ideal conditions, in canine gastrointestinal tracts. Similar injuries in
      traumatized humans deserve study, but existing skin staplers may be ineffective
      for human intestine since gut wall thickness in humans is less than that in dogs.

PMID- 1740804
TI  - Guaiac testing in the diagnosis of rectal trauma: what is its value?
AB  - Rectal examination with guaiac testing is a standard part of the emergency
      department evaluation of acutely traumatized patients. Its major role is in the
      recognition of occult bowel injury. We questioned its efficacy in detecting
      occult rectal injury in patients with penetrating trauma. We reviewed the charts
      of 19 patients with suspected rectal injury. Ten injuries were to the abdomen,
      nine to the buttock, and three to the thigh. Guaiac testing was 69% (11/16)
      sensitive and 33% (1/3) specific. Rigid sigmoidoscopy was 100% (12/12) sensitive
      and 67% (2/3) specific. Sensitivity was 100% (8/8) when the two were combined.
      Our findings suggest that guaiac testing is not accurate enough to rule out the
      presence of occult rectal injury. The result of guaiac testing must not influence
      the decision to further evaluate patients with high-risk injuries.

PMID- 1740805
TI  - Blunt trauma during pregnancy: factors affecting fetal outcome.
AB  - During a 9 1/2-year period, 76 pregnant women who sustained blunt trauma were
      admitted to a level-I trauma center. Fetal outcome was ascertained in 59 patients
      (78%). Successful delivery was noted in 35 patients (46%). Eight patients (11%)
      elected to undergo abortion for nonmedical reasons. Sixteen patients (21%)
      sustained fetal loss, and 17 patients (22%) were lost to follow-up. The 51
      patients who either delivered successfully or experienced a fetal loss were
      studied to determine the factors that affected fetal outcome. Variables analyzed
      included gestational age and maternal age, Glasgow Coma Scale score, serum
      bicarbonate level, pH, PCO2, PO2, blood pressure, heart rate, Injury Severity
      Score, and performance of surgery or diagnostic peritoneal lavage. Logistic
      regression analysis revealed that ISS (p less than 0.01) and admission serum
      bicarbonate level (p less than 0.02) have the most significant correlation with
      fetal outcome. No other variable exhibited a statistically significant influence
      on fetal outcome. This information documents that fetal demise is related to
      severity of maternal injury as characterized by ISS. A low serum bicarbonate
      level corresponds to maternal hypoperfusion and hypoxia, which may be otherwise
      unrecognized because of the normal physiologic changes occurring during
      pregnancy. Based on these findings, routine serum bicarbonate determination in
      all pregnant patients being evaluated for trauma is advocated. Performance of DPL
      and surgery do not have a significant association with fetal loss and therefore
      should not be withheld when indicated in a pregnant patient.

PMID- 1740806
TI  - The pre-Medicare role of city/county hospitals in education and health care.

PMID- 1740807
TI  - Will future surgeons be interested in trauma care? Results of a resident survey.
AB  - Advanced-level general surgery residents were surveyed about their interest in
      providing trauma care upon completion of their residency training. Questionnaires
      were sent to 1,795 residents and 886 (49%) replied. Two thirds of the residents
      stated that trauma was a rewarding field, but only 18% wanted it as a career or
      as a major part of their practice. The interest in trauma fellowships was also
      very low. Disaffection with trauma care was predominant in the survey. Primary
      reasons for these negative feelings were the large amount of nonoperative care
      rendered in treating blunt trauma patients and the unsavory type of patients
      encountered with most penetrating trauma injuries. Lifestyle issues were
      important but were not rated as high as other factors. Complaints about the
      structure of current trauma rotations in many institutions and the negative
      impact of many trauma surgeons as role models were frequently cited as reasons
      for respondents not pursuing trauma care as a career interest.

PMID- 1740808
TI  - Pre-existing disease in trauma patients: a predictor of fate independent of age
      and injury severity score.
AB  - Improvement in trauma management requires a better understanding of the effect of
      a patient's preinjury health status on outcome. Specific historical findings and
      laboratory criteria were used to define pre-existing disease (PED) states and
      determine if they were independent predictors of fate in trauma victims. Of 7,798
      adult patients admitted to a level I trauma center from July 1986 through June
      1990, 16.0% (1,246) had greater than or equal to 1 PED. The PED+ and PED-
      patients had no significant difference in Injury Severity Scores (ISSs) (15.7
      versus 15.6) and admission Glasgow Coma Scale (GCS) scores (13.9 versus 13.8).
      The PED+ patients were older (49.2 versus 30.6 years) (p less than 0.001) and had
      a higher mortality rate (9.2% versus 3.2%) (p less than 0.001) than PED-
      patients. Mortality rates were also elevated for patients with greater than or
      equal to 2 PEDs (18%) and for those with renal disease (38%), malignancy (20%),
      and cardiac disease (18%) (p less than 0.001) compared with PED- patients.
      Controlling for age and ISS, there was an association between PED and mortality
      (Mantel-Haenszel p less than 0.03). Multivariate regression showed that PED is an
      independent predictor of mortality (R2 = 0.1918; p less than 0.0001). The
      greatest increases in mortality were found among patients less than 55 years and
      with ISS less than 20. Changes in prehospital triage criteria and outcome scoring
      are needed. Improvements in the management of trauma victims with chronic disease
      may decrease their mortality rate.

PMID- 1740809
TI  - Splint appliance for the management of posttrauma lip deformities: technical note
      and case reports.
AB  - Trauma sustained to the commissures of the lips will result in perioral tissue
      deficits. Without intervention, this will lead to functional and esthetic
      deformities. Splinting devices have proven to be an effective and economical
      means of treatment. Reviews have appeared in the literature describing techniques
      and treatment regimens for the use of such oral commissure splints. Each has
      specific advantages and disadvantages in application. A variation of these
      previously described splints now in use at the University of Chicago Hospitals is
      presented. Three case histories are presented with discussion of the uses and
      advantages of this appliance.

PMID- 1740810
TI  - Parasymphyseal fracture with an associated temporomandibular joint dislocation:
      case report.
AB  - A case of traumatic mandibular fracture with associated unilateral anterior
      dislocation of the temporomandibular joint in a child is described. Although
      anterior dislocation is common, this combination of fracture and separate
      dislocation to our knowledge has not been reported in a young child. The unusual
      management required in this case is discussed.

PMID- 1740811
TI  - Traumatic bilateral renal artery thrombosis diagnosed by computed tomography with
      successful revascularization: case report.
AB  - Traumatic bilateral renal artery thrombosis is a rare injury. We found 15 cases
      previously reported. An additional case report of a 54-year-old man is presented
      with a review of the literature. The diagnosis was made by computed tomography
      and confirmed by angiography. Successful revascularization was performed. A high
      index of suspicion, early diagnosis, and prompt revascularization are essential
      in obtaining optimal results without hypertension or permanent impairment of
      renal function.

PMID- 1740812
TI  - Pathologic consequences of bilateral pulmonary lower lobectomies: case report.
AB  - Most injuries to the lung can be managed nonoperatively and rarely require
      resection. A case of bilateral hilar injuries requiring bilateral pulmonary lower
      lobectomies is presented. The resulting pulmonary hypertension, right ventricular
      failure, and cardiogenic shock explain the high mortality following extensive
      pulmonary resection in thoracic trauma and support the concept of a conservative
      approach.

PMID- 1740813
TI  - Intensity and efficiency of transmission and the development of microfilaraemia
      and disease: their relationship in lymphatic filariasis.
AB  - Currently available methods for measuring the intensity of transmission in the
      lymphatic filariases are all to some extent unsatisfactory. Clinical methods for
      defining the presence of filarial disease are also less than perfect, and many
      infected persons remain free of symptoms and signs for very long periods.
      Incidence rates of microfilaraemia calculated from prevalence rate data are
      combined with 'entomological inoculation rates' obtained by direct observations
      of vector landing rates, infective larval rates and infective larval densities in
      field studies to determine efficiencies of transmission, and to relate
      transmission parameters to observed microfilarial and disease prevalence rates.
      Published studies from various endemic areas of the world which provide
      sufficient data have been analysed, using reversible catalytic models. In
      general, it seems that much less intense levels of transmission are needed in sub
      Saharan Africa to produce given rates of microfilaraemia and disease than in Asia
      and Oceania, in the case of Wuchereria bancrofti infections; similarly, the genus
      Anopheles appears to produce infection and disease much more efficiently than the
      genera Culex and Aedes when transmitting W. bancrofti. The only example of Brugia
      malayi transmitted by Mansonia spp. analysed provided the highest level of
      transmission efficiency found. Tolerable levels of transmission analogous to
      those used in onchocerciasis cannot at present be defined for the lymphatic
      filariases; it seems that the intensity of transmission required to produce new
      cases of disease is probably below that required to produce new cases or episodes
      of readily detectable microfilaraemia.

PMID- 1740814
TI  - An investigation of some risk factors for severe leptospirosis on Barbados.
AB  - Between November 1979 and the end of December 1986 (7.17 years), 248 cases of
      leptospirosis were confirmed among hospital patients on Barbados (mean 35 per
      year; range 25-57). Considering the 235 who were greater than or equal to 15
      years of age, the annual incidence of leptospirosis was 19.2/100,000 population
      (14.0 for all age groups). There were 173 males and 62 females, and for cases
      aged 15-34 leptospirosis was 9.6 times more common in men than women. Among men,
      incidence increased fairly steadily with age, and an even steadier increase was
      apparent in women up to age 64, with some decline in later years. The incidence
      of disease was much higher among agricultural than other workers and the non
      employed. Highest case numbers were recorded in the parishes of St Michael (65 or
      28%) and Christ Church (36 or 15%), though the incidence was lowest in these two
      parishes (13.1/100,000 and 17.4/100,000, respectively). The highest incidence
      rates were in St Andrew and St Joseph (50.2 and 36.1/100,000, respectively). The
      incidence in areas with rainfall greater than or equal to 1600 mm (32.6/100,000)
      was nearly twice that in areas with rainfall less than 1600 mm (17.3/100,000).
      There is a clear link between cases of severe disease and recent rainfall. Using
      134 patients greater than or equal to 15 years of age with fever due to other
      illnesses as controls, a higher proportion of cases than controls came from rural
      areas. The risk of contracting leptospirosis was increased for all categories of
      manual workers relative to the group at lowest risk (non-manual indoor workers).
      Sugar-cane workers were five times more likely to contract leptospirosis than
      were non-manual indoor workers, while those whose families minded livestock were
      2.5 times more likely, and those with rodents in their garden/yard were 1.8 times
      more likely to do so. Other risk factors examined did not show significant
      associations with the disease. Despite increasing mechanization and the use of
      more protective clothing, agricultural workers are still at high risk from
      leptospirosis. The annual range of cases is likely to stay much as it is in the
      foreseeable future.

PMID- 1740815
TI  - Pattern of road traffic accident cases in a Nigerian university teaching hospital
      between 1987 and 1990.
AB  - This retrospective study was undertaken to obtain recent information on the
      pattern of road traffic accidents (RTA) and the associated disabilities in
      Nigeria. We reviewed the medical records of RTA related cases recorded between
      1987 and 1990 at Obafemi Awolowo University Teaching Hospital, Ile-Ife. Over the
      4-year period, 2667 cases of RTA were recorded and this constitutes 5.3% of the
      total medical and surgical emergencies seen at the hospital. Furthermore, RTA
      cases accounted for 8.1% (range = 1.3-29.30%) of the total medical and surgical
      emergency deaths. Only 353 (13.2%) of the total number of RTA cases required
      hospitalization. About 12.7% of the patients spent less than 2 days in the
      hospital while 24.6% of the patients were hospitalized for more than 2 months.
      The 20-40 years age group recorded the highest incidence of RTA requiring
      hospitalization and males were twice as prone to RTA as females. Pedestrian
      casualties accounted for 28.3% of the RTA cases. The majority (67.4%) of the
      hospitalized RTA patients sustained a fracture and 12.2% died during admission.
      Our findings if extrapolated to all the hospitals in Nigeria confirm the
      speculation that RTA is one of the leading causes of death in Nigeria.

PMID- 1740816
TI  - Role of atropine in management of cardiovascular manifestations of scorpion
      envenoming in humans.
AB  - We undertook a retrospective analysis of 35 victims of red scorpion (Mesobuthus
      tamulus) sting, admitted to our hospital in Mahad, Maharashtra State, India.
      Increase in duration as well as severity of clinical signs, including myocardial
      injury and poor response to conventional treatment, were observed in 17 victims
      treated with atropine compared to another 18 victims who were not so treated. We
      do not advocate routine use of atropine to block transient cholinergic effects of
      scorpion envenoming.

PMID- 1740817
TI  - The prevalence and environmental risk factors for moderate and severe trachoma in
      southern Ethiopia.
AB  - Inflammatory eye disease is a leading cause of reported morbidity throughout
      rural Ethiopia. The purpose of this investigation was to document the prevalence
      of trachoma at all stages and to identify environmental risk factors for moderate
      to severe cases among rural inhabitants of Sidamo Region in southern Ethiopia. An
      ophthalmic examination followed by a blind household interview were completed on
      1222 randomly selected subjects. Those with moderate or severe trachoma were
      compared with normal subjects for rates of exposure to potential environmental
      risk factors. The results of the eye examinations are as follows; normal 59.5%,
      trivial 8.4%, mild 10.3%, moderate 8.5%, severe 8.0%, cicatricial 3.0%, and other
      eye diseases without trachoma 2.3%. Highest prevalence rates for moderate to
      severe trachoma were found in those under 10 and over 45 years of age. Increased
      adjusted odds ratios were found for exposure to garbage disposal near home,
      crowded sleeping arrangements, animals inside the home, cooking in a separate
      room, and living at lower altitudes. The identification of several modifiable
      environmental risk factors for trachoma will be of use in the further development
      of preventive programmes.

PMID- 1740818
TI  - Tropical pyomyositis in India: a clinico-histopathological study.
AB  - Eighteen cases of tropical pyomyositis, aged 12-45 years, were seen over a 3-year
      period. There was clustering of cases in January, February and July to October.
      Male:female ratio was 14:4. Multiple muscular lesions (greater than 2) were
      common (67%). Extramuscular complications were present in 50% of the cases.
      Cardio-pulmonary involvement was most frequent. Muscle biopsies, done in 16
      cases, showed suppurative changes (pus) in 15 cases and one case of non
      suppurative myositis. Muscle necrosis, cellular infiltration with polymorphs and
      haemorrhage in-between muscle fibres were common.

PMID- 1740819
TI  - Evaluation of fractionated circulating filarial antigen in diagnosis of
      bancroftian filariasis.
AB  - Circulating filarial antigen (CFA) isolated from the plasma of microfilaraemic
      patients was fractionated on an Ultrogel ACA 34 column. The second protein peak
      (CFA2) showing filarial antigen was further fractionated by DEAE-cellulose column
      chromatography into two fractions (CFA2 DE1 and DE2). CFA2 DE1 fraction, showing
      antigenic activity, was further evaluated in an ELISA for its diagnostic use in
      bancroftian filariasis. Studies with CFA2 DE1 and anti-CFA2 DE1 antibody showed
      that they were highly active in the detection of filarial antibody and antigen in
      asymptomatic microfilaraemia sera and thus obviate the need for the tedious night
      blood collection and examination. Fractionated filarial plasma can be another
      candidate antigen for immunodiagnosis of bancroftian filariasis.

PMID- 1740820
TI  - Evaluation of an enzyme linked immunosorbent assay (ELISA) using Schistosoma
      mansoni soluble egg antigen as a diagnostic tool for Schistosoma mansoni
      infection in Ethiopian schoolchildren.
AB  - Evaluation of the performance of an ELISA test using S. mansoni soluble egg
      antigens (SEA) in relation to the standard parasitological diagnostic procedure
      (Kato) was conducted in a specially set up study on 400 Ethiopian schoolchildren.
      Faecal samples were collected on 3 successive days for preparation of Kato thick
      smears and two finger prick blood samples were collected onto filter paper from
      all the children on day 1. All helminth ova present in the triplicate Kato slides
      were counted and the ELISA test was carried out on both eluted serum samples.
      Prevalence of infection by Kato was 83.5% in the endemic area and the sensitivity
      and specificity of the ELISA test were 97.6% and 30.3% respectively, whereas the
      specificity of the ELISA in the non-endemic area was 95.5%. The main cause of
      'false positivity' in the endemic area appeared to be inapparent S. mansoni
      infection. Because of its high sensitivity, this ELISA test will clearly be of
      value for seroepidemiological surveys.

PMID- 1740821
TI  - Hospital-based study on neonatal tetanus, Buluba Hospital, 1985-1989.
AB  - Neonatal tetanus is a major cause of morbidity and mortality among neonates in
      Uganda. A retrospective study has been made of 228 cases of neonatal tetanus seen
      in Buluba Hospital over the 5-year period of 1985-1989. The number of cases of
      neonatal tetanus admitted per year to the hospital did not decrease significantly
      during that period suggesting that the immunization programme aimed at
      immunization of pregnant women with tetanus toxoid has not had a clear impact.
      Over 40% of neonatal tetanus cases came from the two nearest subcounties: Waina
      and Imanyiro. Over 75% of admitted cases of neonatal tetanus accounted for 23% of
      all deaths among child admissions. More than 90% of neonatal tetanus cases showed
      the first symptoms of the illness within the first 14 days of life; the shortest
      incubation period was 2 days. The average age at onset was 5.6 days and the
      average age at death was 9.9 days. The need for a more effective immunization
      programme and more intensified activities to increase the proportion of
      deliveries attended by trained personnel and improve hygienic conditions during
      and after deliveries is emphasized.

PMID- 1740822
TI  - False positive serology for visceral leishmanias (kala-azar) using the indirect
      haemagglutination (IHA) method.
AB  - Persistent false serology for kala-azar using the indirect haemagglutination
      technique is described in two patients. One patient had Behcet's disease and the
      other infective endocarditis.

PMID- 1740823
TI  - Cytodiagnosis of rhinosporidiosis.
AB  - Two clinically suspected cases of nasal rhinosporidiosis were studied
      cytologically using a wipe out technique. The smears showed the typical spores of
      the fungus and the cytological diagnosis of rhinosporidiosis was confirmed by
      excisional biopsy. The smear is recommended as a routine preliminary screening
      technique in the diagnosis of suspected cases of rhinosporidiosis.

PMID- 1740824
TI  - Gangrenous cholecystitis due to hepatitis A infection.
AB  - A 6-year-old boy was admitted to hospital with acute gangrenous cholecystitis
      requiring emergency cholecystectomy. Examination of the gall-bladder revealed
      severe inflammation with areas of necrosis and mucosal sloughing; serology
      confirmed hepatitis A infection. Acute cholecystitis due to hepatitis A infection
      has very rarely been reported.

PMID- 1740825
TI  - Health and population data for developing countries available through USAID
      project.

PMID- 1740826
TI  - The efficacy of Doppler umbilical artery velocimetry in identifying fetal
      acidosis. A comparison with fetal biophysical profile.
AB  - In 105 singleton pregnancies in which cesarean section was performed before the
      onset of labor, the efficacy of Doppler umbilical velocimetry in identifying
      fetal acidosis was determined and compared with fetal biophysical profile.
      Doppler velocimetry showed a significant correlation with the umbilical artery pH
      and was also a sensitive indicator of fetal acidosis, comparable to the
      biophysical profile score. Patients were classified into four groups. Groups with
      abnormal Doppler results showed a significantly higher prevalence of fetal
      acidosis, and all the fetuses with abnormal Doppler results were either in
      acidosis or in a growth-retarded state. Our data lend further support to the
      clinical validity of Doppler umbilical velocimetry in identifying fetal acidosis
      or compromise.

PMID- 1740827
TI  - Method for determining the SATA and SAPA intensities for real-time
      ultrasonographic scanning modes.
AB  - Determination of a complete set of sonographic exposure parameters is desirable
      for any clinical ultrasound unit and is particularly important in controlled
      studies of biologic effects. When the exposure system is a diagnostic real-time
      scanner operating in autoscan mode, the determination of two of these parameters,
      the spatial average-temporal average (SATA) and the spatial average-pulse average
      (SAPA) intensities, is not straightforward because of the spatial overlap of
      successive propagating pulses. A method is described for determining these
      intensities for autoscan operation. The primary tool in the method is a digital
      oscilloscope, which supports pretrigger recording and configuring of the
      oscilloscope's memory into segments that can record rapidly occurring successive
      pulses, each segment recording one pulse. Results for a few commercially
      available real-time scanning systems are presented.

PMID- 1740828
TI  - The fetal thyroid: normal and abnormal sonographic measurements.
AB  - The thyroid of 31 fetuses at low risk for perinatal thyroid disease were
      evaluated sonographically. The transverse width and circumference of the fetal
      thyroid was measured prospectively to provide normative values for each
      gestational age. In addition, the thyroid of 23 fetuses at risk for thyroid
      disease were examined sonographically and compared to the control group. At
      birth, 18 of the neonates had no evidence of thyroid dysfunction, whereas 5
      newborns had goiters and abnormal thyroid function. The fetal thyroid
      measurements for these 5 neonates were above the upper limit of the 95%
      confidence interval compared to the control group. The other 18 fetuses in the
      group at risk for thyroid disease but without evidence of thyroid dysfunction at
      birth had fetal thyroid measurement within the normal range.

PMID- 1740829
TI  - Placenta accreta. Additional sonographic observations.
AB  - Recent reports describe the antenatal sonographic diagnosis of placenta accreta
      based on failure to visualize a hypoechoic zone at the placental margin. This
      finding was confirmed in our series of seven cases. New observations in this
      series include prominent large or multiple placental venous lakes and periuterine
      vascularity in six of seven cases, and progressive thinning and disappearance of
      the retroplacental hypoechoic zone on sequential examinations in two of seven
      cases. Loss of normal venous flow pattern on Doppler interrogation of the
      peripheral placental margin also appeared to be of value in two patients.
      Histologic correlates for these findings are suggested on the basis of the
      primary histopathologic feature of placenta accreta: deficiency of the decidua
      basalis. Differential diagnostic considerations, including abdominal pregnancy
      and trophoblastic disease, also are discussed.

PMID- 1740830
TI  - Ultrasonography of cystic parotid lesions in HIV infection. Similarity of
      sonographic appearance with Sjogren's syndrome.
AB  - Bilateral cystic parotid glands occur in some cases of human immunodeficiency
      virus (HIV) infection. This abnormality, which is associated with cervical
      adenopathy, can be defined by sonography in the superficial gland, as noted in
      three men. In retrospect, this parotid disease has similarity to the sonographic
      finding of Sjogren's syndrome, except for the finding of cervical adenopathy, an
      observation not previously appreciated.

PMID- 1740831
TI  - Color Doppler imaging in the assessment of uteroplacental blood flow in abnormal
      first trimester intrauterine pregnancies. An attempt to define etiologic
      mechanisms.
AB  - The addition of color Doppler imaging (CDI) to the vaginal probe now enables
      sonographers to study more accurately the maternal-fetal circulation at the early
      stages of the gestation. Doppler studies of normal intrauterine first trimester
      gestations have been published, and our investigation was an attempt to study
      uteroplacental blood flow in abnormal intrauterine first trimester gestations.
      Although the calculated indices did not differ significantly from those found in
      normal gestations, we did find a higher rate of color detection in gestations
      defined as anembryonic as compared to those defined as missed abortions.
      Circulation abnormalities probably play a significant role in early pregnancy
      failures, and we believe CDI will help define the different etiologic mechanisms
      causing these early complications.

PMID- 1740832
TI  - Duplex and color Doppler appearance of isolated internal iliac aneurysm.

PMID- 1740833
TI  - Congenital syphilis associated with dilation of fetal small bowel. A case report.

PMID- 1740834
TI  - Prenatal diagnosis of vestigial tail.

PMID- 1740835
TI  - Early diagnosis of holoprosencephaly.

PMID- 1740836
TI  - Endosonographic diagnosis of a submucosal gastric cyst.

PMID- 1740838
TI  - When sports and HIV share the bill, smart money goes on common sense.

PMID- 1740837
TI  - Sonographic demonstration of air in the myometrium. A complication of
      culdocentesis.
AB  - Six cases are presented in which air was seen in the myometrium in the
      distribution of the arcuate vessels during sonography performed after
      culdocentesis to exclude ectopic pregnancy. Three of these patients had viable
      intrauterine pregnancies; the others had an incomplete abortion, a complete
      abortion, and a right ectopic pregnancy. This relatively rare complication of
      culdocentesis should be kept in mind, especially when scanning patients with
      suspected inflammatory process of the uterus, so as not to confuse air in the
      arcuate vessels with a uterine abscess.

PMID- 1740839
TI  - World Health Organization consensus statement--consultation on AIDS and sports.

PMID- 1740840
TI  - Like attacker probing defenses, cholera threatens US population from elsewhere in
      this hemisphere.

PMID- 1740841
TI  - From the National Institutes of Health.

PMID- 1740842
TI  - From the Centers for Disease Control. Cholera associated with imported coconut
      milk.

PMID- 1740844
TI  - From the Centers for Disease Control. Eastern equine encephalitis virus--Florida,
      1991.

PMID- 1740843
TI  - From the Centers for Disease Control. Public health assessment--Russian
      Federation.

PMID- 1740845
TI  - A piece of my mind. What we fail to see.

PMID- 1740846
TI  - Closing the chapter on Maharishi Ayur-Veda.

PMID- 1740847
TI  - Closing the chapter on Maharishi Ayur-Veda.

PMID- 1740848
TI  - Closing the chapter on Maharishi Ayur-Veda.

PMID- 1740849
TI  - Closing the chapter on Maharishi Ayur-Veda.

PMID- 1740850
TI  - Closing the chapter on Maharishi Ayur-Veda.

PMID- 1740851
TI  - Turning the tables on probe pressures--go with the flow, abandon the scan?

PMID- 1740852
TI  - Turning the tables on probe pressures--go with the flow, abandon the scan?

PMID- 1740853
TI  - Gender rears its ugly head again.

PMID- 1740854
TI  - Left-handedness in male-to-female transsexuals.

PMID- 1740855
TI  - Pedestrian and hypothermia deaths among Native Americans in New Mexico. Between
      bar and home.
AB  - OBJECTIVE: To determine the nature of excess injury mortality among Native
      Americans in New Mexico. DESIGN: Retrospective review of death certificates for
      deaths from unintentional injuries. SETTING: The state of New Mexico. SUBJECTS:
      New Mexico residents who died of unintentional injuries between January 1, 1980,
      and December 31, 1989. MAIN OUTCOME MEASURE: Cause-specific mortality rates.
      RESULTS: Over half of the excess mortality from all unintentional injuries among
      Native Americans resulted from hypothermia and from pedestrian-motor vehicle
      crashes. New Mexico Native Americans were nearly eight times more likely to die
      in pedestrian--motor vehicle crashes and were 30 times more likely to die of
      hypothermia compared with other New Mexico residents. At death, 90% of those
      Native Americans tested were highly intoxicated (median blood alcohol
      concentrations of 0.24 and 0.18 g/dL [corrected] for pedestrian and hypothermia
      deaths, respectively). Despite the fact that most Native Americans in New Mexico
      live on reservations, most deaths occurred at off-reservation sites in border
      towns and on roads leading back to the reservation. CONCLUSIONS: The possession
      and sale of alcohol is illegal on many Native American reservations. This policy
      forces Native Americans who want to drink to travel long distances to obtain
      alcohol. These data suggest that this policy is also the likely explanation for
      the markedly increased risk of death from hypothermia and pedestrian-motor
      vehicle crashes in this population.

PMID- 1740856
TI  - Lymphocytic choriomeningitis outbreak associated with nude mice in a research
      institute.
AB  - OBJECTIVE: After an employee at a cancer research institute was diagnosed with
      lymphocytic choriomeningitis, an investigation was performed to determine the
      extent of lymphocytic choriomeningitis virus (LCMV) infections among the
      institute's employees and to identify risk factors for infection. DESIGN:
      Retrospective cohort study. SETTING: A US cancer research institute.
      PARTICIPANTS: Eighty-two of 90 institute employees. MAIN OUTCOME MEASURES: Serum
      LCMV antibodies. RESULTS: Seven workers (9%) with definite LCMV infection (LCMV
      IgG antibody titer greater than or equal to 16) and one worker (1%) with probable
      infection (IgG titer = 8) were identified (10% overall seroprevalence). All
      infected employees handled animals or animal tissues and were more likely than
      other animal handlers to have worked with nude mice (Mus musculus) (P less than
      .02). Among the 31 employees who worked with nude mice at the institute, infected
      workers were more likely to clean the cages of nude mice (P much less than .001),
      change their bedding (P less than .01), and change their water (P less than
      .001). The institute had been injecting nude mice with LCMV-infected tumor cell
      lines and had recently increased the nude mouse population and the duration of
      experiments. These changes would have increased the LCMV burden at the facility
      and were temporally associated with the cluster of LCMV infections in employees.
      CONCLUSIONS: This LCMV outbreak, the first reported since 1974, is the first
      associated with nude mice. It illustrates the ongoing hazard LCMV poses in
      research laboratories. Since the symptoms of LCMV infection can be nonspecific,
      clinicians should consider this diagnosis in ill patients who report laboratory
      rodent exposure.

PMID- 1740857
TI  - Infections complicating mycosis fungoides and Sezary syndrome.
AB  - OBJECTIVE: To determine, in patients with mycosis fungoides and Sezary syndrome,
      the incidence of infections, the importance of nosocomial infections, and the
      epidemiologic factors associated with cutaneous and visceral infections. DESIGN
      AND SETTING: Retrospective inception cohort study at a university medical center
      referral clinic. PATIENTS: Three hundred fifty-six patients with mycosis
      fungoides or Sezary syndrome. MAIN OUTCOME MEASURES: Incidence rates for specific
      infections, and multivariate risk ratios for demographic and clinical factors
      associated with infection. RESULTS: Cutaneous bacterial infection was most common
      (17.0 infections per 100 patient-years), followed by cutaneous herpes simplex
      virus and herpes zoster virus infection (3.8 infections per 100 patient-years),
      bacteremia (2.1 infections per 100 patient-years), bacterial pneumonia (1.7
      infections per 100 patient-years), and urinary tract infection (1.4 infections
      per 100 patient-years). Twenty-seven percent of herpesvirus infections
      disseminated on the skin but none disseminated to internal organs. Pneumonia or
      bacteremia was present in 88% of patients who died of infection. Only three
      patients had invasive fungal or protozoal infection. Nosocomial infections
      accounted for 19% of cutaneous bacterial infections, 59% of bacteremias, 62% of
      pneumonias, and 88% of infections leading to death. By logistic and Cox
      regression, the presence of extracutaneous involvement with lymphoma was the most
      important independent risk factor for recurrent bacterial skin infection (risk
      ratio [RR], 12; 95% confidence interval [CI], 1.2 to 120), disseminated
      herpesvirus infection (RR, 28; 95% CI, 2.7 to 290), bloodstream infection (RR,
      5.5; 95% CI, 1.7 to 18), and death from infection (RR, 15; 95% CI, 3.6 to 64).
      CONCLUSIONS: Community-acquired bacterial skin infections are a common cause of
      morbidity in patients with mycosis fungoides and Sezary syndrome but are usually
      treated without hospital admission. Bacteremia and pneumonia, which are usually
      nosocomial, are the major infectious causes of death. Advanced disease stage,
      independent of corticosteroids and other therapies, is the most important risk
      factor for both cutaneous and systemic infections.

PMID- 1740858
TI  - Factors that prompted families to file medical malpractice claims following
      perinatal injuries.
AB  - OBJECTIVE: To identify self-reported reasons that prompt families to file
      malpractice claims following perinatal injuries. DESIGN: Families were
      interviewed by telephone using a questionnaire that contained structured and open
      ended questions. PARTICIPANTS: Mothers of infants who had experienced permanent
      injuries or deaths and had closed malpractice claims in Florida between 1986 and
      August 1989 were interviewed. Questionnaires were completed by 127 (35%) of a
      total of 368 such families. OUTCOME MEASURES: Reasons prompting families to file
      and families' descriptions of medical events, advice from acquaintances, and the
      quality of physician-family communication. RESULTS: Families volunteered numerous
      reasons for filing: advised by knowledgeable acquaintances (33% of respondents),
      recognized cover-up (24%), needed money (24%), recognized that their child would
      have no future (23%), needed information (20%), and decided to seek revenge or
      protect others from harm (19%). Over one third of all families indicated that
      they were told by medical personnel prior to filing that the care provided had
      caused their children's injuries. Families expressed dissatisfaction with
      physician-patient communication. Families believed that physicians would not
      listen (13% of sample), would not talk openly (32%), attempted to mislead them
      (48%), or did not warn about long-term neurodevelopmental problems (70%).
      CONCLUSION: Families give many reasons for filing a claim. Obtaining money may
      not be the only goal for some families who file suit.

PMID- 1740859
TI  - Invasion of the central nervous system by Borrelia burgdorferi in acute
      disseminated infection.
AB  - OBJECTIVE: To determine central nervous system (CNS) involvement in acutely
      disseminated Borrelia burgdorferi infection by measurement of borrelia-specific
      DNA using the polymerase chain-reaction (PCR) assay and to compare the results of
      this with standard serological tests. DESIGN: Prospective study with laboratory
      investigators blinded to clinical data. SETTING: Multicenter office practice with
      a central reference laboratory. PATIENTS: Cerebrospinal fluid (CSF) was collected
      from 12 patients with acute disseminated Lyme borreliosis with less than 2 weeks
      of active disease. The normal control specimens came from 16 patients whose CSF
      samples had been sent to the clinical laboratory for tests unrelated to the
      present study. MAIN OUTCOME MEASURES: Clinical evidence of disease and laboratory
      abnormalities. RESULTS: Eight of the 12 patients (four of six with multiple areas
      of erythema migrans and four of six with cranial neuritis without erythema
      migrans) had B burgdorferi-specific DNA in their CSF. Among the 12 patients
      studied, nine had acute cranial neuritis and six had multiple erythema migrans
      lesions. Just four of the eight who were found to have spirochetal DNA in their
      CSF had complaints suggestive of CNS infection. In three of the PCR-positive CSF
      samples, no other abnormalities were noted. None of 16 samples from controls were
      positive in the PCR assay. CONCLUSION: B burgdorferi can invade the CNS early in
      the course of infection. Careful consideration should be given to choosing
      antibiotics that achieve adequate CSF levels in patients with disseminated
      infection.

PMID- 1740860
TI  - Early predictors of career achievement in academic medicine.
AB  - OBJECTIVE: To identify early personal and scholastic factors that predict
      academic career choice and long-term career achievement among academic
      physicians. DESIGN: A longitudinal cohort study. PARTICIPANTS: Nine hundred forty
      four male physicians who graduated from The Johns Hopkins University School of
      Medicine, Baltimore, MD, from 1948 through 1964. OUTCOME MEASURES: Career
      achievement outcomes included attained faculty rank in 1990 and the number of
      citations (20 to 24 years after graduation) to published work. RESULTS: Of the
      944 physicians, 424 (45%) had chosen academic careers. Scholastic performance and
      research experience in medical school were independently associated with having
      chosen an academic career (P less than .001). Among academicians, higher attained
      rank in 1990 was independently associated with the following: (1) membership in
      Alpha Omega Alpha (relative risk [RR] = 4.94, P = .0001); (2) rank in the top
      third of the graduating class (RR = 2.68, P = .01); and (3) research experience
      in medical school (RR = 3.11, P = .0001). These three factors were also
      independently associated with more citations to participants' published work (P
      less than .05). CONCLUSION: These data suggest that scholastic performance and
      research experience during medical school predict career achievement in academic
      medicine over 20 years in the future.

PMID- 1740861
TI  - Achieving compliance with influenza immunization of medical house staff and
      students. A randomized controlled trial.
AB  - OBJECTIVE: To determine the optimal method to increase influenza immunization
      rates of medical house staff and students. DESIGN: Prospective randomized trial
      and cross-sectional survey. STUDY GROUP: Four hundred forty-two internal
      medicine, obstetrics-gynecology, and general surgery residents and junior medical
      students. MEASUREMENTS: The four interventions employed were (1) an educational
      memorandum outlining vaccine indications sent to all study group members, (2) a
      personal letter mailed to a random sample of half of the remaining unimmunized
      persons, (3) a telephone call to half of the unimmunized letter recipients, and
      (4) vaccine offered directly to the remaining unimmunized persons in clinics and
      conferences. In addition, a questionnaire was administered to all persons
      requesting or offered vaccine. MAIN RESULTS: During the 3 weeks after the
      memorandum, 87 (20%) of 442 persons were immunized. Five weeks after the letter,
      61 (34%) of persons receiving a letter and 30 (17%) of the no-letter controls (P
      = .0005) had been immunized. After the telephone call, there was a statistically
      insignificant trend toward increased compliance. In clinics and conferences, 90%
      of persons reached were immunized and 10% refused, largely extinguishing the
      effect of prior interventions. At completion of the study, 275 (62%) of 442
      participants were immunized, 29 (7%) refused, and 138 (31%) were not reached.
      Questionnaire results revealed that only 32% had ever been previously immunized
      against influenza, yet 70% stated that they had worked despite having
      influenzalike symptoms. CONCLUSION: A high rate of immunization of house staff
      and medical students can be achieved most effectively by offering vaccine in
      clinics and conferences. Continued education about influenza immunization is
      necessary for physicians and medical students.

PMID- 1740862
TI  - Current perspective on Lyme borreliosis.

PMID- 1740863
TI  - Alcohol-related deaths of American Indians. Stereotypes and strategies.

PMID- 1740864
TI  - Epidemic cholera in Latin America.

PMID- 1740865
TI  - Unilateral vocal cord paralysis.

PMID- 1740866
TI  - A 38-year-old female trauma victim of a car bomb.
AB  - This case profoundly affected prehospital and hospital care providers alike. Most
      Midwestern areas have small cities and towns, and most of our trauma results from
      accidents, not deliberate, senseless human acts. There is a quality of life in
      our community that does not involve doing things like this to others. If our
      staff was this affected, it is sobering to think of the profound adjustment
      required of the victim.

PMID- 1740867
TI  - Working with battered women in the emergency department: a model program.
AB  - WomanKind, Inc., can be a prototype for every emergency department in every
      hospital across the country. Program services and delivery can be modified to fit
      the needs and resources of any facility. The mandate is to begin to address the
      underlying causes of ED visits by battered women.

PMID- 1740869
TI  - The Hennepin County Medical Center's Women's Advocacy Program--sixteen years of
      service.

PMID- 1740868
TI  - Attitudes of emergency nurses before and after a 60-minute educational
      presentation on partner abuse.

PMID- 1740871
TI  - Guidelines for intervention by ED nurses in cases of domestic abuse.

PMID- 1740870
TI  - Initial nursing impression in patients with chest discomfort.

PMID- 1740873
TI  - Introducing ENF: a foundation for our profession.

PMID- 1740872
TI  - A 2-year-old with an altered level of consciousness: case review and differential
      diagnosis.

PMID- 1740874
TI  - An assessment of categories of illness and injury among patients seen at and
      admitted to an Australian city hospital.

PMID- 1740875
TI  - Development of the ENA National Standard Guidelines for Prehospital Nursing
      Curriculum.

PMID- 1740876
TI  - The National Standards Guidelines for Prehospital Nursing Curriculum: a job well
      done.

PMID- 1740877
TI  - The emotional trauma of miscarriage in the emergency department: a first-person
      account.

PMID- 1740878
TI  - Recollections of an American nurse in Riyadh during the Persian Gulf War.

PMID- 1740879
TI  - Respiratory syncytial virus (RSV): a common health problem.
AB  - RSV infections pose a variety of considerations for emergency personnel. Nurses
      should be suspicious of this cause of illness during the winter months because of
      its prevalence, should be able to recognize and treat those who are experiencing
      or are at risk for acquiring lower respiratory tract complications, and should be
      aware of the need to reduce the spread of the virus by using isolation
      techniques, vigorous hand-washing protocol, and other protective measures to
      reduce contact with the organism. Patients who are at high risk for respiratory
      distress should be admitted for observation and supportive therapy.

PMID- 1740880
TI  - ED visitor policies sought.

PMID- 1740881
TI  - School of nursing seeks ideas for developing ED clinical nurse specialist
      program.

PMID- 1740882
TI  - A successful bimonthly series of trauma case presentations conducted by primary
      nurses.

PMID- 1740883
TI  - Tips on nursing care of the pediatric organ recipient in the emergency
      department.

PMID- 1740884
TI  - Clinical clearance of the cervical spine.

PMID- 1740885
TI  - Announcing the trauma nursing resource document. Emergency Nurses Association.

PMID- 1740886
TI  - An 11-month-old with unexplained respiratory distress.

PMID- 1740888
TI  - The right time to share.

PMID- 1740887
TI  - HIV positive: the story of one "ordinary" emergency nurse.

PMID- 1740889
TI  - Correction to triage decisions column on Lyme carditis.

PMID- 1740890
TI  - More on pediatric nursing continuing education.

PMID- 1740891
TI  - Death washed by me.

PMID- 1740892
TI  - Leadership in nursing.

PMID- 1740893
TI  - Learning leadership through a community program.

PMID- 1740894
TI  - Classic leadership theories and roles.

PMID- 1740895
TI  - Leadership is changing, are you?

PMID- 1740896
TI  - The Zimmermann-Laband syndrome.
AB  - We report on two patients who exhibit the typical features of the rare Zimmermann
      Laband syndrome such as gingival fibromatosis, swelling of perioral tissues, nail
      hypo/aplasia, and abnormalities of terminal phalanges. The older patient suffers
      from epileptic seizures and shows osseous mandibular hypertrophy, two maxillary
      mesiodentes and lumbar spondylodysplasia. In the 2nd patient, a 3 year old male,
      the characteristic morphological features are already present.

PMID- 1740897
TI  - [Necrotizing enterocolitis--analysis of a case cohort].
AB  - During a period of 25 months 11 newborns treated at the children's university
      hospital of Munster (0.8%) underwent laparotomy for necrotizing enterocolitis
      (NEC). The cases appeared sporadically without forming "clusters" typical of
      infectious etiology. 10 of 11 cases were premature infants (median birth weight
      1280 g) stressing the predisposing role of immaturity. Ischemic events occurred
      in all patients prior to the onset of symptoms. The introduction of surfactant
      therapy during the study period did not influence the incidence apparently.
      Ultrasonography was superior to radiology with regard to detection of
      extraluminal gas. We differentiated two types of clinical courses (3 acute and 8
      protracted). In 5 cases we noticed a relapse of clinical symptoms after uptake of
      oral feeding. 3 newborns died with septic shock. The median hospitalisation time
      was 88.5 days in the 8 survivors. Enterostomy was replaced by definite
      anastomosis after 67.5 days (median). Median daily weight gain was 16.6 g. Late
      complications like permanent stenoses of short bowel syndrome were not observed.
      Early surgical intervention according to the general rules of abdominal surgery
      seems important even in very low birth weight infants.

PMID- 1740898
TI  - [Retrospective study of 160 children with febrile convulsions].
AB  - In a retrospective study of 411 children with cerebral convulsions over a period
      of 4 years, 160 patients with febrile seizures were found. This group consisted
      of 94 boys and 66 girls. The main purpose of this study was to establish the age
      of the first convulsive fit in each child. Febrile convulsions started in the
      first half year, increased in the second half year and culminated in the second
      year of life. This age dependent appearance was explained with passive
      immunization by maternal antibodies so that febrile convulsions appear when these
      antibodies decrease. The first occurrence of febrile convulsions appeared on an
      average of 22.9 months, in children with recurrent febrile convulsions a little
      earlier with 18.2 months. The most interesting fact was that children with a
      family history of febrile seizures showed an even earlier occurrence of the first
      seizure with 14.5 months. This tendency of early incidence of febrile convulsion
      in the group with family history and in the group of recurrent febrile
      convulsions could be shown as statistically significant respectively nearly
      significant in comparing with the group of retarded patients. A peculiar tendency
      for febrile convulsions seems to be documented by recurrent seizures in the
      patient himself, but also by a history of febrile convulsions in other family
      members. Both facts may lead to a very early incidence of febrile convulsions.

PMID- 1740899
TI  - [Psychomotor development of newborn infants at risk with reference to the neuron
      specific enolase].
AB  - In a prospective study the psychomotor development of an unselected collective of
      risk newborn infants up to the end of the second year of life was examined. 199
      children have developed normal, 21 showed developmental abnormalities, 84 light
      to moderate disturbances, and 30 severe disabilities. Already in the newborn
      period the concentration of neuron-specific enolase in the serum was evaluated.
      The NSE could be an indicator of brain damage. The determined values of NSE
      showed a log-normal-distribution at the three times (cord-blood, first or second
      day of life, third or fourth day of life, and ninth to eleventh day of life).
      Significant relationship between the psychomotor development during the first two
      years of life and of NSE-concentration was not found. Nevertheless the diagnostic
      value of the NSE is better with a specificity of 47.7% and a sensitivity of 80.0%
      than those of the results of intracranial ultrasound examination or of the
      erythrocytic-density-test. In contrast to these results the use of the neuron
      specific enolase alone for the prediction of individual prognosis of children is
      not be recommended.

PMID- 1740900
TI  - [Elimination of fat emulsions of various concentrations from the blood.
      Observational study in the intravenous administration of Lipovenos 10% and 20% in
      premature infants with very low birth weight].
AB  - Within the scope of an observation study 40 premature low birth weight infants
      requiring parenteral nutrition received either 10% or 20% lipid emulsions
      (Lipovenos) for 7 days. The 10% lipid emulsion differs from the 20% lipid
      emulsion in the higher phospholipid/triglyceride-ratio (0.06 resp. 0.12). Lipid
      infusion was commenced at 0.5 g triglyceride/kg/24 hours and increased steadily
      to 2 g triglyceride/kg/24 hours. The aim of the study was to compare the effects
      of the two intravenously administered lipid emulsions on serum clearance. The
      serum concentrations of triglyceride and cholesterol did not change significantly
      during the infusion with 20% Lipovenos. Significant increases in the triglyceride
      and cholesterol content were observed only in the serum of the patients who were
      given the 10% Lipovenos. The reduced lipid serum clearance is attributable to the
      higher content of phospholipids in the 10% lipid emulsion. With regard to the
      risk of high cholesterol concentrations and an abnormal LPX serum accumulation,
      administration of 20% lipid emulsion is preferable to 10% lipid emulsion, also
      during the neonatal period.

PMID- 1740901
TI  - [Reference values for the concentration of free triiodothyronine (FT3),
      triiodothyronine (TT3), free thyroxine (FT4), thyroxine (TT4), thyrotropin (TSH)
      and thyroxine-binding globulin (TBG) in umbilical cord blood. Method:
      luminescence-enhanced enzyme immunoassay].
AB  - Physiological concentrations of FT3, TT3, FT4, TT4, TSH and TBG were determined
      using the luminescence enhanced enzyme immunoassay method in cord blood serum (n
      = 100). The results are presented in Table 1.

PMID- 1740902
TI  - Spondylo-costal dysostosis in two siblings.
AB  - Two new cases of Spondylo-Costal Dysostosis (SCD) are reported in two siblings
      with strikingly similar skeletal abnormalities. Parental consanguinity documents
      in this family an autosomal recessive inheritance of trait. Clinical variability
      of SCD is discussed on the basis of clinical and radiological features. Its
      genetic heterogeneity is pointed out even considering the occurrence of cases
      with autosomal dominant as well as recessive inheritance.

PMID- 1740903
TI  - [Ultrasonically-guided percutaneous puncture and drainage of a splenic abscess
      caused by Salmonella heidelberg in a child].
AB  - In a boy aged 9 years and 11 months pain developed in the left upper abdomen
      following Salmonella enteritis infection. Purulent splenitis was diagnosed by
      sonography. Ultrasonically guided percutaneous puncture and drainage, and
      appropriate chemotherapy led to a marked improvement in the clinical picture and
      finally to complication-free remission. In a review of the literature the
      problems associated with purulent splenitis and the possibility of treating it by
      percutaneous puncture are pointed out. Purulent splenitis should be considered in
      all patients with temperatures and unexplained abdominal pain.

PMID- 1740904
TI  - [Anamnestic factors in at-risk SID children with peculiar breathing pattern].
AB  - 436 out of about 9000 infants who were born between April 1987 and November 1990
      in Jena were selected by means of a risk score for a polygraphy monitoring. This
      score contains anamnestic factors of the mother and the infant which are
      characteristic of an enhanced risk for the sudden infant death syndrome (SIDS).
      We performed a day-time polysomnography (ECG, heart rate, respiration, EEG, EOG,
      EMG) with a sleep duration of at least one hour. 23 of the infants investigated
      demonstrated abnormal breathing patterns (increased mean apnea duration, apneas
      longer than 15 s, apneas with bradycardia) and were treated with aminophylline to
      prevent a possible SIDS event. Now we investigated the statistical relation
      between 26 anamnestic factors of our risk score and the need for treatment. In
      univariate statistical comparisons treated infants differed from untreated
      infants concerning the occurrence of intraventricular haemorrhages (IVH), the
      gestational age (GA) (preterm of fullterm) and the occurrence of
      hyperbilirubinemia (HB) in their anamnesis. In a multivariate analysis with all
      26 factors the birth weight was the third important factor beside IVH and GA, but
      only factor IVH was statistically significant. A cluster analysis of the
      variables with respect to the separation of the two groups of infants indicates
      that the variables IVH, GA and HB strongly correlate. In the light of these
      results we can underline that abnormal breathing patterns can be expected
      especially in infants with IVH, short GA and low birth weight.

PMID- 1740905
TI  - [Agnes Karll Institute for Nursing Research].

PMID- 1740906
TI  - [The future of the formation of teachers for the health professions].

PMID- 1740907
TI  - [Talk among patients].

PMID- 1740908
TI  - [Dying--a time of life].

PMID- 1740909
TI  - [Occupational diseases].

PMID- 1740910
TI  - [Honey on the wound].

PMID- 1740911
TI  - [When costs point steeply upward].

PMID- 1740912
TI  - [Method of documentation in decubitus. Decubitus protocol allows for more
      effective treatment].

PMID- 1740913
TI  - [What to do about dependency, caused by the hospital].

PMID- 1740915
TI  - [Only a favorable learning climate can promote education. Interview by Fred Arm].

PMID- 1740914
TI  - [How seriously do you take hygiene regulations?].

PMID- 1740916
TI  - [Good bye, thank you, no more room].

PMID- 1740917
TI  - [The health care system in upheaval. Let us seize the opportunity].

PMID- 1740918
TI  - [Explanations by the Swiss Nursing Association of the public initiative for
      financially acceptable health insurance (poll of February 16, 1992): no
      contribution to the solution of the problem].

PMID- 1740919
TI  - [Many family members push us into an unfortunate role].

PMID- 1740920
TI  - [Nurses between medicine and society. History, to help us understand].

PMID- 1740921
TI  - [Intensive care in the Valais. Ecology of past-diploma nursing education].

PMID- 1740923
TI  - [Home care aide: Geneva should speak out].

PMID- 1740922
TI  - [Home care in the canton of Neuchatel. A new agreement on fees].

PMID- 1740924
TI  - [From exhaustion to dynamic research].

PMID- 1740925
TI  - [Nursing and computers: Melbourne congress 1991. Nurses are more and more
      involved].

PMID- 1740926
TI  - [Running an interdisciplinary team in community health care: a must for those
      responsible for the team].

PMID- 1740927
TI  - [Vote on 16 February 1992 on the popular initiative for a financially affordable
      health insurance].

PMID- 1740928
TI  - [Clinical cancer research and the nurse's role. Cancer research requires
      competence].

PMID- 1740929
TI  - Improved sterile technique diminishes the incidence of positive line cultures in
      cardiovascular patients.
AB  - In order to determine the incidence of positive line cultures, especially as
      affected by differing protocols for line insertion, cultures were obtained from
      lines in residence for up to 4 days from cardiac patients (who received
      Cefuroxime) and vascular patients (who received Cefazolin) as prophylaxis
      perioperatively. Positive cultures were obtained from 95 (19%) of 496 lines in
      cardiac patients and 83 (31%) of 261 lines in vascular patients. There was a
      linear relationship between duration of line residence and the incidence of
      positive line cultures, increasing from 14% on Day 1 to 33% on Day 4. The use of
      full sterile technique at the time of insertion halved the incidence of
      subsequent positive line cultures. Four of the 403 (1%) patients each had a
      single episode of postoperative line sepsis. Another four patients developed
      wound infections with the same organisms as cultured from their lines. One
      patient has had a vascular graft infection with the same organism cultured as was
      isolated from a Swan-Ganz line 1 year previously. These data suggest that
      monitoring lines should be inserted using full sterile technique and removed as
      soon as the patient is hemodynamically stable.

PMID- 1740930
TI  - Post-herniorrhaphy urinary retention: a randomized prospective study.
AB  - Urinary retention is a known complication of inguinal herniorrhaphy. Bladder
      distension due to vigorous fluid administration is believed to contribute to this
      problem. Our hypothesis is that fluid restriction will lower the incidence of
      urinary retention, post-herniorrhaphy. From January 1989 through March 1991, 113
      male patients entered the study. Sixty patients (Group I) received unlimited iv
      fluids (1294 +/- 58 ml) and 9 patients (15%) developed urinary retention. Fifty
      three patients (Group II) received 500 ml or less by protocol (485 +/- 2 ml) and
      5 of these patients developed retention (9%). Thus, fluid restriction lowered the
      incidence of urinary retention post-herniorrhaphy but the difference did not
      reach statistical significance. In addition age over 60 years approached
      significance as a risk factor for postoperative urinary retention.

PMID- 1740931
TI  - Management of local recurrence in well-differentiated thyroid carcinoma.
AB  - Local recurrence of well-differentiated thyroid carcinoma has a reported
      mortality approaching 50%. The University of Kentucky experience was reviewed to
      determine whether aggressive surveillance and treatment with reoperation and/or I
      131 ablation increased survival following recurrence. Records of 66 consecutive
      patients with well-differentiated thyroid carcinoma treated at the University of
      Kentucky Medical Center (1980-1989) were reviewed. Forty-nine cases of papillary
      carcinoma and 17 cases of follicular carcinoma were studied; median follow-up was
      68 months. At presentation, patients with follicular carcinoma were older (48
      versus 35 years; P less than 0.05) and more frequently had metastatic disease
      (17% versus 2%, P less than 0.05). Fifty-eight (88%) patients were alive and
      disease-free at last follow-up. Fifteen patients (24%) had developed recurrent
      disease; median time to recurrence was 24 months. Multivariate regression
      examined the variables of age, sex, histology, tumor size, cervical adenopathy,
      capsular and vascular invasion, multicentricity, and surgical procedure. While
      distant metastases affected actuarial survival, no factor independently predicted
      local recurrence. In six patients with local recurrence, nonpalpable disease was
      detected by I-131 scan. All were treated with ablation and remain disease-free
      (mean follow-up 42 months). Eight patients with local recurrence presented with
      palpable lesions; seven underwent surgery. While two patients developed repeated
      local recurrences, the other five remain disease-free (mean follow-up 52 months).
      Early detection and aggressive treatment of local recurrence improve survival in
      patients with well-differentiated thyroid carcinoma. To facilitate use of I-131,
      we advise total thyroidectomy for patients with well-differentiated thyroid
      carcinoma.

PMID- 1740932
TI  - Serosal patching impairs intestinal adaptation following enterectomy.
AB  - Increasing intestinal absorptive surface by mucosal regeneration on serosal
      patched intestinal defects is a potential surgical treatment for the short bowel
      syndrome. We previously found in long-term studies that serosal patching in dogs
      undergoing 75% enterectomy was deleterious to intestinal adaptation and
      absorption. Our aim was to evaluate the effect of serosal patching on the early
      morphologic and functional changes in postresectional adaptation and to examine
      the role of polyamine metabolic pathways in this process. Five unoperated New
      Zealand white rabbits (GP I) served as controls. Twelve other rabbits underwent
      either 50% distal enterectomy alone (GP II) or simultaneously had two 2 x 5-cm
      full-thickness ileal defects patched with adjacent cecal serosa (GP III). Animals
      in GP II gained an average of 7.2 +/- 5.3% body weight, whereas GP III animals
      lost 5.6 +/- 9.0% body weight (P less than 0.05). Intestinal remnant length was
      significantly less in GP III 3 weeks postoperatively (66 +/- 11 vs 85 +/- 8 cm, P
      less than 0.05) as was mucosal protein content (4.1 +/- 1.8% vs 6.2 +/- 1.9%) but
      villus height was similar in GPs II and III (505 +/- 131 vs 508 +/- 110 microns).
      In vitro mucosal function was similar in all three groups. Crypt cell production
      rate was significantly lower while ornithine decarboxylase and diamine oxidase
      activity were higher in GP III compared to GP II. However, polyamine levels were
      similar in all three groups. Serosal patching impairs intestinal adaptation
      following massive enterectomy. This is due in part to a decrease in proliferative
      activity which is not directly related to altered polyamine levels.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1740933
TI  - The effect of fibrin glue on intraperitoneal contamination in rats treated with
      systemic antibiotics.
AB  - Intraperitoneal fibrin sealant lowers septic mortality in a rat model of
      peritoneal contamination (2 x 10(6) organism inoculum) at the cost of increased
      late intraabdominal abscesses. This study utilized parenteral antimicrobials to
      determine if the protective effect of intraperitoneal fibrin could be achieved
      without increasing the late abscess formation rate. One hundred and fifty-five
      rats were divided into four groups. Gelatin capsules containing various dilutions
      of feces (10(10) CFU/ml) and barium sulfate were placed into the abdomen in all
      groups. Group I controls had no antibiotics or fibrin. In group II, the capsule
      was surrounded by a solution of cryoprecipitate, thrombin, and calcium (fibrin
      "glue"). Groups III (no fibrin, antibiotics) and IV (fibrin, antibiotics)
      received a broad-spectrum cephalosporin intramuscularly postoperatively and then
      daily. Surviving rats were sacrificed on the tenth postoperative day. At a
      moderate volume of fecal inoculum (0.3 ml), fibrin reduced mortality from 100% in
      the control group to 0% in treated animals (P less than 0.001) that did not
      receive antibiotics. Abscesses formed in 10% of the surviving fibrin-treated rats
      which were implanted with 0.1 ml of inoculum. In the 0.2 and 0.3 ml inoculum
      groups substantially more abscesses occurred (75 and 70%, respectively). The
      protective effect of fibrin was not manifested in the antibiotic-treated rats
      since no deaths occurred in either group. At higher and lower inoculum doses, no
      significant differences between fibrin and control groups were observed in
      mortality or abscess formation, whether or not antibiotics were given.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1740934
TI  - The critical relationship of antibiotic dose and bacterial contamination in
      experimental infection.
AB  - Even though the usefulness of prophylactic antimicrobial administration for
      potentially contaminated operations is widely accepted, infection continues to
      occur in a finite number of cases. This study examined whether potential
      infection due to an increasing bacterial inoculum can be prevented or controlled
      by increasing antimicrobial doses. In an initial set of experiments, Sprague
      Dawley rats were given various doses of cefazolin (15, 30, 60, 120 mg/kg)
      intraperitoneally, then serum and tissue levels were quantified. Serum and tissue
      drug concentrations correlated with the dose given. In another set of
      experiments, rats were given doses of either 0, 30 (standard dose), 60, or 120
      mg/kg of cefazolin 30 min prior to subcutaneous inoculation of various doses of
      Staphylococcus aureus. After 6 days, inoculum sites were examined for abscess
      formation and size. At low levels of contamination, increasing in antibiotic dose
      to 30, 60, and 120 mg/kg, abscess formation was eliminated at 50, 80, and 92% of
      inoculum sites, respectively. At moderate levels of contamination, abscesses
      formed at all inoculum sites, but abscess size was significantly smaller as the
      dose increased. When a high inoculum of S. aureus was given, large doses of
      antibiotics provided no additional benefit. These data suggest that the risk of
      infection in this model of experimental infection is significantly related to the
      size of the bacterial inoculum. Increasing the dose of an effective antimicrobial
      increases drug concentration at the site of contamination and reduces the risk of
      infection. Administration of higher doses of prophylactic antimicrobials may be
      more effective when larger amounts of bacterial contamination are anticipated.

PMID- 1740935
TI  - Protein and energy tolerance by stressed geriatric patients.
AB  - Nutritional support of stressed geriatric patients remains empiric and has
      classically been limited by tolerance. Although the hypermetabolic response is
      known to increase protein and calorie demands, tolerance to increased loads of
      delivered nutrients in older patients has been questioned. We compared tolerance
      to nutrient delivery and nitrogen metabolism in 38 stressed surgical patients
      over age 65 to 38 Injury Severity Score or disease matched younger controls.
      Twenty-seven of the 31 geriatric patients (87%) who maintained normal renal
      function (serum creatinine less than 2.0 mg/dl) became azotemic (BUN greater than
      30) while receiving 1.5 to 2.0 g of protein per kilogram of ideal body weight
      compared to only 21% of controls. This phenomenon led to inaccuracies in 17% of
      geriatric nitrogen balance studies because of unaccounted for serum accumulation
      of urea nitrogen (compared to only 6% in the control group). When calculated
      protein requirements were administered to the geriatric group, the mean nitrogen
      balance was -1.6. Resting energy expenditure as measured by indirect calorimetry
      demonstrated a strong correlation between actual calorie expenditures and
      calculated needs based on the Harris-Benedict basal energy expenditure (BEE)
      multiplied by an activity factor of 1.2 and a stress factor of 1.75 for trauma (r
      = 0.86, P less than 0.05) or 1.5 for general surgery patients (r = 0.72, P less
      than 0.05). In summary, energy requirements by stressed geriatric patients can be
      closely defined by calculation of the Harris-Benedict BEE in conjunction with
      appropriate activity and stress factors. However, attempts to deliver traditional
      levels of protein lead to azotemia and are frequently unsuccessful in achieving
      positive nitrogen balance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740936
TI  - Use of stress thallium imaging to stratify cardiac risk in patients undergoing
      vascular surgery.
AB  - Reduction of the cardiac morbidity associated with major vascular procedures
      requires identification of high risk patients prior to operation. This
      retrospective study reviews the records of 126 consecutive patients who underwent
      141 major vascular procedures to determine the accuracy of preoperative clinical,
      laboratory (ECG), and cardiac function testing (stress thallium-201 scintigraphy,
      left ventricular ejection fraction scan) in predicting perioperative cardiac
      complications. An abnormality on oral dipyridamole or treadmill thallium imaging
      was demonstrated prior to 71 (61%) of 116 procedures and included 20 fixed and 51
      reperfusion (reversible) defects. No patient died within 30 days of operation,
      but 11 minor (ventricular arrhythmia) and 15 major (myocardial infarction,
      ischemic congestive heart failure) cardiac complications occurred. A reperfusion
      defect on stress thallium imaging accurately (94% sensitivity, 56% specificity,
      98% negative predictive value) identified high-risk patients while accepted
      clinical rating systems (Goldman, Cooperman, Eagle) and preoperative level of
      left ventricular ejection fraction were less predictive of adverse cardiac
      events. Patients without myocardium at risk by coronary angiography, but a
      reperfusion defect on stress thallium imaging were found to be at high risk for a
      cardiac complication. The study data support the use of stress thallium imaging
      to stratify cardiac risk prior to major arterial surgery.

PMID- 1740937
TI  - Neutrophil (PMN) phagocytosis and chemotaxis after reperfusion injury.
AB  - Neutrophils (PMN) have been implicated as mediators of the reperfusion injury
      which occurs in skeletal muscle after ischemia. This study was performed to
      measure PMN phagocytosis and chemotaxis after 3 hr of ischemia followed by 1 hr
      of reperfusion in a model where a significant reperfusion injury occurred.
      Baseline blood samples were drawn from an ear artery from New Zealand white
      rabbits for PMN and serum. The right iliac and femoral arteries were clamped for
      3 hr which resulted in a severe clinical reperfusion injury. Just prior to clamp
      release, blood was harvested from the right iliac vein. After 1 hr of
      reperfusion, blood was again harvested from the right iliac vein. Phagocytosis
      was measured by the percentage ingestion of zymosan beads by the PMN. The zymosan
      beads had been opsonized with baseline (b), ischemia (i), or reperfusion (r)
      serum. Results for phagocytosis revealed no difference for (b) PMN when opsonized
      by (b), (i), or (r) serum. A significant increase was seen in (i) PMN
      phagocytosis when (i) or (r) serum was present. Also, a significant increase in
      (r) PMN phagocytosis was seen when (i) serum was present (ANOVA: F = 14.47; P =
      0.0002). Chemotaxis was evaluated by the number of PMN migrating across a filter.
      Serum obtained from (b), (i), and (r) blood samples served as the
      chemoattractants. Significant increases in chemotaxis were observed for (b), (i),
      and (r) PMN when (i) serum was used as the chemoattractant (ANOVA: F = 7.11; P =
      0.0025). We conclude: (1) Rabbit PMN harvested after ischemia and reperfusion
      demonstrated increased phagocytosis when (i) serum was present.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1740938
TI  - Hepatic function after porto-systemic shunt.
AB  - Advanced hepatic injury can be identified by the appearance of jaundice,
      coagulopathy, or encephalopathy but these conditions are late, irreversible
      findings and represent the end stage of a long insidious process. Currently
      available methods for assessing "liver function" (SGOT, SGPT, GGT, LDH, etc.) do
      not actually measure liver function. In this study we prospectively evaluated
      "true" liver function in patients undergoing porto-systemic shunt. Effective
      hepatic blood flow [low dose galactose clearance (EHBF)], hepatocyte transport
      (theophylline levels at 24 hr), and hepatic conjugation ability [acetaminophen
      metabolism to its glucuronide and sulfate conjugates ( (S + G)/A) and
      acetaminophen remaining at 24 hr (A24)] were measured in normal males (NL) and in
      patients pre- and post-8-mm H-graft portacaval shunt (PCS). All data are means +/
      SEM, analyzed by Student's t test, and significance was accepted if P less than
      0.05. There were no significant differences in EHBF even after PCS. Hepatocyte
      transport was decreased in pre-op (1.43 +/- 0.16 vs 0.74 +/- 0.08) and post-op
      (1.79 +/- 0.34) PCS patients. Hepatic conjugating ability was also decreased in
      pre-op PCS patients [A24 was increased (0.24 +/- 0.11 vs 0.01 +/- 0.01) while the
      ratio of conjugation products to acetaminophen remained the same]. The ability of
      the liver to conjugate substrate was severely compromised postoperatively [A24 -
      1.27 +/- 0.67, (S + G)/A - 1.19 +/- 0.34]. We believe that changes in liver
      function can be accurately measured using these noninvasive methods, and in using
      these methods we have identified altered hepatocyte transport and conjugating
      ability in patients undergoing porto-systemic shunt surgery.

PMID- 1740939
TI  - The effect of albumin or crystalloid resuscitation on bacterial translocation and
      endotoxin absorption following experimental burn injury.
AB  - Burn injury induces immune suppression and increases susceptibility to infection.
      Hypoalbuminemia is an early and consistent finding following thermal injury and
      is independently associated with gastrointestinal dysfunction and increased rates
      of infectious morbidity. This study assessed the effects of albumin resuscitation
      on burn-induced immunosuppression, bacterial translocation, and absorption of gut
      endotoxin. Male Sprague-Dawley rats, presensitized to keyhole limpet hemocyanin
      (KLH), underwent a 20% dorsal scald burn injury, followed by laparotomy and IVC
      catheterization for fluid resuscitation. Animals were randomized to one of three
      resuscitative regimens: Ringer's lactate 3 ml/kg/% burn, Ringer's lactate 9
      ml/kg/% burn, or 5% human albumin 3 ml/kg/% burn. Delayed hypersensitivity (DTH)
      responses to KLH were depressed 24 hr following injury (preburn 8.9 +/- 0.2 mm,
      post-burn 3.1 +/- 0.3 mm, P less than 0.001) and were significantly lower in
      animals in whom gram-negative bacterial translocation had occurred (2.3 +/- 0.4
      vs 3.6 +/- 0.2 mm, P less than 0.005). Serum albumin levels were lower and rates
      of gram-negative bacterial translocation higher for those animals receiving low
      volume crystalloid resuscitation; animals resuscitated with albumin or high
      volume crystalloid experienced similar degrees of postinjury hypoalbuminemia and
      bacterial translocation. Uptake of radiolabeled endotoxin was maximal in animals
      resuscitated with albumin. Bacterial translocation is believed to be responsible
      for a significant number of late nosocomial infections following trauma. These
      data suggest that the adequacy of early resuscitation rather than the type of
      resuscitative solution is the more important factor in minimizing translocation.

PMID- 1740940
TI  - The effect of fuel source on amino acid metabolism in critically ill patients.
AB  - The ideal energy substrate for critically ill patients receiving total parenteral
      nutrition (TPN) remains controversial. While glucose has been proved to have
      nitrogen sparing properties in postoperative patients, critically ill patients
      tolerate glucose loads poorly and fat appears to be an obligatory fuel in sepsis.
      Furthermore, it is not yet certain whether the changes in whole body protein
      metabolism induced by critical illness are influenced by the nature of the TPN
      provided. This study was conducted on patients admitted to a surgical intensive
      care unit (SICU) who fulfilled the criteria of requiring TPN and mechanical
      ventilation for at least four days. Patients were randomized to receive either
      glucose (G) or equicaloric proportions of glucose and lipid (GF) as an
      intravenous energy source. TPN was commenced early, within 24-48 hr of trauma or
      surgery and admission to the ICU. Nonprotein calorie intake was 125% of
      calculated basal energy expenditure. Nitrogen balance was calculated from 24-hr
      urinary urea excretion. Protein synthesis, turnover, and catabolism were measured
      on Day 4 of the study using an established radiolabeled C14-leucine technique.
      Degree of sepsis and illness were calculated using published scores. Fifty
      patients entered the trial but 32 were excluded by Day 4. Of the 18 patients
      completing an initial four day study, eight went on to complete a second study on
      the alternative regimen--a total of 26 studies (14 G, 12 GF). Net protein
      synthesis was achieved in 18 studies (12 G, 6 FG) and positive nitrogen balance
      by Day 4 in 22 studies. Four patients on the G regimen were withdrawn due to
      glucose intolerance while none of the patients on GF developed glucose
      intolerance or hyperlipidaemia. Both whole body protein synthesis and catabolism
      correlated significantly with degree of sepsis. The type of TPN fuel used, G and
      GF, did not appear to influence whole body protein dynamics, both regimens
      achieving greatly improved whole body protein kinetics.

PMID- 1740941
TI  - Augmentation of acute random pattern skin flap viability in the pig.
AB  - Three experiments were conducted to study the effect of ketanserin and LY53857,
      S2-serotonergic receptor antagonists, on skin blood flow and viability in acute
      random pattern skin flaps (4 x 10 cm) in the pig. In experiment 1, the dose
      response effect of intravenous ketanserin (0, 0.15, 0.25, 0.35, and 0.50 mg/kg)
      on skin flap capillary blood flow was studied 6 hr after skin flap surgery, using
      the radioactive microsphere (15 microns) technique and under pentobarbital
      anesthesia. Significant (P less than 0.05) increase in skin flap blood flow was
      seen at the dosages of 0.25 and 0.35 mg/kg compared with the saline-treated
      control. In experiment 2, the effect of five-day intramuscular ketanserin and
      LY53857 treatment (0.30 mg/kg/day; in divided doses) on skin flap viability was
      studied. The drug treatments were started two days preoperatively. It was
      observed that the length of skin flap viability in ketanserin (6.6 +/- 0.2 cm; n
      = 40 flaps) and LY53857 (6.8 +/- 0.3 cm; n = 40 flaps) treated flaps were
      significantly (P less than 0.05) higher than the saline-treated control (5.5 +/-
      0.1 cm; n = 48 flaps). Ketanserin treatment started 30 min after flap surgery
      also significantly (P less than 0.05) increased the length of skin flap viability
      (6.1 +/- 0.1 cm) compared with the control. There was no significant difference
      in skin viability between ketanserin and LY53857 treated skin flaps. The
      preceding study on the effect of ketanserin treatment on random pattern skin flap
      viability was repeated in experiment 3. Again, it was observed that intramuscular
      ketanserin treatment significantly (P less than 0.05) increased the skin flap
      viability. It was concluded that ketanserin and LY53857 treatment resulted in
      significant augmentation of porcine acute random pattern skin flap viability.
      This is the first experimental evidence to indicate that S2-serotonergic
      receptors participate in the pathogenesis of skin flap ischemia.

PMID- 1740942
TI  - Impaired energy metabolism of lymphocytes in cirrhotics after hepatectomy.
AB  - To clarify the mechanism of high susceptibility to infection in cirrhotics, the
      changes in adenylate energy charge and MTT assay in peripheral blood lymphocytes
      were studied in cirrhotic and noncirrhotic patients in the early postoperative
      period after hepatectomy. The adenylate energy charge measured by radioactive
      labeling of the lymphocyte adenine nucleotide pool showed no significant
      difference preoperatively between cirrhotics and noncirrhotics, but a significant
      difference was observed in the pre- and postoperative distribution of adenine
      nucleotide metabolites (P less than 0.01). In the cirrhotic group, the adenylate
      energy charge of lymphocytes decreased significantly to 0.807 +/- 0.011 on the
      third postoperative day compared with preoperative value (0.891 +/- 0.006, P less
      than 0.01) and was restored to the normal range on the fifth and tenth
      postoperative days (0.886 +/- 0.006, 0.899 +/- 0.014), while no significant
      decrease was observed in the noncirrhotic group. MTT assay revealed that
      lymphocyte cell function decreased significantly in cirrhotics after hepatectomy.
      These results indicate that, in cirrhotic patients, the energy metabolism of
      lymphocytes is already impaired to some extent preoperatively, and that it
      undergoes further deterioration when surgical stress is applied. It is suggested
      that the decreased energy metabolism in the lymphocyte may be responsible for the
      increased susceptibility to infection in postoperative cirrhotics.

PMID- 1740943
TI  - Quality assurance and morbidity and mortality conference.
AB  - Many surgeons assert that Morbidity and Mortality (M & M) conference in itself
      assures an effective quality assurance (QA) program. Recent emphasis on QA in
      other sectors has resulted in other processes for evaluating quality of care. The
      goals of QA programs are to identify adverse patient care events, relate these to
      specific physicians and use this information to improve patient care, and for
      credentialing and privileging physicians. Our aim was to determine the role of
      surgical M & M conference in a QA program which also includes occurrence
      screening, wound infection surveillance, and surgical case review. The weekly M &
      M conference is a discussion of identified complications and deaths submitted
      voluntarily by surgeons. During a 2-year period 5755 procedures were associated
      with 255 complications and 82 deaths. Only 74% of events identified by occurrence
      screening, 35% of cases identified by surgical case review, and 54% of wound
      infections had been submitted to M & M conference. Seventy-four percent of
      surgical residents and 33% of staff surgeons were present at M & M conference
      when their complications were discussed. Level of care (I, accepted practice; II,
      may have managed differently; and III, would have managed differently) was
      assessed for each complication at M & M conference and by peer review of the
      medical record for occurrence screening.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1740944
TI  - [The American FDA recommends suspension of the use of silicone breast implants].

PMID- 1740945
TI  - [How to simplify complicated randomization].

PMID- 1740946
TI  - [Flumazenil--a valuable diagnostic agent in coma but only with clear
      indications].

PMID- 1740947
TI  - [Quality and safety are more important than price when buying radiologic
      equipment].

PMID- 1740948
TI  - [Disposable insulin pen can relieve pressure on home care services].

PMID- 1740949
TI  - [Autism and mental retardation. More attention should be paid to sibling
      relations when helping families with severely handicapped children in the
      future].

PMID- 1740950
TI  - [Actinomycosis, an infection difficult to diagnose and requiring extremely
      prolonged antibiotic therapy].

PMID- 1740951
TI  - [The man behind the syndrome. Nicholas A. Halasz--the man behind a rare
      abnormality. The scimitar syndrome--a condition with the scimitar formed shadow].

PMID- 1740952
TI  - [Hydatid cyst of the spleen is an unusual diagnosis in Sweden].

PMID- 1740953
TI  - [Kidney failure and severe gastrointestinal symptoms were diagnosed as
      amyloidosis].

PMID- 1740954
TI  - [Repeated coagulation analyses were crucial in a case of hepatorenal syndrome].

PMID- 1740955
TI  - [Flupenthixol poisoning. The patient drank a depot preparation intended for
      intramuscular injection].

PMID- 1740956
TI  - [A patient inquiry on the quality assurance work at an oncologic clinic.
      Patients' communication needs are not sufficiently cared for at present].

PMID- 1740957
TI  - [Is the patient feeling as well as expected? New measurement methods can answer
      questions on quality of life of patients with heart surgery].

PMID- 1740958
TI  - [The committees on medical research ethics should change their practice. Focus on
      projects difficult to evaluate, justify decisions].

PMID- 1740959
TI  - Effect of sodium ascorbate on the chemiluminescent response of murine peritoneal
      exudate cells.
AB  - Vitamin C is an effective antioxidant that neutralizes reactive oxygen radicals.
      The purpose of this study was to determine if sodium ascorbate would neutralize
      the reactive oxygen products generated during the respiratory burst of
      thioglycollate-elicited murine peritoneal exudate cells (PEC). In vitro and in
      vivo studies were done. Cells treated in vitro showed a significant, dose
      dependent reduction in chemiluminescence (CL) after activation with opsonized
      zymosan. Higher concentrations of sodium ascorbate (24.2 mM) produced a
      significantly greater reduction in CL than did lower concentrations (0.242 mM).
      This range of sodium ascorbate concentrations overlaps those found in normal
      leukocytes (1-4 mM). Sodium ascorbate at physiological plasma concentrations
      (0.09 mM) did not reduce CL. Cells incubated with 500 mM sodium ascorbate in
      vitro and then washed once prior to zymosan activation also showed a significant
      reduction in CL. In contrast, PEC harvested from mice treated in vivo with sodium
      ascorbate (one or five daily doses of 1.0 M sodium ascorbate, 0.01 ml/g body
      weight) did not show a reduction in CL. This concentration of sodium ascorbate
      represents a dose that is 2310 times greater than the Recommended Dietary
      Allowance (RDA). These studies show that physiological doses of sodium ascorbate
      can quench CL in vitro, but even large doses of sodium ascorbate administered in
      vivo do not affect the CL of harvested murine PEC.

PMID- 1740960
TI  - Insulin secretion and protein phosphorylation in PKC-depleted islets of
      Langerhans.
AB  - Protein kinase C (PKC)-dependent phosphorylation of endogenous substrates was
      measured in electrically permeabilised rat islets of Langerhans. The PKC
      activating phorbol ester, 4 beta-phorbol myristate acetate (PMA), caused a slow
      but prolonged increase in insulin secretion from permeabilised islets, which was
      accompanied by increased 32P incorporation into several islet proteins of
      apparent M.W. 30-50 kDa. Depletion of islet PKC by prolonged exposure to PMA
      abolished subsequent secretory and phosphorylating responses to the phorbol
      ester. However, PKC-depleted islets did not show diminished responses to glucose,
      suggesting that PKC-mediated phosphorylation of these proteins is not essential
      for nutrient-induced insulin secretion.

PMID- 1740961
TI  - Islet hormone pulse intervals are dependent upon sampling frequency.
AB  - Pulsatile insulin secretion has been reported from a variety of in vivo and in
      vitro systems. While it is agreed that insulin pulses exist, there is little
      agreement concerning the basal frequency or interpulse interval either within the
      same species in vivo, as both long and short term pulses have been reported, or
      between in vivo and in vitro preparations. We propose that the frequency of
      sampling may have profound effects upon the calculated pulse interval. Three
      systems were used to test this hypothesis: 1) artificial test data were designed
      to produce regular pulses with an exact 11 min period, 2) perfusate insulin
      concentration from isolated canine pancreata sampled at 1 min intervals and 3)
      peripheral blood insulin concentrations from human volunteers sampled every 2 and
      5 min. Pulse parameters were determined at 1, 2, 5, 20, 15, 30 and 60 min
      sampling intervals for each data set by the use of the computer algorithms Pulsar
      and Cycle Detector. The results indicate that for insulin secretory pulses,
      sampling frequencies longer than 2 min may result in the production of spurious
      pulse trains with multiple longer term pulse periods. It is concluded that islet
      hormone secretory pulse period calculations are dependent upon the sampling
      frequency.

PMID- 1740962
TI  - Negative regulation by dexamethasone of the potentiation of neuromedin C-induced
      growth hormone and prolactin release by estradiol in anterior pituitary cell
      aggregates.
AB  - The bombesin-like peptide neuromedin C (NMC) stimulated the release of growth
      hormone (GH) and prolactin (PRL) from adult male rat anterior pituitary cell
      aggregates cultured in serum-free medium. This effect, particularly on GH
      release, was significantly increased when the cells were cultured in the presence
      of estradiol (E2). The GH response to NMC was not affected by 4 nM dexamethasone
      (Dex) but was enhanced in the presence of 80 nM Dex. However, the strong
      stimulatory action of E2 on the GH response to NMC was completely abolished by 4
      nM Dex. In contrast, the PRL response to NMC was reduced by 4 nM Dex and this to
      a proportionally similar extent in the presence or absence of E2. The present
      data show that glucocorticoids can be both positive and negative regulators of
      the same response system.

PMID- 1740963
TI  - Involvement of the muscarinic receptors in the postsynaptic potentiation of
      neurogenic twitch contraction in the mouse vas deferens.
AB  - Muscarinic agonists and three selective antagonists were used in an attempt to
      characterize the muscarinic receptor subtypes which regulate the electrically
      evoked, neurogenic twitch contraction of the mouse vas deferens. The neurogenic
      contraction was concentration-dependently potentiated by both carbachol and
      oxotremorine, but not McN-A-343. These agonists also potentiated the contraction
      of unstimulated preparations elicited by exogenous ATP. However, potentiation of
      the neurogenic twitch contraction was strongly antagonized by pretreatment with 4
      DAMP (IC50 = 1.38 nM for carbachol, and 4.79 nM for oxotremorine). The inhibitory
      effects of methoctramine and pirenzepine (PRZ) were about 100 times lower than
      those of 4-DAMP; the descending order of antagonistic potencies was: 4-DAMP much
      greater than methoctramine approximately equal to PRZ. These results suggest that
      muscarinic receptors are involved in the postsynaptic potentiation of the
      neurogenic twitch contraction in the mouse vas deferens. Classifications for the
      muscarinic receptor subtypes were discussed.

PMID- 1740964
TI  - Serum phospholipase A2 enzyme activity and immunoreactivity in a prospective
      analysis of patients with septic shock.
AB  - Massive elevations of serum phospholipase A2 activity have been documented in
      patients with septic shock. Serum PLA2 activity correlated to the degree and
      duration of circulatory collapse, while purified native PLA2 reproduced
      hypotension in experimental animals. In a prospective study of patients with
      septic shock, we have determined the relationship of PLA2 enzyme activity to PLA2
      immunoreactivity using radiolabelled E. coli phospholipid substrate and an ELISA
      specific for group II human nonpancreatic PLA2. In all patients, there was a
      clear concordance of the two assays. Maximal PLA2 concentration was increased a
      mean of 554-fold over normal levels. We found no evidence to support the presence
      of activating or inhibitory proteins. These data confirm that the observed
      increase in serum PLA2 activity in septic shock is due to intravascular release
      of group II nonpancreatic PLA2.

PMID- 1740965
TI  - Effect of serotonergic agonists in the nucleus accumbens on d-amphetamine
      stimulated locomotion.
AB  - Serotonergic projections from the raphe nuclei are thought to modulate locomotor
      activity in the rat, and serotonin injection into the nucleus accumbens
      attenuates the hypermotility elicited by amphetamine. The purpose of the present
      study was to characterize the effects of various classes of serotonergic agonists
      administered into the nucleus accumbens on d-amphetamine-stimulated locomotor
      activity in order to determine which serotonin receptor subtypes are involved.
      Administration of the nonselective 5-HT agonist quipazine, the 5-HT-1 agonist
      mCPP, the 5-HT-1a agonist 8-OH-DPAT, the 5-HT-1b agonist CGS-12066B, and the 5HT
      1c/2 agonist DOI did not inhibit d-amphetamine-stimulated locomotor activity.
      Pronounced lateral head weaving was noted after 8-OH-DPAT administration. The
      combination of the 5-HT-1a agonist 8-OH-DPAT and the 5-HT-1b agonist CGS-12066B,
      however, did inhibit d-amphetamine-stimulated locomotor activity. In contrast,
      the 5-HT-3 agonist 1-phenylbiguanide enhanced the locomotor effect of d
      amphetamine. This effect was partially reversed by the 5-HT-3 antagonist MDL
      7222. These studies suggest that serotonin has complex and multiple effects on
      the regulation of locomotor activity within the nucleus accumbens.

PMID- 1740966
TI  - Subacute reserpine treatment reveals preferential coupling between the M3
      muscarinic receptor subtype and phosphatidylinositol turnover.
AB  - Muscarinic receptors in the rat cerebral cortex, cardiac atria and vas deferens
      were identified, quantitated, and characterized relative to phosphatidylinositol
      (PI) turnover as the functional response to stimulation of specific receptor
      subtypes. Receptor densities as determined by 3H-QNB binding were ranked:
      cerebral cortex greater than vas deferens greater than heart. Using displacement
      of 3H-QNB binding by the selective M1 and M2 muscarinic receptor antagonists
      pirenzepine and 11[[2-[(diethylamino)methyl]-1-piperidinyl]acetyl]-5,11-dihydro-
      6H-pyrido [2,3-b] [1,4] benzodiazepine-6-one (AF-DX 116) respectively,
      heterogeneous populations were found in the cerebral cortex and vas deferens. The
      M1 receptor subtype predominated in the former and the M2 predominated in the
      latter. An homogeneous M2 receptor population was present in the heart.
      Methacholine-stimulated accumulation of 3H inositol-1-phosphate was greater in
      the vas deferens than in the cerebral cortex, whereas PI turnover was not
      enhanced in cardiac atria. Reserpine treatment of rats (0.5 mg kg-1 day-1 for 7
      days) increased muscarinic receptor density in the vas deferens coincident with a
      shift in the low affinity pKi for AF-DX 116 to a value comparable to high
      affinity binding, and abolished the enhanced PI hydrolysis. In the cerebral
      cortex, reserpine treatment shifted only the early portion of the methacholine
      dose-response curve to the right. These results are judged to be supportive of
      preferential coupling between the M3 muscarinic receptor subtype and PI turnover.

PMID- 1740967
TI  - Muscarinic antagonists attenuate dizocilpine-induced hypermotility in mice.
AB  - Pretreatment of mice with the muscarinic receptor antagonists scopolamine and
      atropine attenuated the hypermotility (but not the depression of rearing) induced
      by a low dose of dizocilpine maleate [(+)-MK-801; 0.1 mg/kg, i.p.], a non
      competitive NMDA antagonist. In contrast, the muscarinic blockers failed to
      affect hypermotility induced by equieffective doses of phencyclidine (1 mg/kg,
      i.p.) or d-amphetamine (2 mg/kg, i.p.). These results suggest differences between
      the mechanism of behavioral activation produced by dizocilpine and phencyclidine,
      and demonstrate the potential of muscarinic blockade for diminishing the
      behavioral toxicity of NMDA antagonists.

PMID- 1740968
TI  - Degradation of human pancreastatin-52 by human kidney extract.
AB  - We examined the in vitro degradation of human pancreastatin-52 (hPST-52) and a
      larger molecular form (approximate 15 kDa) of human PST by an enzyme extract from
      human kidney. The PST-degrading activity was determined from the amount of
      immunoreactive PST remaining after incubation of hPST-52 or the larger molecular
      form with the enzyme extract. Human PST-52 was degraded to smaller molecular
      forms within 30 min, but the larger molecule was not degraded within 90 min.
      Phosphoramidon, an inhibitor of endopeptidase, metal ion chelators (EDTA and 1,
      10-phenanthroline) and Cu2+ prevented the degradation of hPST-52. These results
      indicated that the enzyme in the kidney extract degraded hPST-52 and smaller
      forms of the peptide, but had no effect on the 15 kDa form.

PMID- 1740969
TI  - Identification of somatogenic binding sites in liver microsomes from normal mice
      and transgenic mice expressing human growth hormone gene.
AB  - Somatogenic binding sites were detected and characterized in microsomal
      preparations from livers of normal mice and mice expressing metallothionein-I/hGH
      (mMT/hGH) hybrid gene, using 125I-labelled bovine or human GH, or a photoreactive
      derivative of hGH (125I-AP-hGH1). Specific binding of 125I-bGH was detected in
      liver microsomes from both normal and transgenic mice with an apparent Kd of 2
      nM. 125I-hGH was partially displaced by bGH. 125I-AP-hGH1 was covalently bound to
      the microsomal preparations, and bGH prevented the formation of the 130 kDa
      species with no appreciable effect on 63 kDa and 70 kDa lactogenic complexes.

PMID- 1740970
TI  - Effects of prenatal administration of testosterone and cortisone on the
      reproductive system of the female rat.
AB  - Testosterone propionate, cortisone, or sesame oil vehicle were given to rats
      during the last week of pregnancy so that effects of the hormones on anogenital
      distance, breeding capacity and vaginal opening of the female progeny could be
      contrasted. Testosterone significantly increased anogenital distance and delayed
      vaginal opening of progeny. When females that had been exposed to testosterone in
      utero were tested for breeding capacity, a significantly smaller number mated
      than in the control group. Female rats that had been exposed to cortisone in
      utero exhibited premature vaginal opening but did not differ from controls in
      anogenital distance, and, unlike the testosterone-exposed rats, mated. Cortisone
      exposed rats carried litters to term and the litters did not differ from those of
      controls in numbers of pups or numbers of living pups at birth. The pups born to
      cortisone-exposed rats had greater birth weights and a higher survival rate to 20
      days of age than pups of controls. Results indicate that testosterone
      administration to rats during pregnancy is far more detrimental to the
      development and subsequent function of the reproductive system of female progeny
      than cortisone and suggest that similar changes which occur in response to
      maternal stress or to administration of ACTH during pregnancy are more likely to
      result from increases in testosterone than from increases in glucocorticoid
      secretion.

PMID- 1740971
TI  - The in vitro dissociation kinetics of (R,R)-[125I]4IQNB is reflected in the in
      vivo washout of the radioligand from rat brain.
AB  - We have determined the kinetics of dissociation of (R)-3-Quinuclidinyl (R)-4
      [125I]Iodobenzilate ((R,R)-[125I]4IQNB) from muscarinic acetylcholine receptor
      preparations from the cortex, hippocampus, caudate/putamen, thalamus, pons and
      colliculate bodies. The dissociation curves are well described by a biexponential
      function and are consistent with subtype selectivity favoring slow dissociation
      from the M1, M3, and M4 receptors with a 20-fold faster dissociation rate for the
      M2 receptor. Following intravenous injection, (R,R)-[125I]4IQNB binds to receptor
      in the rat brain in concentrations which reflect the receptor concentration
      present in a structure. We determined the extent of radioligand present at two
      times, 2 and 24 hrs, as an indication of the relative proportions of m-AChR which
      exhibits rapid vs. slow dissociation of (R,R)-[125I]4IQNB. A good correlation
      between in vitro and in vivo results suggests that the relative populations of
      receptor subtypes can be imaged using in vivo pharmacokinetics of (R,R)
      [125I]4IQNB.

PMID- 1740972
TI  - Thyroxine attenuates hippocampal neuronal damage caused by ischemia in the rat.
AB  - We investigated the effect of thyroxine against neuronal damage caused by
      ischemia in the rat. Neuronal damage was evaluated in the hippocampal CA1
      subfield 7 days after a 10 min forebrain ischemia. Thyroxine was administered to
      animals divided in three groups: 15 min prior to ischemia (group 1), immediately
      after ischemia (group 2), and both before and after ischemia (group 3). The
      treatment of rats with a single dose of thyroxine given pre- or postischemia
      failed to prevent the loss of CA1 pyramidal cells. In contrast, repetitive
      administration of thyroxine before and after ischemia reduced the damage of the
      CA1 pyramidal cells. The mechanisms possibly underlying this neuroprotective
      effect are discussed.

PMID- 1740973
TI  - A sensitive fluorometric assay for reducing sugars.
AB  - A simple and rapid fluorometric assay for reducing sugars that is sensitive to
      the nanomolar range has been developed. The assay involves the derivatization of
      a given sugar with hydrazine at pH 3 to form a hydrazone, which is reacted with
      fluorescamine following adjustment of pH to first 9.4 and then 7.4. The amount of
      sugar in a sample is quantitated by measuring the fluorescence intensity at an
      excitation wavelength of 400 nm and an emission wavelength of 490 nm. The assay
      is precise and reproducible, as indicated by intra- and inter-run variations of
      at most 3% and 4%, respectively. In addition to reducing sugars, the assay can
      also be used to measure aliphatic and aromatic aldehydes, but not acetone.
      Compared with an existing fluorometric sugar assay, the assay reported here does
      not require chromatographic separation of the fluorescent derivative from
      unreacted fluorescamine. The assay can, however, be potentially adapted for
      postcolumn detection of aldehydes, reducing sugars, and hydrazones in HPLC.

PMID- 1740975
TI  - Embryo research: an Islamic response.

PMID- 1740974
TI  - Inhibitory effect of 4-methylpyrazole on antipyrine clearance in rats.
AB  - Pyrazole and 4-methylpyrazole (4-MP) are potent, effective inhibitors of alcohol
      dehydrogenase. Pyrazole and its derivatives also have been shown to affect the
      cytochrome P-450 dependent monooxygenase system. This study was performed to
      investigate the effect of 4-MP on the disposition kinetics of antipyrine (AP).
      Groups of male Fisher 344 rats were given an ip injection of 4-MP (100 mg/kg) or
      4-MP HCl (equivalent to 4-MP 100 mg/kg) or an equivalent volume of saline. AP (20
      mg/kg) was injected intravenously via the jugular vein catheter 30 minutes later.
      Blood samples were collected upto 24 hours and assayed by HPLC. 4-MP pretreatment
      significantly decreased AP clearance from 0.490 +/- 0.032 to 0.095 +/- 0.014 (4
      MP HCl) and 0.076 +/- 0.008 (4-MP) L/hr.kg (p less than 0.01). The volume of
      distribution of AP decreased from 0.82 +/- 0.07 to 0.65 +/- 0.06 (4-MP HCl) and
      0.56 +/- 0.04 (4-MP) L/kg (p less than 0.05). Mean residence time increased from
      1.68 +/- 0.09 to 6.91 +/- 0.58 (4-MP HCl) and 7.39 +/- 0.56 (4-MP) hr (p less
      than 0.01). These results demonstrate a significant inhibitory effect of 4-MP on
      the cytochrome P-450 isozyme(s) which is responsible for AP metabolism in intact
      animals.

PMID- 1740976
TI  - Submersion cases: a retrospective study--1988-1990.
AB  - According to the studied material the majority of the bodies found submersed in
      water (in the area covered by this report) were predominantly those of Caucasian
      males between 20 and 40 years of age, probably sober and without drug consumption
      when they entered the water. The majority of the cases were recovered from the
      water in the late spring and early summer and many of them were in different
      stages of decomposition which made the diagnosis of drowning impossible. The
      diagnosis of the cause and manner of death in such cases requires a complex
      interpretation of all investigative evidence and a logical approach in each case
      in particular.

PMID- 1740977
TI  - Acute pancreatitis: a comparison of the severity of illness in cases first
      diagnosed before and after death, using a modified prognostic index.
AB  - The severity of disease in a series of patients in whom acute pancreatitis was
      diagnosed at autopsy was assessed by the retrospective application of a standard
      prognostic index modified for post-mortem use. The results were compared with
      cases dying of acute pancreatitis which was recognized during life and
      appropriately treated. No difference in disease severity could be identified
      between the two groups. This suggests that patients dying of acute pancreatitis
      unrecognized during life have a severe form of the disease and do not die because
      a mild attack is treated inappropriately. The condition appears to be
      unrecognized in such patients because it presents with atypical features.

PMID- 1740978
TI  - About death.

PMID- 1740979
TI  - Insurance, reinsurance and underwriting names' liability for asbestos-related
      diseases.

PMID- 1740980
TI  - The medico-legal organization of a mass disaster--the Air India crash 1985.

PMID- 1740981
TI  - Criminal liability for the unauthorized use of corpses for medical education and
      research.

PMID- 1740982
TI  - Suicidal strangulation.
AB  - Self-strangulation for committing suicide by the use of ligature is admittedly
      rare. A suicidal strangulation case from Haryana State, India is discussed in the
      light of scene of occurrence, investigations of the ligature and its knot.
      Initially the case was suspected by the police to be a murder, but proved to be
      of suicidal strangulation.

PMID- 1740983
TI  - An unusual case of comingled remains.
AB  - Two motor cyclists were involved in a head-on collision. One of the motor
      cyclists sustained a stab wound to the chest by a portion of long bone derived
      from the other motor cyclist. This case is reported because of its unusual
      nature.

PMID- 1740984
TI  - An unusual injury.
AB  - The case of a young man who died unexpectedly from myocarditis is presented. The
      body was partially embalmed before autopsy at the Victorian Institute of Forensic
      Pathology. Although the cause of death was not a problem to diagnose, this case
      highlights artefacts that embalming may cause and the difficulties it may create
      with interpretation of injury. This is of particular relevance to those forensic
      pathologists who only uncommonly see injuries which are due to embalming.

PMID- 1740985
TI  - Tuberous sclerosis presenting as a suspicious sudden death--a case report and
      review of sudden deaths in epilepsy.
AB  - A case of a suspicious sudden death in a 19-year-old Caucasian female epileptic
      is presented. The brain showed characteristic lesions of tuberous sclerosis. In
      most sudden deaths in idiopathic epilepsy no causative lesion is found in the
      brain. A review of the past five years' cases attributed to sudden deaths in
      epilepsy from our department is presented, with particular reference to findings
      which might be construed as suspicious, e.g., signs of asphyxia and bruising in
      neck muscles, and to findings which support the diagnosis, e.g. biting of the
      tongue, voiding of urine, low levels of medication.

PMID- 1740986
TI  - A case of homicidal choking mistaken for suicide.
AB  - This report presents an autopsy case of the homicidal choking of an adult, who
      died as a result of tissue paper being thrust into his mouth. An in-patient (a 29
      year-old Japanese man) at a mental hospital was choked to death by another male
      in-patient, his roommate, who thrust a large amount of tissue paper into his
      mouth after rendering him slightly unconscious by cervical compression. At the
      time of discovery, this mental patient was believed to have committed suicide by
      inserting tissue paper into his own mouth. Autopsy findings and re-investigation
      of the case revealed that the subject had been murdered. This is a very rare case
      of choking used as a method of homicide.

PMID- 1740987
TI  - An unusual case of accidental smothering.
AB  - A rare accidental death case is presented in which four pieces of packing tape
      adhered tightly over the nose and mouth. The notes for his experimental report,
      left in his room, suggested that the accident happened during his trial to prove
      his theory on respiration to improve physical exercise.

PMID- 1740988
TI  - Sub-lethal poisoning by self-injection with ricin.
AB  - Ricin, one of the most potent toxins known, has a lethal dose range of 1-10 mg
      per kilogram (Crompton and Gall, 1980) when injected. There is no effective
      treatment. We report a case of sub-lethal poisoning by self-injection.

PMID- 1740989
TI  - Dr Hunter and the hunted.

PMID- 1740990
TI  - Sleepwalking and indecent exposure.

PMID- 1740991
TI  - The certification and disposal of the dead in major disasters.
AB  - When a major disaster occurs in which there are a large number of fatalities,
      many tasks have to be undertaken in a very short time and under great pressure.
      By considering in advance the potential difficulties which may be encountered it
      is possible to plan ways of overcoming, or at least minimizing, some of these
      problems. In this paper we have ventilated some of the problems concerning the
      certification and disposal of the victims of a major disaster, as seen from the
      pathologist's point of view.

PMID- 1740992
TI  - Case in point: qualifications for job promotion.

PMID- 1740994
TI  - Women's health: a call for nursing action.

PMID- 1740993
TI  - Nursing needs in Mississippi: supply and demand.

PMID- 1740995
TI  - A comparison of infection rates in a newborn intensive care unit before and after
      adoption of open visitation.

PMID- 1740996
TI  - Frequency of hand washing by registered nurses caring for infants on radiant
      warmers and in incubators.

PMID- 1740998
TI  - Demonstration day: a unique way to learn.

PMID- 1740997
TI  - Factors that influence the use of universal precautions by neonatal nurses.

PMID- 1740999
TI  - Basic proficiency in medication administration.

PMID- 1741000
TI  - Pneumothorax in the newborn.

PMID- 1741001
TI  - U.S. maternal and child health services.

PMID- 1741002
TI  - Clinical trials.

PMID- 1741003
TI  - Education in the NICU. Special teaching needs of teen parents.

PMID- 1741004
TI  - Chloral hydrate.

PMID- 1741005
TI  - Beyond survival: strategies for establishing a follow-up program for infants
      treated with extracorporeal membrane oxygenation.

PMID- 1741006
TI  - HIV-risk behaviors of sterilized and nonsterilized women in drug-treatment
      programs--Philadelphia, 1989-1991.
AB  - From June 1981 through December 1991, 34% of all reported cases of acquired
      immunodeficiency syndrome (AIDS) among women in the United States were attributed
      to heterosexual transmission, and that proportion has been increasing steadily
      (1). Factors associated with an increased risk for heterosexual transmission
      include unprotected sexual intercourse (2), multiple sex partners, and the
      presence of other sexually transmitted diseases (STDs) (1). Women who have been
      surgically sterilized and who are sexually active and/or use injecting drugs may
      need the same prevention services for human immunodeficiency virus (HIV) and
      other STDs as similar nonsterilized women; however, the specific needs of
      sterilized women have not been well characterized. This report compares findings
      from surveys of surgically sterilized and nonsterilized women in drug-treatment
      programs in Philadelphia on their drug use and HIV/STD-risk behaviors and
      assesses changes in risk behaviors among these women after a 9-month period
      during which family-planning counseling and/or gynecologic services were offered.

PMID- 1741007
TI  - Medicare influenza vaccine demonstration--selected states, 1988-1992.
AB  - Influenza and its complications remain a major cause of premature death and
      debilitating illness in the United States, particularly among older persons and
      those with chronic medical conditions. However, only 30% of persons greater than
      or equal to 65 years of age responding to the 1989 National Health Interview
      Survey reported having received influenza vaccine during the previous year (CDC,
      unpublished data, 1991). In 1988, the Health Care Financing Administration (HCFA)
      and CDC began a congressionally mandated 4-year demonstration project to evaluate
      the cost-effectiveness of providing influenza vaccine under Medicare. This report
      reviews preliminary results of the Medicare Influenza Vaccine Demonstration
      during 1988-1992.

PMID- 1741008
TI  - Hepatitis A among homosexual men--United States, Canada, and Australia.
AB  - Although male homosexual activity has been reported as a risk factor for
      hepatitis A, the frequency with which homosexual activity was reported by persons
      with hepatitis A was less than 10% during 1982-1989 (CDC unpublished data, 1990).
      However, in June of 1991, CDC received reports from several cities in the United
      States, Canada, and Australia of an increase in hepatitis A among homosexual men
      during the first 6 months of 1991. This report summarizes data from each of these
      cities.

PMID- 1741009
TI  - Pertussis vaccination: acellular pertussis vaccine for reinforcing and booster
      use--supplementary ACIP statement. Recommendations of the Immunization Practices
      Advisory Committee (ACIP).
AB  - This supplementary statement provides information on and recommendations for the
      use of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). One
      such vaccine was recently licensed, ACEL-IMMUNE.* This vaccine is licensed for
      use only as the fourth and fifth doses of diphtheria, tetanus, and pertussis
      vaccination; it is not licensed for the initial three-dose series in infants and
      children, regardless of age. At least one other DTaP product is anticipated to be
      licensed in the future for use as the fourth and fifth doses. The current
      Immunization Practices Advisory Committee (ACIP) statement on diphtheria,
      tetanus, and pertussis issued August 8, 1991, gives general recommendations on
      pertussis prevention, including the use of whole-cell pertussis vaccines for
      primary and booster vaccination (1).

PMID- 1741010
TI  - Effects of hypoxia and acute osmotic stress on intermediary metabolism in
      Leishmania promastigotes.
AB  - This study further explores the effects of hypoxia and acute osmotic stress on
      intermediary metabolism of Leishmania major and Leishmania donovani. Late log
      phase promastigotes were washed and incubated with glucose as the sole exogenous
      carbon source, and rates of glucose consumption and product formation were
      measured as a function of osmotic strength (610, 305, and 167 mOsm kg-1) and pO2
      (95, 10, and 0% O2) in the presence of 5% CO2. Very mild hypoxia dramatically
      altered flux through the pathways of intermediary metabolism and increased the
      rates of production of the major metabolites, thus confirming the presence of a
      low-affinity O2 sensor which was active under all osmolalities tested. The data
      also require that as pO2 is lowered towards anoxia an endogenous carbohydrate
      source is mobilized. Under aerobic conditions, acute hypo-osmotic stress had
      little effect on product formation, whereas acute hyperosmotic stress altered
      metabolism in a manner similar to mild hypoxia, with the exception of decreasing
      the rates of acetate and succinate production. It was also shown in L. donovani
      promastigotes that the effects of anoxia and hyperosmolality were not additive.
      Thus, separate sensors with partially overlapping actions are involved in the
      metabolic responses to hypoxia and hyperosmolality. There was no apparent species
      specificity for the responses to pO2 and osmotic stress. Uncoupling with carbonyl
      cyanide p-trifluoromethoxyphenylhydrazone caused changes in metabolite flux
      patterns which differed from the changes caused by either hypoxia or acute
      osmotic stress, while rotenone and calcium ionophore A23187 had no significant
      effects. The identity of the sensors responsive to pO2 and osmolality, and the
      mechanisms by which they regulate flux through the pathways of intermediary
      metabolism, require further study.

PMID- 1741011
TI  - Ferritins of Schistosoma mansoni: sequence comparison and expression in female
      and male worms.
AB  - Recombinant clones of Schistosoma mansoni cDNA libraries containing the complete
      coding regions of 2 different ferritin subunits have been isolated and sequenced.
      This allows for the first time a comparison of ferritin sequences from an
      invertebrate with those of vertebrates. The deduced amino acid sequences of both
      Schistosoma ferritin subunit clones show significant homology to vertebrate
      ferritin H chains. Similarity exceeds 50% identity and includes the recently
      identified ferroxidase center which is present only in H chains. However, non
      conservative substitutions of amino acid residues lining the 3-fold symmetry
      channel were found, and a gap of 3 successive amino acids unique to the 2
      Schistosoma ferritin sequences was identified. Remarkably, for each of the 2
      genes, we found a conspicuous difference in the amount of ferritin transcripts
      between females and males: one of the genes is preferentially expressed in
      females, the other in males.

PMID- 1741012
TI  - Comparison of the body wall myosin heavy chain sequences from Onchocerca volvulus
      and Brugia malayi.
AB  - The complete coding sequence of Onchocerca volvulus myosin heavy chain has been
      determined from a series of overlapping cDNAs. The protein sequences from the 2
      filarids, one responsible for subcutaneous filariasis, the other for lymphatic
      filariasis, show 92% identity, and are 1957 amino acids long. Each protein
      sequence is also equally related, with 75% identity, to MHC-B, the protein
      encoded by the unc-54 gene of the free-living nematode C.elegans. Such analysis
      is useful in phylogenetic studies among nematodes, as well as in structure
      function relationships among myosin isolates.

PMID- 1741013
TI  - Characterization of a myosin heavy chain gene from Brugia malayi.
AB  - We have previously shown that an antigen recognized by antibodies in sera of
      several microfilaremic individuals from a Wuchereria bancrofti endemic area bears
      strong homology to an invertebrate muscle protein. We have cloned and sequenced
      the entire gene containing this antigen encoding fragment and present data that
      confirms that the antigen is myosin heavy chain (MHC). This gene, which we have
      named Bmmyo-1 extends over 11 kb and has the potential to encode a protein of
      1957 amino acids. The coding sequence is interrupted by 14 introns, most of which
      are larger than those in the myosin gene of the free-living nematode,
      Caenorhabditis elegans. The protein encoded by this gene bears greatest homology
      (75.1% identity) to the C. elegans myosin isoform MHC-B, encoded by the unc-54
      gene. MHC-B is the major body wall myosin in C. elegans.

PMID- 1741014
TI  - Cysteine is an essential growth factor for Trypanosoma brucei bloodstream forms.
AB  - A modified cystine-free minimum essential medium has been used to address the
      question whether cysteine is an essential growth factor for bloodstream form
      trypanosomes or if its reducing power is sufficient to support parasite growth in
      axenic culture. Bloodstream-form trypanosomes, taken either from freshly isolated
      infected mouse blood or from logarithmically growing axenic cultures were
      transferred to a medium containing 20% dialysed foetal calf serum, 10 microM
      bathocuproine sulphonate and 250 microM cysteine. Growth curves of these cultures
      have been compared to those obtained in identical cultures containing no cysteine
      but cystine and reducing agents (beta-mercaptoethanol, monothioglycerol), or
      reducing agents alone. The results clearly show that cell growth was only
      obtained if cysteine was either directly added to the medium or was reduced from
      cystine by the action of reducing agents. However, neither reducing agents alone,
      nor D-cysteine, supported cell growth. Since cystine is not taken up by
      bloodstream form trypanosomes, and methionine is a regular constituent of the
      medium, we conclude from our results that cysteine is an essential growth factor
      for Trypanosoma brucei.

PMID- 1741015
TI  - Identification of a novel Brugia pahangi beta-tubulin gene (beta 2) and a 22
      nucleotide spliced leader sequence on beta 1-tubulin mRNA.
AB  - We have examined the expression of beta-tubulin genes in the parasitic nematode,
      Brugia pahangi. A genomic library was constructed and screened by hybridization
      with a Haemonchus contortus beta-tubulin cDNA fragment which recognizes several
      B. pahangi beta-tubulin sequences, including sequences which correspond to the
      previously characterized beta 1-tubulin gene. The B. pahangi beta 2-tubulin gene
      was isolated by selecting clones which hybridize to the H. contortus beta-tubulin
      gene but which do not hybridize to the beta 1-tubulin gene. A partial sequence of
      the beta 2-tubulin gene confirms that it codes for a distinct beta-tubulin.
      Southern hybridization analyses show that the beta 2-tubulin sequence exists as a
      single copy gene within the B. pahangi genome. Expression of the beta 2-tubulin
      gene is developmentally regulated and the message is found predominantly in adult
      male worms, whereas the beta 1-tubulin gene is expressed in microfilariae and
      approximately equal levels of the transcript are found in male and female adult
      worms. During mRNA maturation the beta 1-tubulin mRNA of microfilariae and adult
      worms acquires a trans-spliced leader identical to the SL1 of Caenorhabditis
      elegans.

PMID- 1741016
TI  - Cloning of a cDNA encoding phosphoenolpyruvate carboxykinase from Haemonchus
      contortus.
AB  - Biochemical and metabolic data have led to the conclusion that the enzyme
      phosphoenolpyruvate carboxykinase (PEPCK; EC 4.1.1.32) contributes to a critical
      point of divergence in energy conservation pathways between mammals and
      nematodes. To facilitate the determination of the molecular basis for host vs
      parasite differences in PEPCK, we have cloned a cDNA encoding this enzyme from a
      parasitic nematode of ruminants, Haemonchus contortus. H. contortus PEPCK was
      cloned by functional complementation of a PEPCK-, malic enzyme- strain of
      Escherichia coli (E1786) using an egg stage H. contortus cDNA library in lambda
      ZAPII. Selection was for growth on malate as the sole carbon source (malate+
      phenotype). We isolated a plasmid, pPEPCK, which reproducibly confers a malate+
      phenotype in E1786. The sequence of the 2.0-kb EcoRI insert of pPEPCK predicts a
      612-amino acid protein which shows about 74% similarity to Drosophila
      melanogaster and chicken PEPCK. Extracts of E1786[pPEPCK], but not E1786, contain
      IDP- or GDP-dependent PEPCK enzyme activity. Sequence analysis revealed that the
      open reading frame (ORF) in pPEPCK lacked a 5' initiation codon and was probably
      expressed as an in-frame fusion protein with beta-galactosidase. A strategy
      combining library screening with PCR analysis of positive clones led to the
      identification of a clone encoding 6 additional NH2-terminal amino acids,
      including a Met, which, by comparison with known PEPCK amino acid sequences, is
      likely to be the translation initiation site.

PMID- 1741017
TI  - Three beta-tubulin cDNAs from the parasitic nematode Haemonchus contortus.
AB  - Experimental evidence indicates that tubulin is the site of action of the
      anthelmintic benzimidazoles. Furthermore, certain residues of beta-tubulin seem
      to be critical for this mechanism. Although the benzimidazoles selectively affect
      nematode vs. mammalian beta-tubulin, the molecular basis for this differential
      action is not known. To enhance our understanding of this phenomenon, and to
      provide the basis for investigating benzimidazole resistance in parasitic
      nematodes, we undertook the cloning of beta-tubulin cDNAs from the ruminant
      parasite, Haemonchus contortus. We have cloned and sequenced three beta-tubulin
      cDNAs from this organism, beta 12-16, beta 12-164, and beta 8-9. The first 2
      differ at only 23 nucleotides, which give rise to 4 amino acid changes. beta 8-9
      represents a different isotype class from the other two, since it differs
      extensively in the carboxyterminus. By comparing the sequences of these and other
      nematode beta-tubulins with mammalian beta-tubulins, several regions of
      consistent difference can be recognized; the functional significance of these
      regional differences has not been defined. Sequences very similar or identical to
      beta 8-9 and beta 12-16 are present in both benzimidazole-sensitive and
      benzimidazole-resistant populations of H. contortus. However, it appears that
      drug-resistant organisms may differ in the presence of a gene product which is
      closely related to beta 8-9.

PMID- 1741018
TI  - Secondary processing of the Plasmodium falciparum merozoite surface protein-1
      (MSP1) by a calcium-dependent membrane-bound serine protease: shedding of MSP133
      as a noncovalently associated complex with other fragments of the MSP1.
AB  - Merozoites of the malaria parasite Plasmodium falciparum possess on their surface
      proteolytically processed fragments of the merozoite surface protein-1 (MSP1).
      Secondary processing of one of these fragments, MSP1(42), always occurs prior to,
      or at the point of successful erythrocyte reinvasion. It is shown that a product
      of this secondary processing, MSP1(33), is shed in the form of a noncovalently
      associated complex with a number of other proteins, including the MSP1-derived
      species MSP1(38) and MSP1(83). Secondary processing of MSP1(42) is inhibited by
      the chelating agents ethylenediaminetetraacetic acid (EDTA) and ethyleneglycol
      bis-(beta-aminoethyl ether)-tetraacetic acid (EGTA), and this inhibition is
      reversible by addition of excess calcium. Secondary processing occurs in
      preparations of washed, disrupted merozoites, and is inhibited by the protease
      inhibitors phenylmethylsulphonyl fluoride (PMSF) and diisopropyl fluorophosphate
      (DFP), indicating that the protease responsible is a membrane-associated serine
      protease.

PMID- 1741019
TI  - The role of calcium in the invasion of human erythrocytes by Plasmodium
      falciparum.
AB  - The role of calcium in the invasion of human erythrocytes by Plasmodium
      falciparum merozoites has been investigated using a variety of techniques. It has
      been demonstrated using calcium-depleted medium that invasion is dependent upon
      the presence of calcium and that neither magnesium, manganese or zinc may
      substitute for it, suggesting that the effect is calcium specific and not
      dependent upon a non-specific, charge-based mechanism. Using resealed erythrocyte
      ghosts and altering the internal and external concentrations of calcium and the
      chelator EGTA, it has been shown that the role of calcium in invasion, at least
      as far as the target cell is concerned, is in the extracellular environment.
      Similarly, loading either the schizont-infected, or target erythrocyte with the
      membrane permeant calcium chelator Indo-1, at concentrations sufficient to
      chelate approximately 100 times the concentration of resting cell calcium,
      produced no change in the parasite invasion rate. Consequently we conclude that
      calcium plays an extra-cellular role in merozoite invasion of the human
      erythrocyte.

PMID- 1741020
TI  - Repeat structures in a Plasmodium falciparum protein (MESA) that binds human
      erythrocyte protein 4.1.
AB  - The mature-parasite-infected erythrocyte surface antigen (MESA, also known as
      PfEMP-2 and pp300) of Plasmodium falciparum is a phosphoprotein of approx. 250
      300 kDa that is exported from the parasite to the erythrocyte membrane skeleton
      where it binds to protein 4.1. Determination of the primary sequence of MESA
      reveals that it is encoded by 2 exons, a structure common to other exported
      proteins of P. falciparum. The MESA protein is heavily charged and contains 7
      distinct repeat regions that compose over 60% of the protein. The predicted
      secondary structure suggests that MESA is a fibrillar protein and it shows
      similarity to a number of cytoskeletal and neurofilament proteins, including
      myosin, a protein that itself binds to protein 4.1.

PMID- 1741021
TI  - Sequence of a 16-kilodalton sexual stage and sporozoite surface antigen of
      Plasmodium reichenowi and comparison with Pfs16 of Plasmodium falciparum.

PMID- 1741022
TI  - DNA recombination associated with short direct repeats in Leishmania mexicana
      M379.

PMID- 1741023
TI  - Isolation and characterization of genomic clones encoding a serine-rich Entamoeba
      histolytica protein.

PMID- 1741024
TI  - Genome project faces commercialization test.

PMID- 1741025
TI  - Indirect costs. Dingell probe expands.

PMID- 1741026
TI  - US science budget. Seven percent solution: too good to be true?

PMID- 1741027
TI  - Transmembrane signalling. Pivots or pistons?

PMID- 1741028
TI  - Eye development. Function for Ras in sight.

PMID- 1741029
TI  - Prune function?

PMID- 1741030
TI  - Genetics and speciation.
AB  - Called the "mystery of mysteries" by Darwin, speciation is still a little
      understood area of evolution. Genetic analysis, however, has yielded new
      generalizations about speciation and suggests promising avenues of research.

PMID- 1741031
TI  - Evolution of king crabs from hermit crab ancestors.
AB  - King crabs (Family Lithodidae) are among the world's largest arthropods, having a
      crab-like morphology and a strongly calcified exoskeleton. The hermit crabs, by
      contrast, have depended on gastropod shells for protection for over 150 million
      years. Shell-living has constrained the morphological evolution of hermit crabs
      by requiring a decalcified asymmetrical abdomen capable of coiling into gastropod
      shells and by preventing crabs from growing past the size of the largest
      available shells. Whereas reduction in shell-living and acquisition of a crab
      like morphology (carcinization) has taken place independently in several hermit
      crab lineages, and most dramatically in king crabs, the rate at which this
      process has occurred was entirely unknown. We present molecular evidence that
      king crabs are not only descended from hermit crabs, but are nested within the
      hermit crab genus Pagurus. We estimate that loss of the shell-living habit and
      the complete carcinization of king crabs has taken between 13 and 25 million
      years.

PMID- 1741032
TI  - Movement selection in advance of action in the superior colliculus.
AB  - The primate superior colliculus contains a map of saccadic eye movements.
      Saccades are high-velocity eye movements to selected targets in the visual field,
      but little is known about the neural mechanisms responsible for target selection
      or the related problem of choosing a particular movement from the oculomotor
      repertoire. Two classes of neurons have been described in the superior colliculus
      which show bursts of activity before the saccade: discrete bursters display a
      vigorous pre-saccadic burst and prelude bursters show low-frequency activity as a
      prelude to burst onset. We have designed experiments to test whether prelude
      activity is related to saccade selection. Our tasks use a cue to specify which of
      two physically identical visual stimuli is the goal of an impending saccade. This
      cue is spatially and temporally isolated from the potential targets as well as
      from visual cues signalling movement initiation. Our results show that prelude
      activity occurs shortly after information is available for correct saccade
      selection and, more importantly, the activity is predictive of saccade choice.
      The results thus suggest that the superior colliculus participates in the process
      of saccade selection.

PMID- 1741033
TI  - Evidence from mosaic analysis of the masculinizing gene her-1 for cell
      interactions in C. elegans sex determination.
AB  - Sex in Caenorhabditis elegans is determined by a regulatory cascade of seven
      interacting autosomal genes controlled by three X-linked genes in response to the
      X chromosome-to-autosome (X/A) ratio. XX animals (high X/A) develop as self
      fertile hermaphrodites, and XO animals (low X/A) develop as males. The activity
      of the first gene in the sex-determining cascade, her-1, is required for male
      sexual development. XO her-1 loss-of-function mutants develop as self-fertile
      hermaphrodites, whereas XX her-1 gain-of-function mutants develop as masculinized
      intersexes. By genetic mosaic analysis using a fused free duplication linking her
      1 to a cell-autonomous marker gene, we show here that her-1 expression in a
      sexually dimorphic cell is neither necessary nor sufficient for that cell to
      adopt a male fate. Our results suggest that her-1 is expressed in many, possibly
      all, cells and that its gene product can function non-autonomously through cell
      interactions to determine male sexual development.

PMID- 1741034
TI  - Yeast RAD14 and human xeroderma pigmentosum group A DNA-repair genes encode
      homologous proteins.
AB  - Xeroderma pigmentosum (XP), a human autosomal recessive disorder, is
      characterized by extreme sensitivity to sunlight and high incidence of skin
      cancers. XP cells are defective in the incision step of excision repair of DNA
      damaged by ultraviolet light. Cell fusion studies have defined seven XP
      complementation groups, XP-A to XP-G. Similar genetic complexity of excision
      repair is observed in the yeast Saccharomyces cerevisiae. Mutations in any one of
      five yeast genes, RAD1, RAD2, RAD3, RAD4, and RAD10, cause a total defect in
      incision and an extreme sensitivity to ultraviolet light. Here we report the
      characterization of the yeast RAD14 gene. The available rad14 point mutant is
      only moderately ultraviolet-sensitive, and it performs a substantial amount of
      incision of damaged DNA. Our studies with the rad14 deletion (delta) mutation
      indicate an absolute requirement of RAD14 in incision. RAD14 encodes a highly
      hydrophilic protein of 247 amino acids containing zinc-finger motifs, and it is
      similar to the protein encoded by the human XPAC gene that complements XP group A
      cell lines.

PMID- 1741035
TI  - Lactose binding to heat-labile enterotoxin revealed by X-ray crystallography.
AB  - Recognition of the oligosaccharide portion of ganglioside GM1 in membranes of
      target cells by the heat-labile enterotoxin from Escherichia coli is the crucial
      first step in its pathogenesis, as it is for the closely related cholera toxin.
      These toxins have five B subunits, which are essential for GM1 binding, and a
      single A subunit, which needs to be nicked by proteolysis and reduced, yielding
      an A1-'enzyme' and an A2-'linker' peptide. A1 is translocated across the membrane
      of intestinal epithelial cells, possibly after endocytosis, upon which it ADP
      ribosylates the G protein Gs alpha. The mechanism of binding and translocation of
      these toxins has been extensively investigated, but how the protein is orientated
      on binding is still not clear. Knowing the precise arrangement of the ganglioside
      binding sites of the toxins will be useful for designing drugs against the
      diarrhoeal diseases caused by organisms secreting these toxins and in the
      development of oral vaccines against them. We present here the three-dimensional
      structure of the E. coli heat-labile enterotoxin complexed with lactose. This
      reveals the location of the binding site of the terminal galactose of GM1, which
      is consistent with toxin binding to the target cell with its A1 fragment pointing
      away from the membrane. A small helix is identified at the carboxy terminus of A2
      which emerges through the central pore of the B subunits and probably comes into
      contact with the membrane upon binding, whereas the A1 subunit is flexible with
      respect to the B pentamer.

PMID- 1741037
TI  - CLONTECH now offers glyceraldehyde 3-phosphate dehydrogenase (G3PDH) and
      transferrin receptor PCR amplimers and cDNA probes.

PMID- 1741036
TI  - Selection of single-stranded DNA molecules that bind and inhibit human thrombin.
AB  - Aptamers are double-stranded DNA or single-stranded RNA molecules that bind
      specific molecular targets. Large randomly generated populations can be enriched
      in aptamers by in vitro selection and polymerase chain reaction. But so far
      single-stranded DNA has not been investigated for aptamer properties, nor has a
      target protein been considered that does not interact physiologically with
      nucleic acid. Here we describe the isolation of single-stranded DNA aptamers to
      the protease thrombin of the blood coagulation cascade and report binding
      affinities in the range 25-200 nM. Sequence data from 32 thrombin aptamers,
      selected from a pool of DNA containing 60 nucleotides of random sequence,
      displayed a highly conserved 14-17-base region. Several of these aptamers at
      nanomolar concentrations inhibited thrombin-catalysed fibrin-clot formation in
      vitro using either purified fibrinogen or human plasma.

PMID- 1741038
TI  - Ideas for the immunologist.

PMID- 1741039
TI  - Ideas for the immunologist.

PMID- 1741040
TI  - DNA fingerprinting. FBI gives in on genetics.

PMID- 1741041
TI  - Animal experimentation. Swiss public backs research.

PMID- 1741042
TI  - Animal research. Airlines vs activists.

PMID- 1741043
TI  - Gene therapy panel. NIH merger to shorten review.

PMID- 1741044
TI  - Genome project. Patents, round two.

PMID- 1741045
TI  - Pharmaceutical industry. Glaxo benches top manager.

PMID- 1741046
TI  - Patent protection. Canadian drug firms boost R&D spending.

PMID- 1741047
TI  - UK fund created. HIV compensation.

PMID- 1741048
TI  - DNA profiling and the police.

PMID- 1741049
TI  - Gene therapy.

PMID- 1741050
TI  - Disallowing direct costs.

PMID- 1741051
TI  - Radiation biology. Alpha-particle after effects.

PMID- 1741052
TI  - Palaeoanthropology. Old bones match old stones.

PMID- 1741053
TI  - AIDS vaccine developments.

PMID- 1741054
TI  - AIDS vaccine developments.

PMID- 1741055
TI  - AIDS vaccine developments.

PMID- 1741056
TI  - Primary structure of dystrophin-associated glycoproteins linking dystrophin to
      the extracellular matrix.
AB  - The primary sequence of two components of the dystrophin-glycoprotein complex has
      been established by complementary, DNA cloning. The transmembrane 43K and
      extracellular 156K dystrophin-associated glycoproteins (DAGs) are encoded by a
      single messenger RNA and the extracellular 156K DAG binds laminin. Thus, the 156K
      DAG is a new laminin-binding glycoprotein which may provide a linkage between the
      sarcolemma and extracellular matrix. These results support the hypothesis that
      the dramatic reduction in the 156K DAG in Duchenne muscular dystrophy leads to a
      loss of a linkage between the sarcolemma and extracellular matrix and that this
      may render muscle fibres more susceptible to necrosis.

PMID- 1741057
TI  - Earliest Homo.
AB  - The origin of our own genus, Homo, has been tentatively correlated with worldwide
      climatic cooling documented at about 2.4 Myr (million years). It has also been
      conjectured that members of Homo made the first stone tools, currently dated at
      2.6-2.4 Myr. But fossil specimens clearly attributable to Homo before about 1.9
      Myr have been lacking. In 1967 a fossil hominoid temporal bone (KNM-BC1) from the
      Chemeron Formation of Kenya was described as family Hominidae gen. et sp. indet.
      Although a surface find, its provenance within site JM85 (BPRP site K002) was
      established and a stratigraphic section provided indicating the specimen's
      position. This evidence has been affirmed but the exact age of the fossil was
      never determined, and the absence of suitable comparative hominid material has
      precluded a more definitive taxonomic assignment. Here we present 40Ar/39Ar age
      determinations on material from the hominid site indicating an age of 2.4 Myr. In
      addition, comparative studies allow us to assign KNM-BC1 to the genus Homo,
      making it the earliest securely known fossil of our own genus found so far.

PMID- 1741058
TI  - Impaired type II glucocorticoid-receptor function in mice bearing antisense RNA
      transgene.
AB  - Glucocorticoids, in conjunction with their cognate receptors, exert negative
      feedback effects on the hypothalamus-pituitary-adrenal axis, suppressing adrenal
      steroid secretions. Two types of corticosteroid receptor, distinguishable by
      their ability to bind corticosterone, have been identified as classical
      mineralocorticoid (type I) and glucocorticoid (type II) receptors by cloning
      their complementary DNAs. The type I receptor controls the basal circadian rhythm
      of corticosteroid secretion. Both receptor types are involved in negative
      feedback, but the type II receptor may be more important for terminating the
      stress response as it is the only one to be increased in animals rendered more
      sensitive to corticosteroid negative-feedback effects. Here we create a
      transgenic mouse with impaired corticosteroid-receptor function by partially
      knocking out gene expression with type II glucocorticoid receptor antisense RNA.
      We use this animal to study the glucocorticoid feedback effect on the
      hypothalamus-pituitary-adrenal axis.

PMID- 1741059
TI  - Prevention of HIV-1 infection in chimpanzees by gp120 V3 domain-specific
      monoclonal antibody.
AB  - The acquired immunodeficiency syndrome (AIDS) is the late-stage clinical
      manifestation of long-term persistent infection with the human immunodeficiency
      virus type 1 (HIV-1). Immune responses directed against the virus and against
      virus-infected cells during the persistent infection fail to mediate resolution
      of the infection. As a result, a successful AIDS vaccine must elicit an immune
      state that will prevent the establishment of the persistent infection following
      introduction of the virus into the host. The third hypervariable (V3) domain of
      the HIV-1 gp120 envelope glycoprotein is a disulphide-linked closed loop of about
      30 amino acids which binds and elicits anti-HIV-1 type-specific virus
      neutralizing antibodies. The in vitro characteristics of anti-V3 domain antibody
      suggest that this antibody could by itself prevent HIV-1 infection in vivo, an
      idea supported by chimpanzee challenge studies in which protection against the
      HIV-1 persistent infection seemed to correlate with the presence of anti-V3
      domain antibody. Here we directly demonstrate the protective efficacy of anti-V3
      domain antibody in vivo and propose that this antibody is potentially useful as
      both a pre- and post-exposure prophylactic agent.

PMID- 1741060
TI  - Genetic linkage of Werner's syndrome to five markers on chromosome 8.
AB  - Werner's syndrome (WS) is a rare autosomal recessive disease in which the
      affected individuals display symptoms of premature ageing. The substantial
      phenotypic overlap between WS and normal ageing indicates that these two
      conditions may have pathogenetic mechanisms in common. The WS mutation has
      pleiotropic effects, and patients and their cells show many differences compared
      with normals. Despite extensive study of the clinical and biochemical features of
      this disorder, the primary genetic defect remains unknown. We have undertaken a
      genetic linkage study in an effort to identify the locus of the primary defect.
      Here we report close genetic linkage of the WS mutation to a group of markers on
      chromosome 8.

PMID- 1741061
TI  - Transmission of chromosomal instability after plutonium alpha-particle
      irradiation.
AB  - When investigating the biological effects of ionizing radiation on the
      haemopoietic system, a confounding problem lies in possible differences between
      the biological effects of sparsely ionizing, low linear energy transfer radiation
      such as X-, beta- or gamma-rays, and densely ionizing, high linear energy
      transfer radiation such as alpha-particles. To address this problem we have
      developed novel techniques for studying haemopoietic cells irradiated with
      environmentally relevant doses of alpha-particles from a plutonium-238 source.
      Using a clonogenic culture system, cytogenetic aberrations in individual colonies
      of haemopoietic cells derived from irradiated stem cells have been studied.
      Exposure to alpha-particles (but not X-rays) produced a high frequency of non
      clonal aberrations in the clonal descendants, compatible with alpha-emitters
      inducing lesions in stem cells that result in the transmission of chromosomal
      instability to their progeny. Such unexpected instability may have important
      implications for radiation leukaemogenesis.

PMID- 1741062
TI  - Renaturation of DNA catalysed by yeast DNA repair and recombination protein
      RAD10.
AB  - The RAD10 gene of Saccharomyces cerevisiae is required for the incision step of
      excision repair of ultraviolet-damaged DNA, and it functions in mitotic
      recombination. RAD10 has homology to the human excision repair gene ERCC-1. Here
      we describe the purification of the protein encoded by RAD10 and show that it is
      a DNA-binding protein with a strong preference for single-stranded DNA. We also
      show that RAD10 promotes the renaturation of complementary DNA strands.

PMID- 1741063
TI  - Crystal structure of the cell-binding B oligomer of verotoxin-1 from E. coli.
AB  - The Shiga toxin family, a group of cytotoxins associated with diarrhoeal diseases
      and the haemolytic uraemic syndrome, includes Shiga toxin from Shigella
      dysenteriae type 1 and verotoxins produced by enteropathogenic Escherichia coli.
      The family belongs to the A-B class of bacterial toxins, which includes the
      cholera toxin family, pertussis and diphtheria toxins. These toxins all have
      bipartite structures consisting of an enzymatic A subunit associated with a B
      oligomer which binds to specific cell-surface receptors, but their amino-acid
      sequences and pathogenic mechanisms differ. We have determined the crystal
      structure of the B oligomer of verotoxin-1 from E. coli. The structure
      unexpectedly resembles that of the B oligomer of the cholera toxin-like heat
      labile enterotoxin from E. coli, despite the absence of detectable sequence
      similarity between these two proteins. This result implies a distant evolutionary
      relationship between the Shiga toxin and cholera toxin families. We suggest that
      the cell surface receptor-binding site lies in a cleft between adjacent subunits
      of the B pentamer, providing a potential target for drugs and vaccines to prevent
      toxin binding and effect.

PMID- 1741064
TI  - [The hazard of asplenia: a fulminant sepsis].

PMID- 1741065
TI  - [Protocols and standards for family practice].

PMID- 1741066
TI  - [Prevention of fulminant septicemia following splenectomy].

PMID- 1741067
TI  - [Moerman therapy; evaluation of a 50-year effort].

PMID- 1741068
TI  - [Family practice management in urethritis. I. Protocol development].

PMID- 1741069
TI  - [Current viewpoints in the development of cystic kidneys in adults].

PMID- 1741070
TI  - [3 children with a melanoma of the skin].
AB  - Melanoma rarely occurs in children not over 14 years of age. We report on the
      clinical and pathological features of three patients (two girls and one boy aged
      6, 12 and 11 years respectively) from the St Laurentius hospital (Roermond,
      Netherlands) with melanoma of the skin, in whom the lesions histologically
      resembled the more frequently occurring spindle and epithelioid cell naevus (SE
      naevus). In all three cases, metastases were found in the regional lymph nodes.
      Further metastases were found in the last patient only, after follow-up periods
      of 29, 8 and 3 years respectively. The problems in distinguishing between
      melanoma and SE naevus are discussed, on the basis of a literature study and a
      retrospective analysis of 40 cases retrieved from PALGA (the nationwide
      computerized pathological archive in the Netherlands) up to and including 1990.
      As the diagnosis in such cases has important therapeutic consequences, we advise
      to submit the slides to experienced pathologists in the field, such as the
      Pathology Panel of the Dutch Melanoma Committee (Nederlandse Melanoom Werkgroep).

PMID- 1741071
TI  - [Family practice management in urethritis. II. Comparison of clinical management
      to the protocol].
AB  - OBJECTIVE: To describe general practitioners' approach to and management of
      urethritis in men, and to compare this with a general practice protocol for
      urethritis. DESIGN: Descriptive. SETTING: General practices in Amsterdam.
      PATIENTS AND METHODS: In 13 general practices in Amsterdam (23,510 patients, of
      whom 11,627 men) all episodes of urethritis in men (n = 55) were recorded during
      one year (complaints, medical management, diagnosis, medication, follow-up).
      OUTCOME MEASURES: Description of the diagnostic and therapeutic approach and the
      course of episodes; rough comparison with the urethritis protocol. RESULTS: In
      25% the urine sediment was examined; other office tests were rarely performed. In
      30 to 40% out of office microbiological tests were performed. In 50% of new
      diagnoses medication was underdosed, in some cases medication was wrong or not
      broad enough. In 25% explicit education was offered. In 22% new medication was
      given in the follow-up encounter. CONCLUSIONS: (Comparison with protocol.) Urine
      sediment examination as an effective test is performed insufficiently often.
      Other office tests are rarely performed, in accordance with the protocol. Out of
      office microbiological tests are performed too often, judged by the few changes
      of diagnosis and the character of new medication in the follow-up. First
      treatment is often underdosed and sometimes wrong. First treatment should
      preferably be broad, adequately dosed and independent of out of office
      microbiology. Too little education is given concerning the risks of ascending
      infections in female partners and of HIV infection. The referral rate is very
      low. It is important to pay attention to the outcome of this study in
      (postgraduate) education for general practitioners, as they treat the vast
      majority of urethritis patients.

PMID- 1741072
TI  - [A newborn infant with an adult-type kidney disease].
AB  - Autosomal dominant polycystic kidney disease is described in a premature infant.
      A review is given of recent diagnostic procedures and consequences of early
      diagnosis.

PMID- 1741073
TI  - [Medical activities under adverse conditions. Stimezo Internationaal].

PMID- 1741074
TI  - [Exercise-induced anaphylaxis].

PMID- 1741075
TI  - [Characterization of the specialty gastroenterology necessary].

PMID- 1741076
TI  - [Asthma in children; consensus by pediatric pneumologists on long-term treatment.
      I. Diagnosis].

PMID- 1741077
TI  - [Physician and pharmaceutical industry. II. Postmarketing surveillance].

PMID- 1741078
TI  - Learning the art of verbal self-defense.

PMID- 1741079
TI  - National study. Contrasts in A.I.D.S. care.

PMID- 1741080
TI  - Don't let doctors intimidate you.

PMID- 1741081
TI  - Myths & facts ... about fluid imbalance.

PMID- 1741082
TI  - Treating carbon monoxide poisoning.

PMID- 1741083
TI  - Managing patients with T.I.A.s.
AB  - Transient ischemic attacks usually pass quickly, without being diagnosed, but
      they can be extremely dangerous, even fatal. Here's a guide on how to assess,
      treat, and educate your TIA patients.

PMID- 1741084
TI  - "Dr. Dave".

PMID- 1741086
TI  - More than a number.

PMID- 1741085
TI  - How vital are vital signs?

PMID- 1741087
TI  - 25 predictions for perioperative nursing.

PMID- 1741088
TI  - We couldn't come to terms with Hank ... until he signed a contract.

PMID- 1741089
TI  - Artificial airways. Resuscitation guidelines you can follow.

PMID- 1741090
TI  - Avoiding the hazards of look-alike drug names.

PMID- 1741091
TI  - Laser angioplasty.

PMID- 1741092
TI  - How to irrigate the ear.

PMID- 1741093
TI  - Caring for the patient with a C.V.A.

PMID- 1741094
TI  - The chance to care.

PMID- 1741096
TI  - Stillborn--and still in my heart.

PMID- 1741095
TI  - Assessing albumin values.

PMID- 1741097
TI  - Is certification for you?

PMID- 1741098
TI  - Gaining recognition.

PMID- 1741099
TI  - Delayed interval delivery in multiple pregnancies: report of three cases and
      review of the literature.

PMID- 1741100
TI  - Inhibin and activin in reproductive biology.

PMID- 1741101
TI  - A key moment on OH history.

PMID- 1741102
TI  - Smoking--kiss it goodbye.

PMID- 1741104
TI  - Guide to EC Directives. Part 4. European Economic Community Commission.

PMID- 1741103
TI  - Winter blues--seasonal affective disorder.

PMID- 1741105
TI  - The use of work equipment directive.

PMID- 1741106
TI  - Duty to inform staff about their rights.

PMID- 1741107
TI  - History rewritten.

PMID- 1741108
TI  - Inherent problems of attempts to apply sonar and vibrotactile sensory aid
      technology to the perceptual needs of the blind.
AB  - A program of research dealing with two types of sensory aids for the blind--sonar
      and vibrotactile--is described. Rather than immediately assessing the aids in the
      mobility context, which has customarily been the case, the aids' capabilities are
      considered in terms of the major functions of vision, that is, the exteroceptive
      perception of objects, surfaces, and events of the environment, and the
      proprioceptive perception of the self, especially the self in relation to the
      environment. Although sonar aids function very well for localizing objects and
      for providing acoustic flow specifying self-movement, they do not provide high
      acuity pattern and shape information due to the long wavelength of ultrasound
      relative to light. This limitation is considered specifically with respect to the
      visual accomplishment of recovery of three-dimensional structure/motion from
      dynamic two-dimensional images. Vibrotactile sensory aids using optical imaging
      can deliver detailed pattern information to the skin and thus permit assessment
      of the extent to which a nonvisual system can mediate the recovery of structure
      problem. However, in even moderately cluttered or complicated environments the
      skin proves unable to resolve the amount of stimulation it receives
      vibrotactually. The limitations of sonar and vibrotactile sensory aids are
      discussed with respect to future sensory substitution efforts as well as their
      implications for understanding differences and similarities among the senses.

PMID- 1741109
TI  - Problems to be overcome in high-tech devices for the visually impaired.
AB  - Many useful applications of technology have been developed for the visually
      impaired. Many other devices have been developed but remain on laboratory
      shelves; others again have experienced problems in achieving widespread
      acceptability due to such problems as training, maintenance, cost, human factors
      considerations, difficulty in production, and other factors. The present paper
      examines some of these factors in order to shed light on how such problems might
      be avoided or solved in the future. To date, more effort in high technology has
      been brought to bear on problems of the blind than those of the partially
      sighted, so examples are drawn from the former as well as the latter to
      illustrate the points made here.

PMID- 1741110
TI  - Optimal illumination for reading in patients with age-related maculopathy.
AB  - This study was designed to determine optimal levels of illumination for reading
      for patients with age-related maculopathy. These patients comprise a large
      percentage of the low vision population, and illumination has a great impact on
      their reading ability. For many patients in this study, increased illumination
      levels improved their performance. Eleven of the 18 patients preferred
      illumination levels as high as 5920 to 7534 lux (550 to 770 ft-c). This
      information suggests that illumination levels higher than previously recommended
      will improve reading speed in most patients with age-related macular degeneration
      (ARMD).

PMID- 1741111
TI  - Clinical comparison of corneal diameter and curvature in Asian eyes with those of
      Caucasian eyes.
AB  - Anatomical comparisons of the horizontal visible iris diameter (HVID) and the
      average keratometry (Kav) measurements were made between Asians and Caucasians
      and also between males and females. It was found that the HVID was significantly
      different as a function of both culture and gender. Also found was a significant
      difference in the Kav between males and females but not between Asians and
      Caucasians.

PMID- 1741112
TI  - Instrument myopia and the resting state of accommodation.
AB  - I measured the refractive errors of 210 eyes of 105 subjects by means of the
      Canon Autoref R-1 and by the Nikon autorefractometer NR7000. I also measured
      their dark focus of accommodation (DF) with the Canon instrument. Refractive
      errors had similar effects on the differences between the results produced by the
      two autorefractometers and on the changes in DF. The differences were
      statistically significant. Differences between the results produced by the two
      autorefractometers are thought to be mainly due to instrument myopia, which
      itself is strongly related to the resting state of accommodation. My results
      indicate a hyperopic shift in high hyperopes when they are observing through an
      instrument.

PMID- 1741113
TI  - Influence of rigid contact lens base curve radius on tear pump efficiency.
AB  - The effects of rigid contact lens base curve radius changes on tear pump
      efficiency were determined by measuring oxygen uptake on six with-the-rule
      corneas (with toricities between 0.37 and 1.00 D) under three conditions: (1)
      normal open eye, (2) after 5 min of static (without blinking) wear of polymethyl
      methacrylate (non-gas permeable) contact lenses, and (3) after 5 min of dynamic
      (with blinking once every 5 s) wear of the same lenses. The difference between
      the oxygen uptake rates measured under static and dynamic conditions provides an
      index of tear pump efficiency. Each subject wore a series of five lenses: fitted
      on K and 0.05 or 0.10 mm steeper and flatter than the flattest corneal meridian.
      The overall diameter of all lenses was 8.8 mm, the optic zone was 7.4 mm, the
      axial edge lift was 0.09 mm, and all other parameters were constant. The contact
      lens fitted on K was associated with the greatest central corneal oxygen debt
      under static conditions, whereas the same lens also provided for the best tear
      exchange with the blink. In addition, better tear exchange was found to be
      associated with larger palpebral aperture sizes.

PMID- 1741114
TI  - Mascara pigmentation of the bulbar conjunctiva associated with rigid gas
      permeable lens wear.
AB  - We present three patients who were found to have unusual pigmentation of the
      bulbar conjunctiva. The areas, 1 to 2 mm in size, were translucent with dark
      black dust-like particles randomly placed within well defined borders. These
      specks were usually elevated, had a granular texture, and appeared to be
      overlying pingueculae. All three patients wore rigid gas permeable contact
      lenses, were found to have either a short tear break-up time or deficient tear
      aqueous layer, had associated 3:00 and 9:00 o'clock staining, and routinely used
      heavy mascara and/or eyeliner. In one patient, the areas resolved on
      discontinuing contact lens wear. The elevated areas may be associated with minor
      discomfort. We propose that a deficient tear layer and drying adjacent to the
      lens edge may compromise the conjunctival epithelium and prevent efficient
      washing of the pigment particles from the conjunctiva, allowing these granules to
      become embedded in the epithelium. Additional causes of conjunctival pigmentation
      are discussed.

PMID- 1741115
TI  - Hypotony and corneal edema secondary to patching in normal eyes.
AB  - Over the past decade investigators have used patching when studying corneal
      response to eye lid closure. In these studies, corneal edema was thought to be
      secondary to hypoxia, and the results were used to predict corneal response to
      contact lens wear. None of these studies have measured or controlled the
      intraocular pressure (IOP) during eye patching. Reports in the literature
      indicate that hypotonous and hypertensive events may induce corneal edema. In
      order to evaluate the IOP and corresponding corneal changes, measurements were
      made on subjects with patched eyes. Thirty subjects were unilaterally patched and
      randomized into tight and light patch groups to maintain complete lid closure for
      4 h. Measurements of IOP and corneal thickness (CT) were made at baseline and at
      hourly intervals. The contralateral eye served as the control for each subject.
      Our results indicate a significant decrease in IOP and a corresponding increase
      in CT in the tight patched group as compared to the light patch group, and
      baseline controls. These results suggest that the corneal edema which results
      from patching of the eye may be due to hypotony, or a combination of factors
      affecting corneal function, rather than hypoxia.

PMID- 1741117
TI  - Report of the section on binocular vision and perception at the American Academy
      of Optometry.

PMID- 1741116
TI  - Fourth century visual science.

PMID- 1741118
TI  - Statistics Notebook: entry III.E: statistical significance and significance
      level, and entry III.F: P value.

PMID- 1741119
TI  - Field defects in diabetic patients.

PMID- 1741120
TI  - Varied clinical spectrum of necrobiotic xanthogranuloma.
AB  - Four cases are presented that illustrate a wide spectrum of ophthalmologic and
      systemic features of necrobiotic xanthogranuloma (NXG). Case 1 initially had
      signs of Cogan syndrome, and then developed chronic lymphocytic leukemia. Case 2,
      the first case of NXG to undergo autopsy, had progressive cicatricial lid
      retraction and corneal perforation. Case 3 had a more typical presentation of
      diplopia and blepharoptosis caused by orbital and periorbital infiltrative
      masses. Case 4 had nondeforming periocular skin lesions over a 6-year period. In
      all four cases, the diagnosis was made on the basis of characteristic
      histopathologic and laboratory findings. Although the cause of NXG is still
      obscure, in many cases it appears to be a forerunner of lymphoproliferative
      diseases.

PMID- 1741121
TI  - Paraneoplastic pemphigus, cicatricial conjunctivitis, and acanthosis nigricans
      with pachydermatoglyphy in a patient with bronchogenic squamous cell carcinoma.
AB  - A 77-year-old man with chronic conjunctivitis, acanthosis nigricans with
      pachydermatoglyphy, and pemphigus-like mucocutaneous lesions was found to have a
      well-differentiated bronchogenic squamous cell carcinoma. Histopathologic and
      immunofluorescence studies confirmed the diagnosis of paraneoplastic pemphigus.
      Skin lesions resolved with oral prednisone and azathioprine therapy, but the
      conjunctivitis and mucous membrane erosions persisted. The conjunctiva later
      became scarred with foreshortening of the fornices and development of
      symblepharon. External beam irradiation arrested the growth of the tumor but did
      not have any effect on the diseased conjunctiva and other mucous membranes. This
      case demonstrates that cicatrizing conjunctivitis with bullous mucocutaneous
      lesions may be a clinical sign associated with an occult neoplasm.

PMID- 1741122
TI  - Ocular and adnexal findings in patients with facial microsomias.
AB  - The authors reviewed the ocular findings in 49 patients with facial microsomias
      not considered part of a known syndrome. Five patients had bifacial microsomia,
      and 44 patients had hemifacial microsomia. These patients were evaluated in the
      Craniofacial Clinic in the Division of Pediatric Ophthalmology at Children's
      Hospital of Philadelphia between the years 1979 and 1989. Ocular or adnexal
      abnormalities were present in 67% of patients. Visual loss was present in 8% of
      eyes. Amblyopia was present in 16% of patients. Significant refractive errors
      were present in 27% of patients, and anisometropia was documented in 8%.
      Strabismus was present in 22% of patients, and significant lid and adnexal
      abnormalities were seen in 41%. Because ocular or adnexal findings present in a
      significant percentage of patients with more mild forms of facial microsomias,
      regular examinations to uncover and treat these abnormalities are recommended.

PMID- 1741123
TI  - Diagnostic value and limitations of orbital biopsy in Wegener's granulomatosis.
AB  - Patients with Wegener's granulomatosis may present with ophthalmic involvement in
      either the classic or limited forms. Although the overall clinical picture and
      serologic testing for antineutrophil cytoplasmic antibody (ANCA) are important,
      biopsy is often necessary for a definitive diagnosis. Accurate interpretation of
      these orbital biopsies is essential. The authors reviewed the histopathologic
      features of 13 orbital biopsies in patients with well-documented Wegener's
      granulomatosis. The classic triad of vasculitis, tissue necrosis, and
      granulomatous inflammation was seen in 7 of 13 biopsies (54%). Vasculitis in
      combination with other microscopic findings was seen in 4 of 13 (31%) biopsies.
      Giant cells were seldom seen. Two biopsies showed only perivascular infiltrates.
      Based on this study, it appears that a spectrum of histopathologic features can
      be seen in orbital biopsies in Wegener's granulomatosis. This study underscores
      the importance of clinical correlation, the application of the ANCA test, and
      comparison with extraorbital biopsies, if available, when interpreting orbital
      biopsies in the diagnosis of Wegener's granulomatosis.

PMID- 1741124
TI  - Diagnostic value of anti-neutrophil cytoplasmic antibodies in scleritis
      associated with Wegener's granulomatosis.
AB  - Serum antineutrophil cytoplasmic antibodies (ANCAs) are a sensitive and specific
      marker for generalized Wegener's granulomatosis. However, ANCA sensitivity and
      specificity in identifying patients in whom ophthalmic signs constitute the
      presenting or only definitive manifestation of Wegener's granulomatosis have not
      been tested. The authors report on 7 patients in whom scleritis was the initial
      manifestation leading to the diagnosis of Wegener's granulomatosis. Six had the
      limited form of Wegener's granulomatosis. Results of serum ANCA tests were
      positive in all these patients. In contrast, the serum ANCA was negative in 54
      patients with ocular inflammation due to other disorders; 16 of these patients
      had scleritis. Serial ANCA titers reverted to normal in only two of the four
      patients with Wegener's granulomatosis who attained clinical remission. One of
      the patients who did not revert to normal experienced relapse 2 months after
      discontinuation of therapy. Antineutrophil cytoplasmic antibodies appear to be
      both sensitive and specific for Wegener's granulomatosis-associated scleritis,
      and testing is useful in the evaluation of patients with scleritis.

PMID- 1741125
TI  - Surgical management of nasolacrimal duct obstruction in patients with Wegener's
      granulomatosis.
AB  - The treatment of symptomatic nasolacrimal duct obstruction in patients with
      Wegener's granulomatosis is controversial. Dacryocystorhinostomy has been
      effective in patients with long-standing quiescent disease but has been
      complicated by the formation of nasal-cutaneous fistulas in others.
      Dacryocystectomy may be an alternative if epiphora is absent. The authors report
      13 lacrimal bypass surgeries in 9 patients with Wegener's granulomatosis; there
      were 10 operations with adequate follow-up and 6 surgical successes. Failure was
      related to a history of dacryopyocele, localized disease activity in the nose and
      upper airway, extensive periorbital disease, the use of non-maintenance therapy
      to contain disease activity, and prior surgical failure. The authors' experience
      suggests that dacryocystorhinostomy is therapeutically viable in patients with
      Wegener's granulomatosis; intervention is optimal when the disease is quiescent
      without medication and is probably reasonable if activity is controlled with
      maintenance therapy. Anticytoplasmic antibody titers are useful to guide the
      timing of elective surgery.

PMID- 1741126
TI  - Effect of topical mitomycin C on glaucoma filtration surgery in monkeys.
AB  - In this study, an experimental model of glaucoma filtration surgery was used to
      evaluate the clinical and histologic effects of a single intraoperative topical
      application of mitomycin C. Argon laser treatment to the trabecular meshwork
      produced sustained elevation of intraocular pressure in monkeys. Eight eyes of
      four animals were randomly assigned to receive topical mitomycin C or balanced
      salt solution at the time of full-thickness sclerostomy. Surgical success was
      substantially increased in four of five eyes that received mitomycin C when
      compared with three eyes that received topical balanced salt solution. Mitomycin
      C was also effective in prolonging surgical success in two eyes that had
      previously undergone surgery and failed. No significant ocular toxicity was
      observed in eyes treated with mitomycin C. Histologic examination of mitomycin C
      treated eyes showed patent sclerostomies and hypocellular, well-formed bleb
      cavities. A single intraoperative application of mitomycin C has a marked effect
      on postoperative wound healing after filtration surgery in monkeys.

PMID- 1741127
TI  - Retinal hemangioblastoma. A histologic, immunohistochemical, and ultrastructural
      evaluation.
AB  - The authors evaluated the histologic, immunohistochemical, and ultrastructural
      characteristics of two eyes with retinal hemangioblastoma from patients with von
      Hippel-Lindau and von Hippel disease. Results of histologic evaluation showed the
      eyes to have degenerative changes and residual retinal hemangioblastoma.
      Immunohistochemical stains performed for MAC-387, factor XIIIa, lysozyme, alpha 1
      anti-chymotrypsin (histiocyte markers), factor VIII-associated antigen, ulex
      europeaus (endothelial markers), neuron-specific enolase, chromogranin,
      neurofilament (neuroectodermal/neural/neuroendocrine markers) and glial
      fibrillary acid protein (glial marker) showed normal retinal vascular
      endothelium, neurons, and glial cells to stain where expected. Vascular
      endothelium in the retinal hemangioblastomas stained for factor VIII and ulex
      europeaus. Interstitial cells in the stroma of the tumors failed to stain for the
      histiocyte markers, chromogranin, and neurofilament. The stromal cells stained
      for glial fibrillary acid protein and neuron specific enolase. Ultrastructural
      findings in both eyes included endothelial/pericyte-lined vascular channels,
      elongated stromal cells, and plump, vacuolated stromal cells with ultrastructural
      features consistent with glial cells. This study supports the concept that
      retinal hemangioblastoma is composed of a proliferation of capillaries and glial
      cells.

PMID- 1741128
TI  - Immunohistochemical evidence for IgA1 involvement in Graves ophthalmopathy.
AB  - Orbital muscle, adipose tissues, and periorbital muscle from 11 patients with
      Graves ophthalmopathy were studied with in situ assays using monoclonal
      antibodies for IgA1, IgA2, IgM, and IgG. Tissue biopsies were taken from varied
      extraocular muscles and orbital sites. All cases were from patients with severe
      disease or disease of long duration. Control specimens of extraocular muscle
      tissues were obtained from nine patients treated for unrelated orbital disorders.
      Only connective tissue associated with the extraorbital muscles and periorbital
      muscles showed any reactivity. Of the muscle tissue obtained from patients with
      Graves disease all exhibited IgA1 positive staining of the endomysium and
      perimysium, without staining of the muscle fibers themselves. Parallel sections
      of orbital muscles reacted with anti-IgA2 or anti-IgM antibody failed to
      demonstrate staining. Control extraocular muscle tissue did not stain with anti
      IgM and one control muscle of seven reacted minimally with anti-IgA2. Some
      reactivity with anti-IgA1 was seen in four of the seven control muscles but this
      was qualitatively much less than that of muscle tissue from patients with Graves
      disease. Monoclonal anti-IgG did not stain tissue from the six Graves specimens
      and three control specimens tested.

PMID- 1741129
TI  - Inadequate inferior cul-de-sac in the anophthalmic socket.
AB  - A retrospective review of preoperative findings and postoperative results of
      conjunctival cul-de-sac fixation surgery performed on 12 patients with acquired
      anophthalmos and an inadequate inferior conjunctival cul-de-sac was performed.
      Patients with inadequate conjunctiva or other subconjunctival cicatricial
      shortening of the inferior cul-de-sac were not suitable candidates for
      conjunctival cul-de-sac fixation surgery and therefore were excluded from this
      retrospective study. Only those patients with adequate conjunctiva and loss of
      inferior cul-de-sac fixation to the lower eyelid retractor complex were selected.
      Clinical evaluation and theoretical anatomical analysis of this group
      preoperatively suggested that the absent inferior conjunctival cul-de-sac
      fixation could allow the intraconal orbital fat to migrate anteriorly,
      compromising the inferior fornix and prolapsing the conjunctiva of the cul-de-sac
      superiorly. Surgical correction required direct fixation of the conjunctival cul
      de-sac to the periosteum immediately posterior to the inferior orbital rim. No
      externalized sutures or stents were needed to recreate the inferior conjunctival
      cul-de-sac. All 12 patients had improved ability to retain a prosthetic eye
      postoperatively. However, two patients had minimal postoperative lower eyelid
      retraction and an additional two patients had minimal lower eyelid entropion
      after surgery. Secondary surgery was not required in any patient.

PMID- 1741130
TI  - American Academy of Ophthalmology 1991 presidential address.

PMID- 1741131
TI  - Pan-American Association of Ophthalmology 1991 presidential address.

PMID- 1741132
TI  - Joint meeting American Academy of Ophthalmology and Pan-American Association of
      Ophthalmology: 1991 keynote address. Barbarians at the gates: medicine, money,
      and morality.

PMID- 1741133
TI  - An evaluation of optic disc and nerve fiber layer examinations in monitoring
      progression of early glaucoma damage.
AB  - From annual examinations of 813 ocular hypertensive eyes, the authors compared
      optic disc and nerve fiber layer photographs in 2 age-matched subgroups: 37 eyes
      that converted to abnormal visual field tests at the end of a 5-year period and
      37 control eyes that retained normal field tests. Disc change was detected in
      only 7 of 37 (19%) converters to field loss and in 1 of 37 (3%) controls.
      Progressive nerve fiber layer atrophy was observed in 18 of 37 (49%) converters
      and in 3 of 37 (8%) controls. Serial nerve fiber layer examination was more
      sensitive than color disc evaluation in the detection of progressive glaucoma
      damage at this early stage of glaucoma. The evaluation of cup-to-disc ratio or of
      the nerve fiber layer appearance in the initial photograph taken 5 years before
      field loss were equally predictive of future field damage. The position of nerve
      fiber layer defects was highly correlated with the location of subsequent visual
      field loss.

PMID- 1741134
TI  - Age-related decline of disc rim area in visually normal subjects.
AB  - Optic disc parameters and axial lengths were measured in 81 visually normal young
      and elderly white adults (young [n = 41]: 27.2 +/- 5.7 years versus elderly [n =
      40]: 68.8 +/- 8.4 years) using Rodenstock Optic Disc Analyzer and A-scan
      sonography. Axial lengths correlated positively with optic disc parameters
      (Spearman correlation analysis: rim area: P = 0.042, disc area: P = 0.052, and
      cup volume: P = 0.010). Older subjects had a shorter axial length (23.09 +/- 1.02
      mm) and smaller disc rim area (1.171 +/- 0.338 mm2) than younger subjects (23.60
      +/- 1.15 mm and 1.325 +/- 0.314 mm2; Mann-Whitney U test: P = 0.011 and P =
      0.013, respectively). While both axial length and disc rim area declined with age
      (0.011 mm and 0.003 mm2 per year; Spearman correlation analysis: P = 0.032 and P
      = 0.020, respectively), the cup-to-disc and rim area-to-disc area ratios appeared
      to remain relatively constant throughout adult life. The age-related decline of
      disc rim area is consistent with histologic evidence of age-related decline of
      ganglion cell axons. The rim area-to-disc area ratio seems less affected by age,
      and is thus a better parameter to isolate age-related change from disease-related
      change of optic nerve in a longitudinal follow-up of diseases involving the optic
      nerve head.

PMID- 1741135
TI  - 5-FU trabeculectomy.

PMID- 1741136
TI  - Intraocular pressure-dependent dynamic changes of optic disc cupping in adult
      glaucoma patients.
AB  - The authors performed a study of intraocular pressure-dependent changes in optic
      disc cupping in 17 adults with chronic open-angle glaucoma. Analyses with the
      Rodenstock Optic Nerve Head Analyzer were performed at baseline low intraocular
      pressure during therapy, after elevation of intraocular pressure (from
      therapeutic failure or noncompliance), and after reduction of intraocular
      pressure with successful therapy. Optic disc cupping increased significantly upon
      short-term increase of intraocular pressure from baseline of 20.4 +/- 2.5 mmHg to
      31.1 +/- 5.9 mmHg. Optic disc cupping reverted to baseline after persistent
      intraocular pressure reduction to 19.3 +/- 4.8 mmHg. These data demonstrate
      intraocular pressure-dependent dynamic changes of optic disc cupping in patients
      with demonstrable glaucomatous optic nerve damage. They underscore the
      detrimental effect of elevated intraocular pressure and the beneficial effect of
      intraocular pressure reduction on optic disc cup changes.

PMID- 1741137
TI  - Retained nuclei after cataract surgery.
AB  - The authors reviewed the medical records of 36 patients in whom the nucleus or
      nuclear fragments were retained in the eye after cataract surgery. In 4 patients,
      there was no further surgery, and visual acuity deteriorated to counting fingers
      or worse (mean follow-up time, 14 months). Thirty-two patients underwent
      vitrectomy to remove the retained, unencapsulated nuclear material. Sixty percent
      (6 of 10) of patients in whom vitrectomy was performed after 3 weeks had chronic
      glaucoma on long-term follow-up, whereas this complication developed in only 18%
      (4 of 22) of patients in whom vitrectomy was performed in less than 3 weeks.
      Sixty-three percent (21 of 32) of vitrectomy patients had final visual acuity of
      20/200 or better after removal of the retained nuclear fragments. The causes of
      the poorest visual outcome (less than 20/200) included 1 or more of the
      following: corneal decompensation, chronic inflammation, chronic glaucoma with
      optic atrophy, and retinal detachment.

PMID- 1741138
TI  - Posterior continuous curvilinear capsulorhexis. An experimental study with
      clinical applications.
AB  - The posterior continuous curvilinear capsulorhexis technique has been advocated
      in cases of posterior capsule rupture during extracapsular cataract extraction.
      The authors compared posterior continuous curvilinear capsulorhexis with
      posterior capsular sharp-edged tears. Two different types of forces were
      experimentally created on the posterior capsule of 30 human eyes obtained after
      death: (1) implantation and dialing of posterior chamber intraocular lenses (PC
      IOLs) and (2) increased intravitreal pressure by injection of balanced salt
      solution. All posterior capsular tears extended toward the equator, causing major
      capsular defects. In contrast, the posterior continuous curvilinear capsulorhexis
      remained intact in all cases. This experimental study proves that in cases where
      an inadvertent posterior capsular tear occurs, a posterior continuous curvilinear
      capsulorhexis is useful in preventing further capsular damage. Also, in cases
      where a posterior capsulotomy is indicated, a smooth edge created by a posterior
      continuous curvilinear capsulorhexis may be useful to maintain the integrity of
      the capsular bag for PC IOL capsular implantation.

PMID- 1741139
TI  - Paraneoplastic pemphigus and ophthalmology.

PMID- 1741140
TI  - An improved technique for management of dislocated posterior chamber implants.
AB  - Many techniques for repositioning dislocated posterior chamber implants described
      in the recent literature involve intricate intraocular manipulation of a needle
      or other sharp instrument. The author describes an improved sulcus fixation
      technique, which combines the best features of external and internal approaches.
      Its main features involve temporary externalization of the haptics for easy and
      secured placement of suture knots, and subsequent reinternalization of the same
      haptics through horizontal sclerotomies directly external to the ciliary sulcus
      for precise fixation of the dislocated posterior chamber implant with
      consistency. Between May 1989 and December 1990, this technique was successfully
      used for posterior chamber intraocular lens repositioning in 12 cases. The main
      advantages of this technique include: (1) easy suture placement, (2) less chance
      of suture slippage with the secured knots, and (3) avoidance of difficult
      intraocular maneuvers and possible tissue injury. This improved technique
      expedites the process of posterior chamber implant repositioning.

PMID- 1741141
TI  - The Beaver Dam Eye Study. Retinopathy in adults with newly discovered and
      previously diagnosed diabetes mellitus.
AB  - The prevalence of diabetic retinopathy was examined in people with newly
      discovered noninsulin-dependent diabetes mellitus (NIDDM) (n = 50) and in those
      with previously diagnosed diabetes (n = 395) in a population-based study of
      people between the ages of 43 and 86 years who lived in Beaver Dam, Wisconsin
      between 1988 and 1990. Retinopathy was determined from stereoscopic fundus
      photographs. The prevalence of any retinopathy was 10.2% in those with newly
      diagnosed NIDDM, none had proliferative retinopathy, and 2.0% had macular edema.
      These data suggest that asymptomatic people discovered to have NIDDM during
      epidemiologic studies may not need immediate ophthalmoscopic examination at the
      time of their diagnosis because they have a relatively low risk of danger of
      visual loss due to diabetic retinopathy at that time.

PMID- 1741142
TI  - Central serous chorioretinopathy occurring in patients 60 years of age and older.
AB  - The authors report on 13 eyes in 13 patients, 60 years of age or older, with
      idiopathic central serous chorioretinopathy, a condition that typically presents
      in adults between the ages of 30 and 50 years. In older patients, this condition
      can easily be mistaken for macular degeneration with subretinal
      neovascularization. None of the patients in this series had soft drusen,
      geographic atrophy, or subretinal neovascularization, signs of age-related
      macular degeneration or other retinal or macular disease. Subretinal
      neovascularization was not seen either at the time of initial diagnosis or during
      follow-up. The clinical, biomicroscopic, and fluorescein angiographic
      characteristics of this entity are described. The clinical course of 7 of these
      13 eyes that underwent laser photocoagulation treatment is also described.

PMID- 1741143
TI  - Visual recovery in two patients after intravenous methylprednisolone treatment of
      central retinal artery occlusion secondary to giant-cell arteritis.
AB  - Two patients with central retinal artery occlusions secondary to biopsy-proven
      giant-cell arteritis lost visual acuity to no light perception but recovered to
      baseline acuity after treatment with intravenous methylprednisolone at a dose of
      15 to 30 mg/kg/day. The potential advantages and theoretical basis of early and
      aggressive treatment with large-dose intravenous corticosteroids in arteritic
      central retinal artery occlusion are discussed.

PMID- 1741144
TI  - Initial 5-fluorouracil trabeculectomy in young patients.
AB  - The effectiveness of initial trabeculectomy with adjunctive 5-fluorouracil (5-FU)
      for uncomplicated glaucoma in patients age 40 years or younger at the time of
      surgery was evaluated retrospectively in a consecutive series of 20 eyes of 20
      patients. Fifteen patients had juvenile primary open-angle glaucoma, 4 had
      pigmentary glaucoma, and 1 had glaucoma associated with angle recession. Mean
      patient age was 26.8 +/- 9.7 years (range, 13 to 40 years) at the time of
      surgery. The mean total 5-FU dose administered was 27.8 +/- 8.8 mg (range, 15 to
      45 mg). The intraocular pressure (IOP) decreased from 34.4 +/- 11.5 mmHg
      preoperatively to 10.5 +/- 4.0 mmHg postoperatively after a mean follow-up of
      31.1 +/- 17.3 months (range, 11.5 to 70 months). Nineteen eyes (95%) had a
      postoperative IOP of 20 mmHg or less without pressure-lowering medications. One
      patient required additional medical therapy to control the IOP. Complications
      included bleb-related endophthalmitis (2 eyes) and hypotony maculopathy (1 eye).

PMID- 1741145
TI  - Laser-triggered repetitive fluorescein angiography.
AB  - Liposome-encapsulated fluorescent dye has been altered to allow full fundus
      angiography after a single laser shot. By exposing the retinal arteries to laser
      energy where they emerge at the optic disc nerve head, dye release is elicited
      simultaneously in all four quadrants of the retina, without choroidal
      fluorescence, allowing visualization of the retinal microcirculation. Because the
      quantity of dye release is limited, recirculation does not increase background
      fluorescence. The procedure can be repeated many times without delay with
      consistent results. Increasing the laser spot size to 1.5 mm allows consistent
      dye release at energy densities from 0.5 J/cm2 to 3.4 J/cm2. This refinement will
      allow direct comparison in primates of this technique and conventional
      fluorescein angiography. The laser energy delivered to the retina is below
      suggested levels that may be tolerated by the optic nerve.

PMID- 1741146
TI  - Paracentral rheumatoid corneal ulceration. Clinical features and cyclosporine
      therapy.
AB  - Six patients with rheumatoid arthritis (eight eyes) presented with small
      paracentral perforating corneal ulcers in otherwise quiet eyes. Initial
      management in five patients (seven eyes) consisted of systemic immunosuppression
      and therapeutic tissue adhesive with a bandage contact lens or tectonic
      keratoplasty. Ulceration recurred in all of these eyes, and recurrent ulcers
      treated with repeat tectonic keratoplasty or therapeutic tissue adhesive and a
      bandage contact lens all developed recurrent ulceration. The introduction of
      topical cyclosporine therapy in five eyes with recurrent corneal ulceration was
      associated with arrest of keratolysis and rapid re-epithelialization of the ulcer
      in all cases. One corneal ulcer was successfully treated initially with topical
      cyclosporine, tissue adhesive, and a bandage contact lens. In patients with
      rheumatoid arthritis and small paracentral corneal ulcerations or perforations,
      application of tissue adhesive and a bandage contact lens and introduction of
      topical cyclosporine may be the preferred initial treatment.

PMID- 1741147
TI  - Specular microscopic observation of normal human corneal epithelium.
AB  - The authors analyzed the specular microscopic appearance of normal corneal
      epithelium, with particular regard to four cell patterns previously identified in
      pathologic corneas. Corneal epithelia of 75 normal eyes were examined by specular
      microscopy using a special compound contact lens. There were no elongated or
      extra large cells, whereas 44.0% and 35.7% of the corneas showed central
      epithelial nuclei and irregular patterns, respectively. The mean epithelial cell
      area and corresponding mean coefficient of variation (CV) for each of the corneas
      were 595.6 +/- 98.8 microns 2 and 30.3 +/- 15.3%, respectively. The values for
      the endothelium were 325.7 +/- 48.4 microns 2 and 33.6 +/- 6.3%, respectively.
      Although there was a significant Pearson correlation (r = 0.50, P less than 0.01)
      between mean endothelial cell area and age, none existed (r = 0.19, P greater
      than 0.05) between mean epithelial cell area and age, even though there was a
      relationship (r = 0.35, P less than 0.01) between the mean cell areas themselves.
      There were no significant relationships among the CV of the epithelium, that of
      the endothelium, and age. This study presents a powerful new technique and
      baseline data by which to assess normal corneal epithelium and any aberration.

PMID- 1741148
TI  - Superficial juvenile granular dystrophy.
AB  - Seventeen cases of a superficial corneal dystrophy are presented. The lesions are
      subepithelial, limited mainly to Bowman's layer. This dystrophy, although
      clinically different from classic granular dystrophy, is pathologically similar
      to it. Treatment, consisting of superficial keratectomy to 15% to 20% of corneal
      thickness, did not require lamellar grafting and produced good visual results. A
      new classification of granular dystrophy is proposed.

PMID- 1741149
TI  - [The role of combined SPECT studies of regional cerebral blood flow and volume in
      the detection of intracranial vascular malformations].
AB  - Brain perfusion (rCBF) (99mTc--HMPAO) and blood volume (rCBV) (99mTc--RBC)
      investigations were performed by SPECT on 13 patients with intracranial AVM. In
      each cases the rCBF revealed a decreased tracer uptake at the site of the AVM. In
      the rCBV SPECT, abnormal AVM structures with increased radioactivity were
      detected in 92% of cases. In all of the patients surgical resection of the AVM
      was also carried out. In the cases where the rCBF disturbance was equal or larger
      than the rCBV abnormality the surgical complications were more frequent it was
      concluded that combined rCBF--rCBV method is suitable to detect the AVM-s, and to
      clarify their haemodynamic effects. It is helpful in planning the surgical
      intervention, and in the follow-up.

PMID- 1741150
TI  - [Changes in serum levels of lipid and lipoprotein fractions during breast feeding
      under the effect of hormonal contraceptives].
AB  - During the first 3 months of the full-time lactation the level of the lipid and
      lipoprotein fractions does not change in the mother's blood. The levonorgestrel
      contraceptive pills taken during the lactation do not influence considerably the
      lipid-metabolism either. There is only one minute deviation in the levonorgestrel
      group, which is the decreasing though not significant change of the HDL level.
      The contraceptive pills containing levonorgestrel can be given during the
      lactation without any danger from the point of view of mother's lipid-metabolism,
      too.

PMID- 1741151
TI  - [Preparation for elective colon surgery using the mannitol-ceftriaxone method].
AB  - The study includes 450 patients undergoing elective colorectal surgery. Patients
      were divided in three groups. 140 patients were prepared with conventional enema
      and purgatives and a Neomycin-metronidazole prophylaxis. 160 patients of the
      second group were prepared with mannitol (10%) oral 12 hours before the operation
      and a single dose of ceftriaxone (Rocephin) 2 g intravenously 2 hours before
      surgery. 150 patients of the third group were prepared with mannitol by the same
      way described above, and a combination of ceftriaxone 2 g i. v. and metronidazole
      500 mg. i. v. two hours before the operation. The study proved that the mannitol
      combined with ceftriaxone provides a sufficient preparation for colorectal
      surgery within 12 hours prior the operation. The rate of septic complications and
      septic deaths was higher in the first group then in the two others. The
      combination of metronidazole used in the third group showed no advantage versus
      single dose ceftriaxone alone.

PMID- 1741152
TI  - [Current problems of nursing I].
AB  - Doctors don't deal enough with the questions of nursing, in Hungary many of them
      don't know the current problems, the tendency of developing. It was too late and
      only the involved crisis called the international medical public opinion's
      attention to the importance of this question. The elements of activity, which are
      took for up-to-date at present, were already found at the historical periods of
      nursing, but these mostly sank into oblivion or came to nought in the stormy
      periods of history. This happened also in Europe, where was prosperity in the
      time of century's turn and great regression after the Second World War. The
      researches of international corporations connected with nursing tried to uncover
      the causes, make proposals for remending of the troubles so that nursing also can
      reach the level of medicine. The permanent staff came diluted because losses were
      retrieved with unskilled labours; countries concentrated on reconstruction of
      economy, public health was pushed into the background; later during the period of
      prosperity the development of medical technics made technical assistance from a
      lot of nurses, who became the doctor's assistant and not the patient's, whose
      personal necessities were slowly pushed into the background. Nurses massive
      career-leaving and other portents indicated the unfavourable tendency of changes,
      and a new conception was prepared on the basis of detailed analysis to solve this
      problem.

PMID- 1741153
TI  - [Helicobacter pylori allergy].
AB  - A case of a 44 year old woman with antrum gastritis and H. pylori infection was
      reported. After unsuccessful treatment of the disorder with bismuth and
      tinidazole, an auto-vaccine was prepared from the bacterium in order to eliminate
      the infection. After the first injection of the vaccine a generalised urticaria
      was observed. In the development of the skin eruptions a type I, and a type IV
      allergic reaction could be demonstrated using the H. pylori specific RAST-test
      and leukocyte migration inhibition respectively. After eradication of the
      bacterium by amoxycillin treatment, the clinical signs of both the
      gastrointestinal and allergic diseases disappeared.

PMID- 1741154
TI  - [Gallstone ileus after endoscopic sphincterotomy].
AB  - The authors report on a case of gallstone ileus developed after endoscopic
      sphincterotomy (EST). The patient had to be operated and recovered uneventfully
      after enterotomy. Emphasis is placed on the importance of patient's observation
      after EST so this rare complication could be revealed in time.

PMID- 1741155
TI  - [Attempt at reducing the "biographical hiatus" in the life of Samuel Decsy].

PMID- 1741156
TI  - [Homeopathy in Hungary].

PMID- 1741157
TI  - Cellular localization and T antigen binding of the retinoblastoma protein.
AB  - Mutation of the retinoblastoma (Rb) gene is found frequently in human sarcomas,
      lung, bladder and breast carcinomas and is the molecular basis for hereditary
      predisposition to retinoblastoma. The Rb protein is a nuclear phosphoprotein that
      is differentially phosphorylated during the cell cycle. Its precise function is
      unknown but it has been suggested that it may act as a transcriptional regulator
      or as a regulator of cellular DNA synthesis. The Rb protein forms specific
      complexes with the oncogenes of three different groups of DNA tumour viruses. We
      have prepared a new monoclonal antibody to the Rb protein and used it to
      establish sensitive immunoassays for Rb complexed to T antigen. In SV40-infected
      and transformed cells these assays showed that Rb enters a trimolecular complex
      containing p53, Rb and T. A large panel of human tumour cell lines was tested for
      expression, cellular localization and T-binding activity of Rb using the new
      antibody.

PMID- 1741158
TI  - Transformation of normal rat kidney cells by v-K-ras enhances expression of
      transin 2 and an S-100-related calcium-binding protein.
AB  - v-K-ras transformants of normal rat kidney cells (KNRK) exhibit cell surface
      related, transformation-specific properties, including cell-surface fibronectin
      depletion, induction of anchorage- and density-independent growth, and increased
      synthesis of transforming growth factors alpha and beta. To search for potential
      distal effectors of v-K-ras-mediated transformation, we prepared a rabbit
      antiserum directed against intact KNRK cells to immunoprecipitate and compare
      proteins from detergent lysates and conditioned media of labeled NRK, KNRK, B77
      NRK (a v-src transformant) and ts-371-NRK cells (a Ki-MSV encoding a temperature
      sensitive p21v-K-ras). Proteins with enhanced expression in both wild-type v-K
      ras and v-src transformants included a cell-surface phosphoglycoprotein with
      apparent Mr of 79,000 (79K) modified from an 85K protein observed in NRK cell
      lysates, a cytoplasmic 47K and a 10K protein, and a 57K secreted glycoprotein. A
      KNRK-specific 21K membrane-associated protein and secreted 59K and 36K secreted
      glycoproteins were also detected. The expression of the 36K and 59K proteins best
      correlated with temperature-dependent activation of the ts-371-NRK p21v-K-ras.
      Immunoselection of recombinant clones from a KNRK-specific lambda gt11 cDNA
      library allowed identification of the 59K and 10K proteins as transin 2 and an S
      100-related calcium-binding protein identified as p9Ka/42A but not previously
      associated with oncogenic transformation of rat cells. Transin 2 detection by a
      cell-derived antiserum may also suggest the presence of specific cell-surface
      binding sites for this enzyme.

PMID- 1741159
TI  - Sustained induction of egr-1 by v-src correlates with a lack of fos-mediated
      repression of the egr-1 promoter.
AB  - Serum stimulation of quiescent fibroblasts leads to a transient induction of the
      transcription factor egr-1. However, the induction of egr-1 by v-src was found to
      be sustained rather than transient. The proto-oncogene fos has been reported to
      be co-regulated with egr-1 and to repress serum-induced egr-1 expression. We
      found that c-fos prevents v-src-induced gene expression regulated by the egr-1
      promoter. Thus, the sustained induction of egr-1 by v-src could be explained by a
      lack of c-fos induction by v-src. Consistent with this hypothesis, egr-1 and c
      fos were co-induced by serum, but not by v-src, in Balb/c 3T3 cells; v-src did
      not induce c-fos expression in these cells. We propose that sustained expression
      of egr-1 induced by v-src in Balb/c 3T3 cells is due to a lack of c-fos down
      regulation of egr-1.

PMID- 1741160
TI  - Expression of p53 in human neuroblastoma- and neuroepithelioma-derived cell
      lines.
AB  - Overexpression of the nuclear phosphoprotein p53 has been detected in many
      different transformed human cell lines and primary adult tumors. Elevated steady
      state levels of p53 appear to be the result of an increase in the stability of
      the protein and, in adult cancers, high levels of the protein are associated with
      mutation of the p53 gene. In this study, overexpression of p53 was detected in 4
      out of 5 human neuroblastoma-derived cell lines. The protein expressed by each of
      these four lines had a significantly prolonged half-life relative to the p53
      protein in immortalized rodent fibroblasts and normal bovine adrenal medullary
      cells. However, no mutations were detected in the highly conserved regions of the
      p53 gene in these four neuroblastoma lines and the protein being expressed was
      not recognized by the mutant-specific anti-p53 monoclonal antibody, PAb 240. Upon
      retinoic acid-induced differentiation of the LA-N-5 neuroblastoma cell line, the
      level of p53 protein declined, as did the level of p53 mRNA, but the half-life of
      the protein remained unchanged. The high level of protein observed in the
      undifferentiated cell lines appears to result from expression of a stable wild
      type p53 protein and increased transcription. In contrast, p53 protein was
      undetectable in two neuroepithelioma-derived cell lines; the p53 gene in one of
      these lines contained a nonsense mutation, while the other transcribed truncated
      p53 mRNA.

PMID- 1741161
TI  - Transcriptional activity of rel family proteins.
AB  - Our studies originally demonstrated that the v-rel oncoprotein repressed gene
      expression in chicken lymphoid cells, while it activated transcription in rodent
      fibroblasts. Here we report that the c-rel protein can activate expression of
      genes linked to kappa B motifs when low levels of endogenous kappa B-binding
      activity are present. In contrast v-rel, and to a lesser extent c-rel, inhibit NF
      kappa B-mediated activation of the human immunodeficiency virus long terminal
      repeat (HIV LTR) in phorbol ester-stimulated HeLa cells. Competition assays show
      that v-rel competitively inhibits both NF-kappa B and c-rel-mediated
      transcriptional activation. Analysis of mutant HIV LTR-chloramphenicol
      acetyltransferase (CAT) constructs in which all Sp1 or both NF-kappa B elements
      have been deleted shows that NF-kappa B motifs are required for rel-mediated
      effects on gene expression. Transforming v-rel mutants compete efficiently with
      phorbol ester-activated kappa B factors, whereas a transformation-defective
      mutant of v-rel is impaired in this activity. Taken together, these results
      strengthen the hypothesis that v-rel functions as a dominant interfering member
      of rel family proteins. These results also suggest that the ability of v- and c
      rel to activate or repress gene expression in specific cells may result from
      their capacity to compete with endogenous rel family proteins whose expression
      and/or activity are cell-specific.

PMID- 1741162
TI  - Overexpression of c-met proto-oncogene but not epidermal growth factor receptor
      or c-erbB-2 in primary human colorectal carcinomas.
AB  - The epidermal growth factor receptor (EGFR) and the protein products of c-erbB-2
      and c-met proto-oncogenes belong to a family of growth factor receptors with
      tyrosine kinase activity. In human colonic carcinomas, the expression of the EGFR
      and c-erbB-2 have been studied at the protein level only, while c-met expression
      has not been reported. We have examined the mRNA expression of these genes in
      human normal colorectal mucosa and primary carcinomas. The results demonstrate
      that the normal mucosa shows highly variable levels of EGFR and c-erbB-2 mRNAs,
      but expresses consistently low amounts of c-met mRNA. Colorectal carcinomas did
      not express significantly higher levels of the EGFR and c-erbB-2 mRNAs than the
      normal mucosa. In contrast, c-met was consistently and significantly
      overexpressed (mean sixfold) in carcinomas as compared with normal mucosa.
      Seventy percent of paired normal-tumor specimens showed a tumor to normal c-met
      mRNA ratio of greater than 4. The expression of c-met mRNA was also enhanced in
      the adenomas, suggesting that over-expression of this proto-oncogene may have
      mechanistic significance in the early stages of human colorectal carcinogenesis.

PMID- 1741163
TI  - cDNA sequence of a growth factor-inducible immediate early gene and
      characterization of its encoded protein.
AB  - We report the cDNA sequence of 3CH134, an immediate early gene whose
      transcription is rapidly and transiently stimulated by serum growth factors.
      3CH134 encodes a 367 amino acid protein that does not share significant sequence
      similarity with any known protein. 3CH134 is inducible through multiple signal
      transduction pathways, and in the adult mouse is expressed predominantly in the
      lung. Using affinity-purified antibodies, we have identified the 3CH134 protein
      in serum-stimulated Balb/c 3T3 cells and determined that it has a short half
      life.

PMID- 1741164
TI  - Phosphorylation occurs in the amino terminus of the Raf-1 protein.
AB  - The ability of the Raf-1 protein to morphologically transform murine fibroblasts
      can be activated by amino-terminal deletions or substitutions. We have compared
      the phosphorylation states of full-length and representative transforming and non
      transforming amino-terminal deletion mutants of the Raf-1 protein using
      phosphoamino acid analysis and tryptic phosphopeptide mapping. Several
      [32P]orthophosphate-labeled tryptic phosphopeptides that were present in the full
      length Raf-1 protein were absent from the highly transforming 22W Raf-1 mutant
      (lacking 305 amino-terminal residues). Peptide-specific antisera localized Raf-1
      phosphorylation sites to several amino-terminal cyanogen bromide and tryptic
      peptides that are deleted from the 22W protein. A major phosphorylated tryptic
      peptide of the Raf-1 protein was immunoprecipitated by antiserum directed against
      amino acid residues 257-275, a highly conserved region of the raf family. This
      tryptic peptide is entirely deleted from the highly transforming 22W protein.
      Subtractive Edman degradation and electrophoretic analysis of the
      immunoprecipitated tryptic peptide indicated that phosphorylation of the Raf-1
      protein occurs at serine 259. Multiple phosphorylated tryptic peptide forms were
      immunoprecipitated by antiserum directed against Raf-1 residues 283-309. The
      majority of this tryptic peptide is also deleted from the highly transforming Raf
      1 mutant 22W.

PMID- 1741165
TI  - Isolation of azatyrosine-induced revertants from ras-transformed human mammary
      epithelial cells.
AB  - Non-transformed revertant clones were isolated from the ras-transformed MTSV1-7
      (ras) cell line, after treatment with the antibiotic azatyrosine. Azatyrosine
      significantly inhibited the growth of the ras-transformed cells but not of the
      normal MTSV1-7. After 7 days of azatyrosine treatment, approximately 30% of MTSV1
      7 (ras) cells survived, and revertant cell lines were selected by random cloning.
      The azatyrosine-induced revertants (six clones) were considered non-transformed
      on the basis of (a) their substantially reduced ability to form colonies in soft
      agar, and (b) their inability to produce tumours in nude mice. Molecular analysis
      of the revertants revealed that each contains multiple copies of the v-H-ras gene
      and expresses high levels of v-H-ras mRNA, and all revertants sustain elevated
      levels of p21ras protein. Thus, the revertant phenotype induced by azatyrosine
      does not result from inactivation of v-H-ras oncogene or inhibition of its
      expression. In vivo guanine nucleotide binding to p21ras in the revertant cell
      lines demonstrated binding of both GTP and GDP, indicating that reversion to the
      non-transformed phenotype was not due to inability of p21ras to bind GTP. The
      expression of the human K-rev-1 gene, a known tumour-suppressor gene in ras
      transformed NIH3T3 cells, was studied in the isolated azatyrosine revertants. All
      six revertants showed a significant increase in the K-rev-1 transcript levels
      compared with the ras-transformed MTSV1-7 cells. These results suggest that
      tumorigenic transformation of human mammary epithelial cells by v-H-ras may be
      influenced by the level of expression of the tumour-suppressor gene, K-rev-1.

PMID- 1741166
TI  - A divergent ets-related protein, elk-1, recognizes similar c-ets-1 proto-oncogene
      target sequences and acts as a transcriptional activator.
AB  - The ets oncogene superfamily consists of a family of sequence-specific DNA
      binding proteins that activate transcription. We have previously identified two
      new members of the ets oncogene superfamily, namely elk-1 and elk-2. In this
      report we show that the recombinant elk-1 protein expressed in bacteria, like the
      c-ets-1 proto-oncogene, binds in a sequence-specific manner to Moloney murine
      sarcoma virus long terminal repeat, E74 target sequences and the PEA3 motif
      (polyoma enhancer), but does not bind to PU box sequences. Thus analysis of the
      DNA-binding specificity of ets-related proteins supports the view that different
      members show similar DNA-binding specificity, which is a general feature of the
      homeobox proteins. Our data using the chloramphenicol acetyltransferase gene
      linked to a thymidine kinase promoter containing multimers of the elk-1 target
      sequence indicates that elk-1 functions as a transcriptional activator.
      Interestingly, although elk-1 is the most divergent of all the members of the ets
      gene family, it shows very close similarities with c-ets-1 in some of its
      sequence-specific DNA-binding specificities. Here, we propose a new function for
      the elk-1 gene to act as a transcriptional activator of retroviruses and DNA
      tumor viruses.

PMID- 1741167
TI  - Temperature-sensitive mutants of p53 associated with human carcinoma of the lung.
AB  - We have compared the effects of specific point mutations on the tertiary and
      quaternary structure of the human p53 protein. Eight mutants, each derived from
      primary resected tissues of lung carcinomas, were expressed in vitro under
      strictly defined conditions, such that the only known variant was the point
      mutation present in each p53 mRNA. All the mutations were located in highly
      conserved domains. The tertiary structure of each mutant protein was investigated
      by reactivity with anti-p53 monoclonal antibodies directed against conformation
      dependent epitopes. Quaternary structure was examined by gel filtration. Although
      all the mutant proteins exhibited abnormal tertiary structures, their quaternary
      structures appeared similar to wild type, the one exception being p53-tyr135,
      which contains tyrosine in place of cysteine at residue 135. The conformational
      phenotype of mutant human p53 was found to be dependent upon (i) the locus of the
      mutation and (ii) the nature of the amino acid substitution: two different
      substitutions at residue 273 yielded two mutants with differing structural
      properties. We have discovered three mutants of human p53 that are temperature
      sensitive for conformation; one is mutated at codon 273, a 'hotspot' for p53
      mutation in human cancer.

PMID- 1741168
TI  - c-ets-1 DNA binding to the PEA3 motif is differentially inhibited by all the
      mutations found in v-ets.
AB  - The proto-oncogene c-ets-1, one of the two cellular sequences transduced by the
      avian retrovirus E26, encodes for two transcription factors that activate through
      a purine-rich motif. The v-ets oncogene differs from its cellular progenitor p68c
      ets-1 (i) by its fusion to gag- and myb-derived sequences in the E26 P135gag-myb
      ets fusion protein, (ii) by two point mutations, and (iii) by the replacement of
      the 13 C-terminal amino acids present in c-ets-1 by 16 unrelated residues in v
      ets. A 35 kDa protein which binds to the purine-rich PEA3 motif in a sequence
      specific manner has been obtained by expression in Escherichia coli of the 311
      carboxy-terminal amino acids of c-ets-1. Using various v-/c-ets-1 chimeric 35 kDa
      proteins expressed in bacteria, we have shown that all the mutations found in v
      ets, when introduced into this c-ets-1 protein, diminish or even abolish its
      sequence-specific DNA binding. These results demonstrate that, in addition to the
      previously defined 85 amino acids located near the carboxy terminus of the c-ets
      1 protein (the ETS domain), other sequences are required for sequence-specific
      DNA binding. In addition, the c-ets-1 35 kDa polypeptide carrying the two point
      mutations and the viral-specific carboxy terminus, and thus similar to the v-ets
      encoded domain of the E26 P135gag-myb-ets, does not bind to the PEA3 motif.

PMID- 1741169
TI  - Cell type and developmental regulation of the fyn proto-oncogene in neural
      retina.
AB  - The product of the proto-oncogene c-fyn (p59fyn) is a non-receptor tyrosine
      kinase of unknown function. The expression of the p59fyn tyrosine kinase was
      analysed by immunoperoxidase staining of the different neuronal cell types in the
      developing chick neural retina. p59fyn was primarily localized in the cell bodies
      of mature retinal neurons. p59fyn immunoreactivity was most abundant in cell
      bodies of differentiated ganglion, amacrine and photoreceptor cells. The onset of
      p59fyn expression in developing photoreceptors occurred coordinately with
      terminal neuronal differentiation. p59fyn was also found within the outer
      plexiform layer, which contains synaptic terminals of the photoreceptors. At
      embryonic stages prior to photoreceptor differentiation, p59fyn was most highly
      concentrated in the cell bodies of differentiating ganglion and amacrine cells.
      p59fyn autokinase activity in retinal extracts decreased concomitant with the
      final stages of maturation of retinal neurons, suggesting that the p59fyn kinase
      is developmentally regulated. Thus, the expression of p59fyn is regulated in both
      a developmental and cell type-specific manner. The existence of p59fyn in some of
      the same neuronal cells as p60c-src suggests the possibility of functional
      redundancy of these non-receptor tyrosine kinases.

PMID- 1741170
TI  - The use of local anesthetics in the treatment of chronic pain.
AB  - Local anesthetics are an important and effective tool in the treatment of
      patients with chronic pain syndromes. Orthopaedic nurses are in a pivotal
      position to assess potential problems and intervene where appropriate. This
      article addresses the pharmacology of local anesthesia, indications for nerve
      blocks with local anesthetics, and nursing management.

PMID- 1741171
TI  - Pharmacologic strategies for managing pain in children.
AB  - Erroneous presumptions about children's reactions to pain have misguided
      professionals' management of this issue. Recent recognition and understanding of
      the pain experience in children have prompted research and clinical advances in
      treatment and care. Considerable study is still needed to further comprehend the
      difference between the perception and reaction to pain in the pediatric
      population.

PMID- 1741172
TI  - Caring for the orthopaedic patient with sickle cell disease.
AB  - Sickle cell disease (SCD) is an inherited, chronic, painful condition seen
      primarily in blacks and populations from the Mediterranean and Caribbean areas.
      The crescent or sickle shaped red blood cells have a shorter lifespan causing
      severe anemia; they are sticky and easily clump together causing intravascular
      occlusions which eventually damage vital organs. Providing nursing care for
      patients with sickle cell disease can be very challenging because of the chronic
      nature of the illness. Understanding the disease phenomena can facilitate nursing
      assessments and help nurses individualize care for these clients.

PMID- 1741173
TI  - Demystifying ethical decision making.
AB  - Ethical dilemmas frequently occur in the practice of orthopaedic nursing. Nurses,
      however, are often unsure about how to resolve these dilemmas. The language of
      ethics remains elusive. Yet, because nurses have a central role in patient care,
      they need to become more comfortable making ethical decisions related to their
      practice. This article briefly describes the dialectical process of ethical
      decision making and demonstrates this process by using a case presentation.
      Readers are encouraged to put themselves into the role of the bedside nurse in
      the case, determine what they believe to be the right action, and provide a well
      grounded rationale for that decision.

PMID- 1741174
TI  - Development of a nursing automated documentation system.
AB  - As hospital length of stay has decreased and patient acuity has increased, the
      nurse is confronted daily with the challenge of managing time between patient
      care and documentation. Documentation of care has consistently been a time
      consuming and frustrating part of nursing practice. The nursing shortage has only
      compounded this problem. St. Joseph's Hospital has creatively begun to facilitate
      documentation by developing a Nursing Automated Documentation System (NADS) in
      collaboration with CliniCom, Inc. of Boulder, Colorado. This article documents
      the development and implementation of the system.

PMID- 1741175
TI  - Real time ultrasonographic evaluation of the infant hip.
AB  - Although the technique for ultrasonographic evaluation of the infant hip is
      difficult to learn, it is a valuable diagnostic tool. In many institutions, hip
      ultrasonography expands upon and complements the clinical examination and
      minimizes radiographs.

PMID- 1741176
TI  - Initial assessment and management of a patient with a gun shot wound of the
      femur.

PMID- 1741177
TI  - Problem with the Abbott Lifecare 4100 PC plus infuser.

PMID- 1741178
TI  - The bones of the midfoot.

PMID- 1741179
TI  - Lack of evidence of efficacy of cohorting nursing personnel in a neonatal
      intensive care unit to prevent contact spread of bacteria: an experimental study.
AB  - Nurse cohorting was investigated in a modern neonatal intensive care unit (NICU).
      During 99 days bacterial infection and colonization rates were determined in 100
      infants experimentally assigned cohort or noncohorted care. Colonizing isolate
      identity was determined by plasmid profile analyses and biotyping in weekly
      surveillance cultures. Between Days 2 and 7, 3 infections occurred in cohorted
      infants but none in noncohorted ones. No secondary spread of infection or
      definitive colonization cluster occurred. The first colonization rate, at any
      site, was 0.53/patient-week in the noncohorted and 0.3 to 0.4 in the cohorted
      units (P greater than 0.05). Colonization ratios with species other than usual
      skin bacteria in the respiratory tract and with species other than Escherichia
      coli in the rectum were lower for noncohorted infants. Effective infection
      control practices in a modern NICU, including alcohol hand antisepsis, should
      obviate a need for cohorting.

PMID- 1741180
TI  - Tuberculosis in children infected with human immunodeficiency virus: a report of
      five cases.

PMID- 1741181
TI  - Fatal influenza B virus pneumonia in pediatric patients.

PMID- 1741182
TI  - Transfusion-acquired hepatitis A outbreak from fresh frozen plasma in a neonatal
      intensive care unit.

PMID- 1741183
TI  - Pediatric blood culture: comparison of yields using aerobic, anaerobic and
      hypertonic media.

PMID- 1741184
TI  - The role of syphilis serology in the evaluation of suspected sexual abuse.

PMID- 1741185
TI  - Disseminated histoplasmosis as the acquired immunodeficiency syndrome-defining
      illness in an infant.

PMID- 1741186
TI  - Fever and spastic quadriparesis caused by Mycoplasma pneumoniae.

PMID- 1741187
TI  - Antimicrobial therapy for Parinaud's oculoglandular syndrome.

PMID- 1741188
TI  - Amoxicillin therapy for strep throat.

PMID- 1741189
TI  - Intraperitoneal and intravenous fluconazole pharmokinetics in a pediatric patient
      with end stage renal disease.

PMID- 1741190
TI  - Management of unimmunized contacts of patients with invasive Haemophilus disease.

PMID- 1741191
TI  - Demographics of community-acquired bacterial infections in hospitalized children.

PMID- 1741192
TI  - Antimicrobial therapy for suspected sepsis in infants less than three months of
      age.

PMID- 1741193
TI  - Fever without source: management of children 3 to 36 months of age.

PMID- 1741194
TI  - Treatment of skin and skin structure infections.

PMID- 1741195
TI  - Current antibiotic therapy of community-acquired bacterial infections in
      hospitalized children: bone and joint infections.

PMID- 1741196
TI  - Management of community-acquired bacterial pneumonia in hospitalized children.

PMID- 1741197
TI  - Infections of the urinary tract.
AB  - There are many options for the treatment of the child with pyelonephritis. Many
      children can be successfully treated without hospitalization. Appropriate use of
      studies to image the urinary tract to detect renal damage and treatable
      anatomical and functional abnormalities is a key aspect of the management of such
      patients. With appropriate interventions (such as antimicrobial prophylaxis for
      vesicoureteral reflux or surgery for obstructive lesions), subsequent renal
      damage can be averted and the morbidity of recurrent infections often can be
      eliminated.

PMID- 1741198
TI  - Current management of bacterial meningitis in infants and children.

PMID- 1741199
TI  - Options for outpatient management of serious infections.

PMID- 1741200
TI  - Effectiveness of continuous vs. intermittent amoxicillin to prevent episodes of
      otitis media.
AB  - The effectiveness of continuous compared with intermittent amoxicillin
      prophylaxis administered to subjects with a history of recurrent otitis media
      enrolled during the winter respiratory infection season was assessed in a
      prospective single blinded clinical trial. Patients with three or more chart
      documented episodes of otitis media (OM) in the preceding 6 months were enrolled
      and randomly assigned to each treatment group. Patients in the continuous group
      received amoxicillin twice a day every day for up to 4 months. During the same
      period patients in the intermittent group received amoxicillin twice a day only
      when they developed respiratory symptoms of congestion, runny nose or cough.
      Among the 30 patients receiving continuous amoxicillin who were followed for at
      least 3 months, 22 (73%) had no OM episodes and 8 (28%) had one OM episode. Among
      the 25 patients receiving intermittent amoxicillin for at least 3 months, 13
      (52%) had no OM episodes, 8 (32%) had 1 episode and 4 (16%) had 2 episodes.
      Significantly fewer patients had fewer than 2 OM episodes on continuous compared
      with intermittent amoxicillin (P less than 0.04). The incidence density was 0.46
      episode/120 days at risk in the continuous treatment group compared with 1.10
      episodes/120 days at risk for intermittent treatment (P less than 0.03). Among
      patients 12 months or older the incidence density of OM episodes per 120 days was
      3.5 times higher in the intermittent amoxicillin group (0.80) compared with the
      continuous amoxicillin group (0.23) (P = 0.05). The incidence densities of the
      continuous vs. intermittent therapy groups did not differ significantly for
      patients younger than 12 months of age. The findings suggest that continuous
      amoxicillin prophylaxis may be more effective than intermittent treatment in
      preventing OM episodes in patients 12 months or older with a history of recurrent
      otitis media.

PMID- 1741201
TI  - Chlamydial antibodies in children with lower respiratory disease.
AB  - Forty-nine of 255 (19.2%) Argentinean children between the ages of 1 and 18
      months without evidence of viral or bacterial infections, but with clinical and
      radiologic evidence of acute lower respiratory distress, had serologic evidence
      of recent Chlamydia trachomatis infection by the demonstration of specific IgM,
      seroconversion or 4-fold rise in titer or elevated titers by enzyme immunoassay
      and the microimmunofluorescence test. Recent C. trachomatis infection was
      detected in 28 of 166 (16.9%) of children with bronchiolitis and 18 of 89 (20.2%)
      with pneumonia. Three additional children with bronchiolitis had Chlamydia
      pneumoniae-specific antibody. There was a significantly higher prevalence of C.
      trachomatis infection in children living in La Plata city orphanage (26 of 74,
      35.1%) than in those attending 2 pediatric hospitals in Buenos Aires (23 of 181,
      12.7%) (P less than 0.001). C. trachomatis infection was detected in all age
      groups up to 18 months. Thirty of 49 infections were in children older than 3
      months of age and 16 were in children older than 6 months. These results suggest
      that C. trachomatis infection may be associated with bronchiolitis and pneumonia
      in children between the ages of 1 and 18 months of age in Argentina and that a
      proportion may be horizontally transmitted.

PMID- 1741202
TI  - Standardized diagnosis of pneumonia in developing countries.
AB  - The World Health Organization recommends the use of raised respiratory rate and
      chest wall indrawing to enable health workers in developing countries to diagnose
      pneumonia. We evaluated the current World Health Organization guidelines for
      management of the child with cough or difficult breathing in Manila, Philippines
      and Mbabane, Swaziland using an identical protocol in both countries. Raised
      respiratory rate was defined as greater than or equal to 50/minute for children
      ages 2 to 12 months and greater than or equal to 40/minute for children 12 months
      to 5 years. Chest wall indrawing was defined as inward movement of the bony
      structures of the lower chest wall with inspiration. In the Philippines raised
      respiratory rate or chest wall indrawing, when applied by a pediatrician, was
      found to have a sensitivity of 0.81 and specificity of 0.77 for predicting
      pneumonia as determined by a pediatrician with the aid of a chest roentgenogram.
      In Swaziland the sensitivity was 0.77 and the specificity was 0.80. When applied
      by health workers the sensitivity was similar but the specificity was lower. The
      current World Health Organization ARI case management guidelines predicted
      pneumonia with similar sensitivity and specificity in two very different
      developing countries, the Philippines and Swaziland.

PMID- 1741203
TI  - Bone and joint infections caused by multiply resistant Staphylococcus aureus in a
      neonatal intensive care unit.
AB  - Twenty cases of osteomyelitis and/or septic arthritis caused by multiply
      resistant Staphylococcus aureus were documented in an Australian tertiary
      neonatal unit between 1981 and 1987. Eighteen (90%) occurred in the 3 years 1985
      to 1987, an incidence of 9.6/1000 admissions in that period. All osteomyelitis
      and/or septic arthritis occurred in sick premature infants requiring intensive
      support. Eleven (55%) had a birth weight of less than 1500 g. An intravascular
      device was the most common portal of entry (14 of 20, 70%). Systemic symptoms
      were prominent at presentation, with local signs developing later in 18 (90%),
      usually within a week. Radiologic changes were almost always present by 10 days;
      radionuclide bone scanning was insensitive and did not hasten diagnosis.
      Osteomyelitis was multifocal in 11 cases (55%), with the long bones, particularly
      of the upper limb, most commonly affected. Large joint involvement was uncommon
      (15%). Intravenous vancomycin for a mean of 32 days was associated with low
      mortality (1 of 20) and toxicity; surgical drainage was not performed. Follow-up
      at a minimum of 4 months (mean, 25.5 months) showed residual signs in the
      affected limb in 30%, none with significantly impaired function. Skeletal
      infection should be searched for rigorously in neonatal multiply resistant S.
      aureus sepsis. In the absence of large joint disease, vancomycin therapy alone
      for a minimum of 3 weeks gives good short term results with minimal toxicity.

PMID- 1741204
TI  - Invasive neonatal candidiasis: comparison of albicans and parapsilosis infection.
AB  - Severe infections caused by non-albicans Candida species are being increasingly
      reported among infants in neonatal intensive care units. To assess relative
      severity, mortality rates for C. albicans (CA) and C. parapsilosis (CP)
      infections in one neonatal intensive care unit from 1980 to 1990 were compared.
      Invasive candidiasis was defined as Candida recovery from a normally sterile body
      fluid or site with clinical signs of infection. Invasive candidiasis was
      diagnosed and systemic antifungal therapy initiated in 45 infants, 29 with CA and
      16 with CP. No differences were found between CA and CP for birth weight,
      gestational age, age or weight at onset, presence of necrotizing enterocolitis,
      gastrointestinal or genitourinary anomalies, death (all causes), prior incidence
      or duration of antibiotics, parenteral nutrition, steroids or endotracheal
      intubation. Candida infection as the cause of death was more frequent with CA
      than CP (7 of 29 vs. 0 of 16; P = 0.034). Infants with CA were more likely to
      have antecedent thrush (P = 0.007) and perineal Candida dermatitis (P less than
      0.02); those with CP were more likely to have vascular catheters at the time of
      positive culture (P less than 0.02). Though both pathogens occur in similar
      neonatal intensive care unit infants and can cause severe disease, CA appears
      more likely to result in death than CP.

PMID- 1741205
TI  - Long term epidemiological analysis of Citrobacter diversus in a neonatal
      intensive care unit.
AB  - A prolonged outbreak of Citrobacter diversus central nervous system infection
      among hospitalized term infants, peaking in 1979, ceased with establishment of
      nurse-patient cohorting. The outbreak was attributed to dissemination of an
      epidemic strain among infants in an antiquated neonatal intensive care unit. When
      C. diversus colonization recurred within the new neonatal intensive care unit in
      1984, cohorting and bacteriologic surveillance were reinstituted. By utilizing
      biotypes, plasmid profiles and antibiograms, four different C. diversus strains
      were identified circulating during 1979. Strains recovered between 1984 and 1988
      from neonatal intensive care unit infants were similar to those from community
      acquired sources. A strain considered avirulent in 1979 was found causing
      bacteremia in two infants (one with central nervous system disease) in 1984 to
      1988. During cohorting C. diversus acquisition was 0.019/patient-month; after
      cohorting ceased it was 0.017/patient-month. Multiple source introductions
      appeared to occur with different C. diversus strains, some causing infant
      disease. No efficacy of cohorting was evident.

PMID- 1741206
TI  - Eight-year school performance, neurodevelopmental, and growth outcome of neonates
      with bronchopulmonary dysplasia: a comparative study.
AB  - Eight-year outcome is reported for three groups of preterm infants with
      bronchopulmonary dysplasia--group 1 with a birth gestation of less than or equal
      to 31 weeks receiving supplemental oxygen until the equivalent of 36 weeks'
      gestation, group 2 of the same gestation receiving supplemental oxygen to 28 days
      postnatal age but not to 36 weeks gestational age, and group 3 with a gestation
      of greater than or equal to 32 weeks requiring supplemental oxygen for greater
      than 28 days--and for an individually matched preterm neonatal comparison group
      and a term peer comparison group for each bronchopulmonary dysplasia group. The
      subjects all had parents whose mother tongue was English and were matched for
      gender, mother's education, and father's socioeconomic status, and in the case of
      the neonatal comparison groups they also were matched for birth gestation and
      birth weight. Physical growth and psychoeducational and school performance test
      scores were similar for the three bronchopulmonary dysplasia study groups with
      the exception of lower intelligence quotient for those receiving supplemental
      oxygen for the longest time. Children in groups 1 and 2 had outcome scores
      similar to those of the neonatal comparison group and significantly below those
      of their peer comparison groups. On multivariate analysis for group 1 children,
      61% of the variance of academic achievement was related to lowest recorded pH,
      father's socioeconomic status, and lowest recorded PaO2. Compared with the peer
      groups, the study groups continued to show academic delay when the disabled
      children were excluded from analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741207
TI  - Educational outcome of neonatal intensive care graduates.
AB  - Studies of developmental outcome of neonatal intensive care unit graduates have
      generally been limited to the first 2 to 3 years of life, with outcome determined
      by psychometric tests. This study followed neonatal intensive care unit graduates
      born 1975 through 1983 (n = 457) into the public school system and compared their
      educational outcomes with those of newborn nursery graduates (n = 656). Outcomes
      were evaluated by placement in four academic categories: regular classroom,
      academic problems, speech/language impairment, and major impairment. Educational
      outcomes for children of both groups were essentially the same. Their placement
      in the four academic categories were equally affected by nonmedical variables,
      primarily income (below/above poverty level), race, and sex. Seventy percent of
      poverty-level children were in one of the three problem categories, compared with
      40% of children above poverty level. Neither neonatal intensive care unit
      treatment nor low birth weight were major predictors of educational outcome. The
      only clear-cut neonatal intensive care unit effect occurred among children born
      with sensory or physical impairments. Therefore, in order to reduce poor
      educational outcomes, follow-up and intervention programs should be targeted
      primarily to children with diagnosable handicaps and from minority, low-income
      families.

PMID- 1741208
TI  - Lack of agreement of tympanic membrane temperature assessments with conventional
      methods in a private practice setting.
AB  - An infrared tympanic membrane thermometer (FIRST temp) said to approximate core
      temperature accurately is being marketed as a noninvasive, quick, and easy-to-use
      clinical instrument. The determination of tympanic membrane temperatures by this
      device was compared with the determination of oral, rectal, or axillary
      temperatures by a conventional glass thermometer. Subjects were patients of a
      pediatric group practice in Houston, Texas. FIRST temp and conventional
      temperature determinations on individual patients were completed within 5 minutes
      of each other. The presence or absence of otitis media was noted by the examining
      physician. Agreement between the two methods of temperature determination was
      assessed by calculating limits of agreement within which 95% (+/- 2 standard
      deviations) of individual differences would fall. The location of conventional
      thermometer (oral, rectal, axillary), time interval between the two separate
      measures, and the presence or absence of otitis media were entered into a
      multiple regression analysis to determine whether these factors influenced the
      observed differences between the two methods. A total of 144 patients were
      enrolled in the study; oral comparisons were obtained in 92 (57%) patients,
      rectal in 35 (24%), and axillary in 29 (19%). The upper and lower limits of
      agreement between temperature methods were 1.12 degrees C and 0.89 degrees C and
      the mean difference was -0.12 degrees C. Regression analysis revealed that only
      the site of conventional thermometer location (oral, rectal, axillary) was a
      significant predictor of FIRST temp/conventional differences. Each site had a
      range of agreement greater than 1.65% degrees C; axillary temperatures had the
      greatest range (-0.94 degree C to +1.30 degrees C.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1741209
TI  - Appearance of the hymen in prepubertal girls.
AB  - The recent increase in requests for genital examinations in girls who may have
      been sexually abused has necessitated detailed information not previously
      available on normal anatomy of the prepubertal girl. This study was undertaken to
      document the genital anatomy of 211 girls between the ages of 1 month and 7 years
      who presented for well child care or nongynecologic complaints and who had no
      history of sexual abuse. Each child's genitalia was examined and photographed,
      with findings reported reflecting those observed photographically. The study
      population consisted of 36% blacks, 33.6% white non-Hispanics, 29.9% Hispanics,
      and 0.5% Asians. Subjects had a mean age of 21 +/- 20.6 (SD) months. Extensive
      labial agglutination sufficient to obscure the hymen was noted in 5% (10/211) and
      partial agglutination in an additional 17% (35/211). A significant difference was
      noted in hymenal configuration by age, with a fimbriated hymen the most common
      type (46%) in infants aged 12 months or younger and a crescentic hymen the most
      common (51%) in girls older than 24 months (P less than or equal to .001). No
      significant difference was noted in hymen configuration by race. Hymenal bumps
      (mounds) were observed in 7%, hymenal tags in 3%, vestibular bands in 98%,
      longitudinal intravaginal ridges in 25%, and external ridges in 15% of subjects
      in whom the anatomy under study could be visualized. Hymenal notches (clefts)
      occurred superiorly and laterally on the hymenal rim but none were found
      inferiorly on the lower half of the hymen. A narrow rounded hymenal ring with a
      transection was observed in only 1 (0.5%) of 201 subjects and was not considered
      a normal finding.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741210
TI  - Girls with fragile X syndrome: physical and neurocognitive status and outcome.
AB  - The fragile X syndrome, a common X-linked form of mental retardation and autism,
      affects females as well as males. Previous work has shown that approximately 35%
      of heterozygotes (women who carry the fragile X gene) demonstrate cognitive
      impairment. Thirty-two girls, 18 years or younger, who demonstrate the fragile X
      chromosome were evaluated and compared with 19 sisters who do not demonstrate the
      fragile X chromosome. Evaluations included a physical examination, behavioral
      assessment, and intelligence testing. Significant differences (in intellectual,
      behavioral, and physical features) were seen between the two groups. Twenty-five
      percent of fragile X-positive girls had an IQ in the mentally retarded range (IQ
      less than 70) and 28% had an IQ in the borderline range (70 to 84). Prominent
      ears, shyness, and poor eye contact were significant findings in fragile X
      positive girls compared with fragile X-negative girls. Thirty-one percent of the
      fragile X-positive girls had significant attentional difficulties and most of
      these girls were successfully treated with stimulant medication. The majority of
      fragile X-positive girls in this study demonstrated significant behavioral and
      developmental problems which required identification and appropriate treatment.
      Pediatricians and health care providers should be aware of the frequency and
      manner with which fragile X affects females in order to initiate cytogenetic
      studies and treatment when indicated.

PMID- 1741211
TI  - Early expression of the apolipoprotein (a) gene: relationships between infants'
      and their parents' serum apolipoprotein (a) levels.
AB  - The serum concentration of apo(a), the unique apolipoprotein of lipoprotein (a),
      reflects serum lipoprotein (a) levels. High concentrations are associated with
      increased cardiovascular risk. Inasmuch as atherogenesis may begin in childhood,
      the early expression of the apo(a) gene and relationships between serum levels in
      infants and their parents were explored. Serum apo(a) and lipid profiles were
      measured in 51 infants when aged 8.5 +/- 2 months. They were from among 1032
      consecutively born babies in whom apo(a) levels had been measured on day 2 to 5.
      Levels in 18 infants were in the top 5% of the neonatal apo(a) distribution and
      in 33 from below the 95th percentile. Parental values were also assessed.
      Infants' apo(a) levels (n = 51) at the ages of 2 to 5 days and 8.5 +/- 2.3 months
      were highly correlated (r = .73, P less than .0001) and increased from an initial
      median value of 48 U/L (range 1 to 462 U/L) to 100 U/L (5 to 969 U/L) at 8.5
      months, and they were then not different from parental levels. Measurements at
      both times were closely correlated with parental levels. Regression coefficients
      between 8.5-month levels, and the levels of fathers, of mothers, and the average
      level of both parents were 0.439, 0.521 and 0.93, respectively (P less than .0001
      for each). It is concluded that the gene for the regulation of apo(a) is fully
      expressed before the age of 1 year. The apo(a) levels in infants during this time
      track closely and are predictive of parental values.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1741212
TI  - Whole-body cesium 137 activity up to 4 years after the Chernobyl reactor accident
      in premature newborns, newborns, infants, and children.
AB  - Cesium 137 activity was measured after the Chernobyl incident in a whole-body
      radiation counter (4-pi-scintillation counter) in 85 premature and mature
      newborns (group 1), 174 infants and young children up to 2 11/12 years (group 2),
      and 48 children between 3 and 8 years (group 3) from Bonn (Germany) and
      surroundings. In 1987 the mean level of radioactivity in group 2, at 3.7 Bq/kg
      body weight corresponding to a mean radiation exposure of 11 muSv/y, was lower
      than that of group 1 (5.8 Bq/kg, 17 muSv/y) and 3 (9.4 Bq/kg, 28 muSv/y). Up to
      1990 the values of all groups revealed a continuous decrease. The latest
      measurements showed mean values of 0.5 Bq/kg (1.5 muSv/y) in group 1, 0.6 Bq/kg
      (1.8 muSv/y) in group 2, and 0.8 Bq/kg (2.4 muSv/y) in group 3. A comparison with
      present cesium 137 values and determinations of the end of the 1950s and
      beginning of 1960s, both in adults, showed good agreement. The effective dose
      equivalent rates amounted to less than 1% of that from natural radiation
      exposure. These levels should present no teratogenic risks to the population
      studied and, while there are theoretical mutagenic risks, the dose is so low that
      no increase in measurable mutagenic effects should be observed.

PMID- 1741213
TI  - Pediatric organ donation: the paradox of organ shortage despite the remarkable
      willingness of families to donate.
AB  - The 105 pediatric deaths (ages 1 to 16 years) that occurred at Vanderbilt
      University Medical Center during a 31-month period were reviewed to define the
      size of the donor pool in the pediatric population and to assess the role of
      physicians in the procurement of these much-needed organs. Computerized discharge
      abstracts showed that 57 pediatric patients died without contraindications to
      organ donation. Manual review of these 57 medical records yielded 46 records
      suitable for review by Tennessee Donor Services. From this group, 19 eligible
      donors were identified. All eligible donors died from trauma, intracerebral
      hemorrhage, anoxic events, or hydrocephalus. Physicians failed to ask one family
      for permission to donate. All 18 of the families who were asked agreed to donate
      and organs were successfully procured from all 18 patients. These data suggest
      that families of pediatric patients are much more willing to agree to donation
      than the families of adult patients. As a result of this study, a simplified
      audit process has been developed for hospitals to use in evaluating compliance
      with required-request legislation.

PMID- 1741214
TI  - Stimulation of collagen synthesis and linear growth by growth hormone in
      glucocorticoid-treated children.
AB  - Impaired linear growth and skeletal maturation associated with chronic
      glucocorticoid therapy may result from (1) inhibited insulin-like growth factor 1
      (IGF-1) activity; (2) impaired type 1 collagen synthesis; or (3) suppressed
      growth hormone (GH) secretory response to growth hormone-releasing hormone. Each
      mechanism could potentially be improved by exogenous GH treatment. Seven slowly
      growing glucocorticoid-treated children received recombinant DNA human GH (0.3
      mg/kg/per week) for 6 to 21 (mean 13.1 +/- 4.9) months. Height, weight, IGF-1
      activity, glycosylated hemoglobin level, and C-terminal type 1 procollagen level
      were measured every 3 months and growth velocity was calculated. Skeletal
      maturation and 2-hour postprandial serum glucose and insulin levels were assessed
      every 6 months. All patients showed increased growth velocity during treatment
      with GH. Mean growth velocity increased from 3.43 +/- 0.65 cm/y to 6.72 +/- 0.84
      cm/y with GH therapy (P less than .005). Growth velocity standard deviation
      scores corrected for bone age (P less than .005), IGF-1 levels (P less than .05),
      and C-terminal type 1 procollagen levels (P less than .005) also increased with
      GH therapy. C-terminal type 1 procollagen levels correlated well with growth
      velocity (r = .652) while IGF-1 levels did not (r = .17). Glycosylated hemoglobin
      levels remained unchanged, but 2-hour postprandial glucose levels rose during GH
      treatment. Slowly growing glucocorticoid-treated children receiving GH therapy
      increased growth velocity for 6 to 21 months. Initially diminished C-terminal
      type 1 procollagen levels rose with GH therapy, a change which corresponded with
      growth acceleration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741215
TI  - Health-risk behaviors and health concerns among young adolescents.
AB  - This study examined the health concerns and behaviors of 563 adolescents (aged 11
      through 14) from a variety of social, racial, and ethnic backgrounds. Behaviors
      associated with adolescent morbidity and mortality were examined, including
      sexual behavior, substance use, and injury-related behaviors. Although young
      adolescents are often viewed as unlikely participants in these risk behaviors,
      the results of this study suggest that greater attention should be paid to this
      younger group and their health-risk behaviors. A majority of the sample had tried
      alcohol and tobacco, and almost a third had used marijuana. Twenty-one percent
      were sexually active. Prevalence rates varied by social class, race-ethnicity,
      gender, and age. More than 75% of the sample had visited a physician during the
      prior year, suggesting an important role physicians may serve as sources of
      information and positive role models for these young adolescents. The results
      suggest that we stop viewing young adolescents as naive children and begin to
      view them as observers of and participants in a changing social environment that
      has important implications for their current and future health status. Without a
      realistic appraisal of the young adolescent, we can expect to have little overall
      effect on the status of adolescent health in the United States.

PMID- 1741216
TI  - Unusual manifestation of Stevens-Johnson syndrome involving the respiratory and
      gastrointestinal tract.
AB  - There are many recognized acute complications of Stevens-Johnson syndrome:
      however, long-term sequelae involving the respiratory and gastrointestinal tracts
      are exceedingly rare. We present an 8-year-old girl who developed esophageal
      stricture and chronic lung disease while recovering from Stevens-Johnson syndrome
      and discuss these complications with possible mechanisms for their occurrence.

PMID- 1741217
TI  - Self-administered questionnaire for structured psychosocial screening in
      pediatrics.
AB  - Screening for psychosocial risk factors has been limited by lack of a structured
      approach. The purpose of this study was to assess the utility of a self
      administered questionnaire compared with routine history as recorded in the
      medical record in screening for risk factors for dysfunctional parenting in an
      urban pediatric clinic. English-speaking parents were offered questionnaires in
      the waiting room. In addition to routine demographic and medical questions, the
      questionnaires contained standard screening instruments for substance abuse,
      depression, self-esteem, and social support, as well as questions about domestic
      violence, homelessness, and parental history of abuse as a child. Medical records
      were reviewed separately. Of the 114 mothers who returned questionnaires, the
      response rate for sensitive questions such as income was greater than or equal to
      85%. Compared with the medical record, the questionnaire identified significantly
      more mothers with possible substance abuse, depression, low self-esteem, and/or
      history of abuse as a child (P less than .01 for each). Compared with what is
      usually recorded in the medical record, self-administered questionnaires yield
      substantial additional information regarding psychosocial risk factors for
      dysfunctional parenting. Such questionnaires should be considered for routine
      psychosocial screening in clinics serving high-risk populations.

PMID- 1741218
TI  - Acute prolactin and oxytocin responses and milk yield to infant suckling and
      artificial methods of expression in lactating women.
AB  - Breast-feeding is today the major form of infant nutrition in the immediate
      postpartum period. Despite this, recent trends in modern life-styles have raised
      obstacles to successful lactation. These include infant illness and maternal
      responsibilities outside the home, both requiring separation from the mother.
      While the hormonal dynamics of infant suckling are understood, little is known
      about the effects of artificial methods of milk expression. A variety of breast
      pumps exist in the current US market which vary considerably in price and
      effectiveness. To understand better the ability of these pumps to assist women in
      the maintenance of lactation, the current study was undertaken to evaluate their
      effects on milk yield and prolactin and oxytocin release when compared to natural
      infant suckling. Twenty-three women who were exclusively breast-feeding their
      infants were randomly assigned to serially use several pumping methods, as well
      as infant suckling, with blood being taken at 10-minute intervals to determine
      the hormonal responses. The results reveal variability in the prolactin responses
      to the artificial pumping methods, with the greatest responses found with an
      electric pulsatile pump; these responses compare favorably with those of natural
      infant suckling. Other methods were less successful in causing prolactin
      elevations. No differences were seen among the methods in the oxytocin response.
      The results of this study demonstrate striking differences in the ability of
      breast-pumping methods to produce an acute and sustained prolactin rise in breast
      feeding mothers. The large discrepancies found suggest the need for further
      studies in to enable women and health care providers to choose the most
      appropriate method for milk expression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741219
TI  - Persistent antinuclear antibodies in children without identifiable inflammatory
      rheumatic or autoimmune disease.
AB  - One hundred eight children with musculoskeletal pain considered not to be due to
      an autoimmune or inflammatory disease had an antinuclear antibody (ANA) test
      performed. Twenty-four of these children were ANA positive on HEp-2 cell
      substrate at a screening serum dilution of 1:20. A positive ANA test persisted in
      21 of 24 of the patients over a mean time period of 38 months (range 1 to 103
      months). No sera from any patient at initial evaluation had anti-DNA antibodies
      by radioimmunoassay or by indirect immunofluorescence on Crithidia luciliae. One
      patient recently developed elevated anti-DNA (radioimmunoassay) antibodies but
      still has a negative assay on C luciliae. Four patients had antibodies to core
      histones by immunoblotting. None had antibodies to Sm, RNP, Ro (SS-A), or La (SS
      B) by counterimmunoelectrophoresis. No patient developed an overt inflammatory or
      autoimmune disease during a mean follow-up period of 61 months (range 13 to 138
      months). A child with musculoskeletal pain and a positive test for ANA, but with
      no clinical evidence at presentation of inflammatory or autoimmune disease, is at
      low risk of imminently developing such a disease.

PMID- 1741220
TI  - Chronic illness and mental health problems in pediatric practice: results from a
      survey of primary care providers.
AB  - The prevalence of chronic physical illnesses and their association with mental
      disorders was assessed using data collected by primary care pediatricians. A
      chronic illness was diagnosed in 1573 (15.6%) of 10,058 children aged 4 to 16
      years, 945 (9.4%) of whom had a "serious" disorder, 535 (5.3%) had a minor
      disorder (hay fever or dermatitis), and 121 (1.2%) had a speech or language
      disorder. Behavioral problems were identified more often among patients with
      "serious" disorders than among those without chronic illnesses (2.4% vs 1.7%), as
      were emotional problems (5.0% vs 3.1%). Among those with "serious" conditions
      involving the central nervous system, the prevalence of behavioral (5.2%) and
      emotional (10.4%) disorders was still higher. Although children with "serious"
      disorders not involving the central nervous system also showed elevated
      prevalence rates of behavioral (2.1%) and emotional (4.5%) disturbances, this
      increase did not reach statistical significance. No association with "minor"
      chronic disorders was found. The negative impact of these mental health problems
      on the child was more severe when a chronic illness was also present, but
      referrals for mental health services did not reflect his association.

PMID- 1741221
TI  - Prolonged periodic breathing: significance in sleep studies.
AB  - Periodic breathing (PB) is a pattern of breathing that is frequently recognized
      in infants being studied for possible sleep apnea. Infants presenting to a sleep
      laboratory over a 3 1/2-year period who had evidence on their initial study of
      prolonged (greater than 15% of total sleep time) PB were prospectively studied in
      an effort to determine the significance of this pattern of breathing. Of the 331
      infants studied, 40 demonstrated prolonged PB. Sixteen of these infants, who were
      of 37 weeks' gestation or greater at birth and did not receive pharmacologic
      therapy, were studied on at least two occasions (group 1). Of the remaining 24
      infants, 11 were treated with methylxanthines by their attending physician (group
      2), and 13 did not return for sequential studies (group 3). All infants who were
      of less than 37 weeks' gestation at birth were separately evaluated (group 4).
      For group 1, who were studied at a mean age of 15 postnatal weeks, there was a
      mean of 36.4% periodicity which decreased on the second study to 18.0%. By the
      fourth study, this had decreased to 9.2%. In group 2, there was a mean of 41.3%
      periodicity during the first study which decreased to 6.4% on the second study.
      Infants of group 3 had a mean of 31.4% PB on their initial study and the
      premature infants, group 4, had 30.1% PB. All infants showed a decrease in PB
      with sequential studies and no infant was known to have died of sudden infant
      death syndrome or any other disorder in the first year of life.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1741222
TI  - Lung involvement in Langerhans' cell histiocytosis: prevalence, clinical
      features, and outcome.
AB  - In Langerhans' cell histiocytosis, the prognostic significance of pulmonary
      disease is controversial. The clinical and radiological features and lung
      function tests of Langerhans' cell histiocytosis patients presenting to a single
      tertiary referral center between 1981 and 1987 were reviewed. Age at diagnosis
      ranged from 2 weeks to 16 years (median 1.7 years) and the male-female ratio was
      2.4:1. No child presented with lung involvement alone. In 18 (40%) of 45 patients
      with multisystem disease there was clinical and/or radiological evidence of lung
      pathology. Another 6 children (13%) with normal chest roentgenograms had abnormal
      lung function tests, suggesting subclinical ("occult") involvement. Those with
      overt lung disease tended to present at a younger than average age (median 0.6
      years). The most common functional disturbance was reduced lung or respiratory
      compliance with reduced lung volumes. Patients with and without lung involvement
      showed a similar pattern of involvement of other organs, with skin and bone most
      commonly affected. Of the 45 children with multisystem disease, 38 (84%) survived
      2 to 7 years after diagnosis; there was a similar proportion of deaths in
      children with and without lung involvement. It is concluded that lung involvement
      occurs in nearly half of young children with multisystem Langerhans' cell
      histiocytosis but does not adversely affect outcome.

PMID- 1741223
TI  - Physical examination of patients with cerebrospinal fluid shunts: is there useful
      information in pumping the shunt?
AB  - To assess the value of the information derived from pumping the shunt valve in
      hydrocephalic patients with cerebrospinal fluid shunts, the findings on
      examination of 200 consecutive patients were recorded prospectively. The status
      of each shunt was determined on the basis of all available clinical data, and the
      results of the shunt pumping test were compared to the final status of each shunt
      for various subsets of the study group. In the most clinically pertinent subsets,
      the sensitivity of the shunt pumping test in the detection of shunt obstruction
      was 18% to 20%, and the predictive value of a negative shunt pumping test,
      indicating shunt patency, was only 65% to 81%. For the hydrocephalic patient with
      symptoms of shunt malfunction, definitive imaging studies must not be deferred
      because of reassuring findings on examination of the shunt valve.

PMID- 1741224
TI  - Maternal Type A behavior during pregnancy, neonatal crying, and early infant
      temperament: do type A women have type A babies?
AB  - It was hypothesized that type A behavior in pregnant women would be associated
      with increased neonatal crying and differential reports of infant temperament at
      3 months. Type A behaviors during pregnancy were measured in a self-selected
      cohort of 72 healthy, primiparous, middle-class women. Their newborns were
      assessed at 48 hours of age and the women completed an infant temperament
      questionnaire at 3 months. Women who were classified as type A on the Job
      Involvement scale of the Jenkins Activity Survey had infants who cried more
      during a standardized neurobehavioral assessment compared with infants of women
      who were type B on the same scale. Women who were type A for Job Involvement
      rated their 3-month-old infants as more intense and less predictable in their
      responses to the environment. They were also more likely to be breast-feeding
      their infants at 3 months. This is the first study to examine the prevalence and
      nature of maternal type A behaviors during pregnancy and to show their
      relationship to neonatal crying behavior, to maternal report of early infant
      temperament, and to maternal breast-feeding.

PMID- 1741225
TI  - Behavior and parental expectations of child pedestrians.
AB  - Pedestrian injuries remain the most common cause of death from trauma for young
      school-age children. This study was based on the hypothesis that parents'
      abilities to accurately assess their children's street-crossing skills vary with
      the crossing test and age of the children, being less accurate for younger
      children. Children at three developmental levels (aged 5 through 6, 7 through 8,
      and 9 through 10 years) and their parents were evaluated on four street-crossing
      tests and a control vocabulary test. For each test, children's answers were
      compared to parents' estimates of their children's performance. Parents
      overestimated the abilities of their 5-through 6-year-olds on all four tests (P
      less than .01). Parents overestimated the abilities of 7- through 8-year-olds on
      two of the tests (P less than .05) and parents accurately assessed the abilities
      of the 9- through 10-year-olds. On the vocabulary test, parents overestimated
      their children's performance at all age levels (P less than .01). The results
      support the hypothesis and indicate that parents' expectations for their
      children's pedestrian skills are least accurate for 5- and 6-year-olds, with the
      mismatch decreasing as children get older. Inaccurate expectations of children's
      pedestrian skills may be fruitful target for injury prevention programs.

PMID- 1741226
TI  - Diagnosis-related criteria in the consideration of extracorporeal membrane
      oxygenation in neonates previously treated with high-frequency jet ventilation.
AB  - High-frequency jet ventilation (HFJV) is one of several high-frequency techniques
      that are particularly valuable for treating the neonate with lung disease
      refractory to conventional ventilation or with pulmonary air leak. Extracorporeal
      membrane oxygenation (ECMO) has also emerged as a valuable rescue therapy for
      neonates of more than 2000 g birth weight and 34 weeks' gestation with
      intractable respiratory failure. With the concurrent introduction of HFJV and
      ECMO, the authors sought to evaluate the role of HFJV prior to the institution of
      ECMO therapy. The data base for 2856 neonates receiving mechanical ventilation in
      one unit was used to identify 73 (of 298 total) neonates treated with HFJV, who
      were eligible by age and weight criteria for ECMO. Patients were grouped by
      diagnosis, and the oxygenation index (OI) was calculated during therapy. Outcome
      was evaluated for mortality, and the sensitivity of the OI for predicting
      mortality was calculated. Neonates who survived with HFJV alone presented with an
      OI of 0.30 +/- 0.03 (SEM), significantly less than nonsurvivors (0.42 +/- 0.04, P
      = .016). Survivors responded to HFJV with a rapid decrease in OI at 1 hour (0.19
      +/- 0.02, P less than .001) and 6 hours (0.15 +/- 0.01, P less than .001).
      Nonsurvivors did not respond significantly at 1 hour (OI = 0.33 +/- 0.04, P = not
      significant [NS]) or at 6 hours (OI = 0.40 +/- 0.06, P = NS). By diagnosis,
      neonates with respiratory distress syndrome survived more often with HFJV (28/34,
      82%) than neonates with meconium aspiration (10/26, 38%) or diaphragmatic hernia
      (3/9, 33%). Neonates with respiratory distress syndrome seldom presented with
      high OI values, but the majority of those who did survived (5/7 survived with
      initial OI greater than or equal to 0.40).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741227
TI  - National Cholesterol Education Program (NCEP): highlights of the report of the
      Expert Panel on Blood Cholesterol Levels in Children and Adolescents.

PMID- 1741228
TI  - Cholesterol screening by primary care pediatricians: a study of attitudes and
      practices in the Minneapolis-St Paul metropolitan area.
AB  - A telephone survey of the 197 board-certified pediatricians actively engaged in
      primary care in the Minneapolis-St Paul metropolitan area was conducted to assess
      their cholesterol screening practices and hypercholesterolemia management. The
      response rate was 95%. Nearly all the pediatricians (90%) do some cholesterol
      screening, with the majority (58%) screening only children with a strong family
      history of coronary heart disease. Though only 33% screen all their patients, 66%
      advocate universal pediatric screening. Most of the pediatricians indicated they
      would manage hypercholesterolemia patients themselves, nearly always with dietary
      means. Despite their strong support for screening, the pediatricians expressed
      skepticism about the significance of childhood cholesterol level as a predictor
      of adult cardiovascular disease and doubted their effectiveness in getting
      patients to adopt a cholesterol-reducing diet. Their definition of elevated total
      cholesterol level in childhood was consistent with published recommendations, but
      only 29% could define elevated low-density lipoprotein cholesterol level. The
      pediatricians expressed strong opposition to pediatric cholesterol screening in
      schools or in any setting other than clinics and hospitals.

PMID- 1741229
TI  - Accuracy of central venous pressure measurement from the abdominal inferior vena
      cava.
AB  - Central venous pressure measurements in the abdominal inferior vena cava were
      compared with measurements in the right atrium in 10 infants and 10 children
      during cardiac catheterization. At end expiration, the mean pressures at these
      two sites were within 1 mm Hg of each other in all 20 patients, with a mean
      difference of 0.0 +/- 0.36 mm Hg. The abdominal inferior vena cava is a safe and
      convenient site for measurement of central venous pressure, and our study
      confirms that such measurements are accurate.

PMID- 1741230
TI  - Should children, parents, and pediatricians worry about cholesterol?

PMID- 1741231
TI  - American Academy of Pediatrics Committee on Sports Medicine and Fitness:
      Horseback riding and head injuries.

PMID- 1741232
TI  - American Academy of Pediatrics Committee on Psychosocial Aspects of Child and
      Family Health: The child as a witness.
AB  - 1. Children are often involved with the courts in cases of abuse and custody
      dispute and may be required to be witnesses. 2. Pediatricians have important
      roles in assisting children by providing psychosocial support for the precipitant
      life event and the event of subsequent appearance in court. 3. A pediatrician
      also may be able to contribute to a child's adaptation by advocating for
      accommodations in the legal process that are in the child's best interest.

PMID- 1741233
TI  - American Academy of Pediatrics Committee on Psychosocial Aspects of Child and
      Family Health: The pediatrician and childhood bereavement.

PMID- 1741234
TI  - Role of the pediatrician in the multidisciplinary team.

PMID- 1741235
TI  - Little League baseball and head injury.

PMID- 1741236
TI  - Infirmary-style sick child day care.

PMID- 1741237
TI  - Disposable diapers vs the environment.

PMID- 1741238
TI  - Definition of bronchopulmonary dysplasia.

PMID- 1741239
TI  - Do pediatricians like childish ads?

PMID- 1741240
TI  - Pharmaceutical and Biomedical Analysis Meeting. Leiden, The Netherlands, 22,
      November 1991. Abstracts.

PMID- 1741241
TI  - Enzyme inhibition in Cardiovascular disease, Weesp, The Netherlands, 13 December
      1991. Abstracts.

PMID- 1741242
TI  - Impairment: "It's not just drugs".

PMID- 1741243
TI  - HIV and tuberculosis: implications for NJ nurses.

PMID- 1741244
TI  - Purification and biochemical characterisation of the EcoR124 type I modification
      methylase.
AB  - Large scale purification of the type I modification methylase EcoR124 has been
      achieved from an over-expressing strain by a two step procedure using ion
      exchange and heparin chromatography. Pure methylase is obtained at a yield of 30
      mg per gm of cell paste. Measurements of the molecular weight and subunit
      stoichiometry show that the enzyme is a trimeric complex of 162 kDa consisting of
      two subunits of HsdM (58 kDa) and one subunit of HsdS (46 kDa). The purified
      enzyme can methylate a DNA fragment bearing its cognate recognition sequence.
      Binding of the methylase to synthetic DNA fragments containing either the EcoR124
      recognition sequence GAAN6RTCG, or the recognition sequence GAAN7RTCG of the
      related enzyme EcoR124/3, was followed by fluorescence competition assays and by
      gel retardation analysis. The results show that the methylase binds to its
      correct sequence with an affinity of the order 10(8) M-1 forming a 1:1 complex
      with the DNA. The affinity for the incorrect sequence, differing by an additional
      base pair in the non-specific spacer, is almost two orders of magnitude lower.

PMID- 1741245
TI  - Cooperative binding of the globular domains of histones H1 and H5 to DNA.
AB  - In view of the likely role of H1-H1 interactions in the stabilization of
      chromatin higher order structure, we have asked whether interactions can occur
      between the globular domains of the histone molecules. We have studied the
      properties of the isolated globular domains of H1 and the variant H5 (GH1 and
      GH5) and we have shown (by sedimentation analysis, electron microscopy, chemical
      cross-linking and nucleoprotein gel electrophoresis) that although GH1 shows no,
      and GH5 little if any, tendency to self-associate in dilute solution, they bind
      highly cooperatively to DNA. The resulting complexes appear to contain
      essentially continuous arrays of globular domains bridging 'tramlines' of DNA,
      similar to those formed with intact H1, presumably reflecting the ability of the
      globular domain to bind more than one DNA segment, as it is likely to do in the
      nucleosome. Additional (thicker) complexes are also formed with GH5, probably
      resulting from association of the primary complexes, possibly with binding of
      additional GH5. The highly cooperative nature of the binding, in close
      apposition, of GH1 and GH5 to DNA is fully compatible with the involvement of
      interactions between the globular domains of H1 and its variants in chromatin
      folding.

PMID- 1741246
TI  - Slippage synthesis of simple sequence DNA.
AB  - The analysis of slippage synthesis of simple sequence DNA in vitro sheds some
      light on the question of how simple sequences arise in vivo. We show that it is
      possible to synthesize all types of repetitious di- and trinucleotide motifs
      starting from short primers and a polymerase in vitro. The rate of this synthesis
      depends on a sequence specific slippage rate, but is independent of the length of
      the fragments being synthesized. This indicates that only the ends of the DNA
      fragments are involved in determining this rate and that slippage is accordingly
      a short range effect. Slippage synthesis occurs also on a fixed template where
      only one strand is free to move, a situation which resembles chromosome
      replication in vivo. It seems therefore likely that slippage during replication
      is the cause of the observed length polymorphism of simple sequence stretches
      between individuals of a population.

PMID- 1741247
TI  - Molecular and functional analysis of the XPBC/ERCC-3 promoter: transcription
      activity is dependent on the integrity of an Sp1-binding site.
AB  - The human XPBC/ERCC-3 gene, which corrects the excision-repair defect in
      xeroderma pigmentosum group B cells and the UV-sensitive CHO mutant 27-1 cells,
      appears to be expressed constitutively in various cell types and tissues. We have
      analysed the structure and functionality of the XPBC/ERCC-3 promoter.
      Transcription of the XPBC/ERCC-3 gene is initiated from heterogeneous sites, with
      a major startpoint mapped at position -54 (relative to the translation start
      codon ATG). The promoter region does not possess classical TATA and CAAT
      elements, but it is GC-rich and contains three putative Sp1-binding sites. In
      addition, there are two elements related to the cyclic AMP (cAMP)-response
      element (CRE) and the 12-O-tetradecanoyl phorbol-13-acetate-response element
      (TRE) in the 5'-flanking region. Transient expression analysis of XPBC/ERCC-3
      promoter-CAT chimeric plasmids revealed that a 127-bp fragment, spanning position
      -129 to -3, is minimally required for the promoter activity. Transcription of the
      XPBC/ERCC-3 promoter depends on the integrity of a putative Sp1-binding site in
      close proximity to the major cap site. Band shift assays showed that this
      putative Sp1-binding site can interact specifically with a nuclear factor, most
      likely transcription factor Sp1 (or an Sp1-like factor) in vitro.

PMID- 1741248
TI  - The human insulin gene linked polymorphic region exhibits an altered DNA
      structure.
AB  - Regulation of transcription of the human insulin gene appears to involve a series
      of DNA sequences in the 5' region. Hypersensitivity to DNA structural probes has
      previously been demonstrated in regulatory regions of cloned genomic DNA
      fragments, and been correlated with gene activity. To investigate the structure
      of the DNA in the human insulin gene, bromoacetaldehyde and S1 nuclease were
      reacted with a supercoiled plasmid containing a 5kb genomic insulin fragment.
      Both probes revealed the human insulin gene linked polymorphic region (ILPR), a
      region (-363) upstream of the transcriptional start site which contains multiple
      repeats of a 14-15mer oligonucleotide with the consensus sequence
      ACAGGGGT(G/C)(T/C)GGGG, as the major hypersensitive site. Fine mapping and
      electron microscopic analysis both show a very different behaviour of the two DNA
      strands in the region of the ILPR and suggest the G-rich strand may be adopting a
      highly structured conformation with the complementary strand remaining largely
      single stranded.

PMID- 1741249
TI  - The LCR-like alpha-globin positive regulatory element functions as an enhancer in
      transiently transfected cells during erythroid differentiation.
AB  - A positive regulatory element (PRE) similar to the locus control region (LCR) of
      the human beta-globin gene cluster has recently been identified 40 kb upstream of
      the human zeta-globin mRNA cap site (Higgs D.R. W.G. Wood, A.P. Jarman, J.
      Sharpe, J. Lida, I.M. Pretorius, and H. Ayyub. 1990). We investigated the
      influence of the alpha PRE on human alpha-globin promoter activity in transiently
      transfected cells. The introduction of the alpha PRE into alpha-globin
      promoter/CAT expression constructs increased alpha-globin promoter activity by 15
      30 fold in a human erythroid cell line (Putko) as well as in mouse
      erythroleukemia cells (MELCs) induced with hexamethylene bisacetamide (HMBA).
      When these constructs were introduced into uninduced MELCs or HeLa cells, only a
      2-3 fold increase in alpha-globin promoter activity was observed. Deletion of 600
      bp of alpha-globin 5' flanking sequences containing six putative SP1-binding
      sites had no significant effect on levels of alpha-globin promoter enhancement by
      the alpha PRE. We further demonstrated that the alpha PRE and HS2 of the beta-LCR
      could similarly enhance transcriptional activity of the SV40 early promoter in
      HMBA induced MELCs. Finally, we showed that alpha-globin promoter activity in the
      presence of the alpha PRE increased with continued HMBA exposure and was
      coincident with transcriptional activation of endogenous globin genes.

PMID- 1741250
TI  - Promoter selectivity of the stationary-phase forms of Escherichia coli RNA
      polymerase and conversion in vitro of the S1 form enzyme into a log-phase enzyme
      like form.
AB  - Upon growth transition of Escherichia coli cells from exponential to stationary
      phase, RNA polymerase is converted into at least three different forms (S1, S2
      and S3), which could be separately isolated by phosphocellulose column
      chromatography (Ozaki et al., 1991 (2)). Here, the promoter selectivity of these
      three stationary-phase enzymes was examined using an in vitro mixed transcription
      system and an E. coli promoter collection. These altered forms of RNA polymerase
      showed different recognition properties of promoters from that by the log-phase
      holoenzyme (L1). One of the stationary-phase RNA polymerases, S1, was found to be
      converted in vitro into an enzyme like the log-phase form following incubation
      with nucleotides or pyrophosphate. The conversion was indicated by not only the
      shift of elution position from a phosphocellulose column but also the change in
      the promoter selectivity. These results may suggest that RNA polymerase is
      interconvertible between different forms with different promoter selectivity by
      interaction with a phosphorylated compound(s).

PMID- 1741251
TI  - S1 nuclease hypersensitive sites in an oligopurine/oligopyrimidine DNA from the
      t(10;14) breakpoint cluster region.
AB  - Recurring chromosomal translocations are frequently seen in cancers, especially
      in leukemias and lymphomas. The genes affected by these chromosomal
      translocations appear to play an important role in oncogenesis. The mechanism
      underlying the formation of chromosomal translocation is a subject under
      extensive study. In chromosomal translocations involving the Ig and TCR loci,
      complete heptamer-spacer-nonamer signal motifs are usually present at the break
      of the Ig and TCR genes, indicating the involvement of V-D-J recombinase(s). On
      the other hand, in only about 50% of the cases signal motif sequences have been
      found at the break in the other participating chromosome, suggesting that
      different mechanisms may be involved in the scission of the corresponding
      chromosome. Here we report the identification of an oligopurine/oligopyrimidine
      DNA in the t(10;14) breakpoint cluster region associated with T-cell acute
      lymphoblastic leukemia. S1 nuclease mapping revealed multiple S1 hypersensitive
      sites in the oligopurine/oligopyrimidine DNA. These data suggest a role for
      oligopurine/oligopyrimidine sequences (non-B DNA) in the formation of chromosomal
      translocation.

PMID- 1741252
TI  - Biophysical analysis of DNA modified by 1,2-diaminocyclohexane platinum(II)
      complexes.
AB  - Modification of DNA and double-stranded deoxyoligonucleotides with antitumour 1,2
      diamino-cyclohexanedinitroplatinum(II) (Pt-dach) complexes was investigated with
      the aid of physico-chemical methods and chemical probes of nucleic acid
      conformation. The three Pt-dach complexes were used which differed in isomeric
      forms of the dach nonleaving ligand-Pt(1R,2R-dach), Pt(1S,2S-dach) and Pt(1R,2S
      dach) complexes. The latter complex has lower antitumour activity than the other
      two Pt-dach complexes. Pt(1R,2S-dach) complex exhibits the slowest kinetics of
      its binding to DNA and of the conversion of monofunctional binding to
      bifunctional lesions. The anomalously slow electrophoretic mobility of multimers
      of the platinated and ligated oligomers suggests that bifunctional binding of Pt
      dach complexes to a d(GG) site within double-stranded oligonucleotides induces
      bending of the oligomer. In addition, chemical probing of double-helical
      deoxyoligonucleotides modified by the Pt-dach complexes at the d(GG) sites
      reveals that Pt(1R,2S-dach) complex induces more extensive conformational changes
      in the oligomer than Pt(1R,2R-dach) and Pt(1S,2S-dach) complexes. It is proposed
      that different effects of the Pt-dach complexes on DNA observed in this work
      arise mainly from a steric crowding of the axially oriented cyclohexane ring in
      the DNA adduct of Pt(1R,2S-dach) complex.

PMID- 1741253
TI  - In vitro definition of the yeast RNA polymerase I promoter.
AB  - The structure of the ribosomal gene promoter from Saccharomyces cerevisiae has
      been analyzed in a whole cell in vitro extract. The promoter contains at least
      two essential domains, an upstream domain located at the 5' boundary near
      position -150 and a core promoter domain around the site of transcription
      initiation at +1. The upstream domain augments transcription in vitro but is not
      absolutely required. Maintenance of correct spacing between the two domains is
      critical. The in vitro analysis agrees well with prior in vivo analysis and it
      appears that the yeast promoter has a structure very similar to that of
      vertebrate ribosomal gene promoters.

PMID- 1741254
TI  - Identification of USF as the ubiquitous murine factor that binds to and
      stimulates transcription from the immunoglobulin lambda 2-chain promoter.
AB  - To study the specificity and identity of NF-lambda 2, a ubiquitous murine nuclear
      factor that interacts specifically with the promoter of the lambda 2-chain gene
      and stimulates its transcription, competition experiments were carried out using
      DNA fragments from various immunoglobulin regulatory elements. The results showed
      that a fragment containing the H-chain enhancer competed efficiently for the
      binding of NF-lambda 2. Dissection of the H-chain enhancer revealed that the
      microE3 motif contributed the competing ability. Additionally, a regulatory
      region found in the adenovirus major late promoter, which interacts with the
      human general transcription factor USF, competed very efficiently for binding to
      NF-lambda 2. This region contains a sequence, CACGTGAC, which is identical to a
      region within the NF-lambda 2 motif. The pattern of complexes formation using
      oligonucleotide probes corresponding to the NF-lambda 2 and USF motifs were
      identical, and they both differed from that displayed by the E3 probes. Antisera
      against different domains of USF also react specifically with NF-lambda 2 showing
      that this factor is antigenically related, if not identical, to USF. Furthermore,
      the activity of the lambda 2 promoter in an in vitro transcription assay was
      significantly reduced when the nuclear extract used was USF-depleted. Addition of
      exogenous USF to this extract restored the transcription activity. Therefore, we
      conclude that NF-lambda 2 is the murine homologue of USF.

PMID- 1741255
TI  - A new rRNA processing mutant of Saccharomyces cerevisiae.
AB  - We have identified from a collection of temperature sensitive yeast mutants
      strains which fail to process rRNA normally. Characterization of one such mutant
      is reported here. This strain accumulates increased amounts of the 35S primary
      transcript, '24S' molecules extending from the transcription start site to the
      5.8S region, and two classes of 5.8S rRNA with 5' extensions of 7 and 149 bases,
      respectively. We show that this pleiotropic change in the rRNA processing pattern
      is due to a single mutation. Possible models for the function of the mutated gene
      are discussed.

PMID- 1741256
TI  - In vivo stability and kinetics of absorption and disposition of 3' phosphopropyl
      amine oligonucleotides.
AB  - Development of oligonucleotide derivatives as therapeutic agents requires an
      understanding of their pharmacokinetic behavior. The in vivo disposition and
      stability of a prototype of such compounds are reported here. The compound
      studied, a relatively G-rich 38 base 3' phosphopropyl amine oligonucleotide (TFO
      1), was cleared from the circulation with a half-life of approximately 10
      minutes, displaying distribution kinetics consistent with a two compartment
      model. TFO-1 was also readily absorbed into circulation from the peritoneal
      cavity. All tissues examined except brain accumulated the compound reaching
      concentrations calculated to be in the micromolar range. TFO-1 was found to be
      stable in circulation and in tissues in that a large fraction of intact material
      was detected 8 hours after injection, as assessed by gel electrophoresis.
      Approximately 20-30% of the injected dose was excreted in the urine over an 8
      hour period. These results suggest that G-rich oligonucleotides, minimally
      modified at the 3' end, are relatively stable in vivo and have distribution
      kinetics favorable to use as therapeutic agents.

PMID- 1741257
TI  - Poly(rA) binds poly(rG).poly(rC) to form a triple helix.
AB  - Poly(rA) binds poly(rG).poly(rC) to form a triple helix. Evidence for this
      structure includes ultraviolet absorbance mixing curves and melting curves, and
      circular dichroism spectroscopy. The formation of the triple helix depends on the
      length of the poly(rC) strand. Triple helix forms when the average length is
      around 100 nucleotides but does not form when the average length is about 500
      nucleotides.

PMID- 1741258
TI  - Autonomous activity of the alternate aldolase A muscle promoter is maintained by
      a sequestering mechanism.
AB  - The mouse aldolase A gene contains two closely-spaced alternate promoter/first
      exons. The more distal of the two, the M promoter, is muscle-specific while the
      3' promoter, the H promoter, is expressed constitutively. Various segments from
      these promoter regions were linked to a reporter gene and used to transfect the
      myogenic cell line C2C12 and the hepatoma cell line BWTG3. A muscle-specific
      enhancer, MEN1, responsible for 80% of promoter M activity and containing 4
      consensus MyoD binding sites was localized between -2578 to -2723 of the M
      promoter. Another muscle-specific enhancer and a restrictive element, MEN2/MSE,
      were found in the interval -1100 to -350. The MSE restrictive element was found
      to prohibit inappropriate up-regulation of the M promoter by selectively
      sequestering it from H promoter elements in both myoblasts and myotubes. Among
      the H promoter elements was found an enhancer, HEN, situated between -533 and 
      200 which did not function in myotubes. These studies also show that H promoter
      elements can act synergistically with a non-specific element, MAE, located
      between -350 and -130 of the M cap site greatly stimulating M promoter
      transcription in all cell types when the MSE restrictive element was absent.
      Through the analysis of interactions between these elements and the aldolase A
      and HSV-TK promoters we showed that neither the enhancers nor the promoter
      proximal sequences by themselves contain adequate information to reproduce the
      native pattern of aldolase A promoter modulation. Rather, the sequestering of the
      M promoter by the MSE restrictive element and the relative positioning and
      context of promoters M and H appear critical to the regulated expression of
      aldolase A.

PMID- 1741259
TI  - The NH2-terminal arms of trp repressor participate in repressor/operator
      association.
AB  - The 3-dimensional structure of the trp repressor, aporepressor, and
      repressor/operator complex have been described. The NH2-terminal arms of the
      protein, comprising approximately 12-14 residues, were not well resolved in any
      of these structures. Previous studies by Carey showed that the arms are required
      for full in vitro repressor activity. To examine the roles of the arms more fully
      we have removed codons 2-5 and 2-8 of the trpR gene and analyzed the resulting
      truncated repressors in vivo and in vitro. The delta 2-5 trp repressor was found
      to be approximately 25% as active as the wild type repressor in vivo. In in vitro
      equilibrium binding experiments, the delta 2-5 trp repressor was shown to be five
      fold less active in operator binding. The rate of dissociation of the complex
      formed between the delta 2-5 trp repressor and operator was essentially the same
      as the rate of dissociation of the wild type trp repressor/operator complex.
      However association of the delta 2-5 trp repressor with operator was clearly
      defective. Since the NH2-terminal arms of the trp repressor appear to affect
      association predominantly they may play a role in facilitating non-specific
      association of repressor with DNA as repressor seeks its cognate operators. The
      delta 2-8 trp repressor was unstable in vivo and in vitro, suggesting that some
      portion of the NH2-terminal arm is required for proper folding of the remainder
      of the molecule.

PMID- 1741260
TI  - Structure and mapping of the fosB gene. FosB downregulates the activity of the
      fosB promoter.
AB  - We have determined the genomic structure of the fosB gene and shown that it
      consists of 4 exons and 3 introns at positions also found in the c-fos gene. By
      deletion analysis we have characterized a region upstream of the TATA box which
      is the promoter region of the gene. Several consensus sequences have been
      identified, including an SRE and AP-1 binding site whose relative positions are
      identical to those in the 5' upstream region of the c-fos gene. We have also
      shown that FosB and c-Fos can downregulate the activity of the fosB promoter to a
      similar extent. The fosB gene is located in the [A1-B1] region of mouse
      chromosome 7.

PMID- 1741261
TI  - A conserved region in the sea urchin U1 snRNA promoter interacts with a
      developmentally regulated factor.
AB  - The expression of the sea urchin L. variegatus U1 snRNA gene is temporally
      regulated during embryogenesis. Using a microinjection assay we show that a
      region between 203 and 345 nts 5' of the gene is required for expression. There
      are four conserved regions between two sea urchin species in the 345 nts 5' to
      the U1 gene. One region, located at about -300, binds a protein factor which is
      present in blastula but not gastrula nuclei. Three other potential protein
      binding sites within the first 200 nts 5' to the gene have been identified using
      a mobility shift assay and/or DNase I footprinting. Two of these regions bind
      factors which are not developmentally regulated and one binds a factor which is
      developmentally regulated. It is likely that the factor which binds at -300 is
      involved in expression and developmental regulation of the sea urchin U1 snRNA
      gene.

PMID- 1741262
TI  - Isolation and identification of restriction endonuclease Aor51HI from
      Acidiphilium organovorum 51H.

PMID- 1741263
TI  - Identification of the radC102 mutation. Order of the genes in the 81.5-82.0 min
      region of the Escherichia coli chromosome.

PMID- 1741265
TI  - Sequence and genomic locus of a Leishmania protein homologous to rat ribosomal
      protein S8.

PMID- 1741264
TI  - Molecular cloning of the chicken SCL cDNA.

PMID- 1741266
TI  - Characterization of the cDNA sequences of two Xenopus ets-2 proto-oncogenes.

PMID- 1741267
TI  - Nucleotide and deduced amino acid sequence of the recA gene of Vibrio cholerae.

PMID- 1741268
TI  - cDNA nucleotide sequence of Sn, a regulatory gene in maize.

PMID- 1741269
TI  - Nucleotide sequence of the sheep MyoD1 gene.

PMID- 1741270
TI  - Nucleotide sequence of the POL3 gene encoding DNA polymerase III (delta) of
      Saccharomyces cerevisiae.

PMID- 1741271
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 1741272
TI  - DNA containing a chemically reduced apurinic site is a high affinity ligand for
      the E. coli formamidopyrimidine-DNA glycosylase.
AB  - The E. coli Formamidopyrimidine-DNA Glycosylase (FPG protein), a monomeric DNA
      repair enzyme of 30.2 kDa, was purified to homogeneity in large quantities. The
      FPG protein excises imidazole ring-opened purines and 8-hydroxyguanine residues
      from DNA. Besides DNA glycosylase activity, the FPG protein is endowed with an
      EDTA-resistant activity which nicks DNA at apurinic/apyrimidic sites (AP sites).
      In contrast, DNAs containing chemically reduced AP sites are not incised by the
      FPG protein. However, the DNA glycosylase activity of the FPG protein is strongly
      inhibited in the presence of a purified synthetic 24 base-pair double-stranded
      oligonucleotide which contains a single apurinic site transformed chemically
      through borohydride reduction into a ring-opened deoxyribose derivative. The
      ability of the FPG protein to form a complex with this synthetically modified DNA
      was studied by electrophoresis in non-denaturing polyacrylamide gels. The FPG
      protein specifically binds the double-stranded oligonucleotide containing an
      apurinic site previously reduced in the presence of sodium borohydride. The
      complex was identified as a single retardation band on non-denaturing
      polyacrylamide gel electrophoresis. Complex formation is reversible and an
      apparent dissociation constant, KDapp, of 2.6 x 10(-10) M was determined. In
      contrast, no such retardation band was obtained between the FPG protein and
      double-stranded DNA containing an intact apurinic site or single-stranded DNA
      containing either an intact or a reduced apurinic site.

PMID- 1741273
TI  - Copy number control of the streptococcal plasmid pIP501 occurs at three levels.
AB  - Transcriptional analysis of the replication region of plasmid pIP501 has revealed
      three active promoters. The repR gene which is essential for pIP501 replication
      was transcribed from promoter pII. A small antisense RNA (136 nt, RNAIII)
      generated from promoter pIII was complementary to the leader region of the repR
      mRNA. Introduction of either point mutations or deletions into promoter pIII or
      RNAIII resulted in a 5-20fold increased plasmid copy number suggesting a negative
      regulatory function for RNAIII. The copR gene, the complete DNA and amino acid
      sequence of which is reported, was dispensable for pIP501 replication. However,
      deletion of the copR promoter pI and/or the copR coding sequence led to a 10
      20fold increase in plasmid copy number. This effect was also observed when a -1
      frameshift mutation was introduced into the CopR coding region. Mutations in copR
      and pIII/RNAIII were not additive. It is, therefore, proposed that both
      components act at the same level of copy number control most likely in a
      sequential way. A second level of copy number control was found to involve an
      inverted repeat structure upstream of and overlapping with promoter pII.
      Destruction of this repeat sequence by deletion caused an increase in copy number
      2-3fold higher than that observed for either RNAIII or copR mutations. A working
      model is proposed how different components of pIP501 interact to regulate its
      copy number.

PMID- 1741274
TI  - Binding of a nuclear protein to the rat growth hormone silencer element.
AB  - The rat growth hormone (rGH) gene is uniquely expressed in a subset of cells from
      the anterior pituitary. This strongly cell type specific expression is controlled
      by both cis-acting positive sequences that bind the pituitary specific
      transcription factor Pit-1 and cis-acting negative regulatory elements that lie
      upstream of the Pit-1 sites. The negative elements act to prevent expression of
      the gene in inappropriate cell types. Here we report that the most proximal rGH
      silencer element is specifically bound by a protein found in a number of rGH non
      expressing cell types and which exerts a negative regulatory effect through the
      recognition of this rGH element in transient transfection assays. The sequence
      recognized by this protein is similar to sequences of several other negative
      regulatory elements as well as to the consensus binding site for the
      transcription factor NF1. However, the 45 KDa molecular weight identified for
      this protein does not correspond to any of the sizes previously reported for NF1
      suggesting that it is likely to represent a new member amongst this family of
      transcription factors.

PMID- 1741275
TI  - The role of a minor groove spine of hydration in stabilizing poly(dA).poly(dT)
      against fluctuational interbase H-bond disruption in the premelting temperature
      regime.
AB  - Experimental estimates of the premelting Adenine-Thymine base pair opening
      probability for some B-DNA sequences are two orders of magnitude smaller than
      those of other B-DNA sequences. The AT pairs in the sequence with smaller open
      probability seem to be those that have a well defined spine of hydration in the
      minor groove. We show that this spine of hydration can significantly enhance the
      thermal stability of the base pairs to which they are attached. The effect of
      this spine of hydration coupled with the possible stabilization effect
      contributed from neighboring GC pairs can explain the differences in the observed
      AT pair opening probability for different AT containing B-DNA sequences.

PMID- 1741276
TI  - Purification and properties of the MboII, a class-IIS restriction endonuclease.
AB  - After five purification steps a homogeneous preparation of endonuclease MboII was
      obtained, and several properties of the enzyme were determined. MboII is a
      monomer, with Mr under native and denaturing conditions being 47-49 x 10(3) Da.
      Endonuclease MboII is a basic protein (pI 8.3) which remains active when Mg2+ is
      replaced by Mn2+, Co2+, Ca2+, or Fe2+. MboII exhibits a star activity in the
      presence of some of the following reagents or ions: DMSO, glycerol, ethanol (and
      Co2+ or Mn2+ at pH 6). MboII does not bend DNA and is heat sensitive, losing
      activity after 15 min at 50 degrees C.

PMID- 1741277
TI  - The long repetitive polypurine/polypyrimidine sequence (TTCCC)48 forms DNA
      triplex with PU-PU-PY base triplets in vivo.
AB  - Polypurine/polypyrimidine repetitive sequences occur with high frequency in
      eucaryotic genomes, particularly around transcription units. Since such sequences
      are known to adopt triple stranded-structures under appropriate conditions in
      vitro, it is of major interest to know if they occur in vivo, and thus if they
      can have some biological importance by inducing structural constraints in the
      genomic DNA. To this end, we have isolated a (TTCCC)48 sequence, present in the
      promoter of an avian gene, and tested its ability to form PU-PY-PY and PU-PU-PY
      triple helices in vitro, through the oligonucleotide gel shift technique and
      single strand-specific nuclease footprinting. We have then developed an
      oligonucleotide protection assay, which can be adapted to in vivo investigations.
      This strategy leads us to conclude that in vivo conditions allow preponderant
      formation of triplex of the PU-PU-PY class.

PMID- 1741278
TI  - Imaging and nanodissection of individual supercoiled plasmids by atomic force
      microscopy.
AB  - The atomic force microscope (AFM) was used to image supercoiled plasmid DNA
      deposited on a mica surface in either a hydrated or desiccated state. Hydrated
      plasmid was precisely cut by the scanning tip at a location determined by the
      instrument operator. Small pieces of DNA (100-150 nm in length) were excised and
      deposited adjacent to the dissected plasmid, demonstrating that it is possible to
      remove and manipulate genomic DNA fragments, unresolvable by light microscopy,
      from defined chromosomal locations by AFM.

PMID- 1741279
TI  - The MRE4 gene encodes a novel protein kinase homologue required for meiotic
      recombination in Saccharomyces cerevisiae.
AB  - The MRE4 gene was cloned by complementation of the defects of meiotic
      recombination and haploidization in an mre4-1 mutant. Disruption of MRE4 resulted
      in reduced meiotic recombination and spore inviability. The mre4 spore lethality
      can be suppressed by spo13, a mutation that causes cells to bypass the
      reductional division. Analysis of meiotic DNA extracted from the mre4 mutant
      cells revealed that double-strand breaks occurred at the two sites of the HIS4
      LEU2 recombination hot spot, but at a frequency of about 10-20% of the wild type.
      Northern blot analysis indicated that the MRE4 gene produces four transcripts of
      1.63, 3.2, 4.0 and 6.2 kb. All of these transcripts are absent from mitotic cells
      and are meiotically induced. The DNA sequence of the MRE4 open reading frame
      predicts a 497-amino acids protein with a molecular mass of 56.8 kDa. The Mre4
      protein contains highly conserved amino acid sequences found specifically in
      serine-threonine protein kinases. These results suggest that protein
      phosphorylation is required directly or indirectly for meiotic recombination.

PMID- 1741280
TI  - Molecular structures of two new anti-HIV nucleoside analogs: 9-(2,3-dideoxy-2
      fluoro-beta-D-threo-pentofuranosyl)adenine and 9-(2,3-dideoxy-2-fluoro-beta-D
      threo-pentofuranosyl)hypoxanthine.
AB  - The x-ray crystal structures of two new anti-HIV compounds, 9-(2,3-dideoxy-2
      fluoro-beta-D-threo-pentofuranosyl)adenine (2'-F-dd-araA) and 9-(2,3-dideoxy-2
      fluoro-beta-D-threo- pentofuranosyl)hypoxanthine (2'-F-dd-aral), have been
      determined at two temperatures. Both crystals are in the space group
      P2(1)2(1)2(1), and their structures were solved by direct methods. Least-squares
      refinement produced final R-factors of 0.027 for the 2'-F-dd-araA structure and
      of 0.044 for the 2'-F-dd-aral structure, respectively. The latter structure
      contains a two-fold disordered conformation of the sugar moiety. All three
      conformers (one for 2'-F-dd-araA and two for 2'-F-dd-aral) adopt an anti chi CN
      glycosyl torsion angle. The sugar in the 2'-F-dd-araA structure has a C2'-endo
      pucker conformation, whereas the sugar in the 2'-F-dd-aral structure has a
      mixture of C2'-endo and C3'-endo pucker conformations. When the sugar adopts the
      C2'-endo conformation, the torsion angle about the C4'-C5' bond is in a
      transgauche+ conformation. In contrast, when the sugar adopts the C3'-endo
      conformation, the torsion angle about the C4'-C5' bond is in a gauche(+)-gauche-
      conformation. The C2'-F bond distance is 1.406(3) A, similar to that found in
      other aliphatic C-F bonds. The results suggest that the 2'-fluoro-2',3'
      dideoxyarabinosyl nucleosides do not have a strong preference for either C2'-endo
      or C3'-endo sugar pucker.

PMID- 1741281
TI  - Recognition nucleotides for human phenylalanyl-tRNA synthetase.
AB  - The specificity of the interaction between tRNAPhe and phenylalanyl-tRNA
      synthetase isolated from human placenta was investigated. Using yeast tRNAPhe
      transcripts with different point mutations it was shown that all the five
      recognition points for the yeast phenylalanyl-tRNA synthetase (G20, G34, A35, A36
      and A73) are also important for the reaction catalyzed by the human enzyme. A set
      of mutations in nucleotides involved in tertiary interactions of tRNAPhe revealed
      that mutations which maintained the proper folding of the molecule had almost no
      influence on the efficiency of aminoacylation. The most striking difference
      between the yeast and human phenylalanyl-tRNA synthetases involved a mutation in
      the lower two base pairs of the anticodon stem. This mutation did not affect
      aminoacylation with the yeast enzyme, but greatly reduced activity with human
      phenylalanyl-tRNA synthetase.

PMID- 1741282
TI  - Human and human-yeast chimeric U6 snRNA genes identify structural elements
      required for expression in yeast.
AB  - U6 is the most highly conserved spliceosomal snRNA. Previous mutational studies
      have shown that the majority of essential residues in U6 are located in a region
      of 35 nucleotides encompassing a conserved hexanucleotide and stem I and stem II
      of the U4-interaction domain. Although the yeast and human U6 RNAs are 80%
      identical in this region, the human U6 gene cannot functionally replace the yeast
      gene in vivo. The human gene is not transcribed when placed in the context of
      yeast flanking sequences. Transcription of the human gene, but not its function,
      can be stimulated by the introduction of an A block promoter element in the U6
      coding region. Using a set of human-yeast chimeras, we show that the 5' domain
      and the 3' terminal region of the human U6 gene can each functionally replace the
      corresponding yeast domains. However, a combination of both domains in a single
      molecule is lethal. The basis of the inability of the human U6 snRNA to function
      in yeast cells is discussed.

PMID- 1741283
TI  - Fusion of a free left Alu monomer and a free right Alu monomer at the origin of
      the Alu family in the primate genomes.
AB  - In the primate genome, a typical Alu element corresponds to a dimeric structure
      composed of two different but related monomeric sequences arranged in tandem.
      However, the analysis of primate sequences found in GenBank reveals the presence
      of free left and free right Alu elements. Here, we report the statistical study
      of those monomeric elements. We found that only a small fraction of them results
      from a deletion of a dimeric Alu sequence. The majority derives from the
      amplification of monomeric progenitor sequences and constitutes two families of
      monomeric elements: a family of free left Alu monomers that is composed of two
      subfamilies and a small family of free right Alu monomers. Both families predated
      the dimeric Alu elements, and a phylogenetic analysis strongly suggests that the
      first progenitor of the dimeric Alu family arose through the fusion of a free
      left monomer with a free right monomer.

PMID- 1741284
TI  - Highly efficient generation of recombinant baculoviruses by enzymatically
      medicated site-specific in vitro recombination.
AB  - We have used the Cre-lox system of bacteriophage P1 to develop a highly efficient
      in vitrosystem for construction of recombinant baculoviruses. A positive visual
      selection has been included to make identification of recombinant viral progeny
      rapid and straightforward. We report recombination frequencies as high as 5 x
      10(7) recombinants/micrograms starting plasmid DNA and under certain conditions,
      up to 50% of the viral progeny are recombinants. Genes inserted into the
      baculovirus genome can be readily recovered in a simple one step process and re
      inserted after manipulation if required. We have confirmed the structure of
      recovered plasmids by diagnostic restriction endonuclease digestion and the
      structure of recombinant viral genomes by Southern analysis. Possible uses and
      the significance of the system are discussed and experiments currently being done
      to improve it are described.

PMID- 1741285
TI  - Formation of novel hairpin structures by telomeric C-strand oligonucleotides.
AB  - Telomeres are specialized structures at the ends of chromosomes that are required
      for long term chromosome stability and replication of the chromosomal terminus.
      Telomeric DNA consists of simple repetitive sequences with one strand G-rich
      relative to the other, C-rich, strand. Evolutionary conservation of this feature
      of telomeric repeat sequences suggests that they have specific structural
      characteristics involved in telomere function. Absorbance thermal denaturation,
      chemical modification and non-denaturing gel electrophoretic analyses showed that
      telomeric C-strand oligonucleotides form stable non-Watson-Crick hairpin
      structures containing C.C+ base pairs. Formation of such hairpins may facilitate
      previously reported G-strand exclusive interactions.

PMID- 1741286
TI  - Strand specific PCR amplification of low copy number DNA.
AB  - A method for the amplification of a single DNA strand at low copy number is
      described. It is a wholly PCR based approach which involves an initial linear
      amplification of the target using a tagged strand specific primer. This is
      followed by classical PCR amplification of the progeny using a pair of primers,
      one specific for the sequence tagged onto the 5' end of the first round primer,
      the second specific for the target sequence. Given the protocol used the ratio of
      the two strands in the final amplification product was 50:1.

PMID- 1741287
TI  - Effective incorporation of 2'-O-methyl-oligoribonucleotides into liposomes and
      enhanced cell association through modification with thiocholesterol.
AB  - Cholesterol was linked to 2'-O-methyl-oligoribonucleotides (2'-OMe-RNA) via a
      disulfide bond by reacting the 3'-(pyridyldithio)-modified 2'-OMe-RNA with
      thiocholesterol in dichloromethane-methanol solution. This ligation reaction was
      made possible by a novel strategy in which the highly charged oligonucleotide was
      rendered soluble in nonaqueous solvent through conversion to a lipophilic
      amidinium salt. The biodegradable lipophilic modification of 2'-OMe-RNA resulted
      in a large increase in incorporation of such oligonucleotides into liposomes
      prepared by reversephase evaporation. Furthermore, association of these modified
      oligonucleotides with cultured TIB 73 cells was 100-fold higher than that seen
      with unmodified 2'-OMe-RNA in serum-free medium and about 10 to 30-fold higher in
      the presence of 10% calf serum. During incubation with cells, release of the
      internalized oligonucleotide from the thiocholesteryl moiety can be demonstrated.

PMID- 1741289
TI  - Enrichment of oligonucleotide sets with transcription control signals. II:
      Mammalian DNA.
AB  - We studied the frequency distribution of oligonucleotides 10 bp long in a sample
      of 1.6 Mb of mammalian genes, containing 579 sequences from GenBank(R) 55.0, with
      the aim of detecting transcription control signals. 2216 decamers had a frequency
      higher than 10 times the mean and were subjected to further statistical analysis.
      For each of the 2216 decamers (parents), we counted the individual frequencies of
      the 30 decamers differing from the parent by one base mutation (progeny) and then
      calculated two variance/mean chi squares for the progeny, with and without the
      parent. We then studied the distribution of the ratio between the two chi
      squares. Out of 2216 decamers, 346 had a chi square ratio of 1.9 or larger. In
      this final set, which corresponds to less than 0.033 per cent of all possible
      decamers, 18 were found to contain 23 eukaryotic transcription control elements 5
      10 bp of length, such as Sp1 and others. Furthermore, when compared to 210 random
      sets containing 346 decamers, this set contains a highly significant excess of
      the longer signals.

PMID- 1741288
TI  - The MyoD family of myogenic factors is regulated by electrical activity:
      isolation and characterization of a mouse Myf-5 cDNA.
AB  - A full-length cDNA coding for a homolog of the human Myf-5 was isolated from a
      BC3H-1 mouse library and characterized. The clone codes for a protein of 255
      amino acids that is 89%, 88% and 68% identical to the human, bovine and Xenopus
      myf-5, respectively. The mouse Myf-5 cDNA (mmyf-5), as well as sequences coding
      for MyoD, myogenin and Mrf-4, were used to probe Northern blots to analyze the
      effects of innervation on the expression of the MyoD family of myogenic factors.
      Mouse myf-5, MyoD and myogenin mRNAs levels were found to decline in hind limb
      muscles of mice between embryonic day 15 (E15) and the first postnatal week, a
      period that coincides with innervation. In contrast, Mrf-4 transcripts increase
      during this period and reach steady-state levels by 1-week after birth. To
      distinguish if the changes in myogenic factor expression are due to a
      developmental program or to innervation, mRNA levels were analyzed at different
      times after muscle denervation. Mmyf-5 transcripts begin to accumulate 2 days
      postdenervation; after 1 week levels are 7-fold higher than in innervated muscle.
      Mrf-4, MyoD and myogenin transcripts begin to accumulate as soon as 8h after
      denervation, and attain levels that are 8-, 15- and 40-fold higher than found in
      innervated skeletal muscle, respectively. The accumulation of these three mRNAs
      precedes the increase of nicotinic acetylcholine receptor alpha subunit
      transcripts, a gene that is transcriptionally regulated by MyoD-related factors
      in vitro. Using extracellular electrodes to directly stimulate in situ the soleus
      muscle of rats, we found that 'electrical activity' per se, in absence of the
      nerve, represses the increases of myogenic factor mRNAs associated with
      denervation.

PMID- 1741290
TI  - Identification and functional characterization of a cis-acting positive DNA
      element regulating CYP 2B1/B2 gene transcription in rat liver.
AB  - A positive cis-acting DNA element in the near 5'-upstream region of the CYP2B1/B2
      genes in rat liver was found to play an important role in the transcription of
      these genes. An oligonucleotide covering -69 to -98 nt mimicked the gel mobility
      shift pattern given by the fragment -179 to +29 nt, which was earlier found
      adequate to confer the regulatory features of this gene. Two major complexes were
      seen, of which the slower and faster moving complexes became intense under
      uninduced and Phenobarbitone-induced conditions respectively. Minigene cloned DNA
      plasmid covering -179 to +181 nt in pUC 19 and Bal 31 mutants derived from this
      parent were transcribed in whole nuclei and cell free transcription extracts and
      mutants containing only upto -75 nt of the upstream were poorly transcribed.
      Transcription extracts from phenobarbitone-injected rat liver nuclei were
      significantly more active than extracts from uninduced rats in transcribing the
      minigene constructs. Addition of the oligonucleotide (-69 to -98nt) specifically
      inhibited the transcription of the minigene construct (-179 to +181 nt) in the
      cell free transcription system. It is therefore, concluded that the region -69 to
      -98 nt acts as a positive cis-acting element in the transcription of the
      CYP2B1/B2 genes and in mediating the inductive effects of phenobarbitone.

PMID- 1741291
TI  - Chromosome translocation in Plasmodium berghei.
AB  - We describe a chromosome translocation in a karyotype mutant of the rodent
      malarial parasite Plasmodium berghei. In this mutant (named EP) a small
      chromosome (chromosome 7), which has exhibited a size range between 0.9 and 1.4
      Mb in other clones of P. berghei, is translocated to chromosome 13 or 14 with a
      size of about 3 Mb. By comparison of Apa-I restriction fragments of the
      chromosomes from mutant EP and from a reference clone (named HP) of P. berghei,
      we found evidence for a junction of subtelomeric chromosome 7 sequences and
      internal chromosome 13/14 sequences. In addition, a new chromosome of 1.4 Mb
      (named EP7) is present in mutant EP, which is (mainly) composed of sequences of
      chromosome 13/14. EP7 contains one telomeric region derived from chromosome
      13/14. We found evidence that internal sequences of chromosome 13/14 are joined
      to telomeric sequences in the other telomeric region of EP7. The karyotype of
      mutant EP was stable during asexual and sexual multiplication and we found no
      indications for phenotypic changes.

PMID- 1741292
TI  - In vitro DNA replication implicates O2-ethyldeoxythymidine in transversion
      mutagenesis by ethylating agents.
AB  - A 36-nucleotide oligomer containing a single O2-ethyldeoxythymidine (O2-Et-dT)
      adduct at a specific site was synthesized. The oligomer, which corresponds to a
      specific DNA sequence in gene G of bacteriophage phi X174, was used as a template
      by T7 DNA polymerase to investigate the in vitro mutagenic specificity of O2-Et
      dT. At 10 microM dNTP and 5 mM Mg++, the progress of T7 DNA polymerase was
      interrupted by O2-Et-dT: 80% 3' to O2-Et-dT and 14% after incorporating a
      nucleotide opposite O2-Et-dT (incorporation-dependent blocked product). DNA
      synthesis past the lesion was low (6%). Incorporation of a nucleotide opposite O2
      Et-dT and subsequent postlesion synthesis were enhanced by increasing the dNTP
      concentration, with postlesion synthesis reaching 30% at 200 microM. Postlesion
      synthesis was further increased to 45% by addition of 10 mM dAMP to the
      polymerization reactions. DNA sequencing revealed that both dA and dT were
      incorporated opposite O2-Et-dT with dA incorporation impeding the progress of DNA
      synthesis. dT incorporation was efficiently extended implicating O2-Et-dT in
      transversion mutagenesis in vivo. These studies provide a basis for understanding
      the molecular mechanisms by which ethylating agents contribute to cytotoxicity,
      A.T transversion mutagenesis and activation of the oncogene neu by an A.T----T.A
      transversion event in rat neuroblastomas.

PMID- 1741293
TI  - Unusual DNA binding characteristics of an in vitro translation product of the
      CCAAT binding protein mYB-1.
AB  - We have isolated a cDNA that encodes the murine CCAAT-binding protein mYB-1. The
      deduced amino acid sequence shows 95% identity with its presumed human homologue
      (hYB-1A) which was originally isolated as a protein that binds to the Y box of
      MHC class II genes. In vitro translated mYB-1 binds to CCAAT boxes of the MHCIIE
      alpha, HSVTK and mouse PCNA promoters but not to alpha-globin or human thymidine
      kinase CCAAT boxes. Interestingly, complexes formed between the in vitro
      translated protein and the various CCAAT boxes display the property of being
      competed more efficiently with self competitor DNA, regardless of the CCAAT box
      initially used as a probe. A similar phenomenon was observed in a cell extract of
      Con-A stimulated murine splenocytes when the same competition assays were
      performed. These results may reflect the generation of multiple forms of a
      particular CCAAT-binding protein, such as mYB-1, that display distinct, yet
      overlapping, DNA binding specificities.

PMID- 1741294
TI  - Sequence of rat RL/IF-1 encoding an IkappaB, and comparison with related proteins
      containing notch-like repeats [corrected].

PMID- 1741295
TI  - A new 3'-terminus for Xenopus laevis 28S ribosomal RNA.

PMID- 1741296
TI  - Nucleotide sequence of the protamine P1 gene from the whale Orcinus orca predicts
      a unique N-terminal amino-acid motif.

PMID- 1741297
TI  - Nucleotide sequence of the 5.8S ribosomal RNA gene of Lentinula edodes.

PMID- 1741298
TI  - A gene family of HMG-box transcription factors with homology to TCF-1.

PMID- 1741299
TI  - The DNA sequences of the human and hamster secretory ribonucleases determined
      with the polymerase chain reaction (PCR).

PMID- 1741300
TI  - recF in Actinobacillus pleuropneumoniae.

PMID- 1741301
TI  - Nucleotide sequence of the phosphoprotein (P) gene of Newcastle disease virus
      (strain Beaudette C).

PMID- 1741302
TI  - PCR cloning of a nucleotidic sequence coding for the mature part of Chlamydomonas
      reinhardtii thioredoxin Ch2.

PMID- 1741303
TI  - StsI, a new FokI isoschizomer from Streptococcus sanguis 54, cleaves 5'
      GGATG(N)10/14 3'.

PMID- 1741304
TI  - PamI and PamII restriction endonucleases from Phormidium ambiguum.

PMID- 1741305
TI  - High efficiency transformation of Schizosaccharomyces pombe by electroporation.

PMID- 1741306
TI  - Analysis of DNA curvature using circular permutation of 5' end labelled
      fragments.

PMID- 1741307
TI  - PCR amplification of long DNA fragments.

PMID- 1741308
TI  - Phase Lock Gel plasmid micropreps: direct insert screening, probe synthesis and
      sequencing within one day.

PMID- 1741309
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 1741310
TI  - Professional development module. P5: client assessment. Part (ii): Client
      assessment in practice [continuing education credit].

PMID- 1741311
TI  - A sobering issue.

PMID- 1741312
TI  - Money matters.

PMID- 1741313
TI  - Trusts.

PMID- 1741314
TI  - Trusts--how are they shaping up?

PMID- 1741315
TI  - Safe practices.

PMID- 1741316
TI  - A burning question.

PMID- 1741317
TI  - Profile of a profession.

PMID- 1741318
TI  - Running to stand still.

PMID- 1741319
TI  - Death with dignity. Christian Science.

PMID- 1741320
TI  - Wise counsel.

PMID- 1741321
TI  - Infection control. A risk to others.

PMID- 1741322
TI  - Everybody's business.

PMID- 1741324
TI  - High dependency nurse-patient interaction.

PMID- 1741323
TI  - CPNs and adults sexually abused in childhood.

PMID- 1741325
TI  - Opposing views on health care assistants.

PMID- 1741326
TI  - Friends in high places.

PMID- 1741327
TI  - Journal of Wound Care Nursing. Dressings for deep wounds.

PMID- 1741328
TI  - Journal of Wound Care Nursing. Treating Mary's foot ulcer.

PMID- 1741329
TI  - Journal of Wound Care Nursing. Evaluating a dressing.

PMID- 1741331
TI  - Moores to the point. Interview by Linda Davidson.

PMID- 1741330
TI  - Professional development module. P6: Facilitating learning. Part (ii): The
      process of facilitation.

PMID- 1741332
TI  - Split decisions.

PMID- 1741333
TI  - Women's movement?

PMID- 1741334
TI  - Honest PREP-aration.

PMID- 1741335
TI  - Smoked out.

PMID- 1741336
TI  - Care after death.

PMID- 1741337
TI  - Sexual abuse--the ultimate betrayal.

PMID- 1741338
TI  - Sexual abuse--treating the adult survivor.

PMID- 1741339
TI  - Sexual abuse--turning point.

PMID- 1741340
TI  - Mental health--an enviable system.

PMID- 1741341
TI  - Making sense of cataract surgery.

PMID- 1741342
TI  - Nursing narratives--dances with pigs.

PMID- 1741343
TI  - Nursing narratives--gentle persuasion.

PMID- 1741344
TI  - Nursing narratives--'them and us'.

PMID- 1741345
TI  - Give us a break.

PMID- 1741346
TI  - Death with dignity--the Mormon Church.

PMID- 1741347
TI  - Girls will be women.

PMID- 1741348
TI  - Reasons for readmission to hospital.

PMID- 1741349
TI  - Satisfaction with community midwifery.

PMID- 1741350
TI  - The quality of nursing documentation.

PMID- 1741351
TI  - Computing in practice. Information management & technology. Systems of care.

PMID- 1741352
TI  - Infection control--the hazards of communal razors.

PMID- 1741353
TI  - Infection control. Urine collection--in search of a fine specimen.

PMID- 1741354
TI  - Infection control. Urine collection--choosing the right container.

PMID- 1741355
TI  - More nurses doing HIV tests for insurance.

PMID- 1741356
TI  - Hepatitis A, B, C, D, and E. Update on testing and treatment.
AB  - Five major types of viral hepatitis have been identified. Hepatitis A is an
      acute, usually self-limited illness. Prophylaxis with immune globulin (Gamastan,
      Gammar) is effective in household and sexual contacts of infected patients.
      Hepatitis B has both acute and chronic forms. Treatment trials for chronic
      hepatitis B with interferon alfa-2b have shown promise. Hepatitis C is the name
      now given to non-A non-B hepatitis. Interferon alfa-2b (Intron A) has been
      approved for treatment of chronic hepatitis C. Hepatitis D occurs only in
      patients with hepatitis B. The only treatment for hepatitis D is prevention of
      hepatitis B. Hepatitis E is seen after natural disasters in developing regions of
      the world. Further advances in serologic testing and treatment of viral hepatitis
      can be expected.

PMID- 1741357
TI  - Hypercoagulable states. Their causes and management.
AB  - Recognition of patients who should be evaluated for either hereditary or acquired
      hypercoagulable states is important so that treatment may be instituted if
      necessary to prevent thrombosis. Close attention to the medical history,
      medications, family history, and circumstantial risk factors can help identify
      patients at risk so that morbidity and mortality may be reduced. Patients with
      hereditary thrombosis should receive lifelong anticoagulation.

PMID- 1741358
TI  - Diminutive polyps found on flexible sigmoidoscopy. Management and follow-up.
AB  - Diminutive polyps found on flexible sigmoidoscopy are predominantly hyperplastic,
      but it is impossible to rely on endoscopic appearance to make an accurate
      diagnosis. Colonoscopy, polypectomy, and full pathologic evaluation are
      recommended for all such polyps. Follow-up care varies depending on the nature of
      the lesion.

PMID- 1741359
TI  - Safe use of glucocorticoids. How to monitor patients taking these potent agents.
AB  - Glucocorticoids reduce inflammation and combat stress. However, they are very
      powerful, and guidelines for their use must be followed to avoid such adverse
      effects as Cushing's syndrome and adrenal insufficiency. Whenever possible,
      physicians should consider alternative treatment strategies, because the
      consequences of steroid therapy may be worse than those of the disease being
      treated.

PMID- 1741360
TI  - Exercise-induced bronchospasm. Achieving control in asthmatic patients.
AB  - Exercise-induced bronchospasm is a common complication of asthma. Aggressive
      treatment of this conditions permits patients to maintain full activity despite
      their illness. Since most asthmatic patients are healthy except for an
      intermittent respiratory problem, providing them the opportunity to exercise in
      all weather conditions affords a clear improvement in their quality of life.
      Conceptualizing exercise-induced bronchospasm as a hyperreactive airway response
      to rapid inhalation of cool, dry air leads logically to the primary methods used
      to treat this disorder.

PMID- 1741361
TI  - Postoperative pulmonary complications. When are preventive and therapeutic
      measures necessary?
AB  - Relevant clinical and physiologic data are available to help guide decision
      making in the management of patients who are at risk for or already have
      postoperative pulmonary complications. Prophylactic measures should be simple and
      focused. Inexpensive treatment methods should be tried before resorting to more
      individual-intensive and expensive measures. Proper treatment of postoperative
      atelectasis requires adequate patient assessment and knowledge of the therapeutic
      options. Costs, measured in dollars as well as in patient morbidity and
      mortality, are substantially greater when physicians fail to recognize and treat
      reversible disease before elective surgery and when effective postoperative
      therapy is not provided in accordance with individual needs.

PMID- 1741362
TI  - Coronary artery disease. The latest on prevention.
AB  - Because coronary artery disease is the most common cause of death in the United
      States, much effort is being focused on research into prevention of this killer.
      Dr. Lush reviews positive and negative aspects of recent trends and summarizes
      the results of studies on the prophylactic potential of maintenance of normal
      body weight, exercise, aspirin, fish oils, estrogens, and antioxidants.

PMID- 1741363
TI  - Can a market economy fix a broken healthcare system?

PMID- 1741364
TI  - A memorable lesson in orthopedics.

PMID- 1741365
TI  - Solutions to spiraling healthcare costs.

PMID- 1741366
TI  - Solutions to spiraling healthcare costs.

PMID- 1741367
TI  - New treatments for septic shock.

PMID- 1741368
TI  - Risk for renal injury in diabetic hypertensive patients. The physiologic basis
      for blood pressure control.
AB  - In determining a therapeutic approach to coexistent adult-onset (type II)
      diabetes and hypertension in patients who are middle-aged, special attention must
      be given to the pathophysiology of the hypertensive disease and how it affects
      the kidneys. Diabetes and hypertension potentiate renal damage, which clearly
      leads to a reduced life span and increased morbidity. Nonpharmacologic measures
      (eg, exercise, weight control, glycemic control, protein-restricted diet) and
      pharmacologic approaches need to be combined so as to control systemic blood
      pressure yet maintain adequate renal perfusion. Clearly, preexisting accentuated
      vascular reactivity to vasoconstrictive growth factors in diabetic patients
      stimulates maladaptive compensatory responses in the kidney. This precipitates
      greater renal injury superimposed on the relative risk of the hypertension
      diabetes combination itself.

PMID- 1741369
TI  - Risk for renal injury in diabetic hypertensive patients. Pharmacologic
      approaches.
AB  - In the first article of this pair (page 77), Drs Weir and Bakris discussed a
      physiologic approach to management of diabetic hypertensive patients. In this
      article, they discuss the latest findings regarding use of angiotensin-converting
      enzyme inhibitors and calcium channel blockers along with glycemic control and
      reduced protein intake.

PMID- 1741370
TI  - Cluster headache syndrome. Ways to abort or ward off attacks.
AB  - Cluster headache is a syndrome of severe head and facial pain accompanied by
      autonomic abnormalities. Men are affected more frequently than women. Headaches
      occur daily during periods of susceptibility, which may be followed by periods of
      remission. The etiology of cluster headache is uncertain. Recent work suggests
      that hypothalamic dysfunction and/or oxyhemoglobin desaturation may be involved
      in its pathogenesis. Effective medical regimens are available for aborting acute
      attacks and for preventing attacks. Surgical ablation of the trigeminal ganglion
      has been effective in some patients when conventional medical therapy has failed.

PMID- 1741371
TI  - Isolation and characterization of the epsilon subspecies of protein kinase C from
      rat brain.
AB  - The epsilon subspecies of protein kinase C (epsilon PKC) was purified to near
      homogeneity from the soluble fraction of rat brain by successive chromatographies
      on DEAE-cellulose, threonine-Sepharose, phenyl-5PW, Mono Q, heparin-5PW, and
      hydroxyapatite columns. The enzyme from COS-7 cells that were transfected with an
      epsilon PKC cDNA expression plasmid showed the same elution profile. The purified
      enzyme from the brain was a double (96 and 93 kDa) on SDS/PAGE. Both the doublet
      proteins were recognized by antibodies raised against several oligopeptides that
      were parts of the deduced amino acid sequence of the rat brain epsilon PKC. When
      treated with potato acid phosphatase, both doublet proteins disappeared with the
      concomitant appearance of a single protein at 90 kDa, suggesting that epsilon PKC
      exists in the tissue as phosphorylated forms. The physiological significance of
      this phosphorylation is unknown. The enzymes from the rat brain and COS-7 cells
      were indistinguishable from each other in their kinetic and catalytic properties.
      Unlike alpha-, beta I-, beta II-, and gamma PKC, epsilon PKC was independent of
      Ca2+ but absolutely required phosphatidylserine and diacylglycerol for its
      activation; a tumor-promoting phorbol ester could replace diacylglycerol. epsilon
      PKC showed enzymological properties similar to those of delta PKC, except that
      epsilon PKC but not delta PKC was greatly activated by free arachidonic acid.
      Immunoblot analysis revealed that, in marked contrast to delta PKC, epsilon PKC
      is expressed predominantly in the brain tissue and only in trace amounts in
      heart, lung, spleen, thymus, and testis.

PMID- 1741372
TI  - Mechanism of SOS mutagenesis of UV-irradiated DNA: mostly error-free processing
      of deaminated cytosine.
AB  - We measured the kinetics of growth and mutagenesis of UV-irradiated DNA of phages
      S13 and lambda that were undergoing SOS repair; the kinetics strongly suggest
      that most of SOS mutagenesis arises from the deamination of cytosine in
      cyclobutane pyrimidine dimers, producing C----T transitions. This occurs because
      the SOS mechanism bypasses T--T dimers promptly, while bypass of cytosine
      containing dimers is delayed long enough for deamination to occur. The mutations
      are thus primarily the product of a faithful mechanism of lesion bypass by a DNA
      polymerase and are not, as had been generally thought, the product of an error
      prone mechanism. All of these observations are explained by the A-rule, which is
      that adenine nucleotides are inserted noninstructionally opposite DNA lesions.

PMID- 1741373
TI  - Structure of clonal and polyclonal cell arrays in chimeric mouse retina.
AB  - One of the most striking results of recent cell-lineage studies of vertebrate
      retina is the marked variability in the size and types of clones marked by
      retroviral transfection and dye injection of embryonic progenitor cells. Is this
      variability due to microenvironmental modulation of cell determination, to
      lineage restriction, or to experimental perturbation of the progenitor cells? We
      have taken advantage of species-specific DNA probes to mark groups of lineage
      related cells in experimental mouse chimeras. This method of marking cells has
      two distinct advantages over previous methods: direct manipulation of progenitor
      cells is avoided, and clones are established at an earlier stage of retinal
      development. The most notable feature of retinal cohorts in chimeras is their
      structural uniformity--each is a solid radial array that contains the same ratio
      of major cell types as the retina itself. This is true even of the smallest
      monoclonal cohorts, which contain fewer than 200 cells. Our results provides
      compelling empirical support for the hypothesis that the murine retina is made up
      of hundreds of relatively homogeneous radial units, each derived from single
      retinal precursor cells. This finding is inconsistent with micro-environmental
      modulation of clone structure early in development. We raise the possibility that
      the heterogeneity among clones marked by dye injection and transfection is due to
      progressive lineage restriction or to experimental perturbation of the retinal
      progenitor cells.

PMID- 1741374
TI  - The lethal(1)optomotor-blind gene of Drosophila melanogaster is a major organizer
      of optic lobe development: isolation and characterization of the gene.
AB  - The X-chromosomal complementation unit lethal(1)optomotor-blind [l(1)omb] is
      defined by lack of complementation among over a dozen recessive lethal mutations
      that map to the omb gene locus. Mutations in l(1)omb also fail to complement
      viable mutations of three seemingly unrelated functions in this region: bifid
      (bi), manifesting defective wings, Quadroon (Qd), a semi-dominant mutation
      expressing abnormal tergite pigmentation, and In(1)ombH31, giving rise to a
      normal external morphology but with discrete defects in the optic lobes and
      behavior. The locus encodes a 70-kilobase primary transcript that is spliced into
      a 6-kilobase mature RNA. cDNAs for this transcript were isolated and sequenced
      and the derived amino acid sequence was analyzed. Certain features of this
      sequence suggest that the l(1)omb gene product is a nuclear regulatory protein.
      The lethal phase of various apparent null mutants was determined and found to
      occur mainly in the pupal stage. A large proportion of all hemizygous mutant
      males develop to pharate adults that eclose only rarely but can be rescued from
      the pupal case. These animals show a severe maldevelopment of the optic lobes. In
      addition they have only rudimentary wings as well as a Quadroon-like abdominal
      pigmentation. Thus, in the lethal mutants those parts of the body are affected
      for which independent viable mutations have been previously described in the omb
      locus, such as optomotor-blind, bifid, and Quadroon.

PMID- 1741375
TI  - Solid-liquid phase boundaries of lens protein solutions.
AB  - We report measurement of the solid-liquid phase boundary, or liquidus line, for
      aqueous solutions of three pure calf gamma-crystallin proteins: gamma II, gamma
      IIIa, and gamma IIIb. We also studied the liquidus line for solutions of native
      gamma IV-crystallin calf lens protein, which consists of 85% gamma IVa/15% gamma
      IVb. In all four proteins the liquidus phase boundaries lie higher in temperature
      than the previously determined liquid-liquid coexistence curves. Thus, over the
      range of concentration and temperature for which liquid-liquid phase separation
      occurs, the coexistence of a protein crystal phase with a protein liquid solution
      phase is thermodynamically stable relative to the metastable separated liquid
      phases. The location of the liquidus lines clearly divides these four crystallin
      proteins into two groups: those in which liquidus lines flatten at temperatures
      greater than 70 degrees C: gamma IIIa and gamma IV, and those in which liquidus
      lines flatten at temperatures less than 50 degrees C: gamma II and gamma IIIb. We
      have analyzed the form of the liquidus lines by using specific choices for the
      structures of the Gibbs free energy in solution and solid phases. By applying the
      thermodynamic conditions for equilibrium between the two phases to the resulting
      chemical potentials, we can estimate the temperature-dependent free energy change
      upon binding of protein and water into the solid phase.

PMID- 1741376
TI  - Histones H2A/H2B inhibit the interaction of transcription factor IIIA with the
      Xenopus borealis somatic 5S RNA gene in a nucleosome.
AB  - A Xenopus borealis somatic 5S RNA gene was assembled with either the complete
      octamer of histones, (H2A/H2B/H3/H4)2, or the (H3/H4)2 tetramer of histones that
      comprises the central protein kernel of the nucleosome. Gel-mobility shifts,
      DNase I protection, and immunoblotting assays demonstrate that the class III
      transcription factor IIIA (TFIIIA) readily interacts with 5S DNA associated with
      the tetramer but that little or no binding is detected when 5S DNA is associated
      with the full octamer of histones. Thus, the presence of histones H2A and H2B in
      the 5S nucleosome significantly inhibits the interaction of TFIIIA with its
      cognate binding site within the 5S RNA gene. We propose that either the depletion
      of histones H2A and H2B from preexisting nucleosomes or the staged assembly of
      chromatin after replication in which a tetramer of histones H3/H4 associates with
      DNA before histones H2A/H2B will facilitate the binding of transcription factors
      to their cognate DNA sequences.

PMID- 1741377
TI  - Coexpression of mu and gamma 1 heavy chains can occur by a discontinuous
      transcription mechanism from the same unrearranged chromosome.
AB  - We previously documented that a single BCL1 leukemia cell can produce mu and
      gamma 1 immunoglobulin heavy chains with identical variable segments in an
      allelically excluded fashion without heavy chain constant region gene
      rearrangement. To understand the mechanism of dual mu/gamma 1 synthesis in BCL1
      subclones, we have analyzed mature and pre-RNA at the nascent and steady-state
      levels. We find mu and gamma 1 sequences linked in pre-RNA. However, the primary
      mu and gamma 1 transcription units are about the same length (approximately 15
      kilobases). Initiation of gamma 1 pre-RNA occurs upstream of C gamma 1 at sites
      identical to those seen in lipopolysaccharide/interleukin-4-induced normal B
      cells. We propose that dual mu/gamma 1 RNA synthesis occurs by a discontinuous
      transcription mechanism involving either trans-splicing or ligation of mu pre-RNA
      initiated 5' of the variable-diversity-joining region to gamma 1 pre-RNA
      initiated 5' of C gamma 1.

PMID- 1741378
TI  - Unconventional pharmacology of a neuronal nicotinic receptor mutated in the
      channel domain.
AB  - The putative channel-forming MII domains of the nicotinic, gamma-aminobutyric
      acid type A, and glycine receptors contain a highly conserved leucine residue.
      Mutation of this hydrophobic amino acid in the neuronal nicotinic receptor alpha
      7 (Leu-247), reconstituted in Xenopus oocytes, modifies the ionic response to
      acetylcholine and alters desensitization. Furthermore, the Leu----Thr (L247T)
      mutant has two conducting states (46 pS and 80 pS), in contrast with the wild
      type (WT) receptor, which has only one (45 pS). We now show that this mutant
      possesses a rather paradoxical pharmacology: antagonists of the WT receptor such
      as dihydro-beta-erythroidin, hexamethonium, or (+)-tubocurarine elicit ionic
      currents when applied to the L247T alpha 7 mutant and these responses are blocked
      by alpha-bungarotoxin. Furthermore, prolonged application of acetylcholine causes
      desensitization in the WT but leads to a potentiation of the responses to
      acetylcholine or dihydro-beta-erythroidin in the mutant. These data are
      consistent with a scheme in which mutation of Leu-247 renders a desensitized
      state in the WT channel a conducting state. They also strengthen the proposal
      that, in the WT, some competitive antagonists may stabilize desensitized states.
      Finally, these observations may shed light on properties of other ion channels,
      in particular the glutamate receptors, which display multiple conductance levels
      associated with various pharmacological agents.

PMID- 1741379
TI  - Reconstitution of enzymatic activity from fragments of M1 RNA.
AB  - Certain fragments of M1 RNA, the catalytic subunit of RNase P from Escherichia
      coli, either have no enzymatic activity at all or have altered substrate
      specificity compared with that of the intact catalytic RNA. After simple mixing
      in vitro, many of these fragments of M1 RNA can reassociate with other fragments
      to form complexes that have enzymatic activity typical of wild-type M1 RNA.
      Furthermore, inactive M1 RNA molecules with internal deletions can be
      complemented in vitro by other inactive derivatives of M1 RNA that have
      nonoverlapping deletions. Thus, two inactive molecules of M1 RNA can interact to
      form an active RNA enzyme. Functional attributes can be assigned to various
      regions of M1 RNA when the reconstitution process is combined with assays for
      activity with different substrates.

PMID- 1741380
TI  - Fluorescence lifetime imaging of free and protein-bound NADH.
AB  - We introduce a methodology, fluorescence lifetime imaging (FLIM), in which the
      contrast depends on the fluorescence lifetime at each point in a two-dimensional
      image and not on the local concentration and/or intensity of the fluorophore. We
      used FLIM to create lifetime images of NADH when free in solution and when bound
      to malate dehydrogenase. This represents a challenging case for lifetime imaging
      because the NADH decay times are just 0.4 and 1.0 ns in the free and bound
      states, respectively. In the present apparatus, lifetime images are created from
      a series of phase-sensitive images obtained with a gain-modulated image
      intensifier and recorded with a charge-coupled device (CCD) camera. The
      intensifier gain is modulated at the light-modulation frequency or a harmonic
      thereof. A series of stationary phase-sensitive images each obtained with various
      phase shifts of the gain-modulation signal, is used to determine the phase angle
      or modulation of the emission at each pixel, which is in essence the lifetime
      image. We also describe am imaging procedure that allows specific decay times to
      be suppressed, allowing in this case suppression of the emission from either free
      or bound NADH. Since the fluorescence lifetimes of probes are known to be
      sensitive to numerous chemical and physical factors such as pH, oxygen,
      temperature, cations, polarity, and binding to macromolecules, this method allows
      imaging of the chemical or property of interest in macroscopic and microscopic
      samples. The concept of FLIM appears to have numerous potential applications in
      the biosciences.

PMID- 1741381
TI  - Protein affinity chromatography with purified yeast DNA polymerase alpha detects
      proteins that bind to DNA polymerase.
AB  - We have overexpressed the POL1 gene of the yeast Saccharomyces cerevisiae and
      purified the resulting DNA polymerase alpha polypeptide in an apparently intact
      form. We attached the purified DNA polymerase covalently to an agarose matrix and
      used this matrix to chromatograph extracts prepared from yeast cells. At least
      six proteins bound to the yeast DNA polymerase alpha matrix that did not bind to
      a control matrix. We speculate that these proteins might be DNA polymerase alpha
      accessory proteins. Consistent with this interpretation, one of the binding
      proteins, which we have named POB1 (polymerase one binding), is required for
      normal chromosome transmission. Mutations in this gene cause increased chromosome
      loss and an abnormal cell morphology, phenotypes that also occur in the presence
      of mutations in the yeast alpha or delta polymerase genes. These results suggest
      that the interactions detected by polymerase affinity chromatography are
      biologically relevant and may help to illuminate the architecture of the
      eukaryotic DNA replication machinery.

PMID- 1741382
TI  - Molecular characterization of two plant flavonol sulfotransferases.
AB  - cDNA clones coding for flavonol 3- and 4'-sulfotransferases (STs) were isolated
      by antibody screening of a cDNA expression library produced from poly(A)+ RNA
      extracted from terminal buds of Flaveria chloraefolia. Sequence analysis revealed
      full-length cDNA clones with open reading frames of 933 and 960 base pairs, which
      encode polypeptides containing 311 and 320 amino acids, respectively. This
      corresponds to a molecular mass of 36,442 Da for the 3-ST and 37,212 Da for the
      4'-ST. Expression of these clones in Escherichia coli led to the synthesis of
      beta-galactosidase-ST fusion proteins having the same substrate and position
      specificities as those for the 3- and 4'-flavonol ST enzymes isolated from the
      plant. Comparison of the deduced amino acid sequence of the two clones revealed
      an overall identity of 69% in 311 amino acid residues. The two flavonol STs of F.
      chloraefolia also shared significant sequence similarities with steroid and aryl
      STs found in animal tissues and with the senescence marker protein 2 isolated
      from rat liver, suggesting an evolutionary link between plant and animal STs.

PMID- 1741383
TI  - Myb and Ets proteins cooperate in transcriptional activation of the mim-1
      promoter.
AB  - In the generation of the acutely transforming avian retrovirus E26, both myb and
      ets genes have been transduced, leading to the production of a Gag-Myb-Ets fusion
      protein. This co-occurrence of v-myb and v-ets oncogenes suggests that the two
      might have a functional relationship. To look for such a relationship, we tested
      the transcriptional activation activity of Myb alone or with coexpressed Ets-1 or
      Ets-2. Using the promoter of the v-Myb-inducible mim-1 gene as a target, we found
      that full-length c-Myb gene products were poor activators of transcription, while
      an oncogenic (truncated) form of this protein was a strong trans-activator.
      However, coexpression of Ets-2 with full-length or truncated forms of Myb greatly
      increased trans-activation. Coexpression of Ets-1, Fos, Jun, or Myc with Myb did
      not increase trans-activation of the mim-1 promoter. The ability of Myb and Ets-2
      to transactivate was cooperative, since Ets-2 alone gave little or no activation.
      Bacterially synthesized Ets-2 protein was found to bind specifically to the mim-1
      promoter, suggesting that it may be a target for both Myb and Ets proteins. Thus,
      Myb and Ets proteins can cooperate in transcriptional activation, and their co
      occurrence in the E26 virus may reflect a functional relationship between these
      two oncoproteins. Truncated forms of Myb may have a reduced need for cooperating
      factors such as Ets-2, and this might constitute an important mechanism
      associated with oncogenic activation.

PMID- 1741384
TI  - Two members of a conserved family of nuclear phosphoproteins are involved in pre
      mRNA splicing.
AB  - Monoclonal antibody 104 recognizes a subset of amphibian nuclear granules (B
      snurposomes) and active sites of RNA polymerase II transcription in vertebrates
      and invertebrates. Monoclonal antibody 104 reacts with a set of nuclear serine-
      and arginine-rich phosphoproteins (SR family) with strikingly conserved apparent
      molecular masses. The most abundant family members in human (SRp33) and
      Drosophila (SRp55) cell lines can replace one another as essential splicing
      factors in a human cell-free system. Each of these polypeptides can functionally
      replace human SF2, an essential splicing factor that also regulates 5' splice
      site selection of alternatively spliced pre-mRNAs in vitro. Drosophila SRp55 also
      functions as an alternative splicing factor in the human cell-free system.
      Analysis of cloned cDNAs shows that SRp55 and SF2 are highly related and reveals
      regions of similarity to genetically defined regulators of alternative splicing
      in Drosophila. These results suggest that the conserved SR family of
      phosphoproteins, which includes SRp55 and SF2, is involved in constitutive pre
      mRNA splicing and in the specificity of alternative splice site selection.

PMID- 1741385
TI  - Carcinogen-induced frameshift mutagenesis in repetitive sequences.
AB  - We have constructed plasmids pS3G-1 and pSG4 that contain single
      acetylaminofluorene adducts within contiguous runs of three (5'-CCCG1G2G3-3') and
      four (5'-CG1GGG4T-3') guanine residues, respectively. In Escherichia coli, the
      frequency of induced -1 frameshift mutations was strongly dependent on the
      position of modification: pS3G-G3 was approximately 100-fold and 10-fold more
      mutagenic than pS3G-G1 and pS3G-G2, respectively; pSG4-G4 was approximately 600
      fold more mutagenic than pSG4-G1. Mutagenesis was SOS-dependent and was markedly
      reduced in bacteria that were proficient in nucleotide excision repair as
      compared to a repair-deficient uvrA6 mutant. DNA sequencing showed that -1
      frameshift events in pS3G-1 consisted of either targeted mutations (greater than
      90% of induced mutations) within the guanine sequence or semitargeted mutations
      (greater than 10%) in the 5' flanking repetitive cytosine sequence. Semitargeted
      events, which were observed when acetylaminofluorene modification was at G1 and
      G2, show that a lesion can reduce the fidelity of replication at positions 5' to
      its location on the template strand. No semitargeted frameshifts were observed in
      plasmid pSG4, which lacks a repetitive sequence 5' to the adduct. Our results are
      consistent with a model for frameshift mutagenesis in which the
      acetylaminofluorene adduct (i) allows accurate incorporation of cytosine opposite
      the bulky lesion during DNA synthesis and (ii) impedes elongation of
      primer/template termini formed opposite the adduct or 5' to the adduct on the
      template strand, providing increased opportunity for the formation of slipped
      frameshift intermediates.

PMID- 1741386
TI  - Resistance of primary isolates of human immunodeficiency virus type 1 to
      neutralization by soluble CD4 is not due to lower affinity with the viral
      envelope glycoprotein gp120.
AB  - Recombinant soluble CD4 (rsCD4) has potent antiviral activity against cell line
      adapted isolates of the human immunodeficiency virus type 1 (HIV-1) but low
      activity toward HIV-1 primary isolates from patients. A simple hypothesis
      proposed to explain this discrepancy, which questions the therapeutic utility of
      soluble CD4-based approaches, is that the major envelope glycoprotein, gp120, of
      patient virus has lower affinity for CD4 than does gp120 from laboratory viruses.
      To test this hypothesis, we have produced pairs of low- and high-passage HIV-1
      isolates which, depending on culture passage history, display dramatically
      different sensitivities to neutralization by rsCD4. Here, we present evidence
      that the HIV-1 major envelope glycoprotein cDNAs cloned from one such isolate
      pair show only minor differences in their deduced gp120 primary structures, and
      these occur outside regions previously shown to be involved in CD4 interactions.
      In addition, recombinant gp120 from a low-passage rsCD4-resistant patient virus
      binds rsCD4 with high affinity, equal to that previously measured for recombinant
      gp120 from high-passage cell line-adapted virus isolates. These data indicate
      that differences in CD4-gp120 affinity do not account for rsCD4 resistance in HIV
      1 recently isolated from patients.

PMID- 1741387
TI  - Telomeric arrays display high levels of heritable polymorphism among closely
      related plant varieties.
AB  - Tomato telomeres are composed of a terminal 7-base-pair tandem repeat and a
      closely liked 162-base-pair subtelomeric repeat (TGRI). Together, these repeats
      account for 2% of the total chromosomal DNA. Pulsed-field gel electrophoresis has
      been used to examine the long-range physical structure of these arrays in closely
      related varieties, and we report here that these arrays are undergoing heritable
      changes at a frequency as great as 2% per generation. Moreover, comparisons with
      other known hypervariable probes (e.g., human minisatellites and M13 sequences)
      revealed that telomeric sites are more variable than any other known region of
      the plant genome and can be used to distinguish closely related plant varieties
      (tomato and melon) that are otherwise very similar at the DNA level. The fact
      that the polymorphisms are inherited in a mendelian fashion suggests applications
      in genetic mapping of telomeres and identification of varieties.

PMID- 1741388
TI  - Over- and under-representation of short oligonucleotides in DNA sequences.
AB  - Strand-symmetric relative abundance functionals for di-, tri-, and
      tetranucleotides are introduced and applied to sequences encompassing a broad
      phylogenetic range to discern tendencies and anomalies in the occurrences of
      these short oligonucleotides within and between genomic sequences. For
      dinucleotides, TA is almost universally under-represented, with the exception of
      vertebrate mitochondrial genomes, and CG is strongly under-represented in
      vertebrates and in mitochondrial genomes. The traditional
      methylation/deamination/mutation hypothesis for the rarity of CG does not
      adequately account for the observed deficiencies in certain sequences, notably
      the mitochondrial genomes, yeast, and Neurospora crassa, which lack the standard
      CpG methylase. Homodinucleotides (AA.TT, CC.GG) and larger homooligonucleotides
      are over-represented in many organisms, perhaps due to polymerase slippage
      events. For trinucleotides, GCA.TGC tends to be under-represented in phage, human
      viral, and eukaryotic sequences, and CTA.TAG is strongly under-represented in
      many prokaryotic, eukaryotic, and viral sequences. The CCA.TGG triplet is
      ubiquitously over-represented in human viral and eukaryotic sequences. Among the
      tetranucleotides, several four-base-pair palindromes tend to be under-represented
      in phage sequences, probably as a means of restriction avoidance. The
      tetranucleotide CTAG is observed to be rare in virtually all bacterial genomes
      and some phage genomes. Explanations for these over- and under-representations in
      terms of DNA/RNA structures and regulatory mechanisms are considered.

PMID- 1741389
TI  - Murine fumarylacetoacetate hydrolase (Fah) gene is disrupted by a neonatally
      lethal albino deletion that defines the hepatocyte-specific developmental
      regulation 1 (hsdr-1) locus.
AB  - Homozygous deletion of the hepatocyte-specific developmental regulation 1 (hsdr
      1) locus in mouse chromosome 7 results in perinatal death and a pleiotropic
      syndrome characterized by ultrastructural abnormalities of the liver and kidney,
      failure of induction of a number of specific transcription units in the liver and
      kidney during late gestation, and marked overexpression of an enzyme that defends
      against oxidative stress. Previously, the breakpoints of two albino (c) deletions
      (c14CoS and c1FAFyh) that genetically define hsdr-1 were localized, on a long
      range map, in the vicinity of the distal breakpoint of a viable albino deletion
      (c24R75M) that breaks proximally within the c locus. Here we report the use of a
      probe derived from a deletion breakpoint fusion fragment cloned from
      c24R75M/c24R75M DNA to clone a breakpoint fusion fragment caused by the c14CoS
      deletion. The proximal breakpoint of the c14CoS deletion was discovered to
      disrupt a gene (Fah) encoding fumarylacetoacetate hydrolase, the last enzyme in
      the tyrosine degradation pathway. All of the extant c deletions eliciting the
      hsdr-1 phenotype prevent expression of the Fah gene in the liver, and all but one
      disrupt the coding segment of the gene. Therefore, the Fah gene maps within or
      proximal to the hsdr-1 locus, as defined by deletion breakpoints, and disruption
      of this gene may be partially or completely responsible for the phenotypes
      associated with the hsdr-1 deletion syndrome. These mouse mutants may also
      provide models for the human genetic disorder hereditary tyrosinemia, which is
      associated with fumarylacetoacetate hydrolase deficiency and liver and kidney
      dysfunction.

PMID- 1741390
TI  - Role of gender, season, and familiarity in discrimination of conspecific song by
      zebra finches (Taeniopygia guttata).
AB  - Operant conditioning techniques were used to assess how gender and song
      familiarity affect song discrimination in adult zebra finches (Taeniopygia
      guttata). Twenty-five males and females, divided into five cohorts, were trained
      to discriminate between conspecific songs at different times of year. Males
      discriminating between their own and another song from their own aviary reached
      criterion in the fewest number of trials, followed by males discriminating
      between two songs from their own aviary, then by males discriminating between
      songs they had not heard before. Females discriminating between two songs from
      their own aviary required more trials than males to reach criterion, but, unlike
      in males, song familiarity did not have a significant effect on song
      discrimination by females. The number of trials required to reach criterion was
      greater in winter than in summer, suggesting a photoperiodic effect in what has
      been regarded as a nonphotoperiodic species. Gender, season, and familiarity
      appear to affect how zebra finches discriminate between conspecific songs.

PMID- 1741391
TI  - Hemispheric differences in avian song discrimination.
AB  - Auditory input to the right or left forebrain of adult male zebra finches
      (Taeniopygia guttata) was disrupted by lesioning the ipsilateral auditory relay
      nucleus of the thalamus. These birds were then presented with two kinds of
      auditory discriminations: (i) between their own song and the song of a cage mate;
      (ii) between two versions of an unfamiliar zebra finch song that differed only in
      the harmonic profile of one of the syllables. Right-side lesion birds did better
      than left-side lesion ones at discriminating between their own song and the song
      of a cage mate; left-side lesion birds did better on the harmonic profile task.
      We suggest that the two halves of the zebra finch brain process conspecific
      sounds differently, as seems to be the case for humans.

PMID- 1741392
TI  - Testosterone facilitates some conspecific song discriminations in castrated zebra
      finches (Taeniopygia guttata).
AB  - An experiment was designed to test for the influence of testosterone on song
      discriminations. We found that testosterone did have an effect, which interacted
      with practice and the nature of the stimuli. Fourteen adult castrated zebra
      finches (Taeniopygia guttata) were grouped into seven pairs. In each pair, one
      bird was implanted with a testosterone-filled silastic tube and the other was
      implanted with an empty silastic tube. They were then trained on a go/no-go
      operant task to discriminate between bird songs in six consecutive experiments.
      The songs to be discriminated were as follows: experiment 1, two canary song
      segments; experiment 2, the bird's own song and that of the other member of the
      pair; experiment 3, the same two songs as in experiment 2 but with reversed
      stimulus-response contingencies; experiment 4, two other zebra finch songs;
      experiment 5, another two zebra finch songs; and experiment 6, another two canary
      song segments. There were no reliable learning differences between birds treated
      with testosterone or with an empty silastic in experiments 1 and 3-6. However, in
      experiment 2, testosterone-treated birds mastered the discrimination between
      their own song and the song of the other member of the pair in fewer trials than
      birds treated with empty silastics. We suggest that a song's ability to control
      the behavior of male zebra finches is influenced by the nature of the song, prior
      experience with the training paradigm, and hormone levels.

PMID- 1741393
TI  - Mouse model of neurodegeneration: atrophy of basal forebrain cholinergic neurons
      in trisomy 16 transplants.
AB  - Vulnerability of specific brain regions and neuronal populations is a
      characteristic feature of Alzheimer disease and Down syndrome. Cholinergic
      neurons of the basal forebrain degenerate in both disorders. The basis for
      neuronal degeneration is unknown. Mouse trisomy 16 (Ts 16) is an animal model of
      Down syndrome. We sought an experimental system in which the survival and
      development of Ts 16 basal forebrain cholinergic neurons could be examined beyond
      the fetal period. As Ts 16 mice do not survive birth, we transplanted fetal Ts 16
      and control basal forebrain into the hippocampus of young adult mice.
      Transplanted neurons survived and grew neurites in all grafts. Over time, we
      observed selective atrophy of cholinergic neurons in Ts 16 grafts. Denervation of
      the hippocampus produced a significant increase in the size of Ts 16 cholinergic
      neurons. This suggests that hippocampal-derived neurotrophic factors acted to
      prevent degeneration. beta/A4-amyloid-containing plaques were not seen. Ts 16
      provides a model of spontaneous, genetically determined neurodegeneration that
      may be used to understand better the molecular pathogenesis of neuronal
      dysfunction in Alzheimer disease and Down syndrome.

PMID- 1741394
TI  - Simultaneous visualization of seven different DNA probes by in situ hybridization
      using combinatorial fluorescence and digital imaging microscopy.
AB  - Combinatorial labeling of probes (i.e., with two or more different reporters)
      increases the number of target sequences that can be detected simultaneously by
      fluorescence in situ hybridization. We have used an epifluorescence microscope
      equipped with a digital imaging camera and computer software for pseudocoloring
      and merging images to distinguish up to seven different probes using only three
      fluorochromes. Chromosome-specific centromere repeat clones and chromosome
      specific "composite" probe sets were generated by PCR in which different mixtures
      of modified nucleotides, including fluorescein-conjugated dUTP, were
      incorporated. Cosmid clones were labeled similarly by nick-translation. The
      technique has been used to delineate the centromeres of seven different human
      chromosomes, on both 4',6-diamidino-2-phenylindole-stained metaphase spreads and
      interphase nuclei, to map six cosmid clones in a single hybridization experiment
      and to detect chromosome translocations by chromosome painting. Multiparameter
      hybridization analysis should facilitate molecular cytogenetics, probe-based
      pathogen diagnosis, and gene mapping studies.

PMID- 1741395
TI  - Early molecular events in the induction phase of contact sensitivity.
AB  - To assess changes in epidermis-derived cytokine mRNA levels early in the afferent
      phase of allergic contact sensitivity, total epidermal mRNA was analyzed at
      various times after painting skin with haptens. We used a sensitive reverse
      transcriptase-polymerase chain reaction technique to quantitatively compare the
      regulation patterns of the following mRNAs: class II major histocompatibility
      complex I-A alpha, tumor necrosis factor alpha (TNF-alpha), interleukin (IL) 1
      alpha, IL-1 beta, interferon (IFN) gamma, granulocyte/macrophage colony
      stimulating factor, IFN-induced protein 10, and macrophage inflammatory protein
      2. Enhanced Langerhans cell-derived IL-1 beta mRNA signals were detected as early
      as 15 min after skin painting with allergens. TNF-alpha, IFN-gamma, and
      granulocyte/macrophage colony-stimulating factor mRNAs were found to be
      upregulated after application of allergens, irritant, and tolerogens, but class
      II major histocompatibility complex I-A alpha, IL-1 alpha, IL-1 beta, IFN-induced
      protein 10, and macrophage inflammatory protein 2 mRNAs were upregulated only
      after allergen painting. Depletion of specific cell populations demonstrated that
      Langerhans cells were the primary source of the IL-1 beta and class II major
      histocompatibility complex I-A alpha mRNAs, keratinocytes were the primary source
      of TNF-alpha, IL-1 alpha, IFN-induced protein 10, and macrophage inflammatory
      protein 2, and infiltrating T lymphocytes were the source of IFN-gamma. Relevance
      of the molecular findings was demonstrated by the identification of biologically
      active IL-1 alpha and immunoreactive TNF-alpha in culture supernatants. These
      studies demonstrate that Langerhans cell-derived and certain keratinocyte-derived
      cytokine mRNAs are selectively upregulated by allergens in the very early
      afferent phase of contact sensitivity.

PMID- 1741396
TI  - The human 64-kDa polyadenylylation factor contains a ribonucleoprotein-type RNA
      binding domain and unusual auxiliary motifs.
AB  - Cleavage stimulation factor is one of the multiple factors required for 3'-end
      cleavage of mammalian pre-mRNAs. We have shown previously that this factor is
      composed of three subunits with estimated molecular masses of 77, 64, and 50 kDa
      and that the 64-kDa subunit can be UV-crosslinked to RNA in a polyadenylylation
      signal (AAUAAA)-dependent manner. We have now isolated cDNAs encoding the 64-kDa
      subunit of human cleavage stimulation factor. The 64-kDa subunit contains a
      ribonucleoprotein-type RNA binding domain in the N-terminal region and a repeat
      structure in the C-terminal region in which a pentapeptide sequence (consensus
      MEARA/G) is repeated 12 times and the formation of a long alpha-helix stabilized
      by salt bridges is predicted. An approximately 270-amino acid segment surrounding
      this repeat structure is highly enriched in proline and glycine residues
      (approximately 20% for each). When cloned 64-kDa subunit was expressed in
      Escherichia coli, an N-terminal fragment containing the RNA binding domain bound
      to RNAs in a polyadenylylation-signal-independent manner, suggesting that the RNA
      binding domain is directly involved in the binding of the 64-kDa subunit to pre
      mRNAs.

PMID- 1741397
TI  - Ontogeny of a biological clock in Drosophila melanogaster.
AB  - Drosophila melanogaster born and reared in constant darkness exhibit circadian
      locomotor activity rhythms as adults. However, the rhythms of the individual
      flies composing these populations are not synchronized with one another. This
      lack of synchrony is evident in populations of flies commencing development at
      the same time, indicating that a biological clock controlling circadian
      rhythmicity in Drosophila begins to function without a requirement for light and
      without a developmentally imparted phase. It is possible to synchronize the
      phases of rhythms produced by dark-reared flies with light treatments ending as
      early as the developmental transition from embryo to first-instar larva: Light
      treatments occurring at developmental times preceding hatching of the first
      instar larva fail to synchronize adult locomotor activity rhythms, while
      treatments ending at completion of larval hatching entrain these rhythms. The
      synchronized rhythmic behavior of adult flies receiving such light treatments
      suggests that a clock controlling circadian rhythms may function continuously
      from the time of larval hatching to adulthood.

PMID- 1741398
TI  - Antibody-targeted interleukin 2 stimulates T-cell killing of autologous tumor
      cells.
AB  - A genetically engineered fusion protein consisting of a chimeric anti-ganglioside
      GD2 antibody (ch14.18) and interleukin 2 (IL2) was tested for its ability to
      enhance the killing of autologous GD2-expressing melanoma target cells by a tumor
      infiltrating lymphocyte line (660 TIL). The fusion of IL2 to the carboxyl
      terminus of the immunoglobulin heavy chain did not reduce IL2 activity as
      measured in a standard proliferation assay using either mouse or human T-cell
      lines. Antigen-binding activity was greater than that of the native chimeric
      antibody. The ability of resting 660 TIL cells to kill their autologous GD2
      positive target cells was enhanced if the target cells were first coated with the
      fusion protein. This stimulation of killing was greater than that of uncoated
      cells in the presence of equivalent or higher concentrations of free IL2. Such
      antibody-cytokine fusion proteins may prove useful in targeting the biological
      effect of IL2 and other cytokines to tumor cells and in this way stimulate their
      immune destruction.

PMID- 1741399
TI  - Termination efficiency at rho-dependent terminators depends on kinetic coupling
      between RNA polymerase and rho.
AB  - Rho-dependent terminators constitute one of two major classes of terminators in
      Escherichia coli. Termination at these sites requires the concerted action of RNA
      polymerase and rho protein. We present evidence that the efficiency of
      termination at these sites is governed by kinetic coupling of the rate of
      transcription of RNA polymerase and the rate of action of rho protein.
      Termination experiments in vitro indicate that termination efficiency at a rho
      dependent terminator is an inverse function of the rate of elongation of RNA
      polymerase, and each of the mutant phenotypes can be accounted for by the altered
      rate of elongation of the mutant RNA polymerase. Experiments in vivo show that
      fast-moving mutant RNA polymerases are termination deficient, while slow-moving
      mutant RNA polymerases are termination proficient and can suppress the
      termination deficiency of a slow-acting mutant rho protein. Because of the close
      coupling of rho action with RNA polymerase, small changes in the elongation rate
      of RNA polymerase can have very large effects on termination efficiency,
      providing the cell with a powerful way to modulate termination at rho-dependent
      terminators.

PMID- 1741400
TI  - Role of steroid 11 beta-hydroxylase and steroid 18-hydroxylase in the
      biosynthesis of glucocorticoids and mineralocorticoids in humans.
AB  - A gene encoding steroid 18-hydroxylase (P-450C18) was isolated from a human
      genomic DNA library. It was identified as CYP11B2, which was previously
      postulated to be a pseudogene or a less active gene closely related to CYP11B1,
      the gene encoding steroid 11 beta-hydroxylase (P-45011 beta) [Mornet, E., Dupont,
      J., Vitek, A. & White, P. C. (1989) J. Biol. Chem. 264, 20961-20967]. The
      nucleotide sequence of the promoter region of the P-450C18 gene is strikingly
      different from that of the P-45011 beta gene, although the sequences of their
      exons are 93% identical. The transient expression in Y-1 adrenal tumor cells of
      CAT constructs with a series of deletion mutants of promoter regions of both
      genes indicated that the two genes are regulated differently. P-450C18 as
      expressed in COS-7 cells exhibits steroid 18-hydroxylase activity to catalyze the
      synthesis of aldosterone and 18-oxocortisol and exhibits steroid 11 beta
      hydroxylase activity as well. In contrast, P-45011 beta as expressed in the
      cultured cells exhibits steroid 11 beta-hydroxylase activity exclusively but
      fails to catalyze the synthesis of aldosterone and 18-oxocortisol. These results
      indicate that P-45011 beta and P-450C18 are products of two different genes and
      that the former participates in the synthesis of glucocorticoids whereas the
      latter participates in the synthesis of mineralocorticoids in humans.

PMID- 1741401
TI  - Polymorphism in a second ABC transporter gene located within the class II region
      of the human major histocompatibility complex.
AB  - Recent studies have identified genes within the major histocompatibility complex
      (MHC) that may play a role in presentation of antigenic peptides to T cells. We
      have previously described RING4, a gene within the human MHC class II region that
      has sequence homology with members of the ABC ("ATP-binding cassette")
      transporter superfamily. We now report the nucleotide sequence of RING11, a
      second ABC transporter gene located approximately 7 kilobases telomeric to RING4,
      RING11 is gamma-interferon inducible, a property shared with other genes involved
      in antigen presentation. Comparison between the amino acid sequences of RING11
      and RING4 reveals strong homology. We propose that they form a heterodimer that
      transports peptides from the cytoplasm into the endoplasmic reticulum. We have
      identified two RING11 alleles, which differ in the length of their derived
      protein sequence by 17 amino acids. The more common of these alleles is present
      in a Caucasoid population at a frequency of 79%.

PMID- 1741402
TI  - A member of the C/EBP family, NF-IL6 beta, forms a heterodimer and
      transcriptionally synergizes with NF-IL6.
AB  - Using a DNA probe from the DNA-binding portion of the NF-IL6 gene and an antibody
      against the DNA-binding domain of NF-IL6, we isolated a gene homologous to NF-IL6
      in the DNA-binding and leucine zipper domains. This intronless gene, termed NF
      IL6 beta encodes a 269-amino acid protein with a potential leucine zipper
      structure, and the gene product can bind to the CCAAT homology as well as the
      viral enhancer core sequence, as in the cases of NF-IL6 and C/EBP. This gene is
      expressed at an undetectable or a minor level in normal tissues but is induced by
      lipopolysaccharide or inflammatory cytokines, as in the case of NF-IL6. NF-IL6
      beta easily forms a heterodimer with NF-IL6 in vitro and the heterodimeric
      complex binds to the same DNA sequence as the respective homodimers. When
      examined by transient luciferase assays, NF-IL6 beta is consistently a stronger
      transactivator than NF-IL6. Furthermore, NF-IL6 beta shows a synergistic
      transcriptional effect with NF-IL6. These data suggest that NF-IL6 beta is an
      important transcriptional activator in addition to NF-IL6 in regulation of the
      genes involved in the immune and inflammatory responses.

PMID- 1741403
TI  - Suppression of deregulated c-MYC expression in human colon carcinoma cells by
      chromosome 5 transfer.
AB  - Two-thirds of sporadic colon carcinomas express elevated levels of the c-MYC
      protooncogene. In addition, most colon carcinoma cell lines show constitutive
      elevated expression (10- to 40-fold over normal) of MYC RNA and protein that is
      not modulated in response to a mitogenic stimulus. Indirect immunofluorescence
      has been used to detect c-MYC protein in such cell lines, in hybrid cells
      resulting from fusions of such lines with cells that regulate MYC normally, and
      in carcinoma cells to which a normal copy of chromosome 5 has been transferred by
      microcell fusion. The deregulated expression of c-MYC is suppressed by fusion
      with a cell that regulates MYC normally. In addition, transfer of chromosome 5 by
      microcell fusion results in suppression of deregulated expression. Suppressed
      cells are no longer tumorigenic in nude mice. Loss of the transferred chromosome
      results in reexpression of the tumorigenic phenotype and in constitutive elevated
      expression of MYC. These data indicate that function of a tumor-suppressor gene
      on chromosome 5 is necessary for the regulated expression of MYC in at least some
      colon cells. Loss of this suppressor results in deregulated MYC expression and is
      a necessary, but most likely not sufficient, event for the expression of the
      tumorigenic phenotype in a subset of colon carcinomas.

PMID- 1741404
TI  - Internal-image anti-idiotype HIV-1gp120 antibody in human immunodeficiency virus
      1 (HIV-1)-seropositive individuals with thrombocytopenia.
AB  - Anti-CD4 antibody was found in 30% of human immunodeficiency virus (HIV-1)
      seropositive thrombocytopenic patients compared with 5% of nonthrombocytopenic
      seropositive patients (chi 2 = 21.7, P less than 0.001) and was shown by the
      following observations to contain internal-image anti-idiotype antibody (Ab2)
      directed against the antibody (Ab1) to gp120, the HIV-1 envelope glycoprotein
      that binds to CD4: (i) affinity-purified anti-CD4 (Ab2) bound to affinity
      purified anti-HIV-1gp120 (Ab1) on solid-phase radioimmunoassay, and binding could
      be blocked by recombinant CD4 (rCD4) as well as recombinant gp120 (rgp120); (ii)
      F(ab')2 fragments of Ab1 inhibited the binding of Ab2 to rCD4; (iii) Ab2
      inhibited the binding of Ab1 to HIV-1 beads; (iv) Ab2 inhibited the binding of
      Ab1 to gp120 on immunoblot; (v) Ab2 bound to the CD4 receptor on a CD4-bearing T
      cell line, H9; (vi) Ab3 (anti-rgp120) could be produced in vivo by immunizing
      mice with Ab2, and binding of Ab3 to rgp120 could be blocked with rCD4; and (vii)
      three different Ab2 preparations bound to two different homologous Ab1
      preparations. Ab1 or Ab2 alone did not bind to platelets, whereas the idiotype
      anti-idiotype complex did bind to platelets in a concentration-dependent manner.
      Binding of the internal-image complex was 10-fold greater than that of a non
      internal-image Ab1-Ab2 complex composed of anti-HIV-1gp120 and anti-anti-HIV
      1gp120. Thus, patients with HIV-1 thrombocytopenia contain internal-image
      idiotype-anti-idiotype complexes that could be affecting CD4 cell number or
      function, inhibiting HIV-1 binding to CD4 cells or contributing to HIV-1
      thrombocytopenia.

PMID- 1741405
TI  - Phenotypic plasticity in adult sympathetic neurons: changes in neuropeptide
      expression in organ culture.
AB  - Vasoactive intestinal peptide (VIP)-like immunoreactivity is present at low
      levels in the superior cervical ganglion of the adult rat, where immunostained
      neural processes, but only an occasional immunostained cell body, are found.
      However, when ganglia are maintained for 24 or 48 hr in organ culture, their
      content of VIP-like immunoreactivity increases 6- or 31-fold, respectively. When
      examined at 24 hr, the increase in VIP-like immunoreactivity is totally blocked
      by an inhibitor of RNA or protein synthesis. Many neuronal cell bodies and
      processes with immunoreactivity for VIP and the related peptide histidine
      isoleucine amide (PHI) are seen in cultured ganglia. In addition, VIP/PHI mRNA is
      abundant in cultured ganglia but only barely detectable in ganglia prior to
      culture. Under the same culture conditions, neuropeptide Y-like immunoreactivity
      increases to a small extent, and tyrosine hydroxylase activity and total ganglion
      protein remain unchanged. These results support the idea that adult sympathetic
      neurons exhibit plasticity in neuropeptide expression and that this plasticity,
      in the case of VIP, depends on changes in gene expression.

PMID- 1741406
TI  - A human Id-like helix-loop-helix protein expressed during early development.
AB  - The interaction of helix-loop-helix (HLH) proteins is known to regulate the
      differentiation of several different tissues, including mammalian muscle and the
      insect peripheral nervous system. In myoblasts, the products of myogenic HLH
      genes such as MyoD and ubiquitous HLH proteins such as E12 are present at
      constant levels throughout development. An E12 monomer and a MyoD monomer form a
      DNA binding heterodimer that activates muscle-specific genes. These two proteins
      are unable to dimerize in proliferating myoblasts because a negative regulator
      HLH protein, Id, is present. We now report the sequence and structure of a human
      HLH gene related to Id, which has been designated Id-2. Two prominent Id-2 RNA
      molecules of 2.5 and 1.3 kilobases were found in a number of different human
      normal and neoplastic tissues. We believe the larger RNA is a precursor of the
      1.3-kilobase mRNA that encodes an Id-2 protein of 134 amino acids. The HLH region
      of the Id-2 protein is 90% homologous to that of myogenic Id, but the homology is
      much less extensive outside the HLH region. The Id-2 gene is highly expressed
      during early fetal development in several tissues, including those of the central
      nervous system, but is not expressed in the corresponding mature tissues. Id-2
      expression is modulated in association with retinoic acid-induced ganglionic
      differentiation of the neuroblastoma cell line SMS-KCNR. These findings suggest
      that Id-2 is an inhibitor of tissue-specific gene expression, although its
      distinctive pattern of expression during development suggests a role different
      from that of Id.

PMID- 1741407
TI  - Seasonal changes in the function of the hypothalamic-pituitary-testicular axis in
      the Syrian hamster.

PMID- 1741408
TI  - Endothelin 1: mitogenic activity on pulmonary artery smooth muscle cells and
      release from hypoxic endothelial cells.
AB  - Endothelin, a recently described vasoconstrictor, has been shown to be a mitogen
      for vascular smooth muscle cells from systemic arteries and might play a role in
      pulmonary vascular remodeling produced by chronic exposure to hypoxia. We
      examined the effects of endothelin on proliferation of pulmonary artery smooth
      muscle cells and the effects of hypoxia and normoxia on the synthesis and
      secretion of endothelin by endothelial cells. Our results indicate that
      endothelin significantly increased the incorporation of [3H]thymidine by porcine
      pulmonary artery smooth muscle cells (122 +/- 4% to 168 +/- 13% of controls, with
      concentrations of endothelin from 1 to 1000 ng/ml). When tested on bovine
      pulmonary artery smooth muscle cells, endothelin increased [3H]thymidine
      incorporation over controls by approximately 140%; cell counts were increased by
      107 +/- 4% and 122 +/- 7% at doses of 100 ng/ml and 1000 ng/ml, respectively. The
      secretion of endothelin by porcine endothelial cells was not affected by hypoxia
      (3520 +/- 138 pg/ml/10(6) cells in hypoxia vs 3770 +/- 326 pg/ml/10(6) cells in
      normoxia). Transforming growth factor-beta 1 stimulated the release by normoxic,
      and to a lesser degree by hypoxic, porcine endothelial cells of endothelin (4716
      +/- 43 pg/ml/10(6) cells vs 4074 +/- 106 pg/ml/10(6) cells). Taken together, our
      results indicate that endothelin is weakly mitogenic for pulmonary artery smooth
      muscle cells, but may not significantly contribute to the remodeling seen in
      hypoxic pulmonary hypertension.

PMID- 1741409
TI  - A chemical method for intracellular loading of the calcium indicator aequorin in
      mammalian skeletal muscle.
AB  - The bioluminescent calcium indicator aequorin was loaded into bundles of skeletal
      muscle fibers from the rat extensor digitorum longus by macroinjection, a
      technique previously applied only to cardiac muscle. After loading, the amplitude
      and time course of the twitch returned to control values, indicating lack of
      damage to the fibers. Individual light signals (i.e., calcium transients) were
      recorded during each twitch or tetanus without the need for signal averaging. The
      calcium transients obtained were qualitatively and quantitatively similar to
      those reported previously with microinjection of aequorin. Our data suggest that
      macroinjection may be the method of choice for loading aequorin into mammalian
      skeletal muscle.

PMID- 1741410
TI  - Human retinal vascular cells differ from umbilical cells in synthetic functions
      and their response to glucose.
AB  - Cell culture systems have commonly been used to study mechanisms implicated in
      the pathogenesis of diabetic retinopathy, but the great majority of cell
      preparations used have been either of nonhuman retinal origin or nonretinal human
      origin. Because of questions of species and organ specificity in the function of
      cells of vascular origin, in this study, cultured microvascular endothelial cells
      (HREC), pericytes (HRPC), and pigment epithelial cells from the postmortem human
      retina, and endothelial cells from human umbilical vein (HUVEC) were evaluated
      with respect to cell proliferation, and secretory products potentially important
      in diabetic retinopathy, i.e., prostaglandins (PG) and plasminogen activators
      (PA), normalized to DNA content/well, under both basal (5 mM) and high (25 mM)
      glucose conditions. Glucose (25 mM) reduced DNA content similarly in both types
      of endothelial cells, had a lesser effect on HRPC, and did not significantly
      alter the proliferation of pigment epithelial cells. Basal secretion of PGI2
      (measured as 6-keto-PGF1 alpha) was in the order HRPC much greater than HREC
      greater than HUVEC, whereas PGE2 secretion was in the order HREC much greater
      than HRPC greater than HUVEC. Glucose (25 mM) stimulated PGI2 secretion by HRPC,
      but not by either type of endothelial cell, and enhanced PGE2 secretion by HREC,
      but not by HUVEC or HRPC. Release of plasminogen activator activity differed
      between HUVEC and HREC under basal conditions and addition of 25 mM glucose
      stimulated release only from HREC. Glucose (25 mM) stimulated PA secretion by
      HREC, but not by HUVEC. These findings provide evidence that human retinal
      pericytes are an important source of prostacyclin, and that there are differences
      between HREC and HUVEC with respect to secretory functions and their modulation
      by glucose, indicating regional specificity of these functions. Extrapolation to
      human retinal vascular cells from experiments using cells from heterologous
      vascular beds to draw inferences about the pathophysiology of diabetic
      retinopathy are not valid for these cellular functions.

PMID- 1741411
TI  - Developmental delay of lingual lipase expression after guanethidine-induced
      sympathectomy.
AB  - Rat lingual lipase increases during postnatal development. To evaluate the role
      of the sympathetic nervous system in the control of lingual lipase during
      development, suckling rats were chemically sympathectomized by chronic treatment
      with guanethidine. This treatment was found to be effective in suppressing the
      developmental increase of lingual lipase. The effect was age dependent and also
      related to the dose of guanethidine given (i.e., the higher the dose, the more
      effective the suppression is, up to 40 micrograms/g body wt). The effect of
      guanethidine on lingual lipase suppression was not a result of induced stress,
      since simultaneous treatment with RU-38486, a known glucocorticoid receptor
      antagonist, did not prevent the decrease in lingual lipase activity. Ephedrine, a
      known sympathomimetic agent, restored the lingual lipase to a near normal level
      in guanethidine-treated animals, confirming that guanethidine acts through the
      sympathetic nerves. Furthermore, histochemical studies showed that guanethidine
      treatment resulted in the reduction or elimination of catecholaminergic fibers in
      the von Ebner's glands. The effect of guanethidine was found to be transient, in
      that the lingual lipase activity showed complete recovery upon withdrawal of the
      treatment for 1 week. Together, the results indicated that sympathetic nerves
      have an important regulatory role in lingual lipase in rat pups during
      development.

PMID- 1741412
TI  - A simple, single, trial-learning paradigm for conditioned increase in natural
      killer cell activity.
AB  - A change in natural killer (NK) cell activity can be conditioned with one trial
      learning when conditioned stimulus (CS) precedes the unconditioned stimulus (US).
      To avoid the problems associated with two reexposures in our earlier studies, we
      have developed a reliable and simple conditioning protocol utilizing the one
      trial learning and one reexposure to the odor CS. The conditioned change in NK
      cell activity was significantly different (P less than 0.05) from the control
      groups of mice. The paradigm is short and simple in that the conditioned change
      could be demonstrated within 3 days. We have also compared the effects of
      temporal association of CS and US on conditioned increase in NK cell activity.
      Forward conditioning (CS preceded the US) demonstrated a conditioned change, but
      the backward conditioning protocol did not. The paradigm provides a reliable
      approach to the study of mechanisms of the phenomenon of odor-NK conditioning.

PMID- 1741413
TI  - Inhibition of cell metabolism by a smokeless tobacco extract: tissue and species
      specificity.
AB  - Smokeless tobacco contains a nonnicotine inhibitor of posttranslational
      modification of collagen (hydroxylation of [3H]proline) by cultured chick embryo
      tibias and osteoblasts. This study was undertaken to determine whether a methanol
      extract of smokeless tobacco (STE) containing the inhibitor has similar effects
      on collagen-producing cells and tissues other than bone. Its effects on DNA
      synthesis and cell proliferation (incorporation of [3H]thymidine) were also
      determined. Frontal bone, aorta, and cartilage were incubated for 2 days in
      medium containing STE. Glycolysis (lactate production) was stimulated by 80% in
      cartilage, but was not affected in the other tissues; medium alkaline phosphatase
      activity was unaffected. In frontal bone and cartilage, [3H] hydroxyproline
      content was decreased 88% and 57%, respectively, and [3H]proline content was
      decreased 68% and 37%, respectively; neither was affected in the aorta. Confluent
      cultures of collagen-producing mouse fibroblasts or primary osteoblasts obtained
      from chick embryo calvarias were incubated for 2 days in medium containing
      increasing concentrations of STE. Glycolysis and DNA synthesis were not affected.
      Cell proliferation was unaffected in fibroblasts, but was inhibited (34%) at the
      highest STE concentration in osteoblasts. AIPase activity was not detectable in
      fibroblast medium, but was decreased up to 72% in osteoblast medium. Inhibition
      of collagen synthesis by STE was concentration related in both cell types. At the
      highest concentration, [3H] hydroxyproline and [3H]proline contents in the cell
      layers were decreased to the following respective values: fibroblasts 56% and 45%
      and osteoblasts 50% and 29%, respectively. When incubation with STE was
      discontinued for 1 day, recovery did not occur. These findings suggest that
      inhibition of collagen synthesis by STE is not specific for bone, that collagen
      producing cells are directly affected, and that recovery is not immediate. This
      inhibitor could contribute to the periodontal disease often seen in users of
      smokeless tobacco. Its identification and removal would produce a safer product.

PMID- 1741414
TI  - Serum zinc in aging germ-free and conventional rats.
AB  - Zinc nutritional status appears to decline with age in humans and rodents. Since
      germ-free rats outlive their conventional counterparts in better health, serum Zn
      levels were determined in male germ-free and conventional Lobund Wistar rats in
      samples originating from the Lobund Aging Study. Starting at 5 months of age,
      germ-free rats showed significantly higher serum Zn levels than did their
      conventional counterparts. In conventional rats sacrificed up to 30 months of age
      in apparently good health, serum Zn levels showed no effect of age, while a
      slight but significant increase with age was observed in the germ-free rats. In
      healthy germ-free adults (6-24 months of age), serum Zn concentrations were
      approximately 25% higher than those in comparable conventional animals. In
      conventional rats 18-30 months of age (average, 24.5 months), sacrificed because
      of an obvious moribund condition, serum Zn levels were significantly lower than
      those in rats of the same age range (average, 24.9 months) that were obviously
      healthy. Results suggest that the often observed higher absorptive capacity of
      the germ-free gut might have contributed to higher serum Zn levels, and that a
      decline in serum Zn concentration with age may be a consequence, rather than a
      causative factor, of declining health.

PMID- 1741415
TI  - Octopamine and phenylethylamine inhibit prolactin secretion both in vivo and in
      vitro.
AB  - Trace amines are a group of biogenic amines that are present in neural tissue in
      concentrations ranging from 0.1 to 100 ng/g. In the present work, we examined the
      action of two trace amines, octopamine and phenylethylamine, which are found in
      the hypothalamus, on pituitary hormone secretion in different experimental
      situations in vivo and in dispersed anterior pituitary cells. Both octopamine and
      phenylethylamine decreased high prolactin levels due to swimming or
      immobilization stress without affecting other adenohypophysial hormones. With
      regard to the hypoprolactinemic potencies in the immobilization stress model, it
      was observed that p-tyramine, another trace amine, was as potent as octopamine.
      Phenylethylamine was the least effective. To evaluate the site of action of the
      effect described, the three trace amines were tested in dispersed anterior
      pituitary cell cultures in vitro. Tyramine and octopamine reduced prolactin
      secretion in a concentration-dependent manner, at concentrations of 10(-8) to 10(
      5) M, whereas the hypoprolactinemic effect observed for phenylethylamine was very
      weak. In pharmacologic experiments, neither octopamine nor phenylethylamine
      reduced prolactin release when dopaminergic receptors were blocked. This could
      mean that their hypoprolactinemic action was mediated through the release of
      dopamine, or it could be a direct action at a dopaminergic receptor. This is the
      first description of a specific endocrine action both in vivo and in vitro for
      octopamine and phenylethylamine. Further studies are needed to ascertain the
      physiologic or pathologic implication of these findings.

PMID- 1741416
TI  - Selective regulation of eosinophil degranulation by interleukin 1 beta.
AB  - Recent evidence confirms that cytokines such as IL-1, IL-4, IL-5, and GM-CSF may
      enhance or inhibit eosinophil function. Functions that are susceptible to
      modulation include eosinophil-mediated antibody-dependent damage of helminthic
      parasites, oxidative metabolism and degranulation. We have employed IgG and IgE
      coated Sepharose beads to investigate selective modulation of IgG and IgE
      mediated enzyme release by IL-1 beta. Both IgG and IgE-coated beads induced
      release of granular enzymes beta-glucuronidase and arylsulfatase. Enzyme release
      from IgG-stimulated eosinophils was inhibited by preincubation with IL-1 beta
      (100 pg/ml, P less than or equal to 0.05). In contrast, enzyme release by IgE
      stimulated eosinophils was enhanced by IL-1 beta (100 pg/ml, P less than or equal
      to 0.05). These studies support the hypothesis that IL-1 beta has specific
      selective actions on eosinophil function. Furthermore, these actions on particle
      stimulated enzyme release suggest that IgG and IgE mediated processes in
      eosinophils are differentially regulated.

PMID- 1741417
TI  - Ultraviolet radiation in the treatment of skin disease.

PMID- 1741418
TI  - Dosimetric evaluation of a two-dimensional, arc electron, pencil-beam algorithm
      in water and PMMA.
AB  - The accuracy of dose calculations from a pencil-beam algorithm developed
      specifically for arc electron beam therapy was evaluated at 10 and 15 MeV. Mid
      arc depth-doses were measured for 0 degrees and 90 degrees arcs using 12 and 15
      cm radius cylindrical water phantoms. Calculated depth-doses for the 90 degrees
      arced beams in the build-up region were as much as 3% less than measured values;
      the maximum dose was similar in magnitude but at a greater depth; and the
      therapeutic depth, R80, was 2-4 mm deeper. Calculated values of output (dose per
      monitor unit) at the depth of the maximum calculated dose were compared with
      measured values; for arcs ranging from 0-90 degrees, 12 and 15 cm radius water
      phantoms, and collimator widths of 4, 5 and 6 cm, results showed differences as
      great as 7%. Isodose countours for a 90 degrees arc were also measured in a 15 cm
      radius PMMA phantom. At the depth of maximum dose the algorithm predicted doses
      in the penumbral regions, both with and without collimation, which agreed within
      a few per cent of measured values. The largest discrepancies were 5%, which
      occurred in the penumbral portion of the depth-dose fall-off region. Differences
      between measurement and calculation are not believed to be clinically significant
      and are believed to be primarily due to the fact that the algorithm models
      neither large-angle scattering nor the effects of range straggling on the pencil
      beam dose distribution.

PMID- 1741419
TI  - Field matching of electron beams using plastic wedge penumbra generators.
AB  - We describe the use of polystyrene wedges to match adjacent electron beams with
      improved dose uniformity. These wedges were designed to increase the penumbra
      width at the field junction from about 1.5 to about 3.5 cm, to achieve dose
      uniformity. Measurements using thermoluminescent dosimeters (TLD) and therapy
      localization film showed that the use of polystyrene wedges (penumbra generators)
      produced only a small increase (less than 3%) in the surface dose and a small
      increase (less than 1%) in the x-ray contamination. Without wedges at the field
      junction, lateral mismatching of beam edges by 2 or 3 mm may introduce high dose
      variations (120% or more or 50% or less). Similar 2-3 mm set-up errors did not
      cause more than +/- 5% dose variations when plastic wedges were used to match the
      fields. These wedges are particularly useful when matching fields of different
      beam energies or matching fields on curved surfaces, such as the chest wall.

PMID- 1741420
TI  - Transport calculations of depth-dose distributions for gadolinium neutron capture
      therapy.
AB  - Depth-dose distributions were calculated for thermal and epithermal neutron
      fluence and capture gamma ray dose rates using a two-dimensional neutron-coupled
      gamma-ray transport code (DOT 3.5) for gadolinium neutron capture therapy. The
      results show that (i) a capture gamma-ray dose rate of 10 Gy h-1 was obtained
      with a thermal neutron fluence rate of 1.5 x 10(9) cm-2 s-1 in a simulated tumour
      containing 5000 PPM gadolinium placed near the surface of a water phantom, (ii)
      deep-seated tumours may be treated with epithermal neutrons, and (iii) gadolinium
      neutron capture therapy appears to achieve comparable dose distributions to those
      of boron neutron capture therapy.

PMID- 1741421
TI  - Dose distributions of x-ray fields as shaped with multileaf collimators.
AB  - Multileaf collimators (MLC) with various blade widths were simulated using
      standard cerrobend blocks, and three-dimensional dose computations were carried
      out to study the resultant radiation field edges. Film measurements made with 6
      and 18 MV x-ray beams were compared with calculations that employed a three
      dimensional Fourier convolution. A spatial accuracy of better than 3 mm was found
      in the 50% isodose line of the penumbral region with a calculation voxel size of
      5 mm x 5 mm x 5 mm. The computer simulation was used to study the deviation of
      the calculated 50% isodose line from the desired geometric field edge using
      various MLC blade positions. The study suggests that multileaf collimation to the
      outside of the desired field edge will lead to overdose outside the field,
      whereas multileaf collimation to the inside of the desired field edge will lead
      to underdose inside the field. When the direction of travel of the leaves with
      respect to the field edge is near 45 degrees, the 50% isodose of a multileaf
      collimated beam will fall close to the desired edge with no underdose when the
      leaf corners are allowed to insert into the desired field edge by 1.2 mm for 6 MV
      x-rays and 1.4 mm for 18 MV x-rays using a 1 cm wide leaf. These blade offsets
      account for the scattering of photons and electrons in the medium within the
      penumbral region.

PMID- 1741422
TI  - Dielectric properties of the system bovine albumin: urea: betaine in aqueous
      solution.
AB  - Urea (about 5 mol l-1) causes an approximately five-fold increase of the
      dielectric increment of bovine serum albumin at 20 degrees C. The increase is
      reversed by betaine (about 2.5 mol l-1), or prevented if urea and betaine are
      added together. This result can be seen as an electric counterpart to the
      protective role of osmolytes which are secreted by cells and tissues subjected to
      various types of internal or environmental stress.

PMID- 1741423
TI  - A quick accurate method for measuring the microwave dielectric properties of
      small tissue samples.
AB  - A resonant cavity perturbation technique has been developed which provides a
      quick, simple and accurate method of measuring the microwave dielectric
      properties of small, easily prepared samples of tissues, tissue-simulating
      materials and biological fluids. The method gives dielectric properties averaged
      over the sample volume. The measurement accuracy with the apparatus used is +/-
      2.2% for relative permittivity and +/- 3.5% for the loss factor for most tissue
      and biological material samples. With appropriate basic microwave equipment the
      method can be applied over the 1.5-6 GHz range of frequencies of interest for
      active and radiometric tissue microwave imaging.

PMID- 1741424
TI  - Dielectric properties of female human breast tissue measured in vitro at 3.2 GHz.
AB  - Complex permittivities of in vitro diseased and undiseased human female breast
      tissues have been measured at 3.2 GHz using a resonant cavity technique. Ranges
      of dielectric properties and water contents of these tissues are presented.
      Experimental data are compared with models predicted from mixture equations.
      Measured permittivity data lie within limits set by two-phase mixture theory, but
      some conductivity data are in excess of those expected for a mixture of saline
      and protein. At any particular microwave frequency in all tissue of a given type,
      the relationship between permittivity and conductivity may be parametrized using
      the Debye relaxation equations. For each breast tissue type a characteristic
      relaxation frequency was calculated and found to be lower than that of
      physiological saline at the same temperature. It is concluded that the dielectric
      relaxation of tissue water is not the only dispersive process occurring at this
      frequency: dielectric relaxation of bound water and the tail end of a beta
      dispersion may also contribute to the dielectric properties. The similarity of
      the dielectric properties of benign and malignant breast tumours measured in this
      work suggest that in vivo dielectric imaging methods will not be capable of
      distinguishing them.

PMID- 1741425
TI  - Measurement of the thermal diffusivity of human epidermis by studying thermal
      wave propagation.
AB  - The thermal diffusivity of dry human epidermis was determined in vitro by
      studying thermal wave propagation in thin epidermal layers at frequencies between
      10 and 200 Hz. Transmission measurements were performed on samples applied to a
      plane copper support at the underside of which thermal waves were generated by
      means of a square voltage controlled power transistor. Additionally, measurements
      were performed on epidermal layers with metal and air backing, in which thermal
      waves were generated by the absorption of intensity modulated light in a thin,
      superficially applied graphite layer (short and open circuit measurements).
      Thermal waves were detected by means of the laser beam deflection technique which
      allows the contactless measurement of the oscillatory surface temperature of a
      sample with respect to amplitude and phase. A critical discussion of methods
      shows that the thermal diffusivity is most reliably determined by transmission
      experiments. From experimental data obtained by this method a mean value alpha =
      (2.8 +/- 0.9) x 10(-4) cm2 s-1 was evaluated for the thermal diffusivity of dry
      epidermis.

PMID- 1741426
TI  - Concentration dependence of fluorine impurity spin-lattice relaxation rate in
      bone mineral.
AB  - The concentration dependence of the fluoride ion spin-lattice relaxation rate has
      been observed by nuclear magnetic resonance experiments on samples of defatted
      and dried bone. The 19F spin-lattice relaxation rates increased linearly with the
      bone fluoride concentration. Different results were obtained from trabecular than
      from cortical bone. For the same macroscopic fluoride content per gram of bone
      calcium, the relaxation rate is significantly faster in cortical bone. Relaxation
      rates in cortical bone samples prepared from both rats and dogs were apparently
      controlled by the same species-independent processes. For samples from beagle
      dogs, the bulk fluoride concentrations measured by neutron activation analysis
      were 3.1 +/- 0.3 times greater in trabecular bone than in the corresponding
      cortical bone. The beagle spin-lattice relaxation data suggest that the
      microscopic fluoride concentrations in bone mineral were 1.8 +/- 0.4 times
      greater in trabecular bone than in cortical bone. It is concluded that the
      accumulation of fluoride impurities in bone mineral is non-uniform.

PMID- 1741427
TI  - Calculation of dose and contrast for two mammographic grids.
AB  - To aid in selecting optimal conditions for screening mammography practice in
      Sweden, the performance of two mammographic grids (one moving and one stationary)
      has been investigated. Monte Carlo techniques were used to simulate photon
      transport in the breast. Transport through the breast support, grid covers, grid
      and image receptor (33.9 mg cm-2 Gd2O2S) was treated analytically. The contrast
      of a 100 microns calcification has been evaluated for three tissue compositions
      (adipose, glandular, 50:50 fractions by weight of adipose and glandular tissue)
      as a function of breast thickness (2-8 cm) and potential difference (25-30 kV, Mo
      anode). Contrast for a 5 cm 'average' breast at 28 kV was improved by 40% using
      the moving grid and by 30% using the stationary one; the corresponding increases
      in breast absorbed dose, keeping the energy imparted to the image receptor
      constant, were 90% and 150%, respectively. The superior properties of the moving
      grid were due to (i) equal scatter rejection ability and higher transmission of
      primary photons yielding lower scatter-to-primary ratios behind the grid, and
      (ii) less attenuation and filtering of the primary photons in the interspace
      material yielding lower degradation of primary contrast.

PMID- 1741428
TI  - Optimization and evaluation of landmark-based image correlation.
AB  - Image correlation methods enable the complementary use of information from
      different medical images of a patient. These images can be obtained from
      different imaging devices (CT, MR, PET), or, from one imaging device taken at
      different times. Unfortunately, there are few cases in which the requirements for
      later image correlation are taken into account at the time of image acquisition.
      There is therefore a need for correlation techniques requiring no preparation in
      advance. We have developed two correlation methods, both based on three or more
      anatomical or artificial landmarks, to be defined in corresponding image data
      sets. These methods have been evaluated with phantom data as well as with patient
      data. We have improved these correlation methods by using more landmarks and
      special selection criteria. They are applicable to all medical tomograms and to x
      ray pictures taken under stereotactical conditions. The results obtained have
      error ranges in the order of the three-dimensional image resolution.

PMID- 1741429
TI  - Evaluation of imaging properties of a laser film digitizer.
AB  - In this paper we provide a quantitative assessment of the basic imaging
      properties of a laser film digitizer. The characteristic curve of the digitizer
      was determined in terms of the relationship between input optical density and
      output pixel value. Spatial resolution of the laser digitizer was characterized
      using the presampling modulation transfer function (MTF), which was measured
      using a curve fitting technique with an angulated slit. For the noise analysis,
      we compared the Wiener spectra of uniformly exposed film samples before and after
      digitization. The effects of different sampling distances and scanning directions
      were investigated. Our results show that the characteristic curve of the laser
      digitizer was linear. The presampling MTFs of the digitizer were similar at
      different sampling distances and were substantially greater in the vertical
      scanning direction than in the horizontal direction. The noise of the digitized
      film sample was mainly affected by the presampling MTF and structure noise of the
      digitizer.

PMID- 1741430
TI  - A single-shot shimming sequence using low-power RF noise pulses for localized in
      vivo NMR spectroscopy.

PMID- 1741431
TI  - Evaluation of ferromagnetic materials for low-frequency hysteresis heating of
      tumours.

PMID- 1741432
TI  - Constrained least-squares restoration and renogram deconvolution: a comparison by
      simulation.
AB  - Before deconvolution can be used in renography, it is necessary to decide whether
      the renal function is sufficiently good to allow it. To see if this decision can
      be circumvented, an iterative constrained least-squares restoration (CLSR) method
      was implemented in which the point of termination of the iteration occurs when a
      residual vector has a value less than an estimate of the noise in the original
      renogram curve. The technique was compared with the matrix algorithm and with
      direct FFT division. The comparison was achieved by deconvolving simulated
      renogram data with differing transit time spectra and statistics. As expected,
      the FFT technique produced results of little value whereas the CLSR and matrix
      methods produced values of mean transit time (MTT) that differed slightly from
      the expected results. Analysis indicated that the matrix approach was superior
      when the percentage noise component was less than 6% and vice versa. No technique
      produced useful transit time spectra. As the CLSR technique produced better
      results than the matrix method in simulations with relatively long MTTs and high
      noise, it seems reasonable to suggest that it might be used for renogram
      deconvolution without the need for previous inspection of the curves.

PMID- 1741433
TI  - Early-onset repeated dieting reduces food intake and body weight but not
      adiposity in dietary-obese female rats.
AB  - As dieting behavior and attempts at weight loss are becoming increasingly common
      in adolescent girls, we wished to determine whether early-onset repeated dieting
      influenced the development of obesity and its metabolic correlates. Female rats
      were fed a high-fat diet and subjected to six cycles of dieting and regain,
      beginning in the peripubertal period. Although dieted rats weighted less than
      nondieted high-fat fed controls at the completion of the sixth cycle, body
      composition analysis revealed that the two groups were equally obese. Cumulative
      caloric intake was less in dieted rats, suggesting that the pattern of
      consumption promoted by dieting helped to establish the obesity. Resting
      metabolic rate did not differ between the two groups. These data suggest that
      although early-onset repeated dieting may result in reduced body weight, the
      eventual level of adiposity may be unknowingly elevated, potentially leading to
      long-term health risks.

PMID- 1741434
TI  - Effects of prenatal testosterone and ATD on reproductive behavior in guinea pigs.
AB  - Most sexual dimorphisms in reproductive behavior are hormonally organized in the
      guinea pig. The study sought to determine whether the sexually dimorphic
      requirement for the aromatization of testosterone in the activation of mounting
      is organized by testosterone prenatally and whether aromatization of testosterone
      contributes to the organization of mounting behavior. Pregnant females were
      treated with testosterone, the aromatase inhibitor ATD, or vehicle from days 28
      65 of gestation. The offspring were gonadectomized and tested as adults for
      lordosis and androgen-activated mounting behavior. Prenatal testosterone
      treatments altered the hormonal requirements for androgen-activated mounting in
      females such that they resembled normal males, and did not require aromatization
      as adults. Prenatal inhibition of aromatase activity decreased mounting activity
      in females but not in males. This treatment had no influence on lordosis in
      either sex. The results support the hypothesis that the same hormones that
      activate mounting behavior in the adult guinea pig are responsible for the
      organization of mounting behavior.

PMID- 1741435
TI  - Seminal vesicle and preputial gland response to steroids in adult male mice is
      influenced by prior intrauterine position.
AB  - There are differences in serum steroid concentrations during fetal life between
      male mice that develop between two male fetuses (2M males, with elevated
      testosterone) and between two female fetuses (0M males, with elevated estradiol).
      The present studies were undertaken to determine whether prior intrauterine
      position would influence the weight of seminal vesicles and preputial glands in
      adult male mice. To eliminate any potential differences between 2M and 0M males
      in circulating gonadal steroids, all males were castrated in adulthood and
      implanted with silastic capsules containing testosterone (T), dihydrotestosterone
      (DHT) or a combination of T and estradiol-17 beta (E2) or DHT and E2. Three weeks
      later, preputial glands were significantly heavier in 2M than 0M males after
      treatment with T but not DHT. Seminal vesicles were also significantly heavier
      (blotted wet weight) in 2M than 0M males after treatment with T. For 2M males,
      seminal vesicles weighed the same in response to treatment with T or DHT.
      However, relative to the effect of T, DHT significantly increased seminal vesicle
      weight in 0M males such that they were equivalent to weights in 2M males treated
      with T or DHT. This finding suggests that seminal vesicles in 0M males have lower
      concentrations of 5 alpha-reductase and, thus, a lower capacity to metabolize T
      to DHT which is required for normal seminal vesicle function. There were no
      significant effects of E2 (in combination with T or DHT) on seminal vesicle or
      preputial gland weight.

PMID- 1741436
TI  - Construct validity of a self-stimulation threshold paradigm: effects of reward
      and performance manipulations.
AB  - A discrete-trial current-threshold intracranial self-stimulation (ICSS) paradigm
      has been used extensively to examine the effects of drugs on reward thresholds.
      However, there is little work to date validating that this specific procedure
      measures reward. The purpose of the present study was to establish the construct
      validity of this procedure by testing the procedure's ability to measure reward
      effects and to discriminate these reward effects from performance effects. The
      discrete-trial ICSS procedure provides four measures: current thresholds,
      response latency, extra responses and time-out responses. The effects of a
      performance manipulation (variations in the force required to operate the
      manipulandum) and of a reward manipulation (variations in the train duration of
      the electrical stimulation) were evaluated on the four measures. Reward effects
      were reflected primarily in changes in thresholds, with no effect on any of the
      other three measures. Conversely, performance effects were reflected primarily in
      changes in response latency, extra responses and time-out responses, with only a
      small effect on thresholds. Finally, the paradigm's potential as a useful tool in
      the elucidation of the neurobiological basis of reward was demonstrated by
      investigating the effects of two pharmacological agents, cocaine and curare, on
      the four measures derived from the discrete-trial current-threshold ICSS
      procedure. The results suggest that the discrete-trial current-threshold
      procedure can readily discriminate reward from performance treatments.

PMID- 1741437
TI  - The amount eaten in meals by humans is a power function of the number of people
      present.
AB  - The influence of social factors on the eating behaviors of humans was
      investigated by paying 153 adults to maintain 7-day diaries of everything they
      ingested and the number of other people present. Over 3800 meals were separated
      according to the number of other people present at the meal. Meal size,
      macronutrient composition, and the deprivation ratio was found to increase while
      the satiety ratio decreased as a function of the number of people present in a
      fashion best described by a power function. Meal duration and the rate of intake
      were best described as linear functions of the number of people present. Meals
      eaten in large groups were over 75% larger than when eaten alone. The findings
      suggest that social facilitation of naturally occurring meal intake by humans is
      an extremely potent influence on intake that is an instance of a very general
      phenomenon governing many forms of behavior.

PMID- 1741438
TI  - The involvement of glucocorticoids in the acquired immobility response is
      dependent on the water temperature.
AB  - The Porsolt swim test was used to study the role of glucocorticoids in a simple
      learning paradigm. Two experiments were performed. In the first experiment, the
      stressfulness of the situation was manipulated by testing control, sham-operated
      and adrenalectomized mice at different water temperatures (20 degrees C, 25
      degrees C, 30 degrees C and 35 degrees C). In the second experiment, control mice
      were injected with the glucocorticoid antagonist RU38486 (3.2 mg/kg, 10 mg/kg, 32
      mg/kg); adrenalectomized mice were injected with the glucocorticoid agonists
      corticosterone (0.46 mg/kg, 1.0 mg/kg, 2.2 mg/kg) and dexamethasone (0.005 mg/kg,
      0.05 mg/kg, 0.1 mg/kg). The results show that water temperature is a very
      important factor in the Porsolt swim test. It influences the overall behaviour of
      the animals and changes the involvement of glucocorticoids. At a water
      temperature of 25 degrees C, glucocorticoids play an important role in the
      retention of the immobility response; ADX mice are impaired, and this impairment
      can be ameliorated by corticosterone and dexamethasone injection. Furthermore,
      the impairment can be induced in control mice by RU38486. The effects observed at
      25 degrees C were, however, not observable at 20 degrees C, 30 degrees C and 35
      degrees C, which suggests, contrary to previous reports, that glucocorticoids do
      not play a universal role in retention processes.

PMID- 1741439
TI  - Effects of habitual caffeine use and acute ingestion: testing a biobehavioral
      model.
AB  - A recently proposed model of the biobehavioral effects of caffeine suggests that
      acute ingestion impacts physiology and behavior differentially depending on the
      level of habitual usage of the drug. Acute ingestion and habitual usage are
      particularly expected to affect arousal and attentional processes. Subjects in
      the present study were preselected for high and low habitual caffeine use, given
      caffeine or a placebo, exposed to white noise or no white noise, and asked to
      perform on several tasks. Included were an arousal/habituation task (pure tones),
      reaction time, paired associates, anagrams, and vigilance. Electrodermal activity
      and performance were recorded. As predicted, virtually all effects were on the
      arousal/habituation and attentional (vigilance) tasks. Both acute ingestion and
      habitual use increased tonic EDA, and chronic use also reduced phasic responding,
      especially in the presence of a strong habituating stimulus. Both acute and
      habitual use also liberalized the vigilance response criterion, in that subjects
      risked more false alarms in order to attain more hits. In addition, habitual use
      increased sensitivity and reduced accuracy, and acute ingestion increased
      vigilance response time in the presence of white noise. Overall, the model was
      partially supported by these early results, though considerable further research
      is needed.

PMID- 1741440
TI  - Ingestive/aversive response of rats to sweet stimuli. Influence of glucose, oil,
      and casein hydrolyzate gastric loads.
AB  - Facial consummatory responses reflecting ingestive and aversive perceptions were
      studied and quantified in rats chronically implanted with gastric and oral
      catheters. A gustatory stimulus of 50 microliters of 0.6 mol.l-1 sucrose was
      injected into the mouth every 5 min during 90 min. At time zero, one of seven
      loads was injected into the stomach. These consisted of, 5 ml of water, or 5 ml
      solution containing 1 g glucose, 3 g glucose, 1 g casein hydrolyzate, 3 g casein
      hydrolyzate, or of oil 0.6 ml, or 1.4 ml. The typical ingestive facial
      consummatory responses in response to sweet stimuli were observed prior to all
      gastric loads, and also after the water load. On the other hand, the consummatory
      responses to sweet stimuli turned aversive after all three high-calorie gastric
      loads. The magnitude of this decrease in palatability (negative alliesthesia) was
      similar after glucose, casein hydrolyzate, and oil. The reversal of the
      consummatory responses from ingestive to aversive did not reach the threshold of
      statistical significance after the three low-calorie gastric loads. These results
      would tend to show that the intestinal signal for alimentary alliesthesia is
      nonspecific.

PMID- 1741441
TI  - Reinforced variability in rats: effects of gender, age and contingency.
AB  - Operant variability was compared in four groups of Long-Evans rats (young males,
      young females, mature males and mature females) under two different conditions.
      Under VAR contingencies, where response variability was required for
      reinforcement, a sequence of four responses on left (L) and right (R) levers had
      to differ from each of the preceding four sequences. If LLLL, LRLL, RRRR, and
      RRLL had just occurred, then a RLRL sequence, for example, would be reinforced in
      the next trial, but LRLL would not. Sequence variability was compared to that
      under YOKE contingencies, where reinforcement was provided whether or not the
      rats varied their responses. We found that young rats behaved more variably than
      mature rats, this effect most pronounced under the YOKE contingencies, where
      variability was not required. On the other hand, variability was not related to
      gender under either VAR or YOKE conditions. Thirdly, all groups were sensitive to
      the schedule contingencies, behaving more variably under VAR than under YOKE.
      Thus age and schedule requirements influenced operant variability, but gender did
      not.

PMID- 1741442
TI  - Physiological effects of dieting and bingeing in rats.
AB  - Female rats were assigned to dietary conditions as follows for 3.5 months: 1) Low
      fat control (LFC); 2) Moderately high-fat control (HFC); 3) Alternation between
      restricted access to a low-fat diet and ad lib access to a very high fat diet
      (RA); 4) Unrestricted access to the same diets as RA (URA). Results indicate
      that: 1) HFC consumed the same energy as LFC, but showed a tendency to become
      heavier and fatter through greater food efficiency. 2) URA and LFC did not differ
      in body weight, food intake, body composition or energy efficiency. 3) Intake of
      the very high fat diet declined over time in the RA. 4) RA ate less total
      calories, weighed less than all other groups, and showed a tendency for decreased
      percentage body fat and increased percentage of weight gained due to FFM gained.
      Results provide no evidence that dieting and bingeing promote obesity or
      increased preference for dietary fat, and suggest that dietary restriction has
      greater impact on energy balance and body composition than does alternation of
      diet composition.

PMID- 1741443
TI  - Restricted feeding: a nonphotic zeitgeber in the rabbit.
AB  - The free-running circadian rhythms of five behavioral functions of the rabbit
      were masked by unsignalled restricted food access (RF). The rhythms were
      reorganized immediately, a large part of events being assembled around the end of
      food availability. In addition to masking a slower process of entrainment was
      running: a component of anticipatory activity (AA) was established 1-3 h before
      food access. AA consolidated in continuation of the camouflaged free-running
      rhythm. The time of AA establishment correlated significantly with the phase
      angle difference (PAD) between free-running rhythm and RF: it decreased with
      decreasing positive PAD. With the consolidation of AA, the rhythms had attained a
      stable phase relation to RF. At the termination of RF, the circadian rhythms
      started to free-run again, the phase being dependent from that of the preceding
      RF schedule. The period length of the RF zeitgeber (TRF) had some impact on tau
      of the circadian rhythm. This aftereffect was most evident after termination of
      TRF less than 24 h: the free-running rhythm continued for up to 49 days with a
      tau less than 24 h and turned longer thereafter. The results demonstrate the
      entrainment of circadian rhythms of the rabbit by RF in addition to masking.

PMID- 1741444
TI  - Circadian effects of escapable and inescapable shock on the food intake and
      wheelrunning of rats.
AB  - The feeding and running activities of rats were used to characterize the
      stressful effects of footshock. A 12-hour light/dark cycle was continuously in
      effect. During the preshock stage, all rats lived in individual cages where they
      could drink water, press a lever once for each 45 mg food pellet or run in an
      attached running wheel. During the shock stage, rats were moved to cages where
      they could drink and eat, but not run. Five s of light followed by 5 s of a light
      + tone compound preceded five progressively more intense shock levels. Rats in
      group AE were trained to pull a ceiling chain to avoid/escape from footshocks
      that were scheduled 24 hours per day. In group YS, the frequency, intensity and
      pattern of shocks for a rat were yoked to a rat in group AE. Rats in group CN
      were not shocked. During recovery, rats were allowed to resume running. During
      the dark, but not the light of the first day of shock, the intake of groups AE
      and YS was less than the intake of group CN. By the third day of shock, the food
      intake of group AE recovered and was no longer different from the intake of group
      CN. Intake of group YS remained less than the intakes of groups AE and CN during
      the remainder of the shock stage. When shock was terminated, the intake of the YS
      group recovered, but neither running nor food intake differed among groups. These
      results suggest that although inescapable shock disrupts food intake more than
      escapable shock, this disruption is specific to the duration of the shock stage
      and depends on rat's circadian pattern of intake.

PMID- 1741445
TI  - Lesions of the central nucleus of the amygdala block the excitatory effects of
      septal ablation on the acoustic startle reflex.
AB  - Many studies have investigated the role of the septum and the amygdala in
      emotional behavior. While the literature is somewhat inconsistent, most studies
      suggest a role for the septal nuclei in the inhibition of fear and stress
      responses (at the behavioral, autonomic and hormonal levels) while the central
      nucleus of the amygdala is involved in the production of such responses. The
      present study examined the ability of lesions of the central nucleus of the
      amygdala to block the excitatory effects of complete septal ablation on the
      acoustic startle reflex. Septal ablation produced a significant increase in
      startle amplitude which was blocked by concomitant lesions of the central nucleus
      of the amygdala. These results suggest that the increase in startle amplitude
      resulting from septal damage might be due to a disinhibition of neuronal activity
      in the central nucleus of the amygdala, a structure known to mediate the increase
      in startle associated with conditioned and unconditioned fear, or from
      antagonistic interactions at other target sites which themselves modulate
      startle.

PMID- 1741446
TI  - Lordosis in male rats: the facilitatory effect of mesencephalic dorsal raphe
      nucleus lesion.
AB  - The dorsal raphe nucleus was destroyed (DRL) by a radiofrequency lesion generator
      in castrated male rats, and lordosis behavior was observed. Five weeks after the
      surgery, all animals were implanted with two Silastic tubes containing estradiol
      (E2). Behavioral tests were started 2 days after implantation of E2 and carried
      out every other day for 16 days. Castrated control and sham-operated control
      males showed low incidence of lordosis and low lordosis quotient (LQ) throughout
      the tests, whereas all the DRL males displayed lordosis and the mean LQ of the
      group was significantly higher than that of control groups, but lower than that
      of an ovariectomized female group. These results suggested that the dorsal raphe
      nucleus plays an important role in inhibiting lordosis in male rat brain.

PMID- 1741447
TI  - Rat circadian rhythms entrain to a descending saw-tooth light intensity cycle.
AB  - We reexamined whether rat circadian rhythms entrained to the light intensity
      cycle of a descending saw-tooth (ST-d) form, in which illuminance decreased
      rectilinearly from 300 lx to 0 lx in 24 h, and abruptly returned to 300 lx
      (lights-on time). Ambulation, drinking and subcutaneous body temperature were
      simultaneously monitored in 5 intact, 5 pinealectomized and 5 orchiectomized
      rats. Additionally, sleep was monitored in the intact rats. In all the rats,
      entrainment was confirmed during 65 days' exposure to the ST-d cycle. The
      waveforms of the entrained rhythms were much modified compared with those during
      LD 12:12. The estimated activity periods of the entrained rhythms straddled the
      lights-on time of the ST-d cycle. In all the groups of rats, administration of a
      single ST-d cycle in constant dim red light produced only delay shifts
      irrespective of its circadian phase, and there was no significant circadian
      variation in the magnitude of phase shifts. The results indicate that rat
      circadian rhythms entrain to the ST-d cycle with an unexpected phase position,
      which cannot be explained by the phase-response curve.

PMID- 1741448
TI  - Air puff versus shock unconditioned stimuli in rabbit heart rate conditioning.
AB  - The present study examined whether corneal air puff can be used as an
      unconditioned stimulus to elicit reliable classically conditioned heart rate (HR)
      responses in rabbits. The conditioned and unconditioned HR responses were
      assessed during Pavlovian conditioning with different intensities of paraorbital
      shock (2.7, 1.2, or 0.5 mA) or corneal air puff (18.3, 5.9, or 2.2 N/cm2)
      unconditioned stimuli (UCSs). Each experimental group was given one acquisition
      session during which an acoustic conditioned stimulus was paired with either the
      high, medium, or low intensity of a shock or air puff UCS. The results suggest
      that: a) HR is reliably conditioned with a high-intensity air puff UCS, and with
      medium- or high-intensity paraorbital shock stimuli; and b) only UCSs that elicit
      a tachycardiac unconditioned HR response reliably support HR conditioning. It was
      concluded that either air puff or paraorbital shock can serve as an effective UCS
      for HR conditioned responses.

PMID- 1741449
TI  - Thirst and salt appetite induced by hypovolemia in rats: analysis of drinking
      behavior.
AB  - A detailed description of the increased intake of water and 0.5 M NaCl solution
      by rats after colloid-induced hypovolemia was obtained by measuring drinking
      activity every 6 s for 23 h. After an initial phase of largely single-bout water
      drinking that reflected hypovolemic thirst, there was a marked increase in saline
      drinking in multiple-bout episodes. This salt appetite developed while rats were
      volume depleted but persisted for hours even after the plasma volume deficits
      were repaired. Their drinking episodes then seemed to reflect osmoregulation,
      since cumulative intakes of water and saline were in appropriate proportions to
      produce a near-isotonic NaCl solution. Remarkably, rats concocted a 1% NaCl
      solution within 29% of the drinking episodes, by alternating intakes of water and
      saline every 30-90 s. This alternation was too rapid to allow significant
      absorption of ingested fluids from the intestines and changes in plasma
      osmolality, and thereby to permit central osmoreceptors to influence ongoing
      consumption. Instead, we propose that, in these episodes, rats are guided by
      gustatory receptors to obtain the desired NaCl in a palatable solution.

PMID- 1741450
TI  - Clozapine: strong antiaggressive effects with minimal motor impairment.
AB  - Clinical studies have shown clozapine to be effective in the treatment of
      schizophrenia and associated with an extremely low incidence of extrapiramidal
      side effects. Diverse studies indicate that clozapine is an atypical neuroleptic
      with a preferential activity on the mesolimbic structures and a lower affinity
      for striatal D2 receptors than the classical antipsychotics. The purpose of this
      study was to assess the behavioral properties of clozapine, especially its
      effects on aggressive and motor behaviors. Individually housed male mice of the
      OF1 strain were exposed to anosmic "standard opponents" 30 minutes after the last
      drug administration. One category of animals received a single IP dose of the
      compound (0.2, 0.5, 1 or 1.5 mg/kg). Another category received daily doses (0.5,
      1 or 1.5 mg/kg) for 21 days. Encounters were videotaped and behavior evaluated
      using an ethologically based analysis. Clozapine, in the acute treatment
      condition, produced a significant decrease in "attack" and "threat" behaviors
      without "immobility" being significantly increased. These results suggest a
      rather specific antiaggressive action of the compound with little motor
      impairment. In the chronic administration, no significant change in aggressive
      behavior was observed which may be attributed to the development of some degree
      of tolerance.

PMID- 1741451
TI  - Chorda tympani and lingual nerve responses to astringent compounds in rodents.
AB  - A wide variety of compounds in foods and beverages produce astringent sensations
      when introduced into the oral cavity. There is controversy, however, whether
      "astringency," with its associated puckering and drying sensations, is a
      fundamental taste quality or is a tactile sensation. To address this issue,
      electrophysiological recordings were made from the gerbil chorda tympani nerve
      and the rat lingual nerve. The chorda tympani nerve transmits taste information
      from the anterior 2/3 of the tongue, whereas the lingual nerve transmits tactile,
      thermal and pain sensations from the anterior 2/3 of the tongue. The astringent
      compounds tested were: tannic acid, tartaric acid, gallic acid, aluminum ammonium
      sulfate and aluminum potassium sulfate. Tannic acid, tartaric acid, and gallic
      acids were tested at concentrations up to 120 mM over a pH range from
      approximately 2 to 6. The aluminum salts were tested at concentrations up to 160
      mM only at low pH's. All compounds rapidly (and at lower concentrations,
      reversibly) stimulate the chorda tympani nerve in a concentration-dependent
      manner at all pH's tested. The rapidity and reversibility of the chorda tympani
      responses suggest that astringent-tasting compounds interact directly with taste
      cells rather than indirectly by precipitating salivary proteins. At pH 6, tannic
      acid, tartaric acid, and gallic acid all elicit robust chorda tympani responses,
      implying that the ionized forms of these compounds produce taste sensations. None
      of these compounds stimulate lingual nerves over the same concentration and pH
      ranges used in the chorda tympani experiments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741452
TI  - Differential effects of neonatal testosterone treatment on aggression in two
      selection lines of mice.
AB  - Selection lines of mice, artificially selected for aggression based upon the
      attack latency score (ALS), were used. In order to determine the relative
      contribution of neonatal testosterone (T) in the development of aggression, we
      vary the plasma-T level in males of both selection lines on the day of birth. At
      14 weeks the ALS was measured. Neonatal T treatment results in a reduction of
      aggression in the long attack latency (LAL) line, whereas aggressive behaviour of
      the short attack latency (SAL) line is not affected. Both selection lines show
      reduction in testicular weight, although the total amount of T-producing Leydig
      cells was not affected. Neonatal T may cause a permanent reduction in aggressive
      behaviour in in the LAL line only, probably due to differential appearance of
      critical periods. It is suggested that the difference in aggressive behaviour
      between SAL and LAL selection lines is due to a prenatally determined difference
      in neonatal T sensitivity of the brain.

PMID- 1741453
TI  - Age-related changes in spontaneous behavior and learning in NMRI mice from middle
      to old age.
AB  - Spontaneous behavior, sensorimotor reflexes and learning of 3-, 11-, 17- and 22
      month-old virgin female NMRI mice were compared. Sensorimotor abilities decreased
      significantly from the age of 17 months in proportion to the muscular and
      equilibrium demand of the test. Open-field activity, hole board exploration as
      well as activity in the Y maze and plus maze decreased from the age of 11 months.
      However, in the open-field and Y maze, it was not possible to distinguish between
      11-, 17- and 22-month-old mice, whereas in the plus maze, activity was
      drastically decreased in 17- and 22-month-old mice. In the plus maze, indices of
      fear-motivated behavior suggest a greater sensitivity to the situation in the age
      groups of 17 and 22 months. Spontaneous alternation also decreased from the age
      of 11 months, but at the age of 22 months, a rotational behavior emerged. Spatial
      learning was markedly impaired from middle age, i.e., 11 months, as indicated by
      longer latencies and absence of spatial bias in place learning. In cued learning,
      the 11- and 17-month groups eventually reached the level of the 3-month-old mice,
      while the 22-month age group remained impaired. Changes in swimming ability or
      speed did not appear to account for the swimming maze deficits. In contrast, a
      sensory or perceptual deficit cannot be excluded for the oldest mice.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1741454
TI  - The threshold for satiating effectiveness of psyllium in a nutrient base.
AB  - A combination of psyllium fiber with nutrients in a commercially available wafer
      (Fiberall-Ciba Consumer Pharmaceutical) was evaluated for its effectiveness in
      reducing food intake and appetite. Each of 15 nonobese healthy women received no
      wafers and four different amounts (39, 104, 169, and 234 kcal) of the fiber wafer
      with water, in a ratio of 13 kcal (and 0.565 g psyllium) wafer per 41.67 g water,
      30 minutes prior to a test meal of macaroni and beef, on nonconsecutive days.
      Intake of the test meal and hunger ratings were both significantly reduced after
      intake of the two largest wafer amounts (169 and 234 kcal, respectively), in
      comparison with the two smaller amounts and none at all. The reduction produced
      by the largest amount compared to none at all was 122 kcal (about half the energy
      of the amount given). There were no significant differences in intake and hunger
      ratings among the two smaller amounts and none at all. Thus the threshold for
      intake reduction by this product with water lies between 104 and 169 kcal.
      Methodologically, this work underscores the importance of testing the satiating
      effects of foods at multiple levels before conclusions are drawn about their
      satiating effectiveness, and suggests that the threshold for significant
      reduction should be considered as a measure of the product's satiating
      effectiveness. The relative contributions of the nutrients, the fiber, and the
      water to the satiating effect still need to be determined.

PMID- 1741455
TI  - Handling elevates the colonic temperature of mice.
AB  - Handling mice for repeatedly measuring their colonic temperature (Tc) resulted in
      a significant rise in their Tc. When the procedure was repeated day after day,
      this response diminished by habituation, showing the emotional origin of Tc rise.
      Salicylate lowered both the maximal Tc reached during handling and the Tc before
      handling without affecting the difference between the initial and the maximal Tc.
      During the first Tc measurement in a session, concomitant to the Tc rise, ear
      pinna temperature decreased. When Tc reached a plateau during the last
      measurements, ear temperature increased. This vasomotor response suggests that
      stress Tc rise is a regulated Tc change. However, since, contrary to what was
      reported in the rat, the salicylate did not diminish the magnitude of the Tc
      rise, it is doubtful that the emotional Tc rise in mice is a true fever.

PMID- 1741456
TI  - Mechanism of reproductive deficiency in spontaneously hypertensive rats.
AB  - Spontaneously hypertensive rats (SHR) show multiple endocrine disorders. In the
      present work, specific reproductive modifications were analysed using
      normotensive Wistar-Kyoto rats (WKY) as controls. SHR showed delayed vaginal
      opening and first estrus presentation, regular vaginal cycles and released a
      normal number of ova each cycle. When compared with controls, SHR showed a
      decrease in the percentage of successful pregnancies (69% vs. 86% in WKY) and in
      the litter size (7.83 +/- 0.5 vs. 10.41 +/- 0.5). In SHR, progesterone plasma
      levels were significantly increased during the days 1-14 of pregnancy, and on the
      5th day of pregnancy the plasma concentrations of LH but not of FSH were
      enhanced. Mortality during the first month of life was higher in SH (50%) than in
      control (24%) strain. When the SH females were mated with Wistar or WKY males,
      the percentage of pregnancies rose up to 95%. On the contrary, Wistar or WKY
      females mated with SH males showed a decrease in the percentage of pregnancies
      (62.5% and 50%, respectively). Besides, the litter sizes were significantly
      reduced in Wistar females mated with SH males. Newborn SH suckled immediately
      after birth from a WKY mother showed a significant reduction in the mortality
      during the first month of life (8% vs. 50%). In conclusion, our results suggest
      that changes in fertilization and/or implantation processes of SH rats were
      responsible for the reduced pregnancy rate, whereas the increased neonatal
      mortality could be due to lactation activity of SH mothers.

PMID- 1741457
TI  - Plasmid-determined metal resistance mechanisms: range and overview.

PMID- 1741458
TI  - Resistance to cadmium, cobalt, zinc, and nickel in microbes.
AB  - The divalent cations of cobalt, zinc, and nickel are essential nutrients for
      bacteria, required as trace elements at nanomolar concentrations. However, at
      micro- or millimolar concentrations, Co2+, Zn2+, and Ni2+ (and "bad ions" without
      nutritional roles such as Cd2+) are toxic. These cations are transported into the
      cell by constitutively expressed divalent cation uptake systems of broad
      specificity, i.e., basically Mg2+ transport systems. Therefore, in case of a
      heavy metal stress, uptake of the toxic ions cannot be reduced by a simple down
      regulation of the transport activity. As a response to the resulting metal
      toxicity, metal resistance determinants evolved which are mostly plasmid-encoded
      in bacteria. In contrast to that of the cation Hg2+, chemical reduction of Co2+,
      Zn2+, Ni2+, and Cd2+ by the cell is not possible or sensible. Therefore, other
      than mutations limiting the ion range of the uptake system, only two basic
      mechanisms of resistance to these ions are possible (and were developed by
      evolution): intracellular complexation of the toxic metal ion is mainly used in
      eucaryotes; the cadmium-binding components are phytochelatins in plant and yeast
      cells and metallothioneins in animals, plants, and yeasts. In contrast, reduced
      accumulation based on an active efflux of the cation is the primary mechanism
      developed in procaryotes and perhaps in Saccharomyces cerevisiae. All bacterial
      cation efflux systems characterized to date are plasmid-encoded and inducible but
      differ in energy-coupling and in the number and types of proteins involved in
      metal transport and in regulation. In the gram-positive multiple-metal-resistant
      bacterium Staphylococcus aureus, Cd2+ (and probably Zn2+) efflux is catalyzed by
      the membrane-bound CadA protein, a P-type ATPase. However, a second protein
      (CadC) is required for full resistance and a third one (CadR) is hypothesized for
      regulation of the resistance determinant. The czc determinant from the gram
      negative multiple-metal-resistant bacterium Alcaligenes eutrophus encodes
      proteins required for Co2+, Zn2+, and Cd2+ efflux (CzcA, CzcB, and CzcC) and
      regulation of the czc determinant (CzcD). In the current working model CzcA works
      as a cation-proton antiporter, CzcB as a cation-binding subunit, and CzcC as a
      modifier protein required to change the substrate specificity of the system from
      Zn2+ only to Co2+, Zn2+, and Cd2+.

PMID- 1741459
TI  - Copper resistance determinants in bacteria.
AB  - Copper is an essential trace element that is utilized in a number of oxygenases
      and electron transport proteins, but it is also a highly toxic heavy metal,
      against which all organisms must protect themselves. Known bacterial determinants
      of copper resistance are plasmid-encoded. The mechanisms which confer resistance
      must be integrated with the normal metabolism of copper. Different bacteria have
      adopted diverse strategies for copper resistance, and this review outlines what
      is known about bacterial copper resistance mechanisms and their genetic
      regulation.

PMID- 1741460
TI  - Plasmid-mediated resistance to tellurite: expressed and cryptic.
AB  - The ability of some bacteria to grow in the presence of high concentrations of
      tellurium compounds has been recognized for almost 100 years. Since then,
      interest in this phenomenon has generated a slow but steady trickle of
      literature. In the past few years, the use of modern techniques in molecular
      biology has led to a dramatic increase in our understanding of the genetics of
      several bacterial determinants for resistance to tellurium compounds. These
      determinants are frequently found to be encoded by plasmids which carry multiple
      antibiotic resistance determinants. Our understanding of the biochemistry of
      these systems remains limited. In this article, the history of the study of
      bacterial resistance to tellurium compounds is briefly reviewed. This is followed
      by an analysis of the recent developments in the study of plasmid-mediated
      resistance determinants. Finally, preliminary investigations on the possible
      mechanisms of bacterial resistance to tellurium compounds are presented.

PMID- 1741461
TI  - Plasmid chromate resistance and chromate reduction.
AB  - Compounds of hexavalent chromium (chromates and dichromates) are highly toxic.
      Plasmid genetic determinants for chromate resistance have been described in
      several bacterial genera, most notably in Pseudomonas. Resistance to chromate is
      associated with decreased chromate transport by the resistant cells. The genes
      for a hydrophobic polypeptide, ChrA, were identified in chromate resistance
      plasmids of Pseudomonas aeruginosa and Alcaligenes eutrophus. ChrA is postulated
      to be responsible for the outward membrane translocation of chromate anions.
      Widespread bacterial reduction of hexavalent chromate to the less toxic trivalent
      chromic ions is also known. Chromate reduction determinants have not, however,
      been found on bacterial plasmids or transposons. In different bacteria, chromate
      reduction is either an aerobic or an anaerobic process (but not both) and is
      carried out either by soluble proteins or by cell membranes. Chromate reduction
      may also be a mechanism of resistance to chromate, but this has not been
      unequivocally shown.

PMID- 1741462
TI  - Germanium and silver resistance, accumulation, and toxicity in microorganisms.
AB  - Germanium is an inert metal with no known biological function in prokaryotic or
      eukaryotic organisms. Its toxicity is low compared to that of silver. Germanium
      is accumulated in certain bacterial strains by either energy-independent passive
      binding or an energy-dependent mechanism. Little is known about the molecular
      aspects of silver resistance, toxicity, and accumulation in bacterial strains.
      This is surprising because silver has been used as an antimicrobial agent in the
      medical field for centuries. It is likely that silver ions are excluded
      (resulting in decreased silver accumulation) from certain bacterial strains or
      immobilized intracellularly to prevent toxic effects from being exerted. These
      mechanisms of silver resistance have not been fully elucidated. This review
      examines the toxicity and accumulation of germanium and silver in selected
      microbial species. In addition, resistance mechanisms to these biologically
      nonessential metals is discussed, with more emphasis placed on silver-resistant
      bacteria due to the knowledge available.

PMID- 1741463
TI  - An anatomic review of the delay phenomenon: I. Experimental studies.
AB  - A number of experiments were conducted to study the anatomic changes in a flap
      following a surgical delay using the Doppler probe to add precision to the
      technique. After scanning the integument of a series of anesthetized animals with
      the probe, each was sacrificed; a total-body arterial injection was performed
      with a lead oxide mixture, the integument and deep tissues were radiographed
      separately, and the results were correlated and compared with our previous human
      studies. The dog was selected from the range of animals examined, and the
      arterial networks of a number of skin and muscle flaps were studied with and
      without a surgical delay. The study included the use of a tissue expander.
      Results revealed that an adjacent cutaneous perforator could be captured with
      safety on the artery at the base of an undelayed flap; that the survival length
      of that flap was related to the distance between perforators; that the necrosis
      line of the flap usually appeared in the zone of choke vessels connecting
      adjacent territories; that a surgical delay results in a dilatation of existing
      vessels with maximal effect in the zone of choke arteries; that the most
      effective delay was obtained by elevating the flap in stages from the base,
      leaving detachment of the tip until last; that tissue expansion is a form of
      surgical delay, with particular emphasis on vessel hypertrophy; and that similar
      changes occur when a muscle is delayed. The clinical applications of this
      investigation are presented in Part II of this anatomic review of the delay
      phenomenon.

PMID- 1741464
TI  - An anatomic review of the delay phenomenon: II. Clinical applications.
AB  - This paper applies the anatomic concepts and data obtained from our animal
      experimental studies of the delay phenomenon to a series of clinical cases.
      Similar clinical results were obtained to those seen in Part I of our study when
      skin flaps were raised with and without a delay, when a tissue expander was used,
      and when the delay technique was extended to musculocutaneous flaps. In each
      instance, the cutaneous perforators were identified with the Doppler probe to
      facilitate the delay of specific vessels rather than dividing those at random.
      Intraoperative arteriograms and venograms reveal that the choke arteries dilate
      and the anatomically unfavorable valved vein segments become regurgitant. The end
      result is the observation that at least one additional anatomic vascular
      territory can be added to the length of a flap with safety following a surgical
      delay.

PMID- 1741465
TI  - Results of multidisciplinary management of bilateral cleft lip and palate at the
      Iowa Cleft Palate Center.
AB  - Bilateral cleft of the lip and palate is by many standards the most complex and
      severe form of the defect. The complexity and severity of the defect require an
      unusual degree of cooperation among all specialists and especially between the
      surgeon and the orthodontist. There are no published findings that we know about
      in which comprehensive data from a number of disciplines are reported for the
      same group of bilateral cleft patients. Fifty randomly selected patients with
      bilateral complete clefts were examined by the Iowa team and two orthodontists
      from other institutions. The evaluations revealed that a large number of patients
      over the age of 10 have multiple residual problems requiring further treatment.
      Only 23 percent of the older patients studied were judged to have had treatment
      completed by the surgeon, speech pathologist, and orthodontist. It is very
      difficult to state whether the results obtained by our team can be considered
      satisfactory because there are no comparable studies that have attempted to
      evaluate the same parameters in multidisciplinary management.

PMID- 1741466
TI  - Gold eyelid weights in patients with facial palsy: a patient review.
AB  - Lid loading with gold weights inserted into a submuscular pocket in the upper
      eyelid is a useful, simple, and effective method for the treatment of
      lagophthalmos in patients with temporary or permanent facial nerve palsy. The
      incidence of complications in our series was high. The reason for this are
      discussed, and methods of reducing the rate of complications are suggested.

PMID- 1741467
TI  - The relationship of the superficial and deep facial fascias: relevance to
      rhytidectomy and aging.
AB  - Controversy persists regarding the relationship of the superficial facial fascia
      (SMAS) to the mimetic muscles, deep facial fascia, and underlying facial nerve
      branches. Using fresh cadaver dissection, and supplemented by several hundred
      intraoperative dissections, we studied facial soft-tissue anatomy. The facial
      soft-tissue architecture can be described as being arranged in a series of
      concentric layers: skin, subcutaneous fat, superficial fascia, mimetic muscle,
      deep facial fascia (parotidomasseteric fascia), and the plane containing the
      facial nerve, parotid duct, and buccal fat pad. The anatomic relationships
      existing within the facial soft-tissue layers are (1) the superficial facial
      fascia invests the superficially situated mimetic muscles (platysma, orbicularis
      oculi, and zygomaticus major and minor); (2) the deep facial fascia represents a
      continuation of the deep cervical fascia cephalad into the face, the importance
      of which lies in the fact that the facial nerve branches within the cheek lie
      deep to this deep fascial layer; and (3) two types of relationships exist between
      the superficial and deep facial fascias: In some regions of the face, these
      fascial planes are separated by an areolar plane, and in other regions of the
      face, the superficial and deep fascia are intimately adherent to one another
      through a series of dense fibrous attachments. The layers of the facial soft
      tissue are supported in normal anatomic position by a series of retaining
      ligaments that run from deep, fixed facial structures to the overlying dermis.
      Two types of retaining ligaments are noted as defined by their origin, either
      from bone or from other fixed structures within the face.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1741468
TI  - Frey's syndrome: a preventable phenomenon.
AB  - Gustatory sweating, or Frey's syndrome, is a fairly common sequela of partial or
      radical parotidectomy, submaxillary gland surgery, or radical neck dissection. It
      is caused by an anastomotic communication with facial sweat glands by
      parasympathetic secretomotor nerve fibers intended for the excised parotid gland;
      treatments, whether surgical or topical, generally have been less than
      satisfactory. We present the first documented prophylactic approach to Frey's
      syndrome that is performed during and as part of parotidectomy. The surgery
      involves use of the superficial aponeurotic system (SMAS) as an interposing flap
      to interrupt the anastomotic nerve communication with the sweat glands. The SMAS
      is derived from the fascia in the periauricular cheek and neck area that is
      continuous with the platysma muscle. In a prospective study in 55 patients
      undergoing elective parotidectomy, the SMAS flap was elevated during the
      beginning of the operative procedure once it had been determined that fashioning
      of the flap would in no way compromise tumor excision. In all cases, at follow
      up, there has been no clinical evidence of development of Frey's syndrome. We
      have shown that the development of the SMAS flap in parotid gland resections is
      an effective new approach both as a preventative measure against Frey's syndrome
      and as an aesthetic improvement over the usual defect typical of parotidectomies.

PMID- 1741469
TI  - Elimination of the vertical scar in reduction mammaplasty.
AB  - We describe a technique to eliminate the vertical portion of the inverted-T
      incision in patients who have combined enlargement of the breasts and moderate to
      severe ptosis. Initial preoperative markings are made, placing the new nipple
      site at the level of the transposed inframammary crease. The nipple-areola
      complex is then retained on a vascularized pedicle, with major reduction of the
      breast tissue being done in the medial and lateral quadrants. The nipple and
      breast tissue are then tucked underneath the superior skin segment and placed in
      this new position as one would do with the umbilicus in an abdominoplasty. Excess
      vertical skin is removed, and horizontal excess is collected at the midline as a
      small dog-ear. We have found that this dog-ear reduces markedly with time,
      rounding out the inferior portion of the breasts. The remaining small amount of
      excess skin can then be removed under local anesthetic at a later date. We have
      performed this procedure on 20 patients, with follow-up from 6 to 24 months.

PMID- 1741470
TI  - The free vastus lateralis flap: an anatomic study with case reports.
AB  - The suitability of the thigh as a donor site for a new free flap was examined in
      100 cadavers. It was found that the vastus lateralis muscle can be used to form a
      myocutaneous or fasciomuscular flap, the raising of which causes no technical
      problems and leads to no functional and only minor aesthetic impairments.
      Depending on the muscle segment from which the flap is raised, a neurovascular
      pedicle measuring between 8 and 20 cm with a diameter of 2 to 2.5 mm (artery) or
      2.5 to 4 mm (vein) can be formed. The skin island in the myocutaneous flap
      measures on average 8 x 16 cm and is located above the middle portion of the
      muscle. The diameter of the supplying perforator vessel is between 0.7 and 1.2
      mm. The flap can be raised parallel to head and neck surgery and applied as a
      myocutaneous flap for coverage of extensive or perforating defects or intraorally
      as a fasciomuscular flap.

PMID- 1741471
TI  - Microvascular soft-tissue transplantation for reconstruction of acute open tibial
      fractures: timing of coverage and long-term functional results.
AB  - Seventy-two patients with Gustilo grade IIIB open tibial fractures were treated
      with free-tissue transfers. If successful free-tissue transfer for soft-tissue
      reconstruction is performed within 15 days of injury, the risk of major
      complications is 3.6 percent. Long-term retrospective follow-up (mean 42 months)
      revealed successful limb salvage in 93 percent, good aesthetic results in 80
      percent, and patient satisfaction in 96 percent. However, 66 percent of patients
      exhibited significantly decreased range of motion of the ankle, 44 percent
      experienced swelling and edema requiring elastic support and activity
      modification, and 50 percent occasionally required an assistance device for
      ambulation. The long-term employment rate was 28 percent, and no patient returned
      to work after 2 years of unemployment. In contrast, 68 percent of amputees after
      lower extremity trauma over the same period returned to work within 2 years.
      Patients need to realize the disruptive nature of this injury on their family,
      job, and future.

PMID- 1741472
TI  - Tobacco smoking and complications in elective microsurgery.
AB  - This study assesses the risk for complications in patients who chronically smoke
      but who have quit in the perioperative period of an elective free-tissue transfer
      as compared with patients who do not smoke. A retrospective review identified 104
      free-tissue transfers in 93 smokers and 58 transfers in 51 nonsmokers. The
      demographics, wound etiology, and recipient sites were similar in the two
      populations. With the exception of a higher incidence of chronic obstructive
      pulmonary disease (COPD) among smokers, preexisting comorbid factors also were
      similar. Postoperative medical complications were comparable between populations.
      When comparing smokers with nonsmokers, we found that anastomotic patency and
      flap survival were not different (95 versus 94 percent, respectively), that
      delayed wound healing at the recipient site was different (35 versus 24 percent),
      and that smokers require an additional procedure to achieve final wound closure
      more frequently (27 versus 12 percent, p = 0.03). These findings suggest that
      cigarette smokers are at increased risk for complications, not at the site of the
      anastomosis in free-tissue transfer, but rather at the flap's interface with the
      wound or overlying skin graft.

PMID- 1741473
TI  - Monitoring of free flaps with surface-temperature recordings: is it reliable?
AB  - Surface-temperature recording (STR) is one of the oldest and simplest methods of
      postoperative monitoring of free flaps. Its usefulness, however, remains poorly
      documented, and its problems, not well understood. To assess its value, we
      reviewed our series of 600 consecutive free flaps where surface-temperature
      recording was the main method of monitoring used and a detailed temperature
      record was kept. Seventy flaps suffered a postoperative microvascular compromise
      necessitating a surgical reexploration. Of these, 62 charts were satisfactory for
      review and were matched with 62 charts from similar but uncomplicated flaps. The
      derived value C delta T, which represents the change in temperature difference
      (delta T) between flap and control sites over a specified time period, was
      calculated at each time point. Of 10,000 derivations, only once did C delta T
      greater than 1.8 degrees C fail to identify a microvascular thrombosis, and 17
      times a false alarm was given. Therefore, when properly applied and interpreted,
      the sensitivity of surface-temperature recording is 98 percent, and its
      predictive value is 75 percent, making it a simple, inexpensive, and highly
      reliable technique of free-flap monitoring. The thermodynamics behind surface
      temperature recording is reviewed, pointing out the pitfalls that have to be
      avoided in order to improve the reliability of this technique.

PMID- 1741474
TI  - Simultaneous rupture of the ligamentum patellae, medial collateral, and anterior
      cruciate ligaments. A case report.
AB  - We report a case of simultaneous rupture of the ligamentum patellae, medial
      collateral, and anterior cruciate ligaments. The full extent of the injury was
      not recognized on clinical examination. Although this is a rare combination of
      injuries, the integrity of the extensor mechanism should always be confirmed in
      knee injuries.

PMID- 1741475
TI  - Stress fractures of the sacrum in runners. Two case reports.

PMID- 1741476
TI  - Morphological patterns in the developing vertebrate retina.
AB  - Changes in the morphology of the early optic cup were observed in embryos of two
      distantly-related vertebrate species, a teleost fish, northern pike (Esox
      lucius), and chicken (Gallus gallus). A similar morphological pattern was noted
      to appear in both species shortly after the involution of the optic vesicle and
      the formation of the inner retinal layer. At a gross level, three notches were
      observed in the retinal margin at approximately nasal, dorsal, and temporal
      positions, while in histological sections a sharp constriction was found in the
      thickness of the dorsal retinal layer. In both species, this dorsal constriction
      appeared to be continuous with the central or dorsal notch. The time of
      appearance and configuration of this morphological pattern is intriguingly
      similar to the specification and polarity of retinal positional markers, and
      suggest a segmentation hypothesis for the origin of retinal polarity.

PMID- 1741477
TI  - Structural arrangement of the extracellular matrix network during myocardial
      development in the chick embryo heart.
AB  - We analyzed the extracellular matrix and the connective tissue of the developing
      chick myocardium ("myocardial interstitium"). The importance of this myocardial
      element for heart function has been well documented both for the normal and
      pathologic adult hearts. However, little information is available on the
      organization of the embryonic myocardial interstitium and its modifications
      during development and increasing intracardiac pressure. In the present study we
      used light and scanning electron microscopic techniques, and lectin probes to
      study the interstitium of the ventricular myocardium of chick embryos from stage
      29 (day 6 of development) until hatching. Our observations trace the progressive
      appearance and organization of the elements of the extracellular matrix,
      comprising the epimysium, perimysium and endomysium, which form a well-defined
      architectural network. Finally, we discuss the role of these elements of the
      extracellular matrix and their possible relation with the biomechanical
      properties of developing heart.

PMID- 1741478
TI  - Distribution of acetylcholinesterase and zinc in the visual cortex of the mouse.
AB  - The distributions of acetylcholinesterase (AChE) and zinc-containing boutons and
      their cells of origin in the visual cortex of the house mouse (Mus musculus
      domesticus) are described. The primary visual area is defined by both
      acetylcholinesterase and zinc staining. The AChE staining pattern is dark in
      upper layer I and layers IV and VI. It is light in layers II/III and V. The lack
      of a densely stained layer IV in the secondary visual cortices defines the
      borders between primary and secondary areas. Large, multipolar AChE-positive
      neurons are located throughout the cortical layers, but preferentially in layer
      VI. Dense zinc-positive neuropil in the primary visual cortex is apparent in
      layer Ib, upper layer II/III, and layers V and VI. Neurons that give rise to zinc
      containing boutons are situated in layers II/III and VI. The medial and lateral
      borders can be distinguished by a bold contrast of staining in lower layer
      II/III; the secondary areas have more zinc-positive neurons, and the neuropil
      stains darker. A surprising observation of this study is the disparity between
      the mouse and rat visual cortex of the AChE staining pattern. Layer V is very
      light in the mouse, whereas a dark stain has been described in layer V of the
      rat. Layer VI stains heavily in the mouse while less AChE activity has been
      observed in layer VI of the rat.

PMID- 1741479
TI  - Lectin binding sites in developing mouse limb buds.
AB  - The binding sites of the following biotinylated lectins were demonstrated in
      serial paraffin sections of fore- and hindlimb buds from day-9 to day-16 mouse
      embryos with the Avidin-Biotin-Peroxidase Complex (ABC) procedure: Concanavalin A
      (Con A), Soybean Agglutinin (SBA), Wheat Germ Agglutinin (WGA), Peanut Agglutinin
      (PNA), Ricinus Communis Agglutinin I (RCA), Ulex Europaeus I Agglutinin (UEA),
      and Dolichos Biflorus Agglutinin (DBA). Alternating neighbouring sections were
      used to compare the distribution of PNA staining, PNA staining after
      neuraminidase treatment (N-PNA) and the autoradiographic sites of [35S]-sulphate
      uptake. Unspecific binding sites common to all lectins tested were observed in
      periderm and chondrocytes. Several lectin affinities were seen in the
      undifferentiated mesoderm (Con A, WGA, RCA), blood vessels (WGA, PNA, N-PNA, RCA,
      UEA, DBA) and macrophages (Con A, WGA, N-PNA, RCA). A very selective and mainly
      extracellular affinity to N-PNA was demonstrated in the condensed preskeletal
      mesoderm, where it characterizes indistinct prospective chondrogenic,
      perichondral and pre-articular areas. Comparison with the distribution pattern of
      [35S]-sulphate uptake and other previously published histochemical data suggests
      that N-PNA staining occurs at the late blastema stage, i.e. after the stage of
      cell condensation and before the earliest deposit of stainable matrix in
      chondrogenic areas. This property later disappears from the chondrifying
      rudiments, and is maintained in perichondral and pre-articular tissues.
      Surprisingly, only the pre-articular areas bind PNA without pretreatment with
      neuraminidase. A transient RCA binding probably related to terminal morphogenesis
      was detected in the undifferentiated distal part of the predigital columns of day
      12 and day-13 limb buds. From the day-13 stage onwards, diverse new lectin
      affinities appeared in differentiating tissues, such as pretendinous rudiments,
      perichondrium and prospective periosteum, muscular connective tissue, myotubes,
      superficial fasciae and prospective dermis. A strong SBA and PNA staining was
      also detected in the extracellular matrix associated with the epithelial septa
      separating the roots of the digits in day-15 and day-16 limb buds.

PMID- 1741480
TI  - Axon contacts and acetylcholinesterase activity on chicken intrafusal muscle
      fiber types identified by their myosin heavy chain composition.
AB  - Muscle spindles of 8-week old chicken tibialis anterior muscles were examined to
      determine if specific intrafusal fiber types were also characterized by
      differences in motor innervation. Incubation with a monoclonal antibody against
      myosin heavy chains permitted the identification of strongly reactive, moderately
      reactive and unreactive intrafusal fibers. The innervation of each fiber type was
      evaluated in silver-impregnated sections, and in sections incubated with a
      monoclonal antibody against acetylcholinesterase. There was no
      acetylcholinesterase activity at the midequator of any fiber. At the juxtaequator
      and at the pole strongly reactive fibers typically exhibited fewer axon contacts
      and less acetylcholinesterase activity than unreactive and moderately reactive
      fibers. Differences were also recognized at neuromuscular junctions in the size
      and shape of acetylcholinesterase-positive sites. At the juxtaequator and at the
      pole strongly reactive fibers and moderately reactive fibers displayed
      significantly more small, dot-like acetylcholinesterase sites than unreactive
      fibers. On the contrary, the greatest number of larger, stout sites was found on
      unreactive fibers and the least number on strongly reactive fibers. Moderately
      reactive fibers took an intermediate position. The results indicate that myosin
      heavy chain-based chicken intrafusal fiber types are also set apart by
      differences in innervation.

PMID- 1741481
TI  - Vascular anatomy of a dicephalic cat.
AB  - The arterial and venous systems of the neck and heads of a dicephalic iniodymic
      monosomic cat are described. In the arterial system, an anomalous lingual branch
      of the right external carotid formed a large subhyoid arch, extending to the
      midline between both heads, giving off branches supplying the medial aspect of
      both heads and terminating in two medial internal carotid arteries each for the
      right or left head. This vessel was considered as an anomalous supernumerary
      common carotid artery. In the venous system, each lingual branch of linguofacial
      veins united and formed an anomalous venous arch. It received rostrally a long
      midline vein running between both heads and connecting with the medial internal
      jugular system. This vein received tributaries from the left and right heads and
      was considered as a supernumerary jugular vein. From these observations, and
      those of others in the literature, it can tentatively be suggested that, in
      congenital cephalic duplications in domestic mammals, the arterial blood supply
      for the medial aspect of both heads tends to come from the lingual branch of the
      external carotid artery, with an unexplained prevailing contribution of the right
      external carotid system. Two different venous patterns have been observed. In
      animal especies exhibiting a hyoid venous arch, such as carnivores, a midline
      supernumerary external jugular vein draining at the anomalous junction between
      lingual veins of both heads is formed, whilst in animals lacking a constant hyoid
      venous arch, such as ruminants, an asymmetrical supernumerary external jugular
      vein draining into the right "normal" external jugular vein has been repeatedly
      described.

PMID- 1741482
TI  - Unlayered polymicrogyria: structural and developmental aspects.
AB  - Unlayered polymicrogyria was analyzed in four patients with established lesions
      and in one 19- to 20-week-old fetus with lesions in a formative stage whose
      mother had suffered a serious accident two weeks before. Polymicrogyria occurred
      at the banks of porencephalic, sylvian clefts in three cases, and bilaterally in
      the watershed areas of the parieto-occipital lobes in a fourth case.
      Periventricular neuronal heteropias were found in these cases. Cortical lesions
      in the fetus were distributed along the watershed zones of the middle cerebral
      artery. Serial sections revealed that the appearance of microgyria was the result
      of radial tissue cleavage of the cerebral cortex, as shown by the increased
      numbers of blood vessels and astrocytes forming a tissue scar. Golgi studies
      disclosed that the different neuronal types were positioned at the apropriate
      cortical depths in the microgyric cortex. On the other hand, heterotopic nodules
      were composed of pyramidal and non-pyramidal neurons usually found in the upper
      cortical layers in the normal cortex. These features indicate that unlayered
      polymicrogyria is produced by circulatory failure occurring before the end of the
      period of neuroblast migration to the cortical plate. Circulatory failure in the
      radial and unbranched arteries that penetrate from the meningeal surface and
      vascularize the cerebral cortex at midgestation may result in radial tissue
      necrosis of the cortical mantle, whereas failure in the distal, terminal
      territories of these blood vessels may damage radial glial fibres and impair the
      last migration of neuroblasts. The particular morphology of this cortical
      abnormality finally depends on the imbalance in the tangential growth of
      adjoining cortical areas variably destroyed by tissue necrosis.

PMID- 1741483
TI  - Electron microscopic evidence on the acrosomal status of bound sperm and their
      penetration into human hemizonae pellucida after storage in a buffered salt
      solution.
AB  - The hemizona assay (HZA) was developed to evaluate sperm binding potential using
      microbisected human zona pellucida. In this study, eight human oocytes stored in
      a buffered salt solution for 60 days were bisected into two identical hemispheres
      (hemizonae) and coincubated with the spermatozoa from a fertile man. All
      evaluated spermatozoa were tightly bound to the outer surface or had begun
      penetration into the zona pellucida. The hemizonae with bound spermatozoa were
      prepared and fixed for transmission electron microscopy (TEM) using standard
      techniques. Among the 108 sperm bound to the zone we were able to evaluate 25 by
      TEM. Twenty (80%) of the zona bound spermatozoa were partially or completely
      acrosome reacted, while six (20%) of the zona bound sperm had intact acrosomes.
      Acrosome intact, partially acrosome reacted and completely reacted spermatozoa
      were observed within the zona. Penetration pathways or tunnels were seen within
      the zona matrix. The results illustrate, that typically spermatozoa tightly bound
      the human zona pellucida show induction of the acrosome reaction. Importantly,
      following storage of human eggs in salt solution (buffered to 7.4), the zona
      pellucida retain their biological and functional characteristics for at least 90
      days.

PMID- 1741484
TI  - The hemizona assay (HZA) as an experimental model to evaluate the inhibition of
      sperm binding to the murine zona pellucida by isolated zona pellucida protein.
AB  - Compelling evidence has demonstrated that zona binding represents gamete
      recognition by sperm binding with high affinity and specificity to complex
      glycoproteins of the zona pellucida. In the present study we evaluated the
      hemizona assay (HZA) in the investigation of the interaction of mouse spermatozoa
      with unfertilized murine oocytes and hemizonae after exposure to solubilized
      murine zonae pellucidae proteins. The zonae pellucidae were isolated from ovarian
      tissue following described mincing techniques. The sperm binding characteristics
      of murine spermatozoa were studied by using SDS-PAGE isolated ZP2 (+/- 120 Kd)
      and ZP3 (+/- 83 Kd) components of the zona pellucida. Sperm receptor activity was
      examined in a competitive gamete binding fashion using the HZA as an indicator of
      sperm/zona interaction. The results illustrated that isolated, solubilized ZP2
      and ZP3 glycoprotein moieties of the zona pellucida inhibited sperm binding to
      hemizonae and oocytes when compared to controls, and that the HZA can be utilized
      as an internally controlled homologous bioassay to evaluate the effects of zona
      pellucida proteins on tight binding of spermatozoa to the zona pellucida.

PMID- 1741485
TI  - Male alcohol consumption and fecundity in couples attending an infertility
      clinic.
AB  - The relationship between male alcohol intake and fertility was studied for 258
      couples attending an infertility clinic. 21% consumed less than 1 unit per week
      on average, 10% consumed between 1 and 5 units per week, 23% consumed between 6
      and 10 units per week, 27% consumed 11 to 20 units per week and 19% consumed more
      than 20 units per week. There was no significant association between alcohol
      consumption and any semen parameter. 110 men had a female partner who was
      apparently normal. There was no significant difference in the alcohol intake
      between the 'normal' and 'abnormal' female groups. Couples were followed-up for
      up to 32 months. Sixteen women had a treatment independent conception within the
      'normal' female group. There was no significant association between the amount of
      alcohol consumed per week and the fertility outcome.

PMID- 1741486
TI  - Male cigarette smoking and fecundity in couples attending an infertility clinic.
AB  - The relationship between male cigarette smoking and fertility was studied for 330
      couples attending an infertility clinic. 59% did not smoke, 10% smoked between 1
      and 5 per day, 8% smoked between 6 and 10 per day, 16% smoked 11-20 per day and
      7% smoked more than 20 per day. There was no significant association between
      smoking and any semen parameter. 138 men had a female partner who was apparently
      normal. There was no significant difference in smoking habits between the
      'normal' and 'abnormal' female groups. Couples were followed-up for up to 32
      months. Nineteen women had a treatment independent conception within the 'normal'
      female group. There was no significant association between the number of
      cigarettes smoked and the fertility outcome.

PMID- 1741487
TI  - Melatonin and aromatase stimulating activity of human seminal plasma.
AB  - Melatonin concentrations and aromatase stimulating activity were determined in
      human seminal plasma and correlated with sperm density and motility. Aromatase
      stimulating activity was determined with an in vitro rat granulosa cell system
      and melatonin by radioimmunoassay. Compared to normal semen, aromatase
      stimulating activity was lower in azoospermic individuals, while melatonin was
      higher in oligospermic and azoospermic samples. Aromatase stimulating activity
      correlated positively with sperm concentrations and a negative correlation was
      found between melatonin and sperm progression. These findings suggest that low
      sperm production is associated with low aromatase stimulating bioactivity in
      seminal plasma; and melatonin may have an effect upon both sperm production and
      motility.

PMID- 1741488
TI  - Antisperm antibodies in young boys.
AB  - The authors report the results of antisperm antibody tests carried out on a group
      of 159 pre-pubertal boys suffering from various testicular pathologies. The data
      show that 21% of the patients' sera showed antibody activity against antigens on
      the sperm of healthy fertile donors. None of the control sera was ASA positive.
      Some differences were observed in pathology and age distribution of positivity.

PMID- 1741489
TI  - DNA hybridization study using Y-specific probes in an XX-male.
AB  - A 30-year-old male attended the Toyama Medical and Pharmaceutical University
      Hospital with the chief complaint of infertility. Physical examination showed
      bilateral small testes and the semen contained no sperm. Hormonal studies
      revealed hypergonadotropic hypogonadism and cytogenetic studies showed a 46,XX
      karyotype. High-resolution banding showed no abnormalities in both of the X
      chromosomes. Histological examination of both testes showed germinal aplasia and
      the proliferation of Leydig cells. The diagnosis of XX-male was made from the
      above findings. A DNA hybridization study using 17 Y-specific probes revealed the
      presence of a major part of the short arm of the Y chromosome, which had
      presumably been translocated to the X chromosome. The translocated Y short arm
      had a small deletion within it.

PMID- 1741490
TI  - Epidermal growth factor (EGF) is not an index of seminiferous tubular function.
AB  - Epidermal growth factor concentrations and amounts per ejaculate were determined
      in 162 infertile men and in a control group of 50 pregnancy-proven fertile men.
      No differences were found between those groups. The group of infertile patients
      was divided into sub-groups according to their sperm density. EGF values in those
      sub-groups were not significantly different. There was no correlation between EGF
      concentrations and the variables of the sperm analysis that were measured. All
      these data suggest that EGF is not an index of gonadal function. This may be due
      to the fact that probably most EGF in seminal plasma is of prostatic origin.

PMID- 1741491
TI  - How frequent is unintentional childlessness in Germany?
AB  - A representative sample of 1,019 married men and 1,133 women of reproductive age
      was interviewed and revealed that 21.5% had no children. Of these, 20% stated
      that their childlessness was deliberate. Of those who had not conceived about two
      thirds (men: 31%, women: 60%) had already sought medical advice. The men surveyed
      tended to delay seeking medical advice for longer than the women do, who do so
      within one or two years. This indicates that there is a deficit in the data on
      men which results in a lack of knowledge concerning the possible reasons for
      infertility.

PMID- 1741492
TI  - Intrauterine insemination with semen of oligozoospermic men: effectiveness of the
      continuous-step density gradient centrifugation technique.
AB  - There has been an argument as to whether the intrauterine insemination (IUI)
      substantially improves pregnancy rate in cases of oligoasthenozoospermia. The
      present study evaluates the efficiency of the IUI with the use of the life table
      analysis. The insemination was performed after washing and concentrating sperm
      using the continuous-step density gradient centrifugation reported in our
      previous papers. The number of IUI cycles studied was 222 (46 couples), in 13
      cases of which pregnancy was established with a pregnancy rate of 28.3%. The
      cumulative probability of conception reached to 57% at the eleventh cycles of the
      IUI treatment. These results suggest that the potential efficiency of the IUI for
      the oligo-asthenozoospermic cases is high if the sperm is processed in a proper
      method.

PMID- 1741493
TI  - Does magnesium sulfate alter the maternal cardiovascular response to vasopressor
      agents in gravid ewes?
AB  - Magnesium sulfate (MgSO4) attenuates the maternal compensatory response to
      hemorrhage in gravid ewes, perhaps by decreasing the response to endogenous
      vasopressors. The purpose of this study was to determine whether MgSO4 alters the
      cardiovascular response of gravid ewes to vasopressor agents. Sixteen gravid ewes
      underwent a series of experiments consisting of administration of two exogenous
      and two endogenous vasopressors, each with and without a concurrent MgSO4
      infusion. Dose-response curves were constructed for phenylephrine (an alpha 1
      adrenergic agonist), ST-91 (an alpha 2-adrenergic agonist), angiotensin II, and
      arginine vasopressin (AVP). MgSO4 significantly attenuated the increase in
      maternal mean arterial pressure and systemic vascular resistance and the decrease
      in cardiac output during ST-91 infusion but not during phenylephrine, angiotensin
      II, or AVP infusions. MgSO4 significantly attenuated the increase in uterine
      vascular resistance during phenylephrine, ST-91, and angiotensin II infusions and
      the decrease in uterine blood flow during phenylephrine and angiotensin II
      infusions. MgSO4 also appeared to attenuate the decrease in uterine blood flow
      during ST-91 infusion (P = 0.067). The present study suggests that MgSO4
      antagonizes the effects of alpha 1-adrenergic agonists, alpha 2-adrenergic
      agonists, and angiotensin II on the uterine vasculature, thus providing a level
      of protection for the fetus in situations of maternal stress.

PMID- 1741494
TI  - Halothane depresses D600 binding to bovine heart sarcolemma.
AB  - Volatile anesthetics exert their negative inotropic effects by interfering with
      Ca2+ homeostasis in the myocardial cell. The mechanism of this dose-dependent
      action is uncertain. 3H-D600 (3H-Gallopamil), a Ca(2+)-channel antagonist, binds
      to the voltage-dependent Ca2+ channels (VDCC) in a specific, saturable, and
      reversible manner. We used this ligand to study the effect of halothane on the
      binding characteristics of the VDCC in purified bovine heart sarcolemma. Cardiac
      sarcolemmal vesicles were isolated from fresh bovine heart by differential
      centrifugation and filtration. 3H-D600 equilibrium binding assays were performed
      in the presence or absence of 1.0 mM unlabeled D600 to determine total and
      nonspecific binding in room air and at 0.7, 1.3, and 2.5% (vol/vol) halothane.
      Halothane produced a significant dose-dependent and reversible depression of 3H
      D600 specific binding in bovine heart sarcolemma. Depression was completely
      reversed when halothane had evaporated from the samples prior to filtration.
      Halothane 1.3% (vol/vol) produced a 40% reduction in the maximum binding
      capacity. The dissociation constant was not affected by any concentration of
      halothane. One mechanism by which the volatile anesthetics may induce negative
      inotropism is through the reduction of functional VDCCs in the heart, leading to
      reduction of Ca2+ entry. The results of this study support this hypothesis.

PMID- 1741495
TI  - Enhancement by propofol of epinephrine-induced arrhythmias in dogs.
AB  - Although propofol is a widely used intravenous anesthetic, its effect on
      epinephrine-induced arrhythmias remains unknown. This study examined the possible
      interaction between propofol and epinephrine that might affect the induction of
      ventricular arrhythmias in dogs. The arrhythmogenic threshold of epinephrine was
      determined during anesthesia with halothane alone, propofol alone, etomidate
      alone, or etomidate plus varying doses of propofol. The arrhythmogenic dose and
      the corresponding plasma concentration of epinephrine during propofol anesthesia
      (blood propofol concentration 18.0 +/- 0.98 micrograms/ml) were 2.52 +/- 0.43
      micrograms.kg-1.min-1 and 23.6 +/- 8.5 ng/ml, respectively. During halothane
      anesthesia (end-tidal 1.3 MAC), they were 2.66 +/- 0.21 micrograms.kg-1.min-1 and
      35.7 +/- 1.9 ng/ml, respectively. During etomidate anesthesia, they were 9.67 +/-
      1.06 micrograms.kg-1.min-1 and 205 +/- 27.5 ng/ml, respectively. The dose-effect
      relationship for propofol was examined during etomidate plus propofol anesthesia.
      Propofol reduced the arrhythmogenic plasma concentration of epinephrine in a
      concentration-dependent manner: at blood propofol concentrations of 2.33 +/-
      0.46, 5.46 +/- 0.71, and 11.2 +/- 0.81 micrograms/ml, the corresponding plasma
      epinephrine concentrations were 182.6 +/- 52.5, 89.0 +/- 28.8, and 26.6 +/- 6.9
      ng/ml, respectively. These results suggest that propofol enhances epinephrine
      induced arrhythmias in a dose-dependent manner in dogs.

PMID- 1741496
TI  - Epinephrine dosage effects on cerebral and myocardial blood flow in an infant
      swine model of cardiopulmonary resuscitation.
AB  - Although epinephrine increases cerebral blood flow (CBF) and left ventricular
      blood flow (LVBF) during cardiopulmonary resuscitation (CPR), the effects of high
      dosages on LVBF and CBF and cerebral O2 uptake have not been examined during
      prolonged CPR. We determined whether log increment dosages of epinephrine would
      enhance LVBF and CBF and cerebral O2 uptake in an infant swine CPR model. We
      compared these responses with epinephrine to those with the alpha-adrenergic
      agonist, phenylephrine. CPR was performed in five groups (n = 6) of pentobarbital
      anesthetized piglets (3.5-5.6 kg) receiving a continuous epinephrine infusion (0,
      1, 10, and 100 micrograms.kg-1.min-1) or phenylephrine infusion (40 micrograms.kg
      1.min-1). Plasma epinephrine concentrations increased 10-100-fold in the control
      group during CPR and in a stepwise manner such that concentrations were increased
      by more than 10(4) in the 100 micrograms.kg-1.min-1 epinephrine group. In the
      control group with no epinephrine infusion, LVBF decreased to less than 10 ml.min
      1.100 g-1 by 5 min of CPR. With epinephrine in dosages of 10 and 100
      micrograms.kg-1.min-1, LVBF at 5 min was 75 +/- 19 and 44 +/- 15 ml.min-1.100 g
      1, respectively, which was significantly greater than values in the control
      group. With more prolonged CPR, LVBF remained significantly greater than that in
      the control group but only at 10 micrograms.kg-1.min-1 of epinephrine.
      Phenylephrine also increased LVBF for 10 min of CPR when compared with the
      control group. All dosages of epinephrine and phenylephrine maintained CBF close
      to prearrest values for 20 min of CPR. With prolonged CPR, 10 and 100
      micrograms.kg-1.min-1 epinephrine resulted in significantly greater CBF than that
      in the control group. Incremental dosages of epinephrine did not statistically
      increase cerebral O2 uptake or lower the cerebral fractional O2 extraction when
      compared with the control group, despite the higher CBF that was generated. In
      this immature animal CPR model, 10 micrograms.kg-1.min-1 epinephrine is an
      optimal dosage for maximizing both CBF and LVBF, a dosage that substantially
      exceeds the current recommended epinephrine dosage for human infant CPR. In
      addition, for short periods of CPR, 40 micrograms.kg-1.min-1 phenylephrine
      increases CBF and LVBF to levels similar to those generated by high dosages of
      epinephrine.

PMID- 1741497
TI  - Potassium channel blockers potentiate impulse inhibition by local anesthetics.
AB  - The ability of local anesthetics to reduce the amplitude of compound action
      potentials (CAP) of frog sciatic nerve was examined in the absence and presence
      of agents that selectively block K+ channels. In the presence of lidocaine
      concentrations that inhibit the CAP by about 20% at low frequencies of
      stimulation (1 per min, "tonic inhibition"), the addition of the K(+)-channel
      blocker tetraethylammonium ion (TEA, 12 mM) increased this inhibition by another
      15%. Furthermore, the use-dependent inhibition induced by lidocaine at higher
      stimulation frequencies (5-20 Hz, "phasic inhibition") was markedly enhanced by
      TEA: at 20 Hz it increased from 35% with lidocaine alone to 63% with lidocaine
      plus TEA. A comparable potentiation was rendered by 3,4-diaminopyridine (1 mM), a
      different K(+)-channel blocker. Similarly, phasic inhibition by bupivacaine also
      was enhanced by TEA. The K(+)-channel blockers alone slightly depolarized the
      resting membrane, broadened and elevated the CAP, produced no phasic inhibition,
      and, during repetitive stimulation, resulted in a less negative steady-state
      repolarization potential than at rest. Both the broadening of CAP and the
      depolarizing actions of K(+)-channel blockers increased the presence of open and
      inactivated states of the neuronal Na+ channels, and thereby enhanced the binding
      of local anesthetic. The inhibitory actions of saxitoxin, a Na(+)-channel blocker
      that binds equally well to all channel states, were not potentiated by TEA.

PMID- 1741498
TI  - Comparison of halothane, enflurane, and isoflurane with nitrous oxide on
      contractility and oxygen supply and demand in isolated hearts.
AB  - The authors' aim was to examine direct cardiac responses to isoflurane, enflurane
      and halothane, as altered during mild hypoxia by the substitution of nitrogen
      (N2) for oxygen (O2), and additionally by the substitution of nitrous oxide (N2O)
      for N2. Heart rate, atrioventricular conduction time, left ventricular pressure
      (LVP), peak positive and negative derivatives of LVP (dLVP/dtmax), coronary flow,
      O2 delivery (DO2), percent O2 extraction, and myocardial O2 consumption (MVo2)
      were examined in 47 isolated guinea pig hearts. Changes in the ratio of DO2 to
      MVO2 indicated the relationship of autoregulation of coronary flow to myocardial
      O2 utilization. Each heart was first exposed to 96% O2 and then randomly exposed
      to 48% N2 and 48% N2O alone and with three equivalent concentrations of one of
      three volatile anesthetics: isoflurane (n = 15), halothane (n = 16), or enflurane
      (n = 16). Results were as follows: 1) N2 alone significantly decreased LVP,
      +dLVP/dtmax and -dLVP/dtmax, DO2 and MVO2; increased coronary flow; and produced
      no change in heart rate, atrioventricular conduction time, percent O2 extraction,
      or the DO2/MVO2 ratio. 2) Compared to N2, N2O alone only produced additional
      significant decreases in LVP and +dLVP/dtmax. 3) In the presence of N2 or N2O,
      each volatile anesthetic caused significant stepwise decreases in heart rate,
      LVP, +dLVP/dtmax and -dLVP/dtmax, MVO2, and percent O2 extraction; no additional
      change in coronary flow or DO2; and a stepwise increase in the DO2/MVO2 ratio.
      The effects of halothane and enflurane were generally greater than those of
      isoflurane. 4) Each volatile anesthetic caused an additive, parallel depression
      of LVP and percent O2 extraction as a function of MAC with N2O compared to N2.
      This study demonstrates that the direct negative inotropic effects of halothane
      and enflurane are more pronounced than those of isoflurane and are accompanied by
      a greater reduction in O2 utilization by halothane and enflurane than by
      isoflurane in the presence of mild hypoxia alone or with the addition of N2O. The
      study also demonstrates that N2O accentuates the negative inotropic effects of
      volatile anesthetics during reduced O2.

PMID- 1741499
TI  - Halothane alters control of intracellular Ca2+ mobilization in single rat
      ventricular myocytes.
AB  - In an attempt to understand the cellular mechanisms underlying volatile
      anesthetic-induced myocardial depression, halothane-induced negative inotropy was
      investigated in an animal model through continuous monitoring of intracellular
      Ca2+ concentration [( Ca2+]i) in rat ventricular myocytes loaded with fura-2.
      Single cells were stimulated with 15 mM caffeine or 15 mM extracellular K+ (K+O)
      or were paced by extracellular glass suction pipette electrode. With each
      stimulus modality, halothane (0.6-1.5%) caused a significant (P less than 0.05)
      and dose-dependent depression of the Ca2+ transient. Caffeine and electrically
      stimulated Ca2+ transients were reduced, in 1.5% halothane, to 35 +/- 14 and 42
      +/- 8% of control, respectively. Resting or basal [Ca2+]i was unaffected by
      halothane. Halothane did not elicit spontaneous Ca2+ transients in these cells.
      Single cells stimulated by trains of electrical stimuli at 1.0, 1.5, and 2.0 Hz
      showed a change in [Ca2+]i from prestimulus levels to a stimulated baseline
      steady state that appeared to increase with stimulus frequency. Halothane at 0.7%
      increased the change in resting to stimulated baseline [Ca2+]i and depressed net
      transients (P less than 0.05) at 1.0 and 1.5 Hz. In contrast, 0.1 microM
      ryanodine depressed the Ca2+ transients in myocytes stimulated by trains of
      stimuli, but did not potentiate the change in stimulated baseline [Ca2+]i at any
      pacing rate. The results are consistent with the hypothesis that halothane
      reduces Ca2+i availability by causing a net loss of Ca2+ from the sarcoplasmic
      reticulum. The results from experiments using onset of pacing to induce a sudden
      increase in Ca2+i load in previously quiescent myocytes suggest that halothane
      may act to limit sarcoplasmic reticulum and/or sarcolemmal uptake/extrusion
      mechanisms, as compared to ryanodine, which depletes sarcoplasmic reticulum Ca2+
      stores without affecting reuptake and extrusion.

PMID- 1741500
TI  - Intractable pharyngeal spasm following tracheal extubation in a patient with
      undiagnosed tetanus.

PMID- 1741501
TI  - Anaphylaxis during anesthesia: use of radioimmunoassays to determine etiology and
      drugs responsible in fatal cases.

PMID- 1741502
TI  - Another cause of upper airway obstruction.

PMID- 1741503
TI  - The first anesthetic mixture.

PMID- 1741504
TI  - Air entrainment during cardiopulmonary bypass surgery.

PMID- 1741505
TI  - Should calcium be administered prior to separation from cardiopulmonary bypass?

PMID- 1741506
TI  - Postintubation croup in children.

PMID- 1741507
TI  - Transparent dressing is useful for the secure fixation of the endotracheal tube.

PMID- 1741508
TI  - Does systemic anticoagulation increase the risk of internal jugular vein
      cannulation?

PMID- 1741509
TI  - More on standardized alarms.

PMID- 1741510
TI  - Glycopyrrolate and the central anticholinergic syndrome.

PMID- 1741511
TI  - Applications of molecular genetics to anesthesiology.

PMID- 1741512
TI  - EDRF/nitric oxide. The endogenous nitrovasodilator and a new cellular messenger.

PMID- 1741513
TI  - Adverse respiratory events infrequently leading to malpractice suits. A closed
      claims analysis.
AB  - Adverse outcomes associated with respiratory events are the single largest class
      of injury in the American Society of Anesthesiologists Closed Claims Project (762
      of the 2,046 cases, 37%). Inadequate ventilation, esophageal intubation, and
      difficult tracheal intubation are the most common mechanisms of respiratory
      related adverse outcomes. An analysis of closed claims data regarding these
      mechanisms has been reported previously. This report is concerned with 300 claims
      for five other less common but important categories of respiratory-related
      adverse outcomes in which recurrent themes of management error or patterns of
      injury could be identified: airway trauma, pneumothorax, airway obstruction,
      aspiration, and bronchospasm. Airway trauma (97 claims, 5% of the database) was
      associated with difficult intubation in 41 (42%) of the cases and the most
      frequent sites of injury were the larynx, pharynx, and esophagus. Pneumothorax
      (67 cases, 3% of the database) was usually either needle-related (block or
      central vascular catheter placement) or airway management-related
      (instrumentation or barotrauma). Airway obstruction (56 claims, 3% of the
      database) occurred in the upper airway in 39 (70%) of the cases. Aspiration (56
      claims, 3% of the database) usually occurred during general anesthesia, either
      during induction prior to tracheal intubation or during maintenance of anesthesia
      delivered via mask. Bronchospasm (40 claims, 2% of the database) tended to occur
      during induction of general anesthesia in patients with a history of asthma or
      chronic obstructive pulmonary disease and/or smoking. The incidence of severe
      injury (brain damage and death) among these cases in the five categories was 47%
      overall, ranging from 12% in airway trauma claims to nearly 90% in claims for
      airway obstruction and bronchospasm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741514
TI  - Time course of ventilatory depression following induction doses of propofol and
      thiopental.
AB  - To improve our understanding of the respiratory pharmacology of intravenous
      induction agents, the authors compared the acute effects of intravenous (iv)
      propofol 2.5 mg.kg-1 and iv thiopental 4.0 mg.kg-1 on the ventilatory response to
      CO2 (VeRCO2) of eight healthy volunteers. The slope of VeRCO2 decreased from 1.75
      +/- 0.23 to a minimum of 0.77 +/- 0.14 1.min-1.mmHg-1 (mean +/- standard error)
      90 s after propofol; similarly, the slope of VeRCO2 decreased from 1.79 +/- 0.22
      to a minimum of 0.78 +/- 0.23 l.min-1.mmHg-1 30 s after thiopental. For both
      drugs, the slope was less than control in the 0.5-5-min period after injection (P
      less than 0.05). The slope returned to baseline within 6 min after thiopental; in
      contrast, after propofol, the slope remained less than control for the entire 20
      min follow-up period (P less than 0.05 at 6-10, 11-15, and 16-20 min after
      injection). Also, from 6-10, 11-15, and 16-20 min after injection, the slope was
      less after propofol than at corresponding times after thiopental (P less than
      0.05). Recovery of consciousness was approximately 4 min slower after propofol
      than after thiopental; nonetheless, awareness scores returned to baseline within
      14 min after both drugs. The authors conclude that propofol 2.5 mg.kg-1 iv
      produces longer-lasting depression of VeRCO2 than a 4.0 mg.kg-1 iv dose of
      thiopental; after propofol, ventilatory depression may persist despite apparently
      complete recovery of consciousness.

PMID- 1741515
TI  - Biochemical markers of anaphylactoid reactions to drugs. Comparison of plasma
      histamine and tryptase.
AB  - Adverse reactions to drugs require that their mechanisms be elucidated,
      particularly when anaphylaxis is suspected. Early diagnosis can be achieved by
      plasma histamine measurements. Unfortunately, the short plasma half-life of
      histamine and the difficulties in handling the sample usually preclude this
      measurement, although a sensitive radioimmunologic kit is routinely available. It
      has been recently suggested that mast cell tryptase, a component of the mast cell
      granules, could provide an alternative to histamine determination. We have
      measured plasma histamine and tryptase in 19 patients who developed possible
      anaphylactoid reactions to anesthetic or other drugs. Eight patients had
      increased values for both histamine and tryptase. In 4 a muscle relaxant drug was
      proved responsible for the reaction. Six patients had normal levels for both
      substances. In each case, the clinical signs of anaphylaxis were moderate. Two
      patients had normal histamine and high tryptase concentrations, due to late
      sampling (greater than 5 h). In 2 other patients, histamine was high, with normal
      tryptase: in 1, muscle relaxant allergy was further demonstrated. Tryptase half
      life was equal to 90 min in 3 patients. At least 15 min was necessary to reach
      the peak level when the responsible drug was administered intravenously. The best
      time for measuring tryptase was 1-2 h after the reaction (not greater than 6 h),
      whereas for histamine it was 10 min to 1 h. We conclude that measurement of
      plasma tryptase along with measurement of plasma histamine may aid in diagnosis
      of anaphylaxis.

PMID- 1741516
TI  - Long-lasting epidural sensory blockade by n-butyl-p-aminobenzoate in the
      terminally ill intractable cancer pain patient.
AB  - An aqueous suspension of n-butyl-p-aminobenzoate (BAB), a highly lipid-soluble
      congener of benzocaine, was applied epidurally in terminally ill cancer patients
      with intractable pain. The suspension consisted of 10% BAB and 0.025% of the
      nonionic surfactant polysorbate 80 in 0.9% sodium chloride. Twelve consecutive
      patients received epidural BAB because pain was uncontrollable either by
      palliative radiotherapy or oral or epidural administrations of analgesics. The
      catheter or injecting needle was positioned at the segmental level of the pain.
      Repeated epidural injections were administered. In all patients, long-lasting
      sensory blockade (segmental analgesia) occurred, accompanied by a marked
      reduction or even absence of pain. In all patients, treatment with epidural
      opioids, alone or combined with local anesthetics, was no longer necessary. Five
      of the 12 patients did not require further administration of oral opioids. Motor,
      bowel, and bladder function were well preserved. In 6 patients, extensive
      necropsy of the spinal cord and spinal nerves did not reveal pathomorphologic
      changes. The outer aspect of the dura showed signs of focal necrosis on
      microscopy, yet its collagen structure and thickness were unchanged. Epidurally,
      focal infiltrative reactions were seen. The epidural use of an extremely lipid
      soluble--hence hydrophobic--local anesthetic, with an exceptionally low pKa
      (2.3), formulated in suspension of the base, is conceptually innovative and needs
      further investigation. The authors conclude that the epidural administration of a
      BAB suspension may be an effective alternative to the neurolytic agents alcohol
      and phenol and may replace procedures such as cordotomy. Further investigation to
      determine the safety of BAB in this patient group appears warranted.

PMID- 1741517
TI  - Pharmacokinetics of amrinone during cardiac surgery.
AB  - Amrinone is a nonglycosidic noncatecholamine with both vasodilator and positive
      inotropic effects that may be administered to patients undergoing cardiac
      surgery. As an initial step toward elucidating the optimal dosage of amrinone for
      cardiac surgical patients we studied the pharmacokinetics of amrinone during and
      after cardiac surgery requiring cardiopulmonary bypass. The study population
      comprised 35 adult patients, each receiving a single dose of amrinone (0.75, 1.5,
      2.0, or 2.5 mg/kg) administered into the venous reservoir near the end of
      cardiopulmonary bypass. Additionally, 15 of the 35 patients also received
      intravenous infusions of either 5 or 10 micrograms.kg-1.min-1. Arterial blood was
      sampled over the next 22 h, and plasma concentrations of amrinone were determined
      by high-performance liquid chromatography. Protein binding of amrinone, assayed
      by equilibrium dialysis, was 21.6 +/- 2.5%. The decay of amrinone concentrations
      in plasma over time was fit to a biexponential equation by nonlinear least
      squares regression. The manufacturer's recommended dose of 0.75 mg/kg followed by
      an infusion of 10 micrograms.kg-1.min-1 was inadequate to maintain the plasma
      concentration within the therapeutic range based on the pharmacodynamics of
      amrinone in patients with chronic congestive heart failure. This was due to
      significant redistribution of amrinone in the body after the loading dose. To
      maintain a therapeutic plasma concentration of 1.5-2.0 micrograms/ml, a larger
      loading dose or a supplemental loading dose as well as a continuous infusion is
      required.

PMID- 1741518
TI  - Minimum alveolar concentration of desflurane and hemodynamic responses in
      neonates, infants, and children.
AB  - We sought to determine the minimum alveolar concentration (MAC) and hemodynamic
      responses to desflurane in 72 fasting and unpremedicated full-term neonates,
      infants, and children up to 12 yr of age. The patients were divided into six
      groups (n = 12) according to age. After awake tracheal intubation, neonates were
      anesthetized with desflurane in oxygen and air. Infants greater than 1 month of
      age and all older children were anesthetized with desflurane in 100% oxygen, and
      their tracheas were intubated without muscle relaxation. MAC was determined using
      the "up-and-down technique" and logistic regression. Heart rate and systolic
      arterial pressure were recorded awake, at approximately 1 MAC desflurane before
      skin incision and at approximately 1 MAC during the peak hemodynamic responses to
      skin incision. We found that the relationship between MAC (mean +/- standard
      deviation) as determined by the up-and-down technique and age was quadratic,
      reaching a maximum value in infants 6-12 months of age: in neonates 0-1 month MAC
      was 9.16 +/- 0.02%, in infants 1-6 months 9.42 +/- 0.06%, in infants 6-12 months
      9.92 +/- 0.44%, in children 1-3 yr 8.72 +/- 0.59%, in children 3-5 yr 8.62 +/-
      0.45%, and in children 5-12 yr 7.98 +/- 0.43%. MAC values obtained using logistic
      regression were similar. Heart rate decreased an average of 16% before skin
      incision in infants 6-12 months of age and children 1-3 and 3-5 yr of age when
      compared to awake values (P less than 0.025) but did not change significantly in
      the remaining three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741519
TI  - Effects of partial paralysis on the swallowing reflex in conscious humans.
AB  - The ability to swallow may be affected by administration of a small dose of
      muscle relaxant. To test the hypothesis that a subparalyzing dose of a muscle
      relaxant can impair swallowing, effects of partial paralysis produced by
      pancuronium on the swallowing reflex were investigated in eight conscious
      subjects. The swallowing reflex was induced by a bolus injection or a continuous
      infusion of distilled water into the mesopharynx. The swallowing function was
      assessed by electromyogram of suprahyoid muscles (EMGSH), mesopharyngeal pressure
      (Pmeso), and hypopharyngeal pressure (Phypo). Peripheral muscle activity was
      simultaneously determined by train of four ratio (TOFR) of hypothenar muscles to
      electrical stimulation of ulnar nerve and by hand grip strength (HGS). Following
      control measurements, measurements during partial paralysis and after recovery
      from partial paralysis were performed after intravenous administration of
      pancuronium 0.02 mg/kg. Partial paralysis significantly depressed EMGSH (bolus
      injection 44.1 +/- 10.0%, continuous infusion 55.9 +/- 10.2% of control value, P
      less than 0.01). Pmeso also significantly decreased (bolus injection 64.9 +/- 6.7
      to 47.8 +/- 5.8 mmHg, P less than 0.01; continuous infusion 63.4 +/- 7.7 to 52.5
      +/- 5.8 mmHg, P less than 0.05). The TOFR of peripheral muscles decreased to 81.4
      +/- 6.7% of control value (P less than 0.01), and HGS was reduced from 44.6 +/-
      1.9 to 39.4 +/- 2.0 kg (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741520
TI  - Isoflurane anesthesia and circadian temperature cycles in humans.
AB  - Cognitive performance in postsurgical patients may be impaired by disturbances of
      normal circadian rhythm analogous to those produced by rapid transmeridian travel
      ("jet lag"). We therefore tested the hypothesis that isoflurane anesthesia alone
      produces a phase-delay in the human circadian temperature rhythm. We monitored
      central body temperature rhythms (using an ingested sensor) in five young,
      healthy, male volunteers at 3-min intervals for a total of 5 days. On the 3rd
      day, 3 h of 1.0% isoflurane anesthesia was administered beginning at
      approximately 10:00 AM. Thiopental, opioids, and other medications were not
      administered; volunteers were kept normothermic during anesthesia. Visual
      inspection of the data confirmed that periodicity of the temperature cycles
      remained near 24 h and that the curve was sinusoidal. Data were fit using a two
      step sine and cosine regression for each 24-h period. Before anesthesia,
      volunteers demonstrated a consistent 24-h cycle, with a mean temperature (mesor)
      of 36.8 +/- 0.2 degrees C, amplitude of 0.8 +/- 0.2 degrees C, and time of
      maximum temperature (acrophase) of 3:06 PM +/- 2.4 h. Isoflurane anesthesia did
      not produce significant changes in the central temperature mesor. Peak-to-trough
      range (amplitude) of the temperature cycle was significantly reduced on the day
      of anesthesia (0.5 +/- 0.2 degrees C) but returned to normal on the subsequent
      day. Compared with the 2 days preceding isoflurane administration, there was no
      statistically significant change in acrophase on the day following anesthesia.
      These data do not support our hypothesis and suggest that the internal timer
      controlling circadian temperature cycles is resistant to clinical concentrations
      of isoflurane.

PMID- 1741521
TI  - Inhaled nitric oxide. A selective pulmonary vasodilator of heparin-protamine
      vasoconstriction in sheep.
AB  - Nitric oxide (NO) has recently been discovered to be an important endothelium
      derived relaxing factor and produces profound relaxation of vascular smooth
      muscle. To learn if NO could be a potent and selective pulmonary vasodilator, NO
      was inhaled by 16 awake lambs in an attempt to reduce the increase in pulmonary
      artery pressure (PAP) and pulmonary vascular resistance (PVR) induced by either
      the infusion of an exogenous pulmonary vasoconstrictor (the thromboxane analog
      U46619) or the endogenous release of thromboxane that occurs during the
      neutralization of heparin anticoagulation by protamine sulfate. Inhaling greater
      than or equal to 40 ppm of NO during a continuous U46619 infusion returned the
      PAP to a normal value, without affecting systemic blood pressure or vascular
      resistance. Pretreatment with the cyclooxygenase inhibitor indomethacin before
      infusing U46619 did not reduce the pulmonary vasodilatory effect of inhaled NO,
      and we conclude that the dilatory effect of NO on the lung's circulation is
      independent of cyclooxygenase products such as prostacyclin. Continuously
      inhaling NO at 180 ppm did not significantly reduce the mean peak thromboxane B2
      concentration at 1 min after protamine injection; however, the mean values of
      pulmonary hypertension and vasoconstriction at 1 min were markedly reduced below
      the levels in untreated heparin-protamine reactions. Breathing NO at lower
      concentrations (40-80 ppm) did not decrease the mean peak PAP and PVR at 1 min
      after protamine but decreased the PAP and PVR values at 2, 3, and 5 min below
      those of control heparin-protamine reactions. Intravenous infusion of
      nitroprusside completely prevented the transient increase of PAP and PVR during
      the heparin-protamine reaction; however, marked concomitant systemic vasodilation
      occurred. Inhaled NO is a selective pulmonary vasodilator that can prevent
      thromboxane-induced pulmonary hypertension during the heparin-protamine reaction
      in lambs and can do so without causing systemic vasodilation.

PMID- 1741522
TI  - Wiener analysis of nonlinear feedback in sensory systems.
AB  - Experimental studies of certain sensory systems (e.g., vertebrate retinal cells
      and auditory fibers) have yielded qualitative evidence of the presence of
      nonlinear feedback. However, no methods have been available to provide the tools
      for quantitative analysis of this nonlinear feedback mechanism and subsequent
      modeling of the overall dynamics of these sensory systems. Recent results offer
      the analytical means to relate Wiener kernel measurements with corresponding
      nonlinear feedback models and, thus, the ability to model the overall dynamics of
      such sensory systems. Furthermore, our analytical results offer an explanation
      for experimentally observed changes in the waveform of Wiener kernel estimates
      obtained for different white-noise input mean and/or power levels.

PMID- 1741523
TI  - Asymptotic approach of generalized orthogonal functional expansions to Wiener
      kernels.
AB  - Wiener-like orthogonal functional expansions may be constructed with respect to
      test ensembles that are non-Gaussian, nonwhite, or both. Although the original
      Wiener expansion has particularly advantageous analytical properties, orthogonal
      expansions constructed with respect to other ensembles have practical advantages
      for laboratory implementation. We show how functional expansions based on two
      classes of input ensembles--white but non-Gaussian discrete noises and the sum of
      sinusoids--converge to the standard Wiener kernels. For discrete noises, the
      disparity between the standard and nonstandard kernels of a linear-static
      nonlinear transducer is proportional to the kurtosis of the input signal and
      inversely proportional to the ratio of the integration time of the linear filter
      to the time discretization. For the sum of sinusoids, the disparity is inversely
      proportional to the effective number of sinusoids passed by the initial linear
      stage.

PMID- 1741524
TI  - Practical identification of functional expansions of nonlinear systems submitted
      to non-Gaussian inputs.
AB  - Time-domain identification of nonlinear systems represented by functional
      expansions is considered. A general framework is defined for the analysis of
      three identification methods: the widely used cross-correlation method,
      Korenberg's method, and a suboptimal least-squares method based on a stochastic
      approximation algorithm. First, the major characteristics of the underlying
      estimation problem are pointed out. Then, the identification methods are
      interpreted as approximations to an optimal estimator, which helps gain insight
      into their internal functioning and to the investigation of their connections and
      differences. Examination of results previously published and of the simulations
      reported in this article indicate that stochastic approximation is an interesting
      alternative to other existing methods. Identification of a biological system
      stimulated by a non-Gaussian input confirms the practicality of this approach.

PMID- 1741525
TI  - Parallel cascade identification and kernel estimation for nonlinear systems.
AB  - We consider the representation and identification of nonlinear systems through
      the use of parallel cascades of alternating dynamic linear and static nonlinear
      elements. Building on the work of Palm and others, we show that any discrete-time
      finite-memory nonlinear system having a finite-order Volterra series
      representation can be exactly represented by a finite number of parallel LN
      cascade paths. Each LN path consists of a dynamic linear system followed by a
      static nonlinearity (which can be a polynomial). In particular, we provide an
      upper bound for the number of parallel LN paths required to represent exactly a
      discrete-time finite-memory Volterra functional of a given order. Next, we show
      how to obtain a parallel cascade representation of a nonlinear system from a
      single input-output record. The input is not required to be Gaussian or white,
      nor to have special autocorrelation properties. Next, our parallel cascade
      identification is applied to measure accurately the kernels of nonlinear systems
      (even those with lengthy memory), and to discover the significant terms to
      include in a nonlinear difference equation model for a system. In addition, the
      kernel estimation is used as a means of studying individual signals to
      distinguish deterministic from random behaviour, in an alternative to the use of
      chaotic dynamics. Finally, an alternate kernel estimation scheme is presented.

PMID- 1741526
TI  - Decomposition of nonlinear non-Gaussian process and its application to nonlinear
      filter and predictor design.
AB  - An approach for decomposing of a Nonlinear Non-Gaussian Process (NNGP) is
      presented. A set of adjoin processes alpha's are first constructed based on the
      orthogonal principle so that the linear and nonlinear part of the process can be
      completely separated by a correlation operation without the statistical
      assumption on the process (i.e., it is not necessarily a Gaussian Process). The
      linear and nonlinear filters or predictors can then be designed and implemented
      independently and the consistency of parameters is guaranteed. An algorithm is
      given for a second order nonlinear process, and it can easily be extended to
      higher order cases if necessary. The method is first demonstrated by applying it
      to a nonlinear filter design problem, i.e., system identification. Finally, the
      necessity of a proposed decomposition procedure is proven by applying it to an
      example in which the parameters of a signal model are extracted from a version
      which is distorted due to the nonlinearity of the channel.

PMID- 1741527
TI  - Dissection of a nonlinear cascade model for sensory encoding.
AB  - Action potential encoding in the cockroach tactile spine neuron may be treated as
      a single-input, single-output dynamic nonlinear process, where the input is the
      electric current flowing across the neuronal membrane and the output is the
      resultant train of action potentials. The nonlinear behavior of the system may be
      characterized by a functional expansion method which efficiently and accurately
      yields similar kernels to the Wiener method. A simple nonlinear cascade
      consisting of sequential dynamic linear, static nonlinear, and dynamic linear
      components was identified and gives a good approximation to the response of the
      neuron to random stimulation. Next, we attempted to study the components of the
      cascade by the use of a drug, phentolamine, which selectively modifies the
      dynamic behavior of the encoder. Application of phentolamine to the neuron caused
      a significant change in the first dynamic linear component of the cascade without
      affecting the other components. The change was much larger than the variability
      between results obtained from individual animals. This finding has implications
      for the biophysical processes which are involved in the components of the
      cascade.

PMID- 1741528
TI  - Interpretation of functional series expansions.
AB  - While much research has been devoted to the implementation and application of
      Volterra and Wiener functional series expansions in the identification and
      characterization of biological systems, little effort has been focused on the
      fundamental problem of interpreting the resulting kernels. This paper describes
      the application of the series to the components of a known model of the human
      pupil control system. As more complicated elements are put together, insight into
      kernel interpretation is built up incrementally until the total system is
      identified. Practical limitations and methods are also discussed.

PMID- 1741529
TI  - The interpretation of kernels--an overview.
AB  - The kernel identification method is a powerful technique for mathematically
      representing the dynamic behavior of a nonlinear system. This technique has been
      applied to a number of physical and physiological systems. An important
      development which has enhanced the usefulness of the kernel method has been the
      interpretation of the internal structure of a system by examining the shapes of
      the higher-degree kernels. Examples of various nonlinear models with known
      structure are illustrated to show a repertoire of kernel shapes. Variations in
      parameters of these models result in well-defined changes in the shapes of the
      kernels. Also, examples are shown of kernels obtained from physiological systems
      to demonstrate how examination of kernel shapes can lead to accurate predictions
      of the dynamic behavior of the physiological system. Finally, limitations of the
      applicable range of the kernel identification method are discussed.

PMID- 1741530
TI  - Cellular engineering.
AB  - Cellular engineering applies the principles and methods of engineering to the
      problems of cell and molecular biology of both a basic and applied nature. As
      biomedical engineering has shifted from the organ and tissue level to the
      cellular and sub-cellular level, cellular engineering has emerged as a new area.
      A cornerstone of much of this activity is cell culture technology, i.e., the
      ability to grow living cells in the artificial environment of a laboratory.
      Cellular engineering includes the role of engineering in both basic cell biology
      research and in the making of products which use living cells, e.g., tissue
      engineering and bioprocess engineering. The former involves the use of living
      cells in the development of biological substitutes for the restoration or
      replacement of function, and the latter the use of living cells to manufacture a
      biochemical product, e.g., through the use of recombinant DNA technology. In
      fact, as biomedical engineering has expanded to include the cellular level, and
      bioprocess engineering has shifted in interest from microbial organisms to
      include mammalian cells, there are intellectual issues in which an interest is
      shared by these two formerly separate areas of engineering activity. Cellular
      engineering thus transcends the field of biomedical engineering.

PMID- 1741531
TI  - Airway insufflation. Increasing flow rates progressively reduce dead space in
      respiratory failure.
AB  - We have previously shown that airway insufflation (AI) reduces dead space (VD)
      and minute ventilation (VL) in patients with respiratory failure, and when used
      chronically leads to lowered and more stable arterial PCO2. The present study was
      designed to measure the effect of increasing AI flow rate on VD and other aspects
      of gas exchange in respiratory failure in order to examine the hypothesis that AI
      exerts its main physiologic effect by progressive reductions of VD. Five patients
      with varying degrees of respiratory failure caused by either restrictive or
      obstructive lung disease were studied by means of the specialized techniques we
      developed to analyze gas exchange during AI. At 1 L/min (as in transtracheal
      oxygenation), at 5 L/min, and 8 L/min, AI produced progressive reductions in VD,
      tidal volume, and VL. Contrary to our previous study, some of these patients
      accompanied the decrease in VD with not only decreases in VL but with slight
      rises in alveolar ventilation (VA) and decrements in arterial PCO2. The greatest
      percentile decreases in VD and VL occurred in those with the smallest initial
      control values for each of these parameters. In summary, AI exerts its main
      effects on gas exchange through the reductions in VD that it produces, and the
      accompanying decreases in VL and/or slight increases in VA seem to stem from the
      latter.

PMID- 1741532
TI  - Nocturnal positive-pressure ventilation via nasal mask in patients with severe
      chronic obstructive pulmonary disease.
AB  - Intermittent positive pressure ventilation administered nocturnally via a nasal
      mask has been associated with improvements in pulmonary function and symptoms in
      patients with restrictive ventilatory disorders. We hypothesized that nocturnal
      nasal ventilation (NNV) would bring about similar improvements in patients with
      severe chronic obstructive pulmonary disease (COPD). The study used a randomized,
      crossover design, with subjects undergoing NNV or "standard care" for sequential
      3-month periods. Of 23 patients with obstructive lung disease and a FEV1 less
      than 1 L who were initially enrolled, 4 were excluded because of obstructive
      sleep apnea prior to randomization. Among the remaining 19 patients, 7 withdrew
      because of intolerance of the nose mask, 5 were withdrawn because of intercurrent
      illnesses, and 7 completed both arms of the protocol. These latter 7 patients
      used the ventilator for an average of 6.7 h/night, and 3 of the 7 had partial
      relief of dyspnea during ventilator use. However, in comparison with studies
      performed upon initiation or after the standard care arm of the study, studies
      performed after 3 months of NNV revealed no improvements in pulmonary function,
      respiratory muscle strength, gas exchange, exercise endurance, sleep efficiency,
      quality or oxygenation, or dyspnea ratings. The only improvements observed were
      in neuropsychological function, possibly related to a placebo effect or another
      unknown mechanism. Despite the small sample size, our study indicates that NNV is
      not well tolerated by and brings about minimal improvements in stable outpatients
      with severe COPD.

PMID- 1741533
TI  - Reliability of noninvasive oximetry in black subjects during exercise and
      hypoxia.
AB  - The effect of skin pigmentation on the reliability of noninvasive oximetry,
      especially during exercise and hypoxia, has not been thoroughly investigated.
      This is the first study, to our knowledge, that specifically addresses this
      question. Thirty-three young black men performed multistage, steady-state cycle
      ergometry, breathing gas mixtures simulating different altitudes: 33 breathed gas
      simulating sea level (PIO2 = 146 mm Hg), 11 breathed gas simulating 2,300 m (PIO2
      = 110 mm Hg), and 22 breathed gas simulating 4,000 m (PIO2 = 85 mm Hg). Co
      oximeter SaO2 determinations were performed in arterial blood samples obtained
      concurrently with ear oximetry that was measured using Hewlett-Packard 47201A
      (HP) and Blox IIA oximeters. The mean error or bias for the [HP - SaO2] and for
      [Biox IIA - SaO2] +/- 95% CI were: at simulated sea level (SaO2 greater than
      96%): -0.4 +/- 0.3% and 2.1 +/- 0.3%; at simulated 2,300 m (range of SaO2 means,
      89 to 94%): -0.8 +/- 0.5% and 3.5 +/- 0.9%; for simulated 4,000 m (range of SaO2
      means, 75 to 84%): -4.8 +/- 1.6% and 9.8 +/- 1.8%, respectively. A better
      coefficient correlation was observed for all the pairs between SaO2 versus HP (r
      = 0.94, p less than 0.001, n = 279) than for the SaO2 versus Biox IIA (r = 0.80,
      p less than 0.001, n = 242). In conclusion, the HP oximeter appears to estimate
      SaO2 more accurately than the Biox IIA oximeter. The previously described
      overestimation for the Biox IIA ear oximeter and the underestimation for the HP
      ear oximeter at low SaO2 values in whites is exaggerated in blacks.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1741534
TI  - Effect of theophylline on lung function tests, sleep quality, and nighttime SaO2
      in children with cystic fibrosis.
AB  - The effect of theophylline (T) was studied in 12 children with cystic fibrosis
      (CF) (seven males and five females) aged 7 to 17 yr (mean, 11.8 +/- 2.8). T or
      placebo (P) was taken for 10 days in a double-blind, crossover controlled trial.
      During Nights 9 and 10 of each study period, the subjects slept in a sleep
      laboratory, where complete polysomnographs were recorded. Patients were
      subdivided according to T blood levels above or below 10 micrograms/ml: five
      children had a mean serum T of 11.7 +/- 1.6 micrograms/ml (Group 1), and seven
      patients had serum T levels of 6.7 +/- 1.5 micrograms/ml (Group 2). There was no
      difference in pulmonary function between the two periods, but Group 2 had
      significantly better baseline lung function (p less than 0.01). During sleep
      while on T, Group 1 had a higher mean SaO2 (93.1 +/- 0.3% T versus 90.7 +/- 0.3%
      P; p less than 0.0001), less time with a decrease greater than 5% in SaO2 from
      baseline (43.7 +/- 7.9 min T versus 85.8 +/- 7.9 min P; p less than 0.01), and a
      lower heart rate (HR), (77.9 +/- 5.1 bpm T versus 86.1 +/- 4.2 bpm P; p less than
      0.01). Group 2 did not show differences in these parameters. T significantly
      disrupted sleep as measured by sleep efficiency and total wake time independently
      of serum level (p less than 0.01). There was no significant effect of T on the
      incidence of apnea, hypopnea, or body movements during sleep.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1741535
TI  - Effects of theophylline on canine diaphragmatic contractility and fatigue.
AB  - To distinguish the effects of theophylline on respiratory muscle contractility
      from alterations in respiratory muscle interaction or blood flow, we examined in
      vitro contractile properties and fatigue of canine diaphragm in two series of
      experiments. In the first series, a 40-mg/kg aminophylline infusion was given to
      dogs, and diaphragm strips were removed for in vitro study when stable tissue
      fixation of the drug was reached. Compared with control bundles examined before
      aminophylline infusion, no alterations in twitch tension, tetanic tension, or
      force-frequency characteristics were observed. Moreover, theophylline-treated
      strips fatigued faster than control strips, whether subjected to repetitive
      submaximal or maximal contractions (p less than 0.01). In the second series,
      diaphragm bundles were equilibrated with high theophylline doses (400 mg/L) in
      vitro, and inotropic effects compared with the results in the first series.
      Supratherapeutic theophylline concentrations increased force development at low
      stimulation frequencies (p less than 0.05 at 10 Hz) and significantly elevated
      twitch-tetanus ratio (p less than 0.01) but did not protect against development
      of in vitro muscle fatigue. Poor penetration of theophylline in diaphragm bundles
      in vitro was excluded, since drug concentrations in the muscle bundle and the
      muscle bath were virtually equal. We conclude that diaphragmatic tissue
      concentrations correlate well with therapeutic serum and supratherapeutic bath
      levels and that only high theophylline concentrations increase canine
      diaphragmatic contractility in vitro. None of the theophylline concentrations
      studied could protect diaphragm bundles against the development of low- or high
      frequency fatigue in vitro.

PMID- 1741536
TI  - Diagnosis of sleep-disordered breathing by half-night polysomnography.
AB  - We hypothesized that sleep-disordered breathing (SDB), defined by the apnea index
      (AI), the apnea + hypopnea index (A + H/I), or the desaturation event frequency
      (number of desaturations greater than 5%/h slept) (DEF), could be diagnosed after
      less than full-night polysomnography (PSG). Forty-eight consecutive full-night
      PSG sessions were evaluated by separately analyzing the first half (PSG-1/2) and
      the total (PSG-T) sleep time: 134.42 +/- 35.7 and 277.15 +/- 56.5 min (mean +/-
      SD), respectively. PSG-1/2 and PSG-T were not different with respect to AI. The
      DEF was statistically but not clinically higher during PSG-1/2 (41.72 +/- 41
      versus 37.95 +/- 35.8, p = 0.04). Sensitivities, specificities, and predictive
      values of each PSG-1/2 parameter were determined by comparing the values with
      those measured during PSG-T, using cutoff frequencies of both 5 and 10 events/h
      slept to define SDB. At a cutoff frequency of 10, sensitivities and positive
      predictive values were high for all PSG-1/2 parameters (range, 94.6 to 96.9%).
      The specificities of the DEF and AI during PSG-1/2 were also high (93.75 and 95%,
      respectively), but the negative predictive value of the DEF was substantially
      better (93.75 versus 83.3%). With SDB defined by 5 events/h slept, there also
      were high sensitivities (87.9 to 93%), positive predictive values (93.6 to 100%),
      and specificities (86.7 to 100%) for all parameters. Negative predictive values,
      however, were substantially reduced (62.5 to 76.5%). We conclude that PSG during
      2 h of sleep is an appropriate method for evaluating SDB.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1741537
TI  - Time course and calcium dependence of sustained bronchoconstriction induced by
      deep inhalation in asthma.
AB  - We studied six asthmatic patients who showed a progressive decrease in FEV1 when
      successive forced expiratory maneuvers were performed at 1-min intervals. We
      determined the time course of changes in specific airway conductance following a
      single deep inhalation (DI) and the ratio of maximum expiratory flow at 40% of
      FVC from maximal and partial flow-volume curves (MEF40M/P) during a series of
      forced expiratory maneuvers. Specific airway conductance measured 3 s after DI
      was increased by 11 +/- 6 (SE)%, which was not significantly different from an
      increase of 23 +/- 8% observed in six healthy control subjects. Later (i.e., 10
      to 40 s after DI) specific airway conductance was significantly less than the pre
      DI value in asthmatic but not in healthy subjects. Mean FEV1 decreased
      significantly by 28% from the first to the eighth forced expiratory maneuver
      performed during a period of 15 min, whereas MEF40M/P was not significantly
      changed and remained always significantly greater than 1. The voltage-dependent
      calcium channel antagonist nifedipine significantly prevented the reduction of
      FEV1 without affecting MEF40M/P. We conclude that, in some asthmatic individuals,
      DI may induce a transient bronchodilatation followed by a calcium-dependent
      sustained bronchoconstriction. We suggest that the initial bronchodilatation is
      due to the mechanical interdependence between airways and lung parenchyma,
      whereas the sustained bronchoconstriction is due to contraction of the airway
      smooth muscle.

PMID- 1741538
TI  - Immediate and late airway response of allergic rhinitis patients to segmental
      antigen challenge. Characterization of eosinophil and mast cell mediators.
AB  - Segmental antigen bronchoprovocation was used to define the nature of the
      inflammatory process in allergic airway disease. Bronchoalveolar lavage fluid
      obtained from allergic rhinitis patients 12 min after segmental antigen
      instillation (immediate response) revealed a significant increase in histamine
      and tryptase, but no cellular response. Repeat segmental lavage 48 h later (late
      response) showed marked and significant increases in both low and normal density
      eosinophils as well as striking elevations of eosinophil granular protein levels
      (major basic protein, eosinophil-derived neurotoxin, eosinophil cationic protein,
      and eosinophil peroxidase). Leukotriene C4, but not tryptase, concentrations were
      also consistently elevated in late lavage samples. Further, the late lavage
      samples showed a significant increase in interleukin-5 concentrations that
      correlated with the presence of eosinophils and eosinophil granular proteins.
      Neither eosinophils nor soluble mediators of eosinophils increased when normal
      subjects were similarly challenged with antigen. These data suggest that
      eosinophils are attracted to the airway during the late-phase allergic reaction
      and that IL-5 may produce changes in airway eosinophil density and promote the
      release of granular proteins to cause airway injury.

PMID- 1741539
TI  - Increased numbers of mast cells in bronchial mucosa after the late-phase
      asthmatic response to allergen.
AB  - We examined the characteristics of allergen-induced inflammation of the bronchial
      mucosa in asthmatic patients. Studies were carried out 4 h (eight patients) and
      24 h (nine patients) after allergen inhalation challenge; 10 patients were not
      challenged and served as control subjects. We found that in the control group the
      ratio of degranulating to granulated mast cells was higher in patients with than
      in patients without late-phase response. In patients studied 4 h after allergen
      challenge the total number of mast cells was not significantly different from
      that in control subjects; the ratio of degranulating to granulated mast cells was
      increased similarly in patients with and without late-phase response. Among
      patients studied 24 h after allergen challenge, those who had developed the late
      phase response had an increased (p less than 0.05) number of mast cells as
      compared with patients who had not developed the late-phase response, the number
      of mast cells was significantly correlated with the severity of the late-phase
      response (r = 0.80; p less than 0.001). The numbers of eosinophils and
      mononuclear cells and the morphologic abnormalities of bronchial structure
      (altered ratio of cylindrical to goblet cells, thickening of the basement
      membrane, and edema and angiectasis of lamina propria) were similar in the
      different groups of patients. We conclude that the inflammatory events leading to
      the development of the late-phase asthmatic response to allergen represent a
      stimulus for an increase in the number of mast cells in the bronchial mucosa.

PMID- 1741540
TI  - The effect of antioxidants on ozone-induced airway hyperresponsiveness in dogs.
AB  - The role of oxygen radicals in causing ozone-induced airway hyperresponsiveness
      in dogs was examined by pretreating dogs with allopurinol and/or deferoxamine
      mesylate (desferal), which are inhibitors of oxygen radical generation, before
      ozone inhalation. Acetylcholine airway responsiveness was measured before and
      after either air or ozone inhalation (3 ppm for 20 min) on 5 experimental days
      separated by at least 2 wk. On each day, the dogs were pretreated intravenously
      with allopurinol (50 mg/kg) followed by inhaled desferal (1,000 mg inhalation) or
      with allopurinol followed by the diluent for desferal or with the diluent for
      allopurinol and desferal or with both diluents. The effect of ozone on
      acetylcholine airway responsiveness was expressed as the differences in the log
      transformed preozone-postozone acetylcholine provocative concentrations. When
      dogs received both diluents or either treatment alone, ozone inhalation caused
      airway hyperresponsiveness. The mean log differences for the preozone-postozone
      acetylcholine provocative concentration were 0.804 (SEM, 0.17) for both diluents,
      0.524 (SEM, 0.16) for allopurinol alone, and 0.407 (SEM, 0.22) for desferal
      alone. However, the combination of allopurinol and desferal significantly
      inhibited the development of ozone-induced airway hyperresponsiveness, the log
      difference being 0.195 (SEM, 0.11) (p less than 0.05), without inhibiting ozone
      induced neutrophil influx into the airways. The results suggest that the
      production of oxygen radicals is important in the pathogenesis of ozone-induced
      airway hyperresponsiveness.

PMID- 1741541
TI  - Lipid mediators contribute to oxygen-radical-induced airway responses in sheep.
AB  - The purpose of this study was to determine if the bronchoconstriction and airway
      hyperresponsiveness (AHR) resulting from aerosolized xanthine (x; 0.1%)-xanthine
      oxidase (xo; 4.1 U) and the subsequent production of oxygen radicals is mediated
      by the secondary generation of lipid mediators. In seven conscious sheep,
      specific lung resistance (SRL) was measured before and after x-xo challenge;
      approximately 30 min later when SRL had returned to baseline, airway
      responsiveness to carbachol was determined from dose-response curves by
      calculating the cumulative provocating dose of carbachol in breath units (BU,
      defined as one breath of a 1% wt/vol carbachol solution) that increased SRL 400%
      over baseline (PD400). Inhaled x-xo caused in immediate increase in SRL of 162 +/
      36% (mean +/- SE; p less than 0.05) over baseline and decreased PD400 from a
      baseline value of 32.5 +/- 5.0 to 16.6 +/- 1.7 BU (p less than 0.05).
      Pretreatment with the H2O2 scavenger, catalase (CAT,; 38 mg aerosol),
      methylprednisolone succinate (MS; 1 mg/kg given intravenously), the
      cyclooxygenase inhibitor, indomethacin (IND; 2 mg/kg given intravenously), and
      the PAF antagonist, WEB-2086 (3 mg/kg given intravenously) all attenuated the x
      xo-induced increase in SRL (p less than 0.05); the leukotriene D4 antagonist, MK
      571 (5 mg by aerosol) had no effect. All agents inhibited the x-xo-induced
      decrease in PD400: mean BUs were 27 after CAT, 32 after WEB-2086, 34 after IND,
      31 after MS, and 25 after MK-571 (all p less than 0.05 versus x-xo
      alone).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741542
TI  - Interacting effects of atopy and bronchial hyperresponsiveness on the annual
      decline in lung function and the exacerbation rate in asthma.
AB  - The relationship between atopy and bronchial hyperresponsiveness (BHR) on the one
      hand and the annual rate of decline in FEV1 and the annual exacerbation rate on
      the other was studied in 71 adult patients with asthma during a period of 2 yr.
      Atopy (based on seven RAST tests) and BHR (PC20-histamine) were assessed at the
      start of the 2-yr follow-up period, and they were related to the decline in FEV1
      (FEV1 slope) and the exacerbation rate. The results indicated that BHR was
      related to the FEV1 slope independently of the FEV1 level. The mean
      prebronchodilator FEV1 slope was -94 ml/yr (-39 to -149 ml/yr) in patients with
      PC20 less than or equal to 2 mg/ml and -21 ml/yr (+34 to -76 ml/yr) in patients
      with PC20 greater than 2 mg/ml. Atopy alone was not related to the FEV1 slope.
      However, in atopic patients BHR was related to a more pronounced FEV1 slope than
      in nonatopic patients. The slope of the postbronchodilator FEV1 was comparable
      with the slope of the prebronchodilator FEV1, which may indicate that the loss of
      FEV1 was not only due to increased bronchospasm but also to fixed obstruction.
      BHR and atopy were not associated with the exacerbation rate. Asthmatic patients
      with atopy and marked BHR should be looked upon as patients with a risk of
      developing progressive airflow obstruction.

PMID- 1741543
TI  - Evaluation of chronic bronchitis, chronic obstructive pulmonary disease, and
      ventilatory function among workers exposed to 2,3,7,8-tetrachlorodibenzo-p
      dioxin.
AB  - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is produced as an undesirable
      contaminant in the manufacture of 2,4,5-trichlorophenol (TCP) and its
      derivatives. There is considerable concern about the health effects that may be
      associated with exposure to TCDD-contaminated substances. A cross-sectional
      medical study that included a comprehensive medical history, medical examination,
      and measurement of pulmonary function was conducted on workers employed more than
      15 yr earlier in the manufacture of NaTCP and its derivatives at two chemical
      plants. The workers had substantial exposure to substances contaminated with
      TCDD, as evidenced by a mean serum TCDD level, lipid adjusted, of 200 ppt
      compared with a mean of 7 ppt in the unexposed reference group. The comparison
      group consisted of individuals with no occupational exposure to phenoxy
      herbicides who lived in the same communities as the workers. A total of 281
      workers and 260 unexposed referents participated in the medical examination.
      Logistic and linear regression analyses, which contained categorical and
      continuous measures of TCDD exposure, were performed to control for important
      confounders, including cigarette and alcohol consumption. No difference was found
      between workers and referents in the risk for chronic bronchitis or COPD.
      Analysis of the ventilatory function data revealed no association between history
      of exposure to substances contaminated with TCDD and the forced expiratory volume
      at one second (FEV1), forced vital capacity (FVC), or the ratio of FEV1 to FVC
      (FEV1/FVC%).

PMID- 1741544
TI  - Grain dust and lung function. Dose-response relationships.
AB  - Grain dust exposure has been associated with both acute and chronic respiratory
      abnormalities. We sought to answer two questions with regard to this exposure:
      (1) is there a dose-response relationship between grain dust and respiratory
      abnormalities, and (2) is there evidence to suggest that the allowable exposure
      (currently 10 mg/m3 in Canada) be lowered? We compared respiratory symptoms and
      lung function among 454 grain elevator workers and 55 civic workers to estimates
      of lifetime average grain dust exposure. A total of 781 personal air samples
      representing 20 different job titles over a 15-yr period were used to construct a
      job title-time period matrix for average dust exposure levels. The matrix was
      applied to each worker's detailed job history to obtain a value for estimated
      cumulative and average dust exposure. Significant dose-response relationships
      were seen for chronic phlegm production, breathlessness on exertion, FEV1, and
      FVC; and dose-response trends were evident for the longitudinal change in both
      FEV1 and FVC. Workers with estimated average exposure between 4 and 9 mg/m3 were
      found to have significantly lower values for FEV1 and FVC compared to both grain
      workers exposed to less than 4 mg/m3 on average and civic workers, despite no
      difference in duration of employment among these groups. The results indicate a
      strong dose-response relationship between grain dust exposure and both
      respiratory symptoms and lung function and also suggest that the current Canadian
      allowable exposure level of 10 mg/m3 is too high.

PMID- 1741545
TI  - Correlation of clinical and immunologic parameters of the inflammatory activity
      of pulmonary sarcoidosis.
AB  - The evaluation of activation markers such as T4/T8 ratio and HLA-DR expression of
      lymphocytes of bronchoalveolar lavage (L-BAL) is an important clinical approach
      for the staging of sarcoidosis. However, it is not known to what extent this is
      paralleled by an exaggerated lymphocyte function. We investigated the dependence
      of L-BAL activation markers on the production of interleukin-2 (IL-2) by L-BAL
      and on the soluble IL-2 receptor serum level (sIL-2R) in 116 patients with
      sarcoidosis. In none of the combinations tested was a correlation between the two
      groups of parameters found; r less than 0.5, upper 90% confidence limit of r less
      than 0.8. Interestingly, IL-2 production is independent of HLA-DR+ T4 L-BAL, and
      sIL-2R production is independent of the percentage of IL-2+ L-BAL. Our data
      indicate that the L-BAL activation markers and the functional activity of T-cells
      represent independent phenomena.

PMID- 1741546
TI  - Bronchoalveolar lavage cell data in alveolar proteinosis.
AB  - In bronchoalveolar lavage fluid (BAL) from nine patients with alveolar
      proteinosis (AP), total and differential cell count and T-lymphocyte phenotyping
      were done and compared with those in 12 healthy volunteers comparable as to age
      and tobacco consumption. Although total cell count was not significantly
      different from that in control subjects, the most prominent feature in patients
      was an increase in the number of CD4 and CD8 T-lymphocytes within the alveoli.
      Conversely, the macrophage population was significantly reduced. The ratio of
      CD4/CD8 T-lymphocytes tended to be high, but this increase did not reach
      statistical significance. The pathophysiologic mechanism and the meaning of these
      alveolar cell changes in AP remain to be elucidated.

PMID- 1741547
TI  - Increased lung clearance of 99mTcDTPA in allograft lung rejection. The Paris-Sud
      Lung Transplant Group.
AB  - To investigate whether lung 99mTc-DTPA clearance is altered during allograft lung
      rejection, a group of four double lung and 24 heart-lung transplant patients was
      studied using serial measurement of the clearance rate of aerosolized 99mTc-DTPA
      (DTPA-Cl), in association with pulmonary function tests, bronchoalveolar lavage,
      and transbronchial lung biopsies. Using histologic diagnosis as a standard, we
      compared 56 episodes with normal lung histology to 32 episodes with allograft
      lung rejection. A control group of 20 healthy nonsmokers was used to define
      normal DTPA-Cl. In patients with normal lung histology, DTPA-Cl was higher than
      in control subjects (2.62 +/- 0.25 versus 1.20 +/- 0.12 %/min; p less than
      0.001). In the episodes of allograft lung rejection, DTPA-Cl increased to 3.65 +/
      0.41 %/min (p less than 0.02) as compared with episodes of normal lung
      histology. The change in DTPA-Cl during allograft lung rejection was correlated
      (r = 0.3, p less than 0.01) with the increased percentage of lymphocytes in
      bronchoalveolar lavage (27.8 +/- 3.5% in rejection versus 19.9 +/- 2.2% in normal
      histology; p less than 0.02). Sensitivity and specificity of DTPA-Cl measurement
      in detecting lung rejection were 69 and 82%, respectively, versus 45 and 85% for
      FEV1 measurement. These results suggest that DTPA-Cl monitoring could be used in
      conjunction with pulmonary function testing as a noninvasive approach for the
      detection of lung rejection.

PMID- 1741548
TI  - Role of platelet-activating factor in mediating tumor necrosis factor alpha
      induced pulmonary vasoconstriction and plasma-lymph protein transport.
AB  - We assessed the role of platelet-activating factor (PAF) in mediating the
      pulmonary hemodynamic and lymph flow responses to tumor necrosis factor-alpha
      (TNF alpha). The effects of the PAF receptor antagonist WEB 2086 on TNF alpha
      induced pulmonary vasoconstriction and increased pulmonary transvascular plasma
      lymph protein transport were examined. Control (n = 7) and WEB-2086-pretreated (n
      = 7) sheep prepared with chronic lung lymph fistulas were challenged with
      recombinant human TNF alpha (12 micrograms/kg over 0.5 h). Ex vivo challenge of
      platelet-rich plasma (PRP) with 10(-8) M PAF resulted in aggregation of platelets
      from control TNF-challenged sheep, but not of platelets from WEB-treated sheep
      similarly challenged with TNF. The control TNF-alpha-challenged sheep developed
      hemoconcentration, leukopenia, and neutropenia. TNF alpha resulted in increases
      in pulmonary arterial pressure (Ppa) and pulmonary vascular resistance (PVR)
      within 15 min, and the values were sustained for the 5-h experiment duration.
      Pulmonary lymph flow (Qlym) and pulmonary transvascular protein clearance rate
      (Qlym x lymph-to-plasma protein concentration) were increased within 30 min and
      remained elevated for 5 h. The WEB-2086-treated sheep developed similar
      leukopenia and neutropenia after TNF alpha challenge, but the initial increases
      in Ppa and PVR were significantly reduced (p less than 0.05). However, WEB 2086
      did not prevent the threefold increases in Qlym and transvascular protein
      clearance induced with TNF alpha.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741549
TI  - Isoniazid preventive therapy for tuberculosis. Decision analysis considering
      ethnicity and gender.
AB  - The decision to prescribe or withhold isoniazid (INH) preventive therapy for low
      risk tuberculin reactors has been highly controversial, primarily due to
      isoniazid's possible hepatotoxic effects. Previous analyses have explored the INH
      decision only from the perspective of patient age, recognizing that the risks of
      INH-induced hepatotoxicity are age related. Decision analyses presented in this
      paper assess the impact of gender and ethnic group, as well as age, on the INH
      decision. Results for low-risk patients favor prescribing INH preventive therapy
      for all 20-yr-olds, all 35-yr-olds except black women, and no 50-yr-olds,
      projecting life expectancy benefits that range from 3 to 19 days. A comparison
      set of analyses performed for high-risk patients favors prescribing INH for all
      groups except 50-yr-old black women. These findings suggest that ethnicity,
      gender, and age should be considered when making the decision to prescribe or
      withhold INH preventive therapy.

PMID- 1741550
TI  - Detection of human T-cell lymphotropic virus type I-related antibodies in
      patients with lymphocytic interstitial pneumonia.
AB  - Lymphocytic interstitial pneumonia (LIP) is a rare form of interstitial pneumonia
      with infiltration of mononuclear cells in the interstitium, the pathogenesis of
      which is unknown. We studied six patients with LIP to investigate the immunologic
      characteristics of lymphocytes in the lower respiratory tract and the possible
      involvement of human T-cell lymphotropic virus type I (HTLV-I), which is endemic
      in the southwestern region of Japan. Lymphocyte surface antigen phenotyping in
      peripheral blood (PB) and bronchoalveolar lavage fluid (BALF) cells revealed a
      predominance of CD8 positive (suppressor/cytotoxic) T-lymphocytes (PB: 51.5 +/-
      0.8%; BALF: 52.9 +/- 12.7%), which consisted of an increased number of CD8
      positive CD11 negative (cytotoxic) T-lymphocytes (PB: 30.2 +/- 10.5%; BALF: 57.1
      +/- 11.8%). The increased number of cytotoxic T-lymphocytes among patients with
      LIP led us to investigate the possible involvement of HTLV-I, EB virus, and HIV
      in patients with chronic interstitial disorders of LIP, sarcoidosis, and IPF. The
      seropositivity rate for HTLV-I was 83.7% (5/6) in patients with LIP, 3.1% (1/28)
      with IPF, 7.1% (2/28) with sarcoidosis, and 0% (0/28) in healthy volunteers. None
      of the patients were seropositive for either HIV or EB virus. These results
      suggest that HTLV-I may be involved in a direct or indirect role in the
      pathologic mechanisms through the host immune reaction to the antigenicity of the
      virus and/or the possible involvement of viral regulatory genes to disrupt the
      normal immune reaction of the host.

PMID- 1741551
TI  - Immunohistopathology of murine pulmonary histoplasmosis during normal and
      hypersensitive conditions.
AB  - Pulmonary histoplasmosis was induced in nonimmunized and immunized Balb-C nu/+
      mice. The lung tissue burden of H. capsulatum, histopathology, the size of the
      inflammatory area, and the numbers of total T lymphocytes and subtypes in situ
      were evaluated serially after challenge. Over 3 days previously immunized mice
      developed a large lymphocyte/macrophage inflammatory response. This rapidly
      decreased in the next 2 wk. In contrast, the nonimmunized control mice developed
      a predominantly polymorphonuclear infiltrate that evolved more slowly over the
      first week of infection. This initial response was nonspecific but, after the
      first week, shifted to lymphocytes and granuloma formation. The lymphocyte
      infiltration in both immunized and nonimmunized mice was predominantly CD4.
      Previously immunized mice had a rapid decrease in tissue counts of H. capsulatum
      after Day 3, but nonimmunized mice continued to have increased counts through Day
      7 after infection. These studies reproduce in the mouse model a host response
      similar to acute reinfection histoplasmosis in the human. In this condition an
      intense cell-mediated inflammatory response is thought to be elicited by fungal
      antigens and to represent host reaction rather than fungal replication. Our
      experimental model added new information relevant to the understanding of the
      pathogenesis of this process.

PMID- 1741552
TI  - Surfactant protein A, phosphatidylcholine, and surfactant inhibitors in
      epithelial lining fluid. Correlation with surface activity, severity of
      respiratory distress syndrome, and outcome in small premature infants.
AB  - Although surfactant deficiency at birth is the major cause of respiratory
      distress syndrome (RDS), there is insufficient data on surfactant and surfactant
      inhibitors after birth. In the present study, a total of 345 airway specimens
      (AS) from 61 neonates of gestational age of 24 to 29 wk (54 with RDS) were
      analyzed for concentrations of phosphatidylcholine (PC), saturated PC (SPC),
      surfactant protein A (SP-A), nonsedimentable protein, and free amino acids in
      epithelial lining fluid (ELF). The relationship between surfactant indices,
      surface activity, and severity of RDS was studied. Treatment with human
      surfactant containing SP-A increased [PC]ELF and [SPC]ELF to levels found in
      infants without RDS. In placebo-treated infants similar concentrations were first
      reached between Days 4 and 7. Surfactant treatment increased the low SP-A/SPC
      ratio, although this ratio remained lower than that in exogenous surfactant. In
      RDS, the concentrations of free amino acids in ELF were 6 to 31 times higher than
      in infants without RDS. The nonsedimentable proteins of AS and cationic amino
      acids increased the minimum surface tension of SP-A-deficient surfactant from AS.
      Addition of SP-A improved the surface activity. According to multiple regression
      analysis, In [PC]ELF (p less than 0.0001), SPC/PC ratio (p less than 0.0001), In
      SP-A/SPC ratio (p less than 0.0002), and [protein]ELF (p less than 0.01)
      correlated with alveolar-arterial oxygen pressure gradient. Of the infants
      weighing less than 1,000 g, those who were going to die or develop
      bronchopulmonary dysplasia had a strikingly lower SP-A/SPC ratio during the first
      week (less than 25 ng/nmol) than those surviving without BPD.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1741553
TI  - Centrilobular and panlobular emphysema in smokers. Two distinct morphologic and
      functional entities.
AB  - In order to investigate the hypothesis that different morphologic patterns of
      disease might correspond to different mechanical properties of the lung in
      emphysema, pulmonary function tests and lung mechanics were measured in 34
      subjects undergoing lung resection for peripheral lung tumors. Using standard
      microscopic criteria, pure or predominant centrilobular (n = 18) or panlobular (n
      = 16) emphysema was diagnosed in lungs. The degree of emphysema measured by the
      mean linear intercept (Lm) was not significantly different between the two
      groups. However, the coefficient of variation of the interalveolar wall distance
      (CV) was significantly higher for the same Lm in CLE than in PLE. This indicates
      that CLE has an uneven pattern of destruction, whereas PLE is more homogeneous.
      CLE had a higher degree of abnormalities in the small airways (SAD) than did PLE
      (p less than 0.05) mainly because of significantly higher muscle score (p less
      than 0.001) and fibrosis. CLE also had a higher proportion of airways less than
      400 microns in diameter than did PLE (p less than 0.05). Static compliance,
      specific compliance, and the exponential constant (K) were significantly lower (p
      less than 0.005, p less than 0.001, and p less than 0.05, respectively) in CLE
      than in PLE. FEV1/FVC was significantly correlated with SAD in CLE (r = -0.69, p
      less than 0.01) but not in PLE (r = 0.29 p greater than 0.05); conversely,
      FEV1/FVC was significantly correlated with elasticity (K) in PLE (r = -0.72, p
      less than 0.01) but not in CLE (r = 0.08, p greater than 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1741554
TI  - Neuropeptides in the respiratory tract. Part II.

PMID- 1741555
TI  - Columnar papilloma of the bronchus. Case report and literature review.
AB  - Solitary papillomas are rare endobronchial neoplasms that are most commonly lined
      by a squamous epithelium (i.e., squamous papillomas). Papillomas exhibiting
      nonsquamous epithelium are even more unusual; only seven solitary papillomas
      lined by columnar epithelium (i.e., columnar papillomas) have been previously
      described. The current report presents the eighth patient with a columnar
      papilloma and demonstrates some features common to solitary papillomas (i.e.,
      central location in the airways, associated atelectasis), but distinctive from
      squamous papillomas (i.e., absence of malignant potential).

PMID- 1741556
TI  - Hyperthyroidism induced by iodinated glycerol.
AB  - We report a case of iodide-induced thyrotoxicosis after the use of iodinated
      glycerol (Organidin) for the symptomatic treatment of chronic obstructive
      pulmonary disease. In patients with severe chronic obstructive pulmonary disease,
      symptoms of hyperthyroidism may be overlooked. Hyperthyroidism may be induced by
      any iodinated expectorant, especially in patients with preexisting thyroid
      disease.

PMID- 1741557
TI  - Evaluation of the float sign for determining adequacy of specimens obtained with
      transbronchial biopsy.
AB  - This study prospectively evaluated the alveolar content of transbronchial biopsy
      specimens based on whether or not they floated in formalin. One hundred biopsy
      specimens were obtained from 18 patients. Specimens with any alveoli were
      significantly more likely to float (45 of 61, 74%) than those with no alveolar
      tissue (15 of 39, 39%; p less than 0.001). The majority of diagnostic specimens
      were obtained in eight patients with sarcoidosis, where 47 biopsies were
      obtained. Fourteen of 19 specimens (74%) with noncaseating granulomas floated,
      whereas only 11 of 28 (39%; p less than 0.05) nondiagnostic specimens floated.
      The results of this study suggest that this simple bedside observation may serve
      to determine the adequacy of transbronchial biopsy specimens, particularly in
      sarcoidosis.

PMID- 1741558
TI  - Chlamydia pneumoniae, strain TWAR, infection in patients with chronic obstructive
      pulmonary disease.
AB  - TWAR, the only known serovar of Chlamydia pneumoniae, is a newly described
      bacterium that has been identified as a cause of both epidemics and endemic cases
      of pneumonia. The role of TWAR infection in patients with chronic obstructive
      pulmonary disease (COPD) is not known. We conducted a prospective study to
      establish whether TWAR infection is a common cause of acute exacerbations of
      COPD. We studied two groups of patients: 44 patients admitted to the hospital
      with acute exacerbations of COPD, and 65 stable clinic patients with COPD. We
      found that evidence of acute TWAR infection was infrequent in patients with
      exacerbations (5%). In contrast, the majority of patients from both groups had
      serologic evidence of previous TWAR infection (77%). This was not significantly
      greater than the prevalence found in a small group of patients of similar age and
      sex without lung disease from the same institution (73%). TWAR was not isolated
      from the oropharyngeal specimens obtained from 97 subjects, suggesting that it
      does not colonize the respiratory tract of patients with COPD. This study shows
      that at the time of low incidence in the community, acute TWAR infection is
      uncommon in patients with acute exacerbations of COPD. The majority of patients
      with COPD have, however, been infected with TWAR in the past. The clinical
      manifestations of these infections are not known and should be the focus of
      further studies.

PMID- 1741559
TI  - NHLBI workshop summary. Hyperbaric oxygenation therapy.

PMID- 1741560
TI  - Do patients with obstructive sleep apnea have thick necks?

PMID- 1741561
TI  - Chronic airflow limitation in South African gold miners.

PMID- 1741562
TI  - [Maternal-fetal integration of thyroid hormones].

PMID- 1741563
TI  - [Concept and therapeutic management of precocious puberty].

PMID- 1741564
TI  - [Immunology of diabetes].

PMID- 1741565
TI  - [Immunology of diabetes. Pathogenic bases].

PMID- 1741566
TI  - [Immunology of diabetes. Immunologic markers].

PMID- 1741567
TI  - [Molecular analysis of the androgen receptor gene in androgen resistance
      syndrome].

PMID- 1741568
TI  - [Classification of infantile acute non-lymphoblastic leukemia and prognostic
      correlations].

PMID- 1741569
TI  - [Medical audit of the clinical history of the infantile population treated at a
      primary care facility].
AB  - Authors present qualitative and quantitative results of a health quality
      assurance study of pediatric population in primary care. Ten criteria were
      accepted by consensus and level of 90% of fulfilling was taken as optimal
      standard. None of the criteria reached that level. The best fulfilled ones were
      those referring to pregnancy (89%), vaccination (87.7%), lactancy (87%), weight
      at birth (86.7%), parturition (84%) and newborn period (82%). Among qualitative
      results most remarkable were vaccination coverage (95.7%), length of breast
      feeding (1-3 months, 60.6%) and untimely introduction of cereals with gluten
      (35.4%) and full-fat cow milk (50.3%). Authors consider that this kind of study
      is useful in primary care centers. It is necessary to include health care quality
      assurance activities among basic goals of these centers.

PMID- 1741570
TI  - [Evolution of the treatment of acute nonlymphoblastic leukemias in children (1968
      1990)].
AB  - Changes in treatment of ANLL in children over 23 years (1968-90) and advances
      made in the last ten years in a pediatric hematological unit are reported herein.
      Of 124 patients under 15 years of age, 18 of whom were infants, 118 were
      evaluable. Of these, 58 were treated before 1980 and, although complete remission
      (CR) was attained in 75%, the median duration was lower than 12 months and no
      patient survived in CR more than 6 years. From 1981 to 1987, 40 patients received
      one or two induction treatments followed by three consolidations and then blocks
      of sequential intensive chemotherapy for 12-15 months. CR was attained in 87.5%
      and event-free survival (EFS) was 22.5% at 8 years: 14% for those treated from
      1981 to 1983 and 33% for those included in the ANLL-84 protocol. In 1988, a post
      remission protocol with intensification therapy (two high-dose ARA-C treatments
      combined with mitoxantrone in the first and amsacrine in the second) followed by
      allogeneic or autologous bone marrow transplant (BMT) was initiated. Of 20
      patients included, 17 reached CR (85%) and 16 underwent BMT. EFS of the 20
      patients was 65% at 2 years and post-BMT relapse-free survival was 75%. These
      results are compared with those obtained separately with present intensive
      chemotherapy protocols and with BMT and it is concluded that intensification
      treatment followed by BMT (allogeneic or autologous) might constitute an advance
      in the treatment of children with ANLL.

PMID- 1741571
TI  - [Spontaneous and GHRH-induced nocturnal GH secretion in a child population with
      insulin dependent diabetes mellitus].
AB  - It has been studied integrated nocturnal secretion of GH after GHRH test in 15
      diabetic children and 10 short stature children with normal GH secretion. The
      most important findings are: 1) The integrated nocturnal secretion of GH was
      significantly higher in diabetics than in controls (6.27 +/- 3.11 ngrs/ml/min
      versus 3.06 +/- 1.41 ngrs/ml/min P [symbol; see text] 0.01). 2) After an acute
      stimulous with GHRH, diabetic population shows an exaggerated secretion of G. H.
      during the first 90 minutes compared with control population (33.20 +/- 12.41
      ngrs/ml/min versus 18.18 +/- 11.09 P [symbol; see text] 0.01). 3) Both higher
      spontaneous secretion of G. H., and after GHRH test, are independent of metabolic
      control (mean nocturnal glycemies and HBA1) and evolution time of disease.

PMID- 1741572
TI  - [Phosphorus-calcium metabolism in children under prolonged treatment with
      anticonvulsants. (II)].
AB  - Comparative assessments were made regarding the effects of prolonged
      administration of anticonvulsant drugs (phenobarbital, carbamazepine, valproate
      and polytherapy) on the different biochemical parameters related to
      phosphocalcium metabolism, in 98 children between 1 and 14 years. The most patent
      effect was on the levels of 25-Hydroxycholecalciferol which went down
      significantly (p = 0.0001) in children treated with phenobarbital (34.5 +/- 17
      ng/ml) or polytherapy (28.4 +/- 18 ng/ml) in relation to those treated with
      carbamazepine (49.2 +/- 15 ng/ml) or valproate (43.1 +/- 15 ng/ml) and to control
      group (45.9 +/- 13 ng/ml). The alkaline phosphatase has been found significantly
      higher among those treated with phenobarbital, carbamazepine and polytherapy,
      evidencing significant differences in relation to those treated with valproate
      and to control group (p less than 0.05). For calcium, parathyroid hormone and
      osteocalcine levels no differences were found in the different drugs, nor with
      control group. Depending on the duration of treatment there was a significant
      reduction (p = 0.02) in the levels of 25-Hydroxycholecalciferol in children
      treated over 3 years, but no difference for calcium, phosphorous, alkaline
      phosphatase and PTH under this parameter.

PMID- 1741573
TI  - [Celiac disease. Is its clinical pattern changing?].
AB  - Celiac disease (CD) is one of the most malabsorption syndromes in Pediatrics, its
      diagnosis being based on peroral intestinal biopsy. During the period 1974-1988
      we have studied 178 patients with the suspected diagnosis of CD: diagnosis was
      confirmed in 117 whereas 22 are still under study. Mean age of the patients was
      22.5 +/- 22.7 months, diagnosis being made during the first year of life in 32.6%
      of cases. Most cases had a classic clinical onset, although over the last year
      symptoms seen to be less apparent. Several patients presented with atypical
      forms. Also, associated diseases are observed in several cases. CD is often
      presented nowadays with few or atypical symptoms of difficult diagnosis and in
      this context the use of immunologic markers may be specially helpful.

PMID- 1741574
TI  - [Adoption of HIV positive children. A rarely discussed subject requiring
      immediate solution].
AB  - After programme a inquiry-type this carry out itself amongst the families that
      adopted children with antibodies from the human immunodeficiency virus (AcVIH)
      in, they communicate the facts collected about the problematic that raise their
      adoption. They provide some conclusions.

PMID- 1741575
TI  - [Coxalgia in adolescents: apropos of three different cases: chondrolysis,
      transient osteoporosis and epiphyseolysis].
AB  - We report 3 adolescents presenting with hip pain. Idiopathic chondrolysis,
      transient osteoporosis and slipped epiphisis were the final diagnosis. Initial
      diagnosis may be difficult despite adequate investigation. In such cases long
      term follow-up is essential. This paper includes a differential diagnosis of hip
      problems in childhood.

PMID- 1741576
TI  - [Evaluation of the nutritional state in patients with congenital cardiopathy].
AB  - Several anthropometrical, immunological and biochemical parameters have been
      utilized for the detection of chronic undernourishment and inflammation. The
      present work proposes a comparative study between a control group and other of 24
      cardiac patients, with the intention of valuating their nutritional and
      inflammatory state. We have used the index proposed by Ingenbleek (PINI =
      prognostic inflammatory and nutritional index) in which nutritional scoreboards
      and biochemical inflammatories correlate. We find some statistically significant
      differences between cases and controls, both with regard to the value of the
      PINI, and with regard to each of this variables. In the same way, we do not find
      any important correlations within each group among the nutritional biochemical,
      inflammatory and anthropometrical parameters. The clinical impression shows that
      the classification by groups of risk obtained according to the value of the PINI
      is very near to reality. We consider that the PINI index is useful as a
      predictive and evolutive parameter, and it can be used in children with a chronic
      illness.

PMID- 1741577
TI  - [Aortic valva atresia with normal left ventricle and interventricular
      communication].
AB  - We present three patients with aortic atresia, normal left ventricle and
      ventricular septal defect by bidimensional echocardiography. In two patients the
      Norwood's procedure was performed, but they died in the immediate postoperative
      time. The different procedures for the correction of this kind of aortic atresia
      and the necessity of prompt surgical treatment are discussed here.

PMID- 1741578
TI  - [Motor function of the esophagus following surgery for atresia].
AB  - We have studied for periods averaging 111 months 16 survivors out of a series of
      20 children treated for oesophageal atresia (EA) by neonatal end-to-end
      anastomosis. Twelve of them had gastroesophageal reflux (GER) manifested by
      either digestive (vomiting, dysphagia, pyrosis, haemorrhage or foreign body
      impaction) or respiratory symptoms (repeated neumoniae or frequent u.r.i.). pH
      studies decealed very increased acid exposure in these patients. Manometric
      studies showed disorganized peristalsis with near-absence of propulsive waves and
      predominance of mass-contractions. Interestingly both lower esophageal sphincter
      pressure and length were normal. Five children had histological esophagitis and 2
      had Barrett's esophagus. Seven patients have had an anti-reflux procedure and two
      more should be operated in the near future. Our experience reveals that GER
      incidence in EA is very high, that esophageal function is severely impaired in
      this condition, that mucosal lesions can be serious and that funduplication is
      effective. Since it has been demonstrated that esophageal dysfunction in EA
      patients is due to structural anomalies, spontaneous improvement should not be
      expected in them and surgical treatment should be largely indicated. EA patients
      require long-term gastro-enterologic follow-up.

PMID- 1741579
TI  - [Acute renal insufficiency with IgE specific RAST induced by amoxicillin in a 9
      month-old infant].

PMID- 1741580
TI  - [Cervico-mediastinal lipoblastomatosis. Report of a case and review of the
      literature].

PMID- 1741581
TI  - [Accidental ingestion of hydrocarbon and intravascular hemolysis: an infrequent
      complication].

PMID- 1741582
TI  - [Massive thymus hyperplasia in infancy: current status of diagnostic and
      therapeutic technics. Apropos of a recent clinical case].

PMID- 1741583
TI  - [Glycogenosis type III. New aspects in nutritional management].

PMID- 1741584
TI  - Inositol trisphosphate/calcium-dependent acetylcholine release evoked by
      bradykinin in NG108-15 rodent hybrid cells.

PMID- 1741585
TI  - Changes in presynaptic function during long-term potentiation.

PMID- 1741586
TI  - Membrane fusion as seen in rapidly frozen secretory cells.

PMID- 1741587
TI  - Role of specific lipids and annexins in calcium-dependent membrane fusion.

PMID- 1741588
TI  - A dissection of steps leading to viral envelope protein-mediated membrane fusion.

PMID- 1741589
TI  - A lipid/protein complex hypothesis for exocytotic fusion pore formation.

PMID- 1741590
TI  - Millisecond studies of single membrane fusion events.

PMID- 1741591
TI  - The sea urchin cortical reaction. A model system for studying the final steps of
      calcium-triggered vesicle fusion.

PMID- 1741592
TI  - MPP+ enhances potassium-evoked striatal dopamine release through a omega
      conotoxin-insensitive, tetrodotoxin- and nimodipine-sensitive calcium-dependent
      mechanism.

PMID- 1741593
TI  - Subsecond kinetics of inositol 1,4,5-trisphosphate-induced calcium release reveal
      rapid potentiation and subsequent inactivation by calcium.

PMID- 1741594
TI  - The effect of low-energy combined AC and DC magnetic fields on articular
      cartilage metabolism.

PMID- 1741595
TI  - Developmental changes in the pharmacology of Ca(2+)-dependent neurotransmitter
      release.

PMID- 1741596
TI  - Stimulus-induced nuclear Ca2+ signals in fura-2-loaded amphibian neurons.

PMID- 1741597
TI  - The effect of omega-conotoxin GVIA on field potentials in the hippocampus and
      nucleus accumbens in vitro.

PMID- 1741598
TI  - Diazepam enhances Ca2+ levels in rat brain synaptosomes.

PMID- 1741599
TI  - Relationship between membrane depolarization and intracellular free calcium in
      individual nerve terminals from the neurohypophysis.

PMID- 1741600
TI  - Calcium- and barium-activated acetylcholine synthesis and release from isolated
      nerve terminals. Do divalent cations alter membrane potential?

PMID- 1741601
TI  - Long-term monitoring of depolarization-induced exocytosis from adrenal medullary
      chromaffin cells and pancreatic islet B cells using "perforated patch recording".
AB  - (1) Membrane capacitance measurements using perforated patch recording offer the
      possibility of studying the process of depolarization-secretion coupling (DSC) in
      single endocrine cells with unprecedented time resolution and stability. (2)
      Early results with catecholamine-secreting adrenal chromaffin cells and insulin
      secreting pancreatic B cells support longstanding ideas that the Ca(2+)-dependent
      processes underlying DSC are fundamentally similar to those of nerve terminals.
      (3) Future experiments using these approaches should prove useful in sorting out
      those effects of humoral substances that have a predominant effect on
      excitability and Ca2+ entry from those that affect the secretory process itself.

PMID- 1741602
TI  - Calcium dynamics in the presynaptic terminal of barnacle photoreceptors.

PMID- 1741603
TI  - A barium-dependent chromaffin granule aggregating protein from bovine adrenal
      medulla and other tissues.

PMID- 1741604
TI  - A five-year analysis of botulinum toxin type A injections: some unusual features.
AB  - We analyzed patients treated during the past five years with botulinum toxin type
      A for strabismus and blepharospasm, reviewed our successes, failures, and unusual
      cases, and drew conclusions based on these treatments. Thirty-seven percent of
      the strabismus patients were cured, but many patients who were outside the strict
      definitions, still believed that they were significantly improved. A prominent
      feature in the treatment of strabismus was variability. Frequently, patients
      expected to do poorly had encouraging results. One permanent overcorrection
      occurred, and it converted an esotopic patient into an exotropic one with
      diplopia. This has persisted for 2.5 years and is the longest reported
      overcorrection to our knowledge. Our results indicate that larger doses of
      botulinum toxin produce longer spasm-free intervals in the treatment of
      blepharospasm. One patient receiving injections for her blepharospasm discovered
      that its cause was her sedative medication. This is the first reported case of a
      benzodiazepine inducing blepharospasm to our knowledge.

PMID- 1741605
TI  - Neodymium:yttrium aluminum garnet laser anterior capsulotomy.
AB  - Anterior capsulotomy of the lens capsule is one of the important steps before
      extracapsular lens extraction. A neodymium:yttrium aluminum garnet laser anterior
      capsulotomy was done in 144 eyes with immature, mature, and hypermature senile
      cataracts. This noninvasive technique is a safe and useful way to treat immature
      cataracts. To achieve the best result, the time interval between laser
      capsulotomy and surgery should be within six hours. Flap types of capsulotomy
      give the best results.

PMID- 1741606
TI  - A consecutive ultrastructural study of action of homoharringtonine on fibroblasts
      in vitro.
AB  - The authors studied the effect of homoharringtonine (Hh), a semisynthetic Chinese
      herb, on the ultrastructure of in vitro cultured human conjunctival fibroblasts
      (HFb) and its mechanism of action. Preliminary results showed that the main
      characteristics of HFb damage caused by Hh were invagination of the nuclear
      membrane, aggregation and margination of chromatin, and massive vacuolization of
      the cytoplasm. In addition, Hh can inhibit the secretion of collagen fibers and
      the synthesis of microfilaments. Therefore, Hh might be an effective agent in the
      prevention and treatment of proliferative eye disorders.

PMID- 1741607
TI  - Fungal keratitis associated with contact lens wear after penetrating
      keratoplasty.
AB  - A 71-year-old patient had a stromal infiltration at the donor-recipient interface
      two years after penetrating keratoplasty while wearing a "piggyback-type" contact
      lens. The corneal graft sutures in the affected area had been removed one year
      previously. Corneal scraping revealed the presence of Candida parapsillosis, and
      the infection was treated successfully with a combination of amphotericin B and
      flucytosine. The association between contact-lens wear and fungal infections of
      corneal grafts is discussed.

PMID- 1741608
TI  - Iatrogenic lens rupture after a neodymium: yttrium aluminum garnet laser
      iridotomy attempt.
AB  - During the past decade, laser iridotomy has replaced surgery as first-line
      treatment in angle-closure glaucoma. Its simplicity, fewer and less severe
      complications, and speedy recovery was responsible for this. Usually, the more
      common side effects of laser iridotomy are either preventable or easily
      treatable. Reported lens changes are limited to localized nonprogressive
      opacities and an isolated case of lens dislocation. We report the rare instance
      of lens rupture after a neodymium: yttrium aluminum garnet laser iridotomy
      attempt. Proper patient selection, good techniques with cautious use of laser
      energy, and meticulous attention to detail should prevent this complication.

PMID- 1741609
TI  - Evaluation of drug treatments for proliferative vitreoretinopathy using vitreous
      microtensiometry.
AB  - The effectiveness of antimetabolic and anticollagen agents against proliferative
      vitreoretinopathy (PVR) was assessed by vitreous microtensiometry, a new
      technique that measures in situ the tensile strength of vitreous membranes. Two
      PVR models were produced in rabbits by intravitreal injection of bovine retinal
      pigment epithelial (RPE) or fibroblast cells, and the animals subsequently were
      treated with 5-fluorouracil (5-FU) and beta-aminopropionitrile (BAPN),
      administered alone or in combination. The fibroblast PVR model produced high
      strength membranes that did not respond significantly to these therapies. The RPE
      model gave lower-strength membranes that showed marginally significant decreases
      in strength with intravitreal 5-FU and systemic BAPN treatments. However,
      combination therapy showed a highly significant decrease in membrane strength and
      a clinically encouraging reduction in retinal detachment.

PMID- 1741610
TI  - Anterior scleral staphyloma associated with neurofibromatosis.
AB  - We report the case of a woman with neurofibromatosis and anterior scleral
      staphyloma. To the best of our knowledge, this type has not been reported
      previously.

PMID- 1741611
TI  - My kind of biology.

PMID- 1741612
TI  - Control of carbon and nitrogen metabolism in Bacillus subtilis.

PMID- 1741613
TI  - Polymerase chain reaction: applications in environmental microbiology.

PMID- 1741614
TI  - Putative virulence factors of Candida albicans.

PMID- 1741615
TI  - Regulation of human immunodeficiency virus replication.

PMID- 1741616
TI  - Viruses of the protozoa.

PMID- 1741617
TI  - Biochemical diversity of trichloroethylene metabolism.

PMID- 1741618
TI  - Plant genetic control of nodulation.

PMID- 1741619
TI  - Serine beta-lactamases and penicillin-binding proteins.

PMID- 1741620
TI  - Gene amplification in Leishmania.

PMID- 1741621
TI  - Ivermectin as an antiparasitic agent for use in humans.

PMID- 1741622
TI  - Mechanisms of natural resistance to human pathogenic fungi.
AB  - Natural host-resistance mechanisms are essential first-line defenses against most
      mycotic agents; however, these defenses are often not sufficient for complete
      protection. The host relies on the immune responses to provide the additional
      antifungal activity necessary for maximum protection. In systemic mycotic
      diseases, the immune system must be functional to prevent the host from
      succumbing to the disease. Natural resistance mechanisms act together in a
      coordinated manner early in the disease process to either kill or prevent the
      fungal agent from proliferating and gaining entrance to other tissues. The early
      defensive measures of the natural effector mechanisms are usually sufficiently
      effective to provide time for the generally more effective immune defenses to
      develop. Together, the natural defenses and the immune defenses regulate each
      other through cytokine networks, and generally these systems provide the host
      with adequate protection against threatening mycotic agents.

PMID- 1741623
TI  - Nuclear fusion in yeast.

PMID- 1741624
TI  - Prokaryotic osmoregulation: genetics and physiology.

PMID- 1741625
TI  - Genetically engineered baculoviruses as agents for pest control.

PMID- 1741627
TI  - The culture of nursing.

PMID- 1741626
TI  - Techniques for selection of industrially important microorganisms.
AB  - The screening of microorganisms for the production of useful products continues
      to be an important aspect of biotechnology. Although advances in instrumentation,
      genetics, and microbial physiology are having an impact, screening programs are
      still primarily based on so-called classical techniques of enrichment and
      mutagenesis. One area that needs strengthening is the advancement of knowledge in
      microbial physiology. Recent surveys indicate that industry leaders see trained
      microbial physiologists as being the limiting factor in development of
      biotechnology in the coming decade. The largest impediment to development of new
      screening techniques is the ironic lack of programs specifically directed at
      developing new techniques. Too much emphasis is placed on using available
      techniques and relying on sheer labor and screening of vast numbers of organisms
      to produce novel products. In this respect, the Japanese are the exception and
      have proven that the establishment of new programs is worth the cost and effort.
      They are undoubtedly the world leaders in development of screening techniques and
      consequently the discovery of novel products. The isolation of microbes from
      novel and extreme environments holds tremendous promise in two areas. First, as
      Omura (46) and others (9, 48, 65) state, novel organisms will yield novel
      products. Second, such organisms serve as models for the understanding of
      structure and function that will facilitate the genetic manipulation of organisms
      and advance our ability to engineer novel enzymes. Hopefully such advances will
      enable genetic and protein engineering to have a greater impact on screening
      programs and techniques in the future. The earth holds a vast amount of varied
      and unique environments, from natural extremes such as high-altitude deserts and
      thermal springs, to manmade environments such as industrial-waste-treatment
      facilities, from which, with the appropriate methods and techniques, we may
      isolate and evaluate new potential products.

PMID- 1741628
TI  - Nursing and medical care of primary dementia patients in a community hospital
      setting.
AB  - A group of 480 hospital discharges systematically drawn from elderly, community
      hospital discharges were examined in order to describe the hospitalization
      experiences of individuals with admitting or coexisting diagnoses of primary
      dementia. Demented patients (7.1% of the sample) were most likely to be among the
      oldest hospitalized elders. The most frequently recorded patient problem was
      "alteration in thought processes." Most nursing interventions emphasized safety
      precautions, often to the exclusion of psychosocial intervention to maximize and
      support the patient's level of cognitive functioning. Over one fourth of the
      demented patients had written "no code" prescriptions. Approximately 44% of the
      elders in the dementia subsample had prescriptions for psychotropic medications.

PMID- 1741629
TI  - The patient educator role in nursing.
AB  - A stratified random sample (N = 1,230) of staff nurses, nurse administrators, and
      nurse educators were surveyed for their perceptions of the extent of nurses'
      responsibility for patient education and of the level of achievement of patient
      education by nurses. It was found that all three groups rated nurses'
      responsibility for patient education at a high level. Although the staff nurse
      group had statistically significant lower ratings (p = .0005) for nurses' level
      of responsibility for patient education, all three groups rated nurses'
      responsibility above 4 on a 5-point scale, with 5 reflecting primary (highest)
      responsibility. However, achievement of patient education was rated by all three
      groups below 3, the "good" rating on a 5-point scale, with 5 reflecting an
      excellent rating. The findings of this study indicate that the role of the nurse
      as patient educator needs to be strengthened. The satisfactory achievement of
      patient education is essential for the advancement of the nurse's role as patient
      educator.

PMID- 1741630
TI  - Exercise as a health-promoting lifestyle choice.
AB  - The primary purpose of this exploratory study was to examine differences between
      exercisers and nonexercisers in self-esteem, perceived benefits of exercise, and
      perceived barriers to exercise. Second, we investigated how much variation in
      group membership as an exerciser or nonexerciser could be explained by the
      relationship among self-esteem, perceived benefits of exercise, and perceived
      barriers to exercise. A sample of 105 university students completed four
      questionnaires. Using t tests, a significant difference was found between
      exercisers and nonexercisers on self-esteem, perceived benefits of exercise, and
      perceived barriers to exercise. It was found that the three variables
      successfully accounted for 32% of the variation in group membership as an
      exerciser or nonexerciser.

PMID- 1741631
TI  - Resource use in home care agencies.
AB  - Increasing use of home care services in the past decade has led to concern about
      the nature and number of services provided to clients. Because third party payers
      have used case mix measures to develop reimbursement systems for acute and long
      term care facilities, it seems likely that similar measures will be developed for
      home care. Three types of home care agencies were studied to test the usefulness
      of routinely gathered clinical and financial data for predicting resources
      provided. The findings suggest that current data sources may be inadequate for
      predicting the actual delivery of services.

PMID- 1741632
TI  - Family coping: a comparison of stepfamilies and traditional nuclear families
      during pregnancy.

PMID- 1741633
TI  - Nursing research instruments: pathway to resources.
AB  - Measurement of nursing phenomena involves locating and obtaining instruments that
      are reliable, valid, and feasible for use with an intended sample. Beginning with
      a clear conceptualization of the problem and delineation of the measurement
      framework, the process of finding and legally obtaining and using appropriate
      instruments can proceed. Resources for instruments are so numerous today that it
      is especially important to insure that valuable resources are not overlooked.
      Computerized resources offer comprehensive and efficient searches at low cost.
      The persistent nurse researcher who is aware of how to find and use the many
      resources available can select from among the numerous alternatives to measure
      nursing phenomena. The U.S. Copyright Act of 1976 has been shaped over the years
      by court cases and committee work to protect original work, including nursing
      research instruments. Knowledge of the provisions of copyright law may minimize
      the danger of unintentional violation while obtaining research instruments.

PMID- 1741634
TI  - BARRIERS: the barriers to research utilization scale.

PMID- 1741635
TI  - Incorporating research role and practice role.

PMID- 1741636
TI  - Nurse managers: role expectations and job satisfaction.
AB  - The purpose of the study was to assess the relationships among nurse managers'
      perceived job stress/job satisfaction, time allocation, and role expectations.
      The dependent variable was job satisfaction. The sample consisted of 72 nurse
      managers who responded to a self-administered questionnaire. It was found that
      nursing supervisors are satisfied with the actual time allocation of nurse
      managers, whereas physicians and nursing staff believe that more of the nurse
      managers' time should be given to direct patient care. When discrepancies occur
      about the allocation of nurse manager time, the nurse manager is apt to have
      lower job satisfaction.

PMID- 1741637
TI  - Facilitating clinical research: nurse-to-nurse support.

PMID- 1741638
TI  - Fatigue in postpartum women.
AB  - Childbirth and the responsibilities of parenting after birth require a great deal
      of energy. Fatigue in postpartum women is a concern for maternal-child nurses
      because of the impact on the health and parenting ability of the mother. To
      determine fatigue levels and types, 35 women who vaginally delivered were
      surveyed at 2 days, 2 weeks, and 6 weeks postpartum. This sample was found to be
      mildly fatigued, with situational and/or psychological fatigue. Nurses can
      intervene by assessing postpartum fatigue and using teaching/counseling methods
      for knowledge preparation and for clients at risk.

PMID- 1741639
TI  - Effects of caffeinated coffee on intraocular pressure.
AB  - This study examined the effects of caffeinated coffee on the intraocular pressure
      of nonglaucomatous subjects. Subjects were randomly assigned to receive each of
      three treatments: caffeinated coffee, hot water, and no fluid. All subjects were
      given the three treatment conditions over 3 days. The study revealed that
      intraocular pressure after ingesting caffeinated coffee was significantly higher
      than after receiving the other two treatment conditions. It was further found
      that increased intraocular pressure was maintained at significant levels over a 3
      hour period. No significant changes were found in the pulse rate, and findings on
      blood pressure were inconclusive.

PMID- 1741640
TI  - Genital herpes: the disease experience over the first 6 months.

PMID- 1741641
TI  - Effects of patient-controlled analgesia on postoperative pain in adolescents.

PMID- 1741642
TI  - Barriers to using research findings in practice: the clinician's perspective.

PMID- 1741643
TI  - Using art and science to change practice.

PMID- 1741644
TI  - Distinguishing pancreatic carcinoma from other periampullary carcinomas by
      analysis of mutations in the Kirsten-ras oncogene.
AB  - The prevalence of Kirsten (Ki)-ras gene mutations was studied in 105 paraffin
      embedded tissues obtained from 40 patients with pancreatic cancer, 48 with bile
      duct carcinoma (19 distal, 6 middle, and 23 proximal), 16 with ampullary
      carcinoma and 1 with duodenal cancer, by in vitro amplification of target
      sequences by the polymerase chain reaction (PCR). With regard to pancreatic
      cancers, the authors' data confirm the very high frequency (88.6%) of Ki-ras gene
      mutations occurring at codon 12. Five pancreatic carcinomas did not contain the
      Ki-ras mutation and included rare types of histopathology. By histologic review
      after the examination of Ki-ras mutations through PCR, the diagnosis of four
      patients could be legitimately revised from other periampullary carcinoma to
      pancreatic carcinoma. In the ampullary carcinoma, the prevalence of mutations in
      Ki-ras codon 12 was 13.3%. Although there was a large difference in incidence of
      mutations between distal and middle or proximal bile duct carcinoma, the
      prevalence of mutations in bile duct carcinoma was limited to 19.6%. Unlike other
      approaches to diagnose periampullary carcinoma, detection of a mutation in Ki-ras
      codon 12 by PCR may distinguish pancreatic carcinoma from other periampullary
      carcinomas that have better prognoses.

PMID- 1741645
TI  - Pancreatic resection versus peritoneal lavage in acute necrotizing pancreatitis.
      A prospective randomized trial.
AB  - Twenty-one patients with acute fulminant alcoholic pancreatitis were randomly
      allocated to either pancreatic resection group (11 patients) or nonoperative
      peritoneal lavage group (10 patients). Only patients under 50 years were included
      in the study to minimize the role of other severe disease. These patients
      represented the most severe cases of acute pancreatitis at our Department,
      constituting only 2% of all patients with acute pancreatitis during this period.
      The diagnosis was based on clinical symptoms and on signs indicating severely
      impaired systemic organ functions. All patients underwent contrast-enhanced
      computed tomography (CT), which showed contrast enhancement below 30 Hounsfield
      units. In the operated cases, the diagnosis of necrotizing pancreatitis was
      verified histologically. All patients with conservative treatment had dark brown
      fluid at peritoneal puncture. There was a difference (nonsignificant) in
      mortality (3/11 and 1/10, respectively), complication rate, or in the need of
      reoperations between the groups. Nonoperative peritoneal lavage was followed with
      shorter treatment at the intensive care unit (16.2 versus 25.9 days,
      respectively). The hospital stay also was significantly shorter in the
      nonoperative group (44.3 versus 56.1 days). The results indicate that intensive
      conservative treatment is justified as an initial therapy even in the most severe
      cases of acute pancreatitis.

PMID- 1741646
TI  - Sex differences in gallstone pancreatitis.
AB  - From a computerized database comprising 28 pertinent items in each of a
      consecutive series of 664 patients with cholelithiasis, differences were studied
      between men and women. In 52 patients there was a documented attack of acute
      pancreatitis (7.8%). Twenty-five of 174 men had pancreatitis, compared with 27 of
      490 women (p less than 0.0001). Men developed gallstones later in life than
      women, but suffered gallstone pancreatitis earlier in life and in the course of
      their gallstone-related disease. A history of flatulent dyspepsia, chronic
      cholecystitis, and biliary colic was less common in men than in women with
      pancreatitis (p less than 0.0001). Men with pancreatitis had fewer stones in
      their gallbladders than did women (p = 0.0002). The cystic duct and the common
      bile duct in the pancreatitic patient were more likely to be dilated (p less than
      0.0001). In the nonpancreatic group, these ducts were larger in men. Pancreatic
      duct reflux on operative cholangiography was more common both in patients with
      pancreatitis 62% cf 14% (p less than 0.0001), and in men (p less than 0.001).
      Predisposition to pancreatitis relates to duct size rather than stone size per
      se. Men are more susceptible to gallstone migration at an early stage of their
      disease. In addition they have a larger diameter duct system and possibly a
      different anatomic disposition of the sphincter of Oddi, which predisposes them
      to a higher incidence of pancreatitis than women. The data suggest that it is
      cystic duct size that is critical in the pathogenesis of gallstone pancreatitis.

PMID- 1741647
TI  - Causes of renal allograft loss. Progress in the 1980s, challenges for the 1990s.
AB  - A variety of refinements in the care of kidney transplant recipients have been
      instituted over the past decade. The authors studied the overall impact of these
      refinements on kidney allograft losses at a single institution. To do this they
      compared the causes and rates of graft loss for primary kidney transplants in the
      1970s (January 1, 1970 to December 31, 1979; n = 1012; 657 nondiabetics, 355
      diabetics; 617 living donors, 395 cadaver donors) versus the 1980s (January 1,
      1980 to December 31, 1989; n = 1,384; 756 nondiabetics, 628 diabetics; 740 living
      donors, 644 cadaver donors). Overall patient survival improved significantly,
      with rates at 1, 5, and 10 years of 94%, 84%, and 68% for the 1980s, compared
      with 86%, 69%, and 57% for the 1970s (p less than 0.001). Actuarial graft
      survival also improved significantly, with rates at 1, 5, and 10 years of 86%,
      71%, and 52% for the 1980s, compared with 73%, 58%, and 43% for the 1970s (p less
      than 0.001). This improvement occurred even though there were proportionately
      more cadaver donors and diabetic recipients in the 1980s. For both decades
      combined, 24% of the lost grafts were due to chronic rejection, 18% to
      cardiovascular causes of death with function, 13% to infectious causes of death
      with function, and 11% to acute rejection. The overall gain in graft survival
      rates in the 1980s was principally due to fewer cases of acute rejection and
      fewer infectious deaths. Improvement in graft survival due to the two leading
      causes--chronic rejection and cardiovascular causes of death--was relatively
      small, if any. These data indicate that future kidney transplantation research
      should emphasize prevention of chronic rejection and cardiovascular death.

PMID- 1741648
TI  - Elective and emergency hepatic resection. Determinants of operative mortality and
      morbidity.
AB  - To determine the reasons for improved mortality and morbidity rates after major
      hepatic resection, five variables were analyzed retrospectively in 300 patients
      operated on over a 27-year period: (1) the indication for surgery, (2) the
      surgical approach, (3) the urgency with which surgery was performed, (4) the
      nature of the surgical procedure, and (5) the experience of the surgeon. The
      operative mortality rate decreased from 19% between 1962 and 1979 to 9.7% between
      1980 and 1988 (p less than 0.05). The operative mortality rates for patients
      undergoing resection for benign hepatic neoplasms was 3.4%; for metastatic
      tumors, 6.3%; for primary hepatic malignancies, 19%; and for trauma, 33%. Fifty
      seven percent of operations before 1980 were performed through a thoracoabdominal
      exposure as compared with 19% after 1980. Overall a thoracoabdominal exposure of
      the liver was associated with a 20% mortality rate as compared with 8.6% for
      operations with abdominal exposure of the liver (p less than 0.02). Elective
      operations accounted for 65% of hepatic resections before 1980, as compared with
      90% after 1980, and were associated with an 8.8% mortality rate as compared with
      30.7% for urgent and emergency operations (p less than 0.001). Segmental and
      wedge resections were associated with a 5.3% mortality rate as compared with
      14.7% for major hepatic resections (p less than 0.05), but this difference did
      not affect overall operative mortality rates because there was no change in the
      proportion of major hepatic resections after 1980. Surgical experience was not a
      determinant of operative mortality or morbidity rates in elective operations.
      Although there was no reduction in the complication rate after 1980, there was a
      reduction in postoperative stay from 26 days before 1980 to 16 days after 1980 (p
      less than 0.001). A reduction in the incidence of postoperative sepsis and a
      change in its management was associated with improved operative mortality rates.

PMID- 1741649
TI  - Liver transplantation in patients with portal vein thrombosis and central
      portacaval shunts.
AB  - The authors have analyzed the impact of pre-existing portal vein pathology on the
      outcome of orthotopic liver transplantation. The incidence was high in patients
      suffering from chronic active hepatitis, hypercoagulable states, trauma or
      previous dissection of the porta hepatis, and splenectomy. The existence of
      portal vein thrombosis (23 patients) or surgical central portosystemic shunt (10
      patients) was documented by preoperative Doppler sonogram or angiography (26/33),
      or operative findings of occluded vein (7/33). Successful thrombectomy and
      dismantling of portacaval shunts were achieved in most cases (24/33). Only nine
      patients required the placement of an interposition vein graft to the superior
      mesenteric vein. The intraoperative course was characterized by increased blood
      loss and coagulopathy, significantly higher than in patients with a patent portal
      vein. When compared with all liver transplants, the immediate postoperative
      complication rate was higher for primary nonfunction (33% versus 8%), re
      exploration for intraperitoneal bleeding and hematomas, and morbid infections.
      Rethrombosis rate of thrombectomized veins or vein graft was low (2/33). The
      mortality rate was 35% in the presence of portal vein thrombosis (PVT) and 30%
      for portacaval shuct (PCS), both significantly higher than the 12% for other
      orthotopic liver transplant (OLT) patients. These results are expected to improve
      with better patient selection, surgical experience, and anticipation of the
      complex postoperative course. The authors conclude that PVT or the presence of
      PCS are not contraindications to orthotopic liver transplantation.

PMID- 1741650
TI  - Experience with 100 consecutive simultaneous kidney-pancreas transplants with
      bladder drainage.
AB  - From December 1985 to December 1989, 100 consecutive simultaneous pancreas-kidney
      (SPK) transplants were performed at the University of Wisconsin Hospital and
      Clinics. Bladder drainage technique was used for all grafts. One- and three-year
      patient survival was 93% and 90%; kidney survival, 90% and 85%; and pancreas
      survival, 86% and 84%. Quadruple immunosuppressive therapy was used in all
      patients and consisted of either MALG or OKT3 induction, and cyclosporine,
      prednisone, and azathioprine maintenance therapy. OKT3 induction therapy was used
      in 42 patients and Minnesota antilymphocyte globule in 58 patients, with
      equivalent results except for more opportunistic infection with OKT3. The
      duodenal button technique was used in the first 17 patients with systemic
      anticoagulation and was associated with significantly more postoperative bleeding
      and infection compared with the duodenal segment technique. The most common
      surgical complication of the duodenal segment technique was urine leak (13%),
      which usually occurred from the distal duodenal segment. The most common urologic
      complication of bladder drainage was hematuria (13%), which was usually self
      limited. Within 6 months of transplantation, 84% of patients developed urinary
      tract infections, and 25% of patients had opportunistic infections. The surgical
      techniques and immunosuppressive methods used in this series are reviewed, and
      strategies for preventing medical and surgical complications are outlined.

PMID- 1741651
TI  - Depressed gut absorptive capacity early after trauma-hemorrhagic shock.
      Restoration with diltiazem treatment.
AB  - Although bacterial translocation occurs after trauma-hemorrhage, it is unknown
      whether gut absorptive capacity (GAC) is altered under those conditions. The aim
      of this study, therefore, was to determine this and also whether diltiazem (DZ)
      has any effect on GAC after hemorrhage. Rats (n = 12; 270 to 300 g) were lightly
      anesthetized with ether and a 6-cm midline laparotomy performed (i.e., trauma
      induced). A nasogastric tube was inserted, cannulation of a carotid and femoral
      artery and a jugular and the portal veins performed, and the animals allowed to
      recover from anesthesia. They were then bled to a mean blood pressure of 40 mm Hg
      within 10 minutes and maintained at this pressure by further bleeding or return
      of fluid (lactated Ringer's solution [LRS] ) until 40% of the shed blood volume
      (SBV) had been returned in the form of LRS (end of hemorrhage, EH; time from
      onset of hemorrhage to EH = 93.4 +/- 4.4 minutes). The rats then were
      resuscitated with LRS, 3 times the SBV over 45 minutes, followed by 2x over 60
      minutes. One group received 400 micrograms/kg DZ, and another group received
      saline, with the 2x LRS. Sham animals were not hemorrhaged. Gut absorptive
      capacity was determined by the 1-hour D-xylose absorption test at 2 and 4 hours
      after EH. Results demonstrate that GAC is significantly depressed after
      hemorrhage and resuscitation. Administration of diltiazem restored GAC to normal
      levels. Thus DZ is a useful adjuvant to treatment after trauma-hemorrhagic shock,
      because it restores GAC to normal and allows for early enteral nutrition.

PMID- 1741652
TI  - The effect of glucocorticoid administration on bacterial translocation. Evidence
      for an acquired mucosal immunodeficient state.
AB  - Adherence of bacteria to intestinal epithelial cells may be the crucial
      initiating event for translocation and is normally prevented by both specific
      (secretory IgA) and nonspecific (mucus, bacterial antagonism, desquamation)
      mucosal defense mechanisms. The purpose of this study was to examine the effect
      of dexamethasone administration on mucosal immunity; specifically bacterial
      adherence and IgA. Twenty Fischer rats were randomly assigned to two groups of 10
      animals each. Group I received 0.5 mL saline injection intraperitoneally (IP);
      and group II, 0.8 mg/150 g body weight dexamethasone IP per day for 2 consecutive
      days. The cecum mesenteric lymph nodes, and bile were aseptically collected, and
      bacterial adherence, bacterial translocation, and IgA concentration were
      determined. Results indicate that, compared with saline-treated animals,
      dexamethasone-treated animals had a fall in IgA (54 +/- 24 versus 232 +/- 41
      micrograms/mg protein), an increase in bacterial adherence (8.2 +/- 0.5 versus
      3.4 +/- 0.6 cfu (log10)/g cecum), and an increased incidence of bacterial
      translocation to the mesenteric lymph nodes (60% versus 0%). These data suggest
      that glucocorticoids may promote bacterial translocation by impairment of mucosal
      IgA synthesis.

PMID- 1741653
TI  - Surgical management of primary lymphoma of the breast.
AB  - Review of our surgical experience with 10 cases of "primary" lymphoma initially
      confined to the breast and of previous published reports indicates that radical
      surgery is to be avoided. Radiation therapy with limited surgery provides
      excellent local-regional control. The addition of systemic combination
      chemotherapy is warranted in the more aggressive histologic subtypes because
      death is generally due to subsequent disseminated disease.

PMID- 1741654
TI  - Chronic ACE inhibition reduces intimal hyperplasia in experimental vein grafts.
AB  - Intimal hyperplasia is an important factor in the pathophysiology of vein graft
      failure. Local renin-angiotensin systems recently have been shown to modulate the
      development of intimal hyperplasia in arteries after intimal injury. The effect
      of chronic angiotensin-converting enzyme (ACE) inhibition on the development of
      intimal hyperplasia in experimental vein grafts was examined in this study. Ten
      New Zealand White rabbits received 10 mg/kg of captopril daily in their drinking
      water. One week later the right carotid artery was divided and bypassed with the
      reversed right external jugular vein in these rabbits and in 10 matched controls.
      Captopril was continued for 28 days after operation, when all the grafts were
      harvested. Five grafts from each group were perfusion fixed, and the intimal
      thickness in the proximal, middle, and distal segments was determined. Rings from
      the remaining grafts (n = 20 in each group) were studied in vitro under isometric
      tension, and their responses to norepinephrine (NE), histamine (HIST), serotonin
      (5-HT), angiotensin I (AI), and angiotensin II (AII) was measured. The intimal
      thickness of the proximal, middle, and distal segments of the captopril-treated
      grafts were significantly less than controls, being reduced in all segments by
      approximately 40% (p less than 0.0001). With regard to vasoreactivity, the
      captopril-treated grafts were hypersensitive to 5-HT (control ED50 5.5 +/- 0.5 X
      10(-7) mol/L vs. captopril-treated 1.1 +/- 0.2 X 10(-6) mol/L; p less than 0.005)
      although the maximal response was significantly reduced (control 1.6 +/- 0.3 g
      vs. captopril-treated 0.8 +/- 0.1 g; p less than 0.05). There were no differences
      in sensitivity between control and captopril-treated rings with respect to NE,
      HIST, AI, or AII. Four of the ten captopril-treated segments, however, failed to
      respond to AI, and the maximal active tension of the responders was significantly
      reduced (control 0.47 +/- 0.06 g vs. 0.20 +/- 0.05 g; p less than 0.02). These
      results suggest that ACE is involved in the modulation of vein graft intimal
      hyperplasia, and that ACE inhibitors may have therapeutic applications in
      patients undergoing vein bypass procedures.

PMID- 1741655
TI  - Can Doppler pressure measurement replace "exclusion" arteriography in the
      diagnosis of occult extremity arterial trauma?
AB  - Although highly accurate, contrast arteriography is a costly, invasive, and time
      consuming method to rule out occult arterial damage in injured extremities.
      Accordingly the authors assessed the sensitivity and specificity of Doppler
      derived arterial pressure measurements in trauma victims undergoing evaluation
      for possible extremity arterial damage. Arterial pressure index (API) was
      calculated (Doppler arterial pressure distal to injury/Doppler arterial pressure
      in uninvolved arm), but not used in clinical decision making in 100 consecutive
      injured limbs in 93 trauma victims. All patients then underwent contrast
      arteriography. Twenty limbs had an API less than 0.90 and an abnormal
      arteriogram, whereas 75 had both a normal API and a normal contrast study. One
      limb had a significant angiographic abnormality with an API greater than 0.90;
      two others had API less than 0.90 but normal arteriograms. Two limbs with a
      normal API had false-positive arteriograms. When compared with arteriography, an
      API less than 0.90 had a sensitivity of 87% and a specificity of 97% for arterial
      disruption in this series. Sensitivity and specificity rose to 95% and 97% when
      API was compared with clinical outcome. In the absence of obvious signs of
      arterial injury, API may be a reasonable substitute for screening arteriography
      in the traumatized extremity, particularly if close follow-up observation can be
      assured.

PMID- 1741656
TI  - Effects of stress, social support, and self-esteem on depression in children with
      limb deficiencies.
AB  - Limb deficiencies in children are the result of trauma, disease, or congenital
      causes. The potentially negative impact on psychologic adjustment from the
      chronic strain of living with limb deficiencies appears to be mediated by
      perceived social support (interpersonal protective factor), microstressors and
      daily hassles (socioenvironmental risk factor), and self-esteem (intrapersonal
      protective factor). These risk and protective factors were simultaneously
      investigated as potential predictors of depressive symptomatology in 54 children
      with congenital or acquired limb deficiencies. Hierarchical multiple regression
      analyses were used to test the main effects and the interaction effects of the
      predictor variables on depressive symptomatology. None of the interaction terms
      were statistically significant. An overall simultaneous multiple regression
      analysis of the main effects model predicted 72% of the variance in depressive
      symptomatology, with perceived classmate social support emerging as the strongest
      predictor variable. The findings are discussed in terms of the risk and
      protective effects of mediating factors on the psychologic and social adaptation
      of chronically ill and handicapped children.

PMID- 1741657
TI  - Dual-task assessment of reorganization of postural control in persons with lower
      limb amputation.
AB  - Postural control in persons with lower limb amputation was studied using a
      cognitive approach to motor learning. The aim of this study was to show that an
      important characteristic of the central reorganization process after a lower limb
      amputation is the gradually decreasing need of attentional resources to perform a
      motor task. A dual-task procedure was developed to estimate the level of
      automaticity of a quiet, upright standing task. The effect of a concurrent
      attention-demanding task (Stroop task) on the efficiency of balance control was
      determined using force-platform measurements at the start and the end of the
      rehabilitation process. In contrast with a control group, the amputation group
      showed interference effects on body sway caused by the concurrent task both at
      the start (p less than .05) and, less severe, at the end of rehabilitation (p
      less than .05). Improvement of balance control was significant only for the dual
      task condition (p less than .05). The results corroborated the hypothesis that
      dual tasks give information about the restoration of automaticity of postural
      control as an essential characteristic of the central reorganization process in
      persons with lower limb amputation. The role of dual-task procedures as a useful
      approach to skill assessment is discussed.

PMID- 1741658
TI  - Biomechanical gait analysis in obese men.
AB  - The purpose of this study was to identify and compare the kinematic components of
      the walking gait of obese men to those of nonobese men. Self-paced walking trials
      of 12 obese volunteers, ranging in age from 30 to 47 years and in obesity from
      70% to 99% above ideal body weight, were recorded via cinematography. The
      following findings were recorded: (1) obese persons (1.09m/sec) walk
      significantly (p less than .001) slower than nonobese subjects (1.64m/sec); (2)
      obese persons take significantly (p less than .001) shorter strides (1.25m vs
      1.67m) and exhibit step widths (.16m) twice those of nonobese persons (.08m); (3)
      mean hip abduction angles of the obese are significantly (p less than .001)
      different at some events of the walking cycle from the hip angles of nonobese
      persons; (4) mean hip and knee flexion angles are not significantly different for
      obese and nonobese subjects; and (5) obese individuals demonstrate a walking gait
      pattern with significantly greater (p less than .001) mean magnitude of ankle
      dorsiflexion and lesser (p less than .001) mean magnitude of ankle plantar
      flexion than nonobese subjects throughout the walking cycle. It is concluded that
      obese individuals display a walking gait that follows a normal pattern but some
      of the temporal and angular components of their gait are different from those of
      nonobese persons mainly because of the excessive adipose tissue inside their
      thighs.

PMID- 1741659
TI  - Incidence and nature of dysphagia in polio survivors.
AB  - Questionnaires pertaining to swallowing function were mailed to 220 members of
      postpolio support groups in Connecticut. Of the 109 responses, 80 individuals
      reported having no difficulty with swallowing, while 29 reported having either
      intermittent or consistent swallowing problems. Twenty-one of the 29 were seen
      for videofluoroscopic swallowing studies and pulmonary function testing. The
      swallowing studies showed that 43% of these individuals had difficulty with bolus
      control, 19% with delayed swallow response, and 81% with decreased pharyngeal
      transit. Although none of these individuals were observed to aspirate, two were
      judged to be at significant risk. Incidence of dysphagia within the group of
      polio survivors was estimated to be approximately 18%. Seventeen of the 20
      postpolio subjects with dysphagia also demonstrated decreased breathing capacity.
      Although moderately to severely depressed values in the pulmonary function
      measures accompanied moderate dysphagia in certain postpolio individuals, reduced
      values in these same measures were also present in individuals with minimal
      swallowing dysfunction. Therefore, although impaired breathing may complicate
      swallowing dysfunction and vice versa, it does not appear that one can be
      predicated from the other. Management of dysphagia in postpolio individuals is
      discussed.

PMID- 1741660
TI  - Utility of the dexamethasone suppression test in the diagnosis of poststroke
      depression.
AB  - The utility of the dexamethasone suppression test (DST) in the diagnosis of
      depression was examined in an outpatient sample of 29 stroke patients. Results
      indicated that the DST's sensitivity was 15%, its specificity was 67%, and its
      positive predictive value was 48%. These findings suggest that the DST yields no
      more information than would be gained from random assignment of the diagnosis of
      depression. Therefore, it is not a useful measure of mood in these patients.

PMID- 1741661
TI  - Simulator for evaluating shoulder motion as a command source for FES grasp
      restoration systems.
AB  - A simulator has been developed to evaluate the command channels through which a
      quadriplegic patient controls an upper limb neural prosthesis. The simulator
      consists of an animated grasping task implemented on a video screen. The patient
      controls the motion of an animated hand on the screen by moving his or her own
      hand while the animated hand opens and closes under control of the tested command
      channel. Experiments were performed using both able-bodied and quadriplegic
      subjects to evaluate shoulder motion as a command-channel source. The results
      demonstrated that optimal combinations of shoulder command-channel parameters are
      subject specific, which suggests using the simulator in the prescription of upper
      limb neural prostheses and in training quadriplegic persons who use them.
      Additionally, the experimental results quantified the reduction in performance
      that came from using ipsilateral vs contralateral shoulder control and the
      enhancement in performance realized when using substitute sensory force-feedback
      displays.

PMID- 1741662
TI  - [Immunohistochemical features of nephrotoxic serum nephritis in the rat: the role
      of interleukin-1 in the development of heterologous and autologous stages].
AB  - Late heterologous and autologous stages of serum nephritis together with
      glomerular cells in culture are studied biochemically, morphologically and
      immunohistochemically for the assessment of the role of mononuclear leucocyte
      mediator system. The heterologous stage of the nephrotoxic nephritis is
      associated with the increase of Interleukin-I and TxA2 production. Role of
      Interleukin-I in the autologous stage is less pronounced in spite of
      proliferative activity of cultured mesangial cells. The effect of suppressive
      factors prevails in the glomerulus.

PMID- 1741663
TI  - [Membranous nephropathy associated with kidney amyloidosis].
AB  - 15 kidney biopsies from 13 patients with a combination of membranous nephropathy
      and amyloidosis were studied. Membranous nephropathy is shown to precede the
      development of amyloidosis which possesses all the properties of the acquired one
      (AA-amyloid). Transformation of membranous nephropathy into amyloidosis is due to
      the deficiency of the immune system characteristic of both processes. This
      combination is not considered as a special type of amyloidosis but as a peculiar
      feature of membranous nephropathy.

PMID- 1741664
TI  - [Role of sinusoidal cells in the morphogenesis of alcoholic liver cirrhosis].
AB  - 49 liver biopsies in alcoholic liver damage (fibrosis, chronic persisting
      hepatitis, cirrhosis) are studied on semithin sections electron microscopically
      and morphometrically. Morphological varieties of hepatocytes and sinusoidal cells
      are revealed as well as some rules in their proportions. Domination of stellate
      reticulo-endotheliocytes with a high secretory and phagocyte activity correlates
      with high adaptive properties of hepatocytes and transformation of lipocytes into
      fibroblast-like cells without development of intralobular fibrosis. If nonactive
      variant of the stellate reticulo-endotheliocytes prevails, the number of damaged
      hepatocytes and fibroblast-like lipocytes increases, intralobular fibrosis
      becomes pronounced resulting in hepatocyte death. Role of sinusoidal cells in
      realization of alcoholic cirrhosis morphogenesis is discussed.

PMID- 1741665
TI  - [The scientific school of Medical Science academician A. I. Strukov].

PMID- 1741666
TI  - [Structural-functional characteristics of phagocytes in the broncho-alveolar
      lavage fluid in acute focal pneumonia].
AB  - The alveolar macrophages and neutrophils of the bronchoalveolar fluid from 37
      patients with acute focal pneumonia were studied cytochemically. A comparison
      group consisted of 20 patients with primary chronic bronchitis, 11 subjects
      without pulmonary affections served control. Phagocytes with a high motile,
      oxygen-dependent bactericidal and hydrolytic activity as well as with increased
      level of absorptive capacity prevailed during the peak of the disease and its
      regression. At the phase of convalescence the number of phagocytes with a high
      oxygen-dependent bactericidal and hydrolytic activity decreased but their high
      absorptive activity was retained.

PMID- 1741667
TI  - [Morphogenesis of pneumonia in alcoholic intoxication].
AB  - A single moderate dose of ethanol given to 120 Wistar male rats inhibits general
      immune defence and may facilitate the development of pneumonia. No morphological
      changes are found in the surfactant system in acute alcoholic intoxication. In
      chronic alcoholic intoxication with a pronounced withdrawal syndrome, apart from
      the decrease of general immune defence, lung surfactant system is damaged due to
      the direct ethanol effect on type II pneumocytes. These are the leading factors
      in the pneumonia pathogenesis characterized by a grave course and tendency to the
      abscess formation.

PMID- 1741668
TI  - [Kidney adenoma].
AB  - Morphological, electron microscopic, histospectrophotometric and morphometric
      (mean nuclear surface and ellipticity coefficient) studies of small cortical
      adenomas were performed. Surgical (kidneys removed because of renal cell
      carcinoma and shrinkage) and autopsy (atrophic kidney) materials were used. Total
      142 adenomas were found in 93 out of 592 observations. The incidence of adenomas
      in kidneys with renal cell carcinoma was 12%, in contracted kidneys 19.2 and
      19.44% (surgical and autopsy material). Electron microscopic examination was
      performed in 15 adenoma cases. Comparative quantitative DNA determination was
      performed in sections stained by Feulgen using plug-method on the microscope
      spectrum analyzers in 20 cases of adenoma and 15 cases of renal cell carcinoma
      identical histologically to adenocarcinoma. This combined study revealed the
      adenomas heterogeneity. Only part of them (well differentiated with diploid DNA
      histograms and nuclei up to 32 mm2 may be referred to adenomas. All the others
      morphologically and morphometrically are close to adenocarcinomas. The type of
      DNA distribution and mean nuclear surface are most important for differential
      diagnosis between renal adenoma and carcinoma.

PMID- 1741669
TI  - [Morphologic manifestations of the preclinical stage of diabetic nephropathy].
AB  - Kidney biopsies from 10 patients with diagnosed insulin-dependent diabetes
      mellitus of various duration with clinical manifestations of hyperglycemia,
      increased rate of glomerular filtration, presence or absence of microalbuminuria,
      were studied morphologically. Gradual increase of kidney alterations was
      observed: changes of thickness and loosening of basal membrane of glomerular
      capillaries, its focal homogenization, partial mesangium increase due to the
      increase of membranous substance and decrease of cellular component. These
      alterations positively correlate with immunohistochemistry of renal glomeruli.
      Dynamics of morphological changes does not show a direct connection with the
      patient age and the duration of diagnosed disease but is stipulated by the
      presence of one or another antigen of the class II major histocompatibility
      complex.

PMID- 1741670
TI  - [Morphogenesis of diabetic microangiopathy].
AB  - Skin biopsies from 40 patients 17 to 75 years old with type I and II diabetes
      mellitus were studied morphologically. The formation of diabetic microangiopathy
      starts with the damage of endotheliocytes, vascular permeability disturbance,
      activation of pericytes and smooth muscle elements with subsequent thickening of
      basal membranes and capillary and arteriole hyalinosis, these lesions being
      directly related to the duration of diabetes. Diabetic microangiopathy is a
      manifestation of the disease and its morphology is similar in both type I and II
      diabetes.

PMID- 1741671
TI  - [Morphology of lymph nodes in secondary immunodeficiency provoked by acute
      diffuse peritonitis].
AB  - Lymph nodes of 30 patients operated because of acute diffuse peritonitis are
      studied histologically and immunologically. Two types of the lymph node response
      are found during the reactive stage. The response of the 1st type (the beginning
      of peritonitis) is characterized by the activation of T- and B-immunity systems.
      The signs of the depression are characteristic for the 2nd type. Immunodeficiency
      is enhanced in toxic and terminal stages. The most informative index of the
      immunodeficiency degree is a decrease of the ratio T-helper/T-suppressor
      cytotoxic lymphocytes. There is a close correlation between the state of patients
      and immunomorphological changes of lymph nodes and blood. Peritonitis results in
      the development of vitium cordis when intoxication associated with immune
      disturbances strengthens both the inflammation and intoxication.

PMID- 1741672
TI  - [Inflammation, adaptive regeneration and dysregeneration (intercellular
      interaction analysis)].
AB  - Inflammation, regeneration and fibrosis are inseparable components of the
      adaptive tissue response to damage. Systemic analysis indicates that this
      reaction is brought about due to the cooperative interaction of the connective
      tissue and blood cells (neutrophils, labrocytes, thrombocytes, macrophages,
      lymphocytes, fibroblasts) between each other, with intercellular matrix
      (collagen, fibronectin, proteoglycans) and organ parenchyma on the basis of
      feedback mechanisms. The role of the "cell orchestra conductor" changes at
      different stage of reaction; macrophage-fibroblast interaction is the most
      important in the cooperation between inflammation and regeneration. The breakdown
      of the homeostatic autoregulatory mechanisms (particularly those of intercellular
      and intertissue interaction) results in the disturbance of standard reactions,
      disintegration of inflammation and regeneration, chronicity of inflammatory
      reactions, incomplete regeneration, progressing sclerosis, formation of deficient
      granulation and fibrous tissue, tendency to the secondary destruction. The
      process loses the adaptive character and the notion of "dysregeneration" is
      introduced for its characteristics.

PMID- 1741673
TI  - [Congenital hypoplasia of the pancreas with lipomatosis and bone marrow
      dysfunction (Shwachman syndrome)].
AB  - The description is given of Shwachman syndrome in a male of 17, with a long
      anamnesis of malabsorption syndrome, granulocytopenia, repeated bronchopneumonia,
      somatogenic subnanism and hypogonadism. The death resulted from acute
      cardiovascular insufficiency. Post-mortem examination revealed exocrine pancreas
      hypoplasia with lipomatosis, Wirsung duct atresia, fibrocholangiocytosis and fat
      hepatosis, visceral anemia, delay in the maturation of granulocytes in the bone
      marrow, somatogenic polyglandular endocrinopathy, metabolic myocardium necrosis,
      calcinosis of the small arteries wall, lymphoid tissue atrophy, focal pneumonia
      of the upper lobe of the left lung.

PMID- 1741674
TI  - [Pathogenesis of hemolytic-uremic syndrome].
AB  - Current literature on the pathogenesis of the hemolytic-uremic syndrome (HUS) is
      analyzed. A variety of etiologic factors and mechanisms of HUS development is
      considered. The emphasis is laid on the endotoxinemia, damage of the renal vessel
      and glomerular mesangium endothelium and other mechanisms.

PMID- 1741675
TI  - Skeletal muscle ventricles: update after 18 months in circulation.
AB  - Skeletal muscle ventricles (SMVs) have been constructed from canine latissimus
      dorsi muscle and connected to the aorta as aortic diastolic counterpulsators.
      Presently one dog remains alive and well with an SMV that has been functioning
      continuously in circulation for 18 months, without evidence of thromboembolic
      complications. SMVs are able to perform cardiac-type work with an output equal to
      that of the left ventricle at physiologic preloads, when tested with a mock
      circulation device in our laboratory. SMVs have been used for right-sided cardiac
      assist. In acute experiments these ventricles have functioned effectively,
      bypassing the right side of the heart for up to 8 h. Most recently we have tested
      SMVs using them chronically to pump blood in the right-sided circulation, and at
      the time of writing they have been shown to function effectively in this
      configuration for up to 18 days. SMVs may be used in the future as a method of
      treating patients with left- or right-sided heart failure.

PMID- 1741676
TI  - Perspectives for pneumatic and hydraulic circulatory assist devices and their
      application for heart transplantation.
AB  - Intraventricular blood-forcing-principle-based pneumo- and hydraulic assistance
      circulation device test results are proposed. The system consists of a uninipple
      valveless dome pump, a pneumo- or hydraulic drive, and an artificial pericardium.
      Stand tests of these systems and medical-biologic experiments on dogs and 17
      calves were performed. The duration of these experiments was up to several days.
      In this report, the features of surgical techniques, perfusion parameters,
      control principles, hemodynamic variations, complications, and other problems
      concerning realization of the proposed method are discussed.

PMID- 1741677
TI  - Biventricular bypass: alternative to univentricular bypass and total artificial
      heart-bridge.
AB  - Left ventricular and biventricular bypasses (LVBs, BVBs) were performed in 102
      experiments in sheep, goats, and donkeys. Biventricular bypass was performed in
      the assisted circulation mode or in the paracorporeal artificial heart bridge
      (PCAHB) mode when the natural heart fibrillates. During implantation of
      artificial ventricles instead of a heart-lung bypass, counterpulsation was used.
      Several types of connective conduits were developed and tested in experiments.
      The conduits included bifurcational connective pipes that permit "intake" of
      blood into artificial ventricles from atria and ventricles of the natural heart
      simultaneously and consequently provide effective blood flow through shunts not
      depending on the state of the natural heart (acute cardiac weakness or asystole).
      Monitoring gas content (PO2, PCO2, and pH) in the myocardium of both ventricles
      suggested development of right ventricular failure under conditions of LVB before
      hemodynamic changes occurred and confirmed the preferability of BVB over other
      methods of assisted circulation, as it is most effective and capable of
      normalizing short-term cardiac disturbances in the course of the 1st 2 days.
      Survival time of experimental animals (2-3 days for dogs, 5-12 days for sheep,
      goats, and donkeys) is sufficient to overcome acute cardiac insufficiency. This
      suggests that BVB in the assisted circulation mode or PCAHB mode can serve as a
      bridge for cardiac transplantation for the time of search for the available
      organ.

PMID- 1741678
TI  - Extracorporeal mechanical pulsatile pump and its significance for myocardial
      function recovery and circulatory support.
AB  - The authors performed 12 acute (on dogs) and 12 chronic (on calves) assisted
      circulation experiments with the use of the total extracorporeal mechanical pump
      (TEMP) artificial ventricles. The functional morphological research of the
      myocardium suggests that in addition to the possibility of the biological heart
      function full replacement, the artificial ventricle also helps recover damages in
      both the myocardial infarction and distal zones. The critical time period up to
      the onset of artificial circulation is not more than 2 h, and after that
      myocardial changes are irreversible.

PMID- 1741679
TI  - Total artificial heart without valves: principles of design and implantation
      technique.
AB  - A total artificial heart (TAH) without valves is a TAH of a new design. The entry
      and exit are combined in one opening. The excision of the biologic ventricles is
      below the atrioventricular groove, while the outlet and position of the right and
      left ventricles are preserved. The aortic and pulmonary valves have been left
      intact. Bioprostheses BAKS are implanted into the mitral and tricuspidal
      positions. Initial experiments hold much promise: the absence of artificial
      valves decreases the risk of thromboemboly; the natural heart basis remains
      intact, which facilitates the subsequent donor heart transplantation; and the
      work of the new TAH is practically noiseless.

PMID- 1741680
TI  - Clinical indications for the use of the "Poisk-IOM" total artificial heart: the
      experience of 13 implantations in humans.
AB  - Success of total artificial heart (TAH) implantation as a temporary measure
      depends on three factors: proper patient selection, adequate surgical technique,
      and safe cardiac prostheses. From 1986 until March 1990, 237 patients with
      stagnant heart failure were examined. Sixty-one patients (27%) were put on a
      waiting list. Thirty-eight percent of them died awaiting transplantation.
      Thirteen TAH implantations were performed; nine patients who were not on a
      waiting list underwent TAH implantation by urgent indications. Four other
      patients underwent bridge TAH implantation after cardiac surgery. Our experience
      shows that the status of a patient before transplantation is a determinant factor
      and that it is possible to perform TAH implantation only in patients on a waiting
      list.

PMID- 1741681
TI  - Present and future of the artificial heart driving system.
AB  - The totally artificial heart (TAH) is now in development in two trends. First,
      there is the development of a bridge system for temporary support of cardiac
      function. The TAH with the extracorporeal pneumatic driving system Sinus-IS is
      more efficient and safer. Parallel with this, a portable pneumatic driving system
      has been developed. That can be considered a stage in the development of the
      second trend: a totally implantable TAH. This article reviews problems of
      building of the Micron energy system to be used in implantable TAH designs.

PMID- 1741682
TI  - The interaction of heparinized biomaterials with human serum, albumin,
      fibrinogen, antithrombin III, and platelets.
AB  - The influence of the method of heparin (HEP) immobilization on human serum
      albumin (HSA), fibrinogen (FG), and antithrombin III (AT-III) adsorption,
      platelet adhesion, and activation on the surface of polyvinylchloride,
      polyurethane Vitur, and a copolymer of styrene and divinylbenzene was measured.
      The negative correlation between the degree of irreversibility of plasma protein
      adsorption and the amount of adsorbed AT-III for HEP, immobilized onto the
      polymer surface passivated with HSA, FG, and plasma was found. The same negative
      correlation was observed between the amount of AT-III adsorbed on these systems
      and the number of adhered platelets. Schemes of the interaction of surface bound
      HEP with AT-III, including the influence of an irreversibly adsorbed protein
      layer and adhered platelets, have been proposed. The essential role of AT-III in
      heparinized biomaterials/platelet interaction has been shown. A new method of
      combined immobilization of HEP and platelet adhesion inhibitor has been
      elaborated on.

PMID- 1741683
TI  - The heterogeneity of protein/surface interactions and structural alterations of
      adsorbed albumin and immunoglobulin G.
AB  - The theoretical model is developed for the reversible and irreversible protein
      adsorption in kinetic regime by assuming the continuous energetical heterogeneity
      for protein/surface interaction and the possibility of structural alterations of
      adsorbed molecules. The simplest rectangular distributions of adsorption centers
      in energy of activation are used to explain the logarithmic kinetics of IgG and
      human serum albumin (HSA) adsorption on a quartz surface. To explain the
      Freindlich character of HSA adsorption onto a precoated surface, the exponential
      distributions of adsorption centers in energy of activation are used. A
      competitive analysis of some of the approaches allowed for the energetical
      heterogeneity of protein/surface interaction is made. The possibility of lateral
      electrostatic repulsion to form the logarithmic kinetics of HSA adsorption is
      checked experimentally. The influence of the temperature on HSA adsorption onto
      quartz is discussed also.

PMID- 1741684
TI  - Elastic siloxane materials for endoprosthetic applications.
AB  - Data are reported on properties and application in the clinical practice of
      elastic silicone materials for medical uses and items thereof prepared in the
      S.V. Lebedev All-Union Synthetic Rubber Research Institute. The effect of the
      implants on the neighboring tissues and on the living organism as a whole is
      discussed. The possibility of using the materials under consideration for
      endoprostheses is demonstrated.

PMID- 1741685
TI  - Absence of lung reactions after complement depletion during dialysis: an
      experimental study in pigs.
AB  - Sequestration of 111In-labeled neutrophils (polymorphonuclear leukocytes--PMNs)
      in the lungs during sham dialysis was studied dynamically using a gamma camera.
      Five animals were pretreated with cobra venom factor, naja naja (CVF), to achieve
      depletion of the complement system, mainly C5a. Seven animals were studied
      without pretreatment with CVF. Central hemodynamics and gas exchange were studied
      as well as neutrophil function using luminescence and aggregation. In the control
      group there was a significant sequestration of neutrophils in the lungs, which
      reached a maximum between 15 and 17 min after the start of hemodialysis. The
      peripheral neutrophil count decreased concomitantly. These changes were virtually
      absent in the CVF-treated group. PMN aggregation and luminescence were abolished
      in CVF-treated animals. Both pulmonary artery pressure and pulmonary vascular
      resistance increased significantly in the control group, whereas in the CVF group
      these parameters remained unchanged. There were no differences in blood gases,
      platelet count, or hematocrit between the groups. The results clearly indicate
      that the activation of neutrophils within minutes after the start of hemodialysis
      is greatly dependent on C5a activation because it can be abolished by C5a
      depletion. This activation is accompanied by changes in the pulmonary circulation
      with increases in pressure and resistance.

PMID- 1741686
TI  - Experimental study on the hemodynamic effects of veno-arterial extracorporeal
      membrane oxygenation with an automatically driven blood pump on puppies.
AB  - Hemodynamics, mainly the pressure of the heart, was studied while performing veno
      arterial extra-corporeal membrane oxygenation (VA-ECMO) on 16 puppies between the
      right atrium and the right carotid artery with a unique ECMO circuit using an
      automatically driven blood pump. The resulting decrease in the mean pulmonary
      arterial pressure indicated a definite support of VA-ECMO on the volume work of
      the right heart. The right and left ventricular end-diastolic pressures decreased
      during the low flow bypass, but increased significantly with flow over 50
      ml/min/kg. The results indicated biventricular pressure strain due to the
      increase in afterload. The left ventricular systolic pressure gradually increased
      despite the steady decrease in the systemic arterial systolic pressure when
      bypass flow exceeded 60 ml/min/kg. The findings were similar to those in
      peripheral circulatory insufficiency. The authors concluded that VA-ECMO flow
      should be kept as low as possible, in view of undesirable hemodynamic effects on
      both ventricles.

PMID- 1741687
TI  - Fluorocarbon-based oxygen carriers: new orientations.
AB  - Fluosol, a first, low-concentration fluorocarbon emulsion, was recently approved
      for oxygenating the myocardium during percutaneous transluminal coronary
      angioplasty. Improvements in fluorocarbon and emulsion technology have led to the
      development of significantly more stable, more efficient second-generation
      injectable O2 carriers. This progress extends the potential of fluorocarbons in
      medicine to new applications both in diagnostics and in therapeutics. Future
      objectives will aim at adjusting and optimizing the preparation's characteristics
      for each specific application. The emulsifier, or surfactant, which determines
      the external appearance of the fluorocarbon droplets, will play a key role in the
      mastery of emulsion properties. Extensive research efforts are therefore being
      directed toward the synthesis and evaluation of new families of surfactants or co
      surfactants specifically designed for emulsifying fluorocarbons.

PMID- 1741688
TI  - Biochemical changes in knee joint articular cartilage after cemented prosthetic
      hip hemiarthroplasty in dogs.
AB  - Biochemical changes in the distal femoral articular cartilage (knee joint) after
      cemented prosthetic replacement of the femoral head were determined. Femurs from
      dogs (n = 10) that had undergone cobalt-chromium prosthetic hip hemiarthroplasty
      (6-8 months postoperatively) were analyzed for articular cartilage lipids in the
      distal femur. The quantity of phosphatidylserine increased from 0.59 +/- 0.14 mg
      (uninvolved) to 1.52 +/- 0.23 mg (hemiarthroplasty) lipid phosphorus/100 g
      tissue, and the quantity of arachidonic acid in the articular cartilage increased
      from 0.23 +/- 0.07 mg (uninvolved) to 2.07 +/- 0.29 mg/100 g tissue
      (hemiarthroplasty). Likewise, hydroxyproline content was higher in the recipient
      femurs (77.4 +/- 1.58 micrograms/mg cartilage) versus uninvolved femurs (71.8 +/-
      1.03 micrograms/mg cartilage); the activity of acid phosphatase was greater in
      the recipient distal femoral cartilage as compared with the uninvolved femur,
      0.07 +/- 0.01 and 0.06 +/- 0.02 mol hydrolyzed per kilogram per hour,
      respectively, and the hexosamine content was lower in the recipient femur knee
      cartilage versus knee cartilage from uninvolved femurs, 54.5 +/- 1.51 and 63.1 +/
      1.37 micrograms/mg cartilage, respectively. These biochemical changes may
      suggest degeneration of the knee joint articular cartilage after cemented hip
      hemiarthroplasty.

PMID- 1741689
TI  - In vitro hemodynamic analysis of flexible artificial ventricles.
AB  - An in vitro fluid dynamic study was performed to compare the hemodynamic
      characteristics of a rigid and a flexible total artificial heart. The artificial
      ventricles were incorporated into a mock circulatory system, and pressure signals
      within the ventricular chamber, proximal to the inflow valve and distal to the
      outflow valve, were obtained. The instantaneous flow rate through the inflow and
      outflow valves was measured with electromagnetic flow probes. Flow visualization
      studies performed on the flexible ventricle suggested a vortical motion within
      the chamber with a smooth washout of fluid in the next pumping phase, but flow
      disturbances were observed near the wall of the ventricle as well as near the
      outflow valve. The rate of pressure increase (dP/dt) was smaller in the flexible
      ventricle as compared with the rigid ventricle for comparable flows and heart
      rates. The results of the present study indicated that the flexible ventricle
      with polyurethane valves, having the advantage of ease of implantation and cost
      savings, can be a viable alternative as a bridge to transplant.

PMID- 1741690
TI  - Control systems for the electric heart.
AB  - Methods to predict and control cardiac output (CO) accurately in total artificial
      heart (TAH) recipients have varied significantly in the last few decades. Early
      models exhibited minimal control mechanisms and involved fixed pumping
      parameters. Elaborate electromechanical systems that have recently evolved
      require intricate communication between the circulating blood volume and the
      electric pump to maintain blood flow to critical organs. Attempts to quantitate
      specific end-organ blood flow, metabolic alterations, and oxygen delivery and,
      finally, to link these functions to the control of the TAH have not succeeded.
      Current devices seek to predict the needed CO by monitoring preload, afterload,
      or a combination of both. No consensus has developed concerning the appropriate
      physiologic parameters that should be surveyed in vivo and then used to regulate
      the output of the TAH.

PMID- 1741691
TI  - Comparison of creatinine, hippuric acid, 5-hydroxyindoleacetic acid, serotonin,
      and pseudouridine concentrations in blood withdrawn from vein and arteriovenous
      fistula of uremic patients on maintenance hemodialysis.

PMID- 1741692
TI  - Effect of wearing complete dentures on human palatal mucosal blood flow measured
      by 133Xe clearance.
AB  - In eight edentulous subjects, who had not previously worn dentures, blood flow
      was measured by 133Xe clearance after intramucosal injection. Upper and lower
      complete dentures were then constructed for these subjects, and 133Xe clearance
      was measured after the dentures had been worn for 7 and 40 days. Before the
      insertion of dentures the mean blood flow to palatal mucosa was 18.9 +/- 7.1
      ml/100 g/min. Seven and 40 days after wearing dentures the mean flows to the
      palatal mucosa were 10.6 +/- 4.5 and 12.6 +/- 5.3 ml/100 g/min, respectively. The
      difference before and after wearing dentures was statistically significant (p
      less than 0.05). The subjects were asked not to wear the dentures for 24 h after
      the third visit on the 40th day whereupon the blood flow reached almost normal
      levels (16.2 +/- 5.45 ml/100 g/min). The findings show that wearing dentures
      hinders the blood supply to the palatal mucosa, and that after resting the oral
      tissues, blood flow may return to normal levels.

PMID- 1741693
TI  - The effects of human salivary cystatins and statherin on hydroxyapatite
      crystallization.
AB  - The adsorption, at hydroxyapatite surfaces of neutral cystatin SN, acidic
      cystatin S and the phosphoserine-containing acidic cystatin S1 was compared to
      that of statherin. The effects of these adsorbed proteins on the constant
      composition growth kinetics of hydroxyapatite were also studied. The neutral
      cystatin SN had a higher adsorption maximum than the acidic cystatins S and S1.
      Although the affinity of cystatin for hydroxyapatite surfaces was lower than that
      of statherin, their influence on the growth kinetics of hydroxyapatite was
      considerably greater, with the acidic cystatin S1 being the most active. At a
      surface concentration of 7.0 x 10(-8) mol m-2 hydroxyapatite, the cystatins
      decreased the rate of crystal growth by 80-95% as compared to that in the absence
      of protein. At this concentration, statherin showed a growth inhibition of 40%.

PMID- 1741694
TI  - Prostaglandin E2 receptor of rat submandibular salivary glands.
AB  - The binding characteristics of the PGE2 receptor were investigated in membrane
      preparations from these glands. Specific [3H]PGE2 binding was linear as a
      function of the membrane protein concentration and reached steady state by 40 min
      of incubation at 37 degrees C under neutral pH. Scatchard analysis of the binding
      data produced a curvilinear plot with a Kd of 0.18 nM and Bmax of 1.02 fmol/mg
      protein for the high-affinity binding sites, and a Kd of 181 nM and Bmax of 5.72
      pmol/mg protein for the low-affinity binding sites. A competitive displacement
      study indicated that the receptor was specific for prostaglandins of the E
      series. The study is the first to demonstrate the presence of the PGE2 receptor
      in rat submandibular gland and to provide its biochemical features.

PMID- 1741695
TI  - The permeability of cat dentine in vivo and in vitro.
AB  - The apparent impermeability of dentinal tubules to chemicals applied to exposed
      dentine in vivo was investigated. It was shown that whereas Evans' blue diffused
      readily into dentine in extracted teeth, it did not do so in visible amounts when
      it was applied in vivo. In the in vitro experiments, decreasing the pressure of
      the Evans' blue solution to 20 cmH2O below atmospheric apparently prevented the
      dye entering the tubules, while increasing the pressure of the solution to 15
      cmH2O or more above atmospheric in vivo resulted in the dye penetrating the
      dentine in high concentrations. It is concluded that, in cat dentine in vivo,
      there is an outward flow of fluid through exposed dentinal tubules, and that this
      flow is sufficient to substantially reduce diffusion into the tubules of
      chemicals such as Evans' blue.

PMID- 1741696
TI  - Thin-layer chromatographic analyses of lipids in different layers of porcine
      epidermis and oral epithelium.
AB  - Frozen cryosections were cut parallel to the surface of porcine skin and palatal,
      buccal and floor-of-mouth mucosa so as to provide separate samples representing
      various epithelial layers. The samples were dried, extracted with
      chloroform:methanol, and the lipids were chromatographed on silica gel plates in
      various solvent systems. After charring, lipids were quantified with a scanning
      densitometer. Overall, greater differences in proportions and distributions of
      lipid components were evident between keratinized and non-keratinized epithelia
      than between epidermis and keratinized oral epithelium. For epidermis and palate
      there was an increase in neutral lipids, including ceramides, from the deeper
      layers to the surface; ceramides were most abundant in surface layers. In buccal
      epithelium there was a distinct increase in glycosylceramides toward the surface,
      and in both non-keratinized regions ceramides were present in only very small
      amounts. The results suggest that although neutral lipids may be associated with
      a superficial barrier layer in skin and oral mucosa, there are differences in the
      composition of this barrier between keratinized and non-keratinized epithelia.

PMID- 1741697
TI  - Changes in facial skin temperature associated with chewing efforts in man: a
      thermographic evaluation.
AB  - Eleven healthy male adults chewed hard and soft chewing-gums for 5 min. A
      thermographic record of the face on the chewing side was made at the beginning
      of, during and after the effort. Facial temperature distributions during
      open/close cyclic unloaded jaw movements were recorded at a later date. The
      dimensions of the zones whose temperatures were 1.4 degrees C or more higher than
      the central temperature during the experiment were determined. There was a linear
      increase in the dimensions of these zones after the chewing. In contrast, the
      cyclic jaw movements did not result in significant increases. Chewing the hard
      gum produced significantly higher temperature rises than did the soft in the
      masseter area. After the chewing effort, the temperature fell gradually, but did
      not return to the initial state even after 30 min. The overall decreasing pattern
      of the temperature distribution for chewing the soft gum was similar to that for
      the hard gum. The facial temperature associated with chewing efforts rose in
      accordance with the resistance offered by the chewing-gums.

PMID- 1741698
TI  - Age and gender influence on lead accumulation in root dentine of human permanent
      teeth.
AB  - 143 permanent teeth of individuals aged 14-60 yr from a non-occupationally
      exposed population in northern Israel were analysed for lead accumulation in a
      atomic absorption spectrophotometer graphite-furnace. A significant correlation
      was established between lead level and age. No gender correlation was found. The
      results suggest that any study dealing with lead accumulation in different
      populations has to compare groups of the same age range, ignoring the sex of the
      individuals.

PMID- 1741699
TI  - Rat sublingual salivary glands: secretory changes on parasympathetic or
      sympathetic nerve stimulation and a reappraisal of the adrenergic innervation of
      striated ducts.
AB  - Sublingual glands were examined by light and electron microscopy after
      stimulating the parasympathetic nerve (5 Hz continuously) or the sympathetic
      nerve (50 Hz in bursts 1 s every 10 s) and compared with contralateral,
      unstimulated, normal glands from each animal. Parasympathetic stimulation caused
      secretion of mucin from the tubulo-acini and possibly a small amount of
      degranulation from the demilunes but no changes were detected in the striated
      ducts. Sympathetic stimulation, on the other hand, had no effect on the tubulo
      acini or demilunes but caused a surprisingly extensive degranulation of the
      striated ducts plus loss of glycogen from their cells. Reassessment of the
      adrenergic innervation in the glands was therefore undertaken, by means of
      catecholamine fluorescence. This identified a regular association between
      adrenergic nerves and the striated ducts not only in sublingual but also in
      submandibular glands; features that have not previously been recognized. There
      was, however, only a sparse adrenergic innervation of the other parenchymal
      elements in the sublingual glands.

PMID- 1741700
TI  - Responses of calcitonin gene-related peptide-immunopositive nerve fibres in the
      periodontal ligament of rat molars to experimental tooth movement.
AB  - Nerve fibres showing CGRP-immunoreactivity were exclusively distributed around
      blood vessels in the periodontal ligament of normal teeth. The CGRP-positive
      nerves as well as the vessels were more dense during tooth movement and reached a
      maximum density and intensity of immunoreaction after 3 days. After that, the
      immunoreactive nerves gradually disappeared, and returned to the control level by
      the 7th day. Some of the CGRP-nerves were adjacent to bone resorptive lacunae at
      3 days when active remodelling of alveolar bone was taking place. These findings
      suggest that the distribution of CGRP-positive nerves is dynamically changed
      around the blood vessels in the periodontal ligament during tooth movement, and
      that CGRP might affect the regulation of blood flow in the ligament. CGRP is
      possibly involved in the tissue remodelling, directly or indirectly, in addition
      to its function as a neurotransmitter.

PMID- 1741701
TI  - An electron microscopic study of dental plaque of the rat incisor.
AB  - Because rat incisors continuously erupt they provide an opportunity for the study
      of dental plaque at all stages of its development. The youngest plaque would be
      visible at the gingival margin of the tooth as it erupts, and the older plaque
      higher on the tooth. The ultrastructural features of these plaques were studied
      by transmission electron microscopy. Cocci and short rods colonized the cementum
      surface, forming a monolayer. The plaque had a maximum thickness of about 40
      microns, with the inner third rich in fibrillar matrix and the organisms forming
      microcolonies perpendicular to the tooth surface. Cells were haphazardly
      distributed in a loose matrix on the surface of the plaque. In the area of plaque
      disorganization the cementum was covered by isolated groups of bacteria and the
      matrix had holes in it. The rat mandibular incisor may provide a unique model for
      study of how plaque on cementum is initially formed, matures and finally is
      degraded.

PMID- 1741702
TI  - Preliminary nuclear magnetic resonance studies on human saliva.
AB  - Of gustatory-stimulated human whole, parotid, submandibular and sublingual saliva
      only parotid saliva, a serous rather than mucous secretion, presented a
      relatively well-resolved proton NMR spectrum with satisfactory signal-to-noise
      ratio in a short time (30 min). The proton signal intensities showed significant
      circadian rhythms related to the circadian rhythms of protein concentrations in
      saliva. Age- and sex-associated differences in spectra were not observed for
      healthy saliva. On the other hand, marked differences in the spectra were
      observed for patients with suspected sialoadenitis.

PMID- 1741703
TI  - Electrophysiological study on a cochlear outer hair cell.
AB  - In order to examine the mechanoelectrical transduction of a cochlear hair cell,
      the electrical characteristics of the cochlear outer hair cell were studied. Both
      the cell dissociation technique and the patch clamp technique were used in this
      experiment. The membrane current gained by the voltage clamp method had a
      biphasic component, an initial inward current and a following outward current.
      After blocking the outward current by internal Cs ion and external TEA, the
      inward current has voltage-dependent inactivation. Also, the membrane potential
      change was studied by the current clamp method.

PMID- 1741704
TI  - Probational treatment of sudden deafness with prostacyclin: a pilot study.
AB  - Sudden idiopathic hearing loss has occasionally been supposed to be caused by a
      disturbed microcirculation in the inner ear of unknown origin. Little is known
      about the regulation of cochlear blood flow and the effectiveness of drugs in
      cochlear microcirculation. Because animal experiments gave evidence that
      prostacyclin (PGI2) might be one biochemical substratum of local regulators in
      the flow of blood in the stria vascularis, 11 patients with sudden idiopathic
      hearing loss were treated once for 6 h with prostacyclin (10 ng/kg body
      weight/min) in a first open clinical trial. In most cases prostacyclin increased
      hearing level (mean value: 7.4 dB/frequency/day) more than a standard therapy
      with pentoxifylline. The substitution of PGI2 could be another indication of a
      rheologic disorder--whether per se or within a larger context of inflammation
      like interaction--in the inner ear of patients with sudden hearing impairment.

PMID- 1741705
TI  - Early diagnosis of acoustic neuroma (1989) after experience of 37 cases.
AB  - Although the diagnosis of acoustic neuroma as classically described is generally
      thought to be easy, this is not always true for this so-called "ear tumor" which
      is localized within the internal auditory meatus. Recently, remarkable progress
      has been made in the diagnostic instrumentation and operative techniques used to
      treat acoustic neuroma, emphasizing the need for early diagnosis so that
      treatment can take place earlier than before. Through early diagnosis, some cases
      of total resection of acoustic neuroma have recently become possible, with
      preservation of not only facial nerve function, but preservation of auditory
      function as well. In the present report, we outline the early diagnosis of
      acoustic neuroma by summarizing 37 cases of acoustic neuroma experienced at our
      institution. We discuss historical presentations, and laboratory tests used in
      diagnosis including pure tone audiometry, speech audiometry, auditory brainstem
      evoked response (ABR), vestibular caloric stimulation, and computed tomography
      (CT) enhanced by introduction of air into the posterior fossa. Two representative
      cases are also presented. It should be emphasized that no clinical test is 100%
      sensitive or specific, and attention must be paid to chronological discrepancies
      in the patient's presentation and "cookbook"-type approaches to evaluation should
      be avoided.

PMID- 1741706
TI  - Hydrogen peroxide generation by eosinophils in allergic rhinitis.
AB  - It was the aim to study the hydrogen peroxide (H2O2) generation by eosinophils in
      allergic rhinitis caused by house dust which was examined in nasal secretion and
      peripheral blood. The concentration of H2O2 in nasal secretions was increased
      after nasal challenge with house dust, and subsided gradually by the increase of
      peroxidase activity. The population of eosinophils and H2O2 generation which was
      morphologically detected on the plasma membrane of eosinophils in nasal
      secretion, were increased with the release of eosinophil chemotactic activity
      after nasal challenge. Also, in peripheral blood, the number and phagocytic
      activity of eosinophils in extremely high density 1.102 g/ml were increased after
      nasal challenge. A high number of eosinophils was found in a density of 1.097
      g/ml in the high IgE group, but showed less phagocytic activity than in the lower
      IgE group. Considering from these findings, H2O2 generation by eosinophils
      appeared to be an important event in tissue injury and augmentation of allergic
      reaction.

PMID- 1741707
TI  - Plasminogen activator derived from tonsillar lymphocytes of rabbits with arthus
      tonsillitis.
AB  - As an experimental model of human tonsillitis, Arthus tonsillitis of the rabbit
      was produced. In a previous paper, we demonstrated that an increased fibrinolytic
      activity in the circulating blood and increased proteolytic activity of the local
      tissue with Arthus tonsillitis were observed. In the present study, the mechanism
      of the increased proteolytic activity at the local site (tonsil with Arthus-type
      tonsillitis) was examined using cell cultures of lymphocytes originating from the
      tonsil with Arthus-type inflammation. That is, lymphocytes isolated from tonsil
      tissue of the rabbit were cultured in a culture medium for the short term. After
      culture, the used medium was collected and the presence of plasminogen activator
      in the culture medium and lymphocytes was investigated. It was clarified that
      plasminogen activator did exist in the culture medium of lymphocytes originating
      from the tonsil of rabbits with Arthus tonsillitis. Furthermore, addition of T
      cell growth factor to the culture medium of lymphocytes derived from non-treated
      tonsil induced the development of plasminogen activator in that culture medium.
      However, addition of B cell growth factor did not lead to the development of
      plasminogen activator activity in the culture medium. These results suggest that
      plasminogen activator originating from lymphocytes of the tonsil may play an
      important role in the increased proteolytic activity observed at the local site
      of Arthus tonsillitis.

PMID- 1741708
TI  - A double-blind study of the therapeutic efficacy of zinc gluconate on taste
      disorder.
AB  - The therapeutic efficacy of orally given zinc gluconate on taste disorder was
      investigated by a double-blind study in 98 patients with a chief complaint of
      this disease. The subjects were divided into two 49-patient groups and were
      orally given zinc gluconate or the placebo for up to 4 months. Improvement of
      taste examination and subjective symptoms was analyzed in 65 of the subjects.
      Although no significant difference was detected between the two groups in overall
      efficacy, a significant superiority of zinc gluconate to placebo was observed in
      patients with idiopathic and zinc-deficient taste disorder. Comparison of the
      improvement by Ridit analysis showed a significant therapeutic superiority of
      zinc gluconate. In contrast, comparison of the degree of subjective symptomatic
      changes.

PMID- 1741709
TI  - Total laryngeal stenosis in cicatricial pemphigoid.
AB  - Cicatricial pemphigoid in the aerodigestive system is rare, but can be life
      threatening. We report a case of total laryngeal stenosis. During an
      exacerbation, the airway of the patient was obliterated with a cicatrix and
      necessitated an emergency tracheostomy. Six years later when no recurrence of
      pemphigoid was confirmed, laryngofissure operations were performed with a
      satisfactory restoration of laryngeal function. Though otolaryngological
      treatment in the active phases is symptomatic including tracheostomy, surgical
      procedures should be encouraged once the disease has reached a remission.

PMID- 1741710
TI  - Local administration trials of interleukin-2 for head and neck cancer.
AB  - Recombinant interleukin-2 (rIL-2) has been administered locally in 20 patients
      with head and neck cancer. Two complete responses in lower lip cancer and 1
      partial response in lingual cancer have been obtained. Immunohistological study
      reveals that tumor infiltrating lymphocytes (TILs), including activated T
      lymphocytes and natural killer cells, are increased after rIL-2 use.
      Intraarterial chemotherapy, performed subsequently to the local use of rIL-2
      results in a dramatic decrease in tumor size within a short time, and a high
      frequency of CR cases is observed. Local use of rIL-2 is beneficial for treatment
      of head and neck cancers, and induction immunochemotherapy combining locally used
      rIL-2 and arterially infused anticancer drugs plays an important role in a
      multidisciplinary treatment for these cancers.

PMID- 1741711
TI  - Conductive hearing loss with normal tympanic membrane: fibrous change of long
      process of the incus.
AB  - This is a case of conductive hearing loss with the normal tympanic membrane due
      to fibrosis caused by potential inflammation of the long process of the incus.
      High resolution CT was a useful tool for the detection of ossicular disorder.

PMID- 1741712
TI  - A case report of supernumerary tooth and review of literature.
AB  - A boy visited an ear-nose and throat clinic for serous rhinorrhea and a tumor
      like mass in the nasal cavity. X-ray and computered tomographies showed a bone
      like mass with a slightly radiolucent center which seemed to stem from the nasal
      septum. A supernumerary tooth in the nasal cavity was extirpated under local
      anesthesia. In some reports, complications of supernumerary tooth were severe and
      involved areas other than the nose (cleft lip and/or palate, bilateral aniridia
      and ectopia lentis, familial adenomatous polyposis coli, ventricular septal
      defect or patent ductus arteriosus). A case had a risk of inducing severe
      intracranial complication. Therefore we must not overlook a supernumerary tooth.

PMID- 1741713
TI  - Parathyroid gland adenoma in primary hyperparathyroidism: report of two cases-
      chief and oxyphil cell adenoma.
AB  - Parathyroid adenomas are classified into two types: chief cell and oxyphil cell
      variants. In this report two types of parathyroid adenoma in association with
      hyperparathyroidism were examined. Both cases had suffered from renal calculi,
      and underwent operation. The laboratory tests showed high serum calcium and
      parathyroid hormone (PTH) levels. An exploratory surgery revealed a solitary
      tumor in each case. After extirpation of the parathyroid tumor these data
      returned to normal values. Electronmicroscopically, oxyphil cell adenoma in this
      report was characterized by numerous mitochondria and annulate lamellae in the
      cytoplasm. In some tumor cells secretory-like granules were observed.

PMID- 1741714
TI  - Adaptation of sleep and circadian rhythms to the Antarctic summer: a question of
      zeitgeber strength.
AB  - Adaptation of sleep and circadian rhythms was examined in three temperate zone
      dwellers arriving in Antarctica during summer. Rectal temperature, wrist
      activity, and heart rate were monitored continuously, sleep timing and quality
      noted on awakening, and mood and fatigue rated every 2 h while awake. Sleep was
      poorer in 2/3 subjects in Antarctica, where all subjects reported more difficulty
      rising. Sleep occurred at the same clock times in New Zealand and Antarctica,
      however, the rhythms of temperature, activity, and heart rate underwent a delay
      of about 2 h. The subject with the most Antarctic experience had the least
      difficulty adapting to sleeping during constant daylight. The subject with the
      most delayed circadian rhythms had the most difficulty. The delay in the
      circadian system with respect to sleep and clock time is hypothesized to be due
      to differences in zeitgeber strength and/or zeitgeber exposure between Antarctica
      and New Zealand.

PMID- 1741715
TI  - Tracking with a restricted field of view: performance and eye-head coordination
      aspects.
AB  - Vision through a restricted field of view (RFOV) is becoming increasingly common
      in aviation with the use of helmet mounted displays. Our first experiment
      investigated the influence of a narrow (20 degrees) binocular RFOV on performance
      during head-free visuo-manual tracking of a wide range (+/- 85 degrees)
      horizontally moving target. Second, the effects of two levels of RFOV (20
      degrees, 70 degrees) on a similar tracking task presented with various
      eccentricities were compared to full field of view (FOV). Eye and head movement
      around the yaw axis were recorded and analyzed versus head-free visual pursuit
      alone. Tracking performance appeared moderately impaired when RFOV was set to 20
      degrees, but did not improve with a 70 degrees field. Discomfort due to unusually
      large head movements was ruled out as a causal factor. Visuo-manual tracking
      apparently implies a need for head stability. RFOV degrades this basic
      requirement which, in turn, could explain performance impairment. Analysis of eye
      head coordination characteristics following FOV task conditions supports this
      hypothesis.

PMID- 1741716
TI  - Visual contrast sensitivity of U.S. Navy jet pilots.
AB  - Good visual contrast sensitivity (CS) is often described as a visual capability
      important for success as a military aviator and so has been suggested as a
      physical standard for personnel selection and retention. To evaluate this idea,
      we measured the CS of 135 U.S. Navy fighter pilots ranging in age from 24 to 44
      years (mean = 30.20, S.D. = 4.06) and compared these to the CS of non-aviators.
      We obtained the non-aviator data from published studies of other investigators
      who used similar procedures with the same widely used, commercially available
      apparatus (Nicolet CST 2000). In addition to this comparison, we correlated the
      pilots' CS with their air-to-air target detection distances measured during air
      combat maneuver training and to their night carrier landing performance scores.
      The major findings were: 1) The mean CS of the aviators and the non-aviators were
      within +/- 1.0 S.D. of each other in most instances, and those few instances
      where a greater difference was found were parsimoniously explained by
      methodological and procedural factors; 2) sensitivities to different spatial
      frequencies were highly correlated among themselves, indicating much redundancy
      among the measurements; 3) there was no evidence of a relationship between CS and
      air-to-air target detection distances or night carrier landing performance.

PMID- 1741717
TI  - Increased plasma hypoxanthine values in humans during exposure to simulated
      altitude of 7,620 meters (25,000 feet).
AB  - In this study we have determined the effect of severe and moderate hypoxemia on
      plasma hypoxanthine and lactate values. Hypoxemia was induced in healthy humans
      in a low pressure chamber. The test subjects breathed atmospheric air at
      barometric pressures of 279 mm Hg and 385 mm Hg, representing a simulated
      altitude of about 7,620 and 5,334 m (25,000 and 17,500 ft), respectively.
      Exposure to 279 mm Hg represents a severe hypoxemia and all subjects exposed to
      this simulated altitude for 2 min showed symptoms related to hypoxia. After this
      exposure, plasma hypoxanthine increased by an average of 2.4 times compared to
      preexposure values. Exposure to 385 mm Hg represents a moderate hypoxemia and the
      persons tested at this simulated altitude for 45 min showed no or minor symptoms
      related to hypoxia and there was no change in plasma hypoxanthine values. In
      contrast to the unchanged plasma hypoxanthine values there was a 50% increase in
      plasma lactate values after 30 min exposure. We conclude that plasma hypoxanthine
      is a reliable marker for severe cellular hypoxia in humans and that enhanced
      plasma hypoxanthine levels are a rapid response to cellular hypoxia.

PMID- 1741718
TI  - The effect of apomorphine on operant behavior in rats under normoxic and hypoxic
      conditions.
AB  - We studied the effect of apomorphine on the performance of rats, maintained on a
      free-operant shock-avoidance schedule under normoxic and hypoxic (12, 10, and 8%
      O2) environments. In a normoxic environment, apomorphine (1, 2, 4, and 8 mg/kg,
      i.p.) produced stereotyped behaviors and dose-dependent increases in the rats'
      lever-pressing response rate. In a hypoxic environment, however, the increase of
      the response rate induced by apomorphine at 1 mg/kg was suppressed by the hypoxic
      conditions tested. At a dose of 8 mg/kg apomorphine, it was also suppressed by
      exposure to severe hypoxia (10 and 8% O2). These results suggest that the
      impairment of avoidance behavior in rats by hypoxia was not always improved by
      apomorphine, and that the degree of improvement depends on the combined effects
      of the dosage of the drug injected, the degree of hypoxia, and the type of
      behavior observed.

PMID- 1741719
TI  - Role of histamine in motion sickness in Suncus murinus.
AB  - The levels of histamine (HA) and tele-methylhistamine (t-MH) were determined in
      five brain regions of Suncus murinus (suncus) and the effects of motion stimulus
      or drugs influencing the turnover of these amines were studied to elucidate the
      role of histamine in motion sickness. Shaking the animals for 2 min increased HA
      contents in telencephalon and diencephalon without significantly changing the t
      MH levels. alpha-Fluoromethylhistidine (alpha-FMH), which is presumed to deplete
      the neuronal HA, tended to raise the HA levels. alpha-FMH slightly alleviated the
      vomiting response to motion stimulus and suppressed the HA increase in
      diencephalon caused by shaking. Compound 48/80, which releases HA from mast
      cells, did not alter the control HA levels, but effectively prevented the motion
      sickness and completely suppressed the motion-induced rises in HA levels. These
      results provide further evidence that brain HA plays an important role in the
      development of motion sickness.

PMID- 1741720
TI  - Physiological and thermal responses of males with varying body compositions
      during immersion in moderately cold water.
AB  - The effect of body composition on the thermal and metabolic responses of 24 male
      volunteers (20 to 35 years) was examined during 90 min of moderately cold (18,
      22, or 26 degrees C) water immersion to the first thoracic vertebrae. Body
      composition was determined via underwater densitometry. Subjects were divided
      with respect to body fat (high fat (HF) = 18-22%, n = 12; Low fat (LF) = 8-12%, n
      = 12) and randomly assigned to one of three water temperatures. Rectal
      temperature (degree C) after 90 min of immersion did not differ in LF and HF at
      18 degrees C (35.9 vs. 36.2), 22 degrees C (36.0 vs. 36.0), and 26 degrees C
      (36.0 vs. 36.3). Oxygen uptake (VO2, ml-kg-1.min-1) was greater in LF than in HF
      in all water temperatures. Oxygen uptake at 90 min was greater for LF than HF in
      18 degrees C (11.48 vs. 9.19), 22 degrees C (9.79 vs. 4.70), and 26 degrees C
      (6.21 vs. 5.44). Mean skin temperature in LF and HF approached water temperature
      within the first 5 min. Despite the thermal strain of cold water immersion, the
      LF subjects were able to maintain a similar Tre compared to the HF due to a
      significantly greater shivering thermogenesis.

PMID- 1741721
TI  - Airline pilot incapacitation survey.
AB  - A survey, replicating one originally conducted by the International Federation of
      Airline Pilots' Associations (IFALPA) in 1967, was carried out to investigate the
      aetiology of inflight incapacitation on commercial flight decks. The
      questionnaire was constructed by IFALPA and distributed worldwide by its member
      associations. Since response to the questionnaire was voluntary, no control of
      the sample population was possible. The results indicate that 29% of the 4,345
      respondents had been incapacitated at least once. As in 1967, gastro-intestinal
      symptoms accounted for the majority (58%) of incidents, other main causes being
      symptoms of nasal and sinus congestion ('blocked' ear and sinus pain), headaches,
      and faintness or general weakness. Of those who had experienced an incident of
      incapacitation, 48% claimed that safety was actually, or potentially, affected.
      However, when all respondents were asked whether they were concerned about safety
      in the event of incapacitation inflight (excluding take-off and landing), only
      25% expressed concern. Slightly more pilots operating in three-man crews (50.5%)
      thought incapacitation affected the safety of the flight than those operating in
      two-man crews (45.3%).

PMID- 1741722
TI  - The adequacy of corrective lenses worn by United States Air Force aviators for
      annual flight medical examinations.
AB  - Aviators presenting for annual flight medical examinations at the 379th Strategic
      Hospital at Wurtsmith Air Force Base were studied to determine the prevalence of
      substandard visual acuity. The prevalence of the use of outdated (superseded)
      corrective lenses was also studied. We conducted 342 examinations on different
      aviators and 92 (26.9%) of these aviators were found to require corrective
      lenses. There were 23 (6.7%) aviators who were found to have inadequate visual
      acuity and 14 of these (4.1%) were found to be wearing superseded lenses. The
      visual screening method prescribed by the United States Air Force did not
      identify four of the aviators who wore superseded lenses. Three aviators were
      found to be wearing lenses obtained from civil sources. The study suggests that
      improvements could be made in U.S. Air Force visual screening and care.

PMID- 1741723
TI  - Brief cognitive behavior therapy in an undergraduate pilot student: a case
      report.
AB  - This is a case report of a male undergraduate pilot student referred from the
      aerospace medicine service because of difficulty coping with stresses associated
      with undergraduate pilot training (UPT). Two phases of a short-term cognitive
      behavioral treatment program were undertaken. The initial phase of treatment
      involved assisting the student to become aware of cognitive, behavioral, and
      physiological cues that were associated with increased levels of stress, and
      relaxation training. The second treatment phase involved stress inoculation
      strategies and coping procedures that were competency based, rather than mastery
      based. The latter had previously been unsuccessfully used by the student. Results
      indicated increases in self-reported stress management skills and in objective
      reports of training performance. Although generalizability of this study is
      limited, short-term cognitive behavioral therapy procedures are felt to be an
      important tool for improving the performance of UPT students, and may also reduce
      the probability of self-initiated elimination due to subjective stress
      complaints.

PMID- 1741724
TI  - Burn injuries from small airplane crashes.
AB  - Because a large amount of general aviation activity occurs in Central Florida, we
      reviewed our admissions for victims of small airplane crashes. We identified 13
      burn victims of small aircraft accidents over a 7-year period. Of the 13, 12
      survived their burn injuries, an overall survival rate of 92%. The extent of burn
      injury, Abbreviated Burn Severity Index (ABSI), complications, other injuries and
      rehabilitation potential are reviewed. Burn injury resulting from small airplane
      crashes is usually survivable if the patient arrives at the Burn Center alive.
      These burn victims generally are highly motivated individuals, are easily
      rehabilitated, and continue productive lives. Small airports and local hospitals
      should be aware of burn center availability because of the usual major extent of
      the burn injury.

PMID- 1741725
TI  - Situational awareness is more than exceptional vision.
AB  - Superior situational awareness, an extraordinary awareness of the total flight
      environment and aerial combat situation, is a significant contributor to success
      in aerial engagement. Review of over 1,000 published sources has led to the
      formulation of situational awareness as being principally in the cognitive
      domain. Superior awareness involves exceptional sensitivity to performance
      critical cues in the operational environment, an exceptional capacity to
      anticipate changes in system states and operational conditions, and the ability
      to act on those changes in a proactive mode. Three important constructs are
      described: 1) automatic information processing; 2) near-threshold processing; and
      3) skilled memory. In combination, they constitute a pilot attribute which
      uniquely facilitates the full armamentarium of skills and abilities of the
      superior tactical pilot.

PMID- 1741726
TI  - A comparison of the routine medical examination of pilots in 12 air forces.
AB  - All air forces use routine medical examination to ensure the health of their
      pilots and flying safety. I compared pilot physicals in 12 air forces, and
      reviewed literature dealing mainly with routine medical examination of
      asymptomatic individuals. The discussion considers what should be done during the
      routine pilot examination to ensure flying safety, health and mission completion.
      General recommendations are given on ways to keep cost and effort within limits
      without failing to achieve the objective. Methods to achieve this include
      differentiating the intervals between examinations in different age groups and
      inclusion of procedures only beyond a certain age. Caution is advised when
      considering the inclusion of new procedures, and attention should be paid to
      whether such a test can be expected to produce unacceptable numbers of false
      positive results.

PMID- 1741727
TI  - The EEG in pilot selection.
AB  - We summarised and tabulated the literature dealing with the electroencephalogram
      in pilot selection published since a review in 1976. The incidence of seizure
      development in healthy groups with epileptiform discharges in their EEGs was
      found to be very low. An alternative interpretation is offered of the
      significance of epileptiform discharges in these groups in the context of pilot
      selection, and a plea is made for international standardization of procedures in
      this area.

PMID- 1741728
TI  - Sickle cell anemia trait in the military aircrew population: a report from the
      Military Aviation Safety Subcommittee of the Aviation Safety Committee, AsMA.
AB  - The question of whether sickle cell trait (SCT) is potentially dangerous to
      military aircrew personnel who have it and, consequently, whether such
      individuals should be allowed to fly in military aircraft is a very emotional
      issue. This article traces the evolution of how the U.S. military has dealt with
      the problem, and the present status of individuals with SCT in the U.S. military
      aviation community. Extensive studies and means for subjectively evaluating the
      problem were instituted by the Department of Defense in 1981, after making the
      decision not to restrict aircrew with the trait from aviation duties. All
      research projects and educational programs were abruptly stopped in 1985. Today,
      there are no actual restrictions on individuals with SCT for duty in the aviation
      and diving communities.

PMID- 1741729
TI  - General Armstrong's monuments.
AB  - During his term as surgeon general, Maj. Gen. Harry G. Armstrong was interested
      in the French monument commemorating the balloon flight of John Jeffries, the
      first American aviator, and Jean Pierre Blanchard. Maj. Gen. Armstrong proposed
      to visit the monument, located in a French forest, and have it renovated with
      appropriate multi-national ceremonies. The monument is at the landing site of the
      first flight across the English Channel. The authors discovered the former and
      current condition of the monument in Guines, France and compare that monument, of
      interest to Maj. Gen. Armstrong, to a new monument named for him, the newly
      enlarged U.S.A.F. Armstrong Laboratory.

PMID- 1741730
TI  - An appraisal of chemical aversion (emetic therapy) approaches to alcoholism
      treatment.
AB  - More than 35,000 alcoholics have received chemical aversion (emetic therapy) in
      at least 75 settings worldwide since the 1930s. This consummatory aversion (CA)
      treatment, which pairs ethanol ingestion with emetically induced nausea,
      incorporates the highly efficient variety of learning known as taste aversion
      (TA) conditioning. The CA literature indicates that emetic therapy should induce
      conditioned alcohol aversions in many alcoholics. Such aversions have been widely
      reported by clinicians and have been confirmed by recent psychophysiological
      evidence. Long standing evidence of treatment effectiveness is found in the
      results of private hospitals which have consistently produced 1-yr abstinence
      rates approximating 60%. Diminished alcohol craving is a frequently reported
      benefit. Few experimental evaluations have been completed, as is generally the
      case for all alcoholism treatments, but those which used methodologically sound
      temporal parameters during conditioning have supported the clinical efficacy of
      emetic therapy. The clear need for more definitive research notwithstanding,
      there are compelling indications that emetic therapy is a useful component of
      multimodal treatment within certain alcoholic populations. However, its
      availability is severely limited. Many alcoholics could probably benefit from
      expanded treatment availability. The time is ripe for a reevaluation of
      resistances to the clinical use of emetic therapy alcoholism treatment.

PMID- 1741731
TI  - Chemical aversion conditioning in the treatment of alcoholism: further comments.
AB  - The literature on consummatory aversion (CA) conditioning in rats does provide a
      well-developed theoretical foundation for chemical aversion conditioning.
      Nevertheless, differences between rats and humans in CA learning suggest caution
      in extrapolating from the animal laboratory to the treatment of alcoholic
      patients. Serious methodological problems with studies of emetic therapy with
      alcoholics preclude unambiguous evaluation of its effects. Emetic therapy is an
      intrusive and relatively costly form of treatment which has not been shown to be
      more effective than alternative, less costly methods. The onus is on proponents
      of this method to demonstrate its specific advantages over alternative
      treatments.

PMID- 1741732
TI  - Implicit and explicit memory bias for threat in post-traumatic stress disorder.
AB  - We investigated explicit (cued recall) and implicit (word completion) memory in
      Vietnam combat veterans with (n = 24) and without (n = 24) post-traumatic stress
      disorder (PTSD). Half of the subjects in each group encoded combat, social
      threat, positive, and neutral words elaboratively, whereas the others encoded
      these words nonelaboratively. On the cued recall test, under both encoding
      conditions, both groups recalled more combat words than other words. However,
      difference scores obtained by subtracting the mean recall for neutral words from
      the mean recall scores for the other words revealed that PTSD patients exhibited
      a relative explicit memory bias for combat words. That is, PTSD patients tended
      to exhibit poor memory for everything but combat words. On the word completion
      test, only PTSD subjects exhibited an implicit memory bias for combat words. This
      bias was greater for primed than for unprimed words, thereby ruling out a
      response bias. Such memory bias may underlie the 'reexperiencing' symptoms
      characteristic of PTSD (e.g. intrusive thoughts, nightmares).

PMID- 1741733
TI  - Biased cognitive operations in anxiety: artefact, processing priorities or
      attentional search?
AB  - It has been shown that, under certain circumstances, anxiety is associated with a
      processing bias favouring threatening information. To explain why this bias is
      apparent only on certain cognitive tasks, it has recently been proposed that the
      bias operates only when there is competition for processing resources. The
      present study sought to replicate previous evidence for the 'competition'
      hypothesis, while taking into account a potential confounding factor of word
      categorization in the stimulus materials. Anxious patients and normal controls
      were compared on their lexical decision times for threatening, categorized
      neutral and uncategorized neutral words that were presented either alone or
      accompanied by irrelevant nonword stimuli (i.e. absence vs presence of
      competition). The results were only partially consistent with previous findings
      and highlighted the importance of considering separately the effects of word
      valence and word categorization. When the latter was taken into account, the
      results indicated that an anxiety-related bias was only evident when there was
      competition for processing resources and when the information was presented
      outside the focus of Ss' attention. A modified version of the competition
      hypothesis was proposed in the light of these results and previous research into
      attentional biases in anxiety.

PMID- 1741734
TI  - Evaluation of thermal biofeedback treatment of hypertension using 24-hr
      ambulatory blood pressure monitoring.
AB  - Ten male hypertensives, whose BPs were controlled on a combination of
      sympatholytic and diuretic medications, were given 16 sessions of thermal
      biofeedback prior to attempting withdrawal from the sympatholytic drug. Results
      were evaluated using 24-hr ambulatory BP monitoring (ABPM) as well as clinic and
      home BPs, both in multi-baseline-across-subject designs and as a single group.
      Results showed significant treatment effects on 24-hr ABPM data, both at the
      individual level (SBPs only) and in the aggregate analyses (SBP and DBP). BPs
      assessed in the clinic by random zero sphygmomanometer and patient-assessed home
      BPs were also reduced.

PMID- 1741735
TI  - Prevalence of DSM-III-R disorders among nonclinical compulsive checkers and
      noncheckers in a college student sample.
AB  - The prevalence of lifetime DSM-III-R disorders was assessed in a sample of 100
      college students who were classified as compulsive checkers (n = 50) or
      noncheckers (n = 50) on the basis of their responses to the Checking subscale of
      the Maudsley Obsessional-Compulsive Inventory (MOCI). DSM-III-R disorders were
      assessed on the basis of responses to the Diagnostic Interview Schedule, Version
      III Revised (DIS-III-R), administered by trained, lay interviewers, blind to Ss'
      checking status. Checkers, compared to noncheckers, were significantly more
      likely to meet lifetime diagnostic criteria for Major Depressive Episode, Drug
      Abuse/Dependence, and Social Phobia. Analysis of a subsample (n = 74) selected on
      the basis of the consistency of responses to the MOCI across two administrations
      replicated the above effects, with two exceptions: (1) checkers were more likely
      to meet criteria for Obsessive Compulsive Disorder than were noncheckers, and (2)
      for males, but not females, Simple Phobia was more prevalent among checkers than
      among noncheckers. These findings extend our previous work by demonstrating that
      'nonclinical' checking behavior is associated with a broad range of psychological
      syndromes and may, in fact, be more strongly associated with other disorders than
      it is with Obsessive Compulsive Disorder in a nonclinical sample.

PMID- 1741736
TI  - Assertiveness, social support, and psychological adjustment following spinal cord
      injury.
AB  - Tested predictions that assertiveness and social support would be significantly
      predictive of psychological adjustment. Furthermore, it was anticipated that
      assertiveness and certain types of social relationships would differentially
      interact to predict adjustment, since positive and negative effects of both
      variables have been noted in prior research. Trained raters interviewed 156
      persons receiving either in-patient or out-patient care for cord injuries and
      administered measures of assertiveness, social support, depression and
      psychosocial impairment. Persons who reported a keen sense of responsibility for
      the welfare of another reported more depression and impairment. Persons reporting
      higher levels of support facilitating social integration and reassuring personal
      worth were less depressed. Several significant interactions between assertiveness
      and different social support relationships revealed beneficial and deleterious
      effects on depressive behavior and impairment secondary to the disability.
      Results are discussed as they advance theoretical understanding of the effects of
      assertiveness and social support. Implications for discriminate cue learning in
      assertion training for persons with physical disability are proposed.

PMID- 1741737
TI  - What is the revised Fear Survey Schedule for Children measuring?
AB  - This study was designed to investigate parameters of children's fear in terms of
      frequency of fearful thoughts and avoidance behaviour. It is suggested that
      current measures such as the Fear Survey Schedule for Children--Revised (FSSC-R)
      do not assess fearful behaviour in the sense of the occurrence of fearful
      responding in daily life, but rather reflect a negative affective response to the
      thought of occurrence of specific events. A modified version of the FSSC-R
      examined the frequency of fearful thoughts/feelings and avoidance activities
      amongst 376 children aged 7-12 yr. Contrary to predictions, it was found that
      children reported high levels of fearful thoughts and avoidance behaviour to
      those items identified as the greatest fears on the FSSC-R, namely fears of
      injury, illness, death and danger. These events were typically of low probability
      (e.g. earthquakes) and the question was raised as to what children are responding
      to when they are asked to rate their fearful responses. The same pattern of
      results was reflected in older compared to younger children. It is suggested that
      even when children are asked to rate frequency of fearful thoughts or avoidance
      behaviour, they tend to respond to fear questionnaire items according to their
      affective response to the image or thought of the stimulus situation rather than
      their actual fear responses. Both the FSSC-R and the modified version were found
      to discriminate between teacher nominated high and low fearful children and to
      correlate significantly with a self report measure of anxiety.

PMID- 1741738
TI  - Cognitive-behaviour therapy in the treatment of chronic, occupational pain of the
      upper limbs: a 2 yr follow-up.
AB  - Nineteen Ss who experienced chronic, occupational pain of the upper limbs and who
      had previously completed a programme of either individual or group cognitive
      behaviour therapy were followed up 2 yr later. Significant improvements on
      measures of depression, anxiety, coping strategies and interference in daily
      living were found following treatment. Such improvements were not evident for the
      waiting list control Ss and no difference was found between group vs individual
      applications of therapy. A 2 yr follow-up, significant improvements from pre
      treatment levels were evident for depression, coping strategies, significant
      other report of disability, self monitored pain and distress caused by pain.
      While there was generally little evidence of relapse, a significant decline from
      post-treatment levels was found for the individual therapy condition compared to
      the group therapy condition on measures of self monitored pain and interference
      caused by pain. Since post-treatment levels tended to be somewhat superior for
      the individual therapy condition, the overall finding at 2 yr follow-up was of
      minimal difference in outcome for group vs individual forms of cognitive
      behaviour therapy. Despite improvements from pre-treatment levels, the vast
      majority of Ss still reported significant and distressing levels of pain at 2 yr
      follow-up.

PMID- 1741739
TI  - Probing of the expression of the low-density lipoprotein receptor in vivo using
      an anti-receptor monoclonal antibody.
AB  - MAC188 is a rat anti-[low-density lipoprotein (LDL) receptor] monoclonal antibody
      (McAb) which binds to the cell surface receptor with high affinity at
      physiological temperatures, even in the presence of high concentrations of the
      natural ligand, LDL. Binding of McAb MAC188 at 37 degrees C is followed by
      internalization and intracellular sequestering of the receptor, which results in
      the transient disappearance of the receptor from the cell surface. The high
      binding affinity and epitope specificity of McAb MAC188 suggested that this
      antibody could be used to quantify receptor expression in vivo. Mixtures of
      radiolabelled anti-receptor antibody and a control McAb (MAC221) were injected
      intravenously into rabbits, and the clearance from serum and uptake into tissues
      was determined. A fraction of the anti-receptor McAb was cleared rapidly from the
      circulation by a high-affinity and saturable (receptor-dependent) process.
      Receptor-dependent uptake of the anti-receptor McAb was measurable in liver,
      adrenal glands, kidneys, spleen, kidney, thoracic aorta and heart. It was highest
      in liver and adrenal glands and correlated well with the level of receptor
      protein and the rate of LDL transport in individual tissues. Anti-receptor McAbs
      such as MAC188, with suitable domain specificity and binding affinity at
      physiological temperatures, have important advantages over the natural ligand as
      tracers for the receptor in vivo, and may find widespread applications in studies
      of the receptor status (activity) in animals and man.

PMID- 1741741
TI  - Rates of reactions catalysed by a dimeric enzyme. Effects of the reaction scheme
      and the kinetic parameters on co-operativity.
AB  - For the reaction S in equilibrium P catalysed by a dimeric enzyme, the reaction
      schemes are considered on the basis of the KNF model. For each of the ten
      possible schemes, the rate equation is derived on the basis of the combined
      steady-state and rapid-equilibrium assumptions. The curves of the plots of
      initial velocity v versus the substrate concentration [S] and the Hill
      coefficients h calculated from the rate equations depend strongly on the reaction
      scheme and the parameter X1. This parameter is defined by log (KS2/KS1) and is a
      measure of the relative affinities of the first and second protomers for the
      substrate. When X1 less than 0, v-[S] curves for some schemes exhibit negative co
      operativity (h less than 1.0) and v-[S] curves for other schemes are similar to
      that of the Michaelis-Menten scheme, indicating that, even if there is
      interaction between the distinct protomers, sigmoidal rate behaviour is not
      necessarily observed. When X1 greater than 0, all the reaction schemes except
      one, which shows substrate-inhibition kinetic behaviour, exhibit sigmoidal
      kinetic behaviour (h greater than 1.0), and at the limit of X1 much greater than
      0 the Hill coefficients attain the maximum possible value of 2.0. Furthermore, we
      have found that, even if X1 = 0, the v-[S] curve for almost all the schemes
      considered in the present work does not necessarily agree with that for the
      Michaelis-Menten scheme. This means that the deviation of the v-[S] curve from a
      hyperbola can be observed even if there is no interaction between the distinct
      protomers.

PMID- 1741740
TI  - Modulation of complement gene expression by glucocorticoids.
AB  - The addition of dexamethasone, prednisolone or cortisol (in order of efficacy) to
      human monocytes in culture produced dose-related increases in the synthesis rates
      of the complement components C1 inhibitor (C1-inh), factor B (B) and C2. In
      contrast, concentrations of C3 and lysozyme in the culture supernatants were
      decreased. Indomethacin stimulated synthesis of C1-inh, C2 and B, but had little
      effect on synthesis of C3 or lysozyme. The simultaneous addition of cycloheximide
      (2.5 micrograms/ml) abrogated the effects of dexamethasone on synthesis of C2, B
      and C1-inh, but the effect of indomethacin on the synthesis of these components
      was unchanged. These data suggest that protein synthesis is required for the
      effects of glucocorticoids on the synthesis of C2, B and C1-inh to occur.
      Dexamethasone and indomethacin increased the abundances of C1-inh mRNA, B mRNA
      and C2 mRNA in parallel with changes in the synthesis rates of these proteins.
      The changes in mRNA abundance were not transcriptional, but were shown to be due
      to increased mRNA stability. In contrast, dexamethasone decreased the expression
      of C3 and lysozyme by decreasing the rate of transcription of these genes.
      Indomethacin had no effect on transcription of the C3 and lysozyme genes. The
      half-lives of C3 mRNA, lysozyme mRNA and actin mRNA were not altered by
      dexamethasone or indomethacin. It is concluded that the effects of
      glucocorticoids on monocyte synthesis of C2, B and C1-inh are due to increased
      mRNA stability and may be related to inhibition of prostaglandin synthesis, as
      these effects are similar to those produced by indomethacin. The effects of
      dexamethasone on the synthesis of C3 and lysozyme differ from those on C2, B and
      C1-inh as they depend upon a decrease in gene transcription, which is not
      affected by indomethacin.

PMID- 1741742
TI  - Structural studies on the [Bu(t)-Cys18](19-37)-fragment of human beta-calcitonin
      gene-related peptide.
AB  - High-field n.m.r. studies were undertaken upon a peptide fragment of the C
      terminal region of human beta-calcitonin-gene-related peptide (beta-hCGRP).
      Studies on the antigenic [Bu(t)-Cys18]beta-hCGRP-(19-37)-fragment revealed that
      several elements of secondary structure were present when the peptide was
      dissolved in [2H6]dimethyl sulphoxide. In particular an unspecified turn in the
      region of Ser19-Gly20 and a type I beta-turn in the region of Asn31-Val32-Gly33
      were identified. Through-space connections between the terminal Phe37 amide group
      and the beta-protons of Thr50 suggest that the peptide may be folded into a loop
      type conformation. These structural elements appear to overlap with the epitopes
      of a number of monoclonal antibodies and provide a molecular basis for
      understanding the role of the terminal Phe37 amide residue in the immune
      recognition of beta-hCGRP.

PMID- 1741743
TI  - Transforming-growth-factor-beta activation elements in the distal promoter
      regions of the rat alpha 1 type I collagen gene.
AB  - We have located a cis-acting element (alpha 1-TAE) within the promoter sequences
      of the rat collagen alpha 1(I) gene (COL1A1) 1600 bases upstream of the
      transcription start site which mediates transcriptional activation by
      transforming growth factor beta (TGF-beta). The functional significance of this
      region was established by (1) deletion analysis of the alpha 1(I) promoter cloned
      upstream of the bacterial chloramphenicol acetyltransferase (CAT) gene and (2) by
      co-transfection of promoter constructs with double-stranded oligonucleotides. DNA
      mobility-shift assays with radiolabelled alpha 1-TAE demonstrated increased
      nuclear binding activity after TGF-beta stimulation. Oligonucleotides encoding
      the alpha 1-TAE, additional upstream regions within the alpha 1(I) promoter, as
      well as consensus nuclear-factor-1 (NF-1) sequences, competed with the alpha 1
      TAE sequence. The two collagen type I genes are stimulated by TGF-beta through
      different regions of their promoters.

PMID- 1741744
TI  - Characterization of the interaction between p100, a novel G-protein-related
      protein, and rat liver endosomes.
AB  - p100 is a recently identified 100 kDa protein which shares a putative receptor
      binding sequence with the signal transducing G-proteins Gt and Gi. In liver, p100
      immunoreactivity is distributed between the cytosolic and the microsomal
      fractions [Traub, Evans & Sagi-Eisenberg (1990) Biochem. J. 272, 453-458; Udrisar
      & Rodbell (1990) Proc. Natl. Acad. Sci. U.S.A. 87, 6321-6325]. More specifically,
      we have localized the membrane-associated form of p100 to an endosomal
      subfraction of rat liver microsomes. In this study we have investigated the
      nature of the interaction between p100 and microsomal membranes. p100 was located
      on the cytoplasmic surface of the microsomal vesicles, and could be released by
      treatment with 0.5 M-NaCl or 0.5 M-Tris/HCl, pH 7.0. However, p100 was not
      released by non-ionic detergents, such as Triton X-100. Binding of p100 to the
      membrane was reversible, as both membrane-released and cytosolic p100 could re
      bind stripped (Tris-washed) microsomes. Soluble p100 could not, however, bind to
      untreated microsomes. Binding to stripped microsomes approached saturation and
      was inhibited by up to 60% by either heat treatment or mild trypsin treatment of
      the vesicles. This implies that the interaction between p100 and the microsomal
      vesicles involves the direct binding of p100 to vesicular proteins. This binding
      was regulated by both adenine and guanine nucleotides. As p100 contains a region
      similar to the C-terminal decapeptide of alpha i, (the alpha-subunit of Gi) and
      has a localization that is restricted to an endosomal subfraction, we propose
      that cytosolic p100 may bind to cytoplasmically exposed domains of internalized
      receptors. Thus, like the adaptins, p100 may be involved in the process of
      sorting and receptor trafficking through the endosomal compartment of the cells.

PMID- 1741745
TI  - Postnatal changes in sialylation of glycoproteins in rat liver.
AB  - Glycoproteins containing N-linked oligosaccharides were prepared from plasma and
      liver microsomes of rats aged 0-5 weeks, and galactose and sialic acid content
      were determined. The sialic acid/galactose ratios in plasma membrane N-glycans
      remained at about 1 throughout the postnatal period, suggesting that most of the
      galactose residues are sialylated. In the same way, it was suggested that most of
      the galactose residues of microsomal N-glycans were sialylated at 0, 4 and 5
      weeks of age, but that the degree of sialylation was lower at the other ages,
      with a minimum at 2 weeks. When the activities of sialyltransferase and
      galactosyltransferase in liver Golgi membranes were determined, age-dependent
      changes were found, not only in the specific activities of the enzymes, but also
      in the Golgi membrane content per g of liver. The activity of
      galactosyltransferase per g of liver increased immediately after birth, whereas
      that of sialyltransferase remained at a low level for 2 weeks and then increased
      to a constant level at 4 weeks. It is probable that this delayed increase in the
      activity of sialyltransferase results in the decreased sialylation of microsomal
      N-glycans at 1, 2 and 3 weeks. Sialyltransferase was solubilized from the liver
      microsomes of rats aged 2, 3 and 4 weeks and characterized. Phosphocellulose
      column chromatography separated the activity into two subfractions, designated
      transferase I and transferase II in the order of elution. The increase in total
      sialyltransferase activity during this period was caused mainly by an increase in
      transferase I. Rechromatography of each transferase from 3-week-old rats after
      neuraminidase treatment showed that transferase I but not transferase II
      contained sialic acid residue(s) and that desialylated transferase I was eluted
      in a similar way as transferase II. Although the apparent Km value for CMP-N
      acetylneuraminic acid and the heat stability of transferase I were different from
      those of transferase II, the difference was abolished by treating transferase I
      with neuraminidase, suggesting that transferase II may be a desialylated form of
      transferase I. These changes in the sialylation of membrane glycoproteins,
      including sialyltransferase, may be related to the control of liver growth during
      postnatal development.

PMID- 1741746
TI  - T-kininogenase activity of the rat submandibular gland is predominantly due to
      the kallikrein-like serine protease antigen gamma.
AB  - T-kininogen, the major kininogen in rat plasma, releases Ile-Ser-bradykinin (T
      kinin) when incubated with trypsin, but is not a substrate for tissue kallikrein.
      Enzymes able to release T-kinins from T-kininogen have been found in the rat
      submandibular gland, but precise identification of these enzymes and their
      possible relationship to kallikrein-like enzymes has not been established. We
      studied T-kininogenase activity in fractionated submandibular gland homogenate.
      The main T-kininogen catalytic enzyme was purified and characterized, and found
      to be identical to antigen gamma, a kallikrein-like enzyme which we have
      previously characterized. Of other identified kallikrein-like enzymes only tonin
      showed weak T-kininogenase activity, which was about 0.25% of that of antigen
      gamma. No other T-kininogen catalytic enzymes were observed. Antigen gamma
      released a kinin which was identified as T-kinin by reverse-phase h.p.l.c. The T
      kininogenase activity of antigen gamma had a Km of 29 +/- 4 microM and a kcat/Km
      of 140 M-1.s-1, and was comparable with its high and low molecular mass
      kininogenase activity (7.4 and 10 micrograms of kinin/h per mg respectively). In
      contrast, tissue kallikrein released 0.2 and 42,200 micrograms of kinin/h per mg
      respectively. Thus antigen gamma is a weak kininogenase. The isoelectric point of
      antigen gamma, but not its molecular mass, differed from that of other kallikrein
      like enzymes. Isoelectrofocusing in flat-bed gels combined with immunostaining
      was therefore a convenient method for identification. The kallikrein-like nature
      of antigen gamma was demonstrated by its immunological similarity to tissue
      kallikrein and tonin and by 91% and 87% amino acid sequence similarity with tonin
      and kallikrein respectively (67 amino acids sequenced). Complete identity was
      also not observed with other sequenced kallikrein genes, mRNAs or proteins.

PMID- 1741747
TI  - Mechanisms of spermine toxicity in baby-hamster kidney (BHK) cells. The role of
      amine oxidases and oxidative stress.
AB  - Spermine was toxic to BHK-21/C13 cells in the absence of any extracellular
      metabolism of the amine. Inhibition of copper-containing amine oxidases with
      aminoguanidine partially prevented the response, whereas inhibition of polyamine
      oxidase with MDL-72,527 exacerbated the effect. Oxidation by an intracellular
      copper-containing amine oxidase may be involved in the toxicity of spermine,
      whereas the polyamine-interconversion pathway appears to play a cytoprotective
      role. There was no evidence for spermine imposing a state of oxidative stress
      within the cells. Inhibition of catalase and glutathione reductase did not alter
      the cytotoxicity of spermine, and there was no excretion of oxidized glutathione
      into the extracellular medium. The results suggest that spermine itself can exert
      a toxic effect directly on the cells.

PMID- 1741748
TI  - Killing of cells by perforin. Resistance to killing is not due to diminished
      binding of perforin to the cell membrane.
AB  - Different cell types vary widely in their susceptibility to killing by the pore
      forming cytolytic molecule perforin. In particular, the cells responsible for
      synthesis of perforin, i.e. cytotoxic T lymphocytes (CTL) and natural killer (NK)
      cells, are very resistant to cytolysis by this molecule. It has previously been
      suggested that resistance is due, at least in part, to diminished binding of
      perforin to these cells. The purpose of the present study was to compare binding
      of perforin to sensitive and resistant cell types. To this end, perforin was
      biosynthetically labelled prior to purification. The purified labelled protein
      was then utilized to obtain a direct measure of the amount of perforin bound to
      cells during attack. Resistant cells (CTL, neutrophils) bound at least as much
      perforin as did sensitive cells (K562, HL60 etc.), indicating that resistance to
      perforin involves mechanisms operating after binding of the lytic molecule.

PMID- 1741749
TI  - Degradation of glucagon in isolated liver endosomes. ATP-dependence and partial
      characterization of degradation products.
AB  - Endosomes have recently been identified as one major site of glucagon degradation
      in intact rat liver. In this study, a cell-free system has been used to assess
      the role of ATP-dependent acidification in endosomal glucagon degradation and
      identify the glucagon products generated. Percoll gradient fractionation of Golgi
      endosomal fractions prepared 10-30 min after injection of [125I]iodoglucagon
      showed a time-dependent shift of the radioactivity towards high densities.
      Regardless of time, the radioactivity was less precipitable by trichloroacetic
      acid (Cl3Ac) at high densities than at low densities. Chloroquine treatment
      slightly increased the density shift of the radioactivity and decreased its Cl3Ac
      precipitability throughout the gradient. Incubation of endosomal fractions
      containing [125I]iodoglucagon in 0.15 M-KCl at 30 degrees C resulted in a time-
      and pH-dependent generation of Cl3Ac-soluble radioactivity, with a maximum at pH
      4 (t1/2, 7 min). At pH 5, 1,10-phenanthroline, bacitracin and p
      chloromercuribenzoic acid partially inhibited [125I]iodoglucagon degradation. At
      pH 6-7, ATP stimulated [125I]iodoglucagon degradation by 5-10-fold and caused
      endosomal acidification as judged from Acridine Orange uptake. The effects of ATP
      were inhibited by chloroquine, monensin, N-ethylmaleimide and dansylcadaverine.
      Poly(ethylene glycol) (PEG) precipitation of the radioactivity associated with
      endosomes showed that lowering the pH below 5.5 caused dissociation of the
      glucagon-receptor complex, and that, regardless of incubation conditions, all
      degraded [125I]iodoglucagon diffused extraluminally. On h.p.l.c., at least three
      products less hydrophobic than [125I]iodoglucagon were identified in incubation
      mixtures along with monoiodotyrosine. Radiosequence analysis of the products
      revealed one major cleavage located C-terminally to Tyr-13 and two minor
      cleavages affecting Thr-5-Phe-6 and Phe-6-Thr-7 bonds. It is concluded that
      glucagon degradation in liver endosomes is functionally linked to ATP-dependent
      endosomal acidification and involves several cleavages in the glucagon sequence.

PMID- 1741750
TI  - Molecular interaction of the proteasome (multicatalytic proteinase). Evidence
      that the proteasome is not a constituent of the '26 S' multienzyme complex.
AB  - On the basis of recent reports that suggested that proteasomes, via an ATP
      dependent process, become integral components of a '26 S' complex possessing 3
      carboxypropionyl-Leu-Leu-Val-Tyr 4-methylcoumarin-7-ylamide-hydrolysing activity,
      we have investigated the molecular interaction of proteasomes in ATP-stabilized
      fraction II (proteins absorbed on DEAE-matrix and eluted with 0.5 M-KCl) of
      rabbit reticulocytes and mouse liver. Analysis of the various extracts by
      (NH4)2SO4 fractionation, velocity-gradient centrifugation, non-denaturing PAGE
      and SDS/PAGE and immunoblotting with proteasome-specific antisera failed to
      identify the proteasome as part of a higher-molecular-mass '26 S' multienzyme
      complex. In all instances proteasomes are identified in their 'free' 650 kDa '20
      S' form. In addition to the proteasome and independent of the presence of MgATP,
      we isolated a high-molecular-mass proteinase whose electrophoretic migration
      behaviour and sedimentation rate correspond to that of the previously described
      '26 S' proteinase. This '26 S' proteinase possesses a strong 3-carboxypropionyl
      Leu-Leu-Val-Tyr 4-methylcoumarin-7-ylamide-hydrolysing activity and is composed
      of several non-identical polypeptides in the molecular-mass range 20-150 kDa.
      Despite its similarity to proteasomal enzyme activity, protein analysis and
      immunoblotting experiments demonstrate that neither the intact proteasome nor
      subunits thereof are components of the '26 S' proteinase complex.

PMID- 1741751
TI  - Rapid and selective modification of phosphoserine residues catalysed by Ba2+ ions
      for their detection during peptide microsequencing.
AB  - The beta-elimination of phosphoserine residues by dilute alkali is catalysed by
      the presence of group II metal ions. The use of 0.1 M-Ba (OH)2 catalysed the rate
      of beta-elimination of phosphoserine by more than two orders of magnitude
      compared with the use of NaOH at the same OH-ion concentration. Serine and
      threonine residues are unaffected by this treatment. Free thiol groups and
      disulphide bonds are labile to these conditions, but carboxymethylcysteine is
      stable. The rate of beta-elimination of O-glycosidically linked moieties is not
      catalysed under these conditions, and the rate of reaction is thus two orders of
      magnitude slower than for phosphoserine. This specific catalysis was readily
      exploited in the rapid and selective modification of phosphoserine residues under
      mildly alkaline conditions with the nucleophile methylamine via the alpha beta
      desaturated dehydroalanine intermediate to yield the beta-methylaminoalanine
      residue. This modified residue could be easily detected on sequence analysis and
      in amino acid compositions.

PMID- 1741752
TI  - Kinetics of the interaction of chymotrypsin with eglin c.
AB  - The kinetics of binding of recombinant eglin c to bovine pancreatic chymotrypsin
      was studied by conventional and stopped-flow techniques. With nanomolar enzyme
      and inhibitor concentrations, the inhibition was fast and pseudo-irreversible
      (k(assoc.) = 4 x 10(6) m-1.s-1 at 7.4 and 25 degrees C). Reaction of the enzyme
      inhibitor complex with alpha 1-proteinase inhibitor, an irreversible chymotrypsin
      ligand, resulted in a slow release of free eglin c, which was monitored by
      electrophoresis (k(dissoc.) approximately 1.6 x 10(-6) s-1, t1/2 approximately 5
      days). The proflavin displacement method and a stopped-flow apparatus were used
      to monitor the association of chymotrypsin with eglin c under a wide range of
      inhibitor concentration and under pseudo-first-order conditions. At pH 7.4 and 25
      degrees C or 5 degrees C, or at pH 5.0 and 25 degrees C, the pseudo-first-order
      rate constant of proflavin displacement increased linearly with eglin c up to the
      highest concentration tested, suggesting a one-step bimolecular association
      reaction: E + I in equilibrium with EI. However, kassoc. is much lower than the
      rate constant for a bimolecular reaction and its activation energy (66 kJ.mol-1
      at pH 7.4 and 78 kJ.mol-1 at pH 5.0) is far too high for a diffusion-controlled
      step. The enzyme-inhibitor association may therefore occur via a loose pre
      equilibrium complex EI* (Ki* much greater than 5 x 10(-4) M) that rapidly
      isomerizes (k2 much greater than 2 x 10(3) s-1) into an extremely stable final
      complex (Ki approximately 4 x 10(-13) M). Unlike other proteinase-inhibitor
      systems, the chymotrypsin-eglin association is virtually pH-independent.

PMID- 1741753
TI  - Progesterone and oestradiol increase cytosolic Ca2+ in single rat hepatocytes.
AB  - Progesterone (300-400 microM) and oestradiol (25-200 microM) induce a prompt rise
      in the cytosolic free Ca2+ concentration (free Ca) in single rat hepatocytes, but
      testosterone, cortisol and dexamethasone do not. These increases are dependent on
      the presence of extracellular Ca2+. Both progesterone and oestradiol block
      phenylephrine-induced free Ca oscillations. These data suggest a certain
      specificity of the response of free Ca to steroids and may explain some of the
      non-genomic effects of these steroids on hepatocytes.

PMID- 1741754
TI  - pH-dependency of basic ligand binding to alpha 1-acid glycoprotein (orosomucoid).
AB  - The binding interactions of a series of basic ligands with alpha 1-acid
      glycoprotein (AAG) were examined as a function of pH. The binding to AAG
      increased with increasing pH, and the binding data were satisfactorily fitted to
      a model that incorporates the effect of pH and discriminates the association
      constants of neutral (non-protonated) and protonated forms of ligands. It was
      shown that ligands in the neutral form have a markedly higher affinity for AAG
      than the protonated forms, resulting in a concomitant decrease in the pKa of
      bound ligands. The u.v.-visible difference spectra generated upon binding of a
      representative ligand to AAG also showed that there was a contribution to the
      binding arising from the deprotonation of the ligand. It is suggested that all
      tested ligands bind similarly to AAG and that hydrophobic interactions dominate
      high-affinity binding to AAG.

PMID- 1741755
TI  - Identification of a novel serum amyloid A protein in BALB/c mice.
AB  - Four serum amyloid A protein (SAA) genes and two SAA gene products, SAA1 and
      SAA2, were identified in BALB/c mice. Using analytical isoelectric focusing we
      have identified a quantitatively significant new member of the SAA family and
      designated it 'SAA5'. This protein has characteristics never before described for
      any SAA molecule. In the highly conserved region between amino acids 33 and 44,
      identical in all SAAs from all species examined, SAA5 had four amino acid
      substitutions. In addition, the induction of SAA5 by lipopolysaccharide had
      different kinetics from that of the other mouse SAAs. Our data suggest that the
      mouse SAA gene family is more complex in composition and regulation than
      previously surmised.

PMID- 1741756
TI  - Comparison of the domain-level organization of starch hydrolases and related
      enzymes.
AB  - Structure-prediction and hydrophobic-cluster analysis of several starch
      hydrolases and related enzymes indicated the organization of eleven domain types.
      Most enzymes possess a catalytic (beta/alpha)8-barrel and a smaller C-terminal
      domain as seen in crystal structures of alpha-amylase and cyclodextrin
      glucanotransferase. Some also have a starch-granule-binding domain. Enzymes
      breaking or forming endo-alpha-1,6 linkages contain domains N-terminal to the
      (beta/alpha)8-barrel.

PMID- 1741757
TI  - Hydrolysis of transforming growth factor-alpha by cell-surface peptidases in
      vitro.
AB  - Human transforming growth factor-alpha (h-TGF alpha), a 50-amino acid residue
      peptide, was incubated with some purified cell-surface peptidases and with renal
      microvillar membranes prepared from pig and rat. Hydrolysis was monitored by
      h.p.l.c. and activity by a biological assay. Prolonged incubation with relatively
      large amounts of endopeptidase-24.11, aminopeptidase N and peptidyl dipeptidase A
      (angiotensin-converting enzyme) caused no observable hydrolysis and no detectable
      loss of biological activity. Incubation with pig renal microvilli also failed to
      degrade the peptide. In contrast, rat renal microvilli readily degraded h-TGF
      alpha, as did endopeptidase-2, which is located in rat renal and intestinal brush
      borders, but is absent from pig kidneys. This enzyme degraded about 30 nmol of h
      TGF alpha/h per mg of protein. The physiological significance of these results is
      discussed.

PMID- 1741758
TI  - Preferential release of catecholamine from permeabilized PC12 cells by alpha- and
      beta-type protein kinase C subspecies.
AB  - Protein kinase C (PKC) is now recognized as comprising two groups of closely
      related subspecies. The PKC gamma enzyme is apparently present only in central
      nervous tissues, and hence was expected to participate in neurotransmitter
      release. We have utilized a 'depletion-insertion' method to identify the PKCs
      participating in the exocytotic response. PC12 cells were 'down-regulated' by
      prior treatment (24 h) with phorbol 12-myristate 13-acetate (PMA; 1 microM),
      which nearly abolished endogenous PKC activity. Down-regulated PC12 cells were
      loaded with [3H]dopamine, permeabilized with digitonin, and recombinant or
      purified PKCs were inserted and activated with a low dose of PMA (20 nM). Among
      group A PKCs, PKC alpha was the most effective activator of [3H]dopamine release
      (215%), followed by beta II (185%) and beta I (150%). PKC gamma had no consistent
      effect on neurotransmitter release. PC12 cells express PKC alpha and PKC beta,
      but not PKC gamma, as revealed by Northern-blot analysis. We therefore postulate
      that PKC alpha and PKC beta participate in neurotransmitter release, whereas PKC
      gamma might be involved in other neuronal functions.

PMID- 1741759
TI  - Cloning of cDNAs encoding a rabbit renal brush border membrane protein
      immunologically related to band 3. Sequence similarity with microsomal
      dipeptidase.
AB  - Distinct anion transport processes have been identified in the mammalian renal
      proximal tubule, but none of the responsible proteins or genes have been
      isolated. A 43 kDa rabbit microvillus membrane protein that is immunologically
      related to the erythroid anion exchanger (band 3) was a candidate for a renal
      anion transporter. To examine the structural relationship with band 3, we cloned
      cDNAs encoding the 43 kDa protein. The 43 kDa band-3-like protein was purified,
      and a novel sequence of 24 amino acids was obtained from the N-terminus.
      Degenerate oligonucleotides were synthesized based on this sequence, and the
      polymerase chain reaction with single-sided specificity was used to amplify and
      clone a 1330 bp cDNA from rabbit renal cortex. Additional overlapping 272 bp and
      1123 bp cDNAs were obtained by synthesizing and screening a rabbit renal cortical
      cDNA library. The composite sequence was 1483 bp, terminated with (A)16, and was
      similar in size to the principal transcript expressed in rabbit renal cortex. The
      single long open reading frame was predicted to encode a protein composed of 410
      amino acids with a molecular mass of 45,193 Da; 15 amino acids predicted to
      reside at the N-terminus were absent in the mature protein and may constitute a
      signal peptide. There was only limited sequence similarity with human erythroid
      band 3. Rather, the sequence was highly similar to microsomal dipeptidase,
      including the presence of a signal peptide and a consensus sequence for covalent
      linkage to glycosylphosphatidylinositol. In summary, the 43 kDa protein from
      rabbit renal cortex that is recognized by a monospecific antibody to erythroid
      band 3 is most likely a microvillus membrane dipeptidase.

PMID- 1741760
TI  - Structure-function relationships in the cysteine proteinases actinidin, papain
      and papaya proteinase omega. Three-dimensional structure of papaya proteinase
      omega deduced by knowledge-based modelling and active-centre characteristics
      determined by two-hydronic-state reactivity probe kinetics and kinetics of
      catalysis.
AB  - 1. A model of the three-dimensional structure of papaya proteinase omega, the
      most basic cysteine proteinase component of the latex of papaya (Carica papaya),
      was built from its amino acid sequence and the two currently known high
      resolution crystal structures of the homologous enzymes papain (EC 3.4.22.2) and
      actinidin (EC 3.4.22.14). The method used a knowledge-based approach incorporated
      in the COMPOSER suite of programs and refinement by using the interactive
      graphics program FRODO on an Evans and Sutherland PS 390 and by energy
      minimization using the GROMOS program library. 2. Functional similarities and
      differences between the three cysteine proteinases revealed by analysis of pH
      dependent kinetics of the acylation process of the catalytic act and of the
      reactions of the enzyme catalytic sites with substrate-derived 2-pyridyl
      disulphides as two-hydronic-state reactivity probes are reported and discussed in
      terms of the knowledge-based model. 3. To facilitate analysis of complex pH
      dependent kinetic data, a multitasking application program (SKETCHER) for
      parameter estimation by interactive manipulation of calculated curves and a
      simple method of writing down pH-dependent kinetic equations for reactions
      involving any number of reactive hydronic states by using information matrices
      were developed. 4. Papaya proteinase omega differs from the other two enzymes in
      the ionization characteristics of the common (Cys)-SH/(His)-Im+H catalytic-site
      system and of the other acid/base groups that modulate thiol reactivity towards
      substrate-derived inhibitors and the acylation process of the catalytic act. The
      most marked difference in the Cys/His system is that the pKa for the loss of the
      ion-pair state to form -S-/-Im is 8.1-8.3 for papaya proteinase omega, whereas it
      is 9.5 for both actinidin and papain. Papaya proteinase omega is similar to
      actinidin in that it lacks the second catalytically influential group with pKa
      approx. 4 present in papain and possesses a catalytically influential group with
      pKa 5.5-6.0. 5. Papaya proteinase omega occupies an intermediate position between
      actinidin and papain in the sensitivity with which hydrophobic interaction in the
      S2 subsite is transmitted to produce changes in transition-state geometry in the
      catalytic site, a fact that may be linked with differences in specificity in P2
      S2 interaction exhibited by the three enzymes.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1741761
TI  - Protein kinase C promotes arachidonate mobilization through enhancement of CoA
      independent transacylase activity in platelets.
AB  - A role for protein kinase C in arachidonate mobilization was demonstrated.
      Treatment of rat platelets with phorbol myristate acetate (PMA) or the
      diacylglycerol 1-oleoyl-2-acetylglycerol increased the transfer rate of
      arachidonate (AA) from phosphatidylcholine to phosphatidylethanolamine and
      stimulated AA release. The transfer dose-dependently induced by PMA was inhibited
      by staurosporine. Ether phospholipids were the acceptors of AA in these
      stimulated transfer reactions. Membrane-bound protein kinase C activity was
      enhanced by PMA, and this increase was inhibited by staurosporine. AA transfer
      between phospholipids is due to the action of polyunsaturated-fatty-acid-specific
      transacylases. For this purpose, transacylase activities were assayed in cell
      free systems from PMA-treated platelets. We observed that the CoA-independent
      transacylase activity was modulated in parallel to AA transfer as a function of
      PMA concentration. Taken together, the data show that protein kinase C activation
      might promote the mobilization of AA in platelets through the enhancement of CoA
      independent transacylase activity.

PMID- 1741762
TI  - Identification of the "major" polymorphic carbocysteine metabolite as S
      (carboxymethylthio)-L-cysteine.

PMID- 1741763
TI  - Immunochemical detection of covalently modified kidney proteins in S-(1,1,2,2
      tetrafluoroethyl)-L-cysteine-treated rats.

PMID- 1741764
TI  - DNA damage, poly (ADP-ribosyl)ation and apoptotic cell death as a potential
      common pathway of cytotoxic drug action.
AB  - Although various anti-cancer drugs have widely differing primary modes of action,
      the mechanisms of cell death appear similar but are not well understood. To
      investigate this problem we exposed cultured human leukemic T-lymphoblasts to 1
      hr pulse doses of an alkylating agent (mafosfamide) and a topoisomerase II
      inhibitor (etoposide) that cause delayed cell death. The effects of these drugs
      on nucleotide content, poly (ADP-ribosyl)ation and DNA strand breakage were
      assessed. Both drugs caused DNA strand breakage, and although the pattern
      differed, this seemed to be the major mechanism by which cells were killed. The
      degree and time course of the NAD and ATP depletion that mafosfamide and
      etoposide caused were similar. Both drugs caused a nadir in cellular nucleotide
      levels 2 hr after exposure but between 2 and 6 hr there was a partial recovery.
      This correlates with the time course of the DNA damage they caused and appeared
      to result from poly (ADP-ribosyl)ation. Both drugs were shown to cause apoptotic
      cell death associated with endonucleolytic DNA fragmentation. We suggest that DNA
      damage, as a primary or secondary effect, associated with poly (ADP-ribosyl)ation
      and apoptotic cell death may be a common pathway of cytotoxic drug action.

PMID- 1741765
TI  - Cytosol mediated metabolism of the experimental antitumor agent acridine
      carboxamide to the 9-acridone derivative.
AB  - The acridine antitumor agent N-[2'-(dimethylamino)ethyl]acridine-4-carboxamide
      (AC; NSC 601316; acridine carboxamide) is oxidized efficiently in vitro by rat
      and mouse hepatic cytosolic fractions. Under these conditions the oxidase
      activity has an apparent Km of 11 microM towards AC. A single product is formed
      which has been identified as the corresponding 9(10H)-acridone carboxamide by 1H
      NMR and mass spectrometry. Inhibition with menadione and amsacrine, but not
      allopurinol, indicates that this reaction is most likely to be catalysed by
      aldehyde oxidase (EC 1.2.3.1). Several AC analogues with modifications to the
      side chain (the N-oxide, N-monomethyl-, and amino-derivatives) are also
      metabolized to the equivalent acridone product but the 7-hydroxylated and 4
      carboxylic acid acridine derivatives are not.

PMID- 1741766
TI  - The biochemical pharmacology of the thymidylate synthase inhibitor, 2-desamino-2
      methyl-N10-propargyl-5,8-dideazafolic acid (ICI 198583).
AB  - 2-Desamino-2-methyl-N10-propargyl-5,8-dideazafolic acid (ICI 198583) is a more
      water-soluble analogue of the quinazoline-based thymidylate synthase (TS)
      inhibitor, N10-propargyl-5,8-dideazafolic acid (CB3717). A 3-fold loss in TS
      inhibitory activity (murine and human TS, Ki = 10 nM) was accompanied by a 40
      fold increase in growth inhibitory potency against L1210 and W1L2 cells in vitro
      (IC50 = 0.085 and 0.05 microM, respectively) when compared with CB3717. In L1210
      cells a concentrative uptake mechanism was demonstrated for [3H]ICI 198583 (Kt =
      2.9 microM). The L1210:1565 cell line, with an impaired ability to transport
      reduced folates or methotrexate (MTX), was resistant (100-fold relative to the
      wild-type L1210 line) to ICI 198583 (but not CB3717) and did not take up [3H]ICI
      198583 significantly. The measurement of folylpolyglutamate synthetase (FPGS)
      substrate activity demonstrated a Km of 40 microM for ICI 198583 and a Vmax/Km
      (relative to folic acid) of 3.5. The formation of intracellular polyglutamate
      derivatives was demonstrated in both L1210 (mouse) and WIL2 (human) cells grown
      in vitro after exposure to 1 microM [3H]ICI 198583. In L1210 cells, by 4 hr,
      approximately 50% of the intracellular 3H(approximately 1 microM) was found as
      polyglutamate forms of ICI 198583, principally as tri- and tetraglutamates. After
      24 hr the ICI 198583 polyglutamate pool had expanded, the tetraglutamate
      metabolite predominated and there was significant formation of the
      pentaglutamate. Upon resuspension of L1210 cells in drug free medium, ICI 198583
      was largely lost from the cells but the polyglutamates were preferentially
      retained, after 24 hr approximately 70% remained. Synthetic ICI 198583
      polyglutamates were shown to be up to 100-fold more potent as inhibitors of
      isolated TS than the parent compound. Following in vivo administration (500 mg/kg
      i.v.) ICI 198583 was cleared rapidly from the plasma of mice (T1/2 beta = 16 min,
      clearance = 42 mL/min/kg). Despite this clearance there was prolonged, dose
      dependent inhibition of TS in L1210:NCI cells in vivo. Thus, following 500 mg/kg
      i.v. the flux through TS was inhibited by greater than 80% for at least 24 hr.
      Administration of five doses at 5 mg/kg daily of ICI 198583 to L1210:ICR tumour
      bearing mice resulted in greater than 60% of the mice being cured, a 10-fold
      improvement in potency over CB3717. The maximum tolerated dose (MTD) for ICI
      198583 using this schedule was greater than 500 mg/kg/day compared with 200
      mg/kg/day of CB3717.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1741767
TI  - A survey of vasoactive peptide metabolizing enzymes in the rat mesenteric
      arterial bed perfusate.
AB  - We have demonstrated that the isolated perfused rat mesenteric arterial bed (MAB)
      secretes peptidases capable of metabolizing bradykinin and angiotensin I. The
      major degradative pathway of bradykinin by enzymes found in the rat MAB perfusate
      was mediated by carboxypeptidase A-like activity, whereas angiotensin 1
      degradation followed two main routes, one attributable to a carboxypeptidase A
      like enzyme and the other to an endopeptidase. This latter enzyme seems to be a
      novel serine peptidase capable of releasing angiotensin II directly from both
      angiotensin I and renin substrate tetradecapeptide. The rat MAB perfusate was
      also shown to contain additional endo- and exopeptidases that might play a role
      in the metabolism of other vasoactive peptides. Our finding that isolated rat MAB
      secretes peptidases into the perfusion medium indicates that peptide processing
      within the microvasculature environment may be effected by enzymes besides those
      normally found in plasma or associated with cell membranes.

PMID- 1741768
TI  - Chiral inversion of 2-arylpropionic acid non-steroidal anti-inflammatory drugs-
      II. Racemization and hydrolysis of (R)- and (S)-ibuprofen-CoA thioesters.
AB  - The inversion of 2-arylpropionic acids (2-APAs) has become the subject of much
      attention. It is a unique reaction specific to this group of drugs. Inversion
      proceeds via stereoselective activation of the R-enantiomer to its CoA thioester
      whereby it is then racemized and hydrolysed to release free drug. The
      racemization and hydrolysis processes have been examined in this study using
      chemically synthesized CoA thioesters of the ibuprofen enantiomers and in vitro
      models employing rat liver homogenate and the mitochondrial and microsomal
      fractions as the source of the 'racemase' enzymes. Rat liver homogenate mediated
      the racemization and hydrolysis of both (R)- and (S)-ibuprofen-CoA thioesters.
      The rat liver mitochondrial fraction similarly mediated racemization and
      hydrolysis of both CoA thioesters. There was less racemase activity in the rat
      liver microsomal fraction and the data indicated that this fraction may contain
      two hydrolases which act separately on the (R)- and (S)-ibuprofen-CoA thioesters.
      The data are further evidence that the stereoselectivity of the CoA synthetase
      controls the overall stereoselectivity of inversion.

PMID- 1741769
TI  - Induction by perfluorooctanoic acid of microsomal 1-acylglycerophosphocholine
      acyltransferase in rat kidney. Sex-related difference.
AB  - Response of rat kidney to the challenges by perfluorooctanoic acid (PFOA) was
      studied using microsomal 1-acyglycerophosphocholine (1-acyl-GPC) acyltransferase
      as a parameter. Marked induction of the enzyme was brought about in kidney of
      male rats, whereas the induction in kidney of female rats was far less
      pronounced. The sex-related difference in the response of kidney to PFOA was much
      more marked than those seen with p-chlorophenoxyisobutyric acid (clofibric acid)
      or 2,2'-(decamethy-lenedithio)diethanol (tiadenol). Hormonal manipulations
      revealed that the sex-related difference in the response of kidney to PFOA was
      strongly dependent on the state of gonadal hormones of rats. Even after a
      prolonged administration of PFOA for up to 26 weeks, this sex-related difference
      was still evident. Induction of peroxisomal beta-oxidation was brought about
      concurrently with microsomal 1-acyl-GPC acyltransferase and a high correlation
      was confirmed between the inductions of these two parameters.

PMID- 1741770
TI  - Allosteric regulation of cloned m1-m5 muscarinic receptor subtypes.
AB  - Allosteric regulation of [3H]N-methylscopolamine [( 3H]NMS) and [3H]quinuclidinyl
      benzilate [( 3H]QNB) dissociation from the m1-m5 muscarinic receptor subtypes was
      examined in transfected CHO-K1 cells. Half-times of dissociation of [3H]NMS from
      cell membranes (at 23 degrees) ranged from less than 5 min for the m2 subtype to
      more than 60 min for the m5 subtype. For [3H]QNB, half-times (at 37 degrees)
      ranged from 1 hr (m2) to almost 4 hr (m3). The presence of gallamine slowed the
      dissociation of [3H]NMS from all of the subtypes, with an order of potency of m2
      greater than m4 greater than m1 greater than m3 greater than m5. Dissociation of
      [3H]QNB from m1 and m2 receptors was modulated by gallamine in the biphasic
      manner that we have described previously for cardiac receptors; that is, low
      concentrations (1-10 microM) of gallamine accelerated dissociation, while 1 mM
      gallamine slowed it. Verapamil slowed the dissociation of [3H]-QNB from the m2
      receptor in a monophasic manner, while the action of d-tubocurarine was
      qualitatively similar to that of gallamine. The potency of gallamine in
      allosterically regulating the m2 receptor was inversely related to ionic
      strength. Inactivation of pertussis toxin-sensitive G proteins abolished the
      ability of guanine nucleotides to regulate agonist affinity at the m2 receptor,
      but had no effect on allosteric regulation of the m2 receptor. These findings
      indicate that susceptibility to allosteric regulation varies in a complex way
      across muscarinic receptor subtypes and according to the choice of ligand.

PMID- 1741771
TI  - Structure and expression of the cytosolic aldehyde dehydrogenase gene in
      cyclophosphamide-resistant murine leukemia L1210 cells.
AB  - These investigations were performed to clarify the molecular basis for the
      enhanced expression of cytosolic aldehyde dehydrogenase (ALDH-1) enzymatic
      activity in the cyclophosphamide-resistant L1210/CPA murine leukemia cell line,
      as compared to the parental L1210/O strain. Western immunoblot analysis was
      performed using a 15-fold greater quantity of cytosolic protein from the L1210/O
      as compared to the L1210/CPA cell line. Nevertheless, ALDH-1 immunoreactive
      protein could be detected only in the L1210/CPA cells. Northern analyses,
      performed using total cellular and polyadenylated RNA, again demonstrated ALDH-1
      specific transcripts only in the L1210/CPA cell line. This transcript was
      identical in size to the ALDH-1 message expressed by normal murine hepatocytes.
      On Southern analysis, no evidence of gene amplification, gene rearrangement, or
      significant mutations of length was detected. These studies suggest that the ALDH
      1 protein produced by the L1210/CPA cell line is structurally normal. Moreover,
      overexpression of the gene does not appear to have arisen as a result of an
      incremental process, such as gene amplification. Rather, a qualitative
      abnormality in the regulation of this gene appears to exist in the L1210/CPA
      cells, which distinguishes them from L1210/O cells and from normal murine
      lymphocytes.

PMID- 1741772
TI  - Perturbation of the fluidity of the erythrocyte membrane with ionophoric
      antibiotics and lipophilic anaesthetics.
AB  - The fluidity of the rat erythrocyte membrane was evaluated by measurement of
      excimer fluorescence of an intra-molecular forming fluorophore, 1,3-di(1
      pyrenyl)propane. The polyene ionophoric antibiotics, amphotericin B and nystatin,
      were found to fluidize the erythrocyte membrane, as assessed by the increase in
      the excimer/monomer fluorescence intensity ratio, by 42 and 13%, respectively,
      compared with control samples. In contrast, of the peptide ionophoric
      antibiotics, valinomycin demonstrated about twice the effect which gramicidin A
      had on depressing the fluidity of the erythrocyte membrane. On the other hand,
      the general lipophilic anaesthetics, propanidid and althesin, led to an increase,
      by 70 and 32%, respectively, while the local anaesthetic, procaine, led to a
      decrease by 20%, in the fluidity of the erythrocyte membrane. These results were
      explained in the light of the partition coefficients determined for these drugs
      in decane and native membranes, their affinities for specific membrane components
      and the changes which they induce in the permeability properties of erythrocyte
      and other biological membranes.

PMID- 1741773
TI  - Problems with the measurement of monoamine oxidase A protein concentration in
      mitochondrial preparations. Revised molecular activities and implications for
      estimating ratios of MAO A:MAO B molecules from radiochemical assay data.
AB  - There are significant discrepancies in the literature concerning the
      concentration of monoamine oxidase A (MAO A) from a number of tissue sources.
      Therefore, we compared the two principal techniques that have been used for
      quantitation of MAO A protein concentration: (1) titration of the enzyme with the
      MAO A-selective inhibitor clorgyline, and (2) saturation of the enzyme with [3H]
      pargyline followed by immunoprecipitation with an MAO A-specific monoclonal
      antibody. To determine which of the two techniques was likely to yield more
      reliable values for MAO A, MAO A protein concentrations in the same preparations
      were determined by quantitative immunoblotting. [3H]Pargyline binding and
      quantitative immunoblotting yielded comparable values which were markedly lower
      than those obtained by titration of MAO A with unlabeled clorgyline. Therefore,
      clorgyline titration can seriously overestimate the concentration of MAO A
      protein in mitochondrial preparations. Since many literature values for the
      molecular activity of MAO A have relied upon enzyme concentrations determined by
      clorgyline binding, we reevaluated the molecular activities of MAO A and B for
      five important substrates. The ratio, MAO A molecular activity:MAO B molecular
      activity decreased in the order: serotonin (35:1) greater than tryptamine (12:1)
      greater than tyramine (3.3:1) greater than dopamine (2.4:1) greater than
      benzylamine (1:23). No comparable ratio was determined for beta-phenylethylamine
      because of its previously described substrate inhibition of MAO B, although it is
      oxidized faster by MAO B over a wide range of concentrations. Comparison of
      molecular activities and Km values for MAO A and B showed that with the exception
      of benzylamine and beta-phenylethylamine, MAO A oxidizes the other tested
      substrates faster than MAO B over a wide range of concentrations. Therefore,
      measured ratios of MAO A:MAO B activity are generally greater than the ratios of
      MAO A:MAO B molecules in the preparations.

PMID- 1741774
TI  - Menadione-induced DNA damage in a human tumor cell line.
AB  - The nature and extent of menadione (MD)-induced DNA damage were explored using
      the human breast cancer cell line MCF-7. Concentration-dependent single-strand
      (ss) and double-strand (ds) DNA breaks were detected in MD-treated MCF-7 cells
      using the alkaline- and neutral-elution techniques, respectively. The repair of
      ss and ds DNA breaks was extensive but not complete after a 6-hr incubation in
      drug-free medium. Evidence was found for the production of DNA interstrand cross
      links in MCF-7 cells treated with the bifunctional alkylating agent, mitomycin C,
      but not for cells treated with MD. Exposure of MCF-7 cells to etoposide (VP-16),
      mitoxantrone and camptothecin resulted in the detection of significant amounts of
      protein-linked DNA breaks, whereas none were found in MD-treated cells. These
      results support the proposition that MD-induced DNA damage is not likely to be
      mediated via topoisomerases, nor do significant amounts of protein-linked DNA
      form in MD-treated cells. Thus, MD serves as a good model for examination of the
      role of the quinone moiety in DNA damage in relation to redox cycling. Future
      studies directed at elucidation of the biochemical determinants mediating
      formation of reactive oxygen species effecting the MD-induced DNA damage are
      necessary and underway.

PMID- 1741775
TI  - Questioning the reliability of p-nitrophenyl-beta-D-xyloside as probe to study
      the metabolic effects of abrogated proteoglycan synthesis in cultured cells.
AB  - p-Nitrophenyl-beta-D-xylopyranoside (PNP-Xyl) and similar aglycone derivatives of
      xylosides are proposed selective inhibitors of proteoglycan synthesis which are
      used frequently to analyse the metabolic and cellular effects of abrogated
      proteoglycan formation and, hence, tentatively, the functions of these complex
      molecules. Using rat liver fat storing cell (FSC) cultures as a model, the
      possibility was tested that p-nitrophenol (PNP), which might be generated by the
      enzymatic hydrolysis of PNP-Xyl, could mediate some of those effects ascribed
      previously to PNP-Xyl induced inhibition of proteoglycan synthesis. PNP-Xyl and
      PNP inhibited dose-dependently the proliferation of FSC reaching 50% inhibition
      at about 1.9 and 0.6 mM, respectively. The inhibition of proliferation was not
      accompanied by signs of toxic cell damage and was fully reversible after
      withdrawal of the drugs. After an initial 4-fold stimulation of the formation of
      [35S]sulfate-labeled medium glycosaminoglycans (GAG) by PNP-Xyl at 0.1 mM, higher
      concentrations of this compound (about 0.5 mM) but also PNP decreased
      progressively the synthesis of sulfated medium GAG. A proliferation inhibiting
      concentration of PNP (0.75 mM) induced disorganization and reduced the expression
      of desmin- and smooth muscle iso-alpha-actin containing cytoskeletal filaments.
      These effects were similar to related effects reported previously for PNP-Xyl.
      Incubation of FSC with 5 mM PNP-Xyl resulted in a time-dependent increase of PNP
      in medium and cells; intracellular concentrations of PNP were reached sufficient
      to inhibit the mitotic activity of FSC. In lysates of FSC 0.65 nmol
      PNP/hr/micrograms DNA or 1 x 10(5) cells were generated from PNP-Xyl (5 mM) added
      as substrate. Exemplified with PNP-Xyl-treated FSC cultures, the results suggest
      for other cell and organ systems also that PNP, which is enzymatically cleaved
      from PNP-Xyl, might mediate at least some of the major effects attributed
      previously to the inhibition of proteoglycan synthesis. The aglycone may
      interfere with the effects of PNP-Xyl on proteoglycan metabolism and, therefore,
      could complicate in an unpredictable manner the interpretation of metabolic
      inhibitory studies using these compounds.

PMID- 1741776
TI  - Mechanistic aspects of uptake and sinusoidal efflux of dibromosulfophthalein in
      the isolated perfused rat liver.
AB  - Using the isolated perfused rat liver technique we examined whether the
      accumulation and sinusoidal efflux processes of the organic anion
      dibromosulfophthalein (DBSP) are dependent on the intracellular ATP content,
      chloride concentration in the perfusion medium as well as temperature of the
      medium and whether they are mediated by the same or by separate carrier
      mechanisms. The net sinusoidal efflux rate, being the resultant of sinusoidal
      efflux and re-uptake, was decreased more than 50% after lowering the medium
      temperature from 37 to 26 degrees indicating that the efflux process is carrier
      mediated. The uptake rate was decreased only 18% after lowering the medium
      temperature to 26 degrees. Lowering of the hepatic ATP content for more than 80%
      clearly decreased the DBSP uptake rate but not the sinusoidal efflux rate. These
      observations indicate that these opposing transport steps probably are mediated
      by two separate carriers. Additional evidence for this hypothesis originated from
      the observation that sinusoidal efflux of DBSP was decreased about 30% whereas
      hepatic uptake of the substrate remained unaltered after replacing chloride in
      the perfusion medium with gluconate. In summary, we conclude that uptake and
      sinusoidal efflux of DBSP are mediated by two separate carrier systems that are
      influenced differently by ATP depletion, temperature lowering and presence of Cl
      gradients.

PMID- 1741777
TI  - Differential inhibition of epidermal growth factor binding by photoactivated
      psoralens and the tumor promoter 12-O-tetradecanoyl phorbol-13-acetate in cells
      overexpressing protein kinase C.
AB  - A rat fibroblast cell line, R6PKC3, that stably overexpresses the beta-1 form of
      protein kinase C was used to analyze sensitivity to inhibitors of epidermal
      growth factor (EGF) binding. R6PKC3 cells overexpress protein kinase C activity
      53-fold relative to non-overexpressing control R6C1 cells. Inhibition of EGF
      binding by the tumor promoter 12-O-tetradecanoyl phorbol-13-acetate (TPA) and
      photo-activated psoralens was compared in these cells. We found that 125I-EGF
      bound both of the cell lines and was rapidly internalized in a temperature
      dependent process and metabolized. Binding of EGF to the R6 cells overexpressing
      protein kinase C was markedly less than binding to R6C1 control cells. In both of
      the cell lines, TPA and photoactivated psoralens inhibited 125I-EGF binding but
      the response of these cells to these inhibitors was distinct. R6PKC3 cells were
      markedly more sensitive to TPA and were resistant to recovery from TPA-induced
      inhibition of 125I-EGF binding when compared to control cells. These differences
      were not observed in other subclones of cells overexpressing protein kinase C,
      suggesting that they may be unique to R6PKC3 cells. In contrast, no major
      differences in sensitivity to photoactivated psoralens were observed in R6C1 and
      R6PKC3 cells. These data indicate that TPA and photoactivated psoralens inhibit
      125I-EGF binding to these cell lines by distinct mechanisms.

PMID- 1741778
TI  - Mode of action of the lanthionine-containing peptide antibiotics duramycin,
      duramycin B and C, and cinnamycin as indirect inhibitors of phospholipase A2.
AB  - Effects of the lanthionine-containing peptide antibiotics duramycin, duramycin B,
      duramycin C and cinnamycin on the activity of phospholipase A2 from six different
      sources were studied, and their mode of action was investigated. The four
      antibiotics inhibited potently all tested phospholipases A2, with IC50 values of
      around 1 microM, using phosphatidylethanolamine or [1-14C]oleate-labelled
      Escherichia coli, whose phospholipids are rich in phosphatidylethanolamine, as
      substrates. No inhibition was observed when the substrate was
      phosphatidylcholine. Binding of the antibiotics to the lipid fraction of E. coli
      could be demonstrated by co-sedimentation with whole, but not with lipid-depleted
      E. coli. In addition, preincubation of duramycin B with vesicles of
      phosphatidylethanolamine, but not those of phosphatidylcholine, prevented the
      inhibition of phospholipase A2 activity. The interaction of duramycin B and C,
      but not that of the biologically inactive compounds actagardine and the duramycin
      B trisulphoxide, with phosphatidylethanolamine was demonstrated using circular
      dichroism studies. On the other hand, no interaction of duramycin B with
      phosphatidylcholine could be demonstrated. A strict correlation between the
      physico-chemical interaction of the studied lantibiotics, demonstrated by
      circular dichroism spectroscopy, and their inhibition of phospholipase A2 was
      observed. These results suggest that lanthionine-containing peptide antibiotics
      inhibit phospholipase A2 indirectly by specifically sequestering the substrate
      phosphatidylethanolamine. This mode of action is analogous to the one described
      for the protein lipocortin.

PMID- 1741779
TI  - Effect of cholesterol supplementation on acetylcholinesterase activity from sheep
      platelet plasma membrane.

PMID- 1741780
TI  - A second site of action of soman on acetylcholinesterase.

PMID- 1741781
TI  - Enhancement of cross-linking of presynaptic plasma membrane proteins by
      phospholipase A2 neurotoxins.

PMID- 1741782
TI  - Potentiation of the inductive effect of phenobarbital on cytochrome P450 mRNAs by
      cannabidiol.

PMID- 1741783
TI  - Effect of cyclosporin A in vivo on taurocholate uptake by rat hepatocytes.

PMID- 1741784
TI  - In vitro effect of clofibric acid derivatives on rat hepatic microsomal electron
      transport chains.

PMID- 1741785
TI  - A quick method for detecting metabolic cooperation.

PMID- 1741786
TI  - Anti-neoplastic glucuronide prodrug treatment of human tumor cells targeted with
      a monoclonal antibody-enzyme conjugate.

PMID- 1741787
TI  - Contracting speech-language pathology services to Medicare providers.

PMID- 1741788
TI  - Communicating with people who have multiple sensory impairments.
AB  - The good news is that we can be effective teachers, clinicians, interactors, and
      consultants, enabling the learner, ourselves, and significant others to
      communicate more effectively with one another. The bad news is that we can be
      ineffectual, often leading the learner to learned helplessness, prompt
      dependency, and possibly self-injurious behaviors. Extreme measures may be the
      only means that we have given the learner to communicate intents such as, "Stop
      intruding on my space," or "Come attend to me." We can set ourselves and the
      learner up for success or for failure. We, as service providers, have choices and
      options as well.

PMID- 1741789
TI  - Visual assessment of people who are deaf. The essential role of audiologists and
      speech-language pathologists.

PMID- 1741790
TI  - Audiological services. Meeting the needs of people who are deaf and blind.

PMID- 1741791
TI  - Treating behavior problems with communication.

PMID- 1741792
TI  - New methods for evaluating vision.

PMID- 1741793
TI  - The Federal Government's role in educating people with dual sensory impairments.

PMID- 1741794
TI  - School-to-work transition for youth who are both deaf and blind.
AB  - Transition, collaborative planning for desired adult opportunities, and
      implementation of objectives and activities can increase the postsecondary
      employment opportunities open to youth who are deaf and blind. Collaborative
      transition planning is characterized by family-professional partnerships in
      developing visionary personal profiles, systematic and transdisciplinary
      vocational preparation in community-based settings, and infusion of related
      services within educational programs.

PMID- 1741795
TI  - Giving birth to ASHA's special interest divisions. A look at early developmental
      milestones.

PMID- 1741796
TI  - Getting in shape: lean cuisine for the '90s.
AB  - The results of the 1991 Omnibus Survey suggest that members of ASHA exhibit a
      complex sensitivity to the economic environment. On the one hand, budget sizes
      for equipment and supplies have decreased, and professionals are working longer
      hours to provide needed services to clients/patients. On the other hand,
      employment within the professions of speech-language pathology and audiology
      remains strong. Clearly, even in times of fiscal uncertainty, few individuals
      want to forego or delay needed health care services. Data from the survey
      indicated that our professionals may be adapting their work patterns to meet
      society's needs, using less fiscal and human resources. Hopefully, the years
      ahead will bring about positive economic growth and the speech-language pathology
      and audiology professions will have profited from innovative solutions developed
      during these lean years to maintain high quality care on tight budgets.

PMID- 1741797
TI  - Children of poverty. What is their future?

PMID- 1741798
TI  - Research funding for speech-language-hearing: FY 1990 update.

PMID- 1741799
TI  - Mammography and malpractice.

PMID- 1741800
TI  - Propofol does not trigger malignant hyperthermia.

PMID- 1741801
TI  - Should drugs be legalized? Implications of the debate for the mental health
      field.

PMID- 1741802
TI  - The value of arthrography in the decision-making process regarding surgery for
      internal derangement of the temporomandibular joint.
AB  - In this study, the clinical and arthrographic findings from 43 internally
      deranged temporomandibular joints (TMJs) were compared with the intra-surgical
      observations. In 40 of 43 joints, arthrography did not provide any additional
      information useful for diagnosis or treatment. In six joints, the problem was
      misdiagnosed. Only in three joints did arthrography demonstrate the existence of
      perforation in the posterior attachment that had not been suspected during the
      clinical examination. Because of the doubtful importance of arthrographic
      information for the decision-making process, it is suggested that the method be
      applied only in cases in which clinical examination and plain radiographs have
      failed to uncover the signs and symptoms indicative of a TMJ disorder.

PMID- 1741803
TI  - Eukaryote origins. Seeds of a universal tree.

PMID- 1741804
TI  - Complication of continuous spinal microcatheters: should we seek their removal if
      sheared?

PMID- 1741805
TI  - A sticking flutter valve.

PMID- 1741806
TI  - Duration of intravenous fluid replacement after abdominal surgery: a prospective
      randomised study.
AB  - This prospective randomised study examined the possibility of early resumption of
      oral hydration and discontinuation of intravenous fluid replacement after
      emergency or elective abdominal surgery. Following elective cholecystectomy alone
      or with a choledocholithotomy or an emergency Hartmann's procedure for large
      bowel obstruction, patients were randomised to early oral hydration (sips of
      water for 12 h followed by free fluids by mouth for 24 h, when oral intake of
      food was allowed--intravenous hydration was discontinued 6 h after starting the
      intake of free fluids orally) or conventional intravenous hydration (intravenous
      hydration and an oral regimen of water as follows: sips every hour for 12 h, 30
      ml every hour for 24 h, 60 ml every hour for 24 h, 90 ml every hour for 24 h,
      free fluids for 12 h, when food was allowed--intravenous hydration was
      discontinued 6 h after starting the free fluids). The two regimens were equally
      effective in maintaining fluid balance and normal plasma and urinary electrolytes
      without any observed differences in biochemical or metabolic values. Each of free
      fluids by mouth, discontinuation of intravenous hydration, and consumption of
      solid food were achieved in the patients on early oral hydration at time periods
      significantly shorter than those attained with the conventional regimen (P less
      than 0.001). Similarly, patients on the latter regimen were hospitalised for
      significantly longer times than those on early oral hydration (P less than
      0.001). Early oral hydration after biliary surgery or a Hartmann's procedure
      effectively maintains fluid balance and has advantages over the conventional
      intravenous hydration regimen.

PMID- 1741807
TI  - Two kinds of diverticular disease.
AB  - Two kinds of acquired diverticular disease were identified. The more common
      variety presented with pain, bowel symptoms or fistulae, and the less common with
      bleeding. The former patients rarely had a history of bleeding and among the
      latter pain and bowel symptoms were uncommon. In contrast to the few, chiefly
      sigmoid, diverticular often found in the former group, barium enemas of those
      presenting with bleeding usually showed densely packed and extensive diverticula.
      Even where there was no history suggesting perforation or evidence of it at
      operation, specimens resected for the more common form of diverticular disease
      invariably showed histological evidence of previous perforation. There was no
      histological evidence of previous perforation in those specimens resected for
      bleeding. This retrospective clinical, radiological and histological study
      supported the idea that there are two kinds of diverticular disease, one
      associated with perforation and its sequelae, the other associated with bleeding.

PMID- 1741808
TI  - Judgment strategies for coping with ambiguous clinical situations encountered in
      primary health care [corrected].
AB  - This naturalistic study identifies and describes strategies for clinical problem
      solving in situations of uncertainty, from observations of patient/family visits
      in a family health center. Judgment strategies were described for four types of
      uncertainty: information, diagnosis, treatment, and patient response that roughly
      correspond to the phases of assessment, planning, implementation, and evaluation
      of the clinical problem-solving process. The study contributes to increased
      understanding of the practical (experiential) knowledge involved in clinical
      judgment.

PMID- 1741809
TI  - The patient with noncardiogenic pulmonary edema.
AB  - Based on the content of this article, the reader should be able to (1) identify
      the differences between cardiogenic and noncardiogenic pulmonary edema (NCPE);
      (2) identify the most common causes of airway obstruction leading to pulmonary
      edema; (3) state the mechanism of action for the development of NCPE following
      laryngospasm; (4) state the signs and symptoms of NCPE; (5) identify the
      treatment for NCPE; and (6) state three nursing actions that are indicated in the
      care of the patient with NCPE.

PMID- 1741810
TI  - Histopathologic diagnosis of dysplastic nevi: concordance among pathologists
      convened by the World Health Organization Melanoma Programme.
AB  - Dysplastic nevi are an important indicator of risk of cutaneous malignant
      melanoma. The study of and, particularly, international communication regarding
      this group of lesions have been hindered by a lack of precision in diagnosis. In
      an effort to broaden understanding, a panel of pathologists agreed upon a set of
      criteria for the diagnosis of dysplastic melanocytic nevi. Two major and four
      minor criteria were defined. The major criteria are (1) basilar proliferation of
      atypical nevomelanocytes (extending at least three rete ridges or "pegs" beyond
      any dermal nevo-cellular component), and (2) organization of this proliferation
      in a lentiginous or epithelioid-cell pattern. Minor criteria are (1) the presence
      of lamellar fibrosis or concentric eosinophilic fibrosis, (2) neovascularization,
      (3) inflammatory response, and (4) fusion of rete ridges. Diagnosis required
      presence of both major criteria and at least two minor criteria. One hundred
      fourteen histologic specimens of benign acquired nevi, dysplastic nevi, and
      radial-growth-phase melanomas were examined by the members of this panel; their
      diagnoses were compared to determine degree of concordance. The established
      criteria yielded 92% mean concordance overall.

PMID- 1741811
TI  - Malaria in an urban emergency department: epidemiology and diagnostic features of
      25 cases.
AB  - This article presents a retrospective study of 25 patients diagnosed with malaria
      in an urban emergency department (ED) between June 1986 and June 1989. The mean
      annual case rate of malaria in this study group was more than three times the
      national rate. This may be ascribed to the notable ethnic diversity of the
      population. A history of travel to an area endemic for malaria was eventually
      elicited from all patients. The most common chief complaint was fever (56%)
      followed by abdominal pain (12%). Temperatures were elevated in 70% of the
      patients, with a mean temperature of 102.9 degrees F (39 degrees C). Gender was
      found to play a role in delaying diagnosis, with women accounting for 83% of a
      group of patients requiring multiple ED visits before diagnosis. The authors
      conclude that malaria must be considered when diagnosing patients in ethnically
      diverse populations. Gender may be associated with a delay in diagnosis. A
      careful travel history and a peripheral smear are aids in rapid diagnosis.

PMID- 1741812
TI  - Calcium ions and sperm.

PMID- 1741813
TI  - Sustained plasma concentrations of fluoxetine and/or norfluoxetine four and eight
      weeks after fluoxetine discontinuation.

PMID- 1741814
TI  - Bend force systems.

PMID- 1741815
TI  - Identity of Pltgp40 and lysomal integral membrane protein-CD63.

PMID- 1741816
TI  - Dietary fat and breast cancer.

PMID- 1741817
TI  - Plastid origins.

PMID- 1741818
TI  - Posttraumatic stress disorder in World War Two veterans.
AB  - The clinical presentations of chronic posttraumatic stress disorder of 18 world
      war two veterans are detailed. This psychiatric sequelae of trauma may be chronic
      and persistent, as demonstrated by the presence and severity of symptoms 45-50
      years after the onset. Early treatment interventions would appear desirable even
      if not yet conclusively proven to be effective.

PMID- 1741819
TI  - Cervical samplers.

PMID- 1741820
TI  - Pseudodepression in hyponatremia.

PMID- 1741821
TI  - Same day testing for HIV.

PMID- 1741822
TI  - Perinatal bereavement.

PMID- 1741823
TI  - Chronic fatigue syndrome.

PMID- 1741824
TI  - Treatment of intestinal cryptosporidiosis with zidovudine and SMS 201-995, a
      somatostatin analog.

PMID- 1741825
TI  - Re: The Role of Chemical Peeling in the Treatment of Photodamaged Skin. J
      Dermatol Surg Oncol 1990; 16:945-54.

PMID- 1741826
TI  - Pulmonary disease and congestive heart failure.

PMID- 1741827
TI  - The use of dexamethasone in premature infants at risk for bronchopulmonary
      dysplasia or who already have developed chronic lung disease: a cautionary note.

PMID- 1741828
TI  - Infamous acuity system.

PMID- 1741829
TI  - Aspiration pneumonia and the laryngeal mask airway.

PMID- 1741831
TI  - Transcholecystic operative cholangiography: an alternative technique.

PMID- 1741830
TI  - Pulmonary edema of environmental origin--newer concepts.

PMID- 1741832
TI  - Duration of intravenous fluid replacement after abdominal surgery: a prospective
      randomised study.

PMID- 1741833
TI  - Is diet important in rheumatoid arthritis?

PMID- 1741834
TI  - Nd:YAG laser bronchoscopy: rigid or fiberoptic mode?

PMID- 1741835
TI  - Caffeine and aggression.

PMID- 1741836
TI  - Platelet aggregation in Raynaud's phenomenon.

PMID- 1741837
TI  - The care of a patient with noncardiogenic pulmonary edema.

PMID- 1741838
TI  - Cocaine and cerebral atrophy.

PMID- 1741839
TI  - AIDS and insurer discretion.

PMID- 1741840
TI  - Histologic atypia in clinically benign nevi.

PMID- 1741841
TI  - Neurosyphilis and human immunodeficiency virus infection.

PMID- 1741842
TI  - Radiation-induced optic neuropathy.

PMID- 1741843
TI  - Prostitutes, workers and kidneys: Brecher on the kidney trade.
AB  - Brecher argues that the practices of selling blood and kidneys are akin to the
      practices of prostitution and wage-labour since they all involve commodification
      and, by implication, should be subject to legal prohibition. I suggest that these
      practices need not involve commodification and that they should only be condemned
      if people are forced into them because of their lack of power. Rather than these
      practices being prohibited, I suggest that it would be preferable if they were
      subject to state regulation in order to protect the weak from exploitation.

PMID- 1741844
TI  - Amyloidosis.

PMID- 1741845
TI  - Toward more rational nerve conduction interpretations: the effect of height.

PMID- 1741846
TI  - Use of isometric exercise testing can replace isotonic testing to detect and
      evaluate hypertensive populations.

PMID- 1741847
TI  - Maverick nursing?

PMID- 1741848
TI  - Rapid enzyme-linked immunoassay tests for group B streptococcus infection.

PMID- 1741849
TI  - The supraglottic oropharyngeal airway.

PMID- 1741850
TI  - Measurement and manipulation of pulmonary artery wedge pressure in adult
      respiratory distress syndrome.

PMID- 1741851
TI  - Correction of fructosamine values for total protein during pregnancy.

PMID- 1741852
TI  - Comments on "Moebius syndrome: animal model--human correlations and evidence for
      a brainstem vascular etiology".

PMID- 1741853
TI  - Acquired immunodeficiency syndrome and critical care.

PMID- 1741854
TI  - Battery of assays for detecting chemical inhibition of gap junctional
      intercellular communication GJIC.

PMID- 1741855
TI  - Conjugation of phenols in human colonocytes.

PMID- 1741856
TI  - Healing or killing?

PMID- 1741857
TI  - Coaptation of anterior rami of C-3 and C-4.

PMID- 1741858
TI  - Callosotomy for seizures.

PMID- 1741859
TI  - Urodynamics simplified.

PMID- 1741860
TI  - Cardiorespiratory effects during gastrointestinal endoscopy.

PMID- 1741861
TI  - An approach to spinal or epidural catheters that are difficult to remove.

PMID- 1741862
TI  - Tumour surgery of the head and neck.

PMID- 1741863
TI  - Intravaginal prostaglandin E2 gel and cardiovascular changes in hypertensive
      pregnancies.
AB  - Prostaglandin E2 (PGE2) and its analogues may be potent vasodilators, and
      intravaginal PGE2 is known to be absorbed rapidly into the maternal circulation.
      This study investigated any cardiovascular effects from intravaginal PGE2 on 42
      hypertensive pregnant women requiring preinduction cervical ripening. Declines in
      maternal diastolic, systolic, and mean arterial pressures were apparent during
      the first half hour. This trend was mild, was reversible without treatment, and
      did not influence the fetal heart rate baseline or patterns. Fear of clinically
      significant changes should not be a concern, but monitoring during the first hour
      is recommended.

PMID- 1741864
TI  - Fibroepithelial polyps of the vagina in pregnancy.
AB  - A 38-year old pregnant woman presented with a polypoid tumor of the vagina. A
      biopsy revealed benign fibroepithelial polyps. Her pregnancy progressed normally,
      and she underwent an uncomplicated vaginal delivery. Once the benign nature of
      the lesion has been established, a spontaneous vaginal delivery is not
      contraindicated. However, operative vaginal delivery should be avoided to reduce
      the risk of trauma and hemorrhage. Local excision is curative and may be
      performed as an interval procedure when the vaginal vascularity has returned to
      normal.

PMID- 1741865
TI  - Umbilical artery flow velocity waveforms and cord blood viscosity.
AB  - The role of cord blood viscosity in determining the umbilical artery Doppler flow
      velocity waveform (FVW) was investigated in 22 normal pregnancies and 29
      complicated pregnancies. FVWs were quantified by calculating the pulsatility
      index (PI). There was a significant correlation between an abnormal PI (more than
      2 SD from the mean) and fetal growth retardation (less than 5th birthweight
      centile), cesarean section for fetal distress, and raised cord blood hematocrit.
      However, there was no relationship between whole blood or plasma viscosity
      measurements and the umbilical artery PI.

PMID- 1741866
TI  - Prenatal diagnosis of the aneurysm of the vein of Galen by pulsed Doppler unit.
AB  - Aneurysm of the vein of Galen is a rare anomaly. In the severe type, the first
      clinical manifestation of this anomaly is heart failure after birth. Prenatal
      diagnosis is important in preventing heart failure during the postnatal period.
      Here, we report the prenatal diagnosis of a case of aneurysm of the vein of Galen
      in which we used a pulsed Doppler unit combined with a fetal electrocardiogram
      phonocardiogram unit.

PMID- 1741867
TI  - Grading of left-to-right shunting ductus arteriosus in neonates with bedside
      pulsed Doppler ultrasound.
AB  - A nonimaging pulsed Doppler technique was used to grade the magnitude of flow in
      left-to-right shunting ductus arteriosus. The results were compared with those
      obtained with a color Doppler flow mapping technique. The correlation between the
      grading results by these two methods was 0.91 (p less than 0.01). To determine
      hemodynamic influence of left-to-right shunting ductal flow, simultaneous
      measurements of Doppler-derived cardiac output were done. Results showed
      significantly higher cardiac output in infants with grade III shunting than in
      infants with grade 0 and grade I shunting. The nonimaging pulsed Doppler
      ultrasound technique used in the present study proved to be a clinically useful
      and accurate grading system of left-to-right shunting at the ductal level. The
      simple grading system with nonimaging Doppler is a valuable adjunct to the color
      Doppler flow mapping technique. It allows a regular evaluation of ductal flow as
      well as cardiac output.

PMID- 1741868
TI  - Antenatal diagnosis of a rare combined fetal malformation: acardius acephalus and
      single ventricle of the twin.
AB  - The development of an acardius in a monozygotic multiple pregnancy has been
      reported in more than 200 cases. We present the case of an acardius acephalus in
      a twin pregnancy additionally complicated by a serious cardiac malformation of
      the donor twin (single ventricle). Antenatal diagnosis and development as well as
      intrauterine treatment of the donor twin from 26 to 34 weeks of gestation are
      described.

PMID- 1741869
TI  - Management of prenatally detected nonlethal fetal anomalies: is a karyotype of
      benefit?
AB  - The pregnancy outcomes of 155 women who underwent an amniocentesis for a prenatal
      karyotype after being diagnosed by ultrasound as having one or more nonlethal
      structural anomalies are presented. Thirty-three (21%) patients were found to
      have an abnormal karyotype. Knowledge of the prenatal karyotype was useful in the
      subsequent management of these pregnancies. A pregnancy with a fetal anomaly
      diagnosed prior to 24 weeks was more likely to be terminated if an abnormal
      karyotype was also present. In women who were diagnosed as having a fetal anomaly
      with an abnormal karyotype at 24 weeks or later, only 3 of 13 (23%) infants
      survived the neonatal period. Knowledge of the karyotype results influenced
      decisions regarding the place, timing, and route of delivery in these fetuses. In
      32 women, (21%) a karyotype was beneficial by avoiding maternal transport,
      cesarean delivery, and neonatal expenses at a Level III perinatal center.

PMID- 1741870
TI  - Prenatal sonographic features and management of a fetus with Roberts-SC
      phocomelia syndrome (pseudothalidomide syndrome) and pulmonary hypoplasia.
AB  - The Roberts-SC phocomelia syndrome (pseudothalidomide syndrome) is a rare,
      usually lethal condition involving short limbs and occasional hydrocephalus.
      Presented is a case in which prenatal sonographic findings were highly suggestive
      of this syndrome, although not definite. In this fetus, findings of
      hydrocephalus, short limbs, and probable pulmonary hypoplasia changed the
      intrapartum management. The findings, correlated with the postmortem radiography,
      led to diagnosis of probable Roberts-SC syndrome.

PMID- 1741871
TI  - Ranged-gated pulsed Doppler of the umbilical artery in human fetuses during
      normal pregnancies.
AB  - Range-gated pulsed Doppler has permitted the study of umbilical artery flow
      velocity waveforms (FVWs) in human fetuses and is becoming part of the antepartum
      fetal evaluation. No uniform method of describing such velocity waveforms and no
      significant body of normal values using pulsed Doppler can be found in the
      literature. The present study reports on a cohort of 268 patients who had pulsed
      Doppler umbilical artery FVWs performed during their pregnancy. The gestational
      age at the time of the study ranged between 16th and 42nd weeks of gestation in
      normal pregnancies. The systolic to diastolic (S/D) ratio was found progressively
      to decrease as gestation advanced; however, the range of normal values in this
      study was found to be quite large at all gestational ages. The present data
      represent normative data of the umbilical artery FVWs S/D ratio in a large number
      of normal pregnancies as shown by the follow-up of all the patients to delivery.
      Before umbilical artery waveform becomes part of the antenatal armamentarium, we
      advise caution before adopting rigid values that are derived from small groups.
      Lack of standard values for the 95th percentile may result in a premature
      delivery of an otherwise normal fetus.

PMID- 1741872
TI  - Uteroplacental Doppler flow velocity waveform analysis correlates poorly with
      glycemic control in diabetic pregnant women.
AB  - We examined 65 pregnant women with gestational (n = 31) and insulin dependent (n
      = 34) diabetes mellitus in order to evaluate the clinical usefulness of Doppler
      flow velocity waveform analysis in these pregnancies. Umbilical and uterine
      artery flow velocity waveforms were obtained during the third trimester with a
      continuous wave Doppler device. Quality of maternal glycemic control was
      evaluated by hemoglobin (Hb) A1 measurements at the time of delivery in 61
      patients and by mean capillary blood sugars during the third trimester of
      pregnancy in four patients. There was no difference in various clinical and
      Doppler parameters between patients with good glycemic control and those with
      poor control. In contrast, the same clinical and Doppler parameters were
      significantly different in patients with preeclampsia than in those without
      preeclampsia, regardless of glycemic control. There was a poor positive linear
      correlation (r = 0.30, p less than 0.02) between maternal HbA1 and umbilical
      artery flow velocity waveforms (systolic/diastolic ratio). Proteinuria correlated
      better with umbilical artery systolic/diastolic ratio (r = 0.49, p less than
      0.001). We conclude that Doppler flow velocity waveform analysis may be
      clinically useful only in diabetic pregnancies complicated by preeclampsia.

PMID- 1741873
TI  - Acute fatty liver of pregnancy associated with preeclampsia: management of
      hepatic failure with postpartum liver transplantation.
AB  - Acute fatty liver of pregnancy is a potentially fatal disorder. We report a
      patient complicated by preeclampsia, coagulopathy, encephalopathy, and
      hepatorenal syndrome successfully managed by postpartum hepatic transplantation.

PMID- 1741874
TI  - Impact of venous catheters on packed red blood cells.
AB  - This study was designed to test the hypothesis that there would be increased
      hemolysis, as indicated by an increase in plasma free hemoglobin and potassium,
      when packed cells were infused through small gauge percutaneous catheters (24 and
      28 g, PC) compared with short catheters (24 g; SC). We were unable to study the
      28 g PC because after 1 hour, at a flow rate of 10 ml/hr, only 2.4 ml packed
      cells were infused. There was a significant increase in plasma free hemoglobin
      when pre- and postinfusion values were compared (SC, p = 0.005; PC, p = 0.009),
      but a statistically significant increase in potassium only for the SC (p =
      0.008). There were no significant differences between the catheters for either
      potassium or free hemoglobin. For either catheter the quantity of free hemoglobin
      transfused could potentially cause a significant rise in serum bilirubin and
      hemoglobinuria.

PMID- 1741875
TI  - Analgesia versus sedation during Broviac catheter placement.
AB  - Premature infants are capable of mounting physiologic and metabolic responses to
      pain. Systemic and local anesthesia reduce stress responses to major and minor
      surgical procedures. We evaluated the effects of local anesthesia (5 mg/kg
      lidocaine) preceded by either 1 mg/kg secobarbital (S) intravenously or by 2
      micrograms/kg fentanyl (F) intravenously on the stress response to Broviac
      catheter placement. Twenty-nine premature infants ages 5 to 30 days, weighing
      between 650 and 1350 gm, were randomly assigned to either S or F groups. Age,
      birthweight, sex, race, and severity of illness were similar among S and F
      groups. Heart rate and blood pressure remained unchanged throughout the
      procedure. Oxygen saturation (O2sat) declined significantly in both groups during
      skin preparation and wound closure, but not during incision, dissection, or
      tunneling. In spite of fractional inspired oxygen adjustments made in 13 of 14 S-
      and 3 of 15 F-treated patients, decline in O2sat was more common and more
      pronounced (p less than 0.01) in S-treated babies. Hyperglycemic responses
      occurred in all S- and in none of the F-treated patients (p less than 0.001).
      Norepinephrine plasma concentrations did not change during Broviac catheter
      placement in either F or S group. Epinephrine concentrations were more elevated
      in S- than in F-treated patients, although these differences were not
      statistically significant. Low-dose fentanyl analgesia effectively complements
      local lidocaine anesthesia during Broviac catheter placement. Sedatives neither
      abolish metabolic responses to surgical stress nor prevent profound and
      persistent oxygen desaturation.

PMID- 1741876
TI  - Developmental follow-up of very low birthweight premature infants with low free
      thyroxine.
AB  - If a low level of free thyroxine (T4) is predictive of the true hypothyroidism in
      sick premature infants, long-term developmental follow-up of these infants should
      reveal a direct correlation between the free thyroxine level early in life and
      developmental disability in later years. Half of the 16 infants who were followed
      had normal free T4 (0.8 ng/dl or higher) and the remaining 8 infants had a low
      free T4 (0.38 +/- 0.15 ng/dl) during the first 2 weeks of life. Infants with low
      free T4 were followed sequentially during their stay in the neonatal intensive
      care unit and all eight showed free T4 levels more than 0.8 ng/dl by 36 to 44
      weeks postconceptional age without any thyroid replacement. At follow-up, all 16
      infants were functioning within normal range by Stanford-Binet testing at mean
      age of 4.6 years. There was no significant difference between the two groups in
      their motor development, hearing, language, or physical growth. Despite the small
      sample size, it appears there is no correlation between the free T4 levels during
      the first 2 weeks of life in infants 33 weeks' or less gestation and their
      developmental outcome at mean age of 4.6 years.

PMID- 1741877
TI  - Umbilical artery Doppler velocimetry: applications and limitations.

PMID- 1741878
TI  - [Heat radiation--an essential factor of heat transport in caloric vestibular
      tests? Current experimental findings].
AB  - According to the accepted theory, in vestibular testing the caloric stimulus is
      transported from the auditory canal to the lateral semicircular canal by heat
      conduction via the bone. Some findings, however, are not consistent with this
      concept, e.g. the short latency of the vestibular response, and the fact that
      removing of the osseous bridge does not stop the transport of heat to the
      semicircular canal. Physically there are three modes of heat transport:
      conduction, convection, and radiation. So far, only the first two have been
      discussed with regard to vestibular calorization, however, they fail to explain
      the findings mentioned above. We carried out experiments on 10 cadaveric temporal
      bone specimens in order to evaluate the possible effect of heat radiation. With
      experimental conditions strictly regulated (specimens kept in climate box, 37
      degrees C, saturated humidity, standardized irrigation of the auditory canal with
      50 ml of water of 50 degrees C in 15 sec., temperature measured by thermistors at
      selected points of the specimen), the deviation in repeated experiments was
      within 0.1 degree C. In normal temporal bones a spreading of heat along the
      osseous structures was found in accordance with heat conduction via the bone.
      Then the bony bridge between posterior frame of the tympanic membrane and the
      lateral canal was removed along with the tegmen tympani, leaving the auditory
      canal and labyrinth connected only by a small anterior-inferior strut. The rise
      of temperature in the lateral canal, however, was not delayed and reduced, as
      expected, but faster and greater than in the original situation. If, now, a
      reflecting shield was inserted in the cleft between tympanic membrane and
      labyrinth the heat transfer was dramatically reduced. A similar effect could be
      achieved in the intact middle ear by a shield or by filling the cavity with gel.
      Convection as means of heat transport could be excluded. The experiments show
      that heat transport in the vestibular calorization is a complex process, which
      besides heat conduction involves radiation as an essential factor. This explains
      a number of experimental and clinical findings that, so far, had been unclear.

PMID- 1741879
TI  - [Equilibrium disorders and their diagnosis in childhood].
AB  - Vertigo in children is rarer than in adults and the examiner in cases showing
      these symptoms must rely on the parents' or relatives' observations and details.
      Besides the equilibrium disorders caused by hereditary malabsorption or lesions
      in the peripheral or central vestibular structures, e.g. ototoxic drugs, tumours
      in the brain, meningitis, encephalitis, otitis, labyrinthine fistulas or head
      trauma, we only known of typical diseases, associated with vertigo, that develop
      during childhood. These are: so-called benign paroxysmal vertigo of childhood,
      benign paroxysmal torticollis, basilar migraine, spasmus nutans, visual-cliff
      phenomenon, and kinetosis. Careful examinations are necessary to differentiate
      these illnesses from vestibular epilepsy, brain tumours, and hereditary episodic
      vertigo. Neuro-otologic examination in children, especially small children, is a
      kind of "stepchild" in ENT departments. The reasons are the time-consuming
      examination necessary in the case of children and by problems connected with a
      plethora of troublesome individual tests. Additional difficulties arise in cases
      of sensory, mental, and other impairments. - The paper gives an overview of
      vestibular disturbances during childhood and diagnostic procedures for
      determination by means of Frenzel glasses, electronystagmography, cranio
      corpography, and posturography.

PMID- 1741880
TI  - [Masseter muscle flaps and buccal mucosa transposition flaps in the
      reconstruction of the dorsal oral cavity and the oropharynx].
AB  - The m. masseter crossover flap according to Tiwari combined with a buccal mucosa
      transposition flap represents an excellent technique for a primary two-layered
      closure of defects due to surgical removal of T2- and small T3-tumors of the
      posterior part of the lateral floor of the mouth, the posterior edge of the
      tongue, the retromolar trigone, the soft palate and the tonsilar region.
      Especially advantageous are the low postoperative morbidity, the low rate of
      postoperative complications, and good functional and cosmetic results. The
      surgical expenditure is little and recommends the use of this technique also in
      patients with reduced operability.

PMID- 1741881
TI  - [Verrucous carcinoma of the oral mucosa].
AB  - Verrucous carcinoma is a distinct variant of differentiated squamous cell
      carcinoma with low-grade malignancy, slow growth and no metastatic potential.
      Although it has been reported at extraoral sites, the tumor is mostly found in
      the oral mucosa. Clinically warty tumours with a grey-white, deeply cleaved
      surface are detected. The special feature of this tumour type is that it appears
      macroscopically malignant but histologically benign. The diagnosis of verrucous
      carcinoma may be difficult, since it is often lumped with verrucous hyperplasia
      or epidermoid carcinoma. In our study the clinical and histological
      characteristics of 32 cases of verrucous carcinoma of the oral cavity were
      investigated. The most common site was the mandibular buccal sulcus. The average
      age amount to 69 years. Adequate surgical excision is considered the treatment of
      choice. Because of the lack of metastatic spread a systematic treatment of the
      regional lymph nodes ist not mandatory. The prognosis of verrucous carcinoma is
      fairly good.

PMID- 1741882
TI  - [Assessment of the functional final condition following treatment of carcinoma of
      the oral cavity].
AB  - The treatment of carcinoma of the oral cavity (tongue, floor of mouth, lips and
      palate) can lead to different degrees of mutilation. A simple and effective
      method of evaluation is described, that permits to determine the functional
      results of different treatments in individual patients. In a special evaluation
      form, the actual weight of the patient, continuing pain, activities at home and
      at work, xerostomia, visible mutilation, disorders of tongue mobility and
      sensitivity, speech impairment, swallowing disorders and psychological problems
      are assessed. The documentations is completed by application of a score system,
      that allows a reliable determination of functional results after treatment of
      oral cavity carcinoma. About 30 minutes are required to complete the
      investigation. 31 own patients were examined following transoral laser surgery
      for the treatment of oral cavity carcinoma. The results are demonstrated and
      compared to those following conventional surgery.

PMID- 1741883
TI  - [Regeneration of the ciliary beat of human ciliated cells].
AB  - The influence of an isotonic, alkaline saline solution (diluted "Emser Sole" or
      brine from the spa of Bad Ems) on the ciliary beat of isolated cultured human
      ciliated cells of the upper respiratory tract was investigated. The ciliary beat
      was observed via an inverted phase contrast microscope (Zeiss Axiomat IDPC) and
      measured microphotometrically under physiological conditions and after the
      damaging influence of 1% propanal solution. Under physiological conditions the
      saline solution had a positive, although statistically not significant influence
      on the frequency of the ciliary beat. After damage of the cultivated cells by 1%
      propanal solution, the saline solution had a significant better influence on the
      regeneration of the cultured cells than a physiological sodium chloride solution.
      It is concluded that diluted brine from Bad Ems has a positive effect on the
      ciliary beat of the respiratory epithelium and accelerates its regeneration after
      damage by viral and bacterial infections, surgery or inhaled noxae.

PMID- 1741884
TI  - [Is it appropriate to consider wood preservative poisoning in the differential
      diagnosis of chronic recurrent respiratory tract infections?].
AB  - Wood preservatives as pentachlorophenol and lindane containing the highly toxic
      compound dioxin were common to be used to protect woods inside the house. In a
      case report a couple of symptoms are shown as upper airway irritation with dry
      mucosa, headaches, sleeplessness, lack of concentration and psychosomatic
      problems caused by those wood preservatives. The typical sequence of the symptoms
      is given. The results of blood and urine analysis on pentachlorophenol and
      lindane lead to investigations on indoor materials, air and dust. Taking out the
      contaminated materials is the best and only treatment.

PMID- 1741885
TI  - [The value of indirect microlaryngo-stroboscopy in the follow-up care of patients
      with vocal cord carcinoma treated with primary irradiation].
AB  - On the value of indirect Microlaryngo-stroboscopy in the follow-up of patients
      with vocal cord tumors having had primary radiotherapy: The technique of
      stroboscopy is explained, its weight in the evaluation of vocal cords vibration
      is discussed. Arrest of vibration may be a hint for a malignoma, particularly if
      this state develops again after radiotherapy.

PMID- 1741886
TI  - [Speech intelligibility and psychosocial adaptation in various voice
      rehabilitation methods following laryngectomy].
AB  - Intelligibility and psychosocial adjustment are measured by the PLTT (Post
      Laryngectomy-Telephone-Test) and a newly developed questionnaire (FPAL). 110 male
      patients with total or partial laryngectomies are tested. Three different groups
      are compared with each other: laryngectomees with voice prostheses,
      laryngectomees with oesophageal voice or artificial larynx, and patients with
      partial laryngectomies. As was to be expected, intelligibility (single words and
      sentences) was best in patients with partial laryngectomies. The intelligibility
      of the laryngectomees with voice prostheses is significantly higher than the
      intelligibility of patients with oesophageal voice or artificial larynx. There
      was no difference between the groups with regard to the subjective assessment of
      intelligibility in relation to various communication partners. Partial
      laryngectomies have the lowest negative impact on the social and psychological
      situation of the patients. Laryngectomees, however, are more lonely, indicate
      more psychological stress in social interactions, and have a less positive
      evaluation of their life. Statistical analyses reveal no difference in
      psychosocial adjustment between laryngectomees with voice prostheses, oesophageal
      voice and artificial larynges.

PMID- 1741887
TI  - [Aberrant heterotopic salivary gland in a lateral neck cyst].
AB  - An extra aberrant salivary gland located in a branchial cyst is presented. The
      branchial cysts are usually the result of a transformation disturbance of the
      branchial clefts and arches, or are cystic changes of the lymph nodes. The above
      finding can possibly be interpreted if we suppose that an aberrant salivary gland
      located in a lymph node can develop a cyst. The theory that branchial cysts
      originate from lymph nodes is encouraged by our case. This theory can also
      support the existence of unusual tumours in the neck, e.g. adenolymphomas. The
      content of these cysts can be easily approximately estimated via computed
      tomography.

PMID- 1741888
TI  - [The problem of deeply situated parotid tumors].
AB  - Of 804 surgically treated parotid gland tumours, every fifth (19.9%) was situated
      medially from the 8th cranial nerve. Among these deep lobe tumours (DLT) there
      are more malignant tumours (36.8%) than in superficial lobe tumours (SLT; 11.4%).
      This fits especially the carcinoma arising in pleomorphic adenomas (14.3% in DLT;
      3.1% in SLT). Postoperative complications of the 8th cranial nerve, defective
      tumour capsules, and necessary second or third look operations are more
      frequently in DLT than with SLT. Early diagnosis of tumours that are still small,
      is therefore very important.

PMID- 1741890
TI  - Theoretical models for traffic safety.

PMID- 1741889
TI  - [Training and technique of maxillary sinus sinoscopy].

PMID- 1741891
TI  - Population and registered vehicle data vs. road deaths.
AB  - This paper discusses the use of rates to evaluate the effectiveness of
      countermeasures and to compare the safety of different countries and of different
      periods of time. The use of a rate requires an understanding of the shape of the
      curve relating the two variables. The use of the rates "death per registered
      vehicle" or "death per vehicle-kilometer" does not provide a consistent measure
      across time when there is a nonlinear relationship between number of deaths and
      number of vehicles. Predictive equations with one variable forming both part of
      the independent and dependent variable will suffer from spurious correlation.
      Smeed's equation does not predict the number of deaths in the original data set
      with any degree of overall accuracy, and cannot be assumed to predict accurately
      the number of deaths in other countries. The use of the number of persons killed
      rather than the number of fatal accidents might be questioned as one is the
      outcome of the other. More subdivisions of the total would be of more interest
      such as the numbers of different road user types within age groups. While deaths
      might be one of the common currencies of road injuries for comparing countries,
      there is little excuse for using them for examining trends within one country.
      Some performance measures that use the number of accidents and the number of
      persons (injured and uninjured) that are involved in them would be more
      meaningful than using deaths per vehicle.

PMID- 1741892
TI  - Forecasting road accident casualties in Great Britain.
AB  - There is considerable interest in many countries in the way in which their annual
      road accident casualty totals have developed. This leads inevitably to the
      question of how these totals are likely to change in the future. This paper
      assesses national data for Great Britain from 1949-1989 and forecasts the
      casualty total in the year 2000 by extrapolating the long-term decline in the
      rate of casualties per hundred million vehicle-kilometres. This forecast is
      conditional on the traffic growth predicted by that year, but it is found that
      uncertainty over the casualty forecast derives more from the slight
      irregularities in the past decline in the casualty rate than from uncertainty
      over the traffic prediction. Despite the use of a forecasting method that is
      based on an unusually strong time-series model, there is still real uncertainty
      about forecasting casualties over a gap of only 11 years.

PMID- 1741893
TI  - An aggregate accident model based on pooled, regional time-series data.
AB  - The determinants of personal injury road accidents and their severity are studied
      by means of generalized Poisson regression models estimated on the basis of
      combined cross-section/time-series data. Monthly data have been assembled for 18
      Norwegian counties (every county but one), covering the period from January 1974
      until December 1986. A rather wide range of potential explanatory factors are
      taken into account, including road use (exposure), weather, daylight, traffic
      density, road investment and maintenance expenditure, accident reporting
      routines, vehicle inspection, law enforcement, seat belt usage, proportion of
      inexperienced drivers, and alcohol sales. Separate probability models are
      estimated for the number of personal injury accidents, fatal accidents, injury
      victims, death victims, car occupants injured, and bicyclists and pedestrians
      injured. The fraction of personal injury accidents that are fatal is interpreted
      as an average severity measure and studied by means of a binomial logit model.

PMID- 1741894
TI  - A critical review of macro models for road accidents.
AB  - This paper presents a critical review of state-of-the-art macro models for road
      accidents. Such a review is meant to identify and establish the significance of
      policy and socioeconomic variables affecting the level of road accidents. The aim
      is to identify those variables associated with effective policies and
      interventions to enable decision makers to improve the level of road safety. The
      variables that appear to affect the number of fatalities or injuries are: vehicle
      miles travelled (VMT), vehicle population, income (in its various forms),
      percentage of young drivers, intervention policies such as speed limits, periodic
      vehicle inspection, and minimum alcohol-drinking age. Viewed critically, the
      state-of-the-art models being used to explain and predict road accidents are
      still deficient. One possible approach to correcting this deficiency draws from
      consumer utility theory, using analytical models built on a newly constructed
      theoretical framework. Success in estimating such models may improve predictions
      of road accidents, thus demonstrating the comparative cost effectiveness of
      alternative intervention policies.

PMID- 1741895
TI  - The development of traffic and traffic safety in six developed countries.
AB  - Two models are presented, describing the development of traffic and traffic
      safety. Traffic volumes, measured by the total amount of vehicle kilometers per
      year, are expected to follow a sigmoid saturation curve over time. The logistic
      function is used to model this development. The fatality rate, the number of
      fatalities per vehicle kilometer, is chosen to measure safety. The (negative)
      exponential function is selected to model the fatality rates over time. It is
      argued that these two aspects of the traffic system are fundamental and that the
      development of the number of fatalities results by multiplication. Given this
      assumption, the fall in the number of fatalities, noticed in almost all developed
      countries after a steady increase until 1970, does not need a special
      explanation. It follows from the combination of the monotonically increasing
      traffic volumes and the monotonically decreasing fatality rates. The two
      parsimonious models fit the data fairly well for six developed countries. The
      parameters differ substantially between countries, but also show common features.
      It is found from the parameters of the logistic function, that for all countries
      the points of maximum increase in traffic volume coincide just after 1970, the
      moment of the energy crisis. It is concluded from this finding that the energy
      crisis was caused by the cumulating demands of the oil-consuming countries,
      resulting in a reaction of the oil-producing countries. From the parameters of
      the exponential function, it is found that there also is a common point of
      intersection for fatality rates around 1980. It is shown that the development of
      safety is directly related to the development of traffic. The ten-year delay is
      interpreted as the time necessary for planning and implementation of safety
      measures. Finally, a striking relation is found between the volume parameters and
      the fatality-rate parameters, suggesting that the number of fatalities is a
      function of the derivative of the amount of traffic in the mathematical sense.

PMID- 1741896
TI  - Development of traffic and traffic safety: global trends and incidental
      fluctuations.
AB  - In this, and previous related papers, developments of traffic volumes and traffic
      safety are studied from a system-theoretic point of view. It was proved already
      that such an approach is effective and leads to new and interesting theoretical
      facts. Models for the description of long-term developments of traffic volumes
      and safety were established, and particular relations between both developments
      were found. One of these findings was, that the number of fatalities turned out
      to be a function of the derivative of the logistic function describing the
      development of the number of vehicle kilometres over the years. It was noted that
      the model deviations for the number of fatalities and the vehicle kilometres were
      not merely random, but also had systematic components. In the present paper these
      deviations were further investigated. For the Netherlands, it is clearly shown
      that the number of fatalities is a function of the derivative of the number of
      vehicle kilometres, but with a shift in time. The short-term deviations from this
      long-term development are also related to the derivative of the number of vehicle
      kilometres, but without a shift in time. For five other countries similar
      relations were found, although the description of the short-term fluctuations
      seems to be a bit more complicated. In general, it can be concluded that the
      system-theoretic approach turned out to be highly effective for the description
      of long-term and short-term developments in traffic volumes and safety. For the
      Netherlands up to 95% of the variance in fatalities can be "explained" by
      developments in traffic volumes alone. It is clearly demonstrated that, although
      it will be very difficult to single out effects of specific safety measures, the
      combined safety actions taken by a society are very effective in getting the
      safety factor under control. The most valuable fact that can be learned from this
      analysis is that, if increased developments in traffic volume occur or are
      predicted, the immediate safety effects can also be estimated. Therefore,
      anticipatory safety measures can be taken to cope with these effects before (or
      immediately after) the moment they appear, improving safety management at a more
      rational and preventive basis.

PMID- 1741897
TI  - Simple models of fatality trends revisited seven years later.
AB  - The author's original paper presented simple linear models of fatalities based on
      data through 1982 and appeared in this journal in 1984. The earlier paper
      reported good fits through 22 years of fatality counts using population and
      employment data, after adjusting for the short-term effect of the oil shortage
      (in 1974) and the long-term effect of the 55 mph speed limit (beginning in 1974).
      Attempts (reported here) to refit the model through seven additional years were
      less successful. It may be that the relationships originally reported have
      changed, that important new factors have been introduced, or that the original
      fits were partly luck. The recent emphasis on behavioral solutions to safety
      problems (including programs to decrease alcohol use and increase safety belt
      use) is one important change, so the effect of the benefits of these programs on
      the model fits is explored. The original model began to overpredict fatalities
      just as safety benefits were beginning to accrue from increased safety belt use
      and decreased driver-alcohol involvement, and both the model overprediction and
      the benefits of these programs increased over the seven years of data added to
      the original model. Thus, previous government estimates of the number of lives
      saved by these behavioral programs are supported by the observed change in the
      statistical relationship between fatality counts and economic factors.

PMID- 1741898
TI  - Determinants of motor vehicle deaths in the United States: a cross-sectional
      analysis.
AB  - This paper uses 1987 state-level data and least-squares regression to estimate a
      model of motor vehicle deaths in the United States. The model includes several
      factors accounted for in previous cross-sectional studies of these fatalities.
      The estimates suggest that income, the ratio of urban to rural driving,
      expenditures on highway police and safety, motor vehicle inspection laws, and
      adult seat belt use laws with secondary enforcement provisions are inversely
      related to motor vehicle death rates. They also indicate that volume of driving,
      speed, speed variance, driving density, alcohol consumption, temperature, and a
      dummy variable for western states are directly related to the rates.

PMID- 1741899
TI  - Are traffic deaths in Ireland related to alcohol consumption? Restudying a time
      series model.
AB  - The traffic death rate and per capita alcohol consumption in Ireland were found
      by Walsh to be correlated. However, a more detailed analysis shows that changes
      in traffic deaths precede changes in alcohol consumption. Therefore, the
      correlation can not reflect a causal relation. When a speculative variable is
      included, the relation becomes concurrent. The overall conclusion is that there
      is no credible evidence for a relation between per capita alcohol consumption and
      traffic deaths.

PMID- 1741900
TI  - The effect of airline deregulation on automobile fatalities.
AB  - This paper attempts to quantify the effects of airline deregulation in the United
      States on intercity automobile travel and consequently on the number of highway
      fatalities. A demand model is constructed for auto travel, which includes
      variables representing the price and availability of air service. A reduced form
      model of the airline market is then estimated. Finding that deregulation has
      decreased airfares and increased flights, it is estimated that auto travel has
      been reduced by 2.2% per year on average. Given assumptions on the
      characteristics of drivers switching modes and the types of roads they drove on,
      the number of automobile fatalities averted since 1978 is estimated to be in the
      range 200-300 per year.

PMID- 1741901
TI  - The economy as a factor in motor vehicle fatalities, suicides, and homicides.
AB  - The effect of the economy as reflected by employment and unemployment rates on
      motor vehicle fatalities, suicides, and homicides is examined using several
      national databases. First, regression models are fit to these fatality data
      overall as well as for a variety of age-race-gender subgroups. Then time series
      models-autoregressive integrated moving average (ARIMA) and structural time
      series analysis-were fit to the data, both with and without the economic
      indicators, to examine the relative ability of the models to forecast subsequent
      fatalities. No evidence was found using any of the modeling techniques that
      knowledge of yearly values of rates of employment, unemployment, and nonlabor
      force leads to improved forecasts of the level of motor vehicle fatalities,
      suicides, or homicides in the total U.S. population or within various
      subpopulations of interest.

PMID- 1741902
TI  - [Intravenous application of calcitonin following unsuccessful thermocoagulation
      of the dorsal root entry zone].
AB  - Following a traumatic lesion of the brachial plexus, severe pain syndrome in the
      left shoulder and arm developed in a 42-year-old patient. The pain could not be
      relieved by multiple therapeutic attempts. Therefore, electrocoagulation of the
      substantia gelatinosa was performed on the affected side of the evulsed plexus
      from the dorsal aspect of the cervical spinal cord (Dorsal-Root-Entry-Zone
      Lesion, DREZ-operation). After temporary relief, the initial pain syndrome
      returned. Intravenous salmon-calcitonin infusions administered at our pain clinic
      led to almost complete remission of pain. Six months later the original symptoms
      returned and therefore the same infusion scheme was repeated with identical
      results.

PMID- 1741903
TI  - [Preoperative donation of autologous blood and plasma].
AB  - The risk and side effects of homologous blood transfusion led to an increased
      interest in autologous transfusion concepts. Whereas peri- and intraoperative
      procedures are clinical methods, preoperative autologous blood donation belongs
      into the responsibility of a transfusion service in order to ensure qualified
      separation into blood components as well as correct storage and handling. Special
      knowledge in transfusion medicine is necessary for the application of
      preoperative autologous plasmapheresis. On the other hand, its use by clinicians
      under adequate controlled conditions seems to be rather safe. Although autologous
      transfusion includes the lowest risk, side reactions cannot be completely
      excluded. There is also a risk of secondary bacterial contamination. Side effects
      due to the specific composition of the various blood components, to alterations
      during storage and to the way of application have to be considered, too. Severe
      haemolytic transfusion reactions are mostly caused by exchange of blood samples,
      patients or blood units. They are to be expected in autologous blood transfusion
      as well. In addition, there is an increased risk of infection when autologous
      blood components are exchanged accidentally. There is only an indication for
      autologous blood if the total risk of autologous donation as well as transfusion
      in the individual case is lower than the statistical risk of homologous
      transfusion. Autologous blood donation should be offered to all patients
      undergoing elective surgery where blood is likely to be required and when blood
      donation is practicable. Preoperative autologous plasmapheresis is indicated in
      elective surgery if intra- and perioperative autotransfusion methods shall be
      used and a blood loss of at least 1.5 liters can be expected. There are a lot of
      organizational problems in autologous blood transfusion which can be solved by
      adequate information of all persons involved and close cooperation between
      clinicians and transfusion service. The high standard which was developed for
      homologous transfusion in the last 15 years has to be maintained for autologous
      blood transfusion, too.

PMID- 1741904
TI  - [Autologous blood use in patients with rheumatic diseases].
AB  - A four-step autotransfusion concept consisting of preoperative autologous blood
      predeposit, isovolaemic haemodilution, preoperative plasmapheresis and
      intraoperative autotransfusion in rheumatic patients undergoing major planned
      operations associated with considerable blood loss is presented. The
      autotransfusion concept was established in 1988. At that time 47% of the total
      blood demand was replaced by autologous transfusions. In 1989 there was an
      increase to 88% and in 1990 even to 94%. It is pointed out that under
      normovolaemic conditions the chronic anaemia of these rheumatic patients is
      neither a contraindication for preoperative autologous blood predeposit nor for
      intraoperative autotransfusion.

PMID- 1741905
TI  - [A new method of non-invasive determination of the cardiac minute volume in
      ventilated patients].
AB  - A method for the determination of stroke volume and cardiac output from pulse
      synchronized variations of pressure in mechanically ventilated patients is
      described. A comparison with 20 readings obtained by thermodilution showed good
      correlation (r = 0.9866).

PMID- 1741906
TI  - Propofol safely used in a neuroleptic malignant syndrome patient.
AB  - Anaesthetic regimens for patients with the poorly understood neuroleptic
      malignant syndrome (NMS) are not well outlined. In this case report, NMS and its
      questionable relation to malignant hyperpyrexia are outlined. Satisfactory use of
      total intravenous anaesthesia, based on propofol, in an NMS-susceptible patient
      is presented.

PMID- 1741907
TI  - [Perforation of the palate following prolonged orotracheal intubation--a case
      report].
AB  - A report is given on a patient, who showed a perforation of the palate after
      prolonged orotracheal intubation. Etiology as well as prophylactic measures with
      a tracheostomy in good time for avoiding such complications are discussed.

PMID- 1741908
TI  - [The liability of employed physicians in the "New German States" in 1991].
AB  - The law has essentially changed in the "New German States" (in former times "East
      Germany") since the unification of East- and West-Germany on the 3rd of October
      1990. The civil code ("Burgerliches Gesetzbuch = BGB") is now valid for all
      working conditions. But due to the "Unification Treaty" the regulations regarding
      the hospital liability ("Materielle Verantwortlichkeit der Gesundheitseinrichtung
      = mVGe") are still existing until the 31st of December 1991. Now, however, it is
      possible that in case of malpractice the patient may claim the employed physician
      directly liable.

PMID- 1741909
TI  - A new insight into the mycobacterial cell envelope architecture by the
      localization of antigens in ultrathin sections.
AB  - In an attempt to have a better insight into the mycobacterial cell envelope
      architecture, various subcellular fractions of Mycobacterium avium were prepared
      and characterized chemically and ultrastructurally. The various fractions
      corresponding to the mycobacterial "capsular material", outer layer, cell wall
      skeleton, cytoplasmic membrane, and cytosol as well as intact bacteria were then
      used to raise antisera in rabbits. The antisera so raised were then used to
      immunolabel the intact bacteria prior to embedding in epon. In parallel studies,
      bacteria were processed by a novel gelatin-uranyl acetate-low temperature
      Lowicryl HM20 embedding which preserved mycobacterial antigens, permitting to
      immunolabel antigens on ultrathin sections. Immunolabelling of epon-embedded
      intact bacteria showed that in the tripartite structure of the bacterial cell
      envelope, the middle electron-transparent layer acted as a barrier, not
      permitting the antibodies to penetrate into deeper structures. Immunolabelling of
      ultrathin sections showed that mycobacteria were surrounded by a "capsule"
      containing specific surface antigens with a glycocalyx-like topography, and that
      the intermediate electron transparent layer which separated the surface
      amphiphils from the inner arabinogalactan-peptidoglycan layer, was a virtual no
      man's land as it only seldom contained a single gold particle irrespective of the
      various antisera used. Furthermore, location of various layers in the cell
      envelope of M. avium using antisera raised against the subcellular fractions
      prepared was in agreement with chemical and ultrastructural data. A cell envelope
      model compatible with chemical, ultrastructural and immunolabelling data is
      proposed and its validity discussed.

PMID- 1741910
TI  - Coagglutination test for rapid detection of Salmonella enterotoxin.
AB  - The Staphylococcal Coagglutination (CoA) test using Staphylococcus aureus (Cowan
      type-1) cells coated with antiserum against purified Salmonella enterotoxin was
      standardized and carried out to screen Salmonella serotypes for their
      enterotoxigenicity. Of the 101 cell-free culture supernatants from an equal
      number of Salmonella strains belonging to 15 different serotypes tested, 76 were
      found to be enterotoxigenic. All of the 24 strains which gave positive reactions
      in the rabbit ligated ileal loop test were also positive with this test. As
      little as 7.5 ng of purified Salmonella enterotoxin could be detected by the CoA
      test. The presence of enterotoxin in polymyxin B extract of cells and cell-free
      preparation of a S. typhimurium strain was detected as early as after 1.5 and 3.0
      h of incubation, respectively. Besides the test standardized with the antiserum
      to purified V. cholerae toxin (CT) could detect purified toxin in a quantity as
      little as 5.0 ng and also enterotoxigenicity in an E. coli strain (LT+). The
      usefulness of the test as a routine, rapid and economic one for the detection of
      enterotoxin of Salmonella, Vibrio cholerae and E. coli is discussed.

PMID- 1741911
TI  - Sequential culturing method improves recovery of Legionella spp. from
      contaminated environmental samples.
AB  - Investigations were undertaken to improve detection and isolation of Legionella
      spp. from samples containing a large number of non-legionellae isolates. The
      direct fluorescent antibody staining technique was used in conjunction with a
      sequential culturing method which was developed to improve the recovery rate of
      Legionella spp. from such samples. The technique for enrichment and isolation of
      Legionella spp. from environmental samples includes storage at 4 degrees C and
      repeated culture on freshly prepared media. Heat and acid treatments were
      included when deemed appropriate. A DNA probe was used for confirmation of
      Legionella. Treatment of the water samples, as described, and co-cultivation with
      amoebae naturally present in the samples are concluded to be responsible for
      increased success in recovery of Legionella isolates.

PMID- 1741912
TI  - Removal of the antibacterial activity of trimethoprim-sulfamethoxazole, ofloxacin
      and zidovudine by BACTEC resin-containing blood culture medium.
AB  - We determined the capacity of BACTEC resin blood culture media NR 16A and NR 17A
      to remove the antibacterial activity of trimethoprim-sulfamethoxazole, ofloxacin
      and zidovudine. Simulated blood cultures containing increasing antibiotic
      concentrations were inoculated with 10(1), 10(3) and 10(5) CFU/ml blood of
      various bacterial strains and evaluated with the BACTEC infrared growth detection
      system. The antibiotic concentrations were adjusted to give breakpoint
      concentration in the added serum volume or in the total volume of the blood
      culture vials. Recovery rates and time until detection of bacterial growth in
      resin-media were compared with those in resin-free media. Trimethoprim
      sulfamethoxazole and ofloxacin were, similar to piperacillin, inactivated by
      resins at antibiotic concentrations that were up to ten times higher than those
      easily achievable in serum. The antimicrobial effect of zidovudine on gram
      negative bacteria was reduced in resin media at concentrations corresponding to
      fifteen times the peak serum levels. Growth of P. aeruginosa, but not of S.
      aureus, E. coli, K. pneumoniae and Salmonella, was delayed in the presence of
      resins even at subinhibitory antibiotic concentrations when compared with resin
      free media.

PMID- 1741913
TI  - Isolation and characterization of group B streptococcal type antigens X and R.
AB  - The group B streptococcal surface antigens X and R were isolated from culture
      supernatant by ammonium sulphate precipitation and subsequent high performance
      gel filtration (HPLC). The type antigens appeared in numerous protein bands. Type
      antigen X was in the range of 180 kD, type antigen R, in the range of 116 kD. The
      protein antigens reacted specifically with their homologous antisera in Western
      blot analysis and in immunoelectrophoresis, indicating that there was no
      immunological relationship between both proteins. Preparative isoelectric
      focusing of the X and R antigens revealed for both proteins isoelectric points at
      acid pH. Specific antibodies produced against the purified proteins could be used
      for routine serotyping without further absorption.

PMID- 1741914
TI  - Use of the enzyme linked immunosorbent assay (ELISA) to detect the IgM and IgG
      antibody response to Leptospira interrogans Serovar hardjo in pregnant ewes.
AB  - Fourteen pregnant ewes were inoculated with Leptospira interrogans serovar hardjo
      via intramuscular injection or inoculation via the conjunctiva. The serological
      response to inoculation detected by the microscopic agglutination test was
      compared to IgM and IgG antibody levels detected by enzyme linked immunosorbent
      assay. Intramuscular injection produced a better serological response than
      conjunctival inoculation. The mean IgM response was short lived whereas the IgG
      antibody response and the MAT persisted for much longer. The IgM antibody levels
      may be useful as an indicator of recent exposure. Although leptospiruria was not
      established in any of the animals, 6 of the 14 pregnant ewes failed to rear a
      healthy lamb.

PMID- 1741915
TI  - Erythrina lectins detect the H/HI blood groups.
AB  - The lectin purified from Erythrina corallodendron seeds which binds N
      acetyllactosamine greater than N-acetyl-D-galactosamine greater than alpha and
      beta galactosides greater than D-galactose was examined for its ABO(H) blood
      group specificity. It has been shown that this lectin causes the strongest
      hemagglutination of O(H) and weakest of Oh(Bombay) red blood cells, and interacts
      with the H antigen in association with the I antigen. The reactions of Erythrina
      corallodendron and Erythrina indica lectins (which are similar in sugar
      specificity) with erythrocytes of different ABO(H) and Ii blood groups (the I
      bloods were all from adults and the i from either cord or adult bloods) revealed
      the following order of activity: O(H)I greater than A2 I greater than O(H)i adult
      greater than A2BI greater than BI greater than O(H)i cord greater than A1I
      greater than A1i adult greater than Bi cord greater than A1BI greater than Ai
      cord greater than ABi cord greater than OhI. The Erythrina indica lectin showed a
      lower differentiation between the agglutination of O(H) and Oh erythrocytes. Both
      Erythrina lectins exhibited H/HI blood group preference but were not inhibited by
      the saliva from ABO(H) "secretors". Thus they may be classified with the Cytisus
      sessilifolius, Lotus tetragonolobus and Laburnum alpinum lectins which are
      inhibited by lactose but not by H blood group substances in secretions.

PMID- 1741916
TI  - Use of the SL-IV and the PGL-Tb1 glycolipid antigens in ELISA for the diagnosis
      of tuberculosis in AIDS patients.
AB  - At a predetermined specificity of 100.0%, the sensitivity of ELISA using the PGL
      Tb1 and SL-IV antigens and IgG assays was 35.0% for the diagnosis of tuberculosis
      in AIDS patients (44.1% when tuberculosis was diagnosed before AIDS, 21.7% when
      AIDS was diagnosed before tuberculosis). Serial assays in sera collected from 11
      AIDS patients before tuberculosis was diagnosed indicated that significant
      antibody titres were detected 10 months before the onset of clinical
      tuberculosis. Consequently, it was proposed that serodiagnosis using the
      glycolipid specific antigens should help in deciding on preventive
      antituberculosis treatment in these patients.

PMID- 1741917
TI  - Adhesion of Staphylococcus saprophyticus to renal tubular epithelial cells is
      mediated by an N-acetyl-galactosamine-specific structure.
AB  - S. saprophyticus CCM883 and 9325 were found to adhere to the tubular cell line
      LLC-PK1. An ELISA technique was used to determine adherence of bacteria and
      inhibition of adherence by various carbohydrates. Only N-acetyl-galactosamine was
      found to significantly inhibit adhesion (p less than 0.001), which suggests that
      the surface component mediating adhesion recognizes structures on the target cell
      that contain this carbohydrate.

PMID- 1741918
TI  - Chemotherapy in the treatment of periodontopathy.
AB  - We treated 27 patients suffering from periodontitis with 750 mg/d oxytetracycline
      over a fortnight and compared them with a control group of 25 patients who
      received only a placebo. The selection of patients followed certain criteria. For
      controlling of the success of treatment, we developed a simple model of clinical
      and microscopical parameters. A significant difference between both groups could
      be demonstrated six months after starting the treatment.

PMID- 1741919
TI  - Molecular cloning and nucleotide sequence of a new plasmid-coded Klebsiella
      pneumoniae beta-lactamase gene (SHV-2a) responsible for high-level cefotaxime
      resistance.
AB  - Patient specimen isolates of Klebsiella pneumoniae exhibiting an MIC of greater
      than 128 mg/l for cefotaxime were shown to produce a beta-lactamase with a pI of
      7.6, which is encoded on a 66 kb conjugative plasmid. A 3.5 kb Bam HI fragment of
      this plasmid was cloned into pLG339 and totally sequenced. The nucleotide
      sequence of the beta-lactamase gene presented 99% homology to those of SHV-2 and
      SHV-3, the deduced amino acid sequence differed from both enzymes in one and two
      positions, respectively, leading to the denomination SHV-2a for the new enzyme.
      Since the kinetic data of SHV-2a and SHV-2 are similar, too, quantitative effects
      mediated by distinctly different promotor regions are thought to be responsible
      for the elevated MIC for cefotaxime induced by SHV-2a.

PMID- 1741920
TI  - Activation of mononuclear immune cells in response to staphylococcal lipoteichoic
      acid.
AB  - The goal of the present study was to evaluate the influence of staphylococcal
      lipoteichoic acid (LTA) on the activation of mononuclear immune cells. A murine
      tumor necrosis-like factor (TNF-like) was induced in the sera of CD-1 mice which
      had been primed with heat/formalin-inactivated Propionibacterium avidum KP-40 and
      subsequently exposed to LTA extracted from Staphylococcus saprophyticus strain S
      1. Monoclonal antibody against murine TNF (anti-TNF) significantly inhibited the
      cytostatic activity of mice sera against transformed L-929 cells. Freshly
      isolated lymphocytes did not display interleukin 2 (Il-2) receptors, but
      receptors were expressed on Con A incubated cells and in significantly higher
      numbers after coexposure to staphylococcal LTA in vitro. Since the induction of
      TNF (macrophages) and Il-2 receptors (lymphocytes) represent stimulation of the
      mononuclear immune system, staphylococcal LTA may be considered to be an
      immunomodifier.

PMID- 1741921
TI  - A Lyme borreliosis human serosurvey of asymptomatic adults in Ireland.
AB  - Blood samples were obtained through the Blood Transfusion Service in Ireland in
      order to obtain information on the prevalence of asymptomatic B. burgdorferi
      infections and in an attempt to identify the type of habitat that presents the
      most risk of infection. Areas in the country were rated as low, medium or high
      risk based on the availability of suitable tick habitat, access to the public and
      the distribution of deer, the latter parameter being related to both the
      occurrence of rodent reservoir hosts and woodland recreational areas.
      Approximately 100 plasma samples from each of four areas were analysed for IgG
      anti-Borrelia antibodies by indirect immuno-fluorescence with a titre of 1 :80
      indicating a positive reaction in asymptomatic individuals. Prevalence figures of
      15, 11, 8 and 5% were obtained for high, high/medium, medium/low and low risk
      areas respectively. No positive samples were detected in blood from an Icelandic
      population which is not exposed to I. ricinus bites. The overall subclinical
      prevalence (9.75%) is surprisingly high in view of the apparent rarity of
      clinical cases in Ireland, though under-diagnosis probably occurs. These results
      seem to indicate that farmland is less important than woodland as Lyme
      borreliosis habitat. If this is so, it is probably due to the presence in
      woodland of Apodemus sylvaticus, a putative reservoir host, and also to the use
      of such areas for recreation at certain times of the year.

PMID- 1741922
TI  - The discovery of creatinine assimilation in Cryptococcus neoformans, and
      subsequent work on the characterization of the two varieties of C. neoformans.
AB  - The discovery of creatinine assimilation in C. neoformans by Staib served as the
      foundation for our biochemical, genetical, ecological, epidemiological and
      taxonomic studies on the two varieties of C. neoformans for the past 15 years.
      The two varietal concept is now widely accepted and the arrival of AIDS epidemic
      has promoted the recognition of the differences between the two varieties,
      especially in their epidemiology and ecology. Since the agent of cryptococcosis
      in AIDS patients almost always belongs to the var. neoformans even in
      geographical areas prevalent for var. gattii, it is important to study the
      possible differences in the pathogenesis of the two varieties.

PMID- 1741923
TI  - Peritonitis caused by Trichomonas--a preliminary case report.
AB  - Trichomonas infections of the abdominal cavity are uncommon and case histories
      have not been published previously. A patient to whom reference is made this
      paper developed a combined immunodeficiency syndrome and portal hypertension with
      ascites on the basis of a cirrhosis of the liver. This seems to have been the
      precondition for a peritonitis caused by a Trichomonas species.

PMID- 1741924
TI  - In vitro damaging effect of leukocytes, serum, and peritoneal fluid on Ascaris
      suum infective larvae.
AB  - Peritoneal leukocytes, serum, and peritoneal fluid from Ascaris suum-infected or
      noninfected mice were studied using 51Cr release and larval mobility to determine
      if they had in vitro cytotoxicity for A. suum infective larvae. Mouse serum or
      peritoneal fluid from infected and non-infected mice was added to leukocyte
      larvae cultures to determine their effect on leukocyte damage to larvae.
      Leukocytes from A. suum infected mice were cytotoxic for A. suum larvae in the
      presence of serum from infected or noninfected mice but only serum from infected
      mice produced larval cytotoxicity independent of leukocytes or in the presence of
      leukocytes from noninfected mice. Mouse peritoneal fluid from infected or
      noninfected mice was found to damage larvae independent of leucocytes. Cytotoxic
      activity was blocked when serum or peritoneal fluid was heat-inactivated
      suggesting complement as the damaging agent.

PMID- 1741925
TI  - Leptospires isolated from toads and frogs on the Island of Barbados.
AB  - Four pathogenic strains of leptospires were isolated from the kidneys of toads
      (Bufo marinus) and seven from frogs (Eleutherodactylus johnstonei). Isolates from
      two toads and one frog belonged to serovar bim, the causative agent of most cases
      of severe leptospirosis on Barbados. The other eight strains belonged to a new
      serovar within the Australis serogroup. The name bajan is proposed for this new
      serovar of Leptospira interrogans.

PMID- 1741926
TI  - WHO in Europe 1991.

PMID- 1741927
TI  - Extrinsic asthma and environmental allergens.
AB  - House dust mites allergens are one of the most common antigens able to induce a
      high degree of sensitization in a general population. Owing to the possibility of
      quantifying the amount of major mite allergens in the environment,
      epidemiological studies have led to propose threshold values above which there is
      an increased risk for the occurrence of mite sensitizing, for the development of
      asthma and for the occurrence of symptoms. All these studies and some others
      dealing with the number of mites in house dust support the hypothesis that
      exposure to house dust mites may have a major influence on developing allergic
      diseases.

PMID- 1741928
TI  - Intrinsic asthma: myth or reality?
AB  - Asthma is a multifactorial syndrome with different etiologies, both allergic and
      non-allergic. Response to an allergen may be moderate and may often be shown only
      by provocation tests, not by skin tests or RAST. Food allergy is a significant
      cause of asthma. There are many non-allergic causes, from gastro-oesophageal
      reflux to aspirin-intolerant asthma, to sulphites...the list is far from
      exhaustive. Often there is an association of allergic and non-allergic causes.

PMID- 1741929
TI  - [Treatment of asthma in the adult using a combination of salbutamol 100
      micrograms--beclomethasone 50 micrograms. Results of a study on 1917 patients
      seen in general medicine].
AB  - Efficacy and safety of salbutamol--beclomethasone combination were studied in a
      multicentre trial in general practice which included 1917 asthmatic patients.
      During a 7 day run-in period, the number of dyspnea episodes, the morning and
      evening PEFR values were recorded daily. Patients were then treated with 2 puffs
      of salbutamol--beclomethasone combination t.i.d. or q.i.d. Results showed a
      significant improvement of the daily number dyspnea episodes (from 2.7 to 1.4)
      and of the daily number of salbutamol puffs used as rescue medication (from 5,1
      to 2,5) (p less than 0.001). Morning and evening PEFR were increased by 50 litres
      min-1 (p less than 0.001). Symptoms were significantly improved, particularly
      nocturnal dyspnea (p less than 0.001). Minor and usual adverse events were noted
      in only 2,7% of the population. Salbutamol--beclomethasone allows a good control
      of asthma, particularly a good nocturnal cover. This efficacy with a good safety
      profile makes salbutamol--beclomethasone combination a well-adapted maintenance
      treatment of asthma.

PMID- 1741930
TI  - Asthma and HLA system.
AB  - Study of atopic asthma provides an excellent model for our understanding of the
      complex molecular genetics of human immune responsiveness. Family and population
      studies have suggested that multiple genetic factors influence global and
      specific immune responsiveness to allergens. Global response of IgE production
      appears to be controlled by a dominant "atopy gene" unlinked to HLA class II
      associated Ir genes, whereas the specific immune response in terms of IgE and IgG
      antibodies against precise allergens is unequivocally linked to the HLA class II
      molecules. Other genetic factors/polygenic component may influence the bronchial
      hyperreactivity observed among asthmatics. Not the least, the genetics of the
      "releasability" of mediators of inflammation from basophils should also be
      considered in the genetic studies of asthma. Given this overall complexity of
      genetics of asthma, we primarily focused our attention to the genetics of a
      defined subgroup of asthmatic patients. We have chosen to study three well
      defined clinical subsets (atopic asthma with and without aspirin sensitization,
      and nonatopic asthma with aspirin sensitization) in comparison to age and sex
      matched control groups for their HLA class II polymorphism at the DNA level. Use
      of in vitro DNA amplification and allele specific restriction enzymes allowed us
      to define that a particular combination of a specific DQ and DPB alleles is
      highly prevalent among asthmatic patients with aspirin sensitization and this is
      exclusively in an atopic context (R.R. = 54). Intriguingly, an identical
      combination of HLA alleles are similarly enriched among patients with coeliac
      disease. Further studies are required to understand such an intriguing
      similarities of molecular markers between these apparently two unrelated
      disorders.

PMID- 1741931
TI  - Ubiquitous expression of TNF-alpha/cachectin immunoreactivity in human
      endometrium.
AB  - Emerging evidence suggests that cytokines play significant roles as intercellular
      communication signals in human endometrium. In the present report, an
      immunohistochemical staining method and tumor necrosis factor-alpha (TNF-alpha)
      specific polyclonal antibody was used to identify potential in vivo sources of
      this cytokine in human endometrium. During the proliferative and early secretory
      phases of the menstrual cycle, glandular epithelium was distinctly free of any
      immunoreactive product. With the emergence of mid- and particularly late
      secretory phases, however, some glandular epithelial cells started to express TNF
      alpha. In the late secretory phase, glands exhibiting strong staining were
      adjacent to those that were negative for TNF-alpha or only sparingly contained
      positively immunostained cells. Remarkably, the glandular epithelium constituted
      a major source of enhanced expression of TNF-alpha during gestation. In the
      proliferative phase, virtually all stromal cells strongly expressed TNF-alpha,
      and in the secretory phase, some variability of staining could be observed among
      various stromal cells. In gestational endometria, decidual cells and in all
      endometria, endothelial cells strongly expressed immunoreactivity for TNF-alpha.
      These data demonstrate that various constituents of endometria are constitutively
      primed to express TNF-alpha and that this expression is distinctly associated
      with the changes in endometrium that are compelled by hormonal stimuli.

PMID- 1741932
TI  - Screening assays for immunologic infertility: a comparison study.
AB  - Because the immunobead antisperm antibody test (IBT) is difficult to learn and
      results are heavily operator-dependent, we compared findings on IBT with those of
      SpermMAR and SpermCheck in 58 patients to determine whether the latter two tests
      could demonstrate improved screening ability. Assays performed on both sperm and
      serum (i.e., direct and indirect) yielded 100% positive predictive values when
      IBT was used as the standard. Both SpermCheck and SpermMAR are easier to perform,
      and, as the former has a slightly greater sensitivity, we recommend SpermCheck
      for the detection of immunologic infertility.

PMID- 1741933
TI  - Familial recurrent spontaneous abortions.

PMID- 1741934
TI  - Type I conceptus interferons: maternal recognition of pregnancy signals and
      potential therapeutic agents.
AB  - In summary, Type I conceptus interferons of sheep, cows, and goats (perhaps all
      ruminants), which signal maternal recognition of pregnancy, may be useful for
      enhancing fertility in animal agriculture and may have a role in human and
      veterinary medicine as well. The Type I conceptus interferons share antiviral,
      anticellular, and immunosuppressive properties with Type I leukocyte interferons,
      but lack their cytotoxic effects, which may make them especially useful as
      therapeutic agents in human and veterinary medicine. The unique N-terminal
      structure of oTP-1 may account for its distinctive biological properties,
      including its antiluteolytic activity.

PMID- 1741935
TI  - Epidemiology of recurrent spontaneous abortion.
AB  - With recent scientific advances leading to better understanding of the
      immunobiology of recurrent spontaneous abortion (RSA), interest has now focused
      upon the epidemiology of RSA. A cohort of 214 couples with a history of two or
      more consecutive abortions were studied for the prevalence of etiologic factors
      and association with other reproductive failures. The prevalence of causes of RSA
      in this cohort was compared with etiologic factors among 179 couples with a
      history of three or more consecutive abortions. The obstetrical histories of 214
      women with RSA were analyzed for the total number of pregnancies, live births,
      stillbirths, spontaneous abortions, ectopic pregnancies, and hydatidiform moles.
      These numbers were compared with the expected frequency of each in the general
      population. The prevalence of etiologies among 214 with RSA were as follows:
      chromosomal-6%, anatomic-1%, hormonal-5%, immunologic-65%, and unexplained-23%.
      No differences in the prevalence of etiologic factors exist when couples with a
      history of two or more abortions are compared with three or more abortions. When
      the number of ectopic pregnancies, molar pregnancies, and stillbirths among 214
      women with RSA were compared with the expected numbers, the odds ratios were 2.2
      for ectopic pregnancies, 6.0 for molar pregnancies, and 2.3 for stillbirths.
      These data indicate that no difference in the prevalence of etiologies of RSA
      exist when couples with two or more abortions are compared with three or more and
      a comorbidity between RSA and other types of reproductive failure exists.

PMID- 1741936
TI  - Antinuclear autoantibodies in healthy nonpregnant and pregnant women and their
      offspring.
AB  - Antinuclear autoantibodies have previously been detected in sera of healthy women
      although less frequently than in sera of women with autoimmune disorders. The
      effect of pregnancy on antinuclear autoantibody production in healthy women is as
      yet debatable. We present four studies in which, by employing the ELISA method,
      we evaluated the presence of six antinuclear autoantibodies (anti-ds DNA, anti-ss
      DNA, anti-poly(I), anti-cardiolipin, anti-Sm, and anti-RNP) in the sera of more
      than 1,000 healthy pregnant and nonpregnant women, including 196 pairs of matched
      maternal and cord blood sera. In all four studies healthy pregnant women did not
      demonstrate significantly higher prevalence rates of various serum antinuclear
      autoantibodies as compared to healthy non-pregnant women. All detected
      autoantibodies were of the IgM isotype. In only one infant (born to a healthy
      seronegative mother) was an autoantibody (IgM anti-ss DNA) detected. This may
      indicate that in certain circumstances the fetus is capable of self-production of
      autoantibodies.

PMID- 1741937
TI  - Autoantibodies and pregnancy wastage.
AB  - The established association between a relatively specific group of autoantibodies
      binding negatively charged phospholipids and poor pregnancy outcome has advanced
      treatment options for women with this diagnosis. Evidence for an association
      between systemic autoimmune disorders and otherwise unexplained obstetric
      complications, in the absence of a documented antiphospholipid antibody(s), is
      reviewed. The existence of autoantibodies with other specificities that could be
      related to fetal wastage has been suggested by associations between poor
      obstetric histories and nonspecific serologic abnormalities observed in women
      with no clinical signs of an autoimmune disorder. Because signs and symptoms of
      vasospasm such as Raynaud's phenomenon or placental infarction have been observed
      in women with a history of unexplained fetal demise, a search for autoantibodies
      recognizing antigens common to trophoblastic and vascular cell surfaces is
      suggested.

PMID- 1741938
TI  - Mouse model for the treatment of immune pregnancy loss.
AB  - Spontaneous abortions can be associated with preimplantation embryo loss,
      implantation problems and a variety of postimplantation pregnancy failures. The
      long list of possible causes for the postimplantation pregnancy loss includes,
      among others, genetic abnormalities in fetus, anatomical abnormalities of the
      uterus, endocrinological insufficiency, and microbiological problems. However,
      more than 50% of recurrent miscarriages still have no recognized causes. The
      concept that many such abortions may be immunologically mediated has gained
      increasing support over the years. Moreover, immunization of such women with
      husband's or third party leukocytes has resulted in more than 70% of subsequent
      pregnancies resulting in live births. Since neither the mechanisms leading to
      pregnancy loss nor the success of immunotherapy are clear, the set-up of animal
      models for recurrent abortions would be of supreme significance. Our recent data
      show that immunopotentiation of maternal immune system by Complete Freund
      Adjuvant significantly improves pregnancy rate in CBA x DBA/2 mouse combination
      with high percentage of fetal resorptions. This effect is followed by decrease of
      IL 2 production in spleen; increase of MAC 1-positive cells at placenta;
      amplification of suppressive activity of local and systemic lymphocytes and by
      reverse of embryotoxic effect of maternal serum. Data obtained in this model
      seems to be valuable in substantiation of rationale for nonspecific immunotherapy
      of human abortions.

PMID- 1741939
TI  - Fertility impairment and improved fetal survival induced by a tumor cell line in
      mice.
AB  - The BL6-T2 tumor, a regressor melanoma line in C57BL/6J mice shown by us
      previously to be abortifacient, has been cloned in vitro. Clones obtained have
      been tested in vivo for tumorigenicity and effect on gestations, in order to
      correlate the immunogenicity of the tumor and its effect on fetal survival.
      Results demonstrate that high immunogenicity and impairment of fertility do not
      occur in the same tumor clones. We also show that this tumor produces and
      secretes GM-CSF and CSF-1 and that trophoblast cells express in situ mRNA
      encoding for the CSF-1 receptor. We consequently hypothesize that this tumor
      exerts its abortifacient effect not via its strong immunogenicity but via
      cytokines it secretes.

PMID- 1741940
TI  - Radiographic demonstration of the dislocated SC joint.

PMID- 1741941
TI  - Breast ductography in the investigation of nipple discharge.

PMID- 1741942
TI  - The use of macro-radiography in the initial examination of the petrous temporal
      region.
AB  - The results of the survey show that macroradiography of the petrous temporal
      region is not a common practice. However, the results of the tests show that an
      increase in discernible detail can be achieved with only a slight increase in
      geometrical unsharpness, no loss in resolution and, if departmental protocol is
      to produce AP images through the magnified orbits, a reduction of over 100 times
      in the radiation exposure dose to the lens of the eye by producing PA
      macroradiographs instead. Taking into consideration both the image quality of the
      macro-radiographs obtained, and the radiation exposure dose received by the lens
      of the eye, the most suitable macroradiographic technique has been implemented
      within the department as a routine procedure.

PMID- 1741943
TI  - Assessment of dose in computerised tomography.

PMID- 1741944
TI  - Costing radiology services.

PMID- 1741945
TI  - The use of thin metal filters to reduce dose to patients.

PMID- 1741946
TI  - Computed tomography in failed back syndrome.
AB  - A significant number of patients complain of recurrent symptoms following lumbar
      spine surgery. The main differential diagnosis is between post-operative epidural
      fibrosis and recurrent disc protrusion. Computed tomography is generally
      preferred to myelography for making this distinction, not least by the patient.
      Intravenous contrast medium can further improve diagnostic specificity. This
      article reviews the practical aspects and diagnostic accuracy of computed
      tomography in failed back syndrome, and draws attention to the potential pitfalls
      and less common abnormalities which may be encountered.

PMID- 1741947
TI  - Oral toxicity of formaldehyde and its derivatives.
AB  - Formaldehyde (FA) has been commercially produced since the early 1900s. Its
      widespread use in a variety of applications is known to result in appreciable
      exposure of workers and of a section of the general population. Formaldehyde is a
      normal metabolite in mammalian systems. It occurs in air as a product of the
      natural photooxidation of automobile exhaust, combustion processes, incinerators;
      formaldehyde has been found in municipal and industrial effluents and is present
      in food either naturally (fruits and vegetables, in the order of parts per
      million), or as a result of its use as a food additive. The use of FA and its
      derivative, hexamethylenetetramine (HMT), which gradually decomposes to FA under
      acidic conditions as antimicrobial agents in food, raises questions about their
      potential chronic oral toxicity. Furthermore, since FA is a very reactive
      compound and reacts with different macromolecules such as proteins and nucleic
      acids, the safety evaluation of FA as a cheese additive must take into account
      the toxicity of the reaction products between FA and milk components. Biochemical
      aspects, acute and short-term toxicity studies including mutagenicity,
      multigeneration, and reproduction studies, long-term carcinogenicity studies
      after oral administration of FA and HMT are reviewed in this paper. The results
      of these studies indicate that repeated oral exposure of a relatively large
      amount of FA that could overwhelm the normal metabolic capacity of animals to
      convert FA into formiate, CO2, and water produces histopathological gastric
      changes. This paper correlates the hazard caused by the exposure to low levels of
      FA, as far as its carcinogenic potential by oral route is concerned per se or
      regarding its use as a food additive. Based on the evidence that FA is formed
      naturally in food and is a normal mammalian metabolite and that a threshold for
      carcinogenicity exists both after exposure by inhalation and oral administration,
      it may be deduced that FA is not carcinogenic at low levels of exposure.

PMID- 1741948
TI  - The isolated perfused porcine skin flap as an in vitro model for percutaneous
      absorption and cutaneous toxicology.
AB  - The isolated perfused porcine skin flap (IPPSF) is a new perfused skin model
      which allows in vitro cutaneous pharmacology and toxicology studies to be
      conducted in a viable skin preparation which has a normal anatomical structure
      and a functional microcirculation. The purpose of this review is to (1) outline
      the background of this field which indicated the need for this type of model; (2)
      outline the surgical procedures needed to create and harvest viable preparations;
      (3) overview the criteria (biochemical, physiological, and histological) used to
      assess viability during an experiment; (4) present results of percutaneous
      absorption, cutaneous metabolism, transdermal delivery (passive and active), and
      skin distribution experiments conducted to date; (5) present the strategy
      developed to quantitate percutaneous absorption and cutaneous drug distribution
      using compartmental and physiological-based pharmacokinetic models; (6) assess
      the correlation of IPPSF data to in vivo results; (7) define the biochemical,
      physiological and histological (LM, TEM, enzyme histochemistry) response of the
      IPPSF to topically applied cutaneous vesicants; (8) overview where this type of
      in vitro model fits into the overall framework of cutaneous toxicology and
      pharmacology research; and (9) outline possible paths for future development.
      This review should provide the reader with an appreciation of some unique
      problems in this field which require an in vitro model that is closely integrated
      in structure and function to the in vivo setting.

PMID- 1741949
TI  - Nasal cavity enzymes involved in xenobiotic metabolism: effects on the toxicity
      of inhalants.
AB  - A decade ago, the ability of nasal tissues to metabolize inhalants was only dimly
      suspected. Since then, the metabolic capacities of nasal cavity tissues has been
      extensively investigated in mammals, including man. Aldehyde dehydrogenases,
      cytochrome P-450-dependent monooxygenases, rhodanese, glutathione transferases,
      epoxide hydrolases, flavin-containing monooxygenases, and carboxyl esterases have
      all been reported to occur in substantial amounts in the nasal cavity. The
      contributions of these enzyme activities to the induction of toxic effects from
      inhalants such as benzo-a-pyrene, acetaminophen, formaldehyde, cocaine,
      dimethylnitrosamine, ferrocene, and 3-trifluoromethylpyridine have been the
      subject of dozens of reports. In addition, the influence of these enzyme
      activities on olfaction and their contribution to vapor uptake is beginning to
      receive attention from the research community. Research in the next decade
      promises to provide answers to the many still unanswered questions posed by the
      presence of the substantial xenobiotic metabolizing capacity of the nasal cavity.

PMID- 1741950
TI  - Proteinuria: changes and mechanisms in toxic nephropathies.
AB  - During the last few decades, considerable progress has been made in the
      understanding of the pathophysiological mechanisms of proteinuria. A great
      variety of hemodynamic or biochemical mechanisms acting at different sites of the
      nephron have been shown to alter the renal handling and the urinary excretion of
      proteins. The finding which perhaps has had most practical implications is that
      the pattern of protein excretion quantitatively and qualitatively varies with the
      site and severity of renal damage. This has led to the development of a large
      array of methods for the identification and quantitation of specific urinary
      proteins. These methods have been most extensively used by toxicologists in
      experimental, epidemiological, or clinical studies on potentially nephrotoxic
      chemicals (e.g., drugs, heavy metals, solvents, etc.). The present review
      summarizes the current state of knowledge on the mechanisms of proteinuria and
      the use of urinary proteins as indicators of nephrotoxicity.

PMID- 1741951
TI  - Microalgae as food and supplement.
AB  - The microalgae Chlorella spp., Dunaliella spp., and Scenedesmus spp., and the
      cyanobacteria Spirulina spp., and Aphanizomenon flos-aquae, are being used as
      nutrient-dense foods and sources of fine chemicals. They have significant amounts
      of lipid, protein, chlorophyll, carotenoids, vitamins, minerals, and unique
      pigments. They may also have potent probiotic compounds that enhance health.
      Their historical and current use are reviewed in this article.

PMID- 1741952
TI  - The influence of food on food intake: methodological problems and mechanisms of
      action.
AB  - Emphasis has been placed on the understanding of the regulation of food intake in
      the hope of aiding the battle against obesity and of helping to ameliorate the
      anorexia of cancer and eating disorders. Available data suggest that the
      regulatory system is multifaceted and complex. This review focuses on current
      research on the regulation of appetite and satiety by carbohydrates, fats, and
      proteins as well as by artificial sweeteners. Some methodological problems and
      potential mechanisms of action at the biochemical level are discussed. Evidence
      suggests that organisms are more successful in defending against calorie dilution
      than in adjusting to increases in calories. The implications of that defense
      relative to the use of ersatz nutrients are explored.

PMID- 1741953
TI  - The effects of postharvest treatment and chemical interactions on the
      bioavailability of ascorbic acid, thiamin, vitamin A, carotenoids, and minerals.
AB  - All recent health recommendations include admonitions to reduce calories,
      maintain desirable weight, reduce fat, increase complex carbohydrates, and ensure
      an adequate intake of nutrients. Such recommendations require that we know not
      only nutrient composition of foods, but also potential losses and decreased
      bioavailability due to postharvest treatment and chemical interactions. This
      article discusses in some detail the reactions of concern that cause such changes
      and their potential alleviation with several key nutrients. The nutrients
      discussed were chosen as a result of the conclusions of the Joint Nutrition
      Monitoring Report of the Department of Health and Human Services and the U.S.
      Department of Agriculture. Obviously other choices could have been made, but the
      authors felt that the nutrients chosen--ascorbic acid, thiamin, vitamin A,
      carotenoids, calcium, and iron--were representative of a key profile of nutrients
      whose reactivity makes them vulnerable to losses in bioavailability, as well as
      being noted in the Joint Nutrition Monitoring Report.

PMID- 1741954
TI  - Structure of the human type II 3 beta-hydroxysteroid dehydrogenase/delta 5-delta
      4 isomerase (3 beta-HSD) gene: adrenal and gonadal specificity.
AB  - While classical 3 beta-hydroxysteroid dehydrogenase/delta 5-delta 4 isomerase
      deficiency (3 beta-HSD) is a known cause of adrenal hyperplasia resulting in
      ambiguous genitalia and adrenal insufficiency at birth, nonclassical or late
      onset 3 beta-HSD deficiency is found in an important proportion of women with
      androgen excess. We have previously isolated and sequenced the cDNA and gene for
      the human type I 3 beta-HSD, which represents the main species expressed in the
      placenta and skin. Recently, we isolated, sequenced, and expressed the functional
      cDNA encoding type II 3 beta-HSD, which is the predominant 3 beta-HSD expressed
      in human adrenals and gonads. The present study describes the isolation and
      complete sequence of the corresponding type II 3 beta-HSD gene, which is the form
      most likely responsible for human 3 beta-HSD deficiency. The structural gene
      contains four exons of 57, 231, 165, and 1,214 bp, respectively, separated by
      introns of 128, 3,383, and 2,162 bp. DNA sequence analysis of the 5'-flanking
      region reveals the existence of two putative TATA boxes situated 28 and 140
      nucleotides upstream from the transcription start site whereas two putative CAAT
      boxes are located 57 and 38 nucleotides upstream from the TATA boxes,
      respectively. A restriction fragment length pattern specific for each gene has
      been characterized. The present findings should provide the tools required for
      detailed analysis of the molecular basis of 3 beta-HSD deficiency as well as of
      normal sex steroid biosynthesis.

PMID- 1741955
TI  - Identification of nerve growth factor-responsive sequences within the 5' region
      of the bovine preprotachykinin gene.
AB  - The production of substance P and the mRNA encoding its precursor
      (preprotachykinin, PPT) is regulated by nerve growth factor (NGF) in dorsal root
      ganglion (drg) neurons. To explore the mechanism by which NGF regulates the
      production of PPT mRNA, we have transfected PC12 cells and F11 cells with
      plasmids containing the bovine PPT promoter linked to the reporter gene
      chloramphenicol acetyltransferase (CAT). We have identified (i) functional
      elements within the PPT promoter which are necessary for expression in the
      absence of NGF and (ii) two separate regions, each of approximately 250 bp, which
      confer NGF responsiveness. Both regions contained a sequence element, similar to
      a known transcription factor binding site, which is present in several other NGF
      regulated genes.

PMID- 1741956
TI  - Identification of a second human subtilisin-like protease gene in the fes/fps
      region of chromosome 15.
AB  - A cDNA encoding a novel human subtilisin-like protease was identified by a
      polymerase chain reaction (PCR) methodology. PCR primers were designed to be
      specific for the subfamily of eukaryotic subtilisin-like proteases with
      specificity for paried basic amino acid residue processing motifs. The gene
      encoding this protease, designated PACE4, also encoded a smaller subtilisin
      related polypeptide derived by alternate mRNA splicing. The deduced PACE4 protein
      sequence contained a number of interesting features not present in other family
      members, including an extended signal peptide region, and a relatively large
      carboxyl-terminal cysteine-rich region with no obvious membrane anchor sequence.
      As with the fur gene product, the tissue distribution of PACE4 was widespread,
      with comparatively higher levels in the liver. An additional relationship to the
      fur gene product was shown by chromosomal localization studies. The close
      proximity of the fur and PACE4 genes on chromosome 15 suggests that these genes
      probably evolved from a common ancestor by gene duplication.

PMID- 1741957
TI  - Analysis of active site motions from a 175 picosecond molecular dynamics
      simulation of camphor-bound cytochrome P450cam.
AB  - The structure and internal motions of the active site residues of camphor-bound
      cytochrome P450cam have been evaluated on the basis of a 175 psec molecular
      dynamics simulation. The active site residues generally show very small
      deviations away from their starting crystal positions. These residues also
      generally show much smaller fluctuations than for the enzyme as a whole. Phe 87
      is dynamically very unusual and is suggested to play a role in substrate movement
      into and/or out of the active site. The average distance between the heme iron
      and atoms C5, C6, and C3 of camphor is 5.3, 6.0, and 7.0 A, respectively. This
      trend is consistent with the experimentally observed stereospecificity of the
      hydroxylation reaction. On the basis of distance and angle criteria, both 5-exo
      and 5-endo hydrogen abstraction are predicted to occur during the hydroxylation
      reaction; although the 5-exo pathway is expected to be 3-fold more likely.

PMID- 1741958
TI  - Charge grouping approaches to calculation of electrostatic forces in molecular
      dynamics of macromolecules.
AB  - Calculation of long-range electrostatic interactions is the most time-consuming
      step in theoretical simulation of the structure and dynamics of macromolecules.
      In practice very short cutoff distances are used, which may distort the behavior
      of the model system. We describe two accurate approaches to calculation of
      electrostatic forces based on hierarchical grouping of charges into cubes. The
      first is similar to the O(NlogN) algorithm developed by Barnes, J. and Hut, P.,
      Nature (London) 324, 446-449 (1986), for simulation of a gravitational motion of
      N bodies. The second approach we formulate for a system with periodic boundary
      conditions in the nearest image approximation. The calculation of electrostatic
      interactions and a charge grouping procedure are faster than O(N2). The average
      inaccuracy in the force introduced by the grouping does not exceed 1%. We
      describe a small modification of the same approach which makes it suitable for
      long strongly charged polymers as well. This accurate approach to calculation of
      electrostatic interactions is illustrated with an example of the dynamics of ions
      near DNA. Quick equilibration of the ionic distribution is observed during
      molecular dynamics simulation if electrostatic forces are properly calculated,
      while the behavior and distribution of ions are less realistic when the
      conventional cutoff distances are used.

PMID- 1741959
TI  - Computer modelling studies on the mechanism of action of ribonuclease T1.
AB  - The mechanism of action of ribonuclease (RNase) T1 is still a matter of
      considerable debate as the results of x-ray, 2-D nmr and site-directed
      mutagenesis studies disagree regarding the role of the catalytically important
      residues. Hence computer modelling studies were carried out by energy
      minimisation of the complexes of RNase T1 and some of its mutants (His40Ala,
      His40Lys, and Glu58Ala) with the substrate guanyl cytosine (GpC), and of native
      RNase T1 with the reaction intermediate guanosine 2',3'-cyclic phosphate (G
      greater than p). The puckering of the guanosine ribose moiety in the minimum
      energy conformer of the RNase T1-GpC (substrate) complex was found to be O4'-endo
      and not C3'-endo as in the RNase T1-3'-guanylic acid (inhibitor/product) complex.
      A possible scheme for the mechanism of action of RNase T1 has been proposed on
      the basis of the arrangement of the catalytically important amino acid residues
      His40, Glu58, Arg77, and His92 around the guanosine ribose and the phosphate
      moiety in the RNase T1-GpC and RNase T1-G greater than p complexes. In this
      scheme, Glu58 serves as the general base group and His92 as the general acid
      group in the transphosphorylation step. His40 may be essential for stabilising
      the negatively charged phosphate moiety in the enzyme-transition state complex.

PMID- 1741960
TI  - Conformation of DNA-DNA polymerase I complex observed by scanning tunneling
      microscopy.
AB  - The conformation of a complex of a 41 mer/31 mer DNA fragment and the Klenow
      fragment of DNA polymerase I of Escherichia coli was studied by scanning
      tunnelling microscopy (STM). The results shows that near two turns of double
      helix of this DNA fragment was outside of enzyme while another part containing
      more than one turn of helix and 10 nucleotides single strand was combined with
      enzyme. The dimension and shape of DNA polymerase I (KF) in complex were
      different from that of free enzyme. The conformation of DNA-DNA polymerase I (KF)
      complex and the application of STM in studying structure of complex of DNA
      polymerase with DNA were discussed.

PMID- 1741961
TI  - An effective enzyme interacting with poly (dT-dA).poly (dT-dA): a dynamic
      enhancer-repressor action.
AB  - The Green function technique is used to study the open hydrogen bond probability
      of poly(dT-dA).poly(dT-dA) when an effective enzyme is attached to the helix. The
      DNA interstrand hydrogen bond mean motion and probability of fluctuating to an
      open state depends on the internal vibrational frequency of the enzyme. An enzyme
      with internal frequency of 80 cm-1 reduces hydrogen bond motion and the resulting
      probability of hydrogen bond fluctuational opening. An enzyme with internal
      frequency of 72 cm-1 increases hydrogen bond motion and the probability of
      hydrogen bond breaking.

PMID- 1741962
TI  - Molecular structure of antitumor drug steffimycin and modelling of its binding to
      DNA.
AB  - The molecular and crystal structure of steffimycin have been determined by single
      crystal X-ray diffraction to 0.9 angstrom resolution. The triclinic crystals are
      in the space group P1, with the unit cell dimensions of a = 8.606(3) angstrom, b
      = 22.168(7) angstrom, c = 8.448(2) angstrom, alpha = 97.56(3) degrees, beta =
      95.97(2) degrees, gamma = 87.94(3) degrees, Z = 2. The structure was solved by
      direct methods and refined by the full-matrix least-squares method to a final R
      value of 0.065 with 3405 (Inet greater than 2.0 sigma (Inet] observed reflections
      using the NRCVAX software package. The crystal lattice includes 2 independent
      steffimycin, 3 water and one 2-methyl-2,4-pentanediol molecules. The conformation
      of steffimycin is grossly similar to other anthracycline antibiotics including
      daunorubicin. The crystal packing interactions of steffimycin suggest a preferred
      stacking of the aglycone chromophore of the antibiotic which resembles the
      intercalative interactions seen in the daunorubicin-d(CGTACG) (Wang et al.,
      Biochemistry 26, 1152 (1987] and nogalamycin-d(CGT(pS)ACG) (Liaw et al.,
      Biochemistry 28, 9913 (1989] complexes. The atomic coordinates data from these
      complexes were used to model the intercalative binding of steffimycin to DNA. The
      models were then stereochemically idealized by the constraint refinement program
      NUCLSQ. Subsequently XPLOR software package was used for energy minimization of
      these models in vacuo. The model building studies suggest that steffimycin has a
      higher CpG base sequence specificity over the TpA step, similar to that of
      daunorubicin and nogalamycin.

PMID- 1741963
TI  - Site-specific interaction of the antitumor antibiotic dynemicin with branched DNA
      molecules.
AB  - A specific interaction of stable branched DNA molecules with the antitumor
      antibiotic dynemicin is reported. Dynemicin contains an anthraquinone and an
      enediyne unit, and belongs to the family of enediyne antitumor agents. DNA strand
      scission by dynemicin appears to involve interaction of the anthraquinone core
      with DNA and release of a phenyl diradical from the enediyne core that can
      abstract hydrogen atoms from the sugar phosphate backbone of DNA. The cleavage
      patterns of each labeled strand in two branched tetramers of four 16-mers are
      compared with those of the same strands in unbranched duplex controls.
      Differences between the profiles corresponding to scission of branched and duplex
      DNA molecules can be detected in most of the strands. The strongest differences
      define a specific site flanking the branch in each of two branched structures. At
      18 degrees C, cleavage at strand positions demarcating the site of enhanced
      affinity in both junctions is observed to be 70-100% more efficient than at the
      corresponding sequence positions in the control duplex DNA molecules. The
      patterns of preferential cleavage at these sites are significantly altered in the
      presence of excess propidium diiodide, an intercalative drug.

PMID- 1741964
TI  - Determination of DNA cleavage specificity by esperamicins.
AB  - The esperamicins are members of a class of potent antitumor antibiotics that
      contain stained diacetylenic ring systems capable of forming DNA-cleaving
      diradicals upon reaction with thiols. Here we show that the diacetylenic ring
      core itself determines the sequence specificity for scission of duplex DNA):
      esperamicin A1, and three products of hydrolysis of the glycon, esperamicins C,
      D, and E, are found to retain a common sequence preference. The sugar residues
      exert a strong influence on the cleavage efficiency, presumably by interacting
      nonspecifically with DNA. The presence of a branch in the DNA is found locally to
      inhibit scission by esperamicins, and this effect is shown to be due to the core
      also.

PMID- 1741965
TI  - DNA-bending on ligand binding; change of DNA persistence length.
AB  - This paper simulates the helix-characteristic changes of apparent DNA persistence
      length caused by randomly distributed helix bends as induced, e.g., by DNA-bound
      ligand molecules. The parameters varied are the constant angle gamma of helix
      bending and the size alpha of the DNA drug binding site, but also the degree of
      DNA-ligand binding cooperativity and the helix-unwinding angle. If the size of
      the binding site is comparable with the helix pitch, the influence of phasing
      between helix bends and helix screw upon the apparent persistence length is
      obvious. In the accompanying paper experimental data are analyzed in terms of
      this theoretical background.

PMID- 1741966
TI  - DNA-helix bending, stiffening and elongation on ligand binding; analysis for
      several DNA-drug systems, general viscometric DNA response and stereochemical
      implications.
AB  - For several DNA-ligand systems the DNA helix bending, stiffening and elongation
      behaviour is treated quantitatively. The experimental basis are viscosity data
      from literature as a function of r, the ratio of drug molecules bound per DNA
      monomer unit. If the relative viscosity changes delta y1(r) and delta yh(r) for
      DNA of low and high molar mass, respectively, are known, the relative changes of
      contour length, delta L/L degrees, and of persistence length, delta a/a degrees,
      can be evaluated as a function of r, as repeatedly demonstrated. For random
      sequence-independent interactions, helix-bending is reflected by a helix-typical
      increment of delta a/a degrees (r), being zero at r = 0 and also at DNA
      saturation by bound ligand molecules [Reinert, Biophysical Chemistry 13, 1-14
      (1981)]. This characteristic DNA behaviour often enables us to separate the
      bending and the stiffening increment of delta a/a degrees. The theoretical
      treatment of this problem (Schutz and Reinert, J. Biomolec. Struct. & Dynam. 9,
      315-329, 1991) now permits a more detailed study of the ligand-induced DNA
      bending. The ligand-DNA systems treated here concern the following drugs (in
      parentheses DNA bending angle at low r-values): proflavin (8 degrees), daunomycin
      (11 degrees), aclacinomycin A (9.7 degrees, on cooperative interaction),
      actinomycin D (16 degrees), mitomycin C (16 degrees), a double intercalating
      bisphenantridine (12 degrees), 9-deacetyl-daunomycin (8 degrees) and 9-epi
      deacetyl-daunomycin (12-18 degrees). We also demonstrate that the consideration
      of the DNA flexibility and its change on interaction of short DNA molecules with
      intercalating drugs delivers helix elongation values in better accord with the
      theoretical value. In the Appendix, a catalogue of simulated delta y(r)
      dependences is given for both short and long DNA molecules. It systematically
      describes the DNA viscosity response upon typical DNA stiffening, elongation, and
      helix-bending effects.

PMID- 1741967
TI  - The flexibility of A-form DNA.
AB  - We have determined the rise per base pair and persistence length of A-form DNA in
      trifluoroethanol solutions for fragments 350-900 base pairs in length that best
      describe rotational diffusion coefficients determined by transient electric
      birefringence. The 2.6 A spacing between base pairs found in crystal and fiber A
      form structures is preserved in solution. The persistence length is about 1500 A,
      or about three times longer than for B-form DNA. There is no apparent
      electrostatic contribution to the persistence length in the salt concentration
      range 0.2-2.0 mM Na cacodylate. This suggests an even closer association between
      DNA and its neutralizing counterions than predicted by condensation theory,
      perhaps due to a sheath of trifluoroethanol excluded water surrounding the A-form
      helix.

PMID- 1741968
TI  - Molecular dynamics simulations of dinucleoside and dinucleoside-drug crystal
      hydrates.
AB  - Molecular dynamics simulations have been performed on the dinucleoside
      monophosphates rGpC and dCpG, the latter in its intercalation complex with the
      acridine drug proflavine. The simulations were performed on the crystal
      structures, with crystallographically-located solvent molecules. It was found
      that satisfactory results were best obtained with restraints placed on the
      movements of the water molecules. Motions of individual atoms have been examined
      in terms of rms fluctuations and anisotropy and correlation functions. Relative
      motions of groups (phosphates, sugars, bases and proflavine molecules) have been
      analysed.

PMID- 1741969
TI  - Distribution of simple repetitive (TG/CA)n and (CT/AG)n sequences in human and
      rodent genomes.
AB  - Sixteen million nucleotide sequence of genome of various organisms have been
      analysed to detect and study the extent of occurrence of simple repetitive
      sequences. Two sequence motifs (TG/CA)n and (CT/AG)n capable of adopting unusual
      DNA structures, left handed Z-conformation and triple-helical conformation
      respectively, are found to be abundant in rodent and human genomes, but almost
      completely absent in bacterial genome. (TG/CA)n and (CT/AG)n sequences are
      present mostly in the intron or 5'/3' flanking regions of the genes. The presence
      of such repeat motifs in genomic sequence of higher eukaryotes has been
      correlated with their possible functional significance in nucleosome
      organization, recombination and gene expression.

PMID- 1741970
TI  - Improved chips for sequencing by hybridization.
AB  - The SHOM method (Sequencing by Hybridization with Oligonucleotide Matrix)
      developed in 1988 is a new approach to nucleic acid sequencing by hybridization
      to an oligonucleotide matrix composed of an array of immobilized
      oligonucleotides. The original matrix proposed for sequencing by SHOM had to
      contain at least 65,536 octanucleotides. The present work describes a new family
      of matrices, which allows one to reduce the number of synthesized
      oligonucleotides 5-15 times without essentially decreasing the resolving power of
      the method.

PMID- 1741971
TI  - Renal-hepatic-pancreatic dysplasia and its variants.
AB  - A family is reported, in which two pregnancies resulted in the birth of a female
      fetus with multiple congenital anomalies, including renal cystic dyplasia,
      pancreatic fibrosis with dilated pancreatic duct, and some anomalies of the face
      and genitalila. The pathology of the second fetus was revealed by prenatal
      ultrasonographic examination. In the relevant literature 20 additional cases of
      renal-hepatic-pancreatic dysplasia (RHPD) could be found. It is demonstrated that
      cystic renal dysplasia associated with pancreatic fibrosis or cystofibrosis (with
      normal liver) as well as cystic renal dysplasia associated with hepatic fibrosis
      (with normal pancreas) should be considered as incomplete RHPD variants. In 6
      cases out of 22, the infants had some features of the apolysplenia complex,
      including situs inversus and/or heart defects. The association of RHPD and
      apolysplenia has been proved to be an autosomal recessively inherited syndrome.
      Most probably RHPD without apolysplenia represents a separate entity with
      autosomal recessive mode of inheritance as well.

PMID- 1741972
TI  - A child of high intelligence with the Johanson-Blizzard syndrome.
AB  - In this article, a boy is presented with the Johanson-Blizzard syndrome and high
      intelligence. In the literature, a wide range of intellectual abilities of
      children with the Johanson-Blizzard syndrome is reported. To obtain optimal
      conditions for the development of a child with the Johanson-Blizzard syndrome,
      early diagnosis of potential problems that may prevent this normal growth and
      development is recommended. The acquisition of more knowledge concerning the
      hypothetic reasons for intellectual impairment is of vital importance for
      families involved, in the light of genetic counseling.

PMID- 1741973
TI  - Deletion of 7q22 and ectrodactyly.
AB  - We report the case of an infant with 3-limb ectrodactyly and a deletion of most
      of 7q22. This observation, along with 4 similar cases from the literature,
      suggests the presence of a locus affecting limb differentiation in 7q22 near to
      the proximal interface.

PMID- 1741974
TI  - Genetic service in Byelorussia.

PMID- 1741975
TI  - Behavioral and emotional problems in youngsters with Prader-Willi syndrome.
AB  - In this study we document the behavioral/emotional problems of 27 Prader-Willi
      syndrome (PWS) subjects assessed with the Achenbach Child Behaviour Checklist.
      Compared with normal subjects of the same age and sex, PW subjects showed
      significantly more problem behaviour. Of the PWS subjects 87% had total problem
      scores in the clinical range. No significant difference was found in the
      proportion of Prader-Willi patients scored in the clinical range on the
      Internalizing over the Externalizing syndrome. The need for systematic attention
      towards behavioral/emotional problems when PWS patients enter adolescence is
      emphasized.

PMID- 1741976
TI  - Cerebro-oculo-facio-skeletal (COFS) syndrome. The variability of presenting
      symptoms as a manifestation of two subtypes?
AB  - In this paper we present two female newborns with the cerebro-oculo-facio
      skeletal (COFS) syndrome. The variability of presenting symptoms and differences
      in clinical evolution of the two infants favour the suggestion of Preus that two
      subtypes of this autosomal recessive inherited syndrome may exist.

PMID- 1741977
TI  - Noonan phenotype in the basal cell nevus syndrome.
AB  - In this report we present a three-generation family in which five members present
      the basal cell nevus syndrome. In three of them a Noonan phenotype was present.
      The basal cell nervus syndrome is another example of a neural crest dysplasia
      associated with a Noonan-like phenotype. This observation supports the theory
      that the autosomal dominant mutation causing the neural crest dysplasia may lead
      to a Noonan-like phenotype.

PMID- 1741978
TI  - Intelligence and the fra(X) syndrome: a review.
AB  - In this paper we review the data on intelligence in fra(X) males reported up to
      now in the literature, with special attention to its evolution with age. The
      available data suggest a decline in intellectual functioning in relation to age.
      These findings, however, should be interpreted with caution because of sampling
      and other methodological problems related with the fra(X) screening procedures
      and programs in general.

PMID- 1741979
TI  - A hydropic fetus with translucent ribs, arthrogryposis multiplex congenita and
      congenital myopathy: etiological heterogeneity of A.M.C., Toriello-Bauserman
      type?

PMID- 1741980
TI  - Role of gonadal dysgenesis in gonadoblastoma induction in 46, XY individuals. The
      Leuven experience in 46, XY pure gonadal dysgenesis and testicular feminization
      syndromes.
AB  - To stress the importance of gonadal dysgenesis in the genesis of gonadoblastoma
      in the presence of the Y-chromosome, the authors report their experience on 7
      patients with 46, XY Pure Gonadal Dysgenesis (PGD) and 14 patients with complete
      or incomplete forms of Testicular Feminization (TF) syndrome. The diagnostic
      criteria and the clinical and pathological findings are reviewed. Four patients
      with PGD were found to be affected by bilateral (1 patient) or unilateral (1
      patient) gonadoblastomas, and by extragonadal (1 patient) or gonadal (1 patient)
      dysgerminoma, whereas no gonadal tumors were encountered in testes of patients
      with complete (CTF) or incomplete (ITF) forms of TF, underlining the pathogenic
      role of the gonadal dysgenesis.

PMID- 1741981
TI  - How adequately are nurses being prepared for their health teaching role?
AB  - Forty-five Australian faculties and schools of nursing were surveyed by
      questionnaire to gain information about the health education component of
      undergraduate and postgraduate programs, and about current research activity
      relating to the educational role of nurses. Response rate achieved was 69%.
      Almost all institutions indicated involvement in preparing nursing students for
      an educational role, yet only five respondents described research activity
      relating to this. Most preparation was provided in an integrated context rather
      than in separate course units and the length of time allocated varied
      substantially. Responses to questions about content and clinical experiences were
      often omitted or were very general, with those involved in providing separate
      courses being much more likely to supply detailed or specific information. It is
      hypothesised that in general nurses are graduating from Australian colleges and
      universities inadequately prepared for the health educator role.

PMID- 1741982
TI  - Bacterial contamination of three-way taps--one Australian hospital's experience.
AB  - The incidence and types of organisms present in the vacant ports of 424 three-way
      taps were studied. The taps were used in 50 children in ICU. Twenty-five (6%) of
      the taps showed organism growth of one to three colonies from swabs taken of one
      or more vacant ports. The organisms cultured were staphylococci, klebsiella,
      streptococci, bacilli and fungi. While there was no marked difference in the
      growth rate of organisms in three-way taps used in intravenous, intra-arterial
      and central venous lines, growth rate increased with duration of use.

PMID- 1741983
TI  - Augmentation mammaplasty: neither simple nor safe.
AB  - Elective aesthetic cosmetic surgery of the female breast appears not to warrant
      the same attention to informed consent or authorisation as other surgical
      procedures. Arguments for benefits do not need to be persuasive since the
      prospective patient is usually 'sold on the idea'. This paper argues that more
      rather than less information is necessary where the surgery will not achieve what
      is claimed for it and where there are significant risks of harm. Evidence is
      presented to show that augmentation mammaplasty does not provide a solution to
      problems of body image, self-esteem and sexuality; it may result in considerable
      pain, suffering, financial and emotional cost, interference with life choices and
      a loss of trust in health care professionals. In view of the emerging data which
      points to the doubtful efficacy and safety of the procedure and the prosthetic
      devices, and since elective cosmetic surgery is said to be a growth industry,
      checks and balances need to be in place to ensure women are informed participants
      in decision-making. They require the best possible advice, care and support and
      nurses could play a more proactive role as patient advocates.

PMID- 1741984
TI  - A Delphi survey of clinical nursing research priorities in Western Australia.
AB  - In 1989-1990 an investigation was undertaken to ascertain which problems WA
      nurses considered required researching. A modified Delphi technique was employed
      to obtain data from nurses in hospitals and health care agencies throughout the
      metropolitan and rural regions in the state. Participants worked in areas of
      acute care, mental health, paediatrics, gerontology, community health and
      domiciliary services and addictions. Problems identified were categorised into
      three streams; clinical, management and staff development. Respondents were
      required to assign a value to items according to their importance to nurses and
      to patients. They were also asked to indicate whether they considered there was
      an adequate research base relevant to each item. Results reported here are based
      on the 10 priority items identified in the clinical stream.

PMID- 1741985
TI  - Preoperation interviews: a nursing intervention to reduce patients' anxiety.
AB  - A quasi-experimental study was conducted to evaluate the effect of preoperative
      interviews on patients' anxiety levels. A convenience sample of 60 was assigned
      between two groups of equal size: a treatment group in which subjects were
      interviewed by a perioperative nurse or a control group in which subjects were
      not interviewed. All subjects completed state-trait Anxiety Inventory
      questionnaires. Group comparison using analysis of covariance showed subjects who
      were interviewed by the perioperative nurse reported significantly less anxiety
      than control group subjects.

PMID- 1741986
TI  - Developing methods and research instruments for assessing physical and
      psychosocial outcomes of patient care as a function of nursing staff mix.
AB  - This paper describes a study which assesses a wide variety of both physical and
      psychosocial outcomes of patient care against nursing care standards, and as a
      function of two different staff mixes--an 80% registered nurse (RN) 20% enrolled
      nurse (EN) mix and an all-RN staffing regimen. The study is divided into three
      stages: Stage I which concerned the design of the investigation and development
      of research instruments and procedures; Stage II which concerned the field
      testing of all research procedures and assessment of the reliability of research
      instruments and Stage III which will constitute the main study and is presently
      being conducted in an acute medical and an acute surgical ward. This paper is
      confined to a report on Stages I and II and provides the conceptual framework for
      the study, a description of the research instruments and the ways they were
      developed and a description of the research methods. The results from Stage II
      show that the principal research instruments are highly reliable with
      coefficients always in excess of 0.80, and that all of the research methods and
      procedures are practical and feasible. The study is significant because outcome
      based evaluations, while attractive in principle, are in their infancy and little
      guidance appears in the literature about how to conduct these types of
      investigations. This paper attempts to address this deficiency.

PMID- 1741987
TI  - Influences on instructional planning.
AB  - This study investigated the influences on instructional planning decisions of
      nurse academics in 12 Colleges of Advanced Education in New South Wales.
      Questionnaires were completed by 195 respondents and 14 nurse academics in four
      colleges were interviewed. Questionnaire data were analysed for trends and
      transcripts of the interviews were analysed for significant themes. The major
      constraining influences were found to be funding, workload and lack of time.
      Strong facilitating influences were found to be the academics' backgrounds and
      their beliefs concerning teaching, nurse academics, student needs, and learning.
      Other facilitators were heads of nursing schools, interpersonal relationships
      with people in nursing departments, beliefs about knowledge, students, teaching
      resources and 'ideal' curricula. The implications of findings for nursing
      academia, the utility of facilitating factor theory and confirmation of frame
      theory are discussed.

PMID- 1741988
TI  - Standardised clinical evaluation using Bondy rating scale.
AB  - A clinical performance evaluation tool adapted from Bondy's rating scale was used
      to assess all 680 second and third year students in the nursing program of a
      large metropolitan university. Second year students achieved an average score of
      3.98 (out of 5), indicating that they were practising at a supervised level.
      Third year students' average score was 4.37, demonstrating an increased level of
      independence in clinical practice. The results were constant over two years of
      student assessments. Clear demarcation points identifying 'at risk' students were
      found (3.5 for second years and 3.9 for third years) facilitating remediation for
      this group. Criterion referenced definitions were especially useful when a wide
      range of clinical placements and several assessors were involved as they allowed
      consistent assessment of students' progress.

PMID- 1741989
TI  - Renal function in one-kidney, one-clip hypertension and low renin essential
      hypertension.
AB  - One-kidney, one-clip hypertension (1-K, 1-C HT) is initiated by increased
      preglomerular resistance which decreases nephron perfusion and causes several
      intrarenal changes that lead to increased mean arterial pressure (MAP). Elevated
      MAP serves to return nephron perfusion and sodium excretion to normal, so that
      fluid intake and output are balanced. Increased MAP usually occurs through volume
      homeostasis mechanisms that initially raise cardiac output and later elevate
      total peripheral vascular resistance via autoregulatory adjustments. However, if
      adequate volume is unavailable because of sodium restriction, sustained
      activation of the renin-angiotensin system increases blood pressure sufficiently
      to restore nephron perfusion. Thus, depending upon the availability of volume,
      renal perfusion and sodium balance can be restored either by volume retention or
      by increased angiotensin II (ANGII) formation and peripheral vasoconstriction.
      Similarities exist between 1-K, 1-C HT and low-renin essential hypertension
      (LRHT). In both cases, renal-pressure natriuresis is shifted to higher levels and
      there are marked increases in preglomerular resistance that necessitate increased
      MAP to maintain sodium balance. However, in 1-K, 1-C HT, there is a parallel
      shift of pressure natriuresis with little or no change in the slope of this
      curve, similar to that found in the normal-renin essential hypertension. In LRHT
      the slope of pressure natriuresis is decreased, indicating that blood pressure is
      much more salt sensitive than normal. Another difference is that PRA is low
      compared to normal PRA in 1-K, 1-C HT after compensatory increases in MAP. There
      is also no indication of glomerular membrane damage in 1-K, 1-C HT, whereas LRHT
      may have significant glomerulopathy, especially as hypertension progresses. These
      differences suggest that there may be additional factors besides preglomerular
      vasoconstriction involved in the etiology of LRHT. One possible factor is a
      reduction in nephron number in LRHT. Decreased functional nephrons would lead to
      glomerular hyperfiltration and increased distal tubular flow rate in the
      remaining nephrons, causing decreased PRA and eventually glomerular damage.
      Increased fractional sodium reabsorption, particularly in distal tubular
      segments, could also contribute to decreased PRA and cause blood pressure to be
      salt sensitive. These abnormalities, along with preglomerular vasoconstriction,
      may explain many of the characteristics of LRHT.

PMID- 1741990
TI  - Sodium retention and volume expansion as mechanisms.
AB  - After nephrectomy, the level of arterial pressure is determined by the permitted
      degree of fluid volume expansion. With kidneys present, the fundamental
      requirement for fluid volume homeostasis is met by maintaining the balance
      between sodium and water intake and output. When one-kidney, one-clip (1-K,1-C)
      hypertension develops on a free diet, early sodium retention occurs with
      transient increase in extracellular (ECFV) and plasma (PV) volumes, which may
      persist into the chronic stage. In sodium deprivation, hypertension is not
      inhibited and ECFV and PV are not significantly raised. Thus, when sodium is
      available, sodium retention may contribute to the hypertensive mechanism, but
      when unavailable, other mechanisms must be largely, if not wholly, responsible.
      When hypertension is reversed by unclipping, the immediate fall in blood pressure
      is attributable to reduction first in cardiac output and second in peripheral
      resistance, accompanied by diuresis and contraction of PV: but if external fluid
      balance is maintained, cardiac output and blood pressure still fall, although at
      a slower rate, indicating that factors other than volume are implicated. In the
      development of hypertension, the hemodynamic changes are the reverse of those on
      unclipping, with transient increase in cardiac output associated with increased
      myocardial contractility and decreased venous capacity which, when coupled with
      fluid retention, raise mean circulatory filling pressure. In conclusion, the
      kidney possesses many mechanisms for raising pressure and reestablishing sodium
      homeostasis including not only sodium retention, but also release of pressor
      hormones, renin and possibly others, enhanced afferent sympathetic activity and
      suppression of the release of medullary hypotensive factors.

PMID- 1741991
TI  - On the mechanisms and clinical relevance of one-kidney, one-clip hypertension.
AB  - Dr. Skeggs demonstrated the lack of renin dependence in 1-kidney, 1-clip
      hypertension and elucidated some of the differences between that and Dr.
      Goldblatt's classic 2-kidney, 1-clip model of hypertension. Studies of these two
      different types of hypertension have led research in many new directions and
      helped to reveal the role of the renin-angiotensin system in hypertension and
      that system's interaction with sodium-induced vasodilation in both animals and
      humans. More recent research has investigated the processes behind essential
      hypertension and I present here the proposal that, due to nephron heterogeneity,
      essential hypertension in humans is parallel in its pathophysiologic processes to
      Goldblatt hypertension.

PMID- 1741992
TI  - The medullipin system of blood pressure control.
AB  - The medullipin system of BP control has its cellular component in the
      renomedullary interstitial cells (RICs) of the renal papilla. The RICs secrete
      medullipin I which is conveyed to the liver to be activated into Med II. This
      activation appears to involve the cytochrome P-450 dependent enzyme system of the
      liver. Med II is a vasodilator that suppresses sympathetic tone, causes diuresis
      natriuresis and has a suppressive effect on the central nervous system (CNS). As
      such, Med II has biologic actions the exact opposite of major actions of the
      renin-angiotensin system. Angiotensin II is a vasoconstrictor that facilitates
      sympathetic tone, causes salt water retention by the kidney and has stimulatory
      effect on the CNS. These are double feedback BP control systems. One elevates the
      BP and is prohypertensive; the other lowers BP and is antihypertensive. Unclipped
      (UC) the one-kidney, one-clip hypertensive rat has assisted greatly in
      elucidating the medullipin system. The support for these contentions are
      documented in this presentation.

PMID- 1741993
TI  - Physiological effects of the humoral renomedullary antihypertensive system.
AB  - In experiments on rats, the physiological effects of the antihypertensive humoral
      system of the renal medulla were explored. We studied the parameters of blood
      pressure, heart rate, efferent sympathetic nervous activity to the splanchnic
      region, diuresis and natriuresis. The experimental situations included studies on
      normotensive rats, injected with extracted renomedullary lipids (medullipin), and
      normotensive rats extracorporally cross-perfusing an isolated kidney at increased
      pressure levels, to explore the release of renomedullary depressor substances.
      Spontaneously hyperactive rat (SHR) kidneys were also cross-perfused to study
      whether the renomedullary mechanism was reset upwards in this type of primary
      hypertension. Finally, the acute pressure reductions caused by angiotensin
      converting enzyme (ACE)-inhibitors were studied in intact and chemically
      medullectomized (2-bromo-ethylamine hydrobromide) rats to explore whether they
      were at least in part dependent on an intact renal medulla. In normal kidneys the
      renomedullary depressor system was initiated already at physiological pressure
      levels (at or above 100 mm Hg), causing the following humorally induced response
      pattern: the blood pressure fall was associated with decreases in both heart rate
      and sympathetic activity, while diuresis and natriuresis increased. In SHR
      kidneys, perfusion pressure had to be raised between 200 and 250 mm Hg before
      this depressor pattern was activated, revealing an "upward renomedullary
      resetting" well beyond the prevailing SHR blood pressure. The acute blood
      pressure decrease initiated in normotensive rats by an ACE-inhibitor
      (enalaprilat) was abolished in medullectomized rats, indicating an interaction
      between the renin-angiotensin and the renomedullary antihypertensive systems.

PMID- 1741994
TI  - The role of extrarenal renin in Goldblatt hypertension.
AB  - Renin-like activity can be demonstrated in arterial extracts from normal rats and
      from rats with Goldblatt hypertension. We have found no evidence, however, for
      elevated arterial renin levels in relation to plasma renin activity. Studies of
      the reversal of renovascular hypertension indicate that the fall in blood
      pressure produced by renal artery deconstriction is not renin-dependent. However,
      molecular biological techniques indicate that extrarenal renin gene expression is
      altered in some tissues, such as the adrenal gland in Goldblatt hypertension, and
      it is possible therefore that extrarenal renin synthesis is important in blood
      pressure control. This has to be distinguished from renin derived from plasma
      uptake.

PMID- 1741995
TI  - On the role of renin in one-kidney, one-clip hypertension.
AB  - It is known that the renin angiotension system as it is usually understood is not
      the mediator of experimental one-kidney, one-clip (1K,1C) hypertension in
      animals. There is also ample evidence that the blood pressure of dogs and rabbits
      with this form of hypertension can be lowered by immunization with hog renin,
      which implies that renin is the mediator. In an effort to resolve this
      contradiction, we searched for a second hypertensive substance which we thought
      may have been present in the crude hog kidney extracts that had been used to
      immunize the hypertensive animals. Instead, we ultimately discovered that the
      blood pressure of hypertensive rabbits could be lowered by immunization with pure
      hog renin. This remarkable finding could be explained if renin were transformed
      in vivo, exhibiting new antigenic sites and eliciting a second antihypertensive
      antibody. We found such an antibody. When free of antirenin, it lowered the blood
      pressure of 1K,1C hypertensive rabbits. The same antibody stained the cytoplasm
      of vascular smooth muscle cells and certain other cells in the tissues of normal
      and hypertensive rabbits. The presence of this transformed renin in the tissues
      of the rabbit was confirmed by chronic infusion of 125I-labeled renin into
      hypertensive rabbits. A significant portion of the radioactivity was found to be
      incorporated into a very high molecular weight, insoluble form. Its function in
      this location is unknown but must directly or indirectly involve vasoconstriction
      since its neutralization by specific antibody lowers the blood pressure of 1K,1C
      hypertensive rabbits.

PMID- 1741996
TI  - Sickness insurance (or prepaid illness care)

PMID- 1741997
TI  - Resident interest in physical medicine and rehabilitation fellowships. Results of
      a survey.
AB  - Physiatry, one of the six medical specialties that does not currently offer added
      or special qualification certification examinations, does not have accredited
      fellowships in potential subspecialty areas. These issues are currently being
      debated by the leadership organizations within physical medicine and
      rehabilitation such as the Association of Academic Physiatrists, the American
      Academy of Physical Medicine and Rehabilitation, the Physical Medicine and
      Rehabilitation Residency Review Committee and the American Board of Physical
      Medicine and Rehabilitation. Recent events, such as the establishment of funding
      agencies with an interest in medical rehabilitation research training, suggest
      that physiatric fellowships may become more available. A survey was conducted to
      determine whether physiatric residents desire postresidency training and, if
      interested, what type of additional training they would seek. This information
      could be used in formulating policies regarding the establishment, accreditation
      and certification of subspecialty fellowships within physical medicine and
      rehabilitation. Of 968 physiatric residents currently in training, 525 (54%)
      responded to a 22-question survey assessing resident interest regarding
      fellowship training, the different subspecialty areas, salary expectations,
      fellowship duration, preferred amount of time devoted to clinical v research
      work, mentorship, double boarding, accreditation, certification and a section for
      general comments. The results of the survey indicate considerable interest in
      fellowship training, which diminishes as residents approach graduation. Residents
      favored clinically oriented fellowships of 1-yr duration, which should be
      accredited and certified. Sports medicine was identified as the area of greatest
      subspecialty interest.

PMID- 1741998
TI  - Stiff-legged gait in spastic paresis. A study of quadriceps and hamstrings muscle
      activity.
AB  - Stiff-legged gait, ascribed to limited knee flexion during swing in spastic
      paresis, has previously received little detailed investigation. In this study,
      data from 23 patients referred for dynamic electromyographic evaluation of
      spastic stiff-legged gait were analyzed to identify timing of the activity of
      eight muscles during the gait cycle. Stride characteristics and foot switch data
      were also analyzed. Inappropriate activity in at least one of the quadriceps
      muscles during the preswing and/or initial swing phases was found in all 23
      patients. Nine patients (39%) had hamstring activity during preswing. This group
      of 9, compared with the other 14 patients, had a significant reduction in average
      gait velocity and stride length (P less than 0.05) suggesting that preswing
      hamstring activity in stiff-legged gait may be counterproductive. No relation was
      found between biceps femoris (short head) activity and the amount of peak knee
      flexion attained in swing indicating that other factors are more important in
      attaining knee flexion. Delayed heel rise was observed in 21 patients (91%),
      which could imply insufficient calf muscle strength. Further, patients with
      markedly delayed heel rise achieved less peak knee flexion in swing than patients
      with normal or only moderately delayed heel rise (P less than 0.05). This may
      support the notion that adequate calf muscle strength is important in initiating
      knee flexion in the terminal stance/preswing phase. Results from this study
      provide preliminary quantitative information about stiff-legged gait that may
      prove useful in guiding management techniques.

PMID- 1741999
TI  - Relationship between electromyographic activity of the vastus lateralis while
      standing and the extent of bilateral simulated knee-flexion contractures.
AB  - The effect of simulated bilateral knee-flexion contractures (KFC) on the
      electromyographic (EMG) activity of the vastus lateralis was studied by testing
      10 normal subjects using surface EMG to test the hypothesis that the activity of
      the knee extensors would increase as a function of the severity of the
      contracture. The root mean square of the EMG activity was determined from four 4
      s samples taken at 30-s intervals, during 2 min of standing in each of five
      positions of simulated KFC (0 degree, 10 degrees, 20 degrees, 30 degrees and 40
      degrees). A randomly balanced order of conditions was used. KFC were simulated in
      each subject by means of an adjustable line from the subject's waist to the sole
      of each foot. An analysis of variance was used to contrast EMG activity, and a
      significant difference was found between each of the positions (P less than
      0.05). The mean (+/- 1 SD) EMG activity, expressed as a percentage of the maximum
      voluntary contraction, was 0.3% (+/- 0.2) at 0 degree, 7.6% (+/- 5.6) at 10
      degrees, 10.9% (+/- 7.6) at 20 degrees, 16.6% (+/- 12.4) at 30 degrees and 24.0%
      (+/- 14.0) at 40 degrees. A linear relationship was found (r2 = 0.986), expressed
      by the equation y = 0.62 + 0.56 x, where y represents EMG activity and x
      represents the extent of simulated KFC (P = 0.0007). The results provide insight
      into the increased knee extensor activity necessary to stand with KFC and
      underline the importance of treating this common disorder.

PMID- 1742000
TI  - The injured upper extremity and the JAMAR five-handle position grip test.
AB  - Niebuhr and Marion (Am J Phys Med Rehab 1990;69:96-101) recently presented a
      study that utilized healthy subjects who were able to control the amount of force
      exerted during submaximal grip strength efforts. Stokes (J Occup Med 1983;25:683
      684) proposed that a true weakness of grip can be distinguished in the injured
      upper extremity from a feigned effort that yields a flat horizontal type of
      curve. The purpose of this study was to evaluate the five-handle position JAMAR
      grip test in an injured population and compare the curves produced with a group
      of healthy subjects. We found that the patients with well-documented pathology
      produced a curve that was similar in shape to the healthy group; however, the
      curve on the injured extremity was reduced in force output.

PMID- 1742001
TI  - Noninflammatory knee joint effusions in spinal cord-injured and other paralyzed
      patients. Four case studies.
AB  - Four patients with knee effusions are described. Three had spinal cord injuries
      and the fourth had Guillain-Barre syndrome. Of the spinal cord-injured patients,
      the effusions were unilateral in one case and bilateral in another. The third
      patient developed effusions on two separate occasions with bilateral involvement
      once and unilateral involvement once. The patient with Guillain-Barre syndrome
      had bilateral knee joint effusions. All effusions were tapped and revealed type I
      synovial fluid except for one joint that contained some blood cells. Two of the
      three spinal cord-injured patients had heterotopic ossification at the knees
      documented by 99mTe bone scans and two were lying prone for the treatment of
      decubitus ulcers. Similar knee joint effusions have been described by several
      authors in the past. The etiology is unknown; however, we offer the hypothesis
      that paralysis of the muscles adjusting intra-articular knee joint structures may
      be the cause. It is important for clinicians to recognize that benign knee joint
      effusions are likely to be encountered in paralyzed patients. They can be
      evaluated with a simple synovial fluid analysis.

PMID- 1742002
TI  - Deep vein thrombosis in rehabilitating stroke patients. Incidence, risk factors
      and prophylaxis.
AB  - A total of 503 consecutive cases of suspected stroke were examined for potential
      eligibility based on recent development of a paralyzed limb. Of 123 otherwise
      eligible subjects, 22 were found by ultrasound to have deep vein thrombosis (DVT)
      on admission. Therefore, 101 patients were assigned randomly to one of the
      treatment groups or to the control group. The three treatments were adjusted-dose
      heparin, external pneumatic compression and functional electrical muscle
      stimulation. An ultrasound examination of the lower extremities was conducted
      twice a week on each patient until completion of the study (28 days or discharge,
      whichever came first). Electrical muscle stimulation was discontinued after 4 mo
      of the study because of discomfort, blister formation and high drop-out rate. Ten
      patients developed DVT during the study period. In 17 of the 32 cases of DVT,
      venography was performed, which confirmed the ultrasound findings in every case.
      The 32 cases of DVT differed from those without DVT by having a higher prevalence
      of hypertension (P = 0.02), cholesterol (P = 0.08) and a longer time interval
      between stroke and admission (P less than 0.05). We conclude that ultrasound is
      effective for DVT detection in the rehabilitation setting, and two-thirds of such
      cases are detectable on admission.

PMID- 1742003
TI  - Statistical conclusion validity. Multiple inferences in rehabilitation research.
AB  - The problem of multiple statistical inferences and Type I error rates in
      rehabilitation research is examined. The Bonferroni method is the most commonly
      advocated procedure to control Type I error in clinical research. The traditional
      Bonferroni method is often overly conservative and results in a loss of
      statistical power when more than a small number of comparisons are evaluated.
      Adjustments to the Bonferroni method designed to control or reduce the incidence
      of Type I errors and improve the statistical conclusion validity of
      rehabilitation research are presented. The adjusted or sharpened Bonferroni
      methods allow the researcher to control the incidence of Type I errors while
      maintaining statistical power. Adjustments to the Bonferroni method are simple to
      compute and applicable to a wide variety of statistical tests. The use of
      appropriate multiple comparison procedures will reduce the number of Type I
      errors and improve the statistical conclusion validity of rehabilitation research
      studies.

PMID- 1742004
TI  - Orthopedic surgery and rehabilitation for the prolongation of brace-free
      ambulation of patients with Duchenne muscular dystrophy.
AB  - The purpose of this study was to prospectively evaluate the results of a short
      comprehensive program involving early lower extremity musculotendinous surgery
      followed by a definitive course of rehabilitation on contractures and the
      duration of ambulation for patients with Duchenne muscular dystrophy. Seven
      patients were treated while ambulating with little difficulty and six were
      treated just before or after becoming wheelchair-dependent. Predicted post
      treatment duration of ambulation was calculated from established clinical
      criteria. Actual prolongation of brace-free ambulation after treatment was a mean
      of 0.8 yr greater than predicted for the group as a whole but 0.93 yr for the
      group treated early by comparison with 0.63 yr for those treated according to the
      customary approach. The number of falls significantly decreased from 84 +/- 87 to
      1 +/- 1 per month postoperatively (P less than 0.05); however, the speed of
      ambulation over a distance of 10 yards decreased from 10.2 +/- 4 s to 12.1 +/-
      7.3 s. Three patients who had tibialis posterior transfers retained antigravity
      plus dorsiflexor strength and continue to wear normal footwear 2.5, 3.7 and 4.0
      yr after loss of ambulation. We conclude that ambulation becomes more stable and
      brace-free ambulation may be prolonged by a comprehensive program of early
      orthopedic surgery and rehabilitation. Earlier intervention is also better
      tolerated.

PMID- 1742005
TI  - Asthmatic amyotrophy. Three cases.
AB  - Asthmatic amyotrophy is becoming a well established clinical phenomenon. A polio
      like syndrome, it is characterized by an asymmetrical lower motor neuron
      paralysis after an acute asthmatic episode. We are presenting three additional
      cases of this syndrome to add to the literature describing this phenomenon. Our
      cases are similar to the 18 previously reported cases showing an asymmetrical
      flaccid paralysis accompanied by normal sensation. The prognosis for full
      recovery of function is poor. Anterior horn cell damage is postulated because no
      sensory loss has been found in any patients.

PMID- 1742006
TI  - Medical economics for PM&R. II. Current financial trends and the future of PM&R.

PMID- 1742007
TI  - Physical parameters and speed of wheeling associated with two specific
      wheelchairs by individuals with spinal cord function.

PMID- 1742008
TI  - The new stereological methods for interpreting functional morphology from slices
      of cells and organs.

PMID- 1742009
TI  - Agonist-induced fluctuations in cytoplasmic calcium in primary cultures of bovine
      endothelial cells.
AB  - Endothelial cells play an important role in the vascular responsiveness to many
      stimuli by releasing locally active agents. The intracellular signal which links
      the external stimulus to the release of the active compounds is almost certainly
      an elevation in cytoplasmic calcium (Cai2+). Thus a detailed knowledge of Cai2+
      regulation is central to an understanding of the physiology and pharmacology of
      endothelial cells. The present experiments, on single bovine aortic endothelial
      cells, demonstrate that agonists stimulate complex changes in Cai2+. These
      include rapid and regular fluctuations in Cai2+ which are different from the
      oscillations reported in other endothelial cells and non-excitable cells. The
      fluctuations are completely abolished in media containing low calcium, 2 mM
      cobalt or caffeine but are not affected if the cells are bathed in isotonic
      potassium solutions. The hypothesis is put forward that the fluctuations in Cai2+
      are associated with localized influxes of calcium and are possibly involved with
      the recycling of calcium between the internal stores, the cytoplasm and the
      external medium.

PMID- 1742010
TI  - Outward currents in rabbit pulmonary artery cells dissociated with a new
      technique.
AB  - Single cells from the rabbit pulmonary artery were isolated using a new and
      convenient procedure. Strips of muscle were incubated overnight in papain at 6
      degrees C and dispersed the following morning after warming the tissue for 10
      min. This method consistently produced a high yield of relaxed cells, which
      reversibly responded to vasoconstrictors and remained viable for many hours. The
      electrophysiological properties of these cells were studied using the patch-clamp
      technique in the whole-cell configuration. In physiological Ca2+ solution with
      K(+)-filled pipettes, cells had a high input resistance (approximately 17 G
      omega) and an average resting potential of -55 mV. In voltage clamp, several
      components of outward current could be identified. Depolarizing voltage steps
      revealed a prominent, transient current (Itran), having extremely rapid
      activation (less than 5 ms) and inactivation (less than 15 ms) kinetics. Itran
      was followed by a more slowly activating current (IKso) that was sustained over
      100 ms. Both currents were essentially abolished by a 4-aminopyridine (4-AP) and
      sensitive to Ca2+ influx. IKso, but not Itran, was blocked by tetraethylammonium
      (TEA) and had the properties of a Ca(2+)-activated K+ current. Holding the
      membrane potential at -40 mV completely inactivated Itran and unmasked a time
      independent, background current superimposed on IKso. The background current was
      also blocked by 4-AP. In addition, when adenosine triphosphate (ATP), but not
      guanosine triphosphate (GTP), was omitted from the patch-pipette, spontaneous
      bursts of outward current (SOCs) were superimposed on the voltage-activated
      currents. However, since SOCs were rarely observed when ATP and GTP were present
      together, they are unlikely to be active under physiological conditions. Thus at
      least four types of outward current can be distinguished in isolated rabbit
      pulmonary artery cells. These include a novel transient current which could be
      activated from the resting potential. It activates much more rapidly than outward
      currents previously reported in vascular muscle, and would rapidly oppose action
      potential firing. This current could therefore be responsible for the inability
      of large elastic arteries to fire action potentials.

PMID- 1742011
TI  - Catabolism of hyaluronan in rabbit skin takes place locally, in lymph nodes and
      liver.
AB  - The catabolism of hyaluronan has been studied by injecting hyaluronan, labelled
      with 125I-tyramine cellobiose (125I-TC), subcutaneously into the hindpaw of
      rabbits. Following endocytosis, 125I-TC remains in the cells at the site of
      uptake, allowing localization of the site of catabolism. At 6 h after
      subcutaneous injection, 65% of the injected radioactivity was recovered. The skin
      at the injection site contained 47%, the popliteal gland at the side of injection
      10%, and the liver 8% of the injected dose. At 48 h the three organs contained
      40% of the injected dose with 17% in the skin, 10% in the lymph node and 13% in
      the liver. The decline in recovery could be accounted for by urinary excretion of
      the tracer, implying that some tracer had been released from the cells after
      endocytosis. Chromatography revealed that over 85% of 125I-TC-hyaluronan in the
      lymph nodes and liver was of low molecular mass throughout the experiment. In
      skin, 4% of the injected tracer was recovered with low molecular mass at 6 h,
      increasing to 12% of injected dose at 24 and 48 h. Thus, a minimum of 12% of the
      injected tracer was catabolized per 24 h at the skin injection site. If cells in
      skin are responsible for the subsequent release of tracer, as seen from the
      decrease in recovery of the injected dose, another 10-15% of the tracer could
      have been catabolized locally in the skin per day. The major part of the
      hyaluronan injected in the skin was, however, catabolized by lymphatic removal
      and subsequent degradation in local lymph nodes and liver.

PMID- 1742012
TI  - Action potential duration and the inotropic response to reduced extracellular
      potassium in guinea-pig ventricular myocytes.
AB  - The mechanism of the inotropic effect of a reduction of extracellular potassium
      from 5.4 to 2.7 mM was investigated in myocytes isolated from guinea-pig
      ventricle. Action potentials were recorded using intracellular microelectrodes
      and cell shortening was measured by analysis of a video image. Changes in
      cytosolic calcium transients were estimated from calcium-activated currents under
      voltage-clamp conditions. The aim was to determine whether the prolongation of
      action potential duration which was observed to occur in low potassium might
      contribute to the increased shortening and increase in calcium-activated current
      under these conditions. Using a voltage-clamp waveform to mimic the waveform of
      the action potential, it was found that reduction of potassium caused a marked
      increase in cell shortening and of calcium-activated current in the absence of
      prolongation of the 'action potential' waveform. No change in inward calcium
      current was detected when extracellular potassium was reduced. The sensitivity to
      strophanthidin appeared to be increased under these conditions. We conclude that
      prolongation of the action potential is not a major factor contributing to the
      increased cell shortening and to the increased cytosolic calcium transient when
      extracellular potassium is reduced.

PMID- 1742013
TI  - Avian lower intestine adapts to dietary salt (NaCl) depletion by increasing
      transepithelial sodium transport and microvillous membrane surface area.
AB  - A tissue sampling scheme for tandem assessments of whole-organ physiology and
      ultrastructure was applied to the lower intestine (coprodaeum) of White Plymouth
      Rock hens on low- and high-NaCl diets. The objective was to correlate net
      amiloride-sensitive Na transport determined using the Ussing chamber with the
      plasma membrane surface areas due to microvilli at the epithelial cell apex. Hens
      kept on the low-NaCl diet for 3-4 weeks displayed a substantial increase in short
      circuit current and in total microvillous membrane surface area. The latter rose
      from a group mean +/- S.E.M. of about 90 +/- 9.7 cm2 to one of 200 +/- 38 cm2 per
      organ. An increase in epithelial cell membrane contributed to, but did not fully
      explain, the increase in microvillous area. No differences in mean cell height or
      mean cell volume were found but the average cell in the low-NaCl birds was better
      developed in possessing a greater surface area of microvilli. On the high-NaCl
      diet, the epithelium was 33 +/- 2.7 microns tall and contained about 270 +/- 15
      million cells. Each cell had a volume, on average, of 540 +/- 59 microns 3 and a
      microvillous surface of 32 +/- 2.6 microns 2. After NaCl depletion, there were
      420 +/- 75 million cells and the average microvillous surface was 49 +/- 5.3
      microns 2 per cell. The morphological adaptations alone do not explain the
      increased net Na transport found on the low-NaCl diet. Of cardinal importance is
      greater density of open Na channels in apical cell membranes.

PMID- 1742014
TI  - Regulation of cellular water and ionic content in lungs of fetal and adult rats.
AB  - Slices of lungs from late-fetal (1 day pre-partum) and adult rats lost K+ and
      gained Na+, Cl-, water and Ca2+ during pre-incubation at 1 degrees C. These
      changes were reversed upon restoration to 37 degrees C. The recovery of
      composition at 37 degrees C was completely dependent on cell respiration in adult
      slices; by contrast, glycolysis could support partial recovery in the fetal
      slices. Ouabain completely inhibited K+ reaccumulation at both ages but inhibited
      net extrusion of water by no more than 50%. Replacement of medium Cl- with NO3-
      prevented the extrusion of water in the presence of ouabain in adult but not
      fetal slices. Transmission electron microscopy of type II epithelial cells in
      slices of both ages showed that ouabain induced the formation of many cytoplasmic
      vesicles, apparently derived from the Golgi apparatus. Regulation of cell ionic
      and water content is thus generally similar in late-fetal and adult lung tissue,
      but there are differences in the source of ATP and in some features of ouabain
      resistant volume regulation.

PMID- 1742015
TI  - The effect of level of contraction on the electromyographic power spectrum of the
      diaphragm in pigs.
AB  - We investigated the relationship between the frequency components of myoelectric
      power spectra of the diaphragm and the level of diaphragmatic contraction in
      seven anaesthetized spontaneously breathing pigs. Electromyographic activity of
      the costal and crural portions of the diaphragm were recorded with fish-hook
      electrodes and the frequency-power spectra during inspiration were computed and
      expressed in terms of centroid frequency (fc). Diaphragmatic force was indirectly
      assessed as transdiaphragmatic pressure (Pdi) which was measured with balloon
      catheter systems placed in the abdomen and oesophagus. The relationships between
      Pdi and costal and crural fc were assessed during brief (2 min) and incremental
      increases in diaphragmatic contraction, achieved by gradual occlusion of the
      inspiratory line of the breathing circuit. When Pdi was increased to 128, 191,
      287 and 421% of the value measured during unobstructed breathing, costal and
      crural fc rose significantly in all animals because of an increase in the power
      of high-frequency components and a decline in the power of low-frequency
      components. Both costal and crural fc returned to control values within 5 min of
      the release of inspiratory occlusion. Our results indicate that the level of
      contraction is an important determinant of the diaphragmatic myoelectric power
      spectrum and should be taken into consideration when using power spectral
      analysis to diagnose diaphragmatic mechanical failure.

PMID- 1742016
TI  - A study of the action of angiotensin II on perfusion through the cortex and
      papilla of the rat kidney.
AB  - The effect of angiotensin II on blood pressure and perfusion of blood through the
      cortex and papilla regions of the kidney was determined in pentobarbitone
      anaesthetized rats which were subjected to laser-Doppler flowmetry to estimate
      regional renal haemodynamics. Angiotensin II was infused at 10, 45 and 150 ng (kg
      body weight-1 min-1) which caused dose-related increases in blood pressure of 3,
      12 and 24%, respectively, and decreases in cortical perfusion of 9, 15 and 24%,
      respectively. Papillary perfusion did not change at any dose of angiotensin II.
      This pattern and magnitude of responses to angiotensin II in blood pressure,
      cortical and papillary perfusions was essentially unaffected (a) following
      blockade of cyclo-oxygenase activity with indomethacin (1.3 mg kg-1 plus 2 mg kg
      1 h-1), (b) during infusion of a bradykinin antagonist, at 1.3 micrograms min-1,
      (c) when renal perfusion pressure was regulated at control levels and (d)
      following Methylene Blue administration to inhibit potential endothelial-derived
      relaxing factor production. By contrast, infusion of phenylephrine at 5, 10 and
      20 micrograms kg-1 min-1 caused dose-related increases in blood pressure and
      decreases in both cortical and papillary perfusions reaching some 28, 7 and 17%
      respectively at the highest dose of phenylephrine used. These results showed that
      both cortex and papilla were sensitive to vasoconstrictor agents. They are
      compatible with the suggestion that angiotensin II regulates cortical but not
      papillary perfusion in the kidney, and that these responses do not depend on
      prostaglandin, bradykinin, renal perfusion pressure or endothelium-derived
      relaxing factor.

PMID- 1742017
TI  - Arteriolar vasodilatation in frog skeletal muscle in vivo: modification of second
      messenger systems.
AB  - This study was concerned with the role of cyclic nucleotides in the post
      junctional vasodilatation mechanism. Interventions with second messenger systems
      involving cyclic adenosine monophosphate (cyclic AMP) and cyclic guanosine
      monophosphate (cyclic GMP), allowed the role of these nucleotides in vascular
      smooth muscle to be evaluated in the autoperfused, transparent frog muscle, m.
      cutaneous pectoris. The microcirculation was observed by intravital microscopy,
      and arteriolar diameters were continuously recorded. Pre- and post-junctional
      effects were distinguished by comparing results in control frogs with those
      obtained in frogs that had been chemically sympathectomized with either 6
      hydroxydopamine or tetrodotoxin. Arterioles that were pre-contracted with
      adrenaline dilated in response to topical application of forskolin or sodium
      nitroprusside, which are direct activators of intracellular adenylate cyclase and
      guanylate cyclase, respectively. Arterioles were also dilated by 3-isobutyl-1
      methylxanthine (IBMX), which is a non-selective inhibitor of cyclic AMP- and
      cyclic GMP-phosphodiesterase, and by rolipram, which is a selective inhibitor of
      the calcium-independent cyclic AMP-phosphodiesterase. Dibutyryl-cyclic AMP and
      dibutyryl-cyclic GMP also caused vasodilatation. These results indicate that in
      vascular smooth muscle, intracellular mechanisms involving cyclic nucleotides
      (cyclic AMP and cyclic GMP) are important in vasodilatation. They may act in
      conjunction with pre-junctional inhibitory mechanisms on sympathetic nerves.

PMID- 1742018
TI  - Inhibition of Ca2+ mobilization by caffeine in a cultured vascular smooth muscle
      cell line (A7r5).
AB  - The effects of caffeine on the resting level and agonist-induced changes in
      intracellular calcium ([Ca2+]i) have been studied in the vascular smooth muscle
      cell line A7r5. Caffeine (1-30 mM) lowers the resting [Ca2+]i by reducing the
      entry of Ca2+ and inhibits completely the mobilization of Ca2+ by arginine
      vasopressin. Application of forskolin, to elevate cAMP, does not affect the
      resting level of Ca2+i but does abolish the agonist-induced rise. These data add
      to the complexity of caffeine-induced changes in [Ca2+]i and point to a possible
      interaction between cAMP and other second messenger systems mobilizing Ca2+i in
      this cell type.

PMID- 1742019
TI  - Intracellular pH and buffering power measured in isolated single cells from
      pregnant rat uterus.
AB  - Intracellular pH (pHi) affects smooth muscle function yet there have been few
      direct pHi measurements. Using the fluorescent indicator, 2',7'-bis-2
      (carboxyethyl)-5(6)-carboxyfluorescein acetoxymethyl ester, we report here the
      first measurements of pHi and buffering power (beta) in single, isolated, uterine
      smooth muscle cells. Mean pHi in cells from pregnant rat uteri was 7.09 +/- 0.08
      (+/- S.E.M., n = 16 cells; 37 degrees C), and beta was found to be 12.8 +/- 2.8
      mmol/l per pH unit (n = 15). The cells were able to regulate their pHi in the
      presence of butyrate when perfused in nominally CO2-free solution.

PMID- 1742020
TI  - BDNF mRNA is decreased in the hippocampus of individuals with Alzheimer's
      disease.
AB  - In recent years, nerve growth factor (NGF) has gained attention as a potential
      therapeutic agent for Alzheimer's disease (AD). To study the expression of NGF
      and its homologs, brain-derived neurotrophic factor (BDNF) and neurotrophin 3 (NT
      3), postmortem samples of hippocampus from AD and control donors were examined by
      in situ hybridization. Hybridization signal for BDNF, but not NGF or NT-3, was
      decreased in samples of hippocampus from donors with AD. Decreased transcript
      abundance of BDNF mRNA in hippocampi of individuals with AD was verified by an
      RNAase protection assay. These results suggest the possibility that decreased
      expression of BDNF may contribute to the progression of cell death in AD.

PMID- 1742021
TI  - The dopamine beta-hydroxylase gene promoter directs expression of E. coli lacZ to
      sympathetic and other neurons in adult transgenic mice.
AB  - Dopamine beta-hydroxylase (DBH) catalyzes the final step in the biosynthesis of
      norepinephrine, the principal classic neurotransmitter of peripheral sympathetic
      neurons. We have shown that 5.8 kb of 5' upstream region from a cloned human DBH
      gene promoter is sufficient to direct expression of the E. coli lacZ gene in
      transgenic mice to neurons of the locus ceruleus and other classic noradrenergic
      brain stem nuclei, sympathetic ganglion neurons, and adrenal chromaffin cells.
      lacZ expression was also observed in neurons of the enteric system, the retina,
      some sensory and all cranial parasympathetic ganglia, and some diencephalic and
      telencephalic brain nuclei. The expression pattern of the transgene in DBH
      immunonegative sites overlapped with many sites where expression of tyrosine
      hydroxylase or phenylethanolamine N-methyltransferase, two other catecholamine
      biosynthetic enzymes, has been reported.

PMID- 1742022
TI  - Some neuronal cell populations express human dopamine beta-hydroxylase-lacZ
      transgenes transiently during embryonic development.
AB  - The 5' flanking region from the human dopamine beta-hydroxylase gene directs
      expression of bacterial beta-galactosidase reporter genes to a subset of adult
      neurons and adrenal chromaffin cells of transgenic mice. In this paper, we
      examine the spatial and temporal patterns of expression of these transgenes
      during embryogenesis. Expression begins at embryonic day 9 in the developing
      central and peripheral nervous systems and persists in cell populations in which
      expression is observed in adult transgenic mice. However, transient embryonic
      expression occurs in presumptive neuroblasts in developing sensory ganglia and
      ventrolateral neural tube that are destined to synthesize neurotransmitters other
      than catecholamines. These observations support the concept that some cells fated
      to become "non-catecholaminergic" neurons exhibit transient catecholaminergic
      features during their differentiation.

PMID- 1742023
TI  - The inactivation gate of the Shaker K+ channel behaves like an open-channel
      blocker.
AB  - Following voltage-dependent activation, Drosophila Shaker K+ channels enter a
      nonconducting, inactivated state. This process has been proposed to occur by a
      "ball-and-chain" mechanism, in which the N-terminus of the protein behaves like a
      blocker tethered to the cytoplasmic side of the channel and directly occludes the
      pore to cause inactivation. To complement the ample evidence for the involvement
      of the N-terminus, we sought evidence that it blocks the pore directly. We found
      that inactivation exhibits several distinctive properties of pore blockade.
      First, recovery was speeded by increased external K+ concentrations, just as
      blockade can be relieved by trans-permeant ions. Second, single-channel
      experiments show that the channel reopens from the inactivated state upon
      repolarization. These openings were usually required for recovery, as though the
      blocking particle must exit the pore before the channel can close.

PMID- 1742024
TI  - Shaker, Shal, Shab, and Shaw express independent K+ current systems.
AB  - Although many K+ channel genes encoding homologous subunits have been cloned, a
      central question remains: how do these subunits associate to produce the
      diversity of K+ currents observed in living cells? Previous work has shown that
      different subunits encoded by the Shaker gene subfamily are able to form
      heteromultimers, which add to the diversity of currents. However, the
      unrestrained mixing of subunits from all genes to form hybrid channels would be
      undesirable for some cells that clearly require functionally discrete K+
      currents. We show that Drosophila Shaker, Shal, Shab, and Shaw subunits form
      functional homomultimers, but that a molecular barrier to heteropolymerization is
      present. Coexpression of all four K+ channel systems does not alter their
      individual properties in any way. These experiments also demonstrate that
      multiple, independent A-current systems together with multiple, independent
      delayed rectifier systems can coexist in single cells.

PMID- 1742025
TI  - Calcium-induced release of calcium regulates differentiation of cultured spinal
      neurons.
AB  - Voltage-dependent calcium influx has been shown to regulate the differentiation
      of cultured amphibian spinal neurons. We have examined the transient elevation of
      intracellular calcium induced by depolarization, using calcium indicators and
      confocal microscopy with high temporal and spatial resolution. Rapid calcium
      elevations in both the nucleus and the cytosol are primarily due to calcium
      dependent release of calcium from intracellular stores. Depletion of stores
      associated with the endoplasmic reticulum reduces all transients. Elevations
      diminish with neuronal maturation. Depletion of stores of intracellular calcium
      at early times affects neuronal differentiation in a manner similar to the
      prevention of influx. The results indicate that both influx and release are
      necessary to promote neuronal differentiation.

PMID- 1742026
TI  - Role of calcium and protein kinase C in development of the delayed rectifier
      potassium current in Xenopus spinal neurons.
AB  - The delayed rectifier current of embryonic Xenopus spinal neurons plays the
      central role in developmental conversion of calcium-dependent action potentials
      to sodium-dependent spikes. During its maturation, this potassium current
      undergoes a pronounced increase in rate of activation. The mechanism underlying
      the change in kinetics was analyzed with whole-cell voltage clamp of neurons
      cultured under various conditions. Calcium is necessary at an early stage of
      development, to permit influx that triggers subsequent release of calcium from
      intracellular stores. Its action is prevented by depletion of protein kinase C
      and mimicked by stimulation of the kinase. Calcium influx through voltage
      dependent channels at early stages of development regulates the differentiation
      of potassium current kinetics and modulation of the ionic dependence of action
      potentials.

PMID- 1742027
TI  - The duration of neurotrophic factor independence in early sensory neurons is
      matched to the time course of target field innervation.
AB  - To investigate how the onset of neurotrophic factor dependence in neurons is
      coordinated with the arrival of their axons in the target field, we have studied
      the survival of four populations of cranial sensory neurons whose axons reach
      their common central target field, the hindbrain, at different times. We show
      that neurons whose axons reach the hindbrain first survive for a short time in
      culture before responding to brain-derived neurotrophic factor (BDNF). Neurons
      whose axons reach the hindbrain later survive longer before responding to BDNF.
      These differences in survival, which arise prior to gangliogenesis, may play a
      role in coordinating trophic interactions for cranial sensory neurons.

PMID- 1742028
TI  - Neurotrophin-5: a novel neurotrophic factor that activates trk and trkB.
AB  - In vertebrates, the formation and maintenance of neuronal connections are subject
      to regulation by multiple target-derived, diffusible (neurotrophic) factors. Here
      we describe the identification and characterization of a novel neurotrophic
      factor designated neurotrophin-5 (NT-5). NT-5 is structurally related to nerve
      growth factor and is expressed in embryonic as well as adult tissues. Recombinant
      NT-5 promotes the survival of peripheral sensory and sympathetic neurons and
      induces differentiation of the pheochromocytoma cell line PC12. NT-5 activates
      two trk-related tyrosine kinase receptors and shares these receptors with other
      neurotrophins. Activation of multiple receptors may permit a single neurotrophin
      to control target innervation by distinct neuronal populations. Receptor sharing
      could enable neurotrophic factors emanating from distinct targets to cooperate in
      regulating neurons with multiple connections.

PMID- 1742029
TI  - Color Doppler echocardiographic assessment of atrial septal defect size:
      correlation with surgical measurements.
AB  - In patients with atrial septal defect (ASD), color flow Doppler echocardiography
      provides visualization of the transseptal jet, the maximal dimension of which can
      be assumed to correspond to the maximal dimension of the true orifice. To test
      whether color flow Doppler echocardiography can provide an alternative method for
      measurement of ASD size, we studied 63 consecutive patients with
      echocardiographic evidence of ASD. In 48 patients the maximal dimension of the
      jet was measured in the parasternal, apical, or subcostal four-chamber view or in
      the parasternal short-axis view. In the remaining 15 patients transesophageal
      echocardiography was performed because of transthoracic views were inadequate.
      The transesophageal studies also measured, from two-dimensional images, the
      maximal transverse discontinuity in the atrial septum. All patients underwent
      surgical repair, during which the surgeon directly measured the maximal dimension
      of ASD. Linear regression equations were performed to compare transthoracic and
      transesophageal dimensions to those measured at operation. Correlation
      coefficients were as follows for transthoracic versus surgical measurements: r =
      0.745, standard error = 4.35, p less than 0.001. Transesophageal measurements
      derived from both two-dimensional images and echocardiographic jet width showed
      similar excellent correlation with surgical measurements (n = 0.91, standard
      error = 4.33, p less than 0.001; and r = 0.919, standard error = 4.42, p less
      than 0.001, respectively). We conclude that ASD size derived from color flow
      Doppler echocardiography shows a good correlation with the anatomic maximal
      dimension observed at operation. Both transesophageal color flow Doppler
      echocardiography of jet width and direct surgical measurement of the defect
      provide an accurate estimation of ASD size.

PMID- 1742030
TI  - Left atrial appendage dysfunction: a cause of thrombosis? Evidence by
      transesophageal echocardiography-Doppler studies.
AB  - The blood flow velocity patterns within the left atrial appendage were studied by
      transesophageal color flow imaging and pulsed Doppler in 84 patients. At the time
      of the study, 57 of the patients were in sinus rhythm, 25 were in atrial
      fibrillation, and two were in atrial flutter. The relationships between atrial
      rhythm, blood flow pattern and the presence/absence of spontaneous
      echocardiographic contrast or thrombus within the appendage were investigated.
      Transesophageal echocardiography allowed recording of blood flow velocities in 81
      of the 84 patients studied. In 51 of the 55 patients in sinus rhythm the pulsed
      Doppler study showed a biphasic blood flow pattern, whereas a multiphasic pattern
      was found in the two patients with atrial flutter and in 14 patients with atrial
      fibrillation. In four patients with sinus rhythm and 10 patients with atrial
      fibrillation, no significant blood flow velocity could be detected. Thrombus or
      spontaneous echocardiographic contrast were found within the left atrial
      appendage in 20 patients, and in all these patients blood flow was either absent
      or significantly reduced. Our findings indicate that an absent or low blood flow
      velocity within the left atrial appendage represents a predisposing factor for
      thrombosis. Isolated left atrial appendage dysfunction has been documented in
      four patients during sinus rhythm, which may lead to thrombosis. This observation
      may offer an explanation for cardioembolic events that occur occasionally in
      patients without apparent heart disease and sinus rhythm.

PMID- 1742031
TI  - Long-term reproducibility of conventional Doppler analysis in patients with
      prosthetic valves.
AB  - Long-term reproducibility of Doppler recordings made by the same investigator
      using the same ultrasound equipment was determined in 50 clinically stable
      patients. The mean interval between the first and second examination was 16 +/- 7
      months. In 90% of the 33 patients with aortic prostheses, the relative difference
      between the first and second examination was less than 16% (mean value 9.1%) for
      the maximum instantaneous gradient and less than 17% (mean value 7.4%) for the
      mean gradient; the relative difference was less than 20% (mean value 8.5%) for
      the maximum flow velocity in the left ventricular outflow tract and less than 24%
      (mean value 10.8) for the maximum flow velocity ratio. In 90% of the 25 patients
      with mitral prostheses, the absolute difference between the first and second
      examination was less than 3 mmHg for the maximum instantaneous gradient, less
      than 2.5 mmHg for the mean gradient, and less than 20 msec for the pressure half
      time. We conclude that long-term reproducibility of Doppler echocardiographic
      characteristics of prosthetic valve function is good as far as transprosthetic
      gradients or pressure half-time are concerned but is less so for maximum flow
      velocity in the left ventricular outflow tract and the maximum flow velocity
      ratio. Changes beyond the aforementioned values may represent a real change in
      prosthetic valve function.

PMID- 1742032
TI  - Effect of sample volume location on Doppler-derived transmitral inflow velocity
      values.
AB  - In 25 patients with acute myocardial infarction and in 25 normal subjects, pulsed
      wave Doppler echocardiography was performed in the apical four-chamber view with
      the sample volume first between the mitral leaflet tips and then at the mitral
      anulus. The early filing wave (E) and late filling wave (A) peak velocities
      measured from Doppler strip charts were significantly (p less than 0.001) higher
      at the tips in both groups. E velocity increase was greater than A velocity
      increase, producing a significantly (p less than 0.001) higher E/A velocity ratio
      at the tips than at the anulus. The deceleration time was longer at the tips than
      at the anulus (p less than 0.001) in both groups. Therefore it is important to
      know sample volume location in the interpretation of mitral inflow velocity. It
      is critical to maintain the same sample volume location in serial assessments of
      left ventricular diastolic filling characteristics.

PMID- 1742033
TI  - Transesophageal echo-Doppler echocardiographic assessment of pulmonary venous
      flow patterns.
AB  - Fifty-eight of 61 consecutive patients undergoing transesophageal echo-Doppler
      echocardiography provided excellent signals to permit assessment of pulmonary
      venous blood low patterns. Normal antegrade pulmonary venous flow during
      ventricular systole was biphasic and was characterized by a short, low velocity
      (28 +/- 17 cm/sec), early systolic jet (P1), and longer, higher velocity (41 +/-
      23 cm/sec), late systolic jet (P2). Antegrade pulmonary venous flow during
      ventricular diastole (P3) was of moderate velocity (34 +/- 17 cm/sec) and was
      monophasic; during atrial contraction there was transient, low velocity (-17 +/-
      11 cm/sec) and reversal of flow (P4). The early systolic antegrade venous flow
      (P1) was absent or reversed in rhythm disorders, which interrupted normal
      synchronized atrioventricular activation. These rhythm disorders also were
      associated with diminished peak flow velocities during late systole (P2).
      Abnormalities in systolic left ventricular function and mitral regurgitation also
      had this effect. Diastolic flow velocities (P3) remained constant, except in
      patients with mitral regurgitation. In these patients diastolic peak flows were
      significantly increased above normal. In cases of atrial fibrillation or
      ventricular pacing the late diastolic reversal of flow resulting from atrial
      contraction (P4) was absent. CONCLUSIONS: Transesophageal echo-Doppler
      echocardiography gives high quality signals of pulmonary venous inflow to help
      assess function of the left ventricle and left atrium. Multiple factors affect
      the patterns. This study suggests caution in the interpretation of abnormal
      patterns, particularly of reduced systolic pulmonary vein flow in the presence of
      left ventricular dysfunction, atrial fibrillation, ventricular pacing, and mitral
      regurgitation.

PMID- 1742034
TI  - Prediction of rapid versus prolonged healing of infective endocarditis by
      monitoring vegetation size.
AB  - The diagnostic value of transesophageal echocardiography in monitoring the
      clinical course has been evaluated in 83 patients with echocardiographic evidence
      of infective endocarditis. A total of 103 vegetations attached to the aortic or
      mitral valves were detected by use of the transesophageal approach. The patients
      were monitored for a mean of 74 weeks and underwent a minimum of two consecutive
      transesophageal echocardiographic examinations. Group A included patients with
      increasing or remaining constant size of vegetation (8.2 +/- 1.5 to 11.2 mm, p
      less than 0.05) during 4 to 8 weeks of antimicrobial therapy, whereas group B was
      formed by patients with decreasing vegetation size (8.3 +/- 0.8 to 4.9 +/- 0.8
      mm, p less than 0.05). The incidences of complications after diagnosis and onset
      of therapy was higher in group A than in group B: valve replacement (45% versus
      2%, p less than 0.05), embolic events (45% versus 17%, p less than 0.05),
      perivalvular abscess formation (13% versus 2%, p less than 0.05), and mortality
      (10% versus 0%, respectively, p less than 0.05). Staphylococcus aureus was the
      most frequent organism isolated in group A (44% versus 11% in B, p less than
      0.05) and Streptococcus viridans in group B (33% versus 18% in A, p less than
      0.05). Blood cultures were negative in nearly 50% of the patients in each group.
      There was no difference in the incidences of complications in patients with
      positive or negative blood cultures. We conclude that an increase in vegetation
      size during antibiotic therapy predicts a prolonged healing phase of infective
      endocarditis. This prolonged healing period is associated with a significantly
      increased risk of complications, independent of blood culture results. Monitoring
      vegetation size contributes important information concerning prognosis and stage
      of risk, and it aids in the choice of patient management in infective
      endocarditis. Because embolic events after diagnosis and onset of treatment are
      less frequent in rapid-healing endocarditis, surgery cannot be recommended to
      prevent further events taking into account the high risk of surgery.

PMID- 1742035
TI  - Accuracy of three-dimensional volume measurement using biplane transesophageal
      echocardiographic probe: in vitro experiment.
AB  - Two phased-array scanning methods can be used for volumetric transesophageal
      echocardiographic imaging: (1) pull-back "breadloaf" reconstruction, and (2)
      rotation "fan-like" reconstruction. The purpose of this study was to (1) test
      accuracy and precision of pull-back versus rotational geometries for three
      dimensional volume determination, and (2) test accuracy of the resulting
      surface/volume rendered images. The endoscope shaft was inserted into a tube with
      the handle connected to a stepper device. Seventeen balloons (61 to 471 ml) were
      put into a water bath consecutively. Two scans were performed: (1) pull-back: the
      probe was withdraw in 1 mm steps to obtain parallel "breadloaf" slices, and (2)
      rotational: the probe was rotated in increments of 1.8 degrees, 3.6 degrees, or
      5.4 degrees to obtain "fan-like" slices. Each image was digitized for computer
      analysis. The data were interpolated into 128 x 128 x 128 voxels for three
      dimensional reconstruction. Volume measurement was done using a stereometric
      random marking method. Volumes obtained from the reconstructed images were
      compared with the true volume (weight) by linear regression analysis. Excellent
      correlation between measured and actual volumes was obtained from rotation scans
      as follows: for 1.8 degrees steps (r = 0.9987, SEE = 6.5 ml), for 3.6 degrees
      steps (r = 0.9959, SEE = 11.5 ml), and for 5.4 degrees steps (r = 0.9943, SEE =
      13.5 ml). The pull-back scans showed r = 0.9990, SEE = 5.8 ml. Three-dimensional
      surface/volume rendered images of the balloons indicate that 1.8 degrees rotation
      scans are almost as good as 1 mm pull-back scans. We conclude that volume
      measurements from rotation scans in vivo will not be hindered by scan geometry or
      software interpolation.

PMID- 1742036
TI  - Unruptured noncoronary sinus of Valsalva aneurysm: preoperative characterization
      by transesophageal echocardiography.
AB  - We describe a patient with a large unruptured sinus of Valsalva aneurysm that was
      discovered incidentally. Transesophageal echocardiography was used to
      characterize the aneurysm preoperatively, and was helpful intraoperatively in
      assessment of the degree of native aortic valvular regurgitation after repair.
      The use of transthoracic echocardiography, contrast echocardiography, Doppler
      echocardiography, and transesophageal echocardiography are discussed in this
      condition.

PMID- 1742037
TI  - Echocardiographic diagnosis of left ventricular pseudoaneurysm in a child after
      cardiopulmonary bypass.

PMID- 1742038
TI  - Multifaceted echocardiographic approach to the diagnosis of a ruptured sinus of
      Valsalva aneurysm.

PMID- 1742039
TI  - Pseudoaneurysm of the aortic root diagnosed by noninvasive imaging: report of a
      case.
AB  - Pseudoaneurysm of the aortic root is a rare condition typically diagnosed by the
      use of cardiac catheterization and aortography or by surgical exploration. This
      case describes a patient who was shown to have a pseudoaneurysm of the aortic
      root without evidence of any acquired etiologic factors other than
      atherosclerotic vascular disease. Two new advanced techniques of noninvasive
      imaging were used in confirming the diagnosis: transesophageal echocardiography
      and gated magnetic resonance imaging. This case highlights the value of
      techniques such as these to reliably assess the heart and great vessels without
      the need for more invasive procedures.

PMID- 1742040
TI  - Doppler flow velocity patterns of the superior vena cava, inferior vena cava,
      hepatic vein, coronary sinus, and atrial septal defect: a guide for the
      echocardiographer.
AB  - Pulsed-wave Doppler provides the echocardiographer the advantage of range
      resolution; confusion as to the source of Doppler shift information is unusual.
      One area of the heart that may lead to interpretive difficulties, however, is the
      right atrium because the right atrium receives blood flow from three venous
      sources and from the left atrium when an atrial septal defect is present. Our
      article presents information on the normal pulsed-wave Doppler spectral displays
      for the superior vena cava, inferior vena cava, hepatic vein, and coronary sinus.
      Because it is clinically pertinent, methods on how to differentiate these normal
      venous flow patterns from atrial septal defect flow will be emphasized.

PMID- 1742041
TI  - Transesophageal echocardiography: a sonographer's perspective.
AB  - Clinical transesophageal echocardiography is increasingly being applied for the
      evaluation of numerous functional and anatomic cardiac abnormalities. This new
      technology has opened an area of invasive ultrasonography that has changed and
      expanded the role of the cardiac sonographer. The sonographer is essential for
      the implementation and performance of this recent advance in echocardiography.

PMID- 1742042
TI  - Cardiac embryology: basic review and clinical correlations.

PMID- 1742043
TI  - Whistling face syndrome. A case report and literature review.
AB  - The cranio-carpo-tarsal or "whistling face" syndrome was first described by
      Freeman and Sheldon in 1938. More than 60 cases with great variability of
      expression are known till now and autosomal dominant as well as recessive
      inheritance and sporadic cases suggest a genetic heterogeneity. We review 60 well
      documented cases of the literature and present a patient with a severe form, who
      died of bronchopneumonia at the age of 9 months. The facial stigmata of his
      mother and the ulnar deviations of his maternal grandfather support the autosomal
      inheritance of the syndrome.

PMID- 1742044
TI  - Congenital hyperammonemia: symptomatic carrier girl patient and her asymptomatic
      heterozygous mother for ornithine transcarbamylase (OTC) deficiency: specific
      enzyme diagnostic and kinetic investigations for the detection of heterozygous
      genostatus.
AB  - Activities of the specific enzymes of the inherited hyperammonemic syndromes
      (carbamoyl-phosphate synthetase CPS), ornithine transcarbamylase (OTC), arginine
      succinate-synthetase (ASS), arginine-succinate-lyase (ASL) and arginase (ASE)
      were measured in a liver biopsy specimen of a 2 years-old girl suffering from
      chronic hyperammonemia and in the erythrocyte- and leukocyte-homogenisate of her
      parents. The activity of OTC in liver homogenisate of the patient was 62.9
      percent; in the leukocytes of the parents it was 78.5 percent (in mother) and 102
      per cent (in the father) as compared to the controls. Our patient proved to be a
      symptomatic carrier of OTC deficiency and her mother proved to be an asymptomatic
      carrier.

PMID- 1742045
TI  - High consanguinity rate in Hungarian gipsy communities.
AB  - Reproductive data of 1074 gipsy women between 13 and 52 years with one or more
      children were obtained by gipsy social workers through anonymous personal
      interview confirmed by available official documents. Socioeconomic status of five
      different gipsy communities studied is much lower than the Hungarian average.
      Their reproductive activity is also different, e.g., first births occur in much
      younger age. The high endogamy was proved by the gipsy origin of male partners in
      90% of couples. The occurrence of first cousin couples was 16 times higher than
      that of the Hungarian population at large, however, its range was wide from 0% to
      21% in different regions studied.

PMID- 1742046
TI  - Hyperlipemia and hyperlipoproteinemia [HLP] screening among the children from
      premature myocardial infarction risk families.
AB  - Serum lipids and lipoproteins were investigated in the premature myocardial
      infarction (PMI) risk families before 45 years of age with the aid of screening
      for hyperlipemia and hyperlipoproteinemia (HLP): in the case of 174 persons from
      Csongrad County from the Departments of Internal Medicine I and II and of 42
      patients (fathers) suffering from PMI and their 79 "high risk" children from
      Heves County. In the investigated three groups of "high risk" children the
      genetically determined antiatherogenic HDL-Ch level diminished in 34.8, 52.3,
      40.5 per cent. Significant negative correlation was detected between the serum
      HDL-Ch and beta-lipoprotein; significant positive correlations were found between
      the HDL-Ch and the serum lipase activity; between the beta-lipoprotein and the
      phospholipid level; significant negative correlation was proved between the HDL
      Ch and the phospholipid level in the group of PMI patients and their offsprings.
      The Ch/Tg, and the HDL-Ch ratios were significantly diminished in the PMI
      patients' group against the risk children' group, while the Ch/HDL-Ch rate was
      significantly elevated.

PMID- 1742047
TI  - The redistribution of the blood flow under nifedipine treatment in the sheep
      foetuses.
AB  - The Ca(++)-antagonist nifedipine has been successfully employed in the treatment
      of non-gravid hypertension, and was found to inhibit uterine contractions in the
      perimenstrual period, as well as during premature labour in animal models. The
      use of antihypertensive drugs in pregnancy introduces the possibility of
      iatrogenic foetal distress. It has been established that nifedipine crosses the
      placental barrier in the sheep and causes a fall in mean arterial pressure and
      tachycardia in both the ewe and the foetus. This paper examines the effects of
      nifedipine on the foetus when administered to the pregnant ewe. Catheters and
      electrodes were implanted by surgical procedures in 15 ewes and foetal lambs
      between days 118 and 122 of gestation. The redistribution of foetal blood flow
      was measured by the radioactive microsphere injection technique. The infusion of
      nifedipine caused a 9% increase in the combined ventricular output (CVO) from 446
      to 509 ml/min/kg in the foetus. Foetal lung blood flow increased from 29 +/- 6 to
      69 +/- 14 ml/min/kg while figures for the skeletal muscle flow were 109 +/- 34
      and 141 +/- 41.6 ml/min/kg. Heart and brain blood flow, expressed as percentages
      of CVO showed variations of 4.3 and 5.6 percent, respectively. Blood flow in the
      gut, placental membranes, skin, kidney and spleen was reduced. The present
      results show that nifedipine, in addition to its known effects causes a
      redistribution of the foetal circulation.

PMID- 1742048
TI  - Effects of prostaglandin E2 on the newborn respiratory system.
AB  - To test the hypothesis that prostaglandin (PG) E2 is a respiratory depressant in
      the newborn lamb, 12 chronically catheterized, unanesthetized lambs (age 2 to 6
      days) were infused with progressively increasing doses of PGE2 (0.1, 0.5, 1.0 and
      5.0 ug/kg/min: 30 min for each dose) into the ascending aorta. PGE2 caused
      significant, progressive decrease in ventilation (due to decreased tidal volume
      and breathing rate) heart rate, blood pressure and percent of the time spent in
      low voltage electrocortical activity (LVA). PGE2 also caused respiratory
      acidosis, hypoxemia and increased frequency and duration of apneic events
      (greater than 3 sec). During the infusion, there was a dose related increase in
      plasma concentration of PGE2. At 30 min post-infusion, all measured variables
      showed recovery, although arterial pH carbon dioxide tension and plasma PGE2
      remained significantly different from control values and the percent time in LVA
      was even higher than during control. Infusion of the vehicle alone (n = 5) caused
      no significant changes in any of the measured variables. The results, taken in
      combination with previous fetal studies, indicate that PGE2 has marked inhibitory
      effects on breathing movements both before and after birth.

PMID- 1742049
TI  - Erythrocyte damage in newborn babies caused by hyperbilirubinaemia and hypoxia.
AB  - Erythrocyte damage of newborn babies suffering from hyperbilirubinaemia and
      hypoxia was compared with a control group. In the cases of serum bilirubin level
      higher than physiological icterus lipid peroxidation of erythrocytes decreased
      probably due to the antioxidant effect of bilirubin. Moreover, an increase in
      potassium and protein outflow from patients' red blood cells was observed
      indicating a membrane damage both in hyperbilirubinaemic and hypoxic groups.
      Superoxide dismutase activity of serum and erythrocytes did not show significant
      difference in patients compared with healthy newborns. However, the low serum
      coeruloplasmin level in the hypoxic group and the low serum transferrin level of
      babies both with hypoxia and hyperbilirubinaemia suggest an insufficient
      antioxidant defence against free radicals.

PMID- 1742050
TI  - An aetiological study on 6 to 14 years-old children with severe visual handicap
      in Hungary.
AB  - A population-based aetiological study was carried out on 6 to 14 years-old
      severely visually handicapped children in Hungary. Of the 547 recorded cases 491
      (90%) were included in the analysis. Eleven aetiological groups were separated:
      isolated cataracts (16.7%), congenital abnormalities of the eye (15.1%), high
      myopia +/- retinal detachment and other cases (13.4%), retinopathy of premature
      (11.0%), choroidoretinal degenerations (10.0%), syndromes (9.6%), nystagmus
      and/or hypermetropia (9.0%), isolated and complicated optic atrophy (6.7%),
      postnatal causes (4.9%), retinoblastoma (1.8%), prenatal causes (1.8%). A
      significantly higher rate of previous induced abortions was found in the group of
      retinopathy of premature. Perinatal damage syndrome and Mendelian monogenic
      defects are the two most common aetiological categories in the origin of severe
      visual handicaps in Hungary.

PMID- 1742051
TI  - In vitro effect of antitumor drugs on lymphocytic blastogenesis in childhood
      acute lymphoblastic leukemia (ALL) and non-Hodgkin's lymphoma (NHL).
AB  - "In vitro" sensitivity of lectin (PHA, Con A)-stimulated lymphocytes to antitumor
      drugs (ARA-C, ADR, VM26, MTX, CP, VCR, Vepesid, ACLA) and the clinical efficiency
      of the complex therapy was compared in 7 patients with ALL and 2 patients with
      NHL. H3-thymidin incorporation of lymphocytes labelled prior to the drug exposure
      was used as "in vitro" method. A fairly good correlation was found between the
      "in vitro" test and the clinical response to the drug administered. These results
      suggest that this "in vitro" test is useful in choosing the drugs to be
      administered in case of malignancies of children.

PMID- 1742052
TI  - Preparation, sedation, and monitoring of the pediatric patient in the magnetic
      resonance suite.

PMID- 1742053
TI  - Magnetic resonance imaging of the infant brain.

PMID- 1742054
TI  - Magnetic resonance imaging of the pediatric spine.

PMID- 1742055
TI  - Magnetic resonance imaging of the pediatric thorax.

PMID- 1742056
TI  - Magnetic resonance imaging of the pediatric abdomen.
AB  - In many ways, MRI of the pediatric abdomen is in its infancy. Motion will be a
      problem with most of the current pulse sequences, but the problem appears
      manageable given many of the newer software options for motion suppression.
      Faster pulse sequences (approaching CT scan times) will serve to improve image
      quality and reduce the need for sedation. Identification of a reliable enteric
      contrast agent probably will expand the current utility of MRI beyond evaluation
      of solid abdominal viscera. Although preliminary results appear promising,
      controlled comparative studies are necessary to determine the exact role of MRI
      in diagnosis and staging of common pediatric abdominal malignancies. The addition
      of MRI intravenous contrast agents and MR spectroscopy are anticipated to add
      depth and specificity to the diagnostic potential of this exciting modality.

PMID- 1742057
TI  - Magnetic resonance imaging of the pediatric pelvis.

PMID- 1742058
TI  - Magnetic resonance imaging of the pediatric musculoskeletal system.

PMID- 1742059
TI  - [Endoscopic naso-sinus surgery. Technical aspects].
AB  - Perioperative, anaesthetic and special technical aspects of endoscopic surgery of
      the paranasal sinuses are presented, which helped to reduce intraoperative
      bleeding and consequently shortened the time of surgery. The realization of
      certain operative steps has helped to ease the postoperative care accelerating
      the healing process in more than 400 cases.

PMID- 1742060
TI  - [Multiple primary tumors in head and neck oncology].
AB  - After establishing the conditions for considering tumours to be of the second
      primary type, these are classified into groups based on the chronological
      relation among the different lesions. According to placement, we differentiate
      some specific locations, which confer special characteristics to each case. The
      case histories of a series of patients, suffering from multiple primary tumours,
      are presented, covering each of the categories of the preceding classifications
      by typical clinical cases. Finally, a discussion is undertaken of the conceptual,
      diagnostic and therapeutic peculiarities which make these patients all too often
      difficult to interpret.

PMID- 1742061
TI  - [Topographic and cytoarchitectonics analysis of the vestibular complex in rats].
AB  - The limits of the vestibular nuclei and accessory groups were analyzed in 7 rats.
      This information was taken using camera lucida drawings of the vestibular nuclei
      and their neurons in serial sections. The study of the morphometric parameters of
      the neurons (area and maximum diameter) were accomplished by means of a program
      for image analysis. The cells of the superior nucleus had an area and maximum
      diameter of 302.05 microns2 and 24.05 microns, those of the medial nucleus 222.98
      microns2 and 20.49 microns, those of the lateral nucleus 609.94 microns2 and
      34.21 microns, and the descending nucleus cells 327.55 microns2 and 25.24
      microns. The cellular parameters of the associated groups were also studied and
      the distribution of them in several intervals was established.

PMID- 1742062
TI  - [Horizontal supraglottic laryngectomy. A study of 83 cases].
AB  - We present the results obtained in 83 patients with supraglottic laryngeal
      carcinoma treated by supraglottic laryngectomy. We studied the results,
      complications and the survival of these patients treated with this conservative
      surgery. We concluded that this surgical technique improved the survival rates in
      supraglottic carcinomas.

PMID- 1742063
TI  - [Use of morphophotometry in the study of the kinetics of cell populations in
      laryngeal epidermoid carcinoma].
AB  - The use of morpho-photometric techniques in anatomopathology is, on the whole,
      not very frequent at the moment. In this study the authors show the possible
      applications of these quantitative methods for the evaluation of kinetics
      characteristics of cell population in epidermoid carcinomas of the larynx.

PMID- 1742064
TI  - [Physical separation of the populations of cochlear and vestibular efferent
      somas. A study using horseradish peroxidase].
AB  - We have physically separated cochlear and vestibular end organs, and after
      injecting horseradish peroxidase two different populations of efferent somas have
      been described belonging to the cochlea and vestibule.

PMID- 1742065
TI  - [Mastoid osteoma].
AB  - Extra-canalicular osteomas of the temporal bones are rare benign tumours. We
      report a retroauricular osteoma in a 18 years old patient. Usually symptomless,
      they may present for cosmetic reasons. We briefly comment this type of tumours.

PMID- 1742066
TI  - [Craniopharyngioma of the nasopharynx. Apropos of a case].
AB  - A case report of a nine year-old child with a basal skull and nasopharynx
      craniopharyngioma, whose initial manifestation was nasal respiratory
      insufficiency and ophthalmologic pathology, is presented. The diagnosis was
      possible due to some Departments collaboration by excellent images of CT and MR
      and confirmed histopathologically after its total excision performed by U. Fisch
      type C infratemporal approach, which is used for nasopharyngeal carcinomas and
      juvenile angiofibromas.

PMID- 1742067
TI  - [Extramedullary plasmocytoma of the nasopharynx].
AB  - A case of extramedullary plasmacytoma sited in the nasopharynx in a 25 years old
      women is presented. The first symptomatology was otology; no evidence of
      plasmocytoma after clinical study were found in another site. We also do a
      revision of diagnostic and therapeutic management. We ind this case interesting
      because his site of origin and the patient's sex.

PMID- 1742068
TI  - [Solitary extramedullary plasmocytoma of the nasal cavity].
AB  - A case of Extramedullary Plasmacytoma of nasopharynx is reported in a 41 years
      old man. The presenting symptom was bilateral nasal obstruction. Multiple Myeloma
      was excluded. The treatment was surgical excision and postsurgical radiotherapy.
      At present the patient is well.

PMID- 1742069
TI  - [Warthin's tumor: clinical aspects and a cytological study using fine-needle
      puncture-aspiration in 16 cases].
AB  - The clinical and fine-needle cytologic findings of 16 Warthin's tumors (papillary
      cystadenoma lymphomatosum) are presented. They were studied during a period of 38
      months, between February 1987 and April 1990. A preoperative diagnosis of
      "Warthin's tumor" was made in 13 cases (80%); 3 cases were diagnosed as non
      neoplastic benign lesions (2 retention cysts and 1 chronic sialoadenitis). 10
      cases were surgically excised and preoperative diagnosis was histologically
      confirmed. We compare the cytologic findings of our cases with the literature
      ones.

PMID- 1742070
TI  - [Pharyngo-laryngeal spindle cell carcinoma].
AB  - Spindle cell carcinoma, a relatively uncommon neoplasia in the
      otorhinolaryngologic field has a benign polypoid appearance, and often results in
      diagnostic and therapeutic difficulties. A review of the published literature,
      and of all of the eight cases we have had in our department has been made, with
      special attention-being pad to anatomopathologic diagnosis, treatment and
      prognosis. To sum up, it represents a malignant neoplasia epithelial in origin
      and of a difficult clinical and pathological diagnosis, which would be more
      adequately treated by surgical exeresis. It has a worse prognosis than epidermoid
      carcinoma which is common in this part of the throat.

PMID- 1742071
TI  - [Undifferentiated carcinoma of the ear: apropos of a case].
AB  - A case report of ear undifferentiated squamous cell carcinoma is presented. The
      patient complained pain and suppurative ear, which lead to us to practise an
      exploratory atticotomy, and therefore the tumor was detected on its early stages.
      It is a very interesting case report due to its unusual localization, and to the
      early diagnosis to improve the prognosis of these patients.

PMID- 1742072
TI  - [Hemangiopericytoma of the maxillary sinus: apropos of a case].
AB  - Haemangiopericytoma is a rare vascular tumour arising from the proliferation of
      pericytes which are cells surrounding the capillaries. Since 1949 only 54 cases
      of haemangiopericytomas of the nose and paranasal sinuses have been reported in
      the literature. Of the latter, only 8 cases originated from the maxillary sinus.
      We report a further case originated from the maxillary sinus.

PMID- 1742073
TI  - Value of HIV transmembrane glycoprotein oligomers as target antigens in early
      detection of anti-env antibodies.

PMID- 1742074
TI  - Cross-neutralizing antibodies in rabbits immunized with HIV-1 gp160 purified from
      simian cells infected with a recombinant vaccinia virus.
AB  - A recombinant vaccinia virus in which the transcription of the human
      immunodeficiency virus type 1 (BRU isolate) env gene is driven by the 11K late
      vaccinia promoter yields about 10-fold higher amounts of gp160 env protein upon
      infection of monkey cells than does a recombinant in which gp160 is expressed
      using the 7.5K early-late promoter. The gp160 was purified from detergent lysates
      of infected cells by lentil lectin affinity chromatography followed by
      immunoaffinity chromatography, and was obtained in yields of 1-2 mg/10(9) cells
      of material estimated to be about 70% pure. Pairs of rabbits were immunized with
      purified gp160 using either one of five different adjuvants or an
      immunostimulating complex. In all cases a substantial humoral immune response was
      obtained after boosting, including an activity that neutralized the homologous
      (BRU) isolate of HIV-1. In some cases, this activity also neutralized two
      distantly related isolates, SF2 and MN.

PMID- 1742075
TI  - Initial stages of HIV-1 envelope glycoprotein-mediated cell fusion monitored by a
      new assay based on redistribution of fluorescent dyes.
AB  - Membrane fusion is an essential step in the infection of permissive cells with
      human immunodeficiency virus (HIV). Infected cells frequently fuse with each
      other, and then progress to form multinucleated giant cells (syncytia). To gain
      insight into mechanisms of HIV env-mediated membrane fusion, we developed a new
      assay for studying the initial events. The assay is based on the redistribution
      of fluorescent markers between membranes and cytoplasm of adjacent cells examined
      by means of fluorescence video microscopy. Membrane fusion between HIV-1 envelope
      glycoprotein (gp120/41) expressing effector cells and CD4+ target cells was
      observed 90 min after the association of cells, whereas the first syncytia only
      became apparent after 5 h. Moreover, membrane fusion events were observed under
      conditions where no syncytia were detected, for example, when the effector:target
      cell ratio was greater than 100:1, or less than 1:100. A significant number of
      cells with fused membranes were not involved in the syncytia. In order to
      determine whether quantitative differences in receptor expression might influence
      the extent of membrane fusion, we used laboratory-selected variants of CEM cells
      that differ in their expression of CD4. We found that CD4 is required on the
      target membrane for HIV env-mediated membrane fusion, but its extent is only
      partially dependent on CD4 surface concentration. The ability of those CEM
      variants to take part in HIV env-mediated membrane fusion did not correlate with
      their capacity to form syncytia. These findings indicate that additional steps
      are needed to form syncytia after membrane fusion.

PMID- 1742076
TI  - Cellular and antibody responses directed against the HIV-1 principal neutralizing
      domain in HIV-1-infected children.
AB  - The principal neutralizing domain (PND) for antibody response is located within
      the V3 variable region of gp120 and can also stimulate T-cell responses. In some
      adults infected with human immunodeficiency virus (HIV) an HIV-1-specific T-cell
      response can be detected by demonstrating in vitro proliferation to HIV-1
      proteins and peptides. In other HIV-1 infected adults an HIV-1-specific T-cell
      response can involve interleukin 2 (IL-2) secretion in the absence of T-cell
      proliferation. To elucidate the T-cell responses to PND in children, we examined
      the proliferative and the IL-2 secretory responses of peripheral blood
      lymphocytes from 19 HIV-1-infected children toward a peptide which contained a
      highly conserved sequence of the principal neutralizing domain of HIVMN (PND-MN).
      Stimulation with PND-MN induced proliferation of lymphocytes from 2 of the
      children and IL-2 secretion by lymphocytes from 5 of the children. In a 3-month
      old infant, the in vitro cellular response to the PND-MN indicated HIV-1
      infection prior to the detection p24 antigen in her serum. Although antibodies
      directed against PND-MN were detected in all but one of the children examined,
      the presence of high-affinity/avidity antibodies to the PND-MN correlated with
      the presence of a cellular response to PND-MN. Thus, in HIV-1-infected children
      an HIV-1 specific T-cell response in the absence of a proliferative response can
      be assessed by determination of the IL-2 secretory response and correlates with
      the generation of high-affinity/avidity antibodies.

PMID- 1742077
TI  - Characterization of IgG and IgG subclass antibodies present in paired maternal
      and fetal serum which are directed against HIV-1 proteins.
AB  - Passive immunity is conferred to the fetus by maternal antibodies, the majority
      of which are transported across the placenta during the third trimester of
      pregnancy. To determine the placental transport of anti-HIV-1 antibodies, serum
      from 5 women infected with human immunodeficiency virus (HIV) and their abortuses
      were examined for anti-HIV-1 antibodies. The gestational age of the abortuses
      ranged from 18 to 24 weeks and following polymerase chain reaction amplification,
      HIV-1 gag DNA was detected in tissue from 2 of the abortuses. The concentration
      of total IgG antibodies present in cord blood ranged from 2.9% to 12.5% of
      maternal levels. Antibodies directed against the envelope proteins, gp160 and
      gp120, the reverse transcriptase protein, p66, and the capsular protein, p24,
      were present in fetal and maternal serum. Although IgG1 was the predominant
      subclass antibody generated in response to HIV-1 proteins, IgG2, IgG3, and IgG4
      directed against HIV-1 proteins were also detected. There were large differences
      in the antigens recognized by the antibodies produced in the mothers, and the IgG
      subclasses of the antibodies produced. HIV-1 proteins recognized by antibodies
      present in cord blood were similar to those recognized by paired maternal serum
      and IgG1, IgG2, IgG3 recognizing HIV-1 proteins were detected in fetal serum.
      However, there was a dichotomy in placental transport of IgG subclass antibodies
      to HIV-1 proteins. The role of these antibodies in prevention of vertical
      transmission of HIV-1 has yet to be determined.

PMID- 1742078
TI  - Human astrocytes stimulate HIV-1 expression in a chronically infected promonocyte
      clone via interleukin-6.
AB  - Human promonocyte cells chronically infected with human immunodeficiency virus
      type (HIV-1) (clone U1.1.5) were grown in the presence of media conditioned by
      human astrocytes and glioma cell lines U251 and 253. HIV-1 expression was
      assessed by measuring reverse transcriptase activity. All media conditioned by
      unstimulated and lipopolysaccharide (LPS) stimulated glial cells induced HIV-1
      expression and contained detectable levels of interleukin-6 (IL-6) but not tumor
      necrosis factor-alpha (TNF-alpha). An antibody against IL-6, but not against TNF
      alpha, reduced the induction of HIV-1 by the conditioned media in a concentration
      dependent manner. The magnitude of HIV-1 induction by the conditioned media was
      proportional to the concentration of IL-6 in them. The data indicate that normal
      and transformed human astrocytes are capable of stimulating HIV-1 expression in
      chronically infected promonocytic cells by secreting IL-6. The results
      demonstrate that cytokines secreted by neural cells could play an important role
      in regulating HIV-1 expression in the brain.

PMID- 1742079
TI  - Ultraviolet radiation increases HIV-long terminal repeat-directed expression in
      transgenic mice.
AB  - Previously described FVB/N mice harboring a human immunodeficiency virus (HIV)
      long terminal repeat (LTR)/chloramphenicol acetyl transferase (CAT) transgene
      were treated with varying amounts of 254 nm UV-C radiation or 312 nm UV-B
      radiation. At optimal exposure periods, a 20-fold increase in HIV-LTR-directed
      expression was observed in ear specimens collected 24 h following UV-C exposure;
      a fourfold increase in expression was induced by UV-B exposure. Investigation of
      the kinetics of UV-C induction in vivo revealed that LTR-directed gene expression
      began to increase 2 hours after exposure and reached a maximum on Day 3 following
      exposure (greater than 30-fold induction). In experiments examining the kinetics
      of UV-B activation, the maximum level of CAT activity in the ears of irradiated
      transgenic animals was fivefold above levels in unirradiated transgenic controls
      (Day 5). Furthermore, CAT activity was not induced in fur-bearing skin following
      UV exposure; however, a fourfold increase in HIV-LTR-directed expression could be
      elicited when hair was removed by shaving prior to UV-B treatment.

PMID- 1742080
TI  - Cell-mediated infection of human placental trophoblast with HIV in vitro.
AB  - In order to investigate how human immunodeficiency virus (HIV) gains entry to the
      placenta, we have performed in vitro experiments in which highly purified
      trophoblast cells isolated from term human placentas were examined for their
      susceptibility to HIV infection. Trophoblast cells were exposed to cell-free HIV
      1 for up to 24 h, after which the cultures were monitored by p24 antigen capture
      assay, reverse transcriptase assay, and electron microscopy for evidence of virus
      uptake and replication. None was found. In the second series of experiments,
      trophoblast cells were cocultured with HIV-infected MOLT-4 cells for 24 h,
      stained using an anti-HIV antibody, and examined by immunofluorescence
      microscopy. The MOLT cells were strongly positive, as expected, but many
      trophoblast colonies also showed a punctate staining pattern. Examination of
      similar cultures using the electron microscope revealed MOLT cells adherent to
      trophoblast but no evidence of cell-cell fusion. Virions were observed in coated
      pits at the trophoblast cell surface and in endosomes or multivesicular bodies in
      the cytoplasm. These observations are consistent with an endocytosis-mediated
      mechanism of virus entry. Virions were also observed budding from the trophoblast
      plasma membrane, indicating that these cells can support HIV replication. To our
      knowledge, these results show for the first time that HIV can infect placental
      trophoblast cells in vitro. The results suggest that the placenta could become
      infected with HIV by the interaction of virus-infected maternal lymphocytes with
      syncytiotrophoblast bordering the maternal blood in the intervillous space.

PMID- 1742081
TI  - Soluble CD4-PE40 is cytotoxic for a transfected mammalian cell line stably
      expressing the envelope protein of human immunodeficiency virus (HIV-1), and
      cytotoxicity is variably inhibited by the sera of HIV-1-infected patients.
AB  - Sera were obtained from 50 individuals infected with human immunodeficiency virus
      type 1 or from HIV-1-uninfected individuals before or after vaccination with
      recombinant gp160. These sera were evaluated for activity antagonistic to the
      cell-killing activity of the chimeric Pseudomonas exotoxin hybrid protein, sCD4
      PE40. For these studies, Chinese hamster ovary (CHO) cells were transfected with
      a chimeric plasmid encoding the tat, rev, and envelope genes of HIV-1 and a cell
      line was selected for stable expression of the envelope glycoproteins at the cell
      surface (CHO-env). Cytotoxicity of sCD4-PE40 for CHO-env in the presence or
      absence of added human serum was quantitated spectrophometrically following
      enzymatic reduction of a tetrazolium bromide within the mitochondria of viable
      cells (MTT assay). Several HIV+ sera inhibited the cytotoxic activity of sCD4
      PE40; the antagonist had properties consistent with those of immunoglobulins in
      that it was heat stable, absorbed by protein A, and reversible by increasing the
      concentration of sCD4-PE40. Of 15 HIV+ sera which strongly reacted with gp120, 11
      (73%) also potently inhibited sCD4-PE40 cytotoxicity, and cytotoxicity was
      inhibited by sera from some HIV- individuals after, but not before, immunization
      with gp160. These data suggested a role for antibody to gp120 in the antagonistic
      activity. However, not all sera with antibody to gp120 antagonized sCD4-PE40
      cytotoxicity and high levels of antagonist activity were frequently (40%) found
      in HIV+ sera lacking immunoblot-detectable antibody to gp120, or antibody to
      either CD4 or PE40. Grouping of the HIV+ sera according to the patients' absolute
      number of CD4+ cells revealed that the degree of inhibition of sCD4-PE40
      cytotoxicity approached a Gaussian distribution, suggesting that persons with
      CD4+ cell counts between 200 and 700/mm3 may be more likely to possess
      significant levels of serum antagonist. This data have implications for the
      clinical development of sCD4-PE40 or other sCD4-based therapeutics in the
      management of HIV-1 infection.

PMID- 1742082
TI  - Intracellular metabolism of 3'-azidothymidine in isolated human peripheral blood
      mononuclear cells.
AB  - Azidothymidine (AZT) inhibits the replication of human immunodeficiency virus and
      it is the only drug so far licensed for treatment of acquired immunodeficiency
      syndrome (AIDS). A prerequisite for its antiviral activity is phosphorylation by
      cellular nucleoside kinases to the mono-, di-, and triphosphate levels. This
      study determined the capacity of isolated peripheral blood mononuclear cells
      (PBMC), resting or mitogen stimulated, from 36 different people of whom 5 were
      HIV+, to phosphorylate and accumulate intracellular AZT nucleotides. We found a
      large variation in the amount of products formed between PBMC treated at
      different times from the same individual as well as between the PBMC from
      different individuals. Resting PBMC showed the largest interindividual variation
      and their levels of AZT nucleotides were about 60-150-fold lower than in
      activated PBMC. The intracellular half lives of azidothymidine mono-, di-, and
      triphosphates, constituting, on the average, 96-99.2, 0.7-1.8, and 0.4-2.7% of
      total nucleotides at 0.08-1.6 microM AZT, respectively, were also determined. In
      mitogen-stimulated PBMC it was approximately 2.5 +/- 0.6 h for all the
      azidothymidine metabolites. The half-life for intracellular azidothymidine
      monophosphate in resting PBMC from two individuals was determined to 1.5 +/- 0.2
      h. There appeared to be no significant difference in the AZT metabolism in PBMC
      from HIV-positive or-negative persons. A relative decrease in the intracellular
      formation of AZTDP and AZTTP from AZTMP was observed at concentrations of AZTMP
      above 1 microM. This fact may explain why lowering the doses of AZT still gives
      therapeutically efficient levels of the active metabolite AZTTP.

PMID- 1742083
TI  - Changes in lipid composition of human peripheral blood lymphocytes infected by
      HIV.
AB  - The possible differences in lipid composition between human immunodeficiency
      virus- (HIV) infected and uninfected PHA-activated human peripheral blood
      mononuclear cells (PBMC) have been studied. The total fatty acid composition was
      similar, except for the proportion of arachidonic acid, that was slightly higher
      in infected than in noninfected cells. No significant differences were obtained
      in the incorporation of radiolabeled stearic or oleic acids in the different
      lipid classes. The staining of cells with Nile Red showed similar amounts of
      intracytoplasmic lipid droplets. On the contrary, the CH/PL ratio, the major
      factor in determining cell membrane fluidity, was clearly higher in infected than
      in uninfected cells (0.60 and 0.36, respectively). This fact is discussed in
      relation with the known high CH/PL ratio (0.95) of the lipid envelope of HIV.

PMID- 1742084
TI  - Selective stimulation of CD4+ versus CD8+ T-cell subsets in symptomatic and
      asymptomatic HIV-1-infected individuals.
AB  - To analyze the proliferative capacity of CD4+ or CD8+ T-cell subsets of
      individuals infected with human immunodeficiency virus type 1 (HIV-1) and to
      optimize the in vitro conditions for virus replication, CD4+ or CD8+ cells of HIV
      1-infected patients were selectively activated inside the whole peripheral blood
      mononuclear cell (PMNC) population by dual antibody stimulation. To do so PMNC of
      HIV-1-infected individuals were stimulated with the per se nonmitogenic anti-CD3
      antibody fragment BMA030 F(ab)2 crosslinked through goat antimouse antibodies
      with an anti-CD4 or an anti-CD8 antibody, which lead to selective proliferation
      of either the CD4+ or the CD8+ T-cell subset. In the presence of monocyte
      supernatant and recombinant interleukin-2 (rIL2) CD4+ cells of HIV-1 patients
      responded normally upon such stimulation as their proliferation correlated (r =
      0.9) to the percentage CD4+ cells present in the PMNC population. Selective
      stimulation and proliferation of CD8+ cells could, however, only partially be
      elicited by dual antibody stimulation, even in the presence of rIL-2 and monocyte
      supernatant. Their proliferative response did not correspond (r = 0.1) to the
      percentage CD8+ cells present in the PMNC culture. A positive correlation (r =
      0.7) was detected only between percentage CD8+ HLA-DR- cells and proliferation.
      This confirmed previous studies showing that the defective in vitro proliferative
      response of peripheral blood lymphocytes of HIV-infected individuals to mitogens,
      which is usually interpreted being due to a CD4 cell defect, is actually due to a
      failure of CD8+DR+ cells to proliferate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742085
TI  - Lymphoproliferative responses to mitogen and antigen in HIV-infected children.
AB  - We endeavored to study lymphoproliferative responses in children with human
      immunodeficiency virus (HIV) infection and to compare them with normal control
      children. Children were grouped according to age; 6-18 months and greater than 18
      months, and according to CDC classification: asymptomatic (P1), mildly
      symptomatic (P2A), and advanced symptoms (P2D). Absolute CD4 and CD8 numbers were
      compared and found to be higher in the younger age groups. The children in P1 and
      P2A classes demonstrated an increase in CD8+ cells; only the children with AIDS
      showed a significant decrease in CD4+ cells. Lymphoproliferative responses to
      phytohemagglutinin A (PHA) were compared to tetanus toxoid. Only the children
      with acquired immunodeficiency syndrome (AIDS) (P2D) in the older group and only
      the symptomatic children (P2A and P2D) in the younger group showed a significant
      decrease in proliferative responses to PHA. All classes of infected children
      demonstrated a significant decrease in response to tetanus toxoid. We have been
      able to demonstrate a loss of antigen responsiveness which precedes the loss of
      mitogenic responsiveness. Furthermore, we have been able to demonstrate an age
      related increase in lymphoproliferative responses to both PHA and tetanus in HIV
      infected and control children. Therefore, we conclude that children are
      particularly susceptible to the immunologic effects of HIV infection. Loss of
      lymphoproliferative responses to antigen occurs early in infected children and
      precedes the loss of CD4+ helper cells and of PHA responsiveness. This increased
      susceptibility to the immunopathogenesis of HIV infection is due, at least in
      part, to the relative immunodeficiency of infancy.

PMID- 1742086
TI  - Enzyme immunoassay for detection of hybrids between PCR-amplified HIV-1 DNA and a
      RNA probe: PCR-EIA.

PMID- 1742087
TI  - [Cerebral infarction and chronic cerebral circulatory insufficiency].

PMID- 1742088
TI  - [MRI in patients with cerebral infarct and chronic cerebral circulation
      insufficiency].

PMID- 1742089
TI  - [Issues concerning diagnosis of lacunar stroke and RIND].

PMID- 1742090
TI  - [Cerebral blood flow in cerebral arteriosclerosis and cerebral infarction].

PMID- 1742091
TI  - [Intrathecal distribution of ACNU by various modes of its administration analyzed
      by HPLC and autoradiography].
AB  - Various modes of administration of ACNU (nimustine hydrochloride) were tried to
      make clear which mode is the best method to obtain intrathecal diffuse
      distribution of ACNU to match the condition of killing of glioma cells (10
      micrograms/ml; greater than 30 min.). Tried modes of administration included
      1)bolus injection into ventricular cavity, 2)bolus injection into cisterna magna,
      3)bolus injection into lumbar subarachnoid space, 4)ventriculo-lumbar perfusion,
      5)chiasmatic cistern-lumbar perfusion. Used dose of ACNU was 5 mg/body for all
      modes of administration. ACNU level in CSF was measured by HPLC method specially
      developed by authors. To make clear intrathecal distribution of ACNU,
      autoradiography using 14C-ethylene-ACNU was studied after administration of 10
      muCi/Kg of radioactive ACNU. The images were studied by image analyzer system
      (BAS-2,000 system developed by Fuji Film Co. Ltd). Among the modes of
      administration tried, ventriculo-lumbar perfusion method gave the best results in
      terms of lumbar, ventricular, cisterna magna, and basal cistern distribution of
      ACNU to match the cell kill condition experimentally ascertained. Although, bolus
      injection of ACNU into cisterna magna gave sufficient amount of ACNU in lumbar
      region, the initial level of ACNU was too high in cisterna magna, and
      administration of ACNU once a week for three times in a canine cisterna magna
      resulted in considerable deterioration of brain stem and basal structure. In
      addition to it, the level of ACNU in ventricular cavity was not detectable.
      Lumbar bolus injection resulted in also too much ACNU accumulation at the
      injected lumbar area, and at the cisterna magna region, ACNU was not
      detectable.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742092
TI  - [Alterations in cytokinetics and heat shock protein (70 kDa) expression of glial
      cell by hyperthermia].
AB  - Expression of major heat shock and stress-induced protein, HSP70, is known to be
      under complex regulation in tumor cells. In this study, we investigated the
      alternations of cytokinetics and HSP70 expression by hyperthermia in the in vitro
      experimental systems, using two rat glioma cell lines, two human glioblastoma
      cell lines and rat glioblast cells. For hyperthermal treatment the flasks were
      placed in water baths warmed up at 41 -45 degrees C for 15 min. To determine the
      effect of hyperthermia on the cell cycle progression, the changes in the DNA
      distribution of the cell population were studied by flow cytometry (FCM). The
      levels of HSP70 protein were determined by immunoblot analysis. The relationship
      between cell cycle and HSP70 expression was investigated by FCM using PI and FITC
      labelled HSP70 double staining technique. These results were as follows: 1)
      Compared with the control, hyperthermic treatment at 42 degrees C or 44 degrees C
      caused both 354A and T98G cells to accumulate in S phase 18 hours after treatment
      and G2/M phase after 6-18 hours. 2) Hyperthermic treatment at 42 degrees C caused
      C6 cells to accumulate in S phase 6 hours after treatment, whereas heat treatment
      at 44 degrees C caused C6 cells to accumulate in S phase after 18 hours and G2/M
      phase after 6 hours. 3) A172 cells were accumulated only in G2/M phase by
      hyperthermia. 4) Glioblast cells did not show the alterations of cytokinetics by
      heat treatment remarkably. 5) HSP70 protein synthesis were enhanced under
      hyperthermic conditions in all type of cells, whether primary glioblast or
      permanent glioma cell lines.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742093
TI  - [Visual impairment complicated with meningioma].
AB  - Among 106 patients of meningioma surgically experienced the past 10 years between
      1981 and 1990, twelve of meningioma with progressive visual impairment were
      analyzed in relation to postoperative visual outcome. There were four males and
      eight females, and the age ranged from 33 to 61 years with the average 48 years.
      The distribution of tumor location was 6 cases in tuberculum sellae, 3 cases in
      the inner side of sphenoid ridge, and 3 cases in olfactory groove. The size of
      tumor in each case was 2 to 7 cm in diameter, and in 8 cases more than 3 cm. The
      duration of visual disturbance was between 3 months and 10 years with the average
      3 years. For all cases, surgical removal of the tumor was performed totally by
      pterional and bifrontal approach. Consequently, 58.3% of 7 cases had improved
      vision postoperatively, 16.7% of 2 cases remained unchanged, and 25.0% of 3 cases
      were worse, including one case of malignant meningioma, Visual outcome was mainly
      affected by a duration of symptoms, a tumor size, a preoperative visual
      impairment, and in special, a situation of optic nerve where compression of tumor
      itself and adherence to the surrounding tissues took place. On operation, great
      care should be paid for a case of long-standing, severe visual disturbance as
      demonstrating hemianopsia with visual narrowing less than 50 degree by perimetry,
      and also for preservation of the feeding arteries of optic nerves.

PMID- 1742094
TI  - [An autopsy case of progressive supranuclear palsy with olivary hypertrophy].
AB  - Clinical and pathologic findings of an autopsy case of progressive supranuclear
      palsy (PSP) with a 7 year clinical course are described. The patient exhibited
      clinical findings of typical PSP, cerebellar signs and rhythmical myoclonus that
      was about 2 Hz and synchronous in the eyes, palate, and pharynx, which is so
      called palatal myoclonus. Pathological findings compatible with those in PSP i.e.
      loss of nerve cells, neurofibrillary tangles (NFT), and gliosis were found in the
      globus pallidum, thalamus, subthalamic nucleus, substantia nigra, locus
      coeruleus, nucleus of Raphe, reticular formation, dentate nucleus, and inferior
      olives. Nerve cells in the nucleus basalis were preserved. Distinctive findings
      included marked degeneration of the dentate nucleus, prominent hypertrophy of the
      inferior olives, and atrophy and subcortical gliosis of the frontal lobe.
      Hypertrophy of the inferior olives and palatal myoclonus represent an unusual
      PSP. It is presumed hypoxic injury unmasked the palatal myoclonus in this setting
      of dentate nucleus and inferior olivary complex degeneration.

PMID- 1742095
TI  - [Generalized choreic movement associated with subarachnoid hemorrhage].
AB  - A case of generalized choreic movement associated with subarachnoid hemorrhage is
      reported. A 71 year-old hypertensive woman suddenly developed severe headache 14
      days before admission. Consciousness disturbance and involuntary movement
      involving the face and upper extremities appeared about 8 days after onset. The
      involuntary motion was diagnosed as generalized choreic movement. CT scans showed
      subarachnoid hemorrhage with ventricular dilatation and periventricular lucency
      involving bilateral caudate nuclei. On admission the patient was stuporous with
      Hunt & Kosnik Grade 4. She showed involuntary choreic movement in both arms,
      trunk and face; hemiparenis and hyperreflexia were absent. An angiography
      revealed a right internal carotid-anterior choroidal artery aneurysm with
      vasospasm. After clipping the aneurysm in the following day, the consciousness
      disturbance and choreic movement gradually improved. By eight days after
      operation, the choreic movement completely disappeared. An MRI showed lacunar
      infarcts in the bilateral basal ganglia, predominantly in the caudate nuclei. In
      our case, the choreic movement is supposed to have been caused by impaired
      circulation in the bilateral corpora striata due to vasospasm and hydrocephalus
      after subarachnoid hemorrhage, in addition to the preexisting lacunar infarcts in
      the basal ganglia. This is claimed to be the first reported case of generalized
      choreic movement in associated with subarachnoid hemorrhage, which improved after
      surgery.

PMID- 1742096
TI  - [An evaluation of cerebral blood flow and metabolism of reconstructive vascular
      surgery using positron emission tomography--a report of 4 cases].
AB  - Changes in cerebral hemodynamics due to reconstructive cerebral vascular surgery
      were evaluated using positron emission tomography (PET). Three minor stroke cases
      and 1 TIA case, brought on by main trunk stenosis, were included. STA-MCA
      anastomoses was performed in two of the cases and carotid endarterectomy was
      performed in the remaining two cases. CBF, CBV, OEF, CMRO2 and CBF/CBV were
      investigated using PET with the ROIs fixed in both normal and stenosis areas. On
      the two cases of STA - MCA anastomosis, clear hemodynamic improvement was not
      demonstrated. On the two carotid endarterectomy cases, the hemodynamic factors
      showed improvement.

PMID- 1742097
TI  - [CT and 123I-IMP SPECT findings of head injuries with hyponatremia].
AB  - CT and SPECT findings were examined and the relationship between development of
      hyponatremia and lesions was studied in cases who developed hyponatremia
      following head injury. Six cases of hyponatremia after head injury in the last
      two years were used as the subjects. SPECT was performed by the 123I-IMP
      intravenous injection method using Tomomatic 64. Slice 2 of 4 to 6 cm on the OM
      line in the early image was used as the subject site. The data of development of
      hyponatremia was 5.8 patients days, duration 9.2 days, minimum serum Na level
      117.2 mEq/l and minimum plasma osmotic pressure 247.6 mOsm/lH2O. CT findings in
      the hyponatremic stage showed frontal subdural effusion in all the cases. SPECT
      findings revealed a decrease of CBF in the frontal region on both sides and in
      the central region. CBF in the central region also tended to improve at a time
      when hyponatremia improved. In hyponatremia after head injury, lesions are often
      found in the frontal region on CT, and CBF in the central region is also
      decreased bilaterally on SPECT, which is presumed to be concerned with the
      development of hyponatremia.

PMID- 1742098
TI  - Viorica Bergman.
AB  - Middle class, middle aged, female: I can hear the yawns already. This is not a
      description to conjure up the image of a forward-thinking, hard-working dentist
      with a wide portfolio outside her chosen profession. However, both descriptions
      apply to Viorica Bergman.

PMID- 1742099
TI  - Postgraduate qualifications for dentistry in the twenty-first century.
AB  - The publication by the General Dental Council of proposals for a specialist
      register brings into question the applicability of the postgraduate
      qualifications now available. The moves towards a collegiate home for general
      dental practitioners, and compulsory vocational training, are further reasons for
      contemplating radical change.

PMID- 1742100
TI  - 'Self-assessment manual of standards'.

PMID- 1742101
TI  - 'Maxillofacial surgery should become a specialty of medicine'.

PMID- 1742102
TI  - 'Orthodontic aspects of vocational training'.

PMID- 1742103
TI  - 'A denture of a lifetime'.

PMID- 1742104
TI  - Amalgam appendicitis.

PMID- 1742105
TI  - An urgent remedy needed.

PMID- 1742106
TI  - The clinical behaviour of free smooth surface carious lesions monitored over 2
      years in a group of Scottish children.
AB  - As far as the authors are aware, no large-scale clinical studies of free smooth
      surface caries have been carried out in the past, although carious lesions on
      these surfaces can be diagnosed at an 'early' stage. In this study on a group of
      2854 13-year-old children, caries affecting the free smooth surfaces (buccal and
      lingual) was found to be a common problem, with a total of 2917 lesions observed
      on molar teeth at the first examination. Most of the lesions involved no
      macroscopic loss of tooth contour. When the children were examined 2 years later,
      three-quarters of the lesions had either remained static or regressed. Free
      smooth surface lesions were more likely to develop initially, and more likely to
      progress, in individuals with poor oral hygiene. Free smooth surface caries
      experience showed a positive correlation with occlusal and approximal decay
      experience. The number of free smooth surface carious lesions can be used as a
      predictor of caries risk. Strategies for diagnosis and prevention are suggested
      for patients presenting with free smooth surface caries on molar teeth.

PMID- 1742107
TI  - The effect of residence and social class on dental caries experience in 15-16
      year-old children living in three towns (natural fluoride, adjusted fluoride and
      low fluoride) in the north east of England.
AB  - Caries experience in 1374 children aged 15-16 years from three towns in the north
      east of England with varying concentrations of fluoride in drinking water, was
      determined. The mean DMFT values for 15-year-old continuous residents was 1.7 in
      Hartlepool (natural F 1.0-1.3 ppm), 2.5 in Newcastle (F adjusted to 1.0 ppm) and
      3.3 in Middlesbrough (F = 0.2 ppm). Forty per cent of Hartlepool 15-year-olds
      were caries free, compared with 30% in Newcastle and 24% in Middlesbrough. Caries
      prevalence for both Hartlepool and Newcastle 'continuous residents' was lower
      than for non-continuous residents, whereas in Middlesbrough, the low fluoride
      area, non-continuous residents had a lower DMF value than those who had lived in
      Middlesbrough all their lives. There was a slight trend in both Newcastle and
      Middlesbrough for DMFT values to increase from social class I to social class V,
      but no discernable trend was observed in Hartlepool. The results for Hartlepool
      15-year-olds were very similar to those reported by Weaver in 1949.

PMID- 1742108
TI  - Sarcoid-type reaction associated with retained roots: an unusual cyst-like lesion
      of the jaw.
AB  - This report describes the unusual findings following curettage of a large cyst
      like lesion of the mandible in a 47-year-old woman. Histological examination of
      the lesional tissue revealed a sarcoid-type reaction, uncommon in the mandible,
      while further clinical and laboratory investigations failed to demonstrate
      underlying systemic disease.

PMID- 1742109
TI  - The autobiography of Dr Lilian Lindsay.
AB  - Unwillingly, Lilian Lindsay started to commit to paper the story of her
      professional life, although, sadly, this did not progress further than the early
      years of her distinguished career. Her autobiography, entrusted to one of us with
      her personal historical notes and manuscripts in 1950, is published here for the
      first time, with annotations (in italics) to clarify the text by adding
      biographical details of persons she mentions and commenting on places and events.
      For some 40 years Lilian studied the history of dentistry, publishing many
      important papers as well as a book, Short History of Dentistry, but perhaps her
      most important contribution to dental history is her translation of Fauchard's Le
      Chirurgien Dentiste.

PMID- 1742110
TI  - Dental care for the homeless over Christmas 1990.
AB  - Each year since 1970, the charity CRISIS has provided a place of warmth and
      shelter for the homeless of London (guests) over the Christmas period. In 1990
      they converted a large factory warehouse off the Old Kent Road and set it up to
      cook meals, provide beds, games, televisions, hairdressing, chiropody, medical
      and dental care--and information on housing, as well as general advice. Washing
      and cleaning facilities were provided in Portakabins parked in the yard outside
      the warehouse. Guests were provided with a complete change of clothing, which
      were altered to fit if necessary.

PMID- 1742111
TI  - What should dentists prescribe?
AB  - In recent months in Australia the, country's Association has been negotiating
      with the Federal Government over the rights of dentists to prescribe. The
      question is not the legal right to order a drug for a patient, but the
      entitlement of patients to a Government health scheme benefit for the dentist's
      prescription. The debate has, however, opened up broader questions. What is a
      reasonable extent of entitlement? What should a dentist be allowed to prescribe?

PMID- 1742112
TI  - After the contract ... which way now?
AB  - There can be little doubt that the treadmill of NHS dentistry has done little to
      improve standards, and one can only applaud those who are so actively seeking to
      do so. But, perhaps sometimes we should examine our motives. Why do we want to
      improve? We cannot all hope to provide the very best for everyone. There simply
      are not the funds or the dentists. Is it so that we can obtain more money, or
      greater job satisfaction, or to give the patient a better deal?

PMID- 1742113
TI  - Equipment malfunction.

PMID- 1742114
TI  - 'Decontamination of equipment, linen or other surfaces contaminated with
      hepatitis B and/or human immunodeficiency viruses'.

PMID- 1742115
TI  - 'HIV transmission via blood and saliva splashes to the face'.

PMID- 1742116
TI  - Computers in dentistry.

PMID- 1742117
TI  - Five-year longitudinal study of restorative treatment received by Scottish
      children.
AB  - This prospective 5-year longitudinal study followed the dental care of a large,
      representative group of children initially examined in Scotland during the 1983
      UK survey of children's dental health. The Dental Health Services Research Unit
      at the University of Dundee monitored the restorative treatment provided in the
      General Dental Service and the Community Dental Service for 1568 children aged 5,
      8, 12 and 15 years in 1983, using information provided via the Scottish National
      Health Service. Over a 5-year period, records of attendance were received for 85%
      of the children (1340). A large amount of restorative care, distributed very
      unevenly across the sample, was provided. On average, attenders attended once per
      year (range over 5 years: 1-20) and received approximately one filling in each of
      the 5 years (range over 5 years: 0-58). The majority of restorative care (80.6%
      of the 8057 restorations) comprised amalgam fillings in posterior teeth,
      frequently (89%) involving the occlusal surface. This pattern of treatment has
      implications for planning cost-effective preventive care. Factors shown to have a
      significant influence on the number of amalgam fillings placed were initial
      caries prevalence, number of courses of treatment, age group and service.

PMID- 1742118
TI  - An analysis of the effects of place of childhood, undergraduate and postgraduate
      education upon the regional distribution of specialist orthodontic practitioners.
AB  - In 1989, a survey of specialist orthodontic practitioners was carried out.
      Questionnaires were sent to all members of the British Association of
      Orthodontists who were engaged in full-time specialist practice. This yielded a
      response rate of 72%. One part of the questionnaire was directed towards details
      concerned with the practitioner's place of childhood, undergraduate and
      postgraduate education. The regions in the UK were grouped into two large areas
      of the 'north' and the 'south'. It was evident that most of the practitioners had
      received their orthodontic training in the 'south' of England and were employed
      within the same region. Detailed data analysis was carried out using the Mantel
      Haenszel chi-squared test. This revealed that there was a strong association
      between the place of postgraduate orthodontic training and place of employment of
      the specialist practitioner (chi 2 = 48.6, P less than 0.00001). The data suggest
      that one method of reducing the present unequal distribution of the specialist
      orthodontic practitioner would be to increase the number of postgraduate training
      places in those regions with low levels of orthodontic manpower.

PMID- 1742119
TI  - Surgical emphysema of the mediastinum as a consequence of attempted extraction of
      a third molar tooth using an air turbine drill.
AB  - The use of air turbines for the removal of bone or the division of teeth is to be
      deprecated. Surgical emphysema of the neck and mediastinum as a direct result of
      the inappropriate use of an air turbine drill to remove an impacted third molar
      tooth may result in potentially life threatening complications.

PMID- 1742120
TI  - A primary double molar tooth in a child with Russell-Silver syndrome.
AB  - The prevalence of double teeth in the primary dentition, for the British
      schoolchild, is 1.6%. Although primary double teeth in the anterior region of the
      mouth are not uncommon, double teeth in the primary molar region are rare. This
      case report describes the intra-oral findings, and in particular a case of a
      primary molar double tooth, in a young child who has Russel-Silver syndrome.

PMID- 1742121
TI  - Applications of confocal scanning optical microscopy to dentistry.
AB  - Confocal optical microscopy is now a well recognised technique in the fields of
      biological and materials science. This type of light microscope can be considered
      as being midway between optical and electron microscopy. Confocal or scanning
      optical microscopes can make high resolution, thin, optical sections within
      semitransparent samples such as biological tissues. Surface images of samples can
      be produced which are similar in character to those of the SEM, but without many
      of the problems of specimen preparation. The improved resolution and removal of
      out-of-focus blur allows much more information to be gained from fluorescence
      microscopy techniques, with the images capable of 3-D reconstruction of the
      sample. There are basically two types of confocal optical microscope: the laser
      scanning type (CLSM) and the real-time direct view of tandem scanning microscopes
      (TSM). The former are best suited to immunofluorescence microscopy, whilst the
      latter are more appropriate for high-speed reflection imaging, having originally
      been developed for in vivo microscopy.

PMID- 1742122
TI  - First steps in audit.
AB  - The results of two audit projects carried out in a District Orthodontic Unit are
      described. Although prospective data collection was the goal, it was found that
      this method yielded little information as the data collection forms were poorly
      filled in. The main problem was a lack of definition of terms and inadequate
      discussion between clinical and clerical staff. A retrospective audit using five
      clearly defined fields was more successful. It is very important that there is
      provision to verify the data collected. The time commitment for clinical staff
      should not be underestimated.

PMID- 1742123
TI  - High resolution CT and bronchography in the assessment of bronchiectasis.
AB  - To elucidate the reliability of CT in the assessment of bronchiectasis, a
      retrospective study of high resolution CT and bronchography was carried out. A
      segment by segment comparison of 259 segmental bronchi from 70 lobes of 27 lungs
      in 19 patients was performed using bronchography as standard. CT was positive in
      87 of 89 segmental bronchi with bronchiectasis giving a false-negative rate of
      2%. CT was negative in 169 of 170 segmental bronchi without bronchiectasis at
      bronchography, giving a false-positive rate of 1%. There was agreement between
      the two modalities in identifying the different types of bronchiectasis.

PMID- 1742124
TI  - Efficacy of inverted digital luminescence radiography in evaluating chest
      neoplasms.
AB  - Inverted (positive) digital chest radiographs of patients with lung tumors were
      compared with commonly used (negative) digital images, consisting of one
      simulated normal and one contrast enhanced image. The first part of the material
      consisted of 80 patients of whom 40 had tumors and 40 were normal. Five
      radiologists with different experience reviewed the examinations. From their
      answers, ROC curves were constructed. The second part of the material consisted
      of 100 chest phantom examinations with a simulated tumor in the mediastinum (45
      examinations) and/or the left lung (46 examinations). In 31 exposures there was
      no abnormality. These were reviewed by 3 observers and performed as an ROC study
      as well. There was no statistical difference between the different types of
      images or between the observers in the 2 studies.

PMID- 1742125
TI  - CT for predicting the resectability of lung cancer. A prospective study.
AB  - In order to assess the accuracy of CT in predicting the resectability of lung
      cancer, a prospective study was performed on 96 patients undergoing thoracotomy.
      The tumors were classified preoperatively according to the TNM classification and
      the new international staging system for lung cancer, and scored as being
      resectable by lobectomy or pulmectomy, potentially resectable by lobectomy or
      pulmectomy, or nonresectable. Of the tumors predicted to be resectable or
      potentially resectable, 86.6% and 63% were radically resected, respectively, and
      the need for lobectomy versus pulmectomy was correctly estimated in 81.3% of
      them. The insufficiency of CT for defining lymph node metastases and infiltrative
      tumor growth was considered a marked disadvantage of the method.

PMID- 1742126
TI  - CT findings of endobronchial metastasis.
AB  - One hundred and sixty-one patients with pulmonary metastases were studied with
      CT. Six of them proved to have endobronchial (intraluminal) metastatic lesions by
      bronchoscopy. Retrospective analysis of the CT studies showed obstruction and/or
      narrowing of the bronchi in 5 cases while no lesion was observed in one patient.
      Although CT can not always demonstrate intraluminal lesions, it should be
      performed when an endobronchial metastasis from extrathoracic malignancy is seen
      by bronchoscopy because it will show hilar or mediastinal lymphadenopathy, or
      single or multiple pulmonary metastases other than the endobronchial lesion.

PMID- 1742127
TI  - Radiographic grading of extrinsic allergic alveolitis. A comparison between a
      modified ILO classification and a descriptive method.
AB  - We analyzed the acute phase radiographs of 107 consecutive patients with
      clinically confirmed extrinsic allergic alveolitis. Three readers independently
      recorded the profusion and the type of opacities according to the standard ILO
      criteria extended with categories x, y, z, and ground glass for description as
      proposed by McLoud et al. The profusion of the changes was grade 0 in 13%, grade
      1 in 37%, grade 2 in 35%, and grade 3 in 15% of the interpretations. The type of
      predominant small opacities was p in 33%, x in 22%, s in 13%, t in 10%, q in 9%,
      and 0, r, u, y, and z in 13% of the interpretations. Ground glass density was
      seen in 8% of the recordings. The changes were predominantly located in the
      middle and lower lung zones. For comparison, according to the classification of
      Hapke et al. miliary changes (68%) predominated over fibrotic (27%) and normal
      (11%) recordings. The intraobserver agreement was good by both methods, but there
      was less interobserver variation with the ILO method. The semiquantitative
      standardized modified ILO scheme was considered more informative than Hapke's
      descriptive classification for epidemiologic and research purposes.

PMID- 1742128
TI  - Powdered diatrizoic acid for radiography of the respiratory tract. Part II.
      Clinical application.
AB  - The diagnostic and clinical value of 41 examinations using insufflation and/or
      inhalation of powdered diatrizoic acid for tracheobronchography, tracheography,
      laryngography, nasopharyngography, and sinusography was investigated in 35
      patients. Diatrizoic acid was found to be useful when applied by insufflation for
      demonstration of the nasopharynx, trachea and greater bronchi, especially in
      patients with airway stenosis and low pulmonary reserve. Double contrast images
      were obtained with good demonstration of anatomic details and adequate diagnostic
      value. Visualization of the peripheral bronchi by insufflation was satisfactory
      only when excessive secretions were not present. The inhalation method was
      adequate only for visualization of the trachea and main bronchi. The method was
      found to be safe since diatrizoic acid produced no toxic, allergic or febrile
      reactions and was given in relatively small amounts without impairment of
      respiratory function.

PMID- 1742129
TI  - Ultrasonographic anatomy of veins draining the left lobe of the liver.
      Feasibility of live related transplantation.
AB  - The anatomic variations of the left hepatic vein (LHV) in 182 patients with
      normal liver functions were analyzed using ultrasonography in order to clarify
      the feasibility of live related hepatic transplantation (LRHT). LHV was
      demonstrated in 151 patients (83%). Based on the location of the confluence of
      the middle hepatic vein (MHV) and LHV and the ramifications of the left medial
      vein (LMV) and the left superior vein (LSV), the livers were classified into 3
      types: a) intrahepatic confluence (42/151 livers, 27.8%); b) extrahepatic
      confluence (69/151 livers, 45.7%); c) separate insertion (40/151 livers, 26.5%);
      and 23 subtypes. The length of the common trunk and the intrahepatic common trunk
      of MHV and LHV and the distance from LMV or LSV to the confluence of MHV and LHV
      were measured. Overall, the control of LHV in situ for LRHT appeared easy in
      34/151 patients (22.5%), while in 44/151 patients (29.1%), the length of free LHV
      and the common trunk was less than optimal for procurement of a left hepatic lobe
      graft with complete venous outflow and sufficient extraparenchymal length of LHV.

PMID- 1742130
TI  - Angiographic profile in childhood moyamoya disease. A study of 8 Caucasian Indian
      children.
AB  - The cerebral angiograms of 8 patients with childhood moyamoya disease showed that
      the common findings were stenosis/occlusion of the supraclinoid internal carotid
      artery and the proximal segments of the anterior and middle cerebral arteries and
      basal moyamoya. The volume of basal moyamoya and its collateral supply depended
      upon the stage of the disease. Leptomeningeal collaterals were frequent in the
      later stages. Stenotic lesions in the posterior circulation were seen in a
      majority (75%) of patients. A feature unique to the study was evidence of
      intracranial small-vessel disease and stenotic cervical internal carotid artery
      in half of the cases. The disease in the ethnic caucasian Indians seems largely
      similar to the classical disease frequently reported in the Japanese literature.

PMID- 1742131
TI  - Radiation doses to patients and personnel involved in embolization of
      intracerebral arteriovenous malformations.
AB  - Radiation doses to patients and personnel were measured during 5 embolization
      procedures in 5 different patients. Thermoluminescent dosimeters were used to
      measure the absorbed doses in different points of the skin of patients as well as
      personnel. A transmission ionization chamber was used to determine the energy
      imparted in the patients. The effective dose equivalent HE during the procedures
      was estimated to be in the range of 6 to 43 mSv to the patients, 10 to 26 microSv
      to the radiologist in charge of the embolizations, 3 to 24 microSv to the
      assisting radiographer and 13 to 86 microSv to the nurse anesthetist. Radiation
      doses to the patients were considerable but the estimated risks from radiation
      were low compared to the risks of the arteriovenous malformation itself and the
      hazards of the embolization. The annual radiation doses to the personnel were
      well below established dose limits.

PMID- 1742132
TI  - Tissue characterization of intracranial tumors by MR imaging. In vivo evaluation
      of T1- and T2-relaxation behavior at 1.5 T.
AB  - The main purpose of this in vivo study was to provide a detailed description of
      the T1- and T2-relaxation processes in intracranial tumors at 1.5 T. A total of
      100 patients were investigated. Optimal experimental conditions were carefully
      observed, including the use of long TR values. T1 determination was based on a
      partial saturation inversion recovery sequence covering 12 or 6 data points. T2
      determination involved a multiple spin echo sequence with 32 echoes. Calculations
      included biexponential analysis of the 12-point T1 data and all T2 data obtained.
      The results were evaluated in accordance with histopathology. The T1- and the T2
      relaxation times of the prevailing tumor types were significantly different (p
      less than 0.0005). However, biologic scatter and overlap between tumor types were
      considerable. In particular, no discrimination between benign and malignant tumor
      growth was possible. Biexponential evaluation did not increase the specificity,
      although a biexponential relaxation behavior was recognized in 37% of the T2
      curves. The results indicate that tissue heterogeneity is responsible for most of
      the scatter in the relaxation times. It is concluded that tissue characterization
      by MR imaging, based solely on relaxation time measurements, seems to be of no
      value in the differentiation of intracranial tumors.

PMID- 1742133
TI  - MR imaging of patellar cartilage degeneration at 0.02 T. Study of 23 cadaveric
      patellae.
AB  - MR imaging with a 0.02 T resistive magnet was used to establish the correlation
      between the histologic grading of patellar cartilage degeneration and fat water
      separation images or T1- and T2-relaxation times. We examined 23 cadaveric
      patellae. There was a positive correlation between histologically graded
      cartilage degeneration and T1-relaxation time. Patellar cartilage was well
      differentiated from surrounding structures on chemical shift water proton images,
      and an evaluation of cartilage degeneration was possible. No correlation was
      found between cartilage damage and T2-relaxation time. Chemical shift imaging at
      0.02 T is easy to perform and gives further information of cartilage disorders.

PMID- 1742134
TI  - Tumor seeding occurring after fine-needle biopsy of abdominal malignancies.
AB  - Percutaneous fine-needle aspiration biopsy is a commonly used diagnostic
      procedure with a high accuracy and a low complication rate. However, tumor
      seeding in the biopsy tracts has been recorded with a frequency of one in 20,000
      40,000 biopsies. We report 5 cases of percutaneous tumor seeding recorded after
      5,000 fine-needle biopsies of abdominal malignancies at our institution. The risk
      of implantation metastases induced by fine-needle biopsy warrants consideration
      in patients with abdominal malignancies since it may compromise the outcome of
      radical surgery. It should only be performed when the result of the procedure has
      a direct impact on the choice of therapy.

PMID- 1742135
TI  - Sclerotherapy for ablation of the gallbladder after gallstone lithotripsy with a
      mechanical lithotriptor. An experimental study in pigs on the effect of absolute
      ethanol on edematous gallbladder wall.
AB  - Chemical ablation of the gallbladder with absolute ethanol following mechanical
      lithotripsy with the RotoLith lithotriptor was attempted in 10 pigs after open
      cholecystostomy. Two gallbladders removed immediately after the sclerotherapy
      demonstrated extensive ulcerations of the mucosa with preserved glands and
      sinuses under the ulcerations. In 8 gallbladders removed 8 weeks after
      sclerotherapy a gallbladder remnant with hydrops and/or mucus and more or less
      intact epithelium was seen in all the pigs. In order to prevent regeneration of
      epithelium from gallbladder sinuses and glands, more effective sclerosing agents
      must be found.

PMID- 1742136
TI  - Effect of indomethacin and salt depletion on renal proton MR imaging. An
      experimental study in the rat.
AB  - Blockade of the synthesis of vasodilating prostaglandins with non-steroidal anti
      inflammatory drugs (NSAID) renders the renal medulla susceptible to hypoxic
      injury with reduced renal function, especially in clinical conditions
      characterized by volume depletion. Alterations in renal hemodynamics and urine
      production may affect renal MR imaging under these circumstances. We injected
      salt-depleted and control rats undergoing proton MR imaging with indomethacin 10
      mg/kg. Indomethacin abolished the cortico-medullary T2-gradient and markedly
      diminished the overall renal signal in salt-depleted rats only. These changes,
      which progressed over a period of 40 min after indomethacin was injected,
      probably result from renal oligemia and decreased urine production, with an
      associated decrease in T2-values. We suggest that a history of consumption of non
      steroidal anti-inflammatory drugs should be obtained and taken into account in
      the evaluation of renal proton MR imaging, especially in the presence of salt and
      volume depletion.

PMID- 1742137
TI  - Accounting: the dreaded "A" word.

PMID- 1742138
TI  - An educational model for explaining hospice services.
AB  - Explaining the concept and philosophy of hospice can be difficult. There is a
      reluctance in our society to openly address dying/death issues; there is a
      reluctance on the part of many health-care professionals to look beyond physical
      issues. The following model has been used successfully to explain hospice to both
      the general public and health care professionals. It is not intended to introduce
      hospice to a patient/family during the initial referral/assessment visit.

PMID- 1742139
TI  - The prevalence and incidence of pressure ulcers in the hospice setting: analysis
      of two methodologies.
AB  - Hospice patients may be at greater risk of pressure ulcer development than most
      patients. This descriptive study explored the prevalence and incidence of
      pressure ulcers in the hospice setting, utilizing both a prospective and
      retrospective methodological approach. Levine's theory of the four principles of
      conservation formed the theoretical basis for the study, and the Braden Scale for
      Predicting Pressure Ulcer Risk was used for data collection. Prevalence of
      pressure ulcers was noted to be 13 percent in the study. Incidence of pressure
      ulcers was found to be zero percent using prospective methodology and 13 percent
      using retrospective methodology. Five of eight ulcers (62 percent) occurred
      within two weeks of patient death. Factors related to pressure ulcer development
      are presented, as well as a discussion of using research methodologies in the
      hospice setting. The article suggests the need for preventive protocols for skin
      care for patients who are at risk for pressure ulcer development.

PMID- 1742140
TI  - Haven Hugs & Bugs. An innovative multiple-family weekend intervention for
      bereaved children, adolescents and adults.
AB  - This article describes the development and implementation of a unique, two-day
      therapeutic program for bereaved families. Issues relevant to program design are
      presented along with evaluation results. The family focus, the therapeutic value
      of nature, and the relationship of this program to Multiple Family Therapy, time
      limited psychotherapy, and wilderness, camping, or recreation therapy approaches
      are discussed. Questions and suggestions for future evaluation research are
      noted. The high potential therapeutic and cost-effectiveness of such innovative
      approaches to bereavement counseling should motivate further program development
      and outcome research. Information on other weekend bereavement programs is
      appended.

PMID- 1742141
TI  - Completing the hospice organizational model.
AB  - Hospices must be thought of as still being in their formative stages. We need not
      be satisfied with staffing arrangements and practices that, largely for reasons
      of expediency and the lack of other models, were inherited from other healthcare
      agencies or foisted on us by federal bureaucrats and third party payers. These
      external demands will be countered and features unique to hospices created only
      to the extent that all of us are clear about what we most need and want for
      ourselves as staff. That is how we created the patterns used in working with
      clients. Now let us use the same ingenuity in fashioning ways of working among
      ourselves.

PMID- 1742142
TI  - The effects of death education on nurses' attitudes toward caring for terminally
      ill persons and their families.
AB  - This study sought to determine the effectiveness of an education program on
      nurses' attitudes toward caring for terminally ill persons and their family
      members. The program, based on the hospice concept of care, included a didactic
      section based on Kubler-Ross' stages of death and dying, and a role-play model
      designed by the researcher. Data were collected from 34 licensed nurses, aged 18
      to 65, practicing in the midwestern United States. The Frommelt Attitude Toward
      Care of the Dying Scale (FATCOD) was designed by the researcher to assess nurses'
      attitudes. The FATCOD was found to be a valid and reliable tool. All nurses
      completed the tool before and after the education program (pre-test, post-test).
      Compared by a t-test, the scores for the nurses were significantly higher after
      participation in the educational program. The t-value was found to be 2.97,
      significant at the less than 0.01 level, 2-tailed probability = 0.006. These
      findings support the hypothesis that nurses have a more positive attitude toward
      caring for terminally ill persons and their family members after participation in
      the program, than the same nurses had before participating in the program.
      Demographic information including age, years of experience in nursing, highest
      degree held, basic type of nursing preparation and previous education on death
      and dying were analyzed to determine their relationship to the nurses' attitudes.
      The only information which demonstrated any significant relationship to the
      nurses' attitudes was that of previous education on death and dying. These were
      computed by an analysis of variance (ANOVA) F = 3.22, F prob = 0.04, significant
      at less than 0.05 level.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742143
TI  - Nurses' attitudes toward AIDS patients.

PMID- 1742144
TI  - Learning health care in the age of AIDS.

PMID- 1742145
TI  - Tools for autonomy.

PMID- 1742146
TI  - Amyloidosis: clinical picture, immunological and biomolecular features, treatment
      prospects.
AB  - Amyloidosis is the name given to a group of clinically protean diseases whose
      common feature is the tissue accumulation of amyloid fibrils which have specific
      optical and staining properties, and are both insoluble in physiological solvents
      and resistant to proteolytic enzymes. Fibril deposition and progressive
      extracellular infiltration eventually result in atrophy due to compression. The
      structure of these fibrils embraces a wide range: immunoglobulin light chain or
      their fragments, acute phase proteins, hormones, protease inhibitors, beta 2
      microglobulin, natriuretic peptides, and proteins whose function is still
      unknown. Despite this heterogeneity, however, they share a common
      crystallographic beta-pleated sheet structure. The clinical spectrum includes
      apparently primary forms, amyloidosis of myeloma, forms secondary to familial
      Mediterranean fever, Alzheimer's disease, forms associated with type 2 diabetes
      or medullary carcinoma of the thyroid, inherited-familial amyloidosis, and other
      less common conditions. Two pathogenetic phases are involved: enhanced production
      of precursor proteins and their abnormal enzyme cleavage, resulting in the
      formation of intermediate products corresponding to the amyloid fibrils. The
      results of treatment are still disappointing: alkylating agents and/or cortico
      steroids are used in primary forms and for amyloidosis of myeloma; colchicine in
      familial Mediterranean fever; DMSO in renal amyloidosis; plasmapheresis in
      inherited-familial forms, together with the supportive management obviously
      dictated by clinical manifestations.

PMID- 1742147
TI  - Acute and chronic pancreatitis: an up-date.
AB  - According to the 1988 Marseilles-Rome classification inflammatory pancreatic
      diseases are represented by acute (AP) and chronic pancreatitis (CP), pancreatic
      fibrosis and abscesses (due to infection of cystic cavities). Each form is
      defined by specific etiological, pathomorphological, functional and evolutive
      aspects. In our experience with 348 AP cases, gallstones and chronic alcohol
      abuse, alone or together, represent the major causative factors (over 70% of
      cases). Mortality observed in necrotizing AP only, varies from 26% of idiopathic
      to 8% of biliary cases. Ductal scars, exocrine and endocrine impairment were
      observed in about 45% and 20% respectively as sequelae of necrotizing AP,
      whatever the etiology. As far as CP is concerned, the main etiological factor is
      chronic alcohol consumption (82% of cases). The clinical evolution of CP may be
      roughly divided in two phases, the earlier (within 5 years from onset)
      characterized by frequently recurrent pain, calcifications and cystic cavities
      and the later when pain spontaneously regresses and steatorrhea and diabetes tend
      to appear. Heavy alcohol intake, smoking and frequent relapses are related to a
      less favourable course. About 60% of the patients underwent surgery within 5
      years from onset. Pain relief was achieved in the large majority. Reduction in
      alcohol intake and the natural tendency of the disease to burn out, probably aid
      pain relief. Mortality in CP is due to diseases secondary to alcohol and smoking
      abuse (cardiovascular and neoplastic) more than to CP alone. We believe that
      multiple parameters are required for a complete definition of each pancreatic
      patient.

PMID- 1742148
TI  - The late complications of diabetes mellitus.
AB  - Late complications of diabetes mellitus include a variety of clinical pictures,
      mainly related to the involvement of the arterial wall both of large vessels
      (macroangiopathy) and small vessels (microangiopathy), and of the peripheral
      nervous system (neuropathy). Their presence in almost all types of diabetes
      indicates that there is a common pathogenetic mechanism, which can be
      substantially identified in high blood glucose levels and related alterations.
      Hyperglycemia, in fact, leads to some metabolic abnormalities, i.e. non-enzymatic
      glycosylation of proteins and polyol pathway activity; moreover it can negatively
      affect the pattern of some hormones, especially GH and sex steroids, and normal
      rheological and clotting properties of blood. These abnormalities, confirmed by
      experimental models, play a key role in the development of late diabetic
      complications. However some evidence indicates that a genetic background may
      predispose to their development or protect from their onset. The two main forms
      of diabetic retinopathy, non-proliferative and proliferative, show an incidence
      which increases with age and duration of diabetes, reaching 100% when diabetes
      lasts for more than 20 years. The risk of blindness, which is very high for the
      proliferative form, has been dramatically reduced by laser-photocoagulation.
      Diabetic nephropathy affects a lesser number of diabetics but, after a silent or
      preclinical stage, leads to renal failure and subsequent replacement therapy.
      Strict metabolic control in the silent stage and later rigid anti-hypertensive
      treatment can prevent or retard the evolution of this complication. A close
      association has been observed between diabetes and hypertension, which can
      directly affect the onset and evolution of diabetic nephropathy, probably through
      a common genetic mechanism. Diabetic neuropathy has a wide variety of clinical
      manifestations, at somatic, autonomic and central levels and can greatly modify
      the quality and expectancy of life. However, the major cause of death in diabetic
      subjects is large vessel disease or macroangiopathy, which is similar to non
      diabetic atherosclerosis regarding the main histopathological and clinical
      manifestations but has a much higher prevalence and severity. Finally, a specific
      cardiomyopathy has also been described in diabetes mellitus and can account for
      the high rate of heart failure observed in these patients.

PMID- 1742149
TI  - Cardio-respiratory function during sleep.
AB  - Respiratory function undergoes sleep-associated changes which in normal subjects
      leave it unaffected. However in some cases they may be more marked than usual or
      may be superimposed on a pre-existing disease, thus giving rise to sleep-related
      ventilation disorders. These include obstructive sleep apnea syndrome (OSAS),
      nocturnal desaturation events of chronic obstructive pulmonary disease (COPD) and
      restrictive syndromes, as well as nocturnal asthmatic attacks. OSAS is a
      condition characterized by the frequent recurrence of interruptions of oronasal
      flow (greater than 10 s.) due to upper airway occlusion induced by a reduction in
      pharyngeal muscle tone. This phenomenon, particularly prominent in REM sleep,
      results in oxyhemoglobin desaturation and marked cardiovascular consequences
      (arrhythmias, increases in pulmonary and systemic arterial pressure), as well as
      symptoms (loud intermittent snoring, daytime sleepiness, intellectual
      deterioration etc.). Obesity is often associated with OSAS or may lead to a sleep
      related hypoventilation syndrome. Treatment is based on weight loss, surgery of
      upper airway abnormalities, if present, and on splinting of the upper airway by
      the application of nasal continuous positive airway pressure. In COPD and
      restrictive disorders, nocturnal hypoxemia is mainly due to REM-associated loss
      of respiratory muscle tone, as well as in the sleep-related exaggeration of
      functional defects due to COPD (low chemoreceptor sensitivity, high closing
      volume etc.). Treatment is based on oxygen administration, provided that possible
      side-effects are carefully monitored. Nocturnal asthma is due to circadian
      changes in hormonal secretion (catecholamines, cortisol), as well as supine
      posture, reduced muco-ciliary clearance, gastro-esophageal reflux etc. Sleep
      itself plays some role through a depressed arousal reaction in slow wave sleep,
      resulting in more marked and prolonged attacks in this stage. Slow-release
      theophylline or beta-mimetic medications, as well as new chromones and
      antimuscarinic drugs are therapeutic alternatives.

PMID- 1742150
TI  - Ascites in liver diseases.
AB  - The clinical course of patients with cirrhosis of the liver is frequently
      complicated by progressive impairment of renal sodium handling leading to the
      formation of ascites. The occurrence of ascites is generally accompanied by the
      activation of several hormones and intrarenal autacoids and a complex derangement
      of systemic, portal and renal hemodynamics. The earliest "underfilling" theory of
      sodium retention proposes that ascites formation leads to hypovolemia and
      secondary sodium retention. According to the "overflow" theory, ascites formation
      is a secondary event with respect to sodium retention, which occurs as a primary
      phenomenon in the absence of hypovolemia. A third recently developed theory
      suggests that peripheral arteriolar vasodilation is the primary event of
      intravascular underfilling. The major documented site involved in arteriolar
      vasodilation is the splanchnic circulation. Occurrence of underfilling is not
      related to a reduction of plasma volume but to the enlargement of the vascular
      compartment. Vascular underfilling triggers a series of hemodynamic and hormonal
      compensatory events such as an increase in cardiac output and plasma volume,
      activation of the renin-angiotensin-aldosterone and sympathetic nervous system
      and non-osmotic hypersecretion of antidiuretic hormone and sodium retention, all
      of which aim at refilling the vascular compartment. In patients with compensated
      cirrhosis, i.e. without ascites, compensatory events maintain blood volume
      despite vascular underfilling, and so these patients do not develop ascites. In
      patients with decompensated cirrhosis, vascular underfilling due to arterial
      vasodilation, together with a reduced oncotic pressure and a severe degree of
      portal hypertension, favours the development of ascites. Underfilling of the
      arterial circulation is at its maximum in functional renal failure and the
      hepatorenal syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742151
TI  - The application of the theory of systems in internal medicine. State of the art
      and perspectives.
AB  - The application and contribution of Cartesian methodology to the development of
      medicine in physiology, pathophysiology and therapy have been overwhelming. The
      accumulation of knowledge over the last 3 centuries in scientific research is
      largely attributed to Cartesian methodology. This method, which in the past was
      used for the acquisition of nosological data is no longer sufficient for the
      interpretation of complex phenomena which modern science nowadays requires. The
      solution to these complex problems is only possible by means of the application
      of the theory of systems especially for the functional evaluation of biological
      feedback.

PMID- 1742152
TI  - Lymphoproliferative diseases of uncertain classification.
AB  - In spite of the recent progress in the biology and histogenesis of the
      lymphoproliferative diseases, many doubts still remain about their possible
      evolution. On the one hand, many cases have been studied showing a benign course
      in spite of a typical monoclonal phenotype; on the other, some clinically
      aggressive forms of lymphoproliferation prove to be polyclonal throughout their
      course, even when checked with highly sophisticated techniques. In this article
      we have reviewed, in both clinical and etiopathogenetic terms, the classification
      of these processes in the light of the new findings provided by extensive use of
      the most advanced investigational techniques of genotype and phenotype analysis.
      We have recognized three main groups of lymphoproliferative disorders of
      uncertain significance, based on pathophysiological, anatomical and developmental
      considerations: 1) lymphoproliferative diseases that take place on a background
      of either congenital or acquired immunodeficiency, referred to as "opportunistic
      lymphoproliferative disorders"; 2) lymphoproliferative diseases deriving from
      "mucosa associated lymphoid tissue" (MALT); 3) lymphoproliferative diseases of
      uncertain histogenesis, now classified as "T lymphomas". The opportunistic
      lymphoproliferative disorders, particularly in HIV+ patients and transplant
      recipients, often show developmental and etiopathogenetic features which may help
      to elucidate their natural history. Frequent involvement of Epstein-Barr virus
      and the related host's immune response patterns provide powerful tools to outline
      the alternative developmental pathways of such disorders.2+ Worthy of note is
      acute infectious mononucleosis which, though self-limiting when occurring in the
      immunocompetent host, may be considered as a lymphoproliferative process and
      sometimes shows some "aggressive'' morphological aspects. Special attention is
      paid to the obscure origin of Hodgkin's disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742153
TI  - Role of the endothelium in controlling local blood flow.
AB  - During this last decade it has been widely recognized that the vascular
      endothelium reacts to mechanical force as well as to various neurohumoral
      mediators by releasing vasodilator and/or vasoconstrictor substances, and thus
      contributes to the relaxation of local blood vessels and the control of local
      circulation. In addition, substances produced and released by endothelial cells
      play a major role in controlling platelet-endothelium interaction and platelet
      aggregation. The endothelium may contribute to the local control of vascular tone
      by secreting prostacyclin, endothelium-derived relaxing factor(s) (EDRF) or
      endothelium derived contracting factor(s) (EDCF). Prostacyclin, a major
      metabolite of the cyclo-oxygenase pathway in the vascular endothelium and the
      subject of intense studies since its discovery in 1976, has been reviewed many
      times and will therefore not be discussed in this report. We will focus on other
      recently described endothelium-dependent vasoactive mediators, particularly EDRF
      and EDCF.

PMID- 1742154
TI  - Diuresis and intensive saluresis.
AB  - Intensive saluresis, intended as an exceptional though real and practicable
      therapeutic approach, has made unimaginable progress possible in different
      sectors of Internal Medicine relating to hydrosaline balance alterations such as
      chronic and acute renal failure, nephrosic syndrome, refractory heart failure,
      acute pulmonary edema and ascites. We are proud to be the first who followed a
      path that assured patients compensation beyond "classic" therapeutic
      possibilities, and undoubtedly better quality of life, as well.

PMID- 1742155
TI  - Pathogenetic aspects of allergic respiratory syndromes.
AB  - Over the past twenty years great research effort has been made to clarify the
      pathogenetic mechanisms of allergic rhinitis (AR) and bronchial asthma (BA). The
      discovery of two types of Fc epsilon receptors (Fc epsilon RI and Fc epsilon RII)
      has made it possible to understand that allergic reactions can be due to
      interactions between allergens and cytophilic IgE bound not only by mast cells
      and basophils, but also by macrophages, lymphocytes, eosinophils and platelets.
      Knowledge of the complex mechanisms which regulate IgE antibody production has
      substantially improved since it was shown that IL-4 and T/B cell interactions are
      essential for the induction of human IgE synthesis, whereas IFN-gamma plays a
      negative regulatory role. In mice and humans, two types of helper T cells (Th1
      and Th2) have been recognized, they produce different cytokines resulting in both
      cross-regulation of T cell function and B cell activity. In view of their
      particular pattern of cytokine secretion, Th2-type cells would be important in
      the specific response to allergens and in allergic inflammation. New knowledge
      about the mechanisms involved in the effector phase of allergic reactions and
      respiratory tract inflammation has recently been gained. In particular, the
      discovery of a complex network among cytokines, mediators and neuropeptides has
      offered the opportunity for advancing a new, integrative view of how the
      pathophysiological alterations responsible for respiratory allergic syndromes
      come about. We now realize that late phase allergic reactions, chronic allergic
      inflammation and tissue hyperreactivity are induced and maintained by a complex
      inflammatory mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742156
TI  - A statistical approach to computerized EEG: preliminary data on control subjects
      and epileptic patients.
AB  - Factor Analysis represents an important method of extracting salient features
      from EEG data condensing functional as well as spatial informations in a few
      factors and so reducing redundancy of multi-channels computerized EEG data. A 16
      channel computerized frequency analysis of background brain electrical activity
      during 3 functional conditions (eyes closed, eyes open and hyperventilation) were
      performed in 2 groups, 50 healthy subjects and 14 epileptic patients with
      generalized seizures. The differences in each frequency band between the 2 groups
      have been assessed by means of factor scores. Factor scores differences between
      control and epileptic patients have been found in theta and alpha frequency
      bands. These interictal EEG abnormalities were more evident in epileptic
      patients. This preliminary study shows the confirmatory capability of Factor
      Analysis and its usefulness in managing and comparing computerized EEG data.

PMID- 1742157
TI  - Topographic component (parallel factor) analysis of multichannel evoked
      potentials: practical issues in trilinear spatiotemporal decomposition.
AB  - We describe a substantive application of the trilinear topographic
      components/parallel factors model (TC/PARAFAC, due to Mocks/Harshman) to the
      decomposition of multichannel evoked potentials (MEP's). We provide practical
      guidelines and procedures for applying PARAFAC methodology to MEP decomposition.
      Specifically, we apply techniques of data preprocessing, orthogonality
      constraints, and validation of solutions in a complete TC analysis, for the first
      time using actual MEP data. The TC model is shown to be superior to the
      traditional bilinear principal components model in terms of data reduction,
      confirming the advantage of the TC model's added assumptions. The model is then
      shown to provide a unique spatiotemporal decomposition that is reproducible in
      different subject groups. The components are shown to be consistent with
      spatial/temporal features evident in the data, except for an artificial component
      resulting from latency jitter. Subject scores on this component are shown to
      reflect peak latencies in the data, suggesting a new aspect to statistical
      analyses based on subject scores. In general, the results support the conclusion
      that the TC model is a promising alternative to principal components for data
      reduction and analysis of MEP's.

PMID- 1742158
TI  - Accurate matching of electromagnetic dipole data with CT and MR images.
AB  - Interpretation of EEG (electroencephalography) or MEG (magnetoencephalography)
      derived three-dimensional dipole localizations is hampered by poor visualization.
      This paper describes a method for combining dipole data with structural image
      data of the same patient. To ensure high precision this method utilizes external
      markers that are easy to apply. These markers can achieve subslice accuracy and
      can even be used to pinpoint reference points outside the scanned volume.
      Accurate matching is thus provided even in standard imaging protocols employing
      thick slices and/or large interslice gaps. The results of the matching method are
      presented in 2D and 3D visualizations. The hybrid images facilitate the
      interpretation of dipole localizations with respect to the patient's anatomy.

PMID- 1742159
TI  - Brain activity associated with skilled finger movements: multichannel magnetic
      recordings.
AB  - We recorded with a 24-channel SQUID magnetometer cerebral activity preceding and
      following self-paced voluntary 'skilled' movements in four healthy adults. The
      subject pressed buttons successively with the right index and middle fingers
      aiming at a time difference of 40-60 ms; on-line feedback on performance was
      given after each movement. Slow magnetic readiness fields (RFs) preceded the
      movements by 0.5 s and culminated about 20 ms after the electromyogram (EMG)
      onset. Movement-evoked fields, MEFs, opposite in polarity to RFs, were observed
      90-120 ms after the EMG onset. They were followed by an additional 'skilled
      performance field', SPF, 400-500 ms after the EMG onset. The source locations of
      RF, MEF, and SPF were within 2 cm from sources of the somatosensory evoked
      responses, which were situated in the posterior wall of the Rolandic fissure; the
      sources of MEF were closest to the midline. Neural generators of these
      deflections and of the corresponding electric potentials are discussed.

PMID- 1742160
TI  - The value of EEG-mapping in focal cerebral lesions.
AB  - In 148 patients with focal cerebral lesions the findings of EEG mapping, routine
      EEG and CT were compared. Regarding etiology 43 patients suffered from completed
      stroke (CS), 43 patients from transient ischemic attack (TIA), 33 patients had an
      intracerebral hemorrhage (ICH) and 29 an hemispheric tumor. In 37 patients with
      CS (86%) and 27 patients with TIA (63%) the EEG mapping revealed focal changes,
      but only in 28 patients with CS (65%) and in 11 patients (26%) with TIA using
      routine EEG alone. Thus the EEG mapping showed focal abnormalities significantly
      more often. In the remaining patient groups no significant difference in the
      results of EEG mapping or routine EEG could be demonstrated. Focal abnormalities
      corresponding to focal lesions seen in CT were obtained by means of EEG mapping
      in 27 patients (90%) with CS and 10 patients (77%) with TIA, but only in 17
      patients (57%) with CS and 4 patients (31%) with TIA using routine EEG and in
      that way the EEG mapping could indicate focal lesions in CT significantly more
      often than routine EEG. In the remaining patient groups no significant difference
      in the number of focal changes corresponding to lesions in CT could be seen.

PMID- 1742162
TI  - The effect of ethidium bromide on the liquid crystalline phases of aqueous DNA.
AB  - The influence of the intercalation of ethidium bromide (EB) on the
      characteristics of the DNA cholesteric and hexagonal mesophases is studied by
      optical microscopy, circular dichroism, and X-ray diffraction. The distance
      between DNA rods in the hexagonal phase is not modified by the presence of EB
      whereas the pitch of the cholesteric mesophase is considerably shortened by the
      dye. This seems to be related to the stereochemical effect of the intercalation
      rather than to the presence of a random distribution of the positive charge of
      the dye.

PMID- 1742161
TI  - Spatial mapping of SEP in comatose patients: improved outcome prediction by
      combined parietal N20 and frontal N30 analysis.
AB  - The aim of this study is to evaluate whether SEP spatial mapping can improve
      outcome prediction in comparison to the conventional SEP recordings. Twenty
      patients comatose as a result of head injury or cerebral vascular disorders were
      submitted to 19-channel SEP mapping from median nerve stimulation. SEP recording
      were performed within the 4th hospital day in 18 cases and over one month from
      the insult in the remaining two. Nine patients (45%) showed a good recovery or a
      mild disability, 3 (15%) a severe disability and the rest (40%) died or remained
      in a vegetative state. Five patients (28%) had bilaterally normal SEP, 5 (28%)
      the absence of both parietal N20 and frontal N30, while the others (44%) had a
      dissociation N20/N30 (namely, preserved N20 with absent N30). The SEP mapping was
      significantly related to the outcome (P = 0.0087) and improved the outcome
      prediction in comparison to the conventional SEP recordings, allowing to check
      the presence of frontal N30: in patients with bilaterally present N20 the outcome
      appeared to depend upon the N30. SEP mapping proved to be a far superior
      prognostic indicator than the Glasgow Coma Scale. In 3 patients with midline
      shift on CT scan an abnormal spatial distribution of N20 was disclosed by SEP
      mapping. Our preliminary results suggest that SEP mapping may improve the
      assessment of comatose patients in comparison to the use of parietal derivations
      only.

PMID- 1742163
TI  - The circular dichroism of tumor necrosis factor-alpha: measurement into the
      vacuum UV and analysis for secondary structure.
AB  - The circular dichroism (CD) spectrum of tumor necrosis factor-alpha has been
      measured into the vacuum UV to 168 nm. Analysis of the CD for secondary structure
      is in good agreement with X-ray diffraction results, but the analysis is somewhat
      unstable. Adding the CD of this protein together with its X-ray determined
      secondary structure to the basis set should improve subsequent analyses of CD
      spectra for other all-beta proteins.

PMID- 1742164
TI  - Absolute configuration for peptidomimetic residues in bioactive peptides.
AB  - A modern method is reported for the assignment of absolute configuration for
      peptidomimetics in bioactive peptides by use of 1H-NMR parameters in solution.
      Four peptide systems incorporating either retro-inverso modifications or 2
      aminocyclopentanecarboxylic acid (2-Ac5c) as a peptidomimetic for proline are
      discussed. (1) Two 14-membered cyclic dermorphin analogs Tyr-c[D-A2bu-Phe-gPhe-(S
      and R)-mLeu] with a reverse amide bond between gPhe and mLeu residues where gPhe
      denotes a gem-diamino analog of Phe and mLeu refers to a malonyl analog of Leu.
      (2) Two cyclic hexapeptides related to somatostatin, c[gSar6-(S and R)-mPhe7-D
      Trp8-Lys9-Thr10-Phe11], with a reverse amide bond between the gSar and mPhe
      residues where the gSar and mPhe denote the gemdiamino and malonyl analogs of the
      Sar and Phe residues, respectively. The superscript numbers refer to positions in
      native somatostatin. (3) Cyclic hexapeptide somatostatin analogs containing 2
      Ac5c [trans-(1S,2S)-2-Ac5c, trans-(1R,2R)-2-Ac5c,cis-(1R,2S)-2-Ac5c, and cis
      (1S,2R)-2-Ac5c] in place of proline c[(2-Ac5c)6-Phe7-D-Trp8-Lys9-Thr10-Phe11].
      (4) Morphiceptin related analogs incorporating a cis-2-Ac5c residue as shown in
      Tyr-cis-2-Ac5c-Phe-Val-NH2. The methodology described in this investigation could
      be applied to a wide variety of peptide systems.

PMID- 1742165
TI  - Polypeptide models of elastin: CD and NMR studies on synthetic poly(X-Gly-Gly).
AB  - Poly(X-Gly-Gly), simple structural models for the hydrophobic, proline-devoid,
      regions of elastin, have been synthesized and studied by circular dichroism and
      NMR spectroscopies. The results gave evidence of type II beta-turns as the only
      ordered structure present in the polymers. The stability of the turns has been
      shown to decrease on hydration and to increase in the series Leu less than Ala
      less than Val less than Ile.

PMID- 1742166
TI  - The asymmetric hydroformylation in the synthesis of pharmaceuticals.
AB  - The asymmetric hydroformylation reaction represents a potential powerful
      synthetic tool for the preparation of large number of different chiral products
      to be used as precursors of several organic compounds endowed with therapeutic
      activity. Essential and nonessential amino acids, 2-arylpropanoic acids,
      aryloxypropyl- and beta-phenylpropylamines, modified beta-phenylethylamines,
      pheniramines, and other classes of pharmaceuticals are available through
      enantioselective oxo-reaction of appropriate functionalized olefins; this process
      is catalyzed by rhodium or platinum complexes with chiral ligands, mainly
      chelating phosphines, and sometimes affords very high enantiomeric excesses.
      Furthermore, the application of many simple optically active aldehydes arising
      from asymmetric hydroformylation as chiral building blocks for the synthesis of
      complex pharmacologically active molecules such as antibiotics, peptides,
      antitumor macrocycle compounds, and prostaglandins is conveniently emphasized.
      The possibility of a future application of this asymmetric process for the
      production of many synthons to obtain other valuable pharmaceuticals is widely
      discussed too.

PMID- 1742167
TI  - Heat shock induces thermotolerance and inhibition of lysis in a lysogenic strain
      of Lactococcus lactis.
AB  - In this preliminary work, the heat shock response of lactic acid bacteria was
      investigated and characterized. Log-phase Lactococcus lactis cells pre-incubated
      at 40 degrees C before heat challenge at 52 degrees C for 30 min demonstrated
      increased thermotolerance as compared with cells pre-incubated at 30 degrees C.
      The response persisted for at least 60 min. Additionally, we demonstrated that:
      (i) the physiological expression of the heat shock response is temperature
      dependent; (ii) ethanol 4.0% (v/v) caused, to a lesser extent, a response similar
      to the heat shock; and (iii) hydrogen peroxide failed to induce a detectable
      response. Furthermore, we suggest that the induction of the heat shock response
      increases the resistance of a lysogenic strain of L. lactis, treated by mitomycin
      C (1.25 micrograms/ml), to lysis by the bacteriophage.

PMID- 1742168
TI  - Immunomagnetic separation of Salmonella from foods.
AB  - Salmonella could be separated from different inoculated foods using antibody
      coated immunomagnetic beads. When applied on suitable foods, the immunomagnetic
      separation technique showed a sensitivity of 10-20 Salmonella cells/g of the
      original sample. The technology appeared less useful for some food items.

PMID- 1742169
TI  - Production of staphylococcal enterotoxin D in foods by low-enterotoxin-producing
      staphylococci.
AB  - The goal of this investigation was to determine whether staphylococcal strains
      producing enterotoxins at nanogram levels per milliliter in laboratory medium,
      not detectable by gel diffusion methods, could produce sufficient enterotoxin in
      foods to result in food poisoning. Three low-enterotoxin D (SED)-producing
      strains were selected for this research because this enterotoxin is produced in
      smaller amounts than the other enterotoxins. The foods used were cream pie and
      cooked ham, divided into two portions, sterile and non-sterile. Each portion was
      inoculated with known concentrations of the staphylococcal strains under study
      and incubated for 48 h at 25, 30, and 37 degrees C. Samples were taken after 24
      and 48 h. Enterotoxin was detectable in both sterilized and unsterilized cream
      and ham after 24 h at 37 degrees C with an inoculum of 10(3)/g. Some strains
      produced detectable amounts of enterotoxin in the sterilized foods after 24 h at
      30 degrees C and some produced detectable amounts of enterotoxin in the
      sterilized foods after 24 h at 25 degrees C with inocula of 10(4)/g. It can be
      concluded that staphylococcal strains producing enterotoxin at ng/ml levels in
      laboratory medium, not detectable by gel diffusion methods, can produce
      sufficient enterotoxin (ng/g) in foods to cause food poisoning.

PMID- 1742170
TI  - Assessment of the hygienic adequacy of a commercial hot boning process for beef
      by a temperature function integration technique.
AB  - The hygienic performance of a commercial hot boning process for beef carcasses
      was assessed by a temperature function integration technique. The potential
      proliferation of Escherichia coli was calculated from 50 temperature histories
      for the persistently warmest, microbially contaminated regions of product passing
      through both the carcass cutting and carton cooling phases of the process. The
      maximum calculated proliferation was similar to, but the average proliferation
      was more than, the respective values previously obtained for a beef side cooling
      process that complied with Good Manufacturing Practice. After upgrading of the
      carton cooling facility the process was re-assessed. Then, for a sample of 50
      temperature histories, the maximum proliferation was less than, and the average
      proliferation was similar to, the respective values for the side cooling process.
      Observed proliferations of E. coli inocula in cooling cartons of product were
      compared with the proliferations calculated from temperature histories obtained
      from sites close to inocula. The pairs of calculated and observed values mostly
      agree within +/- 1 generation.

PMID- 1742171
TI  - Application of polymyxin-coated polyester cloth to the semi-quantitation of
      Salmonella in processed foods.
AB  - A rapid and economical semi-quantitative test for Salmonella cells in foods is
      proposed. Food samples containing different levels of Salmonella cells were
      homogenized and serially diluted in enrichment broths and then incubated for
      about 20 h at 37 degrees C. The presence of Salmonella cells in each dilution was
      assayed by capturing deoxycholate-extracted Salmonella lipopolysaccharides on a
      sheet of polymyxin-coated polyester cloth, followed by colorimetric detection
      with an anti-Salmonella antibody-enzyme conjugate. The minimum dilutions which
      resulted in no detectable growth were correlated with the extent of Salmonella
      contamination in the food samples.

PMID- 1742172
TI  - Comparison between semisolid Rappaport and modified semisolid Rappaport
      Vassiliadis media for the isolation of Salmonella spp. from foods and feeds.
AB  - Two semisolid media poured in petri dishes, semisolid Rappaport and modified
      semisolid Rappaport Vassiliadis were compared for the recovery of Salmonella spp.
      from 154 high- and low-moisture foods and feeds. Semisolid media were inoculated
      after pre-enrichment in buffered peptone water and after enrichment in Muller
      Kauffmann tetrathionate broth and selenite cystine broth. Also a conventional
      procedure was used, where the enrichment broths were streaked on Brilliant Green
      and bismuth sulphite agars. Of 62 samples found positive for Salmonella by one or
      more methods, semisolid Rappaport detected all of them and 60 when inoculated
      directly from the pre-enrichment broth. Modified semisolid Rappaport-Vassiliadis
      gave only 20 positive samples. The difference in productivity between semisolid
      Rappaport and the other media poured in plates (modified semisolid Rappaport
      Vassiliadis, Brilliant Green and bismuth sulphite agar) was statistically
      significant (P less than 0.001). The incubation temperature recommended for
      modified semisolid Rappaport-Vassiliadis (42 degrees C) was found to be too high.
      By comparison to the other media, semisolid Rappaport gave a 500% increase in the
      detection of the enteritidis serotype of Salmonella.

PMID- 1742173
TI  - Temperature in agar plates and its influence on the results of quantitative
      microbiological food analyses.
AB  - The numbers of colony forming units (cfu) of some strains of Enterobacteriaceae
      growing in Violet Red bile agar at 44 degrees C can vary considerably depending
      on incubation conditions and location of an individual agar plate in a stack. The
      reason is that the heating-up rates of the agar in plates incubated at elevated
      temperatures are slower if the incubators do not have an air circulator and/or if
      the plates are located in the centre of a stack. Variability in agar temperatures
      among different plates after 24 h of incubation at 44 degrees C was higher if
      plates were placed in an incubator with an air circulator than in an incubator
      without one. This effect could be avoided if the plates were incubated enclosed
      in a plastic bag.

PMID- 1742174
TI  - The effect of microwave and conventional cooking on the temperature profiles and
      microbial flora of minced beef.
AB  - Beef mince samples were cooked to the rare, medium and well done states by
      microwave and conventional oven methods. The raw samples all contained large
      numbers of contaminating organisms and low numbers of Listeria monocytogenes were
      detected in the majority of samples. A substantial proportion of the
      contaminating flora survived in mince cooked by microwaves to the rare, medium
      and well done states, prior to a 30-min standing period. Listeria monocytogenes
      survived in all samples cooked by microwaves to the rare state, prior to the
      standing period and was still present in one of three after the standing period.
      It was also detected in one of three samples cooked to medium prior to a standing
      period. This organism was not detected in mince cooked by conventional oven
      methods. In all the samples cooked by microwaves with a standing period and
      samples cooked to rare and medium by conventional oven, survival of some of the
      microflora occurred. The survival rate decreased with the severity of the cooking
      treatment.

PMID- 1742175
TI  - The effects of temperature, pH, sodium chloride and sodium nitrite on the growth
      of Listeria monocytogenes.
AB  - An automated turbidimetric system using multiwelled plates was used to examine
      the effects of different combinations of NaCl (0.5-8.0% w/v), NaNO2 (0-400
      micrograms/ml) pH (4.6-7.4) and temperature (5-30 degrees C) on the growth of
      Listeria monocytogenes in tryptone soya broth. The data presented clearly
      illustrate the combinations that permit visible growth of the organism. The
      ability of L. monocytogenes to grow at low pH levels was strongly influenced by
      incubation temperature as well as NaNO2 concentration. At 20 degrees C and below,
      no visible growth was detected, even with 50 micrograms/ml NaNO2 at pH 5.3 (or
      below) within 21 days. At pH 6.0 and above, NaNO2 had little effect in delaying
      visible growth except at higher concentrations and also at lower incubation
      temperatures.

PMID- 1742176
TI  - Primary erythrocytosis in childhood.

PMID- 1742177
TI  - Fosfomycin--friend or foe?

PMID- 1742178
TI  - Primary immunodeficiencies: milestones in the history of pediatric immunology.
AB  - Pediatric immunology is a recent and important branch of pediatrics. Besides
      development of vaccines, the discovery of primary immunodeficiencies has
      represented a major contribution in the history of pediatric immunology.
      Characterization of these disorders as inborn errors of immunity has been crucial
      for understanding the functional organization and ontogeny of the immune system.
      Thus, progress in the study of immunodeficiency diseases has contributed to
      progress in pediatric immunology as a whole. As a result of these advances and a
      major biotechnology breakthrough, new therapeutic strategies have been devised.
      The benefits of these strategies extend far beyond the area of
      immunodeficiencies; they permit better care of infants and give new therapeutic
      approaches to other inherited disorders.

PMID- 1742179
TI  - A disseminated alveolar rhabdomyosarcoma in a 9-year-old boy disclosed by
      chromosomal translocation (2;13) (q35;q14)
AB  - A 9-year-old boy presented with a small subcutaneous tumor of the trunk and
      diffuse bone marrow involvement. The first histological diagnosis given was
      undifferentiated malignancy possibly of neural crest origin and chemotherapy was
      started immediately using vincristine, cyclophosphamide, cisplatin, and
      teniposide (OPEC). Complete response was achieved after four courses of
      chemotherapy. Histological slides were then reviewed and the final diagnosis of
      alveolar rhabdomyosarcoma (RMS) was retained. Moreover, chromosome analysis of
      malignant cells in the bone marrow revealed a translocation involving chromosomes
      2 and 13:t(2;13) (q35;q14). This specific karyotype finding has been recently
      reported in a few cases and could be specific for alveolar RMS. The patient had a
      relapse 7 months after diagnosis and died 4 months later.

PMID- 1742180
TI  - Primary benign erythrocytosis with high erythropoietin levels and an early
      erythropoietin-sensitive population in the peripheral blood.
AB  - Primary erythrocytosis diagnosed in a 10-month-old female and followed for 12
      years is described. The erythrocytosis was associated with an abnormally elevated
      set point of erythropoietin production in which the sensitivity fluctuated
      independently, but corresponded to the alterations in the oxygen-carrying
      capacity of the blood, when the hematocrit was lowered by phlebotomies. Extensive
      work for secondary erythrocytoses failed to demonstrate a recognizable cause for
      this abnormal erythropoietin production. Erythroid cell cultures from peripheral
      blood mononuclear cells showed the existence of at least two populations: one
      consistent with dramatic expansion of the erythron in keeping with enhanced
      sensitivity to endogenous erythropoietin, and the other consistent with the
      features of typical colonies derived from burst-forming units-erythroid (BFU-Es),
      seen in normal peripheral blood on days 12 to 14 of culture. The expanded
      population was characterized by the appearance of single colonies on days 4 to 6
      and enormous response to the increasing amounts of erythropoietin, which enhanced
      their number, size, and maturation. The combination of clinical and in vitro data
      as well as the absence of any abnormality in the erythropoiesis of the parents
      and sibling suggest that the erythrocytosis in this child represents a new form
      with a benign course.

PMID- 1742181
TI  - Diabetes insipidus 9 years after cessation of therapy for acute lymphoblastic
      leukemia.
AB  - A case of a 16-year-old who developed diabetes insipidus (DI) 9 years after
      cessation of therapy for ALL is reported. Because hereditary and traumatic
      factors are excluded as a cause of DI in this patient, possible explanations may
      be leukemic CNS relapse, secondary brain tumor, primitive idiopathic DI, and late
      sequelae of CNS radiochemotherapy.

PMID- 1742182
TI  - Leiomyoma of the suprarenal gland in a child with ataxia-telangiectasia.
AB  - We report the occurrence of a leiomyoma of the suprarenal gland in a 10-year-old
      girl with ataxia-telangiectasia (A-T). Muscle cell tumors are very uncommon in
      this gland as they are in A-T. Possible reasons for developing nonhematologic
      tumors in this syndrome are reviewed. A defect in DNA repair mechanisms probably
      favors, in young children, the expression of tumors normally expected in the
      aged.

PMID- 1742183
TI  - Fosfomycin does not reduce cytostatic activity of cis-platinum against human
      osteosarcoma cell lines in vitro.
AB  - Fosfomycin has been shown to ameliorate the dose-limiting ototoxicity and
      nephrotoxicity associated with the antineoplastic agent cis-platinum. Clinical
      use of fosfomycin in cis-platinum-treated tumor patients critically depends on
      retaining therapeutic efficacy of cis-platinum while designing modalities to
      reduce side effects. This study uses two independent assay systems for cell
      viability and proliferation; we demonstrate that cytocidal activity of cis
      platinum against human osteosarcoma cell lines is not affected by various
      concentrations of fosfomycin up to 0.1 mg/ml in vitro. This suggests that in
      these cells there is no direct pharmacodynamic interaction of cis-platinum and
      fosfomycin with respect to mechanisms crucial for tumor kill.

PMID- 1742184
TI  - Cell-mediated immunity in children with Hodgkin's and non-Hodgkin's lymphomas.
AB  - Natural killer (NK) cell activity and lymphocyte proliferation to mitogens might
      to have diagnostic implications that will help to distinguish between benign and
      malignant lymphadenopathy in children. In addition, we suggest that NK activity
      and especially the lowering of NK activity after chemotherapy might be of
      prognostic value in NHL children.

PMID- 1742185
TI  - Reversible changes on computed tomography scans of the brain during induction
      therapy for acute lymphoblastic leukemia in children.
AB  - Children with acute lymphoblastic leukemia (ALL) have been shown to develop
      changes on computed tomography (CT) scans of the brain. These changes are seen
      both during and after therapy. Some of the results have been contradictory. Nine
      children with ALL were examined by CT of the brain during induction therapy. All
      children showed normal CT scans on the day of diagnosis. One month later all had
      dilatation of the ventricles and widened sulci. During the next 9 months the CT
      scans gradually were normalized. We conclude that such changes in CT scans of the
      brain are transitory and are caused by the high dose of prednisolone administered
      during induction therapy.

PMID- 1742186
TI  - Isolated muscular relapse in a child with B-acute lymphoblastic leukemia, off
      therapy.

PMID- 1742187
TI  - Clostridium difficile in children with malignant disease.

PMID- 1742188
TI  - Interleukin-6 and thrombocytopoiesis: probable role of platelets during acute
      phase responses.

PMID- 1742189
TI  - Acquired immunodeficiency syndrome (AIDS)--data as at 1 June 1991.

PMID- 1742191
TI  - Outbreaks of rubella in Amish communities, 1991.

PMID- 1742190
TI  - Rabies. Implications of the Channel Tunnel for the United Kingdom's freedom from
      rabies.

PMID- 1742192
TI  - Cholera in Africa.

PMID- 1742193
TI  - Measles surveillance. 1982-1990.

PMID- 1742194
TI  - Hepatitis A.

PMID- 1742195
TI  - Fourth report of the cooperative, open-ended study of slowly growing mycobacteria
      by the International Working Group on Mycobacterial Taxonomy.
AB  - The open-ended study of the International Working Group on Mycobacterial Taxonomy
      is an ongoing project to characterize slowly growing strains of mycobacteria that
      do not belong to well-established or thoroughly characterized species. In this
      fourth report we describe two numerical taxonomic clusters that represent
      subspecies or biovars of Mycobacterium simiae, one cluster that encompasses the
      erstwhile type strain of the presently invalid species "Mycobacterium
      paraffinicum," one cluster that is phenotypically very similar to Mycobacterium
      avium and Mycobacterium intracellulare but may be a separate genospecies, one
      cluster that appears to be phenotypically distinct from M. avium but reacts with
      a nucleic acid probe specific for M. avium, and three tentatively defined
      clusters in proximity to a cluster that encompasses the type strain of
      Mycobacterium malmoense. Of special practical interest is the fact that one of
      the latter three clusters is composed of clinically significant scotochromogenic
      bacteria that can be misidentified as the nonpathogenic organism Mycobacterium
      gordonae if insufficient biochemical tests are performed.

PMID- 1742196
TI  - Numerical analysis and DNA base compositions of some thermophilic Bacillus
      species.
AB  - Morphological, physiological, and biochemical characteristics and the DNA base
      compositions of 133 thermophilic Bacillus strains were determined. A total of 54
      of these strains were received as identified species (mainly Bacillus
      stearothermophilus, Bacillus coagulans, Bacillus brevis, and Bacillus
      licheniformis) from international culture collections, and 79 newly isolated
      strains, which were isolated mainly from sugar diffusion juices of Italian
      plants, were also examined. Numerical taxonomy techniques (simple matching
      coefficient and unweight pair grouping using the mathematical average) and DNA G
      + C values showed that the strains aggregated into nine clusters. Both B.
      licheniformis and B. brevis were well separated from the other organisms. B.
      stearothermophilus and B. coagulans were confirmed as separate clusters and
      exhibited greater heterogeneity than previously shown. The B. stearothermophilus
      strains clustered into four groups, three of which have been recognized
      previously by other authors; the members of the fourth group had distinctive
      characteristics, including considerable biochemical inertness, an inability to
      grow at temperatures greater than 60 degrees C, and a high G + C content. Within
      the B. coagulans cluster the strains with characteristics very similar to those
      of the new species Bacillus smithii clustered together. However, the remaining
      strains were still clearly separated into two groups; one of these groups was
      considered B. coagulans sensu stricto, and the other was distinguished by
      morphological and biochemical criteria, such as spores which do not swell the
      sporangia, utilization of citrate, a higher proteolytic activity, and
      acidification of some carbohydrates. Our results were confirmed by comparing them
      with distinctive characteristics of recently described thermophilic Bacillus
      species.

PMID- 1742197
TI  - Bacillus brevis Migula 1900 taxonomy: reassociation and base composition of DNA.
AB  - Of 87 strains previously identified as Bacillus brevis Migula 1900, 58 had G + C
      contents of 47.0 to 51.9 mol%, a range that included the G + C content (48.7
      mol%) of the type strain. The G + C contents for three other groups consisting of
      5, 7, and 17 strains were 37.0 to 41.9, 42.0 to 46.9, and 52.0 mol% or higher,
      respectively. DNA reassociation studies showed that 25 of the 58 strains with G +
      C contents of 47.0 to 51.9 mol% were closely related genetically to the type
      strain and to each other. For the most part, this genetically related group was
      phenotypically homogeneous; variations in the fermentation of mannitol and
      mannose were observed. My results strongly suggest that many of the strains were
      misclassified as B. brevis. Consequently, much of the phenotypic heterogeneity of
      the species B. brevis Migula 1900 is not due to variations exhibited by
      genetically related organisms, but is the result of variability introduced by the
      presence of genetically unrelated strains.

PMID- 1742198
TI  - Evaluation of the genus Listonella and reassignment of Listonella damsela (Love
      et al.) MacDonell and Colwell to the genus Photobacterium as Photobacterium
      damsela comb. nov. with an emended description.
AB  - The genus Listonella, which was recently described on the basis of 5S rRNA
      sequence data, was found to be of dubious value on the basis of the results of a
      comparison of a number of taxonomic studies involving members of the
      Vibrionaceae. The available data suggest that 5S rRNA sequences may be of limited
      taxonomic use at the intra- and intergeneric levels, at least for apparently
      recently evolved groups, such as the Vibrionaceae. In this light, we assessed the
      generic assignment of the species Listonella damsela. Phenotypic characterization
      of 12 strains of bacteria assigned to L. damsela, including type strain ATCC
      33539, revealed a strong resemblance to members of the genus Photobacterium. All
      of the strains conformed to major characteristics common to all known
      Photobacterium species. The characteristics of these organisms included the
      absence of a flagellar sheath and accumulation of poly-beta-hydroxybutyrate
      during growth on glucose coupled with the inability to utilize DL-beta
      hydroxybutyrate as a sole carbon source. On the basis of the phenotypic data, we
      propose that L. damsela should be reassigned to the genus Photobacterium as
      Photobacterium damsela comb. nov.

PMID- 1742199
TI  - Streptococcus crista sp. nov., a viridans streptococcus with tufted fibrils,
      isolated from the human oral cavity and throat.
AB  - We studied strains of an unusual streptococcus that superficially resembles
      Streptococcus sanguis but has fibrils that are arranged in lateral tufts. These
      strains were originally isolated from human throats and oral cavities and have
      been referred to previously as "Streptococcus sanguis I," the "CR group," and the
      "tufted-fibril group." Until now, insufficient phenotypic data have been
      available to allow reliable differentiation of these strains from other viridans
      streptococcal species, particularly the species in the S. sanguis group.
      Recently, workers have proposed a scheme of phenetic tests that is based on 4
      methylumbelliferyl-linked substrates and conventional biochemical tests and
      allows the tufted-fibril group to be differentiated; these organisms differ from
      other viridans species in being able to hydrolyze arginine but not esculin and in
      producing alpha-L-fucosidase but not beta-glucosidase or alkaline phosphatase.
      These data, together with the results of our DNA-DNA hybridization experiments
      and the unusual ultrastructure of the tufted-fibril strains as determined by
      electron microscopy, demonstrate that these organisms represent a new species,
      for which the name Streptococcus crista is proposed. The DNA base composition is
      42.6 to 43.2 mol% G + C. The type strain is strain CR311 (= NCTC 12479).

PMID- 1742200
TI  - Phenotypic differentiation of bifidobacteria of human and animal origins.
AB  - The phenotypes of 153 strains belonging or related to the genus Bifidobacterium
      were studied. These organisms included 38 collection strains and 115 wild strains
      (41 strains of human origin, 56 strains of animal origin, and 18 strains obtained
      from rivers or sewage). Our phenotypic analysis revealed seven main groups that
      were subdivided into 20 subgroups. Seven subgroups contained no type or
      collection strain. Among the human strains, the type strains of Bifidobacterium
      pseudocatenulatum and B. catenulatum fell into group I, which contained the type
      strains of B. adolescentis (subgroup Ib), B. dentium (subgroup Ic), and B.
      angulatum (ungrouped). The type strain of B. breve belonged to subgroup IIIa1,
      and the type strains of B. infantis and B. longum fell into subgroup IIIb1. Group
      VII comprised only wild strains that were isolated from human infant feces. Among
      the animal strains, group II consisted mainly of bifidobacteria that were
      isolated from pig feces and contained the type strains of B. suis (subgroup IIb),
      B. thermophilum (subgroup IIf), B. choerinum, and B. boum (ungrouped). Wild
      strains belonging to group V were isolated from pig, calf, cow, and chicken
      feces; this included the type strains of B. animalis (subgroup Va), B. magnum
      (subgroup Vb), B. pseudolongum, and B. globosum (subgroup Vc). The strains of
      human origin (groups I, III, and VII) were well separated from the animal strains
      (groups II, IV, and V). It was not surprising that the wild strains isolated from
      surface water or sewage were distributed in the animal groups as well as the
      human groups. Thus, bifidobacteria can be considered to be successful indicators
      of human or animal fecal pollution when they are correctly classified. The
      acidification patterns were not adequate to differentiate Bifidobacterium
      species, as determined previously by Mitsuoka (Bifidobacteria Microflora 3:11-28,
      1984) and Scardovi (p. 1418-1434, in P. H. A. Sneath, N. S. Mair, M. E. Sharpe,
      and J. G. Holt, ed., Bergey's Manual of Systematic Bacteriology, vol. 2, 1986).
      However, enzymatic tests furnished new taxonomic criteria for the genus.

PMID- 1742201
TI  - Codes and abbreviations for approved of effectively published names of genera of
      bacteria published from January 1980 to December 1990.
AB  - Lists of abbreviations for genus names of bacteria are expanded to accommodate
      103 new entries which are names that have been validity published since the
      publication of an updated list by Rogosa et al. in 1986 (Int. J. Syst. Bacteriol.
      36:464-472). These abbreviations are provided to serve the need for appropriate
      codified abbreviations for use in processing or indexing of information on
      computers.

PMID- 1742202
TI  - Validation of the publication of new names and new combinations previously
      effectively published outside the IJSB. List no. 39.

PMID- 1742203
TI  - On the Helicobacter species isolated from the pig-tailed macaque.

PMID- 1742204
TI  - Experimental studies in rats on the effects of asbestos inhalation coupled with
      the inhalation of titanium dioxide or quartz.
AB  - Rats were exposed for 1 year, with a 2-year follow-up, to dust clouds consisting
      of a mixture of amosite or chrysotile asbestos with either titanium dioxide or
      quartz. The addition of titanium dioxide to asbestos did not increase levels of
      pulmonary fibrosis above the amounts produced by chrysotile or amosite alone.
      Quartz, however, greatly increased fibrosis above that produced by the asbestos
      types alone. Both particulate dusts caused an increase in the numbers of
      pulmonary tumours and mesotheliomas compared to asbestos alone but while tumours
      in animals treated with asbestos and quartz tended to occur earlier than tumours
      with asbestos alone, in animals treated with dusts containing titanium dioxide,
      tumour production occurred later than with asbestos alone. In animals treated
      with mixtures of asbestos and quartz, there was evidence of increased transport
      of fibres across the visceral pleural surface and this may be associated with the
      finding of a higher proportion of pleural mesotheliomas than previously reported
      in experimental inhalation studies from any laboratory using the main asbestos
      varieties. The presence of particulate dusts made little difference to the
      amounts of amosite fibre retained in the lung tissue but, with chrysotile,
      titanium dioxide appeared to increase retention while quartz reduced it.

PMID- 1742205
TI  - Effects of ketamine, thiopental sodium and propofol on muscle contractures in rat
      diaphragm in vitro.
AB  - The effects of commonly used intravenous anaesthetic agents ketamine, thiopental
      sodium and propofol on the caffeine-alone or halothane-plus-caffeine-induced
      muscle contractures were investigated to determine safety for use in patients
      susceptible to malignant hyperthermia (MH). The muscle strips from rat diaphragm
      were exposed to one of these anaesthetic agents prior to challenge with caffeine
      8 mmol/l alone or halothane 3% plus caffeine 8 mmol/l together. None of the three
      agents induced contractures when added alone. Ketamine 100 mumol/l and thiopental
      sodium 300 mumol/l augmented neither caffeine-alone nor caffeine-with-halothane
      contractures significantly and these two agents appear to be safe for use in MH
      susceptible patients. In contrast, propofol 150 mumol/l augmented these
      contractile responses significantly and may not be recommended for use in
      patients known to be susceptible to this anaesthetic complication.

PMID- 1742206
TI  - Combined coumarin and omental transfer treatments for canine proximal obstructive
      lymphoedema.
AB  - In a canine model both coumarin treatment (believed to act by increased local
      proteolysis) and surgical transfer of a bridge of vascularized, lymphatic-rich
      omentum cause significant reduction of experimental lymphoedema. The present
      paper describes the effects of consecutive application of these two types of
      treatment. Ten dogs were divided into two equal groups: Group 1 Coumarin
      treatment, 6 months; no treatment, 6 months; omental transfer, 6 months; or Group
      2 Omental transfer, 12 months (biopsied at 6 months); coumarin treatment, 6
      months. Prior to treatment the excess limb circumferences were 2.66 and 3.01 cm
      in Groups 1 and 2 respectively. In Group 1, 6 months coumarin treatment alone
      reduced swelling by 0.78 cm and the final reduction in swelling at 18 months was
      1.03 cm. In Group 2, reduction in swelling 6 months after omental transfer alone
      was 0.96 cm and the final reduction at 18 months was 2.05 cm. The findings
      indicate that in Group 1 there is an additive effect of the two types of
      treatment. However, in Group 2 it is not possible to be certain whether the
      improvement that occurred between 6 and 18 months also reflects an additive
      effect or a later consequence of the earlier omental transfer.

PMID- 1742207
TI  - Morphological and morphometric studies of the airways of sheep with acute airway
      hypersensitivity to inhaled Ascaris suum.
AB  - The airways of 12 sheep with naturally-occurring allergic airway
      hypersensitivity, six of which had changes in both airway resistance and dynamic
      lung compliance (Group A) and six of which had changes in only dynamic lung
      compliance (Group B), were compared quantitatively with six non-reacting sheep
      (Group C) in order to examine the relation between airway hypersensitivity and
      various morphological features thought to be related to airway hypersensitivity.
      Compared to the non-reacting sheep (Group C), the hypersensitive sheep (Groups A
      and B) had a thinner epithelium in medium bronchi and bronchioles, fewer goblet
      cells in bronchioles, and greater gland area at most airway levels. The
      differences of the gland dimensions and the types of mucosubstance between
      hypersensitive and non-reacting animals were more variable. No significant
      differences between the three groups were noted with regard to luminal occlusion
      or epithelial sloughing and squamous metaplasia. Although there was a positive
      association between epithelial thickness and goblet cell density in the small
      airways, the development of allergic airway hypersensitivity in sheep may occur
      in the absence of major morphological changes in the airway epithelium.

PMID- 1742208
TI  - Contribution to the study of septal fibrosis of the liver.
AB  - Cellular and vascular proliferation in the perisinusoidal area of the acinar zone
      III of the liver preceded the formation of septal fibrosis in rats repeatedly
      treated with intraperitoneal injections of pig serum. Deposition of type I, III,
      IV and V collagens and increased amounts of fibronectin and laminin were also
      observed. Immunochemical staining for actin, elastin and desmin better disclosed
      the rich vascularization of the fibrous septa. Hypertrophy and hyperplasia of
      sinusoidal fat-storing cells point to the main role of such cells in the process
      of septum formation, but other connective tissue cells, such as mast-cells, were
      also present. These changes seemed to result from stimulation of the sinusoidal
      macrophage/fat-storing-cell system by foreign material present in the pig serum.
      The model may be useful for further studies on pathogenesis of septal fibrosis of
      the liver.

PMID- 1742209
TI  - A fall in duodenal PGE2 synthesis precedes histological changes and ulceration in
      the cysteamine model of duodenal ulceration.
AB  - The temporal association of histological damage and mucosal prostaglandin E2
      (PGE2) synthesis was examined in the cysteamine model of duodenal ulceration in
      the rat. Four groups of 10 animals were used; a control group (which had a light
      ether anaesthetic, an i.m. injection of vehicle and were killed 18 h later) and
      three treatment groups (which were similarly treated but injected with cysteamine
      (0.3 mg/g body weight) and killed at 6, 18 or 24 h). Estimates of duodenal PGE2
      synthesis and histological assessment of mucosal damage were performed. There
      were four early deaths in the 24-h group due to intra-thoracic haemorrhage. The 6
      h group appeared normal macroscopically. There were seven established and three
      early ulcers in the 18-h group and two established and four early ulcers in the
      survivors of the 24-h group. Microscopically, the 6-h group did not differ from
      controls, but the 18 and 24-h groups showed evidence of mucosal damage compared
      to the control group (P less than 0.001). All three treatment groups synthesized
      less PGE2 than did the control group (P less than 0.001). Thus at 6-h post
      injection, a decrease in PGE2 synthesis was evident but mucosal damage occurred
      later. Histological features correlated negatively with PGE2 synthesis (P less
      than 0.001).

PMID- 1742210
TI  - Effects of dietary fatty acids on the early stages of neoplastic induction in the
      rat pancreas. Changes in fatty acid composition and development of atypical
      acinar cell nodules.
AB  - Diets enriched with fat, especially unsaturated fat, promote experimental
      pancreatic carcinogenesis, but little is known of the effects of individual fatty
      acids. The effect of stearic and oleic acid on pancreatic fatty acids and
      atypical acinar cell nodules (preneoplastic lesions) was studied in 14-day-old
      weanling male Leeds strain rats (n = 60) given the carcinogen azaserine. Rats
      were allocated to one of six groups: untreated controls (n = 10), 20% stearic
      acid diet (n = 10), 20% oleic acid diet (n = 10), carcinogen alone (n = 10),
      carcinogen plus 20% stearic acid diet (n = 10) or carcinogen plus 20% oleic acid
      diet (n = 10). Azaserine was administered by intraperitoneal injection in a dose
      of 30 mg/kg at 2, 3 and 4 weeks of age. When total lipid extracts of pancreas
      were examined, there was an increase in stearic acid in the stearic acid fed
      group and an increase in oleic acid in the oleic acid fed group, irrespective of
      carcinogen treatment. The relative content of all other pancreatic fatty acids
      was suppressed by feeding oleic acid. At 26 weeks, the number and volumetric
      indices of pancreatic atypical acinar cell nodules was increased only in rats
      given azaserine and oleic acid. The enhancing effect of oleic acid on pancreatic
      carcinogenesis may be associated with pancreatic fatty acid changes.

PMID- 1742211
TI  - Hydronephrosis: prevention by restoration of urinary concentrating ability using
      desamino-8D-arginine vasopressin (DDAVP) in Brattleboro rats.
AB  - Male Brattleboro rats with hereditary diabetes insipidus (BDI) were lifetime
      treated with the vasopressin V2 receptor agonist desamino-8D-arginine vasopressin
      (DDAVP), given daily in the drinking fluid. The DDAVP-treated adult male BDI rats
      drank 34 +/- 6 ml/24 h (mean +/- s.e.m.) and excreted urine volumes of 22 +/- 5
      ml/24 h compared with their age-matched untreated controls of 142 +/- 12 and 115
      +/- 7 ml/24 h respectively. There was no significant difference between the mean
      body weights of chronically DDAVP-treated BDI rats (198 +/- 9 g) and untreated
      animals (207 +/- 9 g). Morphometry of sections of kidney confirmed extensive
      hydronephrosis in the right kidneys of the control untreated Brattleboro rats
      only. This was quantified as the area of pelvis expressed as a percentage of
      total cross-sectional area of kidney (17 +/- 3 compared with 5 +/- 1% in the
      chronically DDAVP-treated rats; P less than 0.002). Medium-term treatment of
      adult BDI rats with DDAVP reduced daily fluid output towards normal rat values
      but hydronephrosis was still present. These observations indicate that the
      restoration of fluid balance in adult BDI rats by treatment from conception with
      DDAVP may be an important factor in preventing the development of hydronephrosis
      in these animals.

PMID- 1742212
TI  - In-vitro interaction of human macrophages with Pneumocystis carinii.
AB  - Pneumocystis carinii is an important opportunistic pathogen in patients with
      compromised cell-mediated immunity. T-cell and macrophage function are believed
      to be of prime importance in defence against this organism. The present
      ultrastructural study is aimed at the analysis of the interaction between human
      macrophages and P. carinii in vitro. Adherent peripheral blood mononuclear cells
      from healthy volunteers were exposed in vitro to Pneumocystis derived from lungs
      of steroid-treated rats. The macrophages were harvested at different intervals
      and studied by transmission and scanning electron microscopy. The material used
      for inoculation of macrophages was of identical morphology to previously
      described P. carinii. When mixed with Pneumocystis in vitro, the macrophages
      appeared to move towards the organism, extended pseudopods and ingested
      trophozoites and cysts. Within 24 h, intracellular Pneumocystis underwent
      progressive degeneration inside macrophage vacuoles. This study highlights the
      possible role of macrophages in host defence against P. carinii.

PMID- 1742213
TI  - The role of surfactant in the pulmonary reaction to mineral particles.

PMID- 1742214
TI  - Early bone marrow transplantation for patients with potentially curable
      malignancies.

PMID- 1742215
TI  - How should prognostic factors influence therapy in follicular lymphomas?

PMID- 1742216
TI  - Clinical research in advanced breast cancer: back to the future?

PMID- 1742217
TI  - How should we treat disseminated seminoma?

PMID- 1742218
TI  - Multiple confirmatory trials. How can additional studies be of value?

PMID- 1742219
TI  - Cancer diagnosis by molecular genetic probes: the present and the promise.

PMID- 1742220
TI  - Adjuvant therapy of colon cancer: lessons while looking for breakthroughs.

PMID- 1742221
TI  - The identification of discrete prognostic groups in low grade non-Hodgkin's
      lymphoma. The Scotland and Newcastle Lymphoma Group Therapy Working Party.
AB  - A prognostic model was developed by examination of the prospectively recorded
      presentation characteristics of patients presenting with low grade non-Hodgkin's
      lymphomas (LGL). A geographically distinct group (Edinburgh and Borders) was
      excluded in order to test the validity of the model based on the rest of the
      Scotland and Newcastle Lymphoma Group (SNLG) population. Between 1979 and 1987
      506 patients presented with low grade lymphoma according to Working Formulation
      definition within one of each of the three main pathology categories. The median
      available follow-up was 47 months. In a multivariate analysis performance status,
      age, stage, gender and haemoglobin all contributed separately. 25% of all
      patients had relatively good prognosis with a median survival not reached and 84%
      alive at 5 years. Conversely for the worst prognostic group of 25% of patients
      the median survival is 18 months with only 26% surviving at 5 years. Finally for
      the intermediate group of 50% of all patients, median survival is 69 months with
      58% alive at 5 years. These striking prognostic separations are shown also to be
      valid in sub-group analysis. Thus young patients within any pathology subgroup
      have been identified with bad prognostic lymphoma for whom novel strategies in
      therapy should be devised.

PMID- 1742222
TI  - Epirubicin in breast cancer patients with liver metastases and abnormal liver
      biochemistry: initial weekly treatment followed by rescheduling and
      intensification.
AB  - Fifty-two consecutive patients with breast cancer and liver metastases have been
      treated with epirubicin. All had a serum aspartate aminotransferase more than
      twice the upper limit of normal or a raised bilirubin. Initial treatment was with
      6 cycles of weekly epirubicin 25 mg/m2. In patients whose liver biochemistry
      improved sufficiently, treatment was then changed to a 3-weekly schedule and an
      attempt was made to increase dose-time intensity during a further 6 cycles of
      epirubicin. The UICC response rate was 15/52 (29%, with 95% confidence intervals
      18-42%) and median response duration was 34 weeks. All 23 patients who were
      eligible for rescheduling received epirubicin 3-weekly, but escalation of dose
      intensity was possible in only 5 patients. The activity and tolerability of
      weekly epirubicin has been confirmed in patients with liver metastases from
      breast cancer. However, late dose escalation was impracticable in the majority of
      patients and did not appear to improve outcome.

PMID- 1742223
TI  - Folinic acid + 5-fluorouracil (5-FU) versus equidose 5-FU in advanced colorectal
      cancer. Phase III study of 'GISCAD' (Italian Group for the Study of Digestive
      Tract Cancer).
AB  - In a multicentre Phase III trial, 182 patients were randomized to either folinic
      acid (FA) (200 mg/sqm i.v. x 5 days) + 5-fluorouracil (5-FU) (400 mg/sqm i.v. in
      15' x 5 days) every 4 weeks (Arm A), or to 5-FU alone at the same dosage (Arm B).
      Response rates were 20.6% (Arm A) and 10% (Arm B) with a significant (p = 0.046)
      advantage for FA + 5-FU. Median time to progression (6 and 6 months) and overall
      survival (11.5 and 11 months) were similar in the 2 groups of patients, while
      neither treatment was effective in reducing pain or improving performance status.
      Univariate analysis showed that no prognostic factors other than treatment
      influenced response, although survival was affected by the number and site of
      metastases, performance status, and the presence and degree of pain. Toxicity was
      acceptable and lower in comparison with other Phase II-III trials, with no
      significant difference between the 2 arms. However, in individual patients, grade
      3-4 side effects (mainly stomatitis and diarrhoea) were observed, particularly in
      patients receiving FA: this led to interruption of the treatment in 7 cases. The
      superiority, in terms of objective response, of FA + 5-FU over 5-FU alone would
      seem to justify a large-scale evaluation of this combination in the adjuvant
      setting. Further improvements in relation to advanced disease (i.e.,
      modifications to the schedule and/or introduction of other modulators) are
      warranted.

PMID- 1742224
TI  - A randomized, double-blinded study comparing six doses of batanopride (BMY-25801)
      with methylprednisolone in patients receiving moderately emetogenic chemotherapy.
AB  - Several agents in a new class of antiemetic compounds, 5-hydroxytryptamine (5
      HT3) antagonists, have shown promise as effective antiemetics with fewer side
      effects than metoclopramide. One of these agents, batanopride, produced no severe
      toxicity at doses that prevented emesis due to chemotherapy in early Phase I
      trials. We conducted a randomized, double-blinded, 7 arm clinical trial to: (1)
      identify the presence of a dose-response for complete protection from emesis, and
      (2) compare batanopride with a standard antiemetic, methylprednisolone if a dose
      response was found not to exist. Prior to chemotherapy, six patient groups each
      received a single intravenous dose of batanopride ranging from 0.2 to 6.0 mg/kg
      whereas a seventh group received methylprednisolone 250 mg intravenously.
      Chemotherapy-naive cancer patients scheduled to receive moderately emetogenic
      chemotherapy were eligible. Primary treatment outcomes that were recorded and
      analyzed included the number of episodes of emesis, the time to the first episode
      of emesis as well as the frequency and severity of nausea. Two hundred and eight
      patients accrued between April 1989 and February 1990 were evaluable for
      response. A significant dose-response effect for complete protection from emesis
      was not seen over the first 24 hours after chemotherapy (p = 0.102). However, a
      linear dose-response effect for time to first emesis was evident in a
      multivariate analysis (p = 0.029). While the highest batanopride dose group was
      associated with a higher complete protection rate (CPR) than the control group,
      this group also exhibited a higher incidence of diarrhea (p = 0.013),
      hypotension, and electrocardiographic abnormalities.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1742225
TI  - Cisplatin and etoposide in advanced colorectal carcinoma.
AB  - The cisplatin (P) and etoposide (E) combination has been found to be active in
      several types of solid tumors. It has never been previously tested in advanced
      colorectal cancer. Thirty-three patients with advanced colorectal cancer were
      treated with this combination. Five patients responded (1 complete and 4 partial
      responses) with an overall response rate of 15% (95% confidence limits, 3%-27%).
      Responses were seen in both untreated (3/16) and pretreated (2/17) patients. The
      median duration of response was 28 weeks (range: 23; 80), the median time to
      progression was 16 weeks (range 2; 80) and the median survival time for all
      entered patients was 38 weeks (range: 2; 187+). These results suggest that the PE
      combination has a low but definite activity in advanced colorectal carcinoma,
      particularly in previously untreated patients.

PMID- 1742226
TI  - Continuous infusion of 5-fluorouracil in ovarian cancer patients refractory to
      cisplatin and carboplatin.

PMID- 1742227
TI  - Mouth cooling to prevent doxorubicin-induced stomatitis.

PMID- 1742228
TI  - UKCCCR randomized study of chemo-radiotherapy for advanced head and neck
      carcinoma.

PMID- 1742229
TI  - Use of an electron beam for post-mastectomy radiotherapy: 5-year follow-up of 500
      cases.
AB  - Since 1982, the standard method of postmastectomy regional radiotherapy at the
      Christie Hospital has been to use a single electron field of fixed energy (8 MeV)
      to irradiate the chest wall, matched to a single megavoltage field (4 or 8 MV)
      irradiating the nodal areas in the axilla and supraclavicular fossa. (A separate
      parasternal field was not used.) All 500 cases treated in 1982 and 1983 with this
      method were reviewed (median follow-up 59 months). Four hundred and twenty-two
      were referred directly post-mastectomy and 78 for local recurrence after previous
      mastectomy. Of these, 42 were treated palliatively, and 458 with radical intent.
      In radical cases the given dose in both fields was 40 Gy in 15 fractions in 3
      weeks. The overall survival (n = 458) was 51% (actuarial) at 5 years. At 5 years
      the local recurrence rate by site and UICC stage were as follows: chest wall -
      all Stages 17%, Stage I 4%, Stage II 13%, Stage III 26%, recurrent cases 21%;
      axillary recurrence - all Stages 20%, Stage I 4%, Stage II 10%, Stage III 22%,
      recurrent cases 39%; supraclavicular recurrences - all Stages 9%. Only one
      patient of the 500 treated had a parasternal recurrence. Late effects included
      mild telangiectasia in the electron field and asymptomatic apical lung fibrosis
      in the photon field. There was no match line fibrosis.

PMID- 1742230
TI  - A phase II study of 5-fluorouracil, adriamycin and mitomycin-C in adenocarcinoma
      of the oesophagus.
AB  - We have evaluated the effect of 5-fluorouracil 600 mg/m2, doxorubicin
      ('Adriamycin') 40 mg/m2, and Mitomycin-C 4 mg/m2 (FAM) in two groups of patients
      with adenocarcinoma of the oesophagus, as either a preoperative or primary
      treatment. Response was assessed by barium swallow, CT scan, and measurement of
      metastases where present. Toxicity was as reported for FAM in gastric cancer. In
      the operated group 8 of 22 patients (36%) showed a partial response following two
      courses of FAM. Resection was completed in 20 patients, with six hospital deaths
      (30%). Of the 14 patients who were discharged from hospital, 8 have died (median
      8 months) and 6 are alive at 12 to 27 months, with known recurrence in 1. In the
      non-operated group 6 of 17 patients (35%) showed a response, one complete,
      following one to six (mean 4.2) courses of FAM. Fifteen patients have died
      (median 5 months), and 2 are alive and free from disease at 12 and 17 months.
      Neoadjuvant therapy with FAM in adenocarcinoma of the oesophagus offers no
      advantage over surgery alone, although with inoperable disease FAM may be of use
      in palliation.

PMID- 1742231
TI  - Descriptive epidemiology of primary central nervous system tumours in children: a
      population-based study.
AB  - This study was undertaken to investigate the incidence, outcome and referral
      patterns of central nervous system tumours in a defined childhood population over
      a recent 5-year period. The study incorporated pathological review of all
      available diagnostic material and follow-up assessed survival at a minimum of 5
      years from diagnosis. One hundred and forty-seven cases were reviewed,
      representing an annual incidence of 26.5 per million children aged less than 15
      years. The distribution of individual diagnoses by age, sex and anatomical site
      was similar to comparable data collected previously in the United Kingdom and
      North America, but the inclusion of 28 cases (19%) without biopsy suggested that
      the wider use of computed tomography might account for a small increase in
      incidence over previous estimates. Analysis of referral to the Regional
      Paediatric Oncology Unit showed that the patients referred were younger than
      those not referred and were over-represented amongst the diagnoses of
      medulloblastoma, ependymoma and brain stem glioma, which carry the worst
      prognosis. Survival for all diagnoses together was 51% at 5 years, ranging from
      13% for unbiopsied brain stem gliomas to 100% for juvenile astrocytomas. Referral
      to the Regional Unit appeared to have some survival advantage for children with
      medulloblastoma, although this was not statistically significant. Accurately
      reviewed data such as these are essential in order to assess current workload and
      treatment success, in addition to enabling investigation of future diagnostic and
      treatment strategies.

PMID- 1742232
TI  - The influence of some factors on local control of early glottic cancer.
AB  - A total of 135 patients with T1N0M0 and T2N0M0 carcinoma of the vocal cord were
      treated during a 20-year period at St Mary's Hospital in Portsmouth by local
      radiotherapy. A total of 122 patients were available for local control analysis.
      The local control of T1 tumours was 80.5%, and for T2, 51.1%, total T1 + T2 local
      control was 69.7% (P less than 0.001). The only other factor in univariate
      analysis, which influenced the results was the overall treatment time. In the
      group of patients treated by an overall time of 45 days or less, the local
      control was 83.7%. For longer time it was 62% (P less than 0.02). Multivariate
      analysis confirmed these findings but brought out the importance of vocal cord
      mobility as the best discriminating factor between local control and failure,
      followed by overall treatment time.

PMID- 1742233
TI  - Chemotherapy versus radiotherapy for stage I-II intermediate grade non-Hodgkin's
      lymphomas.
AB  - The clinical outcome of 149 patients with Stage I-II intermediate grade non
      Hodgkin's lymphomas was analysed. There were 77 (52%) males and 72 (48%) females.
      Their median age was 58 years. Eighty patients (54%) had Stage I disease and 69
      (46%) Stage II. Twenty-nine (20%) of them received radiotherapy only, 75 (50%)
      doxorubicin-containing chemotherapeutic regimens and 45 (30%) other less
      intensive chemotherapy. Sixty-two patients had additional radiotherapy following
      chemotherapy. Patients receiving other less intensive chemotherapy were
      significantly older (P = 0.0001) and those receiving radiotherapy alone had a
      significantly higher proportion of Stage I disease (P = 0.007). Patients
      receiving less intensive chemotherapy had a significantly low complete response
      (CR) rate. Patients receiving radiotherapy alone had a significantly high relapse
      rate and low disease-free survival following CR. However, there was no
      significant difference in overall survival regardless of the mode of therapy.
      This lack of survival advantage might be related to the effective salvage
      chemotherapy in some of the radiotherapy failures and the occasional chemotherapy
      related mortality. Additional radiotherapy following chemotherapy did not appear
      to give further benefit.

PMID- 1742234
TI  - Abdominopelvic radiotherapy following surgery and chemotherapy in advanced
      ovarian cancer.
AB  - Thirty advanced ovarian cancer patients have been treated with sequential
      multimodality treatment including primary surgery, cisplatin or carboplatin-based
      polichemotherapy, second-look laparotomy followed by abdominopelvic irradiation
      (moving strip or open-field technique). Toxicity related to the combined
      treatment was acceptable: only three patients failed to complete and two patients
      delayed the prescribed course of radiotherapy because of acute myelosuppression
      or gastroenteric disturbances. One patient without evidence of disease required
      laparotomy for bowel obstruction one month after completion of radiotherapy. No
      other chronic toxicity of clinical significance has been observed. Actuarial
      three-year survival significantly correlated with residual disease at the start
      of radiotherapy: no residuum, 100%, microscopic disease, 52%; less than 2 cm
      macroscopic disease, 27.4% (P less than 0.05), whereas recurrences were less
      frequent only in the group of pathological complete responders (3/9) compared to
      patients with limited disease (6/11 with micro and 7/10 with macroscopic
      residuum). In conclusion radiotherapy following surgery and chemotherapy is not
      associated to serious morbidity but its value in improving progression-free
      survival rates has to be tested in randomized trials.

PMID- 1742235
TI  - Lung abscess: a fatal complication of treatment for testicular teratoma.
AB  - We describe a patient with widely metastatic testicular teratoma who responded to
      intensive combination chemotherapy but developed a lung abscess in a necrotic
      tumour cavity, leading to death before surgical resection of residual lesions
      could take place. Post-mortem examination revealed necrotic tissue and mature
      differentiated teratoma, with no evidence of frank malignancy. This complication
      has not been previously reported in treated teratoma. Resolution of an abscess
      developing in a pre-existing thick-walled lesion is less likely with antibiotics
      alone. Awareness of this might salvage potentially curable cases by earlier
      surgical intervention.

PMID- 1742236
TI  - Selective embolization of internal iliac artery for massive haemorrhage from
      bladder secondary to carcinoma.
AB  - Uncontrolled haemorrhage from the urinary bladder secondary to carcinoma can at
      times be a life-threatening complication. We report a case of recurrent carcinoma
      of bladder where all the conservative measures for controlling hematuria had
      failed. Selective embolization of both internal iliac arteries was undertaken
      which controlled haematuria within 12 hours of the procedure. The procedure had
      not caused any complication up until the patient was last seen 5 months after the
      procedure.

PMID- 1742237
TI  - Radical external beam radiotherapy for localized carcinoma of the prostate using
      a hypofractionation technique.

PMID- 1742238
TI  - Victim blame and the disinhibition of sexual arousal to rape vignettes.
AB  - The present study examined the effects of differing levels of victim blame on the
      sexual arousal of males to rape vignettes. In the first experiment, a between
      subjects experimental design was used to compare four groups of eight university
      males for their erectile responses to vignettes rated as low, medium, and high
      along a victim blame continuum. All groups found a consenting vignette more
      arousing than a nonconsenting vignette, however, this difference was
      significantly smaller for subjects in the high blame condition compared to the
      low and medium blame conditions. A second experiment supported the disinhibiting
      effect of the high victim blame manipulation using 12 university males in a
      within-subjects experimental design. The disinhibiting influence of victim blame
      on male sexual arousal to rape cues was discussed in relation to our broader
      understanding of sexual assault.

PMID- 1742239
TI  - Lesbians in currently aggressive relationships: how frequently do they report
      aggressive past relationships?
AB  - Findings are reported from a survey examining the frequency with which women in
      currently aggressive same-sex relationships also report aggressive past
      relationships involving female partners, male partners, or members of their
      family of origin. Particular attention is paid to victims who also used
      aggression and their perceptions of whether their aggressive behavior was self
      defensive or mutually aggressive. Results indicate that about one-fourth of
      participants had been victims of aggression in current relationships, roughly two
      thirds had been victimized by a previous male partner, and almost three-fourths
      had experienced aggression by a previous female partner. Among those reporting
      having been both victims and users of aggression, about one-fifth had used
      aggression in their current relationship, almost one-third used aggression with a
      previous male partner, and nearly two-thirds had used aggression with a previous
      female partner. A majority of victims who had also used aggression with a
      previous male partner characterized this use as self-defense, as compared to only
      30% of those who had used aggression with a female partner. Instead, aggression
      in relationships involving a female partner was most frequently described as
      mutually aggressive in nature.

PMID- 1742240
TI  - Battered wives: the home as a total institution.
AB  - This paper is based on research which examined the lives of Israeli battered
      women from the phenomenological aspect. Thirty-five unstructured interviews were
      carried out in a shelter for battered women. The women's accounts suggest that
      the situation of battered women resembles that of inmates of total institutions,
      as defined by Goffman (1961). Physical barriers are imposed upon them, and they
      go through a process of mortification of the self which begins soon after the
      marriage. Compulsory confinement to the house damages the self and diminishes the
      ability to cope. Furthermore, it cuts the women off from external sources of
      physical help and moral support. Increased understanding of this harsh reality
      would benefit the social agencies engaged in helping battered women.

PMID- 1742241
TI  - Over- vs. undercontrolled hostility: application of the construct to the
      classification of maritally violent men.
AB  - The purpose of the present investigation was to evaluate the applicability of
      Megargee's (1967) distinction between over- and undercontrolled hostility to
      maritally aggressive men. Subjects were 41 men who were referred for treatment
      for physical marital violence. Data were derived from a written battery of self
      report measures. Overcontrolled hostile men showed patterns of abuse in which
      violent episodes were more severe but less frequent and in which the wife was the
      sole target of the aggressive behavior. Undercontrolled hostile husbands were
      more generally aggressive and more frequently aggressive. Additionally,
      undercontrolled husbands were more likely than overcontrolled husbands to have
      witnessed violence in their families of origin and to have had rejecting mothers.
      Implications for the assessment and treatment of marital violence are discussed.

PMID- 1742242
TI  - Female victims of homicide: a portrait of their killers and the circumstances of
      their deaths.
AB  - The population of 131 arrestees for homicides committed against females during
      1982 and 1983 in Detroit, Michigan, is analyzed in the context of their killings.
      Analyses include demographic and social characteristics of offenders and victims,
      demographic and social relationships between offenders and victims, circumstances
      of offense, and arrest disposition. Where feasible, comparisons are made with
      general populations and samples of homicide offenders.

PMID- 1742243
TI  - The relationship between skin maturation and electrical skin impedance.
AB  - When performing electrophysiological testing, high electrical impedance values
      are sometimes found in neonates. Since excessive impedance can invalidate test
      results, a study was conducted to delineate the relationship between skin
      maturation and electrical skin impedance. This study investigated the skin
      impedance in 72 infants ranging from 196 to 640 days of age from conception.
      Regression analyses demonstrated a significant relationship between impedance and
      age, with the highest impedance centered around full-term gestation with values
      falling precipitously at time points on either side. Clinically, impedance values
      fall to normal levels at approximately four months following full-term gestation.
      Skin impedance values are low in premature infants, but rapidly increase as the
      age approaches that of full-term neonates. Low impedance values in premature
      infants are attributed to greater skin hydration which results from immature skin
      conditions such as 1) thinner epidermal layers particularly at the transitional
      and cornified layers; 2) more blood flow to the skin; and 3) higher percentage of
      water composition. These factors facilitate the diffusion of water vapor through
      the skin. As the physical barrier to skin water loss matures with gestational
      age, the skin impedance reaches a maximum value at full term neonatal age. After
      this peak, a statistically significant inverse relationship exists between
      electrical skin impedance and age in the first year of life. This drop in skin
      impedance is attributed to an increase in skin hydration as a result of the
      greater functional maturity of eccrine sweat glands.

PMID- 1742244
TI  - Cutaneous responses to topical methyl nicotinate in human forearm and vulvar
      skin.
AB  - In order to identify and define differences in percutaneous absorption and
      microcirculatory sensitivity between forearm and vulvar skin we studied the
      response of human forearm and vulvar (labium majus) skin to topical methyl
      nicotinate (MN) in 11 healthy premenopausal volunteers. MN-induced erythema was
      assessed by laser Doppler velocimetry (LDV). The following parameters were
      compared: 1) basal cutaneous blood flow, 2) the time to peak response, 3) the
      magnitude of LDV peak response, 4) the area under the LDV response-time curve and
      5) the decay time to 75% of peak response. Basal cutaneous blood flow at the
      vulva was higher than at the forearm (P less than 0.05); the magnitude of peak
      response was lower at the vulva than at the forearm (P less than 0.01); the area
      under the curve was lower at the vulva than at the forearm (P less than 0.001);
      the decay time to 75% of peak response was shorter at the vulva than at the
      forearm (P less than 0.001). The time to peak response showed no significant
      differences between sites. The results indicate that the MN-induced
      vasodilatation is less intense and lasts shorter in vulvar compared to forearm
      skin.

PMID- 1742245
TI  - Changes in cutaneous microcirculation, hemorrheology and platelet aggregation
      function in dermatomyositis.
AB  - Marked disturbance of microcirculation was observed in 85 cases of
      dermatomyositis: decrease in number and irregular pattern of the capillaries,
      many being tortuous and dilated and having a slow and granular blood stream, as
      well as an increase of vascular permeability. The changes were more marked in
      cases with visceral disorders, or in active disease; however, there was no
      correlation between these changes and the duration of illness. Blood
      hyperviscosity was found in an hemorrheological study. The cause is considered to
      be due to high plasma viscosity, high fibrinogen levels, and increase of
      aggregation of erythrocytes and platelets. Modulation of microcirculation is
      advisable in the treatment of dermatomyositis.

PMID- 1742246
TI  - The effect of 1,25-dihydroxyvitamin D3 on the growth and differentiation of
      cultured human outer root sheath cells from normal subjects and patients with
      vitamin D-dependent rickets type II with alopecia.
AB  - We examined the effect of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) on the growth
      and differentiation of cultured human hair outer root sheath cells (ORSC) from
      normal subjects and patients with vitamin D-dependent rickets type II (DDR-II)
      with alopecia. 1,25(OH)2D3 dose-dependently suppressed the plating efficiency,
      clonal growth, and DNA synthesis of normal ORSC. It enhanced the cornified
      envelope formation and caused morphological changes in the cells. All results
      indicated the existence of specific receptors for 1,25(OH)2D3 in the ORSC, and
      suggest that 1,25(OH)2D3 is a potent inhibitor of proliferation of ORSC as well
      as a stimulator of terminal differentiation. However, the cells from DDR-II
      patients with alopecia did not respond to 1,25(OH)2D3, suggesting a lack of the
      specific receptors in the cells. The differences in the cellular response to the
      hormone between the normal ORSC and those from the patients were apparent and
      easily distinguishable, therefore this experiment may be a rapid and simple
      diagnostic test for DDR-II patients with alopecia. Large number of hairs were
      difficult to obtain from patients with alopecia, and we developed a new culture
      method to accomplish these studies from a few plucked hair follicles. Our system
      may be useful in the culture of ORSC from limited number of follicles, and could
      be utilized to analyse the cellular characteristics of ORSC in patients with hair
      diseases.

PMID- 1742247
TI  - A three-year photopatch study in Thailand.
AB  - Photopatch testing was performed on 274 patients who had history of
      photosensitivity at the Institute of Dermatology Thailand from 1987 through 1989.
      A total of 92 positive photocontact reactions and 71 positive contact reactions
      were seen. The most frequent positive photopatch test reactions were to
      sulfanilamide (18.2%) followed by Jadit (4.4%) chlorpromazine (3.6%) promethazine
      (3.6%) and fenticlor (3.2%). The most common photodermatoses was polymorphous
      light eruption (60.9%). Photocontact dermatitis was established in 28 patients
      (10.2%) while other skin diseases aggravated by sunlight were seen in 47 patients
      (17.2%).

PMID- 1742248
TI  - Processing and statistical analysis of laser Doppler data applied to the
      assessment of systemic anti-inflammatory drugs.
AB  - Continuous laser Doppler measurements of methyl nicotinate-induced skin
      inflammation have been used to evaluate the activities of three oral non
      steroidal anti-inflammatory drugs, indomethacin 50 mg (Indocid), tiaprofenic acid
      100 mg (Surgam) and sodium acetylsalicylate 1 g (Catalgine). They were compared
      in a single-blind, randomized, intra-individual comparison (N = 16) versus
      placebo (lactose). One hour after each drug was ingested, four concentrations of
      methyl nicotinate were applied to the subject's forearms. Simultaneous skin blood
      flow (SBF) measurements were then carried out on the four tested zones, by use of
      four calibrated laser Doppler flowmeters. Computerized processing of recorded SBF
      levels provided data related to flow amplitude, kinetics and magnitude (area
      under the curve) of the reactions. A detailed statistical analysis was performed
      to establish the selectivity of this type of test and the following points were
      demonstrated: adjustment of SBF data to baseline did not improve precision, data
      had to be log-transformed before analysis, and magnitude data gave the best
      product discrimination. Under the conditions of this study, i.e. one hour after
      oral administration and for the indicated doses, the tested products could be
      classified, in terms of anti-inflammatory activity, as follows: Lactose less than
      Indomethacin 50 mg = Tiaprofenic acid 100 mg less than Sodium acetylsalicylate 1
      g.

PMID- 1742249
TI  - Intraepidermal distribution of free amino acids in porcine skin.
AB  - The study describes the vertical distribution of free amino acids in the porcine
      epidermis as compared to the human integument, using a micro-determination TLC
      method based on the reaction of amino acids with dansyl chloride. This
      microanalytical approach demonstrated 22 free amino acids, with the relatively
      largest amounts being present for acidic amino acids and their amides. It was
      obvious that the relative amounts of certain amino acids (alanine, proline,
      valine, glutamine, histidine, glycine, threonine) decreased, whereas acidic amino
      acids (glutamic acid, aspartic acid) increased from the stratum basale up to the
      stratum corneum. This distributional pattern could be verified for the dorsal and
      lateral body regions of the pig breeds used, and for man. The results obtained
      are discussed in view of the development of epidermal keratinization.

PMID- 1742250
TI  - Computed tomographic analysis of gallbladder stones: correlation with chemical
      composition and in vitro shock-wave lithotripsy.
AB  - The recent advent of nonsurgical treatment for gallstones requires accurate in
      vivo analysis of their chemical composition in order to select the best
      candidates. As a preliminary work, we undertook an in vitro CT examination of 53
      surgically removed gallstones and compared their CT patterns with their chemical
      composition. Those results were correlated with in vitro lithotripsy of the
      gallstones. The CT appearances were classified as follows: laminated (43%), dense
      (32%), rimmed (11%), isodense (8%) and faint (6%). The dense pattern contained a
      high calcium content. As the CT density increased, the calcium content increased,
      but the cholesterol content decreased proportionally. The number of shock waves
      needed to break down a gallstone less than 2 mm in size increased with stone
      volume and the cholesterol content increased but did not have any correlation
      with the calcium content level. As a result we found the CT examination to be a
      very sensitive method in detecting small amounts of calcium content in gallstones
      and the CT pattern and density of the gallstones were well correlated with their
      chemical composition, therefore in vivo CT examinations for ESWL candidates are
      desirable.

PMID- 1742251
TI  - Correlation of esophageal lengths with measurable external parameters.
AB  - Previous data for esophageal lengths are based on age related groups or cadaveric
      examination, both of which are improper for application to various individualized
      procedures. Because of the variability in height for any given age and longer
      length in vivo, individualized approximation is needed. Thus, we measured various
      anatomical levels of the esophagus using a flexible endoscope and correlated
      these data with measurable external body intervals. The mean esophageal length
      was 40.92 +/- 2.79, which is longer than the length derived from cadaveric
      examinations. Also, esophageal lengths which correlated better with height than
      any other body intervals, could be calculated from the following equation.
      Esophageal length from the upper incisors to the esophagogastric junction (L) can
      be expressed: L = 0.242 x height (Ht) + 2.078 cm (P = 0.000, R2 = 0525). The data
      from our study indicate that esophageal length can be reliably predicted using
      external body parameters before employing various procedures.

PMID- 1742252
TI  - Circulating HBsAg/IgG complexes in idiopathic chronic glomerulonephritis.
AB  - We measured HBsAg/IgG complexes (CX) quantitatively by ELISA from HBsAg positive
      serum of 35 liver disease patients, 15 patients with glomerular diseases (8
      membranous glomerulonephritis (MGN) 7 membranoproliferative glomerulonephritis
      (MPGN), and 50 healthy carriers of HBsAg. HbsAg/IgG CX was detected in 26 out of
      35 liver disease patients (74.3%), 5 out of 50 healthy carriers (10%), and one of
      both 8 MGN patients (12.5%) and 7 MPGN patients (14.3%). HBsAg/IgG CX was big in
      size and wide spread in the liver disease groups but negligible in the healthy
      carrier group (41 +/- 2.6 ng/ml, n = 5) and MGN (50 ng/ml, n = 1) and MPGN (42
      ng/ml, n = 1) group. In the liver disease group, no one suffered from
      glomerulopathy even with a wide spectrum of HBsAg/IgG CX. These results suggest
      that HBsAg/IgG CX in plasma is non causative of MGN and MPGN.

PMID- 1742253
TI  - Type III hypersensitivity reaction in mushroom growers.
AB  - Some respiratory symptoms in mushroom growers such as mushroom worker's lung
      develop by inhalation of certain agents arising from the environment of mushroom
      cultivation. Recently we observed mushroom workers who had respiratory symptoms
      which might be type III hypersensitivity reaction to the antigen of Pleurotus
      floridae. We gave questionnaires to all the mushroom growers at one of the
      biggest cultivation areas of mushrooms, Pleurotus floridae in Pocheon, Kyunggi
      Province. Those with respiratory symptoms were subjects for the study. CBC, chest
      X-ray, pulmonary function test, skin test with Pleurotus floridae extract, and
      precipitin antibody test to Pleurotus floridae were performed in the study
      subjects. Out of a total 308 mushroom workers, 23 workers (14 males, 9 females)
      had respiratory symptoms. Their mean age was 45 years, and their mean duration of
      engagement was 3.4 years. Their main symptoms were cough (100%), sputum (82.6%),
      dyspnea (43.5%), and fever with chills (13.0%). Two cases showed increased
      interstitial lung markings on chest X-ray films. Sixteen cases (73.9%) showed
      precipitin antibodies against P. floridae extract by
      counterimmunoelectrophoresis. Antibodies against Micropolyspora faeni and
      Thermoactinomyces vulgaris were not detected in any subject.

PMID- 1742254
TI  - A case of post-traumatic coronary occlusion.
AB  - Several cases of transmural myocardial infarction and ventricular aneurysm caused
      by a blunt trauma of the chest have been reported. Nevertheless, the cases
      documented with coronary and ventricular angiography are very few. There has
      always been a debate over the etiological mechanism of such lesions. Since in
      some cases there was no evidence of coronary lesions, it was postulated that they
      were produced by direct myocardial contusion, but in other instances the evidence
      of coronary occlusion was angiographically and pathologically proved. We
      experienced a case of acute myocardial infarction with ventricular aneurysm
      secondary to nonpenetrating chest trauma by an umbrella tip and wish to report
      this unusual case, along with a review of the literature.

PMID- 1742255
TI  - A case of pulmonary cysticercosis.
AB  - Cysticercosis, which has a worldwide distribution is found in man, who is usually
      infected by eating inadequately cooked pork or other contaminated food.
      Cysticercosis develops most commonly in the muscles and brain. Pulmonary
      involvement is very rare and also difficult to recognize because pulmonary
      lesions caused by the presence of cysticerci are difficult to discern from
      pulmonary infiltrates, because other parasitic infestations or tuberculosis, as
      well as metastatic lesions, produce similar chest X-ray findings and similar
      clinical symptoms. We experienced a case of pulmonary cysticercosis confirmed at
      Gyeongsang National University Hospital by means of an open lung biopsy and
      treated successfully with praziquantel (50 mg/kg per day for 15 days). This case
      seems to indicate that pulmonary cysticercosis should be considered as a
      diagnostic possibility in patients with nodular infiltrates in the lungs,
      especially in endemic areas, until such infiltrates are otherwise explained.

PMID- 1742256
TI  - A case of primary T-cell lymphoma of the duodenum.
AB  - Primary malignant lymphoma located in the duodenum is a rarity. A case of primary
      lymphoma of the duodenum in a 27-year-old man, in which the 2 discrete masses of
      duodenal bulb and the second portion with pancreatic head invasion was found, is
      reported here. Immunohistochemical evaluation of the present case showed that
      lymphoma cells expressed the T-cell markers MT1 and UCHL1. Treatment consisted of
      pancreaticoduodenectomy followed by antineoplastic chemotherapy.

PMID- 1742257
TI  - Autoradiographic and immunohistochemical study on the proliferative kinetics of
      intestinal metaplasia.
AB  - In order to elucidate the proliferative behavior of the intestinal metaplasia
      around gastric cancer, the authors used both in vitro tritiated thymidine (3H
      thymidine) autoradiography and in vivo bromodeoxyuridine (BrdUrd)
      immunohistochemistry for labeling the proliferative cells of the normal pyloric
      glands and metaplastic gastric glands. The results of the methods were
      comparable: The labeling pattern and the rate of labeling were very similar. In
      the normal pyloric mucosa, the labeled cells were confined to the isthmus region,
      indicating that pyloric glandular cells are normally renewed from the isthmus
      region. On the other hand, a zone of the labeled cells was found in the lower
      half of the intestinalized mucosa, indicating that cell proliferation took place
      deep in the mucosa, just like the case of normal intestinal glands. The labeling
      indices of the pyloric mucosa were 19.4% by autoradiography and 18.0% by
      immunohistochemistry, and that of the intestinalized gastric glands were 25.2% by
      autoradiography and 24.2% by immunohistochemistry. In conclusion, both 3H
      thymidine autoradiography and BrdUrd immunohistochemistry showed that the
      proliferative kinetics of the intestinalized gastric glands was similar to that
      of the normal intestinal glands rather than the pyloric glands, i.e. a lower
      level of proliferative zone and higher labeling index were present.

PMID- 1742258
TI  - The characteristics of midfacial fractures and the association with ocular
      injury: a prospective study.
AB  - Ocular injuries commonly occur in patients with facial fractures. This
      prospective study was set up to determine the incidence of ocular injuries, as
      assessed by an ophthalmologist, in patients who had sustained midfacial
      fractures. Over a 2-year period, a study of 363 patients who had sustained
      midfacial trauma sufficient to lead to a facial bone fracture (438 fractures) was
      undertaken and patients received a comprehensive examination by an
      ophthalmologist and an orthoptist within 1 week of injury. The characteristics of
      the eye injuries sustained were related to the aetiology of the fracture, the
      type of fracture, and the sex and age of each patient. Ninety percent of patients
      sustained ocular injuries of various severities. Sixty three percent of patients
      sustained only minor or transient ocular injuries, 16% suffered moderately severe
      ocular injury and 12% experienced severe eye injuries. Road traffic accident was
      associated with the highest incidence of severe ocular disorder (9/45 = 20%)
      whilst assaults had the second highest incidence at 11% (20/181). One third of
      all patients with comminuted malar fracture suffered a severe ocular disorder
      (9/27) whilst blow-out fracture came second at 16.7% (6/36). Fifty six patients
      (15.4%) had a decrease in their visual acuity and 9 patients (2.5%) had
      significant traumatic optic neuropathy. Decrease in visual acuity was the main
      clinical finding accompanying the majority of significant eye injuries. When
      ocular injuries were related to aetiology, it was apparent that road traffic
      accidents and assaults associated with alcohol abuse showed the highest incidence
      of major ocular dysfunction. It is suggested that all patients sustaining
      midfacial fracture associated with a significant decrease in visual acuity either
      pre- or postoperatively should have an early ophthalmological review.

PMID- 1742259
TI  - Diplopia following midfacial fractures.
AB  - Over a period of 2 years, 363 patients who had sustained a total of 438 midfacial
      fractures due to blunt trauma received a full ophthalmological examination within
      1 week of injury. Of these, 72 patients (19.8%) developed diplopia. Diplopia was
      most common following road traffic accidents (31%) and least common with simple
      falls (10%). Blow-out fractures of the orbit led to double vision in 58% of
      cases. Eighty two percent of patients recovered from diplopia within 6 months of
      injury; only 1 patient required squint surgery for double vision. The principal
      risk factors for diplopia comprise road traffic accidents, blow-out fractures and
      comminuted malar fractures. Early surgical reconstruction of midfacial fractures
      with conservative management of concomitant motility disorders has, in our
      series, resulted in very few patients having diplopia in the long term.

PMID- 1742260
TI  - Intermaxillary fixation compared to miniplate osteosynthesis in the management of
      the fractured mandible: an audit.
AB  - The hospital records of 30 patients with isolated fractured mandibles treated by
      intermaxillary fixation (IMF) were compared to 30 patients treated by miniplate
      osteosynthesis. The treatment variables assessed were the period of
      hospitalisation, the operating time, the use of intensive care or nurse
      specialing services, the number of outpatient visits, and the cost of materials.
      The cost of each facility was calculated from six sources, so that the average
      cost of each method of treatment could be determined. The results showed that the
      average cost for managing a fractured mandible with IMF was 1000 pounds if the
      intensive therapy unit (ITU) was used and 919 pounds if ward specialing services
      (a single nurse looking after the patient) were used. This compared with an
      average cost of 794 pounds for miniplate osteosynthesis. The extra cost of the
      materials if miniplates were used could be discounted by the longer period of
      hospitalisation, the use of ITU or nurse specialising services, and the greater
      number of outpatient visits that were required for patients treated with IMF. In
      addition the use of IMF significantly increased the time patients spent off work.

PMID- 1742261
TI  - A technique for control of the condylar head during open reduction of the
      fractured mandibular condyle.
AB  - Open reduction of fractures of the neck of the mandibular condyle may be
      technically difficult. Control of the proximal fragment may be achieved by
      insertion of a Moule pin into the condylar neck. This facilitates retrieval of
      the condylar head and alignment of the bone fragments which are essential
      components of the technique. Accurate anatomical reduction and stabilisation of
      the fracture simplifies the technique of miniature plate fixation.

PMID- 1742262
TI  - Titanium mesh (TiMesh) osteosynthesis: a fast and adaptable method of semi-rigid
      fixation.
AB  - Titanium mesh has been used in the USA for the fixation of fractures of the
      facial skeleton since the Vietnam war. Despite the increasing use of titanium
      mesh osteosynthesis for trauma, orthognathic and reconstructive surgery in the
      USA, it is only in recent years that it has gained acceptance in Europe. This
      paper appraises the original titanium mesh osteosynthesis system (TiMesh) in a
      wide range of surgical contexts in the maxillofacial region. It has been found to
      be quick and reliable in placement, highly adaptable and to have considerably
      reduced the operating time. Its further potential advantages in reducing stress
      shielding and improving functional bone healing due to its semi-rigid nature are
      discussed.

PMID- 1742263
TI  - Screw fixation after mandibular sagittal split osteotomy: an intra-oral approach.
AB  - Intra-oral, rigid, non-compressive fixation was used in a feasibility study in 10
      consecutive sagittal split osteotomies using two 3.5 or 2.7 mm diameter AO screws
      on each side. Seven patients were prognathic, three were retrognathic, and two
      had severe mandibular asymmetry. Lower third molars were removed concurrently in
      three patients. Horizontal and vertical stability was assessed by means of
      repeated, digitised cephalometry before operation, at 24-48 h and at 6 months.
      Intermaxillary fixation (IMF) was necessary during the first 48 h in one patient
      where the lingual fragments were too small. Intermaxillary elastics were used
      later in three patients. This method was straightforward, reliable, required no
      skin incisions and stability was similar to that following the use of transbuccal
      screw fixation. Mean horizontal relapse at 6 months (0.6 mm; maximum: 1.5 mm) was
      8% of operative movement. Unsatisfactory occlusion (anterior open bite)
      necessitated removal of screws at 28 days in one patient. This was carried out
      intra-orally under local anaesthesia. These results suggest that stable, screw
      fixation for sagittal split osteotomies can be achieved without recourse to an
      external approach.

PMID- 1742264
TI  - Pre-tapped and self-tapping screws in children's mandibles. A scanning electron
      microscopic examination of the implant beds.
AB  - One hundred 2 mm AO miniscrews were inserted into the mandibles of eight fresh
      cadavers aged 8 to 12 years. Scanning electron microscopic examination of the
      implant beds showed cracks and accumulated bone material, as well as signs of
      crushing and shearing stress, regardless of whether the screws were pre-tapped or
      not. When, during screw insertion, the axis of the screw deviated by at least 10
      degrees from the axis of the tap, two intersecting threads resulted. It is
      concluded that during osteosynthesis in child mandibles pre-tapping is not
      recommended.

PMID- 1742265
TI  - Osteoblastoma: a case report and description of the access used to the
      retromaxillary area.
AB  - A case of benign osteoblastoma in the retromaxillary region which presented as
      chronic left sided facial pain of 3 years' duration is reported. The surgical
      approach to a tumour in this site is difficult and potentially severely
      mutilating. A transfacial access is described.

PMID- 1742266
TI  - The effect of pre-operative perioral skin preparation with aqueous povidone
      iodine on the incidence of infection after third molar removal.
AB  - A study was carried out to measure the incidence of dry socket and wound
      infection following third molar removal under endotracheal general anaesthetic.
      One group of patients received pre-operative preparation of the perioral skin
      with a 10% solution of povidine-iodine, while the other received no skin
      preparation. Routine skin preparation imposes a risk of contact dermatitis and
      necessarily involves expense. In relation to postoperative wound infection, this
      practise was of no benefit. The results of this study provide evidence that skin
      preparation with povidine-iodine prior to third molar extractions should be
      discontinued.

PMID- 1742267
TI  - Blood splashes to the eyes in oral and maxillofacial surgery, and the risks of
      HIV transmission.
AB  - The risk of transmission of HIV through blood and saliva splashes to the mucous
      membranes around the face is unknown. Orthopaedic surgeons are very aware of
      possible risks and are beginning to take appropriate precautions. This present
      study indicates that oral and maxillofacial surgeons have similar risk factors,
      and the minimal precaution of wearing protective glasses should be recommended
      for all intraoral and extraoral surgery.

PMID- 1742268
TI  - Prophylactic antibiotics for patients with artificial joints undergoing oral and
      dental surgery: necessary or not?
AB  - Prophylactic antibiotic cover for certain oral and dental procedures for patients
      with artificial joints is a controversial issue. This paper examines the evidence
      supporting the use of antibiotic cover and concludes that routinely, for the
      majority of patients with artificial joints, it is not justified. Certain
      medically compromised patients with artificial joints have a slightly increased
      risk of infection and, under these circumstances, antibiotic prophylaxis may be
      justified. The antibiotic recommended for this group is cephradine or in the case
      of penicillin allergy, clindamycin. Preoperative dental fitness is mandatory for
      all patients who are to receive artificial joints. This information will be of
      interest to the oral and maxillofacial surgeon in his own clinical practice, and
      when giving advice to local general dental practitioners.

PMID- 1742269
TI  - Granuloma annulare of the supra-orbital region. A case report.
AB  - Granuloma annulare (GA) is a relatively infrequent condition affecting the dermis
      or the subcutaneous tissues. The aetiology of GA is purely speculative, but links
      with other diseases have been reported since the condition was first described.
      This paper discusses the usual presentation of GA, typical sites of involvement,
      and reviews the histology of the subcutaneous lesions of GA. It also reports a
      case of a 31-year-old patient who presented to an oral surgeon with subcutaneous
      lesions in the right supra-orbital region. A comparison between this lesion and
      another histologically similar entity is drawn. The reasoning behind the eventual
      definitive diagnosis is explained, and a review of the literature found GA
      affecting the head and neck to be rare.

PMID- 1742270
TI  - Atypical histiocytic granuloma of the tongue: case report.
AB  - Primary malignant lymphomas of the tongue have rarely been described, and
      reported cases are usually related to the posterior part of the tongue which is
      rich in lymphoid tissue, forming part of Waldeyer's ring. Making a distinction
      between pseudolymphoma and malignant lymphoma is important. Pseudolymphoma is a
      benign lesion not requiring aggressive therapy. Several lesions in the oral
      cavity, including atypical histiocytic granuloma, angiolymphoid hyperplasia with
      eosinophilia, and traumatic ulcerative granuloma with stromal eosinophilia have
      been described as having certain microscopic features similar to those of
      pseudolymphoma. Atypical histiocytic granuloma is not associated with systemic
      disease or dissemination and heals spontaneously despite its microscopic
      appearance.

PMID- 1742271
TI  - Intra-oral lipomata in association with congenital anomalies: a variant of Mohr's
      syndrome?
AB  - Two cases of intra-oral lipomata occurring in association with congenital
      anomalies are reported. These appear to be the first such cases described, in
      what appears to be a variant of Mohr's syndrome.

PMID- 1742272
TI  - The transcoronoid threaded wire: an aid to mandibular reconstruction.

PMID- 1742273
TI  - Merkel cell tumour.

PMID- 1742274
TI  - Traumatic aneurysms of the internal maxillary artery.

PMID- 1742275
TI  - DNA binding specificity of homeodomains.

PMID- 1742276
TI  - Design, chemical synthesis, and expression of genes for the three human color
      vision pigments.
AB  - Color vision in humans is mediated by three pigments from retinal cone
      photoreceptor cells: blue, green, and red. We have designed and chemically
      synthesized genes for each of these three pigments. The genes were expressed in
      COS cells, reconstituted with 11-cis-retinal chromophore, and purified to
      homogeneity using an immunoaffinity procedure. To facilitate the immunoaffinity
      purification, each pigment was modified at the carboxy terminus to contain an
      additional eight amino acid epitope for a monoclonal antibody previously used to
      purify bovine rhodopsin. The spectra for the isolated pigments had maxima of 424,
      530, and 560 nm, respectively, for the blue, green, and red pigments. These
      maxima are in excellent agreement with the maxima previously observed by
      microspectrophotometry of individual human cone cells. The spectra are the first
      to be obtained from isolated human color vision pigments. They confirm the
      original identification of the three color vision genes, which was based on
      genetic evidence [Nathans, J., Thomas, D., & Hogness, D.S. (1986) Science 232,
      193].

PMID- 1742277
TI  - Photolysis intermediates of human rhodopsin.
AB  - Photochemical studies were conducted on human rhodopsin at 20 degrees C to
      characterize the intermediates which precede the formation of metarhodopsin II,
      the trigger for the enzyme cascade mechanism of visual transduction. Human
      rhodopsin was prepared from eyes which had previously been used for corneal
      donations. Time resolved absorption spectra collected from 10(-8) to 10(-6) s
      after photolysis of human rhodopsin in detergent suspensions displayed
      biexponential decay kinetics. The apparent lifetimes obtained from the data are
      65 +/- 20 and 292 +/- 25 ns, almost a factor of 2 slower than the corresponding
      rates in bovine rhodopsin. The spectra can be fit well using a model in which
      human bathorhodopsin decays toward equilibrium with a blue-shifted intermediate
      (BSI) which then decays to lumirhodopsin. Spectra and kinetic rate constants were
      determined for all these intermediates using a global analysis which showed that
      the spectra of the human intermediates are remarkably similar to bovine
      intermediates. Microscopic rate constants derived from this model are 7.4 x 10(6)
      s-1 for bathorhodopsin decay and 7.5 x 10(6) s-1 and 4.6 x 10(6) s-1 for the
      forward and reverse reactions of BSI, respectively. Decay of lumirhodopsin to
      later intermediates was studied from 10(-6) to 10(-1) s after photolysis of
      rhodopsin in human disk membrane suspensions. The human metarhodopsin I in
      equilibrium metarhodopsin II equilibrium appears to be more forward shifted than
      in comparable bovine studies.

PMID- 1742278
TI  - Structure of the pure-spermine form of Z-DNA (magnesium free) at 1-A resolution.
AB  - We describe the three-dimensional X-ray structure of a complex of spermine bound
      to a Z-DNA duplex, [d(CGCGCG)]2, in the absence of any inorganic polyvalent
      cations. We have crystallized the DNA hexamer d(CGCGCG) in the exclusion of
      magnesium and other polyvalent ions and solved its structure at 1.0-A resolution.
      In the crystal of this pure-spermine form of Z-DNA, the relative orientation,
      position, and interactions of the DNA differ from the arrangement uniformly
      observed in over a dozen previously reported Z-DNA hexamers. Moreover, the
      conformation of the Z-DNA hexamer in this structure varies somewhat from those
      found in earlier structures. The DNA is compressed along the helical axis, the
      base pairs are shifted into the major groove, and the minor groove is more
      narrow. The packing of spermine-DNA complexes in crystals suggests that the
      molecular basis for the tendency of spermine to stabilize compact DNA structures
      derives from the capacity of spermine to interact simultaneously with several
      duplexes. This capacity is maximized by both the polymorphic nature and the
      length of the spermine cation. The length and flexibility of spermine and the
      dispersion of charge-charge, hydrogen-bonding, and hydrophobic bonding potential
      throughout the molecule maximize the ability of spermine to interact
      simultaneously with different DNA molecules.

PMID- 1742279
TI  - Stimulation of DNA polymerase alpha activity by microtubule-associated proteins.
AB  - Microtubule-associated protein 2 (MAP2) isolated from porcine brains stimulated
      the activity of DNA polymerase alpha immunopurified from calf thymus or human
      lymphoma cells, in a dose-dependent manner. This stimulation was pronounced when
      activated DNA or poly(dA).(dT)10 was used as the template-primer. DNA polymerase
      alpha bound to a MAP2-immobilized column, whereas preincubation of the enzyme
      with unbound MAP2 prevented binding to the column. These events suggested that a
      physical binding occurred between the polymerase and MAP2. Kinetic analyses
      revealed that MAP2 decreased the Km value of the polymerase for
      deoxyribonucleotides, irrespective of the species of template-primer. A
      concomitant increase in Vmax was observed; however, the extent of the increase
      depended on the species of template-primer. MAP2 also decreased the Km value of
      the polymerase for template-primers when activated DNA of poly(dA).(dT)10 was
      used as the template-primer. Product analyses showed that MAP2 did not
      significantly alter the processivity of the polymerase and the increment of Vmax
      is considered to be due to an increase in the frequency of initiation of DNA
      synthesis. The stimulation by MAP2 occurred specifically in the activity of DNA
      polymerase alpha, but not DNA polymerases beta, gamma, and I from Escherichia
      coli. Other MAPs, tau and 190-kDa MAP, could substitute for MAP2. Thus, the
      specific stimulation of DNA polymerase alpha by MAPs supports the notion of a
      possible involvement of MAPs or MAP-like proteins in DNA replication, in vivo.

PMID- 1742280
TI  - Interaction of ribosomal protein S1 and initiation factor IF3 with the 3' major
      domain and the decoding site of the 30S subunit of Escherichia coli.
AB  - We have studied the effect of the binding of ribosomal protein S1 and initiation
      factor IF3 on the accessibility of nucleotide residues 584-1506 in the small
      subunit of the Escherichia coli ribosome. Protein S1 strongly decreases RNase V1
      attack at G1164, in hairpin 40 of the 3' major domain, and weakly decreases DMS
      attack at C1302, in the central loop of the 3' major domain, and at A1503, in the
      3' minor domain. It also weakly increases the DMS reactivity of A1004, in the 3'
      major domain, and of A901, in the central domain. Factor IF3 strongly decreases
      RNase V1 attack (but not dimethyl sulfate attack) at A1408, in the decoding site,
      and weakly protects A1500, in the 3' minor domain and near the colicin E3
      cleavage site. Neomycin does not interfere with this effect of IF3, but IF3
      interferes with the protective effect of neomycin against dimethyl sulfate attack
      at A1408.

PMID- 1742281
TI  - Crystal structure of the cytochrome P-450CAM active site mutant Thr252Ala.
AB  - The crystal structure of a cytochrome P-450CAM site-directed mutant in which the
      active site Thr252 has been replaced with an Ala (Thr252Ala) has been refined to
      an R factor of 0.18 at 2.2 A. According to sequence alignments (Nelson & Strobel,
      1989), Thr252 is highly conserved among P-450 enzymes. The crystallographic
      structure of ferrous camphor- and carbon monoxide-bound P-450CAM (Raag & Poulos,
      1989b) suggests that Thr252 is a key active site residue, forming part of the
      dioxygen-binding site. Mutation of the active site threonine to alanine produces
      an enzyme in which substrate hydroxylation is uncoupled from electron transfer.
      Specifically, hydrogen peroxide and "excess" water are produced instead of the
      product, 5-exo-hydroxycamphor. The X-ray structure has revealed that a local
      distortion in the distal helix between Gly248 and Thr252 becomes even more severe
      in the Thr252Ala mutant. Furthermore, a solvent molecule not present in the
      native enzyme is positioned in the dioxygen-binding region of the mutant enzyme
      active site. In this location, the solvent molecule could sterically interfere
      with and destabilize dioxygen binding. In addition, the active site solvent
      molecule is connected, via a network of hydrogen bonds, with an internal solvent
      channel which links distal helix residues to a buried Glu side chain. Thus,
      solvent protons appear to be much more accessible to dioxygen in the mutant than
      in the wild-type enzyme, a factor which may promote hydrogen peroxide and/or
      water production instead of substrate hydroxylation. On the basis of
      crystallographic and mutagenesis data, a proton delivery pathway involving
      residues Lys178/Arg186, Asp251, and Thr252 is proposed for wild-type P-450CAM.
      Coordinates of structures discussed in this paper have been submitted to the
      Brookhaven Protein Data Bank (Bernstein et al., 1977).

PMID- 1742282
TI  - Mouse pulmonary cytochrome P-450 naphthalene hydroxylase: cDNA cloning, sequence,
      and expression in Saccharomyces cerevisiae.
AB  - We have isolated a cDNA clone, Nah-2, encoding the cytochrome P-450Nah
      (naphthalene hydroxylase) from a mouse lung lambda ZAP cDNA library using anti
      cytochrome P-450Nah IgG as a probe. This same antibody selectively blocked
      [Nagata, K., Martin, B.M., Gillette, J.R., & Sasame, H.A. (1990) Drug Metab.
      Dispos. 18, 557-564] the cytochrome P-450 in mouse lung microsomes that catalyzed
      the conversion of naphthalene to (1R,2S)-naphthalene 1,2-oxide, which has been
      postulated as a causative agent in the naphthalene-induced tissue-specific
      necrosis of Clara cells in mouse lung. The toxic effect is seen in mouse and not
      in rat. The cDNA encodes a polypeptide of 491 amino acids with a molecular mass
      of 50 kDa. Northern blot analysis with an Nah-2-specific probe revealed that the
      mRNA is expressed in a species- and tissue-specific manner, present only in mouse
      lung and liver and not in that of rat. The mRNA encoding Nah-2 is constitutively
      expressed and is not induced by either phenobarbital, pyrazole, pregnenolone 16
      alpha-carbonitrile, or 3-methylcholanthrene. Comparative amino acid sequence
      analyses with other documented members of the P-450 gene superfamily revealed
      that this encoded protein is in the IIF subfamily. To analyze its substrate
      specificity, the cDNA was inserted into the vector, pAAH5, and expressed in the
      Saccharomyces cerevisiae strain, AH22. The presence of cytochrome P-450Nah in the
      microsomes isolated from transformed cells and analyzed by Western blot was
      confirmed by immunocomplexing product with anti-cytochrome P450Nah IgG.
      Furthermore, activity toward naphthalene in the microsomes from the transformed
      cells established that this clone encodes a naphthalene hydroxylase.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1742283
TI  - Electrochemical and kinetic analysis of electron-transfer reactions of Chlorella
      nitrate reductase.
AB  - Assimilatory nitrate reductase (NR) from Chlorella is homotetrameric, each
      subunit containing FAD, heme, and Mo-pterin in a 1:1:1 stoichiometry.
      Measurements of NR activity and steady-state reduction of the heme component
      under conditions of NADH limitation or competitive inhibition by nitrite
      suggested intramolecular electron transfer between heme and Mo-pterin was a rate
      limiting step and provided evidence that heme is an obligate intermediate in the
      transfer of electrons between FAD and Mo-pterin. In addition to the physiological
      substrates NADH and nitrate, various redox mediators undergo reactions with one
      or more of the prosthetic groups. These reactions are coupled by NR to NADH
      oxidation or nitrate reduction. To test whether intramolecular redox reactions of
      NR were rate-determining, rate constants for redox reactions between NR and
      several chemically diverse mediators were measured by cyclic voltammetry in the
      presence of NADH or nitrate. Reduction of ferrocenecarboxylic acid,
      dichlorophenolindophenol, and cytochrome c by NADH-reduced NR was coupled to
      reoxidation at a glassy carbon electrode (ferrocene and dichlorophenolindophenol)
      or at a bis(4-pyridyl) disulfide modified gold electrode (cytochrome c), yielding
      rate constants of 10.5 x 10(6), 1.7 x 10(6), and 2.7 x 10(6) M-1 s-1,
      respectively, at pH 7. Kinetics were consistent with a second-order reaction,
      implying that intramolecular heme reduction by NADH and endogenous FAD was not
      limiting. In contrast, reduction of methyl viologen and diquat at a glassy carbon
      electrode, coupled to oxidation by NR and nitrate, yielded similar kinetics for
      the two dyes. In both cases, second-order kinetics were not obeyed, and
      reoxidation of dye-reduced Mo-pterin of NR by nitrate became limiting at low scan
      rates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742284
TI  - Identification of a new binding protein for crotoxin and other neurotoxic
      phospholipase A2s on brain synaptic membranes.
AB  - Crotoxin and other neurotoxic phospholipase A2s exert neurotoxicity by acting
      primarily at the presynaptic level. Strong binding of crotoxin and several others
      to synaptic membranes has been demonstrated previously. In this study we used
      simple chemical cross-linking techniques to identify the neuronal membrane
      molecules involved in the binding of these toxins. After 125I-crotoxin had bound
      to synaptosomes from guinea pig brain, treatment with disuccinimidyl suberate,
      disuccinimidyl dithiobis(propionate) or ethylene glycol bis(succinimidyl
      succinate) resulted in the formation of a predominant radioactive conjugate of
      approximately 60 kDa, which was different from the conjugate formed by
      photoaffinity labeling technique in a previous report. The membrane component in
      the conjugate was shown to be a single-chain protein of approximately 45 kDa. In
      subfractions of synaptosomes, this binding protein was mostly found in the
      synaptic membrane fraction and was not present in the mitochondrial fraction.
      Plasma membranes from several nonneural tissues also did not contain this binding
      protein. Unmodified crotoxin inhibited the formation of this adduct with an IC50
      of around 1 x 10(-8) M. Mojave toxin and some other phospholipase A2s were also
      highly inhibitory to this conjugation, and notexin and others were less
      effective, while beta-bungarotoxin and pancreatic PLA2 were totally ineffective.
      We concluded that a new protein of 45 kDa specifically present in neuronal
      membranes is another major molecule responsible for the binding of crotoxin and
      other phospholipase A2s.

PMID- 1742285
TI  - Unrestrained pride: development of a protocol for a restraint free environment.
AB  - This article describes one facility's experience in attempting to enhance
      compliance with nonrestraint policy. The importance of policy implementation is
      emphasized, particularly as it relates to nursing care. In response to a study
      which revealed that a large number of wheelchair restraints were being applied
      indiscriminately, the extended care facility developed a flow chart in order to
      facilitate appropriate decision making and assessment regarding safety and
      restraints. The flow chart/protocol was created to bridge the gap between the
      conceptual policy level and the procedures for restraint application and removal.
      It is based on the nursing process and is dependent on ongoing assessment of the
      resident's status. A survey carried out one year after the initial, pre
      intervention survey revealed that only 6.4% of residents were restrained using
      wheelchair lap belts, compared to the previous 26%, identified as problematic at
      the outset of the study.

PMID- 1742286
TI  - Admission criteria for a special care unit for residents with dementia.
AB  - The recent trend in caregiving for cognitively impaired residents has been to
      provide special care units. One of the questions in establishing a special unit
      is deciding on admission criteria. What range of impairment will benefit the most
      from this type of environment? This paper reports on how one facility developed
      specific assessment criteria for admission to a special unit. The goals were to
      identify potential residents for the unit, reduce subjectivity in the assessment
      process and be able to screen both residents and community applicants. Results of
      the screening instrument demonstrated that it was effective in identifying a
      range of impairments, it screened out the cognitively well and long standing
      psychiatric disorders, and also demonstrated that a pre-set bias did exist as to
      who should be admitted.

PMID- 1742287
TI  - The family support group.
AB  - This article was written as an informative guide for health care professionals.
      It offers a comprehensive view of the implementation of a special program
      designed for families and/or friends only--known as "The Family Support Group".
      Initiated in a Long Term Care Facility the author provides a descriptive analysis
      for identifying the needs of the residents' families and/or friends. The
      rationale leading to the initial development of the group and the special
      mechanisms it provides as a quality assurance measure are explored. It is the
      writer's hope that others will be able to incorporate this idea to their
      facilities regardless of whether it is long term or an acute care setting.

PMID- 1742288
TI  - Hospital-based nursing research programs: a requirement for progress.
AB  - Research has resulted in improvement of the quality of patient care, greater job
      satisfaction for nursing service personnel, and better utilization of personnel.
      Facilitation of research has been accomplished through the establishment of
      nursing research programs in hospitals. However, the current climate of economic
      restraint gives rise to the risk that research in hospitals will be viewed as a
      "budget luxury" which can be eliminated early in the financial review process.
      The need for a nursing research program as part of a modern hospital organization
      is defended in this paper. The benefits of such a program and an infrastructure
      supportive of nursing research are described.

PMID- 1742289
TI  - Issues in long term care.

PMID- 1742290
TI  - Nurses' perception of quality of care.
AB  - Identifying appropriate indicators and barriers can be a difficult task for the
      nurse administrator. This manuscript summarizes a qualitative study which
      examines staff perceptions of these issues. Feedback from the nursing staff was
      specific and helpful in improving systems related to quality of care.

PMID- 1742291
TI  - Session I: Pediatric heart transplantation in historical perspective.

PMID- 1742292
TI  - Session II: Cardiac replacement in infants and children: indication and
      limitations.

PMID- 1742293
TI  - Session III: Initiating the pediatric heart transplantation process.

PMID- 1742294
TI  - Session IV: Surgical techniques in pediatric heart transplantation.

PMID- 1742295
TI  - Session V: The neonatal immune system: window of opportunity?

PMID- 1742296
TI  - Session VI: Rejection/infection: the limits of heart transplantation success.

PMID- 1742297
TI  - Session VIII: Pediatric heart transplantations: the world experience.

PMID- 1742298
TI  - Session IX: Social and ethical controversies in pediatric heart transplantation.

PMID- 1742299
TI  - Postpalatoplasty decrease in respiratory dead space in young children.
AB  - In 20 children with cleft palates age 1.5 to 2 years, respiratory parameters were
      evaluated before, 15 minutes after, and 1 hour after palatoplasty. The dead space
      (VD) in the palatoplasty group decreased from 25.2 +/- 4.7 ml preoperatively to
      12.3 +/- 9.1 ml postoperatively. This decrease improved respiratory efficiency. A
      significant difference was found postoperatively in the partial pressure of CO2
      in arterial blood (PaCO2) between the palatoplasty and control groups. No
      significant differences were found in base excess (BE), arterial pH, pulmonary
      shunt ratio, and the alveolar-arterial O2 difference (A-aDO2) between the groups
      pre- and postoperatively. This finding indicated that temporary respiratory
      failure may exist postoperatively; the phenomena were improved in the recovery
      room. Since lung compliance and airway resistance may also participate in the
      decrease in VD, further evaluation of these factors are necessary.

PMID- 1742300
TI  - Accuracy of information reported by parents and children evaluated by a cleft
      palate team.
AB  - Children with palatal clefts and their parents were interviewed to determine what
      information they had about the cleft and its management. Their responses were
      compared with the standards of 17 team members from seven disciplines. Both
      parent and child were consistently provided information about clefts that they
      were expected to remember. The children's responses met the standards 67 percent
      of the time. Their parents' responses met the standards 80.6 percent of the time.
      Parents accurately predicted their children's responses 92 percent of the time.

PMID- 1742301
TI  - Biologic basis for a risk assessment model for cleft palate.
AB  - A biologic model for palatogenesis is presented, intended as a basis for risk
      assessment. It comprises a sequence of developmental stages: growth and migration
      of neural crest cells, downward growth of palatal buds, elevation of palatal
      shelves, and differentiation of the epithelium followed by shelf fusion. Several
      events representing these stages and amenable to mathematical translation may be
      measurable in the form of biomarkers such as DNA and protein synthesis,
      phospholipid metabolism, and signal transducing systems. Interrupting components
      of the model will result in cleft palate. Teratogens with known mechanisms of
      action are compared with the model. The quantitative risk of cleft palate is
      conceived as a sequence of mathematical probabilities that any stage of the model
      runs an abnormal course. Stage-specific probabilities are determined by a
      chemical's potency and dose, and by duration of exposure and gestational age.
      Species or strain sensitivity may be expressed as quantitative differences in
      model parameters. Although the model is designed for cleft palate, the risk model
      may also estimate a multiple response risk to the same exposures.

PMID- 1742302
TI  - Self-concept of children and adolescents with cleft lip and/or palate.
AB  - The self-concept of 105 children (8 to 11 years) and adolescents (12 to 18 years)
      with cleft lip and/or palate (CLP) was studied using the Piers-Harris Children's
      Self-Concept Scale and selected demographic and medical variables. Results
      indicated that most (98%) of children had average or above average self-concept
      scores. Further analysis, however, demonstrated an interaction between age and
      gender: adolescent girls experienced a more negative self-concept in comparison
      to younger girls and adolescent boys experienced a more positive self-concept in
      comparison to younger boys. In addition, popularity cluster scores for all
      children were below the mean for the normed population. Because children with CLP
      have additional difficulties (i.e., facial disfigurement, speech and language
      deficits, multiple surgeries), professionals should intercede to prevent or
      interrupt negative psychosocial outcomes, particularly for adolescent girls.

PMID- 1742303
TI  - Psychosocial adjustment in children with hemifacial microsomia and other
      craniofacial deformities.
AB  - Psychosocial adjustment was evaluated in different groups of children with
      craniofacial deformities in order to examine the relationships between symmetry,
      functional impairments, and social adaptation. Thirty patients, ages 6 through 16
      years, were assessed using a battery of standard psychologic measures including
      Human Figure Drawing, Tasks of Emotional Adjustment, and Children's Depression
      Inventory. Parents and teachers also provided ratings of the children's
      functioning using the Child Behavior Checklist (parent and teacher forms). Scores
      on the outcome measures were summarized with descriptive statistics and then
      multivariate analyses of variance were conducted to determine the differences in
      psychosocial development between children with symmetric versus asymmetric
      craniofacial deformities and between the presence or absence of a functional
      impairment in children with craniofacial deformities. The results indicate that
      children with symmetric craniofacial deformities score poorer on measures of
      psychosocial adjustment than children with asymmetric deformities (F = 3.20, p
      less than 0.015); however, differences among the groups with or without
      functional impairments were not significant.

PMID- 1742304
TI  - Misarticulation caused by abnormal lingual-palatal contact in patients with cleft
      palate with adequate velopharyngeal function.
AB  - Misarticulations produced by three patients with cleft palate (2 isolated cleft
      palate; 1 unilateral cleft lip, alveolus, and palate) who attained adequate
      velopharyngeal function and normal palatal vault by early surgical repairs were
      examined using electropalatography (EPG) and sound spectrography (SG). Common
      characteristics of lingual-palatal contact in which the contact area was broader
      and/or was more posterior than normal were observed. These misarticulations can
      be divided into three types based on the direction of the breath emission:
      palatalized misarticulation (in which air passes along the midline of the
      palate), lateral misarticulation (in which air flows laterally through the
      occluded dental arch), and nasopharyngeal misarticulation (in which air flows out
      the nose). These three are considered to be similar to intractable posterior
      pattern of articulation in cleft palate patients previously reported. However,
      these types of misarticulations can be produced by cleft patients who have
      achieved adequate velopharyngeal function and normal palatal vault.

PMID- 1742305
TI  - Craniofacial asymmetries in shunt-treated hydrocephalic children.
AB  - The degree and direction of craniofacial asymmetry in the frontal plane was
      studied in a sample of 26 shunt-treated hydrocephalic children aged 5 to 18
      years. Thirteen of the children had the regulating shunt fixed on the right side
      of the head and 13 on the left. The shunt had usually been inserted during the
      first years of life. An age- and sex-matched group of healthy school children and
      students served as controls for cephalometric assessment by means of linear and
      angular measurements. Considerable craniofacial asymmetry was found in the shunt
      treated hydrocephalic children, the direction of asymmetry being related to the
      laterality of the regulating shunt device. The most marked asymmetric changes
      were recorded in the maxillary and mandibular regions, probably due to the
      adaptive nature of these regions.

PMID- 1742306
TI  - Epidemiology of oral clefts in a large South American sample.
AB  - A total of 849,381 newborn children were examined during the years 1967 to 1981,
      in 56 hospitals of eight countries, in the Latin American Collaborative Study of
      Congenital Malformations (ECLAMC). Of these, 741 had a cleft lip with or without
      a cleft palate (CL +/- P), yielding a global prevalence of 0.87 per thousand, and
      115 had cleft palate (CP) only (frequency: 0.13 per thousand). CP frequencies by
      country and by year were essentially homogeneous, but those for CL +/- P showed
      heterogeneity by country (but no temporal trends). Patients thus ascertained,
      with matched, appropriate controls, have been subjected to a detailed
      epidemiologic study. For CP, only the sex ratio deviated from the control values;
      but for CL +/- P the marked divergence in sex ratio was accompanied by
      differences in the two series on the frequency of twin births, birth weight,
      neonatal survival, birth order, medicine use, and occurrence of acute or chronic
      illnesses during the first trimester of pregnancy. Lack of agreement of these
      results with previous data may be due to different types of patient
      ascertainment, sample sizes, and methods of analysis.

PMID- 1742307
TI  - Characteristics of new patients at Illinois cleft palate teams.
AB  - The Illinois Association of Craniofacial Teams (IACT) surveyed all new patient
      visits to member teams in an effort to assess the needs of patients in Illinois.
      The survey determined the number of patients, their age at initial visit, the
      location and status of their defect, and their history of team visits. Four
      hundred eighty new patient visits were recorded. The number of patients was
      substantially lower than expected, and the large majority of older children
      seeing a team for the first time had repaired defects. It is concluded that the
      main opportunity for improving the quality of care for patients with clefts in
      Illinois may be in increasing the use of cleft palate teams.

PMID- 1742308
TI  - Development of a method for rating nasolabial appearance in patients with clefts
      of the lip and palate.
AB  - Comparison of the outcome of treatment of patients with clefts of the lip and
      palate can yield valuable pointers for discriminating between beneficial and
      harmful procedures. The development of a standardized rating scheme to assess the
      facial appearance of these patients is described. The rating scheme can be used
      in conjunction with conventional cephalometric analysis and dental arch
      evaluation. A method is described in which the nasolabial area is masked, thus
      reducing the influence of the surrounding facial features since it is shown that
      judges are influenced by general facial attractiveness. An ordinal scale has been
      evaluated in which four features of the nose and lip are assessed separately and
      in total by a panel of judges. The nasolabial profile, the nasal symmetry, the
      nasal form, and vermilion border were assessed using a 5-point scale. Acceptable
      pooled levels of reliability and reproducibility were obtained. This standardized
      rating system may be used to differentiate treatment outcome in patients from
      different treatment centers.

PMID- 1742309
TI  - Postnatal craniofacial skeleton development following a pushback operation of
      patients with cleft palate.
AB  - A longitudinal growth study of the craniofacial skeleton in 52 (19 males, 33
      females) Danish individuals with cleft palates was performed. Thirty (13 males,
      17 females) had clefts of the soft palate only or clefts extending into the
      posterior third of the hard palate. Twenty-two (6 males, 16 females) had more
      extensive clefts including up to two-thirds of the hard palate. The cleft was
      closed with a pushback operation at 22 months of age. Orthodontic treatment was
      included in the early mixed dentition. Lateral cephalometries were obtained at 5,
      8, 12, 16, and 21 years of age. Twenty-four variables were digitized and
      analyzed. The results indicated that patients with more extensive clefts
      demonstrated significantly smaller anterior cranial base length (N-S), total
      cranial base length (N-Ba), maxillary dentoalveolar base length (A-PMP),
      mandibular length (Cd-Pgn), upper anterior and posterior facial heights (N-ANS
      and P-PMP), and total facial height (N-Gn). Patients with the more extensive
      clefts reached maximum growth spurt later than patients with less extensive
      clefts in all dimensions except the A-PMP and the lower and total facial heights.

PMID- 1742310
TI  - Pressure-flow measurements for selected oral and nasal sound segments produced by
      normal adults.
AB  - Pressure-flow data are often used to provide information about the adequacy of
      velopharyngeal valving for speech. However, there is limited information
      available concerning simultaneous pressure-flow measurements for oral and nasal
      sound segments produced by normal speakers. This study provides normative
      pressure, flow, and velopharyngeal orifice area measurements for selected oral
      and nasal sound segments produced by 10 male and 10 female adult speakers. An
      aerodynamic categorization scheme of velopharyngeal function, including one
      typical category and three atypical categories (open, closed, and mixed) is
      proposed.

PMID- 1742311
TI  - Developmental correlates of midfacial components in a normal and cleft lip and
      palate human fetal sample.
AB  - Midfacial hypoplasia in patients with complete clefts of the lip and palate is
      considered to be the result of congenital dysmorphogenesis combined with surgical
      effects. The present study describes congenital correlates of midfacial
      hypoplasia by examining the relationships between premaxillary size and a number
      of adjacent oronasal capsular components in a sample of second trimester normal
      and complete cleft fetal specimens. Midfacial relationships from previously
      published data from 3-D computer reconstructions of histologic material were
      assessed by multiple regression and path analyses. Stepwise multiple regression
      analysis revealed that the combination of age (body size) and nasal septal length
      were the best predictor variables of premaxillary length and accounted for 90
      percent and 93 percent (p less than .01) of the variance in normal and cleft
      fetal specimens, respectively. Tongue length was seen to slightly increase the R2
      values in the cleft, but not the normal sample. Path analysis results revealed
      that with body size held constant, nasal capsule volume explained only 3 percent
      of premaxillary variance, while septal length accounted for approximately 45
      percent of the variance (p less than .05). Results show that the relationships of
      the midfacial components in the cleft fetal sample closely followed normal second
      trimester midfacial growth patterns and suggest that the septal-traction model
      may be a more parsimonious and primary explanatory mechanism of early midfacial
      growth than the functional matrix model in both normal and complete cleft fetal
      specimens.

PMID- 1742312
TI  - Comparison between multiview videofluoroscopy and nasendoscopy of velopharyngeal
      movements.
AB  - The videofluoroscopic and nasopharyngoscopic observations of velopharyngeal
      movements during speech were compared in 80 subjects with hypernasal speech. An
      endviewing flexible fiberoptic endoscope was used for nasopharyngoscopic
      examination. This failed to demonstrate movements of the lateral pharyngeal walls
      that were videofluoroscopically documented in one third of the patients. In the
      cases of disagreement, the angle of view was impaired because of the presence of
      adenoid tissue. The misinterpretation at nasopharyngoscopy was explained by an
      unfavorable observation position of the flexible scope and failure to pass it
      further into the pharynx. Conclusions are satisfactory that videofluoroscopy is
      an indispensable procedure for assessing velopharyngeal function.

PMID- 1742313
TI  - Development of scales of severity of facial cleft impairment.
AB  - The reliability and validity of human judgments in rating the severity of cleft
      related facial impairment were examined in this series of studies. The goal of
      the research was to develop scales for rating the severity of facial cleft
      impairment using psychophysical methods for measuring human judgment. The
      principle findings were: (1) Four photographic categorized scales with high inter
      group reliability and satisfactory content and construct validity were developed;
      (2) Raters used objective stimulus characteristics of the face to scale
      impairment; (3) Ratings of facial attractiveness decreased as the severity of
      impairment increases; (4) Full face ratings of the severity of impairment
      correlated highly with ratings of the same photographs cropped below the eyes.
      The implications of these findings for clinical and research application are
      discussed.

PMID- 1742314
TI  - Mandible, tongue, and airway in Pierre Robin sequence: a longitudinal
      cephalometric study.
AB  - The purpose of this retrospective longitudinal cephalometric study was to analyze
      size, growth, and relations of the mandible, tongue, and airway in the isolated,
      nonsyndromic Pierre Robin Sequence (PRS) infant. The objective was to understand
      better the early morphologic changes that occur in these structures. The data
      were obtained from lateral cephalometric radiographs taken in the first 2 years
      of life on 17 PRS infants, 26 isolated cleft palate (CP), and 26 normal control
      (N) infants. Mean values of each variable were compared using a univariate
      analysis of variance. A multivariate discriminant function analysis (DFA) was
      also used to characterize group differences. The three groups were distinct
      throughout the period of study. Differences were greater at the earliest age and
      the distinction was greater between the PRS and N infants with the CP infant in
      between, but having more similarity to the PRS infant. Initially, the PRS infant
      had a shorter tongue and mandibular length, narrower airway, smaller tongue area
      and the hyoid position was more posterior and inferior as compared to N. The
      tongue shape and position were specific to the PRS infants. This group
      distinction diminished with age and resulted from an increased mandibular growth
      rate in the PRS infant. These findings support the hypothesis of "partial
      mandibular catch-up growth" in the PRS infant. The increased growth rate in the
      PRS infant improved the airway dimension, which might be partly responsible for
      the natural resolution of the respiratory distress. This increased growth rate
      did not allow for the various structures to reach values equal to normal.

PMID- 1742315
TI  - The effect of apo E secretion on lipoprotein uptake in transfected cells.
AB  - To investigate the role of apolipoprotein E (apo E) secreted by peripheral
      tissues in local lipoprotein metabolism, we developed a cell strain that
      constitutively produced and secreted apo E. A fusion plasmid containing rat apo E
      genomic DNA under control of mouse metallothionein promotor was constructed and
      transfected into Chinese hamster ovary cells. A stable transformant designated
      CHO-MAEII constitutively secreted rat apo E mainly in the form of sialylated free
      protein. The secretion was further enhanced by metal induction up to 1 micrograms
      apo E/ml per 12 h. When incubated with 125I-labeled very low density lipoprotein
      (125I-VLDL) at 37 degrees C, CHO-MAEII took up and degraded 125I-VLDL with higher
      affinity than control cells. Furthermore, considerable amount of methylated 125I
      VLDL was degraded by CHO-MAEII, while no methylated 125I-VLDL was degraded by
      control cells. No significant differences were found in the uptake of 125I-LDL.
      The data indicated that apo E molecules secreted by CHO-MAEII were transferred to
      125-VLDL particles, which caused a higher affinity of these particles for LDL
      receptors on the cells. It is suggested that apo E secreted from peripheral
      tissues enhances the uptake of lipoproteins by themselves or by surrounding cells
      in the local environment which demand cholesterol and express LDL receptors. CHO
      MAEII was a good model for these 'auto- or paracrine-like functions' of apo E.

PMID- 1742316
TI  - The apolipoprotein A-I binding protein of placenta and the SP-40,40 protein of
      human blood are different proteins which both bind to apolipoprotein A-I.
AB  - A complement-associated protein SP-40,40, which is a normal constituent of human
      blood, binds to the main apoprotein, apoA-I, of high density lipoprotein (HDL).
      This protein, which is identical to apolipoprotein J, was compared to another
      apoA-I binding protein purified from human placenta. Immunologically the two apoA
      I binding proteins are different.

PMID- 1742317
TI  - Physico-chemical characterization of Intralipid emulsions.
AB  - Fat emulsions containing soy triacylglycerols (100-300 g/l) and egg-yolk
      phospholipids (12 g/l) are often used for intravenous feeding. Previous studies
      have shown that these emulsions contain chylomicron-like emulsion particles of
      diameters of 300-400 nm and excess phospholipids aggregated as vesicles
      (liposomes), which remain in the infranatant upon floatation of the emulsion
      particles by ultracentrifugation. This work is devoted to the characterization of
      the commercial lipid emulsions commonly denoted Intralipids, with special
      emphasis on the presently ill-defined liposomes. The lipid particles composing
      commercial lipid emulsions (10%, 20% and 30% Intralipids, Kabivitrum Nutrition)
      were characterized by the combined use of physical and chemical methods. Each of
      the emulsions was fractionated by ultracentrifugation in saline into a 'cream'
      layer which floats to the top of the dispersion upon ultracentrifugation and a
      relatively transparent infranatant. The cream layer contains large emulsion
      particles of diameters ranging from 300 to 400 nm, in agreement with theoretical
      considerations based on their chemical composition as determined by chemical
      analysis. The infranatants contain about 1 g/l triacylglycerols in addition to
      phospholipids (from 7.2 g/l in 10% Intralipid to 2.4 g/l in 30% Intralipid) in
      the form of smaller particles of 70-100 nm diameter. Cryo-transmission electron
      microscopy shows that the infranatants contain vesicles (mostly unilamellar) at
      the side of residual small emulsion particles. This conclusion is also consistent
      with the distribution of phospholipids between outer and inner lamellae, as
      determined by 31P-NMR.

PMID- 1742318
TI  - The oxidative modification of low density lipoprotein by nonenzymatically
      glycated peptide-Fe complex.
AB  - Glycated polylysine, a model of glycated peptide, produces Fe(3+)-chelated
      compound, which could be converted to an active form in a nonenzymatic process.
      The exposure of human low density lipoprotein (LDL) to the active glycated
      polylysine-iron complex caused lipid peroxidation significantly higher than LDL
      exposed to Fe3+, accompanied by formation of fluorescence compound in apoprotein
      B (Ex.max. 360 nm, Em.max. 435 nm). Highly modified LDL, which can be judged by
      an obvious increase of fluorescence compound, could be easily endocytized by rat
      peritoneal macrophages. alpha-Tocopherol or probucol possessed powerful
      inhibitory action against active glycated polylysine-iron complex-induced lipid
      peroxidation of LDL. Each of intrinsic proteins tested, such as apotransferrin,
      ceruloplasmin and albumin, at the concentration of normal levels of human blood
      or at the lower levels, also exhibited inhibitory action on the lipid
      peroxidation of LDL.

PMID- 1742319
TI  - Effect of simvastatin on the synthesis and secretion of lipoproteins in relation
      to the metabolism of cholesterol in cultured hepatocytes.
AB  - In primary culture of rat hepatocytes, simvastatin, a powerful HMGCoA reductase
      inhibitor, inhibited acetate incorporation into cellular and secreted cholesterol
      and cholesteryl-esters, without any significant effect on triacylglycerol
      synthesis and secretion. When applied to the culture for 24 h at 10(-7) M, a
      concentration shown to inhibit cholesterol synthesis by 61%, simvastatin
      increased apolipoprotein BH and BL synthesis and secretion and strongly decreased
      apolipoprotein AI synthesis and secretion whereas apolipoprotein AIV remained
      unaffected. The synthesis and secretion of apolipoprotein E was only slightly
      affected in contrast with other situations where cholesterol synthesis decreased.
      All of these modifications occurred at a post-transcriptional level, as the
      corresponding messenger RNAs of the apolipoproteins did not vary. These results
      suggest that either the drug itself or variations in cholesterol synthesis might
      be involved in apo B and apo AI synthesis and secretion.

PMID- 1742320
TI  - Metabolism of polyunsaturated (n-3) fatty acids by monkey seminal vesicles:
      isolation and biosynthesis of omega-3 epoxides.
AB  - Monooxygenases of monkey seminal vesicles can metabolize arachidonic acid (20:4(n
      6)) by w3-hydroxylation to 18(R)-hydroxyeicosatetraenoic acid (18(R)-HETE) and
      eicosapentaenoic acid (20:5(n-3)) to 17,18-dihydroxyeicosatetraenoic acid (Oliw,
      E.H. (1989) J. Biol. Chem. 264, 17845-17853). The present study aimed to further
      characterize the oxygenation of (n-3) polyunsaturated fatty acids. 14C-Labelled
      22:6(n-3), 20:5(n-3), 20:4-(n-3) and 18:3(n-3) were incubated with microsomes of
      seminal vesicles of the cynomolgus monkey, NADPH and a cyclooxygenase inhibitor,
      diclofenac, and the main metabolites were identified by capillary gas
      chromatography-mass spectrometry. 22:6(n-3) was slowly metabolized to 19,20
      dihydroxy-4,7,10,13,16-docosapentaenoic acid, while 20:5(n-3), 20:4(n-3) and
      18:3(n-3) were metabolized more efficiently to the corresponding w4,w3-diols. The
      w3 epoxides, which were obtained from 20:5(n-3) and 18:3(n-3), were isolated in
      the presence of an epoxide hydrolase inhibitor, 1(2)epoxy-3,3,3-trichloropropane,
      and the geometry of the epoxides was determined to be 17S, 18R and 15S, 16R,
      respectively. While 20:5(n-3) was metabolized almost exclusively to the epoxide
      and diol pair of metabolites, 18:3(n-3) was metabolized not only to the w3
      epoxide and the corresponding diol, but also to the w2 alcohol, 17(R)-hydroxy
      9,12,15-octadecatrienoic acid. 22:6(n-3) and 5,8,11,14-eicosatetraynoic acid
      inhibited the biosynthesis of 18(R)-HETE from arachidonic acid (IC50 0.16 and
      0.14 mM, respectively). In comparison with 20:4 or 18:3(n-3), 18:1(n-9) and
      22:5(n-6) appeared to be slowly metabolized by seminal monooxygenases, while
      18:2(n-6) was converted to the w3 alcohol and to smaller amounts of the w2
      alcohol (4:1). Together, the results indicate that the w3-hydroxylase and w3
      epoxygenase enzyme(s) metabolize 20:4(n-6) and 20:5(n-3) almost exclusively to
      the w3(R) alcohol and the w3(R, S) epoxide, respectively, while longer and
      shorter fatty acids either are poor substrates or metabolized with a lesser
      degree of position specificity.

PMID- 1742321
TI  - Interactive effects of dietary (n-3) polyunsaturated fatty acids and chronic
      ethanol intoxication on synaptic membrane lipid composition and fluidity in rats.
AB  - The influence of dietary polyunsaturated fatty acids on fatty acid composition,
      cholesterol and phospholipid content as well as 'fluidity' (assessed by
      fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene (DPH) probes) of brain
      synaptic plasma membranes (SPM) and their interactions with chronic ethanol
      effects were studied in rats fed for two generations with diets either devoid of
      (n-3) fatty acids (sunflower oil diet), rich in alpha-linolenic acid (soya oil
      diet) or in long chain (n-3) fatty acids (sunflower + cod liver oil diet).
      Results were compared with rats fed standard lab chow. Sunflower oil led to an
      increase in the (n-6)/(n-3) ratio in the membranes with an increase of the
      'fluidity' at membrane apolar level; sunflower + cod liver oil decreased the (n
      6)/(n-3) ratio without affecting membrane 'fluidity' while no difference was seen
      between the SPM of rats fed soya oil and standard diet. After 3 weeks alcohol
      intoxication in rat fed the standard diet: oleic alpha-linoleic acids and
      cholesterol levels were increased, arachidonic acid and the double bond
      index/saturated fatty acids were decreased and there was a decrease of 'fluidity'
      in the lipid core of the SPM. Soya oil almost totally abolished these usually
      observed changes in the SPM fatty acids composition but increased oleic acid and
      cholesterol without any change in fluidity. Sunflower oil led to the same general
      alterations of fatty acid as seen with standard diet but to a greater extent,
      with decrease of the 'fluidity" at the apolar level and in the region probed by
      TMA-DPH. When sunflower oil was supplemented with cod liver oil, oleic and alpha
      linoleic acids were increased while the 'fluidity' of the apolar core of SPM was
      decreased. So, the small changes in fatty acid pattern seem able to modulate
      neural properties i.e. the responses to a neurotoxic like ethanol. A structurally
      specific role of PUFA is demonstrated by the pernicious effects of the alpha
      linolenic acid deficient diet which are not totally prevented by the supply of
      long chain (n-3) PUFA.

PMID- 1742322
TI  - A NeuGc-containing trisialoganglioside of bovine brain.
AB  - A N-glycolyneuraminic acid containing trisialoganglioside was isolated from
      bovine brains ganglioside mixture using Q-Sepharose. Its chemical structure was
      characterized as IV3NeuAc, II3NeuAc-NeuGc, Gg4Cer by gas-liquid chromatography, a
      permethylation study, sialidase degradation, TLC/enzyme-immunostaining, fast atom
      bombardment-mass spectrometry, fluorometric HPLC and proton nuclear magnetic
      resonance spectroscopy. This was unique in the mixed sialic acid constituents.
      (formula; see text) This accounted for 0.78% of the gangliosides. The ceramide
      structure was almost identical with those of major bovine brain ganglioside, as
      mainly composed of 18:0 fatty acid (90.9%) and d20:0 sphingosine base.

PMID- 1742323
TI  - Phosphorylation of lysophosphatidylinositol by carrot membranes.
AB  - sn-1 Palmitoyl lysophosphatidylinositol is found in carrot suspension culture
      cells and can be phosphorylated to [32P]lysophosphatidylinositol monophosphate
      (LPIP) when [gamma 32P]ATP is added to isolated membranes. Based on in vivo
      labeling studies, [3H]inositol sn-1 palmitoyl LPIP was found predominantly in the
      plasma membrane-rich fraction or upper phase isolated by aqueous two-phase
      partitioning and LPI was found in the intracellular membrane-rich fraction or
      lower phase (Wheeler and Boss, Plant Physiol. 85, 389-392, 1987). While both
      membrane fractions phosphorylated LPI in vitro, the apparent Km for LPI in the
      intracellular membrane fraction was 180 microM and for the plasma membrane was
      580 microM. When cells were treated with the ionophore, monensin, the percentage
      of [3H]inositol LPIP increased in the whole cell lipid extract. However, the
      monensin treatment decreased the amount of [3H]inositol LPIP and PIP recovered in
      the plasma membrane fraction relative to the sum of the individual lipid,
      [3H]inositol LPIP or PIP, respectively, recovered in both membrane fractions.

PMID- 1742324
TI  - Formation of ketols from linolenic acid 13-hydroperoxide via allene oxide.
      Evidence for two distinct mechanisms of allene oxide hydrolysis.
AB  - Incubations of [1-14C]13-hydroperoxy-9(Z),11(E),15(Z)-octadecatrienoic acid (13
      HPOT) with hydroperoxide dehydrase preparations from flax seeds lead to the
      formation of a novel ketol 2 along with the previously known 12-oxo-13-hydroxy
      9(Z),15(Z)-octadecadienoic (12,13-alpha-ketol) and 9-hydroxy-12-oxo-10(E),15(Z)
      octadecadienoic (gamma-ketol) acids. Compound 2 was identified as 11-hydroxy-12
      oxo-9(Z),15(Z)-octadecadienoic acid (11,12-alpha-ketol) in accordance with the
      data of ultraviolet, mass (chemical ionization and electron impact) and 1H-NMR
      spectra. During long-term (30 min) incubations the yields of gamma-ketol and
      11,12-alpha-ketol increased markedly and the yield of 12,13-alpha-ketol decreased
      in response to the pH change from basic (pH 7.4) to acidic (pH 5.8) conditions.
      Short-term (15 s) incubations of 13-HPOT with hydroperoxide dehydrase, terminated
      by HCl fixation, led to the formation of gamma-ketol and ketol 2. A similar
      incubation, followed by NaOH fixation, afforded only 12,13-alpha-ketol. The
      trapping of allene oxide (a primary product of hydroperoxide dehydrase) with pure
      methanol gives only compound 4 (12,13-alpha-ketol methyl ether). Products 5
      (gamma-ketol methyl ether) and 6 (11,12-alpha-ketol methyl ether) were formed
      along with 4 as a result of trapping with acidified methanol. The results
      obtained indicate that: (a) the formation of 12,13-alpha-ketol is base-dependent;
      (b) the formation of gamma-ketol and ketol 2 is acid-dependent. Two distinct
      mechanisms of allene oxide hydrolysis are proposed: (1) nucleophilic (SN2 or SN1,
      OH- is an attacking group) substitution, resulting in formation of 12,13-alpha
      ketol; (2) electrophilic (SE-like) reaction initiated by protonation of oxirane,
      affording gamma-ketol and 11,12-alpha-ketol.

PMID- 1742325
TI  - Apo B metabolism in the cynomolgus monkey: evidence for post-transcriptional
      regulation.
AB  - Previous studies have shown that hepatic apo B mRNA levels do not increase in
      animals fed high cholesterol diets, even though plasma apo B concentrations
      increase markedly. As a result, it has been suggested that the diet-induced
      increase in plasma apo B levels was due solely to an inhibited clearance of those
      lipoproteins. The present study was undertaken to test that hypothesis. Hepatic
      apo B mRNA levels were measured in liver biopsies taken from five male cynomolgus
      monkeys before and twice after, they began to consume a high cholesterol diet.
      The diet had no effect on hepatic apo B mRNA levels, even though it caused a 7
      fold increase in the plasma apo B levels. However, measurements of the apo B
      secretion rate in eight separate monkeys (four chow-fed and four cholesterol-fed)
      by isotope dilution showed that apo B secretion by the liver was increased 4-fold
      in the cholesterol-fed monkeys. These data, taken together, indicate that apo B
      secretion is not regulated by the rate at which the apo B gene is transcribed,
      but at some point further along in the secretion pathway.

PMID- 1742326
TI  - Changes in fatty acid composition during cell differentiation in the small
      intestine of suckling piglets.
AB  - Alterations of phospholipid fatty acid composition in the renewing intestine were
      studied in the infant piglet. Newborn piglets were fed from birth to 2 weeks of
      age a concentrated cow's milk which defined a standard supply of dietary fatty
      acids. Phospholipids were isolated from the whole mucosa, isolated intestinal
      cells and purified brush border membranes. Intestinal cells were isolated
      according to their position along the crypt-villus axis and cell phospholipids
      were extracted at each step of differentiation. Changes in fatty acid composition
      of cell phospholipids were related to those of lactase activity in the
      corresponding cell homogenates. In cell phospholipids, the relative content of
      linoleic and linoleic acids increased about 2-fold from crypt base to villus tip.
      Substantial contents of alkenylacyl glycerophospholipids (plasmalogens) were
      found in crypt cell phospholipids and in purified brush border membrane
      phosphatidylethanolamine (11 and 14% of alkenyl groups by weight of total fatty
      acids, respectively). The proportion of alkenylacyl glycerophospholipids
      decreased as cells ascended the villus column and became more differentiated. The
      results show that fatty acid compositional changes in differentiating cell
      phospholipids occurred in the immature intestine (before weaning) and suggest
      that these alterations might be related to the appearance of specific functions.

PMID- 1742327
TI  - Elongation and desaturation of arachidonic and eicosapentaenoic acids in rat
      liver. Effect of clofibrate feeding.
AB  - The fatty acid elongation-desaturation ability of 5,8,11,14-eicosatetraenoic
      (20:4(n-6)) and 5,8,11,14,17-eicosapentaenoic (20:5(n-3)) acids was determined in
      both liver microsomal and light mitochondrial (rich in peroxisomes) fractions of
      untreated and clofibrate treated rats. The elongation and the subsequent
      desaturation steps were performed in the corresponding favorable media. 20:5(n-3)
      elongation was about 2-times more extensive than that of 20:4(n-6). Clofibrate
      feeding for 10 days resulted in a marked decrease in the elongation rate with the
      two substrates, while the delta 4 desaturation rate was increased. There were
      small differences in the elongation rate between the microsomal and light
      mitochondrial fractions, however, the relative delta 4 desaturation rate was
      higher in the light mitochondrial fraction than microsomes.

PMID- 1742328
TI  - The regulation of hepatic lipase and cholesteryl ester transfer protein activity
      in the cholesterol fed rabbit.
AB  - Hepatic lipase (HL) and cholesteryl ester transfer protein (CETP) activities are
      both increased in the rabbit by cholesterol feeding. The in vivo regulation of HL
      and CETP were explored by examining changes in specific steady-state mRNA levels
      upon cholesterol feeding. On feeding rabbits cholesterol, HL activity increased 3
      fold after 2 days and remained at 2.6-times the control value at 28 days.
      Specific rabbit HL mRNA levels were assessed by dot blot analysis of liver poly
      (A)+ RNA hybridized with the human HL cDNA. No significant changes in liver HL
      mRNA accompanied the increase in activity seen at days 2 and 7. At day 28 a
      modest rise of 46% was observed. A significant rise in CETP activity, evident 7
      days after the commencement of cholesterol feeding, was maintained until day 28
      when it was 2.4-times the control value. Using the human CETP cDNA as probe,
      rabbit liver CETP mRNA was also found to increase by day 7, rising to 3.7-times
      control by day 28. The strong temporal relationship between the rise in CETP
      activity and mRNA (r = 0.55, P = 0.02) suggests that the regulation of CETP may
      be primarily effected by the levels of specific mRNA. In contrast, the
      discordance between levels of lipase activity and mRNA suggests that post
      transcriptional events may be more important in the regulation of HL in the
      cholesterol fed rabbit.

PMID- 1742329
TI  - Regulation of renin secretion by calcium and chemiosmotic forces: (patho)
      physiological considerations.

PMID- 1742330
TI  - Accumulation and excretion of long-chain acylcarnitine by rat hearts; studies
      with aminocarnitine.
AB  - During Langendorff perfusion of rat heart with aminocarnitine, long-chain
      acylcarnitine (LCAC) accumulates in heart cells, from which it is excreted by the
      heart. The heart function remains intact during this process. The accumulation of
      LCAC can be inhibited by the simultaneous addition of an inhibitor of the outer
      membrane carnitine palmitoyl-coenzyme A transferase (CPT-1), indicating that
      aminocarnitine is a specific inhibitor of the inner membrane isoenzyme (CPT-2).
      LCAC accumulation is associated with glycogen depletion. After 60 min perfusion
      with aminocarnitine, electron microscopy shows large multilamellar lipid
      vesicles, especially in cardiomyocytes, which are depleted in glycogen granula.
      Multilamellar lipid vesicles are also found in the blood vessels. Extraction of
      the perfusate shows the presence of LCAC, fatty acid and
      phosphatidylethanolamine. Morphological analysis with freeze fracturing and thin
      sectioning furthermore reveals that the sarcolemma is not deteriorated during the
      export of LCAC to the coronary vessels. Since cardiac structures and functions
      are intact, LCAC alone is not the clue for ischemic damage. Therefore the present
      work supports the hypothesis that acidosis rather than LCAC is of primary
      importance to ischemic damage.

PMID- 1742331
TI  - Effect of TPA on fructose 2,6-bisphosphate levels and protein kinase C activity
      in B-chronic lymphocytic leukemia (B-CLL).
AB  - Normal B lymphocytes and peripheral mononuclear blood cells from B-chronic
      lymphocytic leukemia (B-CLL) patients were incubated in the presence of the tumor
      promoting phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA). In normal B
      lymphocytes and lymphocytes from five patients with B-CLL, TPA stimulation
      increased lymphocyte fructose 2,6-bisphosphate (fructose 2,6-P2) content and
      activity of 6-phosphofructo 2-kinase (PFK-2), which is the enzyme that catalyzes
      the synthesis of fructose 2,6-P2. This effect was evident after 6 h and maximal
      after 12-24 h of TPA exposure. In three patients, lymphocytes seemed to be
      refractory to TPA stimulation in the conditions described here. Lymphocyte
      stimulation by TPA was associated with the translocation of protein kinase C
      (PKC) from the soluble to the particulate membrane fraction, except in B-CLL
      lymphocytes refractory to the TPA effect. These results give further support to
      the existence within B-CLL of subsets of cells which are refractory to the
      stimulation by TPA and demonstrate that the tumor promoter TPA induces important
      metabolic changes in lymphocytes of some patients with B-CLL.

PMID- 1742332
TI  - Characterization of chloride transport pathways in cultured human keratinocytes.
AB  - In human keratinocytes, mediated transport of Cl- was found to occur mainly by
      two mechanisms: an anion exchange and an electrically conductive pathway. The
      contribution of the anion exchange, which accounted for about 50% of overall Cl-
      efflux, was assessed either by its sensitivity to inhibition by 4,4'
      diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS), and by means of Cl-
      substitution experiments. The anion exchange exhibited a saturation behaviour
      over the range 10-135 mM Cl-; Cl- was more efficient than HCO3-, Br- and NO3- in
      increasing Cl- efflux rate, whereas SO4(2-) and I- inhibited Cl- efflux. The
      electrically conductive Cl- pathway, which accounted for about 40% of total Cl-
      efflux, was inhibited by the Cl- channel blocker 5-nitro-2-(3
      phenylpropylamino)benzoic acid (NPPB) and was at least partially sensitive to
      variation of the plasma membrane potential. The Cl- channel was insensitive to
      elevation in the intracellular concentration of either cyclic AMP and calcium
      ions. Indomethacin, an inhibitor of the cyclooxygenase, failed to reduce Cl-
      efflux, whereas nordihydroguaiaretic acid (NDGA), an inhibitor of the
      lipoxygenase, induced 50% inhibition of Cl- efflux. These results support the
      conclusion that endogenous production of lipoxygenase-derived arachidonic acid
      metabolite(s) might be responsible for high basal Cl- permeability in human
      keratinocytes.

PMID- 1742333
TI  - Modulation of synovial fibroblast plasminogen activator and plasminogen activator
      inhibitor production by protein kinase C.
AB  - Phorbol myristate acetate (PMA) added to human synovial fibroblast cultures
      caused a dose-dependent increase in the production of plasminogen activator
      inhibitor-type 1 (PAI-1). In addition, PMA inhibited endogenous and interleukin-1
      (IL-1) induced plasminogen activator (PA) activity, while increasing mRNA PAI-1
      levels. Other protein kinase C (PKC) activators, mezerein and teleocidin B4,
      caused similar effects. The simultaneous addition of the PKC antagonists, H-7 or
      staurosporine, prevented the inhibition of PA activity by PMA. This study shows
      that activation of PKC inhibits PA and stimulates PAI production in human
      synovial fibroblasts. These results suggest that activation of PKC may play an
      important role in regulating increased PA production associated with joint
      destruction in rheumatoid arthritis (RA).

PMID- 1742334
TI  - Altered blood amino acid distribution in genetically obese mice.
AB  - The present study was undertaken to determine whether the alteration in amino
      acid distribution between the plasma and cellular compartment of the blood,
      previously described in dietary-obese rats, also occurs in genetically obese
      mice. The blood concentration of individual amino acids and its distribution
      between plasma and cells of lean and genetically obese mice (ob/ob) have been
      measured. The results demonstrated that genetically obese mice showed a decrease
      (55%, P = 0.0489) of free amino acids in the blood cells. Most amino acids were
      affected and among the most noteworthy characteristics was the observation that
      the reduction in concentration was more pronounced for the total concentration of
      the essential amino acids which was reduced by 76% (P = 0.0112) compared to cells
      of lean mice. These results suggest that an altered amino acid distribution
      between plasma and blood cells is a consequence of both diet-induced and genetic
      obesities.

PMID- 1742335
TI  - Purification and properties of the uracil DNA glycosylase from Bloom's syndrome.
AB  - Bloom's syndrome uracil DNA glycosylase was highly purified from two non
      transformed cell strains derived from individuals from different ethnic groups.
      Their properties were then compared to two different highly purified normal human
      uracil DNA glycosylases. A molecular mass of 37 kDa was observed for each of the
      four human enzymes as defined by gel-filtration column chromatography and by SDS
      PAGE. Each of the 37 kDa proteins was identified as a uracil DNA glycosylase by
      electroelution from the SDS polyacrylamide gel, determination of glycosylase
      activity by in vitro biochemical assay and identification of the reaction product
      as free uracil by co-chromatography with authentic uracil. Bloom's syndrome
      enzymes differed substantially in their isoelectric point and were thermolabile
      as compared to the normal human enzymes. Bloom's syndrome enzymes displayed a
      different Km, Vmax and were strikingly insensitive to 5-fluorouracil and 5
      bromouracil, pyrimidine analogues which drastically decreased the activity of the
      normal human enzymes. In particular, each Bloom's syndrome enzyme required 10-100
      fold higher concentrations of each analogue to achieve comparable inhibition of
      enzyme activity. Potential mechanisms are considered through which an altered
      uracil DNA glycosylase characterizing this cancer-prone human genetic disorder
      may arise.

PMID- 1742336
TI  - Immunochemical comparison of the major intrinsic protein of eye-lens fibre cell
      membranes in mice with hereditary cataracts.
AB  - Expression of the major intrinsic protein (MIP) of eye-lens fibre cell membranes
      was compared in normal (DBA), cataractous (CAT, LOP, NCT) and chimaeric (CBA-LOP)
      mice at different stages of development using immunofluorescence microscopy and
      immunoblotting techniques. MIP of apparent molecular mass 26 kDa was detected in
      extracts of adult DBA, LOP and CBA-LOP lenses, but only low molecular mass (less
      than 26 kDa) immunoreactive proteins were detected in similar extracts from adult
      CAT and NCT lenses. The corresponding MIP distribution patterns confirmed the
      highly organised fibre-cell histology in embryonic DBA and adult CBA-LOP lenses
      and also highlighted the severe fibre-cell degeneration in the LOP lens. In
      contrast, however, no immunoreactive MIP was detected in situ in embryonic CAT
      and NCT lenses. These results suggest that a structural alteration of MIP occurs
      during embryonic lens development in the cataractous CAT (dominant) and NCT
      (recessive) mutant mice.

PMID- 1742337
TI  - Prepartal lactose concentration in the mammary glands of Uje: WIST rats as a
      simple indicator of approaching parturition.
AB  - Immediately after delivery, lactose was reliably detectable in rat mammary glands
      (mean concentration 6.49 +/- 0.57 mg/g tissue). The concentrations were not
      influenced by prepartal biopsy of contralateral mammary tissue. In the morning of
      the 21st day of gestation (= expected day of labor), lactose was evident in the
      mammary glands of dams delivering at that day (mean concentration 2.39 +/- 0.17
      mg/g tissue). In the tissue of dams delivering on day 22 of gestation, lactose
      was undetectable. A correlation between prepartal lactose concentration of
      mammary gland and time remaining up to beginning of delivery (r = -0.96)
      qualifies this parameter as a rough indicator of term of parturition.

PMID- 1742338
TI  - Group formation of previously single-caged adult rhesus macaques for the purpose
      of environmental enrichment.
AB  - An attempt was made to form two groups of 6 previously single-caged adult female
      and 6 previously single-caged adult male rhesus macaques. The study was based on
      the premise that simultaneous introduction of familiar animals reduces the risks
      involved during group formation. Future group members were therefore given ample
      opportunity to physically interact with each other on a one-to-one basis and were
      considered ready for group formation only when they had demonstrated
      compatibility and clear-cut dominance-subordination relationships. Both group
      formation attempts were failures. Aggressive incompatibility was heralded by
      certain subjects challenging other partners to whom they had originally been
      subordinate. Aggressive harassment was intensive and persistent. Victims showed
      no resistance except for fear-grinning and crouching in submission. They did so
      to no avail. Both groups were split again within the first hour of introduction
      to avoid fatal consequences. It was concluded, that unlike pair-housing, group
      housing of previously single caged adult rhesus macaques is associated with
      considerable risks which cannot be overcome by systematically familiarizing all
      group members before the animals are introduced as a group. There is no guarantee
      that well established dyadic relationships do not break down within the more
      complex social structure of the group, thereby triggering aggressive conflicts
      that put the animals' safety into undue jeopardy.

PMID- 1742339
TI  - Immune response of the Mongolian gerbil (Meriones unguiculatus) to sheep red
      blood cells.
AB  - The immune responses of Mongolian gerbils, Meriones unguiculatus, to sheep red
      blood cells (SRBC) were studied as compared to those of mice. After a single
      injection of SRBC, hemagglutinin titers in gerbils were significantly lower and
      hemolytic plaque-forming cells (PFC) in the spleen were less in number as
      compared to the response of mice. In gerbils the PFC response to a higher dose of
      bacterial lipopolysaccharide (LPS) was rather higher than in mice. The delayed
      type hypersensitivity (DTH) assay on the foot-pad revealed that the
      responsiveness was considerably lower in gerbils than in mice.

PMID- 1742340
TI  - Influence of chronic stress before and/or during gestation on pregnancy outcome
      of young and old Uje: WIST rats.
AB  - Young (70-120 d) and old (11-13 month) Uje:WIST rats were exposed to the strong
      stressor "chronic restraint" before and/or during gestation. Most adverse effects
      on pregnancy outcome were induced in young dams stressed before and during
      gestation (prolonged duration of pregnancy, lower body mass of the newborn pups).
      In old dams chronic restraint did not further deteriorate the age-dependent poor
      reproductive performance, but even rejuvenated it, if stress exposure was limited
      to the premating period.

PMID- 1742341
TI  - The effect of transportation stress on circulating corticosteroids, enzyme
      activities and hematological values in laboratory dogs.
AB  - Stress during transportation was monitored in truck-transported Beagle dogs "IVTK
      HD". Cortisol (F), corticosterone (B), red and white blood cell parameters, and
      enzyme activities in plasma were estimated. Plasma levels of cortisol and
      corticosterone were increased significantly during transportation and returned to
      basal values overnight post arrival. Hematocrit, hemoglobin, erythrocytes and
      leukocytes increased moderately. No obvious differences in enzyme activities were
      observed. Only alpha-HBDH values dropped significantly at the end of the 9.5 h
      transport period. This study confirms, although individual reaction is remarkably
      different, transportation as a potent stressor for Beagle dogs.

PMID- 1742342
TI  - Basic fibroblast growth factor requires a long-lasting activation of protein
      kinase C to induce cell proliferation in transformed fetal bovine aortic
      endothelial cells.
AB  - Basic fibroblast growth factor (bFGF) induces a protein kinase C (PKC)-dependent
      mitogenic response in transformed fetal bovine aortic endothelial GM 7373 cells.
      A long-lasting interaction of bFGF with the cell is required to induce cell
      proliferation. bFGF-treated cells are in fact committed to proliferate only after
      they have entered the phase S of the cell cycle, 12-14 h after the beginning of
      bFGF treatment. Before that time, the mitogenic response to bFGF is abolished by
      1) removal of extracellular bFGF by suramin, 2) addition of neutralizing anti
      bFGF antibodies to the culture medium, 3) inhibition of PKC activity by the
      protein kinase inhibitor H-7, and 4) down-regulation of PKC by cotreatment with
      phorbol ester. Thus the requirement for a prolonged interaction of bFGF with the
      cell reflects the requirement for a prolonged activation of PKC. Similar
      conclusions can be drawn for the PKC activators 12-O-tetradecanoyl phorbol 13
      acetate and 1,2-dioctanoyl-sn-glycerol. The two molecules require 16 and 6 h,
      respectively, of activation of PKC to induce 50% of maximal cell proliferation.
      The requirement for a long-lasting activation of PKC appears to be a mechanism
      for the control of cell proliferation capable of discriminating among transient
      nonmitogenic stimuli and long-lasting mitogenic stimuli.

PMID- 1742343
TI  - Regulation of Cl/HCO3 exchange in gastric parietal cells.
AB  - Microspectrofluorimetry of the fluorescent indicators 2',7'-bis-(2-carboxyethyl)
      5(and-6)carboxyfluorescein and 6-methoxy-N-(3-sulfopropyl)-quinolinium was used
      to measure intracellular pH (pHi), intracellular Cl (Cli), and transmembrane
      fluxes of HCO3 and Cl in single parietal cells (PC) in isolated rabbit gastric
      glands incubated in HCO3/CO2-buffered solutions. Steady-state pHi was 7.2 in both
      resting (50 microM cimetidine) and stimulated (100 microM histamine) PCs.
      Transmembrane anion (HCO3 or Cl) flux rates during Cl removal from or readdition
      to the perfusate were the same in resting and stimulated PCs. These rates
      increased at alkaline pHi, though this pHi dependence was small in the
      physiological range. Maximum velocity (Vmax) for Cl influx or HCO3 efflux was 80
      110 mM/min at pHi 7.6-7.8, and the Km for extracellular concentrations of Cl
      (Clo) was 25 mM; in the physiological range (pHi 7.1-7.3), Vmax for anion fluxes
      was approximately 50 mM/min. Steady-state Cli in the unstimulated PC was 62 +/- 5
      mM, but on histamine stimulation, Cli decreased rapidly to 25 mM and then
      increased back to a steady-state level of 44 mM. HCO3 fluxes due to Cl removal or
      readdition were completely blocked by 0.5 mM 4,4'-diisothiocyanatodihydrostilbene
      2,2'-disulfonic acid (H2DIDS), but Cl fluxes were only inhibited by 80%. H2DIDS
      did not inhibit the decrease in Cli that occurred with histamine treatment.
      Diphenylamine carboxylate (0.5 mM) inhibited Cl flux by only 50% and caused no
      additional inhibition of Cl flux when used in conjunction with H2DIDS.
      Transmembrane anion fluxes during solution Cl removal or readdition occurred 80%
      through the anion exchanger at the basal membrane and 20% through other
      pathway(s), presumably the Cl channel in the apical membrane. We conclude that
      the increase in transport activity via the Cl/HCO3 exchanger that occurs during
      histamine-induced increases in HCl secretion is due mostly to the decrease in
      Cli. In the resting cell with Cli = 62 mM, Clo = 120 mM, pHi = 7.2, and
      extracellular pH = 7.4, the anion exchanger is poised near its thermodynamic
      equilibrium. During histamine stimulation Cli drops from 62 mM to 44 mM, the
      thermodynamic equilibrium of the anion exchanger at the basolateral membrane is
      disturbed, and the anion exchanger then exchanges cellular HCO3 for extracellular
      Cl. Cli serves a crucial regulatory role in stimulus-secretion coupling in the
      PC.

PMID- 1742345
TI  - Site-directed mutagenesis and NMR spectroscopic approaches to the elucidation of
      the structure-function relationships in translation initiation factors IF1 and
      IF3.

PMID- 1742344
TI  - Wound-factor-induced and cell cycle phase-dependent expression of 9E3/CEF4, the
      avian gro gene.
AB  - The gro genes encode for secreted proteins with sequence homologies to
      inflammatory mediators. Little is known about the function of these proteins or
      their regulation. The chicken gro (9E3/CEF4) is expressed abundantly in the cells
      of proliferating cultures but at very low levels in confluent cultures. In vivo,
      this gene is expressed in connective tissue and overexpressed at sites of injury,
      especially in areas of neovascularization. Here we provide a bridge between these
      observations by examining in culture the effect on 9E3 expression and DNA
      synthesis induced by cell damage and by addition of factors known to be released
      on wounding. We mimicked wounding by scraping swaths across confluent cultures of
      embryonic fibroblasts and determined the time dependence of expression of 9E3
      mRNA and incorporation of 3H-thymidine. We find that 9E3 is (1) transiently
      expressed after "wounding" or serum-stimulation; (2) expressed in a cell cycle
      phase-dependent manner; it is triggered during the G0-G1 transition or early in
      G1 and subsides during S-phase; and (3) stimulated to high levels by a-fibroblast
      growth factor (aFGF), bFGF, transforming growth factor alpha (TGF alpha), and TGF
      beta, to intermediate levels by platelet-derived growth factor and not stimulated
      by epidermal growth factor. We also find that cells that are constantly cycling
      do not express 9E3, indicating that they skip either the portion of the cell
      cycle where 9E3 is induced or that they constitutively express a repressor of
      transcription or an RNA-degrading enzyme. Taken together, these observations
      suggest that the product of this gene could play more than one role in vivo. For
      example, in normal tissues the 9E3 protein could be involved in the exit of cells
      from the resting stage, whereas during wound healing the secreted protein or its
      cleavage products also could play a role in angiogenesis.

PMID- 1742346
TI  - Eukaryotic initiation factors eIF-2 and eIF-3: interactions, structure and
      localization in ribosomal initiation complexes.
AB  - More than ten different protein factors are involved in initiation of protein
      synthesis in eukaryotes. For binding of initiator tRNA and mRNA to the 40S
      ribosomal subunit, the initiation factors eIF-2 and eIF-3 are particularly
      important. They consist of several different subunits and form stable complexes
      with the 40S ribosomal subunit. The location of eIF-2 and eIF-3 in these
      complexes as well as the interactions of the individual components have been
      analyzed by biochemical methods and electron microscopy. The results obtained are
      summarized in this article, and a model is derived describing the spatial
      arrangement of eIF-2 and eIF-3 together with initiator tRNA and mRNA on the 40S
      subunit. Conclusions on the location of functionally important sites of
      eukaryotic small ribosomal subunits are discussed with regard to the respective
      location of these sites in the prokaryotic counterpart.

PMID- 1742347
TI  - 2'-O-methylation and inosine formation in the wobble position of anticodon
      substituted tRNA-Phe in a homologous yeast in vitro system.
AB  - Four variants of yeast tRNA-Phe in which the anticodon and 3'-adjacent nucleotide
      (GmAAY) have been replaced by synthetic tetranucleotides NAAG (where N is each of
      the four canonical nucleosides G, C, U or A) are substrates for a yeast tRNA
      modification enzyme which catalyses the S-adenosyl-L-methionine dependent
      formations of Gm-34, Cm-34, Um-34, Am-34 and Im-34 (where Nm represents a 2'-O
      methylnucleoside and I inosine). The kinetics of these nucleosides-34 2'-O
      methylations reveal that yeast tRNA-Phe with G-34 (the natural substrate) is less
      efficiently modified than variants of the same tRNA containing U-34 and C-34. The
      formation of Am-34 in the tRNA containing A-34 was found to be particularly
      inefficient. However, in this tRNA, we observed the formation of I-34 followed by
      a 2'-O-methylation (giving rise to Im-34). In the yeast in vitro system described
      here, inosine formation is not dependent on the addition of any cofactor
      including hypoxanthine; the mechanism of inosine formation in yeast tRNA might
      therefore be distinct from that found in higher eukaryotes.

PMID- 1742348
TI  - Overproduction of the Thermus thermophilus elongation factor Tu in Escherichia
      coli.
AB  - The elongation factor Tu (EF-Tu) encoded by the tufl gene of the extreme
      thermophilic bacterium Thermus thermophilus HB8 was expressed under control of
      the tac promoter from the recombinant plasmid pEFTu-10 in Escherichia coli.
      Thermophilic EF-Tu-GDP, which amounts to as much as 35% of the cellular protein
      content, was separated from the E coli EF-Tu-GDP by thermal denaturation at 60
      degrees C. The overproduced E coli-born T thermophilus EF-Tu was characterized
      by: i) recognition through T thermophilus anti-EF-Tu antibodies; ii) analysis of
      the peptides obtained by cyanogen bromide cleavage; iii) thermostability; iv)
      guanine nucleotide binding activity in the absence and the presence of elongation
      factor Ts; and v) ternary complex formation with phenylalanyl-tRNAPhe and GTP.

PMID- 1742349
TI  - How many EF-Tu molecules participate in aminoacyl-tRNA binding?
AB  - The stoichiometry of the EF-Tu-GTP-aminoacyl-tRNA complex has been re-determined
      by a variety of methods, viz gel filtrations, fluorescence titrations, as well as
      hydrolysis and RNase protection experiments. The results of these experiments
      clearly demonstrate that one aminoacyl-tRNA interacts with only one EF-Tu-GTP
      molecule, in agreement with the established view and in contrast to the recently
      published results by Ehrenberg et al [6].

PMID- 1742350
TI  - Structure-function relationships of elongation factor Tu as studied by
      mutagenesis.
AB  - We have modified elongation factor Tu (EF-Tu) from Escherichia coli via
      mutagenesis of its encoding tufA gene to study its function-structure
      relationships. The isolation of the N-terminal half molecule of EF-Tu (G domain)
      has facilitated the analysis of the basic EF-Tu activities, since the G domain
      binds the substrate GTP/GDP, catalyzes the GTP hydrolysis and is not exposed to
      the allosteric constraints of the intact molecule. So far, the best studied
      region has been the guanine nucleotide-binding pocket defined by the consensus
      elements typical for the GTP-binding proteins. In this area most substitutions
      were carried out in the G domain and were found to influence GTP hydrolysis. In
      particular, the mutation VG20 (in both G domain and EF-Tu) decreases this
      activity and enhances the GDP to GTP exchange; PT82 induces autophosphorylation
      of Thr82 and HG84 strongly affects the GTPase without altering the interaction
      with the substrate. SD173, a residue interacting with (O)6 of the guanine,
      abolishes the GTP and GDP binding activity. Substitution of residues Gln114 and
      Glu117, located in the proximity of the GTP binding pocket, influences
      respectively the GTPase and the stability of the G domain, whereas the double
      replacement VD88/LK121, located on alpha-helices bordering the GTP-binding
      pocket, moderately reduces the stability of the G domain without greatly
      affecting GTPase and interaction with GTP(GDP). Concerning the effect of ligands,
      EF-TuVG20 supports a lower poly(Phe) synthesis but is more accurate than wild
      type EF-Tu, probably due to a longer pausing on the ribosome.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1742351
TI  - The function of the translating ribosome: allosteric three-site model of
      elongation.
AB  - During the last decade, a new model for the ribosomal elongation cycle has
      emerged. It is based on the finding that eubacterial ribosomes possess 3 tRNA
      binding sites. More recently, this has been confirmed for archaebacterial and
      eukaryotic ribosomes as well, and thus appears to be a universal feature of the
      protein synthetic machinery. Ribosomes from organisms of all 3 kingdoms harbor,
      in addition to the classical P and A sites, an E site (E for exit), into which
      deacylated tRNA is displaced during translocation, and from which it is expelled
      by the binding of an aminoacyl-tRNA to the A site at the beginning of the
      subsequent elongation round. The main features of the allosteric 3-site model of
      ribosomal elongation are the following: first, the third tRNA binding site is
      located 'upstream' adjacent to the P site with respect to the messenger, ie on
      the 5'-side of the P site. Second, during translocation, deacylated tRNA does not
      leave the ribosome from the P site, but co-translocates from the P site to the E
      site--when peptidyl-tRNA translocates from the A site to the P site. Third,
      deacylated tRNA is tightly bound to the E site in the post-translocational state,
      where it undergoes codon--anticodon interaction. Fourth, the elongating ribosome
      oscillates between 2 main conformations: (i), the pre-translocational conformer,
      where aminoacyl-tRNA (or peptidyl-tRNA) and peptidyl-tRNA (or deacylated tRNA)
      are firmly bound to the A and P sites, respectively; and (ii), the post
      translocational conformer, where peptidyl-tRNA and deacylated tRNA are firmly
      bound to the P and E sites, respectively. The transition between the 2 states is
      regulated in an allosteric manner via negative cooperatively. It is modulated in
      a symmetrical fashion by the 2 elongation factors Tu and G. An elongating
      ribosome always maintains 2 high-affinity tRNA binding sites with 2 adjacent
      codon--anticodon interactions. The allosteric transition from the post- to the
      pre-translocational state is involved in the accuracy of aminoacyl-tRNA
      selection, and the maintenance of 2 codon--anticodon interactions helps to keep
      the messenger in frame during translation.

PMID- 1742352
TI  - The influence of tRNA located at the P-site on the turnover of EF-Tu.GTP on
      ribosomes.
AB  - The turnover of EF-Tu.GTP on poly-U programmed ribosomes was measured both in the
      presence and in the absence of N-acetylated Phe-tRNA(Phe) at the P-site. The
      reaction was uncoupled from protein synthesis by omitting Phe-tRNA(Phe) at the A
      site. In this reaction, the ribosome can be considered as an enzyme catalysing
      the transition of EF-Tu.GTP to EF-Tu.GTP. A constant EF-Tu.GTP concentration is
      maintained by regenerating GDP to GTP at the expense of phosphoenolpyruvate by
      pyruvate kinase. The rate constants are determined using a procedure which
      corrects for the reduction in specific activity of GTP due to regeneration of the
      nucleotide. Ribosomes with an occupied P-site are more efficient in stimulating
      the GTPase of EF-Tu.GTP than ribosomes with an empty P-site. The data suggest
      that this is mainly caused by an increased affinity of EF-Tu.GTP for ribosomes
      with a filled P-site rather than by an enhanced reactivity of the GTPase centre.

PMID- 1742353
TI  - Functional aspects of ribosomal proteins.
AB  - A short personal recollection of HG Wittmann is given with emphasis on his basic
      contribution to the structure of the ribosome, in particular the ribosomal
      proteins. With these considerations in mind, two interrelated problems are
      reviewed here. The first relates to the internal symmetry both in tRNA and in the
      tetrameric L12-protein complex. The second problem to be addressed relates to the
      dynamics of transfer RNA in the ribosome and the role of L12 proteins in this
      process. The importance of electrostatic repulsion in the maintenance of the
      mutual spatial orientation of tRNAs and L12 in the ribosome is emphasized in
      relation to a pendulum model for how L12 may steer translocation.

PMID- 1742354
TI  - The use of synthetic tRNAs as probes for examining nascent peptides on
      Escherichia coli ribosomes.
AB  - The polyuridylic acid-dependent syntheses of polycysteine and polyserine were
      carried out on Escherichia coli ribosomes using two new synthetic tRNA species.
      The peptides were initiated with N-acetyl or N-acyl coumarin derivatives of
      either Ser-tRNA or Phe-tRNA. The properties of the resulting nascent peptides
      were compared to those of nascent polyphenylalanine chains synthesized under
      similar conditions. This was accomplished by following changes in the
      fluorescence properties of the probes covalently linked to the amino-terminus of
      each of the nascent polypeptides as they were formed on the ribosomes. Nascent
      polycysteine and polyserine peptides appeared quite different from those of
      polyphenylalanine, as indicated by the anisotropy of fluorescence from the amino
      terminal probe. In contrast to serine and cysteine peptides, the synthesis of all
      the polyphenylalanine peptides was insensitive to inhibition by erythromycin,
      even though these peptides were initiated with N-acyl serine. The results support
      the hypothesis that nascent polyphenylalanine peptides have atypical physical and
      chemical properties and demonstrate the utility of using modified tRNAs to study
      ribosome function and the synthesis of proteins.

PMID- 1742355
TI  - Interaction of the release factors with the Escherichia coli ribosome:
      structurally and functionally-important domains.
AB  - There are two major domains of interaction between the Escherichia coli release
      factors (RF-1 and RF-2) and each subunit of the ribosome. RF-2 has a binding
      domain on the shoulder and lower head region of the small subunit at the small
      lobe distant from the decoding site. This is in close proximity to one of the
      domains on the large subunit which includes the body dimer of L7/L12 and L11. The
      other domains of interaction, at the decoding site on the small subunit, and at
      the peptidyltransferase centre of the large subunit of the ribosome, are some
      distance from the first two, although the evidence for direct contact with the
      ribosome is less comprehensive. The release factors may therefore have two
      distinct structural domains, and in support of this concept RF-1 and RF-2 can
      both be cleaved into two fragments by papain. Region-specific antibodies, and
      antibodies against defined peptide within the RF sequences have given an
      indication that a significant part of an interacting RF molecule is in close
      proximity to the ribosome surface, confirming an observation by immunoelectron
      microscopy which suggested that the RF penetrates deeply into the cleft between
      the two subunits. A region of highly conserved primary sequence between the two
      release factors from E coli is also conserved in those from B subtilis suggesting
      it forms an important structural or functional domain. Antibodies against
      peptides from the N-terminal end of this region strongly inhibit binding of the
      RF to the ribosome.

PMID- 1742356
TI  - A rRNA-mRNA base pairing model for UGA-dependent termination.
AB  - A series of site-directed mutations has been constructed in E coli 16S rRNA and
      shown to suppress UGA-dependent translational termination. With the exception of
      the C726 to G base change, all were constructed in helix 34. Characterization of
      these mutations is reviewed here and from these data and mRNA-rRNA base pairing
      model for the termination event is presented. The interaction functions via
      antiparallel base pairing between either 1 of the 2 UCA motifs in helix 34 and
      the complementary UGA stop codon on the message, thus forming a quasicontinuous A
      type helical structure that is further stabilized by stacking enthalpy. Finally,
      rRNA motifs potentially required for UAA and UAG-dependent translational
      termination are discussed.

PMID- 1742357
TI  - Effect of ADP-ribosylation and phosphorylation on the interaction of elongation
      factor 2 with guanylic nucleotides.
AB  - Samples of unmodified EF-2, EF-2 ADP-ribosylated with diphtheria toxin and NAD,
      and/or phosphorylated using ATP and the Ca(2+)-calmodulin dependent kinase III
      partially purified, were irradiated at 254 nm with 32P-labeled GDP or GTP, and
      analyzed by one- and two-dimensional gel electrophoresis. By this method we
      showed that unmodified EF-2 formed a stable complex with GDP but not with GTP,
      whereas phosphorylated EF-2 and ADP-ribosylated + phosphorylated EF-2 formed
      stable complexes even in the absence of irradiation, with GTP but not GDP. ADP
      ribosylated EF-2 did not form stable complexes with either GDP or GTP. Prior ADP
      ribosylation of EF-2 increased its ability to the phosphorylated. These results
      show that the structures of the two domains containing diphtamide 715 and the
      phosphorylatable threonines (between Ala 51 and Arg 60) are interdependent;
      modifications of these residues induce different conformational changes of EF-2
      which alter the interactions of the factor with guanylic nucleotides as well with
      ribosomes.

PMID- 1742358
TI  - Conserved amino acid residues in ribosome-inactivating proteins from plants.
AB  - The amino acid sequences of eleven RIPs sequenced to date have been compared in
      the expectation that this would be useful in the location of functionally and/or
      structurally important sites of these molecules. In addition to several highly
      conserved hydrophobic amino acids, thirteen absolutely conserved residues have
      been found in ricin A-chain: Tyr21, Phe24, Arg29, Tyr80, Tyr123, Gly140, Ala165,
      Glu177, Ala178, Arg180, Glu208, Asn209 and Trp211. The role of these residues as
      well as of the C-terminal region have been discussed based on the results of
      chemical and enzymatic modifications, site-directed mutagenesis, and deletion
      studies.

PMID- 1742359
TI  - Suppression of defective-sporulation phenotypes by mutations in transcription
      factor genes of Bacillus subtilis.
AB  - Mutations in the Bacillus subtilis major RNA polymerase sigma factor gene
      (rpoD/crsA47) and a sensory receiver gene (spoOA/rvtA11) are potent intergenic
      suppressors of several stage 0 sporulation mutations (spoOB, OE, OF & OK). We
      show here that these suppressors also rescue temperature-sensitive sporulation
      phenotypes (Spots) caused by mutations in RNA polymerase, ribosomal protein, and
      protein synthesis elongation factor EF-G genes. The effects of the crsA and rvtA
      suppressors on RNA polymerase and ribosomal protein spots mutations are similar
      to those previously described for mutations in another intergenic suppressor gene
      rev. We have examined the effects of rvtA and crsA mutations on the expression of
      sporulation-associated membrane proteins, including flagellin and penicillin
      binding protein 5* (PBP 5*). Both suppressors restored sporulation and synthesis
      of PBP 5* in several spoO mutants. However, only rvtA restored flagellin
      synthesis in spoO suppressed backgrounds. The membrane protein phenotypes
      resulting from the presence of crsA or rvtA suppressors in spoO strains suggests
      that these suppressors function via distinct molecular mechanisms. The rvtA and
      crsA mutations are also able to block the ability of ethanol to induce spoO
      phenocopies at concentrations of ethanol which prevent sporulation in wild type
      cells. The effects of ethanol on sporulation-associated membrane protein
      synthesis in wild type and suppressor containing strains have been examined.

PMID- 1742360
TI  - Characterization and primary structure of proteins L28, L33 and L34 from Bacillus
      stearothermophilus ribosomes.
AB  - The complete amino acid sequences of 3 proteins from the 50S subunit of Bacillus
      stearothermophilus ribosomes were determined by N-terminal sequence analysis and
      by sequencing of overlapping fragments obtained from enzymatic digestions and
      chemical cleavages. The proteins BstL28, BstL33 and BstL34, named according to
      the equivalent proteins in Escherichia coli ribosomes, consist of 60, 49, and 44
      amino acid residues and have calculated molecular masses of 6811.0, 5908.6, and
      5253.9 Da, respectively. They are highly basic with a content of positively
      charged residues ranging between 29% for L33 and 45% for L34. The 3 proteins were
      positioned in the 2-dimensional map of B stearothermophilus 50S ribosomal
      proteins. The electrophoretic mobilities confirm sizes and net charges deduced
      from the sequences.

PMID- 1742361
TI  - The primary structure of rat ribosomal proteins P0, P1, and P2 and a proposal for
      a uniform nomenclature for mammalian and yeast ribosomal proteins.
AB  - The covalent structures of rat ribosomal proteins P0, P1, and P2 were deduced
      from the sequences of nucleotides in recombinant cDNAs. P0 contains 316 amino
      acids and has a molecular weight of 34,178; P1 has 114 residues and a molecular
      weight of 11,490: and P2 has 115 amino acids and a molecular weight of 11,684.
      The rat P-proteins have a near identical (16 of 17 residues) sequence of amino
      acids at their carboxyl termini and are related to analogous proteins in other
      eukaryotic species. A proposal is made for a uniform nomenclature for rat and
      yeast ribosomal proteins.

PMID- 1742362
TI  - On the conformation of the alpha sarcin stem-loop of 28S rRNA.
AB  - A synthetic RNA that is a substrate for the cytotoxin alpha sarcin has been
      examined by NMR. The molecule in question includes the entire sequence of the so
      called alpha sarcin loop from rat 28S rRNA (U4316-C4332), and it is cleaved at
      the residue that corresponds to G4325, the site of alpha sarcin cleavage in 28S
      rRNA. The data show that the terminal stem designed into the molecule's sequence
      exists, as expected, and that its loop has a definite structure, which is stable
      to at least 40 degrees C under ionic conditions compatible with its cleavage by
      alpha sarcin.

PMID- 1742363
TI  - The interplay between X-ray crystallography, neutron diffraction, image
      reconstruction, organo-metallic chemistry and biochemistry in structural studies
      of ribosomes.
AB  - Crystals of ribosomes, their complexes with components of protein biosynthesis,
      their natural, mutated and modified subunits, have been subjected to X-ray and
      neutron crystallographic analyses. Electron microscopy and 3-dimensional image
      reconstruction, supported by biochemistry, genetic, functional and organo
      metallic studies were employed for facilitating phasing of the crystallographic
      data. For example, a monofunctional multi heavy-atom cluster (undecagold) was
      designed for covalent and quantitative binding to ribosomes. The modified
      particles were crystallized isomorphously with the native ones. Their difference
      Patterson maps contain indications for the usefulness of these derivatives for
      subsequent phasing. Models of the ribosome and its large subunit were
      reconstructed from tilt series of 2-dimensional sheets. The comparison of the
      various reconstructed images enabled an initial assessment of the reliability of
      these models and led to tentative assignments of several functional features.
      These include the presumed sites for binding mRNA and for codon-anticodon
      interactions, the path taken by the nascent protein chain and the mode for tRNA
      binding to ribosomes. These assignments assisted in the design of biologically
      meaningful crystal systems. The reconstructed models are being used to identify
      structural features in initial density maps derived from X-ray and neutron
      diffraction data.

PMID- 1742364
TI  - Heterogeneity of Escherichia coli ribosomes established by scanning transmission
      electron microscopy.
AB  - Quantitative mass image analysis of Escherichia coli ribosomal particles by
      scanning transmission electron microscopy (STEM) provided direct evidence that
      presumably homogeneous preparations of ribosomes are, in reality, populations of
      heterogeneous particles. Variations in composition, relative molecular mass (Mr)
      and shape were observed both in the monosomes and in the ribosomal subunits. None
      of these changes can be resolved visually; they can be evaluated only by computer
      processing. The variations in relative mass and shape monitored by values of
      radius of gyration (RG) were attributed to the loss of ribosomal proteins and/or
      factors and correlated with the changes in ribosome composition and biological
      activity. The highest activity was found in monosomes prepared from the standard
      0.5 M NH4Cl wash. With increasing concentrations (up to 1.5 M) of NH4Cl in the
      wash buffer the activity decreased slowly, then dropped rapidly to about half in
      2 M NH4Cl. The most striking effects were observed in ribosomal particles washed
      with 0.1 M NH4Cl. The 70S monosomes and the 30S subunits attained maximum Mr and
      RG values (2660 kDa and 76 A, and 990 kDa and 75 A, respectively), which were
      greater than the theoretical values, while the activity was minimal
      (approximately 12%). The Mr and RG parameters of the 50S subunits remained
      uneffected by the NH4Cl washes (approximately 1600 kDa and 68 A).

PMID- 1742365
TI  - How does the mRNA pass through the ribosome?
AB  - A working model of the mRNA path through the ribosome is proposed. According to
      the model, the template goes around the small ribosomal subunit along the region
      where its 'head' is separated from other parts of the subunit. The 5'-end of the
      mRNA fragment covered by the ribosome is located near the 3'-terminus of 16S
      rRNA, whereas the 3'-terminal residues of the fragment are situated on the outer
      surface of the subunit, opposite its 'side ledge'. When associated with the 50S
      subunit, the 30S subunit is oriented in such a manner that the decoding center
      faces the L7/L12 stalk. Implications of the proposed working model of the mRNA
      topography for the function of the ribosome are discussed.

PMID- 1742366
TI  - The side-by-side model of two tRNA molecules allowing the alpha-helical
      conformation of the nascent polypeptide during the ribosomal transpeptidation.
AB  - Lim and Spirin [25] proposed a preferable conformation of the nascent peptide
      during the ribosomal transpeptidation. Spirin and Lim [26] excluded the
      possibilities of the side-by-side model proposed by Johnson et al [13] and the
      three-tRNA binding model (A, P and E sites) of Rheinberger and Nierhaus [3].
      However, a slight conformational change at the 3' end regions of both A and P
      site tRNA molecules can enable the three different tRNA binding models to
      converge. With a modification of the angles of the ribose rings of both anticodon
      and mRNA this model can also be related to the model of Sundaralingam et al [19].
      In this model of E coli rRNA the 3' end sequence ACCA76 or GCCA76 of P site tRNA
      is base-paired to UGGU810 of 23S rRNA, while the ACC75 or GCC75 of A site tRNA
      are base-paired to GGU1621 23S rRNA. The conformation of the A76 of A site tRNA
      is necessarily different from that of P site tRNA, at least during the course of
      the transpeptidation. The A76 of A site tRNA overlaps the binding region of
      puromycin. The C1400 of 16S rRNA in this model is located at a distance of 4 A
      from the 5' end of the anticodon of P site tRNA [14] and 17 A from the 5' end of
      the anticodon of A site tRNA [15]. It is also shown that a considerable but
      reasonable modification in the conformation of the anticodon loops could lead to
      accommodation of three deacylated tRNA(Phe) molecules at a time on 70S ribosome
      in the presence of poly(U) as observed experimentally [6]. A sterochemical
      explanation for the negatively-linked allosteric interactions between the A and E
      sites is also shown in the present model.

PMID- 1742367
TI  - Superexpression and fast purification of E coli initiation factor IF2.
AB  - For the production of large quantities of E coli initiation factor IF2 we have
      constructed an improved overexpression system. The gene infB was cloned into the
      thermo-inducible runaway plasmid pCP40 [1] and subsequently transformed into the
      E coli strain C600[pcI857]. In this system the expression of infB is under the
      control of the strong promoter lambda PL and the cells carry the plasmid pcI857,
      which contains a thermosensible lambda cI repressor. Overexpression of IF2, which
      is approximately 30 times higher than the expression in wild-type-cells, is
      induced at 42 degrees C and continues for 2 h at 37 degrees C. From these cells
      pure and active IF2 was obtained using a novel 3-step FPLC-procedure consisting
      of ion-exchange liquid chromatography on Q-sepharose HP, MonoQ and MonoS. In
      approximately 8 h, 5 mg of pure and active IF2 can be obtained from 10 g
      overproducing cells. This corresponds to 5 mg of IF2 per litre of medium. The
      purification was monitored by Western immunoblotting and the activity of the
      purified factor was tested by measuring the stimulation of binding of the
      initiator fMet-tRNA(Met)f to 70S ribosomes in the presence of GTP and poly(A,U,G)
      as messenger RNA. Compared with previous methods our purification procedure
      avoids the use of materials such as DEAE-cellulose and phosphocellulose which
      have relatively poor flow rates. In addition to the higher flow capacity of Q
      sepharose HP, this new matrix can be loaded with an S30 supernatant.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1742368
TI  - Unbiased measures of transmitted information and channel capacity from
      multivariate neuronal data.
AB  - Two measures from information theory, transmitted information and channel
      capacity, can quantify the ability of neurons to convey stimulus-dependent
      information. These measures are calculated using probability functions estimated
      from stimulus-response data. However, these estimates are biased by response
      quantization, noise, and small sample sizes. Improved estimators are developed in
      this paper that depend on both an estimate of the sample-size bias and the noise
      in the data.

PMID- 1742369
TI  - On the sufficiency of the velocity field for perception of heading.
AB  - All models of self-motion from optical flow assume the instantaneous velocity
      field as input. We tested this assumption for human observers using random-dot
      displays that simulated translational and circular paths of movement by
      manipulating the lifetime and displacement of individual dots. For translational
      movement, observers were equally accurate in judging direction of heading from a
      "velocity field" with a two-frame dot life and a "direction field" in which the
      magnitudes of displacement were randomized while the radial pattern of directions
      was preserved, but at chance with a "speed field" in which the directions were
      randomized, preserving only magnitude. Accuracy declined with increasing noise in
      vector directions, but remained below 2.6 degrees with a 90 degrees noise
      envelope. Thus, the visual system uses the radial morphology of vector directions
      to determine translational heading and can tolerate large amounts of noise in
      this pattern. For circular movement, observers were equally accurate with a 2
      frame "velocity field", 3-frame "acceleration" displays, and 2-frame and 3-frame
      "direction fields", consistent with the use of the pattern of vector directions
      to locate the center of rotation. The results indicate that successive
      independent velocity fields are sufficient for perception of translational and
      circular heading.

PMID- 1742370
TI  - Langevin machine: a neural network based on stochastically justifiable sigmoidal
      function.
AB  - In neural networks the activation process controls the output as a nonlinear
      function of the input; and, this output remains bounded between limits as decided
      by a logistic function known as the sigmoid (S-shaped). Presently, by applying
      the considerations of Maxwell-Boltzmann statistics, the Langevin function is
      shown as the appropriate and justifiable sigmoid (instead of the conventional
      hyperbolic tangent function) to depict the bipolar nonlinear logic-operation
      enunciated by the collective stochastical response of artificial neurons under
      activation. That is, the graded response of a large network of 'neurons' such as
      Hopfield's can be stochastically justified via the proposed model. The model is
      consistent with the established link between the Hopfield model and the
      statistical mechanics. The Langevin function (in lieu of conventional hyperbolic
      tangent and/or exponential sigmoids) in determining nonlinear decision
      boundaries, in characterizing the neural networks by the Langevin machine versus
      the Boltzmann machine, in sharpening and annealing schedules and in the
      optimization of nonlinear detector performance are discussed.

PMID- 1742371
TI  - Sequential configuration model for firing patterns in local neural networks.
AB  - This paper presents a sequential configuration model to represent the coordinated
      firing patterns of memory traces in groups of neurons in local networks. Computer
      simulations are used to study the dynamic properties of memory traces selectively
      retrieved from networks in which multiple memory traces have been embedded
      according to the sequential configuration model. Distinct memory traces which
      utilize the same neurons, but differ only in temporal sequencing are selectively
      retrievable. Firing patterns of constituent neurons of retrieved memory traces
      exhibit the main properties of neurons observed in multi microelectrode
      recordings. The paper shows how to adjust relative synaptic weightings so as to
      control the disruptive influences of cross-talk in multipy-embedded networks. The
      theoretical distinction between (primarily anatomical) beds and (primarily
      physiological) realizations underlines the fundamentally stochastic nature of
      network firing patterns, and allows the definition of 4 degrees of clarity of
      retrieved memory traces.

PMID- 1742372
TI  - Cross-talk theory of memory capacity in neural networks.
AB  - The present paper presents a theory for the mechanics of cross-talk among
      constituent neurons in networks in which multiple memory traces have been
      embedded, and develops criteria for memory capacity based on the disruptive
      influences of this cross-talk. The theory is based on interconnection patterns
      defined by the sequential configuration model of dynamic firing patterns. The
      theory accurately predicts the memory capacities observed in computer simulated
      nets, and predicts that cortical-like modules should be able to store up to about
      300-900 selectively retrievable memory traces before disruption by cross-talk is
      likely. It also predicts that the cortex may has designed itself for modules of
      30,000 neurons to at least in part to optimize memory capacity.

PMID- 1742373
TI  - Simulated bipolar cells in fovea of human retina. III. Effects of chromatic
      adaptation in bipolar cell spectral responses.
AB  - Effects of chromatic adaptation on C-type bipolar cells (BC) in human retinal
      fovea are studied. Adaptation of the r-g channel is linear for both central fovea
      and parafovea. Adaptation of the parafovea bl-y channel, on the other hand, is
      nonlinear, which is accounted for by the slower adaptation rate of blue-sensitive
      cones with white light intensity as compared to rates of red- and green-sensitive
      cones. Achromatic adaptation of red- and green-center BCs produces uniform
      response decreases but without unique yellow loci shifts. Achromatic adaptation
      of blue-center BCs, on the other hand, does cause shifts of the unique green
      locus. Shifts of the crossover points for the BC response spectra occur with
      chromatic adaptation; the unique yellow loci shifts to shorter wavelengths with
      adapting wavelengths shorter than 550 nm and longer wave-lengths with longer
      adapting wavelengths than 550 nm. Chromatic adaptation is sufficient to explain
      the Bezold-Bruke effects; but to fully account for these shifts a novel
      hypothesis is proposed. For the green and red spectrum regions Bezold-Brucke
      shifts are due to r-g channel chromatic adaptation, while for the blue spectrum
      region bl-y channel chromatic adaptation accounts for Bezold-Brucke shifts. The
      two channels function independently in an either/or manner. The bl-y channel,
      besides having a unique green locus at 517.7 nm, has a crossover point at about
      670 nm. Chromatic adaptation of the bl-y channel produces shifts of the unique
      red locus, which may account for extraspectral hue shifts.

PMID- 1742374
TI  - Simulated bipolar cells in fovea of human retina. VI. Wavelength discrimination.
AB  - A computer model of simulated bipolar cells (BC) in the human retina is used to
      study wavelength discrimination (lambda delta). lambda delta curves are obtained
      for the two C-types of BCs in the central fovea and the three C-type BCs of the
      parafovea under various conditions. For the parafovea algebraic addition of the
      three C-type BCs with proper weighting of the blue-center BC, such that the
      unique orange locus = 600 nm, gives a combined channel whose lambda delta curve
      agrees remarkably well with those found in the literature based on human and
      primate psychophysics. Other studies include effects of chromatic adaptation and
      dispersion on lambda delta. From this and earlier studies it can be concluded
      that the center/surround organization of the BCs optimize resolution in the
      presence of natural occurring dispersion; in addition a specific BC receptive
      field organization could be picked as being optimal.

PMID- 1742375
TI  - Symbolic grouping versus simple cell models.
AB  - The apparent line-like structure in dot patterns derives substantially from the
      orientation defined by pairings of adjacent dots. Two alternative models have
      been proposed for making these pairings, one in which the individual dots are
      treated as discrete grouping tokens, and the second in which the pairing
      orientation derives from spatial summation by simple cell receptive fields.
      Contradictory evidence has been found both directly in support of, and directly
      against, both models. Much of the debate about these two models has hinged on the
      degree of linearity of summation expected in the simple cell model. Recent
      neurophysiological evidence changes the balance of the debate, invalidating
      certain earlier arguments based on linearity and providing a model way of showing
      that simple cells do indeed play a major, but not necessarily exclusive, role in
      dot groupings.

PMID- 1742376
TI  - Relativistic effects in single-joint voluntary movements.
AB  - We assume that there is an upper limit for the rate of change of controlled
      variables in the motor control system. Superposition of two single-joint motor
      programs can lead to a distortion of their simple algebraic summation similar to
      relativistic Lorenz transformations. Experiments were carried out with the
      subjects performing fast oscillatory elbow movements on the background of a
      smooth elbow flexion. Changes in the period of oscillations during the smooth
      movement were used as index of time transformations. Statistically 5%-7% changes
      in the period were observed for each of the subjects corresponding to the
      predictions of the model.

PMID- 1742377
TI  - Computation of frequency-to-spatial transform by olfactory bulb glomeruli.
AB  - A physiological simulation of 2.5% of the input and inhibitory neurons and 25% of
      the primary mitral/tufted cells in a single mammalian olfactory bulb glomerulus
      was constructed. This physiological simulation used the integrate-and-fire
      paradigm with realistic activation curves and synaptic delays. The dendritic
      integration incorporated non-linear interactive effects of individual cell
      excitatory and inhibitory post-synaptic potentials (PSPs) from both axodendritic
      and dendro-dendritic synaptic contacts. Refractory periods for granule-cell
      inhibition of mitral/tufted cell activity lead to relatively fixed-frequency
      rhythmic activity in the glomerulus, independent of the input frequency from the
      olfactory nerve. Though the frequency of mitral/tufted cell firing in bulb was
      approximately independent of input frequency, the number of cells active in the
      glomerulus was a roughly-linear function of input frequency to the glomerulus,
      indicating the mechanism's ability to function as a frequency-to-spatial encoder.

PMID- 1742378
TI  - In search of the causes of appendicitis.

PMID- 1742379
TI  - Do oral contraceptives cause breast cancer?

PMID- 1742380
TI  - The epidemiology of acute appendicitis in California: racial, gender, and
      seasonal variation.
AB  - The incidence of acute appendicitis has been reported to vary substantially by
      country, geographic region, race, sex, season, and occupation, but the reasons
      for this variation are unknown. We evaluated several risk factors for
      appendicitis by analyzing data from hospital discharge abstracts on all cases of
      acute appendicitis treated surgically in nonfederal hospitals in California from
      1983 to 1986 (N = 102,546). Comparison of age and sex-specific incidence rates
      for four racial/ethnic groups (white, Hispanic, black, and Asian/other) revealed
      rates in blacks and the Asian/other group one-half or less of the rates for
      whites and Hispanics between the ages of 5 and 29 years. Incidence rates in males
      were higher than rates in females in all racial/ethnic groups for most ages (RR =
      1.1-1.7). Seasonal variation in incidence was modest. Peak rates occurred in
      July, August, and September, and the lowest rates occurred in December.
      Hypotheses about the etiology of appendicitis must account for substantial
      racial/ethnic, gender, age variation, and modest seasonal variation in the
      incidence.

PMID- 1742381
TI  - Study designs for dependent happenings.
AB  - In 1916, Sir Ronald Ross defined "dependent happenings" as events where the
      number affected in a unit of time depends on the number already affected. That
      is, the incidence depends on the prevalence, a characteristic of many infectious
      diseases. Because of this dependence, interventions against infectious diseases
      can have not only direct protective effects for the person receiving an
      intervention, but also indirect effects resulting from changes in the intensity
      of transmission in the population. This paper develops the conceptual framework
      for four types of study designs that differentiate and account for direct and
      indirect effects of intervention programs in dependent happenings.

PMID- 1742382
TI  - Prognostic modeling of clinical outcomes: an illustration with data from patients
      with membranous nephropathy.
AB  - Probabilities that a patient will occupy any of five clinically defined
      compartments at different future times are generated and graphed by a personal
      computer. The probabilities are functions of a patient's relevant baseline
      characteristics (treated or control group), clinical status, and follow-up time
      at which the prognosis is made. The illustrative prognostic model is based on a
      reanalysis of detailed individual records for 81 patients with idiopathic
      membranous nephropathy (42 treated with methylprednisolone and chlorambucil; 39
      controls) in a randomized clinical trial. The compartments to and from which
      patients may pass are identified as (1) complete remission, (2) partial
      remission, (3) the nephrotic syndrome, (4) renal failure, and (5) death.
      Estimated risk functions for transitions between compartments involve baseline
      treatment, and intermediate and temporal variables, together with their relevant
      interactions. The model illustrates how, despite the overall advantage of treated
      over control patients, the comparative prognoses can change greatly and can even
      sometimes be reversed, depending on a variety of follow-up experiences.

PMID- 1742383
TI  - Black-white differences in blood pressure among participants in NHANES II: the
      contribution of blood lead.
AB  - Separate studies using data from the second National Health and Nutrition
      Examination Survey, 1976-1980 (NHANES II) have shown that blacks in the United
      States have higher blood lead levels than whites and that blood lead is
      positively related to blood pressure. Based on these reports, we examined data
      from NHANES II to determine the extent to which race differences in blood
      pressure were explained by elevated blood lead levels in blacks. Regression
      analyses, with race as an indicator variable, were used to estimate the
      contribution of blood lead to black-white differences in blood pressure. The
      overall effect of blood lead on race differences in blood pressure was small,
      reflecting, in part, the magnitude of race differences in blood lead and in the
      association of blood lead and blood pressure. Nevertheless, a pronounced and
      consistent effect of lead on race differences in blood pressure was found among
      the poor, particularly women.

PMID- 1742384
TI  - Breast cancer risk and oral contraceptive use: results from a large case-control
      study.
AB  - The association between oral contraceptive use and breast cancer risk was
      examined using data from a case-control study of breast cancer in Long Island,
      New York. Cases were defined as female residents of Nassau and Suffolk Counties
      between the ages of 20 and 79, diagnosed with breast cancer between January 1,
      1984 and December 31, 1986. Age- and county-matched controls were selected from
      driver's license files. Among all women under age 70 at diagnosis, there was no
      association between oral contraceptive use and breast cancer; there was, however,
      a positive association in the subgroup ages 20-49 (adjusted odds ratio = 1.68,
      95% CI: 1.16-2.42). Risk increased with increasing duration of use, but did not
      differ between women who first used oral contraceptives before the first
      pregnancy and those who first used them later, or between women who first used
      oral contraceptives before age 25 and those who first used them at a later age.
      Risk also appeared to increase with number of years of use before the first
      pregnancy or before age 25, although numbers were small. History of benign breast
      disease did not influence risk. The association of breast cancer risk with oral
      contraceptive use appeared stronger in women from Suffolk County than Nassau
      County.

PMID- 1742385
TI  - An efficient program for computing conditional maximum likelihood estimates and
      exact confidence limits for a common odds ratio.
AB  - This paper describes a method and associated computer program for calculating
      exact confidence limits and P values, along with the conditional maximum
      likelihood estimate of the common odds ratio for a series of 2 x 2 tables. The
      program can be used to calculate exact estimates for matched data and is
      considerably faster than others currently available.

PMID- 1742386
TI  - Using logistic regression to estimate the adjusted attributable risk of low
      birthweight in an unmatched case-control study.
AB  - Other authors have shown how to estimate attributable risk based on
      stratification. In this paper, we show how to estimate adjusted attributable
      risks, standard errors, and confidence intervals from an unmatched case-control
      study that has population-based controls and uses the logistic regression model
      to estimate relative risk. We apply the method to data from a case-control study
      of low birthweight. The method is conceptually simple, has no assumptions beyond
      those of the logistic model, makes use of computer-intensive statistical
      techniques (the bootstrap), and extends to interactions. A Fortran computer
      program to carry out the computations is available from the authors upon request.

PMID- 1742387
TI  - On the origin of Hill's causal criteria.
AB  - The rules to assess causation formulated by the eighteenth century Scottish
      philosopher David Hume are compared to Sir Austin Bradford Hill's causal
      criteria. The strength of the analogy between Hume's rules and Hill's causal
      criteria suggests that, irrespective of whether Hume's work was known to Hill or
      Hill's predecessors, Hume's thinking expresses a point of view still widely
      shared by contemporary epidemiologists. The lack of systematic experimental proof
      to causal inferences in epidemiology may explain the analogy of Hume's and
      Hill's, as opposed to Popper's, logic.

PMID- 1742388
TI  - Coffee consumption, birthweight, and reproductive failures.
AB  - We studied the effect of coffee consumption on birthweight, preterm births, and
      congenital malformations. From April 1985 to April 1987, 11,858 pregnant women
      out of 13,815 in two Danish cities responded to a mailed questionnaire on eating
      and drinking habits during pregnancy. Data on pregnancy outcomes were recorded
      from medical files. Maternal coffee consumption of four cups a day or more was
      associated with a moderate decrease in birthweight, especially among smokers. The
      associations between coffee consumption and preterm births or congenital
      malformations were very weak.

PMID- 1742389
TI  - Results and effect of refusal recontact in a case-control study of ectopic
      pregnancy.
AB  - In a population-based study of ectopic pregnancy, a card-back system of initial
      subject contact yielded a positive response from 85.1% of potential cases and
      65.0% of potential controls. We subsequently recontacted by telephone potential
      controls who had declined to participate and offered them $10 compensation for
      participation. We recontacted 205 of the 330 control women who had refused to
      participate. Twenty-eight were found to be ineligible, and 75.7% of the remaining
      177 agreed to participate on recontact. The additional 125 women were not
      recontacted, 9 because of firm initial refusals and 116 because the study ended
      before contact could be sought or made. Controls who initially declined to
      participate but subsequently agreed differed from those who initially agreed on a
      number of demographic and reproductive characteristics, and estimates of ectopic
      pregnancy risk associated with induced abortion and tubal sterilization changed
      slightly with the inclusion of initial nonparticipants. We conclude that use of a
      card-back system of subject contact yields a low level of positive response among
      reproductive-aged women and that many initial nonparticipants can be converted
      into participants by personal contact and the offer of compensation.

PMID- 1742390
TI  - The effect of an informational newsletter on control participation rates: a
      randomized study.
AB  - We employed a randomized study of 344 subjects to determine whether an initial
      contact letter accompanied by an informational newsletter increased participation
      in a population-based case-control study. The results indicated that there was no
      benefit in including a newsletter with a letter of introduction. There may have
      been a slight detrimental effect, since those who received the newsletter were
      less likely to consent to an in-person interview (82%) than those who did not
      (88%).

PMID- 1742391
TI  - In defense of standardized regression coefficients.
AB  - The association between a risk factor and a disease can be expressed as a
      standardized regression coefficient derived from a logistic model. When
      exponentiated, this standardized coefficient equals the odds ratio associated
      with a one-standard-deviation change in the risk factor. Some epidemiologists
      have recently recommended that standardized regression coefficients not be used
      in epidemiologic research. We disagree and provide examples that demonstrate
      that, when a risk factor is continuous, standardized regression coefficients may
      be helpful for comparing variables measured in different units. Standardized
      regression coefficients may also be helpful for comparing the effect of the same
      risk factor in different populations. Misinterpretations can be avoided if the
      standard deviations of the variables of interest are also provided. There is no
      reason to abandon the use of standardized regression coefficients in
      epidemiologic analyses.

PMID- 1742392
TI  - Standardized regression coefficients: a further critique and review of some
      alternatives.

PMID- 1742393
TI  - On the use of standardized regression coefficients.

PMID- 1742394
TI  - Exogenous hormones and colorectal cancer.

PMID- 1742395
TI  - [Critical evaluation of preoperative instrumental staging of rectal tumors.
      Research on the adequate use of US, CT and MR].
AB  - Both traditional exams (rectal exploration, rectoscopy, barium enema, CEA) and
      advanced imaging (31 US, 40 CT and 11 MR) were performed for preoperative
      evaluation of rectal carcinoma in order to assess the accuracy of radiological
      imaging in the T and N staging. The results obtained have not been considered
      satisfactory and it is felt that US, CT and MR should not be employed routinely
      for rectal staging. Indeed accuracy of US, CT and MR is respectively 64%, 75% and
      81% in the T evaluation and 64%, 70% and 64% in the N staging. In order to
      evaluate the effective usefulness of these three latter imaging techniques a
      double therapeutical choice was proposed. The first treatment option was
      suggested on the basis of traditional staging while a second choice was given
      considering US, TC and MR data also. Operatory findings subsequently allowed a
      definitive judgement on the influence of the different techniques on treatment
      selection. US has furnished useful data that could have allowed us to modify
      treatment in one case while in 5 other cases diagnostic error would have
      influenced treatment negatively. CT was useful in 5 cases while in 7 cases it
      would have influenced treatment choice negatively. MR would have been useful in
      one case and harmful in another. It is concluded that only patients with large
      neoplasms (stages T3 and T4) benefit from CT and MR staging with the exception of
      those cases that have tumors above the peritoneal fold or in strict relation with
      the sphincter structures. US was useful only in evaluating relations of neoplasms
      of the anterior rectal wall with nearby pelvic structures.

PMID- 1742396
TI  - [Morpho-functional characteristics of reflux gastritis in patients after
      cholecystectomy and without cholecystectomy].
AB  - The aim of this study was to evaluate some biochemical and histopathological
      aspects in a group of patients with a view to identifying any differences
      depending on whether the pathology was associated with previous cholecystectomy
      or idiopathic. The study involved 23 patients (8 post-cholecystectomy cases and
      15 ulcer-free dyspeptic patients) with the diagnosis of duodenogastric reflux
      gastritis confirmed by endoscopic histopathological evaluation. The following
      parameters were considered: 1) pH and bile salt concentration in gastric juice;
      2) histological classification of antral biopsies (Niemela's criteria); 3)
      dyspeptic symptoms (dyspepsia, pyrosis and epigastric pain, sense of repletion,
      foul-tasting mouth) graded on a scale from 0 to 4. All parameters were considered
      in relation to whether or not Helicobacter Pylori was found in the histological
      specimens. No significant differences were found between the two groups for pH
      and bile salt values or for Helicobacter Pylori positivity. No relationship was
      observed between the Helicobacter Pylori and either the severity of the
      histological picture, the features of the biochemical parameters or the severity
      of the clinical symptoms. Such findings confirm the common pathophysiological
      pattern of reflux gastritis regardless of any permanent biliary tract alterations
      and the low importance of Helicobacter Pylori infection in determining this
      syndrome.

PMID- 1742397
TI  - [Nutritional assessment of aged patients with fractures of the proximal epiphysis
      of the femur].
AB  - Forty-two patients (M/F 9/33; age 78 +/- 10 years) were studied during Hospital
      stay for femoral neck fractures (16 neck, 26 pertrochanteric fractures). All
      underwent fracture surgery (internal fixation in 30, arthroplasty in 12
      patients). Food intake was evaluated daily, supplemented with specific recipes.
      Biochemical assessment of nutritional status (hemoglobin, hematocrit, total
      proteins, albumin, prealbumin, Na, K, Ca, Fe, P, Mg) was performed before and
      after surgery. Nitrogen balance was evaluated in 8 patients in the post-operative
      period (40 determinations). The study group was compared for post-surgical
      complications and mortality during Hospital stay with a historical control group
      without any nutritional survey. Mean daily caloric intake was (M +/- DS) 1014 +/-
      360 in the preoperative period, 960 +/- 210 and 1036 +/- 185 postoperatively (5-9
      and 10-15 days post-surgery, respectively). Mean nitrogen intake was,
      respectively, 7.5 +/- 2.6, 7 +/- 2.1, 6.9 +/- 1.6 gN/day. No significant
      differences were found. In the preoperative period, the following tests were
      found below the normal range: iron (median 30 micrograms/dL), albumin (median 3.1
      g/dL), hemoglobin (median 12 g/dL) hematocrit (median 35%). After surgery, they
      decreased significantly; also prealbumin, in normal limits before surgery (20 +/-
      0.7 mg/dl), decreased significantly 5-9 days after surgery. After 10-15 days from
      surgery, only prealbumin and iron reached the preoperative level.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1742398
TI  - [Eosinophilic gastroenteritis and ascites. Clinical case].
AB  - We report the case of a patient with recurrent subocclusive episodes and diarrhea
      (no malabsorption) associated with ascites, in the absence or liver, kidney or
      heart disease. The demonstration of hypereosinophilia in the peripheral blood and
      in the ascites fluid and the failure to identify parasitic or haematological
      disorders have led to a through examination of the stomach (Endoscopy,
      Echoendoscopy), small bowel (X-rays and Computerized Axial Tomography) and colon
      (colonoscopy) in a search for parietal lesions. The absence of segmental lesions
      and the observation of CAT images of diffuse, regular thickening of the ileum and
      of the mesentery, coupled with the monotonous clinical history spanning over
      three decades, have led to a diagnosis of eosinophilic gastroenteritis with
      involvement of the serosal layer. Serosal involvement is rare in eosinophilic
      disease of the gut; in analogy with other cases reported in the literature,
      steroids have improved clinical symptoms and normalized the hematological
      picture.

PMID- 1742399
TI  - [Diagnostic routine in hepatology].

PMID- 1742400
TI  - [Therapy of chronic non-A, non-B hepatitis with interferon alfa-2B. A controlled
      clinical study and long-term follow-up].
AB  - In order to assess the efficacy of alpha-2b interferon (r-IFN) in the treatment
      of non-A non-B chronic hepatitis, 30 patients were randomised to receive r-IFN (3
      MU subcutaneously three times a week for 24 weeks) or no therapy. A total of 21
      males and 9 females, aged between 24-66 years old and who had had increased
      transaminase levels for at least one year, were included in the study. Three
      patients were ex-drug addicts and 6 had received blood transfusions whereas the
      cause of the infection in the remaining 21 patients was unknown. Hepatic biopsies
      performed prior to the study revealed persistent chronic hepatitis in 7 patients,
      active chronic hepatitis (ACH) in 19 patients and ACH with hepatic cirrhosis in 4
      patients. Anti-HCV antibodies were present in 21 patients (70%). Transaminase
      values returned to normal in 11 (73%) of the 15 patients treated and remained
      unchanged in controls after 6 months of therapy. During the 18-month follow-up
      following the suspension of r-IFN treatment, transaminase values rose again to
      pre-treatment levels in 4 patients. Anti-HCV antibodies did not disappear in any
      of the patients who responded to therapy.

PMID- 1742401
TI  - [Evaluation of the arterial share of portal flow using a scintigraphic technique
      in patients with liver cirrhosis. Correlations with other parameters of portal
      hypertension].
AB  - This study aimed to measure in semiquantitative terms the arterial-venous ratio
      of the portal flow using a scintigraphic technique, by means of a simple
      intravenous injection of a 99mTcDiethylHIDA bolus, a method which was found to be
      extremely simple and non-invasive, with a good degree of repeatibility. The
      percentage of arterialisation of the portal flow was found to be higher in
      cirrhotic patients compared to non-hepatopathic subjects, and among cirrhotic
      patients it was correlated with the severity of disease, the presence and degree
      of esophageal varices, and the presence of porto-systemic shunts, assessed using
      the ammonium chloride test.

PMID- 1742402
TI  - [Treatment of biliary stenosis with expandable metallic prostheses].

PMID- 1742403
TI  - Evolution and facial action in reflex, social motive, and paralanguage.
AB  - Based upon current evolutionary theory and recent laboratory and field data, this
      paper introduces a behavioral-ecology view of human facial displays that
      contrasts with previous views of faces as innate, prototypic, "iconic"
      expressions of fundamental emotions. First, I detail the criteria for
      establishing genetic and epigenetic contributions to facial behavior. Under these
      criteria, cross-cultural communality in canonical facial displays implies neither
      their genetic control nor their fundamental relation to emotion. New findings
      reestablish phylogenetic continuity by showing that human facial displays and
      vigilance for them, like their nonhuman counterparts, coevolve in the service of
      social motives; faces issued in solitude typically reflect imaginary or implicit
      interaction. Two evolutionary trends are probably involved in shaping facial
      actions--emancipation of reflexes, and automatization of instrumental acts.
      Modern conceptions of genetic and cultural evolution, and knowledge about animal
      signaling, suggest new hypotheses regarding the origins and functions of facial
      displays. In so doing, they clarify how facial displays relate to reflexion,
      motive and intention, emotion and psychophysiology, and language and
      paralanguage.

PMID- 1742404
TI  - Controlled and modulated release of basic fibroblast growth factor.
AB  - Basic fibroblast growth factor has multivariate effects in stimulating cell
      growth and the processes that surround tissue repair. Pathophysiologic studies
      have been hampered by the stability of the compound. Though very potent, basic
      fibroblast growth factor is rapidly degraded when injected or ingested.
      Controlled release of basic fibroblast growth factor would allow for examination
      of the chronic effects of this compound. Conventional matrix polymer-based
      release devices were fabricated and basic fibroblast growth factor released in a
      sustained fashion, but 99% of basic fibroblast growth factor mitogenic activity
      was lost. The source of these losses was identified and preventative measures
      examined. Preservation and stabilization of basic fibroblast growth factor was
      accomplished by binding the factor to heparin-Sepharose beads. This permitted
      prolonged storage, repeated handling, and the encapsulation of basic fibroblast
      growth factor within a microspherical controlled-release device using a naturally
      occurring polymer material, alginate. Encapsulation was accomplished with 77%
      efficiency and 87.5 +/- 12% of the basic fibroblast growth factor was released in
      a biologically active form. Release activation and regulation was achieved when
      cleavage of the basic fibroblast growth factor-heparin bonds was enhanced (e.g.
      by enzymatic bond cleavage with heparinase). Kinetic profiles were identified for
      a variety of experimental conditions and the effects of the controlled release of
      basic fibroblast growth factor on BALBc/3T3 fibroblasts examined.

PMID- 1742405
TI  - Stress-enhanced ion release--the effect of static loading.
AB  - Static stresses affect the corrosion behaviour of 316L stainless steel, Ti-6AI
      4V, and a Co-Cr-Mo alloy. Several corrosion parameters are modified by stress,
      although the changes most relevant to the clinical situation are lowering of
      breakdown potentials and increases in corrosion currents. AC impedance techniques
      to measure capacitance allowed the latter effect to be partitioned into
      components of true current density and true area changes. Although loading past
      the yield point can definitely cause stress-enhanced ion release (SEIR), it is
      not required. SEIR can also be caused by elastic loading. The basic mechanism for
      this phenomenon appears to be passive film disruption followed by slow
      repassivation kinetics. Polished, grit-blasted, and porous-coated surfaces were
      examined. The porous-coated materials seemed to be most susceptible to SEIR. If
      effects similar to those observed here apply to in vivo conditions, then tests on
      unstressed alloys in vitro could grossly underestimate ion release rates of
      stressed implant devices in vivo.

PMID- 1742406
TI  - Anticancer gelatin microspheres with multiple functions.
AB  - Biodegradable, hydrophilic gelatin microspheres (GM) with an average diameter of
      70 microns were prepared by cross-linking gelatin with glutaraldehyde for hepatic
      intra-arterial infusion. An anticancer agent, mitomycin C (MMC), together with a
      radioisotope, 131I, were bound to the GM for chemotherapy and local internal
      radiotherapy. The 131I-labelled MMC-GM (131I-MMC-GM) could accumulate in the
      specific site and embolize the hepatic arteries after the hepatic intra-arterial
      infusion, while it caused various effects to the liver cells. The 131I-MMC-GM
      remained within the hepatic arteries for at least one month. In vitro release of
      drugs from the GM was also quantified using a dynamic dialysis method.

PMID- 1742407
TI  - Heterocyclic methacrylates for clinical applications. I. Mechanical properties.
AB  - The mechanical properties of a number of heterocyclic and one cyclic methacrylate
      have been studied for their potential in low polymerization shrinkage systems.
      This study included both homopolymers and room temperature polymerizing systems
      using poly(ethyl methacrylate) powder with a heterocyclic methacrylate monomer.
      The one cyclic methacrylate studied, isobornyl methacrylate, gave an extremely
      brittle polymer; furthermore, it would not form a dough with poly(ethyl
      methacrylate). The homopolymers gave Young's moduli in the range 1.38-2.19 GN/m2,
      i.e. lower than poly(methyl methacrylate). The moduli of poly(ethyl
      methacrylate)/monomer systems are theoretically predictable from the moduli of
      the homopolymers involved. The above materials were generally ductile and the
      mechanical properties indicated a useful class of materials for clinical use.

PMID- 1742408
TI  - Heterocyclic methacrylates for clinical applications. II. Room temperature
      polymerizing systems for potential clinical use.
AB  - A number of useful room temperature polymerizing resins were formulated, based on
      poly(ethyl methacrylate) powder and a range of low shrinkage heterocyclic
      methacrylate monomers. N,N-dimethyl-p-toluidine or p-tolyl diethanolamine were
      used as activating amines, but the latter material is less active and some care
      is necessary with respect to the source of the monomer. Isobornyl methacrylate is
      a useful diluent monomer to reduce the exotherm.

PMID- 1742409
TI  - Heterocyclic methacrylates for clinical applications. III. Water absorption
      characteristics.
AB  - The water absorption and desorption behaviour of poly(isobornyl methacrylate) and
      poly(tetrahydropyran-2-ylmethyl methacrylate) obeyed diffusion laws on repeated
      absorption/desorption cycles. However, the polymers of 2,3-epoxypropyl,
      tetrahydrofurfuryl and tetrahydropyranyl methacrylates did not obey diffusion
      laws, did not equilibrate after 2 yr immersion in water and exhibited very high
      uptake values (30-90%). For 2,3-epoxypropyl methacrylate, the sample
      disintegrated. A clearly detailed structure of the heterocyclic ring is critical.
      The use of these monomers in room temperature polymerizing poly(ethyl
      methacrylate)/monomer systems generally reflected the behaviour of the related
      homopolymers.

PMID- 1742410
TI  - Long-term flexural strength of glass ionomer cements.
AB  - The flexural strength of five glass ionomers was measured at intervals ranging
      from 1 h to 3 months after mixing. The pattern of change in flexural strength is
      material-specific with two water-activated materials having significantly higher
      long-term flexural strengths than the others. This may be attributable to the
      different polyacrylic acids used or to changes in the glass formation in the
      different materials.

PMID- 1742411
TI  - Relationship between chemotaxis and complement activation by ceramic
      biomaterials.
AB  - This paper examines the relationship between complement activation by ceramic
      biomaterials and chemotaxis. Complement activation was examined by both
      neutrophil polarization (a technique which has previously been used to examine
      chemotaxis) and immunoelectrophoresis assays. The results suggest that at
      increasing serum concentrations of both calcium hydrogen phosphate and coral
      (calcium carbonate) powder, the quantity of C3 activation increased, as did the
      quantity of serum-derived chemotactic factors. In the case of tricalcium
      phosphate powder, the quantity of C3 activation and the neutrophil polarization
      response to serum were similar for serum levels between 20 and 80 mg/ml.
      Complement C3 was not activated in serum incubated with calcium hydrogen
      phosphate powder and serum incubated with this material was not chemotactic for
      neutrophils.

PMID- 1742412
TI  - Effect of carboxylate and/or sulphonate ion incorporation on the physical and
      blood-contacting properties of a polyetherurethane.
AB  - Propyl sulphonate and ethyl carboxylate groups were grafted on to the backbone of
      a polytetramethylene oxide-based polyurethane (PEU). The effects of ion type and
      ion content on the polymer's bulk, surface, and blood-contacting properties were
      evaluated. Ion incorporation disrupted the packing of the hard segment but had
      little effect on the overall microphase separation of the polymers. The
      mechanical properties of the ionomers were improved relative to the base PEU,
      although the carboxylate-containing ionomers were weaker than the sulphonate
      containing polymers. As expected, the polymer's water absorption and surface
      polarity increased with increasing ion content. Dynamic and static contact angle
      analysis indicated that the propyl sulphonate-containing polymers were more polar
      than the ethyl carboxylate-containing polymers at the same ion content which is
      attributed to the higher ionic strength of the sulphonate ion. The carboxylate
      containing polymers had no statistically significant effect on the polymer's
      canine ex vivo blood-contacting response. At the same ion content, propyl
      sulphonate incorporation significantly reduced platelet deposition for very short
      blood-contacting times. When both ion types were present in the polymer, the
      propyl sulphonate group appeared to be the primary factor determining the
      polymer's blood-contacting response. The polymer containing 20 mol% propyl
      sulphonate groups significantly reduced platelet deposition and activation while
      also exhibiting enhanced fibrinogen deposition.

PMID- 1742413
TI  - Study of the calcification of bovine pericardium: analysis of the implication of
      lipids and proteoglycans.
AB  - A major problem with cardiac bioprosthesis is the calcification of the tissue
      used in their manufacture, an event which may be promoted by multiple factors. A
      subcutaneously implanted model was used to determine, by selective extractions of
      proteoglycans and lipids, the role played by these compounds in the calcification
      of the bovine pericardial tissue used in the construction of some biological
      valves. The selective extraction of proteoglycans resulted in a great
      accumulation of calcium salts in the tissue, which, moreover, had a reduced
      hydrothermal stability. On the other hand, lipid extraction produced no
      modification in the stability of the tissue and resulted in a lesser calcium
      accumulation than in the control group. Proteoglycans and lipids may, therefore,
      be implicated in mineralization of the pericardial tissue.

PMID- 1742414
TI  - Cytocompatibility of two coating materials, amorphous alumina and silicon
      carbide, using human differentiated cell cultures.
AB  - The cytocompatibility of two coating materials, amorphous alumina and silicon
      carbide deposited by radio-frequency sputtering, was studied using alveolar bone
      osteoblasts and gingival fibroblasts from human healthy tissues.
      Cytocompatibility was assessed at the level of both the basic (attachment,
      proliferation and cell protein content) and the specific features (intracellular
      alkaline phosphatase activity and the cytoskeleton) of the cells in direct
      contact with the coating. Titanium was used as the reference material. The
      results showed that both silicon carbide and amorphous alumina are cytocompatible
      for human fibroblasts and osteoblasts, whereas titanium appears the least
      cytocompatible of all the three substrates. Moreover, the amorphous alumina
      coating seems slightly bioactive. It seems that these coatings, particularly
      amorphous alumina, could be used to protect alloys against corrosion, and
      consequently combine the good mechanical properties of the alloys with the good
      biocompatibility of the coatings. These coatings seem to perform more suitably
      than titanium if the strength of the bond between the coating and the underlying
      alloys is strong enough to give a stable composite material.

PMID- 1742415
TI  - Steric stabilization of microspheres with grafted polyethylene oxide reduces
      phagocytosis by rat Kupffer cells in vitro.
AB  - Sterically stabilized polyethylene oxide-polystyrene copolymer microspheres, (PS
      PEO) and charge stabilized polystyrene (PS) microspheres of similar size (1
      micron) were prepared in order to compare their uptake by cultured rat Kupffer
      cells isolated by centrifugal elutriation. The uptake of the sterically
      stabilized particles was found to be much less than that for the charge
      stabilized control. The uptake of microspheres stabilized with covalently grafted
      PEO was lower or equivalent to that of control microspheres stabilized by the
      adsorption of the non-ionic PEO-polypropylene oxide (PPO-PEO) surfactant
      Poloxamer 238 or Methoxy-PEO. Phagocytic uptake by Kupffer cells at low and body
      temperature (8 degrees C and 37 degrees C) demonstrated that PS-PEO particles
      showed both low adherence and low metabolic uptake. The adsorption of PEO, as
      Poloxamer 238, to particles with covalently attached or grafted PEO resulted in a
      synergistic reduction in uptake that was greater than the individual effects of
      grafting and adsorption alone (P less than or equal to 0.001). It is suggested
      that this combination produces a more effective steric barrier on the particle
      surface with the Poloxamer adsorbing to the surface between the grafted PEO
      chains. The relevance to drug targeting/carrier systems is discussed.

PMID- 1742416
TI  - Biocompatibility of a prolonged-action antialcohol preparation.
AB  - Acid and alkaline phosphatase activities in liver lysosomes and liver
      mitochondria, respectively, as well as in connective tissue capsule were studied
      for an antialcohol preparation (polyurethane carrier and disulfiram at 150, 300
      and 625 mg/kg body weight) implanted subcutaneously. Increased acid phosphatase
      activity was observed in connective tissue capsule on days 14, 30 and 90 after
      implantation and in liver lysosome fraction on days 14 and 30 with preparation
      containing disulfiram at 300 and 625 mg/kg body weight. Alkaline phosphatase
      activity increased both in connective tissue capsule and in liver mitochondria up
      to day 30 only when sample with maximal disulfiram dose was implanted. Acid
      phosphatase activity is an adequate indicator for biocompatibility of prolonged
      action medicine preparations. The data obtained show that the suggested medical
      form containing disulfiram 150 mg/kg body weight is biocompatible. Interaction
      between acid and alkaline phosphatase activity changes and biocompatibility and
      destruction of polymer implants is discussed.

PMID- 1742417
TI  - Tooth movement.
AB  - This article reviews the evolution of concepts regarding the biological
      foundation of force-induced tooth movement. Nineteenth century hypotheses
      proposed two mechanisms: application of pressure and tension to the periodontal
      ligament (PDL), and bending of the alveolar bone. Histologic investigations in
      the early and middle years of the 20th century revealed that both phenomena
      actually occur concomitantly, and that cells, as well as extracellular components
      of the PDL and alveolar bone, participate in the response to applied mechanical
      forces, which ultimately results in remodeling activities. Experiments with
      isolated cells in culture demonstrated that shape distortion might lead to
      cellular activation, either by opening plasma membrane ion channels, or by
      crystallizing cytoskeletal filaments. Mechanical distortion of collagenous
      matrices, mineralized or non-mineralized, may, on the other hand, evoke the
      development of bioelectric phenomena (stress-generated potentials and streaming
      potentials) that are capable of stimulating cells by altering the electric charge
      on their membrane or their fluid envelope. In intact animals, mechanical
      perturbations on the order of about 1 min/d are apparently sufficient to cause
      profound osteogenic responses, perhaps due to matrix proteoglycan-related "strain
      memory". Enzymatically isolated human PDL cells respond biochemically to
      mechanical and chemical signals. The latter include endocrines, autocrines, and
      paracrines. Histochemical and immunohistochemical studies showed that during the
      early places of tooth movement, PDL fluids are shifted, and cells and matrix are
      distorted. Vasoactive neurotransmitters are released from periodontal nerve
      terminals, causing leukocytes to migrate out of adjacent capillaries. Cytokines
      and growth factors are secreted by these cells, stimulating PDL cells and
      alveolar bone lining cells to remodel their related matrices. This remodeling
      activity facilitates movement of teeth into areas in which bone had been
      resorbed. This emerging information suggests that in the living mammal, many cell
      types are involved in the biological response to applied mechanical stress to
      teeth, and thereby to bone. Essentially, cells of the nervous, immune, and
      endocrine systems become involved in the activation and response of PDL and
      alveolar bone cells to applied stresses. This fact implies that research in the
      area of the biological response to force application to teeth should be
      sufficiently broad to include explorations of possible associations between
      physical, cellular, and molecular phenomena. The goals of this investigative
      field should continue to expound on fundamental principles, particularly on
      extrapolating new findings to the clinical environment, where millions of
      patients are subjected annually to applications of mechanical forces to their
      teeth for long periods of time in an effort to improve their position in the oral
      cavity.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1742419
TI  - Cell surface carbohydrates are markers of differentiation in human oral
      epithelium.
AB  - Carbohydrates of the epithelial cell membrane are involved in cell-cell and cell
      substrate interaction, and changes are seen in relationship to cell
      differentiation and neoplastic transformation. The terminal part of carbohydrate
      structures carried on oral epithelial cells often expresses antigens of the ABO
      and Lewis blood group systems. The expression of these antigens are in oral
      mucosa genetically regulated by the A, B, H, Lewis, and secretor genes with
      subsequent correspondence between the blood group antigens expressed on
      erythrocytes and on oral epithelial cells. Variation in expression of
      carbohydrates is also seen in relationship to terminal differentiation in that
      blood group antigens and their immediate precursor structures are sequentially
      expressed on cells during their pathway through the epithelium. Various organs
      and tissues differ in their expression of cell surface carbohydrates. In oral
      mucosa, a close relationship is seen between the type of tissue differentiation
      and expression of blood group antigen; keratinized, nonkeratinized, and
      junctional epithelium all show different patterns of carbohydrate expression.

PMID- 1742418
TI  - Cell adhesion proteins in oral biology.

PMID- 1742420
TI  - Enhanced expression of heat shock protein gene in kidney lymphoid cells of lupus
      prone mice during growing process.
AB  - In the present study, the spontaneous elevation of the transcription of heat
      shock protein (hsp 70) gene in kidney lymphoid cells of lupus-prone mice (MRL
      lpr/lpr) is shown by Northern blot and nuclear run on transcription assay. By
      quantification analysis of hsp 70 gene transcription, more than ten times of the
      enhanced transcription of hsp 70 gene in kidney lymphoid cells of lupus-prone
      mice was first found, in comparison to normal control mice (MRL(-)+/+). The
      elevation of transcriptional level of hsp 70 gene was also found to increase
      during growing process and seemed to have positive correlation with deterioration
      of lupus-related renal disorders in lupus-prone mice. Our observation suggests
      that heat shock proteins may be involved in possible significance in the
      pathophysiology of nephrotic lesions of lupus-prone mice due to lupus-related
      change of kidney lymphoid cells.

PMID- 1742421
TI  - Treatment with IL2/vaccinia recombinant virus leads to serologic, histologic and
      phenotypic normalization of autoimmune MRL/lpr-lpr mice.
AB  - We have analyzed the effect of IL2 administered in vivo on both the
      lymphoproliferation and autoimmune disease progression of MRL/lpr mice. Human IL2
      was delivered by infecting MRL/lpr mice with vaccinia virus recombinants at
      different stages of lpr disease. The results reported here showed that treatment
      of lpr mice with IL2 mediated: (1) restored normal thymic differentiation
      illustrated by an expansion of the double positive population accompanied by
      increased numbers of mature thymocytes; (2) depletion of the peripheral CD3+ CD4-
      CD8- (DN) T-cell population; (3) normalization in the pattern of TcRV beta gene
      expression displayed by mature T cells; (4) decreased urine-protein levels and
      immune complex deposition in the kidney, with a resultant absence of
      glomerulonephritis; and (5) an increased longevity (from 195 to more than 400
      days). We speculate that the dramatic reduction in the abnormally expanded CD3+
      DN T-cell population following IL2 therapy might be directly related to the
      amelioration and/or prevention of autoimmune disease in these mice. Collectively,
      these results suggest that diseases showing a selective expansion of DN cells
      should be envisaged as possible targets for the treatment described here.

PMID- 1742422
TI  - Analysis of the IgG subclass production from rheumatoid arthritis synovial cell
      cultures.
AB  - In man there are four subclasses of IgG which differ from each other with respect
      to their biological properties. Some evidence suggests that the production of
      IgG3 is unusually high in rheumatoid synovia. In this study secretion of IgG
      subclasses by synovial lymphocytes in vitro was measured using sensitive subclass
      specific ELISAs. It was found that, in both synovial membrane- and synovial fluid
      derived cell cultures, the general pattern of IgG subclass secretion was IgG1
      greater than 2 greater than 3 greater than or equal to 4, and that, in most
      cultures, IgG3 was a minor subclass accounting, on average, for only 8% of the
      total IgG. This was similar to the percentage of this subclass in normal human
      serum and in culture supernatants from the patients' peripheral blood
      lymphocytes.

PMID- 1742423
TI  - Isotype and immunoglobulin subclass distribution of eye muscle membrane reactive
      antibodies in the serum of patients with thyroid-associated ophthalmopathy as
      detected in Western blotting.
AB  - We have determined the immunoglobulin (Ig) class (isotype) and IgG subclass of
      autoantibodies in the serum of patients with thyroid-associated ophthalmopathy
      (TAO) or autoimmune thyroid disorders without evident ophthalmopathy reactive in
      Western blotting with antigens of 55, 64, 75 and 95 kDa in pig eye muscle
      membrane (PEMM). The 22 sera studied were shown, previously, to contain IgG
      antibodies reactive with one or more of the four antigens. The majority of sera
      antibodies reactive with PEMM antigens were of two or more IgG subclasses. Of the
      IgG subclass specificities IgG3 and IgG4 subclass antibodies were, overall, the
      most common. We were unable to demonstrate IgG subclass restriction for
      antibodies reactive with the 95 or 55 kDa antigens in PEMM, antibody activity
      being equally distributed in all four subclasses tested. While most of the sera
      which recognized a 64 kDa antigen did so with an IgG4 antibody, all other
      subclasses were also represented. On the other hand all 13 sera reactive with a
      75 kDa antigen did so using Ig of the IgG3 subclass and 12 of these used the IgG4
      subclass as well, IgG1 and IgG2 subclasses being represented in only 3 and 4
      sera, respectively. There were no differences, in respect to Ig class or IgG
      subclass distribution of eye muscle reactive antibodies between patients with
      Graves' hyperthyroidism with ophthalmopathy and those with Hashimoto's
      thyroiditis, and eye disease. Control sera from five normal subjects and three
      patients with nonautoimmune thyroid disorders did not contain antibodies reactive
      with these PEMM antigens of any Ig class or IgG subclass.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1742424
TI  - The functional state of the beta cells in the pathogenesis of insulin-dependent
      diabetes mellitus.
AB  - Besides the thymus-dependent immune system, growing evidence suggests that the
      functional state of the beta cell plays a role in the pathogenesis of Type 1
      (insulin-dependent) diabetes. Increased incidence of diabetes has been described
      after increased insulin production and vice versa, and actual hyperinsulinemia
      has been observed in relation to the diabetogenesis. Prophylactic insulin
      treatment and intensive insulin therapy at diagnosis are discussed. The studies
      referred to are mostly animal model investigations of BB rats and NOD mice and-to
      a lesser degree- of streptozotocin- and encephalomyocarditis-virus-induced
      diabetes. Also human evidence exists, but naturally of a more sporadic character.
      Three possible mechanisms behind the beta cell sensitivity as a function of their
      activity are suggested: increased antigen expression (including both gangliosides
      and proteins) in beta cells with high activity which could activate the
      destruction caused by the immune system, and increased susceptibility to the
      toxicity of interleukins and to diabetogenic agents. With respect to developing
      preventive treatment the described research area may turn out to be very
      important. Further studies both in animal models and in humans are awaited.

PMID- 1742425
TI  - Local IgA and IgM rheumatoid factor production in autoimmune MRL/lpr mice.
AB  - Spontaneous local immunoglobulin (IgA, IgG, IgM) as well as IgA and IgM
      rheumatoid factor (RF) production in salivary glands, lymph nodes, and spleen was
      analyzed at various ages in autoimmune MRL/Mp-lpr/lpr (MRL/lpr) mice by using an
      ELISPOT assay. The longitudinal design of the study permitted correlations with
      severity of disease in salivary glands (sialadenitis). Local production of
      immunoglobulins in salivary glands and lymph nodes occurred with a pattern of IgG
      much greater than IgM greater than IgA. This isotype pattern differed from that
      simultaneously observed in spleen where IgG did not predominate to the same
      extent. Moreover, the spleen was the major site of IgM production. Rheumatoid
      factors constituted a significant fraction of local IgA and IgM in involved
      salivary glands. The pattern of IgA RF isotype expression in salivary glands
      contrasted with that observed in spleen. While the number of IgA and IgG
      secreting cells increase at an early age, the peak of RF production in salivary
      glands occurs in older mice. Furthermore, the level of immunoglobulin secretion
      was positively correlated with disease severity in salivary glands. The results
      suggest that local RF production is a secondary event in salivary gland
      inflammation in MRL/1pr mice rather than an initiating factor in this process.

PMID- 1742426
TI  - An evolutionarily-conserved role for murine Ly-1 B cells in protection against
      bacterial infections.
AB  - The murine Ly-1 B cell lineage, although comprising only a minority of peripheral
      IgM+ B cells, secretes a major proportion of the IgM antibodies occurring
      naturally in serum. Ly-1 B cells also seed a large number of IgA+ plasma cells to
      the gut walls, thereby contributing significantly to production of natural IgA
      antibodies in response to chronic stimulation by the normal gut flora. Apart from
      these naturally-produced antibodies, Ly-1 B cells also produce specific
      antibodies following deliberate immunisation with the bacterial cell wall
      antigens, phosphorylcholine and dextran. The inability of the X-linked
      immunodeficient CBA/N mice to produce antibody responses to these two antigens is
      overcome by reconstitution with normal Ly-1 B cells from the parental CBA strain.
      Ly-1 B cells therefore appear to play a dominant role in natural immunity and
      protection against bacterial infections. The compartmentalisation of development
      and function within murine B cells is suggestive of an evolutionary structuring
      of the murine immune system, with Ly-1 B cells representing a conserved,
      primitive B cell lineage and retaining key, associated functions.

PMID- 1742427
TI  - Modelling adolescent blood pressure patterns and their prediction of adult
      pressures.
AB  - Tracking of blood pressure in adolescent boys is investigated using a
      mathematical model that corresponds to progression along a constant percentile. A
      more general analysis, based on the method of principal components, is also
      proposed that determines various alternative tracks or patterns that are most
      prevalent in the longitudinal blood pressure data. The degree of tracking along a
      constant percentile curve for systolic pressure was moderately high, as evidenced
      by a tracking index of .78 explaining 81% of the variance, but less strong for
      diastolic (tracking index of .60) where tracking along a percentile explained 66%
      of the variance. The value of the more general analysis of blood pressure
      patterns may lie in the assessment of adolescent risk factors for elevated adult
      blood pressure. Using adolescent patterns determined by either statistical model,
      adult systolic at age 38 was predicted (R2 = .22) by the concept of a systolic
      fixed percentile curve in adolescence, and similarly for diastolic (R2 = .21).
      However, the more general analysis based on longitudinal principal components
      further suggests that boys who have a larger than usual systolic peak at age 14
      years, which is near the time of the adolescent physical growth spurt in these
      boys, may be more likely to have higher systolic pressures at age 38. Because the
      adult data were incomplete and highly unbalanced, these findings were obtained
      using random-effects models for longitudinal data.

PMID- 1742428
TI  - A clonal selection based timecourse model for antibody responses to killed
      vaccine, with applications to foot and mouth disease.
AB  - Published models for the timecourse of the immune response are reviewed for their
      applicability to data from animals that have been injected with killed vaccine.
      Simple models are required so that statistical fitting procedures become
      straightforward. A class of models that incorporates the concept of clonal
      selection has been found useful. Immune memory is described in terms of
      persistence of mean antibody affinity when the overall concentration of antibody
      has declined towards background. The model is demonstrated on multipoint affinity
      distributions and initial negative exponential densities, from which conditions
      for boundedness can be developed. Predictions are made that are consistent with
      experiments on the evolution of immunoassay data using foot and mouth disease
      vaccine.

PMID- 1742429
TI  - Analysis of trinomial responses from reproductive and developmental toxicity
      experiments.
AB  - This paper presents a Dirichlet-trinomial distribution for modelling data
      obtained from reproductive and developmental studies. The common endpoints for
      the evaluation of reproductive and developmental toxic effects are the number of
      dead fetuses, the number of malformed fetuses, and the number of normal fetuses
      for each litter. With current statistical methods for the evaluation of
      reproductive and developmental effects, the effect on the number of deaths and
      the effect on the number of malformations are analyzed separately. The Dirichlet
      trinomial model provides a procedure for the analysis of multiple endpoints
      simultaneously. This proposed Dirichlet-trinomial model is a generalization of
      the beta-binomial model that has been used for handling the litter effect in
      reproductive and developmental experiments. Likelihood ratio tests for
      differences in the number of deaths, the number of malformations, and the number
      of normals among dosed and control groups are derived. The proposed test
      procedure based on the Dirichlet-trinomial model is compared with that based on
      the beta-binomial model with an application to a real data set.

PMID- 1742430
TI  - Pooling data for stability studies: testing the equality of batch degradation
      slopes.
AB  - Pharmaceutical products are routinely monitored for their stability over time.
      Stability studies generally consist of a random sample of dosage units (e.g.,
      tablets, capsules, vials) from a batch or several batches placed in a storage
      room and periodically assayed for their drug content. The degradation of the drug
      product is modeled, and according to the Guideline for Submitting Documentation
      for Stability Studies of Human Drugs and Biologics (Food and Drug Administration,
      1987), the shelf-life is calculated as the time point at which the lower 95%
      confidence limit about the fitted regression line crosses the lowest acceptable
      limit for drug content (frequently 90% of the labeled amount). When multiple
      batches are manufactured, preliminary testing for any batch differences (both
      slope and intercept) should precede pooling stability data from all batches in
      the analysis. The Guideline recommends a level of significance of .25 for such
      preliminary testing based on the work described by Bancroft (1964, Biometrics 20,
      427-442). Using such a large significance level helps ensure that the power of
      the test for the batch differences is sufficiently high. This paper presents an
      approach whereby the power of the test is fixed and the significance level of the
      test needed to obtain this power is calculated from the data. If the observed
      significance level does not achieve the calculated significance level, then the
      data can be pooled. Examples will illustrate the relative performance of the FDA
      guideline and the proposed procedure.

PMID- 1742431
TI  - Estimating drug shelf-life with random batches.
AB  - The problem of assessing the shelf-lives of drug products in the market is
      considered. We focus on the situation where the drug characteristic of interest
      has a linear relationship over time and batch-to-batch variation is present. Two
      methods for assessing shelf-lives are proposed based on the weighted least
      squares method under a regression model with random coefficients. An application
      to some stability data from the pharmaceutical industry is presented.

PMID- 1742432
TI  - A numerical solution to the equilibria of the two-locus two-allele selection
      model.
AB  - Examination of the equilibria of the standard two-locus two-allele selection
      model leads to the construction of a polynomial with coefficients derived from
      selective values in the genotypic fitness matrix. This polynomial can be
      partially factored algebraically and numerical techniques are available to
      extract the roots of the remainder. Each root provides a possible value of the
      disequilibrium coefficient and the gametic frequencies at equilibrium, and these
      can be readily checked for stability.

PMID- 1742433
TI  - Residual plots for log odds ratio regression models.
AB  - This article describes graphical diagnostic methods for log odds ratio regression
      models. To study the effects of an additional covariate on log odds ratio
      regression analysis, three types of residual plots based on weighted least
      squares (WLS) are discussed: (i) added variable plot (partial regression plot),
      (ii) partial residual plot, and (iii) augmented partial residual plot. These
      plots provide diagnostic procedures for identifying heterogeneity of error
      variances, outliers, or nonlinearity of the model. They are especially useful for
      clarifying whether including a covariate as a linear term is appropriate, or
      whether quadratic or other nonlinear transformations are preferable. A well-known
      data set for case-control studies is analyzed to illustrate the residual plots.

PMID- 1742434
TI  - A nonparametric estimator of the shift effect for repeated observations.
AB  - In a nonparametric two-sample model for independent observations with repeated
      measurements, a new point estimator and a new distribution-free confidence
      interval for the difference in means are introduced. The method is based on some
      ideas in Hodges and Lehmann (1963, Annals of Mathematical Statistics 34, 598
      611). The asymptotic theory in Brunner and Neumann (1983, Biometrical Journal 24,
      373-389; 1986; Biometrical Journal 28, 394-402) and the results for small sample
      sizes in Brunner and Compagnone (1988, Statistical Software Newsletter 14, 36-42)
      are used. The new estimators are applied to a problem in morphometry.

PMID- 1742435
TI  - Second-order analysis of spatial clustering for inhomogeneous populations.
AB  - Motivated by recent interest in the possible spatial clustering of rare diseases,
      the paper develops an approach to the assessment of spatial clustering based on
      the second-moment properties of a labelled point process. The concept of no
      spatial clustering is identified with the hypothesis that in a realisation of a
      stationary spatial point process consisting of events of two qualitatively
      different types, the type 1 events are a random sample from the superposition of
      type 1 and type 2 events. A diagnostic plot for estimating the nature and
      physical scale of clustering effects is proposed. The availability of Monte Carlo
      tests of significance is noted. An application to published data on the spatial
      distribution of childhood leukaemia and lymphoma in North Humberside is
      described.

PMID- 1742436
TI  - Elementary methods of cohort analysis with several exposure levels.
AB  - This paper proposes an extension of the Mantel-Haenszel rate ratio for the
      dichotomous exposure to the multiple exposure levels. This extension is based on
      the unbiased estimating function approach and yields closed-form Mantel-Haenszel
      rate ratio estimators. Dually consistent variance and covariance estimators of
      the estimating functions are given and a quasi-score-based confidence interval
      for individual common rate ratio is provided. A similar extension to the common
      rate difference case is also given.

PMID- 1742438
TI  - Validation samples.

PMID- 1742437
TI  - Algorithms versus models for analyzing data that contain misclassification
      errors.
AB  - Espeland and Hui (1987, Biometrics 43, 1001-1012) propose a methodology for
      analysing epidemiologic data contaminated by misclassification. They explicate
      their algorithm by a data set concerning cervical cancer and circumcision. We
      reanalyse these data using a conditional independence assumption different from
      theirs, and reach radically different conclusions. Espeland and Hui's methodology
      is a form of correlation analysis. We propose an alternative methodology based on
      the logic of regression analysis.

PMID- 1742439
TI  - Fraudulent statistical methods.

PMID- 1742440
TI  - A comparison of several point estimators of the odds ratio in a single 2 x 2
      contingency table.
AB  - The relative performance of the unconditioned maximum likelihood estimators
      (UMLEs), conditional MLEs (CMLEs), and Jewell-type estimators of the odds ratio
      (OR) and its logarithm were investigated in sets of single 2 x 2 contingency
      tables. The tables were generated by complete enumeration of all possible cell
      frequencies consistent with a single fixed margin. The bias, mean squared error
      (MSE), and average absolute error (AAE) were computed for all estimators using
      the individual table probabilities as weights. The results showed that, for the
      OR, Jewell's estimator usually had smaller bias, MSE, and AAE than either of the
      MLEs. While the differences were often slight for MSE and AAE, for bias it was
      sometimes substantial. For the log(OR), the UMLE usually had the lowest bias, and
      its MSE and AAE were only slightly greater than those for the other estimators.
      Overall, we recommend estimation on the log scale using the UMLE. If OR is to be
      estimated, Jewell's method had strong merit, although it is nonsymmetric with
      respect to the table orientation. In view of this, the UMLE may again be favoured
      in some situations.

PMID- 1742441
TI  - Estimating equations for parameters in means and covariances of multivariate
      discrete and continuous responses.
AB  - Generalized estimating equations are introduced in an ad hoc fashion for the
      covariance matrix of a multivariate response. These equations are to be solved
      jointly with score equations from a generalized linear model for mean parameters.
      A class of quadratic exponential models is used to develop joint estimating
      equations for mean and covariance parameters in a more systematic fashion, and
      proposals for the use of such equations are developed. Comments on the relative
      merits of the ad hoc and model-based approaches to estimation are given and a
      regression illustration with a bivariate response is provided.

PMID- 1742442
TI  - Diagnostic plots in Cox's regression model.
AB  - Two diagnostic plots are presented for validating the fitting of a Cox
      proportional hazards model. The added variable plot is developed to assess the
      effect of adding a covariate to the model. The constructed variable plot is
      applied to detect nonlinearity of a fitted covariate. Both plots are also useful
      for identifying influential observations on the issues of interest. The methods
      are illustrated on examples of multiple myeloma and lung cancer data.

PMID- 1742443
TI  - Bayesian subset analysis.
AB  - As a means of assessing the importance of variation in treatment effect among
      patient subsets, we derived posterior distributions for subset-specific treatment
      effects. The effects are represented by combinations of terms for treatment and
      treatment-by-covariate interaction effects in familiar regression models.
      Exchange-ability among the interactions is a key assumption; thus, the results
      are of interest primarily in the context of examining a collection of subsets
      with no definite a priori distinction relative to treatment effect.
      Exchangeability leads to a shrinking of the posterior distributions of the
      interaction terms toward the natural origin of 0, offsetting the tendency of the
      estimated effects to disperse. The method is applied to parameter estimates from
      a proportional hazards regression analysis of survival data from a clinical
      trial, invoking the approximate multivariate normal distribution of the
      estimates. No subjective prior distributions are required. Vague priors are used
      for all of the regression coefficients except the treatment-by-covariate
      interactions, which are assumed to follow a normal distribution.

PMID- 1742444
TI  - Fitting mixture models to birth weight data: a case study.
AB  - Birth weights by gestational age are compared in two birth cohorts from Northern
      Finland, the first from 1966 and the second from 1985-1986. A curious fact in the
      data is that mean birth weight before the 39th week was lower in the latter
      series although the mean birth weight for the total series was higher. Similar
      findings have been reported in other series. A mixture model with the
      nonparametric regression function is proposed for studying the hypothesis that
      the difference was caused by more frequent gross errors in gestational assessment
      in the earlier cohort. The probability of an error in gestational assessment then
      greatly depends on the observed gestational age, which makes the mixture model
      nonstandard. Maximum likelihood solutions to the parameters in the proposed model
      were computed employing the general expectation-maximization (EM) algorithm. A
      technique for studying the effect of errors on the intrauterine weight gain curve
      is proposed and applied to our two birth cohorts. The risk of underestimation of
      gestational age seems to be larger in the previous series and the differences
      between the growth curves almost totally vanish when "corrected" by means of the
      mixture model.

PMID- 1742445
TI  - A model for incorporating historical controls into a meta-analysis.
AB  - A method is presented for estimating the treatment effect in a meta-analysis when
      some of the studies are comparative studies, and the rest are noncomparative,
      historical control studies. A random-effects model is used in which the baseline
      effect in each study is random, but the treatment effect is constant. With this
      model the appropriate contribution of the historical studies can be determined.
      Extensions of the model are developed to accommodate preliminary tests for bias,
      and for the possibility that the treatment effect is heterogeneous.

PMID- 1742446
TI  - The design of a panel study under an alternating Poisson process assumption.
AB  - We discuss the design of a panel study for the estimation of the average
      durations in the two states of an alternating Poisson process. Two types of
      designs are examined. The first fixes the number of follow-up waves but permits
      the total length of follow-up to vary, and the second varies the number of follow
      up waves with fixed length. Simple expressions for nearly optimal designs are
      presented, and we compare these with designs allowing for continuous observation.
      Both equilibrium and nonequilibrium cases are examined. An example is given using
      morbidity data to illustrate how these results can be applied.

PMID- 1742447
TI  - Modelling the influence of risk factors on familial aggregation of disease.
AB  - One often observes a familial resemblance of risk factors of disease. The
      following question then arises: How much familial aggregation of cases of disease
      would be expected because of this resemblance? This problem is attacked through a
      particular model where the risk is supposed to depend exponentially on the risk
      factors. Only pairs of relatives (father/son) are considered. The calculations
      are performed both with normally distributed risk factors and with particular
      skewed distributions. An application to coronary heart disease is given.

PMID- 1742448
TI  - Nonparametric estimation of the incubation period of AIDS based on a prevalent
      cohort with unknown infection times.
AB  - Estimation of the incubation period distribution of human immunodeficiency virus
      based on prevalent cohorts of subjects, already infected at the time of
      recruitment, is complicated by the absence of information on the original times
      of infection. Here, we overcome this difficulty by using a prior distribution for
      the infection times, based on external data. Our estimate is nonparametric, but
      uses smoothness assumptions to avoid instability. The method is illustrated on
      two prevalent cohorts from San Francisco, separately and combined. The estimates
      produced agree with other published estimates of the incubation period
      distribution.

PMID- 1742449
TI  - A generalized stochastic model for the analysis of infectious disease final size
      data.
AB  - A stochastic infectious disease model was developed by Ball (1986, Advances in
      Applied Probability 18, 289-310) in which the distribution of the length of the
      infectious period is allowed to have any distribution that can be described by
      its Laplace transform. We extend this model such that the infection can be
      transmitted within the population or from an unspecified source outside the
      population. Also, discrete heterogeneity in the population can be modeled to
      incorporate variable susceptibility, variable infectivity, and/or mixing
      behaviors. The model is fitted to serologic data from two influenza epidemics in
      Tecumseh, Michigan, using maximum likelihood estimation procedures. The estimates
      show a clustering pattern by age groups.

PMID- 1742450
TI  - An adaptive weighted log-rank test with application to cancer prevention and
      screening trials.
AB  - A class of adaptive weighted log-rank statistics is described where the vector of
      weights is chosen in a data-dependent way from a family of "smooth" weight
      vectors. A parametric family of weight vectors is identified which includes most
      shapes of weighting vectors that will be near optimal in many cancer prevention
      and screening trials. This family of weight vectors is used in an application of
      the proposed method to data from a breast cancer screening trial. Results from a
      small simulation study comparing the power of the adaptive statistic to that of
      the unweighted log-rank statistic are presented.

PMID- 1742451
TI  - Nonparametric estimation of the size-metastasis relationship in solid cancers.
AB  - This paper is concerned with the relationship between the occurrence of
      metastases and the size of primary cancers. We consider two probabilistic
      characterizations of this relationship. First is the distribution function of
      tumor sizes at the point of metastatic transition; second is the probability that
      detectable metastases are present when the cancer comes to medical attention. The
      equation relating these two functions is developed and conditions for their being
      identical are explored. Since the tumor size at the point of metastasis is not
      usually observable, estimation of the first distribution requires the use of the
      EM algorithm. Nonparametric methods of estimating both functions are explored,
      with attention to the fact that tumors often fail to be measured, particularly
      those that are known to be metastatic. The methods are applied to the estimation
      of primary tumor size at the point of distant metastasis in lung cancer
      (epidermoid and adenocarcinoma) and colorectal cancer and at the point of nodal
      metastasis in breast cancer. Monte Carlo experiments confirm that the bias
      inherent in the methodology is acceptably small.

PMID- 1742452
TI  - Coupling of ferric iron spin and allosteric equilibrium in hemoglobin.
AB  - The allosteric transition in triply ferric hemoglobin has been studied with
      different ferric ligands. This valency hybrid permits observation of oxygen or CO
      binding properties to the single ferrous subunit, whereas the liganded state of
      the other three ferric subunits can be varied. The ferric hemoglobin (Hb)
      tetramer in the absence of effectors is generally in the high oxygen affinity (R)
      state; addition of inositol hexaphosphate induces a transition towards the deoxy
      (T) conformation. The fraction of T-state formed depends on the ferric ligand and
      is correlated with the spin state of the ferric iron complexes. High-spin ferric
      ligands such as water or fluoride show the most T-state, whereas low-spin ligands
      such as cyanide show the least. The oxygen equilibrium data and kinetics of CO
      recombination indicate that the allosteric equilibrium can be treated in a
      fashion analogous to the two-state model. The binding of a low-spin ferric ligand
      induces a change in the allosteric equilibrium towards the R-state by about a
      factor of 150 (at pH 6.5), similar to that of the ferrous ligands oxygen or CO;
      however, each high-spin ferric ligand induces a T to R shift by a factor of 40.

PMID- 1742453
TI  - Linear nonequilibrium thermodynamics describes the dynamics of an autocatalytic
      system.
AB  - A model simulating oscillations in glycolysis was formulated in terms of
      nonequilibrium thermodynamics. In the kinetic rate equations every metabolite
      concentration was replaced with an exponential function of its chemical
      potential. This led to nonlinear relations between rates and chemical potentials.
      Each chemical potential was then expanded around its steady-state value as a
      Taylor series. The linear (first order) term of the Taylor series sufficed to
      simulate the dynamic behavior of the system, including the damped and even
      sustained oscillations at low substrate input or high free-energy load. The
      glycolytic system is autocatalytic in the first half. Because oscillations were
      obtained only in the presence of that autocatalytic feed-back loop we conclude
      that this type of kinetic nonlinearity was sufficient to account for the
      oscillatory behavior. The matrix of phenomenological coefficients of the system
      is nonsymmetric. Our results indicate that this is the symmetry property and not
      the linearity of the flow-force relations in the near equilibrium domain that
      precludes oscillations. Given autocatalytic properties, a system exhibiting liner
      flow-force relations and being outside the near equilibrium domain may show
      bifurcations, leading to self-organized behavior.

PMID- 1742454
TI  - X-ray studies of order-disorder transitions in the myosin heads of skinned rabbit
      psoas muscles.
AB  - Using x-rays from a laboratory source and an area detector, myosin layer lines
      and the diffuse scattering between them in the moderate angle region have been
      recorded. At full overlap, incubation of rigor muscles with S-1 greatly reduces
      the diffuse scattering. Also, three of the four actin-based layer lines lying
      close to the meridian (Huxley, H. E., and W. Brown, 1967. J. Mol. Biol. 30:384
      434; Haselgrove, J. C. 1975. J. Mol. Biol. 92:113-143) increase, suggesting
      fuller labeling of the actin filaments. These results are consistent with the
      idea (Poulsen, F. R., and J. Lowy, 1983. Nature [Lond.]. 303:146-152) that some
      of the diffuse scattering in rigor muscles is due to a random mixture of actin
      monomers with and without attached myosin heads (substitution disorder). In
      relaxed muscles, regardless of overlap, lowering the temperature from 24 to 4
      degrees C practically abolishes the myosin layer lines (a result first obtained
      by Wray, J.S. 1987. J. Muscle Res. Cell Motil. 8:62 (a). Abstr.), whilst the
      diffuse scattering between these layer lines increases appreciably. Similar
      changes occur in the passage from rest to peak tetanic tension in live frog
      muscle (Lowy, J., and F.R. Poulsen. 1990. Biophys. J. 57:977-985). Cooling the
      psoas demonstrates that the intensity relation between the layer lines and the
      diffuse scattering is of an inverse nature, and that the transition occurs over a
      narrow temperature range (12-14 degrees C) with a sigmoidal function. From these
      results it would appear that the helical arrangement of the myosin heads is very
      temperature sensitive, and that the disordering effect does not depend on the
      presence of actin. Measurements along the meridian reveal that the intensity of
      the diffuse scattering increases relatively little and does so in a nearly linear
      manner: evidently the axial order of the myosin heads is much less temperature
      sensitive. The combined data support the view (Poulsen, F. R., and J. Lowy. 1983.
      Nature [Lond.]. 303:146-152) that in relaxed muscles a significant part of the
      diffuse scattering originates from disordered myosin heads. The observation that
      the extent of the diffuse scattering is greater in the equatorial than in the
      meridional direction suggests that the disordered myosin heads have an
      orientation which is on average more parallel to the filament axis.

PMID- 1742455
TI  - Shape transitions and shape stability of giant phospholipid vesicles in pure
      water induced by area-to-volume changes.
AB  - Shape transformations of vesicles of dimyristoylphosphatidylcholine (= DMPC) and
      palmitoyloleylphosphatidylcholine (= POPC) in ion-free water were induced by
      changing the area-to-volume ratio via temperature variations. Depending on the
      pretreatment we find several types of shape changes for DMPC (in pure water) at
      increasing area-to-volume ratio: (a) budding transitions leading to the formation
      of a chain of vesicles at further increase of the area-to-volume ratio, (b)
      discocyte-stomatocyte transitions, (c) reentrant dumbbell-pear-dumbbell
      transitions, and (d) spontaneous blebbing and/or tether formation of spherical
      vesicles. Beside these transitions a more exotic dumbbell-discocyte transition
      (e) was found which proceeded via local instabilities. Pears, discocytes, and
      stomatocytes are stable with respect to small temperature variations unless the
      excess area is close to values corresponding to limiting shapes of budded
      vesicles where temperature variations of less than or equal to 0.1 degree C lead
      to spontaneous budding to the inside or the outside. For POPC we observed only
      budding transitions to the inside leading either to chains of vesicles or to
      distributions of equally sized daughter vesicles protruding to the inside of the
      vesicle. Preliminary experiments concerning the effect of solutes are also
      reported. The first three types of shape transitions can be explained in terms of
      the bilayer coupling model assuming small differences in thermal expansivities of
      the two monolayers. This does not hold for the observed instabilities close to
      the limiting shapes.

PMID- 1742456
TI  - Time-dependent recovery of passive neutrophils after large deformation.
AB  - Experiments are performed in which a passive human neutrophil is deformed into an
      elongated "sausage" shape by aspirating it into a small glass pipette. When
      expelled from the pipette the neutrophil recovers its natural spherical shape in
      approximately 1 minute. This recovery process is analyzed according to a
      Newtonian, liquid-drop model in which a variational method is used to
      simultaneously solve the hydrodynamic equations for low Reynolds-number flow and
      the equations for membrane equilibrium with a constant membrane tension. The
      theoretical model gives a good fit to the experimental data for a ratio of
      membrane cortical tension to cytoplasmic viscosity of approximately 1.7 x 10(-5)
      cm/s (0.17 micron/s). However, when the cell is held in the pipette for only a
      short time period of 5 s or less, and then expelled, the cell undergoes an
      initial, rapid elastic rebound suggesting that the cell behaves in this instance
      as a Maxwell viscoelastic liquid rather than a Newtonian liquid with constant
      cortical tension.

PMID- 1742457
TI  - Picosecond study of the near infrared absorption band of hemoglobin after
      photolysis of carbonmonoxyhemoglobin.
AB  - Picosecond absorption spectroscopy is used to examine the position and band shape
      of the near infrared absorption band of hemoglobin as a function of time after
      the photodissociation of CO from carbonmonoxyhemoglobin. For the earliest delay
      time probed, 35 ps, the peak of the transient spectrum is at 765 nm, red shifted
      by 6 nm from that characteristic of equilibrium deoxyhemoglobin. No evolution in
      either the peak position or band shape is observed for time delays up to 60 ns.
      In addition, the position and shape of the spectrum are independent of photolysis
      energies ranging from 15 microJ/pulse to 150 microJ/pulse, spanning conditions
      under which the photon/heme ratio is varied from 0.01 to 2.0. This indicates that
      the geometry in the heme group is unrelaxed and that equilibration of the
      surrounding protein structure occurs on a time scale longer than 60 ns.

PMID- 1742458
TI  - Single particle tracking. Analysis of diffusion and flow in two-dimensional
      systems.
AB  - Analysis of the trajectories of small particles at high spatial and temporal
      resolution using video enhanced contrast microscopy provides a powerful approach
      to characterizing the mechanisms of particle motion in living cells and in other
      systems. We present here the theoretical basis for the analysis of these
      trajectories for particles undergoing random diffusion and/or systematic
      transport at uniform velocity in two-dimensional systems. The single particle
      tracking method, based on observations of the trajectories of individual
      particles, is compared with methods that characterize the motions of a large
      collection of particles such as fluorescence photobleaching recovery.
      Determination of diffusion coefficients or transport velocities either from
      correlation of positions or of velocities of the particles is discussed. A result
      of practical importance is an analysis of the dependence of the expected
      statistical uncertainty of these determinations on the number of position
      measurements. This provides a way of judging the accuracy of the diffusion
      coefficients and transport velocities obtained using this approach.

PMID- 1742459
TI  - Orientation of melittin in phospholipid bilayers. A polarized attenuated total
      reflection infrared study.
AB  - The helical order parameter of the 26-residue amphiphilic bee venom peptide
      melittin was measured by polarized attenuated total reflection infrared
      spectroscopy (ATR-IR) in dry phospholipid multibilayers (MBLs) and when bound to
      single supported planar bilayers (SPBs) under D2O. Melittin adopted an alpha
      helical conformation in MBLs of dipalmitoyl-phosphatidylcholine (DPPC), 1
      palmitoyl-2-oleoyl-phosphatidylcholine (POPC), a 4:1 mixture of POPC and 1
      palmitoyl-2-oleoyl-phosphatidylglycerol (POPG), and when bound to SPBs of
      POPC:POPG (4:1). The order parameter of the alpha-helix in the bilayers depended
      mainly on the type of membrane preparation, and only little on the phospholipid
      composition of the bilayers. On hydrated SPBs, the helical order parameter was
      negative, indicating that the alpha-helix long axis of melittin was
      preferentially oriented parallel to the plane of the supported membrane. However,
      in dry MBLs, the helical order parameter was positive, indicating that the alpha
      helix of melittin was preferentially oriented parallel to the phospholipid fatty
      acyl chains. It is concluded that the orientation of melittin in membranes
      depends on the degree of hydration of the model membranes rather than on the
      technique which is used for its determination. ATR-IR spectroscopy of
      polypeptides in or associated with supported planar membranes in D2O may become a
      useful tool for the determination of their orientation in and on membranes.

PMID- 1742460
TI  - Ba2+ release from soda glass modifies single maxi K+ channel activity in patch
      clamp experiments.
AB  - Glasses used to fabricate patch pipettes may release components which affect ion
      channels (Cota, G., and C.M. Armstrong. 1988. Biophys. J. 53:107-109; Furman,
      R.E., and J.C. Tanaka. 1988. Biophys. J. 53:287-292; Rojas, L., and C. Zuazaga.
      1988. Neurosci. Lett. 88:39-44). The gating properties of maxi K+ channels from
      Necturus gallbladder epithelium depend on whether borosilicate glass (BG) or blue
      tip hematocrit glass (SG) is used to construct the patch pipettes. The data are
      consistent with solubilization from SG of a component which exerts voltage
      dependent, cytosolic-side specific block, closely resembling "slow block" by Ba2+
      ions. Ringer's solution preincubated with SG, but not with BG, blocked inside-out
      maxi K+ channels when used as bathing solution. Mass spectrometry revealed that
      Ba2+ is released by the glass from fast and slow-release compartments (SG
      contains 3% wt/wt BaO), and is the only ion found in the solution at
      concentrations consistent with the observed channel block. Additionally, SG
      released O2-, Na+, Ca2+, and Mg2+, all to micromolar concentrations. These
      elements do not interfere with maxi K+ channels but they could in principle alter
      the properties of other ion channels. Thus, screening for channel-modifying
      substances released by the glass may be necessary for the adequate interpretation
      of patch-clamp results.

PMID- 1742461
TI  - Membrane binding induces lipid-specific changes in the denaturation profile of
      bovine prothrombin. A scanning calorimetry study.
AB  - Prothrombin denaturation was examined in the presence of Na2EDTA, 5mM CaCl2, and
      CaCl2 plus membranes containing 1-palmitoyl-2-oleoyl-3-sn-phosphatidylcholine
      (POPC) in combination with either bovine brain phosphatidylserine (PS) or 1,2
      dioleoyl-phosphatidylglycerol (DOPG). Heating denaturation of prothrombin
      produced thermograms showing two peaks, a minor one at approximately 59 degrees C
      previously reported to correspond to denaturation of the fragment 1 region
      (Ploplis, V. A., D. K. Strickland, and F. J. Castellino 1981. Biochemistry. 20:15
      21), and a main one at approximately 57-58 degrees C, reportedly due to
      denaturation of the rest of the molecule (prethrombin 1). The main peak was
      insensitive to the presence of 5mM Ca2+ whereas the minor peak was shifted to
      higher temperature (Tm approximately 65 degrees C) by Ca2+. Sufficient
      concentrations of POPC/bovPS (75/25) large unilamellar vesicles to guarantee
      binding of 95% of prothrombin resulted in an enthalpy loss in the main endotherm
      and a comparable enthalpy gain in the minor endotherm accompanying an upward
      shift in peak temperature (Tm approximately 73 degrees C). Peak deconvolution
      analysis on the prothrombin denaturation profile and comparison with isolated
      prothrombin fragment 1 denaturation endotherms suggested that the change caused
      by POPC/PS vesicles reflected a shift of a portion of the enthalpy of the
      prethrombin 1 domain to higher temperature (Tm approximately 77 degrees C). The
      enthalpy associated with this high-temperature endotherm increased in proportion
      to the surface concentration of PS. By contrast, POPC/DOPG (50/50) membranes
      shifted the prethrombin 1 peak by 4 degrees C to a lower temperature and the
      fragment 1 peak by 5 degrees C to a higher temperature. The data lead to a
      hypothesis that the fragment 1 and prethrombin 1 domains of prothrombin do not
      denature quite independently and that binding of prothrombin to acidic-lipid
      membranes disrupts the interaction between these domains. It is further
      hypothesized that PS containing membranes exert the additional specific effect of
      decoupling the denaturation of two subdomains of the prethrombin 1 domain of
      prothrombin.

PMID- 1742462
TI  - Electrolyte effects on bilayer tubule formation by a diacetylenic phospholipid.
AB  - A general effect by dissolved electrolytes to destabilize the curvature of
      bilayer tubules prepared from the diacetylenic phospholipid, 1,2-bis(10,12
      tricosadiynoyl)-sn-glycero-3-phosphocholine is not found. This observation
      discounts the role of an electrostatic interaction between polarization charges
      on the edges of a ferroelectric bilayer as a means by which the cylindrical
      curvature may be stabilized in these structures (de Gennes, P. G. 1987. C. R.
      Acad. Sci. Paris. 304:259-263). The solution-mediated ionic interactions of
      electrolytes with this phospholipid appear not to influence significantly the
      relative stability of the crystalline state of the tubule, but at high levels of
      a few salts, may affect the nucleation and growth of the crystalline bilayer.
      Curvature of the bilayer in these tubular structures apparently derives from an
      interaction that is not very sensitive to the presence of electrolytes.
      Cylindrical curvature may alternatively arise from a bending force within the
      bilayer that is intrinsic to the anisotropic packing of the lipid molecules
      (Helfrich, W., and J. Prost. 1988. Phys. Rev. A38:3065-3068; Chappell, J. S., and
      P. Yager. 1991. Chem. Phys. Lipids. In press), and may therefore be largely
      determined by the packing interactions within the hydrophobic region of the
      tubular bilayer.

PMID- 1742463
TI  - Mass-weighted molecular dynamics simulation of the protein-ligand complex of
      rhizopuspepsin and inhibitor.
AB  - The mass-weighted molecular dynamics simulation method was developed previously
      for sampling the multidimensional conformational space of linear and cyclic
      polypeptides and studying their conformational flexibility. Herein results from
      molecular dynamics simulations of the protein-ligand complex of the aspartyl
      protease rhizopuspepsin and a polypeptide inhibitor are reported. The dihedral
      conformational space sampling for the linear peptide inhibitor in situ was found
      to be increased in the mass-weighted simulation as in other molecular systems
      previously studied. More significantly, the physical space of the enzyme binding
      pocket was also sampled efficiently in the simulations and multiple binding sites
      were identified for the inhibitor. These results suggest that it may be possible
      now to study, by computer simulations, the putative initial enzyme-inhibitor
      complex suggested experimentally from the time-dependent kinetics of enzyme
      inhibition by slow-binding inhibitors (Morrison, J. F., and C. T. Walsh. 1988.
      Adv. Enzymol. 61:201), and/or conformational substates in protein-ligand
      complexes suggested in the study of reassociation dynamics of myoglobin and
      carbon monoxide following photolysis (Austin, R. H., K. W. Beeson, L. Eisenstein,
      H. Frauenfelder, and I. C. Gunsalus. 1975. Biochemistry. 14:5355). Moreover, the
      intermediate binding steps and the molecular flexibility of the inhibitor shown
      in the MWMD simulation may have crucial roles in the ligand binding process.

PMID- 1742464
TI  - Heart rate and hemodynamics.
AB  - Evidence is presented to show that cardiac output is little affected by changes
      in heart rate but the heart volumes, systolic and diastolic, are inversely
      related. Heart rate is controlled by changes in efferent nerves, sympathetic and
      vagal, which are in turn controlled from central and reflex sources. An argument
      is presented showing that reflexes from receptors in the atria control heart
      volumes by affecting, in the short term heart rate, and in the long term water
      intake (thirst) and urine flow, and therefore blood volume. Explanations of the
      mechanisms involved are presented.

PMID- 1742465
TI  - Coronary response to transient increases in transmural pressure.
AB  - Previous studies have shown that transient increases in aortic blood pressure
      obtained by occlusion of the descending thoracic aorta, in anesthetized dogs with
      beta-blockade and vagal section, did not affect coronary vascular resistance
      apart from a non-significant increase just after release of the constriction. The
      present study examined whether this response also occurred in the normally
      innervated heart. Experiments were carried out in six anesthetized dogs, in which
      pressure in the aortic root and in the left ventricle, as well as flow in the
      left circumflex coronary artery, were recorded. Coronary vascular resistance was
      calculated as the ratio of the difference between aortic pressure and left
      ventricular pressure to coronary circumflex flow during the slow inflow phase.
      Before occlusion coronary vascular resistance was significantly lower than during
      the same period in the previous studies using animals with beta-blockade and
      vagal section. During the occlusion, in contrast with the previous investigation,
      the increase in aortic pressure caused a significant increase in coronary
      vascular resistance 10 seconds after the beginning of the occlusion. Coronary
      vascular resistance was further increased immediately after release of the
      occlusion, concomitantly with the decrease in aortic pressure, which fell
      abruptly below the control level. The increase immediately after the release of
      the constriction was qualitatively similar, but greater in extent, to that
      observed in the animals with vagal section and beta-blockade. These differences
      are assumed to depend on a lower vasomotor tone in the normally innervated
      hearts.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742466
TI  - The effects of thyroid state on sarcomere dynamics of ventricular cells and
      contraction of papillary muscles in the rat heart.
AB  - Diastolic sarcomere length, amplitude of maximal sarcomere shortening, maximal
      rate of sarcomere shortening, maximal rate of sarcomere re-lengthening, time to
      peak sarcomere shortening and trans-sarcolemmal ion currents were measured in
      isolated ventricular cells from euthyroid, hypothyroid and hyperthyroid rats. The
      data were compared with the developed tension and time to peak tension of
      papillary muscles. The diastolic sarcomere length was not affected by the changes
      in thyroid state. Hypothyroidism led to an increased time to peak sarcomere
      shortening, an increased time to peak tension of the papillary muscle, and a
      depression of the maximal rates of shortening and elongation of the sarcomeres.
      Changes in dynamics of the sarcomere and contraction of papillary muscle did not
      occur in parallel under the influence of hyperthyroidism. In comparison with the
      euthyroid state, the time to peak tension was shortened and amplitude of
      shortening of the sarcomere was increased. The time to peak shortening of the
      sarcomere and developed tension of papillary muscle remained unaltered. In
      cardiac cells, hypothyroidism was associated with a decreased slow Ca2+ current
      and hyperthyroidism with an increased slow Ca2+ current. In contrast to euthyroid
      and hypothyroid cardiac cells, the hyperthyroid cardiomyocytes exhibited a trans
      sarcolemmal transient inward current after repolarization. Both hypothyroidism
      and hyperthyroidism resulted in a depressed potentiation of sarcomere shortening
      and myocardial developed tension after resting.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742467
TI  - A mathematical model of the flow of blood through the left coronary artery.
AB  - Several models of the coronary circulation have been proposed, relating arterial
      flow waveform and cardiac contraction. Some of them have produced new concepts,
      such as back pressure, and zero flow pressure, founded on an over-simplified
      description of vascular collapse. Experimental studies have shown that the actual
      dynamics of a collapsible tube cannot be adequately described using a lumped
      parameter model. A distributed parameter model is therefore proposed and compared
      with the previous models.

PMID- 1742468
TI  - Group I fibers: pressor reflex and cardiac activity.
AB  - Experiments were performed on cats to see whether stimulation of group I afferent
      fibers from gastrocnemius-soleus muscles induced changes in cardiac activity, in
      addition to the increase in systemic arterial pressure already established. The
      results show that the increase in arterial pressure is accompanied by an increase
      in systolic left ventricular pressure, without any significant changes in cardiac
      inotropism and chronotropism. It is concluded that the cardiac innervation is not
      an important efferent pathway of the pressor reflex evoked by stimulating group I
      afferent fibers, and that the reflex increase in arterial pressure depends mainly
      on an increase in peripheral vascular resistance.

PMID- 1742469
TI  - Activation energy of the cardiac Na+/Ca2+ exchanger in sarcolemmal vesicles and
      reconstituted proteoliposomes.
AB  - Sarcolemmal membrane vesicles isolated from bovine ventricular tissue accumulate
      Ca2+ through the Na+/Ca2+ exchanger when exposed to an outwardly directed Na+
      gradient. This Ca2+ is then released by the same mechanism if the vesicles are
      transferred to a Ca(2+)-depleted Na+ buffer. Using the Ca+ indicator, arsenazo
      III, and a stopped-flow spectrophotometer, we can directly follow the kinetics of
      Ca2+ extrusion. We can thus measure the activity of the Na+/Ca2+ exchanger by the
      initial rate of Ca2+ release. We found that it depends upon the external Na+
      concentration in a cooperative way, with a Hill coefficient of 2. By studying the
      temperature dependence of Na+/Ca2+ exchange, we found that it can be described by
      a single activation energy: Ea = 8.3 +/- 0.4 Kcal/mol. When the Na+/Ca2+
      exchanger is reconstituted into lipid vesicles of defined composition, we observe
      a higher activity if cholesterol is among the lipids. The activation energy
      becomes 6.1 +/- 0.1 Kcal/mol in this system, but the Arrhenius plot shows a
      decreased slope for temperatures above 33 degrees C.

PMID- 1742470
TI  - Capacity of making choices in the brain and its quantitative evaluation: an
      application to comprehension of incomplete sentences and semantic commitments.
AB  - The natural language processor in the brain generates information when it
      disambiguates words while reading a text in which information generation refers
      to making semantic commitments. Contextual facilitation of disambiguation of
      words appearing in the perturbed text that is derived from the unperturbed and
      natural one by deleting words randomly, lets the language processor revise the
      previous semantic commitments continuously. As the frequency of revising the
      previous semantic commitments increases, the amount of information generated by
      the language processor also increases. Revising previous semantic commitments in
      a continuous fashion is the functional property intrinsic to the language
      processor in the brain.

PMID- 1742471
TI  - Directionality of evolution at molecular and organismic levels.
AB  - The molecular evolution theories of Eigen and Kimura are compared and their
      difference is explained. In terms of Eigen's theory for the evolution of
      macromolecules, the selection of genotypes occurs directly. The physical meaning
      of the neutral theory is the degeneracy of the correlation between a phenotype
      and a genotype at the molecular level. A model theory of evolution on a fitness
      landscape is proposed. The theory shows that the constraints of selection
      determined by the structure and dynamics of previous evolution stages increases
      its rate strongly.

PMID- 1742472
TI  - Self-reproducing systems: structure, niche relations and evolution.
AB  - A formal definition of a self-reproducing system is proposed using Petri nets. A
      potential self-reproducing system is a set of places in the Petri net such that
      the number of tokens in each place increases due to some sequence of internal
      transitions (a transition is called internal to the marked subset of places if at
      least one of its starting places and one of its terminating places belongs to
      that subset). An actual self-reproducing system is a system that compensates the
      outflow of its components by reproduction. In a suitable environment every
      potential self-reproducing system becomes an actual one. Each Petri net can be
      considered as an ecosystem with the web of ecological niches bound together with
      trophic and other relations. The stationary dynamics of the ecosystem is
      characterized by the set of filled niches. The process of evolution is described
      in terms of niche composition change. Perspectives of the theory of self
      reproducing systems in biology are discussed.

PMID- 1742473
TI  - Some geometrical considerations on membrane insertion by exocytosis.
AB  - A two-dimensional random walk model is used to describe constitutive exocytic
      transport. Specifically, the possibility of attaining selective vesicle insertion
      by purely geometrical effects is studied. The distribution of vesicle insertion
      on the membrane and the average time of translocation are determined as a
      function of Golgi apparatus size and position, cell morphology and size, walk
      bias due to cytoplasmic streaming or differential movement on microtubules, and
      steric effects caused by other organelles. The simulations suggest that
      significant selectivity in targeting can result from adequate Golgi positioning,
      in accordance with the hypothesis of Golgi reorientation by the microtubular
      network (Singer and Kupfer, 1986, Annu. Rev. Cell Biol. 2, 337-365). The
      selectivity in targeting also depends on the cellular morphology. Segregation of
      vesicle insertion can be obtained in the transport to the cellular front end and
      lateral membrane surfaces of a quadrilateral cell, thus suggesting a geometrical
      component in the exocytic transport in polarized cells.

PMID- 1742474
TI  - Enzymes and theoretical biology: sketch of an informational perspective of the
      cell.
AB  - In the theoretical scenarios of biology, new insights can be gained by the
      introduction of information-processing and artificial intelligence concepts,
      helping to organize the explanation of the many intra- and inter-cellular
      phenomena that molecular biology is accumulating. Enzymes contain some of the
      immediate clues; the whole informational processing of prokaryotic cells is
      another central subject of search. Additionally, prolonging the informational
      perspective of the cell, a significant parallel can be drawn between
      informational processes in biological, social and artificial intelligence
      systems. A more tangible definition of biological complexity and biological
      intelligence emerges.

PMID- 1742475
TI  - Visualizing DNA replication sites in the cell nucleus.
AB  - Studies of DNA replication associated with the nuclear matrix have led to a
      radically new view of replication at the macroscopic level. It is proposed that
      individual replicons and their associated replicational assemblies (replisomes)
      are clustered together during active replication by attachment to the nuclear
      matrix at special sites termed 'clustersomes'. Direct visualization of
      replication sites in permeabilized cells by fluorescence microscopy following
      biotin-11-dUTP incorporation provides support for this model. Discrete
      replication granules are observed with sizes and numbers consistent with each
      granule being a site of replicon cluster synthesis. Distinct patterns of these
      sites are seen in different periods of S-phase. Both the individual granules and
      their early and late S-phase dependent patterns are strikingly maintained
      following extraction of the cells for in situ nuclear matrix structures. Similar
      results were obtained when probing in vivo sites of replication following
      incorporation of 5-bromodeoxyuridine. The three-dimensional organization of these
      replicational granules (clustersomes) is studied using confocal light microscopy
      and an appropriate multidimensional image analysis system.

PMID- 1742476
TI  - Bio Vision: microscopy in three dimensions.
AB  - Conventional electron microscopy is inadequate for visualizing the three
      dimensional networks supporting cell architecture: the cytoskeleton and nuclear
      matrix. Consequently, we have not appreciated the extent to which the cell, its
      biochemistry, and its molecular biology are structured. A new technology
      combining in situ cell fractionation and resinless section electron microscopy
      allows the visualization of cell structure in three dimensions and permits the
      localization of individual components. These techniques reveal a far richer cell
      architecture than had been assumed and will allow important problems of biology,
      which have not surrendered their secrets to a purely biochemical approach, to be
      addressed.

PMID- 1742477
TI  - T-prolymphocytic leukemia.

PMID- 1742478
TI  - Basic and clinical aspects of fibrinolysis and thrombolysis.

PMID- 1742479
TI  - A possible correlation between the type of bcr-abl hybrid messenger RNA and
      platelet count in Philadelphia-positive chronic myelogenous leukemia.
AB  - The Philadelphia (Ph1) chromosome, in which the hybrid bcr-abl gene is formed, is
      thought to be the initial event in chronic myelogenous leukemia (CML). The
      position of the breakpoint within the breakpoint cluster region (bcr) on Ph1
      chromosome and the splicing pattern determine the species of the fused bcr-abl
      messenger RNA (mRNA). We tried to detect the two types of fused mRNAs in 57
      chronic-phase cases of Ph1-positive CML using the polymerase chain reaction
      procedure (RT-PCR). The bcr exon 2/abl exon 2 fused mRNA (b2-a2) was detected in
      17 patients, the bcr exon 3/abl exon 2 fused mRNA (b3-a2) was detected in 34
      patients, and both types of mRNA were detected in six patients. The platelet
      counts of patients who expressed b3-a2 mRNA or both types were significantly
      higher than those of patients who expressed only b2-a2 (841.5 v 373.5 x 10(9)/L;
      P less than .015), although there was no significant difference in the white
      blood cell counts or hemoglobin. This finding suggests a possibility that the
      type of bcr-abl mRNA may affect the thrombopoietic activity in CML.

PMID- 1742480
TI  - A randomized comparison of two doses of human lymphoblastoid interferon-alpha in
      hairy cell leukemia. Wellcome HCL Study Group.
AB  - One hundred thirty-eight patients with hairy cell leukemia were randomized to
      receive either a dose of 2.0 megaunits (MU)/m2 or a 10-fold lower dose of 0.2
      MU/m2 of a highly purified natural alpha-interferon, administered daily for 28
      days followed by a three times a week schedule. Ninety-seven of these patients
      had previously undergone splenectomy, but otherwise none of the patients had
      received prior therapy for their leukemia. The two doses were comparable in their
      effect on improving the neutrophil and platelet count, whereas the higher dose
      had a greater beneficial effect on the hemoglobin level and a greater
      antileukemic effect on the marrow. Acute toxicity in the form of a flu-like
      syndrome, neurologic side effects, neutropenia, and the need for platelet
      transfusions was observed less frequently in the low-dose group, as was the
      chronic fatigue syndrome. No neutralizing antibody activity was seen in the sera
      from 61 patients examined. Because of its beneficial effect on the neutrophil and
      platelet count and a lower degree of toxicity (ie, a superior
      therapeutic/toxicity ratio), the low dose is recommended as initial therapy in
      patients with hairy cell leukemia. This therapy may be followed by dose
      escalation once clinical improvement is observed.

PMID- 1742481
TI  - Long-term results of therapy with interferon-alpha for type II essential mixed
      cryoglobulinemia.
AB  - Severe type II essential mixed cryoglobulinemia (EMC) bears a poor prognosis.
      Treatment with corticosteroids and/or cytotoxic drugs infrequently results in
      long-term remissions, and is associated with significant toxicity. We conducted a
      prospective study with interferon (IFN) in 21 patients with severe type II EMC
      unresponsive to immunosuppressive regimens. They were treated with recombinant
      IFN-alpha 2a (18 patients) or with natural IFN-beta (three patients), alone, at a
      dosage of 3 megaunits (MU)/d for 3 months, followed by 3 MU every other day as
      maintenance. We observed 11 complete remissions, five partial remissions, and
      five minor responses. Of 16 patients observed for more than 1 year, 11 remained
      in remission for 14 to 40 months; five of them remained in complete remission for
      18 to 40 months after withdrawal of treatment. Four patients discontinued
      treatment because of side effects. In four patients who relapsed while on
      maintenance therapy with recombinant IFN-alpha 2a, remission could be reinduced
      by treatment with natural IFN-alpha. The response rate of 77% achieved in this
      study prompts the use of IFN-alpha as a first-choice drug for type II EMC.

PMID- 1742482
TI  - Recombinant human granulocyte-macrophage colony-stimulating factor ameliorates
      zidovudine-induced neutropenia in patients with acquired immunodeficiency
      syndrome (AIDS)/AIDS-related complex.
AB  - To evaluate the effect of recombinant granulocyte-macrophage colony-stimulating
      factor (GM-CSF) on patients with acquired immunodeficiency syndrome (AIDS) or
      AIDS-related complex (ARC) who were intolerant to zidovudine because of
      neutropenia, we performed a randomized, open-label study in which patients were
      assigned to one of two groups. Zidovudine was discontinued in group A patients
      before instituting GM-CSF treatment and was restarted in a graduated fashion over
      4 weeks. Group B patients continued on full-dose (1,200 mg/d) zidovudine therapy
      while beginning GM-CSF therapy. A total of 17 patients were entered, eight in
      group A and nine in group B. Five of eight patients in group A and seven of nine
      in group B had a history of Pneumocystis carinii pneumonia (PCP). All were
      homosexual males, except one female in group A who was the sex partner of a
      bisexual male with AIDS. All patients had neutropenia (absolute neutrophil count
      [ANC] less than 1,000/microL) while taking full-dose zidovudine. The mean CD4 (+/
      SD) lymphocyte level was 37 (+/- 29)/microL and 39 (+/- 44)/microL in groups A
      and B, respectively. After randomization, patients were begun on subcutaneous GM
      CSF at a dose of 1.0 microgram/kg/d. Patients in group A received 2 weeks of
      daily GM-CSF, at which time zidovudine was restarted if the ANC was greater than
      1,000/microL; if the ANC was less than 1,000/microL, the dose of GM-CSF was
      increased to 3.0 micrograms/kg, and at 2-week intervals either zidovudine was
      restarted or the dose of GM-CSF was increased to 5 micrograms/kg and then 10
      micrograms/kg, to maintain the ANC greater than 1,000/microL. Group B patients
      received full-dose zidovudine concurrently with GM-CSF administration. The dose
      of GM-CSF was increased every 2 weeks if necessary to keep the ANC greater than
      1,000/microL while maintaining full-dose zidovudine therapy. Patients in each
      group showed an increase in total white blood cell (WBC) count. Neutrophils and
      eosinophils were responsible for the majority of this increase. Patients in group
      A had a more rapid increase in WBC than those in group B; however, by week 8, the
      WBC in each group was essentially equal. Viral replication as measured by human
      immunodeficiency virus (HIV) p24 antigen (Ag) was decreased in four patients in
      each group, increased in one patient in each group, and remained unchanged in the
      remainder. The ability to culture virus from peripheral blood mononuclear cells
      was not changed by the regimen. The major toxicities of the regimen were fever
      and malaise.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1742483
TI  - In vitro myelopoiesis stimulated by rapid medium exchange and supplementation
      with hematopoietic growth factors.
AB  - We studied the effect of the combination of rapid culture medium exchange with
      the addition of the human hematopoietic growth factors interleukin-3 (IL-3),
      granulocyte-macrophage colony-stimulating factor (GM-CSF), and erythropoietin
      (Epo) on the proliferation and differentiation of human long-term bone marrow
      cultures (LTBMCs). Individually and in combinations, IL-3, GM-CSF, and Epo were
      added to the culture medium of LTBMCs that were maintained with 50% medium volume
      exchange per day. The combination of IL-3 + GM-CSF + Epo generated the most
      prolific cultures with an order of magnitude increase in nonadherent cell
      production from weeks 2 through 8 in culture as compared with unsupplemented
      controls. Under these conditions, the cultures produced as many cells as were
      inoculated every 2 weeks and led to a greater than 2.5-fold expansion in terms of
      the number of nonadherent cells produced over a 6- to 8-week period. Furthermore,
      the LTBMCs produced nonadherent colony-forming unit-GM (CFU-GM) for more than 20
      weeks. The rapid medium exchange combined with the addition of human
      hematopoietic CSFs significantly enhances the proliferation and differentiation
      of LTBMCs. These results indicate that addition of combinations of hematopoietic
      CSFs, together with a rapid medium exchange rate, can provide culture conditions
      that are suitable for the expansion of the progenitor cell pool and perhaps for
      the increased survival of hematopoietic stem cells in culture. Although these
      culture conditions still fall short of full reconstitution of functional human
      bone marrow, they provide an improved approach to hematopoietic cell culture that
      may permit the expansion and manipulation of progenitor cells in vitro.

PMID- 1742484
TI  - Aphidicolin, an inhibitor of DNA replication, blocks the TPA-induced
      differentiation of a human megakaryoblastic cell line, MEG-O1.
AB  - The commitment process of a human megakaryoblastic cell line (MEG-O1) induced
      with phorbol ester, TPA, was investigated with special reference to glycoprotein
      (GP) IIb/IIIa expression, multinuclear formation, and DNA replication. TPA (10(
      7) mol/L) completely inhibited cellular division in MEG-O1, but did not suppress
      de novo DNA synthesis. Two days' culture with 10(-7) mol/L TPA was sufficient for
      MEG-O1 cells to initiate an irreversible commitment process. These cells could
      not resume cell growth and expressed GP IIb/IIIa antigen; some of them showed
      multinuclear form and DNA polyploidy even after removal of TPA from the culture
      medium. DNA histogram analysis showed that, upon treatment with TPA, the
      percentage of cells whose DNA ploidy was more than 8N was 5 to 10 times higher
      than that of control cells. Precise analysis using cell size fractionation by
      centrifugal elutriation method showed that there was strong correlation between
      the percentage of multinuclear cells and DNA polyploidy in TPA-treated cells. The
      percentage and staining intensity of GP IIb/IIIa and other megakaryocytic
      phenotypes such as von Willebrand factor and PAS staining were highest in large
      multinuclear cell populations, suggesting that these cells are the most
      differentiated population in this system. In TPA-treated cells, the activity of
      DNA polymerase alpha, a marker for cell growth, remained at the same level as in
      control cells. Aphidicolin, a specific inhibitor of DNA polymerase alpha,
      completely inhibited the differentiation induction of MEG-O1 cells with TPA
      measured by either GP IIb/IIIa expression or multinuclear cell formation.
      Therefore, DNA replication appears to be involved in the process of phenotypic
      expression as well as endomitosis in megakaryocyte differentiation of MEG-O1
      cells. Aphidicolin was also effective in inhibiting megakaryocytic
      differentiation of other leukemia cell lines such as human erythroleukemia (HEL)
      and K562 cell lines induced with TPA, suggesting the close interplay of DNA
      replication and phenotypic expression in megakaryopoiesis.

PMID- 1742485
TI  - Differentiation-associated expression of prostaglandin H and thromboxane A
      synthases in monocytoid leukemia cell lines.
AB  - To elucidate the differentiation-associated expression of enzymes catalyzing
      arachidonic acid metabolism, we measured arachidonate metabolites by reverse
      phase high pressure liquid chromatography in monocytoid leukemia (ML-1, THP-1,
      and U937) and myeloid leukemia (KG-1) cell lines. Undifferentiated ML-1 or THP-1
      cells produced trace amounts of eicosanoids via the cyclooxygenase (COX) and
      lipoxygenase (LOX) pathways. Upon differentiation induced by phorbol ester
      (phorbol 12-myristate 13-acetate [PMA]), metabolites via the COX pathway were
      increased by 100-fold in ML-1 and THP-1 cells, while the LOX products remained
      barely detectable. All the COX metabolites were elevated, but thromboxane A2
      (TXA2) formation was threefold higher in ML-1 cells than in THP-1 cells. Similar
      time-related increases in COX metabolites were observed in THP-1 cells induced to
      differentiate with retinoic acid. Undifferentiated U937 cells were capable of
      generating a much higher quantity of COX products than ML-1 or THP-1 cells, but,
      upon PMA-induced differentiation, COX products were increased by only two-fold to
      threefold over the undifferentiated cells and the total COX products in
      differentiated U937 cells were only one-seventh of those produced by
      differentiated ML-1 or THP-1 cells. KG-1 cells had an entirely different
      metabolic profile. They produced a large quantity of a metabolite coeluted with
      prostaglandin D2, and PMA had no effect on inducing changes in arachidonic acid
      (AA) metabolism. Increased COX metabolite formation in differentiated THP-1 and
      ML-1 cells was due to an enhanced level of prostaglandin H synthase enzyme mass,
      as measured by Western blot analysis. The TXA synthase activity was also
      increased by approximately 100-fold in PMA-induced ML-1 cells and 10-fold in THP
      1 cells. These findings indicate that increased expression of prostaglandin H and
      TXA synthase enzymes is a feature of differentiated monocytoid leukemia cell
      lines.

PMID- 1742486
TI  - Clinical and laboratory features of 78 cases of T-prolymphocytic leukemia.
AB  - We describe the clinical and laboratory findings of 78 adult patients with T
      prolymphocytic leukemia (T-PLL) studied over the last 12 years. The main disease
      features were splenomegaly (73%), lymphadenopathy (53%), hepatomegaly (40%), skin
      lesions (27%), and a high leukocyte count (greater than 100 x 10(9)/L in 75%)
      with nucleolated prolymphocytes. A variant form with small, less typical cells
      was recognized in 19%. Membrane markers defined a postthymic phenotype TdT-,
      CD2+, CD3+, CD5+, CD7+; in 65%, the cells were CD4+ CD8-, in 21%, they
      coexpressed CD4 and CD8, and, in 13%, they were CD4- CD8+. Serology for human T
      cell leukemia/lymphoma virus Type-I (HTLV-I) was negative in the 27 cases
      investigated. Cytogenetic analysis in 30 cases showed a consistent abnormality of
      chromosome 14, usually inv (14), with breakpoints at q11 and q32 in 76% of cases.
      Trisomy 8, including iso8q, was shown in 53%; t (11;14)(q13;q32) was documented
      in one case; and one had a normal karyotype. The clinical course was progressive
      with a median survival of 7.5 months. Thirty-one patients were treated with 2'
      deoxycoformycin and 15 responded (3 complete remissions and 12 partial
      remissions); the response rate (48%) increased to 58% in patients with a CD4+ CD8
      phenotype. The median survival of responders was 16 months and of nonresponders
      10 months; other treatments were less effective. T-PLL is a distinct clinico
      pathologic entity with aggressive course and characteristic chromosome
      abnormalities. A subgroup of patients may benefit from deoxycoformycin.

PMID- 1742487
TI  - All advanced stage non-Hodgkin's lymphomas with a polymerase chain reaction
      amplifiable breakpoint of bcl-2 have residual cells containing the bcl-2
      rearrangement at evaluation and after treatment.
AB  - Polymerase chain reaction (PCR) of bcl-2 provides an extremely sensitive method
      to detect minimal disease in approximately 50% of patients with non-Hodgkin's
      lymphomas (NHL). In an attempt to determine the clinical usefulness of this
      technique, we examined the bone marrow (BM) of 152 patients with advanced-stage
      NHL at the time of evaluation and after induction or salvage chemotherapy before
      autologous BM transplantation. The BM proved to be an accessible and reproducible
      tissue source to determine PCR positivity because all of the 102 patients
      examined had the same PCR-amplifiable breakpoint in their BM and lymph node. At
      the time of evaluation, PCR analysis in advanced-stage NHL patients added little
      additional information to morphologic analysis because each technique identified
      BM infiltration in approximately 70% of patients. PCR was significantly more
      useful in determining BM infiltration after induction or salvage therapy. At that
      time, approximately 50% of patients had morphologically normal BM, whereas PCR
      analysis remained positive in 100% of those with an amplifiable breakpoint. These
      observations were confirmed in a clinical trial attempting to induce remission in
      previously untreated low-grade advanced-stage NHL patients. In this series, PCR
      was positive in all patients after treatment although the BM was histologically
      uninvolved in 50% of cases, showing that conventional therapy did not eradicate
      bcl-2-positive cells.

PMID- 1742488
TI  - Prognostic correlation of plasma cell acid phosphatase and beta-glucuronidase in
      multiple myeloma: a Southwest Oncology Group study.
AB  - In 1982 a randomized trial of either alternating or syncopated VMCP/VBAP regimens
      for the treatment of active multiple myeloma was begun (Southwest Oncology Group
      Study 8229/30). A concurrent investigation was undertaken to evaluate the
      clinical importance and significance of cytochemically stainable plasma cell acid
      phosphatase (AP) and beta-glucuronidase enzymes (BG). Pretreatment bone marrow
      aspirates were available for analysis from 399 patients for AP and 398 patients
      for BG. The AP scores ranged between 42 and 395, and the BG scores ranged between
      1 and 346. There was a significant increase of AP (P = .001) and BG (P = .002) in
      multiple myeloma as compared with a set of patients with benign plasmacytosis.
      The enzyme scores did not significantly relate to Ig idiotype of myeloma or other
      prognostic variables except that the BG scores varied significantly with the
      level of albumin (P = .03) and hemoglobin (P = .01). Analysis of patient groups
      with different levels of enzyme scores showed that 61 of 398 patients with an AP
      score of less than 130 had a poorer median survival of 1.7 versus 2.8 years for
      patients with higher scores (P = .001). In the multivariate analysis of survival,
      low AP score was an important prognostic factor (P = .006), but BG did not
      contribute significantly. It is suggested that the subset of patients presenting
      with low AP should be considered for specialized or more aggressive therapy.

PMID- 1742489
TI  - Iron absorption in hypotransferrinemic mice.
AB  - We used a unique animal model, the hypotransferrinemic (Htx) mouse, to examine
      the role of transferrin (Tf) in gastrointestinal iron uptake. Despite the absence
      of Tf, Htx animals hyperabsorb iron. Transfusion of red blood cells sufficient to
      normalize the hematocrit and reticulocyte count resulted in a return of iron
      absorption to normal values. These studies indicate that Tf does not play an
      obligate role in iron absorption, either as a carrier or as a humoral signal
      regulating absorption. Transfer of plasma or whole blood from Htx mice or from
      other animal models of iron hyperabsorption to normal mice did not cause an
      increase in iron absorption in recipient animals. Using the plasma or blood
      transfer approach, we have been unable to detect a humoral regulator of
      gastrointestinal iron absorption.

PMID- 1742490
TI  - Identification of four novel delta-globin gene mutations in Greek Cypriots using
      polymerase chain reaction and automated fluorescence-based DNA sequence analysis.
AB  - The molecular basis of most beta-thalassemia syndromes has been defined, while
      the spectrum of mutations causing delta-thalassemia is not well characterized. In
      an attempt to identify such mutations, the region encompassing the delta-globin
      gene from three Greek Cypriot families suspected of having delta-thalassemia was
      amplified by polymerase chain reaction (PCR), and DNA sequence determined using
      an automated fluorescence-based sequencer. Four novel mutations were identified:
      a G----T change at codon 27 that results in an alanine to serine change; a C----T
      change at codon 116 converting arginine to cysteine; a T----C change at codon 141
      converting leucine to proline; and an AG----GG change at the consensus 3'
      acceptor site in IVS-2. While the latter is clearly a thalassemic mutation, the
      low hemoglobin A2 in the first three may be due to either decreased production or
      instability of the altered delta-globin chain. All four mutations may be detected
      by PCR amplification of genomic DNA followed by restriction enzyme digestion. Two
      mutations abolish restriction sites while two create new cleavage sites.
      Screening for molecular defects that cause delta-thalassemia or unstable delta
      globin by PCR amplification and restriction enzyme digestion will lead to correct
      diagnosis of beta/delta-thalassemia compound heterozygotes and improved genetic
      counseling.

PMID- 1742491
TI  - Treatment with recombinant interferon (alpha-2b) early after bone marrow
      transplantation in patients at high risk for relapse [corrected].
AB  - Relapse continues to be a problem after bone marrow transplantation (BMT) for
      hematologic malignancies, particularly in recipients of autologous or T-cell
      depleted allogeneic grafts and in patients with advanced disease. Interferon
      (IFN) has shown antiproliferative activity in several malignant hematologic
      diseases and potentially may be of benefit when administered early after BMT when
      the number of residual cells is minimal. We tested in a phase I study the maximum
      tolerated daily dose of recombinant IFN alpha-2b in patients who had received a
      transplant for a disease at high risk for relapse (acute myeloid leukemia or non
      Hodgkin's lymphoma beyond first remission, advanced myelodysplastic syndrome,
      acute lymphoblastic leukemia at any stage, chronic myeloid leukemia in
      accelerated or blast phase. Recombinant IFN alpha-2b was started at a dose of 0.5
      x 10(6) IU/m2 and escalated by 0.5 x 10(6) IU/m2 in groups of three or four
      patients. The intention was to administer IFN as soon as stable engraftment after
      BMT was achieved (defined as an absolute neutrophil count of greater than 2.0 x
      10(9)/L and platelet count greater than 100 x 10(9)/L for 5 consecutive days) and
      continued for 2 months. A total of 14 patients were enrolled after autologous (n
      = 3) or allogeneic (n = 11) BMT. Dose-limiting toxicity was myelosuppression.
      Significant (grade 2 to 4) neutropenia and thrombocytopenia led to
      discontinuation or dose reduction in five of eight patients receiving 1.5 x 10(6)
      or 2 x 10(6) IU/m2 IFN. Mild to moderate (grade 1 or 2) anorexia, weight loss,
      and fatigue occurred in the majority of patients independent of the IFN dose. De
      novo acute GVHD responsive to steroid treatment developed in 3 of 11 allograft
      recipients. Natural killer (NK) cell function was low before IFN treatment and
      was not improved with the cytokine. Conversely, interleukin-2-activated NK cells
      showed normal function even before starting IFN and no change was seen during IFN
      treatment. Clonogenic hematopoietic progenitor studies showed depression of all
      progenitor lines (colony-forming unit [CFU]-granulocyte, erythroid, monocyte,
      megakaryocyte, CFU granulocyte-macrophage, burst-forming unit-erythroid) by IFN
      at all dose levels except at 0.5 x 10(6) IU/m2. Considering this result and the
      incidence and severity of marrow depression seen at doses greater than 1.0 x
      10(6) IU/m2, we would consider this the maximum dose safely tolerated if IFN
      alpha-2b is administered in this setting for a prolonged course on a daily basis.

PMID- 1742492
TI  - [Three cases of preprosthetic orthodontic extrusion].

PMID- 1742493
TI  - [Clinical use of a computerized periodontal probe (Florida Probe System)].

PMID- 1742494
TI  - [Chronicle of an emergency in the office and laboratory].

PMID- 1742495
TI  - [Stress and the problem of pain in myofascial pain dysfunction syndrome
      (M.P.D.S.)].

PMID- 1742496
TI  - Determination of the embryonic axes of Drosophila.
AB  - The principles of embryonic pattern formation have been studied extensively in
      many systems using classical experimental approaches. In Drosophila, a powerful
      combination of genetics and transplantation experiments, as well as molecular
      biology, have helped to elucidate the mechanisms that operate during oogenesis
      and early embryogenesis to establish a set of positional cues required for axis
      determination in the early embryo. In systematic searches for maternal effect
      mutations a small number of about 30 genes have been identified that specifically
      affect the process of determination of the embryonic axes. These 'coordinate'
      genes define four systems that determine the anteroposterior (AP) axis (three
      systems) and the dorsoventral (DV) axis (one system) independently. In the
      anteroposterior axis, the anterior system determines the segmented region of head
      and thorax, the posterior system determines the segmented abdominal region, and
      the terminal system is responsible for the formation of the nonsegmented termini
      at the anterior and posterior egg tips, the acron and telson. In contrast,
      pattern along the dorsoventral axis is determined by one system only. Although
      all four systems use different biochemical mechanisms, they share several
      properties. (1) The product of one gene in each system is localized in a specific
      region of the freshly laid egg and functions as a spatial signal. (2) In each
      system, this spatial information finally results in the asymmetrical distribution
      of one gene product that functions as a transcription factor. (3) This
      transcription factor is distributed in a concentration gradient that defines the
      spatial limits of expression of one or more zygotic target genes. The combined
      action of these three anteroposterior systems as well as the dorsoventral system
      defines the expression of zygotic target genes in at least seven distinct regions
      along the anteroposterior and at least three in the dorsoventral axis. These
      longitudinal and transverse domains provide a coarse spatial prepattern which is
      then further refined by the action and interaction of zygotic pattern genes.

PMID- 1742497
TI  - Specification of cell fate in the developing eye of Drosophila.
AB  - Determination of cell fate in the developing eye of Drosophila depends on
      cellular interactions. In the eye imaginal disc, an initially unpatterned
      epithelial sheath of cells, single cells are specified in regular intervals to
      become the R8 photoreceptor cells. Genes such as Notch and scabrous participate
      in this process suggesting that specification of ommatidial founder cells and the
      formation of bristles in the adult epidermis involve a similar mechanism known as
      lateral inhibition. The subsequent steps of ommatidial assembly involve a
      different mechanism: undetermined cells read their position based on the contacts
      they make with neighbors that have already begun to differentiate. The
      development of the R7 photoreceptor cell is best understood. The key role seems
      to be played by sevenless, a receptor tyrosine kinase on the surface of the R7
      precursor. It transmits the positional information--most likely encoded by boss
      on the neighboring R8 cell membrane--into the cell via its tyrosine kinase that
      activates a signal transduction cascade. Two components of this cascade--Sos and
      sina--have been identified genetically. sina encodes a nuclear protein whose
      expression is not limited to R7. Constitutive activation of the sevenless kinase
      by overexpression results in the diversion of other ommatidial cells into the R7
      pathway, suggesting that activation of the sevenless signalling pathway is
      sufficient to specify R7 development.

PMID- 1742498
TI  - A genetic and molecular model for flower development in Arabidopsis thaliana.
AB  - Cells in developing organisms do not only differentiate, they differentiate in
      defined patterns. A striking example is the differentiation of flowers, which in
      most plant families consist of four types of organs: sepals, petals, stamens and
      carpels, each composed of characteristic cell types. In the families of flowering
      plants in which these organs occur, they are patterned with the sepals in the
      outermost whorl or whorls of the flower, with the petals next closest to the
      center, the stamens even closer to the center, and the carpels central. In each
      species of flowering plant the disposition and number (or range of numbers) of
      these organs is also specified, and the floral 'formula' is repeated in each of
      the flowers on each individual plant of the species. We do not know how cells in
      developing plants determine their position, and in response to this determination
      differentiate to the cell types appropriate for that position. While there have
      been a number of speculative proposals for the mechanism of organ specification
      in flowers (Goethe, 1790; Goebel, 1900; Heslop-Harrison, 1964; Green, 1988),
      recent genetic evidence is inconsistent with all of them, at least in the forms
      in which they were originally presented (Bowman et al. 1989; Meyerowitz et al.
      1989). We describe here a preliminary model, based on experiments with
      Arabidopsis thaliana. The model is by and large consistent with existing
      evidence, and has predicted the results of a number of genetic and molecular
      experiments that have been recently performed.

PMID- 1742499
TI  - Cell polarity and microtubule organisation during mouse early embryogenesis.
AB  - We have studied the distribution and the role of microtubules in the major
      developmental events occurring during early development of the mouse. These
      events are the setting up of asymmetries within blastomeres, the process of
      asymmetrical cell division and the changes in cellular organisation taking place
      during epithelial differentiation.

PMID- 1742500
TI  - Dominant gain-of-function mutations that lead to misregulation of the C. elegans
      heterochronic gene lin-14, and the evolutionary implications of dominant
      mutations in pattern-formation genes.
AB  - The heterochronic gene lin-14 controls the temporal sequence of developmental
      events in the C. elegans postembryonic cell lineage. It encodes a nuclear protein
      that is normally present in most somatic cells of late embryos and L1 larvae but
      not in later larval stages or adults. Two lin-14 gain-of-function mutations cause
      an inappropriately high level of the lin-14 nuclear protein late in development.
      These mutations delete 3' untranslated sequences from the lin-14 mRNAs and
      identify a negative regulatory element that controls the formation of the lin-14
      protein temporal gradient. The 21 kb lin-14 gene contains 13 exons that are
      differentially spliced to generate two lin-14 protein products with variable N
      terminal regions and a constant C-terminal region. No protein sequence similarity
      to any proteins in various databases was found. The temporal and cellular
      expression patterns of lin-14 protein accumulation is altered by mutations in the
      heterochronic genes lin-4 and lin-28. The lin-4 gene is required to down-regulate
      lin-14 protein levels during the mid-L1 stage. The lin-4 gene product could be
      the trans-acting factor that binds to the negative regulatory element in the lin
      14 3' untranslated region. In contrast, the lin-28 gene activity positively
      regulates lin-14 protein levels during early L1. Thus, these genes act
      antagonistically to regulate the lin-14 temporal switch. The normal down
      regulation of lin-14 within 10 h of hatching is not determined by the passage of
      time per se, but rather is triggered when feeding induces post-embryonic
      development.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742501
TI  - Genetic and cytological control of the asymmetric divisions that pattern the
      Volvox embryo.
AB  - The highly regular pattern in which approximately 2000 small somatic cells and 16
      large reproductive cells (or 'gonidia') are arranged in a typical asexual adult
      of Volvox carteri can be traced back to a stereotyped program of embryonic
      cleavage divisions. After five symmetrical divisions have produced 32 cells of
      equal size, the anterior 16 cells cleave asymmetrically, to produce one small
      somatic cell initial and one larger gonidial initial each. The gonidial initials
      then cease dividing before the somatic cell initials do. The significance of the
      visibly asymmetric divisions is underscored by genetic and experimental evidence
      that differences in size--rather than differences in cytoplasmic quality--are
      causally important in activating the programs that cause small cells to become
      mortal somatic cells and large cells to differentiate as reproductive cells. A
      number of loci, including at least five mul ('multiple gonidia') loci, appear to
      be responsible for determining where and when asymmetric divisions will occur,
      since mutations at these loci result in modified temporal and/or spatial patterns
      of asymmetric division in one or more portions of the life cycle. But the
      capacity to divide asymmetrically at all appears to require a function encoded by
      the gls (gonidialess) locus, since gls mutants fail to execute any asymmetric
      divisions. Second-site suppressors of gls that have been identified may encode
      other functions required for asymmetric division. Cytological and
      immunocytochemical studies of dividing embryos are being undertaken in an attempt
      to elucidate the mechanisms by which cell-division planes are established--and
      shifted--under the influence of such pattern-specifying genes. Studies to date
      clearly indicate a central role for the basal body apparatus, and particularly
      its microtubular rootlets, in establishing the orientation of both the mitotic
      spindle and the cleavage furrow; but it remains to be determined how behavior of
      the division apparatus becomes modified during asymmetric division.

PMID- 1742502
TI  - Gene activation in the amphibian mesoderm.
AB  - Cell potency is progressively restricted in amphibian development by a series of
      cellular interactions called inductions. The mesoderm is believed to develop in
      response to the earliest known induction, in which vegetal cells of the blastula
      divert overlying animal hemisphere cells away from epidermal and towards
      mesodermal fates. We describe two early markers of mesodermal differentiation in
      Xenopus laevis, both mRNAs that encode DNA-binding proteins of the helix-loop
      helix family. One is a frog homologue of MyoD, a gene that in transfection
      experiments can convert cultured fibroblasts into myoblasts. Xenopus MyoD (XMyoD)
      is expressed in the early myotomes, from which the axial musculature develops.
      The accumulation of XMyoD RNA precedes that of transcripts from the cardiac actin
      gene, until now the earliest known marker of the muscle lineage, this result
      indicating that XMyoD could play a role in initiating muscle differentiation in
      normal development. We show by microinjection of synthetic RNA that XMyoD can
      indeed activate muscle-specific gene expression in animal cap cells, which would
      normally form only ectoderm. However, the XMyoD-injected animal caps did not
      produce differentiated muscle, suggesting that additional specific factors are
      required for full myogenesis. The other mRNA is a relative of the twist gene of
      Drosophila, which is required for mesodermal differentiation in flies. This gene
      (Xtwi) is expressed widely in the early frog mesoderm, but not, however, in the
      myotomes, where XMyoD is expressed. Later, the Xtwi gene is activated, in
      response to a second induction, in the developing neural crest.

PMID- 1742503
TI  - Clinical presentation and natural history of chronic persistent hepatitis. A
      multicentre retrospective study on 1197 cases.
AB  - To obtain data on the clinical presentation and the course of the disease of
      biopsy-proven chronic persistent hepatitis (CPH), we coordinated a multicentre
      retrospective study on 1197 patients observed in 16 liver units throughout Italy
      from 1975 to 1985. Most patients were asymptomatic and CPH was often diagnosed
      either after a chance finding of liver enlargement, or increased serum
      aminotransferases and/or HBsAg antigenemia. Of the 1197 patients, 534 (44.6%)
      were HBsAg-positive and 663 (55.4%) were HBsAg-negative. HBeAg was tested in 356
      of the 534 positive cases and detected in 58.4% of them. This percentage was
      higher (80%) in patients under 20. Hepatitis delta virus infection (HD-Ag in
      liver tissue and/or anti-HD in serum) was detected in 28 (14.7%) of the 191
      patients tested on presentation. Liver function tests showed mild hepatic
      involvement in both HBsAg-positive and negative cases, a pronounced derangement
      being observed only in patients with HDV infection. A second liver biopsy was
      performed in 212 patients (144 HBsAg positive and 68 HBsAg negative) and the
      outcome of the disease was evaluated only in these 212 patients. Of the 144 HBsAg
      positive cases followed-up from one to ten years (median 4 years), 47 recovered,
      70 remained unchanged and 27 developed chronic active hepatitis or cirrhosis.
      Clearance of HBsAg was uncommon even in patients who recovered. Being under 15
      years of age favourably affected the course of the disease, while HDV infection
      was correlated to an unfavourable outcome. Among those patients who were HBeAg
      positive on presentation and who underwent a second affect the outcome. Of the 68
      HBsAg-negative clearly affect the outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742504
TI  - Misoprostol prevents NSAID-induced gastroduodenal lesions in patients with
      osteoarthritis and rheumatoid arthritis.
AB  - The clinical use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated
      with significant adverse effects on the integrity of the gastrointestinal (GI)
      mucosa. A unique, double-blind, placebo-controlled, randomized, multicentre study
      investigated the prophylactic co-therapy with misoprostol, a novel PGE1 analog,
      for the prevention of the NSAID-induced gastric and duodenal mucosal lesions. The
      study also investigated whether the co-therapy with misoprostol could interfere
      with the anti-rheumatic action of the NSAIDs using detailed rheumatological
      assessments. Patients with osteoarthritis or rheumatoid arthritis had to be free
      of symptoms and significant erosive and/or haemorrhagic lesions of the upper GI
      tract. The patients were randomized to co-therapy with misoprostol or its
      matching placebo. Follow-up endoscopy and symptoms assessment were carried out
      within 4 weeks and compared to pre-study findings. Misoprostol significantly
      reduced (p less than 0.01) the incidence of erosive and/or haemorrhagic gastric
      and duodenal mucosal lesions. Misoprostol also reduced the proportion of patients
      with epigastric pain (p less than 0.01). Misoprostol was well tolerated and did
      not interfere with the anti-rheumatic activity of the administered NSAID. We
      conclude that misoprostol is safe and effective in the protection against NSAID
      induced gastric and duodenal mucosal lesions and symptoms.

PMID- 1742505
TI  - Plasma osteocalcin levels in liver cirrhosis.
AB  - Osteocalcin, a recently identified protein, is produced by osteoblasts in the
      bone tissue. Its plasma level is a good marker of bone metabolism and is reduced
      in the presence of 'osteodystrophia', commonly found in cholostatic liver
      diseases. We assayed plasma osteocalcin levels in 20 cirrhotic patients and
      compared the values with those of 22 healthy controls. In the same patients we
      also measured the liver function, clotting and mineral metabolism indexes and
      calcitonin plasma levels. Osteocalcin levels were significantly lower in liver
      disease patients than in controls (5.53 ng/ml S.D. 2.57 vs 7.79 ng/ml S.D. 2.23;
      p less than 0.01) and calcitonin plasma levels were much higher in cirrhotics
      (130.18 pg/ml S.D. 212.30 vs 28.9 pg/ml S.D. 13.09; p less than 0.05). We think
      that the low osteocalcin levels observed in cirrhotics may be a consequence of
      "hepatic osteodystrophy" due to low vitamin D and calcium plasma levels.

PMID- 1742506
TI  - Eating behaviour: investigation on the recursive components of hunger sensation
      by iterative rhythmometry.
AB  - The periodic components of hunger have been investigated in the spectrum of
      ultradian and circadian rhythms by means of iterative rhythmometry analysis, a
      method for resolving harmonic components in time series data. The cyclical
      scanning has been applied in human subjects with eating disorders associated with
      leanness, ponderosity and obesity. The sensation of hunger was rhythmometrically
      resolved into ultradian and circadian components which are peculiar for the group
      investigated. Harmonic modelling can be used on an individualized basis for group
      specific configurations and, on that basis, for unphysiologic patterns. A
      comparison with the rhythmometric model of healthy subjects may have a practical
      use in identifying and manipulating behavioural disorders in the propensity to
      eat.

PMID- 1742507
TI  - Gastric antral erosions and Helicobacter pylori infection in cirrhotic patients:
      a pilot controlled study of oral bismuth vs ranitidine therapy.
AB  - A controlled study was performed comparing bismuth and ranitidine oral therapy in
      the treatment of chronic antral erosions and chronic active gastritis and in
      clearing Helicobacter pylori in cirrhotic patients. Forty four patients took part
      in the randomized study. H pylori was present in more than 50% of the patients in
      the study. There was a close association between the presence of H pylori and
      inflammatory activity of gastritis at an antral level (p less than 0.001). CBS
      was significantly better than ranitidine in clearing H pylori (p less than 0.001)
      and reducing inflammatory activity of gastritis (p less than 0.001). This
      reduction was related to H pylori clearance. No action of the two medications was
      observed in improving endoscopic findings of erosive gastritis. H pylori
      clearance did not influence amelioration of endoscopic chronic erosive antral
      gastritis (EG) in cirrhotic patients. These findings suggest that H pylori does
      not seem to play a pathogenetic role in the aetiology of EG in cirrhotic patients
      while it represents an important factor in determining and maintaining the
      inflammatory activity of histologically confirmed gastritis in these patients.

PMID- 1742508
TI  - Common bile duct and sex, age and body mass index in normal humans: an
      ultrasonographic study.
AB  - A probable relationship between Common Bile Duct (CBD) size and sex, age and Body
      Mass Index (BMI) was investigated in healthy volunteers. Real-time
      ultrasonography was employed to visualize gallbladder and CBD. No change of CBD
      size related to sex and BMI was found. A significant increase of CBD related to
      age was recorded.

PMID- 1742509
TI  - Effect of lactobacillus acidophilus and bifidobacterium bifidum on rectal cell
      kinetics and fecal pH.

PMID- 1742510
TI  - Infusional therapy for post-surgical biliary stones.
AB  - A variety of effective non-surgical forms are used for dealing with retained and
      recurrent biliary stones. These are endoscopic papillotomy, infusional therapy,
      intraductal laser or electrohydraulic lithotripsy and extracorporeal shock waves.
      Saline washout or chemical stone dissolution is currently used in high-risk
      subjects or in cases in which endoscopic papillotomy fails. For many years now
      drugs that should dissolve stones topically have been tested by direct infusion
      into the biliary tract. This approach has given better results over the last ten
      years with the adoption of Monooctanoin (Mo) and more recently Methyl tertbutyl
      ether (MTBE). Both preparations have their pros and cons, which are weighed.

PMID- 1742511
TI  - Problems of gastrointestinal endoscopy in Italy.

PMID- 1742512
TI  - Patient's assessment of an information booklet on Crohn's disease written by a
      patient.
AB  - Patients with Crohn's disease want information about the condition. "So you've
      got Crohn's disease", an information booklet written by a patient was sent to
      patients for evaluation. Most found it useful, particularly in the practical
      advice, and suitable for all patients with Crohn's disease. Patients can be a
      valuable source of information for other patients and doctors. They should be
      encouraged to share their experiences.

PMID- 1742513
TI  - Hepatitis C virus antibodies in chronic liver diseases of different aetiology.
AB  - To define the prevalence of Hepatitis C Virus (HCV) infection in patients with
      chronic hepatitis or cirrhosis of any aetiology, we tested a group of 372
      consecutive subjects with biopsy-proven chronic liver disease (CLD) for anti-HCV
      antibodies, excluding active drug-addicts and alcoholics. Our results show that
      in Southern Italy HCV infection is widespread among subjects with cryptogenic
      chronic liver disease, as well as in liver diseases with features of autoimmunity
      (71.7% and 66.7% anti-HCV positive, respectively). Anti-HCV is infrequent among
      non drug-addicted HBsAg positive subjects (4.7%), and bears no relation to
      hepatitis D superinfection. Subjects with CLD and a history of parenteral
      exposure are almost always anti-HCV positive (89.2%). Patients with HBV-related
      CLD and previous drug-addicts are on the average younger than other disease
      groups, irrespective of their HCV status. Among subjects whose CLD is related to
      parenteral exposure, cryptogenic or autoimmune no increase in the rate of anti
      HCV positivity seems to bear a parallel relationship to age. No known risk factor
      for parenteral transmission, other than use of blood or blood products and
      previous drug-addiction, can be clearly related to HCV infection. No trend to
      familiar clustering of HCV-induced liver disease is apparent. Liver disease
      severity, as assessed by transaminase levels and liver histology, does not
      correlate to anti-HCV status.

PMID- 1742514
TI  - Protective effect of cyanidin (IdB 1027) against aspirin-induced fall in gastric
      transmucosal potential difference in normal subjects.
AB  - The effect of the natural flavonoid cyanidin (IdB 1027), 1200mg daily for 8 days,
      on the fall in gastric transmucosal potential difference induced by a single dose
      of aspirin (1000mg by nasogastric tube) was evaluated in 7 normal male
      volunteers. As compared to pretreatment values, IdB 1027 caused a significant
      reduction in both the percentage fall in transmucosal potential difference at the
      time of peak aspirin effect (from 37 +/- 18% to 18 +/- 5%, p less than 0.05) and
      the area under potential difference baseline (from 811 +/- 624 mvolt. min to 338
      +/- 150 mvolt. min, p less than 0.05). These results provide evidence for a
      protecting effect of IdB 1027 against aspirin-induced gastric mucosal damage in
      man.

PMID- 1742515
TI  - A comparison of nizatidine and ranitidine in the maintenance treatment of
      duodenal ulcer. A randomized, double blind, multicentre, 2-year study.
AB  - One hundred and eight patients with an endoscopically documented healed duodenal
      ulcer (DU) participated to a multicentre, randomized, double-blind, long-term
      study. The study was planned with the aim to compare the efficacy of nizatidine
      150 mg with ranitidine 150 mg in preventing relapse during the 2 years following
      the DU healing. Fifty four patients were assigned to each treatment. Endoscopic
      examinations were scheduled at 6, 12 and 24 months. Clinical evaluations were
      performed every two months. Routine laboratory tests were investigated at the
      beginning of the study and at each of the scheduled endoscopies. STATISTICS: chi
      squared test with Yate's correction, Student's t test for unpaired data, Wilcoxon
      Rank Sum test and Logrank test. Twenty five patients dropped-out: 15 in the
      nizatidine and 10 in the ranitidine group. The cumulative relapse rate was 18%
      for nizatidine and 21% for ranitidine treatment (p:ns). Both drugs resulted safe,
      as only minor side effects were registered. IN CONCLUSION: nizatidine is as
      effective and safe as ranitidine in the long-term (2 year) treatment of DU.

PMID- 1742516
TI  - Unusual side effects of mesalazine.

PMID- 1742517
TI  - Exocrine pancreatic involvement in Wegener's granulomatosis. A case report.
AB  - A rare case of exocrine pancreatic damage in a patient with Wegener's
      granulomatosis is reported. The pancreatic amino acid consumption test, a new
      tubeless technique, revealed exocrine pancreatic insufficiency before and after
      immunosuppressive therapy. The presence of exocrine pancreatic insufficiency in
      this patient raises the possibility of pancreatic involvement in Wegener's
      granulomatosis.

PMID- 1742518
TI  - Epithelioid hemangioendothelioma of the liver: report of two cases.
AB  - Epithelioid hemangioendothelioma is a very rare tumour of vascular origin, the
      most peculiar feature of which is that it is composed of endothelial cells
      closely resembling epithelial cells. Confirmation of its endothelial origin is
      achieved by positive staining for Factor VIII-related antigen or by the
      demonstration of Weibel-Palade bodies by electron microscopy. We report two cases
      of primary epithelioid hemangioendothelioma of the liver that occurred in our
      center in the last ten years. The first patient is a 21 year old woman who
      presented with a right upper quadrant pain and an echographic finding of multiple
      hepatic lesions suggestive of metastases. The second patient is a 32 year old
      woman operated on for a cerebral glioma, in whom an abdominal CT scan, performed
      in view of radiotherapy, revealed multiple hepatic lesions, originally
      interpreted as being metastatic. In both cases, diagnosis was made based on the
      histologic examination of biopsies have been adopted in each case: the first
      patient has undergone successful liver transplantation. In the second patient an
      attentive surveillance appeared to be the best option, due to the presence of a
      previous cerebral glioma.

PMID- 1742519
TI  - Physiopharmacology of the peristaltic reflex: an update.
AB  - The peristaltic reflex is one of the simplest models which can be used to study
      the function of enteric neurons by recording intestinal motor activity.
      Peristalsis consists of a coordinated, aborally propagating motor activity which
      requires the functional integrity of receptor pathways, excitatory and inhibitory
      neural pathways and neuromuscular junctions. Luminal distension elicits polarized
      responses: an ascending excitatory response (ascending contraction) and a
      descending inhibitory response (descending relaxation). The present paper reviews
      the most recent acquisitions on the neural pathways and neurotransmitters
      involved in the regulation of the peristaltic reflex.

PMID- 1742520
TI  - An overdose of scientific information?

PMID- 1742521
TI  - L-alanine plasma levels after oral loads in non-alcoholic liver cirrhosis:
      relationship with urea extraformation and ammoniogenesis.
AB  - In the post-absorptive stage L-alanine is the main source of alpha-amino-nitrogen
      reaching the liver as glucose precursor. This aminoacid has been used as a
      measure of urea synthesis capacity in several pathologic conditions, but it has
      not been employed sistematically in patients with liver cirrhosis. We tried to
      address this issue by evaluating: a) L-alanine plasma levels, b) urea
      extraformation (UE), and c) ammoniogenesis after oral L-alanine (0.25 and 0.50
      g/kg b wt) in healthy control subjects and in patients with nonalcoholic
      compensated (Child-Pugh's A class) and decompensated (Child-Pugh's B and C) liver
      cirrhosis. L-alanine plasma levels after oral load were higher and lasted longer
      in cirrhotics as compared to controls. Furthermore, after L-alanine oral load,
      significantly higher ammonia plasma levels were observed in cirrhotics than in
      controls. Changes in the urea extraformation were comparable in cirrhotics and
      controls. Both delayed L-alanine elimination from plasma and L-alanine-induced
      hyperammoniemia were more evident in decompensated cirrhotics and related to L
      alanine dose.

PMID- 1742522
TI  - Hepatitis A in Italy: epidemiology and suggestions for control.
AB  - Seroepidemiologic and surveillance data show that hepatitis A is declining in
      both Northern and Southern Italy, in the latter the decline has been more recent.
      Every year about two thousand cases of acute disease occur. Shellfish consumption
      and travel to endemic areas are at present the most important risk factors in
      Italy. Use of immunoglobulin is effective in controlling outbreaks and preventing
      hepatitis A among travellers. Active immunization for travellers to endemic areas
      will be recommended, when a vaccine will be available. Adequate cooking of
      shellfish is at present the only advisable measure to prevent the risk
      represented by their consumption. Acute morbidity and the occurrence of outbreaks
      suggest the need to keep our attention on hepatitis A infection in Italy.

PMID- 1742523
TI  - Changing epidemiology of hepatitis A virus (HAV) infection: a comparative
      seroepidemiological study (1979 vs 1989) in north-east Italy.
AB  - A comparative seroepidemiological study (1979 vs 1989) on HAV infection, was
      carried out in children and adolescents from North-East Italy. Anti-HAV was
      tested in 850 subjects 6 to 8 years of age and the results were compared to those
      observed in 1979, in 462 subjects of the same age range and from the same
      geographical area. Overall anti-HAV prevalence was 1.9% (ranging from 0.5 to 5.2)
      in 1989 vs 32.5% (ranging from 7.8 to 70.7) in 1979. This dramatic decline of HAV
      infection in children and adolescents reflects the improved sanitation standard
      of our country but, on the other hand, indicates that the number of non-immune
      adults is increasing, with a higher risk of symptomatic infection in the near
      future.

PMID- 1742524
TI  - Changing pattern of hepatitis B infection in children: a comparative
      seroepidemiological study (1979 vs 1989) in north-east Italy.
AB  - Hepatitis B infection was endemic in Italy and household transmission has been
      considered to be the main mode of HBV spread. Prevalence of HBsAg positive
      subjects was therefore higher in children than in adults. Serum samples from 500
      children (aged 6-15 year) without overt liver disease were tested for HBV serum
      markers in 1979. Serological evidence of HBV infection was present in 16% of the
      subjects. To verify a possible decline of HBV infection we designed a
      seroepidemiological study in school children from the same town. Three classes of
      age (6 yrs, 10 yrs, 14 yrs) were selected. Children were recruited from those
      attending primary and secondary schools using a systematic cluster sampling.
      After parents' informed consent sera were collected in May 1989. All were tested
      for anti-HBc: anti-HBc + ve sera were then tested for HBsAg and anti-HBs (EIA
      Abbott Lab., Chicago, Ill. USA). Of the 1635 children one was HBsAg positive and
      21 were positive for any HBV marker. Both the prevalence of HBsAg and that of any
      HBV marker were significantly lower (p less than 0.001) in 1989 when compared to
      the corresponding age-class of 1979.

PMID- 1742525
TI  - Increased risk for gallstone disease in subjects operated on for partial
      gastrectomy with gastro-jejunostomy (BII operation).
AB  - The prevalence of cholelithiasis has been investigated in 301 male subjects (age
      range 35-60 years) operated on for partial gastrectomy with gastro-jejunostomy
      (BII), in 277 unoperated peptic ulcer patients (age range 30-60 years) and in a
      control population of 281 factory's workers (age range 31-58 years). The
      prevalence of gallstone disease resulted significantly higher in BII operated
      subjects (23.9%) than in unoperated (9%) and controls (8.5%). No difference was
      found between unoperated peptic ulcer patients and controls. These results
      indicate that BII operation is a high risk condition for cholelithiasis while
      peptic ulcer disease does not constitute a favourable factor for gallstone
      formation.

PMID- 1742526
TI  - Does the combination of a human fibrin sealant with ranitidine accelerate the
      healing of duodenal ulcer?
AB  - Human fibrin sealant (Tissucol) has been used in surgery for its haemostatic and
      sealing actions and stimulating effect on tissue regeneration. Recently it has
      been used in endoscopy, but controlled trials are not yet available. The aim of
      this study was to evaluate the efficacy of Tissucol on the healing rate of
      duodenal ulcers (DU). Thirty nine previously untreated DU patients received
      ranitidine 150 bid plus endoscopically applied either placebo (19 patients) or
      Tissucol (20 patients). Sixty-five percent of the patients in the Tissucol group
      and 21% in the control group healed after two weeks (p less than 0.02), 75 and
      52.6% respectively after 4 weeks (NS). The endoscopic application of Tissucol
      seems to influence the healing of duodenal ulcer and its use could be suggested
      in selected patients with DU.

PMID- 1742527
TI  - Effect of omeprazole on H. pylori after two weeks of treatment.
AB  - The "clearing" effect of omeprazole 20 mg/daily on Helicobacter pylori (HP) was
      studied in 32 HP positive patients with duodenal ulcer (DU). Endoscopy and antral
      biopsies were made before and after two weeks of treatment with Omeprazole. HLO
      test and histology after Giemsa stain were used for the detection of HP. Fourteen
      of 28 (50%) initially HLO positive and 12 of 30 (40%) initially histological HP
      positive patients became HP negative. Nine of 23 (39%) patients, initially HP
      positive by both methods became HP negative. "Clearing" of HP in this particular
      group of patients did not have any influence on ulcer healing. It is concluded
      that omeprazole used for two weeks has a clearing effect on HP in a high enough
      percentage of patients with DU.

PMID- 1742528
TI  - Propranolol for metronidazole-resistant giardiasis.

PMID- 1742529
TI  - Double pylorus: report of two cases and review of the literature.
AB  - Double pylorus is a rare condition consisting of a double communication between
      gastric antrum and duodenal bulb; in most cases it is a complication of
      penetrating ulcer, sometimes it is a congenital abnormality. The prevalence of
      this rare anomaly ranges from 0.02% to 0.13%; the male:female ratio is about 2:1.
      Two cases of acquired double pylorus are reported with a review of the
      literature. The first case represented an occasional report; in the other one the
      development of double pylorus from confluent prepiloric and bulbar ulcers was
      documented through serial endoscopies. Both patients were affected with chronic
      renal failure and referred previous treatment with diclofenac; however, their
      relationship with double pylorus onset remains unproven.

PMID- 1742530
TI  - Prolonged viral hepatitis type A with cholestasis: case report.
AB  - We describe a clinical case of an eleven year old boy with a protracted
      cholestatic form of viral hepatitis type A. The role of a macrolide antibiotic in
      the determinism of this form of hepatitis is discussed.

PMID- 1742531
TI  - Wandering spleen presenting as an evanescent abdominal mass.

PMID- 1742532
TI  - Experimental gastric cancer.
AB  - Since Sugimura and Fujimura (1967) succeeded in selectively inducing gastric
      carcinomas in rats by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) (1), similar
      models for the induction of gastric carcinomas in other species by using MNNG and
      its ethyl derivative N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) have been
      established. The susceptibility to gastric carcinogenesis, the histologic types
      of gastric carcinomas induced, and their biological behavior depend on the mode
      of treatment, species, strain and/or sex. The organ specificity of MNNG
      correlates well with the level of DNA methylation in target and non-target
      tissues following oral administration in rats. The high concentration of
      methylated DNA bases in the stomach mucosa appears to result from thiol-mediated
      acceleration of the decomposition of MNNG. Experimental gastric carcinogenesis is
      markedly modified by various factors and agents, including bile reflux, bile
      acids, sodium chloride, and ulceration, indicating that both host and
      environmental factors contribute significantly to gastric carcinogenesis by
      chemical carcinogens.

PMID- 1742533
TI  - Zinc and other trace elements in liver cirrhosis.
AB  - Alterations in trace element concentrations may be observed in patients with
      chronic liver disease. Notably, selenium and zinc levels are reduced both in
      serum and in liver tissue of cirrhotic patients. Low selenium levels have been
      involved in the pathogenesis of liver damage as this element is important in
      controlling the levels of toxic oxygen radicals in the cells. Zinc deficiency has
      been involved in the pathogenesis of a number of clinical findings in chronic
      liver disease. These include the possible role of zinc deficiency in the
      pathogenesis of hepatic encephalopathy, by inducing alterations in urea
      metabolism. In CC14 cirrhotic rats oral zinc supplementation reduces ammonia
      levels and increases OCT activity in the liver. Oral zinc supplementation has
      been also proposed in the treatment of cirrhotic patients with chronic hepatic
      encephalopathy, the results however are not yet conclusive.

PMID- 1742534
TI  - Again with problems of gastrointestinal endoscopy.

PMID- 1742535
TI  - Efficacy and safety of clebopride in functional dyspepsia.

PMID- 1742536
TI  - Lymphocyte traffic and adhesion molecules in the gut.

PMID- 1742537
TI  - Treatment of chronic hepatitis C with recombinant interferon alfa.
AB  - We studied the clinical course and the effect of alfa interferon treatment in
      sixty-six patients of Southern Italy suffering from chronic hepatitis C virus.
      The patients were randomly assigned to the control group (33 patients without
      treatment) or to the group treated with 3MU of interferon three times a week for
      six months. Alanine transaminase (ALT) levels normalized in 17 of the 33 treated
      subjects (52%) within two months of treatment. Seven of these "responders"
      relapsed at the end of the six-month treatment period, but ALT normalized in
      these patients after resumption of interferon at the same dosage. None of the non
      responders on 3MU for four months showed improvement even when the dose was
      increased to 6MU. Our results coincide with other reports on interferon treatment
      in hepatitis C virus. Further studies are required to clarify whether or not
      higher doses at the onset of treatment increase the number of responders and
      decrease the frequency of relapses.

PMID- 1742538
TI  - Rifaximine versus neomycin in the treatment of portosystemic encephalopathy.
AB  - In 14 patients with cirrhosis and chronic portosystemic encephalopathy, the
      effectiveness of treatment with a new non-assorbable antibiotic (rifaximine) was
      compared to neomycin. The parameters evaluated were: bradylalia, flapping tremor,
      performance, visual evoked potentials and the trial making test. Both treatments
      were combined with lactulose. The analysis of results showed a rate of positive
      results in the patients treated with rifaximine greater than that with neomycin.
      Differences, however, were not significant.

PMID- 1742539
TI  - The spontaneous bacterial peritonitis in cirrhotic patients. To a new gold
      standard.
AB  - Of 282 consecutive ascites prospectively collected in 54 months, Spontaneous
      Bacterial Peritonitis (SBP) was diagnosed in 8.5% of the cases, "probable" SBP in
      31.1%, Bacteriascites (BA) in 3.5% and Sterile Ascites (SA) (negative ascitic
      fluid culture with PMN less than 250/mm3) in 74.8%. Escherichia Coli (41.6%) and
      Staphylococcus Epidermidis (60%) were the most frequent pathogens isolated in
      patients with SBP and BA, respectively. With regards to in-hospital mortality,
      18% of patients with BA and 50% with SBP died; the mortality seemed to be related
      to the degree of hepatic and renal damage, to a higher peripheral and ascitic WBC
      concentration and to a lower pH of ascitic fluid (FA). When the comparative
      analysis was applied to the four groups of ascites, a different distribution of
      clinical signs and biohumoral parameters appeared. As a matter of fact, abdominal
      pain, fever and rebound tenderness resulted significantly more frequent in SBP
      and "probable" SBP. Furthermore, the mean values of peripheral and ascitic WBC
      concentration, of serum creatinine and of ALT were statistically higher in SBP
      and "probable" SBP than in SA and BA groups. The strict relationship, both
      symptomatologic and biochemical, between SA and BA on the one hand and between
      "probable" SBP and SBP on the other, prompted us to conclude that "probable" SBP
      and SBP represent different patterns of the same disease. Therefore, the
      subclassification in the four groups outlined above would not be in accordance
      with the clinical practice and could give rise to the physician's confusion and
      uncertainty.

PMID- 1742540
TI  - Action of glucomannans on complaints in patients affected with chronic
      constipation: a multicentric clinical evaluation.
AB  - Chronic constipation is a very frequent disease in western countries but fibres
      can often solve the problem. In the present study, authors tested the efficacy
      and the acceptability of glucomannans, hydrophylic carbohydrates with a high
      degree of viscosity, in 93 patients affected with chronic constipation. The
      multicentric, open and non-controlled study was divided into an initial phase
      (treatment with 1g of glucomannans t.i.d. for 1 month) and a maintenance phase
      (1g b.i.d. for one month). We evaluated both objective parameters (number of days
      per week with bowel movements and number of enemas) and abdominal symptoms. After
      one month all assessed parameters showed a statistically significant improvement
      lasting through the second month. Glucomannans were well accepted and devoid of
      relevant side-effects. In conclusion, considering their efficacy and
      tolerability, they can be proposed as an ideal therapeutic tool in the management
      of chronic constipation symptoms.

PMID- 1742541
TI  - Spontaneous rupture of the gallbladder and haemoperitoneum in a patient with
      cardiac valve prostheses.
AB  - A case is reported of isolated spontaneous rupture of the gallbladder with
      obstructed cystic duct and a stone in the cystic cavity, in a patient on
      anticoagulant treatment after cardiac valve replacement. The mechanism of the
      onset, the diagnosis and the treatment of the lesion are discussed together with
      a review of the literature.

PMID- 1742542
TI  - Gastric cancer in Italy.
AB  - Although Gastric Cancer (GC) death rates are decreasing worldwide, in high risk
      areas GC is still a major public health problem. Italy is one of the European
      countries with the highest mortality rates for GC (males: 17.3; females: 8.2 x
      100,000 inhabitants in 1987) which represents the third cause of death due to
      cancer in 1987, accounting for over 14,000 deaths per year (10% of cancer
      deaths). Reasons for the geographic variability in GC occurrence within the
      country are reviewed, discussing the results of two recent analytical
      epidemiological studies carried out in Italy. These large case-control studies
      focused on dietary factors, involving high and low-risk areas for GC (Florence,
      Siena, Forli, Imola, Cremona, Genoa, Cagliari, and Milan). Low socio-economic
      status, family history of GC, residence in rural areas were associated to GC
      risk, while migration from southern areas and body mass index were inversely
      related to GC. Consumption of traditional soups, meat, salted and dried fish,
      cold cuts and seasoned cheeses, as well as the intake of animal proteins and
      nitrites were related to an increased GC risk. On the contrary consumption of
      fresh fruit, citrus fruit, raw vegetables, spices, garlic and olive oil, and
      vitamin C, E and beta-carotene intake were found to be protective factors. Among
      diet-related factors, preference for salty foods and frequent broiling were
      positively related to GC, while the longstanding availbility of a refrigerator or
      freezer and the habits of consuming frozen foods were associated with decreased
      GC risk. These results are discussed in detail, considering the main hypotheses
      on GC carcinogenesis.

PMID- 1742543
TI  - Diagnostic approach to primary sclerosing cholangitis: open questions.
AB  - Over the last ten years the incidence of primary sclerosing cholangitis (PSC)
      presented a progressive increase, showing an association with chronic
      inflammatory bowel disease (IBD) in 50-70% of the cases. Nowadays, however, the
      prevalence of PSC is still unknown, mainly because of its difficult
      identification. In contrast to primary biliary cirrhosis (PBC), which is strongly
      associated with the presence of anti-mitochondrial antibodies (AMA) in serum, a
      similar reliable diagnostic marker has not yet been demonstrated in PSC. In this
      review we tried to investigate the controversial diagnostic aspects which may
      interfere with the initial assessment of PSC syndrome. Alkaline phosphatase (ALP)
      and endoscopic retrograde cholangiography (ERC) are actually the two cornerstones
      of the clinical setting, but if alone, they do not seem to provide sufficient
      accuracy. Furthermore, liver biopsy, perhaps more sensitive but not always
      specific, is generally performed too late. In our opinion, epidemiologic studies
      are needed in Italy and elsewhere in order to evaluate PSC prevalence. Moreover,
      the analysis of these results might lead to an earlier detection of the disease
      and, perhaps, favourably modify its natural history.

PMID- 1742544
TI  - The descriptive epidemiology of primary liver cancer in Italy.
AB  - Using figures from the official death registry, we studied the descriptive
      epidemiology of primary liver cancer (PLC) in Italy from 1969 to 1985. The annual
      age-standardized mortality rate rose from 3.7/100,000 in 1969 to 4.7/100,000 in
      1985, reaching the peak of 6.5/100,000 in 1983. The male/female ratio increased
      from 1.2:1 in 1969 to 2:1 in 1985. The age-specific mortality rate was very low
      in subjects under 55 years of age and peaked in subjects in their seventies and
      eighties. The rate was higher for men in all age-groups. The highest proportion
      of deaths (32%) was observed in the 65-74 year age group. The median age of death
      for patients with PLC was 10 years older than the median age for patients who
      died of alcoholic liver cirrhosis, but similar to that of patients who died of
      liver cirrhosis due to other causes. The highest regional age-standardized
      mortality rate was reported in Lombardia, Lazio and Veneto respectively, where
      hepatitis B virus (HBV) infection is less endemic than in the southern regions
      and the Islands. It should be kept in mind that these findings are not extremely
      accurate because they are based on mortality figures, where the contamination
      with metastatic cases is practically unavoidable; furthermore, their validity and
      comparability are not first-rate due to the wide variation in diagnostic accuracy
      and registration completeness.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742545
TI  - Close connections between endoscopy and gastroenterology.

PMID- 1742546
TI  - Education and training in gastrointestinal endoscopy.

PMID- 1742547
TI  - Microdetermination of hyaluronic acid in human urine by high performance liquid
      chromatography.
AB  - A high performance liquid chromatographic (HPLC) system is described for
      determination of the unsaturated disaccharide (delta Di-HA) derived from
      hyaluronic acid (HA) in human urine by digestion with hyaluronidase SD. The
      effects of eluents on the separation of delta Di-HA and delta Di-0S, which is
      derived from the reaction of chondroitin with the enzyme, have been studied. The
      established chromatographic conditions were as follows--column: a stainless steel
      tube (4 mm i.d. x 250 mm) packed with TSKgel NH2-60; eluent: a mixture of
      acetonitrile and 0.1 M Tris-HCl buffer containing 0.1 M boric acid and 10 mM
      sodium sulphate, pH 7.0 (64:36, v/v). The strong fluorescence of unsaturated
      disaccharide after the reaction with 2-cyanoacetamide in alkaline medium was used
      for post-column detection. The calibration curve for delta Di-HA was linear in
      the range 5 pmol-5nmol with a practical detection limit of 2 pmol. The assay
      coefficients of variation (n = 5) at 200 pmol for delta Di-HA and delta Di-0S
      were 1.7 and 1.5%, respectively. This HPLC system has been applied to the
      determination of HA in human urine.

PMID- 1742548
TI  - Determination and purification of metallothioneins by high performance liquid
      chromatography.
AB  - A rapid, reproducible and sensitive high performance liquid chromatography (HPLC)
      method for the determination and purification of metallothionein-I (MT-I) and
      metallothionein-II (MT-II) in mouse and rabbit livers has been developed.
      Methallothioneins (MTs) were separated by an HPLC anion exchange column, eluted
      through a linear gradient of Tris buffer and the peak containing MTs was
      determined by atomic absorption spectrophotometry. Furthermore, the content of MT
      I or MT-II was calculated by protein peak area in a short time (about 20 min).
      The sample to be tested was homogenized, centrifuged and saturated by cadmium. MT
      I and MT-II were eluted at 15.9 and 19.3 min, respectively. The following mouse
      liver cytosols were tested: controls, Cd-injected samples and 60Co-irradiated
      samples. A detection limit of 5 micrograms/g liver was established for this
      method. We have analysed more than 100 biological samples and obtained
      satisfactory results.

PMID- 1742549
TI  - Plasma B-6 vitamer and plasma and urinary 4-pyridoxic acid concentrations in
      young women as determined using high performance liquid chromatography.
AB  - Plasma B-6 vitamer and plasma and urinary 4-pyridoxic acid concentrations of 21
      young white women, 21-27 years, having radiomonitored pyridoxal 5'-phosphate and
      coenzyme stimulation of erythrocyte alanine aminotransferase activities
      indicative of adequate vitamin B-6 status were determined in an effort to
      establish normal ranges for plasma B-6 vitamers. B-6 vitamers and 4-pyridoxic
      acid were quantitated using reversed phase high performance liquid chromatography
      with fluorometric and ultraviolet detection. Pyridoxal phosphate values obtained
      by radioenzymatic and chromatographic, fluorometric and ultraviolet, assays were
      highly correlated as were pyridoxine phosphate values determined using both
      detectors. The B-6 vitamer and 4-pyridoxic acid values of these subjects should
      be of use in the establishment of normal ranges of these congeners in women.

PMID- 1742550
TI  - Determination of short-chain fatty acids in equine caecal liquor by ion exchange
      high performance liquid chromatography after solid phase extraction.
AB  - A high performance liquid chromatography (HPLC) method was developed for the
      determination of seven short-chain fatty acids in equine caecal liquor. Samples
      were cleaned up on a Sep-pak (C18) cartridge, and the analyte was eluted from the
      extraction cartridge and filtered through a 0.45 micron cellulose nitrate filter.
      The analyte was chromatographed by ion exchange HPLC. Detection was by UV at 210
      nm. Recovery from phosphate buffer (0.05 M, pH 7.0) and equine caecal liquor was
      76.95% (lactic), 76.76% (valeric). The limit of (propionic), 89.35% (isobutyric),
      88.73% (butyric), 80.33% (isovaleric) and 72.61% (valeric). The limit of
      detection of the short-chain fatty acids in phosphate buffer was 0.00006 M
      (lactic), 0.0001 M (acetic), 0.0002 M (propionic), 0.0001 M (isobutyric), 0.0002
      M (butyric), 0.0002 M (isovaleric) and 0.0003 M (valeric). The specificity and
      sensitivity of this method was sufficiently high to allow the characterization of
      the pattern of these short-chain fatty acids in equine caecal liquor following
      intravenous administration of oxytetracycline at the recommended dose rate in a
      pony.

PMID- 1742551
TI  - Comparative performance of ion exchange and ion-paired reversed phase high
      performance liquid chromatography for the determination of nucleotides in
      biological samples.
AB  - We have compared anion exchange chromatography on APS-Hypersil (4.6 x 100 mm)
      eluted with a phosphate gradient with reversed phase chromatography on ODS
      Hypersil (4.6 x 100 mm) in the presence of either tetrabutylammonium (TBA) or
      triethylammonium (TEA) ions with a methanol gradient. The systems have been
      compared both for ease of operation and for their resolving power with standard
      mixtures and acid extracts of both normal red cells (RBC) and ischaemic tissues.
      The two chromatographic modes exhibited similar separating efficiencies for
      standard mixtures of nucleotides but retention times were most stable using
      reversed phase liquid chromatography (RPLC) with TEA. Anion exchange columns
      slowly lost ion exchange capacity but selectivity was unchanged. RPLC in the
      presence of TBA gave reproducibile capacity factors only when operated
      isocratically due to irreversible changes to the silica surface. For RBCs the
      RPLC with TEA and anion exchange systems resolved 17 and 15 peaks, respectively,
      and for the ischaemic samples 22 and 14 peaks, respectively. However, nucleosides
      and bases were also resolved by the ODS column causing chromatographic crowding
      and uncertain peak identification.

PMID- 1742552
TI  - Solid phase extraction of oxcarbazepine and its metabolites from plasma for
      analysis by high performance liquid chromatography.
AB  - A rapid, sensitive and simple-to-operate high performance liquid chromatographic
      method for the simulataneous determination of oxcarbazepine, 10
      hydroxycarbazepine and 10,11-dihydro-10,11-trans-dihydroxy-carbamazepine in
      plasma is described. The drug and its metabolites were extracted from plasma
      using commercially available reversed phase octadecylsilane bonded-silica columns
      (Bond Elut C18, 1 mL capacity). Chromatographic separation of oxcarbazepine and
      its metabolites was achieved using a mobile phase consisting of
      acetonitrile/methanol/water (13:25:62 by volume) at a flow rate of 1.2 mL/min in
      conjunction with a Waters Associates Nova-Pak C18 column. The analytical column,
      in Radial-Pak cartridge form, was used in combination with a LiChrospher 5
      microns C18 guard column. By measuring the UV absorbance at 214 nm, plasma levels
      in the region of 50-100 ng/mL for the drug and its metabolites can be detected
      with only 100 microL of plasma. The method has been applied to pharmacokinetic
      studies of oxcarbazepine and its metabolites in children with epilepsy;
      preliminary pharmacokinetic findings in two patients at steady-state are
      presented.

PMID- 1742553
TI  - Automated quantitative microcolumn chromatography of haemoglobin A2.
AB  - Automated cation exchange microcolumn chromatography of haemoglobins has been
      modified for the analysis of haemoglobin A2. It provides the quantitative data of
      sufficient precision and specificity for the investigation of potential
      heterozygotes for beta-thalassaemia. Results have been compared with an
      established method of electrophoresis followed by densitometry of the eluted
      bands.

PMID- 1742554
TI  - Liver high performance liquid chromatographic porphyrin profiles in experimental
      porphyria induced by peroxidizing herbicides.
AB  - The effect of peroxidizing herbicides on the liver porphyrin content of
      experimental animals was examined. Mice treated with the herbicide oxadiazon
      accumulated uroporphyrin and protoporphyrin in the liver. Formesafen-treated mice
      accumulated uroporphyrin and heptacarboxylic porphyrin.

PMID- 1742555
TI  - Results of speech perception and speech production training for three
      prelingually deaf patients using a multiple-electrode cochlear implant.
AB  - Five studies were conducted to measure changes in the perception and production
      of selected speech targets, with training, in three prelingually deaf patients.
      The two adults and one adolescent were implanted with the Cochlear (Nucleus)
      multiple-electrode prosthesis. The studies were perception and production of
      nasal consonants; perception of syllable-final consonants; perception and
      production of alveolar consonants; auditory-visual perception of alveolar
      consonants; and perception and production of vowels. Perceptual data were
      collected in the audition (implant)-alone condition, except for the auditory
      visual perception of alveolar consonants where the audition-alone, vision-alone,
      and auditory-visual conditions were used. Speech perception data in the audition
      alone condition were also collected from four postlingually deaf adult implant
      patients, without training, to indicate differences between the two classes of
      patients. The three prelingually deaf patients generally showed some improvements
      in speech production. In perception, improvements were recorded only for
      individual patients in some studies. The performance of the adolescent was better
      than that of the two adults in all cases. The perceptual performance of the
      postlingually deaf patients was superior to that of the prelingually deaf
      patients in all cases.

PMID- 1742556
TI  - The influence of eye colour on susceptibility to TTS in humans.
AB  - In order to investigate the function of the inner ear melanin, noise-induced
      temporary hearing loss (temporary threshold shift, TTS) was studied in humans
      with either blue or brown iris colour. Sixty-eight normally hearing teenage boys
      participated in this study. Hearing thresholds before and after exposure were
      established with a computerized sweep frequency audiometer in the frequency range
      0.8-8 kHz. The noise exposure consisted of a 1/3 octave band-filtered noise with
      centre frequency 2 kHz at 105 dB SPL for 10 min. The mean TTS in the frequency
      range 2-8 kHz showed a significant difference with the brown-eyed subjects
      developing least TTS, and the blue-eyed subjects most TTS.

PMID- 1742557
TI  - Earmoulds: some benefits from horn fitting.
AB  - The narrow bore of conventional hearing aid earmoulds restricts the transmission
      of higher auditory frequencies. For subjects with moderate to severe high
      frequency hearing loss this is likely to have an adverse effect on the perception
      and recognition of phonemes with high-frequency components. Twenty-two subjects
      with predominantly high-frequency hearing loss underwent a series of tests to
      compare the performance of earmoulds having conventional 1.9 mm through-tubing
      with earmoulds fitted with a smooth horn with a final internal diameter of 4 mm.
      The test battery comprised free-field Bekesy audiometry, in-the-ear pressure
      measurement, speech audiometry using AB word lists and semantic differential
      rating of the relative sound quality of the two systems. Subjectively the horn
      fitting was rated as clearer, more natural, undistorted and acoustically
      comfortable. Objectively, by both Bekesy audiometry and in-the-ear pressure
      measurement, the horn gave more gain in the higher auditory frequencies. With the
      horn there was improved recognition of phonemes, especially fricatives and
      affricatives.

PMID- 1742558
TI  - A new toy test to investigate the hearing status of young children who have
      English as a second language: a preliminary report.
AB  - The aim of this study was to produce a word list suitable for children aged
      between 2 and 6 years with English as a second language (E2L) to be used in the
      format of a toy test to evaluate hearing status. Two lists of English words were
      compiled using words previously shown to be among the early English words learned
      by children from the Indian sub-continent. These word lists were evaluated in a
      group of 56 children who had recently arrived from Bangladesh. The results of
      this study yielded a final word list of 12 words, arranged into six pairs of
      words with matched vowels. This final word list, used in the E2L Toy Test, is
      currently being evaluated in a multi-centre study, for children between the ages
      of 3 and 6 years.

PMID- 1742559
TI  - A survey of New Zealanders with tinnitus.
AB  - A sample of 338 New Zealanders regularly experiencing tinnitus completed
      questionnaires posted to associations for people with tinnitus or hearing
      impairment. Nearly half the sample was sometimes depressed by tinnitus; those
      reporting depression and those reporting more severe problems as a consequence of
      their tinnitus saw more health-care professionals and used more coping
      strategies. Most respondents did not remember exactly when they first noticed
      their tinnitus; those that did reported a range of events that might have
      precipitated it. Respondents who sought medical help generally rated
      professionals as sympathetic, but few had been offered effective treatment.
      Comparison of the tinnitus sample with a sample of university students and staff
      indicated that though the respondents of the university sample often had some
      experience of tinnitus they reported sensations rather different from those of
      the tinnitus sample.

PMID- 1742560
TI  - Assessing hearing problems within a community survey.
AB  - Community surveys are increasingly being used as a method of collecting health
      and lifestyle data. This report describes the use of a simple question on hearing
      difficulties within such a survey. A systematic sample of 2.5% of the electoral
      register of the four Parliamentary constituencies of Cardiff, Wales, was drawn.
      Of the 5145 individuals in the sample, 83% responded. Age and social class
      explained much of the variability in reported hearing difficulties. A recent fall
      and cigarette consumption were associated with hearing problems, but the
      contribution of alcohol consumption while potentially important did not reach
      statistical significance. This self-administered community survey provided
      hearing data which are consistent with other specialized studies and is a viable
      route for the assessment of community needs.

PMID- 1742561
TI  - Extratympanic electrocochleography with a conductive fluid and flexible
      electrode.
AB  - Poor electrical stability of the recording electrode contact is often responsible
      for unstable recording conditions in extratympanic electrocochleography (ECochG).
      We present a new method with a large contact area formed by conductive fluid
      effectively penetrating the non-conductive film of wax and epidermis down to
      conductive tissue. The need for special cleaning of the external auditory meatus,
      often involving uncomfortable scratching of the sensitive area close to the
      tympanic membrane, has been eliminated, reducing the risk of infection and
      markedly improving the patient's test tolerance. Stable electrical contact
      improves the recording quality. We discuss a simplified clinical method, a new
      type of electrode, and patient risk factors as a result of possible accidental
      electrode movement.

PMID- 1742562
TI  - Prediction of hearing thresholds in children using an automated toy
      discrimination test.
AB  - A previous paper described the development of the prototype of a semi-automated,
      sensitive and accurate version of the McCormick Toy Discrimination Test. In this
      report we describe a further development of the hardware, and demonstrate that
      results obtained from the automated test provide a basis for estimating the mean
      elevation of pure-tone threshold in the child's better ear. The correlation
      between speech and pure-tone results is high. The average of the better ear pure
      tone thresholds at 0.5, 1 and 4 kHz can be predicted from the word-discrimination
      threshold obtained with the toy test, with a 95% confidence interval of +/- 11
      dB.

PMID- 1742563
TI  - Lip-reading/speech-reading (LRD/SPR) for adults. A plea for individual assessment
      to decide upon appropriate method of assistance.

PMID- 1742564
TI  - Spontaneous and evoked otoacoustic emissions.

PMID- 1742565
TI  - IgA testing for diagnosis of retroviral infections in the Caribbean.
AB  - In Guadeloupe, a Caribbean island with a high prevalence of HTLV-I infected
      subjects, the percentage of false positive results for HIV IgG is high, requiring
      additional time and expense for confirmatory tests. This article describes a
      simple way of overcoming this problem. First, all IgG and IgG immune complexes
      are removed by protein G treatment, and then IgA enzyme-linked immunosorbent
      assay (ELISA) and the Western blot test are performed with minor modification of
      commercially available kits.

PMID- 1742566
TI  - Evaluation of newborn arm circumference as an indicator of low birth weight.
AB  - A sample of 1,024 newborns in Recife, Brazil, was studied to help determine the
      precision with which arem circumference measurements could be used to indicate
      low birth weight. The results support the view that when birth weight data are
      unobtainable, arm circumference measurements may be of value in screening for
      newborns needing special care.

PMID- 1742567
TI  - Behavioral response of Anopheles darlingi to DDT-sprayed house walls in Amazonia.
AB  - The behavioral response of Anopheles darlingi females to spraying of house walls
      with DDT was studied along the Ituxi River in Amazonas, Brazil, using a house
      sprayed with 2 g DDT per square meter of wall surface and an untreated house
      serving as a control. It was found that hardly any An. darlingi females entered,
      exited, or took blood meals inside the treated house after it was sprayed with
      DDT, and that specimens marked and released inside the house tended to depart
      immediately. This behavior appears to constitute true repellency rather than
      contact irritability. Since the typical house in the vicinity of the study site
      had only two walls, the persistence of malaria in the local area was probably due
      to home construction practices.

PMID- 1742568
TI  - Development of a registry for diabetes in persons 0-19 years of age in the U.S.
      Virgin Islands.
AB  - A juvenile-onset diabetes registry was recently established in the United States
      Virgin Islands. Hospital and clinic records were used as the primary sources of
      case data, while data procured through a physician survey and mass media campaign
      were used to assess the completeness and validity of the registry listings. The
      data indicated that 39 people 0-19 years old developed diabetes during the study
      period (1 January 1979-31 December 1988), of whom 36 probably had Type 1
      diabetes. Completeness of the primary source data was estimated at 92.3% and
      validity seemed very good (around 100%). Evaluation of these registry data has
      provided new insights into the epidemiology of Type 1 diabetes in the U.S. Virgin
      Islands.

PMID- 1742569
TI  - Years of productive life lost to premature mortality from cardiovascular
      diseases.
AB  - Cardiovascular diseases exact a major toll in both developed and developing
      countries in terms of death, ill health, and premature incapacitation. This
      presentation concerns itself with the economic cost--expressed in terms of years
      of economically active life lost to premature mortality--imposed by
      cardiovascular diseases in relatively developed and undeveloped regions of
      Brazil.

PMID- 1742570
TI  - A program for prevention and control of epidemic dengue and dengue hemorrhagic
      fever in Puerto Rico and the U.S. Virgin Islands.
AB  - The ongoing resurgence of Aedes aegypti in the Americas--abetted by poor mosquito
      control, urbanization, and increased air travel--has led to dengue
      hyperendemicity, more frequent dengue epidemics, and the emergence of dengue
      hemorrhagic fever (DHF). This article describes a program developed to cope with
      this situation that emphasizes disease prevention rather than general mosquito
      control measures.

PMID- 1742571
TI  - Health damage caused by the smoking habit in Chile.
AB  - The authors review available literature on tobacco use in Chile, devoting
      particular attention to smoking prevalences, smoking-related health problems,
      risk factors that tend to encourage smoking, and appropriate control measures.
      Overall, the available data indicate that roughly 40% of Chile's adult population
      smokes, that smoking among women is on the rise, that some 11% of both infant and
      general mortality can be linked to tobacco use, that smoking during pregnancy
      poses serious health risks, and that the attitudes of physicians and other health
      workers can have a crucial impact upon the smoking behavior of their patients.

PMID- 1742572
TI  - Daniel Carrion and Carrion's disease.

PMID- 1742573
TI  - Cholera in the Americas.

PMID- 1742574
TI  - Risk of cholera transmission by foods.

PMID- 1742575
TI  - Status of new cholera vaccines.

PMID- 1742576
TI  - WHO reports on HIV and HBV transmission in the health care setting.

PMID- 1742577
TI  - British Society for Rheumatology. 8th annual general meeting. London, 18-20
      September 1991. Abstracts.

PMID- 1742578
TI  - Quantitative computed tomography: comparative study using different scanners with
      two calibration phantoms.
AB  - To assess computed tomography (CT) scanners in vertebral quantitative computed
      tomography (QCT) measurement, five cadaveric vertebrae fixed in a water phantom
      were measured using 16 CT scanners of 10 different models using two types (CaCO3
      and K2HPO4) of reference phantom. Although the same reference phantoms were used,
      the QCT values varied markedly depending on the CT scanner employed. The
      differences in QCT values were greater in the equivalent amount of CaCO3 than in
      that of K2HPO4. The largest difference between CT scanners was 40 mg/cm3 in the
      equivalent amount of CaCO3 and 28 mg/cm3 in that of K2HPO4. These differences
      were reflected among CT scanners by different slopes and intercepts of the
      reference lines of CaCO3, K2HPO4 and ash density depending on the CT scanner
      used. However, good correlations (r greater than 0.97) were observed for the QCT
      values obtained by various CT scanners. These results show that QCT values on one
      machine can be compared more closely with those of another machine if conversion
      formulae, determined by using materials equivalent to human vertebral bone, are
      employed.

PMID- 1742579
TI  - Initial investigation of childhood urinary tract infection: does the plain
      abdominal X ray still have a role?
AB  - To reassess the plain abdominal X ray (AXR) in the initial investigation of
      childhood urinary tract infection, radiologists from four paediatric units
      prospectively collected data on the yield from the AXR in 683 children. Five
      children had renal calculi. All were detected on ultrasound, but one was not
      visible on the initial AXR. Four spinal abnormalities were identified, none of
      which prompted any action by the clinician involved. While the costs, in both
      financial and radiation risk terms, may be small, the benefit of the AXR appears
      equally small. Where expert paediatric ultrasonography is available we would
      recommend that the AXR be reserved for patients with haematuria, loin pain,
      family history of calculus disease, or where further urinary tract infection
      occurs despite a normal ultrasound scan.

PMID- 1742580
TI  - Floating thrombi: diagnosis and follow-up by duplex ultrasound.
AB  - The clinical features and evolution of floating thrombi (FT) diagnosed by duplex
      ultrasound were examined. In 76 consecutively diagnosed above-knee deep venous
      thromboses the prevalence of FT was 18%. Of 44 FT diagnosed in 39 patients, 18
      (39%) were located in the common femoral, 12 (26%) in the popliteal and seven
      (15%) in the external iliac veins. Serial duplex examinations revealed that 31%
      of FT in the iliofemoral segment disappeared 33% remained unchanged and 36%
      adhered to the vein wall within 2 weeks following diagnosis. After 3 months, 87%
      of the floating segments had disappeared, irrespective of the localization or
      therapeutic regimen. Thirteen patients experienced pulmonary embolism before
      (12/13) or following (4/13) diagnosis of floating thrombosis; three of four
      superficial femoral vein FT embolized. Fifteen per cent of the patients with FT
      died during the study period and 28% of the thrombi were associated with a
      malignant neoplasm; the incidence of malignancy was 60% in superficial and 39% in
      common femoral vein FT.

PMID- 1742581
TI  - Chest radiograph scoring system for use in pre-term infants.
AB  - A scoring system to characterize the pre-term infant's chest radiograph
      appearance has been evaluated. Chest radiographs taken at 1 month of age in 20
      infants (median gestational age 27 weeks) were scored according to abnormalities
      of lung volume, presence of opacification, interstitial changes and cystic
      elements (maximum score 17). The median score was 4 (range 1-14); the highest
      scores were for the only infants with cystic elements and/or interstitial changes
      on their chest radiographs. The scoring system documented accurately the severity
      of neonatal respiratory distress; the highest scores occurred in those infants
      requiring the most prolonged respiratory support, i.e. ventilated beyond 1 week
      of age (p less than 0.01) and oxygen-dependent beyond 1 month (p less than 0.01).
      It was also a useful predictor of chronic respiratory problems, with an 88%
      sensitivity in the detection of infants with the most severe lung function
      abnormalities at 6 months of age.

PMID- 1742582
TI  - Computed tomography attenuation measurements for the characterization of hepatic
      haemangiomas.
AB  - The attenuation values of 21 hepatic haemangiomas in 19 patients were measured on
      non-enhanced computed tomographic (CT) scans and compared with the attenuation of
      adjacent liver and the inferior vena cava (IVC). The attenuation of hepatic
      haemangiomas was lower than that of the surrounding liver, but there was no
      correlation between these two measurements. There was a highly significant
      correlation between the attenuation of haemangiomas and blood in the vena cava (r
      = 0.905, p less than 0.001). All the haemangiomas had attenuations within 7 HU of
      caval blood. By comparison, in 34 hypodense hepatic lesions that did not show
      contrast-enhanced appearances characteristic of haemangioma, there was no
      significant correlation between the attenuation of the lesions and the IVC.
      Nineteen (56%) of these lesions had attenuations differing more than 7 HU from
      that of caval blood. The influence of this observation on the requirement for
      dynamic contrast-medium-enhanced and delayed post-contrast CT in the assessment
      of hepatic lesions is discussed.

PMID- 1742583
TI  - Comparative performance in vitro and in vivo of Lunar DPX and Hologic QDR-1000
      dual energy X-ray absorptiometers.
AB  - The measured absolute bone mineral density values of spine and femur and their
      precision were compared on two dual energy X-ray absorptiometers, the Lunar DPX
      and the Hologic QDR-1000. There were systematic differences between the two
      systems, the Lunar DPX always giving a higher bone density value. The ratio of
      the mean Lunar DPX/Hologic QDR-1000 bone density measurements obtained in vivo
      was 1.13 g/cm2 for spine (L2-L4) and 1.20-1.43 g/cm2 for femur measurements. For
      both systems, short- and long-term precision (coefficient of variation) was below
      0.5% for spine in vitro measurements and below 1.5% for neck of femur in vitro
      measurements. Precision of in vivo measurements was less good, especially for
      femur measurements. The coefficient of variation of spine measurements was
      dependent on bone density and deteriorated with decreased bone mineral density
      and increased body thickness.

PMID- 1742584
TI  - Registration of MR and CT images for skull base surgery using point-like
      anatomical features.
AB  - We have developed a registration technique for combining magnetic resonance
      imaging (MRI) and computed tomography (CT) images of the skull base for use in
      surgical planning. The technique is based on user identification of point-like
      landmarks visible in both modalities. The combination of images involves a small
      amount of expert interaction, is relatively quick and preliminary evaluation
      indicates that it is accurate to within 1.5 mm. Registered or fused images can be
      viewed either on an image processing workstation, or fused images can be printed
      onto conventional film for convenience in clinical use. We present one patient in
      order to demonstrate the technique's indications and advantages.

PMID- 1742585
TI  - Long term results of Cathetron high dose rate intracavitary radiotherapy in the
      treatment of carcinoma of the cervix.
AB  - Between 1967 and 1974, 371 patients with carcinoma of the cervix have been
      treated by a combination of external beam radiotherapy and fractionated high dose
      rate brachytherapy using the Cathetron. A retrospective review was undertaken in
      1986 and median follow-up time was 6 years. Life table analysis of survival and
      complications to 16 years was undertaken. International Federation of Gynaecology
      and Obstetrics (FIGO) stage distribution was 26%, 46% and 28% for Stages I, II
      and III, respectively, and 5 year survival was likewise 94% 63% and 37%. Age and
      histological type or grade were not found to influence survival. Recurrent
      disease was recorded in 142 patients; the first site was within the pelvis in 25%
      and as distant metastases in 17%. Following development of pelvic recurrence
      median survival was 28 weeks. Salvage surgery was performed in 32 patients, of
      whom five probably obtained survival benefit. Significant late morbidity was seen
      in a total of 71 patients (19%); in seven patients this was at more than one
      site. Late morbidity to the small bowel was recorded as Grade 2 in 10 patients
      and Grade 3 in 13; to the rectum, Grade 2 in 10 patients and Grade 3 in two
      patients; to the bladder, Grade 2 in 15 patients and to the vagina Grade 2 in 29
      patients. Median time to onset for small bowel morbidity was 14 months, for
      rectum 18 months, for vagina 20 months and for bladder 52 months. 82% of all late
      morbidity had been seen by 5 years of follow-up, no case of late morbidity of
      recurrence was seen between 11 and 18 years of follow-up. These results are
      comparable to those reported for other methods in use at the time the patients
      were treated.

PMID- 1742586
TI  - Treating the vaginal vault in carcinoma of the endometrium using the Buchler
      afterloading system.
AB  - The advent of high-dose-rate afterloading intracavitary radiotherapy has
      implications for both staff safety and the possibility of convenient, outpatient
      based treatment for the patient. We have carried out a retrospective analysis of
      its use with high-activity iridium 192 and the Buchler machine to treat the
      vaginal valut in patients with adenocarcinoma of the endometrium, most of whom
      also received external-beam radiotherapy to the pelvis. We have compared the
      survival, complication and local control rates with a comparable group of
      historical controls treated with low-dose-rate intracavitary caesium ovoids.
      Complication rates, which included vaginal stenosis not volunteered by the
      patient, were 16% (95% confidence intervals 6-26%) in the study group and 28%
      (95% confidence intervals 17-41%) in the control group, with no serious
      complications requiring surgery. The actuarial survival was 92% at 5 years in the
      study group, and 94% at 5 years in the control group. Local control was 94% at 5
      years in the control group and 98% at 5 years in the study group. The authors
      suggest that the use of high-dose-rate intracavitary radiotherapy, with the
      Buchler afterloading system, for vaginal vault irradiation in carcinoma of the
      endometrium is a convenient, safe and quick method, which does not necessitate
      admission or sedation of the patient. In addition it provides complete radiation
      protection for staff.

PMID- 1742587
TI  - A phantom for the measurement of contrast detail performance in film-screen
      mammography.
AB  - A National Breast Cancer Screening Programme, based on X-ray mammography, has
      been introduced in the UK. The success of this screening programme is dependent
      on the production of high quality radiographs. There are various methods of
      assessing imaging performance in mammography, but contrast detail detectability
      measurements have an advantage in that the observation of radiographs is taken
      into consideration. The design and construction of a contrast detail phantom for
      the assessment of image quality in mammography is described. This phantom can be
      used to assess the imaging performance of mammographic film-screen combinations.
      The results of some measurements to verify the accuracy of the contrast
      predictions are presented together with some initial results of an investigation
      into the contrast detail performance of film-screen combinations used in
      mammography.

PMID- 1742588
TI  - Three-dimensional (3D) ultrasound imaging of the gallbladder and dilated biliary
      tree: reconstruction from real-time B-scans.

PMID- 1742589
TI  - Neonatal hepatic calcification in subcapsular haematoma with hydrops fetalis.

PMID- 1742590
TI  - Oesophageal ruptures complicating balloon dilatation of strictures: a report of
      two cases.

PMID- 1742591
TI  - Relapsing polychondritis: report of an unusual case and a review of the
      literature.

PMID- 1742592
TI  - Thorium dioxide, forgotten but not gone.

PMID- 1742593
TI  - Radiological manifestation of elastofibroma: a case report and review of the
      literature.

PMID- 1742594
TI  - Nitrous oxide--radiosensitizer or radioprotector?

PMID- 1742595
TI  - Percutaneous femoral artery puncture: practice and anatomy.

PMID- 1742596
TI  - How and why are ultrasonic scanners chosen?

PMID- 1742597
TI  - Cholangiography in liver transplantation: a comparison of two types of biliary
      reconstruction.
AB  - Orthotopic liver transplantation has been performed in Birmingham since 1982. Two
      types of biliary reconstruction have been used, the choledocho-choledochostomy
      and the choledocho-cholecysto-choledochostomy (gallbladder (GB) conduit). A
      retrospective study was undertaken to compare the biliary tract complications
      encountered at cholangiography in these two groups to assess which reconstruction
      is safest. In the gallbladder (GB) conduit reconstruction, the incidence of
      biliary leakage (20.4%) and stricture formation (14.4%), the two most serious
      complications, was higher than in end-to-end duct anastomosis (11% and 10%,
      respectively), though these differences did not reach statistical significance.
      This supports evidence from other centres that the choledocho-choledochostomy is
      the procedure of choice to minimize biliary complications. Biliary debris (14.2%)
      presented additional problems and was strongly associated with biliary
      strictures. T-tube related problems were least troublesome. The close
      relationship between hepatic artery occlusion and biliary complications,
      particularly leakage, noted in other studies is also emphasized.

PMID- 1742598
TI  - Low-frequency sensitivity in a gerbilline rodent, Pachyuromys duprasi.
AB  - The contribution of the bulla to low-frequency hearing capability was studied in
      the gerbilline rodent Pachyuromys duprasi. In the frequency range of 0.6-3 kHz,
      the sound pressure behind the tympanic membrane is higher than the pressure in
      the meatus acusticus externus near the eardrum. Gradual augmentation of
      frequencies above 0.6 kHz gives rise to steadily increasing phase lag in the
      bulla relative to that in the meatus. Severing of the incudostapedial joint
      yields results indicating that the phase difference between meatus and bulla is
      caused by resonance properties of the bulla and resistance in the cochlea. Both
      destruction of the bulla and stiffening of the pars flaccida tympani lead to a
      sound pressure decrease in the frequency range around 2 kHz. This drop is
      accompanied by an amplitude decrease of the same magnitude in the cochlear
      microphonic potentials. These results support the hypothesis that the bulla
      functions like a Helmholtz resonator in the frequency range of 1-3 kHz, improving
      sound transduction to the cochlea. These experimental findings, in conjunction
      with theoretical considerations involving bulla volume, orifice area of the
      resonator, and resonance frequency of the bulla, suggest that the theoretically
      required area of the resonator's orifice is, in fact, of the same magnitude as
      the area of the pars flaccida tympani. The middle-ear system of P. duprasi thus
      consists of a resonating bulla in which the area of the pars flaccida tympani
      constitutes the resonator's opening towards the meatus and in which the pars
      tensa tympani functions as a pressure gradient receiver, due to phase differences
      caused by the resistance of the cochlea and by the resonance properties of the
      bulla. By these functional principles the peripheral auditory system of P.
      duprasi is capable of low-frequency perception despite the smallness of its
      structures. The middle ear in P. duprasi thus represents a prime example of a
      strategy: the dimensional constraints derived from a general bauplan for the
      peripheral auditory system have here been overcome.

PMID- 1742599
TI  - Retinal projections in the freshwater butterfly fish, Pantodon buchholzi
      (Osteoglossoidei). I. Cytoarchitectonic analysis and primary visual pathways.
AB  - The freshwater butterfly fish, Pantodon buchholzi, is a member of the most
      primitive radiation of teleosts. The retinofugal projections were studied in this
      fish with autoradiographic and horseradish peroxidase (HRP) methods, and the
      cytoarchitecture of the retinorecipient regions in the diencephalon and pretectum
      was analyzed with Bodian-, cresylecht-violet- and acetylcholinesterase-reacted
      sections. The rostral diencephalon of Pantodon contains a large retinorecipient
      nucleus, not previously identified in any other fish, i.e. nucleus
      rostrolateralis. Other nuclei that are described correspond to those previously
      recognized in other species. The majority of retinorecipient nuclei are positive
      for acetylcholinesterase, particularly those in the pretectum, as has been found
      in other species of teleosts. Most of the retinofugal fibers decussate in the
      optic chiasm. Some fibers project via the axial optic tract to preoptic nuclei
      and a region in the rostral hypothalamus. Fibers leave the medial optic tract to
      terminate in nucleus rostrolateralis and in dorsal and ventral thalamic nuclei,
      accessory optic and tubercular nuclei, periventricular and central pretectal
      nuclei, and sparsely in the deep tectal fascicle and terminal field. Dorsal optic
      tract fibers project to the dorsal accessory optic nucleus, superficial and
      central pretectal nuclei, and superficial and deep tectal layers. Ventral optic
      tract fibers project to the superficial pretectum, accessory optic nuclei,
      posterior tuberculum, nucleus corticalis in the central pretectum, and
      superficial tectal layer. Fibers that remain in the ipsilateral optic tract
      project to most of the targets reached by contralaterally projecting fibers. A
      few fibers in the contralateral medial optic tract redecussate via the posterior
      commissure to reach the ipsilateral periventricular pretectum. No labeled
      retinopetal cells caudal to the olfactory bulb were identified in any of the HRP
      cases.

PMID- 1742600
TI  - Retinal projections in the freshwater butterfly fish, Pantodon buchholzi
      (Osteoglossoidei). II. Differential projections of the dorsal and ventral
      hemiretinas.
AB  - Pantodon buchholzi, the freshwater butterfly fish, is a member of the
      Osteoglossomorpha, the most primitive of the four major teleost radiations. The
      projections of fibers originating in the dorsal and ventral hemiretinas in
      Pantodon, as determined with autoradiography, are reported here. Fibers
      originating in the ventral hemiretina reach their targets through the axial,
      medial and dorsal optic tracts. Fibers that originate in the dorsal hemiretina
      reach their points of termination by way of the axial, medial and ventral optic
      tracts. Projections of the various tracts to preoptic, thalamic, tubercular,
      pretectal and tectal regions, as described in the previous study of total retinal
      projections, were verified. The retinal projections to the preoptic, thalamic and
      tubercular nuclei do not map topographically. Ventral hemiretinal fibers are
      mapped, however, onto the dorsal part of the nucleus pretectalis superficialis
      pars parvocellularis, the rostral part of the dorsal accessory optic nucleus, the
      entire nucleus pretectalis periventricularis pars ventralis and the dorsomedial
      portion of the optic tectum. Ventral hemiretinal fibers also supply most if not
      all the retinal innervation to the central pretectal nucleus. In contrast, dorsal
      hemiretinal fibers are mapped onto the ventral part of nucleus pretectalis
      superficialis pars parvocellularis, the entire dorsal accessory optic nucleus and
      the ventrolateral portion of the optic tectum. The dorsal and ventral hemiretinal
      projections to the tectum about at a cytoarchitectonically recognizable point,
      indicating that no discontinuity is present in the retinal connectivity with the
      tectum. The pars parvocellularis of nucleus pretectalis superficialis is a
      simple, unfolded, and nonlaminar structure in Pantodon. This structure contrasts
      markedly with the more complex, folded structure of the nucleus in the majority
      of other examined teleosts. The orientation of the projections from the dorsal
      and ventral hemiretinas onto this nucleus in Pantodon is congruent with that seen
      in other fishes only after a schematic unfolding of the nucleus in these fishes.

PMID- 1742601
TI  - Comparative cytoarchitectonic analysis of some visual pretectal nuclei in
      teleosts.
AB  - The posterior pretectal nucleus, which in Osteoglossum receives second order
      visual input and projects to the inferior lobe of the hypothalamus, was
      identified and characterized in species from all major groups of non-neoteleost
      teleosts. The hypothesis that the posterior pretectal nucleus in these species is
      homologous to both the pars intermedius of the superficial pretectal nucleus and
      nucleus glomerulosus in acanthopterygians is supported by multiple similarities
      in relative position and cytoarchitecture. Nucleus corticalis, which receives
      retinal input and projects to the posterior pretectal nucleus (or to nucleus
      glomerulosus), was identified in species belonging to three of the four major
      teleost radiations. Both the posterior pretectal nucleus and nucleus corticalis
      are plesiomorphic for teleosts. The presence of glomeruli in the posterior
      pretectal nucleus and nucleus glomerulosus in esocids and acanthopterygians,
      respectively, and the presence of two nuclei, the pars intermedius and nucleus
      glomerulosus, in acanthopterygians, as opposed to one nucleus, the posterior
      pretectal nucleus, are apomorphies.

PMID- 1742602
TI  - Isolation of a rat S100 alpha cDNA and distribution of its mRNA in rat tissues.
AB  - In order to clarify the reported discrepancies in S100 alpha protein and mRNA
      distribution in rat tissues, a rat S100 alpha cDNA has been isolated and this
      species homologous probe along with a rat S100 beta cDNA probe has been used to
      examine S100 mRNA expression in rat tissues. Although the rat S100 alpha cDNA was
      missing approximately 30 nucleotides of coding sequence, only 4 conservative
      changes in amino acid sequence were observed when the deduced amino acid sequence
      was compared to the bovine S100 alpha amino acid sequence. Thus, S100 alpha
      proteins, like S100 beta proteins, are highly conserved among species. All
      nineteen of the tissues examined (including cerebrum and cerebellum) contained
      S100 alpha mRNA. In addition, S100 beta mRNA was detected in thirteen of the
      nineteen tissues examined. These results are in agreement with previous protein
      distribution studies and further demonstrate that S100 proteins are not brain
      specific and are expressed in a large number of tissues. Although S100 alpha and
      S100 beta mRNAs were detected in rat tissues which had previously been reported
      to contain S100 alpha and S100 beta protein, a direct correlation between the
      protein and mRNA levels were not observed, suggesting that different mechanisms
      regulate S100 expression in various tissues. S100 alpha exhibited a single
      similar size mRNA species (0.5 Kb) in all tissues examined, as did S100 beta (1.5
      Kb), suggesting that the individual S100 proteins are expressed as single mRNA
      and protein products in rat tissues.

PMID- 1742603
TI  - Nucleus A10 dopaminergic neurons in inbred mouse strains: firing rate and
      autoreceptor sensitivity are independent of the number of cells in the nucleus.
AB  - Inbred mouse strains have different numbers of midbrain dopaminergic neurons; for
      example, BALB/cJ mice have 20-25% more neurons than CBA/J mice. As the number of
      cells decrease, for example in Parkinson's disease and in animals with midbrain
      dopaminergic cell lesions, the activity of their remaining cells increases. The
      purpose of the present experiment was to determine whether the functional
      properties of dopaminergic neurons in the ventral tegmental area (nucleus A10)
      differ in inbred mouse strains which possess different numbers of cells. The
      firing rate and autoreceptor sensitivity of A10 dopaminergic cells were examined
      in the in vitro slice preparation in BALB/cJ, C3H/HeJ, CBA/J, and DBA/2J mouse
      strains. It was observed that the autoreceptors on mouse dopaminergic neurons
      exhibit pharmacological properties of dopamine autoreceptors; activation of the
      autoreceptor produced a marked inhibition (50-70%) in cell firing rate by
      quinpirole (10(-8) M), LY-141865 (10(-7) M), (+)-3-(3-hydroxyphenyl)-N-n-propyl
      piperidine (10(-6) M), propyl-norapomorphine (10(-5) M) and dopamine (10(-4) M),
      and this inhibition was blocked or reversed by specific dopamine D2 receptor
      antagonists [(-) sulpiride and spiroperidol, 10(-6) M]. The baseline firing rates
      of the A10 cells did not differ among the four inbred strains [range 2.5 +/- 0.2
      (C3H/HeJ)-3.4 +/- 0.3 (CBA/J) spikes/s +/- SEM], and there was no significant
      difference in autoreceptor sensitivity among the mouse strains as assessed either
      by superfused dopamine (inhibitory dose 50% approximately 150 microM), or by
      superfused quinpirole (inhibitory dose 50% approximately 10 nM).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1742604
TI  - Biogenic amine localization in cardiac ganglion intrinsic neurons: electron
      microscopic histochemistry of SIF cells.
AB  - The parasympathetic cardiac ganglion in the mudpuppy, N. maculosus, contains
      postganglionic nerve cells and intrinsic neurons, many of which are small
      intensely fluorescent (SIF) cells. Several bioactive substances have been
      localized in the intrinsic nerve cells which may have integrative effects at
      synapses within the ganglion. Ganglionic intrinsic neurons can be identified
      electron microscopically by the presence of numerous cytoplasmic granular
      vesicles 80-120 nm in diameter. Throughout the ganglion there are bundles of
      unmyelinated fibers some of which are filled with granular and agranular vesicles
      and axosomatic terminals with similar vesicles synapsing on principal
      parasympathetic nerve cells. To understand the aminergic contribution to
      ganglionic synaptic circuitry the chromaffin reaction was used. The intrinsic
      neurons (i.e., SIF cells) were readily identified by their characteristic
      intracellular granule population. All intrinsic nerve cells identified showed
      granules which were positively labelled by the chromaffin reaction. Granular
      vesicles in synaptic profiles on principal cells (P cells) were also labelled
      indicating a direct aminergic synaptic innervation to these cells. The cell
      bodies of intrinsic neurons, ensheathed with supportive glial-like cellular
      processes, rarely received synapses. Elemental microanalysis was used to verify
      the chromium content of the electron dense product within the granular vesicles.
      These studies demonstrated direct aminergic synaptic input to at least a
      subpopulation of principal parasympathetic cells in the cardiac ganglion of
      mudpuppy.

PMID- 1742605
TI  - Effect of melatonin replacement on serum hormone rhythms in a patient lacking
      endogenous melatonin.
AB  - A potentially confounding variable inherent in studies designed to examine the
      effect of melatonin administration in humans is the presence of an endogenous
      melatonin rhythm in the experimental subjects. The effects of exogenous melatonin
      administration on serum hormone rhythms was recently examined in a male patient
      who lacked detectable circulating levels of endogenous melatonin. The patient's
      pineal gland had been destroyed five years previously in the course of treatment
      for a pineal astrocytoma. On three separate occasions, over approximately a one
      year period, the patient was given daily oral melatonin replacement (2 mg/day, 1
      mg/day and 0.5 mg/day). These experiments were designed to assess the effects of
      exogenous melatonin on serum growth hormone, prolactin, cortisol and testosterone
      rhythms. Analysis of blood samples collected every 2-4 hours periods both before
      and during melatonin replacement revealed that the exogenous melatonin rhythm was
      associated with improvements in self-reported sleep and mood ratings. Melatonin
      administration produced robust nocturnal peaks in serum growth hormone and
      prolactin levels immediately following ingestion of the hormone, while serum
      cortisol and testosterone rhythms were not influenced. These results suggest that
      melatonin may modulate the coordination and enhancement of selected biological
      rhythms in man.

PMID- 1742606
TI  - Identification of a mouse brain beta-spectrin cDNA and distribution of its mRNA
      in adult tissues.
AB  - A mouse brain beta-spectrin of cDNA was identified within a lambda Gt11
      expression library using an antibody which specifically binds with the 235 kDa
      spectrin beta-subunit. Restriction mapping and DNA sequencing analyses of the
      brain cDNA revealed that this clone contained 1185 bp of sequence, of which a 999
      bp single open reading frame encoding 333 amino acids was determined. The deduced
      amino acid sequence exhibited homology with beta-spectrins, demonstrating the
      characteristic 106 amino acid repeating unit. The homology between our mouse
      brain sequence and human RBC beta-spectrin was approximately 56% beginning at the
      beta 15 repeat unit and extending to the C-terminus of sequence elucidated for
      human RBC sequence. An additional 62 amino acids were found at the C-terminus of
      the 235 kDa brain beta-spectrin subunit not seen in the human RBC sequence. The
      approximately 1.2 Kb brain spectrin cDNA insert hybridized with a single 9 Kb
      mRNA transcript in various adult mouse tissues, with the most abundant
      hybridization demonstrated in RNA isolated from brain tissue. This mRNA was found
      to be present at high levels in heart tissue and at lower levels in spleen and
      skeletal muscle tissue. The 9 Kb mRNA was different in content and in size to
      mRNAs which hybridized with a cDNA encoding the mouse erythroid beta-spectrin
      subunit, demonstrating that the brain spectrin cDNA is a distinct gene product
      and represents the first known sequence of a nonerythroid beta-spectrin subunit.

PMID- 1742607
TI  - The effect of synapsin I phosphorylation upon binding of synaptic vesicles to
      spectrin.
AB  - We have previously demonstrated that brain spectrin is attached to small
      spherical synaptic vesicles via synapsin I. These studies utilized a novel
      microfiltration assay in which 125I-labelled synaptic vesicles were incubated
      with brain spectrin which was covalently attached to cellulosic membranes. In
      these studies purified dephosphosynapsin I was demonstrated to competitively
      inhibit the binding of the synaptic vesicles to the immobilized brain spectrin
      with a KI = 45 nM. In the current study we demonstrate that phosphorylation of
      synapsin I site 1 (0.74 mol Pi/mol synapsin I) with cAMP-dependent protein kinase
      and sites 2 and 3 (2.0 mol Pi/mol synapsin I) with Ca(2+)-calmodulin kinase II
      had little effect upon its interaction with brain spectrin. cAMP-dependent
      protein kinase phosphorylated synapsin I and Ca(2+)-calmodulin kinase II
      phosphorylated synapsin I both inhibited the binding of 125I-labelled synaptic
      vesicles to immobilized brain spectrin with a KI of 23 nM and 24 nM respectively.
      We conclude that phosphorylation of synapsin I does not down-regulate the
      interaction of synaptic vesicles with brain spectrin.

PMID- 1742608
TI  - Comparison of the effects of acute and chronic ibotenic and quisqualic acid
      nucleus basalis lesioning.
AB  - The present study examines the effects of acute (1 month recovery) and chronic (8
      month recovery) bilateral quisqualic (quis) and ibotenic (ibo) acid nucleus
      basalis (NB) lesioning on the activity of cholinergic neurons and on passive
      avoidance (PA) and water-maze (WM) performance. Our data demonstrate that A: The
      activity of choline acetyltransferase (ChAT) in cortical tissue and the number of
      ChAT positive neurons in the NB were decreased 1 and 8 months after quis or ibo
      NB lesioning. B: Ibo NB lesioning produced a greater nonspecific subcortical cell
      loss than quis NB lesioning. C: PA retention was impaired by acute and chronic
      quis and ibo NB lesioning. D: Acute ibo NB lesioning impaired acquisition and
      reversal learning in WM performance whereas chronic ibo NB lesioning impaired
      only reversal WM learning. Acute and chronic quis NB lesioning impaired reversal
      WM learning. The present results suggest that NB cholinergic neurons do not
      recover spontaneously from excitotoxin-induced damage and that they may be
      importantly involved in inhibitory avoidance and spatial reversal learning
      performance.

PMID- 1742609
TI  - Restraint and stimulation of bed nucleus of the stria terminalis produce similar
      stress-like behaviors.
AB  - Restraint stress, electrical stimulation of the bed nucleus of the stria
      terminalis (BNST), and the combination of restraint stress and BNST stimulation
      were studied using a computerized animal activity monitoring system. Both
      restraint and the combination of restraint and BNST stimulation produced
      increases in locomotor, exploratory and stereotypic activity all of which
      returned to baseline within an hour while BNST stimulation alone also increased
      measurements of locomotor and exploratory behavior some of which remained
      elevated throughout the three-hour period of measurement. BNST stimulation also
      produced vigorous escape behavior and biting which were not seen with restraint
      alone. Thus electrical stimulation of BNST produces behavior which is
      qualitatively similar to the behavior produced by stress but differs in time
      course.

PMID- 1742610
TI  - Nigrostriatal dopaminergic cell activity is under control by substantia nigra of
      the contralateral brain side: electrophysiological evidence.
AB  - The biochemical balance between right- and left-ascending DA systems is an
      essential factor to regulate behavioral lateralization. However, there is no
      electrophysiological evidence for the regulation of interhemispheric DA systems.
      In the present paper we report electrophysiological evidence supporting the
      hypothesis that the A9 DA cells are under control of the contralateral substantia
      nigra. The activity of more than 80% of the A9 cells recorded was affected by
      contralateral SN stimulation. This is a very high proportion because the
      previously reported response of A9 cells to ipsilateral caudate stimulation is
      proportionally lower. The potency of a stimulus, estimated as the number of
      action potentials induced or inhibited by each electrical stimulation of the
      contralateral substantia nigra or by the percentage of modification in the number
      of action potentials induced or inhibited in relation to the spontaneous
      potential expected, was also high. The response to the contralateral stimulation
      was complex. Fifty-four percent of all the DA cells studied showed more than a
      single response. Forty-four percent showed at least one stimulation and at least
      one inhibition. Because 1) the percentage of cells with at least one stimulation
      (70%) was higher than the percentage of cells with at least one inhibition (56%),
      and 2) the potency of stimulations was higher than the inhibition potency, the
      present data provide evidence that contralateral control of A9 cells is mainly
      excitatory. The percentage of cells activated by contralateral stimulation was
      high, between 30 ms and 220 ms and between 400 ms and 700 ms. The probability of
      inhibition was higher than the probability of activation between 10 ms and 30 ms
      and between 230 and 380 ms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742611
TI  - Contrasting effects of stress on medial and sulcal prefrontal cortex self
      stimulation.
AB  - Male Wistar rats were subjected to either 25 controllable or uncontrollable
      footshocks and then tested for changes in fixed-interval 5-second (FI-5) self
      stimulation of the medial prefrontal cortex (MPC), sulcal prefrontal cortex (SPC)
      or nucleus accumbens (NAS). Controllable footshock caused a moderate facilitation
      of MPC self-stimulation (30% above baseline rates) but inhibited SPC self
      stimulation (32% below baseline rates). Uncontrollable footshock had no effect on
      MPC self-stimulation but inhibited SPC self-stimulation (52% below baseline
      rates). An inhibition of SPC self-stimulation was also evident 24 hours following
      controllable or uncontrollable footshock. NAS self-stimulation was unaffected by
      footshock. Changes in locomotor activity were not consistently related to changes
      in self-stimulation following footshock. These results are discussed in terms of
      the different effects of mild stress on the release of reward-relevant
      neurotransmitters in the MPC, SPC and NAS. The possible role of stress-induced
      hypoalgesia in determining the stress-induced facilitation of MPC self
      stimulation is also discussed.

PMID- 1742612
TI  - Luteinizing hormone sensitivity to naloxone in maturing male chimpanzees.
AB  - We have systematically investigated the involvement of endogenous opioids in
      gonadotropin secretion during primate sexual maturation by examining LH/FSH
      responses to gonadotropin-releasing hormone (GnRH) and changes in LH secretion
      during infusions of saline or naloxone, an opiate antagonist, in ten male
      chimpanzees between one and nine years of age. Animals were anesthetized with
      ketamine (10 mg/kg) and injected or infused IV with GnRH, naloxone or saline.
      Circulating levels of serum LH were elevated to the same extent (approximately
      400%) in response to GnRH (100 micrograms) in animals 1-5 years old (juvenile)
      and in animals 6-9 years old (pubertal). No differences were noted between the
      two groups in GnRH-stimulated levels of serum FSH. During treatment with naloxone
      (0.14 mg/kg bolus followed by 0.2 mg/kg/h maintenance infusion for 3 h), serum LH
      levels in pubertal animals were significantly (p less than 0.05) elevated by as
      much as 95% over LH levels found during treatment with saline. Juvenile animals,
      on the other hand, failed to demonstrate significant increases in serum LH
      following naloxone at the doses tested. A strong correlation (r = .84) was found
      between circulating testosterone and serum LH levels during naloxone treatment.
      These data indicate that opioid inhibition of LH secretion can be reversed by
      naloxone only when puberty is reached in chimpanzees and suggest an alteration in
      opioid regulation of GnRH near the time of puberty. The strong correlation
      between testosterone levels and LH responses to naloxone suggests that steroids
      may participate in the maturation of opioid control of LH during puberty of
      nonhuman primates.

PMID- 1742613
TI  - Chronic Ro 15-1788 treatment increases REM sleep in rats.
AB  - Administration of Ro 15-1788, a benzodiazepine antagonist (3.6 mg/kg/day in
      drinking water for 14 days), increased total sleep and rapid eye movement (REM)
      sleep in rats. Standard six-hour EEG recording periods were obtained on day 0, 1,
      3, 7, 10, 14, as well as 24 and 72 hours following withdrawal. Enhanced REM sleep
      reached significance on day 7 of continuous drug treatment and remained
      significantly increased on day 10 and 14, as well as at 24 and 72 hours following
      drug withdrawal. The present data show that chronic administration of Ro 15-1788
      increases total sleep time due to increases in REM sleep. The actions of Ro 15
      1788 presumably occur through either adenosinergic or cholinergic mechanisms.

PMID- 1742614
TI  - Anterograde neuroanatomical tract tracing with central nervous system injections
      of immunoglobulin G: a light and electron microscopic evaluation.
AB  - Normal rabbit serum (NRS) was pressure injected into the forebrain of rats to be
      tested as an anterograde neuroanatomical tracing substance. Undiluted NRS was
      stereotaxically injected into the bed nucleus of the stria terminalis (BST) with
      a 1-microliter Hamilton syringe. Postinjection survival times ranged from 24 h to
      14 days. An immunohistochemical method utilizing goat anti-rabbit IgG antibody
      was used to detect the rabbit IgG within vibratome sections. Visualization of the
      final reaction product (diaminobenzidine, DAB) was enhanced by a silver/gold
      postintensification (SGI) method. Rabbit IgG-containing neural structures were
      examined at both light and electron microscopic (EM) levels. At the injection
      site neuronal soma, dendrites and axons were filled homogeneously with the SGI
      DAB at 24 h, 48 h, 7 days and 14 days indicating local neuronal uptake, storage
      and transport of rabbit IgG. In the hypothalamus many anterogradely filled axons
      were present and displayed short collateral branches and terminals. EM
      examination revealed synaptic terminals containing IgG, without signs of
      transsynaptic transport after 14 days. Signs of retrograde transport of IgG were
      never observed. A propensity of neurons to take up, sequester and anterogradely
      transport immunoglobulin G is indicated.

PMID- 1742615
TI  - Lateralized action of androgen on development of behavior and brain sex
      differences.
AB  - Androgens have been linked to asymmetric brain development. Our results show that
      in sexually active male gerbils, the volume of the sexually dimorphic area, pars
      compacta (SDApc) of the preoptic region was positively correlated with the
      emission rate of an ultrasonic courtship vocalization. Day 1 postnatal treatment
      of female gerbils with testosterone propionate (TP, 100 micrograms, n = 16) or
      diethylstilbestrol (DES, 5 micrograms, n = 22) followed by ovariectomy and
      implantation of testosterone (T) filled silastic capsules in adulthood (day 120
      130), increased mean volumes of the SDApc (TP, 1.21: DES, 0.84 mm3 x 10(-3)) and
      a second sexually dimorphic nucleus, the suprachiasmatic nucleus (SCN) (TP, 295:
      DES, 287.7 mm3 x 10(-3] compared to control females (n = 13) also given T in
      adulthood (SDApc = 0.37, SCN = 197.0 mm3 x 10(-3)). Rates of sexually dimorphic
      ultrasonic calls emitted during sexual interactions with estrous females (TP,
      39.3: DES, 28.1 per min) were also increased relative to female controls (22.5
      per min). With both treatments, significant covariances were revealed between
      vocalization rates and the left SDApc volumes [TP (rho), rho = .74: DES, rho =
      .43], but not the contralateral nucleus. Asymmetric development was absent in
      control females which received T as adults. Lateralization was specific to the
      SDApc, since no relationship was seen between either rates of calling and SCN
      volumes, or frequencies of nonvocal sexual components and the volumes of the
      SDApc or SCN. We conclude that steroid sex hormones influence lateralization of
      brain structure related to vocal behavior. The hormonal effect, which is likely
      to involve estrogen, occurs during neonatal development.

PMID- 1742616
TI  - Anorexia and adipsia: dissociation from fever after MIP-1 injection in
      ventromedial hypothalamus and preoptic area of rats.
AB  - Certain cytokines such as tumor necrosis factor (TNF) and interleukin-1 (IL-1)
      act centrally to affect eating behavior and thermoregulation and may be involved
      in the physiological mechanisms leading to anorexia, adipsia and loss in body
      weight. The newly discovered macrophage inflammatory protein-1 (MIP-1) infused
      into the anterior hypothalamic, preoptic area (AH/POA) evokes an intense
      hyperthermia. The present experiments were designed to determine whether MIP-1
      affects the feeding mechanism in the ventromedial hypothalamus (VMH)
      independently of the thermoregulatory mechanism in the AH/POA. For the
      microinjection of MIP-1, guide cannulae were implanted stereotaxically in the rat
      just above the VMH or AH/POA. Following postoperative recovery, each unrestrained
      rat was adapted to procedures whereby body temperature and intakes of food and
      water available ad lib were monitored at predetermined intervals. When an
      efficacious dose of 5.6 picograms (pg) MIP-1 was microinjected in a volume of 0.5
      microliters into the VMH, the intake of food in the rat was reduced significantly
      in the short term and throughout the following 22 h. Within intervals of 30 min
      and 4.0 h following MIP-1, the amount of food consumed was 4.0 and 10 g,
      respectively, below that eaten by control rats given the saline solvent vehicle
      injected at the same site in the VMH. Over the entire test period, the intake of
      water was similarly significantly below that of the control rats. Whereas MIP-1
      injected into the AH/POA evoked fever accompanied by a transient decline in
      feeding, the body temperature of the rats was unaffected by the cytokine injected
      in the VMH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742617
TI  - Effects of haloperidol on motor and cognitive functioning in aged mice.
AB  - The effects of haloperidol on motor and functioning and cognitive functioning
      were studied in young (3-5 months old) and aged (20-22 months old) male mice by
      examining haloperidol-induced catalepsy and haloperidol-induced decrements in
      performance on a radial arm maze. The aged mice were much more sensitive to these
      adverse effects of haloperidol than were the young mice. Studies of the
      distribution of radioactivity from [3H]haloperidol to the brain indicated that
      the differences in sensitivity to this drug were not due to pharmacokinetic
      differences. The results demonstrate that mice are suitable for studies of aging
      induced changes in the behavioral effects of neuroleptic agents.

PMID- 1742618
TI  - Changes in physiological parameters of rat cerebrospinal fluid during chronic
      sampling: evaluation of two sampling methods.
AB  - Although rat cerebrospinal fluid (CSF) is increasingly being used in
      pharmacological and biochemical research, methodological studies on basic
      physiological data are lacking. We have determined the albumin content and number
      of erythrocytes and leukocytes in CSF obtained by two different methods of
      sampling from cisterna magna-repeated sampling from an implanted cannula and by
      repeated punctures. In the initial samples the albumin content was 0.08 +/- 0.03
      micrograms/microliters. Chronic cannulation of the cisterna magna resulted in a
      meningeal reaction with increased cell and albumin content: a reaction that could
      be reduced but not prevented by using a sterile cannula. The number of leukocytes
      but not erythrocytes was highly correlated to the albumin content. Repeated
      sampling in the absence of a permanent cannula did not significantly increase
      albumin content but carried a higher risk for erythrocyte contamination.

PMID- 1742619
TI  - [Development of genetic and molecular approaches for the diagnosis and study of
      the pathogenicity of Helicobacter pylori, agent of gastric inflammatory
      diseases].
AB  - Helicobacter pylori (H. pylori) is a small gram-negative bacillus, recently
      discovered, found in the stomach of patients with active chronic gastritis and
      duodenal ulcers. Production of a potent urease has been described as a trait
      common to all H. pylori so far isolated. To clarify the role of urease in the
      pathogenic process, as well as to engineer genetic tools useful for the diagnosis
      of H. pylori, we cloned the genes responsible for urease activity. A genomic
      library was constructed in Escherichia coli (E. coli) from the chromosomal DNA of
      the H. pylori strain 85P using a shuttle cosmind vector that we constructed in
      vitro capable of replicating both in E. coli and Campylobacter jejuni (C.
      jejuni). The genes responsible for the urease biosynthesis were cloned into E.
      coli host, then mobilized into C. jejuni where they were expressed. At least six
      different genes were shown to be required for the expression of the synthesis of
      an active enzyme; these genes belong to the same cluster and are regulated at the
      transcriptional level. The two genes encoding the two subunits of the urease
      enzyme were identified and sequenced; the products of these genes were compared
      to the other bacterial ureases. The genetic approach allowed to determine the
      amino-acid sequence of the most immunogenic antigens of H. pylori. In addition,
      it provides us with genetic tools: a 294-base pairs (bp) DNA fragment internal to
      one of the urease genes, was shown to be specific of H. pylori strains. This
      fragment was selectively amplified by polymerase chain reaction (P.C.R.) using
      two primers designed to target the urease region of all H. pylori isolates
      present in biological specimen. In addition, P.C.R. followed by direct DNA
      sequencing of the 294-bp amplified product was shown to be useful to identify and
      to distinguish between different H. pylori isolates.

PMID- 1742620
TI  - [Molecular and cellular bases of Shigella flexneri virulence].
AB  - Shigella flexneri, a Gram negative bacillus, causes bacillary dysentery, an
      ulcerative disease of the human colon, by invading intestinal epithelial cells.
      Entry into epithelial cells occurs via an induced phagocytic process which
      involves the actino-myosin complex. The host-cell receptor and the transmembrane
      signal which initiate reorganization of the cytoskeleton are under study. Binding
      to integrins has recently been demonstrated in related models such as the entry
      of Yersinia pseudotuberculosis and Bordetella pertussis into cells. Bacterial
      genes necessary to achieve entry are located on five contiguous loci covering 30
      kb on a 220 kb virulence plasmid in S. flexneri. Locus 2 has been particularly
      studied. Six genes organized as an operon encode highly immunogenic proteins
      among which IpaB (62 kD) and IpaC (48 kD) are the invasins of this microorganism
      which subsequently grows very rapidly within infected cells due to its capacity
      to lyse the membrane bound phagocytic vacuole. Once free within the cytoplasm,
      bacteria interact again with the cell cytoskeleton. They first express Olm
      (organelle like movement), a phenotype reflecting intracellular movement along
      actin stress cables. They subsequently express Ics (intracellular spread), a
      phenotype by which intracellular bacteria induce nucleation and polymerization of
      actin followed by accumulation of this material at one end of the bacillus. This
      process causes rapid random movement leading to the formation of protusions which
      allow passage to adjacent cells. A combination of these two movements achieves
      bacterial colonization of the epithelium.

PMID- 1742621
TI  - [Virulence factors of Salmonella: from molecular genetics to diagnostic
      applications].
AB  - Salmonella serotype Typhimurium is a facultative intracellular pathogen that
      causes a systemic infection in naturally, or experimentally, infected mice. After
      oral contamination, Typhimurium colonizes the ileal mucosa and Peyer's patches
      and invades draining mesenteric lymph nodes. From these primary sites of
      infection, bacteria dissiminate to the reticuloendothelial system and proliferate
      rapidly in spleen and liver. Several virulence factors are encoded by chromosomal
      genes. The ability of Typhimurium to adhere to and invade epithelial cells has
      been associated with flagella, pili of type I and mannose-resistant
      haemagglutinating activity. By comparing the virulence of isogenic strains, it
      appeared that these traits played a marginal role and were not essential for full
      virulence expression. It is now clear that other surface structures are important
      for the invasiness capacity of Typhimurium. To multiply in the
      reticuloendothelial system, a complete lipopolysaccharide is necessary for the
      bacteria in resisting serum bactericidal activity and producing tissue damage.
      Salmonella have evolved a specialized iron-binding ligand, termed enterobactin,
      to acquire iron necessary for their multiplication. Enterobactin competes with
      the host iron-binding proteins (transferrin or lactoferrin) to secure the iron
      required by the bacteria. Though the presence of an enterotoxin in Salmonella is
      still controversial, there is now substantial evidence to support this concept.
      Recently, a gene encoding an enterotoxin has been cloned from Typhimurium and
      expressed in E. coli. Typhimurium strains harbour a 90 kilobases (kb) plasmid
      which is essential for virulence. This plasmid encodes virulence factors required
      for replication of Salmonella in liver and spleen. It was postulated that the
      plasmid allowed Typhimurium to multiply in Kupffer cells and in splenic
      macrophages. The virulence-associated region of the plasmid restored full
      virulence to plasmidless strains. Transposon insertion mutagenesis demonstrated
      the existence of two DNA sequences, designated Vir A and Vir B, which are
      essential for virulence expression. The Vir A region has been sequenced; it
      encodes four polypeptides with apparent molecular mass of 27,000, 28,000, 33,000
      and 70,000. The Vir B region encodes two polypeptides of 38,000 and 43,000. In an
      attempt to identify bacterial components contributing to invasion of HeLa cells
      by Salmonella serovar Typhi, we cloned a 30 kb DNA sequence necessary for entry
      of bacteria into epithelial cells. However, this sequence is not sufficient for
      conferring an invasive phenotype to E. coli strains. From this DNA fragment, a
      short segment of 487 bp was subcloned, sequenced and used as probe to detect
      Salmonella.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1742622
TI  - [Multiple transplantation of abdominal organs].
AB  - The transplantation of multiple abdominal viscera including liver-duodenum
      pancreas, liver-stomach-duodenum-pancreas, and liver-intestine is being performed
      with increasing frequency and success. These procedures and other variations are
      derived from a seldom used multivisceral operation in which all of the foregoing
      organs are transplanted in bloc. It is described here how the full multivisceral
      transplantation and its less extensive derivatives are based on the same
      principles of procurement, preservation, and postoperative management. With all
      of these multiple organ permutations and with intestinal transplantation alone,
      management is complicated by inclusion in the grafts of a large lymphoreticular
      component which is capable of causing graft versus host disease (GVHD). Because
      of a systematic error in therapeutic philosophy, past efforts have been directed
      at altering or damaging the lymphoreticular cells by pretreatment of the donor or
      of the organs with drugs, irradiation or other means. From recent observations,
      the alternative approach is suggested of keeping these lymphoid depots intact
      which then become the site of 2 way cell traffic after transplantation. Under
      powerful immunosuppression such as that provided with FK 506, the donor
      lymphoreticular cells can circulate in the recipient without causing clinical
      GVHD, and the lymphoreticular cells in the graft become those of the recipient
      (local chimerism) without causing rejection. Even with avoidance of rejection and
      GVHD, metabolic interrelations between the grafted organs, and also between the
      graft organs and retained recipient viscera can affect the fate of the individual
      transplanted organs or retained recipient organs. The best delineated of these
      metabolic influences are mediated by the endogenous splanchnic hepatotrophic
      factors of which insulin has been the most completely studied. An understanding
      of these various immunologic and non-immunologic factors combined with the more
      potent immunosuppression which is now available is sure to stimulate efforts at
      transplantation of abdominal organs and particularly of the hollow viscera which
      heretofore have resisted such clinical efforts.

PMID- 1742623
TI  - [Contribution of the incidence of urban sewage spreading to dietary chromium].
AB  - The sewage sludges contain fertilizing matters that justify their use in
      agriculture. Simultaneously, they hold minerals that are directly proportional to
      the nature and intensity of industrial activity. The more abundant are chromium,
      lead, zinc; cadmium and mercury are also found. The concentration in chromium
      varies from 0.2 to 20.0 g/kg of dry matter. Its assimilation by the rootlet and,
      later, its intestinal absorption, are essentially dependent on its chemical
      state; the hexavalent forms have a high biodisponibility and are more toxic than
      the trivalent compounds. In vegetals, the assimilated chromium is stopped in the
      root, associated to iron hydrates; a small fraction reaches the leaves and a
      weaker part comes up to the grain. (Table I). If the concentration of chromium-
      mainly hexavalent salts--is very important in soil, the mechanism of regulation
      in the rootlet becomes inefficacious and chromium diffuses in the whole plant
      (Table II). The development of spraying of sludges and composts will increase the
      quantity and efficiency of chromium in vegetals, because of various factors: the
      wastes of many industries: chromium plating plants, tanneries, painting and
      dyeing industries throw out hexavalent chromium; if the sewage sludges are
      purified by an irradiation treatment, it will tend to oxidize the whole chromium
      in hexavalent forms; at last, the presence of sewage sludges in the arable soil
      favours the assimilation of chromium by inhibiting that of iron (Figure 1). Then,
      in absence of iron hydrates that regularize the diffusion of chromium in the
      plant, this latter tends to overrun more easily the aerial tissues and organs of
      vegetals. On the whole, the spraying of sewage sludges supplies the soil with
      chromium that will easily be assimilated by the plant, considering that it will
      be mainly at an hexavalent state. Compared with other trace elements held in the
      sludges, chromium is assimilated by the plant in a clearly more important
      proportion (Table III). That is why the consequences of spraying concern more
      particularly chromium than other elements, even if they are toxic. The
      intensification of spraying will contribute to increase the chromium intake that
      varies from 100 to 200 micrograms/day and whose 60% are provided by foods of
      vegetal origin. The consequences of a more important intake will be dependent on
      chemical state of chromium. If the hexavalent salts are predominant, an increase
      of intake will provoke a high intestinal absorption, a raising of chromium rate
      in liver, kidney, spleen, bone, etc. This situation will eventually be
      responsible for a chronic intoxication.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1742624
TI  - [Clinical and biological epidemiology of onco-retroviral HTLV-I and II
      infections].
AB  - Human T cell leukemia virus type I and II are endemic in South West Japan and in
      large parts of the equatorial belt in Central and South America, in Africa, and
      in some Pacific islands, areas where 1 to 5% of the general populations are
      infected. Pockets of high prevalence up to 15% and even 35% can be observed. The
      transmission of HTLV-I includes: maternal to offspring through breast feeding,
      sexual mainly from men to women and through blood exchange (blood transfusion,
      intravenous drug abusers, etc.) The diseases being proven to be caused by HTLV-I,
      include acute adult T cell leukemias as described in Japan, in 1977, in which the
      HTLV-I provirus is clonally integrated in leukemic cells, and a progressive
      spastic encephalomyelopathy named TSP/HAM, frequent in HTLV-I endemic areas, and
      in which an active viral replication takes place. No specific treatment being
      available, vaccine development, more feasible than for HIV, is critical since 8
      to 12% of seropositive individuals develop HTLV-I associated diseases.

PMID- 1742625
TI  - [The draft decree to modify the decree n. 83-766 of August 24, 1983 standardizing
      the list of professional duties performed by speech therapists].

PMID- 1742626
TI  - [Comparative physiology: saturated fatty acids and cholesterolemia in ruminants].
AB  - Despite of great intestinal absorption of saturated fatty acids from rumen
      elaboration the cholesterolemia of ruminants is low. A such state comes from an
      important production of propionic acid in the rumen reducing hepatic cholesterol
      synthesis.

PMID- 1742627
TI  - [Importance of monoclonal antibodies in the analysis of tumor markers].
AB  - Due to their extreme specificity, monoclonal antibodies (Mabs) have been very
      useful for new analytical progresses in the field of tumor markers. For example,
      it has been possible to analyse only calcitonin, independently of its precursors
      in the patients with medullary thyroid carcinomas. These precursors have been
      estimated and found increased in the absence of calcitonin for many cancer
      patients, specially with small cell lung tumors. The assay of HCG and its
      subunits with a great specificity and sensitivity is an other interesting example
      of the analytical power of Mabs. The usefulness of the assay of beta subunit is
      now clear in the diagnostic and follow up of choriocarcinoma and perhaps in the
      screening of high risk pregnancies. An other example can be derivated of our
      works on neuropeptide Y (NPY). The assay of NPY is highly difficult, due to its
      great similarity with other neuropeptides (PYY and PP). Mabs have been used to
      solve these analytical problems. The assay of NPY is useful not only for patients
      with neuroendocrine tumors, but also experimentally in the rat hypothalamus for
      research in nutrition.

PMID- 1742628
TI  - [Course of follicular lymphomas in a series of 281 patients].
AB  - From 1963 to 1988, 281 patients suffering follicular lymphomas and without
      previous treatment were treated in the same institution. One hundred and thirty
      three had a localized disease (72 stages I, 61 stages II) ans 148 an extended
      disease (83 stages III and 85 stages IV). In the absence of dramatic therapeutic
      improvement quite all patients were treated in a homogeneous manner with radical
      radiotherapy for localized disease and palliative chemotherapy for extended ones.
      Median follow-up is 9 years. Ten year overall survival is 38% and relapse free
      survival 29.5%. Multivariate analysis show two main prognosis factors: age (+ or 
      60 years) and tumoral mass (as shown by stage or number of involved area).
      Survival depends also on complete remission. Age and tumoral mass allows us to
      define three prognosis groups: favorable, intermediate, unfavorable. These groups
      justify different therapeutic approach and different proposals for prospective
      therapeutic trials.

PMID- 1742629
TI  - [The African and Malagasy Council for higher education: objectives and programs].
AB  - The African and Malgach Council for University Education is an inter-african
      institution. The anthors remind its organisation and show its aim and basic
      programms: recognition and equivalence of the degrees--teaching of the
      traditional medication--establishment of inter-african comettees--organisation of
      concors for associated professors in laws and medicine.

PMID- 1742630
TI  - [Peridural obstetrical analgesia and the cicatricial uterus. A 4-year
      evaluation].
AB  - 191 women with previous cesarean section in 291 indexed between October 1985 and
      September 1989 underwent a trial of labor. 146 patients received epidural
      analgesia in the course of labor. Vaginal delivery occurred in 126 patients
      (86.3%). Duration for epidural analgesia in labour was 163 +/- 110 min. The
      intrauterine pressure for monitoring continuous was 51.00 +/- 15.40 mmHg. We
      report four uterine dehiscences and one rupture. In no case, epidural analgesia
      did not delay the diagnosis. The use of epidural analgesia for trial of labor in
      previous cesarean section did not increase maternal or fetal risk.

PMID- 1742631
TI  - [A phlebocavographic evaluation of the size of the inferior vena cava for the
      placement of a DIL percutaneous caval filter. A preliminary study apropos of 10
      cases].
AB  - With the DIL filter it is possible to make the partial interruption of the
      inferior vena cava percutaneously. It exists in three sizes corresponding to the
      variations of the size of the vena cava. The aim of this study is to estimate the
      real size of the vena cava by means of the radiological measures of the
      phlebocavography permitting--the correct choice of the size of the filter
      necessary for the optimisation of its efficiency--to avoid the difficulties of
      the placing.

PMID- 1742632
TI  - [Does the Leveen valve still have a place in the treatment of refractory ascites?
      An evaluation of 107 cases].
AB  - One hundred and seven patients have been treated by the peritoneovenous shunt
      (PVS) : 54 patients from 1979 to 1984 (P1) and 53 patients from 1985 to 1990
      (P2). The mean age was 58 years (25-79 years) and 73 % of the patients had a
      cirrhosis of alcoholic origin. The mortalities at two weeks and one month were 22
      % and 26 % for P1 and 6 % and 11 % for P2. The risk of operation was related to
      the importance of hepatic and kidney insufficiency and to the importance of
      hyponatremia. Long term outcome depended on the causal illness. At short term,
      the morbidity can be reduced and the PVS should be indicated earlier in the
      progression of the illness.

PMID- 1742633
TI  - [Postoperative analgesia in shoulder surgery using an interscalene catheter: 3
      years' experience].

PMID- 1742634
TI  - [Postoperative analgesia using propacetamol].
AB  - Postoperative analgesia using propacetamol was studied in 50 patients, 42 +/- 16
      years old, after little or moderate surgery. Two grams of propacetamol in
      intravenous perfusion were administered every six hours. Three scales were
      utilized to note the intensity of the pain (simple verbal, behavioral and visual
      analogue scales), before the first injection and, one, four, six hours after.
      From this study, satisfactory analgesic efficiency and good tolerance of
      propacetamol were established.

PMID- 1742635
TI  - [Collective medical transport by air of the war wounded].

PMID- 1742636
TI  - [Inverted vision following transurethral resection of the prostate].

PMID- 1742637
TI  - [Prolonged curarization in a case of Lambert-Eaton syndrome].

PMID- 1742638
TI  - [Acute paranoia following a sudden alprazolam withdrawal].

PMID- 1742639
TI  - [Characteristics and limitations of pediatric anesthesia in a non-university
      milieu (private hospital)].

PMID- 1742640
TI  - [A comparative study of 3 preventive anticoagulation protocols used successively
      in orthopedics at the CHU of Limoges. A retrospective study of 953 total hip
      prostheses (single or repeat)].

PMID- 1742641
TI  - [Resuscitation following poisoning and asphyxia. 1877].

PMID- 1742642
TI  - Bronchial hyper-reactivity and skin sensitivity.

PMID- 1742643
TI  - Topical capsaicin therapy in chronic rhinitis: a way forward?

PMID- 1742644
TI  - Investigative use of bronchoscopy, lavage and bronchial biopsies in asthma and
      other airways diseases.

PMID- 1742645
TI  - Methotrexate in asthma.

PMID- 1742646
TI  - Fibroblasts and asthma.

PMID- 1742647
TI  - Radioimmunoassay of human eosinophil cationic protein (ECP) by an improved
      method. Establishment of normal levels in serum and turnover in vivo.
AB  - A radioimmunoassay was developed allowing measurement of the cytotoxic cationic
      ECP. The assay, which has a total incubation time of 3.5 hr, is a double antibody
      assay with radiolabelled ECP, covering the concentration range of 2-200
      micrograms/l. Performance data show a detection limit of less than 2 micrograms/l
      and a cross-reactivity with eosinophil protein X (EPX/EDN) of less than 0.06%.
      The coefficient of variation (%) within the measuring range was, within assay 4.8
      10.4, and total 6.6-12.0. The assay is useful for measurement in various body
      fluids including serum, nasal secretions and bronchoalveolar lavage fluid, and
      dilution of samples prior to analysis was generally not required. Sera from 100
      apparently healthy individuals revealed a geometric mean of 6.0 micrograms ECP/l
      and a range (95%) of 2.3-15.9 micrograms/l. The elimination rate of ECP, t1/2, in
      vivo was estimated to be 65 min when ECP was measured in serum. Comparisons
      between this assay and a method previously described showed that the new method
      is superior with regard to precision and assay procedure.

PMID- 1742648
TI  - Double-blind cross-over trial of oral sodium cromoglycate in patients with
      irritable bowel syndrome due to food intolerance.
AB  - Twenty patients with irritable bowel syndrome due to food intolerance were
      randomized to either oral sodium cromoglycate or placebo in a double-blind cross
      over trial. The study consisted of treatment with either sodium cromoglycate or
      placebo for 8 weeks, followed by the cross-over treatment for 8 further weeks.
      Patients were allowed to eat the offending foods during the study. Eighteen
      patients completed the study. Analysis of patients' diary card scores showed a
      statistically significant difference in favour of sodium cromoglycate. There was
      a long carry-over effect in the active-placebo order group. Therefore oral sodium
      cromoglycate seems to be a useful treatment in patients with irritable bowel
      syndrome and proven food intolerance.

PMID- 1742649
TI  - Sensitivity to common allergens: relation to respiratory symptoms and bronchial
      hyper-responsiveness in children from three different climatic areas of
      Australia.
AB  - In order to examine further the relation between atopy, as defined by skin-prick
      tests, and respiratory illness, we studied three populations of schoolchildren
      aged 8-11 years and living in different climatic areas of New South Wales,
      Australia. Skin-prick tests were performed using 13 commercial allergen extracts.
      Respiratory and allergic symptoms were assessed using a self-administered
      questionnaire to parents and bronchial hyper-responsiveness (BHR) was measured by
      histamine inhalation test. We defined current asthma as BHR together with
      symptoms of wheeze in the 12 months prior to study. Children with one or more
      positive skin weals of greater than or equal to 3 mm had significantly more
      recent wheeze, hayfever, eczema and BHR than children with smaller weals (P less
      than 0.001). In each area, 95-97% of all atopic children were sensitized to one
      of the following seven allergens: house dust, Dermatophagoides farinae, D.
      pteronyssinus, cat dander, plantain, rye grass, and Alternaria tenuis. Thus,
      these seven selected allergen extracts and a skin weal of 3 mm could be used to
      detect clinically relevant atopy in these populations of children. Sensitivity to
      house dust mite had the strongest independent association with current asthma in
      all three areas. The associations of other allergen sensitivities with BHR or
      current asthma were area dependent, indicating the influence of local allergen
      levels on respiratory illness in children. The potency of house dust mite
      sensitivity in increasing the risk of children having BHR and current asthma is
      confirmed.

PMID- 1742650
TI  - Unilaterality of obstruction after acute nasal allergen provocation. Relation of
      allergen dose, nasal reactivity and the nasal cycle.
AB  - We examined unilaterality of obstruction after acute bilateral nasal allergen
      provocation in two groups of pollen-sensitive volunteers studied out of season.
      One group was challenged on one occasion with a threshold allergen dose and on
      another with placebo. We measured nasal airway resistance (NAR) unilaterally for
      3.5 hr before the challenges and for 40 min after. Most subjects' noses had
      marked asymmetry of response. Over half showed marked obstruction on one side and
      none at all on the other side. The side which showed higher resistance and
      greater lability before challenge was typically more obstructed after. In a
      second group we compared responses to threshold and x 10 threshold doses.
      Threshold challenge produced results similar to those seen with the first group.
      After the higher allergen dose, there was some obstruction in the less responsive
      side and the rate of rise was much slower. Obstructive response after acute
      threshold allergen challenge is typically one-sided. This pattern may be related
      to the stage of the nasal cycle in which the challenge was delivered. Higher
      allergen doses produce more obstruction in the less responsive side but the
      response is still asymmetrical.

PMID- 1742651
TI  - Skin prick testing using allergen-coated lancets: a comparison between a multiple
      lancet device and a single lancet applied with varying pressures.
AB  - Allergen-coated lancets have been developed to simplify skin prick testing. The
      effect of variation in application pressure on the response to prick tests was
      assessed in 20 atopic subjects, and the results compared to the response obtained
      with a newly devised multiple lancet device (MLD), capable of holding up to eight
      lancets and of providing a standardized application pressure. A positive weal
      (greater than or equal to 7 mm2) using light pressure occurred in 2/20 subjects,
      compared with 14/20 after moderate pressure. The largest weals were obtained
      using hard pressure and with the MLD (all 20 subjects obtained positive weals)
      and there was no significant difference in weal size between the two. There was
      evidence of a late reaction in 4/17 subjects with the MLD and with hard pressure
      applied to a single lancet, but in only one with moderate and in none with light
      pressure. Thus both the early and late skin responses are dependent on the
      pressure applied. The newly designed MLD allows skin prick tests to be performed
      using a standard pressure. It is also convenient for multiple allergen testing of
      uncooperative children.

PMID- 1742652
TI  - Improvement of symptoms of non-allergic chronic rhinitis by local treatment with
      capsaicin.
AB  - Sixteen adult patients suffering from severe chronic non-allergic rhinitis with
      nasal vasoconstrictor abuse for more than a year, received, under local
      anaesthesia, an intranasal spray of capsaicin (3.3 x 10(-3) mol), the pungent
      agent in hot pepper, once weekly for 5 weeks. The subjective intensity of their
      nasal obstruction, rhinorrhoea and sneezing frequency were evaluated throughout
      the study and the vascular effects of capsaicin on the nasal mucosa were recorded
      by anterior rhinomanometry and laser Doppler flowmetry. Calcitonin gene-related
      peptide (CGRP) is a vasodilator agent present in sensory nerves and may play a
      major role in the vascular component of neurogenic inflammation. Therefore, the
      nasal mucosa content of CGRP-like immunoreactivity (CGRP-LI) was determined by
      radioimmunoassay in biopsies obtained before and after the capsaicin treatment.
      Intra-nasal capsaicin application evoked a larger vascular response in patients
      with rhinitis than in controls (P less than 0.05). Both nasal vascular responses
      and subjective discomfort following capsaicin were markedly reduced after the
      fifth application (P less than 0.01). In parallel, a 50% reduction of the CGRP-LI
      content in the nasal biopsies was observed. All symptoms were significantly
      improved throughout a 6 month follow-up period. No significant side-effects
      occurred and weaning from nasal vasoconstrictor agents was possible. Both the
      subjective symptom score and objective measurements of vascular reactivity
      suggest that repeated intra-nasal capsaicin application could be beneficial for
      patients with chronic rhinitis, possibly by reducing hyperreactive nasal
      reflexes.

PMID- 1742653
TI  - Quantifying serum antibody class and subclass responses by enzyme immunoassay in
      humidifier-related disease.
AB  - Antibody activity in the major classes and IgG subclasses against antigens in
      factory humidifier water was quantified by enzyme immunoassay (EIA) in 88
      subjects who were exposed at work to the output from these contaminated
      humidifiers. Those with work-related symptoms had significantly higher mean
      titres than those who were symptom free, although values overlapped. The
      individuals with the highest IgG antibody titres also had the highest titres of
      IgM and IgA antibody, and these parameters did not discriminate between those
      with and without symptoms any better than the IgG titre. This was also true for
      the IgG subclasses where activity was predominantly measured in IgG1. Quantifying
      the IgG antibody allowed us to demonstrate a significant correlation with years
      of work exposure (P less than 0.001). There was no significant association
      between antibody and cigarette smoking, as assessed by smoking history and
      confirmed objectively by serum cotinine levels. There was a significant
      correlation with total IgG level (P less than 0.001) suggesting that a non
      specific immune enhancement may accompany the specific response. The antibody
      titres were followed up to 3 years after modification of the humidification
      systems, and during this time symptoms resolved and the antibody levels
      progressively fell to undetectable levels. The EIA was adapted to measure antigen
      at nanogram levels thus providing a rapid test for screening of humidifer water
      as well as a technique that may help identify the nature of the antigens
      involved.

PMID- 1742654
TI  - Allergy from cellulase and xylanase enzymes.
AB  - Modern biotechnical methods have enabled production of many new types of
      potentially allergenic proteins. Enzymes have long been known to be respiratory
      allergens, but relatively few cases of skin allergy have been reported. Here we
      describe four patients who developed occupational allergic respiratory symptoms,
      three with bronchial asthma and one with allergic rhinitis, caused by cellulase
      and/or xylanase enzymes. Each patient also had urticarial symptoms after skin
      contact with these enzymes. In addition, one of the patients had allergic contact
      dermatitis from cellulase, and one from xylanase. Allergic contact dermatitis was
      verified by positive patch tests with the enzymes, and the immediate allergy was
      revealed by skin prick tests, specific IgE determinations (RAST) and RAST
      inhibition tests. All patients had positive RASTs to both cellulase and xylanase.
      In the RAST inhibition test 20 microliters of cellulase brought about a 94%
      inhibition, indicating the specificity of the RAST. Xylanase (20 microliters, 5%
      w/v) gave an 92% inhibition of cellulase RAST, indicating cross-reactivity
      between cellulase and xylanase. Three patients have been able to continue at
      their previous places of work, but at different worksites. One of the patients
      requires continuous medication for asthma and had to change her job because of
      persistent symptoms.

PMID- 1742655
TI  - A case of occupational asthma, rhinitis and urticaria due to sesame seed.

PMID- 1742656
TI  - Psychological treatments of asthma.

PMID- 1742657
TI  - Consumer report says "Amalgam fillings are still best bet".

PMID- 1742658
TI  - "The silver-mercury connection"--a report.

PMID- 1742659
TI  - Biocompatibility.

PMID- 1742660
TI  - Esthetic resin posterior restorations.

PMID- 1742661
TI  - Computer systems for dental practice management. A new generation of independent
      dental software.
AB  - A new generation of computer programs for dental patient management eliminates
      total dependence on the vendor for programming support. The software design
      enables information collected with the dental system to be transferred to popular
      off-the-shelf programs designed for business. A simplified example is used to
      illustrate for practitioners the advantages of this type of data structure
      management. Programs designed on this basis offer optimum performance and
      expandibility for both present and future needs.

PMID- 1742662
TI  - Orthodontic treatment for the adult periodontal patient.
AB  - The purpose of this article is to outline a method of orthodontic treatment for
      adult patients, particularly those with periodontal disease. The rationale for
      recommending orthodontics to these patients is discussed, with an emphasis on
      periodontal and occlusal management during treatment. Methods of using
      orthodontics to improve the periodontal status of adult patients are also
      demonstrated. Finally, there is a brief discussion on retention, and age
      considerations, as well as the obligations of both dentists and patients.

PMID- 1742663
TI  - Effects of glove powder on radiographic quality.
AB  - The use of powered rubber gloves in the provision of dental care has produced a
      new variable in radiographic quality assurance procedures. Wearing powder-coated
      gloves while processing X-ray films can reduce the quality of the images obtained
      on processed radiographic film. To ensure that the optimum quality of processed
      film images is achieved, the operator must be careful to prevent the
      contamination of the film and processing solutions with powder.

PMID- 1742664
TI  - A clinical study of radiographic selection criteria for edentulous patients.
AB  - This study was designed to determine if radiographic selection criteria could be
      developed and applied in the examination and treatment planning of edentulous
      patients. Fifty-one patients were examined and radiographs were prescribed for
      seven patients, where indicated by the selection criteria chosen. Previously
      obtained screening panoramic films were interpreted first, for findings in the
      areas covered by the prescribed films, and then for occult findings in the
      remaining areas. Thirty-three patients showed occult positive findings, none of
      which had clinical significance. For this population, the prescription of
      radiographs provided the appropriate radiographic information for making
      treatment decisions. For the vast majority of patients (49), screening panoramic
      films were unproductive and therefore unnecessary.

PMID- 1742665
TI  - Benign mucous membrane pemphigoid: a case report.
AB  - A relatively rare systemic disease, benign mucous membrane pemphigoid
      (cicatricial pemphigoid) usually starts in the mouth and is clinically
      characterized by bullae that rupture and form an ulcer. A distinctive Nikolsky's
      sign is apparent using gentle air blasts or finger pressure. The pharynx, larynx,
      nose, esophagus, genitals and eyes can also be affected. Involvement of the
      conjunctivae can lead to scarring and ensuing blindness. The following case of a
      healthy 77-year-old man, diagnosed as suffering from mucous membrane pemphigoid,
      is of particular interest since several confusing clinical observations,
      including poor oral hygiene, the possibility of a contact dermatitis or an
      adverse antibiotic reaction, made the diagnosis more difficult. A careful medical
      history, examination and consultation process is paramount to initiating proper
      treatment and subsequent relief of symptoms. Benign mucous membrane pemphigoid
      must always be considered in any patient with desquamative epithelium of the oral
      mucosa.

PMID- 1742666
TI  - High density lipoproteins and coronary artery disease.

PMID- 1742667
TI  - Human clinical trials of the dilatable pulmonary artery banding prosthesis.
AB  - OBJECTIVE: To test the hypothesis that the dilatable pulmonary artery banding
      prosthesis is as effective and safe to use as conventional fixed fabric bands,
      and provides an additional nonsurgical option for dilation. DESIGN: Nonrandomized
      prospective human clinical trial. SETTING: British Columbia's Children's Hospital
      for tertiary care. PATIENTS: All patients admitted with congenital heart defects
      who required banding of the pulmonary artery during a 17 month period. The
      patients who received a dilatable band were selected on the basis of their
      cardiologist's preference. INTERVENTIONS: Surgical banding was performed using
      accepted techniques. Intraluminal balloon dilation of the pulmonary artery band
      was done using techniques accepted for intraluminal balloon dilation in pulmonary
      valvuloplasty. MAIN RESULTS: Eleven patients received the dilatable bands and
      eight received fixed bands. There was no evidence of failure of the bands to
      maintain their function. One patient required intraluminal balloon dilation of
      the dilatable band. This was successfully accomplished without complication. The
      dilatable bands were easier to remove than the fixed bands, but required greater
      surgical dexterity to place and adjust. One of the dilatable bands was applied
      too distally and one too tightly. One fixed band was applied too tightly and
      another too loosely, requiring a second banding operation. CONCLUSIONS: The
      dilatable pulmonary artery banding prosthesis is as effective and safe to use as
      a fixed fabric band. It is easier to remove and provides a nonsurgical option for
      dilation.

PMID- 1742668
TI  - Cardiac abnormalities in patients with systemic lupus erythematosus.
AB  - OBJECTIVE: To determine the prevalence of cardiac abnormalities in patients with
      systemic lupus erythematosus. DESIGN: Prospective survey. SETTING: Rheumatic
      diseases unit of a university hospital. PATIENTS: Volunteer sample comprising 83%
      of patients with systemic lupus erythematosus followed annually in the rheumatic
      disease unit (93 patients; mean age 46 +/- 13 years; female 79, male 14). These
      patients were age-matched with 16 female control volunteers (mean age 43 +/- 5
      years) recruited from hospital staff. INTERVENTIONS: Electrocardiograms, two
      dimensional echocardiograms and radionuclide angiograms were performed in
      patients and controls. Anticardiolipin antibodies were measured by enzyme-linked
      immunosorbent assay in the systemic lupus erythematosus patients. MAIN RESULTS:
      At least one cardiac abnormality was detected in 44 of 93 systemic lupus
      erythematosus patients (47%). These abnormalities included: aortic valve
      thickening 12%; mitral valve thickening, prolapse, vegetations or stenosis 23%;
      left ventricular segmental dysfunction 4%; left ventricular global hypokinesis
      4%; right ventricular hypokinesis 4%; left ventricular hypertrophy 14%; left
      ventricular diastolic dysfunction 16%; and pericardial effusion 2%. Three of the
      16 controls (19%) had cardiac abnormalities consisting of mitral valve prolapse
      (one), right ventricular hypokinesis (one) and pericardial effusion (one).
      Cardiac abnormalities were more common in the systemic lupus erythematosus group
      compared with controls (47% versus 19%, P less than 0.05). Raised anticardiolipin
      antibodies were specific (88%) but not sensitive (33%) for the presence of
      cardiac abnormalities in systemic lupus erythematosus patients. Renal disease and
      prednisone therapy were more common in systemic lupus erythematosus patients with
      cardiac involvement than in such patients without evidence of cardiac disease
      (40% versus 16%, P = 0.03; and 81% versus 59%, P = 0.04, respectively).
      CONCLUSIONS: Cardiac abnormalities can be identified noninvasively in 47% of
      patients with systemic lupus erythematosus.

PMID- 1742669
TI  - Normalized left ventricular filling indexes to detect diastolic dysfunction in
      hypertension and in hypertrophic cardiomyopathy.
AB  - In order to establish a normalizing method for left ventricular filling indexes,
      peak filling rate (PFR) and time to peak filling rate (TPFR), derived from
      resting radionuclide ventriculography using Fourier analysis with third-order
      harmonics, were analyzed in 45 normal subjects, 40 hypertensive patients, and 29
      patients with hypertrophic cardiomyopathy. PFR was significantly negatively
      correlated with age (r = -0.62) and significantly positively correlated with peak
      ejection rate (PER) (r = 0.58) in normals. TPFR normalized for heart rate (N
      TPFR) was correlated positively with age in normals (r = 0.60) and hypertensives
      (r = 0.49) but not in patients with hypertrophic cardiomyopathy. N-TPFR was not
      significantly correlated with systolic parameters. A significant relationship
      between PFR normalized to PER (PFR/PER) and age was observed in normals (r = 
      0.58) but not in patients with hypertension or hypertrophic cardiomyopathy. To
      cancel the ageing effect, individual data of PFR/PER and N-TPFR were expressed as
      a percentage of the predicted regression value in normal subjects (%PFR/PER and
      %N-TPFR, respectively). Per cent PFR/PER was significantly lower and %N-TPFR was
      significantly greater in patients with hypertension and hypertrophic
      cardiomyopathy compared to normals. When normal limits of these indexes were
      defined as %PFR/PER greater than 80% and %N-TPFR less than 120%, the sensitivity,
      specificity and diagnostic accuracy of differentiating normals from patients with
      hypertension or hypertrophic cardiomyopathy were 41 of 45 (91%), 44 of 68 (65%),
      and 85 of 113 (75%), respectively. These findings indicate that %PFR/PER and %N
      TPFR might be more reasonably normalized parameters for describing diastolic
      filling and its abnormality.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742670
TI  - The effectiveness of various modes of nonsynchronized retrovenous perfusion in
      salvage of ischemic myocardium in the pig.
AB  - The effectiveness of intermittent coronary sinus occlusion was compared to a new
      non-electrocardiogram-synchronized coronary sinus retroperfusion system in terms
      of ability to reduce myocardial infarct size. In 40 anesthetized, open-chest pigs
      the left anterior descending coronary artery was occluded for 4 h and then
      reperfused for 1 h. In the arterial group, the coronary sinus was intermittently
      occluded (5 s inflation, 5 s deflation) with retroperfusion of arterial blood at
      60 mL/min during balloon inflation. In the venous group, the protocol was
      identical to the arterial group except that venous blood was retroperfused at the
      same flow rate during balloon inflation. In the intermittent coronary sinus
      occlusion group, the coronary sinus was similarly occluded, but there was no
      active retroperfusion. In the control group, no intervention was performed. In
      the three experimental groups, retroperfusion was maintained throughout the 4 h
      occlusion period. Infarct size, assessed by tetrazolium staining and expressed as
      a percentage of the in vivo area at risk, was greater in control animals (86.3 +/
      7.5%) compared to either arterial (44.1 +/- 12.9%; P less than 0.001) or venous
      groups (57.7 +/- 15.5%; P less than 0.001) but not compared to the intermittent
      coronary sinus occlusion group (78.0 +/- 10.2%; not significant). Active
      retroperfusion with arterial blood did not achieve significantly greater salvage
      compared to active retroperfusion with venous blood (not significant), although
      both produced significantly greater salvage than intermittent coronary sinus
      occlusion (P less than 0.03). Mean coronary sinus pressure was 56.1 +/- 25.4,
      38.8 +/- 5.6 and 17.1 +/- 6.4 mmHg in the arterial, venous and intermittent
      coronary sinus occlusion groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742671
TI  - The Canadian Atherosclerosis Society--history and present status.
AB  - Since its inception in 1983 the Canadian Atherosclerosis Society (CAS) has
      established itself firmly on the national and international scene as a forceful
      scientific voice. Its presence and activities have had their dominant expression
      at annual meetings held jointly with the Royal College of Physicians and Surgeons
      of Canada (RCPSC) and the Canadian Society for Clinical Investigation (CSCI) and
      in sponsoring other scientific and educational events, the most important of
      which was the Canadian Consensus Conference on Cholesterol (Ottawa, March 1988).
      It provided a forum for interaction between the scientific community, government,
      funding agencies, industry and the general public, and culminated in concrete
      recommendations for the populace of Canada. It also 'induced' a continuum in
      governmental and public concern for health with respect to atherosclerosis, and
      beyond it, the field of cardiovascular diseases. This dialogue continues. As a
      member (Constituent Society) of the International Atherosclerosis Society (IAS),
      the CAS has a voice in the international community, its policies and activities.
      The membership increase from 69 in 1983 to 175 in 1991 reflects steady growth of
      the CAS. The Society has been active in other areas (publications, awards for
      young investigators, and common educational endeavours with other groups) and
      will be host to the 1994 International Symposium on Atherosclerosis. Over a short
      period of only eight years, all of the above attests to sufficient progress (or
      achievement) for any scientific society. And yet, there remain quite a few areas
      not addressed as yet and some sad experiences (eg, that with the Long Term
      Planning Committee) that must be quickly remedied, if the Society is to keep pace
      with the everchanging emphasis in research that in the final analysis aims at
      improving the overall well-being and health of all Canadians. Inherent in the
      definition of history is the premise that accounts be provided of facts only.
      Historians who research their subjects derive these facts from studying the
      necessary accounts relating to these 'facts', using different and preferably
      controversial resources, so as to present the facts as objectively as possible.
      It is impossible, however, to fulfill all the above criteria for a historian who
      lived through every phase of 'life' of the subject of his or her account, because
      no matter how objective one wishes to remain (and bends backwards to achieve
      this) there will be always an element of a personal prism through which the
      historian lived the 'life' with his subject. For being human and thus unable to
      eliminate entirely that personal component, this writer asks humbly for the
      reader's understanding.

PMID- 1742672
TI  - Pictorial essay: transabdominal and endovaginal sonography of adnexal masses.
AB  - Endovaginal sonography is rapidly becoming the diagnostic procedure of choice
      when evaluating patients with early pregnancy and assessing uterine
      abnormalities. However, there has been relatively little discussion of
      endovaginal sonography in the evaluation of adnexal masses. Using endovaginal
      sonography we studied 50 patients with clinically suspected adnexal masses, in
      whom transabdominal sonography was either suboptimal or failed to adequately
      characterize the mass. The purpose of this pictorial essay is to depict the
      normal anatomy of the ovaries and adnexa and highlight the unique contribution of
      endovaginal sonography in diagnosing a variety of adnexal masses, including tubal
      and ovarian lesions.

PMID- 1742673
TI  - Screening for breast cancer with mammography.
AB  - Mammography is generally accepted as a useful problem-solving clinical tool in
      characterizing known breast lesions, so that appropriate and timely treatment can
      be given. However, it remains grossly underutilized at what it does best:
      screening. The major strengths of mammography are a) its ability to detect breast
      cancer at a smaller, potentially more curable stage than any other examination,
      and b) its proved efficacy in reducing breast cancer mortality in asymptomatic
      women aged 40-74. If, as has recently been estimated, screening with mammography
      and physical examination can be expected to lower breast cancer deaths by 40%-50%
      among those actually examined (13), then the lives of almost 20,000 U.S. women
      might be saved each year if screening were to become very widely used. The
      challenges of the next decade are clear, to mount much more effective campaigns
      to educate physicians and lay women about the life-saving benefits of breast
      cancer screening, to devise increasingly effective and lower cost screening
      strategies, to further improve the current high quality of mammographic imaging
      despite its increasing proliferation, and to train large numbers of breast
      imaging specialists to guarantee that the growing case load of screening and
      problem-solving mammograms is interpreted with a very high level of skill.

PMID- 1742674
TI  - Infected abdominal aortic aneurysm due to Salmonella: CT evaluation.
AB  - Two cases of infected abdominal aortic aneurysm (IAAA) caused by salmonella are
      reported and the computed tomography (CT) features are discussed and compared
      with the pathologic findings. Additionally, a review of the literature was
      performed. A well-enhanced para-aortic mass (PAM) beyond the calcified intima of
      the abdominal aorta on the CT, which was initially considered to represent a
      leakage from the infected aneurysm, was observed in 5 of the 6 reported cases
      (including ours) and identified as a pseudoaneurysm. In one case, multiple gas
      collections within the PAM were demonstrated for the first time in IAAA due to
      salmonella.

PMID- 1742675
TI  - Mesenteric panniculitis: findings on CT, MRI, and angiography. Case report.
AB  - The computed tomography (CT), magnetic resonance (MR), and angiographic features
      of a case of mesenteric panniculitis are presented. The MR characteristics of
      this rare disorder have not previously been reported. The value of MR in arriving
      at the preoperative diagnosis of this disorder is discussed.

PMID- 1742676
TI  - Detection of internal mammary lymph node enlargement: comparison of CT scans and
      conventional roentgenograms.
AB  - Sixty-two patients with breast cancer had thoracic computed tomography (CT) scans
      and conventional chest radiographic (CXR) examinations separated by an average of
      29 days. CT served as the gold standard showing 13 cases with enlarged internal
      mammary nodes 0.4 to 7 cm in diameter. Original CXR interpretations were
      available. Additionally, these films were reinterpreted, without knowledge of the
      CT results, with special attention to the retrosternal region on the lateral film
      including the use of a bright light and comparison to prior lateral views.
      Original CXR interpretations detected only one (7 cm) enlarged node. Sensitivity
      was 8% and specificity 100%. Reinterpretation of the CXRs, without knowledge of
      the CT results, with special attention to the retrosternal region yielded five
      true positive and seven false positive determinations for a sensitivity of 38%
      and specificity of 86%. No enlarged node under 2.5 cm in diameter was detected on
      CXR. Sensitivity of CXR can be considerably improved by careful evaluation of the
      retrosternal space, but at the cost of considerable increase in false positive
      examinations. CT is necessary to achieve reasonable sensitivity and specificity
      in the detection of internal mammary lymphadenopathy.

PMID- 1742677
TI  - Venous sinus thrombosis as a cause of parenchymal and intraventricular hemorrhage
      in the full-term neonate.
AB  - A case of parenchymal and intraventricular hemorrhage in a full-term neonate is
      reported. The underlying cause in our patient is thought to be related to
      cerebral sinovenous occlusive disease secondary to Protein C deficiency, a rare
      coagulopathy.

PMID- 1742678
TI  - Imaging of retroperitoneal rhabdomyosarcoma mimicking hypernephroma.
AB  - Malignant tumors that arise in the perinephric space often present a diagnostic
      dilemma. These retroperitoneal tumors may resemble renal carcinomas, extrahepatic
      lymphoma, metastatic disease, or tumors arising in other retroperitoneal organs.
      We present a case of a patient with a primary retroperitoneal rhabdomyosarcoma
      who had an extensive diagnostic workup prior to surgical intervention that was
      thought to be consistent with an aggressive renal cell carcinoma.

PMID- 1742679
TI  - Communicating intrathoracic hydrocele.
AB  - Tense ascites may cause herniation of parietal peritoneal reflection into the
      mediastinum at the gastroesophageal junction. This may produce a mass visible on
      chest radiograph and computed tomography (CT). This communicating intrathoracic
      hydrocele may occur in the absence of hiatal hernia and may be confused with
      other middle mediastinal fluid collections including necrotic tumor, abscess,
      cyst of foregut origin, or pancreatic pseudocyst. Recognition of this entity in
      patients with ascites should prevent diagnostic confusion and unnecessary further
      evaluation.

PMID- 1742680
TI  - Osseous metastasis in medulloblastoma: MRI findings in an unusual case.
AB  - An 11-year-old boy with a history of medulloblastoma developed blastic osseous
      metastases. The metastases were detected by noting diffuse areas of low signal
      intensity within the calvarium on T1-weighted and T2-weighted magnetic resonance
      (MR) scans of the brain. The MR appearance of osseous metastases in
      medulloblastoma has not been reported previously. Extraneural metastases in
      medulloblastoma are relatively rare. The literature is briefly reviewed.

PMID- 1742681
TI  - Ossifying fibroma in the nasopharynx. A case report.
AB  - Ossifying fibroma localized in the nasopharynx of a 35-year-old man with
      histopathologic and radiologic findings has been reported. Because of its rarity,
      the subject has been presented and discussed.

PMID- 1742682
TI  - Metastatic hypernephroma masquerading as acute cholecystitis.
AB  - Renal cell carcinoma can metastasize to multiple anatomic sites. The metastasis
      may simulate certain disease entities depending on the location and particular
      organ involved. It is important to recognize that these metastases can present
      many years after the primary tumor has been treated. We present a case in which a
      primary hypernephroma was surgically removed and subsequently 13 years later
      presented with metastatic disease to the gallbladder clinically simulating acute
      cholecystitis.

PMID- 1742683
TI  - Detection of the fetus in the cul-de-sac by transabdominal and transvaginal
      ultrasound. A case report.
AB  - The most common reason for a fetus in the cul-de-sac is ectopic pregnancy, such
      as rupture of tubal pregnancy, ovarian pregnancy, and intraabdominal pregnancy (1
      3). A case of the fetus in the cul-de-sac complicated by uterine perforation was
      imaged transabdominally and transvaginally on September 13, 1990.

PMID- 1742684
TI  - Perinephric hemorrhage secondary to adrenal myelolipoma. Case report.
AB  - Spontaneous perinephric hemorrhage has been described as occurring secondary to a
      number of primary renal abnormalities, but rarely from other causes. We describe
      the computed tomography (CT) and ultrasound findings of this event resulting from
      hemorrhage from an adrenal myelolipoma.

PMID- 1742685
TI  - Health care in Ontario.

PMID- 1742686
TI  - Drinking and pregnancy.

PMID- 1742687
TI  - CPPNW turns pacifist.

PMID- 1742688
TI  - Guidelines for medical technology in critical care.

PMID- 1742689
TI  - Meeting the iron needs of infants and young children: an update.

PMID- 1742690
TI  - Jehovah's Witnesses and the transfusion debate: "We are not asking for the right
      to die".

PMID- 1742691
TI  - Hazard of yawning.

PMID- 1742692
TI  - A survey of resuscitation training in Canadian undergraduate medical programs.

PMID- 1742693
TI  - Ontario's health number: a threat to privacy and a solution.

PMID- 1742694
TI  - Non-insulin-dependent (type II) diabetes mellitus.
AB  - Non-insulin-dependent (type II) diabetes mellitus is an inherited metabolic
      disorder characterized by hyperglycemia with resistance to ketosis. The onset is
      usually after age 40 years. Patients are variably symptomatic and frequently
      obese, hyperlipidemic and hypertensive. Clinical, pathological and biochemical
      evidence suggests that the disease is caused by a combined defect of insulin
      secretion and insulin resistance. Goals in the treatment of hyperglycemia,
      dyslipidemia and hypertension should be appropriate to the patient's age, the
      status of diabetic complications and the safety of the regimen. Nonpharmacologic
      management includes meal planning to achieve a suitable weight, such that
      carbohydrates supply 50% to 60% of the daily energy intake, with limitation of
      saturated fats, cholesterol and salt when indicated, and physical activity
      appropriate to the patient's age and cardiovascular status. Follow-up should
      include regular visits with the physician, access to diabetes education, self
      monitoring of the blood or urine glucose level and laboratory-based measurement
      of the plasma levels of glucose and glycated hemoglobin. If unacceptably high
      plasma glucose levels (e.g., 8 mmol/L or more before meals) persist the use of
      orally given hypoglycemic agents (a sulfonylurea agent or metformin or both) is
      indicated. Temporary insulin therapy may be needed during intercurrent illness,
      surgery or pregnancy. Long-term insulin therapy is recommended in patients with
      continuing symptoms or hyperglycemia despite treatment with diet modification and
      orally given hypoglycemic agents. The risk of pancreatitis may be reduced by
      treating severe hypertriglyceridemia (fasting serum level greater than 10 mmol/L)
      and atherosclerotic disease through dietary and, if necessary, pharmacologic
      management of dyslipidemia. Antihypertensive agents are available that have fewer
      adverse metabolic effects than thiazides and beta-adrenergic receptor blockers.
      New drugs are being developed that will enhance effective insulin secretion and
      action and inhibit the progress of complications.

PMID- 1742695
TI  - Increasing brain cancer rates in Canada.
AB  - OBJECTIVE: To analyse brain cancer patterns in Canada, particularly according to
      age and sex distributions, temporal patterns and regional variations. Changes in
      diagnostic techniques, survival rates and trends by tumour type were also
      examined. DESIGN: Descriptive epidemiologic study based on Canada-wide population
      data for 1959-88. OUTCOME MEASURES: Rates of death, incidence and admission to
      hospital because of brain cancer, as well as survival time and methods of
      diagnosis. SUBJECTS: Incidence and death rates and time trends were examined for
      Canada as a whole, by province and by census division. RESULTS: The rates of
      death from brain cancer increased rapidly among Canadians aged 55 years or more
      from 1959 to 1988. In particular, age-adjusted death rates increased by 117%,
      797% and 118% among men 65 to 74 years, 75 to 84 and 85 or more respectively. The
      corresponding increases among women were 138%, 535% and 400%. The incidence rates
      also increased substantially. The trends in incidence rates by tumour type
      indicated that the increase was more pronounced for glioblastomas. The incidence
      rates of cases detected histologically, radiologically and clinically all
      increased. CONCLUSIONS: Because glioblastomas are generally easier to diagnose
      than astrocytomas and because the incidence rates of glioblastomas were found to
      increase substantially, the increased brain cancer rates among elderly people may
      not be entirely attributable to improved diagnostic techniques. However, analytic
      investigations of the impact of changes in diagnostic procedures on brain cancer
      trends are needed to clarify this issue.

PMID- 1742696
TI  - Five cases of erroneously diagnosed HIV infection.

PMID- 1742697
TI  - Hyperlipidemia in pregnancy.

PMID- 1742698
TI  - The menace of obesity. 1926.

PMID- 1742699
TI  - It is time for a new consensus on animal-based experimentation.

PMID- 1742700
TI  - It is "almost easier" to find human research subjects than animal ones,
      researcher says.

PMID- 1742701
TI  - Fat's in the fire in British food fight.

PMID- 1742702
TI  - Canada's medical manpower problems pale in comparison with Germany's.

PMID- 1742703
TI  - Lesbians face unique health care problems.

PMID- 1742704
TI  - Breast implants do not appear to pose cancer risk, Alberta researcher says.

PMID- 1742705
TI  - Dr. Wilfred Grenfell and the forgotten people of Newfoundland and Labrador.

PMID- 1742706
TI  - A multidisciplinary treatment approach to postpartum psychoses.
AB  - Psychosis after childbirth occurs as a result of unique developmental and social
      demands. The authors have developed a treatment approach for the management of
      postpartum psychotic mothers admitted with their babies, based on their
      experience on an acute psychiatric inpatient unit with a special interest in the
      treatment of postpartum disorders. Five phases of the acute illness and recovery
      process are outlined. For each phase, a typical clinical situation, the specific
      tasks of the phase, and special problem areas are presented. The management
      guidelines are based on a multidisciplinary team and phase-oriented approach.

PMID- 1742707
TI  - Dimensions of personality pathology.
AB  - The reliability of DSM-III-R diagnoses of personality disorders is poor and their
      validity has yet to be established. There is little evidence that the features of
      personality pathology cluster into these diagnostic entities. For these reasons,
      it is important to explore alternative ways of classifying personality disorders.
      In this preliminary study, reliable scales were developed to assess 100
      personality dimensions which were systematically developed. The factorial
      structure underlying the dimensions was evaluated in a heterogeneous sample of
      110 subjects from the general population. Sixteen components, accounting for
      81.4% of the variance, were retained for rotation to oblique structure. The
      components were labelled social avoidance, narcissism, insecure attachment,
      compulsive behaviours, interpersonal disesteem, mobility, anxiousness, conduct
      problems, stimulus seeking, identity disturbance, self-harm, rejection,
      diffidence, and hypersensitivity. Two components were not interpreted because
      they only had one or two salient loadings.

PMID- 1742708
TI  - Psychiatric aspects of heart transplantation.
AB  - Psychiatrists have been an integral part of the heart transplant team at the
      Royal Victoria Hospital in Montreal since the program was set up in September
      1984. One hundred and twenty five candidates were evaluated for the operation; 12
      were found to be unsuitable for surgery because of psychiatric illness. Heart
      transplant recipients who had previously suffered from a psychiatric disorder
      fared worse than those who had not. The psychiatrist's recommendations for or
      against surgery depended on the patient's ability to cope with a number of
      stressors, including compliance with the medical regimen, waiting for a donor,
      the surgical procedure itself, adaptation to life with a new organ, and the
      resolution of a distressing emotional state. Post-operative complications ranged
      from organic mental syndromes to depression. With the increase in heart
      transplantations, the competition for organ donors is intensifying and patient
      selection requires greater involvement of psychiatrists.

PMID- 1742709
TI  - Psychiatric disorders in children and adolescents: the contribution of the
      child's temperament and the parents' psychopathology and attitudes.
AB  - Correlates of child psychopathology were studied in a community sample of 210
      children and adolescents (with equal numbers of boys and girls). Children
      suffering from a psychiatric disorder had more temperamental difficulties and
      their parents showed a higher level of psychopathology than those without a
      disorder. Furthermore, a regression analysis revealed that difficult
      temperamental traits in the child and the parents' attitudes toward the child
      were primary predictors of psychiatric disorders in the child. The relationship
      between the parent and child as well as the environment-temperament impact on
      child psychopathology are discussed.

PMID- 1742710
TI  - Evaluation of I-C papaverine in patients with psychogenic and organic impotence.
AB  - Forty men with organic or psychogenic impotence, who were highly motivated for
      treatment, were offered instruction in the intracavernosal (I-C) self-injection
      of papaverine and regular ongoing supervision by the investigator. Twenty
      declined immediately, citing a number of reasons, notably qualms about pain of
      the injection, side-effects and the unnaturalness of the method. Eleven patients
      discontinued the drug within 11 months; nine used it for at least one year, and
      all were continuing with it albeit less frequently at the time of assessment.
      Those who discontinued treatment differed significantly from those who did not;
      the latter initially used the drug less frequently (less than once per month),
      did not have a regular sexual partner or had a poor relationship with their
      sexual partner, and reported a decline in libido during use of the drug. The
      findings suggest that I-C papaverine, although effective in treating impotence,
      is not a panacea, and a large percentage of users (55% in our study) are likely
      to discontinue the drug within a relatively short period of time.

PMID- 1742711
TI  - Long-term psychiatric treatment.
AB  - Is long term psychiatric care superfluous? Can it be provided by non medical
      therapists? This paper examines this question from the perspective of one patient
      who was in therapy for 20 years.

PMID- 1742712
TI  - Adolescent murderers.
AB  - Clinical, developmental and environmental factors were retrospectively studied in
      14 adolescent murderers who had been referred to a forensic psychiatric clinic
      over an 11 year period. Results of these analyses were compared with findings
      from previous reports. The majority of subjects came from split families. There
      was a greater than expected degree of psychiatric illness in the adolescents.
      Previous psychiatric contact, antisocial behaviour and substance abuse were
      common among these adolescents. A tentative profile of adolescents who are likely
      to commit murder can therefore be drawn up, which may suggest direction for
      preventive action and rehabilitation.

PMID- 1742713
TI  - Establishing a model for care in schizophrenia: one program's experience.
AB  - Unified service systems for the chronic mentally ill are frequently proposed yet
      rarely implemented. This paper presents a program developed specifically to meet
      the needs of young people with schizophrenia and their families. The program's
      evolution and design, from its origins in a hospital to its eventual base in the
      community, are described. The implications of a clinical teaching unit affiliated
      with a university are outlined. The experience of a typical patient and his
      family provides a view from a clinical context. Hypotheses arising from this case
      study point to future empirical work in the development of model programs in the
      care of the long term mentally ill.

PMID- 1742714
TI  - Consent to treatment: loophole in the Ontario Mental Health Act.
AB  - The issue of using substitute consent to obtain treatment for patients who are
      not competent to consent to treatment is complex. The authors present a case
      which illustrates that patients may delay treatment for extended periods of time
      by repeatedly challenging their incompetency status. The authors present
      proposals to change the present system.

PMID- 1742715
TI  - Organic dissociative syndrome associated with antimigraine pharmacotherapy.
AB  - This report describes an acute organic brain syndrome with a fugue-like state in
      association with antimigraine pharmacotherapy. The differential diagnosis of: 1.
      possible psychotoxic effects of the combination of propranolol, imipramine, and
      butalbital; 2. confusional migraine with amnesia; and 3. psychogenic dissociation
      is considered. Although organically induced dissociative states are of clinical,
      neuropsychological and medico-legal significance, the DSM-III and DSM-III-R have
      specific categories only for dissociative conditions that are strictly
      psychogenic in origin.

PMID- 1742716
TI  - Educating physicians for contemporary responsibilities in the field of
      developmental disabilities.
AB  - In 1977, an academic division concerned with developmental disabilities was
      established in the Department of Psychiatry at Queen's University in Kingston,
      Ontario. This paper describes the division's educational programs for
      undergraduate and post-graduate students. Reference is made to the resources
      (i.e. faculty, practicum settings) and the curricula required. Both are
      considered in relation to published information on such endeavours. The
      contemporary public policy for shifting the care of persons with developmental
      disabilities from institutions to the community is noted. Successful
      implementation of this policy depends in part on preparing physicians to meet the
      challenges of providing medical and psychiatric care in mainstream health care
      services.

PMID- 1742717
TI  - A first episode of mania after age 80.
AB  - The case of a patient whose first episode of mania (DSM-III-R diagnosis) occurred
      after age 80 is presented; the patient had no previous psychiatric illness.
      Diagnostic and therapeutic issues are discussed with special regard to features
      of mania in old age, secondary mania (organic mood syndrome), pseudodementia,
      MHPG excretion and carbamazepine treatment.

PMID- 1742718
TI  - Musical hallucinations: report of two unusual cases.
AB  - Two elderly patients with musical hallucinations are described. In the first
      case, the musical hallucinations were precipitated by the administration of
      benzodiazepines. The symptoms in the second case resembled those described in
      cases of visual hallucinosis (Charles Bonnet syndrome) in the elderly. Issues
      related to the presentation and course of musical hallucinations are discussed.

PMID- 1742719
TI  - A case of pseudologia fantastica with antisocial personality disorder.
AB  - A case of pseudologia fantastica with antisocial personality disorder is
      described. It is important to obtain previous admission records as early as
      possible so patients can be confronted with the discrepancies in their history.
      The concept of pathological lying is discussed.

PMID- 1742720
TI  - Body size estimation in characterizing dysmorphic symptoms in patients with body
      dysmorphic disorder.

PMID- 1742721
TI  - Hair loss associated with fluoxetine treatment.

PMID- 1742722
TI  - Genetic errors, cell proliferation, and carcinogenesis.

PMID- 1742723
TI  - Use of mentholated cigarettes and lung cancer risk.
AB  - Black males have higher age-adjusted lung cancer incidence rates compared to
      white males, and blacks of both sexes have higher rates of increase in lung
      cancer incidence over past decades. The majority of black smokers smoke
      mentholated cigarettes. These observations prompted us to assess the effect of
      smoking mentholated cigarettes on lung cancer risk, using data from a hospital
      based case-control study of tobacco-related cancers. Analysis was restricted to
      current cigarette smokers and was carried out on 588 male lung cancer cases and
      914 male control patients and on 456 female lung cancer cases and 410 female
      controls interviewed between 1985 and 1990. The prevalence of menthol usage did
      not differ between cases and controls of either sex. No significant association
      was observed between either short-term (1-14 years) or long-term (15+ years)
      menthol use and lung cancer in logistic regression analyses adjusting for
      covariates. For specific histological types of lung cancer there was no
      indication of an association with menthol usage.

PMID- 1742724
TI  - Identification of nuclear matrix proteins in the cancer and normal rat prostate.
AB  - The nuclear matrix is the structural component of the nucleus that determines
      nuclear morphology and organizes the DNA in a three-dimensional fashion that is
      tissue specific. Previously, some of the nuclear matrix proteins have been
      reported to be both tissue and cell type specific and are altered with the state
      of differentiation and transformation. This study demonstrates that the nuclear
      matrix is specific for the individual lobes of the normal rat prostate and that
      the nuclear matrix undergoes changes in protein composition in the Dunning
      prostate cancer tissue. Additionally, in the Dunning rat prostate adenocarcinoma
      cell lines, there is a range of tumor phenotypes and the nuclear matrix varies in
      composition in each tumor cell type. These differences in the nuclear matrix
      proteins are associated with quantitative changes in nuclear morphology that form
      the pleiomorphic state of the cancer nucleus.

PMID- 1742725
TI  - Dysregulation of parathyroid hormone-like peptide expression and secretion in a
      keratinocyte model of tumor progression.
AB  - Using a human keratinocyte model of tumor progression, we have examined the
      regulation of gene expression and secretion of a parathyroid hormone-like peptide
      (PLP) that has been implicated in the pathogenesis of hypercalcemia in cancer. A
      rapid and transient induction of PLP mRNA in response to serum stimulation was
      demonstrated in both established (HPK1A) and malignant (HPK1A-ras) cells; however
      the dose dependent increases were greater in HPK1A than in HPK1A-ras. Significant
      inhibition of this induction was noted with the addition of 1,25-dihydroxyvitamin
      D3 at a lower concentration in HPK1A than in HPK1A-ras. Amino-terminal PLP
      immunoreactivity and bioactivity correlated well (r = 0.98) when measured in
      conditioned medium. In the absence of mitogenic stimuli, malignant keratinocytes
      (HPK1A-ras) secreted significantly more PLP than established (HPK1A)
      keratinocytes. However, in response to increasing concentrations of epidermal
      growth factor and fetal bovine serum, PLP release was far greater from HPK1A
      (maximum 13 x basal) than from HPK1A-ras (maximum 3 x basal) cells. In addition,
      1,25-dihydroxyvitamin D3 was more effective in inhibiting both basal and
      stimulated PLP secretion in HPK1A than in HPK1A-ras cultures. Reduction of
      extracellular Ca2+ from 2.0 mM to 0.5 mM appeared to be more effective at an
      early time point in reducing PLP secretion from the established cells compared
      with the malignant cells. These studies therefore demonstrate a progressive
      dysregulation of PLP expression and secretion in human keratinocytes in the
      transformation from established to malignant phenotype and may have important
      implications for understanding the pathogenetic mechanisms involved in vivo in
      the development of hypercalcemia in cancer.

PMID- 1742726
TI  - Differential expression of bcl2 protooncogene in neuroblastoma and other human
      tumor cell lines of neural origin.
AB  - The bcl2 protooncogene was originally discovered because of its involvement in
      t(14;18) chromosomal translocations frequently found in non-Hodgkin's lymphomas.
      The expression of this gene is reported to be highly tissue specific, with bcl2
      mRNAs being readily detectable only in hematolymphoid tissues and brain. To
      explore the possible involvement of bcl2 in neural tumors, we surveyed a variety
      of tumor cell lines for the presence of the p26-BCL2 protein by
      immunoprecipitation and immunoblotting methods. Very high levels of BCL2 protein
      were found in three of nine neuroblastoma (NB) cell lines examined; these levels
      of p26-BCL2 were comparable to lymphoma cell lines that contain a t(14;18).
      Despite the impressive relative amounts of BCL2 protein, however, no structural
      alterations or changes in the methylation status of bcl2 genes were detected in
      these NB cell lines by conventional Southern blotting. Of the other NB cell lines
      surveyed, three contained intermediate levels of BCL2 and another three cell
      lines had little or no detectable BCL2 protein, raising the possibility that
      determination of relative levels of BCL2 protein may help to segregate
      neuroblastomas into groups with different biological and clinical
      characteristics. BCL2 protein levels were not influenced by induction of neuronal
      differentiation with nerve growth factor in two of the two cell lines examined
      [SH-SY5Y (high BCL2); GICAN (low BCL2)] and did not correlate with N-MYC gene
      amplification or expression of nerve growth factor receptors. NB cell lines that
      contained little or no detectable BCL2 protein, however, tended to contain
      significant proportions of flat epithelioid cells, whereas bcl2-expressing cell
      lines were composed primarily of neuronal-like cells, suggesting that expression
      of this protooncogene correlates with the differentiation characteristics of
      these tumor cell lines. In addition to NBs, lower levels of BCL2 protein were
      also found in a variety of other neural crest-derived tumors and tumor cell
      lines, including some neuroepitheliomas, Ewing's sarcomas, neurofibromas, and
      melanomas. With regard to tumors of central nervous system origin, bcl2
      expression was absent from most medulloblastomas but was detected at moderate to
      low levels in a retinoblastoma and some glioblastoma multiforme cell lines. Taken
      together, these findings imply that bcl2 protooncogene expression is
      differentially regulated within the various lineages of cells that give rise to
      the nervous system.

PMID- 1742727
TI  - Photoreactivation of ultraviolet radiation-induced skin and eye tumors of
      Monodelphis domestica.
AB  - Chronic exposure of the opossum Monodelphis domestica to UV radiation (UVR) leads
      to the formation of cutaneous and corneal tumors. Groups of shaved opossums were
      exposed 3 times/week to: (a) UVR alone; (b) UVR followed immediately by 1 h of
      photoreactivating light (PRL) (320-700 nm); (c) 1 h of PRL followed by UVR; and
      (d) 1 h of PRL alone. Exposures were terminated after 70 weeks of treatment.
      Analysis of data plotted as probability of tumor formation versus weeks from
      first exposure shows that post-UVR exposure to PRL significantly (P less than
      0.005) delayed the time to appearance of cutaneous tumors from a 50% probability
      of tumor formation at 73 weeks for those animals exposed to UVR alone to 128
      weeks for those animals exposed to PRL after UVR. Pre-UVR exposure to PRL delayed
      the appearance of tumors by 6 weeks when compared to the UVR alone group, but the
      difference between the two groups was not statistically significant. The yield
      (number of tumors/surviving animal) of cutaneous tumors at 70 and 110 weeks
      following initiation of treatments also was significantly less in those animals
      exposed to PRL after, but not before, UVR. Based on the specificity of the PR
      repair pathway to act only on pyrimidine dimers, these results suggest that
      dimers are involved in the induction of cutaneous tumors. The results obtained
      with the induction of corneal tumors are more difficult to interpret. While
      exposure to PRL significantly delayed the appearance of corneal tumors, the
      magnitude of the effect was the same regardless of whether the PRL was given
      before or after each UVR exposure.

PMID- 1742728
TI  - Relationship between DNA cross-links, cell cycle, and apoptosis in Burkitt's
      lymphoma cell lines differing in sensitivity to nitrogen mustard.
AB  - We surveyed 11 Burkitt's lymphoma cell lines for chemosensitivity to nitrogen
      mustard (HN2) in order to determine whether any simple correlates to cytotoxic
      response might be revealed. The lines tested varied over a 5-fold range in
      concentration of HN2 required to inhibit tumor cell growth by 50%. Drug
      sensitivity correlated neither with continental origin of tumor, growth fraction,
      presence of Epstein-Barr virus, nor with the precise locations of (8;14)
      translocation breakpoints. Furthermore, contrary to experience with other cell
      lines, no simple correlation was found between the HN2 sensitivity of the four
      most divergent lines (low sensitivity, CA46 and MC116 cells; high sensitivity,
      Namalwa and JLP119 cells) and exposure to DNA cross-links (area under the DNA
      cross-linking-versus-time curve). In addition, we found similar extents of gene
      specific HN2-induced damage in the native and translocated c-myc alleles of CA46
      and JLP119 cells. At equimolar HN2 treatment, CA46 cells exhibited a profound
      arrest in G2M phase, while JLP119 cells exhibited prolonged S-phase delay. This
      suggested that despite similar DNA cross-link exposure, JLP119 cells were less
      able to complete DNA replication while repair was in progress. As cell cycle
      distribution returned to near normal, JLP119 cells exhibited DNA degradation
      characterized by oligonucleosome-sized DNA fragments prior to cell membrane
      disintegration. Our findings indicate that HN2-sensitive Burkitt's lymphoma cells
      may be more susceptible to delay in S phase for a given frequency of DNA cross
      links and that prolongation of S phase correlated with apoptotic cell death.

PMID- 1742729
TI  - Measurement of serum L-asparagine in the presence of L-asparaginase requires the
      presence of an L-asparaginase inhibitor.
AB  - The antileukemic activity of L-asparaginase (ASNase), an important component of
      therapy for acute lymphoblastic leukemia, is thought to result from depletion of
      serum L-asparagine (Asn). In studies of the pharmacological effects of ASNase,
      investigators have reported prolonged reduction in the serum concentration of Asn
      after the administration of ASNase. Such measurements may not be valid because
      ASNase present in the blood sample may hydrolyze Asn before its determination. We
      examined recovery of [U-14C]Asn from blood samples with and without various
      concentrations of added ASNase. In the presence of greater than or equal to 0.01
      IU/ml of ASNase, the amount of [U-14C]Asn recovered was less than 15% of that
      without ASNase. Utilizing this assay, we studied the effect of 2 known inhibitors
      of ASNase in an attempt to improve Asn recovery. In the presence of aspartic beta
      semialdehyde (ASA), or 5-diazo-4-oxo-L-norvaline (DONV), and up to 1.0 IU/ml
      ASNase, Asn levels remained at greater than 90% of control. ASA prevented the
      hydrolysis of exogenous Asn in blood samples drawn from patients after ASNase
      injection. We also developed a method to determine Asn in serum utilizing high
      pressure liquid chromatography. Using this method, we found that the Asn level
      was greater than 90% of a normal level in the presence of 40 mM DONV and 1.0
      IU/ml ASNase. Examination of serum from 4 patients treated with ASNase showed
      that Asn is detectable 7-19 days sooner when DONV is present in the blood
      collection system than in its absence. We conclude that: (a) as little as 0.01
      IU/ml ASNase can hydrolyze Asn added to blood; (b) continued hydrolysis of Asn by
      ASNase ex vivo can result in falsely low serum Asn measurements; (c) ASA or DONV
      present in the collection tubes obviates the problem of continued ASNase
      activity; and (d) the degree and duration of Asn depletion after ASNase therapy
      is much less than previously believed. Thus, for accurate measurements of the
      duration and degree of Asn depletion by ASNase, an ASNase inhibitor such as ASA
      or DONV should be present in the blood collection system.

PMID- 1742730
TI  - Metastatic potential and substrate dependence of cell motility and attachment in
      the Dunning R-3327 rat prostatic adenocarcinoma model.
AB  - Cancer cell motility has been associated with metastatic potential of sublines of
      the Dunning R-3227 rat prostatic adenocarcinoma model. However, three sublines of
      high motility lacked the capacity for metastasis. In all previous works, motility
      has been studied upon plastic and only upon attached cells at least 18 h after
      gravity plating. We studied two highly motile sublines; MAT-LyLu metastasizes to
      lungs and lymph nodes whereas PIF-1 metastasizes rarely. We compared the motility
      and attachment capability of cells from the Dunning model in serum-free media
      upon plastic, glass, laminin, type IV collagen, fibronectin, and elastin to
      determine whether study upon more physiological surfaces could better explain the
      discrepancy in metastatic capability observed in vivo. In the high-motility low
      metastatic PIF-1 and high-motility high-metastatic MAT-Lylu sublines, membrane
      ruffling, pseudopodal extension, and cellular translation upon plastic in serum
      free media were reduced (P less than 0.0001) by 33 and 31, 70 and 60, and 77 and
      65%, respectively. When returned to serum-containing media, biological
      characteristics (histology, chromosomal number, growth rate, host survival, and
      metastatic potential) were unchanged. Motility was affected by substrate
      (analysis of variance, P less than 0.05); however, no consistent pattern of
      enhancement or detriment occurred in any substrate across both sublines. When
      motility was compared between sublines, membrane ruffling and cellular
      translation were relatively unaffected by substrate, whereas pseudopodal
      extension was altered significantly by different substrates. However, upon
      individual substrates, no significant differences in motility existed between the
      two sublines to resolve the inconsistency of high-motility but low-metastatic
      potential in the PIF-1 subline. Therefore, we examined cell attachment, since in
      order for a metastatic cell to be motile upon substrate, it must first attach to
      it. Percentage of 10(5) cells attached was determined in serum-free media with
      the use of a cell counter after 1, 2, 4, 8, and 16 h on plastic and plastic
      coated with laminin, fibronectin, elastin, or type IV collagen. Cell attachment
      increased with time (P less than 0.05) on all substrates for MAT-LyLu (r = 0.95)
      and PIF-1 (r = 0.98). Attachment of MAT-LyLu cells was impaired by fibronectin
      and enhanced by elastin, laminin, and type IV collagen compared to plastic at all
      time points.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1742731
TI  - DNA damage and differential cytotoxicity produced in human carcinoma cells by CC
      1065 analogues, U-73,975 and U-77,779.
AB  - U-73,975 (U-73) and U-77,779 (U-77), two analogues of the
      cyclopropylpyrroloindole antitumor antibiotic CC-1065, are promising novel
      chemotherapeutic agents which are known to alkylate the N3 position of adenine in
      a sequence-selective manner. The concentration of U-73 required to produce a 1
      log cell kill in 6 human tumor cell lines varied from 20-60 pM. U-77 was more
      cytotoxic than U-73, with the concentrations required for a 1 log cell kill
      ranging from 1-20 pM. The cytotoxicity of U-73 and U-77 was found to be
      independent of the guanine O6-alkyltransferase phenotype. The sensitivity of the
      BE and HT-29 human colon carcinoma cells was increased when the time of drug
      exposure was increased from 2 to 6 h. DNA interstrand cross-links, as measured by
      the technique of alkaline elution, could only be detected when HT-29 or BE cells
      were exposed to extremely high concentrations of U-77 for 6 h. No other forms of
      DNA damage were detected in genomic DNA with either compound. U-77 was also found
      to induce DNA interstrand cross-links in naked DNA, as measured by an agarose gel
      method. The rate of interstrand cross-linking was extremely rapid with the
      "second-arm" of the cross-link being completed within 2 h. The mechanism by which
      these cyclopropylpyrroloindole compounds elicit their cytotoxicity, however,
      remains to be elucidated.

PMID- 1742732
TI  - Flavone acetic acid directly induces expression of cytokine genes in mouse
      splenic leukocytes but not in human peripheral blood leukocytes.
AB  - Flavone-8-acetic acid (FAA) is a flavonoid drug that augments mouse natural
      killer activity, induces cytokine gene expression, and synergizes with
      recombinant interleukin 2 for the treatment of murine renal cancer. However, FAA
      has been largely inactive in human clinical trials. In the present study we
      investigated the ability of FAA treatment to directly induce cytokine mRNA
      expression in total mouse splenic leukocytes and selected leukocyte subsets, as
      well as in total human peripheral blood leukocytes. Analysis of RNA isolated from
      FAA-treated mouse splenic leukocytes demonstrated that treatment with greater
      than or equal to 100 micrograms/ml of FAA induced expression of tumor necrosis
      factor alpha (TNF-alpha) mRNA by 1 h and induced maximal expression of TNF-alpha,
      alpha-interferon, and gamma-interferon mRNA within 3 h. The expression of all
      cytokine genes was diminished by 6 h. Interferon biological activity was detected
      in the supernatants of mouse splenic or peripheral blood leukocytes after
      treatment with FAA. These results correlate well with the previously reported
      induction of cytokine mRNA genes and biological activity by FAA in vivo. In
      contrast, FAA did not induce detectable mRNA expression or cytokine protein
      secretion by human peripheral blood leukocytes under similar conditions. These
      results demonstrate that FAA can directly stimulate cytokine gene expression in
      mouse but not in human leukocytes. Further studies performed with highly purified
      positively selected mouse CD4+ or CD8+ splenic T-lymphocytes, as well as purified
      B-cells, demonstrated that the FAA-induced expression of gamma-interferon mRNA
      was mainly induced in the CD8+ lymphocyte subset. alpha-Interferon mRNA was
      expressed largely in the B-cell population, while TNF-alpha mRNA was induced in
      all leukocyte subsets tested. Therefore, these results suggest that the
      immunomodulatory effects of FAA in mice are direct, but different cytokines are
      induced from different leukocyte subsets. Further, the data suggest that
      flavonoid compounds or analogues that stimulate cytokine gene expression in human
      cells might be therapeutically active in cancer patients.

PMID- 1742733
TI  - Factors influencing mutation at the hprt locus in T-lymphocytes: women treated
      for breast cancer.
AB  - Forty-nine women with breast cancer were enrolled in a prospective, longitudinal
      study of the genetic damage caused by treatment. Assays of mutant frequency at
      the hprt locus in peripheral blood lymphocytes were performed at approximately 6
      month intervals for 2 years. Treatment consisted of surgery alone or additional
      tamoxifen, radiotherapy, or chemotherapy in various combinations. At 6 months,
      there was an elevation of mean mutant frequency compared to initial values (P =
      0.004) which persisted for as many as 2 years. A significant elevation at 6
      months occurred only in the group of women who received combination chemotherapy
      (P = 0.005). Within this group, 5 of 15 patients had striking elevations of
      mutant frequency following chemotherapy (greater than 3 SD). Three of these 5
      women had serum folate levels in the deficient range, while only one of 9
      patients with lesser responses to chemotherapy were folate deficient. The change
      in mutant frequency after chemotherapy was inversely related to serum folate
      levels (P = 0.05) and to the number of years of smoking cigarettes (P = 0.01). We
      conclude that of the various modalities used to treat breast cancer, only
      chemotherapy was accompanied by a high risk of somatic mutation. A subset of
      patients manifested substantial increases in mutant frequency, often in
      association with low serum folate levels.

PMID- 1742734
TI  - Expression of HSP-28 and three HSP-70 genes during the development and decay of
      thermotolerance in leukemic and nonleukemic human tumors.
AB  - Leukemic cells appear to develop less thermotolerance and then to lose their
      thermotolerance more rapidly than do other tumor cell lines. The reason for this
      phenomenon is not known. After heat shock (or other environmental stresses),
      mammalian cells preferentially synthesize a set of proteins known as heat shock
      proteins (HSPs). HSP-28 and the various isoforms of HSP-70 have been suggested as
      being responsible for the development of thermotolerance. In these studies, we
      have attempted to determine by their expression with HSPs positively correlate
      with the development and decay of thermotolerance and whether the expression of
      these genes could explain the differing thermotolerance response observed between
      leukemic and nonleukemic tumor cells. Polymerase chain reaction was used to
      detect the expression of HSP-28 and several HSP-70 genes. Our data indicate that
      the expression of all three heat-inducible HSP-70 genes, 70A (Hunt and Morimoto,
      Proc. Natl. Acad. Sci. USA, 82: 6455-6459, 1985), 70B (Voellmy et al., Proc.
      Natl. Acad. Sci. USA, 82: 4949-4953, 1985), and 70B' (Leung et al., Biochem J.,
      267: 125-132, 1990) correlate with the development and decay of thermotolerance
      in nonleukemic tumor cell lines after heat or arsenite treatment. HSP-28 (Hickey
      et al., Nucleic Acids Res., 4: 4127-4145, 1986) failed to correlate with
      thermotolerance development; it was not induced after 45 degrees C primary heat
      shock. In leukemic cells, however, none of the HSPs were induced for extended
      periods of time. The lack of coordinate expression of HSP genes in cells of
      myeloid origin may explain the poor induction and maintenance of thermotolerance
      that is observed in these cells.

PMID- 1742735
TI  - Alterations of the p53 tumor suppressor gene during mouse skin tumor progression.
AB  - The two-stage murine skin tumorigenesis model is widely used to study the
      development of squamous cell neoplasias. We have investigated expression of the
      p53 and retinoblastoma tumor suppressor genes in eight murine skin tumor cell
      lines of varied histopathology and malignant potential, in seven in vivo-derived
      clones from these cell lines, and in 39 primary short-term cultures of similarly
      induced skin tumors at various stages of tumor progression. One squamous cell
      carcinoma cell line and three more malignant clones derived from it revealed
      mutations of the p53 protein by immunoprecipitation analyses despite normal-sized
      p53 transcripts. Sequence analysis identified the nature of the point mutations
      in these lines, a G----C transversion in codon 132. Mouse retinoblastoma
      transcripts and protein were unaltered in all the cell lines examined. Among
      short-term cultures of skin tumors, the p53 gene appeared normal in all
      papillomas and early well-differentiated carcinomas by Southern and
      immunoprecipitation analyses. In contrast, four of eight tumors from later stages
      of promotion (50-60 weeks) possessed alterations in p53, including loss of the
      p53 product, and loss of immunoreactivity with a murine-specific antibody
      recognizing only wild-type p53 protein. Loss of heterozygosity at the p53 locus
      was similarly observed in several more malignant tumors from later stages of
      promotion. In contrast retinoblastoma expression was normal regardless of the
      stage of promotion or histological grade of the tumor. Direct sequence analyses
      of exons 5 through 8 of the p53 gene in eight advanced murine skin tumors
      revealed a 25% incidence of p53 mutations. These point mutations were located in
      codons 245 and 263. Collectively, these data indicate that alterations in the p53
      gene occur in 25 to 50% of murine skin tumors induced by the two-stage
      tumorigenesis protocol and are later events in murine skin tumor progression.
      Moreover, these alterations are associated with tumors possessing a more
      malignant and/or poorly differentiated phenotype.

PMID- 1742736
TI  - Disruption of cellular energy balance by suramin in intact human prostatic
      carcinoma cells, a likely antiproliferative mechanism.
AB  - The antiparasitic drug, suramin, has antiproliferative effects in human carcinoma
      cells. It has been suggested that this occurs through blockade of growth factor
      receptor interactions. Three types of evidence that suramin rapidly inhibits
      cellular respiration or disrupts cellular energy balance in intact cells of the
      human prostate carcinoma cell line, DU145, are presented. Beginning at
      approximately 10(-4) M, suramin rapidly causes dose-dependent inhibition of
      tetrazolium conversion by mitochondrial dehydrogenases in intact cells,
      demonstrating an inhibition of respiration. This effect is reversed by exchange
      with suramin-free media but not by pretreatment with serum, epidermal growth
      factor, insulin-like growth factor I, acidic and basic fibroblast growth factors,
      or calcium. Rhodamine 123 (10 micrograms/ml) uptake by mitochondria in intact
      DU145 cells is inhibited in the presence of 10(-3) M suramin. Treatment with 10(
      4)-10(-3) M suramin causes the loss of rhodamine 123 from cells with mitochondria
      prestained with rhodamine 123, indicating that suramin is acting as an ionophore
      or respiratory poison. Also shown by electron microscopy are progressive toxic
      changes in mitochondria of DU145 cells within 1 h after treatment with 10(-4) M
      suramin. These data indicate that in intact DU145 cells 10(-4) M suramin rapidly
      disrupts cellular energy balance or respiration as seen by three studies of
      mitochondrial state. Disruption of energy balance or respiration represents a
      likely antiproliferative mechanism, as is thought to be a primary mechanism for
      the action of suramin in parasitic diseases. This proposed mechanism of action
      for suramin can explain the most prominent observed clinical toxicities of
      nephrotoxicity, adrenal toxicity, coagulopathy, and demyelinating neuropathy.

PMID- 1742737
TI  - Camptothecin and its derivatives induce expression of the c-jun protooncogene in
      human myeloid leukemia cells.
AB  - We have recently demonstrated that certain camptothecin derivatives are effective
      agents in the treatment of human tumor xenografts in nude mice. While
      camptothecin and its derivatives are recognized as inhibitors of topoisomerase I,
      little is known about the effects of these agents on specific gene expression,
      particularly genes involved in growth control. The c-jun early response gene
      codes for a leucine zipper transcription factor. The present studies demonstrate
      that 20(S)-camptothecin, 9-amino-20(S)-camptothecin, and 9-nitro-20(S)
      camptothecin inhibit the growth of human U-937 myeloid leukemia cells and induce
      expression of the c-jun gene. c-jun transcripts were increased at 3 h and reached
      a maximum at 6 h of drug exposure. We also demonstrate that the induction of c
      jun gene expression by these agents occurs at the transcriptional level. H7, a
      nonselective inhibitor of protein kinase C, completely blocked c-jun expression
      in 20(S)-camptothecin-treated cells, while another protein kinase inhibitor,
      HA1004, had no detectable effect. Similar findings were obtained for other
      leucine zipper encoding genes, including jun-B. These results suggest that 20(S)
      camptothecin, 9-amino-20(S)-camptothecin, and 9-nitro-20(S)-camptothecin activate
      a cellular response involving the induction of early response genes. Finally, we
      demonstrate that induction of c-jun expression occurs in association with
      internucleosomal DNA fragmentation, a characteristic of programmed cell death.

PMID- 1742738
TI  - Antitumor activity of gamma-interferon in ascitic and solid tumor models of human
      ovarian cancer.
AB  - We have investigated the action of recombinant human gamma-interferon (rHuIFN
      gamma) against human ovarian cancer xenografts growing as ascites or as bulky
      solid i.p. tumors in nude mice. Both forms of the disease responded to i.p.
      rHuIFN-gamma with significant increases in mouse survival time, and in 2 of 3
      ascitic models the mice were cured of peritoneal disease. The activity of rHuIFN
      gamma was dose and schedule dependent, and xenografts derived from 3 different
      patients showed a heterogeneity of response. Peak i.p. levels of rHuIFN-gamma in
      nude mice bearing multiple i.p. solid tumors were similar to those found in
      ovarian cancer patients receiving i.p. rHuIFN-gamma, but clearance was more rapid
      in the mice. Rat gamma-interferon had no antitumor activity at the same doses and
      schedules although it had some biological activity in the nude mice. Histological
      examination of treated tumors revealed increased necrosis and loss of cellular
      organization with large areas of hypocellular epithelial mucin. These changes
      were preceded by a fall in tumor tryptophan and a rise in tumor kynurenine. We
      conclude that rHuIFN-gamma has a direct dose related antitumor effect on ovarian
      cancer xenografts that is preceded by increased metabolism of tryptophan.

PMID- 1742739
TI  - Bifunctional antibody: a binary radiopharmaceutical delivery system for imaging
      colorectal carcinoma.
AB  - In clinical studies we have evaluated a unique monoclonal antibody-based drug
      delivery system, a bifunctional antibody designed to deliver imaging or
      therapeutic agents, such as radioisotopes, drugs, or biologics, to tumor cells,
      while minimizing the dose to normal tissue. The bifunctional antibody, with one
      specificity to a tumor-associated antigen (carcinoembryonic antigen) and another
      specificity to a hapten, is injected and allowed to localize at a tumor site for
      4 days. A hapten, tagged with a radioisotope, is subsequently injected for
      delivery to and capture by the prelocalized antibody at the tumor site. In
      studies reported here, the sulfhydryl groups of Fab' fragments of ZCE-025 and CHA
      255 were linked with bis-maleimidomethyl ether to form an F(ab')2 bifunctional
      antibody coupled by a stable thioether linkage. EOTUBE, a hydroxyethylthiourido
      derivative of benzyl EDTA, was used as the hapten carrier of 111In. Fourteen
      patients 62-82 years old with recurrent or metastatic adenocarcinoma of the colon
      were studied. Twenty of 21 known lesions were imaged, and eight of nine new
      lesions were confirmed. With this fundamentally new approach to drug delivery,
      clearance from normal tissue is rapid, and high tumor:normal tissue ratios are
      expeditiously achieved.

PMID- 1742740
TI  - Cancer cachexia syndrome developed in nude mice bearing melanoma cells producing
      leukemia-inhibitory factor.
AB  - Melanoma-derived lipoprotein lipase inhibitor (MLPLI) is a factor purified from
      the conditioned medium of a human melanoma cell line, SEKI, which induced severe
      cachexia in tumor-bearing nude mice. Amino acid sequencing revealed that the
      amino-terminal portion was identical to that of leukemia-inhibitory factor (LIF).
      To determine whether MLPLI is actually LIF, the expression of LIF mRNA was
      examined in the SEKI melanoma cell line. Northern blot analyses revealed that the
      cell line displayed an intense hybridizable band with a molecular size of 3.8
      kilobases, suggesting that MLPLI is identical to LIF. The relationship between
      the development of the cancer cachexia syndrome and the expression of LIF mRNA
      was examined in four melanoma xenografts, SEKI, G361, A375 and MEWO, in nude
      mice. SEKI- and G361-bearing nude mice developed cancer cachexia syndrome, and
      their body weights decreased by the 25th day after the transplantation to 73.6%
      and 73.8% of the control, respectively. A375- and MEWO-bearing nude mice,
      however, did not develop the syndrome. Northern blot analyses revealed that G361
      as well as SEKI expressed a large amount of LIF mRNA, but A375 and MEWO did not,
      suggesting a close relationship between the expression of LIF mRNA and the
      development of the syndrome. These data support the concept that MLPLI, or LIF,
      plays an important role in the development of the cancer cachexia syndrome
      observed in melanoma-bearing nude mice.

PMID- 1742741
TI  - Isolation and characterization of human melanoma cell variants expressing high
      and low levels of CD44.
AB  - Variants of the human melanoma cell line LT5.1 were selected for high and low
      expression of the Mr 90,000 CD44 glycoprotein by using the Hermes-3 monoclonal
      antibody combined with fluorescence-activated cell sorting. Cells were single
      cell cloned and clones of CD44 high-expressing and CD44 low-expressing phenotype
      were isolated. The variants, which exhibited up to a 7-fold difference between
      high and low expression, have maintained a stable phenotype over a period of 3
      months in tissue culture. Northern blot analysis of mRNA from the different
      clones showed correlation of levels of transcripts with fluorescence-activated
      cell sorting analysis data. Wound migration assays, utilizing the different
      clones, showed that the low-expressing clones manifested less motility than did
      cells showing high levels of CD44. Homotypic aggregation of cells was increased
      in those cells expressing high levels of CD44, and these variants were also
      better able to adhere to hyaluronate substrates. All of these activities were
      inhibited by the presence of anti-CD44 antibody. When injected i.v. into nu/nu
      BALB/c mice, the low-expressing clones gave significantly fewer lung nodules than
      the high-expressing clones, although the two variant types did not differ in
      their capacity to form s.c. tumors in similar mice. These results suggest that
      the CD44 molecule, possibly as a function of its activities as a hyaluronate
      receptor, may play a vital role in determining the fate of hematogenously
      disseminating melanoma cells.

PMID- 1742742
TI  - Liver cancer in transgenic mice carrying the human immunodeficiency virus tat
      gene.
AB  - Patients with the acquired immunodeficiency syndrome are at risk to develop a
      variety of different cancers. Based on epidemiological data, Kaposi's sarcoma and
      non-Hodgkin's lymphoma have been clearly associated with infection by the human
      immunodeficiency virus (HIV). Additional cancers such as basal cell and squamous
      cell carcinomas, melanoma, and hepatocellular carcinoma have also been reported
      to be associated with a diagnosis of acquired immunodeficiency syndrome. A direct
      causal role of HIV has yet to be established for any of these cancers. We now
      report that transgenic mice carrying the HIV tat gene develop a high incidence of
      hepatocellular carcinoma after a long latency and that these changes in the liver
      are likely to be initiated by extrahepatic growth signals from the tat expressing
      cells in these mice. We predict that as acquired immunodeficiency syndrome
      patients begin to respond to therapy and show prolonged survival, such
      "secondary" malignancies induced by HIV will become increasingly prevalent.

PMID- 1742743
TI  - Interstitial hypertension in superficial metastatic melanomas in humans.
AB  - Since 1950, several investigators have demonstrated that interstitial
      hypertension is a pathophysiological characteristic of experimental solid tumors.
      To date, interstitial fluid pressure (IFP) has not been measured in human tumors
      in situ. In this study we measured with the wick-in-needle technique the
      interstitial fluid pressure in superficial melanoma metastases (n = 12) in
      patients (n = 10) before and during systemic therapy. In the majority of tumors
      the pressure was found to be almost uniform, while in others it varied
      severalfold. The large variations in IFP in some tumors may be due to technical
      or biological factors. With the data obtained before and during therapy grouped,
      the mean IFP in melanoma lesions varied between 2 and 41 mm Hg with an overall
      mean of 14.3 +/- 12.5 (SD). IFP was found to be significantly higher (P less than
      0.01) in large (22.8 +/- 13 mm Hg; n = 6) than in small (5.8 +/- 2mm Hg; n = 6)
      lesions. This study demonstrates that IFP can be measured in human tumors using
      the wick-in-needle technique and that the pressure in some of the large melanomas
      exceeds the values measured to date in rodent tumors or human tumor xenografts.
      The latter result suggests that caution must be exercised in extrapolating values
      of pathophysiological parameters from transplanted tumors to human tumors.

PMID- 1742744
TI  - Interstitial hypertension in carcinoma of uterine cervix in patients: possible
      correlation with tumor oxygenation and radiation response.
AB  - Elevated tumor interstitial fluid pressure (IFP) is believed to be responsible,
      at least in part, for the poor penetration and heterogeneous distribution of
      blood-borne therapeutic agents and nutrients in solid tumors. Using the wick-in
      needle technique, IFP was measured in human patients with squamous cell carcinoma
      of the uterine cervix at the initial and final stages of fractionated external
      beam radiotherapy. Mean IFP values ranged from 10 to 26 mm Hg with an overall
      mean of 15.7 +/- 5.7 (SD) mm Hg in stage IIB and IIIB tumors (n = 12) and from 0
      to 3 mm Hg in normal cervix (n = 3). IFP decreased in some patients with therapy
      while in others it increased. The changes in IFP values agree well with the
      clinical response to radiotherapy (n = 7, P less than 0.05). Oxygen tension,
      measured in selected tumors (n = 3) with polarographic oxygen microelectrodes,
      inversely correlated with IFP. These results show for the first time that the IFP
      in human cervical carcinomas is elevated, and that it can be lowered in some
      tumors using fractionated radiation therapy. These findings also suggest that IFP
      values may provide an indication of tumor oxygenation and that IFP modifications
      could be prognostic indicators of radiation response.

PMID- 1742745
TI  - Differential regulation of the stability of cyclic AMP-dependent protein kinase
      messenger RNA in normal versus neoplastic mouse lung epithelial cells.
AB  - Neoplastic mouse lung epithelial cells contain greatly diminished activity,
      protein, and mRNA for the type I isozyme of cyclic AMP-dependent protein kinase
      (PKA I), while expression of the type II isozyme (PKA II) is similar to that of
      normal lung cells. A time course of PKA mRNA content in transcriptionally
      inhibited cells indicated that most PKA mRNAs are more stable in the neoplastic
      E9 cell line than in related nontumorigenic C10 cells. To address the basis of
      this differential stability, we treated both cell lines with cycloheximide, an
      inhibitor of protein synthesis, in the presence or absence of the transcriptional
      inhibitor, 5,6-dichloro-1-b-ribofuranosyl-benzimidazole (DRB). The rate of PKA II
      regulatory subunit alpha mRNA decay in the presence of DRB was unaffected by
      cycloheximide treatment in E9 cells but decreased upon the addition of
      cycloheximide to DRB-treated C10 cells. The combination of these two agents
      markedly destabilized PKA II mRNAs (PKA catalytic subunit alpha and PKA II
      regulatory subunit alpha) relative to DRB treatment alone in neoplastic E9 cells,
      causing them to decay at a rate equal to that in C10 cells. PKA II mRNA may be
      specifically stabilized by a protein with a relatively short half-life in
      neoplastic E9 cells. These results suggest the involvement of tumor-specific
      factor(s) in the regulation of PKA mRNA stability, a potential mechanism for
      conferring the observed differential responsiveness of normal and neoplastic lung
      cells to cyclic AMP.

PMID- 1742746
TI  - Rearrangements on chromosome 11q23 in hematopoietic tumor-associated t(11;14) and
      t(11;19) translocations.
AB  - We previously demonstrated that the breakpoint of t(11;14)(q23;q32) in the RC-K8
      B cell lymphoma cell line lies between CD3 and THY1/ETS1 on chromosome 11q23, and
      we cloned this region and named it the rck locus. Pulsed-field gel
      electrophoresis showed that the rck probe B (distal to the breakpoint) and the
      porphobilinogen deaminase (PBGD) probe detect the same germ line band and also
      the same rearranged band when DNA from RC-K8 cells was digested with NotI enzyme.
      Furthermore, Southern blot analysis with somatic cell hybrids showed that the
      PBGD gene moved to the 14q+chromosome, which confirmed PBGD to be more distal to
      the centromere than the rck locus. These data allowed us to construct the
      following order of genes: 11 cen-q23-CD3-rck-PBGD-THY1/ETS1. In this study, three
      infantile leukemia cell lines with t(11;19)(q23;p13) translocation were also
      analyzed by pulsed-field gel electrophoresis. CD3D probe detected the rearranged
      bands in DNA from two of them after digestion with NotI and SacII enzymes,
      demonstrating that the breakpoints of both cell lines were estimated to be within
      360 kilobases of CD3D.

PMID- 1742747
TI  - Clinical aspects of the use of calcium antagonists in cerebrovascular disease.
AB  - Calcium antagonists may be useful for certain cerebrovascular conditions. In
      addition to producing a variable amount of cerebral vascular relaxation, high
      doses of some of these drugs may block calcium entry into neurons. Clinical
      trials in patients with vasospasm have clearly shown that calcium antagonists can
      improve outcome. Clinical trials in patients with acute stroke have been
      inconclusive, and have been flawed by delayed patient entry. Cardiovascular side
      effects may limit the safety and efficacy of calcium antagonists in acute stroke
      patients. Further investigation of early treatment with cerebroselective agents,
      possibly in conjunction with complementary therapies, is needed.

PMID- 1742748
TI  - Banisterine and Parkinson's disease.
AB  - It is of historical interest that 63 years ago Louis Lewin reported the use of a
      hallucinogenic compound prepared from the South American vine, Banisteria Caapi,
      to treat Parkinson's disease (PD). This psychoactive compound, named banisterine,
      proved to be identical to harmine, but 30 years were to pass before it was shown
      to be a reversible monoamine oxidase (MAO) inhibitor. The first reports of the
      use of banisterine to treat postencephalitic parkinsonism in 1929 created a stir
      in the popular press and banisterine was hailed as a "magic drug." Despite
      continued studies of the harmala alkaloids by other researchers, interest in the
      therapeutic value of these compounds vanished during the 1930's. The story of
      banisterine is reviewed because it was the first MAO inhibitor to be used in
      parkinsonism, and illustrates the historical role of psychoactive drugs in the
      development of effective therapies, and in elucidating the pathophysiology of PD.

PMID- 1742749
TI  - L-threonine in the treatment of spasticity.
AB  - Preclinical data indicate that the administration of the amino acid L-threonine
      increases glycine levels in rat spinal cord. In order to investigate glycinergic
      mechanisms in spasticity, and other signs of the upper motor syndrome, we gave
      4.5 and 6.0 g/day of L-threonine to 18 patients with familial spastic paraparesis
      (FSP) according to a double-blind, crossover protocol. The response to treatment
      at the end of each 2-week period was based upon three measures: the physician's
      global impressions; the patients' global impressions; and semiquantitative
      ratings of strength, muscle tone, DTRs, walking, hopping, and running. Blood and
      CSF were collected during each treatment period for amino acid analyses. Based
      upon the severity rating scales, there was a statistically significant (p less
      than 0.02) decrease in motor impairment and spasticity during L-threonine
      administration compared to placebo treatment; significant treatment effects were
      not found on the physician's and patients' global impressions. Plasma and CSF
      levels of threonine increased significantly during L-threonine treatment but
      glycine levels did not change. These data indicate that L-threonine significantly
      suppressed the signs of spasticity even though the benefits were not clinically
      valuable.

PMID- 1742750
TI  - Interactions of sleep and clonidine on daytime prolactin secretion in humans.
AB  - The suppressive roles of adrenergic stimulation and rapid eye movement (REM)
      sleep on human prolactin (PRL) secretion are controversial. We examined the
      effects of sleep, clonidine (an alpha 2-adrenergic agonist), and their
      interaction on PRL secretion. Two groups of normal men (nine each) were studied
      in two morning sessions. Each group received either placebo or clonidine in both
      sessions. Subjects remained awake in the first session and in the next session
      they were asked to sleep for 3 h after the test dose was given. Blood samples
      were drawn at 30-min intervals and polysomnographic recordings were obtained at
      each session. PRL concentrations remained at baseline and no clonidine effect was
      detected while awake. PRL concentrations increased in placebo and clonidine
      groups during sleep. Despite significant suppression of REM sleep in the
      clonidine group, no differences were detected between the placebo and clonidine
      groups in peak PRL or mean PRL concentrations during the study. Also, no
      significant difference was detected in comparing PRL responses during non-REM
      sleep in both groups. The results suggest that alpha 2-adrenergic stimulation
      does not have a significant role in modulating human PRL secretion during sleep.

PMID- 1742751
TI  - Clenbuterol-induced tardive dyskinesia.
AB  - A 73-year-old man with a history of obstructive lung disease who received
      clenbuterol 20 mg b.i.d. over 5 years developed dyskinetic movements mainly of
      the respiratory muscles, closely resembling neuroleptic-induced dyskinesias.
      Despite drug withdrawal, abnormal movements persisted unchanged. Treatment with
      reserpine successfully controlled the dyskinetic movements. Clinicians should be
      aware of this potentially harmful effect of long-term clenbuterol therapy.

PMID- 1742752
TI  - Sublingual apomorphine in Parkinson's disease: a clinical and pharmacokinetic
      study.
AB  - The clinical response and the pharmacokinetic parameters of 3 mg subcutaneous
      (SC) and 30 mg sublingual (SL) apomorphine were compared in nine patients with
      Parkinson's disease. The magnitude of the motor responses (evaluated by tapping
      and walking tests and the Webster scale) was similar for SC and SL apomorphine.
      However, the onset to action was delayed after SL when compared with SC
      apomorphine. No significant difference was found in bioavailability (area under
      the curve: AUC) or peak plasma concentration (Cmax) between SC and SL
      apomorphine, whereas time to peak plasma concentration (Tmax) was shorter after
      SC apomorphine. Eight other patients were treated for a mean time of 4 months
      with SL apomorphine with a significant reduction in daily "off" hours. However,
      four of these eight patients developed stomatitis after some weeks of treatment.
      These results indicated that (a) pharmacokinetics parallel the clinical response
      to SL apomorphine, (b) SL apomorphine can reduce severe off periods in
      parkinsonian patients when used chronically, and (c) its long-term use is limited
      by a severe side effect (stomatitis).

PMID- 1742753
TI  - Orthostatic tremor: successful treatment with phenobarbital.
AB  - This article describes two patients with orthostatic tremor. The tremor affected
      the legs while standing and had a frequency of 14-16 Hz. We remark on the success
      of therapy with phenobarbital.

PMID- 1742754
TI  - Naloxone partly counteracts apomorphine side effects.
AB  - The effects of naloxone on side effects provoked by apomorphine (APO)
      administration in patients with parkinsonian syndrome have been studied. The
      group under study included eight patients with Parkinson's disease and four with
      parkinsonism who received 100 micrograms/kg s.c. APO acutely to test dopaminergic
      responsiveness. All patients were treated with 20 mg domperidone tablets t.i.d.
      and then for 2 consecutive days (in double blind fashion) were given a 2-hour
      i.v. saline infusion alone or with naloxone (8 mg) starting 30 min before APO
      administration. In both groups, naloxone delayed the appearance of sleepiness,
      and reduced the intensity of yawning, sleepiness, nausea, and vomiting as
      compared with saline. These findings indicate a potential usefulness of naloxone
      and other opioid antagonists in preventing acute APO side effects.

PMID- 1742755
TI  - Prolonged survival following the inadvertent intrathecal administration of
      vincristine: clinical and electrophysiologic analyses.
AB  - A 23-year-old man with a lymphoblastic lymphoma accidentally received 2.0 mg of
      vincristine intrathecally instead of intravenously. Although he underwent
      immediate CSF drainage, symptoms of an ascending myeloencephalopathy developed at
      48 h. This progressed to coma, initially with a diffusely slow EEG, which evolved
      into alpha coma. He also developed a left frontal focus of epileptiform activity.
      He was transferred to our institution 1 month later. His court-appointed guardian
      refused to allow discontinuation of supportive treatment; therefore, the
      evolution of the disorder can be followed for 12 months. Although alpha coma
      remained the predominant pattern, some EEG evolution did occur, with a
      progressive decrease in amplitude being most prominent. An increase in amplitude
      in the 10th month was accompanied by the return of some nystagmoid eye movements.
      The patient's lymphoma then recurred, and further treatment was not attempted.
      This tragic case, in which transient exposure to a microtubular poison produced
      severe CNS toxicity, allows some insights into the mechanisms of alpha coma.

PMID- 1742756
TI  - Acute dystonia induced by sulpiride.
AB  - We report a 15-year-old boy who, after the administration of 100 mg i.v. of
      sulpiride, presented an acute dystonic reaction consisting of oculogyric crises,
      retrocollis, opysthotonus, and dystonic postures in the left arm and hand. The
      symptoms were reversed after the injection of biperiden. This side effect has not
      been described previously. Sulpiride can induce the same extrapyramidal adverse
      reactions as the classical neuroleptic drugs.

PMID- 1742757
TI  - Managed health care.

PMID- 1742758
TI  - Denver homeless being trained.

PMID- 1742759
TI  - Position statement on HIV/AIDS.

PMID- 1742760
TI  - Myocardial protection with verapamil during ischaemia and reperfusion:
      dissociation between myocardial salvage and the degree of ATP depletion during
      ischaemia.
AB  - STUDY OBJECTIVE: The aim was to evaluate the protective effect of verapamil
      during myocardial ischaemia and reperfusion. DESIGN: In vivo phosphorus-31 (31P)
      magnetic resonance spectroscopy was performed on rats pretreated with verapamil
      (mg.kg-1 intraperitoneal) and controls during a 45 min left coronary artery
      occlusion and 60 min reperfusion. In separate groups of animals, haemodynamic
      measurements were taken at baseline, during ischaemia, and during reperfusion.
      Infarct size was determined by staining with triphenyltetrazolium chloride.
      EXPERIMENTAL MATERIAL: Female Sprague-Dawley rats were used (control group n =
      25, experimental group n = 24). MEASUREMENTS AND MAIN RESULTS: Infarct size was
      significantly reduced in the verapamil group compared to controls: 9.9(SEM 2.3)%,
      n = 19 v 28.5(2.7)%, n = 19, p less than 0.001 (infarct % of left ventricular
      mass). Myocardial phosphocreatine and ATP levels were reduced to similar levels
      in both verapamil and control animals after 45 min ischaemia: 56.8(3.4)%, n = 10,
      v 61.4(1.8)%, n = 11 NS; 67.7(2.7)%, n = 10 v 69.7(2.9)%, n = 11, NS (% of
      baseline value). After 60 min reflow, there was significant recovery of
      phosphocreatine [91.1(4.2)% of baseline, p less than 0.05] and ATP [86.8(2.7)% of
      baseline, p less than 0.05] in the verapamil group, but no recovery of high
      energy phosphates in controls [66.3(2.8), NS; 69.6(2.7), NS]. The left
      ventricular systolic pressure, heart rate, rate-pressure product, and maximum
      rate of left ventricular pressure development were similar prior to ischaemia,
      and during ischaemia in both groups. There was an inverse correlation between
      infarct size and the degree of phosphocreatine recovery after 60 min of
      reperfusion (PCr recovery (%) = -0.99 x infarct size (%) + 101; r = 0.91; p less
      than 0.01; n = 14). Furthermore, in a separate group of animals (n = 9), there
      was a significant correlation between the size of the ischaemic area at risk and
      the degree of phosphocreatine decline after 15 min of coronary occlusion (PCr
      reduction (%) = 0.91 x risk area (%) + 5.6; r = 0.97; p less than 0.01).
      CONCLUSIONS: Pretreatment with verapamil extends the ischaemic time after which
      reperfusion results in myocardial salvage in this model of ischaemia and
      reperfusion. This protective effect is independent of the haemodynamic
      determinants of myocardial oxygen demand and the degree of ATP and
      phosphocreatine depletion during the ischaemic period. In this model of
      reversible ischaemia, 31P magnetic resonance spectroscopy is useful for
      quantitating both the size of the ischaemic region during coronary artery
      occlusion and infarct size after reperfusion.

PMID- 1742761
TI  - End systolic pressure-length relations in halothane anaesthetised dogs: effects
      of regional ischaemia and inotropic agents.
AB  - STUDY OBJECTIVE: The aim was to investigate the effects of regional myocardial
      ischaemia, calcium, and verapamil on (a) the hysteresis and (b) slope and length
      axis intercept of the left ventricular end systolic pressure-length relationship.
      DESIGN: Segment length in myocardium supplied by the left anterior descending
      coronary artery was measured in anaesthetised dogs using sonomicrometry. Three
      levels of regional myocardial ischaemia were produced by stenosis and occlusion
      of the left anterior descending artery (ischaemia 1, ischaemia 2, and occlusion).
      A snare placed around the descending thoracic aorta was used to obtain temporary
      aortic occlusions. SUBJECTS: Seven open chested mongrel dogs were used, weight 17
      kg (range 16-20). MEASUREMENTS AND MAIN RESULTS: After abrupt release of
      temporary aortic occlusions, end systolic lengths were greater than before the
      occlusion in the normal myocardium. This hysteresis was abolished by regional
      myocardial ischaemia. However, hysteresis was insensitive to calcium and
      verapamil. The length axis intercept of the end systolic pressure-length
      relationship was increased during ischaemia 2, during coronary occlusion, and
      after administration of verapamil; its slope was increased after coronary
      occlusion. CONCLUSIONS: (1) Viscoelastic properties of the myocardium make a
      major contribution to hysteresis of the end systolic pressure-length
      relationship; and (2) the length axis intercept of this relationship is not
      constant and its slope does not appear to be a sensitive indicator of regional
      myocardial contractility during regional ischaemia.

PMID- 1742762
TI  - Reflection as a cause of mid-systolic deceleration of pulmonary flow wave in dogs
      with acute pulmonary hypertension: comparison of pulmonary artery constriction
      with pulmonary embolisation.
AB  - STUDY OBJECTIVE: The aim was to examine whether mid-systolic deceleration of the
      pulmonary flow wave occurred in acute pulmonary hypertension due to pulmonary
      artery constriction and pulmonary embolisation, and if so whether it was related
      to reflection. DESIGN: Various degrees of pulmonary hypertension were induced by
      both pulmonary artery constriction and pulmonary embolisation in dogs. During
      control periods and during pulmonary artery constriction and pulmonary
      embolisation, pulmonary flow and pulmonary artery pressure were recorded, and the
      forward and backward (reflected) flow waves were separated from the measured
      pulmonary flow wave by the method of Westerhof et al. MATERIALS: 20 adult mongrel
      dogs were used and 10 dogs qualified for analysis. The other 10 dogs, which died
      before both interventions were completed, were excluded. MEASUREMENTS AND MAIN
      RESULTS: During pulmonary artery constriction, a distinct mid-systolic
      deceleration of the pulmonary flow wave was observed in five of the 10 dogs,
      while during pulmonary embolisation, no mid-systolic deceleration was found in
      these five dogs. The distinct deceleration of the pulmonary flow wave was related
      to a steep fall and early negative peak in the backward flow wave. CONCLUSION:
      Mid-systolic deceleration of pulmonary flow wave is likely to be related to
      reflection.

PMID- 1742763
TI  - Enhanced circulating levels of neurally derived calcitonin gene related peptide
      in spontaneously hypertensive rats.
AB  - STUDY OBJECTIVE: Calcitonin gene related peptide (CGRP) is a potent endogenous
      vasodilator. The peptide is released from perivascular nerve endings and can
      normally be detected in the circulation. An attempt was made to determine the
      concentrations and partially characterise the immunoreactive forms of circulating
      CGRP in a genetically hypertensive rat strain, the "spontaneously hypertensive
      rat" (SHR) and its genetic control, Wistar-Kyoto (WKY). DESIGN: Immunoreactive
      plasma CGRP levels were measured using a highly sensitive carboxyl terminal
      specific CGRP radioimmunoassay together with high performance liquid
      chromatography. Plasma immunoreactive CGRP (i-CGRP) levels were also measured 6 h
      after intraperitoneal colchicine administration (10 mg.kg-1 body weight) to both
      groups of rats. EXPERIMENTAL MATERIAL: Eight SHR rats were compared with eight
      WKY rats, both groups aged 7 weeks. MEASUREMENTS AND MAIN RESULTS: Mean i-CGRP
      levels were threefold higher in the SHR group compared to controls, while plasma
      calcitonin levels were not different between the two groups. There was a
      significant correlation (Kendall's correlation coefficient, r = 0.57; p = 0.024)
      between i-CGRP levels and the mean systolic blood pressure (measured by the
      indirect tail cuff method) in SHR but not WKY rats. Similar profiles of i-CGRP
      were observed in both SHR and WKY rats, when acid-methanol extracts of pooled
      plasma were chromatographed under similar conditions. It was also confirmed that
      circulating CGRP in both SHR and WKY strains was derived from perivascular nerve
      endings, by demonstrating a complete abolition from plasma of previously
      detectable i-CGRP following the administration of colchicine. CONCLUSIONS: The
      study shows that CGRP is normally released from vascular nerve endings, and that
      high concentrations of the circulating peptide are found in hypertension. This
      might represent a mechanism to counteract the excessive vasoconstrictor
      influences that underly the development and maintenance of hypertension.

PMID- 1742764
TI  - Role of the endothelium in modulation of the acetylcholine vasoconstrictor
      response in porcine coronary microvessels.
AB  - STUDY OBJECTIVE: The aim was to investigate the role of the endothelium in
      modulating the acetylcholine response in porcine coronary microvessels and
      compare the results with simultaneously studied large coronary arteries. DESIGN:
      Coronary microvessels [104 (SEM 3.3) microns; range 38-150] were removed from
      fresh porcine hearts and studied in vitro during no flow constant pressure
      conditions. Endothelium derived relaxing factor (EDRF) activity and the role of
      the endothelium in modulating the acetylcholine response in microvessels was
      assessed by measuring changes in intraluminal diameter using a video tracking
      device. Large coronary arteries were simultaneously studied using conventional
      isometric ring techniques. EXPERIMENTAL MATERIAL: Fresh porcine hearts were
      obtained from a local slaughterhouse. MEASUREMENTS AND MAIN RESULTS:
      Acetylcholine was a potent vasoconstrictor (EC50 = 0.17 microM) of passively
      distended microvessels. The effects of EDRF were studied by either inactivation
      with haemoglobin or inhibition of EDRF synthesis with N-omega-nitro-L-arginine.
      Preconstricted microvessels exposed to either N-omega-nitro-L-arginine or
      haemoglobin constricted further, consistent with basal release of EDRF. Neither
      drug affected passively distended microvessels. The acetylcholine vasoconstrictor
      response was potentiated after exposure of microvessels to either drug. Atropine,
      but not indomethacin, blocked the acetylcholine response in microvessels. As with
      microvessels, acetylcholine was a vasoconstrictor (EC50 = 0.3 microM) of large
      coronary arteries. In contrast to microvessels, indomethacin antagonised
      acetylcholine vasoconstriction in vessels with intact endothelium. Bioassay
      experiments using indomethacin-treated large epicardial donor artery segments
      showed basal release of EDRF but no EDRF release in response to acetylcholine.
      CONCLUSIONS: The results show the microvessels and large coronary arteries are
      similar in their vasoconstrictor response to acetylcholine, that both release
      EDRF basally, and that vasoconstriction to acetylcholine is importantly modulated
      by the endothelium. In large arteries, acetylcholine does not stimulate EDRF
      release and, in contrast to microvessels, a cyclo-oxygenase product influences
      the vasoconstrictor action of acetylcholine.

PMID- 1742765
TI  - Influence of adenosine on the stimulatory effect of isoprenaline and insulin on
      myocardial contractility in vivo.
AB  - STUDY OBJECTIVE: In vitro investigations have indicated that adenosine can
      inhibit beta adrenergic stimulated increases in cardiac contractility. The
      present study was designed to determine the ability of adenosine to inhibit
      isoprenaline induced increases in contractility in vivo. Adenosine has been
      reported to exert its inhibitory effects on contractility by inhibiting adenylate
      cyclase. Thus, adenosine should have no effect on positive inotropic agents that
      act independently of adenylate cyclase. We therefore assessed the ability of this
      nucleoside to inhibit the positive inotropic effect of insulin, a hormone that
      exerts a positive inotropic effect independently of alterations in cyclic AMP.
      DESIGN: Saline or adenosine (10 mumol.ml-1) was infused into the circumflex
      artery at 1 ml.min-1 as a background. Isoprenaline (20 or 200 pmol.min-1) was
      infused into the artery during saline or adenosine infusion. The response to
      insulin was determined during hyperinsulinaemic euglycaemic clamp. SUBJECTS: 16
      adult mongrel dogs were anaesthetised with pentobarbitone. Five dogs were used in
      isoprenaline studies, and 11 dogs in insulin studies. MEASUREMENTS AND MAIN
      RESULTS: Dogs were instrumented to obtain measurements of mean arterial blood
      pressure, heart rate, circumflex artery blood flow (Q), instantaneous left
      ventricular pressure, and posterior left ventricular wall thickness. We used the
      slope of the end systolic pressure-dimension relationship (Ees) as an index of
      myocardial contractility, previously shown to reflect changes in myocardial
      inotropic state independent of influence from afterload and preload. Left
      ventricular dP/dtmax was derived from left ventricular pressure with respect to
      time, and Ees was determined from left ventricular pressure and wall thickness.
      Neither adenosine, isoprenaline, nor insulin alone caused any significant changes
      in mean arterial pressure or heart rate. Adenosine caused a significant increase
      in Q. Both left ventricular dP/dtmax and Ees were significantly increased by
      either insulin or both doses of isoprenaline. Adenosine inhibited the increases
      in these indices caused by isoprenaline, but not those caused by insulin.
      CONCLUSIONS: Adenosine is capable of inhibiting the positive inotropic effect of
      isoprenaline in vivo. The results suggest that adenosine does not inhibit
      positive inotropic responses that act independently of the stimulation of
      adenylate cyclase.

PMID- 1742766
TI  - Changes in myocardial energy metabolism in elective coronary angioplasty.
AB  - STUDY OBJECTIVE: The aim was to investigate the effect of coronary angioplasty on
      myocardial energy metabolism, and to assure the safety of the procedure in
      patients with coronary heart disease. DESIGN: Before angioplasty a catheter was
      introduced into the coronary sinus. Blood samples were taken simultaneously from
      femoral artery and coronary sinus before balloon inflation, upon balloon
      deflation, and two minutes later, and arteriovenous differences in myocardial
      substrates, pH, PCO2, oxygen saturation, and adenosine catabolites were
      determined. PATIENTS: 14 patients with angiographically documented coronary
      artery disease with lesions in the left coronary artery suitable for elective
      coronary angioplasty were included in the study. RESULTS: During balloon
      inflation the positive femoroarterial-coronary sinus difference of lactate turned
      negative, from 0.21(SEM 0.05) mM to -0.10(0.11)mM, p less than 0.02. At the same
      time pH and PCO2 differences increased: from 0.04(0.00) U to 0.07(0.01) U, p less
      than 0.01, and from -1.15(0.10) kPa to -1.41(0.10) kPa, p less than 0.01,
      respectively. The changes were, however, transient and the arteriovenous
      differences in these metabolic variables rapidly returned towards preinflation
      levels after balloon deflation. The femoroarterial-coronary sinus concentration
      differences in glucose and free fatty acids became positive in coronary
      angioplasty. The energy state remained good during the procedure as assessed from
      the negligible net efflux of adenosine and its degradation products. CONCLUSIONS:
      Elective coronary angioplasty can be performed without any persistent
      derangements in myocardial metabolism, and may in fact lead to improvement of
      utilisation of some myocardial substrates. Lactate appears to be a more sensitive
      indicator of short term ischaemia than adenosine degradation products.

PMID- 1742767
TI  - Improvement in contractile recovery of isolated rat heart after cardioplegic
      ischaemic arrest with endogenous phosphocreatine: involvement of antiperoxidative
      effect?
AB  - STUDY OBJECTIVE: The aim was to attempt to get further insight into the mechanism
      of the cardioprotective action of phosphocreatine (PCr). DESIGN: Three
      experimental protocols were used: (1) The effect was examined of exogenous PCr
      (10 mmol.litre-1) on myocardial oxidative damage produced by H2O2 perfusion (90
      mumol.litre-1) of isolated rat heart. (2) Isolated rat hearts were subjected to
      35 min cardioplegic ischaemia followed by reperfusion. A control group was
      studied along with two PCr groups, one corrected for Ca2+ to compensate its
      binding with PCr (1.4 mmol.litre-1 CaCl2 in St Thomas's Hospital cardioplegic
      solution), and the other not (1.2 mmol.litre-1). (3) The effect was studied of
      PCr alone and in combination with the antioxidant tocopherol phosphate (0.1
      mumol.litre-1) on contractile and metabolic recovery of isolated rat heart
      reperfused after 40 min cardioplegic ischaemia. EXPERIMENTAL MATERIAL: Studies
      were performed on hearts of 84 male Wistar rats, weighing 250-300 g. MEASUREMENTS
      AND MAIN RESULTS: (1) Oxidative stress resulted in irreversible contracture and
      impairment of sarcolemmal integrity revealed by using the transmembrane tracer
      ionic lanthanum. These effects coincided with the decrease of developed pressure
      from 116 (SEM 3) to 38(3) mm Hg and rate-pressure product from 498(13) to 165(16)
      mm Hg.s-1. The Ca2+ binding property of PCr was estimated experimentally and the
      stability constant of the complex CaPCr was found to be 35.4(0.7) mmol; from this
      the Ca2+ bound by PCr was calculated to be 14% in the experimental conditions
      used. Ca2+ concentration in K-H buffer containing PCr was increased to compensate
      its binding with PCr. PCr prevented H2O2 induced contracture, preserved
      sarcolemmal integrity, and attenuated H2O2 induced decrease in developed pressure
      and rate-pressure product [73(6) mm Hg and 340(28) mm H.s-1, respectively, p less
      than 0.05 compared with control]. (2) PCr reduced the diastolic pressure [29(10)
      v 68(10) mm Hg in control group at 30 min of reperfusion, p less than 0.05] and
      enhanced the developed pressure [81(10) v 46(10) mm Hg in controls, p less than
      0.05] and rate-pressure product [325(44) v 158(40) mm Hg.s-1 in controls, p less
      than 0.05]. When CaCl2 was increased to 1.4 mmol.litre-1 the protective effect of
      PCr was not abolished. (3) PCr resulted in improvement of developed pressure
      [49(7) v 18(5) mm Hg in controls at 40 min of reperfusion, p less than 0.05] and
      rate-pressure product [184(27) v 71(20) mm Hg.s-1 in controls, p less than 0.05].
      The degree of contractile recovery in the tocopherol group was almost the same as
      in the PCr group. Combined addition of PCr and tocopherol further increased the
      developed pressure and rate-pressure product to 72(4) mm Hg and 284(23) mm Hg.s
      1, respectively. Similarly, PCr and tocopherol in combination provided
      substantial inhibition of creatine kinase release into perfusate, at 3.8(0.4) v
      10.9(2.5) IU in controls, p less than 0.05. CONCLUSIONS: PCr decreases the
      vulnerability of myocardium to oxidative stress and ischaemic damage. These
      effects cannot be explained by PCr induced shifts in Ca2+ concentration.
      Protective effects of PCr and tocopherol are quantitatively additive, most
      probably due to their different mechanisms of action, and tocopherol may be
      effective in extending the ability of PCr to stabilise cell membrane structure.

PMID- 1742768
TI  - Reduction of experimental myocardial infarct size by oral administration of alpha
      tocopherol.
AB  - STUDY OBJECTIVE: The aim was to determine whether high dose dietary vitamin E
      could improve myocardial resistance to ischaemia and reperfusion. Vitamin E is an
      important physiological antioxidant which can be accumulated to high levels in
      the myocardium, without toxicity, by chronic dietary supplementation. DESIGN:
      Subjects were fed a standard laboratory feed and water ad libitum for 10 d, plus
      either d-alpha-tocopoheryl acetate 200 IU.kg-1.d-1 orally (vitamin E group), or
      no supplement (control group). The animals then underwent either 60 or 180 min of
      left anterior descending coronary artery ligation, followed by 6 h reperfusion.
      The area at risk was identified by colloidal carbon, and necrosis by triphenyl
      tetrazolium chloride and light microscopy. SUBJECTS: Studies were performed on
      New Zealand white rabbits weighing approximately 3.5 kg. MEASUREMENTS AND MAIN
      RESULTS: In the 60 min ligation study, the control group had 30.5 (SD 4.0)%
      necrosis of the area at risk but the vitamin E group had no necrosis (n = 5 per
      group, p less than or equal to 0.0001). In the 180 min ligation study, the
      control group had 74.1 (11.5)% necrosis of the area at risk whereas the vitamin E
      group had 23.1 (7.2)% (n = 5 per group, p less than or equal to 0.0001).
      CONCLUSIONS: High dose dietary supplementation with vitamin E can improve
      myocardial tolerance to ischaemia and reperfusion, significantly reducing
      myocardial infarct size.

PMID- 1742769
TI  - Failure of cyclo-oxygenase inhibition to protect against arrhythmias induced by
      ischaemia and reperfusion: implications for the role of prostaglandins as
      endogenous myocardial protective substances.
AB  - STUDY OBJECTIVE: It has been suggested that the balance between the release from
      the heart of prostacyclin and thromboxane A2 is a major determinant of the
      severity of arrhythmias during ischaemia and reperfusion. This has been examined
      in a dog model. DESIGN: Three different cyclo-oxygenase inhibitors in doses
      adequate to prevent formation of both prostacyclin and thromboxane--aspirin (7
      mg.kg-1), flurbiprofen (3 mg.kg-1), and sodium meclofenamate (2 mg.kg-1) with or
      without nafazatrom or dazmegrel--were given prior to a combined occlusion
      reperfusion insult, and the severity of resulting arrhythmias examined. MATERIAL:
      Adult greyhound dogs were used: controls n = 29; aspirin n = 10; flurbiprofen n =
      10; sodium meclofenamate +/- nafazatrom or dazmegrel n = 22. MEASUREMENTS AND
      MAIN RESULTS: None of the interventions modified the severity of ischaemic
      arrhythmias induced by coronary artery occlusion and release. The numbers of
      ventricular extrasystoles during the 40 min occlusion period were similar in all
      groups: controls 653(SEM 109); aspirin 690(187); flurbiprofen 454(132);
      meclofenamate 833(218). Ventricular fibrillation from the combined occlusion
      reperfusion insult was also similar; controls 83%; aspirin 80%; flurbiprofen 80%;
      meclofenamate 100%. In the doses used all three inhibitors prevented the increase
      in plasma concentrations of thromboxane A2 [from 104(23) to 166(34) pg.ml-1] and
      prostacyclin [from 450(80) to 720(110) pg.ml-1] seen in control untreated dogs
      subjected to coronary artery occlusion. The addition of sodium meclofenamate to
      either nafazatrom (10 mg.kg-1 orally) or dazmegrel (3 mg.kg-1 intravenously),
      which when given alone are markedly protective, abolished this protection.
      CONCLUSION: The results show the importance of maintaining prostacyclin release
      in modifying the severity of ischaemic and reperfusion arrhythmias, and again
      suggest that prostacyclin is an "endogenous antiarrhythmic substance".

PMID- 1742770
TI  - Glutamic acid decarboxylase of embryonic avian retina cells in culture:
      regulation by gamma-aminobutyric acid (GABA).
AB  - 1. Retina-cell aggregate cultures expressed glutamate decarboxylase activity (L
      glutamate 1-carboxylase; EC 4.1.1.15) as a function of culture differentiation.
      2. Glutamic acid decarboxylase (GAD) activity was low in the initial phases of
      culture and increased eight-fold until culture day 7, remaining high up to day 13
      (last stage studied). 3. The addition of GABA to the culture medium 24 h after
      cell seeding almost totally prevented the expression of GAD activity. 4. In
      association with decreased enzyme activity, aggregates exposed to GABA did not
      display immunoreactivity for GAD, suggesting that GAD molecules were either lost
      from GABAergic neurons or significantly altered with GABA treatment. 5. Control,
      untreated aggregates showed intense GAD immunoreactivity in neurons. Positive
      cell bodies were characterized by a thin rim of labeled cytoplasm with thickest
      labeling at the emergence of the main neurite. 6. Heavily labeled patches were
      also observed throughout the aggregates, possibly reflecting regions enriched in
      neurites. 7. The GABA-mediated reduction of GAD immunoreactivity was a reversible
      phenomenon and could be prevented by picrotoxin.

PMID- 1742772
TI  - Cluster headache--course over ten years in 189 patients.
AB  - One-hundred-and-eighty-nine cluster headache patients, referred to Parma and
      Pavia Headache Centres between 1976 and 1986 with a disease duration of over 10
      years, were interviewed about the course of cluster headache. They were
      classified as episodic (n = 140) or chronic (n = 49) cluster headache patients on
      the basis of course during the year of onset. Episodic patients showed the
      following outcome: maintenance of an episodic form (primary episodic form) in
      80.7% of cases, shift towards a chronic form (secondary chronic form) in 12.9%
      and shift towards an intermediate pattern ("combined" form) in 6.4%. In chronic
      patients, cluster headache was still chronic (primary chronic form) at the moment
      of observation in 52.4% of cases, while it turned into an episodic form
      ("secondary" episodic form) in 32.6% and into a "combined" form in 14.3%.
      Nineteen patients (10%) had had no attacks for at least three years at the moment
      of examination. We can conclude from our data that: cluster headache is a disease
      of long duration, perhaps lifelong; episodic cluster headache tends to worsen;
      chronic cluster headache may easily turn into a better prognostic episodic form;
      prophylactic drugs are unable to induce recovery. The following factors seem
      related to a poor outcome: a later onset, the male gender and a disease duration
      of over 20 years for the episodic forms.

PMID- 1742771
TI  - Rhythmic regulation of retinal melatonin: metabolic pathways, neurochemical
      mechanisms, and the ocular circadian clock.
AB  - 1. Current knowledge of the mechanisms of circadian and photic regulation of
      retinal melatonin in vertebrates is reviewed, with a focus on recent progress and
      unanswered questions. 2. Retinal melatonin synthesis is elevated at night, as a
      result of acute suppression by light and rhythmic regulation by a circadian
      oscillator, or clock, which has been localized to the eye in some species. 3. The
      development of suitable in vitro retinal preparations, particularly the eyecup
      from the African clawed frog, Xenopus laevis, has enabled identification of
      neural, cellular, and molecular mechanisms of retinal melatonin regulation. 4.
      Recent findings indicate that retinal melatonin levels can be regulated at
      multiple points in indoleamine metabolic pathways, including synthesis and
      availability of the precursor serotonin, activity of the enzyme serotonin N
      acetyltransferase, and a novel pathway for degradation of melatonin within the
      retina. 5. Retinal dopamine appears to act through D2 receptors as a signal for
      light in this system, both in the acute suppression of melatonin synthesis and in
      the entrainment of the ocular circadian oscillator. 6. A recently developed in
      vitro system that enables high-resolution measurement of retinal circadian
      rhythmicity for mechanistic analysis of the circadian oscillator is described,
      along with preliminary results that suggest its potential for elucidating general
      circadian mechanisms. 7. A model describing hypothesized interactions among
      circadian, neurochemical, and cellular mechanisms in regulation of retinal
      melatonin is presented.

PMID- 1742773
TI  - Histamine receptors in the isolated human middle meningeal artery. A comparison
      with cerebral and temporal arteries.
AB  - The subtypes of histamine receptors mediating dilatation of human meningeal
      arteries have been tested in vitro, using "selective" antagonists, and compared
      with cerebral and temporal arteries previously examined. Dilatory responses were
      tested after preconstriction with prostaglandin F2 alpha. Both mepyramine and
      cimetidine caused a parallel shift to the right of the histamine concentration
      response curve, suggesting the presence of both H1- and H2-receptors. Combined
      treatment with mepyramine and cimetidine caused further displacement of the
      concentration-response curve to the right. Schild analysis indicated pA2 values
      of 6.3 for cimetidine and 9.8 for mepyramine in situations of near complete
      blockade of either of the receptors. Both H1- and H2-receptors seem of importance
      for the histamine-induced dilatation in meningeal arteries and neither appear to
      dominate. The data considered in conjunction with our previous findings support
      the finding that experimental histamine-induced headache due to vasodilatation is
      intracranial of origin.

PMID- 1742774
TI  - The similarities and differences of migraine with aura and migraine without aura:
      a preliminary study.
AB  - A preliminary study was undertaken to provide clinical evidence to support the
      hypothesis that: "Migraine with aura, migraine without aura and aura alone are
      the same condition, which differ in degree rather than pathophysiology." At the
      City of London Migraine Clinic, 50 patients consecutively attending the clinic
      with a past or present history of migraine with aura were questioned. Of the 50
      patients questioned 36 (70%) had a combination of migraine with aura, migraine
      without aura and/or aura alone; i.e. 70% had had more than one type of migraine
      attack. The duration, severity and frequency of attacks did not differ between
      migraine with and migraine without aura. Conclusion--the results support the
      hypothesis that migraine with and migraine without aura, and aura alone are not
      separate conditions, because: (1) most patients suffer from more than one type of
      migraine attack; (2) there are no significant differences in the characteristics
      of the migraine attacks in the different groups; (3) there are no significant
      differences in the characteristics of the subjects.

PMID- 1742775
TI  - Propranolol in the treatment of acute migraine attacks.
AB  - The efficacy of the beta-adrenoceptor antagonist propranolol in the acute
      treatment of patients in attacks of either classical (migraine with aura) or
      common migraine (migraine without aura) headache was assessed in a double-blind
      placebo-controlled crossover trial with fixed doses. The trial was carried out on
      25 patients. The treatment period was set at eight weeks, with the provision of
      shortening or lengthening it if necessary with a maximum period of seventeen
      weeks. A minimum of three migraine attacks were treated during each treatment
      period. Patients were assessed according to: the mean duration and mean severity
      per treatment period of migraine attacks. The secondary efficacy assessment was
      made on the basis of the percentage of attacks requiring escape medication per
      treatment period. The study, based on the t-distribution statistical model with a
      confidence level of 95%, showed that propranolol had no significant effect in
      aborting acute attacks of migraine when compared with placebo.

PMID- 1742776
TI  - A note on the action of glutamine on cortical spreading depression.
AB  - Application of a solution of 1-glutamine, 75 mM, to the pia-arachnoid surface of
      the dorsolateral neocortex of rabbits under dial-urethane anaesthesia was found
      to reversibly render the tissue insusceptible to spreading depression. It is
      suggested that this amide may play a part in the opposition normally offered by
      the tissue to undergo spreading depression. Some evidence is adduced which seems
      to support this suggestion.

PMID- 1742777
TI  - Double wire technique for additional guiding catheter support in anomalous left
      circumflex coronary artery angioplasty.
AB  - This case report presents an example of the use of the double wire technique for
      additional guiding catheter bracing support in percutaneous transluminal coronary
      angioplasty (PTCA) of a stenosis in an anomalous circumflex (CX) artery arising
      within the ostium of the right coronary artery (RCA). It illustrates the ease of
      this technique in comparison to conventional guiding catheter cannulation, which
      may be more difficult and yield poor backup support in this unusual anatomic
      situation.

PMID- 1742778
TI  - Two hugging balloons at high pressures successfully dilate a lesion refractory to
      routine coronary angioplasty.
AB  - A small portion of lesions are refractory to coronary angioplasty even when very
      high pressures are used. This leads to a failed angioplasty and emergent bypass
      surgery. We successfully attempted the technique of hugging balloons or two
      polyethelene terephthalate (PET) balloons inflated simultaneously side by side
      which successfully dilated a lesion which would not dilate using standard
      techniques. This technique successfully dilated the lesion as the geometry of two
      balloons inflated side by side is different from one balloon. Two balloons
      inflated side by side consists of two outer semi-circles and a central
      trapezoidal square area. This altered geometric configuration may be important in
      successfully dilating a lesion refractory to standard dilating techniques. Higher
      pressures can be attained with smaller balloons as the burst pressure is higher
      in smaller balloons compared to larger balloons.

PMID- 1742779
TI  - Coronary artery to middle cardiac vein fistula following endomyocardial biopsy in
      a heart transplant patient.
AB  - Coronary artery fistulas draining directly into the right ventricle have been
      recognised as a complication of transvenous endomyocardial biopsy procedures
      performed in heart transplant recipients. We report a case where a fistula
      drained into the middle cardiac vein and outline the possible mechanism of
      occurrence and its prevention. The diagnostic and therapeutic aspects of these
      "acquired" fistulas are reviewed.

PMID- 1742780
TI  - Interpretation of cardiac pathophysiology from pressure waveform analysis:
      percutaneous balloon valvuloplasty.
AB  - The hemodynamic findings of aortic, mitral and pulmonary balloon valvuloplasty
      serve to identify classical valvular lesions and their responses to graded or
      abrupt catheter dilation techniques. The production of mild insufficiency after
      valve dilation is generally well tolerated. Severe valvular insufficiency
      produces the expected hemodynamic alterations, but acute decompensation may be
      witnessed over brief periods of time. The use of extra stiff guidewires across
      dilated valves, especially the aortic valve, may also produce an exaggerated
      hemodynamic picture of insufficiency. Although gradients may be reduced, the
      effect of valve dilation on aortic valve area is generally small. A discussion of
      factors influencing valve area calculations will be the subject of a future
      "Rounds."

PMID- 1742781
TI  - Coronary artery quantitation and data management system for paired
      cineangiograms.
AB  - A computerized system designed to optimize the quantitation of coronary vessels
      on 35 mm cineangiograms is described and validated. Because the system has two
      cine film digitizers, it processes paired coronary arteriograms for the
      evaluation of serial changes in coronary arteries. A database system was
      specifically designed for the storage of coronary artery quantitation data which
      resides on a file server in a local area network and may be accessed by multiple
      workstations. In radiographic phantom studies of nine contrast-filled lucite
      cylinders of known size, the overall accuracy and precision for the measured
      diameters were 0.069 mm and 0.066 mm respectively. Measurements of minimum
      diameter and percent diameter stenosis of 21 coronary lesions selected from 17
      routine cineangiograms showed high degree of intraobserver and interobserver
      reproducibility.

PMID- 1742782
TI  - Method to allow safe catheterization of extremely obese patients.

PMID- 1742783
TI  - Initial experiences with a miniaturized pressure transducer during coronary
      angioplasty.
AB  - A newly constructed pressure sensor with a diameter of 0.45 mm was evaluated in
      15 patients undergoing balloon coronary angioplasty (PTCA). The sensor and an
      optic fiber were mounted on a 0.018" guide wire, which was used in the balloon
      catheter. Pressure gradients were recorded before and after PTCA, respectively.
      The pressure tracings were of satisfactory quality in all cases. The mean
      systolic and diastolic gradients before PTCA were 32 +/- 20mm Hg and 44 +/- 26mm
      Hg, respectively. Pressure gradients were also obtained with the balloon placed
      in the lesion in order to simulate the conventional way of pressure measurement
      through the balloon catheter. In this setting, the systolic and diastolic
      gradients were 77 +/- 32mm Hg and 59 +/- 25mm Hg, respectively. Following balloon
      dilatation, the systolic pressure gradient decreased to 14 +/- 12mm Hg, and the
      diastolic gradient to 13 +/- 11mm Hg. In conclusion, this new pressure sensor
      delivers recordings of good quality and may be especially of interest during
      angioplasty due to its small diameter.

PMID- 1742784
TI  - Performance characteristics of a new shape of guiding catheter for PTCA of the
      left coronary artery.
AB  - The inability to successfully perform angioplasty commonly involves inadequate
      guiding catheter performance. We evaluated the use of a new left coronary guiding
      catheter for angioplasty (PTCA) of lesions in both the left anterior descending
      and left circumflex arteries. The Nesto guide in two different sizes was used in
      100 consecutive PTCA cases as a primary catheter. The catheter successfully
      cannulated the left main coronary artery in 93 patients and PTCA was successfully
      performed in 85 patients for target lesions at various locations in either or
      both vessels. Positive features of this new guiding catheter include superior
      back-up support and ease of disengagement.

PMID- 1742785
TI  - Coronary artery to left ventricular fistula.

PMID- 1742786
TI  - Right heart catheterization.

PMID- 1742787
TI  - Selective thrombolysis with rt-PA: a promising approach for the management of
      embolic cerebrovascular complications during left heart catheterization?

PMID- 1742788
TI  - Cardiac catheterization 1990: a report of the Registry of the Society for Cardiac
      Angiography and Interventions (SCA&I).
AB  - This report presents the first year's experience of a totally computerized
      cardiac catheterization laboratory reporting system, including the results and
      complications of invasive and interventional procedures. Sixty-three laboratories
      reported a total of 71,916 patients studied between January 1 through December
      31, 1990. Two previous registry reports have been published. Compared with data
      acquired by previous methods, in spite of an older and sicker population, the
      mortality for diagnostic procedures has remained remarkably constant (0.11%). The
      computerized format facilitates data collection and analysis, helps resolve new
      issues as they arise and serves as a method of monitoring quality of laboratories
      and individuals.

PMID- 1742789
TI  - Predictors of early mortality in patients with angiographically documented left
      main coronary artery disease.
AB  - To determine predictors of early death after coronary angiography in patients
      with significant left main coronary artery disease (greater than or equal to 60%
      diameter narrowing, LMCAD), we reviewed the clinical records of patients with
      LMCAD who died after angiography. Of 1,288 patients with LMCAD studied between
      January 1978 and October 1989, 21 died within 2 days after angiography (group 1).
      As a control group, 85 patients were randomly sampled from 1,196 patients who
      survived at least 30 days after angiography (group 2). The predictors of early
      death after angiography in patients with LMCAD were older age (P less than 0.05),
      New York Heart Association Class III or IV (P less than 0.005), shorter duration
      of unstable angina (P less than 0.005), higher left ventricular end-diastolic
      pressure (P less than 0.006), lower ejection fraction (P less than 0.005), and
      significant left circumflex artery disease (P less than 0.006). The use of
      heparin infusion after angiography did not appear to be a significant factor. It
      is suggested that earlier operation or more aggressive management be undertaken
      in patients who, at cardiac catheterization, have significant LMCAD associated
      with the above-listed variables.

PMID- 1742790
TI  - Angioplasty in ulcerative coronary artery disease: acute results and early follow
      up.
AB  - The safety and efficacy of percutaneous transluminal coronary angioplasty (PTCA)
      for stenoses involving ulcerative lesions were retrospectively studied. Seventy
      seven patients (62 men and 15 women, mean age 62 +/- 10 years) representing 3.4%
      of 2,250 patients treated with PTCA during the period January 1, 1988 and June
      30, 1990, had pre-PTCA stenoses defined as ulcerated. Twenty-eight (36%) of the
      stenoses were localized in the left anterior descending coronary artery, 9 (12%)
      in the left circumflex and 40 (52%) in the right coronary artery. During
      angioplasty, percent diameter stenosis was reduced from 73 +/- 14% to 22 +/- 13%
      and transstenotic gradient decreased from 48 +/- 18 to 12 +/- 6 mm Hg. Clinical
      success (freedom from angina at discharge without coronary bypass surgery,
      infarction or death) was achieved in 70 patients (90.9%). There were seven
      unsuccessful cases: three underwent elective coronary bypass surgery, one was
      managed medically, and three developed a major flow interrupting dissection
      during the procedure requiring emergency coronary bypass surgery. There were no
      deaths. At mean follow-up of 7.6 months, 45 of 61 patients (73.7%) remained
      asymptomatic. One patient needed an elective coronary bypass surgery and five
      patients had a successful repeat PTCA. In conclusion, PTCA for an ulcerated
      stenosis can be performed safely with a high primary success rate and a favorable
      early clinical course.

PMID- 1742791
TI  - Effect of drugs on a noninvasive index of arterial compliance in healthy and
      heart failure patients.
AB  - Ten healthy (aged 28 to 39) and ten heart failure NYHA II (aged 19 to 49) male
      subjects were prospectively studied under no drugs, under furosemide (40 mg/day),
      under captopril (150 mg/day) and under their association. Arterial compliance
      (ml/mmHg) was measured in all subjects at rest and supine. Heart failure etiology
      was dilated cardiomyopathy or ischemic heart disease without significant
      regurgitation. Arterial compliance was significantly higher in healthy than in
      heart failure patients in all studied conditions (p less than 0.001) (healthy =
      2.2 + 0.29 vs. heart failure = 0.79 + 0.14). Neither single drug nor their
      association induced any change in healthy subjects. Arterial compliance
      progressively increased in heart failure with furosemide, captopril, and their
      association (no drug = 0.79 + 0.14; furosemide = 0.87 + 0.15; captopril = 0.94 +
      0.15 and furosemide + captopril = 0.99 + 0.14). Captopril induced a higher
      increment than furosemide (p less than 0.001) and their association even a higher
      increment (p less than 0.001) than any single drug. Thus captopril and/or
      furosemide increased arterial compliance in heart failure but not in healthy
      subjects, possibly through changes in arterial wall edema and smooth muscle
      contraction.

PMID- 1742792
TI  - Combined intravascular ultrasound/angioplasty balloon catheter: initial use
      during PTCA.

PMID- 1742793
TI  - Production of glycosaminoglycans by human skin fibroblasts growing in a collagen
      lattice.
AB  - Production of glycosaminoglycans (GAG) by human skin fibroblasts cultured in
      collagen lattices closely resembled that already described for the same cells
      grown as monolayers on plastic. There was no inhibition of GAG corresponding to
      that of DNA and protein synthesis and similar controls by cell density and anti
      inflammatory drugs operated in 3-dimensional as in 2-dimensional culture. The
      bulk of the GAG synthesised in lattice culture was hyaluronic acid, as in
      monolayers.

PMID- 1742794
TI  - Effect of vasopressin and protein kinase C inhibitors on junctional conductance
      in isolated heart cell pairs.
AB  - The effect of vasopressin on junctional conductance (gj) in isolated heart cell
      pairs was investigated. The results indicated that vasopressin (60 nM) causes a
      decrease in gj of 53% (S.E. +/- 5) (n = 10) within 15 sec. of its administration
      to the bath. The effect of vasopressin was dose-dependent and was suppressed by
      staurosporine (50 microM)--a potent inhibitor of protein kinase C. Inhibitors of
      protein kinase C by themselves increased gj. The results indicate that protein
      kinase C plays an important role in the control of gj in heart muscle.

PMID- 1742795
TI  - Toxicity of gentamicin in organ culture of fetal rat intestine.
AB  - The effect of gentamicin in the culture of fetal rat intestine was studied. Fetal
      rat intestine was cultured with gentamicin or kanamycin at the concentration
      between 4 to 200 micrograms/ml. Kanamycin did not have influence on lactase,
      maltase and ALP activities. On the other hand, gentamicin caused decrease of
      lactase and ALP activities at the concentration of 40 and 200 micrograms/ml
      compared with the activities at 4 micrograms/ml. Maltase activities did not
      decrease with gentamicin. Our data suggest that gentamicin could affect lactase
      and ALP activities and lower concentration should be used in the culture.

PMID- 1742796
TI  - Increased release of von Willebrand factor antigen by endothelial cells whilst in
      active growth phase.
AB  - Human umbilical vein endothelial cells and fibroblasts were grown in tissue
      culture (with and without added endothelial cell growth supplement) to
      confluence. von Willebrand factor antigen was measured in supernatants every 24
      hours. Cells grown in medium with growth supplement reached confluence before
      those grown without the supplement. von Willebrand factor antigen release was
      greatest under both sets of conditions when cells were in their most active
      growth phase, and rate of release slowed when cells were confluent. Fibroblasts
      grew more rapidly, showed a small response to the growth supplement, but
      supernatant von Willebrand factor antigen could not be detected. The implications
      of these findings for atherogenesis are discussed.

PMID- 1742798
TI  - Effect of nerve growth factor on lesioned PC12 cells.
AB  - The protecting effect of nerve growth factor (NGF) from hydrogen peroxide was
      studied on PC12 cells conditioned at 1 mM hydrogen peroxide with NGF and without
      NGF in comparison with cells treated with neither hydrogen peroxide nor NGF. NGF
      treatment of PC12 cells increased significantly the activity of catalase
      representing induction of free radical detoxifying mechanisms. The protection
      effect of NGF was reflected also on enhanced activities of choline
      acetyltransferase (ChAT) and acetylcholinesterase (AChE) in the cells.

PMID- 1742797
TI  - Expression of laminin by human fibroblasts, HT1080 fibrosarcoma cells and MCF-7
      breast adenocarcinoma cells. Lack of regulation by the cell density and
      extracellular matrix.
AB  - We have cultured normal fibroblasts, fibrosarcoma HT1080 cells and breast
      adenocarcinoma MCF-7 cells on various substrates (plastic, collagen type I,
      laminin). All cell types used adhered on the three substrates with, however, a
      delayed attachment on laminin. On all substrates, cell grew as monolayer with the
      exception of MCF-7 cells that formed clusters on laminin. The epithelial MCF-7
      cells as well as mesenchymal cells (fibroblasts and tumoral HT1080 cells)
      synthesized laminin and expressed mRNA coding for laminin B1 chain and for the 67
      kD laminin binding protein. The levels of these mRNAs were not modulated by
      culture conditions which affect cell morphology nor by cell density.

PMID- 1742799
TI  - Intracellular calcium of longitudinal muscles isolated from pregnant rat
      myometrium.
AB  - Longitudinal muscle cells were successfully isolated from pregnant rat myometrium
      (21 days of gestation) with more than a 95% survival rate. The approximate size
      of relaxed cells was 232.2 +/- 74 microns in length and 16.2 +/- 7.0 microns in
      width. Using the fluorescent indicator Fura-2, the concentration of intracellular
      free calcium ([Ca2+]i) in resting state cells was calculated to be 116 +/- 18.5
      nM. The isolated cells responded well to K+, acetylcholine and oxytocin in terms
      of contraction as well as the increase in [Ca2+]i. The increase in [Ca2+]i
      induced by acetylcholine and K+ appeared to be mainly due to an influx of
      extracellular Ca2+. On the other hand, the oxytocin-induced increase in [Ca2+]i
      was mainly due to a release of Ca2+ from intracellular storage sites in the
      isolated cells. Isolated longitudinal muscle cells can serve as a useful tool in
      establishing the relationship between [Ca2+]i and regulation of the uterine
      contraction at the final stage of pregnancy.

PMID- 1742801
TI  - Changes in tissue fibronectin in elastase induced lung injury.
AB  - We studied changes in rat lung fibronectin (FN) content and synthesis after
      endobronchial administration of elastase. A severe hemorrhagic neutrophilic
      alveolitis ensued with plasma protein leakage, initial rise in tissue FN content,
      and sustained rise in FN synthesis. Unlike fibrotic models where initial rises in
      tissue FN levels are sustained, levels in this model normalized promptly. This,
      in the setting of increased synthesis is consistent with increased degradation.
      This degradation of tissue FN may result in the disruption of the lung
      architecture, interfere with the deposition of newly synthesized matrix and could
      partly explain the development of emphysema in a model where excess fibronectin
      synthesis is observed.

PMID- 1742800
TI  - Ultrastructural localization of the nuclear protein mitotin during the cell
      cycle.
AB  - The work presents the results of the immunoelectron microscopical localization of
      mitotin in different phases of the cell cycle. The distribution of the protein
      was studied using its specific monoclonal antibody and immunogold labeling in
      synchronized WISH cells. In S phase the antigen was found in the nucleoplasm
      usually over the interchromatin granules. In G2 phase the amount of mitotin
      increases and it can be found also in the nucleolus. In mitosis the immunogold
      granules are always out of the condensed chromosomes.

PMID- 1742802
TI  - Ultrastructural localization of dystrophin in chicken smooth muscle.
AB  - We investigated the presence of dystrophin in gizzard smooth muscle by
      immunofluorescence assay, immunoblot detection and an immunogold electron
      microscopy technique. Western blot analyses, using antibodies raised against
      sequences 1173-1728 and 3357-3660 of the dystrophin molecule, revealed the
      presence of a major intact 400 kDa protein band and an immunofluorescence
      localization restricted to the periphery of the smooth muscle cells. We were able
      to precisely determine the dystrophin distribution along the plasmalemma whereas
      caldesmon molecules were present in the cytoplasm. The most commonly observed
      distance between two neighbouring dystrophin molecules suggested a self
      associating arrangement. We discuss these findings in relation to the function of
      dystrophin in the smooth muscle cell structure.

PMID- 1742803
TI  - Human leucocyte migration through collagen matrices containing other
      extracellular matrix components.
AB  - The purpose of this study was to investigate the migration of human peripheral
      blood leucocytes through collagen gels containing extracellular matrix components
      in vitro. This further extends the findings of a previous study (Reid et al,
      1990), using rabbit peritoneal neutrophils, in which it was found that increasing
      the mechanical strength of the gels decreased the cell migration. In the current
      study it was found that human neutrophil and lymphocyte migration through
      collagen matrices was inhibited by increasing the collagen concentration, whereas
      the presence of serum had no effect on migration. Incorporation of chondroitin
      sulphate into collagen gel matrices resulted in a slight increase in leucocyte
      migration. The presence of elastin had no effect on the migration of leucocytes
      through collagen matrices, whereas incorporation of hyaluronate into collagen
      matrices decreased leucocyte migration. The morphology of these matrices suggests
      that altered migration was not due to differences in pore size between fibres.

PMID- 1742804
TI  - Differential effects of concanavalin A, serum and cytokines on proteoglycan
      elaboration and DNA synthesis by mononuclear cells from human peripheral blood.
AB  - Human blood derived mononuclear cell (MC) cultures required concanavalin A (Con
      A) stimulation to synthesize and secrete into the medium high levels of a
      protease-resistant proteoglycan (PG) containing predominantly chondroitin sulfate
      (CS), which was elaborated largely by T-cells in culture. PG and DNA synthesis
      were studied in MC cultures in the absence and presence of Con A as well as serum
      and some biologically active polypeptide factors. In the presence of Con A,
      stimulation of PG synthesis was substantially greater in T-cell enriched cultures
      than in B-cell enriched cultures. DNA synthesis was also stimulated in the
      presence of Con A. This stimulation was concentration-dependent, but required the
      presence of serum for additional responses. DNA and cell proliferation were
      stimulated by interleukin-2 (IL-2), but PG production was not stimulated by
      conditioned media, IL-1, IL-2, IL-3, or transforming growth factor-beta (TGF
      beta). Our results indicate that the elaboration of PG from T-cells of human MC
      is independent of the effects of regulatory peptides on cell proliferation and
      DNA synthesis.

PMID- 1742805
TI  - Hepatitis A outbreak in Grand Forks, British Columbia, 1990.

PMID- 1742806
TI  - Three dimensional structure of GD1b and GD1b-monolactone gangliosides in
      dimethylsulphoxide: a nuclear Overhauser effect investigation supported by
      molecular dynamics calculations.
AB  - A comparative study on the conformational features of the oligosaccharide moiety
      of GD1b and GD1b lactone gangliosides, in dimethylsulphoxide, has been carried
      out by nuclear Overhauser effect investigation; the experimental interresidue
      contacts have been used for restrained molecular mechanics and dynamics
      calculations. For GD1b, the tetrasaccharide beta-GalNAc-(1----4)-[alpha-Neu5Ac-(2
      ----8)-alpha-Neu5Ac-(2----3)]-beta-Gal has a circular arrangement leaving a
      highly hydrophobic region with seven hydrogens pointing towards the center. At
      one side of this region the three electron rich groups GalNAc--NH, external
      Neu5Ac--OH4 and internal Neu5Ac--COO- are grouped together; at the other side
      five polar groups (four hydroxy groups and the external Neu5Ac carboxylate)
      define a large annular hydrophilic region. The external Neu5Ac is close to the
      external Gal residue, and the external Neu5Ac--COO- is within van der Waals
      contact with the inner Neu5Ac-OH9 group. The beta-Gal-(1----3)-beta-GalNAc
      glycosidic linkage shows a high degree of freedom. For GD1b-L, the trisaccharide
      beta-GalNAc-(1----4)-[alpha-Neu5Ac-(2----3)]-beta-Gal is disposed to forming
      rigid partially circular arrangement showing strong interresidue contacts between
      the inner Neu5Ac-H8 and both GalNAc-H1 and GalNAc-H5. The conformation of the
      lactone ring is the boat 9(A),2(B)B. The lactonization of the disialosyl residue
      induces a strong variation of the preexisting torsional glycosidic angles phi and
      psi, leaving the external Neu5Ac far from the external Gal. In both GD1b and GD1b
      lactone gangliosides, the conformation of the sialic acid side chain is the same
      as that of the free sialic acid in which the H7 is trans to H8 and gauche to H6,
      thus indicating that the presence of glycosidic and/or ester linkages does not
      affect the conformational properties of sialic acid. Both GD1b and GD1b lactone
      containing sialic acid carboxylate anion(s) or undissociated carboxyl group(s)
      show the same three dimensional structure, indicating that the presence of
      charges does not affect the intrinsic conformational features of gangliosides.

PMID- 1742807
TI  - Incorporation of phosphonic acid diesters into lipid model membranes. Part II. X
      ray and neutron diffraction studies.
AB  - Mixtures of egg phosphatidylcholine and phosphonic acid diethyl or dibutyl esters
      of the general type RP(O)(OR')2 with R = hexane or dodecane were studied at room
      temperature in the fluid lamellar state by X-ray and by neutron diffraction.
      Generally a molar ratio of lipid and ester of 1:0.5 was used. Additionally an
      equimolar lipid/ester mixture of hexane phosphonic acid diethyl ester was
      studied. Depending on the ester used and its concentration a single L alpha-phase
      was observed above a certain water content which changes to an L alpha + water
      two phase system at high water concentration. Despite the large amounts of the
      amphiphilic ester molecules incorporated in the membrane and their high molecular
      asymmetry, the mixtures qualitatively show the typical hydration and swelling
      behaviour of non-charged lipid membranes. However, the incorporation of the
      esters induces a higher hydration capacity, a lateral extension and a decrease in
      membrane thickness. The position of the ester molecules and their orientation in
      the membrane were determined by neutron diffraction using partially deuterated
      esters. The esters were found to be located with their phosphonic moiety near or
      in the lipid/water interface. The lamellar structure contradicts this location of
      the cone-shaped ester molecules which should increase the tendency to form
      hexagonal structures. However, the experimental findings can be understood if one
      considers a partial interdigitation of the last hydrocarbon groups of the lipid
      chains accompanied by a larger disorder in the hydrophobic centre of the
      membrane. In the case of hexane phosphonic acid dibutyl ester, a vertical
      translocation of the ester takes place below a certain water content where it is
      distributed between two locations at the lipid water interface and the centre of
      the membrane.

PMID- 1742808
TI  - A structural study of interfacial phospholipid and lung surfactant layers by
      transmission electron microscopy after Blodgett sampling: influence of surface
      pressure and temperature.
AB  - Monolayer studies of the lung surfactant extract (LSE), dipalmitoyl
      phosphatidilcholine (DPPC) and dioleyl phosphatidilcholine (DOPC) have been
      performed in the dynamic condition at various temperatures. These compounds were
      also studied by differential scanning calorimetry, and the Langmuir Blodgett
      films were examined by electron microscopy. The combination of these techniques
      allowed us to describe precisely the collapse process, which was found to be
      different above and below the transition temperature of the lipids. However,
      whereas a phase separation for DPPC/DOPC mixtures occurred at all temperatures
      studied, this separation was observed for LSE only at temperatures lower than
      that characteristic of the "rigid state" to "liquid-like state" transition
      temperature. The ability of LSE to rapidly respread upon decompression appears to
      be due to the formation of piled amorphous aggregates formed during compression
      of its monolayers.

PMID- 1742809
TI  - Aggregation behavior of lipid IVA in aqueous solutions at physiological pH. 1:
      Simple buffer solutions.
AB  - We have investigated the aggregation behaviour of lipid IVA (a bioactive
      precursor of lipid A and the lipid anchor of lipopolysaccharide) in aqueous
      solutions in the physiological pH range using dynamic light scattering, nuclear
      magnetic resonance, fluorescence, surface pressure, electron microscopy and force
      field simulation studies. The sonication of lipid IVA in PBS, Tris and Hepes
      produces vesicles which are stable in the concentration range of 10(-3) - 10(-7)
      M, possibly even at lower concentrations. The vesicle size is not sensitive to
      the nature of the buffer, only to the pH and to some extent to the ionic
      strength. The long time stability of the small unilamellar vesicles as well as
      the structureless 1H-NMR spectra might be attributed to a rigid surface
      structure. This structure is also supported by the simulation studies. We have
      tentatively proposed a coexistence of micelles and/or other aggregates with the
      bilayered vesicles at higher lipid concentrations in order to explain some of the
      experimental observations.

PMID- 1742810
TI  - Membrane specificity of non-monotonic trends in cation-mediated injury to rapidly
      frozen phospholipid vesicles.
AB  - Phospholipid vesicles like erythrocyte ghosts [1] have been shown to display
      trends in freeze-thaw injury with Group I ions which are non-monotonic in nature.
      That is to say, the relative extent of injury with such ions, measured as calcein
      release, does not follow a lyotropic series related solely to the hydrated ionic
      radii of these ions. By incorporation of cholesterol into the vesicles the non
      monotonic nature of these trends has been shown to be highly membrane specific.
      Thus the non-monotonic trends in cation mediated freeze-thaw injury are shown to
      be independent of bulk solution properties.

PMID- 1742811
TI  - Effect of the fungicides tributyltin acetate and tributyltin chloride on
      multilamellar liposomes: fluorescence studies.
AB  - The influence of tri-n-butyltin acetate (TBTA) and tri-n-butyltin chloride (TBTC)
      on the physico-chemical state of charged and neutral phospholipids was
      investigated using multilamellar liposomes. The thermal dependence of steady
      state fluorescence polarization of DPH and its charged derivative TMA-DPH was
      recorded. The two fungicides lowered DPPC phase transition temperature and
      broadened the temperature range of the transition in different ways. The effects
      were concentration-dependent. The results show that TBTC interacts more
      effectively with DPPC model membranes rather than TBTA. Moreover, TBTC broadens
      and shifts the main phase transition (Tm) more effectively in DPPC rather than in
      DMPC liposomes. Below Tm, TBTC decreases fluorescence polarization (P) in all
      phospholipids used. Above Tm P is almost constant in phospholipids with saturated
      acyl chains, except for DMPG. In fact, an increase of P is detectable in this
      lipid as in PLs with unsaturated acyl chains. It is suggested that the effects of
      TBT on liposomal membranes are dependent on the anion moiety and phospholipids
      characteristics.

PMID- 1742812
TI  - Noninvasive measurement of cerebral blood flow: techniques and limitations.

PMID- 1742813
TI  - Obstetric anaesthesia in patients with primary pulmonary hypertension.

PMID- 1742815
TI  - Concurrent increases in brain electrical activity and intracranial blood flow
      velocity during low-dose ketamine anaesthesia.
AB  - The purpose of the present study was to assess the effects of low-dose ketamine
      on spontaneous brain electrical activity (EEG) and intracranial blood flow
      velocity. Twenty healthy volunteers were divided into two groups: Group I (n =
      10) received 0.25 mg.kg-1 ketamine iv; Group II (n = 10) received 0.5 mg.kg-1
      ketamine iv. Mean arterial blood pressure (MAP), heart rate (HR), end-tidal PCO2
      (PETCO2), and arterial oxygen saturation (SaO2) were measured. The EEG was
      recorded from temporo-occipital recording sites over both hemispheres. Blood flow
      velocity in the middle cerebral artery was measured using a transcranial Doppler
      ultrasound system. All variables were evaluated at baseline and for 60 min
      following ketamine. Administration of ketamine resulted in increases of MAP and
      HR in both groups to a similar degree. The PETCO2 and SaO2 did not change in
      either group over time. Ketamine caused a dose-dependent, transient shift in the
      EEG to synchronous high-voltage slow waves with an increase in total power (Group
      I: 301 +/- 38%; Group II: 104 +/- 28%). These changes were associated with dose
      dependent increases in mean blood flow velocity (Group I: 35 +/- 7%; Group II: 68
      +/- 10%). Our data suggest that increases in intracranial blood flow velocity are
      closely correlated to increases in neuronal activity and are not secondary to
      changes in systemic haemodynamic variables.

PMID- 1742814
TI  - Cerebrovascular responses to carbon dioxide in children anaesthetized with
      halothane and isoflurane.
AB  - To determine the effects of isoflurane and halothane on cerebrovascular
      reactivity to CO2, 30 children aged one to six years were anaesthetized with
      isoflurane or halothane in an air and oxygen mixture with an FIO2 of 0.3. The end
      tidal concentrations (0.5 minimum alveolar concentration (MAC) or 1.0 MAC) of
      isoflurane or halothane were age-adjusted. After achieving a steady-state at both
      0.5 MAC and 1.0 MAC isoflurane and halothane, the end-tidal carbon dioxide
      tension (PETCO2) was randomly adjusted to 20, 40, or 60 mmHg. Cerebral blood flow
      velocity (CBFV) and the cerebrovascular resistance index (RI+) in the middle
      cerebral artery (MCA) were measured by a transcranial Doppler monitor. Three
      measurements of CBFV and RI+ were obtained at each PETCO2 and isoflurane or
      halothane concentration. Any rise in the PETCO2 caused an increase in CBFV during
      both 0.5 MAC (r2 = 0.99 and 0.99) and 1.0 MAC (r2 = 0.96 and 0.95) isoflurane and
      halothane anaesthesia, respectively (P less than 0.05). The CBFV for isoflurane
      increased as PETCO2 increased from 20 to 60 mmHg for both 0.5 MAC and 1.0 MAC (P
      less than 0.05). The CBFV for halothane increased as PETCO2 increased from 20 to
      40 mmHg for both 0.5 MAC and 1.0 MAC halothane (P less than 0.05), but did not
      change as PETCO2 increased from 40 to 60 mmHg for both 0.5 MAC and 1.0 MAC
      halothane. The RI+ showed an inverse relationship with CBFV at each PETCO2 for
      0.5 MAC (r2 = 0.98 and 0.99) and 1.0 MAC (r2 = 0.76 and 0.53) isoflurane and
      halothane, respectively (P less than 0.05). The CBFV did not differ significantly
      between 0.5 and 1.0 MAC isoflurane and halothane at corresponding PETCO2 values.
      The cerebrovascular response to CO2 at 20 mmHg between 0.5 MAC and 1.0 MAC
      halothane was not significantly different. These data strongly suggest that
      isoflurane and halothane in doses up to 1.0 MAC do not affect the cerebrovascular
      reactivity of the MCA to CO2 in anaesthetized, healthy children.

PMID- 1742816
TI  - Local cerebral blood flow with prostaglandin E1 or trimethaphan during cerebral
      aneurysm clip ligation.
AB  - This study was performed to examine changes in local cerebral blood flow during
      hypotensive anaesthesia with either prostaglandin E1 (PGE1) or trimethaphan
      (TMP). Local cerebral blood flow (LCBF), mean blood pressure (MBP), heart rate
      (HR), and hourly urine output (UO) were studied in 51 patients undergoing
      cerebral aneurysm surgery with neuroleptanalgesia (NLA). The incidence of
      vasospasm after aneurysm surgery, and outcome (Glasgow Outcome Scale) at
      discharge were evaluated. Measurements of LCBF were made using a thermal gradient
      blood flow meter. The dose of PGE1 or TMP was adjusted to maintain MBP at about
      70 mmHg, and LCBF was studied during and after PGE1 or TMP administration.
      Hypotensive drugs were discontinued at the completion of aneurysm clipping. After
      starting PGE1 or TMP, MBP decreased immediately, but HR did not change in either
      group. The LCBF decreased 30 min after the start of TMP administration and
      increased immediately after its discontinuation, whereas PGE1 did not affect
      LCBF. Urine output increased during PGE1 administration but was unchanged during
      TMP. Neither drug affected surgical outcome or the incidence of vasospasm. These
      results suggest that PGE1 may be preferable to trimethaphan for hypotensive
      anaesthesia in cerebral aneurysm surgery because LCBF is maintained.

PMID- 1742818
TI  - Haemodynamic response to induction of anaesthesia with ketamine/midazolam.
AB  - The haemodynamic responses following induction of anaesthesia with ketamine and
      midazolam have not been determined previously. Twenty adult patients for elective
      myocardial revascularization were randomized to two regimens for induction of
      anaesthesia. Patients in Group I received ketamine, 2 mg.kg-1, and midazolam, 0.2
      mg.kg-1 and those in Group II received ketamine, 2 mg.kg-1, and midazolam, 0.4
      mg.kg-1. Measurements were recorded at baseline, 1 min post-induction, and at
      one, three, five and ten minutes after tracheal intubation. Tachycardia and
      hypertension (greater than 20% increases from awake baseline values) were treated
      with esmolol, 250 micrograms.kg-1. There were 11 patients in Group I and nine
      patients in Group II. There were no significant intergroup differences in
      demographic or haemodynamic variables. Both groups had decreases (P less than
      0.05), in stroke volume, pulmonary capillary wedge pressure, and right
      ventricular end-diastolic volume at multiple study intervals following
      anaesthetic induction. None of these changes required clinical intervention. Five
      patients (all in Group II) had hypertensive responses to tracheal intubation.
      Preoperative hypertension (mean arterial pressure greater than or equal to 100
      mmHg) was a predictor (P less than 0.05) of a hypertensive response to
      intubation, independent of the midazolam dose. Intravenous ketamine and midazolam
      was associated with a high incidence (25%) of haemodynamic responses to tracheal
      intubation. The higher dose of midazolam did not provide any haemodynamic
      advantage.

PMID- 1742817
TI  - Cardiovascular and endocrine effects of clonidine premedication in neurosurgical
      patients.
AB  - The present study was conducted to examine the haemodynamic and endocrine effects
      of clonidine, given as sole preanaesthetic medication, in neurosurgical patients.
      Nineteen patients of ASA physical status I and II, subjected to craniotomy,
      randomly received po premedication of either clonidine (300 micrograms, n = 9) or
      placebo (n = 10). Blood pressure and heart rate were monitored continuously,
      while arterial blood samples were collected at specific times, from induction of
      anaesthesia to recovery, for the measurement of plasma concentrations of
      epinephrine, norepinephrine, cortisol, aldosterone, and glucose. Clonidine
      treatment led to a decrease in mean arterial blood pressure (MABP), heart rate
      (HR), and plasma cortisol and aldosterone concentrations throughout the study,
      compared with placebo (P less than 0.05). Clonidine, however, did not prevent
      increases in MABP (16 +/- 5 mmHg, mean +/- SE, P less than 0.05) and HR (18 +/- 4
      bpm, P less than 0.05) during induction of anaesthesia, which was comparable to
      the placebo group. Plasma catecholamine concentrations did not differ between the
      two groups. Plasma glucose concentrations increased in both groups at the end of
      the study (P less than 0.05), but were lower in clonidine-treated patients (P
      less than 0.05). Though statistically significant, the observed inhibitory
      haemodynamic and endocrine effects of clonidine seem to be of minor clinical
      importance. As the action of clonidine on cerebral blood flow regulation is not
      well known, we see no advantage in the preanaesthetic administration of clonidine
      to neurosurgical patients with normal cardiovascular status.

PMID- 1742819
TI  - Stability of the intraoperative arterial to end-tidal carbon dioxide partial
      pressure difference in children with congenital heart disease.
AB  - The purpose of this study was to evaluate the stability of the arterial PCO2
      (PaCO2) to end-tidal PCO2 (PETCO2) partial pressure difference (Pa-ETCO2) during
      surgery using PETCO2 monitoring, in children with congenital heart disease (CHD).
      Forty children with CHD were studied: ten children with no interchamber
      communication and normal pulmonary blood flow (PBF) (normal group); ten acyanotic
      children with increased PBF (acyanotic-shunting group); ten cyanotic children
      with mixing type lesions and normal or increased PBF (mixing group), and ten
      cyanotic children with right-to-left intracardiac shunts demonstrating decreased
      and variable PBF (cyanotic-shunting group). Simultaneous PaCO2 recordings and
      PETCO2 measurements were obtained for each patient during five intraoperative
      events: (1) control time, arterial line placement under anaesthesia; (2) time 1,
      patient preparation; (3) time 2, immediately after sternotomy; (4) time 3, after
      heparin administration; and (5) time 4, immediately after aortic cannulation.
      Initially, cyanotic children demonstrated a greater Pa-ETCO2 compared with
      acyanotic children (P less than 0.05). There was no difference in the Pa-ETCO2
      over time in the control, acyanotic-shunting, or mixing groups. The Pa-ETCO2 in
      the children with cyanotic-shunting lesions at times 2 and 3 was greater (P less
      than 0.05) than at their control times. We conclude that the Pa-ETCO2 of children
      with acyanotic-shunting and mixing congenital heart lesions is stable
      intraoperatively, although patients with mixing congenital heart lesions may
      demonstrate large individual variations. In children with cyanotic-shunting
      congenital heart lesions, the Pa-ETCO2 is not stable. The PETCO2 cannot be used
      during surgery to estimate reliably the PaCO2 in children with cyanotic CHD.

PMID- 1742821
TI  - Day surgical anaesthesia: which patients? Which procedures?

PMID- 1742822
TI  - Outpatient anesthesia. Which is the best anaesthetic technique?

PMID- 1742820
TI  - Brachial plexus block with bupivacaine: effects of added alpha-adrenergic
      agonists: comparison between clonidine and epinephrine.
AB  - The effects of clonidine and epinephrine, administered into the brachial plexus
      sheath, were evaluated in 60 patients who underwent surgery of the upper limb.
      All patients received 40 to 50 ml of 0.25% bupivacaine, injected into the
      brachial plexus sheath, using the supraclavicular technique. The patients were
      randomly allocated to two groups so that 30 patients received 150 micrograms
      clonidine hydrochloride (Group I), and 30 received 200 micrograms epinephrine
      (Group II). The quality and the duration of analgesia were assessed as well as
      the possible side-effects. The block produced with the addition of clonidine was
      longer (994.2 +/- 34.2 vs 728.3 +/- 35.8 min) and superior to that with
      epinephrine (P less than 0.001). No major side-effects were recorded. We conclude
      that the injection of clonidine into the brachial plexus sheath is an attractive
      alternative to epinephrine to prolong the duration of analgesia following upper
      limb surgery under conduction anaesthesia.

PMID- 1742823
TI  - Selection of patients for paediatric ambulatory surgery.

PMID- 1742824
TI  - Outpatient anesthesia. What are the problems in the recovery room?

PMID- 1742825
TI  - Pulmonary hypertension and cardiomyopathy: anaesthetic management for caesarean
      section.
AB  - Pulmonary hypertension in pregnant women is uncommon but is associated with a
      high mortality. We present the case of a 14-yr-old parturient with pulmonary
      hypertension and cardiomyopathy who required a Caesarean section. Management
      goals included: (1) maintaining right ventricular function, (2) avoiding the
      haemodynamic effects of general endotracheal anaesthesia, and (3) minimizing
      narcotic-related neonatal respiratory depression. While most authors agree on
      invasive pulmonary and systemic monitoring, opinions differ as to the optimal
      method of providing anaesthesia for these patients. The successful use of lumbar
      epidural anaesthesia with lidocaine and fentanyl is described. When the local
      anaesthetic was administered slowly and in increments, epidural anaesthesia was
      safe for both mother and fetus.

PMID- 1742826
TI  - Anaesthetic management of a complex morbidly obese parturient.
AB  - A case is presented of a morbidly obese parturient who had multiple medical
      problems. She had angina and was receiving nitrate therapy, had insulin-dependent
      diabetes mellitus, hypertension, asthma and benign intracranial hypertension
      (pseudotumour cerebri). Lumbar epidural analgesia was chosen for labour and
      delivery and resulted in an uneventful outcome.

PMID- 1742827
TI  - Anaesthesia for caesarean section in a patient with acute fatty liver of
      pregnancy.
AB  - A 23-yr-old woman presented in labour and hepatic failure. The clinical diagnosis
      was acute fatty liver of pregnancy. A Caesarean section was performed under
      epidural anaesthesia, after correction of a coagulopathy. Epidural anaesthesia
      was chosen because of the potential deleterious effects of general anaesthesia on
      liver blood flow and function.

PMID- 1742828
TI  - Persistent sacral nerve root deficits after continuous spinal anaesthesia.
AB  - Neurological deficits following spinal anaesthesia are rare. We report two cases
      of persistent sacral nerve root deficits after continuous spinal anaesthesia
      (CSA) performed with hyperbaric lidocaine through a lumbar microcatheter. In both
      cases the dose of 5% lidocaine (5.7 and 4.3 ml) was greater than usual. In the
      immediate postoperative period the constellation of neurological deficits
      included perianal hypaesthesia, lower extremity paresis, urinary retention, and
      difficult defaecation. Both patients have residual perianal hypaesthesia and
      difficult defaecation. In these cases, the high-dose requirements of local
      anaesthetic via microcatheter CSA with focal sensory block suggests nonuniform
      distribution of the hyperbaric lidocaine. Microcatheter CSA may convey a unique
      risk of maldistribution of the local anaesthetic solution and local
      neurotoxicity.

PMID- 1742829
TI  - Intraoperative pacemaker failure in an infant.
AB  - Pacemakers in children can present clinical challenges during surgery. We present
      a case report of an infant whose pacemaker reverted to a backup mode when
      electrocautery was used during surgery. The resulting bradycardia did not respond
      either to a magnet placed over the generator or to iv atropine. The circulation
      was supported by isoproterenol until the pacemaker was re-programmed by the
      manufacturer. Such devices require care and understanding if problems during
      surgery are to be avoided.

PMID- 1742830
TI  - Acute epiglottitis in the adult: is intubation mandatory?
AB  - Acute epiglottitis (AE) in the adult results in inflammation of the supraglottic
      structures and carries the potential for complete airway obstruction. There is
      disagreement in the medical literature as to the appropriate management of the
      airway in the adult with AE. Some authors advocate intubation in all patients
      while others propose more selective intervention, intubating the trachea only in
      those patients presenting with airway compromise. We reviewed our institutional
      experience with 21 patients over the last seven years admitted with a proven
      diagnosis of AE. Six patients presented with respiratory distress, three in
      severe distress with symptoms and signs of upper airway obstruction. The three
      patients in severe distress were taken to the operating room, in two the tracheas
      were intubated and one underwent tracheostomy after failed intubation. All other
      patients were monitored but their tracheas were not intubated. The majority of
      the patients were monitored for 24 hr in the ICU before transfer to wards. No
      patient initially monitored required tracheal intubation for progression of
      disease. There were no deaths. Recommendations for the care of the airway in the
      adult with AE based on our experience and a review of approximately 1000 cases
      reported in the last ten years are presented. It is our opinion that adults
      presenting without respiratory symptoms may be safely monitored in an intensive
      care setting given that provision is made for tracheal intubation or tracheostomy
      should respiratory distress become evident.

PMID- 1742832
TI  - Abdominal aortic aneurysm repair in a patient with a cardiac transplant.
AB  - We describe successful elective abdominal aneurysm repair in a patient with a
      cardiac transplant. In light of the unique physiology and pharmacology of the
      denervated heart, this presented an unusual combination of complex problems.
      Whereas the normally innervated heart increases cardiac output via neural
      stimuli, the denervated heart relies primarily on the Frank Starling mechanism
      which is dependent on preload and myocardial contractility. Thus, rapidly
      changing haemodynamic variables associated with aortic cross-clamping require
      scrupulous attention to the maintenance of adequate preload as well as myocardial
      function which can only be manipulated by direct-acting agents. We conclude that
      the denervated heart will readily compensate for the haemodynamic changes brought
      about by infrarenal aortic crossclamping if a high-normal preload is maintained
      and if the transplanted donor heart is free of pathology with good inherent
      myocardial contractility.

PMID- 1742831
TI  - Postoperative opisthotonus and torticollis after fentanyl, enflurane, and nitrous
      oxide.
AB  - Most drug-induced extrapyramidal symptoms are due to blockade of dopaminergic
      receptors and are treated with anticholinergic drugs. We report a patient with
      severe postoperative extrapyramidal symptoms which responded to physostigmine and
      indicated a different aetiology. A young, healthy female outpatient developed
      severe extrapyramidal symptoms after an uneventful 50 min anaesthetic with
      thiopentone, fentanyl (100 micrograms), enflurane, and nitrous oxide. Although
      the trachea was not extubated until she obeyed commands, the patient developed
      opisthotonus, which resolved initially after treatment with thiopentone (40 mg),
      diazepam (5 mg), and diphenhydramine (50 mg). The opisthotonus recurred
      approximately 25 min later, in association with torticollis, obtundation, and
      periodic apnoea. A tentative diagnosis of central anticholinergic syndrome was
      proposed, and fentanyl was considered to have been responsible. Naloxone (0.4 mg)
      induced no improvement, but physostigmine (2 mg) reversed the dystonic symptoms
      and periodic apnoea and improved her mental status. The response to physostigmine
      may have been due specifically to increased levels of acetylcholine at the
      cholinergic receptors, or to a nonspecific analeptic effect.

PMID- 1742833
TI  - Measurement of cardiac output--transtracheal Doppler versus thermodilution.
AB  - The ABCOM 1 transtracheal Doppler (TTD) has been developed as a non-invasive
      cardiac output monitor. With this device, cardiac output is continuously
      calculated from ascending aortic blood flow velocity and aortic diameter obtained
      via an ultrasound transducer incorporated into the tip of an endotracheal tube.
      We evaluated the clinical use of the ABCOM 1 monitor and compared cardiac outputs
      obtained using the TTD system with simultaneous thermodilution (TD) measurements.
      We found the operation of the ABCOM 1 monitor to be difficult and time-consuming.
      In our operating rooms, acceptable Doppler signal quality was difficult to
      obtain. There was no correlation between 36 simultaneously obtained TTD and TD
      cardiac output measurements. The average difference between measurement
      techniques and the limits of agreement were unacceptably large (mean difference =
      3.04 L.min-1, mean +/- 2 SD = -6.04 to 12.48 L.min-1). Separately analyzing only
      those measurements during which Doppler signal quality was adequate did not
      improve agreement between TTD and TD measurements. On the basis of these
      findings, TTD cannot be recommended as a clinical cardiac output measurement
      technique.

PMID- 1742834
TI  - Deliberate hypotension for intracranial aneurysm surgery: changing practices.

PMID- 1742835
TI  - Critical incident report: total airway obstruction secondary to design of a
      tracheostomy set.

PMID- 1742836
TI  - Uterine relaxation can be life saving.

PMID- 1742837
TI  - Spinal anaesthesia for caesarean section.

PMID- 1742838
TI  - A practical, "hands-free" method for mask anaesthesia.

PMID- 1742839
TI  - Hypocarbia during anaesthesia in children with moyamoya disease.

PMID- 1742840
TI  - Propofol infusion in carcinoid syndrome.

PMID- 1742841
TI  - An unusual reaction to precurarization.

PMID- 1742842
TI  - The TURP syndrome.

PMID- 1742843
TI  - Plasma and cerebrospinal fluid pharmacokinetics of cytosine arabinoside in dogs.
AB  - Cytosine arabinoside (ara-C) is a component of many protocols for the treatment
      of CNS (central nervous system) leukemia and lymphoma in humans and dogs. It is
      also used for the prophylaxis of CNS metastasis in acute lymphoblastic leukemia.
      Although ara-C enters the cerebrospinal fluid (CSF) of human cancer patients
      after i.v. administration, it is unclear whether a similar CNS distribution
      occurs in humans whose blood-brain barrier has not been compromised by invasive
      disease. No information on the penetration of ara-C into the CSF in dogs is
      available. We studied the plasma and CSF pharmacokinetics of 600 mg/m2 ara-C in
      ten healthy male dogs after its administration as a rapid i.v. bolus (six dogs)
      or as a 12-h i.v. infusion (four dogs). Ara-C concentration in blood and CSF
      samples was determined by high-performance liquid chromatography (HPLC). After an
      i.v. bolus of ara-C, the mean plasma distribution half-life was 7.1 +/- 4.5 min
      and the mean elimination half-life was 69 +/- 28 min. The mean plasma clearance
      was 227 +/- 125 ml min-1 m-2. The peak concentration of ara-C in the CSF was 29
      +/- 11 microM, which occurred at 57 +/- 13 min after the ara-C bolus. The CSF
      elimination half-life was 113 +/- 26 min. During a 12-h infusion of ara-C (50 mg
      m-2 h-1), the plasma steady-state concentration was 14.1 +/- 4.2 microM, the CSF
      steady-state concentration was 8.3 +/- 1.1 microM, and the CSF: plasma ratio was
      0.62 +/- 0.14. The plasma elimination half-life was 64 +/- 19 min and the plasma
      clearance was 214 +/- 69 ml min-1 m-2. The CSF elimination half-life was 165 +/-
      28 min. No clinically significant toxicity was observed over a 21-day period
      following drug administration in either of the treatment groups. Our data
      indicate that ara-C crosses the blood-brain barrier in normal dogs and that i.v.
      administration of this drug has potential as a treatment modality for neoplasia
      involving the CNS.

PMID- 1742844
TI  - Effect of bismuth nitrate given in combination with cis
      diamminedichloroplatinum(II) on the antitumor activity and renal toxicity of the
      latter in nude mice inoculated with human bladder tumor.
AB  - The effects of bismuth nitrate pretreatment on the toxicity and antitumor
      activity of cis-diamminedichloroplatinum (cisplatin, CDDP) were examined in nude
      mice that had been inoculated with human bladder-tumor tissue. Pretreatment with
      bismuth nitrate depressed the renal toxicity of CDDP without compromising its
      activity against a transplantable human bladder tumor. Renal metallothionein (MT)
      and bismuth (Bi) levels in nude mice were markedly increased by Bi
      preadministration, but no significant MT induction was observed in inoculated
      human bladder-tumor tissue in which only a trace amount of Bi was incorporated.
      Furthermore, it was confirmed that tumor platinum (Pt) concentrations in CDDP
      treated mice were not affected by Bi pretreatment. Thus, the administration of Bi
      compounds prior to chemotherapy with CDDP may provide an effective mode of
      treatment for advanced bladder tumors.

PMID- 1742845
TI  - Chemosensitisation of a drug-sensitive parental cell line by low-dose cyclosporin
      A.
AB  - We investigated the chemosensitisation of the parental EMT6 mouse mammary tumour
      cell line by low doses of cyclosporin A (CsA). This cell line has not previously
      been exposed to cytotoxic drugs but expresses low levels of P-glycoprotein. We
      produced greater than 2-fold sensitisation to doxorubicin, colchicine and
      vincristine using 0.084 microM (0.1 micrograms/ml) CsA. Cellular accumulation of
      doxorubicin and daunorubicin was also increased by this dose. In the MDR subline
      EMT6/AR1.0, much higher doses of CsA were required to effect optimal restoration
      of doxorubicin or daunorubicin accumulation. The effects of CsA on the parent
      line could not be increased by extended preincubation of cells with the
      sensitiser. These effects of CsA in the EMT6 parent cell line occur at a dose
      that is 1 order of magnitude lower than those previously reported to produce
      significant chemosensitisation.

PMID- 1742846
TI  - The relative nephrotoxicity of cisplatin, cis-[Pt(NH3)2(guanosine)2]2+, and the
      hydrolysis product of cisplatin in the rat.
AB  - An examination of the comparative nephrotoxicity in the rat of cisplatin, its
      hydrolysis product (mostly cis-[Pt(NH3)2Cl(H2O)]+ under the conditions applied),
      and cis-[Pt(NH3)2(guanosine)2]2+ revealed that these compounds differed
      significantly in the extent of renal damage they produced following their i.v.
      injection in Sprague-Dawley rats. The hydrolysis product was found to be the most
      toxic of the three complexes studied and produced nephrotoxicity at doses lower
      than those at which cisplatin was nephrotoxic. Under the conditions used, the
      i.v. administration of cis-[Pt(NH3)2(guanosine)2]2+ resulted in no observable
      signs of nephrotoxicity at levels at which an equimolar dose of cisplatin
      produces clear evidence of renal function impairment and morphological
      alterations. The nephrotoxicity of these complexes appears to be generally
      related to the ease with which they undergo nucleophilic substitution reactions.
      The lack of substantial nephrotoxicity found for cis-[Pt(NH3)2(guanosine)2]2+
      suggests that the products resulting from the action of the DNA repair processes
      on platinated DNA do not contribute significantly to the nephrotoxicity of
      cisplatin. Renal platinum levels found following the administration of these
      compounds correlated with the degree of nephrotoxicity produced by each compound,
      but no general correlation of nephrotoxicity and renal platinum levels was found.
      The nephrotoxicity of cis-[Pt(NH3)2Cl(H2O)+ on a molar basis was estimated to be
      approximately 3 times as great as that of cisplatin itself.

PMID- 1742847
TI  - Clinical pharmacokinetics of 3-deazaguanine.
AB  - 3-Deazaguanine (3DG), an antipurine antimetabolite, has recently completed a
      phase I clinical trial at this Institute. The drug was given on a daily x 5
      schedule by i.v. infusion over 0.25-2.16 h. The pharmacokinetics of 3DG during 16
      courses were studied in 12 patients at doses of 200-800 mg/m2. 3DG in plasma was
      measured by an isocratic reverse-phase high-performance liquid chromatographic
      (HPLC) procedure carried out on IBM phenyl columns at 40 degrees C using 10 mM
      phosphate buffer (pH 7) as the mobile phase and detection at 300 nm. Plasma decay
      of 3DG was biexponential in all patients. The AUC correlated linearly with dose
      at 200-600 mg/m2 but deviated from linearity at doses greater than 600 mg/m2. The
      drug was cleared rapidly from plasma; at doses of 200-600 mg/m2, the mean plasma
      clearance was 61.64 +/- 9.97 l/h and the mean terminal-phase elimination half
      life was 1.6 +/- 0.6 h. The steady-state volume of distribution (98.9 +/- 29.1 l)
      and distribution coefficient (1.24 +/- 0.39 l/kg) indicated extensive tissue
      distribution for the drug. No statistically significant difference was observed
      between the pharmacokinetics of 3DG on day 1 and that on day 4 as evaluated in
      three patients for whom complete plasma data were available on both days.

PMID- 1742848
TI  - Pharmacokinetic contribution to the improved therapeutic selectivity of a novel
      bromoethylamino prodrug (RB 6145) of the mixed-function hypoxic cell
      sensitizer/cytotoxin alpha-(1-aziridinomethyl)-2-nitro-1H-imidazole-1-ethanol
      (RSU 1069).
AB  - RB 6145 is a novel hypoxic cell sensitizer and cytotoxin containing both an
      essential bioreductive nitro group and a bromoethylamino substituent designed to
      form an alkylating aziridine moiety under physiological conditions. In mice, RB
      6145 is 2.5 times less toxic but only slightly less active than the aziridine
      analogue RSU 1069, giving rise to an improved therapeutic index. However, the
      mechanism for the enhanced selectivity is not clear. Reasoning that this may lie
      in a more beneficial pharmacokinetic profile, we investigated the plasma
      pharmacokinetics, tissue distribution and metabolism of RB 6145 in mice using a
      specially developed reversed-phase HPLC technique. An i.p. dose of 190 mg kg-1
      (0.5 mmol kg-1) RB 6145 produced peak plasma concentrations of about 50
      micrograms ml-1 of the pharmacologically active target molecule RSU 1069 as
      compared with levels of around twice this value that were obtained using an
      equimolar i.p. dose of RSU 1069 itself. The plasma AUC0-infinity value for
      administered RSU 1069 was ca. 47 micrograms ml-1 h and that for the analogue RSU
      1069 was ca. 84 micrograms ml-1 h. No prodrug was detectable. Another major RB
      6145 metabolite in plasma was the corresponding oxazolidinone, apparently formed
      on interaction of the drug with hydrogen carbonate. The oxazolidinone initially
      occurred at higher concentrations than did RSU 1069, with the levels becoming
      very similar from 30 min onwards. Post-peak plasma concentrations of both RB 6145
      metabolites declined exponentially, displaying an elimination t1/2 of ca. 25 min,
      very similar to the 30-min value observed for injected RSU 1069. The plasma AUC0
      infinity value for the metabolite RSU 1069 was about 1.3 and 1.6 times higher
      following i.p. injection of 95 mg kg-1 (0.25 mmol kg-1) of the prodrug as
      compared with administration via the oral and i.v. routes, respectively. After
      i.v. injection, peak levels of the oxazolidinone metabolite were twice those
      observed following both i.p. and oral dosing and possibly contributed to the
      acute toxicity. After an i.p. dose of 190 mg kg-1 RB 6145, concentrations of RSU
      1069 and the oxazolidinone metabolites rose to 40% and 33%, respectively, of the
      ambient plasma level in i.d. KHT tumours. The peak level of metabolite RSU 1069
      was ca. 6 micrograms g-1 as compared with 10 micrograms g-1 following an
      equimolar dose of RSU 1069 itself; the tumour AUC0-infinity value for the
      metabolite RSU 1069 was some 35% lower.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1742849
TI  - Bayesian estimation of doxorubicin pharmacokinetic parameters.
AB  - Doxorubicin was given by brief i.v. infusion (doses ranging from 25 to 72 mg/m2)
      to 28 patients for 2-7 successive courses of chemotherapy (68 courses studied in
      all). A Bayesian approach was developed to determine the individual
      pharmacokinetic parameters of doxorubicin. Statistical characteristics of the
      population pharmacokinetic parameters were first evaluated for 19 patients and a
      total of 30 courses, which, when combined with 4 individual plasma concentrations
      of drug, led to a Bayesian estimation of individual pharmacokinetic parameters
      for the remaining 38 courses. The estimated parameters for the elimination phase
      (A3/V1 and t1/2 elimination) and the residual plasma level at 48 h as computed by
      Bayesian estimation on this reduced sub-optimal sampling protocol were compared
      with a maximal likelihood estimation of these parameters. No statistically
      significant differences were found. Performance of the developed methodology was
      evaluated by computing bias and precision. The mean errors were -0.0315 x 10(-4)
      l-1 for A3/V1, 0.0839 h for t1/2 elimination, and -0.22 ng/ml for c(48 h). The
      precision of the prediction of these three parameters (0.304 x 10(-5) l-1, 3.34
      h, and 0.659 ng/ml, respectively) remained lower than the interindividual
      standard deviation (1.42 x 10(-4) l-1, 14.9 h, and 4.54 ng/ml, respectively).
      This procedure enables the estimation of individual pharmacokinetic parameters
      for doxorubicin at minimal cost and minimal disturbance of the patient.

PMID- 1742850
TI  - A phase I trial of continuous-infusion cyclophosphamide in refractory cancer
      patients.
AB  - Cyclophosphamide demonstrates enhanced tumoricidal activity with decreased bone
      marrow toxicity when given on a divided-dose schedule in certain animal models. A
      total of 22 patients presenting with refractory metastatic cancer were treated in
      a phase I trial of continuous infusion of cyclophosphamide over 96 h.
      Granulocytopenia of less than 500/microliters that lasted for greater than 14
      days or thrombocytopenia of less than 25,000/microliters that lasted for greater
      than 14 days was the target dose-limiting toxicity in the absence of
      nonhematologic grade 4 toxicity. The maximal tolerated dose was 7 g/m2. Three
      patients died. Of 21 evaluable patients, 9 responded, including 8/9 who had
      experienced disease progression during prior oxazaphosphorine-containing
      combination chemotherapy. Clinically meaningful responses were observed in
      patients who had demonstrated clinical resistance to an oxazaphosphorine drug
      given at lower doses.

PMID- 1742851
TI  - Pharmacokinetics of navelbine after oral administration in cancer patients.
AB  - The pharmacokinetic behavior of navelbine was investigated in 19 patients
      presenting with advanced cancers (mainly women with breast cancer). Navelbine was
      given orally at seven dose levels of up to 200 mg/week. For a given dose,
      patients received four successive weekly treatments. Five subjects also received
      two different doses. After drug administration, plasma was collected for 48 or 72
      h and monitored for navelbine concentration by radioimmunoassay. Absorption of
      navelbine was very rapid after oral administration: maximal drug concentrations
      were reached within the first 1 or 2 h (Tmax, 0.9-1.75 h; cmax, 70.9-832.6
      ng/ml), with absorption constants ranging from 0.85 to 2.42 l/h. A comparison of
      dose-normalised plasma concentration profiles revealed significant time
      dependence in six evaluable patients (P less than 0.001). Only four subjects who
      received low doses (less than or equal to 100 mg/week) exhibited time-independent
      kinetics. All of the five patients who were treated at different doses displayed
      apparent dose dependence (P less than 0.001). No individual profile was
      characterised by both time- and dose-independent pharmacokinetics. In all, 18
      patients presented biphasic plasma concentration-decay patterns, and only 1
      subject exhibited monophasic decay kinetics. The navelbine pharmacokinetic
      parameters obtained following oral administration were similar to those observed
      after i.v. bolus injection and were characterised by high oral clearance (0.43
      1.45 1 h-1 kg-1), a large apparent volume of distribution (27.4-45.9 1/kg), and a
      long terminal half-life (24.2-56.5 h). Large intra- and inter-individual
      variations in pharmacokinetic parameters were observed. Moreover, after a high
      dose of 200 mg, an enterohepatic cycle and/or a delay in navelbine's absorption
      at a distal intestinal site as evidenced by a marked plasma level rebound was
      observed.

PMID- 1742852
TI  - Intracellular uptake and cytotoxic effect in vitro of doxorubicin and epirubicin
      in human leukemic and normal hematopoietic cells.
AB  - Leukemic cells from patients presenting with acute nonlymphoblastic leukemia and
      normal hematopoietic bone marrow cells from healthy donors for allogeneic bone
      marrow transplantation were incubated for 3 h with doxorubicin and epirubicin at
      different concentrations. The intracellular uptake at the end of the incubation
      was determined by photofluorometry in leukemic cells from 15 patients and in
      normal cells from 9 donors for bone marrow transplantation. Cytotoxicity in vitro
      against granulocyte/macrophage colony-forming units (CFU-GM) was determined in
      normal cells from 7 donors, and in vitro toxicity against leukemic cells was
      determined by a clonogenic technique in cells from 6 patients and by vital dye
      staining (DiSC) following 4 days' culture in cells from 15 patients. Epirubicin
      was significantly less toxic than doxorubicin to normal hematopoetic cells (72%
      +/- 20% survival of cells for epirubicin vs 45% +/- 13% for doxorubicin at a
      concentration of 0.2 microM; P less than or equal to 0.005). As analyzed by the
      DiSC assay, 0.2 microM epirubicin was slightly more toxic to leukemic cells than
      was the same concentration of doxorubicin (47% vs 61% survival, P less than or
      equal to 0.01), but the clonogenic assay revealed no difference in toxicity to
      leukemic cells. At a concentration of 0.2 microM, the mean intracellular uptake
      of epirubicin in leukemic cells was 0.43 +/- 0.26 nmol/mg protein as compared
      with 0.33 +/- 0.14 nmol/mg protein for doxorubicin (not significant). In normal
      cells, the uptake of epirubicin at a concentration of 0.2 microM was 0.47 +/-
      0.25 nmol/mg protein as compared with 0.31 +/- 0.21 nmol/mg protein for
      doxorubicin (not significant). The reduced myelotoxicity observed in vitro
      together with the retained toxicity to leukemic cells indicates that the
      therapeutic index of epirubicin is better than that of doxorubicin.

PMID- 1742853
TI  - A pharmacokinetic and pharmacodynamic study of the new anthracycline pirarubicin
      in breast cancer patients.
AB  - We evaluated the pharmacokinetics of pirarubicin during 16 courses of therapy in
      4 patients suffering from breast cancer who were treated with an association of
      pirarubicin (30-60 mg/m2 according to the hematologic tolerance to the previous
      course, the first course being given at a dose of 40 mg/m2) and continuous
      infusions of 5-fluorouracil (750 mg/m2 daily for 5 days). Pirarubicin's
      pharmacokinetics and metabolism were linear within this dose range; the
      metabolites identified were pirarubicinol, doxorubicin and doxorubicinol (AUC
      ratios of metabolite/pirarubicin were 0.6, 0.64 and 0.57 respectively).
      Pirarubicin's decay from plasma followed a two-compartmental pattern, showing
      half-lives of 15.6 min and 16.6 h; the total plasma clearance of the drug was 140
      l/h-1/m-2, and the total volume of distribution was 2,830 l/m2. A relationship
      was observed between some pharmacokinetic parameters and the toxic effects of the
      drug: the percentage of survival of granulocytes was significantly correlated
      with the AUC values for doxorubicin and doxorubicinol, whereas that of platelets
      was significantly correlated with the AUC values for pirarubicin and
      pirarubicinol. This is the first study to demonstrate a
      pharmacokinetic/pharmacodynamic relationship for pirarubicin.

PMID- 1742854
TI  - Etoposide, folinic acid, and 5-fluorouracil in carboplatin-pretreated patients
      with advanced gastric cancer.
AB  - A group of 20 patients with gastric cancer, refractory to or with no change after
      two or three cycles of carboplatin were treated with etoposide/folinic acid/5
      fluorouracil (ELF). An objective remission rate of 45% (9/20), a median remission
      duration of 8 months and a median survival time of 11 months were achieved.
      Toxicities were mild to moderate only. These results are comparable to those
      being achieved with ELF in previously untreated gastric cancer patients and
      confirm its efficacy and good tolerability.

PMID- 1742855
TI  - Positive phase II study in the treatment of advanced malignant melanoma with
      fotemustine.
AB  - To date, dacarbazine (DTIC) has been the most effective drug in the treatment of
      advanced metastatic melanoma, achieving response rates of up to 28% (mean, 21%).
      Multidrug responses were generally no better than those obtained using
      monotherapy. A quite promising clinical trial was conducted using the new
      nitrosourea fotemustine. A total of 19 patients presenting with advanced
      malignant melanoma (clinical stage IV according to the 1987 UICC classification
      system) underwent treatment involving a more rapid infusion of the drug and a
      reduction in the rest period from 5 to 3 weeks. This monotherapy with fotemustine
      yielded two complete responses and seven partial responses; in addition, four
      patients showed no change and six cases progressed after the induction cycle
      (median duration of response to date, 7.6 months, including four cases that have
      not relapsed). Fotemustine was well tolerated by the patients, with the only mild
      side effects being thrombocytopenia, leukocytopenia and easily controlled
      nausea/vomiting. Preclinical studies performed previously indicated that
      fotemustine inhibits enzymes involved in the ribonucleotide reduction pathway
      (i.e. DNA synthesis), whereby responding patients (n = 3) appeared to favor the
      thioredoxin reductase/thioredoxin electron transfer to ribonucleotide reductase,
      whereas non-responders (n = 4) expressed the alternate glutathione
      reductase/glutaredoxin mechanism. The 47% response rate obtained in these studies
      vs the 24% reported previously for fotemustine may reflect variations in enzymes
      in the ribonucleotide reduction pathway in different patients. However, the
      efficacy of fotemustine against advanced melanoma warrants more extensive trials
      of this drug, especially since the quality of life of the patients during and
      after chemotherapy was not severely affected.

PMID- 1742856
TI  - Interactions between platelet-activating factor and prostanoids during mesenteric
      ischemia-reperfusion-induced shock in the anesthetized dog.
AB  - The effects of platelet-activating factor (PAF) on prostanoid release during
      mesenteric ischemia-reperfusion-induced shock were investigated in anesthesized
      dogs 1) by measuring plasma levels of prostaglandin (PG)F2 alpha, 6-keto-PGF1
      alpha and thromboxane (TX)B2 in the superior mesenteric vein during reperfusion
      following 2 hr occlusion of the superior mesenteric artery; 2) by monitoring the
      effects of BN 52021, a specific PAF receptor antagonist and indomethacin on
      hemodynamic parameters and prostanoid levels; and 3) by studying circulatory
      responses to PAF and PGF2 alpha injected into the superior mesenteric vein in the
      presence of BN 52021 or indomethacin. Restoration of the blood flow following 2
      hr ischemia resulted in an immediate dramatic decrease in mean arterial blood
      pressure, with a concomitant increase in mean portal venous pressure, hematocrit
      values, and plasma prostanoid levels. Pretreatment of the animals either with BN
      52021 (4 mg.kg-1) or indomethacin (2 mg.kg-1 plus 3 mg.kg-1hr-1) prevented the
      circulatory collapse and the increase in prostanoid levels during reperfusion.
      Administration of exogenous PAF (0.1 micrograms.kg-1) or PGF2 alpha (10
      micrograms.kg-1) into the superior mesenteric vein evoked hypotension similar to
      that observed during reperfusion. Pretreatment of the animals with BN 52021
      completely prevented the effects of PAF but failed to modify the responses to
      PGF2 alpha. Indomethacin at a dose that inhibited prostanoid formation was highly
      effective to attenuate the hypotensive response to exogenous PAF. These data
      suggest that prostanoid formation may be secondary to PAF release in circulatory
      collapse evoked by intestinal ischemia-reperfusion and give further support to
      the notion of the importance of PAF prostanoid interaction during ischemia
      reperfusion-induced shock.

PMID- 1742857
TI  - Cardiac output and organ blood flow in experimental septic shock: effect of
      treatment with antibiotics, corticosteroids, and fluid infusion.
AB  - Septic shock from intraperitoneal (i.p.) injection of live Escherichia coli
      bacteria in rats induces marked pathophysiological changes, including 40%
      decrease in plasma volume (PV), cardiac output, and oxygen consumption with 100%
      mortality within 24 hr. The present study evaluates cardiac output and organ
      blood flow before and after treatment of septic shock with an effective
      antibiotic (AB), plasma volume (PV) expansion, and corticosteroids (CS), alone
      and in combination. Treatment was initiated at 5.5 hr after bacterial injection,
      at a time when AB therapy did not improve 24 hr survival rate. Cardiac output
      decreased from 28.6 +/- 3.1 (SD) to 15.4 +/- 2.8 ml/min/kg (P less than .01) in
      septic rats concomitant with redistribution of blood flow from carcass to the
      heart, brain, intestines, liver, and adrenal glands. Absolute arterial blood flow
      increased only to the adrenal glands and the liver to 158% (P less than .01) and
      167% (P less than .01) of control values, respectively. AB, CS, and Ringer's
      lactate (RL) alone or in combination did not significantly improve any organ
      blood flow compared to untreated septic animals but increased survival
      significantly to about 60% (P less than .01). Albumin (ALB) and CS in combination
      expanded PV to 138% (P less than .01), restored cardiac output to 100%, and
      achieved supranormal blood flow values to the brain (109%), liver (125%), small
      intestine (147%) (P less than .01), and kidneys (190%) (P less than .01) of
      preshock levels. More importantly, survival at 24 hr was 90% (9/10) (P less than
      .001). It is concluded that a colloid diluted in an electrolyte solution,
      combined with CS, and an effective antibiotic agent are necessary therapeutic
      ingredients for the successful recovery of experimental E. coli sepsis.

PMID- 1742858
TI  - Endothelial-dependent and -independent responses in the thoracic aorta during
      endotoxic shock.
AB  - Endotoxic shock is characterized by a variety of hemodynamic disturbances which
      result in tissue hypoperfusion. There is some evidence for endothelial damage
      caused by endotoxin. The present study addressed the hypothesis that vascular
      responsiveness to endothelial-dependent vasodilators is altered in endotoxic
      shock. Dose-response relationships for an endothelial-dependent vasodilator,
      acetylcholine, and an endothelial-independent vasodilator, adenosine, were
      determined in guinea pig aortic rings. Rings were examined from either control
      (untreated) animals or from animals given Escherichia coli endotoxin (4 mg/kg,
      i.p.) 16 hr prior to functional studies. Dose-response relationships to adenosine
      were similar in aortic rings from control and shocked animals. However, response
      to acetylcholine were attenuated by 30% (P less than .05) in the shocked group.
      To distinguish between a direct, acute effect of endotoxin versus effects
      produced by systemic changes that occur during shock, rings were isolated from
      untreated animals and incubated with endotoxin in vitro for 30 min prior to and
      during dose-response measurements. Incubation with endotoxin caused no change in
      aortic responses to adenosine or acetylcholine. Electron microscopy revealed a
      separation of the endothelium from the internal elastic lamina and an increase in
      inter-endothelial gaps in rings isolated from shocked animals. These structural
      changes were not observed in rings from untreated animals or in rings incubated
      with endotoxin in vitro. We conclude that endothelial-dependent vasodilation is
      attenuated during endotoxic shock. The functional changes are correlated with
      ultrastructural alterations of the endothelium.

PMID- 1742859
TI  - Cardiac function in an ovine model of endotoxemia.
AB  - Eight awake sheep were monitored with ultrasonic crystals, positioned at the
      anterior and posterior left ventricular wall. A left-sided intraventricular
      pressure transducer and a right ventricular ejection fraction catheter were
      positioned in the right and left hearts, respectively. After administration of
      endotoxin (Escherichia coli, LPS 1.5 micrograms/kg in 30 min), the hemodynamic
      variables showed a triphasic course. Phase I, (0-1 hr post LPS) was characterized
      by an increased pulmonary artery pressure and a decreased right ventricular
      ejection fraction. The inability of the right ventricle to compensate for the
      increased preload resulted in a fall of the left ventricular preload, stroke
      volume, and cardiac output. Three hours after LPS administration a second drop of
      the cardiac output was noted (phase II). This occurred as a result of a fall in
      preload. Eight hours post LPS a hyperdynamic phase (phase III) was distinguished,
      with a high cardiac output and a low systemic vascular resistance. During this
      time there was evidence of probable reduced myocardial contractility.

PMID- 1742860
TI  - Systemic and mesenteric O2 metabolism in endotoxic pigs: effect of graded
      hemorrhage.
AB  - Normally, supply-dependency of oxygen uptake (VO2) is not demonstrable unless
      oxygen delivery (DO2) is less than a critical value (DO2crit) below which VO2 is
      linearly dependent upon DO2. Because recent evidence suggests that VO2 is
      pathologically supply-dependent in endotoxic or septic animals and humans, we
      sought to determine whether 1) pathological systemic and/or mesenteric oxygen
      extraction (O2EXT) defects occur in a porcine model of endotoxicosis and 2)
      arterial lactate and ileal intramucosal pH (pHI) serve as useful markers of
      supply-dependency of VO2 in endotoxic animals. Normal (group I, n = 11) and
      endotoxic (group II, n = 8) anesthetized pigs were subjected to graded
      hemorrhage. Endotoxicosis was induced by infusing Escherichia coli
      lipopolysaccharide (150 micrograms/kg bolus at t = 0 min and 20 micrograms/kg-hr
      at t = 60 min). From t = 0-60 min, pigs in group II were resuscitated with
      hetastarch and blood (12 ml/kg each). Hemorrhage was initiated at t = 0 min or t
      = 70 min in groups I and II, respectively. DO2crit was determined by a modified
      "dual-line" regression method. Systemic DO2crit was 12.9 +/- 0.9 ml/kg-min in
      group I and 16.9 +/- 1.3 ml/kg-min in group II (P less than .05). Systemic O2EXT
      at DO2crit was similar in both groups. Arterial lactate concentration at DO2crit
      was significantly higher in endotoxic pigs (group I, 2.64 +/- 0.29 mM; vs. group
      II, 3.88 +/- 0.45 mM; P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742861
TI  - Prophylaxis and treatment of newborn endotoxic shock with anti-lipid A monoclonal
      antibodies.
AB  - The newborn is very susceptible to gram-negative sepsis/septic shock. The
      mortality of newborn endotoxic shock continues to be high. Since lipid A is
      responsible for the toxic effects of lipopolysaccharide, anti-lipid A antibodies
      may prevent endotoxic shock in the newborn. This study showed that both anti
      lipid A monoclonal IgG (A78S1) and anti-lipid A monoclonal IgM (A523) decreased
      the mortality of endotoxic shock in 10 day old rats. Prophylactic administration
      of A78S1 and A523 to the pregnant rat decreased the mortality of endotoxic shock
      in their 0-day-old offspring. Prophylaxis was due to transplacental passage of
      A78S1 treatment. The mechanism of prophylaxis remains unclear in A523 treatment.

PMID- 1742862
TI  - Effect of injured vessel size on bleeding following hypertonic saline infusion in
      "uncontrolled" hemorrhagic shock in anesthetized rats.
AB  - Hypertonic saline (HTS) infusion in "uncontrolled" hemorrhagic shock (UCHS) leads
      to increased bleeding from injured vessels, fall in mean arterial pressure (MAP),
      and early mortality. The effect of injured vessel size on blood loss in response
      to HTS treatment was studied in Neurolidal Ketalar anesthetized Hebrew University
      strain rats. The animals were randomly assorted into 4 groups: In group I (n = 8)
      UCHS was induced by resection of 8% of the terminal portion of the rats' tail and
      the animals were untreated. In group II (n = 8) UCHS was induced as in group I
      and the animals were treated with 5 ml/kg NaCl 7.5% (HTS). In group III (n = 9)
      UCHS was induced by 50% resection of the animal's tail, and the animals were
      untreated. In group IV (n = 12) UCHS was induced as in group III and the animals
      were treated with 5 ml/kg HTS Resection of 8% of the animal's tail was followed
      by bleeding of 2.6 +/- 0.3 ml and fall in MAP from 107 +/- 7 to 80 +/- 10 torr (P
      less than .005) within 5 min. Resection of 50% of the animal's tail was followed
      by bleeding of 4.3 +/- 0.4 ml (P less than .01) and fall in MAP to 41 +/- 6 torr
      (P less than .001) after 5 min. Infusion of HTS in group II was followed by
      further blood loss of 4.9 +/- 07 ml within 4 hr while in untreated group I, blood
      loss was only 3.4 +/- 0.4 ml (P less than .05), MAP remained unchanged, and there
      was no mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742863
TI  - Mechanical manifestations of activation in cardiac muscle.

PMID- 1742864
TI  - Fatty acid metabolism and contractile function in the reperfused myocardium.
      Multinuclear NMR studies of isolated rabbit hearts.
AB  - The hypothesis that substrate availability can alter contractile function in
      reperfused myocardium after global ischemia was investigated in this study.
      Isolated rabbit hearts were placed in a dual tuned (31P/13C) NMR probe with a 9.4
      T magnet and perfused with the following substrates given individually or in
      combination: 10 mM glucose, 2 mM palmitate, and 2.5 mM [3-13C]pyruvate. Glucose
      was the sole substrate present for all groups of hearts before the onset of 10 or
      20 minutes of zero-flow ischemia. Contractility (dP/dt) was significantly higher
      in hearts reperfused with glucose compared with hearts reperfused with palmitate
      or the combination. In addition, myocardial oxygen consumption/unit of work at
      reperfusion was more efficient with glucose than with palmitate. ATP content
      during reperfusion was similar with glucose and palmitate and did not account for
      improved function with glucose. To determine if inhibition of pyruvate metabolism
      by palmitate might result in altered postischemic function, additional hearts
      were reperfused with 2.5 mM [3-13C]pyruvate provided alone or in combination with
      palmitate. Using 13C NMR spectroscopy, it was shown that with the addition of
      palmitate, pyruvate oxidation was decreased in control and 10-minute ischemic
      hearts as is consistent with inhibition of pyruvate dehydrogenase by fatty acids.
      However, palmitate/pyruvate did not worsen postischemic function as compared with
      palmitate or pyruvate alone. Tricarboxylic acid cycle activity was slowed in
      reperfused pyruvate hearts, but no further reduction was observed when palmitate
      was present. In conclusion, palmitate reduces the mechanical function of the
      reperfused isolated rabbit heart as compared with glucose. This effect of
      palmitate does not appear to be caused by suppression of pyruvate oxidation or by
      a change in high energy phosphate content.

PMID- 1742865
TI  - Coronary microvascular resistance in hypertensive cats.
AB  - Chronic systemic hypertension has been shown to alter the distribution of
      vascular resistance in many microvascular beds. The purposes of this study were
      to assess the effects of chronic systemic hypertension on the pressure
      distribution in the coronary microcirculation and to determine the microvascular
      site where coronary vascular resistance is increased. Cats were made hypertensive
      using a one-kidney, one-wrap model (Page model). A servonulling system was used
      to directly measure pressures in the epimyocardial microvessels of the beating
      left ventricle in normotensive and hypertensive cats. In chronically hypertensive
      cats, mean arterial pressure was 153 +/- 5 mm Hg compared with 98 +/- 3 mm Hg in
      normotensive cats (p less than 0.05). Left ventricular mass was increased
      approximately 34% in hypertensive cats (9.4 +/- 0.3 versus 7.0 +/- 0.3 g, p less
      than 0.05). Myocardial perfusion measured using radiolabeled microspheres was not
      different between hypertensive and normal cats. Coronary vascular resistance of
      the left ventricle was increased in hypertensive cats (0.90 +/- 0.08 versus 0.66
      +/- 0.05 mm Hg x min x 100 g/ml, p less than 0.05). Microvascular pressures were
      measured in three groups of microvessels: small, less than 200 microns; medium,
      200-300 microns; and large, greater than or equal to 300 microns. Mean
      microvascular pressures of large, medium, and small arterial microvessels in
      hypertensive cats were 144 +/- 8, 127 +/- 6, and 115 +/- 7 mm Hg,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742866
TI  - Comparison of crossbridge dynamics between intact and skinned myocardium from
      ferret right ventricles.
AB  - This study compares the crossbridge kinetics of intact and skinned preparations
      from ferret cardiac muscles at 20 degrees C to determine whether skinning causes
      any alteration in the crossbridge response to an imposed length change. A
      papillary or trabecular muscle was isolated from the right ventricle, the muscle
      length adjusted to give the maximum twitch tension (Lmax), and the preparation
      was subjected to Ba2+ contracture. When steady tension developed, the length of
      the preparation was perturbed sinusoidally in 19 discrete frequencies, ranging
      from 0.13 to 135 Hz, and at a small peak-to-peak amplitude (0.25% Lmax). We
      identified three exponential processes in the sinusodial force-response to the
      imposed length oscillation, and these were labeled processes B, C, and D in order
      of increasing speed. A slow process, A, normally present in fast-twitch skeletal
      muscles, is very small or absent in cardiac muscles. Process B is an exponential
      delay, and the muscle produces oscillatory work on the forcing apparatus;
      processes C and D are exponential advances in which the muscle absorbs work. The
      preparation was chemically skinned and activated in the presence of (mM) CaEGTA 6
      (pCa 4.55), MgATP 5, magnesium propionate 1, and phosphate 1, pH 7.0, with ionic
      strength adjusted to 200 mM with potassium propionate. We found that the
      crossbridge kinetics were not altered by the skinning procedure. The apparent
      rate constants extracted from the sinusoidal analysis were nearly identical in
      Ba2+ contracture (intact preparation) and in Ca2+ activation (skinned
      preparation), and the Nyquist plots were similar. Because the rate constants
      changed sensitively with the substrate (MgATP) concentrations, we concluded that
      the substrate is adequately supplied during Ba2+ contracture in the intact
      preparation. Our study demonstrates the compatibility of results obtained from an
      intact and from a skinned preparation.

PMID- 1742867
TI  - Adenine nucleotide release from isolated perfused guinea pig hearts and
      extracellular formation of adenosine.
AB  - The quantification of adenine nucleotides released from the heart is hampered by
      their rapid dephosphorylation to adenosine in the extracellular space catalyzed
      by highly active ectonucleotidases. To determine the total release of adenine
      nucleotides from isolated Langendorff-perfused guinea pig hearts, ecto 5'
      nucleotidase was effectively blocked by infusion of alpha, beta-methylene-ADP
      (AOPCP, 50 microM). Adenine nucleotides were measured in the coronary venous
      effluent by the luciferin-luciferase method after enzymatic rephosphorylation to
      ATP. In hearts perfused at a constant flow rate (10 ml/min) with normoxic buffer
      (95% O2, 5% CO2) the release +/- SEM of adenine nucleotides and adenosine was
      0.06 +/- 0.01 (n = 11) and 0.04 +/- 0.01 (n = 13) nmol/min. In the presence of
      AOPCP, the release of adenine nucleotides increased to 0.43 +/- 0.04 nmol/min (n
      = 9; p less than 0.05), whereas adenosine remained unchanged. Hypoxic perfusion
      (10% O2, 85% N2, 5% CO2) caused a threefold increase in adenine nucleotide
      release but a 40-fold increase in adenosine. In contrast, global ischemia (30
      seconds) caused adenine nucleotide and adenosine release to rise to similar
      values of 1.06 +/- 0.10 and 0.80 +/- 0.14 nmol/min (n = 9). Stimulation of hearts
      with isoproterenol (4 nM) likewise increased the release of adenine nucleotides
      (0.50 +/- 0.04 nmol/min) and adenosine (0.87 +/- 0.21 nmol/min) (n = 6). To
      determine the cellular source of adenine nucleotides released from the heart, the
      coronary endothelial adenine nucleotide pool was selectively prelabeled by
      [3H]adenosine. Global ischemia increased the specific radioactivity of released
      adenine nucleotides by 57%. The findings indicate that 1) adenine nucleotides and
      adenosine are released at the same order of magnitude from the well-oxygenated
      heart; 2) beta-adrenergic stimulation and ischemia stimulate the release of
      adenine nucleotides and adenosine, both purines reaching vasoactive
      concentrations in the effluent perfusate; 3) during hypoxic perfusion only the
      release of adenosine is greatly enhanced; and 4) the coronary endothelium
      preferentially contributes to the ischemia-induced adenine nucleotide release.

PMID- 1742868
TI  - Effects of TA-3090, a new calcium channel blocker, on myocardial substrate
      utilization in ischemic and nonischemic isolated working fatty acid-perfused rat
      hearts.
AB  - Experimental studies have shown that calcium channel blockade has a protective
      effect on the ischemic myocardium. Although these agents may act by decreasing
      intracellular Ca2+ accumulation during reperfusion or to reduce oxygen
      requirements by decreasing myocardial work load, recent evidence suggests that
      calcium blockers may also favorably alter energy substrate metabolism in ischemic
      and reperfused myocardium. In this study, TA-3090, a new calcium channel blocker
      with minimal effect on myocardial work load, was used to study the effect of
      calcium channel blockade on both myocardial substrate utilization and reperfusion
      recovery of ischemic hearts. Isolated working rat hearts were perfused at an 11.5
      mm Hg preload and an 80 mm Hg afterload with Krebs-Henseleit buffer containing 11
      mM glucose, 1.2 mM palmitate, and 500 microunits/ml insulin. In aerobically
      perfused spontaneously beating hearts, a 0.5 microM dose of TA-3090 had a mild
      depressant effect on heart rate but no effect on peak systolic pressure
      development. In paced hearts (250 beats/min), 0.5 microM TA-3090 had no effect on
      either peak systolic pressure development or contractility. Fatty acid and
      glucose oxidation was determined by measuring 14CO2 production in hearts perfused
      with either [14C]palmitate or [14C]glucose, respectively, whereas glycolysis was
      determined by measuring 3H2O production from [3H]glucose. Under aerobic
      conditions, fatty acid oxidation was not altered by TA-3090, but a significant
      decrease in glucose oxidation and glycolytic rates was observed. If hearts were
      subjected to a 30-minute period of no-flow ischemia, the addition of 0.5 microM
      TA-3090 to the perfusate before ischemia significantly improved reperfusion
      recovery of mechanical function. The protective effects of TA-3090 were not
      observed if TA-3090 was added at the time of reperfusion and were not related to
      a depression of function before ischemia. TA-3090, added before ischemia,
      significantly reduced glycogen and ATP depletion during no-flow ischemia and also
      significantly decreased glycolytic rates in hearts subjected to low-flow ischemia
      (coronary flow = 0.5 ml/min). Combined, our data suggest that the beneficial
      effects of calcium channel blockade on the ischemic myocardium are not related
      solely to a decrease in myocardial work load or metabolic demand before ischemia,
      but rather may in part be related to a decrease in myocardial energy demand
      during ischemia itself, resulting in preservation of ATP and a decrease in
      glycolysis. The decrease in glycolytic rates during ischemia may also result in a
      reduction of glycolytic product accumulation during ischemia.

PMID- 1742869
TI  - Energetics of isometric force development in control and volume-overload human
      myocardium. Comparison with animal species.
AB  - Alteration in crossbridge behavior and myocardial performance have been
      associated with myosin isoenzyme composition in animal models of myocardial
      hypertrophy or atrophy. In the hypertrophied human heart, myocardial performance
      is altered without significant changes in myosin isoenzymes. To better understand
      this discrepancy, isometric heat and force measurements were carried out in 1)
      control and volume-overload human myocardium, 2) control, pressure-overload, and
      hyperthyroid rabbit myocardium, and 3) control and hypothyroid rat myocardium. In
      control human myocardium, peak isometric twitch tension was 44.0 +/- 11.7 mN/mm2,
      and maximum rate of tension rise was 69.2 +/- 21.0 mN/sec.mm2. In volume-overload
      human myocardium, peak twitch tension and maximum rate of tension rise were
      reduced by 55% (p less than 0.05) and 65% (p less than 0.05), respectively. The
      average force-time integral of the individual crossbridge cycle, calculated by
      myothermal techniques, was increased by 85% (p less than 0.005) in volume
      overload human myocardium. In control and hormonally altered myocardium, both
      across and within species (control human, control rat, control rabbit,
      hypothyroid rat, and hyperthyroid rabbit), there was a close relation between the
      crossbridge force-time integral and the percentage of V3-type myosin isoenzyme in
      the myocardium. However, hemodynamically altered (volume-overload human and
      pressure-overload rabbit) myocardium did not follow this relation. Across and
      within species, there were significant correlations between maximum rate of
      tension rise and average tension-dependent heat rate (r = 0.97, p less than
      0.001) and between maximum rate of tension fall and average tension-independent
      heat rate (r = 0.82; p less than 0.025). Furthermore, there were close inverse
      relations between these heat rates and the crossbridge force-time integral. In
      addition, there was an inverse relation between tension-independent heat and the
      crossbridge force-time integral. Across and within species total myocardial
      energy turnover was significantly correlated with the crossbridge force-time
      integral (relative total heat, r = -0.84, p less than 0.02; relative total
      activity related heat, r = -0.88, p less than 0.01). The present findings
      indicate that 1) factors separate from myosin isoenzymes account for the altered
      crossbridge cycle in volume-overload human and pressure-overload rabbit
      myocardium, 2) changes in excitation-contraction coupling processes accompany
      changes in the crossbridge cycle within and across species, and 3) the force-time
      integral of the crossbridge cycle is a major determinant of total myocardial
      energy turnover.

PMID- 1742870
TI  - Mechanisms responsible for the heterogeneous coronary microvascular response to
      nitroglycerin.
AB  - Nitroglycerin dilates large (greater than or equal to 100 microns) but not small
      coronary arterial microvessels, and a putative metabolite of nitroglycerin, S
      nitroso-L-cysteine, has been shown in vitro to dilate both large and small
      coronary microvessels. Based on this evidence, we tested the hypothesis that the
      lack of response of small coronary microvessels was due to an inability of small
      coronary microvessels to convert nitroglycerin into its vasoactive metabolite and
      examined possible explanations for this phenomenon. We studied left ventricular
      epicardial microvessels in vivo using video microscopy and stroboscopic epi
      illumination in anesthetized, open-chest dogs. Diameters were determined while
      the epicardium was suffused with nitroglycerin, S-nitroso-L-cysteine, or S
      nitroso-D-cysteine (all 10 microM) and nitroglycerin in the presence of L- or D
      cysteine (100 microM). None of the agents affected systemic hemodynamics.
      Nitroglycerin dilated large arterioles (20 +/- 2%) but not small arterioles (1 +/
      1%). Both S-nitroso-L-cysteine and S-nitroso-D-cysteine were potent dilators of
      all size classes of microvessels. Concomitant application of L-cysteine and
      nitroglycerin evoked dilation in small microvessels (22 +/- 4%, p less than 0.5
      versus nitroglycerin alone) and larger microvessels (27 +/- 6%, p = NS versus
      nitroglycerin alone). D-Cysteine did not alter the microvascular response to
      nitroglycerin in either small (7 +/- 4%, p = NS versus nitroglycerin alone) or
      large (18 +/- 3%, p = NS versus nitroglycerin alone) microvessels. Neither L
      cysteine nor D-cysteine had a direct effect on microvascular diameter. These
      findings suggest that 1) sulfhydryl groups are required for the conversion of
      nitroglycerin to its vasoactive metabolite; 2) the interaction between
      nitroglycerin and sulfhydryl residues is a stereospecific process, indicating
      either an intracellular mechanism or a membrane-associated enzymatic reaction;
      and 3) a lack of available sulfhydryl groups may be responsible for the lack of
      response of small coronary arterioles to nitroglycerin.

PMID- 1742871
TI  - Cellular basis of chronic ventricular remodeling after myocardial infarction in
      rats.
AB  - To determine whether the hypertrophic response of the surviving myocardium after
      infarction leads to normalization of ventricular hemodynamics and wall stress,
      the left coronary artery was ligated in rats. One month later, the rats were
      killed. In infarcts affecting an average 38% of the free wall of the left
      ventricle (small infarcts), reactive hypertrophy in the spared myocardium
      bordering and remote from the scar was documented by increases in myocyte cell
      volume per nucleus of 43% and 25%, respectively. These cellular enlargements
      resulted in a complete reconstitution of functioning tissue. However, left
      ventricular end-diastolic pressure was increased, left ventricular dP/dt was
      decreased, and diastolic wall stress was increased 2.4-fold. After infarctions
      resulting in a 60% loss of mass (large infarcts), myocyte hypertrophy was 81% and
      32% in the regions adjacent to and distant from the scar, respectively. A 10%
      deficit was present in the recovery of viable myocardium. Functionally,
      ventricular performance was markedly depressed, and diastolic wall stress was
      increased ninefold. The alterations in loading of the spared myocardium were due
      to an increase in chamber volume and a decrease in the myocardial mass/chamber
      volume ratio that affected both infarct groups. Chamber dilation was the
      consequence of the combination of gross anatomic and cellular changes consisting,
      in the presence of small infarcts, of a 6% and a 19% increase in transverse
      midchamber diameter and in average myocyte length per nucleus, respectively. In
      the presence of large infarcts, transverse and longitudinal chamber diameters
      expanded by 27% and 11%, respectively, myocyte length per nucleus expanded by
      26%, and the mural number of myocytes decreased by 10%. In conclusion,
      decompensated eccentric ventricular hypertrophy develops chronically after
      infarction, and growth processes in myocytes are inadequate for normalization of
      wall stress when myocyte loss involves nearly 40% or more of the cells of the
      left ventricular free wall. The persistance of elevated myocardial and cellular
      loads may sustain the progression of the disease state toward end-stage
      congestive heart failure.

PMID- 1742872
TI  - Digital angiographic impulse response analysis of regional myocardial perfusion.
      Estimation of coronary flow, flow reserve, and distribution volume by
      compartmental transit time measurement in a canine model.
AB  - A system impulse response function that describes the kinetics of radiographic
      contrast material transit through the coronary circulation was calculated from
      175 selective digital angiograms of normal and stenotic arteries in 10 dogs
      during rest and hyperemia. The goal of the study was to determine if the flow and
      distribution volume characteristics of the epicardial coronary arteries and the
      myocardial microcirculation could be stimulated by specific mathematical
      compartments of a lagged normal density model impulse response function in which
      the flow/distribution volume ratio is the inverse of the mean transit time. The
      arterial compartment mean transit time correlated with flow (r = 0.75); however,
      the correlation was significantly improved in individual dogs (r = 0.83 +/- 0.13;
      p less than 0.005) and was highly dependent on the length of the conduit vessel.
      The microcirculation compartment mean transit time was distributed as two
      populations with respect to flow. There was a linear correlation during hyperemia
      (r = 0.87) and a nonlinear relation during rest, which was characteristic of an
      autoregulating system. Resting values of microcirculation compartment mean
      transit time correlated with coronary flow reserve (r = 0.84) and differed
      significantly between vessels that were normal and those with subcritical
      stenosis, critical stenosis, or total occlusion (p less than 0.01 for all
      comparisons). The estimated microcirculation compartment distribution volume
      increased from a minimum of 4.0 +/- 1.5 ml/100 g myocardium in normal vessels
      with resting flow to 11.2 +/- 3.5 ml/100 g during hyperemia. These data suggest
      that the model compartments functionally describe the physiological behavior of
      their anatomic analogues and permit the quantification of microcirculatory
      autoregulation from a single measurement at rest without provoking hyperemia.

PMID- 1742873
TI  - Platelet and fibrin modification by radiographic contrast media.
AB  - The effect of the radiographic contrast agents, iopamidol and diatrizoate, on
      fibrin assembly and structure as well as platelet surface charge was studied.
      Increasing the iopamidol concentration from 0 to 4.5 mM prolongs the fibrin
      gelation time from 20 to 105 seconds (an anticoagulant effect) and reduces the
      fibrin fiber mass/length ratio from 3.2 x 10(12) to 0.5 x 10(12) Da/cm (i.e.,
      produces very thin fibrin fibers). Ultraviolet difference spectroscopy of
      fibrinogen showed both a 15-nm shift in the ultraviolet difference maximum for
      iopamidol (suggesting binding) and a perturbation of the aromatic amino acid side
      chain region for fibrinogen (suggesting a conformational change in fibrinogen) as
      the concentration of iopamidol was increased from 0 to 9 mg/ml. Binding of
      iopamidol to fibrinogen was also shown by affinity chromatography using a
      Sepharose-fibrinogen column. Electrophoretic quasi elastic light scattering was
      used to show platelet interaction with iopamidol as reflected in a reduction in
      the platelet electrophoretic mobility from 2.0 to 0.5 (microns-cm)/(V-sec) as the
      concentration of iopamidol was increased from 0 to 4.5 mM. In addition, the ionic
      radiopaque contrast agent, Renografin, was also studied and found to inhibit
      fibrin monomer assembly. Although iopamidol is not shown to be thrombogenic,
      iopamidol does appear to reduce platelet surface charge, bind fibrinogen, and
      modify fibrin clot structure.

PMID- 1742874
TI  - Ryanodine does not affect calcium current in guinea pig ventricular myocytes in
      which Ca2+ is buffered.
AB  - Calcium current in mammalian ventricular muscle is altered in the presence of
      ryanodine. Previous studies performed on rat ventricular cells have shown a
      slowing of Ca2+ current inactivation and suggest the hypothesis that ryanodine,
      by reducing the release of Ca2+ from the sarcoplasmic reticulum, reduces the
      availability of Ca2+ for inactivation of Ca2+ current (Ca(2+)-dependent
      inactivation). Another hypothesis is that the effects of ryanodine on Ca2+
      current are due to a mechanical connection of the ryanodine receptor with the L
      type Ca2+ channel. To further test these hypotheses we examined the effect of
      ryanodine on Ca2+ current in single voltage-clamped guinea pig ventricular
      myocytes that contained Ca2+ indicator and Ca2+ buffer. We used fura 2
      (pentapotassium salt) to confirm that the ryanodine we used was capable of
      abolishing Ca2+ release from the sarcoplasmic reticulum during the period in
      which it was present. We perfused the cells with 10 mM EGTA to block changes in
      intracellular Ca2+ concentration. In the absence of internal EGTA, Ca2+ currents
      displayed biexponential inactivation and Ca(2+)-dependent inactivation (steady
      state inactivation curves turned up at positive potentials). Inactivation was
      slowed by ryanodine at 10 microM. In cells perfused internally with EGTA,
      however, ryanodine had no effects, and steady-state inactivation curves were not
      shifted to the right. We conclude that, in guinea pig ventricular myocytes, the
      effects of ryanodine on Ca2+ current are mediated by Ca2+ and thus the effects of
      ryanodine do not provide a basis on which to postulate a physical connection
      between the L-type Ca2+ channel and the ryanodine receptor (sarcoplasmic
      reticulum Ca2+ release channel).

PMID- 1742875
TI  - Does load dependence of relaxation differ between left and right cardiac muscle?

PMID- 1742876
TI  - Bioactive gonadotrophin secretion in man.

PMID- 1742877
TI  - Iodine-131 treatment of hyperthyroidism: current issues.

PMID- 1742878
TI  - Thirst and vasopressin.

PMID- 1742879
TI  - Osmotic and non-osmotic regulation of thirst and vasopressin secretion in
      patients with compulsive water drinking.
AB  - OBJECTIVE: To examine the osmotic and non-osmotic regulation of thirst and AVP
      release in patients with compulsive water drinking. DESIGN: A 2-hour intravenous
      infusion of hypertonic (855 mmol/l) sodium chloride solution, followed by a 2
      hour drinking period. PATIENTS: Seven patients with compulsive water drinking,
      seven patients with diabetes insipidus and seven healthy controls. MEASUREMENTS:
      Plasma AVP, osmolality, sodium and haematocrit, thirst ratings on a visual
      analogue scale and the volume of water drunk in 2 hours following infusion.
      RESULTS: Plasma AVP responses to osmotic stimulation, and non-osmotic inhibition
      by drinking, were normal in patients with compulsive water drinking. Basal thirst
      ratings were higher in compulsive water drinking than in either diabetes (P less
      than 0.001) or controls (P less than 0.001), despite lower basal plasma
      osmolalities. There was a significant rise in thirst ratings during saline
      infusion, which correlated closely with plasma osmolality, in all three groups,
      but the final thirst ratings were higher in compulsive water drinkers, who
      subsequently drank more water than in either diabetes insipidus (P less than
      0.01) or controls (P less than 0.001). Drinking rapidly lowered thirst ratings in
      controls and diabetes insipidus before changes occurred in plasma osmolality, but
      remained elevated in patients with compulsive water drinking. Linear regression
      analysis defined a lower osmotic threshold for thirst in compulsive water
      drinking compared with controls or diabetes insipidus. CONCLUSIONS: There are
      abnormalities of the osmotic stimulation and non-osmotic inhibition of thirst in
      compulsive water drinking, suggesting that the underlying defect is one of
      interpretation of osmotic and non-osmotic inputs. Measurement of thirst responses
      during hypertonic saline infusion and subsequent water drinking may provide
      useful diagnostic information in the differentiation of polyuric states.

PMID- 1742880
TI  - Influence of thyroxine treatment on thyroid size and anti-thyroid peroxidase
      antibodies in Hashimoto's thyroiditis.
AB  - OBJECTIVE: It has been postulated that a decrease in thyroid size can be achieved
      by thyroxine treatment in patients with goitrous Hashimoto's thyroiditis but no
      objective data are available. We have therefore investigated the influence of
      thyroxine treatment on ultrasonically determined thyroid size. We also measured
      serum antithyroid peroxidase antibodies. DESIGN: Consecutive patients with
      goitrous Hashimoto's thyroiditis was studied. PATIENTS: Thirteen women
      participated; all had goitrous thyroiditis. TREATMENT: To render them euthyroid
      thyroxine was given for 24 months. MEASUREMENTS: Thyroid size was measured
      ultrasonically and antithyroid peroxidase antibodies were measured using a
      commercial radioimmunological method. RESULT: Concomitant with the gradual
      increase in serum free thyroxine and free triiodothyronine index values and a
      fall in serum thyrotrophin level, a gradual decrease in thyroid volume from 50.4
      +/- 6.8 ml (mean +/- SEM) to 34.1 +/- 5.7 ml (32%), P less than 0.001 was
      demonstrated. Antithyroid peroxidase antibodies were present in high
      concentrations in all subjects but the mean serum level was not significantly
      changed at 24 months after initiation of treatment. CONCLUSION: A clinically
      significant reduction in thyroid volume related to normalization of thyroid
      function but unrelated to changes in antithyroid peroxidase antibody can be
      achieved during L-thyroxine treatment of hypothyroid goitrous Hashimoto's
      thyroiditis.

PMID- 1742881
TI  - Pituitary macroadenomas associated with hyperprolactinaemia: immunocytochemical
      and in-situ hybridization studies.
AB  - OBJECTIVE: We have assessed whether in-situ hybridization for prolactin messenger
      RNA (mRNA) provides additional information for the classification of pituitary
      macroadenomas associated with hyperprolactinaemia. DESIGN: In-situ hybridization
      for PRL mRNA was performed on surgical biopsies of pituitary adenomas and the
      results correlated with serum PRL levels and PRL immunoreactivity. PATIENTS:
      Twenty-one patients (11 men, 10 women) were included; five had normal serum PRL
      levels, 11 mild hyperprolactinaemia (less than 3000 mU/l) and five marked
      hyperprolactinaemia (greater than 3000 mU/l). MEASUREMENTS: Immunocytochemistry
      for PRL and in-situ hybridization for PRL mRNA were performed on surgical
      biopsies. RESULTS: Immunoreactivity for PRL was detected in tumours from all
      patients with serum PRL greater than 3000 mU/l and in one of 11 patients with
      mild hyperprolactinaemia. Positive signal for PRL mRNA was detected in four of
      five immunopositive cases studied, in a further two cases with mild
      hyperprolactinaemia, and in one tumour associated with normal serum PRL level.
      CONCLUSIONS: In-situ hybridization provides evidence of PRL gene activation in
      the absence of immunoreactivity for prolactin. This may reflect low levels of
      hormone storage or defective translation of the mRNA.

PMID- 1742882
TI  - A distribution method for analysing the baseline of pulsatile endocrine signals
      as exemplified by 24-hour growth hormone profiles.
AB  - OBJECTIVE: To develop a method for quantifying the distribution of concentrations
      present in hormone profiles, which would allow an observer-unbiased estimate of
      the time concentration attribute and to make an assessment of the baseline.
      DESIGN: The log-transformed concentrations (regardless of their temporal
      attribute) are sorted and allocated to class intervals. The number of
      observations in each interval are then determined and expressed as a percentage
      of the total number of samples drawn in the study period. The data may be
      displayed as a frequency distribution or as a cumulative distribution. Cumulative
      distributions may be plotted as sigmoidal ogives or can be transformed into
      discrete probabilities (linear probits), which are then linear, and amenable to
      regression analysis. Probability analysis gives estimates of the mean (the value
      below which 50% of the observed concentrations lie, which we term 'OC50').
      'Baseline' can be defined in terms of percentage occupancy--the 'Observed
      Concentration for 5%' (which we term 'OC5') which is the threshold at or below
      which the hormone concentrations are measured 5% of the time. PATIENTS: We report
      the use of applying this method to 24-hour growth hormone (GH) profiles from 63
      children, 26 adults and one giant. RESULTS: We demonstrate that GH effects
      (growth or gigantism) in these groups are more related to the baseline OC5
      concentration than peak concentration (OC5 +/- 95% confidence limits: adults 0.05
      +/- 0.04, peak-height-velocity pubertal 0.39 +/- 0.22, giant 8.9 mU/l).
      CONCLUSIONS: Pulsatile hormone profiles can be analysed using this method in
      order to assess baseline and other concentration domains.

PMID- 1742883
TI  - Correlation of plasma insulin and insulin-like growth factor-I with indices of
      androgen transport and metabolism in women with polycystic ovary syndrome.
AB  - OBJECTIVE: Polycystic ovary syndrome (PCOS) is said to be associated with
      hyperinsulinaemia. Insulin stimulates androgen production by ovarian tissue in
      vitro and previous studies have identified a positive correlation of insulin with
      androstenedione. The aim of the present study was to discover whether insulin
      levels correlate with clinical presentation and with markers of androgen
      transport and metabolism in women with PCOS. DESIGN: Within-group analysis of
      clinical and biochemical characteristics of a consecutive series of women with
      PCOS, focusing on correlations of plasma insulin with clinical presentation and
      androgens. Insulin levels were also compared with a control group of normal
      women. PATIENTS: Forty-seven women who presented with hirsutism, cycle
      abnormalities or both, with ultrasound proven PCOS, were recruited. Mean age was
      26.6 +/- 0.7 years (mean +/- SEM), BMI 27.3 +/- 1.2 kg/m2. MEASUREMENTS: Plasma
      insulin levels were measured at 30-minute intervals for 3 hours following a 75 g
      glucose load. Blood was also taken for measurement of testosterone (T),
      androstenedione (A), free testosterone (fT), sex hormone binding globulin (SHBG)
      and insulin-like growth factor-I (IGF-I). Androsterone glucoronide (AG), a marker
      of peripheral androgen metabolism, was also measured. RESULTS: Neither basal
      insulin nor the sum of insulin measurements during the glucose tolerance test
      (sumINS) in women with PCOS were significantly different from a control group
      with normal ovaries. Within the PCOS group, basal insulin was greater in women
      with irregular cycles or amenorrhoea than in those with regular ovulatory menses
      (8.0 +/- 1.1 vs 3.1 +/- 1.5 mU/l, P less than 0.01) despite similarly raised
      androgen levels. Both basal insulin and sumINS correlated with BMI in women with
      PCO (r = 0.37, P less than 0.05 and r = 0.64, P less than 0.01 respectively) but
      not in controls. There was no significant correlation between insulin or IGF-I
      levels and T, A or AG despite a positive correlation of AG (but no other
      androgen) with BMI. SHBG showed an inverse correlation and fT correlated
      positively with sumINS (r = -0.51, P less than 0.01; r = 0.39, P less than 0.05).
      Regression analysis of each of the androgens on the other variables demonstrated
      no significant relationship between insulin and androgens. CONCLUSIONS: These
      data suggest that, in vivo, the major effect of insulin on androgen secretion is
      mediated by changes in SHBG rather than by direct stimulation of ovarian androgen
      production. Higher insulin concentrations in anovulatory compared with ovulatory
      women with hyperandrogenaemia may indicate that insulin resistance in the ovary
      contributes to the mechanism of anovulation in PCOS.

PMID- 1742884
TI  - The short Synacthen test in acute hospital admissions.
AB  - OBJECTIVE: We wished to define the cortisol response to 250 micrograms
      intramuscular tetracosactrin (Synacthen) in acute hospital admissions, using a
      modern immunoassay for cortisol. DESIGN: We performed a prospective study of, as
      near as possible, a consecutive series of 161 admissions to a single unit.
      PATIENTS: We studied 50 patients (age range 67-98, mean 80.3 years, 31-female, 19
      male) admitted as an emergency, from whom it was possible to obtain informed
      consent, and whom it was possible to study within 24 hours of admission.
      MEASUREMENTS: We measured baseline, increment and peak serum cortisol following
      administration of 250 micrograms intramuscular tetracosactrin between 0800 and
      0900 hours. RESULTS: Baseline cortisol concentrations ranged from 288 to 1585
      nmol/l (mean 706; median 665). Peak cortisol concentrations ranged from 602 to
      2265 nmol/l (mean 1076; median 999). Baseline and peak cortisol concentrations
      showed a significant correlation (P less than 0.001). Increment varied from 10 to
      747 nmol/l (mean 374; median 336) and did not correlate with baseline.
      CONCLUSIONS: In acute hospital admissions, baseline serum cortisol between 0800
      and 0900 hours should exceed 250 nmol/l. Peak serum cortisol after 250 micrograms
      intramuscular tetracosactrin should exceed 600 nmol/l. Calculation of the
      increment is of no value.

PMID- 1742885
TI  - Long-term follow-up of hypothalamic-pituitary function in patients with
      transsphenoidal pituitary herniation and midfacial anomalies.
AB  - OBJECTIVE: We wished to determine whether patients with transsphenoidal pituitary
      herniation were at risk of developing pituitary failure. DESIGN: We followed up
      hypothalamic-pituitary function annually in patients with midfacial anomalies and
      pituitary herniation. PATIENTS: Two patients who had transsphenoidal pituitary
      herniation and midfacial anomalies were included and the literature was reviewed.
      RESULTS: Both patients became gonadotrophin, TSH and growth hormone-deficient
      despite neurosurgical repair. CONCLUSION: We conclude that the early diagnosis
      and neurosurgical repair of transsphenoidal pituitary herniation may prevent
      central nervous system infection and rhinorrhoea. Surgical repair may not prevent
      pituitary failure as was evident in both of our cases. Periodic evaluation of the
      hypothalamic-pituitary axis is essential to determine whether early hormonal
      replacement therapy is necessary.

PMID- 1742886
TI  - Pattern of secretion of bioactive and immunoreactive gonadotrophins in normal
      pubertal children.
AB  - OBJECTIVE: The aim was to investigate the relationship between the nocturnal
      pulsatile secretory patterns of immunoreactive and bioactive luteinizing hormone
      in normal children at various stages of puberty. DESIGN: Blood samples were taken
      at 15-minute intervals from 2000 hours to 0800 hours. Pubertal stage was assessed
      by the method of Tanner (1962). PATIENTS: Thirty-four healthy siblings (17 males,
      17 females) of diabetic children were recruited (median age 13.1, range 9.1-20.9
      years). They were of normal height, non-obese, and covered the range of puberty.
      MEASUREMENTS: Follicle stimulating and luteinizing hormone levels were measured
      by radioimmunoassay in all 34 subjects; bioactive LH (B-LH) was assayed in a
      subgroup of 13 subjects selected to encompass the range of normal puberty.
      Oestradiol (girls) and testosterone (boys) were also measured at hourly
      intervals. RESULTS: Immunoreactive luteinizing and follicle stimulating hormone
      concentrations showed a progressive rise during puberty in both sexes. FSH
      concentrations were significantly higher in females than in males at all stages
      of puberty. Overnight mean bioactive luteinizing hormone concentrations were
      higher than immunoreactive luteinizing hormone levels in all the girls studied (n
      = 7). Although the number of bioactive luteinizing hormone pulses (31) was
      greater than immunoreactive pulses (27), the profiles were generally very
      similar. In the early pubertal girls an increase in the bioactive: immunoreactive
      ratio was observed during the middle of the night with the onset of pulsatility.
      Oestrogen was detected in the girls in breast stage 4-5 but not in two of the
      early pubertal girls, despite pulses of immunoreactive and bioactive luteinizing
      hormone. The boys had higher mean bioactive than immunoreactive luteinizing
      hormone levels and overall bioactive and immunoreactive luteinizing hormone and
      testosterone concentrations increased with puberty stage. Concordance between
      bioactive and immunoreactive hormone pulses was good although more immunoreactive
      pulses (16) were seen than bioactive pulses (14). As in the girls, an increase in
      the bioactive: immunoreactive ratio was observed in the middle of the night with
      the onset of pulsatility at genital stage 2 but, in contrast to the oestrogen
      data in the girls, testosterone secretion always followed luteinizing hormone
      pulsatility overnight. CONCLUSION: We conclude that mean overnight immunoreactive
      luteinizing and follicle stimulating hormone concentrations increase during
      puberty in both sexes. Bioactive luteinizing hormone levels are two to three
      times higher than immunoreactive luteinizing hormone in both sexes, but there is
      very little discordance between immunoreactive and bioactive luteinizing hormone
      pulsatility. The bioactive: immunoreactive ratio increases with the occurrence of
      pulsatility overnight in early pubertal children. The relationship between these
      changes in bioactive and immunoreactive luteinizing hormone and sex steroids is
      clearest in boys where the nocturnal testosterone rise always follows pulsatile
      LH secretion.

PMID- 1742887
TI  - Current role of magnetic resonance imaging and gadolinium enhancement in current
      British ENT practice.

PMID- 1742888
TI  - Episodic nocturnal hypoxia and nasal packs.
AB  - Nasal obstruction influences respiration during sleep and nasal packs may cause
      obstructive sleep apnoea. In order to investigate this, the perioperative oxygen
      saturation was monitored for 3 nights with continuous pulse oximetry in 12
      patients, who had bilateral nasal packs after septoplasty. A significant increase
      in the number of nocturnal episodes of hypoxia and a significant prolongation of
      the mean duration of the individual hypoxic periods were demonstrated during the
      first and the second post-operative nights. The clinical significance of these
      results is as yet unknown, but the use of partial nasal packing in septoplasty is
      advocated. Further investigations of nocturnal oxygen desaturation and design of
      nasal packs, securing the post-operative nasal airway, are needed.

PMID- 1742889
TI  - Late results of laterofixation in the treatment of bilateral abductor paralysis
      of the vocal cords: a clinical study with long-term follow-up.
AB  - Thirty-four patients with bilateral vocal cord abductor paralysis were treated
      surgically during the period from 1960 to 1979. The main cause of paralysis was
      thyroid surgery (85%). Woodman's external laterofixation was performed in 31
      patients, 1 had laterofixation by laryngofissure and 2 had endoscopic
      arytenoidectomy. In Woodman's procedure the body of the arytenoid cartilage was
      removed in 10 cases and mobilized from the cricoarytenoid joint in 21 cases.
      Thirteen of the 34 patients needed further surgery. Including previously
      performed procedures in 6 patients, altogether 68 operations were performed and
      17 patients (50%) were operated on more than once. The immediate failure rate of
      laterofixation was 22% but the need for reoperation increased with time and the
      total failure rate of the method was 44%. Endoscopic arytenoidectomy was
      successful in 1 of 2 cases as a primary operation and in 3 of 3 cases as
      secondary operation. Follow-up time ranged from 2 months to 29 years 8 months
      (mean 15 years 10 months).

PMID- 1742890
TI  - Oesophageal speech after laryngectomy: a study of possible influencing factors.
AB  - 52 patients with laryngeal carcinoma were studied before and after laryngectomy
      with regard to what factors might influence the development of oesophageal
      speech. The investigations consisted of oesophageal manometry, a follow-up
      interview and a review of surgical approaches and radiotherapy. 43% of the
      patients achieved socially acceptable oesophageal speech, 22% were able to speak
      single words, and 35% had no oesophageal speech at all. 61% had post-operative
      dysphagia. Age was the only factor which significantly correlated to intelligible
      speech. The intraoesophageal pressure during oesophageal phonation exceeded in
      all cases the low PO-HPZ pressure after operation. The extension of surgery and
      radiation field, severity of dysphagia, alcohol and smoking habits, and mental
      condition did not differ between the 3 groups of oesophageal speech. It was
      concluded that the rather complicated process of acquiring oesophageal speech is
      much more dependent on learning ability which decreases with age than on various
      kinds of motor dysfunction after laryngectomy.

PMID- 1742891
TI  - The prevalence of psychological disturbance in neurotology outpatients.
AB  - This study assesses the prevalence of psychological disturbance among a
      consecutive series of 120 neuro-otology outpatients, using a structured interview
      conducted by a clinical psychologist. 42% of all patients were found to be in
      need of, and were offered, psychological help (27% of those with hearing loss,
      45% of those with tinnitus and 64% of those with dizziness). 86% of those offered
      psychological help accepted it. Current psychological distress was associated
      with the number of symptoms complained of and past psychiatric history. Patients
      completed the General Health Questionnaire which was found to have a sensitivity
      rate of 82% and a specificity rate of 87% in this setting. Physicians were also
      asked to rate patients' psychological state; close agreement was found between
      these ratings and those of a psychologist. The contribution of psychological
      assessment of neuro-otology patients is discussed.

PMID- 1742892
TI  - Aspirating middle ear effusions when inserting ventilation tubes: does it
      influence post-operative otorrhoea, tube obstruction or the development of
      tympanosclerosis?
AB  - This prospective study examined the influence of aspirating middle ear effusions,
      immediately prior to ventilation tube insertion, upon the subsequent development
      of otorrhoea and tympanosclerosis. 50 children were studied and aspiration of
      effusions did not influence the incidence of purulent otorrhoea or ventilation
      tube obstruction within 1 month of surgery. The development of tympanosclerosis
      did not correlate with effusion aspiration, but in those ears which had an
      effusion aspirated there was a relation between operative bleeding and the
      development of tympanosclerosis.

PMID- 1742893
TI  - Squamous carcinoma of the posterior pharyngeal wall.
AB  - We present 70 patients with tumours of the posterior pharyngeal wall, considering
      tumours of the posterior hypopharyngeal and posterior oropharyngeal wall as one
      unit. Almost half (45%) of the patients were in poor general condition at the
      time of presentation, and 60% had Stage III or IV tumours. One-third of the
      patients were untreated, and surgery was mainly reserved for patients with Stage
      I and II tumours. The larynx could be preserved in two-thirds of those undergoing
      surgery. The best current method of repair of the posterior pharyngeal wall after
      partial pharyngectomy appears to be a revascularized radial forearm flap. The
      median survival for patients with Stage I tumours was 236 weeks, but for patients
      with Stages II-IV tumours was only 33 weeks. There was no significant difference
      between the survival for II-IV stage groups, but there was between Group I and
      the rest. We identify 2 defects in the UICC classification system: lack of
      definition of the lateral limit of the posterior pharyngeal wall, and a gross
      discrepancy between size and T staging of tumours arising primarily from the
      posterior wall of the hypopharynx.

PMID- 1742894
TI  - Expression of epidermal growth factor receptor in glottic carcinoma and its
      relation to recurrence after radiotherapy.
AB  - The expression of EGFR was determined immunohistochemically in two groups of
      patients with glottic carcinoma, one that recurred after a full course of
      radiotherapy and one that did not. Using a 4-graded scale (-,+,++, ) 80% (12/15)
      of the recurrent carcinomas had a staining intensity and proportion of stained
      cells of ++ or more. The same figure for non-recurrent carcinomas was 39% (7/18).
      The difference is statistically significant (chi-squared with Yates' correction,
      P less than 0.05). The results indicate that an increased expression of EGFR may
      influence the rate of recurrence of glottic squamous cell carcinoma after
      radiotherapy.

PMID- 1742895
TI  - Rehabilitation of facial nerve palsy.
AB  - Forty-nine patients underwent 158 procedures (including 19 revisions) for
      complete facial palsy. The variety of causes of facial palsy are enumerated, with
      the various procedures used to rehabilitate the face. Some improvement is
      invariably achieved. It is concluded that a readiness to intervene with a wide
      choice of procedures as early as realistically possible offers the best outcome
      in function and cosmetic appearance.

PMID- 1742896
TI  - Ossicular geometry and the choice of technique for ossiculoplasty.
AB  - The dimensions of the space between the handle of the malleus and the plane of
      the head of the stapes have been investigated in 31 preserved temporal bones and
      20 patients with defects of the incus. The width (A) and depth (B) were measured
      directly and other dimensions were then calculated. In the preserved temporal
      bones A varied between 0.5 and 3 mm (mean 2.0 mm), while for the patients the
      range was 1.5-3.8 mm (mean 2.2 mm). The dimension B varied between 1 and 2.5 mm
      (mean 1.7 mm) in the temporal bones and between 0 and 2 mm in the patients (mean
      0.9 mm). This difference is statistically significant (P less than 0.0001). The
      angle at which a graft placed directly between the stapes head and malleus handle
      would lie relative to the long axis of the stapes varied between 14 degrees and
      71 degrees in the temporal bones (mean 49 degrees) and between 0 degrees and 79
      degrees in the patients (mean 63 degrees). This difference is also statistically
      significant (P less than 0.001). These differences may be due to chronic
      Eustachian tube dysfunction or to a tendency of the malleus to become displaced
      medially when it is not supported by the incus/stapes complex. These findings
      have significant implications for the mechanical properties of different methods
      of ossiculoplasty, and the relative position of the malleus and stapes should be
      taken into account when choosing the technique to be used in an individual case.

PMID- 1742897
TI  - A study of the complications of grommet insertion for secretory otitis media in
      the presence of nasopharyngeal carcinoma.
AB  - Accepted treatment of secretory otitis media, in the presence of nasopharyngeal
      carcinoma treated with radiotherapy, includes the insertion of a grommet. This
      study analyses the incidence of otorrhoea following this treatment as compared to
      a control group. Results show that persistent otorrhoea occurred frequently (68%)
      in the study group and was refractory to antibiotic therapy. Alternative methods
      of management of the secretory otitis, such as a hearing aid, should be
      considered to avoid the complications of grommet insertion in this group of
      patients.

PMID- 1742898
TI  - The effect of glycerol on the guinea-pig hydropic ear.
AB  - The aim of this paper was to investigate the effect of glycerol on experimental
      endolymphatic hydrops in guinea-pigs. The right endolymphatic sac and duct were
      obliterated through an extradural posterior fossa approach. Some animals received
      a 3 g/kg dose of glycerol for a period of 7 days, whereas others received the
      same dose for 30 days. The activity of glycerol was studied by investigating the
      volumetric changes in the scala media determined with a computerized planimeter.
      Glycerol induced a significant reduction of the hydrops showing its effectiveness
      and suggesting a strial metabolic response.

PMID- 1742899
TI  - Audit of stapedectomy results in a teaching hospital.
AB  - The number of stapedectomies performed annually has declined since 1963. Also,
      surgery has become available at an increasing number of centres, resulting in a
      further fall in the number of such operations performed in teaching hospitals.
      Several studies have suggested benefit might be gained, both by patients and by
      otology as a speciality, from limiting training to post-graduates who show an
      aptitude for otology, and concentrating surgery in a small number of specialized
      centres. We report a series of 179 patients who had stapedectomy performed for
      otosclerosis in a teaching hospital. We have retrospectively compared the
      audiological outcome and complication rates for consultants and surgical
      trainees. For the two groups, there is no significant difference in postoperative
      hearing levels and complication rates are similar. Our success rate is comparable
      to other major series. We conclude that stapedectomy is a safe procedure to teach
      adequately experienced and supervised trainees.

PMID- 1742900
TI  - The nature of the epithelium in acquired cholesteatoma. Part 2. Cell culture.
AB  - The exact nature and role of the epithelial layer in cholesteatoma remains
      undetermined. The aim of this study was to investigate cholesteatoma epithelium
      and normal aural epithelia in common cell culture conditions. Samples of
      cholesteatoma, external meatal epidermis and middle ear mucosa were obtained,
      successfully grown in cell culture, and subcultured. No significant morphological
      differences were found between cholesteatoma and aural epidermis. The only
      differences noted were delayed onset of colony formation, and the need to
      subculture prior to the cultures becoming confluent in the cholesteatoma
      cultures. Further research is required to account for these differences in growth
      patterns.

PMID- 1742901
TI  - Treatment of recurrent acute tonsillitis with clindamycin. An alternative to
      tonsillectomy?
AB  - The failure of treatment with penicillin in patients suffering from acute beta
      haemolytic streptococcus Group A tonsillitis, may be due to the presence of beta
      lactamase-producing bacteria. Several studies indicate that treatment with
      clindamycin may prevent recurrence and thereby eliminate the need for
      tonsillectomy. In this prospective study, 54 patients with recurrent acute
      tonsillitis were investigated. 29 patients were treated with clindamycin, 150 mg
      4 times daily for 10 days, while 25 patients received no antibiotic treatment and
      served as a control group. A significantly reduced number of episodes of acute
      tonsillitis (P less than 0.01) and of tonsillectomy (P less than 0.001) was found
      in the group of patients treated with clindamycin.

PMID- 1742902
TI  - The effect of early blood transfusion on severe epistaxis.
AB  - This retrospective study assesses the effect of early blood transfusion on the
      subsequent progress of patients admitted with severe epistaxis. Both further
      bleeding and surgical procedures were more frequent in those receiving blood
      within the initial 24 h. It was concluded that the need for early blood
      transfusion should be assessed with care.

PMID- 1742903
TI  - Sleep nasendoscopy: a technique of assessment in snoring and obstructive sleep
      apnoea.
AB  - It appears that uvulopalatopharyngoplasty (UVPP) is a reliable procedure for
      reducing snoring, but much less reliable when used as a treatment for OSAS. This
      is thought to be because of poor patient selection in that the site of the
      problem is not always the site of the operation. We present the technique of
      sleep nasendoscopy which allows direct visualization of the site or sites of
      obstruction in a sleeping patient. Our study has shown that there are patients
      with obstructive sleep apnoea syndrome (OSAS) in whom the only site of pharyngeal
      obstruction is at the velopharynx. These patients should do well with the
      relatively simple procedure of UVPP. This is not true for many other OSAS
      patients in whom we found that obstruction was multisegmental. This helps to
      explain the frequently poor results of UVPP in OSAS patients. We feel that this
      form of preoperative assessment will avoid unnecessary surgery.

PMID- 1742904
TI  - The stunned and hibernating myocardium: a brief review.
AB  - DEFINITIONS: Stunned myocardium is viable myocardium salvaged by coronary
      reperfusion that exhibits prolonged postischemic dysfunction after reperfusion.
      Hibernating myocardium is ischemic myocardium supplied by a narrowed coronary
      artery in which ischemic cells remain viable but contraction is chronically
      depressed. CLINICAL EVIDENCE: Stunned myocardium has been identified in the
      following patient groups: (1) thrombolysis or percutaneous transluminal coronary
      angiography (PTCA) in patients with acute evolving infarction; (2) unstable
      angina; (3) exercise-induced angina; (4) coronary artery spasm; (5) platelet
      aggregation or transient thrombosis of a coronary artery; (6) PTCA for chronic
      myocardial ischemia; and (7) immediately following coronary artery bypass graft
      (CABG). Evidence of hibernating myocardium (LV dysfunction) is found in the
      patient with severe coronary artery stenosis, even in asymptomatic patients at
      rest. Stunned myocardium returns to normal after a prolonged period of time
      (hours to weeks). Hibernating myocardium returns to normal function rather
      quickly if the cause is removed. DIFFERENTIATION: Stunned myocardium can be
      differentiated from hibernating myocardium by three clinical parameters, namely,
      LV wall motion, myocardial perfusion, and myocardial metabolism. Stunned
      myocardium has abnormal wall motion that tends to normalize in response to
      inotropes and postextrasystolic potentiation. Perfusion is adequate and
      metabolism is also adequate. Hibernating myocardium also has abnormal wall
      motion, which normalizes after nitrates, inotropes, post extrasystolic
      potentiation (PESP), PTCA, or CABG. Myocardial perfusion is reduced but can be
      reversed with PTCA or CABG and metabolism is adequate.

PMID- 1742905
TI  - Influence of minimal angiographic visible collateral circulation on myocardial
      function during PTCA.
AB  - The potential protective role of angiographically visible minimal collateral
      circulation in diagnostic angiograms, not reaching or filling the target vessel
      (RENTROP class 1), on myocardial function during percutaneous transluminal
      coronary angioplasty (PTCA), was studied in two groups of patients undergoing
      elective PTCA of the left anterior descending artery (LAD). In the first study
      group consisting of 22 patients, influence of collateral circulation class 1 on
      left ventricular regional function was evaluated. In this group, 14 patients
      showed no angiographic collaterals and 8 patients showed collateral circulation
      class 1 in diagnostic angiograms. Increase of end-diastolic and end-systolic
      volume indices as well as decrease of global left ventricular function was not
      significantly different inpatients with and without such minimal collateral
      circulation. In patients without collaterals, the decrease of regional left
      ventricular function was significantly more pronounced in the left anterior
      length segment (p less than 0.05) and a trend was observed in the anterolateral
      (p = 0.059) and apical (p = 0.053) segments. In a second group, consisting of 29
      patients, hemodynamic parameters were measured and, in addition to grading of
      collateral circulation in diagnostic angiograms, angiographically visible
      collateral circulation was estimated during occlusion of the LAD by injecting
      contrast materials into the right coronary artery. An increase of
      angiographically visible collaterals during the ischemic period of various
      degrees was documented in 26 (90%) of 29 patients. Combining patients of both
      study groups, increase in left ventricular end-diastolic pressure during ischemia
      was significantly higher (p less than 0.05) in patients without collaterals on
      diagnostic angiography (n = 34) than in patients with collateral circulation
      class 1 (n = 14).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742906
TI  - Relationship between electrocardiographic patterns and angiographic features in
      isolated left circumflex coronary artery disease.
AB  - The relation of electrocardiographic (ECG) patterns to clinical and angiographic
      features was assessed in 89 patients with isolated left circumflex coronary
      artery (LCx) disease (46 with and 43 without myocardial infarction). ECG
      abnormalities were present in 75 patients; there were isolated Q waves in 20, an
      abnormal R wave in lead V1 with or without inferior and/or lateral Q waves in 21,
      and isolated ST-T wave changes in 34 cases. Inferior abnormalities on the
      electrocardiogram were similar in patients with proximal or distal stenoses of
      the LCx, but an abnormal R wave in lead V1 correlated with proximal LCx stenosis
      (p less than 0.01). Lateral abnormalities were more common in stenoses of the
      obtuse marginal branch and proximal LCx than in distal stenosis (all p less than
      0.01). Compared with patients without myocardial infarction with or without ST-T
      wave changes and those with infarction without an abnormal R wave in lead V1,
      patients with LCx-related infarction and an abnormal R wave in lead V1 associated
      with inferior and/or lateral Q waves had larger left ventricular end-diastolic
      and end-systolic volumes, lower ejection fraction, higher incidence of total
      occlusion of proximal LCx without collateral vessels, and more cardiac events
      during follow-up. This study suggests that an abnormal R wave in lead V1
      associated with lateral abnormalities on the standard electrocardiogram may be
      clinically useful in predicting proximal LCx stenosis and identifying a subset of
      postinfarction patients with left ventricular dysfunction due to a large infarct
      size.

PMID- 1742907
TI  - Elevation of factor VII activity and mass in coronary artery disease of varying
      severity.
AB  - The present study was undertaken to determine whether the extent of Factor VII
      elevation correlated with the severity of coronary artery disease and whether
      zymogen or activated Factor VII was responsible for this elevation. A group of 69
      patients with coronary artery disease with old myocardial infarction was compared
      with 28 control subjects. The patient groups showed elevated levels of Factor VII
      procoagulant activity (FVII:C) and more markedly elevated Factor VII antigen
      (FVII:Ag) levels than the control group; therefore they had a decreased FVII:C to
      FVII:Ag ratio. The increased Factor VII level in the patient groups was caused by
      elevated Factor VII zymogen levels, and not by activated Factor VII. Since FVII:C
      levels strongly correlated with the titer of thrombin-antithrombin III complexes
      in all patients, the hypercoagulable state accompanying severe coronary
      atherosclerosis seems to underlie the increase of FVII and TAT in the stable
      phase of myocardial infarction.

PMID- 1742908
TI  - Diastolic pressure-volume relationship during handgrip exercise in patients with
      coronary artery disease.
AB  - There is some controversy regarding the mechanisms of an upward shift in the left
      ventricular diastolic pressure-volume curve during ischemia. The effects of
      handgrip exercise on the pressure-volume curve were examined in 21 patients with
      coronary artery disease and in 6 control subjects. Pressure-volume curves were
      constructed from digitized left ventricular pressure and volume derived from
      biplane left ventriculogram. Diastolic pressure-volume curve shifted upward in 12
      patients with coronary artery disease during handgrip exercise (Group 1), but not
      in the other 9 patients who were similarly afflicted (Group 2). The upward shift
      did not occur in any control subject. No difference was observed in rate-pressure
      product gain during exercise. In Group 1, left ventricular end-diastolic pressure
      increased (p less than 0.01) and ejection fraction was reduced (p less than
      0.01), although it did not change in Group 2. In Group 1, the time constant was
      prolonged (p less than 0.01) with no change in the coefficient for elastic
      modulus. In Group 2, these parameters remained unchanged. Group 1 was accompanied
      by more extensive asynergy than Group 2. Thus, isometric handgrip exercise
      resulted in an upward shift in the diastolic pressure-volume curve in patients
      with coronary artery disease. Incomplete relaxation and/or the viscoelastic
      properties of the left ventricle associated with ischemia could be responsible
      for this phenomenon.

PMID- 1742909
TI  - Exercise performance and beta-adrenergic blockade in patients with complete heart
      block treated with ventricular inhibited pacing.
AB  - The effect of beta-adrenergic blockade (propranolol) on exercise performance was
      studied in 15 patients (12 men and 3 women, mean age 70 years) with complete
      heart block treated with a ventricular-inhibited pacemaker (VVI). In a double
      blind procedure, the patients were randomly given either 0.1 mg/kg of propranolol
      or saline solution i.v. before a first exercise test and vice versa before a
      second test. The interval between the tests was 24 hours. Nine patients were in
      sinus rhythm, 4 patients had atrial flutter, and 2 others had atrial
      fibrillation. The exercise capacity was on an average 11% lower with propranolol
      than with placebo (p less than 0.001). The most marked reductions (20 and 33%)
      were found in the two patients with atrial fibrillation. The atrial rate in
      patients with sinus rhythm was significantly lower with propranolol than placebo
      both at rest (68 vs. 83 beats/min, p less than 0.001) and at maximal work load
      (91 vs. 141 beats/min, p less than 0.001). The present findings show that beta
      blockade has negative effects on exercise capacity in patients with complete
      heart block treated with VVI pacemakers. This finding should be considered in the
      selection of drug treatment in patients with fixed rate pacing and concomitant
      hypertension and/or ischemic heart disease.

PMID- 1742910
TI  - Catheter balloon valvuloplasty of stenotic porcine bioprosthetic valves: Part II:
      Mechanisms, complications, and recommendations for clinical use.
AB  - During the last several years dilating balloons have been applied in the
      treatment of stenotic cardiac valves. This interest has been extended to stenotic
      porcine bioprosthetic valves. Part I of this review discusses the pathologic
      changes producing stenotic porcine prosthetic valves. Part II of this review
      describes an in vitro study of porcine prosthetic valve valvuloplasty defining
      the mechanisms, complications, and clinical applications. Results of this study
      indicate a limited and cautious role in balloon dilation of stenotic
      bioprosthetic valves.

PMID- 1742911
TI  - Accelerated idioventricular rhythm detected during elective surgery in a healthy
      man.
AB  - Accelerated idioventricular rhythm (AIVR) is found most commonly in the presence
      of underlying heart disease. It is characterized by acceleration of a latent
      pacemaker that normally depolarizes slowly. We describe a 30-year-old man who was
      found to have episodes of accelerated idioventricular rhythm (AIVR) on cardiac
      monitoring during elective orthopedic surgery. Noninvasive evaluation including
      two-dimensional echocardiography was unremarkable. No late potentials were
      detected on a signal-averaged electrocardiogram. During an exercise tolerance
      test, AIVR was suppressed as heart rate increased. A 24-h Holter monitor revealed
      that the AIVR rate was consistently 73-76 beats/min, which appeared whenever the
      sinus rate slowed to this level. The patient has been asymptomatic, and the
      rhythm has persisted at least through a 5-month follow-up period.

PMID- 1742912
TI  - Angina pectoris due to possible vasospasm of small coronary arteries.
AB  - Recently, the presence of vasospasm in small coronary arteries is speculated in
      animals and humans. A 40-year-old female patient complained of chest pain at
      rest. Left ventriculogram showed normal wall motions. Left and right coronary
      arteries were also normal. After methylergometrine maleate was selectively
      administered to a right coronary artery, she complained of chest pain, and ST
      segment elevation was detected in leads II, III, and aVF of ECG. Right coronary
      arteriography was performed immediately, but no coronary stenosis was found. The
      next day, methylergometrine maleate was again administered intravenously and the
      patient complained of chest pain, but no ischemic changes were observed in ECG.
      Thallium-201 myocardial scintigraphy followed immediately. Apical perfusion
      defect was detected in stress image. In the delayed image, it showed complete
      redistribution. Three days later, catheterization and scintigraphy were performed
      at the same time. When methylergometrine maleate was administered to the left
      coronary artery, she complained of chest pain within a few minutes of the
      injection; however, ECG remained unchanged. 201Tl myocardial scintigraphy was
      performed immediately. In the stress image, it showed apical perfusion defect as
      shown in the intravenous methylergometrine maleate injection study. It also
      showed complete redistribution in the delayed image. Apical perfusion defect can
      be attributed to myocardial ischemia of left coronary artery, which are too small
      to be detected by conventional coronary arteriography. Vasospasm in small
      coronary arteries may be involved in this phenomenon.

PMID- 1742913
TI  - Critical noise level reduction for correct identification of late potentials: an
      illustrative case report.
AB  - The precision of detection of late potentials (LPs) on signal-averaged
      electrocardiography (SAECG) depends on the degree of noise reduction. The
      recommended low-noise endpoint is 0.3 microV. We describe a patient with
      sustained ventricular tachycardia after myocardial infarction with very low
      amplitude LPs in whom a noise level lower than 0.3 microV was necessary in order
      to obtain an abnormal result of the SAECG. The presence of LPs was confirmed by
      spectral temporal mapping of the SAECG.

PMID- 1742914
TI  - Cytoplasmic pH regulation in monocytes and macrophages: mechanisms and functional
      implications.
AB  - Maintenance of cytoplasmic pH (pHi) within a narrow physiological range is
      critical to optimal cell function. Monocytes and macrophages (Mos) actively
      regulate their pHi through three distinct plasma membrane ion transport systems:
      (1) Na+/H+ exchange; (2) Na(+)-dependent anion exchange; and (3) vacuolar-type H+
      ATPases. Alterations in the functional state of monocytes and Mos have been
      linked to changes in pHi and/or its regulation by these ion transport systems.
      Differentiation, proliferation, and activation of Mos in response to a variety of
      agents are associated with increased Na+/H+ exchange. The resultant cytoplasmic
      alkalinization typically observed in HCO3(-)-free media likely plays a
      permissive, rather than a triggering, role in mediating Mo response to most of
      these agents. Prevention of cytoplasmic acidification is essential during Mo
      activation, when production of metabolic acid increases. This is of particular
      importance within the in vivo microenvironment of an abscess or tumour, where pHi
      is further threatened by the low extracellular pH (pHo) which typically prevails.
      At low pHo, H+ ATPase-mediated H+ extrusion plays a critical role in maintenance
      of pHi, preserving the ability of Mos to generate a respiratory burst. The
      requirement for maintenance of pHi within a range conducive to efficient Mo
      function may explain why Mos have acquired a variety of parallel systems for pHi
      regulation.

PMID- 1742915
TI  - Safety and immunogenicity of subcutaneous H. influenzae vaccines in 15-17 month
      old children.
AB  - To evaluate the safety and immunogenicity of subcutaneously administered PRP and
      PRP-D, one hundred and one healthy 15 to 17 month-old children were randomly
      assigned to receive two subcutaneous doses, 2 months apart, of either vaccine.
      The incidence of local and systemic reactions did not differ significantly
      between the two groups. PRP antibody levels in the pre-immunization sera of 95%
      of subjects were below the level associated with immediate protection from Hib
      disease (less than 0.15 microgram/ml). After the first dose, 32% of PRP and 70%
      of PRP-D (p less than 0.001) recipients achieved antibody levels of greater than
      or equal to 0.15 microgram/ml, and 8% and 26% (p = 0.003) respectively achieved
      levels greater than or equal to 1 microgram/ml, a level believed to predict long
      term protection. After the second dose, antibody levels greater than or equal to
      0.15 microgram/ml were reached in 38% of PRP and 88% of PRP-D (p less than 0.001)
      recipients and levels of greater than or equal to 1 microgram/ml were reached in
      22% and 78% respectively (p less than 0.001). The geometric mean levels of PRP
      antibody after immunization were significantly higher in the PRP-D group after
      both the first and second doses (p less than 0.001). These results suggest that
      subcutaneous administration of both vaccines is safe, but PRP-D results in
      significantly higher antibody levels compared to PRP. The levels were lower than
      what has been reported following intramuscular administration.

PMID- 1742916
TI  - Renal handling of cisplatin: interactions with organic anions and cations in the
      dog.
AB  - Cis-diamminedichloroplatinum (II) (cisplatin CDDP) is an extremely potent
      chemotherapeutic agent. Its efficacy, however, is hindered by the cumulative dose
      dependent nephrotoxicity which can lead to permanent renal impairment. The
      mechanisms of the renal transport of cisplatin are not clear. As a first step
      towards understanding the renal handling of cisplatin we studied its renal
      clearance in dogs, as well as the effects of organic anion and cation
      administration on cisplatin. Our results document net tubular secretion of
      cisplatin. Both an organic anion (probenecid) and cations (quinidine, cimetidine,
      ranitidine) significantly decreased renal clearance of free CDDP without
      affecting GFR.

PMID- 1742917
TI  - The relationship between the absolute granulocyte count, platelet count and total
      leukocyte count in cancer chemotherapy patients.
AB  - A cohort of 383 patients with a variety of malignancies receiving various
      chemotherapy programs was analyzed to determine the relationship between the
      absolute granulocyte count (AGC) and the total leukocyte count (TLC). Specific
      groups, who were elderly, had proven bone marrow involvement, or were receiving
      significant doses of prednisone, were studied. The relationship between the TLC
      and thrombocytopenia was also examined. Results revealed that in all groups there
      was a correlation between the TLC and the AGC with correlation coefficients
      ranging from 0.82 to 0.88. Both life-threatening thrombocytopenia and
      granulocytopenia were rare, providing and TLC was greater than 3.0 x 10(9)/L.

PMID- 1742918
TI  - Monocyte membrane ferritin in hemochromatosis.
AB  - To further evaluate a possible abnormality in the reticuloendothelial cells in
      hemochromatosis, the binding of a monoclonal anti-human liver ferritin antibody
      to monocytes was studied in 19 patients with hemochromatosis, 8 patients with
      secondary iron overload, 1 patient with hyperferritinemia without iron overload,
      and 15 normal volunteers. Binding of the antibody to the monocytes was analyzed
      using a fluorescence-activated cell sorter (FACS). Binding of the anti-ferritin
      antibody to monocytes was demonstrated in 34.7 +/- 4.5% (mean +/- standard error)
      of the monocytes in untreated hemochromatosis patients (mean serum ferritin =
      2294 +/- 415 micrograms/L), 6.75 +/- 2.03% in treated hemochromatosis patients
      (mean serum ferritin = 263 +/- 85 micrograms/L), 12.3 +/- 2.7% of the monocytes
      in the secondary iron overload patients (mean serum ferritin = 2476 +/- 867
      micrograms/L), 4.1% in the patient with hyperferritinemia (serum ferritin = 1192)
      and 4.1 +/- 0.5% of the monocytes in the normal volunteers (mean serum ferritin =
      55.2 +/- 11.9 micrograms/L). % binding of anti-ferritin antibody was
      significantly greater in hemochromatosis patients compared to patients with
      secondary iron overload (p less than 0.05) despite a comparable degree of iron
      overload in the secondary iron overload group. The addition of exogenous human
      ferritin to samples from treated hemochromatosis patients and normal volunteers
      did not significantly increase the % of monocytes binding anti-ferritin antibody.
      These results suggest that monocytes from iron-loaded hemochromatosis patients
      express increased surface ferritin which may represent release of ferritin and a
      metabolic defect characteristic of hemochromatosis.

PMID- 1742919
TI  - Effect of intermediate-dose naloxone on cardiovascular and sympathoneural
      adjustments to exercise.
AB  - The effects of intermediate-dose naloxone on sympathetic nerve activity and
      cardiovascular adjustments to exercise were examined in two series of
      experiments. In the first series 10 normal male volunteers, mean age 28 +/- 5
      (SD) years received i.v. naloxone, mean 0.28 +/- 0.6 mg/kg in 0.1 mg/kg aliquots
      60-90 min after 45 min of submaximum treadmill exercise. Naloxone had no
      detectable effect on supine blood pressure, heart rate, plasma norepinephrine, or
      epinephrine concentrations or muscle sympathetic nerve burst frequency at rest or
      during the strain phase of the Valsalva manoeuvre, but decreased slightly
      sympathetic burst incidence at rest (p less than 0.05). In the second study, 8 of
      these subjects repeated the exercise protocol 15 to 20 min after 0.1 mg/kg i.v.
      naloxone. Supine blood pressure, heart rate, plasma norepinephrine and
      epinephrine concentrations before and 15 min after naloxone were virtually
      identical. A comparison of results from both study days did not reveal a naloxone
      effect on blood pressure during or up to 60 min after exercise, whereas the heart
      rate response to exercise was attenuated (p less than 0.002). Intermediate-dose
      naloxone has no apparent effects on blood pressure during and after exercise,
      attenuates the chronotropic response to exercise, and has only modest inhibitory
      effects on muscle sympathetic nerve activity.

PMID- 1742920
TI  - Dietary alterations of plasma lipoproteins influence their interactions with
      proteoglycan enriched extracts from neointima of normal and injured aorta of
      rabbit.
AB  - The interactions between serum lipoproteins isolated from rabbits fed a
      cholesterol-supplemented diet for six weeks, and soluble extracts of arterial
      neointima enriched in proteoglycans extracted from normocholesterolaemic rabbit
      aortas, were studied in an in vitro system. Neointimal tissues of rabbit aorta,
      which developed during three months following a selective endothelial injury,
      were excised and the areas covered or uncovered by regenerated endothelium were
      separated. To isolate the proteoglycan enriched fraction, both normal and injured
      tissue was homogenized in a sucrose solution containing protease inhibitors,
      centrifuged, and further fractionated by gel exclusion chromatography. The
      composition of the soluble extracts and each of their corresponding proteoglycan
      enriched fractions were analyzed in terms of protein and glycosaminoglycan
      content. Lipoproteins of donor animals fed an atherogenic diet were prepared by
      sequential ultracentrifugal flotation after density adjustment with KBr. Aliquots
      of electrophoretically pure lipoprotein fractions were incubated with
      proteoglycan enriched fraction from uninjured, denuded, or endothelium-covered
      neointima in the presence of Ca++ and Mg++ at 4 degrees C. The complexes formed
      during incubation were separated by centrifugation. The cholesterol content of
      the complexes was considered as an index of binding capacity. Results were
      expressed as micrograms of cholesterol bound per mg of glycosaminoglycan. The
      data reveal the higher affinity of hypercholesterolaemic lipoprotein fractions
      for aortic proteoglycans, as compared to normocholesterolaemic lipoproteins. In
      addition, when evaluating the relevance of the proteoglycan enriched fraction
      source, the affinity of fractions extracted from aortic neointima was found to be
      much higher for hypercholesterolaemic lipoproteins. These results suggest the
      role that proteoglycan-lipoprotein interactions could play in the event of the
      combined actions of endothelial injury and hypercholesterolaemia in the
      pathogenesis of atherosclerosis.

PMID- 1742921
TI  - The effect of human recombinant erythropoietin on iron absorption and hepatic
      iron in a rat model.
AB  - In order to ascertain whether recombinant human erythropoietin (EPO) therapy
      would result in further intestinal iron absorption in the setting of systemic
      iron loading, iron absorption was measured in iron-loaded rats receiving EPO
      therapy and a control group of iron-loaded rats. Parenteral iron dextran (100 mg)
      resulted in hepatic siderosis with predominantly a reticuloendothelial
      distribution. EPO was given by intraperitoneal injection (100 U/kg) for 10 days.
      Radioiron absorption was measured by total body counting. Iron absorption in EPO
      treated rats was 4.8 +/- 2.0% (n = 12) and 4.5 +/- 2.2% (n = 10) in the control
      rats (p greater than 0.05). Mean hemoglobin in the EPO rats was 201 +/- 12.5 g/L
      and 140 +/- 18.2 g/L in the control rats (p less than 0.001). Mean hepatic iron
      concentration was 73 +/- 16 mumol/g in the control rats and 34 +/- 9.1 mumol/g in
      the EPO-treated rats (p less than 0.001). This study suggests that iron-loaded
      rats do not demonstrate an increase in intestinal iron absorption with EPO
      therapy despite a significant erythropoiesis. The reduction in hepatic iron
      concentration suggests that reticuloendothelial iron is accessible and mobilized
      to produce new red blood cells.

PMID- 1742922
TI  - Seroprevalence and demographic characteristics of injection drugs users among
      individuals at risk for HIV infection in Winnipeg, Manitoba, Canada.
AB  - From June 1986 to March 1990, a prospective seroprevalence survey and
      questionnaire of individuals at risk for HIV infection was conducted with
      volunteers in Winnipeg. Of 610 individuals enrolled, 146 were injected drug users
      (IDU). Fifteen IDU were in a methadone treatment program and all were
      seronegative. Three of 131 remaining IDU were HIV-1 seropositive (2.3%), a rate
      similar to 2.2% positive (20+ of 927) in diagnostic specimens from IDU tested in
      the province. Demographics and behaviour of 131 IDU were compared with 335
      individuals, of whom 112 were gay/bisexual [24 of whom also had sexually
      transmitted diseases (STD)] and 223 heterosexuals who had STD. Males enrolled
      were significantly older than females. Multivariate analysis showed that factors
      independently associated with IDU were: a younger age, less education, mental
      health counselling, unemployment, and a history of jaundice or hepatitis. Drugs
      most commonly used were Ritalin/Talwin, cocaine, and heroin. Over 90% of
      individuals admitted to sharing needles. In spite of the low seroprevalence of
      HIV-1 infections, these individuals are important for the potential spread of HIV
      because of multiple means of acquiring and transmitting HIV and a high rate of
      needle sharing.

PMID- 1742923
TI  - Effects of class I anti-arrhythmic drugs in infarcted tissue.
AB  - An in vitro model was used to examine the electrophysiological effects of anti
      arrhythmic drugs in infarcted tissue. After 24 h of coronary artery occlusion in
      the dog, endocardial preparations were removed from the infarcted zone.
      Intracellular action potentials recorded from surviving Purkinje fibres on the
      endocardial surface showed reduced maximum upstroke velocity (Vmax), increased
      action potential duration and enhanced automaticity. The rate-dependent effect of
      lidocaine on Vmax and conduction was more prominent in Purkinje fibres that
      survived myocardial infarction than in normal Purkinje fibres. Tocainide,
      flecainide, and O-demethyl encainide reduced Vmax in both normal Purkinje fibres
      and Purkinje fibres surviving infarction. Similar to lidocaine, these drugs
      showed the greatest reduction of Vmax in Purkinje fibres surviving infarction at
      the shortest stimulation cycle length tested. In contrast, maximal drug effects
      on action potential duration were observed when long stimulation cycle lengths
      were used. Our results indicate that most Class I anti-arrhythmic drugs showed
      rate-dependent properties in normal Purkinje fibres as well as in Purkinje fibres
      surviving infarction. The increased sensitivity of the ischemic myocardium to
      anti-arrhythmic drugs resulting in greater reductions of Vmax and conduction may
      contribute to a greater potency of anti-arrhythmic drugs in the suppression of
      arrhythmias associated with ischemia. Conversely, while slowing of conduction can
      abolish re-entry arrhythmias by producing a bidirectional block, further slowing
      of conduction by anti-arrhythmic drugs can favour the development of new re-entry
      pathways and may contribute to their pro-arrhythmic effects.

PMID- 1742924
TI  - Commentary on 'Links between passive smoking and disease: a best evidence
      synthesis--a report of the Working Group on Passive Smoking'. CIM Vol. 13, No. 1:
      17-42, 1990.

PMID- 1742925
TI  - Papillary cancer in a patient treated with radioiodine for Graves'
      hyperthyroidism. Case report and a review of the risk.
AB  - A small encapsulated papillary thyroid cancer was found in a patient who had
      received I-131 therapy for Graves' disease 31 months previously. The relationship
      of Graves' hyperthyroidism and thyroid cancer is discussed, as well as the
      possible role of I-131 as a cause of the cancer. The published data do not
      support I-131 as an etiology. The patient is clinically well and cured of both
      hyperthyroidism and the cancer.

PMID- 1742926
TI  - Evaluation of phlegmasia cerulea dolens using radionuclide venography.
AB  - Phlegmasia cerulea dolens (PCD) is characterized by the presence of massive
      venous occlusion of the veins in an extremity, leading to ischemia and sometimes
      gangrene. We report a case of phlegmasia cerulea dolens that was evaluated by
      radionuclide venography. We report both this case and information regarding
      phlegmasia and therapy of PCD to promote awareness of this disorder among
      radiologists and nuclear medicine physicians who perform radionuclide venograms.

PMID- 1742927
TI  - HMPAO scintigraphy, MRI, and CT of a vascular fibrous dysplasia of the
      craniofacial bones.
AB  - The authors present the case of a child with a predominantly unilateral
      craniofacial fibrous dysplasia and a substantial redirection of internal carotid
      blood flow to the dysplastic bone. The case illustrates the advantages of using
      multiple imaging modalities in the evaluation of this disorder. CT showed the
      diagnostic findings of fibrous dysplasia and demonstrated the extent of bony
      involvement. MRI showed the extent and vascularity of the intradiploic fibrous
      mass and best demonstrated the distortion of underlying cerebral structures. Tc
      99m HM-PAO brain scintigraphy demonstrated adequate ipsilateral cerebral
      perfusion, thereby excluding any significant cerebral "steal."

PMID- 1742928
TI  - Disassociation of splenic accumulation of Tc-99m MDP and radiocolloid.
AB  - Two cases of splenic uptake of Tc-99m MDP are presented, in which there was
      preserved reticuloendothelial activity (Tc-99m sulfur colloid accumulation). In
      addition to the literature data, data from these cases were used to show the
      disassociation of uptake of bone agents and radiocolloid in the spleen. Prior
      reports, in which both agents concentrated in the spleen, were tabulated. An
      updated gamut on splenic accumulation of Tc-99m MDP or analogues was given.

PMID- 1742929
TI  - Intraventricular photon deficiency in gated cardiac blood pool imaging due to
      left ventricular metastases from renal cell carcinoma.
AB  - Cardiac metastasis can occur with any widely disseminated malignancy, especially
      from carcinoma of the kidney, stomach, lung, breast, or from melanocarcinoma.
      Metastasis to the myocardium can protrude from the endocardium into the
      intraventricular cavity of the left ventricle. We present a case of renal cell
      carcinoma and left ventricle cavitary metastases, documented by an echocardiogram
      demonstrated in a cardiac blood pool study as a photon-deficient area in the left
      ventricle cavity.

PMID- 1742930
TI  - Iatrogenic obstructive jaundice caused by the balloon of a Foley catheter. Case
      report.
AB  - A rare kind of obstructive jaundice caused by compression on the common bile duct
      due to an inflated Foley catheter balloon placed in the duodenum after Suguira
      surgery for bleeding esophageal vesicles secondary to portal hypertension is
      presented. After deflating the balloon, the obstruction was relieved. Tc-99m HIDA
      studies were helpful in the diagnosis of obstruction of the common bile duct and
      the response following the deflation.

PMID- 1742931
TI  - Reversible functional asplenia in systemic lupus erythematosus.
AB  - A 44-year-old woman with a history of systemic lupus erythematosus on no steroid
      or immunosuppressive medication presented in septic shock complicated by renal
      failure and disseminated intravascular coagulation. The patient was treated with
      antibiotics. Liver-spleen scintigraphy with Tc-99m albumin colloid initially
      failed to reveal tracer accumulation in the spleen. Follow-up study after one
      year revealed normal tracer uptake in the spleen. The transient blockade of
      reticuloendothelial system by immune complexes is the most likely mechanism.
      Other possible mechanisms include disturbed vascular supply due to thrombosis
      secondary to the disseminated intravascular coagulation or vasculitis.

PMID- 1742932
TI  - Prediction of radionuclide bone imaging findings by Gleason histologic grading of
      prostate carcinoma.
AB  - To evaluate a relationship between Gleason scores and Tc-99m HMDP bone imaging
      findings, data from 48 men (aged 45 to 77; mean, 67) with prostate carcinoma who
      had a bone imaging study at the time of presentation were reviewed. Cumulative
      Gleason scores were divided into two groups: high scores (6-10), 32 men; low
      scores (2-5), 16 men. Of the 32 men with high Gleason scores, 15 tested positive
      for multiple metastases and 17 tested negative. Tumors of the 16 men with low
      Gleason scores were negative for metastasis. A chi-square association between
      Gleason scores and the presence of metastases, either of a superscan pattern or
      multiple metastases, was 10.9 (1 df, P less than 0.001). The results indicate
      that a superscan pattern or multiple metastases were found exclusively in the
      bone images of patients with high histologic grades; bone images negative for
      metastases were associated with low-grade tumors. We conclude that positive bone
      imaging for metastases at the initial scan occurs only in patients who have high
      Gleason scores, that patients with high Gleason scores might or might not have
      skeletal metastasis, and that skeletal metastasis is not predictable in patients
      with low Gleason scores.

PMID- 1742933
TI  - Massive tricuspid regurgitation identified on renal flow scintigraphy.
AB  - A Tc-99m glucoheptonate renal flow study performed in a patient with chronic
      renal insufficiency and worsening congestive heart failure demonstrated evidence
      of massive tricuspid regurgitation, with activity appearing in a markedly dilated
      inferior vena cava within 4 seconds of the tracer bolus entering the right
      ventricle. Autopsy subsequently confirmed the scintigraphic findings,
      demonstrating an incompetent tricuspid valve secondary to immobilization of the
      posterior leaflet as a result of adhesions from a longstanding right ventricular
      pacemaker wire.

PMID- 1742934
TI  - Scintigraphic distribution of Pneumocystis carinii pneumonia in AIDS treated with
      prophylactic inhaled pentamidine.

PMID- 1742935
TI  - Scintigraphic evaluation of a patient with enterocutaneous fistulas using Tc-99m
      latex particles.

PMID- 1742936
TI  - Scintigraphic findings in angiosarcoma of the skull.

PMID- 1742937
TI  - Unsuspected finding on a gastric emptying study.

PMID- 1742938
TI  - The uterine blush on In-111 labeled leukocyte scintigraphy.

PMID- 1742939
TI  - Sternoclavicular pyarthrosis demonstrated on bone scan. Correlation with CT and
      MRI.

PMID- 1742940
TI  - The "yarmulke' sign of Paget's disease.

PMID- 1742941
TI  - Further studies on acid phosphatase in obese subjects.
AB  - Low activity genetic variants of acid phosphatase (ACP1) are positively
      associated with extreme body mass deviations in obese subjects. The same pattern
      has been found in non-diabetic children, in diabetic pregnant women, and in non
      diabetic adult subjects. Low activity variants of ACP1 also show a positive
      association with family history of obesity, supporting the hypothesis of an
      enhancing action of these variants on expressivity of obesity.

PMID- 1742942
TI  - HLA antigen frequencies in children born to HIV-infected mothers.
AB  - Tissue-typing for HLA-A, B, and DR antigens was carried out on 53 babies, 47 of
      them unrelated, born to mothers known to be HIV-infected from intravenous drug
      usage or sexual contact with drug users. These babies were followed up to assess
      whether HLA phenotype was associated with vertical transmission of HIV infection
      or disease progression. Of the 47 unrelated babies, eight became infected with
      HIV. The frequency of HLA-DR3 was three times higher in the HIV-positive infants
      compared to the HIV-negative infants (43 per cent vs 15 per cent) in our study
      population. Conversely, HLA-A3 was three times less common in the HIV-positive
      infants (12.5 per cent vs 42 per cent). A comparison of HLA antigens between our
      study group babies and babies born to healthy mothers unselected for HIV status
      revealed higher proportions of HLA-B18, B7, and DR2 in the study group. Moreover,
      the combination, A3, B7, DR2 was four times commoner in our study population
      relative to controls (RR = 3.9; p less than 0.003), but was found only in babies
      who were not HIV infected. The combination A1, B8, DR3, in contrast, was found
      less often than expected in our study group (RR = 0.39) and was
      disproportionately represented amongst the infected babies. We have observed an
      unexpectedly low (6 per cent) mother-to-infant transmission rate of HIV among
      prospectively studied intravenous drug users. We speculate that the unusually
      high ratio of the common antigen combinations (often halotypes), A3, B7, DR2 to
      A1, B8, DR3 in this population may be contributory.

PMID- 1742943
TI  - Interactive effect of HLA and Gm and genetic heterogeneity tested in 79
      rheumatoid arthritis families.
AB  - The hypothesis that there is an interactive effect between HLA and Gm genes in
      rheumatoid arthritis (RA) was tested in a sample of 79 RA families. An analysis,
      of the joint segregation of these two markers in RA sibpairs, confirmed the
      previously described effect of HLA in RA but did not provide evidence of an
      independent effect of Gm alone or in interaction with HLA. The additional
      hypothesis that the previously described correlation between RA and autoimmune
      thyroid disease is due to genetic factors, was also investigated in relation to
      HLA and Gm. Therefore, we examined the segregation of HLA and Gm in RA sibships
      depending on the presence or the absence of autoimmune thyroid disorder. This
      analysis showed significant heterogeneity in HLA segregation (P = 0.02) with an
      HLA effect restricted only to sibships without thyroid disease. There was no
      evidence that thyroid disease influenced Gm segregation (P = 0.19). The effect of
      thyroid disease on HLA segregation suggests that the familial association between
      RA and autoimmune thyroid disease is at least partially due to genetic factors.

PMID- 1742944
TI  - Interaction of immunoglobulin allotypes (Gm and Km), HLA, and sex in insulin
      dependent (type 1) diabetes.

PMID- 1742945
TI  - Protection of chimpanzees from infection by HIV-1 after vaccination with
      recombinant glycoprotein gp120 but not gp160.

PMID- 1742946
TI  - HIV-1 entry into quiescent primary lymphocytes: molecular analysis reveals a
      labile, latent viral structure.

PMID- 1742947
TI  - Induction of CD8+ cytotoxic T-cells by immunization with purified HIV-1 envelope
      protein in ISCOMs.

PMID- 1742949
TI  - HIV-1 infection of normal human macrophage cultures: implication for silent
      infection.

PMID- 1742948
TI  - Genetic organization of a chimpanzee lentivirus related to HIV-1.

PMID- 1742950
TI  - Growth and metabolism of Pneumocystis carinii in axenic culture.

PMID- 1742951
TI  - Direct and cytokine-mediated activation of protein kinase C induces human
      immunodeficiency virus expression in chronically infected promonocytic cells.

PMID- 1742952
TI  - High concentrations of recombinant soluble CD4 are required to neutralize primary
      human immunodeficiency virus type-I isolates.

PMID- 1742953
TI  - Fragments of the HIV-Tat protein specifically bind TAR RNA.

PMID- 1742954
TI  - The effect of interleukin 4 (BSF-1) on infection of peripheral blood monocyte
      derived macrophages with HIV-1.

PMID- 1742955
TI  - The nucleocapsid protein isolated for HIV-1 particles binds zinc and forms
      retroviral-type zinc fingers.

PMID- 1742956
TI  - Characterization of a monoclonal antibody with CD44 like reactivity.
AB  - QE7.3E8 is a monoclonal antibody which precipitates two bands (90 and 160 kd)
      from a B cell line and four (90, 130, 146, and 160 kd) from monocytes. Whilst
      this immunoprecipitation pattern suggests that QE7.3E8 is a CD18 antibody, a
      number of other results are inconsistent with this interpretation. In particular,
      QE7.3E8 stains lymphoid tissue with a distribution clearly distinguishable from
      CD18 antibodies; it precipitates four bands from a T cell line which does not
      express the CD11b and CD11c alpha chains, and cross immunoprecipitation with
      QE7.3E8 and a CD11a antibody show that the molecules recognized by these
      antibodies are not associated. However, in tissue distribution and sequential
      precipitation experiments QE7.3E8 behaves like a CD44 antibody. CD44 identifies a
      single 85 kd protein, but high molecular weight complexes have been described,
      accounting for the multiple bands seen in immunoprecipitation studies. Sequential
      immunoprecipitation using QE7.3E8 and a Workshop-clustered monoclonal antibody
      (SBU 25-32) indicate that the QE7.3E8 reacts with the CD44 antigen.

PMID- 1742957
TI  - Benazepril approved for treatment of hypertension.

PMID- 1742958
TI  - Treatment options for a patient with osteoarthritis and a history of ulcer
      disease.

PMID- 1742959
TI  - Hyperthyroidism associated with mercury poisoning.

PMID- 1742960
TI  - Ethnicity and clozapine-induced agranulocytosis.

PMID- 1742961
TI  - Management of postoperative pain by continuous epidural infusion of analgesics.
AB  - The anatomy and physiology of the epidural space and the mechanism of action,
      sites of action, and pharmacokinetics of analgesics administered by continuous
      epidural infusion are reviewed, and the efficacy, adverse effects, and
      postoperative indications for use of analgesics administered by this route are
      discussed. Narcotics selectively block pain conduction by occupying specific
      opiate receptors in the spinal cord. Local anesthetics provide analgesia by
      axonal membrane blockade; they also can produce nonselective sympathetic and
      somatic (sensory and motor) blockade in addition to analgesia. A narcotic-local
      anesthetic mixture should provide an additive analgesic effect, without an
      increase in the incidence of adverse effects. Comparative efficacy studies have
      shown that continuous epidural infusions of narcotics, local anesthetics, and
      narcotic-local anesthetic combinations, when used appropriately, may produce
      better analgesia than conventional bolus methods of pain relief. Continuous
      epidural infusions also offer a safety advantage over intermittent epidural
      injections because peak and trough levels of the analgesic agent are avoided.
      Adverse effects of epidurally administered narcotics include respiratory
      depression, pruritus, urinary retention, nausea and vomiting, and sedation.
      Adverse effects of epidurally administered local anesthetics include urinary
      retention, hypotension, numbness, motor weakness, tachyphylaxis, and, rarely,
      systemic toxicity. The cost of epidurally administered drugs is substantially
      higher than that for i.m. or i.v. narcotic analgesia, but this cost may be offset
      by other benefits such as a shorter hospital stay. Current studies suggest
      superior analgesia for the majority of surgical procedures with continuous
      epidural analgesia infusions compared with more traditional methods of providing
      analgesia.

PMID- 1742962
TI  - Treatment of chronic iron overload.
AB  - The clinical features and therapy of chronic iron overload are reviewed. Chronic
      iron overload is classified as primary or secondary hemochromatosis. In primary
      hemochromatosis a genetic defect in iron metabolism results in increased
      absorption of iron from the gastrointestinal tract. The excess iron in secondary
      hemochromatosis may be derived from increased gastrointestinal absorption due to
      ineffective erythropoiesis or from medicinal, dietary, or transfusional sources.
      Phlebotomy is the treatment of choice in patients with primary hemochromatosis.
      Iron chelation therapy is indicated in patients who are not candidates for
      phlebotomy. Deferoxamine mesylate, the only commercially available iron chelator,
      is usually administered subcutaneously or intravenously over 10-12 hours/day.
      Serum ferritin concentrations are measured every three to six months to monitor
      the effectiveness of therapy. The adverse effects of deferoxamine include local
      skin reactions, ototoxicity, cataracts, growth impairment, and increased
      susceptibility to infectious organisms. Patient compliance may be compromised by
      the routes of administration and cost of deferoxamine. Early detection and prompt
      treatment are necessary to prevent organ damage. Phlebotomy and iron chelation
      therapy are effective in the treatment of chronic iron overload.

PMID- 1742963
TI  - Altered aminoglycoside volume of distribution in patients with acquired
      immunodeficiency syndrome.

PMID- 1742964
TI  - Disorders of the testes.

PMID- 1742965
TI  - Current diagnosis and management of impotence.

PMID- 1742966
TI  - Antibodies as predictors of type 1 diabetes.

PMID- 1742967
TI  - Acromegaly: etiology, diagnosis and management.

PMID- 1742968
TI  - Menopause medicine: current treatment options and trends.
AB  - Demographic trends and increasing demand, as well as the intricacy of the
      emerging field of menopause medicine, dictates the need for a multidisciplinary
      approach for the care of the peri- and postmenopausal patient. A menopausal
      program benefits the individual patient by obviating the acute symptoms and by
      preventing long-term consequences. As morbidity and mortality rates associated
      with the long-term implications are reduced, substantial public health aspects
      are also beneficially affected. Cost effectiveness of a menopause program and
      routine HRT should be calculated as the net present value (NPV) for the health
      care financing program, and should prove to be greater than the NPV of future
      costs anticipated without an investment in primary preventive menopause program.
      We believe that the educated use of a menopause counseling program will yield an
      increasing benefit for the individual patient and the community. Should menopause
      be regarded as an endocrinopathy, thus justifying routine HRT, or are we engaged
      in the "medicalization" of a physiologic process? Bearing in mind the data
      reviewed above, it seems to us that ample reason exists to make every woman aware
      of the opportunity to receive long-term HRT. The decision to use it depends
      heavily on the patient's own informed assessment of her particular benefit-risk
      equation. Combined-continuous estrogen-gestagen replacement seems to provide the
      desired multisystem beneficial effects, and at the same time be the most
      convenient and associated with the least short-term side effects. Although
      emerging trends regarding the long-term risks associated with the use of such
      regimes are reassuring, more information needs to be elaborated before final
      conclusions can be offered.

PMID- 1742969
TI  - Diabetic ketoacidosis: etiology, pathophysiology and treatment.

PMID- 1742970
TI  - Diabetes in pregnancy: rationale and guidelines for care.
AB  - The management of pregnancy in a woman with diabetes is directed toward insuring
      a normal outcome for the mother and her newborn baby. There is ample evidence
      from studies in both humans and animals that maintenance of a normal maternal
      metabolic environment, particularly blood glucose concentrations, can avoid or
      ameliorate the complications of pregnancy responsible for increased morbidity and
      mortality in the mother and her baby. It is essential that this metabolic
      normalcy be achieved preconceptionally if congenital malformations, the leading
      cause of death in IDMs, are to be avoided. Thus, preconceptional care, intensive
      regulation of maternal glucose metabolism and fetal surveillance throughout
      pregnancy are critical. The use of the multidisciplinary team to optimize care
      has led to significant reductions in maternal and perinatal morbidity/mortality
      in IDMs, and is thus essential to successful outcomes in pregnancies complicated
      by diabetes.

PMID- 1742971
TI  - Diagnosis and treatment of thyroid disease in infants.

PMID- 1742972
TI  - Management of diabetes in the elderly.

PMID- 1742973
TI  - Diagnosis and treatment of osteoporosis.

PMID- 1742974
TI  - Assessment of instability and gait in elderly persons.

PMID- 1742975
TI  - Hearing loss in the elderly: causes, impact and treatment.

PMID- 1742976
TI  - Thiazide diuretic agents and prevention of hip fracture.

PMID- 1742977
TI  - Depression in the elderly.
AB  - Depression in the elderly can be difficult to diagnose but often responds well to
      treatment. In treating late-life depression, we have the satisfaction not only of
      relieving our patients' distress but very likely of prolonging their lives as
      well.

PMID- 1742978
TI  - Effects of aging process on digestive functions.

PMID- 1742979
TI  - Principles of pain management in older people.
AB  - The management of chronic pain should be a priority in geriatric care. Pain is a
      common problem that has tremendous potential to influence the physical function
      and quality of life of elderly people during their remaining years. Much research
      and education is still needed to further our understanding of pain and its
      management among elderly people. Existing pain management strategies should be
      tailored for the special needs of the geriatric population. Applications of "high
      tech" pain management strategies, such as morphine pumps and chronic spinal
      infusions, need to be clarified for older people. Finally, family and caregiver
      considerations should be included in chronic pain management strategies.

PMID- 1742980
TI  - The aging skin.

PMID- 1742981
TI  - Advances in clinical research in Alzheimer's disease.
AB  - There has been an explosion of clinical research on Alzheimer's disease (AD) in
      recent years, shedding light on many aspects of the disease. These include the
      differentiation of AD from normal aging, appreciation of genetic aspects of the
      disease, characterization of its pathology and pathophysiology, and the
      beginnings of a rational approach to treatment. Alzheimer's disease (AD) is a
      clinicopathologic diagnosis. In the near future, it may be possible to confirm
      the clinical diagnosis by examination of spinal fluid or by skin biopsy, but the
      diagnosis of AD in 1991 is based on history, direct examination of the patient
      and, ultimately, confirmation by microscopic examination of the brain. In short,
      we stand very close to where Dr. Alzheimer stood when he reported a hitherto
      unrecognized form of dementing illness in a 51-year-old woman. Alzheimer's case
      was cited by the editor of the journal in which it was published as an example of
      the need to look closely at patients from both clinical and pathologic
      perspectives so that individual diseases might eventually be separated out from
      syndromes such as dementia. Since Alzheimer's report, many clinical studies have
      shed further light on this disease. Two important deterrents to Alzheimer's
      disease research were the presumption that dementia is either a normal age
      related phenomenon or a psychotic disorder of old age. The assumption that
      dementia is a product of normal aging or a functional psychotic disorder of late
      life was first challenged by Corsellis, who found a strong correlation between
      the severity of cerebral degenerative change and clinical diagnosis of patients
      who died in a psychiatric hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1742982
TI  - Integration versus interactive activation: the joint influence of stimulus and
      context in perception.
AB  - Empirical results from both reading and speech perception indicate that stimulus
      and context information have independent influences on perceptual recognition.
      Massaro (1989) argued that these data are inconsistent with an interactive
      activation and competition (IAC) model (McClelland & Rumelhart, 1981), and
      consistent with the fuzzy logical model of perception (FLMP) (Massaro, 1979;
      1989). McClelland (1991) than modified the interactive activation model to be
      stochastic rather than deterministic and to use a best one wins (BOW) decision
      rule, allowing it to predict independent influences of stimulus and context. When
      tested against real data, however, the network proposed by McClelland and
      extended by us gives a poorer description of actual empirical results than the
      FLMP. To account for the dynamics of information processing, the SIAC model, an
      interactive model based on the Boltzmann machine, and the FLMP are formulated to
      make quantitative predictions of performance as a function of processing time. It
      is shown that the dynamic FLMP provides a better description of the time course
      of perceptual processing than does interactive activation. The SIAC and Boltzmann
      models have difficulty predicting 1) context effects given little processing time
      and 2) a strong stimulus influence given substantial processing time. Finally, we
      demonstrate that the FLMP predicts that context can improve the accuracy of
      performance, in addition to providing a bias to respond with the alternative
      supported by context. In summary, there is now both empirical and theoretical
      evidence in favor of the FLMP over SIAC models of pattern recognition. We
      therefore argue that interactive activation is both less consistent with
      empirical results and not necessary to describe the joint influence of stimulus
      and context in language perception.

PMID- 1742983
TI  - Coordinating cognitive information: task effects and individual differences in
      integrating information from several sources.
AB  - In many tasks people have to coordinate the information from several sources. An
      example would be driving a car while listening to directions. The driver has to
      establish a correspondence between a visual picture and verbal instructions. This
      paper addresses two questions concerning information coordination. Is there an
      ability to coordinate information received from several sources that is different
      from the ability to deal with information from each source, alone? Does
      coordination simply involve allocating resources to deal with the component
      tasks, or does the act of coordination itself constitute a separate task? Four
      experiments examined the coordination of a verbal component task with a visual
      spatial and with an auditory component task. The results showed that the ability
      to coordinate perceptual and verbal information is separate from the ability to
      deal with either perceptual or verbal information, alone. A simple resource
      sharing model was not adequate in explaining how coordination occurred. We relate
      our results to a model in which perceptual reasoning occurs independently of
      verbal processing, but transforming perceptual information into a propositional
      form is affected by concurrent verbal processing.

PMID- 1742984
TI  - Recent changes in health related dental behaviors in Norway.
AB  - There has been a substantial decrease in the prevalence of caries in younger age
      groups in the western world during the last 15 years. A corresponding increase
      has been reported regarding use of preventive remedies. Since prevention and
      control of dental disease is highly dependent upon personal behavior,
      investigations of dental health behaviors within subgroups of the population are
      important for future preventive strategies. Occurrence and changes in individual
      dental health behaviors in Norway were studied through four sets of cross
      sectional data collected in 1981, 1983, 1985, and 1987. Personal interviews
      performed by trained interviewers were held with probability samples, each of
      about 1400 persons, covering the Norwegian population aged 15 and above. During
      the 6-yr period the proportion of individuals who brushed their teeth and used
      fluoride dentifrice every day increased. The number of people who used toothpicks
      or dental floss every day also increased from 1981 to 1985. A marked decrease
      was, however, observed in use of interdental remedies from 1985 to 1987. Daily
      use of dental floss was reduced by 10 percent points. Logistic regression showed
      that the reduction in the probability of using interdental aids was most
      pronounced among those with few teeth. Lower importance attached to dental health
      education, at all levels, combined with difficult economic times since 1987,
      might account for the decrease in daily use of interdental aids in Norway.

PMID- 1742985
TI  - Knowledge, attitudes and behaviour in relation to dental health of adults in
      Belfast, Northern Ireland.
AB  - The aim was to investigate the knowledge, attitudes and behaviour related to
      dental health of adults living in two neighbouring areas in Belfast, Northern
      Ireland. 81 adults aged 30 yr or over from two neighbouring residential areas in
      South Belfast completed a structured interview. The responses of those who
      retained natural teeth were very different from those who were edentulous. Those
      in the higher socioeconomic status groups had clearer knowledge, more positive
      attitudes and more appropriate behaviour related to dental health than those in
      lower socioeconomic status groups. The differences between the residents of the
      two areas were less obvious than those noted between the different socioeconomic
      status groups. It was concluded that the results revealed misconceptions amongst
      adults in Northern Ireland regarding the causes of dental disease and how it
      might be prevented both in themselves and in their children.

PMID- 1742986
TI  - Self-assessment of dental conditions: validity of a questionnaire.
AB  - In order to determine the validity of dental data obtained from a questionnaire,
      100 subjects randomly selected from 2383 respondents were examined clinically.
      The quality of dental status was ordered in four groups for the number of missing
      and replaced teeth and for denture status. For the number of missing and replaced
      teeth, the observed agreement between the clinical diagnosis and the
      questionnaire answers was 65% for both the maxilla and the mandible, and the
      agreement estimated by Kappa was 0.52. However, the disagreement was not randomly
      distributed, since reporting of better dental status than the actual one was much
      more common than reporting of poorer status. Regarding denture status, the
      agreement between self-assessment and clinical diagnosis was good; all removable
      dentures in situ at the clinical examination were reported by the subjects as
      some kind of denture, although not always the correct type. The results of the
      study indicate that the use of self-assessment might be reasonable when measuring
      denture status, and that self-assessment of the number of missing and replaced
      teeth is a biased estimate of the clinical diagnosis. Thus appropriate action
      should be taken when using this type of data.

PMID- 1742987
TI  - Measures of dental disease occurrence.
AB  - The purpose of the paper is to relate standard epidemiologic and statistical
      methods for measures of disease occurrence to the description of prevalence
      proportions and incidence rates of dental diseases. No new concepts are
      introduced, but the choice of the unit of analysis of numerator and denominator
      is discussed, and the biological interpretation of the within-patient correlation
      coefficient is discussed.

PMID- 1742988
TI  - Correlations between caries prevalence and potential etiologic factors in large
      samples of 4-5-yr-old children.
AB  - A data base containing information on dental caries, oral hygiene, gingival
      state, Streptococcus mutans and lactobacillus counts, and salivary flow rate and
      buffer capacity in some 2800 4-5-yr-old South African children was created in
      1984. The children were equally distributed in four groups; rural black, urban
      black, urban Indian, and urban white. In this study, the data were used for
      simple linear correlations between all the factors including caries as well as
      stepwise multiple regression analyses between caries prevalence and the
      independent factors in each of the four groups. The highest r value obtained in
      the single correlations was 0.56 for dmfs/lactobacillus count in the white group.
      The overall pattern of the groups did not vary much. In the stepwise multiple
      regression analyses, lactobacilli entered first in all groups. S. mutans and oral
      hygiene interchanged as Nos. 2 and 3, and gingival state or buffer capacity came
      out as No. 4. The highest percentage of caries variability explained by these
      regressions was 25%, in the urban black group, while the lowest was 12%, in the
      indian group. It was concluded that our generally accepted etiologic factors are
      unsatisfactory to explain variation in caries in observational studies, which
      among other things might be ascribed to the inadequate way these factors
      generally are measured or estimated.

PMID- 1742989
TI  - Prediction of periodontal bone height from partial radiographic examination.
AB  - The object of the present study was to determine the relationship between the
      periodontal bone height as determined from the total dentition and that predicted
      from a limited number of teeth. The material comprised 247 subjects aged 21-60 yr
      with an average of 26.3 remaining teeth. All patients were radiographically
      examined by an intra-oral full mouth survey. The bone height was measured for
      each tooth and a mean of all single tooth specific values was calculated for each
      subject. The relationship between the measured value and the predicted value was
      expressed in terms of correlation coefficients. The correlation between the
      measured value and the predicted value improved with increasing number of teeth
      included in the predictor. It ranged from r = 0.79 (single tooth) to r = 0.98
      (four teeth). It was concluded that the number of radiographs exposed and teeth
      examined can be considerably reduced when estimating the alveolar bone height for
      periodontal screening.

PMID- 1742990
TI  - Prevalence study of oral precancerous lesions within a complex screening system
      in Hungary.
AB  - Previous epidemiological studies, performed in conjunction with compulsory lung
      screening examinations, showed good results in detecting oral lesions in Hungary,
      where the mortality rate of oropharyngeal cancer has increased by more than 30%
      in the past decade. Oral examinations were performed on a district population
      sample in Budapest, called regularly for X-ray lung examinations. Precancerous
      lesions and conditions were diagnosed and grouped according to internationally
      accepted criteria. Oral examinations of 7820 individuals were performed: 42.9% in
      men and 57.1% in women; 42% of all examined subjects were over 60 yr of age. Oral
      leukoplakia was diagnosed in 104 cases (1.3%). Histologic examination revealed
      squamous cell carcinoma in one case. About 70% of oral leukoplakias occurred in
      men and 30% in women. Oral lichen was diagnosed in six cases (0.08%). The
      prevalence of smokers was 86.5% in the leukoplakia group as compared with with
      29% in the non-lesion group. The new organizational screening model seems to
      function well in the "risk group" of elderly persons, especially in the early
      diagnosis of oral cancer and precancerous lesions.

PMID- 1742991
TI  - Radiographic interpretation and treatment decisions among dental therapists and
      dentists in Western Australia.
AB  - All dentists and dental therapists employed in the Community Dental Services in
      Western Australia were invited to participate in a questionnaire study to find
      out about their use of radiographs and opinions and knowledge about the diagnosis
      of approximal caries. Replies were received from 45 dentists (95.1%) and 207
      dental therapists (84.0%). Most dentists would not restore a lesion before it
      appeared on radiograph to have reached the dentine, while therapists were more
      likely to consider a restoration for a lesion just in enamel. Sixty percent of
      all respondents thought that a cavity was present when the radiographic lesion
      was confined to enamel. Fifty-seven percent of dentists thought that an average
      lesion took at least 12 months to progress from outer enamel to dentine, while a
      majority of dental therapists thought this would take less than 12 months.
      Radiographs were not frequently taken by the participants. Operators' opinions
      about cavity formation were the most important predictor of choice of treatment.
      In general, these participant's responses were similar to those provided by
      Norwegian and Dutch respondents in similar surveys conducted 5-6 yr ago, but the
      present participants worked in an optimally fluoridated area and might therefore
      have been expected to have adopted more cautious criteria for restorative
      treatment. Differences between dentists and dental therapists were generally not
      great. The results suggest that calibration of the operators in the service would
      offer benefits.

PMID- 1742992
TI  - Caries experience in the primary dentition of Tanzanian and Finnish 3-7-year-old
      children.
AB  - Caries experience of primary teeth in relation to age, sex, ethnic group,
      socioeconomic status and frequency of consuming sweet snacks and drinks was
      studied among groups of Tanzanian and Finnish 3-7-yr-olds, a total of 1118
      children. In all age groups the Tanzanian children had higher mean dmft scores
      than Finnish children did. In the Finnish group the mean dmft score was higher at
      age 7 than at age 3, while in the Tanzanian group no statistically significant
      difference in dmft scores was found between age groups. In both groups maxillary
      incisors and molars were the main teeth affected by caries. Frequent consumption
      of sweet snacks and drinks increased the risk for caries in Tanzanian but not in
      Finnish children. High socioeconomic status decreased the risk for caries in
      Finnish children but among Tanzanian children high SES was not associated
      significantly with the risk of developing caries. According to these results,
      caries experience in Tanzanian urban nursery school children was significantly
      higher than in Finnish children of the same age, the differences being especially
      high among the youngest age groups.

PMID- 1742993
TI  - Caries prevalence and treatment need amongst children in an Arabian community.
AB  - A total of 1400 Saudi Arabian children in age groups 6-12 and 15 yr in private
      and public schools were examined for dental caries and treatment need in the
      cities of Jeddah (less than 0.30 ppm fluoride in drinking water), Rabagh (0.77
      ppm F-) and Mecca (2.47 ppm F-). The mean dmft in 6-yr-olds in private schools in
      Jeddah was 2.9 compared with 6.3 in public schools (P less than 0.001). The d
      component accounted for 65% of the total dmft in private schools and 76% in
      public schools in Jeddah. The mean dmft values in private and public schools in
      Rabagh were 1.5 and 2.8 respectively and 2.7 and 2.8 in Mecca; the d component
      accounted for approximately 65% in all groups. The figures for permanent teeth in
      12- and 15-yr-olds show similar trends with caries levels being the highest in
      public schools in Jeddah; approximately 60% of the total DMFT was attributable to
      the D component in both school types in all three cities. Most of the treatment
      required in all three cities comprised one- or two-surface fillings. The need for
      treatment was significantly higher in public schools.

PMID- 1742994
TI  - Periodontal status of individuals in early stages of human immunodeficiency virus
      infection.
AB  - The purpose of this study was to evaluate the association of periodontal health
      and human immunodeficiency virus infection among individuals in the early stages
      of disease who were participating in randomized placebo-controlled clinical
      trials of zidovudine. Previous reports have described a rapidly progressive
      periodontitis and atypical gigivitis associated with late stages of infection by
      the human immunodeficiency virus. A health history was completed by each subject.
      Baseline oral examinations were completed on 97 asymptomatic patients and nine
      with AIDS-related complex (ARC) during their regular clinic visit. Follow-up
      examinations were conducted at 3-month intervals throughout the 48 weeks of the
      oral study. Evaluations of plaque, calculus, gingival abnormalities, caries, and
      periodontal disease were conducted. Periodontal measurements included plaque
      index (PI), gingival index (GI), bleeding index (BI), probing depth (PD), and
      observation for cratering, necrosis, and tooth mobility on six teeth in each
      patient. More than half of the subjects had visited their dentist during the
      previous year and had had an oral prophylaxis; less than 25% of them had had
      either restorative work or extractions. The mean scores for periodontal indices
      averaged over the course of the study in asymptomatic and ARC respectively were:
      PI: 0.9 (SE 0.04) and 0.9 (SE 0.08), 0.818; GI: 1.0 (SE 0.04) and 0.9 (SE 0.07),
      P = 0.412; BI: 0.6 (SE 0.04) and 0.4 (SE 0.07), P = 0.278; PD: 2.9 (SE 0.05) and
      2.6 (SE 0.10), P = 0.140. There was no evidence of cratering, necrosis, or tooth
      mobility in either group. Few had calculus or dental caries. There were no
      clinically significant differences detected between ARC versus asymptomatic
      patients. Dental histories and oral examinations showed that two groups of
      patients in early stages of HIV-disease were in good periodontal health.

PMID- 1742995
TI  - Dental erosion in a population of Swiss adults.
AB  - The purpose of this study was to determine the prevalence of dental erosion in an
      adult population in Switzerland. 391 randomly selected persons from two age
      groups (26-30 and 46-50 yr) were examined for frequency and severity of erosion
      on all tooth surfaces. Information was gathered by interview about lifestyle,
      dietary and oral health habits. For facial surfaces 7.7% of the younger age group
      and 13.2% of the older age group showed at least one tooth affected with erosion
      with involvement of dentin (grade 2). 3.5 teeth per person in the younger and 2.8
      teeth per person in the older age group were affected. Occlusally, at least one
      severe erosion was observed in 29.9% of the younger and 42.6% of the older sample
      with 3.2 and 3.9 erosion-affected teeth per person, respectively. 3.6% of the
      younger age group and 6.1% of the older age group showed slight lingual erosion
      on the maxillary anterior teeth. Severe lingual erosions were scarce. Data from
      interviews and multiple regression analyses revealed that acids from beverages
      are significantly associated with presence of erosion.

PMID- 1742996
TI  - Exploration of prediction models for caries risk assessment of the geriatric
      population.
AB  - The purpose of this study was to demonstrate a method for establishing a model
      designed to predict the caries risk of elderly individuals. Twenty-three patients
      over the age of 65 and living in a semi-independent retirement center were
      examined; several variables were collected and analyzed for their ability to
      predict the development of new carious lesions. The analysis was performed using
      logistic regression where the proportion of new decay was used as the dependent
      variable. The model for prediction of combined coronal and root caries included
      the variables flow rate, gender, and root caries index. The proposed method has
      the advantages of easily collected data, individualized criteria, and the ability
      to order patients as to the relative risk of developing decay.

PMID- 1742997
TI  - Relationship between general health, social factors and oral health in women at
      the age of retirement.
AB  - Relationships between some medical, psychological, social factors and oral health
      were analyzed within a comprehensive study of women around the age of retirement.
      The study was performed in Malmo in 1985-1986 and included 165 women retiring
      from work between 851201 and 870131. Women in qualified professional positions
      and with high prosperity indices had an average significantly more remaining
      teeth and were less often edentulous than the others. The same applied to
      unmarried women compared to divorcees and widows. There were significant
      correlations between full blood glucose and serum urate concentrations and number
      of teeth, DFT and DFS. The mean number of prescribed drugs was negatively related
      to the number of remaining teeth and high drug consumption was positively related
      to oral dryness. Women complaining of strain, overwork, restlessness and
      difficulty in relaxing reported more often problems with oral dryness. Oral
      dryness was also related to high blood values of calcium, urate and
      triglycerides, while the serum levels of cholesterol were low. There were no
      differences between smokers and non-smokers concerning any of the studied tooth
      related variables, oral dryness, hypertension or bodyweight. The results indicate
      a close relationship between general health, social factors and oral health.

PMID- 1742998
TI  - Salivary levels of mutans streptococci, lactobacilli, yeasts, and root caries
      prevalence in non-institutionalized elderly dental patients.
AB  - Root caries prevalence was recorded for a consecutive sample of dental patients
      (n = 146), aged over 55 yr and with at least 12 natural teeth. The mean root DFS
      score of the males (n = 49) was 6.34 +/- 4.55 and for the females (n = 97) 3.76
      +/- 3.31 (P less than 0.001). The salivary levels of mutans streptococci,
      lactobacilli, and yeasts were determined in addition to salivary flow rate and
      buffering capacity. Subjects with greater than 1 root DFS had significantly
      higher salivary levels of mutans streptococci, lactobacilli, and yeasts. They
      also had fewer teeth and more exposed root surfaces. In step-wise multivariate
      analyses the factors significantly related to the root DFS score were the number
      of exposed root surfaces, number of teeth, sex and salivary yeast levels (R2 =
      0.41). In the multivariate analyses salivary levels of mutans streptococci were
      not significantly related to any clinical measurement of root caries experience
      due to the greater strength of association between the root DFS score and
      salivary levels of yeasts. Subjects prescribed medicines with a reported
      xerostomic effect had significantly fewer active root lesions than those not
      prescribed such medicines and salivary levels of all microorganisms studied were
      significantly elevated in subjects prescribed medications containing sucrose.

PMID- 1742999
TI  - Dental health of 5-year-old children in Abu Dhabi, United Arab Emirates.

PMID- 1743000
TI  - Primary herpetic gingivostomatitis: no longer a disease of childhood?

PMID- 1743001
TI  - Clinical relevance of a medical history in dental practice: comparison between a
      questionnaire and a dialogue.

PMID- 1743002
TI  - TQuery: a context-sensitive temporal query language.
AB  - Users of electronic medical databases request pertinent information by recasting
      their clinical questions into a formal database query language. Because the query
      language is the user's only access to the data, the query language must be
      powerful enough to enable users to express their data requirements. However, a
      competing need is for the query language to be restrictive enough so that queries
      can have unambiguous semantics and the query processor can generate correct
      answers. We describe a query language, called TQuery , that was designed
      specifically to formulate database queries that are dependent on temporal and
      contextual relationships. TQuery specifications express contextual constraints
      without the need to explicitly reference calendar dates. TQuery is the database
      query language used to retrieve patient data from an object-oriented electronic
      patient medical-record system called the temporal network (TNET). TNET and TQuery
      were developed to support the real-time temporal reasoning and representation
      needs of a LISP workstation-based medical expert system.

PMID- 1743003
TI  - A practical method to integrate some stiff systems.
AB  - A compact, absolutely stable numerical method is presented to integrate stiff
      systems of pseudo-linear, ordinary, first-order differential equations, commonly
      found in the simulation of biological models. Solutions are stepwise approximated
      by a complete set of first order rational polynomials. Mass balance is preserved
      by the approximations. No matrix inversions are required. Besides being stable,
      the method is also convergent and can be used with deferred approximation to the
      limit h = 0. Comparisons between this method and the Stoer-Bullirsch algorithm
      and fourth-order Runge-Kutta method are presented.

PMID- 1743004
TI  - A computer program for randomizing patients with near-even distribution of
      important parameters.
AB  - In clinical trials, the methods for achieving an event or near-even distribution
      of important patient parameters have been tedious and often disappointing. In
      this paper, a computer program for minimizing differences between experimental
      groups with respect to such important parameters, based on a method described by
      Traves (Clin. Pharmacol. Ther. London 15, 443, 1974) is presented. The program is
      available from the author.

PMID- 1743005
TI  - An empirical analysis of likelihood-weighting simulation on a large, multiply
      connected medical belief network.
AB  - We are developing a probabilistic reformulation of the Quick Medical Reference
      (QMR) system. Our current probabilistic model of the QMR knowledge base of
      internal medicine consists of a two-level, multiply connected, belief network.
      Because of the size and connectivity of this belief network, most exact
      algorithms for calculating the posterior marginal probabilities of diseases are
      not applicable. In this paper, we analyze the convergence properties of an
      approximation algorithm, called likelihood-weighting simulation, on the QMR-DT
      belief network. Specifically, on two difficult diagnostic cases, we examine the
      effects of Markov blanket scoring, importance sampling, and self-importance
      sampling, demonstrating that the Markov blanket scoring and self-importance
      sampling significantly improve the convergence of the simulation on our model.

PMID- 1743006
TI  - Management of complex immunogenetics information using an enhanced relational
      model.
AB  - Flow cytometry has become a technique of paramount importance in the
      armamentarium of the scientist in such domains as immunogenetics. In the PENGUIN
      project, we are currently developing the architecture for an expert database
      system to facilitate the design of flow-cytometry experiments. This paper
      describes the core of this architecture--a methodology for managing complex
      biomedical information in an extended relational framework. More specifically, we
      exploit a semantic data model to enhance relational databases with structuring
      and manipulation tools that take more domain information into account and provide
      the user with an appropriate level of abstraction. We present specific
      applications of the structural model to database schema management, data
      retrieval and browsing, and integrity maintenance.

PMID- 1743007
TI  - The role of a clinically based computer department of instruction in a school of
      medicine.
AB  - The evolution of activities and educational directions of a department of
      instruction in medical computer technology in a school of medicine are reviewed.
      During the 18 years covered, the society at large has undergone marked change in
      availability and use of computation in every aspect of medical care. It is argued
      that a department of instruction should be clinical and develop revenue sources
      based on patient care, perform technical services for the institution with a
      decentralized structure, and perform both health services and scientific
      research. Distinction should be drawn between utilization of computing in medical
      specialties, library function, and instruction in computer science. The last is
      the proper arena for the academic content of instruction and is best labelled as
      the philosophical basis of medical knowledge, in particular, its epistemology.
      Contemporary pressures for teaching introductory computer skills are probably
      temporary.

PMID- 1743008
TI  - On the homogeneity of personality disorder clusters.
AB  - This study was conducted using as subjects persons seeking psychiatric care in a
      public intake facility. Patients who received a diagnosis of a personality
      disorder (PD) on axis II constituted the study sample. The study is unique in
      that it attempts to analyze in a treatment population the relationships between
      all of the personality disorders (PD) stipulated in DSM-III with emphasis on
      their relationships to the associated features recorded in the remaining axes of
      DSM-III. The specific aim of the study was to determine the variation that exists
      with respect to clinical and demographic variables across the PD clusters
      categorized in DSM-III and across the PD types of each of the DSM-III PD
      clusters. In general, considerable inhomogeneity was shown within and across
      clusters in both demographic and clinical variables, although differences among
      clusters were noted as well. Cluster B differs prominently from its cohorts with
      respect to demographic and clinical characteristics. Some of the limitations of
      these results are emphasized.

PMID- 1743009
TI  - Alexithymia and depression: distinct or overlapping constructs?
AB  - Previous research showing moderate to high correlations between the Toronto
      Alexithymia Scale (TAS) and Beck Depression Inventory (BDI) has generated
      controversy as to whether alexithymia and depression are distinct or overlapping
      constructs. The present study addressed this controversy using the statistical
      method of factor analysis. In a sample of undergraduate university students, a
      correlation matrix comprising items from both the TAS and BDI yielded a four
      factor solution with virtually no overlap of the significant factor loadings for
      the items from each scale, and with the factors corresponding closely with their
      respective construct. These results were replicated and cross-validated with a
      sample of psychiatric outpatients. The findings support the view that alexithymia
      is a construct that is distinct and separate from depression.

PMID- 1743010
TI  - French views on positive and negative symptoms: a conceptual history.
AB  - The history of the positive/negative terminology, as applied to psychiatric
      symptoms, can be divided into an early period of original meanings, a second one
      of French elaboration, and the current revival. This report addresses issues
      concerning the meaning, referent, and nature of the link between the positive and
      the negative as dealt with in French publications by Ribot, Janet, de
      Clerambault, Nayrac, Von Monakow and Mourgue, and Ey. It is shown how these
      authors modified the old Reynoldian terminology to meet ongoing epistemological
      needs, and in doing so exhausted the conceptual permutations through which the
      positive/negative dichotomy can be put. To render their views intelligible, the
      historical origin of concepts such as evolutionism, Jacksonian, inhibition,
      psychological automatism, and synchrony and diachrony is briefly mentioned. It is
      suggested that the French writers helped to bridge the gap between Reynolds and
      the present, but that the conceptual subtlety that characterized their work has
      not been matched by the leaders of the current revival.

PMID- 1743011
TI  - Philosophy and the DSM-III.
AB  - This report explores the interface between psychiatry and the DSM-III, arguing
      that philosophy and psychiatry are of value to one another. Three trends within
      philosophy are delineated--positivism, hermeneutics, and a synthetic position.
      These trends are applied to the DSM-III and to specific issues in psychiatric
      nosology such as the definition of mental disorder, the question of establishing
      boundaries between different psychiatric disorders, and the differentiation of
      organic and functional disorders. It is argued that while nosologists often think
      of themselves along positivist lines, and are often criticized by hermeneutic
      thinkers for just these assumptions, a synthetic view accounts best for how
      psychiatric science works. It is concluded that philosophy undergirds psychiatric
      nosology, while psychiatric nosology raises a series of philosophical questions.

PMID- 1743012
TI  - Pre-Vietnam contents of posttraumatic stress disorder veterans' service medical
      and personnel records.
AB  - We reviewed the pre-Vietnam contents of the service medical and personnel records
      of 250 Vietnam combat veterans, in an attempt to identify factors predisposing to
      the development of posttraumatic stress disorder (PTSD). PTSD and non-PTSD
      veterans did not differ significantly on self-reported medical history items,
      sick call visits, or military efficiency and conduct ratings. There were trends
      for PTSD veterans to have lower arithmetic aptitude, more self-reported school
      difficulties, and (paradoxically) lower pulse rate at military induction.

PMID- 1743013
TI  - Psychiatric heterogeneity in antisocial alcoholics: relation to familial
      alcoholism.
AB  - There is some indication that addicts who qualify for a diagnosis of antisocial
      personality disorder (ASP) do not comprise a homogeneous group with respect to
      psychopathology. This preliminary study attempted to determine the extent to
      which DSM-III diagnosed ASP alcoholics with alcoholism on both sides of their
      family could be differentiated with respect to childhood behavioral problems and
      additional adult psychopathology from ASP alcoholics with low degrees of familial
      alcoholism. Two groups of ASP alcoholic patients were compared: (1) 11 high
      familial (bilineal) alcoholics, and (2) 22 low familial (nonfamilial or
      unilineal) alcoholics. Few group differences were found in sociodemographic or
      alcohol-related characteristics, although the high familial group tended to be
      younger. However, the high familial alcoholism group tended to report more
      childhood antisocial behaviors and more childhood behavior problems overall. The
      high familial alcoholism group also reported more psychopathology on three of the
      10 Minnesota Multiphasic Personality Inventory (MMPI) clinical scales, paranoia
      (P less than .05), schizophrenia (P less than .06), and masculine-feminine (P
      less than .025). Effect sizes for these three variables were in the moderate
      range. The group MMPI profile of the high familial alcoholism group was
      indicative of serious characterological disturbances, while that of the low
      familial alcoholism group was much more normal. The results of this preliminary
      study provided evidence suggesting that antisocial individuals with a high degree
      of familial alcoholism are more likely to manifest psychopathology than
      antisocial individuals with a lesser degree of familial alcoholism.

PMID- 1743014
TI  - An empirical examination of soothing tactics in borderline personality disorder.
AB  - Little empirical information is available regarding the process of self-soothing
      in borderline individuals, as well as in normal subjects. This study examined the
      frequency of used of soothing "things," soothing "behaviors," and soothing
      "psychological activities" in three groups: borderline personality disorder,
      major depressive disorder without concurrent personality disorder, and college
      students. Results indicated that: (1) borderline individuals reported using
      soothing things at comparable levels to the other two groups; (2) borderline
      subjects and those with major depressive disorders used more adaptive soothing
      behaviors than did college students; (3) borderline subjects used more
      maladaptive soothing behaviors than the other two groups; and (4) borderline
      individuals used psychologically soothing activities at frequencies comparable to
      the other two groups. These results are intended to begin the process of
      developing a soothing profile for individuals with borderline personality
      disorder.

PMID- 1743015
TI  - Social breakdown in the elderly, I. Case studies and management.
AB  - This report focuses on the syndrome of social breakdown of the elderly (SBE),
      which, although common, has attracted surprisingly little attention in clinical
      geropsychiatry. Profound social isolation, extreme neglect of self-care, and
      stubborn refusal of help are the main characteristics of SBE. In most cases, the
      syndrome of SBE is part of a well-defined major psychiatric illness (secondary
      SBE). In other cases, stressful life events cause lifelong personality
      abnormalities to deteriorate into full-blown syndrome of SBE (pure SBE). Two
      detailed case histories highlight the clinical features of pure SBE and its
      management.

PMID- 1743016
TI  - Social breakdown in the elderly, II. Sociodemographic data and psychopathology.
AB  - Current understanding of the sociodemographic and psychopathological
      characteristics of the syndrome of social breakdown of the elderly (SBE) is
      reviewed. In DSM-III-R terms, pure SBE may be best classified as an adjustment
      disorder with profound social withdrawal. It is argued that pure SBE is a form of
      "personality development" in accord with Jaspers's concept of meaningful
      connections.

PMID- 1743017
TI  - DSM-III-R personality disorders in panic and obsessive-compulsive disorder: a
      comparison study.
AB  - Forty-eight patients with panic disorder/agoraphobia (PAD) and 30 with obsessive
      compulsive disorder (OCD) were assessed for DSM-III-R axis II personality
      disorders (PD) and the presence of the same anxiety disorder in the relatives of
      probands (homotypic disorders). No specific personality disorder was present
      significantly more often in either of the two groups. Agoraphobia was not
      associated with higher rates of axis II disorders in PAD patients. Duration of
      illness did not influence the presence of a PD in patients of both groups.
      Secondary cases of the same anxiety disorder were significantly more common among
      first-degree relatives of PAD patients. A discriminant analysis performed on the
      most frequent personality traits of both groups provided a correct classification
      of cases of 97.4%. Our results do not support the hypothesis of PD as secondary
      to anxiety disorders and confirm previous findings of a lack of specificity
      between DSM-III-R axis II categories and OCD and PAD.

PMID- 1743018
TI  - Causal attributions in first-degree relatives of depressed and agoraphobic
      inpatients.
AB  - Causal attributions in 77 first-degree relatives of major depressed, agoraphobic,
      major depressed and agoraphobic (comorbid), and dysthymic inpatients were
      studied. The hypothesis that the relatives of comorbid and dysthymic patients
      should exhibit more "depressogenic" causal attributions for bad events than the
      relatives of major depressed and agoraphobic patients was partly supported.
      Relatives of dysthymic patients attributed bad events to more internal causes and
      assigned more importance to the events themselves than did relatives of major
      depressed patients. Relatives of patients with major depression and agoraphobia
      comorbidity attributed bad events to more internal causes than did the relatives
      of major depressed patients. Statistically controlling for differences in sex,
      age, social class, and depressive symptom level did not significantly alter the
      results among the four groups.

PMID- 1743019
TI  - An attempt to evaluate the risk factors related to coronary heart disease in
      Hungary.
AB  - Using questionnaires, the authors evaluated the risk of coronary heart disease in
      different groups of Hungarian society. Among physicians, teachers, factory
      workers and agricultural workers, the latter seem to be at the highest risk. On
      the basis of these results obtained in a population of 363 agricultural
      employees, a detailed risk factor analysis was made. These results were compared
      with those of the Framingham Offspring Study. Hungarians show alarmingly often a
      high blood cholesterol level, hypertension, smoking and obesity (the latter
      factor in women). The more frequent occurrence of the three main risk factors
      (high blood cholesterol, hypertension, smoking) in young Hungarians is concordant
      with the fact that the incidence of myocardial infarction in young people in
      Hungary is one of the highest in the world. The frequency of a positive parental
      history and obesity in men is lower in the Hungarian population than in the
      American one. The risk of coronary heart disease in the examined Hungarian
      population is considered high. The authors have launched a preventive programme.

PMID- 1743020
TI  - Diagnosis of myocardial ischaemia by means of precordial ST mapping and exercise
      201-thallium scintigraphy.
AB  - The authors compared the results of examination by means of exercise precordial
      ST mapping and exercise 201-thallium scintigraphy in 43 patients with ischaemic
      heart disease and in 10 controls. The methods have been found to be equally
      helpful in establishing the diagnosis of myocardial ischaemia. 201-thallium
      scintigraphy is preferred when trying to quantify the lesion and to localize it.
      The currently available techniques of exercise EGG mapping do not always make
      determination of ischaemia distribution possible. The benefits inherent in either
      method are their non-invasiveness and good reproducibility, features making them
      ideal tools for assessing the effect of treatment.

PMID- 1743021
TI  - Determination of elastin-antielastin circulating immune complexes in serum of
      normal subjects and atherosclerotic patients.
AB  - Healthy subjects of different ages and a group of atherosclerotic patients were
      tested for the presence of elastin-antielastin circulating immune complexes (CIC)
      in their sera. For the purpose the authors used a method based on sequential
      precipitation with rising concentrations of polyethylene glycol (PEG),
      dissociation of the precipitated CIC and further analysis of the resuspended
      precipitates for the presence of elastin derived peptides by an enzyme-linked
      immunosorbent assay (ELISA). Elastin-antielastin CIC were detected only in the
      serum of atherosclerotic patients and that of healthy subjects over 60. The
      elastin-antielastin CIC obtained from the serum of atherosclerotic patients were
      precipitated by higher PEG concentrations mainly and had a higher elastin content
      in comparison with those isolated from the serum of healthy persons over 60.

PMID- 1743022
TI  - Angiographic evidence of coronary artery ectasia: our experience.
AB  - The purpose of this angiographic study was to make a review of patients with
      coronary artery ectasia (CAE) and to compare the average coronary artery
      diameters of proximal, middle and distal segments of the following three groups
      of coronary arteries: Group E (ectatic segments in patients with CAE and
      ischaemic heart disease), Group E-n (presumably normal segments in the same group
      of patients) and Group N (normal coronary arteries of control patients). It was
      found that distal segments of all three coronary arteries and the middle segment
      of the circumflex artery in Group E-n were significantly narrower than the
      corresponding segments in Group N (p = 0.001 or less than 0.05 respectively),
      which suggested the arteriosclerotic origin of both, CAE and distal coronary
      artery involvement.

PMID- 1743023
TI  - Essential hypertension and insulin resistance.
AB  - Insulin resistance (IR) appears to be an important risk factor of both
      hypertension and atherosclerosis. Moreover, it is present also in obesity,
      dyslipoproteinaemia and non-insulin dependent diabetes. IR could be found in
      untreated hypertension and even in normotensive children of hypertensive parents.
      It alters carbohydrate, lipid and protein metabolism and participates directly in
      the development of hypertension. The diagnosis of IR is possible by simple
      determination of insulin and glyceamia during glucose tolerance test. The
      differential diagnosis is obligatory because IR is not specific just for
      hypertension. Treatment, with the exception of nonpharmacological measures, is
      unsatisfactory. However, results of newest research are highly promising.

PMID- 1743024
TI  - What are the causes of unsatisfactory control of arterial hypertension in the
      population?
AB  - A cross-sectional epidemiological study was conducted in the late 1980's in 660
      men and 440 women, aged 35-60 years to assess the level of control of arterial
      hypertension (AH) in an industrial population. A relatively high rate of blood
      pressure (BP) assessment was found; only 2% of those screened had never their BP
      measured. Despite this, 44% of men and 40% of women with a high BP were unaware
      of their AH and conversely 15% of women and 12% of men with a positive history of
      AH were found to have BP less than 140/90 mmHg. Sufficient AH control was
      provided only in one fifth of the total amount of 300 hypertensive subjects. The
      paper evaluates the detection rate of our epidemiological study designed to
      assess the current status of control of AH and the causes of the unsatisfactory
      level of detection and control of a high BP are discussed.

PMID- 1743025
TI  - The effect of acute and chronic nitrate administration in precapillary and
      postcapillary pulmonary hypertension.
AB  - The effect of nitrates was monitored in 16 patients with precapillary, and in 12
      patients with postcapillary pulmonary hypertension (PH). The patients had
      haemodynamic examination on acute administration of 10 mg of isosorbide nitrate
      (ID) in infusion and after 2-month therapy with 120 mg of isosorbide dinitrate
      retard daily. Acute ID administration decreased filling pressure of both
      ventricles, pulmonary and aortic pressure, pulmonary and systemic resistance and
      increased blood flow. No significant difference was found between the two types
      of PH. Long-term administration resulted in a statistically significant decrease
      in filling pressure (in both ventricles) and pulmonary pressure, even though the
      decrease was less pronounced than those seen following acute administration.
      Again, no statistical differences were noted between the two types of PH. While
      acute administration of nitrates decreases both preload and afterload, chronic
      administration decreases only preload. The implications of this finding for
      therapeutic practice are discussed.

PMID- 1743026
TI  - Acute pulmonary embolism and chronic thromboembolic pulmonary hypertension: is
      there a relationship?

PMID- 1743027
TI  - Computer analysis of drug therapy in cardiac patients. Preliminary communication.
AB  - The authors present a system of computer control in drug therapy of cardiac
      patients aimed at preventing complications and adverse interactions of
      simultaneously administered drugs. The system includes data on the 196 most
      frequently used cardiac drugs and 433 other drugs showing clinically important
      interactions with cardiac drugs.

PMID- 1743028
TI  - Cathepsin D activity of an aortic polyester double velour DALLON graft.
AB  - Cathepsin D activity, protein and acid-soluble tyrosine contents in a polyester
      double velour DALLON graft were evaluated in an experiment lasting one year,
      performed in 36 male mongrel dogs. The cathepsin D activity in the intimal,
      medial and adventitial layers of the graft on the 7th day of the experiment was
      much higher than in a normal artery and vein. In the intimal and medial layers of
      the graft, this activity increased in the 1st and 4th months of the experiment.
      In all the layers, cathepsin D activity fell to the level of the activity in
      normal vessels after one year of the experiment. The protein and acid-soluble
      tyrosine contents in all the graft layers were highest on the 7th day after which
      they decreased gradually.

PMID- 1743029
TI  - Dynamics of lipid peroxidation in isoprenaline-induced myocardiopathy.
AB  - The dynamics of lipid peroxidation in isoprenaline-induced myocardiopathy was
      studied in rats. Spontaneous and Fe(II)- catalyzed generation of malondialdehyde
      (MDA)-like products and chemiluminescence in the heart, liver and brain
      homogenates were measured. The increase in the interval between treatment of rats
      with isoprenaline and their killing up to 48 hours led to an increase in MDA
      content in the heart. Both spontaneous and Fe(II)-induced chemiluminescence also
      reached their maxima after 48 hours. These data show that well expressed lipid
      peroxidation in the rat heart occurs approximately 48 hours after isoprenaline
      application. Isoprenaline metabolization in the liver leads to generation of
      activated oxygen species which are able to induce lipid peroxidation in the
      presence of Fe(II). The treatment of rats with isoprenaline caused well-expressed
      lipid peroxidation in the brain. The maximum of this process occurred
      approximately 36 hours after isoprenaline application. The results show that both
      spontaneous and Fe(II)-induced chemiluminescence might be used for the estimation
      of lipid peroxidation in rat heart homogenates.

PMID- 1743030
TI  - The functional state of the creatine kinase system of myocardial mitochondria in
      alcoholic cardiomyopathy.
AB  - The authors studied the chronic effect of ethanol on the functional state of
      creatine kinase system in myocardial mitochondria of adult rats. Mitochondrial
      functions were determined in skinned fibres prepared according to Veksler without
      mitochondria isolation. Compared with control values, ethanol was found to
      decrease statistically significantly the velocity of creatine-stimulated
      mitochondrial respiration (Vcr) and that of maximum ADP-induced stimulation of
      mitochondrial respiration (Vmax). The chronic action of alcohol also reduces the
      respiratory activation by creatine (%Cr) which ranks among the most sensitive
      indicators of mitochondrial respiration regulation by creatine kinase. The
      authors have demonstrated that the function of the creatine kinase system of
      myocardial mitochondria is impaired in alcoholic cardiomyopathy in the adult rat.

PMID- 1743031
TI  - Differential asymmetries for positive and negative emotion: hemisphere or
      stimulus effects?
AB  - Two experiments were carried out to determine whether expressive asymmetries in
      facial stimuli might underlie evidence of differential hemispheric responses to
      positive and negative emotion. Experiment 1 systematically varied stimulus
      orientation; Experiment 2 included both normally oriented and reversed (mirror
      image) faces. We replicated previous reports of a left field advantage for happy
      faces and a right field superiority for sad faces only when normally oriented
      faces were used. Mirror-image stimuli tended to produce the opposite pattern of
      results, and a combination of the two (Exp. 2) eliminated the visual field
      differences for each emotion. The findings underscore the importance of
      controlling for stimulus asymmetries in visual laterality studies, and are
      discussed in terms of current notions about the lateralization of both the
      perception and expression of emotion.

PMID- 1743032
TI  - A longitudinal study of word-reading ability in Alzheimer's disease: evidence
      from the National Adult Reading Test.
AB  - The purpose of this longitudinal study was to examine word-reading ability of
      subjects with probable Alzheimer's disease (AD), using the National Adult Reading
      Test (NART). In addition to the NART, a battery of neuropsychological tests was
      administered to 18 AD and 20 elderly control subjects at yearly intervals over 3
      years. Repeated measures analysis with grouping factors showed that the controls
      scored better than AD subjects on the NART at each test date and the AD subjects
      scored significantly worse over time. NART scores were significantly correlated
      with dementia severity in AD subjects at final testing only, suggesting that the
      NART is sensitive to dementia severity only at the later stages of the disease.
      Associations between the NART and other cognitive measures yielded few
      significant results. Finally, error responses to NART words were summarized by
      type and percentage for each group at each test session.

PMID- 1743033
TI  - A new test of object decision: 2D silhouettes featuring a minimal view.
AB  - A new test of object decision in which a minimal view 2D silhouette of an object
      is presented together with 3 nonsense shapes has been administered to a
      consecutive series of patients with right and left hemisphere lesions. There was
      a significant deficit in the right hemisphere lesion group as compared with the
      left hemisphere group. It is concluded that this object decision test provides a
      measure of the integrity of pre-semantic perceptual processing systems.

PMID- 1743034
TI  - The relationship of depression to symptomatology and lesion site in aphasic
      patients.
AB  - The prevalence of depression was examined in 54 patients recruited by speech
      pathologists and separated into four groups according to aphasia type (Broca's vs
      Wernicke's) and the duration of illness (less than six months vs more than six
      months). Evaluation of depression was made through questionnaires, completed by
      the spouse or speech pathologist, and patient interviews. The four groups were
      similar in demographical variables, in severity of aphasia and in lesion size
      (from CAT scan analyses). The prevalence of depression for the total sample was
      low (15%). Univariate analyses (ANOVA) did not show significant differences
      between the groups on the depression scales. The severity of depression was not
      correlated with lesion size or location. It was concluded that Wernicke's
      aphasics do not experience depression less often nor less severely than Broca's
      aphasics and that the incidence of depression in aphasia is not high. These
      results are in contrast with those obtained in earlier studies. Reasons for the
      discrepancies between this and other studies are discussed.

PMID- 1743035
TI  - Increased reading speed for words and pronounceable non-words: evidence of
      preserved priming in amnesics.
AB  - Twelve amnesics with various aetiologies were compares with 12 matched control
      subjects on a task which examined the increase in reading speed for lists of
      words and pronounceable non-words that were shown several times and read twice
      during a training phase. After a four minute delay the reading speed for the
      primed lists was compared with that for an equal number of umprimed lists. No non
      specific practice effects were observed. The amnesics showed an equal
      proportional increase in reading speed for primed words list to that of their
      controls, and, if anything, a slightly greater reading speed increase for non
      words. These effects were found even when an amnesic subgroup, selected because
      its baseline reading speed was closely matched to that of the controls, was used
      for the comparison. The patients' preserved priming for the novel information
      found in the non-word list reading task occurred in conjunction with very
      impaired free recall for the contents of the lists. The effects occurred in
      patients of all aetiologies used in the study and confirm and extend the findings
      of Moscovitch, Winocur and McLachlan (1986).

PMID- 1743036
TI  - Confabulation following aneurysm of the anterior communicating artery.
AB  - Nine subjects with aneurysms of the anterior communicating artery (ACoA) and 17
      subjects with other intracranial hemorrhages (ICH) were evaluated for
      confabulatory responses under two naturally occurring conditions: (1) when
      subjects were not oriented to person, place, month and year, (2) when subjects
      were fully oriented. Confabulation was observed in all 9 of ACoA patients both
      during disoriented and oriented periods. In contrast, 7/17 of the other ICH
      patients showed signs of confabulation while disoriented, whereas only one
      continued to display confabulatory tendencies while fully oriented. Confabulation
      was more severe in the ACoA group. These data suggest that the confabulation
      observed in the other ICH group may be secondary to an acute confusional state
      while the prolonged confabulation in ACoA patients may be a manifestation of a
      more primary cerebral disorder.

PMID- 1743037
TI  - Interhemisphere transfer in males and females.
AB  - Sex differences in the speed of interhemisphere transfer of visual information
      were assessed by means of a modified version of a task on which Potter and Graves
      (1988) have recently reported significantly lower error rates in females. The
      main aim was to examine the effect of including a control condition in which
      stimuli are presented centrally. In the light of their results, it was predicted
      that any advantage to females would be restricted to the peripheral condition
      since central presentations do not necessarily require interhemisphere transfer.
      Response latencies and errors were measured. No interaction between sex and
      position of presentation was found to occur. It is suggested that the lower error
      rates observed by Potter and Graves in females may have been the result of sex
      differences in speed-error trade off rather than in interhemisphere transfer.

PMID- 1743038
TI  - Korsakoff amnesics are poor at judging the sequence of two tones.
AB  - Alcoholic amnesics were given a test of temporal sequencing ability devised by
      Efron which has practically no memory component. These amnesics were very
      impaired on the task. However, the extent of this impairment did not relate to
      the magnitude of their "target memory" deficit nor did it relate to the ability
      to make temporal judgements from memory. Two other groups of amnesics (3 post
      encephalitis and 4 with ruptured aneurysms of the anterior communicating artery)
      did not show impairments on the sequencing task. Data from the amnesic patient
      N.A. (who was unimpaired on the task), three other amnesics (who showed a
      tendency to be poor at the task) and two frontally damaged patients (one of whom
      performed especially badly on the sequencing task but had no obvious memory
      difficulties) were also presented. It is argued that deficits in temporal
      discrimination may not be found in all amnesics but, when they are observed, are
      an incidental feature related to additional (possibly cortical damage.
      Implications of the results for the view that amnesia results from a deficit in
      the use of contextual information (including temporal information) are
      considered.

PMID- 1743039
TI  - Anterior corpus callosum atrophy and verbal fluency in multiple sclerosis.
AB  - To determine whether different portions of the corpus callosum (CC) are
      responsible for transferring the information of specific cognitive modalities,
      eighteen females with relapsing-remitting Multiple Sclerosis (MS) were studied
      using neuropsychological procedures and Magnetic Resonance Imaging (MRI).
      Measures of both anterior and posterior CC areas were obtained in patients with
      MS as well as in eighteen age and sex matched healthy controls. MRI scans were
      additionally analyzed for each patient in order to evaluate the extent of
      demyelinating lesions in both periventricular and subcortical areas. Patients
      with MS exhibited a significant decrease in both the anterior and posterior CC
      areas compared with normal subjects. The results of statistical analysis showed
      that, even when the effect of demyelinating lesions was taken into account within
      a regression equation, the atrophy of anterior CC area strongly affected the
      performance on verbal fluency task. These data emphasize the importance of the
      anterior CC area for the interhemispheric transfer of cognitive information
      associated with verbal fluency.

PMID- 1743040
TI  - Number impairments following hypokalemia: a case study.
AB  - A case study is reported of a 55 year old female (B.B.) who complained of
      significant difficulty manipulating and remembering numbers. Twenty-four years
      prior to the present complaint, B.B. had been hospitalized for idiopathic
      hypokalemia and secondary hyperaldosteronism. The present study examined the
      nature and extent of B.B.'s cognitive impairments. On standardized and
      experimental tests of intelligence and general cognitive ability, she scored
      quite well. However, she demonstrated significant impairments in digit span,
      number processing and calculation, memory for biographical details involving
      numbers and general number knowledge. The implications of such a constellation of
      impairments are discussed from both cognitive and neurological perspectives.

PMID- 1743041
TI  - Instruction effects on gender differences in visual field advantages during
      lexical decision tasks.
AB  - Two experiments explored the effects of speed, accuracy, on speed and accuracy
      instructions on visual field advantages to lexical decisions in males and
      females. In Experiment 1, right visual field advantages in reaction time appeared
      in the groups of males in the accuracy condition and in the speed and accuracy
      condition. In Experiment 2, feedback consistent with the instructions was given
      to subjects. Females and males in the accuracy condition showed a right visual
      field advantage in the second block of trials. These findings suggest that
      cognitive variables mediate right visual field advantages to lexical decisions in
      males and females.

PMID- 1743042
TI  - Pure apraxic agraphia with recovery after drainage of a left frontal cyst.
AB  - A case is reported of isolated apraxia of writing in which general limb praxis
      was spared. Spontaneous writing, writing to dictation and copying were equally
      affected. Letter selection and spelling were preserved and other language
      functions intact. A CT scan revealed a left frontal arachnoid cyst. After
      surgical drainage the agraphia resolved. The anatomical basis of the disorder is
      discussed in the light of modern information processing models of writing.

PMID- 1743043
TI  - Hemispheric differences in the processing of pictures of typical and atypical
      semantic category members.
AB  - In the following experiment, pictures of typical and atypical category members
      were categorised by subjects after presentation to either the left or right
      visual field. Three different categories were investigated. The results in part
      replicate a previous study by Zaidel (1987), who found an interaction between
      visual field and typicality. She suggested this result might reflect different
      conceptual organisations for each hemisphere. However, in the present study, the
      Visual Field x Typicality interaction was not evident in the two other categories
      investigated, and it is argued that any conclusion regarding conceptual
      organisation may be premature. Further work is needed to address the issue.

PMID- 1743044
TI  - Therapy of upper gastrointestinal tract cancers.
AB  - Esophageal and gastric cancers are highly virulent tumors with an especially poor
      prognosis. They are rather common tumors in the United States with an anticipated
      annual incidence of approximately 32,000 new patients in 1991. Adenocarcinomas of
      the proximal stomach and lower esophagus are rapidly increasing in incidence; the
      reasons for this remain unclear. Endoscopic ultrasonography has offered a new
      dimension to staging especially of the primary tumor but also shows promise for
      more accurate identification of nodal metastasis. While stage remains the single
      most important prognostic variable, biological studies investigating tumor
      markers are a high priority; aneuploidy and HER-2/neu amplification or
      overexpression may predict poor outcome in gastric cancer. Esophageal and gastric
      cancers have a high local and distant failure rate when treated with conventional
      therapy. New developments in chemotherapy in the neoadjuvant and postoperative
      setting are under intense investigation in an attempt to improve prognosis for
      these diseases.

PMID- 1743045
TI  - Recent articles of nutritional interest to pediatricians.

PMID- 1743046
TI  - Foster children and the foster care system, Part I: History and legal structure.

PMID- 1743047
TI  - Immunizations.

PMID- 1743048
TI  - Kawasaki syndrome.

PMID- 1743049
TI  - Pleural diseases: multimodality imaging and clinical management.
AB  - The parietal and visceral pleura are specialized membranes which are highly
      efficient in keeping the pleural space essentially dry and free of protein and
      particulate matter. Radiology has played a pivotal role in the understanding of
      pleural diseases because radiography and, more recently, computed tomography
      (CT), sonography, and magnetic resonance imaging (MRI) have allowed in vivo
      visualization of abnormalities. In addition, these newer modalities have been
      invaluable in guiding diagnostic and therapeutic measures. Cross-sectional
      imaging techniques, particularly CT, are frequently of assistance in determining
      whether tube thoracostomy or other surgical measures are indicated, and when
      these procedures should be performed. The application of newer imaging modalities
      in expediting the management of pleural diseases is emphasized. The anatomy,
      histology, and physiology of the pleura, in both normal and disease states, are
      also reviewed.

PMID- 1743050
TI  - Cardiothoracic trauma.

PMID- 1743051
TI  - The use of antibiotics in general surgery.

PMID- 1743052
TI  - How do sperm activate eggs?

PMID- 1743053
TI  - Proteoglycans in development.

PMID- 1743054
TI  - Development of mouse hematopoietic lineages.

PMID- 1743055
TI  - Dorsal-ventral pattern formation in the Drosophila embryo: the role of
      zygotically active genes.

PMID- 1743056
TI  - Control of cell lineage and cell fate during nematode development.

PMID- 1743057
TI  - Inducing factors and the mechanism of body pattern formation in vertebrate
      embryos.

PMID- 1743059
TI  - A new adventure.

PMID- 1743058
TI  - Patterning of body segments of the zebrafish embryo.

PMID- 1743060
TI  - A dermatologic dairy. Portrait of a practice.

PMID- 1743061
TI  - Space dermatology: a specialty in evolution.
AB  - The last thirty years have demonstrated the ability of humans to survive both
      brief and prolonged durations of microgravity in the unique environment of space.
      The maintenance of health and well-being during spaceflight has been the focus of
      physicians and health care personnel involved in space medicine. It follows that
      dermatology will become a defined component of space medicine, as skin-related
      physiology and subsequent disorders are elucidated and as health maintenance
      protocols are developed. This information will become part of the core of what
      can be called space dermatology.

PMID- 1743062
TI  - Human experience in space.
AB  - Dr. Carr recounts his own experience in space on the Skylab III mission. He notes
      that medical research in space continues today, and compares current Shuttle
      missions with those of Skylab.

PMID- 1743063
TI  - Physiological changes during spaceflight.
AB  - Before human beings first explored space, many dire predictions from the
      scientific community suggested that weightlessness was not compatible with life.
      Although these prophesies have been proven false, many physiological alterations
      do occur in microgravity conditions. Other systems are altered as well, but the
      cardiovascular, musculoskeletal, and immune systems undergo adaptations that may
      pose problems for the space traveler, especially on returning to gravity.

PMID- 1743064
TI  - Space nursing.
AB  - Rogers' nursing science of unitary human beings has potential for providing a
      unique understanding of human life and health in space as well as on Earth. When
      planning for nursing services beyond the planetary level, we must focus these on
      people as integrated wholes in mutual process with a radically different
      environment. The overview effect, as experienced by astronauts and others,
      suggests that future space inhabitants are precursors of spacekind.

PMID- 1743065
TI  - Cutaneous wound healing in space.
AB  - With the expected increase in extended-length space exploration missions and the
      establishment of permanent space stations, there is an increased chance of
      cutaneous injury occurring in astronauts due to trauma or unexpected emergency
      surgery. Will these wounds heal properly in space? This question remains
      unanswered. Several basic areas of the wound healing process need to be
      investigated through controlled scientific studies on spaceflights.

PMID- 1743066
TI  - A brief history of trying: man, NASA, and medicine.
AB  - The development of the V2 rocket during World War II raised the possibility of
      manned spaceflight to the level of "serious consideration." Concepts of aviation
      medicine led to the specialty of space medicine. Projects Mercury, Gemini,
      Apollo, Skylab, and Apollo-Soyuz, and the Space Transportation System have helped
      us gain important biomedical information, including but not limited to,
      microgravity and its effects on red cell mass, orthostatic tolerance, exercise
      capacity, bone density, and muscle nitrogen levels. Problems of "space motion
      sickness" and micro-organisms in space have become major concerns. This analytic
      review covers these topics and relevant others.

PMID- 1743067
TI  - A health maintenance facility for space station freedom.
AB  - We describe a health care facility to be built and used on an orbiting space
      station in low Earth orbit. This facility, called the health maintenance
      facility, is based on and modeled after isolated terrestrial medical facilities.
      It will provide a phased approach to health care for the crews of Space Station
      Freedom. This paper presents the capabilities of the health maintenance facility.
      As Freedom is constructed over the next decade there will be an increase in
      activities, both construction and scientific. The health maintenance facility
      will evolve with this process until it is a mature, complete, stand-alone health
      care facility that establishes a foundation to support interplanetary travel. As
      our experience in space continues to grow so will the commitment to providing
      health care.

PMID- 1743068
TI  - The history of the Space Dermatology Foundation.
AB  - The five-year history of the Space Dermatology Foundation is reviewed. How the
      organization was conceived, its purpose, and what it intends to accomplish are
      presented.

PMID- 1743069
TI  - History of self-experimentation in dermatology: should we go first--sometimes?
AB  - Because of its availability, the skin has been used over the years for self
      experimentation. Many examples can be cited, including the heroic self
      experiments of Carrion of Peru with verruga peruana and those of Goldberger with
      pellagra and Pediculoides ventricosus. My personal self-experimentation began
      with sensitization to Japanese lacquer. From that starting point I experimented
      with chemical warfare agents, cortisone versus hydrocortisone, bites of various
      arthropods, and finally, experiments with lasers. Some dermatologists will
      continue to do self-experimentation when they acquire infections from their
      patients. I believe that sometimes, for their patients' benefit, they should go
      first.

PMID- 1743070
TI  - Transcribed and nontranscribed parts of the human ribosomal gene repeat show a
      similar pattern of distribution in nucleoli.
AB  - The distribution pattern of the transcribed and nontranscribed parts of human
      ribosomal RNA genes were visualized simultaneously in the same cells by
      nonautoradiographic in situ hybridization. DNA probes labeled with either
      digoxigenin or biotin were detected in the same cells by different fluorescence
      systems. The signals from both the transcribed and nontranscribed parts showed a
      similar distribution pattern. This finding is not compatible with the conclusion,
      suggested by earlier studies, that the transcribed and nontranscribed parts of
      the rRNA genes are located at different sites within the nucleoli or in different
      nucleolar components.

PMID- 1743071
TI  - A low-copy repeat located in subtelomeric regions of 14 different human
      chromosomal termini.
AB  - Two cosmid clones, cG1A3 and cG1A6, containing large blocks of a telomeric repeat
      sequence, (TTAGGG)n, were isolated independently. Restriction mapping and
      fingerprinting studies suggested that cosmid cG1A6 is entirely contained within
      cG1A3. Competitive in situ hybridization localized cG1A3 to 14 different human
      telomeres and one internal site at 2q14----q21, indicating the presence of a
      subtelomeric low-copy repeat within this cosmid.

PMID- 1743072
TI  - Localization of the gene encoding insulin-degrading enzyme to human chromosome
      10, bands q23----q25.
AB  - Insulin-degrading enzyme (IDE) is a cytosolic proteinase involved in the cellular
      processing of insulin. Using somatic cell hybrid analysis and in situ chromosomal
      hybridization, we have localized the gene encoding IDE to human chromosome 10,
      bands q23----q25. The murine Ide gene was previously mapped to Chromosome 19;
      together, these results suggest that the IDE gene is a member of a conserved
      syntenic group on human chromosome 10, bands q23----q25 and mouse Chromosome 19.

PMID- 1743073
TI  - Ribosomal RNA gene site polymorphism in Bufo terrestris.
AB  - Individual specimens of Bufo terrestris were discovered that possessed ribosomal
      gene locations in addition to those normally found. Every specimen from an island
      population that was examined had extra sites, whereas fewer individuals from
      coastal mainland populations and none from inland populations had them. Although
      the extra ribosomal gene locations probably did not arise through gross
      structural chromosome rearrangements, their origin remains unclear.

PMID- 1743074
TI  - Failure of chromosomally abnormal sperm to participate in fertilization in the
      Chinese hamster.
AB  - The selection of chromosomally abnormal gametes was investigated in the Chinese
      hamster by direct chromosome analysis of meiotic cells and one-cell embryos
      obtained from crossing heterozygotes for two reciprocal translocations,
      T(1;3)7Idr and T(1;3)8Idr. Expected frequencies of male and female gametes with
      different chromosome constitutions were estimated by scoring of secondary meiotic
      metaphase (MII) cells in the translocation heterozygotes. The frequency of
      gametes with each karyotype that participated in fertilization was investigated
      in pronuclei from translocation heterozygotes in one-cell embryos obtained from
      crossing the heterozygotes with karyo-typically normal animals. Compared with the
      expected frequencies from MII scoring, the frequencies of male pronuclei having
      some karyotypes in one-cell embryos decreased significantly. The karyotypes of
      male pronuclei showing a decreased frequency were commonly characterized by a
      deficiency of the long-arm segment of chromosome 1 (q13----qter) or by a
      deficiency of almost the whole arms of chromosome 3. On the other hand, the
      frequencies of female pronuclei with the same karyotypes were all consistent with
      those estimated from MII scoring. These results suggest that sperm nullisomic for
      certain segments of some chromosomes may fail to participate in fertilization.

PMID- 1743075
TI  - Chromosomal localization of the major histocompatibility complex (MHC) in the
      rhesus monkey and chimpanzee by fluorescence in situ hybridization.
AB  - Genes for the major histocompatibility complex (MHC) were localized by
      fluorescence in situ hybridization to the long arm of rhesus monkey chromosome 5.
      This localization contradicts previous reports, based on genetic investigation of
      somatic cell hybrids, that placed the MHC on chromosome 2 of this species. In the
      chimpanzee, the MHC loci were localized to 5p21.3, corresponding precisely to
      their location on human chromosome 6p21.3.

PMID- 1743076
TI  - Cytological evidence of maternal meiotic errors in a line of chickens with a high
      incidence of triploidy.
AB  - Direct evidence of the nature of maternal meiotic errors in a selected line of
      chickens with a high incidence of triploidy was obtained by using cytologically
      marked paternal gametes derived from a closely related avian species. Matings
      were made by artificial insemination of female chickens of the selection line and
      a control line with semen from ring-necked male pheasants. A total of five
      triploid, one pentaploid, and 21 diploid hybrid embryos were karyotyped. Each
      triploid hybrid embryo contained one set of paternal pheasant chromosomes and two
      sets of maternal chicken chromosomes, providing irrefutable cytological evidence
      that the triploids were derived from diploid ova produced by females of the
      selection line. The pentaploid hybrid contained one set of paternal pheasant
      chromosomes and four sets of maternal chicken chromosomes, indicating that it had
      been derived from a tetraploid ovum. Females of the selection line are thought to
      have a genetically mediated susceptibility to nondisjunction which is responsible
      for the high incidence of meiotic errors. Evidence is provided that the non
      disjunction occurs at both meiosis I and meiosis II.

PMID- 1743077
TI  - [Two additional cases of autosomal trisomy, 61,XY,+12 and 61,XX,+12, in cattle].
AB  - Two new cases of trisomy of chromosome No. 12 in cattle are reported. The
      phenotypic effects of this chromosome aberration are described and discussed.

PMID- 1743078
TI  - C-band polymorphisms in exotic inbred strains of mice: a method for mapping
      centromeric ends of chromosomes.
AB  - The major satellite DNA of Mus musculus appears as a pericentromeric
      heterochromatin block in all chromosomes but the Y. While C-banding readily
      reveals the presence of this heterochromatin block, there is considerable
      polymorphism in C-band size among the chromosomes and among different subspecies.
      We have studied the distribution of C-band size differences in the chromosomes of
      15 exotic inbred laboratory strains and substrains derived from wild populations
      of different subspecies of M. musculus. The variation in C-band size among these
      inbred strains can serve as a useful codominant cytological marker for estimating
      recombinational distances between the centromere and proximal genes in linkage
      crosses.

PMID- 1743079
TI  - The mouse Y* chromosome involves a complex rearrangement, including interstitial
      positioning of the pseudoautosomal region.
AB  - Cytological analysis of the mouse Y* chromosome revealed a complex rearrangement
      involving acquisition of a functional centromere and centromeric heterochromatin
      and attachment of this chromosomal segment to the distal end of a normal Y*
      chromosome. This rearrangement positioned the Y* short-arm region at the distal
      end of the Y* chromosome and the pseudoautosomal region interstitially, just
      distal to the newly acquired centromere. In addition, the majority of the
      pseudoautosomal region was inverted. Recombination between the X and the Y*
      chromosomes generates two new sex chromosomes: (1) a large chromosome comprised
      of the X chromosome attached at its distal end to all of the Y* chromosome but
      missing the centromeric region (XY*) and (2) a small chromosome containing the
      centromeric portion of the Y* chromosome attached to G-band-negative material
      from the X chromosome (YX). Mice that inherit the XY* chromosome develop as
      sterile males, whereas mice that inherit the Y*X chromosome develop as fertile
      females. Recovery of equal numbers of recombinant and nonrecombinant offspring
      from XY* males supports the hypothesis that recombination between the mammalian X
      and Y chromosomes is necessary for primary spermatocytes to successfully complete
      spermatogenesis and form functional sperm.

PMID- 1743080
TI  - Synapsis and obligate recombination between the sex chromosomes of male
      laboratory mice carrying the Y* rearrangement.
AB  - The synaptic and recombinational behavior of the sex chromosomes in male
      laboratory mice carrying the Y* rearrangement was analyzed by light and electron
      microscopy. Examination of zygotene and pachytene X-Y* configurations revealed a
      surprising paucity of the staggered pairing configuration predicted from the
      distal position of the X pseudoautosomal region and the subcentromeric position
      of the Y* pseudoautosomal region. When paired at pachynema, the X and Y*
      chromosomes usually assumed configurations similar to those of typical sex
      bivalents from normal male laboratory mice. The X and Y* chromosomes were present
      as univalents in more than half of the early- and mid-pachytene nuclei,
      presumably as a result of steric difficulties associated with homologous
      alignment of the pseudoautosomal regions. When paired at diakinesis and metaphase
      I, the X and Y* chromosomes exhibited an asymmetrical chiasmatic association
      indicative of recombination within the staggered synaptic configuration. Both
      pairing disruption and recombinational failure apparently contribute to
      diakinesis/metaphase I sex-chromosome univalency, as most cells at these stages
      possessed X and Y* univalents lacking evidence of prior recombination.
      Recombinant X or Y* chromosomes were detected in all metaphase II complements
      examined, thus substantiating the hypothesis that X-Y recombination is a
      prerequisite for the normal progression of male meiosis.

PMID- 1743081
TI  - For the love of Tony and Joanne, Tenci, Kristi, Wayne, Robie and Ricky.

PMID- 1743082
TI  - [Illustration of vertical control in hyperdivergence with the Tweed technique].

PMID- 1743083
TI  - [Why become a dentist?].

PMID- 1743084
TI  - [The cauterizing cement of J. J. Borgne, Brussels dentist in 1869].

PMID- 1743085
TI  - [Interconnection between sensitivity to ouabain and malignancy in murine cells].

PMID- 1743087
TI  - [Basic characteristics of a parallel dual DNA helix by scanning tunnel microscopy
      data].

PMID- 1743086
TI  - [Structural-functional state of artificial and native membranes under the effect
      of antineoplastic agents based on platinum coordination complexes].

PMID- 1743088
TI  - [Enzymatic-transport system of epithelial cells, stroma, and the muscle-serous
      layer of the rat small intestine].

PMID- 1743089
TI  - [A new secreted protein from Saccharomyces cerevisiae, stimulated by heat shock].

PMID- 1743090
TI  - [Increase in the affinity of rat brain M-cholinergic receptors upon one-time
      administration of the cholinolytic, amizyl].

PMID- 1743091
TI  - [Synergism of processes of generating active forms of oxygen and proteolysis as a
      possible reason for developing influenza].

PMID- 1743092
TI  - [Functional significance of proliferative activity of retinal pigment epithelium
      cells during early postnatal development of the Syrian hamster (Cricetus
      auratus)].

PMID- 1743093
TI  - [Comparative characteristics of neuronal activity of the frontal cortex and
      caudate nucleus of the monkey during realization of delayed behavior].

PMID- 1743094
TI  - [Long-term results of coronary angioplasty in relation to vessel size].
AB  - Repeat angiography was performed after 3-4 months in 927 of 1386 consecutive
      patients (67%) who had a successful percutaneous coronary angioplasty (PTCA)
      between 1986 and 1988. The degree of coronary artery stenosis was determined
      angiographically before PTCA, immediately after and 3-4 months later. Patients
      were assigned to one of four groups according to balloon diameter at dilatation:
      Group 1: 1.5-2.0 mm; group 2: 2,5 mm; group 3: 3.0 mm; group 4: 3.4-4.2 mm.
      Vessel wall proliferation occurred in all four groups after PTCA. In patients
      with angiographically demonstrated recurrence (first recurrence: 308 patients,
      second recurrence: 43 patients) another balloon dilatation was undertaken and a
      repeat angiography 3-4 months later. Long-term success rate (less than 50%
      stenosis) differed significantly according to the post-PTCA vessel diameter: 48%
      in group 1, 63% in group 2, 66% in group 3 and 80% in group 4 (analysis of
      variance: P less than 0.001). PTCA thus produces better long-term results in
      large than in small vessels.

PMID- 1743095
TI  - [Atraumatic Clostridium septicum infection in granulocytopenia].
AB  - A fatal Clostridium septicum infection occurred in three patients. Case 1. A 55
      year-old man died of septicaemia resulting from granulocytopenia of uncertain
      aetiology; it was associated with perforation of ileal mucosal ulcers. Autopsy
      revealed neutropenic enterocolitis and diffuse gas formation, especially in the
      brain, caused by Clostridium septicum. Case 2. A 18-year-old boy developed a
      caecal invagination during imipenem-induced granulocytopenia. A fulminant
      postoperative Clostridium septicum infection ended fatally. At autopsy many
      ulcers were found at the site of invagination with gas formation involving all
      organs. Case 3. Myonecrosis of the left arm, caused by Clostridium septicum,
      developed without external cause in a 12-year-old girl with congenital
      neutropenia. Despite aggressive surgical intervention she died of toxic shock.
      Autopsy revealed caecal mucosal ulcers as the portal of entry of Clostridium
      septicum.

PMID- 1743096
TI  - [Dual cause of obstructive jaundice: cholangiolithiasis and malignant choledochal
      stenosis].
AB  - Endoscopic retrograde cholangiopancreatography in a 78-year-old woman with right
      sided upper abdominal pain and jaundice (total bilirubin 8.9 mg/dl) revealed two
      stones, of about 1 cm diameter each, in the biliary duct. They were removed after
      papillotomy. Because of persisting jaundice (total bilirubin 7.6 mg/dl) and a
      history of two years of recurrent cholecystitis a cholecystectomy was performed.
      At operation an advanced carcinoma of the gallbladder was discovered, with tumour
      compression of the extrahepatic choledochal duct. After removal of the
      gallbladder the stenosis was bridged with a T-drain. For permanent bile diversion
      of a self-expanding stent was endoscopically implanted. The patient has been
      symptom-free so far for 6 months. It is stressed that, especially in elderly
      patients, malignant choledochal stenosis must be included in the differential
      diagnosis of obstructive jaundice caused by stones and diagnostic procedures
      undertaken accordingly.

PMID- 1743097
TI  - [Varicosis of the great saphenous vein as a main symptom of iatrogenic
      arteriovenous fistula].
AB  - A 22-year-old man with movement-dependent knee-joint pain was operated on for
      patellar chondroplasia and meniscal dysplasia after two previous arthroscopic
      removal of free joint bodies had failed to bring relief. A few months after the
      operation the same leg had become swollen with signs of venous congestion, long
      saphenous vein varicosity and traumatic pretibial crural ulcer. The long
      saphenous vein was partially excised. 18 months after the arthrotomy there was
      clinical and colour-Doppler evidence of an arteriovenous fistula with false
      aneurysm in the region of the popliteal artery as cause of the venous congestion.
      The ulcer healed completely after ligation of the fistula and excision of the
      false aneurysm. --Arterio-venous fistula should be included in the differential
      diagnosis as a possible cause of postoperative swelling of a limb.

PMID- 1743098
TI  - [Clinical aspects and diagnosis of community-acquired pneumonia].

PMID- 1743099
TI  - [Prehospital thrombolysis in acute myocardial infarct].

PMID- 1743100
TI  - [When will fibrinogen screening become available?].

PMID- 1743101
TI  - [Endoscopy in patients with joint prostheses only under antibiotic prophylaxis?].

PMID- 1743102
TI  - [Therapy of severe systemic lupus erythematosus].

PMID- 1743103
TI  - [Coumarin-induced necrosis].

PMID- 1743104
TI  - [Catheter ablation. Curative treatment in symptomatic Wolff-Parkinson-White
      syndrome].

PMID- 1743105
TI  - Preoperative evaluation of patients with advanced tumors of the skull base.
AB  - The purpose of the pre-operative assessment in patients with advanced skull base
      disease, is to provide the treating physicians with as much data as possible
      pertaining to the patient and the disease. The meticulous analysis of this
      clinicoradiologic evaluation will help in planning the method and magnitude of
      tumor resection, and functional defect reconstruction.

PMID- 1743106
TI  - Radiographic evaluation of the skull base.
AB  - The anatomic complexities of the skull base and the variable clinical
      presentation of skull base tumors often precludes accurate determination of tumor
      boundaries by history and physical alone. Imaging, employing computed tomography
      (CT) and magnetic resonance imaging (MR) allows for accurate tumor mapping and
      planning of appropriate therapeutic intervention. Calvarium floor involvement and
      extracranial lesions are well delineated by CT. While multiplanar MR is
      unparalleled in demonstrating tumor boundaries and extension through the skull
      base. In order to employ these imaging modalities in an efficient way, it is
      important to understand the limitations and capabilities of these modalities as
      well as the imaging characteristics of common skull base lesions.

PMID- 1743107
TI  - Transsphenoidal approaches to the skull base.

PMID- 1743108
TI  - Transoral approaches to the skull base.

PMID- 1743109
TI  - Craniofacial resection.

PMID- 1743110
TI  - Transtemporal approaches to the skull base.
AB  - Transtemporal approaches to lesions of the posterior fossa and/or temporal bone
      afford direct access with minimal manipulation of the subdural spaces. In most
      instances, the primary concern is the preservation of seventh nerve integrity or
      restoration of seventh nerve function in the event of loss of facial nerve
      integrity. The transtemporal approaches afford the surgeon the ability to trace
      the seventh nerve from normal to diseased regions and so increased the
      possibility of anatomical preservation. In addition, the availability of the
      seventh nerve for transposition or rerouting makes nerve grafting easier in the
      event of seventh nerve sacrifice. Limitation of the craniectomy site within the
      temporal bone without violating the deep cervical musculature avoids the
      complication of severe postoperative headaches so frequently seen in suboccipital
      resections. Thorough knowledge of the temporal bone anatomy and intracranial
      structures is mandatory prior to utilization of this procedure.

PMID- 1743111
TI  - Temporal bone resection.
AB  - It must be emphasized that the greatest impact of survival can only be obtained
      through an early diagnosis and a radical treatment program. Any granulation
      tissue must be sent for biopsy to rule out the possibility of malignancy in the
      setting of chronic otitis media. Once carcinoma is diagnosed, imaging studies
      must be obtained to define the extent of the tumor. Under diagnosis is the rule
      with these malignancies. Tumors limited to the external auditory canal can be
      adequately resected with a lateral temporal bone resection. Extension into the
      middle ear and mastoid aircell systems requires either a subtotal temporal bone
      resection or a lateral temporal bone resection with a radical mastoidectomy and
      petrousectomy. The inclusion of the petrous apex with the resection, as in a
      temporal bone resection, does not add to survival but increases morbidity.
      Radical postoperative radiation therapy is essential for maximum local control
      and survival with these malignancies.

PMID- 1743112
TI  - The infratemporal fossa approach to skull base surgery.
AB  - The infratemporal fossa approach, in conjunction with the application of
      microsurgical technique and improved perioperative care, has permitted
      significant advances in lateral skull base surgery. The glomus jugulare tumor is
      the prototypical neoplasm resected by this approach, although this technique can
      be applied to a host of additional benign and malignant lesions of the skull
      base. This approach entails identification and control of the cranial nerves and
      great vessels in the neck, anterior transposition of the facial nerve, and
      infralabyrinthine petrosectomy. Intracranial tumor extension and petrous carotid
      artery involvement remain limiting factors. Significant morbidity, particularly
      neurologic deficit and hemorrhage, may occur due tot the nature and location of
      lateral skull base tumors. Recent advances in preoperative embolization and
      temporary carotid artery balloon occlusion have advanced the limits of resection
      via the infratemporal fossa approach.

PMID- 1743113
TI  - Management of high parapharyngeal space tumors.

PMID- 1743114
TI  - Complications of skull base surgery.
AB  - As skull base resections have increased in complexity and magnitude, so have the
      complications associated with the procedures. In this paper, we have reviewed the
      major complications of skull base surgery, including CSF leak, bleeding, stroke,
      meningitis, cranial nerve deficits and recurrent disease. This report summarizes
      the factors that lead to these complications, as well as measures to prevent
      them. We have also discussed our approach to the management of these
      complications, with particular emphasis on CSF leak and vagal nerve paralysis.

PMID- 1743115
TI  - Effect of otitis media on development: a community-based study.
AB  - Otitis media history until age 3 years were recorded for 233 children as part of
      the surveillance in a Community Program for Promotion of Growth and Development
      (PROD) conducted in a western neighborhood of Jerusalem. Recurrent otitis media
      (6 or more episodes) occurred more frequently among children who were of North
      African or Asian origin, of lower social class and maternal education, and whose
      duration of breast feeding was less than 26 weeks. Children with recurrent otitis
      media also failed the 7-month hearing test more frequently than other children.
      The mean Developmental Quotient score at 2 years and the mean Stanford Binet
      score at 3 years were statistically significantly lower among children with
      recurrent otitis media, even after controlling for maternal origin and length of
      breast feeding. These findings underscore the importance of early identification
      and early intervention for otitis media.

PMID- 1743116
TI  - Fetal and preterm newborn cerebral blood flow velocity.
AB  - Using Doppler ultrasound, cerebral blood flow velocities (CBFV) in the first
      month of life of normoxemic preterm infants born in the 28th gestational week
      with stable circulatory conditions were examined. The results were compared with
      fetal CBFV in the 28th to 32nd weeks of pregnancy. Peak systolic (PSV), end
      diastolic (EDV) and time averaged maximum velocities (TAMV) were evaluated from
      the Doppler shifts recorded from the middle cerebral artery (MCA). Cerebral
      circulatory changes in neonates in the first 4 weeks of life were much more
      pronounced than in fetuses at the corresponding gestational age (28-32 weeks).
      After the rapid increase in neonatal CBFV in the first 3 weeks of life, our
      results appear to indicate a stabilisation between the 3rd and 4th week
      (corresponding to the 32 gestational weeks). The significance of, and possible
      mechanisms for, these changes are discussed.

PMID- 1743117
TI  - Circadian rhythms in early human development.
AB  - The body temperature, heart rate and rest-activity cycles of 12 low-risk preterm
      infants (29-35 weeks) were continuously recorded in the neonatal intensive care
      unit over a period of 1-2 weeks. Throughout the recordings the light was on
      continuously, the feeding was done intra-gastrically every 2 h and the incubator
      temperature was constant. Under such conditions a significant circadian rhythm
      was found in the body temperature and heart rate of more than 50% of the infants.
      These findings indicate the possible existence of an endogenous circadian rhythm
      in early human infancy. Since lights are continuously on in the neonatal
      intensive care unit, this might impair the time of emergence of day-night
      entrainment of the biological clock in preterm infants.

PMID- 1743118
TI  - Detectability of auditory evoked response components in preterm infants.
AB  - In determining the detectability of brainstem, middle latency and cortical
      auditory evoked responses in preterm newborns, one has to deal with the ongoing
      maturation of the auditory system. In the preterm period the detectability of
      evoked responses is closely related to the appearance of the individual evoked
      response components. The detectability of the individual evoked response
      components in preterm infants is important, because low detectability rates make
      the absence of a particular evoked response component irrelevant with respect to
      the clinical-neurophysiological correlation. In a longitudinal study we
      determined the detectability and cumulative detectability, i.e. the presence of
      individual evoked response components in one or more recordings of evoked
      response components in 37 low risk preterm infants between 30 and 41 weeks
      conceptional age (CA). On the basis of their detectability it is concluded that
      evoked response components, determined between 30 and 34 weeks CA, are generally
      of limited use for clinical application, except for auditory brainstem response
      (ABR) components I, IIn, V and Vc and middle latency response (MLR) component Na.
      Our study made clear that improvement can be achieved by performing more than one
      examination within a period of approximately 4 weeks between the recording
      sessions. The cumulative detectability rates after two recordings showed
      improvement for all components involved in this study. The cumulative
      detectability rates of ABR components I, II, IIN, III, V, IIc, IIINc, Vc, MLR
      components Na and P0, and auditory cortical response (ACR) components PbP1 and
      N2p are sufficient to use as measures in the neurophysiological judgement of
      functional integrity of the central auditory pathway in preterm infants.

PMID- 1743119
TI  - Quantitative analysis of T and B cell subsets in healthy and sick premature
      infants.
AB  - This work proposes a serial quantitative analysis of the numbers and percentages
      of B and T cell subsets in 104 consecutive premature infants (PI) between birth
      and six months of age as compared with 21 normal term infants. First, in order to
      ascertain the effects of perinatal distress at birth (respiratory distress,
      neonatal asphyxia) on certain parameters of the immune system, the PI were
      divided into two groups. One comprised 36 healthy preterms, the other, 68
      preterms with perinatal distress. It was then shown that healthy PI differed from
      full-term infants by their higher absolute numbers of T cells (CD2-positive) and
      helper T cell subset (CD4-positive). These increases in CD2- and CD4-positive
      cells correlated with gestational age (GA). An increase in B lymphocytes (CD20
      positive cells) was also documented but no correlation with GA could be seen.
      Secondly, perinatal distress was found to be concomitant with transient decrease
      in percentages and absolute numbers of CD2- and CD4-positive cells, particularly
      in PI of less than 28 weeks of gestation. The B cells (CD20- and CD21-positive
      cells) were not different in absolute numbers. Respiratory distress had a more
      discernable effect than fetal asphyxia on the immune system. Finally, no
      immunological parameters tested could at any time predict the occurrence of
      infection in PI during the first 6 months of life.

PMID- 1743120
TI  - Cranial computed tomography in the under twos.
AB  - One hundred consecutive cranial computed tomographic scans were reviewed in
      children aged 0-2 years, presenting to the Royal Belfast Hospital for Sick
      Children. The mean age at scanning was 8.3 months and 73% of the scans were
      abnormal. The majority of scans were performed electively (78%). The commonest
      indication for a scan was seizures (31) and the diagnostic yield was highest
      where they were associated with other neuro-developmental symptoms. The
      usefulness of the CT scan was not limited to the abnormal studies but contributed
      to management in children with normal scans by excluding important intracranial
      pathology. Developmental CNS malformation (16 scans) and cerebral atrophy (15
      scans) were the most frequent CT abnormalities encountered.

PMID- 1743121
TI  - Spontaneous chromosome fragility in chorionic villus cells.
AB  - Human fragile sites are only very rarely expressed spontaneously. In this paper
      we report the presence of non-random spontaneous chromosome lesions (CL) in
      chorionic villus samples and their coincidence with fragile site (FS) bands. The
      average number of CL was about 9% both in RPMI-1640 and in Chang media. To
      determine any possible influence of external factors other than culture media,
      the results were grouped according to age of gestation. No differences were
      observed among the different groups. A total of 101 chromosome lesions could be
      precisely identified by sequential Leishman Staining/Wright G-banding; 76.2% of
      them coincided with FS-bands. The most affected region was at 1q12-1q21.1 (15.8%
      of total CL); other FS with a clustering of breakpoints in our study were 1p36,
      1q44, 2q37, 3p24, 3q27, 10q22 and 16q23. These results suggest that spontaneous
      expression of some FS could be a characteristic of embryonic tissues.

PMID- 1743122
TI  - Evaluation of endosonography in sclerotherapy of esophageal varices.
AB  - During intravariceal sclerotherapy of esophageal varices with polidocanol in 32
      patients with portal hypertension due to liver cirrhosis of various etiologies,
      endosonographic assessment of both esophageal and gastric intramural vessels was
      carried out in order to evaluate the usefulness of endosonography in the follow
      up of the variceal status. In all cases endosonography demonstrated esophageal
      and gastric varices; in contrast, only five cases of gastric varices could be
      demonstrated by endoscopy. Furthermore, different stages of variceal obliteration
      following sclerotherapy could be demonstrated by means of endosonography, and it
      was possible to identify incomplete obliteration in about one-third of the
      patients in whom inadequate sclerotherapy was suspected endoscopically. In
      addition, the status of gastric varices during sclerotherapy was demonstrated by
      means of endosonography. Only in cases of adequate sclerotherapy of esophageal
      varices, as assessed by both endoscopic and endosonographic criteria, were
      gastric varices plugged. On the basis of these findings endosonography would
      appear to be a useful technique for the diagnosis and follow-up of esophageal and
      gastric varices during intravariceal sclerotherapy.

PMID- 1743123
TI  - Guillotine needle biopsy as a supplement to endosonography in the diagnosis of
      gastric submucosal tumors.
AB  - The presumptive diagnosis of gastric submucosal tumors can be made by endoscopic
      ultrasonography (EUS) but histological confirmation is still required. A special
      guillotine biopsy device (Flexi-Temno) which enables collection of adequate
      submucosal samples by the endoscopic approach was therefore evaluated. After
      visualization by EUS the guillotine needle biopsy was performed in 21 patients
      with submucosal tumors of the stomach. There were 2 failures in 2 patients with
      leiomyomas. The diagnosis suggested by EUS was confirmed by guillotine biopsy in
      17 cases. Guillotine biopsy detected 2 cases of unsuspected leiomyosarcoma which
      were confirmed surgically. In cases of solid submucosal tumors confirmed on EUS,
      the guillotine needle biopsy enables a definitive histologic diagnosis. Thus
      malignancies can be detected when EUS findings are not significant.

PMID- 1743124
TI  - Endoscopic manometry of the sphincter of Oddi and pancreatic duct in patients
      with papillary stenosis.
AB  - The function of the sphincter of Oddi (SO) in patients with papillary stenosis
      was evaluated using endoscopic manometry to determine its possible contribution
      to pancreatic dysfunction. A total of 30 patients with papillary stenosis were
      divided into two groups according to the pattern of narrowing of the sphincter
      zone observed in ERCP studies: group A, a mild form, and group B, a severe form.
      Group C (control) comprised 12 subjects with no abnormality of the pancreas or
      biliary system. The SO contraction pressure was significantly higher in group A
      (115.1 mmHg) than in groups B (79.2) and C (91.1). The SO basal pressure in
      groups A (11.5 mmHg) and B (10.3) was significantly higher than in group C (5.8).
      The pancreatic duct pressure in group A (15.5 mmHg) was significantly higher than
      in group C (9.7), while group B (11.1) showed an intermediate value. The increase
      in pancreatic duct pressure following intravenous secretin was significantly
      greater in groups A and C than in B. The BT-PABA test in groups A and C revealed
      a normal value in contrast to group B. A significant correlation was observed
      between these two factors. The function of both the SO and the pancreas thus
      appears to be abnormal in patients with severe narrowing of the SO and papillary
      stenosis.

PMID- 1743125
TI  - The quality of gastroenterological reports based on free text dictation: an
      evaluation in endoscopy and ultrasonography.
AB  - The majority of physicians consider the use of free dictation for medical reports
      to be essential in many domains. One of the main criticisms of structured data
      entry is the possible lack of flexibility and completeness. Electronic
      documentation systems exist for endoscopy and ultrasonography examinations which
      are based on structured input as well as on free dictation. Endoscopy and
      ultrasonography reports based on free dictation were evaluated for omissive
      errors. The data evaluated was drawn from a database of 18,239 gastroscopy and
      3,340 colonoscopy reports dictated by 28 physicians over 74 months, and 18,834
      ultrasonography reports dictated by 37 physicians over 42 months. The error rates
      varied from 0% to 41.8% depending upon the particular feature and the particular
      examination, but were usually below 15%. The results were independent of the
      experience of the examiner. This study provides baseline measurements of omissive
      error rates for selected findings in gastrointestinal endoscopy and abdominal
      ultrasonography which can be used as standards for the development and evaluation
      of systems for collection of clinical data.

PMID- 1743126
TI  - The SADE system: an endoscopic database manager.
AB  - The development of the SADE database manager was commenced in 1985 since no
      commercially available systems were suited for the needs of a large endoscopy
      unit. Over a period of five years, this database was programmed, revised and
      enhanced through the joint efforts of gastroenterologists and programmers, the
      SADE system being implemented for daily use on 1 January 1989. The patient
      administration and medical record modules are fully implemented and functional,
      while the statistical module has only recently been finished. The present
      features of the system are described, and the limitations discussed. Instant
      report generation and direct access to previous medical data are the most
      immediate benefits of the system. The initial intention to have structured
      anamnestic data had to be modified to suit the need for flexibility and ease of
      free text input by the users.

PMID- 1743127
TI  - SADE database for endoscopic procedures: aspects of clinical use.
AB  - The time aspects of daily use of a clinical database system in an endoscopy
      department were studied. The SADE database system for endoscopic procedures was
      introduced for daily use at Ulleval Hospital on 1 January 1989. The average
      weekly programme of the endoscopy unit includes 57 gastroduodenoscopies, 23
      colonoscopies and 12 ERCP/EPTs. During three consecutive weeks of the study the
      mean physician input time was 4 min 17 sec per patient (range 57 sec to 15 min),
      individual variation depending mainly on the extent of the report. Assistants
      spent a mean time of 4 min 23 sec for each patient. Thus, a total of 8 min 40 sec
      was spent for every patient seen. Endoscopic units should analyze their routines
      and needs before introducing an electronic data base manager.

PMID- 1743128
TI  - SISCOPE: a multiuser information system for gastrointestinal endoscopy.
AB  - SISCOPE is an integrated data management system for use in gastrointestinal
      endoscopy units which operates in the multiuser mode on UNIX minicomputers or MS
      DOS personal computers and can be used for patient bookings, endoscopic data
      entry and retrieval, and automatic report generation in upper gastrointestinal
      endoscopy, proctologic examinations, colonoscopy and peritoneoscopy. The
      description of endoscopic findings is remarkably detailed and data entry very
      rapid due to an advanced design of input screens that incorporates several recent
      concepts, including windows, menu bars and pull-down menus; typing is eliminated
      as data is entered with a mouse by pointing at options within menus. Endoscopic
      findings can be described under eight headings: morphology, topography,
      qualifiers, modifiers, signs of bleeding, endoscopic diagnosis, pathological
      diagnosis and etiology. Terminology is based strictly 3on the OMED system.
      SISCOPE also allows recording of details on endoscopic procedures, indications
      for the examination, preparation, premedication, complications and late entry of
      pathology reports. After entering all data, a report in natural language is
      produced automatically, the entire process taking one minute on average. Data
      retrieval programs give on-line access to previous examinations of a given
      patient and automatically generate activity reports. A formal language allows
      direct queries to the database and transfer of data for statistical analysis or
      other data processing. The system is simple to learn and use because operation is
      intuitive and all endoscopic techniques share the same basic menu structure and
      screen design.

PMID- 1743129
TI  - Endoscopic management of biliary hydatid disease: report on six cases.
AB  - Six patients with a ruptured Echinococcus liver cyst were treated by means of
      endoscopy. The treatment consisted of endoscopic sphincterotomy, cyst material
      extraction and hypotonic saline lavage via a nasobiliary catheter. In five
      patients successful complete endoscopic treatment was achieved, including removal
      of daughter cysts. In the sixth patient only partial treatment could be performed
      with clearance of daughter cysts since there was no communication with the main
      liver cyst. Follow-up ultrasonography, CT and ERCP in all patients showed
      complete cure and no evidence of disease recurrence in five of them. The sixth
      patient required surgery one month after endoscopic treatment of the acute
      biliary obstruction.

PMID- 1743130
TI  - Endoscopic sphincterotomy in the management of postoperative complications of
      hepatic hydatid disease.
AB  - The results obtained using endoscopic sphincterotomy (EST) in the management of
      postoperative biliary complications of hepatic hydatid disease are presented. The
      outcome was favourable in all eight patients treated with no associated morbidity
      or mortality. In three patients the clinical manifestations of cholangitis
      resolved, and in five of six patients the external bile fistula previously
      present for 26 to 68 days closed within 3 to 15 days. In one patient with a long
      standing fistula (5 years) the bile outflow was reduced from 600cc to 50-100cc
      per day. No complications due to EST were encountered. The results show that EST
      can be considered the treatment of choice for biliary fistulae following surgery
      for hepatic hydatid disease and for drainage of bile in patients with cholangitis
      due to hydatid disease.

PMID- 1743131
TI  - Role of endoscopic ultrasonography in the treatment of esophageal varices.

PMID- 1743132
TI  - Endoscopic sclerotherapy in 1991: still evolving.

PMID- 1743133
TI  - A critical look at the Sydney classification of gastritis.

PMID- 1743134
TI  - Endosonography of groove pancreatitis.
AB  - Groove pancreatitis is a rare form of chronic pancreatitis. Distinction between
      pancreatitis and pancreatic carcinoma is often difficult. Two cases of groove
      pancreatitis diagnosed by endosonography are described. A hypoechoic pattern
      between the duodenal wall and pancreas was clearly imaged in both patients.
      Narrowing of the second part of the duodenum and evidence of bile duct
      obstruction were also found. The endosonographic diagnosis was confirmed either
      by surgery or follow-up examination.

PMID- 1743135
TI  - An unusual case of active tuberculosis of the oesophagus in an adult.
AB  - A case is reported of a 56-year-old woman of Libyan origin presenting with
      dysphagia, retrosternal pain and weight loss. Oesophago-gastroduodenoscopy
      revealed an ulcerated tumor in the upper oesophagus strongly suggesting a
      malignancy. A positive Mendel-Mantoux test along with histological evidence of
      epitheloid cell granulomas and clinical findings consistent with pulmonary and
      lymph node tuberculosis led to the presumptive diagnosis of oesophageal
      tuberculosis. The diagnosis was later confirmed by positive bacteriological
      cultures of oesophageal biopsies and gastric washings. It is very unusual for
      dysphagia to be the presenting symptom of active adult tuberculosis. Oesophageal
      tuberculosis is extremely rare and must be distinguished predominantly from
      oesophageal carcinoma.

PMID- 1743136
TI  - Endoscopic band ligation for treatment of non-variceal upper gastrointestinal
      bleeding.
AB  - An endoscopic band ligation method was successful in achieving hemostasis in two
      patients who had severe coagulopathy and profuse gastrointestinal bleeding from a
      visible vessel in the stomach. Bleeding was not controlled by multiple
      epinephrine injections or BICAP electrocoagulation. The technique of band
      ligation was easy to perform and may provide an alternative treatment for non
      variceal upper gastrointestinal bleeding in selected cases.

PMID- 1743137
TI  - Intramural hematoma of the esophagus after variceal sclerotherapy.
AB  - Two patients with cirrhosis are presented who developed retrosternal pain and
      dysphagia immediately after sclerotherapy of esophageal varices. Extensive
      submucosal bleeding of the esophageal wall was demonstrated radiologically and
      endoscopically. Complete resolution occurred spontaneously and did not lead to
      residual complications such as strictures. Intramural hematoma of the esophagus
      is an unusual complication after endoscopic variceal sclerotherapy.

PMID- 1743138
TI  - Splenic injury as a complication of endoscopy: two case reports and a literature
      review.
AB  - Two cases of splenic injury - one after a difficult colonoscopy and the other
      after routine ERCP - are reported. Splenic injury as a complication of endoscopic
      procedures is relatively rare, but over the past several years this complication
      has been increasingly reported. Review of the literature revealed 11 cases
      occurring after colonoscopy and one after ERCP. Although most of the patients
      presented with acute abdominal symptoms, some had mild vague symptoms. In two
      cases the injury was overlooked entirely. Diagnosis was established at laparotomy
      in four cases, by CT in four, by ultrasonography in two, by chance observation in
      two, by angiography in one and by paracentesis in one. All patients except the
      most recent three reported underwent surgery, with one mortality occurring three
      weeks after the operation.

PMID- 1743139
TI  - Computer graphics simulation for teaching.

PMID- 1743140
TI  - Esophageal bezoar due to sucralfate.

PMID- 1743141
TI  - Guaiac-positive stools and ulceration of the colon associated with salmonellosis.

PMID- 1743142
TI  - Choledochoduodenal fistula: a rare sequel of duodenal ulcer.

PMID- 1743143
TI  - Duplication of the cystic duct detected by endoscopic retrograde
      cholangiopancreatography.

PMID- 1743144
TI  - Deleterious circulation of intestinal contents through the biliary tract after
      cholecystojejunostomy.

PMID- 1743145
TI  - Association of annular pancreas and pancreas divisum.

PMID- 1743146
TI  - Increase of methylguanidine and guanidinoacetic acid in the brain of amygdala
      kindled rats.
AB  - Guanidino compounds are intrinsic chemoconvulsants. We investigated the regional
      and time-dependent changes of these compounds in the amygdala (AM) of kindled
      rats versus electroconvulsive shock (ECS) seizures using high-performance liquid
      chromatography (HPLC). Twenty-eight days after the last AM-kindled seizure,
      guanidinoacetic acid (GAA) and methylguanidine (MG) levels were significantly
      increased in the bilateral AM as compared with those of control rats, which had
      been implanted with electrodes but were not stimulated. Both compounds, however,
      tended to decrease in the bilateral AM after ECS seizure. In addition, we
      measured these compounds after induction of one afterdischarge (AD) in the AM.
      These compounds increased significantly 7 days after AD was induced in the
      ipsilateral AM. We suggest that the increase of these compounds is coincident
      with AD generation and specific to AM kindling and the kindled state.

PMID- 1743147
TI  - Interictal behavioral alterations and cerebrospinal fluid amino acid changes in a
      chronic seizure model of temporal lobe epilepsy.
AB  - This study extends our previous work in which we described the presence of an
      interictal behavioral disturbance in a chronic animal model of temporal lobe
      epilepsy (TLE). In this study, we investigated the cerebrospinal fluid (CSF)
      neurotransmitter changes underlying the development of chronic recurrent seizures
      of temporal lobe origin and interictal behavioral disturbance in cats made
      epileptic after intrahippocampal injection of kainic acid (KA). Using high
      performance liquid chromatography, we measured 22 putative neurotransmitter amino
      acids. After intrahippocampal KA injection, cats developed an initial acute
      period of intense seizure activity. Cisternal CSF amino acids, which were
      repeatedly sampled during the acute period through a permanent indwelling
      cannula, were unchanged apart from a mild elevation in CSF alanine. The high
      level seizure activity gradually decreased, and cats entered a chronic epileptic
      period characterized by recurrent yet intermittent temporal lobe seizures. CSF
      GABA levels during the chronic epileptic period were significantly decreased. In
      contrast, CSF levels of other amino acids--alanine, tyrosine, taurine, aspartic
      acid, and glutamic acid--did not change significantly. Behavioral testing also
      showed a heightened interictal defensive reactivity during the chronic epileptic
      period. To the extent that CSF GABA concentration reflects brain GABA
      concentration, this study suggests that a decrease in brain GABA may contribute
      both to the epilepsy and interictal emotional lability of animals with a chronic
      seizure disorder of temporal lobe origin.

PMID- 1743148
TI  - Long-term effects of pilocarpine in rats: structural damage of the brain triggers
      kindling and spontaneous recurrent seizures.
AB  - Structural damage of the human brain (perinatal damage, cerebral trauma, head
      injury, cerebrovascular and degenerative diseases, intracranial tumor, metabolic
      diseases, toxins, drug-induced seizures) may lead to chronic epilepsy in
      survivors. Epidemiologic analyses show that a considerable time-delay occurs
      between the exposure of the brain to injury and the appearance of seizures. Such
      seizures are usually partial or mixed, may develop at any age, and are difficult
      to treat. In rats subjected to structural damage of the brain induced by
      sustained convulsions triggered by systemic administration of the cholinergic
      agent pilocarpine, spontaneous seizures may develop after a mean latency of 14-15
      days. The mean frequency of spontaneous recurrent convulsions remains constant
      for several months. Evolution of these convulsions proceeds through several
      electrographic and behavioral stages resembling kindling. Kindling may be
      otherwise induced in rodents by repeated systemic administration of convulsants
      or by repeated electrical stimulation of sensitive brain regions. These
      observations demonstrate that structural damage of the brain may lead to
      spontaneously recurrent convulsions (chronic epilepsy) in rats and that kindling
      may be involved in the evolution of such a condition. This finding suggests that
      kindling mechanisms underlie the development of epileptic foci from structural
      brain lesions. Such mechanisms may be involved in the etiology of some forms of
      epilepsy in humans.

PMID- 1743149
TI  - Electroencephalographic characteristics of audiogenic seizures induced in
      metaphit-treated small rodents.
AB  - Adult male mice, rats, and guinea pigs were subjected to intense sound
      stimulation of an electric bell (100 dB, 12 kHz for 60 s) after a single
      intraperitoneal (i.p.) injection of metaphit (1-(1-(3 isothiocyanatophenyl)
      cyclohexyl)piperidine) (50 mg/kg). When the animals were tested 24 h after
      administration of metaphit, audiogenic seizures were observed. None of the
      control saline-injected animals had convulsions. EEG recordings demonstrated the
      appearance of paroxysmal activity and spike-wave complexes in the trace from
      cortical and hippocampal electrodes, with frequency and amplitude increasing with
      time. Behaviorally, myoclonic jerks of facial muscles, ears, and neck appeared,
      but no correlation was noted between EEG and the motor phenomena. Auditory
      stimulation was necessary to elicit the full-blown sequence of seizure responses
      consisting of wild running followed by clonic and then tonic extension. At the
      time of seizures, repetitive high-amplitude spikes and waves appeared in the EEG,
      followed by profound EEG and behavioral depression. None of the animals died
      during or immediately after seizures. The seizure response to sound stimulation
      of mice, rats, and guinea pigs was phenomenologically similar, with minor
      differences in quantitative pattern of convulsive components, which suggests that
      all three animal species share the common property of extreme susceptibility to
      audiogenic stimulation caused by metaphit administration.

PMID- 1743150
TI  - Study of the prevalence of epilepsy among schoolchildren in Valladolid, Spain.
AB  - A population study was performed to estimate the prevalence of epilepsy in the
      juvenile population of Valladolid, Spain. Using a mixed questionnaire (postal
      domiciliary), we studied a sample of 5,100 primary school pupils (aged between 6
      and 14 years) and 48 pupils receiving state-run special education. We also
      identified all the students receiving private special education and from specific
      special education centers belonging to the same age group (90 and 145,
      respectively). The prevalence of epilepsy in the school age population on
      December 1, 1987 was estimated at 5.72/1,000 inhabitants. Our results are
      comparable to those of other studies in Western countries.

PMID- 1743151
TI  - Images of epilepsy in literature.
AB  - Literature primarily reflects and affirms existing attitudes and conceptions
      regarding the epilepsy population. In the fiction of many nations for many
      centuries, individuals with epilepsy have emerged as evil or saintly, as
      geniuses, or as objects of pity whose lives were not worth living. The character
      who had epilepsy was outside the realm of personal identification--too far
      beneath or too far above us. Nevertheless, there were exceptions. Literature, as
      well as film and television, especially in the last 2 decades, has shown both
      readers and audiences that there are human beings who have epilepsy (rather than
      who are epileptics). These human beings are simply part of the continuum of what
      we know as normal: no more and no less than merely human.

PMID- 1743152
TI  - Joan of Arc.
AB  - For centuries, romantics have praised and historians and scientists debated the
      mystery of Joan of Arc's exceptional achievements. How could an uneducated
      farmer's daughter, raised in harsh isolation in a remote village in medieval
      France, have found the strength and resolution to alter the course of history?
      Hypotheses have ranged from miraculous intervention to creative psychopathy. We
      suggest, based on her own words and the contemporary descriptions of observers,
      that the source of her visions and convictions was in part ecstatic epileptic
      auras and that she joins the host of creative religious thinkers suspected or
      known to have epilepsy, from St. Paul and Mohammed to Dostoevsky, who have
      changed western civilization.

PMID- 1743153
TI  - Cerebrospinal fluid lactate levels and prognosis in status epilepticus.
AB  - Despite recent advances in the treatment of status epilepticus (SE), the
      mortality and morbidity associated with this condition remains high. Although the
      reasons for this excessive mortality are not known, several factors are
      suspected, including cerebral ischemia, cardiovascular collapse, toxic
      stimulation by neurotransmitters and hormones, or toxic products of intermediary
      metabolism. Cerebral lactic acidosis can cause cortical injury and has been shown
      to occur with seizures in experimental animals and in a limited number of human
      studies. We determined cerebrospinal fluid (CSF) and plasma lactate in 29
      patients with generalized SE of diverse etiology. CSF was obtained within 12 h of
      termination of clinical seizure activity. The mean CSF lactate for all SE
      patients was elevated (3.74 +/- 0.31 mM) as compared with that of normal controls
      (1.60 +/- 0.10 mM) from non-neurologic patients undergoing spinal anesthesia. In
      patients who died or had a poor neurologic recovery, CSF lactate level was 5.36
      +/- 0.58 mM (9 patients), whereas in 20 patients who showed good recovery CSF
      lactate level was 3.01 +/- 0.22 mM (p less than 0.005). The results demonstrate
      that SE causes a significant increase in CSF lactate and suggest that the
      magnitude of lactate elevation may serve as a predictive indicator of morbidity
      and mortality.

PMID- 1743154
TI  - Role of the frontal lobes in the propagation of mesial temporal lobe seizures.
AB  - The depth ictal electroencephalographic (EEG) propagation sequence accompanying
      78 complex partial seizures of mesial temporal origin was reviewed in 24 patients
      (15 from the University of Pittsburgh Epilepsy Center and 9 from UCLA). All
      patients were monitored with bilateral mesial frontal and mesial temporal depth
      electrodes and later received anterior temporal lobectomy. Ictal EEG records were
      categorized according to sequence of spread from the temporal focus to the other
      regions. Although propagation patterns varied both within and between patients,
      certain features were notable: (a) It was very common for seizure activity to
      spread initially to the ipsilateral frontal lobe (observed in 22 of 24 patients).
      (b) The most common mode of spread (15 of 24 patients) was initiating temporal
      lobe----ipsilateral frontal lobe----contralateral frontal lobe----contralateral
      temporal lobe. (c) Occasionally, seizure discharges invaded the frontal lobes but
      failed to invade the contralateral temporal lobe (2 of 24 patients). (d) Seizure
      activity occasionally invaded the contralateral temporal lobe prior to invading
      the frontal lobes (2 of 24 patients). Other notable features included (i) a clear
      tendency for mesial temporal seizure discharges initially to invade orbitofrontal
      (as opposed to anterior cingulate) cortex and (ii) the emergence of a period of
      clear asymmetry in the frontal lobes during which high-amplitude, rapid
      discharges were present on the side ipsilateral to the initiating temporal lobe.
      These results suggest that the prefrontal region, especially the orbitofrontal
      cortex, is strongly influenced by mesial temporal ictal activity. This region
      appears to be frequently involved in the propagation of seizures initiated in the
      mesial temporal lobe and may play a role in the interhemispheric propagation of
      mesial temporal seizures.

PMID- 1743155
TI  - Analysis of foramen ovale electrode-recorded seizures and correlation with
      outcome following amygdalohippocampectomy.
AB  - We report a detailed electroclinical analysis of 320 seizures recorded by foramen
      ovale electrodes in 77 potential candidates for selective temporal lobe surgery
      because of antiepileptic drug-resistant seizures. The exact localization of the
      origin of seizure discharges, the electroencephalographic (EEG) seizure onset
      patterns, transhemispheric propagation, propagation time, duration of discharge,
      laterality of discharge termination, postictal focal slowing, correspondence
      between foramen ovale recordings and the scalp EEG, and the influence of
      antiepileptic drug modifications were studied and correlated with the clinical
      seizure semiology and with postoperative outcome following selective
      amygdalohippocampectomy. In general, the foramen ovale electrode technique
      provided good neurophysiological information in candidates for selective
      amygdalohippocampectomy. The following ictal signs predicted a good surgical
      outcome: (a) unilateral and anterior mediobasal temporal lobe seizure onset, (b)
      short seizure duration, (c) no or infrequent contralateral seizure discharge
      propagation, and (d) if propagation to the contralateral mediobasal temporal lobe
      occurred, the postoperative outcome was better the later the contralateral
      mediobasal temporal lobe was affected. Postoperative outcome was also better the
      less frequently contralateral interictal spikes occurred. No direct predictive
      value could be attributed to the presence of an initial arrest reaction.

PMID- 1743156
TI  - Natural history of recurrent seizures after resective surgery for epilepsy.
AB  - Seizures persist or recur in 20-60% of patients after resective surgery for
      intractable partial epilepsy. Further information about the natural course of
      these seizures is lacking in the literature. During one decade of epilepsy
      surgery at a single institution, we identified 72 patients with recurrent
      postoperative seizures after resective procedures for epilepsy. Prospectively
      compiled seizure diaries, hospital records, and outpatient office records were
      reviewed and supplemented by telephone communications to assess subsequent
      seizure frequency. Follow-up data was available ranging from 6 months to 7 years
      5 months (mean 3 years 5 months). The likelihood of persistent seizures and
      recurrent intractability was examined with life-tables. Seizures recurred within
      the first postoperative year in 86% of patients and were similar to preoperative
      events in 74% of patients. After the first seizure recurrence, there was 80%
      likelihood of persistent seizures in the next 6 years and 40% likelihood of
      intractability (more than one seizure a month despite optimal medical therapy).
      The interval until recurrence within the first postoperative year did not affect
      the likelihood of subsequent seizures or intractability. Late seizure recurrence
      (after the first year) was not associated with any instances of subsequent
      intractability. Recurrent seizures after extratemporal resections were more
      likely to become persistent and intractable than seizures recurring after
      temporal resections. This information provides rational prognostication and
      assists in counseling patients with recurrent seizures after resective surgery
      for intractable epilepsy.

PMID- 1743157
TI  - Intracarotid amobarbital procedure: I. Prediction of decreased modality-specific
      memory scores after temporal lobectomy.
AB  - To assess predictive value of the intracarotid amobarbital procedure (IAP) for
      decreased postoperative modality-specific memory, we studied 37 temporal
      lobectomy patients with intractable partial epilepsy who were selected for
      operation independent of preoperative IAP findings. When ipsilateral IAP failure
      was defined by an absolute method as a retention score less than 67%, the results
      were not associated with decreased modality-specific memory after operation. When
      ipsilateral IAP failure was defined by a comparative method as a retention score
      at least 20% lower after ipsilateral than contralateral injection, the results
      showed greater differences between groups, but differences still did not achieve
      statistical significance. Four left-resection patients who failed the ipsilateral
      IAP had a median postoperative change in the Wechsler Memory Scale-Revised (WMS
      R) Verbal Memory Index score of -14%, whereas 16 left-resection patients who
      passed the ipsilateral IAP had a mean postoperative change in the WMS-R Verbal
      Memory Index score of -7.5% (p = 0.12). These results suggested that the IAP
      interpreted comparatively may be a helpful adjunctive test in assessment of
      relative risk for modality-specific memory dysfunction after temporal lobectomy,
      but larger series of operated patients are needed to confirm this possibility. In
      this series, complete amnesia was not noted after ipsilateral injection, even in
      patients with postoperative modality-specific memory decline.

PMID- 1743158
TI  - Intracarotid amobarbital procedure: II. Lateralizing value in evaluation for
      temporal lobectomy.
AB  - The intracarotid amobarbital procedure (IAP) was assessed for lateralizing value
      in 37 patients who later had temporal lobectomy for intractable epilepsy. Among
      patients who failed IAP memory testing on one side (defined as a retention score
      for test items at least 20% lower on one side than the other), significantly more
      patients failed the injection contralateral (16 of 20, 80%) than ipsilateral (4
      of 20, 20%) to the side of later resection (p = 0.008). In addition, preoperative
      EEG evidence of bilateral temporal epileptogenicity was significantly more
      frequent among patients who failed the ipsilateral IAP injection (2 of 4, 50%)
      than among patients who passed the ipsilateral IAP injection (2 of 33, 6%) (p =
      0.050). Finally, failure of the contralateral IAP injection involved
      significantly more severe amnesia for test items (median retention score 25%)
      than did failure of the ipsilateral injection (median retention score 59%) (p =
      0.047). Profoundly low retention scores less than 33% occurred only with
      contralateral injection. These findings suggest that the IAP has some adjunctive
      lateralizing value for the epileptogenic hemisphere in patients with temporal
      lobe epilepsy, especially when the retention score with one injection is
      profoundly low.

PMID- 1743159
TI  - Computerized analysis of EEG background activity in epileptic patients.
AB  - Background activity was studied in 128 idiopathic epilepsy patients and 30 normal
      controls using EEG topography and t-statistic significance probability mapping (t
      SPM). In epileptic patients, EEG background activity showed a marked increase in
      delta, theta, alpha 1, and beta 1, and a decrease in alpha 2 activity as compared
      with controls. Untreated epileptic patients had a significant increase in delta,
      theta, and alpha 1 as compared with controls. For epileptic patients treated with
      antiepileptic drugs (AEDs), the most marked slowing was observed in the
      polytherapy group, followed by the monotherapy group and then the untreated
      group. Among seizure types, patients with partial seizures (PS) tended to exhibit
      more slowing than patients with only generalized tonic-clonic seizures (GTC).
      Moreover, PS had a right-left asymmetry in alpha 2 and beta 1 activities. In a
      comparison of AEDs, patients receiving carbamazepine (CBZ) and phenobarbital (PB)
      showed no significant difference as compared with the untreated group. In
      contrast, patients receiving valproate (VPA) showed a decrease in slow and fast
      activities. EEG changes associated with each AED were different in GTC and PS.
      Patients receiving VPA for GTC showed a decrease in theta and beta 1 activities,
      but those with PS showed a decrease only in delta activity.

PMID- 1743160
TI  - Transient global amnesia as a postictal state from recurrent partial seizures.
AB  - A 60-year-old patient had a 3-year history of recurrent memory disturbances. The
      video electroencephalographic (EEG) recording of one attack showed that the
      amnesic state, which clinically resembled transient global amnesia, was
      characterized by a normal EEG tracing followed by electroclinical complex partial
      seizures. We suggest that "epileptic" transient global amnesia is postictal in
      nature.

PMID- 1743161
TI  - Speech during partial seizures: intracranial EEG correlates.
AB  - Vocalization during a seizure may help predict the location of seizure onset or
      identify structures ultimately involved in the seizure. Spontaneous vocalization
      during seizures was studied retrospectively in 22 patients with refractory
      complex partial seizures evaluated with bilateral intracranial electrodes. Of 22
      patients, 12 vocalized during seizures. Seizures were as likely to originate from
      language-dominant (6/12) as from language-nondominant mesial temporal cortex
      (6/12). Fluent speech frequently occurred as seizure activity was recorded from
      language-dominant temporal lobe neocortex (6/12 seizures). Of the patients with
      well-localized seizure onsets who did not speak (6/10), seizures arose from both
      language-dominant and -nondominant mesial temporal cortex. We conclude that the
      presence or absence of vocalizations during a seizure does not reliably indicate
      the anatomic regions in which the seizure begins or spreads.

PMID- 1743162
TI  - Chronic, habitual cocaine abuse and kindling-induced epilepsy: a case report.
AB  - Kindling has been suggested as a possible mechanism for cocaine-induced seizures
      in chronic cocaine abusers, even though no convincing examples have been
      reported. We report a 37-year-old woman who initially experienced generalized
      tonic-clonic seizures (GTC) only immediately after "crack" use. She had a normal
      examination, negative family or past history for seizures, and normal cranial
      computed tomography and EEG. After she had abused cocaine almost daily for 2
      years, her EEG demonstrated bitemporal slowing with independent spikes, and
      seizures were no longer temporally associated with acute cocaine use. Thereafter,
      despite complete abstinence from cocaine and treatment with phenytoin, she
      continued to experience four to six GTC a month. In light of the lack of other
      predisposing factors for epilepsy, this case may represent an example of cocaine
      induced kindling in humans.

PMID- 1743163
TI  - Longitudinal EEG studies in a kindred with Lafora disease.
AB  - We reviewed 18 EEG studies in four members of a family with the Lafora form of
      progressive myoclonic epilepsy. Each patient was the product of a consanguinous
      marriage and presented as a teenager with progressive seizures, myoclonus,
      dementia, and ataxia, and had biopsy proven disease. The EEG early in Lafora
      disease has spike-wave activity resembling that seen in a primary generalized
      epilepsy; the background slowing is more typical of a secondary generalized
      epilepsy. With disease progression, there is increased epileptiform activity, and
      a striking change in the spike-wave complexes, with a marked increase in
      frequency up to 6-12 Hz, and many more short duration polyspike components.
      Unlike some other forms of secondarily generalized epilepsy, the EEG in Lafora
      disease is distinguished by an increased frequency of the spike-wave complexes
      with disease progression.

PMID- 1743164
TI  - Clinical and neurophysiological development of Unverricht-Lundborg disease in
      four Swedish siblings.
AB  - Four siblings aged 12-18 years with progressive myoclonus epilepsy demonstrated a
      subclinical stage at the age of 9-11 years, with visual blackouts and polyspike
      electroencephalographic (EEG) activity on photic stimulation, an early myoclonic
      stage at the age of 12-15 years, with increasing segmental, stimulus-sensitive
      myoclonus, occasional nocturnal buildup myoclonic "cascade" seizures, slowing of
      EEG alpha-activity, episodic 4-6 Hz bilateral sharp waves and polyspikes with
      myoclonias on photic stimulation, and a disabling myoclonic stage at the age of
      16-18 years, with periodic generalized myoclonias, nocturnal myoclonic "cascade"
      seizures, ataxia, dysarthria, mental changes, intermittent wheelchair dependency,
      and continuous EEG slow waves with polyspikes and intense myoclonias on photic
      stimulation. One of the siblings died at the age of 18 years with no apparent
      cause of death. Treatment with antiepileptic drugs other than valproate may have
      contributed but none of the siblings were ever treated with phenytoin. Extensive
      clinical and laboratory investigations revealed no abnormalities and excluded
      other known possible causes of progressive myoclonus epilepsy. The diagnosis was
      consistent with Unverricht-Lundborg disease and rested on typical age of onset,
      clinical signs, EEG, and evoked response abnormalities. Buildup myoclonic
      seizures are typical in advanced stages of Unverricht-Lundborg disease. We have
      labeled these myoclonic "cascade" seizures. A typical seizure was studied with
      video-EEG and cardiorespiratory monitoring. Characteristics revealed were onset
      with continuous arrhythmic myoclonic jerks followed by intense rhythmic myoclonus
      with increasing muscle tone that successively reduced the amplitude of the jerks.
      The EEG during the whole seizure showed intense polyspike activity. Obstructive
      apnea was seen at the peak of the seizure. There were no cardiac dysrhythmias.
      Consciousness was normal or only slightly impaired. Postictal drowsiness was not
      observed. Myoclonic "cascade" seizures are easily confused with generalized tonic
      clonic seizures.

PMID- 1743165
TI  - Epileptic nystagmus.
AB  - Two cases of epileptic nystagmus (EN) are described. The first patient had no
      history of seizures and experienced attacks of EN associated with oscillopsia and
      followed by horizontal diplopia and esotropia. These episodes could be triggered
      by certain visual stimuli and ocular pressure. The second patient had a history
      of generalized tonic-clonic seizures. He displayed episodes of EN that changed
      direction in the course of the attacks simultaneously with a shift of the EEG
      discharge from one occipital region to the other. Cortical blindness followed
      postictally. On recovery from the postictal state, both patients were
      neurologically normal. With standard electrodes, the EEG seizures associated with
      EN involved the occipital, posterotemporal, and parietal areas of the scalp
      contralateral to the fast phase of the nystagmus. In the first patient, use of
      supplementary scalp electrodes further localized the seizures to an anterior
      occipital site intermediate between standard occipital and posterotemporal
      electrodes. Thirty-six previously reported cases of EN were associated with
      partial seizures. Horizontal EN most commonly results from seizure activity
      involving the occipital cortex, although participation of adjoining portions of
      the parietal and temporal cortexes is possible.

PMID- 1743166
TI  - Epilepsy: diagnostic and treatment strategies for the next decade. Tenth Annual
      Merritt-Putnam Symposium. November 15, 1990, San Diego, California. Proceedings.

PMID- 1743167
TI  - Do seizures cause brain damage?
AB  - Children with epilepsy are at significant risk for cognitive impairment and
      behavioral abnormalities. In most children with epilepsy, the likely reason for
      cognitive impairment is the underlying pathology responsible for the seizures.
      However, there is considerable controversy about whether seizures per se can
      cause brain damage or increase subsequent susceptibility to seizure. Although
      some longitudinal studies have related a decline in intellectual abilities to
      continued seizures, other studies indicate that treatment with antiepileptic
      drugs or progression of the encephalopathic process is responsible for the
      decline. Both clinical and animal studies have focused on the long-term effects
      of seizures on the developing brain. Whereas prolonged seizures may cause
      permanent neurologic sequelae in the mature animal, the immature brain may be
      more resistant to the long-term sequelae of seizures.

PMID- 1743168
TI  - Localization of partial epilepsy using magnetic and electric measurements.
AB  - Dipole methods applied to brain electric and magnetic fields have made several
      significant advances in investigation of epilepsy and sensorimotor cortex. The
      magnetoencephalogram (MEG) and the MEG-electroencephalogram (EEG) combination
      have contributed substantially. The MEG-EEG combination has shown a mean accuracy
      of somatosensory evoked response (SER) localization of the central fissure
      similar to electrocorticography (ECoG), resolution of ambiguity in ECoG of
      alternative configurations of hand sensorimotor cortex, and resolution of
      ambiguity of the causes of the difference between EEG and ECoG map patterns. MEG
      has shown simple dipolar maps of the temporal lobe interictal spike, localization
      estimates with about 6 mm error, and spatial separation of propagating multiple
      sources. MEG and EEG have shown a new neocortical propagation pathway in the
      temporal lobe, noninvasive estimates of the area of the spike focus, and
      complementary detection sensitivity. Application of spatiotemporal multiple
      dipole modeling in the simplest field using MEG has given a realistic
      quantification of spike zones. MEG and EEG have shown simple dipolar patterns for
      seizure origin, suggesting focality of some frontal seizures, and appears to
      increase EEG utility. Improved accuracy may result from a combined methodology
      including MEG and EEG. Dipole methods have potential utility as a noninvasive
      diagnostic procedure in epilepsy.

PMID- 1743169
TI  - Functional anatomy: a challenge for the decade of the brain.
AB  - At the beginning of the "Decade of the Brain," a number of aims for epilepsy
      research can be identified. These range from fundamental questions about the
      mechanisms of seizure etiology to the ways that seizures disturb brain function
      and structure. Information from such research will help in the development of new
      treatment and rehabilitative strategies for patients with epilepsy. Current tools
      from molecular biology have greatly expanded the promise and challenges for
      epilepsy research. As these investigative efforts are undertaken, however, it is
      important to recall the biological environment in which epilepsy occurs. Three
      major axes can be identified: the organizational axis (spanning from molecules
      through synapses to neuronal circuits to behavior), the time axis (relating to
      the chronobiology of epilepsy and diversities of seizure expression as a function
      of age), and the functional-anatomy axis (relating to the rich heterogeneity of
      the brain). Focusing on functional anatomy, certain principles can be developed
      from work with experimental models of seizures in the hippocampus and related
      structures. Three levels of functional anatomy are examined--network, local
      circuit, and individual neuron. This information can serve as a basis for
      directing epilepsy research in the future.

PMID- 1743170
TI  - Localization of lesions by neuropsychological testing.
AB  - Neuropsychological evaluation differs from other methods used to localize
      cerebral lesions in that it analyzes cognitive function. Tests sample widely
      among cognitive abilities, contrasting language proficiency with visuospatial
      skills. A thorough assessment of memory is crucial in the investigation because
      of the prominence of the temporal lobes in epileptogenesis and their importance
      in memory. Different aspects of learning and memory are tested, and measures
      sensitive to hippocampal function should be included. Patients who will undergo
      elective surgery may also undergo intracarotid sodium amobarbital tests, which
      provide additional information about the integrity of each hippocampal region.
      Appraisal of frontal-lobe function is another important part of
      neuropsychological evaluation. A growing number and variety of neuropsychological
      tests have proven to be sensitive to lesions in this large and complex cortical
      area. Frontal-lobe function could be expected to vary according to the function
      of subregions within the frontal lobes, and some tests appear to be sensitive to
      specific regions.

PMID- 1743171
TI  - Pharmacokinetic pitfalls of present antiepileptic medications.
AB  - Some patients fail to respond to antiepileptic drugs (AEDs) or their response
      varies over time. Unexpected fluctuations in AED concentrations can cause loss of
      seizure control or side effects. Recent advances in AED clinical pharmacology
      have characterized a number of factors that alter AED concentrations. Storage of
      carbamazepine (CBZ) and phenytoin (PHT) formulations in hot, humid conditions
      alters the dosage form and reduces bioavailability up to 50%. Diurnal changes in
      gastrointestinal physiology affect disintegration of valproate (VPA) enteric
      coated tablets, reducing nighttime drug concentrations 30 to 40% compared with
      daytime values. Drug-drug interactions or pathophysiologic conditions (e.g.,
      hypoalbuminemia) may displace AEDs from protein-binding sites reducing total but
      not unbound drug concentrations decrease. VPA not only displaces PHT from protein
      binding sites but inhibits its metabolism, causing a decrease in total
      concentration and an increase in the unbound concentration, occasionally
      necessitating a reduction in PHT dosage. Alterations in drug metabolism can cause
      fluctuations in the concentrations of AEDs and active metabolites. Enzyme
      inhibitors such as cimetidine or VPA can increase concentrations of both CBZ and
      CBZ epoxide (CBZE). Enzyme inducers such as ethanol, PHT, CBZ, and phenobarbital
      accelerate the metabolism of other AEDs. Some forms of physiologic stress
      increase binding to alpha 1-acid glycoprotein (AAG), which is stimulated within
      hours of a myocardial infarction or major surgery. Total CBZ and CBZE, both of
      which bind to AAG, increase over the same period. Stress may also activate
      hepatic drug metabolism. Unbound PHT clearance increases 7 to 21 days following
      head trauma, necessitating larger maintenance doses. Age greater than 65 years is
      associated with decreases in protein binding and drug clearance and longer
      elimination half-lives. In elderly patients, AED dosage may need to be reduced
      and the dosing interval extended. Knowledge of these factors permits prospective
      assessment of risk and the design of treatment plans that minimize fluctuations
      in response.

PMID- 1743172
TI  - New pharmacokinetic methods for the study of antiepileptic medications of the
      1990s.
AB  - New methods that will be useful in the study of the pharmacokinetics of both new
      and established antiepileptic drugs include stable-isotope tracer techniques for
      studies of absorption, elimination, and drug interactions; the microperfusion
      technique and the staggered stable-isotope administration technique for the study
      of distribution; and the correction of trough drug serum concentration values to
      mean serum concentration values. New pharmacokinetic methods for a study of drugs
      with new and unique properties include a double stable-isotope technique to deal
      with the unique pharmacokinetic properties of prodrugs and techniques for
      describing the biologic half-life of drugs that have a high affinity for active
      sites.

PMID- 1743173
TI  - Routine laboratory monitoring for serious adverse effects of antiepileptic
      medications: the controversy.
AB  - Rare, serious adverse effects of antiepileptic drugs (AEDs) include
      hepatotoxicity and bone marrow suppression. Current management includes routine
      laboratory monitoring during therapy with AEDs, a practice, however, that is
      controversial, as some clinicians believe that such monitoring is ineffective and
      that clinical monitoring is sufficient. Unfortunately, routine laboratory
      monitoring cannot predict acute idiosyncratic drug reactions, which will remain
      unpreventable until specific markers are available to identify susceptible
      patients. Nevertheless, routine laboratory monitoring may be helpful for early
      detection of chronic adverse reactions such as subclinical hepatotoxicity,
      leukopenia, or thrombocytopenia, which are usually mild and clinically
      insignificant but are occasionally more severe. Routine liver function tests may
      be especially important during valproate therapy because pathologic data suggest
      that some cases of valproate (VPA)-induced hepatic failure are the result of
      chronic liver damage and cirrhosis. Although levels of hepatic enzymes may be
      elevated during an early reversible stage of VPA toxicity, by the time clinical
      symptoms develop, hepatic failure may be irreversible.

PMID- 1743174
TI  - Can humans think? The Ergonomics Society Lecture 1991.
AB  - For many years, computer scientists have been concerned with whether computers
      can think. Considerable thought, therefore, goes into designing 'thinking'
      computer systems and into wondering whether they really can think, or just
      pretend to. On the other hand, it is 'obvious' that humans can think, and
      therefore little thought has gone into the related question, 'Can humans think?'
      This paper explores the ergonomic implications of the affirmative answer.
      Computers get better treatment than humans, yet humans are more than machines.
      However, not only do designers seem to forget this, but they do not even treat
      users with the same respect as they would a machine.

PMID- 1743175
TI  - The effect of the size of one and two traffic signs on two measures of perceptual
      performance.
AB  - A large object can delay the perception of a small object, which hints that the
      use of larger objects in general and larger traffic signs in particular may be
      counterproductive. The present study employed either one traffic sign or two
      contiguous traffic signs on a post in a photograph of a road scene.
      Identification of a small target sign was not slower when a second sign was
      contiguous than when there was only the one small target sign, regardless of
      whether the contiguous sign was large or small. Furthermore, when a counting task
      was used with the same stimuli, a large sign accelerated the response to two-sign
      stimuli, again regardless of the contiguous sign's size. In addition, the
      response to two-sign stimuli was not slower than the response to one-sign
      stimuli. The large small comparisons of both experiments reduce the concern that
      employing a large traffic sign will delay the perception of a second contiguous
      sign. Moreover, the one-two comparisons of both experiments imply that employing
      two contiguous signs will not delay the perception of a sign, despite widespread
      evidence that a nearby object will delay the perception of a target object.

PMID- 1743176
TI  - Effects of vertical vibration on passenger activities: writing and drinking.
AB  - Two laboratory studies have investigated how handwriting ability and holding a
      cup of liquid depend on the characteristics of whole-body vertical vibration. The
      effects of vibration magnitude (0.16 to 2.5 ms-2 r.m.s.), vibration frequency
      (0.5 to 10 Hz), and vibration duration (2 cycles to 10 s) on handwriting were
      studied with 20 subjects. Subjects were asked to copy letters of the alphabet by
      writing on a hand-held surface. Writing speed decreased and subjective ratings of
      writing difficulty increased with increasing vibration magnitude, particularly in
      the frequency range 4 to 8 Hz. Writing difficulty also increased with increasing
      duration of vibration. A 10 s exposure to 5 Hz vibration at 2.0 ms-2 r.m.s.
      resulted in subjective estimates corresponding to 'extremely difficult'. The
      effects of vibration magnitude (0.63 to 1.6 ms-2 r.m.s.), vibration frequency
      (0.5 to 10 Hz), and vibration duration (2 cycles to 10 s) on the spilling of
      liquid from a hand-held cup were also investigated in a group of 20 subjects. The
      probability of spilling the liquid, the quantity of liquid spilt, and subject's
      estimates of the probability of spillage were determined for all conditions.
      Greatest interference with the task occurred at 4 Hz, with the lowest vibration
      magnitude (0.63 ms-2 r.m.s.) causing measured and estimated spillage
      probabilities of approximately 85%. The interference was much less at other
      frequencies, with 0.63 ms-2 r.m.s. causing less than 10% measured probability of
      spillage below 3 Hz and above 5 Hz. The estimated probability of spillage was
      generally greater than the observed probability of spillage when the spillage
      probability was low, but less than the observed probability when the spillage
      probability was high. Increasing the duration of vibration increased the
      probability of spillage, and also increased the volume of liquid spilt.

PMID- 1743177
TI  - Workload and musculoskeletal problems: a comparison between welders and office
      clerks (with reference also to fishermen).
AB  - Previous studies have shown that subjective as well as clinical shoulder signs
      and symptoms are more common among welders than among office clerks. In the
      present study we wished to further evaluate the influence of different jobs on
      musculoskeletal problems, as well as the relationship between objective signs and
      subjective symptoms. This study confirmed that symptoms and signs from the
      shoulder were more common among the welders, who also had more subjective
      symptoms and clinical signs from other parts of the musculoskeletal system. Range
      of motion in different joint systems was, however, similar in the two groups
      except in external rotation of the shoulder, where welders had a more limited
      range. The degree of co-existence of subjective symptoms and clinical signs
      differed between different parts of the musculoskeletal system and was low
      particularly in the low back, hips, and ankles. This indicates low validity of
      many common clinical methods for determining musculoskeletal dysfunction. General
      health was good in both vocational groups and isometric strength for the welders
      was intermediate between that of office clerks (who had lower strength) and that
      of fishermen (who had higher strength, as disclosed in a previous investigation).
      To a similar degree welders and fishermen also had objective signs from most
      parts of the musculoskeletal system, whereas subjective symptoms from some parts
      of the body and medical consultations due to these problems were more common
      among welders. Atrophied shoulder muscles were more common among welders than
      among fishermen, whereas crepitations in the shoulder tended to be more common
      among the fishermen. This indicates that heavy dynamic work and prolonged static
      work may both induce shoulder injuries, but of different types.

PMID- 1743178
TI  - The design of manual handling tasks: revised tables of maximum acceptable weights
      and forces.
AB  - Four new manual handling experiments are reviewed. The experiment used male and
      female subjects to study lifting, lowering, pushing, pulling, and carrying tasks.
      Each experiment used a psychophysical methodology with measurements of oxygen
      consumption, heart rate, and anthropometric characteristics. Independent
      variables included task frequency, distance, height and duration; object size and
      handles; extended horizontal reach; and combination tasks. The results of the
      four experiments were integrated with the results of seven similar experiments
      published previously by this laboratory. The integrated data were used to revise
      maximum acceptable weights and forces originally published in 1978. The revised
      tables are presented and compared with the original tables.

PMID- 1743179
TI  - The objective measurement of pain using a motor-performance task.
AB  - An objective method for measuring endogenous pain in the wrist which originates
      in cervicobrachial disorders was improved. The method employed the plate-pushing
      task, which was reported previously (Taniguchi and Satow 1988a, b). The first
      improvement was achieved by introducing a load to be placed on the wrist while
      subjects were pushing the plate. In this way, it became easier to induce pain
      caused by disorders in the wrist. Another improvement was a new procedure by
      which a subject was told to change her pressure against a balance as instructed.
      This made it possible to identify the degree of pressure exerted which produce
      pain. Effects of dominance of hands, and of ordering the trials so as to begin
      with the dominant hand and switch to non-dominant, or vice versa in the tests
      were also examined, but were found to be not significant. Finally, the new method
      proved to be highly useful as an objective method for measuring pain of this sort
      because the method could produce very similar conditions to those associated with
      ordinary pain causing motion.

PMID- 1743180
TI  - The effects of alcohol on learning as a function of drinking habits.
AB  - Thirty-six subjects were categorized as light social drinkers (LSD) and 36 as
      heavy social drinkers (HSD) on the basis of both biological criteria, gamma
      glutamyl transferase (GGT) and the mean corpuscular volume (MCV) and by self
      reports of drinking habits. This study examined the effects of alcohol (0.7
      ml/kg) and of noise (75 dB(A] on learning and performance, in choice RT and in
      immediate memory tasks. Each subject was tested in two consecutive sessions (the
      time factor) under one of the following experimental conditions: (a) silence +
      placebo; (b) silence + alcohol; (c) noise + placebo; and (d) noise + alcohol. On
      immediate memory, there was a strong effect of time which interacted with
      'drinker' category, suggesting that HSD subjects learn less rapidly than LSD.
      Time interacted also with state (sober or intoxicated), showing that learning
      might be impaired even by a moderate dose of alcohol. On the reaction time task
      no main effects were found but the time X drinker category interaction was
      significant; in session 1 LSD's RT were shorter than those of HSD. It is
      suggested that regular heavy drinking might affect the learning abilities of
      those who are not yet labelled as alcoholics.

PMID- 1743181
TI  - Amygdaloid kindling during wakefulness and paradoxical sleep in the cat. 2. Sleep
      organization changes produced by kindling development.
AB  - The effect of daily electrical amygdaloid stimulation (kindling, K) during waking
      (W-K) and paradoxical sleep (PS-K) on sleep organization was tested in 2 groups
      of chronically implanted adult male cats. Animals were stimulated 3 h after the 8
      h sleep recordings were begun. Percentage, total time, and mean duration and
      number of episodes of W, slow wave sleep I and II, and PS stages were determined.
      Also, the mean interval of occurrence and hourly accumulation of PS were
      assessed. Recordings were performed before, throughout, and immediately after
      kindling and 2 months after the last recorded kindled seizures. Analysis of total
      recording time demonstrated that in both W-K and PS-K animals the kindling
      process provoked only transitory changes which returned to baseline values during
      kindling and immediately after. Analysis of pre- and post-stimulation periods
      demonstrated compensatory changes in W and PS percentage during the late stages
      of kindling. We conclude that rather than sleep diminution, kindling provokes a
      circadian shift of W and PS stages.

PMID- 1743182
TI  - A comparison of recurrent inhibition and of paired-pulse facilitation in
      hippocampal slices from normal and genetically epileptic mice.
AB  - Tottering mice exhibit inherited generalized epilepsy of the 'absence' type. In
      hippocampal slices from these mutant mice studied in vitro, pairing an alvear
      antidromic stimulus to an orthodromic one revealed a strong recurrent inhibition
      (RI) of CA1 pyramidal neurons. RI was maximal at 10 ms inter-pulse interval (IPI
      70% decrease of population spike, PS) gradually decreasing to 15% at 320 ms IPI.
      At 10 ms IPI it shifted the input/output curves to the right and decreased
      maximum PS. In the group of slices from epileptic mice the early part of RI (2.5
      60 ms) was indistinguishable from that of normal mice, with respect to both its
      strength and its liability to activity-dependent decrement induced by a train of
      antidromic stimuli (8 s, 5 Hz). However, the delayed part (80-320 ms) was
      slightly stronger in the epileptic group. Also in this group only the train of
      antidromic pulses caused a significant and lasting decrease in the unconditioned
      orthodromic PS. Paired-pulse facilitation was equally strong in the 2 groups of
      slices. It is concluded that mechanisms underlying epileptogenic
      hyperexcitability in the tottering mutant may not include a failure of
      inhibition, at least in the CA1 area of the hippocampus. On the contrary some
      inhibitory mechanisms may be stronger.

PMID- 1743183
TI  - Trans-2-en-valproate: reevaluation of its anticonvulsant efficacy in standardized
      seizure models in mice, rats and dogs.
AB  - The anticonvulsant potency of the trans isomer of 2-en-valproate (trans-2-en-VPA)
      was determined in standardized models for different seizure types in rodents and
      dogs. In mice and rats, adverse effects were quantified by the rotarod and
      chimney tests. Clinically established antiepileptic drugs (valproate,
      ethosuximide, phenobarbital, carbamazepine, phenytoin, diazepam) were used for
      comparison. Based on time course studies, drug potencies were determined and
      compared at the individual time of peak anticonvulsant effect. Potency
      comparisons were based on administered dosages and, in the case of trans-2-en-VPA
      and valproate, also on plasma levels determined after administration of
      anticonvulsant doses. The data show that trans-2-en-VPA exerts anticonvulsant
      effects against different seizure types, i.e., myoclonic, clonic, and tonic
      seizures in rodents and (myo)clonic seizures in dogs. In most seizure models,
      trans-2-en-VPA was more potent than valproate, when both compounds were compared
      at their individual times of peak effect. Time course and pharmacokinetic studies
      showed that duration of action and pharmacokinetic characteristics of trans-2-en
      VPA and valproate are similar. In the rotarod and chimney tests in mice and rats,
      trans-2-en-VPA was more potent than valproate. However, because of the higher
      anticonvulsant potency of trans-2-en-VPA, protective indices calculated from
      rodent models were similar to those of valproate. Similarly, in dogs trans-2-en
      VPA exerted anticonvulsant effects at doses below those which induced sedation
      and ataxia. In view of the previously reported advantages of trans-2-en-VPA
      compared to valproate with respect to teratogenic and hepatotoxic effects, the
      present data substantiate that trans-2-en-VPA might be a valuable alternative to
      valproate in antiepileptic therapy.

PMID- 1743184
TI  - Spike-wave discharges and sleep-wake states in rats with absence epilepsy.
AB  - The occurrence of spike-wave discharges was studied in relation to the daily
      fluctuations of vigilance level in rats. Eight rats of the WAG/Rij strain, an
      animal model for idiopathic generalized epilepsy of the absence type, which were
      equipped with cortical EEG and nuchal EMG electrodes, served as subjects. It was
      found that spike-wave discharges predominantly occur during light slow wave sleep
      and passive wakefulness. REM sleep, active wakefulness, and deep slow wave sleep
      are less susceptible to the occurrence of spike-wave discharges. Finally, spike
      wave discharges tend to prevail in transitional states. A crucial role for the
      degree of stability of the level of vigilance in the genesis of absence seizures
      is suggested.

PMID- 1743185
TI  - Seizure frequency, patient-perceived seizure severity and the psychosocial
      consequences of intractable epilepsy.
AB  - It is generally recognised that the assessment of treatment effects in epilepsy
      using seizure frequency as the only outcome measure may lack sensitivity. A
      patient-based seizure severity scale has been developed and initial results
      confirm its reliability and validity. As part of the further development of this
      scale it is important to explore the relationship between seizure severity,
      seizure frequency and the psychosocial consequences of intractable epilepsy. One
      hundred patients with medically refractory partial seizures completed a quality
      of life questionnaire including measures of physical (seizure severity and
      frequency), social and psychological well-being (anxiety, depression, self
      esteem, locus of control and happiness). Multivariate analysis demonstrated that
      individual psychological variables were best predicted by other psychological
      variables. However, when these were removed from analysis, seizure severity was
      the most significant predictor of self-esteem (P = 0.005), locus of control P =
      0.039) and anxiety (P = 0.048). Seizure frequency did not contribute
      significantly to the variance of any of the psychological factors. These results
      highlight the importance of considering seizure severity when assessing treatment
      effects in epilepsy and provide further evidence for the construct validity of a
      novel patient-based seizure severity scale.

PMID- 1743186
TI  - Magnetic resonance of intracranial epidermoids.
AB  - The magnetic resonance images of seven patients with biopsy-proven epidermoids
      were evaluated. The epidermoids were hypointense on T1-weighted images.
      Intermediate density images revealed the tumors to be heterogeneous in signal
      intensity consisting of areas of hypo- and isointensity. Signal intensity on T2
      weighted images was hyperintense and inhomogeneous in all but one case. CT
      performed in five patients demonstrated the tumors to be well-defined hypodense
      lesions without contrast enhancement.

PMID- 1743187
TI  - Paranasal sinuses in pediatric patients by MRI: normal development and
      preliminary findings in disease.
AB  - A two-part study using medium field strength magnetic resonance imaging (MRI) was
      designed to describe the normal paranasal sinus development and to provide
      preliminary criteria for clinical sinus disease. In part I of the study the
      paranasal sinuses were retrospectively evaluated in 80 infants and children aged
      0-17 years undergoing brain MRI for indications both unrelated and related to
      sinus disease. We developed MRI criteria for independent grading of paranasal
      sinus development and 'anatomical' sinus disease, i.e., disease as seen by the
      radiologist. We quantified the variability in extent of sinus pneumatization (a
      measure of sinus development) in infants and young children. Part II of the study
      was a double-blind prospective study in 21 patients to correlate 'anatomical'
      disease with 'clinical' sinus disease. In this limited preliminary study,
      clinical sinus disease was only seen in the patients with moderate or severe
      anatomical disease (sensitivity 100%; specificity 100%).

PMID- 1743188
TI  - Radioisotopic detection of portal hemodynamic changes after liver surgery.

PMID- 1743189
TI  - Radiology of the AS 800 artificial urinary sphincter; normal appearances and
      complications.
AB  - Thirteen adult male patients who had an AS 800 artificial urinary sphincter
      inserted are reviewed. Five have had malfunction, and in four the causes were
      diagnosed radiologically. These included: fistula formation, leakage of hydraulic
      fluid, air in the system, and inadequate deflation of the cuff. Since the
      sphincter is filled with contrast medium, it is ideally suited to radiological
      assessment.

PMID- 1743190
TI  - Preliminary European intravenous clinical experience with a new, low osmolar,
      nonionic contrast medium: ioversol (Optiray).
AB  - The intravenous clinical trial program of ioversol (Optiray), a low osmolar,
      nonionic, monomeric contrast agent characterized by high hydrophilicity, is
      evaluated on the basis of results from the first clinical trials conducted in
      Europe as part of the development of the 300 and 350 mgI/ml formulations: 7
      double-blind, comparative trials and 5 single trials were performed in a total of
      743 patients, of whom 472 received ioversol and 271 a monomeric nonionic
      reference product. The diagnostic efficacy of ioversol was equivalent or superior
      to that of the reference products and tolerance was comparable to that of
      nonionic agents in terms of pain and heat sensations. No significant difference
      in adverse reactions was found and all the contrast agents studied were well
      tolerated by the patients.

PMID- 1743191
TI  - Effects of two low osmolality contrast media on red blood cell filterability and
      aggregation in vitro.
AB  - The in vitro effects of ionic ioxaglate and non-ionic iopamidol were compared.
      Filtration measurements were carried out on an hemorheometer; erythrocyte
      aggregation was evaluated by means of an erythrocyte aggregometer, and red blood
      cell morphology was observed with an optical microscope. Ioxaglate and iopamidol
      reduced erythrocyte filterability to the same extent; by contrast neither ionic
      nor non-ionic contrast media significantly modified aggregation or shape of red
      blood cells. The decrease of erythrocyte deformability observed in this study may
      cause clotting in catheters or syringes during angiographies investigations.

PMID- 1743192
TI  - CT diagnosis of isolated systemic supply to the lung: a congenital broncho
      pulmonary vascular malformation.

PMID- 1743193
TI  - Effects of optimization and image processing in digital chest radiography: an ROC
      study with an anthropomorphic phantom.
AB  - A digital system for chest radiography based on a large image intensifier was
      compared to a conventional film-screen system. The digital system was optimized
      with regard to spatial and contrast resolution and dose. The images were
      digitally processed for contrast and edge enhancement. A simulated pneumothorax
      and two simulated nodules were positioned over the lungs and the mediastinum of
      an anthropomorphic phantom. Observer performance was evaluated with ROC analysis.
      Five observers assessed the processed digital images and the conventional full
      size radiographs. The time spent viewing the full-size radiographs and the
      digital images was recorded. For the simulated pneumothorax, the results showed
      perfect performance for the full-size radiographs and detectability was high also
      for the processed digital images. No significant difference in the detectability
      of the simulated nodules was seen between the two imaging systems. The results
      for the digital images showed a significantly improved detectability for the
      nodules in the mediastinum as compared to a previous ROC study where no
      optimization and image processing was available. No significant difference in
      detectability was seen between the former and the present ROC study for small
      nodules in the lung. No difference was seen in the time spent assessing the
      conventional full-size radiographs and the digital images. The study indicates
      that processed digital images produced by a large image intensifier are equal in
      image quality to conventional full-size radiographs for low-contrast objects such
      as nodules.

PMID- 1743194
TI  - Digital chest radiography: should images be presented in negative or positive
      mode?
AB  - The observer performance for video monitor images presented in positive mode
      ('bones black') was compared to that of images presented in negative mode ('bones
      white') in a digital system for chest radiography based on a large image
      intensifier. In the first part of the study (I), the original, non-linear grey
      scale reversal performed in the computer of the digital image intensifier system
      (DS1000) was studied together with fixed and variable settings of light and
      contrast. In the second part of the study (II), true grey-scale reversal
      performed in a minicomputer (Micro VAX II) where the images were also processed
      with edge and contrast enhancement, was studied. The time spent viewing the
      images was also recorded. Before the second part of the study, the image
      intensifier system was optimized with regard to spatial and contrast resolution
      and dose settings. Simulated pathology was randomly positioned over the lungs and
      the mediastinum of an anthropomorphic phantom. Observer performance was evaluated
      with Receiver Operating Characteristic (ROC) analysis on the digital images. In
      the first part of the study, a significant advantage for the positive images was
      seen, but no significant difference between fixed and variable settings of light
      and contrast. In the second part of the study, no significant difference in the
      detectability of the test structures was seen between positive and negative
      images. A significant improvement in the detectability was seen between the first
      and the second part of the study for the nodules over the mediastinum in both
      negative and positive images. No significant difference in the time spent
      observing positive and negative images, was seen.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1743195
TI  - The scatter-to-primary ratio as a function of varying X-ray absorption measured
      by computed radiography.
AB  - Some scatter studies have previously been conducted using film as a detector. The
      serious limitations caused by the narrow latitude, the non-linear density
      response, and the required optical densitometric measurements of film can be
      avoided by computed radiography (CR) which provides linear numeric data over a
      wide dynamic range. The imaging plate is used as a large-area detector and the
      data is analyzed from the computer memory. Variation in the scatter-to-primary
      ratio within an image caused by absorption differences was simulated in a water
      aluminum phantom. The measurement technique showed repeatable results, being
      comparable to the values expected on the basis of previous studies. A multiple
      pencil-beam (MPB) imaging device was also compared to a standard 1:12 grid by
      this technique. The maximal scatter-to-primary ratio in our model was up to 7.9
      with no scatter reduction, 1.5 with grid, and 0.4 with the MPB device. The
      variation caused by the absorption of primary radiation was much less in the MPB
      modality, and the MPB system was also less sensitive to an increase in the used
      tube voltage from 60 to 120 kVp. The benefits of multiple pencil-beam imaging in
      scatter reduction are briefly discussed.

PMID- 1743196
TI  - Transabdominal ultrasound of the stomach: a pictorial essay.

PMID- 1743197
TI  - Radiologic aspects of breast cancers detected through a breast cancer screening
      program.
AB  - Early detection of breast cancer and reduced mortality in women with this disease
      is today attributed to the widespread use of mammography. High-quality
      performance is essential in every step of breast cancer screening programs in
      order to avoid unnecessary anxiety and surgery in the women concerned. This
      report presents the radiologic aspects of screening cancers. A total of 8370
      asymptomatic women aged between 50-69 years were screened with 2-view
      mammography, of which only 70 (0.84%) were selected for surgery after a thorough
      work-up. Cancers were verified histologically in 61 women and 9 showed non
      malignant histology, giving a cancer detection rate of 7.3 cancers per thousand
      screened asymptomatic woman. The benign/malignant ratio in the operated cases is
      thus approximately 1:7. The cancers detected showed all existing types of
      mammographic features where 77% (47 cases) showed rather typical findings, such
      as spiculated densities both with and without microcalcifications and with
      microcalcifications only. The remaining 23% (14 cases) showed parenchymal
      distortions, asymmetric and well-defined densities, both with and without
      calcifications. Our results indicate that surgery can be minimized without
      impairing the breast cancer detection rate. Radiologists in screening programs
      should be aware that a large proportion of non-palpable breast cancers present in
      rather unconventional forms. This point is important in order to maintain a high
      cancer detection rate and thereby justify the widespread use of mammography as a
      screening tool for breast cancer in asymptomatic women.

PMID- 1743198
TI  - Fibroadenoma of the breast: in vivo magnetic resonance characterization.

PMID- 1743200
TI  - 1992 and all that.

PMID- 1743199
TI  - Magnetic resonance findings in 92 acoustic neuromas.
AB  - A retrospective analysis of the MR findings in 92 cases of acoustic neuromas is
      presented. The method of examination included in all cases intravenous injection
      of Gadolinium (Gd-DTPA or DOTA) with realization of sections in the axial and
      coronal planes. In 21 cases native MR studies were performed in the axial plane,
      before Gadolinium injection, with T1WI (n = 21), and T2WI (n = 6) images. Tumors
      were strictly intracanalar in 19 cases (20.7%), only localized in the
      cerebellopontine angle (CPA) in 5 cases (5.4%), and in 68 cases (73.9%) the
      tumors had intra- and extracanalar components. In this last group of lesions,
      63.2% completely filled the internal auditory canal (IAC), and 36.8% occupied the
      internal portion of the IAC. In most cases (85.3%) the mean diameter of the CPA
      component was less than or equal to 2.5 cm. Lesions were more frequently
      homogeneous (58.8%) after Gd i.v.-enhancement. Heterogeneity was noted mainly in
      large lesions (greater than 2.5 cm: 100%). In all cases but one, the tumors were
      round, or oval-shaped, well-delineated, and did not present significant contact
      with the petrous bone. In 80.9% of CPA lesions, the center of the tumor was
      posteriorly excentered in relation to the internal auditory canal, whereas it was
      centered in 16.2% of cases. Widening of the IAC was observed in 51.1% of cases.
      In 45.2% of tumors of the CPA, smoothing of the posterior edge of the porus was
      visible.

PMID- 1743201
TI  - An autoradiography study of postoperatively labelled thyroid tissue and iodine
      storage.
AB  - Samples of fresh thyroid tissue obtained from 15 patients undergoing thyroid
      surgery were incubated with iodine 125 in culture solution to which thyroid
      stimulating hormone (TSH) had been added and then examined by autoradiography.
      The radioactivity registered actively during the 90-min incubation period was
      primarily found in the lumina of follicles. Even morphologically similar
      follicles showed very heterogeneous uptake of radioiodine; small follicles often
      contained the highest concentrations of activity. The method applied appears to
      be particularly useful for answering the question as to whether and to what
      extent individual papillary or follicular thyroid carcinomas are able to store
      radioiodine. This information obtained immediately after surgery may contribute
      towards establishing the patient's prognosis and help in deciding on
      postoperative therapy and follow-up. Because of the heterogeneity of radioiodine
      uptake, it is mandatory to examine a representative sample of carcinoma tissue in
      order to obtain well-established results.

PMID- 1743202
TI  - Effects of cigarette smoking on iodine 123 N-isopropyl-p-iodoamphetamine
      clearance from the lung.
AB  - Iodine 123 N-isopropyl-p-iodoamphetamine (123I-IMP), originally developed as a
      brain scanning agent, is also taken up by the lung. To evaluate the effects of
      cigarette smoking on the kinetics of IMP in the lung, we studied 123I-IMP
      clearance from the lung in 18 volunteers (8 non-smokers and 10 smokers). After
      the injection of 111 MBq of 123I-IMP into the medial cubital vein, the time
      activity curve for 60 min and the regional activity using 1 frame per minute and
      a 64 x 64 matrix were obtained. The 123I-IMP clearance curve was described as
      follows: C(t) = A1e-k1t + A2e-k2t (A1, A2: intercepts, and k1, k2: slopes of the
      exponential components). 123I-IMP clearance was delayed in smokers, and k2 was
      smaller in smokers. Also, a correlation between k1, k2, and the number of
      cigarettes smoked per day was found (r = -0.65, r = -0.74, respectively, P less
      than 0.01). In conclusion, this study suggests that the delayed clearance and
      retention of 123I-IMP in the lung indicate lung metabolic disorders due to
      cigarette smoking.

PMID- 1743203
TI  - Assessment of anthracycline-induced myocardial damage by quantitative indium 111
      myosin-specific monoclonal antibody studies.
AB  - To assess chemotherapeutically induced myocardial damage, myosin-specific
      antibody scans and ejection fraction measurements were performed in 32 patients
      with breast cancer and in 9 patients with other tumours. All patients had
      received chemotherapy including anthracyclines. The ejection fraction decreased
      by less than or equal to 10% in 14 of 41 (34%) patients after chemotherapy.
      Antimyosin uptake in the myocardium was observed in 38 of 41 (92%) patients after
      chemotherapy. Antimyosin uptake was quantified by means of a heart-to-lung ratio,
      revealing a correlation between the degree of antimyosin uptake in the myocardium
      and the cumulative dose of anthracycline. Patients with a decreased ejection
      fraction showed more intense antimyosin uptake, indicating more severe myocardial
      damage. A higher degree of antimyosin uptake was found in 17 breast cancer
      patients treated with doxorubicin compared with 15 patients treated with
      mitoxantrone. We conclude that antimyosin studies provide a sensitive, non
      invasive method to monitor myocardial damage in patients treated with
      anthracyclines. Antimyosin uptake in the myocardium precedes ejection fraction
      deterioration. This technique may be helpful in the early identification of
      patients at risk of congestive heart failure during chemotherapy including
      anthracyclines.

PMID- 1743204
TI  - Monoclonal antibody BW431/26 labelled with technetium 99m and indium 111: an
      investigation of the biodistribution and the dosimetry in patients.
AB  - As a competitive diagnostic tool for the detection of malignant tumours and other
      pathological conditions, monoclonal antibodies have long been established. Herein
      we give the biokinetic data of the antibody BW 431/26 and the consequent
      radiation dose to patients. These parameters were recorded in 39 patients, using
      the antibody labelled either with technetium 99m or indium 111. Remarkable
      differences were observed between the two radionuclides. Whereas the indium
      labelled one showed biexponential elimination kinetics, the technetium-labelled
      one is eliminated linearly over time. The distribution pattern of the two is
      identical, although the radiation dose varies quite a lot, being 20-fold higher
      with indium 111 when total body exposure is taken into account (for 111In the
      whole-body radiation exposure is 0.1 mGy/MBq; for 99mTc it is 0.0047 mGy/MBq).
      With respect to these results and considering the general availability of the
      technetium-labelled Ab, it is the best choice for diagnostic use.

PMID- 1743205
TI  - Clinical experience with the adrenal scanning agents iodine 131-19
      iodocholesterol and selenium 75-6-selenomethylcholesterol.
AB  - Adrenocortical scintigraphy with iodine 131-19-iodocholesterol or selenium 75-6
      selenomethylcholesterol was performed in 94 patients with proven or suspected
      adrenal disease. According to the final diagnosis, 36 patients suffered from
      primary aldosteronism, 33 from Cushing's syndrome, 8 from low renin hypertension,
      6 from nonfunctioning adrenal tumour, 4 from simple obesity, 3 from adrenal
      metastases, 1 from congenital adrenal hyperplasia, 1 from virilizing adrenal
      adenoma, 1 from extraadrenal phaeochromocytoma, 1 from ganglioneuroma. Surgical
      confirmation of the diagnosis was obtained in most cases. With a few exceptions,
      the scintigraphy results were consistent with the final diagnosis. The two
      tracers were equally effective adrenal scanning agents. Tracer concentration was
      measured in a number of surgical specimens, mostly from patients given
      selenocholesterol. This measurement in surgical samples has not been reported in
      previous studies with this agent. The results provided a direct validation of
      uptake measurements in vivo. The data, collected over a 17-year period,
      demonstrate that despite the advent of new imaging techniques, adrenal
      scintigraphy that gives both functional and morphologic information still has an
      important role in the diagnosis of adrenal disease.

PMID- 1743206
TI  - Excretion of gallium 67 in human breast milk and its inadvertent ingestion by a 9
      month-old child.
AB  - The concentration of radioactivity excreted in breast milk following the
      administration of gallium 67 to 3 patients was measured in milk samples obtained
      for several days after injection. Similar values were obtained from all 3
      patients, with milk samples obtained approximately 120 h after administration
      containing 4.3-5.7 Bq/ml per MBq of 67Ga administered. These values are lower
      than those previously reported. The image of a child who had inadvertently been
      breast-fed for 48 h after administration of 67Ga to the mother showed activity in
      the intestines only. Our results seem to confirm recommendations by other authors
      that gallium scintigraphy should be avoided in nursing mothers. Should the
      administration of 67Ga be inevitable, breastfeeding should be discontinued, since
      interruption periods of approximately 2 weeks may be required to reduce the
      effective dose equivalent to the infant below 1 mSv. However, close contact
      between mother and child need not be avoided.

PMID- 1743207
TI  - Facilitated transport of glucose from blood to brain in man and the effect of
      moderate hypoglycaemia on cerebral glucose utilization.
AB  - The effect of steady-state moderate hypoglycaemia on human brain homeostasis has
      been studied with positron emission tomography using [U-11C]-D-glucose as tracer.
      To rule out any effects of insulin, the plasma insulin concentration was
      maintained at the same level under normo- and hypoglycaemic conditions. Reduction
      of blood glucose by 55% increased the glucose clearance through the blood-brain
      barrier by 50% and reduced brain glucose consumption by 40%. Blood flow was not
      affected. The results are consistent with facilitated transport of glucose from
      blood to brain in humans. The maximal transport rate of glucose from blood to
      brain was found to be 62 +/- 19 (mean +/- SEM) mumol hg-1 min-1, and the half
      saturation constant was found to be 4.1 +/- 2.3 mM.

PMID- 1743209
TI  - Unexpected uptake of technetium 99m hexakis-2-methoxy-isobutylisonitrile in giant
      lymph node hyperplasia of the mediastinum (Castleman's disease).
AB  - The case of a patient with giant lymph node hyperplasia of the mediastinum who
      unexpectedly showed focal uptake of technetium 99m hexakis-2
      methoxyisobutylisonitrile (99mTc-MIBI) is presented in this article. The patient
      was included in our research programme of tumor imaging with 99mTc-MIBI because
      the appearance of the mass on the chest radiogram and CT scan resembled a
      mediastinal tumour. Final diagnosis of giant lymph node hyperplasia was achieved
      through histopathological examination of the surgically removed lymph node.

PMID- 1743208
TI  - Scintigraphy in the clinical evaluation of disorders of mineral and skeletal
      metabolism in renal failure.
AB  - In patients with renal bone disease skeletal and extra-skeletal abnormalities can
      be visualised using conventional bone scintigraphy. Some of these abnormalities
      are associated with characteristic scintigraphic appearances, which are reviewed
      in detail, and the possible mechanisms involved are discussed. Specific imaging
      with iodine 123 serum amyloid P component and iodine 131 beta 2-microglobulin is
      also discussed in the diagnosis of beta 2-microglobulin amyloidosis specific to
      patients on dialysis. In the light of available evidence, it appears that bone
      scintigraphy plays, so far, a limited role in the clinical evaluation of skeletal
      and extra-skeletal abnormalities in chronic renal failure. The potential role of
      bone scintigraphy in identifying patients with aluminium-related bone disease
      needs to be investigated further, and in this respect special attention must be
      given to the problem of high soft-tissue activity associated with impaired renal
      function. Timing haemodialysis sessions before scintigraphic imaging deserves
      wider recognition as it reduces high soft-tissue activity, thereby allowing bone
      uptake to be assessed more accurately. Specific imaging of amyloidosis resulting
      from beta 2-microglobulin deposition is a promising technique, but the relative
      value of the two proposed radiopharmaceuticals needs further clarification.

PMID- 1743210
TI  - A simple method for the preparation of gallium chloride from the citrate
      solution.

PMID- 1743211
TI  - Small-intestinal abnormalities in cystic fibrosis patients.
AB  - A survey is given of the pathophysiology of the main alterations in the small
      intestine of cystic fibrosis patients. Special attention is paid to the
      understanding of meconium ileus in the fetus and the newborn, the repercussion of
      duodenal acidity on the duodenal mucosa and the intraduodenal digestion, and
      primary and secondary biochemical alterations in the secretory-digestive
      absorptive function of the small-intestinal mucosa. The meconium equivalent
      syndrome and its connection with the atypical course of intussusception and
      appendiceal perforation with silent pelvic abscess are also discussed.

PMID- 1743212
TI  - Left ventricular thrombus in a 2-year-old boy with cardiomyopathy: lysis with
      recombinant tissue-type plasminogen activator.
AB  - A 2-year-old boy with cardiomyopathy and clinical signs of cardiac failure
      presented with an echodense structure in the left ventricle. This structure was
      seen from different echocardiographic views adjacent to a hypokinetic area of the
      apex and lateral free wall. It was different in texture and motion from the
      underlying myocardium and thus met the diagnostic criteria of a left ventricular
      thrombus. This thrombus protruded into the cavum and was partly mobile. In view
      of a high embolic risk, thrombolytic therapy with recombinant tissue plasminogen
      activator was started. The thrombus resolved within 72 h without any embolic or
      bleeding complications. No recurrence of the thrombus was observed during a 3
      month follow up period.

PMID- 1743213
TI  - Documented latent coeliac disease in a child with insulin-dependent diabetes
      mellitus.
AB  - The histological development of coeliac disease has been documented in a child
      with insulin-dependent diabetes mellitus (IDDM). Serum antigliadin IgG was
      temporarily present at the onset of IDDM. It is assumed that IDDM may exert a
      trigger effect on the development of coeliac disease.

PMID- 1743214
TI  - Optic gliomas in children with neurofibromatosis type 1.
AB  - Over a 24-year period, optic gliomas were found in 29 children, 16 of whom had
      neurofibromatosis type 1 (NF-1). These 16 children comprised 21% of all children
      referred for management of NF-1 and its complications. The finding of optic
      glioma led to the diagnosis of NF-1 in 4 children. The mean age at diagnosis of
      optic glioma in NF-1 children was 6.4 years, and the average estimated duration
      of visual symptoms prior to diagnosis was 2.1 years. Most optic gliomas in NF-1
      children were ascertained because of a visual complaint (69%), and an even
      greater number of children (88%) had an abnormal ophthalmological examination.
      The optic chiasm was involved in 75% of the patients. All of the seven children
      with optic glioma examined by visual evoked potential had an abnormal response
      ipsilateral to the tumour. The majority of the children received radiation
      therapy. After a mean follow up period of 5.8 years no deaths had occurred due to
      optic glioma, but in 35% of the children vision was worse. We conclude that optic
      glioma is a common, serious complication in NF-1 children. Routine care of such
      patients should include regular noninvasive investigations aimed at detecting
      lesions of the optic pathway.

PMID- 1743215
TI  - Cytoplasmic granules in leukaemic cells of the cerebrospinal fluid in a child
      with non-granular acute lymphocytic leukaemia.
AB  - We report a child with relapsed acute lymphocytic leukaemia in whom cytoplasmic
      granules were present in the leukaemic cells of the cerebrospinal fluid (CSF) but
      not in those of the bone marrow (BM). The leukaemic cells of the BM were of B
      cell lineage whereas those of the CSF had both B-cell and myeloid antigens.

PMID- 1743216
TI  - Transcobalamin II deficiency: case report and review of the literature.
AB  - A male Caucasian infant presented at 6 weeks of age with failure to thrive,
      diarrhoea, macrocytic anaemia, and decreased IgG. He had normal serum B12 and
      folate levels. Serum cobalamin binding capacity showed no detectable
      transcobalamin II. Both parents showed levels consistent with a heterozygous
      state. The literature is extensively reviewed, and the importance of early
      diagnosis to prevent neurological dysfunction is stressed.

PMID- 1743217
TI  - Cord serum IgE and early detection of the atopic phenotype: suitable for routine
      screening?
AB  - Cord serum IgE has been shown to be a valuable marker for the prediction of
      atopy. Our study was designed to verify these findings for possible systematic
      screening recommendation. Our study consisted of 338 children who were followed
      from birth to 18 months. Cord serum IgE was measured by paper immunosorbent test
      and radioimmunoassay. All other data (sex, family history and environment, diet,
      occurrence of atopic manifestations) were recorded. Of the 338 children, 118
      (34.9%) developed obvious clinical symptoms of atopy during the study period.
      Using the receiver operator curve we found an IgE level of 1.20 IU/ml to be the
      best cut-off point as a predictor of atopy with 95% specificity but 13%
      sensitivity. Combination with other predictors such as sex, family history,
      environmental factors and diet did not increase the predictive value of the test.
      Because of this low sensitivity we conclude that cord serum IgE is insufficient
      to detect individuals at risk for atopy even if associated with genetic and
      environmental factors. Thus it should not be recommended for routine screening
      purposes; more sensitive markers are needed.

PMID- 1743218
TI  - Cartilage hair hypoplasia in infancy: a misleading chondrodysplasia.
AB  - Among children with recessive metaphyseal dysplasia, cartilage hair hypoplasia,
      as described by McKusick is often recognized only during the 2nd year or later.
      The early radiological changes observed in six children with cartilage hair
      hypoplasia demonstrate the misleading aspect of this chondrodysplasia:
      micromelia, massive appearance of the long bones and round inferior femoral
      epiphyses, without distinct metaphyseal involvement. Early diagnosis permits the
      organisation of clinical, immunological and orthopaedic follow up and allows for
      correct genetic counselling.

PMID- 1743219
TI  - Chronic pancreatitis in a child with glycogen storage disease type 1.
AB  - A case of chronic pancreatitis in an 8-year-old boy with glycogen storage disease
      type 1a (GSD 1a) is presented. This patient had a history of hyperlipidaemia
      unresponsive to dietary therapy, e.g., a carbohydrate-rich diet, uncooked
      cornstarch, and nocturnal intragastric tube feedings. He had recently suffered
      bouts of abdominal pain and diarrhoea. Serum amylase and trypsin were elevated,
      abdominal CT revealed the presence of a pseudocyst of the pancreas. The presence
      of chronic pancreatitis was confirmed by endoscopic retrograde
      cholangiopancreatography and an infected pseudocyst was removed at laparotomy.

PMID- 1743220
TI  - Mitral valve and tricuspidal valve prolapse in Melnick-Needles syndrome.

PMID- 1743221
TI  - An infant having Potter facies without pulmonary hypoplasia after prolonged
      oligohydramnios due to a placental mass.

PMID- 1743222
TI  - Acute caffeine poisoning in a child.

PMID- 1743223
TI  - pT1 bladder cancer.
AB  - pT1 bladder tumors invade the lamina propria and are more aggressive biologically
      than superficial pTa or in situ carcinomas (Tis). Among patients with pT1 tumors
      treated by transurethral resection (TUR), 30% develop a muscle-invasive neoplasm
      within 3-5 years, but intravesical chemotherapy or BCG reduce progression rates
      to 20 and 14%, respectively. Tumor variables favoring progression include
      multiple, recurrent pT1 tumors, high grade (G3), solid configuration and
      associated Tis. Many pT1 tumors can be managed conservatively, but patients
      failing an adequate trial (3-6 months) of TUR and intravesical therapy are best
      treated by cystectomy.

PMID- 1743224
TI  - Analyses of factors affecting the outcome of combination chemotherapy in patients
      with advanced bladder cancer.
AB  - Thirty-seven patients with advanced bladder carcinoma were treated with a
      combination of methotrexate, vinblastine, adriamycin and cisplatin (M-VAC).
      Attempts were made to identify the factors related to the results of the present
      regimen using multivariate analyses. Factors related to the results were presence
      of distant metastases and prior chemotherapy. The effect of the M-VAC
      chemotherapy was disappointing in most patients with distant metastases and prior
      chemotherapy. This was prominent in patients with prior chemotherapy including
      cisplatin. These results seem to show clinically the development of resistance to
      cisplatin in advanced bladder cancer. Methods to overcome this resistance should
      be studied.

PMID- 1743225
TI  - Alpha-interferon and oral fluorouracil in the treatment of unremovable and/or
      metastatic renal cancer.
AB  - We present the results obtained in a study of the pharmacological action (phase
      II) of alpha-interferon and oral fluorouracyl administered in our 2-year study
      (Feb. 1988-Feb. 1990) in 10 patients suffering from surgically unremovable or
      metastatic renal cancer. Our results were: 1 patient with complete regression of
      lung metastasis; 5 with progressive disease within 3-4 months from beginning of
      treatment and 2 deaths with stable disease after 4-5 months. Two patients
      abandoned treatment and their disease progressed within 4-5 months.

PMID- 1743226
TI  - Intravesical chemotherapy (mitomycin C) versus immunotherapy (bacillus Calmette
      Guerin) in superficial bladder cancer.
AB  - Both intravesical mitomycin C (MMC) and bacillus Calmette-Guerin (BCG; Pasteur
      strain F) were effective in the present prospective randomized multicenter study
      consisting of 91 patients with frequently recurrent superficial (Ta-T1) bladder
      cancer. The result was in favour of BCG, as shown by the measurements with
      complete response (CR), disease-free interval and recurrence rate. CR of 58% with
      MMC and 40% with BCG were reached in 22 instillation series on carcinoma in situ
      of 18 patients. Due to side effects, MMC instillations were discontinued in 8.6%,
      and BCG instillations in 19.6%, respectively. After the 2-year follow-up also 1
      case of pulmonary tuberculosis occurred in the BCG group.

PMID- 1743227
TI  - Vesicoureteral reflux in the renal transplantation candidate.
AB  - The incidence and severity of urinary tract infection episodes were evaluated in
      two groups of renal transplantation patients. Group 1 consisted of 11 patients
      transplanted following successful surgical correction of a noninfected
      vesicoureteral reflux in native kidneys, and group 2 of 28 patients transplanted
      with a noninfected vesicoureteral reflux. An increased incidence of acute urinary
      tract infection episodes was noted in group 2 as compared to group 1 (42.8 vs.
      18%), with a mean of 2.6 +/- 1.4 episodes per patient in group 2 and 0.5 +/- 0.32
      in group 1. Asymptomatic bacteriuria was not statistically different in the two
      groups (36.4 vs. 25%). In group 2, the incidence of urinary tract infection
      episodes increased in patients presenting high-grade (3 and 4) reflux in native
      kidneys. Despite the relatively low number of patients involved, our observations
      indicate that high-grade vesicoureteral reflux in native kidneys must be operated
      before transplantation, even when there is no history of urinary tract infections
      and urine cultures are sterile.

PMID- 1743228
TI  - Ureteroneocystostomy in the neuropathic bladder associated with high-grade
      reflux.
AB  - Between 1976 and 1987, a total of 25 ureteroneocystostomies were performed in 17
      patients with neuropathic bladder associated with high-grade reflux III-V. An
      overall success rate of 82.4% is reported. Special complications included
      postoperative renal deterioration, especially after tapering of megaureters.
      During follow-up, contralateral reflux was noticed in 44% after unilateral
      treatment of reflux. Preoperative cystoscopy to define trigone abnormalities is
      mandatory.

PMID- 1743229
TI  - Flow-cytometric analysis of testes in infertile men: a comparison of the ploidy
      to routine histopathologic study.
AB  - DNA flow-cytometric analysis was performed on the testicular needle biopsies of
      25 infertile men with azoospermia or oligozoospermia to evaluate the ability of
      DNA histograms in order to detect and quantify alterations in spermatogenesis.
      Concomitant histopathologic study was performed on the tissues from needle
      biopsy. In contrast to difficulty in quantifying spermatogenesis in
      histopathologic examination, flow-cytometric analysis revealed characteristic
      ploidy patterns in the relative proportions of haploid (1 n), diploid (2 n) and
      tetraploid (4 n) cells corresponding to the histopathologic appearances of normal
      spermatogenesis, hypospermatogenesis, maturation arrest and aspermatogenesis.
      Findings evaluated with flow cytometry were well correlated with those from
      routine histopathologic study. In 21 of these patients (84%) there was
      concordance between histopathologic and flow-cytometric diagnoses. However, in 4
      patients (16%) there was discordance between two diagnostic modalities. In
      conclusion, DNA flow cytometry of testicular biopsies was a reproducible,
      objective and quantitative approach in evaluating infertile men, and it is a
      promising method to investigate spermatogenesis in an outpatient clinic in lieu
      of formal testicular histopathologic study.

PMID- 1743230
TI  - Hypospadias: Duckett pedicle tube urethroplasty.
AB  - The Duckett transverse tube pedicle urethroplasty was used to repair the primary
      hypospadias of 190 boys over an 11-year period. The fistula rate was 34.4%. The
      majority of boys have obtained a satisfactory cosmetic and functional result with
      a single operation.

PMID- 1743231
TI  - Renal duplications: the impact of perinatal ultrasound on diagnosis and
      management.
AB  - Perinatal urology is a rapidly expanding field in pediatric urology bringing
      significant changes in the diagnosis and management of congenital uropathies.
      Renal duplication was detected by antenatal and perinatal ultrasound in 19 cases
      (22 duplicated systems). In most cases, no precise diagnosis could be established
      in utero (4 of 13), but this lack of accuracy is of little clinical significance
      since all newborns with suspected uropathies undergo complete urological
      investigations in the perinatal period. Voiding cystogram demonstrated reflux in
      11 of 22 cases. On postnatal urography a functioning upper pole was demonstrated
      in 11 of 22 kidneys. There were 12 ureteroceles: in 8 a nonfunctioning upper pole
      was removed, while 3 were endoscopically incised with good functional improvement
      and 1 was reimplanted. Early recognition of congenital uropathies in association
      with duplication by prenatal ultrasound significantly improves patient care
      allowing early postnatal relief of obstruction by less invasive methods and
      before infection or persistent obstruction worsens the prognosis.

PMID- 1743232
TI  - An operation for incisional lumbar hernia.
AB  - To date, no standard technique for incisional lumbar hernia repair can be
      recommended since it depends on the size of the defect in the transversalis
      fascia. A new technique for this purpose, by using plication of the normal
      fascia, is described.

PMID- 1743233
TI  - Quantitative evaluation of the penile vascular status by means of the 99mTc
      penogram in conjunction with either papaverine or prostaglandin E1 in the
      anaesthetised baboon model.
AB  - The evaluation of both the arterial blood supply and the venous drainage of the
      penis is essential in the assessment of the impotent male. The vasoactive drugs
      papaverine and prostaglandin E1, as intracavernous injections, cause penile
      erections by influencing arterial blood supply and venous drainage. These drugs
      were used in a baboon model together with a 99mTc-penogram to provide information
      on the vascular status of the penis. An increase in penile blood pool was
      observed, more dramatic and rapid after administration of papaverine. A
      quantitative assessment of the vascular status seems possible and will next be
      monitored in a vascular-compromised baboon for purposes of clinical application.

PMID- 1743234
TI  - DNA ploidy, S phase fraction and G2 fraction as prognostic determinants in
      prostatic adenocarcinoma.
AB  - The results of DNA flow cytometry (FCM), histological features and clinical stage
      of prostatic adenocarcinoma were correlated to outcome in 91 patients during a
      mean follow-up period of 15.6 years. Aneuploidy was detected in 33 (36%) tumours,
      and 59 (64%) tumours were diploid. Eighteen (20%) tumours showed a tetraploid DNA
      index. The frequency of tetraploidy increased towards high-stage and high-grade
      tumours. Aneuploidy, high S phase fraction (SPF) and G2 fraction were
      significantly related to clinical stage, histological grade and perineural
      infiltration. Progressing tumours (T category) had higher SPF values (p =
      0.0248), and progression in N (p = 0.0122) and M categories (p = 0.0021) was
      related to high G2 fraction as well. In T1-2 tumours, DNA ploidy (p = 0.0280) and
      SPF (p = 0.0230) predicted progression, whereas histological grade had no
      significant predictive value. The clinical stage (T) predicted crude survival (p
      = 0.0005). Results show that FCM gives prognostic information in prostatic
      adenocarcinoma beyond that of histological grading.

PMID- 1743235
TI  - Nomogram for penile biothesiometry.
AB  - Three hundred and fifty men, aged between 17 and 80 years, with normal sexual
      anamnesis and without any neurological pathology, underwent finger (index) and
      penile biothesiometry using a biothesiometer. Tabular and graphical nomograms
      were obtained according to age and instrumental values. The use of the above
      mentioned nomograms is an effective aid in detecting each individual case.

PMID- 1743236
TI  - Urethral sphincteric responses to sacral root stimulation.
AB  - Deafferentation and stimulation of sacral nerves in patients with complete spinal
      cord lesions is a good model to study the parasympathetic influence on urethral
      behavior. During intradural sacral deafferentation from S2 to S4/S5 in
      preparation for implantation of the Finetech-Brindley anterior sacral root
      stimulator, sacral roots were stimulated with 3 and 30 Hz and 3 and 10 V and the
      bladder and urethral responses noted. Stimulation of the posterior roots at 3 Hz
      gives a urethral relaxation without bladder contraction. At this frequency,
      anterior sacral root stimulation has no effect on bladder nor urethral pressure.
      Stimulation of the anterior roots at 30 Hz produces simultaneous bladder
      contraction and urethral relaxation. These findings support the presence of an
      afferent parasympathetic inhibitory mechanism in the spinal micturition center in
      the human.

PMID- 1743237
TI  - Bilateral renal cell carcinoma with caval invasion in a woman with duplicated
      inferior vena cava.
AB  - Workup of a woman presenting with a palpable right flank mass, detected bilateral
      renal solid lesions, later proved to be renal cell carcinomas, and caval invasion
      in the presence of duplicated inferior vena cava. This association does not
      appear to have been previously described. The patient underwent right radical
      nephrectomy, cavotomy and auriculotomy with caval thrombus removal and delayed
      enucleation of left renal masses and left adrenalectomy. Eighteen months after
      surgery the patient is alive and without local and distant recurrence.

PMID- 1743238
TI  - Cysts of the prostate, seminal vesicles and diverticulum of the ejaculatory
      ducts.
AB  - The close proximity of the prostate, vas deferens, seminal vesicles and
      ejaculatory ducts are a diagnostic challenge to the cysts located in that region.
      Three patients with diverticulum of the ejaculatory ducts, 2 with prostate cysts
      and 1 patient with seminal vesicle cyst are presented. Transrectal ultrasound,
      computed tomography and magnetic resonance imaging together with aspiration of
      the cyst establish diagnosis and probably prevent unnecessary exploration.

PMID- 1743239
TI  - Prostate cancer in a 75-year-old man after four decades of testicular androgen
      deprivation.
AB  - In a 75-year-old patient referred for mild obstructive symptoms, physical
      examination revealed a clinically manifest T2B cancer of the prostate (CaP)
      involving the right lobe, and bilateral testicular atrophy (TA), right
      cryptorchidism with TA after orchiopexy at age 10, and left mumps orchitis with
      secondary atrophy at age 35). Since the age of 35, the patient had a limited
      sexual life and fathered no children. Transrectal ultrasonography demonstrated a
      small prostate (21 cm3) with a large hypoechoic zone in the right lobe, an
      isoechoic left lobe and no sign of capsular/seminal involvement. Three biopsies
      of the right lobe demonstrated a cancer (Gleason 4-3; score 7) of the right lobe,
      3 biopsies of the left lobe showed an atrophic prostate with slight intra-acinar
      hyperplasia and moderate dysplasia. Morphometric studies showed these findings to
      be consistent with long-standing androgen deprivation. Serum prostate-specific
      antigen (PSA) was 8.7 ng/ml, whereas serum testicular androgens were within the
      castrate value (serum testosterone 0.2 ng/ml, dihydrotestosterone less than 0.05
      ng/ml). Serum LH and adrenal androgens were within normal ranges. Bone scan was
      negative and NMR demonstrated no nodal enlargement. Considering the age of the
      patient, antiandrogen therapy was given (cyproterone acetate 50 mg t.i.d.). The
      patient reported marked improvement at 3 and 6 months of follow-up and PSA fell
      to 1 ng/ml at month 6. However, repeat rectal exams and ultrasonography showed no
      dramatic modification of the gland. The patient has since been lost to follow-up.
      Two conclusions may be drawn from this observation. Testicular androgen
      deprivation at age 35 although leading to prostatic atrophy does not prevent the
      development of CaP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1743240
TI  - Urological complications associated to uterus didelphys with unilateral
      hematocolpos. A case report and review of the literature.
AB  - Complete duplication of vagina, cervix and uterus, with imperforate hemivagina
      and renal agenesis is a rare condition with less than 120 cases published. In
      those articles, urological complications are uncommon with only a 10% of the
      total. We report 2 cases of uterus didelphys with unilateral hematocolpos and
      ipsilateral renal agenesis with urological clinical complications. One of them
      presented a very rare onset complaining of acute urinary retention. The other
      patient was referred for difficulty in micturition and abdominal pain which is
      the most common symptom of this entity. A description of both cases and a
      literature review of this congenital complex syndrome and its urological
      complications are reported.

PMID- 1743241
TI  - Effect of lacidipine, a long-acting calcium antagonist, on hypertension and
      lipids: a 1 year follow-up.
AB  - The effect of lacidipine, a dihydropyridine calcium antagonist on lipid
      metabolism, has been followed in 8 patients with uncomplicated mild to moderate
      essential hypertension treated for up to 14 months. There were significant
      reductions in the systolic and diastolic pressures, from 167/102 to 146/91 mm Hg
      at 2 months, and to 137/85 mm Hg at the end of the study. Blood lipid
      concentrations did not change during the observation period (cholesterol 5.1 vs
      5.3 mmol.l-1, triglycerides 1.1 vs 1.0 mmol.l-1, HDL-cholesterol 1.1 vs 1.2
      mmol.l-1). The results show that lacidipine did not affect lipid metabolism and
      suggest that calcium antagonists may be safely prescribed for a prolonged period
      to patients with combined hypertension and hyperlipidaemia.

PMID- 1743242
TI  - Haemodynamic effects of glyceryl trinitrate following repeated application of a
      transdermal delivery system with a phasic release profile.
AB  - The haemodynamic effects and plasma concentrations of glyceryl trinitrate (GTN)
      and its dinitrate metabolites were investigated in 8 healthy male volunteers
      during 5 days of application of a new transdermal delivery system (TDS) with time
      dependent release characteristics, which were considered to prevent or to
      diminish development of nitrate tolerance. On the first and fifth day of
      administration the following haemodynamic parameters were determined: digital
      pulse ratio of height of systolic peak to height of dicrotic wave (i.e. a/b
      ratio), heart rate and systolic blood pressure under orthostatic conditions. Peak
      plasma concentrations of GTN were 139 and 155 pg.ml-1 on the first and fifth day
      of treatment, and the corresponding trough concentrations (i.e. 24 h after
      administration) were 52.5 and 36.6 pg.ml-1, respectively. Compared to placebo,
      the area under the effect curve of the a/b-ratio of the digital pulse was
      increased on the first (25.6%) and fifth day (13%). A significant increase of
      heart rate and a decrease of systolic blood pressure were seen only on the first
      day of treatment. The haemodynamic effects of sublingual GTN 0.8 mg were reduced
      by 69% (a/b-ratio) and 52% (standing heart rate) on the fifth day compared to the
      pretreatment values. Thus, the phasic release of GTN from the new TDS can be
      demonstrated by the time course of the plasma concentrations of GTN and its
      metabolites. Nevertheless, following repeated administration the hemodynamic
      effects are blunted.

PMID- 1743243
TI  - The effect of angiotensin II on haemodynamic and plasma noradrenaline responses
      to tyramine infusion in man.
AB  - Six normal volunteers were studied on four separate occasions. On each occasion
      they received two concomitant infusions which were either placebo/placebo,
      placebo/tyramine, angiotensin II/placebo or angiotensin II/tyramine. Angiotensin
      II infusion was given at a constant rate of 2ng/kg/min whereas the tyramine
      infusion consisted of 10 min increments at 1.25, 2.5, 3.75, 5, 7.5 and 10
      micrograms.kg-1.min-1. Tyramine infusion caused a dose dependent increase in
      systolic blood pressure with increases in diastolic blood pressure and plasma
      noradrenaline only at the highest doses. These changes were not affected by
      concomitant angiotensin infusion. We have therefore found no evidence to support
      the enhancement of haemodynamic or plasma noradrenaline responses to tyramine
      infusion by low dose infusion of angiotensin II in man.

PMID- 1743244
TI  - Reproducibility of Doppler blood flow velocity waveform measurements: study on
      variability within and between day and during haemodynamic intervention in normal
      subjects.
AB  - Reproducibility of Doppler blood velocity waveform measurements in external and
      internal carotid, middle cerebral, and brachial arteries and ascending aorta was
      determined in 8 normal male volunteers twice daily on three occasions each
      separated by two or more weeks. Measurements were made in supine and standing
      positions at rest and after taking glyceryl trinitrate and in the supine position
      after performing a standardized exercise test. The Doppler blood flow waveform
      indices showed a between days coefficient of variation of less than 15% both for
      baseline measurements and during haemodynamic change induced by exercise or
      glyceryl trinitrate. We conclude that Doppler blood velocity waveform measurement
      in different vascular beds is reproducible at baseline and when the
      cardiovascular system is interrupted pharmacologically or physiologically.

PMID- 1743245
TI  - Treatment of insomnia with two benzodiazepines: a double-blind crossover study.
AB  - Twenty-eight patients (12 M, 16 F) with insomnia were treated with nitrazepam 5
      mg/d and oxazepam 25 mg/d, each for 11 days, in a double-blind crossover
      comparison with placebo. Half the patients received nitrazepam in the first drug
      period, and oxazepam in the second and the other half followed the contrary
      sequence. Both nitrazepam and oxazepam were found to be effective in inducing
      sleep and increasing sleep quality. No effects on dreaming or adverse effects
      were found. Nitrazepam did influence the frequency of awakening, but only in the
      second drug period. In the first period it reduced self-waking. It is concluded
      that both nitrazepam and oxazepam were effective in inducing sleep and in
      improving sleep quality.

PMID- 1743246
TI  - Inhibition of ex-vivo PAF-induced platelet aggregation by the PAF-antagonist RP
      48740: relationship to plasma concentrations in healthy volunteers.
AB  - RP 48740, 3-(3-pyridyl)-1H,3H-pyrrolo [1,2-c] thiazole-7-carboxamide, a specific
      competitive PAF-receptor antagonist in vitro, was given to 29 healthy male
      volunteers for 7 days. Plasma drug concentrations and ex-vivo PAF-induced
      platelet aggregation were assessed on Days 1, 4, and 7. RP 48740 had linear
      pharmacokinetics after single and repeated doses. It caused stable inhibition of
      PAF-induced platelet aggregation in a dose-dependent manner. The effect
      disappeared within 24 h, even after 7 days of repeated doses. The effect of RP
      48740 displayed a sigmoidal relation to the plasma drug concentration; I50 2.3
      (0.3) mg.l-1. There were no clinical or biological adverse reactions to RP 48740
      during the study.

PMID- 1743247
TI  - Enhancement of propoxyphene bioavailability by ethanol. Relation to psychomotor
      and cognitive function in healthy volunteers.
AB  - The interaction between a single oral dose of 130 mg propoxyphene and 0.5 g/kg
      body weight ethanol was investigated in 12 healthy male volunteers by 9 objective
      performance tests, 8 visual analogue self-rating scales and the measurement of
      plasma propoxyphene, norpropoxyphene and ethanol concentrations, using a double
      blind threeway crossover design. Volunteers were each given one of three
      treatments, propoxyphene + ethanol, placebo + ethanol and propoxyphene alone,
      separated by a two week interval. The performance tests were completed before and
      1.25 and 4 h after drug intake, and the self-rating scales before and 1.25, 4 and
      10 h after it. Ethanol was shown to enhance the bioavailability of propoxyphene
      by 25% probably by reducing its first-pass metabolism. However, despite this
      pharmacokinetic effect no pharmacodynamic interaction was found. Subjective
      ratings disclosed that the effect of ethanol on physical and mental sedation
      predominated over the effects of propoxyphene.

PMID- 1743248
TI  - Urinary glucuronide excretion of fenofibric and clofibric acid glucuronides in
      man. Is it polymorphic?
AB  - The possible polymorphism of the glucuronidation reaction in man has been
      investigated using two hypolipidaemic compounds, fenofibrate and clofibrate, as
      the test probes. The formation of fenofibryl and clofibryl glucuronides was
      identified by their susceptibility to hydrolyses by beta-glucuronidase. The
      urinary excretion of the glucuronides was measured in 72 healthy volunteers after
      a single dose of fenofibrate, and in 104 subjects given a single dose of
      clofibric acid. Fenofibrate was excreted at a lower rate than clofibrate, since
      13.94% and 26.55% of the doses of fenofibrate and clofibrate respectively, were
      recovered in urine in 8 h. Correlation analysis indicated that sex and body mass
      index significantly influenced the formation of fenofibryl glucuronide, whereas
      age and oral contraceptives affected the excretion of clofibryl acid glucuronide.
      The 8-hour urinary excretion patterns of clofibryl glucuronide and of clofibric
      acid presented a Gaussian distribution, whereas those of fenofibryl glucuronide
      and fenofibric acid showed 2 populations. When the metabolic ratio free
      fenofibric acid/glucuronide was considered, 84.7% of subjects presented the ratio
      0.147, and 15.3% had the 3-fold higher ratio of 0.421. The study has shown, in
      the human population studied, that the glucuronidation of fenofibric acid but not
      that of clofibric acid may present a polymorphism.

PMID- 1743249
TI  - Pharmacokinetics of halofantrine and n-desbutylhalofantrine in patients with
      falciparum malaria following a multiple dose regimen of halofantrine.
AB  - Halofantrine is a new blood schizontocidal drug used for the treatment of
      multidrug-resistant falciparum malaria. The pharmacokinetics of halofantrine
      (HAL) and its principal metabolite, N-desbutylhalofantrine (BHAL), was
      investigated in 6 adult male patients of Melanesian origin with uncomplicated
      falciparum malaria. The patients received 500 mg of halofantrine hydrochloride at
      times 0, 6 and 12 h (total 1.5 g). All patients responded to treatment with a
      mean parasite clearance time of 52.7 h and a mean fever clearance time of 33.8 h.
      The following kinetic parameters (mean values) were determined for HAL and BHAL,
      respectively: maximum plasma concentration (Cmax) = 896 and 491 ng.ml-1; time to
      reach the Cmax (tmax) = 15 and 56 h; elimination half-life (t1/2) = 91 and 79 h
      and the mean residence time (MRT) = 71 and 102 h. Based on the clinical response
      the plasma concentrations of HAL and BHAL were adequate for the treatment of
      uncomplicated falciparum malaria in the 6 patients.

PMID- 1743250
TI  - Dose-dependent absorption and elimination of cefadroxil in man.
AB  - The pharmacokinetic behaviour of cefadroxil was dose-dependent in healthy male
      volunteers following the oral administration of single doses of 5, 15, and 30
      mg.kg-1. As the dose of cefadroxil increased from 5 to 15 and 30 mg.kg-1, the
      peak plasma concentrations, normalized to 5 mg.kg-1, decreased significantly from
      15.1 to 10.7 and 7.6 mg.l-1, while the corresponding normalized areas under the
      plasma concentration-time curves from 0 to 2 h decreased significantly from 1258
      to 946 and 801 min.mg.l-1. When the same subjects were given 5 mg.kg-1 of
      cefadroxil together with 45 mg.kg-1 of cephalexin, the absorption of cefadroxil
      was slowed to a similar or greater extent than with the high dose of cefadroxil.
      Although the absorption rate decreased as the dose increased, the systemic
      availability of cefadroxil was essentially complete at all doses, as judged by
      the 24 h urinary recoveries of the antibiotic. Kinetic analysis of the plasma
      concentration-time curves gave the best fit with a zero-order followed by a first
      order absorption process, consistent with saturable intestinal absorption of
      cefadroxil. The elimination rate of cefadroxil was directly related to dose and
      plasma concentrations, and the clearance at the dose of 5 mg.kg-1 was
      significantly increased by the simultaneous administration of high-dose
      cephalexin. The renal clearance of cefadroxil ranged from 98 ml.min.l-1 at total
      plasma cephalosporin (cefadroxil + cephalexin) concentrations less than 2.5 mg.l
      1 to 156 mg.l-1 at concentrations greater than 40 mg.l-1.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1743251
TI  - Antibiotics policies in the developing world.

PMID- 1743252
TI  - Racemic therapeutics--ethical and regulatory aspects.
AB  - Racemic therapeutics are fixed ratio mixtures of stereoisomers to be regarded
      biologically as different compounds. Usually only one of the isomers fully
      contributes to the therapeutics action, and the other is often classifiable as
      "isomeric ballast". Due to differences in turnover and pharmacokinetics, the
      proportion of enantiomers (1:1 in the racemate) continuously changes in plasma.
      The implications of the neglect of stereoselectivity for various levels in the
      investigation of racemic drugs are discussed and summarized in Table 2. The fact
      is that clinical investigators, Ethical Committees and regulatory authorities
      have for decades accepted invalid pharmacokinetic data on some 25% of
      therapeutics. That those racemates remain in use make the benefit of and
      necessity for kinetics generally questionable. Exposure of patients to the
      "isomeric ballast" present in about 50% of the most commonly used drugs will
      probably contain for many decades. As a result of a change in attitude of the
      regulatory authorities, however, for new drugs the choice in future between the
      racemic therapeutic or the single isomeric ballast-free drug will largely be
      based on a critical evaluation of the chiral characteristics with regard to their
      therapeutic, toxicological and pharmacokinetic aspects.

PMID- 1743253
TI  - Central and peripheral haemodynamic responses to felodipine in congestive heart
      failure.
AB  - Using non-invasive radionuclide techniques, we studied the arterial and venous
      effects of 0.1 mg/kg oral felodipine in 12 men with heart failure due to
      ischaemic heart disease aged 37-72 y. All were in New York Heart Association
      Class II or III, required frusemide 40-120 mg daily and were clinically stable.
      Felodipine produced significant falls in blood pressure (-19%) and systemic
      vascular resistance (-39%) with increases in cardiac index (+34%), heart rate
      (+12%) and left ventricular ejection fraction (from 0.25 to 0.32). Peripheral
      venous volume fell by 10.6% after felodipine indicating venoconstriction rather
      than venodilatation and may be caused by an acute sympathetic reflex associated
      with the increase in heart rate. Our results confirm that felodipine is an
      arterial vasodilator. The previously observed changes in cardiac filling
      pressures may simply represent improved ventricular function as a consequence of
      reduced afterload, not venodilatation.

PMID- 1743254
TI  - Acute haemodynamic effects of i.v. nitrendipine in healthy subjects.
AB  - The haemodynamic effects of an i.v. infusion of 2 mg nitrendipine have been
      studied in six healthy volunteers. Nitrendipine significantly decreased the
      systolic (-8.3%) diastolic (-19.9%) and mean arterial (-11.6%) blood pressures
      and the peripheral vascular resistance (-57.8%), and significantly increased leg
      blood flow (+128%). Stroke volume did not change. Due to the increase in heart
      rate (+28.5%), the cardiac output (2.8.2%) rose significantly. The haemodynamic
      effects were closely related to the serum nitrendipine concentration. The
      sigmoidal Emax-model was appropriate to describe the data. Pronounced
      interindividual differences in the serum nitrendipine concentrations required to
      elicit 50% of the maximum haemodynamic effect (EC50) were observed. The EC50 for
      the increase in leg blood flow ranged from 2.9 to 30.9 ng/ml and for the
      reduction in peripheral vascular resistance from 2.1 to 25.7 ng/ml.
      Interindividual differences in EC50 values were less pronounced if based on
      unbound serum nitrendipine levels. The fraction of nitrendipine not bound to
      serum proteins showed a three-fold difference between subjects, with free
      fractions ranging from 0.011 to 0.036. The unbound EC50 values for the increase
      in leg blood flow varied between 0.06 and 0.44 ng/ml and for the reduction in
      peripheral vascular resistance from 0.07 to 0.35 ng/ml. Based on the serum
      concentrations associated with comparable haemodynamic effects nitrendipine was
      at least three-times more potent than nifedipine.

PMID- 1743255
TI  - Rat retinal ganglion cells in culture.
AB  - A stable cell culture system of identified retinal ganglion cells would
      facilitate the investigation of cellular mechanisms of damage from glaucoma and
      other disorders. We have developed a reliable technique to culture retinal
      ganglion cells on a glial cells monolayer which extends viability and promotes
      extensive neurite outgrowth. Dissociated retinal cells from 5-7-day-old Sprague
      Dawley rats were cultured on glial monolayers derived from rat cerebral
      hemispheres. Retinal ganglion cells were labeled with retrograde fluorescent
      markers injected into the superior colliculus or in culture with monoclonal
      antibody to Thy-1 antigen. Since Thy-1 antigen is not entirely specific for
      retinal ganglion cells, and fluorescent markers fade in older cultures, the
      identity of Thy-1 marked cells was confirmed with whole-cell electrophysiologic
      recordings. Labeled, physiologically intact retinal ganglion cells were
      identified for at least 31 days in culture. Many retinal ganglion cells showed
      neurite elongation of 2 mm or more and developed complex intercellular networks.
      This cell culture system may be used to form the basis for future studies of the
      electrophysiology and transport properties of retinal ganglion cells under normal
      culture conditions and under adverse conditions such as those that mimic ischemia
      or mechanical deformation.

PMID- 1743256
TI  - Quantitation of ischemic damage in the rat retina.
AB  - In order to determine thresholds for irreversible cellular injury in the rat
      retina, timed acute no-flow ischemic episodes of 30-180 min duration were
      produced by elevation of intraocular pressure (IOP) above systolic pressure.
      Quantitation of irreversible degeneration and cell loss following a 2-week post
      ischemic interval was performed by computer-assisted measurements from histologic
      sections. Alterations of thickness of retinal layers and linear cell density were
      determined for ischemia of selected durations (30, 60, 80, 90, 120 and 180 min).
      Different thresholds were evident for inner and outer retinal damage. Neurons of
      the inner nuclear layers showed extensive loss with episodes at 60 min. Decrease
      in the thickness of the inner plexiform layer provided the best index of this
      inner nuclear damage. The outer retina was more resistant, with photoreceptors
      showing extensive damage only after 90 min in conjunction with pigment epithelial
      metaplasia and degeneration. Two-hour episodes produced full-thickness
      degeneration with loss of pigment epithelium and sparing of the peripheral
      retina. Greater sensitivity of the inner retina suggested problems with
      restoration of the retinal circulation. Horseradish peroxidase infusions did
      reveal central microcirculatory defects in retinal wholemounts of some specimens
      with episodes longer than 60 min. Refinements of the methods resulted in outcomes
      sufficiently reproducible for quantitative assessment of acute ischemic injury.
      The rat retina provides an economical basic tissue model of acute ischemic injury
      affecting neurons, glia, and microvasculature. Quantitation of this injury
      promises great utility in testing agents with potentially protective effects on
      acute ischemic injury.

PMID- 1743257
TI  - Muller glial cells of the goldfish retina are phagocytic in vitro but not in
      vivo.
AB  - The role of Muller glial cells in the process of degeneration and regeneration of
      the goldfish retina is poorly understood. One potential role is phagocytosis of
      neuronal debris in degenerating retinas. We investigated the phagocytic capacity
      of Muller glial cells of the goldfish retina both in vitro and in vivo. Muller
      glial cells from primary or first passage cultures were incubated with latex
      beads to assess their phagocytic ability, and acridine orange staining was used
      to identify phagolysosomes in living Muller glial cells. These experiments showed
      that Muller glial cells are phagocytic in culture. Cell identity was verified
      with an antibody raised against glial fibrillary acidic protein (GFAP). For the
      in vivo experiments fluorescent latex beads alone or in combination with the
      metabolic poison ouabain were injected into the posterior chamber. At various
      intervals (4 days to 8 weeks) after injection the retinas were prepared for
      immunocytochemistry. Polyclonal anti-GFAP and NN-1, a monoclonal antibody which
      recognizes macrophages and microglia within the goldfish retina, were used to
      identify the phagocytic cells. When the beads were injected into the eye, they
      were phagocytosed by macrophages/microglia cells but not by Muller cells.

PMID- 1743258
TI  - Effect of varying oxygen concentrations on the proliferation of retinal
      microvascular cells in vitro.
AB  - Microvascular fragments and pure cultures of either retinal microvascular
      endothelial cells, retinal pericytes or Tenon's capsule fibroblasts were grown on
      a gas permeable substrate while exposed to varying oxygen concentrations (5, 10,
      20, 40 and 95% oxygen). For all three cell types cell proliferation was greatest
      under the lowest oxygen concentration and decreased as the oxygen concentration
      increased. The decrease in the proliferative ability of cells exposed to the
      higher oxygen concentrations could be reversed if the cells were returned to a
      normoxic environment. Endothelial cells were the most sensitive to changes in
      oxygen tensions showing a proliferative response after 24 hr exposure as opposed
      to 48 hr for pericytes and fibroblasts. These results suggest a direct mechanism
      by which the intra-vitreal and intra-retinal oxygen tension may influence both
      the development of preretinal new vessels (in response to retinal ischaemia) and
      also the regression of neovascularization following scatter photocoagulation or
      vitrectomy.

PMID- 1743259
TI  - Interferon-gamma induces the expression of major histocompatibility antigens by
      human retinal glial cells.
AB  - Retinal glial cells normally do not express major histocompatibility (MHC)
      molecules. However, the expression of MHC antigens by retinal glial cells under
      certain pathological conditions suggests that these cells may play a role in
      immune responses of the retina. At present, the identity of molecules that may
      regulate the expression of class I and class II MHC antigens by retinal glial
      cells has not been established. Since interferon-gamma (IFN-gamma) induces MHC
      antigens in a variety of cell types, we examined the effect of this lymphocyte
      product on class I and class II antigen expression by human retinal glial cells
      in culture. Glial cells derived from post-mortem donor eyes were exposed to
      recombinant human IFN-gamma. Cells with MHC class I or class II antigens were
      detected with the use of specific monoclonal antibodies that were labeled
      directly or indirectly with fluorescent probes. Fluorescence of labeled cells was
      assayed by flow cytometry. Exposure to IFN-gamma increased the expression of
      class I and class II antigens by the retinal glial cells. Double labeling studies
      showed that 90% of the glial cells induced to express class II antigens also had
      class I antigens. Overall, the results show that IFN-gamma can regulate the
      expression of MHC molecules by human retina glial cells in culture. These
      findings are consistent with the concept that glia may play a role in
      immunological disorders affecting the retina.

PMID- 1743260
TI  - Post-translational arginylation in the bovine lens.
AB  - This study demonstrates post-translational arginylation of bovine serum albumin
      and endogenous lens proteins by bovine lens arginyl-tRNA:protein transferase.
      This reaction has been proposed to be the first step in marking specific proteins
      for degradation by the non-lysosomal, ATP-dependent, ubiquitin-mediated
      proteolytic pathway. The transferase was obtained by the method used for
      isolation of the same enzyme from reticulocytes (Ferber and Ciechanover, 1987,
      Nature 326, 808-11). Incorporation of [3H]Arg was linear for at least 2 hr at 37
      degrees C. The amount of incorporation was directly proportional to the amount of
      lens enzyme or substrate added. Arginylation was ATP-dependent. A requirement for
      tRNA was demonstrated by inhibition upon pretreatment of the enzyme preparation
      with nuclease to hydrolyse endogenous tRNA, and restoration of activity upon
      replacement of tRNA. [3H]Leu, [3H]Lys and [3H]His were not incorporated,
      demonstrating specificity of the reaction for arginine. This is the first
      demonstration of post-translational modification of proteins by arginylation in
      the lens.

PMID- 1743261
TI  - Autoradiographic, electrophoretic, and immunocytochemical studies of
      glycoproteins of the rabbit iris.
AB  - L-[3H]fucose was injected either intravitreally or intra-aqueously into adult
      rabbits which were killed at several time points after injection. SDS
      polyacrylamide gel electrophoresis and fluorography of iris extracts revealed
      that most of the proteins are glycoproteins containing fucose residues.
      Autoradiography of semi-thin histologic sections demonstrated that glycoprotein
      synthesis was most prominent in the epithelium of the iris, while little protein
      synthesis was evident in the stroma of the iris. The results of these experiments
      indicated that the glycoproteins of the iris undergo renewal. The protein band
      pattern of the iris extracts was very similar to that of extracts of the ciliary
      body. The high-molecular-weight cartilage matrix glycoprotein (CMGP), an
      intrinsic component of the ciliary body, vitreous, and aqueous humor, was
      detected by immunohistologic studies only in the stroma of the iris. The results
      of immunohistochemical analyses of the eyes of young rabbits (1-21 days old), in
      addition to the autoradiographic findings, strongly suggest that CMGP is not an
      intrinsic glycoprotein of the iris stroma, at least in this species.

PMID- 1743262
TI  - Abnormalities of the electroretinogram and visual-evoked potential in vitamin E
      deficient rats.
AB  - Flash electroretinograms, retinal oscillatory and cortical visual-evoked
      potentials were recorded in 10-month vitamin E deficient rats and in age-matched
      controls. A significant increase in the latency (P less than 0.0001) and decrease
      in amplitude (P less than 0.0001) of the electroretinogram a- and b-waves were
      observed in the vitamin E deficient rats compared with controls. The vitamin E
      deficient rats also showed a significant delay (P less than 0.002) in early
      oscillatory potentials. No significant group differences were obtained in the P1
      latency or P1-N1 amplitude of the visual-evoked potential; however, the N1 peak
      was significantly delayed (P = 0.01) in the vitamin E deficient rats. This study
      shows, for the first time, that the electroretinogram and visual-evoked potential
      to flash stimulation provide a sensitive index for monitoring the visual effects
      of vitamin E deficiency in the rat.

PMID- 1743263
TI  - Mapping of Fc gamma receptors in the human and porcine eye.
AB  - By using an immunohistochemical technique, we detected a strong reaction product
      for Fc gamma receptors in the keratoconjunctival epithelium, uveal trabecular
      meshwork, optic nerve, and muscle walls of the retinal and ciliary vessels of
      infant human eyes; moderate staining was seen on the corneal endothelium,
      corneoscleral trabecular meshwork, non-pigmented ciliary epithelium, ciliary
      muscle fibers, endothelial lining of ocular blood vessels, as well as the
      anterior region of Muller cells, the outer nuclear layer, and pigment epithelium
      of the retina. In aged human and porcine eyes, the same structures stained
      somewhat less intensely than did those in infant human tissues. Primary cultures
      of porcine trabecular cells demonstrated a more intense immunoreaction product
      than did tertiary cultures. We discuss the possible role of Fc gamma receptors in
      various ocular inflammatory conditions and the implications of age-dependent
      expression by human trabecular cells in the pathogenesis of open-angle glaucoma.

PMID- 1743264
TI  - Mitogenic effects of excitatory amino acids in the adult rat retina.
AB  - We studied the retinas of adult rats after the intravitreal injection of
      excitatory amino acids and ouabain. Kainic acid, domoic acid, N-methyl D-asparate
      and ouabain produced swelling and vacuolization of the outer plexiform, inner
      nuclear and inner plexiform layers and pyknosis. Mitoses were present in retinas
      treated with all agents other than N-methyl D-asparate. Rompun ketamine
      anesthesia blocked the mitogenic effects. Immunohistochemical labeling of both
      glial fibrillary acidic protein and S100 protein would indicate that the mitoses
      are occurring in glial cells. We suggest that the mitogenic effects are mediated
      through action on glial cationic channels, and might account for the reactive
      gliosis observed in some retinal lesions.

PMID- 1743265
TI  - In utero and milk-mediated effect of aldose reductase inhibitor on galactose
      cataracts.
AB  - Our previously reported investigations showed that cataracts could be induced in
      fetal lenses through the maternal feeding of galactose during pregnancy. We also
      reported that the lens opacity present at birth reverses completely by 30 days of
      age if there is no further post-natal exposure to galactose. This investigation
      was designed to investigate if an aldose reductase inhibitor (ARI) has any cross
      placental effect in preventing galactose-induced cataracts in fetuses. We have
      also evaluated if there are any milk-mediated effects of galactose on cataract
      induction and of galactose and ARI on the maintenance or reversal of opacities
      induced in utero. Pregnant Sprague-Dawley rats were fed either 50% galactose or
      rat chow with or without the ARI, (2R,4S)-6-fluoro-2-methyl spirochroman-4,4'
      imidazolidine-2',5'-dione (Eisai compound E-0722). Following parturition, pups of
      mothers from the different dietary groups were either fed by their own mothers or
      foster fed by lactating females fed either rat chow or 50% galactose with or
      without the ARI. Lenses of the pups were examined at desired intervals with light
      and scanning electron microscopes. We observed that: (a) both galactose and the
      ARI had a cross-placental effect on the fetal lenses in the development and
      inhibition of cataracts, respectively; (b) galactose had very little, if any,
      milk-mediated effect on either the induction of cataracts in newborn pups that
      were born with transparent lenses or the maintenance of cataracts induced in
      utero; (c) the ARI appeared to have a milk-mediated effect, which accelerates the
      reversal of cataract associated alterations in lenses of pups with cataracts
      induced in utero, leading to further reinstatement of lens transparency; and (d)
      the presence of ARI in the diet of rats during pregnancy and/or post-parturition
      provided continued protection to the lenses of pups that were exposed to a
      galactose diet following birth.

PMID- 1743266
TI  - Cellular expression of collagen IV mRNA in eye.

PMID- 1743267
TI  - Influence of bicarbonate and insulin on pigment synthesis by cultured adult human
      retinal pigment epithelial cells.

PMID- 1743268
TI  - S cone-driven but not S cone-type electroretinograms in the enhanced S cone
      syndrome.

PMID- 1743269
TI  - HIV tests costs exceed benefits.

PMID- 1743270
TI  - Targeted HIV screening fails.

PMID- 1743271
TI  - Family planning clinics: facing higher costs and sicker patients.
AB  - Family planning clinics throughout the United States are facing a variety of
      obstacles that threaten their ability to provide necessary contraceptive services
      to low-income women and teenagers, according to interviews with clinic
      administrators. In the last few years, the proportion of patients coming to
      family planning agencies in need of screening or treatment for sexually
      transmitted diseases (STDs) has increased dramatically. Many providers report
      that 10-15 percent of their clients are infected with chlamydia, the most
      prevalent STD. The increasing costs of Pap tests and contraceptives are also
      major problems: As a result of recent federal legislation, the price of Pap tests
      has risen substantially, and that of contraceptives is beginning to increase
      steeply. Finally, Title X funding for family planning services has decreased 66
      percent over the last decade if both cuts and inflation are taken into account.
      As a result of the squeeze between increased costs and decreased public funding,
      clinics have been forced to charge higher fees, maintain long waiting lists for
      appointments and curtail community outreach. In addition, growth of the family
      planning patient population has slowed dramatically, and even declined, in some
      places.

PMID- 1743272
TI  - Public funding of contraceptive, sterilization and abortion services, fiscal year
      1990.
AB  - In FY 1990, the federal and state governments spent $504 million to provide
      contraceptive services and supplies, according to results of a survey of state
      health, social services and Medicaid agencies conducted by The Alan Guttmacher
      Institute. Medicaid accounted for 38 percent of all public funds spent on
      contraceptive services, Title X provided 22 percent, and two federal block-grant
      programs--Social Services and Maternal and Child Health--together were
      responsible for 12 percent of public expenditures. State governments accounted
      for the remaining 28 percent of public funding. Although public expenditures for
      contraceptive services have risen by $154 million over the past decade, when
      inflation is taken into account, expenditures have actually fallen by one-third.
      Since 1980, the proportion of public contraceptive expenditures contributed by
      Title X has been cut virtually in half, while the proportion contributed by state
      governments has nearly doubled. When inflation is taken into account, Title X
      expenditures for contraceptive services have fallen by almost two-thirds since
      1980. The federal and state governments together spent $95 million to subsidize
      sterilization services in 1990, and $65 million to provide abortion services. The
      federal government was the major source of funding for sterilization services but
      provided less than one percent of the cost of abortion services. Because of
      changes over time in survey methodology and the difficulties some states had in
      separating out expenditures by type of care, these data are approximations.

PMID- 1743273
TI  - Determinants of unintended childbearing among ever-married women in the United
      States: 1973-1988.
AB  - A downward trend in unwanted childbearing has reversed among large segments of
      the population, according to data from the 1988 National Survey of Family Growth.
      The proportion of births in the previous five years that were unwanted at
      conception fell from 14 percent in 1973 to eight percent in 1982, but increased
      to 10 percent in 1988. Between the 1982 and 1988 surveys, increases were most
      pronounced among women with less than a high school education and among women
      living below the federal poverty level. Differences between black women and white
      women in levels of unwanted childbearing, which were converging prior to 1982,
      have since grown considerably, particularly among the poor and the less educated.

PMID- 1743274
TI  - Testing for sexually transmitted diseases among women of reproductive age: United
      States, 1988.
AB  - Approximately 13.3 million women aged 15-44--about 26 percent of all women of
      reproductive age who had ever had intercourse--were tested for sexually
      transmitted diseases (STDs) in the 12 months before the 1988 National Survey of
      Family Growth. Slightly over half of the women tested received the test as part
      of a family planning visit. Women who used clinics for family planning services
      were most likely to be tested--54 percent compared with 34 percent of women who
      used a private doctor for family planning and 16 percent of women who did not
      receive family planning services that year. The findings suggest that access to
      medical care, especially access to family planning clinics, has strong effects on
      a woman's chances of being screened for STDs, independent of her individual
      characteristics. The most important individual characteristic affecting the
      chance of being tested for an STD was race: About 47 percent of black, 27 percent
      of Hispanic, and 23 percent of white and other women were tested in the 12 months
      before the survey. Among groups with high-risk behaviors, only 34 percent of
      sexually experienced teenagers were screened for STDs in the past year, as were
      only 43 percent of women with a positive STD history and 32 percent of women with
      10 or more lifetime partners.

PMID- 1743275
TI  - Condom use with regular and casual partners among women attending family planning
      clinics.
AB  - A survey of 16,632 women attending family planning clinics in Pennsylvania found
      that only 13 percent of the sample used condoms. Moreover, 67 percent of the
      women with regular partners never used condoms with those partners, and 72
      percent of women who had casual partners never used them with those partners.
      Levels of condom use with both regular and casual partners were higher among
      women younger than 20, those who were nonwhite, those with multiple partners and
      those who reported a previous STD infection. However, women who had sex partners
      who used intravenous drugs were less likely to use condoms with regular or casual
      partners than were women who did not have drug-using partners.

PMID- 1743276
TI  - Efficacy of the simultaneous use of condoms and spermicides.

PMID- 1743277
TI  - A future for Title X?

PMID- 1743278
TI  - Abortion underreporting.

PMID- 1743279
TI  - Transduction of enzyme-ligand binding energy into catalytic driving force.
AB  - We propose a testable general mechanism by which ligand binding energy can be
      used to drive a catalytic step in an enzyme catalyzed reaction or to do other
      forms of work involving protein molecules. This energy transduction theory is
      based on our finding of the widespread occurrence of ligand binding-induced
      protein macrostate interconversions each having a large invariant delta H0
      accompanied by a small but highly variable delta G0. This phenomenon, which can
      be recognized by the large delta Cp0's it generates, can provide the necessary
      energy input step but is not in itself sufficient to constitute a workable
      transduction mechanism. A viable mechanism requires the additional presence of an
      'energy transmission step' which is terminated to trigger the 'power' stroke at a
      precise location on the reaction coordinate, followed by an energetically
      inexpensive 'return' step to restore the machine to its initial conditions. In
      the model we propose here, these additional steps are provided by the existence
      of ligand inducible 2-state transitions in the free enzyme and in each of the
      enzyme complexes that occur along the reaction coordinate, and by the selective
      blocking of certain of these interconversions by high energetic barriers. We
      provide direct experimental evidence supporting the facts that these additional
      mechanistic components do exist and that the liver glutamate dehydrogenase
      reaction is indeed driven by just such machinery. We describe some aspects of the
      chemical nature of these transitions, and evidence for their occurrence in other
      systems.

PMID- 1743280
TI  - Identification of the phosphorylation sites of H2B histone by a catalytic
      fragment of p72syk from porcine spleen.
AB  - Phosphorylated sites of calf thymus H2B histone were investigated with a
      catalytic fragment of 72 kDa protein-tyrosine kinase (p72syk). Three of five
      tyrosine residues in H2B histone can be phosphorylated by this kinase. In this
      analysis, H2B histone was thoroughly phosphorylated in vitro with [gamma-32P]ATP
      and the kinase, and then digested with a lysylendopeptidase. The resulting
      radioactive phosphopeptides were separated by a reverse-phase column on high
      performance liquid chromatography. Subsequent sequential Edman degradation of the
      purified phosphopeptides revealed that 40Y, 83Y and 121Y were phosphorylated.
      121Y is the major phosphorylated residue in H2B histone. No phosphorylation was
      detected in 37Y and 42Y. Although the consensus sequence was not defined from
      these analyses, our data suggest that higher-order structure(s) in addition to
      primary one may participate in recognition of H2B histone by this protein kinase.

PMID- 1743281
TI  - Striking structural and functional similarities suggest that intestinal sucrase
      isomaltase, human lysosomal alpha-glucosidase and Schwanniomyces occidentalis
      glucoamylase are derived from a common ancestral gene.
AB  - Sequence comparison of the primary structure of the yeast Schwanniomyces
      occidentalis glucoamylase (GAM) with GAMs in different microorganisms did not
      reveal significant similarities. By contrast, striking similarities were,
      surprisingly, found with 3 mammalian secretory and integral membrane proteins:
      the 2 subunits of intestinal brush border sucrase-isomaltase and human lysosomal
      alpha-glucosidase. The similarities among these proteins are found as clusters of
      up to 8 amino acids and distributed all over the protein sequences. The major
      sequence differences are found in the N-terminal regions accounting, probably,
      for the different cellular locations of these proteins. The high level of
      similarities between sucrase, isomaltase, Sch. occidentalis GAM and human
      lysosomal alpha-glucosidase suggest that these proteins are derived from the same
      ancestral gene. To our knowledge, this is the first report that describes
      similarities between a yeast secretory protein and mammalian secretory and
      integral membrane proteins.

PMID- 1743282
TI  - Phosphorylation of alpha-crystallin B in Alexander's disease brain.
AB  - The phosphorylation of alpha-crystallin B was studied in homogenates of autopsy
      samples of brain tissue from patients with Alexander's disease, a condition
      characterized by over-expression of this protein. After incubation in the
      presence of [gamma-32P]ATP and cAMP the homogenates were analyzed by two
      dimensional electrophoresis, (isoelectric focusing followed by SDS-PAGE). Three
      major polypeptides having the same molecular weight as bovine lens alpha
      crystallin B and pIs 7.1, 6.9 and 6.7 were detected in the Coomassie blue stained
      gels. These three polypeptides were recognized by an alpha-crystallin B-specific
      antiserum in Western blots. The polypeptides with pIs 7.1 and 6.7 co-migrated in
      isoelectric focusing gels with bovine lens alpha B and its phosphorylated form
      alpha Bp, respectively. Radioautography of the two-dimensional gels demonstrated
      the presence of 32P in the most acidic polypeptide. The results demonstrate the
      occurrence of alpha B phosphorylation in Alexander's disease brain tissue.

PMID- 1743283
TI  - Purification and characterization of a Kunitz-type trypsin inhibitor from Leaf
      nosed viper venom.
AB  - A Kunitz-type trypsin inhibitor was purified from Leaf-nosed viper venom and the
      primary structure determined by peptide analysis. In relation to other trypsin
      inhibitors, the protein has an extended C-terminal segment and a distinct pattern
      of residue alterations at the functionally important contact sites with
      proteases.

PMID- 1743284
TI  - Catalytic fragment of protein kinase C exhibits altered substrate specificity
      toward smooth muscle myosin light chain.
AB  - Smooth muscle myosin light chain (LC) can be phosphorylated by myosin light chain
      kinase (MLCK) at Ser19 and Thr18 and by protein kinase C (PKC) at Thr9 and Ser1
      or Ser2 under the in vitro assay conditions. Conversion of PKC to the
      spontaneously active protein kinase M (PKM) by proteolysis resulted in a change
      in the substrate specificity of the kinase. PKM phosphorylated both sets of sites
      in LC recognized by MLCK and PKC as analyzed by peptide mapping analysis. The PKM
      catalyzed phosphorylation of these sites was not greatly affected by a MLCK
      inhibitor, ML-9, nor by the activators of MLCK, Ca2+ and calmodulin.

PMID- 1743285
TI  - Ca2+ binding properties of type X collagen.
AB  - Type X collagen is a developmentally regulated collagen that is only synthesized
      by chondrocytes of the hypertrophic and calcifying zone in fetal cartilage. There
      is evidence in the literature that type X collagen may be involved in cartilage
      calcification. Here we show that type X collagen synthesis precedes calcium
      deposition in nodules of fetal human chondrocytes forming in cell culture and
      present evidence that type X collagen binds calcium in a specific and dose
      dependent manner. In an assay using bovine type X collagen coupled to beads and
      45Ca2+ we determined a total of about 15 binding sites per alpha 1(X) chain with
      a dissociation of 32 microM.

PMID- 1743286
TI  - An impaired peroxisomal targeting sequence leading to an unusual bicompartmental
      distribution of cytosolic epoxide hydrolase.
AB  - To gain an understanding of the mechanism by which the subcellular distribution
      of cytosolic epoxide hydrolase (cEH) is directed, we have analyzed the carboxy
      terminal region of rat liver cEH by means of cDNA cloning to define the structure
      of its possible peroxisomal targeting sequence (PTS). Purified cEH was subjected
      to peptide analysis following endoproteinase Glu-C digestion and HPLC-separation
      of the fragments. The obtained sequence information was used to perform PCR
      experiments resulting in the isolation of a 680 bp cDNA clone encoding the
      carboxy terminus of cEH. The deduced amino acid sequence displays a terminal
      tripeptide Ser-Lys-Ile which is highly homologous to the PTS (Ser-Lys-Leu) found
      in other peroxisomal enzymes. This slight difference appears to be sufficient to
      convert the signal sequence into an impaired and therefore ambivalent PTS,
      directing the enzyme partly to the peroxisomes and allowing part to reside in the
      cytosol.

PMID- 1743287
TI  - Immunological identification and sequence characterization of a peptide derived
      from the processing of neuroendocrine protein 7B2.
AB  - A newly raised antiserum against the C-terminal region of neuroendocrine protein
      7B2 was used to purify a novel peptide from the culture media of the mouse
      corticotroph cell line AtT-20. Based on partial sequencing, this peptide, which
      we call Cter-7B2, begins at Ser156 and appears to result from the cleavage of
      pro7B2 after a five-basic-residue sequence. Thus, 7B2 processing may contribute
      to the diversity of peptides found in neuronal and endocrine cells.

PMID- 1743288
TI  - Mechanism of maturation and nature of carbohydrate chains of boar sperm acrosin.
AB  - The acrosin zymogen proacrosin exists in two molecular forms which are believed
      to be single-chain polypeptides. During autoactivation in a cell-free system, the
      55 and 53 kDa zymogens are sequentially converted into the 49, 36, 31 and 25 kDa
      forms. A similar mechanism of maturation was revealed, when the calcium ionophore
      A23187 was added to suspensions of boar spermatozoa. The 49 kDa form has been
      identified as the first active acrosin form in the maturation cascade. However,
      this form is indistinguishable from the 53 kDa zymogen in SDS-PAGE at nonreducing
      conditions. Two carbohydrate chains were evidenced on the acrosin molecule. The
      chain attached to the Asn3 of the acrosin light chain was enzymatically cleaved
      without loss of acrosin activity. By contrast, the carbohydrate chain linked to
      the acrosin heavy chain could be cleaved only after acrosin denaturation. Based
      on the susceptibility of acrosin to endoglycosidases F and H, a biantennary
      structure of both carbohydrate chains is proposed.

PMID- 1743289
TI  - The modulation of ferryl myoglobin formation and its oxidative effects on low
      density lipoproteins by nitric oxide.
AB  - This study has investigated the interactions between nitric oxide and haem
      protein radicals. The results demonstrate that nitric oxide interacts with
      activated ferryl myoglobin species with reduction to metmyoglobin, but the extent
      and duration of the reduction depends on the relative concentrations of nitric
      oxide and hydrogen peroxide. Ferryl myoglobin has a much greater relative
      potential for oxidising polyunsaturated fatty acid side chains in low density
      lipoproteins than in cell membranes. The peroxidative response can be modulated
      by nitric oxide: ferryl myoglobin-mediated peroxidation of LDL may be enhanced or
      suppressed by nitric oxide depending on the relative concentrations of NO and
      hydrogen peroxide.

PMID- 1743290
TI  - In vivo study of the state of order of the membranes of gram-negative bacteria by
      Fourier-transform infrared spectroscopy (FT-IR).
AB  - Temperature-induced order/disorder transition profiles were obtained from the
      membranes of intact Gram-negative bacterial cells by FT-IR analysis of the
      frequency shifts of the acyl chain methylene symmetric stretching band as a
      monitor. Cells grown at different temperatures yielded distinct transition
      profiles. At the individual growth temperatures, however, the nearly alike
      frequency values indicated a very similar 'state of order' of the bacterial
      membranes. The FT-IR data were complemented by GC analysis of whole cell fatty
      acid composition. The FT-IR data obtained in vivo gave direct evidence of the
      adaptation of the 'state of order' and 'fluidity' of bacterial membranes to
      varying growth temperatures.

PMID- 1743291
TI  - Purkinje cells of rat and chicken cerebellum contain calreticulin (CaBP3).

PMID- 1743292
TI  - The 3' promoter region involved in RNA synthesis directed by the turnip yellow
      mosaic virus genome in vitro.
AB  - We have previously shown that the last 100 nucleotides from the 3' end of turnip
      yellow mosaic virus (TYMV) RNA compete in vitro with genomic RNA for the TYMV
      specific RNA-dependent RNA polymerase (RdRp). To further characterize the
      promoter on genomic RNA that produces complementary RNA strands, shorter
      fragments corresponding to the 3' region of the viral RNA were generated and used
      in in vitro assays. Fragments as short as 38 nucleotides corresponding to the 3'
      end of TYMV RNA compete with the viral RNA for the RdRp suggesting that the 3'
      promoter on plus strand RNA is probably less than or equal to 38 nucleotides
      long. These transcripts are themselves used as templates in vitro.

PMID- 1743293
TI  - Histone H1 and the regulation of transcription by nuclear receptors.
AB  - Histone H1 is a eukaryotic repressor which recognizes specific DNA structures,
      and nucleotides regulate its interaction with DNA. Since their mode of action may
      be considered similar to that observed in the case of plasma membrane GTPases, H1
      may be regarded as an ATP/GTPase involved in the action of nuclear receptors. A
      hypothesis is put forward here to suggest that transcriptional activators CTF/NF
      I and AP-1 (fos/jun), for example, are effectors for H1. H1 and CTF/NF-I may be
      members of a stimulatory regulatory cascade for nuclear receptor action that ends
      with selective activation of chromatin through histone modification and the
      disruption or a more subtle structural change of a specific nucleosome, while an
      opposite effect may be obtained through modification of fos/jun by H1.

PMID- 1743294
TI  - Structure of the active 27-residue fragment of human calpastatin.
AB  - A synthetic 27-residue peptide corresponding to exon 1B of the endogenous
      inhibitor calpastatin contains a well-conserved region and has an ability to
      inhibit the cysteine endopeptidase calpain specifically. We examined the solution
      structure of this peptide in DMSO-d6 by two-dimensional 1H NMR spectroscopy.
      Although regular secondary structures such as alpha-helix and beta-sheet were not
      found, the region from Ile18 to Arg23 formed a well-defined structure with a type
      I beta-turn. This region coincided well with the highly conserved region of
      calpastatin. The result strongly suggests that this turn structure is essential
      for the inhibitory activity of calpastatin.

PMID- 1743295
TI  - Different types of microsomal enzymes catalyze ortho- or para-hydroxylation in
      the biosynthesis of carnation phytoalexins.
AB  - Cell suspension cultures of carnation (Dianthus caryophyllus L.) accumulate, upon
      challenge with crude fungal elicitor, various dianthramide phytoalexins, all of
      which derive from N-benzoylanthranilate. In vitro, microsomes from the elicited
      carnation cells hydroxylated N-benzoylanthranilate in the 4- and/or 2'-positions
      to yield the hydroxyanthranilate and/or salicyloyl derivatives. 2'-Hydroxylation
      was shown to precede 4-hydroxylation in the formation of N-salicyloyl-4
      hydroxyanthranilate, and both these activities depended strictly on NADPH and
      molecular oxygen. 4-Hydroxylation was shown to be catalyzed by cytochrome P-450
      dependent monooxygenase(s), whereas the 2'-hydroxylating activity appeared to be
      due to a novel class of enzymes, also responding synergistically to NADH in
      combination with NADPH and showing apparent inhibition by cytochrome c but not by
      carbon monoxide. The difference in type of 4- and 2'-hydroxylases was
      corroborated by the exclusive inhibition of either activity in imidazole vs. MOPS
      buffers as well as their differential heat sensitivities. In the course of these
      studies, low concentrations of N-salicyloylanthranilate turned out to inhibit the
      cytochrome P-450-dependent 4-hydroxylation more strongly than any of the
      commercial inhibitor chemicals tested, while neither the substrate, N
      benzoylanthranilate, nor the final product, N-salicyloyl-4-hydroxyanthranilate,
      exhibited such significant inhibition. In addition, 2'-hydroxylation activity was
      affected much less by N-benzoylanthranilate, N-salicyloylanthranilate or by
      inhibitor chemicals. The results demonstrate the requirement of two different
      classes of hydroxylase activities that appear to introduce the antimycotic
      quality to the dianthramides for phytoalexin defense.

PMID- 1743296
TI  - Inhibition of protein kinase C is associated with a decrease in c-myc expression
      in human myeloid leukemia cells.
AB  - Treatment of human myeloid leukemic cells with phorbol esters such as 12-O
      tetradecanoylphorbol-13-acetate (TPA) is associated with activation and then
      partial down-regulation of protein kinase C activity. Previous work has suggested
      that the activation of protein kinase C by TPA contributes to the decrease in c
      myc expression during differentiation of these cells. The present studies
      demonstrate that the decline in c-myc mRNA levels following exposure of HL-60
      cells to TPA is preceded by an increase in expression of this gene. In contrast,
      exposure of HL-60 cells to inhibitors of protein kinase C activity is associated
      with down-modulation of c-myc expression. Similar findings have been obtained in
      U-937 myeloid leukemia cells. Taken together, these findings suggest that phorbol
      esters have a biphasic effect on c-myc expression. Whereas the activation of
      protein kinase C by phorbol esters may be associated with an increase in c-myc
      gene expression, the subsequent partial down-regulation of kinase activity may
      initiate a cascade of events resulting in the down-modulation of c-myc
      expression.

PMID- 1743297
TI  - Identification of a 220 kDa membrane-associated plant cell protein
      immunologically related to human beta-spectrin.
AB  - Electrophoretic analysis of low ionic strength extracts of tomato plant leaves
      revealed the presence of two proteins of apparent molecular weights of 240 kDa
      and 220 kDa which co-migrated with purified human erythrocyte alpha- and beta
      spectrin subunits. Immunochemical analyses employing an affinity-purified
      polyclonal antibody to human erythrocyte beta-spectrin reacted specifically with
      the 220 kDa plant cell protein. Immunofluorescence microscopy indicated that the
      beta-spectrin antibody recognized an antigen which was primarily restricted to
      the peripheral areas of the cells. Collectively, these results suggest that the
      cells of higher plants contain polypeptides related to the spectrin family of
      proteins. It is proposed that the plant cell possesses a membrane skeleton which
      is structurally and perhaps functionally analogous to that of the animal cell.

PMID- 1743298
TI  - 1H, 13C and 15N backbone assignments of cyclophilin when bound to cyclosporin A
      (CsA) and preliminary structural characterization of the CsA binding site.
AB  - The backbone 1H, 13C and 15N chemical shifts of cyclophilin (CyP) when bound to
      cyclosporin A (CsA) have been assigned from heteronuclear two- and three
      dimensional NMR experiments involving selectively 15N- and uniformly 15N- and
      15N,13C-labeled cyclophilin. From an analysis of the 1H and 15N chemical shifts
      of CyP that change upon binding to CsA and from CyP/CsA NOEs, we have determined
      the regions of cyclophilin involved in binding to CsA.

PMID- 1743299
TI  - A unique vacuolar processing enzyme responsible for conversion of several
      proprotein precursors into the mature forms.
AB  - Proprotein precursors of vacuolar components are transported from the endoplasmic
      reticulum into vacuoles, where they are proteolytically processed into their
      mature forms. However, the processing mechanism in plant vacuoles is very
      obscure. Characterization of a purified processing enzyme is required to
      determine whether a single enzyme is responsible for processing many vacuolar
      proteins with a large variability of molecular structure. If this is true, how
      can it recognize the numerous varieties of processing sites? We have now purified
      a processing enzyme (Mr = 37,000) from castor bean seeds. Our results show that
      the purified enzyme can process 3 different proproteins isolated from either the
      endoplasmic reticulum or transport vesicles in cotyledon cells to produce the
      mature forms of these proteins which are found at different suborganellar
      locations in the vacuole: the 2S protein found in the soluble matrix, the 11S
      globulin found in the insoluble crystalloid and the 51 kDa protein associated
      with the membrane. Thus a single vacuolar processing enzyme is capable of
      converting several proprotein precursors into their respective mature forms.

PMID- 1743300
TI  - Demonstration of L1-related mRNAs in rat brain using DNA oligonucleotide probes.
AB  - Only one copy of the cell adhesion molecule L1 gene is present in the mouse
      genome, and only one mRNA of 6 kilobases (kb) is expressed in mouse brain [1987,
      Neurosci. Lett. 82, 89-94]. We have constructed 5 synthetic oligonucleotide
      probes covering different parts of the published mouse L1 cDNA sequence. Using
      these probes 3 distinct mRNAs of 9.0, 7.0 and 6.0 kb in rat brain could be
      demonstrated. Hybridizations performed at different stringency conditions
      indicated that the 9.0 and 7.0 kb mRNAs were highly related to the L1 mRNA of 6.0
      kb expressed in rat brain. The 7.0 kb mRNA is possibly coding for a rat homologue
      of chicken Nr-CAM, whereas the 9.0 kb mRNA may code for a new member of the L1
      family.

PMID- 1743301
TI  - The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology in
      Warsaw.

PMID- 1743302
TI  - Surgical oncology in Poland.

PMID- 1743303
TI  - Ten years of experience with Parks' coloanal sleeve anastomosis for the treatment
      of post-irradiation rectovaginal fistula.
AB  - Twenty-four cases of coloanal sleeve anastomosis for the repair of rectovaginal
      post-irradiation fistula are described. All patients were previously irradiated
      because of carcinoma of the uterine cervix. Eleven patients had simultaneous
      repair of vesicovaginal fistula. One postoperative death was observed. Of the 23
      surviving patients, functional results were good in 18. In 16 patients with
      difficult stripping of the rectal mucosa, surgical curettage was performed. The
      latter procedure is suggested as a useful method in relevant cases.

PMID- 1743304
TI  - Surgical and cryosurgical salvage of oral and oropharyngeal cancer recurring
      after radical radiotherapy.
AB  - The results of salvage surgery or cryosurgery performed in 62 cases of oral or
      oropharyngeal cancer, recurring or persisting after radical radiotherapy, were
      analysed retrospectively. Salvage surgery was performed in 33 cases. The
      relatively high frequency of postoperative complications observed in years 1973
      1984, has declined since 1985, concomitant with the introduction of myocutaneous
      flaps for reconstruction. Twenty-nine patients who were disqualified from major
      surgery, were treated by cryosurgery. Using both methods, 3-year overall survival
      was obtained in 24.1% of cases.

PMID- 1743305
TI  - Preoperative radiotherapy combined with resection of squamous cell carcinoma of
      the mid-thoracic oesophagus. Does a histopathological malignancy grading system
      assess actual survival?
AB  - The aim of our study was to assess the reproducibility of the findings of
      Hambraeus et al. In their group of patients with squamous cell carcinoma of the
      oesophagus who underwent preoperative radiotherapy and resection, the
      histopathological malignancy grading score system was found to predict survival.
      We studied nine patients with squamous cell cancer of the mid-thoracic
      oesophagus, who had received radiotherapy followed by surgery and survived over
      12 months. We did not confirm the prognostic value of the histopathological
      malignancy grading score system.

PMID- 1743306
TI  - Preoperative concurrent chemotherapy and radiotherapy for local-regional and
      advanced squamous cell carcinoma of the thoracic oesophagus: preliminary results
      of a pilot study.
AB  - Preliminary experience based on the results of a pilot study on preoperative
      concurrent continuous i.v. infusion chemotherapy and radiotherapy for squamous
      cell carcinoma of the oesophagus in eight consecutive patients is presented.
      Chemotherapy consisted of 5-fluorouracil and cisplatin. Radiotherapy (Co-60) was
      delivered to a total dose of 3000 cGy. Clinical tolerance was good in four of
      eight patients, but poor in the remaining four, including three septic deaths.
      Oesophagectomy was performed in five patients with no postoperative deaths.
      Postoperative complications (Horner syndrome, hydrothorax, abdominal wound
      dehiscence) were observed in three cases. The response was categorized as
      complete (CR), partial (PR) or stable disease (SD), based on a comparison of the
      initial and immediate preoperative imaging studies and on the presence of tumour
      degeneration and/or necrosis in pathological examination of operative specimens.
      CR was observed in 1/8 patients, PR in 4/8 and SD in 3/8. Concurrent preoperative
      chemo- and radiotherapy may be effective as a neo-adjuvant or remission-inducing
      modality in the combined treatment of oesophageal carcinoma, however, it may also
      lead to fatal complications.

PMID- 1743307
TI  - Surgical delay of TRAM flaps for breast reconstruction.
AB  - The lower transverse rectus abdominis myocutaneous (TRAM) flap may give excellent
      results in breast reconstruction using autogenous tissues alone, however,
      surgical technique is demanding, and the risk of necrosis owing to vascular
      failure is high. We observed excellent vascularity of the flap in all 20 cases
      operated upon so far; in all these cases skin island was surgically delayed for
      one week before final transfer.

PMID- 1743308
TI  - The application of continuous thoracic epidural anaesthesia in outpatient
      oncological and reconstructive surgery of the breast.
AB  - The use of continuous thoracic epidural anaesthesia allows several oncological
      and reconstructive operations of the breast to be performed on an outpatient
      basis. The method is easy and safe in the hands of an experienced anaesthetist,
      and the recovery is immediate. The potential side effects (transient haemodynamic
      changes) may result from the sympathetic blockade and can be easily controlled
      during the operation. The method is not advocated in cases in which substantial
      blood loss is anticipated.

PMID- 1743309
TI  - Preoperative chemotherapy in primarily inoperable cancer of the breast.
AB  - One hundred and sixty patients with primarily inoperable breast cancer entered
      the preoperative chemotherapy protocol. The majority of patients (156) received
      chemotherapy according to the Cooper regimen (CMFVp), the remaining four were
      treated by the FAC regimen. Subsequently, mastectomy was performed in all
      patients. Postoperative treatment was chosen according to the hormonal status:
      premenopausal patients received chemotherapy (CMF), postmenopausal,
      hormonotherapy (tamoxifen). Overall 3 and 5-year survival rates were 58% and 38%,
      respectively. The degree of degeneration of cancer cells was estimated. Five-year
      overall survival rate in patients with significant cancer cell degeneration
      (greater than 75%) was higher, compared with patients without cancer cell
      degeneration (68% vs 33%, respectively P less than 0.002). We conclude that
      chemotherapy does not increase the rate of postoperative complications, and that
      the degeneration of cancer cells found in the specimen is an important factor
      with respect to improved survival.

PMID- 1743310
TI  - Breast cancer in elderly women: characteristics of the disease.
AB  - The records of 325 women aged over 70 years, with breast cancer were reviewed to
      identify the characteristics of the disease in elderly women and to determine the
      eventual effect of age on its management. Over 50% of patients were in the
      advanced stage (stage III or IV). The percentage of inoperable cases increased
      with greater delay between the onset of first symptoms and the first medical
      consultation (Chi-square (chi 2) = 42.8 P less than 0.001), but the delay time
      did not influence relative survival rates. Axillary lymph node status, stage of
      the disease and recurrences were the major factors influencing survival.
      Postoperative complications were analysed. Other, co-existing diseases were found
      in a significant number of patients (145, 44.6%); they did not influence long
      term results but increased postoperative mortality and morbidity. We conclude
      that breast cancer in elderly women can be treated by appropriate surgical
      therapy if the patient's overall performance status is good. Advanced age alone
      is not a contra-indication to the relevant therapy, corresponding with the stage
      of the disease.

PMID- 1743311
TI  - Early experience with 'fish-shaped' incision for mastectomy.
AB  - Early experience with the modified transverse incision for mastectomy is
      presented. A 'fish-shaped' incision, by adding two triangles at the lateral tip,
      decreases the amount of excess skin and prevents the 'dog ear' deformity, makes
      up the difference in the length of the transverse edges depending on the location
      of the tumour and provides easy access to the axilla.

PMID- 1743312
TI  - Differential diagnosis of thyroid tumours. An immunocytochemical study.
AB  - Fifty-seven patients with thyroid tumours, 11 malignant lymphomas, 12 follicular,
      eight papillary and 26 medullary carcinomas, were studied. HE stained sections
      and immunocytochemical reactions with mono- and polyclonal antibodies were
      evaluated. The usefulness of thyroglobulin staining in differential diagnosis of
      infiltrations and metastases was stressed. The group of medullary carcinomas was
      morphologically polymorphic and presented unexpected patterns of
      immunoreactivity. Recent embryological findings were discussed providing better
      understanding of this group of carcinomas. The presence of thyroglobulin, along
      with other markers in areas of medullary carcinoma in polymorphic tumours, and
      the presence of neuro-endocrine markers in areas of follicular or papillary
      differentiation seem to be concordant with the theory of a pluripotential cell,
      derived from neural crest and capable of differentiation into a variety of forms.

PMID- 1743313
TI  - The cancer problem in Poland: epidemiological trends, organization of specialized
      treatment, intervention programmes and research.

PMID- 1743314
TI  - Intravenous immunoglobulin treatment for recurrent abortions caused by
      antiphospholipid antibodies.
AB  - There is an association between the presence of antibodies that bind to anionic
      phospholipids and the occurrence of repeated spontaneous abortion. Many
      uncontrolled studies have reported favorable pregnancy outcome in women treated
      with steroids, low-dose aspirin, heparin, or their combination. Similarly,
      treatment failures have been reported with most of these therapeutic regimens.
      Immunoglobulins play a central role in immune regulation. A wide spectrum of
      human diseases are associated with decreased or abnormal regulation of Ig levels.
      Recently, IV preparations of Ig have become available for clinical use, including
      treatment of patients with recurrent abortions and high levels of
      antiphospholipid antibodies. The effectiveness of this new mode of therapy can be
      related to several immunological mechanisms such as blockade of antibody binding
      to receptors on macrophages, increase in T suppressor cells, or decrease in
      antibody synthesis. The latter effect may be mediated by anti-idiotypic
      antibodies in the Ig preparation. Determination of dosage of IV Ig, duration of
      treatment, and treatment intervals are all empirical in patients with recurrent
      abortions and high levels of antiphospholipid antibodies because antiphospholipid
      antibody levels are not useful for monitoring therapy. Although the data
      available at present are promising, additional randomized trials are needed to
      determine the efficacy of IV Ig in patients with immunological recurrent
      abortions.

PMID- 1743315
TI  - Partners in pursuit of excellence: development of an embryo laboratory
      accreditation program.

PMID- 1743316
TI  - Prevalence of human immunodeficiency virus in an infertile population.
AB  - OBJECTIVE: To assess the prevalence of human immunodeficiency virus (HIV)
      antibody in infertility. DESIGN: Prospective cross-sectional blind study.
      SETTING: An infertility clinic in Barcelona. PATIENTS: Three hundred thirty-five
      consecutive patients (308 infertile women and 27 spontaneous recurrent aborters)
      were seen between January 1989 and May 1990. MAIN OUTCOME MEASURE: Human
      immunodeficiency virus serostatus. RESULTS: The rate of seropositivity in the
      group of patients studied was 0.3% (95% confidence interval 0% to 0.9%).
      CONCLUSION: Further studies are desirable to establish the value of routine HIV
      testing in infertility patients as a population of women actively seeking
      pregnancy.

PMID- 1743317
TI  - Effects of vehicle supplementation on total estradiol absorption from a
      transdermal estradiol delivery system.
AB  - OBJECTIVE: To evaluate the effects of vehicle supplementation on serum estradiol
      (E2) delivery pharmacokinetics from the Ciba-Geigy (Summit, NJ) 0.1-mg Estraderm
      Patch. DESIGN: Postmenopausal women were randomized to a 28-day crossover
      treatment protocol separated by a 14-day wash out period. SETTING: Normal human
      volunteers were studied in an academic research environment. PATIENTS,
      PARTICIPANTS: The subject pool included eight healthy postmenopausal women
      between 32 and 60 years of age. INTERVENTIONS: In treatment A, a 0.1-mg Estraderm
      Patch was worn for 7 days; in treatment B, and identical patch was worn into
      which 0.6 mL of ethanol was injected on day 3 of use. MAIN OUTCOME MEASURES:
      Serum E2 levels were measured in both groups. RESULTS: Although E2 absorption
      showed characteristic interpatient variability, addition of ethanol significantly
      extended the mean time for serum E2 levels to return to baseline, without
      increasing peak absorption. The mean extension was 50 hours. CONCLUSION: The
      addition of ethanol to the Estraderm Patch increased the duration of elevated
      serum E2 levels measured in menopausal women, thus potentially increasing the
      effective life span of the transdermal therapeutic system.

PMID- 1743318
TI  - Comparative bioavailability of orally and vaginally administered progesterone.
AB  - OBJECTIVE: To study the pharmacokinetics of progesterone (P) in healthy
      premenopausal female volunteers to compare the bioavailability of orally or
      vaginally administered hormone. DESIGN: Subjects were randomly allocated to
      receive either oral P or a vaginal pessary then crossed over to the alternate
      preparation 1 month later. SETTING: The study was conducted in outpatient
      setting. SUBJECTS: All subjects were healthy, normal female volunteers who
      underwent a physical and gynecological examination before the study. None were
      using oral contraceptives. Ten subjects (mean age 32.6 +/- 7.3 years) entered the
      study and all completed it. INTERVENTIONS: Progesterone was administered as 200
      mg of micronized hormone or as a pessary containing 400 mg. MAIN OUTCOME MEASURE:
      Plasma levels of P were measured by radioimmunoassay to test the apriori
      hypothesis of similar bioavailability. RESULTS: Peak plasma P concentrations
      attained within 4 hours after oral administration ranged from 8.5 to 70.6 ng/mL,
      whereas after vaginal administration the peak levels were attained within 8 hours
      and ranged from 4.4 to 181.1 ng/mL. Considerable interindividual variation was
      noted. Area under the plasma concentration-time curve for the two formulations
      was not significantly different (F = 1.09; P greater than 0.1; ANOVA).
      CONCLUSIONS: The two formulations had similar bioavailability.

PMID- 1743319
TI  - Factors associated with withdrawal bleeding after administration of oral
      micronized progesterone in women with secondary amenorrhea.
AB  - OBJECTIVE: To compare two dosages of oral micronized progesterone (P) and placebo
      for withdrawal bleeding and side effects. DESIGN: Prospective, randomized, double
      blind. SETTING: Academic institution. PARTICIPANTS: Out of 190 screened with
      oligomenorrhea/amenorrhea, 60 who qualified completed the study. INTERVENTIONS: A
      10-day course of (1) oral micronized P 300 mg, (2) oral micronized P 200 mg, or
      (3) placebo. MAIN OUTCOME MEASURES: Withdrawal bleeding, side effects, and
      changes in lipids. Endogenous estradiol (E2) concentrations at baseline and P
      concentrations during treatment were correlated with bleeding response. RESULTS:
      Withdrawal bleeding occurred in 90% of women taking 300 mg, 58% of women taking
      200 mg, and 29% of women taking placebo (P less than 0.0002 for 300 mg versus
      placebo). Side effects occurred similarly among the groups (P = not significant).
      Lipid concentrations were unchanged. Endogenous E2 and treatment P concentrations
      were of limited predictive value for withdrawal bleeding. CONCLUSIONS:
      Progesterone 300 mg induced significantly more withdrawal bleeding than placebo,
      with similar side effects. Bleeding response cannot be predicted reliably from E2
      and P concentrations.

PMID- 1743320
TI  - Results of ovulation induction using human menopausal gonadotropin or purified
      follicle-stimulating hormone in hypogonadotropic hypogonadism patients.
AB  - OBJECTIVE: To compare ovarian performance and hormonal levels, after ovulation
      induction, in patients with isolated hypogonadotropic hypogonadism, using two
      different gonadotropin drugs. DESIGN: Patients were treated during consecutive
      cycles, using the same stimulation protocol, with human menopausal gonadotropin
      (hMG) in the first treatment cycle and purified follicle-stimulating hormone
      (FSH) in the second one. SETTING: Specialist Reproductive Endocrine Unit.
      PATIENTS, PARTICIPANTS: Nine patients with isolated hypogonadotropic
      hypogonadism. MAIN OUTCOME MEASURE: Duration of stimulation, number of leading
      follicles, serum estradiol (E2) concentration and endometrial thickness at the
      time of human chorionic gonadotropin administration, and the occurrence of
      ovulation. RESULTS: Compared with hMG, treatment with purified FSH required
      significantly more ampules of drug (P less than 0.04) but resulted in a
      significant reduction in the number of leading follicles (P less than 0.05),
      serum E2 concentrations (P less than 0.002), endometrial thickness (P less than
      0.02) and the occurrence of ovulation (P less than 0.05). CONCLUSION: This study
      in isolated hypogonadotropic hypogonadism patients is consistent with the two
      cell two-gonadotropin hypothesis, that both gonadotropins are required to
      accommodate their synergistic action for appropriate steroidogenesis. In treating
      this group of patients, the superior efficacy of hMG compared with purified FSH
      preparation is beyond question.

PMID- 1743321
TI  - Endocrinology of gonadotropin-releasing hormone induced cycles in hypothalamic
      amenorrhea: the role of the pulse dose.
AB  - OBJECTIVE: To find the treatment regimen giving a maximum chance of ovulation and
      a minimal chance of multiple follicular development in pulsatile gonadotropin
      releasing hormone (GnRH) therapy in patients with hypothalamic amenorrhea.
      DESIGN: We propectively studied the endocrinology of cycles induced with 5, 10,
      and 20 micrograms GnRH pulse doses, randomly assigned per patient, comparing this
      with the endocrinology of spontaneous menstrual cycles. SETTING: All patients
      were treated at the Academic Hospital of the Vrije Universiteit, Division of
      Reproductive Endocrinology and Fertility. PATIENTS: Fifteen patients with
      hypothalamic amenorrhea were treated for one to three cycles; 14 normally cycling
      volunteers were studied for one cycle. MAIN OUTCOME MEASURE: Number of ovulations
      per pulse dose; luteinizing hormone, follicle-stimulating hormone, total urinary
      estrogens (Es), and pregnanediol were measured per cycle day and per stimulation
      day. RESULTS: The endocrinology of all ovulatory cycles remained within the
      normal range. First treatment cycles showed significantly higher ovulation rates
      compared with subsequent cycles. Significantly more anovulation was observed in
      cycles with 5-micrograms pulse doses. Luteal Es were significantly higher in
      induction cycles compared with controls. CONCLUSIONS: The optimum treatment
      regimen should be to start induction with 5 micrograms/pulse in the first cycle
      and to raise the dose to 10 micrograms/pulse in subsequent cycles, regardless of
      the outcome of the first cycle. After ovulation, the pulse interval should be
      changed to 240 minutes.

PMID- 1743322
TI  - Transvaginal ultrasound-guided follicular aspiration in the management of
      anovulatory infertility associated with polycystic ovaries.
AB  - STUDY OBJECTIVE: To investigate whether or not transvaginal ultrasound (US)
      guided follicular aspiration can effectively induce ovulation and facilitate
      pregnancy in anovulatory patients with polycystic ovaries (PCO). DESIGN: Eight
      patients with polycystic ovarian disease (PCOD) and 10 patients with PCO were
      participants who failed to ovulate by the medical therapies. Most of persistent
      follicles were punctured, and their contents were thoroughly aspirated during the
      midluteal phase. The same ovarian stimulation regimen as used in the previous
      cycles were administered in the cycles after the aspiration. MAIN OUTCOME
      MEASURES: Evidence of ovulation and a subsequent pregnancy was ultrasonically
      monitored after the aspiration, and the responsiveness of pituitary gonadotropins
      to gonadotropin-releasing hormone was tested in these patients. RESULTS: The
      ovulation rates were 87.5% per patient, 52.6% per cycle monitored in PCOD
      patients and 100% per patient, 63.3% per cycle monitored in PCO patients,
      respectively. Half of the patients both with PCOD and PCO achieved pregnancy
      after the aspiration. A significant decrease (P less than 0.05) of the basal and
      peak levels of serum luteinizing hormone was observed after the aspiration.
      CONCLUSIONS: The US-guided follicular aspiration seems to be a new surgical
      method for treating anovulatory patients with PCO.

PMID- 1743323
TI  - Elimination of ovulation and menstrual cyclicity (with danazol) improves
      dysphoric premenstrual syndromes.
AB  - OBJECTIVE: To assess whether the therapeutic effect of danazol on premenstrual
      syndromes (PMS) is associated with suppression of ovulation. DESIGN: After 1
      month on placebo, we administered 200 mg/d of danazol for 90 days to 24 women
      with dysphoric PMS. Symptoms during ovulatory cycles were compared with
      anovulatory periods. SETTING: Outpatient PMS program in a general hospital.
      PATIENTS: Twenty-four women who had dysphoric PMS and otherwise were physically
      and mentally healthy. INTERVENTIONS: None (except the oral medication). MAIN
      OUTCOME MEASURE: Prospective daily monitoring of symptoms with the Daily Rating
      Form, before, during, and after treatment. RESULTS: Twenty of 23 anovulatory
      periods were symptom-free versus 6 of 32 ovulatory periods (chi 2 = 15.63, P =
      0.0002). CONCLUSION: The beneficial effect of danazol as treatment depends mostly
      on achieving an an-ovulatory state and elimination of hormonal cyclicity and not
      on the drug per se.

PMID- 1743324
TI  - Local luteolytic effect of prostaglandin F2 alpha in the human corpus luteum.
AB  - OBJECTIVE: To evaluate the effects of prostaglandin (PG)F2 alpha on human corpus
      luteum (CL) function in vivo. DESIGN: The effects of a single injection of PGF2
      alpha into the CL was studied. SETTING: The patients underwent elective surgery
      at the Department of Obstetrics and Gynecology, Sahlgrenska Hospital, University
      of Goteborg, Sweden. PARTICIPANTS: Twenty women with regular menstrual cycles
      undergoing laparoscopy for legal sterilization with tubal clips volunteered for
      the study. INTERVENTIONS: Prostaglandin F2 alpha (3 mg) was injected through the
      abdominal wall into the CL. In control cases, vehicle was injected into the CL or
      PGF2 alpha into the contralateral ovary. MAIN OUTCOME MEASURE: After the
      injections, serum was analyzed for progesterone (P) and luteinizing hormone using
      fluoroimmunoassay and enzyme-immunoassay, respectively. Menstrual data were
      recorded. RESULTS: In contrast to control cases, intraluteal injection of PGF2
      alpha caused both an immediate fall of greater than 30% in serum P and a
      shortening of the luteal phase by 2 to 5 days. Luteinizing hormone varied
      independently of the changes in serum P levels. CONCLUSION: The results suggest a
      local role for PGF2 alpha in human luteolysis.

PMID- 1743325
TI  - Severe ovarian hyperstimulation syndrome: role of peripheral vasodilation.
AB  - OBJECTIVE: To investigate the pathogenesis of the systemic hemodynamic
      disturbance and the renal production of vasodilator prostaglandins (PGs) in the
      ovarian hyperstimulation syndrome. DESIGN: Prospective longitudinal study.
      SETTING: Assisted Reproduction Unit of the Hospital Clinic i Provincial in
      Barcelona. PATIENTS: Five in vitro fertilization patients with ascites because of
      severe ovarian hyperstimulation syndrome. MAIN OUTCOME MEASURES: Measurement
      during the syndrome and 4 weeks after recovery of the following: cardiac output,
      arterial pressure, estimated peripheral vascular resistances, hematocrit,
      standard renal function tests, plasma renin activity, plasma aldosterone,
      norepinephrine and antidiuretic hormone concentrations, and urinary excretion of
      PGE2 and 6-keto-PGF1 alpha. RESULTS: During the syndrome, all patients showed
      arterial hypotension (74.2 +/- 3.8 versus 85.8 +/- 1.0 mm Hg), tachycardia,
      increased cardiac output (6.4 +/- 0.2 versus 4.4 +/- 0.1 L/min), low peripheral
      vascular resistance (929 +/- 52 versus 1,568 +/- 51 dyn/sec per cm-5), high
      plasma levels of renin (72 +/- 25 versus 0.5 +/- 0.1 ng/mL per h-1),
      norepinephrine (639 +/- 141 versus 203 +/- 21 pg/mL) and antidiuretic hormone
      (6.1 +/- 1.6 versus 1.5 +/- 0.1 pg/mL), and increased urinary excretion of PGE2
      (551 +/- 152 versus 106 +/- 44 pg/min) and 6-keto-PGF1 alpha (470 +/- 76 versus
      99 +/- 11 pg/min). No evidence of hemoconcentration, as assessed by hematocrit,
      was observed in any patient. CONCLUSIONS: (1) Severe ovarian hyperstimulation
      syndrome is related to marked arteriolar vasodilation that leads to underfilling
      of the arterial vascular compartment and stimulation of endogenous
      vasoconstrictor systems and (2) the increased urinary excretion of PGs probably
      represents a homeostatic response to antagonize the renal effects of these
      systems.

PMID- 1743326
TI  - Are consumers of modern fertility treatments satisfied?
AB  - OBJECTIVE: To determine the extent of patients satisfaction with fertility
      treatments, its antecedents, and its correlates. DESIGN: This is a two-wave
      correlational panel study in which consumer satisfaction was assessed 6 and 12
      months after admission to the clinic. PATIENTS: The sample consisted of 385
      couples who consulted the fertility clinic of a large metropolitan hospital.
      MEASURES: After their admission, patients completed scales measuring psychosocial
      disturbances. These variables were reassessed 6 and 12 months later along with a
      consumer satisfaction questionnaire. RESULTS: Patients were generally satisfied
      with modern fertility treatments. Approximately 10% of the sample expressed
      dissatisfaction with received services. Analyses revealed that consumer
      satisfaction was significantly related to poor psychosocial functioning at intake
      and after 6 months. CONCLUSIONS: Our results suggest that consumers of fertility
      treatments are generally satisfied with the quality and quantity of service they
      received at the clinic. The more patients exhibited personal, marital, and social
      symptoms of distress when they were admitted to the clinic, the more they were
      likely to be later dissatisfied with fertility treatments.

PMID- 1743327
TI  - Aging of endometrium and oocytes: observations on conception and abortion rates
      in an egg donation model.
AB  - OBJECTIVE: To assess the comparative contribution of endometrial and oocytic
      aging to the decline in fertility with age. DESIGN: Retrospective analysis of
      conception and abortion rates in an egg donation program, with respect to donor
      and recipient ages. PATIENTS: All oocyte recipients had ovarian failure. Donors
      were women undergoing in vitro fertilization who contributed up to a third of
      retrieved oocytes. INTERVENTIONS: None. RESULTS: Thirty pregnancies (28
      intrauterine) were recorded in 169 reception cycles originating from 91 donation
      cycles. Women who conceived were younger than those who did not (median age 31
      versus 37; P less than 0.046), with no difference in age of donors. There was a
      significant difference in spontaneous abortion rate by age of donor rather than
      by age of recipient. Donors to successful pregnancies were younger than donors to
      aborted pregnancies (median age 27.5 versus 33; P less than 0.0211), but the 11
      women with aborted pregnancies did not differ in age from the 17 women with
      successful pregnancies. CONCLUSIONS: In women, endometrial function as expressed
      by conception rate in the recipients declines with age, whereas it is oocyte age
      that primarily influences risk of abortion.

PMID- 1743328
TI  - The effect of pituitary suppression and the women's age on embryo viability and
      uterine receptivity.
AB  - OBJECTIVE: To examine the effect of pituitary suppression and the women's age on
      embryo viability and uterine receptivity. DESIGN: Retrospective analysis of 394
      embryo transfers (ET) after in vitro fertilization (IVF). SETTING: Community
      hospital IVF program from 1986 to 1990. PATIENTS: Three groups were studied:
      women less than 40 years with pituitary suppression (group 1) and without
      pituitary suppression (group 2); women 40 years of age and older with pituitary
      suppression (group 3). INTERVENTIONS: Pituitary suppression was achieved in
      groups 1 and 3 with daily leuprolide acetate starting in the luteal phase; human
      menopausal gonadotropin and progesterone were given intramuscularly. MAIN OUTCOME
      MEASURES: Ongoing and multiple ongoing pregnancy rates (PRs) were compared in the
      three groups. A mathematical model of implantation was used to estimate embryo
      viability and uterine receptivity. RESULTS: Ongoing and multiple ongoing PRs per
      ET in group 1 (28.6% and 12.3%) were significantly higher than the corresponding
      rates in group 2 (16.9% and 2.4%) and in group 3 (16.9% and 3.4%). Implantation
      analysis revealed higher embryo viability without change in uterine receptivity
      with pituitary suppression (group 1 versus 2). Decrease in both embryo viability
      and uterine receptivity was noted in women greater than 40 (group 1 versus 3).
      CONCLUSIONS: (1) Pituitary suppression improved implantation outcome by
      increasing embryo viability with no change in uterine receptivity and was
      associated with a high multiple PR in women less than 40; (2) in women greater
      than 40 both embryo viability and, to a lesser extent, uterine receptivity were
      decreased; (3) transfer of a larger number of embryos in older patients may
      improve IVF outcome without excessive risk of multiple pregnancy.

PMID- 1743329
TI  - Cotreatment with growth hormone, after pituitary suppression, for ovarian
      stimulation in in vitro fertilization: a randomized, double-blind, placebo
      control trial.
AB  - OBJECTIVE: To explore the effect of cotreatment with growth hormone (GH) for
      ovarian stimulation after pituitary suppression. DESIGN: A randomized, double
      blind, placebo-controlled study. SETTING: Specialist Reproductive Endocrine and
      In Vitro Fertilization (IVF) Unit. PATIENTS, PARTICIPANTS: Twenty-five IVF
      patients who had responded suboptimally in a previous treatment cycle. A subgroup
      of 18 patients were found to have ultrasound (US) findings of polycystic ovaries
      (PCO). MAIN OUTCOME MEASURE: The amount of gonadotropin used, development of
      follicles greater than or equal to 14 mm, number of oocytes collected,
      fertilized, cleaved and replaced, serum and follicular fluid (FF) insulin-like
      growth factor I (IGF-I) concentrations. RESULTS: Cotreatment with GH was
      associated with a significant reduction in gonadotropins requirement (P less than
      0.05). In patients with US-diagnosed PCO more follicles developed (P less than
      0.05), more oocytes were collected (P less than 0.03), fertilized (P less than
      0.004), and cleaved (P less than 0.02). A significantly higher FF IGF-I
      concentrations were found in patients receiving cotreatment with GH compared with
      those who received placebo (P less than 0.04). CONCLUSION: We believe that there
      may be a place for GH treatment in selected IVF cycles after pituitary
      suppression but what the role of IGF-I should further be investigated.

PMID- 1743330
TI  - Poor implantation of cryopreserved reinsemination-fertilized human embryos.
AB  - OBJECTIVE: To investigate whether a poor rate of implantation after in vitro
      fertilization (IVF) was due to poor embryonic/endometrial synchrony during the
      original IVF cycle, we have cryopreserved reinseminated-fertilized embryos for
      later more synchronous replacement after thawing. The chance of implantation of
      fresh reinseminated fertilized human oocytes is approximately one tenth that of
      timely fertilized embryos. STUDY DESIGN AND DATA: Retrospective study of 35
      original oocyte collections in which initial normal fertilization was 47.3%
      (129/273 oocytes), with 49.6% fertilization (67/135) upon reinsemination. Of
      these, 70 initially fertilized and 67 reinsemination-fertilized embryos were
      cryopreserved, and 50 initially fertilized and all 67 reinsemination-fertilized
      embryos were subsequently thawed with 72% and 63% cryosurvival, respectively,
      (not significant). SETTING: Private infertility clinic. RESULTS: In 11 cycles, 23
      thawed initially fertilized embryos (group A) were replaced with a 21.7%
      implantation rate per embryo; in 10 cycles, 13 initially fertilized and 12
      reinsemination-fertilized embryos (group B) were replaced together with an 8%
      implantation rate; finally, in 16 cycles, 30 reinsemination-fertilized embryos
      (group C) were replaced with a 3.3% implantation rate (group A versus group C: P
      = 0.076). Comparison of clinical pregnancies between these groups was
      significantly different (6/11 versus 1/16; P = 0.0427). CONCLUSION:
      Reinsemination-fertilized embryos survive freezing as well as initially
      fertilized embryos, but better embryonic/endometrial synchrony does not improve
      chances of their implantation.

PMID- 1743331
TI  - Microinjection of human oocytes: a technique for severe
      oligoasthenoteratozoospermia.
AB  - OBJECTIVE: To determine outcome after microinjection with very poor quality sperm
      and after failed fertilization. DESIGN: Group 1, fresh oocytes from patients with
      very low sperm density and motility on the day of oocyte recovery; Group 2, 1-day
      old oocytes that failed to fertilize. SETTING: All material was obtained from the
      National University Hospital. PATIENTS: One hundred and thirty-one from group 1;
      35 from group 2. INTERVENTIONS: Sperm was injected subzonally or directly into
      the ooplasm. MAIN OUTCOME MEASURE: Normal and abnormal fertilization and
      pregnancy. RESULTS: Subzonal transfer was done on 771 oocytes in group 1 and 188
      oocytes in group 2. Multiple sperm were transferred [mean of 6.6 for group 1 and
      7.3 for group 2]. Monospermic fertilization occurred in 16.6% and 14.9%,
      respectively. Polyspermy and parthenogenetic activation were low at 2.3% and
      2.8%, respectively. Five pregnancies were obtained, but only one delivered.
      Ooplasmic injection (single sperm heads) was done in 38 oocytes from three
      patients with extremely severe oligozoospermia; only four two-pronuclear zygotes
      were obtained and replaced into two patients, without any resulting pregnancy.
      CONCLUSIONS: Subzonal transfer may be a viable technique for patients with severe
      sperm problems.

PMID- 1743332
TI  - Assessment of the relevance of zona pellucida antibodies in serum and cervical
      mucus in patients who have fertilization failure during in vitro fertilization.
AB  - OBJECTIVE: To assess whether antibodies to the zona pellucida can cause
      fertilization failure during in vitro fertilization (IVF). DESIGN: Two methods
      for detecting zona pellucida antibodies were used to assess 20 women undergoing
      IVF. Nine patients had failed fertilization during the treatment cycle. SETTING:
      Academic IVF department of a teaching hospital. PATIENTS: Infertile patients
      previously assessed as requiring IVF. INTERVENTIONS: Gonadotropin-releasing
      hormone analogue to achieve pituitary down regulation and human menopausal
      gonadotropin for superovulation. Transvaginal ultrasound directed oocyte
      recovery. Cervical mucus and serum samples were obtained. MAIN OUTCOME MEASURES:
      The presence of antizona pellucida antibodies in serum or cervical mucus in
      relation to fertilization. RESULTS: Seven of 20 patients had antizona antibodies
      in serum and 7 of 20 patients had antibodies in mucus. Only 1 patient had
      antibodies in both samples. No correlation between the presence of antibodies in
      either sample and failure of fertilization was found. CONCLUSION: Detection of
      antizona pellucida antibodies by the methods described have no role in the
      prediction of IVF.

PMID- 1743333
TI  - Movement characteristics of human epididymal sperm used for fertilization of
      human oocytes in vitro.
AB  - STUDY OBJECTIVE: To develop mathematical models using kinematic parameters from
      Computer-Aided Sperm Analysis (CASA) that predict the fertilization rate of sperm
      recovered from the caput epididymidis and to test the hypothesis that
      fertilization was enhanced by the presence of specific sperm subpopulations in
      the inseminate. SETTING: In vitro fertilization (IVF) program. PATIENTS: Thirteen
      patients with congenital absence of the vas deferens provided epididymal sperm
      for IVF as well as for CASA. RESULTS: The mathematical model that was most
      predictive of fertilization rates included kinematic parameters of the epididymal
      aspirate (percent motility), the inseminate used for IVF (curvilinear velocity
      [VCL]), and the change in sperm movement after in vitro processing by the mini
      Percoll technique (difference in amplitude of lateral head displacement [ALH]).
      Multivariate cluster analysis revealed that inseminates that resulted in higher
      fertilization rates had subpopulations of sperm that were characterized by high
      VCL and high mean angular displacement, as well as a greater change in ALH after
      processing. CONCLUSION: In vitro fertilization with epididymal sperm was more
      likely to succeed when the sperm population that was initially aspirated had a
      higher proportion of motile cells and when these sperm were capable of
      capacitation in vitro as indicated by the appearance of sperm subpopulations with
      motility that resembled hyperactivation.

PMID- 1743334
TI  - 31P magnetic resonance spectroscopy for diagnosing abnormal testicular function.
AB  - OBJECTIVE: To determine if testicular 31P magnetic resonance (MR) spectroscopy
      can be of additional clinical value. DESIGN: A controlled study in three selected
      subjects groups. SETTING: All participants were referred to the outpatient clinic
      of our Department of Obstetrics and Gynecology. PARTICIPANTS: Normal healthy
      volunteers (n = 13), oligozoospermic (n = 14), and azoospermic patients (n = 17;
      6 with epididymal obstruction and 11 with severe germ cell depletion) were
      selected on the basis of semen analysis, hormone determinations, and, if
      necessary, on operative exploration. INTERVENTIONS: Magnetic resonance
      spectroscopy was performed on a Philips Gyroscan S15 (Philips Medical Systems,
      Best, the Netherlands). MAIN OUTCOME MEASURE(S): The routine clinical analyses
      were compared with the outcome of testicular MR spectroscopy to test the
      hypothesis that MR spectroscopy can be of additional value in the diagnosis of
      idiopathic oligozoospermic or azoospermic patients. RESULTS: The MR spectra of
      normal volunteers were significantly different from oligozoospermic patients (P
      less than 0.001), from azoospermic patients with germ cell depletion (P less than
      0.001), and from azoospermic patients with an obstruction (P less than 0.05).
      Between the two azoospermic groups also a significant difference was found (P
      less than 0.001). CONCLUSIONS: These results show that MR spectroscopy is a
      reliable technique to monitor the testicular function.

PMID- 1743335
TI  - Comparison of gonadotropin-releasing hormone and gonadotropin therapy in male
      patients with idiopathic hypothalamic hypogonadism.
AB  - OBJECTIVE: To compare pulsatile gonadotropin-releasing hormone (GnRH) therapy
      with gonadotropin therapy in male patients with idiopathic hypothalamic
      hypogonadism. DESIGN: Prospective study. Patients had free choice between the two
      forms of therapy. SETTING: Patients were treated on an outpatient basis in our
      department. PATIENTS: Eighteen patients of matched age (mean [+/- SD] age: 21.1
      +/- 3.0 years and 23.6 +/- 7.3 years) and similar testicular volume were treated
      in each group. INTERVENTIONS: Pulsatile GnRH therapy was started with 4
      micrograms GnRH subcutaneously every 2 hours using a portable pump and
      gonadotropin therapy with 3 x 2,500 IU human chorionic gonadotropin (hCG) weekly
      injected intramuscularly. After 8 to 12 weeks of hCG treatment, 150 IU human
      menopausal gonadotropin two to four times weekly were added. RESULTS:
      Testosterone (T) and estradiol (E2) levels increased significantly higher (T: P
      less than 0.03; E2; P less than 0.001) in the gonadotropin group than in the GnRH
      group (T: 22.5 +/- 8.1 versus 16.8 +/- 5.5 nmol/L; E2: 150 +/- 70 versus 88. +/-
      59 pmol/L). Five patients developed gynecomastia during gonadotropin therapy. The
      rise of testicular volume was significantly more pronounced (P less than 0.001)
      in the GnRH group (delta testicular volume = 8.1 +/- 2.0 mL) than in the
      gonadotropin group (delta testicular volume = 4.8 +/- 1.8 mL). Ten patients of
      the GnRH and 8 of the gonadotropin group had positive sperm counts, ranging from
      1.5 to 26 x 10(6) spermatozoa/mL. The latter was achieved more rapidly in the
      GnRH group (12 +/- 1.6 versus 20 +/- 2.3 months: P less than 0.02). CONCLUSIONS:
      Endocrine and exocrine testicular function can be normalized by both forms of
      therapy. Gonadotropin therapy has more side effects. Gonadotropin-releasing
      hormone leads to a higher testicular volume and a more rapid initiation of
      spermatogenesis compared with gonadotropin therapy.

PMID- 1743336
TI  - Cryopreservation of the occasionally improved semen samples for intrauterine
      insemination: a new approach in the treatment of idiopathic male infertility.
AB  - OBJECTIVE: To assess the value of treating idiopathic male infertility by
      intrauterine insemination (IUI) of the occasionally improved cryopreserved semen.
      DESIGN: Two groups of idiopathic oligospermic patients were chosen at random and
      treated by IUI using processed fresh semen in group A and the best available
      cryopreserved semen samples pooled with fresh samples in group B. SETTING:
      Egyptian IVF-ET Centre, Maadi, CAiro, Egypt. PATIENTS, PARTICIPANTS: One hundred
      fifty infertile couples because of idiopathic oligoasthenospermia. INTERVENTION:
      Intrauterine insemination. MAIN OUTCOME MEASURE: The pregnancy rate was evaluated
      after an average of three treatment cycles. RESULTS: The pregnancy rate (PR) was
      significantly higher in group B when compared with group A. The improvement in
      the PR was highly significant in the subgroup of patients for whom reasonable
      semen samples could be collected and cryopreserved. CONCLUSIONS: Our study
      indicates that IUI with fresh semen pooled with cryopreserved occasionally
      improved semen samples for the treatment of oligoasthenospermia results in an
      improved PR.

PMID- 1743337
TI  - Defining the valid hemizona assay: accounting for binding variability within
      zonae pellucidae and within semen samples from fertile males.
AB  - OBJECTIVE: To achieve a better understanding of the variability in sperm and
      oocyte binding capacities will optimize use of the hemizona assay (HZA) as a
      predictor of sperm function. DESIGN: Limitations of the HZA were more clearly
      delineated by current studies: (1) variability of sperm binding capacity of men
      over a 90-day interval; (2) variability of sperm binding using different oocytes;
      and (3) lower limits of the number of sperm bound from the fertile control in two
      laboratories. PATIENTS: Semen was obtained from proven fertile men and one
      subfertile individual. MAIN OUTCOME MEASURE: The number of sperm tightly bound to
      the hemizona were measured and compared. RESULTS: In the initial study, 6 fertile
      control men exhibited a similar degree of variability in zona binding when
      studied over a 90-day interval. Average sperm binding for individuals ranged from
      68 to 127. Second, 3 of the 15 simultaneous assays showed very low numbers of
      sperm bound, indicating that 20% of the zonae had poor binding. Third, from 18
      men who had 0% fertilization in an in vitro fertilization system using mature
      oocytes, evaluation of their sperm by HZA was performed. The sperm bound poorly
      and the 95% confidence interval was 20 sperm bound. Thus, the fertile controls
      should bind greater than 20 sperm to distinguish them from the infertile group in
      the HZA system resulting in a valid assay. CONCLUSIONS: With these guidelines,
      applications of the HZA may be made with greater reassurance of a valid bioassay
      of sperm fertilizing potential.

PMID- 1743338
TI  - Filtration of spermatozoa through L4 membrane: a new method.
AB  - OBJECTIVE: To explore the possibility of using the L4 membrane filtration device
      for processing of spermatozoa for intrauterine insemination and other assisted
      reproductive techniques. DESIGN, SETTING, PATIENTS: Semen samples from 15
      patients attending an infertility clinic of a tertiary referral institution and
      from seven fertile donors were used for the study. MAIN OUTCOME MEASURES: The
      effect of L4 membrane filtration was studied on the following semen parameters:
      sperm motility, velocity, percentage of normal and abnormal sperm forms, and
      percentage and concentration of round cells in semen. RESULTS: The statistical
      analysis of data from both the subfertile patient population and the normal
      fertile donor group showed similar improvement in semen quality after L4 membrane
      filtration. Therefore, the results for these two groups were combined for
      statistical purposes. Our findings demonstrate a significant increase in normal
      sperm forms and a decrease in abnormal forms after filtration of specimens
      through the L4 membrane. In all subjects, the mean sperm motility increased from
      47% to 77% (P less than 0.0001); velocity increased from 30 to 48 microns/seconds
      (P less than 0.0001); normal sperm forms increased from 53% to 84% (P less than
      0.0001); abnormal forms decreased from 28% to 10% (head defects) (P less than
      0.0001); neck defects from 3.5% to 1% (P less than 0.0006); tail defects from 8%
      to 3.5% (P less than 0.005); and undifferentiated round cells decreased from 6%
      to less than 1% (P less than 0.002) after filtration. The concentration of round
      cells counted by the Makler chamber (Sefi Medical, Haifa, Israel) decreased
      significantly from 6 x 10(6)/mL to 0.2 x 10(6)/mL (P less than 0.0003).
      Similarly, white blood cell counts measured by the Endtz test also decreased from
      3.4 x 10(6)/mL to less than 0.1 x 10(6) (P less than 0.043). CONCLUSION: We
      conclude that the filtration of the semen specimens through L4 membrane results
      in a significant improvement in semen parameters and should be considered as an
      adjunct in sperm processing.

PMID- 1743339
TI  - Pregnancy after fimbriectomy reversal: results of microsurgery augmented by
      gamete intrafallopian tube transfer and embryo transfer.
AB  - In this study, fimbriectomy reversal resulted in a 43% intrauterine PR and a
      fecundability of 6.6%. The cumulative PR and the fecundability were 57% and 7.8%,
      respectively, when microsurgery was augmented by GIFT and embryo cryopreservation
      during the same treatment cycle and by subsequent embryo thaw and transfer.

PMID- 1743340
TI  - A novel superovulation regimen: three-day gonadotropin-releasing hormone agonist
      with overlapping gonadotropins.

PMID- 1743341
TI  - Influence of endometrial thickness and echo patterns on pregnancy rates during in
      vitro fertilization.
AB  - Previous data has suggested that improved PRs were seen in women with increased
      endometrial thickness as determined by sonography before oocyte retrieval. The
      hyperstimulation protocol used was CC-hMG. The study presented herein was
      initiated to evaluate if a similar trend was evident in women whose
      hyperstimulation protocol included the long LA-hMG therapy. We also demonstrated
      an improved PR in women with greater endometrial thickness, but in general, the
      endometrium was thicker in the pregnant women treated with the gonadotropin
      releasing hormone agonist than in those treated with CC.

PMID- 1743342
TI  - A comparison of intrauterine insemination, intraperitoneal insemination, and
      natural intercourse in superovulated women.
AB  - In a prospective comparison of IP, IUI, and natural intercourse following
      superovulation in couples diagnosed as having unexplained infertility, semen
      factors, or sperm antibodies, pregnancy rates were found to be significantly
      higher after IP. Pregnancy rates were also higher in the unexplained infertility
      group when compared with those with semen factors. It was concluded that IP in
      combination with superovulation offered a simple, inexpensive, safe alternative
      to GIFT.

PMID- 1743343
TI  - Anaphylaxis during intrauterine insemination secondary to bovine serum albumin.
AB  - A case of anaphylaxis is reported after IUI with sperm processed in Tyrode's
      solution supplemented with BSA. The patient had a positive prick cutaneous test
      to BSA and also had specific IgE antibody against it. Repeat IUI using the
      patient's own blood serum instead of BSA for processing the sperm proceeded
      without incident. Clinicians should be aware of this rare, but not
      inconsequential, adverse effect of using xenogeneic proteins during IUI and other
      assisted reproductive techniques.

PMID- 1743344
TI  - Mullerian defects in women with normal reproductive outcome.
AB  - The incidence of uterine congenital anomalies because of mullerian defects in the
      normal fertile population is 3.2% (22/679). Twenty (90%) of them are septate
      uteri, whereas a bicornuate (5%) and a didelphys uterus (5%) have been also found
      in this population. Based on these findings, we question the usefulness of the
      septum resection in patients with septate uterus and no previous reproductive
      failure.

PMID- 1743345
TI  - Term pregnancy after fallopian tube transposition.
AB  - A 23-year-old woman suffered from primary sterility because of congenital
      malformation of the uterus and tubes. There was a left unicornuate uterus. The
      left ovary and the isthmic and ampullary parts of the right tube were missing.
      Microsurgical transposition of the left tube was performed successfully. Our
      technique may encourage microsurgeons to use transposition of fallopian tube in
      cases in which only one tube and one ovary on contralateral sides are available.

PMID- 1743346
TI  - Treatment of unruptured tubal pregnancy by local injection of methotrexate and
      prostaglandin F2 alpha in 52 patients.
AB  - Uncomplicated tubal pregnancies were treated by local injection of methotrexate
      (25 to 50 mg) and PGF2 alpha (5 to 10 mg). Trophoblastic resorption occurred in
      50 (96.1%) of 52 patients within 20 days after treatment and without side
      effects. Three months after treatment, the affected tube was patent in 43 (91.4%)
      of 47 patients continuing in the study, and the subsequent intrauterine pregnancy
      rate was 40.4%. The combined use of methotrexate and PGF2 alpha appears to be a
      promising treatment for tubal pregnancy and should be evaluated further.

PMID- 1743347
TI  - Reliability of the visual diagnosis of ovarian endometriosis.
AB  - The visual diagnosis of endometrioma at laparotomy in 245 women operated on for
      ovarian cysts demonstrated a sensitivity of 97%, specificity of 95%, positive and
      negative predictive value of 98% and 94%, respectively, and overall accuracy of
      96%. Because the visual detection of endometriomas is remarkably accurate,
      ovarian biopsy, although desirable in some cases, would seem dispensable for a
      correct laparoscopic diagnosis and staging of the disease.

PMID- 1743348
TI  - Penetration of zona-free hamster oocytes by ejaculated cryopreserved gorilla
      spermatozoa.
AB  - Semen obtained by electroejaculation from two lowland gorillas were cryopreserved
      in TEST yolk to evaluate the ability of spermatozoa to penetrate zona-free
      hamster oocytes. Thawed semen was processed through a two-layer Percoll density
      gradient to obtain motile spermatozoa for the SPA. The processed sperm penetrated
      greater than 25% of the zona-free hamster oocytes. Thus, the use of TEST yolk to
      cryopreserve gorilla semen and processing the thawed semen through Percoll
      gradient to concentrate motile spermatozoa may facilitate sperm capacitation and
      the ability to penetrate oocytes.

PMID- 1743349
TI  - A critical look at hCG "doubling time".

PMID- 1743350
TI  - Genetic source of femininity.

PMID- 1743351
TI  - Myco-contamination of incubators used for human pre-embryo culture.

PMID- 1743352
TI  - Antisperm antibodies in serum and genital tract secretions.

PMID- 1743353
TI  - Complications of 5--fluorouracil after trabeculectomy.
AB  - Trabeculectomy has a very high success rate, however, certain eyes are known to
      be at high risk of failure due to scarring of the conjunctival bleb. Such eyes
      include those with a previous failed filter, eyes with glaucoma secondary to
      uveitis and neovascularisation and the eyes of children and young adults.
      Trabeculectomy is generally accepted to have less successful results in patients
      of African race although good results are reported from some centres. The
      effectiveness of treatment with 5-fluorouracil in improving the results of
      trabeculectomy has been established in a number of pilot studies and clinical
      trials. Early studies used 100 mg of 5-fluorouracil in divided doses. Serious
      complications were recorded and lower dose regimes have been advised to improve
      the safety of the technique. Similar success in improving the chance of success
      to trabeculectomy has been found with doses of 40 mg with a lower incidence of
      side effects. We report complications associated with the use of 5-fluorouracil
      in a total dose of 50 mg in a group of 49 eyes undergoing trabeculectomy and
      postoperative 5-fluorouracil and describe the previously unreported increased
      incidence of thin cystic blebs in these eyes.

PMID- 1743354
TI  - Pilocarpine to prevent acute pressure increase following primary laser
      trabeculoplasty.
AB  - The effect of pilocarpine pretreatment on the transient pressure elevations
      immediately following primary laser trabeculoplasty was investigated in a
      prospective, randomised study. Fifty eyes of 50 patients, 33 with exfoliative and
      17 with simple glaucoma, were treated in 360 degrees of the trabecular meshwork.
      The mean maximum pressure increase was 2.4 (SD = 4.4)mm Hg with pilocarpine
      pretreatment and 12.8 (SD = 11.2)mm Hg without pretreatment (p less than 0.05).
      Except in two cases, all peak pressures appeared during the first two hours after
      treatment. The degree of chamber angle pigmentation was predictive of the
      magnitude of the post laser hypertensive pressure response in eyes without
      pretreatment (p less than 0.05).

PMID- 1743355
TI  - Meibomian gland disease. Classification and grading of lid changes.
AB  - In recent years attention has been paid to meibomian gland dysfunction (MGD) as a
      distinct clinical entity responsible for chronic symptoms and signs and occurring
      independently or in association with atopy, cicatrising mucosal disorders and
      rosacea. Attempts to correlate MGD with microbiological and lipid biochemical
      changes are confounded by the absence of a clear descriptive language for the
      disorder and its associated changes. Such a language is crucial for the conduct
      of cross-sectional and natural history studies and therapeutic clinical trials.
      We present a comprehensive classification and grading scheme of meibomian gland
      disease, supporting our observations with illustrations.

PMID- 1743356
TI  - Is raised intraocular pressure a bad prognostic sign in acute corneal graft
      rejection?
AB  - One hundred and forty acute corneal rejection episodes in 94 patients were
      studied retrospectively. Sixteen episodes in 15 eyes were associated with raised
      intraocular pressure (IOP) on admission, three of whom had had previously
      elevated IOP. At six weeks, six (37.5%) still required hypotensive therapy. Five
      eyes with raised IOP at rejection had lost vision at six weeks. Five of the six
      eyes with graft failure at review had raised IOP either pre-graft, at rejection
      or at follow-up. Eyes grafted for herpes simplex keratitis with hypertensive
      rejection episodes had a higher mean admission IOP, with a more short-lived rise
      than other eyes.

PMID- 1743357
TI  - The use of a single pulse of intravenous methylprednisolone in the treatment of
      corneal graft rejection. A preliminary report.
AB  - In corneal graft rejection, rapid reversal of the rejection process is necessary
      to minimise endothelial cell loss. Ten consecutive patients with acute
      endothelial rejection were treated with a single 500 mg pulse of
      methylprednisolone intravenously and topical prednisolone 1% drops hourly. The
      rejection episode was successfully reversed in eight (80%) of the 10 grafts. This
      preliminary trial indicates that cortico-steroid pulse therapy may be beneficial
      in the management of severe corneal graft rejection with the advantage of
      avoiding prolonged oral corticosteroid therapy.

PMID- 1743358
TI  - The role of penetrating keratoplasty in the management of microbial keratitis.
AB  - Penetrating keratoplasty was performed as an emergency procedure in 52 eyes which
      had perforated from acute microbial keratitis and in a further 11 where
      perforation had not yet occurred. The results are compared with those of
      keratoplasty in 33 non-infected perforations and 20 eyes where there had been
      microbial keratitis which had responded to medical therapy leaving a scarred
      cornea. This latter group had both a better five year survival (90%) compared to
      all the others (51%), p less than 0.05, and achieved significantly better visual
      acuities, p less than 0.005.

PMID- 1743359
TI  - Vascular changes in the posterior segment in clinical and experimental ocular
      inflammatory disease.
AB  - Posterior segment inflammatory disease can have several different effects on the
      retinal vasculature, all of which have potentially sight threatening
      consequences. Blood-retinal barrier breakdown is a common feature of the disease
      process with resulting retinal and macula oedema. Very little is known about the
      mechanism of this breakdown and in particular whether it is at the endothelial
      cell membrane or at the tight junctions between the endothelial cells--a matter
      of importance if better therapeutic regimes are to be devised in the future. This
      paper looks at this question in two animal models of posterior uveitis using
      different techniques.

PMID- 1743360
TI  - Binocular diplopia in unilateral aphakia: the role of botulinum toxin.
AB  - We have treated 12 unilaterally aphakic patients, with a manifest squint and
      binocular diplopia, with botulinum toxin injection to the appropriate horizontal
      rectus muscle, in an attempt to reduce the angle of squint and thereby resolve
      the diplopia. In all cases a short-term reduction in the angle of squint was
      achieved. In nine patients, whose aphakia was corrected with a contact lens, and
      eight of whom had had their lenses removed because of trauma, this reduction was
      only temporary. In three patients, however, who had had a non-traumatic cataract
      removed, replaced with a posterior chamber implant, control of the deviation was
      maintained long after the acute effect of the toxin had disappeared, with the
      development of coarse binocular single vision, a fusion range, and abolition of
      all diplopia. The possible reasons for these different responses are discussed
      and it is suggested that in cases of binocular diplopia following lens
      extraction, botulinum toxin treatment should be considered prior to any
      extraocular muscle surgery, as temporary reduction of the deviation may be
      sufficient to allow recovery of binocular single vision.

PMID- 1743361
TI  - Treatment of strabismus after retinal detachment surgery with botulinum
      neurotoxin A.
AB  - Thirty-one consecutive patients were treated with injections of Botulinum
      Neurotoxin A to rectus muscles for strabismus following retinal detachment
      surgery. In 14 cases the presenting problem was diplopia and in 17 cases the
      presenting problem was cosmetic appearance. A total of 67 injections was given.
      Twenty-seven cases had nine months or more follow-up. Of these, four of 11 cases
      with diplopia had fusion restored, four were shown to have no fusion potential,
      and three had temporary improvement only. In 16 cases with a primary cosmetic
      problem there was no useful effect in two, three had surgery as an alternative,
      three were realigned long-term, and eight had continuing maintenance therapy with
      toxin. Over half the series had undergone multiple detachment surgery, often for
      giant tears and other complex pathology.

PMID- 1743362
TI  - Three wall orbital decompression for Graves' ophthalmopathy via a coronal
      approach.
AB  - Ten patients with dysthyroid eye disease who underwent a three wall orbital
      decompression procedure performed via a coronal approach were reviewed. The
      indications, results, complications and surgical techniques involved in this
      surgery are discussed. We believe that this approach offers a number of
      advantages over other techniques and has a role in the management of carefully
      selected patients with dysthyroid eye disease who have severe unilateral or
      bilateral proptosis, with or without dysthyroid optic neuropathy.

PMID- 1743363
TI  - The oval pupil.
AB  - The dynamics of pupillary dilation induced by Phenylephrine 10% and
      Cyclopentolate 1% have been examined by flash photography. A correlation between
      anterior chamber depth and the pupil shape on dilation with Phenylephrine
      Hydrochloride 10% is described. It is postulated that these pupillary dilation
      dynamics support a sympathetic abnormality as a trigger for acute primary angle
      closure glaucoma.

PMID- 1743364
TI  - The systemic and genetic significance of congenital optic disc anomalies.
AB  - Optic disc anomalies have great significance as a clue to associated systemic
      problems and as a marker of inherited disease. Optic nerve hypoplasia and
      colobomas of the optic disc are the main visually significant disorders; however,
      the Morning Glory disc anomaly and Aicardi's syndrome may also be associated with
      visual impairment.

PMID- 1743365
TI  - Clearing the cataract backlog in a (not so) developing country.
AB  - There is a significant backlog of patients waiting for cataract operations in the
      United Kingdom. In England in the first quarter of 1989, there were 74,000
      patients in total on ophthalmology waiting lists, of which approximately 75% were
      cataract cases. Although there is currently a significant shortfall of around 225
      consultant ophthalmologists, as defined by the College of Ophthalmologists'
      standard, the backlog is also due to the imbalance in, and inefficient use of,
      resources. There are a number of possible ways of clearing the backlog, including
      local initiatives, contracting for clinical services and the expansion of day
      case surgery, which has been shown to be a cost-effective alternative to in
      patient surgery. However, not only are reorganisations in the provision of
      surgical services required, managerial initiatives also need to be taken.

PMID- 1743366
TI  - Inter and intra observer reproducibility of the new Oxford CCD Scheimpflug
      camera.
AB  - Scheimpflug photography is a well recognised technique for obtaining sagittal
      views of the anterior structures of the human eye in vivo. A new generation of
      Scheimpflug camera, which uses a CCD (charge coupled device) instead of film,
      permitting the digitised image achieved to be directly analysed using
      computerised linear scanning densitometry, is described. The advantages and
      present limitations of this system over the older film using system are discussed
      and the reproducibility of the new CCD system in its ability to measure certain
      features of the crystalline lens is presented.

PMID- 1743367
TI  - Maximising the sensitivity and specificity of non-contact tonometry in glaucoma
      screening.
AB  - Data from a glaucoma screening study involving 88.5% of the population age 50 and
      over of a single handed general practitioner were reanalysed to determine the
      effect of altering the protocol for intraocular pressure assessment and the
      effect of changing the referral threshold. The predictive power of the Keeler
      Pulsair noncontact tonometer was found to decrease from 22.5% at four pulses per
      eye to 12.3% when only one pulse per eye was used, with a reduction of
      sensitivity from 91.7% to 75%. The sensitivity of the same device fell from 91.7%
      if all patients with an IOP greater than 21 mmHg were deemed as having a positive
      screen, to 41.6% when only patients with an IOP greater than 26 mmHg were
      considered for referral. To create a balance between high sensitivity and
      acceptable predictive power of a positive result in a population where 50% of
      glaucoma sufferers are known prior to screening, we advise that four pulses per
      eye should be used with an IOP of greater than 22 mmHg used as the significant
      finding indicating that the patient required referral.

PMID- 1743368
TI  - A new clinical slit lamp reference stand.

PMID- 1743369
TI  - Lack of pancreatic maldigestion in atopic dermatitis.
AB  - Twenty adult patients affected by atopic dermatitis (AD) were submitted to the p
      aminobenzoic acid (PABA) test in order to evaluate the proteolytic pancreatic
      function. All but one showed a normal PABA test. These results seem to exclude a
      proteolytic maldigestion as a pathogenetic factor in AD.

PMID- 1743370
TI  - Malignant melanoma in southern Germany: different predictive value of risk
      factors for melanoma subtypes.
AB  - The presented case-control study with 204 melanoma patients and 200 control
      persons assesses the significance of melanoma risk factors for an ethnically
      homogeneous population from a geographically small region. In a multivariate
      analysis of the data the total number of benign naevi proved to be the most
      predictive parameter with a relative risk (RR) of 14.9 (total number of naevi
      higher than 50). The constitutional factors red hair colour and skin type 1 were
      less predictive with an RR of 2.9 and 4.9, respectively. Occupational and
      recreational sun exposure were of ancillary importance (RR 1.8 and 2.1). The
      assessment of the risk for the subtypes of melanoma however showed a clear
      difference in the predictive value of the mentioned risk factors. The risk of
      developing superficial spreading melanoma is nearly exclusively defined by the
      number of benign naevi (RR 24.8), red hair colour was of subordinate importance
      (RR 4.2), whereas the risk of lentigo maligna melanoma is dependent on skin type
      1 (RR 12.9) and sun exposure (RR 3.4).

PMID- 1743371
TI  - Primary localized cutaneous nodular amyloidosis: case report and biochemical
      analysis of amyloid.
AB  - We report a patient with scalp lesions of primary localized cutaneous nodular
      amyloidosis. The extensive examination revealed no systemic involvement. Analysis
      of glycosaminoglycans (GAGs) in amyloid deposits showed a twofold increase as
      compared with normal skin, which was due to the increase in dermatan sulfate.
      Local disorders of GAG metabolism may be related to the amyloid fibril formation.
      Amyloid fibrils were purified and identified electron-microscopically, which
      consisted of two major 12,000- and 13,000-dalton and minor 29,000- and 48,000
      dalton peptides. Western blotting analysis showed a minor 29,000-dalton peptide
      reactive with antibodies against both kappa and lambda light chains of
      immunoglobulin. There is a possibility that some components of amyloid in some
      cases of primary localized cutaneous nodular amyloidosis may consist of both
      kappa and lambda immunoglobulin light chains.

PMID- 1743372
TI  - Lack of correlation between in vitro immunological alterations and the
      development of scleroderma-like skin lesions in toxic oil syndrome patients.
AB  - We examined whether immunological disturbances could influence the development of
      scleroderma-like skin lesions in patients affected by the Spanish toxic oil
      syndrome (TOS). To this end, peripheral blood mononuclear cells (PBMC) were
      collected from 13 chronic patients and 8 control subjects. All patients had
      suffered a toxic-induced severe neuromyopathy, and 6, in addition, had developed
      sclerodermoid skin manifestations. The phenotypic profile and the concentrations
      of interleukin-2 (IL-2) and of molecules with B cell differentiation factor IgG
      activity (BCDF-IgG) in supernatants of phytohemagglutinin-stimulated lymphocytes
      were analyzed both in patients and in normal controls. Molecules with BCDF-IgG
      activity were found increased in supernatants of mitogen-stimulated lymphocytes
      from TOS patients. Concentrations of IgG secreted by staphylococcus aureus-SAC-B
      blasts in the presence of TOS PBMC supernatant was 88 +/- 32.62 ng/ml (mean +/- 1
      SD) versus 53 +/- 5.34 ng/ml in the presence of control supernatant (p less than
      0.01). Levels of BCDF-IgG activity in TOS PBMC supernatants positively correlated
      with IgG serum levels (r = 0.69, p less than 0.01). The phenotypic profile of
      lymphocyte populations and the production of IL-2 were not altered in TOS
      subjects. No statistically significant differences were observed in the
      lymphocyte distribution nor in the IL-2 and BCDF-IgG production when comparing
      patients with or without scleroderma-like skin lesions. The results indicate that
      there was a dysfunction of the immune response in TOS subjects, which, however,
      was not sufficient for the development of the sclerodermoid lesions.

PMID- 1743373
TI  - Topical tretinoin decreases healing times of electroepilation-induced wounds.
AB  - There is evidence that topical tretinoin promotes wound healing, especially when
      the wound area is pretreated. In our study, 5 patients were pretreated for 2
      weeks with 0.05% tretinoin cream to one groin or axilla, followed by
      electroepilation to both sides. Electroepilation created small, superficial
      wounds. Healing was defined as complete re-epithelialization. In all patients the
      pretreated side showed a significantly decreased healing time as compared to the
      nonpretreated side. Pretreatment of skin with topical tretinoin may be useful in
      reducing healing times of patients undergoing electroepilation.

PMID- 1743374
TI  - Intravenous single-dose ceftriaxone treatment of chancroid.
AB  - The antimicrobial susceptibility of Haemophilus ducreyi varies according to the
      geographic region. Increased resistance to trimethoprim and/or sulfamethoxazole
      led the Centers for Disease Control to recommend 250 mg ceftriaxone as a single
      intramuscular dose for chancroid. Intravenous or muscular routes of
      administration result in equivalent bioavailability. To avoid side effects such
      as syringe abscess and lidocaine intolerance, we prefer intravenous ceftriaxone
      therapy. The efficacy of this regimen is reported in 3 cases of chancroid. The
      intravenous administration of 1 g of ceftriaxone in chancroid seems to be as
      effective as administration by the intramuscular route, but it may lower the risk
      of syringe abscess, lidocaine intolerance and the emergence of resistant strains.

PMID- 1743375
TI  - Nucleolar organizer regions argyrophilic associated proteins in cutaneous
      melanocytic lesions.
AB  - We applied a simple silver staining technique to visualize nucleolar organizer
      regions associated proteins (AgNORs) for the study of 47 melanocytic lesions (20
      malignant melanomas, 5 dysplastic nevi, 4 Spitz nevi, 2 Reed and Gartman's
      fusiform nevi and 16 melanocytic nevi). A statistically significant difference
      existed between the numbers of AgNORs per cell in benign and malignant lesions as
      a group. However, some overlapping counts were found, limiting the usefulness of
      the technique in differentiating benign from malignant lesions in individual
      cases.

PMID- 1743376
TI  - Dermatomyositis and pregnancy. Case report and review of the literature.
AB  - Dermatomyositis is a rare disease complicating pregnancy. We treated a patient in
      whom two pregnancies were complicated by dermatomyositis. In the first of the two
      gestations, a mild form of the disease arose in the last trimester. In the second
      gestation, the disease was inactive following treatment with 0.3 mg/kg/day
      prednisolone. Both the mother and two children have since been doing well.

PMID- 1743377
TI  - Subcutaneous leiomyosarcoma developing in a radiation dermatitis.
AB  - A case of subcutaneous leiomyosarcoma developing in a skin affected by radiation
      dermatitis is presented. A 59-year-old patient had been suffering from radiation
      dermatitis induced by radiotherapy for a mediastinal tumor diagnosed at 24 years
      of age. Thirty-four years later, slow growing nodules developed in this lesion.
      Light and electron microscopic studies revealed that the tumor was a subcutaneous
      leiomyosarcoma. There is no previous report of a subcutaneous leiomyosarcoma
      developing in radiation dermatitis.

PMID- 1743378
TI  - Stratum corneum lipid function.
AB  - The stratum corneum contains a complex mixture of polar and nonpolar lipids in
      its intercellular spaces. These lipids, present in form of multiple lamellae,
      have been investigated for their role in providing the epidermal barrier to
      transcutaneous water loss, the selective barrier from the inside to the outside
      of the organism and partly the process of physiological desquamation. The
      composition of these lipids varies from species to species, with the body region
      and the degree of keratinocyte differentiation. The most undifferentiated layers
      of the epidermis contain typical membrane lipids, phospholipids, while more
      differentiated layers contain ceramides, cholesterol and free fatty acids.
      Essential fatty acids are essential for the maintenance of the lamellar
      structures and epidermal barrier function. Epidermal linoleic and arachidonic
      acids derive from exogenous sources. Only recently attempts have been made to
      elucidate the timing and regulation of epidermal fatty acid metabolism.
      Keratinocytes do not express a low molecular weight fatty acid binding protein
      like other cells active in lipid metabolism, but may employ alternative ways in
      fatty acid uptake and metabolism.

PMID- 1743379
TI  - The skin: an immunoreactive target organ during interleukin-2 administration?
AB  - Six patients with metastatic malignant melanoma were treated systemically with
      dacarbazine and interleukin-2 (IL-2). During IL-2 administration all patients
      developed a macular erythematous rash followed by scaling which began 24-48 h
      after IL-2 infusion. The dermatological changes were associated with elevated
      interferon-gamma and tumor necrosis factor alpha serum levels (immunoradiometric
      assay). Histology revealed nonspecific spongiotic foci in the epidermis and a
      perivascular mononuclear infiltrate in the dermis. Immunohistochemistry
      characterized this infiltrate mainly as activated T helper lymphocytes and
      revealed the expression of intercellular adhesion molecule 1 by endothelial cells
      and keratinocytes that might have been induced by interferon-gamma. The skin
      reactions associated with systemic IL-2 administration, show that the skin
      actually participates as a target organ. They should be differentiated from drug
      eruptions.

PMID- 1743380
TI  - Noninvasive procedures in dermatology. Potential infective risks and need for
      sterility.
AB  - Although in the area of incisional surgery the level of sterile techniques has
      improved in recent years and approaches that of the surgical standards in other
      specialties, one cannot say the same with regard to some of the nonsurgical or
      semisurgical procedures. Here, unfortunately, there are even no standards to aim
      for and no guidelines to adopt. Since in the field of nonsurgical cosmetic skin
      care dermatologists have a unique position, we alone must shoulder the
      responsibility for setting the standards and determining the appropriate
      conditions for carrying out these procedures. Unfortunately, it appears that in
      certain of the dermatologic procedures not involving actual skin incision, the
      level of sterility has not improved for decades. In such dermatologic procedures
      there are marked discrepancies between the care taken to maintain a high degree
      of sterility of instruments that penetrate the skin, compared with the lack of
      attention to sterility of instruments that do not directly penetrate the skin and
      the area surrounding the procedure site. It seems that the guiding principle we
      must strive for is to prevent the transmission of infection from one patient to
      another. The emphasis should be not on sterility per se but on the prevention of
      transmission of disease from patient to patient.

PMID- 1743381
TI  - Early detection of scleroderma spectrum disorders in patients with Raynaud's
      phenomenon.
AB  - Fifty patients with the chief complaint of Raynaud's phenomenon (RP) presented at
      our scleroderma clinic from March to December 1990. Physical examination, routine
      laboratory tests (blood, urine and chest X-ray), determination of the pattern of
      RP, antinuclear antibody (ANA) tests and examination for nailfold bleeding were
      performed. Three patients were diagnosed as having systemic sclerosis sine
      scleroderma, 15 patients as having RP with positive anticentromere antibody and 6
      patients as having an incomplete form of mixed connective tissue disease. Thus, a
      total of at least 24 patients out of 50 (48%) were shown to have a scleroderma
      spectrum disorder. A definite RP pattern (triphasic or biphasic and bilateral),
      positive ANA and positive nailfold bleeding were strongly correlated
      statistically, suggesting that these are simple useful findings for the early
      detection of scleroderma spectrum disorders in patients with RP. We expect that
      there are many undiagnosed patients with an early-stage scleroderma spectrum
      disorder in the general population.

PMID- 1743382
TI  - A new classification of Ota's nevus based on histopathological features.
AB  - According to the distribution of the dermal melanocytes, Ota's nevus was
      classified into 5 types: superficial (type S), superficial dominant (type SD),
      diffuse (type Di), deep dominant (type DD), and deep (type De). The histological
      types were, as expected, relatively well-correlated with the color of the nevus:
      the most brownish lesions represented type S or type SD, while the most bluish
      lesions showed types Di, DD or De. Furthermore these types were strongly
      correlated with the location of the nevus: types S and SD were more frequent on
      cheeks, whereas types Di, DD and De more frequently occurred on eyelid, temple
      and forehead. When combining both colorations and locations of the nevus, our
      classification appeared much more significant. Our new histological
      classification of Ota's nevus may be very useful in making a therapeutic
      prognosis of the disease.

PMID- 1743383
TI  - The epidermal pentapeptide pyroGlu-Glu-Asp-Ser-GlyOH inhibits murine hair growth
      in vivo and in vitro.
AB  - Tissue growth may be controlled by negative feedback mechanisms. Recently, a
      pentapeptide, pyroGlu-Glu-Asp-Ser-GlyOH ('epidermal pentapeptide', EPP), which
      slows the growth of mouse epidermis in vivo and of mouse keratinocytes in vitro,
      was isolated from mouse epidermis. Since inhibitory molecules like EPP might be
      part of the feedback systems underlying hair growth control, we assessed the
      effect of synthesized EPP on the growth of hair follicles, using rodent in vivo
      and in vitro assays. We report for the first time that intraperitoneally injected
      EPP (30 nmol/animal/day over 6 days) significantly slows the growth of hair
      follicles in plucking-induced anagen skin of C57 B1-6 mice (as assessed by
      microscopic morphometry). Using an in vitro organ culture assay, EPP inhibits the
      incorporation of 3H-thymidine into mouse pelage anagen follicles. That this
      epidermal-derived peptide affects hair growth raises the possibility that hair
      growth may be regulated by an inhibition/disinhibition mechanism under
      participation of EPP-like molecules and that the epidermis may play a role in the
      control of hair growth.

PMID- 1743384
TI  - Effect of non-enzymatic glycosylation and heating on browning of human stratum
      corneum and nail.
AB  - The purpose of the present study was to examine the effect of non-enzymatic
      glycosylation and subsequent heating on the browning of the plantar stratum
      corneum and the finger-nail, and to elucidate the pathogenesis of the yellow skin
      and the yellow nail seen in diabetic subjects. We incubated stratum corneum and
      nail from non-diabetics in 0 (control), 10 (only nail), 20 (only nail), 100 and
      250 mM glucose buffer at 37 degrees C for 5 days. These glycosylated samples were
      dialysed against distilled water for 96 h. Distilled water was changed every 24
      h. Then samples were dried for 24 h. The extent of non-enzymatic glycosylation
      was measured by furosine content. Each 5 mg of sample was hydrolysed by 6 N HCl
      and processed for measurement of furosine by high-performance liquid
      chromatography. The rest of each sample was stored at 37, 42 (only nail), 47 and
      52 degrees C for 14 days. Browning of the stratum corneum was assessed
      macroscopically, and that of the nail by spectrophotometry. Based on their
      spectrophotometric reflectances. Munsell's scores (H = hue score, V = lightness
      score, C = saturation score) and (H + C)/V were calculated for objective
      evaluation of browning. Incubation of the stratum corneum and nail with glucose
      buffer increased their non-enzymatic glycosylation (furosine) dose dependently.
      Macroscopically, the browning of the stratum corneum was enhanced in proportion
      to the glucose concentration and storage temperature. However, samples incubated
      in 10 and 20 mM glucose and stored at 42 degrees C did not show visible browning.
      Munsell's score of the nail samples treated by glycosylation and heating showed
      increased hue and saturation but reduced lightness. (H + C)/V values of these
      nail samples were significantly higher than those of the control. We could not
      detect any fluorescence with Wood light in the browned samples. The present in
      vitro study demonstrated that the browning of the stratum corneum and the nail
      depended on the extent of both non-enzymatic glycosylation and storage
      temperature. We suggested a hypothesis that the non-enzymatic glycosylation and
      the storage temperature of the stratum corneum and the nail might be a
      contributory factor in the development of yellow skin and yellow nail in diabetic
      patients.

PMID- 1743385
TI  - Skin lesions in carbon monoxide intoxication.
AB  - A 25-year-old man who survived carbon monoxide intoxication presented
      erythematous cutaneous lesions with blister formation in pressure areas.
      Histologic examination revealed subepidermal vesicles with extensive sweat gland
      necrosis. We discuss the clinicopathological findings of carbon monoxide
      poisoning. Similar cutaneous features have been observed in patients with various
      kinds of drug-induced coma.

PMID- 1743386
TI  - Pemphigus erythematosus with suprabasilar acantholysis and lichenoid tissue
      reaction or a combination of pemphigus vulgaris and lupus erythematosus: a new
      entity?
AB  - We present a 36-year-old woman with pemphigus erythematosus that showed
      histopathologically supra-basilar acantholysis and lichenoid tissue reaction. To
      our knowledge this is the first case of pemphigus erythematosus with such unusual
      histopathologic presentation to be reported.

PMID- 1743387
TI  - Cogan's syndrome. An unusual etiology of urticarial vasculitis.
AB  - We report the case of an 18-year-old black woman with urticarial vasculitis,
      vestibuloauditory dysfunction and superficial keratitis. Oral steroid therapy was
      effective in reducing most clinical manifestations with high-dosage dependency.
      However, only intravenous pulses of methylprednisolone allowed slight improvement
      of hearing. In this case, we emphasize urticarial vasculitis as a new
      manifestation of atypical Cogan's syndrome. A significant titer of Chalmydia
      trachomatis antibodies was found in our patient: their role in the pathogenesis
      of Cogan's syndrome is discussed.

PMID- 1743388
TI  - Cutaneous ulceration: an unusual complication of intravenous pentamidine therapy.
AB  - Pentamidine is one of two agents currently used to treat infections with
      Pneumocystis carinii. The intramuscular route of administration is associated
      with cutaneous side effects such as dermal necrosis, sterile abscesses and ulcer
      formation at the injection site, while urticaria may develop near the site of
      intravenous drug infusion. This is a report of a renal transplant patient with
      Pneumocystis pneumonia who developed chemical cellulitis and ulceration following
      the extravasation of intravenous pentamidine into the soft tissues of the left
      hand and forearm. The area healed slowly over 7 weeks, but there was a residual
      loss of cutaneous sensation. In a review of the literature no report of a similar
      case was found.

PMID- 1743389
TI  - Concomitant granuloma annulare and necrobiosis lipoidica. Report of a case and
      review of the literature.
AB  - A case of concomitant granuloma annulare (GA) and necrobiosis lipoidica (NL) is
      presented. The etiology of these two disorders remains obscure. The similarity of
      the histopathology in GA and NL might suggest a common origin. However, a review
      of the 5 previous cases of concomitant GA and NL and recent biochemical,
      immunological and immunohistochemical studies comparing GA to NL indicates an
      independent etiology for these two histologically related disorders. Some
      evidence points toward a closer relationship of NL with diabetes than GA, while
      GA may be related to delayed-type hypersensitivity reactions.

PMID- 1743390
TI  - Atypical neutrophilic dermatosis on the upper extremity affected by
      postmastectomy lymphedema: report of 2 cases.
AB  - We describe 2 female patients, both with a history of radical mastectomy for
      breast cancer, in whom several indurated erythematous plaques developed on the
      upper extremity affected by postmastectomy lymphedema. There were no general
      symptoms or leukocytosis. Histopathological examination showed a dense
      neutrophilic infiltrate without a feature of vasculitis in the dermis and
      subcutis. Dramatic therapeutic response was observed to treatment with potassium
      iodide. These findings resemble Sweet's syndrome, but such cases have not been
      previously reported. Possible pathogenic mechanisms for these unique cutaneous
      eruptions are discussed.

PMID- 1743391
TI  - Incontinentia pigmenti with hyperkeratotic lesions in adulthood and possible
      squamous cell carcinoma.
AB  - A case of incontinentia pigmenti with extensive and progressive hyperkeratotic
      lesions at the age of 25 years is reported. The histology showed a
      keratoacanthoma-like picture and signs compatible with squamous cell carcinoma.
      To our knowledge this has not been previously reported.

PMID- 1743392
TI  - Conjugal blocks in Tetrahymena pattern mutants and their cytoplasmic rescue. I.
      Broadened cortical domains (bcd).
AB  - The cortical pattern mutant broadened cortical domains (bcd) in Tetrahymena
      thermophila is unable to complete the nuclear events associated with conjugation.
      bcd x bcd pairs become arrested at the "nuclear exchange" configuration. Genetic
      analysis reveals that the bcd conjugal block is 100% penetrant, under
      macronuclear control, and rescueable (a) by outcrossing to a wild-type partner,
      (b) by administration of a hyperosmotic shock 5 hr after cells are mixed for
      mating, or (c) by cytoplasmic transfusion from a wild-type donor. Cytological
      analysis reveals that the conjugal block is primarily the result of failure in
      pronuclear fusion (karyogamy). bcd pairs also exhibit reduced nuclear exchange
      efficiency and a failure of macronuclear anlagen formation. The hypothesis is
      proposed that the bcd+ gene codes for a microtubule-based organelle "motor"
      similar to kinesin.

PMID- 1743393
TI  - Conjugal blocks in Tetrahymena pattern mutants and their cytoplasmic rescue. II.
      janus A.
AB  - A conjugal block phenotype is described for the Tetrahymena pattern mutant, janA.
      janA exhibits a characteristic "janus" phenotype in which cells develop with a
      global mirror-image duplication of the ventral pattern of cortical organelles.
      janA cells are competent to form mating pairs, but later become irreversibly
      fused as heteropolar doublets. The few pairs that successfully dissociate fail to
      undergo postconjugal oral replacement and perish. The janA conjugal block is 100%
      penetrant, is under prezygotic macronuclear control, and is lethal. Here we
      characterize this conjugal block genetically and cytologically and demonstrate
      that it can be rescued by a transferable, wild-type product. New insights into
      late conjugal events, especially the replacement of the oral apparatus, are
      reported for wild-type cells as well.

PMID- 1743394
TI  - A comprehensive analysis of the developmental and tissue-specific expression of
      the isoactin multigene family in the rat.
AB  - The present study represents the first comprehensive analysis of isoactin gene
      expression in the developing rat. Our results clearly demonstrate that the
      developmental and tissue-specific expression of the actin multigene family is a
      highly integrated and complex process involving a variety of regulatory
      paradigms. The distinct temporal patterns of expression reported in this study
      indicate that there are three key phases in the regulation of expression of the
      actin multigene family during development. These include early embryonic
      development, late fetal development, and early postnatal development. The
      specific spatial patterns of expression observed in this study demonstrate that
      the expression of the actin multigene family is much more permissive than
      previously reported. This permissive expression includes a wide range of
      "ectopic" expression of the striated muscle isoactins as well as an extended
      expression of the alpha-smooth muscle isoactin. These findings expand our current
      understanding of the expression of the actin multigene family in development and
      provide a fundamental basis for future studies directed at investigating these
      processes.

PMID- 1743395
TI  - Characterization of a cDNA encoding a protein involved in formation of the
      skeleton during development of the sea urchin Lytechinus pictus.
AB  - In order to investigate the role of proteins in the formation of mineralized
      tissues during development, we have isolated a cDNA that encodes a protein that
      is a component of the organic matrix of the skeletal spicule of the sea urchin,
      Lytechinus pictus. The expression of the RNA encoding this protein is regulated
      over development and is localized to the descendents of the micromere lineage.
      Comparison of the sequence of this cDNA to homologous cDNAs from other species of
      urchin reveal that the protein is basic and contains three conserved structural
      motifs: a signal peptide, a proline-rich region, and an unusual region composed
      of a series of direct repeats. Studies on the protein encoded by this cDNA
      confirm the predicted reading frame deduced from the nucleotide sequence and show
      that the protein is secreted and not glycosylated. Comparison of the amino acid
      sequence to databases reveal that the repeat domain is similar to proteins that
      form a unique beta-spiral supersecondary structure.

PMID- 1743396
TI  - Extracellular matrix (mesoglea) of Hydra vulgaris. I. Isolation and
      characterization.
AB  - Hydrozoans such as Hydra vulgaris, as with all classes of Cnidaria, are
      characterized by having their body wall organized as an epithelial bilayer with
      an intervening acellular layer termed the mesoglea. The present study was
      undertaken to determine what extracellular matrix (ECM) components are associated
      with Hydra mesoglea. Using polyclonal antibodies generated from vertebrate ECM
      molecules, initial light and electron microscopic immunocytochemical studies
      indicated the presence of type IV collagen, laminin, heparan sulfate
      proteoglycan, and fibronectin immunoreactive components in Hydra mesoglea. These
      immunocytochemical observations were in part supported by biochemical analyses of
      isolated Hydra mesoglea which indicated the presence of fibronectin and laminin
      based on Western blot analysis. Amino acid analysis of total mesoglea and some of
      its isolated components confirmed the presence of collagen molecules in mesoglea.
      Additional studies indicated the presence of (1) a gelatin binding protein in
      Hydra which was immunoreactive with antibodies raised to human plasma fibronectin
      and (2) a noncollagen fragment extracted from mesoglea which was immunoreactive
      to antibodies raised to the NC1 domain (alpha 1 subunit) of bovine glomerular
      basement membrane type IV collagen. These observations indicate that Hydra
      mesoglea is evolutionarily a primitive basement membrane that has retained some
      properties of interstitial ECM.

PMID- 1743397
TI  - Extracellular matrix (mesoglea) of Hydra vulgaris. II. Influence of collagen and
      proteoglycan components on head regeneration.
AB  - Hydra are characterized by having their body wall organized as an epithelial
      bilayer with an intervening acellular layer termed the mesoglea. As an extension
      of the previous study which indicated that mesoglea is a primitive basement
      membrane which has retained some characteristics of interstitial extracellular
      matrix, the present study was undertaken to analyze the role of mesoglea
      components during head regeneration in Hydra vulgaris. Studies were conducted
      that utilized drugs that affect collagen processing or secondary collagen
      structure (beta-aminoproprionitrile; 2,2'-dipydridyl; and cis-4-hydroxy-L
      proline) and a drug that inhibits addition of glycosaminoglycan chains to
      proteoglycan core proteins (p-nitrophenyl-beta-D-xylopyranoside). These studies
      indicated that alterations in the structure of collagens or proteoglycans caused
      blockage of head regeneration in Hydra as monitored over a 48-hr period. Blockage
      of head regeneration was reversible once the drugs were removed, indicating that
      the drugs were not having a general toxic effect on the organism. Radiotracer
      studies also indicated that blockage of head regeneration was not simply due to a
      general depression of protein synthesis by the drugs. Various controls indicated
      that each drug was affecting mesoglea components under the conditions utilized in
      these studies. These observations indicate that preservation of normal mesoglea
      structure is required for Hydra head regeneration to proceed.

PMID- 1743398
TI  - Interstitial stem cell proliferation in hydra: evidence for strain-specific
      regulatory signals.
AB  - We have examined the growth behavior of small numbers of interstitial stem cells
      transplanted into tissue of genetically unrelated strains of Hydra
      magnipapillata. We show that such stem cells, which are at low density following
      transplantation, proliferate more rapidly than the stem cells of the host, which
      are at normal density. The rapid proliferation is similar to the proliferation
      rate of stem cells transplanted into interstitial cell free tissue. The results
      suggest that stem cells transplanted into heterotypic tissue are unable to
      "sense" the presence of host stem cells and to adopt their growth rate to that of
      the surrounding cells. Thus, the feedback signal which negatively regulates stem
      cell growth as a function of stem cell density must be strain specific.

PMID- 1743399
TI  - Developmental analysis of ocular morphogenesis in alpha A-crystallin/diphtheria
      toxin transgenic mice undergoing ablation of the lens.
AB  - The role of the lens in early eye development was examined in transgenic mice
      carrying the cytotoxic diphtheria toxin A gene driven by hamster alpha A
      crystallin promoter sequences. Mice hemizygous for this construct are
      microphthalmic and contain a vacuolated and highly disorganized lens, whereas
      adult homozygous mice are completely ablated of the lens and lack a pupil,
      aqueous and posterior chamber, vitreous humor, iris, and ciliary body and show
      extensive convolution of the sensory retina. Developmental analysis of animals
      homozygous for the transgene revealed that the optic cup and lens vesicle form
      normally and that ablation of the lens occurs as a gradual degenerative process
      beginning between Days 12 and 13 of gestation. Degeneration of the lens vesicle
      coincides with retarded growth and development of the neuroretina, sclera, and
      cornea. The anterior lip of the optic cup fails to differentiate into the normal
      epithelium of the iris and ciliary body and the vitreous body does not develop.
      Although the retinal layers apparently form normally, retinal folding becomes
      prominent following lens degeneration. These results suggest that development of
      a functional lens from Embryonic Day 12.5 onward is critical for formation of the
      ciliary epithelium, iris, and vitreous body, as well as for appropriate growth,
      development, and maintenance of morphology of the retina, cornea, sclera, and
      optic nerve. Our results also provide information on the time course of DT-A
      mediated cell destruction in vivo and are discussed in context with previous lens
      ablation studies and the importance of developmental analysis for interpretation
      of the extent to which morphogenetic aberrations are concurrent with or secondary
      to genetic ablation of the target tissue.

PMID- 1743400
TI  - A gradient of gap junctional communication along the anterior-posterior axis of
      the developing chick limb bud.
AB  - A modification of the scrape-loading/dye transfer technique was used to study gap
      junctional communication along the anterior-posterior (A-P) axis of embryonic
      chick wing buds at an early stage of development (stage 20/21) when positional
      values along the A-P axis are being specified. Extensive intercellular transfer
      of the gap junction-permeable dye, lucifer yellow, from scrape-loaded mesenchymal
      cells to contiguous cells occurs in the posterior mesenchymal tissue of the wing
      bud adjacent to the zone of polarizing activity, which is thought to be the
      source of a diffusible morphogen that specifies A-P positional identity according
      to its local concentration. Considerably less transfer of lucifer yellow dye
      occurs in scrape-loaded mesenchymal tissue in the middle of the limb bud compared
      to posterior mesenchymal tissue, and little or no transfer of lucifer yellow is
      observed in the mesenchymal tissue in the anterior portion of the limb bud. No
      intercellular transfer of the gap junction-impermeable dye, rhodamine dextran,
      occurs in any region of the limb bud. These results indicate that there is a
      gradient of gap junctional communication along the A-P axis of the developing
      chick wing bud. This gradient of gap junctional communication along the A-P axis
      might generate a graded distribution of a relatively low molecular weight
      intracellular regulatory molecule involved in specifying A-P positional
      identities.

PMID- 1743401
TI  - In situ hybridization studies on the expression of type X collagen in fetal human
      cartilage.
AB  - Type X collagen is a short, non-fibril-forming collagen restricted to the
      hypertrophic, calcifying zone of growth plate cartilage. It is developmentally
      regulated and found exclusively in hypertrophic cartilage. Here we report on the
      structure and distribution of human type X collagen based on the cloning of a PCR
      fragment covering 292 bp of the carboxy-terminal, non-triple-helical domain.
      Seventy-five percent of the sequence are identical to that of chicken type X
      collagen at nucleic acid level and 84% at amino acid level. This probe was used
      for in situ hybridization analyses of type X collagen expression in a human
      growth plate. Human fetal cartilage, which is different from the avian cartilage
      bone transition zone, showed strong type X collagen expression confined to the
      lower hypertrophic zone of the growth plate. The upper zone of hypertrophic
      chondrocytes did not contain alpha 1(X) transcripts, indicating that type X
      collagen expression follows cellular hypertrophy. The distribution of type X
      collagen mRNA has been previously unreported in chondrocytes from zones of
      secondary ossification and in chondrocytes associated with endochondral bone
      trabecules containing calcified cartilage. In situ hybridization analyses with
      probes for type I and II collagen on consecutive sections indicated a spatial
      gradient in chondrocyte differentiation in the human epiphysis. Chondrocytes of
      low type II collagen expression in the resting zone are followed by proliferating
      columnar chondrocytes with strong type II collagen expression and a zone of
      hypertrophic chondrocytes synthesizing type X and type II collagen. In contrast
      to findings in avian growth cartilage in some of our samples of human epiphyseal
      cartilage hypertrophic chondrocytes continued to strongly express type II
      collagen down to the chondro-osseous junction. Transcripts of the alpha 2(I)
      collagen gene, however, were detected only in perichondrium, vascular cavities,
      and bone, but not in hypertrophic or any other chondrocytes. The above
      observations demonstrate that the isolation of the human type X collagen DNA will
      contribute to studies of pathways of chondrocyte differentiation in the mammalian
      growth plate.

PMID- 1743402
TI  - Directional mesoderm cell migration in the Xenopus gastrula.
AB  - The movement of the dorsal mesoderm across the blastocoel roof of the Xenopus
      gastrula is examined. We show that different parts of the mesoderm which can be
      distinguished by their morphogenetic behavior in the embryo are all able to
      migrate independently on the inner surface of the blastocoel roof. The direction
      of mesoderm cell migration is determined by guidance cues in the extracellular
      matrix of the blastocoel roof and by an intrinsic tissue polarity of the
      mesoderm. The mesodermal polarity shows the same orientation as the external
      guidance cues and is strongly expressed in the more posterior mesoderm. The
      guidance cues of the extracellular matrix are recognized by all parts of the
      dorsal mesoderm and even by nonmesodermal cells from other regions of the embryo.
      The extracellular matrix consists of a network of fibronectin-containing fibrils.
      The adhesiveness of this matrix does not vary along the axis of mesoderm
      movement, excluding haptotaxis as a guidance mechanism in this system. However,
      an intact fibronectin fibril structure is necessary for directional mesoderm cell
      migration. When the assembly of fibronectin into fibrils is inhibited, mesoderm
      explants still migrate on the amorphous extracellular matrix, but no longer
      directionally. It is proposed that polarized extracellular matrix fibrils may
      normally guide the migrating mesoderm to its target region.

PMID- 1743403
TI  - Pattern of epithelial cell cycling in hydra.
AB  - We have investigated the spatial pattern of epithelial cell cycling in a mutant
      strain of Hydra magnipapillata (sf-1). This strain has temperature sensitive
      interstitial stem cells and thus polyps containing only epithelial cells can be
      obtained by growth at the restrictive temperature. Epithelial animals were pulse
      labeled with the thymidine analog 5'-bromo-2'-deoxyuridine (Brdu) and stained
      with anti-Brdu antibody to visualize S phase cells. Our results indicate that
      Brdu-labeled cells are broadly and fairly evenly distributed along the body
      column. Feeding stimulates a rapid decrease and then an increase in labeled cells
      in gastric tissue; labeled cells in the head are not affected. Starvation leads
      to a twofold decrease in labeled cells in the gastric region; the density of
      labeled cells in head tissue remains similar to that in well-fed animals. During
      bud formation the number of labeled epithelial cells increases significantly in
      the evaginating bud. During head regeneration the number of labeled cells
      declines sharply during the first 12 hr and then increases to a density typical
      of head tissue by 24-36 hr of regeneration. The results indicate the release of
      signals by feeding and regeneration which inhibit mitosis. By contrast head
      tissue and developing buds express signals stimulating mitosis. Thus changes in
      epithelial cell cycling in hydra are closely correlated with morphogenetic events
      as well as with feeding stimuli.

PMID- 1743404
TI  - A cytoplasmic gradient of Ca2+ is correlated with the growth of lily pollen
      tubes.
AB  - We have measured the distribution of cytoplasmic calcium in lily pollen tubes by
      microinjecting them with indo-1 and performing fluorescence ratio image analysis
      on them. All of the 16 tubes that were growing at the time of the calcium
      measurements showed a gradient of [Ca2+]i in the tip region, with Ca2+ being 1.25
      to 3.32 times higher at the distal end in 15 cases and more than 5 times higher
      in one case. The extent of the gradient ranged from 22 to 65 microns. Most of the
      15 nongrowing tubes either had no gradient or had lower Ca2+ in the tip region.
      While we have confirmed a previous report that lily pollen tubes can be loaded
      with the membrane-permeable acetoxymethyl ester forms of calcium indicators, the
      dyes loaded in this way are visibly partitioned into organelles and this method
      of loading is, therefore, not useful for the measurement of [Ca2+]i.
      Iontophoresis of the dye free acids into tubes produces a more uniform and
      diffuse fluorescence which does not appear to partition into organelles. Indo-1
      remains in the pollen tubes longer than fura-2. The correlation between growth
      and the [Ca2+]i gradient in the apical portion of the pollen tube is discussed in
      relation to previous reports that have suggested that such a gradient should
      exist during polarized growth.

PMID- 1743405
TI  - Effects of exogenous putrescine on murine preimplantation development in vitro.
AB  - After first demonstrating that murine embryos take up putrescine from the medium
      in which they are cultured in vitro, fertilized eggs were placed in culture and
      maintained for 4 days in medium supplemented with varying amounts of putrescine.
      Their development was monitored each day. While embryos that were cultured in
      putrescine-supplemented medium developed at the same rate as control embryos, a
      significantly higher percentage of the putrescine-treated embryos attained the
      blastocyst stage as compared to the control group.

PMID- 1743406
TI  - Sea urchin USF: a helix-loop-helix protein active in embryonic ectoderm cells.
AB  - We previously characterized a DNA-binding factor in nuclear extracts of
      Strongylocentrotus purpuratus embryos that bound Spec gene promoters, was
      ectoderm specific, and had properties similar to the vertebrate transcription
      factor USF. Here we describe a cDNA clone, suUSF, isolated from an S. purpuratus
      cDNA library, with sequence homology to human USF. Spec gene promoter fragments
      formed sequence-specific complexes with suUSF, and antibodies against suUSF
      inhibited binding activity in nuclear extracts. Reaction of USF-site containing
      probes with filter-bound nuclear proteins demonstrated that suUSF binding
      activity was enriched in ectoderm cells, and immunoblotting showed a similar
      ectoderm enrichment. These data demonstrated that suUSF was responsible for the
      ectoderm-specific activity observed in sea urchin extracts.

PMID- 1743407
TI  - Myelination as an expression of the functional maturity of the brain.
AB  - A prospective cross-sectional study was performed on hydrocephalic infants and
      children. MRI was used to assess the state of myelination and to quantify the
      intracranial cerebrospinal fluid (CSF) volume repeatedly in all children. At the
      same time, neurodevelopmental testing was performed. A positive correlation was
      found between the progress of myelination and psychomotor development, but there
      were no significant correlations between CSF volume and myelination or between
      CSF volume and psychomotor development. This study provides strong evidence in
      favour of Flechsig's thesis that myelination expresses the functional maturity of
      the brain. The interdependency of neuronal maturation and progress of myelination
      are discussed.

PMID- 1743408
TI  - Outcome after childhood encephalitis.
AB  - The prognosis for 73 children treated for encephalitis between 1973 and 1983 was
      evaluated. 70 children participated in a follow-up examination 2.4 to 12.9 years
      after the acute phase of the disease. The 61 school-aged children had lower
      performance and full-scale IQs than their randomly selected, age- and sex-matched
      controls. Visual acuity was more often reduced, and they more often had focal
      slowing on EEG and electronystagmogram abnormalities. Clinically, these
      differences were not significant. Encephalitis with a poor prognosis occurred
      seldom, the incidence being 3.5 cases per one million children at risk annually.
      These results show that the prognosis for childhood encephalitis is much better
      than anticipated on the basis of experience mainly with herpes simplex virus
      encephalitis.

PMID- 1743409
TI  - Simple developmental speech delay: a follow-up study.
AB  - The authors followed 38 children with delayed speech development approximately
      two to four years after initial diagnosis, assessing and comparing their
      subsequent speech and language, and over-all development. Nearly all of the
      children had appropriate language levels for their general development. Just over
      half had less articulation competence than expected for their age, but this was
      not related to language achievement or age. It appears that the prognosis for
      future language development is favourable for these children. The results suggest
      that articulation might be a developmentally related process with a good
      prognosis, but further follow-up is necessary to determine ultimate competence of
      children in whom this is delayed.

PMID- 1743410
TI  - Low to moderate maternal alcohol use before and during pregnancy, and
      neurobehavioural outcome in the newborn infant.
AB  - Of 2002 randomly selected pregnant women recruited prospectively over a three
      year period for an extensive questionnaire survey, a stratified subsample of 665
      mothers was selected for mother-infant follow-up on the basis of pre-pregnancy
      alcohol intake. Infant outcome was assessed by detailed clinical examination and
      application of a modified Einstein Neonatal Behavioural Assessment Schedule
      (ENBAS) performed at 24 to 72 hours of age. Of the infant responses to 25 ENBAS
      items, only tonus showed a small but significant relationship to pre-pregnancy
      maternal alcohol intake. The authors conclude that low to moderate maternal
      alcohol intake has no significant effect on newborn neurological status.

PMID- 1743411
TI  - Head circumference and intellectual performance of patients with Duchenne
      muscular dystrophy.
AB  - The head circumferences of 64 patients with Duchenne muscular dystrophy were
      measured and found to be greater than those of a normal population. The patients
      had relative, and in 12 cases, absolute macrocephaly. 47 of the 64 patients
      underwent intelligence testing and were found to be significantly intellectually
      impaired, particularly in verbal and language skills. There was no correlation
      between head circumference or absolute macrocephaly and intellectual performance.
      The cause of macrocephaly in these patients is unknown and its relevance to the
      aetiology of intellectual impairment in Duchenne muscular dystrophy is not yet
      clear.

PMID- 1743412
TI  - Developmental patterns of normal nutritive sucking in infants.
AB  - The purpose of this investigation was to quantify normal nutritive sucking, using
      a microcomputer-based instrument which replicated the infant's customary bottle
      feeding routine. 86 feeding sessions were recorded from infants ranging between
      1.5 and 11.5 months of age. Suck height, suck area and percentage of time spent
      sucking were unrelated to age. Volume per suck declined with age, as did
      intersuck interval, which corresponded to a more rapid sucking rate. This meant
      that volume per minute of sucking time was fairly constant. The apparatus
      provided an objective description of the patterns of normal nutritive sucking in
      infants to which abnormal sucking patterns may be compared.

PMID- 1743413
TI  - Psychological characteristics of Sotos syndrome.
AB  - A preliminary investigation of the psychological characteristics of 16 children
      aged between five and 15 years who met the strict diagnostic criteria for Sotos
      syndrome demonstrated that, while cognitive abilities vary, there are behavioural
      patterns that are characteristic of the disorder. The children were reported to
      have high rates of behavioural disturbance at home, particularly tantrums,
      destructiveness, social withdrawal, and eating and sleeping difficulties. The
      children were reported to present fewer problems in the school environment. Other
      difficulties expressed by parents are also described and quantified.

PMID- 1743414
TI  - Leg movements in the supine position of infants with spastic diplegia.
AB  - Leg movements in the supine position of 49 infants with spastic diplegia (three
      to 11 months corrected age) were examined. Only simultaneous flexion and
      extension of the hips and knees were seen, with exceptional isolated hip
      movements; the simultaneous movements had synergic features. When the knees were
      flexed, the hips were flexed, abducted and externally rotated, and the ankles
      were dorsiflexed. When the knees were extended, the hips were extended, adducted
      and internally rotated and the ankles were plantar-flexed. Hip flexion combined
      with knee extension (leg elevation) and isolated knee movements were not seen in
      diplegic infants, but were seen in all control preterm infants with a good
      prognosis, after five and six months corrected age, respectively. The absence of
      these movements is a useful diagnostic item for spastic diplegia.

PMID- 1743415
TI  - Purine metabolites and pyrimidine bases in cerebrospinal fluid of children with
      simple febrile seizures.
AB  - Adenosine monophosphate, inosine monophosphate, inosine, adenosine, guanosine,
      adenine, guanine, hypoxanthine, xanthine, uric acid and pyrimidine bases were
      determined in the CSF of 18 children after simple febrile seizures and in a
      control group. There was no statistically significant difference between the two
      groups for any of these metabolites. This suggests that simple febrile seizures
      neither significantly disturb the metabolism of nucleotides, nucleosides or
      bases, nor significantly deplete neuron adenosine triphosphate ATP levels.

PMID- 1743416
TI  - Severe gastric distension in seven patients with cerebral palsy.
AB  - This is a report of two children who had severe recurrent gastric distension and
      vomiting, and five who experienced severe gastric distension without vomiting.
      Two of the five died during an episode of acute gastric distension. All had
      marked nutritional depletion, and severe spastic quadriplegia due to either
      cerebral palsy or acquired brain injury. None of the patients had significant
      gastroesophageal reflux. Positioning the patients in the left lateral decubitus
      position temporarily relieved their obstructions. Complete resolution of the
      distension and/or vomiting did not occur until after adequate weight gain. Loss
      of fat stores may lead to this type of recurrent gastric distension.

PMID- 1743417
TI  - Severe microcephaly associated with congenital varicella infection.
AB  - A case of second-trimester congenital varicella infection, in association with
      isolated microcephaly and severe brain damage, is reported, and cases of
      classical congenital varicella syndrome are compared on a clinical and
      immunological basis. This case, together with others cited in the literature,
      suggests that congenital varicella infection may lead to microcephaly and
      neurological abnormalities, without the presence of skin lesions. Although first
      trimester infection has been considered the most likely to produce congenital
      abnormalities, the second trimester may be more commonly implicated; indeed there
      may not be a critical period if varicella causes secondary disruption of
      differentiated tissues.

PMID- 1743418
TI  - Autistic syndrome with onset at age 31 years: herpes encephalitis as a possible
      model for childhood autism.
AB  - The author describes a previously healthy man who contracted herpes encephalitis
      at the age of 31 years, and over the following months developed all the symptoms
      considered diagnostic of autism. This case report casts doubt on the notion of
      autism as an exclusively developmental disorder. It is suggested that temporal
      lobe damage may cause autism in some cases.

PMID- 1743419
TI  - Familial infantile myasthenia: a diagnostic problem.
AB  - The authors report the diagnostic difficulties experienced with two siblings
      presenting with recurrent apnoeic attacks caused by the rare condition, familial
      infantile myasthenia. Standard repetitive nerve stimulation studies were normal
      in both cases, while changes typical of a subacute neurogenic condition were
      noted on concentric needle electromyography in one. A 14-day course of
      pyridostigmine did not elicit any clinical improvement in the elder sibling, in
      whom tracheomalacia was diagnosed by chest fluoroscopy and bronchoscopy. This
      infant died at the age of 11 months with hypoxic brain-damage after a severe
      apnoeic episode. For the second sibling, a positive decremental response was
      obtained in the hypothenar muscles only after two minutes continuous 10 Hz
      stimulation of the ulnar nerve. This child has responded well to treatment with
      pyridostigmine.

PMID- 1743420
TI  - Examining the evidence for a common structural basis to autism.

PMID- 1743421
TI  - The spinal muscular atrophies.

PMID- 1743422
TI  - Familial schizencephaly.
AB  - Familial cases of schizencephaly hitherto have been associated with readily
      diagnosable metabolic conditions or malformation syndromes. Where such
      associations are absent, it is usually considered to be a sporadic event without
      a genetic contribution. Described here are a brother and sister with identical
      bilateral symmetrical schizencephaly. Genetic counselling must therefore allow
      for the possibility of an autosomal recessive form of this condition.

PMID- 1743423
TI  - Control of drooling with transdermal scopolamine in a child with cerebral palsy.
AB  - Transdermal scopolamine patches (1.5 mg) were used to control drooling in a two
      year-old boy with severe spastic quadriparetic cerebral palsy and developmental
      delay. He responded well to the continuous scopolamine therapy, with a decrease
      in drooling, and a secondary decrease in respiratory distress and frequency of
      suctioning. No significant side-effects were noted.

PMID- 1743424
TI  - Diagnostic issues in autism--are we measuring the emperor for another suit of
      clothes?

PMID- 1743425
TI  - The aetiology of intellectual disability in Western Australia: a community-based
      study.
AB  - A register of intellectual disability is being established to assess the level
      and aetiology of intellectual disability in all children born and/or living in
      Western Australia. 1602 children aged between six and 16 years were identified
      who had IQs less than 70. 40 per cent had a definite genetic basis, 20 per cent
      an environmental cause and 40 per cent were of unknown aetiology. The insult was
      prenatal in 61 per cent, 10 per cent had a possible perinatal cause, 8 per cent
      were postnatal and for 21 per cent the timing could not be assessed.
      Approximately 20 per cent had concomitant cerebral palsy and 13 per cent were
      epileptic. A disparity was found between rural and urban areas, the prevalence
      being 9.9 and 6.5 per 1000 live births.

PMID- 1743426
TI  - The predictive value of microcephaly during the first year of life for mental
      retardation at seven years.
AB  - Of 41 term infants surviving to seven years of age with head circumferences (HC) 
      3 SD, 21 were mentally retarded (IQ less than or equal to 70) at seven years. HC
      - 2 SD was associated with mental retardation in 11 per cent of children. Socio
      economic status did not affect mental outcome of children with HC - 3 SD, but
      higher socio-economic level was associated with better outcome for those with HC 
      2 SD or who were normocephalic. Mental retardation in children with HC - 3 SD
      was more common in children with additional pathology. Of 25 children with no
      other pathology, one-quarter were mentally retarded at seven years; this was more
      common in children of normal birthweight. Disproportionate head-to-height ratio
      did not significantly affect outcome, although short stature was associated with
      less favourable outcome for those with HC - 2 SD or who were normocephalic.

PMID- 1743427
TI  - Normal ranges of hip motion of preterm infants.
AB  - The hip motion of 158 preterm infants with gestational ages between 25 and 36
      weeks was measured. The results of this study, compared with those of previous
      studies of term infants, show that hip motion changes with increasing gestational
      age above 25 to 27 weeks.

PMID- 1743428
TI  - Frontal lobe complex partial seizures in children: a form of epilepsy at
      particular risk of misdiagnosis.
AB  - The clinical and EEG findings are described of six children considered to have
      complex partial seizures of frontal lobe origin. The findings correspond
      generally with those reported for adult patients. Video-recordings of attacks in
      some cases and ictal cassette EEG recordings provided important diagnostic
      information. A definite frontal abnormality on neuro-imaging was seen in only one
      case. The seizures were closely associated with sleep, and anti-epileptic drug
      treatment was usually of limited value. The considerable diagnostic confusion
      surrounding seizures of this type, including their misdiagnosis as pseudoseizures
      or primary sleep disorder, is partly the result of the clinical peculiarities of
      this type of seizure, but also of clinicians' limited awareness of the condition.

PMID- 1743429
TI  - Genomic potential in mammals.
AB  - Embryos of amphibians, fish, sheep, cattle, swine and rabbits have been
      multiplied by nuclear transfer. Successful nuclear transfer in these species has
      been accomplished by transfer of a blastomere from a late stage embryo into an
      enucleated oocyte or egg with large scale multiplication achieved by serial
      repetition of the procedure using blastomeres from nuclear transfer embryos. This
      allows the production of clonal lines, which when appropriately selected for
      performance in a given trait, can be reproduced to capture in the offspring
      expression of both additive and nonadditive inheritance. The efficiency of
      producing offspring from nuclear transfer is low in mammals in both frequency of
      morula or blastocyst produced and maintenance of pregnancy after embryo transfer.
      In domestic animals the largest number of offspring from one embryo has been
      eight calves. Embryos as late as the 64-cell stage in cattle and 120-cell
      blastocyst in sheep have been used successfully as donors of blastomeres.
      Recloning has also been done in cattle. Potentially, nuclear transfer provides a
      mechanism for multiplication and production testing of clonal lines, a method for
      rapid genetic improvement and a means for rapid propagation of a selected
      genotype.

PMID- 1743430
TI  - Temporal and spatial expression of genes for cartilage extracellular matrix
      proteins during avian mandibular arch development.
AB  - We have examined the temporal expression of genes for extracellular matrix
      proteins (type I collagen, type II collagen, and the cartilage specific
      proteoglycan core protein) during the development of the avian mandibular arch.
      We detected low levels of type II collagen mRNA in the mandibular arch as early
      as stage 15. Type II collagen mRNA remained low but increased slightly as
      development progressed from stage 15 to stage 25. More dramatic increases
      occurred after stage 25 coincident with overt chondrogenesis. In contrast, mRNA
      for the core protein of cartilage specific proteoglycan was not detected prior to
      the onset of chondrogenesis, appeared at stage 25, and increased thereafter. Type
      I collagen mRNA was also present as early as stage 15 and dramatically increased
      after stage 28/29, coincident with initiation of osteogenesis. Using in situ
      hybridization, we found that type II collagen mRNA became detectable in the
      center of the mandible around stage 24/25 coincident with the initiation of
      chondrogenesis. At later stages (26-32) type II collagen mRNA was localized in
      the cartilaginous rudiment. The pattern of hybridization observed with the
      proteoglycan core protein probe at later stages of development was essentially
      identical to that observed with the type II collagen probe. In contrast, the
      probe for the alpha 1 (I) collagen mRNA was localized over the perichondrium,
      over differentiated bone, and in areas within the mandibular arch where bone
      formation had been initiated.

PMID- 1743431
TI  - Induction of tubules in rat metanephrogenic mesenchyme in the absence of an
      inductive tissue.
AB  - Differentiation of metanephrogenic mesenchyme to renal tubular epithelium
      requires induction by the ureteric bud in vivo or any of several embryonic
      tissues in vitro. In an effort to eliminate the tissue requirement in embryonic
      induction, extracellular matrices and soluble factors were analyzed individually
      or in combination for their ability to stimulate tubulogenesis in uninduced
      metanephrogenic mesenchyme from 13-gestation-day rat embryos. These evaluations
      have established that pituitary extract and epidermal growth factor (EGF) in
      concert with a matrix can promote morphogenesis of mesenchymal rudiments in
      culture. While type I collagen, laminin, or fibronectin matrices all promoted
      tubulogenesis in the presence of pituitary extract and EGF, type IV collagen
      proved the most effective. Under these conditions, tubules were induced in 23/24
      mesenchymal rudiments by 9 days in culture. Mesenchyme was not induced prior to
      explanation since it formed no tubules when cultured in a medium that allowed
      tubulogenesis in intact embryonic kidneys. Preliminary characterization of the
      undefined factor in pituitary extract was consistent with a protein of molecular
      weight greater than 100,000 but less than 300,000. When uninduced metanephrogenic
      mesenchyme from mouse was used instead of rat tissue, a similar pattern of
      morphogenesis was not observed, suggesting that the described medium is
      inappropriate for promoting differentiation in mouse or, less likely, that
      different mechanisms mediate differentiation in rat and mouse. These studies show
      that embryonic induction can occur in explanted rat renal mesenchyme in an
      appropriate environment and does not require the presence of an inductive tissue.

PMID- 1743432
TI  - Stage-related chondrogenic potential of avian mandibular ectomesenchymal cells.
AB  - We have examined the in vitro stage-related chondrogenic potential of avian
      mandibular ectomesenchymal cells using micromass cultures. Our results indicate
      that mandibular ectomesenchymal cells as early as stage 16, soon after the
      formation of the mandibular arches and well before the initiation of in vivo
      chondrogenesis, have chondrogenic potential which is expressed in micromass
      culture. There is an increase in the total area of the cultures occupied by
      cartilage when cells from increasing stages of development are used. The nodular
      pattern of chondrogenesis in these cultures indicates that mandibular
      ectomesenchymal cells are a heterogenous population from the time of mandibular
      arch formation. In addition, we studied the temporal expression of the genes for
      extracellular matrix proteins during in vitro chondrogenesis and correlated the
      morphological changes with the pattern of gene expression. Low levels of type II
      collagen mRNA are present in the cultures prior to detection of any stainable
      cartilage matrix and increase 5 fold just before the onset of chondrogenesis in
      vitro. On the other hand mRNA for cartilage proteoglycan core protein was not
      detected until the second day of culture when stainable cartilage matrix was
      present and progressively increased thereafter. Messenger RNA for type I collagen
      was present at the time of initiation of cultures and continuously increased
      during the culture period. Our experiments also indicated that embryonic
      epithelia can inhibit the in vitro chondrogenesis of mandibular ectomesenchymal
      cells and that the inhibitory effect of embryonic epithelia is independent of its
      age and site of origin.

PMID- 1743433
TI  - Trials and tribulations: the cost of developing gene therapies.

PMID- 1743434
TI  - Harland G. Wood. September 2, 1907 - September 12, 1991.

PMID- 1743435
TI  - The value of accreditation of animal laboratory care.

PMID- 1743436
TI  - New insights into the metabolic regulation of insulin action and insulin
      resistance: role of glucose and amino acids.
AB  - In primary cultured adipocytes, metabolic substrates such as glucose and amino
      acids have profound effects on modulating insulin's stimulatory actions on
      glucose uptake and protein synthesis. Insights into how substrates modulate
      insulin action were recently obtained when we discovered that the routing of
      incoming glucose through the hexosamine biosynthesis pathway leads to a
      refractory state over a period of several hours in which the ability of insulin
      to stimulate glucose uptake is severely impaired--a state known as insulin
      resistance. Glutamine:fructose-6-phosphate amidotransferase was found to play a
      central role in the development of insulin resistance as this enzyme catalyzes
      the first and rate-limiting step in the formation of hexosamine products.
      Collectively, these results are consistent with the idea that the hexosamine
      biosynthesis pathway serves as a glucose sensor coupled to a negative feedback
      system that can limit the extent of glucose uptake in response to hyperglycemic
      and hyperinsulinemic conditions.

PMID- 1743437
TI  - Corticosteroids, receptors, and the organ-specific functions of 11 beta
      hydroxysteroid dehydrogenase.
AB  - Reversible oxidation of the biologically active corticosteroids to the inactive
      11-dehydrocorticosteroids is catalyzed by 11 beta-hydroxysteroid dehydrogenase
      (11 beta HSD). The properties of the enzyme based on clinical observations of
      individuals with defective 11 beta HSD expression, and laboratory studies of the
      properties and behavior of the enzyme, are consistent with separate 11 beta
      dehydrogenase and 11-oxoreductase species. However, recombinant enzyme expressed
      in mammalian cells retain both activities, leading to the conclusion that 11 beta
      HSD is a unique, reversible enzyme. 11 beta HSD is present in most tissues, but
      its specific functions in most tissues are unknown. How the enzyme may mediate
      corticosteroid-receptor interaction is illustrated by studies using kidney,
      testis, and brain. In kidney, 11 beta HSD prevents glucocorticoids from competing
      inappropriately with aldosterone for mineralocorticoid receptor (MR). Lack of
      enzyme in humans due to natural causes or inhibition by pharmacological agents
      results in maximum activation of MR by glucocorticoids, leading to the clinical
      symptoms of apparent mineralocorticoid excess. Leydig cells of the testes
      synthesize testosterone, a process that is suppressed by events initiated by the
      binding of corticosteroid to glucocorticoid receptors (GR). Depletion of active
      steroid mediated by 11 beta HSD may initiate testosterone production at puberty
      and affect testosterone production during adult life, as for example during
      periods of stress. The heterogeneous distribution of MR and GR in the brain
      reflects the specific regional effects of glucocorticoids and mineralocorticoids
      on neural function. Colocalization of 11 beta HSD and corticosteroid receptors in
      brain may be important in controlling the specificity of corticosteroid
      interaction with GR and MR. The patterns of 11 beta HSD-steroid-receptor
      interaction illustrated with these three tissues may provide models applicable to
      other tissues in which corticosteroid receptors and 11 beta HSD coexist.

PMID- 1743438
TI  - Glycosidase inhibitors: inhibitors of N-linked oligosaccharide processing.
AB  - The biosynthesis of the various types of N-linked oligosaccharide structures
      involves two series of reactions: 1) the formation of the lipid-linked saccharide
      precursor, Glc3Man9(GlcNAc)2-pyrophosphoryl-dolichol, by the stepwise addition of
      GlcNAc, mannose and glucose to dolichyl-P, and 2) the removal of glucose and
      mannose by membrane-bound glycosidases and the addition of GlcNAc, galactose,
      sialic acid, and fucose by Golgi-localized glycosyltransferases to produce
      different complex oligosaccharide structures. For most glycoproteins, the precise
      role of the carbohydrate is still not known, but specific N-linked
      oligosaccharide structures are key players in targeting of lysosomal hydrolases
      to the lysosomes, in the clearance of asialoglycoproteins from the serum, and in
      some cases of cell:cell adhesion. Furthermore, many glycoproteins have more than
      one N-linked oligosaccharide, and these oligosaccharides on the same protein
      frequently have different structures. Thus, one oligosaccharide may be of the
      high-mannose type whereas another may be a complex chain. One approach to
      determining the role of specific structures in glycoprotein function is to use
      inhibitors that block the modification reactions at different steps, causing the
      cell to produce glycoproteins with altered carbohydrate structures. The function
      of these glycoproteins can then be assessed. A number of alkaloid-like compounds
      have been identified that are specific inhibitors of the glucosidases and
      mannosidases involved in glycoprotein processing. These compounds cause the
      formation of glycoproteins with glucose-containing high mannose structures, or
      various high-mannose or hybrid chains, depending on the site of inhibition. These
      inhibitors have also been useful for studying the processing pathway and for
      comparing processing enzymes from different organisms.

PMID- 1743439
TI  - Molecular insights into eukaryotic chemotaxis.
AB  - Many cells display directed migration toward specific compounds. The best-studied
      eukaryotic models of chemotaxis are polymorphonuclear leukocytes, which respond
      to formylated peptides and Dictyostelium amoebas, which respond to extracellular
      cAMP. In both cell types, chemoattractants bind to surface receptors that contain
      seven transmembrane domains and interact with G proteins. Some cells, such as
      fibroblasts, undergo chemotaxis toward compounds whose receptors lack this motif
      and transmit their signals by other mechanisms. The cytosolic changes elicited by
      chemoattractants include increased levels of cAMP, cGMP, inositol phosphates, and
      calcium. These changes are correlated with actin polymerization and other
      cytoskeletal events that result in preferential extension of pseudopods toward
      the chemoattractant. Dictyostelium cell lines in which specific genes have been
      disrupted have demonstrated the necessity of a cAMP receptor (cAR1) and a G
      protein alpha-subunit (G alpha 2) for responsiveness to cAMP. Other proteins,
      such as myosin heavy chain and several actin binding proteins, are dispensible
      although their absence does affect the details of chemotaxis. The disruption of
      other relevant genes and the genetic reconstitution of chemotaxis in cells
      lacking crucial proteins should reveal many clues about this complicated and
      fascinating process.

PMID- 1743440
TI  - The steroid receptor superfamily: mechanisms of diversity.
AB  - The steroid receptor superfamily of ligand-dependent transcription factors is
      characterized by marked conservation of both structure and function between the
      various receptors. Despite their well-documented extensive similarities, these
      receptors respond to a diverse range of ligands, which results in an even more
      impressive diversity of function. A variety of strategies is used at each point
      in the pathway from ligand binding to gene expression to achieve this diversity.
      The nature of the ligand is important as are the tissue-specific patterns of
      receptor gene expression, the presence of binding proteins, and the effects of
      cell- or tissue-specific ligand-modifying enzymes. Once bound to the receptor,
      the nature of which may vary as a result of either differential splicing or gene
      duplication yielding multiple isoforms, the activated receptor may form hetero-
      or homodimers. A complex interplay then occurs between the receptor dimer, other
      nuclear proteins, the response element, and the promoter complex to regulate gene
      expression. These elements may vary as a function of the cell type, other
      stimuli, and the context and sequence of the response element (or elements) in a
      given gene. By these mechanisms diversity may even be achieved for a given
      ligand, receptor subtype, gene, or cell. The observations may help to explain
      certain phenomena in hormone biology that are difficult to reconcile with the
      previous, simple, univariant model of steroid hormone action.

PMID- 1743441
TI  - Neuropeptide Y and natural killer cell activity: findings in depression and
      Alzheimer caregiver stress.
AB  - A reduction in immune function has been found in patients with a major depressive
      disorder and in persons undergoing severe life stress. This study investigated
      the association between increased sympathetic nervous system activity and reduced
      natural killer (NK) cytotoxicity in depression and Alzheimer caregiver stress. NK
      activity and plasma concentrations of epinephrine, norepinephrine, and
      neuropeptide Y were measured in depressed patients (n = 19) and age- and gender
      matched controls (n = 19), and in Alzheimer spousal caregivers (n = 48) and
      matched noncaregiver controls (n = 17). Plasma levels of neuropeptide Y, but not
      circulating basal levels of catecholamines, were significantly (P less than 0.01)
      elevated in the depressed patients and in the caregivers compared with respective
      controls. NK activity was significantly (P less than 0.001) lower in the
      depressed patients than in their controls, but not different between the
      caregivers and the noncaregiver controls. Circulating concentrations of
      neuropeptide Y, but not catecholamines, were inversely correlated (r = -0.31, P
      less than 0.001) with NK activity. In addition, multiple regression analyses
      demonstrated that the significant (P less than 0.01) association between
      neuropeptide Y and natural cytotoxicity was independent of the relative
      contribution of age and basal and dynamic levels of epinephrine and
      norepinephrine. These findings suggest that increased sympathetic nervous system
      activity and the release of neuropeptide Y may be associated with the modulation
      of NK cytotoxicity.

PMID- 1743442
TI  - [Myocardial scintigraphy with 99mTc MIBI. The use of a single-day protocol in a
      multiregional center: a comparison between planar and tomographic imaging].
AB  - The use of a single-day protocol for 99mTc MIBI myocardial scintigraphy is
      particularly well-suited for the nuclear medicine departments that are the
      referral centres for the cardiology departments of several community hospitals.
      The aim of the study was to compare, in the same patient population, the
      diagnostic accuracy of planar and SPECT imaging with 99mTc MIBI using a single
      day protocol. Thirty-nine patients (31 males and 8 females, age range 32-69
      years) were studied because of effort chest pain. Of them, 7 had a pre-test
      probability of coronary artery disease less than 2.5%; coronary angiography
      demonstrated significant coronary obstructions in the remaining 32 subjects and
      21 of them also had a history of previous myocardial infarction. All patients
      underwent 99mTc MIBI myocardial scintigraphy with acquisition of planar and SPECT
      images after injection of a low dose (370 MBq) at rest and after a second higher
      dose (1110 MBq), injected approximately four hours later during exercise stress
      testing. The normalcy rate in the 7 patients with low pre-test probability was
      100% using both imaging techniques. For the diagnosis of previous infarction, the
      sensitivities of planar and SPECT images were 71% and 96% respectively. For the
      diagnosis of effort ischemia the sensitivity values were 34% and 88%,
      respectively, using planar and SPECT imaging. With regard to the classification
      of the diseased coronary arteries, the sensitivities of planar and SPECT studies
      were 42% and 79% respectively, and the related specificities were 91% and 77%. We
      may conclude that using a single-day protocol planar imaging seems to allow lower
      levels of diagnostic accuracy both for the diagnosis of effort ischemia and the
      classification of the diseased vessels as compared to SPECT, which appears
      therefore in a similar setting the imaging technique of choice.

PMID- 1743443
TI  - [Changes in the wall motion of left ventricle in dipyridamole-induced ischemic
      cardiopathy studied by nuclear magnetic resonance. A comparison with myocardial
      scintigraphy with 99mTc MIBI].
AB  - To investigate whether magnetic resonance imaging (NMR) can detect alterations in
      LV contractility during myocardial ischemia, ten patients aged 32-72 with
      coronary artery disease underwent ECG gated NMR performed at 0.5 Tesla after
      intravenous infusion of high dose dipyridamole (DP) (0.7 mg/Kg) over 5 minutes.
      LV contraction in planes similar to echo short axis projection was imaged under
      condition, 3' and 15-20' after infusion of DP by fast multiphasic imaging (FMI),
      multiple angulated cine-NMR sequence with a temporal resolution of 50 m/sec.
      Entity and size of perfusion defects after DP were determined by Tc 99m MIBI
      myocardial scintigraphy. In all patients changes in LV contractility appeared at
      NMR in the same site of perfusion impairments revealed with MIBI. In 8 patients
      the alterations lasted even more than 20' after the first NMR scan. NMR provides
      the opportunity of performing long-lasting assessment of ventricular wall
      contractility and enables to exactly localize the site and extension of kinetic
      changes as well as their time of onset and time duration.

PMID- 1743444
TI  - [The diagnostic and prognostic value of echo-dipyridamole in patients with
      suspected coronary disease: a comparison with the stress test].
AB  - The aim of the study was to assess the relative diagnostic and prognostic
      accuracy of high-dose dipyridamole echocardiography test (DET: 2D-echo monitoring
      during dipyridamole infusion up to 0.84 mg/kg over 10') vs maximal symptom
      limited bicycle exercise electrocardiography test (EET) in patients with chest
      pain addressed to coronary angiography. We initially considered 477 consecutive
      patients, meeting the following inclusion criteria: 1) history of chest pain; 2)
      off antianginal therapy; 3) no previous myocardial infarction and/or obvious
      regional left ventricular dyssynergy of contraction. All patients were submitted
      to a DET and EET--on different days and in random order--within 1 week of
      coronary angiography (which was performed independently of test results). DET
      could not be performed in 32 patients for a poor acoustic window in resting
      conditions (n = 31) or for asthmatic disease requiring xanthine therapy (n = 1);
      EET could not be performed in 54 patients for inability to exercise, or resting
      electrocardiographic abnormalities making the EET interpretable. The overall
      feasibility was of 445/477 for DET and 423/477 for EET (93 vs 89%, p = ns).
      Criteria for positivity were: transient regional dyssynergy absent in the
      baseline examination for DET; ST segment shift greater than .15 m V from baseline
      for EET. Angiographically assessed coronary artery disease (CAD) was considered
      present when a luminal reduction greater than or equal to 50% occurred in at
      least 1 major coronary vessel. There were 135 pts with no significant CAD and 256
      with CAD; 137 had single, 70 double, 49 triple and/or left main (15) vessel
      disease. The specificity was higher in DET vs EET (96 vs 59%, p less than .01).
      The overall sensitivity of DET was similar to EET (67 vs 69%, p = ns), with no
      significant differences in the subset with single (56 vs 63%, p = ns), double (74
      vs 69%, p = ns) or triple (88 vs 86%, p = ns) vessel disease. Patients were
      followed-up for 26 +/- 22 (range 1 to 73) months considering only death and
      myocardial infarction as end-points. A Cox stepwise survival analysis identified
      the Wall Motion Score Index (an integrated semiquantitative measure of extent and
      severity of the dyssynergy) at peak dipyridamole as the most powerful prognostic
      predictor (X2 = 18.5, p less than 0001) of all invasive (number of stenotic
      coronary vessels, X2 = 5.8, p less than .05) and noninvasive (exercise
      electrocardiography positivity, p = ns) parameters.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1743445
TI  - [The prevention of the myocardial toxicity of doxorubicin with superoxide
      dismutase].
AB  - The production of oxygen free radicals during anthracycline therapy has been
      proposed as a determinant of the toxicity of anthracyclines. Oxygen radical
      generation might specifically affect the myocardium because of the low
      antioxidant defense systems in cardiac tissue. The aim of the present
      investigations was to evaluate the potential cardioprotective effect of
      superoxide dismutase (SOD) against the delayed cardiomyopathy induced by
      doxorubicin (DXR) in a rat model. Female Sprague Dawley rats received 3 mg/kg of
      DXR intravenously weekly for 4 weeks. SOD was administered intravenously at the
      dose of 10,000 U/Kg one minute before and 30 minutes after each DXR
      administration. Cardiac toxicity was monitored in vivo by means of
      electrocardiography (QaT interval), by determining the contractile properties of
      isolated atria, and by light and electron microscopy evaluation of left ventricle
      fragments excised 5 weeks after the last DXR administration. The degree of
      morphologic lesions was quantitated according to the score system proposed by E.
      Billingham. DXR treated rats showed, in comparison with control animals treated
      with saline a decrease of body weight gain, a progressive and irreversible
      prolongation of QaT, decrease of contractility of isolated atria, and significant
      morphologic lesions consisting in myocyte vacuolization and myofibrillar loss.
      SOD significantly prevented the impairment of body weight gain, QaT prolongation
      and the impairment of myocardial contractility. Moreover morphologic lesions were
      significantly reduced in rats receiving DXR + SOD. The present data indicate that
      SOD could represent an important issue in myocardial protection against DXR
      cardiotoxicity.

PMID- 1743446
TI  - [The behavior of the arterial pressure at rest and under exertion in normotensive
      and hypertensive subjects exposed to acute hypoxia at a median altitude].
AB  - In order to evaluate blood pressure changes at rest and during effort in response
      to moderate altitude acute hypoxia, we performed noninvasive blood pressure
      monitoring and maximal bicycle stress testing in 10 normotensive and 13 untreated
      mild hypertensive subjects at sea-level and in a mountain resort (m. 2572). Blood
      pressure was measured every 10 minutes by the Spacelabs 5200 pressurometer and
      bicycle stress test was performed at initial workload of 50 watts and steps of 50
      watts every 3 minutes until exhaustion. Mean systolic blood pressure resulted
      unchanged in the normotensive subjects (120.8 +/- 10.6 vs 121.5 +/- 6.9 NS) while
      in the hypertensive ones it increased slightly at 2572 m. (131.0 +/- 12.3 vs
      137.0 +/- 13.1 NS). Mean diastolic blood pressure did not increase significantly
      at 2572 m in either group (respectively from 74.5 +/- 90 to 80.1 +/- 7.9 NS and
      from 88.3 +/- 10.2 to 94.7 +/- 10.7 NS) even if blood pressure increase was
      relevant in some hypertensive subjects. During the monitoring, heart rate
      increased at 2752 m in both groups, even if this difference was significant in
      the hypertensive group only (respectively 82.8 +/- 11.8 vs 94.3 +/- 13.2 in
      normotensive subjects-NS-and 88.0 +/- 6.3 vs 104.0 +/- 7.8 in hypertensive
      subjects-p less than 0.001). During the ergometric test submaximal systolic blood
      pressure (100 and 150 watts) increased slightly in both groups, but this
      difference was significant in hypertensive subjects at a workload of 150 watts
      only (208.3 +/- 18.2 vs 219.3 +/- 19.2 p less than 0.05).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1743447
TI  - [Holter monitoring with a pill-shaped esophageal electrode].
AB  - This study analyzes the possibility of using an oesophageal lead in the
      ambulatory ECG monitoring in order to improve the diagnostic effectiveness of the
      method by reliable identification of atrial activity. The oesophageal Holter
      monitoring was performed on 19 patients (pts) (8 F and 11 M, aged 34 to 79
      years). These patients posed precise diagnostic problems unsolved by previous
      conventional Holter recordings. The oesophageal Holter recording was carried out
      with a Spacelabs recorder, model 90205 with two channels. One electrode was
      positioned in the standard lead CM5 and the second in the oesophagus using an
      Esodyn 2 electrode with a dynamic configuration made by C.B-Bioelettronica
      (Calenzano, Florence). The oesophageal lead was connected with the recorder by
      filter model EHF-4. The electrode was swallowed by the patient and the best
      position regulated on the P diphasic deflection of the highest amplitude. The
      monitoring allowed correct identification of the P wave over a 24-hour period.
      The arrhythmia which required the oesophageal Holter monitoring was recorded
      again in 15 of 18 patients examined. In each of these cases it was possible to
      solve the diagnostic question. The following arrhythmias were found: constant
      time correlation between the P deflection and the QRS in accordance with a
      supraventricular tachycardia with intraventricular conduction delay (4 pts); A-V
      dissociation in accordance with a ventricular tachycardia (2 pts); pause caused
      by atrioventricular block 2:1 (1 pt), second degree sinus-atrial block (1 pt),
      blocked premature atrial beats (4 pts); premature ventricular and premature
      atrial beats with intraventricular conduction delay (3 pts).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1743448
TI  - [Right atrial isomerism with pulmonary atresia: the angiocardiographic
      characteristics and pulmonary circulatory patterns].
AB  - The patterns of pulmonary circulation were assessed by angiography in a series of
      24 patients with right atrial isomerism (asplenia syndrome) and pulmonary
      atresia. Mean age at catheterization was 21.5 days (range 1 day-11 months). The
      pulmonary arteries were confluent in 22 cases (91.7%). Eighteen patients (75%)
      had ductus-dependent pulmonary circulation in presence of confluent pulmonary
      arteries, similar to cases of pulmonary atresia combined with complex congenital
      heart disease. The ductus appeared in continuity with the aortic arch, shaping an
      acute angle with the descending aorta, as in cases of pulmonary atresia with
      ventricular septal defect. A bilateral ductus was present in 5 cases (20.8%), 3
      with confluent and 2 with nonconfluent pulmonary arteries. One patient presented
      multiple systemic collaterals to the lungs. All the other patients had normal
      arborization of the pulmonary arteries. Seven patients presented an obstructed
      total anomalous pulmonary venous connection: 4 in inferior vena cava and 3 in
      superior vena cava. These anatomical observations provide useful information for
      the surgical palliation of these anomalies and, probably, warrant pre-operative
      angiographic evaluation in all the patients with right atrial isomerism.

PMID- 1743449
TI  - [The diagnosis of pulmonary embolism: the role of noninvasive technics].
AB  - Today a large group of patients with pulmonary embolism is still undetected
      because this disease is not suspected. We evaluated the role of routine clinical
      procedures such as history, chest x-ray, electrocardiogram and blood gas analysis
      in the diagnosis of this disease. We studied 177 patients sent to our observation
      with suspicion of pulmonary embolism, which was later confirmed in 97 and
      excluded in 80. Prolonged immobilization, surgical procedures and deep vein
      thrombosis are the most frequent predisposing factors (P less than 0.05 or less)
      in patients with pulmonary embolism with respect to patients with unconfirmed
      suspicion of embolism. Among symptoms and signs, pleuritic chest pain, sudden
      onset of dyspnea, tachypnea, fever, enlarged jugular veins, enhanced pulmonary
      component of the second heart sound, pulmonary systolic murmur and basal
      hypophonesis were the most frequent signs (P less than 0.005 or less) in patients
      with embolism. Among radiographic signs "sausage" descending pulmonary artery,
      diaphragmatic elevation, pulmonary infarction, Westermark sign and azygos vein
      enlargement were more frequent (P less than 0.05 or less) in patients with
      embolism with respect to patients with unconfirmed suspicion of embolism. Among
      electrocardiographic signs, tachycardia, P-R segment displacement and negative T
      wave in V1-V2 were more frequent in patients with embolism with respect to
      patients with unconfirmed suspicion of embolism (P less than 0.05 or less). PO2,
      standard pO2 and pCO2 were significantly lower (P less than 0.001) in patients
      with embolism. After discriminant analysis of the whole data set most patients
      were correctly classified as embolic (90/97) and non-embolic (75/80).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1743450
TI  - The Framingham Heart Study shows no increases in coronary heart disease rates
      from cholesterol values of 205 to 264 mg%.

PMID- 1743451
TI  - [Informatics for cardiology at the ACC '91. Congress of the American College of
      Cardiology].

PMID- 1743452
TI  - Atrioventricular block following therapy with recombinant interleukin 2.

PMID- 1743453
TI  - [Rosa fresca aulentissima].

PMID- 1743454
TI  - [Further comment on the classification of unstable angina].

PMID- 1743455
TI  - ANA releases statement on mobilization of nurses.

PMID- 1743456
TI  - One song: many voices.

PMID- 1743457
TI  - What do we do when we disagree?

PMID- 1743458
TI  - Issues of concern to nurse practitioners.

PMID- 1743459
TI  - Opportunities in gerontological nursing.

PMID- 1743461
TI  - School health on the move.

PMID- 1743460
TI  - Should GNA continue to be a union?

PMID- 1743462
TI  - Taking the mystery out of delegate credentialing.

PMID- 1743463
TI  - Open letter to Santa.

PMID- 1743464
TI  - Power Line for women and children.

PMID- 1743465
TI  - [Counseling in artificial fertilization].
AB  - Since 1 October 1990, German legislation requires compulsory counselling of an
      infertile couple before artificial insemination on the medical and psychosocial
      aspects, by a doctor not performing the treatment. A prerequisite of successful
      counselling, which enables the couple to take a decision and helps coping with
      the psychosocial stress of sterility and its consequences, is, in addition to the
      intrinsic motivation of the couple, also the empathy and the discussion with the
      doctor. Subject for counselling should be the burdens of therapy, effects of the
      sterility upon sexuality, partnership, and communication, motivations for wanting
      a child and the functions of the child for both partners individually and as a
      partnership. As a prophylactic measure against the development of a neurotic
      desire for a child and a fixation upon sterility therapy, alternative resolving
      strategies for therapy failure should be discussed and developed.

PMID- 1743466
TI  - [Duration of desire for a child, contraceptive behavior and rate of previous
      infertility treatment. An epidemiologic study of 750 consecutive patients in
      labor at the Oldenburg Gynecologic Clinic using a structured interview].
AB  - In order to gain current information, on how long a healthy couple desiring a
      child has to wait until conception, on previous contraceptive behaviour and prior
      infertility treatment, 750 women were interviewed within 7 days after delivery
      between January and November, 1989, using a standardised questionnaire. This
      sample represents one third of all patients, who delivered a child in an
      Oldenburg hospital during the time period covered. 544 women had desired a
      pregnancy, an additional 206 women had not directly planned a pregnancy, and 73
      of these had taken no precautions against conception, since they were willing to
      accept a pregnancy if it should occur. 133 women called their pregnancy an
      "accident", which in 87 couples occurred despite some kind of contraceptive
      procedure. The absolute number of contraceptive failures was highest for timed
      intercourse (n = 38) and users of oral contraceptives (n = 32). Couples without a
      history of infertility treatment had to wait for an average period of 3.4 months
      before a conception occurred (95% confidence limits: 3.1-3.8 months). The mean
      age of the women in this group was 28.1 +/- 0.2 years, whereas on an average
      their male partners were 30.9 +/- 0.2 years of age. The likelihood to achieve
      pregnancy within the first 4 months of trying, varied between 13 and 15% per
      month. After 6 months of waiting, the pregnancy rate per cycle was reduced to 6%,
      whereas, after one year, the likelihood for conception was only 1%. Half of all
      couples desiring a pregnancy achieved this within 4 months.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1743467
TI  - [Pregnancy after direct oocyte-sperm transfer (DOST)--a simple alternative to in
      vitro fertilization (IVF)].
AB  - We report on the first pregnancies achieved at our clinic following direct oocyte
      sperm-transfer (DOST). Immediately after follicular aspiration, oocytes together
      with spermatozoa prepared by the swim-up-technique are transferred to the uterus
      in a manner similar to the embryo transfer following IVF. Our study population
      consists of 9 patients with bilateral tubal occlusion, accompanied by a male
      factor in three cases. Up to now, we have achieved four pregnancies, including
      one twin pregnancy, all occurring, when a male factor was absent. The method
      described appears promising in terms of efficiency, reduction in the costs and
      technical procedures during treatment of human infertility.

PMID- 1743468
TI  - [Prenatal diagnosis with chorionic villi and placenta puncture biopsy in the 1st
      to 3d trimester of pregnancy: diagnostic value of chromosome studies].
AB  - Chorionic villus sampling and placental biopsies became established diagnostic
      alternatives to amniocentesis worldwide during the 80's. Safety and accuracy are
      the most important criteria for the evaluation of these newer techniques as
      compared to amniocentesis. We report on our experience with more than 3400
      chromosome analyses between 1985 and 1990 from first to third trimester of
      pregnancy in a single centre. Most obvious is the higher frequency of mosaicism,
      which is often, but not always confined to the placenta. Mosaicism accounts for
      the overwhelming majority of all discrepant (so-called false negative or false
      positive) cytogenetic findings. The most important prerequisites for diagnostic
      accuracy of chromosome analyses are meticulous separation of villi immediately
      after the sampling procedure as well as simultaneous use of direct preparation
      and cell culture. If mosaicism is not taken as sound evidence for foetal
      aneuploidy, the accuracy of cytogenetic diagnoses after chorionic villus sampling
      and placental biopsies is in the same range as the one after amniocentesis.

PMID- 1743469
TI  - [Bacteriologic findings before and in transcervical chorionic villi biopsy and
      their clinical relevance].
AB  - Between August 1987 and May 1989, bacteriological examinations of smears from the
      cervical canal was performed in 358 pregnant women, who underwent transcervical
      sampling of chorionic villi. The outcome of 349 of these pregnancies is
      documented. 12 of these patients (3.5%) had an artificial abortion for genetic
      reasons. In 12 other patients, the pregnancy ended before 28 weeks (one child
      surviving). Microbiological examinations showed that in 187 women (52%), it was
      possible to culture one or more microorganisms from the cervical canal. The most
      frequently detected pathogen was Chlamydia trachomatis (111 women, 31%). In
      pregnancies, where more than one microorganism could be cultured, the risk of
      following abortion was 8.9 times higher than in those, where no pathogens could
      be found. In only two of the 12 women with a subsequent spontaneous abortion
      (16.6%), no microorganism could be found. The bacterial contamination of the
      cervical canal during TC-CVS seems to be a risk factor for subsequent abortion.
      Therefore, a bacteriological examination of cervical flora should be performed
      before as well as during TC-CVS, and antibiotic therapy should be initiated in
      case of positive results.

PMID- 1743470
TI  - [Pregnancy with an extremely rare P blood group with anti-PP1Pk].
AB  - The authors report on a successful pregnancy in a young Turkish patient with p
      and anti-PP1Pk-antibodies. Anti-PP1Pk is considered to cause haemolytic diseases
      in the newborn and habitual abortions. The patient was treated via plasma
      exchange and substitution with intravenous immunoglobulin. At 31 weeks of
      gestation the patient underwent Caesarean section due to growth retardation and
      pathological signs in the fetal CTG. The child has developed well up to two years
      after the delivery. Based on our data and a review of the literature, the
      effectiveness of therapy by plasmapheresis and/or immunoglobulin is discussed.

PMID- 1743471
TI  - [Placental maturity at term and functional placental performance: CTG changes in
      relation to histologic detection of placental maturation reserves].
AB  - Cardiotocography (CTG) is to be considered today's most sensitive monitoring tool
      for the functional surveillance of placental performance during parturition. 351
      cardiotocographically monitored singleton pregnancies were used as patient
      material for fine tissue examination of the state of maturity of the villi of the
      relevant placentas. In histological assessment, placental diagnoses are allocated
      to defined CTG changes; in particular, however, the identification of reserves,
      capable of maturing (immature intermediate villi in the centres of the placental
      subdivisions or placentones), is subject to separate scrutiny. The following
      results emerge clearly: terminal placentas without maturing potentials,
      prematurely matured placentas and placentas with deficiency of terminal villi, as
      well as the absence of immature intermediate villi in the centers of the
      placentones, are connected with a suspected prepathological or pathological CTG
      assessment. The histological groups have the lowest incidence of the normal
      oscillatory type and normal oscillatory frequency and have the highest proportion
      of abnormal CTG assessments according to the Hammacher score. The absence of the
      identification of potential maturing reserves (immature intermediate villi) is
      associated with the highest incidence of Caesarean sections (29.8%). These
      results show, that the physiological maturing potentials (immature intermediate
      villi) which can be identified up to term are a histological indication towards
      regular placental performance, even in labour.

PMID- 1743472
TI  - [Maternal morbidity after abdominal cesarean section in relation to bacterial
      amniotic fluid colonization and premature rupture of fetal membranes].
AB  - At the time of Caesarean section, amniotic fluid was collected transabdominally
      from 1025 patients. In 990 patients cultures were performed on the amniotic
      fluid. The incidence of Caesarean section of all patients was 16.1%, the
      perinatal mortality in all patients 0.61%, in cases of Caesarean section 1.93%.
      The influence of bacterial colonisation in the amniotic cavity was analyzed with
      respect to premature ruptured membranes and frequency of vaginal examinations on
      the maternal post-operative morbidity (wound-seroma and abscess 2.4%, febrile
      morbidity 17%, urinary tract infection 19%). Bacterial contamination was present
      in 33.3% of the amniotic fluid or uterine cavity, after ruptured membranes in
      44.3%, without ruptured membranes in 23.35%. There is a significant influence of
      the positive cultured amniotic fluid on the wound healing and on the febrile
      morbidity, while the urinary tract infection has been not influenced. The
      bacterial contamination of the amniotic fluid is correlated to the frequency of
      vaginal examination and the presence of ruptured membranes. The following
      microbiologic isolates were found in the amniotic fluids: Staphylococcus
      epidermidis 36.38%, Streptococcus B 12.23%, Streptococcus D 10.3%, Escherichia
      coli 8.42%, Staphylococcus aureus 7.88%, Peptococci 3.26%, Streptococcus
      salivarius 2.99%, Bacteroides 2.4%. According to these data, patients with
      ruptured membranes of an interval of more than 12 hrs and with more than 7
      vaginal examinations could be selected for antibiotic prophylaxis to achieve a
      reduction in febrile morbidity and in wound infection.

PMID- 1743473
TI  - [Current status of vaginal ultrasound--a worldwide survey].
AB  - In the last five years, vaginosonography has become a routine procedure in
      Obstetrics and Gynaecology. Many obstetricians, gynaecologists, radiologists and
      ultrasonographers have recognized the advantages of this method. A number of
      manufacturers of ultrasound equipment offer several types of vaginal probes.
      Nevertheless, the rapid development of vaginosonography has led to some
      disadvantages concerning a standardised terminology and image display. In this
      study we collected data on the current standards of vaginosonography. To gain
      data on the current use of vaginosonography, we sent out questionnaires to the
      1107 departments of Obstetrics/Gynaecology in the FIGO Registry of 1985. In an
      accompanying letter we asked the chairmen to pass on the questionnaire to the
      appropriate specialist. The questionnaire was designed to gather information
      about the personnel performing vaginosonography and such as technique, transducer
      frequency, position of the patient and image display used. We received 366
      responses. Vaginosonographic investigations are performed in 84% of the
      Obstetrics/Gynaecological University Departments, of which 90% of
      vaginosonography was performed by an obstetrician or gynaecologist, 5% by a
      radiologist and 5% by a technician. Predominantly end firing scanners were
      preferred. The number of electronic and mechanical scanners were nearly identical
      (55% vs 45%). The preference for a scanner with a narrow (less than 120 degrees)
      or wide angle (greater than 120 degrees) was very similar (53% vs 47%). More than
      half of the replies indicated (54%) used a transducer frequency of 5 MHz, 46%
      preferred scanners with a frequency between 5.5 and 7.5 MHz. In 55%, the
      gynaecological examination table was considered superior to a flat
      table.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1743474
TI  - [Value of vaginal ultrasonography in noninvasive assessment of the endometrium of
      the postmenopausal uterus].
AB  - The endometrial carcinoma shows an increasing incidence and represents today the
      most frequent malignoma of the female pelvis. Until now all techniques of
      detection of this carcinoma or its precursors are invasive and thus are not
      suitable for screening investigations. Vaginosonography, as the first non
      invasive diagnostic method, now supplies knowledge about the state of the
      endometrium. At the Gynaecological Department of the University of Homburg/Saar,
      West Germany, 221 patients had been preoperatively subjected to vaginosonography
      before they underwent surgery. Sonographical and histological findings
      corresponded in atrophic endometrium in 82%, in regular, perimenopausal
      endometrium in 91%, in endometrial polyps and hyperplasia of the endometrium in
      56%, and in endometrial carcinoma in 79%. With regard to the detection of
      endometrial cancer, a specificity of 96%, a sensitivity of 93%, a positive
      predictive value of 79% and an accuracy of 96% were established. Thus, according
      to our experience, vaginosonography represents a valid, non-invasive diagnostical
      method as a suitable instrument for screening the endometrium.

PMID- 1743475
TI  - [New knowledge concerning hemostatic changes in gestosis and HELLP syndromes for
      clinical practice].

PMID- 1743476
TI  - [Brucellosis-induced granulomatous non-puerperal mastitis--a case report].
AB  - An acute manifestation of a chronic brucellosis localised to the female breast is
      described. A granulomatous mastitis was identified on histological examination.
      To our knowledge, this is the first reported occurrence of this phenomenon. It is
      pointed out that it is clinically difficult to distinguish this type of infection
      from an inflammatory carcinoma of the breast.

PMID- 1743477
TI  - [Managing a high risk pregnancy after liver transplantation from the
      obstetrician's point of view. A case report].
AB  - We report about a pregnancy and obstetrical management of a patient who had
      undergone a liver transplantation. Following a normal pregnancy, the newborn was
      born spontaneously in the 39th week of pregnancy. During the pregnancy the CSA
      blood levels were controlled frequently as well as the fetal development. An
      amniocentesis for chromosomal analysis, measurement of AFP blood levels, virus
      diagnostic and a phase III ultrasound diagnostic were performed. Immediately
      after delivery the baby was examined carefully by a pediatrician. Management of
      such a risk pregnancy, after organ transplantation, is possible if there is a
      close interdisciplinary cooperation between obstetricians, pediatricians,
      transplant surgeons and internal medicine specialist.

PMID- 1743478
TI  - [HELLP syndrome--postpartum].
AB  - This report is on a 35-year-old II-para (status post-Caesarean Section due to
      breech presentation, at that time normal pregnancy) progress, who was
      hospitalized with hypertension and proteinuria during the 40th week of pregnancy.
      Both symptoms occurred initially three days before hospitalization. Blood
      pressure was within the high normal range (140/90 mmHg) as a result of medication
      with Dihydralazine (50 mg/die). After induction of labour with prostaglandin
      (PGE2), the patient delivered normally, and the highest blood pressure measured
      was 140/90 mmHg, following a subsequent curettage under general anaesthesia,
      which had to be performed due to incomplete deliver of the placenta. Two hours
      post delivery, sudden epigastric pain occurred, followed by nausea and vomiting.
      Blood chemistry showed the development of a severe post-partal HELLP-Syndrome
      with acute renal failure. The case demonstrates, that the life threatening
      picture of the HELLP-Syndrome may develop without preexistent severe hypertension
      or proteinuria. For this reason a post-delivery screening of blood chemistry
      should be mandatory in cases of severe epigastric or right-upper-quadrant pain.

PMID- 1743479
TI  - [Heterologous and autologous breast reconstruction--current status. Report on the
      2d Congress of the Society of Reconstructive Surgery in Gynecology 22 to 24
      February 1991 in Baden-Baden].

PMID- 1743480
TI  - The Gene (H.J. Muller 1947).

PMID- 1743481
TI  - Control of large chromosomal duplications in Escherichia coli by the mismatch
      repair system.
AB  - Excessive recombination between repeated, interspersed, and diverged DNA
      sequences is a potential source of genomic instability. We have investigated the
      possibility that a mechanism exists to suppress genetic exchange between these
      quasi-homologous (homeologous) sequences. We examined the role of the general
      mismatch repair system of Escherichia coli because previous work has shown that
      the mismatch repair pathway functions as a barrier to interspecies recombination
      between E. coli and Salmonella typhimurium. The formation of large duplications
      by homeologous recombination in E. coli was increased some tenfold by mutations
      in the mutL and mutS genes that encode the mismatch recognition proteins. These
      findings indicate that the mismatch recognition proteins act to prevent excessive
      intrachromosomal exchanges. We conclude that mismatch repair proteins serve as
      general controllers of the fidelity of genetic inheritance, acting to suppress
      chromosomal rearrangements as well as point mutations.

PMID- 1743482
TI  - Genetic and molecular analysis of new female-specific lethal mutations at the
      gene Sxl of Drosophila melanogaster.
AB  - We have isolated three female-specific lethal mutations at the gene Sex-lethal
      (Sxl): Sxlfb, Sxlfc and Sxlfd. We have carried out the complementation analysis
      between these mutations and other previously reported Sxlf mutations. It is
      possible to classify the alleles tested in this report into two complementation
      groups: the bc group defined by Sxlfb, and Sxlfc, and the LS group defined by
      SxlfLS. The other alleles tested affect both complementation groups albeit with
      different degrees. Contrary to what happens with mutations at the LS group,
      mutations at the bc group do not affect sex determination, nor late dosage
      compensation nor oogenesis. Both Sxlfb and Sxlfc present a DNA insertion of at
      least 5 kb between position -10 and -11 on the molecular map, within the fourth
      intron. On the contrary, Sxlfd, a strong mutation affecting all Sxl functions, is
      not associated to any detectable DNA alteration in Southern blots, so that it
      seems to be a "point" mutation. In agreement with their phenotypes, both
      Sxlfc/SxlfLS and Sxlfc homozygous female larvae express only the late Sxl
      transcripts characteristic of females, while females homozygous for SxlfLS
      express only the late Sxl transcripts characteristic of males. Moreover, Sxlfc
      presents a lethal synergistic interaction with mutations at either da or the X:A
      ratio, two signals that define the initial activity state of Sxl, while SxlfLS do
      not. These data suggest that the two complementation groups are related to the
      two sets of early and late Sxl transcripts, which are responsible for the early
      and late Sxl functions, respectively: Sxlfb and Sxlfc would affect the early
      functions and SxlfLS would affect the late Sxl functions.

PMID- 1743483
TI  - The Drosophila Broad-Complex encodes a family of related proteins containing zinc
      fingers.
AB  - The Broad-Complex (BR-C) is essential for metamorphosis in Drosophila
      melanogaster. This locus is coextensive with the 2B5 ecdysone-responsive early
      puff and is necessary for puffing and transcription of many subsequently
      activated late genes in the developing salivary gland. Mapping of 31 cDNA clones
      indicates that approximately 100 kb of the genome is devoted to the synthesis of
      many BR-C RNAs. Sequence analyses of these cDNA clones show that the BR-C encodes
      a family of related proteins characterized by a common core amino-terminal domain
      fused to alternate carboxy domains each containing a pair of zinc fingers. Most
      proteins also contain domains rich in distinctive amino acids located between the
      common core and zinc finger regions. BR-C mutant alleles resulting from
      chromosomal rearrangements at 2B5 are associated with deletions of 5'
      untranslated sequences, separation of the core coding domain from the downstream
      zinc finger domains, or a P element insertional disruption of a zinc finger
      coding sequence. We infer that the BR-C directly regulates late gene expression
      by specifying the synthesis of a family of proteins with DNA binding potential.

PMID- 1743484
TI  - Geographic distribution and inheritance of three cytoplasmic incompatibility
      types in Drosophila simulans.
AB  - Wolbachia-like microorganisms have been implicated in unidirectional cytoplasmic
      incompatibility between strains of Drosophila simulans. Reduced egg eclosion
      occurs when females from uninfected strains (type W) are crossed with males from
      infected strains (type R). Here we characterize a third incompatibility type
      (type S) which is also correlated with the presence of Wolbachia-like
      microorganisms. Despite the fact that the symbionts cannot be morphologically
      distinguished, we observed complete bidirectional incompatibility between R and S
      strains. This indicates that the determinants of incompatibility are different in
      the two infected types. S/W incompatibility is unidirectional and similar to R/W
      incompatibility. A worldwide survey of D. simulans strains showed that type S
      incompatibility was found only in insular populations which harbor the
      mitochondrial type SiI. Both W and R types were found among mainland and island
      populations harboring the worldwide mitochondrial type SiII. Type S
      incompatibility could be involved in the reinforcement of the geographical
      isolation of SiI populations.

PMID- 1743485
TI  - The lethal(1)TW-6cs mutation of Drosophila melanogaster is a dominant antimorphic
      allele of nod and is associated with a single base change in the putative ATP
      binding domain.
AB  - The l(1)TW-6cs mutation is a cold-sensitive recessive lethal mutation in
      Drosophila melanogaster, that affects both meiotic and mitotic chromosome
      segregation. We report the isolation of three revertants of this mutation. All
      three revert both the meiotic and mitotic effects as well as the cold
      sensitivity, demonstrating that all three phenotypes are due to a single lesion.
      We further show that these revertants fail to complement an amorphic allele of
      the nod (no distributive disjunction) locus, which encodes a kinesin-like
      protein. These experiments demonstrate that l(1)TW-6cs is an antimorphic allele
      of nod, and we rename it nodDTW. Sequencing of the nod locus on a nodDTW-bearing
      chromosome reveals a single base change in the putative ATP-binding region of the
      motor domain of nod. Recessive, loss-of-function mutations at the nod locus
      specifically disrupt the segregation of nonexchange chromosomes in female
      meiosis. We demonstrate that, at 23.5 degrees, the meiotic defects in nodDTW/+
      females are similar to those observed in nod/nod females; that is, the
      segregation of nonexchange chromosomes is abnormal. However, in nodDTW/nodDTW
      females, or in nodDTW/+ females at 18 degrees, we observe a more severe meiotic
      defect that apparently affects the segregation of both exchange and nonexchange
      chromosomes. In addition, nodDTW homozygotes and hemizygous males have previously
      been shown to exhibit mitotic defects including somatic chromosome breakage and
      loss. We propose that the defective protein encoded by the nodDTW allele
      interferes with proper chromosome movement during both meiosis and mitosis,
      perhaps by binding irreversibly to microtubules.

PMID- 1743486
TI  - A functional and structural analysis of the Sex combs reduced locus of Drosophila
      melanogaster.
AB  - We have undertaken a developmental genetic analysis of the homeotic gene Sex
      combs reduced (Scr) of Drosophila melanogaster by examining embryonic and adult
      phenotypes of mutations affecting Scr gene function. Molecular mapping of Scr
      breakpoint lesions has defined a segment of greater than 70 kb of DNA necessary
      for proper Scr gene function. This region is split by the fushi tarazu (ftz)
      gene, with lesions affecting embryonic Scr function molecularly mapping to the
      region proximal (5') to ftz and those exhibiting polyphasic semilethality
      predominantly mapping distal (3') to ftz. Gain-of-function mutations are
      associated with genomic rearrangements and map throughout the Scr locus. Our
      analysis has revealed that the Scr locus encompasses genetic elements that are
      responsible for functions in both the embryonic and larval to adult periods of
      development. From these studies, we conclude that Scr is a complex genetic locus
      with an extensive regulatory region that directs functions required for normal
      head and thoracic development in both the embryo and the adult and that the
      regulation of Scr during these two periods is distinct.

PMID- 1743487
TI  - A trans-acting regulatory gene that inversely affects the expression of the
      white, brown and scarlet loci in Drosophila.
AB  - A trans-acting regulatory gene, Inr-a, that alters the level of expression of the
      white eye color locus as an inverse function of the number of its functional
      copies is described. Several independent lines of evidence demonstrate that this
      regulatory gene interacts with white via the promoter sequences. Among these are
      the observations that the inverse regulatory effect is conferred to the Adh gene
      when fused to the white promoter and that cis-regulatory mutants of white fail to
      respond. The phenotypic response to Inr-a is found in all tissues in which white
      is expressed, and mutants of the regulator exhibit a recessive lethality during
      larval periods. Increased white messenger RNA levels in pupal stages are found in
      Inr-a/+ individuals versus +/+ and a coordinate response is observed for mRNA
      levels from the brown and scarlet loci. All are structurally related and
      participate in pigment deposition. These experiments demonstrate that a single
      regulatory gene can exert an inverse effect on a target structural locus, a
      situation postulated from segmental aneuploid studies of gene expression and
      dosage compensation.

PMID- 1743488
TI  - Use of in vitro mutagenesis to analyze the molecular basis of the difference in
      Adh expression associated with the allozyme polymorphism in Drosophila
      melanogaster.
AB  - In natural populations of Drosophila melanogaster, the alcohol dehydrogenase
      (Adh) locus is polymorphic for two allozymes, designated Slow and Fast. Fast
      homozygotes generally have a two- to threefold higher ADH activity level than
      Slow homozygotes for two reasons: they have a higher concentration of ADH protein
      and the Fast protein has a higher catalytic efficiency. DNA sequencing studies
      have shown that the two allozymes generally differ by only a single amino acid at
      residue 192, which must therefore be the cause of the catalytic efficiency
      difference. A previous P element-transformation experiment mapped the difference
      in ADH protein level to a 2.3-kb HpaI/ClaI restriction fragment; which contains
      all of the Adh coding sequences but excludes all of the 5' flanking region of the
      distal transcriptional unit. Here we report the results of a site-directed in
      vitro mutagenesis experiment designed to investigate the effects of the amino
      acid replacement. This replacement has the expected effect on catalytic
      efficiency, but there is no detectable effect on the concentration of ADH protein
      estimated immunologically. This result shows that the average difference in ADH
      protein level between the allozymic classes is due to linkage disequilibrium
      between the amino acid replacement and one or more other polymorphisms within the
      HpaI/ClaI fragment. Sequence analysis of several Fast and Slow alleles suggested
      that the other polymorphism might be a silent substitution at nucleotide 1443,
      but another in vitro mutagenesis experiment reported here shows that this is not
      the case. Therefore, the molecular basis of the difference in ADH protein
      concentration between the allozymic classes remains an open question.

PMID- 1743489
TI  - Low nucleotide diversity in man.
AB  - The nucleotide diversity (pi) in humans is studied by using published cDNA and
      genomic sequences that have been carefully checked for sequencing accuracy. This
      measure of genetic variability is defined as the number of nucleotide differences
      per site between two randomly chosen sequences from a population. A total of more
      than 75,000 base pairs from 49 loci are compared. The DNA regions studied are the
      5' and 3' untranslated regions and the amino acid coding regions. The coding
      regions are divided into nondegenerate sites (i.e., sites at which all possible
      changes are nonsynonymous), twofold degenerate sites (i.e., sites at each of
      which one of the three possible changes is synonymous) and fourfold degenerate
      sites (i.e., sites at which all three possible changes are synonymous). The pi
      values estimated are, respectively, 0.03 and 0.04% for the 5' and 3' UT regions,
      and 0.03, 0.06 and 0.11% for nondegenerate, twofold degenerate and fourfold
      degenerate sites. Since the highest pi value is only 0.11%, which is about one
      order of magnitude lower than those in Drosophila populations, the nucleotide
      diversity in humans is very low. The low diversity is probably due to a
      relatively small long-term effective population size rather than any severe
      bottleneck during human evolution.

PMID- 1743490
TI  - Variance of neutral genetic variances within and between populations for a
      quantitative character.
AB  - The variances of genetic variances within and between finite populations were
      systematically studied using a general multiple allele model with mutation in
      terms of identity by descent measures. We partitioned the genetic variances into
      components corresponding to genetic variances and covariances within and between
      loci. We also analyzed the sampling variance. Both transient and equilibrium
      results were derived exactly and the results can be used in diverse applications.
      For the genetic variance within populations, sigma 2 omega, the coefficient of
      variation can be very well approximated as [formula: see text] for a normal
      distribution of allelic effects, ignoring recurrent mutation in the absence of
      linkage, where m is the number of loci, N is the effective population size, theta
      1(0) is the initial identity by descent measure of two genes within populations
      and t is the generation number. The first term is due to genic variance, the
      second due to linkage disequilibrium, and third due to sampling. In the short
      term, the variation is predominantly due to linkage disequilibrium and sampling;
      but in the long term it can be largely due to genic variance. At equilibrium with
      mutation [formula: see text] where u is the mutation rate. The genetic variance
      between populations is a parameter. Variance arises only among sample estimates
      due to finite sampling of populations and individuals. The coefficient of
      variation for sample gentic variance between populations, sigma 2b, can be
      generally approximated as [formula: see text] when the number of loci is large
      where S is the number of sampling populations.

PMID- 1743491
TI  - Pairwise comparisons of mitochondrial DNA sequences in stable and exponentially
      growing populations.
AB  - We consider the distribution of pairwise sequence differences of mitochondrial
      DNA or of other nonrecombining portions of the genome in a population that has
      been of constant size and in a population that has been growing in size
      exponentially for a long time. We show that, in a population of constant size,
      the sample distribution of pairwise differences will typically deviate
      substantially from the geometric distribution expected, because the history of
      coalescent events in a single sample of genes imposes a substantial correlation
      on pairwise differences. Consequently, a goodness-of-fit test of observed
      pairwise differences to the geometric distribution, which assumes that each
      pairwise comparison is independent, is not a valid test of the hypothesis that
      the genes were sampled from a panmictic population of constant size. In an
      exponentially growing population in which the product of the current population
      size and the growth rate is substantially larger than one, our analytical and
      simulation results show that most coalescent events occur relatively early and in
      a restricted range of times. Hence, the "gene tree" will be nearly a "star
      phylogeny" and the distribution of pairwise differences will be nearly a Poisson
      distribution. In that case, it is possible to estimate r, the population growth
      rate, if the mutation rate, mu, and current population size, N0, are assumed
      known. The estimate of r is the solution to ri/mu = ln(N0r) - gamma, where i is
      the average pairwise difference and gamma approximately 0.577 is Euler's
      constant.

PMID- 1743492
TI  - A source of small repeats in genomic DNA.
AB  - The processes of spontaneous mutation are known to be influenced by neighboring
      DNA. Imperfect nearby repeats in the neighboring DNA have been observed to mutate
      to form perfect repeats. The repeats may be either direct or inverted. Such a
      mutational process should create perfect direct and inverted repeats in
      intergenic DNA. A larger than expected number of direct repeats has generally
      been observed in a wide range of species in both coding and noncoding DNA.
      Simulations are carried out to determine how this process might influence the
      repetitive structure of genomic DNA. These simulations show that small repeats
      created by this kind of a mutational process can explain the excess number of
      repeats in intergenic DNA. The simulations suggest that this mechanism may be a
      common cause of mutations, including single-base changes. The influences of the
      distance between imperfect repeats and of their degree of similarity are
      investigated.

PMID- 1743493
TI  - Influence of gene flow and breeding tactics on gene diversity within populations.
AB  - Expressions describing the accumulation of gene correlations within and among
      lineages and individuals of a population are derived. The model permits different
      migration rates by males and females and accounts for various breeding tactics
      within lineages. The resultant equations enable calculation of the probabilistic
      quantities for the fixation indices, rates of loss of genetic variation,
      accumulation of inbreeding, and coefficients of relationship for the population
      at any generation. All fixation indices were found to attain asymptotic values
      rapidly despite the consistent loss of genetic variation and accumulation of
      inbreeding within the population. The time required to attain asymptotic values,
      however, was prolonged when gene flow among lineages was relatively low (less
      than 20%). The degree of genetic differentiation among breeding groups,
      inbreeding coefficients, and gene correlations within lineages were found to be
      primarily functions of breeding tactics within groups rather than gene flow among
      groups. Thus, the asymptotic value of S. Wright's island model is not appropriate
      for describing genetic differences among groups within populations. An
      alternative solution is provided that under limited conditions will reduce to the
      original island model. The evolution of polygynous breeding tactics appears to be
      more favorable for promoting intragroup gene correlations than modification of
      migration rates. Inbreeding and variance effective sizes are derived for
      populations that are structured by different migration and breeding tactics.
      Processes that reduce the inbreeding effective population size result in a
      concomitant increase in variance effective population size.

PMID- 1743494
TI  - Genealogy of neutral genes and spreading of selected mutations in a
      geographically structured population.
AB  - In a geographically structured population, the interplay among gene migration,
      genetic drift and natural selection raises intriguing evolutionary problems, but
      the rigorous mathematical treatment is often very difficult. Therefore several
      approximate formulas were developed concerning the coalescence process of neutral
      genes and the fixation process of selected mutations in an island model, and
      their accuracy was examined by computer simulation. When migration is limited,
      the coalescence (or divergence) time for sampled neutral genes can be described
      by the convolution of exponential functions, as in a panmictic population, but it
      is determined mainly by migration rate and the number of demes from which the
      sample is taken. This time can be much longer than that in a panmictic population
      with the same number of breeding individuals. For a selected mutation, the
      spreading over the entire population was formulated as a birth and death process,
      in which the fixation probability within a deme plays a key role. With limited
      amounts of migration, even advantageous mutations take a large number of
      generations to spread. Furthermore, it is likely that these mutations which are
      temporarily fixed in some demes may be swamped out again by non-mutant immigrants
      from other demes unless selection is strong enough. These results are potentially
      useful for testing quantitatively various hypotheses that have been proposed for
      the origin of modern human populations.

PMID- 1743495
TI  - A mathematical model of interference for use in constructing linkage maps from
      tetrad data.
AB  - In determining genetic map distances it is necessary to infer crossover
      frequencies from the ratios of recombinant and parental progeny. To do this
      accurately, in intervals where multiple crossovers may occur, a mathematical
      model of chiasma interference must be assumed when mapping in organisms
      displaying such interference. In Saccharomyces cerevisiae the model most
      frequently used is that of R.W. Barratt. An alternative to this model is
      presented. This new model is implemented using a microcomputer and standard
      numerical methods. It is demonstrated to fit ranked tetrad data from
      Saccharomyces more closely than the Barratt model and thus generates more
      accurate estimates of map distances when used with two-point data. A computer
      program implementing the model has been developed for use in calculating map
      distances from tetrad data in Saccharomyces.

PMID- 1743496
TI  - What's in a name? "Mental" or "physical," "psychiatric" or "medical"?

PMID- 1743497
TI  - A profile of academic medical-psychiatric units.
AB  - Medical-psychiatric inpatient programs are a relatively recent phenomenon.
      Although interest in these programs seems widespread, they are still found
      primarily at academic medical centers. The authors surveyed 11 such academic
      units. Variations found between their patient populations, milieu, and
      organization suggest that these programs, in general, are still in an early stage
      of evolution. It is hoped that these data will provide a descriptive base of how
      these programs have developed.

PMID- 1743498
TI  - Organization and development of pediatric medical-psychiatric units. Part I:
      Administrative, financial, and political issues.
AB  - The growing literature regarding the development of medical-psychiatric units to
      facilitate diagnosis and treatment of patients with combined medical and
      psychiatric disorders is primarily limited to adult populations. Almost no
      published information is available concerning combined pediatric medical
      psychiatric units. This article, the first in a two-part series, outlines the
      organization and development of a child and adolescent medical-psychiatric unit
      within a pediatric hospital. Various academic, administrative, political,
      financial, and clinical issues that must be considered during the developmental
      process are delineated and discussed. The second part of the series will address
      clinical management issues.

PMID- 1743499
TI  - The role of SPECT brain imaging in assessing psychopathology in the medically
      ill.
AB  - Cerebral single photon emission computed tomography (SPECT), a method of
      functional brain imaging, measures cerebral blood flow and metabolism. This paper
      describes the imaging procedure and several cases where cerebral SPECT was of use
      in the differential diagnosis of medically ill patients who also presented with
      psychopathology. SPECT patterns in cerebrovascular disease, dementia, focal
      epilepsy, and AIDS are at present the best described and seem to be the most
      specific. Often changes in regional cerebral blood flow are seen before
      structural changes become apparent on CT or MRI. Cerebral SPECT can add valuable
      diagnostic information in assessing psychopathology in the medically ill and can
      often lead to changes in treatment.

PMID- 1743500
TI  - Managing Medicare reimbursement on medical-psychiatry units.
AB  - Many general hospitals are confronting issues of financial strain precipitated to
      a large extent by Medicare payment reductions. The viability of psychiatry
      programs within general hospitals more than ever depends upon some demonstration
      of their financial as well as clinical contribution. The aim of this study is to
      review some of the basic parameters governing Part A (hospital) Medicare
      reimbursement of DRG-exempt general hospital psychiatry units and to provide
      options for improving their financial viability. There are a number of specific
      mechanisms involved in managing Medicare cost and reimbursement. Establishing a
      system for gatekeeping is important because significant control of payor mix and
      length of stay resides with the unit gatekeeper. Establishing liaison for short
      stay patients with nursing home papers is important because Medicare pays on a
      target cost per discharge. The identification of short-stay patients is
      financially very favorable, and often critical to balance the unavoidable longer
      stay patients. This paper also discusses how medical-psychiatric units can
      interface most effectively with medical-surgical units. Finally, there is some
      discussion of the need to develop pre- and postadmission outpatient medical
      psychiatric programs. The financial aspects of medical-psychiatry care, if not
      the increasing scrutiny of managed care, will force further development of such
      outpatient programs.

PMID- 1743501
TI  - Psychiatric disorders in two general hospitals: a survey of prevalence and
      treatment by nonpsychiatrist physicians.
AB  - This study reports an opinion survey of 211 nonpsychiatrist physicians in two
      general hospitals who estimated that 16.1% of their patients have psychiatric
      disorders and that they spent 13.8% of their time in treating the psychiatric
      components of their patients' illnesses. Physicians indicated that anxiety and
      psychosomatic and depressive illness were the most frequent psychiatric disorders
      and that one-third of them would personally treat such disorders without referral
      to psychiatric consultation. The findings also suggest that adequate
      undergraduate psychiatric education was associated with increased recognition of
      psychiatric disorders and more preference for their personal treatment. In
      addition, it provides a possible explanation for the discrepancy between the high
      prevalence of psychiatric disorders in general hospital patients and the low
      referral rate to psychiatric consultation.

PMID- 1743502
TI  - Child psychiatry consultations to pediatric inpatients: a literature review.
AB  - While the prevalence of psychiatric disorders in clinical pediatric populations
      is high, only a few studies have systematically examined child psychiatry
      consultations to pediatric inpatients. This paper reviews this body of literature
      and indicates important areas for further study. Some of the studies did not
      report basic data such as the number of consults, age, sex, or race of referrals,
      and referral rate. Without such basic data, it is impossible to make adequate
      comparisons between studies. Several studies did not report economic status or
      admission diagnosis of the child, psychiatric intervention/treatment on the ward,
      or psychiatric referral after discharge. Mostly the samples were small, including
      data on less than 100 inpatient consults. There is a need for greater consistency
      in the classification of reasons for referral, so that accurate and meaningful
      comparisons can be made across sites. The examination of psychiatric diagnoses
      was complicated by the wide range of diagnostic classifications that have been
      used. Standardization on the DSM-III-R/IV diagnostic system would make for
      greater comparability between studies. It would be useful in planning for
      services if future studies included cost as well as efficacy studies with a
      randomized control group.

PMID- 1743503
TI  - "Never been done before"--consultative issues in innovative therapies.
AB  - The transition of a medical or surgical procedure from impossible to standard
      therapy requires a stage of experimentation, during which research priorities
      must be balanced with the interests of the patient. This paper examines such a
      "first case," and the interpersonal and group dynamics that play a part in the
      choice of a specific patient to be the first to receive that procedure.

PMID- 1743504
TI  - Regarding treatment of primary care patients with psychiatric disorders.

PMID- 1743505
TI  - Mania precipitated by prednisone and bromocriptine.

PMID- 1743506
TI  - The continuing evolution and update of a literature search schema for
      consultation-liaison psychiatry: 1991.

PMID- 1743507
TI  - Nucleotide sequence and expression of the algE gene involved in alginate
      biosynthesis by Pseudomonas aeruginosa.
AB  - Alginate (Alg), a random polymer of mannuronic acid and glucuronic acid residues,
      is synthesized and secreted by Pseudomonas aeruginosa primarily during its
      infection of the lungs of cystic fibrosis patients. The molecular biology and
      biochemistry of the enzymatic steps leading to the production of the Alg
      precursor GDP-mannuronic acid have been elucidated, but the mechanism of polymer
      formation and export of Alg are not understood. We report the nucleotide sequence
      of a 2.4-kb DNA fragment containing the algE gene, previously designated alg76,
      encoding the AlgE protein (Mr 54,361) that is believed to be involved in these
      late steps of Alg biosynthesis. Expression of algE appears to occur from its own
      promoter. The promoter region contains several direct and inverted repeat
      sequences and shares structural similarity with promoters of several other alg
      genes from P. aeruginosa. In addition, the AlgE protein was overproduced from the
      tac promoter in P. aeruginosa. N-terminal amino acid sequence analysis showed
      that the polypeptide contains a signal peptide which is cleaved to form the
      mature protein during AlgE export from the cell cytoplasm.

PMID- 1743508
TI  - A split zinc-finger protein is required for normal yeast growth.
AB  - We have identified a gene that, when present in multiple copies, partially
      inhibits nuclear protein localization in Saccharomyces cerevisiae. This gene
      encodes a protein that is a unique member of the Cys2His2 zinc-finger family of
      DNA-binding proteins. It is designated SFP1 for split finger protein because its
      two zinc-finger domains are separated from one another by 40 amino acids (aa) as
      opposed to the usual spacing of 7 or 8 aa for Cys2His2 proteins. Disruption of
      the SFP1 gene results in slow cell growth, with cells having multiple, nucleated
      buds.

PMID- 1743509
TI  - Selection of secretory protein-encoding genes by fusion with PHO5 in
      Saccharomyces cerevisiae.
AB  - Secretory protein-encoding genes of Saccharomyces cerevisiae have been cloned by
      a novel procedure that is based on the functional selection of their fusions with
      acid phosphatase (APase) at the DNA level. DNA fragments that functionally
      replace the promoter and signal sequence-encoding regions of the PHO5 gene
      (encoding APase) have been obtained by positive selection from a pool of cloned
      random DNA fragments. Five unique DNA sequences containing the promoter, and
      encoding signal sequences have been isolated. We have also isolated the complete
      gene, SSP120, encoding one of these S. cerevisiae secretory proteins, SSP120.
      Gene disruption studies have shown that the SSP120 gene is not essential for
      viability and growth. The SSP120 amino acid (aa) sequence has 13.5% identity with
      the middle 88-250 aa residues of the chicken glycosylation site-binding protein.
      However, SSP120 disruption did not affect protein glycosylation in yeast. The
      present study provides an alternative approach for the isolation of genes
      encoding secretory proteins, in contrast to classical genetic approaches that
      require isolation of functionally defective mutations followed by gene isolation
      by functional complementation. The present procedure should contribute to our
      understanding of protein sorting by permitting the cloning of genes encoding
      proteins targeted to different organelles in the secretory pathway.

PMID- 1743510
TI  - Lignin peroxidase from the basidiomycete Phanerochaete chrysosporium is
      synthesized as a preproenzyme.
AB  - The cDNA clone L18 encoding lignin peroxidase LiP2, the most highly expressed LiP
      isozyme from Phanerochaete chrysosporium strain OGC101, was isolated and
      sequenced. Comparison of the cDNA sequence with the N-terminal sequence of the
      mature LiP2 protein isolated from culture medium suggests that the mature protein
      contains 343 amino acids (aa) and is preceded by a 28-aa leader sequence. In
      vitro transcription followed by in vitro translation and processing by signal
      peptidase resulted in cleavage at a site following the Ala21 (counted from the N
      terminal Met1 of the initial translation product). The resultant protein contains
      a 7-aa propeptide, indicating that LiP is synthesized as a preproenzyme.

PMID- 1743511
TI  - pUBEX/pUBSEX: a versatile expression vector system for production of fusion and
      nonfusion proteins in Escherichia coli.
AB  - Despite the large number of expression vectors now available, none provide the
      facility of allowing fusion and nonfusion protein production from the same vector
      system. In some situations it is preferable to obtain an insoluble fusion
      protein, in others a soluble nonfusion protein may be required. We have designed,
      constructed and tested a modification of the pEX vectors, in which it is possible
      to express the product of a suitably inserted cDNA either as part of a Cro-beta
      galactosidase (Cro-beta Gal) fusion or as a delta Cro fusion which contains only
      nine noninsert-encoded amino acids at its N terminus. The conversion from Cro
      beta Gal to delta Cro fusion protein production is achieved by a simple
      intramolecular deletion of lacZ sequence from the pUBEX vector, to create the
      pUBSEX variant. Plasmid pUBEX can be induced to produce large amounts of
      insoluble Cro-beta Gal fusion proteins, whereas pUBSEX will produce predominantly
      soluble delta Cro fusion proteins.

PMID- 1743512
TI  - Identification of a unique specificity determinant of the colicin E3 immunity
      protein.
AB  - Plasmid immunity to a nuclease-type colicin is defined by the specific binding of
      an immunity (or inhibitor) protein, Imm, to the C-terminal nuclease domain, T2A,
      of the colicin molecule. Whereas most regions of colicin operons exhibit
      extensive sequence identity, the small plasmid region encoding T2A and Imm is
      exceptionally varied. Since immunity is essential for the survival of the
      potentially lethal colicin plasmid (Col), we inferred that T2A and Imm must have
      co-evolved, retaining their mutual binding specificities. To evaluate this co
      evolution model for the col and imm genes of ColE3 and ColE6, we attempted to
      obtain a stabilized clone from a plasmid which had been destabilized with a non
      cognate immunity gene. A hybrid Col, in which the immE3 gene of the ColE3 was
      replaced with immE6 from ColE6, was lethal to the host cells upon SOS induction.
      From among this suicidal cell population, we isolated a stabilized, i.e.,
      evolved, clone which produced colicin E3 (E3) stably and exhibited immunity to
      E3. This change arose from only a single mutation in ImmE6, from Trp48 to Cys,
      the same residue as in the ImmE3 sequence. In addition, we constructed a series
      of chimeric genes through homologous recombination between immE3 and immE6.
      Characterization of these chimeric immunity genes confirmed the above finding
      that colicins E3 and E6 are mostly distinguished by only Cys48 of the ImmE3
      protein.

PMID- 1743513
TI  - Cloning and transcriptional analysis of the ADE6 gene of Saccharomyces
      cerevisiae.
AB  - The Saccharomyces cerevisiae gene, ADE6, encoding 5'-phosphoribosylformyl
      glycinamidine synthetase (EC 6.3.5.3) has been cloned by complementation of an
      ade6 auxotroph. Transformation of ade6 mutants with ADE6-carrying centromeric
      plasmids restored normal, adenine-independent growth behavior in the recipients.
      Strains containing a disrupted ade6 allele were constructed and behaved as stable
      adenine auxotrophs. Southern transfer and genetic analyses of strains carrying a
      disrupted ade6 allele demonstrated that the cloned gene was ADE6 and not a
      suppressor. The cloned ADE6 DNA was mapped on the RAD2-proximal fragment of
      chromosome VII by hybridization on yeast chromosomes separated by pulsed-field
      gel electrophoresis. Northern-blot hybridization experiments show that the ADE6
      region produces two different mRNA species of approx. 5 and 2 kb. Disappearance
      of the larger, but not the smaller, transcript is associated with ade6 mutations.
      A threefold repression in the amount of the 5-kb ADE6 mRNA is observed when
      growth medium is supplemented with exogenous adenine.

PMID- 1743514
TI  - The gene encoding squalene epoxidase from Saccharomyces cerevisiae: cloning and
      characterization.
AB  - The gene (ERG1) encoding squalene epoxidase (ERG) from Saccharomyces cerevisiae
      was cloned. It was isolated from a gene library, prepared from an allylamine
      resistant (AlR) S. cerevisiae mutant, by screening transformants in a sensitive
      strain for AlR colonies. The ERG tested in a cell-free extract from one of these
      transformants proved to be resistant to the Al derivative, terbinafine. From this
      result, we concluded that the recombinant plasmid in the transformant carried an
      allelic form of the ERG1 gene. The nucleotide sequence showed the presence of one
      open reading frame coding for a 55,190-Da peptide of 496 amino acids. Southern
      hybridization experiments allowed us to localize the ERG1 gene on yeast
      chromosome 15.

PMID- 1743515
TI  - Molecular cloning of the Candida maltosa ADE1 gene.
AB  - The structural gene (ADE1) encoding phosphoribosyl-aminoimidazole
      succinocarboxamide synthetase (SAICAR synthetase; EC 6.3.2.6) in Candida maltosa
      has been isolated by functional complementation of an ade1 strain of
      Saccharomyces cerevisiae. The gene was localized on a 2.5-kb BamHI DNA fragment.
      Nucleotide sequence analysis of the cloned gene has revealed an open reading
      frame encoding a protein (SAICAR synthetase) with an Mr of 32,751. The codon bias
      index, 0.68, indicates that the ADE1 gene is a moderately highly expressed gene.
      The cloned gene shows 63.5% nt identity and 65.2% deduced amino acid identity
      with the S. cerevisiae ADE1 gene which encodes the same enzymatic activity. The
      gene may be used as a convenient genetic marker for construction of a new host
      vector system for C. maltosa.

PMID- 1743516
TI  - A bacterial homolog to the mitochondrial enoyl-CoA hydratase.
AB  - A 257-amino acid (aa) open reading frame in the photosynthetic bacterium,
      Rhodobacter capsulatus, shows significant homology to the mitochondrial enoyl-CoA
      hydratase (290 aa). This similarity in size and sequence suggests that R.
      capsulatus oxidizes fatty acids using specific components, more like the
      mitochondrial system than the multifunctional component system of Escherichia
      coli.

PMID- 1743517
TI  - Nucleotide sequence of the gene encoding yeast C-8 sterol isomerase.
AB  - The ERG2 gene encoding the Saccharomyces cerevisiae C-8 sterol isomerase, an
      enzyme involved in plant, animal, and fungal sterol biosynthesis was sequenced. A
      large open reading frame comprising 222 amino acids was observed.

PMID- 1743518
TI  - Introduction of single-copy sequences into the chromosome of Escherichia coli:
      application to gene and operon fusions.
AB  - We have developed a general method for the introduction of any cloned sequence
      into the chromosome of Escherichia coli. This method employs an Hfr strain which
      carries a fragment of bla (the pBR322 gene imparting ampicillin resistance)
      between lacI and lacZ. Plasmid-borne inserts which are flanked by sequences from
      bla and lacZ can be introduced at this locus by homologous recombination. The
      isolation of recombinants is enhanced by selection for transfer of an integrated
      copy of the plasmid during conjugation. Once introduced into the chromosome, the
      inserted sequences can be transferred to other strains by conventional methods
      such as P1 transduction or conjugation. This method is suitable for the transfer
      of any cloned sequence to the chromosome and is particularly well suited to the
      construction of chromosomal gene and operon fusions with lacZ.

PMID- 1743519
TI  - The hydC region contains a multi-cistronic operon (nik) involved in nickel
      transport in Escherichia coli.
AB  - We have cloned the multigenic hydC locus of Escherichia coli on a 7.1-kb BamHI
      EcoRI fragment. Since its gene products are likely to be involved in the specific
      nickel transport [Wu et al., Mol. Microbiol. 3 (1989) 1709-1718], we propose a
      new gene designation, nik, to replace hydC. In vivo gene expression studies and
      complementation analysis support the notion that the nik locus is a multi
      cistronic operon consisting of two to five genes. The first two genes, arranged
      in the order nikA and nikB, encode two proteins of 59 and 27.5 kDa, respectively.
      The downstream genes direct the biosynthesis of three polypeptides of 30, 28 and
      25.5 kDa. Southern-blot analysis showed that mutant HYD720 carries a chromosomal
      deletion of 5.1-kb covering both nikA and nikB, whereas a 0.8-kb deletion in
      mutant HYD790 includes the sole nikB region. The cloned nik operon and the
      deletion mutants will aid greatly in the further molecular characterization of
      the multicomponent-specific transport of nickel in E. coli.

PMID- 1743520
TI  - A C-terminal deletion in Corynebacterium glutamicum homoserine dehydrogenase
      abolishes allosteric inhibition by L-threonine.
AB  - In Escherichia coli, Bacillus subtilis and Corynebacterium glutamicum, homoserine
      dehydrogenase (HD), the enzyme after the branch point of the threonine/methionine
      and lysine biosynthetic pathways, is allosterically inhibited by L-threonine. To
      investigate the regulation of the C. glutamicum HD enzyme by L-threonine, the
      structural gene, hom, was mutated by UV irradiation of whole cells to obtain a
      deregulated allele, homdr. L-Threonine inhibits the wild-type (wt) enzyme with a
      Ki of 0.16 mM. The deregulated enzyme remains 80% active in the presence of 50 mM
      L-threonine. The homdr gene mutant was isolated and cloned in E. coli. In a C.
      glutamicum wt host background, but not in E. coli, the cloned homdr gene is
      genetically unstable. The cloned homdr gene is overexpressed tenfold in C.
      glutamicum and is active in the presence of over 60 mM L-threonine. Sequence
      analysis revealed that the homdr mutation is a single nucleotide (G1964) deletion
      in codon 429 within the hom reading frame. The resulting frame-shift mutation
      radically alters the structure of the C terminus, resulting in ten amino acid
      (aa) changes and a deletion of the last 7 aa relative to the wt protein. These
      observations suggest that the C terminus may be associated with the L-threonine
      allosteric response. The homdr mutation is unstable and probably deleterious to
      the cell. This may explain why only one mutation was obtained despite repeated
      mutagenesis.

PMID- 1743521
TI  - Sequences of three genes specifying xylanases in Streptomyces lividans.
AB  - The entire nucleotide (nt) sequences of three genes (xlnA, xlnB and xlnC) of
      Streptomyces lividans encoding three distinct xylanases (Xln) have been
      determined. The nt sequences were confirmed by comparing the deduced amino acid
      (aa) sequences with the ones derived from the N-terminal aa sequences of the
      mature purified proteins. The N-terminus of the XlnA showed some homology with
      either the N-termini or the C-termini of eight other Xln and of two exo
      glucanases. The N-terminus of XlnB is homologous to that of XlnC and to Xln of
      seven other microorganisms.

PMID- 1743522
TI  - Juxtaposition of the genes encoding Mycoplasma pneumoniae cytadherence-accessory
      proteins HMW1 and HMW3.
AB  - The loss and reacquisition of high-Mr (HMW) proteins, HMW1, 2, 3, 4 and 5, by
      Mycoplasma pneumoniae correlates with cytadherence phase variation. We are
      cloning and characterizing the genes encoding HMW1-5 to understand the mechanism
      regulating their coordinate expression. HMW1 was purified by polyacrylamide-gel
      electrophoresis. Amino acid (aa) sequence data were obtained from enzymatically
      generated peptide fragments from HMW1. A degenerate 17-mer probe synthesized
      based upon the aa sequence of one peptide clearly identified a single 4.75-kb
      BamHI fragment of M. pneumoniae DNA under stringent hybridization conditions.
      This fragment was cloned into pUC19 to generate pKV16. Restriction mapping of the
      4.75-kb BamHI fragment in pKV16 revealed a possible overlap with the 9.4-kb EcoRI
      fragment containing the gene encoding protein HMW3. Southern blotting and
      reciprocal hybridization studies confirmed this overlap, establishing the
      juxtaposition of the genes encoding HMW1 and HMW3. Finally, physical mapping
      analysis by probing restriction fragments of M. pneumoniae DNA resolved by pulsed
      field gel electrophoresis with the cloned genes encoding HMW1 and HMW3 revealed
      definitively that the hmw locus maps to a 106.8-kb ApaI fragment, rather than a
      117.5-kb ApaI fragment, as had been reported previously for hmw3 [Krause and
      Mawn, J. Bacteriol. 172 (1990) 4790-4797].

PMID- 1743523
TI  - A small multigene family encodes the rod-core linker polypeptides of Anabaena sp.
      PCC7120 phycobilisomes.
AB  - The cpc operon of Anabaena sp. PCC7120 is shown to encode ten genes: 5'-cpcB-cpcA
      cpcC-cpcD-cpcE-cpcF- cpcG1-cpcG2-cpcG3-cpcG4-3'. The 3' portion of this operon
      includes four tandemly repeated genes encoding phycocyanin (PC)-associated, rod
      core linker polypeptides of the phycobilisomes (PBS). The products of these four
      genes are most similar at their N termini, and overall are 50-61% identical and
      68-76% similar to one another. The four CpcG proteins of Anabaena sp. PCC7120 are
      41-47% identical and 62-65% similar to the single CpcG rod-core linker protein in
      Synechococcus sp. PCC7002. The N-terminal domains of the polypeptides are also
      more distantly related to the conserved domains of other types of rod-linker
      polypeptides associated with PC, phycoerythrin, and allophycocyanin (AP). Three
      of these rod-core linker proteins (CpcG1, CpcG2, and CpcG4) were demonstrated to
      occur in isolated PBS by N-terminal amino acid sequence analyses. These results
      indicate that previously proposed models for the PBS of Anabaena sp. are
      incorrect. It is suggested that the PBS of Anabaena sp. have eight peripheral
      rods, each of which interacts with the AP of the core via a specific rod-core
      linker (CpcG) polypeptide.

PMID- 1743524
TI  - Autopsy: the final peer review.

PMID- 1743525
TI  - Study: atypical pneumonias not as rare in elderly as believed.

PMID- 1743526
TI  - Newer joint prostheses offer advantages for arthritic elderly.

PMID- 1743527
TI  - Healthcare reform: are physicians losing ground?

PMID- 1743528
TI  - Pneumonia in the elderly: empiric antimicrobial therapy.
AB  - Pneumonia, the leading cause of death due to infectious disease in the elderly,
      can be difficult to diagnose in this age group because clinical signs and
      symptoms are often muted. Without a definitive isolate, the physician must
      institute empiric therapy with broad-spectrum antibiotics according to the
      patient's condition and the setting in which the pneumonia developed. The
      cephalosporins, because of their safety profiles, are often used alone or in
      combination with other drugs to achieve broad antimicrobial coverage in elderly
      patients with pneumonia. In general, elderly patients with pneumonia should be
      hospitalized, although nursing home residents may be managed in the nursing home
      if adequate staff and resources are available.

PMID- 1743529
TI  - Diagnosing cognitive dysfunction in the elderly: primary screening tests.
AB  - The recognition of cognitive disturbances in geriatric patients has important
      clinical implications for the primary care physician. Commonly seen cognitive
      dysfunctions include dementia, pseudodementia, delirium, and frontal lobe
      syndrome; these may be confounded by overlapping depression. The cognitive
      examination covers such intellectual and behavioral functions as attention,
      memory, and language. As many psychiatric disorders result from neurologic brain
      disease, a psychiatric examination is essential. Mental status questionnaires are
      useful for screening of high-risk populations for dementia and to quantify the
      degree of cognitive dysfunction for purposes of management planning and
      surveillance.

PMID- 1743530
TI  - CPR in the elderly: when should it be performed?
AB  - Data comparing the success of CPR in elderly hospitalized persons, those living
      in the community, and those in long-term care facilities show varying results. In
      general, elderly patients who receive CPR following arrest do not fare as well as
      younger patients, but there appears to be a subgroup of elderly in whom the
      success rate is relatively high. Specifically, patients who demonstrate
      ventricular fibrillation or ventricular tachycardia are more likely to survive
      than are those demonstrating asystole or electromechanical dissociation. Most
      studies have not shown a difference in mental or functional impairment between
      older and younger survivors of cardiac arrest.

PMID- 1743531
TI  - Benign symptomatic hyperandrogenism in a postmenopausal woman.
AB  - Hyperandrogenemia in postmenopausal women requires an evaluation to exclude
      pathologic ovarian or adrenal causes. Our patient exhibited no signs of
      hypercortisolism, congenital adrenal hyperplasia, or adrenal or ovarian neoplasia
      based on biochemical testing and pelvic sonography. We hypothesized that
      unexplained androgen excess in our patient was due to the development of
      gonadotropin-dependent excess ovarian stromal androgen production. This syndrome
      may be comparable to gestational hyperreactio luteinalis where elevated
      gonadotropins stimulate ovarian stromal androgen production. If tumor can
      confidently be excluded, such women may benefit from gonadotropin suppression
      with long-acting GnRH-a.

PMID- 1743532
TI  - Vegetative dysfunction and disease of central nervous system. Italian Society of
      Neurology Study Group on the Autonomic Nervous System. Proceedings of the 5th
      workshop, Bari, November 9-10, 1990.

PMID- 1743533
TI  - Acetylcholine release in experimental autonomic neuropathy.
AB  - Autonomic neuropathy is a common complication of diabetes. In this study we
      evaluated autonomic neuropathy by determining somatostatin (S-14)-evoked
      acetylcholine (Ach) release from postsynaptic parasympathetic fibers in the atria
      of controls (C) and streptozotocin diabetic rats (STZ-D), with and without
      tetrodotoxin (TTX). The release induced by S-14 did not differ in C and STZ-D.
      TTX blocked S-14 induced Ach in C but failed in STZ-D. TTX resistance in STZ-D
      may be explained by variations of membrane potential in nerve fibers.

PMID- 1743534
TI  - Urine retention due to intra-spinal cord injection of colchicine in rats:
      improved recovery of bladder function by monosialoganglioside GM1 and nerve
      growth factor administration.
AB  - Intra-spinal cord injection of a low dose of colchicine (2 micrograms/rat) at the
      lumbar level affects the micturition reflex leading to voiding suppression,
      bladder hypertrophy and overflow incontinence which lasts about four weeks. The
      administration of nerve growth factor and monosialoganglioside GM1 normalizes
      urine output within 3 days and improves recovery of the bladder contraction
      tested by a cystometric analysis.

PMID- 1743535
TI  - Vagally-induced non-adrenergic, non-cholinergic inhibitory motility in the rabbit
      stomach "in vivo".
AB  - In atropine-treated rabbits, electrical stimulation of vagal nerves at low
      frequency and low basal gastric volumes evoked a biphasic response: rapid onset
      relaxation followed by rebound contractions. Increase in the frequency of
      stimulation and/or in basal gastric volume caused a depression of the rebound
      contraction and a conversion of the biphasic response into a triphasic one: i.e.,
      the post-stimulus excitatory motility was followed by a long-lasting slow
      relaxation. The rebound contraction, which was mimicked by arterial injections of
      prostaglandin E2, appears to be a key factor in the conversion of one type of
      response into the other.

PMID- 1743536
TI  - Cardiorespiratory effects evoked by electrical stimulation of somatic afferent
      fibers.
AB  - Several neurophysiological studies have shown that electrical activation of
      afferent fibers of somatic nerves can evoke inhibitory or excitatory
      cardiovascular responses. The present investigation was undertaken to examine the
      effects induced by electrical stimulation of somatic nerves on cardiocirculatory
      and respiratory functions in anesthetized rabbits. Both low frequency stimulation
      and high frequency stimulation of afferent fibers of somatic nerves caused two
      distinct patterns of cardiocirculatory and respiratory reflex responses
      absolutely similar to those observed in our previous experiments on rabbits with
      dynamic and static exercise. The present findings do not support the existence in
      the somatic nerves of afferent fibers with cardiorespiratory effect having
      physiological functions different from that of producing cardiopulmonary
      adjustments to muscular activity.

PMID- 1743537
TI  - Heart "timing" versus artery "timing". Neurovegetative effects in compensated and
      decompensated cardiocirculatory failure.
AB  - The hypothesis that the main local goal of the neurovegetative cardiovascular
      regulation is to set and maintain the cardiac cycle and the time constant of the
      arterial system within a given reciprocal proportion is discussed in this paper.
      Drastic changes in this reciprocal proportion can induce cardiocirculatory
      failure. Three different models of cardiocirculatory failure (congestive,
      hypovolemic and anaphylactic) have been considered in order to test the
      hypothesis. It is possible to outline a theory that is, decompensated failure
      occurs at very high levels of sympathoadrenal activation, when the arterial time
      constant increases when compared to the cardiac cycle, owing to mechanical
      properties of the arterial wall.

PMID- 1743538
TI  - Anti-fatigue action exerted by the sympathetic nervous system in the rabbit
      digastric muscle.
AB  - Stimulation of the cervical sympathetic trunk, at frequencies within the
      physiological range, consistently elicits a partial recovery of the contractile
      force in the fatigued digastric muscle. This action, together with the tension
      potentiation induced by the sympathetic system in the non-fatigued muscle, could
      improve the muscular performance under the physiological conditions associated
      with increase in the sympathetic outflow.

PMID- 1743539
TI  - Maintained cellular function of adrenal medullary cells in parkinsonian
      dysautonomia.
AB  - Adrenal gland involvement in Parkinson's disease was reported by different
      authors. Further studies became relevant after adrenal was proposed as
      dopaminergic donor for neurotransplantation. Chromaffin cells were grown in
      culture and the effects of nerve growth factor (NGF) tested: no differences were
      observed between parkinsonian and control cells. The expression of the beta-NGF
      mRNA in the parkinsonian adrenal was analyzed: a specific cDNA was synthesized
      and a 168 bp portion amplified using PCR. The products were identified and the
      identity of the fragment was confirmed by sequencing. Quantitative PCR
      demonstrated a beta-NGF mRNA concentration exceeding 5 fg/micrograms of total
      adrenal RNA. These findings demonstrate the retained functional capacity of the
      parkinsonian adrenal to respond to NGF and express the beta-NGF mRNA.

PMID- 1743540
TI  - Sympathetic functions in parkinsonism treated with stereotactic surgery:
      observations in ten patients.
AB  - Ipsilateral sympathetic deficits, that is symptoms and signs consistent with a
      diagnosis of Horner's syndrome, have been described in patients who have
      undergone thalamotomy for dyskinesia as well as for parkinsonism. The present
      patient material consists of 10 patients with parkinsonism who had undergone
      stereotactic surgery. Since anhidrosis and miosis are two integral components of
      Horner's syndrome, forehead sweating and pupillometric response to
      sympathicomimetic agents have been investigated in this preliminary work. The
      tests were carried out a considerable time postoperatively. Sweating was
      stimulated in two different ways: by body heating and by parenterally
      administered pilocarpine. OH-amphetamine and phenylephrine (an indirectly and a
      directly acting sympathicomimetic agent) were used in the pupillometric tests.
      The results were compared with those obtained in a healthy control group. With
      the OH-amphetamine test, there were some indications of a changed sympathetic
      activity on the surgical side. However, when comparing these results with those
      obtained by the phenylephrine test, the inference seems to be allowable that
      parkinsonian patients operated in this way (target area: ventro-oral thalamic
      nuclei (Voa and Vop) and the reticular thalamic nucleus) show no definite
      sympathetic supersensitivity at the late postoperative stage. Our data suggest
      that the response pattern of the pupils and the sweat glands may be related to
      the surgical method used and/or to the interval from operation to investigation.

PMID- 1743541
TI  - Correlation of cardiovascular autonomic function tests, magnetic resonance brain
      imaging and clinical features in suspect cases of multiple system atrophy.
AB  - Nine patients presenting with parkinsonian features and no other clinical
      abnormalities were studied. These patients were evaluated for dopaminergic
      responsiveness, for cardiovascular reflex autonomic function, and underwent high
      field magnetic resonance scan. A 0 to 5 point probability score was used to
      evaluate the possibility that parkinsonian signs were the presenting symptoms of
      multiple system atrophy (MSA). Five patients were considered at risk for having
      MSA: three of them were classified as possible MSA cases (score 2-3), two of them
      were classified as probable cases of MSA (score 4-5). In patients at risk for
      MSA, no specific pattern of combination of clinical and laboratory data was
      found; all patients had different combinations of positive findings.

PMID- 1743542
TI  - Multisystem evaluation in one case of pure autonomic failure.
AB  - Pure autonomic failure (PAF) is a rare syndrome characterized by a primitive
      failure of the autonomic nervous system (ANS). We have studied a 53-year old
      woman suffering from PAF by using ANS provocative tests investigating the
      cardiovascular system (standing up test, controlled ventilation, Valsalva
      manoeuvre, handgrip test, cold pressor test, mental stress test, plasma
      catecholamine levels), tests investigating the intrinsic ocular innervation
      (pupil reactivity), and the bladder function (urodynamic tests). Our results have
      shown abnormalities of all the studied parameters and they have also confirmed
      that these patients need a multidisciplinary autonomic evaluation to correctly
      identify the syndrome.

PMID- 1743543
TI  - Alterations of thermoregulation in Parkinson's disease.
AB  - Sweating and superficial vasodilator responses were studied in 22 patients
      suffering from Parkinson's disease in order to evaluate the thermoregulatory
      function. Sweating was evaluated on different areas of the body with a
      colorimetric method (Minor's method). The superficial vasodilatation at the level
      of the face was assessed after oral intake of nitroglycerin by means of
      telethermography. Sweating and superficial vasodilatation were reduced in
      parkinsonian patients compared with control subjects. Asymmetries in sweating and
      superficial vasodilator responses were also observed between the left and right
      sides of the body in the patients. The decreased heat elimination was more
      apparent on the symptomatic side in patients with hemiparkinsonism. No
      relationship was found between the alterations of the thermoregulation and the
      other clinical features of Parkinson's disease.

PMID- 1743544
TI  - Relationship between bladder dysfunction and brain MRI in multiple sclerosis.
AB  - We studied 70 consecutive patients with definite multiple sclerosis (MS) to
      examine the relationship between magnetic resonance imaging (MRI) cerebral
      findings and urinary disturbances. Thirty-two subjects (46%) had urinary symptoms
      and 38 (54%) were asymptomatic. Patients with urinary symptoms exhibited greater
      overall functional disability. A significant correlation between the presence of
      midbrain lesions and urinary dysfunctions was found which may indicate an
      important role of the mesencephalic formation to preserve continence.

PMID- 1743545
TI  - Analysis of sympathetic skin responses in a group of healthy subjects and in
      patients affected by sphincter disorders and impotence.
AB  - Bilateral palmar and plantar sympathetic skin responses (SSRs) to pudendal and
      median nerves stimulation have been recorded in a population of 10 healthy adult
      subjects. A group of 11 patients affected by sphincter disorders and/or impotence
      of neurological origin (diabetic neuropathy, ischaemic myelopathy, myelitis,
      cauda aequina syndrome) was investigated and results were compared with normal
      values obtained from the control group. The technique is focused on the
      vegetative component of innervation and is shown to give complementary
      information on sympathetic dysfunction, in addition to traditional techniques
      relating to somatic innervation (electroneurography, electromyography,
      somatosensory evoked potentials.

PMID- 1743546
TI  - Twenty-four hours blood pressure and heart rate profiles in diabetics with and
      without autonomic neuropathy.
AB  - Previous studies have shown an increased incidence of sudden deaths and lower
      survival in diabetics with autonomic neuropathy. In hypertensive non diabetic
      patients a direct correlation has been found between nocturnal blood pressure
      levels and left ventricular hypertrophy. We have shown in diabetics with
      autonomic neuropathy a flattening in nocturnal blood pressure reduction and
      increased 24 hours blood pressure values compared to diabetics without autonomic
      neuropathy and controls. Our results suggest that abnormalities in 24 hours blood
      pressure profile might play a role in the increased incidence of cardiovascular
      morbidity and mortality in diabetics with autonomic neuropathy.

PMID- 1743547
TI  - Micturition syncopes.
AB  - Micturition syncope accounts for 8.39% of the total number of syncopes and is
      prevalent among men in the 50 and 60 year age groups. The cardiovascular
      vegetative nervous system is unaffected in patients with micturition syncope.
      Sixty-one percent of patients with micturition syncope also exhibit other kinds
      of syncope. These patients experience vasovagal reaction during the vegetative
      activation tests more often than patients exclusively with micturition syncope.

PMID- 1743548
TI  - Effects of posture, effort and psychophysiological activation on atrio
      ventricular node and Kent bundle refractoriness.
AB  - A new protocol is described for non-invasive evaluation of electrophysiological
      effects of autonomic nervous system on both normal and abnormal atrio-ventricular
      conduction in patients with Wolff-Parkinson-White (WPW) syndrome. In 64 WPW
      patients with stable Kent-type ventricular preexcitation transoesophageal atrial
      pacing has been carried out to quantify changes in both atrioventricular (AV)
      node and Kent bundle refractoriness and maximal conductive capability induced by
      posture, physical exercise and psychophysiological activation. A significant
      shortening of AV nodal and accessory pathway refractory periods was found,
      induced by manoeuvres enhancing the sympathetic outflow, being the AV node the
      most sensitive structure. This finding suggests that an exhaustive investigation
      protocol of WPW patients should include the evaluation of the neurovegetative
      effects on cardiac electrophysiological parameters, under conditions which can
      reproduce as close as possible the individual situations a patient has to face in
      his real life.

PMID- 1743549
TI  - Plasma tetranectin and ovarian neoplasms.
AB  - Plasma tetranectin was measured in 67 controls, 121 patients with a benign or
      malignant ovarian tumor, and 24 patients with another benign gynecologic disease
      to evaluate the predictive value of plasma tetranectin. A significant reduction
      of plasma tetranectin was found in every malignant tumor type except for mucinous
      tumors. Further a significant correlation was found between stage of tumors and
      plasma tetranectin. Depending on the cutoff level the sensitivity for stage 1
      cancer ranged from 52 to 71%. In stage 1 + 2 the sensitivity ranged from 58 to
      75% and for advanced cancer (stage 3 + 4) from 80 to 95%. The corresponding
      specificities ranged from 97 to 84%. Plasma tetranectin may be a useful tool for
      detecting early stages of ovarian cancer.

PMID- 1743550
TI  - Rationale for using pathologic tumor dimensions and nodal status to subclassify
      surgically treated stage IB cervical cancer patients.
AB  - Between 1969 and 1988, 401 patients were treated by radical hysterectomy and
      pelvic lymphadenectomy for Stage IB cervical carcinoma at the University of
      Alabama at Birmingham. In multivariate analysis, pathological tumor diameter (P
      less than 0.0001) and the presence of lymph node metastasis (P = 0.0005) proved
      to be the dominant two histopathologic features that significantly correlated
      with overall survival. Although 5-year survival for the overall group was 85%, 5
      year survival in patients with lesions greater than 3.0 cm in diameter and with
      regional nodal metastasis was less than 30%. This discrepancy in survival in
      surgically treated early-stage cervical cancer patients supports a need for
      subcategorization by risk factors such as pathologic tumor dimensions and nodal
      status and for further investigation of alternative neoadjuvant and adjuvant
      therapies in those early-stage cervical cancer patients deemed at high risk for
      poor overall survival.

PMID- 1743551
TI  - Squamous cell carcinoma of the vulva: prognostic factors influencing survival.
AB  - One hundred seventy-two cases of patients with squamous cell cancer of the vulva
      treated at the University of Michigan Medical Center from 1975 to 1988 are
      reported. The mean age was 66 years with a range of 21 to 101 years. The
      distribution by stage included Stage I, 65; Stage II, 44; Stage III, 50; and
      Stage IV, 13 patients. Groin node dissections performed on 145 patients showed
      negative nodes, 58%; unilateral positive nodes, 28%; and bilateral positive
      nodes, 14%. The distribution of patients with positive nodes was influenced by
      stage: Stage I, 14%; Stage II, 23%; Stage III, 72%; Stage IV, 92%. The overall
      cumulative 5-year survival was 71% and this was significantly influenced by stage
      of disease: Stage I, 94%; Stage II, 91%; Stage III, 36%; Stage IV, 26%. Stages
      I/II and III/IV were combined for analysis. In Stages I/II, survival was
      significantly influenced by tumor grade while size, patient age, and lymph node
      status did not influence survival. In Stage III/IV, survival was significantly
      influenced by tumor size, node status, and number of positive nodes while grade,
      patient age, and tumor location did not influence survival. Squamous cell cancer
      of the vulva is effectively treated with radical surgery but advanced-stage
      disease with regional metastases significantly alters survival.

PMID- 1743552
TI  - Splenectomy in gynecologic oncology: indications, complications, and technique.
AB  - Although uncommonly performed in this setting, splenectomy is sometimes indicated
      in patients with gynecologic malignancies. From January 1970 through March 1989,
      45 patients at The University of Texas M.D. Anderson Cancer Center underwent
      splenectomy during the course of gynecologic laparotomies. All procedures were
      performed by the gynecology staff and trainees. Twenty-seven patients (60%) had
      ovarian cancer; endometrial and cervical cancers were present in three patients
      each. The remaining 11 patients had other diseases. Splenectomy was planned
      preoperatively in only 9 patients (20%). Thirteen patients (29%) underwent
      splenectomy because of injury to the spleen. Injury was most commonly due to
      traction during omentectomy, resulting in capsular laceration. The injury was
      immediately recognized in 12 patients; 1 patient required reexploration for
      hemoperitoneum. In 24 patients (53%), splenectomy was performed for tumor
      reduction. Pathologic examination showed that 11 of 24 patients had capsular
      involvement by tumor, 7 had parenchymal metastases, and 6 had no direct splenic
      involvement. Residual tumor following cytoreduction was smaller than 2 cm in
      62.5% of patients. Splenectomy is a well-tolerated procedure and the operative
      approach can be tailored to the clinical situation and distribution of tumor. An
      attempt should be made to repair splenic injury when tumor involvement is not
      present.

PMID- 1743553
TI  - Ifosfamide with mesna in squamous carcinoma of the cervix: phase II results in
      patients with advanced or recurrent disease.
AB  - Twenty-four evaluable patients with recurrent or advanced squamous carcinoma of
      the cervix were treated with ifosfamide (IFX) and mesna every 3 weeks. The
      initial dose of IFX was 1.5 g/m2 q.d. Days 1-5. Mesna was given by continuous
      infusion (1.5 g/m2/day Days 1-6). Seventy-four courses of treatment were given to
      24 patients. All patients were evaluable for toxicity and response. The median
      survival was 26 weeks from initiation of chemotherapy. There were 4 complete
      responders (CR); there was 1 partial responder. The response rate was 20.8% (CI,
      4-38%). One CR patient remains in clinical remission 30 months after initiation
      of therapy. The other 3 responders recurred after a disease-free interval of 8,
      12, and 18 weeks. WBC below 3000/mm3 occurred in 19 patients and was life
      threatening (below 1000/mm3) in 5 patients. One patient had life-threatening
      hemorrhagic cystitis. Eleven patients developed CNS symptoms during treatment
      including somnolence, coma, and acute delirium.

PMID- 1743554
TI  - Cancer of the cervix--old and young, now and then.
AB  - A study of two 5-year periods, 1960-1964 and 1982-1986, in Queensland is made.
      Changing patterns of preinvasive and invasive cervical carcinoma in the world
      literature are discussed. The age of presentation, stage, histology, and results
      in Queensland for cervical carcinoma are analyzed. There are over 500 patients in
      each quinquennium. While the total female population has increased 86%, the
      maximum increase is in patients under 35 years and over 65. There has been a 50%
      decrease in the incidence of cervical carcinoma, but a doubling under the age of
      30. The stage at diagnosis has markedly improved with 88% stage Ib in the young
      as opposed to 50% formerly. Late-stage disease remains a problem of the aged. The
      mortality in both time spans increases with age. Histologic patterns show an
      increase in nonsquamous patterns and increased mortality in the rare patterns. We
      have no evidence of the emergence of a rapidly progressive carcinoma in the
      young. Papanicolaou smear and education programs appear to be preventing cervical
      carcinoma and allowing diagnosis of the disease at an earlier stage and age. This
      is reflected in a decrease in mortality from 9.6 per 100,000 (1960-1964) to 4 per
      100,000 (1982-1986).

PMID- 1743555
TI  - The inability of Gore-Tex Surgical Membrane to inhibit post-radical pelvic
      surgery adhesions in the dog model.
AB  - We investigated the ability of Gore-Tex Surgical Membrane (Gore-SM) to inhibit
      PRPSA formation in 10 adult female canines undergoing radical hysterectomy,
      bilateral salpingo-oophorectomy, omentectomy, and resection of the
      pelvic/abdominal peritoneum. At the time of surgery, one-half of the
      pelvic/abdominal peritoneal defect was covered with a tailored single layer of
      the Gore-SM. The membrane was sutured into place with 3-O Dexon in an interrupted
      manner. Each animal served as its own internal control. No
      operative/postoperative deaths or postoperative complications occurred. Four
      weeks postsurgery, euthanasia was effected, necropsy performed, and adhesions
      quantified. Adhesion scores for the Gore-SM-covered areas (n = 10; mean score,
      2.76 +/- 1.47; median, 2.46) were significantly higher than those for control
      areas (n = 10; mean score, 1.46 +/- 2.13; median, 1.81; P = 0.01). Adhesions to
      the Gore-SM occurred at wrinkles in or at the edges of the membrane. In
      contradistinction to the findings of other investigators using different animal
      models, the Gore-SM appears to increase PRPSA in this unique model.

PMID- 1743556
TI  - Etoposide (VP-16), ifosfamide/mesna, and cisplatin chemotherapy for advanced and
      recurrent carcinoma of the cervix.
AB  - A Phase II study of VP-16 (etoposide), ifosfamide/mesna, and cisplatin (VIP) in
      advanced and recurrent carcinoma of the cervix was initiated March 1989. VP-16,
      75 mg/m2, ifosfamide, 1.0 g/m2, and cisplatin, 25 mg/m2, were administered
      intravenously daily for 3 consecutive days, every 28 days to a maximum of six
      cycles. Fourteen patients were entered on protocol. Eight patients had objective
      responses, all complete. Response duration ranged from 7+ to 24+ months. The
      chemotherapy was well-tolerated. Hematologic toxicity was the major toxicity and
      was manageable. VIP appears to be active in advanced carcinoma of the cervix.

PMID- 1743557
TI  - Prognostic value of flow cytophotometric DNA content analysis in single treatment
      stage IB-IIA squamous cell carcinoma of the cervix.
AB  - DNA content was measured flow cytometrically in archival tissue from 65 single
      treatment stage IB and IIA squamous cell carcinomas of the cervix with at least 5
      years of clinical follow-up. Thirty-five cases were treated exclusively by
      hysterectomy and thirty exclusively by radiation therapy. Tumors were categorized
      into four groups on the basis of DNA content and cell cycle distribution. DNA
      content was measured relative to the position of the first resolvable cell peak.
      G2/M and S-phase fractions were estimated as percentage of cells with DNA
      contents greater than or equal to relative position 1.70 and percentage of cells
      with relative positions between 1.20 and 1.70, respectively. The 40 tumors
      characterized as either aneuploid or nondemonstrably aneuploid with high S-phase
      fraction estimate had a 5-year recurrence rate significantly higher than that of
      the 25 tumors categorized as tetraploid or nondemonstrably aneuploid with low S
      phase fraction estimate (52 and 4%, respectively; chi 2 = 15.8, P less than
      0.001). Similar results were found when radiation and surgically treated tumors
      were considered independently (chi 2 = 7.95, P less than 0.005 and chi 2 = 5.7, P
      less than 0.025, respectively). These data suggest that an increased 5-year
      recurrence rate is associated with both abnormal DNA content and elevated S-phase
      fraction in stage IB-IIA squamous cell carcinoma of the cervix, and that this
      relationship is largely independent of treatment method.

PMID- 1743558
TI  - Is CA-125 monitoring useful in patients with epithelial ovarian carcinoma and
      preoperative negative CA-125 serum levels?
AB  - Between December 1983 and December 1988 we examined the postoperative tumor
      marker development and correlated this to the clinical course of the disease in
      56 patients suffering from primary epithelial ovarian carcinoma of International
      Federation of Gynecology and Obstetrics stages I-III and with a preoperative CA
      125 serum level less than or equal to 65 U/ml. In 54% of all cases there was a
      reduction of more than 50% of the CA-125 serum level within the first 3 months
      after surgery. Nine out of thirteen patients with progressive disease (69%)
      showed an increasing CA-125 serum level with a median lead time of 6 months (0-11
      months) prior to clinical diagnosis. These preliminary results indicate that the
      monitoring of cancer patients with CA-125 tumor marker seems to be a useful
      method of early diagnosis of progressive disease even in patients with
      preoperative serum levels lower than 65 U/ml.

PMID- 1743560
TI  - Prognosis of ovarian cancer developing in the residual ovary.
AB  - Elective oophorectomy at the time of hysterectomy for benign disease in women
      during their fifth decade is an important issue for both gynecologist and
      patient. It has been suggested that cancer developing in the residual ovary has a
      worse prognosis than the national average (L. McGowan, Obstet. Gynecol. 69, 386,
      1987). In an effort to corroborate such finding, 36 women with epithelial ovarian
      cancer developing in the residual ovary after prior hysterectomy were compared to
      a group of 121 patients with epithelial ovarian cancer and no previous surgery.
      Analysis was made of age, stage at diagnosis, feasibility of cytoreductive
      surgery, and survival in both groups. Only age distribution was found to be
      significantly different between the two groups of patients (P less than 0.001).
      Neither FIGO staging or quality of cytoreductive surgery showed a statistically
      significant difference between both groups. At 3 years, 41% of the subjects with
      cancer in the residual ovary were alive, compared to 42% in the group without
      previous hysterectomy. The corresponding figures for 5-year survival are 34 and
      27%, respectively (P = 0.939). On the basis of our findings we conclude that the
      overall prognosis for patients with ovarian cancer developing in the residual
      ovary does not appear to be any worse than that reported for ovarian cancer in
      general.

PMID- 1743559
TI  - Phase II trial of high-dose cisplatin with sodium thiosulfate nephroprotection in
      patients with advanced carcinoma of the uterine cervix previously untreated with
      chemotherapy.
AB  - Cisplatin is one of the most active single agents in the treatment of advanced
      cancer of the cervix. The concurrent administration of the nephroprotective
      agent, sodium thiosulfate, has enabled exploitation of the therapeutic potential
      of cisplatin. To explore the role of cisplatin dose intensity in the treatment of
      patients with cancer of the uterine cervix, patients with persistent/recurrent
      measurable disease were treated with cisplatin at 200 mg/m2 as a 2-hr infusion
      with sodium thiosulfate given at 3.3 g/m2 1 hr prior to cisplatin and 6.6 g/m2
      during the cisplatin infusion. Treatment was repeated monthly. Due to the known
      cumulative toxicity of cisplatin, treatment beyond two cycles (400 mg/m2) was
      given only to those patients who had at least demonstrated a PR. Audiologic
      evaluation was done prior to each cycle of treatment. Eleven patients were
      entered with a median age of 43 years (range, 25-57), a median KPS of 80% (range,
      60-90%), and nine epidermoid and two adenocarcinoma, and all patients had
      received previous pelvic irradiation. Twenty-eight cycles of treatment were
      given: 1, five cycles; 3, three cycles; 7, two cycles. No greater than or equal
      to 3+ hematologic, neurologic, or renal toxicity was demonstrated. Ototoxicity
      was demonstrated in the mild to moderate hearing loss range (3000-8000 Hz). The
      greatest threshold shift occurred after the first course of cisplatin. There were
      three PRs with a maximum duration of 4 months. Due to the significant toxicities
      encountered, the low response rate, and the limited duration of responses, this
      trial was closed early to accrual.

PMID- 1743561
TI  - Clear cell adenocarcinoma of the vagina: a second primary in a diethylstilbestrol
      exposed woman?
AB  - A clear cell adenocarcinoma of the vaginal remnant in a diethylstilbestrol (DES)
      exposed woman developed 20 years after anterior exenteration for a histologically
      similar stage II vaginal cancer. Arguments favoring a new primary cancer over a
      late recurrence are presented. This case probably represents the first report of
      a second primary vaginal clear cell cancer after DES exposure in utero. The
      implications of a second vaginal primary and the need for long-term surveillance
      in DES-exposed women are discussed.

PMID- 1743562
TI  - Correction of incontinent ileocolic urostomy with Kock's nipple valve.
AB  - Continent urostomy procedures may be replacing the incontinent ileal or colon
      conduit as the preferred method of urinary diversion in gynecologic cancer
      patients. One method of continent urinary diversion utilizes the detubularized
      ascending and transverse colon as a reservoir with a tapered segment of distal
      ileum as the stoma through which the patient catheterizes the pouch (Miami
      pouch). Failures of this procedure have been reported. A case report of such a
      failure is presented. This patient was managed by replacing the tapered ileal
      stoma with a Kock intussuscepted nipple valve made from proximal ileum. The
      patient is now continent. This technique warrants further investigation as a
      method of treating patients with continent urostomies of various types (Kock,
      Indiana, Miami, Mainz) that become partially or completely incontinent.

PMID- 1743563
TI  - Ovarian cancer.

PMID- 1743564
TI  - Ultrasound screening for familial ovarian cancer.
AB  - We have used transvaginal ultrasonography to screen 776 asymptomatic women for
      familial ovarian cancer. Every woman had at least one first- or second-degree
      relative develop the disease (677, 87%; and 98, 13%, respectively). The mean age
      of the study population was 51 years (range, 24 to 78 years); 52% were
      premenopausal, 36% were naturally postmenopausal, and 12% had undergone a
      hysterectomy. Overall, 43 women (5.5%) were referred for surgical investigation
      and 39 had a laparatomy. Nineteen/thirty-nine (48%) had bilateral ovarian masses,
      and 15% of abnormal ovaries had more than one type of histopathology. Twenty
      three tumors and thirty-two tumor-like conditions were detected. There were 3
      cases of primary ovarian cancer (prevalence, 3.9/1000), all FIGO stage Ia. None
      of the women has developed ovarian cancer within the first year of the scan
      (giving a provisional detection rate of 100%). The false positive rate was 40/773
      (5.2%), the predictive value of a positive screen result was 7.7%, and the odds
      in favor of finding any mass at laparotomy were about 19 to 1 or for any tumor, 1
      to 1. At surgery the odds against finding primary ovarian cancer were 12 to 1.
      The positive predictive value of the screening procedure and the prevalence of
      the disease were significantly higher than the corresponding values from a
      previous population-based screening program.

PMID- 1743565
TI  - The effects of early removal of indwelling urinary catheter after radical
      hysterectomy.
AB  - Radical hysterectomy has long been a primary mode of therapy for selected
      gynecologic malignancies. The lower urinary tract is an area associated with
      complications following this procedure. Lack of satisfactory reflex micturition
      and urinary retention, diminished bladder sensation, infection, and fistula
      formation are common adverse sequelae. Prolonged indwelling catheterization is a
      cornerstone of postoperative management after radical hysterectomy. An
      alternative regimen consisting of early postoperative catheter removal, with a
      strict voiding schedule, and intermittent self-catheterization (ISC) for postvoid
      residuals (PVR) was prospectively investigated. Intermittent self-catheterization
      was initiated only if the PVR 12 hr after catheter removal was greater than 75
      ml. Twenty-six patients who underwent radical hysterectomy were studied.
      Catheters were removed between the fifth and ninth postoperative day. Eighteen
      patients (69%) had PVRs less than 75 ml at 12 hr and were successfully managed
      with a strict voiding schedule only. Eight patients (31%) had 12-hr PVRs greater
      than 75 ml and were managed with a strict voiding schedule and ISC until the PVR
      was less than 75 ml for two consecutive voids. These patients were evaluated with
      fluorourodynamics and none had an abnormal study. Compared to 25 historical
      control patients, study group median indwelling catheter duration was less (6.0
      days compared to 30.0 days) with no increase in postoperative complications. On
      the basis of these data, early removal of indwelling urinary catheters after
      radical hysterectomy appears to be an acceptable alternative to long-term
      catheterization.

PMID- 1743566
TI  - [Genital bleeding in childhood and adolescence].

PMID- 1743567
TI  - [The development of puberty and gonadal function following administration of
      cytostatic agents in childhood].

PMID- 1743568
TI  - [Diagnostic and surgical pelviscopy in children and adolescents].

PMID- 1743569
TI  - [Experiencing menstruation].

PMID- 1743570
TI  - [Contraception in adolescents].

PMID- 1743571
TI  - [Sterilization of mentally retarded girls].

PMID- 1743572
TI  - [The value of ultrasonography in pediatric and adolescent gynecology].

PMID- 1743573
TI  - [Ultrasonographic assessment of tumors of the adnexa in childhood].

PMID- 1743574
TI  - [Evaluation of gynecological diseases according to the law for severely
      handicapped].

PMID- 1743575
TI  - [Medical rehabilitation for the prevention of occupational and employment
      disability based on gynecologic diseases].

PMID- 1743576
TI  - [Stress in the life of a woman].

PMID- 1743577
TI  - [Limits to work load of women in occupational life].

PMID- 1743578
TI  - [Fatal peritoneal mesothelioma disease in women caused by asbestos exposure at
      the work place].

PMID- 1743579
TI  - [MPEL levels and pregnancy].

PMID- 1743580
TI  - [Maternal welfare at the work place and work disability during pregnancy].

PMID- 1743581
TI  - [Effect of gainful employment on pregnancy].

PMID- 1743582
TI  - [Pregnancy-caused employment prohibition or disease-caused work disability:
      procedures by gynecologists in the provision of doctors' certificates].

PMID- 1743583
TI  - [Work at the display screen and pregnancy].

PMID- 1743584
TI  - [Risk of exposure to chemicals in pregnancy].

PMID- 1743585
TI  - [Pregnancy and anesthesia].

PMID- 1743586
TI  - [Embolizing leg and pelvic vein thrombosis in late pregnancy: indication for
      simultaneous interdisciplinary procedures].

PMID- 1743587
TI  - [Antepartum CTG (II)].

PMID- 1743588
TI  - [Diagnosis of infection in at risk pregnancies].

PMID- 1743589
TI  - The effect of low affinity platelet factor 4 (LAPF4) secreted by human
      megakaryoblastic cell line (MEG-01) upon human bone marrow fibroblasts.
AB  - BACKGROUND: The role of low affinity platelet factor 4 (LAPF4) in the hemopoietic
      microenvironment has not yet been clarified. METHODS: Low affinity platelet
      factor 4 (LAPF4) was purified from normal human platelets and the culture medium
      of the human megakaryoblastic cell line (MEG-01), and their effects upon the
      growth of human bone marrow fibroblasts were assessed in order to investigate the
      biological role of LAPF4. The purified LAPF4 was added to the culture media of
      human bone marrow fibroblasts up to the concentration of 200 ng/m1, and the
      growth rate of fibroblasts and the uptake of 3H-thymidine into fibroblasts were
      measured. RESULTS: The molecular weight of LAPF4 from MEG-01 was approximately
      8,800, which corresponded to the monomer type of LAPF4 from normal platelets. The
      density of fibroblasts after 10 days of culture was 4.6 +/- 0.9 x 10(5)/ml, 7.8
      +/- 0.8 x 10(5)/ml and 11.3 +/- 0.6 x 10(5) in control medium, in the medium with
      LAPF4 from platelets and in the medium with LAPF4 from MEG-01, respectively,
      which indicates that LAPF4 from MEG-01 enhanced the growth rate of bone marrow
      fibroblast almost 2.5 times. The uptake of 3H-thymidine into fibroblasts was
      significantly increased by 1,000 ng/ml of LAPF4 from MEG-01. CONCLUSIONS: These
      results suggest that LAPF4 may play a role in the proliferation of fibroblasts.

PMID- 1743590
TI  - Non-Hodgkin's lymphoma in the elderly: the impact of advanced age on therapeutic
      options and clinical results.
AB  - BACKGROUND: Treatment of older patients with non-Hodgkin's lymphoma (NHL) is
      difficult and conflicting. Lower responsiveness to therapy has been reported;
      however, the high risk of treatment morbidity, drug-dose reduction, and the
      occurrence of unrelated deaths might account for the poor outcome of NHL in the
      elderly. METHODS: We retrospectively analyzed the therapeutic approach and the
      outcome in 90 NHL patients aged 65 years or older. Histologic classification was
      according to the Working Formulation. RESULTS: Twenty-nine patients with low
      grade NHL have been managed conventionally: complete response (CR) rate was 34.5%
      and median overall survival was 35 months. Sixty-one patients with intermediate
      grade (IG, 36 cases) or high-grade (HG, 25 cases) NHL were treated as follows: 5
      stage I-IE cases underwent radiation therapy; of 56 stage II-IV patients, 14 had
      conservative single-agent therapy and 32 received an attenuated CVP regimen. Only
      10 patients were considered suitable for attenuated CHOP or CHOP-like programs.
      Overall CR rate was 50% for IG and 32% for HG NHL: Median survival was 33 months
      and 10 months (p less than or equal to 0.05), respectively. For IG and HG
      patients, the attainment of CR influenced survival significantly. Treatment
      morbidity was observed in 41% of patients. Resistant lymphoma was the major cause
      of death (31/36) during the first six months of therapy. CONCLUSIONS: In our
      experience, the outcome of elderly NHL patients treated with conservative
      therapeutic approaches is poor. Intensive chemotherapy regimens tailored to
      individual patients are needed to improve clinical results.

PMID- 1743591
TI  - A regimen for antithrombin III substitution in patients with acute lymphoblastic
      leukemia under treatment with L-asparaginase.
AB  - BACKGROUND AND METHODS: Seventeen adult patients with acute lymphoblastic
      leukemia (ALL) treated with L-asparaginase (20,000 IU/m2 on six alternate days)
      were infused with antithrombin III (AT III) concentrates (Kybernin P, Behring).
      Substitution therapy was aimed at increasing the reduced AT III concentration
      usually found in these patients, since AT III deficiency is thought to be
      associated with an increased risk of thrombosis. Two schedules of AT III
      administration, different in dosage, timing and duration were evaluated. The
      first 7 patients (group A) received a fixed dose of 2,000 U every day for 6
      times, starting with the second L-asparaginase (L-ase) infusion, independently of
      their plasma AT III levels. In the following 10 patients (group B), 20-25 U/Kg
      b.w. were administered daily for 7 times only when the plasma AT III level was
      lower than 60% with plasma fibrinogen higher than 100 mg/dl and platelet count
      higher than 50 x 10(9)/l, or when AT III was below 40%. Thirteen patients who
      received L-ase without AT III substitution served as controls. RESULTS AND
      CONCLUSIONS: Both substitution regimens resulted in mean plasma AT III nadir
      values significantly (p less than 00.1) higher than in the controls. Our data
      suggest that, in ALL patients receiving L-ase according to the L20 protocol,
      satisfactory plasma AT III levels may be assured with infusions of 20-25 U/Kg
      b.w./day for 7-10 days, starting by day 2 of L-ase treatment.

PMID- 1743592
TI  - Hybrid phenotypes and lineage promiscuity in acute leukemia.
AB  - Clinical data indicate that AL are heterogeneous diseases with variable
      responsiveness to chemotherapeutic agents. Based on this evidence, the efforts of
      most investigators are aimed at providing rapid identification of AL features
      predictive of distinct prognostic outcomes. A considerable number of reagents
      (including MoAb and molecular probes) available from commercial sources has been
      widely used for diagnostic purpose, leading to the identification of
      "inappropriate" antigen expression and to diagnoses of "mixed" AL (M-AL). The
      latter still lacks adequate definition and identification criteria, but is
      frequently reported as a novel entity associated with poor clinical outcome. The
      use of more accurate methodologic approaches, as well as a better elucidation of
      normal hemopoietic cell characteristics suggest that true M-AL occur quite
      rarely: the features of normal precursor counterparts are more frequently
      conserved. "Ectopic" marker expression, however, which should not be interpreted
      as reflecting lineage infidelity, may in some instances explain different
      clinical courses in AL patients. Further elucidation of normal stem cell
      features, and adequate standardization of AL immunophenotyping--to be performed
      under proper technical conditions--are needed for a better evaluation of M-AL,
      both in terms of diagnosis and classification, as well as regarding their
      clinical significance.

PMID- 1743593
TI  - Immunohistochemistry of malignant lymphomas. Advantages and limitations of the
      new monoclonal antibodies working in paraffin sections.
AB  - On the basis of the experience derived from the study of 2,000 biopsies, the
      authors critically review the problem of the newly generated monoclonal
      antibodies (mAbs) working in paraffin sections. The reliability and drawbacks of
      the most commonly used reagents are examined, with special reference to their
      employment in the diagnosis of malignant lymphomas. The authors underline that
      only a few mAbs are really specific, since most reagents give rise to a certain
      number of cross-reactivities. In the light of this, a wide panel of antibodies
      should always be applied in the diagnosis of lymphoid tumours in order to avoid
      possible misinterpretations, which can actually lead to wrong therapeutical
      decisions.

PMID- 1743594
TI  - Clinicopathological evolution and multilineage involvement in erythroleukemia:
      report of a case.
AB  - Results of sequential chromosome and cytologic studies in a patient with
      erythroleukemia (EL) by FAB criteria are described here. Major karyotype
      aberrations (MAKA) as well as normal karyotypes were detected at presentation,
      when the patient showed erythroid hyperplasia with moderate leftward shift of
      erythropoiesis and trilineage myelodysplasia, a picture suggestive of
      multilineage involvement. Following conventional induction therapy, the patient
      entered a myelodysplastic phase (MDS) with the features of refractory anemia with
      excess of blasts and subsequently relapsed with classical EL with maturation
      arrest of erythroblasts. Chromosome studies revealed a 46, XY karyotype in the
      MDS phase and only MAKA at leukemia relapse. These findings provide further
      evidence of a multistep cytogenetic and clinicopathological evolution of EL.
      Concomitant cytogenetic and morphologic studies in this patient seem to suggest
      the presence of chromosomally abnormal erythroblasts and confirm the existence of
      a association between MAKA and maturation arrest of erythroblasts.

PMID- 1743595
TI  - Recombinant human granulocyte-macrophage colony stimulating factor (rHuGM-CSF) in
      cyclic neutropenia.
AB  - We describe the case of a 12-year-old boy affected by cyclic neutropenia, at high
      risk of developing life-threatening infections, treated with recombinant human
      granulocyte-macrophage colony stimulating factor (rHuGM-CSF). The drug was
      effective in reducing the severity of neutropenia and infectious complications in
      our patient. It was administered for brief periods of time, in contrast to the
      daily continuous administration reported for rHuG-CSF. Therefore, more extensive
      studies must be performed to identify the most effective time schedule for the
      drug. In vitro studies of hemopoietic progenitor cells were useful, in this case,
      to predict treatment response.

PMID- 1743596
TI  - Disseminated histiocytosis with undetermined Langerhans' cells simulating an
      acute non lymphoid leukemia.
AB  - The authors report on a case of disseminated Langerhans' cell histiocytosis with
      a clinical presentation and a bone marrow simulating, at onset, an acute leukemia
      non lymphoid. A hepatic needle biopsy performed for the progressive enlargement
      of the liver oriented the diagnosis towards a Langerhans' cell histiocytosis. The
      morphological, immunohistochemical and ultrastructural study of these cells
      showed them to be undetermined, i.e. Langerhans' cell precursors.

PMID- 1743597
TI  - Trigeminal neuropathy in a case of mesenteric localized Castleman's disease.
AB  - Peripheral neuropathy of the limbs has so far been observed in very few patients
      with localized Castleman's disease, generally of the plasma-cell type. In the
      present case report, of a plasmacellular type localized within the mesenterium, a
      25-year-old woman exhibited a clinical picture of right trigeminal neuropathy
      (together with more common constitutional symptoms and laboratory findings),
      which promptly disappeared after surgical removal of the mesenteric mass. To our
      knowledge, a similar impairment of cranial nerves, and specifically of the
      trigeminal, has never been reported in patients with the localized form of
      Castleman's disease.

PMID- 1743598
TI  - Selective metaphasic blockade of erythroblasts in the bone marrow of patients
      treated sequentially with recombinant human erythropoietin and vincristine.
AB  - In the course of a phase I-II clinical study exploring the therapeutic potential
      of recombinant human erythropoietin in malignancy-associated anemias, a
      significant morphologic aspect was found in the marrow aspirates in two cases.
      The first was a patient with Hodgkin's disease, and the other a patient with
      acute T lymphoblastic leukemia. Bone marrow aspirates were performed while the
      patients were receiving recombinant human erythropoietin (rHu-EPO), 24 hours
      after the administration of vincristine, which was part of the therapeutic
      regimens. In all myeloaspirates over 90% of the numerous erythroblasts were in
      metaphasic arrest or displayed all the other aspects of so-called C mitoses,
      including star and ball metaphases, scattered chromosomes and multinuclear cells
      expressing so-called reconstructive polyproidism. All these alterations are
      caused by vincristine, a vinca dimer alkaloid, binding mechanistically to tubulin
      and thus blocking the polymerizing process that forms the mitotic spindle. The
      target cells for erythropoietin are specifically responsive cells, including
      microscopically identifiable erythroblasts. This is the first morphological
      demonstration in man of the combined effects of erythropoietin as a mitogen and
      vincristine as a mitotic blocker.

PMID- 1743599
TI  - Centella Asiatica Triterpenic Fraction (CATTF) reduces the number of circulating
      endothelial cells in subjects with post phlebitic syndrome.
AB  - Here we report a study performed in order to assess the number of circulating
      endothelial cells (EC) in normal subjects and in patients with postphlebitic
      syndrome (PPS), and the effect of treatment with Centella Asiatica Triterpenic
      Fraction (CATTF), a drug which has been demonstrated to be effective in promoting
      wound healing in vivo. EC counts were determined by means of differential
      centrifugation and phase contrast microscopy. Patients with PPS showed an
      increased number of circulating EC in comparison to normal subjects (3.8 +/- 1.2
      cells versus 1.5 +/- 0.6 per counting chamber). Treatment for three weeks with
      CATTF caused a statistically significant reduction of circulating EC (1.80 +/-
      0.6 cells per counting chamber).

PMID- 1743600
TI  - Fluconazole for disseminated Cryptococcosis in a patient with Hodgkin's disease.

PMID- 1743601
TI  - [The implication of stimulus-evoked ATP release from neuronal and extraneuronal
      sites].
AB  - Characteristics of the ATP release from non-neuronal tissues were reviewed in
      connection with that from neuronal tissues. alpha 1-Adrenoceptor and M3
      cholinoceptor stimulation produced a postjunctional ATP release from smooth
      muscles such as the vas deferens and ileal longitudinal muscles of the guinea
      pig, suggesting the existence of a coupling mechanism between the stimulation of
      the receptor for the transmitter and postjunctional ATP release. Accompanied with
      positive inotropic action, cardiotonics elicit postjunctional ATP release, which
      is derived from mitochondria, in atrial muscles, whereas these drugs are
      incapable of producing the release from papillary muscles. Possible physiological
      roles of ATP released to synapses from nonneuronal tissues are considered as
      follows: 1) the nucleotide may act as an opener of Ca2+ and K+ channels, 2) ATP
      in the synapse seems to serve as a transsynaptic neuromodulator after conversion
      to adenosine.

PMID- 1743602
TI  - [Pharmacological effects and metabolism of extracellular ATP].
AB  - Cells are equipped with complex mechanisms for synthesis of ATP and try to keep
      the intracellular level of this compound, which is indispensable for maintenance
      of normal function and integrity, as constant as possible. Thus, it is generally
      believed that ATP rarely cross the plasma membrane of viable cells. However,
      since the first report of Holton in 1959, the release of nucleotides from cells
      has become an established fact, and the physiological role and metabolism of the
      released ATP has become an important topic; potent actions of extracellular
      purine nucleotides and nucleosides have been recognized for many years. In 1972,
      Burnstock demonstrated that ATP has a transmitter role in certain types of nerves
      and proposed a concept of purinergic nerve. The receptor for purine nucleotides,
      designated as P2, as opposed to P1, by Burnstock in 1978 was further
      subclassified in 1985 into P2X and P2Y by himself, and we now have a train of P2
      receptors, such as P2S, P2T, P2Z and so forth. In this review, I summarized the
      characteristics of these purinoceptors. Pharmacological effects and metabolism of
      extracellular nucleotides were discussed and a brief mention was made of ecto
      nucleotidases.

PMID- 1743603
TI  - Natural foods and their ecological implications for Macaca thibetana at Mount
      Emei, China.
AB  - Natural food plants of partly provisioned groups of Macaca thibetana included
      about 196 species belonging to 135 genera and 72 families. The macaques consumed
      mainly bamboo shoots and fruits for about 2 months in autumn, whereas they relied
      on active or passive provisions from visitors, a variety of structural parts of
      plants and a small amount of invertebrates in late spring and summer and ate
      mainly mature leaves and bark for the rest of the year. About half of the species
      eaten came from the dense herb and shrub layers. This forest-dwelling species
      shows a distinctive feeding and foraging pattern in comparison with other
      macaques, explaining why M. thibetana has the largest body weight of all
      macaques.

PMID- 1743604
TI  - Colonic adenocarcinoma and hepatic myelolipomas in a Goeldi's monkey (Callimico
      goeldii).

PMID- 1743605
TI  - [Latex allergies in occupations and everyday living].

PMID- 1743606
TI  - [Insulin injection aid. Experiences with its use in Type II diabetes patients].
AB  - This article reports on the experience gained with an insulin injection aid for
      use by type II diabetics. The baseline data provided by a questionnaire survey
      are discussed in detail. The "pen" proved simple to use and was readily accepted.
      A number of shortcomings were identified and improvements suggested. The
      significantly superior metabolic control observed in patients using such aids is
      briefly discussed. In addition, detailed consideration is given to the models
      presently available and desirable future prospects are identified.

PMID- 1743607
TI  - [Psychosocial changes following cardiopulmonary resuscitation].

PMID- 1743608
TI  - [Digital luminescence radiography . 2: Technical implementation and clinical
      application--future developments].
AB  - In the previously published Part 1 of this paper the basic principle of digital
      luminescence radiography (DLR) was presented and the technical implementation of
      the data acquisition system with its advantages and disadvantages as compared
      with conventional radiography were described [3]. Part 2 covers processing,
      display, archiving and communication of image data; in addition, suggestions for
      future improvements in the technique are made. Image processing research is
      directed towards optimal presentation of the detected data by spatial frequency
      filtering with unsharp masking and by gradation enhancement. Additional
      information can be acquired by means of dual energy investigations. The image is
      displayed on either monitor or transparent X-ray film. Picture archiving requires
      large storage capacities, and picture communication needs fast transfer rates. At
      present, about 450 installations for digital luminescence radiography are in
      clinical use worldwide. Routine use can be expected when technical improvements
      have been implemented.

PMID- 1743609
TI  - [Interactions with anabolic steroids].

PMID- 1743610
TI  - [Treatment of moderate and severe pain. Ketorolac--a new analgesic].
AB  - Overall, the studies available to date show that ketorolac is a powerful
      analgesic with no action on the central nervous system and a long-lasting effect
      of rapid onset. The analgesic effectiveness of ketorolac in the treatment of
      moderate to severe pain, is comparable with that of 10-12 mg of morphine, 100 mg
      of pethidine, or 30 mg of pentazocine. However, ketorolac, an inhibitor of
      prostaglandin synthesis, is not subject to the strict regulations of the narcotic
      drugs law. On account of its favorable adverse reactions profile, ketorolac is
      particularly well suited for the treatment of postoperative pain. Further major
      indications are pain associated with trauma to bones and muscles, as also cancer
      related pain, in which area, a "saving effect" on simultaneously employed opiates
      and opioids can be achieved.

PMID- 1743611
TI  - Effects of glucagon-like peptide 1 (7-36) amide and glucagon on amylin release
      from perfused rat pancreas.
AB  - The effects of glucagon-like peptide 1 (7-36) amide [GLP-1 (7-36) amide] and
      glucagon on the release of islet amyloid polypeptide (IAPP), or amylin, from the
      isolated perfused rat pancreas were studied. In the presence of 5.6 mM glucose,
      GLP-1 (7-36) amide and glucagon stimulated the release of amylin from the
      perfused pancreas. The infusion of GLP-1 (7-36) amide at a concentration of 10(
      9) M elicited a biphasic release of amylin similar to that of insulin. The
      cumulative output of amylin induced by 10(-9)M GLP-1 (7-36) amide was
      significantly higher than that by 10(-9)M glucagon (p less than 0.01). The
      amylin/insulin molar ratios induced by GLP-1 (7-36) amide and glucagon were about
      1% and did not differ significantly. These findings suggest that GLP-1 (7-36)
      amide and glucagon stimulate the release of amylin from the pancreas and that the
      concomitant secretion of amylin and insulin might contribute to glucose
      homeostasis.

PMID- 1743612
TI  - Kinetic studies on hepatic handling of glucagon using the model of non
      recirculating perfused rat livers.
AB  - Using the model of the in vitro non-recirculating perfused rat liver we studied
      kinetic aspects of the hepatic handling of glucagon. Under conditions of a 20 min
      glucagon infusion (glucagon mass flows of 0.05, 0.46 and 4.75 ng/g liver/min,
      respectively) according to a rectangular profile both total and individual
      glucagon extractions were dependent on mass flow and time. The time course of
      glucagon extraction started with an acute phase within the first minute of
      infusion with a maximum value of 70%, which decreased within the following 30 sec
      by more than 40%. Depending on concentration, there was a progressive decrease in
      the hepatic extraction of glucagon up to the end of perfusion. Hepatic glucagon
      degradation was found to take place only at a little extent. Immediately after
      terminating the hormone infusion, the liver changed over into a glucagon
      releasing organ. Kinetics of glucagon infusion and glucagon-induced hepatic
      glycogenolysis did not distinguish by parallelism but rather by phase shifting.

PMID- 1743613
TI  - Polyamine influences on the prolactin stimulation of phosphoprotein synthesis in
      hydroxyurea synchronized MCF-7 human mammary epithelial cells.
AB  - The actions of prolactin on the rate of synthesis of an isoelectrically
      precipitable (pH 4.6) phosphoprotein fraction of the MCF-7 human mammary
      epithelial cell line were determined in cells synchronized at the G1:S interphase
      of the cell cycle employing hydroxyurea in a serum-free defined medium. Cells not
      allowed to enter the S-phase of DNA replication, by maintaining hydroxyurea in
      the incubation medium, exhibited an increased rate of [3H] leucine incorporation
      into the isoelectrically precipitable phosphoprotein fraction when exposed to
      prolactin and 1-5 mM spermidine. Cells released from the hydroxyurea induced
      synchrony exhibited an increased rate of [3H] leucine incorporation in response
      to prolactin when ornithine, putrescine, or spermidine were present. The
      polyamine spermine was ineffective in allowing prolactin's action on
      phosphoprotein synthesis. In synchronized cells released from the hydroxyurea
      block, prolactin was shown to effect an increased rate of phosphoprotein
      synthesis at the posttranscriptional G1 stage of the cell cycle. All prolactin
      responses were attained with physiological concentrations of the hormone. During
      and subsequent to the synchrony period with hydroxyurea, the presence or absence
      of insulin was found to be useful for the "staging" of the cell cycle to maintain
      cell synchrony and obtain prolactin effects on phosphoprotein synthesis.

PMID- 1743614
TI  - Triiodothyronine control of ATP-citrate lyase and malic enzyme during
      differentiation of a murine preadipocyte cell line.
AB  - In the Ob 17 preadipocyte cell line, during adipose differentiation, T3 amplified
      the progressive expression of two enzymes of the lipogenic pathway, ATP-citrate
      lyase (ATP-CL) and malic enzyme (ME) as previously described for fatty acid
      synthase (FAS) and fatty acid synthesis, and in the same time-period of
      development. However, the stimulation by T3 was sustained at late stages of
      differentiation whereas it declined in FAS studies. The stimulation was preceded
      by an increase in the relative abundance of the specific mRNAs. Two ME mRNA
      species were detected (21S and 27S) and found to be differently distributed.
      Their abundance was asynchronously increased by T3 with a predominant effect on
      the 21S species. Culture of the cells in a thyroid-hormone depleted medium
      prevented any significant increase of ME activity. Early inclusion of T3 largely
      restored ME development whereas late elimination of T3 only moderately impaired
      it. It is suggested that T3 plays a crucial role at an early step of adipose
      differentiation, this leading to an increased expression of a set of late adipose
      phenotypes such as several lipogenic enzymes.

PMID- 1743615
TI  - Serotonin content of the interscapular brown adipose tissue of growing rats.
AB  - In brown fat of newborn rats the serotonin (5HT) content is high during the first
      five days of life. This may play a part in the lipid repletion of the tissue,
      lipids being the main fuel for nonshivering thermogenesis. Subsequently 5HT
      increases more in young rats reared at 16 degrees C than in those reared at 28
      degrees C but to a lesser extent than norepinephrine (NE) content. A possible
      role of 5HT in thermoregulation of the rat during the early postnatal period is
      discussed.

PMID- 1743616
TI  - HGH20k species and variability of GH responses to long-duration exercise in male
      cyclists fed different food supplements.
AB  - Exercise studies dealing with hGH have always considered this hormone as a unique
      molecular entity. We postulated that the well-known variability in blood total
      hGH response could possibly be explained, at least in part, by concomitant
      changes in blood hGH20k levels, variant form possibly expressing some of the hGH
      anti-insulinic properties. Six male trained cyclists were imposed a 2-hr long
      ergocycle exercise. Food supplements were given prior to and/or during exertion
      to exacerbate a possible contribution from hGH20k to total hGH variability by
      modification of substrate availability. Both blood total hGH and hGH20k levels
      increased with exercise, the largest increases being observed in absence of
      supplementation. Large variability of responses were observed in both blood total
      hGH and hGH20k levels, the latter variant contributing minimally to total blood
      hGH response (4.3 +/- 0.8%), and being closely associated with the main species
      (r = 0.90; p less than 0.001). It was concluded that variations associated with
      hGH20k increases observed in response to prolonged exercise cannot explain the
      large intra-and inter-individual variability measured in blood total hGH
      response.

PMID- 1743617
TI  - Serum manganese-superoxide dismutase in patients with diabetes mellitus and
      thyroid dysfunction as judged by an ELISA.

PMID- 1743618
TI  - Diurnal variation of leucyl aminopeptidase activity in the rat hypothalamus.

PMID- 1743619
TI  - Thermal and nutritional influences on cardiac muscle 3,5,3'-triiodothyronine
      nuclear receptors.

PMID- 1743620
TI  - Effect of ovarian follicular fluid peptide (OFFP) on FSH and EGF binding to
      granulosa cells.

PMID- 1743621
TI  - Evidence for liver epinephrine.

PMID- 1743622
TI  - Phase II trial of ifosfamide and mesna in previously treated patients with non
      Hodgkin's lymphoma: Cancer and Leukemia Group B study 8552.
AB  - Ifosfamide (1.25 g/m2 intravenously/day x 5) with mesna (20 per cent of the
      ifosfamide dose x six doses on each day of ifosfamide therapy) was administered
      to 46 previously treated patients with non-Hodgkin's lymphoma of which 31 were
      eligible and evaluable. A 29 per cent response rate (9/31) was observed (two CR
      and seven PR) with a median duration of response of 2.5 months. Myelosuppression
      was dose-limiting. Hemorrhagic cystitis was observed in three patients (10 per
      cent). Nausea and vomiting was generally mild or moderate. One patient developed
      transient neurotoxic symptoms with confusion and disorientation. An additional
      patient developed an anaphylactic-type reaction with shortness of breath and
      respiratory stridor during the fourth course of therapy. Ifosfamide, as a single
      agent, produces remissions of limited duration in non-Hodgkin's lymphoma in
      patients in second or third relapse.

PMID- 1743623
TI  - Toxicity and preliminary results with a new eight-drug regimen (CEOP-IMVP-DEXA)
      in the treatment of aggressive lymphomas.
AB  - A combination of two non-cross-resistant regimens, CEOP and IMVP-Dexa given every
      4 weeks, three to six times according to response was tested in patients with
      untreated histological proven high and intermediate grade non-Hodgkin's lymphoma.
      To date eight Austrian centres entered 37 patients in this multicentre trial.
      Data are available from 33 patients, three were excluded, two because of
      pretreatment, one because of wrong histology. Twenty-five patients are evaluable
      for response, 21 had a complete and three a partial remission, two of them
      entered a complete remission after radiotherapy to residual disease, resulting in
      a complete remission rate of 92 per cent. Only one patient progressed during
      therapy. Until now three patients relapsed after achieving a remission.
      Observation time is 0.4-23.8 months, median 8.8 months. Toxicity was primarily
      hematologic with 53.3 per cent of patients having granulocyte nadirs below 0.5 x
      10(9)/L and 3.3 per cent below 0.1 x 10(9)/L. Although 60 per cent of patients
      had infections, there was only one life-threatening infection in an AIDS patient.
      CEOP-IMVP-Dexa can be safely given even in smaller hematologic centres and is
      able to achieve a high rate of complete responses in patients with high and
      intermediate grade malignant non-Hodgkin's lymphomas.

PMID- 1743624
TI  - Sequential versus alternating chemotherapy for high grade non-Hodgkin's
      lymphomas: a randomized multicentre trial.
AB  - In a multicentre phase III trial 146 previously untreated patients with high
      grade non-Hodgkin's lymphomas stage II-IV were randomized to receive either four
      cycles of CHOEP (cyclophosphamide 750 mg/m2 iv d 1, doxorubicin 50 mg/m2 iv d 1,
      vincristine 2 mg iv d 1, etoposide 100 mg/m2 iv d 3-5, prednisolone 100 mg po d 1
      5) (treatment arm A), or four cycles of chemotherapy with hCHOP (cyclophosphamide
      1200 mg/m2 iv d 1, doxorubicin 40 mg/m2 iv d 1 + 2, vincristine 2 mg iv d 1,
      prednisolone 100 mg po d 1-5) alternating with IVEP (ifosfamide 1500 mg/m2 iv d 1
      5, vindesine 3 mg/m2 iv d 1, etoposide 120 mg/m2 iv d 3-5, prednisolone 100 mg po
      d 1-5) (treatment arm B). After four cycles of chemotherapy an involved field
      irradiation with a total dose of 35 Gy was given to all patients in complete or
      partial remission without persisting extranodal disease. A complete response (CR)
      was seen in 124/146 patients (86 per cent) with 87 per cent CR in arm A versus 83
      per cent CR in arm B. During a median follow-up of 17 months (range 2-40) 30
      patients relapsed (16 patients arm A, 14 patients arm B). The overall survival at
      40 months is projected to be 71 per cent versus 70 per cent for arm A and B,
      respectively. Disease-free survival is projected to be 68 per cent in arm A and
      59 per cent in arm B at 40 months. So far, the differences in CR, survival and
      disease-free survival are not statistically significant.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1743625
TI  - Ifosfamide continuous infusion plus etoposide in the treatment of elderly
      patients with aggressive lymphoma: a phase II study.
AB  - A prospective phase II study was performed to evaluate efficacy and toxicity of
      continuous infusion ifosfamide plus etoposide combination in elderly patients
      (older than 70 years) with intermediate or high grade non Hodgkin's lymphoma.
      Chemotherapy was administered with mesna in order to avoid hemorrhagic cystitis.
      The 21 patients included were either unable to receive the usual front-line
      chemotherapy given in our institution or relapsing after or not responding to
      conventional chemotherapy. Only one out of 97 courses of chemotherapy was
      followed by serious complication consisting in non-lethal pneumonitis. Four out
      of seven previously untreated patients and five patients treated in first relapse
      achieved complete response (75 per cent). Out of nine refractory or previously
      multi-treated patients, only one achieved complete response. We conclude that
      combination of continuous infusion ifosfamide plus etoposide deserves to be
      evaluated on a larger scale so that the optimum doses and schedule may be
      defined.

PMID- 1743626
TI  - Twin-track studies of ifosfamide and mitoxantrone (I-M) in recurrent high grade
      non-Hodgkin's lymphoma and Hodgkin's disease. Yorkshire Regional Lymphoma and
      Central Lymphoma Groups.
AB  - Fifty-seven patients, initially diagnosed as having advanced high grade non
      Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD) refractory to first-line
      treatment or in relapse, were treated with ifosfamide 6 g/m2, infused over 48 h,
      followed by mitoxantrone 12 mg/m2. The regimen repeated at three-weekly
      intervals. Of 33 patients with NHL evaluable for response, 10 (30 per cent)
      achieved complete remission and six partial remission, giving an overall response
      rate of 48 per cent. Two patients subsequently went on to bone marrow transplant
      (BMT)--one allogeneic and the other autologous. Of 18 patients with HD evaluable
      for response, seven (39 per cent) achieved complete remission and six partial
      remission, giving an overall response rate of 72 per cent. Two of this group also
      went on to BMT (both autografts). The principal toxicity was neutropenia, though
      central nervous system changes were observed in 10 patients. The possibility of
      increasing the safety of the regimen by increasing the time of infusion to 72 h
      is discussed. Given the need to offer alternative treatment to patients in these
      categories, this combination (I-M) is of value in relapsed patients, especially
      where options are limited because of previous multi-drug treatment. Remissions
      may not be prolonged but allow the effective application of additional intensive
      treatment including bone marrow transplantation.

PMID- 1743627
TI  - IMVP-16 followed by high dose chemotherapy and autologous bone marrow
      transplantation as salvage treatment for malignant lymphoma.
AB  - Thirty patients with high-grade malignant lymphoma were treated with ifosfamide
      VP16213-methotrexate (IMVP-16) combination chemotherapy after failing to respond
      completely or after relapsing on CHOP-like therapy. Responders to the salvage
      therapy subsequently were treated with ablative chemotherapy (BCNU, VP16213, Ara
      C and melphalan) and autografted. Of these 30 patients 11 were in relapse, 11
      were partial responders and eight failed CHOP-like therapy. There were eight
      complete remissions and 12 partial responses to IMVP-16. These 20 patients were
      transplanted, together with one nonresponder. Ten of these 21 patients are
      disease-free survivors 16 to 76 months (median 32) after autografting. There were
      three treatment-related deaths: one before and two during the autografting
      procedure. Using one of the best salvage therapy combinations followed by high
      dose chemotherapy and autografting is feasible. The results of this study suggest
      that an appreciable number of patients may be cured by this procedure.

PMID- 1743628
TI  - VIM3-ARA C: an effective salvage regimen in refractory or recurrent aggressive
      non Hodgkin's lymphoma. A report on 18 cases.
AB  - Based on encouraging results of previous combination regimens, we used a
      combination of VM26, ifosfamide, methyl GAG, mitoxantrone (or adriamycin), high
      dose (HD) methotrexate and HD Ara C to treat 18 patients with relapsed or
      refractory NHL. Front-line therapy had been in most of them a reinforced CHOP
      regimen. Twelve patients (67 per cent) responded: there were nine (50 per cent)
      partial responses (PR) and three (17 per cent) complete remissions (CR). Nine of
      these 12 responders were grafted (eight autologous, one allogeneic transplants),
      one relapsed before autograft could be performed and the two remaining patients
      were excluded from autograft because of positive bone marrow. Five of nine
      patients remained free of disease after 11+ to 27+ months. Response rate was
      higher in patients who relapsed 'off' therapy (2/3), but CR was also obtained in
      two refractory NHL and persisted for 11+ and 26+ months, suggesting that VIM3-ARA
      C was, at least partially, non-cross-resistant with front-line adriamycin
      containing regimens.

PMID- 1743629
TI  - Ifosfamide in the treatment of high-grade recurrent non-Hodgkin's lymphomas.
AB  - We report the results of two phase II trials of ifosfamide in very high risk
      patients with either partially responsive or recurrent non-Hodgkin's lymphomas.
      In the first study, in which patients were extremely heavily pretreated (50 per
      cent had received a very intensive salvage regimen containing very high dose
      cyclophosphamide), there were two complete responses, two partial responses and
      one objective (minimal) response among 14 patients treated. Toxicity was
      acceptable even in this end-stage patient group. We concluded that ifosfamide is
      an active agent even in patients with tumours resistant to cyclophosphamide. The
      second trial was a pilot study in 13 patients of a regimen incorporating VP16,
      ifosfamide/mesna, and high dose ara-C (VIPA). There were four complete responses,
      five partial responses and two objective responses. Two patients died in complete
      remission from toxic complications, while a third, with a stably regressed
      mediastinal mass died after completion of the protocol. While very toxic, we
      considered that this regimen was highly effective, and have since incorporated a
      slightly less intensive combination of the same drugs into the primary therapy of
      high risk patients. Since the primary toxicity of the VIPA combination was
      myelosuppression, the use of a modified protocol incorporating colony stimulating
      factors to ameliorate the side-effects and possibly increase dose rate is worthy
      of further exploration in patients with recurrent B cell tumours.

PMID- 1743630
TI  - Pediatric non-Hodgkin's lymphoma abdominal presentations: a comparative study
      between two treatment regimens at the National Cancer Institute Cairo.
AB  - Abdominal presentations of pediatric NHL are rarely amenable to complete surgical
      resection. Chemotherapy is the hallmark of treatment for pediatric NHL. Treatment
      of various types of this disease including intra-abdominal NHL in children with
      various protocols have not exceeded 54 per cent two-year disease-free survival.
      We have attempted to study and compare the effects of two treatment regimen upon
      two groups of previously untreated children up to the age of 16 years who
      presented to the Pediatric Oncology Unit at the NCI. The first group included 18
      children who presented between 1983 and 1985 and were treated by a modified St
      Jude regimen: while the second group of patients was comprised of 19 children who
      presented between 1985 and 1987 and were treated by a multi-national protocol:
      the MCP 842. The two groups will be compared with respect to various patient
      characteristics, response to therapy and their two-year disease-free survival as
      well as overall survival.

PMID- 1743631
TI  - Prolonged disease-free survival in pediatric non-Hodgkin's lymphoma using
      ifosfamide-containing combination chemotherapy.
AB  - Pediatric non-Hodgkin's lymphoma (NHL) constitutes 16 per cent of pediatric
      malignancies reported to the National Cancer Institute (NCI) in Cairo. The
      adopted treatment for these cases was, from 1982 to July 1985, a modified St
      Jude's regimen consisting of: vincristine, cyclophosphamide, adriamycin,
      prednisone and intrathecal methotrexate for the first 6 weeks for induction,
      followed by cranial irradiation for cranial prophylaxis. Patients in remission
      received maintenance therapy for 18 months. Of 32 patients complete remission
      (CR) was achieved in 24 patients (75 per cent); partial remission (PR) in one
      patient (3 per cent); five patients showed no response (15 per cent) while two
      patients died during the induction phase. At 60+ months follow-up, 60 per cent of
      cases are still alive, disease-free, and overall survival is 66 per cent. A new
      protocol was adopted in 1985, consisting of alternating cycles: A and B, for 4-8
      cycles. Cycle A: cyclophosphamide, high dose ara-C, adriamycin, and vincristine.
      Cycle B: ifosfamide, methotrexate, VP 16, with intrathecal methotrexate. The
      response in 39 cases is: CR in 31 cases (82 per cent); PR in four cases (10 per
      cent); no response in three cases (8 per cent). At 60+ months, the disease-free
      survival is 60 per cent, and overall survival 80 per cent. This new protocol has
      the advantage of: short duration of therapy and so better patient compliance, no
      maintenance therapy or cranial irradiation with its sequelae in the future.
      Moreover, it has a better overall survival.

PMID- 1743632
TI  - Victims' services in community mental health centers.

PMID- 1743633
TI  - Social work takes active role in health care reform.

PMID- 1743634
TI  - Oppositional defiant disorder and conduct disorder.

PMID- 1743635
TI  - Do benzodiazepines cause depression?

PMID- 1743636
TI  - Combined therapy for a 30-year-old woman with early-onset dysthymia.

PMID- 1743637
TI  - Residential programs for persons with severe mental illness: a nationwide survey
      of state-affiliated agencies.
AB  - About 1,500 agencies responded to a nationwide survey of community residential
      programs affiliated with state departments of mental health that was conducted in
      1986-87. The agencies served more than 59,000 individuals who had psychiatric
      disabilities in more than 16,000 residential settings. The results reveal rapid
      growth in the number of programs since 1980 and the availability of a broad range
      of residential programs. Group homes and supervised apartments were the most
      common types of residential programs identified in the survey. The most commonly
      offered services were social and recreational activities, medication supervision,
      and on-site crisis intervention. Programs also offered such services as client
      advocacy and case management. Most program staff did not have professional
      training in a mental health field.

PMID- 1743638
TI  - States' strategies for promoting supported housing for persons with psychiatric
      disabilities.
AB  - Survey data were used to analyze state government efforts to promote supported
      housing for persons with psychiatric disabilities in five states--Ohio, Oregon,
      Rhode Island, Washington, and Wisconsin. States worked to increase mental health
      service consumers' access to affordable housing by increasing the number of state
      staff who address housing issues, by developing housing units, and by increasing
      consumers' income. Legislative mandates and financial incentives were used to
      encourage service providers to offer more flexible support services. States
      promoted consumers' involvement in the mental health system by encouraging their
      participation in state-level decision making and by providing financial support
      to consumer organizations.

PMID- 1743639
TI  - A ten-year perspective on three models of sheltered care.
AB  - Data from three surveys of California sheltered care residents and facilities
      were used to determine which of three models best describes the use of sheltered
      care by residents and the provision of services to residents between 1973 and
      1983. The continuum-of-care model emphasizes a person's movement along a
      treatment continuum to greater independence. In the residual model, the focus is
      on providing habitation for a chronic population from the era before
      deinstitutionalization. The developmental model emphasizes providing long-term
      care to persons who seek supported living arrangements at a particular point in
      their life cycle. Results indicated that the developmental model best describes
      the way residents used sheltered care, while service provision was based on the
      continuum-of-care model. In light of these findings, it should be determined
      whether service provision reflects the actual needs of this population.

PMID- 1743640
TI  - Effects of sheltered care environments and resident characteristics on the
      development of social networks.
AB  - Two hundred and thirty-four members of a 1973 sample of sheltered care residents,
      three-fourths of whom had schizophrenic disorders, were followed up between 1983
      and 1985 to examine the role of supportive and of transitional, high-expectation
      sheltered care environments in the development of residents' social networks. The
      influences of revolving-door treatment experiences, psychopathology, and
      institutionalization were taken into account. The results showed that supportive
      rather than transitional, high-expectation environments contributed to the
      development of emotionally and instrumentally supportive social networks. Higher
      levels of psychopathology and a history of institutionalization resulted in the
      absence of certain support relationships. Surprisingly, revolving-door treatment
      experiences were related to positive support and social network outcomes.

PMID- 1743641
TI  - Factors affecting SSI support for sheltered care residents with serious mental
      illness.
AB  - The complexity of Supplemental Security Income (SSI) regulations and procedures
      allegedly inhibits eligible persons with serious mental illness from obtaining
      and retaining support. This study examined factors affecting continued SSI
      support among 393 sheltered care residents with serious mental illness ten years
      after an initial positive eligibility determination. At follow-up between 1983
      and 1985 of 225 cohort members, 182 were receiving SSI benefits, 28 were eligible
      for SSI due to their low income but were not receiving benefits, and 15 were
      income-ineligible. The financially needy were most likely to receive SSI support
      for longer periods of time, and the most severely disturbed spent the least
      amount of time on SSI. Income-eligible nonrecipients were likely to be young,
      transient patients using emergency room services as opposed to receiving
      outpatient counseling.

PMID- 1743642
TI  - Attitudes of sheltered care residents toward others with mental illness.
AB  - The social acceptance expressed by 234 former mental patients and by the general
      public toward persons with serious mental illness was compared. Factors that may
      affect social acceptance of such persons, including personal characteristics and
      experiences that promote identification with mentally ill persons and the
      subject's level of psychological distress, were examined. Former patients
      expressed attitudes that were much more accepting than those of the general
      public. As hypothesized, individual characteristics and experiences likely to
      increase former patients' identification with their peers (that is, visible
      deviant appearance, a high level of involvement within the sheltered care
      community, and the experience of negative community reactions to a resident's
      facility) were related to a higher score on a Guttman scale of social acceptance.
      An increased level of self-reported psychological distress tended to moderate
      such supportive attitudes.

PMID- 1743643
TI  - Short-term group interventions for mentally ill young adults living in a
      community residence and their families.
AB  - Data from 12 families of chronic mentally ill young adults who were living in a
      supportive residential facility were used to compare the effects on family
      functioning of a multiple-family psychoeducational group and a multiple-family
      support group. The psychoeducational group provided information about mental
      illness and family dynamics and taught effective communication and conflict
      management skills. The support group consisted of unstructured discussions about
      topics raised by the families. Both groups met once a week for five weeks and
      included both parents and their mentally ill adult children. The emotional
      climate, level of organization, and other aspects of the family environment were
      assessed before and after treatment and at three-month follow-up. Both groups
      helped families to become more cohesive, to manage conflict more effectively, and
      to obtain a greater internal locus of control.

PMID- 1743644
TI  - Comparison of outcomes for clients seeking and assigned to supported housing
      services.
AB  - As part of state-supported interventions to reduce risk of rehospitalization,
      seriously disabled psychiatric patients who had been involuntarily hospitalized
      twice in the previous three years were assigned to receive supported housing
      services in an Oregon community. Compared with 22 voluntary clients in the same
      supported housing program, the 21 involuntary (assigned) clients rated higher on
      risk factors such as history of suicide attempts, self-neglect, homelessness, and
      medication noncompliance, The involuntary clients showed a much higher
      utilization of supported housing services and case management, psychiatric, and
      shelter services during the nine months after entry into the program, and they
      had a higher one-year rehospitalization rate. However, they used substantially
      fewer inpatient days in the six months after entry in the program than in the six
      months before.

PMID- 1743645
TI  - Creating a supportive environment using staff psychoeducation in a supervised
      residence.
AB  - The prevailing approach to rehabilitation in residential care emphasizes goal
      attainment. This approach often produces considerable stress for residents, most
      of whom have schizophrenia. Based on the view that low-demand environments,
      incorporating graduated expectations, may be more appropriate for this patient
      population, a three-component model for creating and maintaining a calm,
      supportive environment in a supervised residence was developed. The model
      utilizes staff psychoeducation, which is based on the principles of family
      psychoeducation, a highly effective intervention for patients with schizophrenia.
      The three components of the model are training in supportive interaction, a
      medication-monitoring program, and a behavioral approach to problem solving.
      Resident groups promote each of these components. The groups' goals are
      encouragement of positive, low-key interactions, compliance with medications, and
      slow, steady rehabilitation.

PMID- 1743646
TI  - Awards presented to exemplary state-university collaborations in California,
      Kentucky, and Pennsylvania.

PMID- 1743647
TI  - Parkinson's disease, depression, and chronic pain.

PMID- 1743648
TI  - A system for improving psychiatric record keeping.

PMID- 1743649
TI  - Readmission patterns of frequent users of inpatient psychiatric services.

PMID- 1743650
TI  - Psychiatric inpatients' knowledge of their rights.

PMID- 1743651
TI  - Power and governance issues in general hospital psychiatry.

PMID- 1743652
TI  - HIV seroconversion.

PMID- 1743653
TI  - State hospitals in the 1950s.

PMID- 1743654
TI  - Hypersalivation and clozapine.

PMID- 1743655
TI  - Clinical training funds can help promote needed change.

PMID- 1743656
TI  - Perspectives on work and rehabilitation.

PMID- 1743657
TI  - Refining the concept of dysthymia.

PMID- 1743658
TI  - Inpatient treatment of adolescents with psychiatric and substance abuse
      disorders.

PMID- 1743659
TI  - The quiet success of the national plan for the chronically mentally ill.
AB  - In 1978 the President's Commission on Mental Health called for a national plan
      for the care of persons with chronic mental illness. The plan was completed and
      released in 1980, but was never adopted as the policy of the incoming Reagan
      Administration. Despite changes in attitudes in the 1980s toward the federal
      government's role in human services and an atmosphere of fiscal restraint, many
      of the plan's specific recommendations for changes in Supplemental Security
      Income, Social Security Disability Insurance, Medicaid, and Medicare have been
      implemented. In this paper, the implementation of these recommendations is
      analyzed. The authors discuss some of the strategies used by mental health
      advocacy groups to make gains in the 1980s. Recommendations for the 1990s are
      discussed.

PMID- 1743660
TI  - Individual psychotherapy with schizophrenic outpatients in the public mental
      health system.
AB  - Forty-two therapists conducting individual psychotherapy with schizophrenic
      outpatients in a public mental health system responded to a questionnaire that
      focused on the types of interventions used and the issues and problems
      encountered in therapy. The therapists spent 59 percent of their time in
      supportive, problem-solving work and only 32 percent in traditional
      psychotherapeutic interventions, such as providing insight. The most common
      issues in therapy were relationship problems, family concerns, depression,
      losses, and the role of medications in the client's life. The most significant
      impediments to therapeutic work were the lack of community resources, the
      client's noncompliance with medications and lack of motivation, and dual
      diagnoses. Suggestions are offered for improving psychotherapy with schizophrenic
      outpatients in the public mental health system.

PMID- 1743661
TI  - Methodology for evaluating the Monroe-Livingston capitation system.
AB  - This paper presents the methodology for evaluating the Monroe-Livingston
      demonstration project's capitation payment system (CPS), based in Rochester, New
      York, for chronic mentally ill patients. To allow for both patient and provider
      choice within the experimental design, 1,587 CPS-eligible patients were randomly
      assigned at the start of the study to control or experimental conditions, with
      the intent of capturing in the experimental group a significant number of
      patients who would later be enrolled in the CPS. Protocols, which included
      measures of symptomatology, functioning, and resource utilization, were completed
      at baseline for 422 of the 605 patients contacted for inclusion in the study. The
      baseline control group included 143 patients; the experimental group included 279
      patients, 153 of whom were eventually enrolled in the CPS.

PMID- 1743662
TI  - Can multiaxial diagnosis predict future use of psychiatric hospitalization?
AB  - Demographic and diagnostic intake data on about 10,000 patients at a public
      psychiatric facility were used to assess whether information recorded on various
      DSM-III axes could predict the frequency of patients' psychiatric
      hospitalizations over a follow-up period. Compared with patients who had been
      hospitalized only once or not at all, patients with three or more
      hospitalizations during the study period were more likely to be single and black
      and to come from lower social classes. They were more likely to have an axis I
      diagnosis of an alcohol-related disorder, a substance use disorder, or a
      psychotic disorder. When samples from the patient groups were matched on key
      demographic variables and primary axis I diagnosis, the multiaxial resources of
      DSM-III were not helpful in predicting future use of hospitalization. The results
      reinforce the importance of axis I diagnosis and demographic characteristics in
      assessing course and prognosis.

PMID- 1743663
TI  - Substance use disorders in patients with chronic fatigue.
AB  - A high prevalence of mood disorders has been found among persons with chronic
      fatigue. The comorbidity of mood disorders and substance use disorders has long
      been recognized. In this study, the prevalence of substance use disorders among
      100 patients with chronic fatigue was examined. Twenty-eight patients met DSM-III
      R criteria for a lifetime diagnosis of substance abuse or dependence; ten of
      these patients had a current diagnosis. Forty-nine patients had no history of
      substance abuse or dependence but had other lifetime psychiatric diagnoses.
      Twenty-three patients had no history of substance abuse or psychiatric illness.
      No differences in demographic characteristics or in the features of chronic
      fatigue were found among the three groups. Patients with chronic fatigue who had
      a lifetime history of a substance use disorder reported more lifetime depressive
      symptoms and were more likely to have had suicidal ideation or attempts.

PMID- 1743664
TI  - Patterns of contact of patients' families with mental health professionals and
      attitudes toward professionals.
AB  - Previous studies have shown that many relatives of mentally ill persons are
      dissatisfied with their relationships with mental health professionals. In this
      study, 274 relatives or close friends of 168 recently discharged mental patients
      reported on 1,198 separate contacts with mental health professionals during the
      course of the patient's illness. Primary kin, such as parents and spouses, were
      most likely to be in contact with professionals. Different types of professionals
      were more likely to be in contact with relatives at different points in the
      patient's illness. Relatives' satisfaction varied significantly for the different
      types of professionals. Depending on the reason for the contact, 53 to 73 percent
      of the relatives reported being very satisfied or satisfied with the outcome.
      Respondents were most satisfied with their contacts with psychologists, followed
      by nurses, case managers, social workers, and psychiatrists.

PMID- 1743665
TI  - A program to help staff cope with psychological sequelae of assaults by patients.
AB  - Mental hospital staff who are assaulted by patients are at risk of developing
      symptoms associated with posttraumatic stress disorder. The Assaulted Staff
      Action Program (ASAP), a voluntary program, offers support to staff victims of
      patient assaults in a state mental hospital. ASAP team members debrief assault
      victims, assessing the victim's sense of control, social supports, and ability to
      make sense of the incident. A short-term support group is offered. During the
      program's first 90 days, the team responded to 67 assaults. Ten days after the
      assaults, many of the victims had not regained a sense of control, did not have a
      support network, and were unable to make sense of the incident. These factors put
      them at risk for PTSD symptoms. The costs of such a program are discussed.

PMID- 1743666
TI  - Use of inpatient psychiatric care at a VA medical center after implementation of
      a prospective payment system.
AB  - A retrospective audit of patients' utilization of inpatient psychiatric care at a
      Department of Veterans Affairs medical center before and after implementation of
      a prospective payment system compared patterns of utilization by chronic and
      nonchronic patients. It also examined changes over time in the size of the two
      groups, total number of bed days used, mean number of admissions, mean length of
      stay, and mean cumulative two-year length of stay. Four years after
      implementation of the prospective payment system, chronic patients constituted 3
      percent of the patient population but used 15.2 percent of all bed days. Both
      chronic and nonchronic patients had a similar decrease in mean length of stay
      over the period, but chronic patients' mean number of admissions rose by more
      than 70 percent. The mean cumulative two-year length of stay of chronic patients
      remained stable over the period while that of the nonchronic patients decreased
      by 33.2 percent.

PMID- 1743667
TI  - Psychiatry in Zimbabwe.
AB  - Like many developing countries, Zimbabwe has a shortage of trained mental health
      professionals. The country is coping by developing an expanded role for nurses
      and other nonphysician mental health workers and by emphasizing use of medication
      in treating mental illnesses. The authors review traditional Zimbabwean beliefs
      about mental illness and healing and describe culturally specific patterns of
      illness presentation. To reverse the historic pattern in which psychiatric care
      was centralized in cities, Zimbabwe is establishing a countrywide system of
      primary health clinics, part of whose role is to screen and treat common mental
      disorders, educate communities about mental illness, and promote prevention of
      illness.

PMID- 1743668
TI  - Substance abuse among veterans with a diagnosis of schizophrenia.

PMID- 1743669
TI  - A comparison of referrals by police and other sources to a psychiatric emergency
      service.

PMID- 1743670
TI  - A mental health fellowship program in an HMO setting.

PMID- 1743671
TI  - Violence and ECA data.

PMID- 1743672
TI  - Limits on HMO benefits.

PMID- 1743673
TI  - Cost of monitoring clozapine.

PMID- 1743674
TI  - Combining approaches to care.

PMID- 1743675
TI  - The inpatient-outpatient gap.

PMID- 1743676
TI  - Research key element of plan to improve services for severely mentally ill
      persons.

PMID- 1743677
TI  - Data watch. Survey shows diverse demand for rehabilitation.

PMID- 1743678
TI  - This year's most quotable quotes: what health care leaders said about the issues.

PMID- 1743679
TI  - A decade of change: AHA's annual survey traces national trends, 1980-1990.

PMID- 1743680
TI  - Rising voices: how editorial writers looked at health care.
AB  - With attention turning to the nation's domestic problems and the 1992
      presidential election coming up, the last quarter of 1991 saw a marked increase
      in the number of editorials and opinion pieces devoted to health care topics.
      Many newspapers and magazines targeted the broader--and thornier--issue of
      national health care reform, but narrower and no less critical issues also
      received play, including Medicaid underpayment, emergency department overcrowding
      and HIV testing for health care workers.

PMID- 1743681
TI  - Hospitals battle heart attacks with new chest pain centers.
AB  - Chest pain emergency centers are among the most popular new ambulatory care
      services being added in U.S. hospitals. In the past year, at least 80 hospitals
      have added such facilities, bringing the total to about 103 in 33 states,
      according to the Maryland cardiologist who pioneered the concept. Still, it
      remains to be seen whether these facilities will become a reliable long-term
      source of increased admissions.

PMID- 1743682
TI  - Weighing pros, cons of contract rehab services.

PMID- 1743683
TI  - Employee empowerment key to culture change.

PMID- 1743684
TI  - AHA and hospitals take shortcut to Data Bank.

PMID- 1743685
TI  - House bill slashes nurse education funding.

PMID- 1743686
TI  - New HCFA rule calls for electronic cost reports.

PMID- 1743687
TI  - Medicare change could benefit retirees under 65.

PMID- 1743688
TI  - Hospitals apply the lessons of PPS to RBRVS.

PMID- 1743689
TI  - Key discriminators in the manpower equation.

PMID- 1743690
TI  - Pathology trainee manpower: APC program directors' questionnaire, 1989 results.
AB  - The shortage of pathologists is being created by a combination of three factors:
      inadequate trainee recruitment, high trainee attrition, and accelerating
      practitioner attrition. The current report provides comprehensive data on the
      first two factors. The third factor is, by every estimate, likely to become worse
      over the decade beginning in 1988. Demographics show that greater numbers of
      pathologists will be reaching retirement age every year. The trainee attrition
      problem appears to be very serious, and we currently do not have data on why
      residents leave pathology training, when they leave, or where they go (ie, to
      what other specialties, etc). Future APC program directors' questionnaires must
      address these issues. Yet, we must also solve a serious problem in recruitment.
      Currently, about 35% to 38% of all first-year pathology residents decide to enter
      pathology only after entering residency programs in other specialties with the
      intent to remain in that specialty. Therefore, we need to recognize both the
      problem of inadequate recruitment and the problem of high attrition in order to
      address the serious manpower shortage facing pathology. When shortages occur in
      specialties, practitioners tend to cease performing the most time-intensive tasks
      (eg, autopsy). However, shortages of the magnitude predicted for pathology
      suggest that many more tasks traditionally performed by pathologists may very
      well be in jeopardy. In such a setting, other specialties (especially
      subspecialties) are likely to fill the void. This is likely to be catalyzed by
      the emergence of the new resource-based relative-value scale. Subspecialties in
      medicine and surgery will be looking for additional ways to retain income when
      they cannot expect as much for their services as before. This scenario is
      especially worrisome given the necessity for the practice of pathology to expand
      into the domain of molecular biology. Unless problems causing the shortage in
      pathology manpower are addressed, not only are our traditional practices
      threatened, we are also likely to have inadequate manpower to take advantage of
      those areas crucial for the future of pathology.

PMID- 1743691
TI  - Nuclear magnetic resonance in pathology: I. Principles and general aspects.
AB  - Nuclear magnetic resonance (NMR) has become established as a powerful diagnostic
      imaging technique in medicine. The power of NMR as a tool for characterizing
      molecular structure and for quantitative analysis of complex mixtures in the
      clinical laboratory or even in vivo is beginning to be exploited. In the clinical
      laboratory, NMR can analyze the complex mixtures of bodily fluids, intact cells,
      tissues, and their extracts. Phosphorus-31 or 1H NMR spectroscopy in vivo can
      provide a noninvasive probe of high-energy compounds, amino acids, and compounds
      of phospholipid metabolism. The basic principles of NMR spectroscopy are
      presented here, with emphasis on the various NMR parameters and the information
      they provide. A companion article presents a survey of applications in pathology.

PMID- 1743692
TI  - Flow cytometric DNA analysis of human solid tumors: a review of the
      interpretation of DNA histograms.
AB  - A survey of over 225 recent studies examining the relationship between the flow
      cytometric DNA analysis of solid tumors and clinical prognosis indicates that
      criteria used to classify DNA histograms are variable and often inconsistent with
      the recommendations proposed by the Convention on Nomenclature for DNA Cytometry.
      Numerous reports not only lack unambiguous descriptions of the histogram features
      used to differentiate diploid from aneuploid DNA distributions, but also
      inadequately describe the technical aspects of data acquisition, standardization,
      and inclusion or exclusion of subpopulations by gating. In many cases, the
      coefficient of variation of the diploid and aneuploid G0/1 peaks, which would
      allow an assessment of histogram quality, is not reported. Because of the
      differences in DNA histogram interpretation, extrapolation of the results among
      laboratories may be difficult and is probably not reliable. This review
      summarizes the criteria that have been used to classify the DNA histograms and
      illustrates the effects of these different classifiers on DNA ploidy analysis and
      clinical conclusions.

PMID- 1743693
TI  - The two forms of bronchiolitis obliterans in heart-lung transplant recipients.
AB  - Bronchiolitis obliterans has emerged as the major long-term complication of heart
      lung transplantation. We reviewed the histologic findings in lungs obtained from
      11 patients who had received a combined heart-lung transplant at The Johns
      Hopkins Hospital. Ten lungs were obtained at autopsy, and one was obtained from a
      patient who was retransplanted because of severe bronchiolitis obliterans.
      Bronchiolitis obliterans was identified in seven of these 11 lungs. Three of the
      seven lungs with bronchiolitis obliterans were from patients who had received
      their transplants more than 6 months previously; the bronchiolitis obliterans in
      these patients was characterized by a relatively acellular concentric fibrosing
      process that was limited to the terminal bronchioles. The bronchiolitis
      obliterans in these three patients was felt to be secondary to chronic lung
      allograft rejection. Four of the seven patients with bronchiolitis obliterans had
      received their transplants less than 6 months previously; the bronchiolitis
      obliterans in these patients was focal and cellular. It extended into the distal
      alveolar spaces and, in several cases, was associated with aspirated material and
      foreign body-type giant cells. All four of these patients had concurrent
      infections, aspiration, or large airway obstruction, which were felt to be
      responsible for the development of bronchiolitis obliterans. Bronchiolitis
      obliterans in lung allograft recipients may have a variety of etiologies, and the
      etiology of this process in a particular case can often be deduced by the
      morphologic appearance of this lesion.

PMID- 1743694
TI  - Hepatic pathology in pediatric acquired immunodeficiency syndrome.
AB  - In a retrospective study we assessed the hepatic changes in children with the
      acquired immunodeficiency syndrome by reviewing 12 biopsy specimens and 48
      autopsy specimens from 54 children. Hepatopathology differed in biopsy and
      autopsy material. In biopsy specimens, chronic active hepatitis with
      predominantly T8 lymphocytes by tissue immunochemistry was common (five of 12
      specimens). Fatty degeneration and hepatocellular necrosis were either absent,
      mild, or patchy. On the other hand, at autopsy, chronic active hepatitis was not
      observed. The most prominent changes were extensive fatty degeneration,
      nonspecific portal mononuclear infiltration, portal fibrosis, and confluent
      (ischemic) necrosis. Opportunistic infections such as Mycobacterium avium
      intracellulare (MAI) were noted only at autopsy. In addition, three unusual
      morphologic characteristics were noted: nodular lymphoplasmacytic portal
      infiltrate, a pseudosarcomatous variant of Mycobacterium avium-intracellulare
      infection, and multinucleated giant cells (foreign both type and giant cell
      transformation of hepatocytes).

PMID- 1743695
TI  - Mineral-associated hepatic injury: a report of seven cases with X-ray
      microanalysis.
AB  - The patterns of hepatic injury associated with various minerals were studied in
      seven patients. The subjects included one patient who was a sandblaster (silica
      by inhalation), one patient who was a dental laboratory technician (silica and
      chromium-cobalt alloy by inhalation), one patient with inhalational talcum powder
      abuse, and four chronic intravenous (IV) drug abusers (talc by IV injection). In
      all cases, the liver was examined by light and polarizing microscopy, and by
      scanning electron microscopy with energy-dispersive x-ray microanalysis. In the
      two patients with silica exposure, silica-containing sclerohyaline nodules were
      diffusely present in portal tracts and lobules. Both chromium-cobalt alloy and
      silica were present in the dental technician. In contrast, in all cases of talc
      exposure, aggregates of talc-laden macrophages were present in portal and
      centrilobular areas. Three IV drug abusers and the talcum powder abuser had
      histologic evidence of chronic hepatitis, most probably of viral etiology. We
      conclude that mineral type plays an important role in the pathogenesis and
      fibrogenesis of hepatic lesions. Compared with silica, talc primarily elicits a
      macrophage response without granuloma formation or fibrosis. Hepatic silicosis is
      a rare complication in dental laboratory technicians, and chromium-cobalt alloy
      may contribute to hepatic injury and fibrosis in this setting.

PMID- 1743696
TI  - The pleomorphic xanthoastrocytoma and its differential diagnosis: a study of five
      cases.
AB  - Five brain tumors with the histopathologic features of pleomorphic
      xanthoastrocytomas (PXAs) are presented. Computed tomography scans showed a
      remarkable homology. Two cases had atypical localizations for a PXA, while one 46
      year-old patient did not conform to the normal age distribution of this tumor.
      Nevertheless, in these cases, the histopathology was always characteristic for
      PXA, a remarkable pleomorphism, in addition to simultaneous expression of glial
      fibrillary acidic protein and histiocytic markers in the various tumor cells. In
      one of the presented tumors, however, clusters of neoplastic neuronal cells were
      also found. In this particular case, differential diagnostic criteria to
      distinguish between a PXA and a desmoplastic infantile ganglioglioma are lacking.

PMID- 1743697
TI  - Significance of the smooth muscle cell component in Peutz-Jeghers and juvenile
      polyps.
AB  - We have previously reported the presence of smooth muscle cells (SMCs) in the
      lamina propria of both tubular and villous adenomatous polyps. In the current
      study, we investigated the presence and distribution of SMCs with
      immunohistochemical techniques using anti-alpha smooth muscle actin and anti
      desmin antibodies on a series of hamartomatous polyps. In five Peutz-Jeghers
      polyps, large tree-like branches of SMCs were observed, while in 13 juvenile
      polyps, rare elongated SMCs were found in the lamina propria, partially
      surrounding cystically dilated glands. Apart from the quantitative differences,
      the SMC distribution was similar in the two types of hamartomatous polyps and not
      dissimilar from the pattern described in neoplastic polyps. These findings make
      the category "juvenile polyp" less clear and its differentiation from other
      histologic types of polyp less sharp. Thus, the presence or absence of SMCs
      cannot form the basis of the differential diagnosis between adenomatous and
      hamartomatous polyps.

PMID- 1743698
TI  - Rhabdomyolysis associated with cocaine abuse.
AB  - There have been recent reports of rhabdomyolysis associated with cocaine abuse.
      The pathologic findings from these cases have not been described. Pathologic
      abnormalities in two fatalities with cocaine-associated rhabdomyolysis, including
      one with hyperpyrexia, acute renal failure, and disseminated intravascular
      coagulation, are discussed in detail. Skeletal muscle in both cases showed
      necrosis without evidence of vasculitis, polarizable foreign crystals, or other
      specific lesions. The individual with renal failure showed acute tubular necrosis
      with granular myoglobin casts in tubules. The mechanism of cocaine-associated
      rhabdomyolysis is unclear, but potentially includes ischemia due to
      vasoconstriction, direct toxicity, hyperpyrexia, and increased muscle activity
      from agitation or seizure. Adulterants may also play a role. In unexplained cases
      of rhabdomyolysis, toxicologic evidence of cocaine should be sought. In those
      cases of rhabdomyolysis associated with acute renal failure, the presence of
      cocaine in blood may be prolonged because of impaired renal clearance.

PMID- 1743699
TI  - Flow cytometric study of nodular fasciitis, proliferative fasciitis, and
      proliferative myositis.
AB  - DNA ploidy was assessed retrospectively, using flow cytometry, in 13 nodular
      fasciitis (NF) lesions, three proliferative myositis (PM) lesions, one
      proliferative fasciitis lesion, and 12 other benign fibrous lesions (BFLs). All
      were diploid. In view of the large amounts of cellular debris, cell cycle
      analysis was possible in only seven NF lesions, three PM lesions, and six BFLs.
      The mean percentage of S phase did not differ markedly between the combination of
      NF and PM lesions (6.6%) and BFLs (7.1%); the mean percentage of G2 + M phase
      (5.4%) of the NF/PM lesion combination was twice as large as that of the BFLs
      (2.5%). No correlation was detected between the cell cycle analysis and the
      mitotic count, the predominant histologic type in NF lesions, or the predominant
      stroma in PM lesions.

PMID- 1743700
TI  - Angiocentric immunoproliferative lesions: a molecular analysis of eight cases.
AB  - Angiocentric immunoproliferative lesions (AILs) are believed to represent a
      unique type of extranodal malignant lymphoma on the basis of clinicopathologic
      and immunophenotypic evidence. However, molecular studies to assess clonality
      have been performed on a small number of cases. In this study we assessed the
      clonality of eight AILs using restriction fragment analysis, the Southern blot
      technique, and probes to assess the configuration of the T-cell receptor beta,
      gamma, and delta chain genes and the immunoglobulin heavy and K light chain
      genes. In addition, the presence of the Epstein-Barr (EB) viral genome was
      assessed by using both Southern blot analysis (seven cases) and polymerase chain
      reaction amplification (five cases). Our results demonstrate that gene
      rearrangements are rare in AILs. A clonal gene rearrangement was identified in
      only one case, a grade III AIL with a rearrangement of the T-cell receptor delta
      chain gene. In two additional AILs (both grade III), the EB viral genome was
      detected as a single band by Southern blot analysis with a probe derived from the
      terminal repeat region of the virus, suggesting that a single episomal
      configuration of the EB viral genome was present in each case, as would occur in
      a clonal population of infected cells. In the remaining cases there was no
      evidence of clonality, although EB sequences were detected in one of four cases
      using the polymerase chain reaction. The rarity or absence of gene rearrangements
      in AILs is difficult to explain if AILs are malignant, presumably monoclonal
      lymphomas. However, their frequent association with the EB virus may suggest an
      analogy between AILs and lymphoproliferative disorders that occur in
      immunosuppressed patients. These findings further emphasize the unique
      clinicopathologic aspects of AILs and may also be useful diagnostically in the
      differential diagnosis of lymphoproliferative disorders.

PMID- 1743701
TI  - Double muscularis mucosae in Barrett's esophagus.
AB  - To clarify the histology and morphogenesis of the double muscularis mucosae in
      Barrett's esophagus, eight specimens resected from patients with Barrett's
      esophagus were compared histopathologically with 352 specimens resected from
      patients without Barrett's esophagus. A double muscularis mucosae was observed in
      seven (87.5%) of the eight cases with Barrett's esophagus, but in none of the 352
      cases without Barrett's esophagus. The mucosa in the segment of Barrett's
      esophagus consisted of columnar epithelium, a superficial lamina propria, a
      superficial muscularis mucosae, a deep lamina propria, and a deep muscularis
      mucosae. The distal end of the superficial muscularis mucosae was connected to
      the deep muscularis mucosae at the esophagogastric junction, and its proximal end
      was located in fibrous tissue below the squamocolumnar junction of the mucosal
      epithelium or the distal edge of the erosive lesion. The deep muscularis mucosae
      in the portion with Barrett's esophagus was continuous with the original
      muscularis mucosae of the proximal esophagus and muscularis mucosae of the
      stomach. Barrett's esophagus is considered to be not merely a metaplastic lesion
      within the epithelium, but a newly developed lesion containing columnar
      epithelium, lamina propria, and a superficial muscularis mucosae on the lamina
      propria of the esophageal mucosa.

PMID- 1743702
TI  - Paraganglioma of the urinary bladder: immunohistochemical, ultrastructural, and
      DNA flow cytometric studies.
AB  - Primary paraganglioma arises infrequently in the urinary bladder. We present the
      clinicopathologic, immunohistochemical, ultrastructural, and DNA flow cytometric
      findings in three cases (one man and two women). Ages at diagnosis were 19, 35,
      and 45 years. One female presented with paroxysmal headaches and hypertension
      that followed urination; the remaining two patients presented with hematuria.
      Immunohistochemical studies revealed positive reactivity for chromogranin (three
      patients), met-enkephalin (three), leu-enkephalin (three), vasoactive intestinal
      polypeptide (two), serotonin (one), and S-100 protein (one; sustentacular cells
      only). Neurosecretory granules were identified in all cases; in the patient with
      hypertension, the granules were small with eccentric cores similar to those of
      adrenal pheochromocytomas. A nondiploid DNA flow cytometric pattern was present
      in all three patients, an aneuploid pattern was present in two, and a tetraploid
      pattern was present in one. After diagnosis, one patient was alive without
      progression at 7 years, one died of an uncertain cause at 5 years, and one
      suffered multiple recurrences over a 24-year period before developing metastatic
      disease. While the presence of aneuploidy has been shown to be a predictor of
      malignant behavior in adrenal pheochromocytomas, our study illustrates that DNA
      ploidy cannot be used as a diagnostic criterion for malignancy in urinary bladder
      paraganglioma.

PMID- 1743703
TI  - Malignant ileal carcinoid with metastasis to adenocarcinoma of the ovary.
AB  - Metastasis of one tumor to another is an intriguing and rare phenomenon. Lung and
      breast malignancies are common donor tumors, while renal cell carcinoma and
      meningioma serve as frequent recipients. We report a case of malignant carcinoid
      of the ileum with metastasis to adenocarcinoma of the ovary. Histologic
      examination of the ovary showed a clear dimorphic pattern consisting of uniform
      polygonal cells arranged in an insular pattern and highly pleomorphic epithelioid
      cells forming small glands or solid nests. Immunocytochemical studies firmly
      established the distinct identity of the two tumors.

PMID- 1743704
TI  - Signet-ring chondrosarcoma: a new morphologic entity.
AB  - A 65-year-old, otherwise healthy white man presenting with an asymptomatic
      anterior chest wall mass diagnosed from a routine preoperative chest x-ray is
      reported. A fine needle aspirate of the mass was initially interpreted as a
      metastatic adenocarcinoma with prominent "signet-ring" features, but
      ultrastructural study of the cell block later suggested a chondrosarcoma. The
      resected surgical specimen confirmed the diagnosis of a grade 2 chondrosarcoma,
      with most of the tumor cells containing a large, clear, single vacuole shown to
      be lipid. The positive immunostaining for vimentin and S-100 as well as the
      ultrastructural appearance confirmed the diagnosis of a chondrosarcoma. Flow
      cytometric DNA analysis of the tumor on two separate occasions documented a very
      large aneuploid cell population (50% to 60%) which, when interpreted with the
      histologic appearance, suggested an aggressive tumor. This case illustrates the
      first published example of a "signet-ring" chondrosarcoma.

PMID- 1743705
TI  - Pigmented adrenal pheochromocytomas.

PMID- 1743706
TI  - The family and HIV.
AB  - The impact of HIV and AIDS on the family is described, with particular focus on
      the situation where the child is the first member of the family to be diagnosed.
      The results of the social stigma, the effect on relationships together with the
      global, economic and cultural aspects of the disease make it unique. These issues
      are discussed and an integrated approach to confidentiality, the provision of
      services for families and involvement of the community is described.

PMID- 1743707
TI  - Clinical, virological and immunological features of primary HIV-1 infection.

PMID- 1743708
TI  - Declining trends in some sexually transmitted diseases in Belgium between 1983
      and 1989.
AB  - OBJECTIVE: To examine trends in some sexually transmitted diseases in Belgium and
      to discuss them in the light of the European background. DESIGN: Analysis of the
      time trends of C trachomatis and N gonorrhoeae infections diagnosed by a network
      of microbiological laboratories, and of male urethritis diagnosed by a network of
      general practitioners. SETTING: Belgium. SUBJECTS: Reports of C trachomatis and N
      gonorrhoeae infections by a network of microbiological laboratories, and of male
      urethritis by a network of general practitioners, to the Institute of Hygiene and
      Epidemiology. RESULTS: Whereas an increase in the number of C trachomatis
      infections, more pronounced among women, was observed up to 1986, a small
      decrease has been observed afterwards in males. The mean number of chlamydial
      infections per laboratory and per year was 4.2 in 1983, 15.7 in 1986 and 13.9 in
      1989. A decrease in the number of N gonorrhoeae infections, more pronounced among
      men, has been observed. The mean number of cases of gonorrhoea per laboratory and
      per year was 10.9 in 1983 and only 2.2 in 1989. The same declining trend has been
      observed in another surveillance programme of male urethritis, based on a network
      of general practitioners. The number of cases of male urethritis per 100 patient
      encounters went down from 0.06 in 1982-3 to 0.04 in 1988-9. CONCLUSION: The
      declining trend in Western Europe in incidence of gonococcal infections and of
      urethritis in men is also occurring in Belgium, but genital chlamydial infections
      remain an important public health problem.

PMID- 1743709
TI  - The importance of ethnicity as a risk factor for STDs and sexual behaviour among
      heterosexuals.
AB  - OBJECTIVES: To study risk factors for sexually transmitted diseases (STDs) and
      sexual behaviour. Especially to assess whether there is a higher risk of being
      infected with STDs among ethnic minorities, and if so for what reasons. SETTING:
      STD-clinic of the Municipal Health Service of Amsterdam, the Netherlands.
      SUBJECTS: Cross-sectional study of heterosexuals (255 men and 343 women) with
      multiple sexual partners, who participated between October 1987 and January 1990.
      RESULTS: Besides STD-related complaints, ethnicity was an important independent
      predictor of one or more diagnosed genital STDs. STD-prevalence was higher among
      men born in Turkey (47%, OR = 3.4) and men born in Surinam (36%, OR = 2.1),
      compared with Dutch men (21%). While Turkish men had mainly riskful sexual
      behaviour with prostitutes, Surinam men had more often riskful sexual contact
      with private partners. Among women, STD prevalence was higher among West-European
      (38%, OR = 2.3) and Latin-American women (30%, OR = 1.6), compared with Dutch
      women (21%). Latin American women had more often riskful sexual contact with
      clients; sexual behaviour of West-European women was riskful with both clients
      and private partners. CONCLUSIONS: Prevention activities should be directed at
      specific sexual and ethnic groups, sources of information should be carefully
      selected, and some groups should be addressed differently with regard to language
      but to content as well.

PMID- 1743710
TI  - A survey of female prostitutes at risk of HIV infection and other sexually
      transmissible diseases.
AB  - OBJECTIVE: To determine risk factors for the transmission of human
      immunodeficiency virus (HIV), including injecting drug use (IDU), sexual
      behaviour and other sexually transmissible diseases (STDs), in female prostitutes
      who attended the Sydney Sexual Health (previously STD) Centre. DESIGN: We
      surveyed by questionnaire 231 (47%) of 491 female prostitutes who visited the
      Centre over a 19 month period from 1986 to 1988. All were tested for HIV
      antibody. MAIN OUTCOME: All the women were seronegative for HIV but a number of
      major risk factors for infection were identified. RESULTS: Seventeen of 26 (65%)
      current injecting drug users had shared needles in the previous 6 months.
      Nineteen per cent of those surveyed had bisexual non-paying partners and 21% had
      partners who injected drugs. Sixty nine per cent always used condoms for vaginal
      intercourse with paying clients, but they were rarely used with non-paying
      partners. Condom use was also rare for anal intercourse with clients and/or
      partners by those (18%) who practised it. Seventeen per cent used condoms alone
      for contraception and 48% relied on oral contraceptives. We found a reduction in
      gonorrhoea, herpes and trichomoniasis when compared with a 1985 study conducted
      at the same Centre. However, there was an increase in reported abnormal cervical
      cytology. CONCLUSION: In spite of behaviour change by some, there are still many
      women working as prostitutes in Sydney who remain seriously at risk of HIV
      infection. We recommend more widespread use of barrier methods of contraception,
      intensified efforts to prevent the sharing of intravenous needles, closer
      monitoring of the health of prostitutes, and scientific study of their paying and
      non-paying sexual partners.

PMID- 1743711
TI  - Characterisation of PPNG and non-PPNG Neisseria gonorrhoeae isolates from
      Singapore.
AB  - OBJECTIVE: To characterise Neisseria gonorrhoeae isolates from Singapore. DESIGN:
      Characterisation of Neisseria gonorrhoeae isolates by auxotyping, serological
      analysis and plasmid profile analysis. SPECIMENS: Sixty randomly collected
      isolates from 41 symptomatic, untreated males and 19 female prostitutes were
      studied. RESULTS: Auxotyping of 25 PPNG and 35 non-PPNG strains showed that the
      Pro-auxotype was prevalent among both PPNG (56%) and non-PPNG (42.5%) strains.
      Prototrophic strains comprised 28% of PPNG and 32.5% of non-PPNG strains
      respectively. Serovar analysis showed that with the exception of seven serogroup
      WI strains, the majority belonged to serogroup WII/III. Serovar Aedih was
      predominant among both serogroup WI PPNG (80%) and non-PPNG (100%) strains.
      Serogroup WII/III PPNG strains were represented by nine serovars with the
      predominant serovars being Bacjk (28%) and Bcgjk (16%). Eleven serovars were
      identified in the WII/III non-PPNG strains and the major serovars were Bajk
      (20%), Bacjk (17%), Back (11.4%) and Beghjk (11.4%). Analysis of the 25 PPNG
      strains showed that 16 of them carried the 4.4 MDa (Asian type) resistance
      plasmid and nine strains harboured the 4.4 MDa plasmid in conjunction with the
      24.5 MDa transfer plasmid. The cryptic plasmid of 2.6 MDa was present in 27 of
      the 35 non-PPNG strains. Five of the non-PPNG strains harbouring the cryptic
      plasmid also contained the 24.5 MDa transfer plasmid. The plasmid combination of
      2.6 + 7.8 + 24.5 MDa was detected in three non-PPNG strains. CONCLUSION: The
      combination of epidemiological methods used in this study indicated the
      heterogeneity of N gonorrhoeae strains in Singapore. A total of 16 different
      combinations of auxotype, plasmid profile and serovar were seen in the 25 PPNG
      strains compared with 24 such combinations in the 35 non-PPNG strains. Such
      sensitive differentiation would otherwise not be possible using either auxotype
      serovar (A/S) or auxotype-plasmid analysis.

PMID- 1743712
TI  - A comparison of interferon alfa-2a and podophyllin in the treatment of primary
      condylomata acuminata. The Condylomata International Collaborative Study Group.
AB  - OBJECTIVES: to compare the response to treatment and recurrence rate of
      condylomata accuminata using subcutaneous injection of interferon alfa 2a 1.5
      million units three times weekly for four weeks, or podophyllin resin 25% applied
      to lesions twice weekly for up to six weeks. DESIGN: Randomised open study.
      SETTING: Multicentre European study in genitourinary medicine,
      dermatovenereology, and gynaecology departments. PATIENTS: 87 males and 67
      females with condylomata acuminata for less than six months and no history of
      previous treatment. MAIN OUTCOME MEASURES: Complete clearance of lesions and
      evidence of recurrence at three months and nine months after treatment commenced.
      RESULTS: A complete response was achieved at three months in 15 of 64 (23%) in
      the interferon treated group, and 31 of 69 (45%) in the podophyllin treated group
      (p = 0.003). At nine months 10 of 13 patients in the interferon group and 22 of
      30 patients in the podophyllin group remained completely clear of lesions.

PMID- 1743713
TI  - HLA antigens in donovanosis (granuloma inguinale).
AB  - OBJECTIVE: To compare the frequencies of HLA antigens in patients with
      donovanosis and in controls. DESIGN: HLA Class I, Class II and DQ antigens were
      detected in patients with genital ulceration caused by donovanosis and in a
      control group. SETTING: City Health STD Clinic, King Edward VIII Hospital,
      Durban, South Africa. Participants--Sixty (47 men, 13 women) patients with
      donovanosis. RESULTS: HLA B57 was detected in nine of 60 (15%) with donovanosis
      and 75 of 1478 (5.1%) controls (RR = 3.3 chi 2 = 11.0, p = 0.001, p corrected =
      0.026). CONCLUSIONS: A possible link between donovanosis and HLA B57 could be
      explained by coexisting alleles or immune response genes in linkage
      disequilibrium altering disease susceptibility.

PMID- 1743714
TI  - Ultrastructural aspects of infection with Treponema pallidum subspecies pertenue
      (Pariaman strain).
AB  - OBJECTIVE: To study ultrastructural aspects of infection with Treponema pertenue
      (Pariaman strain), originating from West Sumatra, Indonesia. MATERIALS AND
      METHODS: Biopsy material originating from skin lesions in ten young children
      suffering from early infectious yaws in Indonesia, and rabbit testicular tissue
      inoculated with T pertenue. Human skin as well as rabbit testicular tissue was
      examined by means of conventional electron microscopy. RESULTS: In human skin,
      treponemes were found in interepidermal spaces in 5 out of 10 specimens. In two
      of five positive specimens, treponemes were also seen in the dermis. In one out
      of five specimens from rabbit testicular tissue a profusion of treponemes was
      found lying in the interstitial myxomatous tissue. Microorganisms showed no
      adhesion to fibroblasts. CONCLUSION: This ultrastructural study of T pertenue
      demonstrated the scarcity and focal distribution of treponemes in tissue and did
      not reveal any morphological differences from the Gauthier strain of T pertenue.
      No differences from the ultrastructure of T pallidum were observed either.

PMID- 1743715
TI  - An analysis of false positive reactions occurring with the Captia Syph G EIA.
AB  - AIM: The Captia Syph G enzyme immuno assay (EAI) offers the potential for the
      rapid automated detection of syphilis antibodies. This study was designed to
      assess the role of other sexually transmitted diseases (STDs) in producing false
      positive reactions in the Captia Syph G EIA. The role of rheumatoid factor (RF)
      as a potential source of false positives was also analysed. METHODS: Patients who
      attended a genitourinary medicine (GUM) department and gave a false positive
      reaction with the EIA between 1988 and 1990 were compared with women undergoing
      antenatal testing and with the control clinic population (EIA negative) over the
      same time period. The incidence of sexually transmitted disease (STD) in the
      clinic population and the false positive reactors was measured in relation to
      gonorrhoea, chlamydia, genital warts, candidiasis, "other conditions not
      requiring treatment" and "other conditions requiring treatment." Male: female sex
      ratios were also compared. Ninety two RF positive sera were analysed with the
      EIA. RESULTS: The rate of false positive reactions did not differ with respect to
      the diagnosis within the GUM clinic population. The antenatal group of women,
      however, had a lower incidence of false positive reactions than the GUM clinic
      group. No RF positive sera were positive on Captia Syph G EIA testing.
      CONCLUSIONS: There is no cross reaction between Captia Syph G EIA and any
      specific STD or with RF positive sera. The lower incidence of false positive
      reactions in antenatal women is unexplained but may be related to physiological
      changes associated with pregnancy.

PMID- 1743716
TI  - Multiple prostatic abscesses presenting with urethral discharge.
AB  - Prostatic abscess has become less common, is now usually related to urinary tract
      infection, and is a rare cause of urethral discharge. The case is described of a
      man with prostatic abscesses caused by Staphylococcus aureus possibly related to
      recent skin abrasions. Transrectal ultrasound was used to make the diagnosis and
      to facilitate repeated drainage with a successful outcome.

PMID- 1743717
TI  - HIV encephalopathy presenting as hypomania.

PMID- 1743718
TI  - The Gist-Brocades travelling fellowship, 1990.

PMID- 1743719
TI  - Should training in colposcopy be obligatory in higher specialist training in
      genitourinary medicine?

PMID- 1743720
TI  - HIV infection in Tirupati, India.

PMID- 1743721
TI  - Endemic syphilis in Bulgaria.

PMID- 1743722
TI  - Incidence of Neisseria gonorrhoeae and Chlamydia trachomatis infections in
      Strasbourg over 8 years.

PMID- 1743723
TI  - Female paraurethral ducts and glands as the sites of agents of sexually
      transmitted diseases.

PMID- 1743724
TI  - Treatment of genital herpes with chlorous acid releasing gel.

PMID- 1743725
TI  - Nd:Yag laser treatment of extensive recalcitrant anal condyloma acuminata.

PMID- 1743726
TI  - Complications of treatment for cryptosporidial diarrhoea.

PMID- 1743727
TI  - Cervical infection with Chlamydia trachomatis.

PMID- 1743728
TI  - Syphilis and the elderly.

PMID- 1743729
TI  - Frequency analysis of the electrocardiogram with maximum entropy method for
      identification of patients with sustained ventricular tachycardia.
AB  - Late potentials in the terminal phase of the QRS-complex during sinus rhythm have
      been proposed to identify a subgroup of patients with myocardial infarction at
      risk of ventricular tachycardia (VT). Frequency analysis of the ECG with Fourier
      transform (FFT) has been applied for detection of these microvolt level signals,
      but is limited by poor frequency resolution of short data segments and spectral
      leakage. We therefore developed frequency analysis using the maximum entropy
      method (MEM) based on an autoregressive (AR) model. Orthogonal electrocardiograms
      were recorded from the body surface of patients with and without VT, and healthy
      persons after low noise, high-gain amplification. Multiple 40 ms segments (time
      intervals 2 ms, AR-parameters tapered) were analyzed (spectrotemporal mapping):
      low-frequency components were eliminated by building difference spectra with
      optimal high order and fixed low order. The MEM-spectra revealed high frequency
      components (40-200 Hz) in the terminal phase of the QRS-complex and in the ST
      section in 26/38 patients with VT, but only in 2/20 without VT and in 1/20
      healthy persons (p less than 0.05). Unlike FFT, MEM allowed localization of late
      potentials by the analysis of short data segments. Thus, MEM offers promise for
      noninvasive identification of patients with sustained VT after myocardial
      infarction and detailed analysis of late potentials.

PMID- 1743730
TI  - Optimal a posteriori time domain filter for average evoked potentials.
AB  - Evoked potentials measured with scalp electrodes are often described as a
      deterministic process corrupted by unrelated noise. The common procedure to
      determine the signal is to average N repetitive measurements. By obtaining
      additional information from the N measurements, signal detection can be improved.
      An algorithm that estimates the signal autocorrelation from N given measurements
      is proposed. The estimator is consistent and unbiased, and its variance tends to
      0 as o(N). Two filters that are applied to the average response are introduced.
      Both depend on the estimation of the signal and the noise autocorrelations. One
      filter is based on the assumption that the average response is a stationary
      process. The second filter coefficients are obtained by minimizing the mean
      squared error (MSE) of an optimal filter of a nonstationary process applied on a
      single sweep. When a small number of sweeps are averaged, the stationary
      assumption is adequate, and the MSE of the stationary optimal filter is two to
      five times less than the MSE of the average response. When a large number of
      measurements are considered, the error in estimating the autocorrelations
      decreases. In this case, applying the optimal filter for a nonstationary process
      leads to a significant improvement in the signal estimation.

PMID- 1743731
TI  - Nonlinear system identification by m-pulse sequences: application to brainstem
      auditory evoked responses.
AB  - The purpose of this paper is to introduce a method for characterizing the
      nonlinear behavior of the auditory system. The method uses an m-pulse sequence as
      the stimulus and employs a general nonlinear framework for the auditory system.
      Like Sutter's binary m-sequence approach, the m-pulse sequence approach is
      computationally efficient since calculation of the first-order input-output cross
      correlation function is all that is necessary for obtaining the nonlinear
      characteristics of the system. The nonlinear system characteristics are reflected
      in pulse kernels in contrast to binary kernels associated with the binary m
      sequence approach. By assuming the system under study is a third-order nonlinear
      system, binary and pulse kernels are shown to be related to Volterra kernels. The
      results suggest that the m-pulse sequence can be used to study the system
      nonlinear effects of varying the stimulus repetition rate more effectively than
      conventional methods. Preliminary physiological data obtained by applying m-pulse
      sequences to the brainstem auditory evoked response (BAER) clearly illustrates
      the feasibility of obtaining replicable evoked responses using this method.

PMID- 1743732
TI  - Information contained in sensory nerve recordings made with intrafascicular
      electrodes.
AB  - Multiunit recordings were made in anesthetized cats with chronically implanted
      intrafascicular electrodes over a period of six months. Neural signals recorded
      with these electrodes consisted of activity in sensory fibers innervating a
      variety of cutaneous mechanoreceptors. Mechanical stimuli were used to
      selectively activate individual nerve fibers, and the receptive field and
      receptor type were identified for each unit. Over a period of six months, there
      was a net shift in the recorded population, but the electrodes continued to
      provide a representative sample of the activity in the fascicle as a whole. The
      total number of units from which activity could be recorded remained roughly
      constant with time, and individual units persisted in the recordings for up to
      six months. These results indicate that intrafascicular electrodes could be used
      to sample information carried by individual somatosensory fibers on a long term
      basis.

PMID- 1743733
TI  - Influence of tissue inhomogeneities on noninvasive muscle fiber conduction
      velocity measurements--investigated by physical and numerical modeling.
AB  - The determination of conduction velocity in the muscle fibers of single motor
      units from noninvasive recordings of single motor unit action potentials can be
      improved by the method of spatially filtering multielectrode EMG. The use of this
      conduction velocity as a diagnostic tool requires a high reliability of the
      detected values. However, experiments did reveal that the measured conduction
      velocity values showed remarkably high fluctuations depending on the recording
      site along the muscle fibers which could not be attributed to the influence of
      the endplate and tendon region. The present work examines the hypothesis that the
      observed fluctuations in propagation velocity were caused by electrically
      inhomogeneous tissue, regions of different electrical conductivity which are
      located between the excited muscle fibers and the recording electrodes and which
      cause a deformation of the extracellular electric current field. The
      investigation was performed by means of a physical model as well as by finite
      element model calculations. In both models single, simple shaped (cylindrical)
      inhomogeneity regions with a conductivity of 0.1 to 10 times that of the
      surrounding medium and diameters ranging between 1.6 and 2.7 mm were placed
      between excitation sources and recording site. The results indicate that the
      observed conduction velocity fluctuations of up to some 10% can be well
      attributed to inhomogeneity effects of the tissue conductivity. Based on these
      results, one may look for signal processing methods to cut down such fluctuations
      in conduction velocity measurements.

PMID- 1743734
TI  - Computer-aided design of two-dimensional electric-type hyperthermia applicators
      using the finite-difference time-domain method.
AB  - A hyperthermia applicator design tool consisting of a finite-difference time
      domain (FDTD) technique in combination with a graphical display of electric
      fields and normalized linear temperature rise is described. This technique
      calculates, rather than assumes, antenna current distributions; it includes
      mutual interactions between the body and the applicator, and it calculates
      driving-point impedance and power delivered to the applicator. Results show that
      the fundamental limitation of 2-D electric-type applicators is overheating of the
      fat by normal components of the electric field, which exist because of near
      fields and capacitive coupling with the muscle. Two factors which contribute to
      the capacitance are the muscle conductivity and the small antenna size in air.
      Two examples of applicators designed to avoid fat overheating are described: a 27
      MHz segmented dipole for heating large tumors to 7 cm depth, and a 100-MHz dipole
      for small tumors to 5 cm depth. The first uses a water bolus, and the second uses
      a water bolus with low-permittivity strips to reduce normal fields at the antenna
      ends. The results of this study describe fundamental limitations of electric
      field applicators, and illustrate the use of a powerful applicator design tool
      that allows rapid evaluation of a wide range of ideas for applicators which would
      require months and years to test experimentally.

PMID- 1743735
TI  - Eccentric spheres models of the head.
AB  - Equations are derived for electric potentials (electroencephalograms) and
      magnetic fields (magnetoencephalograms) produced by dipolar sources in three
      eccentric spheres models of the head. In these models, I) the thickness of the
      layer representing the skull varies around the model, II) the thickness of the
      scalp layer varies, and III) the electrical conductivity of an eccentric
      spherical "bubble" in the brain region varies. Using these equations, it was
      found that variations in these features of the models have at most only small
      effects on the general spatial patterns of the electric potentials and the radial
      component of the magnetic fields. However, some significant effects on the
      amplitudes were found. The effects of the variations in the skull and scalp layer
      thicknesses on the field amplitudes were found to be significantly smaller than
      on the potential amplitudes. The effects on the field amplitudes of the
      variations in the bubble conductivity were found to be only somewhat smaller than
      on the potential amplitudes. It was also found that the effects of variations in
      these features of the models on source localization accuracy were significantly
      smaller for inverse solutions using fields than for solutions using potentials.

PMID- 1743736
TI  - A model for the cortico-cortical neural interaction in multisensory-evoked
      potentials.
AB  - This paper addresses the methodological problem of enhancing selective responses
      from the central nervous system when two (or more) different sensorial stimuli
      are simultaneously presented to the subject. In particular, contemporaneous
      visual and somato-sensory stimulation is considered and a model of signal and
      noise interaction is developed for the processing of the evoked responses. An
      ARXX parametric model (AutoRegressive with two eXogenous inputs) is introduced
      and a least squares algorithm is used to determine the selective response of the
      two neural systems from the overall evoked response. Such an analysis may be also
      carried out on a sweep-by-sweep basis. Applications of this method are the
      following ones: i) modeling of multisensory potentials; ii) description of
      facilitation or defacilitation phenomena in multitasking experiments; iii)
      analysis of cortico-cortical neural interactions.

PMID- 1743737
TI  - A control method for a nonlinear multivariable system: application to
      interstitial laser hyperthermia.
AB  - An original adaptive control method is presented for controlling a nonlinear
      multivariable system. The method, which could be described as a modified quasi
      linear approach, involves dividing the source excitation into a series of pulsing
      rounds and is implemented as a control algorithm on a computer. The theory
      underlying the method is developed with reference to an application involving
      temperature control in interstitial laser hyperthermia. In this application, the
      method is both successful and necessary to achieve optimally uniform elevated
      temperatures in a ground beef phantom. Apart from variable and parameter
      definitions, the method is otherwise general and might be useful for controlling
      a nonlinear system in which no prior exact characterization of the system is
      possible. Simulations were conducted to assess the effectiveness of the method in
      systems for which the unit excitation response changes by factors ranging from
      zero to three over the total period of excitation. In each case the method has
      proven stable.

PMID- 1743738
TI  - Goniometric motion controller for the superconducting coil in a magnetic
      stereotaxis system.
AB  - For the purpose of positioning the 80 kg, 2 T superconducting coil/cryostat used
      in the developmental version of a magnetic stereotaxis system, a four degree-of
      freedom goniometer has been designed, built, and tested. Computer-controlled,
      stepping motor actuators enable movement of the coil via either joystick,
      keyboard, or translator-module keypad commands. An integral arrangement of
      counterweights and counterbalances minimizes the overall weight and size of the
      goniometer, while maintaining static and dynamic stability during operation. As
      much of the structure as possible has been made of nonmagnetic materials (mostly
      aluminum) to minimize distortion of the superconducting coil's field. In this
      paper, we present the design principles for the goniometer, describe the
      essential features of its construction, and discuss its performance
      characteristics and limitations. We also discuss a strategy for performing
      precision magnetic stereotaxis procedures with an arrangement of static
      superconducting coils.

PMID- 1743739
TI  - A quantitative analysis of pendular motion of the lower leg in spastic human
      subjects.
AB  - The purpose of this study was to examine gravity-induced oscillations of the
      lower leg in normal and spastic subjects, with a view towards evaluating a
      clinical test of spasticity called the "pendulum" test. Motivations for studying
      the pendulum test were to determine if realistic aspects of spasticity and
      neuromuscular control could be incorporated into a description of the motion, and
      to better understand the underlying neurophysiological disturbances in
      spasticity. For passive limb motion (in which no reflex excitation occurred), a
      second-order linear model did not provide an adequate description of the motion
      for either spastic or normal legs. Instead, system equations including nonlinear
      mechanical properties simulating asymmetries in the swing and amplitude dependent
      variations in stiffness and damping provided a more accurate description. For
      spastic limb motion (in which reflex excitation did occur), accurate simulation
      required components accounting for abnormal reflex activation, coinciding with
      the time course of EMG activation. These included increased stiffness and damping
      with their gains related to reflex EMG magnitude, and changes in the rest length
      of the stiffness. Comparison of numerical solutions of the equations with
      experimental data showed our nonlinear model simulated the motion accurately,
      with the variance accounted for usually exceeding 90%.

PMID- 1743740
TI  - A low-cost fiber-optic strain gage system for biological applications.
AB  - A new low-cost strain measurement system has been developed for the mechanical
      testing of biological soft tissues. The technique creates four spots of light on
      a tissue sample surface by piercing the tissue sample with two pairs of small
      light-conducting optical fibers (one pair for each axis of a biaxial stretch),
      terminated by high intensity infrared emitters. A large-area photodiode, located
      below the tissue sample, detects the light emitted from the two pairs of light
      spots. Analog and digital circuitry analyze the current signal from the
      photodiode to determine the position of a light-spot in real time. Each infrared
      emitter is sequentially cycled "on" at a rate of 3 kHz and the resulting
      photodiode current signal, after being converted to a voltage signal, is held by
      an integrated circuit sample and hold amplifier. Analog differencing of pairs of
      light-spot voltage signals provides a final output proportional to the separation
      between coaxial light-spots.

PMID- 1743741
TI  - A water-cooled EM applicator radiating in a phantom equivalent tissue-
      experiments and numerical analysis.
AB  - A prototype of a water-cooled electromagnetic applicator for intracavitary
      hyperthermia has been tested. The temperature distributions produced in a
      polyacrylamide dissipative medium have been shown using liquid crystals. A
      complete electromagnetic and heat transfer model can predict the experimental
      temperatures.

PMID- 1743742
TI  - Laser Doppler velocimetry stabilized in one dimension.

PMID- 1743743
TI  - A clinico-radiological study of secondary mycoses in pulmonary tuberculosis.
AB  - Clinical and radiological differences were compared in Fungus positive (74) and
      negative (66) cases of pulmonary tuberculosis. Cough, expectoration, dyspnoea,
      and fever were marked in former group than that of latter. Anaemia, leucocytosis,
      raised ESR, abnormal radiological shadows and mycetoma in healed cavity were also
      noted in significant number in fungus positive cases.

PMID- 1743744
TI  - Epidermoid cyst of the spleen--with unusual findings. A case report.
AB  - Epidermoid cyst in a six and half year old male child is reported. The cyst was
      quite huge thereby reducing the splenic tissue. Histologically the epithelial
      lining showed dysplastic changes and unusual calcification of the collagenous
      connective tissue.

PMID- 1743745
TI  - Tritium metabolism in man.
AB  - Tritium metabolism in human beings was studied in volunteers who had exposure to
      tritiated water accidentally, by measuring the organically bound tritium with
      liquid scintillation counter, in sperms and plasma proteins. 2% of the initial
      urinary tritium specific activity was incorporated as bound tritium in sperms. In
      plasma proteins, on the 20th day of exposure, tritium bound in globulin was 3
      times higher than that of albumin, tritium bound in globulin was 3 times higher
      than that of albumin.

PMID- 1743746
TI  - Comparison of latex agglutination test with the standard ASO test for
      antistreptolysin O antibodies.

PMID- 1743747
TI  - Startle epilepsy--a case report.

PMID- 1743748
TI  - Height-weight relationship in young healthy Indian girls.
AB  - The relationship between height and weight in young healthy Indian girls (8--18
      years) was developed. It is concluded that the relationship of the form:log w =
      0.98 h + 0.14 holds good to the data on height h (in metres) and weight w (in
      kilograms) for this group of subjects, the logarithm is taken to the base 10. The
      results of the present study show that Ehrenberg's equation of the form : log w =
      0.8 h + 0.4 may not be extended upto the age of 18 years in young healthy Indian
      girls.

PMID- 1743749
TI  - Intestinal parasitism in Himachal Pradesh.
AB  - A total of 1629 cases were included in the study for the presence of intestinal
      parasites during 12 mobile camps in different areas of Himachal Pradesh. 47.08%
      were positive for parasites. The prevalence rate of helminthic parasites was
      32.41% and that of protozoal parasites was 20.81%. The parasitic prevalence has
      been discussed in the light of peculiar geographical situation of the area.

PMID- 1743750
TI  - A possible role of caesium radiations in the control of propagation of hookworm.
AB  - Faeces charcoal mixtures containing eggs of sheep hookworm, Haemonchus contortus
      were exposed to caesium radiations (23 r to 1656 r) from 1st to 7th day of
      incubation. Each plate was exposed only once. A dose related inhibition of
      transformation of eggs to infective larvae was observed. The maximum effect was
      observed on 2nd day of incubation. The radiation has maximum effect on the 1st
      stage larvae followed by 2nd stage. The 3rd stage or ineffective larvae are
      relatively resistant to the effect of radiation.

PMID- 1743751
TI  - A pilot study of parenteral lincomycin therapy in soft tissue infections.
AB  - From our study it is clear that lincomycin, given 300 mg intra muscularly daily
      in a single dose, is effective in a wide range of soft tissue infections
      especially those involving the head and neck region. An overall success rate of
      88.8 per cent was observed in the 150 patients selected for the study. It is
      significant that in none of the subjects was any untoward reaction observed or
      reported. Hitherto all the previous systematic surveys on lincomycin appear to
      have been carried out on bone infections where, undoubtedly, lincomycin is highly
      effective. This pilot study furnishes an encouraging report on the successful
      treatment of soft tissue infections with parenteral lincomycin.

PMID- 1743752
TI  - High vaginal swab(HVS), routine microscopy and culture sensitivity in diabetic
      and non diabetic, a comparative retrospective study of five years.
AB  - Diabetic women are significantly more prone to develop vaginitis (both bacterial
      and fungal) than non diabetic. Among the positive cases predominant bacterial
      isolate being E. Coli. All fungus positive culture yielded the growth of candida
      species. Direct wet film preparation of the fungus positive cases revealed only
      30% were positive for fungus, thus if candida vaginitis is suspected, the
      diagnosis cannot be ruled out on the basis of negative direct preparation. More
      over, diabetics should be advised maintain proper glycaemic control and personal
      hygiene to get rid of this distressing problem.

PMID- 1743753
TI  - Is pulse pressure a stimulus for altered vascular structure in chronic
      hypertension?

PMID- 1743754
TI  - Nerve growth factor synthesis in vascular smooth muscle.
AB  - Details of the interdependent, trophic relation between smooth muscle and its
      neural innervation are not well known despite suggestions that neural influences
      may contribute significantly to hypertensive and other cardiovascular disease.
      Vascular smooth muscle is a major target of innervation by neurons of the
      sympathetic nervous system. Sympathetic neurons depend on a constant supply of
      the potent neurotrophic peptide nerve growth factor. Nerve growth factor
      regulates an impressive list of neuronal and perhaps muscle properties, yet its
      source in vessels and the determinants of its synthesis are not known. We have
      taken advantage of the cytoarchitecture of the aorta to demonstrate that vascular
      smooth muscle cells synthesize nerve growth factor. The survival of cultured
      sympathetic neurons is supported in a nerve growth factor-dependent manner by co
      culture with pure rat aortic vascular smooth muscle cells. Furthermore, pure
      smooth muscle cell cultures contain nerve growth factor-specific messenger RNA.
      Levels of messenger nucleic acid coding for nerve growth factor in smooth muscle
      are regulated by contractile agonists (angiotensin II, arginine vasopressin) and
      the adrenergic agonist phenylephrine. This suggests a link between muscle
      activity and growth factor production. Secretion of nerve growth factor protein
      by vascular smooth muscle was measured using a sensitive two-site immunoassay.
      Secretion is highest during muscle growth. Secretion is elevated by angiotensin
      II and arginine vasopressin but slightly inhibited by phenylephrine. These
      results suggest that cultured vascular smooth muscle can serve as a useful model
      in which to study the cellular regulation of trophic factor synthesis in health
      and disease.

PMID- 1743755
TI  - Regulation of insulin-like growth factor I messenger RNA levels in vascular
      smooth muscle cells.
AB  - We have previously demonstrated specific insulin-like growth factor I (IGF I)
      messenger RNA (mRNA) transcripts in cultured rat aortic smooth muscle cells
      (RASM). To define the role of IGF I in the autocrine growth program of vascular
      smooth muscle cells, we quantitated IGF I mRNA levels in proliferating and
      quiescent (serum-deprived for 48 hours) RASM. IGF I mRNA levels were markedly
      decreased in quiescent cells, and this effect was reversible on reexposure to
      serum. Since platelet-derived growth factor (PDGF) acts synergistically with IGF
      I to stimulate vascular smooth muscle cell growth, we exposed quiescent RASM to
      PDGF AB or BB and quantitated IGF I transcript levels. Both PDGF dimers caused a
      marked, rapid increase in IGF I message levels. To determine whether induction of
      IGF I mRNA levels correlated with secretion of IGF I, we measured immunoreactive
      IGF I in RASM conditioned medium after separation of IGF I binding proteins by
      gel filtration chromatography. PDGF caused a significant increase in IGF I
      release at 24 hours. These findings indicate that IGF I mRNA levels in vitro are
      regulated by serum and by growth factors such as PDGF. Serum deprivation
      reversibly decreases IGF I transcript levels, and exposure of quiescent cells to
      PDGF increases IGF I mRNA levels and IGF I release. Regulation of IGF I
      expression by competence growth factors such as PDGF may play an important role
      in the control of vascular smooth muscle cell growth.

PMID- 1743756
TI  - Lipid bilayer in genetic hypertension.
AB  - Membrane microviscosity, phospholipid composition, and turnover were measured in
      cultured vascular smooth muscle cells isolated from mesenteric arteries of stroke
      prone spontaneously hypertensive and age-matched, normotensive Wistar-Kyoto rats.
      Membrane microviscosity, measured with fluorescence polarization, revealed
      greater microviscosity (lower fluidity) of the membranes isolated from smooth
      muscle cells from hypertensive as compared with those isolated from normotensive
      rats (p less than 0.01). Preincubation of membranes from hypertensive rats with 5
      mM calcium reduced membrane microviscosity in "core" and in "surface" regions of
      the bilayer toward values observed in Wistar-Kyoto rats. Phospholipid composition
      did not differ between intact aortas and cultured mesenteric cells or between
      those tissues obtained from normotensive and from hypertensive rats. The total
      lipid-associated radioactivity was significantly lower in cells from stroke-prone
      spontaneously hypertensive rats than in those from Wistar-Kyoto controls (p less
      than 0.01). Phosphatidylcholine incorporated 70% and phosphatidylinositol 16% of
      total lipid-associated radioactivity, with no difference between cells from
      hypertensive and normotensive animals. Turnover of phosphatidylethanolamine was
      greater in cells from Wistar-Kyoto rats (p = 0.02), whereas turnover of
      phosphatidylserine was greater in cells from stroke-prone spontaneously
      hypertensive rats (p = 0.04). The greater microviscosity of the lipid bilayer in
      hypertension is a generalized defect of the matrix in which the transport
      proteins function. We hypothesize that this defect is responsible for the
      multiple abnormalities of membrane transport systems that have been described in
      genetic hypertension.

PMID- 1743757
TI  - Rise and fall of agonist-evoked platelet Ca2+ in hypertensive rats.
AB  - We previously reported an enhanced peak response of intracellular free Ca2+ to
      thrombin in platelets of spontaneously hypertensive rats in comparison with
      normotensive Wistar-Kyoto rats. In the present study, we compared the platelet
      intracellular Ca2+ response to the receptor-linked agonist thrombin with the
      response to the Ca2+ ionophore ionomycin. Basal intracellular Ca2+ was higher in
      hypertensive platelets as was leakage of fura-2. We confirmed the previous
      finding that the thrombin-induced intracellular Ca2+ peak is greater in platelets
      of hypertensive rats and noted that the rate of recovery from peak intracellular
      Ca2+ is significantly greater in this model. In contrast, the peak platelet
      intracellular Ca2+ response to ionomycin (50 nM and 5 microM) was not different
      between the two strains, and the rate of recovery from the peak response was only
      slightly depressed in hypertensive rats after the low dose of ionomycin. Internal
      Ca2+ discharge capacity, assessed by the intracellular Ca2+ response to a maximal
      dose of ionomycin in Ca(2+)-free medium, was not different between platelets of
      the two strains. Thus, activated platelet intracellular Ca2+ is not altered in
      the hypertensive rat when the nonphysiological ionophore ionomycin is used as
      agonist. However, a heightened intracellular Ca2+ response is observed when the
      receptor-mediated agonist thrombin is used. These results are consistent with the
      hypothesis that differences in receptor-linked second messenger pathways underlie
      the altered intracellular Ca2+ response in platelets of genetically hypertensive
      rats and may contribute to differences both in the mobilization of Ca2+ and in
      its fall.

PMID- 1743758
TI  - Effects of angiotensin subtype 1 and subtype 2 receptor antagonists in
      normotensive versus hypertensive rats.
AB  - The purpose of this study was to examine in vivo the importance of angiotensin
      subtype 1 (AT1) versus subtype 2 (AT2) receptors in spontaneously hypertensive
      (hypertensive) versus normotensive Wistar-Kyoto (control) rats. Intravenous
      infusions of DuP 753, a selective AT1 receptor antagonist, abolished the pressor
      responses to intravenous infusions of angiotensin II in both strains, and the
      potency of DuP 753 in this regard was similar in the two strains. DuP 753 also
      abolished angiotensin II-induced aldosterone release in both strains; however,
      with respect to inhibiting angiotensin II-induced aldosterone release, DuP 753
      was more potent in hypertensive compared with control rats. In hypertensive but
      not control rats, DuP 753 inhibited angiotensin II-induced aldosterone release at
      doses lower than required to inhibit angiotensin II-induced pressor responses.
      Intramesenteric infusions of DuP 753 abolished mesenteric vascular responses to
      intramesenteric infusions of angiotensin II with a similar potency in both
      strains. In control but not hypertensive rats, angiotensin II consistently
      potentiated noradrenergic neurotransmission in the mesenteric vascular bed, and
      this effect of angiotensin II was abolished by DuP 753. High doses of PD123177, a
      selective AT2 antagonist, did not influence any of the aforementioned effects of
      angiotensin II in either strain.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1743759
TI  - Effect of energy-restricted diet on sympathetic muscle nerve activity in obese
      women.
AB  - Twenty obese women aged 45-65 years with borderline hypertension were allocated
      randomly to either a group with an energy-restricted diet or to a control group.
      Body weight, blood pressure, urinary sodium, and urinary excretion of
      norepinephrine and plasma volume were recorded. Resting muscle sympathetic nerve
      activity was measured in the peroneal nerve by tungsten microelectrodes and
      expressed as bursts per minute. These measurements were repeated after 3 days of
      semistarvation and after a body weight reduction of 7% while each patient's
      weight was in a steady state. After 3 days of semistarvation, only body weight
      was reduced, whereas after the long-term energy intake restriction, there were
      reductions of body weight (79.9 +/- 3.4 versus 74.1 +/- 3.4 kg; p less than
      0.001), diastolic blood pressure (93 +/- 3 versus 86 +/- 4 mm Hg; p = 0.01), and
      muscle sympathetic nerve activity (49 +/- 2 versus 42 +/- 3 bursts/min; p less
      than 0.05). Other variables were unchanged. There were no changes in body weight,
      blood pressure, or muscle sympathetic nerve activity in the control group. We
      conclude that body weight decrease in obesity results in a reduction of blood
      pressure that is at least partially caused by a reduction of sympathetic
      vasoconstrictor activity.

PMID- 1743760
TI  - Effects of acute carbohydrate administration on central and peripheral
      hemodynamic responses to mental stress.
AB  - Essential hypertension is closely related to conditions with impaired glucose
      tolerance and hyperinsulinemia. To evaluate a possible interaction between the
      sympathetic nervous system and carbohydrate ingestion on the circulatory
      responses to psychosocial stress, we compared the hemodynamic effects of an oral
      glucose challenge with those observed after placebo in 10 glucose-tolerant,
      normotensive young men at rest and during standardized mental stress. After
      glucose, resting cardiac output increased by 20% (p less than 0.05), which was
      mainly due to an increased heart rate (+14%; p less than 0.001). Since total
      peripheral resistance decreased by 13% (p less than 0.02), mean arterial pressure
      was unaffected by glucose. In spite of this, glucose loading was associated with
      a slight increase in systolic blood pressure and a gradual decrease of diastolic
      blood pressure. Resting forearm blood flow was unaffected by glucose. The stress
      response after placebo was characterized by the expected increase in cardiac
      output and mean arterial pressure, and an unchanged total peripheral resistance.
      By contrast, in the postprandial state the pressor response to stress was solely
      dependent on an increased systemic vascular resistance, and cardiac output was
      unaffected by stress. After glucose, the stress-induced muscular vasodilation in
      the forearm was reduced to 40% of that observed after placebo (p less than 0.01).
      Thus, acute carbohydrate administration has significant hemodynamic effects in
      humans. Furthermore, during the postprandial period there is a marked alteration
      of the pattern of the circulatory responses to psychosocial stress, characterized
      by attenuated muscular vasodilation and a rise in systemic vascular resistance.

PMID- 1743761
TI  - Abnormal renal hemodynamics in black salt-sensitive patients with hypertension.
AB  - African-Americans with essential hypertension are more prone to the development
      of renal failure and are frequently salt-sensitive as well. Because alterations
      of intrarenal hemodynamics are important in the progression of renal disease and
      because salt-sensitive animal models with hypertension manifest a greater
      propensity to develop glomerulosclerosis in association with a rise in glomerular
      capillary pressure, we tested whether the renal hemodynamic adaptation to high
      dietary Na+ intake differs in salt-sensitive and salt-resistant hypertensive
      patients. We studied 17 black and nine white patients with essential hypertension
      who were placed on a low Na+ diet (20 meq/day) for 9 days, followed by a high Na+
      diet (200 meq/day) for 14 days. During the last 4 days of each diet regimen, they
      received 30 mg/day of slow-release nifedipine. Eleven blacks were salt-sensitive,
      and all whites were salt-resistant. During the low Na+ diet period, salt
      sensitive and salt-resistant patients had similar mean arterial pressure,
      glomerular filtration rate, effective renal plasma flow, and filtration
      fraction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1743762
TI  - Sodium excretion and racial differences in ambulatory blood pressure patterns.
AB  - The influence of Na+ excretion and race on casual blood pressure and ambulatory
      blood pressure patterns was examined in a biracial sample of healthy,
      normotensive children and adolescents (10-18 years; n = 140). The slopes relating
      24-hour urinary Na+ excretion to systolic blood pressure were different for both
      black and white subjects for casual blood pressure (p less than 0.001) and blood
      pressure during sleep (p less than 0.03). For casual blood pressure, the slope
      was significant for black subjects (beta = 0.17; p less than 0.001) but not for
      white subjects. For blood pressure during sleep, the slope was again significant
      for black subjects (beta = 0.08; p less than 0.01) but not for white subjects.
      Na+ excretion was also related to awake levels of systolic blood pressure for
      black subjects (beta = 0.08, r = 0.36; p less than 0.01), although the slopes for
      both black and white subjects were not significantly different. Further analyses
      indicated the results were not due to racial differences in 24-hour urinary K+
      excretion. However, plasma renin activity was marginally related to Na+ excretion
      in white subjects (r = 0.22; p less than 0.06) but not black subjects, a finding
      that is consistent with previous studies. Na+ excretion was not associated with
      diastolic blood pressure or heart rate in either group under any condition. The
      results of this study support research that has demonstrated a stronger relation
      between Na+ handling and casual blood pressure in black subjects and extend these
      findings to blood pressure while the subject is both awake and asleep.

PMID- 1743763
TI  - Mutagenicity study of urine from smoking and non-smoking road tanker drivers.
AB  - Urine from 32 road tanker drivers handling petrol, diesel, paraffin and white
      spirit was tested in the Salmonella/microsome mutagenicity system using tester
      strains TA98 anbd TA100. Urine samples were collected before and after tanking
      and were concentrated 250-fold on XAD-2 columns before testing. Controls were 33
      office employees from the same plant. No effect on urinary mutagenicity of
      occupational exposure to petroleum products was found. Significant differences in
      mutagenic effect were demonstrated between smokers and non-smokers.
      Methodological experiments demonstrated a dose/response effect of smoking on
      urinary mutagenicity. A modified test using a preincubation period and an
      increased concentration of bacteria was more sensitive than the standard Ames
      test to mutagens from tobacco smoking.

PMID- 1743764
TI  - Indoor climate and air quality in new offices: effects of a reduced air-exchange
      rate.
AB  - In response to a request from the personnel of a credit bank that had been moved
      into a new building, an evaluation was made of employee health complaints. The
      prevalence of symptoms was determined using a self-administered questionnaire.
      Ventilation effectiveness, contaminant concentrations (which included chemicals
      and bioaerosols) and microclimate were studied to establish their relationship to
      environmental discomfort and to the health problems mentioned by the employees.
      Indoor air quality--which was assessed in different seasons--revealed relatively
      high levels of carbon dioxide and bioaerosols in areas occupied by employees as
      compared with other places. Temperature and humidity were considered to be
      satisfactory. Although a causative agent was not isolated, the authors conclude
      that an ineffective rate of room air exchange, possibly in interaction with
      chemical contaminants, may be responsible for the discomfort and, perhaps, for
      the health symptoms experienced by workers in fully enclosed rooms.

PMID- 1743765
TI  - Work load and physiological responses during asbestos removal with protective
      clothing.
AB  - The removal of asbestos-containing building materials requires the use of dust
      repelling protective clothing and a respirator. The present study was aimed at
      measuring physiological responses to asbestos removal in actual work situations.
      The subjects were eight asbestos workers. During the work, the men wore permeable
      or impermeable clothing along with a powered or non-powered filtering device
      including a full-face or half-face mask. Environmental parameters, work postures,
      heart rate (HR), the skin temperature at two sites and the rectal temperature
      were recorded every minute during work. Perceived exertion, thermal sensation,
      thermal comfort, and skin wetness were rated by the subjects. The ambient
      temperature at work sites ranged from 19 degrees to 37.5 degrees C and relative
      humidity, from 21% to 50%. The mean HR ranged from 101 to 141 beats min-1. The
      calculated (from HR measurements) average oxygen consumption (VO2) varied from
      0.9 to 1.9 l min-1, which corresponded to 27%-60% of the maximal value. The peak
      rectal temperature and the highest mean of two measurements of skin temperature
      were 37.7 degrees +/- 0.3 degree C and 34.4 degrees +/- 0.9 degree C,
      respectively. The sweat rate varied from 162 to 583 g h-1. Poor work posture was
      common during asbestos removal. The arms were elevated over shoulder level for
      35% of the work time. During the work the mean physiological strain was
      considered to be moderate, with some heavy peak loads being registered.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1743766
TI  - Correlation of levels of volatile versus carcinogenic particulate polycyclic
      aromatic hydrocarbons in air samples from smokehouses.
AB  - In the present study, data on the concentration of polycyclic aromatic
      hydrocarbons (PAH) in air samples from fish smokehouses (Nordholm et al. 1986)
      and meat smokehouses (Hansen et al. submitted for publication) were used to
      analyze the extent to which six different volatile PAH compounds could function
      as markers for the total concentration of six different carcinogenic particulate
      PAH compounds. Although a significant positive correlation was observed between
      the concentration of each of six volatile compounds and the total concentration
      of carcinogenic PAH compounds, a particularly good correlation was observed for
      phenanthrene, anthracene, fluoranthene and pyrene. Calculations of the
      sensitivity, specificity, positive predictive value and negative predictive value
      of these potential markers revealed that naphthalene and phenanthrene exhibited
      the highest sensitivity as markers for total carcinogenic PAH compounds in air
      samples from smokehouses, whereas fluoranthene and pyrene displayed the highest
      specificity. However, when the applicability of the six markers was tested on air
      samples from iron foundries, only naphthalene and pyrene were useful as markers
      for the carcinogenic compounds. The present study indicates that naphthalene and
      pyrene might function as markers for carcinogenic PAH compounds, that are present
      at low concentrations and are therefore difficult and time-consuming to measure
      directly.

PMID- 1743767
TI  - Acute effects of transient vertical whole-body vibration.
AB  - The question as to whether shock-type whole-body vibration causes increasingly
      acute strain was investigated. Random vibrations were superimposed with shocks
      differing in amplitude and in number per unit of time in a systematic manner. The
      weighted root mean square (rms) acceleration was kept constant in all over the
      varied experiments. A total of 17 men were exposed to vibration from an
      electrohydraulic simulator. The following strain criteria were used: biodynamic
      behavior of the trunk and the head, electrical activity of the muscles of the
      back and the neck, subjective sensation, skin temperature in the lumbar area and
      visual and tracking performance. It was found that increasing shock amplitude
      and, in some experiments, also increasing numbers of shocks led to increasingly
      acute effects that varied, depending on the kind of shock used. New methods
      should be developed for the assessment of transient vibration that are better
      than the existing standards.

PMID- 1743768
TI  - Carpal tunnel syndrome: role of occupation.
AB  - A total of 21 consecutive patients who underwent surgery for carpal tunnel
      syndrome in a regional hospital were analysed for their trade and serum alpha 1
      antitrypsin phenotypes. The majority of these cases were women and mostly manual
      trades and professions were involved. Furthermore, heterozygous antitrypsin
      phenotypes were more frequent among the surgical cases than among the general
      Swiss population. In a second stage, the incidence of carpal tunnel syndrome in
      Switzerland was studied for 1 year from June 1988 through May 1989 using the
      sentinel system developed by the Federal Office of Public Health Administration.
      In all, 188 cases were found, most of whom were women, which was compatible with
      the frequency in other countries. A complementary questionnaire that was filled
      out by 65 cases and their matched controls showed that housewives and shop clerks
      were overrepresented among the patients. Likewise, exposure to vibrating tools
      and frequent extensions and/or flexions of the wrist were mentioned more often by
      the cases than by the controls. The present study confirms previous findings that
      women are at greater risk of developing carpal tunnel syndrome especially in jobs
      requiring repetitive movements or operation of vibrating tools. A constitutional
      element in pathogenesis was suggested by observations that the mothers of the
      cases had often also been afflicted with carpal tunnel syndrome and that the
      frequency of distribution of antitrypsin phenotypes in patients differed from
      that in the general population.

PMID- 1743769
TI  - An epidemiological study of cancer risk among workers exposed to ethylene oxide
      using hemoglobin adducts to validate environmental exposure assessments.
AB  - Cancer morbidity was investigated in a cohort of 2,170 ethylene oxide (EO)
      exposed workers from 2 plants producing disposable medical equipment. The
      subjects had been employed for at least 1 year during the periods 1970-1985 and
      1964-1985, respectively. The exposure to EO was assessed for each of six job
      categories in the plants with respect to each calendar year, on which basis
      values for individual cumulative exposure to EO (ppm-years) were calculated. The
      levels of hydroxyethyl adducts to N-terminal valine (HOEtVal) in hemoglobin
      fitted well with the values estimated for airborne exposure to EO. No increased
      cancer incidence was found [standardized morbidity ratio (SMR), 0.78; 95% CI,
      0.49-1.21)]. No leukemia was observed, but one case of non-Hodgkin's lymphoma,
      one case of myeloma, and one case of polycythemia vera were diagnosed as compared
      with two expected hematopoietic and lymphatic tumors (SMR, 1.54; 95% CI, 0.32
      4.5). No stomach cancer was detected as compared with the 0.5 case expected.
      There were no significant exposure-response associations between estimates of
      exposure to EO and cancer morbidity.

PMID- 1743770
TI  - Effect of simultaneous exposure to toluene and xylene on their respective
      biological exposure indices in humans.
AB  - Studies that specifically address the influence of controlled human exposure to a
      combination of solvents on the biological monitoring of exposure are limited in
      number. The present study was undertaken to investigate whether simultaneous
      exposure of human volunteers to toluene and xylene could modify the respective
      metabolic disposition of these solvents. Five adult Caucasian men were exposed
      for 7 consecutive h/day over 3 consecutive days to 50 ppm toluene and 40 ppm
      xylene either separately or in combination in a dynamic, controlled exposure
      chamber (low-level exposure). The experiment was repeated three times at
      intervals of 2 weeks. In another experiment, three subjects were exposed to 95
      ppm toluene and 80 ppm xylene or a combination of both for 4 h (high-level
      exposure). The concentration of unchanged solvents in blood (B) and in end
      exhaled air (EA) as well as the urinary excretion of hippuric acid (HA) and
      methylhippuric acids (MHAs) were determined. Simultaneous exposure to the lowest
      level of solvents did not alter the concentration of unchanged solvents in blood
      or in exhaled air (average of 3-weekly means; single vs mixed exposure at 6.5 h
      exposure): B-toluene, 77.1 vs 78.1 micrograms/100 ml; B-xylene, 67.6 vs 77.8
      micrograms/100 ml; EA-toluene, 9.9 vs 9.5 ppm; EA-xylene, 5.3 vs 4.8 ppm.
      Similarly, mixed exposure did not modify the excretion of urinary metabolites
      during the 3- to 7-h exposure period: HA, 1.11 vs 1.11 g/g creatinine: MHAs, 0.9
      vs 0.87 g/g creatinine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1743771
TI  - Dose-dependent increase in 2,5-hexanedione in the urine of workers exposed to n
      hexane.
AB  - The concentrations of 2,5-hexanedione (2,5-HD), an n-hexane metabolite, and 2
      acetylfuran (2-AF) were measured in urine samples from 123 workers who had
      predominantly been exposed to n-hexane vapor and 53 workers who had experienced
      no exposure to solvents. The time-weighted average intensity of exposure to n
      hexane vapor was determined by a diffusive sampling method. For biological
      monitoring of exposure, urine samples were collected late in the afternoon during
      the second half of a working week and were analyzed in the presence and absence
      of acid hydrolysis (at pH less than 0.5) for 2,5-HD and 2-AF by gas
      chromatography on a nonpolar capillary DB-1 column. The urinary 2,5-HD
      concentration increased as a linear function of the intensity of exposure to n
      hexane, showing a correlation coefficient of 0.64-0.77 after acid hydrolysis and
      that of 0.73-0.83 in the absence of hydrolysis, depending on the correction for
      urinary density (P less than 0.01 in all cases, with no improvement in the
      coefficient occurring after the corrections). In contrast, 2-AF levels were
      independent of n-hexane exposure. The geometric mean 2,5-HD concentration in
      urine samples from 53 nonexposed men was 0.26 mg/l as observed (i.e., with no
      correction), 0.19 mg/l after correction for a urinary specific gravity of 1.016,
      and 0.23 mg/g creatinine after correction for creatinine concentration, and the
      geometric standard deviation was approximately 2.

PMID- 1743772
TI  - Study on suspended particulate matter and polycyclic aromatic hydrocarbons in
      indoor and outdoor air.
AB  - To study changes in the concentration of suspended particulate matter (SPM) in
      indoor and outdoor air, a new portable sampler (AND sampler) was designed that
      could separately collect particles exhibiting aerodynamic diameters of greater
      than 10 microns, 2-10 microns, and less than 2 microns. The relationship between
      the airborne particle concentration in indoor air and that in outdoor air varied
      with the aerodynamic diameter of the particles. The concentration of SPM in the
      indoor air increased in proportion to that in the outdoor air. The concentration
      of polycyclic aromatic hydrocarbons (PAH) in SPM also varied with the aerodynamic
      diameter of the particles. Fine particles exhibiting an aerodynamic diameter of
      less than 2 microns contained high concentration of PAH. The concentrations of
      benzo(k)fluoranthene, benzo(a)pyrene, and benzo(ghi)perylene in indoor air
      increased in proportion to those in outdoor air.

PMID- 1743773
TI  - The influence of climatic conditions on the heat balance of the human body.
AB  - The structure of heat exchange between the human body and its surroundings has
      been studied according to M.I. Budyko's model. Comparative measurements were
      carried out in the Polish Lakeland (maritime, temperate warm climate), in Central
      Mongolia (continental, temperate cool climate), and in the Kara Kum desert (dry
      subtropical climate). The results deal with the summer and early autumn seasons.
      The calculations indicate that the quantitative apportionment of various forms of
      heat exchange depend on specific weather conditions, which are typical for the
      distinguished climatic zones.

PMID- 1743774
TI  - Effects of cold stress on glutathione and related enzymes in rat erythrocytes.
AB  - Effects of acute and chronic cold stress on glutathione and related enzymes in
      rat erythrocytes were investigated. Blood from both cold-acclimated (CA) and cold
      adapted (CG) rats had significantly lower concentrations of glutathione than
      blood from control animals. Superoxide dismutase activity was increased
      significantly in CA rats and tended to rise in CG rats. Activity of glutathione
      peroxidase in erythrocytes was inconsistent in that it tended to increase in CA
      rats but decreased significantly in CG rats. The results may imply that CG rats
      suffered deleterious effects of hydrogen peroxide. On the other hand, there were
      marked decreases in glutathione peroxidase and glutathione reductase activities
      in acutely cold-exposed rats in conjunction with unchanged levels of glutathione.
      In all treatments the state of riboflavin metabolism was estimated to be
      adequate, since no increases were observed in the erythrocyte glutathione
      reductase activity coefficient.

PMID- 1743775
TI  - Productivity of pure- and crossbred cattle in a subtropical environment.
AB  - The influence of different breeds of sire and dam types on cow productivity in an
      arid, subtropical environment was studied. Cows with calves sired by Simmentaler,
      Hereford and Bonsmara bulls were more (P less than 0.05) productive than those
      with calves sired by Afrikaner bulls. Simmentaler sires were superior (P less
      than 0.05) to Bonsmara sires. Crossbred cows of predominant (greater than 50%)
      Bos taurus breeding were generally superior to crossbreds of predominant B.
      indicus breeding and purebreds. Crossbreeding systems to utilize breed effects to
      optimise cow productivity within environmental constraints are discussed.

PMID- 1743776
TI  - Effect of chronic microwave radiation on T cell-mediated immunity in the rabbit.
AB  - Experiments were conducted to elucidate the effects of chronic low power-level
      microwave radiation on the immunological systems of rabbits. Fourteen male
      Belgian white rabbits were exposed to microwave radiation at 5 mW/cm2, 2.1 GHz, 3
      h daily, 6 days/week for 3 months in two batches of 7 each in specially designed
      miniature anechoic chambers. Seven rabbits were subjected to sham exposure for
      identical duration. The microwave energy was provided through S band standard
      gain horns connected to a 4K3SJ2 Klystron power amplifier. The first batch of
      animals were assessed for T lymphocyte-mediated cellular immune response
      mechanisms and the second batch of animals for B lymphocyte-mediated humoral
      immune response mechanisms. The peripheral blood samples collected monthly during
      microwave/sham exposure and during follow-up (5/14 days after termination of
      exposures, in the second batch animals only) were analysed for T lymphocyte
      numbers and their mitogen responsiveness to ConA and PHA. Significant suppression
      of T lymphocyte numbers was noted in the microwave group at 2 months (P less than
      0.01, delta % 21.5%) and during follow-up (P less than 0.01, delta % 30.2%). The
      first batch animals were initially sensitised with BCG and challenged with
      tuberculin (0.03 ml) at the termination of microwave irradiation/sham exposure
      and the increase in foot pad thickness (delta mm), which is a measure of T cell
      mediated immunity (delayed type hypersensitivity response, DTH) was noted in both
      the groups. The microwave group revealed a better response than the control group
      (delta % +12.4 vs. +7.54). The animals were sacrificed and the tissue T
      lymphocyte counts (spleen and lymph node) were analysed.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1743777
TI  - Seasonal energy requirements and thermoregulation of growing pouched mice,
      Saccostomus campestris (Cricetidae).
AB  - Pouched mice (Saccostomus campestris) were born in captivity during January and
      March and subsequently maintained under long photoperiod (14 h light: 10 h dark)
      at 25 degrees C. During their first winter (July) and the following summer
      (January) the pouched mice were exposed to natural photoperiod in an unheated
      laboratory for 3 weeks prior to measurement. The pouched mice continued to grow
      during the study, and were significantly heavier after summer exposure than after
      winter exposure 6 months earlier. Although this increase in body mass would
      result in a decline in their surface area to volume ratio there was no
      significant decline in minimal thermal conductance (Cm) and winter-exposed
      pouched mice had a relatively lower Cm than expected. Meanwhile the smaller,
      winter-exposed animals displayed a significantly higher capacity for non
      shivering thermogenesis, together with higher levels of basal metabolism than
      summer individuals. These differences were not solely attributable to the
      contrasting body mass of each group and it is therefore clear that S. campestris
      can increase thermoregulatory heat production, and modify heat loss following
      exposure to short photoperiod and cold during their first winter. Despite the
      significant increase in metabolism, the overall energy requirements of small,
      winter-exposed animals were significantly lower than those for heavier pouched
      mice following exposure to summer conditions. These results suggest that growing
      pouched mice can effectively adapt to lower temperature conditions during their
      first winter, yet accrue considerable overall savings in total energy
      requirements as a result of their smaller body mass.

PMID- 1743778
TI  - Is calcium excess in western diet a major cause of arterial disease?
AB  - The daily requirement of a young adult for calcium is 300-400 mg, the quantity
      consumed in many third-world countries. The dietary intake can be doubled or
      trebled by consumption of milk, thus half a litre of milk, consumed by many
      individuals daily in prosperous countries, adds 600 mg. The need for calcium is
      greatly reduced in old age, so that the excess from a given intake becomes more
      pronounced. The potential hazard of a high intake is that a small fraction finds
      its way into soft tissues. The aorta is notably prone to calcification, resulting
      in loss of elasticity. The aorta and its large branches constitute an elastic
      reservoir, distended during systole and contracting in diastole. This contraction
      provides the energy for the maintenance of diastolic pressure, which decreases
      with the deterioration of elasticity and needs a continually increasing systolic
      pressure to restore its normal value. The heart is disadvantaged in two ways. Its
      work is increased by having to eject the systolic volume into a stiffer
      reservoir, and the diastolic filling of the coronary arteries is reduced. This is
      the main cause of hypertension in old age--there is no increase in blood pressure
      with age in undeveloped countries where intake of calcium is low. The best cure
      would be prevention: the reduction of intake of calcium in prosperous countries.
      Failing that, phytic acid is suggested as the best calcium antagonist. Phytic
      acid, a natural product present in grains, converts dietary calcium into
      insoluble phosphates which pass unabsorbed through the digestive tract. The
      presently used calcium antagonists are not so satisfactory.

PMID- 1743779
TI  - Advances in cardiac surgery in the last decade.

PMID- 1743780
TI  - Permanent cardiac pacing in children: morbidity and efficacy of follow-up.
AB  - The data from 50 permanently paced children [mean standard deviation follow-up
      5.3 +/- 3.7 years] were reviewed, with special attention being paid to the cause
      of complications and the efficacy of follow-up. The 5-year survival (SD) of the
      patients was 78 +/- 6%; mortality was mainly due to the underlying cardiac
      disease. The 5-year survival (SD) of the pacing systems was 48 +/- 8%. Surgical
      interventions were necessary every 4.9 patient years. Of these interventions, 58%
      were caused by lead-related problems. Epicardial leads showed significantly more
      exit blocks and high thresholds than endocardial leads. Endocardial leads,
      therefore, should be used at a younger age than is now the current practice, from
      5 years of age onwards, for example. If epicardial leads are used, the pacemaker
      must have a high output facility. Since exit block occurred only within the first
      3 months after implantation, we suggest frequent transtelephonic monitoring
      during the first 3 months. Holter monitoring appeared to be the most effective
      and sensitive method of detecting malsensing and should be performed regularly.

PMID- 1743781
TI  - Effects of prostaglandin E1 given in low doses on the histopathology of the
      arterial duct.
AB  - The histopathology of the arterial duct was studied in relation to the maximal
      infusion rate of prostaglandin E1 administered in 35 infants with congenital
      heart disease. Two groups were distinguished based on the maximal infusion rate.
      The group receiving prostaglandin at low dose received 0.01 to 0.05
      micrograms/kg/min (16 cases), the group having a high dose received greater than
      0.05 to 0.7 micrograms/kg/min (19 cases). The histopathology was compared between
      the groups. Ductal damage was less common in the cases receiving a low rate of
      infusion than in those having a high rate of infusion. Multivariate analysis
      showed no relation between ductal pathology and the age of onset or duration of
      treatment, nor on the total dose of prostaglandin E1. Histological abnormalities
      were more common in patients with a gestational age equal to or greater than 40
      weeks. Ductal damage was less common in patients with pulmonary atresia or
      stenosis compared with other anatomic diagnoses. Low dose infusions are
      recommended for treatment with prostaglandin E1 in infants with congenital heart
      disease.

PMID- 1743782
TI  - Familial dilated cardiomyopathy: a transverse and longitudinal clinical and
      echocardiographic study.
AB  - The familial occurrence of hypertrophic cardiomyopathy is well known; familial
      dilated cardiomyopathy has so far received less attention. Ten families with two
      or more members affected by dilated cardiomyopathy were studied by
      echocardiography. In 3 out of 10 families, a transverse study extended to even
      apparently healthy subjects was carried out, which included a total of 45
      subjects. In 19 out of the 45, dilated cardiomyopathy (either symptomatic or
      asymptomatic) was diagnosed at echocardiography. Three more relatives, already
      dead of the disease, were identified through hospital records. A clinical and
      echocardiographic longitudinal study, lasting up to 11 years, was carried out in
      5 of the 10 families. During the follow-up, 8 out of 19 patients who, at first
      examination were affected by dilated cardiomyopathy, died, one improved, 3
      remained in stable condition and 7 were lost at follow-up. One of two patients
      who presented echocardiographic findings suggestive of border-line dilated
      cardiomyopathy returned to normality and the other developed dilated
      cardiomyopathy. The clinical and echocardiographic findings in our patients, and
      in their relatives, suggest the possibility that idiopathic dilated
      cardiomyopathy may be a multifactorial disease in which genetic factors might
      play a variable role.

PMID- 1743783
TI  - Symptom-limited, self-paced walking in the assessment of cardiovascular disease
      in patients with and without heart failure: the predictive value of clinical,
      anthropometric, echocardiographic and ergonometric parameters.
AB  - The assessment of functional capacity in heart disease remains problematic, and
      it is unclear whether maximal exercise testing is physiologically reflective of
      the activities of daily living or the quality of life. We therefore employed a
      symptom-limited, self-paced walking protocol to assess the physical conditions of
      41 Nigerian cardiac patients, with and without heart failure. The walking time,
      walking speed and distance as well as the energy expenditure (Kcal.min-1) were
      markedly reduced (P less than 0.001) in patients with heart failure (n = 26)
      compared to the cardiac patients not in failure (n = 15). The double product
      corrected for exercise time (an index of myocardial oxygen use) was, however,
      significantly higher (P less than 0.001) in the group with heart failure. Using
      multiple regression analysis, the parameters of self-paced walking capacity
      (distance, walking time, and speed) could reliably be predicted (r2 greater than
      0.9) from age, body surface area, energy expenditure, and echocardiographic left
      ventricular dimension in the patients without heart failure. The presence of
      heart failure appeared to weaken the predictability of the regressions. A
      significant correlation was obtained between the self paced exercise time and the
      Bruce protocol treadmill time (r2 = 0.91, P = 0.004) in a subgroup of the
      patients with heart failure. Thus, the self-paced walking test is sensitive to
      changes in congestive heart failure and the exercise capacity can be predicted
      from age and biophysical parameters. The wider clinical usage of this modality,
      especially in frail patients, is hereby recommended.

PMID- 1743784
TI  - Low-dose simvastatin for the treatment of hypercholesterolaemia in recipients of
      cardiac transplantation.
AB  - There is increasing evidence that hypercholesterolaemia is an important
      contributor to the development of accelerated coronary arterial disease in the
      cardiac allograft. The optimal drug therapy of hypercholesterolaemia in
      recipients after cardiac transplantation, however, has not been defined.
      Simvastatin (an inhibitor of hydroxy-methyl glutaryl-coenzyme A reductase), at a
      dose of 10 mg/day, was administered to 12 recipients with serum total cholesterol
      greater than or equal to 7.8 mmol/l and serum triglyceride less than or equal to
      4.5 mmol/l refractory to dietary measures during a follow-up period of 1-5 years
      after cardiac transplantation. All patients received maintenance doses of
      cyclosporin A and, in some instances, azathioprine and prednisolone. After 2
      months treatment with simvastatin, serum total cholesterol was significantly
      reduced from 8.8 +/- 0.3 mmol/l (mean +/- SEM) to 5.5 +/- 0.5 mmol/l, P less than
      0.001, low density cholesterol from 6.6 +/- 0.4 to 3.8 +/- 0.3 mmol/l, P less
      than 0.001 and triglycerides from 2.4 +/- 0.2 mmol/l to 1.8 +/- 0.2 mmol/l, P
      less than 0.005. These changes were maintained after a period of treatment of 8
      months. Serum high density cholesterol, hepatic transaminase levels, serum
      creatinine, creatine kinase and cyclosporin A blood levels were not altered by
      treatment with simvastatin. It is concluded that, in this study group, low-dose
      simvastatin appears to be well tolerated and has favourable lipid modifying
      properties.

PMID- 1743785
TI  - Indoor passive smoking: its effect on cardiac performance.
AB  - We studied 19 nonsmoker male volunteers, 9 healthy (mean age 30.5 +/- 8.5), and
      10 with previous myocardial infarction (mean age 53.8 +/- 5.3), who underwent
      exercise stress testing twice: in a smoke-free environment and in a smoking
      environment (carbon monoxide concentration 30-35 ppm). We measured peak exercise
      power, time to recovery of pre-exercise heart rate, expired concentration of
      carbon monoxide and plasma carbon monoxide. Obtained data were compared by using
      t-test. P less than 0.05 was statistically significant. Mean data observed in
      healthy people were as follows. Peak exercise power 220 +/- 30 watts in a smoking
      environment versus 220 +/- 30 in a smoke-free environment (P greater than 0.05).
      Time to recovery of pre-exercise heart rate 19 +/- 4 minutes in a smoking
      environment versus 8.5 +/- 4 in a smoke-free environment (P less than 0.01).
      Expired concentration of carbon monoxide before exercise 2.3 +/- 2.01 ppm versus
      8.5 +/- 1.6 (P less than 0.01) after exercise in a smoking environment, and 2.3
      +/- 2 ppm before exercise versus 2.1 +/- 1.9 after exercise in a smoke-free
      environment (P less than 0.05). Plasma carbon monoxide before exercise 1.4 +/-
      0.2% versus 1.7 +/- 0.4 after exercise in a smoking environment (P greater than
      0.05), and 1.2 +/- 0.4% before exercise versus 1.2 +/- 0.4 in a smoke-free
      environment (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1743786
TI  - Acute aortitis and aortic incompetence due to systemic rheumatological disorders.
AB  - We report the clinical, laboratory and echocardiographic features of five cases
      of aortic incompetence associated with ankylosing spondylitis, rheumatoid
      arthritis and undefined connective tissue diseases. Immunosuppression with
      steroids and cytotoxic agents was used to suppress aortic root inflammation in
      four cases; in three the aortic root size stabilized and the patients remain well
      with no evidence of increasing aortic incompetence. In one case, control of the
      inflammatory process was never fully achieved for any length of time and the
      patient died shortly after aortic valve replacement. A fifth case required urgent
      valve replacement and remains well. A systemic rheumatological disorder should be
      considered in cases of apparent "lone" aortic incompetence and conversely aortic
      incompetence should not be overlooked in established systemic rheumatological
      disease. Immunosuppressive therapy may prevent or delay the need for aortic valve
      replacement in such cases.

PMID- 1743787
TI  - The role of captopril as single therapy in hypertension and angina pectoris.
AB  - Eighteen hypertensive patients with a resting diastolic blood pressure between
      100 and 120 mmHg who also had angina and proven coronary arterial disease entered
      a dose titration study to evaluate the efficacy of captopril as a single therapy
      in hypertension and coexisting stable angina. Captopril was administered for 2
      weeks at 25 or 50 mg three times daily and the patients evaluated subjectively
      and by maximal symptom limited treadmill exercise testing. In comparison to
      placebo captopril 25 mg and 50 mg dosage increased time to 1 mm ST depression
      from 188.2 +/- 24.4 sec on placebo to 337.6 +/- 29.5 and 364.2 +/- 36.2 sec
      respectively (P less than 0.01). The maximum ST segment depression was reduced
      from 2.5 +/- 0.25 mm on placebo to 1.4 +/- 0.22 mm on captopril 25 mg and 1.2 +/-
      0.30 mm on captopril 50 mg (P less than 0.01). Exercise duration increased from
      310.3 +/- 21.4 sec on placebo to 438.3 +/- 27.3 sec on captopril 25 mg and to
      460.9 +/- 26.5 sec on captopril 50 mg (P less than 0.01). The resting systolic
      blood pressure decreased from 184.1 +/- 4.7 mmHg on placebo to 159 +/- 4.2 mmHg
      on captopril 25 mg and to 150.9 +/- 4.6 mmHg on captopril 50 mg (less than 0.01).
      Similarly, diastolic blood pressure decreased from 111.6 +/- 2.1 mmHg on placebo
      to 93.8 +/- 1.3 mmHg on captopril 25 mg and to 90.0 +/- 1.7 mmHg on captopril 50
      mg (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1743788
TI  - Noninvasive determination of the left ventricular end-systolic pressure.
AB  - To find a noninvasive method for estimating left ventricular end-systolic
      pressure, 40 patients were studied during cardiac catheterization. Arterial
      pressure was taken directly from the ascending aorta. Carotid pulse tracing and
      measurement of blood pressure by cuff sphygmomanometry were taken simultaneously.
      The tracings were calibrated and left ventricular end-systolic pressure was
      estimated directly and indirectly. Simple linear regression analysis gave the
      equations: (1) left ventricular end-systolic pressure direct = 0.56 left
      ventricular end-systolic pressure indirect + 43.8 (r = 0.61, P = 0.00004), and
      (2) left ventricular end-systolic pressure direct = 0.39 systolic arterial
      pressure indirect + 48.8 (r = 0.62, P = 0.00002). To test the accuracy of the
      technique the study was continued in 40 patients. Left ventricular end-systolic
      pressure was also estimated by the 2 equations. Left ventricular end-systolic
      pressure direct was correlated with left ventricular end-systolic pressure
      estimated by the 2 equations and there was no statistical difference. This
      noninvasive technique is a bedside method for clinical measurement of left
      ventricular end-systolic pressure.

PMID- 1743789
TI  - Left ventricular volumes and function immediately after balloon mitral
      valvoplasty.
AB  - To evaluate acute changes in left ventricular volumes and function immediately
      after successful percutaneous balloon mitral valvoplasty, twenty young patients
      with isolated rheumatic mitral stenosis (male 9, female 11, mean age 22 +/- 6
      years) were studied. The area of the orifice of the mitral valve following
      valvoplasty, increased from 0.97 +/- 0.27 cm2 to 2.46 +/- 0.75 cm2 (P less than
      0.001). No significant change was observed in left ventricular end-diastolic
      volumes (117 +/- 27 ml to 119 +/- 29 ml, P greater than 0.10), end-systolic
      volumes (51 +/- 21 ml to 50 +/- 20 ml, P greater than 0.10), ejection fraction
      (0.57 +/- 0.10 to 0.58 +/- 0.10, P greater than 0.10) and left ventricular
      meridian wall stress (68 +/- 20.10(3) dynes/cm2 to 65 +/- 14, P greater than
      0.10) immediately after valvoplasty. There was no acute change in heart rate,
      left ventricular end-diastolic pressure, cardiac index and grade of mitral
      regurgitation. Patients with depressed left ventricular ejection fraction (less
      than or equal to 0.55, n = 10) and those with normal ejection fraction (greater
      than 0.55, n = 10) had similar baseline left ventricular end-diastolic volumes
      and showed no significant change in volumes and ejection fraction after the
      procedure, although the former group had a greater orificial area after
      valvoplasty (P less than 0.05). We conclude that an acute increase in the orifice
      of the mitral valve in patients with rheumatic mitral stenosis is not associated
      with any significant change in left ventricular volumes and function.

PMID- 1743790
TI  - Pathogenesis of various forms of double outlet right ventricle in mouse fetal
      trisomy 13.
AB  - The pathogenesis of double outlet right ventricle with or without pulmonary
      infundibular atresia in mouse fetal trisomy 13 was studied at the organ level
      using microdissection and scanning electron microscopy. Altogether, 394
      karyotyped trisomic embryos were collected between 11 days and 16 hours of
      gestation (presence of a vaginal plug = day 1) and 15 days of gestation at
      intervals of 8 hours, and at 16 days of gestation. The hearts were perfusion
      fixed, microdissected, and prepared to be observed in scanning electron
      microscope in the following standardized orientations: frontal, right or left
      profile, septal and parietal halves of the right ventricle and outflow tract
      (conotruncus). Comparison of 276 trisomic hearts with their normal counterparts
      described previously has shown that: the first pathognomonic feature is the
      abnormal anterior position of the proximal part of the parietal outflow tract
      ridge or of both ridges (at 12 days and 16 hours of gestation); the abnormal
      anterior fusion of these ridges ("coalescence") results in a mesenchymal mass
      behind which is deviated the pulmonary part of the outflow tract lumen; from 14
      days and 16 hours of gestation on, this lumen is either obstructed, resulting in
      a supravalvar stenosis of the pulmonary trunk and subsequently evolving into
      double outlet right ventricle with pulmonary infundibular atresia; or, in a
      minority of cases, this lumen is not obstructed and the heart develops into
      double outlet right ventricle without pulmonary infundibular atresia. The
      pathogenesis of these malformations differs from most of the known hypotheses
      based on deductions from human malformed hearts, as well as from observations of
      the pathogenesis of similar outflow tract malformations, such as those found in
      the Keeshond dog or rats treated with trimethadione.

PMID- 1743791
TI  - Functional tricuspid regurgitation following replacement of the mitral valve.
AB  - In this series, the effect of replacement of the mitral valve was examined in
      86/900 (9.6%) patients who had developed moderate functional tricuspid
      regurgitation, secondary to rheumatic mitral valvar disease. These patients were
      subdivided according to the severity of pulmonary hypertension and impairment of
      right ventricular function. Forty-six patients presented with severe pulmonary
      hypertension and 40 patients had moderate pulmonary hypertension (mean main
      pulmonary arterial pressure: 78 +/- 14 mmHg vs 41 +/- 6 mmHg; P less than 0.05).
      The latter had more advanced disease, greater impairment of right ventricular
      function and dilatation of the right heart chambers. Functional tricuspid
      regurgitation regressed in 38/42 survivors with severe pulmonary hypertension and
      persisted or progressed significantly in 22/34 survivors with impaired right
      ventricular function despite successful replacement of the mitral valve. The
      latter underwent replacement of the tricuspid valve (n = 16) or tricuspid
      annuloplasty (n = 6), at a mean interval of 44 +/- 4.4 months after replacement
      of the mitral valve, which resulted in 8/22 (23.5%) early deaths. Functional
      tricuspid regurgitation is more likely to persist in patients with advanced right
      ventricular failure. Tricuspid valvar competence should be restored in these
      patients at initial replacement of the mitral valve.

PMID- 1743792
TI  - Anomalous origin of the left pulmonary artery from the ascending aorta in a
      patient with tetralogy of Fallot and "absent pulmonary valve".
AB  - The rare association of tetralogy of Fallot, rudimentary formation of the
      leaflets of the pulmonary valve, and anomalous origin of the left pulmonary
      artery from the ascending aorta is described in a two-month-old infant. The
      diagnosis was made by cardiac catheterisation and angiography.

PMID- 1743793
TI  - Fatal myocardial infarction in hypertrophic cardiomyopathy associated with non
      penetrating chest trauma.
AB  - Myocardial infarction as a result of injury to the coronary arteries is a rare
      complication of non-penetrating chest trauma. We report a case of fatal inferior
      wall myocardial infarction following traumatic injury to the right coronary
      artery, complicated by atrioventricular dissociation, in a patient with a
      combination of hypertrophic cardiomyopathy and non-occlusive coronary artery
      disease.

PMID- 1743794
TI  - Cardiogenic shock due to neoplastic infiltration of cardiac muscle.
AB  - We present a patient with cardiogenic shock resulting from extensive neoplastic
      infiltration of the inferolateral left ventricular cardiac muscle by an
      epidermoid carcinoma of the lower third of the oesophagus.

PMID- 1743795
TI  - Anteroseptal myocardial infarction clinically mimicking right ventricular
      infarction.
AB  - Acute transmural anteroseptal myocardial infarction with acute left ventricular
      failure can also raise systemic venous pressure in the absence of right
      ventricular infarction. Right ventricular infarction, therefore, should not be
      diagnosed simply by the presence of systemic venous congestion.

PMID- 1743796
TI  - Traumatic ventricular septal defect: serial follow-up with Doppler ultrasound.
AB  - A three-year-old girl presented with a gunshot wound of the chest. Cross
      sectional and Doppler echocardiography enabled precise location of the bullet,
      and assessment of the haemodynamic effects of the traumatic ventricular septal
      defect. Serial ultrasound examination in the acute stage confirmed that the
      bullet was well embedded in the left ventricular myocardium, and the ventricular
      septal defect was restrictive, enabling conservative management.

PMID- 1743797
TI  - Brucella endocarditis.
AB  - Between 1987 and 1990, three patients with abscesses produced by Brucella
      endocarditis were admitted to the Department of Infectious Diseases, "Ospedali
      Riuniti", Bergamo, Italy. In each case, the diagnosis was based on a history of
      ingestion of milk products, positive Wright serology, positive blood and valvar
      culture, and echocardiography. Medical therapy alone was not found to be
      effective in treatment, all patients requiring surgical intervention. One case
      required urgent surgical treatment and underwent three further operations up to
      the final implantation of a valved tube. According to our experience, Brucella
      endocarditis is a rare but serious disease which requires a combination of
      medical and surgical therapy.

PMID- 1743798
TI  - Transesophageal echocardiography and magnetic resonance imaging for the
      assessment of saccular aneurysm of the transverse thoracic aorta.
AB  - We report a patient who initially presented with hoarseness and was admitted to
      our hospital with chest pain, caused by a saccular aneurysm of the thoracic
      aortic arch. The initial diagnosis was made by cross-sectional echocardiography,
      the extension and morphology of the saccular aneurysm being detected by
      transesophageal echocardiography. Magnetic resonance imaging confirmed the
      measurements of the aneurysm and clearly showed the anatomic relation with
      surrounding structures and arch vessels. The patient refused operation and died
      during in-hospital stay. A rupture of the thoracic aneurysm was the cause of
      death.

PMID- 1743799
TI  - Endocarditis due to Streptococcus agalactiae presenting with myositis.
AB  - A case of endocarditis of the aortic valve due to Streptococcus agalactiae is
      described in which the patient presented with a myositis sparing the myocardium.
      The patient required emergency replacement of the valve, and made a good
      recovery.

PMID- 1743800
TI  - Amiodarone-induced torsades de pointes: the possible facilitatory role of
      digoxin.
AB  - Poorly controlled supraventricular arrhythmias in a hypokalaemic 74 year old
      woman were treated with oral amiodarone. This caused torsades de pointes, and was
      preceded by marked prolongation of the QT interval. The induction of torsades de
      pointes by amiodarone is thought to be an idiosyncratic reaction to amiodarone
      itself which is facilitated by electrolytic abnormalities. The present case,
      however, indicates the possibility of a pro-arrhythmic effect secondary to an
      interaction between amiodarone and digoxin.

PMID- 1743801
TI  - Percutaneous balloon mitral valvoplasty for young patients with rheumatic mitral
      stenosis.

PMID- 1743802
TI  - Striving for standards in bioequivalence assessment: a review.

PMID- 1743803
TI  - The challenge for clinical pharmacology in developing countries: the current
      situation.

PMID- 1743804
TI  - Effects of food intake on the bioavailability of sulpiride from AEA film-coated
      tablet having a pH-dependent dissolution characteristic in normal or drug-induced
      achlorhydric subjects.
AB  - The effect of food intake on the bioavailability of sulpiride from a commercial
      film-coated tablet (100 mg/T) treated with polyvinylacetal diethylaminoacetate
      (AEA), which remains undissolved at pH above 4 approximately 5, were investigated
      in four healthy male subjects in the normal state or in a drug-induced
      achlorhydric state. The drug was administered as a single oral 100 mg dose of
      sulpiride under the fasting and nonfasting state using a crossover study design.
      Fifteen urine samples were collected over a 48 h period following sulpiride
      administration to determine sulpiride concentrations by HPLC. The bioavailability
      was estimated from the cumulative amount excreted unchanged in urine over 48 h
      (Du48). When AEA film-coated tablet was taken by subjects in the normal state,
      the bioavailability under the fasting state differed markedly among the four
      subjects due to differences in gastric acidity. The effect of food intake on the
      bioavailability also differed markedly among the individuals, being lower in high
      gastric acidity subject and higher in those with low gastric acidity subjects.
      When AEA film-coated tablet was taken by subjects in a simulated achlorhydric
      state, the bioavailability under the fasting state was very poor for all four
      subjects and did not show inter-subject variation. With food intake, the
      bioavailability increased 6-fold, probably due to the more vigorous movement of
      the formulation in the gastrointestinal tract, since both the basal and the meal
      stimulated gastric acid secretion were markedly inhibited in the simulated
      achlorhydric state.

PMID- 1743805
TI  - Influence of type I and type II diabetes mellitus on phenytoin steady-state
      levels.
AB  - Phenytoin kinetics was studied in male type I and type II diabetic patients, ten
      in each group. Age and sex matched epileptic patients receiving phenytoin alone
      served as control groups. Steady-state concentration of phenytoin was
      significantly lower in both types of diabetics compared to respective controls.
      The Vmax and Vmax/Km of phenytoin were significantly increased in type I
      diabetics. The Vmax was unaltered in type II diabetics but the Vmax/Km was higher
      in them. Protein binding of the drug was decreased in both groups. It is
      concluded that phenytoin kinetics is increased in both types of diabetics which
      may be responsible for the lower steady-state concentration of the drug.

PMID- 1743806
TI  - Comparison of three regimens of Parlodel-SRO in levodopa-treated parkinsonians: a
      randomized double-blind crossover study.
AB  - Parlodel-SRO is a newly developed slow-release formulation of bromocriptine,
      which prevents initial plasma peak--a known source of adverse events--and extends
      the half-life of the compound, an interesting feature for the management of motor
      symptoms in Parkinsonians. This study was designed to determine the best daily
      administration schedule for 30 mg Parlodel-SRO in 18 parkinsonians previously
      treated with levodopa and standard Bromocriptine (Br). The 30 mg dose was
      replaced from one day to the next, in a randomized, double-blind latin square
      design trial. Three consecutive 7-day courses were implemented, during which a
      total daily dose of 30 mg P-SRO was administered in one dose, two intakes
      (b.i.d.) and three intakes, (t.i.d.) respectively. The b.i.d. schedule produced
      the best improvement in UPDRS scores, especially as to postural stability,
      walking, bradykinesia; it also provided greater pharmacological stability
      throughout the assessment day. Adverse event analysis was not in favor of a
      single daily dose. It appeared that P-SRO administered in two 15 mg intakes
      (morning and evening) produces the best benefit-risk ratio in Parkinsonians who
      were already being treated with levodopa.

PMID- 1743807
TI  - Hypocalcemic effects of rectal and intramuscular administration of synthetic
      salmon calcitonin.
AB  - To assess the acute biological activity of a new rectal form of synthetic salmon
      calcitonin (SMC), 10 healthy subjects were randomly assigned, according to a
      crossover design, to single doses of either 50 IU SMC intramuscularly or 100 IU
      SMC rectally. Ionized and total calcium were measured as SMC bioactivity
      indicators in blood samples collected during a 6-hour period after the
      administration of the drug. In all the subjects, rectal administration of 100 IU
      of SMC induced falls in both plasma total calcium and whole blood ionized
      calcium: similar levels were observed after intramuscular injection of 50 IU of
      SMC. The pharmacodynamic bioavailabilities for total and ionized calcium of the
      100 IU suppository and the 50 IU intramuscularly were 106% and 60%. The total and
      ionized calcium AUCs were the same after i.m. injection and suppository. We
      conclude that, in normal subjects, synthetic salmon calcitonin administered by
      the rectal route at the dose of 100 IU is effective and has the same biological
      effects as 50 IU of SMC given intramuscularly. Therefore, this new rectal form
      may be a useful alternative to parenteral injection.

PMID- 1743808
TI  - Trimethadione tolerance test for one-point estimation of the severity of liver
      damage in cirrhotic patients.
AB  - We evaluated the adequacy of the trimethadione (TMO) tolerance test (the method
      of estimation from the serum dimethadione [DMO]/TMO ratio, DMO is only one
      metabolite of TMO, at 4 hours after oral administration of TMO) for estimating
      the severity of liver damage in 40 cirrhotic patients with and without hepatic
      encephalopathy. Serum dimethadione (DMO)/TMO ratios in a single blood sample
      after oral administration of TMO were significantly lower in cirrhotic patients
      with (0.07 +/- 0.02, p less than 0.05) or without (0.29 +/- 0.12, p less than
      0.05) hepatic encephalopathy than in normal subjects (0.63 +/- 0.04). Serum
      DMO/TMO rations showed a good correlation with the following laboratory data:
      plasma indocyanine green retention at 15 minutes (r = -0.857, p less than 0.001),
      serum choline-esterase activity (r = 0.844, p less than 0.001), and albumin (r =
      0.736, p less than 0.001). In cirrhotic patients with hepatic encephalopathy, the
      serum DMO/TMO ratio was found to be below 0.10, which was 16% of the normal
      level, by the TMO tolerance test. These findings suggest that the TMO tolerance
      test is a useful indicator of the hepatic parenchymal function in cirrhotic
      patients.

PMID- 1743809
TI  - Drugs and personality: comparison of drug users, nonusers, and other clinical
      groups on the 16PF.
AB  - This article reviews published 16PF research on drug users. It also compares the
      16PF scores of a new sample of nonusers with scores of matched groups of heavy,
      chronic users of cocaine, amphetamine, opiates, and barbiturates/sedative
      hypnotics, as well as combined groups of stimulant users, depressant users, and a
      combined group of users of all substances. No significant differences were found
      among drug user groups, but the profile of the nonuser group was distinctive. K
      Means Cluster Analyses, as well as Cattell's Similarity and Pearson Product
      Moment Correlation Coefficients, were used to compare profiles of these new
      samples with the 19 groups described in an earlier meta-analysis of published
      16PF studies. Data from the new samples did not cluster with data from other
      published research, although certain specific similarities appeared in more
      detailed correlational analyses. Methodological problems are discussed, and it is
      recommended that in future studies drug user groups be more carefully selected
      and defined, sample descriptions be more thorough and complete, complete profile
      information be routinely provided, and efforts be made to explore the utility of
      the Cattell CAQ in studies of drug users/misusers.

PMID- 1743810
TI  - Family involvement for improving the abstinence rate in the rehabilitation
      process of female alcoholics.
AB  - We investigated the effect of family involvement on abstention of 90 female
      alcoholics in recovery processes by multivariate analysis. The abstinence rate of
      the family-involved group was significantly higher than that of the group not
      involved (p less than .05). The logistic regression model in which family
      involvement, age, marital status, eligibility for welfare assistance, and history
      of previous psychiatric inpatient care were used as independent variables
      indicated that family involvement was the only variable having a significant
      effect on abstention (p less than .05).

PMID- 1743811
TI  - Memories of parental rearing in alcohol and drug addicts: a comparative study.
AB  - Memories of parental rearing were investigated in 48 polydrug addicts and 91
      alcohol addicts with the EMBU, an instrument for assessing parental rearing
      styles. Drug addicts remember their fathers and mothers as more rejecting and
      overprotecting and their mothers as more favoring than do alcoholics. When the
      age and the sex of addicts are taken into account, the kind of addiction and the
      sex of the addicts can explain a part of the variance of the overprotection
      dimension by fathers and mothers. The age of the addicts can explain a part of
      the variance of the rejection dimension by fathers and mothers. Finally, the
      variance in the favoring dimension by mothers can be explained by the kind of
      addiction.

PMID- 1743812
TI  - Drug use among New York City prison inmates: a demographic study with temporal
      trends.
AB  - In a sample of over 2,500 medical charts from inmates arrested in 1986 in New
      York City, the rate of intravenous drug use peaked at 43% in male inmates aged 36
      to 40. Younger inmates had progressively lower rates of intravenous drug use.
      Inmates detained for longer time periods and female inmates had particularly high
      rates of intravenous drug use. Rates of intravenous drug use were 30% among
      Hispanic, 26% among White, and 16% among Black inmates. Although overall rates of
      drug use among all male inmates in 1986 have remained unchanged since 1975, drug
      use was most prevalent in inmates aged 31 to 40 in 1986, the same criminal
      "cohort" which in 1975 had the highest rate of drug use. Implications for
      targeting of AIDS and drug-related counseling among inmates are discussed.

PMID- 1743813
TI  - Drinking habits among high school students in Perugia, Italy, in 1981 and 1988:
      time trends and correlates.
AB  - The prevalence of alcohol consumption among 9th (14-15 years old) and 13th grade
      (18-19 years old) high school students in Perugia, Italy, was investigated in
      1981 and 1988. Wine was the most popular beverage, although its use declined in
      the 7-year period. Beer consumption remained stable, but it was at a lower level
      than wine. Overall, alcohol consumption showed a slight decline among both 9th
      and 13th graders. However, the proportion of excessive drinkers increased, and a
      growing phenomenon of drunkenness among students was observed. Alcohol
      consumption was positively associated with sex and smoking and negatively
      associated with father's education and knowledge of the health hazards of alcohol
      abuse by multivariate analysis.

PMID- 1743814
TI  - Alcohol use and negative consequences among American college students in West
      Germany.
AB  - Numerous investigations have recently focused on the prevalence and causes of
      problem drinking among American college students. The present study examined
      alcohol consumption and negative consequences due to drinking among 216 American
      college students at an American university in West Germany. American students in
      Germany reported a substantially higher frequency and amount of drinking, along
      with higher rates of negative consequences as compared to their stateside peers.
      The data are discussed in terms of the relationship between the American
      collegiate life-style of alcohol abuse and life in an alcohol-permissive society.
      Recommendations for changing the collegiate norm of alcohol abuse are presented.

PMID- 1743815
TI  - The role of the psychologist on the drug user treatment team.
AB  - Current practice in drug user treatment tends to provide, within any one agency,
      essentially the same treatment for all clients entering that agency. Instead, an
      agency should use a team approach, with a specific and unique treatment plan for
      every client, provided by the members of the team. The psychologist should play a
      central role on this team, being responsible for the treatment plan, for an
      individual evaluation plan, for assessing progress, for program evaluation, and,
      in many instances, for supervision of treatment staff. The functions and the
      different roles played by the psychologist are described, and the characteristics
      and skills needed for success are listed.

PMID- 1743816
TI  - Adult children of alcoholics: the effects of background and treatment on ACOA
      symptoms.
AB  - This research attempts to identify the factors that differentiate adult children
      of alcoholics (ACOAs). A national purposive sample of ACOAs (n = 500) was
      administered an ACOA index measuring ACOA symptoms. An ANOVA analysis for the
      ACOA index scores showed gender, minority race or ethnicity, rating of parents'
      relationship, receiving help as a child, and seeking treatment as an adult to
      have significant effects. Notably, minorities scored significantly lower on the
      ACOA index, and seeking treatment increased the scores, even in interaction with
      parents' relationship and receiving help as a child. These findings point to the
      need for differentiating treatment for ACOAs and developing more effective
      treatment in general. They also confirm the importance of offering even informal
      support to children in troubled families.

PMID- 1743817
TI  - The alcohol use disorders identification test (AUDIT) in a college sample.
AB  - This study was conducted to estimate the psychometric properties of the
      questionnaire section of the Alcohol Use Disorders Identification Test (AUDIT) in
      a college sample using DSM-III criteria for alcohol abuse as the criterion
      standard. This alcohol screening test was developed for the 10 country AMETHYST
      project. In this young adult sample the instrument exhibited a sensitivity of .84
      and specificity of .71 when utilizing the recommended cut-off score of 11. The 10
      item questionnaire section of the AUDIT appears to have important advantages over
      other alcohol screening instruments such as the CAGE and the MAST.

PMID- 1743818
TI  - Recidivism among high risk youths: a 2 1/2-year follow-up of a cohort of juvenile
      detainees.
AB  - We report some results from a longitudinal study of juvenile detainees. Analyses
      were directed toward determining whether the youths' alcohol or other drug use
      and their emotional/psychological problems at entry into the detention center
      predicted subsequent arrests for new offenses during the 24 and 30 months
      following their initial interviews. Statistically significant relationships were
      found between the youths' demographic characteristics (age, race, gender),
      referral history, reason for placement in the detention center, cocaine use (as
      measured by urinalysis), and recidivism. The magnitude of these relationships
      increased with the length of the follow-up period.

PMID- 1743819
TI  - The effect of nicotine, silver acetate, and placebo chewing gum on the cessation
      of smoking. The influence of smoking type and nicotine dependence.
AB  - The effects of nicotine (NI), silver acetate (SA), and ordinary (PL) chewing gum
      on the cessation of smoking were compared through ratings on six smoking types
      and physiological nicotine dependence (F-score) in a placebo-controlled and
      randomized study that included 496 smokers in a group-support setting. Results
      were evaluated after 26 weeks. Ratings on smoking types 1, 3, 4, 5, and 6 and F
      score were related to success rates. The effect of NI was superior to SA in
      smokers with high type 1 ratings, the effects of NI and SA were almost equal and
      superior to PL in smokers with high type 4 and 6 ratings, and the effect was
      independent of the F-score. Treatment of smokers with NI and SA should be
      restricted to smoking types in which an effect superior to PL is documented, and
      research should be performed to find support for smoking types where SA and NI
      have a clear effect.

PMID- 1743820
TI  - Substance misuse among native and rural high school students in Quebec.
AB  - A questionnaire exploring the smoking habits, past and current use of alcoholic
      beverages, cannabis, and other illicit drugs was distributed among Francophone
      and Native high school students in a rural area of Quebec. The lifetime
      prevalence figures indicated that use of illicit drugs was significantly higher
      among Native students. This held true particularly for stimulants and inhalants
      (p less than .001). Figures for the 1-year prevalence indicated that use of
      stimulants in Native students remained still significantly higher (p less than
      .01). However, consumption of alcoholic beverages was more important in
      Francophone students (p less than .05). A gender difference was observed in
      Native students, females reporting an earlier involvement with most substances
      under study. This tendency decreased with age. The implications of this study for
      the prevention of alcohol and substance abuse among rural and Native youths are
      discussed.

PMID- 1743821
TI  - Alcohol control: issues in taxing, production, and distribution.
AB  - Many developing nations are experiencing increasing problems associated with
      their people's increasing use of the drug alcohol. Economic interests and the
      governments' need for revenue are predominant and obscure the need for the
      governments to accept their public health responsibilities. As indicated in this
      paper, the control of alcohol problems requires developing nations' governments
      to take a balanced approach to taxing, production, and distribution of alcoholic
      beverages. Furthermore, the UN and the developed nations must participate in
      these endeavors to ensure that the developing nations will not be exploited
      commercially.

PMID- 1743822
TI  - Crack: new directions in drug research. Part 2. Factors determining the current
      functioning of the crack economy--a program for ethnographic research.
AB  - Factors which hypothetically influence rates, volumes, and methods of income
      generation in crack distribution, use, and misuse are indicated, and a research
      program to investigate them is suggested. This research will contribute
      significantly to the development of a theoretical framework which adequately
      relates substance using/abusing and trafficking populations to the wider
      community and will explain why crack use and distribution have had such different
      outcomes than marijuana. Factors to be researched include: polyethnicity, crack
      related deculturation, gender differentiation in crack use and effects,
      neighborhood effects, vertically organized crack-distributing organizations,
      crack-related violence and crime, and replacement of previous drug markets by
      crack.

PMID- 1743823
TI  - Correcting for the underreporting of drug use in opinion surveys.
AB  - Survey data is one of the major mechanisms for measuring patterns of drug use
      across populations. But because drug use can be both a legal and an illegal
      activity, the accuracy of self-reported measures of use has been a continual
      problem. The sealed booklet questionnaire overcomes these problems by
      guaranteeing the respondent some degree of anonymity. This paper reports results
      from a modified booklet method used in a drug use survey with a national
      population sample. The method produces better estimated than direct questions,
      yet guarantees the respondent anonymity. In addition, the analysis shows that
      underreporting for different drugs is behaviorally motivated rather than drug
      specific. The results suggest that adults are more concerned about potential use,
      while adolescents are more concerned about past use.

PMID- 1743824
TI  - The balanced placebo design: effects of alcohol and beverage instructions cannot
      be independently assessed.
AB  - Subjects were randomly assigned to the four cells of the balanced placebo design,
      with 10 males and 10 females per cell. Following told-alcohol or told-no alcohol
      beverage instruction manipulations, participants consumed either a vodka-tonic
      beverage containing a dose of vodka sufficient to induce a peak blood alcohol
      level of 0.05% or a beverage containing only tonic water. Subjects' self-report
      ratings of beverage alcohol content indicated that alcohol overrode the effects
      of beverage instructions in the told-tonic/given-alcohol condition. It was
      concluded that the design cannot independently evaluate effects of both alcohol
      and beverage instructions when behaviorally significant alcohol doses are
      administered.

PMID- 1743825
TI  - A comparison of perceived self among drug addicts and nonaddicts.
AB  - The Adjective Check List was employed to compare the self-concepts of 41 male
      drug addicts, 44 male nonaddicted technical school students, and 37 male
      nonaddicted psychiatric patients. A large number of significant differences were
      found. Three scoring systems were used that yielded a total of 23 scales. There
      were nine scales on which the addict group was different from the normal group
      but the psychiatric nonaddict group was not. These nine scales are of particular
      interest since they represented traits that differentiated addicts from normals.
      These traits appear to be related to addiction rather than general maladjustment.
      Implications for treatment are discussed.

PMID- 1743826
TI  - The impact of drug testing on the morale and well-being of mandatory
      participants.
AB  - The impact of drug testing on the morale of mandatory participants was assessed
      through interviews and questionnaire responses of 500 intercollegiate athletes
      required to participate in a urine testing program. Subjects varied widely in
      their experiences. Most were not greatly affected, but some were embarrassed,
      humiliated, upset, and anxious about being inaccurately identified as drug users.
      Others experienced positive benefits: new information, a novel and interesting
      conversation piece, and a socially acceptable way to refuse drugs offered in
      friendship. Some said that testing benefited their athletic performance and
      school work. A number of recommendations were made to humanize and improve the
      experience: a better orientation about what to expect, more effective educational
      sessions, a warmer, more comfortable testing setting, more reasonable drug
      testing objectives, and more rigorous testing standards.

PMID- 1743827
TI  - Behavioral strategies used by long-term successful self-quitters.
AB  - Smoking-cessation programs have been shown to produce unreliable long-term
      results. Thus, efficient methods still need to be identified. One way of getting
      relevant information on successful smoking cessation is to study the quitting
      methods of unaided, long-term, successful quitters. A structured questionnaire
      was designed specifically for this purpose. Results from 70 self-quitters
      indicated that self-quitters typically had high motivation before attempting to
      quit and used aversive and operant methods currently stressed in the literature.
      Graded habituation and nicotine-based methods were used by some self-quitters.
      The findings suggest a two-stage model of quit-smoking program which gives
      greater attention initially to the systematic development of motivation to quit.
      This model, it is postulated, might enhance the long-term efficacy of smoking
      cessation programs.

PMID- 1743828
TI  - High energy shock waves in the treatment of delayed and nonunion of fractures.
AB  - The treatment of delayed and nonunion of fractures by a single extracorporeal
      dose of high energy shock waves generated in a water medium and focused on the
      fracture site is reported. The shock waves break up sclerotic bone by producing
      microfissures and numerous bony fragments because of the difference in impedance
      between bone (and calculi) and soft tissues. Osteogenesis is stimulated and
      contributed to union in 70 out of 82 fractures within a reasonable time.
      Treatment was given as an outpatient with regional anaesthesia; there were no
      side effects or complications.

PMID- 1743829
TI  - Results of the Putti-Platt operation for recurrent anterior dislocation of the
      shoulder.
AB  - Between 1973 and 1981, 101 patients had a Putti-Platt repair for recurrent
      dislocation of the shoulder; 89 of them were followed up and 43 underwent a
      clinical examination, 23 being assessed with the Cybex dynamometer. The 46 who
      did not attend were interviewed by telephone. The mean follow up time was 8 +/- 2
      years (range 5-14 years). Redislocation occurred in 18 patients (20%), but this
      was twice as high in patients who were aged under 26 years at the time of
      operation compared with those who were older (29% versus 13%). The time of
      recurrence was between 1 and 11 years after operation. A decrease in strength and
      power of abduction, internal and external rotation, was found in the affected
      shoulder. Restriction of all measured movements, particularly external rotation,
      was also found in all patients. Nevertheless most had a high functional score and
      relatively few symptoms. We conclude that the Putti-Platt procedure has a high
      recurrence rate in younger patients, and we hesitate to recommend it for young
      active individuals.

PMID- 1743830
TI  - Delayed open reduction for supracondylar fractures of the humerus.
AB  - Twenty children with grade IV supracondylar fractures of the humerus had an open
      reduction 11 to 17 days after injury. The delay was due to swelling and blisters.
      Most patients recovered a useful range of movement and there were no
      complications. A posterior approach with V-Y plasty of the triceps makes it easy
      to align the fragments and reduces the incidence of cubitus varus. Apprehension
      about the risk of increasing the extent of myositis ossificans is unfounded.

PMID- 1743831
TI  - Management of the Galeazzi fracture.
AB  - Fifty-one adults with Galeazzi fractures were treated by operation and the
      results compared in cases treated early, late and after inadequate initial
      treatment. We conclude that in cases treated up to 10 weeks after injury,
      immobilisation with the forearm in full supination in an above elbow cast helps
      to maintain stability of the inferior radioulnar joint. The distal end of the
      ulna should only be excised after 6 months, and if the symptoms warrant it. In
      patients who were inadequately treated initially, the distal end of the ulna
      should be excised at the time of the operation on the radius, but a poor result
      is the inevitable outcome. Union, or nonunion of the ulnar styloid did not affect
      the end result.

PMID- 1743832
TI  - Stress fracture of the diaphysis of the ulna.
AB  - Stress fracture of the diaphysis of the ulna is rare and only 6 cases were found
      in a literature review. We present a further case occurring in a weightlifter.

PMID- 1743833
TI  - Vascularised osteocutaneous fibular transfer to the tibia.
AB  - We have reviewed 25 cases of vascularised osteocutaneous fibular transfers
      carried out between 1982 and 1988. The patients all had chronic osteomyelitis of
      the tibia, with extensive bone loss and associated soft tissue defects, following
      severely comminuted fractures. Union of the grafted bone could be seen in
      radiographs taken 3 to 4 months after operation. The results were generally
      satisfactory, but there were some complications.

PMID- 1743834
TI  - Complications of suppurative arthritis and osteomyelitis in children.
AB  - Three children with suppurative arthritis and osteomyelitis are described to
      emphasise that delayed or incorrect diagnosis may lead to serious cardiopulmonary
      complications. In two patients, bilateral bronchopneumonia developed with
      pneumatocoeles, pneumothorax and empyema. The other had cardiac failure from
      septic pericarditis. In one case, disarticulation of the knee was needed as a
      life-saving measure, and the other leg developed an infected pseudarthrosis of
      the tibia. The causative organism in each case was staphylococcus aureus and no
      evidence of immunodeficiency was demonstrated.

PMID- 1743835
TI  - Radiological study of alignment after total knee replacement. Short radiographs
      or long radiographs?
AB  - The axial alignment on short and long radiographs was measured in 50 knees in 34
      patients who had undergone posteriorly stabilised (Insall-Burstein) condylar knee
      arthroplasty. A mean difference of 1.6 degrees was found when the tibiofemoral
      angles were compared on short and long radiographs. Short radiographs are
      probably adequate for routine assessment of knee replacements in a busy out
      patient clinic, but for accurate scientific studies the long radiographs are
      preferable.

PMID- 1743836
TI  - Posteriorly stabilised (Insall-Burstein) total condylar knee arthroplasty. A
      follow-up study of 157 knees.
AB  - We reviewed 157 knees in 118 patients who underwent posteriorly stabilised
      (Insall-Burstein) knee replacement arthroplasty. Their mean age at operation was
      69 years (range 47 to 85 years) and the average follow-up was 3.5 years (range 2
      to 7 years). The "BASK" knee function assessment chart was utilised to evaluate
      the functional and clinical results. One hundred and thirty-five knees (86%) had
      excellent or good results, 16 knees (10%) had fair results and six (4%) had poor
      results. The mean postoperative BASK score was 79 points and the average
      postoperative knee flexion was 95 degrees (range 65 degrees to 130 degrees). Two
      patients had a superficial infection, one deep sepsis requiring revision
      arthroplasty and two mechanical loosening. Patellar impingement symptoms were
      present in 8% of the knees, although they were troublesome in less than half.
      Varus alignment of the knee and a varus tilt of the tibial component of more than
      2 degrees correlated with the incidence of radiolucent lines around the tibial
      prosthesis. 90% of the patients were pleased or satisfied with the functional
      result. The total condylar knee is a safe, reliable and versatile prosthesis.

PMID- 1743837
TI  - Fibular aplasia. Early surgical correction in two cases.
AB  - Two infants with bilateral fibular aplasia are described. They were operated on
      at 1 1/2 years and 8 months respectively in order to obtain a stable axial
      position of the foot beneath the tibia. The procedures consisted of soft tissue
      releases together with angulation osteotomies of the tibiae in one, and splitting
      the distal tibial epiphysis in the other. Both patients are now able to walk well
      barefoot or in custom-made shoes; no orthotic devices are needed. This type of
      conservative approach should be considered rather than amputation in selected
      cases.

PMID- 1743838
TI  - Autogenous osteoperiosteal grafts in the reconstruction of full-thickness joint
      surface defects.
AB  - Free, autogenous periosteal grafts from the medial metaphysis of the proximal
      tibia have been used to reconstruct full thickness cartilage defects of the
      articular surfaces of the knee joint. If there was a bone defect, it was
      initially filled with cancellous bone graft. The method is illustrated by six
      patients, three with acute traumatic patellar defects and three with local
      sclerotic osteochondritis of the medial femoral condyle. The latter had loose
      fragments unsuitable for fixation and single excision would have left a large and
      deep defect. The grafts have given satisfactory results, 14 to 59 months after
      the procedures. Clinical grading of the defects has been monitored by radiographs
      with arthroscopy of two knees and CT scan of one knee.

PMID- 1743839
TI  - [Total prosthesis after ankylosis of the hip joint. Report of 22 cases].
AB  - Between 1968 and 1987 we carried out a total replacement arthroplasty on 22 hips
      which were either ankylosed or had previously undergone arthrodesis. The hips
      were revised because of pain due to pseudoarthrosis or malposition, pain in the
      other joints such as the lumbar spine, the ipsilateral knee or the contralateral
      hip, fractures about the hip, or professional disability. Significant functional
      and subjective improvement was obtained. The revised hips were painfree, stable
      and had an average range of flexion of 70 degrees. Pain in other joints was
      improved if their degenerative changes were moderate, but many required further
      procedures. Revision of a hip arthrodesis to a replacement arthroplasty is a
      worthwhile procedure in suitable cases.

PMID- 1743840
TI  - Rupture of the ankle ligaments.
AB  - A prospective randomised trial of treatment of ruptured ankle ligaments was
      carried out at our institute. Two hundred patients were randomly assigned to 4
      treatment groups. The results at 1 and 2 years after injury showed that
      functional treatment with a newly designed brace appeared to be the method of
      choice. This gives good mechanical stability, a shorter time off work and the
      ability to resume full sporting activity within 3 months of injury. Operation is
      only indicated for dislocations of the ankle and foot, ankle ligament rupture
      with additional intraarticular damage and second stage injuries or re-ruptures.

PMID- 1743841
TI  - Immune inhibition of repair of canine skull trephine defects implanted with
      partially purified bovine morphogenetic protein.
AB  - The healing of 14-mm trephine skull defects was observed in ten adult mongrel
      dogs. First and second set trephine operations were performed to determine
      whether xenogeneic bovine bone morphogenetic protein (bBMP) and associated bone
      matrix water-insoluble noncollagenous proteins (iNCP) incite an immunological
      humoral response inhibiting bone repair. The effects of immunization to BMP/iNCP
      were observed by serum radioimmunoassay, and by correlated roentgenographic and
      histological analysis of deposits of new bone. The first set implants of
      bBMP/iNCP induced 96% healing while the regeneration of the second set trephines
      was 34% less than the first set. The second set was associated with a significant
      increase in serum anti-BMP antibodies. While xenogeneic bBMP induced complete
      healing of trephine defects when implanted without previous immunization, and
      repair in response to a second set of bBMP/iNCP was always incomplete, further
      research with high purified recombinant BMP is required to measure immune effects
      in a statistically significant number of pure bred recipients.

PMID- 1743843
TI  - Comparison of distraction epiphyseolysis and partial metaphyseal corticotomy in
      leg lengthening.

PMID- 1743842
TI  - The treatment of spinal kyphosis.
AB  - The modern management of kyphosis depends on the diagnosis, but there are common
      factors on which rational treatment can be based. An understanding of the
      biomechanics is very important, especially in planning operations on the spine.
      The greatest single advance has been the anterior approach. Scheuermann's disease
      in children is best treated by bracing, but most other deformities need anterior
      and posterior fusion. Modern instrumentation benefits both the patient and the
      surgeon.

PMID- 1743844
TI  - The John Frederick Adrian Sprent Prize of the Australian Society for
      Parasitology. Citation for Desmond R. Hennessy.

PMID- 1743845
TI  - The John Frederick Adrain Sprent Prize of the Australian Society for
      Parasitology. Citation for Stephen C. Barker.

PMID- 1743846
TI  - Manipulation of benzimidazole pharmacokinetics (J. F. A. Sprent Prize lecture,
      September 1987).

PMID- 1743847
TI  - Evolution of host-parasite associations among species of lice and rock-wallabies:
      coevolution? (J. F. A. Sprent Prize lecture, August 1990).

PMID- 1743848
TI  - Experimental American leishmaniasis and Chagas' disease in the Brazilian squirrel
      monkey: effect of dual infection on antibodies to parasite antigens.
AB  - Adult, laboratory-bred squirrel monkeys (Saimiri sciureus) were infected with
      either Leishmania braziliensis braziliensis or L. b. panamensis and, 42 weeks
      later, they were challenge-infected with Trypanosoma cruzi. Another group of
      monkeys was infected with T. cruzi and challenged with L. b. braziliensis after
      42 weeks. Immunoblotting was used to examine parasite antigens bound by
      antibodies in plasma obtained from the monkeys during the course of primary and
      challenge infections. During primary infections Leishmania-infected monkeys
      produced antibodies which bound to a number of Leishmania antigens, most notably
      a Leishmania antigen of 72 kDa, which were not recognized by antibodies produced
      by the monkeys given a primary infection of T. cruzi. These Leishmania-induced
      antibodies were no longer detectable 42 weeks after primary infections. However,
      when the Leishmania-infected monkeys were challenged with T. cruzi they once
      again produced antibodies capable of binding numerous Leishmania antigens,
      including the antigen of 72 kDa, which had not been recognized by antibodies
      produced by the monkeys with primary T. cruzi infections. A similar phenomenon
      was observed in T. cruzi-infected animals following Leishmania challenge.

PMID- 1743849
TI  - Mechanism of 3-0-methylglucose uptake by Hymenolepis diminuta.
AB  - The mechanism by which Hymenolepis diminuta (Cestoda) absorbs 3-0-methylglucose
      (30MG) in vitro was analyzed. Influxes of 0.1 and 0.01 mM-3H-30MG during
      incubations ranging from 5 s to 60 min were not affected significantly when 10 mM
      unlabeled 30MG was present as an inhibitor. After 60 min in 0.1 mM-3H-30MG, the
      concentration of labeled substrate within tapeworms (0.04 mumol ml-1 worm water =
      0.04 mM) was less than that of the bathing medium. Tapeworms incubated for 1 h
      with either 5 mM-glucose or 5 mM-beta-methylglucose (beta MG) gained 15-20% more
      water than did tapeworms in saline alone, but addition of 5 mM-30MG to the saline
      had no significant effect on weight change. When the 3H-30MG concentration was
      varied from 0.01 to 10 mM, influxes were a linear function of substrate
      concentrations. These analyses show that H. diminuta absorbs 30MG by simple
      diffusion alone. Thus, use of this monosaccharide to estimate the internal
      concentration of actively transported sugars (e.g. glucose or beta MG) in H.
      diminuta is invalid.

PMID- 1743850
TI  - Echinococcus granulosus: development of an intermediate host mouse model for use
      in vaccination studies.
AB  - A mouse model has been developed to evaluate potential protective antigens which
      could render intermediate hosts resistant to a challenge infection with
      Echinococcus granulosus eggs. DBA/2J, CBA/J, Balb/cJ, C57/B16J and CF-1 mice were
      initially infected orally and parenterally with eggs, hatched eggs or activated
      oncospheres. Generally less than 1% of the oral dose established as cysts. Mean
      cysts counts were increased when Balb/cJ mice were injected intraperitoneally or
      intravenously with activated oncospheres. A challenge regime using 600 activated
      oncospheres injected intraperitoneally into adult Balb/cJ mice was subsequently
      adopted yielding means of 15-51 cysts per mouse. When activated oncospheres were
      injected intraperitoneally into Balb/cJ, DBA/2J and CF-1 mice, cysts were
      restricted to the peritoneal cavity. Activated oncospheres injected
      intravenously, however, lodged almost exclusively in the lung and thoracic
      cavity, except in DBA/2J mice where 55% lodged in the liver. This anatomical
      localization enabled the outcome of prior infection and challenge to be monitored
      separately. Prior infection rendered Balb/cJ mice fully resistant to subsequent
      challenge.

PMID- 1743851
TI  - Genetic variation in the Heterodoxus octoseriatus group (Phthiraptera): a test of
      Price's model of parasite evolution.
AB  - Most of the genetic variation in the H. octoseriatus group is present as fixed
      gene differences between species which have been described on morphological
      criteria. Based on allozymes, the taxonomic status of some species was
      challenged. There was insufficient evidence, however, to demonstrate that these
      were not 'good' biological species. Overall, the limited intraspecific variation
      was present as fixed gene differences among lice from different hosts and from
      different colonies of hosts; heterozygotes were rare. Two predictions derived
      from Price's model of parasite evolution were met: populations of lice were
      genetically homogeneous and, where genetic markers were present, we found
      substantial genetic variation among populations. These data contrast with those
      for endoparasitic helminths, where, in general, the amount of genetic variation
      is similar to that of free-living invertebrates.

PMID- 1743852
TI  - Dactylogyrids on the gills of roach in central Finland: features of infection and
      species composition.
AB  - Monogenean parasites were examined from the gills of 660 roach (Rutilus rutilus)
      in four interconnected lakes in Central Finland between February and November
      1986 and in three of the same lakes between February and December 1988. One of
      the lakes is eutrophic and polluted due to a paper and pulp mill, one is
      oligotrophic and in a natural state, and the other two lakes are eutrophic. The
      prevalence of Dactylogyrus infection was always high. Differences between the
      lakes and the years were observed in the intensity of infection, which was
      significantly higher in the polluted lake. The intensity was also higher in older
      fish. Nine Dactylogyrus species were found, and of these D. crucifer and D. nanus
      were numerically dominant in all of the lakes studied, especially in the
      oligotrophic lake. In 1986 D. fallax, D. similis and D. suecicus constituted
      significant proportions of the fauna in the polluted lake. D. micracanthus was
      most common in the eutrophic lakes. In 1988 the species composition in the
      polluted lake was most similar to that in the eutrophic lake.

PMID- 1743853
TI  - Trypanosoma brucei: peptide mapping of partially homologous variable surface
      glycoproteins.
AB  - Antigenic variation in Trypanosoma brucei is caused by amino acid sequence
      changes in a major surface glycoprotein. Each trypanosome may contain between 100
      and 1000 genes coding for this glycoprotein. Some of these genes are members of
      partially homologous gene families. In addition, segments of different genes may
      combine to form 'hybrid' or 'mosaic' genes. Thus, surface glycoproteins exist
      containing varying amounts of amino acid sequence homology. For investigations of
      molecular mechanisms of antigenic diversity it is important to identify sub-sets
      of trypanosomes expressing related surface glycoproteins. We describe here a
      simple method based on trypanosome surface labeling followed by peptide mapping
      to indicate homologous peptides present in one sub-set of T. brucei surface
      glycoproteins.

PMID- 1743854
TI  - A cladistic analysis of the genera in the subfamily Pudicinae (Nematoda,
      Trichostrongyloidea, Heligmonellidae).
AB  - A parsimony analysis was performed on 37 specific taxa belonging to the subfamily
      Pudicinae (family Heligmonellidae), which contains parasites mainly from South
      American caviomorph rodents. Thirteen characters were used from the synlophe
      (rotation of axis, presence of carene, carene asymmetry, presence of comaretes,
      single ventral comarete length, ridge discontinuity, ventral ridge numbers,
      presence of a peculiar posterior synlophe, presence of supernumerary spines) and
      the male caudal bursa (relative length of rays 9 and 10, caudal bursa type,
      division of the dorsal ray, divergence of the 10th rays). The cladogram shows a
      consistency index of 1.0. The subfamily Pudicinae has two synapomorphies. Two
      suprageneric groups are recognized. Suprageneric group 1 shows one synapomorphy
      and contains Heligmostrongylus, Fuellebornema, Sciurodendrium and
      Pseudoheligmosomum; suprageneric group 2 shows two synapomorphies and contains
      Pudica, Acanthostrongylus, Justinema and Durettestrongylus. Five genera are
      defined on the basis of synapomorphies. The genera Heligmostrongylus,
      Sciurodendrium and Pudica which are considered paraphyletic, however, are
      retained due to lack of knowledge as to their relationships.

PMID- 1743855
TI  - A nuclear magnetic resonance study of the glucose metabolism of Hymenolepis
      diminuta exposed to histamine and serotonin in vitro.
AB  - The direct effects of the inflammatory mediators, histamine (HI) and serotonin
      (SE), on the glucose metabolism of Hymenolepis diminuta in vitro were studied by
      analyzing the excretory products from culture media, containing D-1-13C-glucose
      and various concentrations of HI and/or SE, by 1H-nuclear magnetic resonance
      (n.m.r.) spectroscopy. The results revealed that HI markedly accelerated the
      glycolysis process by increasing the amount of lactate production. The increased
      glycolytic activity was reflected in a concentration-dependent increase in
      glucose uptake. Excretion of acetate was also stimulated by HI. A low
      concentration of SE significantly increased succinate, acetate and lactate
      excretions, whereas a high concentration had little effect on lactate production
      and significantly decreased succinate and acetate excretions. A combination of HI
      and SE treatment at a low concentration had no significant effect, but at a high
      concentration showed an additive effect, with an increase in lactate production,
      a decrease in succinate production and an increase in glucose uptake. Thus this
      work confirms that HI and SE directly influence, albeit differently, energy
      metabolism of the tapeworm H. diminuta.

PMID- 1743856
TI  - Aspects of the morphology and life cycle of Lecithocladium excisum (Digenea,
      Hemiuridae), a parasite of Scomber spp.
AB  - Previously undescribed motile cystophorous cercariae which develop in sporocyst
      like germinal sacs in the bullomorph opisthobranch Philine aperta are
      experimentally shown to develop into Lecithocladium excisum (Digenea,
      Hemiuridae), a common stomach parasite of mackerel Scomber scombrus in the north
      east Atlantic and adjacent seas. Between 3 and 8% of P. aperta from the northern
      Oresund, Denmark, were infected with cercariae of L. excisum. Ninety per cent
      were infected with Rhopalura sp. (Orthonectida). Copepods of the genera Acartia,
      Paracalanus, Pseudocalanus, Eurytemora and Oithona were experimentally infected.
      Pressure exerted by their mouth limbs caused delivery tube eversion and the
      injection of the cercarial body into the copepod haemocoel. The metacercariae did
      not grow in the above mentioned hosts at 12 degrees C, but 590 microns long
      metacercariae developed within 22 days in laboratory-reared A. tonsa at 18
      degrees C. The ctenophore Pleurobrachia pileus and the holoplanktonic polychaete
      Tomopteris helgolandica, which were found to be naturally infected with
      metacercariae of L. excisum, may act as transport hosts.

PMID- 1743857
TI  - Taenia solium: inhibition of spontaneous evagination of cysticerci by the host
      inflammatory capsule.
AB  - The effect of the host's inflammatory capsule or of physical restraint on the
      spontaneous evagination capacity of Taenia solium cysticerci was evaluated.
      Parasites obtained from infected pig muscle, in which the surrounding
      inflammatory capsule was not eliminated, were unable to evaginate spontaneously
      after 12 or 60 h of culture. This phenomenon was not abolished when the capsule
      was eliminated and the parasites were cultured in semi-solid agar or in liquid
      medium.

PMID- 1743858
TI  - A simple method for the purification of mitochondrial DNA from Plasmodium
      falciparum.
AB  - Mitochondrial DNA (mtDNA) from Plasmodium falciparum was isolated by conventional
      differential centrifugation in an SS34 rotor, a simpler method than CsC1
      centrifugation of total DNA as employed by other workers. The nature of the
      sample was verified by sequencing a polymerase chain reaction (PCR) product
      obtained using oligonucleotide primers derived from known malarial mtDNA
      sequence.

PMID- 1743859
TI  - Babesia bovis host cell recognition proteins.
AB  - Babesia bovis enters host erythrocytes by invagination but nothing is known of
      the proteins involved. By means of metabolic labelling, differential
      centrifugation in oil and salt elution, a number of babesial proteins have been
      shown to bind to bovine erythrocytes. Strong binding is evidenced only by a 38/19
      kDa pair. Preliminary experiments indicate that these two proteins also bind to
      human erythrocytes, although apparently to a lesser extent.

PMID- 1743860
TI  - A cyst-like stage of Blastocystis hominis.
AB  - A cyst-like form of Blastocystis hominis is described in stools and in culture.
      This form is more common in stored stools than fresh material. A cyst wall is
      secreted under the surface coat of the cell, and the surface coat and cell debris
      subsequently separate from the cyst. Whether this stage can withstand adverse
      environmental conditions and is infective to a new host remain to be determined.

PMID- 1743861
TI  - Ocular leprosy--the continuing challenge.

PMID- 1743862
TI  - Comparison of the old and new W.H.O. leprosy disability grading scheme for ocular
      disabilities.
AB  - We compared the old (1970) and new (1988) World Health Organization schemes for
      classifying the ocular disabilities in leprosy patients. 509 leprosy patients
      from eight resettlement villages in central South Korea were examined and graded
      by eye according to both of the schemes. A more liberal definition of severely
      disabled in 1988 resulted in a 119% increase in eyes graded as severely disabled
      in this population. 59 eyes were graded as severely disabled by the old scheme
      and 129 eyes were so graded according to the new scheme. Keratitis, one of three
      measures of moderate disability in the old scheme, was replaced by corneal
      anaesthesia in the new scheme, but this change did not make a substantial
      difference in the number of patients in the moderately impaired category. In the
      absence of longitudinal studies documenting the significance of keratitis, it is
      unclear whether the change in an improvement. The new disability scheme improved
      upon the old by removing the criteria for mild impairment.

PMID- 1743863
TI  - Leukoplakia of the cornea presenting as fingerprint epithelial lines: a case
      report.
AB  - Opacities in association with fingerprint patterns of the epithelium were seen in
      the upper half of the right cornea of a 52-year-old patient complaining of
      decreased vision. Removal of the corneal epithelium from the involved area
      resulted in visual improvement and normalization of corneal appearance.
      Histological examination of the removed epithelium failed to reveal the typical
      intraepithelial formation of basement membrane invaginations even in the areas
      corresponding to the fingerprint patterns. Moderate to severe degree of atypia
      were seen in the epithelial cells. No abnormalities were observed in 3
      conjunctival specimens excised at the time of epithelial removal. The diagnosis
      of corneal dysplasia (leukoplakia) was made. Our report is the first description
      of epithelial fingerprint patterns of the cornea associated with leukoplakia.

PMID- 1743864
TI  - In vitro viability of choroidal melanomata following pre-enucleation irradiation.
AB  - In a group of eighteen patients with uveal melanomas, seven underwent low-dose
      pre-enucleation irradiation of approximately 2000 cGy. All the tumours were
      propagated in tissue culture and the growth characteristics of tumour cells from
      irradiated eyes were compared with tumour cells from non-irradiated eyes.
      Cultures were observed with phase-contrast microscopy, and radioactive thymidine
      labelling was used to study cell turnover. Although tissue samples from
      peripheral areas of irradiated tumours produced a mixture of viable and non
      viable cells, with reduced ability to attach to substrate, central regions of
      irradiated tumours contained viable cells which propagated freely in tissue
      culture.

PMID- 1743865
TI  - Reservations about the Malbran technique.

PMID- 1743866
TI  - Corneal endothelial cell morphology under permanent wear of rigid contact lenses.
AB  - The influence of the permanent wear of rigid high Dk-lenses (nominal Dk 71 or 92)
      with elliptical geometry on the corneal endothelium was assessed. For this
      purpose the endothelium of 16 patients was compared by specular microscopy before
      and after the permanent wear. The wearing time of the lenses varied between 7 and
      24 months. Computerized morphometric analysis of the photographs revealed that
      the variability in cell size (polymegathism) and in cell shape (pleomorphism) did
      not change during the wearing period. It is suggested that this is due to the
      high gas-permeability and the elliptical geometry of the contact lenses.

PMID- 1743867
TI  - Spectrophotometric analysis of sodium fluorescein aqueous solutions.
      Determination of molar absorption coefficient.
AB  - The usefulness of sodium fluorescein (SF) and related physical parameters were
      analysed. Two factors that may affect the molar absorption coefficient (epsilon)
      of this compound were the presence of impurities and the pH of the solution. As
      discrepant values can be found in the literature for that coefficient, a
      purification technique was used and SF quantification was performed according to
      sodium concentration determined by atomic absorption spectrophotometry. The molar
      absorption coefficient of the SF solution in phosphate buffer pH 7.4 was
      determined. To study the influence of pH on epsilon determination, absorption
      spectra at pH1, 3, 5, and 10 were also analysed.

PMID- 1743868
TI  - B-mode echography of choroidal melanoma; echographic and histological aspects of
      choroidal excavation.
AB  - The B-mode images of 32 patients affected with a malignant melanoma of the
      choroid were studied, in particular with respect to choroidal excavation. The
      degree of visibility of choroidal excavation at the B-scan was compared with the
      thickness of the choroid, scleral invasion, vascularisation, retinal detachment
      and the reflectivity of the tumour. None of these histological and echographical
      features appeared to be significantly related to the degree of the visibility of
      choroidal excavation. Also the condition of the choroid was studied. At
      examination of all the histological sections no choroid was found between tumour
      and sclera. This implies that choroidal excavation should be visible at echograms
      in every case instead of only in 75% of the cases as was found for our series.

PMID- 1743869
TI  - Congenital ichthyosis in a Libyan child with ophthalmic manifestations.
AB  - This report presents a Libyan child with congenital ichthyosis of the recessive
      lamellar variety complicated by severe ectropion of both upper and lower eyelids.
      Over a period of 12 months the degree of ectropion diminished and the anterior
      segments of the eyes were preserved using regular lubricating drops, vitamin A
      ointment and intermittent topical antibiotic therapy. Despite the pronounced
      initial upper eyelid ectropion no surgery was required to relieve the ectropion
      or prevent corneal exposure.

PMID- 1743870
TI  - A comparison of unweighted and fluctuation-weighted indices (within the central
      28 degrees of glaucomatous visual fields measured with the Octopus automated
      perimeter).
AB  - The main visual field indices of Flammer and the analogous ones of Heijl have
      been compared based on a population of 113 glaucomatous visual fields. It is
      shown that for the population studied, the differences between the two sets of
      indices are negligible for Octopus G1 program results and that they may thus be
      used interchangeably.

PMID- 1743871
TI  - Cataract instruments and devices--'cost and quality'.

PMID- 1743872
TI  - Nasal mucociliary function in the normal newborn.
AB  - Nasal mucociliary transport has been studied using the seroalbumin-Tc99m
      radioisotope method in 10 adults and 10 normal newborns under 28 days of age. The
      mean transport velocity was 8 and 6 mm/min for the normal adults and newborns,
      respectively, with no significant differences between the two (P = 0.07).

PMID- 1743873
TI  - The influence of tonsillar obstruction and tonsillectomy on facial growth and
      dental arch morphology.
AB  - Children, who were tonsillectomized because of sleep apnea were examined with
      respect to facial growth and dental arch morphology. Dental casts and lateral
      roentgencephalograms were analysed before surgery and two years after
      tonsillectomy. The findings were compared to data from children without
      tonsillary obstruction. A higher proportion of malocclusion than normal,
      especially open bite and crossbite, was noticed before surgery. Two years after
      surgery, 77% of the open bites were normalised and 50-65% of the buccal and
      anterior crossbites. The best results were seen in children operated before the
      age of 6.

PMID- 1743874
TI  - Stratified squamous epithelium in relation to the tympanic membrane: its
      development and kinetics.
AB  - The pathways of auditory epithelial migration on the human tympanic membrane and
      their rate of movement were investigated by Hopkins rod photography of dye
      markings. The origin of these pathways was determined in both the human and the
      mouse by studying the development of the stratified squamous epithelium of the
      tympanic membrane and external auditory meatus from earliest embryonic life to
      maturity. Two pathways of migration are present. In one, epithelium moves from
      the region covering the tip of the handle of the malleus upwards to the lateral
      process and then posterior-superiorly with all dye on the pars flaccida to its
      posterior superior edge. In the second, dye moves centrifugally and radially
      outwards from the edges of the handle and pars flaccida regions to the annulus.
      Rate of movement can be determined approximately only and by reference to
      anatomical landmarks. The first pathway was traced embryologically to migration
      possibly commencing in the fundus of the primordial first branchial groove. The
      second pathway has its source in the growth of the meatal plate. A study of the
      development of the early meatal plate in the mouse suggests that movement of
      epithelium over the pars tensa region could be the result of a "pulling" effect
      of mitotically active cells in a generation center at the edge of the tympanic
      membrane resulting from negative contact inhibition.

PMID- 1743875
TI  - Bacteriological nasal flora in newborns indicating health and/or development of
      infection.
AB  - During delivery, a fetus otherwise sterile during the intrauterine life, comes in
      contact with bacterial flora of the mother's birth canal, and then also with the
      ward personnel's skin and respiratory system flora. Due to the absence of
      competitive bacteriological flora, the nasal cavity is gradually colonized by
      microorganisms, especially those with a capacity of adhesion to epithelial cells
      of respiratory nasal mucosa. Bacteriological flora of the newborn's nasal flora
      was observed on days 1 and 3 postpartum, in an attempt to determine whether a
      finding of pathogenic bacterial flora in newborn's nasal mucosa indicates a
      localized infection only or points to the possible development of generalized
      infection. Bacteriological nasal flora was monitored in infants born by
      spontaneous delivery and in those born by cesarean section. In mothers of infants
      born by spontaneous delivery, bacteriological flora from the cervix uteri was
      investigated. Results of the study performed by usual methods revealed
      Escherichia coli and Staphylococcus aureus to prevail in the pathogenic flora.
      Gram-negative microorganisms were found to be good indicators of local infection
      of newborn's nasal mucosa, regardless of the absence of clinical symptoms.

PMID- 1743876
TI  - Retrospective study of the prevalence of bilateral sensorineural deafness in
      childhood.
AB  - This retrospective study was undertaken to estimate the causes of severe
      sensorineural deafness (greater than 40 dB HL) in children. The children were
      identified from case notes of all referrals made to the Children's Hearing
      Assessment Centre during a 5-year period (from 1st January 1981 to 31st December
      1985). Results were tabulated and conclusions drawn following a literature
      search. It was deduced that following better antenatal screening, a more active
      immunisation program and improvements in resuscitation of small preterm infants,
      there was a shift of cases from prenatal to perinatal causes. The proportion of
      cases of severe sensorineural deafness was much the same as in previous studies.

PMID- 1743877
TI  - Quality of life issues in chronic otitis media with effusion: parameters for
      future study.
AB  - This pilot project studied 61 children with chronic otitis media with effusion.
      The 12-month period prior to ventilation tube surgery was compared with the 12
      months after surgery with respect to numbers of health care visits, the use of
      antibiotics, parental perceptions of hearing and speech problems, and other
      selected parameters. Significant decreases were found in total health care visits
      (mean decrease: 6.18 visits, P less than 0.001). Ear-related health care visits
      also decreased significantly (mean decrease = 10.93, P less than 0.001). Total
      health care visits correlated strongly with visits for ear problems both before
      and after surgery (r = 0.4474, P less than 0.001). Usage of antibiotics
      significantly decreased. Parental reports concerning the issues of secondary
      speech and hearing problems raised questions for additional study. In addition,
      the qualitative comments offered by parents suggest the breadth of impact of
      chronic otitis media with effusion in this patient population, and point the
      direction for future research.

PMID- 1743878
TI  - The two-headed stethoscope: its use for ruling out airway foreign bodies.
AB  - Foreign body aspiration is a common concern for physicians and surgeons who care
      for children. Evaluating infants and toddlers to rule out this possible diagnosis
      is often fraught with difficulties. Specifically, the standard stethoscope is of
      limited use unless unilateral asymmetry of breath sounds can be appreciated.
      Inspiratory and expiratory chest X-rays in children often appear to show a very
      similar diaphragmatic excursion and, unless the object is radiodense, the
      determination of foreign body aspiration is frequently not possible. Other
      procedures, such as flexible or rigid endoscopy, are more invasive and are
      reserved for children with positive findings or a less acute but more perplexing
      scenario. We present the use of the two-headed stethoscope as an option for
      evaluation of children to rule out foreign body aspiration. Our experience with
      this instrument over the past 10 years has consistently allowed us to non
      invasively differentiate the presence or absence of objects in the airway.

PMID- 1743879
TI  - A comparison of anterior cricoid split with and without costal cartilage graft
      for acquired subglottic stenosis.
AB  - The use of the anterior cricoid split has allowed the extubation of multiple
      children who would otherwise require tracheostomy. Success, however, has been
      variable and difficult postoperative complications have occurred. Since 1981, 22
      children at the Children's Hospital and Medical Center in Seattle, Washington
      have failed extubation because of subglottic disease as defined previously by
      Cotton and Seid. Two approaches have been used in managing the extubation of
      these children, one employing the anterior cricoid split and one employing the
      anterior cricoid split with immediate tracheoplasty using costal cartilage
      grafting. Immediate costal cartilage grafting resulted in fewer complications and
      a higher success rate in extubating patients with acquired subglottic stenosis.

PMID- 1743880
TI  - Neurogenic tumours of the parapharyngeal space in the paediatric age group.
AB  - Two cases of neurogenic tumours of parapharyngeal space in children of 7 years
      old are presented. Difficulties during the diagnosis, investigations and
      management are discussed along with a review of the available literature. CAT
      scan with sialography, carotid angiography during surgery, angle mandibulectomy
      and liberal incision to expose the great vessels for better control of bleeding
      are stressed to minimise the peri-operative complication and to assist in
      complete removal of the tumours.

PMID- 1743881
TI  - Pharmaceutical industry joins WHO to combat AIDS.

PMID- 1743882
TI  - Ethical issues in AIDS prevention/control.

PMID- 1743883
TI  - Why AIDS cannot be transmitted by insects.

PMID- 1743884
TI  - Carrying the torch for nursing's new tomorrow.

PMID- 1743885
TI  - Developing nurse managers in Hungary.
AB  - Success in the work of nursing administrators can be realized only if they have
      their own sphere of competency and authority. In the Hungarian management system,
      however, nursing administrators are only functional leaders; they do not have
      authority for decisionmaking nor do they have a major leadership role. Most hand
      in proposals and carry out decisions made by the general director/chief physician
      or other leaders of the hospital. Below, an overview of the present status of
      Hungarian nursing administrators and a suggested new structure of management that
      would provide nursing administrators with a full and independent right of
      decision, which would greatly improve the efficiency of nursing care.

PMID- 1743886
TI  - Nursing diagnoses of culturally diverse patients.
AB  - As the world's people become more mobile and the record number of refugees seek
      new homes, nurses are being increasingly faced with the caring of people from a
      culture different than their own. More than ever, there is a need for nursing
      care planned around unique cultural healthcare beliefs, values and practices of
      patients. However, incorporating cross-cultural defining characteristics into
      nursing diagnoses has been slow and difficult, the main reason being that nursing
      diagnoses are built into a classification system based on "labelling" which is
      "unintentionally culturally insensitive and may even stereotype clients." To help
      nurses in caring for culturally diverse patients, additions suggested to the
      classification system of nursing diagnoses are given below.

PMID- 1743887
TI  - Reflections on an international theory of nursing.

PMID- 1743889
TI  - The future of neuro-ophthalmology.

PMID- 1743888
TI  - Promoting assertive behaviours in traditional societies.
AB  - Nurses have been encouraged to speak out, to exert power and to stand up for
      their rights as well as the rights of patients. Yet in many cultures strong
      assertive women are accepted less readily by both men and other women. The
      question then is: How can nurses in a traditional society be helped to develop
      assertive behaviours? Based on their experience in Malawi and Nepal, the authors
      identify the factors influencing nonassertive behaviours and present a model to
      foster appropriate behaviours in nurses in these and similar countries.

PMID- 1743890
TI  - Magnetic resonance imaging applications in ophthalmology.

PMID- 1743891
TI  - Botulinum toxin injections for treatment of blepharospasm and hemifacial spasm.

PMID- 1743892
TI  - Neuro-ophthalmology: odds and ends.

PMID- 1743893
TI  - Ocular Lyme borreliosis--1991.

PMID- 1743894
TI  - Carotid endarterectomy and its alternatives in managing amaurosis fugax.

PMID- 1743895
TI  - Automated perimetry in neuro-ophthalmology.
AB  - The automated perimeter presents new challenges to clinicians comfortable with
      the use of the Goldmann perimeter in neuro-ophthalmic diagnosis. An understanding
      of the basic differences between kinetic and static threshold perimetry, an
      intelligent choice of automated test programs, and an interpretive strategy
      focusing on the vertical meridian will result in optimal use of this important
      technological advance.

PMID- 1743896
TI  - Management of nonspecific inflammatory and lymphoid orbital lesions.

PMID- 1743897
TI  - Optic nerve sheath decompression: history, techniques, and indications.
AB  - Despite skepticism regarding the efficacy of the procedure, ONSD now has an
      established role in the management of visual loss associated with chronic
      papilledema. The surgical procedure requires microscopic dissection of the
      intraorbital optic nerve to avoid permanent damage to the nerve and its vascular
      supply. Recent (albeit controversial) investigations concerning ONSD for ischemic
      disease of the optic nerve suggest that the procedure may have more
      pathophysiological effects than were once believed.

PMID- 1743898
TI  - Retinal and optic nerve head disorders masquerading as diseases of the central
      nervous system.

PMID- 1743899
TI  - Cultural differences in interpersonal responses to depressives' nonverbal
      behaviour.
AB  - The Social Impression and Interpersonal Attraction of British depressed patients
      was rated by British and German subjects on the basis of the patients' video
      recorded nonverbal behaviour. Depressives were rated negatively by all subjects.
      Males in both cultural groups agreed in their ratings of depressives but German
      females expressed a more negative attitude than British females. This is
      attributed to cultural differences in sex-appropriate interactive behaviour. The
      importance of studying the expression of depression and its meaning within a
      particular cultural context is indicated and the role of cultural differences in
      interactive behaviour is discussed with respect to intercultural assessment and
      treatment of depression.

PMID- 1743900
TI  - Parasuicide and alcohol: a 20 year survey of admissions to a regional poisoning
      treatment centre.
AB  - The relationship between alcohol dependence, alcohol consumption and parasuicide
      was studied among patients admitted over a twenty year period (1968-87) to a
      regional poisoning treatment centre in Edinburgh. Both alcohol dependence and
      consumption of alcohol at the time of the parasuicidal act were reported more
      commonly by men than by women. An examination of temporal trends showed little
      change among male patients, while the proportion of females diagnosed as alcohol
      dependent or consuming alcohol at the time of the act tended to increase over
      time. A comparison of alcohol dependent (AD) and non-alcohol dependent (non-AD)
      parasuicides over the period 1982-87 revealed differences in respect of
      sociodemographic characteristics (the AD group containing more unemployed,
      especially long term) clinical variables (the AD group being more likely to have
      acted suicidally and to have received psychiatric treatment in the past, yet less
      likely to be currently diagnosed psychiatrically ill), family features and social
      problems. The implications of the study findings for research and service
      delivery are mentioned.

PMID- 1743901
TI  - Returning for follow up: attendance compliance in an Indian psychiatric clinic.
AB  - Attendance compliance was studied in first time outpatient attenders at an Indian
      psychiatric clinic. Compliance was positively associated with the patient's
      willingness to attend the initial consultation, being given an early appointment
      time for the first follow up appointment, good work prognosis and informing the
      patient's accompanying relative of this good work prognosis. Factors associated
      with decreased compliance were telling the patient the expected duration of
      treatment and an illness duration of less than six months at the time of
      presentation. The results have implications for timing of the subsequent
      appointment, developing rapport with the patient and being circumspect about what
      the patient is told.

PMID- 1743902
TI  - DSM-III in the training of British psychiatrists: a national survey.
AB  - All 223 psychiatric clinical tutors in the UK were surveyed on their use of DSM
      III in their postgraduate training programmes. Results indicate that DSM-III is
      widely used in clinical training to some extent in the majority of schemes (73%)
      and in the schemes where it is used it is rated as moderately useful by nearly
      everyone (93%). DSM-III is generally perceived to have positive effects on
      learning basic elements of psychopathology and in offering a common language for
      diagnostic discussion. Interestingly only 16% of users felt that DSM-III was so
      complicated that it impeded rather than facilitated the teaching of diagnosis.
      Few schemes provide specific teaching courses and case conferences provide the
      major forum for teaching DSM-III.

PMID- 1743903
TI  - Psychotropic drug prescribing to chronic schizophrenics in a Hong Kong hospital.
AB  - There is little information on the prescription practice for chronic
      schizophrenics, especially in Asia. A survey in a mental hospital in Hong Kong
      revealed a high mean daily dose of antipsychotics and a high frequency of use of
      anticholinergic drugs. The significance of these findings is discussed.

PMID- 1743904
TI  - Attitudes of Chinese and American male students towards mental illness.
AB  - Attitudes towards mental illness were measured by the Opinion About Mental
      Illness Scale (OMI) for 83 male graduate college students from American and
      Chinese cultural backgrounds. The OMI questionnaire consisted of five factors: A)
      Authoritarianism, B) Benevolence, C) Mental Hygiene Ideology, D) Social
      Restrictiveness, and E) Interpersonal Etiology. Statistically significant
      differences between the two groups of subjects on Factors A, B, D and E of the
      OMI were found. American students performed lower on "Authoritarianism", on
      "Social Restrictiveness", and on "Interpersonal Etiology", and higher on
      "Benevolence" than Chinese subjects.

PMID- 1743905
TI  - Marital satisfaction among San Francisco Chinese-Americans.
AB  - This study investigates variables that predict marital satisfaction in a group of
      San Francisco Chinese-Americans. Using Campbell, Converse and Rodgers' model of
      satisfaction as a framework (1976), 41% of the variance of marital satisfaction
      is accounted for with objective demographics and subjective assessments of
      marriage components derived from the Locke-Wallace Marital Adjustment Scale
      items. Chinese-Americans are generally satisfied with their marriage, with men
      reporting higher satisfaction levels than women. Agreement on life aims and moral
      behaviour emerges as the most important predictor of marital quality. In
      addition, for men, agreement in relating to in-laws and friends is also found to
      be a significant predictor of marriage satisfaction.

PMID- 1743906
TI  - Experienced Turkish nurses' attitudes towards mental illness and the predictor
      variables of their attitudes.
AB  - General attitudes towards mental illness, attitudes towards two vignettes, and
      possible predictor variables of these attitudes were investigated among
      experienced Turkish nurses. The analyses showed that the nurses accepted both
      organic and psychological causation and had rather positive views on drug
      treatment, psychotherapy, and prognosis. However, they were more favourably
      disposed towards psychological causation and psychotherapy; the paranoid
      schizophrenia description was more readily perceived as mental illness and more
      'negative' ratings were recorded for this than was the case in the description of
      neurosis. In terms of predictors, university education was related to lower
      acceptance of psychotherapy and chances of recovery; older respondents showed
      higher social distance to the neurosis vignette. The findings were discussed
      within the context of previous findings from Turkey and other countries.

PMID- 1743907
TI  - The administration of academic time in a radiology department.

PMID- 1743908
TI  - Radiotracers and the heart. State of the turf.

PMID- 1743909
TI  - Malignant hyperthermia. Diagnosis, treatment, genetics, and pathophysiology.

PMID- 1743910
TI  - Curriculum for musculoskeletal radiology.
AB  - Although general suggestions have been made regarding a radiology residency
      curriculum, no specific list of entities has been offered. Over the past ten
      years, we have developed a resident-run morning conference in musculoskeletal
      radiology that is supervised by faculty and covers a specific curriculum. We
      offer our curriculum as an example that may assist other departments in
      developing their own curricula.

PMID- 1743911
TI  - Comparison of magnetic resonance imaging and ultrasonography in staging early
      prostate cancer. Results of a multi-institutional cooperative trial.

PMID- 1743912
TI  - Categorical course approach to resident teaching in cardiac radiology.

PMID- 1743913
TI  - The fellowship phenomenon.

PMID- 1743914
TI  - Therapeutic alternatives for subacute peripheral arterial occlusion. Comparison
      by outcome, length of stay, and hospital charges.
AB  - Thrombolytic therapy using streptokinase or urokinase has been shown to be a
      viable alternative to surgical thrombectomy in patients with subacute peripheral
      arterial occlusion. Urokinase is associated with higher success and lower
      complication rates than streptokinase, but the cost of urokinase is at least
      seven times higher. To address questions of utility and effectiveness in the
      treatment of subacute peripheral arterial occlusions, the authors designed a
      retrospective study of patients treated either by surgical thrombectomy (n = 70),
      thrombolysis with streptokinase (n = 19), or thrombolysis with urokinase (n =
      22). Outcome of therapy, length of hospital stay, and total hospital charges in
      the three groups were examined. Treatment successes in the three groups, defined
      as complete clearing of the occluded segment with patency maintained for 60 days,
      were 76% for thrombectomy, 32% for streptokinase, and 64% for urokinase. Total
      duration of hospitalization was 21.1, 21.3, and 11.5 days (P less than .05),
      respectively. Mean charges for thrombolytic agents were $690 for streptokinase
      and $6429 for urokinase. Mean total hospital charges, however, were $25,978 for
      streptokinase, $22,203 for urokinase, and $25,336 for thrombectomy (P = NS). The
      higher cost of urokinase, then, accounted for the similar total charges, despite
      the shortened length of stay. These results suggest that urokinase is cost
      effective compared to streptokinase for subacute peripheral arterial occlusion.
      Compared to thrombectomy, thrombolysis with urokinase has a marginally lower
      patency rate at 60 days, but a significantly shorter length of hospital stay.

PMID- 1743915
TI  - Graded stress radiography of injured anterior cruciate ligaments.
AB  - Fifty-five patients with clinical suspicion of injury to their anterior cruciate
      ligament (ACL) were examined by graded stress radiography before arthroscopic
      verification in an effort to determine the loss of ACL function as a result of
      ligament tearing. Using a commercially available stress device capable of
      applying varying pressures to the mid-calf, anterior drawers were measured from
      lateral radiographs at 0-, 7-, 14-, and 21-kiloPascal pressures and used to
      calculate the equivalent elastic modulus of the remaining ACL fibers. According
      to viscoelastic theory, this modulus is proportional to the number of elastically
      active fibers in the ligament. To verify the validity of this concept, the stress
      strain relationship of a freshly excised ACL ligament was examined in a tensile
      testing machine, and the procedure was repeated after the ligament had been
      partially transsected with a scalpel. Comparison with the elastic modulus of the
      (intact) ACL of the opposite knee permits an estimate of the percentage of
      rupture in cases of partial tears. Overstretched ligaments show essentially
      normal viscoelastic properties once the slack in the ligament has been taken up.
      Complete tears, on the other hand, show a complete breakdown in the viscoelastic
      properties of the ACL. The results show that partial tears can be diagnosed by
      graded stress radiography with a sensitivity of 20% and specificity of 90%.
      Diagnosis of overstretched ligaments had sensitivity of 50% and specificity of
      94%. Complete tears were detected with sensitivity of 88% and specificity of 75%
      as diagnosed against all other ACL lesions and including normals.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1743916
TI  - Local demineralization as a model for bone strength reductions in lytic
      transcortical metastatic lesions.
AB  - The structural consequences of bone density changes associated with lytic
      metastatic lesions were investigated using an experimental model of regular,
      lytic metastatic lesions in bone. Circular holes were drilled in the mid
      diaphyseal cortex of paired adult canine femora. The region around the defect was
      demineralized in one bone of each pair with 0.8 N HCl. Specimens were tested to
      failure in four-point bending. Defect size was determined from conventional
      planar radiographs as the maximum apparent defect diameter divided by the
      periosteal diameter. Demineralization resulted in irregular defect geometries,
      which increased the maximum defect dimension 33% to 57% with respect to the
      original drill hole diameter. Demineralization resulted in additional strength
      reductions beyond those expected from the original drill hole alone. Despite the
      irregular demineralization patterns observed, strength reductions were in close
      agreement with those predicted from data for regular, nondemineralized holes (r2
      = 0.93). The results demonstrate that irregular diaphyseal defect borders may not
      require more complex fracture risk predictors than can be determined from
      analytic and experimental studies of regular defect geometries. Our results also
      demonstrate that errors of over 100% can occur when measuring diaphyseal defect
      size from radiographs that are not optimally aligned with respect to the defect.

PMID- 1743917
TI  - The prevalence of asymptomatic gallstones in the general population.
AB  - The gallbladder and biliary system were scanned by real-time ultrasound in 2274
      patients undergoing diagnostic ultrasound for other than gallbladder disease.
      Patients (212) with previous gallbladder symptoms or with nonvisualization of
      their gallbladder were excluded from the study. Obesity is the most important
      risk factor for the development of asymptomatic gallstones in women (P less than
      .01), although it is not a significant factor in men. Increasing age is an
      important risk factor for both sexes, and the only significant risk factor in men
      (P less than .01). While few men have asymptomatic gallstones before the age of
      40, 5% of women aged 20-29 and 9% aged 30-39 do. In the 40 and over age group,
      men (14%) and women (11%) had insignificantly different prevalences. In women,
      the number of previous pregnancies is a significant risk factor (chi-square =
      5.4, P = .02). For instance, there is a 3%, 8%, and 17% overall frequency of
      gallstones in women with 0, 3, and 6 or more previous pregnancies, respectively.
      A stepwise logistic regression analysis, after adjusting for age, body mass
      index, and for women, number of pregnancies, found no significant increased risk
      related to race (P = .40), high blood pressure (P = .43), heart disease (P =
      .47), or diabetes (P = .46). After age adjustment, there is no significant gender
      effect (P = .25). Asymptomatic gallstones are a relatively common occurrence in
      men over 40 and women over 30. While age is the only significant risk factor in
      men, obesity, parity, and to a lesser extent age were significant risk factors in
      women.

PMID- 1743918
TI  - Solid-state phosphorus-31 nuclear magnetic resonance differentiation of bone
      mineral and synthetic apatite used to fill bone defects.
AB  - Bioabsorption of synthetic apatite compounds used to promote bone healing and
      remodeling has been difficult to evaluate. In this study, solid-state phosphorus
      31 nuclear magnetic resonance (NMR) has been used to characterize and quantitate
      bone mineral and a synthetic apatite in order to establish a model for
      bioabsorption studies. Pulverized solid samples of cortical rabbit bone and a
      synthetic fluoridated apatite were examined in vitro at variable degrees of
      hydration. A 9.4 T superconducting spectrometer was used to obtain 31P magic
      angle spinning NMR spectra and T1 relaxation times. Quantitation was attempted in
      mixed samples using T1 recovery data. Bone mineral and synthetic apatite could be
      distinguished by chemical shift and T1 relaxation time in variable hydration
      states, and were readily differentiated in mixtures by their T1 relaxation time.
      NMR estimates of relative proportions of components in mixed samples were
      accurate within 2% of evaluations based on weight. Solid-state 31P NMR therefore
      provides a suitable method for monitoring the bioabsorption of synthetic
      apatites.

PMID- 1743919
TI  - Urine profiles and kidney histology following intravenous diatrizoate and iohexol
      in the degeneration phase of gentamicin nephropathy in rats. Effects on urine and
      serum profiles.
AB  - Urine chemical profiles were followed for three or nine days after intravenous
      injection of diatrizoate, iohexol, or saline in 30 rats, where a
      tubulointerstitial nephropathy was induced by gentamicin given over an eight-day
      period. Another ten rats injected with saline served as controls. Compared to
      injection of saline, both iohexol and diatrizoate induced dysfunction. The
      excretion of the cytoplasmic enzyme lactate dehydrogenase was significantly
      greater following iohexol than following diatrizoate. No significant differences
      between the two media were shown by the various serum components examined. Among
      the gentamicin-treated rats, light microscopy showed prolonged occurrence of
      tubular necrosis and a more intensive round cell infiltration following iohexol
      than following diatrizoate and saline. Both contrast media induced further
      temporary renal dysfunction in rats with gentamicin nephropathy; iohexol induced
      more morphologic changes than diatrizoate.

PMID- 1743920
TI  - In vivo and in vitro evaluation of Gd-DTPA-polylysine as a macromolecular
      contrast agent for magnetic resonance imaging.
AB  - Polylysine covalently linked to moieties of gadopentetate (Gd-DTPA), for use as a
      macromolecular blood pool marker for contrast material-enhanced magnetic
      resonance imaging (MRI), was characterized by means of physicochemical
      measurements and pharmacokinetics in rats and rabbits and compared with Gd-DTPA.
      Gd-DTPA-polylysine was composed of a series of polymers of different molecular
      sizes that on average were labeled with 60 to 70 Gd-DTPA moieties (average
      molecular weight, 48,700 daltons [D]). For the macromolecular compound Gd-DTPA
      polylysine, relaxivity was three times higher than that of Gd-DTPA. The LD50
      value of 17 mmol/kg reflects a fairly high acute intravenous tolerance of the
      macromolecular compound in mice. Even though the volume of distribution of Gd
      DTPA-polylysine in rabbits approached the extracellular fluid space (indicating
      that the macromolecular compound was also leaking slowly into the interstitial
      space), the half-life of distribution of the macromolecular compound in the
      extracellular fluid space was significantly prolonged, thus making the compound
      suitable as a blood pool marker for MRI. In rats the elimination of Gd-DTPA
      polylysine occurred predominantly via the renal route. High-pressure liquid
      chromatography-size-exclusion chromatography of the fractionated urine samples
      revealed that the renal clearance must be the integral sum of the separate
      clearances of each molecular weight species. No biodegradation of the polypeptide
      was observed, and biodistribution studies revealed only minimal retention of Gd
      in the body of the rat.

PMID- 1743921
TI  - Pharmacokinetics of Gd-DTPA in patients with chronic renal failure.
AB  - We investigated the pharmacokinetics of dimeglumine gadopentetate (Gd-DTPA), a
      contrast agent for magnetic resonance imaging (MRI), in 24 patients with chronic
      renal failure whose creatinine clearance ranged from 7.2 to 70.0 mL/minute
      (median 25.4 mL/minute). After single intravenous administration of 0.1 mmol/kg,
      the serum levels of Gd-DTPA were monitored up to five days and urine and feces
      were collected quantitatively up to two days. The pharmacokinetic parameters were
      calculated from the concentration-time profile in the serum and urine using an
      open two-compartment model. No changes in the volume of distribution (Vc and
      Varea) or in the half-life of distribution were found for patients with chronic
      renal failure as compared to patients with normal renal function. However, in
      correlation with the reduced glomerular filtration rate in patients with chronic
      renal failure, the half-life of elimination was prolonged and serum and renal
      clearance were decreased. The recovery of Gd-DTPA in urine was 92.1% +/- 12.1% of
      the dose administered, and extrarenal elimination was less than 0.4%, indicating
      that glomerular filtration remains the predominant route of elimination. Only for
      patients with highly impaired renal function (creatinine clearance less than 20
      mL/minute) was the recovery in the urine less than complete.

PMID- 1743922
TI  - A phase I clinical trial with gadodiamide injection, a nonionic magnetic
      resonance imaging enhancement agent.
AB  - Twenty adult male volunteers were studied in an unblinded, ascending-dose study
      to evaluate the safety, tolerance, and pharmacokinetics of intravenously
      administered nonionic gadodiamide injection. Dosages administered were 0.05, 0.1,
      0.2, and 0.3 mmol/kg. Subjects were monitored from 36 hours before, through 72
      hours after administration. There were no clinically relevant changes in vital
      signs or electrocardiograms. No clinically significant changes occurred in blood
      or urine laboratory parameters, although a tendency for minor, transient
      elevations in serum iron levels 8 to 48 hours after administration was noted.
      These changes were not dose-related. Nine of 20 subjects reported at least one
      adverse event; all events were transient and of mild intensity, the most common
      being dizziness/lightheadedness and perversion of taste or smell. One subject
      reported discomfort consisting of mild stinging at the injection site during
      administration. Gadodiamide was excreted unmetabolized in the urine with greater
      than 95% recovery at 72 hours after administration. The serum elimination half
      life was approximately 70 minutes.

PMID- 1743923
TI  - Preoperative computed tomography for transhiatal esophagectomy.
AB  - We report the results of a retrospective evaluation of preoperative chest
      computed tomography (CT) in 50 consecutive patients with esophageal carcinoma
      confirmed surgically. Forty patients underwent transhiatal esophagectomy without
      thoracotomy. In ten cases, blunt dissection of the esophageal carcinoma was
      impossible because of involvement of an adjacent organ. Transhiatal esophagectomy
      carries lower morbidity and mortality rates than the standard thoracotomy
      procedure, although long-term survival is considered to be the same with either
      method. The overall sensitivity of CT in detecting involvement of an adjacent
      organ, thus contraindicating the transhiatal procedure, was 90%, with an overall
      specificity of 92%. The positive predictive value was 75%, and the negative
      predictive value 89%. The negative predictive value of CT for tracheobronchial
      invasion, the main surgical risk in the transhiatal procedure, was 90%. A
      negative preoperative CT appears to be a reliable indicator for patients
      undergoing transhiatal esophagectomy.

PMID- 1743924
TI  - The effect of a low-osmolar radiographic contrast medium on in vivo and
      postmortem renal size.
AB  - High osmolar radiographic contrast media (CM) are known to cause an increase in
      renal size. To examine the effect of low-osmolar CM on renal size, 14
      anesthetized dogs received 12 intravenous bolus injections of 0.5 mL/kg iohexol
      (541 mOsm/L). The postmortem renal, cortical, and medullary volumes were
      determined by fluid displacement. Renal volumes of 18 control dogs were
      determined similarly. The mean (+/- SEM) postmortem renal volumes were 66.1 +/-
      2.2 mL for the CM group and 52.3 +/- 3.3 mL for the control group (P = 0.003),
      whereas the cortical and medullary volumes were similar. Six dogs were also
      scanned by fast computerized tomography before and after iohexol administration.
      The in vivo whole renal and medullary volumes enlarged from 67.4 +/- 3.0 to 77.1
      +/- 2.8 mL (P = 0.006), and from 28.5 +/- 2.0 to 35.1 +/- 1.1 mL (P = 0.026),
      respectively, while the cortical volume remained unaltered. These results suggest
      that even low osmolar CM may significantly increase renal volume, probably by
      causing tubular expansion.

PMID- 1743925
TI  - Morphology and growth of the fetal stomach.
AB  - To assess the development of the fetal stomach, we performed 162 esophageal
      injections of contrast media into spontaneously aborted normal fetuses from 7.5
      to 26 weeks of gestation. The length of esophagus and trunk, greater and lesser
      curvature, and vertical and oblique axis of stomach were measured, and the means
      and standard deviations at each gestational age were calculated. The most
      frequently encountered patterns of stomach shape were: the standard shape, 90%;
      steerhorn, 3%; and horizontal stomach, 2%. The final shape of the stomach is not
      assumed at least until the the age of 22 weeks. Regarding the growth of stomach,
      with age, the greater curvature grew at a much faster rate than the lesser
      curvature, and the distance between skin and outer border of the stomach
      increased. The oblique axis of the stomach did not rotate after eight weeks;
      gastric surface area showed the fastest growth after 14 weeks. The
      gastroesophageal junction cephalad relative to the trunk ascended through week
      25, due to the differential growth of the trunk and esophagus.

PMID- 1743926
TI  - Identifying drug exposed infants.
AB  - Better outcome for pregnancy and infant is achieved by identification,
      intervention and medically appropriate follow up of drug affected pregnancies.
      Health care professionals should familiarize themselves with the special needs of
      this special population.

PMID- 1743927
TI  - Cocaine and pregnant women: a hospital study.
AB  - How prevalent is cocaine use among pregnant women? This study of pregnant and
      newborn populations at Broadlawns Medical Center in Des Moines showed positive
      rates of 7.1% and 3.6%, respectively. The study also showed that accepted risk
      factors are not reliable indicators of drug use.

PMID- 1743928
TI  - Iowa's infant mortality: looking worse, doing better.
AB  - Interstate comparisons of infant mortality data can be misleading unless causes
      of infant death are considered, says this author. In Iowa the percentage of
      preventable deaths dropped almost 35% in recent years.

PMID- 1743929
TI  - Prevalence of fetal alcohol syndrome largely unknown.

PMID- 1743930
TI  - Fatal pertussis in an Iowa infant.
AB  - Much media attention has been paid to neurological disease induced by DPT
      vaccine, but what about the risk of pertussis to unimmunized children? The
      authors present a case report of fatal whooping cough in a 5-week-old baby.

PMID- 1743931
TI  - HIV infection in childbearing women.
AB  - A blinded survey of HIV infection in childbearing women is being conducted in 43
      states and territories. After one year of participation in the survey, 6 of
      37,846 women bearing live children in Iowa were found to be infected with HIV.

PMID- 1743932
TI  - In defense of the little ones.

PMID- 1743933
TI  - Maternal-fetal conflicts.

PMID- 1743934
TI  - Aldol condensations after Carlo Ricci.

PMID- 1743935
TI  - Patient Self-Determination Act. Community education.

PMID- 1743936
TI  - Patient Self-Determination Act. Institutional quandaries.

PMID- 1743937
TI  - The spirit of the PSDA. Patient Self-Determination Act.

PMID- 1743938
TI  - Patients, providers, and the PSDA. Patient Self-Determination Act.

PMID- 1743939
TI  - PSDA in the nursing home. Patient Self-Determination Act.

PMID- 1743940
TI  - Patient Self-Determination Act. Trumping advance directives.

PMID- 1743941
TI  - PSDA in the clinic. Patient Self-Determination Act.

PMID- 1743942
TI  - Patient Self-Determination Act. Honoring broader directives.

PMID- 1743943
TI  - Patient Self-Determination Act. On behalf of the patient.

PMID- 1743944
TI  - Oregon update.

PMID- 1743945
TI  - Of balloons and bicycles--or--the relationship between ethical theory and
      practical judgment.

PMID- 1743946
TI  - For experts only? Access to hospital ethics committees.

PMID- 1743947
TI  - In re Helga Wanglie.

PMID- 1743948
TI  - When the doctor's on drugs.

PMID- 1743949
TI  - Zuckerman's dilemma. A plea for environmental ethics.
AB  - E.B. White's Charlotte's Web serves as an environmental parable for our time. As
      we reflect on our relationship with nature, we might consider the three ways in
      which Wilbur the pig was valued in White's story. His instrumental value cashes
      out in ham hocks and sausage. His aesthetic value earns him a ribbon at the
      county fair. His moral value is the value he has in and of himself, and Charlotte
      the spider loves him for it. We can value nature the way Charlotte valued Wilbur,
      or we can, as the farmer Zuckerman did at first, see the natural world only in
      terms of the pork chops it provides.

PMID- 1743950
TI  - Animal ethics reconsidered.

PMID- 1743951
TI  - Abortion remains a live issue.

PMID- 1743952
TI  - Fetal tissue research and the misread compromise.
AB  - The bill to restore federal funding for human fetal tissue research has been
      passed by the House and awaits Senate approval. But it requires women who are
      willing to donate fetal tissue to certify that they did not have an abortion with
      the intent to donate. It further requires researchers to keep the certifications
      on file and available for government audit. Both requirements spell trouble.

PMID- 1743953
TI  - Hysterectomy in Scotland, 1961-1984.

PMID- 1743954
TI  - A new Pick based computer thyroid register based on the national SAFUR
      requirements for local usage.
AB  - Patients with thyroid disease require lifelong surveillance to detect late onset
      hypothyroidism and to monitor thyroid replacement therapy. This is best achieved
      by a shared-care computer system. We describe the introduction to Tayside
      (Ninewells Hospital) of a new computerised thyroid follow-up programme based on
      the Patient Record System under a Pick operating system, run on a Honeywell-Bull
      minicomputer. This new programme has allowed the transfer of patients from the
      previous Aberdeen based SAFUR centralised service to a locally based unit,
      offering an improved, updated and cost effective method for thyroid disease
      surveillance. Audit, clinical and financial, may now be more efficiently
      achieved, allowing local needs to direct the service provision.

PMID- 1743955
TI  - Misplacement in long stay geriatric care, psychogeriatric care and Part IV
      accommodation.
AB  - The dependency and behavioural characteristics of 1,461 elderly people in long
      stay geriatric and psychogeriatric wards and Part IV accommodation were surveyed.
      Misplacement, defined as having dependency and behaviour characteristics normally
      associated with admission to another form of care, was widespread, ranging from 5
      51% in the different facilities visited. It was greatest in psychogeriatric wards
      and least in geriatric wards. In Part IV accommodation there was a significant
      inverse relationship between length of stay and appropriateness of placement.

PMID- 1743956
TI  - The establishment of a centralised referral service leads to earlier abortion.
AB  - In 1988 a centralised referral service for termination of pregnancy was
      established in Edinburgh. This has led to a significant reduction in the time
      women who have requested termination wait to see a gynaecologist (mean 4.7 days)
      and in the time it takes before suction termination of pregnancy is undertaken
      (total wait 10.2 days). In 1988 only 40% of induced abortions in Edinburgh were
      carried out at 9 weeks gestation or before while in 1989 that figure had risen to
      60%. In 1989 less than 10% of pregnancies were terminated at or after 12 weeks
      gestation, compared with 21% in 1988. Reasons for delays in obtaining an abortion
      are multifactorial but rapid referral once a woman has made the decision to seek
      help will be essential if she is to avail herself of the advantages of medical
      termination--only available until eight weeks of pregnancy.

PMID- 1743957
TI  - The Chief Scientist reports... The diets of Scottish men and women in relation to
      nutritional recommendations for health.
AB  - Diets of middle-aged Scottish men and women were assessed by food frequency
      questionnaire as part of the Scottish Heart Health Study (a cross-sectional study
      of risk factors for coronary heart disease (CHD) in 22 regions). The data have
      allowed evaluation of the diets of different (high CHD risk) sub-groups with
      respect to nutrient composition and major nutrient sources. This paper summarises
      the key nutrient source findings by non-manual and manual occupational groups;
      discusses the Scottish diet in relation to recent recommendations for healthy
      eating and recommended daily allowances for antioxidant vitamins; and considers
      ways of achieving dietary change.

PMID- 1743958
TI  - Alcohol misuse in Scotland--is there a growing health problem?
AB  - This paper reviews currently available data on alcohol related morbidity and
      mortality in Scotland. It confirms that admissions to psychiatric hospitals are
      unlikely to be a reliable indicator of trends in alcohol-related conditions
      because of the influence of local practice. Discharge rates for general (non
      psychiatric) hospitals where an alcohol-related diagnosis has been made are
      reviewed and even using caution in interpreting the data, the results suggest
      that there is a worrying increase in rates of discharges with an alcohol-related
      diagnosis. Finally trends in deaths for both alcoholic liver disease (ICD 571.0
      3) and unspecified chronic liver disease (ICD 571.4-9) are examined. It is
      concluded that other indicators of health related harm should be considered.
      These might include data from those presently seen in out-patient departments
      with an alcohol related condition as well as patients misusing alcohol who attend
      their General Practitioner (GP).

PMID- 1743959
TI  - A framework for the assessment of health care priorities in Scottish health
      boards.

PMID- 1743960
TI  - Career paths of physician executives.
AB  - Survey data from a sample of physicians whose primary professional activity is
      administration were used to examine their previous administrative positions and
      career paths. Forty percent reported administrative positions in more than one
      type of health care organization, and time spent in administration increased with
      age and years in administration. Most responders with senior titles had four or
      more positions in a single type of organization or two positions in different
      types of organizations. These findings should be useful for further investigation
      on the physician executive role, as well as in career planning.

PMID- 1743961
TI  - Outcomes measurement: compliance tool or strategic initiative?
AB  - This article explores how hospitals are using outcomes measurement to deal with
      their changing environment. Based on interviews at thirty-one hospitals, the
      study reveals three very different management approaches and three different uses
      of the same outcomes measurement tool.

PMID- 1743962
TI  - Analyzing the health care environment: "You can't hit what you can't see".
AB  - The health care environment of the 1990s promises to be every bit as dynamic and
      complex as the environment of the 1980s. Health care managers must identify
      emerging issues and incorporate these issues into the strategic management
      process. This article discusses a five-step process for analyzing the changing
      environment facing health care organizations.

PMID- 1743963
TI  - Codependency: management and administrative policy implications.
AB  - Health care practitioners may exhibit behaviors that are considered dysfunctional
      for personal well-being. These behaviors, feelings, and thoughts could affect the
      manager-employee relations, as well as the implementation of patient care. This
      discussion focuses on the relevance of codependency in human resource management.
      Implications of codependency for organizational structure, standards of care, and
      managerial roles are pointed out. Specific strategies are outlined in recognizing
      manifestations of codependency. Finally, administrative interventions such as the
      Employee Assessment and Counseling Programs are suggested to prevent the negative
      outcomes of codependency which can affect job performance.

PMID- 1743964
TI  - A managerial approach to costing fixed assets in health care organizations: the
      role of depreciation and interest.
AB  - The economic aspect of depreciation and interest on capital are incorporated
      within a managerial accounting framework by treating both items as imputed
      charges to be debited to the users of the assets' services. The costs of these
      services is examined for individual assets that provide either uniform or
      declining service over the expected life, and for a stock of assets where the
      character of the individual assets is ignored. By using imputed charges, the
      hospital's net income is allocated to its sources.

PMID- 1743965
TI  - Hospital free cash flow.
AB  - Hospital managers may find it difficult to admit their investments have been
      suboptimal, but such investments often lead to poor returns and less future cash.
      Inappropriate use of free cash flow produces large transaction costs of exit. The
      relative efficiency of investor-owned and tax-exempt hospitals in the product
      market for hospital services is examined as the free cash flow theory is used to
      explore capital-market conditions of hospitals. Hypotheses concerning the current
      competitive conditions in the industry are set forth, and the implications of
      free cash flow for risk, capital-market efficiency, and the cost of capital to
      tax-exempt institution is compared to capital-market norms.

PMID- 1743966
TI  - Hospitals' investment and return from volunteer departments and auxiliaries:
      evidence from one community.
AB  - In addition to their nonpecuniary outputs, volunteer and auxiliary programs can
      make a significant financial contribution to the hospital. Evidence from one
      community suggests a direct correspondence between a hospital's investment and
      return from these programs. Hospitals appear to invest little in these
      activities, however.

PMID- 1743967
TI  - Health care in the United States.

PMID- 1743968
TI  - HCMR interview: Richard Johnson. Interview by Montague Brown.

PMID- 1743969
TI  - Responses to prospective payment by rural New Mexico hospitals.
AB  - A cross-sectional study is used to determine how rural New Mexico hospitals
      altered service diversification, inpatient service emphasis, and service
      promotion during Medicare's prospective payment system (PPS) transition and
      posttransition phases. Results suggest that the hospitals implemented distinct
      strategies in response to PPS. The posttransition strategies were examined for
      their association with improved revenue and utilization indicators. Few of the
      service diversification and promotional strategies were consistent predictors of
      performance. Emphasis on fine-tuning inpatient services was the most promising
      predictor of higher utilization and revenue measures. The implications for other
      rural hospitals are discussed.

PMID- 1743970
TI  - Predicting hospital choice for rural Medicare beneficiaries: the role of severity
      of illness.
AB  - Previous research has confirmed that desirable hospital attributes as well as
      increased distance, or travel time, have an impact on hospital choice. These
      studies have become increasingly sophisticated in modeling choice. This study
      adds to the existing literature by estimating the effect of both hospital and
      individual characteristics on hospital choice, using McFadden's conditional logit
      model. Some patient characteristics have not previously been accounted for in
      this type of analysis. In particular, the effect of a patient's complexity of
      illness (as measured by Disease Staging) on the choice of hospital is taken into
      account. The data consist of over 12,000 Medicare discharges in three overlapping
      rural market areas during 1986. The hospital choice set was aggregated into seven
      groups of urban and rural hospitals. Results indicate that rural Medicare
      beneficiaries tend to choose hospitals with a large scope of service and with
      teaching activity over those with a lower scope of service and no teaching
      activity, holding other factors constant. Distance is a deterrent to hospital
      choice, especially for older Medicare beneficiaries. The more complex cases tend
      to choose larger urban and rural hospitals over small rural hospitals more often
      than less complex cases do.

PMID- 1743971
TI  - Uncompensated care before and after prospective payment: the role of hospital
      location and ownership.
AB  - Research was undertaken to determine the effects of hospital ownership, location,
      and Medicare's prospective payment system (PPS) on inpatient uncompensated care.
      A nonequivalent group design was used with repeated measures of uncompensated
      care (UNCC) on 137 system hospitals taken pre- and post-PPS. Investor-owned
      system hospitals demonstrated the largest increase in UNCC (37 percent) under the
      PPS. Results suggest that not-for-profit and investor-owned system hospitals are
      becoming more similar in levels of uncompensated care provided and that the PPS
      has had a negative effect on rural hospital profitability.

PMID- 1743972
TI  - Nursing home costs, Medicaid rates, and profits under alternative Medicaid
      payment systems.
AB  - This analysis compares nursing home costs, Medicaid payment rates, and profits
      under three Medicaid nursing home payment systems: case-mix, facility-specific,
      and class-rate systems. Data used were collected from 135 nursing homes in seven
      states. The association of case mix with costs, rates, and profits under the
      three payment systems was of particular interest. Case mix was more strongly
      associated (positively) with patient care cost and the Medicaid rate for the case
      mix systems than for the other systems, particularly the class-rate systems. In
      contrast, case mix and profits were not associated in the case-mix or facility
      specific systems, but were negatively associated in the class rate systems.
      Overall, the results suggest that case-mix systems have some important advantages
      over other payment systems, but further research is needed on larger samples and
      involving the newer case-mix systems.

PMID- 1743973
TI  - Using medical care: the views and experiences of high-risk mothers.
AB  - Two recurrent unsolved problems of health services practice and policy in modern
      industrial countries are those of social class inequalities and user
      dissatisfaction. This article presents data related to these issues drawn from a
      sample of British childbearing women deemed "at risk" by health professionals. A
      third focus is on the relationship between past experiences of maternity care,
      and the patterns of service provision and perceptions of needs and satisfaction
      revealed in a subsequent pregnancy. Findings show a tendency for patterns of care
      to be differentiated by social class, with working class women generally
      receiving comparatively poor service. Satisfaction with general practitioner
      (community-based) prenatal care is higher than with hospital care. The more
      socially disadvantaged women in the sample are more likely to be dissatisfied
      with their medical care. The three major pregnancy needs highlighted by the
      sample women are for more continuity of care, more sympathetic medical care, and
      help with household finances. Adverse previous childbearing experiences are
      related to more dissatisfaction in the subsequent pregnancy.

PMID- 1743975
TI  - Cribs.
AB  - We evaluated four cribs with adjustable mattress supports from four
      manufacturers. Three of the units are rated Acceptable, and one unit is rated
      Conditionally Acceptable--it is Acceptable on the condition that it is purchased
      without its semidetachable slat option. We describe the rationale behind our
      Evaluation in the Introductory Comments below. And in the Crib Assessment and
      Purchasing Guide, which follows the Conclusions and Ratings, we provide general
      guidance to help readers evaluate cribs that were not included in this study.

PMID- 1743974
TI  - Factors associated with hospitalization in a sample of chronic hemodialysis
      patients.
AB  - This study examines the hospitalization experience of a sample of chronic
      hemodialysis patients, using primary data sources. There were multiple causes of
      hospitalization over the six-month tracking period, with stays extending from 1
      to 87 days. Patients were more likely to be hospitalized if they had a negative
      hepatitis antigen, lower functional status scores, lower phosphate and protein
      levels, repeated access procedures, other cardiovascular conditions, arthritis,
      psychiatric disorders, ischemic peripheral vascular disease, lung disease, or
      larger households. Hospitalization for access-related problems was associated
      with arthritis, previous access procedures, and blood pressure levels.
      Sociodemographic and treatment characteristics did not have a significant
      influence on the risk of hospitalization. Improved management in these clinical
      areas may improve the quality of life of chronic hemodialysis patients and reduce
      the high level of expenditures associated with delivering inpatient services to
      this segment of the Medicare population.

PMID- 1743976
TI  - Infrared ear thermometry.
AB  - Many hospitals are considering using infrared (IR) ear thermometers (also called
      tympanic membrane thermometers) as an alternative to traditional temperature
      measurement devices. IR technology allows users to quickly and noninvasively
      measure body temperature by inserting a directional probe into the ear canal. For
      infection control, ear thermometers offer the advantages of not contacting mucous
      membranes and eliminating the need for special handling procedures. For use on
      unconscious patients or those who are otherwise unwilling or unable to cooperate
      with traditional techniques, IR ear thermometers offer a more comfortable and
      less stressful method of temperature taking for both patients and nurses,
      especially where rectal temperatures are used. The recent entry into this market
      by major companies and distributors and the release of several new IR ear
      thermometers have helped to further stimulate interest in this technology.
      However, a complete transition to IR ear thermometers throughout the hospital may
      not be necessary and should be made only after these devices have been
      successfully used in selected clinical locations, such as emergency departments,
      critical care areas, recovery areas, and labor and delivery rooms. Clinical users
      must be familiar with the technique needed for temperature measurement with these
      instruments and understand the differences between temperatures taken in the ear
      canal and those obtained from traditional sites. In the following article, we
      first present and overview of clinical thermometry, describing traditional
      temperature-measurement sites and devices. We then discuss the advantages and
      disadvantages of using the ear canal, including the tympanic membrane (TM), as a
      site for temperature measurement.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1743977
TI  - Rubber universal breathing-circuit adapters: risk of increased disconnections.

PMID- 1743978
TI  - Xomed laser-shield endotracheal tubes: flammable tubes still being used.

PMID- 1743979
TI  - COULTER lyse S IIIdiff: reagent lot gives erroneous results.

PMID- 1743980
TI  - Stryker surgical microsurgical drills: activation by ESUs.

PMID- 1743981
TI  - Positron emission tomography in the investigation of neuropsychiatric disorders:
      update and comparison with magnetic resonance imaging and computerized
      tomography.
AB  - In many neuropsychiatric disorders, PET imaging offers functional insights
      unavailable from anatomic imaging alone. Functional deficits may be more
      extensive than structural findings would indicate, may occur before the detection
      of anatomic changes, or may even occur in the absence of any structural lesions.
      We contrast the current role of PET with that of MRI and CT in the investigation
      of neuropsychiatric disorders including stroke, tumor, head trauma, epilepsy,
      schizophrenia, movement disorders, normal aging and dementia.

PMID- 1743982
TI  - The role and rationale of nuclear medicine procedures in the differential
      diagnosis of renovascular hypertension.
AB  - The use of radionuclides in the differential diagnosis of renovascular
      hypertension has gone through many periods of enthusiasm and of disappointment.
      Regardless of the problems with the routine renogram, the availability of gamma
      camera renal evaluation makes possible meaningful preintervention of screening.
      The use of the test as a follow-up procedure is an extremely important but often
      overlooked application of radionuclides in the evaluation of renovascular
      hypertension. The radionuclide technique is a sensitive and accurate method of
      evaluating the results of percutaneous angioplasty or surgery or renal function
      in the affected kidney of patients with renovascular disease. A major change in
      our approach to the nuclear medicine diagnosis of renovascular hypertension has
      been the introduction of captopril renography. Although there is still a great
      deal of work to be done and many investigators are actively studying captopril
      renography, the potential of the test is clear. Captopril renography should
      include a baseline renogram, followed by the administration of 25 mg of captopril
      and a repeat study. Specificity and sensitivity data on this test probably will
      not be available for several years, but preliminary results are encouraging
      enough to justify routine use at this time in clinics in which screening for
      renovascular hypertension is carried out.

PMID- 1743983
TI  - Progress in research on ligands, nuclides and techniques for labeling monoclonal
      antibodies.
AB  - This paper reviews the current methods for radiolabelling monoclonal antibodies
      with particular emphasis on radiometals useful for radioimmunoscintigraphy. The
      discussion, however, is equally applicable to therapeutic radionuclides. The
      advantages and the pitfalls of the various techniques are critically evaluated.
      Both direct labeling methods, as well as indirect methods using the bifunctional
      chelating agent approach, are covered. Recent work on the development and
      synthesis of new and more specific chelating agents, including the approach of
      utilizing rigid polyaminocarboxylates, is described. Preliminary promising
      results with these newer generation chelating agents are presented.

PMID- 1743984
TI  - Technetium-99m-labeled proteins for imaging inflammatory foci.
AB  - Polyclonal human IgG (IgG), antinuclear antibody (TNT-1), and human serum albumin
      (HSA), were labeled with 99mTc by a method recently developed in our laboratory,
      and administered i.v., each to a separate group of five mice, bearing
      inflammatory foci induced by an i.m. injection of 40 microL turpentine or 5 x
      10(8) E. coli and 5 x 10(8) Entercocci. TNT-1 labeled with 125I served as a
      control and 67Ga-citrate as a "gold standard". At 4 or 24 h post injection,
      animals were imaged and sacrificed for tissue distribution studies. At 4 h in the
      turpentine group, the abscess-to-muscle ratios were: 67Ga, 4.8 +/- 2.1, 125I-TNT
      1, 4.3 +/- 1; 99mTc-TNT-1, 3.5 +/- 1.8; 99mTc-IgG, 3.9 +/- 0.6; and 99mTc-HSA,
      4.3 +/- 1. In the microorganism group, these ratios were 2.6 +/- 0.6, 3.3 +/-
      0.5, 3.4 +/- 0.08, 3 +/- 1.1 and 4.1 +/- 0.6, respectively. Autoradiographic
      examination of infected tissues indicated that leakage of labeled proteins into
      interstitial space due to increased capillary permeability may be one of the
      major mechanisms of uptake.

PMID- 1743985
TI  - Quantitative imaging of mouse L-6 monoclonal antibody in breast cancer patients
      to develop a therapeutic strategy.
AB  - L-6, a mouse IgG2a anti-adenocarcinoma monoclonal antibody (MoAb) with favorable
      immunopathology and mouse biokinetics, was evaluated for cancer
      radioimmunotherapy by pharmacokinetic studies in 10 patients with breast cancer.
      The effect of escalating the preinfused protein dose was studied in two patients
      at each level, using 50, 100, 150, 200 and 400 mg of unlabeled L-6 prior to a 10
      mCi imaging dose of 131I L-6. Quantitative imaging, and blood and urine
      clearances were obtained. After the 50 mg preinfusion, rapid blood clearance and
      lung extraction of the radiopharmaceutical occurred immediately post injection.
      Greater preload amounts of L-6 were associated with an increase in the intercept
      of the slow phase of the blood clearance from 17 to 22% injected dose (ID) with
      50 mg to 70 to 80% ID with 400 mg (P less than 0.01). Lung uptake of the
      radiopharmaceutical immediately post injection decreased from 15 to 19% ID (50
      mg) to 6 to 8% ID (400 mg). Tumors were visualized only after larger L-6
      preloads, but in these patients small chest tumors contained 0.6-1.2% ID (0.1%
      ID/g maximum). This study suggests that L-6 reactive sites that are readily
      available in the lung can be saturated, so that a subsequent dose of I-131 L-6 is
      delivered to the tumor. This approach provides a new strategy for developing an
      effective method for radioimmunotherapy using a MoAb that has some cross
      reactivity. Quantitative imaging contributed to detection of the cross-reactivity
      and the strategy for overcoming it.

PMID- 1743986
TI  - Strategies for enhancement of radioimmunotherapy.
AB  - Two new strategies for increasing tumor uptake have been investigated. First the
      effect of interleukin-2 (IL-2) on tumor uptake of 125I-Lym-1 antibody in nude
      mice was investigated. Secondly, the use of 67Cu-labeled Lym-1 was evaluated in
      patients. In nude mice implanted with Raji human lymphoma, a greater than 2-fold
      enhancement of tumor uptake of 125I-Lym-1 was observed after administration of
      PEG-interleukin-2 (PEG-IL-2). The macrocycle 1,4,8,11-tetraazacylcotetradecane
      N,N',N",N"'-tetraacetic acid (TETA), synthesized specifically for copper
      chelation, has been conjugated to Lym-1 for 67Cu labeling of the monoclonal
      antibody (MoAb). There was no evidence for bone or normal marrow uptake and the
      residence time in the tumor was prolonged. Surprisingly, a dose of 4.4 mCi that
      was intended for imaging induced substantial tumor regression in a patient.

PMID- 1743987
TI  - Radionuclide assessment of blood-brain barrier disruption performed for
      chemotherapy of high grade malignant brain gliomas.
AB  - Compared to the conventional mode of chemotherapy of malignant brain gliomas
      following surgery and radiation therapy, chemotherapy after transient disruption
      of the blood-brain barrier coupled with intraarterial administration of
      methotrexate improved median survival from 12-14 to 22 months in our experience.
      Technetium-99m-DTPA brain scintigraphy played a unique and important role in the
      documentation of optimum blood-brain barrier disruption. Patients with excellent
      clinical outcome had significantly (P less than 0.0005) better blood-brain
      barrier disruption than patients with poor outcome. The results indicate that the
      clinical outcome is related to the degree of blood-brain barrier disruption.

PMID- 1743988
TI  - Recent developments in 99mTc and 123I-radiopharmaceuticals for SPECT imaging.
AB  - Availability of 123I of high radionuclidic purity has encouraged the development
      of 123I-based radiopharmaceuticals for the assessment of myocardial fatty acid
      metabolism, myocardial neuronal activity, and for receptor and antibody imaging.
      Advances in the chemistry of technetium have resulted in the development of novel
      agents for myocardial and cerebral perfusion and renal function studies.
      Monoclonal antibodies labeled with 99mTc show promise for imaging neoplastic
      lesions, myocardial infarcts, and thrombus localization. Recent developments in
      123I and 99mTc agents for myocardial and brain imaging studies are discussed.

PMID- 1743989
TI  - Radionuclide methods of detecting acute gastrointestinal bleeding.
AB  - It is clinically very important to localize the bleeding site in suspected
      patients. Current common diagnostic methods are endoscopic, angiographic, and
      radionuclidic. Of the noninvasive procedures, 99mTc-RBC and 99mTc-colloid methods
      have gained wide popularity. In our series of a comparative study, the RBC method
      has been shown to be more accurate than the colloid method. The 99mTc-RBC method
      should be available as a routine emergency procedure in every large clinical
      center.

PMID- 1743990
TI  - Assessment of lysosomal function by quantitative histochemical and cytochemical
      methods.
AB  - Quantitative histochemistry and cytochemistry enables a direct link to be made
      between metabolic functions such as the activity of lysosomal enzymes and the
      morphology of a tissue or a type of cell. Several approaches exist such as
      microchemistry based on (bio)chemical analysis of a single cell or a small piece
      of tissue dissected from a freeze-dried section. This technique has been
      routinely used for prenatal diagnosis of inherited enzyme defects and especially
      of lysosomal storage diseases. Other approaches are cytofluorometry or
      cytophotometry, which are based on the principle that a fluorescent or coloured
      final reaction product is precipitated at the site of the enzyme. The amount of
      final reaction product is analysed per cell or per unit volume of tissue using
      either a microscope cytofluorometer or flow cytometer for fluorescence
      measurements or an image analysing system or scanning and integrating
      cytophotometer for absorbance measurements. In principle, fluorescence methods
      are to be preferred over chromogenic methods because they are more sensitive and
      enable multiparameter analysis. However, only a limited number of fluorogenic
      methods are at hand that give a final reaction product which is sufficiently
      water-insoluble to guarantee good localisation. The best results have been
      obtained with methods based on naphthol AS-TR derivatives and with methods for
      the demonstration of protease activity using methoxynaphthylamine derivatives as
      substrates and 5'-nitrosalicylaldehyde as coupling reagent. Chromogenic methods
      are far better with respect to localisation properties and, therefore, most
      commonly used for quantitative histochemical analysis of lysosomal enzyme
      activities.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1743991
TI  - The role of lysosomes in hyaline droplet nephropathy induced by a variety of
      pharmacological agents in the male rat.
AB  - The male rat is prone to hyaline droplet formation in renal proximal tubular
      cells. Several unrelated pharmaceutical agents exacerbate the formation and
      accumulation of these droplets. Where the loading of the proximal tubular cells
      is marked it gives rise to increased cell turnover and a hyaline droplet
      nephropathy develops. Cytochemical procedures, have confirmed that this
      accumulation of hyaline droplets represents an increase in the size and number of
      secondary lysosomes involved in protein uptake and metabolism. This
      predisposition of the male rat to develop hyaline droplet nephropathy relates to
      (1) the large amounts of the low-molecular-weight protein alpha 2U globulin in
      the glomerular filtrate, (2) the resistance of the globulin to proteolysis, and
      (3) the low protease activity in the proximal tubule lysosomes. The current data
      would suggest that the pharmacological agents, which cause the nephropathy, exert
      their effect by reducing the proteolytic breakdown of alpha 2U globulin in the
      proximal tubule lysosomes. This results in the overloading of a system which is
      already operating near maximal load. Female rats, and all other species excrete
      only small amounts of alpha 2U globulin or similar proteins, which are more
      easily hydrolyzed. Thus it is argued that the type of hyaline droplet nephropathy
      induced by these pharmacological agents is unique to the male rat and of little
      relevance to man.

PMID- 1743992
TI  - Immunocytochemical and labelled tracer approaches to uptake and intracellular
      routing of immunoglobulin-G (IgG) in the human placenta.
AB  - Isolated lobules of freshly delivered human term placenta were (a) subjected to
      an indirect immunoelectron ultracryo method in which the immunoreactivity of
      endogenous Immunoglobulin-G (IgG) to rabbit anti-human IgG antibody was localized
      with protein-A-colloidal gold and (b) extracorporeally perfused and human IgG
      molecules complexed to horseradish peroxidase (HRP) added to the maternal
      perfusate and the uptake of IgG-HRP over different perfusion durations visualized
      ultrastructurally by using diaminobenzidine cytochemistry. Immunoreactivity to
      anti-human IgG antibody was localized all along the apical plasmalemma, in apical
      coated and uncoated vesicles, in apical and juxtanuclear multivesicular bodies,
      and in basal vesicles of the syncytiotrophoblast layer of the placenta. The
      stroma separating the syncytiotrophoblast from the foetal endothelium as well as
      vesicles within the endothelium were immunoreactive. No immunoreactivity was
      localized in paracellular clefts of endothelia. A similar distribution of
      exogenous IgG-HRP was observed for the perfused placentae. When bovine IgG-HRP or
      HRP alone were used as control tracers no uptake was seen for the former whilst
      the latter was observed only in early endosomal vesicles of the
      syncytiotrophoblast. The pattern of localization visualized in both studies is
      consistent with receptor-mediated uptake of IgG by the syncytiotrophoblast and a
      vesicular transport of IgG across the foetal endothelium.

PMID- 1743993
TI  - Predicting the behaviour and selectivity of fluorescent probes for lysosomes and
      related structures by means of structure-activity models.
AB  - Cultured rat fibroblasts were exposed to 50 fluorescent probes of varied
      physicochemical characteristics. Probe concentrations, fluorochrome excitation
      wavelength and period of illumination, and cell-probe contact time were varied.
      Structure-activity relationships defining a number of classes of fluorescent
      probes for lysosomes and related processes and compartments were demonstrated.
      Numerical specifications are now available for several familiar classes of
      probes: (a) acidotropic weak bases, used as markers for low pH compartments; (b)
      markers of adsorptive pinocytosis, involving non-specific protein binding; (c)
      markers for fluid phase pinocytosis; and (d) viability stains involving
      intralysosomal enzymic activity. Two novel classes of probes have also been
      specified numerically: (a) acid-precipitated weak acids, as markers for low pH
      compartments; and (b) lipid-binding markers of adsorptive pinocytosis. Overall,
      these structure-activity models provide a tool for predicting whether or not
      compounds enter cells; and whether they accumulate in lysosomes and related
      compartments. Pathways of entry are also predicted. This tool should permit
      design and selection of improved probes, and provide a better understanding of
      existing reagents. Moreover these models are expected to be applicable to
      interactions between any non-polymeric xenobiotic with lysosomes and related
      compartments.

PMID- 1743994
TI  - Energy depletion and autophagy. Cytochemical and biochemical studies in isolated
      rat hepatocytes.
AB  - In this paper, data dealing with the sensitivity of autophagy towards partial ATP
      depletion in isolated rat hepatocytes are reviewed. Partial reduction of
      intracellular ATP causes: (1) a decrease of proteolytic flux; (2) a decrease in
      uptake of cytosolic components into the autophagic-lysosomal compartment; (3)
      either a decrease or no change in the ratio between volume densities of
      autophagosomes and lysosomes, depending on whether or not the cytosolic phosphate
      potential is affected; and (4) impairment of the lysosomal proton pump. It is
      concluded that the consecutive steps of autophagy all respond to relatively small
      changes of intracellular ATP concentration.

PMID- 1743995
TI  - A quantitative immunoelectronmicroscopic study on soluble, membrane-associated
      and membrane-bound lysosomal enzymes in human intestinal epithelial cells.
AB  - We have used quantitative immunoelectronmicroscopy to compare the in situ
      localization of acid alpha-glucosidase, lysosomal acid phosphatase, beta
      hexosaminidase and glucocerebrosidase in intestinal epithelial cells of the human
      duodenum. Differences between these four lysosomal enzymes were observed with
      respect to their presence at the apical cell surface. Transport to the apical
      membrane seems to be a more important intracellular route for lysosomal acid
      phosphatase and acid alpha-glucosidase than it is for beta-hexosaminidase. The
      membrane associated lysosomal enzyme glucocerebrosidase is not transported to the
      microvilli. The studies emphasize that lysosomal enzyme transport pathways are
      enzyme and cell type specific.

PMID- 1743996
TI  - Localization of lysosomal antigens in activated T-lymphocytes.
AB  - The lysosomal compartment has been examined in activated T-lymphocytes by
      immunogold electron microscopy and subcellular fractionation. Immunoprecipitation
      and sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) of
      radiolabelled extracts of the T-cells showed that they contained three antigens
      which are fundamental to normal lysosomal function: a representative lysosomal
      enzyme beta-glucuronidase, a lysosomal associated membrane protein (LAMP-1), and
      the cation-independent mannose 6-phosphate lysosomal enzyme targeting receptor
      (MPR). Immunogold labelling showed that beta-glucuronidase was present in the
      rough endoplasmic reticulum, the Golgi complex and Golgi-associated vesicles. The
      enzyme was also found to accumulate in distinct, non-Golgi organelles in which
      LAMP-1 was co-localized, probably lysosomes. LAMP-1 was also found in tubular
      elements of the Golgi and in a complex of vesicles clustered near the nucleus
      where MPR was also present at high density. Fractionation of homogenates from
      lymphocytes on Percoll gradients revealed that beta-glucuronidase was distributed
      throughout the low density region containing rough endoplasmic reticulum, Golgi
      and plasma membrane components, and the high density region which contained only
      lysosomal activity. Multiple immunogold electron microscopy of the latter
      fraction showed the presence of homogenous vesicles which had large amounts of
      beta-glucuronidase within the lumen, LAMP-1 at the periphery and no MPR. These
      vesicles were probably mature lysosomes, arising from pre-lysosomal organelles
      enriched for LAMP-1 and MPR.

PMID- 1743997
TI  - Catalytic histochemistry of acid and neutral hydrolases in plant seedlings.
AB  - In contrast to human and animal tissues, little information is available on the
      activity, distribution and functional role of acid and neutral hydrolases in
      plant cells and tissues. Because it is known that these enzymes are relatively
      active during germination, they were analysed histochemically during this process
      using light microscope azo, azoindoxyl, indigogenic and tetrazolium methods.
      Proteases, glucosidases and glucuronidases could not be detected. Non-specific
      acid phosphatases were species-independent and showed considerable activities in
      aleuron and nutritional cells, in other cell types of cotyledon or endosperm
      tissue and in different types of embryonic cells. Acid glycosidases and non
      specific esterases, in contrast, displayed a species-dependent activity and
      differences in localization. Of the glycosidases, alpha-D-galactosidase was the
      most active. Non-specific esterases, acid phosphatase and glucosaminidase were
      also present in the extracellular matrix. During germination, acid hydrolase
      activity either decreased or increased, depending on the seedling species and
      enzyme.

PMID- 1743998
TI  - Uptake of horseradish peroxidase by human oesophageal explants over 24 h.
AB  - Human oesophageal biopsies, endoscopically and histologically normal, were
      incubated in Ham's F10 for periods up to 24 hours in the presence of horseradish
      peroxidase. The fluid phase marker was taken up most avidly by the prickle cells
      but to a lesser extent in the functional layers and by basal cells. Endocytosed
      markers proceeded to multivesicular bodies (segrosomes). Horseradish peroxidase
      was later deposited in lysosome-like structures and also in the Golgi apparatus.
      The lesser uptake by the functional cells may represent reduced access of the
      marker to the cells due to the intercellular barrier.

PMID- 1743999
TI  - Electron microscopical demonstration of thiols and disulphides in the porcine
      epidermis.
AB  - This study describes the electron microscopical distribution of free thiols and
      disulphides in the epidermis of the domestic pig and the wild boar, as compared
      to light microscopical histochemistry. With the silver methenamine method, silver
      labelling of thiols was clearly achieved on the keratohyalin and cytofilament
      accumulations in the cells of the living epidermis and the plasma membrane of
      granular cells. To a certain extent, the envelope and cytoplasm of young
      corneocytes reacted equally intensively. Disulphides were very abundant in the
      filaments, keratohyalin granules, and cell envelope of granular cells, and,
      particularly, in the envelope (marginal band) of corneal cells; the latter
      structure being distinctly delineated from the background. As a specific feature,
      the viable epidermis of the wild boar stained strongly for disulphides. The
      results obtained are discussed in view of actual concepts of epidermal
      keratinization and corneal cell function.

PMID- 1744000
TI  - Characterization of an expressible nonclassical class I HLA gene.
AB  - Screening of a human cosmid library representing genomic DNA from an individual
      homozygous for the HLA-DR2 B7 A2 haplotype yielded 109 class I HLA-specific
      clones. One cosmid clone, Ice 6.23, had a full-length nonclassical class I gene
      within a 5.4-kb HindIII fragment. The Ice 6.23-5.4H gene was cloned into the
      unique NotI site of an expression vector pSV2.Not, a derivative of pSV2neo, which
      was constructed to contain a second SV40 early region promoter adjacent to an
      introduced NotI site. The resulting construct was transfected into the P815-B2M
      cell line, a derivative of the mouse mastocytoma P815 (HTR) line which expressed
      human beta2-microglobulin following stable transfection with a cloned human beta2
      microglobulin gene. Following transfection the Ice 6.23-5.4 H gene was found to
      be expressed at both the mRNA and cell surface product levels. DNA sequencing of
      this gene suggests that it is allelic to the HLA-6.0 gene clone (HLA-G) of
      Geraghty et al. (Proceedings of the National Academy of Sciences USA, 84:9145,
      1987); thereby revealing a HindIII restriction fragment length polymorphism at
      the HLA-G locus. An extraordinarily high degree of sequence similarity (99.92%)
      between these two genes, which derive from unrelated HLA haplotypes, suggests
      strong conservative selection pressure at the HLA-G locus. A flanking single copy
      sequence probe 4 kb distant from the Ice 6.23-5.4H gene was used to generate long
      range restriction mapping at the HLA-G locus.

PMID- 1744001
TI  - Contribution of T-cell receptor-contacting and peptide-binding residues of the
      class II molecule HLA-DR4 Dw10 to serologic and antigen-specific T-cell
      recognition.
AB  - The relative contributions of putative T-cell receptor (TCR)-contacting and
      peptide-binding residues of a major histocompatibility complex (MHC) class II
      restriction element to serologic and antigen-specific T-cell recognition were
      investigated by site-specific mutagenesis. Amino acids 70 and 71 in the DR beta 1
      domain of DR4 Dw10 are uniquely differnet from the other Dw subtypes of DR4.
      Residue 70 is predicted to be located at the membrane-distal surface of the class
      II molecule, where it may influence T-cell recognition by a direct interaction
      with a TCR. Residue 71 is predicted to form part of the antigen-binding groove
      where its influence on T-cell recognition may be mediated indirectly via an
      effect on peptide binding. Transfected murine L cells were produced expressing
      the products of DR4 Dw10B genes in which the codons for residues 70 and 71 had
      been mutated towards DR4 Dw14. Support for the predicted orientations of beta
      chain residues 70 and 71 was lent by the observation that only residue 70 plays
      an important role in the formation of a serologic determinant. Mutation of this
      residue was sufficient to produce recovery of recognition by a human monoclonal
      antibody, NI, which has specificity for all the DR4 subtypes with the exception
      of DR4 Dw10. The human T-cell clone HA1.7, specific for influenza virus
      hemagglutinin (HA) peptide 307-319 and restricted by DR1 Dw1, exhibits degeneracy
      of MHC restriction on the DR4 Dw subtypes with the exception of DR4
      Dw10.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744002
TI  - Immunochemical analysis of a recombinant, genetically engineered, secreted HLA
      A2/Q10b fusion protein.
AB  - We engineered a fusion gene which encodes the alpha 1 and alpha 2 domains of HLA
      A2 with the alpha 3 and truncated transmembrane domains of the murine class I
      like protein Q10b, and transferred it into mouse L cells along with the gene for
      human beta 2-microglobulin (beta 2m). The secreted rA2/Q10b gene product
      consisted of a single heavy chain of molecular weight 42 kd that was
      noncovalently associated with the human beta 2m light chain. Native detergent
      solubilized HLA-A2 and secreted rA2/Q10b proteins were found to be similar by:
      (a) the binding to mouse monoclonal anti-HLA antibodies in an ELISA; (b) the
      blocking of lysis of HLA-A2+ cells by human anti-HLA-A2,-B17, anti-HLA-A2,9,28,
      and anti-HLA-A2,28 cross-reactive group (CREG) antisera in a complement-dependent
      cytotoxicity assay; and (c) the ability when coupled to Sepharose to selectively
      purify HLA-A2,9,28 and HLA-A2,28 CREG-specific antibodies. Mouse L cells
      expressing rA2/Q10b produced as much as 2.5 micrograms protein per 10(6)
      cells/day, or 50- to 100-fold more antigen on a per cell basis than the level of
      HLA-A2 expressed by B-lymphoblastoid cell line or spleen cells. Thus rA2/Q10b
      represents a viable alternative to detergent-solubilized HLA-A2 for purification
      of anti-HLA-A2 antibodies and analysis of anti-HLA-A2 immune responses.

PMID- 1744003
TI  - DRw11 haplotypes: continuum of DRB1 diversity augmented by unique DQ/DRw52
      associations.
AB  - cDNA sequencing of the first domains of DRB1, DRB3, DQA1, and DQB1 alleles was
      used to examine the extent of diversity in American black individuals expressing
      several DRw11 haplotypes. In addition to previously described DRw11 alleles,
      DRB1*1102 and DRB1*1103, two new DRB1 alleles, DRB1*11012 and DRB1*11042, were
      identified which differ from previously described alleles at the nucleic acid but
      not at the protein level. Gene conversion-like events have likely generated the
      DRw11 microvariation resulting in the merging of DRw11 with the DRw13 allele
      family. The DRw11 alleles are associated with various DQ alleles: DQw1 (DQw5 and
      DQw6), DQw7, and a serologically undefined DQ allele. This undefined DQ molecule,
      comprised of a DQ alpha/beta combination encoded by a DQw7 alpha gene (DQA1*0301)
      and a DQw2 beta gene (DQB1*0201), was previously observed in some DR7 and DR9
      haplotypes. DRw11 haplotype diversity is augmented by the association of one of
      the DRw11 alleles with the DRw52c allele in contrast to the more common DRw11,
      DRw52b association. The extensive diversity exhibited by the DRw11 and DRw13
      family of haplotypes coupled with their high frequency in populations of African
      ancestry suggest that the DRw11/w13 allele family may be very old and/or that
      these haplotypes carry some selective advantage.

PMID- 1744005
TI  - The cost of treating patients infected with the human immunodeficiency virus
      (HIV) in the United States.

PMID- 1744004
TI  - Effect of HLA phenotype and gender on expression of various forms of class I HLA
      in plasma.
AB  - To understand the complexity of plasma HLA antigens, the distribution of
      different molecular weight forms of class I HLA in plasma was investigated in 44
      HLA-phenotyped and unrelated individuals. Plasma class I HLA were
      immunoprecipitated by using the W6/32 anti-HLA monoclonal antibody, separated by
      SDS-polyacrylamide gel electrophoresis and characterized by immunoblotting with
      the HC-10 monoclonal antibody. Four different forms of HLA heavy chains (HLA-HC)
      with relative molecular masses of 44, 39, 36, and 34 kd were detected. Plasma
      samples from all individuals contained 44 and 36 kd HLA-HC, but varied as to the
      presence of 39 and 34 kd HLA-HC. Eighteen percent of the individuals did not have
      any detectable class I HLA with 39-kd heavy chains in their plasma and 61% did
      not have plasma class I HLA with 34-kd heavy chains. Thus, four different
      distribution patterns were identified for plasma class I HLA among all
      individuals included in our study. The distribution patterns in four different
      individuals were evaluated quarterly and remained unchanged during 1 year follow
      up. A significant association of absence of 39-kd plasma class I HLA-HC with
      female gender (p less than 0.05) and HLA-B7 phenotype (p less than 0.00015) was
      also found. Further pedigree analyses of four families of HLA-B7-positive and 39
      kd HLA-HC-negative probands indicated that genetic factor(s) other than those
      associated with HLA-B7 allele and female gender is involved in regulating the
      expression of the plasma class I HLA with 39-kd heavy chains.

PMID- 1744006
TI  - Osteopathic medical educators should heed lesson from interns.

PMID- 1744007
TI  - Cutaneous immunopathology of androgenetic alopecia.
AB  - Male pattern baldness is assumed to result from a combination of normal serum
      concentrations of androgen and an appropriate genetic background. To study
      whether inflammation contributes to the development of androgenetic alopecia,
      direct immunofluorescence and dermatopathologic studies were performed on biopsy
      specimens from bald scalp of patients, with specimens from uninvolved scalp of
      these patients or from scalp of volunteers who were not bald serving as controls.
      Granular deposits of Immunoglobulin M or C3 (or both) were found at the basement
      membrane in 25 (96%) of 26 study patients and 1 (12%) of 8 control subjects.
      Granular C3 was also deposited on eccrine myoepithelial cells in 8 (31%) of 26
      study patients, but no control subjects. Porphyrins were found in the
      pilosebaceous canal in 15 (58%) of 26 study subjects and in 1 (12%) of 8 control
      subjects. These results support an inflammatory pathogenesis of androgenetic
      alopecia. Propionibacterium acnes is known to produce porphyrins. Ultraviolet
      radiation may excite microbiologic porphyrins that could activate C3 and,
      subsequently, the complement cascade producing inflammatory mediators.

PMID- 1744008
TI  - Dementia in patients with the acquired immunodeficiency syndrome.
AB  - Central nervous system (CNS) manifestations are common in patients with the
      acquired immunodeficiency syndrome (AIDS). The most common CNS syndrome is a
      dementing illness referred to as the AIDS dementia complex, in which motor and
      cognitive changes may also be seen. Neurodiagnostic studies are fairly
      characteristic, though highly nonspecific. Dementia may precede overt
      manifestations of AIDS, and either an insidious or a fulminant course may be
      seen. Appropriate management of the patient with AIDS includes differentiating
      dementia from psychologic responses to the disease.

PMID- 1744009
TI  - Blood ethanol testing.
AB  - The justification for blood ethanol testing springs from the ubiquitous abuse of
      alcoholic beverages. Those dealing with patients who abuse alcohol must
      understand the correlations between dose, time, blood level, and behavior.
      Enumerated here are the strengths of various testing methods and the requisites
      for legally defensible testing. The challenge remains to determine blood ethanol
      levels in such a manner that the results are scientifically valid and legally
      defensible.

PMID- 1744010
TI  - Osteopathic interns' attitudes toward their education and training.
AB  - The attitudes of two groups of osteopathic medical interns toward their education
      are compared. The two groups, referred to as osteopathic ideologists and
      allopathic ideologists, were selected on the basis of their reported first choice
      of medical school and internship. The groups differed significantly concerning
      preparation for and commitment to an osteopathic medical career; adherence to
      osteopathic tenets; evaluation of quality of education; plans for future
      training; and career plans. Both groups, however, reported a lack of coherence
      and integration of osteopathic medical principles and practices in their
      education. Implications for osteopathic medicine and osteopathic medical
      education are discussed.

PMID- 1744011
TI  - Incomplete rectal obstruction secondary to adenocarcinoma of the prostate.
AB  - Ureteral and bladder outlet obstruction are well-known sequelae of adenocarcinoma
      of the prostate. Contiguous extension of prostate cancer locally to involve the
      rectum is an uncommon phenomenon. It has been suggested that this is because
      Denonvillier's fascia is an effective barrier to posterior extension of malignant
      prostatic neoplasms. Herein, we report a case of this unusual association as well
      as a review of the literature.

PMID- 1744012
TI  - Red eyes and red rash with fever: an uncommon initial presentation for
      staphylococcal obturator abscess with adjacent ischial osteomyelitis.
AB  - "Red eyes and red rash with fever" is a common pediatric complaint; however, it
      is an uncommon initial presentation for staphylococcal obturator abscess with
      adjacent ischial osteomyelitis. The case of a 13-year-old boy who was admitted to
      the hospital with conjunctivitis, erythematous maculopapular lesions, and fever
      and had this final diagnosis is reported. The differential diagnosis included
      various bacterial diseases, several viral illnesses, and rickettsial disease.

PMID- 1744013
TI  - Axillary disruption of axillobifemoral graft.
AB  - Axillary disruption of axillobifemoral grafts has not previously been reported
      after appropriate placement of the graft medially on the axillary artery and
      proper subpectoral tunneling. Six weeks after undergoing such surgery followed by
      a relatively uncomplicated postoperative course, the patient--an 81-year-old man-
      was found unconscious at home. He was resuscitated, and taken to an emergency
      room where he had a respiratory arrest. At surgery, it was found that the
      polytetrafluoroethylene graft had separated from the axillary artery. Inspection
      of the axillary artery showed a completely intact suture line on the artery
      itself. Graft cultures tested negative. The authors believe the anastomotic
      disruption was the result of trauma to the anastomosis during cardiopulmonary
      resuscitation and external cardiac massage.

PMID- 1744014
TI  - How analytic is psychoanalytic psychotherapy?
AB  - This essay attempts to resolve some of the ambiguities regarding the
      differentiation of psychoanalytic psychotherapy from psychoanalysis. It argues
      that they result from a failure to recognize that psychotherapy, although it is
      grounded in psychoanalytic knowledge, is fundamentally different from
      psychoanalysis in that it does not have as its goal an uncovering of the
      unconscious and therefore does not use the psychoanalytic method devised for this
      purpose. Psychotherapy, in this view, is understood as a reality-oriented process
      that helps a person understand the present in continuity with a consciously
      accessible past and that promotes the integration of divergent but alternatively
      conscious aspects of the self and the object. The conceptual framework for
      psychotherapy thus understood is to be found in developmental psychology, object
      relations theory, and the psychology of the self. The essentially analytic
      aspects of such a process reside in the psychoanalytic knowledge of human
      development that guides our understanding of the clinical material but also the
      limits of our therapeutic endeavors; in the analytic attitude of openness to the
      accessible and individual meaning of a patient's communications that guards
      against imposing cognitively deduced interpretations of supposedly unconscious
      meanings; and in the engagement of, and respect for, the patient's observing ego.

PMID- 1744015
TI  - The nuclear bomb: a concretization and erotization of power.
AB  - This article contends that the nuclear bomb is the concrete representation of an
      archaic idealizing system. It uses concepts published by Atwood and Stolorow
      (1984) to demonstrate how the bomb is no protection at all to our national
      defense; rather it compensates for empty or poorly developed psychological
      structure and function of individual and group. The continued proliferation of
      the bomb--some 70,000 at last count--despite the knowledge that just a few can
      obliterate our world is testimonial to the need for a concrete and visible mound
      of weapons. Since this need can never be satisfied by these means, there can
      never be enough bombs to be sufficient. The article extends the concept of this
      faulty or absent development of psychological structure to the weakening or loss
      of primary affiliative bonding between individuals and groups, which has
      psychohistorical roots. Three historical developments intertwine and reinforce
      one another: (1) the isolation of national defense to weapons and war; (2) the
      evolution of a modern science based on a duality between body (affects) and mind
      (cognition) and contributing to sexual polarization, in which masculinity has
      been identified with valued objectivity and femininity has been identified with
      devalued affiliative affects; (3) the equation of sex and aggression with power
      and their use as substitutes for derailed development of affiliative needs and
      functions.

PMID- 1744016
TI  - Somatization: a perspective from self psychology.
AB  - Somatization is a complex phenomenon that occurs in many forms and diverse
      settings. It is not necessarily pathological and may be found in a variety of
      psychiatric disorders. Much of the psychiatric literature has focused on patients
      with conversion disorders and hypochondriasis. Psychoanalytic theories regarding
      such conditions were largely based upon concepts of drive, conflict, and defense.
      The perspective from self psychology, with its emphasis on subjective experience
      and the sense of self, may further enhance the psychoanalytic understanding of
      somatization. Individuals with disturbances in the stability and organization of
      the self may present with somatic symptoms and disturbances in emotional
      awareness. Somatization in such cases may be the experiential manifestation of a
      disturbance in the cohesion of the self and/or may result from defensive
      operations to ward off affect. The latter may be prominent when affective arousal
      triggers the psychological threat of fragmentation. Somatization may diminish in
      such individuals when a self-object relationship is formed that bolsters and
      consolidates the sense of self. The integration of affect into ongoing subjective
      experience may also be an important aspect of psychoanalytic treatment in such
      patients.

PMID- 1744017
TI  - Child sexual abuse: origins, dynamics, and treatment.
AB  - This article is intended as an overview of the current literature on child sexual
      abuse. There are some patterns of psychopathology seen in both the abused and the
      abusers that warrant further scrutiny. The presence of narcissistic pathology in
      both groups is interesting, particularly in light of the generationality of child
      sexual abuse. This finding raises the issue of the nature of psychic injury
      incurred by some of the victims and places it at the level of early self
      development.

PMID- 1744018
TI  - Is psychoanalytic theory relevant to the psychology of women?
AB  - This article reviews the literature addressing the relevance of psychoanalytic
      theory to the psychology of women and offers a possible rapprochement between
      these divergent perspectives. This rapprochement is accomplished first by
      defining "psychoanalytic theory" and "the psychology of women" in line with
      current scholarship, then by comparing and contrasting these definitions in an
      item-by-item analysis. The basic tenets of modern psychoanalytic theory emerge as
      highly relevant to the understanding of the psychology of women, despite the fact
      that particular "brands" of psychoanalytic theory may not demonstrate this same
      compatibility.

PMID- 1744019
TI  - Adaptation to developmental transformations during the various phases of
      motherhood.
AB  - The developmental processes that surround pregnancy and motherhood exert powerful
      and all-encompassing effects on the lives of the women undergoing such changes.
      Research has recently determined that the physiological and emotional
      transformations that occur in pregnant women may have a significant impact on the
      relationship that gradually develops between mothers and their infants. The
      growth of this relationship with the infant is directly related to the
      developmental challenges confronting the expectant women and new mother. Although
      many women are fearful or ambivalent about expressing their emotions during such
      periods of developmental change because of the implications of such feelings,
      exploratory work that encourages the disclosure of dreams and fantasies often
      enables the therapist to predict the patient's future ability to cope with the
      challenges of motherhood. This article examines five cases in which the
      developmental transformations experienced by the woman during the antenatal and
      postnatal periods significantly influenced the evolution of an attachment
      relationship with the infant.

PMID- 1744020
TI  - Somatic correspondences during psychoanalysis.
AB  - Somatic as well as cognitive correspondences occur during psychoanalytic
      treatment. The somatic type have received little, if any, attention from the
      analytic community, at least in terms of published references. Somatic
      symptom(s), activated by external events in his or her life, first appear in the
      analyst. Almost immediately thereafter identical or closely similar experiences
      appear in the analysand and (during the treatment hour) are verbalized by him or
      her. Should attempts to understand correspondences stop at this point, it is easy
      to conclude they are due to mere coincidence, but they have deep, unconscious
      roots. Analytic exploration of these roots reveals practically simultaneous
      occurrence of certain activated conflict residues in the analyst and comparable
      ongoing but far less worked-through conflict areas in the analysand. The brief
      interval when these activated facets become approximate in intensity appears to
      be the trigger for the correspondence. Preoedipal aspects of unconscious conflict
      are more apt to be reflected in somatic correspondence, whereas oedipal aspects
      are more likely to be expressed in cognitive correspondence. In any event, data
      available from the case material reported suggest that from a psychological point
      of view the unconscious plays a significant role in extrasensory and unverbalized
      communication and suggest addition of the concept of body-language transference
      to that of thought transference.

PMID- 1744021
TI  - Princess Marie Bonaparte, Edgar Allan Poe, and psychobiography.
AB  - Princess Marie Bonaparte was a colorful yet mysterious member of Freud's inner
      circle of psychoanalysis. In analysis with Freud beginning in 1925 (she was then
      45 years old), she became a lay analyst and writer of many papers and books. Her
      most ambitious task was a 700-page psychobiography of Edgar Allan Poe that was
      first published in French in 1933. She was fascinated by Poe's gothic stories-
      with the return to life of dead persons and the eerie, unexpected turns of
      events. Her fascination with Poe can be traced to the similarity of their early
      traumatic life experiences. Bonaparte had lost her mother a month after her
      birth. Poe's father deserted the family when Edgar was two years old, and his
      mother died of tuberculosis when he was three. Poe's stories helped him to
      accommodate to these early traumatic losses. Bonaparte vicariously shared in
      Poe's loss and the fantasies of the return of the deceased parent in his stories.
      She was sensitive and empathetic to Poe's inner world because her inner world was
      similar. The result of this psychological fit between Poe and Bonaparte was her
      psychobiography, The Life and Works of Edgar Allan Poe. It was a milestone in
      psychobiography but limited in its psychological scope by its strong emphasis on
      early childhood trauma. Nevertheless it proved Bonaparte a bona fide creative
      psychoanalyst and not a dilettante propped up by her friendship with Freud.

PMID- 1744022
TI  - Creative brainstorms: a story of madness and genius.

PMID- 1744023
TI  - Defense and coping in the antinomy between self-maintenance and adaptation.
AB  - After definitions of the terms defense and coping, the disturbances of both
      linked to narcissistic personality disorders, borderline personality disorders,
      and major depressions are described. All three are characterized by deficient
      narcissism. In narcissistic personality disorders, defense and coping are
      hindered mainly because of a lack of narcissistic investment of the ego, in
      borderline personality disorders preponderantly because of a fragmentation-prone
      ego with its rigid defenses, and in major depressions primarily because
      narcissistic emptiness or depletion breaks down interest of the ego to get along
      with the environment or leads to an extreme overinvestment of the remaining
      narcissism in the objects. Finally, the three levels of object relations--the
      narcissistic--fusionary one, the level of active ego performances, and the level
      of free decisions--and their functioning with respect to coping in the three
      disorders mentioned are discussed.

PMID- 1744024
TI  - Childhood asthma: a developmental and biopsychosocial model for treatment.

PMID- 1744025
TI  - Childhood asthma in interaction with family, school, and peer systems: a
      developmental model for primary care.
AB  - The developmental/biopsychosocial approach to primary care of childhood asthma
      offered in the above model emphasizes four interlocking features: 1.
      Consideration of the biologic, psychologic, and social aspects of asthma which
      interact with one another and influence disease management and psychosocial
      functioning and development of the asthmatic child 2. The importance of balance
      between disease management and quality of life and developmental needs of the
      patients and their families 3. Appreciation and facilitation of a developmentally
      synchronized shift toward self care of the asthma and its social and emotional
      aspects; 4. Central role played by the primary care provider (or health care
      team) in integrating developmental/biopsychosocial aspects of comprehensive
      treatment for childhood asthma.

PMID- 1744026
TI  - Food-induced asthma in China: an analysis in 40 cases.
AB  - Forty patients with a history of recurrent attacks of asthma after ingesting
      certain foods are described. All of these individuals had positive intracutaneous
      skin tests to at least one of the food allergens which was suggested by their
      history to cause an attack. In four of these patients, a bronchoprovocational
      challenge was performed with an aerosolized extract of the potential offending
      food. Clinical manifestations, possible mechanisms, and diagnostic measures for
      food-induced asthma are discussed.

PMID- 1744027
TI  - Effect of oral administration of a prostacyclin analog (OP-41483) on pulmonary
      function and bronchial responsiveness in stable asthmatic subjects.
AB  - To examine whether prostacyclin has an attenuating effect on nonspecific
      bronchial responsiveness in asthma, we measured provocative concentration of
      methacholine producing a 20% fall in forced expiratory volume in 1 second (PC20
      FEV1) before and after oral administration of a chemically stable prostacyclin
      analog (OP-41483) (200 micrograms 4 times a day for 4 days) in 8 patients with
      stable asthma. Neither baseline pulmonary function nor PC20-FEV1 significantly
      improved after the treatment. These results suggest that prostacyclin may have no
      direct effect on bronchial responsiveness in asthmatics. Further studies using
      more potent and long-lasting prostacyclin mimetic will be needed to confirm the
      conclusion.

PMID- 1744028
TI  - Asthma in pregnancy.

PMID- 1744029
TI  - Effect of yoga training on exercise tolerance in adolescents with childhood
      asthma.
AB  - Forty six young asthmatics with a history of childhood asthma were admitted for
      yoga training. Effects of training on resting pulmonary functions, exercise
      capacity, and exercise-induced bronchial lability index were measured. Yoga
      training resulted in a significant increase in pulmonary function and exercise
      capacity. A follow-up study spanning two years showed a good response with
      reduced symptom score and drug requirements in these subjects. It is concluded
      that yoga training is beneficial for young asthmatics.

PMID- 1744030
TI  - Acute respiratory distress due to vocal cord dysfunction in cystic fibrosis.

PMID- 1744031
TI  - Disappearance of allergic reaction to cromolyn (cromoglycate) by avoidance and
      then reintroduction.

PMID- 1744032
TI  - The product of the Rhizobium meliloti ilvC gene is required for isoleucine and
      valine synthesis and nodulation of alfalfa.
AB  - Tn5-induced mutants of Rhizobium meliloti that require the amino acids isoleucine
      and valine for growth on minimal medium were studied. In one mutant, 1028, the
      defect is associated with an inability to induce nodules on alfalfa. The Tn5
      mutation in 1028 is located in a chromosomal 5.5-kb EcoRI fragment.
      Complementation analysis with cloned DNA indicated that 2.0 kb of DNA from the
      5.5-kb EcoRI fragment restored the wild-type phenotype in the Ilv- Nod- mutant.
      This region was further characterized by DNA sequence analysis and was shown to
      contain a coding sequence homologous to those for Escherichia coli IlvC and
      Saccharomyces cerevisiae Ilv5. Genes ilvC and ilv5 code for the enzyme
      acetohydroxy acid isomeroreductase (isomeroreductase), the second enzyme in the
      parallel pathways for the biosynthesis of isoleucine and valine. Enzymatic assays
      confirmed that strain 1028 was a mutant defective in isomeroreductase activity.
      In addition, it was shown that the ilvC genes of Rhizobium meliloti and E. coli
      are functionally equivalent. We demonstrated that in ilvC mutant 1028 the common
      nodulation genes nodABC are not activated by the inducer luteolin. E. coli ilvC
      complemented both defective properties (Ilv- and Nod-) found in mutant 1028.
      These findings demonstrate that R. meliloti requires an active isomeroreductase
      enzyme for successful nodulation of alfalfa.

PMID- 1744033
TI  - Mapping, sequence, and apparent lack of function of araJ, a gene of the
      Escherichia coli arabinose regulon.
AB  - We report the mapping, sequencing, and study of the physiological role of the
      fourth arabinose-inducible operon from Escherichia coli, araJ. It is located at 9
      min on the chromosome and codes for a single 42-kDa protein that shows no
      significant homology to other known proteins. Destruction of the chromosomal araJ
      gene does not detectably affect either of the two arabinose transport systems,
      the ability of cells to grow on arabinose, or the induction kinetics of the
      araBAD operon, and thus the physiological role of AraJ, if any, remains unknown.
      We have also found a long open reading frame upstream of araJ. The sequence of
      this upstream open reading frame was found to be identical to the previously
      reported sequence of the sbcC gene (I. S. Naom, S. J. Morton, D. R. F. Leach, and
      R. G. Lloyd, Nucleic Acids Res. 17:8033-8044, 1989). The carboxyl region of SbcC
      has an amino acid sequence consistent with this region of SbcC forming an
      extended alpha-helical coiled-coil.

PMID- 1744034
TI  - Substitution of active-site His-223 in Pseudomonas aeruginosa elastase and
      expression of the mutated lasB alleles in Escherichia coli show evidence for
      autoproteolytic processing of proelastase.
AB  - The neutral metalloprotease elastase is one of the major proteins secreted into
      the culture medium by many Pseudomonas aeruginosa strains. Encoded by the lasB
      gene, the 33-kDa elastase is initially synthesized as a 53-kDa preproenzyme which
      is processed to the mature form via a 51-kDa proelastase intermediate. To
      facilitate studies on proteolytic processing of elastase precursors and on
      secretion, we developed systems for overexpression of lasB in Escherichia coli
      under the control of the inducible T7 and tac promoters. Although the 51-kDa
      proelastase form was detectable in E. coli under inducible conditions, most of
      the elastase produced under these conditions was found in an enzymatically active
      33-kDa form. The amino-terminal sequence of the first 15 amino acid residues of
      this 33-kDa elastase species was identical to that of the mature P. aeruginosa
      enzyme, suggesting that processing was autocatalytic. To test this possibility,
      the codon in lasB encoding His-223, a presumed active-site residue, was changed
      to encode Asp-223 (lasB1) and Tyr-223 (lasB2). The effects of these mutations on
      enzyme activity and processing were examined. No proteolytic or elastolytic
      activities were detected in extracts of E. coli cells containing the lasB mutant
      alleles. Overexpression of the mutated lasB genes in E. coli resulted in the
      accumulation of the corresponding 51-kDa proelastase species. These were
      processed in vitro to the respective 33-kDa forms by incubation with exogenous
      purified elastase, without an increase in proteolytic activity. Molecular
      modeling studies suggest that the mutations have little or no effect on the
      conformation of the mutant elastases. In addition, wild-type elastase and the
      mutant proelastases were localized to the periplasm of E. coli. The present
      results confirm that His-223 is essential for elastase activity and provide
      evidence for autoproteolytic processing of proelastase.

PMID- 1744035
TI  - 13C nuclear magnetic resonance and gas chromatography-mass spectrometry studies
      of carbon metabolism in the actinomycin D producer Streptomyces parvulus by use
      of 13C-labeled precursors.
AB  - Fructose and glutamate metabolism was monitored in cell suspensions of
      streptomyces parvulus by 13C nuclear magnetic resonance. The experiments were
      performed for cells grown with various 13C sources in a growth medium containing
      D-[U-13C]fructose, L-[13C]glutamate, or L-[U-13C]aspartate and with nonlabeled
      precursors to compare intracellular pools in S. parvulus cells at different
      periods of the cell life cycle. The transport of fructose into the cells was
      biphasic in nature; during rapid transport, mannitol, fructose, and glucose 6
      phosphate were accumulated intracellularly, whereas during the passive diffusion
      of fructose, the intracellular carbohydrate pool comprised mainly trehalose (1,1'
      alpha-alpha-D-glucose). The regulation of fructokinase activity by the
      intracellular intermediates may play an important role in fructose catabolism in
      S. parvulus. Transaldolase activity in S. parvulus was determined from the 13C
      nuclear magnetic resonance labeling pattern of trehalose carbons obtained from
      cells grown in medium containing either L-[U-13C]aspartate or L-[U-13C]glutamate.
      Only carbons 4, 5, and 6 of the disaccharide were labeled. Isotopomer analysis of
      the trehalose carbons led us to conclude that the flux through the reverse
      glycolytic pathway, condensation of glyceraldehyde 3-phosphate with
      dihydroxyacetone phosphate, makes at best a minor contribution to the 13C-labeled
      glucose units observed in trehalose. The pentose pathway and transaldolase
      activity can explain the labeling pattern of 4,5,6-13C3 of trehalose. Moreover,
      the transfer of the 13C label of L-[U-13C]aspartate into the different
      isotopomers of trehalose C4, C5, and C6 by the transaldolase activity allowed us
      to calculate the relative fluxes from oxaloacetate via gluconeogenesis and
      through the tricarboxylic acid cycle. The ratio of the two fluxes is
      approximately 1. However, the main carbon source for trehalose synthesis in S.
      parvulus is fructose and not glutamate or aspartate. The 13C enrichment and
      isotopomer population, measured by nuclear magnetic resonance and gas
      chromatography-mass spectrometry, of the actinomycin D peptide ring enabled us to
      specify the origins of the five amino acids of actinomycin D. Threonine and
      proline exhibited isotopomer populations similar to that of the extracellular L
      [13C]glutamate, indicating that protein catabolism is the origin of their 13C
      label, whereas the isotopomer populations of sarcosine and N-methylvaline were
      similar to those of the new intracellular pool of S. parvulus that originated
      from D-[U-13C]fructose during the production of actinomycin D.

PMID- 1744036
TI  - Extracellular fibrils and contact-mediated cell interactions in Myxococcus
      xanthus.
AB  - Contact-mediated cell-cell interactions play an important role in the social life
      style of Myxococcus xanthus. Previous investigations have demonstrated that
      fimbriae (also referred to as pili) and extracellular fibrils are involved in
      these social interactions (L. J. Shimkets, Microbiol. Rev. 54:473-501, 1990). We
      have used the relatively new technique of low-voltage scanning electron
      microscopy (an ultra-high-resolution scanning technique that allows for the
      nanometer resolution of biological materials) to observe the topological details
      of cell-cell interactions in M. xanthus. Our observations indicated that the
      fibrils (which measure approximately 30 nm in diameter) are produced most
      extensively by cells that are in close contact with each other and are aberrantly
      produced by the cohesion-deficient dsp mutants. Immunogold analysis identified an
      antigen which is located exclusively on the extracellular fibrils. Western blots
      (immunoblots) of this antigen (designated FA-1 for fibrillar antigen 1) indicated
      that it is composed of several immunoreactive bands (molecular size range, 90 to
      14 kDa), all of which are sensitive to protease digestion. A technique for fibril
      isolation was developed by using FA-1 as a fibril-specific marker. Low-voltage
      scanning electron microscope observations of swarming cells demonstrated that the
      expression of fibrils is differentially regulated between adventurous
      (individual) and socially (group) motile cells. The differential expression of
      fibrils suggests the existence of a mechanism for the regulation of fibril
      biosynthesis that functions within the overall system governing social
      interactions in M. xanthus.

PMID- 1744037
TI  - Synthesis and fractionation properties of SpoIIGA, a protein essential for pro
      sigma E processing in Bacillus subtilis.
AB  - sigma E, a major sporulation-specific sigma factor of Bacillus subtilis, is
      derived from an inactive precursor protein (pro-sigma E). The formation of sigma
      E from pro-sigma E requires the products of several stage II genes, including
      spoIIGA, a gene that is cotranscribed with the pro-sigma E coding region
      (spoIIGB, or sigE). SpoIIGA has been hypothesized to be both a membrane-bound
      protein and the protease which converts pro-sigma E into sigma E. to learn more
      of its properties, we joined the Escherichia coli lacZ gene to the 3' end of
      spoIIGA as a translational fusion, creating a gene whose product was found to
      contain both beta-galactosidase and SpoIIGA activities. Assaying for the beta
      galactosidase activity of the chimeric protein as a measure of its abundance, we
      determined that the spoIIGA::lacZ product accumulated to approximately 10% the
      level of a spoIIGB::lacZ fusion protein. Using differential centrifugation to
      fractionate B. subtilis extracts that contained beta-galactosidase fusion
      proteins, we observed that the beta-galactosidase activity of the spoIIGA::lacZ
      fusion protein was preferentially associated with a Triton X-100-sensitive, fast
      sedimenting portion of the extract, while the beta-galactosidase activity of the
      spoIIGB::lacZ fusion protein remained primarily in the supernatant fraction. If
      the properties of the fusion proteins are assumed to be representative of those
      of the products of the genes to which lacZ is joined, these results support the
      hypothesis that SpoIIGA is a membrane-bound protein that acts catalytically in
      the processing of pro-sigma E into sigma E.

PMID- 1744038
TI  - Genetic evidence for interaction of sigma E with the spoIIID promoter in Bacillus
      subtilis.
AB  - During sporulation in Bacillus subtilis, new RNA polymerase sigma factors are
      produced. These sigma factors direct the transcription of genes that are required
      for this cellular differentiation. In order to determine the role of each sigma
      factor in this process, it is necessary to know which promoters are recognized by
      each sigma factor. The spoIIID gene product plays an important role in the
      establishment of mother cell-specific gene expression during sporulation. We
      found that substitution of an alanine at position 124 of the sporulation-specific
      sigma factor sigma E suppressed the effect of a single-base-pair transition at
      position -13 of the spoIIID promoter. This alanine substitution in sigma E did
      not suppress the effect of a transversion at position -12 of the spoIIID
      promoter. The allele specificity of the interaction between sigma E and the
      spoIIID promoter is strong evidence that sigma E directs transcription from the
      spoIIID promoter during sporulation. Position 124 in sigma E is located within a
      region that is highly conserved among the regions in other sigma factors that
      probably interact with the -10 regions of their cognate promoters.

PMID- 1744039
TI  - Molecular analysis of Bacillus subtilis ada mutants deficient in the adaptive
      response to simple alkylating agents.
AB  - Previously, we isolated and characterized six Bacillus subtilis ada mutants that
      were hypersensitive to methylnitroso compounds and deficient in the adaptive
      response to alkylation. Cloning of the DNA complementing the defects revealed the
      presence of an ada operon consisting of two tandem and partially overlapping
      genes, adaA and adaB. The two genes encoded proteins with methylphosphotriester
      DNA methyltransferase and O6-methylguanine-DNA methyltransferase activities,
      respectively. To locate the six mutations, the ada operon was divided into five
      overlapping regions of about 350 bp. The fragments of each region were amplified
      by polymerase chain reaction and analyzed by gel electrophoresis to detect single
      strand conformation polymorphism. Nucleotide sequences of the fragments
      exhibiting mobility shifts were determined. Three of the mutants carried sequence
      alterations in the adaA gene: the adaA1 and adaA2 mutants had a one-base deletion
      and insertion, respectively, and the adaA5 mutant had a substitution of two
      consecutive bases causing changes of two amino acid residues next to the
      presumptive alkyl-accepting Cys-85 residue. Three mutants carried sequence
      alterations in the adaB gene: the adaB3 mutant contained a rearrangement, the
      adaB6 mutant contained a base substitution causing a change of the presumptive
      alkyl-accepting Cys-141 to Tyr, and the adaB4 mutant contained a base
      substitution changing Leu-167 to Pro. The adaB mutants produced ada transcripts
      upon treatment with low doses of alkylating agents, whereas the adaA mutant did
      not. We conclude that the AdaA protein functions as the transcriptional activator
      of this operon, while the AdaB protein specializes in repair of alkylated
      residues in DNA.

PMID- 1744040
TI  - A gene cluster required for coordinated biosynthesis of lipopolysaccharide and
      extracellular polysaccharide also affects virulence of Pseudomonas solanacearum.
AB  - Bacterial cell surface components can be important determinants of virulence. At
      least three gene clusters important for extracellular polysaccharide (EPS)
      biosynthesis have been previously identified in the plant pathogen Pseudomonas
      solanacearum. We have found that one of these gene clusters, named ops, is also
      required for lipopolysaccharide (LPS) biosynthesis. Mutations in any
      complementation unit of this cluster decreased EPS production, prevented the
      binding of an LPS-specific phage, and altered the mobility of purified LPS in
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis. However, restoration
      of LPS biosynthesis alone was not sufficient to restore virulence to the wild
      type level, suggesting that EPS is important for pathogenesis.

PMID- 1744041
TI  - Cloning and nucleotide sequencing of a novel 7 beta-(4
      carboxybutanamido)cephalosporanic acid acylase gene of Bacillus laterosporus and
      its expression in Escherichia coli and Bacillus subtilis.
AB  - A strain of Bacillus species which produced an enzyme named glutaryl 7-ACA
      acylase which converts 7 beta-(4-carboxybutanamido)cephalosporanic acid (glutaryl
      7-ACA) to 7-amino cephalosporanic acid (7-ACA) was isolated from soil. The gene
      for the glutaryl 7-ACA acylase was cloned with pHSG298 in Escherichia coli JM109,
      and the nucleotide sequence was determined by the M13 dideoxy chain termination
      method. The DNA sequence revealed only one large open reading frame composed of
      1,902 bp corresponding to 634 amino acid residues. The deduced amino acid
      sequence contained a potential signal sequence in its amino-terminal region.
      Expression of the gene for glutaryl 7-ACA acylase was performed in both E. coli
      and Bacillus subtilis. The enzyme preparations purified from either recombinant
      strain of E. coli or B. subtilis were shown to be identical with each other as
      regards the profile of sodium dodecyl sulfate-polyacrylamide gel electrophoresis
      and were composed of a single peptide with the molecular size of 70 kDa.
      Determination of the amino-terminal sequence of the two enzyme preparations
      revealed that both amino-terminal sequences (the first nine amino acids) were
      identical and completely coincided with residues 28 to 36 of the open reading
      frame. Extracellular excretion of the enzyme was observed in a recombinant strain
      of B. subtilis.

PMID- 1744042
TI  - Genetic method to identify regulons controlled by nonessential elements:
      isolation of a gene dependent on alternate transcription factor sigma B of
      Bacillus subtilis.
AB  - We describe a general, in vivo method for identifying Bacillus subtilis genes
      controlled by specific, nonessential regulatory factors. We establish the use of
      this approach by identifying, isolating, and characterizing a gene dependent on
      sigma B, an alternate transcription factor which is found early in stationary
      phase but which is not essential for sporulation. The method relies on two
      features: (i) a plate transformation technique to introduce a null mutation into
      the regulatory gene of interest and (ii) random transcriptional fusions to a
      reporter gene to monitor gene expression in the presence and absence of a
      functional regulatory product. We applied this genetic approach to isolate genes
      comprising the sigma B regulon. We screened a random Tn917lacZ library for
      fusions that required an intact sigma B structural gene (sigB) for greatest
      expression, converting the library strains from wild-type sigB+ to sigB
      delta::cat directly on plates selective for chloramphenicol resistance. We
      isolated one such fusion, csbA::Tn917lacZ (csb for controlled by sigma B), which
      mapped between hisA and degSU on the B. subtilis chromosome. We cloned the region
      surrounding the insertion, identified the csbA reading frame containing the
      transposon, and found that this frame encoded a predicted 76-residue product
      which was extremely hydrophobic and highly basic. Primer extension and promoter
      activity experiments identified a sigma B-dependent promoter 83 bp upstream of
      the csbA coding sequence. A weaker, tandem, sigma A-like promoter was likewise
      identified 28 bp upstream of csbA. The csbA fusion was maximally expressed during
      early stationary phase in cells grown in Luria broth containing 5% glucose and
      0.2% glutamine. This timing of expression and medium dependence were very similar
      to those for ctc, the only other recognized gene dependent on sigma B.

PMID- 1744043
TI  - Effect of chromosome location of Bacillus subtilis forespore genes on their spo
      gene dependence and transcription by E sigma F: identification of features of
      good E sigma F-dependent promoters.
AB  - Translational lacZ fusions to forespore genes of Bacillus subtilis were not
      expressed in spoIIAC (sigma F) or spoIIIE mutants when the lacZ fusions were
      integrated at the loci of the same genes or at the SP beta locus. However, some
      of these genes, including gerA, gpr, spoIIIG (sigma G), and sspE, were expressed
      in spoIIIE mutants and spoIIIE spoIIIG double mutants (but not in spoIIAC
      mutants) when the lacZ fusions were integrated at the amyE locus. When tested,
      the beta-galactosidase made in these mutants was found only in the forespore, and
      the 5' ends of the mRNAs produced in these mutants were identical to those in a
      Spo+ background. Analysis of the in vitro transcription of forespore genes by RNA
      polymerase containing sigma F (E sigma F) revealed a direct correlation between
      good in vitro transcription by E sigma F and expression at the amyE locus in
      spoIIIE mutants. This result suggests that forespore genes are transcribed by E
      sigma F in spoIIIE and spoIIIE spoIIIG mutants. Comparison of the promoter
      regions of genes transcribed well and poorly by E sigma F in vivo and in vitro
      showed that good transcription by E sigma F was correlated with G residues at
      positions -15 and -16, a purine residue at position -13, and a T residue at
      position -7 relative to the start site of transcription. The importance of these
      residues in sigma F recognition was confirmed by analysis of the E sigma F
      dependent transcription in vivo and in vitro of mutant ssp genes.

PMID- 1744044
TI  - Analysis of the lsi region involved in lipooligosaccharide biosynthesis in
      Neisseria gonorrhoeae.
AB  - The genetic locus (lsi-1) responsible for the transformation of the
      lipooligosaccharide (LOS)-defective Neisseria gonorrhoeae mutant FA5100 to LOS
      expression was studied by deletion mutagenesis and sequence analysis. An open
      reading frame that was preceded by a leader sequence containing regions with the
      potential to form hairpin loops was identified. A perfect sigma 70 promoter
      consensus sequence was found upstream from this open reading frame. Promoter
      function was screened for functionality by using lac fusion cassettes and in
      vitro transcription-translation analysis. A frameshift mutation in the lsi-1 gene
      was constructed by site-directed mutagenesis and introduced into the chromosome
      of FA19, the LOS-expressing isogenic parent strain of FA5100. The mutant was
      characterized by Southern blotting, sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, and Western blotting (immunoblotting) and found to be
      phenotypically identical to FA5100.

PMID- 1744045
TI  - Control of Escherichia coli lysyl-tRNA synthetase expression by anaerobiosis.
AB  - Escherichia coli lysyl-tRNA synthetase was previously shown to occur as two
      distinct species encoded by either the lysS or the lysU gene. The expression of
      one of these genes, lysU, is under the control of cell growth conditions. To
      study the regulation of lysU, delta lysS strains were constructed. During aerobic
      growth at 37 degrees C or below, the amount of the lysU product in the cell is so
      reduced that delta lysS bacteria grow only poorly. The reduced expression of lysU
      is not related to the steady-state lysyl-tRNA synthetase concentration in the
      cell, since the expression of a lysU::lacZ fusion is insensitive to the absence
      of either lysS or lysU or to the addition of a multi-copy plasmid carrying either
      lysU or lysS. During anaerobic growth in rich medium, the lysU gene becomes
      strongly expressed and, in cell extracts, the amount of lysyl-tRNA synthetase
      activity originating from lysU may become seven times greater than the activity
      originating from lysS. In minimal medium, lysU expression is only slightly
      induced. Evidence that the sensitivity of lysU expression to anaerobiosis, as
      well as to low external pH conditions (E. W. Hickey and I. N. Hirshfield, Appl.
      Environ. Microbiol. 56:1038-1045, 1990), is governed at the level of
      transcription is provided.

PMID- 1744046
TI  - The major carotenoid pigment of a psychrotrophic Micrococcus roseus strain:
      purification, structure, and interaction with synthetic membranes.
AB  - The major carotenoid pigment of a psychrotrophic Micrococcus roseus strain was
      purified to homogeneity from methanol extracts of dried cells by reverse-phase
      liquid chromatography and was designated P-3. On the basis of the UV-visible,
      infrared, mass, and 1H nuclear magnetic resonance spectra of P-3, it was
      identified as bisdehydro-beta-carotene-2-carboxylic acid. The pigment interacted
      with synthetic membranes of phosphatidylcholine and dimyristoyl
      phosphatidylcholine and stabilized the membranes. These results also indicate
      that P-3 is different from canthaxanthin, the major carotenoid pigment from a
      mesophilic M. roseus strain.

PMID- 1744047
TI  - Trehalose synthesis genes are controlled by the putative sigma factor encoded by
      rpoS and are involved in stationary-phase thermotolerance in Escherichia coli.
AB  - The rpoS (katF) gene of Escherichia coli encodes a putative sigma factor (sigma
      S) required for the expression of a variety of stationary phase-induced genes,
      for the development of stationary-phase stress resistance, and for long-term
      starvation survival (R. Lange and R. Hengge-Aronis, Mol. Microbiol. 5:49-59,
      1991). Here we show that the genes otsA, otsB, treA, and osmB, previously known
      to be osmotically regulated, are also induced during transition into stationary
      phase in a sigma S-dependent manner. otsA and otsB, which encode trehalose-6
      phosphate synthase and trehalose-6-phosphate phosphatase, respectively, are
      involved in sigma S-dependent stationary-phase thermotolerance. Neither sigma S
      nor trehalose, however, is required for the development of adaptive
      thermotolerance in growing cells, which might be controlled by sigma E.

PMID- 1744048
TI  - Characterization of the haloacid dehalogenase from Xanthobacter autotrophicus
      GJ10 and sequencing of the dhlB gene.
AB  - The haloacid dehalogenase of the 1,2-dichloroethane-utilizing bacterium
      Xanthobacter autotrophicus GJ10 was purified from a mutant with an eightfold
      increase in expression of the enzyme. The mutant was obtained by selecting for
      enhanced resistance to monobromoacetate. The enzyme was purified through
      (NH4)2SO4 fractionation, DEAE-cellulose chromatography, and hydroxylapatite
      chromatography. The molecular mass of the protein was 28 kDa as determined with
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis and 36 kDa as
      determined with gel filtration on Superose 12 fast protein liquid chromatography.
      The enzyme was active with 2-halogenated carboxylic acids and converted only the
      L-isomer of 2-chloropropionic acid with inversion of configuration to produce D
      lactate. The activity of the enzyme was not readily influenced by thiol reagents.
      The gene encoding the haloacid dehalogenase (dhlB) was cloned and could be
      allocated to a 6.5-kb EcoRI-BglII fragment. Part of this fragment was sequenced,
      and the dhlB open reading frame was identified by comparison with the N-terminal
      amino acid sequence of the protein. The gene was found to encode a protein of
      27,433 Da that showed considerable homology (60.5 and 61.0% similarity) with the
      two other haloacid dehalogenases sequenced to date but not with the haloalkane
      dehalogenase from X. autotrophicus GJ10.

PMID- 1744049
TI  - The bacteriocin lactococcin A specifically increases permeability of lactococcal
      cytoplasmic membranes in a voltage-independent, protein-mediated manner.
AB  - Lactococcin A is a bacteriocin produced by Lactococcus lactis. Its structural
      gene has recently been cloned and sequenced (M. J. van Belkum, B. J. Hayema, R.
      E. Jeeninga, J. Kok, and G. Venema, Appl. Environ. Microbiol. 57:492-498, 1991).
      Purified lactococcin A increased the permeability of the cytoplasmic membrane of
      L. lactis and dissipated the membrane potential. A significantly higher
      concentration of lactococcin A was needed to dissipate the membrane potential in
      an immune strain of L. lactis. Lactococcin A at low concentrations (0.029
      microgram/mg of protein) inhibited secondary and phosphate-bond driven transport
      of amino acids in sensitive cells and caused efflux of preaccumulated amino
      acids. Accumulation of amino acids by immune cells was not affected by this
      concentration of lactococcin A. Lactococcin A also inhibited proton motive force
      driven leucine uptake and leucine counterflow in membrane vesicles of the
      sensitive strain but not in membrane vesicles of the immune strain. These
      observations indicate that lactococcin A makes the membrane permeable for leucine
      in the presence or absence of a proton motive force and that the immunity
      factor(s) is membrane linked. Membrane vesicles of Clostridium acetobutylicum,
      Bacillus subtilis, and Escherichia coli were not affected by lactococcin A, nor
      were liposomes derived from phospholipids of L. lactis. These results indicate
      that lactococcin A acts on the cytoplasmic membrane and is very specific towards
      lactococci. The combined results obtained with cells, vesicles, and liposomes
      suggest that the specificity of lactococcin A may be mediated by a receptor
      protein associated with the cytoplasmic membrane.

PMID- 1744050
TI  - Cloning, characterization, and expression of the spoVB gene of Bacillus subtilis.
AB  - Mutation of the spoVB gene in Bacillus subtilis causes the production of spores
      containing a defective cortex and unable to acquire heat resistance. The spoVB
      locus is highly linked to another spo locus, spoIIIF, characterized by a single
      mutation (I. L. Lamont and J. Mandelstam, J. Gen. Microbiol. 130:1253-1261,
      1984). A 18-kb DNA region overlapping the spoIIIF-spoVB region was cloned in
      successive steps starting from a Tn917 insertion in the nic locus. The exact
      location of the spoIIIF and spoVB loci was defined with various integrative
      plasmids carrying subfragments of that region. DNA sequencing established that
      spoIIIF and spoVB are a single monocistronic locus encoding a 518-amino-acid
      polypeptide with features of an integral membrane protein. The precise location
      of the spoIIIF590 and spoVB91 mutations in that unique open reading frame was
      determined, and both mutations were sequenced. A null mutation was engineered in
      the spoIIIF-spoVB locus and led to a typical spoVB phenotype, identical to the
      phenotype created by either spoIIIF590 or spoVB91, suggesting that the original
      spoIIIF mutant contained a secondary mutation arresting sporulation at an earlier
      stage. A transcriptional spoVB-lacZ fusion was constructed, and its expression
      was found to be directly dependent on RNA polymerase containing sigma E. A null
      mutation of spoVB had no effect on expression of sspB and cotA, members of the
      sigma G- and sigma K-controlled regulons respectively, while expression of cotC,
      a member of the latest known mother cell regulon, was delayed and strongly
      reduced. These results are consistent with SpoVB being involved in cortex
      biosynthesis and affecting only indirectly expression of late sporulation genes.

PMID- 1744051
TI  - Cloning and sequencing of the gene for a Pseudomonas paucimobilis enzyme that
      cleaves beta-aryl ether.
AB  - We isolated Pseudomonas paucimobilis SYK-6, which was able to degrade various
      dimeric lignin compounds (Y. Katayama, S. Nishikawa, M. Nakamura, K. Yano, M.
      Yamasaki, N. Morohoshi, and T. Haraguchi, Mokuzai Gakkaishi 33:77-79, 1987). This
      metabolic process is a distinct characteristic of this bacterium, which is
      equipped with an enzymatic modification system for various dimeric lignin
      compounds involved in the tricarboxylic acid cycle. Cleavage of the beta-aryl
      ether linkage is essential in this process, because this linkage is the most
      abundant (approximately 50%) in lignin. Here, we report the isolation and
      characterization of the beta-etherase gene, which contains an open reading frame
      of 843 bp and which we call ligE. This gene was expressed in Escherichia coli,
      and the enzyme had the same kinetic properties as the P. paucimobilis SYK-6
      enzyme.

PMID- 1744052
TI  - Characterization of endoglucanase A from Clostridium cellulolyticum.
AB  - A construction was carried out to obtain a high level of expression in
      Escherichia coli of the gene celCCA, coding for the endoglucanase A from
      Clostridium cellulolyticum (EGCCA). The enzyme was purified in two forms with
      different molecular weights, 51,000 and 44,000. The smaller protein was probably
      the result of proteolysis, although great care was taken to prevent this process
      from occurring. Evidence was found for the loss of the conserved reiterated
      domains which are characteristic of C. thermocellum and C. cellulolyticum
      cellulases. The two forms were extensively studied, and it was demonstrated that
      although they had the same pH and temperature optima, they differed in their
      catalytic properties. The truncated protein gave the more efficient catalytic
      parameters on carboxymethyl cellulose and showed improved endoglucanase
      characteristics, whereas the intact enzyme showed truer cellulase
      characteristics. The possible role of clostridial reiterated domains in the
      hydrolytic activity toward crystalline cellulose is discussed.

PMID- 1744053
TI  - Characterization of PDC6, a third structural gene for pyruvate decarboxylase in
      Saccharomyces cerevisiae.
AB  - Pyruvate decarboxylase is the key enzyme in alcoholic fermentation in yeast. Two
      structural genes, PDC1 and PDC5 have been characterized. Deletion of either of
      these genes has little or no effect on the specific pyruvate decarboxylase
      activity, but enzyme activity is undetectable in mutants lacking both PDC1 and
      PDC5 (S. Hohmann and H. Cederberg, Eur. J. Biochem. 188:615-621, 1990). Here I
      describe PDC6, a gene structurally closely related to PDC1 and PDC5. The product
      of PDC6 does not seem to be required for wild-type pyruvate decarboxylase
      activity in glucose medium; delta pdc6 mutants have no reduced specific enzyme
      activity, and the PDC6 deletion did not change the phenotype or the specific
      enzyme activity of mutants lacking either or both of the other two structural
      genes. However, in cells grown in ethanol medium the PDC6 deletion caused a
      reduction of pyruvate decarboxylase activity. Northern (RNA) blot analysis showed
      that PDC6 is weakly expressed, and expression seemed to be higher during growth
      in ethanol medium. This behavior remained obscure since pyruvate decarboxylase
      catalyzes an irreversible reaction. Characterization of all combinations of PDC
      structural gene deletion mutants, which produce different amounts of pyruvate
      decarboxylase activity, showed that the enzyme is also needed for normal growth
      in galactose and ethanol medium and in particular for proper growth initiation of
      spores germinating on ethanol medium.

PMID- 1744054
TI  - Cell cycle parameters of Escherichia coli K-12.
AB  - A computer simulation routine was used to calculate the DNA distributions of
      exponentially growing cultures of Escherichia coli K-12. Simulated distributions
      were compared with distributions obtained experimentally by flow cytometry.
      Durations of the DNA replication period (C) and the postreplication period (D)
      were found by minimizing the difference between theoretical and experimental DNA
      histograms. It was demonstrated that the K-12 strains AB1157 and CM735 had C and
      D periods that differed widely from each other and from those of the previously
      measured strain B/rA, while strain MC1000 was shown to have the same durations of
      the C and D periods as strain B/rA. The variation between K-12 strains may
      explain the divergence in the literature regarding their C and D periods. Strains
      W3110 and AB1157 recA1 had DNA histograms that could not be adequately simulated
      by the classical Cooper-Helmstetter model, which is consistent with the
      asymmetrically located origin and terminus for W3110 and the asynchrony of
      initiation for AB1157 recA1.

PMID- 1744055
TI  - Characterization of the heat shock response in Mycobacterium bovis BCG.
AB  - We have for the first time characterized the heat shock response in mycobacteria
      both at the level of transcription, by RNA extraction, Northern (RNA) blotting,
      and hybridization with gene-specific probes for the Mycobacterium tuberculosis 65
      and 71-kDa heat shock proteins (HSPs), and at the level of translation, by
      [35S]methionine labelling, sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, and autoradiography. We observed increased synthesis of 40-, 65
      , 71-, and 90-kDa proteins, which appear to be major HSPs in mycobacteria. The 40
      , 71-, and 90-kDa HSPs are coordinately regulated in terms of temperature
      requirements and kinetics of induction but differ in the levels of expression.
      The 65- and 71-kDa HSPs are differentially regulated in response to temperature,
      with different kinetics and levels of induction. mRNA transcript sizes for the 71
      , 65-, 40-, and 30-kDa proteins were found to be broadly consistent with DNA
      sequence open reading frames. A maximum increase of about 69-fold in the levels
      of mRNA for the 71-kDa HSP after 45 min of heat shock at 45 degrees C was
      observed, whereas the 65-kDa HSP mRNA increased only 5-fold. It was also found
      that in M. bovis BCG, as in Escherichia coli, a major control mechanism of the
      heat shock response is operative at the level of transcription. An ability to
      characterize the heat shock response in mycobacteria provides an experimental
      model with which to study environmentally regulated gene expression and an
      opportunity to identify virulence genes, which may coregulate as part of the heat
      shock regulon.

PMID- 1744056
TI  - Release of a cell surface protein during development of Myxococcus xanthus.
AB  - VGP is a major cell-surface glycoprotein present in vegetative cells of
      Myxococcus xanthus. Serological assays indicated that this protein was released
      from cells and accumulated in the medium during development, i.e., aggregation,
      fruiting body formation, and myxosporulation. Cells induced to form spores in the
      absence of aggregation retained VGP, indicating that loss of VGP was associated
      with developmental aggregation rather than myxosporulation. Anti-VGP antibodies
      inhibited vegetative cell gliding, suggesting the protein may also be required
      for motility.

PMID- 1744057
TI  - Specificity of SOS mutagenesis in native M13lacI phage.
AB  - Base substitutions account for 90% of all forward mutations sequenced in
      unmodified M13lacI DNA grown in both UV-irradiated and nonirradiated hosts. The
      principal effect of SOS induction was an increase in the contribution of
      transversions, in particular A.T----T.A events.

PMID- 1744058
TI  - Regulation of laccase biosynthesis in the plant-pathogenic fungus Cryphonectria
      parasitica by double-stranded RNA.
AB  - Transmissible hypovirulence of the chestnut blight fungus, Cryphonectria
      parasitica, is associated with cytoplasmic double-stranded-RNA (dsRNA) viruses.
      The fungal laccase has attracted interest because its activity is reduced in
      hypovirulent dsRNA-containing strains. A laccase cDNA clone was isolated by
      screening a cDNA expression library with antibodies against the purified
      extracellular laccase. The amino acid sequence deduced from part of the cDNA
      clone revealed high homology to other fungal laccases, especially to the
      Neurospora crassa laccase. A major laccase transcript 2.3 kb in length was
      detected in Northern (RNA) blots. In liquid culture, extracellular laccase
      activity was reduced by about 75% in the hypovirulent (dsRNA-free) strain
      EP155/2. In contrast, production of biomass was not affected by the dsRNA.
      Northern blot analysis indicated that dsRNA down regulates laccase biosynthesis
      by reducing laccase mRNA accumulation. The laccase gene is one of several
      developmentally regulated genes affected by the presence of dsRNA.

PMID- 1744059
TI  - Localization of outer surface proteins A and B in both the outer membrane and
      intracellular compartments of Borrelia burgdorferi.
AB  - Borrelia burgdorferi B31 with and without outer membranes contained nearly
      identical amounts of outer surface proteins A and B. The majority of each
      immunogen also was localized intracellularly by immunocryoultramicrotomy. These
      results are inconsistent with the widely held belief that outer surface proteins
      A and B are exclusively outer membrane proteins.

PMID- 1744060
TI  - Regulation of the adhE gene, which encodes ethanol dehydrogenase in Escherichia
      coli.
AB  - The respiratory control of adhE, which encodes ethanol (alcohol) dehydrogenase in
      Escherichia coli, was examined at the transcriptional level by using various phi
      (adhE'-lacZ) adhE+ merodiploid strains. Expression of the adhE'-lacZ operon
      fusion was increased about eightfold by anaerobic growth. Under anaerobic growth
      conditions, provision of nitrate lowered the level of expression. Nitrate
      repression was more severe than aerobic repression. From analyses of various
      mutants with mutations related to nitrate reduction, nitrate repression appears
      to result from two effects. (i) When nitrate was present, NarL, the positive
      regulator of the nar operon, exerted a direct repression on adhE expression,
      which was demonstrable even aerobically. (ii) The chemical reduction of nitrate
      exerted an indirect effect by altering the cellular redox potential.

PMID- 1744061
TI  - A 102-center prospective study of seizure in association with bupropion.
AB  - BACKGROUND: This trial was conducted to determine the incidence of seizures
      associated with the use of bupropion. METHOD: A total of 3341 depressed patients
      from 102 sites were enrolled in this 8-week, prospective, open trial. Following
      the 8-week treatment phase, patients could elect to enroll in a humanitarian
      continuation phase of unlimited duration. Dosing was initiated at 225 mg/day and
      increased to 450 mg/day as tolerated. Investigators carefully monitored seizure
      occurrences and rated their patients' response to and tolerance of bupropion.
      RESULTS: A total of 1986 patients (61%) completed the 8-week treatment phase, and
      1616 (81%) of these elected to be maintained on bupropion treatment in the
      humanitarian continuation phase. The observed seizure rate was 0.24% for the
      treatment phase and 0.40% for the entire study. An 8-week survival analysis
      performed on patients with a dosing regimen of 300 to 450 mg/day yielded a
      cumulative rate of 0.36%. Patients, including those previously resistant to
      antidepressant treatment, responded to and tolerated bupropion well. CONCLUSION:
      These rates confirm earlier seizure estimates and fall within accepted parameters
      for antidepressant drugs. This trial enhances bupropion's position as a valuable
      alternative for the management of depression.

PMID- 1744062
TI  - Hypochondriasis and obsessive compulsive disorder: overlaps in diagnosis and
      treatment.
AB  - BACKGROUND: Hypochondriasis is a disorder for which there are no established
      effective treatments. Hypochondriacs, in their obsessions about illness,
      compulsions to check with others, and failure to be reassured, share many
      features in common with those who have obsessive compulsive disorder (OCD).
      METHOD: The authors present a case series of six patients with DSM-III-R
      hypochondriasis, five of whom also had a history of OCD. Two of the six agreed to
      be treated with doses of fluoxetine typically used to treat OCD. RESULTS: Both
      patients, one of whom had no past history of OCD, showed a marked improvement in
      hypochondriacal symptoms. CONCLUSION: These findings suggest that a subgroup of
      patients with hypochondriasis may be particularly responsive to serotonin
      reuptake blockers.

PMID- 1744063
TI  - Painful ejaculation associated with antidepressants in four patients.
AB  - BACKGROUND: Painful ejaculation associated with tricyclic antidepressants is
      rarely reported in the medical literature. METHOD: Painful ejaculation following
      the administration of imipramine and clomipramine is described in four patients.
      RESULTS: The phenomenon occurred in all patients during the first 3 weeks of
      treatment and disappeared within several days when the tricyclic dosage was
      reduced or the medication was withdrawn. CONCLUSION: Painful ejaculation was
      apparently evoked by tricyclic antidepressant administration. Clinicians should
      be aware of this underreported side effect.

PMID- 1744064
TI  - An open trial of fluoxetine in patients with anorexia nervosa.
AB  - BACKGROUND: Anorexia nervosa is a disorder of unknown etiology with a high rate
      of relapse and no known treatment. Because anorexia nervosa shares some
      similarities with obsessive compulsive disorder, we hypothesized that a serotonin
      specific medication might be useful in the treatment of this illness. METHOD: We
      administered an open trial of fluoxetine to 31 patients with DSM-III-R anorexia
      nervosa. Most anorexics were started on fluoxetine treatment after inpatient
      weight restoration and then discharged from the hospital and followed up as
      outpatients. RESULTS: At the time of follow-up (11 +/- 6 months on fluoxetine),
      29 of the 31 patients had maintained their weight at or above 85% average body
      weight (97% +/- 13% average body weight for the group). We judged response as
      good in 10, partial in 17, and poor in 4 anorexics as measured by improvements in
      eating behavior, mood, and obsessional symptoms. Restrictor anorexics responded
      significantly better than bulimic and/or purging-type anorexics. CONCLUSION: This
      open trial suggests that fluoxetine may help patients with anorexia nervosa
      maintain a healthy body weight as outpatients. The reasons for the positive
      effects of fluoxetine are uncertain, but the agent may help by improving eating
      behavior and/or reducing obsessionality, depression, and anxiety. It is important
      to emphasize that this was not a double-blind, placebo-controlled study. Thus we
      can not be certain of the efficacy of fluoxetine and caution that fluoxetine
      should not be used as the sole treatment of anorexia nervosa at this time.

PMID- 1744065
TI  - Carbamazepine for treatment-resistant melancholia.
AB  - BACKGROUND: There have only been a few studies of the role of carbamazepine in
      the management of treatment-resistant depression. METHOD: The response to
      carbamazepine of 16 melancholic patients, who had been depressed for an extended
      period despite a number of standard treatments, was studied retrospectively.
      RESULTS: Seven patients (44%) had a moderate or marked improvement. The
      responders included both psychotic and nonpsychotic depressives, and patients
      with concurrent organic brain disease. There was, however, a high rate of
      complications, with 5 of these 7 responders (71%) having to discontinue
      carbamazepine because of adverse effects. This high rate of complications may
      have reflected the older age of our sample. CONCLUSION: These findings suggest
      the efficacy of carbamazepine in melancholic patients who have not responded to
      conventional treatments, but indicate that the high rate of significant side
      effects may limit its long-term usefulness.

PMID- 1744066
TI  - Fluoxetine-induced bradycardia.

PMID- 1744067
TI  - Personality disorder diagnosis in old age.

PMID- 1744068
TI  - Clomipramine treatment of trichotillomania.

PMID- 1744069
TI  - Does fluoxetine induce suicidality?

PMID- 1744070
TI  - Environmental influences on the onset of winter depression.

PMID- 1744071
TI  - von Willebrand factor.

PMID- 1744072
TI  - Marker exchange of the structural genes for nitric oxide reductase blocks the
      denitrification pathway of Pseudomonas stutzeri at nitric oxide.
AB  - Bacterial denitrification reverses nitrogen fixation in the global N-cycle by
      transforming nitrate or nitrite to dinitrogen. Both nitrite and nitric oxide (NO)
      are considered as the chemical species within the denitrification pathway, that
      precede nitrous oxide (N2O), the first recognized intermediate with N,N-bonds
      antecedent to N2. Molecular cloning of the structural genes for NO reductase from
      Pseudomonas stutzeri has allowed us to generate the first mutants defective in NO
      utilization (Nor- phenotype) by marker exchange of the norCB genes with a gene
      cassette for gentamicin resistance. Nitric oxide reductase was found to be an
      indispensable component for denitrification; its loss constituted a conditionally
      lethal mutation. NO as the sole product accumulated from nitrite by mutant cells
      induced for nitrite respiration (denitrification). The Nor- mutant lost the
      capability to reduce NO and did not grow anymore anaerobically on nitrate. A Nir
      Nor- double mutation, that inactivated also the respiratory nitrite reductase
      cytochrome cd1 rendered the bacterium again viable under anaerobiosis. Our
      observations provide evidence for a denitrification pathway in vivo of NO2(-)---
      NO----N2O, and N,N-bond formation catalyzed by NO reductase and not by cytochrome
      cd1.

PMID- 1744073
TI  - Ribosome-independent GTPase activity of translation initiation factor IF2 and of
      its G-domain.
AB  - In the absence of ribosomes, Bacillus stearothermophilus translation initiation
      factor IF2 (Mr = 82 kDa) and its GTP-binding domain (i.e. the G-domain, Mr = 41
      kDa) promote barely detectable hydrolysis of GTP. Upon addition of some aliphatic
      alcohols, however, the rate of nucleotide cleavage is substantially increased
      with both IF2 and G-domain, the highest stimulation being observed with 20% (v/v)
      ethanol. Under these conditions, the rates of ribosome-independent GTP hydrolysis
      with both IF2 and G-domain are approximately 30-fold lower than the corresponding
      rates obtained in the presence of ribosomes, while the Km for GTP is
      approximately the same in all cases. These results indicate that, as with the
      other two prokaryotic G proteins involved in translation (i.e. elongation factors
      EF-Tu and EF-G), also in the case of IF2, the GTPase catalytic center resides in
      the factor and, more specifically, in its G-domain.

PMID- 1744074
TI  - A synthetic peptide mimic of plasma apolipoprotein E that binds the LDL receptor.
AB  - Human plasma apolipoprotein E (apoE) is a low density lipoprotein (LDL) receptor
      ligand. It targets cholesterol-rich lipoproteins to LDL receptors on both hepatic
      and peripheral cells. The region of apoE responsible for its binding to the LDL
      receptor has been localized to amino acids 140-160. An apoE 141-155 monomeric
      peptide and a dimeric 141-155 tandem peptide were synthesized and tested for
      their inhibition of 125I-LDL degradation by human fibroblasts and human monocytic
      like cells, THP-1. The monomer had no activity at 250 microM, but the dimer
      inhibited 125I-LDL degradation by 50% at 5 microM. The inhibition was specific
      for the LDL receptor because the dimer did not inhibit the degradation of 125I
      acetylated LDL by scavenger receptors expressed by phorbol ester-stimulated THP-1
      cells. As reported for native apoE, amino acid substitutions of Lys-143----Ala,
      Leu-144----Pro, and Arg-150----Ala decreased the inhibitory effectiveness of the
      dimer. Furthermore, a trimer of the 141-155 sequence had a 20-fold greater
      inhibitory activity than the dimer. Studies with a radioiodinated dimer indicated
      that some of the inhibitory activity could be a result of the interaction of the
      dimer with LDL. However, direct binding of the 125I-dimeric peptide to THP-1
      cells was observed as well. This binding was time-dependent, linear with
      increasing cell number, Ca(2+)- but not Mg(2+)-dependent, saturable, inhibited by
      lipoproteins, and increased by preculture of the cells in lipoprotein-depleted
      medium. Therefore, a synthetically prepared dimeric repeat of amino acid residues
      141-155 of apoE binds the LDL receptor.

PMID- 1744075
TI  - Structure of oligosaccharides on Saccharomyces SUC2 invertase secreted by the
      methylotrophic yeast Pichia pastoris.
AB  - Saccharomyces SUC2 invertase, secreted by the methylotrophic yeast Pichia
      pastoris and purified to homogeneity from the growth medium by DE-52
      chromatography, appeared on sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis as a diffuse ladder of species at 85-90 kDa, while the secreted
      Saccharomyces form migrated as a broad band from 100 to 150 kDa. Endo-beta-N
      acetylglucosaminidase H released the Pichia invertase carbohydrate generating a
      60-kDa protein with residual Asn-linked GlcNAcs and oligosaccharides separated on
      Bio-Gel P-4 into Man8-11GlcNAc. Nearly 75% of the oligosaccharides were equally
      distributed between Man8,9GlcNAc, while 17% were Man10GlcNAc and 8% were
      Man11GlcNAc. Oligosaccharide pools were analyzed for homogeneity by high-pH anion
      exchange chromatography, and structures were assigned using 500 MHz one- and two
      dimensional 1H NMR spectroscopy. Pichia Man8GlcNAc was the same isomer as found
      in Saccharomyces, which arises by removing the alpha 1,2-linked terminal mannose
      from the middle arm of the lipid-oligosaccharide Man9GlcNAc (Byrd, J. C.,
      Tarentino, A. L., Maley, F., Atkinson, P. H., and Trimble, R. B. (1982) J. Biol.
      Chem. 257, 14657-14666). The Man9GlcNAc pool was 5% lipid-oligosaccharide
      precursor and 95% Man8GlcNAc isomer with a terminal alpha 1,6-linked mannose on
      the lower-arm alpha 1,3-core-linked residue (Hernandez, L. M., Ballou, L.,
      Alvarado, E., Gillece-Castro, B. L., Burlingame, A. L., and Ballou, C. E. (1989)
      J. Biol. Chem. 264, 11849-11856). An alpha 1,2-linked mannose on the new alpha
      1,6-linked branch in Man9GlcNAc provided 80% of the Man10GlcNAc, which is the
      structure on Saccharomyces invertase (Trimble, R. B., and Atkinson, P. H. (1986)
      J. Biol. Chem. 261, 9815-9824). A minor Man10GlcNAc (12%) and the principal
      Man11GlcNAc (82%) were the major Man9,10GlcNAc with novel alpha 1,2-linked
      mannoses on the preexisting alpha 1,2-linked termini. Although Pichia glycans did
      not have terminal alpha 1,3-linked mannoses as found on Saccharomyces core
      oligosaccharides, over 60% of the structures were isometric configurations unique
      to lower eukaryotes.

PMID- 1744076
TI  - Quantitative analysis of molecular species of diacylglycerol and phosphatidate
      formed upon muscarinic receptor activation of human SK-N-SH neuroblastoma cells.
AB  - Quantitative changes in the total mass and the molecular species of 1,2-diacyl-sn
      glycerol (DAG) and phosphatidic acid (PA) formed upon muscarinic receptor
      activation were studied in cultured human SK-N-SH neuroblastoma cells. DAG was
      isolated from the total lipid extracts of carbachol (CCh)-stimulated and
      unstimulated cells and after benzoylation, was subjected to reverse phase high
      performance liquid chromatography to separate the component species. The
      molecular species of DAG were identified by analyzing the fatty acid composition
      of each separated fraction by gas chromatography, and their total and individual
      masses were quantified from the known amount of an internal standard, 1,2
      distearoyl-sn-glycerol, added during the extraction of the lipid. Relatively high
      basal levels of DAG (1.5 nmol/mg protein) are present in these cells, and
      addition of CCh elicited a 50-60% increase in the total amounts of DAG within 5
      min. The increase was biphasic: an initial major peak at 5 min was followed by a
      sustained increase that persisted for at least 30 min. An increase in DAG was
      elicited by both full and partial muscarinic agonists and was blocked by
      atropine. The presence of extracellular Ca2+ was necessary for muscarinic
      receptor-activated formation of DAG. To determine the source of the DAG, the
      molecular species of the major phospholipids present in SK-N-SH cells were also
      analyzed. The phospholipids were first enzymatically hydrolyzed to DAGs which
      were then analyzed as described above. A number of unusual fatty acids, the major
      one being 20:3 (n-9), were present in these lipids especially in the
      phosphoinositides and also in the DAG formed after CCh stimulation. Within 5 s of
      CCh stimulation there were transient increases in the DAG species representative
      of phosphoinositides. By 5 min the newly formed molecular species of DAG
      resembled a mixture of phosphoinositides and phosphatidylcholine (PC).
      Quantitative comparison of the molecular species compositions of
      phosphoinositides, PC, and newly formed DAGs indicated that at time periods up to
      10 min, approximately 30% of the DAG originated from the phosphoinositides and
      the rest from PC. At longer intervals (greater than 20 min), most (85%) of DAGs
      originated from PC. Activation of muscarinic receptors in SK-N-SH cells also
      elicited an increase in PA (200% in 5 min). A quantitative molecular species
      analysis, using 1,2-distearoyl-sn-glycerol-3-P as internal standard, was
      performed by enzymatic (alkaline phosphatase) hydrolysis of PA to DAG and
      subsequent analysis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1744077
TI  - Identification of the pheophytin-QA-Fe domain of the reducing side of the
      photosystem II as the Cu(II)-inhibitory binding site.
AB  - Oxygen evolution by photosystem II membranes was inhibited by Cu(II) when 2,6
      dichlorobenzoquinone or ferricyanide, but not silicomolybdate, was used as
      electron acceptor. This indicated that Cu(II) affected the reducing side of the
      photosystem II. The inhibition curves of Cu(II), o-phenanthroline and 3-(3,4
      dichlorophenyl)-1,1-dimethylurea (DCMU), were compared; the inhibitory patterns
      of Cu(II) and o-phenanthroline were very similar and different in turn from that
      of DCMU. Cu(II) did not eliminate or modify the electron paramagnetic resonance
      signal at g = 8.1 ascribed to the non-heme iron of the photosystem II reaction
      center, indicating that the inhibition by Cu(II) was not the result of the
      replacement of the iron by Cu(II). Controlled trypsin digestion of thylakoid
      membranes inhibited oxygen evolution using 2,6-dichlorobenzoquinone, but had no
      effect when using ferricyanide or silicomolybdate. Using ferricyanide, oxygen
      evolution of trypsin-treated thylakoids was insensitive to DCMU but became even
      more sensitive to Cu(II) and o-phenanthroline than nontreated thylakoids;
      however, trypsinized thylakoids were insensitive to inhibitors in the presence of
      silicomolybdate. We conclude that Cu(II) impaired the photosystem II electron
      transfer before the QB niche, most probably at the pheophytin-QA-Fe domain.

PMID- 1744078
TI  - Activation of the proteinase B precursor of the yeast Saccharomyces cerevisiae by
      autocatalysis and by an internal sequence.
AB  - Proteinase B (PrB) is a subtilisin-like serine protease found in the vacuole of
      the yeast Saccharomyces cerevisiae. It is first made as a large precursor that
      consists of a putative signal sequence, a 260-amino acid pro region, the serine
      protease domain, and two small COOH-terminal post regions (Moehle, C. M., Dixon,
      C. K., and Jones, E. W. (1989) J. Cell Biol. 108, 309-324). This precursor is
      glycosylated and proteolytically processed at least three times before mature
      enzyme is formed. To determine whether an intact PrB catalytic site is required
      for proteolytic processing of the precursor, point mutations were generated at
      the codons for the active site serine or aspartate residues by site-directed
      mutagenesis. The effect of these mutations on PrB processing suggests that the
      large pro region may be cleaved by an intramolecular, autocatalytic mechanism.
      The properties of a prb1 mutant that accumulates a 37-kDa precursor in addition
      to mature sized mutant PrB antigen suggests that the final proteolytic cleavage
      step is also autocatalytic. A prb1 deletion that lacks codons for the large pro
      region was made to test whether this part of the precursor is required for
      formation of mature PrB. Analysis of this mutant revealed two functions for this
      region: it prevents N-linked glycosylation of the serine protease domain and it
      allows the PrB precursor to be processed by proteinase A. The pro region can
      fulfill this latter function if added as a separate molecule, so long as
      glycosylation of the catalytic domain is prevented by other means.

PMID- 1744079
TI  - Transforming growth factor-beta 1 inhibits scavenger receptor activity in THP-1
      human macrophages.
AB  - The macrophage scavenger receptor, a 220-kDa trimeric membrane glycoprotein,
      mediates the internalization of modified forms of low density lipoprotein (LDL)
      such as acetyl-LDL and oxidized-LDL and thus is likely to play a key role in
      atheroma macrophage foam cell formation. In addition, recent evidence suggests
      that the scavenger receptor may be an important macrophage binding site for
      lipopolysaccharide involved in lipopolysaccharide scavenging by macrophages.
      However, little is known about the regulation of this important receptor. We now
      report that the induction of scavenger receptor activity (as measured by acetyl
      LDL stimulation of intracellular cholesterol esterification) seen in phorbol
      ester-differentiated THP-1 human macrophages was completely suppressed to the
      level seen in undifferentiated THP-1 monocytes by picomolar concentrations of
      transforming growth factor-beta 1 (TGF-beta 1). 125I-Acetyl-LDL degradation was
      inhibited in a dose-dependent manner by TGF-beta 1, with maximal inhibition
      (approximately 70%) occurring at 24 pM TGF-beta 1. Scatchard analysis revealed
      that TGF-beta 1 treatment resulted in a approximately 2-fold decrease in receptor
      number, and Northern blot analysis of RNA isolated from differentiated THP-1
      macrophages demonstrated approximately 2-fold less scavenger receptor mRNA in TGF
      beta 1-treated cells compared with that in macrophages not treated with TGF-beta
      1. Since TGF-beta 1 is thought to be present in both atherosclerotic and
      inflammatory lesions, the above findings may have physiological relevance
      regarding the regulation of atheroma foam cell formation and/or the regulation of
      lipopolysaccharide clearance by macrophages.

PMID- 1744080
TI  - Mechanism of fluoride activation of G protein-gated muscarinic atrial K+
      channels.
AB  - Aluminum fluoride (AlF4-) activates the heterotrimeric G protein Gs (stimulatory
      G protein of adenylylcyclase) (Sternweis, P. C., and Gilman, A. G. (1982) Proc.
      Natl. Acad. Sci. U. S. A. 79, 4888-4891) and GT (transducin), and for GT, Bigay
      et al. (Bigay, J., Deterre, P., Pfister, C., and Chabre, M. (1985) FEBS Lett.
      191, 181-185) have made the intriguing proposal that AlF4- acts by mimicking the
      gamma-phosphate of GTP. The endogenous G protein (probably G alpha i-2 or G alpha
      i-3 (Yatani, A., Mattera, R., Codina, J., Graf, R., Okabe, K., Padrell, E.,
      Iyengar, R., Brown, A. M., and Birnbaumer, L. (1988) Nature 336, 680-682) that
      stimulates the muscarinic atrial K+ (K+[ACh]) channel is also thought to be
      activated by AlF4- (Kurachi, Y., Nakajima, T., and Ito, H. (1987) Circulation 76,
      105P). To investigate the AlF4- mechanism, we applied potassium fluoride (KF) to
      the cytoplasmic face of inside-out membrane patches excised from guinea pig
      atria. We found that KF activated single K+[ACh] channel currents in both a
      concentration- and a Mg(2+)-dependent manner. Activation persisted following
      removal of KF, but unlike activation by guanosine 5'-(3-thiotriphosphate) (GTP
      gamma S), was fully reversed by removal of Mg2+. Evidence for Al3+ involvement
      was that the Al3+ chelator deferoxamine (500 microM) inhibited KF activation and
      that at low concentrations of KF (less than 1 mM), micromolar AlCl3
      concentrations potentiated KF stimulation. The rate of activation produced by KF
      was far slower than the rate produced by GTP or GTP gamma S, and unlike these
      guanine nucleotides, the rate was unchanged in the presence of agonist. To test
      the gamma-phosphate-mimicking hypothesis, we evaluated the requirement for GDP;
      and to accomplish this, it was necessary to establish a condition that ensured
      exchange of guanine nucleotides. This condition was satisfied by using the
      muscarinic agonist carbachol because both the rate and the extent of activation
      of the K+[ACh] channels produced by GTP were much faster in carbachol, and both
      were greatly slowed when GDP was added along with GTP. By contrast, the effects
      of KF were unchanged by carbachol in the presence or absence of GDP. Further
      evidence that GDP is not essential for activation by AlF4- was provided by the
      observation that during carbachol activation and following extensive washing with
      GMP, guanosine 5'-O-(2-thiodiphosphate) at blocking concentrations had no effect
      on activation produced by KF.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1744081
TI  - Identification of novel factors which bind specifically to the core promoter of
      the immunoglobulin heavy chain gene.
AB  - Nuclear extracts from HeLa cells and the B-cell line, BJA-B, generated two
      protein-DNA complexes which bound specifically to sequences in the TATA box of
      the immunoglobulin heavy chain gene (IgH) promoter. Complex A also bound the core
      promoter of a retroviral long terminal repeat but did not bind to five other
      promoters including the adenovirus major late promoter. Of these seven promoters,
      complex B bound only to the IgH promoter. Footprinting analysis revealed that
      both complexes A and B bound sequences which include the TATA element, and
      complex A additionally contacted sequences downstream to +28. Mutation of the IgH
      TATA element from ATTAATATA to GCTA-TAAAA, the optimal TATA sequence as found in
      the major late promoter, resulted in a 10-fold decrease in binding to complex A
      and a 25-fold decrease in binding complex B. Surprisingly, both transfection
      experiments in HeLa cells and in vitro transcription experiments with whole
      nuclear extract demonstrated that mutation of the TATA box in the core IgH
      promoter to this consensus sequence resulted in a 2-fold decrease in the level of
      transcription. These data suggest that the specific sequence of the TATA region
      is important, and factors which recognize these sequences, such as complex A and
      B, may modulate the level of transcription from the IgH promoter.

PMID- 1744082
TI  - The role of ATP and free ADP in metabolic coupling during fuel-stimulated insulin
      release from islet beta-cells in the isolated perfused rat pancreas.
AB  - The isolated perfused rat pancreas was used to test the hypothesis that total
      cellular ATP or the ratio of ATP/free ADP plays the primary role in coupling
      intermediary metabolism to the biophysical events that are the basis of glucose
      stimulated insulin release. The pancreas was preperfused for 20 min with 4.0 mM
      of a physiological mixture of 20 amino acids plus 4.2 mM glucose, and insulin
      release was then stimulated for 150 s by suddenly increasing the glucose to 8.3
      mM. The pancreas was sampled at 24, 48, 72, and 150 s after the switch. The
      content of total ATP, ADP, AMP, Pi, phosphocreatine, and creatine were measured
      in beta-cell enriched cores of pancreatic islets microdissected from freeze-dried
      pancreas cryostat sections. Metabolites were measured by quantitative
      histochemical enzymatic cycling techniques. Modeling studies were carried out to
      assess the impact of biochemical analytical results on the membrane potential of
      the beta-cells. The level of free ADP was calculated using the creatine kinase
      equilibrium reaction and an intracellular pH of 7.2. First phase insulin release
      was stimulated at least 10-fold with the maximum reached 45 s after adding high
      glucose. The biochemical analytical data demonstrate that the total cellular
      level of the putative coupling factor ATP and of the ratios ATP/free ADP and
      ATP/free ADP x Pi are not significantly influenced by a glucose level change that
      causes a more than 10-fold surge of insulin release. The strength and limitations
      of the present experimental strategy and the implications of the results for our
      understanding of metabolic coupling in glucose-stimulated insulin release are
      discussed.

PMID- 1744083
TI  - Drosophila laminin A chain sequence, interspecies comparison, and domain
      structure of a major carboxyl portion.
AB  - Recent studies ascribed some biological actions of cell adhesion and cell
      outgrowth to the carboxyl-most 1200 amino acids of vertebrate laminin A chains.
      Here we report a 6.1-kilobase pair nucleotide cDNA sequence encoding 1951 amino
      acids and the carboxyl end of a Drosophila laminin A chain. It corresponds to the
      mouse laminin A domains G, I, II, and III, but may represent a different type of
      laminin A chain. The arrangement of the cysteine-rich repeats of domain III
      resembles that of B2 chains. However, it has more amino acid identity with a
      portion of the mouse laminin A chain domain IIIb than with other laminin repeats.
      Domains I and II are consistent with an interrupted coiled-coil alpha-helical
      model of the long arm of laminin but are poorly conserved. The G domain contains
      five subdomains which are individually related to subdomains of vertebrate
      laminin A chains. The results indicate that laminin G subdomains should be
      considered individually, rather than merely as parts of a G-globule. A sequence
      of hydroxyamino acids contributes to a spacer between two of the subdomains.
      Stretches of hydroxyamino acids may be indicative of junctions between domains of
      extracellular Drosophila proteins.

PMID- 1744084
TI  - Dietary sucrose enhances processing of mRNA-S14 nuclear precursor.
AB  - The rapid response of rat hepatic mRNA-S14 to hormonal or dietary manipulation
      makes it an excellent model to study the control of lipogenic enzyme mRNA. The
      mechanism of regulation of this mRNA by triiodothyronine (T3) or sucrose remains
      controversial. Although initial studies suggested that T3 stabilized the nuclear
      precursor, subsequent studies suggest that T3 acts by increasing the
      transcriptional rate of this gene. More recently, the induction of mRNA-S14 by
      sucrose administration was shown to be associated with an increase in
      transcriptional "run-on" activity. Because T3 and carbohydrate feeding
      synergistically regulate this mRNA, we studied the response to short and long
      term high carbohydrate feeding in hypothyroid and euthyroid rats. We found the
      response to the lipogenic diet was rapid in hypothyroid rats, with maximal levels
      of mRNA-S14 attained by 4 h (2.2 +/- 0.6 chow fed versus 13.5 +/- 2.5
      pg/micrograms RNA on lipogenic diet). The rapid induction by the lipogenic diet
      contrasts with the diminished response to sucrose by gastric gavage (4.6 +/- 1.2
      pg/micrograms RNA) over the same time interval. Despite the large increase in the
      mature mRNA induced by the lipogenic diet, the rise in the nuclear precursor was
      small and not different from that observed after sucrose gavage (0.14 +/- 0.01
      chow, 0.26 +/- 0.03 sucrose gavage, 0.25 +/- 0.04 pg/micrograms RNA lipogenic
      diet). The molar ratio of the mature to precursor mRNA-S14 showed progressive
      increases with the smallest level in the fasting rat, an intermediate level in
      the chow-fed and sucrose gavaged rats, and the highest level in the animals fed a
      lipogenic diet (2.1, 16.5, 16.3, 62.7, respectively). Based on the previously
      reported half-life for the mature mRNA-S14, these data show that feeding sucrose
      by gavage or by a lipogenic diet leads to enhanced fractional conversion of
      precursor to mature mRNA-S14 with a simultaneous stabilization of the precursor
      mRNA-S14.

PMID- 1744085
TI  - Allene oxide and aldehyde biosynthesis in starfish oocytes.
AB  - Allene oxides are a very unusual type of epoxide that, in biological systems, are
      formed by the enzymic dehydration of fatty acid hydroperoxides (lipoxygenase
      products). This reaction occurs widely in plants, in which allene oxide synthesis
      is a key step in the conversion of linolenic acid to jasmonic acid, the plant
      growth regulator. We report biosynthesis of the allene oxide (8R)-8,9-epoxyeicosa
      (5Z,9,11Z,14Z)-tetraenoic acid via the (8R)-lipoxygenase metabolism of
      arachidonic acid in starfish oocytes. Formation of the allene oxide was deduced
      from high pressure liquid chromatography, UV, gas chromatography-mass
      spectrometry and 1H-NMR analyses of the precise structure and mechanism of
      biosynthesis of its major hydrolysis product, the alpha-ketol 8-hydroxy-9
      ketoeicosa-(5Z,11Z,14Z)-trienoic acid. A second enzymic activity detected in the
      oocytes (hydroperoxide lyase) cleaves specifically the (8R)-hydroperoxy substrate
      into C7 and C13 fragments, identified as the hydroxyacid, (5Z)-7-hydroxyheptenoic
      acid, and two aldehydes, (2E,4Z,7Z)-tridecenal and its 4E isomer. Discovery of
      the allene oxide synthase and hydroperoxide lyase marks the first definitive
      localization of these enzymic activities to an animal cell. It was established
      previously that the (8R)-lipoxygenase metabolite (8R)-HETE will activate the
      maturation (re-initiation of meiosis) of starfish oocytes. The individual 8
      lipoxygenase products may be involved at distinct stages of cell development.

PMID- 1744086
TI  - Quantitation of acyl-CoA and acylcarnitine esters accumulated during abnormal
      mitochondrial fatty acid oxidation.
AB  - We have used radio-high pressure liquid chromatography to study the acyl-CoA
      ester intermediates and the acylcarnitines formed during mitochondrial fatty acid
      oxidation. During oxidation of [U-14C]hexadecanoate by normal human fibroblast
      mitochondria, only the saturated acyl-CoA and acylcarnitine esters can be
      detected, supporting the concept that the acyl-CoA dehydrogenase step is rate
      limiting in mitochondrial beta-oxidation. Incubations of fibroblast mitochondria
      from patients with defects of beta-oxidation show an entirely different profile
      of intermediates. Mitochondria from patients with defects in electron transfer
      flavoprotein and electron transfer flavoprotein:ubiquinone oxido-reductase are
      associated with slow flux through beta-oxidation and accumulation of long chain
      acyl-CoA and acylcarnitine esters. Increased amounts of saturated medium chain
      acyl-CoA and acylcarnitine esters are detected in the incubations of mitochondria
      with medium chain acyl-CoA dehydrogenase deficiency, whereas long chain 3
      hydroxyacyl-CoA dehydrogenase deficiency is associated with accumulation of long
      chain 3-hydroxyacyl- and 2-enoyl-CoA and carnitine esters. These studies show
      that the control strength at the site of the defective enzyme has increased.
      Radio-high pressure liquid chromatography analysis of intermediates of
      mitochondrial fatty acid oxidation is an important new technique to study the
      control, organization and defects of the enzymes of beta-oxidation.

PMID- 1744087
TI  - The complete sequence of perlecan, a basement membrane heparan sulfate
      proteoglycan, reveals extensive similarity with laminin A chain, low density
      lipoprotein-receptor, and the neural cell adhesion molecule.
AB  - A heparan sulfate proteoglycan is a component of all basement membranes. This
      molecule consists of three heparan sulfate side chains linked to a large core
      protein of approximately 400 kDa. We have isolated seven overlapping murine cDNA
      clones that encode the entire mRNA sequence of 12.685 kilobases of this molecule.
      This sequence has a single open reading frame of 3,707 amino acids that encodes
      for a protein of 396 kDa. Identical or near identical matchups with nine peptide
      sequences derived from the core protein of the molecule isolated from the
      Engelbreth-Holm-Swarm tumor were found with the deduced sequence. Sequence
      analysis and data base comparison of the deduced sequence show the protein to
      consist of five different domains, most of which contain internal repeats. Domain
      I contains a start methionine followed by a typical signal transfer sequence and
      a unique segment of 172 amino acids that contains the three probable sites of
      heparan sulfate attachment, SGD. Domain II contains four cysteine- and acidic
      amino acid-rich repeats that are very similar to those found in the LDL receptor
      and proteins such as GP330. Domain III consists of cysteine-rich and globular
      regions, both of which show similarity to those in the short arm of the laminin A
      chain. Domain IV contains 14 repeats of the immunoglobulin superfamily that are
      most highly similar to the immunoglobulin-like repeats in the neural cell
      adhesion molecule. Domain V contains three repeats with similarity to the laminin
      A chain G domain that are separated by epidermal growth factor-like regions not
      found in the laminin A chain. As the primary structural data agree with the
      appearance of the molecule in the electron microscope as a series of globules
      separated by rods, or "beads on a string," we have adopted the name perlecan for
      this molecule. The variety of domains in perlecan suggest multiple interactions
      with other molecules.

PMID- 1744088
TI  - GATA-binding transcription factors in mast cells regulate the promoter of the
      mast cell carboxypeptidase A gene.
AB  - The transcription factors GATA-1, GATA-2, and GATA-3 were found to be expressed
      in several mouse and rat mast cell lines that contain mast cell carboxypeptidase
      A (MC-CPA) and other proteases in their cytoplasmic granules. GATA-1 mRNA was not
      detected in P815 cells, an immature mouse mastocytoma-derived cell line that
      lacks electron-dense granules and has low levels of secretory granule proteases.
      Because the 5'-flanking regions of the mouse and human MC-CPA genes contained a
      conserved GATA-binding motif 51 base pairs upstream of their translation
      initiation sites, the ability of GATA-binding proteins to regulate the promoter
      activity of the MC-CPA gene was examined in rat basophilic leukemia cells, mouse
      P815 cells, and transfected mouse P815 cells that expressed GATA-1. In all three
      mast cell lines, the promoter activity of the MC-CPA gene depended on the GATA
      binding site. GATA-1, GATA-2, and GATA-3 are thus the first DNA-binding proteins
      identified in mast cells which regulate the promoter activity of a gene that
      encodes a secretory granule protease.

PMID- 1744089
TI  - ATP-dependent regulation of flagellar adenylylcyclase in gametes of Chlamydomonas
      reinhardtii.
AB  - Adenylylcyclase activity in the flagella of gametes of Chlamydomonas reinhardtii
      was inhibited by prior incubation at or below 30 degrees C in the presence of
      ATP. This decrease did not occur in the absence of ATP, in the presence of the
      ATP analog 5'-adenylylimidodiphosphate (App(NH)p), or in the presence of ATP plus
      the protein kinase inhibitor staurosporine (2 microM). If ATP treatment was
      performed in the absence of an ATP-regenerating system, activity initially
      declined and subsequently recovered. Incubation of flagella at 45 degrees C in
      the absence of ATP or incubation at lower temperatures in the presence of either
      App(NH)p or staurosporine both increased adenylylcyclase activity (over 10-fold)
      and blocked subsequent ATP-dependent loss of activity at 30 degrees C. This heat
      induced activation was prevented by the presence of ATP plus an ATP-regenerating
      system. Incubation of flagella with [gamma-32P]ATP followed by gel
      electrophoresis in sodium dodecyl sulfate indicated the presence of endogenous
      protein kinase and protein phosphatase activities. These data suggest that the
      flagellar adenylylcyclase in Chlamydomonas gametes is inhibited by
      phosphorylation and stimulated by dephosphorylation. This mechanism for
      regulating adenylylcyclase may underlie the rapid increase in cyclic AMP that is
      induced by flagellar adhesion during fertilization in Chlamydomonas.

PMID- 1744090
TI  - Conformational requirement for lysine hydroxylation in collagen. Structural
      studies on synthetic peptide substrates of lysyl hydroxylase.
AB  - An attempt has been made to understand the conformational determinants that
      govern the hydroxylation of selected lysyl residues in the nascent collagen
      molecule by lysyl hydroxylase (EC 1.14.11.4). A series of peptide substrates of
      the enzyme, ranging in length from 3 to 12 residues, were synthesized. These
      included: tert-butyloxylcarbonyl (t-Boc)-Ile-Lys-Gly; Boc-Ala-Lys-Gly; N-acetyl
      Ala-Lys-Gly-Ser; Hyp-Gly-Pro-Lys-Gly-Glu; Leu-Hyp-Gly-Ala-Lys-Gly-Glu; Gly-Phe
      Hyp-Gly-Leu-Hyp-Gly-Ala-Lys-Gly-Glu; (Hyp-Gly-Pro-Lys-Gly-Glu)2; and Ala-Arg-Gly
      Ile-Lys-Gly-Ile-Arg-Gly-Phe-Ser-Gly. The conformational features of these
      peptides were studied by spectroscopic methods so as to relate this information
      with the kinetic parameters for the interaction of these peptides with purified
      lysyl hydroxylase. Spectroscopic data, supported by conformational energy
      calculations, indicated that the tripeptides t-Boc-Ile-Lys-Gly and t-Boc-Ala-Lys
      Gly adopt a gamma-turn structure in water and trifluoroethanol with Lys in the
      second position of the turn. In the tetra- and larger peptides two structures,
      the beta-turn and a polyproline-II (PP-II) type extended conformation, were
      identified. The proportions of these two structures in a given peptide depended
      on the polarity of the solvent. All of the peptides were hydroxylated by lysyl
      hydroxylase isolated from chicken embryos. In contrast, a control peptide, t-Boc
      Ala-Gly-Lys which adopted a beta-turn with Lys at the end of the turn, was not
      hydroxylated. Competitive inhibition of the hydroxylation of protocollagen by
      some of the peptides showed a common binding site for these substrates in the
      enzyme's active site. Kinetic data on the peptides indicated improved
      hydroxylation rate (higher Vmax) in peptides having relatively higher beta-turn
      content and improved binding (lower Km) in peptides with higher content of the PP
      II structure. The efficacy of the substrate was also governed by its chain
      length. These data suggest that the conformational criterion for lysine
      hydroxylation in collagen-related peptides is the presence of a "bent" structure,
      such as the gamma- or beta-turn at the catalytic site of lysyl hydroxylase and an
      "extended" PP-II type structure at the binding site(s) of the enzyme's active
      site. This suggestion also provides a conformational rationale for earlier
      observations on the substrate specificity of lysyl hydroxylase.

PMID- 1744091
TI  - Modulation of renal epithelial cell growth by glucosylceramide. Association with
      protein kinase C, sphingosine, and diacylglycerol.
AB  - Two independent approaches were employed to explore the potential role of
      endogenous glucosylceramide or a closely related glucosphingolipid in mediating
      the cellular proliferation of Madin-Darby canine kidney cells. First, cultured
      cells were depleted of glucosphingolipids by exposure to a glucosylceramide
      synthase inhibitor, D-threo-1-phenyl-2-decanoylamino-3-morpholino-1-propanol.
      This agent markedly inhibited cell growth and DNA synthesis in a time- and
      concentration-dependent manner. Second, cells were grown in the presence of
      conduritol B epoxide, an inhibitor of glucosylceramide beta-D-glucosidase.
      Exposure of cells to this inhibitor resulted in the time-dependent accumulation
      of glucosylceramide with a corresponding increase in cellular proliferation.
      Alterations in protein kinase C activity were evaluated as a potential mechanism
      for these effects on growth. Both membrane- and cytosol-associated protein kinase
      C (PKC) activity declined under conditions of glucosylceramide synthase
      inhibition and increased under conditions of beta-glucosidase inhibition. The
      changes in PKC activity were evident after DEAE-cellulose purification.
      Diacylglycerol levels increased in response to both glucosylceramide synthase and
      beta-glucosidase inhibition. Ceramide and sphingosine levels changed only in the
      presence of D-threo-1-phenyl-2-decanoylamino-3-morpholino-1-propanol, increasing
      due to lack of conversion to glucosylceramide. However, the elevation in
      endogenous sphingosine was probably insufficient to account for the decrease in
      PKC, considering the high level of diacylglycerol in the cells. These data
      demonstrate an association between glucosylceramide levels, PKC activity, and
      cell growth.

PMID- 1744092
TI  - Regulation of free cytosolic Ca2+ concentration in the outer segments of bovine
      retinal rods by Na-Ca-K exchange measured with fluo-3. I. Efficiency of transport
      and interactions between cations.
AB  - Regulation of free cytosolic Ca2+ concentration in the rod outer segments (ROS)
      isolated from bovine retinas was examined with the fluorescent Ca(2+)-indicating
      dye fluo-3. In situ calibration of cytosolic fluo-3 was done in the presence of
      the Ca2+ ionophore A23187 and yielded a dissociation constant of 500 nM for the
      Ca(2+)-fluo-3 complex. Ca2+ influx in Ca(2+)-depleted ROS was completely
      abolished when internal Na+ was removed suggesting that Ca2+ influx exclusively
      occurred via Na-Ca-K exchange. The most striking observation was that Na-Ca-K
      exchange could mediate a rapid increase in cytosolic free Ca2+ over the most of
      the usable indicating range of fluo-3 (from 10 nM to 2 microM), even when exposed
      to free external Ca2+ concentrations as low as 10 nM. From a comparison between
      changes in free Ca2+ and changes in total Ca2+, we conclude that physiologically
      occurring changes in cytosolic free Ca2+ are mediated by exchange fluxes less
      than 1% of the maximal Na-Ca-K exchange flux. The Na-Ca-K exchanger could mediate
      both K(+)-dependent and K(+)-independent Ca2+ influx; Li+ caused a complete
      inhibition of K(+)-independent Ca2+ influx, but had no effect on K(+)-dependent
      Ca2+ influx. We examined the complex interactions of alkali cations with Ca2+
      influx and discuss the results in terms of a three-site model for the Na-Ca-K
      exchanger (Schnetkamp, P. P. M. and Szerencsei, R. T. (1991) J. Biol. Chem. 266,
      189-197). Ca2+ competed with one Mg2+ ion or two Na+ ions for binding to a common
      site. High K+ concentration greatly diminished the ability of Na+ and Mg2+ to
      compete with Ca2+ for this common site on the exchanger protein. As a result,
      high internal K+ induced a conformation of the exchange protein that kinetically
      favoured Ca2+ extrusion.

PMID- 1744093
TI  - Regulation of intracellular free Ca2+ concentration in the outer segments of
      bovine retinal rods by Na-Ca-K exchange measured with fluo-3. II. Thermodynamic
      competence of transmembrane Na+ and K+ gradients and inactivation of Na(+)
      dependent Ca2+ extrusion.
AB  - Regulation of cytosolic free Ca2+ in the physiologically relevant submicromolar
      range was measured in isolated intact bovine rod outer segments (ROS) with the
      intracellular Ca(2+)-indicating dye fluo-3. Changes in free Ca2+ were compared
      with changes in total Ca2+ measured with 45Ca fluxes and a good qualitative
      correlation was observed. Ca2+ homeostasis in isolated bovine ROS was exclusively
      mediated via the Na-Ca-K exchanger. Free cytosolic Ca2+ concentration was lowered
      by an increase in the inward Na+ gradient, was raised by an increase in external
      K+, and was raised by depolarization of the plasma membrane. The simplest
      stoichiometry consistent with these qualitative observations is 4Na:(1Ca + 1K).
      The individual K:Ca, Na:Ca, and K:Na coupling ratios were deduced from
      quantitative changes in cytosolic free Ca2+ upon changes in the transmembrane Na+
      and K+ gradients. The observed changes in free Ca2+ did not agree with changes in
      free Ca2+ calculated on the basis of the above fixed stoichiometry which may
      reflect the flexibility in the Ca:K coupling ratio observed before in flux
      experiments (Schnetkamp, P. P. M., Szerencsei, R. T., and Basu, D. K. (1991) J.
      Biol. Chem. 266, 198-206). The most dramatic discrepancy was observed for the
      Na:Ca coupling ratio: the expected very large changes in cytosolic free Ca2+ upon
      changes in the transmembrane Na+ gradient were not observed. Rapid Na(+)-induced
      Ca2+ extrusion was unable to lower cytosolic free Ca2+ below 100 nM, even under
      nonequilibrium conditions and despite the observation that Ca2+ influx via
      reverse Na-Ca-K exchange readily occurred at a free external Ca2+ concentration
      of 20 nM. We conclude that the Na(+)-dependent extrusion mode of the Na-Ca-K
      exchanger occurs in a brief (20-s) burst of high maximal velocity transport
      followed by a nearly complete inactivation of transport. The importance of our
      findings for Ca2+ homeostasis in functioning rod photoreceptors is discussed.

PMID- 1744094
TI  - Disulfide bonding controls the processing of retroviral envelope glycoproteins.
AB  - The mitogenic membrane glycoprotein (gp55) encoded by Friend erythroleukemia
      virus is inefficiently processed from the rough endoplasmic reticulum (RER) and
      only 3-5% reaches plasma membranes. Because this processed component (gp55P)
      contains larger and more complex oligosaccharides, it can be separated from RER
      gp55. In nonreducing conditions, gp55P is a unique disulfide-bonded dimer,
      whereas RER gp55 consists of monomers and dimers with diverse intrachain and
      interchain disulfide bonds. This suggests that gp55 folds heterogeneously and
      that only one homodimer is competent for export from the RER. Pulse-chase
      analyses of gp55 components labeled with radioactive amino acids indicated that
      formation of diverse disulfide-bonded components occurred within minutes of
      polypeptide synthesis and that malfolded components did not later isomerize to
      generate dimers competent for export from the RER. Chemical studies suggested
      that all 12 cysteines of gp55 were oxidized within 5 min after synthesis of the
      protein. In contrast, the envelope glycoprotein precursor (gPr90) encoded by a
      replication-competent murine leukemia virus folds more homogeneously, and it is
      then processed and cleaved to form an extracellular glycoprotein gp70 plus a
      transmembrane protein p15E. The fully processed glycoprotein contains an
      unoxidized cysteine sulfhydryl that isomerizes reversibly with a disulfide bond
      that links gp70 to p15E. Consequently, only a proportion of gp70 and p15E is
      disulfide-bonded, and dissociation occurs when the environment becomes even
      slightly reducing. The gp55 glycoprotein appears to be an extreme example of
      protein malfolding associated with imprecise and irreversible disulfide bonding.
      We discuss evidence that folding inefficiencies are common for retroviral
      proteins that have newly evolving pathogenic functions.

PMID- 1744095
TI  - Arginine 197 of lac repressor contributes significant energy to inducer binding.
      Confirmation of homology to periplasmic sugar binding proteins.
AB  - Based on primary sequence homology between the lactose repressor protein and
      periplasmic sugar-binding proteins (Muller-Hill, B. (1983) Nature 302, 163-164),
      a hypothetical sugar-binding site for the lac repressor was proposed using the
      solved x-ray crystallographic structure of the arabinose-binding protein (ABP)
      (Sams, C. F., Vyas, N. K., Quiocho, F. A., and Matthews, K. S. (1984) Nature 310,
      429-430). By analogy to Arg151 in the ABP sugar site, Arg197 is predicted to play
      an important role in lac repressor binding to inducer sugars. Hydrogen bonding
      occurs between Arg151 and the ring oxygen and 4-hydroxyl of the sugar ligand, two
      backbone carbonyls, and a side chain in ABP, and similar interactions in the lac
      repressor would be anticipated. To test this hypothesis, Arg197 in the lac
      repressor protein was altered by oligonucleotide-directed site-specific
      mutagenesis to substitute Gly, Leu, or Lys. Introduction of these substitutions
      at position 197 had no effect on operator binding parameters of the isolated
      mutant proteins, whereas the affinity for inducer was dramatically decreased,
      consistent with in vivo phenotypic behavior obtained by suppression of nonsense
      mutations at this site (Kleina, L. G., and Miller, J. H. (1990) J. Mol. Biol.
      212, 295-318). Inducer binding affinity was reduced approximately 3 orders of
      magnitude for Leu, Gly, or Lys substitutions, corresponding to a loss of 50% of
      the free energy of binding. The pH shift characteristic of wild-type repressor is
      conserved in these mutants. Circular dichroic spectra demonstrated no significant
      alterations in secondary structure for these mutants. Thus, the primary effect of
      substitution for Arg197 is a very significant decrease in the affinity for
      inducer sugars. Arginine is uniquely able to make the multiple contacts found in
      the ABP sugar site, and we conclude that this residue plays a similar role in
      sugar binding for lactose repressor protein. These results provide experimental
      validation for the proposed homology between ABP and the lac repressor and
      suggest that homology with ABP may be employed to generate additional insight
      into the structure and function of this regulatory protein.

PMID- 1744096
TI  - Mechanism of conversion of human apo- to holomethionine synthase by various forms
      of cobalamin.
AB  - Methionine synthase catalyzes the conversion of N5-methyltetrahydrofolate and
      homocysteine to tetrahydrofolate and methionine. Methylcobalamin (Me-Cbl) is
      tightly bound to methionine synthase and is required for enzymatic activity. When
      added to crude tissue homogenates, Me-Cbl stimulates methionine synthase but
      similar stimulation is observed with hydroxocobalamin, cyanocobalamin (CN-Cbl),
      and adenosyl-Cbl, although the mechanisms involved are unknown. We prepared human
      apomethionine synthase and studied its activation in the presence of [14C]CN-Cbl
      and [14CH3]Me-Cbl with concentrations of 2-mercaptoethanol ranging from 0.15 to
      100 mM. We observed that the removal of the labeled upper axial ligands from CN
      Cbl and Me-Cbl both paralleled the activation of human apomethionine synthase.
      Spectral studies employing CN-Cbl and Me-Cbl showed that both forms of Cbl must
      be converted to Cob(II)alamin before they can bind to human apomethionine
      synthase and convert it to its activated holoenzyme form. Studies with 14
      different Cbl analogues with alterations in various portions of the corrin ring
      and the nucleotide showed that all of the analogues were able to fully activate
      human methionine synthase when they were reduced with 2-mercaptoethanol. Full
      activation occurred at lower concentrations of many of the Cbl analogues than
      occurred with Cbl itself. We conclude that Me-Cbl and other forms of
      Cob(III)alamin do not bind to human apomethionine synthase and that all must
      first be reduced to Cob(II)alamin before such binding can occur. The fact that
      human methionine synthase shows little absolute specificity for alterations in
      various portions of the Cbl molecule suggests that the potent inhibition of
      mammalian methionine synthase activity observed in vivo with various Cbl
      analogues is due to inhibition of intracellular Cbl transport or to inhibition of
      the enzymatic formation of Cob(II)alamin rather than to direct inhibition of
      mammalian methionine synthase itself.

PMID- 1744097
TI  - The effect of carbohydrate on the structure and stability of erythropoietin.
AB  - Erythropoietin is a glycoprotein hormone that stimulates the maturation of late
      erythroid progenitor cells. It has three N-linked and one O-linked carbohydrates
      which play an important role in the biosynthesis and biological activities of the
      protein. To determine the role the carbohydrate might have in maintaining the
      conformational stability of the protein, the protein expressed in mammalian cells
      (fully glycosylated), the asialo mammalian-expressed protein, and the protein
      expressed in Escherichia coli (no carbohydrate) were compared for their stability
      to guanidine HCl, pH, and temperature. Circular dichroism was used to follow
      protein unfolding. Both the intact and asialo mammalian-expressed proteins
      unfolded with a cooperative transition in guanidine HCl, with a midpoint at 1.75
      M guanidine HCl. The E. coli-expressed material unfolded with a midpoint of 1.2 M
      guanidine HCl, and a delta G of unfolding which was 1.4 kcal/mol less than that
      of the two glycosylated molecules. The E. coli-derived protein was also
      significantly less stable to pH-induced conformational changes, showing a
      cooperative transition in 35% glycerol with a midpoint at pH 4.4, while both the
      intact and asialo mammalian-expressed molecules had a transition midpoint of pH
      3.75 in the absence of glycerol, and approximately pH 3 in the presence of 35%
      glycerol. The E. coli-expressed molecule unfolded and precipitated upon heating
      to 44 degrees C, while the asialo and intact mammalian-expressed proteins
      remained soluble, with a Tm of 56 degrees C. From these experiments, the
      carbohydrate appears to play a critical role in stabilizing the erythropoietin
      molecule to denaturing conditions, and this increased stability does not depend
      on the presence of sialic acid.

PMID- 1744098
TI  - Molecular cloning and characterization of prolactin-like protein C complementary
      deoxyribonucleic acid.
AB  - In this report, we describe the isolation and characterization of a full length
      cDNA clone for rat prolactin-like protein C (PLP-C) and describe the expression
      of PLP-C mRNA in the developing rat placenta. Nucleotide sequence analysis of the
      PLP-C cDNA clone predicted a mature protein of 238 amino acids, including a 30
      amino acid signal sequence. The predicted PLP-C amino acid sequence contains
      seven cysteine residues, three tryptophan residues, and two putative N-linked
      glycosylation sites. Six of the cysteine residues in PLP-C are located in
      positions homologous to the cysteines of pituitary prolactin (PRL). Additional
      sequence similarities with pituitary PRL and other members of the rat placental
      PRL family are evident. The PLP-C gene was localized to rat chromosome 17.
      Northern blot analysis showed that the PLP-C cDNA clone specifically hybridized
      to a 1.0-kilobase mRNA. PLP-C mRNA was first detectable between days 13 and 14 of
      gestation, peaked by day 18 of gestation, and remained elevated until term. In
      situ hybridization analysis indicated that PLP-C mRNA was specifically expressed
      by spongiotrophoblast cells and some trophoblast giant cells in the junctional
      zone region of rat chorioallantoic placenta.

PMID- 1744099
TI  - Involvement of the distal histidine in the low affinity exhibited by Hb Chico
      (Lys beta 66----Thr) and its isolated beta chains.
AB  - Hemoglobin (Hb) Chico (Lys beta 66----Thr at E10) has a diminished oxygen
      affinity (Shih, D. T.-b., Jones, R. T., Shih, M. F.-C., Jones, M. B., Koler, R.
      D., and Howard, J. (1987) Hemoglobin 11, 453-464). Our studies show that its P50
      is about twice that of Hb A and that its cooperativity, anion, and Bohr effects
      between pH 7 and 8 are normal. The Bohr effect above pH 8 is somewhat reduced,
      indicating a small but previously undocumented involvement of the ionic bond
      formed by Lys beta 66 in the alkaline Bohr effect. Since the oxygen affinity of
      the alpha-hemes is likely to be normal, that of the beta-hemes in the tetramer is
      likely to be reduced by the equivalent of 1.2 kcal/mol beta-heme in binding
      energy. Remarkably, both initial and final stages of oxygen binding to Hb Chico
      are of lowered affinity relative to Hb A under all conditions examined. The
      isolated beta chains also show diminished oxygen affinity. In T-state Hb A,
      Lys(E10 beta) forms a salt bridge with one of the heme propionates, but
      comparison with other hemoglobin variants shows that rupture of this bridge
      cannot be the cause of the low oxygen affinity. X-ray analysis of the deoxy
      structure has now shown that Thr beta 66 either donates a hydrogen bond to or
      accepts one from His beta 63 via a bridging water molecule. This introduces
      additional steric hindrance to ligand binding to the T-state that results in
      slower rates of ligand binding. We measured the O2/CO partition coefficient and
      the kinetics of oxygen dissociation and carbon monoxide binding and found that
      lowered O2 and CO affinity is also exhibited by the R-state tetramers and the
      isolated beta chains of Hb Chico.

PMID- 1744100
TI  - Progesterone-regulated cyclic modulation of membrane metalloendopeptidase
      (enkephalinase) in human endometrium.
AB  - Membrane metalloendopeptidase (MMEP; EC 3.4.24.11; enkephalinase) catalyzes the
      degradation of endothelins, enkephalins, atrial natriuretic factor, substance P,
      and other small bioactive peptides. We found that MMEP is present in human
      endometrium, localized primarily in stromal cells of this tissue, and that the
      specific activity of MMEP (and immunoreactive MMEP protein) in endometrial tissue
      is correlated in a highly significant positive manner with the concentration of
      progesterone in plasma. In estrogen-treated, human endometrial stromal cells in
      monolayer culture, the specific activity of MMEP increases in response to
      treatment with progestin; and, this increase is accompanied by increases in
      immunoreactive MMEP protein, newly synthesized MMEP, and MMEP mRNA.

PMID- 1744101
TI  - Identification of regulatory sequences in the type 1 plasminogen activator
      inhibitor gene responsive to transforming growth factor beta.
AB  - Regulation of the human type 1 plasminogen activator inhibitor (PAI-1) promoter
      by transforming growth factor-beta (TGF beta) was studied. An 800-base pair
      fragment from the PAI-1 promoter and 5'-flanking region was fused to the firefly
      luciferase reporter gene and transfected into Hep3B human hepatoma cells.
      Treatment of the cells with TGF beta induced luciferase activity by more than 50
      fold. Transfection studies using constructs with 5' or 3' deletions through this
      region revealed that two sequences were important in the TGF beta response. The
      first sequence was located in the proximal promoter (-49 to -87) and mediated an
      11-fold induction with TGF beta, while the second more distal region (-636 to 
      740) contained two sequences which together mediated a 50-fold or greater
      response. Sequence comparison indicated that both of the responsive regions
      contained sequences with high homology to the AP-1 consensus binding site.
      Moreover, gel retardation analysis experiments demonstrated that both sequences
      bound a common nuclear protein, and that an oligonucleotide containing a
      consensus AP-1 sequence was able to compete for the binding of this common
      protein. Thus, the response of the PAI-1 gene to TGF beta is mediated by at least
      two separate regions, and both of these regions contain DNA sequences homologous
      to the AP-1 binding site.

PMID- 1744102
TI  - Isolation and characterization of the human gene for ADP-ribosylation factor 3, a
      20-kDa guanine nucleotide-binding protein activator of cholera toxin.
AB  - ADP-ribosylation factors (ARFs) are approximately 20-kDa guanine nucleotide
      binding proteins that stimulate the ADP-ribosyltransferase activity of cholera
      toxin in vitro. Five different human ARFs have been identified by cDNA cloning.
      Northern analysis using ARF 3-specific oligonucleotides identified two mRNAs of
      3.7 and 1.2 kilobases (kb). We report here the complete nucleotide sequence of
      the 3.7-kb ARF 3 mRNA derived from three overlapping cDNAs isolated from human
      hippocampus and fetal brain cDNA libraries, as well as the structure of human ARF
      3 gene. Sequences of two overlapping genomic clones indicated that the ARF 3 gene
      spans approximately 18.3 kb and contains five exons and four introns. The
      conserved amino acid sequences involved in guanine nucleotide binding by ARF 3
      are distributed among separate exons, as found in other GTP-binding protein
      genes. Translation initiates in exon 2 which includes the sequence GXXXXGK that
      probably participates in phosphate binding and GTP hydrolysis. The sequence DVGG
      in exon 3 coordinates binding of Mg2+ and the beta-phosphate of GDP. In the ARF 3
      gene in contrast to those of other GTP-binding proteins, the sequence NKXD (which
      is thought to contribute to the specificity of interaction with the guanine ring)
      is divided between exons 4 and 5. The latter encodes the COOH-terminal 53 amino
      acids of ARF 3 and contains greater than 2500 base pairs of untranslated DNA. The
      sequence AATTAA is 19 bases 5' to the polyadenylation addition site of the 3.7-kb
      mRNA. Multiple transcription start sites were identified by primer extension and
      S1 and mung bean nuclease analyses. The 5'-flanking region of exon 1 contains
      neither a TATA nor a CAAT box, but is high in GC content (greater than 70%) and
      includes three potential Sp1-binding sites (GC box), consistent with the
      promoters described for several housekeeping genes. The 1.2-kb ARF 3 mRNA is
      shown to arise by use of an alternative polyadenylation signal (AACAAA) at
      nucleotide 1091 within the ARF 3 cDNA.

PMID- 1744103
TI  - Amino acid sequences Gly-Pro-Leu-Tyr and Asn-Pro-Glu-Tyr in the submembranous
      domain of the insulin receptor are required for normal endocytosis.
AB  - We have recently shown that the immediately submembranous domain of the human
      insulin receptor (hIR) is required for rapid ligand-dependent internalization
      (Thies, R. S., Webster, N. J., and McClain, D. A. (1990) J. Biol. Chem. 265,
      10132-10137). This region contains one copy of an NPXY sequence that is required
      for endocytosis of the low density lipoprotein receptor. In order to dissect and
      analyze the specific sequences involved in endocytosis of the insulin receptor,
      we have mutated the NPXY sequence from NPEY (residues 957-960) to APEA
      (NPEY/APEA). In addition, we have mutated a similar sequence in the same region,
      changing GPLY (residues 950-953) to APLA (GPLY/APLA). The cDNAs encoding the
      normal hIR and these mutant receptors were transfected into Rat 1 fibroblasts.
      The expressed receptors bound insulin with high affinity and retained insulin
      stimulated tyrosine kinase activity. Despite the ability of these mutant
      receptors to bind insulin and undergo autophosphorylation, the GPLY/APLA receptor
      internalized insulin at only 32% of the rate of normal hIR at low receptor
      occupancy. On the other hand, the NPEY/APEA receptor internalized insulin at 87%
      of the normal rate. These results were confirmed by measuring internalization of
      photoaffinity-labeled insulin receptors. Another receptor with both the NPEY/APEA
      and GPLY/APLA mutations internalized to a lesser degree than the GPLY/APLA
      receptor and at a rate equivalent to that seen for a receptor with the entire
      submembranous domain deleted. A receptor with the complete normal submembranous
      domain but with the tyrosine kinase and C-terminal region of the hIR deleted
      exhibited only a basal internalization rate. We conclude that the information
      contained in the GPLY and, to a lesser extent, the NPEY sequences are necessary
      but not sufficient for signaling internalization of the insulin receptor.

PMID- 1744104
TI  - Hormonal activation of gene transcription in ras-transformed NIH3T3 cells
      overexpressing RII alpha and RII beta subunits of the cAMP-dependent protein
      kinase.
AB  - ras-Transformed NIH3T3 (R3T3) cells were transfected with expression vectors for
      the RII alpha and RII beta regulatory subunits of the type II isozyme of cAMP
      dependent protein kinase, and the effects on gene activation by corticotropin
      releasing factor (CRF) and prostaglandin E1 (PGE1) were analyzed. In RII alpha
      and RII beta-overexpressing cells, type II isozyme levels were increased, and
      type I isozyme levels were eliminated, demonstrating that both RII regulatory
      subunits compete efficiently with RI for catalytic subunit. The type II isozyme
      separated into three peaks on high performance liquid chromatography, referred to
      as A, B, and C. Western blot analysis strongly suggests that peak A and peak C
      correspond to holoenzymes containing RII beta and RII alpha, respectively.
      Overexpression of RII alpha resulted in the loss of peak A and a dramatic
      reduction in RII beta protein with no change in RII beta mRNA, indicating that
      the level of RII beta protein is controlled posttranscriptionally and that RII
      beta protein may become unstable when displaced from C. The role of type I and II
      kinases in transcriptional activation was investigated by comparing the response
      of control and RII expressing clones to site-selective cAMP analogs and the
      hormones, CRF and PGE1. The site-selective analogs demonstrated that either type
      I or type II kinase could activate the cAMP-responsive alpha-subunit promoter.
      The response to various concentrations of CRF or PGE1 was identical in control
      cells and transfected clones containing very little type I kinase. These
      experiments suggest that in the CRF and PGE1 response pathways leading to gene
      induction, the magnitude and sensitivity of the response are not influenced by
      the presence or absence of type I cAMP-dependent protein kinase.

PMID- 1744105
TI  - Gene structure of mammalian acetylcholinesterase. Alternative exons dictate
      tissue-specific expression.
AB  - The genes encoding mouse and human acetylcholinesterases have been cloned from
      genomic and cosmid libraries. Restriction analysis and a comparison of sequence
      with the cDNAs have defined the exon-intron boundaries. In mammals, three
      invariant exons encode the signal peptide and the amino-terminal 535 amino acids
      common to all forms of the enzyme whereas alternative exon usage of the next exon
      accounts for the structural divergence in the carboxyl termini of the catalytic
      subunits. mRNA protection studies show that the cDNA encoding the hydrophilic
      catalytic subunits represents the dominant mRNA species in mammalian brain and
      muscle whereas divergent mRNA species are evident in cells of hematopoietic
      origin (bone marrow cells and a erythroleukemia cell line). Analyses of mRNA
      species in these cells and the genomic sequence have enabled us to define two
      alternative exons in addition to the one found in the cDNAs; they encode unique
      carboxyl-terminal sequences. One mRNA consists of a direct extension through the
      intervening sequence between the common exon and the 3' exon deduced from the
      cDNA. This sequence encodes a subunit lacking the cysteine critical to oligomer
      formation. Another mRNA results from a splice that encodes a stretch of
      hydrophobic amino acids immediately upstream of a stop codon. This exon, when
      spliced to the upstream invariant exons, should encode glycophospholipid-linked
      species of the enzyme. Homologous sequence, identity of exon-intron junctions,
      and identity of position of the stop codon are seen for this region in mouse and
      human. Polymerase chain reactions carried out across the expected intron region
      and mRNA protection studies show that this splice occurs in mouse bone marrow and
      erythroleukemia cells yielding the appropriate cDNA.

PMID- 1744106
TI  - A ribosomal calmodulin-binding protein from Dictyostelium.
AB  - Using 125I-calmodulin as a probe, we have recently identified specific
      Ca2+/calmodulin-binding proteins in cell extracts from the cellular slime mold,
      Dictyostelium discoideum: a major 22-kDa activity, a soluble 78/80-kDa protein,
      and several membrane-associated high Mr proteins (Winckler, T., Dammann, H., and
      Mutzel, R. (1991) Res. Microbiol. 142, 509-519). cDNA clones for at least two of
      these proteins have been isolated by ligand screening of a lambda gt11 prophage
      expression library. Antibodies directed against the lacZ-cDNA-encoded fusion
      protein from one of the clones recognized a single 22-kDa component in D.
      discoideum extracts which comigrated with the endogenous 22-kDa calmodulin
      binding protein. The cDNA-derived nucleotide sequence predicts a protein of Mr
      21,659 with 56% sequence identity (69% homology) with rat ribosomal protein L19.
      The endogenous 22-kDa calmodulin-binding activity was associated with ribosomes.
      It was found to be an integral constituent of the large ribosomal subunit, since
      it cosedimented with 60 S ribosomal subunits in sucrose density gradients in the
      presence of 0.5 M NH4Cl. Our observations point to a physiological role for
      calmodulin in the Ca2+ regulation of eukaryotic protein synthesis. Support for
      this comes from recent studies showing inhibition of protein synthesis by
      calmodulin antagonists in Ehrlich ascites tumor cells (Kumar, R. V., Panniers,
      R., Wolfman, A., and Henshaw, E.C. (1991) Eur. J. Biochem. 195, 313-319).

PMID- 1744107
TI  - Role of disulfide bonds in biologic activity of human interleukin-6.
AB  - We have examined the functional importance of the two disulfide bonds formed by
      the four conserved cysteines of human interleukin (IL-6). Using a bacterial
      expression system, we have synthesized a series of recombinant IL-6 mutants in
      which the constituent cysteines of the first (Cys45-Cys51), second (Cys74-Cys84),
      or both disulfide bonds of recombinant human interleukin-6 were replaced by other
      amino acids. Each mutant was partially purified and tested in four representative
      bioassays. While mutants lacking Cys45 and Cys51 retained activity similar to
      nonmutated recombinant IL-6, the activity of mutants lacking Cys74 and Cys84 was
      significantly reduced, especially in assays involving human cell lines. These
      results indicate that the first disulfide bond of human interleukin-6 is not
      required for maintenance of normal biologic activity. However, the fact that
      mutants lacking Cys45 and Cys51 were more active than corresponding cysteine-free
      mutants indicates that the disulfide bond formed by these residues contributes to
      biologic activity in the absence of the second disulfide bond. Competition
      binding studies with representative mutants indicate that their affinity for the
      human IL-6 receptor parallels their biologic activities on human cells.

PMID- 1744108
TI  - Bombinin-like peptides with antimicrobial activity from skin secretions of the
      Asian toad, Bombina orientalis.
AB  - The structures and hemolytic and bactericidal activities of three bombinin-like
      peptides, or BLP-1-3, from the skin of Bombina orientalis are described. The
      peptides were isolated from the skin of B. orientalis and sequenced by tandem
      mass spectrometry and are amphipathic, cationic peptides of 25-27 amino acids in
      length. The sequence of the most abundant member (BLP-1) is: Gly-Ile-Gly-Ala-Ser
      Ile-Leu-Ser-Ala-Gly-Lys-Ser-Ala-Leu-Lys-Gly-Leu- Ala-Lys-Gly-Leu-Ala-Glu-His-Phe
      Ala-Asn-NH2. All three peptides were found to share considerable, but not
      complete, homology with bombinin, an antimicrobial, hemolytic peptide first
      isolated by Michl and Csordas (Csordas, A., and Michl, A. (1970) Monatsh. Chem.
      101, 182-189) from the skin of Bombina variegata. The BLPs have been assayed for
      antibiotic and hemolytic activity and found to be more potent than magainin 2 (a
      related antimicrobial peptide from Xenopus laevis) in their ability to kill
      bacteria. However, no significant hemolytic activity was found for these peptides
      which suggests a selectivity for prokaryotic over eukaryotic membranes. The
      molecular basis for antibacterial activity is presumed to be due to their
      predicted amphipathic alpha-helical structures which is supported by circular
      dichroism measurements that found significant helical content (63-69% alpha
      helix) in 40% trifluoroethanol. Last, a cDNA library was constructed from the
      skin of B. orientalis and screened with an oligonucleotide probe complementary to
      the COOH terminus of BLP-1. Several clones were isolated and sequenced that
      encode BLP-1 and BLP-3, as well as an additional peptide (BLP-4) that differs by
      two amino acid substitutions from BLP-3.

PMID- 1744109
TI  - Effects of gene mutations in lipoprotein and hepatic lipases as interpreted by a
      molecular model of the pancreatic triglyceride lipase.
AB  - A molecular model of human pancreatic lipase (Winkler, F. K., D'Arcy, A., and
      Hunziker, W. (1990) Nature 343, 771-774) is used to explain the possible
      structural effects of the amino acid mutations identified to date in the human
      lipoprotein and hepatic lipase genes. A sequence homology profile was used to
      evaluate the alignment of the amino acid sequences of all three lipolytic enzymes
      (Kirchgessner, T. G., Chuat, J.-C., Heinzmann, C., Etienne, J., Guilhot, S.,
      Svenson, K., Ameis, D., Pilon, C., D'Auriol, L., Andalibi, A., Schotz, M. C.,
      Galibert, F., and Lusis, A. J. (1989) Proc. Natl. Acad. Sci. U. S. A. 86, 9647
      9651) with respect to the secondary structure elements identified in the
      pancreatic lipase. As expected, maximum homology is observed in internal regions
      namely the hydrophobic strands of the central beta-pleated sheet. This
      observation strongly supports the hypothesis that all three molecules exhibit a
      very similar three-dimensional structure, particularly in the N-terminal
      catalytic domain. There is considerable variation in some of the surface loops
      connecting the individual strands, whereas others are conserved. It is
      hypothesized that the most conserved loops located around the active site are
      responsible for the catalytic function (similar for all three enzymes), whereas
      those that markedly differ are involved in the regulation at the molecular level,
      namely the binding of colipase (pancreatic enzyme) and apolipoprotein CII
      (lipoprotein lipase). The currently available library of hepatic and lipoprotein
      gene mutations seems to indicate that the majority of mutants disrupt the folding
      of the polypeptide chain, rather than affect specific constellations in and
      around the catalytic site or regulatory loops.

PMID- 1744110
TI  - Copper K-extended x-ray absorption fine structure studies of oxidized and reduced
      dopamine beta-hydroxylase. Confirmation of a sulfur ligand to copper(I) in the
      reduced enzyme.
AB  - The structure of the copper sites in oxidized and reduced dopamine beta
      hydroxylase has been studied by extended x-ray absorption fine structure
      spectroscopy using a restrained refinement approach to data analysis. An
      histidine-rich active site has been found to be present with an average histidine
      coordination of between two and three histidine ligands per copper. In the
      oxidized protein, the data support four-coordination, involving two to three
      imidazole groups at 1.99 A with additional ligands derived from water or
      exogenous O-donor groups at an average distance of 1.94 A. Studies on the reduced
      enzyme have focused on resolving the controversy in the literature (Scott, R. A.,
      Sullivan, R. J., De Wolfe, W. E., Dolle, R. E., and Kruse, L. I. (1988)
      Biochemistry 27, 5411-5417; Blumberg, W. E., Desai, P. R., Powers, L., Freedman,
      J. H., and Villafranca, J. J. (1989) J. Biol. Chem. 264, 6029-6032) as to whether
      a S/Cl scatterer is a ligand to Cu(I). Five independent samples of reduced enzyme
      prepared under conditions designed to probe the Cu(I) ligand environment have
      been measured and analyzed. All five samples gave identical spectra and could be
      simulated by two to three imidazoles (1.93 A) and 0.5 S/Cl (2.25 A) per Cu(I).
      The spectra were insensitive to the presence of added bromide or to exclusion of
      chloride during preparation. The results establish that the heavy atom scatterer
      is derived from a sulfur donor. Some evidence was found for an additional O/N
      scatterer at 2.6 A in the reduced enzyme. A hypothesis for the structure of the
      copper sites has been proposed involving inequivalent CuA(His)3(H2O)...CuB
      (His)2X(H2O) coordination in the oxidized enzyme, which upon reduction loses
      coordinated water and coordinates a sulfur probably from a methionine.

PMID- 1744111
TI  - Structure-activity relationships of interleukin-8 determined using chemically
      synthesized analogs. Critical role of NH2-terminal residues and evidence for
      uncoupling of neutrophil chemotaxis, exocytosis, and receptor binding activities.
AB  - Interleukin-8 (IL-8) is an inflammatory mediator that stimulates neutrophil
      migration and functional activation. Analogs of human IL-8 were chemically
      synthesized, purified, and compared with the full-length 72-residue synthetic IL
      8 for their ability to stimulate neutrophil chemotaxis and exocytosis as measured
      by assaying for release of elastase, as well as their binding to specific
      receptors in competition assays. Analogs corresponding to the less abundant
      natural forms, 3-72, 4-72, and 77-residue IL-8, were evaluated and the 3-72 and 4
      72 had 2-5-fold higher potencies, whereas the 77-residue IL-8 was 2-fold less
      potent. A major finding was that NH2-terminal residues 4, 5, and 6 were
      absolutely essential for IL-8 activity and receptor binding. Quantitative
      dissociation of elastase release and chemotaxis activity was detected with 5-72,
      which compared with 1-72, was 80-fold less potent in the elastase assay, but was
      only slightly less potent in stimulating chemotaxis. IL-8 6-72 lacked all the
      biological activities tested but had detectable receptor binding activity. The
      NH2-terminal peptide, AVLPRSAKEL, lacked activity and receptor binding,
      suggesting that the NH2-terminal region alone is not sufficient for function.
      Comparison of analogs shortened at the COOH terminus showed that potency was
      progressively reduced as the COOH-terminal residues were excluded. However
      activity was retained in an analog (1-51) with the entire COOH-terminal alpha
      helix and beta turn missing. A peptide corresponding to the COOH-terminal 22
      residues, although inactive alone, synergized with the 1-51 analog in stimulating
      elastase release. The results suggest that the NH2-terminal residues 4, 5, and 6,
      which are disordered in the IL-8 solution structure, are directly involved in
      receptor binding, but the COOH-terminal alpha helix is probably important for
      stabilizing the three-dimensional structure. Other regions within residues 7-51
      are also functionally important.

PMID- 1744112
TI  - An active serine is involved in covalent substrate amino acid binding at each
      reaction center of gramicidin S synthetase.
AB  - The condensing peptide forming multienzyme of gramicidin S synthetase (gramicidin
      S synthetase 2) was specifically labeled at its putative thiotemplate sites for L
      valine and L-leucine by covalent incorporation of the 14C-labeled substrate amino
      acids. The thioester complexes of the multienzyme were digested with CNBr,
      Staphylococcus aureus V8 protease, and pepsin. Reaction center peptides
      containing the [14C]valine and [14C]leucine labels were isolated in pure form.
      They show a high degree of sequence similarity and contain the same consensus
      sequence LGGH/DXL. The labels were eliminated in the first Edman degradation
      step. A dehydroalanine was identified which can originate from either a cysteine
      or a serine. The comparison of the chemical results with the deduced amino acid
      sequence of the grsB gene encoding the gramicidin S synthetase 2 revealed that 4
      such motifs are located within the gene structure, each of them being localized
      in the 3'-terminal region of one of 4 gene segments grsB1-B4. They have a size of
      approximately 2 kilobases and presumably code for the 4 amino acid activating
      domains of the synthetase. Surprisingly a serine was found at each putative
      substrate amino acid-binding position instead of a cysteine as postulated by the
      thiotemplate mechanism. Therefore the data suggest that active serine residues
      are involved in nonribosomal peptide syntheses of microbial peptides.

PMID- 1744113
TI  - Phorbol ester induces manganese-superoxide dismutase in tumor necrosis factor
      resistant cells.
AB  - The effects of phorbol ester (TPA) and other known stimulators such as tumor
      necrosis factor (TNF), interleukin-1, and lipopolysaccharide on induction of mRNA
      for manganese-superoxide dismutase (Mn-SOD) were investigated in various cell
      lines. TPA enhanced Mn-SOD mRNA expression in TNF-resistant cell lines including
      HeLa cells, in which the other reagents also induced expression of the gene, but
      did not affect TNF-sensitive cells, in which the other stimulators did not alter
      expression of the gene. HeLa cells which had been desensitized to TPA by
      pretreatment with TPA for 24 h expressed Mn-SOD mRNA at a slightly higher level
      than the cells without TPA treatment. TPA-pretreated cells stimulated with TNF,
      however, expressed Mn-SOD mRNA at about twice the level of TNF-stimulated, TPA
      untreated cells. When protein synthesis was inhibited by cycloheximide during TPA
      pretreatment, TNF no more enhanced the Mn-SOD mRNA accumulation. These data
      suggest that at least two separate signal-transducing pathways are involved in
      expression of this gene. One is triggered by protein kinase C activation itself
      in the absence of new protein synthesis. The other can be activated by
      stimulation with TNF, interleukin-1, or lipopolysaccharide and in which a protein
      factor that can be induced by TPA treatment is involved.

PMID- 1744114
TI  - fMet-Leu-Phe-induced activation of phospholipase D in human neutrophils.
      Dependence on changes in cytosolic free Ca2+ concentration and relation with
      respiratory burst activation.
AB  - In this study, we have investigated the Ca2+ requirements for the activation of
      phospholipase D by the tripeptide fMet-Leu-Phe (fMLP) in human neutrophils. EGTA
      inhibited the activation of phospholipase D (PLD) by 55% (n = 4). When the
      initial transient rise in [Ca2+]i was prevented by loading the cells with limited
      amounts of the Ca2+ chelator 1,2-bis(O-aminophenoxy)ethane-N,N,N',N'-tetraacetic
      acid acetoxymethyl ester (BAPTA/AM), PLD activation was inhibited by 92% (n = 4).
      In the presence of both chelators, PLD activation was only 4% of control. In
      electropermeabilized neutrophils, too, the activation of PLD after the addition
      of fMLP strongly depends on the Ca2+ concentration, being almost absent with 100
      nM free Ca2+ present and reaching maximum activation with a free [Ca2+] of 500
      nM. We subsequently investigated the relationship between PLD activation and the
      activation of the respiratory burst. In neutrophils loaded with BAPTA/AM (10
      microM), in which PLD activation was almost absent, a respiratory burst could be
      induced by fMLP, albeit with a much longer lag time. A respiratory burst could
      also be elicited by fMLP in electropermeabilized neutrophils incubated with 100
      nM free Ca2+. This response, however, was strongly enhanced in the presence of 1
      microM Ca2+. Our results indicate that changes in [Ca2+]i are essential for the
      activation of PLD by fMLP, but probably do not constitute the sole activation
      signal. In addition, our data provide evidence that PLD activation is important,
      but not necessary, for activation of the neutrophil respiratory burst.

PMID- 1744115
TI  - Localization of chromatophore proteins of Rhodobacter sphaeroides. I. Rapid
      Ca(2+)-induced fusion of chromatophores with phosphatidylglycerol liposomes for
      proteinase delivery to the luminal membrane surface.
AB  - A protease delivery system was developed for the exclusive and controlled
      digestion of proteins exposed at the morphological inside (periplasmic surface)
      of Rhodobacter sphaeroides chromatophores. In this procedure, proteinase K is
      encapsulated within large unilamellar liposomes which are fused to the
      chromatophores in the presence of Ca2+ ions. The liposomes were prepared by a
      detergent dialysis procedure from native phosphatidylglycerol and found to
      undergo rapid bilayer fusion with purified chromatophore preparations above a
      threshold concentration of 12.5 mM CaCl2. The fusion process was complete within
      10 min at 35 mM Ca2+ with about 80% of the pigment located in the fusion
      products. Electron micrographs of freeze-fracture replicas confirmed the
      intermixing of the lipid bilayers and the unilamellar structure of the fused
      membrane vesicles. The procedure did not affect the labile B800 chromophore of
      the B800-850 antenna complex, but reduced slightly the absorption due to the B875
      core antenna. Emission from both light-harvesting complexes was increased in the
      fused membranes, suggesting a partial dissociation of photosynthetic units in the
      expanded bilayer. The results, together with those presented in the following
      paper (Theiler, R., and Niederman, R. A. (1991) J. Biol. Chem. 266, 23163-23168),
      demonstrate that this new method fulfills the stringent requirements for a
      successful delivery of macromolecules to the chromatophore interior.

PMID- 1744116
TI  - The poly-N-acetyllactosamines attached to lysosomal membrane glycoproteins are
      increased by the prolonged association with the Golgi complex.
AB  - The poly-N-acetyllactosamines on neutrophils and monocytes have been shown to
      serve as ligands for various selectins present on endothelial cells and
      platelets. We have previously shown that only a limited number of glycoproteins
      contain poly-N-acetyllactosamine and found that lysosomal membrane glycoproteins
      (lamps) are the major glycoproteins carrying poly-N-acetyllactosamine. In order
      to understand the reason why only certain glycoproteins can be modified by poly-N
      acetyllactosamine, we have utilized 21 degrees C incubation conditions, which
      were previously shown to cause the accumulation of glycoproteins at the trans
      Golgi. HL-60 cells were labeled with [3H]galactose at 21 or 37 degrees C for 6 or
      24 h, and lamp-1 and lamp-2 were immunoprecipitated. Upon examination by sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis, each lamp from HL-60 cells
      incubated at 21 degrees C exhibited a much broader, slower migrating band than
      that isolated from the cells incubated at 37 degrees C. The number of N-glycans
      containing poly-N-acetyllactosamine, estimated by their binding to tomato lectin
      column, increased approximately 30-50% after incubation at 21 degrees C than
      incubation at 37 degrees C. The analysis of oligosaccharides released by endo
      beta-galactosidase digestion demonstrates that the amount of side chains
      containing three or more N-acetyllactosamine repeats increased about 100% after
      incubation at 21 degrees C, and methylation analysis confirmed these results. The
      same analysis and the results obtained by ion-exchange chromatography also
      provided evidence that the N-glycans of lamps are sialylated at 21 degrees C as
      much as at 37 degrees C. Pulse-chase experiments using [35S]methionine labeling
      indicated that the time necessary for processing of lamps is much longer at 21
      degrees C than at 37 degrees C. These results therefore indicate that incubation
      at 21 degrees C causes the lamps to reside longer within the Golgi complex, and
      such longer residence allows lamps to acquire more polylactosaminoglycan. These
      results also suggest that the time necessary for moving through the Golgi complex
      is a critical factor for poly-N-acetyllactosamine formation.

PMID- 1744117
TI  - The carboxyl-terminal tripeptide Ala-Lys-Ile is essential for targeting Candida
      tropicalis trifunctional enzyme to yeast peroxisomes.
AB  - The gene encoding Candida tropicalis peroxisomal trifunctional enzyme, hydratase
      dehydrogenase-epimerase (HDE), was expressed in both Candida albicans and
      Saccharomyces cerevisiae. The cellular location of HDE was determined by
      subcellular fractionation followed by Western blot analysis of peroxisomal and
      cytosolic fractions using antiserum specific for HDE. HDE was found to be
      exclusively targeted to and imported into peroxisomes in both heterologous
      expression systems. Deletion and mutational analyses were used to determine the
      regions within HDE which are essential for its targeting to peroxisomes. Deletion
      of a carboxyl-terminal tripeptide Ala-Lys-Ile completely abolished targeting of
      HDE to peroxisomes, whereas large internal deletions of HDE (amino acids 38-353
      or 395-731) had no effect on HDE targeting to peroxisomes in either yeast. This
      tripeptide is similar to, but distinct from, other tripeptide peroxisomal
      targeting sequences (PTSs) as identified in peroxisomal firefly luciferase and
      four mammalian peroxisomal proteins. Substitutions within the carboxyl-terminal
      tripeptide (Ala----Gly and Lys----Gln) supported targeting of HDE to peroxisomes
      of C. albicans but not of S. cerevisiae. This is the first detailed analysis of
      the peroxisomal targeting signal in a yeast peroxisomal protein.

PMID- 1744118
TI  - The cyclophilin multigene family of peptidyl-prolyl isomerases. Characterization
      of three separate human isoforms.
AB  - Cyclophilin (CyP), a major cytosolic protein possessing peptidyl-prolyl cis-trans
      isomerase activity, has been implicated as the specific receptor of the
      immunosuppressive drug cyclosporin A (CsA). To identify other potential CsA
      receptors related to CyP, two human cDNA libraries were screened under low
      stringency conditions using human CyP cDNA (encoding hCyP1) as a probe. Two cDNAs
      were identified which encode distinct proteins related to human hCyP1. These two
      novel proteins, designated hCyP2 and hCyP3, share 65 and 76% amino acid sequence
      homology with hCyP1, respectively. Both hCyP2 and hCyP3 contain NH2-terminal
      hydrophobic extensions of 32 and 42 amino acids, respectively. Protein-specific
      antibodies revealed the predominant association of hCyP2 and hCyP3 with membranes
      and subcellular organelles, which suggests that the amino-terminal leader
      sequences of the two CyP isoforms may act as signal peptides. In contrast to the
      results with hCyP1, Southern blot analysis indicated that both hCyP2 and hCyP3
      gene sequences are represented infrequently in the human genome. Northern and
      Western blot analysis showed that the distribution of mRNA and proteins of the
      three hCyPs in differing tissues and cell types was similar. Each hCyP protein
      was expressed in Escherichia coli, purified, and shown to be an active peptidyl
      prolyl isomerase. Substrate specificity was examined with 11 synthetic peptides
      (Suc-Xaa-Yaa-Pro-Phe-4-nitroanilide), and inhibition of the peptidyl-prolyl
      isomerase activities associated with hCyP1, hCyP2, and hCyP3 was studied with
      CsA, MeAla6-CsA and MeBm2t1-CsA. From both equilibrium considerations and the
      results of kinetic characterizations it is proposed that of these three CyP
      proteins, hCyP1 is the most likely intracellular target for CsA.

PMID- 1744119
TI  - Requirements for primer synthesis by bacteriophage T7 63-kDa gene 4 protein.
      Roles of template sequence and T7 56-kDa gene 4 protein.
AB  - Gene 4 of bacteriophage T7 encodes two proteins, a 63-kDa protein and a colinear
      56-kDa protein, that are essential for synthesis of leading and lagging strands
      during DNA replication. The gene 4 proteins together catalyze the synthesis of
      oligoribonucleotides, pppACC(C/A) or pppACAC, at the single-stranded DNA
      sequences 3'-CTGG(G/T)-5' or 3'-CTGTG-5', respectively. Purified 56-kDa protein
      has helicase activity, but no primase activity. In order to study 63-kDa gene 4
      protein free of 56-kDa gene 4 protein, mutations were introduced into the
      internal ribosome-binding site responsible for the translation of the 56-kDa
      protein. The 63-kDa gene 4 protein was purified 16,000-fold from Escherichia coli
      cells harboring an expression vector containing the mutated gene 4. Purified 63
      kDa gene 4 protein has primase, helicase, and single-stranded DNA-dependent
      dTTPase activities. The constraints of primase recognition sequences, nucleotide
      substrate requirements, and the effects of additional proteins on
      oligoribonucleotide synthesis by the 63-kDa gene 4 protein have been examined
      using templates of defined sequence. A three-base sequence, 3'-CTG-5', is
      necessary and sufficient to support the synthesis of pppAC dimers. dTTP
      hydrolysis is essential for oligoribonucleotide synthesis. Addition of a 7-fold
      molar excess of 56-kDa gene 4 protein to 63-kDa protein increases the number of
      oligoribonucleotides synthesized by 63-kDa protein 100-fold. The increase in
      oligonucleotides results predominantly from an increase in the synthesis of
      tetramers, with relatively little change in the synthesis of dimers and trimers.
      The presence of 56-kDa protein also causes 63-kDa protein to synthesize "pseudo
      templated" pppACCCC pentamers at the recognition sequence 3'-CTGGG-5'. T7 gene
      2.5 protein, a single-stranded DNA binding protein, increases the total number of
      oligoribonucleotides synthesized by 63-kDa gene 4 protein on single-stranded M13
      DNA, but has no effect on the ratio of dimers to trimers and tetramers.

PMID- 1744120
TI  - Stimulation of endothelin-1 gene expression by insulin in endothelial cells.
AB  - The present study characterized the regulation of the genetic expression of the
      vasoactive peptide endothelin-1 (ET-1) by insulin in bovine aortic endothelial
      cells. By RNA blot analysis, insulin (1.67 x 10(-8) M) increased ET-1 mRNA levels
      by 2.3-fold over the basal within 10 min and attained a maximum (5.3-fold
      increase) in 2 h. Dose-response studies showed that a maximum effect of insulin
      was reached at 1.67 x 10(-8) M although a significant increase can be observed at
      1.66 x 10(-9) M. Radioligand receptor studies indicated that the affinity
      constant for insulin receptors on endothelial cells correlated closely with the
      dose response observed for ET-1 mRNA. The ET-1 mRNA half-life was estimated with
      actinomycin D studies to be 20 min in control cells and was not affected by
      insulin treatment. Moreover, the effects of phorbol 12-myristate 13-acetate (PMA)
      and insulin were additive in the induction of ET-1 gene expression. When protein
      kinase C in the bovine aortic endothelial cells was down-regulated by
      preincubation with 8 x 10(-7) M PMA for 24 or 48 h, insulin was still able to
      increase ET-1 mRNA levels whereas PMA was ineffective. Using a chloramphenicol
      acetyltransferase (CAT) fusion plasmid containing the CAT gene and the 5'
      flanking region of the ET-1 gene (Lee, M. E., Bloch, K. D., Clifford, J. A., and
      Quertermous, T. (1990) J. Biol. Chem. 265, 10446-10450), we observed that 1.67 x
      10(-8) M insulin increased CAT enzyme activity and mRNA levels. The insulin dose
      response curve observed for CAT activity correlated with that observed for ET-1
      mRNA levels. These results suggest that insulin stimulates expression of the ET-1
      gene at the transcriptional level via its own receptors. This effect is mediated
      mostly through a protein kinase C-independent pathway, suggesting the existence
      of an insulin-responsive element in the ET-1 gene 5'-flanking sequence.

PMID- 1744121
TI  - Synthesis and characterization of 5-azido-UDP-glucuronic acid. A new
      photoaffinity probe for UDP-glucuronic acid-utilizing proteins.
AB  - A new active site-directed photoaffinity analogue, [beta-32P]5-azido-UDP
      glucuronic acid (UDP-GlcA), was enzymatically synthesized from [beta-32P]5-N3UDP
      Glc using UDP-glucose dehydrogenase. The product was characterized by its
      mobility on ion exchange and two thin-layer chromatographic systems, by its UV
      absorbance at 288 nm, and the loss of this absorbance after UV irradiation of the
      compound. Photoincorporation of [beta-32P]5-N3UDP-GlcA into bovine liver UDP-Glc
      dehydrogenase (EC 1.1.1.22) was saturable with an apparent Kd of 12.5 microM, and
      was inhibited by the known active-site effectors UDP-GlcA, UDP-Glc, and UDP
      xylose. When human liver microsomes with known UDP-glucuronosyltransferase (EC
      2.4.1.17) activities were photolabeled with [beta-32P]5-N3UDP-GlcA, major
      photolabeled bands of 35-37 and 50-54 kDa were detected. When rat liver
      microsomes from phenobarbital-injected rats were photolabeled with [beta-32P]5
      N3UDP-GlcA, there was a marked increase in photoincorporation of a 51-kDa protein
      as compared with control animals. Evidence is presented which suggests that the
      photolabeled 51-54-kDa proteins in the liver microsomes from both tissues are UDP
      glucuronosyltransferase and that [beta-32P]5-N3UDP-GlcA represents a new
      alternative approach in the study of UDP-glucuronosyltransferase and other UDP
      GlcA-utilizing enzymes.

PMID- 1744122
TI  - A serum- and glucocorticoid-regulated 4-kilobase mRNA encodes a cyclooxygenase
      related protein.
AB  - The profound influence of glucocorticoid hormones on the inflammatory response
      includes a rapid and significant reduction in the synthesis of cyclooxygenase
      (prostaglandin G/H synthase, PGHS), the key enzyme for prostaglandin
      biosynthesis. In analyzing the glucocorticoid effects on PGHS synthesis in C127
      mouse fibroblasts, we detected a novel 4-kilobase (kb) mRNA that is related to a
      PGHS cDNA cloned from an ovine seminal vesicle library. This RNA is much more
      prevalent in cycloheximide-treated cells and, based on stringency analysis and
      preliminary sequence data, arises from a gene distinct from that transcribed into
      the previously cloned 2.8-kb PGHS cDNA. Furthermore, the 4-kb mRNA encodes a 70
      kDa protein that is specifically immunoprecipitated by anti-PGHS serum. The
      abundance of the 4-kb mRNA is strongly decreased by dexamethasone and increased
      by serum within 2 h whereas the 2.8-kb PGHS mRNA, which is also seen in these
      cells, does not consistently change. These changes in the level of the 4-kb mRNA
      with serum and dexamethasone treatment parallel changes in the level of
      synthesized PGHS protein detected in both metabolically labeled cells and in in
      vitro translated mRNAs. This discovery of a cyclooxygenase-related gene that is
      transcriptionally regulated by serum and glucocorticoid hormones in a manner
      identical to that reported for cyclooxygenase activity may help clarify issues
      regarding cyclooxygenase regulation and suggests that two distinct and
      differentially regulated cyclooxygenase species exist.

PMID- 1744123
TI  - Concerted modulation of alpha 1(XI) and alpha 2(V) collagen mRNAs in bovine
      vascular smooth muscle cells.
AB  - We have isolated a partial cDNA for alpha 1(XI) collagen from a bovine smooth
      muscle cell (SMC) library. Previously, this collagen was not known to be
      expressed in SMCs. Comparison of the nucleotide and deduced amino acid sequence
      of the 2.7-kilobase bovine clone and the human alpha 1(XI) sequence indicates 92
      and 98% homology, respectively. Bovine SMCs in culture were found to produce
      alpha 1(XI) mRNA. However, alpha 2(XI) and alpha 1(II) collagen RNA were not
      detectable; therefore, SMCs cannot synthesize the same type XI collagen as found
      in cartilage. Since type XI collagen is structurally related to type V collagen,
      the expression of alpha 1(XI) and alpha 2(V) collagen mRNA in SMCs was
      characterized. Levels of alpha 1(XI) and alpha 2(V) collagen mRNAs were low in
      exponentially growing SMCs and increased 3-4-fold as cells became confluent.
      Increased mRNA levels were also observed when exponentially growing subconfluent
      SMCs were incubated in medium containing 0.5% fetal bovine serum for 24 h,
      similar to the effects of serum deprivation on the expression of types I and III
      collagen genes (Kindy, M. S., Chang, C.-J., and Sonenshein, G. E. (1988) J. Biol.
      Chem. 263, 11426-11430). However, as cell density increased, serum deprivation
      resulted in very different responses for these collagen genes. Serum deprivation
      caused a decrease in expression of alpha 1(XI) and alpha 2(V) collagen mRNAs in
      cultures as they approached confluence. In contrast, at confluence alpha 1(I) and
      alpha 2(I) mRNA levels no longer responded to serum concentration whereas
      expression of alpha 1(III) mRNA remained inducible by serum deprivation. These
      results suggest concerted regulation of alpha 1(XI) and alpha 2(V) collagen gene
      expression, which is distinct from that for the chains of type I and type III
      collagen with respect to cell density and serum.

PMID- 1744124
TI  - Differential expression of small chondroitin/dermatan sulfate proteoglycans, PG
      I/biglycan and PG-II/decorin, by vascular smooth muscle and endothelial cells in
      culture.
AB  - Cultured bovine aortic smooth muscle (BASM) and endothelial (BAE) cells, like
      articular chondrocytes, synthesize two populations of small chondroitin/dermatan
      sulfate (CS/DS) proteoglycans (PGs) of similar size as PG-I/biglycan and PG
      II/decorin. However, Northern blot analyses demonstrated that BAE cells express
      detectable amounts of mRNA transcripts only for PG-I/biglycan, whereas BASM cells
      and articular chondrocytes express mRNA transcripts for both PG-I/biglycan and PG
      II/decorin. Endothelial cells from human umbilical vein also expressed detectable
      amounts of mRNA transcripts only for PG-I/biglycan, and not PG-II/decorin.
      Antiserum raised against bovine PG-II/decorin immunoprecipitated an apparent
      single PG species with relative molecular mass (Mr) of approximately 120,000
      180,000 from BASM cell and articular chondrocyte cultures but failed to
      immunoprecipitate an equivalent PG species from BAE cell cultures, consistent
      with the results from Northern blot analysis. In contrast, immunoprecipitations
      by antisera to PG-I/biglycan indicated that cultured endothelial cells synthesize
      two forms of PG-I/biglycan with Mr values slightly larger than 200,000 and
      120,000-140,000. It is likely, based on the magnitude of the size difference,
      that these two forms of PG-I/biglycan differ in the number of glycosaminoglycan
      chains. Additionally, BASM but not BAE cells were found to express detectable
      amounts of mRNA transcripts for type I collagen. The above results indicate that
      the two main cell types of the vascular wall, endothelial and smooth muscle
      cells, express different sets of small interstitial CS/DS PGs and that the
      synthesis of PG-II/decorin by these cells correlates with the expression of type
      I collagen, a collagen known to interact specifically with this PG. These
      differences in the expression of extracellular matrix molecules may be important
      in regulating the cell type-specific functions of endothelial and smooth muscle
      cells within the vascular tissue.

PMID- 1744125
TI  - Purification of the transforming growth factor-beta (TGF-beta) binding
      proteoglycan betaglycan.
AB  - We report the purification of betaglycan, a low-abundance membrane proteoglycan
      with high affinity for transforming growth factor-beta (TGF-beta). Betaglycan
      solubilized from rat embryo membrane preparations was purified to near
      homogeneity by sequential chromatography through DEAE-Trisacryl, wheat germ
      lectin-Sepharose, and TGF-beta 1-agarose. Purified betaglycan has properties
      similar to betaglycan affinity-labeled in intact cells: it binds TGF-beta 1 and
      TGF-beta 2 with KD approximately 0.2 nM, contains heparan sulfate and chondroitin
      sulfate glycosaminoglycan (GAG) chains and N-linked glycans attached to a 110-kDa
      core protein, and can spontaneously associate with phosphatidylcholine liposomes.
      The betaglycan core obtained by enzymatic removal of the GAG chains has high
      affinity for TGF-beta and associates with artificial liposomes, indicating that
      the core protein binds TGF-beta and anchors to membranes independently of the GAG
      chains present on the native protein or of any ancillary protein.

PMID- 1744126
TI  - Multiple origins of the human glycophorin Sta gene. Identification of hot spots
      for independent unequal homologous recombinations.
AB  - Human glycophorin Sta (HGpSta), one of the structural variants of erythrocyte
      membrane sialoglycoproteins, is encoded by a delta-alpha hybrid gene that arose
      from a single unequal crossover between the parent HGpB(delta) and HGpA(alpha)
      genes. We report here the identification of two new HGpSta genes (type A and type
      B) in four unrelated Sta heterozygotes from two ethnic groups. These Sta genes
      represent distinct genetic isoforms that differ from the previously reported Sta
      gene (type C) in the location of crossing-over sites. Comparison of nucleotide
      sequences among HGpB(delta), HGpA(alpha), and HGpSta type A genes revealed that
      the delta-alpha unequal crossover for the Sta type A gene occurred 110-246 base
      pairs downstream from pseudoexon III. In the crossing-over site of this Sta gene,
      an AT-rich sequence lying 3' to a nonameric palindrome was found to be highly
      similar to the lambda phage attachment site, att B, in inverted orientation. In
      the Sta type B gene, the delta-alpha crossing-over point was localized to an AG
      rich sequence that is 302-490 base pairs downstream from pseudoexon III. Multiple
      lambda chi-like elements were identified at the crossover boundaries and within
      the breakpoint of this Sta gene. These results suggest strongly that recurrent
      and independent unequal recombination events have occurred in the formation of
      multiple Sta genes and that particular genomic sequences are important in
      defining the recombination sites for these homology-driven processes.

PMID- 1744127
TI  - The Drosophila RBP-J kappa gene encodes the binding protein for the
      immunoglobulin J kappa recombination signal sequence.
AB  - We previously isolated a cDNA encoding the 60-kDa murine protein (RBP-J kappa
      protein) that specifically binds to the immunoglobulin J kappa recombination
      signal sequence. The RBP-J kappa gene is highly conserved in a wide variety of
      organisms including man, Xenopus, Drosophila, and yeast. We have isolated and
      characterized the Drosophila homologue of the RBP-J kappa gene. The Drosophila
      RBP-J kappa gene was mapped to the polytene region 35BC of chromosome 2. The
      nucleotide sequence of this gene indicates that it is not one of the known genes
      located in the 35 BC region. The nucleotide and amino acid sequences of the
      Drosophila and mouse RBP-J kappa genes are 60 and 75% homologous, respectively.
      The central 248-residue regions of RBP-J kappa proteins of the two species are
      93% homologous and include the 40-residue integrase motif. The Drosophila RBP-J
      kappa protein expressed in COS cells bound to the J kappa recognition sequence
      with the same specificity as the murine counterpart. These results suggest that
      Drosophila may have a site-specific recombination system which utilizes the
      immunoglobulin recombination signal sequence. Implications for evolution of
      immunoglobulin gene rearrangement were also discussed.

PMID- 1744128
TI  - Hypoxia enhances phosphorylation of eukaryotic initiation factor 4A in maize root
      tips.
AB  - We have identified two isoforms of initiation factor 4A (eIF-4A) in maize root
      tips, with distinct isoelectric points and similar molecular mass (approximately
      50 kDa). Both isoforms of maize eIF-4A cross-react with antibodies raised against
      wheat germ eIF-4A, and one of the maize proteins (higher pI isoform) comigrates
      with purified wheat germ eIF-4A on two-dimensional gels. The two maize eIF-4As
      were indistinguishable by comparative peptide fingerprint analysis, which also
      showed a very strong similarity between eIF-4A in maize roots and wheat germ.
      Maize eIF-4As copurify with eIF-4F and eIF-(iso)4F on a 7-methyl-GTP-Sepharose
      affinity column, indicating that they are part of the 5'-cap-binding complex. Two
      dimensional gel electrophoresis and immunoblotting of proteins from 32P-labeled
      maize root tips revealed that the lower pI isoform of eIF-4A is phosphorylated.
      Two-dimensional phosphopeptide maps of trypsin-digested eIF-4A contained one
      principal phosphorylated fragment; phosphoamino acid analysis indicated
      phosphorylation of threonine. In oxygenated maize root tips, the ratio of
      phosphorylated to nonphosphorylated eIF-4A is approximately 0.2. This ratio
      increases to approximately 1 within 20 min following the onset of hypoxia, due to
      interconversion between the two maize eIF-4A isoforms. The hypoxia-induced
      phosphorylation of eIF-4A is discussed with respect to metabolic responses, and
      the translational control of gene expression, in hypoxic plant tissues.

PMID- 1744129
TI  - Cloning and characterization of a testis-specific thymosin beta 10 cDNA.
      Expression in post-meiotic male germ cells.
AB  - Thymosin beta 10 is one of a small family of proteins closely related in sequence
      to thymosin beta 4, recently identified as an actin-sequestering protein. A
      single molecular weight species of thymosin beta 10 mRNA is present in a number
      of rat tissues. In adult rat testis, an additional thymosin beta 10 mRNA of
      higher molecular weight was identified. Nucleotide sequencing of cDNA clones
      complementary to the testis-specific thymosin mRNA indicated that this mRNA
      differed from the ubiquitous thymosin beta 10 mRNA only in its 5'-untranslated
      region, beginning 14 nucleotides upstream of the translation initiation codon.
      These results, together with primer extension experiments, suggest that the two
      thymosin beta 10 mRNAs are transcribed from the same gene through a combination
      of differential promoter utilization and alternative splicing. The novel thymosin
      beta 10 mRNA could be detected only in RNA isolated from sexually mature rat
      testis. Both mRNAs were present in pachytene spermatocytes; only the testis
      specific mRNA was detected in postmeiotic haploid spermatids. Immunoblot analysis
      using specific antibodies showed that the thymosin beta 10 protein synthesized in
      adult testis was identical in size to that synthesized in brain.
      Immunohistochemical analysis showed that the protein was present in
      differentiating spermatids, suggesting that the testis-specific thymosin beta 10
      mRNA is translated in haploid male germ cells.

PMID- 1744130
TI  - Structure of the agonist-binding site of the nicotinic acetylcholine receptor.
      [3H]acetylcholine mustard identifies residues in the cation-binding subsite.
AB  - To characterize the structure of the agonist-binding site of the Torpedo
      nicotinic acetylcholine receptor (AChR), we have used [3H]acetylcholine mustard
      [( 3H]AChM), a reactive analog of acetylcholine, to identify residues
      contributing to the cation-binding subsite. Reaction of [3H]AChM, in its
      aziridinium form, with AChR-rich membrane suspensions, resulted initially in
      reversible, high affinity binding (K approximately 0.3 microM) followed by slow
      alkylation of the acetylcholine-binding site. Incorporation of label into AChR
      alpha-subunit was inhibited by agonists and competitive antagonists, but not by
      noncompetitive antagonists, and reaction with 3 microM [3H]AChM for 2 h resulted
      in specific alkylation of 0.6% of alpha-subunits. Within the alpha-subunit,
      greater than 90% of specific incorporation was contained within an 18-kDa
      Staphylococcus aureus V8 proteolytic fragment beginning at Val-46 and containing
      N-linked carbohydrate. To identify sites of specific alkylation, [3H]AChM-labeled
      alpha-subunit was digested with trypsin, and the digests were fractionated by
      reverse phase high pressure liquid chromatography. Specifically labeled material
      was recovered within a single peak containing a peptide extending from Leu-80 to
      Lys-107. NH2-terminal amino acid sequencing revealed specific release of 3H in
      cycle 14 corresponding to alpha-subunit Tyr-93. Identification of Tyr-93 as the
      site of alkylation was confirmed by radiosequence analysis utilizing o
      phthalaldehyde to establish that the released 3H originated from a peptide
      containing prolines at residues 2 and 9. Because [3H]AChM contains as its
      reactive group a positively charged quaternary aziridinium, alpha-subunit Tyr-93
      is identified as contributing to the cation-binding domain of the AChR agonist
      binding site. The selective reaction of [3H]AChM with tyrosyl rather than acidic
      side chains indicates the importance of aromatic interactions for the binding of
      the quaternary ammonium group, and the lack of reaction with the tyrosyl or
      acidic side chains within alpha 190-200 emphasizes the selective orientation of
      acetylcholine within its binding site.

PMID- 1744131
TI  - Transgenic mice that express a mini-gene version of the human gene for type I
      procollagen (COL1A1) develop a phenotype resembling a lethal form of osteogenesis
      imperfecta.
AB  - A mini-gene version of the human gene for a pro-alpha 1(I) chain of type I
      procollagen (COL1A1) was prepared that contained -2.5 kilobases of the promoter
      region and the 5'- and 3'-ends of the gene but lacked a large central region
      containing 41 exons. The construct was modeled after a sporadic in-frame deletion
      of the human gene that produced a lethal variant of osteogenesis imperfecta,
      because it caused synthesis of shortened pro-alpha 1(I) chains that associated
      with normal pro-alpha 1(I) and pro-alpha 2(I) chains and caused degradation of
      both the shortened and normal pro-alpha chains through a process called
      procollagen suicide. The mini-gene was used to prepare transgenic mice. Eight of
      15 transgenic mice expressed varying levels of the gene. All except one of the Fo
      founders were phenotypically normal, but several of the founders were apparently
      mosaic since they produced F1 progeny that died shortly after birth with a
      distinctive phenotype. The phenotype included extensive fractures of ribs and
      long bones similar to the fractures seen in lethal variants of osteogenesis
      imperfecta. Mice with the lethal phenotype expressed much higher levels of the
      mini-gene than transgenic mice without the lethal phenotype. Experiments with
      cultured skin fibroblasts from the transgenic mice demonstrated that shortened
      pro-alpha 1(I) chains synthesized from the mini-gene became disulfide-linked to
      pro-alpha 1(I) chains synthesized from the endogenous mouse gene. The results
      demonstrate that a mutated type I procollagen gene based on the model of
      procollagen suicide can be used to produce a severe phenotype of osteogenesis
      imperfecta that is genetically transmitted.

PMID- 1744132
TI  - Isolation and functional properties of an arginine-selective endoprotease from
      rat intestinal mucosa. A putative prosomatostatin convertase.
AB  - The endoproteolytic activity previously detected in rat intestinal mucosal
      extracts (Beinfeld M., Bourdais, J., Kuks, P., Morel, A., and Cohen, P. (1989) J.
      Biol. Chem. 264, 4460-4465), was purified to homogeneity as a 65-kDa molecular
      species. This putative proprotein-processing enzyme cleaves the peptide bond on
      the carboxyl side of a single arginine residue in hepta-[Leu62-Gln-Arg-Ser-Ala
      Asn-Ser68] or trideca-[Asp56-Glu-Met-Arg-Leu-Glu-Leu-Gln-Arg-Ser-Ala-Asn-+
      ++Ser68] peptides, reproducing the prosomatostatin sequence around Arg64, the
      locus for endoproteolytic release of either somatostatin-28 or its NH2-terminal
      fragment, somatostatin-28-(1-12), from their common precursor. This enzyme
      exhibits a strict selectivity for arginyl residues, as demonstrated with related
      substrates, and did not cleave at lysyl residues. Moreover, only arginyl residues
      belonging to peptides of the prosomatostatin family were cleaved, since no
      hydrolysis of peptides from other prohormones was detected. In addition, the
      arginine residue situated at position -5 on the NH2-terminal side of Arg64 not
      only did not function as a cleavage locus, but had no effect on the overall
      cleavage kinetics of the prosomatostatin-(56-68) peptide substrate. This enzyme
      also cleaved, but with much less efficiency, the peptide bond on the carboxyl
      side of an arginine in peptides containing either an Arg-Lys or a Lys-Arg doublet
      corresponding to prohormone cleavage sites. This enzyme was insensitive to
      divalent cation chelators, was completely inhibited by aprotinin and leupeptin,
      and was somewhat inhibited by other serine-protease inhibitors. It is concluded
      that this endoprotease is a serine protease and could be involved in prohormone
      or proprotein post-translational processing at single arginine cleavage sites.

PMID- 1744133
TI  - Binding of elastin to Staphylococcus aureus.
AB  - Many pathogenic bacteria specifically bind to components of the extracellular
      matrix. In this study, we report the specific association of Staphylococcus
      aureus with elastin, a major structural component of elastic tissue. Competition
      assays in which the binding of radiolabeled tropoelastin was inhibited by excess
      unlabeled elastin peptides, but not by other proteins, established the
      specificity of the interaction. Kinetic studies showed that tropoelastin binding
      to the bacteria was rapid and saturable. Scatchard analysis of the equilibrium
      binding data indicated the presence of a single class of high affinity binding
      sites (KD approximately 4-7 nM) with approximately 1000 sites per organism.
      Protease susceptibility suggested that the elastin binding moiety on S. aureus
      was a protein, which was confirmed by the isolation of a 25-kDa elastin-binding
      protein from S. aureus extracts through affinity chromatography. Using a
      truncated form of tropoelastin, the bacterial binding domain on elastin was
      mapped to a 30-kDa fragment at the amino end of the molecule. Although the
      precise amino acid sequence recognized by the staphylococcal elastin receptor has
      not been characterized, it is clearly different from the region of tropoelastin
      that specifies binding to mammalian elastin receptors.

PMID- 1744134
TI  - In vivo restriction. Sequence and structure of endonuclease II-dependent cleavage
      sites in bacteriophage T4 DNA.
AB  - Endonuclease II of bacteriophage T4 is required for in vivo restriction of
      cytosine-containing DNA from its host, Escherichia coli, (as well as from phage
      mutants lacking cytosine modification), normally the first step in the
      reutilization of host DNA nucleotides for synthesis of phage DNA in infected
      cells. The phage cytosine-DNA is fragmented incompletely to yield genetically
      defined fragments. This restriction is different from that of type I, II, or III
      restriction enzymes. We have located seven major endonuclease II-dependent
      restriction sites in the T4 genome, of which three were analyzed in detail; in
      addition, abundant sites were cleaved in less than or equal to 5% of all
      molecules. Sites I, II, and III shared the sequence 5'-CCGNNTTGGC-3' and were
      cleaved in about 25% (I and III) and 65% (II) of all molecules, predominantly
      staggered around the first or second of the central unspecified base pairs to
      yield fragments with one 5' base. The less frequently cleaved sites I and III
      deviated from site II in predicted helical structure when viewed from the
      consensus strand, and in sequence when viewed from the opposite strand. Thus,
      interaction with a particular helical structure as well as recognition of the
      bases in DNA appears important for efficient cleavage.

PMID- 1744135
TI  - Characterization and molecular cloning of a proenzyme form of a ribosome
      inactivating protein from maize. Novel mechanism of proenzyme activation by
      proteolytic removal of a 2.8-kilodalton internal peptide segment.
AB  - Ribosome-inactivating proteins (RIPs) are a widely distributed family of plant
      enzymes that are remarkably potent catalytic inactivators of eukaryotic protein
      synthesis. All RIPs described to date, including the A-chain of the plant
      cytotoxin ricin, are polypeptides of 25-32 kDa and share significant amino acid
      sequence homologies. We have characterized and cloned an RIP from maize (Zea
      mays). In contrast to previously described RIPs, we have found that maize RIP is
      synthesized and stored in the kernel as a 34-kDa inactive precursor (isoelectric
      point = 6.5). During germination, this neutral precursor is converted into a
      basic, active form (isoelectric point greater than 9) by limited proteolysis,
      which removes 25 amino acids (2.8 kDa) of net charge -6 from the center of the
      polypeptide chain. Additional processing also occurs at the amino and carboxyl
      termini of the polypeptide. The sequence of the internal processed region is
      unique and it is equivalent to an insertion centered around Thr-156 in the amino
      acid sequence of ricin toxin A-chain, i.e. in the center of the enzymatically
      active domain. The generation of an active enzyme by removal of a large amino
      acid segment from the middle of a precursor polypeptide chain represents a novel
      mechanism of proenzyme activation that is distinct from more conventional
      activation mechanisms involving NH2-terminal proteolytic processing. A two-chain
      active RIP (comprised of 16.5- and 8.5-kDa fragments that remain tightly
      associated) is produced from this processing event.

PMID- 1744136
TI  - Chronic ethanol exposure increases levels of protein kinase C delta and epsilon
      and protein kinase C-mediated phosphorylation in cultured neural cells.
AB  - Exposure to ethanol for several days increases the number and function of
      dihydropyridine-sensitive Ca2+ channels in excitable tissues. In the neural cell
      line PC12, this process is blocked by inhibitors of protein kinase C (PKC),
      suggesting that PKC mediates ethanol-induced increases in Ca2+ channels. We
      report that treatment with 25-200 mM ethanol for 2-8 days increased PKC activity
      in PC12 cells and NG108-15 neuroblastoma-glioma cells. Detailed studies in PC12
      cells showed that ethanol also increased phorbol ester binding and
      immunoreactivity to PKC delta and PKC epsilon. These changes were associated with
      increased PKC-mediated phosphorylation. Ethanol did not activate the enzyme
      directly, nor did ethanol increase levels of diacylglycerol. Ethanol-induced
      increases in PKC levels may promote up-regulation of Ca2+ channels, and may also
      regulate the expression and function of other proteins involved in cellular
      adaptation to ethanol.

PMID- 1744137
TI  - Characterization of trypsin-sensitive factor(s) required for endosome-endosome
      fusion.
AB  - Fusion of endosomes appears to be required at early steps of receptor-mediated
      endocytosis. These fusion events have been reconstituted using a cell-free assay
      and have been shown to require both cytosolic and membrane-associated proteins.
      We report here that trypsinization of endosomes completely inhibited fusion.
      Addition of untreated cytosol cannot restore fusion of trypsinized endosomes.
      However, fusion activity is restored by the addition of either untreated vesicles
      or a high salt extract containing peripheral membrane proteins (KE). KE contains
      both the membrane-associated factor(s) required for the reconstitution of fusion
      using trypsinized endosomes and the factors that are normally provided by the
      cytosol. The restorative activity of KE was sensitive to trypsin treatment or
      incubation at 100 degrees C, but was largely N-ethylmaleimide (NEM)-resistant.
      This and other criteria demonstrated that the trypsin-sensitive factor is
      distinct from N-ethylmaleimide-sensitive factor (NSF), an NEM-sensitive protein
      involved in vesicular fusion, and from other known factors that may participate
      in membrane fusion events. Preliminary fractionation studies indicate that the
      restorative activity of KE is associated with one or more high molecular weight
      proteins. The present study indicates that a novel trypsin-sensitive protein(s)
      is involved in endosome-endosome fusion. This factor is membrane-associated and
      is not found in an active form in cytosol as prepared.

PMID- 1744138
TI  - Type II collagen mRNA containing an alternatively spliced exon predominates in
      the chick limb prior to chondrogenesis.
AB  - A series of cDNA clones corresponding to the 5' end of the chicken type II
      collagen mRNA were generated using a single-sided polymerase chain reaction
      technique. Analysis of these cDNAs showed that the second exon of the gene is
      alternatively spliced such that it is either present or absent in the mRNA. This
      exon encodes a 70-amino acid cysteine-rich globular domain which is present in
      the amino-terminal propeptides of alpha 1(I), alpha 1(III), and alpha 2(V)
      procollagen chains but which was previously thought to be absent from type II
      procollagen. Analysis of the expression of the two alternatively spliced forms of
      the chicken type II collagen mRNA showed that the mRNA without the second exon
      was the predominant form (approximately 90%) in sternal cartilage from 14-day
      embryos, but in precartilage limb mesenchyme only the form including the second
      exon was detected. This later form was also present in a number of non-cartilage
      tissues including embryonic calvaria, skin, heart, skeletal muscle, and brain; no
      type II collagen mRNA was detected in liver. Studies of developing limbs from
      progressive embryonic stages suggest that the appearance of the mRNA lacking the
      second exon is a relatively late event during chondrogenesis.

PMID- 1744139
TI  - Ligand-induced internalization and increased cell calcium are mediated via
      distinct structural elements in the carboxyl terminus of the epidermal growth
      factor receptor.
AB  - Signals that can mediate ligand-induced receptor internalization and calcium
      regulation are present in a 48-amino acid "calcium-internalization" domain in the
      C' terminus of the epidermal growth factor (EGF) receptor. The basis of calcium
      and internalization regulation signalled by this 48-amino acid sequence was
      analyzed using deletion and substitution mutant receptors. Cells expressing
      truncated receptors containing either the NH2- or COOH-terminal portion of the 48
      residue domain displayed high affinity EGF-dependent endocytosis and receptor
      down-regulation. These endocytosis-competent EGF receptor mutants that lacked any
      autophosphorylation site were unable to increase the concentration of
      intracellular calcium. To investigate the role of self-phosphorylation in EGF
      induced calcium mobilization, phenylalanine was substituted for the single
      autophosphorylated tyrosine residue in this region of an internalization
      competent truncated receptor. The receptor-mediated calcium response was
      abolished, while ligand-dependent receptor internalization was unimpaired. These
      results demonstrate that EGF-dependent receptor endocytosis and calcium
      mobilization are separate events. Tyrosine self-phosphorylation is required for
      increased [Ca2+]i, while structural features distinct from autophosphorylation
      are required for receptor internalization.

PMID- 1744140
TI  - Protein kinase activity required for an early step in interferon-alpha signaling.
AB  - Interferon-alpha (IFN alpha) induces an immediate transcriptional response of a
      restricted set of genes in target cells. Specific transcription is mediated by
      the cytoplasmic activation of a transcription factor complex termed ISGF3. ISGF3
      is a multimeric protein complex composed of a regulatory component (ISGF3 alpha),
      which is activated following IFN alpha treatment, and a DNA-binding component
      (ISGF3 gamma), which recognizes the IFN alpha-stimulated response element (ISRE).
      Following activation, ISGF3 alpha translocates to the nucleus where ISGF3
      assembles as a high affinity complex on the ISRE. The biochemical basis for
      receptor-mediated activation of ISGF3 is unknown. We report that two potent
      protein kinase inhibitors, staurosporine and K-252a, ablated the transcriptional
      response to IFN alpha treatment. These inhibitors prevented the activation of the
      ISGF3 alpha component without affecting the ISGF3 gamma component, resulting in
      no accumulation of mature ISGF3 in nuclei of treated cells. Although these agents
      are potent inhibitors of protein kinase C (PKC), PKC does not mediate ISGF3 alpha
      activation. Down-regulation of PKC by chronic exposure of cells to 12-O
      tetradecanoylphorbol-13-acetate, which led to complete loss of PKC-immunoreactive
      material, failed to ablate the transcriptional response to IFN alpha or the
      activation of ISGF3 alpha. The PKC-specific inhibitor calphostin C did not
      perturb activation or nuclear accumulation of ISGF3. We conclude that a novel,
      staurosporine/K-252a-sensitive kinase is required for ISGF3 activity and may
      participate in receptor-mediated signal transduction.

PMID- 1744141
TI  - Study of the endoproteolytic cleavage of platelet glycoprotein IIb using
      oligonucleotide-mediated mutagenesis.
AB  - The precursor of platelet membrane glycoprotein IIb (GPIIb) undergoes
      endoproteolytic cleavage into heavy and light chains post-translation.
      Endoproteolysis occurs within a 17-amino acid stretch of the precursor that
      contains 4 arginine residues, 3 in dibasic sequences [Lys-Arg (855-856) and Arg
      Arg (858-859)] and a single arginine at 871. To determine the site of GPIIb
      cleavage and its role in the function of the glycoprotein IIb/IIIa heterodimer,
      we mutated arginine 856, the di-arginine sequence 858-859, and arginine 871 and
      coexpressed the mutants with glycoprotein IIIa (GPIIIa) in COS-1 cells. Each
      GPIIb mutant formed recombinant GPIIb-IIIa heterodimers, but mutants lacking
      arginine at 856 or 858-859 failed to undergo cleavage. Nevertheless, heterodimers
      containing the uncleaved GPIIb were expressed on the cell surface. Because
      endoproteolysis most often occurs after arginines in dibasic sequences, we next
      expressed GPIIb mutants containing lysine at 856 or aspartic acid at 855 with
      GPIIIa. Both mutants were cleaved and surface-expressed, indicating that the
      dibasic sequence at 858-859, but not at 855-856, is required for GPIIb cleavage.
      Lastly, we tested the function of GPIIb-IIIa containing uncleaved GPIIb by
      measuring adhesion of transfected cells to immobilized fibrinogen. We found no
      difference in the adhesion of cells expressing either wild-type or mutant GPIIb,
      indicating GPIIb-IIIa heterodimers containing uncleaved GPIIb maintain their
      ability to interact with fibrinogen.

PMID- 1744142
TI  - Regulation of integrin-type cell adhesion receptors by cytokines.
AB  - Integrin heterodimers which share a common beta 1 subunit are the major cellular
      receptors for many extracellular matrix proteins. Here, we show that two
      inflammatory mediators, interleukin-1 beta (IL-1 beta) and tumor necrosis factor
      alpha (TNF-alpha), can regulate the expression of the alpha 1 beta 1 integrin
      heterodimer, known to be a laminin and collagen receptor. In human skin
      fibroblasts 10 units/ml IL-1 beta increase the biosynthesis of the alpha 1
      integrin subunit an average of 4.5-fold. Furthermore, IL-1 beta can turn on alpha
      1 subunit expression in MG-63 human osteosarcoma cells even in conditions where
      the untreated MG-63 cells do not express it in detectable amounts. The effect of
      TNF-alpha on alpha 1 subunit expression is similar. Both IL-1 beta and TNF-alpha
      increased MG-63 cell adhesion on laminin. The effect of transforming growth
      factor-beta 1 (TGF-beta 1) on integrin expression in MG-63 cells has been
      previously described (Heino, J., and Massague, J. (1989) J. Biol. Chem. 264,
      21806-21811). TGF-beta 1 decreases the biosynthesis of alpha 3 subunit but
      increases the production of alpha 2 subunit. IL-1 beta potentiates the effects of
      TGF-beta 1. Furthermore, in the presence of TGF-beta 1 the increase in the
      expression of alpha 1 subunit by IL-1 beta is even larger. Thus, IL-1 beta and
      TGF-beta 1, which usually have antagonistic functions in connective tissue, can
      regulate integrin expression in a synergistic way.

PMID- 1744143
TI  - Thromboxane A2 synthase. Modification during "suicide" inactivation.
AB  - Thromboxane synthase is a ferrihemoprotein which undergoes mechanism-based
      inactivation during catalysis. This "suicide" process may be an important factor
      for limiting thromboxane A2 biosynthesis in cells. Although the kinetics have
      been characterized for purified enzyme and platelets, the chemical basis for
      inactivation has remained unclear. Protein modification or alteration of the heme
      prosthetic group is each compatible with the irreversible nature of suicide
      inactivation of thromboxane synthase. We have investigated these two
      possibilities using enzyme purified to homogeneity. Our data show that the Soret
      absorbance spectrum of thromboxane synthase is unaltered by additions of
      prostaglandin endoperoxide H2 which cause enzymatic inactivation. Using a coupled
      cyclooxygenase/thromboxane synthase system and polyacrylamide gel electrophoresis
      we have demonstrated that the enzyme retains radiolabel under nondenaturing gel
      conditions. Label incorporation is reduced by the competitive thromboxane
      synthase inhibitor U63557, an agent that also protects the enzyme from
      inactivation. Under denaturing conditions the radiolabel localizes with the
      released heme prosthetic group. In addition, interaction of the heme prosthetic
      group with cyanide was prevented by inactivating the enzyme with prostaglandin
      H2. In similar experiments, the lipid hydroperoxide 15(S)
      hydroperoxyeicosatetraenoic acid inactivated thromboxane synthase with concurrent
      bleaching of the Soret spectrum. Labeling studies with a coupled soybean
      lipoxygenase/thromboxane synthase system indicate that, in this case, the
      apoenzyme is modified. These results suggest that the mechanism of thromboxane
      synthase inactivation during thromboxane A2 biosynthesis involves a tight,
      nondestructive association of substrate or product with the prosthetic heme
      group. Inactivation by hydroperoxides, however, appears to result from apoenzyme
      modification. These reactions may have important implications for cellular
      physiology and pathophysiology of thrombosis.

PMID- 1744144
TI  - A novel family of progesterone-induced, retinol-binding proteins from uterine
      secretions of the pig.

PMID- 1744145
TI  - Pancreatic beta cells express two autoantigenic forms of glutamic acid
      decarboxylase, a 65-kDa hydrophilic form and a 64-kDa amphiphilic form which can
      be both membrane-bound and soluble.

PMID- 1744146
TI  - Three-dimensional acceleration of the tibia during walking and running.
AB  - Measurements of tibial acceleration during walking and running were obtained by
      means of a triaxial accelerometer. The accelerometer was fixed to the free end of
      a Steinmann pin inserted into the right tibia of one volunteer subject. The
      patterns of tibial acceleration showed little step-to-step variation within each
      experimental condition. Following foot strike and depending upon footwear, the
      resultant tibial acceleration reached between 2.7 and 3.7 g during walking. The
      tibia experienced maximal accelerations of 10.6 g during running. The high values
      of tibial acceleration recorded in the antero-posterior (AP) and medio-lateral
      (ML) directions clearly revealed the importance of measuring all three components
      of acceleration to quantify the magnitude of the shock experienced by the lower
      limbs during locomotor activities.

PMID- 1744147
TI  - The free moment of ground reaction in distance running and its changes with
      pronation.
AB  - Many running injuries are successfully treated with footwear modifications
      designed to reduce pronation, but the underlying mechanism of treatment is not
      well understood. Previous attempts to correlate reduction in pronation with
      changes in ground reaction parameters have been unsuccessful. In this study, the
      free moment of ground reaction (Mz') was measured for 10 rearfoot strikers
      running at 4.5 m s-1 in each of three different pairs of running shoes designed
      to vary the extent of pronation during ground contact. Mz' patterns were highly
      variable between feet, but were repeatable within a given foot/footwear
      combination. Mz' was greatest in magnitude during the first half of support, when
      it acted in a direction resisting foot abduction, a component of pronation. It
      was opposite in sign and smaller in magnitude during the last 30% of support. The
      peak magnitude and the net angular impulse of Mz' were both increased
      significantly with increases in pronation. A net ground reaction moment was also
      calculated about a vertical axis fixed in the shoe, and was used in a first
      approximation model of the shoe/ground interface to predict when the foot is most
      likely to ab/adduct during running. In conclusion, this study characterized the
      Mz' pattern for a well-defined group of runners, and found that Mz' is sensitive
      to relatively large within-subject changes in pronation.

PMID- 1744148
TI  - A piece-wise non-linear elastic stress expression of human and pig coronary
      arteries tested in vitro.
AB  - Eight human and nineteen pig unembalmed proximal left anterior descending and
      circumflex coronary arteries were subjected to linear volume changes (2 s ramp
      time) at three fixed axial extensions while immersed in a physiological saline
      bath at body temperature. Measured parameters included: lumen pressure, outside
      diameter, axial force, and axial extension. The deformations were measured using
      a video dimensional analyzer. The arteries were inflated to pressures well above
      the physiological range at each axial extension. A latex inner tube was placed
      inside of each specimen to prevent leakage, and its effects upon the measured
      stresses were corrected analytically. With this method, the average
      circumferential and axial stresses could be computed directly from the
      experimental data. In both directions the average stresses measured displayed two
      distinct regions: stresses occurring for small diameter changes (physiological
      pressures) and stresses occurring for large diameter changes (high pressures).
      The resulting average small strain and large strain stress components were curve
      fit separately and, when reassembled, provided a piece-wise model of the stress
      response of coronary arteries over a wide range of inflation pressures and axial
      extensions.

PMID- 1744149
TI  - A microstructurally-based finite element model of the incised human cornea.
AB  - A mechanical model of the human cornea is proposed and employed in a finite
      element formulation for simulating the effects of surgical procedures, such as
      radial keratotomy, on the cornea. The model assumes that the structural behavior
      of the cornea is governed by the properties of the stroma. Arguments based on the
      microstructural organization and properties of the stroma lead to the conclusion
      that the human cornea exhibits flexural and shear rigidities which are negligible
      compared to its membrane rigidity. Accordingly, it is proposed that to a first
      approximation, the structural behavior of the cornea is that of a thick membrane
      shell. The tensile forces in the cornea are resisted by very fine collagen
      fibrils embedded in the ground substance of the stromal lamellae. When the
      collagen fibrils are cut, as in radial keratotomy, it is argued that they become
      relaxed since there is negligible transfer of load between adjacent fibrils due
      to the low shear modulus of the ground substance. The forces in the cornea are
      then resisted only by the remaining uncut fibrils. The cutting of fibrils induces
      an anisotropy and inhomogeneity in the membrane rigidity. By assuming a uniform
      angular distribution of stromal lamellae through the corneal thickness, geometric
      arguments lead to a quantitative representation for the anisotropy and
      inhomogeneity. All material behavior is assumed to be in the linear elastic
      regime and with no time-dependency. The resulting constitutive model for the
      incised cornea has been employed in a geometrically non-linear finite element
      membrane shell formulation for small strains with moderate rotations. A number of
      numerical examples are presented to illustrate the effectiveness of the proposed
      constitutive model and finite element formulation. The dependence of the outcome
      of radial keratotomy, measured in terms of the immediate postoperative shift in
      corneal power, on a number of important factors is investigated. These factors
      include the value of the elastic moduli of the stromal lamellae (dependent on the
      patient's age), the incision depth, the optic zone size, the number of incisions
      and their positions, and the intraocular pressure. Results have also been
      compared with expected surgical corrections predicted by three expert surgeons
      and show an excellent correspondence.

PMID- 1744150
TI  - Determination of biomechanical characteristics of restrictive adhesions and of
      functional impairment after flexor tendon surgery: a methodological study of
      rabbits.
AB  - Formation of restrictive adhesions is one of the main obstacles in rehabilitation
      following hand surgery. Most experimental work, however, involves only a
      macroscopic and/or histologic evaluation of the amount of adhesions, and their
      functional characteristics are poorly described. The aim of this study was to
      develop an experimental technique for characterization of the biomechanical
      properties of the finger-tendon unit. An instrument was developed for continuous
      and simultaneous recording of tensile load, tendon excursion and angular rotation
      in the distal interphalangeal joint of rabbit digits. Utilizing this instrument,
      it was revealed that the first 50 degrees of flexion required virtually no
      tensile load either in unoperated digits or immediately after tenorrhaphy.
      Thereafter, the load required to obtain further flexion was progressively
      increased. The strength of adhesions, determined 2 weeks after tenorrhaphy, was
      best expressed as the maximum tensile load recorded before 50 degrees of flexion
      was reached. This measurement could also be used to register the strength of the
      tendon repair and to detect partial tendon rupture during the measurement. The
      technique allows both adequate measurements of the strength of the adhesions and
      of the tendon gliding ability after flexor tendon surgery.

PMID- 1744151
TI  - A geometric theory of the equilibrium mechanics of fibers in ligaments and
      tendons.
AB  - This paper presents a theoretical analysis of the equilibrium mechanics of
      bending and twisting fiber geometries in ligaments and tendons. The theory
      predicts that the bending of loaded fibers is necessarily accompanied by large
      transverse pressures and pressure gradients. The predicted pressures are
      especially large at the bone tunnel entries of ligament grafts, where they can
      equal or exceed the applied tensile loads. Experimental measurements of internal
      pressures confirm these predictions.

PMID- 1744152
TI  - Thoracic injury potential of basic competition taekwondo kicks.
AB  - A major concern in competition taekwondo is the injury potential posed by many of
      the powerful kicks used. An investigation of the kinetics of four kicks
      frequently used in competition was performed with high speed video. Velocities
      were measured, and energy was calculated. Typical values for basic swing kicks
      were 15 ms-1 and 200 J. Basic thrust kicks possessed 45% less velocity but 28%
      more energy than swing kicks. Linkage models were developed to simulate the
      motion and kinetics of the kicking leg. Injury potential was evaluated through
      thoracic compression and viscous criterion models. These models predict a
      significant probability of serious injury with all kicks, with thoracic
      deflections from 3 to 5 cm and peak viscous tolerance values from 0.9-1.4 ms-1,
      when no protective body equipment is used.

PMID- 1744153
TI  - A novel approach to the distortion assessment of denture impression trays.
AB  - A novel method to treat and interpret distortion of denture impression trays has
      been proposed. When compared with the conventional method this approach, based on
      the general least squares principle, offers a significant advantage since the
      displacement for each individual point can be traced providing more profound
      insight into the character of the overall deformation itself. The method was
      applied to study dental impression trays manufactured of self-curing acrylic. The
      results indicate the existence of a large degree of individuality and non-uniform
      behaviour of a specific tray material. The method developed here can be applied
      to specimens of any arbitrary size and shape and it is not limited by the number
      of the reference points.

PMID- 1744154
TI  - On the estimation of joint kinematics during gait.
AB  - In gait analysis, the concepts of Euler and helical (screw) angles are used to
      define the three-dimensional relative joint angular motion of lower extremities.
      Reliable estimation of joint angular motion depends on the accurate definition
      and construction of embedded axes within each body segment. In this paper, using
      sensitivity analysis, we quantify the effects of uncertainties in the definition
      and construction of embedded axes on the estimation of joint angular motion
      during gait. Using representative hip and knee motion data from normal subjects
      and cerebral palsy patients, the flexion-extension axis is analytically perturbed
      +/- 15 degrees in 5 degrees steps from a reference position, and the joint angles
      are recomputed for both Euler and helical angle definitions. For the Euler model,
      hip and knee flexion angles are relatively unaffected while the ab/adduction and
      rotation angles are significantly affected throughout the gait cycle. An error of
      15 degrees in the definition of flexion-extension axis gives rise to maximum
      errors of 8 and 12 degrees for the ab/adduction angle, and 10-15 degrees for the
      rotation angles at the hip and knee, respectively. Furthermore, the magnitude of
      errors in ab/adduction and rotation angles are a function of the flexion angle.
      The errors for the ab/adduction angles increase with increasing flexion angle and
      for the rotation angle, decrease with increasing flexion angle. In cerebral palsy
      patients with flexed knee pattern of gait, this will result in distorted
      estimation of ab/adduction and rotation. For the helical model, similar results
      are obtained for the helical angle and associated direction cosines.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1744155
TI  - Skin carcinogenesis in man and in experimental animals. International Symposium.
      October 29-31, 1991, Heidelberg, Germany. Abstracts.

PMID- 1744156
TI  - Cancer of unknown primary site.

PMID- 1744157
TI  - Pineal melatonin inhibition of tumor promotion in the N-nitroso-N-methylurea
      model of mammary carcinogenesis: potential involvement of antiestrogenic
      mechanisms in vivo.
AB  - The N-methyl-N-nitrosourea (NMU) model of hormone-responsive rat mammary
      carcinogenesis was used to address the hypothesis that melatonin (Mel), the
      principle hormone of the pineal gland, inhibits tumorigenesis by acting as an
      anti-promoting rather than an anti-initiating agent. Daily late-afternoon
      injections of Mel (500 micrograms/day), restricted to the initiation phase of NMU
      mammary tumorigenesis, were ineffective in altering tumor growth over a 20-week
      period. When Mel treatment was delayed for 4 weeks after NMU and then continued
      through the remainder of the promotion phase, only tumor number was significantly
      lower than in controls. However, when Mel injections encompassed the entire
      promotion phase, both tumor incidence and number were significantly lower than in
      the controls. Although elimination of the endogenous Mel signal via pinealectomy
      promoted tumor growth, the effect was not statistically significant. Serum levels
      of estradiol and tumor estrogen receptor content were unaltered by either Mel or
      pinealectomy. While Mel treatment failed to affect circulating prolactin levels,
      pinealectomy caused a two-fold increase in serum prolactin. The estradiol
      stimulated recrudescence of tumors following ovariectomy was completely blocked
      by either 20, 100 or 500 micrograms Mel/day or tamoxifen (20 micrograms/day).
      Thus, Mel appears to be an anti-promoting hormone that may antagonize the tumor
      promoting actions of estradiol in this model of mammary tumorigenesis.

PMID- 1744158
TI  - Tumorigenicity, invasion, and metastasis of human gastric cancer in nude mice.
AB  - Tumors derived from 105 patients with gastric cancer were subcutaneously
      heterotransplanted into nude mice in order to study their tumorigenicity and
      malignant behavior. Of the 105 gastric cancers, 45 were successfully transplanted
      (a 42.9% tumorigenesis rate). The tumorigenesis rate of Borrmann type 1 and 2
      cancers (77.8%) was significantly higher than that of type 3 and 4 cancers
      (34.6%). Also, the tumorigenesis rate of differentiated carcinoma (57.1%) was
      significantly higher than that of undifferentiated carcinoma (30.9%). Spontaneous
      metastases from the subcutaneous tumors were observed in 5 of the 37 established
      tumor lines (13.5%), and macroscopic pulmonary metastases were common with one
      tumor line (SCK-29). Although most of the subcutaneous gastric cancers showed
      local expansion without distant metastasis, the same tumor cells implanted into
      the peritoneal cavity exhibited invasive growth and/or metastasis. Thus, the
      expression of a metastatic phenotype by human gastric cancer was influenced by
      the host microenvironment. The SCK-29 tumor line with its high metastatic
      potential may be useful for studies on the mechanism of blood-borne metastasis.

PMID- 1744159
TI  - Karyotypic change from heteroploidy to near diploidy associated with development
      of cisplatin resistance in a rat ovarian tumour cell line.
AB  - In a rat ovarian tumour cell line a 33-fold resistance to cisplatin (O-342/DDP)
      was developed in vitro by continuous exposure of the parental cell line (O-342)
      to stepwise increase cisplatin concentration in the culture medium. Both cell
      lines had a similar growth rate in vitro. Development of resistance was
      accompanied by a change of the karyotype from heteroploidy in chemosensitive O
      342 cells to near diploidy in resistant O-342/DDP cells as shown by chromosome
      number distribution. This finding was confirmed by measuring cellular DNA content
      using flow-cytometry analysis. Flow karyotyping showed significant differences in
      chromosomal DNA contents between both cell lines. Our results suggest that the
      parent line O-342 consists of at least two subpopulations, a cisplatin-sensitive
      and a cisplatin-resistant one, corresponding to hyperploidy and near diploidy,
      respectively. Continuous cisplatin exposure of O-342 cells selectively killed the
      sensitive fraction, resulting in the karyotypic change observed.

PMID- 1744160
TI  - Influence of recombinant tumour necrosis factor alpha on blood flow and antibody
      localisation in human tumour xenografts in nude mice.
AB  - Mice with s.c. grafts of gastric carcinoma MKN45 or osteosarcoma 788T were
      injected i.v. with recombinant tumour necrosis factor alpha (rTNF alpha) and
      tumour blood flow rates were determined 4 h later as a fraction of the cardiac
      output g tissue-1. With MKN45, the tumour blood flow rate was significantly
      reduced from a mean of 1.86% cardiac output g-1 to 0.84% and 0.65% with 50 and
      200 micrograms kg-1 rTNF alpha respectively. With 788T, the tumour blood flow
      rate was reduced at 50 micrograms kg-1 rTNF alpha from 1.13% cardiac output g-1
      to 0.56%. There were essentially no changes in blood flow rates in other organs.
      The effect of rTNF alpha on localisation of monoclonal antibodies into these
      xenografts were examined. When a single dose of rTNF alpha (50 micrograms kg-1)
      was given at the same time as labelled NCRC-2 antibody there was a significant
      reduction in localisation into 788T osteosarcoma xenografts. In other tests, mice
      were injected daily for 3 days with 50 micrograms kg-1 rTNF alpha. They were
      injected i.v. with monoclonal antibody 4 h after the first injection and
      dissected on the 4th day. With 788T there was a small but not statistically
      significant reduction in the absolute amount of NCRC-2 antibody localising in
      tumour, although this reduction was greater when results were expressed as tumour
      to-blood ratios. With MKN45 xenografts, treatment with rTNF alpha had little
      effect on tumour localisation of an anti-(carcinoembryonic antigen) monoclonal
      antibody (NCRC-24). These studies show that TNF can be administered so as to
      reduce tumour blood flow and with little effect on tumour localisation of
      antibody, suggesting that combination therapy with TNF and antibodies or their
      immunoconjugates is feasible. Other studies have suggested that TNF can increase
      antibody localisation into tumours, but this was not seen here, and in some cases
      administration could reduce tumour localisation. It appears that this method of
      enhancing antibody localisation may be critically dependent on scheduling, and
      therefore it may not be extensively applicable.

PMID- 1744161
TI  - Prostatic atrophy in dogs after intravenous administration of a ureido
      ethylimidazoline derivative (CGP15'720A).
AB  - 1-(2-[4-Pridyl)-2-imidazoline-1-yl]-ethyl)-3-(4-carboxyphenyl)urea (CGP15'720A)
      is an experimental antineoplastic agent with marked activity against carcinogen
      induced lung tumors in Syrian hamsters and human lung tumor xenografts in nude
      mice. A preclinical toxicity study of this agent was carried out in mice and dogs
      which demonstrated the relatively nontoxic nature of the agent. In mice, single
      intraperitoneal dosage of 12 g/m2 did not produce lethality; however, lethality
      (30% of treated mice) was seen during treatment with 6 g/m2 daily for 5 days. No
      hematological, serum-chemistry or histopathological changes were detected in mice
      after single or five consecutive treatments with 12 g/m2. Dogs were treated with
      doses ranging from 5 g/m2 to 80 g/m2, with deaths occurring in a non-dose-related
      fashion after 10, 20, and 40 g/m2. Acute neurological toxicity after infusion was
      the dose-limiting toxicity in dogs. There were no consistent hematological or
      serum-chemistry aberrations in the treated dogs. The most consistent
      histopathological finding was prostatic atrophy, which was detected in 5/12 dogs
      in this series.

PMID- 1744162
TI  - Killing of Burkitt-lymphoma-derived Daudi cells by ultraviolet-inactivated
      vaccinia virus.
AB  - Interaction of active and UV-inactivated vaccinia virus at high multiplicity
      caused cytological changes and inhibition in cellular protein and DNA synthesis,
      thus arresting the multiplication of Burkitt-lymphoma-derived Daudi cells and
      eventually killing the cells. Adsorption to the cells but the lack of penetration
      was evident by immunofluorescence, electron microscopy and [3H]thymidine-labeled
      virus incorporation. Viral DNA synthesis or virus replication was not
      demonstrated. Thus, it appears that the massive adsorption of viral particles,
      active or UV-inactivated, or possibly a "toxic" component that resides in the
      virion, damages the plasma membrane and may be responsible for killing the cells
      by a mechanism of lysis from without.

PMID- 1744163
TI  - The heterogeneity of solid human xenotransplant tumours.
AB  - Fifteen xenograft tumour lines (4 osteosarcomas and 11 squamous carcinomas) were
      established on nude mice in numerous passages. Over a period of 4 years, samples
      were taken and studied systematically in more than 4000 histological slides. Of
      the tumour lines, 12 (4 osteosarcomas and 8 squamous carcinomas) showed
      remarkable dedifferentiation, but also redifferentiation towards a higher grade.
      There was a correlation between the rate of tumour takes in mice and poor
      prognosis in patients, but none between tumour doubling time and the phases of
      the cell cycle. Altogether, the results showed a great heterogeneity of human
      xenotransplants in terms of biological behaviour and morphological changes.

PMID- 1744164
TI  - Effects of an androgenic derivative on pre-established mammary tumours chemically
      induced in the rat.
AB  - The effects were studied of an androgenic derivative--danazol--administered at
      doses of 10-12 mg kg-1 day-1 during 97 days to rats with dimethylbenz[a]
      anthracene-induced mammary tumours. Our main observations were as follows. (a)
      Danazol did not influence ovarian function at the end of the assay. (b) The
      treatment with danazol reduced the incidence (P less than 0.05), number of
      tumours (P less than 0.05) and volume of malignant mammary tumours; on the other
      hand, the values of these parameters for benign tumours and those of doubtful
      expression were similar in both experimental groups. (c) Such differential action
      of Danazol seems to be due to the different incidence and/or content of receptors
      of both types of tumours. (d) The latter results lead to a hypothesis for the
      mechanism of action of danazol based on its behaviour at different levels.

PMID- 1744165
TI  - Production of interleukin-1 beta and tumour necrosis factor-alpha in patients
      with benign or malignant ovarian tumours.
AB  - To assess the role of interleukin-1 beta (IL-1 beta) and tumour necrosis factor
      alpha (TNF alpha) in the physiological host defence mechanisms against
      malignancies, the production of these cytokines in sera, ascitic and cyst fluids
      and in the tumour tissues of patients with benign or malignant ovarian tumours
      was studied. IL-1 beta was found neither in the sera nor in the ascitic fluids of
      these patients. It was also virtually absent from the cyst fluid samples.
      However, a mean value of 790 pg IL-1 beta/g tumour was found. Like IL-1 beta, TNF
      alpha was virtually absent in the serum samples. It was, however, detectable in
      the ascitic and cyst fluids and tumour tissues. The TNF alpha concentrations were
      highest in the tumour tissues, with a mean level of 328 pg/g tumour. When
      comparing the level of IL-1 beta and TNF alpha in patients with benign tumours to
      that seen in patients with malignant tumours, no differences in production were
      observed, regardless of the origin of the test samples. Our results indicate the
      production of IL-1 beta and TNF alpha in patients with ovarian tumours. More
      importantly, the finding that the production of these cytokines in patients with
      benign tumours is similar to that in patients with malignant tumours supports the
      conclusion that the production of these cytokines is more a nonspecific indicator
      of an inflammatory process than a specific response to a malignant process.

PMID- 1744166
TI  - Effects of radiation fractionation on four squamous cell carcinoma lines with
      dissimilar inherent radiation sensitivity.
AB  - The effect of radiation fractionation was investigated using a new 96-well-plate
      clonogenic assay in four squamous cell carcinoma lines. Earlier experiments had
      shown that two of the cell lines (UT-SCC-1A and UM-SCC-14A) were inherently
      relatively sensitive to irradiation, and two (UM-SCC-1 and UM-SCV-1A) relatively
      resistant. All of the four carcinomas from which the cell lines were established
      had poor clinical outcome. The radiation doses were given as a single exposure,
      or split into two or three equal fractions with a 24-h interval. The two
      inherently sensitive cell lines showed enhanced survival after radiation
      fractionation as compared with a single dose, whereas the resistant cell lines
      did not. The result suggests that both the inherent resistance of cancer cells to
      irradiation and the repair of sublethal radiation damage may lead to treatment
      failure, and that shortening of the total irradiation time may overcome cancer
      cell recovery between fractions in some, but not in all carcinomas.

PMID- 1744167
TI  - Histological and immunohistochemical findings of prostatic carcinoma after
      external or interstitial radiotherapy.
AB  - In a retrospective study, the extent of reactions of different types of prostatic
      carcinomas to external or interstitial radiotherapy was compared with reactions
      to hormonal therapy. It is shown that prostatic carcinomas of different grades of
      differentiation can be divided into two main subgroups with distinctly different
      survival rates; i.e., prostatic carcinomas grades of malignancy Ib/IIa and grades
      IIb/III. Within an observation time of 10 years, the prostatic carcinoma grade of
      malignancy Ib/IIa shows a good response to external and interstitial
      radiotherapy. None of the patients died of the prostatic carcinoma. In the more
      poorly differentiated prostatic carcinomas, 2 out of 11 patients with external
      radiotherapy died of the carcinoma. The death rates from disease after hormonal
      therapy were higher, and the survival times were very short without therapy.
      Regressive changes are much more distinctly expressed in the better
      differentiated carcinoma group. Differential diagnostic difficulties between
      regressive changes in carcinomatous glands and normal glands could be resolved by
      immunohistochemical proof of high-molecular-mass cytokeratin in basal cells.

PMID- 1744168
TI  - The role of insulin-related substance in Hodgkin's disease.
AB  - An insulin-related growth-promoting substance was detected in the serum of a
      patient with Hodgkin's disease who suffered from severe hypoglycaemia, as well as
      in the supernatant of homogenized spleen tissue of the same patient. Low
      concentrations of this substance enhanced DNA synthesis of short-term-cultured
      spleen tumour cells obtained from the same patient, while the addition of anti
      insulin antiserum interfered with that effect. Moreover, the preincubation of
      this insulin-related substance with the anti-insulin antiserum abrogated its
      stimulatory effect on tumour cell proliferation. Both insulin and the insulin
      related substance bound to patients splenocytes to a similar extent. The data
      suggest that the insulin-related substance, found in this particular case of
      Hodgkin's disease, plays a role in tumour progression by an autocrine mechanism.

PMID- 1744169
TI  - Hydrogen peroxide-induced oxidative stress to the mammalian heart-muscle cell
      (cardiomyocyte): lethal peroxidative membrane injury.
AB  - Oxidative stress induced by hydrogen peroxide (H2O2) may contribute to the
      pathogenesis of ischemic-reperfusion injury in the heart. For the purpose of
      investigating directly the injury potential of H2O2 on heart muscle, a cellular
      model of H2O2-induced myocardial oxidative stress was developed. This model
      employed primary monolayer cultures of intact, beating neonatal-rat
      cardiomyocytes and discrete concentrations of reagent H2O2 in defined, supplement
      free culture medium. Cardiomyocytes challenged with H2O2 readily metabolized it
      such that the culture content of H2O2 diminished over time, but was not depleted.
      The consequent H2O2-induced oxidative stress caused lethal sarcolemmal disruption
      (as measured by lactate dehydrogenase release), and cardiomyocyte integrity could
      be preserved by catalase. During oxidative stress, a spectrum of cellular
      derangements developed, including membrane phospholipid peroxidation, thiol
      oxidation, consumption of the major chain-breaking membrane antiperoxidant (alpha
      tocopherol), and ATP loss. No net change in the protein or phospholipid contents
      of cardiomyocyte membranes accompanied H2O2-induced oxidative stress, but an
      increased turnover of these membrane constituents occurred in response to H2O2.
      Development of lethal cardiomyocyte injury during H2O2-induced oxidative stress
      did not require the presence of H2O2 itself; a brief "pulse" exposure of the
      cardiomyocytes to H2O2 was sufficient to incite the pathogenic mechanism leading
      to cell disruption. Cardiomyocyte disruption was dependent upon an intracellular
      source of redox-active iron and the iron-dependent transformation of internalized
      H2O2 into products (e.g., the hydroxyl radical) capable of initiating lipid
      peroxidation, since iron chelators and hydroxyl-radical scavengers were
      cytoprotective. The accelerated turnover of cardiomyocyte-membrane protein and
      phospholipid was inhibited by antiperoxidants, suggesting that the turnover
      reflected molecular repair of oxidized membrane constitutents. Likewise, the
      consumption of alpha-tocopherol and the oxidation of cellular thiols appeared to
      be epiphenomena of peroxidation. Antiperoxidant interventions coordinately
      abolished both H2O2-induced lipid peroxidation and sarcolemmal disruption,
      demonstrating that an intimate pathogenic relationship exists between sarcolemmal
      peroxidation and lethal compromise of cardiomyocyte integrity in response to H2O2
      induced oxidative stress. Although sarcolemmal peroxidation was causally related
      to cardiomyocyte disruption during H2O2-induced oxidative stress, a
      nonperoxidative route of H2O2 cytotoxicity was also identified, which was
      expressed in the complete absence of cardiomyocyte-membrane peroxidation. The
      latter mode of H2O2-induced cardiomyocyte injury involved ATP loss such that
      membrane peroxidation and cardiomyocyte disruption on the one hand and cellular
      de-energization on the other could be completely dissociated.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1744170
TI  - Calcium transport by sarcoplasmic reticulum of vascular smooth muscle: I. MgATP
      dependent and MgATP-independent calcium uptake.
AB  - The components of 45calcium (Ca) uptake were studied in saponin skinned rat
      caudal artery. The steady-state Ca content increased when the free Ca
      concentration was varied from 10(-8) to 10(-4) M but was reduced by azide when
      the free Ca concentration exceeded 3.1 microM. The azide sensitivity and low
      affinity for Ca were consistent with functional mitochondria. The azide
      insensitive component consisted of a small bound and a larger releasable Ca
      fraction. After skinning in Triton X-100, approximately 4 mumol Ca/kg wet tissue
      remained, which represented a tightly bound but slowly exchangeable Ca pool. The
      Ca content was independent of the free Ca concentration and MgATP, and it was not
      released with A-23187 or Ca. The Ca content of the larger fraction was a higher
      order function of the free Ca concentration and was released with A-23187,
      indicating it resided within a membrane-bounded structure. Ca uptake by the
      releasable fraction was increased by oxalate, MgATP, phosphocreatine,
      temperature, phosphate, and ruthenium red and represents Ca sequestered by the
      sarcoplasmic reticulum (SR) with little contribution from other Ca binding or
      storage sites. It is described by the coefficients Umax = 96.94 mumol/kg wet
      tissue, K1/2 = 0.75 microM, and Hill coefficient = 1.70. The SR in this
      preparation regulates cytosolic Ca concentrations under physiological conditions
      and can accumulate Ca by MgATP-dependent and MgATP-independent process. The
      larger, MgATP-dependent Ca uptake is described by the coefficients Umax = 72.87
      mumol/kg wet tissue, K1/2 = 0.8 microM, and Hill coefficient = 2.09 and is
      consistent with Ca sequestered by the Ca-transport ATPase of smooth muscle SR.
      The smaller, MgATP-independent uptake is described by the coefficients Umax =
      24.14 mumol/kg wet tissue, K1/2 = 0.56 microM, and Hill coefficient = 1.01 and
      represents Ca sequestered by an unidentified mechanism or by a subpopulation of
      SR.

PMID- 1744171
TI  - Inhibition of protein synthesis and heat protection: histidinol-resistant mutant
      cell lines.
AB  - The mechanism of histidinol (HST)-induced heat protection was investigated to
      test the hypothesis that the cessation of protein synthesis itself is one of the
      events involved in heat protection. For this study, we isolated three HST
      resistant mutant strains. HST (5 mM), which inhibited protein synthesis by 88% in
      the wild type, caused only 0, 9, and 25% inhibition in three mutants,
      respectively. The drug, which afforded heat protection, (i.e., a 125-fold
      increase in survival from 4 x 10(-3) to 5 x 10(-1) after 2 hr at 43 degrees C in
      wild type), did not protect mutant cells from heat killing. In contrast,
      cycloheximide (10 micrograms/ml) which inhibited protein synthesis by 95% in both
      wild type and mutant cell types, protected both cell types from heat killing.
      Therefore, these results suggest that the cessation of protein synthesis, per se,
      preventing synthesis of nascent polypeptides, is a major event leading to heat
      protection.

PMID- 1744172
TI  - Stimulation of large proteoglycan synthesis in cultured smooth muscle cells from
      pig aorta by endothelial cell-conditioned medium.
AB  - We have previously shown (Berrou et al., J. Cell. Phys., 137:430-438, 1988) that
      porcine endothelial cell-conditioned medium (ECCM) stimulates proteoglycan
      synthesis by smooth muscle cells from pig aorta. ECCM stimulation requires
      protein cores for glycosaminoglycan chain initiation and is accompanied by an
      increase in the hydrodynamic size of proteoglycans secreted into the medium. This
      work investigates the mechanisms involved in the ECCM effect. 1) Control and ECCM
      stimulated proteoglycan synthesis (measured by a 20 min [35S]-sulfate labeling
      assay) was not inhibited by cycloheximide, indicating that the proteoglycans were
      composed of preexisting protein cores and that ECCM stimulates glycosylation of
      these protein cores. 2) Whereas ECCM stimulation of [35S]-methionine
      incorporation into secreted proteins only occurred after a 6 h incubation, the
      increase in [35S] methionine-labeled proteoglycans was observed after 1 h, and
      the increase was stable for at least 16 h. 3) As analysed by electrophoresis in
      SDS, chondroitinase digestion generated from [14C] serine-labeled proteoglycans 7
      protein cores of high apparent molecular mass (550-200 kDa) and one of 47 kDa.
      The two protein cores of highest apparent molecular masses (550 and 460 kDa), but
      not the 47 kDa protein cores, showed increased [14C]-serine incorporation in
      response to ECCM (51%, as measured by Sepharose CL-6B chromatography). 4)
      Finally, incorporation of [35S]-sulfate into chondroitinase-generated
      glycosaminoglycan linkage stubs on protein cores was determined by Sepharose CL
      6B chromatography: ECCM did not modify the ratio [35S]/[14C] in stimulated
      protein cores, indicating that ECCM did not affect the number of
      glycosaminoglycan chains. The results of these studies reveal that 1) endothelial
      cells secrete factor(s) that preferentially stimulate synthesis of the largest
      smooth muscle cell proteoglycans without structural modifications and 2) the
      stimulation proceeds via increased glycosylation of protein core through
      enhancement of xylosylated protein core, followed by enhanced protein synthesis.

PMID- 1744173
TI  - Sheep amniotic fluid has a protein factor which stimulates human fibroblast
      populated collagen lattice contraction.
AB  - Sutured incisional wounds made in fetal sheep and rabbits heal without scarring.
      Fetal sheep excisional wounds can close by contraction, but those in fetal
      rabbits do not. In vivo and in vitro evidence suggests that rabbit amniotic fluid
      inhibits wound contraction. The question arises: does sheep amniotic fluid
      promote wound contraction because their fetal wounds close by contraction? Sheep
      amniotic fluid (SAF) from 100 and 125 days gestation was tested in fibroblast
      populated collagen lattice (FPCL) system, an in vitro model of wound contraction.
      SAF stimulated FPCL contraction in a dose responsive manner. SAF from a 100 day
      fetus was more stimulating than a 125 day SAF. SAF enhanced FPCL contraction in
      the presence or absence of serum. SAF was fractionated by size, using column
      chromatography. It yielded a fraction with an estimated molecular weigh near
      40,000 daltons, which stimulated FPCL contraction. The factor was inactivated by
      proteolytic digestion and heat denaturation. This protein fraction which
      stimulates FPCL contraction is not related to 1) actin-myosin filaments enhanced
      contraction by ATP-induced cell contraction, 2) promotion of fibroblast
      elongation on glass surface or in collagen, or 3) increased cell number by
      enhanced fibroblast duplication in a collagen matrix. A mechanism for SAF
      promotion of FPCL contraction was investigated but not identified.

PMID- 1744174
TI  - Characterization of spleen colonies derived from mice with mutations at the W
      locus.
AB  - Mice with mutations at the W locus have a hemopoietic stem cell defect
      characterized by an apparent deficiency of spleen colony forming cells (CFU-S).
      In the present report, we provide evidence that mutant cells form colonies and we
      compare the characteristics of the colonies derived from mutant and normal cells.
      To perform the colony-derivation studies, marrow cells were transferred into
      lethally irradiated congenic hosts that differed from the donors in the
      ubiquitous genetic marker, glucose phosphate isomerase (GPI-1). Donor GPI-1
      comprised over 50% of the marker in the host spleen and marrow by 12 days post
      injection, regardless of whether the donor was mutant or normal. To characterize
      the colonies, serially sectioned host spleens were examined microscopically.
      Colonies are present by 8 days post-transplantation regardless of donor genotype,
      but mutant colonies are distinctly different from normal colonies. The proportion
      of blast and granulocyte colonies is always greater in W/Wv than in +/+
      recipients. Unlike the W/Wv donors, the +/+ donors generate primarily erythrocyte
      colonies at 8, 10, and 14 days and mixed colonies at 12 days post-injection.
      Colonies from the mutant mice are generally smaller but visible colonies do
      appear by 12 days. The results are consistent with the notion that the anemia in
      W/Wv mice is caused by the early restriction of differentiating cells to a non
      erythrocyte lineage accompanied by the delayed amplification of mutant
      hemopoietic cells. Whether this means erythrocyte-committed cells are absent or
      are present but unable to respond to the appropriate cytokines is not possible to
      determine from the current experiments.

PMID- 1744175
TI  - Depolarization of the membrane potential decreases the ATP-induced influx of
      extracellular Ca2+ and the refilling of intracellular Ca2+ stores in rat thyroid
      FRTL-5 cells.
AB  - The aim of the present study was to investigate the effect of membrane
      depolarization on ATP-induced changes in intracellular Ca2+ ([Ca2+]i) and the
      refilling of intracellular Ca2+ stores in thyroid follicular FRTL-5 cells.
      Depolarizing the cells with 50 mM K+, an amount sufficient to almost totally
      depolarize the cells as determined by bisoxonal, significantly reduced the ATP
      induced uptake of 45Ca2+. This effect was not dependent on an enhanced efflux of
      Ca2+, as no difference in the ATP-induced efflux of 45Ca2+ was obtained between
      control cells and depolarized cells. The ATP-induced transient increase in
      [Ca2+]i in Fura-2 loaded cells was not altered by depolarization, whereas the ATP
      induced plateau in [Ca2+]i was decreased compared with control cells.
      Furthermore, in cells stimulated with ATP in a Ca(2+)-free buffer, readdition of
      Ca2+ after the termination of the ATP response induced a decreased response in
      [Ca2+]i in depolarized cells. Refilling of intracellular Ca2+ stores was
      investigated by first stimulating the cells with noradrenaline (NA). The effect
      of NA was then terminated with prazosin, and the cells restimulated with ATP. In
      cells depolarized with high K+, the response to ATP was decreased compared with
      that seen in control cells. The results thus suggest that both the ATP-induced
      influx of extracellular Ca2+ and the refilling of intracellular Ca2+ stores is
      decreased in depolarized FRTL-5 cells.

PMID- 1744176
TI  - Na+/K+/Cl- cotransport is stimulated by a Ca(++)-calmodulin-mediated pathway in
      BALB/c 3T3 fibroblasts.
AB  - In the present study, we investigated the role of intracellular Ca++ in the
      stimulation of the Na+/K+/Cl- cotransport in synchronized BALB/c 3T3 cells. The
      Na+/K+/Cl- cotransport was stimulated by the growth factors EGF, TGF-alpha, IGF
      1, and IGF-2, which do not activate protein kinase C, but do induce a transient
      increase in free cytoplasmic Ca++. In addition, direct activation of protein
      kinase C by the phorbol ester 12-O-tetradecanoyl-phorbol-13-acetate (TPA) did not
      affect the Na+/K+/Cl- cotransport activity of quiescent cells. The Na+/K+/Cl-
      cotransport was also stimulated by the above mitogens in cells pretreated with
      the phorbol ester TPA. This treatment led to a progressive decline in the
      activity of cellular protein kinase C. This result implies that cells deficient
      in protein kinase C may still support stimulation of the Na+/K+/Cl- cotransport.
      Taken as a whole, these findings suggest that the Na+/K+/Cl- cotransport is
      stimulated predominantly by a protein kinase C-independent mechanism in BALB/c
      3T3 fibroblasts. Both the intracellular Ca++ antagonist 8-(N,N-diethylamino)octyl
      3,4,5-trimethoxybenzoate (TMB-8) and two potent calmodulin antagonists,
      trifluoperazine (TFP) and chloropromazine (CP), blocked serum- and mitogen
      stimulated Na+/K+/Cl- cotransport. These results suggest that the Na+/K+/Cl-
      cotransport is stimulated by an increase of intracellular Ca++ and subsequently
      by a Ca(++)-calmodulin-mediated pathway in the synchronized BALB/c 3T3
      fibroblasts.

PMID- 1744177
TI  - Desmin is present in proliferating rat muscle satellite cells but not in bovine
      muscle satellite cells.
AB  - The presence of desmin was characterized in cultured rat and bovine satellite
      cells and its potential usefulness as a marker for identifying satellite cells in
      vitro was evaluated. In primary cultures, positive immunohistochemical staining
      for desmin and skeletal muscle myosin was observed in rat and bovine myotubes. A
      small number of mononucleated cells (20% of rat satellite cells and 5% of bovine
      satellite cells) were myosin-positive, indicative of post-mitotic differentiated
      myocytes. In bovine satellite cell cultures 13% of the mononucleated cells were
      desmin-positive, while 84% of the mononucleated cells in rat satellite cell
      cultures were desmin-positive. Rat satellite cell mass cultures and bovine
      satellite cell clonal density cultures were pulsed with 3H-thymidine, and
      autoradiographic data revealed that greater than 94% of dividing rat cells were
      desmin-positive, suggesting that desmin is synthesized in proliferating rat
      satellite cells. However, no desmin was seen in cells that incorporated labeled
      thymidine in bovine satellite cell clones. Analysis of clonal density cultures
      revealed that only 14% of the mononucleated cells in bovine satellite cell
      colonies were desmin-positive, whereas 98% of the cells in rat satellite cell
      colonies were desmin-positive. Fibroblast colonies from both species were desmin
      negative. In order to further examine the relationship between satellite cell
      differentiation and desmin expression, 5-bromo-2'-deoxyuridine (BrdU) was added
      to culture medium at the time of plating to inhibit differentiation. Fusion was
      inhibited in rat and bovine cultures, and cells continued to divide. Very few
      desmin-positive cells were found in bovine cultures, but greater than 90% of the
      cells in rat cultures stained positive for desmin. The presence of desmin and
      sarcomeric myosin was also evaluated in regenerating rat tibialis anterior five
      days after bupivacaine injection. In regenerating areas of the muscle many desmin
      positive cells were present, and only a few cells stained positive for skeletal
      muscle myosin. Application of desmin staining to rat satellite cell growth assays
      indicated that rat satellite cells cultured in serum-containing medium were
      contaminated with fibroblasts at levels that ranged from approximately 5% in 24
      hr cultures to 15% in mature cultures. In defined medium 4 day cultures contain
      approximately 95% to 98% desmin-positive satellite cells.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1744178
TI  - Germ cell mitogenic activity is associated with nerve growth factor-like
      protein(s).
AB  - The mitogenicity of germ cell proteins released from round spermatids (RS) and
      pachytene spermatocytes (PS) was investigated. Germ cells were isolated by
      centrifugal elutriation from 90-day-old rat testes and incubated in a supplement
      enriched culture media that lacked exogenous proteins. The conditioned culture
      media of RS and PS were dialysed/concentrated and lyophilized to prepare RS
      protein (RSP) and PS protein (PSP). Mitogenic activity of RSP and PSP was
      determined by 3H-thymidine incorporation into Swiss 3T3 fibroblasts. RSP and PSP
      stimulated 3H-thymidine incorporation by fibroblasts in a dose-dependent manner.
      At a higher concentration of RSP (300 micrograms/ml), fibroblast proliferation
      was stimulated from 6- to 20-fold of control cultures, whereas PSP (300
      micrograms/ml) stimulated fibroblast proliferation 2.5-fold of control cultures.
      Since RSP exhibited substantially greater mitogenic activity than PSP we further
      investigated the RSP mitogenic substance(s) by immunoneutralization with
      antibodies against several growth factors. The mitogenic activity of RSP was
      significantly reduced by treatment with nerve growth factor (NGF) antibody, while
      neither the treatment of RSP with acidic fibroblast growth factor (aFGF)
      antibody, nor basic fibroblast growth factor (bFGF) antibody significantly
      modified the mitogenic activity of RSP. Interestingly, murine NGF-beta,
      recombinant human NGF-beta, and bovine serum albumin (BSA) did not exhibit
      mitogenic activity on 3T3 fibroblasts. Nevertheless, the presence of a NGF-like
      protein in RS and PS was confirmed by indirect immunofluorescence staining with a
      murine NGF antibody. Subsequently, a Western blot analysis with the NGF antibody
      identified two immunoreactive bands of 41 +/- 2 kDa and 51 +/- 1 kDa in both RSP
      and PSP under reduced conditions. These germ cell NGF-like proteins were
      apparently different from similarly prepared murine and human NGFs (13 kDa) in
      their molecular weight. Furthermore, neurite outgrowth from pheochromocytoma
      cells (PC-12), a functional bioassay for NGF-like activity, was stimulated by
      addition of RSP and PSP to the culture media of the PC-12 cells. These results
      demonstrate mitogenic activity in germ cell proteins (RSP and PSP) and identify a
      NGF-like protein(s) which is associated with most of this activity.

PMID- 1744179
TI  - The effects of chronic exposure to supraphysiological concentrations of 3, 5, 3'
      triiodo-L-thyronine (T3) on cultured GC cells.
AB  - We have characterized the effects of supraphysiological concentrations of T3 on
      GC cells, a cultured cell line in which physiologic concentrations of T3 regulate
      cell growth, protein content, and growth hormone (GH) production. GC cells were
      exposed to 3 times (1.0 nM) and 80 times (25.0 nM) the physiologic concentration
      of T3 (0.3 nM) for either 4 d or for greater than 3 months. Both short and
      prolonged exposure to supranormal T3 concentrations supported maximal cell growth
      rate and induced significant increases in total protein (P less than 0.025) and
      GH production (P less than 0.01) per cell when compared to measurements in
      control GC cells. In addition, exposure to 1.0 nM and 25.0 nM T3 for greater than
      3 months enhanced the toxicity of heat shock in a manner similar to previously
      described effects on GC cells due to T3 exposure of shorter duration. Thus,
      initial responses to raised T3 concentrations in cultured GC cells persisted
      without alteration when hormone exposure was prolonged for greater than 3 months.

PMID- 1744180
TI  - Cell cycle dependent alterations of chromatin structure in situ as revealed by
      the accessibility of the nuclear protein AF-2 to monoclonal antibodies.
AB  - We have recently described a novel nuclear antigen, AF-2, which is related to
      cell cycle dependent alterations of chromatin structure. We show by two parameter
      flow cytometry on a cell by cell basis that the antigen is accessible to specific
      monoclonal antibodies only in mitotic and postmitotic early G1-phase cells. The
      evaluation of nuclease susceptibility and AF-2 antigen accessibility reveals
      different subcompartments of the G1-phase of the cell cycle with distinct
      chromatin conformations. Digestion with DNase I seems to alter the chromatin
      structure according to concentration and this is reflected by an increase of the
      antigen accessibility. Chromatin in the more condensed early G1-phase is
      specifically digested by lower concentrations of the enzyme than chromatin in
      later stages of interphase. Chromatin from cells in the late-G1, S-, and G2
      phases shows a higher relative resistance to DNase I and a reduced accessibility
      of the AF-2 antigen to monoclonal antibodies. Nuclease S1 has a similar effect on
      chromatin topology, as revealed by the reaction with anti-AF-2 antibodies,
      without digestion of detectable amounts of DNA. The antigen becomes available to
      the antibodies in almost all cells by digestion with high concentrations of DNase
      I or Nuclease S1.

PMID- 1744181
TI  - Lectin binding to gp60 decreases specific albumin binding and transport in
      pulmonary artery endothelial monolayers.
AB  - The effect of albumin binding to cultured bovine pulmonary artery endothelial
      cell (BPAEC) monolayers on the transendothelial flux of 125I-labelled bovine
      serum albumin (BSA) was examined to determine its possible role on albumin
      transcytosis. The transport of 125I-BSA tracer across BPAEC grown on gelatin- and
      fibronectin-coated filters (0.8 microns pore diam.) was affected by the presence
      of unlabelled BSA in the medium in that transendothelial 125I-BSA permeability
      decreased, reaching a 40% reduction at BSA concentrations equal to or greater
      than 5 mg/ml. BSA binding to BPAEC monolayers was saturated at concentration of
      10 mg/ml with an apparent binding affinity of 6 x 10(-7) M. In contrast, gelatin
      added to the medium altered neither 125I-BSA binding nor transport. Several
      lectins were tested for their ability to inhibit 125I-BSA binding and transport.
      One lectin, Ricinus communis (RCA), reduced 125I-BSA binding by 70% and transport
      by 40%. Other lectins, Ulex europaeus, Triticum vulgare, and Glycine max
      decreased neither 125I-BSA binding nor transport. The reduction of 125I-BSA
      transport by RCA was not observed in the presence of saturating levels of BSA,
      indicating that RCA influenced only the albumin-dependent component of transport.
      RCA, but not other lectins, precipitated a 60 kDa plasmalemmal glycoprotein from
      cell lysates of surface radioiodinated BPAEC monolayers. This 60 kDa glycoprotein
      appears to be the equivalent of gp60 identified previously as an albumin binding
      glycoprotein in rat microvascular endothelium. In summary, approximately 40% of
      albumin transport across BPAEC monolayers is dependent on albumin binding. This
      component of albumin transport is inhibited by 80% by the binding of RCA to gp60.
      These results suggest that binding of albumin to gp60 on pulmonary artery
      endothelial cell membrane is a critical determinant of transendothelial albumin
      flux involving mechanisms such as plasmalemmal vesicular transcytosis.

PMID- 1744182
TI  - Group B streptococcus infection in mother and child.
AB  - Despite significant advances in obstetric and pediatric health care, group B beta
      hemolytic Streptococcus (GBS) remains one of the most prevalent and devastating
      pathogens in peripartum women and their newborn infants. It may cause urinary
      tract infection, chorioamnionitis and endometritis, bacteremia, and cesarean
      wound infection in the peripartum period. Moreover, GBS accounts for nearly 50%
      of serious neonatal bacterial infections. Approximately three in every 1,000
      children born in the United States acquire pneumonia, sepsis, or meningitis from
      GBS, with combined mortality and morbidity exceeding 50% despite appropriate
      antibiotic and supportive therapy. Estimates indicate that more than 10,000
      infants are affected annually, at a cost of more than $300 million. Neonatal
      disease is divided into early- and late-onset syndromes: The illness emerging
      after six days of age differs in terms of GBS serotype, clinical manifestations,
      and outcome from the disseminated process seen in earlier onset. We describe two
      infants infected with GBS and discuss risk factors, pathogenesis, diagnosis,
      therapy, and options for disease prevention in the peripartum woman and her
      infant.

PMID- 1744183
TI  - Planetary protection.

PMID- 1744184
TI  - Into the heart.

PMID- 1744185
TI  - Beta-blocker overdose in an LPN.

PMID- 1744186
TI  - An unusual cause of fever in a newborn infant.

PMID- 1744187
TI  - Contractile protein alterations in heart failure.
AB  - After nearly three decades of intense investigation, the precise cellular
      mechanisms underlying impaired contractility in heart failure remain to be
      defined. Nevertheless, growing use of the tools of molecular biology promises new
      insights into how alterations of contractile proteins mediate the functional
      derangements of failure.

PMID- 1744188
TI  - Adenocarcinoma of the liver without a detectable primary.

PMID- 1744189
TI  - Syndromes derived from the Child Behavior Checklist for clinically referred
      Israeli boys aged 6-11: a research note.
AB  - Child Behavior Checklists (CBCL) were completed by parents of 450 clinically
      referred Israeli boys aged 6-11. Principal components analyses with varimax
      rotation yielded 10 syndromes: aggressive, uncommunicative/social withdrawal,
      depressed, delinquent, hyperactive, somatic complaints, anxious, immature,
      unpopular, and odd. The first seven syndromes were highly correlated with
      American and Dutch syndromes derived from the CBCL providing further evidence of
      their cross-cultural robustness.

PMID- 1744190
TI  - Child behaviours as stressors: replicating and extending the use of the CARS as a
      measure of stress: a research note.
AB  - Autistic children represent a source of stress for their parents, but the most
      appropriate way to measure this stress is not clear. Two studies in the
      literature compared parents' and professionals' ratings of symptom severity, and
      had parents rate the stressfulness of each symptom. The present study sought to
      replicate past research, and to extend it by validating this method of measuring
      parental stress compared to more traditional measures. Results indicated that
      mothers, fathers, and professionals agreed on the severity of child behaviours.
      Mothers found these behaviours significantly more stressful than fathers. The
      stress related to specific child behaviours was significantly correlated with
      more general measures of parental stress.

PMID- 1744191
TI  - Debate and argument. Concordance for the syndrome of autism.

PMID- 1744192
TI  - Annotation: growing up as a twin: twin-singleton differences in psychological
      development.

PMID- 1744193
TI  - IQ and the genetics of autism.
AB  - While there seems to be general agreement that genetic factors play some role in
      the etiology of autism, many important questions remain unresolved. The purpose
      of this paper is to review five issues with respect to the association between
      low IQ and autism from a familial-genetic viewpoint: (1) does IQ estimate the
      severity of the autistic genotype?; (2) what is the relationship between
      probands' and sibs' IQs?; (3) what is the relationship between parents' and
      probands' IQs?; (4) why do females with autism have lower IQs than males with the
      disorder?; and (5) does IQ vary with the cause of autism? With respect to each
      issue, possible resolutions are outlined, as are the implications for
      understanding the genetic mode of transmission. The review concludes with a
      possible model for the genetic etiology of autism.

PMID- 1744194
TI  - A comparison of ICD-9 and ICD-10 diagnoses of child and adolescent psychiatric
      disorders.
AB  - ICD-9 and ICD-10 categories were compared in a consecutive cohort of patients
      attending a public child and adolescent psychiatric service. There were some
      remarkable changes in the frequency of comparable diagnoses that reflect both
      systematic effects due to the changed format of the ICD-10 as well as certain
      changes specific to the service.

PMID- 1744195
TI  - The inter-rater reliability of child and adolescent psychiatric disorders in the
      ICD-10.
AB  - Using the ICD-10 criteria for mental and behavioral disorders, a series of five
      written case-histories was rated by 32 clinicians with various training
      backgrounds and different degrees of clinical expertise. As expected, reliability
      was dependent on clinical expertise and increased when an option for an
      alternative diagnosis was provided in addition to the main diagnosis. Inter-rater
      agreement in 10 written case-histories rated by senior child and adolescent
      psychiatrists was to 66%. In comparison with previous studies based on the ICD-9,
      there is some evidence that the improved conceptualization of the ICD-10
      contributes to better reliability.

PMID- 1744196
TI  - The transition to adolescence: the role of gender and stress in problem behavior
      and competence.
AB  - The differential change of boys and girls across pre-adolescence, early
      adolescence, and middle adolescence was examined. The participants were 259
      children, their mothers, and their social studies teachers. The children
      completed a measure of internalizing problems and adults completed measures of
      the child's externalizing and internalizing problems and competence. Relative to
      girls, boys had more problems and less competence at pre-adolescence and/or less
      problems and more competence by mid-adolescence. A stressor, parental divorce,
      did not exacerbate the gender by developmental age period interaction. The
      differential vulnerability of boys and girls at different developmental periods
      is considered.

PMID- 1744197
TI  - Familial adversities and child psychiatric disorders.
AB  - The well known association between child and adolescent psychiatric disorders and
      chronic adversities was proved in a field sample. Children (356) were
      investigated at the ages of 8 and 13 years. The association between child
      psychiatric disorders and chronic adverse conditions in the familial environment-
      measured by the FAI--was analysed with respect to the variables: age, sex,
      psychiatric diagnoses, and course (stability) of disorder. The FAI proved to be
      predictive of psychiatric disorder, in particular of early onset disorder, of
      disorders in boys, and of conduct disorders. According to the results, the common
      assumption that chronic adversities cause child psychiatric disorders must be
      viewed cautiously.

PMID- 1744198
TI  - Infant crying patterns in the first year: normal community and clinical findings.
AB  - To provide information about persistent infant crying, crying durations and
      patterns were measured at four age points (1-3, 4-6, 7-9 and 10-12 months) in
      normal community (N = 400) and clinical (N = 68) samples. The findings provide a
      range of prevalence figures and descriptive statistics which may be useful for
      parents and professionals faced with infant crying. A large developmental shift
      in crying amount, and two age-related changes of crying pattern, were found.
      Clinical infants showed the same crying profiles as the general community
      infants, but were found to cry substantially more. Although mothers of first
      borns were more likely to seek clinical referral, there were no birth-order
      differences in crying amount or pattern. The findings' implications for studies
      of infant temperament and development are indicated.

PMID- 1744199
TI  - A reassessment of the role of ethnicity in children's social perception.
AB  - This study examines the salience of ethnicity in 8- and 11-year-old children's
      social categorizations and preference judgements. Unlike previous research,
      children were afforded the possibility of responding to photographs of target
      persons on the basis of either individual characteristics (expressed affect) or
      group characteristics (ethnicity and gender), and it was found that ethnicity was
      seldom used as a basis for categorizing persons, nor was it widely implicated in
      judgements of preference. Since this study was conducted in an area virtually
      devoid of ethnic minority groups, a replication was undertaken in an inner city
      area of London. Apart from the finding that ethnicity appeared to be a fairly
      salient basis for categorization amongst the 8-year-old children, results
      essentially similar to those of the first study were obtained. Implications of
      the data for children's social perception are discussed.

PMID- 1744200
TI  - Localization of visual targets inside and outside the field of view: the effect
      of hearing loss.
AB  - In two experiments the eye and head localization responses of auditorially
      handicapped children to visual targets in a surrounding circular display were
      compared with the corresponding responses of age-matched controls (Experiment 1,
      mean age: 131 months, hearing loss of auditorially handicapped children greater
      than 90 dB; Experiment 2, two age groups with mean ages: 72 and 123 months,
      hearing loss of auditorially handicapped greater than 50 dB). It was hypothesized
      that an auditory deprivation results in a deficient spatial orientation to the
      regions outside the visual field. This in turn should affect the actual
      localization behaviour to visual targets situated within those regions.
      Differences between the auditorially handicapped and non-handicapped children
      were found with respect to the localization times of so-called 'reversal'
      responses of eye (Experiment 1) and head (Experiment 2) to targets situated
      outside the field of view. In the second experiment significant age-effects were
      present. The implications of these findings for the presence of specific
      differences in cognitive spatial abilities between auditorially handicapped and
      hearing children are discussed.

PMID- 1744201
TI  - Differences in the structure of social behaviour of autistic children and non
      autistic retarded controls.
AB  - Social and task-oriented behaviours of autistic children were compared to those
      of individually age- and IQ-matched non-autistic retarded controls. Autistic
      children showed deficits in visual reciprocity, in indicating joint attention and
      referential head gestures, and in the integration of gaze and gestures when
      reacting to tasks. The findings confirmed the notion of social and pragmatic
      communicative deficits in autism. The implications of these findings for theories
      of social behaviour in autism (avoidance, facial perception, theory of mind) are
      discussed.

PMID- 1744202
TI  - Characterization of a tryptic digest by high-performance displacement
      chromatography and mass spectrometry.
AB  - High-performance displacement chromatography (HPDC) provides a means of
      increasing the capacity of a chromatographic column, while maintaining the
      resolution afforded by high-performance liquid chromatographic (HPLC)
      instruments. The high capacity and high resolution of HPDC can be exploited in
      tryptic mapping to facilitate the characterization of a protein preparation. In
      this manner, minor constituents of the mixture, which may be difficult to isolate
      by conventional chromatographic methods, can be obtained in sufficient amounts to
      permit chemical characterization by established techniques. The isolation by HPDC
      of peptides obtained by digestion of recombinant human growth hormone (rhGH) and
      the subsequent characterization of the peptides are described. The identification
      of certain of these peptides revealed information on the specificity of trypsin
      for the substrate, rhGH, and for autolysis. Fractions from the HPDC tryptic map
      were collected and analyzed by electrospray ionization mass spectrometry (ESI-MS)
      either directly or following further separation by gradient elution HPLC.
      Fragment ions observed in the ESI mass spectra facilitated identification of
      peptides obtained by HPDC tryptic mapping.

PMID- 1744203
TI  - Application of capillary zone electrophoresis to the characterization of multiple
      antigen peptides.
AB  - Capillary zone electrophoresis (CZE) was applied to the analysis of a recently
      described class of synthetic branched peptides, multiple antigen peptides (MAPs).
      In comparison with high-performance liquid chromatography (HPLC), CZE showed
      superior resolution of minor impurities in samples of MAPs obtained by
      preparative chromatography. MAPs that differed only in the substitution of
      uncharged residues (Ala-Ser) could be separated by the addition of organic
      solvents (acetonitrile, methanol, ethanol) to the aqueous background electrolyte.

PMID- 1744204
TI  - Performances and limits of plasma desorption mass spectrometry in the primary
      structure determination of proteins.
AB  - The resolution, sensitivity, matrix effect, cationization and spectral
      suppression in plasma desorption mass spectrometry (PD-MS) were investigated in
      the context of peptide analysis. Excessive cationization may be avoided by the
      addition of citric acid on the target. The importance of the relative net charge
      of peptides in PD-MS spectra suppression was confirmed. Esterification of
      peptides is shown to be an easy way to overcome spectral suppression. Provided
      that cationization and spectral suppression of peptides are under control, PD-MS
      is an excellent tool for protein sequence analysis, affording the necessary
      complement to automated Edman degradation.

PMID- 1744205
TI  - Adsorption-desorption isotherm hysteresis of beta-lactoglobulin A with a weakly
      hydrophobic surface.
AB  - Adsorption-desorption isotherms of bovine beta-lactoglobulin A (beta-lact A) on a
      weakly hydrophobic stationary phase (C1-ether) were measured by frontal analysis.
      The adsorption isotherms obtained at different pH were found to be dramatically
      different in shape, column capacity and desorption reversibility. At pH 4.5, an S
      shaped adsorption isotherm was observed whereas at pH 6.0 a Langmuir isotherm was
      found. In addition, the desorption isotherm at pH 6.0 was found to overlap with
      the adsorption isotherm, and the adsorption-desorption process of beta-lact A
      under this condition could be characterized by a fully reversible Langmuir model.
      The desorption isotherm at pH 4.5, however, did not retrace the adsorption
      isotherm, resulting in hysteresis loops. A higher aggregate (tetramer) of beta
      lact A is shown to be in an equilibrium with the beta-lact A protomer (dimer) at
      pH 4.5 whereas the dimer alone is predominant at pH 6.0. It is further shown that
      changes in the absorption coefficient between the adsorption and the desorption
      cycles for the tetramer at pH 4.5 can account for the hysteresis. The results
      demonstrate that pH can be a sensitive parameter in protein adsorption isotherm
      behavior and ultimately the behavior of species in preparative-scale
      chromatography.

PMID- 1744206
TI  - Laser-excited fluorescence detection of gas-phase chromatography eluates.
AB  - A high-spectral-resolution laser-excited molecular fluorescence gas
      chromatographic (GC) detection system is evaluated. It utilizes a pulsed
      supersonic jet expansion to yield very-narrow-bandwidth (e.g. less than or equal
      to 0.1 nm) fluorescence excitation spectra that may be rapidly scanned via a
      tunable dye laser. A microcomputer synchronizes the entire system, collects data,
      performs calculations, and creates visual displays of results. The laser-excited
      fluorescence detection system was interfaced to a gas chromatograph to exploit
      both the selectivity of the chromatography and the excellent spectral selectivity
      of the detector. Fluorescence excitation chromatograms were acquired by
      monitoring fluorescence emission from selected transition wavelengths
      characteristic of the GC eluates. The excitation wavelengths were also programmed
      to change at appropriate retention times to provide greatest selectivities for
      individual analytes as they eluted, and to allow multiple analytes to be
      determined in a single elution. Response factors for the system varied
      appreciably from run to run, which precluded the use of external standard
      quantitation procedures. However, excellent stabilities for within-run relative
      response factors were sufficient to allow for good quantitative measurements
      using internal standard techniques.

PMID- 1744207
TI  - Influence of mobile phase composition on evaluation of lipophilicity by partition
      chromatography.
AB  - The problems of the concentration dependence of retention indices and the
      applicability of extrapolated values in the evaluation of lipophilicity were
      studied. The reversed-phase high-performance liquid chromatography of
      arylalkanoic acids were carried out with experimental data for substituted estra
      1,3,5 (10)-trienes, benzodiazepines, dermorphine derivatives and dansylamides
      selected from the literature for this purpose. Fair linear relationships between
      slopes of concentration dependences and extrapolated and non-extrapolated values
      of RM and log k' were found. Equivalence of these indices in the evaluation of
      lipophilicity can be inferred. Statistically significant dependences of log P
      (sigma pi) values on concentration slopes make it possible to use them as new
      parameters of lipophilicity. The goodness of fit of these relationships increases
      when the values of ET(30), as a measure of the solvatochromic solvent polarity of
      mobile phases, are used instead of the change in modifier concentration.

PMID- 1744208
TI  - Characterization and determination of organic compounds in the mutagenic XAD-2
      extracts of drinking water.
AB  - Amberlite XAD-2 extracts, which exhibit mutagenicity in the Ames assays, of
      drinking water sampled each month during the period from April 1988 to March 1989
      were studied in order to characterize and determine the organic pollutants. The
      major organic pollutants were phthalate ester plasticizers such as dibutyl and
      di(2-ethylhexyl) phthalate. Several polynuclear aromatic hydrocarbons (PAHs) and
      the organocholorine pesticide oxadiazon were also identified to be present at low
      concentrations. The XAD-extractable and chromatographable organic pollutants were
      found to be composed of PAHs with a mean concentration of 0.136 micrograms/l(ca.
      10% of the total amount of organic compounds detected), phthalates with a mean
      value of 0.405 micrograms/l(ca. 30%) and other compounds with a mean value of
      0.845 micrograms/l(ca. 60%). The concentrations and compositions of these organic
      pollutants were correlated with the effective rainfall content of the river and
      with the water temperature.

PMID- 1744209
TI  - Liquid chromatographic method for the determination of the carbohydrate moiety of
      glycoproteins. Application to alpha 1-acid glycoprotein and tissue plasminogen
      activator.
AB  - A rapid procedure is described for the qualitative and quantitative analysis of
      the carbohydrate composition of glycoproteins by liquid chromatography with light
      scattering detection. The analysis was carried out in three steps. First, the
      glycoprotein samples were purified by a two-step purification on a Sephadex G-25
      column with a 90% yield. Second, the selectivity of the separation and the
      sensitivity of detection of monosaccharides, as methyl glycosides obtained by
      direct methanolysis of glycoproteins, were improved by modified simplex
      optimization of the methanolysis parameters (temperature, methanolic hydrochloric
      acid strength and reaction time) determined at 66 degrees C, 1.2 M and 8.1 h for
      alpha 1-acid glycoprotein (alpha-AGP) and 73 degrees C, 1.5 M and 12.5 h for
      tissue plasminogen activator (tPA). Finally, the method was applied to the
      determination of the carbohydrate moiety of the two N-glycosylated glycoproteins
      alpha-AGP and tPA.

PMID- 1744210
TI  - Column liquid chromatographic determination of carbadox and olaquindox in feeds.
AB  - A column liquid chromatographic method for simultaneous determination of carbadox
      and olaquindox in swine feeds is described. The drugs were extracted from feeds
      with carbon tetrachloride-dimethylformamide (80:20) at 60 degrees C for 30 min.
      The extract was mixed with water (25:45). After centrifugation the aqueous layer
      was chromatographed on a reversed-phase column using gradient elution and
      ultraviolet detection at wavelengths of 305 and 262 nm. Recoveries from samples
      fortified at levels of 20-50 ppm were 92 +/- 9% for carbadox and 93 +/- 6% for
      olaquindox (means +/- standard deviations, n = 71).

PMID- 1744211
TI  - Liquid chromatographic method for the determination of calcium cyanamide using
      pre-column derivatization.
AB  - A specific and stability-indicating high-performance liquid chromatographic
      (HPLC) method has been developed for the analysis of calcium cyanamide in bulk
      material and dosage form. Calcium cyanamide in samples was converted into dansyl
      cyanamide. A muBondapak C18 column was employed for HPLC with 0.01 M sodium
      phosphate (pH 6.3)-acetonitrile (75:25, v/v) as the mobile phase. The proposed
      HPLC method was validated for linearity, specificity, accuracy and
      reproducibility.

PMID- 1744212
TI  - Determination of sulfonamides by liquid chromatography, ultraviolet diode array
      detection and ion-spray tandem mass spectrometry with application to cultured
      salmon flesh.
AB  - Ion-spray mass spectrometry was investigated for the analysis of 21 antibacterial
      sulfonamide drugs. All of the sulfonamides analyzed gave positive ion mass
      spectra with abundant protonated molecules and no fragmentation. Tandem mass
      spectrometry (MS-MS) using collision-induced dissociation provided structural
      information, allowing the identification of common fragmentation pathways and the
      differentiation of isomeric and isobaric sulfonamides. A reversed-phase high
      performance liquid chromatographic method was developed, using gradient elution
      and ultraviolet diode-array detection (DAD), enabling the separation of 16 of the
      sulfonamides. Combined liquid chromatography (LC)-MS was accomplished using the
      ion-spray interface. Analyses of a mixture of sulfonamide standards were
      performed with gradient elution and the mass spectrometer configured for full
      scan acquisition, selected-ion monitoring, or selected-reaction monitoring.
      Procedures for the analysis of sulfadimethoxine (SDM), a representative
      sulfonamide used in the aquaculture industry, are described. The presence of SDM
      in cultured salmon flesh was confirmed at levels as low as 25 ng/g by a
      combination of LC-DAD and LC-MS-MS.

PMID- 1744213
TI  - Pre-column derivatization of sulfa drugs with fluorescamine and high-performance
      liquid chromatographic determination at their residual levels in meat and meat
      products.
AB  - A rapid, sensitive and selective high-performance liquid chromatographic method
      is described for simultaneous determination of eight sulfa drugs in meat and meat
      products using pre-column derivatization with fluorescamine. The drugs are
      sulfisomidine, sulfadiazine, sulfamerazine, sulfadimidine, sulfamonomethoxine,
      sulfamethoxazole, sulfadimethoxine and sulfaquinoxaline. The method includes
      blender extraction of 3-g samples with chloroform, partition with 3 M
      hydrochloric acid, derivatization with fluorescamine at pH 3.0 and subsequent
      high-performance liquid chromatographic analysis on a C18 column with
      fluorescence detection at an excitation wavelength of 405 nm and an emission
      wavelength of 495 nm. The drugs were separated with a mobile phase of
      acetonitrile-2% acetic acid (3:5) at 55 degrees C. The average recovery from
      samples fortified at 0.1 ng/g was 92.6% with a coefficient of variation of 6.2%.
      The detection limit was 0.01 ng/g for sulfaquinoxaline and 0.005 ng/g for the
      other seven drugs. The method was field-tested in a survey of 37 samples
      including beef (five), pork (seven), chicken (seven), ham (five), sausage
      (eight), bacon (two) and roast beef (three). Sulfadimidine was detected in one
      pork sample at the level of 0.295 ng/g and in ham at 0.178 ng/g.

PMID- 1744214
TI  - Determination of hexahydrophthalic anhydride in air using gas chromatography.
AB  - Two methods for the determination of hexahydrophthalic anhydride (HHPA) in air
      were developed. In a solid sorbent method, HHPA was sampled in Amberlite XAD-2
      tubes, eluted in toluene and analysed by gas chromatography with flame ionization
      detection. The sampling rates were 0.2 and 1.0 l/min. At 15 micrograms/m3
      (relative humidity less than 2%) and 27 micrograms/m3 (relative humidity 70%) no
      breakthrough was observed. However, at 160 micrograms/m3 (relative humidity less
      than 2%), 6% breakthrough was found. The sampling efficiency of the sampling
      rates 0.2 and 1.0 l/min did not differ. In a bubbler method, HHPA was sampled in
      bubblers filled with 0.1 M sodium hydroxide solution. The sodium salt of
      hexahydrophthalic acid was formed. No breakthrough was observed using a sampling
      rate of 1.0 l/min. The samples were stable during storage for eight weeks in a
      refrigerator. The HHP acid was esterified with methanol-boron trifluoride and
      analysed by gas chromatography-flame ionization detection. Apparatus for the
      generation of standard atmospheres of HHPA, in the range of 10-3000
      micrograms/m3, was developed using the diffusion principle. For the solid sorbent
      method the precision (coefficient of variation) of the overall method was 2-7%,
      and for the bubbler method 3-19% (range 15-160 micrograms HHPA/m3; relative
      humidity = less than 2-70%). A comparison between the two methods was performed
      using the standard atmosphere. The concentrations found by the solid sorbent
      method were 86-98% of those found by the bubbler method (range 15-160 micrograms
      HHPA per m3; relative humidity = less than 2-70%). In work environment air, 93%
      was found using the solid sorbent method relative to the bubbler method at a mean
      concentration of 330 micrograms/m3 (coefficient of variation = 39%; range 200-540
      micrograms/m3). For both methods, concentrations greater than 3 micrograms/m3
      could be quantified at 60 min sampling with a sampling rate of 1.0 l/min.

PMID- 1744215
TI  - Stereoisomeric purity determination of captopril by capillary gas chromatography.
AB  - The GC method developed for the stereoisomeric purity determination of captopril
      is based on the combined information derived from the analyses of the captopril
      sample on two GC systems, one with a chiral and the other with an achiral column.
      The limit of detection has been determined to be 0.02% (w/w) for (R,S) or (S,R)
      and 0.03% for (R,R), with corresponding minimum quantifiable levels of 0.08% and
      0.09%.

PMID- 1744216
TI  - Comparison of the performance of immunosorbents prepared by site-directed or
      random coupling of monoclonal antibodies.
AB  - The majority of methods used to prepare immunosorbents immobilize antibodies
      through their reactive amino acid residues. The bound antibody activity of these
      immunosorbents is low. Hydrazide-based matrices couple antibodies through
      carbohydrate chains frequently located in the Fc region. This paper reports a
      comparative study of the performance of immunosorbents prepared by cyanogen
      bromide or hydrazide immobilization methods. The experiments utilized murine
      monoclonal antibodies to the human plasma proteins Factor IX or Protein C. The
      antibodies were immobilized at low densities to beaded agarose matrices which had
      similar properties. The hydrazide immunosorbents had binding efficiencies which
      were lower (anti-Factor IX) or up to 1.6-fold higher (anti-Protein C) than
      comparable cyanogen bromide coupled gels. However, there was no improvement in
      performance due to lower recoveries of bound protein from the hydrazide gels.
      Control experiments demonstrated that oxidation of antibody which is required for
      its coupling to hydrazide gels had no effect on antibody binding to antigen. Our
      results indicate that, as with cyanogen bromide coupling methods, site-directed
      immobilization through carbohydrate residues results in a restricted ability to
      bind to antigen. Both monoclonals were found to contain carbohydrate in their
      Fab' regions through which coupling may have occurred. The frequency of
      carbohydrate in the Fab region and the ability to control glycosylation at these
      sites are factors which may impact the utility of carbohydrate-directed
      immobilization of antibodies.

PMID- 1744217
TI  - Use of M13 single-stranded DNA digoxigenin labelled probe for detection of human
      parvovirus B19 viraemia.
AB  - A dot-blot hybridization assay for serum B19 DNA is described using a non
      radioactive (digoxigenin) M13 single-stranded DNA probe. The assay is sensitive
      (0.3 pg of B19 DNA) and has several advantages over similar assays which use
      radioactive or non-radioactive labelled plasmid probe for the routine detection
      of B19 DNA in sera.

PMID- 1744218
TI  - Production of monoclonal antibodies reactive with a denatured form of the Friend
      murine leukemia virus gp70 envelope protein: use in a focal infectivity assay,
      immunohistochemical studies, electron microscopy and western blotting.
AB  - Four monoclonal antibodies were selected for their ability to recognize the
      envelope protein of Friend murine leukemia virus (F-MuLV) in methanol-fixed
      tissue culture cells. Each of these monoclonal antibodies was found to react only
      with F-MuLV. By using recombinant retroviruses, it was determined that each of
      the monoclonal antibodies recognized the C-terminal one-third of the F-MuLV gp70
      envelope protein. The monoclonal antibodies were effective in
      radioimmunoprecipitation of F-MuLV proteins, and one of the antibodies, 720, was
      also effective in Western blotting. The ability of antibody 720 to react with F
      MuLV in methanol-fixed cells facilitated the use of a sensitive immunoperoxidase
      method with a focal virus infectivity assay. In immunohistochemical studies using
      light microscopy, antibody 720 could specifically label F-MuLV-infected cells in
      acetone-fixed tissue sections from F-MuLV-infected animals. Finally, in immuno
      gold labelling studies using electron microscopy, antibody 720 could be used to
      distinguish F-MuLV from amphotropic MuLV.

PMID- 1744219
TI  - The diagnosis of acute viral hepatitis A or B by microparticle enzyme
      immunoassay.
AB  - The traditional approach to the diagnosis of viral hepatitis has been to collect
      a serum sample and to test it for the presence of hepatitis B surface antigen
      (HBsAg), IgM to the core of HBV (anti-HBc IgM) and IgM to HAV (anti-HAV IgM) by
      solid phase radio- or enzyme immunoassays. Microparticle enzyme immunoassay
      technology (IMx-Abbott Laboratories) has been introduced as an automated carousel
      system for the detection of these markers. A side-by-side, blinded comparison of
      IMx to current IA was performed for HBsAg on 659 specimens submitted from March
      to July 1990, of which 72 (10.8%) were positive by AUSRIA (Abbott RIA for HBsAg)
      and 2 of these were discordant in IMx. Both were near the cutoff and by
      confirmatory testing one was positive and the other negative. Forty three percent
      (25/58) of frozen stored sera tested for anti-HBc IgM, by IMx, were positive by
      EIA (Corzyme M). One specimen near the cutoff was negative by EIA but weakly
      positive by IMx. Anti-HAV IgM was found in 21.8% (46/211) of sera with 100%
      correlation by IMx. Thus IMx had the following percent sensitivies and
      specificities: HBsAg; 98.6, 99.9; anti-HBc IgM; 100, 99.9; anti-HAV IgM; 100,
      100. The test set-up times for the 3 markers in the IMx were similar to the RIA
      and EIA. The turnover time was 45 min for a full IMx carousel compared to: AUSRIA
      short incubation (4 h), or long incubation (14 h); Corzyme M-short (4.75 h) or
      long (20 h); anti-HAV IgM (23 h).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744220
TI  - Development of a dot-immunobinding assay for detection of citrus tristeza virus.
AB  - The dot-immunobinding assay (DIBA) was adapted for detection of citrus tristeza
      virus (CTV) and compared with DAS-ELISA and DAS-indirect ELISA. DIBA was easy to
      perform and as sensitive as either ELISA procedure for CTV diagnosis. The entire
      test could be performed in 2-3 h using polyclonal antibodies, with minimal
      laboratory equipment. Three different polyclonal antibodies gave a strong
      positive reaction with 12 selected CTV isolates; however, each serum had to be
      cross-absorbed with sap from healthy plants before use. The broad spectrum 3DF1
      monoclonal antibody reacted with most of the CTV isolates. The MCA-13 strain
      specific monoclonal antibody was specific for most severe CTV isolates. As
      blocking agents, 3% bovine serum albumin (BSA), 3% gelatin, 0.5% non-fat dry milk
      or 5% Triton X-100 gave an adequate white background on the nitrocellulose
      membranes and permitted discrimination between infected and healthy samples.
      However, 3% gelatin gave the best contrast between green for the healthy samples,
      and purple color for infected samples.

PMID- 1744221
TI  - Serological techniques for detection of citrus tristeza virus.
AB  - Citrus tristeza virus (CTV) is the most economically important virus disease of
      citrus. In the last ten years, remarkable progress has been achieved in the
      development and improvement of new serological methods for CTV detection so that
      serology has become a dependable tool for many research, extension and regulatory
      purposes worldwide. CTV-specific polyclonal antisera and monoclonal antibodies
      have been developed in different research laboratories and used extensively in a
      wide range of different studies. This review describes the diverse serological
      methods developed for CTV detection and analyzes the advantages, disadvantages,
      relative sensitivity, applications, and present status of each method.

PMID- 1744222
TI  - [Advances in hepatitis virus research. The clinical issues of hepatitis C].

PMID- 1744223
TI  - [Radionuclide ventriculographic evaluation of exercised left ventricular
      performance in asymptomatic diabetic patients].
AB  - Radionuclide ventriculography was made in 49 asymptomatic diabetic patients, aged
      30-70 years, to investigate cardiac function. Comparisons were made with 33 age-
      and sex-matched non-diabetic controls. Radionuclide ventriculography was
      performed at rest and during dynamic exercise by multigraded, supine bicycle
      ergometer. The resting left ventricular ejection fractions were similar between
      the diabetic patients and control subjects. No significant rise in the left
      ventricular ejection fractions during dynamic exercise was observed in the
      diabetic patients [58.4 +/- 9.8% (mean +/- SD) to 60.3 +/- 9.9]. In the control
      subjects, the left ventricular ejection fractions increased during dynamic
      exercise [59.3 +/- 8.4 to 63.0 +/- 11.4 (p less than 0.05)]. Peak ejection rates
      were similar in both groups at rest [-2.62 +/- 0.64 (s-1) vs -2.66 +/- 0.52] and
      during dynamic exercise [-3.25 +/- 0.74 vs -3.23 +/- 0.90]. Time to end-systole
      were similar in both groups at rest [315 +/- 42 (ms) vs 309 +/- 42] and during
      dynamic exercise [258 +/- 37 vs 262 +/- 37]. The resting peak filling rates were
      similar in both groups [2.27 +/- 0.62 (s-1) vs 2.45 +/- 0.58], and the peak
      filling rates increased (p less than 0.001) during dynamic exercise in both
      groups [2.68 +/- 0.61 vs 3.28 +/- 0.74]. However, the percent changes of the peak
      filling rates were significantly lower in diabetic patients (p less than 0.001).
      In four of the diabetic patients, hypokinesis of the intraventricular septum was
      observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744224
TI  - [Abnormal left ventricular function in diabetic patients, with special reference
      to abnormal diastolic function. Preclinical findings through diabetic
      cardiomyopathy].
AB  - In order to elucidate the nature of cardiovascular involvement in diabetes
      mellitus (DM), we analyzed a high-resolution time-activity cure obtained from a
      gated equilibrium radionuclide left ventriculography (RLVG) in 50 cases
      consisting of 3 groups; G-C: normal controls (n = 17, male 10 and female 7, age
      49.6 +/- 9.6 years old), G-DM: patients with DM without clinical signs of
      ischemic heart disease (n = 17, male 13 and female 4, age 58.3 +/- 9.9 years
      old), and G-DM + MI: patients with DM complicated myocardial infarction (n = 16,
      male 14 and female 2, age 59.5 +/- 10.0 years old). Indexes of cardiac
      performance during both systole and diastole obtained from RLVG were as follows:
      ejection fraction (EF), peak ejection rate (PER), peak filling rate (PFR), time
      from the start of systole to PER (T-PER1), time from end-systole to PFR (T-PFR2),
      diastolic relaxation rate (DRR) during the first third of diastole (DRRe) and
      during the whole diastole (DRRt). There were no significant differences in EF and
      PER (systolic parameters) between G-C and G-DM. These parameters were
      significantly lower only in G-DM +/- MI. However, DRRe and DRRt (diastolic
      parameters) were significantly smaller, and T-PFR1 and T-PFR2 were longer in G-DM
      and G-DM + MI than in G-C. PFR was significantly lower in G-DM + MI than in the
      other two groups and there was no significant difference between G-DM and G-C. In
      addition, DRRe was significantly lower in patients with retinopathy than in
      patients without retinopathy in both G-DM and G-DM + MI. It is concluded that DM
      can cause impairment of diastolic relaxation of the left ventricle before the
      appearance of distinct cardiac dysfunction during systole and that it might be
      probably due to microangiopathy. These results suggest a poor prognosis of MI in
      patients with DM.

PMID- 1744225
TI  - [The pulmonary function and histopathological studies of the lung in diabetes
      mellitus].
AB  - The pulmonary function and microscopic change of the lungs of diabetic patients
      were examined and compared with those of non-diabetic patients to assess the
      diabetic microangiopathy in lung. For pulmonary function study, spirogram flow
      volume curve, diffusing capacity and arterial blood gas analysis were performed
      in 52 diabetic patients and 48 age- and sex-matched control subjects. Diffusing
      capacity, % vital capacity, total lung capacity, residual volume and 25% maximal
      expiratory flow were significantly less in the diabetic group than in the control
      group. PaO2 was also decreased in the diabetic group. There were no significant
      differences between the two groups in the other parameters. For histopathological
      study, the lungs of 35 autopsied cases of a diabetic group and 26 autopsied cases
      of a non-diabetic group. There were no significant differences in age and sex
      between the two groups. The two groups were compared and studied by measuring the
      thickness of alveolar capillary walls, pulmonary arteriolar walls and alveolar
      walls with a light microscope and an eye piece micrometer. The alveolar capillary
      walls, the pulmonary arteriolar walls and the alveolar walls had thickened
      significantly in the diabetic patients. These studies suggested that histological
      changes (microangiopathy) in the lungs are a cause of pulmonary function
      abnormalities.

PMID- 1744226
TI  - [Enhancement of epidermal growth factor receptor (EGF-R) expression on glioma
      cells by cytokines].
AB  - Recombinant tumor necrosis factor alpha (TNF-alpha) significantly enhanced
      epidermal growth factor receptor (EGF-R) expression in U373-MG glioma cell line
      as determined by binding of anti-EGF-R monoclonal antibody (MAb) 425. The optimal
      dose of TNF-alpha was 1000 U/ml of media. When TNF-alpha was combined with
      recombinant interferon gamma (IFN-gamma), further upregulation of EGF-R was
      observed. However, IFN-gamma itself did not show any EGF-R enhancement in this
      cell line. Scatchard analysis of receptor binding revealed that this enhancement
      of EGF-R expression was due to an increase in the EGF-R density. TNF-alpha did
      not affect expression of other brain tumor-associated antigens defined by MAb
      ASHE2, ASHG4 and ASAY1. Cultured fibroblasts showed no upregulation of EGF-R by
      TNF-alpha, suggesting a differential effect of TNF-alpha on EGF-R expression on
      glioma cells and normal cells. We investigated whether TNF-alpha treatment of
      glioma cells increased the tumoricidal effects of radiolabeled MAb 425 which
      correlate with MAb density on tumor cell surfaces. Growth inhibition of glioma
      cells in culture by 125I-labeled MAb 425 was significantly enhanced after
      treatment of the cells with TNF-alpha. In previous clinical trials, 125I-labeled
      MAb 425 has shown immunotherapeutic effects in glioma patients. The present study
      provides the basis for considerations of combined immunotherapy of glioma
      patients with 125I-labeled MAb 425 and cytokines.

PMID- 1744227
TI  - [Evaluation of acute myocardial infarction by 201T1 single-photon emission
      computed tomography using scoring system].
AB  - In 36 patients with acute myocardial infarction (AMI) 201T1 single-photon
      emission computed tomography (SPECT) examinations were performed in a relatively
      early phase of AMI. The short and long axis views of the left ventricle (LV) were
      divided into 6 segments. Images of each segment were assigned scores (segmental
      scores) based on a visual evaluation of the extent of 210T1 accumulations as
      follows: 1 = normal; 2 = relatively low; 3 = low; 4 = severely low; 5 = cold. The
      sum total of the segmental scores constituted the SPECT score. SPECT scores were
      compared with maxGOT, maxLDH, maxCPK and maxCK-MB, Killip classification and
      Forrester hemodynamic subset on admission, and LV ejection fraction (LVEF).
      Segmental scores were compared with LV wall motion evaluated by left
      ventriculography. The results are summarized as follows: 1) There were
      significant correlations between SPECT scores and maxGOT, maxLDH, maxCPK and
      maxCK-MB (r = 0.62, r = 0.60, r = 0.51 and r = 0.39, respectively). 2) SPECT
      scores in patients with Killip group III were significantly higher than in
      patients with Killip group I + II (p less than 0.05). However, no significant
      differences in maxGOT, maxLDH, maxCPK and maxCK-MB were observed between patients
      with Killip group III and those with Killip group I + II. 3) SPECT scores were
      significantly higher in patients with Forrester group III + IV than in patients
      with Forrester group I + II (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744228
TI  - [An experimental study to determine the most effective delay procedures on
      secondary vascularized skin island flaps].
AB  - Secondary vascularized flaps made from implanted vascular bundles in the
      subcutaneous tissues have dominant vascularities. Animal experiments were
      performed using white rabbits, two types of skin flaps were made on their backs.
      The first delay procedure was performed on the left side where the vascular
      bundle had been implanted with an elevation of distally based flap (size 2 cm x 7
      cm). 28 out of 32, secondary vascularized skin island flaps survived either
      partially or completely in the first procedure. Moreover, the first delay method
      was observed to be efficacious in 15 out of 16 cases (p less than 0.01). The
      viability of vascular bundles of secondary vascularized flap was thus proved. The
      first stage of the second delay procedure was performed in bilateral side using
      the same procedure as the first delay. Two weeks later, two types of delay method
      were carried out. On the left side, a proximally based flap (size 2 cm x 7 cm)
      was made at the distal area of the first delay flap. On the right side, a
      bipedicled flap was made (size 2 cm x 14 cm). These flaps were elevated as
      secondary vascularized skin island flaps two weeks later. In all cases, the
      latter procedure produced a longer survival rate compared with the former (p less
      than 0.01). It was concluded experimentally that the most effective second delay
      procedure was the bipedicled flap method.

PMID- 1744229
TI  - [Study of fetal responses to external vibratory acoustic stimulation].
AB  - Effects of a 5-second external vibratory acoustic stimulation (VAS, 500 Hz, 75
      db) were studied in 155 healthy pregnant women from 34 to 41 weeks' gestational
      age on the fetal heart rate and gross fetal body movement. Fetal behavioral
      states were also studied in 88 out of the 155 patients. The following results and
      conclusions were obtained. 1) VAS induced significant increases in the fetal
      heart rate baseline, the mean amplitude, the mean duration, and the mean time
      spent % of fetal heart rate accelerations and gross fetal body movements. 2) VSA
      induced significant changes in fetal behavioral states at states 1F and 3F, but
      no changes in states 2F and 4F. 3) Reaction to VAS was recognized also in the low
      birth weight (less than 2,500 g) group, but the duration of the reaction was
      shorter than that in the normal (greater than or equal to 2,500 g) group. 4) By
      lowering the incidence of false non reactive NST with VAS test, it was possible
      to predict the fetal prognosis better than NST alone. 5) Inasmuch as VAS changed
      the fetal behavioral state from resting phase to active phase, the use of VAS in
      addition to NST was very helpful in more accurate understanding of fetal heart
      rate monitoring.

PMID- 1744230
TI  - [Innervation of the sacroiliac joint. Macroscopical and histological studies].
AB  - Macroscopical and histological studies were carried out to clarify nerve
      innervation of the sacroiliac joint which is believed to have a role in the
      development of low back pain. Eighteen Japanese adult cadavers were used for
      gross anatomical examination and six for histological examination of the nerve
      supply to the joint. The results were as follows: 1) It is suggested by the gross
      examination that the upper ventral portion of the joint is mainly innervated by
      the ventral ramus of the 5th lumber nerve. 2) The lower ventral portion of the
      joint was mainly supplied by the ramus of the 2nd sacral nerve or branches from
      the sacral plexus. 3) Lateral branches of the dorsal ramus of the 5th lumber
      nerve were considered to be the main nerves which innervated the upper dorsal
      portion of the joint. 4) The lower dorsal portion was innervated by nerves
      arising from a plexus composed of lateral branches of the dorsal rami of the
      sacral nerves. 5) The nerves which innervate the joint range in diameter from
      0.292 mm to 0.997 mm, and no difference was found among those in the four
      subdivisions of the joint. 6) Histological examination revealed that nerve fibers
      and the terminals were present in the joint capsule and adjoining ligaments. The
      nerve fibers varied from 0.2 micron to 2.5 microns in diameter and ended with
      five morphologically different terminals.

PMID- 1744231
TI  - [Percutaneous transluminal coronary angioplasty. The primary results from the
      registry of the First Department of Internal Medicine, Nippon Medical School].

PMID- 1744232
TI  - [Reperfusion therapy for acute coronary occlusion].

PMID- 1744233
TI  - Preventing war.

PMID- 1744234
TI  - Health in development.

PMID- 1744235
TI  - Public health, not social warfare: a public health approach to illegal drug
      policy.
AB  - This article makes three major arguments: (I) the current War on Drugs undercuts
      public health values and premises, resulting in a war on the poor,
      disenfranchised, people of color, the homeless, and the unemployed; (2) drug
      problems should be addressed primarily within the realm of public health policy
      rather than criminal justice policy; and (3) to achieve a viable public health
      drug policy, the public health community needs to build grassroots support and
      become effective activists. The article reviews the history of past drug wars,
      analyzes recent trends in illegal drug use and problems, and critiques current
      policy initiatives and their consequences. It then outlines a comprehensive,
      public health approach to addressing illegal drug problems, and concludes with an
      analysis of what steps are needed to become effective in the public policy arena.

PMID- 1744236
TI  - Generational equity and public health policy: a critique of "age/race war"
      thinking.
AB  - A potent new tool in the politics of fiscal retrenchment lies in the creation of
      a framework for policy analysis which implicitly or explicitly "blames" the old
      for poverty and economic hardships in the young. This paper examines the recent
      efforts to promulgate this generational equity or "age/race wars" perspective and
      demonstrates that opinion poll data fail to support the rhetoric of growing
      age/race group antagonisms over entitlement programs for the old. The assumptions
      underlying the generational equity framework are critiqued, and the race and
      ethnic issues embedded within this framework are examined. In particular, we
      explore spurious assumptions concerning the relative financial wellbeing of the
      elderly, escalating Social Security and Medicare costs as a primary cause of
      poverty in the young, and growing resentment of programs for the old among
      minorities and youth. Attempts to deligitimate the claims of the elderly through
      the advancement of the ideology of age/race wars are seen to have significant
      implications for public health policy, with the country's recent experience with
      the Medicare Catastrophic Coverage Act serving as an important case in point. The
      need for an alternative policy framework stressing the interdependence of
      generations is suggested, and some guiding principles put forward toward the
      development of such an alternative framework.

PMID- 1744237
TI  - Population behavior change: a theory-based approach.
AB  - Behavioral science provides useful ideas about how programs of mass communication
      and community participation can produce synergistic influences on the lifestyles
      and policy decisions of populations and their representatives. Media campaigns
      featuring real-life behavior models and community networks mobilized to promote
      behavior change provide a theoretically sound paradigm for community-level
      activities to accelerate the diffusion of innovation in health. Illustrative case
      studies demonstrate how behavioral science concepts can be applied to preventing
      HIV infections and to promoting citizen lobbying against selected nuclear weapons
      systems.

PMID- 1744238
TI  - The reform of the British National Health Service.
AB  - After a 40-year existence as a service sheltered from market influences, the
      reforms introduced in 1990 and coming into effect at this time profoundly alter
      the role of hospitals and primary care physicians. The hospitals may sell and
      purchase services across former boundaries; the family doctor has a host of
      additional duties under the new contract. The details of these arrangements and
      professional criticisms are described.

PMID- 1744239
TI  - Resolution: From the Gulf War to peace and disarmament. World Council of Health
      Worker Organizations for Social Well-Being, Health and Peace.

PMID- 1744240
TI  - Serotoninergic innervation of the thalamus in the primate: an immunohistochemical
      study.
AB  - Little is known of the serotoninergic innervation of the thalamus in primates;
      therefore, we undertook a detailed study of the distribution of 5
      hydroxytryptamine (5-HT)-immunoreactive neuronal profiles in the thalamus of the
      squirrel monkey (Saimiri sciureus) with a specific antibody directly raised
      against 5-HT. All thalamic nuclei in the squirrel monkey displayed 5-HT
      immunoreactive fibers, but none contained immunopositive cell bodies. The 5-HT
      innervation of the thalamus derived from extrinsic fibers arising mostly from the
      midbrain raphe nuclei and forming the transtegmental system. Most of the fibers
      destined to the thalamus collected into a major bundle that swept dorsoventrally
      within the midbrain tegmentum and coursed beneath the thalamus along its entire
      caudorostral extent. Several fiber fascicles broke off from this main bundle at
      different levels and ascended dorsally to innervate the various thalamic nuclei.
      Overall, the 5-HT innervation of the thalamus in the squirrel monkey was more
      massive than would have been expected from earlier studies in nonprimate species.
      Marked differences in the regional density of innervation were noted both between
      the various nuclei and within single nuclei. The most densely innervated nuclei
      were those delineating the principal subdivisions of the thalamic mass, that is,
      the midline, rostral intralaminar, limitans, and reticular nuclei, where very
      dense fields of isolated axonal varicosities occurred. In contrast to the rostral
      intralaminar nuclei, which were rather uniformly innervated, the centre
      median/parafascicular complex contained immunoreactive fibers and isolated
      varicosities distributed according to a mediolateral gradient. The habenula and
      the ventral anterior nucleus were among the most weakly innervated nuclei. In the
      latter nucleus, as well as in more densely innervated nuclei, thin varicose
      fibers formed numerous pericellular contacts on cell bodies and proximal
      dendrites of thalamic neurons. The 5-HT innervation of the lateral nuclear group
      as well as that of the medial and lateral geniculate nuclei ranged from very weak
      to dense. The mediodorsal nucleus displayed a highly heterogeneous 5-HT
      innervation that varied from weak in its central portion to moderate or dense in
      its medial and lateral borders. A moderate 5-HT innervation was observed in the
      anterior nuclear group. The surprisingly dense and heterogeneous 5-HT innervation
      of the thalamus noted in the present study suggests that serotonin may be
      involved in several specific functions of the thalamus in primates.

PMID- 1744241
TI  - Ultrastructural changes in the nucleolus of facial motor neurons following
      axotomy during an early critical period in development.
AB  - In this study, the effects of axotomy on the ultrastructure of the nucleolus and
      associated organelles were examined in fetal, newborn, and early postnatal facial
      motoneurons of the hamster. Golden hamsters used for this study were the 14-day
      fetus, newborn (0 days; less than 6 hr) and 2, 4, 7, and 9 days postnatal ages,
      with 3 animals per group. For prenatal surgeries, pregnant hamsters were
      anesthetized and the facial nerves severed in the fetuses via electrocautery
      through the uterine wall and amniotic membrane. For postnatal surgeries, the
      animals were anesthetized and the right facial nerve exposed and severed at its
      exit from the stylomastoid foramen. At the appropriate postoperative times, the
      animals were reanesthetized and perfused-fixed. The facial nuclear groups were
      dissected and processed for routine electron microscopy. Microbody and coiled
      body frequencies were determined from the number of neurons containing these
      structures per number of neurons sampled per animal in each experimental or
      control group and subjected to statistical analysis. Nucleolar reactive changes
      that occurred during this developmental sequence fell into two major categories.
      The first category displayed by most injured cells consisted of an initial
      compacting of fibrillar material and reduction in vacuolar space. The second
      category appeared to represent a progression from this first stage of nucleolar
      reactivity into degenerative changes involving a striking segregation of
      nucleolar components into five distinct regions. The incidence of microbodies
      increased as a result of axotomy, whereas the presence of coiled bodies decreased
      at the later postoperative stages in the older animals. With increasing age and
      nucleolar maturation, the nucleolar reactive pattern became less pronounced and
      severe, and neuronal survival predominated. It appears, therefore, that the two
      categories of nucleolar changes following axotomy during early development
      correlate with changes observed in nucleoli under conditions of rRNA
      downregulation. It is hypothesized from these results that a key step in the
      ability of neurons to survive axotomy and successfully regenerate at these early
      developmental stages occurs at some point in ribosomal RNA transcription and/or
      processing. Complementary information at the molecular level concerning changes
      in nucleolar synthetic activity and ribosome production will be necessary to test
      this hypothesis.

PMID- 1744242
TI  - The mossy cells of the fascia dentata: a comparative study of their fine
      structure and synaptic connections in rodents and primates.
AB  - In this study the fine structure and synaptic connections of mossy cells in the
      rat and monkey fascia dentata were analyzed. In order to study commissural
      connections of identified mossy cells in the rat, hilar neurons were retrogradely
      labeled by horseradish peroxidase (HRP) or Fast Blue (FB) injections into the
      contralateral hippocampus. Vibratome sections containing retrogradely HRP-labeled
      hilar neurons were Golgi-impregnated and gold-toned. Hilar commissural neurons
      identified by contralateral FB injection were intracellularly labeled with
      Lucifer Yellow (LY). Lucifer Yellow staining was made electron-dense by
      photoconversion thereby allowing for an electron microscopic analysis of the
      retrogradely labeled and intracellularly stained neurons. With these two
      different approaches, we succeeded in identifying rat mossy cells projecting to
      the contralateral hippocampus. Mossy cells in the fascia dentata of primates
      (Papio anubis, Macaca mulatta, Saimiri sciureus) were, like mossy cells of rats,
      either Golgi-impregnated and gold-toned or intracellularly injected with LY. No
      major differences were found between mossy cells of rats and monkeys. The mossy
      cell dendrites originated from the two sides of an ovoid cell body and were
      mainly oriented parallel to the granule cell layer. In contrast to the rat,
      dendrites of mossy cells in the primate did not respect the granule cell layer
      and penetrated frequently into the molecular layer. The occurrence of
      excrescences on proximal dendrites was a characteristic feature of all mossy
      cells. These large spines were more complex in the primate than in the rat. In
      both rats and primates they formed numerous asymmetric synapses with large
      boutons of mossy fibers. Peripheral dendrites were covered with small, simple
      spines. Interestingly, these peripheral dendrites lacking excrescences also
      established asymmetric synapses with mossy fiber boutons as well as asymmetric
      and symmetric contacts with smaller terminals of unknown origin. These findings
      indicate that in both rats and primates the thorny excrescences are not the only
      target of the mossy terminals. While the proximal portions of the mossy cell
      dendrites appear to be exclusively contacted by the granule cells, a larger
      number of neuron types may converge on the distal dendrites. The axons of mossy
      cells, in both rats and primates, although incompletely stained with the present
      methods, were seen to ramify in the hilar region. Our results demonstrate that,
      despite minor species differences, the mossy cells of the fascia dentata
      represent a cell type that is preserved in phylogenetically distant species.

PMID- 1744243
TI  - Prefrontostriatal connections in relation to cortical architectonic organization
      in rhesus monkeys.
AB  - Prefrontostriatal connections were investigated in rhesus monkeys using the
      autoradiographic technique to examine whether there are systematic relationships
      with regard to the architectonic organization of the prefrontal cortex. On the
      basis of progressive laminar elaboration, the different regions of the prefrontal
      cortex can be grouped into two architectonic trends. The dorsal trend, which
      begins in the medial proisocortical areas, can be followed through the
      dorsolateral prefrontal cortex, culminating in the dorsal arcuate region. The
      ventral trend, which originates in the orbital proisocortex, can be traced
      through the inferior prefrontal convexity to the ventral arcuate region. The
      results show that the main connections from the prefrontal cortex to the striatum
      are to the head and body of the caudate nucleus. These connections are
      topographically organized. Medial and dorsal prefrontal areas project
      predominantly to the dorsal and central portion of the head and body of the
      caudate nucleus, whereas orbital and inferior prefrontal areas are related mainly
      to the ventral and central portion. Moreover, prefrontostriatal connections have
      a medial-lateral topography. Medial and orbital prefrontal areas project medially
      in the head and body of the caudate nucleus, whereas the dorsal and ventral
      arcuate regions project laterally, adjacent to the internal capsule. The
      prefrontal regions above and below the principal sulcus project mainly to the
      intermediate sector of the head and body of the nucleus. However, there appears
      to be some degree of overlap of corticostriatal projections from the dorsal and
      ventral prefrontal regions, as well as within each trend. Relatively minor
      projections are directed to the putamen as well as to the tail of the caudate
      nucleus from certain subregions of the prefrontal cortex. Thus the distribution
      of prefrontostriatal connections seems to reflect the architectonic organization
      of the prefrontal cortex. Possible functional aspects of prefrontostriatal
      connectivity are considered in the light of behavioral and physiological studies.

PMID- 1744244
TI  - Superior paraolivary nucleus in the pigmented guinea pig: separate classes of
      neurons project to the inferior colliculus and the cochlear nucleus.
AB  - The superior paraolivary nucleus is a large component of the superior olivary
      complex in rodents and a major source of input to the inferior colliculi and the
      cochlear nuclei. In the present study, retrograde transport of the fluorescent
      tracers Fluoro-Gold, Fluoro-Ruby (tetramethyl rhodamine conjugated to dextran),
      fluorescein-coated microspheres, and Fast Blue were used to reveal the morphology
      and collateral projection patterns of cells in the superior paraolivary nucleus.
      The ascending projections to the inferior colliculus from the superior
      paraolivary nucleus arise mainly from round, multipolar cells, including large
      cells that project exclusively to the inferior colliculi and not to the cochlear
      nuclei. Projections to the ipsilateral and contralateral inferior colliculi arise
      from cells with similar morphology and, in fact, many of the cells that project
      contralaterally project ipsilaterally as well. Projections to the ipsilateral and
      contralateral cochlear nuclei arise primarily from cells that do not have
      collicular projections. On average, the somas of these cells are significantly
      smaller and more elongated than those that project to the inferior colliculi.
      Overlap between these ascending and descending systems is restricted to a small
      percentage of cells that send collateral projections to both the ipsilateral
      cochlear nucleus and the ipsilateral inferior colliculus. These cells are small
      and moderately elongated. Thus the ascending and descending projections examined
      here arise largely from different cells that belong to different morphological
      classes.

PMID- 1744245
TI  - Sexual dimorphism of the anterior commissure and massa intermedia of the human
      brain.
AB  - Neuroanatomical sex differences were observed in the midsagittal area of both the
      anterior commissure and the massa intermedia on analysis of postmortem tissue
      from 100 age-matched male and female individuals. The anterior commissure, a
      fiber tract whose axons in primates primarily connect the two temporal lobes, was
      an average of 12%, or 1.17 mm2 larger in females than in males. The massa
      intermedia, a structure that crosses the third ventricle between the two thalami,
      was present in 78% of the females and 68% of the males. Among subjects with a
      massa intermedia, the structure was an average of 53.3% or 17.5 mm2 larger in
      females than in males. Inclusive of subjects with and without a massa intermedia,
      this structure was a mean of 76% or 16.93 mm2 greater in females than in males.
      These sex differences were present despite the fact that the brains of males were
      larger than those of females. Since a majority of subjects were adults, it is
      unknown when sexual differentiation occurred. Anatomical sex differences in
      structures that connect the two cerebral hemispheres may, in part, underlie
      functional sex differences in cognitive function and cerebral lateralization.

PMID- 1744246
TI  - Effects of high fat diets on hibernation and adipose tissue in Turkish hamsters.
AB  - The effects of dietary fat saturation and fat content on hibernation and several
      properties of white and brown adipose tissue (WAT and BAT, respectively) were
      investigated in Turkish hamsters (Mesocricetus brandti). Male hamsters were
      housed in a long photoperiod (LD 16:8) at 23 degrees C and fed one of three
      diets: (1) chow (6.5% fat per weight), (2) chow + 13.5% vegetable oil (OIL, 20%
      fat per weight [largely unsaturated fat]) and (3) chow + 13.5% vegetable
      shortening [(SHORTENING, 20% fat per weight (largely saturated fat)]. Five weeks
      later body weights had stabilized and the animals were transferred to a short
      photoperiod (LD 8:16) at 3 degrees C. At the peak of the hibernation season (17
      weeks) the animals were sacrificed within 24 h of arousal. Chow-fed hamsters had
      the greatest percentage of animals hibernating and days found torpid compared
      with the two fat-fed groups, with no differences found between the latter two
      groups for these measures. There were no differences between hibernating (HIB)
      and non-hibernating (NON-HIB) hamsters across or within the diet groups for any
      of the BAT measures [uncoupling protein content, mitochondrial mass, lipoprotein
      lipase (LPL) activity, and in vivo lipogenesis], nor were there significant
      effects of the diet on these measures. CHOW- and OIL-fed HIB hamsters showed
      decreases in body weight. All HIB groups had decreases in each carcass component,
      several fat pad weights, testes weight, and food intake. No consistent
      differences in WAT LPL activity or in vivo lipogenesis were found between HIB and
      NON-HIB hamsters.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744247
TI  - Isolation and characterization of parvalbumins from skeletal muscles of a
      tropical amphibian, Leptodactylus insularis.
AB  - Parvalbumins were isolated from skeletal muscles of a tropical amphibian,
      Leptodactylus insularis, and three new isotypes were identified. The total
      concentration of parvalbumins in L. insularis was the same as the total amounts
      found in an amphibian from the temperate or variable zone (Rana temporaria).
      Muscles of the thigh and foreleg had the maximum parvalbumin concentration (0.35
      mmol.kg wet weight-1). Samples from pectoralis and rectus abdominis muscles had
      significantly less (0.29 mmol.kg-1). Three previously unknown parvalbumin
      isotypes (IV, IIIa, and IIIb) were isolated from the tropical amphibian. They
      were different from the isotypes (IVa and IVb) predominant in R. temporaria
      skeletal muscle. Parvalbumins are thought to have a role in the short-term
      removal of myoplasmic Ca2+ during muscle relaxation. Hence, the unique isotypes
      in L. insularis may reflect optimal molecular adaptations retained during the
      animal's evolution in a constantly warm environment.

PMID- 1744248
TI  - Purification and characterization of sulfatases from Haliotis rufescens: evidence
      for changes in synthesis and heterogeneity during development.
AB  - The digestive glands of many marine molluscs are rich sources of arylsulfatase
      enzymes which may function in the catabolism of sulfated polysaccharides in the
      diets of herbivorous species. Arylsulfatases, partially purified from the
      hepatopancreas of the red abalone, Haliotis rufescens, were investigated with
      respect to heterogeneity, catalytic requirements, and timing of induction during
      development. Four hepatopancreatic enzymes were purified from adult animals using
      a combination of hydrophobic interaction and anion-exchange chromatography.
      Zymograms of the four partially-purified enzymes produced by electrophoresis
      under nondenaturing conditions revealed a fifth, relatively more basic isozyme.
      All four partially-purified enzymes appear to be monomeric, with molecular
      weights of approximately 43,000 Da each, as measured by gel filtration. The
      affinities for p-nitrocatechol sulfate, pH optima, and strengths of inhibition by
      anions displayed by these enzymes are similar to the values reported for other
      molluscan arylsulfatases. Three of the four enzymes have Km values between 0.8
      and 2.0 mM for p-nitrocatechol sulfate; the remaining enzyme (A2) has a Km of 6.7
      mM. All four enzymes have pH and temperature optima of 5.5 and 45 degrees C,
      respectively. Three of the four enzymes have-t 1/2 (50 degrees C) values of 3.5
      min; the enzyme A4 has a t 1/2 (50 degrees C) of 8.5 min. A monoclonal antibody
      directed against form A1b does not cross react with any of the other
      hepatopancreatic arylsulfatases when assayed by Western blot, confirming the
      structural heterogeneity of the adult enzymes. Total arylsulfatase activity
      increases in a biphasic manner during early abalone development, with the first
      increase occurring early in larval maturation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744249
TI  - Role of transferrin in iron uptake by the brain: a comparative study.
AB  - The role of specific transferrin (Tf) and Tf receptor interaction on brain
      capillary endothelial cells in iron transport from the plasma to the brain was
      investigated by using Tf from several species of animals labeled with 59Fe and
      125I, and 15-day and adult rats. The rate of iron transfer was much greater in
      the 15-day rats. It was greatest with Tf from the mammals, rat, rabbit and human,
      but much lower with chicken ovotransferrin and quokka (a marsupial), toad,
      lizard, crocodile, and fish Tf. The uptake of Tf by the brain showed a similar
      pattern, except for a very high uptake of ovotransferrin (ovoTf). Iron uptake by
      the femurs (a source of bone marrow) was also high with Tf from the mammalian
      species and low with the other types of Tf, but showed little change with aging
      of the animals. It is concluded that iron transport into the brain is dependent
      on the function of Tf receptors, probably on capillary endothelial cells, and
      that these receptors show the same type of species specificity as the receptors
      on immature erythroid cells. Also, the decrease in iron uptake by the brain as
      rats age from 15 days to adulthood is specific for the brain and is not a general
      effect of the aging process.

PMID- 1744250
TI  - Effects of six trace metals on calcium fluxes in brown trout (Salmo trutta L.) in
      soft water.
AB  - Calcium fluxes were measured simultaneously in brown trout fry maintained in an
      artificial soft water medium of [Ca] 20 mumol.1(-1) and pH 5.6, and exposed to
      each of six trace metals (Al, Cu, Fe, Ni, Pb, and Zn). The trace metal
      concentrations represented typical and maximum levels found in acid waters
      experiencing declining fishery status. In the absence of trace metals, evidence
      is presented which suggests that ca. 91% of Ca taken up from the external medium
      was by extraintestinal active transport. Calcium efflux was stimulated by both
      concentrations of Al, Cu, Fe, and Pb. Efflux was also stimulated by [Ni] 170
      nmol.1(-1) and [Zn] 3000 nmol.1(-1). In some cases, response to increased efflux
      was stimulation of influx. Lack of stimulation of influx resulted in negative net
      Ca fluxes. Net Ca losses were recorded at both concentrations of Al, Pb, and Ni,
      lower concentrations only of Fe, and higher concentrations only of Cu and Zn.

PMID- 1744251
TI  - Differences in the hypoxic contraction of small isolated pulmonary arteries of
      cat and rabbit.
AB  - In small (less than 300 microns diameter) pulmonary arterial (PA) rings isolated
      from the cat, hypoxia induced a transient contraction (250 +/- 120 mg, n = 7),
      whereas in rings of rabbit PA of the same size, hypoxia had no significant effect
      (n = 19). Precontraction by 40 mmol KCl.1(-1), noradrenaline (NA) 10(-6) mol.1(
      1), or histamine (His 10(-5) mol.1(-1)) did not modify this difference between
      the two species and did not potentiate the hypoxic contraction of small rings of
      the cat PA. Large rabbit pulmonary arterial segments (300-2000 microns) exhibited
      no response to hypoxia before precontraction (n = 15). In the presence of
      procaine (2%) rabbit PA rings (n = 6, small) exhibited no hypoxic contraction.
      These results in vitro reflect previous in vivo observations.

PMID- 1744252
TI  - Condoms and coitus: adolescents attitudes to AIDS and safe sex behavior.
AB  - This study investigated the relationship between sexual risk taking and attitudes
      to AIDS precautions among a sample of approximately 1000 non-virgin adolescents
      attending 15 colleges and universities in Victoria, Australia. Four attitudinal
      dimensions were isolated: Antiprecautions, Risk Denial, Abrogation of
      Responsibility and Fatalism. These attitudes showed meaningful relationships with
      different types of sexual risk: risk with a casual partner, risk with a regular
      partner, and multiple partnering. Different patterns of association emerged for
      males and females, with female risk behavior being more strongly related to
      antiprecautions attitudes. These differences were discussed in the light of
      gender-stereotypic responses to sexual situations, and their implications for
      educational interventions were explored.

PMID- 1744253
TI  - AIDS knowledge and beliefs, and sexual behavior of sexually delinquent and non
      delinquent (runaway) adolescents.
AB  - This study assessed general knowledge of AIDS, beliefs about preventing AIDS, and
      sexual behavior among two groups of male adolescents at high risk of HIV/AIDS: 60
      sexually delinquent males and 57 non-delinquent runaway males. Significantly
      fewer sexually delinquent than non-delinquent (runaway) males had experienced
      sexual intercourse with a consenting female partner (45 vs. 89 per cent).
      Sexually delinquent youths scored significantly lower than non-delinquent youths
      in general knowledge of AIDS (65 vs. 73 per cent) and were not able to
      discriminate safer behaviors from those which were less safe (42 vs. 71 per
      cent). Both groups reported moderate support for beliefs about preventing AIDS.
      These results suggest HIV/AIDS prevention programs that attempt to increase
      knowledge are needed by these youths, particularly for sexually delinquent
      youths.

PMID- 1744254
TI  - Young offenders and alcohol-related crime: what interventions will address the
      issues?
AB  - Although most young offenders will grow out of both drinking and crime,
      interventions aimed at reducing crime through reducing drinking or reducing
      drinking so as to reduce health and social problems are important for some
      offenders. Where the aim is to reduce crime by reducing drinking, it is essential
      to assess carefully the relationship between the two in each person to ensure
      that this is logical. Since most adolescents drink and since controlled drinking
      is achievable by younger people with fewer alcohol-related problems, moderation
      rather than abstinence is a realistic goal for most young offenders. Behavioural
      self-control training is one type of intervention which can effectively encourage
      moderate drinking, but this has to be conducted in ways that will engage young
      offenders' interest, for example through self-help manuals, developing peer
      interventions and using simulated bar settings. In addressing the questions of
      which types of people commit which types of crime and what part alcohol plays in
      setting the conditions for crime to occur, studying the effects that young
      offenders expect alcohol to have under various conditions may contribute to the
      development of cognition modification components of interventions and enable
      better matching of clients with programmes.

PMID- 1744255
TI  - A metacognitive analysis of decision making in adolescence.
AB  - Samples of 43 early (CA = 13 years) and 41 middle (CA = 15 years) adolescents
      were compared on three categories of metacognitive knowledge as they relate to
      decision making--person knowledge, task knowledge and strategy knowledge.
      Metacognitive knowledge was assessed using a 19-item questionnaire. Consistent
      with our hypothesis, middle adolescents showed significantly greater
      metacognitive knowledge than early adolescents on all three scales. Self-reported
      decision making style (using the Flinders Adolescent Decision Making
      Questionnaire) and decision making performance on a hypothetical scenario were
      also measured. Middle adolescents reported a more competent decision making style
      than early adolescents, while group differences on the scenario were not found.
      Adolescents completing the scenario scored significantly higher on all measures
      of decision making metacognition. Significant correlations were found between
      metacognitive knowledge of decision making, self-reported decision making style
      and performance on the decision scenario task. By middle adolescence
      understanding of what is involved in the activity of decision making is well
      developed. This growth in understanding, accompanied by changes in social
      domains, plays a part in decision execution and style.

PMID- 1744256
TI  - Family relationship patterns: perceptions of teenage mothers and their non-mother
      peers.
AB  - Perceptions of self and family members were determined at two time periods for a
      sample of 30 teenage mothers and 30 non-mothers using the Family Relations
      Inventory and a family map exercise. Both at present and from childhood
      reminiscences, teen mothers perceived their mothers and sisters more positively
      than did non-mothers; fathers and brothers of the adolescent mothers were viewed
      more negatively than were those of the non-mothers. Results are discussed in
      light of prior explanations of adolescent motherhood with respect to family
      dynamics. An approach to intervention is suggested.

PMID- 1744257
TI  - Leisure activities of adolescent school students: predictors of participation and
      interest.
AB  - Frequency of participation and levels of interest in more than 60 leisure
      pursuits were measured via a questionnaire administered to 1248 adolescent high
      school students. The relationship between participation and levels of interest
      was measured by correlation as well as by asking the students to nominate up to
      three activities they would like to participate in but cannot and to indicate the
      reason for their non-participation. Factor analyses reduced the Participation and
      Interest items to six factors each. Multiple regressions were then conducted on
      the derived factor-score variables. Sex was the major predictor of participation
      in sports and vocational activities and of interest in sporting and gregarious
      activities. Age, school location, ethnicity and SES were lesser predictors for
      groups of activities such as the social and outdoor pursuits. The results are
      discussed in terms of the theoretical and practical implications of the
      relationship between participation and interest as well as the prediction of
      participation and interest levels by developmental and social factors.

PMID- 1744258
TI  - Production of proteases by psychrotrophic microorganisms.
AB  - Six milk-derived psychrotrophic microbial cultures were screened for the ability
      to grow at refrigerated temperatures and produce proteases in reconstituted skim
      milk. Of these, two cultures, Pseudomonas fluorescens M3/6 and Pseudomonas fragi
      K122, produced extracellular protease(s) beginning 7 d postinoculation when the
      cultures had entered late log or early stationary phases of growth. Further work
      with these two cultures showed that intracellular proteases were present after
      only 20-h incubation, before detection of the extracellular proteases. Using H-D
      valyl-L-leucyl-L-lysyl-4-nitroanilide (S-2251), a sensitive substrate for plasmin
      activity, P. fluorescens was shown to have greater intracellular proteolytic
      activity than extracellular activity at 20 h of incubation. The intracellular
      enzyme activity remained constant while the extracellular and periplasmic
      activities increased over the remaining 6-d incubation period. The proteases in
      crude extracellular extracts from both cultures were characterized and were heat
      stable with broad temperature (7 to 52 degrees C) and pH (pH 5.5 to 8.5) ranges
      for activity and were inhibited by the metal chelator, EDTA, indicating that they
      were metalloproteases.

PMID- 1744259
TI  - Microbiological analysis and starter culture growth in retentates.
AB  - Pasteurized skim milk was concentrated by UF to 2-, 4-, and 5-fold. The
      retentates were evaluated for microbiological quality, heat treatments to
      inactivate microorganisms, and lactic acid bacterial starter culture activity.
      Aerobic mesophilic bacterial counts in raw milk decreased from an initial 1.4 x
      10(6) to 3.9 x 10(2) cfu/ml after pasteurization. During UF, counts increased
      from 3.9 x 10(2) cfu/ml UF, counts increased from 3.9 x 10(2) cfu/ml in
      pasteurized milk to 1.4 x 10(3), 1.4 x 10(4), and 1.8 x 10(4) cfu/ml in 2-, 4-
      and 5-fold retentates, respectively. Psychrotrophic bacterial counts decreased
      from 9.9 x 10(5) cfu/ml in raw milk to 3.7 x 10(1) cfu/ml in pasteurized milk and
      gradually increased to 1.0 x 10(2), 2.5 x 10(2), and 1.4 x 10(3) cfu/ml in 2-, 4
      , and 5-fold retentates, respectively. Thermophilic bacterial counts remained
      less than 10 cfu/ml in all samples. Skim milk and retentates inoculated with five
      starter cultures at 1% failed to decrease the pH below 4.6 in (2-, 4- and 5
      fold). The 4- and 5-fold retentates inoculated with Lactococcus lactis spp.
      cremoris or Lactococcus lactis spp. lactis cultures were partially coagulated
      with pH greater than 5.6. In general, the pH of retentates remained higher than
      that of skim milk. Clotting of uninoculated samples was observed, and a spore
      forming contaminant, tentatively characterized as Bacillus cereus and capable of
      clotting milk at a pH greater than 6, was isolated from the clotted
      samples.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744260
TI  - Quantification of alpha s1-casein in goat milk from French-Alpine and Anglo
      Nubian breeds using reversed-phase high performance liquid chromatography.
AB  - Samples of isoelectrically precipitated goat casein from the milks of French
      Alpine and Anglo-Nubian breeds were separated into four components in a single
      run by reversed-phase HPLC. The proportion of alpha s1-casein thus resolved was
      determined quantitatively. The method uses a reversed-phase C-4 column and a
      linear gradient from 30 to 50% acetonitrile in 30 min with trifluoroacetic acid
      constant at .1%. Sodium dodecyl sulfate-PAGE was carried out to establish the
      identity of the isolated components. By a comparison with previously published
      results for caprine and bovine milk caseins, the four peaks were identified as
      kappa-, alpha s2-, alpha s1-, and beta-casein. Quantitative variations in the
      chromatographically resolved alpha s1-casein fraction of goat milk were evident.
      Some individual goat milks contained high levels of alpha s1-casein (2.70 g/L),
      but others contained significantly low levels (.12 g/L). There was no statistical
      difference in the overall means between breeds in alpha s1-casein composition,
      but cluster analysis statistics showed three distinct categories of alpha s1
      producers: high, medium, and low. Interestingly, 6 of 15 French-Alpine goats and
      only one Anglo-Nubian goat fell into the "low" producer category (.38 +/- .2
      g/L). Thus, expression of the alpha s1-component may be genetically regulated but
      may not be a breed-specific trait.

PMID- 1744261
TI  - Separation of beta-casein A1, A2, and B using cation-exchange fast protein liquid
      chromatography.
AB  - beta-Casein genetic variants A1, A2, and B were separated using cation-exchange
      fast protein liquid chromatography. beta-Casein from a herd bulk casein sample
      eluted as a series of three peaks. Casein samples from individual cows containing
      known combinations of beta-casein A1, A2, and B were used to confirm that the
      three peaks were beta-casein genetic variants. An acid-PAGE gel confirmed the
      identity of the peaks that eluted from the column.

PMID- 1744262
TI  - Association of kappa-casein glycosylation with milk production and composition in
      Holsteins.
AB  - A total of 545 milk samples were collected from 53 Holstein cows for 1 yr. On
      test day, morning milk yields were recorded; milk samples were analyzed for N
      acetylneuraminic acid, protein, fat, casein, kappa-casein, and SCC. the
      relationship between the degree of glycosylation of kappa-casein and morning milk
      yield and composition was investigated. Data were analyzed using least squares
      procedures with a model that included test day, parity, stage of lactation, SCC,
      and phenotype for kappa-casein as fixed effects and N-acetylneuraminic acid
      content of kappa-casein as covariate. After adjustments were made for effects of
      environmental and genetic factors, the degree of glycosylation of kappa-casein
      was associated with morning milk yield, protein, and casein content. Milk yield
      increased linearly with an increase of N-acetylneuraminic content up to
      approximately 70 micrograms/mg of kappa-casein.

PMID- 1744263
TI  - Relative buffering capacity of goat milk, cow milk, soy-based infant formulas and
      commercial nonprescription antacid drugs.
AB  - Buffering capacities of goat milk (Alpine, Nubian), cow milk (Holstein, Jersey),
      soy-based infant formulas, and non-prescription antacid drugs were estimated.
      Total N, protein, NPN, and P2O5 as major buffering entities were quantified for
      each milk category. Nubian goat milk had the highest levels of the three major
      buffering chemical entities, and the infant formulas contained less total N and
      NPN compared with natural goat and cow milks. Buffering capacities of the
      formulas also were lower than those of natural milks. Combinations of milk and
      antacid drugs had higher buffering capacities than either the milk or drug alone.
      Drug plus goat milk combinations upon addition of more than 2 ml of acid titrant
      exhibited fewer changes in pH than the respective drug plus cow milk
      combinations.

PMID- 1744264
TI  - Comparison between lactoferrin and subepithelial matrix protein binding in
      Staphylococcus aureus associated with bovine mastitis.
AB  - Staphylococcus aureus strains (n = 100) isolated from bovine mastitis were
      classified according to the presence of capsular polysaccharide serotype 5 (n =
      46), type 8 (n = 26), and non-5/8 (n = 28). Strains from each type were tested
      for protein interaction in a 125I-labeled ligand binding assay. A majority of
      type 5 and type 8 strains showed a higher degree of binding to lactoferrin,
      fibronectin, and IgG than the non-5/8 strains. Fibrinogen binding was low in all
      serotypes. Most of the type 5 and non-5/8 strains bound less than 10% laminin,
      whereas type 8 strains bound laminin in the 11 to 20% range. Non-5/8 strains
      significantly differed from type 5 in lactoferrin, fibronectin, fibrinogen, and
      IgG and also from type 8 in fibrinogen and IgG binding. The differences in
      protein binding between type 5 and type 8 were nonsignificant. The degree of
      lactoferrin binding in all types positively correlated with laminin binding.
      Lactoferrin and fibrinogen bindings were correlated in type 5 and type 8 strains.
      Lactoferrin and fibronectin bindings were correlated only in type 5 strains.
      These data suggest that bovine lactoferrin binding is common and associated with
      subepithelial matrix protein interactions in certain serotypes of S. aureus.

PMID- 1744265
TI  - Effect of anticapsular antibodies on neutrophil phagocytosis of Staphylococcus
      aureus.
AB  - One of the major virulence factors of Staphylococcus aureus is development of an
      exopolysaccharide capsule in vivo, which inhibits recognition of antibodies to
      highly antigenic cell wall by neutrophils. To circumvent this inhibition, an
      attempt was made to produce anticapsular antibodies. Three cows per group were
      immunized in midlactation by injections in the area of the supramammary lymph
      node and intramuscularly and were boosted on d 14, 42, and 70 with three variants
      of Smith S. aureus: compact, unencapsulated; diffuse, rigid capsule; and diffuse
      large clearing, exceptionally large flaccid capsule using dextran sulfate as
      adjuvant. Serum agglutination and ELISA titers of cows immunized with diffuse and
      diffuse large clearing increased after immunization and after each boost and
      remained elevated to the end of the experiment at 112 d. Phagocytosis of diffuse
      and diffuse large clearing, measured by flow cytometry, was enhanced by
      immunization with either organism. No antibody response to capsule or enhanced
      phagocytosis of diffuse developed in cows immunized with compact. However,
      anticompact antibodies were opsonic for diffuse large clearing. These data show
      that bovine antibodies to S. aureus capsule are opsonic for bovine neutrophils
      and that capsule plays a role in inhibition of cell-wall opsonization of S.
      aureus.

PMID- 1744266
TI  - Antibacterial activity of bovine mammary gland lymphocytes following treatment
      with interleukin-2.
AB  - The antibacterial characteristics of bovine mammary gland lymphocytes were
      evaluated following in vitro activation with recombinant human interleukin-2.
      Mammary gland effector cell populations were prepared by enzymatic digestion of
      mammary tissue followed by centrifugation through a discontinuous Percoll
      gradient. Functional activity of cells cultured for 48 h with or without
      interleukin-2 were evaluated by direct cytotoxicity using K562 target cells and
      by antibacterial activity against Staphylococcus aureus. Cytotoxic activity of
      interleukin-2-treated mammary gland lymphocytes was enhanced compared with
      control cultures, which exhibited no cytotoxic capabilities following 48 h of
      culture. Bactericidal activity also was elevated in cells cultured in interleukin
      2-supplemented media. Enhanced expression of major histocompatability complex
      class II molecules on the surface of interleukin-2-treated lymphocytes was
      associated with the higher level of cell activation. Phenotypic analyses of the
      recovered population showed that the majority of cells were lymphocytes bearing
      CD2 molecules. It may be possible to activate these effector cell populations in
      vivo and increase resistance of the mammary gland to bacterial infections in a
      nonspecific manner.

PMID- 1744267
TI  - Efficacy of a cephapirin dry cow product for treatment of experimentally induced
      Staphylococcus aureus mastitis in heifers.
AB  - A dry cow product containing 300 mg of cephapirin benzathine was evaluated in
      pregnant and nonpregnant Jersey heifers for its effect on experimentally induced
      Staphylococcus aureus mastitis. Cephapirin was detectable in mammary secretion of
      nonpregnant heifers for up to 5 wk and in tissue for 1 wk after intramammary
      infusion. Staphylococcus aureus was not detectable in tissue and secretion of
      treated quarters at 1 and 3 wk but was not eliminated from two quarters of one
      heifer tested at 6 wk posttreatment. Histologic evaluation of mammary tissue from
      nonpregnant heifers revealed significant differences in leukocytosis between
      uninfected and S. aureus-infected quarters but no differences in epithelium,
      lumen, and stroma, indicating no difference in secretion potential or glandular
      development. Twenty-five pregnant Jersey heifers were experimentally infected in
      two quarters with S. aureus 12 to 14 wk prepartum. After 1 to 3 wk, 13 heifers
      were infused in 21 S. aureus-infected quarters with a commercial cephapirin dry
      cow product. Nine infected quarters were left untreated. All treated quarters
      were bacteriologically negative both at calving and through 2 mo after calving.
      Of the 9 infected quarters not treated prepartum, 1 spontaneously cured and 2
      became non-functional. The remaining quarters were treated at calving with a
      commercial cephapirin lactating cow product. Of these, 3 cured and 3 failed to
      resolve.

PMID- 1744268
TI  - Histological response of the bovine mammary gland to intramammary devices.
AB  - Histologic response of the bovine mammary gland to presence of three intramammary
      device models (abraded, star, or grooved) was studied in 12 lactating cows.
      Uninfected quarters fitted with devices exhibited greater leukocyte infiltration
      into teat and gland cistem linings as well as into mammary parenchyma adjacent to
      the gland cistem compared with unfitted control quarters. Cytologic alterations
      to cistem linings in device-fitted quarters ranged from degeneration and
      sloughing of surface cells of the double-layered epithelium to hyperplasia,
      stratification, and keratin formation. In uninfected quarters, quantification of
      mammary parenchymal components showed no differences among models for percentages
      of epithelium, but percentage of lumen was lowest and stroma highest for the star
      intramammary device model, suggesting reduced secretory activity or mammary
      involution in response to these intramammary devices. Presence of bacterial
      infection amplified the histologic responses to all devices. Leukocyte
      infiltration remained greater in device-fitted quarters compared with controls
      but was elevated over uninfected quarters for all treatments. Likewise,
      hyperplasia, stratification, and keratin formation of the cistem epithelial
      lining were more frequently observed in infected quarters. Among models in
      infected quarters, percentage of lumen was lowest and stroma highest in quarters
      fitted with abraded devices. In most cases, presence of infection masked any
      effect of devices on mammary parenchymal components. Plaque formation was
      observed on all models and tended to be thicker on those retrieved from infected
      quarters. Electron microscopic examination showed that plaque was composed of
      leukocytes, cell debris, keratin, and amorphous material. Results demonstrated
      that most intramammary device models were successful in stimulating leukocytosis
      into the gland, and tissues from fitted quarters displayed alterations to
      cisternal linings; however, quarters fitted with these devices exhibited reduced
      secretory activity.

PMID- 1744269
TI  - Analysis of somatic cell count data by a peak evaluation algorithm to determine
      inflammation events.
AB  - Increases in SCC are an expression of inflammation events in the udder.
      Inflammation events are sporadic, of variable amplitude and duration, and can be
      analyzed by computer programs designed to evaluate pulses of hormone secretion.
      Baseline values for SCC, which take into account long-term trends, were
      calculated using the PULSAR peak evaluation algorithm. An inflammation event was
      defined as an increase of log2(SCC) of at least 1 unit from the preceding data
      point if the observed value exceeded the baseline value by a threshold value.
      Incidence rate, duration, and amplitude of inflammation events were calculated.
      Weekly composite milk SCC from individual cows from two Florida dairy farms were
      recorded. Data were analyzed for effects of season (summer and fall) and bST in
      two separate data sets. Incidence rate of inflammation events was higher in
      summer than in fall (4.31 and 2.91 events per cow x year). In one of two data
      sets only, duration of inflammation events was longer in cows treated with bST
      (2.4 +/- .2 vs. 1.6 +/- .2 wk). In contrast, least squares analysis of variance
      of log2(SCC) did not detect differences due to season or bST. The use of the peak
      evaluation algorithm led to the detection of seasonal and bST effects on
      inflammation events in cows.

PMID- 1744270
TI  - Reduced lactational performance following intravenous endotoxin administration to
      dairy cows.
AB  - Nonpregnant lactating cows were given 100 micrograms of endotoxin via the jugular
      vein to determine effects of intravenous endotoxin administration on mammary
      inflammation and lactational performance. At the first milking (11 h)
      posttreatment, milk yield was reduced 33%. Milk fat percentage was elevated at
      this time, but lactose concentration was decreased. Milk yield and composition
      returned to pretreatment levels within 2 d. Clinical mastitis was not induced by
      endotoxin treatment, but milk SCC, NAGase, serum albumin, and lactoferrin were
      increased by 50%. This increase was small compared with increases during mastitis
      and may have resulted from lower milk volume. These results support the
      hypothesis that part of the reduced lactational performance during endotoxin
      mastitis is mediated by systemic pathophysiological responses and indicate that
      intravenous endotoxin administration may be a useful model to study adverse
      effects of infectious disease on lactational performance.

PMID- 1744271
TI  - The influence of insulin and amino acid supply on amino acid uptake by the
      lactating bovine mammary gland.
AB  - Four lactating dairy cows received arterial infusions of insulin (1.41 U/h), an
      AA mixture (threonine, methionine, leucine, phenylalanine, and lysine at 5.87,
      1.90, 3.55, 2.17, and 4.21 mmol/h, respectively), and a combination of the two in
      a 4 x 4 Latin square. The infusions were performed over a 3-d period directly
      into the extra pudic artery on both sides of the mammary gland, and samples were
      taken simultaneously of the downstream extra pudic arterial blood and also of
      subcutaneous abdominal venous blood. Blood flow was measured by dye dilution
      using p-amino-hippuric acid and was increased by 37% by infusion of insulin plus
      AA (P less than .05). Infusions of AA tended to increase the arteriovenous
      difference and uptake of the infused AA (P less than .05 for phenylalanine) and
      had varying effects on the uninfused AA. Inclusion of insulin in the AA infusion
      tended to increase uptake of infused AA, whereas infusions of insulin alone
      tended to decrease uptake. There were no significant effects of infusion on milk
      yield or composition.

PMID- 1744272
TI  - Comparison of somatotropin and growth hormone-releasing factor on milk yield,
      serum hormones, and energy status.
AB  - Holstein cows received 12 mg/d of growth hormone-releasing factor (continuous
      i.v. infusion, n = 5), 14 mg/d of bST (single daily i.m. injection, n = 8), or no
      treatment (controls, n = 8) for 60 d. Compared with controls (31.6 kg/d), bST and
      growth hormone-releasing factor increased milk yield to 34.2 and 37.0 kg/d,
      respectively. The increase in milk yield induced by the growth hormone-releasing
      factor was greater than that for bST. Milk yield was not different among groups
      following cessation of treatment. Milk energy output was 24.2 Mcal/d in controls,
      and growth hormone-releasing factor increased milk energy output to 28.5 Mcal/d.
      Milk energy output of cows receiving bST was 26.1 Mcal/d. Growth hormone
      releasing factor increased DMI (23.2 kg/d) over that of controls (21.1 kg/d),
      whereas bST (21.5 kg/d) did not. Relative to controls, bST increased averaged
      daily serum somatotropin from 1.3 to 7.6 ng/ml and insulin-like growth factor-I
      from 67.5 to 116.0 ng/ml. Relative to bST, growth hormone-releasing factor
      increased serum somatotropin to 16.3 ng/ml and insulin-like growth factor-I to
      202.6 ng/ml. Relative to control (115.8 meq/dl) and bST (158.1 meq/dl), growth
      hormone-releasing factor increased plasma NEFA (230.3 meq/dl). During treatment,
      calculated energy balance was negative for cows receiving growth hormone
      releasing factor but positive for bST and control cows. Milk composition, body
      condition score, BW, and apparent digestibility of DM were not different among
      treatments. We conclude that i.v. infusion of 12 mg/d mg of growth hormone
      releasing factor has greater galactopoietic activity than i.m. injections of 14
      mg/d of bST.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744273
TI  - Postparturient metabolic and production responses in cows previously exposed to
      long-term treatment with somatotropin.
AB  - Postparturient metabolic and production responses were studied for 85 multiparous
      cows consisting of controls and animals that had been previously exposed to long
      term treatment with bST. Older cows previously exposed to bST at high doses (51.6
      mg/d) had lower milk yields than controls. However, there were no significant
      differences compared with controls in milk yield for lower dose (17.2 mg/d) older
      cows or parity 2 cow groups. The bST-treated groups had higher postpartum DMI,
      lower serum FFA, lower serum beta-hydroxybutyrate levels, and higher serum
      glucose than controls. Some bST-exposed groups had lower milk fat but higher milk
      protein levels. All bST-treated groups had significantly lower ratios of C18 to
      C4 to 10 milk fatty acids. Control cows of both parity groups were in higher body
      condition and weighed more than bST-treated cows prior to calving. The
      differences in postpartum metabolism may be attributed to differences in body
      composition resulting from bST treatment in the prior lactation, because use of
      body condition score prior to calving as a covariate did not substantially alter
      responses. The control cows probably had greater reserves of mobilizable lipid.
      These contentions are supported by changes in milk composition for bST-treated
      cows, which were consistent with animals of greater appetite, mobilizing less
      lipid. The bST-treated cows were probably more energetically efficient milk
      producers because they produced milk from feed rather than from mobilization of
      tissue stores. These data suggest that bST use in a prior lactation may have
      potential benefit in reducing risk of metabolic disorders associated with lipid
      mobilization in the postparturient period.

PMID- 1744274
TI  - Expert system for evaluation of reproductive performance and management.
AB  - A microcomputer expert system for dairy herd reproductive management was
      developed using an expert system shell and Turbo Pascal. The expert system
      initially examines the broad areas of days open, days to first breeding,
      detection of estrus, and conception rate to determine whether a problem exists.
      Interpretations ranging from "excellent" to "severe" were established for each
      trait. The system then selects an area for evaluation that has the largest
      negative influence on days open. Once an area has been selected for further
      evaluation, the expert system utilizes information from the user and DHI reports
      developed by the Dairy Records Processing Center in Raleigh, NC. These reports
      identify problems with conception categorized by production, parity, service
      number, days in milk, breed, and service sire. In addition, questions are
      presented by the expert system to isolate problems of accuracy of data, use of
      natural service, semen handling, AI technique, detection of estrus, signs of
      estrus, and other management areas. Recommendations and suggestions are given.
      Ten commercial herds having a conception rate less than 40% were evaluated by the
      expert system and by an extension reproduction specialist who supplied
      information for the system. Of 100 areas investigated, the expert system and
      extension specialist identified 47 as potential problem areas, agreeing on 85% of
      them. Most discrepancies resulted from the specialist applying a less restrictive
      standard when values were close to a preselected threshold.

PMID- 1744275
TI  - Evaluation of uterine body and bilateral uterine horn insemination techniques.
AB  - Uterine body and bilateral horn insemination techniques were compared in 364
      Jersey cows and 138 heifers by two inseminators. For horn inseminations,
      approximately one-half of the semen was placed in left uterine horn just prior to
      the point of resistance. The remainder of semen was then placed in the right
      uterine horn just prior to the point of resistance. Animals were inseminated in
      the uterine body on even days of the month throughout the study. On odd days of
      the month, animals were inseminated in both uterine horns. A total of 62.9% of
      286 animals inseminated in the uterine body were pregnant versus 54.2% of 216
      animals inseminated in both uterine horns. Differences were greater for cows than
      for heifers and at first and second services than at third or greater services.
      These results favor current recommended techniques to deposit semen into the
      uterine body correctly.

PMID- 1744276
TI  - Iron sulfate and feed pelleting to detoxify free gossypol in cottonseed diets for
      dairy cattle.
AB  - Thirty-two lactating cows were fed ad libitum diets with 1) 18.7% soybean meal,
      2) diet 1 plus 500 ppm supplemental Fe from FeSO4.H2O, 3) 15% whole cottonseed,
      or 4) diet 3 plus 500 ppm Fe from FeSO4.H2O. Dry matter intakes were similar
      except for cows fed diet 2, which was lower. Cows fed whole cottonseed diets
      ingested 23 g/d of free gossypol per cow. Free gossypol apparently excreted was
      lower than its intake. Iron excretion was similar to Fe intake. Blood metabolites
      and productive performance did not differ among the diet groups. No signs of
      gossypol toxicity were observed. Twelve neonatal Holstein male calves were fed a
      commercial milk replacer for 4 wk, then were allowed ad libitum access to diets
      with 1) 27% soybean meal, 2) 50% whole cottonseed, or 3) diet 2 plus 500 ppm Fe
      from FeSO4.H2O. Dry matter intakes were similar but slightly lower for calves fed
      diet 3. Daily individual intakes of free gossypol from diets 2 and 3 were 2 g,
      which was lower than the expected 4 g due to an apparent effect of pelleting.
      Blood metabolites did not differ among the groups, and calves averaged about .6
      kg of daily gain on these diets. A follow-up study showed that pelleting reduced
      free gossypol by as much as 70% in whole cottonseed and by 48% in cottonseed
      meal. Pelleting represents a mechanism to decrease the toxicity of gossypol in
      cottonseed products.

PMID- 1744277
TI  - Feeding supplemental fat and undegraded intake protein to early lactation dairy
      cows.
AB  - Forty-eight Holstein cows (16 primiparous) were fed alfalfa silage-based TMR
      containing 18% CP with 33 or 36% of the CP as undegraded intake protein and with
      0 or 2.8% supplemental fat (DM basis). Expeller soybean meal replaced solvent
      soybean meal to vary undegraded intake protein, and sodium alginate-treated
      tallow was used as the fat source. A standard diet containing solvent soybean
      meal without fat was fed during the first 21 d postpartum for covariate
      adjustment of milk production. A continuous lactation design with 2 x 2 factorial
      arrangement of treatments was used with supplemental fat and undegraded intake
      protein as main effects. Feeding supplemental fat increased actual milk (32.9 vs.
      31.7 kg/d) but decreased milk protein concentration. Cows fed supplemental fat
      also had higher BW, and weight gain was significant with time. Increasing
      undegraded intake protein did not affect milk yield, composition, or component
      yield. There were no significant interactions between supplemental fat and
      undegraded intake protein on milk yield or composition. Milk fatty acid
      composition was not altered by addition of undegraded intake protein, but C6 to
      C14 fatty acids were reduced by adding supplemental fat. Results do not support
      the strategy of increasing levels of undegraded intake protein when supplemental
      fat is fed. Variation in undegraded intake protein content of feed-stuffs appears
      to be of more importance in ration formulation than interactions between
      supplemental fat and protein.

PMID- 1744278
TI  - Lactational performance of high producing dairy cows fed diets containing salmon
      meal and urea.
AB  - Thirty Holstein cows were used in a 12-wk trial to study the effects of salmon
      meal and urea on lactational performance. Two experimental diets, one containing
      5.6% salmon meal and the other 5.2% salmon meal plus .42% urea, were compared
      with a soybean meal control diet. Salmon meal and urea replaced a portion of the
      soybean meal. Dietary undegraded intake protein levels (expressed as percentage
      of CP) were 28.8, 35.6, and 32.4% for soybean meal, salmon meal, and salmon meal
      plus urea. Total mixed diets (average 17.3% CP, 17.6% ADF) consisting of 60%
      concentrate mixture and 40% bromegrass silage (DM basis) were fed twice daily.
      Total DMI was lower with salmon meal compared with soybean meal (20.2 versus 22.2
      kg/d); salmon meal plus urea (21.2 kg/d) was intermediate. Actual milk production
      was similar for all diets (average 41.1 kg/d). Percentage milk fat and 4% FCM
      yield were lower with salmon meal (2.56%, 31.6 kg/d) and salmon meal plus urea
      (2.50%, 31.4 kg/d) than with soybean meal (3.03%, 35.9 kg/d). Gross efficiency
      (weight FCM/weight DMI) was higher for soybean meal than for salmon meal and
      salmon meal plus urea. Acetate: propionate tended to be higher with the soybean
      meal diet. The use of a high oil fish meal to provide a source of rumen
      undegraded intake protein, alone or in combination with urea, resulted in a
      decrease in milk fat percentage and yield without any beneficial effects on milk
      production or lactational efficiency.

PMID- 1744279
TI  - Effect of sometribove on rumen fermentation, rate of passage, digestibility, and
      milk production responses in dairy cows.
AB  - Six ruminally and duodenally fistulated Holstein cows 60 d postpartum were
      assigned randomly to each of two treatments in a single reversal design.
      Treatments consisted of placebo or 25 mg of sometribove (bST) injected daily.
      Treatments were initiated at 60 d +/- 7 postpartum and maintained for 6 wk with a
      3-wk adjustment between treatment periods. All cows received a TMR consisting of
      16% CP and 1.67 Mcal of NE I/kg of DM. Influence of bST on rumen fermentation
      characteristics, digesta rate of passage, apparent nutrient digestibility, and
      milk production was evaluated. Milk yield of treated animals was 4.0 kg/d higher
      than controls. The 3.5% FCM and milk production efficiency (3.5% FCM/DMI) were
      significantly higher in treated animals than in controls (29.0 vs. 25.4 kg/d and
      1.38 vs. 1.21 kg/kg, respectively). Percentage of rumen cellulolytic bacteria (of
      total viable bacteria) was not significantly different for bST-treated animals
      (6.4 vs. 3.4%). Total number of rumen protozoa tended to be higher (7.25 vs. 6.55
      x 10(3)/ml) in bST-treated animals. Ruminal percentages of CP, NH3 N, alpha-amino
      N, VFA, and pH were unaffected by treatment. Sometribove treatment did not
      significantly affect liquid dilution or solids turnover rates. Percentages of CP,
      alpha-amino N, and NH3 N content in duodenal samples were unaffected by
      treatment. Total tract apparent digestibility of nutrients and mean daily DMI
      were unaffected by treatment.

PMID- 1744280
TI  - Zinc absorption, metabolism, and endogenous excretion in zinc-deficient and
      normal calves over an extended time.
AB  - Zinc metabolism was studied in Zn-deficient and control Holstein calves over a 2
      mo period following a single oral or i.v. 65Zn dose. In both orally and i.v.
      dosed animals, all gastrointestinal tissue sections from Zn-deficient animals
      contained more 65Zn than comparable tissues of controls. Contents of proximal
      small intestinal sections of Zn-deficient calves contained more 65Zn 8 to 10 wk
      after dosing than did those from controls; however, the reverse occurred in the
      distal small intestine, cecum, and large intestine. With both dosing methods, Zn
      deficient calves retained more 65Zn throughout the study. Daily 65Zn excretion
      rate as a percentage of that retained declined for 6 wk after dosing, indicating
      a constantly increasing biological half-life. For deficient calves, the
      biological half-life was about 500 d in the later weeks of the experiments. In
      orally dosed, Zn-deficient animals, specific activity of fecal 65Zn exceeded that
      of serum Zn throughout the study. This shows a shortcoming in the basic
      assumption of measuring endogenous Zn loss from fecal and serum specific
      activities and total fecal stable Zn. Thus, endogenously excreted Zn is not
      representative of that remaining.

PMID- 1744281
TI  - Estimation of genetic parameters using sampled data from populations undergoing
      selection.
AB  - In populations undergoing selection, genetic (co)variances may be altered in
      amounts dependent on selection intensity among parents and the mating structure.
      In order to estimate the genetic parameters of the unselected population, all
      information that led to the current population must be included in the analysis.
      This is often not possible due to missing information or computer limitations,
      and, therefore, only samples of data and pedigree information of recent
      generations are included in analysis, and simplified operational models are used.
      Biases in genetic parameters, which were estimated by multitrait derivative-free
      REML method, were investigated in different strategies of sampling data and
      pedigree. In dual purpose cattle, in which young bulls are selected for growth
      before being progeny tested for milk yield, heritabilities and additive genetic
      correlations were all unbiased when all data and all relationships were used in
      an animal model. Using only recent data but all relationships in an animal model
      also gave unbiased estimates of heritabilities. Using an animal model for growth
      but a sire model for milk with all data gave an unbiased estimate of heritability
      for milk. When only recent data were used, the heritability estimate for milk was
      biased downward. In single purpose dairy populations, sire models gave biased
      estimates of genetic parameters even when all data were included in the analysis.
      Treating sire effects on second crop of daughters as fixed did not overcome
      selection bias.

PMID- 1744282
TI  - The use of integer programming in dairy sire selection.
AB  - A computerized sire selection integer program, IPSIRE, was developed to test the
      optimality of solutions obtained by using MAXBULL, a popular computerized sire
      selection aid. The IPSIRE program uses an optimization software package and a
      compatible spreadsheet; MAXBULL uses linear programming techniques. The computer
      programs were compared using large and small data sets. Multiple combinations
      were run, varying the levels requested for PD fat percentage, PD type, and price
      paid per unit of semen. All other constraints were held constant. The objective
      function for all combinations maximized PD milk. The IPSIRE program exceeded
      MAXBULL by an average of $2.5 for PD dollars and 7.3 kg (16.1 lb) for PD milk
      using the small bull data base. Sire averages for traits PD type, PD fat
      percentage, and price paid were not different between the two programs. Similar
      trends were seen using the large bull data base. The IPSIRE program exceeded
      MAXBULL by an average of $1.2 for PD dollars and 4.1 kg (9.0 lb) for PD milk,
      whereas sire averages for PD fat percentage, PD type, and price paid were not
      different between programs. The goal for PD type had the least influence of the
      three goals on sire averages for PD milk. The goal for price paid had the
      greatest impact on realized PD milk; higher goals for price paid produced
      solutions with higher values for realized PD milk. The IPSIRE program required
      longer computational times for finding solutions that maximized PD milk than
      MAXBULL.

PMID- 1744283
TI  - Heritability of hypocalcemia at first parturition in Norwegian cattle: genetic
      correlations with yield and weight.
AB  - Minimum plasma calcium level around parturition and its relation to BW at
      parturition, milk yield, and weight change in mo 1 of lactation were studied in
      334 first lactation Norwegian cows. Minimum plasma calcium level was reached 18
      to 30 h postpartum. Single observations for all animals were fitted with a
      multitrait animal model including all genetic relationships. Heritabilities of
      the traits were calcium postpartum, .11; milk yield, .35; BW, .65; and weight
      change, .17 with standard errors about .10. Genetic correlations between calcium
      postpartum and the other traits were milk yield, -.49; BW, -.66; and weight
      change, .42 with standard errors about .25. Environmental factors with detectable
      effect on hypocalcemia were age at parturition and calving season. Regression of
      calcium postpartum on age was -2.66 x 10(-4) mmol/L per d. Calvings shortly after
      the pasture season were related to higher calcium postpartum than calvings after
      3 to 4 mo with indoor feeding.

PMID- 1744284
TI  - Site of digestion of starch in the gastrointestinal tract of dairy cows and its
      effect on milk yield and composition.
AB  - Physical and chemical processing of feed ingredients and feeding management
      strategies are major instruments of manipulating amount and site of starch
      digestion in the gastrointestinal tract. Generally, as rumen escape of starch
      increases, postruminal starch digestion increases, and there does not appear to
      be a limitation to intestinal starch digestion. However, the efficiency with
      which postruminal starch is digested decreases, which represents a limitation
      that warrants investigation. Even though digestible dietary starch is presented
      to the intestine, there is no net glucose absorption at the portal vein, and
      plasma glucose levels remain relatively unaffected. This result may be associated
      with the large metabolic requirement for postruminally absorbed glucose, which is
      preferentially used for oxidative metabolism at the visceral tissue level. In
      addition, peripheral glucose concentration is highly regulated. A possible
      implication is that the exogenous glucose supply may spare endogenously
      synthesized glucose for gut metabolism, allowing more to be directed to the
      mammary gland. Amino acids also may be spared (less metabolism of dietary and
      tissue amino acids in the gut). Current production studies yield no clear
      evidence as to the benefits of postruminal digestion of starch to enhance milk
      yield or to change its composition. However, studies suggest that starch digested
      postruminally is used more efficiently for milk synthesis than that digested in
      the rumen.

PMID- 1744285
TI  - Balancing carbohydrates and proteins for optimum rumen microbial yield.
AB  - Establishing conditions under which rumen fermentation will be optimized requires
      an understanding of the nutrient requirements of the mixed microbial population.
      The major nutrients required by rumen microbes are carbohydrates and proteins,
      but the most suitable sources and quantities needed to support maximum growth
      have not been determined. Digestion of proteins results in the production of
      peptides, which can accumulate in the rumen. Peptides are further hydrolyzed to
      amino acids, some of which are deaminated, producing ammonia. Although peptides,
      amino acids, and ammonia all may individually serve as sources of N for various
      microbes, the total population achieves the highest growth rate on mixtures of
      all three sources. In a somewhat analogous manner, carbohydrates are digested by
      exoenzymes to oligosaccharides that are available for crossfeeding by the mixed
      microbial population. Based on data from both in vitro and in vivo studies, there
      is general agreement that rate of digestion of carbohydrates is the major factor
      controlling the energy available for microbial growth; in addition, rate of
      digestion of total carbohydrate is directly related to proportion of starches,
      pectins, and sugars. Proteins affect both total fermentation and production of
      microbial DM per unit of carbohydrate fermented. It appears that the quantity of
      ruminally available protein needed to optimize microbial growth may, under some
      conditions, be as high as 14 to 15% of diet DM.

PMID- 1744286
TI  - A theoretical model for understanding dentists' behavior in treating patients
      with AIDS.
AB  - This paper attempts to expand on a model from the theory of reasoned action to
      help us identify and better understand the reasons dentists do or do not treat
      dental patients with, or at risk for, AIDS. We propose in the model that the
      dentist's actual behavior in treating dental patients with, or at risk for, AIDS,
      in his or her practice is a function of both his or her intention to treat such
      patients and his or her nonvolitional factors relevant to the behavior. The
      dentist's intention to treat patients with AIDS or HIV infection, or those
      belonging to high risk groups, is influenced by two belief components: (1)
      attitudinal variables, which are the dentist's beliefs about the consequences of
      treating such patients and the value that these consequences have for him or her;
      and (2) normative variables, which indicate the dentist's perceptions of how his
      or her reference groups view the treatment of such patients in his or her
      practice and his or her motivation to comply with those views. Finally, both the
      two belief components and the nonvolitional factors are affected by the personal
      characteristics and the environmental variables.

PMID- 1744287
TI  - Factors that affect patient attitudes toward infection control measures.
AB  - This study examined how differences in infection control procedures and patients'
      perceived knowledge of infection control, and how AIDS and hepatitis might affect
      attitudes toward the use of such measures. Patients receiving treatment at two
      sites where the methods of infection control and the frequency of their use
      differed (dental school and private dental practices) were surveyed concerning
      their approval/acceptance of infection control measures and self-report of
      knowledge concerning infectious disease and possible transmission of infectious
      disease during dental treatment. Data were collected from 379 patients, 272 from
      the dental school and 107 from five private practices. A high percentage (95
      percent) of both dental school and private patients felt they were adequately
      protected, while fewer than 2 percent expressed anxiety about infection control
      procedures being used in either setting. Factors such as gender, age, and years
      of formal education did not significantly affect attitudes toward infection
      control measures, but age and education were correlated with perceived knowledge
      of infectious diseases. Patients' reported knowledge of infectious disease had a
      significant effect on their decision to leave a practice if the dentist was HIV
      positive. A significantly higher percentage of dental school patients felt that
      barrier infection control techniques should be used routinely. Patients treated
      where such techniques were not routinely used nevertheless expressed satisfaction
      with that level of protection, implying that patients tend to accept the level of
      infection control being practiced where they receive treatment.

PMID- 1744288
TI  - Accreditation of predoctoral dental education: clinical outcomes assessment.
AB  - The Curriculum Outcomes Review and Evaluation (CORE) system of outcomes
      assessment used in the accreditation of Canadian Dental Faculties by the
      Commission on Dental Accreditation of the Canadian Dental Association is
      described. The CORE system, which has become an integral part of the regular
      accreditation site visit of Canadian dental predoctoral programs consists of (a)
      two methods of chart review, (b) assessment of the performance of a random sample
      of final year students in both diagnosis and treatment planning and in case
      presentation, (c) a structured observation in the clinical setting, (d) the
      application of a detailed and focused survey instrument prior to the site visit,
      and (e) the solicitation of feedback from involved students, faculty members,
      school administrators and accreditation site visitors. The overall response to
      the CORE program was favorable and plans to expand the program to dental hygiene
      accreditation are described.

PMID- 1744289
TI  - Use of screening blood studies in dental schools.

PMID- 1744290
TI  - Developing an undergraduate hospital dentistry program.

PMID- 1744291
TI  - Dental seniors' evaluation of their curriculum and the number of clock hours of
      instruction.

PMID- 1744292
TI  - Curriculum guidelines for predoctoral preventive dentistry.

PMID- 1744293
TI  - Curriculum guidelines for predoctoral implant dentistry.

PMID- 1744294
TI  - Extended selections for pyrethroid resistance in the German cockroach
      (Dictyoptera: Blattellidae).
AB  - Selection experiments with a pyrethrins-susceptible and a pyrethrins-resistant
      strain of German cockroaches, Blattella germanica (L.), were conducted for 17
      generations with either permethrin or fenvalerate as the selecting agent. Large
      nymphs were left on treated glass surfaces for extended periods of time each
      generation. Mortality was assessed at 24 h. The level of resistance was
      determined periodically by time-mortality testing. The VPI-susceptible strain
      served as the basis for comparison. The pyrethrins-susceptible strain developed
      resistance to pyrethrins early in the selection process; this strain ultimately
      became resistant to allethrin, phenothrin, permethrin, fenvalerate, cyfluthrin,
      and cypermethrin. Fenvalerate caused faster development of resistance than did
      permethrin. The pyrethrins-resistant strain, selected with fenvalerate, quickly
      became resistant to allethrin, permethrin, phenothrin, and fenvalerate.
      Ultimately, it developed resistance to all nine pyrethroids tested.

PMID- 1744295
TI  - Effect of temperature on the toxicities of ten pyrethroids to German cockroach
      (Dictyoptera: Blattellidae).
AB  - Of 10 pyrethroids tested by topical application of male German cockroaches,
      Blattella germanica (L.), d-phenothrin was the least toxic at 19, 26, or 31
      degrees C. lambda-cyhalothrin was most toxic. Pyrethroids with the alpha-cyano
      moiety (fluvalinate, fenvalerate, cypermethrin, esfenvalerate, tralomethrin,
      cyfluthrin, and lambda-cyhalothrin) were more toxic than those without this
      functional group (d-phenothrin, resmethrin, and permethrin). At LC50, toxicity
      was negatively related to temperature. Temperature-toxicity responses of five of
      seven alpha-cyano pyrethroids were parallel, possibly indicating qualitatively
      identical but quantitatively different levels of detoxification enzymes.

PMID- 1744296
TI  - Influence of attractants on behavior of screwworms (Diptera: Calliphoridae) in a
      tropical wet forest in Costa Rica.
AB  - In a mark-release-recapture study, sheep wounds and rotted liver were used as
      attractants to study movements of the screwworm fly, Cochliomyia hominivorax
      (Coquerel), in a Costa Rican tropical wet forest in the wet season. When sites
      were monitored for less than 1 h, liver attracted between 3 and 12.2 times more
      flies of both sexes than did wounds, but proportionately fewer gravid and parous
      females. Only 24.6% of females marked at liver sites were recaptured; seldom
      (3.1%) did they visit sheep wounds. Females originally marked at sheep wounds
      remained at the study site longer, visited both sheep and liver sites, and
      greater than 50% were recaptured. Some females were observed for 16 d and one
      laid four clutches of eggs. Only 8% of the marked males were recaptured and none
      was recaptured less than 2 d later. Only a small proportion of the adult
      screwworms at a locality visited wounds on sentinel sheep; the majority of the
      adults were transient.

PMID- 1744297
TI  - Alternative to sentinel animals for collecting egg masses from wild females of
      the screwworm (Diptera: Calliphoridae).
AB  - Egg masses from wild populations of the screwworm, Cochliomyia hominivorax
      (Coquerel), were obtained by collecting females from rotted liver, holding them
      for 3 d until egg maturation and then placing them on heated ground beef for
      oviposition. Nearly 50% of the females oviposited. Fertility of egg masses was 66
      and 95% at the two collection sites. Decreased fertility was associated with
      collections of virgin females. Average weight +/- SD of the egg masses was 13.7
      +/- 1.40 mg; the number of eggs per mass averaged 343. This method of obtaining
      egg masses from wild screwworm females is a cost-effective, sensitive alternative
      to the use of sentinel animals in the field. The use of rotted liver costs less,
      takes less time, and takes less equipment than the traditional sentinel animal
      technique.

PMID- 1744298
TI  - Influence of starvation and lighting on the movement behavior of the German
      cockroach (Blattodea: Blattellidae).
AB  - Computerized moving-image analysis measured the influence of starvation and
      lighting conditions on the locomotor activity of the German cockroach, Blattella
      germanica (L.). Starvation increased the distance traveled, velocity, and the
      proportion of time in motion of adult males and last instars but did not increase
      adult female movement. For females, males, and nymphs, starvation increased
      cockroach residence time around the source of water and harborage and decreased
      the distance traveled by females and nymphs around the observation arena's edge.
      Fluorescent light reduced the proportion of time in motion for males, but the
      velocity of males was greater in fluorescent light relative to infrared light.
      Adult males and females stopped more frequently in infrared light. Overall, males
      and nymphs were more mobile than females and they explored larger areas. The
      moving-image analysis technique is an efficient and accurate tool for observing
      movement of individual cockroaches and has applications in repellency,
      attractancy, and basic movement behavior studies.

PMID- 1744299
TI  - Seasonal movement and spatial distribution of the sheep ked (Diptera:
      Hippoboscidae) on Wyoming lambs.
AB  - When populations of adult sheep ked, Melophagus ovinus (L.), infesting unshorn
      lambs were monitored at the University of Wyoming Paradise Farm during 1986, we
      determined the body regions on which keds would be found at various times of the
      year and their seasonal population trends for optimal sampling. Results suggested
      that ked populations were consistently greater on the ribs than on any other area
      of the lamb. No significant differences were detected for ked populations between
      sides of a lamb. Distinct and similar ked population trends over time occurred
      only in the rib, thigh, shoulder, hind leg, belly, and hind flank areas of the
      lambs, suggesting that a significant seasonal migration did not occur. Analyses
      for seasonal population fluctuations indicated that ked populations increased in
      the winter and spring, decreased in summer and then increased again in the fall.
      Thus, sampling for keds in the rib area at shearing, which begins in March in
      Wyoming and runs through mid-April, would be an opportune time to detect keds. At
      other times of the year, the rib area should be inspected for presence of sheep
      ked.

PMID- 1744300
TI  - Advancing beyond pressure in ICU monitoring of the acute injured brain.

PMID- 1744301
TI  - Oxygen cost of breathing during weaning.

PMID- 1744302
TI  - Jugular bulb catheterization does not increase intracranial pressure.
AB  - Cerebral venous monitoring through jugular bulb catheterization (JBC) allows
      assessment of global oxygen delivery adequacy. Because of concern that venous
      obstruction by catheterization may cause or exacerbate intracranial hypertension,
      physicians are reluctant to puncture this vessel in brain-injured patients. We
      evaluated the impact of JBC on intracranial pressure (ICP). 37 consecutive
      pediatric patients with jugular bulb catheters and ICP monitoring were studied.
      ICP was monitored in 28 patients during JBC. Also immediately after JBC and daily
      thereafter the contralateral, ipsilateral, and bilateral jugular veins were
      compressed in all 37 patients to assess patency of these vessels. Change in ICP
      was noted. If ICP increased more than 5 torr, compression was stopped.
      Preinsertion ICP was 17.3 +/- 5.1 and postinsertion 17.2 +/- 5.1 torr. The
      maximum rise in ICP was 2 torr in a single patient while 6 others had a decrease
      in ICP. 120 compression tests were performed. Compression ipsilateral to the
      catheter caused the ICP to rise from 16.0 +/- 4.3 to 18.4 +/- 4.4 torr, and in
      contralateral compression 15.9 +/- 4.2 to 17.0 +/- 4.4. Neither the duration of
      catheterization nor the precompression ICP correlated with the rise in ICP. These
      data revealed no evidence of jugular venous obstruction in the catheterized
      vessel. We conclude that JBC can be performed in patients without aggravating an
      elevated ICP.

PMID- 1744303
TI  - Plasma catecholamines and oxygen consumption during weaning from mechanical
      ventilation.
AB  - Previous studies on oxygen consumption (VO2) during weaning from mechanical
      ventilation assumed that an increase in VO2 (delta VO2) reflected oxygen
      consumption by respiratory muscles (VO2RESP), and proposed delta VO2 as a weaning
      predictor. We measured VO2 CO2 production (VCO2) and plasma catecholamines in 20
      short-term ventilated patients during weaning by SIMV and CPAP. delta VO2 as a
      percentage of VO2 during spontaneous ventilation (delta VO2%) ranged from 4.8% to
      41.5%. VCO2 also increased and correlated with VO2. Plasma adrenaline and
      noradrenaline increased significantly to levels known to produce considerable
      increases in metabolic rate. Mean arterial pressure and heart rate concomitantly
      increased, but spontaneous minute ventilation decreased. Thus, since the
      increased plasma catecholamines are calorigenic, the assumption that delta VO2
      represents VO2RESP is incorrect. Although mean delta VO2% of successfully weaned
      patients was significantly less than that of failure-to-wean patients, the wide
      scatter of individual values in the latter group excludes delta VO2% as an
      accurate weaning predictor.

PMID- 1744304
TI  - The cost of an intensive care unit: a prospective study.
AB  - The cost of intensive care for patients admitted to the ICU were estimated.
      Patients suffering from severe combined acute respiratory and renal failure who
      required mechanical ventilation and renal replacement therapy (SCARRF-D) cost per
      day significantly more than non-renal patients (pounds 938 compared to pounds 653
      per patient respectively) and their average length of stay in hospital is nearly
      4 times as long (28.8 compared to 7.6 days respectively). Approximately 44% of
      the total cost was staff related (28% for the provision of nurses and 16% for the
      rest). Retrieving information related to cost was difficult, time consuming and
      labour intensive.

PMID- 1744305
TI  - Combined high-frequency ventilation in children with severe adult respiratory
      distress syndrome.
AB  - Six children conventionally ventilated for acute pulmonary parenchymal failure
      developed severe hypoxemia (mean PaO2 48 +/- 7 mmHg at an FiO2 of 0.95 +/- 0.08)
      persisting for more than 6 h despite a progressive increase in positive end
      expiratory pressure (PEEP) to 14.7 +/- 1.5 cmH2O. Combined high-frequency jet
      ventilation (HFJV, mean rate 225 b/min superimposed on small tidal volume
      conventional ventilation) resulted in a sustained increase in PaO2 to 93 +/- 21
      mmHg, p less than 0.05 while peak inspiratory pressure decreased from 47 +/- 8 to
      35 +/- 6 cmH2O and positive end expiratory pressure could be reduced to 5.8 +/-
      4.5 cmH2O, p less than 0.05 and FiO2 to 0.88 +/- 0.10. This improvement occurred
      without new barotrauma nor deleterious effects on hemodynamic function or
      diuresis. After a mean of 62 h of combined function or diuresis. After a mean of
      62 h of combined HFJV, persistent improvement in gas exchange allowed us to
      resume conventional mechanical ventilation at lower airway pressures in 4
      children who continued to improve and survived. The 2 other children maintained
      satisfactory gas exchange on combined HFJV, but ultimately died from multiple
      organ failure. We conclude that combined HFJV might prove helpful to relieve
      profound hypoxemia and possibly decrease the risk of barotrauma in children with
      catastrophic pulmonary failure.

PMID- 1744306
TI  - Antibiotic levels in bronchial tree and in serum during selective digestive
      decontamination.
AB  - Selective digestive decontamination has been found to prevent pulmonary
      infections in mechanically ventilated patients. The aims of this study were: 1)
      to determine whether detectable levels of antibiotics could be found in bronchial
      tree secretions of patients receiving SDD, and 2) to evaluate antibiotic serum
      levels. In 15 patients receiving mechanical ventilation and SDD for 10 days or
      more, tobramycin and amphotericin B levels were determined every 3 days in the
      following specimens: tracheal aspirates, distal bronchial secretions and blood
      samples. 82% of tracheal aspirates contained detectable (greater than 0.18 mg/l),
      tobramycin concentrations; the levels varied widely between patients and large
      day-to-day variations were observed. Every patient had at least 1 tracheal
      aspirate with tobramycin level higher than 0.5 mg/l during his course. 40% of
      distal specimens contained detectable tobramycin levels (10 patients). Serum
      determinations showed detectable concentration of tobramycin in 50% of the
      specimens (9 patients). Two patients with renal failure had serum tobramycin
      levels higher than 2 mg/l. In 13 tracheal aspirates cultures were positive and 15
      species were isolated; 13 had a MIC higher than the corresponding tobramycin
      level in tracheal secretions. We conclude that substantial levels of antibiotics
      can be found frequently in respiratory tract specimens of patients receiving SDD.
      Therefore, the usual microbiological criteria used to assess respiratory tract
      infection may be unreliable in this setting and other criteria may be required.
      Follow-up of antibiotic serum levels is required, especially in patients with
      renal failure.

PMID- 1744307
TI  - Injurious sleep behavior disorders (parasomnias) affecting patients on intensive
      care units.
AB  - There are no previous reports on parasomnias (sleep behavior disorders) affecting
      patients on intensive care units (ICUs). During 8 years of clinical practice, we
      evaluated over 200 adults with complaints of injurious, sleep-related behaviors,
      20 of whom had ICU admissions while their parasomnias had been active and
      generally undiagnosed/untreated. Mean age during ICU confinement was 62.8 (+/- SD
      13.1) years; 85.0% (17/20) were males. Patients underwent comprehensive clinical
      examinations along with extensive polysomnographic and audiovisual monitoring
      (electrooculogram, 9 channel EEG with paper speeds of 15 and 30 mm/sec,
      electromyogram [submental and 4 limbs], EKG, airflow). The polysomnographic
      studies were diagnostic for the REM sleep behavior disorder (vigorous dream
      enactment during rapid eye movement [REM] sleep) in 85.0% (17/20) of patients,
      and for night terrors/sleepwalking in 15.0% (3/20). Three groups of parasomnia
      ICU relationships were identified: i) Parasomnias originating in ICUs, stroke
      induced (n = 3); ii) Admission to ICUs resulting from parasomnia-induced
      injuries: C2 odontoid process fracture and C3 spinous process fracture with
      severe concussion (n = 2); iii) Parasomnias in patients admitted to ICUs for
      various other medical problems (n = 15). Physicians should be thus alerted about
      the possibility of injurious, but usually treatable, parasomnias in ICU patients.

PMID- 1744308
TI  - An experimental study of different ventilatory modes in piglets in severe
      respiratory distress induced by surfactant depletion.
AB  - In 19 anesthetized piglets 3 ventilatory modes were studied after inducing
      pulmonary insufficiency by bronchoalveolar lavage by the method of Lachmann. The
      lavage model was considered suitable for reproduction of severe respiratory
      distress. This model was reproducible and stable with respect to alveolar
      collapse, decrease in static chest-lung compliance and increase in extravascular
      lung water. The ventilatory modes studied were volume-controlled intermittent
      positive-pressure ventilation (IPPV), pressure-controlled inverse ratio
      ventilation (IRV), and pressure-controlled high-frequency positive-pressure
      ventilation (HFPPV). The 3 ventilatory modes were used in random sequence for at
      least 30 min to produce a ventilatory steady state. Ventilation with no PEEP,
      permitting alveolar collapse, was interposed between each experimental mode. The
      ability to open collapsed alveoli, i.e. alveolar recruitment, was different. The
      recruitment rate for IPPV was 74%, but for IRV and HFPPV it was 95%,
      respectively. Although IRV provided the best PaO2, this was at the expense of
      high airway pressures with circulatory interference and reduced oxygen transport.
      In contrast to this, HFPPV provided lower airway pressures, less circulatory
      interference and improved oxygen transport. In the clinical setting there might
      be negative effects on vital organs and functions unless the ventilatory modes
      are continuously and cautiously adapted to the individual requirements in
      different phases of severe respiratory distress. Therefore, one ventilatory
      strategy could be to "open the airways" with IRV, but then switch to HFPPV in an
      attempt to maintain the airways open with lesser risk of barotrauma and with
      improved oxygen transport.

PMID- 1744309
TI  - Acute trichloroethylene poisoning by ingestion: clinical and pharmacokinetic
      aspects.
AB  - Five hours after ingestion of an unknown amount of trichloroethylene (TCE) a 32
      year-old woman was admitted to hospital in deep coma. The neurological condition
      remained unchanged for 3 days, after which there was an improvement of the
      central nervous system function. The concentrations of TCE in the blood, which
      were measured during 7 days after the solvent ingestion, gave us the opportunity
      to study some toxicokinetic parameters of TCE. Using a physiologically based
      pharmacokinetic model, the toxicokinetic parameters and blood concentrations of
      TCE are discussed in relation to the neurological conditions. Moreover the same
      model has suggested that the alveolar hyperventilation during the first 12 h
      following the TCE poisoning is the only treatment which may shorten the duration
      of the poisoning.

PMID- 1744310
TI  - Pancreatitis related to severe acute hypertriglyceridemia during pregnancy:
      treatment with lipoprotein apheresis.
AB  - We report a clinical observation of acute pancreatitis due to severe
      hypertriglyceridemia in a pregnant woman. In order to decrease the serum
      triglyceride level rapidly, two lipaphereses were undertaken using the double
      filtration technique. This lipoprotein apheresis technique is briefly described
      and the efficacy in reducing rapidly hypertriglyceridemia is outlined. Like in 3
      previously published reports, the patient had a rapid recovery, confirming that
      lipoprotein apheresis should be an adequate and a well-tolerated treatment in
      such a condition.

PMID- 1744311
TI  - Heparin-induced thrombocytopaenia complicated by bilateral adrenal haemorrhage.
AB  - Acute adrenal insufficiency due to bilateral adrenal haemorrhage is an important
      clinical diagnosis and its association with heparin-induced thrombocytopaenia is
      infrequent. We report on a patient in whom life threatening acute adrenal
      insufficiency occurred consequent to such an association. The clinical
      manifestations simulated septic shock, highlighting the need to consider
      specifically acute adrenal insufficiency in such settings, and institute therapy
      promptly prior to obtaining results of confirmatory tests.

PMID- 1744312
TI  - Continuous arterio-venous haemodialysis during emergency hepatic
      retransplantation.

PMID- 1744313
TI  - Recovery from adult respiratory distress syndrome after high dose
      corticosteroids.

PMID- 1744314
TI  - Vasopressin in septic shock--a useful or dangerous agent?

PMID- 1744315
TI  - Euthanasia.

PMID- 1744316
TI  - Fortuitous discovery of the association of true and false left ventricular
      aneurysm in a patient in cardiogenic shock.

PMID- 1744317
TI  - Severe theophylline toxicity treated with oral activated charcoal.

PMID- 1744318
TI  - TNF levels in severe malaria treated by exchange transfusion.

PMID- 1744319
TI  - Acute renal failure in paediatric patients: the role of continuous
      haemofiltration.

PMID- 1744320
TI  - In search of the dysoxic threshold.

PMID- 1744321
TI  - Five years experience with continuous extracorporeal renal support in paediatric
      intensive care.
AB  - Continuous arterio-venous haemofiltration (CAVH) and continuous veno-venous
      haemofiltration (CVVH) were used as renal support in 52 critically ill infants
      and children with acute renal failure. The majority of the patients were on
      mechanical ventilation (90%) and needed vasopressor support (85%). Uraemia was
      satisfactorily controlled with both treatment modes. Post-treatment serum urea
      levels were not different between survivors (94 +/- 8.8 mg/dl) and non-survivors
      (99.5 +/- 8.8 mg/dl). There were significant differences between survivors and
      non-survivors in the mean arterial pressure (64.7 +/- 3.8 vs 48.0 +/- 2.2 mmHg, p
      less than 0.001), the number of organ system failures (2.9 +/- 0.16 vs 3.8 +/-
      0.21, p less than 0.025), and the severity of illness assessed by the acute
      physiologic score for children (APSC 19.4 +/- 1.9 vs 26.3 +/- 1.9, p less than
      0.01). The overall mortality was 48%. The mortality in the CVVH group (65%) was
      higher than in the CAVH group (40%). Death was significantly related to sepsis (p
      less than 0.005) and multiple system organ failure (p less than 0.005). A major
      complication during CAVH was one femoral artery thrombosis after 12 days of
      treatment. Technical problems were only observed during CVVH. CAVH and CVVH are
      safe and effective methods of continuous renal support for critically ill
      paediatric patients with multiple system organ failure. CAVH is simpler, needs no
      specially trained staff and seems to the ideal renal replacement system for
      critically ill infants.

PMID- 1744322
TI  - Delivery dependent oxygen consumption in patients with septic shock: daily
      variations, relationship with outcome and the sick-euthyroid syndrome.
AB  - Delivery dependent oxygen consumption (DDOC) is observed in patients with sepsis
      and vital organ dysfunction, and has been related to outcome. Similarly the sick
      euthyroid syndrome is associated with a high mortality. We examined the daily
      variations of DDOC and its relation to hormonal changes, particularly those of
      the thyroid. In 22 patients, 14 with septic shock and 8 post-operative controls,
      oxygen delivery was increased by increasing cardiac output with vasodilation by
      phentolamine, during a total of 207 days. DDOC varied markedly between
      consecutive days in individual patients with sepsis, in both survivors and non
      survivors. DDOC was related to severity of illness, assessed by APACHE II score
      (r = 0.50, p = 0.017), and plasma levels of triiodothyronine (T3), r = -0.49, p =
      0.011, and thyroxine (T4), r = -0.53, p = 0.012. No correlation was observed
      between DDOC and outcome, nor blood levels of lactate, epinephrine,
      norepinephrine, dopamine or cortisol. In conclusion, we observed a marked
      disturbance of systemic oxygen uptake autoregulation in patients with septic
      shock which varied during the clinical course and was related to the sick
      euthyroid syndrome.

PMID- 1744323
TI  - Is minitracheotomy a simple and safe procedure? A prospective investigation in
      the intensive care unit.
AB  - Patients with imminent respiratory failure due to sputum retention were assessed
      for minitracheotomy (MT). MT was considered potentially useful in 79 patients but
      only attempted in 73, 54 men and 19 women, aged 23-81 years (median 65 years).
      Insertion of the cannula failed in 4 cases. Sputum retention and atelectasis were
      successfully treated in 87% (N = 60). Treatment by MT in medical and neurological
      patients seems as effective as in surgical patients (success rate 81% versus
      90%). The frequency of complications was 16%. Most complications were
      insignificant and occurred during cannulation, but a few severe complications
      were seen. To minimize the number of these it is essential that MT is done only
      by doctors who are familiar with the procedure. MT can be recommended for
      treatment of sputum retention and atelectasis in surgical and
      medical/neurological intensive care patients with preserved cough function.

PMID- 1744324
TI  - Usefulness of severity indices in intensive care medicine as a predictor of
      nosocomial infection risk.
AB  - To evaluate the relationship between severity and nosocomial infection in
      critical patients, we have conducted a prospective study at the Intensive Care
      Unit of the University of Granada Hospital (Spain). Patients' severity was
      evaluated by APACHE II and TISS. We found a positive association with nosocomial
      infection risk for an APACHE II score greater than 12 points (RR = 2.45) and for
      first-day TISS greater than 20 points (RR = 2.51). With a multivariate analysis
      we did not find an association between APACHE II and nosocomial infection risk,
      but each TISS point suggests an infection risk increment of 6%. We concluded TISS
      may be considered a good infection risk predictor. TISS could also be taken into
      account when nosocomial infection rates from several ICUs are compared.

PMID- 1744325
TI  - Time oriented score system (TOSS): a method for direct and quantitative
      assessment of nursing workload for ICU patients. Italian Multicenter Group of ICU
      research (GIRTI).
AB  - A method for direct quantitation of nurses' workload required by ICU patients is
      described. Each nursing activity has been timed in 14 different ICUs
      participating in the multicentre study, and the results averaged. Nursing acts
      were grouped in different homology lists, complied according to operative
      similarities. Some lists include general nursing acts, which are common to all
      patients admitted to ICU, others include acts peculiar to different organ system
      abnormalities or acts ancillary to the general group, finally one list includes
      emergency or occasional acts which are not encountered in every patient. The TOSS
      is a simple and rapid method for ICU nurses' workload assessment, can be computed
      both at admission and during the stay in ICU, and can provide factual information
      on the nurse/patient ratio necessary in a specific environment. TOSS validation
      was conducted with a yearly prospective study collecting 2710 patients. TOSS
      values varied according to diagnosis, severity of illness (SAPS) and intensity of
      processes (TISS), and TOSS specificity was demonstrated by the possibility of
      selecting a wide combination of nurse/patient ratios from 1:4 to 1:1 not possible
      with TISS.

PMID- 1744326
TI  - The haemodynamic effects of intermittent haemofiltration in critically ill
      patients.
AB  - The haemodynamic effects of intermittent high volume venovenous haemofiltration
      were studied in 13 critically ill patients. The mean negative fluid balance
      during filtration was 1.21 and the mean duration of treatment 3 h 40 min. The
      cardiac index fell initially (4.5 +/- 0.2 to 3.8 +/- 0.21/min/m2; p less than
      0.05) but then remained stable throughout treatment before returning to baseline
      at the end of haemofiltration. The mean arterial pressure was unchanged with an
      increase in the systemic vascular resistance (651 +/- 33 to 765 +/- 65
      dyne.s/cm5; p less than 0.05) suggesting that vascular responsiveness is
      maintained during haemofiltration.

PMID- 1744327
TI  - Subclavian vein catheterization in critically ill children: analysis of 322
      cannulations.
AB  - Complications in 322 percutaneous subclavian vein catheters placed in 272
      children by the infraclavicular approach were investigated prospectively. Ages
      ranged from 4 days to 15 years. Incidents during catheter introduction occurred
      in 13 cases, and were more common when insertion was on the right side (p less
      than 0.01). Nine (2.8%) required urgent treatment: (6 pneumothorax, 1
      hydrothorax, and 2 hemothorax). Anomalous lodging of the catheter tip was more
      common when insertion was on the right side (p less than 0.05). Complications
      during catheter maintenance were 3 venous thromboses, 3 catheter obstructions,
      and 7 migrations out of position. There was no significant difference in
      complications related to age. Catheter cultures were positive in 33 (17%) of 190
      catheters cultured (27 through colonization and 6 through catheter-related
      sepsis). Staph. epidermidis was the organism most frequently isolated (19 cases;
      58%). Catheterization time of more than 5 days and catheter-related sepsis were
      statistically associated (p less than 0.05). Staph. epidermidis isolation and
      duration of cannula use were statistically related (p less than 0.01). No
      catheter-related deaths occurred. We conclude that subclavian vein
      catheterization is a simple and useful procedure that entails relatively few
      serious complications when performed by experienced pediatricians.

PMID- 1744328
TI  - The P50 is reduced in critically ill patients.
AB  - A prospective study was designed to measure the P50 in 20 critically ill
      patients, and compare it with the P50 measured in 20 normal individuals. Arterial
      blood gases, lactate, haemoglobin (Hb) and phosphate (PO4) levels were also
      measured and compared with the P50 in the critically ill patients. The mean P50
      of the critically ill patients was 24.5 mmHg (SD +/- 2.9) and was significantly
      lower than the mean P50 of 26.2 (SD +/- 2.2) in the normal individuals (p less
      than 0.05). In the critically ill patients, strong correlations were observed
      between the P50 and the arterial pH and base excess (BE) levels, with
      coefficients of 0.79 and 0.69 respectively whereas correlations between the P50
      and arterial oxygen tension (PO2), carbon dioxide tension (PCO2), lactate, Hb and
      PO4 levels were poor, with correlations of 0.001, 0.008, 0.07, 0.13 respectively.
      It is concluded that the P50 is commonly reduced in critically ill patients, and
      has a strong correlation with arterial pH and BE.

PMID- 1744329
TI  - Preliminary clinical trials of a computer-based cardiac arrest alarm.
AB  - The use of a high reliability cardiac arrest alarm utilising the continuously
      monitored values of patient heart rate and mean arterial blood pressure is
      described, based on a sample of 167 patients monitored for a total of 5116 h. The
      analogue heart rate and mean blood pressure signals are sampled at 1 s intervals,
      and a smoothing algorithm is applied to each of the resulting series which
      rejects artefacts, and identifies slope and step changes in each. Certain
      combinations of events in the 2 series, occurring within a preset time window,
      determine whether a cardiac arrest alarm or warning signal should be activated by
      the system. A total of 30 acute events occurring in 14 patients during the course
      of the study were each identified within 10 s. No cardiac arrest event was
      misdiagnosed by the algorithm during the period of the study. The algorithm also
      generates warnings which may have predictive value, and which will be the subject
      of further research. A final false alarm rate of about 1/200 h of monitoring was
      observed in adults (1/50 h in children), with evidence that these rates could be
      substantially improved.

PMID- 1744330
TI  - Respiratory changes after open-heart surgery.
AB  - Breathing pattern was studied non-invasively in 20 coronary artery bypass surgery
      patients before the operation and post-operatively after weaning from mechanical
      ventilation. Post-operatively minute ventilation (VE), breathing frequency (Fr)
      and mean inspiratory flow (VT/TI) increased (28%, 42%, 27%; p less than 0.01, p
      less than 0.001, p less than 0.01, respectively), while tidal volume (VT)
      decreased (15%, p less than 0.025). CO2 production (VCO2) and oxygen consumption
      (VO2) increased postoperatively (p less than 0.001 for both), contributing to the
      increase in ventilatory demand. Reduced variation of VT and Fr (p less than
      0.001, p less than 0.01, respectively) and number of sighs (p less than 0.001)
      were characteristic of the post-operative breathing pattern. Post-operatively an
      increase in the contribution of rib cage (%RC) to tidal volume in the supine
      position was observed suggesting reduced motion of the diaphragm. All patients
      had atelectasis, 17 had pleural fluid and only 6 normal vascularity post
      operatively. The shallow breathing in combination with increased ventilatory
      demand, impaired gas exchange and the surgical trauma of the thorax predispose to
      postoperative respiratory complications.

PMID- 1744331
TI  - Upper airway obstruction due to erysipelas.
AB  - Erysipelas is a rare cause of airway compromise. A case of a 57-year-old female
      is described who developed upper airway obstruction secondary to erysipelas of
      the neck. Emergency treatment by awake fiberoptic bronchoscopy with intubation
      over the bronchoscope followed by intravenous antibiotics produced rapid clinical
      improvement. Lymphatic obstruction of the laryngeal structures is the most likely
      physiologic mechanism.

PMID- 1744332
TI  - ARDS--associated with adult Still's disease.

PMID- 1744333
TI  - Septic shock and multiple organ failure: treatment with haemofiltration?

PMID- 1744334
TI  - Using the health belief model for bulimia prevention.
AB  - The author discusses application of the Health Belief Model to bulimia prevention
      (reduction of bulimic-like behaviors of food obsessions, bingeing, and various
      forms of purging). She considers the individual's beliefs about bulimia and
      bulimic-like behaviors as a means of predicting the likelihood of behavior change
      to prevent clinically diagnosable bulimia, includes a description of each Health
      Belief Model component, and offers implications for further research.

PMID- 1744335
TI  - HIV-related sexual behaviors of college students.
AB  - A follow-up study explored the prevalence of behavioral risk factors for HIV
      infection in a population of college students. Two hundred forty-three single
      students ranging in age from 17 to 24 years who identified themselves as
      heterosexual completed questionnaires related to planned and unplanned sexual
      intercourse and such other factors as alcohol and nonprescription drug use that
      might increase the risk of HIV infection. Forty-seven percent of the men and 57%
      of the women stated that they had had sexual intercourse from 1 to 5 times
      primarily because they were intoxicated, a phenomenon that increased with age
      until only 19% of those over 21 had never had sex because of intoxication.
      Seventeen percent of the sexually active men and 21% of the women said that they
      had used condoms. Nineteen percent of the men and 33% of the women acknowledged
      consenting to sexual intercourse because they felt awkward in refusing. The
      dangerous interaction between alcohol use and high-risk sexual activities
      suggested that college HIV prevention efforts should make the connection between
      the two risk factors explicit.

PMID- 1744336
TI  - The periodic health examination in college students revisited.
AB  - The periodic health examination is a group of tasks carried out by physicians and
      nurses at regular intervals, but not always yearly, to determine either the risk
      of subsequent disease or to identify disease in its early, asymptomatic state.
      The Guide to Clinical Preventive Services, published in 1989 by the United States
      Preventive Services Task Force, sets common American standards for these
      procedures. The guide lists those preventive activities recommended for persons
      aged 19-39 years. Every patient encounter in our student health services should
      be considered an opportunity for preventive activities. This article offers a
      simple check list for office use.

PMID- 1744337
TI  - College health services in California.
AB  - College health services are an underrecognized segment of California's health
      delivery system. Higher education institutions in California vary in their
      arrangements for the provision of health services. Some of the smaller
      institutions provide nurse triage, first aid, and referral only, whereas other
      institutions provide 24-hour-per-day/7-day-per-week comprehensive ambulatory and
      inpatient services. More than 200 full-time equivalent physicians are employed in
      college health services in California. Patient profiles served by college health
      services targeted the traditional college student age range. Some institutions,
      however, have expanded their services to include nonstudent university employees
      and their dependents. Comparing numbers of outpatient visits and professional
      staffing requirements to student enrollment showed significant variability
      between institutions, depending upon the scope of services provided (basic,
      intermediate, comprehensive) and the type of student population (residential,
      commuter, mixed).

PMID- 1744338
TI  - Nursing diagnosis as a needs assessment tool for campus health promotion.

PMID- 1744339
TI  - Implementing a comprehensive health education program for international students.

PMID- 1744340
TI  - The need for an expanded college consumer health curriculum.

PMID- 1744341
TI  - Baby boom parents and homosexuality: continued challenge for college health
      educators.

PMID- 1744342
TI  - Ethics and dental amalgam removal.

PMID- 1744343
TI  - The final curtain?

PMID- 1744344
TI  - The future of fluoride. Correction.

PMID- 1744345
TI  - Dental associations, FDA question safety of lasers on hard tissues.

PMID- 1744346
TI  - Regenerating the periodontium in advanced periodontal disease.
AB  - Current techniques can benefit patients with advanced periodontal disease and
      oral injuries. Future technology offers even greater promise for regenerating
      periodontal tissue.

PMID- 1744347
TI  - Using endosseous dental implants for patients with ectodermal dysplasia.
AB  - Congenitally missing teeth and poorly developed or absent alveolar ridges are
      signs often associated with various types of ectodermal dysplasia. Endosseous
      dental implants may be used to support fixed mandibular prostheses in patients
      with ectodermal dysplasia. Anatomical factors and age considerations require
      careful attention to treatment planning.

PMID- 1744348
TI  - The enemy is us. Some thoughts on the shortage.

PMID- 1744349
TI  - Managing occlusal surfaces of young permanent molars.
AB  - The practice of restoring occlusal surfaces of young permanent teeth with just
      amalgam or waiting and watching for caries to occur is outdated. Today, there are
      several treatment options.

PMID- 1744350
TI  - Capitation: the choice is yours.

PMID- 1744351
TI  - HIV testing.

PMID- 1744352
TI  - Opportunity knocks in market for allied dental personnel.

PMID- 1744353
TI  - Mediator release in aspirin-induced reactions.

PMID- 1744354
TI  - Near-fatal asthma: clinical and physiologic features, perception of
      bronchoconstriction, and psychologic profile.
AB  - We studied 19 subjects with asthma (11 men and eight women, aged 20 to 66 years),
      6 months to 5 years after a near-fatal (NF) episode of asthma (NF group). Mean
      duration of asthma was 16.3 +/- 2.4 years. On reevaluation, all subjects were
      using an inhaled beta 2-agonist and inhaled steroids (mean daily dose of
      budesonide, 1070 micrograms [N = 5], and beclomethasone, 1079 micrograms [N =
      14]). Two subjects were taking prednisone, 10 and 15 mg/day. Subjects were
      matched for age, sex, atopic status, baseline FEV1, and medication use to a
      control group (C group) of subjects with asthma who had never experienced an NF
      asthma episode. All subjects had the following evaluation: (1) questionnaire on
      the characteristics of their asthma, (2) spirometry, (3) morning and evening
      measurements of peak expiratory flow rates (PEFR) with daily recordings of asthma
      symptoms for 4 weeks, and (4) psychometric evaluation with the Minnesota
      Multiphasic Personality Inventory. Ten subjects of the NF group and 13 of the C
      group had a methacholine challenge with scoring of dyspnea on a modified Borg
      scale. Mean percent predicted (+/- SEM), FEV1, FVC, and PEFR were similar for the
      NF and C groups with respective values of 63.4 (4.4), 61.3 (5.6), 81.1 (4.5),
      79.1 (3.8), 61.3 (5.6), and 62.4 (6.1). Geometric mean of the provocative
      concentration of methacholine causing a 20% drop in FEV1 (milligrams per
      milliliter) was 0.61 for the NF group (N = 10) and 1.18 for the C group (N =
      13).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744355
TI  - Assay for the major dog allergen, Can f I: investigation of house dust samples
      and commercial dog extracts.
AB  - Monospecific rabbit antibodies were used to develop a sensitive two-site enzyme
      immunoassay to measure a major dog hair and dander allergen, Can f I. This Can f
      I assay demonstrated no reaction with 17 heterologous allergen sources, including
      dog albumin, cat, guinea pig, and horse. Analysis of serial dilutions of purified
      Can f I and the international standard for dog was parallel. The assay was
      considered specific for Can f I with a lower limit of detection at 0.03
      micrograms/ml. Total imprecision was from 2% to 6%. Commercial dog extracts for
      specific immunotherapy contained from 0.7 to 290 micrograms of Can f I per
      milliliter. The assay was used to measure Can f I in 136 house dust samples
      collected from 103 homes across the United States. Concentration of the dog
      allergen was expressed as micrograms of Can f I per gram of dust. Prevalence of
      Can f I in the dust samples ranged from less than 0.3 to 10,000 micrograms/gm.
      Serial dilutions of samples containing Can f I were parallel to the standard. The
      median Can f I value for homes with a dog in residence was 120 micrograms/gm, and
      for homes with no dog, 3 micrograms/gm. With few exceptions, homes with no dog in
      residence had less than 10 micrograms/gm. This Can f I assay will provide useful
      information for assessing commercial extracts as well as monitoring dog-allergen
      exposure and allergen-control methods.

PMID- 1744356
TI  - Asthmatic responses to passive cigarette smoke: persistence of reactivity and
      effect of medications.
AB  - The present study assessed the persistence of cigarette-smoke reactivity and the
      effects of drug pretreatment on bronchial responsiveness to environmental tobacco
      smoke (ETS). Two groups of subjects were chosen for the study. Group I consisted
      of 15 atopic smoke-sensitive subjects with asthma, six of whom were defined
      "reactors" and nine "nonreactors" to ETS challenge. Group II consisted of 15
      atopic subjects without asthma and with documented upper respiratory tract
      symptoms on exposure to ETS. All subjects were challenged for 2 to 6 hours with
      mechanically generated ETS in a static inhalation chamber. Five/six subjects in
      group I, who were previously demonstrated as reactors 24 months earlier, remained
      reactive within 1 to 2 hours of continuous ETS exposure. Pretreatment with
      albuterol, cromolyn, and a combination of albuterol and cromolyn 30 minutes
      before ETS exposure significantly diminished airway reactivity to ETS. All nine
      previous nonreactors in group I remained nonreactive despite rechallenge with ETS
      for up to 6 hours. Group II subjects challenged under identical conditions did
      not reveal a significant decline in FEV1 on challenge with ETS. These studies
      demonstrate the persistence of ETS reactivity during a 2-year period. Although
      cromolyn sodium and/or albuterol can protect against reactivity, mechanisms of
      ETS-induced airway reactivity remain unknown.

PMID- 1744357
TI  - Findings before diagnoses of asthma among the elderly in a longitudinal study of
      a general population sample.
AB  - Forty elderly subjects who denied ever having asthma or emphysema on enrollment
      in a longitudinal epidemiologic study later reported consulting a doctor for
      asthma when they were older than 60 years of age. The average age at which the
      diagnosis was reported was 70.8 years, after a mean follow-up of 8.5 years.
      Findings on enrollment in the newly diagnosed subjects with asthma are compared
      with findings in the 1145 subjects who provided follow-up information when they
      were older than age 60 years but had never developed asthma. At the time of
      enrollment, most subjects later diagnosed as having asthma already had wheezing
      symptoms, suggesting at least a mild asthmatic state, and many subjects had
      impaired ventilatory function, a positive allergy skin test (especially in
      association with rhinitis), and blood eosinophilia. Thirty-five percent of the
      subjects recalled "respiratory trouble before age 16" despite denying prior
      asthma. The likelihood of a new asthma label was very closely related to the age
      sex-standardized serum-IgE level before diagnosis. Newly diagnosed subjects with
      asthma demonstrated much greater rates of decline in FEV1 than control subjects
      or than subjects who already had known asthma on enrollment. We conclude that (1)
      symptoms suggesting asthma are usually present for many years before the
      diagnosis of the disease in elderly subjects, (2) the serum-IgE level is closely
      related to the likelihood of a subsequent asthma diagnosis, even in this age
      group, and (3) a rapid fall in lung function often occurs around the time of
      initial diagnosis.

PMID- 1744358
TI  - The effect of immunotherapy on eosinophil accumulation and production of
      eosinophil chemotactic activity in the lung of subjects with asthma during
      natural pollen exposure.
AB  - Two groups of birch pollen--allergic patients with seasonal rhinoconjunctivitis
      and asthma were followed during two consecutive birch-pollen seasons, one group,
      N = 10, during a season with high pollen load, and one group, N = 15, during a
      season of low pollen load. Half the patients were treated with immunotherapy (IT)
      for 3 and 4 years, respectively. The other half of the patients served as control
      group (non-IT). Bronchoalveolar lavage (BAL) was performed once before each
      season and once during the pollen season. Eosinophil (EOS) numbers in BAL were
      increased (p less than 0.01) during the season with high pollen load but not in
      the season with a low pollen load, and this increment was absent in the IT
      treated group. Also, the EOS cationic protein levels were raised in the non-IT
      treated group during the season with a high pollen load. The levels of EOS and
      neutrophil chemotactic activity were raised in BAL in both seasons in the non-IT
      treated group compared with the IT-treated group (p less than 0.02, p less than
      0.003, p less than 0.04, and p less than 0.005 in high- and low-load pollen
      season, respectively). Serum and BAL eosinophil chemotactic activity (ECA) were
      positively correlated (p less than 0.001). We conclude that there is an influx of
      active EOSs into the lung of pollen-allergic patients with asthma during a pollen
      season, which may be abrogated by IT. Furthermore, the generation of ECA appears
      to be an extremely sensitive marker of antigenic exposure, and the potent
      inhibition of the generation of ECA by IT may provide a clue as to the mechanism
      of this treatment.

PMID- 1744359
TI  - Recombinant allergens for immunoblot diagnosis of tree-pollen allergy.
AB  - Diagnosis of type I allergy essentially depends on the availability of defined
      allergens, which can be provided by recombinant deoxyribonucleic acid (DNA)
      technology. We have previously isolated the c(complementary)DNAs encoding the
      major birch-pollen allergen, Bet v I, and another allergen with a molecular
      weight of 14 kd that was identified as birch profilin and designated Bet v II.
      These cDNAs were isolated from a lambda gt11 expression library by screening with
      the serum IgE from allergic patients. To obtain expression in Escherichia coli of
      recombinant allergens without additional fused polypeptides, both cDNAs were
      inserted into the plasmid pKK223-3. E. coli cells expressing Bet v I and birch
      profilin (Bet v II) were used for the preparation of recombinant proteins. These
      proteins were tested for their IgE-binding properties on immunoblots with sera
      from 100 different birch pollen-allergic patients. All patients' sera, which
      reacted with the natural allergens, Bet v I and Bet v II, demonstrated an
      identical IgE-binding pattern to recombinant birch-pollen allergens. Recombinant
      allergens may therefore be useful for the setup of diagnostic tests that allow
      the discrimination of different IgE-binding patterns as well as for patient
      tailored immunotherapy.

PMID- 1744360
TI  - Cockroach allergenic activity: analysis of commercial cockroach and dust
      extracts.
AB  - Previous investigations demonstrated that cockroach whole bodies and feces are
      important sources of allergens in the induction/exacerbation of bronchial asthma.
      The current study investigated different cockroach source materials, commercial
      extracts, and house dust extracts for cockroach allergenic activity. In general,
      extracts from four different sources of either American or German cockroaches
      contained similar amounts of allergenic activity by RAST inhibition. Three
      commercial American cockroach extracts compared by RAST inhibition had similar
      allergenic activity on an equal protein basis. Skin test results correlated house
      dust reactivity to both commercial and inhouse cockroach wholebody extracts and
      to fecal extracts. Six different samples of house dust obtained from vacuum
      cleaners in the New Orleans area and three commercially obtained house dust
      extracts contained varying quantities of cockroach allergenic activity by RAST
      inhibition. These studies demonstrate that commercial cockroach extracts vary in
      allergenic activity and that all house dust extracts tested contain cockroach
      allergens.

PMID- 1744361
TI  - The 31 kd major allergen, Alt a I1563, of Alternaria alternata.
AB  - A component of Alternaria extract, previously identified as the major allergen,
      Alt a I1563, was purified to homogeneity from Alternaria mycelium by means of
      acetone precipitation and ion-exchange chromatography. The homogeneity of Alt a
      I1563 was assessed by one single band after sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis, by one single radiolabeled band after transfer to
      nitrocellulose, and by one single peak after size-exclusion chromatography by
      high-performance liquid chromatography. Alt a I1563 was isolated as a heat-stable
      acidic glycoprotein (carbohydrate content, 20%; pI, 4.0 to 4.5; 31 kd). The role
      of the carbohydrate moiety in the allergenicity is suggested. This major allergen
      is located in the cytoplasm of mycelium and spore.

PMID- 1744362
TI  - Acute consumption of C1 inhibitor in a patient with acquired C1-inhibitor
      deficiency syndrome.
AB  - Acquired C1-inhibitor (C1 INH) deficiency is usually found in association with an
      underlying disease that is believed to be responsible for increased C1 INH
      catabolism, ultimately leading to the development of C1 INH deficiency. We report
      a remarkable patient with acquired C1 INH deficiency in whom a unique progression
      of complement- and contact-system abnormalities has been observed. S. G. suffers
      from recurrent episodes of angioedema and hypotension. Results of repeated
      complement studies were initially normal, and the patient was diagnosed as having
      idiopathic anaphylaxis. Two years later, the patient was found to develop acute
      consumption of C1 INH with activation of the complement and contact systems
      during episodes of angioedema. The patient continued to have normal C1 INH levels
      and to have no evidence for complement- or contact-system activation between
      attacks of angioedema. One year later, her course evolved into a more typical
      course for acquired C1 INH deficiency consisting of continuously low functional
      C1 INH levels with evidence of activation of the complement and contact systems.
      S. G. provides a unique insight into the development of acquired C1 INH
      deficiency.

PMID- 1744363
TI  - Airborne dust mite allergens: comparison of group II allergens with group I mite
      allergen and cat-allergen Fel d I.
AB  - The form in which allergens become airborne is important because it may influence
      both symptoms caused by allergen exposure and methods used to reduce exposure.
      The group I allergens from dust mites only become airborne during disturbance and
      fall rapidly, which is in keeping with their being carried on fecal pellets.
      Their mean size is approximately 20 microns in diameter. By contrast, the cat
      allergen Fel d I is airborne on particles varying from greater than 10 to less
      than 2 microns in diameter, some of which remain airborne even without
      disturbance. A second group of mite allergens, molecular weight 14,000, are
      equally important and are associated predominantly with mite bodies. With a
      monoclonal antibody-based assay and a cascade impactor, we have investigated the
      form in which group II mite allergens become airborne. The results reveal that
      these allergens only become airborne during disturbance and that they fall within
      15 minutes. However, the mean size of particles carrying group II allergens
      appears to be slightly smaller than the mean size of particles carrying group I
      allergens. In addition, the quantities of group II allergen becoming airborne
      during disturbance (mean, 26 ng/m3) could not be explained by the quantity found
      in fecal particles. Thus, group II mite allergens become airborne in a form quite
      distinct from cat allergens and very similar to group I mite allergens; however,
      it appears unlikely that fecal particles are the main form in which group II
      allergens become airborne.

PMID- 1744364
TI  - Activated T cells and eosinophilia in bronchoalveolar lavages from subjects with
      asthma correlated with disease severity.
AB  - Activated T-lymphocytes may regulate the eosinophilic inflammation of bronchial
      asthma. In the present study, we investigated T cell activation and eosinophilia
      in blood and bronchoalveolar lavage (BAL) in 17 patients with asthma not
      receiving steroid treatment. Compared to normal individuals, BAL from patients
      with asthma contained significantly increased numbers of both lymphocytes and
      eosinophils (EOSs). The lymphocytosis consisted of increased numbers of both CD4+
      and CD8+ T cells, and these T cell populations expressed elevated levels of T
      cell activation markers (interleukin-2 receptor [CD25], HLA-DR, and very late
      activation antigen 1). Close correlation was found between numbers of BAL CD4+ IL
      2R+ T cells and numbers of EOSs. Moreover, the numbers of activated T cells and
      EOSs were related to the severity of asthma as measured by impairment of FEV1 and
      increased methacholine bronchial responsiveness. We demonstrate in both blood and
      BAL a close correlation between T cell activation, eosinophilia, and severity of
      asthma, suggesting that recruitment and activation of lymphocytes and EOSs are
      fundamental to the pathogenesis of bronchial asthma.

PMID- 1744365
TI  - Sensitization to Blomia tropicalis and Lepidoglyphus destructor in
      Dermatophagoides spp-allergic individuals.
AB  - Serum was collected from 77 atopic subjects from Cartagena, Colombia, who had a
      positive skin test (greater than or equal to 3 mm) to either Dermatophagoides
      farinae (Df) (73) or D. pteronyssinus (Dp) (70). Twenty-nine healthy volunteers
      with negative allergy histories and negative skin tests were used as control
      subjects. RAST and RAST-inhibition assays were used to study the prevalence of
      specific IgE to Blomia tropicalis (Bt), Lepidoglyphus destructor (Ld), and Df.
      RAST results were considered positive when a serum bound greater than or equal to
      1% of the total counts added; 69 atopic subjects (89.6%) were positive to Df, 66
      (85.5%) to Bt, and 46 subjects (59.7%) were positive to Ld. RAST results,
      analyzed by regression analysis, revealed the following correlation coefficients:
      Df versus Bt, r = 0.59; Df versus Ld, r = 0.44; and Bt versus Ld, r = 0.52. RAST
      inhibition assays with a serum pool of 11 individuals highly allergic to all
      three mites (mean specific IgE to all mites, greater than or equal to 18.2
      percent total counts bound) demonstrated considerable cross-reactivity between Bt
      and Ld and moderate cross-reactivity between Df and Bt and Ld. Bt, Df, and Ld
      possess unique, as well as common, allergens. Sensitization to Bt and Ld is very
      common in mite-allergic individuals in Cartagena, Colombia.

PMID- 1744366
TI  - Characterization of allergen-induced bronchial hyperresponsiveness and airway
      inflammation in actively sensitized brown-Norway rats.
AB  - Bronchial responsiveness to inhaled acetylcholine (ACh) and inflammatory cell
      recruitment in bronchoalveolar lavage fluid (BALF) were studied in inbred Brown
      Norway rats actively sensitized to, and later exposed to, ovalbumin (OA). We
      examined animals 21 days after initial sensitization at 18 to 24 hours, or 5 days
      after a single challenge, or after the last of seven repeated exposures
      administered every 3 days. BALF was examined as an index of inflammatory changes
      within the lung. Animals repeatedly exposed to OA aerosols had an increased
      baseline lung resistance and a significant increase in bronchial responsiveness
      to inhaled ACh compared to control animals at both 18 to 24 hours and 5 days
      after the last OA exposure. Sensitized animals receiving a single OA aerosol also
      demonstrated bronchial hyperresponsiveness (BHR) to inhaled ACh (p less than
      0.01) at 18 to 24 hours of a similar order as the multiple-exposed group. There
      was a significant increase in eosinophils, lymphocytes, and neutrophils in BALF
      at 18 to 24 hours but not at 5 days after single or multiple exposure to OA
      aerosol in the sensitized groups. Control animals demonstrated no changes in
      bronchial responsiveness, although a small but significant increase in
      inflammatory cells was observed compared to saline-only treated animals. There
      was a significant correlation between bronchial responsiveness and eosinophil
      counts in the BALF in the single allergen-exposed group (Rs = 0.68; p less than
      0.05). We conclude that (1) BHR after allergen exposure in sensitized rats is
      associated with the presence of pulmonary inflammation but persists despite the
      regression of inflammatory cells in BALF after multiple OA exposures, and (2)
      this rat model has many characteristics of human allergen-induced BHR.

PMID- 1744367
TI  - Diagnostic laboratory immunology: a subspecialty that encompasses clinical as
      well as laboratory immunology.

PMID- 1744368
TI  - Validity of skin tests to cyclophosphamide and metabolites.

PMID- 1744369
TI  - IgE antibodies in tick bite-induced anaphylaxis.

PMID- 1744370
TI  - Physicians and death.

PMID- 1744371
TI  - Nepali birth practices.

PMID- 1744372
TI  - A Kenyan mission hospital.

PMID- 1744373
TI  - Future physicians' attitudes on women's reproductive rights: a survey of medical
      students in an American university.
AB  - The July 1989 US Supreme Court decision in Webster v Reproductive Health Services
      restricts both women's access to legal abortion and physicians' latitude when
      performing abortions. We surveyed 197 medical students at the Columbia University
      College of Physicians and Surgeons regarding their general attitudes toward
      abortion as well as their specific opinions concerning the Webster decision and
      the possible restriction of minors' access to abortion represented by three then
      undecided cases. Of those surveyed, 85.8% were pro-choice by self-description as
      compared with 14.2% pro-life. The antiabortion group was predominantly male
      (78.6%) and of Catholic background, while there were no significant gender and/or
      religious correlates among the pro-choice group. The majority of the respondents
      (83.2%) disagreed with either one or both stipulated restrictions of Webster and
      81.4% did not support limiting minors' access to abortion in any way. Moreover,
      only 19.8% admitted to a change in general attitude toward abortion during their
      medical education.

PMID- 1744374
TI  - Treatment of premenstrual dysphoric symptoms in depressed women.
AB  - Although research has established a strong association between premenstrual
      dysphoric symptoms and depression, there is little data on the effect of
      antidepressents on premenstrual symptoms. This study compared the efficacy of
      three treatments--imipramine, phenelzine, and placebo--on the premenstrual
      symptoms of women with atypical depression who had responded to treatment for
      their depressive symptoms. The Premenstrual Assessment Form (PAF) was used to
      rate the type and degree of premenstrual symptomatology. After 12 weeks, at least
      two-thirds of the women on active medication showed improvement on most measures
      of premenstrual symptoms to the degree that they had essentially no premenstrual
      problems after treatment. By comparison, only half of a group of women who had
      responded to placebo treatment of 6 weeks duration showed such improvement.

PMID- 1744375
TI  - Immunohistochemical study on gastrin-releasing peptide-containing peripheral
      nerve fibers in rat, macaque and human.
AB  - Distribution of gastrin-releasing peptide (GRP)-containing peripheral nerve
      fibers in the respiratory organs, digestive tracts and hearts of rat, monkey and
      human was studied with immunohistochemical method. In the trachea, GRP
      immunoreactive nerve fibers were observed in the lamina propria and surrounded
      ducts and acini of tracheal serous glands with a basket-like appearance. In the
      lung, immunoreactive nerve fibers were scattered in the lamina propria of bronchi
      and bronchioles, and also the adventitia of veins. In the digestive organs, such
      as esophagus, duodenum and jejunum, numerous GRP-immunoreactive nerve fibers were
      distributed in the lamina propria and muscle layer; especially in the former
      layer where they were seen running up to the apical part of villi. GRP-containing
      nerve bundles and branched fibers were also observed in the atrial muscle layer.
      These results gave a morphological basis to future studies of the functional
      significance of GRP on autonomic mechanisms.

PMID- 1744376
TI  - Sympathoneural and skeletal muscle contributions to plasma dopa responses in
      pithed rats.
AB  - Dihydroxyphenylalanine (DOPA) in plasma has been thought to originate from
      sympathetic nerve endings and to reflect catecholamine biosynthesis, because
      changes in DOPA levels follow pharmacologically- or environmentally-induced
      manipulations that alter turnover of the sympathetic neurotransmitter,
      norepinephrine (NE). Skeletal muscle may be an additional, non-neural source of
      circulating DOPA. In the present study we examined sympathoneural and skeletal
      muscle contributions to DOPA in arterial plasma in pithed rats. Electrical
      stimulation of the spinal cord causes discharges of sympathetic post-ganglionic
      neurons, with attendant release of NE into the bloodstream, and discharges of
      spinal motoneurons, which causes diffuse contraction of skeletal muscle.
      Stimulation of the spinal cord rapidly elevated arterial plasma concentrations of
      NE, dihydroxyphenylglycol (DHPG), and DOPA. Pre-treatment with curare, a skeletal
      muscle relaxant, did not affect the NE and DHPG responses but attenuated the DOPA
      responses by about 50%. Administration of chlorisondamine, a ganglionic blocker,
      abolished NE and DHPG responses to cord stimulation, and DOPA responses were
      decreased by about 90%. Adrenal-demedullation did not affect the stimulation
      induced DOPA responses. The results demonstrate that in pithed rats undergoing
      spinal cord stimulation, DOPA is released into the bloodstream. Since this
      response is markedly inhibited after ganglionic blockade and also attenuated
      after skeletal muscle paralysis, the results provide indirect evidence that DOPA
      formed in sympathetic neurons can be stored in a non-neuronal pool and released
      during skeletal muscle contraction.

PMID- 1744377
TI  - Analysis of preganglionic nerve evoked cholinergic contractions of the guinea pig
      bronchus.
AB  - We compared cholinergic bronchial muscle contractions induced by vagus nerve
      (preganglionic) stimulation (VNS) with those induced by electrical field
      (postganglionic) stimulation (EFS). When normalized to their respective maximum
      response, the frequency-response curves (10 s trains) between 4 and 16 Hz were
      similar between VNS and EFS; however, at frequencies of 0.1-2 Hz, and at
      frequencies greater than 32 Hz, the VNS contractions were significantly less than
      EFS. When contractions elicited by 100 pulses were examined, it was found that
      the responses to VNS were maximal at 10-30 Hz then declined significantly to 82
      35% of maximal between 40 and 200 Hz, whereas the response to EFS was essentially
      unchanged at frequencies up to 60 Hz and declined only to 72% of maximal up to
      200 Hz. At frequencies as low as 20 Hz, the contractions evoked by VNS faded to
      45 +/- 9% of the peak contraction during 60 sec of continuous stimulation,
      whereas those evoked by 60 sec continuous EFS remained constant. This fade
      observed during prolonged VNS was not blocked by the antagonists, pirenzepine and
      AFDX-116, at concentrations selective for M1 and M2 muscarinic receptors,
      respectively; nor was the fade blocked by pre-treatment with indomethacin,
      propranolol, phentolamine, or choline. At frequencies greater than 10 Hz, the
      amplitude of the preganglionic compound action potential also faded during
      repetitive stimulation. The results support the hypothesis that the airway
      ganglion neurons innervating guinea pig bronchial smooth muscle effectively
      filter preganglionic stimuli, especially at low and relatively high frequencies.
      During continuous vagus nerve stimulation, preganglionic mechanisms may also play
      a role in limiting the ultimate output of airway ganglia.

PMID- 1744378
TI  - Alpha- and beta-adrenoceptor-mediated effects on nerve stimulation-evoked release
      of neuropeptide Y (NPY)-like immunoreactivity in the pithed guinea pig.
AB  - The effect of one beta-adrenoceptor agonist and one antagonist on preganglionic
      nerve stimulation (PNS)-evoked increase of plasma neuropeptide Y-like
      immunoreactivity (NPY-LI) was studied in the pithed guinea pig, both in the
      presence and in the absence of the alpha 2-adrenoceptor antagonist yohimbine.
      Four periods of PNS (8 Hz for 30 s with 20 min intervals) were applied and the
      increases of mean arterial blood pressure (delta BP), heart rate (delta HR) and
      plasma NPY-LI (delta NPY-LI) were analysed. Infusion of the non-selective beta
      agonist isoprenaline (0.15 micrograms x kg-1 x min-1 i.v.) tended to reduce delta
      BP in response to PNS and significantly increased HR at baseline without changing
      the maximal HR response. Pretreatment with yohimbine (1 mg x kg-1 i.v.)
      significantly increased delta BP in response to PNS by about 20% without any
      change in basal HR being observed. The non-selective beta-adrenoceptor antagonist
      propranolol (5 mg x kg-1 i.v.) significantly reduced delta BP and delta HR both
      in the presence and in the absence of yohimbine. Isoprenaline infusion enhanced
      plasma delta NPY-LI by 37% in comparison with the corresponding control. This
      effect of isoprenaline appeared to be slow in onset and could be blocked by
      propranolol, which per se did not significantly change plasma delta NPY-LI.
      Pretreatment with yohimbine caused a three to four-fold increase in plasma delta
      NPY-LI, which was slightly reduced both in the presence of isoprenaline (-39%)
      and propranolol (-27%). In conclusion, the sympathetic neurotransmission, also
      with regard to neuronal NPY, seems to have two adrenergic control mechanisms: one
      inhibitory and one facilitatory mediated by presynaptic alpha 2- and beta
      adrenoceptors, respectively. The facilitatory control mechanism could not be
      demonstrated if the release of neuronal NPY was already greatly enhanced by alpha
      2-adrenoceptors.

PMID- 1744379
TI  - Mucosal distortion by compression elicits polarized reflexes and enhances
      responses of the circular muscle to distension in the small intestine.
AB  - The possibility that distortion of the mucosa by compression might be a
      sufficient stimulus to evoke reflex responses in intestinal muscle, and that such
      reflexes might summate with distension-evoked (stretch) reflexes, was tested in
      isolated segments of guinea pig small intestine. Opened segments of intestine
      were pinned flat in an organ bath with, or without, distending balloons embedded
      in its base. Intracellular microelectrode recordings were taken from the circular
      muscle oral and anal to sites of application of sensory stimuli. Pressure against
      the mucosa, which distorts the villi without the wall being stretched, evoked
      polarized reflex responses in the circular muscle, consisting of excitatory
      junction potentials oral and inhibitory junction potentials anal to the stimulus.
      Distension stimuli applied by 6-mm diameter balloons that pushed against either
      the serosal or the mucosal surface also evoked excitatory junction potentials in
      the muscle oral to the stimulus and inhibitory junction potentials at anal sites.
      Response amplitudes were 20% greater when the distending balloon pushed against
      the mucosal surface. Responses to distension from the serosal side were of 20%
      greater amplitude when combined with mucosal distortion by compression than
      without such compression. It is concluded that peristaltic movements that are
      commonly studied in the small intestine can be consequences of reflexes elicited
      at the same time from mucosal distortion receptors and from stretch receptors.

PMID- 1744380
TI  - What does the absence of Helicobacter pylori from the antrum imply?
AB  - Helicobacter pylori is absent in the antrum of approximately 5, 25, and 35% of
      patients with duodenal ulcer, gastric ulcer, and non-ulcer dyspepsia respectively
      and in the majority of asymptomatic healthy subjects from the West. The absence
      of H. pylori from the antrum could result from failure of exposure to (Group A)
      or colonization by (Group B) or temporary (Group C) or permanent (Group D)
      clearance of H. pylori, after initial colonization. Marked differences in the
      incidence of absence of H. pylori in antrum of different age group of control
      subjects from the West and the developing nation (such as India) are discussed.

PMID- 1744381
TI  - Study designs and diagnostic criteria need standardization to effectively compare
      worldwide ulcer trends.
AB  - The development of technology and worldwide communication systems has spurred the
      growth of international comparative studies. These comparative epidemiological
      studies can be fruitful if they utilize a uniform approach. We address some of
      the strengths and limitations of these types of studies, and suggest they should
      be carried out using prospectively designed protocols.

PMID- 1744382
TI  - Gastrin and colorectal neoplasia--chicken or egg, or both?

PMID- 1744383
TI  - Pancreatic pseudocyst drainage--the needle or the scalpel?
AB  - A sizable number of pancreatic pseudocysts resolve spontaneously. Some, however,
      require intervention. Surgery was the only option available for many years.
      Recently, however, newer methods, such as percutaneous drainage and endoscopic
      cystotenterostomy have been used. Percutaneous drainage is inexpensive, has a low
      complication rate, and is done under local anesthesia. The recurrence rate is
      high with a one-time needle aspiration; this rate can be reduced to less than 10%
      by using an indwelling catheter. All these factors tend to make percutaneous
      continuous catheter drainage the first choice in the management of pseudocysts
      that require intervention. Experience with the endoscopic technique is still
      limited.

PMID- 1744384
TI  - Patterns of dyspepsia during the course of duodenal ulcer.
AB  - Dyspepsia patterns during the course of duodenal ulcer (DU) were examined in
      terms of the number of consecutive months that patients experienced dyspepsia
      either intermittently or continuously, or were dyspepsia-free. The patients (n =
      224) were community-based. After ulcer healing, they were evaluated every 3
      months for less than or equal to 7 years. Antiulcer agents were prescribed at the
      physicians' discretion. We analyzed the data on a patient-month basis using a 2
      state Markov chain model. The fitted mean number of consecutive months with
      dyspepsia and the number of months dyspepsia-free were, respectively, 1.7 and 14
      in patients on antiulcer agents, and 1.5 and 9 in patients not taking them. On
      average, patients experienced dyspepsia during 15% of months studied if they were
      on antiulcer agents, and during 20% of months if not. Regardless of antiulcer
      therapy, dyspepsia periods were lengthened by age, especially greater than 60
      years; male sex; widowhood/divorce/separation; increasing acetaminophen use; and
      increasing length of time since initial onset of ulcerlike dyspepsia. Dyspepsia
      free periods were lengthened by age greater than 70 years, and shortened by
      widowhood/divorce/separation and increasing cigarette consumption. These results
      suggest that dyspepsia occurs for less than or equal to 20% of the time in DU
      patients on about a yearly basis. The least dyspepsia may be expected in patients
      neither widowed, divorced, nor separated, in whom length of time since the
      initial onset of ulcerlike dyspepsia does not exceed 7 years, and who neither
      smoke nor use analgesics regularly.

PMID- 1744385
TI  - Acid and gastric ulcer pain.
AB  - We have shown previously that acid is one factor, although not the only one, in
      the pathogenesis of duodenal ulcer pain. In the present study patients with
      gastric ulcer were endoscoped without sedation or premedication. Under direct
      vision the ulcer craters were infused sequentially with 0.1 N HCl and normal
      saline, the sequence of infusion being randomized and double blind. Typical ulcer
      pain occurred in seven of 19 patients during acid infusion compared with one with
      saline (p = 0.023). Two patients who developed pain on acid were rechallenged
      after their pain disappeared, and typical pain recurred in both. Acid therefore
      has a definite role in the pathogenesis of gastric ulcer pain.

PMID- 1744386
TI  - Predicting histologic findings from endoscopic appearance of early gastric
      cancer.
AB  - In 156 cases of depressed early gastric cancer in the antrum or corpus, the
      differences between differentiated and undifferentiated carcinoma were studied by
      comparing the histological diagnosis of the resected specimens and their
      endoscopic appearance. We reached the following conclusions: (a) Younger patients
      more often had undifferentiated carcinoma (mean age: 59.8 years) than
      differentiated carcinoma (mean age: 77.2 years). (b) One hundred and twenty-five
      of 156 cases were limited to the mucosa and 29 cases were limited to the
      submucosa. (c) Undifferentiated gastric cancers more often invaded beyond the
      mucosa even when the tumor was small than did differentiated tumors. (d) Many
      differentiated tumors showed a smooth depressed surface, erythema at the edge of
      the cancer, and tapering of the gastric rugae. (e) In undifferentiated lesions
      the depressed tumor surface had a varied appearance, with various sized granules
      and nodules, as well as fading of the mucosal color and fusion of the rugae. It
      is important at endoscopy to consider not only whether a lesion is benign or a
      malignant, but also to consider its histological type. In particular, it is vital
      to detect small, undifferentiated gastric cancers as early as possible.

PMID- 1744387
TI  - Celiac sprue after surgery of the upper gastrointestinal tract. Report of 10
      patients with special attention to diagnosis, clinical behavior, and follow-up.
AB  - The clinical onset of celiac sprue (CS) may be precipitated by upper digestive
      tract surgery. We report a series of 10 patients who developed CS after diverse
      types of peptic ulcer surgery. Six were male and 4 female. Gastrectomy with
      Billroth II anastomosis was performed in 5 patients, truncal vagotomy and
      pyloroplasty in 2, parietal cell vagotomy and pyloroplasty in 1, and vagotomy
      with gastrojejunal anastomosis in 2. We found that eight patients had had
      previous symptoms that suggested CS. Symptoms occurred early in the postoperative
      period. Severe diarrhea and striking weight loss were the most prominent clinical
      findings. The response to gluten-free diet was independent of the type of
      surgical procedure performed and was similar to that observed in the general
      celiac population.

PMID- 1744388
TI  - Chronic diarrhea with normal stool and colonic examinations: organic or
      functional?
AB  - To investigate whether the clinical history and basic laboratory test results can
      differentiate between an organic or functional cause of chronic diarrhea and thus
      avoid unnecessary hospital admissions and invasive procedures, we reviewed the
      charts of 58 adult patients admitted during 6 years because of chronic diarrhea
      who had normal stool and colonic examinations. The final diagnoses were irritable
      bowel syndrome in 34 patients, organic diarrhea in 21, and unknown cause in
      three. The following clinical data did not help in the differential diagnosis:
      age, sex, duration of diarrhea, presence of continuous diarrhea, abdominal pain,
      stool frequency or volume, and presence of stool mucus. Significant weight loss,
      nocturnal diarrhea, and the absence of tenesmus were associated with an organic
      cause. One or more laboratory alterations (increased erythrocyte sedimentation
      rate, anemia, hypokalemia, and low serum albumin level) were found in 62% of
      patients with organic diarrhea but in only 3% of those with functional disease; p
      less than 0.001. In 20 of 21 patients with organic diarrhea, an syndromic
      diagnosis (fat malabsorption, n = 13; inflammatory bowel disease, n = 4; and
      secretory diarrhea, n = 3) could be obtained with three simple tests (stool fat,
      rectal biopsy, and fecal water osmolality and electrolyte determination,
      respectively). Our study confirms that a detailed history and a few simple
      laboratory data can help to distinguish between functional and organic diarrhea
      and so avoid extensive investigation. The syndromic diagnosis of organic diarrhea
      can also be approximated with relatively easy tests.

PMID- 1744389
TI  - Can isolation of Aeromonas hydrophila from human feces have any clinical
      significance?
AB  - A total of 27,480 stool specimens from 15,548 patients with gastroenteritis were
      analyzed for bacterial enteropathogens during a 4-year period between 1986-89 at
      a major referral center in Saudi Arabia. Bacterial pathogens were isolated from
      1,152 patients, Salmonella being the most frequent, followed by Campylobacter,
      Shigella, and Aeromonas hydrophila. The latter bacterium was found in 58
      patients; seven of them were associated with other enteric pathogens, but A.
      hydrophila was the only organism in 51 patients. All had gastrointestinal
      symptoms, the most common being diarrhea (92%), followed by abdominal pain (68%),
      fever (37%), and vomiting (27%). Stool specimens from 1,368 control patients were
      negative for A. hydrophila.

PMID- 1744390
TI  - Elevated serum gastrin levels in patients with colorectal neoplasia.
AB  - Gastrin stimulates the growth of some human colon adenocarcinomas grown in vitro
      or as xenografts in nude mice. To evaluate the possibility of elevated plasma
      gastrin levels in patients with adenomatous polyps or colorectal cancer, we
      carried out a radioimmunoassay in subjects fasting overnight and undergoing
      colonoscopy. The study included 190 patients who were divided into three groups:
      controls (n = 65), those with benign adenomas (n = 63), and those with
      adenocarcinomas (n = 62). The mean values of plasma gastrin in the cancer group
      (112.71 +/- 16.65 pg/ml) were significantly higher than those of the control
      group (40.41 +/- 1.88 pg/ml) as well as those of the polyp group. Mean plasma
      gastrin values in the polyp group (54.27 +/- 5.29 pg/ml) were also significantly
      higher than those of the control group. In the cancer group, 32 of 62 patients
      (51.6%) had gastrin levels greater than the control mean +2 SD, as opposed to
      only 10 of 63 (15.9%) in the polyp group. The number, size, histologic type, and
      presence of dysplasia in the polyp group and the location or Dukes' stage in the
      cancer group had no significant influence on gastrin levels in this study.
      Preliminary results in cancer patients with elevated preoperative gastrin levels
      show a postoperative reduction in six of seven patients. The exact cause and role
      of hypergastrinemia in tumor growth in such patients remains to be determined.
      Measurements taken both before and after colectomy coupled with a systematic
      search for specific gastrin receptors would be useful.

PMID- 1744391
TI  - Circadian periodicity and other clinical features of biliary pain.
AB  - We studied the time of onset and other clinical features of biliary pain in 54
      patients living in Northern Italy. All patients had cholelithiasis documented by
      ultrasonography. The time of onset of pain followed a circadian periodicity with
      its peak occurring at 9:30 p.m. The typical biliary pain was steady, mostly
      localized in the right upper quadrant of the abdomen or the epigastrium, lasted
      over 1 h, and required analgesics for relief. The pain was not related to meals
      or body position. What precipitates biliary pain is still an enigma.

PMID- 1744392
TI  - Tuberculous abscess of the liver in acquired immunodeficiency syndrome.
AB  - We present two human immunodeficiency virus (HIV) positive patients; each was
      diagnosed with tuberculous abscess of the liver and treated with good clinical
      response. A review of the literature indicates there is no typical clinical
      presentation. A high index of suspicion plus special stains of tissue material
      are required to make the diagnosis in appropriate patients, especially because
      this is a treatable condition even in patients with AIDS.

PMID- 1744393
TI  - Transition from nutcracker esophagus to achalasia. A case report.
AB  - We report a middle-aged woman with nutcracker esophagus who progressed to classic
      achalasia in two years. Several previous reports have documented progression of
      nutcracker esophagus to diffuse esophageal spasm and diffuse esophageal spasm to
      achalasia, but the only previous report of nutcracker esophagus progressing to
      achalasia was in a child. Our case suggests that, in some instances, nutcracker
      esophagus and achalasia may share the same pathogenesis.

PMID- 1744394
TI  - Barrett's esophagus and achalasia. A case report.
AB  - A 70-year-old woman with no previous gastroesophageal surgery gave a 6-month
      history of dysphagia. Barium studies suggested a diagnosis of achalasia.
      Esophageal manometry showed absence of peristalsis and a high lower esophageal
      sphincter pressure. Endoscopy showed a dilated esophagus with food residue, and
      Barrett's esophagus was present. The association of Barrett's esophagus and
      achalasia must be rare.

PMID- 1744395
TI  - Postshunt myelopathy.
AB  - Postshunt myelopathy is a rare, severely debilitating syndrome complicating
      portosystemic shunts that is characterized by spastic paraparesis. In this report
      we describe a 39-year-old woman with alcoholic liver disease and postshunt
      myelopathy resulting in an inability to walk. The syndrome did not become
      manifest until eight years after construction of a side-to-side portacaval shunt.
      This case is compared with reported literature on the subject.

PMID- 1744396
TI  - Gastric mucosa in female patients with fundic glandular polyps.
AB  - To evaluate the characteristics of the gastric mucosa in women with fundic
      glandular polyps, we examined gastric acid secretion, fasting serum levels of
      pepsinogen I and gastrin, and gastric histology in 11 female patients with fundic
      polyps, and compared the results with 30 female controls without endoscopic
      abnormalities and 50 female patients with gastric foveolar hyperplastic polyps.
      No significant difference was found in gastric and secretion and fasting serum
      levels of pepsinogen I and gastrin between the patients with fundic glandular
      polyps and the control subjects. Histological examination showed that atrophic
      gastritis was generally not found in the patients with fundic glandular polyps.
      In contrast, gastric acid secretion and fasting serum levels of pepsinogen I were
      significantly lower and serum gastrin levels were significantly higher in the
      patients with foveolar hyperplastic polyps than in the other two groups. Also,
      patients with foveolar hyperplastic polyps had a higher prevalence and further
      advanced atrophic gastritis in the fundus than did the other two groups. Our
      investigations demonstrated that fundic glandular polyps arise from gastric
      mucosa without atrophic gastritis, whereas foveolar hyperplastic polyps develop
      from mucosa affected by atrophic gastritis, especially type A gastritis.

PMID- 1744397
TI  - Ultrasound imaging of pancreatico-duodenal transplants.
AB  - A preliminary investigation of the role of ultrasound, including color and duplex
      Doppler, was performed in recipients of cadaveric pancreatico-duodenal
      transplants. Twenty such examinations were done on three patients. Three
      different complications were noted: rejection, pancreatitis, and peripancreatic
      abscess. The mean normal resistive index (RI) was 0.71 +/- 0.12. The normal
      allograft anteroposterior (AP) dimension ranged from 1.5 to 2.0 cm.
      Intraparenchymal and main feeding vessels were demonstrated easily. RI
      calculations alone were not helpful in diagnosing graft rejection. However, this
      diagnosis can be made using a new biochemical marker, serum anodal trypsinogen.
      We conclude that when used in conjunction with a reliable biochemical marker for
      rejection (serum anodal trypsinogen), ultrasound, including color and duplex
      Doppler, provides an important adjunct for the rapid, inexpensive, and complete
      evaluation of patients with pancreatico-duodenal transplants.

PMID- 1744398
TI  - Changing pattern of peptic ulcer in India. An endoscopic study of 1,188 ulcer
      patients.
AB  - Earlier studies have described a profile of peptic ulcer different in developing
      and developed countries. In a prospective endoscopic study in India over 5 years
      and 8 months involving 5,948 patients with upper gastrointestinal symptoms, we
      detected peptic ulcers in 1,188. There were 920 patients with duodenal ulcer
      (DU), 185 with gastric ulcer (GU), and 83 with combinations of the two. The male
      to female ratio was 4.2:1. About half the ulcers were in patients age greater
      than or equal to 40 years. Of the 223 (18.7%) patients with peptic ulcer
      complications, gastrointestinal bleeding was the most common (12.7%) and gastric
      outlet obstruction was less common (6.2%). Endoscopic evidence of duodenal bulb
      deformity was seen in 74.4% of DU patients. A comparison of these results with
      data from previous Indian studies suggests a changing trend of peptic ulcer with
      respect to age and sex distribution, the ratio between DU and GU, and
      complications of peptic ulcer. The profile of peptic ulcer in north India today
      is similar to that seen in Western countries four to five decades ago. We discuss
      possible factors responsible for this change.

PMID- 1744399
TI  - Incidence and indications for cholecystectomy in a public health district of a
      small town in central Italy.
AB  - There are major differences in cholecystectomy rates between different countries.
      We prospectively recorded all gallbladder operations in L'Aquila, Italy (a small
      town in central Italy with a population of about 98,700 inhabitants) from June
      15, 1987 to June 14, 1988. During that year 210 cholecystectomies were performed
      (women and girls = 71.4%), for a calculated yearly incidence rate of 0.212%.
      Cholecystectomy was elective in 85.2%, urgent in 8.6%, and was performed in the
      course of other abdominal operations (mainly colon cancer) in the remaining 6.2%.
      Half (44.3%) of the patients were operated on because of at least one episode of
      biliary colic, and 9.0% because of an acute complication. Respectively 16.2% and
      30.5% were operated on because of dyspeptic symptoms or to prevent symptoms or
      complications. Gallstones were not found in six, while exploration of the common
      bile duct revealed gallstones in seven patients. The chemical analysis showed
      that 84.7% were cholesterol stones (mixed or pure). We presume that most observed
      differences in cholecystectomy rates between different Western countries are more
      likely owing to differences in indications for surgery rather than to differences
      in prevalence of gallstones.

PMID- 1744400
TI  - The classification of digestive problems into "organic" and "functional" should
      not be abandoned: a surgical point of view.
AB  - To avoid the two pitfalls of medicine, it is essential to maintain the
      distinction between "functional disorders" and "organic diseases." Medicalization
      consists in forgetting the suffering of a patient and focusing on a sick organ.
      This is incorrect scientifically, because it dismisses the complexity of science
      by deleting many variables at work, and of course it is a very inhumane way to
      practice medicine. Conversely, psychiatrization runs the risk of rationalization
      by forgetting the reality of the body. Functional disorders can be observed and
      the abnormalities measured by various objective ways; a positive finding does not
      imply there is a lesion, because many psychophysiological links have been
      demonstrated. Moreover, secondary gains lead some patients either to lie or
      submit to unnecessary surgery.

PMID- 1744401
TI  - Digestive diseases are functional and organic.
AB  - The classification of digestive problems into organic and functional is logical
      and helpful in medical practice. The diagnosis of a functional disorder must be
      positive--not only exclusive.

PMID- 1744402
TI  - Primary gastric lymphoma occurring in familial Mediterranean fever.

PMID- 1744403
TI  - Appendiceal lymphoma: a case report.

PMID- 1744404
TI  - Smoking habit on gastric bicarbonate secretion in patients with duodenal ulcer.

PMID- 1744405
TI  - Midgut malrotation with partial obstruction of duodenojejunal junction due to
      Ladd's bands.

PMID- 1744406
TI  - Pulmonary tuberculoma associated with Crohn's disease.

PMID- 1744407
TI  - Hemolytic anemia secondary to interferon treatment for chronic B hepatitis.

PMID- 1744408
TI  - Superior mesenteric vein thrombosis as a manifestation of a latent
      myeloproliferative disorder.

PMID- 1744409
TI  - Lower anterior versus abdominoperineal resection.

PMID- 1744410
TI  - A rare cause of severe bleeding from the anterior duodenal wall: the cystic
      artery.

PMID- 1744411
TI  - In vitro endoscopic Polaroid photography for CLO test of Helicobacter pylori.

PMID- 1744412
TI  - Treatment with ursodeoxycholic acid of bile reflux gastritis after
      cholecystectomy.

PMID- 1744413
TI  - Bronchoesophageal fistula complicating aphthous esophageal ulcer in AIDS.

PMID- 1744414
TI  - A cylindrical dilatation of the right hepatic duct in a young asymptomatic
      patient.

PMID- 1744415
TI  - Multiple gastric carcinoid in type A gastritis: clinical findings and therapeutic
      proposal.

PMID- 1744416
TI  - The role of bile salt uptake in canalicular bile formation. Transport systems and
      acinar heterogeneity.

PMID- 1744417
TI  - Propranolol and haemodynamic response in cirrhosis.
AB  - In the present study, we compared cirrhotic patients who had a decrease in the
      hepatic venous pressure gradient after propranolol intake to patients without a
      decrease. Twenty patients with cirrhosis and oesophageal varices were
      investigated during hepatic vein catheterization before and 90 min after an oral
      dose of 80 mg propranolol. The hepatic venous pressure gradient decreased by
      12.6% (19.0 +/- 4.7 to 16.3 +/- 3.6 mm Hg, p less than 0.05). Eight (40%) out of
      20 patients had a decrease of less than 10% in protal pressure (non-responders).
      Responders had a higher baseline cardiac index than non-responders (3.79 +/- 0.74
      vs. 2.83 +/- 0.53 1.min-1.m-2; p less than 0.01). No difference in the effect of
      propranolol on portal pressure was observed between patients with or without
      ascites, or between Child-Turcotte A, B, and C class patients. Our results
      suggest that cirrhotic patients who respond to oral propranolol with a decrease
      in portal pressure are more hyperdynamic than those without a significant fall in
      portal pressure.

PMID- 1744418
TI  - Dilatation of the inferior vena cava using an expandable metal stent in Budd
      Chiari syndrome.
AB  - Caval compression secondary to hypertrophy of the caudate lobe is a well known
      complication of Budd-Chiari syndrome. This paper describes the use of an
      expandable metal stent to overcome external caval compression. Meso-caval
      shunting was subsequently performed with a good end result.

PMID- 1744419
TI  - Altered biosynthesis of gangliosides in developing biliary cirrhosis in the rat.
AB  - The biosynthesis of gangliosides was studied in developing biliary cirrhosis in
      rats 14, 28, and 42 days after bile duct obstruction. The total content and
      patterns of gangliosides in livers and sera, and the activity of six hepatic
      ganglioside synthases in a cell-free system were determined. Up to 7-fold
      increased synthase activities were strictly correlated in time and extent with
      increased total contents of gangliosides in liver and serum. In addition, altered
      patterns of serum gangliosides were observed. The results clearly demonstrate
      that the liver is the main source of elevated serum gangliosides in biliary
      cirrhosis in the rat. Increased hepatic biosynthesis and the secretion of
      gangliosides into the serum appear to be an important pathogenetic event.
      Alterations of hepatic enzyme activities indicate that GL2 and GM3 synthase
      regulate total hepatic ganglioside content. However, certain abnormalities in
      ganglioside patterns which were observed in the liver and sera of cirrhotic
      animals can not be explained by changes in hepatic enzyme activity. They indicate
      additional pathobiochemical mechanisms to be involved, e.g., altered
      hepatocellular processing and/or impaired secretion into bile.

PMID- 1744420
TI  - Regional sympathetic activity, severity of liver disease and hemodynamics in
      patients with cirrhosis.
AB  - One hundred and eight patients with cirrhosis (23 grade A, 46 grade B and 39
      grade C, according to Pugh's classification) underwent hemodynamic studies and
      plasma catecholamine concentration measurements. Blood samples were withdrawn
      from the pulmonary artery (n = 108), the hepatic vein (n = 108), the azygos vein
      (n = 59), the right renal vein (n = 66), the right jugular vein (n = 34) and the
      femoral vein (n = 33). Plasma noradrenaline concentrations in the pulmonary
      artery and the hepatic vein were more elevated in grade B (607 +/- 52 and 402 +/-
      42 pg/ml, respectively) and C patients (630 +/- 59 and 475 +/- 53 pg/ml,
      respectively) than in grade A patients (411 +/- 51 and 243 +/- 40 pg/ml,
      respectively). Plasma noradrenaline concentrations from these two vessels were
      negatively correlated with indocyanine green clearance. These results indicate
      that both overall and splanchnic sympathetic activities are dependent on altered
      hepatic function. Significant correlations were found between the wedged hepatic
      venous pressure and plasma noradrenaline concentrations from either the pulmonary
      artery, the hepatic vein or the azygos vein. These correlations indicate that
      both overall and splanchnic sympathetic activities are dependent on the degree of
      portal hypertension. Moreover, significant correlations were found between
      hepatic venous plasma noradrenaline concentrations and systemic hemodynamic
      values, suggesting that splanchnic sympathetic nervous activity could either play
      a role in the systemic hyperkinetic syndrome or be a consequence of this
      hyperkinetic syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744421
TI  - The acinar location of the sodium-independent and the sodium-dependent component
      of taurocholate uptake. A histoautoradiographic study of rat liver.
AB  - The acinar location of tritium-labelled taurocholate taken up from sodium
      containing and sodium-free perfusion media in isolated perfused rat liver was
      made visible by means of histoautoradiography on cryoslices at low, medium and
      high bile salt concentrations. In antegrade perfusion studies, in the presence of
      sodium, with taurocholate concentrations of 1 and 20 microM, respectively, the
      silver grain label was mainly restricted to acinar zones 1. At an 80 microM
      concentration, zones 2 and 3 were also labelled but with decreasing intensities
      towards the terminal hepatic venules. At 120 microM taurocholate, all acinar
      zones were nearly equally labelled. In the absence of sodium, antegrade liver
      perfusions with 1, 20 and 120 microM taurocholate resulted in an almost
      homogenous labelling of all acinar zones and retrograde perfusions in a silver
      grain density slightly decreasing towards the terminal portal venules. The
      results indicate that hepatocytes of all acinar zones are capable of taking up
      taurocholate by both a sodium-dependent and a sodium-independent pathway. The
      contribution of the sodium-independent uptake to the overall uptake of
      taurocholate increases with increasing zonal recruitment at higher
      concentrations. The sodium-dependent uptake, however, is always dominant.

PMID- 1744422
TI  - Effects of molsidomine, a long acting venous dilator, on portal hypertension. A
      hemodynamic study in patients with cirrhosis.
AB  - The present study investigated the effects of molsidomine, a predominant venous
      dilator which, contrary to organic nitrates, does not produce pharmacological
      tolerance on splanchnic and systemic hemodynamics in patients with cirrhosis.
      Twenty-seven cirrhotic portal hypertensive patients were studied prior to and up
      to 2 h after the oral administration of 2 mg of molsidomine (n = 11), 4 mg of
      molsidomine (n = 8) or placebo (n = 8). Molsidomine caused a significant
      reduction in the hepatic venous pressure gradient. The mean decrease at 60 min
      was -6.8 +/- 9% after 2 mg (p less than 0.05) and -15.4 +/- 12% after 4 mg (p
      less than 0.01). The decrease in the hepatic venous pressure gradient was
      maintained at 120 min: -11% after 2 mg (p less than 0.05) and -19% with 4 mg (p
      less than 0.01). This was associated with mild changes in azygos blood flow and
      with a significant decrease in hepatic blood flow (-17%, p less than 0.05). There
      was a moderate reduction in mean arterial pressure (-12.6% after 2 mg and -13.2%
      after 4 mg, p less than 0.01), which was due to a reduction in cardiac output,
      without any significant fall in systemic vascular resistance. Placebo
      administration did not change systemic or hepatic hemodynamics. This study shows
      that molsidomine causes a significant and sustained reduction in portal pressure
      in patients with cirrhosis, suggesting the potential role of this agent in the
      treatment of portal hypertension.

PMID- 1744423
TI  - Conserved core protein sequences in hepatitis B virus infected patients without
      anti-HBc.
AB  - The absence of detectable anti-HBc antibodies in some hepatitis B virus (HBV)
      infected patients may be due to altered core-protein (HBc) sequences. To
      investigate this possibility we sequenced the pre-C/C-region of HBV isolated from
      12 juvenile cancer patients who incurred a nosocomial infection of HBV during
      chemotherapy but did not develop anti-HBc antibodies or acute cytolytic episodes.
      The sequences demonstrated the highest sequence homology to the pre-C/C region of
      a previously cloned HBV genome (subtype ayw) and no deletions or striking
      mutations were detected. Up to 7 years after infection almost all the survivors
      developed low titers of anti-HBc antibodies but no clinical signs of hepatic
      damage. These results suggest that chemotherapy may induce a tolerance status to
      HBcAg, the most immunogenic HBV protein.

PMID- 1744424
TI  - The protective effects of SA3443, a novel cyclic disulfide, on chronic liver
      injuries in rats.
AB  - The effects of (4R)-hexahydro-7,7-dimethyl-6-oxo-1,2,5-dithiazocine-4- carboxylic
      acid (SA3443), a novel cyclic disulfide compound, on the development of chronic
      liver injury were studied in rats, using two types of models, carbon
      tetrachloride (CCl4)-induced chronic liver injury and heterologous serum (swine
      serum)-induced liver fibrosis. SA3443 (30-100 mg/kg, p.o.) significantly
      suppressed increases in serum transaminase and alkaline phosphatase activity
      induced by CCl4-treatment for 10 weeks. This compound also inhibited increases in
      hepatic lipids and hydroxyproline content in CCl4-treated rats. In the
      histopathological studies, treatment with SA3443 resulted in a decrease in the
      degree of hepatic necrosis, fibrosis and steatosis. On the other hand, 8-weeks
      treatment with swine serum revealed hepatic fibrosis without appearance of
      necrosis or fatty accumulation. In this model, SA3443 (30 mg/kg, p.o.) reduced
      the hepatic hydroxyproline level, and diminished the formation of connective
      tissue in the liver. These findings indicate that SA3443 protects the liver
      against chronic liver injuries induced by CCl4 and heterogeneous serum.

PMID- 1744425
TI  - Hepatic uptake of fluorescein, investigated by video fluorescence microscopy and
      digital image analysis.
AB  - We evaluated fluorescence microscopy combined with digitized image analysis for
      the investigation of fluorescein transport in the intact rat liver. The images of
      the surface of isolated rat livers which were perfused directly under a
      microscope were projected onto a silicone-intensified target camera, stored on a
      video tape and analyzed with a microcomputer equipped with an image digitizer. It
      was shown that, after correction of the day-to-day variability of the optical and
      electronical system, the increase in fluorescence intensity of the liver surface
      following fluorescein infusion depended linearly on the fluorescein concentration
      in the perfusion medium up to 1 mM. Since, under the conditions used, biliary
      secretion and metabolic influences were found to be insignificant the uptake
      mechanism is probably predominantly simple diffusion.

PMID- 1744426
TI  - Early chronic administration of propranolol reduces the severity of portal
      hypertension and portal-systemic shunts in conscious portal vein stenosed rats.
AB  - We investigated the effects of early chronic administration of propranolol on
      systemic and splanchnic hemodynamic changes, and the development of portal
      systemic shunts in conscious, unrestrained, portal vein stenosed rats. Compared
      to rats receiving placebo, early chronic propranolol (75 mg kg-1 day-1)
      administration to rats begun 3 days before portal vein stenosis and then
      continued for 10 consecutive days, resulted in a significant decrease in both
      portal pressure (11.8 +/- 1.5 mmHg) and portal-systemic shunts (48 +/- 18%) which
      were measured 2 to 3 h after the final dose of propranolol (15.2 +/- 1.5 mmHg and
      84 +/- 5%, respectively). These beneficial effects were also observed 18 to 24 h
      after the final dose of chronic propranolol. In rats given propranolol
      continuously for 5 days starting 5 days after portal vein stenosis, portal
      pressure (11.8 +/- 1.2 mmHg) was significantly lower than in the placebo group
      but portal-systemic shunts (76 +/- 14%) were not significantly different. In rats
      receiving a single dose of propranolol (75 mg/kg) 10 days after portal vein
      stenosis and measured 2 to 3 h after propranolol administration, portal pressure
      (12.8 +/- 1.0 mmHg) was significantly lower than in the placebo group. Portal
      systemic shunts (72 +/- 17%), however, showed no significant difference from the
      placebo group. Similar values in portal pressure (13.3 +/- 1.2 mmHg) and portal
      systemic shunts (83 +/- 21%) were also observed in rats 18 to 24 h after a single
      dose of propranolol.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744427
TI  - Chronic administration of ethanol with high vitamin A supplementation in a liquid
      diet to rats does not cause liver fibrosis. 1. Morphological observations.
AB  - Rats of two strains (BN/BiRij and WAG/Rij) were fed the ethanol-containing Lieber
      De Carli liquid diet supplemented with high amounts of vitamin A for 16 months.
      In contrast to Lieber and co-workers, who showed liver fibrosis developing within
      9 months on the same diet in Sprague-Dawley rats, we were unable to demonstrate a
      histological and biochemical increase in liver collagen in either strain.
      Steatosis was present to a varying degree in both strains in ethanol-treated
      rats, but also in control animals. Considerable liver inflammation with focal
      necrosis accompanied by severe systemic inflammation was observed in 60% of the
      ethanol-treated WAG rats. This suggests that, at least in rats, the main effects
      of chronic ethanol consumption on the liver may be secondary to interference with
      host resistance to infections. The ethanol-high vitamin A Lieber-De Carli liquid
      diet does not necessarily elicit fibrosis or other characteristic histological
      abnormalities of human alcoholic liver disease.

PMID- 1744428
TI  - Chronic administration of ethanol with high vitamin A supplementation in a liquid
      diet to rats does not cause liver fibrosis. 2. Biochemical observations.
AB  - The inability of the 'ethanol/high vitamin A Lieber-DeCarli diet' to induce liver
      fibrosis in two different rat strains was further evaluated by determining
      changes in parameters of liver cell damage and of retinoid and lipid metabolism.
      In the ethanol/vitamin A-treated group, slight but constant hepatic cell damage,
      as indicated by elevated alanine aminotransferase, aspartate aminotransferase and
      glutamate dehydrogenase activities in blood, was already observed at 6 months and
      maintained until the time of death at 16 months. Serum gamma-glutamyl
      transaminase activities were not raised. Moderate parenchymal liver cell damage
      was not accompanied by fibrosis. Hypertriglyceridemia or hypercholesterolemia
      were observed at 6-16 months of chronic alcohol administration. This response was
      strain dependent. In ethanol-treated rats of both strains, total liver retinoids
      and serum retinol concentrations were not altered. Therefore, the hypothesis that
      interaction between alcohol and retinoids is a major factor in the pathogenesis
      of alcoholic liver disease, needs to be reconsidered.

PMID- 1744429
TI  - Hepatitis delta virus, a model of liver cell pathology.

PMID- 1744430
TI  - Galen on "glands" and "spongy flesh": with special reference to an ancient
      mechanico-biophysical theory for superficial lymph node function.

PMID- 1744431
TI  - "Anti-moine; anti-biotique": the public fortunes of the secret properties of
      antimony potassium tartrate (tartar emetic).

PMID- 1744432
TI  - Disease, death, and disorder on the American frontier.

PMID- 1744433
TI  - Allied cooperation in malaria prevention and control: the World War II Southwest
      Pacific experience.

PMID- 1744434
TI  - Acute pancreatitis and pancreatic cancer. Biology, diagnosis, and therapy.
      Proceedings of the fourth meeting of the International Association of
      Pancreatology and the third meeting of the International Pancreatic Cancer Study
      Group. August 20-23, 1990, Nagasaki City, Japan.

PMID- 1744435
TI  - Technical guidance of endoscopic pancreatocholangiography.
AB  - Endoscopic pancreatocholangiography, frequently abbreviated as ERCP, is an X-ray
      examination of the pancreatic and biliary ducts cannulating the duodenal papilla
      using the fiberscope. This procedure is the only clinical examination of the
      pancreatic duct, and is an indispensable technique for endoscopic treatments and
      further investigations: endoscopic papillotomy, drainage, lithotomy,
      endoprothesis, pancreatoscopy, and collection and cytology of pure juice. For
      this examination, a skill in endoscopy is required, and the understanding of the
      papilla orifice, which consists of prolapsed ampullar folds in the living body,
      is essential. The catheter should be inserted straight toward the individual
      duct: the pancreatic and the biliary duct. As ultrasonography and computed
      tomography are advanced, the clinical roll of ERCP should be reevaluated.
      However, the pancreatography expresses exactly the ductal pathology, which is
      reflected by the background pathology of the pancreas: chronic pancreatitis,
      nonfusion, pancreatobiliary maljunction, small cancerous, mucous-producing
      tumors, and cystic lesions.

PMID- 1744436
TI  - Diagnosis of pancreatic cancer. Alteration of glucose metabolism.
AB  - Alterations of glucose metabolism occur frequently in association with pancreatic
      cancer. Whether diabetes predisposes or is a consequence of pancreatic cancer has
      not been settled. We have found that induced diabetes prevents development of
      pancreatic cancer in the hamster model and that genetically diabetic Chinese
      hamsters resist pancreatic cancer induction, whereas the nondiabetic strain does
      not. Also, preliminary clinical data indicates that diabetes is associated with
      pancreatic cancer and that the two conditions develop simultaneously. We have
      found diabetes or impaired glucose tolerance in 76% of the pancreatic cancer
      patients at the time of cancer diagnosis. The diabetic condition improved after
      75% pancreatectomy. Although the preliminary observations suggest that diabetes
      accompanies the disorder of pancreatic cancer, additional data are needed before
      any conclusion can be drawn.

PMID- 1744437
TI  - The study of the mass screening of persons without symptoms and of the screening
      of outpatients with gastrointestinal complaints or icterus for pancreatic cancer
      in Japan, using CA19-9 and elastase-1 or ultrasonography.
AB  - To investigate the possibility of detecting carcinomas of the pancreas at an
      early stage by mass screening of persons without symptoms or by screening the
      outpatients with gastrointestinal complaints or jaundice, we performed a
      multicentral study of the mass screening of 10,162 persons at five local areas
      and of the outpatient screening of 4506 at 17 hospitals for pancreatic cancer in
      Japan for two years from 1984 to 1985, using serum CA19-9 and elastase-1
      determinations or ultrasonography. Mass screening of 10,162 persons over 40 years
      old found only four (0.04%) cases of pancreatic cancer, including one case that
      was curatively treated. According to the screening of 4506 outpatients with
      gastrointestinal complaints or icterus, 85 (1.9%) patients were found to have
      pancreatic cancer. Of these 85 patients, 28 could undergo curative treatment. In
      addition to them, 73 (1.6%) patients with other digestive organ cancer were
      found. Our results suggest that the mass screening of persons without symptoms is
      not worthwhile in the early detection of pancreatic cancer, but outpatient
      screening is useful for detecting curative cancers of the pancreas.

PMID- 1744438
TI  - Immunotherapy with monoclonal antibody (Mab) in pancreatic adenocarcinoma.
AB  - Conventional therapy of pancreatic exocrine cancer is disappointing. The poor
      prognosis of the disease challenges development of novel therapeutic strategies.
      We report the results of clinical trials of the monoclonal antibody (Mab) 17-1A
      in patients with histologically verified unresectable pancreatic exocrine cancer.
      No antitumor response was seen in 18 patients treated with Mab 17-1A (500 mg)
      admixed with 10(9) autologous mononuclear cells, and 81% of the patients
      developed antimouse antibody response. Combination of recombinant gamma
      interferon and Mab 17-1A mixed with autologous mononuclear white cells resulted
      in complete response of 4-mo duration in 1 out of 25 evaluable patients and
      unusually stable disease from 4 to 48+ mo in another 6 patients. High
      intermittent doses of infused Mab 17-1A did not show any objective antitumor
      response and caused serious anaphylaxis in two of the patients in the trial.
      Because examination of six pancreatic adenocarcinoma cell lines with different
      doses of Mab 17-1A and IL-2 failed to augment lytic activity of mononuclear
      effector cells against all cancer cell lines tested, there seemed to be no
      rationale for pursuing clinical studies with IL-2 and Mab 17-1A in either the
      murine or chimeric form. Attractive therapeutic approaches include active
      immunotherapy with immunization using idiotypic antibodies or targeted toxicity
      with the use of radioimmunoconjugates, particularly 125I-labeled chimeric Mab 17
      1A.

PMID- 1744439
TI  - Surgical treatment of pancreatic cancer. The Japanese experience.
AB  - Since 1973, 194 patients with pancreatic carcinoma have undergone surgery in our
      clinic, including 134 with carcinoma of the head of the pancreas. Of these 134
      patients, resections were performed on 61 (45.5%), 49 (36.6%) of whom underwent a
      curative resection based on macroscopic evidence. Seven of the patients who
      underwent macroscopic curative resection survived for five years, giving a five
      year survival rate of 26.4% by the Kaplan-Meier method after excepting seven
      operative deaths. We compared the extent of pancreatic cancer by constructing
      survival curves according to the General Rules published by the Japan Pancreas
      Society. There was no statistical difference in survival based on tumor size or
      stage; however, there was a significant difference in the survival curves of so
      and se, being the absence or presence of the anterior capsule of the pancreas;
      rpo and rpe, being the absence or presence of invasion of the retroperitoneal
      tissue; ew(-) and ew(+), being the absence or presence of invasion at the
      surgical margin of resection; and n0 and n1, being the extent of lymph node
      metastasis. The results of this comparison suggest that extended radical
      pancreatectomy may be indicated for the treatment of pancreatic cancer, since the
      standard radical operation for pancreatic cancer may miss tumors that have spread
      to the retroperitoneum and extrapancreatic nerve plexus.

PMID- 1744440
TI  - Surgical treatment of pancreatic cancer. The Swedish experience.
AB  - The development at a university hospital of radical surgery for exocrine
      pancreatic cancer has been studied for the time period 1958-1989. It was found
      that the number of operations per year increased gradually, being 6.6/year during
      the last 5 years, giving a resection rate of 15%. The resection rate did not
      change during the studied time period. The size, grade of differentiation, or
      stage of tumor did not change. There was no significant tendency toward
      decreasing operation time and blood loss, although a technically more complicated
      operation has been done in the last 30 cases (change from total to subtotal
      duodenopancreatectomy). The hospital mortality rate decreased from 33 to 3%. The
      rate and severity of post-operative complications also strongly decreased. For
      the last 30 cases, there was also a prolonged long-term survival. We conclude
      that the total management of patients radically operated on for exocrine
      pancreatic cancer is today much better than it was a decade or two ago.

PMID- 1744441
TI  - Evidence of effective multidisciplinary treatment for resectable pancreatic
      cancer from the viewpoint of the CA19-9 level.
AB  - Nineteen patients with resectable pancreatic cancer have been treated by a
      multidisciplinary approach at the National Cancer Center Hospital. This therapy
      included extended pancreatic resection, intraoperative irradiation by 30 Gy of
      electrons, and intraoperative hepatic arterial or portal infusion of mitomycin C.
      Furthermore, postoperative chemotherapy with mitomycin C, using Seldinger's
      method or iv administration, was added. The study consisted of 13 patients with
      carcinoma of the pancreatic head and six patients with carcinoma of the body and
      tail. The one- and three-year survival rates for these patients were 88 and 50%,
      respectively. The five-year survival rate was calculated as 28%, although there
      is only one five-year survivor. The effectiveness of this therapy was studied by
      changes in Carbohydrate Antigen 19-9 (CA19-9) level. Thirteen of the 15 patients
      with high CA19-9 levels showed a decrease to a level less than 50 U/mL after this
      therapy. In the postoperative course, the patients showing a tendency of
      elevation of the CA19-9 level could be suspected of having cancer recurrence at
      this time without any physical sign or other laboratory findings.

PMID- 1744442
TI  - Effect of insulin treatment on the regeneration of the remnant pancreas after
      major pancreatectomy in dogs.
AB  - The effect of exogenous insulin treatment on the pancreatic regeneration after
      major pancreatectomy was evaluated in dogs. More than 92% of the pancreas was
      removed near the duodenum with the main pancreatic duct left intact. All 26 dogs
      developed diabetes mellitus (DM) immediately after surgery, and these dogs were
      divided into two groups: insulin-treated group (n = 19) and noninsulin-treated
      group (n = 7). All seven dogs in the noninsulin-treated group died within seven
      weeks after surgery, whereas all dogs in the insulin-treated group survived until
      the twelfth week, except for six dogs sacrificed on the seventh week, and finally
      seven (53.8%) of 13 dogs recovered from DM. DNA and polyamine syntheses in the
      remnant pancreatic tissue at the third day increased more significantly in the
      insulin-treated group than in the noninsulin-treated group. Sigma IRI in IV-GTT
      was maintained more significantly in the insulin-treated group, and the
      regeneration rate at the seventh week was also significantly higher in the
      insulin-treated group than in the noninsulin treated group. Furthermore, the
      regeneration rate of the remnant pancreas at seventh week correlated well with
      DNA synthesis and ornithine decarboxylase activity on the third day. The
      exogenous insulin treatment after major pancreatectomy enhanced the proliferation
      of the remnant pancreas within the first week, and it maintained endogenous
      insulin secretion, promoting pancreatic regeneration.

PMID- 1744443
TI  - Mechanism of acute pancreatitis. Cellular and subcellular events.
AB  - A membrane-bound system through which secretory and lysosomal proteins travel in
      a vectorial fashion is essential for the preserved integrity of pancreatic acinar
      cells. This system is composed of an ordered array of compartments, such as the
      rough endoplasmic reticulum, the Golgi complex, lysosomes, and secretory
      granules. As a principle, in acute pancreatitis the final steps of this transport
      seem to be disturbed. Caerulein-induced pancreatitis is a valuable experimental
      model for studying altered intracellular transport, and compartmentation of
      lysosomal and digestive enzymes. The formation of enlarged secretory vacuoles
      containing lysosomal and digestive enzymes is paralleled by the activation of
      lysosomes and degradation of cellular organelles in autophagosomes. On the level
      of secretory and autophagic vacuoles, activation of serine proteases occurs,
      which in addition to increasing lysosomal enzyme activities can represent the
      initial stage for acinar cell destruction and the development of pancreatitis.

PMID- 1744444
TI  - Mechanisms of acute pancreatitis. Vascular etiology.
AB  - Vascular mechanisms play an important but controversial role in the pathogenesis
      of acute pancreatitis. In experimental animals, injection of wax, powder, air,
      mercury, and microspheres into the pancreatic artery causes pancreatitis by end
      artery occlusion with resulting cellular infarction. Larger microspheres do not
      cause pancreatitis because collateral blood flow is preserved. Clinical evidence,
      such as microthrombi and atheromatous emboli in the pancreatic artery of patients
      with pancreatitis, supports pancreatic infarction as an etiologic agent.
      Experimental and clinical studies have suggested that pancreatic ischemia may
      also cause pancreatitis, but these studies have not been conclusive. We have
      compared five hours of total occlusion of the pancreaticoduodenal artery along
      with four hours of reperfusion to bile injection into the pancreatic duct as
      causes of pancreatitis. Bile injection caused a significant increase in serum
      amylase, activation of trypsin in pancreatic exudate, and histologic evidence of
      necrotizing pancreatitis. Pancreatic blood flow decreased as pancreatitis
      developed. Ischemia for five hours did not cause a significant increase in serum
      amylase or activation of trypsin in pancreatic exudate. Only edema was seen
      histologically, but there was no necrosis. Pancreatic blood flow increased with
      reperfusion. We believe ischemia aggravates, but does not initiate pancreatitis.
      Ischemia does not induce inflammation and necrosis in the pancreas, although
      infarction does.

PMID- 1744445
TI  - Classification of acute pancreatitis.
AB  - Increased knowledge of the natural history, etiology, morphology, complications
      and systemic response of the patient to acute pancreatitis has led to a rapid
      evolution in the classification of acute pancreatitis. It is recommended that the
      following elements be included in a classification system of acute pancreatitis:
      1. A definition of acute pancreatitis and its complications based on CT scan,
      ultrasound, ERCP, and angiographic and histologic findings. 2. A statement
      regarding the etiology of the patient's pancreatitis. 3. An assessment of the
      patient's systemic response to his or her pancreatitis by means of APACHE II
      and/or Ranson's signs of severity. This system, through the use of ultrasound, CT
      scan with vascular enhancement, and clinical and laboratory tests, can be
      utilized to classify patients initially, on the day of hospital admission, with
      regard to etiology, morphology, and physiologic severity. Later in their hospital
      course, the complications of pancreatitis, e.g., fluid collections, necrosis,
      pseudocysts, infected necrosis, abscesses, fistulas, pancreatic, enteric, and
      cutaneous, pseudoaneurysm, and splenic vein thrombosis, can be added to the
      classification as modifiers when and if they occur. The process of the
      development and confirmation of theories of the origin and nature of the cosmos
      and evolution of concepts regarding the classification of pancreatitis have
      something in common. Theory generally stimulates experimental observation whose
      purpose is to test the theory's validity. New theories are generated when
      experimental observations demonstrate inconsistencies in previously held beliefs.
      Just as our understanding of the cosmos is undergoing constant change based on
      new data and new theories, so are our concepts regarding the classification of
      pancreatitis.

PMID- 1744446
TI  - Evaluation of severity of acute pancreatitis. According to a report of the
      cooperative national survey in Japan.
AB  - In the cooperative national survey of acute pancreatitis achieved by the Research
      Committee of Intractable Diseases of the Pancreas supported by the Japanese
      Ministry of Health and Welfare, 2553 cases of acute pancreatitis, except mild
      cases, were collected throughout Japan. The severity of disease classification
      systems that used both the clinical signs of the systemic and local complications
      and the laboratory values was evaluated. It is probable that the multiple
      criteria have the potential to provide improved measurement of severity and
      progress of acute pancreatitis.

PMID- 1744447
TI  - Surgery in acute pancreatitis. The Japanese experience.
AB  - Seventy-eight cases of severe acute pancreatitis were admitted to Mie University
      and its affiliated hospitals. These were subdivided into Group I (1976-1983) and
      Group II (1984-1989). The rate of early death was 34.8% in Group I and 9.3% in
      Group II. Among operated cases, peritoneal drainage alone was not effective with
      the worst mortality rate of 47.1%, especially in gallstone pancreatitis, with a
      100% mortality rate. Early detection of infected necrosis or abscess using
      enhanced CT and subsequent drainage should be performed in cases of severe acute
      pancreatitis. A total 1182 cases of severe acute pancreatitis out of 12,309 cases
      of acute pancreatitis were collected in Japan by Saito et al., who belong to the
      Research Committee of Intractable Diseases of the Pancreas supported by the
      Japanese Ministry of Health and Welfare. Furthermore, 473 cases of severe acute
      pancreatitis in the Japanese literature reported from 1987 to 1990 were reviewed.
      Then, surgical indications and procedures were discussed. The incidence of
      necrosectomy has been increased to 10.3% from 3%, and biliary drainage procedure
      increased for severe acute pancreatitis. Indication of necrosectomy with or
      without open drainage method should be carefully evaluated in each institution.

PMID- 1744448
TI  - Surgery in acute pancreatitis. The United States experience.
AB  - Considerable controversy has existed in the United States regarding the operative
      management of acute pancreatitis. Recently, areas of consensus have begun to form
      regarding necrotizing pancreatitis and biliary pancreatitis. However, the role of
      surgery and endoscopy for the prevention of recurrent acute pancreatitis in
      patients with pancreas divisum has not as yet been established. In the United
      States, few areas of contemporary surgery have remained as controversial as the
      operative approach to patients with acute pancreatitis. Recently, however, newer
      methodologies have appeared that seem capable of addressing those current
      surgical disputes that exist in necrotizing pancreatitis, biliary pancreatitis,
      pancreas divisum, and in the various complications of acute pancreatitis.

PMID- 1744449
TI  - Regulation of pancreatic exocrine secretion.
AB  - The exocrine pancreas secretes throughout 24 hours. In both interdigestive and
      postprandial states, pancreatic secretion is regulated by neural and hormonal
      actions, and neurohormonal interactions. At the turn of this century, the
      prevailing theory of Pavlov (1) that pancreatic exocrine secretion was
      exclusively regulated by secretory fibers in both vagi and splanchnic nerves was
      refuted by Bayliss and Starling in 1902, who put forward their hypothesis that
      pancreatic secretion was stimulated by a circulating hormone, "secretin," which
      was released by hydrochloric acid from the duodenal mucosa (2). Soon, Pavlov
      conceded to the hypothesis of Bayliss and Starling. Pavlov adopted the theory of
      a dual mechanism--nervous and hormonal--of the regulation of pancreatic
      secretion. In recent decades, explosions of new information about old and newly
      discovered gut hormones or peptides and neuropeptides have resulted in a better
      understanding of the regulatory mechanism of the exocrine pancreas, and also
      opened new, exciting frontiers in the investigations of the physiology and
      pathophysiology of pancreatic secretion.

PMID- 1744450
TI  - Clinical trial with a protease inhibitor gabexate mesilate in acute pancreatitis.
AB  - To evaluate whether early administration of protease inhibitors could improve
      mortality and morbidity in acute pancreatitis (AP), we made a retrospective
      analysis of 23 patients with severe AP and 88 with mild to moderate AP who were
      treated in our institute and four affiliated medical centers during the 10-y
      period from 1980 to 1990. Intravenous infusion of a protease inhibitor, Gabexate
      Mesilate (FOY), was started within 24 h from onset of AP (early administration)
      in 17 patients with severe AP and 51 with mild to moderate AP. The remaining
      patients were put on FOY later than 24 h from onset of AP (late administration).
      Comparison of the mortality and morbidity between the two groups, early vs late
      administration of FOY, led to the following conclusions: (1) Early administration
      of FOY significantly improved mortality (29.4 vs 83.3%) in severe AP, although
      the improvement in mortality was not directly proportional to the shortening of
      the time lag between the onset of AP and the start of FOY, and (2) earlier
      administration of FOY brought about significantly earlier recovery of abdominal
      pain, hyperamylasemia, and leucocytosis in mild to moderate AP.

PMID- 1744451
TI  - Hormones and pancreatic cancer.
AB  - Several polypeptide hormones have been demonstrated to stimulate or inhibit cell
      division in the cells of the pancreas. Therefore, receptors for these hormones
      have been sought in pancreatic carcinomas, and several examples have been
      reported. In some instances, stimulation of tumor growth by the corresponding
      peptide has been demonstrated or growth was blocked by a receptor antagonist.
      Receptors and binding proteins for steroid hormones also have been reported in
      carcinomas of the pancreas. In experimental carcinogenesis, the growth of
      preneoplastic lesions and incidence of neoplasms have been influenced by both
      peptide and steroid hormones in some species. Experimental manipulation of sex
      steroid hormones has yielded both inhibition and enhancement of growth of human
      and rat pancreatic cancers, but thus far, clinical trials have failed to document
      advantageous approaches for steroid or antihormonal therapy. These observations
      imply that trophic or growth-inhibiting polypeptide and steroid hormones may
      serve as promoters or inhibitors of carcinogenesis in the pancreas, and may
      influence the growth of established carcinomas. Receptor blockers may provide a
      clinical approach for slowing the growth of some cancers.

PMID- 1744452
TI  - Growth factors and pancreatic cancer.
AB  - Cultured human pancreatic cancer cells produce a number of growth factors,
      including transforming growth factor-alpha (TGF-alpha). These cells also
      overexpress the epidermal growth factor (EGF) receptor and exhibit a parallel
      increase in EGF receptor mRNA levels. TGF-alpha, which binds to the EGF receptor,
      is more potent than EGF in enhancing the anchorage-independent growth of several
      pancreatic cancer cell lines, including T3M4 cells. In contrast, EGF is more
      efficient than TGF-alpha with respect to EGF receptor downregulation and tyrosine
      phosphorylation in T3M4 cells. Further, T3M4 cells recycle EGF, but markedly
      degrade TGF-alpha. It is suggested that the production of multiple growth
      factors, the overexpression of the EGF receptor, the recycling of EGF, and the
      attenuated ability of TGF-alpha to downregulate the EGF receptor combine to
      enhance the growth advantage of human pancreatic cancer cells.

PMID- 1744453
TI  - Diagnosis of pancreatic cancer. Serological markers.
AB  - Many serological markers that are widely used for delecting pancreatic cancer are
      discussed. Some are good indicators, but others are not. Among them, CA19-9 and
      SPan-1 radioimmunoassays have a higher sensitivity and specificity. However,
      these markers are neither tumor-specific nor pancreatic cancer-specific. Accurate
      understanding of their measurement made it possible to diagnose pancreatic
      cancer, even when the cancer was small, and to monitor the patients after
      treatment.

PMID- 1744454
TI  - Radioimmunodiagnosis of pancreatic cancer disease.
AB  - From a theoretical point of view, immunoscintigraphy of exocrine pancreatic
      cancer offers itself as a promising diagnostic method. However, the actually
      available clinical and experimental data point out that the indication for
      diagnostic application in patients with pancreatic carcinoma has to be viewed
      more critically than in the case of, e.g., colorectal cancer disease. The quality
      of imaging depends on a lot of factors, such as the cellular antigen expression,
      the affinity of the MAbs to the corresponding antigens expressed by the cells,
      tumor vascularization, tumor size, and unspecific background activity as well as
      on labeling techniques, the kind of antibodies used, and the technical equipment.
      All these factors may vary from one patient to the other and from one center to
      the other. In summarizing the available clinical data, we have to state that
      immunoscintigraphy does not allow early detection of pancreatic cancer and,
      consequently, does not allow screening for early stages in asymptomatic patients.
      Even nowadays primary diagnosis and staging should be based on the imaging
      methods of ultrasound, CT and/or ERCP, and angiography. With respect to detection
      of local recurrence and especially peritoneal carcinosis, immunoscintigraphy,
      however, may be superior when compared to the other imaging methods. The
      potential clinical value for followup and as a preinvestigation to assess the
      probability of effective MAb treatment has still to be evaluated in prospective
      clinical studies. Altogether, a lot of experimental and clinical work remains to
      be done to introduce immunoscintigraphy of pancreatic cancer into clinical
      practice as a routine method.

PMID- 1744455
TI  - [Maintenance of the activation of peritoneal macrophage in patients with ovarian
      cancer by the repeated administration of sizofiran and interferon gamma].
AB  - Four patients with ovarian cancer were treated with a 20mg injection of
      sizofiran, a MW 450,000 beta-1,3-glucan, intramuscularly one day before and
      4,7,11,14,18 and 21 days after second look laparotomy and with the administration
      of 2 million units of interferon gamma intraperitoneally at 0,4,7,11,14,18 and 21
      days after second look laparotomy. Peritoneal macrophages were obtained from the
      patients by peritoneal washing with saline through an indwelled tube. The number
      of macrophages was increased to about 30 times after the treatment. The
      concentrations of interleukin 1, interferon gamma, tumor necrosis factor and
      prostaglandin E2 in the media of 24-hour cultured macrophage with 10
      micrograms/ml of LPS were also increased throughout the treatment. These data
      suggest that the every 3 to 4 day treatment with sizofiran and interferon gamma
      maintained the activation of peritoneal macrophages which might lead to retention
      of the antitumor activity in patients with ovarian cancer.

PMID- 1744456
TI  - [Two-dimensional and Doppler echocardiographic evaluation of intrauterine blood
      flow dynamics in the fetuses with a ventricular septal defect].
AB  - In nine fetuses with ventricular septal defect (VSD), intracardiac blood flow was
      observed with color Doppler ultrasound. Interventricular shunt velocity, maximum
      systolic velocity in the ascending aorta and pulmonary artery, trans
      atrioventricular blood flow velocity, and the flow pattern in the inferior vena
      cava were also measured with pulsed Doppler ultrasound. The cardio-thoracic ratio
      and ejection fraction were measured by B- and M-mood ultrasound. In all four
      fetuses with isolated VSD a bidirectional shunt was demonstrated. In the three
      normal developed fetuses time analysis showed a right (RT)-to-left (LT) shunt
      during systole and a LT-to-RT during diastole with maximum systolic velocities of
      61cm/s, 42cm/s and 68cm/s. In the five fetuses with complexed cardiac
      malformation, two fetuses had a unidirectional shunt and three fetuses had a
      bidirectional shunt, which was a LT-to-RT during systole and a RT-to-LT during
      diastole. These studies indicate that although the systolic pressure in the right
      ventricle is slightly higher than that in the left, the pressure is almost the
      same in both ventricles. The presence of unidirectional shunting or a different
      time relationship from that of normal fetuses in bidirectional shunting would
      necessitate a careful check for other cardiac malformations.

PMID- 1744457
TI  - [Prenatal diagnosis of carbamyl phosphate synthetase deficiency by fetal liver
      biopsy].
AB  - Carbamyl phosphate synthetase deficiency (CPSD) is one of the enzyme defects of
      the urea cycle and inherited as an autosomal recessive. A definitive enzymatic
      diagnosis of CPSD can be made by biochemical assay of liver biopsy material, but
      not of cultured fibroblasts. In pregnancy at risk for CPSD, prenatal diagnosis
      was attempted by fetal liver biopsy, performed at 22 weeks of gestation. CPS
      activity was present and a healthy baby was delivered at term. The technique
      employed for fetal liver biopsy is described together with an evaluation of its
      possible role in prenatal diagnosis.

PMID- 1744458
TI  - [The effects of pregnancy on prolactin secretion in occulted hyperprolactinemia].
AB  - The changes in the maternal prolactin level during pregnancy and puerperium were
      studied in 14 patients with occulted hyperprolactinemia, 5 patients with
      functional hyperprolactinemia, and 135 women with normoprolactinemia. All of
      those with occulted hyperprolactinemia and functional hyperprolactinemia became
      pregnant through bromocriptine treatment. Higher prolactin levels were noted in
      occulted hyperprolactinemic patients from the first to second trimester of
      pregnancy, but in the third trimester prolactin levels fell to the normal control
      levels. This change completely resembled the change in functional
      hyperprolactinemic patients. Prolactin secreting capacities after puerperium
      returned to normal in 4 of the 5 patients with occulted hyperprolactinemia. These
      4 became pregnant for the second time without any treatment. However, the other
      patient, whose prolactin secreting capacity was aggravated after the first
      puerperium, became pregnant the second time through bromocriptine treatment.
      These results indicate the following: 1) most cases of occulted hyperprolctinemia
      which may be due to functional lesions return to normal after pregnancy, 2) in
      rare cases of occulted hyperprolactinemia, prolactin secretion capacity is
      aggravated after the pregnancy, 3) it is important to observe the natural history
      of the patient in the treatment of occulted hyperprolactinemia.

PMID- 1744459
TI  - [Significance of intermittent CDDP therapy for improving long-term prognosis in
      patients with advanced ovarian cancer].
AB  - In cases of advanced ovarian cancer, intermittent CDDP therapy (ICDDPT) was
      applied after the first operation and induction chemotherapy, and its efficacy
      and limit were studied. One cycle of this therapy involved consecutive 5 day CDDP
      treatment (25-30mg/body/day). The therapy was repeated at intervals of 3 months.
      In many cases, ovarian cancer was histologically rated as epithelial
      adenocarcinoma. The study included 18 cases in total. ICDDPT was applied to 13
      cases in which no tumor mass was detected by second look operation (SLO) or which
      showed clinical remission after operation. Only 3 of these 13 cases showed
      recurrence, and all these 13 are still living. Of the 5 cases in which SLO
      disclosed a tumor mass or which did not show remission after the first operation,
      2 died. When the survival rate after ICDDPT was compared by the Kaplan-Meier
      method with that of controls without CDDP therapy, the effectiveness of ICDDPT
      was demonstrated. The survival rate could therefore be improved by ICDDPT. The
      therapy particularly improved the long term prognosis of SLO negative cases and
      cases in clinical remission. It seems necessary to repeat this therapy for a long
      period to achieve satisfactory results. In SLO positive cases and cases without
      clinical remission, the therapy had only a limited effect.

PMID- 1744460
TI  - [The effect of immediate delivery on the fetus with reverse end-diastolic flow
      velocity in umbilical artery velocimetry].
AB  - Reverse end-diastolic flow velocity suggests a catastrophic fetal condition. Some
      authors have suggested that perinatal management of these pregnancies should be
      more aggressive. Despite increased opportunities to use Doppler ultrasonography,
      guidelines for clinical management of such pregnancies have not been established.
      We have applied immediate delivery to 6 patients out of 7 patients who showed
      reverse end-diastolic flow velocity. When the study population was compared with
      the population of the other authors, there were no differences in gestational age
      at diagnosis, birth weight, or incidence of maternal hypertension. However, the
      study patients were delivered at significantly higher Apgar scores and had a
      lower perinatal mortality rate. These results suggest that immediate delivery of
      the fetus with reverse end-diastolic flow may be correlated with a favorable
      perinatal outcome.

PMID- 1744461
TI  - [Disorder of serum electrolytes following CAP therapy].
AB  - Combination chemotherapy with Cyclophosphamide, Adriamycin and Cisplatin (CAP) is
      one of the most effective chemotherapies for ovarian cancer. Severe vomiting
      induced by this treatment may cause a disorder of the serum electrolytes. Severe
      hyponatremia was observed in one patient who complained of convulsions and
      unconsciousness. Accordingly we studied the disorder of serum electrolytes in 158
      courses of CAP treatment (44 patients) during the five years from 1984 to 1988.
      The serum electrolytes were influenced by the amount of vomiting in this study.
      Consequently frequent examination of serum electrolytes is necessary during this
      treatment.

PMID- 1744462
TI  - [Statistical analysis of possible causes of repeated spontaneous abortions].
AB  - The possible causes of early pregnancy failure in one thousand, three hundred and
      seventeen women (n = 1,317) with a history of repeated reproductive wastage were
      analysed and the results of treatment for each etiology were evaluated. Out of
      1,200 hysterosalpingographies, 188 (15.7%) congenital uterine anomalies were
      detected and the degree of each uterine cavity deformity was evaluated by the X/M
      ratio. Metroplasty was performed on 71 women with no other causes of spontaneous
      abortion, and more than 84% of the post-operative pregnancy were successfully
      maintained. One hundred and four (n = 104, 5.5%) out of 949 couples with a high
      incidence of reproductive failure had either a chromosomal abnormality or normal
      variants in the wife and/or husband. Twelve cases (n = 12, 8.1%) had a positive
      analysis for anticardiolipin antibody among 148 women examined. Immunotherapy
      utilizing the husband's lymphocytes was indicated for four hundred and seventy
      three (n = 473) other couples with no other abnormalities likely to induce
      spontaneous abortions. This treatment brought approximately 80% of pregnancies to
      successful termination and 199 deliveries were recorded with this immunotherapy.
      The present study suggests that the causes of early pregnancy failure are
      complex, but that most of the causes of repetitive wastage are curable after
      exact diagnosis and appropriate treatment.

PMID- 1744463
TI  - [Evaluation of fetal renal arterial blood flow waveforms with pulsed Doppler
      flowmetry and the correlation to estimated fetal body weight, fetal urine
      production rate and amniotic fluid volume].
AB  - Fetal renal arterial blood flow waveforms in 69 fetuses at 28 to 41 weeks of
      gestation were evaluated by means of pulsed doppler flowmetry. The pulsatility
      index (PI) in non-retarded fetuses gradually decreased as the gestational age
      advanced. A negative correlation was found between the PI in non-retarded fetuses
      and the weeks of gestation (r = -0.676, p less than 0.01). PI of the renal artery
      was higher in IUGR than in non-retarded fetuses, and no negative correlation was
      found between the PI in IUGR and gestational age (r = -0.337). The PI in all
      fetuses including IUGR was negatively well-correlated to estimated fetal body
      weight (r = -0.633, p less than 0.01). These results showed that the PI of the
      renal artery has a negative correlation with fetal body weight but not with aging
      of the fetus. The rate of fetal urine production in 19 cases and the diameter of
      the amniotic pocket in 44 cases at 36 to 40 weeks of gestation were next
      examined. The PI of the fetal renal artery also showed a negative correlation to
      the urine production rate (r = -0.544, p less than 0.01) and the diameter of the
      amniotic pocket (r = -0.517, p less than 0.01). The results suggested that an
      increase in the impedance of the fetal renal artery causes a decrease in urine
      production. These observations indicated that the assessment of renal blood flow
      waveforms may be useful in evaluating the development and well-being of the
      fetus.

PMID- 1744464
TI  - [Changes in coagulability and fibrinolytic activity in the patients with ovarian
      hyperstimulation syndrome].
AB  - Ovarian hyperstimulation syndrome (OHSS) is occasionally seen following hMG-hCG
      treatment in combination with a GnRH agonist. Increased coagulability and
      decreased renal perfusion may be life threatening in some severe cases. In order
      to evaluate coagulo-fibrinolytic activity, several related factors in the general
      circulation were examined for approximately 2 weeks after admission in 11
      patients with severe OHSS. The results are as follows. 1. Fibrinopeptide A (FPA)
      was increased during the initial stage of OHSS followed by a gradual decrease.
      However, the level remained slightly higher than normal for 2 weeks after the
      onset of severe OHSS. 2. Fibrinopeptide B beta 15-42 (FPB beta 15-42) showed
      grossly similar patterns to those of FPA. 3. D-dimer levels were constantly
      higher than normal from the initial to the late stages of OHSS. 4. Thrombin
      Antithrombin III complex (TAT) was markedly increased on the days of admission
      followed by a gradual decrease during the following week. 5. Antithrombin III
      (ATIII), plasminogen and alpha 2 plasmin inhibitor (alpha 2PI) showed only
      minimal decreasing patterns throughout blood samplings. 6. Increases in FPA, FPB
      beta 15-42 and D-dimer were greater in the cases with severe hemoconcentrations.
      Our present data suggest that severe OHSS brings on hypercoagulability resulting
      in microthrombosis. In order to avoid development of coagulopathy, prophylactic
      treatment should be considered for patients with OHSS.

PMID- 1744465
TI  - [Clinical backgrounds in two kinds (absolute and relative) of mild pregnancy
      induced hypertension].
AB  - The criteria for pregnancy induced hypertension (PIH) have been determined by the
      Japanese Obstetrics and Gynecology Society. Mild PIH is classified into two
      types. One is "Absolute-PIH (A-PIH)" diagnosed by 1) systolic blood pressure
      (SBP) greater than = 140mmHg and less than 160mmHg or 2) diastolic blood pressure
      (DBP) greater than = 90mmHg and less than 110mmg. Another one is "Relative-PIH (R
      PIH)" diagnosed by 3) an increase in SBP greater than = 30mmHg compared to normal
      SBP or 4) an increase in DBP greater than = 15mmHg compared to normal DBP.
      However, there has been no report in which two types of PIH are assessed. Our
      hypothesis is that the pathophysiology of two types of PIH is different. The
      purpose of this study is to clarify the pathophysiological difference by
      evaluating the clinical backgrounds. We evaluated 963 nullipara and 747 multipara
      whose pregnancies were recorded from the 1st trimester (multiple pregnancy and
      pre-term delivery before 32 gestational weeks were excluded). Among 765 nullipara
      women, 79.4% were diagnosed as having normal blood pressure (N-group), 7.1% as A
      PIH, and 13.0% as R-PIH. In the multipara N-group, the figures were 632 women
      (84.6%), A-PIH, 4.6% and R-PIH, 10.3%. Clinical backgrounds showed that the
      incidence of hypertensive family history, high hematocrit (greater than = 39.0)
      before the 12th gestational week or obesity (Kaup index greater than = 24 before
      pregnancy) was significantly higher in A-PIH than in the N-group of nullipara and
      higher in the A-PIH than in the R-PIH and N-groups of multipara.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1744466
TI  - RGD-containing peptides inhibit experimental peritoneal seeding of human ovarian
      cancer cells.
AB  - A synthetic peptide containing the RGD (Arg-Gly-Asp) sequence is known to inhibit
      the attachment between cells and the extracellular matrix (ECM) in vitro, and
      also inhibit experimental pulmonary metastasis of murine melanoma cells in vivo.
      Prevention of peritoneal seeding by RGD-containing peptides has never previously
      been discussed. In this study, the inhibition of peritoneal seeding by RGD
      containing peptides is examined, using the in vivo experimental peritoneal
      seeding model with human ovarian cancer cells (JHOC-1). Intraperitoneal (i.p.)
      inoculation of nude mice with JHOC-1 cells soon resulted in peritoneal seeding in
      all of the mice. Most of them expired within 4 to 80 weeks, and none survived for
      as long as 10 weeks. GRGDS (Gly-Arg-Gly-Asp-Ser) sequenced synthetic peptides
      were administered by i.p. injection after tumor cell inoculation following some
      regimens, and the changes in body weight and the periods of survival of the
      peptides-treated and untreated mice were observed. Intraperitoneal administration
      of 2mg/mouse of GRGDS peptides (every 8 hours, for 4 days, beginning just after
      tumor cell inoculation) significantly prolonged the survival periods of the tumor
      implanted mice. In this study, RGD-containing peptides were found to be able to
      prevent in vivo experimental peritoneal seeding by continual i.p. administration.
      This might indicate that RGD and integrins plays a critical role in peritoneal
      seeding as well as in hematogeneous metastasis.

PMID- 1744467
TI  - [Antiphospholipid antibodies induced by immunization with husband's lymphocytes
      in the sera of women with unexplained recurrent spontaneous abortion].

PMID- 1744468
TI  - Endothelin-1 induces inositol phosphate production in rat pregnant myometrium.

PMID- 1744469
TI  - [The relationship between cervical maturity at cervical cerclage and its
      outcome].

PMID- 1744470
TI  - [A case report of lymphocytic hypophysitis complicated with visual disorder in
      late pregnancy and puerperium].

PMID- 1744471
TI  - [Conservative surgical management of repeated ectopic pregnancy: a study of 15
      cases].

PMID- 1744472
TI  - [A case of diabetes insipidus occurring in early gestational stage].

PMID- 1744473
TI  - [The clinical significance of lupus anticoagulant (LAC) in the pathogenesis of
      preeclampsia].

PMID- 1744474
TI  - Trial study on endometrial polypectomy by newly developed snare under flexible
      hysteroscopy.

PMID- 1744475
TI  - Primary malignant lymphoma of the endometrium: report of a case and review of the
      literatures.

PMID- 1744476
TI  - Users' perceptions of a computerised information system in intensive care
      (ABICUS) on introduction and after 2 months use.
AB  - The aim of the present study was to assess the perceived utility of a
      computerised information system in an intensive care unit (ICU). Questionnaires
      were devised in which ICU staff indicated the ease or difficulty of obtaining and
      recording information (a) under the previous manual system, (b) soon after the
      introduction of the computerised system and (c) two months after computerisation.
      Results indicated the system was well received immediately and this favourable
      attitude persisted unchanged after two months experience. The questionnaire
      method also served to pinpoint some particular interface problems which are to be
      remedied in future versions of the system.

PMID- 1744477
TI  - Multivariable optimization of mechanical ventilation. A linear programming
      approach.
AB  - The proposed method aims at improved ventilatory care with reduced morbidity. It
      combines two important aspects of mechanical ventilation: gas exchange and lung
      mechanics. A single criterion was selected as optimization index of lung trauma:
      peak respiratory power (PRP) defined as the maximum product of pressure times
      flow during inspiration. Arterial blood gases reflect gas exchange and constitute
      the constraints of the problem. The constraints as well as the optimization index
      are expressed as linear functions of the input variables (frequency of breathing,
      tidal volume, and positive end expiratory pressure). A linear programming
      approach can therefore be used to determine the values of input variables that
      minimize PRP and at the same time keep arterial blood gases within the prescribed
      limits. The coefficients of the constraints and the optimization index equation
      are found by manipulating input variables in order to obtain four different
      values of PaO2, PaCO2 and PRP (there are four coefficients in each equation). The
      coefficients can then be calculated and the optimization procedure run. In a
      pilot study 5 patients suffering from diseases of varying pulmonary pathology
      were investigated with this method. In 4 out of 5 the ventilator treatment
      improved in terms of blood gas values (mean increase in PaO2 was 4.7%) and
      reduction of mechanical load on the lungs (mean PRP reduction was 20%). Lower PRP
      is accompanied by lower mean power and pressure values, which results in
      increased cardiac output. Presently, the main problem is the time it takes to
      determine the patient coefficients (approx one hour), a procedure that needs to
      be simplified.

PMID- 1744478
TI  - Computerized monitoring at Vanderbilt University status and future directions.
AB  - A computerized monitoring system utilizing touch screen input has been developed
      and tested at our university. Logical extensions of this technology include the
      development of a portable input device and the packaging of the physical system.
      Further extensions of this technology include, as necessary, the introduction of
      other monitoring modalities, such as respiratory and evoked potential data
      acquisition and analysis.

PMID- 1744479
TI  - Recursive programming--a valuable technique.

PMID- 1744480
TI  - Computer generated discharge summaries for a neonatal unit.
AB  - Computer generated discharge summaries are gaining in popularity. A simple and
      flexible method for generating neonatal summaries using commercially available
      software is described.

PMID- 1744481
TI  - Measuring the quality of critical care.

PMID- 1744482
TI  - The outcome index and system outcome score: a method of quality assurance through
      outcome analysis in the special care area.
AB  - A scoring system intended to assess mortality risk and permit surveillance,
      evaluation and comparison of medical care was developed in our Surgical Intensive
      Care Unit. Five simple clinical components were identified and assigned scores
      according to their statistically validated relationship to mortality and the
      summation of the component scores resulted in a daily System Outcome Score (SOS).
      Cluster analysis was used to divide the creation data set of 2,777 patients into
      suitable groupings of scores to predict mortality and the clustering was
      confirmed for reproducibility with a validation set of an additional 2,860
      patients. Two patient care surveillance techniques were then developed. The first
      involved the definition of three unfavourable SOS patterns evolving during the
      course of a patient's admission and detection of one or more of these patterns
      permits identification of specific patients for whom review of care delivered may
      be appropriate. The second involves a global assessment of care utilizing the
      Outcome Index (OI) which relates overall mortality risk in the unit to the actual
      mortality rate over a given time period. The effectiveness of care can then be
      compared between different time periods within the one unit or between different
      units with similar patient mix. A simple menu driven program has been developed
      for the IBM personal computer and clones that facilitates data storage and
      retrieval, production of outcome reports and customization of the scoring ranges
      to meet local standards of performance.

PMID- 1744483
TI  - Postoperative biosynthetic human growth hormone increases the strength and
      collagen deposition of experimental colonic anastomoses.
AB  - This study examined the effects of preoperative treatment with 2.0 mg
      biosynthetic human growth hormone (b-hGH)/kg/day on the bursting strength and
      collagen deposition of experimental left colonic anastomoses, and of intact colon
      from sham-operated rats. The anastomotic bursting pressure was 55% higher in the
      b-hGH treated animals on day 2 (p less than 0.05) and 79% higher on day 4 (NS; p
      = 0.056), and the bursting wall tension was 65% higher on day 2 (p less than
      0.05) and 112% higher on day 4 postoperatively (p less than 0.05), than saline
      injected controls. The hydroxyproline content of the anastomotic segment in the b
      hGH treated rats increased by 56% on day 4 (p less than 0.005) and by 30% on day
      6 postoperatively (p less than 0.05), compared with controls. At 3 cm proximal to
      the anastomoses the defatted dry weight and hydroxyproline content of the healing
      colons were increased after 6 days compared with the sham-operated rats. There
      was, however, no difference between the b-hGH treated rats and the paired
      controls, indicating that growth hormone is not involved in this process.

PMID- 1744484
TI  - The effect of yoga on puborectalis paradox.
AB  - Nine patients with severe defaecation difficulties primarily considered to be due
      to puborectalis dysfunction (puborectalis paradox), verified by electromyography
      (EMG) of the striated anal sphincter muscles, were offered training in Yogic
      techniques of relaxation and muscle control in order to change the activity of
      the pelvic floor muscles during attempted defaecation. Five patients completed
      the training program of 20 2-hour sessions and were re-examined clinically and
      with EMG. One patient regained a normal EMG pattern but none of the patients
      improved clinically.

PMID- 1744485
TI  - Epidemiology of faecal incontinence in selected patient groups.
AB  - It is known that only a minority of patients with faecal incontinence report
      these symptoms to their physicians. Epidemiological estimates based on medical
      chart data, therefore, may contain a detection bias. To evaluate such bias in
      epidemiological data, we evaluated prospectively the presence of faecal
      incontinence in selected patient groups with a proven high incidence of such
      symptoms and compared it to the incidence in a group of healthy controls. If the
      patient acknowledged faecal incontinence in the questionnaire, the medical chart
      was checked to see if these symptoms had been noted during previous work-up; this
      was used to estimate the number of unregistered cases if the epidemiological
      estimate is based on medical chart data. The incidence of incontinence was
      significantly elevated in all patient groups as compared to the controls, but
      only up to 5% of patients with faecal incontinence, regardless of the underlying
      mechanism, had these incontinence symptoms noted in the medical charts. We
      conclude that for the estimation of the prevalence and incidence of faecal
      incontinence, data from medical charts contain a detection bias which
      systematically underestimates the real presence of faecal incontinence.

PMID- 1744486
TI  - The role of nailbed vasospasm in Crohn's disease.
AB  - Local cooling of the nailfold capillaries produces a typical blood flow stop
      reaction in patients with Raynaud's phenomenon. We applied the same test to 35
      patients with Crohn's disease and compared the results with the findings in a
      control group of 35 healthy subjects matched for age and sex by nailfold
      videomicroscopy. We found a flow stop with cold exposure in 27 of the 35 patients
      with Crohn's disease (mean duration 38 s) in contrast to 2 of the 35 control
      subjects only (mean duration 12 s). There was no significant difference in skin
      temperature between the two groups. Intravital microscopy of nailfold capillaries
      revealed an evident reduction of the capillary density (p = 0.001) and crest
      diameter of the capillary loop (p = 0.02) compared to normal subjects. The strong
      association of a vasoconstrictive reaction in finger microcirculation in patients
      with Crohn's disease suggests a vasospastic tendency in this disorder that might
      manifest in the mesenteric capillaries also. This new finding of microcirculatory
      disturbance may play a role in the pathophysiology of Crohn's disease and be
      related to a general vasospastic syndrome.

PMID- 1744487
TI  - Transanorectal ultrasonography in the staging of anal epidermoid carcinoma.
AB  - Fifty consecutive patients with anal canal epidermoid carcinoma were evaluated by
      transanorectal ultrasonography (TRUS) at diagnosis. Forty-six patients were
      treated with primary radiotherapy plus bleomycin. Twenty-eight of the last 30
      patients underwent, in addition, planimetric volume determination. The ultrasound
      findings were compared with clinical stage as assessed by digital palpation.
      Tumours in clinical stages T1-2 showed evidence of penetration through the
      anorectal muscular wall at ultrasound (UT3-4) in two-thirds of the cases. This
      was the case in all tumours in clinical stages T3-4. A clear correlation between
      tumour size, depth of invasion, and tumour volume, respectively, and residual
      tumour after a "pre-operative" dose of 40 Gy plus bleomycin was found. When
      combining clinical stage with TRUS, all tumours classified as T1-2/UT1-2 had a
      complete response (CR) after the first radiotherapy period, whereas the
      corresponding figures for those with deep invasion ultrasonographically (T1-2/UT3
      4 and T3-4/UT3-4) were 64 percent and 0 percent, respectively. It thus appears
      that TRUS could complement digital palpation in staging anal canal carcinoma.

PMID- 1744488
TI  - Pouch dynamics--a simple test of ileo-anal pouch evacuation.
AB  - A simple technique for quantifying ileo-anal pouch evacuation has been used to
      compare patients with good pouch function and fully spontaneous defaecation (n =
      10) to patients with a symptomatic disorder of pouch evacuation (n = 10), usually
      due to a pouch-anal stricture (n = 7). Pouch emptying was significantly less
      efficient in those with disordered evacuation (median 54% evacuated) than in
      those with good function (median 98% evacuated, p = 0.02) and significantly
      slower (median 22.4 sec vs 5.2 sec to evacuate 75% of instilled barium, p less
      than 0.02) even when of comparable efficiency. Testing of four further patients
      with high stool frequency but neither stenosis nor symptomatic difficulty with
      evacuation excluded a significant disorder of evacuation in three but identified
      inefficient emptying in the fourth. This test may prove useful in the
      investigation of patients with poor pouch function of uncertain origin.

PMID- 1744489
TI  - Extended resection in the treatment of colorectal cancer.
AB  - Between 1975 and 1990, 525 patients underwent resection of colorectal cancer in
      our unit. Of these, 38 had tumour invading adjacent structures and underwent an
      extended resection. Overall, there were 67 cases treated palliatively. Of these,
      three were in the group of 38 having an extended resection. When the groups of
      radical not extended (n = 423) and radical extended resections (n = 35) were
      compared, respective values for mortality (1.9% vs 0) and morbidity (12.8% vs
      11.3%) were not different. Respective local recurrence rates (13% vs 26%) were
      significantly greater after extended resection. Five-year survival after extended
      resection was 30%, no different from the general survival rate for standard
      resections for T2-3 node-positive tumours. Extended resection is thus a safe and
      important approach for locally advanced tumours.

PMID- 1744490
TI  - Benign lymphoid polyposis of the colon. Report of a case in an adult.
AB  - A new case of benign lymphoid polyposis of the colon in an adult is presented.
      Relatively frequent in childhood, this disease remains exceptional in adults. The
      main concern is differentiation from adenomatous polyposis; the differential
      diagnosis can be particularly difficult for complex forms of polyposis with
      coexistent adenomatous and lymphoid polyps. Benign lymphoid polyposis of the
      colon does not appear to have any propensity for malignant degeneration, and
      major surgical resection is not indicated.

PMID- 1744491
TI  - Surgery for idiopathic megarectum and megacolon.

PMID- 1744492
TI  - Effect of sympathetic innervation on the human internal anal sphincter.

PMID- 1744493
TI  - Chronic femoral arteriovenous fistula masquerading as the postphlebitic syndrome.
AB  - A patient with a traumatic femoral arteriovenous fistula was misdiagnosed for 11
      years as having "postphlebitic syndrome." Angiography revealed diffuse dilatation
      of the veins and arteries of the right lower extremity with the iliac vein
      measuring 16.0 cm in diameter and the cava 6.0 cm in diameter. Operative repair
      of the fistula has resulted in marked clinical improvement and return of the
      patient to fulltime employment. A history of trauma should be sought when a
      patient presents with unilateral chronic venous insufficiency.

PMID- 1744494
TI  - Organ procurement and transplantation in Louisiana: an update after 16 years.

PMID- 1744495
TI  - ECG of the month. Short-circuits. Wolff-Parkinson-White syndrome.

PMID- 1744496
TI  - Superior vena cava syndrome associated with malignant mesothelioma.
AB  - A 70-year-old former shipyard worker presented with dyspnea and edema of the
      upper thorax suggesting the diagnosis of superior vena cava syndrome. Further
      evaluation revealed mesothelioma with both epithelial and spindled histologic
      patterns. The extensive mesothelioma had invaded the adventitia of the superior
      vena cava, the pleura of the lungs bilaterally, the superficial myocardium, and
      the liver. A terminal hyercoagulable state with great vein thrombosis was also
      contributory. To our knowledge this is the first documented case of superior vena
      cava syndrome associated with malignant mesothelioma.

PMID- 1744497
TI  - Medicare payment reform: RBRVS ... and a whole lot more.

PMID- 1744498
TI  - Regulation of infectious waste in Louisiana.
AB  - The purpose of the article is to acquaint readers of the JOURNAL with the
      requirements of state regulation of infectious waste, especially as it pertains
      to individual physicians and their medical offices. A brief historical
      perspective is given, followed by a brief summary of pertinent data relating to
      disease transmission via infectious waste and injuries attributable to infectious
      waste. Suggestions which comply with the law for disposal of infectious waste
      from a physician's office are given.

PMID- 1744499
TI  - Subglottic stenosis.
AB  - Subglottic stenosis, a laryngeal narrowing, can be either congenital or acquired.
      There are various anatomic abnormalities of the cricoid that explain the
      congenital types. The acquired type is due to prolonged intubation in 90% of
      cases. Anterior cricoid split can obviate the need for a tracheotomy in the
      neonate with minimal nonfibrotic subglottic stenosis. Laryngotracheal
      reconstruction allows correction of the more severely stenotic children. Both of
      these procedures strive to provide an adequate airway and a satisfactory voice.

PMID- 1744500
TI  - Treatment of thrombosis associated with septic shock.

PMID- 1744501
TI  - Enhancement of tissue plasminogen activator-induced fibrinolysis by activated
      protein C in endotoxin-treated rabbits.
AB  - Endotoxin-treated rabbits produce high levels of plasminogen activator inhibitor
      1 (PAI-1), which inhibits fibrinolysis by neutralizing endogenous tissue-type
      plasminogen activator (t-PA). These animals will develop renal fibrin deposition
      when infused with ancrod, an enzyme that acts directly on fibrinogen. In normal
      rabbits with an intact fibrinolytic system, ancrod induces hypofibrinogenemia
      without fibrin deposition. Rabbit PAI-1 activity can be neutralized by
      recombinant human t-PA or by bovine activated protein C. The present study
      determined the efficacy of these two agents used alone or in combination in
      neutralizing increased PAI-1 activity and in preventing renal fibrin deposition
      in a rabbit model. Male New Zealand rabbits first received intravenous endotoxin
      to increase PAI-1 activity. Ancrod was infused intravenously during hour 4 to 5,
      and the kidneys were examined at hour 5.5. Renal fibrin deposition occurred in
      100% (6 out of 6) of the endotoxin-treated rabbits that received ancrod; this was
      reduced to 14% (1 out of 7) for rabbits receiving t-PA (170 micrograms/kg) before
      and during the ancrod infusion. Fibrin deposition occurred in only 12% (1 out of
      8) of the rabbits that received a 10-fold lower dose of t-PA (17 micrograms/kg)
      combined with activated protein C (1 mg/kg) before and during the ancrod.
      Activated protein C at this dose completely neutralized plasma PAI-1 activity.
      However, low-dose t-PA and activated protein C did not prevent fibrin deposition
      when used as single agents, with fibrin deposition occurring in 75% and 100% of
      rabbits, respectively. The data indicate that activated protein C can neutralize
      plasma PAI-1 activity in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744502
TI  - Increased urinary zinc excretion after thermal injury.
AB  - Urinary zinc excretion normally plays a minor role in zinc homeostasis; however,
      urinary zinc excretion is markedly elevated after trauma or surgery, and
      mechanism(s) for this zinc loss are poorly defined. In this study we evaluated
      multiple potential mechanisms for increased urinary zinc excretion in patients
      with thermal injury. We documented that patients with severe thermal injury had
      markedly elevated urinary zinc excretion. Above 20% total body surface area burn,
      however, the severity of thermal injury did not correlate with urinary zinc
      excretion. Serum zinc concentrations were depressed on initial evaluation and
      gradually increased during the hospital course, whereas peak urinary zinc
      excretion occurred 2 to 5 weeks after injury. Thus the depression in serum zinc
      concentration did not temporally relate to the observed pattern of hyperzincuria.
      Increased urinary zinc excretion also did not temporally relate to urinary
      excretion of the amino acids cysteine and histidine (both of which tightly bind
      zinc) nor to urinary 3-methylhistidine excretion, a marker of muscle breakdown.
      Urinary amylase excretion, a marker of renal tubular dysfunction, did follow the
      pattern of urinary zinc loss to some extent, although this correlation was not
      perfect. Increased oral intake of zinc via zinc supplements resulted in
      significantly increased urinary zinc excretion. Patients receiving total
      parenteral nutrition (TPN) did not have significantly increased urinary zinc
      excretion when compared with people receiving their total nutrient intake by
      mouth.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744503
TI  - Autologous platelet kinetics in patients with severe thrombocytopenia:
      discrimination between disorders of production and destruction.
AB  - Measurements of platelet survival and turnover in severe thrombocytopenia have
      proven difficult to perform and interpret. To examine the mechanisms by which
      platelet life span is reduced and to determine the capacity of platelet kinetic
      studies to discriminate between increased platelet destruction and impaired
      platelet production in patients with moderate to severe thrombocytopenia, we
      developed a modified method for labeling autologous platelets with indium-111
      oxine (which increases labeling efficiency, reduces the required volumes of
      blood, and decreases platelet manipulation in vitro) and conducted a prospective
      study in 26 patients with thrombocytopenia. Seventeen patients had megakaryocytic
      hypoplasia (platelet count 51 x 10(9)/L, range 10 x 10(9)/L to 150 x 10(9)/L;
      reduced megakaryocytes in marrow smears and biopsy sample), nine patients had
      clinical idiopathic thrombocytopenic purpura (ITP) (platelet count 79 x 10(9)/L,
      range 19 x 10(9)/L to 150 x 10(9)/L; normal to increased megakaryocytes with
      otherwise normal marrow, and seven patients displayed the presence of
      autoantibodies directed against platelet glycoproteins IIb-IIIa or Ib). Although
      platelet life span was shortened in all patients, the average platelet survival
      time measured in patients with megakaryocyte hypoplasia was substantially longer
      than that measured in patients with ITP. Only platelet survival times measured in
      patients with megakaryocyte hypoplasia were predicted by the degree of
      thrombocytopenia. Platelet turnover was reduced in all patients with
      megakaryocytic hypoplasia but was variable in the patients with ITP. Platelet
      turnover values correlated with circulating platelet counts in patients with
      marrow hypoplasia but not in the patients with ITP.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1744504
TI  - Tyrosine and N-carbamoyl-tyrosine in end-stage renal disease during continuous
      ambulatory peritoneal dialysis.
AB  - Lower-than-normal tyrosine concentrations of unexplained pathogenesis in plasma
      and intracellular body water have been reported in patients with chronic renal
      failure. We found a derivative of tyrosine that is not measured by the usual
      methods of amino-acid analysis because its alpha-amino group is blocked and
      cannot react to form other derivatives. An in vivo covalent reaction with urea
      derived cyanate forms alpha-amino-carbamoyl-tyrosine (N-C-Tyr) in patients with
      end-stage renal disease. A longitudinal study of patients with end-stage renal
      disease who were treated with continuous ambulatory peritoneal dialysis shows
      that plasma that is obtained within 4 hours of the morning meal contains 70.1 +/-
      6 mumol/L of tyrosine (mean +/- SEM) and 77.2 +/- 12 mumol/L of N-C-Tyr (mean +/-
      SEM). Thus there is a molecule of N-C-Tyr for each molecule of tyrosine present.
      The carbamoylation index or ratio of N-C-Tyr to tyrosine, blood urea nitrogen,
      episodes of peritonitis, and changes in dialysis protocol were compared. A
      reduction in the number of peritoneal dialysis exchanges resulted in parallel
      increases in carbamoylation index and blood urea nitrogen. Altering dialysis by
      increasing the number of exchanges or adding supplemental hemodialysis resulted
      in a decrease in the carbamoylation index with a delayed decrease in blood urea
      nitrogen. We found a significant increase of N-C-Tyr (p = 0.005) and of the
      carbamoylation index (p = 0.004) during six episodes of peritonitis compared with
      10 periods of no peritonitis in two patients who had multiple episodes of
      peritonitis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744505
TI  - Bacterial lipopolysaccharides alter human endothelial cell morphology in vitro
      independent of cytokine secretion.
AB  - Lipopolysaccharides derived from six bacterial species were found to alter human
      endothelial cell morphology in vitro in a species-dependent and dose-dependent
      manner. Lipopolysaccharides derived from Salmonella enteritidis (SeLPS) induced
      the strongest response, whereas lipopolysaccharides from Vibrio cholerae produced
      no effect. Cell-shape changes induced by SeLPS (10 micrograms/ml) were noticeable
      by 24 hours and reached a maximum by 72 hours, thus paralleling the effects
      produced by the recombinant cytokines interferon gamma (IFN-gamma) (10(3) U/ml),
      tumor necrosis factor (10(2) U/ml), and interleukin-1 (5 to 10 U/ml).
      Pretreatment of human endothelial cells with IFN-gamma (10(3) U/ml) for 24 hours
      induced an accelerated morphologic response to subsequent SeLPS (10
      micrograms/ml) stimulation and vice versa, suggesting independent pathways of
      action. Simultaneous treatment of human endothelial cells with SeLPS and IFN
      gamma produced a more rapid onset of morphologic changes and a stronger overall
      effect. Culture medium containing polymyxin B inhibited cell-shape changes
      induced by lipopolysaccharides but not those induced by the cytokines.
      Conditioned medium generated over a 12-hour period following a 24-hour SeLPS/IFN
      gamma stimulation did not contain measurable cytokine antigens, nor did it induce
      biologic responses associated with interleukin-1, IFN-gamma, and tumor necrosis
      factor alpha. The results indicate that lipopolysaccharides act directly on
      endothelial cells as well as synergistically with IFN-gamma to alter cell
      morphology and may, therefore, contribute to the vascular pathology of gram
      negative infections.

PMID- 1744506
TI  - The primary structure of serum amyloid A protein in the rabbit: comparison with
      serum amyloid A proteins in other species.
AB  - Rabbit serum amyloid A (SAA) protein was isolated from acute-phase serum by
      ultracentrifugation, molecular seive chromatography, and ion-exchange
      chromatography. The complete amino acid sequence of the protein was established
      by sequence analysis of peptides derived from trypsin and Staphylococcus
      proteinase digestion of the protein. The molecule consisted of 104 amino acids
      and had an amino terminus that was blocked by pyrrolidonecarboxylic acid.
      Heterogeneity was not observed at any residue, which suggests that the material
      sequenced consisted of a single serum amyloid A species. The protein is highly
      homologous to serum amyloid A from humans and other animals, particularly in the
      middle portion of the molecule (positions 33 to 63), which suggests that this
      region may be important in its function. This highly conserved region may also
      contain the determinants for amyloid formation.

PMID- 1744507
TI  - Neutralizing antibody responses in patients with AIDS with neurologic
      complications.
AB  - Although the human immunodeficiency virus type 1 (HIV-1) is frequently isolated
      from the cerebrospinal fluid of infected patients, only a small percentage of
      patients are found to have clinical dementia or neuropathies (or both). The
      reasons for this remain unclear. In our study, serum neutralizing antibody titers
      against the human T cell leukemia virus-IIIB isolate of HIV-1 were tested in 10
      patients with acquired immunodeficiency syndrome (AIDS) with neurologic
      complications and 20 patients with HIV infection without neurologic
      complications. Titers were significantly lower in the neuro-AIDS group,
      suggesting that impaired neutralizing antibody responses in this subpopulation of
      patients may be involved in the immunopathogenesis of AIDS encephalopathy.

PMID- 1744508
TI  - Alpha-thalassemic traits are common in the Taiwanese population: usefulness of a
      modified hemoglobin H preparation for prevalence studies.
AB  - The aim of this study was to determine the crude prevalence of alpha-thalassemia
      traits in Taiwan. A total of 1435 healthy employees from a statewide company were
      randomly screened by complete blood count determination with indices. Subjects
      with mean corpuscular volume less than 80 fl were analyzed by hemoglobin
      electrophoresis on cellulose acetate to exclude beta-thalassemia and with serum
      ferritin to exclude iron deficiency. Modified hemoglobin H inclusion staining was
      performed to confirm the diagnosis of alpha-thalassemia traits, and DNA probe
      studies were used to confirm the validity of this test. The overall prevalence
      rate of alpha-thalassemia trait was 3.4% (48 out of 1435). In persons of mainland
      Chinese origin, prevalence was 0.4%, and among persons of Taiwanese origin, it
      was 4.0% (47 out of 1171). We conclude that alpha-thalassemia traits are common
      genetic disorders in Taiwan and that antenatal screening is advised to reduce the
      frequency of occurrence of hemoglobin Bart's hydrops fetalis. The methods we used
      proved to be reliable and inexpensive.

PMID- 1744509
TI  - Endogenous platelet fibrinogen surface expression on activated platelets.
AB  - Intracellular platelet fibrinogen surface expression was studied in
      arabinogalactan-purified, resting, and thrombin-stimulated platelets. Platelet
      fibrinogen is derived from endocytosis of plasma fibrinogen by megakaryocytes.
      Like a variety of other adhesive proteins, it is stored in the platelet alpha
      granule. Platelet fibrinogen surface expression was studied by using the antigen
      binding fragments of a murine monoclonal antibody to platelet fibrinogen, F26,
      and an immunopurified polyclonal antifibrinogen antibody. Studies correlating
      platelet fibrinogen surface expression with the presence of the glycoprotein IIb
      IIIa (GPIIb-IIIa) complex showed that in the presence of ethylene glycol
      tetraacetic acid (EGTA) at 37 degrees C, neither the GPIIb-IIIa complex nor
      platelet fibrinogen was expressed on the surface of thrombin-activated platelets.
      Similar experiments performed in the presence of EGTA and calcium showed
      proportional expression of the GPIIb-IIIa complex and platelet fibrinogen. The
      addition of Arg-Gly-Asp-Ser-containing peptides, the pentadecapeptide of the
      fibrinogen gamma-chain carboxy terminus, or the monoclonal antibody 10E5, when
      directed against the GPIIb-IIIa complex before thrombin activation, inhibited 65%
      to 94% of the platelet fibrinogen expression, as determined with the polyclonal
      and monoclonal antigen-binding fragments. When these same inhibitory agents were
      added immediately after or 5 minutes after thrombin, the amount of inhibition
      decreased significantly. Similar studies with a washed platelet system revealed
      that when the inhibitors of platelet fibrinogen expression were added before
      thrombin stimulation, the degree of inhibition observed was only 24% to 38%. This
      suggests that the major portion of platelet fibrinogen expression involves the
      release of platelet fibrinogen and its subsequent binding to GPIIb-IIIa. This
      binding may occur within the open canalicular system or on the platelet surface;
      in either case, wherever the site of released platelet fibrinogen binding occurs,
      it can be markedly inhibited by the RGD-containing peptides and the gamma-chain
      fibrinogen peptides. Approximately 10% to 30% of platelet fibrinogen may be
      expressed prebound to a platelet receptor, or else it is released and binds to a
      platelet receptor other than the GPIIb-IIIa complex.

PMID- 1744510
TI  - Memorial minute for William B. Castle, MD.

PMID- 1744511
TI  - The management of oral mexiletine and intravenous lidocaine to treat chronic
      painful symmetrical distal diabetic neuropathy.
AB  - Intravenous local anesthestics administered to patients with chronic pain have
      been shown to provide significant levels of systemic analgesia. Furthermore, oral
      mexiletine which is similar in structure has been demonstrated to be efficacious
      in the treatment of diabetic neuropathy. It is recommended that this combined
      form of treatment be considered with those patients whose diabetic neuropathy is
      resistant to more conventional forms of treatment.

PMID- 1744512
TI  - Tuberculosis in the intensive care unit: a chemotherapeutic controversy.
AB  - A survey of 150 practicing pulmonary physicians was conducted to determine
      chemotherapy preferences for the treatment of the patient suffering respiratory
      insufficiency secondary to active nonmiliary tuberculosis. An equal sample was
      selected from both the private sector and academic medicine in order to determine
      if antituberculous agent selection differed between these two groups. The
      majority of the 109 physicians who responded to the questionnaire (64.2%)
      indicated that they would use isoniazid, rifampin, and a third agent. There was
      no statistical difference in the choice of ethambutol, pyrazinamide, or
      streptomycin as the third drug. There was no difference between university and
      community based physicians in the use of three drug combinations or in the
      selection of the specific third agent. This study suggests that, although the
      majority of pulmonologists responding would treat the patient with respiratory
      insufficiency from tuberculosis with an aggressive three drug approach, there is
      no consensus as to which agent should be the third drug.

PMID- 1744513
TI  - Upper extremity wound management: intermediate infections.
AB  - A careful history and physical examination, including information regarding
      position of the hand at the time of injury, presence of other disease,
      handedness, age, and occupation, are all essential to evaluate hand infection. If
      surgery is anticipated, antibiotics should generally be withheld until operative
      cultures are obtained. Infections secondary to human bite injuries are common and
      are usually caused by a blow of the fist to the mouth. These injuries can produce
      crippling sequelae, must be managed promptly and aggressively, and often require
      surgery. Flexor tenosynovitis, often caused by a penetrating injury, may be
      treated nonoperatively if the patient presents within 24 to 48 hours of onset.
      Older injuries always require incision and drainage of the flexor tendon sheath.
      Most authors agree that surgical management of dog bite wounds to the hand is
      essential. Cat and arthropod bites may also require surgery.

PMID- 1744514
TI  - Resection of renal cell carcinoma with vena cava extension using circulatory
      arrest.
AB  - Resection of renal cell carcinoma with extension into the inferior vena cava can
      result in massive blood loss, incomplete removal of the tumor, and systemic
      dissemination of malignant cells. A case is presented in which circulatory arrest
      with total body exsanguination permitted relatively safe resection in a bloodless
      operative field.

PMID- 1744515
TI  - Health promotion: the physician's changing role.

PMID- 1744516
TI  - James Given Carpenter, MD, 1854-1942.

PMID- 1744518
TI  - Lung diseases: where we are now and where we are going.

PMID- 1744517
TI  - Of consistency and of honor.

PMID- 1744519
TI  - Interstitial lung disease: state of the clinical art.
AB  - Interstitial lung diseases pose a great challenge to the clinician because of the
      indolent and variably active nature of these disorders and the limited number of
      therapeutic options. Adjunctive therapy includes supplemental oxygen in hypoxic
      patients, bronchodilators in patients with an obstructive lung component, and
      aggressive use of antibiotics in febrile patients on potent immunosuppressive
      therapy and suspected or confirmed infections. In younger patients who present
      late in their illness or deteriorate on therapy, lung transplantation is the only
      option. Recent advances in our knowledge of the cellular and molecular mechanisms
      operating in ILD and techniques which include gene amplification and cloning
      promise to yield more effective treatments for these diseases which currently
      produce a high incidence of morbidity and mortality.

PMID- 1744520
TI  - Asthma in the adult: management in the '90s.

PMID- 1744521
TI  - Recent advances in mechanical ventilatory support for adults.

PMID- 1744522
TI  - Restrictive covenant law in Georgia: back to the drawing board.

PMID- 1744523
TI  - Stereotactic radiosurgery.

PMID- 1744524
TI  - Of youth and the future--of attention.

PMID- 1744525
TI  - The Data Bank: why it should be abolished.

PMID- 1744526
TI  - Controlling violence: a retail approach.

PMID- 1744527
TI  - MAG slays the dragon: the saga of HealthCare COMPARE.

PMID- 1744528
TI  - The use of long-acting drugs in the treatment of rheumatoid arthritis.
AB  - Experience to date strongly indicates that long-acting drugs currently used in
      treatment of rheumatoid arthritis are very potent antiinflammatory agents which
      act in most cases by completely unknown mechanisms. All of them have built in but
      recognizable toxicity which can usually be prevented by appropriate monitoring.
      Although most of them offer relatively short term (up to 3 years) benefits, with
      the probable exception of methotrexate, nonetheless they can offer for a period
      of time improved function and relief of pain for many individuals. Thus, even
      though they do not dramatically affect the long-range outcome of the disease,
      they continue to offer useful benefit for patients with rheumatoid arthritis who
      are not responding to conservative therapy. Some of the long-acting agents are
      only slightly more toxic than the widely nonsteroidal antiinflammatory drugs
      which do have a definite risk of serious upper gastrointestinal bleeding.
      Currently the use of combinations as well as the continued introduction of new
      drugs in this class, offer hope that greater benefit than we can currently
      provide is within reach over the next few years.

PMID- 1744529
TI  - Closing the doors or selling your practice: options to consider.

PMID- 1744530
TI  - Rust v. Sullivan, and the future of abortion under a more conservative Supreme
      Court.

PMID- 1744531
TI  - Function and organ sparing role of radiation therapy in cancer management.

PMID- 1744532
TI  - CT findings of seeding tumors.
AB  - From 1981 to 1989 there were 43 from 154 cases of metastatic brain tumors, which
      seeded along the CSF pathways found in the Department of Radiology, Siriraj
      Hospital Medical School, Bangkok. These seeding tumors were spread from both
      primary intracranial (25 cases) and extracranial neoplasms (18 cases). Among the
      primary intracranial tumors, pineal neoplasm was the most frequent site (48%).
      The next rank was ependymoma (20%), medulloblastoma (16%), glioma (12%) and
      others (4%). The majority of extracranial neoplasms that seed in the CSF pathways
      were malignancy of lung (44.4%), choriocarcinoma (22%) and breast (11%). Lateral
      ventricle was the most frequent site of seeding (65%). The remaining tumors
      seeded in cisterns, leptomeninge and spinal subarachnoid space. CT is sensitive
      in detecting seeding tumors but not specific for each type of tumor.

PMID- 1744533
TI  - An outbreak of El Tor cholera in an institution for the mentally retarded in
      Nonthaburi, June-July 1987.
AB  - In June and July 1987, an outbreak of cholera caused by V.cholerae O1, biotype El
      Tor, serotype Inaba, occurred in an institution for the mentally retarded in
      Nonthaburi. Of the 447 retarded inmates, 74 were found to be infected and one
      died. Epidemiological investigation revealed that the inmates with severe mental
      retardation who ate food in their own sleeping-room were significantly (p less
      than 0.001) more likely to be infected than those taking food in the dining-room.
      We hypothesize that the liquid diet commonly served to the more severely mentally
      retarded may have increased the risk of infection by more rapid gastric emptying.
      The long average period of time for meal consumption among these individuals may
      have allowed the organisms to multiply to a level capable of causing disease.
      Contamination of food with cholera might have occurred during food handling in
      the kitchen or within the sleeping-room where overcrowded conditions and poor
      personal hygiene facilitated person-to-person spread of infection. Prompt
      implementation of control measures effectively terminated cholera transmission in
      the outbreak.

PMID- 1744534
TI  - Marital problems: an analysis of the causes among 115 clinical couples.
AB  - Among 115 couples seeking counselling for marital problems from Jan 1, 1987-Dec
      31, 1989, 86.1 per cent of the consultations were initiated by the wives.
      Striking characteristics were as follows: 51.3 per cent of the couples had
      husbands who were either younger or more than three years older than their wives.
      A total of 62.6 per cent had dated less than bands with lower educational
      attainment or educational attainment more than three years higher than their
      wives. Sixty-two drop six had dated less than 1 year; 46.1 per cent married
      because of parental suggestions or had unreal expectations about marriage; 40.9
      per cent did not get both partners' parents to agree to their marriage; 46.1 per
      cent had premarital sexual relationships, 26.1 per cent did not register for a
      marriage license; 26.1 per cent did not hold a wedding celebration. A history of
      divorce among both partners' first degree relatives was lacking in only 41.7 per
      cent of the couples. The three most frequent marital problems were extramarital
      sexual activity, lack of intimacy and not loving the partner. The wives had a
      marginally significant trend to face the problems arising from their partners'
      extramarital sexual relationships more often than the husbands. The problem of
      not loving the partner was found significantly more frequently during the first
      five years of marriage.

PMID- 1744535
TI  - Effects of Folia orthosiphonis on urinary stone promoters and inhibitors.
AB  - Yaa-Knuatmaeo or Folia orthosiphonis showed both favourable and non favourable
      effects of stone prevention. Uric acid and uric acid containing stone may be
      prevented by the increased alkalinity of the urine after drinking Orthosiphon
      tea. The unfavourable effect of orthosiphon being the excretion of oxalate in the
      urine may result in higher risk of stone formation. However, this study may or
      may not apply to the stone patients since it has been done only on healthy
      persons and all parameters were within normal limits. We feel that Orthosiphon
      tea may be beneficial in prevention of uric acid stone formation. This study was
      supported by a grant from the Medicinal Herbs Development Fund, Mahidol
      University.

PMID- 1744536
TI  - Histochemical stainings, biological cultures and therapeutic responses of
      granulomatous lymphadenitis in Ramathibodi Hospital-prospective study of 57
      cases.
AB  - The study was designed to delineate the etiology of granulomatous lymphadenitis
      which is one of the most common lesions encountered in our routine surgical
      pathology practice. Fifty-seven lymph nodes diagnosed histopathologically as
      granulomatous lymphadenitis were cultured and stained by special histochemical
      stains for tuberculosis, fungus, anaerobic and aerobic bacteria. M.tuberculosis
      was isolated in 60-70 per cent of lesions. The remaining 30-40 per cent of the
      lesions failed to demonstrate any infectious agent but most of the available
      follow-up cases showed satisfactory response to antituberculous drugs. Ziehl
      Neelsen's stain showed very low sensitivity but excellent specificity and is
      still recommended for use to differentiate from other infectious agents in the
      areas where infectious agents are prevalent.

PMID- 1744537
TI  - An in vitro study on mefloquine/quinine in Plasmodium falciparum malaria.
AB  - An in vitro designed for determining sensitivity of Plasmodium falciparum strains
      isolated from Kanchanaburi Province, to Mefloquine/Quinine combination, was
      carried out. The MIC values of Mefloquine/Quinine for the P.falciparum strains
      were found to be 0.075/3.75 to 0.225/11.15 nM/ml. The changes observed following
      the drug treatment were an enlargement of the space between the outer and the
      inner limiting membrane of the parasitophorous vacuole. These changes were
      followed by cytoplasmic degeneration and vacuolation.

PMID- 1744538
TI  - Clinical study on antithrombotic effects of ticlopidine in ischemic stroke.
AB  - The investigators conducted a clinical study on antithrombotic effectiveness in
      ischemic stroke at Siriraj Hospital Medical School, Mahidol University from May
      1987 to May 1989. Twenty-nine patients, 16 males and 13 females were enrolled in
      the study. The ages of the patients ranged from 30-87 years with a mean age of 63
      +/- 11 years. Ticlopidine (250 mg) could significantly inhibit platelet
      aggregation induced by ADP and collagen within 24 hours of drug administration.
      After 1 week to 6 months, only aggregation by ADP was still inhibited
      significantly without significant effects on fibrinolytic activity and
      prostacyclin. Hematocrit was significantly decreased at the 1st and 2nd month of
      treatment. Serious side effects were skin rash and severe headache while the
      other common ones were dizziness, and diarrhea but these effects disappeared
      without discontinuing the drug. Most patients who suffered from nausea, diarrhea
      and headache, had temporary elevated SGPT. It may be concluded that only half of
      the recommended dose of ticlopidine has inhibitory effects on both phases of ADP
      induced aggregation without interfering with fibrinolytic activity and can
      maintain prostacyclin. However, it also possesses either serious or common side
      effects. This drug, therefore, should be used with the awareness of the
      clinician.

PMID- 1744539
TI  - Group A beta-hemolytic streptococcal type M11 sepsis and empyema: a case report.
AB  - A case of serious suppurative disease caused by GABHS in a previously well 2
      month-old Thai female presenting with clinical features of sepsis and right
      pleural effusion was reported. Treatment was initially with cloxacillin and a
      right side intercostal drainage. When subsequent cultures of blood and pleural
      fluid grew GABHS; intravenous penicillin was substituted. She made an uneventful
      recovery. Typing of the GABHS revealed non typable T-antigen and M-protein 11
      GABHS, although very sensitive to penicillin, can cause severe and rapidly
      progressive disease in a very young infant. This is the first case of GABHS type
      M11 causing pleural effusion and sepsis in an infant ever reported in Thailand.
      Epidemiologic study might be indicated if an epidemic should occur.

PMID- 1744540
TI  - Successful surgical removal of intrinsic medullar vascular malformation: a case
      presentation.
AB  - A 22-year-old man with an intrinsic arteriovenous malformation (AVM) of the
      medulla, who presented with recurrent subarachnoid hemorrhage and bulbar palsy
      was described. The successful total surgical removal of this AVM was
      demonstrated. The clinical, roentgenographic, pathological features and surgical
      approach of the brainstem vascular malformation were summarized.

PMID- 1744541
TI  - Vitamin B12 deficiency: report of a childhood case.
AB  - An 11-year-old boy who presented with anemia, premature grey hair, hyperpigmented
      skin, paresthesia, recurrent aphthous ulcers and epistaxis was eventually proved
      to be a case of vitamin B12 deficiency. Due to the paucity of this deficiency,
      the diagnosis may easily be delayed and overlooked resulting in unfavorable
      consequences. Therapeutic response to vitamin B12 was dramatic in this reported
      case.

PMID- 1744542
TI  - Polysplenia syndrome: a case with congenital heart block, infarction of a splenic
      mass, and a short pancreas.
AB  - A case of polysplenia with congenital heart block, infarction of a splenic mass,
      and a short pancreas was reported. The infant died of severe heart failure at the
      age of 28 days. Deformity of the SA node was suspected to be the cause of
      congenital heart block but could not be demonstrated because of some limitations
      of autopsy procedure. Redundant splenic pedicle might cause infarction of a
      splenic mass after birth. The author suggests that, in addition to the semi
      annular pancreas, the pancreatic anomalies of this syndrome should include the
      short pancreas.

PMID- 1744543
TI  - Effects of lidocaine and verapamil on defibrillation in humans.
AB  - Patients with automatic defibrillators frequently require chronic antiarrhythmic
      drug therapy or receive acute therapy with the onset of symptoms. The effects on
      energy requirements for defibrillation of lidocaine hydrochloride and verapamil
      hydrochloride, two commonly used antiarrhythmic agents, were examined in 20
      successive patients undergoing corrective arrhythmia surgery. The minimum energy
      requirement for ventricular defibrillation before and 5 minutes after the
      administration of 150 mg of lidocaine intravenously (n = 8), or 10 minutes after
      10 mg of verapamil intravenously (n = 12), were determined. Each patient was
      assigned to receive either verapamil or lidocaine. Three mesh coil defibrillating
      electrodes (Medtronic 6891, 6892) were sutured to the epicardium of the right and
      left ventricles. Ventricular fibrillation was induced using alternating current.
      After a minimum of 10 seconds of fibrillation, the minimum energy for
      defibrillation was established using sequential pulse defibrillation. The
      preselected drug was then infused and the ventricular defibrillation energy was
      again determined after 5 or 10 minutes circulation time. Lidocaine did not alter
      the minimum energy for defibrillation (3.0 +/- 1.4 J vs. 3.0 +/- 1.8 J, mean +/-
      SD), despite plasma levels of lidocaine that averaged 13.2 +/- 1.9 mumol/l. In
      contrast, verapamil significantly increased (3.9 +/- 2.2 J vs. 6.5 +/- 2.9 J) the
      minimum energy necessary for defibrillation. The difference in defibrillation
      energy was significantly correlated to the fall in systolic blood pressure
      induced by verapamil administration (r = 0.72). These data reinforce the
      necessity for determining efficacy of defibrillation when medication changes are
      instituted. Verapamil should be used with caution in patients with automatic
      defibrillators and marginal defibrillation threshold.

PMID- 1744544
TI  - ST/HR slope and improved exercise ECG detection of myocardial ischemia in
      patients with suspected coronary artery disease.
AB  - Predictive values of ST/HR slope and ST-segment displacement during symptom
      limited exercise were determined in 85 patients who underwent coronary
      angiography for suspected coronary artery disease, using perfusional and
      functional radionuclide images with 99mTc-2-methoxy-isobutil-isonitrile as an
      index of stress-induced myocardial ischemia. ST/HR slope showed a better
      sensitivity than conventional stress-induced changes of ST-segment displacement
      (96% vs. 73%, respectively). In patients with clinical suspicion of coronary
      artery disease, the main result was the negative predictive value of ST/HR slope
      when compared with conventional ST-segment displacement (98% vs. 41%). ST/HR
      slope was unable to perfectly separate patients with different degrees of
      ischemia, however, subjects without scintigraphic signs of stress-induced
      ischemia and patients with ischemic impairment in three myocardial regions were
      correctly identified as distinct populations. In patients with a previous
      myocardial infarction, no difference was found between the two criteria and a
      wide overlap of ST/HR slope values was present. The authors conclude that ST/HR
      slope is useful to detect the rate of change in electric parameters during
      exercise and might therefore more adequately be used to separate normal from
      definitely abnormal responses to exercise.

PMID- 1744545
TI  - Digitization of electrocardiograms by desktop optical scanner.
AB  - The fidelity of a semiautomated technique for converting paper electrocardiogram
      (ECG) tracings to digital form by optical scanning was examined. Sample tracings
      from one nonmechanical and three mechanical ECG writers (recorders) were used.
      The optically scanned signals were compared with the digitized version (402 Hz,
      12-bit precision) of the original analog signals using time- and frequency-domain
      correlation coefficients and root mean square error. A total of 261 QRS complexes
      and 207 RR intervals were examined in 21 leads acquired from 8 patients. When
      data were low-pass filtered at 25 Hz, the correlation coefficients for the 261
      QRS complexes were 0.997 +/- 0.005 (mean +/- SD) for the time domain data, 0.992
      +/- 0.010 for the complex frequency domain (amplitude and phase) data, and 0.998
      +/- 0.002 for the power spectrum. The corresponding correlations for the 207 RR
      intervals were 0.993 +/- 0.008, 0.992 +/- 0.008, and 0.993 +/- 0.009. The RMS
      errors, normalized for signal amplitude, were 2.62 +/- 1.28 (percent +/- SD) for
      QRS complexes and 1.82 +/- 0.87 for RR intervals. The correlations for the
      mechanical ECG recorder tracings were the same or better than those of the
      nonmechanical recorder, and the RMS errors were generally smaller. When data were
      low-pass filtered at 105 Hz, the correlation coefficients ranged from 0.984 to
      0.996 for the QRS complexes and 0.982 to 0.988 for RR intervals. Root mean square
      errors were 4.54 +/- 2.03 and 2.38 +/- 1.14, respectively. For purposes of
      arrhythmia analysis by QRS classification, digitization of ECG signals by optical
      scanning appears equivalent to acquisition via standard analog-to-digital
      conversion.

PMID- 1744546
TI  - The Brody effect revisited.
AB  - This paper reexamines the Brody effect, both in the far-field and in the near
      field approximation. It stresses the fact that near an inhomogeneity the Brody
      factor is not a constant but a function of space. A full documentation of this
      function for realistic values of the inhomogeneity as relevant to
      electrocardiography is included. The existence of a zone having "anomalous" Brody
      factors is demonstrated. Moreover, the importance for this problem of the zero
      reference point is stressed.

PMID- 1744547
TI  - Mechanisms by which calcium modulates diastolic depolarization in sheep cardiac
      Purkinje fibers.
AB  - The mechanisms by which calcium modulates diastolic depolarization (DD) in sheep
      cardiac Purkinje fibers were studied in vitro. Increasing [Ca]o from 2.7 mM to
      10.8 mM increased both the slope and amplitude of DD, induced oscillatory
      potentials (V(os)), and prolonged depolarization (V(ex)). The steepening of DD
      occurred even in the absence of an obvious V(os). The increase in DD amplitude
      was due both to an increase in the maximum diastolic potential and to a less
      negative steady-state level. At constant [Ca]o, increasing the driving rate had
      effects similar to those induced by increasing [Ca]o. The increase in DD slope
      and amplitude was least at the slowest rates and leveled off at the fastest rates
      in high [Ca]o. Lowering [Ca]o decreased DD slope and amplitude, but spontaneous
      activity could be present during interruption of the drive. In slowly driven
      fibers, increasing [Ca]o to 10.8 mM initially shifted the maximum diastolic
      potential and steady state DD to more negative values, and subsequently shifted
      the latter (but not the former) to less negative values. On recovery, a transient
      depolarization occurred. Quiescent fibers exposed to high [Ca]o also underwent a
      transient hyperpolarization and a subsequent depolarization, whereas reciprocal
      effects occurred when [Ca]o was lowered. It is concluded that [Ca]o modulates DD
      through several different mechanisms and that most (but not all) modifications
      induced are brought about by changes in [Ca]i.

PMID- 1744548
TI  - Different effects of reoxygenation on the electrical activity of ventricular
      muscle.
AB  - Response of a hypoxic and acidotic (HA, with exogenous lactate) ventricular
      muscle tissue to subsequent reoxygenation in the absence of substrate (0 mM
      dextrose) was different from that of a Purkinje fiber. The K+ concentration in
      this solution (4.6 mM) was slightly higher than that in Tyrode solution (2.7 mM).
      The observed effects of reoxygenation of such a ventricular tissue were also
      variable. The ventricular muscle tissue exhibited the following different
      responses on reoxygenation after hypoxia and acidosis: (1) arrhythmias, without
      much depolarization of the membrane potential, (2) oscillatory after-potentials
      (OAPs) during the late diastole, which lessened in amplitude as the time of
      reoxygenation increased, but no arrhythmias, or (3) a pronounced slowed phase of
      repolarization (hump), but no arrhythmias. These different effects of
      reoxygenation did not occur if concentration of K+ in HA was very much higher
      than 4.6 mM. Common to these three different responses was the prolongation of
      the action potential durations during reoxygenation at the 50% and 90% levels of
      repolarization (APD50 and APD90) and a slight increase in the resting tension
      after 30-40 minutes of reoxygenation. Some of the observed responses of
      ventricular muscles were well mimicked by increasing extracellular calcium, but
      the different and variable effects of arrhythmias, OAPs, and prolonged APD
      require further analysis.

PMID- 1744549
TI  - Effects of myocardial infarction on cardiac electrical field properties using a
      numerical expansion technique.
AB  - This study was undertaken to quantify basic cardiac electrical field properties
      using the Karhounen-Loeve (K-L) numerical expansion technique after experimental
      myocardial infarction. Transmural anterior myocardial infarction was produced in
      seven dogs by injection of liquid latex into the anterior descending artery;
      posterior myocardial infarction was produced in five dogs by injection of the
      circumflex artery. Body surface potentials from 84 electrodes were recorded
      during sinus rhythm prior to and 1 week after infarction. Electrical field
      properties during the QRS, ST, and QRST intervals were computed by the K-L method
      based upon areas calculated for each lead. The ratio of the sum of magnitude of
      the first three eigenvectors to the sum of all computed eigenvectors expressed as
      a percentage was used as a measure analogous to field dipolarity. Values before
      infarction were high during the QRS (97.1% +/- 2.0%, mean +/- 1SD), ST (96.0% +/-
      5.1%), and QRST (97.7% +/- 2.7%) intervals, with no significant difference
      between the three periods. After infarction, the ratio during QRS decreased
      significantly, with lower values after posterior (61.9% +/- 11.7%) than after
      anterior (91.1% +/- 6.0%) infarction (p less than 0.001). Values during ST and
      QRST intervals were not significantly changed by infarction. Spatial patterns of
      the first eigenvector indicated that the derived QRS area electric field is
      directed away from the myocardial lesion for both anterior and posterior
      infarcts. Thus, experimental myocardial infarction produces significant changes
      in cardiac electrical field properties as measured by the K-L technique.

PMID- 1744550
TI  - Comparison of the effects of pirmenol and lidocaine on intraventricular
      conduction in canine myocardial infarction.
AB  - Effects of pirmenol hydrochloride and lidocaine hydrochloride on intraventricular
      conduction were examined in the infarcted heart of anesthetized dogs. The effects
      of the drugs on the excitation induced by ventricular stimulations were
      determined with coupling intervals between 150 and 1,000 ms. Effects of the drugs
      on the His bundle electrocardiograms were also examined. Pirmenol in doses of 1-5
      mg/kg prolonged the conduction time in the infarcted zones over a wide range of
      coupling intervals. Pirmenol at 5 mg/kg blocked the delayed conduction at a short
      coupling interval in the infarcted zones. The effect of pirmenol on the
      conduction time in the normal zone was slight. Lidocaine in doses of 3 and 10
      mg/kg prolonged the conduction time in the infarcted zone at a short coupling
      interval. Pirmenol did not significantly prolong PQ or AH interval. In
      conclusion, pirmenol selectively depressed the delayed conduction in the
      infarcted zone, which could result in a reentrant pathway. The effect of pirmenol
      on delayed conduction was dependent on the coupling interval and was quite
      different from that of lidocaine.

PMID- 1744551
TI  - Analysis of bites on three-dimensional vectorcardiography after coronary artery
      ligation in dogs.
AB  - The serial changes in the QRS loops of vectorcardiograms were investigated
      following ligation of a branch of the left anterior descending artery (LAD) by
      the three-dimensional rotation method in 18 dogs. Concave inflections of the QRS
      loop, defined as "bites," were best delineated when the loop was viewed from a
      left cranial or right caudal direction. Bites appeared 48 +/- 8 minutes after LAD
      ligation in all of the dogs, and their development was closely related to the
      temporal changes in the % sigma R and QRS point score on a standard 12-lead
      electrocardiogram. Q waves were not observed on the electrocardiograms in 9 dogs.
      In the remaining 9, they appeared 117 +/- 18 minutes after LAD ligation. The bite
      duration, area, and amplitude were compared with the anatomical extent of the
      infarcts. A significant positive correlation was found between bite duration and
      infarct size. The detection of bites on the three-dimensionally rotated
      vectorcardiogram appears to have a high sensitivity for anterior myocardial
      infarction and could potentially become a useful diagnostic tool.

PMID- 1744552
TI  - Active immunization with a synthetic peptide region of growth hormone: increased
      lean tissue growth.
AB  - The effects of active immunization against a specific peptide region of GH
      (sequence 134-154) were examined in a species relevant for animal production in
      vivo. Peptide-immunized lambs exhibited significant increases in carcass protein
      and water contents and consequently increased carcass weight. The comparatively
      smaller increases in carcass water and protein contents which occurred in GH
      treated lambs were offset by decreased fat accretion. Thus, even though peptide
      immunization improved lean tissue growth, it did not simply enhance all actions
      of GH or mimic exogenous hormone administration. This is the first definitive
      demonstration that endogenously produced antibody may enhance endogenous hormone
      activity and performance in animals.

PMID- 1744553
TI  - The form and function of the Leydig cells in hypophysectomized rams treated with
      pituitary extract when spermatogenesis is disrupted by heating the testes.
AB  - The morphology and in-vivo function of the Leydig cells were studied in rams when
      spermatogenesis had been disrupted by a single exposure of the testes 20 days
      earlier to a temperature of about 42 degrees C for 45 min. To avoid complications
      due to changed negative feedback from the testes to the pituitary with consequent
      changes in the degree of gonadotrophic stimulation, ten of the animals (five
      heated and five unheated) were surgically hypophysectomized when the testes were
      heated and then treated twice daily with pituitary extract. Six intact rams
      (three heated and three unheated) were also studied. The heat-affected testes
      were about half the size of the unheated testes, and blood plasma flow was
      closely related to testis weight. There were no differences in the testosterone
      concentrations in spermatic venous blood, testicular lymph or rete testis fluid,
      or in oestradiol in spermatic venous plasma from heated or unheated testes.
      Consequently, testosterone secretion by the heat-affected testes was markedly
      reduced, and the concentrations in jugular blood were also lower in the heat
      affected rams than in controls. The volume of the interstitial tissue was less in
      absolute terms in the heat-affected rams, but it made up a greater fraction of
      the testes. The absolute volume of the blood plus lymph vessels, and their
      fraction of the interstitial tissue were lower in the heat-affected testes,
      although there was no effect on their volume as a fraction of the whole testis.
      The heat-affected testes of the hormone-treated rams had fewer Leydig cells, but
      each cell was larger; no equivalent difference was found in the intact rams.
      However, the dose of pituitary extract chosen was somewhat excessive, as there
      were higher than normal concentrations of FSH, LH and testosterone in jugular
      blood plasma, of testosterone and oestradiol in testicular venous blood plasma
      and of testosterone in rete testis fluid in the hormone-treated hypophysectomized
      rams. The testes of the unheated hypophysectomized rams increased in size by
      about 20% during treatment with pituitary extract, although testicular blood
      plasma flow was lower per unit weight of testis. The absolute volume of each
      Leydig cell and the total volume in absolute terms and as a fraction of the
      interstitial tissue was greater in the hormone-treated than in the untreated
      rams, but not the volume as a fraction of the whole testis. The total number of
      Leydig cells was higher in the hormone-treated unheated rams than in all the
      other rams taken together.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1744554
TI  - Growth hormone regulation of insulin-like growth factor-I mRNA in rat adipose
      tissue and isolated rat adipocytes.
AB  - The effects of hypophysectomy and hormonal replacement therapy on insulin-like
      growth factor-I (IGF-I) mRNA in rat adipose tissue and adipocytes were studied.
      The effects of GH and IGF-I in vitro on IGF-I mRNA and IGF-I production were also
      studied in cultured rat adipocytes. Male rats were hypophysectomized at about 50
      days of age and given replacement therapy with cortisol (400 micrograms/kg per
      day) and thyroxine (10 micrograms/kg per day). GH was given as a single i.v. or
      s.c. injection and also as a continuous s.c. infusion for 6 days. Epididymal fat
      pads were excised and used either for isolation of adipocytes or for
      determination of IGF-I mRNA in adipose tissue. A solution hybridization assay was
      used. The IGF-I mRNA content of adipocytes was analysed either immediately after
      isolation or after short-term (2-3 days) culture with or without GH or IGF-I.
      Hypophysectomy resulted in a marked decrease in IGF-I mRNA in both tissue and
      cells. Replacement therapy (in vivo) with cortisol and thyroxine alone had no
      effect, whereas additional treatment with GH caused a dose-dependent increase in
      IGF-I mRNA. IGF-I mRNA was also increased after a continuous s.c. infusion of GH.
      A single i.v. injection of GH (100 micrograms) resulted in an increase in IGF-I
      mRNA after approximately 2 h, with maximal levels around 6 h after the injection.
      In cultured adipocytes, addition of GH to the culture medium increased IGF-I mRNA
      in a dose-dependent manner and a marked increase was observed with a
      concentration of GH of 1 ng/ml. Addition of IGF-I (100 ng/ml) had no effect. The
      increase in IGF-I mRNA after addition of GH (100 ng/ml) was detectable after 3 h.
      The concentration of IGF-I in the culture medium was increased 24 h after the
      addition of GH. These results demonstrate that GH induces IGF-I mRNA in both
      adipose tissue and isolated fully differentiated adipocytes and that this
      increase in IGF-I mRNA results in increased IGF-I production.

PMID- 1744555
TI  - Effect of administration of human chorionic gonadotrophin on criteria used to
      assess testosterone administration in athletes.
AB  - Abnormal ratios of testosterone to epitestosterone (T/E) and testosterone to LH
      (T/LH) in the urine of male athletes are indicative of testosterone
      administration. The T/E ratio has been adopted by the International Olympic
      Committee as the sole criterion used in the detection of testosterone
      administration. An athlete is usually considered to have failed a drug test if
      the urinary T/E ratio is greater than 6. Human chorionic gonadotrophin (hCG) has
      been used by some male athletes to stimulate testicular secretion of
      testosterone. The purpose of this investigation was to examine whether the
      urinary T/E ratio can remain unaffected by administration of hCG to normal adult
      males. Administration of hCG resulted in large increases in serum testosterone
      concentrations and urinary T/LH ratios but small changes in urinary T/E ratios of
      two subjects (maximum T/E values observed were 0.8 and 1.2 respectively). These
      observations suggest that the urinary T/LH ratio is a valuable indicator of hCG
      as well as of testosterone administration. This study is the first to measure
      urinary T/LH ratios using the technique of gas chromatography-mass spectrometry
      for quantification of testosterone, and highly specific monoclonal antibodies for
      the measurement of LH. An ultrafiltration method is proposed as part of a
      confirmatory procedure to be adopted in the measurement of urinary gonadotrophins
      for drug control in sport.

PMID- 1744556
TI  - Effects of exogenous growth hormone on growth and body composition in genetically
      selected mice.
AB  - The effects of exogenous GH on growth and body composition were investigated in
      lines of mice selected for high or low body weight (P-lines) or high or low body
      fat (F-lines). Mice from all lines were given daily injections of recombinant
      bovine GH or a placebo for 21 days from 4 weeks old. They were killed and various
      organ weights measured. There was no consistent effect of GH on organ weights. In
      all lines of mice the rate of weight gain and final weight increased in response
      to GH. In both lines selected for body fat, GH treatment decreased fat content.
      The low body weight mice also became less fat, but in the high body weight mice
      GH treatment increased fat percentage. The results indicate that the differences
      in growth rate and body composition observed in these lines are not due to
      differences in responsiveness to GH.

PMID- 1744557
TI  - Thyroidal inhibition of chicken pituitary growth hormone: alterations in
      secretion and accumulation of newly synthesized hormone.
AB  - Hypothyroidism reduces GH synthesis and release in several mammalian species, in
      which thyroid hormone directly stimulates GH gene transcription. In contrast,
      hypothyroidism stimulates GH secretion in birds, in which thyroid hormone
      directly inhibits pituitary GH release. We have, therefore, investigated the
      effects of thyroid status on the accumulation of newly synthesized GH in the
      pituitaries of 8- to 10-week-old Leghorn cockerels in vitro and in vivo. The
      incorporation of [35S]methionine into immunoprecipitable GH ([35S] GH) was
      increased, over a 4-h incubation period, in glands from birds made hypothyroid by
      injections of methimazole (50 mg/kg day for 10 days) in comparison with glands
      from vehicle-injected controls. Treatment with tri-iodothyronine (T3, 100
      micrograms/kg per day for 10 days) in vivo did not significantly alter the
      accumulation of [35S]GH in vitro but did block the release of [35S]GH in response
      to a GH secretagogue (thyrotrophin-releasing hormone; exposure to 280 nmol/l for
      30 min) and reduced immunoassayable pituitary GH content. Pretreatment of glands
      from euthyroid birds with T3 (100 nmol/l) in vitro (for 20 h) reduced the basal
      accumulation of [35S]GH as well as that induced by another GH secretagogue (GH
      releasing factor; 100 nmol/l) during a 6-h labelling period. These results show
      that, unlike the generally stimulatory action of thyroid hormone in mammals, in
      birds, T3 exerts a direct inhibitory effect on the accumulation of newly
      synthesized pituitary GH.

PMID- 1744558
TI  - Pulsatile LH secretion in streptozotocin-induced diabetes in the rat.
AB  - This study aimed to determine the effect of streptozotocin (STZ)-induced diabetes
      on pulsatile LH secretion in the mature male rat. LH pulse frequency was reduced
      by 56% and pulse amplitude by 54%, with a consequential decrease of 72% in mean
      LH levels 8 days after i.v. administration of STZ (55 mg/kg) to castrated Wistar
      rats compared with castrated non-diabetic controls. Twice daily insulin treatment
      completely reversed all parameters of pulsatile LH secretion to control values.
      Food-restricted non-diabetic controls, studied to distinguish the metabolic
      effect of diabetes from that of concurrent weight loss, demonstrated a 34%
      reduction in LH pulse frequency but no significant changes in LH pulse amplitude
      or mean LH levels compared with non-diabetic controls given free access to food.
      To distinguish whether the decreased LH pulse amplitude in diabetes was due to a
      reduction in either the quantity of hypothalamic gonadotrophin-releasing hormone
      (GnRH) released per secretory episode or to decreased pituitary responsiveness to
      GnRH, the responsiveness of the pituitary to exogenous GnRH (1-1000 ng/kg body
      weight) was tested in diabetic rats after castration, using a full Latin square
      experimental design. The net LH response (total area under response curve over 40
      min following GnRH) was decreased by 33% (P = 0.001) in diabetic compared with
      control rats. The decreased LH pulse frequency in STZ-induced diabetes therefore
      suggests that the metabolic effect of diabetes is to decelerate directly the
      firing rate of the hypothalamic GnRH pulse generator independent of testicular
      feedback. These effects were fully reversed by insulin treatment and were only
      partly due to the associated weight loss.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744559
TI  - Regulation of prostate growth.

PMID- 1744560
TI  - Growth regulation in the gobiid teleost, Gillichthys mirabilis: roles of growth
      hormone, hepatic growth hormone receptors and insulin-like growth factor-I.
AB  - Studies of the teleost Gillichthys mirabilis were undertaken to assess the role
      of GH in regulating hepatic GH receptors, insulin-like growth factor-I (IGF-I)
      activity and cartilage growth. Hypophysectomized G. mirabilis were injected with
      saline vehicle or with 10, 100 or 1000 ng tilapia GH (tGH)/g every other day for
      2-3 weeks. Growth, judged by increased body weight and length, was inhibited by
      hypophysectomy and stimulated by increasing tGH doses. Hepatic GH receptors,
      measured by 125I-labelled tGH binding, were decreased 50% by hypophysectomy. An
      additional dose-dependent reduction in binding was observed 24 h after tGH
      injection, but MgCl2 stripping of membranes suggested receptor occupation by
      exogenous tGH. IGF-I activity, measured by 35SO4 incorporation into oral
      cartilage explants in vitro, was decreased 50% by hypophysectomy and increased to
      200% of intact control levels after injection of 1000 ng tGH/g. In a second
      experiment, 35SO4 incorporation by oral cartilage from hypophysectomized fish
      injected with 10, 100 or 1000 ng tGH/g was stimulated to intact control levels.
      Effects of feeding and tGH injection on in-vitro responsiveness of oral cartilage
      to recombinant bovine IGF-I (rbIGF-I; 10-1000 ng/ml) were also assessed. Oral
      cartilage from fed fish showed a parabolic dose-response curve, whereas oral
      cartilage from starved fish had a lower basal rate of 35SO4 incorporation and a
      linear dose-response relationship. Oral cartilage from hypophysectomized G.
      mirabilis showed a significantly attenuated response to rbIGF-I which was
      restored by tGH injection, suggesting that the GH status of the animal is
      important for sensitivity of target tissue to IGF-I. Because of its similarity to
      other vertebrate systems, G. mirabilis presents a good teleost model of growth
      regulation and of the functions and interactions of GH and IGF-I.

PMID- 1744561
TI  - Effect of thyroid state and cold exposure on rat liver mitochondrial protein mass
      and function.
AB  - The effects of thyroid state on liver mitochondrial protein mass was investigated
      in rats at 24 and 4 degrees C, as was oxidative phosphorylation using substrates
      which represent the final catabolic products of the metabolic fuels. In rats at
      24 degrees C, a significant increase in mitochondrial protein mass (about +40%)
      was observed only in hyperthyroid animals, while a significant increase due to
      cold exposure was found in hypothyroid (+45%) and euthyroid (+35%) rats. In rats
      at 24 degrees C, hypothyroidism significantly decreased the oxidation of
      glutamate and palmitoyl carnitine but not of pyruvate, while hyperthyroidism only
      increased the oxidation of palmitoyl carnitine. On the other hand, exposure to
      cold significantly increased the oxidation of glutamate and pyruvate only in the
      presence of tri-iodothyronine. Our results underline not only the fact that a
      simple and single hypothesis for thyroid effects cannot be adopted, but also that
      any study concerning oxidative metabolism should be carried out using different
      substrates and involving different pathways of oxidation.

PMID- 1744562
TI  - Interaction between cortisol and arachidonic acid on the secretion of LH from
      ovine pituitary tissue.
AB  - In several species, glucocorticoids act directly on the pituitary gonadotroph to
      suppress the gonadotrophin-releasing hormone (GnRH)-induced secretion of the
      gonadotrophins, especially LH. A mechanism for this action of these adrenal
      steroids has not been established, but it appears that the glucocorticoids
      influence LH release by acting on one or more post-receptor sites. This study
      investigated whether glucocorticoids disrupt GnRH-induced LH release by altering
      the liberation of arachidonic acid from plasma membrane phospholipids, a
      component of GnRH-induced LH release. Using perifused ovine pituitary tissue, it
      was established that exposure of gonadotrophs to 1-1000 nmol cortisol/l for 4 h
      or longer significantly reduced GnRH-stimulated LH release with the maximal
      inhibitory effect being observed after 6 h of exposure to cortisol. This
      suppressive effect of cortisol could be reversed by administration of arachidonic
      acid, which in its own right could stimulate LH release from ovine pituitary
      tissue. Furthermore, the inhibitory effect of cortisol on GnRH-stimulated LH
      release could be directly correlated with decreased pituitary responsiveness to
      GnRH-stimulated arachidonic acid liberation, consistent with our hypothesis that
      glucocorticoids can suppress GnRH-induced secretion of LH by reducing the amount
      of arachidonic acid available for the exocytotic response of GnRH.

PMID- 1744563
TI  - Modulation of immunoreactive epidermal growth factor levels in the submandibular
      gland, pancreas, liver, kidney and gastrointestinal tract of suckling rats by
      cortisone and tri-iodothyronine.
AB  - Suckling rats exhibit age-dependent differences in epidermal growth factor (EGF)
      levels in several organs. The present studies evaluated the effects of two
      hormones known for their maturative effect on suckling rats, cortisone and tri
      iodothyronine (T3), on immunoreactive EGF levels in specific organs. Suckling
      rats were administered cortisone (5 mg/100 g body weight per day) or T3 (50
      micrograms/100 g body weight per day) on days 8, 9, 10 and 11 after birth, and
      killed on day 12. Submandibular glands, kidneys, pancreas, liver and
      gastrointestinal tract mucosa and lumen were assayed for immunoreactive EGF by a
      species-specific radioimmunoassay. Low levels of EGF in the submandibular glands
      were increased slightly by both T3 and cortisone treatment. Cortisone evoked a
      tenfold increase in EGF in the pancreas, but had no effect on levels in the
      kidney or liver. In contrast, T3 evoked a sixfold increase in the EGF level in
      the kidney, but had no effect on levels in the pancreas or liver. Hormonal
      administration had no effect on EGF levels in the stomach. Within the intestinal
      tract, cortisone had no effect on the luminal EGF content of the duodenum,
      jejunum or ileum, but caused a decrease in the midjejunum. T3 evoked a decrease
      in the luminal EGF content of the ileum. The effect of cortisone on mucosal EGF
      content varied between regions; an increase was seen in the duodenum with a
      decrease in the midjejunum and ileum. T3 administration resulted in a significant
      decrease in EGF only in the mucosa of the ileum.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744564
TI  - Regulatory functions for inhibin and activin in human ovaries.

PMID- 1744565
TI  - The control of FSH secretion in the larger domestic species.

PMID- 1744566
TI  - The influence of vanadate on insulin counter-regulatory hormones in obese fa/fa
      rats.
AB  - Vanadate has been shown to improve glucose homoeostasis in mildly glucose
      intolerant and severely insulin-resistant fa/fa rats. The present study examined
      whether changes in insulin counter-regulatory hormones contribute to this
      beneficial effect of vanadate. Since oral administration of Na3VO4 caused a
      decrease in food intake and stopped the increase in body weight, vanadate-treated
      fa/fa rats were compared with both controls with food available ad libitum and
      pair-fed rats. Slightly lower plasma glucose levels were maintained in
      conjunction with markedly lower plasma insulin levels in vanadate-treated rats,
      and this effect was not simply due to the smaller body weight of the animals.
      Compared with control rats, treatment with vanadate affected neither basal plasma
      glucagon levels nor the increase in glucagon levels observed after insulin
      induced hypoglycaemia or after i.v. injection of arginine. Compared with pair-fed
      rats, treatment with vanadate prevented the fall in basal plasma glucagon and its
      exaggerated rise in response to insulin that mere food restriction produced.
      Plasma corticosterone levels were high in fa/fa rats. Vanadate and pair-feeding
      similarly decreased basal plasma levels of corticosterone as well as nocturnal
      corticosteronuria. Thus the attenuation of the hypercorticism of fa/fa rats
      results from the reduction in body weight gain rather than from a specific action
      of vanadate. Vanadate did not influence urinary excretion of noradrenaline, an
      index of neural sympathetic activity, but prevented the increase in adrenaline
      excretion, an index of adrenal medulla activity, that was produced by food
      restriction in pair-fed rats. In conclusion, vanadate administration has no or
      little specific effects on three major insulin counter-regulatory hormones. This
      reinforces the suggestion that the beneficial effects of vanadate on glucose
      homoeostasis in fa/fa rats are mainly due to a correction of insulin resistance
      in peripheral tissues.

PMID- 1744567
TI  - Regulation of DNA synthesis in chicken adipocyte precursor cells by insulin-like
      growth factors, platelet-derived growth factor and transforming growth factor
      beta.
AB  - Adipose tissue growth can occur by both hypertrophy and hyperplasia. The capacity
      for adipocyte hyperplasia in vivo resides in a population of fibroblast-like
      adipocyte precursor cells but the regulation of the proliferation of these cells
      by growth factors has not been well characterized. This study was designed to
      determine the effects of the insulin-like growth factors (IGF-I and IGF-II),
      platelet-derived growth factor (PDGF) and transforming growth factor-beta 1 (TGF
      beta 1) added alone or together on the proliferation of primary adipocyte
      precursor cells in vitro. Adipocyte precursor cell proliferation measured by
      [3H]thymidine incorporation into DNA was stimulated by all of these growth
      factors and was particularly marked with PDGF. IGF-I or IGF-II added together
      with TGF-beta 1 produced a greater than additive response and the effect of PDGF
      was synergistic with that of IGF-I at certain concentrations. Stimulation of
      proliferation of some cell types by TGF-beta has been linked to the secondary
      production of PDGF but the evidence we have suggests that this is unlikely in
      chicken adipocyte precursors. DNA synthesis in response to TGF-beta 1 required
      only a short exposure to the peptide, and conditioned medium from chicken
      adipocyte precursor cells previously exposed to TGF-beta had no effect on DNA
      synthesis when added to fresh batches of cells. Addition of TGF-beta 1 together
      with PDGF produced a synergistic effect whereas an additive effect would be
      expected if PDGF mediated the effect of TGF-beta 1.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1744568
TI  - Effects of a sustained release formulation of the gonadotrophin-releasing hormone
      agonist histrelin on serum concentrations of gonadotrophins and oestradiol, and
      ovarian LH/human chorionic gonadotrophin receptor content in the rat.
AB  - Pituitary and ovarian function were studied during the loss and recovery of
      oestrous cyclical activity in rats following treatment with a sustained release
      formulation of the gonadotrophin-releasing hormone (GnRH) agonist [imidazole
      benzyl-D-His6,Pro9-ethylamide]-GnRH (histrelin). A single s.c. injection of
      microencapsulated histrelin (10-300 micrograms peptide/kg) induced a dose
      dependent disruption of normal oestrous cyclical activity with a persistent
      dioestrous-like vaginal cytology. In preliminary studies, pituitary gland
      stimulation and desensitization were demonstrated when serum LH and FSH levels
      were greater 1 week after administration of 10 micrograms microencapsulated
      histrelin/kg compared with 300 micrograms microencapsulated histrelin/kg. Changes
      in pituitary and ovarian function were assessed over time following injection of
      microencapsulated histrelin (100 micrograms peptide/kg). LH secretion was maximal
      within 8 h and then gradually declined, remaining at dioestrous levels from days
      7 to 28. Serum oestradiol concentrations remained low and rose above dioestrous
      levels only on day 28. In contrast, ovarian LH/human chorionic gonadotrophin
      (LH/hCG) receptor content fell within 8 h and, after a nadir on day 7, slowly
      returned to dioestrous levels by day 28. The increase in ovarian LH/hCG receptor
      content preceded any significant change in pituitary gonadotrophin secretion,
      indicating a differential pattern of recovery for pituitary and ovarian function.
      Subsequent studies tested the possibility that these temporal differences in
      pituitary and ovarian function may result from histrelin acting directly on these
      tissues. Treatment with histrelin microcapsules (300 micrograms peptide/kg)
      prevented any increase in LH secretion in response to a GnRH challenge 3 days
      later, indicating a direct action of histrelin on the pituitary gland.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1744569
TI  - Production and purification of biologically active recombinant tilapia
      (Oreochromis niloticus) prolactins.
AB  - Recombinant expression vectors carrying tilapia prolactin-I or -II (tiPRL-I or
      tiPRL-II) cDNA were constructed and the tiPRL-I and II proteins were produced in
      E. coli as inclusion bodies. These inclusion bodies were dissolved in 6 mol
      urea/l. Refolding of the proteins was followed by SDS-PAGE under non-reducing
      conditions so as to visualize the oxidized state of the molecules. Proteins tiPRL
      I and tiPRL-II were purified by gel filtration and ion-exchange chromatography.
      The N-terminal sequence and bioactivities of both purified proteins were then
      analysed. Recombinant tiPRL-I and tiPRL-II induced a significant rise in plasma
      calcium levels as well as in mucocyte density in the abdominal skin epithelium.
      When tested on kidney membrane, both proteins exhibited potency in competing with
      125I-labelled tiPRL-I for binding sites, but tiPRL-I seemed to be more potent
      than tiPRL-II in competing for these sites. The results obtained for the
      biological activities tested suggest that both recombinant prolactins were
      correctly refolded and had retained the full biological activity previously
      observed with the natural hormone preparations extracted from the animals.

PMID- 1744570
TI  - Oestradiol-17 beta induces the major vitelline envelope proteins in both sexes in
      teleosts.
AB  - During growth of the ovarian follicle, the teleost oocyte becomes surrounded by
      an acellular coat, the vitelline envelope. The nature, origin and number of the
      vitelline envelope proteins in fish appear to vary with species. In this work,
      polyclonal antibodies directed against vitelline envelope proteins from rainbow
      trout, brown trout and turbot were used to show that oestradiol-17 beta induces
      the major vitelline envelope proteins in juveniles, both males and females, from
      different species. The fact that males can synthesize vitelline envelope
      constituents shows that the origin of these proteins is not confined to the
      ovary. The vitelline envelope of rainbow trout eggs consists of three major
      proteins, designated alpha (60 kDa), beta (55 kDa) and gamma (50 kDa). The amino
      acid composition of each of the three proteins indicated that the three proteins
      are alike and the suggestion that these proteins represent a separate class of
      structural proteins is sustained.

PMID- 1744571
TI  - Transferrin inhibits aromatase activity of rat granulosa cells in vitro.
AB  - The effect of transferrin on basal and FSH-stimulated aromatase activity of
      granulosa cells from immature female rats treated with diethylstilboestrol (DES)
      was examined in vitro by a radiometric method. The basal activity of the enzyme
      was very low after 3 days of incubation. Treatment with FSH (20 ng/ml) resulted
      in a 9.6-fold increase in activity, whereas coincubation with increasing doses of
      transferrin (3-300 micrograms/ml) produced a dose-dependent inhibition of FSH
      stimulated aromatase activity with a projected minimal effective dose of less
      than 2 micrograms/ml. A time-course study showed that the inhibitory effect of
      transferrin on aromatase activity has become significant at 48 h of incubation.
      The inhibitory action of transferrin on the enzyme complex was further confirmed
      by showing that the FSH dose-response curve was significantly suppressed by
      concomitant treatment with 100 micrograms transferrin/ml with a maximum
      suppression of 54.1% at a dose of 30 ng FSH/ml. The possibility that transferrin
      may act through a non-specific inhibitory effect seems unlikely, as no changes in
      cell number and DNA content per well were observed. In fact, protein synthesis
      was enhanced after treatment with transferrin. Aromatase activity, stimulated by
      several promoters of cyclic AMP (cAMP), such as prostaglandin E2 (PGE2),
      forskolin and 8-bromo-cAMP, was significantly suppressed by 100 micrograms
      transferrin/ml (36.6, 47.4 and 23.4% inhibition respectively), suggesting that
      the effect of transferrin on FSH action may involve a site(s) distal to cAMP
      generation. These findings indicated that transferrin, present in follicular
      fluid, may play an important role in the regulation of granulosa cell
      differentiation.

PMID- 1744572
TI  - Oral insulin in diabetic dogs.
AB  - Bovine crystalline insulin, mixed with an absorption enhancer, was loaded by hand
      into gelatin capsules, which were then coated with an azopolymer designed to
      deliver the insulin in the upper colon. In 34 experiments with 14
      pancreatectomized mongrel dogs of both sexes, the coated capsules were
      administered orally after a pre-dose period of 1 h. The dogs had cannulae in the
      portal vein, hepatic vein and femoral artery and Doppler flow probes on the
      portal vein and hepatic artery. Insulin and food were withdrawn the day before an
      experiment. Responses measured were plasma glucose, plasma insulin, hepatic
      glucose production rate, hepatic plasma flow rate and plasma glucagon-like
      immunoactivity (GLI). Control experiments, with capsules without insulin,
      produced small changes from 'pre-dose' values. Insulin-containing capsules,
      without the azopolymer coating, resulted in some early changes consistent with
      upper gastrointestinal absorption. Single oral doses (66 to 400 nmol/kg) of
      insulin in completely coated capsules produced peaks of portal plasma insulin and
      transient decreases in plasma glucose, hepatic glucose production, hepatic plasma
      flow and plasma GLI. The changes usually began 1.5-2 h after administration of a
      single dose, and lasted for up to 3 h, but were not significantly related to the
      dose of insulin. Multiple oral doses of insulin, given at 1.5-h intervals,
      resulted in multiple peaks of plasma insulin, a continuing dose-dependent fall in
      plasma glucose to near-euglycaemia with the highest dose, and profound decreases
      in hepatic glucose production and plasma GLI. These data demonstrate that insulin
      absorbed from the gastrointestinal tract causes changes in glucose metabolism in
      the diabetic dog that are consistent with the action of insulin primarily on the
      liver and that repeated oral doses are necessary to correct the hyperglycaemia.

PMID- 1744573
TI  - Regulation of testicular insulin-like growth factor-I in pubertal growth hormone
      deficient male rats.
AB  - GH plays a major role in pubertal growth, effects mainly mediated by stimulation
      of insulin-like growth factor-I (IGF-I) production by the liver. However, the
      role of GH in the regulation of pubertal onset, spermatogenesis and fertility is
      still under debate. GH and FSH have, in addition, been implicated in the
      regulation of IGF-I production by Sertoli cells in a number of studies, although
      conflicting results have been reported. The interpretation of studies using GH
      deficient mutant mice has been complicated by the presence of additional defects
      in the hypothalamic-pituitary-gonadal axis of these animals. We have therefore
      used GH-deficient mutant male rats with no other documented hormonal deficiencies
      to study the effect of GH administration on somatic and testicular development,
      circulating and testicular IGF-I concentrations and testicular histology. Body
      weights in GH-deficient rats substituted with GH were not significantly different
      from untreated or GH-treated normal rats and were significantly higher than body
      weights in untreated dwarf rats. Similarly, circulating IGF-I concentrations in
      GH-treated GH-deficient rats were not significantly different from those in
      untreated or GH-treated normal rats but were significantly higher than
      circulating IGF-I concentrations in untreated dwarf rats. No differences in
      testicular IGF-I concentrations were observed in any of the groups studied.
      Testicular weights remained low in both untreated and GH-treated GH-deficient
      animals compared with control animals but spermatogenesis was qualitatively and
      quantitatively normal in all groups at the end of the observation
      period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744574
TI  - Effects of beta-endorphin and naloxone on corticosterone and cortisol release in
      the newt (Triturus carnifex): studies in vivo and in vitro.
AB  - The effects of beta-endorphin and its receptor antagonist, naloxone, on
      corticosterone and cortisol production in male and female Triturus carnifex were
      studied in vivo and in vitro. In the in-vivo experiment, the animals were
      injected s.c. with beta-endorphin and/or naloxone, and killed after 15, 30, 90
      and 360 min. In the in-vitro experiment, interrenal tissues, with and without
      added pituitary, were incubated with beta-endorphin and/or naloxone for 15, 30,
      60 and 120 min. The data obtained in vivo and in vitro from males and females
      were in agreement. Treatment with beta-endorphin caused a significant decrease in
      corticosterone and cortisol release, while naloxone induced an increase in the
      two corticosteroids at the same times as the decrease caused by beta-endorphin.
      The combined beta-endorphin plus naloxone treatment did not change corticosterone
      and cortisol levels. These results suggest that, in Triturus carnifex, opioids
      are involved in the regulation of the hypothalamo-pituitary-interrenal axis. In
      particular, the in-vitro results indicate a direct effect of opioids on
      interrenal steroidogenesis.

PMID- 1744575
TI  - Bombesin and bradykinin increase inositol phosphates and cytosolic free Ca2+, and
      stimulate DNA synthesis in human endometrial stromal cells.
AB  - The present studies were carried out to investigate the effect of several growth
      factors on human endometrial stromal cells. In human endometrial stromal cells,
      bombesin and bradykinin provoked an increase in intracellular free Ca2+ and in
      labelled inositol phosphates when pre-incubated with [3H]myoinositol. Some or
      possibly all of the initial increase in intracellular free Ca2+ represented a
      mobilization of Ca2+ from intracellular stores and the second phase of the
      response depended on Ca2+ influx from the extracellular medium. [3H]Thymidine was
      added to human cultured endometrial stromal cells with bombesin, bradykinin,
      epidermal growth factor (EGF), prostaglandin F2 alpha, vasopressin and platelet
      derived growth factor. Bombesin, bradykinin and EGF stimulated the incorporation
      of [3H]thymidine into DNA in quiescent cells. In conclusion, bombesin and
      bradykinin are growth factors which activate phospholipase C in human endometrial
      stromal cells, while EGF stimulates DNA synthesis without the activation of
      phospholipase C.

PMID- 1744576
TI  - B cell tolerance in mice transgenic for anti-CD8 immunoglobulin mu chain.
AB  - To analyze in vivo the induction of B cell tolerance against a T cell surface
      antigen, we generated transgenic mice expressing an anti-CD8.2 mu heavy chain
      gene. We show that self-specific B cells are efficiently tolerized if they
      express the membrane-bound form of the transgenic mu chain on their surface but
      that they can escape tolerization if they express only the secreted form. In the
      latter, we find an enhanced expression of anti-CD8.2 antibodies after polyclonal
      B cell activation. As a result, transgenic anti-CD8.2 antibodies bind to the CD8+
      T cells but they did not induce their elimination. Furthermore, we observed the
      preferential expression of a limited subset of endogenous light chains with the
      transgenic mu chain. This suggests a positive or negative selection for
      particular heavy and light chain combinations in B lymphocytes.

PMID- 1744577
TI  - Structure and neutrophil-activating properties of a novel inflammatory peptide
      (ENA-78) with homology to interleukin 8.
AB  - A new neutrophil-activating peptide, termed ENA-78, was identified in the
      conditioned media of stimulated human type II epithelial cell line A549. In
      response to stimulation with either interleukin 1 beta (IL-1 beta) or tumor
      necrosis factor alpha (TNF-alpha), ENA-78 was produced and secreted concomitantly
      with IL-8, GRO alpha, and GRO gamma. ENA-78 consists of 78 amino acids [sequence;
      see text] and has a molecular weight of 8,357. It has four cysteines positioned
      identically to those of IL-8 and analogues, and thus belongs to the CXC family of
      peptides. ENA-78 is related to neutrophil-activating peptide 2 (NAP-2) and GRO
      alpha (sequence identity, 53% and 52%, respectively) and IL-8 (22% identity).
      Like NAP-2 and GRO alpha, ENA-78 stimulates neutrophils, inducing chemotaxis, a
      rise in intracellular free calcium and exocytosis. Cross-desensitization
      experiments indicate that ENA-78 acts through the same type of receptors as IL-8,
      NAP-2, and GRO alpha.

PMID- 1744578
TI  - Hemolysis of human erythrocytes is a new bioactivity of gangliosides.
AB  - Using sheep erythrocytes and liposomes, an inhibitory effect of gangliosides has
      been shown on the activation of the alternative pathway of complement. However,
      in studies using human erythrocytes, we found that gangliosides had hemolytic
      activity that was possibly mediated through activation of the alternative
      pathway. Pretreatment of human erythrocytes obtained from healthy volunteers or
      paroxysmal nocturnal hemoglobinuria (PNH) patients with a ganglioside mixture
      purified from human erythrocytes enhanced their susceptibility to homologous
      human complement, and resulted in dose-dependent hemolysis. The enhancement was
      more marked in PNH erythrocytes than control cells. Protease treatment of the
      ganglioside mixture did not change its hemolytic activity, but sialidase
      treatment abolished the activity. Among the major erythrocyte gangliosides,
      II3NeuAc-LacCer (GM3) was the most potent hemolytic agent. Gangliosides purified
      from bovine brain were also active, while neither nonsialylated
      glycosphingolipids, the ceramide moiety, or sialic acid alone were active. Sialic
      acid residues in the ganglioside molecules were essential to this activity, but
      the amount of the residue or the source of the gangliosides seemed not to be
      important. Several treatments inhibiting the alternative but not classical
      complement pathway markedly reduced the ganglioside hemolytic activity. This
      novel bioactivity of gangliosides was thus suggested to be mediated partly by
      activation of the alternative pathway.

PMID- 1744579
TI  - Human immunodeficiency virus type 1 activates the classical pathway of complement
      by direct C1 binding through specific sites in the transmembrane glycoprotein
      gp41.
AB  - Human immunodeficiency virus type 1 (HIV-1), in contrast to animal retroviruses
      such as murine leukemia virus, is not lysed by human complement. Nevertheless,
      HIV-1 activates complement via the classical pathway independent of antibody, and
      C3b deposition facilitates infection of complement receptor-bearing cells. Using
      gel exclusion chromatography on Sephacryl S-1000, purified virions were found to
      bind 125I-labeled C1q, but not 125I-labeled dimeric proenzyme C1s. Virions
      activated the C1 complex, reconstituted from C1q, proenzyme C1r, and 125I-labeled
      proenzyme C1s, to an extent comparable with that obtained with immunoglobulin G
      ovalbumin immune complexes. To determine the activating viral component,
      recombinant viral proteins were used: in the solid phase, soluble gp41 (sgp41)
      (the outer membrane part of gp41, residues 539-684 of gp160) bound C1q, but not
      dimeric proenzyme C1s, while gp120 was ineffective. In the fluid phase, sgp41
      activated the C1 complex in a dose- and time-dependent manner, more efficiently
      than aggregated Ig, but less efficiently than immune complexes. To localize the
      C1 activating site(s) in gp41, synthetic peptides (15-residue oligomers spanning
      amino acids 531-695 of gp160) were used. Peptides covering positions 591-605 and
      601-620 and, to a lesser extent, positions 561-575, had both the ability to bind
      C1q and to induce C3 deposition. These data provide the first experimental
      evidence of a direct interaction between the C1 complex and HIV-1, and indicate
      that C1 binding and activation are mediated by specific sites in gp41.

PMID- 1744580
TI  - Reduction of lupus nephritis in MRL/lpr mice by a bacterial superantigen
      treatment.
AB  - The effects of biweekly intravenous injections of Staphylococcus Enterotoxin B
      (SEB) into autoimmune MRL-lpr/lpr (MRL/lpr) mice were investigated. Rather than
      causing the expansion of V beta 8+ T cells, SEB administration resulted in the
      reduction V beta 8+, CD4-CD8- "double-negative" (DN) T cells. This was shown by
      FACS analysis as this putative pathogenic population was diminished in both
      spleen and lymph node. The symptoms of systemic lupus erythematosus (SLE) in
      MRL/lpr, which include high titers of anti-DNA antibodies and circulating immune
      complexes and proteinuria, were reduced in SEB-treated mice in a dose-dependent
      manner. The clinical parameters of SLE in MRL/lpr, which include lymph node
      hyperplasia and necrotic vasculitis, were suppressed in 50-micrograms SEB-treated
      mice. T cells bearing V beta 6 T cell receptor, which does not interact with SEB,
      were not reduced with SEB administration. Thus, disease suppression was
      associated with a specific reduction in the number of V beta 8+, DN T cells.
      These results implicate a possible therapeutic role of superantigen-based
      immunotherapy in V beta-restricted, T cell-dominated clinical syndromes.

PMID- 1744581
TI  - Gorilla class I major histocompatibility complex alleles: comparison to human and
      chimpanzee class I.
AB  - 14 gorilla class I major histocompatibility complex (MHC) alleles have been
      isolated, sequenced, and compared to their counterparts in humans and
      chimpanzees. Gorilla homologues of HLA-A, -B, and -C were readily identified, and
      four Gogo-A, four Gogo-B, and five Gogo-C alleles were defined. In addition, an
      unusual Gogo class I gene with features in common with HLA-A and its related
      pseudogene, HLA-H, is described. None of the gorilla alleles is identical or even
      closely related to known class I alleles and each encodes a unique antigen
      recognition site. However, the majority of polymorphic substitutions and sequence
      motifs of gorilla class I alleles are shared with the human or chimpanzee
      systems. In particular, elements shared with HLA-A2 and HLA-B27 are found in Gogo
      A and -B alleles. Diversity at the Gogo-B locus is less than at the Gogo-A locus,
      a trend the opposite of that seen for HLA-A and -B. The Gogo-C locus also appears
      to have limited polymorphism compared to Gogo-A. Two basic Gogo-C motifs were
      found and they segregate with distinctive sets of HLA-C alleles. HLA-A allels are
      divided into five families derived from two ancient lineages. All chimpanzee A
      alleles derived from one of these lineages and all gorilla alleles derive from
      the other. Unlike chimpanzee Patr-A alleles, the Gogo-A alleles do not clearly
      partition with one of the HLA-A families but have similarities with two. Overall,
      gorilla class I diversity appears from this sampling to show more distinctions
      from class I HLA than found for chimpanzee class I.

PMID- 1744582
TI  - Interleukin 7 generates antitumor cytotoxic T lymphocytes against murine sarcomas
      with efficacy in cellular adoptive immunotherapy.
AB  - Interleukin 7 (IL-7) is a 25-kD cytokine that was initially described as a pre-B
      cell growth factor. This cytokine has also been shown to have T cell
      proliferative and differentiation effects. In this report, we demonstrate that
      antitumor cytotoxic T lymphocytes (CTL) generated by secondary in vitro
      sensitization of draining lymph node cells in IL-7 are effective in treating 3
      day syngeneic methylcholanthrene (MCA) sarcoma pulmonary metastases in mice. In
      vivo titrations comparing IL-7 to IL-2 antitumor CTL show that they have
      equivalent potency in adoptive immunotherapy. IL-7 antitumor CTL generated
      against MCA sarcomas of weak immunogeneity are also tumor specific in their in
      vivo efficacy. This study represents the first successful use of a cytokine other
      than IL-2 for the generation of cells with in vivo efficacy in cellular adoptive
      transfer.

PMID- 1744583
TI  - Lipopolysaccharide-mediated transcriptional activation of the human tissue factor
      gene in THP-1 monocytic cells requires both activator protein 1 and nuclear
      factor kappa B binding sites.
AB  - Lipopolysaccharide (LPS) activation of cells of monocytic lineage leads to rapid
      and transient expression of a set of inflammatory gene products, including tissue
      factor (TF). This transmembrane receptor is the major cellular initiator of the
      blood coagulation cascades, and induced expression of TF is postulated to play a
      role in inflammation. Functional studies using transfected THP-1 monocytic cells
      revealed the presence of a 56-bp LPS response element (LRE) within the TF
      promoter that conferred LPS responsiveness to a heterologous promoter. LPS
      stimulation of these cells activated proteins that bound to nucleotide sequences
      within the LRE resembling consensus binding sites for activator protein 1 (AP-1)
      and nuclear factor kappa B (NF-kappa B). Induction of the TF gene may represent a
      prototypic example of gene activation in monocytic cells by assembly of
      transcription factor complexes, and may clarify the role of AP-1 and NF-kappa B
      in the regulation of other LPS-responsive genes.

PMID- 1744584
TI  - Macrophage deactivation by interleukin 10.
AB  - Recombinant mouse interleukin 10 (IL-10) was exceedingly potent at suppressing
      the ability of mouse peritoneal macrophages (m phi) to release tumor necrosis
      factor alpha (TNF-alpha). The IC50 of IL-10 for the suppression of TNF-alpha
      release induced by 0.5 microgram/ml lipopolysaccharide was 0.04 +/- 0.03 U/ml,
      with as little as 1 U/ml suppressing TNF-alpha production by a factor of 21.4 +/-
      2.5. At 10 U/ml, IL-10 markedly suppressed m phi release of reactive oxygen
      intermediates (ROI) (IC50 3.7 +/- 1.8 U/ml), but only weakly inhibited m phi
      release of reactive nitrogen intermediates (RNI). Since TNF-alpha is a T cell
      growth and differentiation factor, whereas ROI and RNI are known to inhibit
      lymphocyte function, it is possible that m phi exposed to low concentrations of
      IL-10 suppress lymphocytes. m phi deactivated by higher concentrations of IL-10
      might be permissive for the growth of microbial pathogens and tumor cells, as TNF
      alpha, ROI, and RNI are major antimicrobial and tumoricidal products of m phi. IL
      10's effects on m phi overlap with but are distinct from the effects of the two
      previously described cytokines that suppress the function of mouse m phi,
      transforming growth factor beta and macrophage deactivation factor. Based on
      results with neutralizing antibodies, all three m phi suppressor factors appear
      to act independently.

PMID- 1744585
TI  - A novel beta 4, alpha 6 integrin-associated epithelial cell antigen involved in
      natural killer cell and antigen-specific cytotoxic T lymphocyte cytotoxicity.
AB  - Efficient immune responses require interactions between cell adhesion molecules
      on lymphocytes and counter-receptors on antigen presenting cells or target cells.
      While target-specific receptors or ligands have not been identified for natural
      killer (NK) cells, cell adhesion molecules have been implicated in the
      interaction between NK cell effectors and tumor cell targets. Herein, we describe
      monoclonal antibodies (mAbs) against a carcinoma cell line that efficiently block
      the cytolytic activity of interleukin 2-activated NK cell lines and clones. L280
      mAb reacts with secretory epithelial cells in normal human tissues, but does not
      react with hematopoietic cells or other tissue types. Biochemical analysis
      revealed that L280 mAb immunoprecipitates the beta 4, alpha 6 integrin, as well
      as a novel 98-kD glycoprotein, and probably reacts with a carbohydrate epitope on
      these molecules. Involvement of the L280 antigen in cellular immunity is not
      restricted to NK cell-mediated cytotoxicity. L280 mAb also efficiently inhibits
      alloantigen-specific cytotoxicity against Colo-205 cells mediated by human
      histocompatibility leukocyte antigen (HLA)-A2 alloantigen specific alpha beta
      TCR+ and gamma delta-TCR+ cytotoxic T lymphocyte (CTL) clones. Additionally, we
      demonstrate that L280 mAb blocks cytotoxicity mediated by influenza peptide
      specific HLA-restricted CTL clones. These data indicate that the antigen
      recognized by L280 mAb is important in both NK and CTL function, and that an as
      yet unidentified receptor for this epithelial antigen is present on both NK and T
      lymphocytes. The restricted expression of L280 antigen indicates that this
      molecule may be important in immune reactions in epithelial tissues.

PMID- 1744586
TI  - Limiting dilution analysis of cytotoxic T lymphocytes to human immunodeficiency
      virus gag antigens in infected persons: in vitro quantitation of effector cell
      populations with p17 and p24 specificities.
AB  - The presence of cytotoxic T lymphocytes (CTL) to the gag antigens of human
      immunodeficiency virus (HIV) has been described in infected populations. We found
      that the majority of this immune response as measured in bulk CTL assays of
      unstimulated peripheral blood mononuclear cells (PBMC) is directed against the
      p24 component of the p55 gag precursor protein. Using limiting dilution analysis
      of this effector cell population we confirm that the majority of activated gag
      specific CTL circulating in the PBMC of infected hemophilic patients are directed
      at p24 determinants and are present at frequencies of 1/36,000 to 1/86,000
      lymphocytes. By performing in vitro stimulation after limiting dilution, the
      precursor population of gag-specific CTL are characterized and quantitated. HIV
      gag-specific CTL precursors are identified at frequencies of 1/1700 to 1/17,000
      lymphocytes and are made up of cells with both p17 and p24 specificities. No HIV
      gag-specific CTL precursor cells are identified in the PBMC of HIV-uninfected
      individuals. These studies demonstrate that CTL directed at both p17 and p24
      determinants make up the cellular immune repertoire in HIV-infected individuals
      but that only the p24-specific CTL are routinely found in an activated state in
      the circulation.

PMID- 1744587
TI  - Expression of paragloboside-like lipooligosaccharides may be a necessary
      component of gonococcal pathogenesis in men.
AB  - To learn how lipooligosaccharide (LOS) phase variations affect pathogenesis, we
      studied two male volunteers who were challenged intraurethrally with Neisseria
      gonorrhoeae that make a single LOS of 3,600 daltons and sequentially followed LOS
      expression by gonococci as urethritis developed. LOS variation occurred in vivo.
      Signs and symptoms of gonorrhea began with the appearance of variants making
      4,700-dalton LOS that are immunochemically similar to glycosphingolipids of human
      hematopoietic cells (Mandrell, R.E., J.M. Griffiss, and B.A. Macher. 1989. J.
      Exp. Med. 168:107) and that have acceptors for sialic acid. A variant that
      appeared at the onset of leukorrhoea was shed by 34/36 men with naturally
      acquired gonorrhea at the time they sought medical attention; the other two shed
      the variant associated with dysuria. None shed the challenge variant. These data
      show that in vivo phase shifts to higher molecular mass LOS that mimic human cell
      membrane glycolipids are associated with the development of gonococcal
      leukorrhea.

PMID- 1744588
TI  - A gene required for class II-restricted antigen presentation maps to the major
      histocompatibility complex.
AB  - We have previously described a set of mutants (16.23-selected mutants) of a B
      lymphoblastoid cell line that are defective in the presentation of intact
      proteins to class II-restricted T cells, but effectively present immunogenic
      peptides. The mutations in these mutants are recessive in somatic cell hybrids
      and are not in Class II structural genes. Here, we report on a unique mutant,
      5.2.4, in which a similar defect in class II-restricted antigen presentation has
      occurred in association with a one-megabase homozygous deletion in the class II
      region of the major histocompatibility complex (MHC). The defects in class II
      presentation among three of the 16.23-selected mutants, and between these mutants
      and 5.2.4, are noncomplementary in somatic cell hybrids. This suggests that the
      class II presentation-defective phenotype in all four mutants results from
      lesions in a single MHC-linked gene, a conclusion strengthened by the finding
      that in a hybrid made with a second, unrelated MHC deletion mutant, T2, the class
      II presentation defect in a 16.23-selected mutant is also not complemented.
      Mutant 5.2.4, in addition to its class II presentation defect, is also defective
      in surface expression of MHC class I molecules, most likely because its deletion
      encompasses the peptide supply factor 1 gene, whose function is known to be
      required for normal abundance of cell surface class I molecules. However, the
      surface abundance of class I molecules is normal in the 16.23-selected mutants,
      suggesting that the lesions affecting class I surface abundance and class II
      presentation result from mutations in different genes.

PMID- 1744589
TI  - Strong priming of T cells adoptively transferred into scid mice.
AB  - We have examined the requirements for activating unprimed T cells in vivo by
      transferring T cells into scid mice, which lack mature B and T cells. Purified
      adult thymocytes and a protein antigen, keyhole limpet hemocyanin (KLH), were
      injected into scid mice. scid mice injected with T cells and KLH developed
      cellular lymph nodes containing CD4+ and CD8+ T cells. Cells recovered from the
      lymph nodes of injected scid mice proliferated and secreted interleukin 2 in
      response to KLH in vitro. The results indicate that T cells can be primed to KLH
      in the scid mouse in the absence of B cells.

PMID- 1744590
TI  - Conversion of a self peptide sequence into a Kd-restricted neo-antigen by a Tyr
      substitution.
AB  - We have previously found that a Tyr residue was critical for the interaction of
      peptides with the Kd molecule, and therefore may be acting as an anchor residue.
      In the present report we show that it is possible to convert a self peptide
      sequence into a Kd-restricted neo-antigen by a single Tyr substitution at
      position 2 of the peptide. This supports the idea that Tyr is a critical element
      in the binding motif of Kd-restricted peptides and is a finding that could also
      prove useful for vaccine development.

PMID- 1744591
TI  - Human immunodeficiency virus infection of eosinophils in human bone marrow
      cultures.
AB  - Normal human bone marrow, cultured in vitro with interleukin 5 to promote
      eosinophil production and maturation, was inoculated with cell-free isolates of
      human immunodeficiency virus type 1 (HIV-1). CD4 expression by eosinophil
      precursors, determined by immunocytochemistry, was found to be greatest early in
      their maturation with a rapid decline after 28 d in culture. Productive HIV
      infection of eosinophil precursors was detected 14 d after inoculation, by a
      combination of immunostaining for HIV-1 p24 and gp41/160 and in situ
      hybridization for viral RNA, together with assay of culture supernatants for p24
      antigen and reverse transcriptase activity. Thus, eosinophils are susceptible to
      productive HIV-1 infection in vitro and may be an important reservoir for the
      virus in vivo.

PMID- 1744592
TI  - Fine specificity of cytotoxic T lymphocytes primed in vivo either with virus or
      synthetic lipopeptide vaccine or primed in vitro with peptide.
AB  - Standard synthetic peptide preparations contain numerous peptidic byproducts in
      small amounts, which may be efficiently recognized by cytotoxic T lymphocytes
      (CTL). Recognition patterns of such peptide mixtures by CTL may serve as a kind
      of fingerprint for CTL fine specificity. Three types of H-2Db-restricted CTL were
      compared in this way. CTL primed in vivo either with A/PR/8/34 influenza virus or
      with a synthetic lipopeptide vaccine prepared from influenza nucleoprotein (NP)
      peptide 365-380 showed identical fine specificity. Both recognize virus-infected
      cells. In contrast, CTL primed in vitro with NP 365-380 had a different fine
      specificity and they did not recognize virus-infected cells. Most significantly,
      the two in vivo primed CTL types efficiently recognized the natural viral
      nonapeptide NP 366-374 presented by virus-infected H-2b cells, whereas the in
      vitro primed CTL failed to do so.

PMID- 1744593
TI  - Species differences in spatial memory among Clark's nutcrackers, scrub jays, and
      pigeons.
AB  - An operant nonmatching to sample procedure was used to compare the spatial memory
      abilities of 3 avian species. A trial consisted of the presentation of a
      spatially defined sample, a delay interval, and a 2-choice test during which the
      correct location was the new location. A single spatial location served as the
      sample in Experiment 1. The delay interval was manipulated using a titration
      procedure. In Experiment 2, 1, 2, or 3 sequentially illuminated locations served
      as the sample. The delay was 1 of 4 predetermined intervals. In Experiment 3,
      sample presentation was the same as Experiment 2, but the delay interval was
      titrated. In all of the experiments, the performance of nutcrackers was
      consistently better than the performance of scrub jays and pigeons (Experiment 1)
      and was correlated with differences in their foraging ecology.

PMID- 1744594
TI  - Echoic memory in the rat: effects of inspection time, retention interval, and the
      spectral composition of masking noise.
AB  - Memory for tones (1100 vs. 2330 Hz) was studied in 4 rats (Rattus norvegicus), as
      affected by the durations of both target tones (30 to 620 ms) and noise-filled
      retention intervals (0 to 480 ms). With a 0-ms delay, performance was near
      asymptotic with the 30-ms tone, but the memory of this brief tone suffered a
      massive decrement at retention intervals as brief as 60 ms; in contrast, memory
      for the 340-ms tone was stable for at least 240 ms. If the retention interval was
      filled by band-stop noise (with targets presented in the spectral gap), then the
      rat's memory for brief tones was superior to that obtained with the standard
      broad-band noise filler, and band-stop noise was better than a band-pass noise
      that had the tones embedded in the region of its spectral energy. These findings
      are consistent with the hypotheses that auditory memory in the rat consists of a
      transient sensorylike echoic store and a short-term store more resistant to the
      effects of retroactive interference.

PMID- 1744595
TI  - Serial learning by rhesus monkeys: I. Acquisition and retention of multiple four
      item lists.
AB  - Two rhesus monkeys were trained to learn eight 4-item lists, each composed of 4
      different photographs. Lists were trained in successive phases: A, A----B, A----B
      ---C, and A----B----C----D. After List 4, retention, as measured by the method of
      savings, was, on average, 66% (range: 44-84%). Indeed, all 4 lists could be
      recalled reliably during a single session with neither a decrement in accuracy
      nor an increase in the latency of responding to each item. Response latencies on
      a subset test employing all possible 2- and 3-item subsets of each 4-item list
      support the hypothesis that monkeys form linear representations of a list.
      Latencies to Item 1 of a subset varied directly with the position of that item in
      the original list. On List 1, latencies to Item 2 varied directly with the number
      of intervening items between Item 1 and Item 2 in the original list. During the
      acquisition of Lists 5-8, both Ss mastered the A----B and A----B----C phases of
      training in the minimum number of trials possible.

PMID- 1744596
TI  - Conditioning of the rabbit's nictitating membrane response to a CSA-CSB-US serial
      compound: manipulations of CSB's associative character.
AB  - Response acquisition to a trace conditioned stimulus (CSA) can be facilitated by
      insertion of a second stimulus (CSB) at the end of the trace interval just before
      the unconditioned stimulus (US). This effect may arise from serial mediation of
      trace conditioning, second-order conditioning, or both. Whereas serial mediation
      relies only on the presence of CSB, associative transfer relies on CSB's
      associative strength. In the present experiments, the presence of CSB was fixed,
      whereas CSB's associative strength was manipulated by (a) extinction of CSB, (b)
      latent inhibition of CSB, and (c) prior CSB-US pairings. In the first 2 cases,
      the level of responding to CSA was reduced in a fashion parallel to that of CSB.
      However, in the third case, partial blocking of conditioned response (CR)
      acquisition to CSA was observed. The results are discussed with reference to the
      role of associative transfer to both facilitating and blocking CR acquisition to
      CSA.

PMID- 1744597
TI  - Establishing intermodal equivalence in preweanling and adult rats.
AB  - Interactions between olfactory and brightness conditioning were examined in
      infant (16-day-old) and adult rats. Conditioning to an odor (methyl salicylate
      [MS] paired with footshock [FS]) was followed by subthreshold conditioning to an
      unscented black box (paired with FS). Controls were given unpaired presentations
      in either the 1st or the 2nd phase of this treatment. No age-related differences
      in conditioning occurred when either phase was presented alone. Significant
      aversion to the black box was observed after the experimental treatment only in
      infants, and brightness conditioning potentiated odor conditioning in infants but
      not adults. In the infants, odor-extinction procedures weakened the aversion to
      the black box as well as to MS. Olfactory-to-visual transfer required that the
      same unconditioned stimulus be paired with both conditioned stimuli. These
      results may reflect an infantile disposition for unitization.

PMID- 1744598
TI  - Development of intersensory function: age-related differences in stimulus
      selection of multimodal compounds in rats as revealed by Pavlovian conditioning.
AB  - Preweanling and adult rats were exposed to Pavlovian stimulus pairings with
      lights, tones, and light-tone compounds as conditional stimuli (CSs). Tone
      intensity was varied. As was found in previous studies using flavor CSs, odor
      CSs, or both, in which significant overshadowing or potentiation occurred to an
      element of a compound, overshadowing was less likely and potentiation more likely
      for preweanlings than for adults. Several experiments supported the view that
      these effects reflect an age-related difference in the controlling properties of
      stimuli: Young rats are more disposed to encode multimodal compounds on the basis
      of amodal intensity, whereas their elders are more likely to encode modality
      specific properties of light and sound. Differential reinforcement in the
      presence of lights, tones, and light-tone compounds made preweanlings' stimulus
      selection appear more adultlike and may be a cause of development of intersensory
      function.

PMID- 1744599
TI  - Diabetes screening.

PMID- 1744600
TI  - Efficient diagnosis.

PMID- 1744601
TI  - Vasectomy: principles and comments.

PMID- 1744602
TI  - Sports medicine: the times, they are a-changin'.

PMID- 1744603
TI  - Complications in a series of 1224 vasectomies.
AB  - BACKGROUND: The assessment of a vasectomy technique should be based on the
      incidence of complications resulting from the procedure. Differing diagnostic
      criteria for defining complications and the belated occurrence of some adverse
      events, however, have made such appraisals difficult. The purpose of this paper
      is to suggest criteria for defining vasectomy-related problems and to present the
      results of a long-term study of 1224 vasectomies. METHODS: The records of 1224
      men who had a vasectomy performed by the same technique during a 4-year period
      were reviewed, and documented complications were tabulated and evaluated.
      Patients were referred residents of the lower mainland of British Columbia, and
      the majority were married. The group included a wide spectrum of ages, races, and
      occupations. Twelve categories of potential complications were defined, of which
      10 were actually encountered in the study group. Infection was defined as having
      had antimicrobial drugs prescribed, and regret as having returned to discuss a
      reversal; all other complications were diagnosed based on a documented clinical
      diagnosis. RESULTS: Complications had been documented in 124 cases (10.6%) and
      included 46 minor infections (3.8%), 2 serious infections (0.16%), 23 instances
      of epididymitis (1.9%), 16 cases of sperm granuloma (1.3%), and 4 minor
      hemorrhages (0.33%). Of 3 failures, only one (0.08%) was due to recanalization.
      No serious hemorrhages or late failures were seen. CONCLUSIONS: Satisfactory
      results were believed to be related to surgical technique and the liberal use of
      antimicrobial drugs. The low recanalization rate was attributed to the treatment
      of the ends of the vas with multiple loops of polyglycolic acid ligature.

PMID- 1744604
TI  - Lifestyles and health risks of collegiate athletes.
AB  - BACKGROUND: No study has comprehensively assessed the health behaviors of
      intercollegiate athletes. To determine whether they may be at increased risk for
      unhealthy lifestyle behaviors, we compared the lifestyle and health risk
      behaviors of a group of college athletes with those of their nonathletic peers.
      METHODS: A confidential survey questionnaire addressing preventable lifestyle
      behaviors was given to 109 intercollegiate athletes and 110 nonathlete controls.
      RESULTS: Athletes had a significantly (P less than .05) higher proportion of
      "risky" lifestyle behavior patterns compared with the nonathletes in the
      following areas: quantity of alcohol consumed; driving while intoxicated with
      alcohol or other drugs; riding with an intoxicated driver; use of seatbelts; use
      of helmets when riding a motorcycle or moped; use of contraception; number of
      sexually transmitted diseases; and number of sexual partners. CONCLUSIONS:
      College athletes appear to be at higher risk for certain maladaptive lifestyle
      behaviors. Comprehensive lifestyle assessment and preventive health intervention
      deserve further study to determine whether they can facilitate the adoption of
      positive lifestyle behaviors in this high-risk group.

PMID- 1744605
TI  - Accuracy of patient encounter and billing information in ambulatory care.
AB  - BACKGROUND: This study examined the degree of accuracy of billing data in an
      academically affiliated family practice. METHODS: The progress notes from 1253
      consecutive visits were independently reviewed by two family physicians, and the
      diagnoses, use of procedures, and level of service were determined for each
      visit. Discrepancies between the reviewers were resolved by consensus. These data
      were compared with the data on the corresponding billing form that had been
      completed by the care providers (ie, physicians on the faculty, physicians in
      training, family nurse practitioners, and nurses). RESULTS: There was poor
      agreement between the billing form and progress note on level of service and
      number of diagnoses (kappa = 0.37 and kappa = 0.28, respectively). The progress
      note usually indicated that a higher level of service should have been billed for
      a visit than actually was billed. Underreporting of the number of diagnoses was
      substantial; the billing forms listed only 69% of the diagnoses identified in the
      progress notes. In 60% of visits, each diagnosis on the billing form had a
      matching diagnosis in the progress note. This could be improved to 78% of visits
      if broad categories of disease were used. Residents were similar to faculty in
      the accuracy of reported level of service and types of diagnoses, but were more
      likely to underreport the number of diagnoses. CONCLUSIONS: Ambulatory care data
      from computerized billing files may not be sufficiently accurate for proper
      reimbursement of physician services or for use in research.

PMID- 1744606
TI  - Relationship of infant mortality to the availability of obstetrical care in
      Indiana.
AB  - BACKGROUND: Projects that are currently under way in Indiana to improve access to
      obstetrical care have not addressed the availability of these services in
      nonmetropolitan areas. This study was designed to identify all physicians who
      were providing obstetrical services in every county throughout the state to
      determine if there is a correlation between the availability of these services
      and the infant mortality rate in nonmetropolitan counties. METHODS: A state-wide
      physician profile maintained by the Indiana Academy of Family Physicians was
      cross-referenced with a telephone survey of all hospitals in the state to
      identify those physicians providing obstetrical services within each county in
      Indiana. The number of physicians in each county was then compared with the
      number of births per year by mothers from that county to determine whether
      nonmetropolitan counties had sufficient physicians to provide obstetrical
      services. Finally, these findings were compared with the most recent infant
      mortality rate for each nonmetropolitan county. RESULTS: A total of 610 family
      physicians, 311 obstetricians, and 75 general practitioners were providing
      obstetrical care in Indiana. There were 10 counties that did not have a physician
      who delivered babies practicing in that county. Thirty-two counties had more
      women who needed obstetrical care than the current number of physicians could
      serve. There was a negative correlation between physician availability and infant
      mortality in Indiana's nonmetropolitan counties (r = -.38; P less than .02).
      CONCLUSIONS: Access to care for pregnant patients is a major problem in rural
      Indiana and hampers Indiana's ability to reduce its current infant mortality
      rate.

PMID- 1744607
TI  - 'White coat' hypertension in children.
AB  - BACKGROUND: Research with ambulatory blood pressure monitoring (ABPM) clearly
      demonstrates the importance of identifying "white coat" hypertension before
      making the diagnosis of hypertension. While the existence of white coat
      hypertension has been documented in adults, it is unknown whether this phenomenon
      is present during childhood. Therefore, the purposes of this study were to
      determine whether white coat hypertension exists in children with a positive
      family history of essential hypertension; and if it exists, to compare 24-hour
      ambulatory blood pressure patterns among normotensive, white coat hypertensive,
      and hypertensive children. METHODS: One hundred fifty-nine children (aged 5 to 15
      years) participated in the study. Based on office systolic and diastolic
      measurements and 24-hour ABPM, subjects were placed into one of three groups:
      normotensive, white coat hypertensive, and hypertensive. RESULTS: Forty-four
      percent of 34 subjects with systolic blood pressures greater than or equal to
      95th percentile were reclassified as white coat hypertensive; 56% remained
      hypertensive. Group comparisons of 24-hour ABPM patterns showed significant
      differences between groups. Also, the ABPM patterns of white coat hypertensive
      patients were significantly different from those of normotensive patients.
      CONCLUSIONS: This study documented the existence of white coat hypertension in
      children and showed that white coat hypertensive children were significantly
      different from normotensive and hypertensive children on most comparisons of 24
      hour ABPM data. Also, when age and sex were controlled, heavier children had a
      more significant chance of having elevated systolic blood pressure than normal
      weight children, regardless of their race, height, or body mass index.

PMID- 1744608
TI  - Colpophotography systems: a review.
AB  - Colpophotography and video colposcopy systems are useful for pathology
      documentation purposes, patient education, and colposcopy training. A wide
      variety of colposcopic visual media components are available to enhance routine
      colposcopy. Colpophotographic systems supplied by eight colposcope manufacturers
      were critically evaluated by a colposcopist and a medical photographer.
      Components were independently and objectively analyzed. Photographic examination
      considered color, illumination uniformity, and coverage of illumination at all
      possible colposcopic magnifications. Photographs were developed by a standardized
      technique. The investigation results clearly demonstrated variability between
      different colpophotographic systems. Quality colpophotography is dependent on
      certain colposcope features and potential modifications. Colpophotography and
      video colposcopy systems complement the standard colposcopic procedure.

PMID- 1744609
TI  - Superficial thrombophlebitis of the anterior chest wall (Mondor's disease).

PMID- 1744610
TI  - Foley catheter retention: a case report.

PMID- 1744611
TI  - US Preventive Services Task Force: an update on current activities.

PMID- 1744612
TI  - Morphological basis of "growling" in the king cobra, Ophiophagus hannah.
AB  - A bioacoustic analysis is conducted on the defensive sounds produced by 21
      species of snakes. The "typical" snake hiss is described as having a broad
      frequency span (from roughly 3,000 to 13,000 Hertz) and a dominant frequency near
      7,500 Hertz. The "growl" of the king cobra (Ophiophagus hannah) differs from the
      "typical" snake hiss in consisting solely of frequencies below 2,500 Hertz, with
      a dominant frequency near 600 Hertz. Structural analysis of the upper respiratory
      tract of O. hannah suggests that the "growl" is produced by tracheal diverticula
      functioning as low-frequency resonating chambers. This hypothesis is supported in
      several ways. An acoustic analysis of a mechanical model of the trachea
      demonstrates the potential for these diverticula to produce resonance effects. A
      "growl" also occurs in the mangrove ratsnake (Gonyosoma oxycephalum), a species
      that also has tracheal diverticula. Flushing the respiratory tract of G.
      oxycephalum with helium produces a shift of over 1,000 Hertz in the "growl," a
      shift that is indicative of a resonance effect.

PMID- 1744613
TI  - Chemical repellency in birds: relationship between chemical structure and
      avoidance response.
AB  - We examined how molecular structure of 24 anthranilate and benzoic acid
      derivatives correlated with drinking behavior in European starlings Sturnus
      vulgaris. The effectiveness of bird repellents was associated with basicity, the
      presence of an electron-donating group in resonance with an electron-withdrawing
      carboxylic group on a phenyl ring, and a heterocyclic ring in the same pi cloud
      plane as the phenyl ring. Of the benzoic acid derivatives tested in this study,
      methyl, ethyl, dimethyl, and linalyl anthranilate as well as anthranilic acid and
      4-ketobenztriazine were repellent to birds. Water consumption was significantly
      reduced relative to control levels at concentrations as low as 0.05%
      (weight/volume) for the best repellents. Further statistical tests showed that
      reduction in consumption for the best repellents was absolute, not significantly
      different from zero consumption. Anthranilic acid isomers were moderately good
      repellents. The ability to generate a model predicting repellency allows for the
      efficient identification and development of ecologically sound, nonlethal, taxa
      specific repellents to be used for the protection of wildlife in agricultural and
      industrial applications.

PMID- 1744614
TI  - The effects of orchidectomy and gonadotropins on steroidogenesis and oogenesis in
      Bidder's organs of the toad Bufo woodhousii.
AB  - In the family Bufonidae, male toads possess rudimentary ovaries, called Bidder's
      organs, which are attached to the testes. The mechanisms involved in the
      inhibition of oogenesis in these structures were investigated in male Bufo
      woodhousii. Orchidectomized and sham-operated animals were injected with
      gonadotropins (pregnant mare serum gonadotropin [PMSG] + human chorionic
      gonadotropin [hCG]) for 26 days and the effects of these hormones on oogenesis
      and steroidogenic activity (3 beta-hydroxysteroid dehydrogenase [3 beta-HSD] and
      17 beta-HSD) in the Bidder's organ were quantified. Bilateral orchidectomy alone
      resulted in the growth of bidderian oocytes and a shift towards later stages of
      oogenesis. Gonadotropins enhanced this effect and stimulated the proliferation of
      new germ cells. In the presence of testes, however, bidderian oogenesis remained
      inhibited despite high levels of circulating gonadotropins. In both ooplasm and
      follicular layers of the bidderian oocytes of all toads, 3 beta-HSD and 17 beta
      HSD activities were detected by histochemistry. Follicular enzymatic activity
      increased in orchidectomized toads treated with PMSG + hCG but decreased in sham
      operated toads treated with gonadotropins. Testis weights, rudimentary oviduct
      weights, and plasma steroid levels increased in intact toads injected with hCG +
      PMSG. Gonadotropins had no effect on plasma steroid levels in orchidectomized
      toads, however. These results suggest that the testes play a major role in the
      inhibition of oogenesis in Bidder's organs of B. woodhousii and are a major
      source of androgens. High circulating levels of gonadotropins do not overcome the
      inhibitory effects of the testes.

PMID- 1744615
TI  - The behavior and cytoskeletal system of chick gastrula mesodermal cells on
      substrata coated with lines of fibronectin.
AB  - In order to investigate the mechanism of the formation of the mesodermal layer
      during chick gastrulation, we observed the behavior of fragments of mesodermal
      cells explanted and cultured on substrata coated with parallel lines of
      fibronectin (FN). We also examined the distribution of F-actin, alpha-actinin,
      and vinculin in explanted fragments by immunocytochemical methods noting
      particularly their distribution with respect to FN lines. Explants of mesodermal
      cells flattened on FN-coated substrata and then became elliptical with the major
      axis of the ellipse oriented along the FN lines and migrated along them. The
      peripheral cells of explants extended filopodia and lamellipodia which attached
      preferentially to FN lines and then contracted, pulling other mesodermal cells in
      explants along passively. Vinculin and alpha-actinin in peripheral anchoring
      filopodia and lamellipodia co-localized with the terminations of F-actin bundles
      and with FN lines, suggesting that the peripheral cells were the moving force for
      explant translocation. We propose based on these results that in vivo, peripheral
      cells of invaginated cell mass are guided by the known FN-rich fibrous
      extracellular matrix on the basal surface of epiblast to move outwards; the rest
      linked to the peripheral cells are pulled away from the primitive streak to
      spread in tandem to form the mesodermal layer.

PMID- 1744616
TI  - Early innervation of skeletal muscle during tail regeneration in urodele
      amphibians.
AB  - The innervation pattern of skeletal muscles was studied in the normal and
      regenerating tail of Notophthalmus viridescens. Silver staining for nerve endings
      and histochemical localization of acetylcholinesterase (AChE) were used for light
      microscopy. In In normal musculature, AChE positive reactions were localized at
      the ends of the muscle fibers where they are anchored on connective tissue septa
      by myotendinous junctions. At this level, silver staining shows nerve terminals
      forming endplates. During regeneration, positive reactions for AChE appear de
      novo as dense plates localized at the ends of the newly formed myotubes. The
      mechanisms involved in the localization of AChE on this surface seem to operate
      before previous local contacts by nerve terminals. From the ultrastructural data
      and immunohistochemical results with anti-laminin antibody, these observations
      suggest that regenerating muscle fibers determine a region of post-synaptic
      specialization in close relation with the organization of myotendinous regions
      and basement membrane formation. Nerve-muscle contacts appear at these levels at
      stage IV (15-20 days after amputation) in the stump and in the rostral part of
      the regenerate (transition zone). These nerve terminals are provided by the
      disorganized peripheral nervous system of the injured segment. In the regenerate
      a similar pattern of AChE reaction can be seen in every myotube, differentiating
      according to a rostro-caudal gradient. Innervation at the ends of the muscle
      fibers is in spatiotemporal relation with the exists of the ventral roots from
      the regenerating nerve cord as the regenerate continues to grow in length.

PMID- 1744617
TI  - Chronology and morphology of temperature-dependent sex determination.
AB  - Temperature sensitivity and gonadal differentiation were studied in a turtle,
      Trachemys scripta, with temperature-dependent sex determination. Sex
      determination was sensitive to both the duration and magnitude of incubation
      temperature. Temperature exerted an "all or none" effect on the ovarian or
      testicular nature of most gonads, but affected the length of ovaries in a graded
      fashion. Collectively, the results indicate that sex determination is controlled
      by the quantitative effect of temperature during a period beginning prior to
      (histologically detectable) sexual differentiation and extending to a time when
      initial sex specific changes are evident in the gonads.

PMID- 1744618
TI  - Genetic analysis of androgenetic rainbow trout.
AB  - We analyzed a number of genetic characteristics in androgenetic rainbow trout
      (Oncorhynchus mykiss) and their progeny. The androgenetic progeny of individual
      androgenetic males appeared genetically identical to each other based on eight
      enzyme loci. Their viability was no higher than that of androgenetic progeny of
      outbred males. Homozygous androgenetic female rainbow trout produced very poor
      quality eggs. When common eggs and sperm from outbred individuals were used to
      produce androgenetic and gynogenetic progeny, the yield of gynogenetic progeny
      was higher but some were heterozygous at protein loci, while no androgenetic
      progeny were heterozygous. Some androgenetic diploid rainbow trout were
      successfully produced from cryopreserved sperm. The progeny of some androgenetic
      males crossed to normal females were virtually all males, while the progeny of
      other males were virtually all females. This suggests that both XX and YY
      androgenetic individuals may develop as males. Androgenesis is likely to be
      useful for generating homozygous clones for research and for recovering strains
      from cryopreserved sperm.

PMID- 1744619
TI  - Proliferation of lymphocyte-like cells from the solitary tunicate, Styela clava,
      in response to allogeneic stimuli.
AB  - Lymphocyte-like hemocytes (LLCs) of solitary tunicates proliferate in response to
      allogeneic stimuli. In vitro labeling of proliferative hemocytes from the
      solitary species Styela clava revealed significantly greater proliferative
      activity among individuals immunized with allogeneic tissue as opposed to
      autogeneically primed and naive animals. Enhanced proliferation was restricted to
      discrete crypts of dividing cells within the body wall of recipients. Here,
      increased proliferative activity was specifically associated with LLCs. These
      data support previous results which implicated LLC activity with immunological
      memory that is evident in allograft rejection. Hence, it is postulated that
      adaptive histoincompatibility responses in solitary tunicates depend upon the
      specific proliferation of immunocompetent cells.

PMID- 1744620
TI  - An increase of intracellular free Ca2+ is essential for spontaneous meiotic
      resumption by mouse oocytes.
AB  - The involvement of calcium ions in the mechanism of meiotic resumption has been
      studied in mouse oocytes made resistant to the lethal effects of calcium-free
      medium (CFM) by zona pellucida removal (De Felici et al., '89). We show here that
      such oocytes undergo meiotic resumption in CFM (as evaluated by germinal vesicle
      breakdown, GVBD) at a rate comparable to that shown by oocytes cultured in medium
      containing 1.7 mM Ca2+. The addition to CFM of 50 u M Quin2/AM (a membrane
      permeable, high affinity Ca2+ chelator) totally prevents GVBD, while purported
      antagonists of Ca2+ release from intracellular stores, such as 150 uM 8-(N,N
      diethylamino)octyl-3-4-5 trimethoxybenzoate (TMB-8) or 300 uM chlortetracycline,
      only cause a slight meiotic delay. On the other hand, if the oocytes are pre
      incubated for 30 min in CFM supplemented with 100 uM TBM-8 plus 0.2 mM dibutyryl
      cyclic AMP (dbcAMP, a reversible inhibitor of GVBD), and then cultured in the
      same medium, without dbcAMP, a sustained inhibition of meiotic maturation is
      obtained. Our observations suggest that an increase in intracellular free Ca2+ is
      essential for meiotic resumption by mouse oocytes; in the experimental absence of
      external Ca2+, release of the cation from internal stores is sufficient to allow
      meiotic resumption.

PMID- 1744621
TI  - At least half of capacitated, motile mouse sperm can fertilize zona-free mouse
      oocytes.
AB  - The percentage of individual sperm capable of fertilizing zona pellucida-free
      mouse oocytes was investigated by placing motile sperm near zona-free oocytes
      with a micromanipulator. Incubation with one or two capacitated sperm per oocyte
      resulted in 50% and 70% fertilization, respectively, compared to 88% for cumulus
      intact (10(5) sperm/ml) and 87% for zona-free (2 x 10(3) sperm/ml) control
      oocytes. When sperm were treated with .1 microM calcium ionophore A23187 to
      facilitate the acrosome reaction, fertilization rates for single motile sperm
      were markedly lower than for capacitated, nontreated single sperm (4% and 35%,
      respectively). Similar fertilization rates resulted when one sperm was incubated
      per two ova (4% and 48% per sperm for A23187-treated and controls, respectively).
      When a lower dose of A23187 (.001 microM) was used to treat sperm, 7% of oocytes
      incubated with single sperm were fertilized. These experiments demonstrate that
      at least half of motile, capacitated mouse sperm are capable of fertilizing zona
      free mouse oocytes in vitro, and that motile, A23187-treated mouse sperm resulted
      in poor fertilization rates.

PMID- 1744622
TI  - The detection of aerosol propellants in body fluids and tissue by gas
      chromatography-mass spectrometry.
AB  - The increased incidence of aerosol abuse in recent years has led to the
      development of a method for the detection of halogenated hydrocarbons in body
      fluids and tissue compatible with other routine methods. The use of the method in
      two background studies and a case investigation is described.

PMID- 1744623
TI  - A simple method for collection of gunshot residues from clothing.
AB  - Simple equipment for the sampling of gunshot residue particles from clothing,
      inside of bags, pockets, etc, is described. Collection was achieved by vacuuming
      through a double filtration system constructed from a Nucleopore aerosol holder
      connected to an ordinary vacuum cleaner. The collected particles were examined by
      scanning electron microscopy. Good results were observed in functional tests of
      this equipment and the method has been introduced into casework in our
      laboratory. Various experiments on possible contamination of clothing by GSR
      particles were performed. The usefulness of clothing as evidence material in
      searching for GSR particles is discussed.

PMID- 1744624
TI  - Eliminating ill-founded eliminations in handwriting comparison cases.
AB  - Document examiners sometimes eliminate writers on the basis of differences which
      are given too much weight. This article is an attempt to explain some conditions
      whereby differences in the writing of one individual are misinterpreted as
      significant differences, when they are actually caused by conditions which are
      unknown to the examiner.

PMID- 1744625
TI  - The analysis of clingfilms by infrared spectroscopy and thermal desorption
      capillary gas chromatography.
AB  - An automated thermal desorption gas chromatography technique has been adapted to
      analyse traces of volatile compounds in proprietary food-wrapping films. Fourteen
      brands of polyvinylchloride film, seven brands of polyethylene film and one
      polyvinylidene chloride film were discriminated. Prior infrared analysis was used
      to identify the polymer type. The chromatograms showed minor changes in volatiles
      along the length of a roll of film and major changes in films exposed to daylight
      or in contact with cannabis resin.

PMID- 1744626
TI  - The attribution of blame and type of crime committed: transcultural validation.
AB  - This study examines the relationship between type of offence and the attributions
      offenders make about their criminal act. The subjects were 98 Icelandic criminals
      who had completed the Gudjonsson Blame Attribution Inventory. Significant
      differences in attribution were found between offender groups. Sex offenders and
      those who had committed acts of interpersonal violence reported most guilt about
      their offence and they attributed cause for their offence more to mental factors
      (eg, loss of self-control) than other types of offender. Violent offenders had
      the highest external attribution and sex offenders the lowest. The findings with
      regard to the three attributions are remarkably similar to those found previously
      for British offenders.

PMID- 1744627
TI  - A continuous model for interpreting the positions of bands in DNA locus-specific
      work.
AB  - A simple but rigorous approach is offered for evaluating the evidential value of
      single locus DNA autoradiographs. This approach does not use a binning technique
      and it does not treat alleles as discrete variables. Instead, the allele
      distribution is considered to be continuous. The variation between two comparable
      bands is assessed using previously determined experimental parameters. The
      Bayesian treatment leads to an expression of the "quality of a match".

PMID- 1744628
TI  - Decision making in clinically depressed patients. A transcultural social
      psychological study.
AB  - One of the most important cognitive deficits in depression is said to be the
      patient's inability to make decisions. A research design involving a cross
      cultural comparison between Australian and Japanese normal controls (N = 309 and
      N = 743, respectively) and clinically depressed patients (N = 59 and N = 45,
      respectively) was used to examine the influence of culture on illness and
      decision-making behavior, and whether deficits in decision making may be related
      to culture. It was found that depression had a greater effect on decision making
      in Australian patients than in Japanese patients. While many differences were
      found between Australian and Japanese nondepressed students, few differences were
      found between Australian and Japanese depressed patients. Thus, there appears to
      be an important interactional effect of culture and depression on decision
      making. The theoretical and clinical implications of the results are discussed.

PMID- 1744629
TI  - Neurochemical mechanisms of chronic antisocial behavior (psychopathy). A
      literature review.
AB  - This article reviews the important emotional correlates of chronic antisocial
      behavior from the standpoint of primary and secondary psychopathy. Primary
      psychopaths exhibit a conspicuous lack of empathetic emotions and secondary
      psychopaths exhibit a conspicuous excess of inappropriate emotions. The article
      points out the relationship between passive-avoidance learning deficits and
      primary psychopathy and between central nervous system serotonergic dysfunction
      and primary and secondary psychopathy.

PMID- 1744630
TI  - Posttraumatic stress disorder, depression, and somatic symptoms in U.S. Mien
      patients.
AB  - This report describes treatment over a period of 6 years of Mien refugees from
      highland Laos in the Indochinese Psychiatric Program of the Oregon Health
      Sciences University (Portland, OR). The medical and psychiatric problems of 84
      patients were presented through somatic symptoms such as headache, dizziness, or
      musculoskeletal pain. Primary care medical problems were identified and treated,
      with the major focus on the two most common psychiatric diagnoses: major
      depression and posttraumatic stress disorder. Cultural beliefs about illness and
      medication interfered with adherence to prescribed treatment. A marked
      sensitivity to side effects of certain antidepressants also resulted in
      subtherapeutic doses. Patients rarely volunteered their traumatic histories,
      psychiatric problems, or dissatisfaction with medications. However, the effective
      use of medication for somatic complaints, along with the continuing recognition
      of Mien health beliefs in psychosocial treatments, allowed for the development of
      a trusting doctor-patient relationship and continued psychiatric care.

PMID- 1744631
TI  - Psychotherapy for dysthymia. A naturalistic study of ten patients.
AB  - Ten early and late onset dysthymia cases, diagnosed by DSM-III criteria, were
      treated with the Cognitive-Behavioral Analysis System of Psychotherapy, a
      standardized, three-stage therapy system developed specifically for the treatment
      of dysthymia. The cases are presented as naturalistic, direct-replication
      studies. Reliability of data trends within and across stages of treatment and
      generalization of effects across patients were demonstrated. The out-of-control
      depressive state at treatment outset is challenged by demonstrating to each
      patient that their depressive predicament is self-produced and maintained by
      maladaptive living strategies. The essential goals of therapy are teaching the
      patient a) to accept total responsibility for their depression and b) to achieve
      and maintain mood control by enacting adaptive daily living strategies. The
      progressive assumption of personal responsibility for the debilitative mood state
      is accompanied by a corresponding shift in a locus of control set from
      externality to internality. Patients were then taught situational coping
      strategies, and treatment ended when mood control was evinced. All cases were
      treated by J.P.M. The 10 cases met therapy termination criteria, and nine (one
      exception) were found in remission for dysthymia at follow-up of 2 years or more.
      Cognitive behavior psychotherapy, which directly attacks the helplessness and
      hopelessness plight of the dysthymic and teaches adaptive coping skills, appears
      to be an effective therapeutic strategy for the disorder.

PMID- 1744632
TI  - Dynamic treatment of panic disorder: a review.
AB  - A review was conducted of the psychoanalytic and psychodynamic literature in
      order to identify patients with panic disorder who received dynamic treatment.
      Thirty-five cases were located that fit the description of panic disorder. Their
      characteristics are compared with those of a current anxiety disorder clinic
      panic disorder population. Features of the successful dynamic treatment of panic
      disorder are summarized.

PMID- 1744633
TI  - Neuropsychological deficits in chronic schizophrenics. Relationship with symptoms
      and behavior.
AB  - Thirty-nine hospitalized chronic schizophrenics were administered the Luria
      Nebraska Neuropsychological Battery (LNNB) and the Weschler Adult Intelligence
      Scale-Revised when they were clinically stable. Test variables were related to
      Brief Psychiatric Rating Scale ratings and two behavioral measures of ward
      functioning, points and activities. Spearman correlations of test variables with
      the symptom and behavioral measures were entered into a series of median polish
      analyses. There was an overall significant relationship between the two sets of
      variables. Neuropsychological test variables that were most highly correlated
      with symptom/behavioral measures were LNNB Left Frontal, Memory, and Intellectual
      Processes scales. The positive symptoms of thought disorder and hallucinations
      were most consistently related to neuropsychological variables. In contrast with
      other findings in the literature, negative symptoms were not significantly
      correlated with neuropsychological performance.

PMID- 1744634
TI  - Involvement in an outreach and residential treatment program for homeless
      mentally ill veterans.
AB  - Descriptive data derived from initial assessment interviews and from standardized
      3-month progress reports are presented on 1684 homeless, chronically mentally ill
      veterans who were contacted at nine sites in a national Department of Veterans
      Affairs outreach program. Levels of involvement in the program were modest, with
      only 16% of those screened having over 10 clinical contacts and 24% still
      involved after 3 months. Demographic and clinical characteristics were weakly
      associated with continued involvement, but those admitted to residential
      treatment were 5.4 times more likely to be involved in the program than those not
      admitted. Admission to residential treatment appears to be the strongest
      determinant of clinical engagement of the homeless mentally ill.

PMID- 1744635
TI  - Low dose desipramine treatment of cocaine-related panic attacks.
AB  - Thirteen patients meeting DSM-III-R criteria for panic disorder with or without
      agoraphobia that started during or shortly after cocaine exposure were treated in
      the UCLA Anxiety Disorders Program (Los Angeles, CA). Low starting doses (ranging
      from 2.5 to 10 mg/day) of desipramine were used. Doses were then slowly increased
      to an average daily dose of 25 mg. Eleven patients who were able to tolerate an
      initial increase in panic anxiety responded to this treatment strategy with
      almost full resolution of panic attacks. The authors discuss the possible value
      and mechanisms of low dose treatment of cocaine-related panic attacks.

PMID- 1744636
TI  - Does a retrovirally encoded superantigen cause multiple sclerosis?

PMID- 1744637
TI  - Girolamo Fracastoro 1484-1553.

PMID- 1744638
TI  - The metabolic landscape of cortico-basal ganglionic degeneration: regional
      asymmetries studied with positron emission tomography.
AB  - Regional metabolic rate for glucose (rCMRGlc) was estimated using
      [18F]fluorodeoxyglucose (FDG) and positron emission tomography (PET) in five
      patients (four men, one woman; mean age 68; mean disease duration 2.4 years) with
      clinical findings consistent with the syndrome of cortico-basal ganglionic
      degeneration (CBGD). Left-right rCMRGlc asymmetry, (L-R)/(L + R) x 100, was
      calculated for 13 grey matter regions and compared with regional metabolic data
      from 18 normal volunteers and nine patients with asymmetrical Parkinson's disease
      (PD). In the CBGD group mean metabolic asymmetry values in the thalamus, inferior
      parietal lobule and hippocampus were greater than those measured in normal
      control subjects and patients with asymmetrical PD (p less than 0.02). Parietal
      lobe asymmetry of 5% or more was evident in all CBGD patients, whereas in PD
      patients and normal controls, all regional asymmetry measures were less than 5%
      in absolute value. Measures of frontal, parietal and hemispheric metabolic
      asymmetry were found to be positively correlated with asymmetries in thalamic
      rCMRGlc (p less than 0.05). The presence of cortico-thalamic metabolic asymmetry
      is consistent with the focal neuropathological changes reported in CBGD brains.
      Our findings suggest that metabolic asymmetries detected with FDG/PET may support
      a diagnosis of CBGD in life.

PMID- 1744639
TI  - Dissection of the extracranial vertebral artery: report of four cases and review
      of the literature.
AB  - Four cases of cervical vertebral artery (VA) dissection are reported. In three
      patients VA dissection was associated with neck trauma. All patients were young
      or middle-aged (range 27 to 49 years). In two there was a history of migraine.
      Pain preceded neurological symptoms from hours to six weeks. Three patients had
      neurological deficits including elements of the lateral medullary syndrome, and
      one experienced recurrent transient ischaemic attacks in the vertebrobasilar
      territory. Angiographic findings included irregular stenosis, occlusion and
      pseudoaneurysm; in two patients VA abnormalities were bilateral. All patients
      were treated with anticoagulants and improved. In a review of 28 cases with
      traumatic dissection and 29 cases with spontaneous dissection of the VA reported
      in the literature, distinct clinical and angiographic features emerge. Aetiology
      remains obscure in most cases of spontaneous dissection and management is still
      controversial.

PMID- 1744640
TI  - The apomorphine test in parkinsonian syndromes.
AB  - The dopamine receptor agonist apomorphine has been used successfully to treat on
      off swings in Parkinson's disease. Its value as a predictor of dopa
      responsiveness in idiopathic Parkinson's disease (IPD) was assessed and its
      potential role in differentiating IPD from the Parkinsonian plus syndromes (PPS)
      of multisystem atrophy, progressive supranuclear palsy and olivopontocerebellar
      atrophy was investigated. The response to an injection of apomorphine was
      observed in 20 patients with IPD and eight with PPS after being off levodopa for
      12 hours. Patients were reassessed after taking levodopa for one month. Nineteen
      of the 20 patients (95%) with IPD showed a positive response to apomorphine and
      18 (90%) to oral levodopa. In the PPS group, two patients (25%) responded to the
      apomorphine injection but not to oral levodopa. Apomorphine produced severe
      drowsiness in the PPS patients. It is suggested that the test can predict dopa
      responsiveness in IPD and may be of help in confirming a doubtful diagnosis. It
      has potential value in differentiating IPD from PPS.

PMID- 1744641
TI  - The Chalfont Seizure Severity Scale.
AB  - Seizure severity has been largely neglected in studies of patients with epilepsy
      and the evaluations of treatment. A seizure severity scale, that measures the
      components of seizures that cause patients the most disturbance, is presented
      with an assessment of the scale's validity and reliability.

PMID- 1744642
TI  - The influence of stimulus properties on visual neglect.
AB  - Twenty five patients with right cerebral hemisphere damage and neglect
      participated in a series of bisection experiments. As expected, long lines were
      bisected to the right of true midpoint. By contrast, large circles and long white
      paper strips were bisected accurately, or with leftward errors. Small objects
      were less sensitive to stimulus properties: short lines and paper strips, and
      small circles, were bisected to the left of true midpoint, and these leftward
      errors were equally common as rightward errors with long lines. When asked to
      draw a perpendicular line of the same length as the presented horizontal line,
      patients overestimated the length of short lines but underestimated that of long
      lines. Presenting lines in near and far extrapersonal space selectively affected
      bisection of short lines. The results suggest that two opposing, independent
      mechanisms determine bisection performance in left neglect.

PMID- 1744643
TI  - The effect of posture on the normal and pathological auditory startle reflex.
AB  - The effect of posture on the EMG pattern of the normal auditory startle reflex
      was investigated. The startle response to an unexpected auditory tone was studied
      in eleven normal subjects when standing, and in six normal subjects when sitting
      relaxed or tonically plantar flexing both feet. Reflex EMG activity was recorded
      in the tibialis anterior and soleus about twice as frequently when standing, than
      when sitting relaxed. In addition, the median latencies to onset of reflex EMG
      activity in the tibialis anterior and soleus were about 40 and 60 ms shorter
      during standing, than when sitting relaxed. No short latency EMG activity was
      recorded in the calf muscles during tonic plantar flexion of the feet, while
      sitting. The effect of posture on the EMG pattern of the pathological auditory
      startle reflex was studied in five patients with hyperekplexia. In three patients
      the latency to onset of reflex EMG activity in the tibialis anterior was shorter
      when standing, than when sitting relaxed. The EMG pattern of the reflex response
      to sound was studied in detail in two of these patients and consisted of up to
      three successive components. The expression of each EMG component depended on the
      postural set of the limbs. In particular, a distinct short latency component was
      found in posturally important muscles following auditory stimulation. This short
      latency component was not recorded when sitting relaxed. It is concluded that the
      EMG pattern of the physiological and pathological auditory startle response is
      not fixed, but may change with the postural stance of the body. This finding
      supports the theory that the normal startle reflex and the abnormal startle
      reflex in hyperekplexia have a common brainstem origin.

PMID- 1744644
TI  - Striatal blood flow, glucose metabolism and 18F-dopa uptake: difference in
      Parkinson's disease and atypical parkinsonism.
AB  - Striatal blood flow, glucose metabolism and 18F-Dopa uptake were studied with
      positron emission tomography (PET) in eight non-demented patients with idiopathic
      Parkinson's disease and eight with atypical Parkinsonism. Patients with atypical
      Parkinsonism had no specific cause for the Parkinsonian symptoms and were
      clinically different from Parkinson's disease with lack of resting tremor and a
      poor response to dopaminergic drugs. Decreased 18F-Dopa uptake in the putamen was
      observed in patients with Parkinson's disease and atypical Parkinsonism compared
      with normal controls. 18F-Dopa uptake in the head of the caudate was also
      significantly reduced in both conditions but relatively less in Parkinson's
      disease. Decreased blood flow and glucose metabolism in the striatum associated
      with a global cerebral decrease were also observed in patients with atypical
      Parkinsonism compared with controls, while they were preserved in patients with
      Parkinson's disease, indicating affected neurons not only in the striatum but
      also in the cerebrum in patients with atypical Parkinsonism compared with
      patients with Parkinson's disease. The differences in the caudate 18F-Dopa
      uptake, and blood flow and glucose metabolism in the cerebrum including the
      striatum between Parkinson's disease and atypical Parkinsonism assessed by PET
      may be due to the differences in the pathophysiological mechanism between
      Parkinson's disease and atypical Parkinsonism.

PMID- 1744645
TI  - Effects of alcohol on myoclonus and somatosensory evoked potentials in
      dyssynergia cerebellaris myoclonica.
AB  - Three brothers with dyssynergia cerebellaris myoclonica received alcohol to study
      the correlation between improvement of myoclonus and alteration in somatosensory
      evoked potentials (SEPs). Alcohol considerably improved myoclonus for about six
      hours in two patients (cases 1 and 2) but had only a mild effect in one (case 3).
      All three patients had giant cortical SEPs. The amplitudes of median N20-P25 and
      P25-N35 components and tibial N30-P40 and P40-N50 components were considerably
      decreased after alcohol ingestion in two patients (cases 1 and 2) but unchanged
      or slightly decreased in one (case 3). The peak latencies of those components
      were not affected by alcohol. There was thus a good correlation between the
      suppression of myoclonus and the decrease in giant SEP amplitude.

PMID- 1744646
TI  - Long-term cognitive deficits in patients after surgery on aneurysms of the
      anterior communicating artery.
AB  - The long term recovery of a series of 27 patients who had undergone rupture and
      repair of an aneurysm of the anterior communicating artery was assessed using a
      number of neuropsychological measures. Testing took place 12 to 84 months post
      surgery. On the basis of the results from tests of intellect, memory, and
      conceptual learning, three subgroups of patients were identified: those with
      persuasive cognitive defects, those with evidence of residual frontal lobe damage
      and those who showed no evidence of dysfunction. The occurrence of cerebral
      vasospasm was the most consistent predictor of long term cognitive deficit.

PMID- 1744647
TI  - The prognosis of primary intracerebral tumours presenting with epilepsy: the
      outcome of medical and surgical management.
AB  - It is not known whether conservative or early aggressive (resective surgery with
      or without radiotherapy) management is better for tumours presenting with
      epilepsy. The prognosis of 560 patients with a clinical and CT diagnosis of
      intrinsic supratentorial tumour was examined retrospectively. Epilepsy was the
      first symptom in 164 patients. Histological confirmation of diagnosis was
      available in 391 (70%) of cases. Median survival was 37 months in the group
      presenting with epilepsy and six months in those presenting with other symptoms
      (p less than 0.0001). Patients presenting with epilepsy were more likely to have
      a normal clinical examination, a non-enhancing low density lesion on CT scan and
      a low grade tumour. From Cox's stepwise proportional hazards model, significant
      independent variables adversely affecting prognosis were increasing age, focal
      neurological signs and enhancing CT lesions at diagnosis, non-resective surgery
      and male sex. Of those presenting with epilepsy 80 patients had surgical
      treatment within two months of CT diagnosis. The Cox's model failed to identify
      any beneficial effects for either early resective surgery or radiotherapy. In
      primary intracerebral tumours with presentations other than epilepsy, resective
      surgery and radiotherapy were amongst the important factors associated with
      prolonged survival. Primary intracerebral tumours presenting with epilepsy are
      relatively benign and their outcome appears to be chiefly determined by clinical
      factors.

PMID- 1744648
TI  - The workload of neurosurgeons: implications of the 1987 practice survey in the
      USA.
AB  - The number of neurosurgeons per million population is much lower in Europe than
      in the USA, where the point prevalence of neurosurgeons doubled between 1963-87.
      Results of a 1987 survey of USA neurosurgical practice show that surgery filled
      25% of total time in professional activity. Of all cases treated, 64% were spinal
      disorders and 24% were intracranial disorders. Use of a relative value scale for
      neurosurgical procedures makes possible a rough and ready estimate of a
      neurosurgeon's weekly aggregate workload. However, the concept of a mean surgical
      workload must be examined within the context of the known variation of case mix
      and volume of surgical services in different practices.

PMID- 1744649
TI  - Radiological evidence of sinus infection in patients with multiple sclerosis.
AB  - The prevalence of radiological criteria of chronic sinus infection was compared
      in 42 cases of clinically definite or laboratory supported definite multiple
      sclerosis and 84 controls. No increase in relative risk of multiple sclerosis
      associated with the presence of chronic sinus infection was observed (odds ratio
      1.2, 95% CI 0.5 to 3.1). The maxillary sinus was infected more often than the
      other paranasal sinuses but there was no difference in the distribution of
      infection within the sinuses between cases and controls. These results do not
      confirm an earlier report of an association between chronic sinus infection and
      multiple sclerosis.

PMID- 1744650
TI  - Olfactory impairment in motor neuron disease: a pilot study.
AB  - The ability to identify smells was tested in nine males and six females with
      motor neuron disease (MND) of varying severity, using the University of
      Pennsylvania Smell Identification Test (UPSIT). The olfactory impairment found in
      MND patients compared with age and sex matched controls is statistically
      significant at the 0.005 level. The relationship with Parkinson's disease, with
      Alzheimer's dementia and the possible aetiological implications of this new
      aspect of the MND are discussed.

PMID- 1744651
TI  - Pseudopseudohypoparathyroidism and spinal cord compression.
AB  - A 42 year old Greek male with pseudo-pseudohypoparathyroidism presented with
      difficulty in walking and with lower limb weakness. His physical signs included
      short stature, thick neck, short fourth metacarpals and metatarsals, and a
      spastic paraparesis. Serum calcium and phosphate and parathyroid concentrations
      were normal. Myelography demonstrated compression of the cervical and lumbar cord
      in association with local bony abnormalities.

PMID- 1744652
TI  - Dementia of frontal lobe type and motor neuron disease. A Golgi study of the
      frontal cortex.
AB  - Neuropathological findings in a 38 year old patient with dementia of frontal lobe
      type and motor neuron disease included pyramidal tracts, myelin pallor and neuron
      loss, gliosis and chromatolysis in the hypoglossal nucleus, together with frontal
      atrophy, neuron loss, gliosis and spongiosis in the upper cortical layers of the
      frontal (and temporal) lobes. Most remaining pyramidal and non-pyramidal neurons
      (multipolar, bitufted and bipolar cells) in the upper layers (layers II and III)
      of the frontal cortex (area B) had reduced dendritic arbors, proximal dendritic
      varicosities and amputation of dendrites as revealed in optimally stained rapid
      Golgi sections. Pyramidal cells in these layers also showed depletion of
      dendritic spines. Neurons in the inner layers were preserved. Loss of receptive
      surfaces in neurons of the upper cortical layers in the frontal cortex are
      indicative of neuronal disconnection, and are "hidden" contributory morphological
      substrates for the development of dementia.

PMID- 1744653
TI  - Ophthalmoplegic migraine and recurrent sinus arrest.

PMID- 1744654
TI  - Reversal of foot drop in sciatic nerve endometriosis.

PMID- 1744655
TI  - Should clinicians be given hard copies of duplex carotid ultrasound images?

PMID- 1744656
TI  - Hyperventilation tetany: effect of carbamazepine.

PMID- 1744657
TI  - Reversible pituitary stalk enlargement in cranial diabetes insipidus.

PMID- 1744658
TI  - Cardiovascular autonomic function tests--are three Valsalva's and six deep
      breaths necessary or will singles do?

PMID- 1744659
TI  - Benign relapsing meningo-myelitis.

PMID- 1744660
TI  - Creutzfeldt-Jacob disease following cadaveric dura mater graft.

PMID- 1744661
TI  - Cognitive impairments and depression in Parkinson's disease.

PMID- 1744662
TI  - Misconceptions and inappropriate use of terms in hyperthermic syndromes.

PMID- 1744663
TI  - Sexual function in patients with Parkinson's disease.

PMID- 1744664
TI  - Patient Self Determination Act.

PMID- 1744665
TI  - Caregiving stress among community caregivers for the elderly: does
      institutionalization make a difference?
AB  - Nurses in community settings are frequently exposed to elderly persons who
      receive a significant amount of physical and/or psychosocial support from one or
      more informal caregivers. Although numerous investigations exist examining stress
      and coping in persons who provide such care for elderly persons, little is known
      about the caregiver's status once full-time caregiving ceases. This study
      describes emotional and physical components of caregiving stress in a convenience
      sample of 124 caregivers. Of these, 31 had placed their charge in a nursing home,
      while 93 had not. A multivariate analysis of variance (MANOVA) between placed
      nonplaced groups revealed no significant differences in the total score or Role
      and Personal Strain subscales of the Burden Interview (J. Zarit & S. Zarit,
      1983). Implications for community health nursing practice involve providing
      ongoing counseling and support of the caregiver and his or her charge, preparing
      both for the placement experience should it be indicated, and continued follow-up
      care post-placement. Greater collaboration between community-based and
      institutionally based nurses can facilitate implementation of these strategies.

PMID- 1744666
TI  - Home visiting outcomes and quality of life measures.
AB  - Public Health agencies are faced with the task of self-evaluation. For years,
      they have evaluated themselves solely through utilization as demonstrated by the
      numbers of patients that they have served. A new thrust is to change the methods
      of evaluation by devising and implementing a quality assurance (QA) system.
      Traditional QA systems focus on acutely ill patients and are based on the medical
      model. In contrast, public health focuses on well or chronically ill patients
      with services that involve mostly palliative treatment, disease prevention,
      and/or health promotion. The criteria used by hospitals do not apply. Thus,
      public health agencies are forced to review their standards and develop criteria
      applicable to public health. This re-examination of public health can stimulate
      new ways of viewing old programs and therefore, elicit information that has never
      been gathered before.

PMID- 1744667
TI  - Self-image among early adolescents: revisited.
AB  - Early adolescence is the developmental period during which children make the
      physical, psychological, cognitive, and social transitions to adolescence.
      Because the development of a healthy conceptualization of the self is
      foundational to adequate functioning later in life, self-image is a concept of
      interest to clinicians and researchers. Offer, Ostrov, and Howard (1981)
      conducted considerable research in the area and demonstrated that early
      adolescents have the capacity for self-reflection and are willing to share their
      reflections with others. Most early adolescents tend to be self-conscious due,
      chiefly, to the numerous physical and emotional changes occurring during this
      time period (M. P. Strommen & A. L. Strommen, 1985). Behavior is characterized by
      moodiness, impulsiveness, peer influence (Robin, 1985), and a growing resistance
      to authority. These factors usually result in an awkward child attempting to
      exert independence in an unprecedented fashion about a variety of topics
      (Manning, 1983). The purpose of this study was to investigate the self-image of
      early adolescents, aged 11 to 14 years, in order to plan for the health and
      developmental needs of middle school children and their families. Survey data
      were collected to answer the questions: (a) What is the self-image of a
      representative sample of middle school students in the community?; and (b) Are
      there differences in self-image based on gender, race, and parental occupation?

PMID- 1744668
TI  - Six years after an economic crisis: child's anxiety and quality of peer
      relationships.
AB  - The purpose of this 6-year follow-up study was to determine whether there is a
      long-term relationship between economic stress and childrens' anxiety and peer
      related behaviors. Data were collected from 39 of the 52 families in the original
      study. Analysis resulted in several interesting findings. Economic stress in 1983
      was a moderate predictor of state anxiety, trait anxiety, and peer rejection in
      girls in 1989. Descriptive evidence was provided to indicate that detrimental
      effects of economic stressors on the family as a unit continue beyond the initial
      stress event. Implications for community health nurses (CHNs) are addressed.

PMID- 1744669
TI  - Technological dependency: a preliminary model and pilot of home total parenteral
      nutrition.
AB  - As hospital costs increase and durations of hospital stays decrease, clients are
      being discharged to home care in more acute states and often with demands for
      high technology therapy. To assist in understanding the experiences families face
      in adapting to either short- or long-term dependence on technology, a model was
      developed from literature and research review. The literature review suggested
      that self-care practices affected each of the family members' adaptation. The
      model was developed to indicate self-care issues and problems impacting
      adaptation to high technology at home. A pilot study was conducted to determine
      if interviews and questionnaires would collect data necessary to test the model.
      This article describes the pilot study results. Data indicated that relationships
      and role changes did occur after the family became technologically dependent.
      Also, although depression and anxiety were common responses, the family members
      felt capable and successful in their caregiving roles.

PMID- 1744670
TI  - Comparative effects of cuff size and tightness of fit on accuracy of blood
      pressure measurements.
AB  - To determine the effect of snugness of cuff wrap on the accuracy of blood
      pressure (BP) measurements, we performed two studies on 6 healthy volunteers. In
      both studies, control values were obtained from the right upper arm with cuffs of
      appropriate size and snug fit. Study 1 had two phases. In the first, cuffs of
      appropriate size were wrapped snugly around the upper left arm of seated
      subjects. The effects of two other degrees of cuff snugness on the measurement of
      BP were evaluated by placing a filled 250-mL intravenous fluid bag between the
      cuff and arm over the triceps, measuring BP, then draining the same bag of half
      its contents and then all of its contents without rewrapping the cuff ("loose,"
      "very loose" fit), each time measuring BP. The second phase of study 1 was
      identical in procedure, except that the cuffs used on the left arm were one size
      too small. In study 2, the experimental cuffs were placed just above the right
      ankle. To alter the signal-to-noise ratio, BP was raised or lowered: the standing
      position elevated mean BP by an average of 90 mm Hg, and elevation of the legs
      decreased mean BP by an average of 43 mm Hg. In study 1, we found that
      appropriately sized cuffs, whether wrapped tightly or loosely, gave correct BP
      readings. Cuffs snugly wrapped, but too small for the subject, gave high BP
      readings, on the average by approximately 10 mm Hg. Loose wrapping of small cuffs
      gave variable results in individual subjects that exaggerated systolic BP from 2
      to 80 mm Hg. In study 2, elevating the legs or standing decreased or increased BP
      consistently. Loose wrapping of appropriately sized cuffs around the ankles of
      the subjects had no additional significant effect on BP.

PMID- 1744671
TI  - End-tidal carbon dioxide pressure in neonates and infants measured by aspiration
      and flow-through capnography.
AB  - In 25 anesthetized, intubated, artificially ventilated, and paralyzed healthy
      neonates and infants, end-tidal PCO2 (PETCO2) measured by remote multiplexed mass
      spectrometry was 1.86 +/- 1.58 mm Hg lower than arterial PCO2 (PaCO2). PETCO2
      measured by a flow-through cuvette was 1.02 +/- 1.64 mm Hg lower than PaCO2. The
      difference between the two methods of capnography was not significant. Values for
      PETCO2 obtained by mass spectrometry changed -0.43 +/- 1.43 mm Hg from baseline
      after 15 minutes of aspiration at a sample flow rate of 240 ml/min. Values for
      PETCO2 obtained with flow-through capnography changed -0.17 +/- 2.17 mm Hg from
      baseline after 15 minutes. In both methods, the changes from baseline in PETCO2
      over time were not significant. These results suggest that both methods of
      capnography studied are reliable and may be used safely in neonates despite high
      sample flow rates and added apparatus dead space (0.6 ml for tracheal tubes less
      than or equal to 4.0 mm OD and 4.9 ml for tracheal tubes greater than 4.0 mm OD).

PMID- 1744672
TI  - Clinical utility of a colorimetric end-tidal CO2 detector in cardiopulmonary
      resuscitation and emergency intubation.
AB  - The purposes of this study were to evaluate the clinical utility of a
      colorimetric end-tidal CO2 (ETCO2) detector in confirming proper endotracheal
      intubation in patients requiring emergency intubation, to determine if this new
      device can be used as an adjunct to judge the effectiveness of cardiopulmonary
      resuscitation (CPR), and to determine whether the device can predict successful
      resuscitation from cardiopulmonary arrest. We studied prospectively 110 patients
      requiring emergency intubation for either respiratory distress (53 patients) or
      cardiopulmonary arrest (57 patients) by recording the color range of the
      indicator after the initial intubation. In patients who suffered a
      cardiopulmonary arrest, the color range was also recorded during CPR after the
      endotracheal tube was confirmed to be in the tracheal position and perfusion
      optimized, and at the moment CPR was stopped. The ETCO2 detector was 100%
      specific for correct endotracheal intubation in all patients. It was also highly
      sensitive (0.98) for correct endotracheal intubation in patients with respiratory
      distress. However, it was not sensitive (0.62) in patients with cardiopulmonary
      arrest and low perfusion. The sensitivity improved (0.88) when we used the ETCO2
      range obtained after attempts to increase perfusion. A low ETCO2 color range in
      19 patients undergoing CPR was interpreted as low cardiac output and prompted the
      physicians to attempt to increase perfusion. Of the patients who underwent CPR,
      no patient whose ETCO2 level remained less than 2% was successfully resuscitated.
      Those patients who had an ETCO2 level greater than or equal to 2% had a
      significantly higher incidence of successful resuscitation.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1744673
TI  - A noninvasive method of estimating mean pulmonary artery pressure in the
      pneumatic total artificial heart.
AB  - Accurate hemodynamic monitoring is essential for the clinical management of the
      recipient of a total artificial heart (TAH). The high incidence of pulmonary
      congestive disorders in this population complicates this already formidable task.
      Lack of diagnostic pulmonary artery pressure (PAP) information is recognized as a
      fundamental source of these problems. Because conventional methods of obtaining
      hemodynamic information are difficult to implement in TAH recipients, improvement
      of TAH case management depends on the development of innovative monitoring
      strategies. Noninvasive monitoring techniques have been developed for three
      (right atrial pressure, left atrial pressure, and aortic pressure) of the four
      auxiliary circulatory pressures used to quantify hemodynamic performance.
      Development of the fourth, for PAP, was the subject of this work. We developed a
      noninvasive, in vitro method of estimating mean PAP in the Jarvik-7 TAH (Symbion,
      Inc, Salt Lake City, UT) recipient. This information was obtained by analyzing
      the relationship between the pneumatic right drive pressure (RDP) and PAP
      waveforms produced by a Jarvik-7 (70 ml) connected to a Donovan mock circulation
      and driven by a Utahdrive System IIIe Controller (Symbion, Inc, Salt Lake City,
      UT). Total artificial heart driver parameters (i.e., heart rate, percent systole,
      and vacuum) were manipulated to produce a range of ventricular filling volumes
      (FV), from 40 to 60 ml, for three distinct states of the pulmonary vasculature:
      hypotensive, normal, and hypertensive. A unique multiple-linear regression
      equation was derived for each FV from the RDP-PAP relationship exhibited under
      these conditions. Comparison of computed estimates of PAP with actual
      measurements showed overall average correlations of greater than 0.92, with a
      standard error of the estimate of less than 1.9 mm Hg. The mean difference
      between actual and computed PAP measurements was -0.03 +/- 2.0 Hg. Estimations
      were accurate within 8.5% of true PAP values. Additional experimentation revealed
      that while the RDP-PAP relationships are dependent on FV, they are independent of
      the manner in which FV was obtained. Estimates proved useful over the clinical
      operating range of the pneumatic heart driver, as well as over the normal
      physiologic range of PAP in the human. This method is readily applicable to a
      computer-based monitoring implementation, although its effectiveness needs to be
      demonstrated in vivo.

PMID- 1744674
TI  - Noninvasive Doppler blood pressure monitoring in the monoplace hyperbaric
      chamber.
AB  - We describe a noninvasive method of monitoring blood pressure in the monoplace
      hyperbaric chamber. A standard blood pressure cuff was placed on the patient's
      arm. A Doppler probe, linked to an ultrasonic Doppler flow detector outside the
      chamber, was secured over the patient's radial artery. Cuff inflation tubing and
      the Doppler probe wires were passed into the chamber by modifying a standard
      disposable hyperbaric intravenous pass-through. Blood pressure readings were
      determined by inflating and slowly deflating the cuff from outside the chamber
      while observing the sphygmomanometer within the chamber and listening for the
      first audible flow signal from the Doppler detector, corresponding to the
      systolic blood pressure. To minimize the risk of fire in the oxygen-filled
      monoplace hyperbaric chamber, the patient, Doppler detector, and chamber were
      grounded. Doppler readings obtained from nine normal subjects whose arterial
      pressures were being measured with indwelling radial arterial catheters (approved
      as part of another study by the hospital's Investigational Review Board) compare
      closely with the subject's blood pressures measured with this noninvasive method:
      114 +/- 7.6 mm Hg (mean +/- 1 SD) compared to 112 +/- 8.1 mm Hg, respectively (n
      = 92 measurements in 8 subjects). We conclude that this noninvasive method of
      monitoring blood pressure within the monoplace hyperbaric chamber is accurate and
      suitable for monoplace clinical purposes.

PMID- 1744675
TI  - Erroneous mass spectrometer data caused by a faulty patient sampling tube: case
      report and laboratory study.
AB  - We report an error due to faulty sampling of gas for mass spectrometry by side
      stream analysis that occurred during a general anesthetic for a surgical
      procedure. Two defects in the patient sampling tube were present. First, a crack
      was discovered in the polyvinylchloride tubing at the connection to the patient
      circuit. Second, secretions had accumulated in the end of the tubing that caused
      a partial obstruction to gas sampling. This combination promoted the
      contamination of respiratory gases sampled from the anesthesia circuit with
      entrained room air. This entrainment, however, occurred only during exhalation
      while ventilation was being controlled with a descending (during exhalation)
      bellows. The particular sampling error was reproduced and characterized in a mock
      circuit to simulate the sampling tube defects. It was determined that both a leak
      and a partial obstruction were necessary conditions for the sampling error to
      exist.

PMID- 1744676
TI  - Eliminating diathermy-induced artifacts during intraoperative monitoring of
      somatosensory-evoked potentials: a hardware solution.
AB  - Somatosensory-evoked potentials (SEPs) recorded intraoperatively are often
      contaminated by artifacts arising from unipolar diathermy. This increases
      variability in serial SEP recordings and decreases the reliability of SEPs for
      intraoperative monitoring. Rejection of single sweeps on the basis of a voltage
      criterion can only partially prevent the inclusion of sweeps containing
      artifacts. We describe a low-cost hardware system that will halt SEP acquisition
      automatically before diathermy becomes active. Activation of the diathermy switch
      will halt SEP acquisition by sending a digital inhibit signal to the evoked
      potential machine via a fiberoptic cable. A timer delays the activation of the
      diathermy until the last sweep has been completed. To allow the
      electroencephalographic amplifiers to recover from any overload condition
      resulting from the high-voltage/high-frequency input during diathermy,
      acquisition is resumed only after a user-selectable time interval. The system was
      evaluated in 50 patients. It effectively interrupted SEP acquisition each time
      diathermy was used. By eliminating diathermy noise from the averaged waveforms,
      the system will allow evoked potential monitoring even during periods of
      intensive use of diathermy.

PMID- 1744677
TI  - Cerebral oxygen monitoring with near infrared spectroscopy: clinical application
      to neonates.
AB  - Near infrared spectroscopy is a new noninvasive optical method for bedside
      monitoring of cerebral oxygenation. It uses differential absorbance of near
      infrared light to assess relative changes in the oxidation-reduction state of
      cytochrome aa3, as well as changes in the amounts of oxyhemoglobin,
      deoxyhemoglobin, and blood volume in the monitored field. Although this technique
      is applicable to all ages and sizes of patients and to multiple clinical
      settings, the majority of clinical studies to date have focused on the neonate.
      These studies have demonstrated its potential for advancing neonatal care and in
      understanding how diseases and therapies affect cerebral oxygenation. This paper
      reviews the near infrared spectroscopy technique and summarizes its potential
      applications in the field of neonatal intensive care.

PMID- 1744678
TI  - A regularity statistic for medical data analysis.
AB  - A new statistic has been developed to quantify the amount of regularity in data.
      This statistic, ApEn (approximate entropy), appears to have potential application
      throughout medicine, notably in electrocardiogram and related heart rate data
      analyses and in the analysis of endocrine hormone release pulsatility. The focus
      of this article is ApEn. We commence with a simple example of what we are trying
      to discern. We then discuss exact regularity statistics and practical
      difficulties of using them in data analysis. The mathematic formula development
      for ApEn concludes the Solution section. We next discuss the two key input
      requirements, followed by an account of a pilot study successfully applying ApEn
      to neonatal heart rate analysis. We conclude with the important topic of ApEn as
      a relative (not absolute) measure, potential applications, and some caveats about
      appropriate usage of ApEn. Appendix A provides example ApEn and entropy
      computations to develop intuition about these measures. Appendix B contains a
      Fortran program for computing ApEn. This article can be read from at least three
      viewpoints. The practitioner who wishes to use a "black box" to measure
      regularity should concentrate on the exact formula, choices for the two input
      variables, potential applications, and caveats about appropriate usage. The
      physician who wishes to apply ApEn to heart rate analysis should particularly
      note the pilot study discussion. The more mathematically inclined reader will
      benefit from discussions of the relative (comparative) property of ApEn and from
      Appendix A.

PMID- 1744679
TI  - Intra-aortic balloon pump prevents transtracheal Doppler endotracheal tube
      measurements of cardiac output.

PMID- 1744681
TI  - Society for Neuroanesthesia and Critical Care bibliography.

PMID- 1744680
TI  - Pulse oximetry during transport of the critically ill.

PMID- 1744682
TI  - Computerization of anesthesia information management--users' perspective.

PMID- 1744683
TI  - Glutathione levels and chemosensitizing effects of buthionine sulfoximine in
      human malignant glioma cells.
AB  - Biopsy samples and cultured cells derived from them were obtained from 39
      patients with malignant glioma and were analyzed for 1) glutathione (GSH)
      content; 2) sensitivity to 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and/or
      nitrogen mustard (HN2) treatment and 3) the effect of buthionine sulfoximine
      (BSO) treatment on BCNU and/or HN2 cytotoxicity. The average GSH concentration of
      biopsy specimens was lower than those of cultured cells (2.36 +/- 0.44 vs. 11.42
      +/- 2.32 nmol/10(6) cells). While some of the tumor specimens were sensitive to
      either BCNU or HN2, the majority were resistant to both. However, 8 of 23 tumors
      tested showed enhanced sensitivity to BCNU following treatment with BSO. Five of
      17 tumors were similarly sensitized to HN2 by BSO. These results suggest that BSO
      chemosensitization may be of value for certain patients and that screening assays
      may help identify treatment-sensitive individuals.

PMID- 1744684
TI  - Primary glial tumor patients treated by combining cis-platin and etoposide.
AB  - Thirty eight patients with malignant gliomas (27 GBM and 11 AA) were treated with
      up to 7 cycles of CDDP + VP16 every month after surgery. Chemotherapy was planned
      as two cycles before and 5 cycles after radiation (42 Gy) using a three times
      daily fractionation schedule. No severe toxicity was observed. The object of our
      study was to investigate the antitumor effectiveness by combining CDDP plus VP16
      against primary malignant glial tumors. The time to tumor progression (TTP) and
      survival time (ST) of the GBM patients in the present study were 38.5 and 68.5
      weeks respectively. The TTP of the AA patients was 73 weeks and the ST was not
      calculated as most patients are still alive. By the 18th. month after surgery,
      38% of GBM and 74% of AA patients treated with (CDDP + VP16) are still alive.
      This study demonstrates that the combination of CDDP and VP16 is effective in
      patients with malignant gliomas.

PMID- 1744685
TI  - Intravascular lymphomatosis (neoplastic angioendotheliosis) of the central
      nervous system: case report and literature review.
AB  - A 63-year-old woman developed gradual slowness, recurrent multifocal deficits,
      severe constitutional symptoms and hypopituitarism which progressed to death over
      2.5 months. Elevation in lactico dehydrogenases was the main biological
      abnormality. Necropsy showed an intravascular malignant proliferation which
      proved to be a lymphoma of B-lineage. In order to better define diagnostic
      criteria, we reviewed previously reported cases of intravascular lymphomatosis of
      the central nervous system. A strategy for establishing the diagnosis is
      proposed.

PMID- 1744687
TI  - Inhibition of glucocorticoid secretion by the hippocampal formation in the
      primate.
AB  - Inhibition of the adrenocortical axis by glucocorticoids (GCs) occurs at both
      hypothalamic and suprahypothalamic sites. In the rat, the hippocampus has been
      shown to be an essential suprahypothalamic site. The present study shows that the
      hippocampal system serves a similar role in the nonhuman primate. Bilateral
      lesions that included the hippocampal formation and the parahippocampal cortex;
      the hippocampal formation, parahippocampal cortex, and the amygdala; or the
      fornix all produced GC hypersecretion in cynomolgus monkeys. The hypersecretion
      occurred throughout the day. Moreover, these lesions were also associated with
      dexamethasone resistance (i.e., GC hypersecretion following administration of the
      synthetic GC dexamethasone). The hypersecretion could not be attributed to acute
      surgical trauma, because neither circumscribed lesions of the amygdala nor
      conjoint lesions of the perirhinal and parahippocampal cortex produced
      adrenocortical abnormalities. Finally, in agreement with data derived from the
      rat, the GC hypersecretion following hippocampal lesions was transient. Secretory
      activity returned to normal levels by 6-15 months in all operated groups. Thus,
      the primate hippocampal system appears to share some neuroendocrine functions
      with the rodent.

PMID- 1744688
TI  - The molecular and pharmacological properties of muscarinic cholinergic receptors
      expressed by rat sweat glands are unaltered by denervation.
AB  - Previous studies have indicated that denervation of adult rodent sweat glands
      results in the loss of secretory responsiveness to muscarinic agonists. To
      elucidate the molecular basis of this loss, we have characterized the muscarinic
      cholinergic receptor present in adult rat sweat glands and examined the effects
      of cholinergic denervation on its properties and expression. When homogenates of
      gland-rich tissue from adult animals were assayed with [N-methyl-3H]-scopolamine,
      a high-affinity muscarinic antagonist, the concentration of muscarinic receptors
      was 301 fmol/mg protein and the affinity was 131 pM. Autoradiographic analysis
      demonstrated that ligand binding sites were detectable only on glands. In
      competition studies with well-characterized muscarinic agents, the receptor
      exhibited typical muscarinic pharmacology. Further investigation with the
      selective muscarinic antagonists 4-diphenylacetoxy-N-methylpiperidine methiodide,
      pirenzepine, and AF DX-116 revealed that the sweat gland receptor belongs to the
      M2 glandular pharmacological subtype. In situ hybridization histochemistry with
      receptor subtype-specific oligonucleotide probes indicated that rat sweat glands
      express the m3 molecular receptor subtype. Seven days after sciatic nerve
      transection, when denervated glands were compared to those on the contralateral
      unoperated side, there was no significant difference either in the concentration
      or affinity of muscarinic binding sites or in receptor density or distribution.
      Furthermore, the molecular subtype and the level of its expression were
      unchanged. Thus, it appears that muscarinic binding sites and m3 receptor mRNA
      are present in denervated sweat glands that are unresponsive to muscarinic
      stimulation. These results suggest that the regulation of responsiveness occurs
      at a point distal to the expression of muscarinic receptors.

PMID- 1744689
TI  - Developmental expression of muscarinic cholinergic receptors and coupling to
      phospholipase C in rat sweat glands are independent of innervation.
AB  - During development, the innervation of rat sweat glands undergoes a striking
      change from noradrenergic to cholinergic function. The acquisition of secretory
      responsiveness by the glands is temporally correlated with the appearance of
      cholinergic properties. In addition, responsiveness fails to appear in the
      absence of innervation. To investigate the basis of the onset of functional
      transmission and secretory responsiveness and its possible relationship to
      innervation, we analyzed the development of muscarinic cholinergic receptors in
      sweat glands, examined their expression in the glands of adult rats
      sympathectomized at birth, and assayed the ability of muscarinic agonists to
      increase phosphoinositide (PI) turnover. Autoradiographic and in situ
      hybridization analysis revealed that muscarinic ligand binding sites were first
      detectable as glands begin to form on postnatal day 4 (P4). Between P4 and P14,
      receptor concentration increased in parallel with mRNA for the m3 receptor
      subtype. On P14, the concentration of ligand binding sites approached adult
      levels, although only a small proportion of glands at this age secrete in
      response to nerve stimulation or cholinergic agonists. When the pharmacological
      properties of muscarinic receptors in sweat glands of adult rats sympathectomized
      at birth were compared to those of normal glands, the concentration and affinity
      determined with [N-methyl-3H]-scopolamine and the Ki values determined with the
      subtype-selective muscarinic antagonists 4-DAMP, pirenzepine, and AF DX-116 were
      similar. In addition, the molecular subtype was unchanged as was the level of m3
      message. Studies of PI turnover in response to muscarinic stimulation indicated
      that the receptors expressed in sweat glands isolated from sympathectomized and
      acutely denervated, as well as control, rats were functionally coupled to
      phospholipase C. The absence of sympathetic innervation therefore does not appear
      to influence either the development of muscarinic receptors or their coupling to
      PI turnover. Our results suggest that functional sympathetic cholinergic
      innervation plays a central role in the development and maintenance of secretory
      function at a step distal to signal transduction across the cell membrane.

PMID- 1744690
TI  - Processing of beta-amyloid precursor protein in microglia and astrocytes favors
      an internal localization over constitutive secretion.
AB  - Microglial cells and astrocytes are closely associated with nearly all compact
      deposits of the amyloid beta-protein found in the senile plaques characteristic
      of Alzheimer's disease and trisomy 21. The biosynthesis and metabolic fate of the
      beta-amyloid precursor protein (beta APP) in astrocytes has not been
      characterized, and its identification in microglia has not been described. Here,
      we report the expression of beta APP by astrocytes and microglia in primary
      cultures of cerebral cortex from newborn rats. Using metabolic labeling followed
      by immunoprecipitation, we show that both astrocytes and microglia express
      substantial amounts of the major isoforms of beta APP. This is confirmed by PCR
      mediated amplification of the corresponding mRNAs, showing that all three major
      transcripts (beta APP695, beta APP751, and beta APP770) are present in relatively
      equal amounts. Despite rapid turnover of the precursor, astrocytes and microglia
      show a reduced production of soluble fragments of beta APP compared to cells
      transfected with beta APP cDNAs. The relative amount of soluble beta APP
      molecules generated is both cell type and isoform specific. Immunocytochemistry
      reveals that full-length beta APP is located in internal membranous vesicles,
      with only very little insertion at the cell surface. The latter data are in
      agreement with the reduced ability of microglia and astrocytes to cleave the beta
      APP into soluble derivatives. Our findings indicate that both astrocytes and
      microglia strongly express all three major forms of beta APP but apparently
      process these molecules by an alternative pathway that generates very small
      amounts of soluble beta APP. The immunocytochemical localization and the
      biochemical data lead to the suggestion that beta APP may not function
      principally as a cell surface or secreted protein in vivo but may have an
      important intracellular function.

PMID- 1744691
TI  - A computational model for the overall pattern of ocular dominance.
AB  - In layer IV of the primary visual cortex, in both the macaque monkey and the cat,
      geniculocortical terminals representing the two eyes are segregated into
      alternating zones known as ocular dominance bands. Viewed tangentially, in the
      monkey these bands take the form of a series of branching parallel stripes that
      run roughly perpendicular to the border of striate cortex. In the cat, the
      overall ocular dominance pattern consists of irregularly branching, beaded bands
      that exhibit no predominant orientation. If the striking differences in the
      appearance of these two patterns reflect important differences in the basic rules
      governing cortical ocular dominance, then this poses a problem for attempts to
      formulate general principles of visual cortical organization. However, it has
      been suggested that the differences in the appearance of the ocular dominance
      patterns in these two species could result simply from known differences in the
      boundary conditions of their geniculocortical pathways. This article describes
      the formulation and testing of a single computational model that accurately
      predicts the quite dissimilar ocular dominance patterns in cats and monkeys. This
      model also generalizes to predict the different ocular dominance patterns
      observed in young and old three-eyed frogs, supporting the notion that the
      overall pattern of ocular dominance is governed by a common set of rules. The
      significance of these results is discussed in terms of previous models, which
      have focused largely on local processes underlying the development of ocular
      dominance segregation. Although the present model is not a developmental one, it
      does shed some light on potential mechanisms for establishing retinotopy in
      striate cortex and on possible developmental relationships between the
      geniculostriate pathway and intrinsic modularity of the striate cortex.

PMID- 1744686
TI  - Neuro-oncology index and review (adult primary brain tumors). Radiotherapy,
      chemotherapy, immunotherapy, photodynamic therapy.

PMID- 1744692
TI  - Vacuous jaw movements and feeding deficits in rats with ventrolateral striatal
      dopamine depletion: possible relation to parkinsonian symptoms.
AB  - A series of experiments examined the effects of regional dopamine depletions
      produced by intrastriatal injections of 6-hydroxydopamine on voluntary and
      involuntary movements in rats. Depletion of dopamine in the ventrolateral
      striatum produced a substantial decrease in food intake, from which the animals
      recovered. Rats with dopamine depletions in anteroventromedial or dorsolateral
      striatum did not have significant feeding deficits. Rats with ventrolateral
      dopamine depletions showed no deficits in locomotor activity or rearing behavior;
      however, depletions of dopamine in dorsolateral striatum significantly reduced
      rearing. Vacuous jaw movements that resemble chewing were produced by dopamine
      depletion in the ventrolateral striatum, but not the anteroventromedial or
      dorsolateral striatum. Systemic administration of haloperidol (0.4 mg/kg)
      increased vacuous chewing responses in dopamine-depleted and control rats. Thus,
      vacuous chewing responses can result from reduced functional activity of striatal
      dopamine, and these responses share some characteristics with human parkinsonian
      symptoms. In addition, these data support the notion that the neostriatum is
      functionally heterogeneous and that the ventrolateral region is particularly
      important for oral motor control.

PMID- 1744693
TI  - Influence of spinal cord stimulation on the innervation pattern of muscle fibers
      in vivo.
AB  - In chick embryo, chronic stimulation of the brachial spinal cord at a fast rhythm
      from days 7 to 18 of development induced an increase in AChE activity sites and
      ACh receptor (AChR) clusters in slow anterior latissimus dorsi (ALD) muscle. Most
      AChR clusters and AChE spots were contacted by nerve endings. A previous study
      showed that such spinal cord stimulation causes changes in ALD muscle properties,
      especially the appearance of a high proportion of fast type II fibers (Fournier
      Le Ray et al., 1989). Analysis of the synaptic pattern in different fiber types
      of experimental ALD muscle indicated a decrease in the distance between
      successive AChE spots in slow type III fibers compared to controls, whereas the
      intersynaptic distance in fast type II fibers was very similar to that in the
      rare fast fibers developing in control ALD. Fast fibers of experimental muscles
      exhibited less AChR than did slow fibers. The increased number of neuromuscular
      junctions in ALD muscle after spinal cord stimulation appeared to be
      preferentially located in slow fibers. Electron microscopy showed no change in
      the number of axons in ALD nerve after spinal cord stimulation. The activity
      imposed on brachial motoneurons apparently caused terminal sprouting of ALD nerve
      in target muscle, thus accounting for the increase in neuromuscular contacts in
      ALD muscle fibers. Differences in the distribution of nerve contacts indicate
      that the type of muscle fiber innervated may play a critical role in the synaptic
      pattern during chick embryogenesis.

PMID- 1744694
TI  - Muscarinic agonists activate an inwardly rectifying potassium conductance in
      medial pontine reticular formation neurons of the rat in vitro.
AB  - Intracellular recordings were obtained from neurons in pontine reticular
      formation slices of the rat to characterize a cholinergic-gated increase in
      conductance. The conductance increase was associated with a hyperpolarization of
      the membrane potential and with an outward current under voltage-clamp
      conditions. Current-voltage relations and potassium substitution experiments
      indicated mediation by a change in permeability, primarily to potassium. This
      potassium conductance exhibited inward rectification at membrane potentials
      negative to resting potential, a novel finding for cholinergic actions in CNS
      neurons. Further characterization of this inwardly rectifying potassium
      conductance revealed marked sensitivity to low concentrations of barium.
      Cholinergically evoked currents were relatively unaffected by the presence of
      extracellular cesium. Cholinergic effects persisted in TTX. The outward currents
      elicited by carbachol or methacholine were blocked only by high concentrations of
      pirenzepine, a selective antagonist of the M1 muscarinic receptor. The
      interaction between these agents is quantitatively consistent with cholinergic
      action at postsynaptic muscarinic receptors of the non-M1 subtype.

PMID- 1744695
TI  - Normally unused positional cues guide ectopic afferents in the leech CNS.
AB  - Central projections from peripheral sensory neurons segregate into distinct,
      ventrally positioned longitudinal tracts within the segmental ganglia of the
      leech Hirudo medicinalis. As documented here, there is an additional tract in the
      neuropils of the fifth and sixth body ganglia, located at the lateral margin and
      formed by afferent axons (the "sex afferents") originating from sensory neurons
      located in the male and female genitalia. Ablation of the genitalia results in
      the complete absence of this additional tract. We asked (1) whether segmental
      differences exist in the distribution of pathway cues available to the sex
      afferents, and (2) whether central pathway selection by these axons is specific.
      We transplanted the primordia of the male genitalia to several ectopic positions
      posterior to the sixth body segment and labeled the ectopic sex afferents in
      order to examine their paths in the CNS. In about 50% of the experimental
      animals, afferent axons originating in the transplanted tissue segregated into a
      distinct lateral fiber bundle within the neuropil of a nearby ganglion, in a
      position corresponding to their normal one in the sex ganglia. The sex afferents
      therefore find their normal pathways even in the ganglia of inappropriate
      segments, although these pathways are not used by any other afferents in these
      ganglia. We propose, therefore, that the positional cues employed by afferent
      axons to select appropriate pathways in the ganglionic neuropil are expressed in
      all segments of the leech CNS, regardless of whether such cues are normally used
      by afferent axons in each segment.

PMID- 1744696
TI  - Testosterone differentially regulates the regenerative properties of injured
      hamster facial motoneurons.
AB  - We have previously demonstrated that systemic administration of testosterone
      accelerates functional recovery, as measured behaviorally, from facial paralysis
      induced by facial nerve crush axotomy in gonadectomized adult male hamsters. In
      this investigation, the hypothesis that testosterone enhances return of motor
      function by increasing the rate of axonal regeneration following injury was
      tested using fast axonal transport of radioactively labeled proteins to assess
      facial nerve regeneration. Adult castrated and intact males, and intact females,
      were subjected to right facial nerve crush axotomy at the stylomastoid foramen.
      One-half of the axotomized animals in each group received subcutaneous implants
      of testosterone, with the remainder of the animals sham implanted. Systemic
      administration of testosterone resulted in a 26-30% increase in the rate of
      regeneration of the fastest growing population of axons in the male experimental
      groups, regardless of whether the animal was castrated or not. This rate increase
      is similar to that observed in the conditioning lesion paradigm utilized by
      others. In the females, testosterone had a significant, but less pronounced,
      effect on the rate of axonal regeneration, which may be due in part to inherent
      gender-related differences in regenerative properties of facial motoneurons. A
      surprising finding of this study was that no shortening of the delay of sprout
      formation by testosterone was observed across the various experimental groups.
      These data suggest that the mechanism by which gonadal steroids act in the
      injured nervous system is partly through the differential regulation of the
      regenerative properties of the injured cell, presumably via hormone receptor
      mediated action at the level of the neuronal genome.

PMID- 1744697
TI  - Spontaneous action potential activity and synaptic currents in the embryonic
      turtle cerebral cortex.
AB  - We used loose-patch and whole-cell recording techniques to study the development
      of spontaneous action potential activity and spontaneous excitatory and
      inhibitory synaptic currents in embryonic neurons in the cerebral hemispheres of
      turtles. Sporadic action potential activity appeared early in development at
      stage 17, soon after morphologically identifiable pyramidal and nonpyramidal
      neurons were first observed in the cortex. As the cortical plate matured in
      midembryonic stages, action potential activity became more regular and fell into
      one of two distinct patterns, tonic and intermittent high-frequency firing.
      Spontaneous excitatory and inhibitory postsynaptic currents (EPSCs and IPSCs)
      appeared at developmental stages 18 and 20, respectively, after action potential
      activity was established. EPSCs and IPSCs exhibited characteristic ionic
      dependence and pharmacology throughout development. EPSCs reversed in direction
      at the equilibrium potential for cations and were sensitive to 6-cyano-7
      nitroquinoxaline-2,3-dione, an antagonist of the non-NMDA type of glutamate
      receptor. IPSCs reversed at the equilibrium potential for chloride and were
      sensitive to bicuculline methiodide, a GABAA receptor antagonist. Spontaneous
      synaptic currents differed in their time course of development and in waveform
      parameters. Spontaneous synaptic currents differed in their time course of
      development and in waveform parameters. Spontaneous EPSCs appeared at stage 18
      and increased progressively in frequency, from 0.2 +/- 0.1 Hz at stage 20 to 3.2
      +/- 2.0 Hz at stage 26 (hatching), while spontaneous IPSCs appeared at stage 20
      and surpassed EPSCs in frequency, increasing to 7.1 +/- 1.6 Hz at stage 26. EPSCs
      exhibited stable amplitudes during development, with a mean conductance of 126 +/
      20 pS at stage 26, while IPSCs increased in mean amplitude, from 180 +/- 12 pS
      at stage 18 to 260 +/- 44 pS at stage 26. The rise time to peak conductance of
      both types of synaptic currents increased with developmental time, for EPSCs
      increasing from 1.5 +/- 0.5 msec at stage 20 to 2.7 +/- 0.6 msec at stage 26 and
      for IPSCs increasing from 2.9 +/- 0.2 msec at stage 18 to 6.2 +/- 0.8 msec at
      stage 26. While the decay time constants increased for EPSCs, from 3.9 +/- 1.2
      msec at stage 20 to 8.7 +/- 2.3 msec at stage 26, decay time constants for IPSCs
      showed a decreasing trend from 24.0 +/- 5.2 msec at stage 18 to 18.4 +/- 5.3 msec
      at stage 26. The excitatory and inhibitory synaptic currents were sensitive to
      the sodium channel blocker TTX and were thus dependent, in part, on spontaneous
      action potential activity.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1744698
TI  - Antagonism of central growth hormone-releasing factor activity selectively
      attenuates dark-onset feeding in rats.
AB  - Exogenous growth hormone-releasing factor (GRF) has been shown to activate
      feeding by central mechanisms involving the suprachiasmatic nucleus/medial
      preoptic area (SCN/MPOA). Until now, however, the role played by endogenous GRF
      in the SCN/MPOA in naturally occurring eating has remained unknown. To
      investigate this, the effects of SCN/MPOA injections of GRF antiserum (AS-GRF) on
      feeding in rats were studied. In light of SCN involvement in the control of
      circadian rhythms, AS-GRF was tested during the light and dark phases of the
      photoperiod. Results indicated that AS-GRF significantly attenuated dark-onset
      feeding but had no effect on feeding during the mid-dark, mid-light, or light
      onset periods. These results suggest that endogenous GRF does play a role in
      naturally occurring feeding and that it may be involved in the circadian
      organization of feeding.

PMID- 1744699
TI  - Sodium-bicarbonate cotransport in retinal Muller (glial) cells of the salamander.
AB  - An electrogenic Na+/HCO3- cotransport system was studied in freshly dissociated
      Muller cells of the salamander retina. Cotransporter currents were recorded from
      isolated cells using the whole-cell, voltage-clamp technique following the block
      of K+ conductance with external Ba2+ and internal Cs+. At constant pHo, an
      outward current was evoked when extracellular HCO3- concentration was raised by
      pressure ejecting a HCO3(-)-buffered solution onto the surface of cells bathed in
      nominally HCO3(-)-free solution. The HCO3(-)-evoked outward current was reduced
      to 4.4% of control by 0.5 mM DIDS (4,4'-diisothiocyanatostilbene-2,2'
      disulfonate), to 28.8% of control by 2 mM DNDS (4,4'-dinitrostilbene-2,2'
      disulfonate), and to 28.4% of control by 2 mM harmaline. Substitution of choline
      for Na+ in bath and ejection solutions reduced the response to 1.3% of control.
      Bicarbonate-evoked currents of normal magnitude were recorded when methane
      sulfonate was substituted for Cl- in bath, ejection, and intracellular solutions.
      Similarly, an outward current was evoked when extracellular Na+ concentration was
      raised in the presence of HCO3-. The Na(+)-evoked response was reduced to 16.2%
      of control by 2 mM DNDS and was abolished by removal of HCO3- from bath and
      ejection solutions. Taken together, these results (block by stilbenes and
      harmaline, HCO3- and Na+ dependence, Cl- independence) indicate that salamander
      Muller cells possess an electrogenic Na+/HCO3- cotransport system. Na+/HCO3-
      cotransporter sites were localized primarily at the endfoot region of Muller
      cells. Ejection of HCO3- onto the endfoot evoked outward currents 10 times larger
      than currents evoked by ejections onto the opposite (distal) end of the cell. The
      reversal potential of the cotransporter was determined by DNDS block of
      cotransport current. In the absence of a transmembrane HCO3- gradient, the
      reversal potential varied systematically as a function of the transmembrane Na+
      gradient. The reversal potential was -0.1 mV for a [Na+]o:[Na+]i ratio of 1:1 and
      -25.2 mV for a Na+ gradient ratio of 7.4:1. Based on these values, the estimated
      stoichiometry of the cotransporter was 2.80 +/- 0.13:1 (HCO3-:Na+). Possible
      functions of the glial cell Na+/HCO3- cotransporter, including the regulation of
      CO2 in the retina and the regulation of cerebral blood flow, are discussed.

PMID- 1744700
TI  - Myelin sheath survival following axonal degeneration in doubly myelinated nerve
      fibers.
AB  - Axonal contact plays a critical role in initiating myelin formation by Schwann
      cells. However, recent studies of "double myelination" have indicated that myelin
      maintenance continues in Schwann cells completely displaced from physical contact
      with the axon. This raises the possibility either that diffusible trophic factors
      are produced by the axon, or that the axon is not required for myelin maintenance
      by these displaced Schwann cells. To test these hypotheses, the axons involved in
      double myelination in the mouse superior cervical ganglion (SCG) were transected
      surgically by a transganglionic lesion. The inferior pole of the SCG was resected
      to limit axonal regeneration. This method produced a typical Wallerian pattern of
      degeneration in the superior pole, without compromising the blood supply or
      introducing nonspecific trauma. EM analysis at 1 and 5 d postoperatively showed
      that initially the axon degenerated, followed by breakdown of the inner myelin
      sheath. In those configurations where the outer Schwann cell was only partly
      displaced from the axon, the outer myelin sheath degenerated simultaneously.
      However, in completely displaced internodes the outer sheath survived
      degeneration of the axon and inner sheath. Outer internodes remained intact for
      at least 5 weeks after transection (the longest time point in this study), at
      which time they enclosed reorganized processes of the inner Schwann cells, their
      basal lamina, and numerous collagen fibrils. Axonal regeneration within surviving
      outer internodes was rare and was characterized by the development of typical
      Remak ensheathment by the inner Schwann cells. We conclude that in the mouse SCG,
      myelin maintenance does not depend on the continued presence of the axon. These
      data suggest further that myelin breakdown in Wallerian degeneration may be
      initiated by mechanisms other than absence of a viable axon.

PMID- 1744701
TI  - Contending with the elements.

PMID- 1744702
TI  - Seeking swifter approvals for new radioactive tracers.

PMID- 1744704
TI  - The development and application of mathematical models in nuclear medicine.

PMID- 1744703
TI  - Noninvasive quantification of hepatic arterial blood flow with nitrogen-13
      ammonia and dynamic positron emission tomography.
AB  - To determine if dynamic PET and 13N-ammonia can be utilized to quantitate
      regional hepatic arterial blood flow (rHABF) noninvasively, eight anesthetized
      dogs and eight human volunteers were examined with PET following intravenous
      bolus administration of 13N-ammonia. Hepatic time-activity curves and the
      arterial input function were derived from ROIs drawn over the right lateral
      superior segment of the liver and the left ventricle of the heart, respectively.
      rHABF was quantitated using a two-compartment model, with comparison with
      simultaneously acquired microsphere blood flow measurement (MS) in the canine
      studies. rHABF derived from canine dynamic PET with 13N-ammonia were linearly
      related to microsphere values (rHABF = 0.92 x MS + 0.04, r = 0.98), with a mean
      of 0.40 ml/min/g. The results in eight normal volunteers gave a rHABF value of
      0.26 +/- 0.07 ml/min/g. Dynamic 13N-ammonia hepatic PET allows noninvasive
      quantification of rHABF.

PMID- 1744705
TI  - Detection of infection in postoperative orthopedic patients with technetium-99m
      labeled monoclonal antibodies against granulocytes.
AB  - A prospective study of 106 orthopedic patients was performed for the detection of
      infection in the early postoperative stage using 99mTc-labeled murine Mabs
      directed against epitopes on granulocytes. Accuracy was 81% in the hips (n = 26),
      81% in the thigh (n = 21), 84% in the knee (n = 19), and 100% in the tibia (n =
      27). The technique did not work well in the spine where false-negative results
      were observed in the three patients studied. One patient suffered transient
      swelling of the eyelids following injection. Optimal imaging results were
      obtained 2-6 hr postinjection.

PMID- 1744706
TI  - Assessment of right ventricular overload by a thallium-201 SPECT study in
      children with congenital heart disease.
AB  - Thallium-201 planar and SPECT studies were performed in 38 children with
      congenital heart disease using high-resolution three-headed SPECT. The 201Tl
      total or average right ventricular-to-left ventricular (RV/LV) count ratios were
      measured by summed short-axis images. In the planar study, the RV/LV systolic
      pressure ratio correlated with 201Tl RV/LV average count ratio (r = 0.91) better
      than that in the SPECT study (r = 0.78). However, in the SPECT study, patients
      with atrial septal defect (n = 9), ventricular septal defect (n = 13), tetralogy
      of Fallot and double outlet right ventricle (n = 6) showed a characteristic
      distribution in the plot of RV/LV pressure ratio versus 201Tl RV/LV total count
      ratio. A prospective study showed that the RV/LV average count ratio was a good
      predictor of RV/LV pressure ratio (n = 19, r = 0.91). Three-headed SPECT is
      useful for pediatric cardiac studies, and the overload types found in congenital
      heart disease seemed to be differentiated by the SPECT study.

PMID- 1744707
TI  - Clinical evaluation of a scintigraphic method for diagnosing
      inflammations/infections using indium-111-labeled nonspecific human IgG.
AB  - This study was undertaken as part of a Phase II study to assess the sensitivity
      and safety of 111In-DTPA-human IgG, an imaging agent for the detection of
      inflammations and/or infections. Forty patients with infection/inflammation on
      the basis of clinical findings, microbiologic results, and/or the basis of
      results from other imaging modalities were studied. For evaluation of
      sensitivity, whole-body images were obtained at 6-12 hr (early) and 20-28 hr
      (delayed) postinjection and occasionally at 48 hr. No adverse reactions were
      recorded in any of the 40 patients studied. Positive results were obtained in 37
      of 37 evaluable subjects (100%). The test appears to be a promising method for
      the detection of inflammation and/or infection.

PMID- 1744708
TI  - A quantitative model of technetium-99m-DTPA-galactosyl-HSA for the assessment of
      hepatic blood flow and hepatic binding receptor.
AB  - Technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin
      (99mTc-GSA) was studied in normal volunteers and in patients with impaired liver
      function. The extrapolation approach originated the absolute dose of 99mTc-GSA in
      blood and the hepatic blood volume. The heart and liver regression curves were
      simultaneously fractionated into the three compartments (extrahepatic blood,
      hepatic blood and hepatocytes). Four differential equations were integrated with
      the six parameters as variables, and the smallest residual sum of squares was
      obtained by the damping Gauss-Newton method. The result of hepatic blood flow was
      1603 +/- 144 (ml/min) in normal controls, which was compatible with previously
      reported values. Maximal removal rate (mg/min) showed statistically significant
      differences between the normal volunteers and patients with chronic hepatitis or
      liver cirrhosis. Our kinetic model of 99mTc-GSA can be used in the evaluation of
      liver function.

PMID- 1744709
TI  - The role of bone scintigraphy in the evaluation of talar dome fractures.
AB  - We undertook a retrospective study of 122 patients with ankle pain to determine
      the accuracy of bone scintigraphy using 99mTc-methylene diphosphonate (MDP) for
      detection of osteochondral talar dome fractures (OCTDF). Plain radiographs, which
      were available in 97 patients, had not revealed any abnormality in the talar
      dome. Bone scintigraphy was followed by CT, which was considered to be the
      reference test in diagnosing OCTDF. Analysis of our data showed that when the
      bone scan findings in the two highest confidence categories (high and moderate
      probability) were accepted as abnormal, the sensitivity and the specificity of
      the test were 0.94 and 0.76, respectively. Although CT is mandatory to establish
      the stage of OCTDF, it cannot be used routinely due to its high cost. Bone
      scintigraphy appears to be a good screening procedure that will identify patients
      who are likely to benefit from further radiographic studies such as CT. These
      findings are subject to further confirmation in a prospective study.

PMID- 1744710
TI  - Reference values for red cell survival times.
AB  - The first purpose of this investigation was to investigate in 35 young normal
      male subjects the use of the Dornhorst function and the weighted-mean method to
      calculate reference values for mean red cell survival time with and without
      correction for elution of 51Cr. We compared survival times calculated with the
      Dornhorst and weighted-mean methods with survival time estimated with linear or
      exponential models. Two methods to correct for elution of 51Cr from red cells
      were investigated. For the first method, correction factors were generated using
      the Dornhorst function fitted to mean survival curves obtained from the normal
      subjects. In the second method, the new Dornhorst rate constant method, the
      survival time, corrected for elution of 51Cr, was directly calculated from the
      experimental survival curve without applying correction factors. Correction for
      elution using the Dornhorst rate constant method was not successful and resulted
      in nonphysiologic values. The 95% confidence range of red cell survival time for
      reference subjects without correction for 51Cr elution was 37-74 days for the
      weighted-mean method and 37 to 73 days for the Dornhorst method. The 95%
      confidence range for normal subjects when the survival curves were corrected for
      elution was 47-179 days for the Dornhorst method and 58-161 days for the weighted
      mean method. The poor results obtained with the Dornhorst rate constant method
      and the large 95% confidence range were due to the rapid and large variation in
      elution rate of 51Cr from red cells.

PMID- 1744711
TI  - Significance of intensity of delayed activity during technetium-99m-RBC
      gastrointestinal bleeding study.
AB  - In 27 patients with normal hepatic function, delayed concentration of
      radioactivity (during 99mTc-RBC gastrointestinal bleeding studies) was compared
      with liver blood-pool activity. That is, for images at 4 to 24 hr postinjection,
      grading was accomplished by comparison to the liver blood pool (less than, equal
      to, or greater than hepatic activity). There was a correlation between the
      accuracy of scan interpretation (for active bleeding and localization) and the
      intensity of activity as related to the liver. This simple grading system may be
      useful for interpretation of delayed images during bleeding studies.

PMID- 1744712
TI  - Application of (methyl-11C)-methionine in the multicellular spheroid system.
AB  - Human glioma (U-343 MGa) and human colon carcinoma (HT-29) cell lines were
      cultured as multicellular spheroids, and the accumulations of the L- and D
      enantiomers of 11C-methionine were investigated. The accumulation of
      radioactivity in the spheroids was expressed as relative counts, by dividing the
      radioactivity measured in the spheroid with the radioactivity of the same volume
      of the incubation medium. The experiments were verified using 14C-labeled L- and
      D-methionine. The influence of spheroid volume, specific activity, incubation
      time, washing time, and the environmental temperatures were investigated. The
      spheroid model was used to determine the effect of the lipoxygenase inhibitors BW
      A4C and AA-861, the ether-phospholipid type PAF-antagonist CV-6209 and the
      protein synthesis inhibitor cycloheximide on methionine uptake. The results
      showed that 11C-L-methionine can be applied in the study of drug effects on
      multicellular tumor cell aggregates.

PMID- 1744713
TI  - Fluorine-18-altanserin: a radioligand for the study of serotonin receptors with
      PET: radiolabeling and in vivo biologic behavior in rats.
AB  - No-carrier-added [18F]altanserin was synthesized by nucleophilic substitution of
      the corresponding nitro compound with [18F]fluoride in the presence of kryptofix
      222 and K2CO3. After purification by preparative HPLC, [18F]altanserin was
      produced in less than 2 hr with a radiochemical yield of 10% (EOS) and a specific
      activity of 0.8-1.3 Ci/mumol. In rats, the tracer localized rapidly in the whole
      brain (0.5% ID/g organ) with a high binding to the frontal cortex. The frontal
      cortex/cerebellum ratio increased with time and reached a plateau of 11 at 2 hr
      postinjection. This uptake in S2 receptor regions was saturable and could be
      blocked by pretreatment with various S2 antagonists. This radiopharmaceutical
      appears to be more selective for S2 receptor sites than other ligands available
      today and allows the study of S2 receptors under in vivo conditions.

PMID- 1744714
TI  - Gallbladder visualization during post-therapy iodine-131 imaging of thyroid
      carcinoma.
AB  - A persistent, extra-thyroidal focus of 131I on whole-body imaging of thyroid
      carcinoma usually represents a functioning metastasis. We report a case of 131I
      localization within a septated gallbladder, initially mimicking an isolated
      hepatic metastasis. Adjunctive liver/spleen and hepatobiliary scintigraphy helped
      to elucidate the true nature of this 131I activity.

PMID- 1744715
TI  - Metastatic angiosarcoma with thrombocytopenia and intratumoral indium-111
      platelet deposition.
AB  - A 66-yr-old woman with cutaneous angiosarcoma of the face presented with
      thrombocytopenia and metastases to the skeleton. Scintigraphic imaging with 111In
      oxine-labeled autologous platelets demonstrated localization of radiolabeled
      platelets at sites of metastatic tumor. This imaging study suggests intratumoral
      destruction of platelets by the metastases of the malignant vascular tumor as the
      cause of the patient's thrombocytopenia.

PMID- 1744716
TI  - Localization of recurrent medullary thyroid carcinoma with technetium-99m
      methoxyisobutylnitrile scintigraphy: a case report.
AB  - This case report demonstrates the successful localization of metastatic medullary
      thyroid carcinoma with 99mTc-labeled methoxyisobutylnitrile (MIBI). Disease
      recurrence was initially localized using 201Tl and by immunoscintigraphy with
      111In-labeled anti-carcinoembryonic antigen (anti-CEA) antibody fragments.
      Scintigraphy with 99mTc-MIBI yielded higher target-to-background ratios than
      201Tl or 111In-anti-CEA. Technetium-99m-MIBI may be a useful agent in the
      localization of recurrent medullary thyroid carcinoma.

PMID- 1744717
TI  - Thallium-201 SPECT depicts radiologically occult lung cancer.
AB  - A case of radiologically occult lung cancer is presented in which 201TI SPECT of
      the chest clearly delineated the involved area. A 66-yr-old man underwent chest
      screening examinations for asymptomatic smokers and presented a positive sputum
      cytology for lung cancer. Conventional chest x-ray, tomography of computed
      radiography, and a CT scan failed to locate the lesion in the lung. Thallium-201
      SPECT, however, was successful in depicting the area of the involvement.

PMID- 1744718
TI  - Residual spleen found on denatured red blood cell scan following negative colloid
      scans.
AB  - The technetium-sulfur colloid liver-spleen examination is widely used to evaluate
      patients with idiopathic thrombocytopenic purpura for residual splenic tissue
      following splenectomy. Technetium-labeled heat-damaged red blood cell imaging is
      another sensitive test for residual splenic tissue. We recently encountered a
      patient with idiopathic thrombocytopenic purpura who was initially evaluated with
      a technetium sulfur colloid scan which was negative. A denatured red blood cell
      scan was subsequently performed which revealed intense focal activity in the
      region of the splenic bed. Surgery confirmed this to be splenic tissue. Our
      results emphasize the utility of the denatured red blood cell examination in the
      setting of strong clinical suspicion for residual splenic tissue following a
      negative sulfur colloid study.

PMID- 1744719
TI  - Cellular basis for the elevated gallium-67 computed lung index in a rheumatoid
      lung patient.
AB  - A patient with high levels of serum rheumatoid factor and an open lung biopsy
      which showed high-grade interstitial pneumonia with large numbers of lymphocytes
      and plasmocytes had intense gallium uptake in the lungs. Lymphocytes and/or
      plasmocytes might be responsible for the gallium uptake even though neutrophils
      are usually credited with high-level uptake. Differential cell counts
      demonstrated plasmocyte and lymphocyte preponderance, but neutrophil paucity. In
      vitro cell cultures of purified neutrophils, monocytes, leukemic plasmocytes, and
      resting and stimulated lymphocytes with 67Ga showed that plasmocytes take up
      comparatively low levels of 67Ga, but that activated lymphocytes take up levels
      that approach neutrophils. It is probable that both rheumatoid lung plasmocytes
      and activated lymphocytes are responsible for the pulmonary 67Ga concentration in
      this patient.

PMID- 1744720
TI  - Myocardial accumulation of monoclonal antimyosin Fab in hypertrophic
      cardiomyopathy and postpartum cardiomyopathy.
AB  - Indium-111-antimyosin Fab scan was performed in patients with hypertrophic and
      postpartum cardiomyopathies to assess whether or not myocardial damage can be
      delineated. In two patients with hypertrophic cardiomyopathy, intense and diffuse
      antimyosin uptake was observed, although there was no evidence of acute
      myocardial damage or wall motion abnormality. A patient with postpartum
      cardiomyopathy showed a dense and relatively localized accumulation in the left
      ventricular anterior wall in association with thallium perfusion and wall motion
      abnormalities. Thus, antimyosin scanning can delineate not only manifested but
      also subclinical myocardial damage in hypertrophic and postpartum
      cardiomyopathies which may not be detectable by other techniques.

PMID- 1744721
TI  - Reference range determination: the problem of small sample sizes.
AB  - The process of developing and validating a quantitative test includes
      determination of a reference range. Traditionally this has been taken as the mean
      +/- 2 standard deviations for a random sampling from a reference population.
      However, this method fails to recognize the substantial variability in the sample
      mean and standard deviation for the small sample sizes frequently encountered in
      nuclear medicine. A new approach, which involves calculating confidence intervals
      for the upper and lower bounds of the traditionally defined range, recognizes
      three ranges of values: normal, indeterminate, and abnormal. The principles of
      this approach are illustrated using differential renal function in twelve renal
      transplant donors. The 99mTc-DTPA differential uptake between 1 and 2 min gave a
      traditionally-defined single-kidney range of 50% +/- 8%, whereas with our method
      the normal range would be 50% +/- 6% with indeterminate ranges of 37%-44% and 56%
      63%. These values are consistent with the wide variation in reference ranges
      reported in the literature, and suggest that much of this variability may be a
      statistical artifact resulting from inadequate sample sizes. A nomogram has been
      derived that permits the power of the reference range determination to be easily
      calculated from the sample size. Analysis of the effect of sample size on the
      accuracy of the upper and lower bounds of the reference range is advocated
      whenever small reference populations are used.

PMID- 1744722
TI  - Biological background subtraction improves immunoscintigraphy by subsequent
      injection of antigen.
AB  - We have developed an 111In-labeled antibody for in vivo use directed against
      tissue plasminogen activator demonstrating focal fibrinolytic activity. However,
      a major problem in immunoscintigraphy is the low signal-to-noise ratio due to
      circulating antibody. The hepatic clearance of t-PA is very rapid. The effect of
      a subsequent injection of a small amount of t-PA shortly after the antibody
      administration to increase the blood clearance rate of the formed antigen
      antibody complexes was examined in six rabbits. More than 99% of the circulating
      antigen-antibody complexes were eliminated by the liver within 10 min. This
      technique could make immunoscintigraphy a first line diagnostic tool in acute
      medicine including imaging of thromboembolic lesions in organs with high blood
      volumes such as the lungs, the heart, and the brain.

PMID- 1744723
TI  - Immunoscintigraphy of thrombi.

PMID- 1744724
TI  - Diagnostic accuracy and deep venous thrombosis: a biostatistician's perspective.

PMID- 1744725
TI  - The art of bone scintigraphy--technical aspects.

PMID- 1744726
TI  - Performance standards in positron emission tomography.
AB  - A standard set of performance measurements is proposed for use with positron
      emission tomographs. This set of measurements has been developed jointly by the
      Computer and Instrumentation Council of the Society of Nuclear Medicine and the
      National Electrical Manufacturers Association. The measurements include tests of
      spatial resolution, scatter fraction, sensitivity, count rate losses and randoms,
      uniformity, scatter correction, attenuation correction, and count rate linearity
      correction.

PMID- 1744727
TI  - Clinical PET--a modest proposal.

PMID- 1744728
TI  - Assessment of myocardial infarction with three radiotracers.

PMID- 1744729
TI  - Development of new radiopharmaceuticals.

PMID- 1744730
TI  - The nurse executive and the governing body. Synergy for a new era.
AB  - Nurse executives play a vital role in the overall governance of healthcare
      organizations, and many participate on governing boards. However, we lack a model
      for effective governing-body relations and contributions. The author presents
      major functions of the governing body with emphasis on the critical elements
      provided by the nurse executive. The author also defines major outcomes for
      nursing.

PMID- 1744731
TI  - Implementing an ethics committee in rural institutions.
AB  - Ethical conflicts occur in rural as well as in urban healthcare institutions. One
      means of addressing these complex issues is through interdisciplinary discussions
      by a bioethics committee. There are, however, social, economic, geographic, and
      demographic variations unique to both environments that can impact ethical
      issues, and these must be addressed when such a committee is implemented in
      either setting. The authors describe the rural variations and the implications
      for nurse administrators who often assume an active role in planning and
      organizing bioethics committees.

PMID- 1744732
TI  - Work redesign in high-intensity environments. ProACT for critical care.
AB  - Hospitals are becoming immense intensive care units despite a continuing shortage
      of critical care nurses. While there has been widespread application of work
      redesign concepts in nursing during the last several years, few projects
      involving critical care have been reported. The authors describe a comprehensive
      restructuring initiative in the critical care setting and focus on the
      administrative implications of this work.

PMID- 1744733
TI  - Feeding the homeless.
AB  - Nurses have a unique role in addressing homelessness, an issue of vital national
      concern. The management and organizational expertise of nurses can be key
      elements to coordinating community resources to assist the homeless. The authors
      describe the design and implementation of a community meal program for the
      homeless.

PMID- 1744734
TI  - Designing an internal organizational merger.
AB  - Healthcare managers face problems resulting from restructuring and downsizing
      activities meant to increase operational efficiency and reduce costs. Although
      keys to the success of multiorganizational mergers are well documented,
      directives for managing internal mergers are less clearly stated. The authors
      discuss a five-step plan designed to facilitate an internal merger through the
      strategic coordination of stakeholders.

PMID- 1744736
TI  - Healthy People 2000: challenges and opportunities.

PMID- 1744735
TI  - Maximizing market potential in home care.
AB  - National trends in demographics and skyrocketing healthcare costs are escalating
      the demand for home healthcare. As a result, competition for a share of the home
      care dollar has become fierce. In the next decade, home care providers-
      hospitals, proprietary companies, and nonprofit agencies--will be competing for a
      portion of the projected $60 billion in home care earnings. The author offers
      three recommendations to providers who wish to ensure survival and growth in
      these fast-moving times.

PMID- 1744737
TI  - Planning the interview for a clinical nurse researcher.
AB  - The number of clinical nurse researcher positions seems to be increasing in
      healthcare agencies today. There are some unique features of the clinical nurse
      researcher role, including the complexities of a research position, the
      relatively recent introduction of the role in some clinical settings, and the
      frequency with which the position is coupled with other major clinical,
      administrative, or educational responsibilities. To increase the effectiveness of
      both the chief nurse executive and the clinical nurse researcher during the
      employment interview, the authors discuss five lines of inquiry that the
      interviewer or candidate can use.

PMID- 1744738
TI  - Administrative prosperity: principle IV, staying renewed in your career.

PMID- 1744739
TI  - Atopic status as a factor in job decision making in grain workers.
AB  - We conducted allergy skin-prick testing on 207 young cereal grain workers within
      0.27 years of the commencement of their employment in the grain industry and
      again after 1.34 years of employment on 124 workers. We also studied 120 control
      subjects on the first observation and 105 on the second observation. Grain
      workers had lower prevalence than did the controls of positive skin tests on the
      first observation, and this difference increased by the second observation.
      Respiratory symptoms were more frequent among grain workers with positive skin
      tests who dropped out of the industry than among those who stayed in the
      industry. We conclude that atopic status may be a factor in job selection and
      drop out decision making and may be a factor explaining the healthy worker
      effect.

PMID- 1744740
TI  - The inefficiency of surgical masks for protection against droplet nuclei
      tuberculosis.

PMID- 1744742
TI  - In defense of TLVs.

PMID- 1744741
TI  - Brain cancer and exposure to electromagnetic fields.

PMID- 1744743
TI  - Advances in cancer biomarkers as applied to chemical exposures: the ras oncogene
      and p21 protein and pulmonary carcinogenesis.
AB  - Pulmonary carcinogenesis due to occupational and environmental exposures to
      chemical carcinogens such as polycyclic aromatic hydrocarbons presents an
      interesting model for study of possible oncogene-related cancer biomarkers.
      Polycyclic aromatic hydrocarbons are important respiratory carcinogens and have
      been shown to cause specific mutational lesions that can lead to the activation
      of the ras oncogene and expression of its p21 protein product; ras oncogene
      activation and p21 expression frequently are detected in human lung cancers. In
      addition, the p21 protein is detectable via immunoblotting techniques in the
      serum of lung cancer patients and in selected persons in exposed worker cohorts
      at risk for the development of lung cancer. Thus, the ras oncogene and p21
      protein may be useful biomarkers for monitoring pulmonary carcinogenesis in
      exposed populations.

PMID- 1744744
TI  - Lung cancer and hydrogen chloride exposure: results from a nested case-control
      study of chemical workers.
AB  - There are few epidemiologic data available to address the question of potential
      carcinogenic effects of hydrogen chloride (HCl) exposure on humans. An
      opportunity arose to augment a nominal HCl exposure classification that had been
      done earlier for a nested case-control study of lung cancer among a cohort of
      chemical manufacturing employees. Working from first-hand knowledge of the
      relevant chemical processes and limited HCl monitoring data, a certified
      industrial hygienist estimated average exposures for each of the job assignments
      of 308 lung cancer cases and 616 comparison workers. The risk of lung cancer was
      then analyzed in relation to several measures of HCl exposure, including
      duration, a cumulative exposure score, highest average exposure, and latency.
      None showed evidence of an association between HCl exposure and lung cancer. This
      is consistent with the limited rodent bioassay data, which also failed to find a
      tumorigenic response from HCl. Thus, even at high level occupational exposures
      (up to 3000 micrograms/m3 for several years) there is no evidence that HCl is a
      human carcinogen.

PMID- 1744745
TI  - The cost-effectiveness of work-site wellness programs for hypertension control,
      weight loss, and smoking cessation.
AB  - The cost-effectiveness of work-site wellness programs for reducing cardiovascular
      disease risks of employees was examined at three manufacturing plants. A fourth
      plant was used as a control site to estimate levels of risk reduction achieved
      from wellness screening and preexisting services, without further interventions.
      The cardiovascular disease risks included in the study were hypertension,
      obesity, and cigarette smoking. The annual direct cost per employee for
      postscreening interventions was $2.97 for site 1 (control site), $17.68 for site
      2 (health education), $30.96 for site 3 (health education plus follow-up
      counseling), and $38.31 for site 4 (health education, follow-up counseling plus
      plant organization for health promotion). Of the three experimental sites, sites
      3 and 4 were more effective and more cost-effective than was site 2, both in
      terms of engaging employees at risk of cardiovascular disease into treatment or
      program participation and of reducing their risks or preventing relapse. For
      engaging employees into treatment/program participation, sites 3 and 4 were nine
      to ten times more cost-effective than was site 2; for reducing risks/preventing
      relapse, sites 3 and 4 were five to six times more cost-effective than was site
      2. At sites 3 and 4, the total direct cost per percent of risks reduced/relapse
      prevented was less than one dollar ($.67 and $.74, respectively) per employee per
      year. Program costs may vary considerably across companies because of differences
      in salary structures and overhead costs. These are held constant in this report
      for comparison across program models.

PMID- 1744746
TI  - Introducing management skills and issues in preventive medicine residency
      programs: a survey.
AB  - A questionnaire survey of 60 accredited preventive medicine residency programs
      was conducted to determine the percentage of programs in which management
      training is undertaken and to identify the nature of such training. Forty eight
      of the 60 programs (80%) returned a completed questionnaire. Forty three of the
      48 programs responding (90%) state that the teaching of management skills is a
      defined goal of their program. Ninety percent introduce management skills in the
      practicum year in an administration rotation or by providing opportunities to
      practice management skills in other rotations. Thirty five (73%) of responding
      programs present didactic sessions containing a focus on management issues, and
      academic year courses contain a focus on management skills or issues in 46 (96%).
      Considering the need for management training in preventive medicine careers, we
      are encouraged by these figures. However, although this survey determined the
      extent to which management training is undertaken and the reported content
      thereof, it did not attempt to evaluate the depth or effectiveness of this
      training. Therefore, we must continue to emphasize a longitudinal and
      multidimensional approach to management training during the residency years.

PMID- 1744747
TI  - Work-site smoking policies in small businesses.
AB  - A growing number of workers in the United States are employed in small
      businesses. This study describes the experiences of small work sites in
      implementing policies restricting smoking. In the fall of 1987, we surveyed by
      telephone 216 work sites employing 120 or fewer persons. Compared with companies
      without policies, companies with policies were larger and reported having fewer
      smokers and more management support for smoking policies. Seventy-three percent
      of work sites without a smoking policy said they would be very likely to
      implement a policy if it were required by law; 42% of work sites with a policy
      reported offering smoking cessation assistance to their employees. Overall
      satisfaction and compliance with the smoking policy was high among work sites
      with a policy. The findings of this study have key implications for other small
      businesses considering implementing a smoking policy.

PMID- 1744748
TI  - Utilization of preventive health services by an employed population.
AB  - To determine the utilization rates of selected preventive services in an employed
      population, we analyzed the responses of 18,053 health profile participants.
      Overall utilization rates for preventive services were high: 86.0% of respondents
      had their blood pressure checked, 94.0% of all women had a Pap smear and 81.3%
      had clinical breast examinations, 42.4% of respondents aged 40 and older had a
      rectal examination and 31.8% of those aged 50 and older had a test for occult
      blood in the stool, and 33.7% had a routine sigmoidoscopy. With the exception of
      blood pressure screening, the percentage of our respondents utilizing preventive
      services was considerably higher than the corresponding percentages in the US
      population as reported in the National Health Interview Survey. Nevertheless, the
      results suggest substantial opportunity for employers to encourage the
      appropriate use of preventive health services among employees.

PMID- 1744749
TI  - Work stress in emergency medical technicians.
AB  - To better understand the dynamics underlying their high turnover rate, emergency
      medical technicians (EMTs) were asked to participate in a union-sponsored study.
      Fifty-two percent of 200 EMT union members returned the three mailed
      questionnaires: the Occupational Stress Index, which assesses stress, strain, and
      coping; the Staff Burnout Scale for Health Professionals; and a survey that
      probed areas of job satisfaction. The sample had high stress, strain, and burnout
      scores. Coping skills were within the normal range. Burnout, stress, strain, and
      coping (BSS&C) were significantly related to job satisfaction, worry about
      infectious diseases, and perceptions of being poorly treated by emergency room
      personnel and fire fighters. BSS&C also were related to being upset by "runs"
      related to injuries from violence, drug overdoses, and exposure. Job
      dissatisfaction was related to attitudes that the job adversely affects one's
      family, that the EMT quarters are uncomfortable, and that administrators are not
      knowledgeable of the job demands and skills of EMTs. Areas of great discontent
      were the low salary of the profession and the inadequacy of the equipment.

PMID- 1744750
TI  - The positive known association design: a quality assurance method for
      occupational health surveillance data.
AB  - Quality control must be an integral component of an occupational health
      surveillance program. The positive known association design offers the
      occupational health physician a method to test, on a population basis (ie, high
      periodic medical surveillance examination participation rates by the employees),
      the quality of periodic medical surveillance data. Several well-established
      biological associations were evaluated and observed in this study, including a
      dramatic relation between white blood cell counts and smoking. We highly
      recommend that the positive known association design be incorporated in the
      quality assurance procedures of occupational health surveillance programs.

PMID- 1744751
TI  - Factors predicting readmission of older general medicine patients.
AB  - OBJECTIVES: 1) Identify demographic, clinical social support, functional, and
      psychological factors about which data are available within 24 hours of hospital
      admission associated with emergent unscheduled readmission for a group of older
      general medicine patients; 2) develop a model to predict emergent readmission.
      DESIGN: Interview- and chart-based study of emergent admissions that occurred
      within 60 days of discharge. SETTING: General medicine wards of the Memphis
      Veterans Affairs Medical Center, an 862-bed university-affiliated tertiary care
      facility. PATIENTS/PARTICIPANTS: General medicine patients greater than or equal
      to 65 years old (n = 173). Inclusion criteria were willingness to participate,
      written consent (patient or family member), and patient interview within 36 hours
      of admission. MEASUREMENTS AND MAIN RESULTS: The dependent variable was emergent
      readmission within 60 days of discharge from the hospital. Independent variables
      included demographic (age, race, income, education), social support (marital
      status, living arrangements), psychological (cognition, depression), activities
      of daily living functioning, and clinical (diagnoses, type and source of
      admission, length of stay, numbers of hospitalizations and days of
      hospitalizations in the past year, illness severity) parameters. Readmitted
      patients were emergently admitted and more severely ill, had more diagnoses of
      chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF),
      less ischemic heart disease, and more hospitalizations and hospital days in the
      past year (all p less than 0.05). Logistic regression identified diagnostic group
      (COPD or CHF), emergent admission, and admission severity of illness as
      predictive of readmission. The likelihood of being readmitted was 5.4. Accuracy
      of the three-variable model was 76%, predicted value positive, 73%, and
      predictive value negative, 77%. CONCLUSIONS: Chronically ill patients who are
      severely ill at index admission and who have had several hospitalizations in the
      past year tend to be readmitted. Using this model, high-risk patients may be
      prospectively targeted to reduce readmissions.

PMID- 1744752
TI  - Predicting the need for hospitalization of ambulatory patients with pneumonia.
AB  - OBJECTIVE: To develop clinical guidelines to identify patients with pneumonia who
      might be safely treated as outpatients. DESIGN: Retrospective chart review to
      derive guidelines, with subsequent prospective validation. SETTING: Initial
      review completed for patients seen in the emergency room (ER) of a university
      hospital and a community-based internal medicine practice. Validation conducted
      in the ERs of a university hospital and a community teaching hospital.
      PATIENTS/PARTICIPANTS: Individuals aged 16 years and older presenting with newly
      diagnosed pneumonia. Follow-up obtained through mail or telephone contact and
      chart review. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: During the
      initial retrospective review, 141 pneumonia patients without obvious reasons for
      hospital admission were identified and then classified as hospitalization
      necessary or unnecessary. Of these patients, 33 were classified as requiring
      admission. Multivariate analysis identified five variables that differentiated
      low-risk from high-risk study patients. These variables (and their relative
      weights) were: serious comorbid illness (3 points); preexisting lung disease (2
      points); multilobar lung involvement by the disease by chest x-ray (2 points);
      observed or likely aspiration (2 points); and symptom duration of less than 7 or
      greater than 28 days (1 point). Risk scores were calculated using these
      variables. Patients with low scores (0-2 points) rarely had complications, and
      only one of 53 such patients (2%) was judged to require hospitalization. In
      contrast, patients with high scores (greater than or equal to 6 points) had
      frequent complications and 20 of 29 (69%) were felt to need hospitalization.
      Similar results were found during the validation phase. CONCLUSIONS: Clinical
      findings appear to help distinguish patients who need admission for treatment of
      pneumonia from those who do not. If validated in other settings, the clinical
      utility of these guidelines in assisting decision making about hospitalization
      should be determined.

PMID- 1744753
TI  - The cost and effectiveness of an education program for adults who have asthma.
AB  - STUDY OBJECTIVE: To determine whether a self-management training program
      decreases emergency department visits and reduces costs for patients with asthma.
      DESIGN: Randomized controlled trial of an educational program. SETTING: Two sites
      -an urban emergency room and a suburban emergency room. PATIENTS: 241 asthma
      patients between the ages of 18 and 70 years. Of the 119 patients in the
      intervention group and the 122 in the control group, 185 (76%) were available for
      follow-up. INTERVENTION: All patients seen in the emergency departments were
      given usual medical care and follow-up. Patients in the intervention group were
      asked to attend three educational sessions on asthma conducted by a specially
      trained RN. The program stressed importance of medication compliance, methods to
      control and prevent attacks, effects of drugs and rationale for their use,
      relaxation exercises, and smoking cessation. MEASUREMENT AND MAIN RESULTS: All
      patients received telephone interviews four, eight, and 12 months after entry
      into the study. Reports based on hospital admissions and emergency room
      utilization were verified by billing records. Three patients died during the
      study, none from asthma-related problems. The intervention group had
      significantly fewer asthma-related emergency visits (16 visits per 100 persons)
      than did the control group (39 per 100 persons); p = 0.0005 for the 12 months of
      follow-up. The effect of the intervention on asthma-related emergency department
      visits was strongest during the initial four months postintervention (68 per 100
      persons versus 220 per 100 persons, p = 0.003). The financial analysis showed
      that the $85/person cost for the educational sessions was offset by the
      $628/person reduction in emergency room charges. CONCLUSION: Education enables
      patients with asthma to decrease utilization of emergency services.

PMID- 1744754
TI  - Seizure vs. syncope: measuring serum creatine kinase in the emergency department.
AB  - OBJECTIVE: To determine the utility of serum creatine kinase measurement for
      diagnosing generalized tonic-clonic seizures in patients presenting to an
      emergency department with transient loss of consciousness. DESIGN: Prospective
      evaluation of a diagnostic parameter. Retrospective data collection with blinded
      assignment to diagnostic groups. SETTING: University teaching hospital. PATIENTS:
      Sequential sample of 205 patients with transient loss of consciousness. The study
      group consisted of 96 patients who had creatine kinase measurements in the
      emergency department. MEASUREMENTS AND MAIN RESULTS: An investigator blinded to
      the results of creatine kinase measurements retrospectively classified events
      into seizure and nonseizure groups on the basis of clinical presentation, prior
      history, and follow-up investigations. Mean (+/- SE) creatine kinase level was
      significantly higher in the seizure group (231.1 +/- 34.8 U/L vs. 70.5 +/- 5.6
      U/L, p less than 0.001). Elevated creatine kinase had a test specificity of 0.98
      (95% CI 0.90-1.00) and a sensitivity of 0.43 (95% CI 0.28-0.59). The
      discriminating power of creatine kinase elevation was directly related to the
      time interval between the event and testing (p less than 0.0001). Among samples
      taken more than three hours after the event, test sensitivity was 0.80 (0.52
      1.00) and specificity was 0.94 (0.71-1.00). CONCLUSION: Creatine kinase may be a
      useful test for evaluating patients with transient loss of consciousness. The
      test is highly specific for diagnosing generalized seizures in the emergency
      department. Test sensitivity improves by sampling serum at least three hours
      after the event.

PMID- 1744755
TI  - Hypochondriacal patients, their physicians, and their medical care.
AB  - OBJECTIVE: To examine the views hypochondriacal patients have of their
      physicians, and their physicians' assessments of the hypochondriacal patients.
      DESIGN: A sample of patients meeting DSM-III-R diagnostic criteria for
      hypochondriasis was obtained by screening consecutive medical outpatients. They
      underwent a battery of self-report questionnaires and structured interviews,
      their medical records were audited, and their physicians completed questionnaires
      about them. A random sample of nonhypochondriacal patients from the same clinic
      served as a comparison group. SETTING: A large general medicine outpatient clinic
      of an academic teaching hospital. PATIENTS: 41 DSM-III-R hypochondriacs and 71
      comparison patients. MEASUREMENTS AND MAIN RESULTS: Hypochondriacal patients were
      more dissatisfied with their physicians than were comparison patients. Physicians
      rated the hypochondriacal patients as more frustrating to care for, more help
      rejecting, and more demanding. Physician ratings of how hypochondriacal their
      patients were correlated significantly with their ratings of how frustrating they
      considered the patients (R2 = 0.36) and with objective measures of how
      hypochondriacal the patients were (incremental R2 = 0.08). Physician estimates of
      anxiety and depression in the hypochondriacal patients were not statistically
      related to patient anxiety and depression. In contrast, physician estimates of
      patient anxiety and depression were significantly associated with the presence of
      anxiety and depression in comparison patients. CONCLUSIONS: The physician's use
      of the term hypochondriasis is closely associated with his or her frustration
      with the patient and is associated with objective measures of the extent of
      hypochondriacal symptoms. In addition, the presence of DSM-III-R hypochondriasis
      impairs the physician's accuracy in assessing the levels of the patient's anxiety
      and depression.

PMID- 1744756
TI  - Sympathy, empathy, and physician resource utilization.
AB  - OBJECTIVE: To test the hypothesis that physicians preferring a sympathetic over
      an empathetic response to a hypothetical patient's misfortune will utilize more
      health care resources in the care of their patients. DESIGN: Physicians were
      asked to select either the sympathetic response or the empathetic response to a
      hypothetical patient's misfortune (death of a spouse) and to state their
      preferences for intubation of a hypothetical end-stage lung-disease patient. For
      each physician, hospital records were retrospectively reviewed to assess the mean
      number of laboratory tests ordered per clinic patient and the mean duration of
      cardiopulmonary resuscitations he or she performed before declaring his or her
      efforts unsuccessful. SETTING: General medicine clinic at a large urban hospital.
      PARTICIPANTS: 101 physicians above the postgraduate year-I level who attended the
      general medicine clinic. MEASUREMENTS AND MAIN RESULTS: As hypothesized,
      physicians selecting the sympathetic option (n = 58) had a greater mean
      preference for intubation (p less than 0.02), ordered more laboratory tests per
      patient in clinic (p less than 0.03), and performed cardiopulmonary resuscitation
      for longer periods of time before declaring their efforts unsuccessful (p less
      than 0.06) than did physicians selecting the empathetic option (n = 38).
      CONCLUSIONS: These data suggest that the constructs of sympathy and empathy
      reflect psychological aspects of physicians that have a measurable influence on
      their practice behaviors.

PMID- 1744757
TI  - Physicians' and nurses' perceptions of ethics problems on general medical
      services.
AB  - OBJECTIVE: To understand the kinds of clinical situations physicians and nurses
      regard as "ethics problems." DESIGN: The authors prospectively studied
      physicians' and nurses' perceptions of ethics problems using paired interviews.
      Individual interviews were conducted with physicians and nurses as they cared for
      the same patients during a six-week period. Each was asked whether any ethics
      problems had arisen in the care of his or her patients and, if so, to give a
      brief description of each problem. SETTING: Three general medical services in a
      497-bed community teaching hospital. PARTICIPANTS: 13 physicians (mostly family
      medicine residents) and 42 nurses caring for 142 patients. MAIN RESULTS: The
      physicians and nurses thought ethics problems were present in 75 of the 142
      patients cases. Physicians and nurses identified ethics problems with similar
      frequencies; however, they often identified ethics problems in different patient
      cases or identified different ethics problems in the same case. Physicians and
      nurses described a variety of problem types. Physicians identified more problems
      related to quality of life, inappropriate hospital admissions, and cost of care;
      nurses identified more problems related to patient preferences, family wishes,
      pain management, implementing treatments, and discharge planning. A fourth of the
      ethics problems identified by physicians and nurses involved interstaff
      conflicts. CONCLUSIONS: The physicians and nurses studied considered a broad
      range of clinical situations to be "ethics problems," and they perceived them to
      occur frequently. Systematic differences were found between physicians' and
      nurses' perceptions of ethics problems, and many ethics problems generated
      interstaff conflicts. Incorporating this kind of information into clinical ethics
      education programs, and into hospital policies, may represent a useful approach
      toward improving physician-nurse interaction.

PMID- 1744758
TI  - Practical problems of conducting patient-satisfaction surveys.
AB  - OBJECTIVE: Patient-satisfaction surveys have been used frequently to assess the
      humanistic behaviors and skills of internal medicine housestaff. In conducting
      their first such survey, the authors found that many practical problems affected
      the progress and outcome of the project. This discussion of the authors'
      experiences is intended to be helpful to others considering patient-satisfaction
      surveys as part of their housestaff-evaluation process. DESIGN: A description of
      the practical aspects of conducting a patient-satisfaction survey as well as the
      problems that the authors encountered. SETTING: Both inpatient and outpatient
      settings at a major university internal medicine residency program.
      PATIENTS/PARTICIPANTS: Ambulatory and hospitalized patients under the care of
      categorical internal medicine interns were eligible for participation in the
      study. INTERVENTIONS: An established, validated patient-satisfaction
      questionnaire with high reported reliability was given to patients. MEASUREMENTS
      AND MAIN RESULTS: Although well over 90% of patients were willing to participate,
      10% of participating outpatients and 16% of participating hospital patients could
      not provide a usable patient-satisfaction questionnaire even with assistance.
      Certain patient characteristics were responsible for these decreased completion
      rates. Among the hospitalized patients, 42% of all eligible patients were either
      too ill or too cognitively impaired to even be approached for participation in
      the study. CONCLUSIONS: Patient-satisfaction surveys are labor-intensive, require
      significant resources, and are temporally demanding. Results from them must be
      viewed with certain caveats.

PMID- 1744759
TI  - Gastroenterology consultations from the internal medicine physician's
      perspective.
AB  - OBJECTIVE: To examine the patterns of use of gastroenterology consultations by
      internal medicine physicians. DESIGN: A survey of licensed physicians in the
      three metropolitan areas in Arizona where gastroenterologists are available. The
      physicians were asked how likely they were to obtain gastroenterology
      consultations for a variety of different gastrointestinal illnesses. Comparisons
      between groups were done with chi-square analysis. MEASUREMENTS AND MAIN RESULTS:
      Forty-six percent of the physicians responded. The majority of respondents
      believed that esophagogastroduodenoscopy and colonoscopy should be available
      without gastroenterology consultation (65% and 64%, respectively). Physicians in
      practice more than ten years were less prone to request consultation for
      gastrointestinal complaints that were likely to result in endoscopic procedures,
      such as the diagnosis of peptic ulcer disease or inflammatory bowel disease, or
      guaiac-positive stool. Internal medicine residents were more likely to seek
      consultations for both endoscopic and cognitive gastrointestinal complaints.
      Internal medicine residents were far more likely to request gastroenterology
      consultations for most patients with upper-gastrointestinal-tract bleeding (91%
      vs. 60%, p less than 0.001) and lower-gastrointestinal-tract bleeding (65% vs.
      22%, p less than 0.0001) than were internists practicing more than ten years.
      CONCLUSIONS: The majority of internal medicine physicians would like to order
      endoscopic procedures without gastroenterology consultations, much as they order
      radiography. Recently trained physicians are far more likely to request
      consultants for procedure-related problems.

PMID- 1744760
TI  - Do resident and staff physicians differ in the types and costs of
      antihypertensive drugs they select?
AB  - OBJECTIVE: To compare the types and costs of drugs prescribed by resident and
      staff physicians treating patients with uncomplicated essential hypertension.
      DESIGN: Cross-sectional study, using a computer-based medical record database.
      SETTING: Primary care internal medicine clinic in a large teaching hospital.
      PATIENTS/PARTICIPANTS: Hypertensive patients seen by ten postgraduate year-1 (PGY
      1) and PGY-2 primary care internal medicine residents and four staff physicians
      practicing in the same clinic. MEASUREMENTS AND MAIN RESULTS: The types and costs
      of antihypertensive drugs prescribed for the patients treated by resident and
      staff physicians were compared. A larger proportion of patients of resident
      physicians than of staff physicians were treated with calcium channel blockers
      [19(15%) vs. 40(4%), p less than 0.001]; residents prescribed thiazide diuretics
      less frequently and beta-blockers more frequently than did staff physicians,
      although these differences were not significant. The estimated average wholesale
      price of antihypertensive drugs for patients cared for by residents was 35%
      higher than that for patients cared for by staff physicians ($0.73 vs. $0.54, p =
      0.048). This difference was not fully explained by differences in practice
      composition. CONCLUSIONS: Resident physicians in this study selected more
      expensive medications to treat hypertension than did their faculty preceptors,
      even when differences in practice composition were considered.

PMID- 1744761
TI  - The impact of the night float system on internal medicine residency programs.
AB  - OBJECTIVE: To study the design, method of implementation, perceived benefits, and
      problems associated with a night float system. DESIGN: Self-administered
      questionnaire completed by program directors, which included both structured and
      open-ended questions. The answers reflect resident and student opinions as well
      as those of the program directors, since program directors regularly obtain
      feedback from these groups. SETTING/PARTICIPANTS: The 442 accredited internal
      medicine residency programs listed in the 1988-89 Directory of Graduate Medical
      Education Programs. RESULTS: Of the 442 programs, 79% responded, and 30% had
      experience with a night float system. The most frequent methods for initiating a
      night float system included: decreasing elective time (42.3%), hiring more
      residents (26.9%), creating a non-teaching service (12.5%), and reallocating
      housestaff time (9.6%). Positive effects cited include decreased fatigue,
      improved housestaff morale, improved recruiting, and better attitude toward
      internal medicine training. The quality of medical care was considered the same
      or better by most programs using it. The most commonly cited problems were
      decreased continuity of care, inadequate teaching of the night float team, and
      miscommunication. CONCLUSION: Residency programs using a night float system
      usually observe a positive effect on housestaff morale, recruitment, and working
      hours and no detrimental effect on the quality of patient care. Miscommunication
      and inadequate learning experience for the night float team are important
      potential problems. This survey suggests that the night float represents one
      solution to reducing resident working hours.

PMID- 1744762
TI  - Integrating occupational health into the medicine clerkship using problem-based
      learning.
AB  - OBJECTIVE: To improve medical students' ability and willingness to obtain
      occupational histories from their patients. PARTICIPANTS: General medicine
      faculty and internal medicine teaching residents, who participated as
      instructors, and medical students during their required internal medicine
      clerkships. SETTING: The primary teaching hospitals of two medical schools.
      DESIGN: During alternate months, students participated in problem-based sessions
      that included occupational health objectives (intervention) or attended the
      standard small-group didactic sessions (control). Process evaluations were
      collected from students and faculty in the intervention group following each
      session. Outcome evaluation was performed using chart audit and multiple-choice
      testing to compare the intervention and control groups. INTERVENTION:
      Intervention students participated in at least one problem-based session
      incorporating occupational aspects of disease into clinical internal medicine.
      Instructors received information packets and materials but had no other expertise
      in occupational medicine. MEASUREMENTS AND MAIN RESULTS: The great majority of
      ratings on the process evaluations showed that the students were "moderately" to
      "extremely" interested in the session attended. No student rated any session to
      be a "waste of time," and over 90% of students would recommend the session being
      evaluated to a friend. Chart audit showed that students in the intervention group
      recorded slightly more occupational information than did those in the control
      group (an average of 2.97 vs. 2.37 pieces of information, p = 0.06). When the
      most commonly documented data (employment status and job title) were ignored, the
      difference between group means (1.1 vs. 0.91) was significant (p = 0.03),
      suggesting that intervention students were more likely to probe further into a
      patient's occupational history. Both groups of students collected less
      occupational information from women than from men (t = 3.22, p = 0.0035).
      Multiple-choice tests revealed no difference between the two groups in overall
      medical knowledge or occupational medicine knowledge. CONCLUSIONS: Problem-based
      learning with specific occupational content is well accepted by students and
      modestly improves their occupational history taking.

PMID- 1744763
TI  - Casemix in an internal medicine clerkship: educational value of the clinical
      problems seen.
AB  - OBJECTIVE: To evaluate the casemix seen during an internal medicine clerkship and
      to assess the educational value of the problems seen. DESIGN: A modified Delphi
      group opinion technique was used to develop a clerk log that included priority
      problems for internal medicine. Over a 12-month period, clerks recorded their
      exposure to the problems seen during their eight-week rotations. General
      internists rated the importance of each of the problems on a three-point scale.
      SETTING: The inpatient internal medicine services in six university teaching
      hospitals. SUBJECTS: All clinical clerks in a single undergraduate year recorded
      their experiences. All university-based general internists participated in rating
      problem importance. MEASUREMENTS AND MAIN RESULTS: The final approved log
      contained 72 problems, 64 of which received importance ratings greater than or
      equal to 2 on the three-point scale. The frequency of clerk exposure per problem
      was high and the correlation between frequency of exposure and importance was
      good. Ten important problems had relatively low exposure and four problems of
      lower importance had high exposure. CONCLUSIONS: The clinical clerks were exposed
      to a broad spectrum of diseases, but some key problems were not well represented
      on the wards. Alternative strategies, including increased ambulatory care
      exposure, will be required to complete the exposure and to assure that the
      quality of patient exposure matches the quantity.

PMID- 1744764
TI  - Fellowship training in academic general internal medicine: a curriculum survey.
AB  - OBJECTIVE: To determine whether current fellowships in general internal medicine
      (FGIM) meet the perceived needs and objectives of physicians entering careers in
      academic internal medicine. DESIGN: A modified Delphi method yielded the 18
      curricular elements included in the mailed survey. Participants outlined both
      actual and ideal fellowship experiences by rating the degree of emphasis of each
      curricular element on a Likert scale. Respondents then prioritized elements by
      rank-ordering them on perceived importance. Current job descriptions and opinions
      on related issues in FGIM were collected. PARTICIPANTS: Potential fellows,
      current fellows, and recent graduates were surveyed. Individuals were identified
      through the Society of General Internal Medicine associates' mailing list and
      solicitation of program directors. Nonfellow associates served as the proxy group
      for potential fellows. MEASUREMENTS AND MAIN RESULTS: 579 surveys were mailed;
      348 (60%) responses were received, of which 288 (50%) were suitable for analysis.
      Of all respondents, 38% were current fellows and 40% were recent graduates. When
      asked to prioritize educational needs during fellowship training, respondents
      ranked research methodology, ambulatory medicine, critical review of the
      literature, epidemiology, biostatistics, teaching skills, medical consultation,
      grant writing, preventive medicine, and design of educational curriculum as the
      top ten. Only minor deviations in rank order were found between graduates and
      nongraduates. Mean Likert scale scores for degree of emphasis of each curricular
      element in graduates' actual fellowships were compared with mean scores for
      graduates' ideal fellowship descriptions. High-priority elements that were
      perceived as adequately emphasized included research methodology, critical
      analysis of the literature, epidemiology, and biostatistics. High-priority
      elements that were perceived as inadequately emphasized included ambulatory
      medicine, teaching skills, medical consultation, grant writing, preventive
      medicine, and design of educational curricula. CONCLUSIONS: FGIM largely meet the
      expectations of their fellows for preparation for research responsibilities.
      However, several curricular elements concerned with preparation for future
      clinical and teaching responsibilities are perceived by graduates as
      underemphasized. These areas deserve increased emphasis during fellowship
      training to better prepare fellows for their future roles in academic general
      internal medicine.

PMID- 1744765
TI  - Physician-patient gender congruence and the physical examination.
AB  - To assess the hypothesis that breast, genitourinary (GU), and rectal examinations
      are performed more frequently when the physician and patient are of the same
      gender, the authors reviewed the records of 529 patients in a housestaff medical
      clinic. They found no significant difference between gender-congruent and gender
      incongruent patient encounters in the rates of these examinations. However,
      higher rates of performance by primary care housestaff compared with those of
      internal medicine housestaff were noted in all categories. The authors conclude
      that performances of breast, GU, and rectal examinations were not related to
      gender congruence but may have been associated with the houseofficers' training
      program.

PMID- 1744766
TI  - The procedural and interpretive skills that third-year medicine clerks should
      master: views of medicine clerkship directors.
AB  - The authors surveyed medicine clerkship directors to determine which procedural
      and interpretive skills they felt third-year medical students should acquire. Of
      the 101 (81%) who responded, 91 felt that specific procedural and interpretive
      skills should be achieved by the end of the third-year medicine clerkship. Twenty
      seven percent of these 91 reported having students keep a record of their
      activities; 35% reported testing students in the interpretation of various tests
      used in the evaluation of hospitalized patients on medicine services; and one
      clerkship director reported that his students were tested in their abilities to
      perform procedures. There was substantial disagreement by medicine clerkship
      directors over the procedural and test/study-interpretation skills in which
      medicine clerks should become proficient during the third-year medicine
      clerkship.

PMID- 1744767
TI  - Vitamins and minerals in HIV infection.

PMID- 1744768
TI  - Status panic among physicians.

PMID- 1744769
TI  - Predicting readmissions of elderly patients.

PMID- 1744770
TI  - Evaluating the quality of qualitative research: a proposal pro tem.

PMID- 1744771
TI  - Nurses evaluating humanism.

PMID- 1744772
TI  - Tetanus immunization of the elderly.

PMID- 1744773
TI  - Image invariance with changes in size: the role of peripheral contrast
      thresholds.
AB  - The appearance of objects generally does not change with changes in the size of
      their retinal image that occur as the distance from the observer increases or
      decreases. Contrast constancy ensures this invariance for suprathreshold image
      features, but fully robust size invariance also requires invariance at threshold,
      so that near-threshold image features do not appear or disappear with distance
      changes. Since the angular size and the eccentricity of image features covary
      with distance changes, the threshold requirement for invariance could be
      satisfied approximately if contrast thresholds were to vary as the product of the
      spatial frequency and the eccentricity from the fovea. This model fits contrast
      thresholds for orientation identification over spatial frequencies of 1-16
      cycles/deg and for retinal eccentricities of as much as 23 deg. Contrast
      detection thresholds from six different studies conform to this model over an
      even wider range of spatial frequencies and retinal eccentricities. The fitting
      variable, the fundamental eccentricity constant, was similar for all three
      studies that measured detection along the horizontal meridian and was higher for
      the orientation identification contrast thresholds along the same meridian. The
      eccentricity constant from studies that measured detection along the vertical
      meridian was higher than the constant calculated for the horizontal meridian and
      lower than the eccentricity constant for chromatic isoluminance gratings. Our
      model and these results provide new tools for analyzing the visibility of
      displays and for designing equal-visibility or variable-visibility displays.

PMID- 1744774
TI  - Peripheral spatial vision: limits imposed by optics, photoreceptors, and receptor
      pooling.
AB  - We examined the contribution of optical and photoreceptor properties as well as
      receptor pooling to eccentricity-dependent variations in spatial vision by
      comparing the performance of ideal observers with that of human observers. We
      measured contrast sensitivity functions in human observers and calculated such
      functions in ideal observers for retinal eccentricities of 0-40 deg. Comparisons
      of human and ideal performance in a variety of tasks reveal that many aspects of
      the variation in spatial vision with eccentricity can be understood from an
      analysis of the discrimination information available at the retinal ganglion
      cells.

PMID- 1744775
TI  - Birefringence of the human crystalline lens in vivo.
AB  - We studied aspects of the birefringence in the human crystalline lens. With the
      use of Mueller-matrix ellipsometry in vivo on both accommodated and
      unaccommodated eyes, we found no difference between the associated retardations.
      We calculated form birefringence of the lens by interpreting the membranes of the
      lens fiber cells as Wiener bodies. The resulting retardation for a light beam
      that passes the lens as in the experiments exceeds by far the measured total
      retardation. We conclude that form and intrinsic birefringence of the lens cancel
      out.

PMID- 1744776
TI  - Stimulus determinants of achromatic constancy.
AB  - Achromatic constancy refers to the invariance of either lightness or brightness
      despite changes in illumination intensity. Previous results disagree as to the
      extent to which constancy occurs with fixed luminance ratio conditions. This may
      reflect a lack of distinction between lightness and brightness. We measured both
      lightness and brightness constancy with fixed luminance ratios between test and
      annular fields under conditions varying in stimulus duration and adaptation.
      Lightness constancy occurred for all ratios under sustained viewing conditions
      and irrespective of adaptation level. Brightness constancy occurred for high
      contrast stimuli and under sustained viewing conditions. These results support a
      bidimensional description of achromatic stimuli and suggest that lightness and
      brightness are the outcomes of two functionally distinct processes.

PMID- 1744777
TI  - Influence of shape and perimeter length on induced color contrast.
AB  - The magnitude of induced color contrast was measured for tests whose areas,
      perimeter lengths, and shapes were independently varied. Test shapes were
      smoothly contoured, multiple-lobed figures generated from unitary Fourier shape
      descriptors. The shapes had from 3 to 40 lobes and were equal in area to a disk
      of diameter 2 deg, with perimeter lengths of 1.25, 1.75, 2.25, and 2.75 times the
      circumference of a 2-deg disk. The surround was a 5-deg disk. The surround was
      modulated sinusoidally along one of the three cardinal directions of color space
      around an equal-energy white of 50 cd/m2. The observer nulled the modulation
      induced into the test by adjusting the amplitude of real modulation in the test.
      The amplitude of nulling modulation was the measure of induction. The main result
      was that the amount of induction was similar for all tests of equal area
      irrespective of the shape or the length of perimeter.

PMID- 1744778
TI  - Effects of chromatic adaptation on opponent interactions in monkey increment
      threshold spectral-sensitivity functions.
AB  - The effects of chromatic adaptation on the opponent interactions of cone
      mechanisms were investigated by using increment-threshold spectral-sensitivity
      (ITSS) functions and threshold-versus-radiance (TVR) curves in rhesus monkey
      subjects. The TVR curves showed shape- and field-sensitivity invariance for both
      580- and 500-nm adapting backgrounds and indicated that three cone mechanisms
      were mediating detection over moderate adapting-field intensity levels.
      Differential adaptation between the long-wavelength-sensitive (L) and the middle
      wavelength-sensitive (M) opponent (L - M) and nonopponent (L + M) channels and
      the short-wavelength-sensitive (S) channel caused changes in the shape of the
      ITSS function as the adapting-field intensity was increased without changes in
      the level of cone interaction. Chromatic adaptation also resulted in significant
      changes in the shape of the ITSS functions, but it still exhibited characteristic
      L-M opponent interactions. Converting ITSS data to cone-contrast coordinates for
      R-G adapting fields indicated that the relative contribution of the L and M cones
      at the second site was approximately equal (detection contour slope approximately
      1). Consequently, most of the changes in the shape of ITSS functions under
      chromatic adaptation are explained by the von Kries adaptation principle. ITSS
      functions on a green background also exhibited opponent interactions between S
      cones and longer-wavelength cones. The cone-contrast coordinates, when expressed
      for S cones, showed that the inhibitory interactions occur because the S-cone
      signal subtracts from both M and L cones.

PMID- 1744779
TI  - On the germ theory of disease.

PMID- 1744780
TI  - A comparison of bacterial resistance to antimicrobials in Riyadh, Medina, and
      Oklahoma City.
AB  - Many bacteria are known to develop resistance to anti-microbial agents following
      their clinical use. The resistance pattern varies from one geographic location to
      another depending upon the patient population and local history of antibiotic
      use. The bacterial resistance to commonly used antimicrobial agents in Oklahoma
      City was found to be different from two cities in Saudi Arabia, especially
      amongst Gram-negative bacilli. A total of 13,575 fresh clinical isolates from the
      Veterans Administration Medical Center (VAMC), Oklahoma City, Oklahoma; the King
      Faisal Specialist Hospital and Research Centre (KFSH), Riyadh; and the King Fahad
      Hospital (KFH), Medina, Saudi Arabia; were used. There were 6,270 isolates of
      Enterobacteriaceae, 2,799 pseudomonads and Acinetobacter, and 4,506 Gram positive
      strains of staphylococcus bacteria. Gram-negative bacteria from KFH were
      considerably more resistant to ampicillin, gentamicin, and trimethoprim
      sulfamethoxazole than at KFSH and VAMC. On the other hand, Staphylococcus aureus
      isolated from VAMC exhibited a significantly higher degree of resistance to
      oxacillin and trimethoprim-sulfamethoxazole than those at KFSH and KFH.

PMID- 1744781
TI  - The descriptive epidemiology of Lyme disease in Oklahoma.
AB  - Lyme disease is a tick-borne illness that primarily occurs in the United States
      in three endemic areas: the northeast, upper midwest, and pacific coastal
      regions. Although Oklahoma is considered a non-endemic area of Lyme disease,
      other tick-borne infections such as Rocky Mountain spotted fever, ehrlichiosis,
      and tularemia occur at endemic levels. In order to determine the extent of Lyme
      disease in Oklahoma, the Oklahoma State Department of Health collected
      information on all possible cases of Lyme disease. The first reported Oklahoma
      case occurred in 1985. In 1988, and 1989, 8 and 25 cases, respectively, of Lyme
      disease were reported in Oklahoma residents who acquired their infection
      indigenously. The mean age of case-patients was 38 years. Twenty-eight of 33
      (85%) case-patients were white, and 4 of 33 (12%) were American Indian (race was
      unknown for 1 case-patient). The female/male ratio was 2.3. Most case-patients
      had onset of illness between May and September. Twenty-two counties reported
      cases, with Oklahoma County accounting for 4 of 33 (12%). Only 21 of 33 (64%)
      recalled a tick bite, and only 19 of 33 (58%) had erythema migrans. Continued
      active case-finding and passive reporting (as now mandated by state law) will
      further increase our knowledge of the epidemiology, ecology, and prevention of
      Lyme disease in Oklahoma.

PMID- 1744782
TI  - A comparison of human and animal mouth flora.
AB  - Human bite injuries are often believed to be more serious than animal bite
      injuries. One reason for this distinction might be a species difference in the
      microbial mouth flora. In order to compare this possibility, we cultured the
      mouths of humans, dogs, and cats. Human oral flora contained the smallest number
      of bacteria followed by dog and cat oral flora, respectively. Veillonella parvula
      was cultured from all humans and was also found in dog and cat mouths, but less
      frequently. V parvula is not usually considered a virulent organism but
      occasionally may become a pathogen and should not be overlooked especially
      following human bite injury.

PMID- 1744783
TI  - Patient demographic characteristics and housestaff performance in the care of
      patients with human immunodeficiency virus disease.
AB  - A retrospective review of the medical records of 45 patients with human
      immunodeficiency virus (HIV) disease was conducted in an Oklahoma internal
      medicine teaching clinic. Demographics of this patient population and house staff
      performance in the care of these patients was evaluated. The study population
      demographics were similar to national findings with the exception of lower
      documented homosexual/bisexual transmission among males and higher heterosexual
      transmission among females. Deficiencies in documentation were noted in the areas
      of route of acquisition, mental status, and functional level. In several
      instances patients who were candidates for zidovudine and/or Pneumocystis
      prophylaxis were not receiving these treatments. The quality of care could be
      enhanced through the use of HIV evaluation and treatment protocols as well as
      specially designed, HIV-specific medical records to improve data collection.
      These HIV-specific medical records can be found in the appendices.

PMID- 1744784
TI  - [Effects of heavy metal ions in endocochlear DC potential and cochlear
      microphonics in the guinea pig--the influence of calcium on the cochlea].
AB  - Endocochlear DC potential (EP) and cochlear microphonics (CM) in the guinea pig
      under the influence of the divalent heavy metal cations of manganese, nickel,
      cobalt and cadmium, and the trivalent cation of lanthanum were investigated. The
      area from the scala tympani to the scala vestibuli was perfused with control and
      test solutions. CM decreased gradually to 50-80%, but EP showed no change after
      perfusion with a solution containing 1 mM of metal ions. At a concentration of 10
      mM, EP decreased from 80 mV to 10-20 mV and CM decreased to 15-55%. At 100 mM, EP
      increased by about 10 mV at the beginning of perfusion, remained steady for 1
      min, and then rapidly decreased to 0-10 mV. Meanwhile, CM continued to decrease,
      finally sustaining a 10-56% reduction. The decrease in EP and CM were
      irreversible, and perfusion of the area with the standard solution for 20 min had
      no effect. The osmolarity of the artificial perilymph containing 100 mM of metal
      ions was twice as high as that of the normal physiological solution. The effects
      of osmolarity, however, were excluded because perfusion with an artificial
      perilymphatic solution made hypertonic by either NaCl or sucrose changed neither
      EP nor CM. The application of 100 mM of metal ions topically to the round window
      membrane caused no change in EP. The alkali metal ions are known to inhibit
      inward Ca2+ current. Therefore, the present results suggest that Ca2+ ions play a
      role in maintaining EP generation in the stria vascularis and CM generation in
      the organ of Corti.

PMID- 1744785
TI  - [Subclinical swallowing disorder in patients with abnormal sensation in the
      throat].
AB  - Measurement of swallowing pressure was done in 75 patients who complained of
      abnormal sensation such as obstructive sensation, difficulty in swallowing, etc.
      in the throat without noticeable cause. Abnormal swallowing pressure curves were
      observed in 33 patients (44%), and 76% of them showed abnormal elevation of the
      pressure at the hypopharyngeal or cervical esophageal region. These results
      indicated that subclinical swallowing disorder, particularly abnormal high
      swallowing pressure, can be a possible cause of their complaints. The author
      assumed that abnormal elevation of swallowing pressure is due to hypertonicity of
      the hypopharyngeal and cervical esophageal muscles. By the animal experiments
      using dog, a muscle relaxant, eperizone hydrochloride, revealed to change muscle
      tonus of the hypopharyngoesophageal muscles. Intravenous administration of the
      drug decreased swallowing pressure and prolonged the relaxation time of the
      cricopharyngeal muscle. Clinically the muscle relaxant showed to be effective in
      ameliorating the complaint of the patients with abnormal high swallowing pressure
      at the hypopharyngeal or cervical esophageal region. Based on the above results,
      the author proposed that the clinical entity, hypopharyngeal-cervical esophageal
      hypertonicity, causes a subclinical swallowing disorder leading to the abnormal
      sensation in the throat.

PMID- 1744786
TI  - [Antibody-producing ability of mononuclear cells from human tonsils: a
      consideration for immunological pathogenesis and operative indication of
      recurrent tonsillitis].
AB  - Antibody-production of mononuclear cells from human tonsils was examined by
      enzyme-linked immunosorbent assays in the culture system following polyclonal
      stimulations with pokeweed mitogen. The results were summarized and discussed as
      follows; 1) Age-related changes were not observed. 2) Antibody-producing ability
      in the intermittent phase of recurrent tonsillitis was significantly impaired. 3)
      Antibody-production in the recrudescent phase of recurrent tonsillitis was
      increased and might be reactivated probably by stimuli of the recent infection in
      vivo. 4) It was suggested that the recurrent tonsillitis was due to the low
      antibody-production ability of tonsillar mononuclear cells. 5) These results gave
      an immunological basis on the operative indication of recurrent tonsillitis.

PMID- 1744787
TI  - [Conventional X-ray versus CT in diagnosis of chronic sinusitis in children].
AB  - The interpretation of conventional radiographic views for sinusitis in children
      has given rise to considerable controversy. Thirty-three children (66 sides of
      sinuses) aged from 4 to 15 years who were suspected of having chronic sinusitis
      were studied to determine the accuracy of conventional X-ray examination,
      comparing the results with those of CT. Coronal CT was taken after conventional X
      ray examination (Waters and occipito-frontal views), and the time interval
      between these two examinations was 0 to 14 days (average 5.1 days). The rate of
      correspondence in diagnosis of sinus pathology between conventional X-ray views
      and CT was 74.3% in the maxillary sinus and 40.9% in the ethmoid. The rate of
      overestimation with conventional X-ray views was 24.2% in the maxillary sinus and
      56.1% in the ethmoid, while that of underestimation was 1.5% and 3.0% in the
      maxillary and the ethmoid sinus respectively. The incidence of false positives
      according to conventional X-ray views was 8.0% in the maxillary sinus and 33.3%
      in the ethmoid. Our results indicate that Waters view is sufficient to diagnose
      maxillary sinus pathology in children. However, additional radiologic
      examinations, such as CT, are necessary in investigating the pathologic
      conditions of the ethmoid sinus, since diagnostic significance of occipito
      frontal view for ethmoid pathology is doubtful in children. A routine
      preoperative CT is recommended, which allows a detailed evaluation of pathologic
      changes and anatomical relations of the ethmoid before embarking a surgical
      intervention for the ethmoid sinus in children.

PMID- 1744788
TI  - [A case of bilateral nontraumatic internal carotid aneurysms presenting with
      recurrent massive epistaxis].
AB  - A case of bilateral nontraumatic internal carotid aneurysms presenting with
      recurrent massive epistaxis was reported. A 37-year-old female complaining of
      massive epistaxis from the left nostril was admitted to our hospital. After
      admission, she experienced recurrent massive epistaxis, but had no cranial nerve
      palsies. Carotid angiography demonstrated an aneurysm of the cavernous portion of
      the left internal carotid artery partially protruding into the sphenoid sinus.
      Neck clipping of the aneurysm was unsuccessful, therefore the left internal
      carotid ligation in the neck was performed with a Selverstone clamp. After the
      ligation, no rebleeding and neurological deficits occurred. Postoperative carotid
      angiography showed an aneurysm of the right internal carotid artery at the same
      site. The carotid angiography of 3 months later and 1 year and 3 months later
      revealed that the left aneurysm decreased in size and the right one remained
      unchanged. Twenty-one cases including ours that presented nontraumatic internal
      carotid aneurysm of the cavernous portion were reviewed. Twelve cases had no
      cranial nerve palsies, and 7 cases including ours had no other symptoms than
      massive epistaxis. Because massiveness of epistaxis from an internal carotid
      aneurysm often threatens one's life, diagnosis should be made by carotid
      angiography as soon as possible. There are several surgical procedures for such
      aneurysms. Clipping is the ideal method which can interrupt the blood flow to the
      aneurysm completely, but it is very difficult to be performed anatomically.
      Carotid ligation in the neck with little surgical invasion was an excellent
      method in 7 cases without rebleeding and neurological deficits. Bilateral
      intracavernous internal carotid aneurysms were found in our case and another
      case.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744789
TI  - [Nonsequential vector analysis of body sway in Meniere's disease].
AB  - Body sway test which examines the vestibulo-spinal reflex is sensitive for
      evaluating vestibular dysfunction in patients with vertigo, dizziness or
      unsteadiness. Body sway is usually evaluated by measuring the length and area of
      traces on the force platform. However, it is not necessarily possible to evaluate
      abnormal body sway with these indicators because there is a discrepancy between
      sway length and area. In the present study, 8 directional vectro-posturography
      was developed and applied to the patients with Meniere's disease. Averaging of
      measurements at moving 3 points was used to eliminate high frequency noise over
      4.92Hz. The subjects consisted of 66 patients with unilateral Meniere's disease
      and 31 normal controls. Eight directional vectrogram allowed measurement of shift
      area and directionality, simultaneously. The patient's group showed statistically
      significant body sway in the right forward and left backward direction with eyes
      open, in all the directions with eyes closed, when compared with the control's
      group. The effect of vision on postural stability was studied by obtaining 8
      directional Romberg's quotients. The patients with Meniere's disease had
      significantly in forward-backward, and left-forward and right-backward direction
      when compared with controls. However, laterality of the affected side was not
      detected from the vectrogram. The effect of endolymphatic sac operation on
      postural stability was evaluated in the patients of unilateral Meniere's disease
      who showed progressive hearing loss and resisted conservative medication therapy.
      The results showed unstable body sway in the condition with eyes closed until at
      least 4 months after the operation. The patients with Meniere's disease presented
      pathological body sway, even during symptom free periods, when examined with 8
      directional vector posturography. Power spectral analysis of body sway indicated
      that most energy was distributed at frequencies lower than 0.5Hz. Nevertheless,
      directional preponderance of body sway was characterized by higher frequency
      components. The findings infers that postural stability at the frequency range
      over 0.5Hz, may be governed by the input of vestibular organs.

PMID- 1744790
TI  - [Allergic rhinitis nasal epithelial cell conditioned medium stimulates growth and
      differentiation of basophil/mast cell and eosinophil progenitors from atopic
      blood].
AB  - We examined the conditions, kinetics and cell sources for basophil/mast cell and
      eosinophil colony stimulating activity (CSA) production by nasal epithelial cells
      taken from house dust (HD) nasal allergic patients. Epithelial scrapings removed
      from HD nasal allergic patients were grown to confluence over 7 days as a
      monolayer of epithelial cells in medium supplemented with fetal calf serum (FCS)
      on collagen coated microwell plates. CSA in nasal epithelial cells conditioned
      medium (CM) was assessed with density-gradient separated, nonadherent peripheral
      blood mononuclear cells in 14-day and 21-day methylcellulose assays. In the 14
      day methylcellulose assays, the number of Eo-type colonies in the presence of
      either 10% or 5% CM was significantly higher than the background number of Eo
      type colonies (negative control). Comparison of Gm CSA among 1%, 5% and 10% CM
      with negative, revealed no significant differences. We also compared the Eo-type
      CSA in the presence of 10% significant differences. We also compared the Eo-type
      CSA in the presence of 10% CM in the 14-day methylcellulose assay with 21-day
      methylcellulose assay. There was no significant difference in the number of Eo
      type colony between the 14-day and 21-day methylcellulose assays. We also
      examined the composition of the cells in the colonies in the 14-day and 21-day
      methylcellulose cultures. The percentage of metachromatic granule containing
      cells in a Eo-type colony in 14-day methylcellulose assay was significantly
      higher than in a Eo-type colony in 21-day methylcellulose assay.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1744791
TI  - [Problems in evaluating the efficacy of treatment of sudden deafness].
AB  - 1) The indices of hearing recovery for sudden deafness was examined. Because it
      did not reflect the severity of the initial hearing loss, the standard of the
      Japanese Ministry of Welfare was thought to be inadequate. 2) Since the prognosis
      of sudden deafness was known to be influenced by several factors, it seemed to be
      necessary for evaluating the efficacy of treatment to exclude various modifying
      factors. For this purpose predicting hearing recovery based on multiple
      regression analysis is appropriate. 3) The predicting recovery rate with the
      actual recovery rate for 4 kinds of treatment was compared. No significant
      difference was found between the expected values and the observed values. 4) The
      scatter diagram indicated 2 groups of patients. This might be due to different
      pathophysiology of sudden deafness. In the good recovery group, the recovery rate
      for prostaglandin E1 therapy was significantly better than the expected one.

PMID- 1744792
TI  - [Effect of recognition of head and neck malignancies on patients' psychosomatic
      condition and personality].
AB  - In order to elucidate the effect of recognition of head and neck malignancies on
      patients' psychosomatic condition and personality, we applied the Cornell Medical
      Index Health Questionnaire (CMI) and the Maudsley Personality Inventory (MPI) and
      collected medical and psychological data from 35 male (42-78 years of age;
      average 62.5) and 15 female (20-76 years of age; average 54.7) patients with
      malignant head and neck tumors (10 nose and paranasal, 8 oral, 8 pharyngeal, 14
      laryngeal, 6 thyroid gland and 4 others). The two tests were done twice for each
      patients; at first immediately before hospitalization for treatment of the tumors
      at Mie University Hospital and secondly just before discharge from the hospital.
      The period of hospitalization ranged 1 to 13 months, average 3.3 months. At the
      end of hospitalization doctors and nurses who had mainly taken care of the
      patients estimated the patients' recognition of their malignancy by analyzing
      behavior and information mainly from their family and classified patients into
      three groups; Group R (Patients who recognized that they were patients with head
      and neck malignancies) comprised 22 patients, Group N (who did not recognize the
      condition) comprised 15 and Group U (who could not be classified into Groups R or
      N) comprised 13. Comparison among the three groups revealed the followings. 1)
      Patients in Group R were relatively young (average 56.3 years) and extrovert
      (estimated by MPI) and their somatic and psychological complaints registered on
      the CMI were less than those in other 2 groups. Psychosomatic condition after
      recognition that they had been patients with malignant tumors was better than
      before.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744793
TI  - [A study on the tonsil with focal infections--with special reference to the newly
      devised tonsillar cryptscope and the architecture of vessels in crypts].
AB  - It is well known that inflamed human palatine tonsils have many surface crypts
      showing characteristic lymphoepithelial symbiosis, which play an important role
      in immune response. The cryptepithelia are rich in blood vessels. This
      proliferation of blood vessels is said to be the initiation of various kinds of
      immune responses. We devised a tonsillar cryptscope in order to observe the
      tonsillar crypt. Scopy with the cryptscope confirmed seven characteristic types
      of capillary vessels. The cryptscopic figures showed different patterns in
      tonsillar diseases such as hypertrophic tonsil, recurrent tonsillitis and tonsil
      with focal infection (palmoplantar pustulosis and psoriasis vulgaris). In this
      study the significances of tonsillar cryptscopic figures were investigated
      through the study of three dimensional structures of blood vessels and immuno
      histology. In order to understand the structure of capillary vessels in details,
      human palatine tonsils were studied using corrosion casting techniques with a
      scanning electron microscope. Horseshoe type capillary vessels corresponded to
      the curved capillary vessels in the epithelium. This type of capillary vessel was
      observed in the epithelia covering the interfollicular area. The tonsillar blood
      vessels, along with closely related substances in the epithelium and the
      parenchyma, were immuno-histologically examined. Where the lymphocytes had
      densely infiltrated the epithelium, the basement membrane became thickened and
      often disrupted; the endothelial cells were also enlarged. Adrian et al reported
      that lymphocytes invaded from the capillary vessels within the epithelia. Thus it
      was suggested that the horseshoe type was related to lymphocyte invasion of the
      epithelia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1744794
TI  - [Transcranial color Doppler guided Matas' test].
AB  - Carotid artery involvement in head and neck tumor is a great concern to surgeons
      because of the unpredictable effects of its resection. For the investigation of
      brain collateral circulation, color Doppler guided Matas' test has been performed
      to examine blood flow in the middle cerebral artery (MCA) and internal carotid
      artery (ICA). SSA-270A convex (3.75MHz) and linear (3.75MHz, 2.5MHz) array probes
      (Toshiba Co., Ltd.) were used for this investigation. A temporary occlusion test
      (60 sec) was performed on the common carotid artery (CCA) in thirty patients who
      were scheduled to undergo radical neck dissection. The blood flow velocity of MCA
      during Matas' test was recorded. Then relative flow (percent blood flow before
      the test) of MCA during the 60 sec Matas' test was measured. The relative mean
      flow was 72% with a standard deviation of 15%. The results of thirty patients
      were classified into four groups according to the relative flow of MCA after 60
      sec occlusion of the common carotid artery: Group A, over 87% (three cases);
      Group B, 86-72% (twelve cases); Group C, 71-57% (twelve cases); Group D, under
      56% (three cases). Brain collateral circulation (BCC) of the Group A patients was
      considered to be excellent, and therefore reconstructive vascular surgery (RVS)
      was not necessarily indicated. In Group B patients (fair) and Group C patients
      (slightly poor) further investigation of BCC, i.e., Balloon Matas' test
      (occlusion of CCA and ICA), SPECT and brain angiography, was considered to be
      necessary. In Group D patients (poor) RVS was inevitable if either CCA or ICA had
      to be resected. Important information is provided by this noninvasive examination
      to predict the risk of carotid resection. This test seems to be useful to
      determine whether or not RVS is indicated.

PMID- 1744795
TI  - [Application of color Doppler to the head and neck region].
AB  - In the diagnosis of the head and neck region it is important to investigate the
      relationship between the lesions and surrounding vessels, including their
      hemodynamics, pre- and/or postoperatively. For this purpose color Doppler has
      been used in recent years. However, there is little information on the use of
      color Doppler in this region. This report describes an attempt to apply this
      examination to the region of the head and neck. Standard methods of detection of
      the main arteries and internal jugular vein have been devised, and the blood
      velocity and flow of those arteries were measured using SSA-270A convex (3.75
      MHz) and linear (3.75 MHz, 2.5 MHz) array probes (Toshiba Co., Ltd.). This
      technique was also applied to several clinical cases. The results of these
      investigation were as follows. 1) The middle cerebral, vertebral and basilar, and
      carotid arteries and their branches could be studied. 2) Blood velocity and flow
      of the main arteries were reasonable when compared with the results of
      scintigraphy and electromagnetic studies. 3) The vessels surrounding the tumors
      were easy to detect. The location or hemodynamics of metastatic tumors,
      pseudoaneurysm, and tongue hemangioma could also be displayed. The technique was
      also useful for the blood flow estimation in the portion of vascular anastomosis.

PMID- 1744796
TI  - The expression of parathyroid hormone messenger RNA in normal and abnormal
      parathyroid tissue.
AB  - The distribution and expression of preproparathyroid hormone (PTH) mRNA were
      investigated in parathyroid tissue from 57 parathyroidectomy specimens. PTH mRNA
      was detected by in situ hybridization using digoxigenin-labelled oligonucleotide
      probes. Cell morphology was seen to correlate with PTH mRNA expression. Strong
      expression of PTH mRNA was confined to cells which on haematoxylin and eosin
      staining had large vesicular nuclei. These included both vacuolated and non
      vacuolated cells. Chief cells with small dark nuclei and scanty cytoplasm had
      little or no expression. In both adenoma and chief cell hyperplasia, the striking
      difference from normal was the greatly increased proportion of cells expressing
      PTH mRNA. In adenomas, the rim of uninvolved parathyroid tissue showed PTH mRNA
      expression similar to that of normal parathyroid. In hyperplasia, there was
      frequently concordance of staining within individual nodules. The findings
      establish morphological criteria for activity of parathyroid tissue and support
      current concepts of the different pathogenesis of hyperplasia and adenoma. The
      expression of PTH mRNA in oxyphil change and parathyroid carcinoma was also
      investigated.

PMID- 1744797
TI  - Leakiness of gastric superficial and foveolar cells. A quantitative electron
      microscopic study using tannic acid.
AB  - Two adjacent antral biopsies were taken endoscopically from 41 patients attending
      a clinic for the investigation of upper gastrointestinal tract symptoms. One was
      processed for histopathological grading and assessment of the Helicobacter pylori
      by light microscopy. The other was fixed in tannic acid, which demonstrates cell
      leakiness, and processed for electron microscopy. On each grid, the light
      (electron lucent) and dark (electron dense-leaky) gastric superficial and
      foveolar cells away from mechanical trauma of biopsy were counted, along with the
      number of H. pylori which were in contact with the epithelial cells. There was a
      significant relationship between histological grade of gastritis and the extent
      of electron microscopic damage, i.e., the degradation of normal to leaky cells
      and the number of H. pylori per leaky cell. If the patients were divided into two
      groups with minimal and maximal gastritis and compared against each other, then
      there was a significant difference between the two groups with respect to surface
      cell damage, polymorphs per unit area, the number of glands invaded by
      polymorphs, light/dark cells, Helicobacter grades assessed light microscopically
      or totals counted in contact with epithelial cells by electron microscopy, the
      number of Helicobacter per cell, and the age of the patients. There was no
      difference between the two groups on their endoscopic appearances or treatment
      with H2 blockers or NSAIDS.

PMID- 1744798
TI  - CD23 expression in non-Hodgkin lymphoma: immunohistochemical demonstration using
      the antibody BU38 on paraffin sections.
AB  - The leucocyte antigen CD23 is upregulated in the early stages of B-cell
      activation by Interleukin-4 (IL-4), and functions as an IgE receptor and
      lymphocyte growth factor. We have studied the expression of CD23 in 68 cases of
      non-Hodgkin lymphoma (NHL) using the antibody BU38. This new antibody has the
      great advantage of being applicable to routinely-processed paraffin sections.
      CD23 was expressed in tumour cells in 27 out of 36 cases of low grade NHL and 3
      out of 32 cases of high grade NHL. Follicular dendritic cells were strongly
      positive and were seen in follicular lymphomas. Macrophages were also positive
      and were numerous in high grade lesions.

PMID- 1744799
TI  - MHC antigen expression in human oral squamous carcinoma cell lines.
AB  - This study quantified the constitutive and interferon-gamma (IFN-gamma)
      stimulated expression of MHC class I (HLA-ABC and beta 2 microglobulin) and class
      II antigens (HLA-DR, -DP, -DQ) on normal and malignant oral keratinocytes using
      radioimmunoassay and immunocytochemical techniques. Normal keratinocytes and
      three of four malignant cell lines (H103, H157, H314) expressed MHC class I
      antigens constitutively; IFN-gamma increased MHC class I expression with
      significant changes in normals, H157 and H314. Normal keratinocytes expressed
      significantly more constitutive MHC class I antigens than H103 and H157 and
      significantly more IFN-gamma stimulated MHC class I antigens than H103, H157 and
      H314. MHC class II antigens predominantly were not expressed constitutively on
      normals, H103 and H157 but, in H314, HLA-DR, -DP and -DQ antigens were
      demonstrated on 35, 11 and 5 per cent of cells, respectively, and resulted in a
      non-coordinated pattern of expression (HLA-DR greater than -DP = -DQ). IFN-gamma
      induced HLA-DR on normals, H103 and H157, whilst HLA-DP and -DQ remained
      undetectable. In H314, IFN-gamma enhanced HLA-DR, -DP and -DQ (significant
      increase of HLA-DQ) but the interrelationship between these antigens was
      maintained (HLA-DR greater than -DP = -DQ). Normal keratinocytes expressed
      significantly more IFN-gamma stimulated HLA-DR than H103 and H157 but
      significantly less HLA-DR than H314 under similar experimental conditions. One
      oral malignant cell line (H191) did not express MHC class I and MHC class II
      antigens either constitutively or in response to IFN-gamma. The results
      demonstrate aberrant patterns of MHC expression (absence, enhanced, diminished)
      in the different malignant oral keratinocyte cell lines.

PMID- 1744800
TI  - Immunocytochemistry of malignant mesothelioma: OV632 as a marker of malignant
      mesothelioma.
AB  - In pleural or ascitic effusions the cytomorphological distinction of
      adenocarcinoma cells, reactive mesothelial cells, and malignant mesothelioma
      cells often causes a diagnostic dilemma. The value of immunocytochemistry was
      investigated on cytological smears of 24 well-established cases of malignant
      mesothelioma, a selected series of 31 metastatic adenocarcinomas, and 20 smears
      of patients without known malignancy. In these smears we scored the
      immunoreactivity with a panel of four monoclonal antibodies. In addition to
      antibodies for epithelial membrane antigen (EMA) and carcinoembryonic antigen
      (CEA), the monoclonal antibody MOC31 and the ovarian carcinoma specific antibody
      OV632 were incorporated in the panel. With none of these four antibodies was
      immunostaining of reactive mesothelial cells found. CEA- and MOC31-positive
      tumour cells were frequent in metastatic adenocarcinomas, but occurred rarely in
      malignant mesotheliomas. EMA-positive tumour cells were found in all metastatic
      adenocarcinomas (100 per cent) and in most malignant mesotheliomas (83 per cent).
      In addition to the expected reactivity of OV632 with ovarian carcinomas, 22 of 24
      malignant mesotheliomas contained immunopositive tumour cells, while only a small
      proportion of non-ovarian adenocarcinomas reacted with this antibody. This
      selective staining of malignant mesothelioma cells, but not reactive mesothelial
      cells, with OV632 now permits the positive identification of malignant
      mesothelioma cells in male patients.

PMID- 1744801
TI  - Composition and organization of cell-substratum contacts in normal and neoplastic
      renal epithelium.
AB  - We have investigated the molecular basis of the organization of cell-substratum
      contact in normal and neoplastic renal epithelium. The several components of
      focal contacts and non-collagenous basement membrane glycoproteins have been
      identified by antibodies, detected by immunofluorescence and viewed by laser
      scanning microscopy. Tubular epithelial cells grown on glass coverslips expressed
      laminin at the cell periphery. Co-localized with laminin were receptors of the
      beta 1 integrin class, and the cytoplasmic plaque proteins vinculin and talin.
      When basement membrane glycoproteins laminin or fibronectin were exogenously
      supplied by growing cells on coated coverslips, the vinculin-, talin- and
      integrin-containing contacts became organized into linear arrays with intervening
      free cell membranes. Under these conditions the actin cytoskeleton became highly
      organized. By contrast some tumour cells showed a reduction in focal contact
      molecules and a failure to organize these structures in response to laminin or
      fibronectin. This loss of cell matrix interaction may be important during the
      progression of renal tumours.

PMID- 1744802
TI  - LPD, a glandular or vascular problem?

PMID- 1744803
TI  - Insulitis in type 1 (insulin-dependent) diabetes mellitus in man--macrophages,
      lymphocytes, and interferon-gamma containing cells.
AB  - This study sought to determine, firstly, the relative frequency of lymphocytes
      and macrophages and, secondly, the percentage of lymphocytes containing
      interferon-gamma in inflamed islets (insulitis) of patients with type 1 (insulin
      dependent) diabetes. Autopsy pancreases of 12 patients who had died of recent
      onset type 1 diabetes and one pre-diabetic patient who had died of cardiomyopathy
      were examined immunohistochemically. In the 87 islets that were studied, the
      lymphocyte macrophage ratio was 9.7:1 and approximately 40 per cent of the
      lymphocytes contained interferon-gamma. Interferon-gamma release in the insulitis
      process may be involved in the pathogenesis of type 1 diabetes.

PMID- 1744804
TI  - Behavior problems and adaptive functioning in children with mild and severe
      closed head injury.
AB  - Assessed behavior problems and adaptive functioning in children with mild or
      severe closed head injuries, on average more than 2 years postaccident. To ensure
      that any problems detected in the present study were not merely preexisting
      problems, potential subjects were excluded if there was a history of preexisting
      CNS damage, significant developmental delay, or behavior problems. Children with
      severe head injuries had an excessive rate of behavior problems and impaired
      adaptive functioning. Children with mild head injuries also had an excessive rate
      of behavior problems (comparable to that of children with severe head injuries)
      but did not have impaired adaptive functioning. Results are discussed in terms of
      six alternative ways brain injury and behavior problems can be related
      functionally.

PMID- 1744805
TI  - Disease experience and psychosocial adjustment in children with juvenile
      rheumatoid arthritis: children's versus mothers' reports.
AB  - Adjustment in children with juvenile rheumatoid arthritis (JRA) has been
      evaluated most frequently by parental or teacher reports and with reference to
      disease severity. In this study, 38 children, ages 7 to 13 with JRA, and their
      mothers were interviewed. Modest correlations were found between children and
      mothers in their assessments of children's perceived competence in several
      domains (i.e., athletic competence, social acceptance, physical attractiveness,
      and global self-worth) and in their perceptions of how JRA is experienced by
      children and families. Children's perceptions of the disease experience were
      significantly correlated with the four measures of perceived competence, even
      after controlling for disease severity. The results highlight the importance of
      cross-validating parental reports with children's self-reports, and demonstrate
      the need to consider variables other than disease severity--in particular how JRA
      is interpreted by children--in predicting their adjustment.

PMID- 1744806
TI  - Neuropsychological function in young children who have undergone liver
      transplantation.
AB  - Presented neuropsychological data from 20 patients between the ages of 4 and 9
      years, who had undergone liver transplantation at least 12 months prior to study
      participation, and compared them to a control group of 20 children with cystic
      fibrosis. The liver transplant group showed deficits in VIQ, PIQ, visual-spatial
      and abstraction/reasoning skills, but not in alertness/concentration, motor, or
      sensory-perceptual functions. On motor and sensory-perceptual tests, no
      differences were found in direction of lateralization of deficits. Visual-spatial
      deficits found in this study sample are similar to those found in adults with end
      stage liver disease and in a previous report of an overall older group of
      children following liver transplantation. However younger children have greater
      evidence of generalized impairment and VIQ deficits which have not been found in
      older groups. Findings are discussed in relation to possible etiology, location
      of brain damage, and clinical implications.

PMID- 1744807
TI  - A comparison of memory and attention in Turner syndrome and learning disability.
AB  - Compared short-term verbal memory, sustained attention, and impulsivity in 13
      children with Turner syndrome to 13 females and 14 males with learning disability
      who had neuropsychological patterns similar to the children with Turner syndrome.
      Similar patterns of short-term memory deficits were found in all three groups.
      There were no significant differences among the groups on computer measures of
      sustained attention and impulsivity. However, extreme variability of the
      attention and impulsivity scores for the Turner syndrome group may reflect
      atypical attention deficit disorder in some of these children.

PMID- 1744808
TI  - Prevention of spinal cord injury: an elementary education approach.
AB  - Spinal cord injury (SCI) results in permanent paralysis and most often happens to
      teenagers and young adults. High risk behaviors are most often the cause;
      therefore these injuries are often preventable. In response to a gap in existing
      prevention programs, an elementary age SCI prevention program was developed,
      designed for implementation by teachers. Evaluation was carried out via a quasi
      experimental pre-post comparison group design. Experimental students demonstrated
      significantly improved knowledge of SCI and its prevention. Similar changes in
      self-reported safety belt use were not noted. Development of the curriculum,
      related grant activities, and plans for national dissemination are described.

PMID- 1744809
TI  - Cognitive remediation in pediatric head injury: a case study.
AB  - Little work has been done in delineating cognitive remediation approaches for
      pediatric survivors of head injury. The use of a cognitive remediation approach
      is described in a case study of a 16-year-old male, who was 1 1/2 years post
      severe traumatic brain injury. Specific techniques and treatment course are
      outlined to demonstrate the model offered as one meeting the unique needs of the
      pediatric survivor. This model emphasizes a behavioral, individually tailored
      approach with clear delineation of a functional academic skill goal of competence
      in mathematical computation. Results indicate accomplishment of goals and some
      generalization of skills obtained to a math domain that was not the major focus
      of the remediation attempts.

PMID- 1744810
TI  - The children's eating behavior inventory: reliability and validity results.
AB  - Eating and mealtime problems are common in childhood. They occur across a broad
      age span, in normally developing children and in a wide variety of developmental
      and medical disorders. There is no currently available standard instrument by
      which to assess these problems. The Children's Eating Behavior Inventory (CEBI)
      was developed according to a conceptual framework based upon a
      transactional/systemic understanding of parent-child relationships. It was
      completed by 206 mothers of nonclinic children and 110 mothers of clinic
      children. Results of test-retest and internal reliability testing indicate that
      the CEBI meets criteria for instrument reliability. Construct validity is
      demonstrated by the significant difference between the clinic and nonclinic
      groups in the mean total eating problem score and in the mean number of items
      perceived to be a problem.

PMID- 1744811
TI  - Sickle cell disease in children and adolescents: the relation of child and parent
      pain coping strategies to adjustment.
AB  - Examined pain coping strategies in 72 children and adolescents with sickle cell
      disease and their parents using the Coping Strategies Questionnaire, and found
      that pain coping strategies could be reliably assessed. Children high on Negative
      Thinking and Passive Adherence were less active, required more health care
      services, and were more psychologically distressed during painful episodes.
      Children high on Coping Attempts were more active and required less frequent
      health care services. Parents high on Coping Attempts and low on Passive
      Adherence had children who were more active.

PMID- 1744812
TI  - Athermal effects of microwaves.

PMID- 1744813
TI  - "A perspective on 'athermal' effects".

PMID- 1744814
TI  - Microwave blood plasma defroster.
AB  - A microwave blood plasma defroster capable of thawing up to four bags of frozen
      blood plasma at a time is described. The unit stops automatically when the plasma
      reaches a preset temperature, and all operating parameters are monitored for
      safety. Comparative testing showed that blood plasma thawed in this device was
      indistinguishable from plasma thawed in a water bath.

PMID- 1744815
TI  - Programmable sweep radiometer system as a new tool for non-invasive thermometry.
AB  - A new microwave radiometer system consisting of a frequency sweep-type radiometer
      and an ultra wideband antenna has been developed. A computer-controlled
      radiometer system covers the input frequency range from 0.5 GHz to 8 GHz. It can
      be used not only as a multispectral radiometer system whose frequencies can be
      chosen freely, but also as a frequency sweep-type radiometer system whose
      frequency is continuously swept during measurement. When an antenna is attached
      to a forearm, the sensitivity of the radiometer system exceeds 0.09 degree C when
      the integration time is 3 sec and IF bandwidth is 500 MHz. The new microwave
      radiometer system may be utilized for non-invasive thermometry of the human body.

PMID- 1744816
TI  - On the role of 26-deoxylaidlomycin in laidlomycin biosynthesis.
AB  - 3H-26-deoxylaidlomycin (I) was fed to growing cultures of Streptoverticillium
      olivoreticuli IMET 43782 producing both I and laidlomycin (II). The incorporation
      of labelled I into laidlomycin II was neglible showing a role of I as precursor
      of II to be at variance. Otherwise, a measurable conversion was achieved by the
      use of sonicated 48 hrs mycelium suggesting that final oxidation of I to II could
      be mediated by a compartmentized oxidoreductase.

PMID- 1744817
TI  - Analysis of extrinsic factor associated with 379 injuries occurring during 34,236
      military parachute descents.
AB  - A retrospective study of 34,236 consecutive static line parachute descents by
      trained parachutists, in which 379 were injured, is described. Injury rates
      associated with extrinsic factors were compared and then analyzed using logistic
      regression. A table describing the association with extrinsic factors, with
      relative risks, is at Annex A. The overall injury rate was 1.11% (1.11 injured
      per 100 descents). Rates from Helicopter (0.20%) and Balloon (0.13%) were low,
      and the study thus concentrated on aeroplane descents (injury rate 1.46%).
      Extrinsic factors associated with increased injury rates were carriage of
      equipment; wind speed and direction; numbers exiting and (on logistic regression)
      night descents. The overall rates appear higher than expected, possibly due to
      equipment weight potentiating the other factors. A prospective study is required
      to investigate the effect of equipment weight after which peace time training
      constraints should be reviewed. (Two approaches are described.)

PMID- 1744818
TI  - The epidemiology of snake bite presenting to British Military Hospital Dharan
      during 1989.
AB  - Fifty-eight cases of snake bite seen at the British Military Hospital, Dharan,
      Nepal during 1989 were studied prospectively. Data is presented on the
      epidemiology and outcome of snake bite in this area of lowland Nepal with details
      of the age and sex of patients, date and time of bite, delay in arrival at
      hospital, use of tourniquets, circumstances of the bite, and snake
      identification. Neurotoxicity due to envenomation was recorded in 11 patients. No
      case of coagulopathy was recorded. The overall case fatality was 5.2% but
      mortality amongst those exhibiting signs of neurotoxicity was 27.3%.

PMID- 1744819
TI  - Community acquired pneumonia in the Gulf.

PMID- 1744820
TI  - A study into loss of consciousness.
AB  - The case notes of patients admitted with loss of consciousness (LOC) to BMH
      Rinteln over 18 months were retrospectively studied. Forty percent of those
      diagnosed as epileptic were heavy goods vehicle (HGV) drivers. This paper audits
      the criteria for diagnosis and discusses its implications on the soldier's
      career.

PMID- 1744821
TI  - Trauma care in a military hospital.
AB  - The results of a quinquennial audit of trauma care in the Cambridge Military
      Hospital using the TRISS method is presented. 113 cases were analysed. The mean
      age was 32 years and the mean Injury Severity Score 16. Twenty-five deaths
      occurred of which 12 were potentially preventable. Means of reducing the number
      of preventable deaths are discussed.

PMID- 1744822
TI  - Stone fish and stingrays--some notes on the injuries that they cause to man.
AB  - A review is presented of past and present records of injuries caused by these
      fish with particular reference to the occasional fatalities that have ensued. The
      wide geographical range of species of both types indicate a variety of current
      Service postings where such injuries can be sustained. The pharmacological
      actions of the venoms of both types are summarised as far as they are known.
      Modern lines of management are described which stress the need for thorough
      debridement of these injuries.

PMID- 1744823
TI  - A simple method of isolated digital exsanguination.

PMID- 1744824
TI  - A mobile anaesthetic--rapid evacuation from hospital.
AB  - The use of the Triservice Anaesthetic Apparatus for the emergency evacuation of
      an anaesthetised patient from nuclear, biological and chemical (NBC) collective
      protection in a tented hospital complex in the Gulf is described. Because of its
      compact size and portability the Triservice Anaesthetic Apparatus may prove to be
      ideal for use in emergency evacuation.

PMID- 1744825
TI  - Traumatic rupture of bicepts brachii--a hazard of military parachuting.
AB  - Closed traumatic rupture of the biceps brachii has not been reported occurring to
      a British military parachutist. This paper describes such an injury to a British
      military parachutist using United States (US) Army equipment and procedures. The
      discussion highlights differences between British Army and US Army equipment and
      procedures which make the chances of this injury occurring to a British
      paratrooper very small.

PMID- 1744826
TI  - Trans-radial styloid, trans-scaphoid, trans-triquetral perilunate dislocation.
AB  - A rare case of trans-radial styloid, trans-scaphoid, trans-triquetral perilunate
      dislocation is described. The injury was treated by reduction and internal
      fixation using a Herbert screw and Kirschner wire. A good functional result was
      achieved. A review of the literature illustrates that early surgery is
      recommended. Alternative surgical approaches are discussed.

PMID- 1744827
TI  - West African malaria.
AB  - Plasmodium falciparum malaria poses an increasing risk to travellers to West
      Africa. The development of chloroquine resistant in West Africa has further
      compounded the risk. Two cases of falciparum malaria from Sierra Leone are
      presented. One represents the classic missed case and the other a probable case
      of chloroquine resistant (RI vide infra) falciparum malaria. These cases
      highlight the danger of the missed or late diagnosis; the need for
      chemoprophylaxis, even in emigrants; the threat posed to the international
      traveller by malaria; and the problem of chloroquine resistant Plasmodium
      falciparum (CRPF) malaria from West Africa. The position of Plasmodium falciparum
      malaria in West Africa is reviewed along with the problem caused by chloroquine
      resistance.

PMID- 1744828
TI  - Oesophageal spasm as a side effect of nerve agent pre-treatment system.

PMID- 1744829
TI  - Pilonidal sinus in an amputee.

PMID- 1744830
TI  - Future of the Army medical services.

PMID- 1744831
TI  - Scavenging from the triservice anaesthetic apparatus (TSA)

PMID- 1744832
TI  - Warming intravenous fluids.

PMID- 1744833
TI  - Ethics, economics and science.

PMID- 1744834
TI  - 'Cardiogenic dementia' revisited.

PMID- 1744835
TI  - Metchnikoff revisited.

PMID- 1744836
TI  - Otitis media and its sequelae.

PMID- 1744837
TI  - Hearing loss in chronic renal failure-hearing threshold changes following
      haemodialysis.
AB  - The prevalence of sensorineural hearing loss, measured by pure tone audiometry,
      was determined in 66 patients with chronic renal failure and threshold changes
      following haemodialysis were measured in 31 patients. The incidence of hearing
      loss was 41% in the low, 15% in the middle and 53% in the high frequency ranges
      respectively. No correlations with weight changes, haematocrit, metabolic bone
      disease or ototoxic drug history were found. Of 62 ears studied, 38% had a
      decrease in low frequency threshold after dialysis and 9% had an increase.
      Threshold in 22/31 ears with pre-existing low frequency loss altered after
      dialysis with little change in other frequencies and no correlation with weight
      changes. In conclusion, we find a high incidence of low and high frequency
      hearing losses in chronic renal failure patients. Fluctuation in low frequencies
      with dialysis is common. Possible mechanisms include treatment induced changes in
      fluid and electrolyte composition of endolymph.

PMID- 1744838
TI  - Open access exercise electrocardiography: a service to improve management of
      ischaemic heart disease by general practitioners.
AB  - An initial study of the use of open access exercise electrocardiography by
      general practitioners (GPs) in South East Kent showed that patient selection and
      interpretation of test results was frequently incorrect. After issuing
      guidelines, modifying the request form and instituting registrar review of all
      requests, significant improvements in both referral pattern, result
      interpretation and patient management have resulted. Forty-nine GPs requested 110
      exercise tests during 1988/89. Twelve per cent were not undertaken after
      discussion with the referring practitioner. Eighty-four per cent of those tested
      would have been referred to the district general hospital cardiology outpatient
      department in the absence of open access exercise electrocardiography service.
      Six per cent of patients were referred directly for invasive investigation.
      Thirty-five per cent were referred to the district general hospital cardiology
      outpatient department, whilst 42% were spared hospital referral based on the
      result of the investigation. Better use of the modified service was suggested by:
      referral of fewer patients with non-cardiac chest pains (P = 0.002); more
      patients with a moderate pre-test probability of ischaemic heart disease (P less
      than 0.05); fewer inappropriate requests (P less than 0.01); and fewer
      inappropriately undertaken tests (P less than 0.001) than in the previous study.
      All patients with strongly positive test results were appropriately managed. Open
      access exercise electrocardiography in the format investigated is potentially a
      cost-effective and useful tool to improve diagnosis and management of heart
      disease by GPs.

PMID- 1744839
TI  - Patients learning from each other: self-help groups for people with diabetes.

PMID- 1744840
TI  - Accuracy of reagent strip testing for urinary tract infection in the elderly.
AB  - The accuracy of reagent strip testing for urinary tract infection (UTI) was
      assessed in 100 elderly patients (50 acute patients admitted to hospital and 50
      attending the day hospital). Reagent strip sensitivities were: acute patients
      urinary nitrite 83%, blood 67%, protein 72% and leucocytes 72%, and day hospital
      patients-urinary nitrite 90%, blood 65%, protein 30% and leucocytes 60%. Urinary
      nitrite specificities were 100% for both groups of patients. Only 28% of patients
      with a UTI had specific symptoms of the infection; pyrexia and a raised WBC also
      proved poor indicators. Urinary nitrite was thus the most accurate immediate
      indicator of UTI.

PMID- 1744841
TI  - Conserving blood in preparation for elective surgery.
AB  - A prospective study was carried out for a period of 6 months (September 1987 to
      28 February 1988) to evaluate the possible misuse of blood transfusion service in
      the department of surgery, Amiri Teaching Hospital, Kuwait. There was a monthly
      wastage of 45 +/- 13 units of blood. Five hundred and eleven units of blood were
      crossmatched but never transfused. The time taken by the blood bank technicians
      in crossmatching blood which was never used amounted to 54.4% of the normal
      working hours. An annual loss of about US$25000.00 was calculated to have
      occurred.

PMID- 1744842
TI  - Frankincense and myrrh as remedies in children.
AB  - Two cases of therapy with frankincense and myrrh in children are presented. The
      long history of this unusual treatment is outlined, demonstrating that for
      several millenia such agents have been employed in a number of medical contexts,
      as well as in the perfume and incense industries. Myrrh has found recent
      pharmacological application in the reduction of cholesterol and triglycerides, as
      predicted by several traditional therapies.

PMID- 1744843
TI  - Observations on the intrinsic blood supply to the human patella: disruption
      correlated with articular surface degeneration.
AB  - The intrinsic blood supplies of 13 human patellae with varying degrees of
      articular surface degeneration were studied by perfusion techniques. Disruption
      of the normal pattern of arterial arcades correlated with increasing surface
      wear.

PMID- 1744844
TI  - Role of drugs and alcohol in patients with head injury.
AB  - In an effort to define the role that substance abuse has to play in head
      injuries, a prospective study of 204 patients presenting to the Accident and
      Emergency (A&E) Department over a 10-week period was carried out. Urine samples
      were collected and assayed for the presence of common drugs of abuse and alcohol.
      One or other substance (drugs or alcohol) was detected in 43% of patients. The
      association between alcohol and head injuries has been confirmed and the
      importance of drugs in this area has been addressed and found to be of some
      significance. More rapid and accurate methods of assaying these substances may
      improve our management of head injury patients.

PMID- 1744845
TI  - Postoperative fluid therapy--put not thy faith in dextrose saline: discussion
      paper.

PMID- 1744846
TI  - Long-term difficult-to-manage patients--their need for continuity of care:
      discussion paper.

PMID- 1744847
TI  - Angiodysplasia: a review.

PMID- 1744848
TI  - Lucja Frey and the auriculotemporal nerve syndrome.

PMID- 1744849
TI  - From blood pressure to hypertension: the history of research.

PMID- 1744850
TI  - Unilateral choanal atresia.

PMID- 1744851
TI  - Blastocystis hominis complicating ulcerative colitis.

PMID- 1744852
TI  - Successful treatment of neonatal purpura fulminans with epoprostenol.

PMID- 1744853
TI  - Reversal of cognitive deficit by cardiac pacing in a young man with dystrophia
      myotonica.

PMID- 1744854
TI  - Bilateral internuclear ophthalmoplegia as a false localizing sign.

PMID- 1744855
TI  - Acquired C1-inhibitor deficiency preceding malignant lymphoma by 7 years.

PMID- 1744856
TI  - Moraxella lacunata infectious arthritis.

PMID- 1744857
TI  - Lead poisoning due to Asian ethnic treatment for impotence.

PMID- 1744858
TI  - Medical helicopter systems.

PMID- 1744859
TI  - The war on cancer.

PMID- 1744860
TI  - Myalgic encephalomyelitis.

PMID- 1744861
TI  - Surgeons and the risk of contamination during operations.

PMID- 1744862
TI  - Pathology; is it well taught?

PMID- 1744863
TI  - The Coma report: sugars and dental caries.

PMID- 1744864
TI  - Haemorheological treatment of ischaemia--facts or fancy?

PMID- 1744865
TI  - What is the best dosage schedule for patients?

PMID- 1744866
TI  - The police doctor in and out of court--a view from the bench.

PMID- 1744867
TI  - A novel approach to anxiolytic premedication for day-case patients.
AB  - The usefulness of 10 mg timolol orally as a non-sedative anxiolytic premedicant
      for day-case patients was examined in a double-blind placebo-controlled study.
      Patients were invited to take part by letter sent the week before gynaecological
      (n = 40) or oral (n = 60) surgery was scheduled. Indices of anxiety and alertness
      were obtained prior to administration of the tablet; quality of previous
      anaesthetic experience was also recorded. In those patients with no previous or
      unpleasant previous anaesthetic experience a significant reduction in anxiety
      amongst those given timolol was identified. Haemodynamic differences between the
      groups were not clinically significant, and return of psychomotor function was
      not delayed by timolol. Timolol effectively reduces situational anxiety, is non
      sedative, and is advocated as a premedicant for anxious day-case patients and
      others in whom rapid return of psychomotor function is desirable.

PMID- 1744868
TI  - Low dose botulinum toxin in spasmodic torticollis.
AB  - Botulinum toxin has been successfully used to treat spasmodic torticollis. The
      optimum dosage is not clear and the recommended doses in the United Kingdom are
      20-25 ng. We have used much lower doses (average 13 ng) without loss of efficacy
      and accompanied by a reduction in side effects. We treated 12 patients (eight
      women and four men) with a mean duration of torticollis of 4 years. Eleven of the
      12 patients (91%) showed an improvement in total scores for pain and degree of
      head movement. The benefits appeared a week after treatment and lasted for 3
      months. Side effects were minimal and transient. Our experience suggests low
      doses of the toxin may be equally efficacious.

PMID- 1744869
TI  - Impact of an extensive in situ component on the presence of residual disease in
      screen detected breast cancer.
AB  - This study investigates the histopathological characteristics of a consecutive
      series of 100 screen detected breast cancers in relation to residual disease.
      Tumour type, size, grade, resection margins and extent of primary or associated
      in situ disease were all assessed by one pathologist. Thirty-seven women
      underwent further surgery (wider excision or mastectomy) and the resected
      specimen was examined for residual in situ or invasive cancer. In total, 36
      cancers had an extensive in situ component, of which 69% were predominantly
      intraduct carcinoma of comedo type. Of the 37 women who underwent further
      resection, 21 (57%) women had residual cancer. Of those with initial disease at
      the resection margin, 16/25 (64%) had residual disease. Five of 12 (42%) with
      disease close to (within 2-3 mm) but not at the margin had residual disease. Of
      those with an extensive in situ component, 18/25 (72%) had residual disease,
      whereas only 2/12 (17%) women with none or some in situ disease had residual
      cancer. In screen detected breast cancer, residual cancer was present in 72% of
      women with an extensive in situ component at initial surgery. These women
      comprise a group in which conservation surgery may be inappropriate if
      completeness of excision is considered a prerequisite for breast conserving
      surgery.

PMID- 1744870
TI  - Rape and sexually transmitted diseases: patterns of referral and incidence in a
      department of genitourinary medicine.
AB  - A retrospective study was carried out of all women attending a Department of
      Genitourinary Medicine over a 3-year period. Note was taken of referring source,
      presenting symptoms, infection detected at STD screening and follow-up
      attendance. Comparison was also made between the number of women referred by the
      police surgeon and the number who actually attended. We observed an overall
      incidence of STD of 35% and noted that many infections had a similar prevalence
      to that of our normal clinic population over the same time period. Only 13% of
      the women referred by the police attended although after the initial visit
      attendance was similar regardless of referral source. A number of asymptomatic
      women were noted to have infection with Neisseria gonorrhoeae and Chlamydia
      trachomatis. Although, the risk of significant STD following sexual assault is
      low greater efforts should be made to encourage women to attend for screening
      whether or not they are symptomatic.

PMID- 1744871
TI  - Do routine clinic visits prevent de-stabilization in patients awaiting coronary
      revascularization?
AB  - We examined retrospectively the usefulness of routine clinic visits in preventing
      adverse cardiac events in 115 patients awaiting coronary surgery or angioplasty.
      Mean waiting time from angiography to revascularization was 126 days. A total of
      126 visits were made by 80 patients. No deaths occurred, but one patient, despite
      three visits, suffered myocardial infarction at 316 days post-angiography. Eight
      patients required admission for unstable angina, five having been on the waiting
      list for less than 5 weeks. The mean number of clinic visits, number of diseased
      vessels and proportion on triple anti-ischaemic therapy were similar in the
      patients suffering such events and those remaining stable. In conclusion, the
      inherent unpredictability of coronary disease greatly limits the role of interim
      clinic visits in the prevention of adverse cardiac events in patients awaiting
      revascularization.

PMID- 1744872
TI  - Can outpatient non-attendance be predicted from the referral letter? An audit of
      default at neurology clinics.
AB  - Data obtained from new patient referral letters to regional and peripheral
      neurology clinics were studied prospectively over a 6-month period in an attempt
      to determine factors predicting non-attendance. Attendance at peripheral clinics
      was significantly better, confirming their value. At regional clinics, factors
      associated with non-attendance were male sex, patient age less than 50 years,
      urban home address, referral from Accident and Emergency Departments, symptom
      duration less than 12 months, and wait for appointment more than 2 months. Of
      these, referral source and waiting time were identified as factors which could be
      modified, confirming that this analysis of referral letters was a useful
      exercise.

PMID- 1744873
TI  - Management of generalized faecal peritonitis--can we do better?
AB  - Generalized faecal peritonitis is associated with a mortality of over 50% in most
      series of cases. Despite great improvements in the standards of intensive care
      the morbidity and mortality associated with this condition have not improved, in
      part due to recurrent intra-abdominal sepsis. This preliminary study investigated
      the role of laparotomy, repeated abdominal lavage and debridement to determine
      whether such a policy might lead to an improvement in outcome. Of six cases
      studied three had perforated diverticular disease, two had Crohn's disease.
      Twenty lavages were performed on these six patients who had a mean ICU stay of 8
      days. Five out of the six patients left hospital and remain well, one patient
      died of septicaemia and pre-existing renal failure. This study found that
      laparotomy, repeated abdominal lavage and debridement may be effective in
      reducing the morbidity and mortality of generalized faecal peritonitis and
      further study of this technique is appropriate.

PMID- 1744874
TI  - Use of an antibacterial powder spray to prevent post prostatectomy urinary
      infection.
AB  - To prevent ascending urinary infection in patients following transurethral
      prostatectomy, we have studied the use of a topical antibacterial agent applied
      to the groin and external genitalia. A prospective randomized controlled trial
      was conducted, with 50 patients being treated by daily application of a 2%
      polynoxylin powder, and 50 patients acting as untreated controls. Patient age and
      duration of catheterization were similar in the treated and untreated groups. No
      significant benefit was seen in the treated cohort (P greater than 0.05) in terms
      of reduction in postoperative urinary infection.

PMID- 1744875
TI  - Gut fermentation: a reappraisal of an old clinical condition with diagnostic
      tests and management: discussion paper.

PMID- 1744876
TI  - Some observations of George James Guthrie on gunshot wounds of the thigh during
      the Crimean War (1854-1855).

PMID- 1744877
TI  - 'Medium red with fresh fruity nose ...': doctors and viniculture in 19th century
      Australia.

PMID- 1744878
TI  - London's last private medical school.

PMID- 1744879
TI  - Angiocentric T-cell lymphoma in skin.

PMID- 1744880
TI  - Cutaneous extension of Hodgkin's disease.

PMID- 1744881
TI  - Haemoptysis after Dwyer instrumentation for idiopathic scoliosis.

PMID- 1744882
TI  - Computed tomography as an aid to diagnosis of early pulmonary actinomycosis.

PMID- 1744883
TI  - Lightning strike and autonomic failure--coincidence or causally related?

PMID- 1744884
TI  - Hypothyroidism and renal impairment.

PMID- 1744885
TI  - Spontaneous rupture of the oesophagus (Boerhaave's syndrome): conservative versus
      surgical management.

PMID- 1744886
TI  - Family therapy for anorexia nervosa--why not?

PMID- 1744887
TI  - Spontaneous adverse drug reaction reports.

PMID- 1744888
TI  - Pathology: is it well taught?

PMID- 1744889
TI  - Crohn's disease of the vulva.

PMID- 1744890
TI  - Falls in the elderly.

PMID- 1744891
TI  - Honey and healing of leg ulcers.

PMID- 1744892
TI  - Lipids in non-insulin dependent diabetes: a case for treatment?

PMID- 1744893
TI  - Value of emergency cardiac enzymes.

PMID- 1744894
TI  - Anal cancer: the case for earlier diagnosis.

PMID- 1744895
TI  - Medical malpractice crisis.

PMID- 1744896
TI  - Superior oblique palsy following ethmoidal surgery.

PMID- 1744897
TI  - Circumcision and sand.

PMID- 1744898
TI  - Protecting the index finger during surgery.

PMID- 1744899
TI  - Conformational changes in human red cell membrane proteins induced by sugar
      binding.
AB  - We have previously shown that the human red cell glucose transport protein and
      the anion exchange protein, band 3, are in close enough contact that information
      can be transmitted from the glucose transport protein to band 3. The present
      experiments were designed to show whether information could be transferred in the
      reverse direction, using changes in tryptophan fluorescence to report on the
      conformation of the glucose transport protein. To see whether tryptophan
      fluorescence changes could be attributed to the glucose transport protein, we
      based our experiments on procedures used by Helgerson and Carruthers [Helgerson,
      A. L., Carruthers, A., (1987) J. Biol. Chem. 262:5464-5475] to displace
      cytochalasin B (CB), the specific D-glucose transport inhibitor, from its binding
      site on the inside face of the glucose transport protein, and we showed that
      these procedures modified tryptophan fluorescence. Addition of 75 mM maltose, a
      nontransportable disaccharide which also displaces CB, caused a time-dependent
      biphasic enhancement of tryptophan fluorescence in fresh red cells, which was
      modulated by the specific anion exchange inhibitor, DBDS (4,4'-dibenzamido-2,2'
      stilbene disulfonate). In a study of nine additional disaccharides, we found that
      both biphasic kinetics and DBDS effects depended upon specific disaccharide
      conformation, indicating that these two effects could be attributed to a site
      sensitive to sugar conformation. Long term (800 sec) experiments revealed that
      maltose binding (+/- DBDS) caused a sustained damped anharmonic oscillation
      extending over the entire 800 sec observation period. Mathematical analysis of
      the temperature dependence of these oscillations showed that 2 microM DBDS
      increased the damping term activation energy, 9.5 +/- 2.8 kcal mol-1 deg-1, by a
      factor of four to 39.7 +/- 5.1 kcal mol-1 deg-1, providing strong support for the
      view that signalling between the glucose transport protein and band 3 goes in
      both directions.

PMID- 1744900
TI  - Diversity of K+ channels in the basolateral membrane of resting Necturus oxyntic
      cells.
AB  - Patch-clamp techniques have been applied to characterize the channels in the
      basolateral membrane of resting (cimetidine-treated, nonacid secreting) oxyntic
      cells isolated from the gastric mucosa of Necturus maculosa. In cell-attached
      patches with pipette solution containing 100 mM KCl, four major classes of K+
      channels can be distinguished on the basis of their kinetic behavior and
      conductance: (1) 40% of the patches contained either voltage-independent (a) or
      hyperpolarization-activated (b), inward-rectifying channels with short mean open
      times (16 msec for a, and 8 msec for b). Some channels showed subconductance
      levels. The maximal inward conductance gmax was 31 +/- 5 pS (n = 13) and the
      reversal potential Erev was at Vp = -34 +/- 6 mV (n = 9). (2) 10% of the patches
      contained depolarization-activated and inward-rectifying channels with gmax = 40
      +/- 18 pS (n = 3) and Erev was at Vp = -31 +/- 5 mV (n = 3). With
      hyperpolarization, the channels open in bursts with rapid flickerings within
      bursts. Addition of carbachol (1 mM) to the bath solution in cell-attached
      patches increased the open probability Po of these channels. (3) 10% of the
      patches contained voltage-independent inward-rectifying channels with gmax = 21
      +/- 3 pS (n = 4) and Erev was at Vp = -24 +/- 9 mV (n = 4). These channels
      exhibited very high open probability (Po = 0.9) and long mean open time (1.6 sec)
      at the resting potential. (4) 20% of the patches contained voltage-independent
      channels with limiting inward conductance of 26 +/- 2 pS (n = 3) and Erev at Vp =
      -33 +/- 3 mV (n = 3). The channels opened in bursts consisting of sequential
      activation of multiple channels with very brief mean open times (10 msec). In
      addition, channels with conductances less than 6 pS were observed in 20% of the
      patches. In all nine experiments with K+ in the pipette solution replaced by Na+,
      unitary currents were outward, and inward currents were observed only for large
      hyperpolarizing potentials. This indicates that the channels are more selective
      for K+ over Na+ and Cl-. A variety of K+ channels contributes to the basolateral
      K+ conductance of resting oxyntic cells.

PMID- 1744901
TI  - Response of chloride efflux from skeletal muscle of Rana pipiens to changes of
      temperature and membrane potential and diethylpyrocarbonate treatment.
AB  - Efflux of 36Cl- from frog sartorius muscles equilibrated in two depolarizing
      solutions was measured. Cl- efflux consists of a component present at low pH and
      a pH-dependent component which increases as external pH increases. For
      temperatures between 0 and 20 degrees C, the measured activation energy is 7.5
      kcal/mol for Cl- efflux at pH 5 and 12.6 kcal/mol for the pH-dependent Cl-
      efflux. The pH-dependent Cl-efflux can be described by the relation mu = 1/(1 +
      10n(pK alpha-pH], where mu is the Cl- efflux increment obtained on stepping from
      pH 5 to the test pH, normalized with respect to the increment obtained on
      stepping from pH 5 to 8.5 or 9.0. For muscles equilibrated in solutions
      containing 150 mM KCl plus 120 mM NaCl (internal potential about -15 mV), the
      apparent pK alpha is 6.5 at both 0 and 20 degrees C, and n = 2.5 for 0 degrees C
      and 1.5 for 20 degrees C. For muscles equilibrated in solutions containing 7.5 mM
      KCl plus 120 mM NaCl (internal potential about -65 mV), the apparent pK alpha at
      0 degrees C is 6.9 and n is 1.5. The voltage dependence of the apparent pK alpha
      suggests that the critical pH-sensitive moiety producing the pH-dependent Cl-
      efflux is sensitive to the membrane electric field, while the insensitivity to
      temperature suggests that the apparent heat of ionization of this moiety is zero.
      The fact that n is greater than 1 suggests that cooperativity between pH
      sensitive moieties is involved in determining the Cl- efflux increment on raising
      external pH. The histidine-modifying reagent diethylpyrocarbonate (DEPC) applied
      at pH 6 reduces the pH-dependent Cl- efflux according to the relation, efflux =
      exp(-k.[DEPC].t), where t is the exposure time (min) to DEPC at a prepared
      initial concentration of [DEPC] (mM). At 17 degrees C, k-1 = 188 mM . min. For
      temperatures between 10 and 23 degrees C, k has an apparent Q10 of 2.5. The Cl-
      efflux inhibitor SCN- at a concentration of 20 mM substantially retards the
      reduction of the pH-dependent Cl- efflux by DEPC. The findings that the apparent
      pK alpha is 6.5 in depolarized muscles, that DEPC eliminates the pH-dependent Cl-
      efflux, and that this action is retarded by SCN- supports the notion that
      protonation of histidine groups associated with Cl- channels is the controlling
      reaction for the pH-dependent Cl- efflux.

PMID- 1744902
TI  - Characterization of BADS-binding proteins in epithelial plasma membranes.
AB  - When a fluorescent stilbene was added to epithelial plasma membrane suspension
      the emission spectrum showed a broad peak containing overlapping emissions
      resulting from different adducts. By focusing on a specific emission wavelength a
      common site having a dissociation constant of approximately 5 microM was
      calculated in the rat kidney, small intestine, pancreatic islets and shark rectal
      gland. This binding could be displaced by loop diuretics, (e.g., furosemide with
      an IC50 of 40 microM), DIDS (ki 1 microM) and thiocyanate. These results pose
      certain questions such as: (i) whether the evidence for multiple peaks are due to
      specific interactions representing multiple binding affinities and (ii) whether
      the binding of stilbene and the observed displacement can be identified on a
      specific protein. Separating the proteins present in the purified basolateral and
      brush-border membranes by SDS-PAGE, transfer of these proteins onto
      nitrocellulose paper and labeling of the nitrocellulose strips by radioactive
      BADS (4-benzamido-4'aminostilbene-2-2'disulphonic acid) and bumetanide could
      identify labeled proteins. These experiments showed that whereas some proteins
      bound either BADS or bumetanide, one protein with a molecular weight of
      approximately 100 or 130,000 D appeared to bind both. This protein was found on
      the basolateral membrane in the rat kidney cortex and medulla and the shark
      rectal gland and in the basolateral and brush-border membranes of the small
      intestine. Displacement of the protein-bound stilbene by loop diuretics could not
      be quantitated on the nitrocellulose transfer strips for this protein. Antibodies
      raised against the cytoplasmic fragment of band 3 reacted with the stilbene
      labeled 100-130,000 D proteins indicating sufficient immuno-cross-reactivity
      between the separate species. These experiments involving binding of BADS and
      bumetanide and cross-reactivity with the human band 3 antibody suggest that these
      kilodalton proteins could structurally resemble human band 3.

PMID- 1744903
TI  - Sodium-dependent L-serine transport in plasma membrane vesicles isolated from
      Ehrlich cells by two-phase compartmentation.
AB  - Plasma membrane vesicles were prepared from Ehrlich cells using two-phase system
      compartmentation. The highly pure plasma membrane vesicles obtained presented a
      negligible mitochondrial contamination and were suitable for studies of amino
      acid transport. L-Serine transport showed a clear ionic specificity, maximum
      incorporation being observed when an inwardly directed NaSCN gradient was used.
      Na(+)-dependent L-serine transport was dependent on assay temperature and
      membrane potential, and it seemed to be carried out by two different transport
      systems. An essential sulfhydryl group seemed to be involved in the transport
      process.

PMID- 1744904
TI  - Ba(2+)-induced action potentials in osteoblastic cells.
AB  - Trains of long-duration "action potentials" were induced by Ba2+ in osteoblast
      like rat osteosarcoma cells (ROS 17/2.8), under current clamp and voltage clamp.
      Large depolarizing pulses were seen in microelectrode measurements at 37 degrees
      C following the addition of 10 or 20 mM Ba2+ to physiological bathing medium.
      Application of BAY K 8644 resulted in the onset of the pulses at earlier times
      and at more negative potentials. The pulses were blocked by nifedipine and Cd2+,
      but not by Ni2+. Large inward current pulses were seen in whole-cell patch
      technique voltage-clamp measurements at 37 degrees C in the presence of from 10
      to 110 mM Ba2+ in the bathing medium. The current pulses were not seen at 22
      degrees C in the presence of 110 mM Ba2+, but could be induced by BAY K 8644.
      These pulses were not blocked by TTX, but were blocked by nifedipine, Cd2+, Zn2+,
      Co2+, and by an increase in bathing [Ca2+]. The shape and frequency of the
      current pulses were the same as for voltage pulses under current clamp. A model
      that can explain these observations involves opening of L-type Ca2+ channels in a
      voltage-independent manner by cytosolic Ba2+ via a screening of Ca2+ from sites
      that produce either inactivation or a lower probability of opening in the
      activated state. There would be a closing of these channels at higher [Ba2+] as
      Ba2+ is forced onto these sites. A refractory period is also required to give
      repeated pulses of openings.

PMID- 1744905
TI  - Characterization of constitutive exocytosis in the yeast Saccharomyces
      cerevisiae.
AB  - Constitutive exocytosis was investigated in the yeast Saccharomyces cerevisiae
      using temperature-sensitive mutant (sec) strains which do not allow vesicle
      fusion to the plasma membrane at the restrictive temperature. Secretory vesicles
      were accumulated in the cell at the restrictive temperature and then protein
      synthesis was blocked with cycloheximide. Upon returning the cells to the
      permissive temperature the contents of the accumulated vesicles were secreted.
      This allowed the study of constitutive exocytosis independent of the processes
      responsible for vesicular biosynthesis. Neither the kinetics nor magnitude of
      exocytosis were affected by removal of external Ca2+ or perturbations of
      cytosolic Ca2+. This suggests that in those systems where calcium is required for
      exocytosis it is a regulatory molecule and not part of the mechanism of membrane
      fusion. Release occurred over a very broad range of pH and in media with
      different ionic compositions, suggesting that ionic and potential gradients
      across the plasma membrane play no role in exocytosis in yeast. High osmolarity
      inhibited the rate, but not the extent, of release. A novel inhibitory effect of
      azide was detected which occurred only at low pH. Vanadate also inhibited release
      in a pH-independent manner. Secretion occurred at the same rate in cells with or
      without accumulated vesicles. This infers a rate-limiting step following vesicle
      accumulation, perhaps a limiting number of release sites on the plasma membrane.

PMID- 1744906
TI  - Activation of osmolyte efflux from cultured renal papillary epithelial cells.
AB  - The rabbit renal papillary epithelial cell line PAP-HT25 accumulates sorbitol and
      other organic osmolytes when cultured in hypertonic media. When returned to
      isotonic media, PAP-HT25 cells swell because of water influx and then shrink to
      their normal volume because of rapid osmolyte and water efflux (volume regulatory
      decrease, VRD). Sorbitol efflux from PAP-HT25 cells during VRD was reduced to 18%
      of control by incubation of the cells with 100 microM eicosatetraynoic acid
      (ETYA), indicating that an enzyme that metabolizes arachidonic acid (AA) is a key
      component of the efflux process. Sorbitol efflux was unaffected by incubation
      with cyclooxygenase and lipoxygenase inhibitors but was reduced to 9% by
      incubation with 100 microM ketoconazole and to 37% by incubation with 100 microM
      SKF-525A, indicating that the cytochrome P-450 limb of the AA cascade is involved
      in the efflux process. The efflux of other organic osmolytes betaine and
      myoinositol, but not glycerolphosphorylcholine, was also inhibited by incubation
      with ETYA and ketoconazole.

PMID- 1744907
TI  - Major myelin proteolipid: the 4-alpha-helix topology.

PMID- 1744908
TI  - AIDS-related health behavior: coping, protection motivation, and previous
      behavior.
AB  - The purpose of this study was to examine Rogers' protection motivation theory and
      aspects of Janis and Mann's conflict theory in the context of AIDS-related health
      behavior. Subjects were 84 heterosexual men and women and 147 homosexual men with
      multiple sexual partners; LISREL's path-analysis techniques were used to evaluate
      the goodness of fit of the structural equation models. Protection motivation
      theory did fit the data but had considerably more explanatory power for
      heterosexual than for homosexual subjects (49 vs. 22%, respectively). When coping
      styles were added, different patterns of findings were found among both groups.
      Adding variables such as social norms and previous behavior increased the
      explained variance to 73% for heterosexual subjects and to 44% for homosexual
      subjects. It was concluded that although protection motivation theory did fit the
      data fairly adequately, expanding the theory with other variables--especially
      those related to previous behavior--could improve our understanding of AIDS
      related health behavior.

PMID- 1744909
TI  - Relaxation, reduction in angry articulated thoughts, and improvements in
      borderline hypertension and heart rate.
AB  - An intensive 7-week relaxation therapy was evaluated in a sample of unmedicated
      borderline hypertensive men. All subjects were provided state-of-the-art medical
      information regarding changes known to affect hypertension favorably, e.g., lower
      salt intake and regular exercise. In addition, relaxation subjects were trained
      in muscle relaxation that entailed audiotaped home practice. As predicted,
      relaxation combined with hygiene lowered blood pressure more than did hygiene
      alone. Neither treatment favorably affected a paper-and-pencil measure of anger
      but relaxation did lower anger-hostility on a new cognitive assessment procedure,
      Articulated Thoughts in Simulated Situations (ATSS). Moreover, ATSS anger
      hostility reduction was correlated with blood pressure or heart rate reductions,
      for all subjects and especially for those in the Relaxation condition. This
      represents the first clinically demonstrated link between change in a cognitive
      variable and change in cardiovascular activity. Finally, results were especially
      strong in subjects high in norepinephrine, suggesting its importance in essential
      hypertension.

PMID- 1744910
TI  - A comparison of hormone therapy, coping skills training, and relaxation for the
      relief of premenstrual syndrome.
AB  - Approximately 10% of women are severely affected by premenstrual syndrome (PMS)
      during their reproductive years. Several biological theories of causation have
      been proposed and each has provoked treatment attempts through medication to
      little sustained effect. As many of the reported complaints are psychological, a
      new treatment approach was considered using cognitive-behavioral therapy. A
      preliminary study which combined cognitive-behavioral therapy with drug treatment
      produced considerable symptom reduction. The present study examined the efficacy
      of cognitive-behavioral therapy alone in direct comparison with hormone
      treatment. Relaxation instructions were provided to a control group. Initial
      rapid responses to drug treatment and relaxation diminishes after 2 months,
      together with marked attrition in the control group. Significant positive
      benefits from cognitive-behavioral therapy were achieved after the first
      treatment month that continued throughout and were maintained at follow-up 3
      months later. Implications for future management are discussed.

PMID- 1744911
TI  - When does a choice of coping strategies help? The interaction of choice and locus
      of control.
AB  - Undergraduate student volunteers either were given a choice of coping strategies
      or were assigned to a coping strategy which was used to help them tolerate the
      cold pressor. Subjects who were given a choice of coping strategies reported
      their strategy to be more credible and perceived a greater sense of control than
      subjects who were not given a choice. Improved pain tolerance, however, did not
      result directly from being given a choice. Increases in pain tolerance depended
      on locus of control. Subjects who had a high internal health locus of control
      reported a greater strength of self-efficacy and demonstrated increased pain
      tolerance following a choice of strategies. In comparison, subjects who reported
      a more external health locus of control did not benefit from receiving a choice.
      This study has implications for our understanding of the role of choice in
      therapy and for improving the effectiveness of our interventions with
      individuals.

PMID- 1744912
TI  - Perceived health problems in subjects with varying cardiovascular diagnoses.
AB  - To study perceived health problems in subjects with differing cardiovascular
      status, the Nottingham Health Profile (NHP) was administered to 210 subjects 55
      years of age and over. Subjects were categorized as being cardiovascular
      "Normals," being hypertensive, having isolated coronary artery disease, or both
      being hypertensive and having coronary artery disease. An analysis of variance
      between the four cardiovascular strata on each of the six subscales of the NHP
      yielded significant differences between the groups on the subscales Pain,
      Physical Mobility, Energy, and Social Isolation. Subsequent conservative post hoc
      analyses of the group means on each of these variables indicated that the group
      with isolated coronary artery disease differed significantly from both the
      hypertensives and the Normals in Physical Mobility. For the Pain subscale the
      subjects with isolated coronary artery disease differed significantly from those
      with hypertension. There were no differences among the four cardiovascular groups
      in perceived health problems on the subscales Emotional Reactions and Sleep.

PMID- 1744913
TI  - Pain sensitivity in offspring of hypertensives at rest and during baroreflex
      stimulation.
AB  - Healthy males with a parental history of hypertension (PH+) showed reduced pain
      sensitivity to a constrictive thigh-cuff pressure stimulus as compared to
      individuals without a parental history of hypertension. The protocol included
      eight trials in which a thigh-cuff was inflated until the subject reported the
      stimulus to be "painful." The PH+ group exhibited significantly lower pain
      sensitivity as indicated by (1) higher levels of constrictive pressure when pain
      was first reported and (2) lower subjective pain ratings at maximum constrictive
      pressure. To assess the role of baroreflex stimulation on pain sensitivity in
      these groups, four trials were administered concurrently with external carotid
      pressure stimulation. There were no significant differences in pain sensitivity
      in each group as a function of baroreflex stimulation. The results suggest that
      the hypoalgesia observed in hypertensives may predate the development of
      sustained elevations in blood pressure.

PMID- 1744914
TI  - The effects of gender on diagnosis of psychological disturbance.
AB  - This research examines the effect of patient gender on the detection of
      psychological disturbance. In Study 1, primary-care patients were requested to
      complete the General Health Questionnaire (GHQ), a measure of nonpsychiatric
      psychological disturbance, prior to their consultation. The patient's GHQ score
      was compared with physician judgments about the level of disturbance in that
      patient (N = 1913). Although there were a similar number of GHQ high scorers
      among males and females, the physicians classified significantly more females
      than males as disturbed. The doctors classified as disturbed a larger proportion
      of nondisturbed women than nondisturbed men. In order to explore the behavior of
      recent medical graduates, Study 2 examined the detection behavior of interns in
      an outpatient department with 384 of their patients. The interns behaved in a
      similar manner to the primary-care physicians.

PMID- 1744915
TI  - Intraosseous administration of digoxin: same-dose comparison with intravenous
      administration in the dog model.
AB  - Intraosseous access has become the method of choice for venous access in
      critically ill and injured children when more traditional methods are not
      immediately available. However, there is a paucity of information concerning drug
      levels achieved via the intraosseous route. We report initial data on the
      comparison of serum digoxin levels after administration of the drug to dogs
      through both the intraosseous and intravenous routes. These data indicate that
      intraosseous infusion of digoxin results in similar serum levels to those
      attained after IV administration, and may therefore afford a reliable means of
      initial digitalization.

PMID- 1744916
TI  - Current therapy of hand burn injuries.

PMID- 1744917
TI  - The impact of the National Cancer Act.

PMID- 1744918
TI  - Experts mull testing guidelines for family cancers.

PMID- 1744919
TI  - Cancer program becomes case study in public policy formation.

PMID- 1744921
TI  - Black teens have low smoking rates.

PMID- 1744920
TI  - Meeting spotlights advances in cancer immunotherapy.

PMID- 1744922
TI  - Centers improve cancer control in Appalachia.

PMID- 1744923
TI  - Cancer Act anniversary encourages reflection, new visions.

PMID- 1744924
TI  - Pharmacokinetics of leucovorin metabolites in human plasma as a function of dose
      administered orally and intravenously.
AB  - Studies have shown that conversion of leucovorin to the metabolite 5,10
      methylenetetrahydrofolate (5,10-CH2FH4) is responsible for enhancement of the
      antitumor effects of fluorouracil given in combination with leucovorin, but the
      biochemical basis of this conversion in humans is not fully understood. To
      determine a possible sequence of metabolic steps, we studied the pharmacokinetics
      of leucovorin and its reduced folate metabolites in plasma in healthy volunteers.
      Groups of five subjects were given two equal doses of 10, 25, 125, 250, or 500
      mg/m2 leucovorin, one orally and one intravenously at a 30-day interval. A
      sensitive radioenzymatic method that we developed previously was used to measure
      plasma concentrations of [S]5-formyltetrahydrofolate, 10-formyltetrahydrofolate
      (10-CHOFH4), 5-methyltetrahydrofolate (5-CH3FH4), and the combined 5,10-CH2FH4
      plus tetrahydrofolate (FH4) pools. Intravenous administration of leucovorin
      resulted in dose-dependent accumulation of 5,10-CH2FH4 + FH4 exceeding 2 microM
      at peak levels. After oral and intravenous administration, 10-CHOFH4 and 5,10
      CH2FH4 + FH4 exhibited peak levels earlier and were eliminated more rapidly than
      5-CH3FH4. Accumulation of all metabolites after intravenous administration was
      linearly dose dependent, while oral administration appeared to result in
      saturation. We propose that the host activation of leucovorin suggested by these
      findings could be responsible for elevation of intratumor 5,10-CH2FH4 levels,
      thus enhancing the antitumor effects of fluorouracil. These results also suggest
      that 10-CHOFH4, 5,10-CH2FH4, and FH4 are intermediate metabolites and that 5
      CH3FH4 is the terminal metabolite. In addition, our results indicate that
      attainment of high plasma levels of the metabolites active in modulation of the
      therapeutic effects of fluorouracil is best achieved through intravenous
      administration of high doses of leucovorin. Our future studies will address the
      proposed sequential conversion pathway and, thus, the mechanism by which
      pharmacologically relevant reduced folates accumulate in plasma after leucovorin
      administration.

PMID- 1744925
TI  - Human IgM monoclonal antibody 16.88: pharmacokinetics and immunogenicity in
      colorectal cancer patients.
AB  - Twenty colorectal cancer patients were given an intravenous injection of human
      IgM monoclonal antibody (MAb) 16.88 (8 mg) conjugated to 131I for tumor
      localization. After a 2-week interval, a second injection with 200, 500, or 1000
      mg of unlabeled antibody added was given to groups of five patients each. at the
      end of the 2-hour infusion, 66% of the radioactivity remained in the circulation.
      Blood clearance of the 131I-labeled MAb 16.88 was biphasic with a mean half-life
      (T1/2 alpha) of 12 hours and T1/2 beta of 45 hours. Clearance rate was 0.09
      L/hour. More than 90% of the 131I in serum was protein bound, with an
      immunoreactive fraction of 80% in the first 48 hours. Size exclusion
      chromatography indicated no degradation products other than 131I in serum and
      urine. The urinary excretion rate of 131I increased to 1.5% of the dose per hour
      at 24 hours, with 50% of the dose excreted in 34 hours. The pharmacokinetic
      profile of 131I-labeled MAb 16.88 was neither influenced by the total protein
      dose of antibody administered nor affected by specific uptake in tumor tissue in
      individual patients, as determined on early immunoscintigrams. The larger
      antibody doses showed a slightly slower excretion of 131I. The assays applied to
      determine immunogenicity were enzyme-linked immunosorbent assay,
      radioimmunoassay, and the dot-blot assay. They had sensitivities ranging from 5
      ng/mL to 0.5 micrograms/mL for goat or rabbit antihuman IgM. The assays did not
      reveal antihuman antibody responses.

PMID- 1744926
TI  - Association of asbestos exposure with colorectal adenomatous polyps and cancer.

PMID- 1744927
TI  - Smoking-attributable cancer mortality.

PMID- 1744928
TI  - Pulmonary toxicity of deferoxamine in children with advanced cancer.

PMID- 1744929
TI  - Infections of the infratemporal fossa: imaging/clinical correlations.
AB  - While infections of the infratemporal fossa are occasionally documented in the
      otolaryngologic literature, a recent computer literature search failed to
      identify any significant series of cases describing this potentially fatal
      infection. This presentation focuses attention on the joint clinical/imaging
      experience of 11 cases of infratemporal fossa infection, as seen at the Soroka
      Medical Center of the Ben Gurion University of the Negev, in Beer-Sheva, Israel,
      and the Mount Sinai Hospital, of the University of Toronto, in Toronto, Canada.
      This manuscript reviews our experience, with particular emphasis on the effective
      role and accuracy of CT scanning in identifying the correct anatomic and
      pathologic diagnosis, as well as in the planning of treatment.

PMID- 1744930
TI  - Pharmacodynamics and pharmacokinetics of carprofen, a non-steroidal anti
      inflammatory drug, in healthy cows and cows with Escherichia coli endotoxin
      induced mastitis.
AB  - The pharmacodynamics of carprofen and its pharmacokinetics in plasma and milk of
      healthy cows and cows with endotoxin-induced mastitis were studied after a single
      intravenous dose of 0.7 mg/kg body weight. Carprofen was administered to five
      clinically healthy cows and to the same cows 3 weeks later, 2 h after
      intramammary infusion of endotoxin. Mastitis developed in all endotoxin-infused
      quarters. The pharmacokinetic characteristics of carprofen in healthy cows were a
      small volume of distribution (0.09 l/kg), a relatively low systemic clearance
      (2.4 ml/h kg), and a long elimination half-life (30.7 h). In the mastitic cows,
      systemic clearance (1.4 ml/h kg) was significantly lower (P less than 0.01), and
      elimination half-life (43.0 h) was significantly longer (P less than 0.01) than
      in the normal animals. Concentrations of carprofen in milk from healthy quarters
      were below the limit of detection for the assay (0.022 micrograms/ml). In milk
      from mastitic quarters, concentrations of carprofen increased up to 0.164
      micrograms/ml during the first 12 h after induction of mastitis, but were less
      than 0.022 micrograms/ml at 24 to 48 h. Compared with the untreated mastitic
      controls, carprofen treatment significantly reduced heart rate (P less than
      0.01), rectal temperature (P less than 0.001), quarter swelling (P less than
      0.01) and other parameters measured. Local and systemic adverse reactions to
      carprofen were not observed.

PMID- 1744931
TI  - Further studies on the antinociceptive activity and respiratory effects of
      buprenorphine in sheep.
AB  - The thermal and mechanical analgesic profile of buprenorphine at a dose rate of
      1.5 micrograms/kg i.v. was investigated in five sheep. This dose produced
      significant analgesia for 40 min against the thermal stimulus, but no mechanical
      antinociception. A higher dose rate of 12 micrograms/kg also failed to produce
      antinociception to a mechanical stimulus. In addition, the effect of the drug (6
      micrograms/kg) on respiratory gas tensions was determined and no significant
      changes were observed.

PMID- 1744932
TI  - Studies of meclofenamic acid and two metabolites in horses--pharmacokinetics and
      effects on exercise tolerance.
AB  - The pharmacokinetics and the effects on treadmill exercise of the anti
      inflammatory drug meclofenamic acid were studied in seven Standardbred horses
      after single intravenous and/or oral doses. The decline in plasma concentration
      after a single intravenous dose of meclofenamic acid (2.2 mg/kg b.wt) was
      described by a two-compartment open model. The average elimination half-life was
      1.4 h, the apparent volume of distribution 0.14 l/kg and the plasma clearance
      0.12 l/h kg. Absorption was the rate-limiting step after oral administration. Non
      compartmental analysis showed a mean absorption time of 4.3 h. The
      pharmacokinetics of two metabolites of meclofenamic acid were also studied in two
      of the horses. The elimination half-lives of the two metabolites were virtually
      the same in each horse (3.0 h and 3.4 h). The blood lactate response to exercise
      was significantly decreased after treatment with meclofenamic acid, indicating a
      lower utilization of the glycolytic ('anaerobic') energy contribution during
      exercise. Circulatory capacity was apparently unaffected with an unchanged heart
      rate response to exercise.

PMID- 1744933
TI  - Clenbuterol plasma concentrations after repeated oral administration and its
      effects on cardio-respiratory and blood lactate responses to exercise in healthy
      Standardbred horses.
AB  - To evaluate the effects of clenbuterol on cardio-respiratory parameters and blood
      lactate relation to exercise tolerance, experimental horses performed
      standardized exercise tests on a high-speed treadmill before and after
      administration of the drug. Clenbuterol was administered in feed to six healthy
      Standardbreds at a dose rate of 0.8 micrograms/kg b.wt twice daily for 5.5 days.
      Each horse was tested twice, without and with a respiratory mask, during two
      consecutive days. One week elapsed between the baseline tests without drug and
      the tests with clenbuterol treatment (each horse served as its own control). The
      results show an unchanged heart rate response to exercise 2 h after the last
      clenbuterol administration. The blood lactate response and the arterial oxygen
      tension during exercise did not differ before and after drug treatment. The
      oxygen uptake as well as pulmonary ventilation relative to the work load
      performed was essentially unaffected. The arterial pH during exercise was
      significantly increased (P less than 0.05) following clenbuterol treatment.
      Plasma levels of clenbuterol were maximal 2 h post-administration with values
      between 0.45 and 0.75 ng/ml. The plasma half-life of elimination was 10.4 h (+/-
      2.25 SD). In conclusion, clenbuterol did not cause any major effects on the
      cardio-respiratory and blood lactate parameters studied in healthy horses
      performing submaximal exercise tolerance tests.

PMID- 1744934
TI  - Pharmacokinetics of tinidazole in dogs and cats.
AB  - Pharmacokinetics of tinidazole in dogs and cats after single intravenous (15
      mg/kg) and oral doses (15 mg/kg or 30 mg/kg) were studied in a randomized
      crossover study. Tinidazole was completely absorbed at both oral dose levels in
      cats and dogs. Peak tinidazole concentration in plasma was 17.8 micrograms/ml in
      dogs and 22.5 micrograms/ml in cats after 15 mg/kg p.o. The oral dose of 30 mg/kg
      resulted in peak levels of 37.9 micrograms/ml in dogs and 33.6 micrograms/ml in
      cats. The apparent total plasma clearance of the drug was about twofold higher in
      dogs than in cats, resulting in an elimination half-life that was twice as long
      in cats (8.4 h) as in dogs (4.4 h). The apparent volume of distribution was 663
      ml/kg in dogs and 536 ml/kg in cats. Therapeutic plasma drug concentrations
      higher than the MIC values of most tinidazole-sensitive bacteria were achieved
      for 24 h in cats and for 12 h in dogs after a single oral dose of 15 mg/kg. From
      the pharmacokinetic standpoint tinidazole seems to be well-suited to clinical use
      in small animal practice.

PMID- 1744935
TI  - Comparison of mucosal drug conjugative rates along the gastrointestinal tract of
      female sheep.
AB  - The comparative distribution of p-nitrophenol UDP-glucuronosyl-transferase, 1
      chloro-2,4-dinitrobenzene glutathione-S-transferase and sulphamethazine N
      acetyltransferase activities was studied along the gastrointestinal mucosa of
      female Lacaune sheep. Gastrointestinal mucosa was characterized by a very low and
      unequal N-acetyltransferase activity when activities were expressed per g of wet
      organ. The duodenum contained highest activities (4.1 nmol/g min). When results
      were expressed per mg of cytosolic protein, the duodenal activity (0.64 nmol/mg
      min) was sixfold higher than in liver (0.11 nmol/mg min). There was a lack in N
      acetyltransferase activity accepting isoniazid as substrate.
      Glucuronosyltransferase activity was approximately threefold higher in microsomal
      fractions of the mucosal lining of gastric and colonic intestine (0.43-0.58
      nmol/g min) than in small intestine or caecum (0.10-0.26 nmol/mg min). Concerning
      cytosolic glutathione S-transferase activity, two- to threefold higher activities
      were obtained in omasum, jejunum, duodenum and ileum (1021-2164 nmol/g min) than
      in other parts (341-799 nmol/g min) when results were expressed per g of wet
      organ. These data were compared with corresponding hepatic activities determined
      in the same six female sheep.

PMID- 1744936
TI  - Pharmacokinetics of antipyrine and sulphadimidine (sulfamethazine) in camels,
      sheep and goats.
AB  - The pharmacokinetics of antipyrine and sulphadimidine were studied in male
      camels, sheep and goats. The two drugs were administered concomitantly. Following
      intravenous injection of antipyrine (25 mg/kg) and sulphadimidine
      (sulfamethazine) (100 mg/kg), the pharmacokinetics of the two drugs were
      adequately described by a one-compartment model. Antipyrine half-life in goats
      (2.58 h) was shorter than that in sheep (4.04 h) and camels (18.78 h). The plasma
      clearance was greatest in goats then sheep and then camels. For sulphadimidine, a
      significantly greater volume of distribution was observed in camels and the
      greatest plasma clearance and shortest half-life were reported in goats.
      Sulphadimidine half-life was 2.77 h in goats, 4.72 h in sheep and 7.36 h in
      camels. The present results suggest that goats have the fastest elimination of
      these drugs from the circulation, followed by sheep and then camels.

PMID- 1744937
TI  - The effects of experimentally induced bronchopneumonia on the pharmacokinetics
      and tissue depletion of gentamicin in healthy and pneumonic calves.
AB  - The effects of a bovine bronchopneumonia model on the pharmacokinetics and tissue
      residue depletion profiles of gentamicin in calves weighing 90-140 kg was
      explored. Two groups of heifer calves were used. The first was a normal group,
      while the second group had bronchopneumonia induced. A scoring system was
      developed to evaluate the extent of disease in the groups. A bimodal distribution
      of the serum pharmacokinetic parameters in the pneumonic group was caused by the
      effects of dehydration. When the severely dehydrated calves were omitted from the
      analysis, serum clearance of gentamicin was significantly higher in the pneumonic
      group than in the normal group (P less than 0.05). The pharmacokinetic equations
      used to fit the tissue concentrations varied from tissue to tissue and between
      groups. Because the best equation of a particular tissue's concentrations varied
      between groups, withdrawal periods, which are normally determined in healthy
      animals, may be inappropriate in diseased animals. Addition of several parameters
      (serum creatinine, serum urea nitrogen, albumin, fibrinogen, and total protein
      concentrations, white blood cell counts, central fluid volume, volume of
      distribution at steady state, area under the serum concentration vs time curve,
      serum clearance, and elimination rate constant) to these tissue-depletion models
      using multiple regression improved the prediction of a concentration in a given
      tissue.

PMID- 1744938
TI  - Clinical investigations of halothane and isoflurane for induction and maintenance
      of foal anesthesia.
AB  - Fifty-eight foals were divided into two groups for study of aspects of the
      clinical anesthetic management of foals and to characterize effects of halothane
      (n = 30) and isoflurane (n = 28) in foals. There were no significant differences
      (P greater than 0.05) in the demographics of the two groups. Results of hemograms
      and biochemical analysis of venous blood samples before and after anesthesia were
      either not influenced or only mildly (clinically unimportant) affected by either
      agent. Like adult horses, foals have an increased PaCO2 when anesthetized with
      inhaled anesthetics. We could detect no difference in the magnitude of increase
      in PaCO2 with either anesthetic. Anesthetic induction and recovery was most rapid
      with isoflurane. The quality of induction and recovery was similarly acceptable
      with either agent. Heart rate during isoflurane was not significantly different
      from conscious conditions but during halothane, heart rate was significantly less
      than control except at 91-120 min when statistical significance was not detected.
      These results support the clinical impression that foals can be safely and
      reliably anesthetized with either agent.

PMID- 1744939
TI  - Relaxant effects of theophylline and clenbuterol on tracheal smooth muscle from
      horse and rat in vitro.
AB  - A comparison between the relaxant effects of clenbuterol and theophylline on
      horse tracheal smooth muscle has been made in vitro. Rat tracheal smooth muscle
      was also investigated as a reference. The tracheal preparations were initially
      contracted with carbachol since the smooth muscle did not spontaneously develop
      tone. The response of the carbachol-contracted preparations to theophylline was
      the same in the two species. The response to clenbuterol varied. In only five out
      of eleven horses were the tracheal smooth muscles sensitive to clenbuterol (mean
      pD2 = 7.92 M). In the remaining six horses the tracheal smooth muscles were
      insensitive to clenbuterol (mean pD2 = 3.59 M), yet the preparations responded
      well to theophylline with complete relaxation. All rat tracheal preparations were
      insensitive to clenbuterol.

PMID- 1744940
TI  - The pharmacokinetics and locomotor activity of alfentanil in the horse.
AB  - The pharmacokinetics of alfentanil were investigated in the horse. Four doses of
      alfentanil (4, 10, 20 and 40 micrograms/kg) were given to four horses at
      different times and their locomotor activity monitored. Doses of 20 and 40
      micrograms/kg produced a significant increase in locomotor activity. The plasma
      concentrations of alfentanil were measured in six standing horses and the
      pharmacokinetics calculated. It was found that the decay curves were best
      described by a biexponential equation. The elimination half-life (t1/2 beta) was
      21.65 +/- 3.99 min and the clearance (Cl) was 14.1 +/- 0.7 ml/kg/min. The same
      horses were anaesthetized with xylazine-ketamine and maintained with halothane in
      oxygen for the first experiment and isoflurane in oxygen for the second
      experiment. The pharmacokinetics were again calculated from measured plasma
      alfentanil concentrations. There were significant differences between the
      kinetics in the conscious and the anaesthetized animals but there were no
      significant differences in alfentanil kinetics between the two anaesthetic
      agents. The t1/2 beta for alfentanil under halothane and isoflurane anaesthesia
      were 55.95 +/- 20.77 and 68.03 +/- 23.22 min, respectively, and the Cl values
      were 14 +/- 1.7 and 13.6 +/- 1.32 ml/kg/min.

PMID- 1744941
TI  - Plasma thiamphenicol concentrations in calves after intratracheal administration.

PMID- 1744942
TI  - Concentrations of phenylbutazone and oxyphenbutazone in post-parturient mares and
      their neonatal foals.

PMID- 1744943
TI  - Disposition kinetics of gentamicin in buffalo calves (Bubalus bubalis) following
      single intravenous administration.

PMID- 1744944
TI  - Effect of some organic vehicles on the rate of elimination of intravenously
      administered ronidazole in pigeons.

PMID- 1744945
TI  - Haemophilus influenzae declining among young?

PMID- 1744946
TI  - North Carolina's maternal health campaign ignores smoking, maternal health
      advocates fume.

PMID- 1744947
TI  - Implanted defibrillators slash sudden death rate in study, thousands more may get
      them in future.

PMID- 1744948
TI  - From the Health Care Financing Administration.

PMID- 1744949
TI  - From the Centers for Disease Control. Foodborne nosocomial outbreak of
      Salmonella.

PMID- 1744950
TI  - From the Centers for Disease Control. Patterns of sexual behavior change.

PMID- 1744951
TI  - A piece of my mind. Requiem for an unknown leper.

PMID- 1744952
TI  - Use of animals in medical education.

PMID- 1744954
TI  - Conflicts in health care spending.

PMID- 1744953
TI  - Reimbursement, beneficence, and advance directives.

PMID- 1744955
TI  - Differences in mortality from coronary artery bypass graft surgery.

PMID- 1744956
TI  - Hospital variables associated with quality of care for breast cancer patients.
AB  - OBJECTIVE: To determine the degree of compliance with clinical standards among
      hospitals for care of breast cancer patients and account for variations in
      compliance. DESIGN: Analysis of cancer registry data submitted to the American
      Cancer Society, Illinois Division, Chicago, for a concurrent prospective
      descriptive study of breast cancer, supplemented by other hospital data from
      public sources. SETTING: Ninety-nine Illinois hospitals evenly distributed among
      rural counties, counties with small cities outside the Chicago metropolitan area,
      exurban counties in the Chicago metropolitan area, suburban Cook County, and
      urban Chicago. PATIENTS: A total of 5766 newly diagnosed patients with
      histologically confirmed breast cancer in 1988, representing 84% of the estimated
      6900 new cases in the state for that year. MAIN OUTCOME MEASURES: Descriptive
      statistics and multiple linear regression analyses of five dependent quality
      variables from clinical indicators related to early diagnosis, hormone receptor
      determination, adjuvant therapy, radiation therapy, and axillary lymph node
      dissection. RESULTS: At the hospitals studied, (1) late stage (IIb through IV) at
      diagnosis was associated with urban location, higher proportion of poorly insured
      patients, fewer breast cancer cases treated, and lower oncology charges
      (proportion of variance explained, R2 = .50, P less than .00001); (2) omission of
      hormone receptor test for stages II through IV was associated with urban location
      and higher proportion of poorly insured patients (R2 = .18, P less than .00003);
      and (3) omission of indicated radiation therapy was associated with urban
      location and fewer breast cancer cases (R2 = .21, P less than .00001). Omission
      of adjuvant therapy and omission of axillary lymph node dissection were not
      significantly associated with any of the hospital variables examined.
      CONCLUSIONS: The findings suggest that there is a group of urban hospitals,
      generally small and marginally reimbursed, where comprehensive diagnosis and
      treatment of breast cancer are not obtained.

PMID- 1744957
TI  - Early diagnosis of perinatal HIV infection by detection of viral-specific IgA
      antibodies.
AB  - OBJECTIVES: To evaluate the clinical utility of a human immunodeficiency virus
      (HIV)-IgA serological assay for diagnosis of perinatally acquired HIV infection.
      DESIGN: Coded serum samples prospectively collected from children born to HIV
      infected mothers and uninfected mothers were analyzed by HIV-IgA immunoblot.
      SETTING: A university hospital in Baltimore, Md, and an outpatient clinic in Port
      au-Prince, Haiti. POPULATION: Five hundred thirty-nine serum samples were
      obtained sequentially from 278 children born to HIV-infected women (116 from The
      Johns Hopkins Hospital and 62 from Port-au-Prince) and from 42 control children
      born to HIV-seronegative children in Port-au-Prince. OUTCOME MEASURES: Results
      from the HIV-IgA serological assays were compared with the known infection status
      of the child at 15 months of age as determined by the standard IgG Western blot
      and the clinical classification of the Centers for Disease Control. Sensitivity,
      specificity, and predictive values were calculated at different ages and
      collectively for children 3 months of age or older. RESULTS: The HIV-IgA assay
      was positive in one of six specimens from HIV-infected children under 1 month of
      age, six of nine specimens from infected children at 3 months of age, and 160 of
      161 specimens from 47 HIV-infected children 6 months of age or older. Of 334
      specimens from 243 uninfected children, 333 were negative by the HIV-IgA assay.
      The overall sensitivity and the specificity of the IgA assay for children older
      than 3 months of age were 97.6% and 99.7%, and the positive and negative
      predictive values were 99.4% and 98.7%, respectively. CONCLUSION: Although the
      HIV-IgA assay had a low sensitivity within the first months of life, the high
      sensitivity, specificity, and predictive values of this assay demonstrate its
      utility for the diagnosis of perinatally acquired HIV infection after the third
      month of age. Early diagnosis with this relatively simple and inexpensive
      serological assay should aid in the implementation of antiviral therapy and
      provide useful information for the care of children born to HIV-infected mothers
      in both developing and developed countries.

PMID- 1744958
TI  - Clinical utility of HIV-IgA immunoblot assay in the early diagnosis of perinatal
      HIV infection.
AB  - OBJECTIVE: To ascertain the sensitivity, specificity, predictive value, and
      clinical use of a human immunodeficiency virus (HIV)-IgA immunoblot assay for
      diagnosing perinatal HIV infection in infants tested at birth to 1 month, 3
      months, and 6 months of age. DESIGN: Prospective, longitudinal cohort study of
      children born to HIV-infected and noninfected women. The HIV-IgA immunoblot
      assays were performed at birth to 1 month, 3 months, and 6 months of age and
      compared with the Centers for Disease Control's classification system of HIV
      infection in the children. Children were followed up for at least 15 months to
      ensure accuracy of infection status. SETTING: Municipal hospital in central
      Brooklyn, NY, where the prevalence of HIV infection is high. PATIENTS: Serum
      samples from 58 children, 22 with documented HIV infection, 18 noninfected
      children born to seropositive women, and 18 children born to noninfected women,
      were studied. MAIN OUTCOME MEASURE: Diagnosis of HIV infection using the Centers
      for Disease Control's classification scheme was compared with diagnosis using the
      HIV-IgA immunoblot assay for children 6 months of age or younger. RESULTS: The
      HIV-IgA immunoblot assay yielded negative results at 3 and 6 months of age for
      all 18 infants born to seronegative women; for the 18 seroreverting, noninfected
      children born to infected women, the assay yielded negative results at 1 month, 3
      months, and 6 months of age. The positive predictive value of the assay was 100%-
      no false-positive results were identified in the 88 serum samples obtained from
      noninfected infants. For the HIV-infected children, sensitivity was a function of
      age: one (5.9%) of 17 infants had an assay that yielded positive results at birth
      to 1 month of age, 13 (62%) of 21 infants had assays that yielded positive
      results at 3 months of age, and 17 (77%) of 22 infants had assays that yielded
      positive results at 6 months of age. The presence or absence of symptoms did not
      affect the sensitivity. CONCLUSION: The HIV-IgA immunoblot assay can detect a
      significant proportion of infected children during an early asymptomatic period
      of their life. This relatively inexpensive, easily standardized assay may allow
      for institution of therapy before the onset of clinical symptoms.

PMID- 1744959
TI  - 25-year mortality after surgical repair of congenital heart defect in childhood.
      A population-based cohort study.
AB  - OBJECTIVE: To determine long-term survival and the cause of death after repair of
      one of eight congenital heart defects in childhood. DESIGN: Cohort study.
      SETTING: General community. PARTICIPANTS: All Oregon residents with one of eight
      congenital heart defects, which was repaired surgically between 1958 and 1989
      when the patient was aged 18 years or younger, including (1) tetralogy of Fallot;
      (2) isolated ventricular septal defect; (3) isolated atrial septal defect; (4)
      coarctation of the aorta; (5) aortic valvular stenosis; (6) pulmonary valvular
      stenosis; (7) transposition of the great arteries; and (8) patent ductus
      arteriosus. Follow-up of this cohort of 2701 individuals was obtained from 94%.
      MAIN OUTCOME MEASURE: Mortality from cardiac and noncardiac causes. RESULTS: Age
      at surgery and operative mortality have decreased significantly over the last 30
      years. Late cardiac mortality at 25 years after surgery was 5% for tetralogy of
      Fallot and isolated ventricular septal defect, 10% for coarctation of the aorta,
      17% for aortic stenosis, 5% for pulmonic stenosis, and less than 1% for patent
      ductus arteriosus; there were no late cardiac deaths after atrial septal defect
      repair. For transposition, late cardiac mortality was 15% at 15 years after the
      Mustard operation and was 2% at 10 years after the Senning operation. CONCLUSION:
      Surgical repair of most congenital heart defects is associated with lingering
      cardiac mortality, particularly for aortic stenosis, coarctation, and
      transposition.

PMID- 1744960
TI  - A critical analysis of the resource-based relative value scale.
AB  - BACKGROUND--There is a general perception that procedural medical services are
      reimbursed at an inappropriately greater rate than cognitive services. By
      congressional mandate, the Health Care Financing Administration (HCFA) has been
      directed to establish a Medicare fee schedule to shift funding under a budget
      neutral assumption from procedural to cognitive services. To provide a rational
      basis for this change, Hsiao et al (Harvard-Hsiao) developed a resource-based
      relative value scale (RBRVS) that equates the value of a service to the resources
      necessary to generate the service. METHODS--Instead of focusing on relative
      values and fee schedules ("price-per-unit-service"), the present study employs
      the standard commercial/industrial method of determining reimbursement rate
      (income divided by hours of labor) for 15 medical and surgical specialties. Data
      from independent sources are used to determine income and hours of professional
      effort for each of the specialties studied. Harvard-Hsiao and HCFA predicted the
      percent change in income for each of the specialties under the initial RBRVS and
      the HCFA fee schedule. The predicted income was then employed in this study to
      recompute reimbursement rates under the newly proposed payment systems. RESULTS:
      CURRENT PAYMENT SYSTEM--Average annual incomes for medical and surgical
      specialties are $124,500 and $176,600, respectively, a 42% difference (P = .03).
      Average weekly work hours (nominal hours, as adjusted for overtime) for medical
      and surgical specialties are 70.6 and 87.8, respectively (P = .005). Average
      hourly reimbursement rates for medical ($33.90) and surgical ($38.80) specialties
      are not substantially different (P, not significant). The difference in annual
      income is explained by the 17.2 hours per week of additional work hours by
      surgeons. The erroneous perception that procedurists are reimbursed at a higher
      rate than cognitive practitioners likely arises from differences in billing
      methods by which surgeons shift charges for cognitive work hours to the 18% of
      their time spent in the operating room. RESULTS: PROPOSED RBRVS AND HCFA PAYMENT
      SYSTEM--The income of all specialties is equalized about a mean of $132,500 (+/-
      $21,400 [1 SD]) by varying reimbursement rates in such a way that the effect of
      working hours is fully discounted. Reimbursement rates under the proposed payment
      system make no recognition of the hours of professional effort, postgraduate
      specialty training, or putative differences in the nature of the physician's
      work. CONCLUSION: --The RBRVS, and the HCFA fee schedule to the extent that it is
      based on that scale, are inappropriate bases for the reform of the physician
      reimbursement system.

PMID- 1744961
TI  - 'Melanoma? It can't be melanoma!' A subset of melanomas that defies clinical
      recognition.
AB  - We diagnosed histologically 178 cases of malignant melanoma in 1990. Thirteen
      cases were recorded in which the diagnosis of malignant melanoma was not
      considered by the clinician prior to biopsy or, in retrospect, following
      pathologic diagnosis. Eight of the 13 lesions were amelanotic. The majority were
      deeply invasive at the time of biopsy, implying poor prognosis. Despite
      improvements in early detection of malignant melanoma, a significant subcategory
      of melanomas escapes clinical diagnosis.

PMID- 1744962
TI  - Cost-effectiveness of HA-1A monoclonal antibody for gram-negative sepsis.
      Economic assessment of a new therapeutic agent.
AB  - OBJECTIVE: To assess the cost-effectiveness of the HA-1A monoclonal antibody for
      the treatment of gram-negative bacteremia. DESIGN: Cost-effectiveness analysis of
      a randomized, double-blind, placebo-controlled trial using clinical efficacy data
      reported in the medical literature. SETTING: Hospitalized patients with sepsis.
      PATIENTS: 543 patients with sepsis and suspected gram-negative infection.
      Patients enrolled in the study met strict criteria for sepsis, including fever or
      hypothermia (less than 35.6 degrees C or greater than 38.3 degrees C),
      tachycardia (greater than 90 beats per minute), tachypnea (greater than 20
      breaths per minute), and hypotension or two of six signs of systemic toxicity.
      INTERVENTION: HA-1A vs placebo in addition to usual care. MAIN OUTCOME MEASURES:
      We determined the range of possible cost-effectiveness ratios for HA-1A therapy,
      using modeling techniques when clinical or economic variables were unknown. We
      subjected the model to rigorous sensitivity analysis. We calculated the
      incremental cost of care and years of life saved for patients with sepsis and
      modeled two different treatment strategies: treat all patients with sepsis or
      test and then treat only patients with positive test results. $24,100 per year of
      life saved based on the treat strategy and $14,900 based on the test strategy. In
      sensitivity analysis the ratios ranged from $5200 to $110,200 per year of life
      gained. Annual costs of care for these two strategies are $1.3 billion for the
      test strategy and $2.3 billion for the treat strategy. CONCLUSION: Economic
      assessment of new technologies early in their development can be used to guide
      their efficient clinical introduction.

PMID- 1744963
TI  - Quality of care. Time to act.

PMID- 1744964
TI  - Advances in early diagnosis of perinatal HIV infection.

PMID- 1744965
TI  - Blood, money, and hemophiliacs--the fatal story of France's 'AIDSgate'.

PMID- 1744966
TI  - Diarrhoea.

PMID- 1744967
TI  - Etiology and management of diarrhoeal diseases in Karachi.
AB  - The incidence of diarrhoeal disease are very high in our population and bacterial
      etiology amounts to 43.55% of all cases. Pathogen such as Aeromonas hydrophila,
      Plesiomonas shigelloides, Yersinia enterocolitica and Campylobacter are also
      present in significant numbers, they make up 50% of bacterial causes. All enteric
      pathogens can be easily isolated on commonly used media and could be precisely
      identified by simple biochemical tests.

PMID- 1744968
TI  - Ramadan fasting and thyroid hormone profile.
AB  - A study comprising 41 males, 5 females of the age ranging from 28 to 56 years was
      conducted during Ramadan of 1989 to compare T3, T4 and TSH levels in fasting with
      the levels of non-fasting conditions. Each individual gave 6 blood samples: One
      sample was taken 20 days before the onset of Ramadan, 3 samples at different
      fasting days and last two samples were drawn 23 days and five months after the
      end of Ramadan, respectively. The results showed a significant gradual rise in
      TSH throughout the fasting month, although the mean levels remained within normal
      limits. Pre- Ramadan levels were re-attained well after the end of Ramadan. There
      was no significant change in T3 and T4 levels.

PMID- 1744969
TI  - Sero-epidemiological survey of malaria by immunofluorescence in Pakistan
      (District Gujranwala-Punjab).
AB  - Indirect Immunofluorescence Antibody (IFA) Technique was employed, for field
      detection of malarial parasite. The technique involved application of homologous
      antigen slides of Plasmodium falciparum and P. vivax prepared in the field
      conditions. Serological study, simultaneously using P. falciparum and P. vivax
      antigens, brought out a clearer picture of distribution and role of the parasite
      species in the epidemiology of the disease in the area studied. The survey
      supported the contention of persistence of transmission of malaria in Gujranwala
      District.

PMID- 1744970
TI  - Sertoli cell only syndrome (SECOS): lessons from case studies.
AB  - Between June 85 and December 87, 69 testicular biopsies were submitted for
      histopathological examination during investigation of infertility; ten (14%)
      patients had a Sertoli cell only syndrome. The history, clinical features, and
      hormonal profiles were analyzed in an attempt to categorize these patients on
      aetiological basis. Two followed treatment of malignancy--one by radiation for
      testicular cancer and one by cyclophosphamide for a lymphoma. One had unilateral
      cryptorchidism. Mumps was etiological factor in one patient. FSH levels
      determined in 6 patients were elevated in all suggesting a possible dependence of
      (sick) Sertoli cells on spermatogenic cells for production of inhibin.
      Alternative explanations include changes in sertoli cell enzymes or FSH
      receptors. Testosterone levels are in the low normal range suggesting that Leydig
      cells may also be affected by the etiological factor producing the syndrome. Two
      patients who had earlier received a higher Johansen score were found to have a
      sertoli cell only syndrome on expert review of testicular biopsies. It is
      suggested that the condition is more common than hitherto reported and is often
      confused with maturation arrest. Testicular histopathology should be done by
      specialists in testicular pathology.

PMID- 1744971
TI  - Maternal morbidity in the Department of Obstetric and Gynaecology, Jinnah
      Postgraduate Medical Centre Karachi.
AB  - Maternal morbidity was observed in 377 obstetric cases at Jinnah Postgraduate
      Medical Centre (JPMC) during a period of one year. Morbidity rate was 4.4% of
      total deliveries. Three hundred and twenty-four (86%) mothers had no proper
      antenatal supervision. Infection was more common after abdominal delivery and
      injury to genital tract after vaginal delivery. The most serious injury was
      rupture of gravid uterus. Thirty-seven cases of ruptured uterus were admitted in
      one year and 5 cases occurred within the hospital (1 in 1225 deliveries).

PMID- 1744972
TI  - Neuro osteoarthropathy (Charcot's joint) in a young diabetic.

PMID- 1744973
TI  - Collagenous colitis.

PMID- 1744974
TI  - Clinical trials in surgery.

PMID- 1744975
TI  - The role of vascular smooth-muscle cells in atherogenesis: phenotypic modulation
      of the medial smooth-muscle cells in the aortic bifurcation.
AB  - To elucidate the mechanism of migration of vascular smooth-muscle cells (SMCs)
      from media to intima, we have investigated the phenotypic modulation of the
      medial SMC at bifurcation of the celiac artery in 5 children and 3 young persons
      using a transmission electron microscope. We counted the number of separated SMCs
      from the elastic layers, although the medial SMCs are fundamentally attached to
      the elastic fibers, and are still contractile in their phenotypes. Both proximal
      and distal portions revealed that SMCs in the media were more or less present in
      the separated state and were ultrastructurally consistent with the synthetic
      state of SMC in the proximal area and the contractile state in distal areas. In
      order to migrate from media to intima, medial SMC should separate from the
      elastic layers and transform their phenotypes. In this paper, we examined the
      relationship between vascular SMCs and elastic layers in the media and ascertain
      that it was responsible for the contribution to the subsequent phenotypic
      modulation and their migration of medial SMCs.

PMID- 1744976
TI  - Impairment of a protective system against atherosclerosis--genetic disorders in
      HDL metabolism.

PMID- 1744977
TI  - Anticoagulant heparin-like glycosaminoglycans on endothelial cell surface.
AB  - Atherosclerosis is associated with an accumulation of proteoglycans.
      Proteoglycans and/or glycosaminoglycans, in particular heparan sulfate, produced
      by endothelial cells are thought to play important roles in diverse vascular
      functions. Of particular note is that they possess anticoagulant functions, i.e.,
      heparin-like antithrombin cofactor activity. Incubation of antithrombin III with
      endothelial cell cultures resulted in a specific, saturable binding of this
      protease inhibitor presumably to the endothelial cell surface. In addition,
      thrombin inactivation by antithrombin III was accelerated on the endothelial
      surface, providing strong evidence that heparan sulfate on the surface of
      endothelial cells exerts a heparin-like activity. beta-D-xyloside or cytokine
      treatments altered the synthesis of heparan sulfate on the endothelial cell
      surface, resulting in decreased anti-thrombin III binding and diminished heparin
      like anticoagulant activity of endothelial cells. The modulation of endothelial
      heparin-like compounds by these pharmacologic or physiologic agents may have
      pathophysiologic implications in thrombosis as well as atherogenesis.

PMID- 1744978
TI  - Platelet-derived endothelial cell growth factor: structure and function.
AB  - Platelet-derived endothelial cell growth factor (PD-ECGF) is a 45-kDa single
      chain polypeptide, which stimulates the growth and chemotaxis of endothelial
      cells in vitro and angiogenesis in vivo. Purification from human platelets and
      cDNA cloning of PD-ECGF disclosed that it is a novel type of angiogenic factor
      without sequence similarity to hitherto known proteins. PD-ECGF is present in
      human platelets as well as in placenta. Amino acid sequencing of PD-ECGF from
      human placenta revealed that the placental form has an additional 5 amino acids
      at the N-terminus. In cultured cells, it is produced by normal fibroblasts as
      well as some transformed cell lines. PD-ECGF lacks a hydrophobic signal sequence
      and remains inside the producer cells. PD-ECGF may act at sites of injury as a
      wound hormone and thus play an important role under several physiological and
      pathological conditions.

PMID- 1744979
TI  - Small GTP-binding proteins in bovine aortic smooth muscle.
AB  - In bovine aortic smooth muscle, GTP-binding activity was equally distributed in
      the membrane and cytosol fractions. The most abundant GTP-binding proteins (G
      proteins) in each fraction were purified to near homogeneity and characterized.
      The most abundant G protein in the membrane fraction had a Mr value of about
      22,000 (m22K G) as estimated on sodium dodecyl sulfate-polyacryl-amide gel
      electrophoresis (SDS-PAGE). m22K G and the human platelet smg p21, a ras p21 like
      G protein having the same effector domain as ras p21s, were eluted at the same
      retention time on C4 reversed-phase high performance liquid chromatography
      (HPLC). Moreover, m22K G was specifically recognized by an anti-smg p21
      polyclonal antibody. m22K G was phosphorylated by cyclic AMP-dependent protein
      kinase with a stoichiometry of one phosphate/molecule of protein. The most
      abundant G protein in the cytosol fraction had a Mr value of about 21,000 (c21K
      G) as estimated on SDS-PAGE. c21K G was ADP-ribosylated by botulinum ADP
      ribosyltransferase and about 0.4 mol of ADP-ribose was maximally incorporated
      into 1 mol of c21K G. c21K G and the bovine brain rhoA p21, another ras p21 like
      G protein, were eluted at the same retention time on C4 reversed-phase HPLC and
      migrated at the same position on two-dimensional gel electrophoresis. These
      results indicate that the major G proteins in the membrane and cytosol fractions
      of bovine aortic smooth muscle are smg p21 and rhoA p21, respectively. Possible
      roles of these G proteins in vascular smooth muscle are discussed.

PMID- 1744980
TI  - Decreased sulfhydryl groups of serum albumin in coronary artery disease.
AB  - We hypothesized that oxidative processes in myocardial tissues initiated by
      ischemia also cause the same kind of changes in blood proteins and lead to
      oxidation of sulfhydryl groups (SH). To test this hypothesis, the ratio (%MA) of
      mercaptalbumin to total albumin (= mercaptalbumin + nonmercaptalbumin) and the
      total SH contents of serum were measured in patients with coronary artery
      disease. There was a positive correlation between %MA and total SH contents and
      both values were reduced in proportion to the severity of the coronary artery
      disease. Furthermore, these values were lower early hours after the onset of
      acute myocardial infraction than 4 weeks later. These results support our
      hypothesis, and may provide a basis for the administration of agents which can
      counteract oxidative stress in order to protect myocardium in patients with
      coronary artery disease.

PMID- 1744981
TI  - A case of unusual longevity of tetralogy of Fallot confirmed by cardiac
      catheterization.
AB  - We describe a 61-year-old woman with tetralogy of Fallot and dextrocardia with
      complete situs inversus. The functional status of this patient was New York Heart
      Association (NYHA) class II and the systemic blood pressure was 100/54 mmHg. The
      hematocrit was 54.4% and the arterial partial pressure of oxygen was 53 mmHg. On
      cardiac catheterization, both pulmonary valvular and infundibular stenoses were
      of equal severity and the aorta and main pulmonary artery were of equal size. We
      think that this patient has survived to this unusual age for tetralogy of Fallot
      because of unusually low systemic pressure and a proper balance between the
      ventricular septal defect and the pulmonary stenosis.

PMID- 1744982
TI  - A case of clinically diagnosed pure septal infarction.
AB  - Interventricular septal involvement in myocardial infarction is usually
      associated with infarction of the left ventricular anterior free wall, as the
      obstruction is at the major portion of the left anterior descending coronary
      artery. Acute myocardial infarction with obstruction only of the first septal
      branch is rare. We describe here a case of pure septal infarction. The case was
      diagnosed by emergency coronary arteriogram (CAG). Although the patient had a
      large first septal branch, his global left ventricular function was preserved.
      Abnormal findings were localized in only septal region as determined by left
      ventriculography (LVG), two-dimensional echocardiography (2DE), and 99mtechnetium
      pyrophosphate (99m Tc-PYP) and 201thallium (201Tl) myocardial scintigraphy.

PMID- 1744983
TI  - The importance of good endocardial reflow immediately after reperfusion for
      myocardial salvage in dogs.
AB  - We studied the importance of reflow after reperfusion for myocardial salvage. In
      19 open-chest dogs, the left anterior descending coronary artery was occluded for
      3h and then reperfused. Non-radioactive colored microspheres were injected into
      the left atrium to measure regional myocardial blood flow (RMBF). Immediately
      after occlusion, RMBF was reduced to 23 +/- 2% (of control) in the inner layer
      and 32 +/- 2% in the outer layer. Five minutes after reperfusion, RMBF was
      increased to 170 +/- 20% and 156 +/- 11% of control in the inner and outer
      layers, respectively. One week later, RMBF in the inner layer was reduced to 63
      +/- 4% but it was not reduced (100 +/- 6%) in the outer layer. There was a
      roughly positive correlation between the inner/outer flow ratio measured 5 min
      after reperfusion and myocardial creatine kinase activity. Myocardial necrosis
      determined by triphenyl tetrazolium chloride stain varied inversely with the
      inner/outer flow ratio. These results indicate that good reflow in the inner
      layer 5 min after reperfusion is a favorable indicator for myocardial salvage.

PMID- 1744984
TI  - Blood coagulation and fibrinolysis in SART-stressed (repeated cold-stressed) rats
      and drug effects on the altered hemostatic parameters.
AB  - Blood coagulation and fibrinolytic activity was studied in SART (specific
      alternation of rhythm in temperature)-stressed animals found to exhibit
      thrombocytopenia and prolonged bleeding time, and drug effects on the
      abnormalities were evaluated. 1) SART-stressed rats revealed prolongation of
      activated partial thromboplastin and thrombin time, no change in prothrombin
      time, decreased plasma fibrinogen levels, and shortened euglobulin clot lysis
      time (ELT). Antithrombin III and alpha 2-plasmin inhibitor activity remained
      constant following stress exposure. 2) During stress, fibrinogen levels declined
      from day 5 and remained depressed up to day 14. Reduction in ELT developed in a
      similar manner to fibrinogen. 3) Decreased fibrinogen levels were prevented by
      consecutive doses of tranexamic acid, an antifibrinolytic, and Neurotropin, a
      sedative analgesic. Shortened ELT was counteracted by chronic treatment with
      Neurotropin and alprazolam, an anxiolytic. Single administrations of the above
      agents failed to affect either change. These results indicate that SART-stressed
      animals exhibit suppressed intrinsic coagulability and enhanced fibrinolytic
      activity, but normal extrinsic coagulability. Considering the previous report
      together with the above results, the hemostatic system under SART stress tends
      uniformly toward hemorrhage. Moreover, Neurotropin appears to improve and
      normalize hemostatic imbalance due to SART stress, a chronic form of stress.

PMID- 1744985
TI  - Effect of phospholipase A2 on temperature-induced high-affinity [3H]tryptamine
      binding sites in rat brain.
AB  - To investigate a link between membrane phospholipids and tryptamine binding
      molecules, we examined the effects of phospholipases A2 and D on the temperature
      sensitive high-affinity [3H]tryptamine binding sites in rat brain. When the
      phospholipase A2-treated membranes were exposed to 1% bovine serum albumin (BSA)
      before assaying for [3H]tryptamine binding, a complete dose-dependent inhibition
      curve was observed. At a concentration of 0.03 U, the action of phospholipase A2
      resulted in the splitting of phosphatidylserine (PS), choline phosphatides (PC)
      and ethanolamine phosphatides (PE) by about 32, 34 and 65%, respectively, and
      reduced [3H]ligand binding by about 32%. On the contrary, in the case of
      phospholipase D (500 U), PS and PC decreased by about 8% and 33% and PE by about
      29% with no significant alteration in the binding capacity. Moreover, Scatchard
      analysis of the [3H]tryptamine binding showed that phospholipase A2 drastically
      increased only the KD value of the high affinity sites, and this was accompanied
      by a decrement of the Bmax values of both the high and low affinity binding
      sites. From these results, it is inferred that certain lipids (PS) may be a
      modulator for the function of the temperature-induced high-affinity
      [3H]tryptamine binding molecules.

PMID- 1744986
TI  - Congestive heart failure model in rabbits: effects of digoxin and a drug
      containing toad venom.
AB  - A low-output-type heart failure model was established in rabbits by protease
      treatment of the surface of the left ventricular anterior wall. Heart rate,
      aortic blood flow (AoF), left ventricular pressure (LVP) and maximal rate of rise
      of LVP (max dP/dt) in this model were maintained at lower levels than in normal
      rabbits, while left ventricular end-diastolic pressure (LVEDP) and systemic
      vascular resistance (SVR) were maintained at higher levels, and mean blood
      pressure (MBP) remained at a normal level. Intraduodenal administration of
      digoxin and a drug containing toad venom (Kyushin:KY) improved the hemodynamic
      parameters by increasing the AoF, LVP and max dP/dt and by decreasing the LVEDP
      and SVR without a significant change in MBP. These results suggest that the
      beneficial effects of digoxin and KY on this heart failure model originate from
      their cardiotonic activity.

PMID- 1744987
TI  - Enhancement of the ambulation-increasing effect of opioid analgesics by ethanol
      in mice.
AB  - The interaction between opioid analgesics (morphine and buprenorphine) and
      central depressants (ethanol, pentobarbital and diazepam) was investigated by
      means of ambulatory activity in mice. The ambulation-increasing effect of both
      morphine (10 mg/kg, s.c.) and buprenorphine (1 mg/kg, s.c.) was enhanced by the
      combined administration of ethanol (0.8-3.2 g/kg, p.o.) in a dose-dependent
      manner. Naloxone (0.1 mg/kg, s.c.) was effective for reducing the enhanced
      ambulatory activity. The pretreatment with Ca-cyanamide (5 mg/kg, p.o., 30 min
      before) reduced the enhancement of the ambulation-increasing effect induced by
      the combined administration of opioid analgesics with ethanol, although it
      scarcely modified that of morphine and buprenorphine alone. On the other hand,
      neither pentobarbital (1-30 mg/kg, s.c.) nor diazepam (0.25-2 mg/kg, s.c.)
      modified markedly the ambulation-increasing effect of morphine and buprenorphine.
      The present results suggest that ethanol specifically interacted with opioid
      analgesics when the mouse's ambulatory activity was used as the indicator.

PMID- 1744988
TI  - Studies on antinephritic effect of TJ-8014, syo-saiko-to-kyo-shyokyo-ka-ouren
      bukuryou (5): Effects on puromycin aminonucleoside nephrosis and its mechanisms.
AB  - The effect of TJ-8014, a lyophilized extract of Syo-Saiko-To without Zingiberis
      rhizoma, annexing Coptidis rhizoma and Hoelen, on puromycin aminonucleoside (PAN)
      nephrosis in comparison with the effect of dipyridamole was evaluated. PAN
      nephrosis was induced in rats by intraperitoneal injections of PAN, once daily
      for 6 days. When TJ-8014 was given from the initial day of PAN treatment (just
      before PAN injection) at 2.0 g and 4.0 g/kg/day, p.o., it was markedly inhibited
      urinary protein excretion and elevation of serum cholesterol content-throughout
      the experimental periods. In addition, the mild adhesion of Bowman's capsule to
      capillary walls in glomeruli was also improved by TJ-8014 at 2.0 g and 4.0
      g/kg/day, p.o. Dipyridamole was also effective in inhibiting the urinary protein
      excretion as well as histopathological changes. TJ-8014 at 4.0 g/kg/day, p.o.
      inhibited the decrease in superoxide dismutase (SOD-like), catalase and
      glutathione peroxidase activities in the renal cortex and SOD-like activity in
      the glomeruli in PAN-induced nephrosis. Dipyridamole failed to inhibit the
      decrease in scavenger activities. These results suggest that TJ-8014 is effective
      against PAN-induced nephrosis, and they suggest that the mechanisms of action of
      this medicine may be partly due to the enhancing activities of scavengers in the
      renal cortex and glomeruli.

PMID- 1744989
TI  - A reliable method for the production of antral gastric ulcer by a combination of
      2-deoxy-D-glucose, aspirin and ammonia in rats.
AB  - In order to establish a reliable method for the production of gastric antral
      ulcer in rats, combined treatments with three factors: a vagal stimulant, a
      mucosal barrier breaker and a necrotizing agent were investigated. By the
      combined administration of 2-deoxy-D-glucose (2-DG; 200 mg/kg, i.v.), aspirin
      (100-400 mg/kg, p.o.) and hydrochloric acid (0.15 and 0.35 N, 0.5-1.5 ml/100 g,
      p.o.) or ammonia solution (0.5-1.0%, 0.5-1.5 ml/100 g, p.o.), gastric lesions
      were prominently induced in sites of both the corpus and antrum on day 2. The
      largest antral ulcer was induced by the combination of 2-DG (200 mg/kg), aspirin
      (200 mg/kg) and ammonia solution (1%, 10 ml/kg); and the mean antral ulcer index
      (mm2) was 43.1 +/- 4.4 and the incidence was 100%. The antral ulcer was found to
      penetrate the muscularis mucosae and still observed on day 21 and day 28 after
      ulcer induction in a few cases. From these findings, it was indicated that this
      antral ulcer would be a useful model for studying the etiology and therapy of
      gastric ulcer disease.

PMID- 1744990
TI  - Drug effects on cognitive function in mice determined by the non-matching to
      sample task using a 4-arm maze.
AB  - A new task for the analysis of drug effects on the cognitive function in mice was
      investigated using a 4-arm maze with three selectable arms. Each trial consisted
      of a forced run either to the right or left arm containing a food pellet, which
      was changed for each trial, followed by a free-choice run after a delay (0-120
      sec). The correct response was to turn to the arm 180 degrees opposite from the
      forced one. Entrance into the center arm in the free-choice run, which was called
      the non-reward response, was not reinforced at any time. As the delay became
      longer, correct responses decreased, but non-reward response errors remained
      unchanged in the well-trained mice. Without increasing the non-reward response,
      scopolamine and atropine, but not methylscopolamine, decreased the correct
      response in a delay-dependent manner at a low dose range, while diazepam did so
      in a delay-independent manner. Physostigmine ameliorated scopolamine-induced
      impairment in performance, but had less effect on the delay-induced decrease in
      the correct response. Other tested drugs (chlorpromazine, haloperidol,
      apomorphine, phentolamine, propranolol, lithium chloride, ketamine, and caffeine)
      had no significant effect on performance. These results suggest that CNS
      muscarinic blockades and diazepam treatment selectively attenuate working memory
      in different ways.

PMID- 1744991
TI  - Effects of MCI-727, a new anti-ulcer agent, on plasma secretin concentration in
      rats and dogs and pancreatic exocrine secretion in rats.
AB  - In the present study, we investigated the effects of MCI-727, a new anti-ulcer
      agent, on plasma immunoreactive secretin concentration in rats and dogs using
      secretin specific RIA with the ethanol extraction method. Plasma secretin levels
      were increased dose-dependently 10 min after oral administration of MCI-727 in
      rats (control: 5.5 +/- 0.6; MCI-727, 10 mg/kg: 10.4 +/- 2.6; 30 mg/kg: 15.3 +/-
      1.5; 100 mg/kg: 20.7 +/- 2.6 pg/ml, n = 6). Teprenone also caused a significant
      increase of plasma secretin at 10 min after oral administration at the doses of
      30, 100 and 300 mg/kg. Under the same conditions, MCI-727 and teprenone did not
      alter the plasma immunoreactive gastrin concentration in rats. From the results
      of the time course study, the increasing effect of MCI-727 (30 mg/kg, p.o.) on
      plasma secretin remained for at least 240 min after administration. On the other
      hand, the increasing effect of teprenone (200 mg/kg, p.o.) was only observed at
      30 and 60 min after administration. Furthermore, MCI-727 had increasing effects
      on plasma secretin concentration in dogs, but teprenone had no effects in this
      species. The volume of pancreatic secretion and the pancreatic bicarbonate output
      increased after intra-duodenal administration of MCI-727 at 30 and 100 mg/kg in
      rats. Similar effects were also observed with teprenone (30-300 mg/kg, i.d.) or
      secretin (Secrepan, 0.1-1.0 unit/kg, i.v.).

PMID- 1744992
TI  - Possible optimization of sulphadimidine dosage for acetylator phenotyping.
AB  - The effect of different doses of sulphadimidine (250, 500, 750 and 1000 mg) on
      acetylation capacity in 10 normal individuals was investigated in a randomized
      cross-over study design. The subjects were initially phenotyped with an oral dose
      of 750 mg of sulphadimidine. Four weeks later, each subject was assigned four
      different doses of sulphadimidine. The acetylator phenotype was classified for
      each dose as rapid if the percentage of acetylated sulphadimidine in the post
      dose 5-6 hour urine is more than 70% and as slow if less than 70%. The results
      indicate a clear separation into two phenotypes, even with the smallest dose of
      the drug. A slow acetylator in the 10 subjects showed a saturation of the
      acetylation capacity with increasing doses. This trend was not observed in the
      remaining subjects who were identified as rapid acetylators regardless of the
      doses. An oral dose of 750 mg of sulphadimidine is suggested as a 'standard' or
      optimum dose for acetylator phenotype testing.

PMID- 1744993
TI  - Involvement of nicotinic receptors in the dorsal motor nucleus of the vagus in
      regulation of gastric motility in rats.
AB  - Roles of nicotinic receptors in the dorsal motor nucleus of the vagus (DMV) in
      the regulation of gastric motility were investigated in urethane-anesthetized
      rats in which an intragastric balloon had been placed. Nicotine (0.1 nmole)
      microinjected into the DMV but not the nucleus ambiguus induced dual changes, a
      decrease followed by an increase in gastric motility. Administration of 0.1 nmole
      of hexamethonium into the DMV significantly inhibited the decrease in gastric
      motility induced by intravenously administered nicotine.

PMID- 1744994
TI  - Extracellular ATP stimulates steroidogenesis in bovine adrenocortical fasciculata
      cells via P2 purinoceptors.
AB  - Effects of ATP and other purine derivatives on steroidogenesis in primary
      cultured bovine adrenocortical fasciculata cells were examined. At concentrations
      higher than 1 microM, ATP showed a potent stimulative effect on the cortisol
      production of the cells. The potency order of the steroidogenic effect of the
      tested purine derivatives was ATP greater than ADP much greater than adenosine
      much greater than AMP. alpha,beta-Methylene ATP had no stimulative effect on the
      steroidogenesis at concentrations as high as 1 mM. Theophylline did not
      antagonize the steroidogenic effect of ATP. These results suggest that bovine
      adrenocortical fasciculata cells possess the P2y purinoceptors that are linked to
      steroidogenesis.

PMID- 1744995
TI  - Nilvadipine, a new calcium channel blocker, reduces ischemic brain injury in
      rats.
AB  - The effects of nilvadipine, a dihydropyridine type calcium channel blocker, on
      cerebral infarction induced by focal brain ischemia was studied in rats. The area
      of infarction was measured 24 hr after occlusion of the middle cerebral artery
      (MCA) in spontaneously hypertensive rats using triphenyltetrazolium chloride.
      Nilvadipine, given immediately after MCA occlusion, reduced the area of
      infarction significantly at doses of 0.32 mg/kg (i.p.) and 3.2, 10 and 32 mg/kg
      (p.o.). Nicardipine suppressed the area of infarction at a dose of 32 mg/kg
      (p.o.). The results suggest that nilvadipine is effective against ischemic brain
      injury.

PMID- 1744996
TI  - Autoradiographic localization of human calcitonin sensitive binding sites in rat
      brain.
AB  - Using 125I-salmon calcitonin (sCT) as a ligand, in vitro autoradiography of rat
      brain outlined specific anatomical localization of human calcitonin (hCT)
      sensitive binding sites. The results presented herein show that there are hCT
      sensitive binding sites in the ventral part of the lateral septum among the sCT
      specific binding sites distributed throughout the diencephalon.

PMID- 1744997
TI  - The abilities of specific kappa-opioid agonists, U-50,488H and U-62,066E, to
      cause antitussive tolerance were lower than that of morphine.
AB  - We examined whether the chronic administration of selective kappa-opioid agonists
      could produce antitussive tolerance, in a comparison with the mu-opioid morphine.
      A certain degree of tolerance to the antitussive effects of morphine appeared in
      rats treated chronically with this drug. However, chronic administration of U
      50,488H and U-62,066E, highly selective agonists for the kappa-opioid receptor,
      does not result in the development of tolerance to their respective antitussive
      effects. These results suggest that the ability of kappa-opioid agonists to cause
      tolerance to their respective antitussive effects was lower than that of a mu
      opioid agonist.

PMID- 1744998
TI  - Involvement of protein kinase activation in neurotrophic effects of basic
      fibroblast growth factor in cultured brain neurons.
AB  - The influences of K-252a and staurosporine, protein kinase inhibitors, on
      neurotrophic effects of basic fibroblast growth factor (bFGF) were investigated
      in dissociated cell cultures of the striatum, hippocampus and cerebellum of fetal
      rats. Addition of 1 ng/ml bFGF enhanced the survival of cultured neurons of all
      brain regions tested. Both K-252a (10-200 nM) and staurosporine (1-100 nM)
      blocked the survival promoting effects of bFGF in a concentration-dependent
      manner. These results suggest that bFGF exerts its neurotrophic effects through
      activation of protein kinase(s).

PMID- 1744999
TI  - Of safe harbors ... and treacherous shoals.

PMID- 1745000
TI  - The Primary Care Bridging Plan.

PMID- 1745001
TI  - The EACH Concept. Part I: The basics.

PMID- 1745002
TI  - Communications with Kansas physicians.
AB  - The uneven geographic distribution of population, physicians and treatment
      facilities in Kansas may at times create difficulties in bringing unusual patient
      problems and needed medical expertise together. Technology currently exists for
      establishing communication links ranging from live, two-way, audio-video
      communication connections and computers to the common telephone. This survey
      indicates that the medical community has great interest in developing functional
      and cost-effective links. The two campuses of the medical school are working to
      provide better and broader communications access to the physicians of the state.

PMID- 1745003
TI  - Medicare/Medicaid fraud and abuse (safe harbors) OIG anti-kickback regulations.

PMID- 1745004
TI  - Physician to rancher (and back again). Part two.

PMID- 1745005
TI  - Cutting strokes off at the neck.

PMID- 1745006
TI  - Angiotensin actions in the kidney: renewed insight into the old hormone.

PMID- 1745007
TI  - Interleukin-1 beta stimulates human mesangial cells to synthesize and release
      interleukins-6 and -8.
AB  - Interleukin-1 beta (IL-1 beta) and tumor necrosis factor (TNF) have been reported
      to stimulate human mesangial cells (HMC) to proliferate and synthesize
      eicosanoids. We have examined whether they also induce HMC to release cytokines.
      In this study we show that both IL-1 and TNF stimulate HMC to release IL-6 and IL
      8. Cycling and quiescent HMC were stimulated with various concentrations of
      either recombinant IL-1 beta or TNF for 1 to 24 hours. IL-1 beta at doses as low
      as 6 pg/ml stimulated mesangial cells to synthesize mRNA for both IL-6 and IL-8
      as assessed by Northern analysis; mRNA for tubulin remained constant, which
      demonstrated a specific increase in mRNA. Secretion of IL-6 and IL-8 into the
      culture medium increased (4.5 to 18 ng/ml and 4 to 40 ng/ml, respectively)
      measured by ELISAs. TNF had similar effects but only in high concentrations
      (greater than 100 ng/ml). IL-1 beta did not stimulate cells to proliferate, as
      measured by 3H thymidine incorporation. TNF caused proliferation but only in
      concentrations over 100 ng/ml. We conclude that IL-1 beta is a potent stimulator
      of human mesangial cell production of IL-6 and IL-8, both of which may influence
      injury in nephritis. TNF also stimulates mesangial cells but only in
      pharmacological doses.

PMID- 1745008
TI  - Changes in intracellular sodium during the hydroosmotic response to vasopressin.
AB  - During vasopressin (VP)-induced water movement, toad urinary bladder epithelial
      cells undergo unique morphological changes. The osmolality within these
      responding cells remains relatively stable despite the large transcellular
      transport of water. We hypothesized that the hydroosmotic response to VP may be
      associated with a net increase in sodium either as an aid in maintaining the
      intracellular osmolality or as part of a Na-Ca exchange process. Changes in
      intracellular sodium (Nai) were monitored over time in individual hemibladders
      using 23Na NMR. Hemibladders were mounted as bags on glass pipets and filled with
      deionized water. During NMR studies, the serosal bath consisted of aerated 2.4 mM
      HCO3 amphibian Ringer's (pH 8.1) made up with 15% D2O containing the shift
      reagent, dysprosium tripolyphosphate (1 mM). This reagent allowed for
      visualization of Nai by shifting the extracellular Na signal; it did not affect
      basal or VP stimulated water flow, short-circuit current, or high energy
      phosphate metabolism as seen by 31P NMR. Changes in Nai were determined by
      integrating the area under the unshifted Na peak at each measurement and
      expressing differences as a ratio relative to baseline. The initial Nai signal
      from unstimulated hemibladders remained stable in these tissues over at least 180
      minutes. Within 30 minutes of VP (20 mU/ml) exposure, however, the Nai peak
      increased 2.47 times above pretreatment baseline (N = 16, P less than 0.001). The
      Nai signal returned toward baseline values with removal of VP from the serosal
      bath but only after approximately 90 minutes. When change in cell shape and water
      movement were prevented by having isotonic sorbitol in the mucosal bath, VP
      produced no change in the Nai signal (N = 10).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745009
TI  - Visceral peritoneum is not essential for solute transport during peritoneal
      dialysis.
AB  - The importance of visceral peritoneum in determining transperitoneal solute
      exchange was studied by determining the influence of evisceration on diffusive
      solute transport during peritoneal dialysis. Three series of experiments were
      performed in anesthetized New Zealand White rabbits. Series 1 studies compared
      solute transport rates from eviscerated rabbits (N = 5) with those from sham
      operated controls (N = 5). Series 2 studies compared solute transport rates from
      eviscerated (N = 6) and sham-operated rabbits (N = 5) with application of
      circumferential abdominal compression to control intraperitoneal pressure and
      presumably maximize dialysate-peritoneum contact. Series 3 studies compared
      solute transport rates from sham-operated rabbits (N = 4) with and without
      applied circumferential abdominal compression. Transperitoneal solute exchange of
      creatinine and FITC-labeled neutral dextran (15 to 40 A) was equally assessed by
      both the dialysate to plasma concentration ratio at the end of the exchange and
      the diffusive permeability-area product of the peritoneum. Evisceration reduced
      creatinine (P less than 0.001) and dextran (15 to 30 A, P less than 0.05)
      transport to approximately one quarter that of controls in series 1 rabbits. When
      circumferential abdominal compression was applied in series 2 rabbits, however,
      evisceration had no effect on peritoneal solute transport rates. Moreover,
      circumferential abdominal compression per se had no effect on solute exchange in
      series 3 experiments. These findings demonstrate that the influence of
      evisceration on peritoneal solute transport depends on the experimental
      conditions. These observations further demonstrate that visceral peritoneum is
      not essential for solute transport during peritoneal dialysis.

PMID- 1745010
TI  - Morphometric study of glomerular slit diaphragms fixed by rapid-freezing and
      freeze-substitution.
AB  - The widths of slit diaphragms in rat glomeruli were quantitatively measured on
      electron micrographs obtained by the rapid-freezing and freeze-substitution (FS)
      fixation method and compared to those prepared by conventional chemical fixation
      procedures, such as tannic acid, glutaraldehyde and osmium tetroxide (TGO) or
      glutaraldehyde and osmium tetroxide (GO) fixation. When fixed by FS using 2%
      osmium tetroxide, glomerular slit diaphragms had widths of 33.8 +/- 3.6 nm, but
      when fixed by TGO or GO they had widths of 47.0 +/- 4.3 and 48.7 +/- 5.5 nm,
      respectively. The width of slit diaphragms was significantly narrower after
      cryofixation than after conventional TGO or GO fixation (P less than 0.001).
      Similarly, the distance between neighboring foot processes at 50 nm from slit
      diaphragms was significantly narrower after cryofixation (P less than 0.001). The
      widths were 98.6 +/- 17.1 nm after TGO fixation, 122.0 +/- 29.3 nm after GO
      fixation and only 54.8 +/- 18.7 nm after FS fixation. These foot processes were
      significantly broader after FS fixation. The foot processes were 179.2 +/- 59.4
      nm in breadth after TGO fixation (P less than 0.001), 188.8 +/- 78.2 nm after GO
      fixation (P less than 0.01) and 235.1 +/- 87.2 nm after FS fixation. These
      results suggest that the cytoplasm of foot processes shrinks when the tissue is
      prepared by conventional chemical fixation methods, and that the broadening of
      slit diaphragms is an artifact separation of the margins of adjacent foot
      processes due to shrinkage. We propose that TGO fixation alters the structure of
      slit diaphragms by causing them to shrink.

PMID- 1745011
TI  - Red cell trapping and postischemic renal blood flow. Differences between the
      cortex, outer and inner medulla.
AB  - The distribution of blood flow in the rat kidney after 60 minutes of renal
      ischemia was studied by single-fiber laser-Doppler flowmetry. Blood flow in
      superficial cortex and inner medulla was measured with a probe directed towards
      the kidney surface and exposed papilla, respectively. Outer medullary blood flow
      was measured with a probe introduced through the renal core. After ischemia the
      blood flow decreased to 60% of the preischemic value (P less than 0.01) in
      superficial cortex and to 16% (P less than 0.01) in outer medulla, while inner
      medullary blood flow increased paradoxically to 125% (P less than 0.01). There
      was extensive trapping of red blood cells (RBC) in the outer medulla, but not in
      the inner medulla or cortex. The fractional RBC volume as measured by
      radiolabeled RBCs was 21% in the inner stripe of the outer medulla, but 2% in
      this area in a normal kidney. To investigate the influence of RBC trapping on
      intrarenal distribution of blood flow after ischemia, the hematocrit was reduced
      from 46% to 31% by isovolemic hemodilution. When performed before ischemia, this
      maneuver almost completely abolished RBC trapping. In this group blood flow in
      both outer and inner medulla was almost unchanged after ischemia, while
      superficial cortical blood flow decreased to 66% (P less than 0.01) of the pre
      ischemic value. It is concluded that RBC trapping in the outer medulla causes a
      large decrease in blood flow in this area and, at the same time, shunting of
      blood to the inner medulla. In the absence of RBC trapping, blood flow of both
      outer and inner medulla is well preserved after ischemia.

PMID- 1745012
TI  - Early renal medullary hypoxic injury from radiocontrast and indomethacin.
AB  - We evaluated the acute changes in cortical and outer medullary oxygen tension and
      the alterations in renal function and morphology within the first 90 minutes
      after the administration of indomethacin and iothalamate to anesthetized Sprague
      Dawley rats. Both agents were found to produce marked and protracted outer
      medullary hypoxia averaging 12 +/- 4 and 9 +/- 2 mm Hg, respectively (mean +/-
      SE). Given together to salt depleted uninephrectomized rats they produced an
      early hypoxic injury localized selectively in the outer medulla. This lesion
      progressed from 3 +/- 1% of medullary thick ascending limbs (mTALs) at 15 minutes
      to 22 +/- 7% at 24 hours. Condensed "dark" cells were observed at 15 minutes,
      probably representing a type of early injury. Residual red cell mass, quantified
      in the outer medullary vasculature of perfusion-fixed kidneys and presumably
      reflecting stasis, was substantially increased in iothalamate treated rats. Red
      cell mass in the interbundle zone correlated with mTAL necrosis. Taken together,
      these results show an early period of medullary hypoxia, accompanied by a
      selective injury to mTALs in the central interbundle zone with apparent stasis.
      These findings contrast sharply with the ischemia-reflow pattern of renal damage
      and emphasize the important role of medullary hypoxia in the genesis of acute
      renal failure in this model.

PMID- 1745013
TI  - Renal entactin (nidogen): isolation, characterization and tissue distribution.
AB  - Entactin/nidogen (E/N) was isolated from bovine renal tubular basement membrane.
      Apparent molecular weight, amino acid composition, and molecular configuration by
      electron microscopy rotary shadowing were similar to that of nidogen from EHS
      mouse tumor. The identity of bovine E/N was confirmed using a thrombin derived
      peptide, the sequence of which corresponded to a region within mouse and human
      E/N. Monoclonal and polyclonal anti-E/N antibodies were used to determine the
      distribution of E/N in human kidney by immunofluorescent and immunoelectron
      microscopy. E/N was present in all renal basement membranes and was distributed
      through the full width of the glomerular basement membrane (GBM) with
      accentuation along its epithelial aspects. E/N distribution was similar to that
      of novel collagen chain alpha 3(IV) NC domain in the GBM. In the mesangium, E/N
      was distributed mainly in the peripheral mesangial region that is bounded by the
      GBM, while classical collagen chain alpha 1(IV) NC as present diffusely
      throughout the mesangium. In the developing nephron, E/N was present in basement
      membranes of the ureteric bud, primitive vesicle and S-form. In all instances,
      E/N co-localized with laminin B2 chain. Prominent E/N detection within the
      mesangium was observed in diseases where mesangial expansion was present. This
      process was also seen in early diabetic nephropathy, but disappeared with disease
      progression. However, all thickened diabetic renal basement membranes showed an
      increase in E/N which was also present in Kimmelstiel-Wilson lesions. E/N was
      observed in the GBM "spikes" of membranous glomerulonephritis and in epithelial
      crescents associated with various disorders. The association between E/N, laminin
      and type IV collagen chains observed in the normal kidney were maintained in
      disorders with altered E/N distribution. We could not detect any changes in the
      distribution of E/N in other acquired and hereditary kidney diseases. These
      observations reflect the involvement of E/N in the structure and disease
      alteration of renal basement membranes and mesangial matrix.

PMID- 1745014
TI  - Mesangial cell behavior in a three-dimensional extracellular matrix.
AB  - To understand the role of mesangial matrix in regulating responses of mesangial
      cells (MCs), particularly as a cause of disease, we examined the behavior of MCs
      cultured in a three-dimensional extracellular matrix (ECM). Mouse and rat MCs
      were incorporated into ECM composed of type I collagen gel matrix (CGM) and
      basement membrane-type gel matrix (BGM), and their shape and proliferation were
      assessed. The effect of gel matrix on MC migration was also studied. MCs
      exhibited marked elongation and proliferation in CGM, whereas these behavior were
      inhibited by increasing the ratio of BGM. Although CGM allowed MC migration, BGM
      restricted it to a great extent. To identify the cause of our findings, we
      examined the effects of ECM components in our experimental system. Laminin,
      fibronectin, type IV collagen, and heparin-like proteoglycans (heparan sulfate
      and heparin) were each mixed separately with CGM at a concentration of 50
      micrograms/ml gel. Whereas fibronectin promoted MC elongation and proliferation,
      and laminin inhibited MC migration, type IV collagen and heparin-like
      proteoglycans inhibited all three activities of MCs. Our findings suggest that
      basement membrane-type mesangial matrix is important in regulating the behavior
      of MCs in vivo.

PMID- 1745015
TI  - Impaired insulin secretion of aging: role of renal failure and
      hyperparathyroidism.
AB  - Available data indicate that insulin secretion is impaired with aging. Almost all
      the studies that examined insulin secretion by old animals did not take into
      consideration the state of renal function or the blood levels of parathyroid
      hormone (PTH). Old animals may have chronic renal failure (CRF) and secondary
      hyperparathyroidism, and both of these conditions impair insulin secretion. It is
      possible, therefore, that the impaired insulin secretion of aging is not due to
      old age per se, but rather to associated CRF and excess PTH. The present study
      examined this issue in adult (6 month old) and senescent rats (2 year old) with
      and without CRF and excess PTH. Senescent rats without CRF had normal renal
      function and normal blood levels of PTH, and the values were not different from
      those observed in adult rats. Creatinine clearance in senescent rats with CRF was
      significantly (P less than 0.01) lower and serum levels of PTH were significantly
      (P less than 0.01) higher than in senescent animals without CRF and than in the
      adult rats as well. Only the senescent rats with CRF displayed glucose
      intolerance during intravenous glucose tolerance test. For any given level of
      blood glucose, plasma insulin levels were lower in senescent rats with CRF than
      in the adult rat or senescent animals without CRF.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1745016
TI  - Isolation of a novel complement regulatory factor (GCRF) from glomerular
      epithelial cells.
AB  - Cultured rat glomerular epithelial cells (GEC) are able to prevent both antibody
      directed and spontaneous (alternative pathway) complement activation. In this
      study, a novel complement regulatory factor (GCRF) was isolated from GEC. The
      ability to accelerate the decay of alternative pathway C3/C5 convertases formed
      on sheep erythrocytes (EC3bBbP) was used to guide purification. GEC were
      solubilized in Triton X-114 and GCRF was recovered in the aqueous phase.
      Complement inhibitory material also was present in the culture supernatant, which
      likely represented GCRF. By Mono Q anion exchange chromatography, GCRF eluted at
      greater than or equal to 0.6 M NaCl and by Superose 6 size-exclusion
      chromatography, it had a Kav less than or equal to 0.3. GCRF reduced the t1/2 of
      EC3bBbP from 128 minutes in buffer alone to 41 minutes in 3 micrograms/ml GCRF
      protein, and also prevented formation of EC3bBbP in a dose-dependent fashion.
      Digestion with chondroitinase ABC, neuraminidase, or trypsin, but not with
      heparitinase or chondroitinase AC significantly reduced the activity and size of
      GCRF, demonstrating that it is a sialic acid-containing dermatan sulfate
      proteoglycan. Thus, cultured rat GEC synthesize and secrete into the medium,
      GCRF, a dermatan sulfate proteoglycan with complement inhibitory activity.

PMID- 1745017
TI  - Glomerular renin synthesis and storage in the remnant kidney in the rat.
AB  - The intrarenal renin-angiotensin system can exert local control of the nephron
      and its circulation. In the subtotally nephrectomized model of chronic renal
      disease in the rat, angiotensin appears to play a prominent role in glomerular
      function. Glomeruli in this model demonstrate greater staining for
      intraglomerular renin by immunofluorescence microscopy than do those in control
      rats. Glomeruli from remnant nephrons contain increased renin content. Also,
      glomeruli from remnant nephrons contain an increased proportion of the mRNA for
      renin. Adriamycin-induced nephrosis did not evoke the same degree of renin
      staining and did not lead to increased glomerular expression of the renin gene,
      findings that argue against permselective defects and glomerular trapping as the
      sole cause of the glomerular renin in the remnant kidney model. Thus, renin
      synthesis and accumulation occur in the remnant glomerulus and this migration may
      underlie in part the dependence of glomerular function on the renin-angiotensin
      system in this model.

PMID- 1745018
TI  - Role of ornithine decarboxylase for proliferation of mesangial cells in culture.
AB  - To elucidate the role of polyamine metabolism in the regulation of mesangial cell
      growth, we examined the involvement of ornithine decarboxylase (ODC), the rate
      limiting enzyme for polyamine synthesis, in the mitogenesis of cultured rat
      mesangial cells (MCs). Resting MCs, stimulated with fetal calf serum (FCS 10%),
      showed an induction of ODC activity from undetectable values in resting cells to
      mean = 5035 nmol CO2/10(10) cells.hr (range 3157 to 7154, N = 5), which is 25
      fold above the detection limit. We found a single peak of ODC activity eight to
      ten hours after stimulation, declining to 22 to 34% of peak levels after 24
      hours. 3H-thymidine (TdR) uptake, an S-phase marker of MC replication, peaked at
      24 hours, reaching 10.7-fold values of resting MCs. ODC mRNA levels were low in
      resting cells. After serum stimulation there was a two- to 10-fold increase in
      ODC mRNA with a maximum after six hours. ODC activity with similar kinetics but
      lower peak levels was also induced by incubating MCs with mitogens, such as
      platelet-derived growth factor (PDGF-AB 20 ng/ml), arginine vasopressin (AVP 10(
      7) M), phorbol myristate acetate (PMA 10(-7) M), interleukin 1 alpha and beta (IL
      1 alpha 10 U/ml, IL-1 beta 10 U/ml). In the presence of alpha
      difluoromethylornithine (DFMO), an enzyme-activated irreversible inhibitor of
      ODC, the growth rate of MCs, assessed by cell counts and by 3H-TdR uptake, was
      markedly reduced by 62 to 100%. This antiproliferative effect of DFMO could be
      reversed by addition of putrescine, the reaction product of ODC.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1745019
TI  - Distribution of epidermal growth factor in the kidneys of rats exposed to
      amikacin.
AB  - The distribution of epidermal growth factor (EGF) was examined by
      immunocytochemistry in the kidneys of rats exposed to amikacin, an aminoglycoside
      antibiotic causing tubular necrosis at high dose. Five-animal groups were treated
      for 4 or 10 days with amikacin at daily doses of 15, 40, 80 or 200 mg/kg. The
      drug was delivered i.p. twice a day. One hour before termination, each rat
      received an i.p. injection of [3H] thymidine to evaluate DNA synthesis in renal
      tissue. After sacrifice, the kidneys were processed for morphological (semithin
      and paraffin sections) and biochemical analysis (measurement of DNA synthesis by
      [3H] thymidine incorporation in vivo). Amikacin induced in proximal tubules a
      dose-related lysosomal phospholipidosis, which was assessed by the morphometric
      evaluation of altered lysosomes ("myeloid bodies") on semithin section. However,
      frank evidence of acute tubular necrosis was only observed in rats receiving
      amikacin at a daily dose of 200 mg/kg. Concomitantly with the development of
      tubular necrosis, there was a rise in the rate of cell turnover, reflected by an
      increase of DNA synthesis in renal tissue. This sign of tubular regeneration was
      accompanied by a redistribution of EGF immunoreactivity, as revealed by
      immunocytochemical staining. Within renal cortex of control rats, EGF
      immunoreactivity predominantly appeared in distal tubules and collecting ducts
      (97% of examined tubular sections). In contrast, in treated animals where the
      renal cortex displayed evidence of tubular necrosis/regeneration, EGF
      immunoreactivity was frequently associated with proximal tubules (more than 30%
      of examined tubular sections, as compared to 3% in controls).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1745020
TI  - Sigmoidal relationship between calcitonin and calcium: studies in normal,
      parathyroidectomized, and azotemic rats.
AB  - Calcitonin secretion is stimulated by acute hypercalcemia. Furthermore, in the
      rat, the calcemic response to parathyroid hormone (PTH) is decreased by
      calcitonin stimulation. However, in renal failure, it is not known if an increase
      in the serum calcium concentration within the physiologic range of serum calcium
      stimulates calcitonin and whether the increased calcitonin decreases the calcemic
      response to PTH. In the present study, four groups of pair-fed rats were
      evaluated: normals (N); parathyroidectomy (PTX); and two groups with renal
      failure (RF)--basal serum calcium less than 8.5 mg/dl (RFa) and basal serum
      calcium greater than 8.5 mg/dl (RFb). Hypocalcemia was induced by
      parathyroidectomy or in the RFa group, by a high phosphate diet. Increases in the
      serum calcium were produced by a 48 hour infusion of rat 1-34 PTH. In the RFa and
      PTX groups, stimulation of calcitonin was observed as the serum calcium increased
      from hypocalcemia to normal levels of calcium (P less than 0.01). In all four
      groups, increasing the serum calcium from normal levels to hypercalcemia
      increased the serum calcitonin level (P less than 0.05). The relationship between
      serum calcitonin and calcium was best expressed as a sigmoidal curve. In the two
      groups with basal hypocalcemia, PTX and RFa, the calcitonin-calcium curve was
      shifted to the left of the N and RFb groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745021
TI  - Effect of mesangial cell lysis and proliferation on glomerular hemodynamics in
      the rat.
AB  - To elucidate an involvement of mesangial cells in the regulation of glomerular
      hemodynamics, renal micropuncture techniques and glomerular morphometry were
      employed in Munich-Wistar rats with mesangial cell lytic or proliferative lesions
      induced by administration of an antibody reactive with Thy-1.1-like antigens on
      the mesangial cell surface. The antibody-induced mesangial cell lysis at day 1
      resulted in a significant decrease in glomerular ultrafiltration coefficient,
      leading to reduction in single nephron glomerular filtration rate (SNGFR) in
      spite of a significant increase in both glomerular hydrostatic pressure and
      single nephron plasma flow (SNPF). During the antibody-induced proliferative
      lesion at day 6, glomerular ultrafiltration coefficient and SNGFR remained
      reduced; however, SNPF was now decreased. Morphometric analysis showed the
      enlargement of capillary luminal volume and the development of new open space in
      the mesangium accessible for blood flow in the mesangial cell-lytic glomeruli at
      day 1. An increase in mesangial cell volume was found in the proliferative
      glomeruli at day 6. The total area of peripheral glomerular basement membrane,
      presumed as the probable filtration area, was unchanged in these glomeruli. These
      results indicate that mesangial lesions decrease glomerular ultrafiltration
      coefficient, and suggest that mesangial cells participate in regulation of
      glomerular filtration rate.

PMID- 1745022
TI  - Acute intradialytic well-being: results of a clinical trial comparing polysulfone
      with cuprophan. Bergamo Collaborative Dialysis Study Group.
AB  - We conducted a multicenter, randomized, double-blind, controlled clinical trial
      to compare the effects of a synthetic, high-flux polysulfone membrane with a
      standard cuprophan one on acute clinical complications during a diffusive
      dialysis procedure. The principal end-point, that is, the number of hypotensive
      episodes, was similar in polysulfone (39; 23.8%) and cuprophan (32; 19.5%).
      Likewise, no significant difference was found between the two membranes as far as
      the secondary end-point was concerned, that is, the effect on headache, nausea,
      pruritus and sense of well-being. We conclude that high-flux polysulfone, acutely
      used in standard diffusive dialysis, has no favorable influence on hypotensive
      episodes and does not affect some typical dialysis-related symptoms any
      differently from cuprophan membrane. The need is stressed for well-controlled
      studies specifically designed to assess the worth of new dialysis techniques and
      materials that may vastly raise the cost of dialysis treatment.

PMID- 1745023
TI  - Decreased postheparin lipolytic activity in renal transplant recipients with
      cyclosporin A.
AB  - The patterns of hyperlipidemia in renal transplant recipients (RTRs) are more
      variable than in the uremic state, showing increases in both very low-density
      lipoprotein (VLDL) and low density lipoprotein (LDL). This has been attributed,
      at least in part, to immunosuppressive therapy, especially to treatment with
      corticosteroids. Postheparin lipolytic activity (PHLA) was determined in 28 RTRs.
      Sixteen patients presenting with hyperlipidemia comprised group A, who were aged
      49.8 +/- 13.5 years, and had a cholesterol of 8.24 +/- 1.86 mmol/liter,
      triglycerides of 6.02 +/- 3.33 mmol/liter. Twelve patients presenting cholesterol
      and triglyceride values within the normal range were in group B, and were aged
      48.6 +/- 13.3 years. All RTRs received cyclosporin A (CsA) twice daily orally,
      which were divided in two equal doses and adjusted to provide CsA blood trough
      levels (RIA) in a range of 250 to 350 ng/ml. Twenty-one RTRs were additionally
      treated by alternate-day corticosteroids, whereas seven patients had CsA on their
      sole immunosuppressive agent. PHLA (mumol free fatty acids/ml/hr, given 10 and 20
      min after 100 U/heparin kg body wt intravenously) was commonly reduced in RTRs
      (group A at 10/20 min: 5.6 +/- 1.1/5.26 +/- 1.2; group B: 8.26 +/- 2.91/8.38 +/-
      3.44) as compared to the values obtained in healthy controls (15.3 +/- 2.9/17.2
      +/- 5.0). This was mainly due to a reduction of the activity of the hepatic
      triglyceride lipase, and to a minor extent to a reduced activity of peripheral
      lipoprotein lipase. There was no statistically significant difference of PHLA in
      RTRs with or without corticosteroid treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745024
TI  - Epidemiologic study of analgesic abuse: mortality study in 7275 working women
      (1968-1987).
AB  - In a prospective, longitudinal investigation over a period of 20 years in 7275
      working women 30 to 49 years old, we examined the effect of the ingestion of
      analgesics on cause-specific mortality. Evidence of intake of phenacetin and
      salicylate containing analgesics was obtained at a urine screening in 1967 and
      was shown to relate to intake between 1968 to 1978. Life table analysis of the
      effect of phenacetin intake on overall mortality showed significant differences
      between the groups of women with intake (N = 613) versus no intake (N = 4175):
      for total [relative risk (RR) = 2.1, P less than 0.001], urorenal (RR = 24.4, P
      less than 0.001), cardiovascular (RR = 4.5, P less than 0.001), and cancer
      mortality (RR = 1.9, P less than 0.001). No significant effects on overall or
      cause-specific mortality were found for salicylate intake. These results make a
      causal relationship between the amount of analgesic containing phenacetin
      consumed and the risk of death from urorenal disease likely. Furthermore, the
      data show an elevated risk for cardiovascular disease and cancer for phenacetin
      intake. No such relationships are demonstrable for the use of salicylate.

PMID- 1745025
TI  - Role of platelet activating factor in gentamicin and cisplatin nephrotoxicity.
AB  - The present study was undertaken to evaluate the effects of platelet activating
      factor (PAF) antagonists on nephrotoxicity induced by gentamicin (GENTA) and
      cisplatin (DDP) in rats. PAF infusion provoked a 56% decline in single nephron
      (SN) GFR due to a decrease in glomerular plasma flow (QA, 55%), glomerular
      transcapillary hydraulic pressure (delta P, 13%), and glomerular ultrafiltration
      coefficient (Kf, 37%). Four days after a single dose of DDP (6 mg/kg, i.p.) we
      observed non-oliguric acute renal failure (ARF) with reduced SNGFR (45%), QA
      (46%) and delta P (10%) and unchanged Kf. GENTA administration for 10 days (40
      mg/kg, i.p. daily) induced a decline in SNGFR (40%), QA (41%) and Kf (41%).
      Chronic treatment with a GENTA + PAF antagonist (BN 52021) partially prevented
      the decline in SNGFR (22%) by an amelioration in QA (25%) and Kf (13%). However,
      simultaneous treatment with DDP and BN 52063 completely prevented the ARF induced
      by DDP, normalizing all parameters of renal function. Thus, PAF may be a
      potential mediator involved in the nephrotoxicity induced by GENTA and DDP.

PMID- 1745026
TI  - Long-term results of renal transplantation in children.
AB  - The results of renal transplantation in 37 children, 3 through 16 years of age,
      who received transplants prior to June, 1970 in our center, were examined. Twenty
      three received kidneys from living-related donors and 14 received kidneys from
      cadaver donors. Patient survival rates were 78% at 10 years and 68% at 20 to 26
      years. Graft survival rates were 56% at 10 years, 31% at 20 years, and 23% at 22
      to 26 years. Twenty children received on or more retransplants. At follow-up, 23
      (62%) of the patients had functioning grafts and two (5%) were undergoing
      dialysis. Cataracts, hypertension, and aseptic necrosis of bone were the most
      common medical complications and most of the patients were more than two standard
      deviations below average height. Most enjoyed good rehabilitation, however: more
      than 70% were employed or performing full time housework, more than 50% were
      married, 24% had children, and all had normal activity at least part of the time.
      These results, achieved with immunosuppressive methods now considered obsolete,
      indicate that renal transplantation is a satisfactory long-term treatment for
      children with renal failure.

PMID- 1745027
TI  - Plasma exchange in focal necrotizing glomerulonephritis without anti-GBM
      antibodies.
AB  - To determine whether plasma exchange was of additional benefit in patients
      treated with oral immunosuppressive drugs for focal necrotizing
      glomerulonephritis (without anti-GBM antibodies), we performed a randomized
      controlled trial with stratification for renal function on entry. Forty-eight
      cases were analyzed, 25 in the treatment group (plasma exchange, prednisolone,
      cyclophosphamide and azathioprine) and 23 in the control group (drug therapy
      only). There was no difference in outcome in patients presenting with serum
      creatinine less than 500 mumol/liter (N = 17), or greater than 500 mumol/liter
      but not on dialysis (N = 12), all but one of whom had improved by four weeks.
      However, patients who were initially dialysis-dependent (N = 19) were more likely
      to have recovered renal function (P = 0.041) if treated with plasma exchange as
      well as drugs (10 of 11) rather than with drugs alone (3 of 8). Long-term follow
      up showed that improvement in renal function was generally maintained. The
      results of this trial confirm that focal necrotizing glomerulonephritis related
      to systemic vasculitis responds well to immunosuppressive drugs when treatment is
      started early, and suggest that plasma exchange is of additional benefit in
      dialysis-dependent cases.

PMID- 1745028
TI  - Angiotensin II receptor-mediated proliferation of cultured human fetal mesangial
      cells.
AB  - Accumulating evidence suggests that angiotensin II (Ang II) may play an important
      role in renal growth and glomerular development. During nephrogenesis, a complex
      relationship between the capillary and renal mesangium develops. Since the
      mesangial cell is a centrally-located pericyte with contractile, endocrine, and
      immune modulating functions, it may play a unique role in maintaining normal
      glomerular function. Therefore, we examined whether Ang II affects proliferation
      of human fetal mesangial cells in vitro and compared these findings to mesangial
      cells isolated from adult kidney. In these primary isolates, we studied the
      relationship between Ang II receptors and the mitogenic activity of angiotensin.
      Scatchard analysis of the binding of 125I[Sar1,Ile8]Ang II to subconfluent
      cultured human fetal mesangial cells revealed the presence of one class of
      binding sites with a Kd of 1.25 nM and a Bmax of 70 fmol/1 x 10(5) cells. Ang II
      receptors on adult mesangial cells had similar binding kinetics with a Kd of 1.6
      nM and Bmax of 65 fmol/10(5) cells in subconfluent culture. In subconfluent
      culture of fetal mesangial cells, Ang II increased [3H]thymidine incorporation by
      130% (P less than 0.005). In subconfluent culture of adult mesangial cells, Ang
      II increased [3H]thymidine incorporation by only 35% (P less than 0.05). In
      confluent culture of fetal mesangial cells, Ang II receptor number and mitogenic
      response were reduced. The Ang II antagonist [Sar1,Ile8]Ang II (1 microM)
      inhibited the mitogenic response of fetal mesangial cells to Ang II. Ang II
      increased fetal mesangial cell number by 25% (after 4 days) in serum-free medium
      supplemented with insulin or supplemented with insulin and 1% Nutridoma (P less
      than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745029
TI  - Renal ammoniagenesis in humans with chronic potassium depletion.
AB  - Renal ammonia production and distribution and ammonia precursor utilization were
      evaluated in eight patients with chronic potassium depletion (CPD) and
      aldosterone-producing adenoma and in 20 controls. In CPD, urinary ammonia
      excretion and ammonia added to renal venous blood were about twofold higher than
      in controls; thus, total ammonia production was significantly augmented (88.0 +/-
      10.3 mumol/min.1.73 m2 vs. 45.0 +/- 2.6 in controls). Total ammonia production
      was inversely correlated with serum potassium and directly correlated with urine
      flow. Stepwise multiple regression analysis showed that both factors, mainly
      serum potassium, significantly influence ammonia production and account for 61.4%
      of variations in ammonia production. Renal extraction of glutamine was
      significantly increased (56.6 +/- 5.9 mumol/min.1.73 m2 vs. 34.6 +/- 3.1 in
      controls), and this could account for ammonia production. The ratio of urinary
      ammonia excretion to total ammonia production, an index of the intrarenal ammonia
      distribution, was similar in patients and controls, and was significantly
      correlated with urine pH and true renal blood flow (RBF). Stepwise multiple
      regression analysis showed that RBF, urine pH and urine flow also significantly
      affected ammonia distribution. However, these factors accounted for only 41.7% of
      variations in intrarenal ammonia partition, urine pH having a minor role. We
      conclude that in patients with CPD other factors besides urine pH, urine flow and
      RBF intervene in the ammonia partition between urine and blood.

PMID- 1745030
TI  - Metabolic acidosis and skeletal muscle adaptation to low protein diets in chronic
      uremia.
AB  - To maintain nitrogen equilibrium when prescribed a low protein diet (LPD),
      metabolic adaptations occur involving a reduction protein turnover, principally
      decreased muscle protein degradation. Studies suggest that in patients with
      chronic renal failure (CRF) uncomplicated by metabolic acidosis (MA), these
      adaptive responses are intact. Because MA stimulates muscle proteolysis, this
      study examined the hypothesis that in CRF complicated by MA, the adaptation to
      LPD may be impaired, inducing a nitrogen wasting state. Six adults with CRF (mean
      GFR: 12.8 +/- 1.5 ml/min) and MA (mean serum bicarbonate: 17.0 +/- 1.0 mM/liter)
      receiving an unrestricted diet (protein intake: 1.2 g/kg body wt/day) were
      converted to an isocaloric LPD (protein: 0.6 g/kg body wt/day). Two weeks later
      total urinary nitrogen losses decreased, but skeletal muscle protein catabolism
      (SMPC), assessed from the urinary 3-methyl histidine:creatinine ratio, increased,
      demonstrating impairment in the adaptive down-regulation of SMPC. The LPD was
      continued for a further two weeks and MA was corrected with oral sodium
      bicarbonate (mean serum bicarbonate: 24.3 +/- 1.2 mM/liter). Correcting MA
      decreased SMPC to a level below that measured prior to protein restriction. The
      decreased SMPC was paralleled by further decreases in urinary nitrogen losses,
      confirming that MA impaired nitrogen utilization. It is concluded that MA can
      override the expected metabolic adaptive response to a LPD. The associated
      impairment of nitrogen utilization not only diminishes the efficacy of the diet,
      but also accelerates the loss of lean body mass.

PMID- 1745031
TI  - Anti-interleukin-1 alpha autoantibodies in hemodialysis patients.
AB  - IL-1 activity is increased in hemodialysis patients and interest has recently
      been focused on IL-1 antagonism in various clinical settings. We studied the
      presence of anti-IL-1 alpha autoantibodies in sera from 49 hemodialysis patients,
      159 kidney graft recipients and 89 chronic renal failure patients without renal
      replacement therapy. Within the three month study period 32.6% of the
      hemodialysis patients were found to present with anti-IL-1 alpha autoantibodies,
      in contrast to 5.6% of kidney graft recipients, 8.9% of chronic renal failure
      patients, and only 1.4% of healthy subjects. The presence of these autoantibodies
      was neither associated with primary kidney disease nor with the type of dialysis
      membrane we used. In addition, in antibody positive patients a pronounced
      increase of IL-1 alpha serum levels within a dialysis session from 14.8 +/- 4.7
      pg/ml to 26.4 +/- 11.2 pg/ml (P less than 0.0005) was observed, contrasting to
      the more even increase from 14.1 +/- 3.1 pg/ml to 19.3 +/- 12.7 pg/ml (P less
      than 0.05) in the antibody negative group. Neither clinical symptoms due to
      adverse effects of IL-1 alpha nor some influence on erythropoiesis mediated by IL
      1 alpha could be envisaged. Thus, we believe, that anti-IL-1 alpha
      autoantibodies, present in high frequency in hemodialysis patients, have a
      neutralizing effect on IL-1 alpha in these patients.

PMID- 1745032
TI  - Mechanisms of diabetic hyperfiltration.

PMID- 1745033
TI  - [Current treatment protocol in cardiovascular diseases in childhood. 1: Heart
      failure, diseases in the neonatal period, congenital heart defects. 2:
      Arrhythmias, carditis, cardiomyopathies, shock, hypertension].
AB  - It is given an overview about actual strategies of the treatment of children
      suffering from heart diseases. Partly proven drugs are given in an optimized
      doses e.g. digoxin and digitoxin where as other new drugs and therapeutic
      principles are introduced e. g. catecholamines and vasodilator agents,
      antiarrhythmic drugs or electrotherapy and antiarrhythmic surgery. Various
      functional disturbances of the cardiovascular system can occur in the newborn
      period. New diagnostic principles especially echocardiography with doppler
      sonography, holter monitoring and exercise testing have lead to better
      therapeutic regimens. Heart catheterizations have new therapeutic tools like the
      balloon valvuloplasty of a stenotic pulmonic valve. At least the advances of
      cardiac surgery have lead to a shift of the time of correction to early
      childhood. Two step interventions are more and more removed and the related
      children and their families will have a better outcome and a better life quality.

PMID- 1745034
TI  - [Neonatal nutrition with enriched human milk. EOPROTIN 60 in comparison with
      human albumin].
AB  - The influence of feeding fresh human milk supplemented either with EOPROTIN (n =
      13) or human albumin (n = 15) on biochemical parameters and growth were studied
      in preterm infants with gestational ages below 32 weeks p.m. up to the 42nd day
      of postnatal life. In both feeding groups the intakes of protein, energy and
      electrolytes were similar. The serum concentrations of bile acids, alpha-amino
      nitrogen and prealbumin, the renal excretion of total nitrogen, alpha-amino
      nitrogen, urea and ammonia as well as the growth in weight and length were
      studied in all infants. The supplementation of the fresh human milk with EOPROTIN
      results in significant lower serum concentrations of alpha-amino-nitrogen (1.56
      +/- 0.21 vs 2.03 +/- 0.27 mmol/l; p less than 0.01), higher serum concentrations
      of prealbumin (89.8 +/- 20.3 vs 72.7 +/- 13.3 mg/l; p less than 0.02), and lower
      urinary excretion of total nitrogen (7.4 +/- 0.9 vs 8.9 +/- 1.1 mmol/kg/day); if
      compared to the results found in the infants fed human albumin supplemented human
      milk. The higher nitrogen retention in the EOPROTIN than in the human albumin fed
      infants was associated by a significant higher growth in weight (16.6 +/- 1.4 vs
      13.7 +/- 1.9 g/kg/day; p less than 0.01) as well as in length (1.02 +/- 0.08 vs
      0.87 +/- 0.1 cm/week; p less than 0.01). The results indicate that the
      bioavailability of EOPROTIN is higher than that of human albumin. The observed
      differences in the nutritional response between the two human milk supplements
      may be based on differences in the amino acids composition which is in EOPROTIN
      adapted to the nutritional available part of the protein in human milk.

PMID- 1745035
TI  - [Obstructive respiratory tract diseases in children and Parvovirus B19
      infections].
AB  - Acute respiratory diseases (ARD) due to parvovirus B 19 infection can be observed
      relative frequently in children. In 21 children (infants, toddlers and school
      children) we have seen acute or prolonged obstructive bronchitis/bronchiolitis
      (15 infants), acute subglottic laryngitis (3 toddlers) and acute asthmatic
      attacks (3 children of school age) in connection with parvovirus B 19 infection.
      Other respiratory viruses (adeno-, influenza, parainfluenza and RS-virus) could
      be excluded as agents causing the ARD. We suggest that parvovirus B 19 can
      provoke ARD with obstructive ventilatory disturbances of the upper or lower
      airways in children with a specific endogenous predisposition (small or unstable
      bronchial walls, or bronchial or tracheal mucosal hyperreactivity).

PMID- 1745036
TI  - [Mental development of children with congenital hypothyroidism--a
      neuropsychological follow-up study].
AB  - 57 children with congenital, clinical diagnosed hypothyroidism were assessed with
      the Luria-Nebraska-Neuropsychological Battery-Children's Revision. The results of
      the psychomotor assessment were in conformity with the mental development.
      Univariate correlations between begin of therapy and mental development were not
      found in all groups.

PMID- 1745037
TI  - [Studies on the predictive value and prognostic significance of compliance
      measurements in artificially ventilated newborn infants].
AB  - In 29 mechanical ventilated preterm infants the compliance of the respiratory
      system (Crs) was determined. Newborn infants with severe respiratory distress
      syndrome show a decreased Crs. A significant correlation could be proved between
      the Crs and the pCO2 as well as the inspiratory pressure. The second estimation
      of the Crs after 48 hours refers to the prognosis of the ventilated newborn
      infants.

PMID- 1745038
TI  - [Acrocephalosyndactylia of the Apert Type (McK 10120)].

PMID- 1745039
TI  - [Carpenter syndrome (McK 20100, 20102, 27235)].

PMID- 1745040
TI  - A study on the brain structures related to conditioned emotional response by
      means of [14C]2-deoxy-D-glucose method.
AB  - Brain structures activated during conditioned emotional response were studied by
      means of the [14C]2-deoxyglucose method. The experimental (CSE) animals were
      conditioned with paired 25 25-sec-long flicker sequences (CS) and 1-sec-long 150
      V AC electric shocks (US), while the control (CSC) animals were given only 25 CS
      sequences. Average densities of a unit square (200 microns x 200 microns) of 47
      nuclei or cortical areas in the left hemisphere were obtained from an
      autoradiogram and the optical density ratio (ODR), which is the relative optical
      density of each structure to that of the corpus callosum, was calculated.
      Comparison of ODRs of each structure from both groups revealed a significant
      increased uptake of [14C]2-deoxyglucose (P less than 0.05, Mann-Whitney U-test)
      in the caudal portion of area 10, area 2, area 18 and the hippocampal formation.

PMID- 1745041
TI  - A novel type of regulatory protein for the GDP/GTP exchange reaction of smg p25A,
      a ras p21-like small GTP-binding protein, in bovine brain cytosol.
AB  - A regulatory protein for smg p25A, a ras p21-like small GTP-binding protein, was
      purified to near homogeneity from bovine brain cytosol. This regulatory protein,
      named smg p25A GDP dissociation inhibitor (GDI), regulated the GDP/GTP exchange
      reaction of smg p25A by inhibiting the dissociation of GDP from and the
      subsequent binding of GTP to it. Both the GDP- and GTP-bound forms of smg p25A
      bound to synaptic plasma membranes and vesicles. smg p25A GDI formed a complex
      with the GDP-bound form of smg p25A and thereby inhibited its binding to
      membranes and furthermore induced the dissociation of the prebound protein from
      the membranes. These results indicate that smg p25A GDI is a novel type of
      regulatory protein for the GDP/GTP exchange reaction and the intracellular
      translocation of smg p25A.

PMID- 1745042
TI  - Isolation and characterization of protein kinase C from rat brain synaptosome
      cytoskeleton.
AB  - Synaptosomes prepared from brain tissues are known to retain morphological and
      functional characteristics of the nerve ending. Little information is available,
      however, as to the biochemical events underlying synaptogenesis and transmitter
      release. Increasing body of evidence suggests that protein kinase C (PKC) plays
      crucially important roles through phosphorylation of membrane proteins such as
      GAP-43 (for 43-kDa growth-associated protein) and 87-kDa MARCKS (for
      myristoylated, alanine-rich C kinase substrate) in many aspects of the neuronal
      function. Among them, arrangement of membrane cytoskeletal protein is proposed to
      be one of the primary sites of PKC action. The present study is an attempt to
      isolate and characterize PKC associated with synaptosomal membrane cytoskeleton.
      Rat brain synaptosomal Triton X-100 insoluble elements (cytoskeleton) contains
      specific [3H]phorbol dibutyrate binding activity and 78-kDa protein which reacts
      with an antibody against beta II-PKC subspecies. Although 78-kDa protein could
      not be solublized by the treatment with various ionic and non-ionic detergents
      and/or high concentrations of salts such as NaCl and LiBr, the fragment of 78-kDa
      protein was produced and solublized from cytoskeleton by limited proteolysis with
      calpain II, which cleaves PKC at one or two specific sites of the enzyme to
      produce catalytic and regulatory fragments. The solubilized 46-kDa fragment was
      identical with the catalytic fragment of beta II-PKC. The results indicate that
      this PKC subspecies is tightly associated with the cytoskeletal network of
      synaptic membranes.

PMID- 1745043
TI  - Suppressive effect of 1,25(OH)2D3, and glucocorticoids on production of tumor
      necrosis factor-alpha by human peripheral blood adherent cells.
AB  - Effect of 1,25(OH)2D3 and glucocorticoids on production of TNF-alpha by human
      peripheral blood adherent cells (HPBAC) was investigated. TNF-alpha was measured
      by ELISA method using monoclonal antibody against human recombinant THF-alpha.
      Maximal TNF-alpha production by HPBAC was observed in 4 to 8 hr after incubation
      when these cells were cultured for 24 hr with 10 micrograms/ml lipopolysaccharide
      (LPS), 10 ng/ml 12-o-tetradecanoyl-phorbol-13-acetate (TPA) and 10(-5) M
      indomethacin (INDM). When graded concentration of 1,25(OH)2D3 was added to HPBAC
      in the presence of above stated dose of LPS, TPA and INDM, a significant
      suppression of TNF-alpha production was first observed at the concentration of
      10(-8) M (P less than 0.05). Similar significant suppressive effect was also
      observed by adding hydrocortisone and dexamethasone at the concentration of 10(
      8) M (P less than 0.05) and 10(-7) M (P less than 0.05), respectively. These
      results may suggest that 1,25(OH)2D3 has the same inhibitory effect on
      monocyte/macrophage function as glucocorticoids.

PMID- 1745044
TI  - Axillary dissection in breast cancer: when, why, how much, and for how long?
      Another operation soon to be extinct?

PMID- 1745045
TI  - An immunological aspect of melanoma and its potential application in adjuvant
      therapy.
AB  - In an attempt to understand some of the natural immunological characteristics of
      cutaneous melanoma so that we can plan justifiable immunotherapeutic approaches,
      23 patients were studied. The autologous leukocyte migration inhibition assay was
      utilized to assess in vitro their tumor-specific cellular immunity. This assay
      was specifically used because when presensitized lymphocytes are exposed to the
      same antigen, they release lymphokines which inhibit the natural migration of the
      leukocytes. All the patients were staged pathologically according to the TNM
      system. Twelve of them had regional metastasis, i.e., stage III, and underwent
      regional lymphadenectomy. The other 11 had distant metastases, i.e., stage IV
      disease, and all their gross tumors were resected. These 23 patients were the
      source of tumor material and peripheral blood. Fresh autologous leukocytes were
      obtained for the assays, from each patient, on the day of surgery and prior to
      the administration of the preoperative medications. These were tested in vitro,
      on the same day, with freshly prepared autologous tumor extracts as the source of
      autologous tumor antigens. The results revealed that the preoperative leukocytes
      of patients with stage III melanoma expressed hypersensitivity to their tumors,
      with significant inhibition of their leukocyte migration, compared to those with
      distant metastases who expressed no such sensitivity, P = 0.012. Such
      hypersensitized lymphocytes may be capable of producing more efficient lymphokine
      activated killer (LAK) cells for an effective adjuvant adoptive immunotherapy.

PMID- 1745046
TI  - Functional outcome in patients treated with surgery and irradiation for soft
      tissue tumours.
AB  - One hundred five consecutive patients underwent surgical resection and adjuvant
      irradiation in treatment of soft tissue sarcoma or aggressive fibromatosis. All
      patients were entered in a prospective study evaluating functional outcome and 88
      patients were examined at 12 months following surgery. Outcome was characterized
      using the Enneking system as well as documenting employment/recreational status
      and limb edema. Sixty-eight of 88 patients had functional scores of 21 or better
      (out of a possible total of 35). Forty-four patients were serially evaluated at
      12 and 24 months and there was no difference in their outcome at the 2 time
      points. Univariate analysis demonstrated that large tumour size, postoperative
      complications, and neural sacrifice were associated with poor functional outcome.

PMID- 1745047
TI  - Diagnosis and management of sacrococcygeal chordoma.
AB  - Chordoma is a rare, slow-growing but locally aggressive malignant tumor derived
      from the primitive notochord and located along the axial skeleton. Between 1973
      and 1991, of 15 patients with chordomas treated at the Medical College of
      Virginia, eight originated in the sacrococcygeal area. There was a median one
      year interval between the onset of symptoms and diagnosis (range of four months
      to six years) for this latter group. Two patients had undergone coccygectomies
      and one patient a lumbar discectomy prior to establishing the correct diagnosis
      of sacral chordoma. Seven patients underwent resection and one refused therapy.
      The four patients who had an initial wide radical resection had a longer disease
      free survival than the three who underwent local excision. Three of four patients
      had metastatic disease at the time of death. Early diagnosis and aggressive
      initial surgical resection are necessary for long-term survival.

PMID- 1745048
TI  - Effect of prostaglandin E in multiple experimental models. VIII. Effect on host
      response to metastatic tumor.
AB  - Prostaglandin E (PGE) is produced by certain tumors and is reported to decrease
      primary tumor growth. We evaluated its effect in multiple tumor models utilizing
      a 1 week course of the long acting PGE derivative dimethyl-PGE (dPGE) at a dosage
      of 100 micrograms/kg/day vs. a lactated Ringers control. For all tumor models, a
      suspension of 1 x 10(6) colon carcinoma cells were injected into Wistar-Furth
      rats. When the suspension was injected subcutaneously and the drug was begun at
      the time of tumor challenge, there was no effect on survival. When the tumor was
      injected intraperitoneally or intravenously and the drug begun at the time of
      tumor challenge, dPGE decreased survival time. When the tumor was administered
      intravenously but dPGE was delayed for 5 days, there was no effect on survival
      time. When rats were given a 1 week course of dPGE or saline, dPGE was found not
      to alter natural killer (NK) cell cytotoxicity, macrophage cytotoxicity,
      spontaneous lymphocyte blastogenesis, or mitogen stimulated blastogenesis. dPGE
      failed to alter lymphocyte metabolism of glucose in nonstimulated lymphocytes,
      but decreased the rate of glucose metabolism and adenosine deaminase activity in
      mitogen stimulated lymphocytes. In conclusion, PGE appears to enhance metastatic
      growth of tumor lines where it does not alter primary tumor growth. This effect
      does not appear immunologically mediated.

PMID- 1745049
TI  - Imaging-guided and nonimaging-guided fine needle aspiration of liver lesions:
      experience with 406 patients.
AB  - The aim of the present study was to determine the diagnostic accuracy of
      different modes of fine needle aspiration (FNA) of liver lesions. A total of 492
      FNAs were performed on 406 patients in order to confirm or to rule out focal or
      multifocal neoplastic disease: 29% under ultrasound (US) guidance, 3% with
      computed tomographic (CT) guidance, 67% preoperatively, and 1% intraoperatively
      without imaging guidance. Based on histologic, cytologic, and clinical findings,
      final diagnoses were reached in 387 patients, of whom 264 had malignant liver
      disease and 123 had benign liver disease. Of 321 aspirations performed in
      patients with malignant liver disease, the cytologic findings suggested
      malignancy in 225 (70.1%), suspected malignancy in 25 (7.8%), and did not reveal
      malignancy in 71 aspirations (22.1%). Among the 123 patients with benign liver
      disease, the cytologic findings were reported as benign in all but two patients,
      who had false-positive cytologic findings. The overall sensitivity, specificity,
      positive, and negative predictive values for cytologic findings were 85.6, 98.4,
      99.1, and 76.1%, respectively. The overall diagnostic accuracy was 89.7%. In one
      patient, fatal intraperitoneal bleeding due to chronic intravascular coagulation
      complicated the FNA procedure. We conclude that imaging-guided FNA as well as
      nonguided FNA for cytologic diagnosis of liver lesions are highly accurate and
      only rarely may be associated with a fatal complication.

PMID- 1745050
TI  - Combining independently effective anticancer agents may not augment the
      independent antitumor effects: a study using human digestive organ cancer
      xenograft lines in nude mice.
AB  - Five human digestive organ cancer xenograft lines were subcutaneously
      transplanted in nude mice, and 7 anticancer agents (ACAs) were intravenously
      administered singly or in combinations at 4 times the standard clinical doses.
      Cisplatin (P) was effective in 4 lines and 5-fluorouracil (F) was effective in 3
      lines. A total of 8 combinations with 2 effective ACAs were assessed in 4 lines
      and only 1 combination (FP) resulted in an augmented antitumor effect in a single
      line. A total of 11 combinations with 1 effective ACA plus 1 ineffective ACA were
      assessed in 2 lines, and only 1 combination (F + carboquone [CQ; Esquinon])
      resulted in an augmented effect in a single line. A total of 5 combinations with
      independently ineffective ACAs were assessed in 1 line, and 1 combination (FP)
      resulted in augmented antitumor activity. No 2-ACA combinations showed enhanced
      side effects. Two combinations with 3 effective ACAs were assessed in 2 lines and
      1 combination (FP + mitomycin C) resulted in an augmented effect with a greater
      mortality rate. A total of 12 combinations with both effective plus ineffective
      ACAs were assessed in 2 lines, and 3 combinations (FP + Adriamycin or FP + CQ or
      FP + etoposide) resulted in an augmented effect in 1 line with enhanced side
      effects. These results indicate that the combination of independently effective
      ACAs does not always cause an augmented antitumor effect, and may sometimes
      result in augmented side effects. According to this study, the 3-ACA combinations
      with FP + 1 effective agent appear to be the best regimens for digestive organ
      cancer.

PMID- 1745051
TI  - p53 alterations in all stages of breast cancer.
AB  - Overexpression of the nuclear phosphoprotein p53 is one of the most frequently
      detected abnormalities in human cancer and appears to be associated with mutation
      of the p53 gene. In this study of breast cancer, p53 overexpression was detected
      in two (15%) of 15 pure intraductal tumors, 73 (25%) of 291 primary invasive
      carcinomas, 13 (50%) of 26 lymph nodes containing metastatic breast cancer, and
      two of four established breast cancer cell lines. Sequence analysis of selected
      specimens confirmed that p53 overexpression was associated with mutation of the
      gene, while no mutations were detected in specimens without p53 overexpression.
      Thus, overexpression of p53 occurs in all stages of breast cancer and is
      consistently associated with the production of mutant proteins.
      Immunohistochemical analysis is a simple method which reliably predicts the
      presence of most p53 gene mutations in breast cancer specimens.

PMID- 1745052
TI  - Intermediate lymphocytic lymphoma: its frequency and characteristics in Japan.
AB  - The nature of intermediate lymphocytic lymphoma (ILL) in Japan was investigated.
      For this purpose, we have reviewed 1,766 cases of malignant lymphoma and related
      diseases, and 38 cases were selected as ILL. In two cases, small lymphoid cells
      proliferated as a wide mantle of atrophic secondary follicles. The frequency of
      ILL in nodal and extranodal non-Hodgkin's lymphoma was 3.4% and 3.9%,
      respectively. The frequency was high in orbit and salivary gland lymphomas; two
      out of three cases and one out of six cases, respectively. Age range (median) and
      sex ratio (M:F) in nodal and extranodal cases were 34-65 (52) years and 2.1:1 and
      22-82 (61) years and 1.1:1, respectively. The majority of nodal ILL presented as
      systemic disease, but extranodal ILL usually presented as localized disease. ILL
      when treated with chemotherapy and/or radiotherapy had a favorable prognosis, the
      5-year survival rate was 82%.

PMID- 1745053
TI  - Bilateral renal oncocytomas: management and nuclear analysis.
AB  - Only 16 cases of bilateral renal oncocytomas have been previously reported in the
      English language literature, 9 of which were treated with bilateral surgical
      resections. We report a case treated with bilateral partial nephrectomy. Although
      pathological examination revealed grade I oncocytomas on both sides, flow
      cytometry demonstrated tumor DNA content to be aneuploid on one side and diploid
      on the other, the first cellular differences reported in a case of bilateral
      renal oncocytomas. The management of suspected renal oncocytomas is discussed,
      with emphasis on the need for complete excision in most patients. The results of
      nuclear studies of these tumors, including DNA flow cytometry, cytogenetics, and
      molecular analysis of both nuclear and mitochondrial DNA, are reviewed.

PMID- 1745054
TI  - Epidermoid cyst of the testicle in children.
AB  - Epidermoid cyst of the testicle is rare in children and only four previous cases
      have been reported. We add two cases and discuss their presentation and
      management. Both children presented with solid testicular masses, one of which
      was asymptomatic and the other was painful. Physical examination and ultrasound
      could not differentiate between a benign and malignant process. One child
      underwent radical orchiectomy and one child underwent local excision alone. Both
      are free of disease at follow-up.

PMID- 1745055
TI  - Carcinoma of the cystic duct.
AB  - Carcinoma of the cystic duct is a rare neoplasm, and we herein report four cases
      of carcinoma of the cystic duct. The patients consisted of a 69 year old and 71
      year old woman and a 61 year old and 93 year old man. They complained of either
      abdominal pain or abdominal mass. All the tumors were microscopically well
      differentiated adenocarcinoma, mostly limited to the wall, that showed no lymph
      node or distant metastasis. Three patients who had undergone resection were doing
      well 20 days, 67 months, and 125 months after the operation, respectively. These
      findings may suggest that not only the early development of symptoms caused by
      obstruction of the narrow lumen of the cystic duct, but also slow growth and late
      metastasis produce a favorable clinical course in patients with carcinoma of the
      cystic duct.

PMID- 1745056
TI  - Reduction in HLA-DR antigen density on alveolar macrophages of smokers.
AB  - The expression of HLA class II genes is essential to the antigen-presenting
      function of monocytes and macrophages. With a new cytofluorometric method of
      single-cell analysis we investigated the density of HLA-DR antigen expression on
      alveolar macrophages (AM) of smokers. Although all AM of nonsmokers (100 +/- 1%)
      expressed HLA-DR antigens, only 79 +/- 12% of AM from smokers showed positive
      findings (p less than 0.001). Furthermore, the antigen density of those cells
      expressing this antigen was significantly reduced in smokers (p less than 0.001).
      The defective expression of class II genes on AM of smokers might contribute to
      the impaired antigen-presenting function found by some previous investigators.

PMID- 1745057
TI  - Lung reflexes and receptor activity in a rabbit model of pulmonary fibrosis.
AB  - Our objective was to see if activity of individual slowly and rapidly adapting
      pulmonary receptors was changed by pulmonary fibrosis. Diffuse interstitial lung
      fibrosis of several weeks' standing was induced in 8 rabbits. They displayed
      changes in lung mechanics and patterns of breathing, when compared to control
      rabbits, similar to those seen in patients who develop pulmonary fibrosis. Lung
      reflexes in the fibrotic rabbits were more profoundly changed than eupneic
      breathing in a way that could be interpreted as slowly adapting receptor
      activity, which was increased, being overpowered by a prepotent input from
      pulmonary rapidly adapting receptors. An increase in number of active rapidly
      adapting receptors was found in the fibrotic rabbits during direct vagal
      recording. We have demonstrated that pulmonary receptor activity is changed by
      lung fibrosis. It may be that these changes in receptor activity produce
      conflicting respiratory drives that could result in the sensation of dyspnea.

PMID- 1745059
TI  - Percutaneous transthoracic needle biopsies in the rapid diagnosis of pulmonary
      tuberculosis.
AB  - From May, 1987, to December, 1990, 173 percutaneous transthoracic needle biopsies
      (PTNB) using a 19-gauge spinal needle under uniplane fluoroscopic guidance were
      performed in 160 patients. Thirty-one patients had a final diagnosis of pulmonary
      tuberculosis. These patients with tuberculosis underwent a total of 35 biopsies.
      Twenty of 35 (57%) had definite histologic features of tuberculosis with
      stainable acid-fast bacilli, 4/35 (11.5%) had granulomatous or caseous lesion
      consistent with tuberculosis, and 11/35 had nonspecific inflammatory changes.
      When results were matched with the sputum culture results, 15/35 specimens (43%)
      provided the exclusive means of diagnosis of tuberculosis. Five of 35 (14%)
      patients developed postbiopsy pneumothoraces. The overall acceptance by patients
      was good. This report indicates the potential usefulness of PTNB in the rapid
      diagnosis of selected cases of suspected pulmonary tuberculosis. The yield was
      comparable to fiberoptic bronchoscopy, currently commonly used in the diagnosis
      of pulmonary mycobacterial disease. The procedure was noted for its simplicity.

PMID- 1745058
TI  - Lactoferrin and secretory IgA in the bronchoalveolar lavage fluid from patients
      with a stable asthma.
AB  - We have measured lactoferrin and secretory IgA (sIgA) in the unconcentrated
      bronchoalveolar lavage fluid (BALF) from nonsmoking healthy volunteers (n = 10)
      and nonsmoking patients with stable asthma (n = 14). The median concentrations
      and the ranges of lactoferrin were controls, 0.13 mg/L (0.01-0.43 mg/L); asthma,
      0.41 mg/L (0.07-7.51 mg/L). For sIgA the results were controls, 0.48 mg/L (0.12
      1.47 mg/L); asthma, 1.29 mg/L (0.65-14.6 mg/L). The concentrations in the
      epithelial lining fluid (ELF) were calculated on the basis of urea in BALF and
      serum. SIgA and lactoferrin levels in the BALF and ELF from the patients with
      asthma were higher than in controls (Mann-Whitney U-test, p less than 0.03). Our
      results indicate that in patients with stable asthma the airway epithelial cells
      are activated, resulting in an enhanced secretion of lactoferrin and enhanced
      secretory transport of sIgA into the airway lumen.

PMID- 1745060
TI  - Immune parameters in a population of institutionalized elderly subjects:
      influence of depressive disorders and endocrinological correlations.
AB  - Twenty-six institutionalized elderly subjects, selected as healthy according to
      the SENIEUR protocol, were compared to adult controls to establish correlations
      between affective disorders and immune abnormalities and to investigate
      underlying neuroendocrine mechanisms. After an extensive psychodiagnostic
      examination, 35% of the aged subjects were classified as depressed. Cutaneous
      delayed hypersensitivity tests showed reduced responses in the aged, but no
      correlation was found with the psychological status. Examination of the
      peripheral blood lymphocyte subsets revealed no imbalance in the percentages of
      CD3+, CD4+, CD8+ cells in the aged. A slight reduction in the CD4+/CD8+ cell
      ratio could however be detected in the non-depressed aged, as compared to adult
      controls. The CD4+/CD45R+ cell subset was reduced in non-depressed aged. The
      percentage of B lymphocytes was reduced in the aged, mostly in the non-depressed
      subjects. No changes were detected in the percent of OKDR+ cells. The percentage
      of CD16+ cells was found unchanged, while that of Leu7+ cells was significantly
      higher in the aged than in the adults and in the non-depressed than in the
      depressed aged. Leu7+ cell levels were negatively correlated with the depression
      score. On double labelling, the percent of CD16+/Leu7+ cells appears increased in
      the subgroup of depressed aged and positively correlated with age. Plasmatic and
      urinary cortisol levels were both positively correlated with depression score.
      Urinary cortisol level was higher in the depressed aged. These parameters, as
      well as plasmatic ACTH, beta-endorphin and urinary catecholamines, were not
      correlated with immune responses. Based on these findings, we recommend that the
      neuroendocrinological conditions should be taken into account when healthy
      subjects are examined in studies of immune senescence.

PMID- 1745061
TI  - Impairment of lymphocyte activities in depressed aged subjects.
AB  - Lymphocyte activities were determined in a population of 26 institutionalized
      aged subjects, selected as healthy according to the SENIEUR protocol and
      previously reported to display immunological and endocrinological abnormalities
      correlated with depressive disorders. The lymphocyte mitotic response to PHA,
      which was reduced in aged as compared to adult subjects, was found to be
      significantly lower and negatively correlated with the depression score in the
      elderly subjects. In supernatants of PHA-stimulated lymphocyte culture from aged
      subjects, IL-2, IL-4 and gamma-IFN levels were very low and more severely
      affected in the depressed aged group. Each cytokine production was negatively
      correlated with age and depression score. NK activity was lower in the aged and
      it could be augmented by the addition of IL-2 or alpha-IFN, even though to a
      lesser extent than in the adult subjects. The nondepressed aged displayed higher
      levels of IL-2 inducible NK activity than the depressed aged subjects. IL-2 and
      alpha-IFN stimulated NK activities were negatively correlated with depression
      score. The present work indicates that the psychological status could affect
      lymphocyte reactivity in the aged. Given the relatively high frequency of
      affective disorders in these subjects, the psychological status should be
      considered in studies of immune senescence.

PMID- 1745062
TI  - Calcium 'homeostatic' effect of 1 alpha,25-dihydroxycholecalciferol on young
      adult mouse calvaria in organ culture.
AB  - The effect of 1 alpha,25-dihydroxycholecalciferol on calcium release from
      cultured young adult (75-day-old) mouse calvaria in the presence of indomethacin
      or dexamethasone was studied. Indomethacin (2.8 x 10(-7) M) or dexamethasone (10(
      8) M) abolished or considerably inhibited basal calcium release. At 2.6 x 10(-7)
      M, 1 alpha,25-dihydroxycholecalciferol prevented the effect of either
      indomethacin or dexamethasone, resulting in higher calcium release levels
      approximating those observed in cultures containing only 1 alpha,25
      dihydroxycholecalciferol. We have shown previously that in contrast to its effect
      on neonatal mouse calvaria in culture, 1 alpha,dihydroxycholecalciferol either
      failed to enhance or even inhibited basal calcium release from cultured 75-day
      old mouse calvaria. Furthermore, 1 alpha,25-dihydroxycholecalciferol inhibited
      PTH- or PGE2-enhanced calcium release from such cultures. These studies
      demonstrated that, at the same concentration, 1 alpha,25-dihydroxycholecalciferol
      decreases high calcium release due to various bone resorption-stimulating factors
      and increases low calcium release values due to various bone resorption
      inhibiting factors. This suggested that this vitamin D3 metabolite directly
      regulates the degree of bone resorption at the bone tissue level resulting in a
      local calcium 'homeostasis'.

PMID- 1745063
TI  - No relationship between the age-related decrease in prostacyclin production and
      the level of intracellular lipid peroxidation in human umbilical vein endothelial
      cells in culture.
AB  - Some investigators have speculated that a decrease in prostacyclin production
      observed during ageing of endothelial cells is caused by an increase in
      intracellular lipid peroxide. We checked this speculation using an in vitro model
      to study the ageing of human vascular endothelial cells. For this purpose we
      determined the levels of intracellular lipid peroxide of endothelial cells at
      various culture ages, and found that the level of intracellular lipid
      peroxidation did not increase during in vitro ageing. Amounts of intracellular
      lipid peroxide also differed depending on the growth phase, the addition of
      heparin and the strain of endothelial cells, but the cells producing prostacyclin
      at a low level did not necessarily contain larger amounts of intracellular lipid
      peroxide. Therefore, we postulate that the age-related decrease in prostacyclin
      production is not due to an increase in the amount of intracellular lipid
      peroxide as a function of age.

PMID- 1745064
TI  - Muscle fiber branching--difference between grafts in old and young rats.
AB  - Large numbers of branched muscle fibers occur in the freely grafted rat extensor
      digitorum longus muscle. The ratio of branched/non-branched muscle fibers in
      grafts is much higher in old (24 months) than in young (4 months) host rats.
      Cross-age transplants show that the proportion of branched muscle fibers is
      related to the age of the grafted muscle and not to the age of the host. This is
      in contrast to mass and maximum isometric tension, in which the age of the host,
      rather than the age of the grafted muscle, is the determinant of the success of
      the muscle graft.

PMID- 1745065
TI  - Effect of aging and other factors on monocyte aryl hydrocarbon hydroxylase
      activity.
AB  - A measure of the activity of macrophage drug metabolizing enzymes through assay
      of peripheral monocytes was used to assess the hepatic enzymatic status and
      thereby evaluate age related changes in drug metabolism. Blood was obtained from
      elderly subjects (aged 74.8 +/- 5.2, mean +/- S.E., n = 16) and a young control
      group (aged 23.5 +/- 2.0, n = 27). Monocyte AHH activity was used as an index of
      liver drug metabolism, ALT activity as an index of liver function, monocyte media
      IL-1 and as an index of macrophage activation and serum IL-1 levels as a measure
      of endogenous pyrogenic activity. The medium collected from the cultured
      monocytes was also assessed for the presence of AHH inhibitory activity. Subjects
      provided information relating to their age, sex, alcohol consumption, cigarette
      smoking, recent infection, recent surgery, disease status and medications which
      could alter drug metabolism. Elderly patients were drawn both from independent
      seniors living at home and seniors visiting a geriatric day hospital and compared
      to a control group of young healthy volunteers. Using the experimental design AHH
      activity did not differ within experimental error between aged (0.832 +/- 0.32
      nmol/mg prot. per h, n = 16) and young control subjects (0.452 +/- 0.17, n = 27).
      ALT activity did not differ between aged (2.83 I.U. +/- 0.46) and young (4.24 +/-
      0.82). Monocyte AHH activity did not differ between males (0.45 +/- 0.14, n = 33)
      compared to females (0.65 +/- 0.18, n = 29), but was significantly higher in
      smokers (2.5 +/- 1.0, n = 5) compared to non-smokers (0.35 +/- 0.05, n = 52).
      Mild to moderate alcohol use showed no significant effect on AHH activity. There
      was no significant difference between the mean level of MCM inhibition of murine
      hepatocyte AHH between elderly (44.3 +/- 8.32%, n = 8) and control (31.5 +/-
      6.21%, n = 15) subjects, but a larger proportion of the elderly population
      demonstrated such an effect. Serum IL-1 levels (range 0-55.9 pg/ml) were compared
      to MCM IL-1 and AHH inhibitory activity in the elderly and young group.

PMID- 1745066
TI  - Hepatic drug metabolism during development in food-restricted female Sprague
      Dawley rats.
AB  - Hepatic drug metabolism was investigated in female Sprague-Dawley rats fed ad
      libitum (A) or a restricted diet (R) (implemented from age 1 month), at 1.5, 4.5
      and 12 months to determine the short- and long-term effects of caloric
      restriction. Microsomal cytochrome P-450 content and NADPH cytochrome c reductase
      activity were not modified by age. While dietary restriction did not affect
      cytochrome P-450, it significantly increased NADPH cytochrome c reductase
      activity at all time periods when compared to corresponding A-fed groups. Aniline
      hydroxylase and aminopyrine N-demethylase activity tended to decrease with age in
      the A-fed groups but the differences did not prove to be statistically
      significant. A significant decrease of aminopyrine N-demethylase was observed
      with age in R rats. A significant reduction of aniline hydroxylase activity was
      noted in the R groups compared to age-matched A-fed controls. In contrast,
      aminopyrine N-demethylase activity increased significantly, but only at 1.5
      months of age. Glutathione S-transferase activity was augmented between 1.5 and
      4.5 months of age, and this was followed by a significant decrease at age 12
      months in both A and R groups. Dietary restriction had no effect on this
      enzymatic activity. The microsomal cholesterol and phospholipid content as well
      as the cholesterol/phospholipid molar ratio changed significantly between 1.5 and
      4.5 months of age but not between 4.5 and 12 months of age. These parameters were
      unaltered by dietary restriction. In conclusion, in the female Sprague-Dawley rat
      there are no statistically significant changes in hepatic microsomal components
      and drug metabolizing capacity between 1.5 and 12 months of age. Dietary
      restriction resulted in significant changes in enzymes related to drug metabolism
      which varied with the enzyme examined. In general, these changes were similar
      after short- or long-term dietary intervention.

PMID- 1745067
TI  - Growth retardation in senescent arterial smooth muscle cells and its reversal
      following brain stimulation: implications for atherogenesis.
AB  - Advancing age and psychosocial stress are each associated with a rising incidence
      of atherosclerosis. In this investigation we attempted to answer the question of
      whether they are independent of each other or not. Since a key feature of
      atherosclerosis is the proliferation of arterial smooth muscle cells (ASMC), we
      transplanted aortic tissue from aged rats, half of which had received
      hypothalamic stimulation, as a model for stress, to growth supporting medium,
      immediately after stimulation and observed their growth behavior for a period of
      4 months. Similar observations were carried out on young animals for comparison.
      Although there was little difference in outgrowth frequency of explants from
      young animals between stimulated and non-stimulated subjects, in the case of the
      older rats, explants from animals which were not stimulated were considerably
      retarded in their growth, whereas those from subjects which had received HS, grew
      as well as those of the younger ones. These results show that HS can reverse the
      growth decline in aortic tissues explanted from senescent rats. They also suggest
      that age per se is not atherogenic in terms of proliferative behavior of ASMC,
      whereas when interacted with a stressful condition, this may be the case. Since
      in the elderly there is a decreased tolerance to stress, the 'atherogenic'
      effects of age in these individuals may be mediated through the stress response.

PMID- 1745068
TI  - Mathematical modeling for the aging process: normal, abnormal and self
      terminating phenomena in spatio-temporal organization.
AB  - An elucidation of the aging process is attempted using a simple one-dimensional
      multicellular system, a prototype of living organisms. This model analysis has
      the advantage of making us investigate the two types of modes of their dynamical
      behavior: (i) the local modes of behavior of individual cells and (ii) the global
      modes of behavior of the total system. At first, each cell is assumed to have
      biochemically excitable kinetics for local modes, and then what kind of the
      global modes results with change in intercellular interaction is examined. With a
      simple interaction as possibly occurs in the early stage of differentiation, the
      model displays well-coordinated spatio-temporal patterns. This may be interpreted
      as a normal state. With a more complex interaction as possibly occurs in the late
      stage of growth, however, the model produces much more erratic patterns. This may
      refer to an abnormal state. Interestingly, these abnormal patterns can be
      transformed into normal patterns, when the activity of some parts of this model
      is turned 'off'; the system can survive at the sacrifice of its parts. This makes
      us imagine that programmed cell death plays an important role in development
      during morphogenesis. When individual cells become less sensitive to
      intercellular signals and still possess intrinsic excitability, then the normal
      patterns are developed for a short while before being replaced by rather
      irregular patterns. As time proceeds, however, all activity of them disappears.
      We call this a 'self-terminating' phenomenon, which may refer to aging. This
      strongly suggests that the loss of the total system function, leading to death,
      results from a global mode of system failure but not from a local mode of
      subsystem failure.

PMID- 1745069
TI  - Age-associated changes in neuroaxonal transport in the hypothalamo
      neurohypophysial system of the mouse.
AB  - In this study, we investigated age-associated changes in neuroaxonal transport of
      the hormone vasopressin (AVP) and its associated neurophysin (NPII), from the
      supraoptic nucleus (SON) of the hypothalamus to the neurohypophysis. C57BL/Icrfat
      male mice of 6 and 28 months of age were injected in the hypothalamus with L
      [35S]cysteine. Animals were killed up to 2.25 h after injection and NPII and AVP
      from the SON and neurohypophysis were separated using HPLC, and the fractions
      counted for radioactivity. In the SON, radiolabelled NPII and AVP were first
      detected after 0.50 h in both young and old mice. There was no significant
      difference between the age-groups in the incorporation of radiolabel over the
      time course studied. Radiolabelled NPII in the neurohypophysis was significantly
      above background after 1.25 h in the young, and after 1.50 h in the old mice. The
      differences between the two age groups was significant (P = 0.05). Radiolabelled
      AVP followed a similar trend, but was not significantly above background until
      1.50 h in the young and 1.75 h in the old. The differences between the two age
      groups was on the point of significance (P = 0.056). These results indicate a
      significant reduction of up to 25% in the rate of axonal transport of
      neurohypophyseal peptides with advancing age.

PMID- 1745070
TI  - Longitudinal Gompertzian analysis of breast cancer mortality in the U.S., 1962
      1987: demonstration of a disorder displaying complex deterministic mortality
      dynamics.
AB  - Age-adjusted mortality rates for breast cancer (BC) in the United States from
      1962 to 1987 were subjected to longitudinal Gompertzian analysis. Age-adjusted BC
      mortality rate distributions for women display two distinct Gompertzian slopes.
      Between age 15 and 40 years, age-adjusted BC mortality rate distributions
      intercepted at age 33.5 years and mortality rate (per 100,000) 5.83. Between age
      50 and 85 years, age-adjusted BC mortality rate distributions intercepted at age
      60.4 years and mortality rate 77.0. These two distinct Gompertzian regions
      correspond to the clinical and biological classification of BC into pre- and post
      menopausal varieties. The observation that postmenopausal BC increases in
      environments conducive to survival and that premenopausal BC increases in
      environments that are less favorable becomes understandable when BC mortality
      dynamics are viewed from a competitive and deterministic perspective.

PMID- 1745071
TI  - Age-related differences in promoter-induced extension of in vitro proliferative
      life span of Syrian hamster fibroblasts.
AB  - The proliferative capacity of Syrian hamster dermal fibroblasts has been
      previously shown to be inversely related to the age of the donor (Mech. Ageing
      and Dev., 34 (1986) 151). The present study demonstrates an inverse correlation
      between in vivo age and the in vitro morphological and proliferative response of
      Syrian hamster dermal fibroblasts to the tumor promoter phorbol-12,13
      didecanoate. Treatment of fetal fibroblasts with promoter increased the
      proliferative life span of the cultures by approximately 2-fold, but did not
      increase the frequency of conversion to established cell lines. Neonatal and
      young adult fibroblasts exhibited intermediate responses to promoter treatment,
      showing 54.9% and 33.1% extension, respectively. In contrast, promoter treatment
      had no significant effect on aged adult fibroblasts. Maximal extension required
      continual treatment beginning in primary culture or at passage 1. Promoter
      induced extension of proliferative life span appears to be mediated through the
      prolonged maintenance of small, highly proliferative cells that are present in
      primary cultures of these cells.

PMID- 1745072
TI  - A study on the basic nature of human biological aging processes based upon a
      hierarchical factor solution of the age-related physiological variables.
AB  - The purpose of this study is to determine the laws governing the aging processes
      based on a hierarchical factor solution of the age-related physiological
      variables. Healthy individuals (462) who had taken a 2-day health examination
      were studied. Twenty-seven physiological variables were submitted to hierarchical
      factor solution. The analysis revealed that there was a fixed pattern in the
      variations of these 27 physiological variables. In this hierarchical factor
      solution, three group factors as functioning at different levels of complexity
      composed of the 16 common factors were extracted. Of these group factors, the
      first and third group factors can be referred to the aging process. The first
      group factor, the so-called factor 1 loaded with most of physiological variables,
      was interpreted as a primary aging factor which presented the primary process of
      human aging. The third group factor, the so-called factor 6 to 16 loaded only
      with a few variables related to a single physiological system or organ, were
      interpreted as system-specific secondary aging factor. These results obtained by
      the hierarchical factor solution thus seem to support the notion that biological
      age changes can be viewed as time dependent complex integration of the primary
      and secondary aging processes.

PMID- 1745073
TI  - Comparison of rates of neuronal development and survival in human and rat
      cerebral cortical cell cultures.
AB  - A problem that has not been addressed directly at the cellular and molecular
      levels concerns the basic mechanisms governing rates of development and aging in
      the nervous system. We have begun to examine this problem by employing parallel
      cell cultures of cerebral cortical neurons taken from rat and man, two species
      with markedly different developmental periods and life spans. Cortical cultures
      were established from rat and human fetuses and were maintained under identical
      conditions. Long-term neuronal survival in human cortical cultures was strikingly
      greater than in rat cortical cultures, and axonal outgrowth was significantly
      slower in the human neurons. These differences were consistently observed in a
      variety of culture media. Exchanges of culture medium between cultures of the two
      species did not alter the differences in neuronal survival and axon outgrowth
      suggesting that the differences between human and rat neurons were probably not
      due to factors released into the culture medium. Furthermore, the differences
      were not related to developmental stage at the time of culture initiation since
      similar results were obtained in cultures established from fetuses of different
      gestational ages. These initial data indicate that differences in the
      developmental time courses and life spans of human and rat cerebral cortex are
      reflected at the level of the individual neuron, and provide a system in which to
      explore the mechanisms responsible for these differences.

PMID- 1745074
TI  - Hydrogen peroxide production by mitochondria may be a biomarker of aging.
AB  - The hypothesis that rate of intracellular prooxidant production is associated
      with the rate of aging was tested by comparing the rate of H2O2 generation by
      mitochondria in houseflies of similar chronological but different physiological
      ages. Physiological age represents the life expectancy or 'nearness to death'.
      Average and maximum life spans of flies were extended 2-fold by the elimination
      of flying activity. In addition, using senescence-related loss of flight ability
      as a phenotypic marker of impending death, relatively short-lived and long-lived
      subpopulations of flies were isolated from cohort populations. Rate of H2O2
      generation was measured fluorometrically in mitochondria from thoracic flight
      muscles using alpha-glycerophosphate as a substrate and without employing any
      respiratory inhibitors as is often the case in mammalian studies. The rate of
      mitochondrial H2O2 release was found to be associated with life expectancy or the
      physiological age of flies rather than the chronological age. At the same
      chronological age, mitochondria from flies with a shorter life expectancy had a
      markedly higher rate of H2O2 generation than those with a longer life expectancy.
      Results of this and some previous studies in this laboratory are interpreted to
      suggest that the rate of prooxidant generation rather than the level of
      antioxidant defenses may be a key correlate of the rate of aging.

PMID- 1745075
TI  - Skeletal muscle atrophy in old rats: differential changes in the three fiber
      types.
AB  - This study was undertaken to reevaluate the effects of ageing on skeletal muscle
      mass and on mitochondrial and glycolytic enzyme levels in the different types of
      skeletal muscle in rats. It was found that some muscles atrophy with ageing,
      while others do not, in male rats. Atrophy appears to occur in weight-bearing
      muscles, and is most marked in those with a high proportion of type IIb fibers.
      The muscles that did not atrophy are non-weight-bearing, and include the
      epitrochlearis (predominantly type IIb fibers) and the adductor longus
      (predominantly type I fibers). The average cross-sectional area of muscle fibers
      in the plantaris muscles of 28-30-month-old rats was approximately 30% smaller
      than that of 9-10-month-old animals, providing evidence that the approximately
      30% lower weight of the plantaris in the old group was entirely due to fiber
      atrophy. The proportion of type IIa fibers was decreased and the proportion of
      type I fibers was increased in the plantaris of the old rats. The respiratory
      capacity of the soleus muscle (predominantly type I fibers), and the glycolytic
      capacity of the superficial, white (type IIb) and deep, red (predominantly type
      IIa) portions of the vastus lateralis, were reduced in the old rats. Our results
      provide evidence that ageing has differential effects on the three types of
      skeletal muscle fiber, and on weight-bearing and non-weight-bearing muscles, in
      the rat.

PMID- 1745076
TI  - The structure of self-reported physical health among the aged in the United
      States and Japan.
AB  - This article attempts to extend the generalizability of a three-dimensional model
      of self-reported physical health among the aged to a nonwestern culture.
      Consisting of three interrelated dimensions, chronic illness, functional status,
      and self-rated health, this model was empirically evaluated by using national
      data on the aged gathered in the United States and Japan. The three-dimensional
      specification was found to apply equally well to U.S. and Japanese elderly. In
      addition to examining the internal structure of this three-dimensional model, the
      study assessed the model's relationships with a set of selected exogenous
      variables including age, sex, marital status, and education. The relationships
      between the selected exogenous variables and physical health dimensions are
      largely similar in both countries. However, clear differences appeared in at
      least three instances.

PMID- 1745077
TI  - Economic determinants of annual hours worked by registered nurses.
AB  - This study was guided by the economic theory of the decision to work, with
      secondary survey data (N = 16,880) derived from the National Sample Survey of the
      Population of Registered Nurses, November 1984, used to analyze the effects of
      economic and sociodemographic variables on the number of hours worked annually by
      registered nurses (RNs). When separate analyses were performed for the entire
      sample and for unmarried RNs alone, regression coefficients estimated for the
      RN's wage indicated that raising wages would result in modest increases in the
      number of annual hours worked. This effect was not present when either married
      RNs or those who were widowed, divorced, or separated were used in regression
      analyses. Male RNs worked 11 weeks more than married, female RNs, and nonwhite
      RNs worked almost 7 weeks more per year than white, married RNs. RNs with an
      associate degree in nursing worked more hours than those with a diploma
      certificate, and the presence of young children at home had a substantial
      negative effect on the number of hours RNs worked.

PMID- 1745078
TI  - A time-insensitive predictive instrument for acute myocardial infarction
      mortality: a multicenter study.
AB  - This study develops a "time-insensitive" predictive instrument for acute
      myocardial infarction mortality that would be useful both as a real-time clinical
      decision aid in the emergency medical setting and also for retrospective
      assessment and comparison of medical care based on risk-adjusted mortality
      predictions. This was done using prospectively-collected data on 5,773 patients
      with chief complaints of chest pain or other symptoms suggesting acute cardiac
      ischemia who came to six New England hospitals over a 2-year period. In phase
      one, based upon 4,099 patients, multivariate logistic regression was used to
      develop the predictive instrument. In phase two, its accuracy and diagnostic
      performance were tested on an independent sample of 1,387 patients presenting
      with symptoms compatible with acute cardiac ischemia. Discrimination between
      patients who lived and those who died was reflected by receiver-operating
      characteristic (ROC) curve areas of 0.85, 0.80, and 0.76, respectively, for all
      emergency department study subjects regardless of final diagnosis, subjects who
      proved to be having acute cardiac ischemia, and subjects who proved to be having
      acute infarction. Good calibration was shown by the fact that the predicted
      mortality was found to not vary significantly from actual mortality rates across
      deciles of predicted probabilities from 0% to 100%. In phase three, based on all
      945 study subjects with acute myocardial infarction, each of the six hospitals'
      actual mortality rates were compared to their rates predicted by the predictive
      instrument. Actual hospital mortality rates ranged from 9.9% to 19.3%, with one
      hospital having a significantly higher rate (P = 0.005) and two hospitals both).
      Predicted mortality rates ranged from 13.4% to 19.4%, with one hospital having a
      significantly higher predicted rate (P = 0.005) and two hospitals having
      significantly lower predicted rates (P = 0.04 and P = 0.03). Individual
      hospitals' differences between actual and predicted mortality ranged from -3.4%
      to +3.1% (all NS). When grouped by hospital type, the actual mortality rates were
      14.9%, 17.3%, and 13.0%, respectively, for urban teaching, smaller city teaching,
      and rural nonteaching hospitals (all NS). The predicted mortality rates were
      16.5%, 17.1%, and 13.6%, respectively, with the rate for rural nonteaching
      hospitals being significantly lower (P = 0.009). No hospital type had significant
      differences between their actual and predicted mortality rates (NS). The time
      insensitive predictive instrument for acute infarction mortality shows potential
      for risk-adjusted studies of hospitals mortality for multihospital groups,
      hospital-to-hospital comparisons, and within-hospital assessment.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1745079
TI  - Controlling variation in health care: a consultation from Walter Shewhart.
AB  - The control of unintended variation is an objective central to modern industrial
      quality management methods, based largely on the theoretical work of Walter A.
      Shewhart. As industrial quality management techniques find their place in health
      care, professionals may feel threatened by the effort to reduce variation.
      Understanding may reduce this fear. Variation of the types addressed in quality
      control efforts erodes quality and reliability, and adds unnecessarily to costs.
      Such undesirable variation derives, for example, from misinterpretation of random
      noise in clinical data, from unreliability in the performance of clinical and
      support systems intended to support care, from habitual differences in practice
      style that are not grounded in knowledge or reason, and from the failure to
      integrate care across the boundaries of components of the health care system.
      Quality management efforts can successfully reduce each of these forms of
      variation without insult to the professional autonomy, dignity, or purpose of
      health care professionals. Professionals need to embrace the scientific control
      of variation in the service of their patients and themselves.

PMID- 1745080
TI  - Accuracy of Medicare claims data for estimation of cancer incidence and resection
      rates among elderly Americans.
AB  - To explore the reliability of Medicare Part A claims data for clinical and health
      services research related to the care of patients with cancer, the authors
      compared estimates of the incidence of and resection rates for cancer of the
      breast, colon, and lung derived from analysis of Medicare Part A data versus data
      from the National Cancer Institute's Surveillance, Epidemiology, and End Results
      (SEER) Program. Incidence rates of breast, colon, and lung cancer estimated from
      Medicare Part A data were within 6% of estimates derived from SEER data.
      Resection rates estimated from Medicare Part A data, in contrast, were 12% to 27%
      lower than resection rates based on SEER data. This discrepancy is not explained
      by variations in practice between regions participating in versus those not
      participating in the SEER registries but may be due to undercoding of surgical
      procedures in Medicare Part A data. This analysis suggests that Medicare data can
      provide useful insights into the care of patients with cancer, but research
      regarding inpatient procedures employed in management of cancer should be based
      on analysis of Medicare Parts A and B data combined.

PMID- 1745081
TI  - Variation in intensive care unit practices in two community hospitals.

PMID- 1745082
TI  - Willingness-to-pay as a measure of benefits. Relevant questions in the context of
      public decisionmaking about health care programs.

PMID- 1745083
TI  - [Concentrations of serum cholesterol in Spanish children: results of a study on
      the isle of Menorca].
AB  - BACKGROUND: The little knowledge about the distribution of total cholesterol (TC)
      in childhood and adolescence in Spain, makes the planification of preventive
      measures for cardiovascular diseases difficult. The aim of this study is to
      determinate these values in the island of Menorca. METHODS: A sample of 1,062
      boys and girls 6 to 18 years of age was studied. Blood samples were obtained by
      venipuncture and were analyzed by the enzymatic techniques of cholesterol
      esterase, cholesterol-oxidase, and peroxidase. RESULTS: Boys showed lower mean TC
      values than girls in almost all age groups. In both sexes, a descending phase was
      observed in the TC by age curve at the beginning of the adolescence. TC values
      above 5.17 mmol/l (200 mg/dl) were recorded for 7% of participants, being this
      proportion lower than the value found in the Spanish study of Fuenlabrada (13%).
      CONCLUSIONS: Results obtained are compared with other national and international
      studies. The values of this study rank an intermediate position between the
      highest mean TC values registered in Norway and the lowest registered in Israel.

PMID- 1745084
TI  - [Multiple nosocomial infections in a university hospital].
AB  - BACKGROUND: Multiple hospital-acquired infections (MHAI) have not been properly
      evaluated, and therefore data on their leading epidemiological features are
      lacking. In the present study, MHAI in a university hospital were evaluated
      during a 5 year period. METHODS: Data were obtained from the institution program
      of hospital acquired infection surveillance, which is based on the daily review
      of microbiological reports with subsequent confirmation of the data in the
      service where the patient is admitted. RESULTS: The number of detected MHAI was
      1,202 in 522 infected patients, corresponding to 10.3% of the overall number of
      patients with hospital-acquired infections (HAI). By age groups, the patients
      over 60 years were the most affected (62.7%), whereas the less affected were
      those below 40 years (13.6%). By hospital areas, the surgical area had the
      highest incidence (55.3%) and the gynecological area had the lowest incidence
      (2.4%). Double infections were the most common ones in all services, with 79.1%
      of the overall number. The service with the greatest number of patients with MHAI
      was Surgery (37.9%). Urinary tract infections were the most common type.
      CONCLUSIONS: The results show that male surgical patients over 60 years of age
      were the group at highest risk of MHAI.

PMID- 1745085
TI  - [Clinico-hematological characteristics of acute transformation of chronic
      myeloproliferative syndromes].
AB  - BACKGROUND: The aim of the present study was to analyze the blastic
      transformation occurring during chronic myeloproliferative diseases (CMPD) and to
      establish the differences between them. METHODS: The clinical and hematological
      characteristics of 54 patients in blastic crisis (BC) of a CMPD were analyzed: 40
      chronic myelogenous leukemias (CML), 9 idiopathic myelofibroses (IMF), 4
      polycythemia vera (PV), and one essential thrombocythemia (ET). The results were
      analyzed by the BMDP statistical program. RESULTS: The BC of CML appeared in
      younger patients (p less than 0.05). Only in this group did some patients achieve
      complete remission. Moreover, in this BC a greater incidence of visceromegalies
      and leukocytoses were observed. The BC of the IMF patients led to marked anemia
      (p less than 0.01) and bone marrow infiltration (p less than 0.05); these
      leukemias were more frequent in males and began with lymphadenopathies and
      visceromegalies. The transformations of PV were preceded by a longer chronic
      phase and had a lower incidence of visceromegalies and a nearly normal hemoglobin
      count value. The patient with acute leukemia secondary to ET did not display
      visceromegalies but did have anemia, leukopenia and a normal platelet count. None
      of the four groups responded to therapy, and their survival was short.
      CONCLUSIONS: Blast transformations of different myeloproliferative disorders have
      their own idiosynchratic clinical and hematological characteristics, some of
      these may be related to the chronic phase of disease.

PMID- 1745086
TI  - [Cholesterol in Spanish children and adolescents. Uncertain outlook for the
      future cardiovascular risk of the population].

PMID- 1745087
TI  - [Rheumatoid arthritis and multiple neoplasms].
AB  - In patients with rheumatoid arthritis the appearance of neoplastic disease has
      been fundamentally described of lymphoproliferative origin. The case of a 59 year
      old woman with rheumatoid arthritis of a 4 year evolution is reported. The
      patient was treated with gold salts and methotrexate and presented successively a
      bronchogenic carcinoma and a non-Hodgkin lymphoma. The epidemiologic studies in
      the relation of rheumatoid arthritis-neoplasia are discussed and the pathogenic
      hypotheses to the immune alterations as well as the treatments employed are
      described.

PMID- 1745088
TI  - [Prevention of azoospermia in patients treated with chemotherapy and/or
      radiotherapy].

PMID- 1745089
TI  - [Liver transplantation].

PMID- 1745090
TI  - [Recurrent acute streptococcal thyroiditis].

PMID- 1745091
TI  - [Pulmonary scintigraphy with gallium-67 in the early detection of Pneumocystis
      carinii pneumonia].

PMID- 1745092
TI  - [Hypercoagulability and exanthematous Mediterranean fever].

PMID- 1745093
TI  - [Soft tissue sarcoma].

PMID- 1745094
TI  - [Randomly].

PMID- 1745095
TI  - [Glycated hemoglobin, glycosylated hemoglobin or glycohemoglobin? A problem of
      biochemical nomenclature].

PMID- 1745096
TI  - [Infectious arthritis in hemophiliac patients with positive antibodies to human
      immunodeficiency virus. Apropos of 4 cases].

PMID- 1745097
TI  - [Incidence of seroconversion for the human immunodeficiency virus in non
      hemophiliac patients receiving low doses of prothrombin complex factors].

PMID- 1745098
TI  - [Complicated parapneumonic pleural effusion resolved with antibiotic treatment].

PMID- 1745099
TI  - [Prevention of traffic accidents by physician's consultation].

PMID- 1745100
TI  - Losartan, a nonpeptide angiotensin II (Ang II) receptor antagonist, inhibits
      neointima formation following balloon injury to rat carotid arteries.
AB  - Angiotensin-converting enzyme inhibitors have been shown to inhibit intimal
      thickening following balloon catheterization of rat carotid arteries. To assess
      the role of the renin-angiotensin pathway and the angiotensin type-I (AT1)
      receptor in this effect, the nonpeptide Ang II antagonist losartan (DuP 753) or
      vehicle was infused continuously i.v. in rats from two days before to two weeks
      after balloon injury to the left common carotid artery; drug effects upon intimal
      thickening were examined histologically. Losartan produced a dose-dependent
      reduction in cross-sectional area of intimal lesions determined two weeks post
      balloon injury. At 5 mg/kg/day a nonsignificant 23% reduction of intimal area was
      observed. At the higher dose of 15 mg/kg/day, losartan produced a 48% reduction
      in intimal area (P less than 0.05) compared to the vehicle-infused group. The
      cellular density of the neointima was not affected by losartan, indicating a
      probable effect of the drug upon migration and/or proliferation of smooth muscle
      cells. In separate groups of non-ballooned rats, losartan infusions of 5 and 15
      mg/kg/day produced significant rightward shifts (averaging 6.4- and 55-fold,
      respectively) in curves relating increases in blood pressure to intravenous Ang
      II in pithed rats determined between 2 and 16 days following initiation of
      losartan infusion. Mean arterial blood pressure (determined under alpha
      chloralose anesthesia) was reduced following continuous losartan infusion for 6
      days from 128 +/- 8 mm Hg (vehicle) to 105 +/- 8 mm Hg at 5 mg/kg/day (P less
      than 0.05), and 106 +/- 4 mm Hg at 15 mg/kg/day (P less than 0.05). Thus,
      losartan attenuated the vascular response to balloon catheter injury, and this
      effect was associated with functional block of vascular AT1 receptors. The
      results support a role for Ang II, acting via AT1 receptors, in myointimal
      thickening subsequent to balloon injury of rat carotid arteries.

PMID- 1745101
TI  - Minireview: enzymatic properties of ribosome-inactivating proteins (RIPs) and
      related toxins.
AB  - Ribosome-inactivating proteins (RIPs) are a group of proteins that inhibit
      protein synthesis in eucaryotic cells. While the biological effects have been
      well characterized, the underlying enzymatic mechanisms have not been elucidated
      until recently. Two different mechanisms have been identified. Plant and
      bacterial RIPs act as N-glycosidases. They cleave a single N-glycosidic bond
      between adenine and ribose at a specific nucleotide A-4324 of the 28S rRNA of the
      60S ribosomal subunit. On the other hand, the fungal RIPs act as ribonucleases
      and cleave a single phosphodiester bond between G-4325 and A-4326 of the same
      rRNA, just one nucleotide away from the site of action of plant/bacterial RIPs.
      Other protein synthesis inhibitory proteins act by their ADP-ribosyltransferase
      activity which modify and thus inactivate elongation factor-2. Recently, some
      toxins have been shown to possess deoxyribonuclease activity which may also
      account for their toxicity.

PMID- 1745102
TI  - Ion-sparing diuresis by 2,3-dibenzylbutane-1,4-diol, a synthetic mammalian-lignan
      derivative.
AB  - Diuretic properties of a synthetic lignan, 2,3-dibenzylbutane-1,4-diol
      (hattalin), and a naturally occurring arctigenin were examined in BALB/c male
      mice and Wistar male rats. Intra peritoneal administration of hattalin (50 mg/kg)
      in mice increased urine volume by 1.7-3.1 fold that of placebo-treated animals 40
      260 min after administration (p less than 0.05 vs control). In contrast, 100
      mg/kg of arctigenin had no effect on urine volume in mice. Hattalin (100 mg/kg),
      arctigenin (100 mg/kg), or furosemide (50 mg/kg) as a positive control was
      administered orally to rats, and accumulated urine volume was measured for up to
      6-12 h. The urine volume of animals administered with hattalin showed 1.4-1.5
      fold that of placebo-treated animals after 2-6 h of administration (P less than
      0.05, n = 10). On the other hand, arctigenin showed no significant effect on
      urine volume for up to 12 h after administration (n = 8). The urine volume in
      animals administered with furosemide (n = 10) was 2.0-3.0 fold that of placebo
      treated animals (P less than 0.01). Furosemide increased total Na+, K+, or Cl-
      excretion by 1.9, 1.8 or 2.2 fold, respectively, when compared with placebo
      treated controls (P less than 0.01), whereas hattalin decreased Na+ excretion by
      3.6 times (P less than 0.01), K+ excretion by 1.4 times (not significant), and Cl
      excretion by 3.1 times (P less than 0.01). Serum Na+ and K+ levels did not
      change in both furosemide- and hattalin-administered rats, however, serum Cl-
      levels in these animals significantly decreased (P less than 0.01) when compared
      with controls. The results suggest that the diuretic property of hattalin is due
      to a novel mechanism which is different from that of furosemide or other
      diuretics modifying the ion-exchange at the uriniferous tubules.

PMID- 1745103
TI  - Enzymatic degradation of tumor necrosis factor by activated human neutrophils:
      role of elastase.
AB  - Although the role of tumor necrosis factor-alpha (TNF) as mediator of
      inflammation is now well established, its interactions with polymorphonuclear
      neutrophils (PMN) are not fully understood. Therefore, we investigated the
      possible hydrolytic action on TNF of intra-lysosomal enzymes released by
      activated PMN in the extracellular medium. We first incubated 125I radiolabeled
      TNF in vitro with activated PMN and by HPLC analysis, we observed a degradation
      process completely blocked by the previous addition of alpha 1-Antitrypsin (AT)
      to the incubation medium. By comparing several degradative patterns of TNF
      obtained with purified leukocyte proteases and supernatant of activated PMN, we
      identified elastase as the major enzyme involved in this catabolic process of
      TNF. In a second part, we determined the bioactivity of the cleavage fragments of
      recombinant human TNF (rhTNF) by a cytotoxicity assay. None of the fragments was
      found biologically active. Our results suggest that, at inflammatory sites, an
      enzymatic degradation of TNF may occur in the pericellular area of activated PMN.
      This new catabolic pathway leading to inactivation of TNF might be regarded as an
      effective local negative feed-back process limiting the potentially toxic effects
      of this cytokine.

PMID- 1745104
TI  - Antagonism of acute cocaine toxicity by buprenorphine.
AB  - The effect of buprenorphine pretreatment on the acute cocaine toxicity was
      assessed in male Swiss Webster mice. Buprenorphine pretreatment (0.15 or 0.30
      mg/kg ip, 30 mins before) significantly attenuated the lethal effects of cocaine
      (60-140 mg/kg ip). The dose of cocaine which resulted in 50% mortality (LD50) in
      saline pretreated group was 100.61 mg/kg while the LD50 of cocaine in
      buprenorphine (0.15 and 0.3 mg/kg) pretreated groups were 113.57 and 118.16 mg/kg
      respectively. There was no significant change in the ratio of brain/plasma levels
      of cocaine in buprenorphine pretreated group when compared to the ratio from
      saline treated controls. Furthermore, neither naloxone (10 mg/kg ip, 15 mins
      before) nor naltrexone (3 mg/kg ip, 15 mins before) pretreatment affected the
      LD50 of cocaine. When tested 0.5, 1, 2, 4, 8 and 24 hrs after cocaine
      administration, sublethal dose of cocaine (80 mg/kg ip) injection resulted in
      significant increase in the plasma lactate dehydrogenase (LDH) levels.
      Buprenorphine pretreatment significantly attenuated cocaine-induced release of
      LDH. These results suggest that buprenorphine could be of potential advantage
      over naloxone in the management of cocaine and heroin ("speed ball") toxicity and
      in studies on the pharmacotherapy of cocaine-induced toxicity, LDH levels may be
      used as a biochemical marker to assess the protective effects of drugs.

PMID- 1745105
TI  - A novel and sensitive radioreceptor assay for serum melatonin levels.
AB  - A simple and sensitive radioreceptor assay (RRA) has been developed to measure
      melatonin levels in serum. The assay is based on competition between 2
      [125I]iodomelatonin ([125I]MEL) and melatonin for binding to high-affinity
      binding sites in chick forebrain. To measure the amount of melatonin present in a
      serum sample, it was extracted with dichloromethane and added to the assay
      medium. The percentage inhibition of radioligand binding in the presence of the
      extracted serum was determined and compared to the percent displacement by known
      amounts of melatonin in a standard curve. There was little or no cross-reactivity
      with other structurally related compounds. The sensitivity of the assay is
      approximately 1.5pg/0.15 mL and the intra- and inter-assay variations are
      approximately 8%. Since the RRA results are comparable to that of an established
      radioimmunoassay (RIA), it provides a sensitive and rapid alternative to the more
      time consuming RIA.

PMID- 1745106
TI  - Inhibition of human blood aldehyde dehydrogenase activity by cigarette-smoke
      condensate.
AB  - The effect of a cigarette-smoke condensate (CSC) and three CSC subfractions on
      the aldehyde dehydrogenase (ALDH; EC 1.2.1.3) activity in human blood cells was
      examined under physiological conditions in vitro. Incubation of intact or
      sonicated cells with different concentrations of crude CSC resulted in a dose
      dependent reduction of the ALDH activity. The inactivation was only restored in
      part after extensive washing of the cells, indicating that the inhibition
      observed was mainly irreversible. The nonvolatile (NV) subfraction of the CSC
      caused a reduction in ALDH activity similar to that obtained with crude CSC,
      while the semivolatile (SV80) and volatile (SV20) subfractions did not
      significantly affect ALDH. The present results, showing that the human blood cell
      ALDH is inactivated by constituents of cigarette smoke in vitro, suggest that the
      blood ALDH activity reduction found in habitual smokers is also caused by
      components formed during the combustion of tobacco.

PMID- 1745107
TI  - Preferential loss of body fat during starvation in dietary obese rats.
AB  - This study was undertaken to examine whether diet-induced obesity alters the
      amount and/or composition of weight lost during starvation. The amount and
      composition of weight lost during a 4-day period of starvation was determined
      before and at 17, 30 and 42 weeks after rats (350 g of body weight) were given a
      high fat diet (HFD). To control for effects of aging, a second group of rats, fed
      standard laboratory chow, was also subjected to similar periods of starvation.
      Although total weight loss during starvation was never greater for HFD rats than
      for chow-fed rats, the former group showed a clear patter of increasing loss of
      body fat and total energy and conservation of fat-free tissues with periods of
      starvation later in life. In addition, chow-fed rats showed substantial energy
      conservation during each period of starvation (i.e. they lost less energy each
      day than their pre-starvation energy requirements). In contrast, HFD rats
      demonstrated substantial energy conservation only at 17 weeks and not at 30 or 42
      weeks; during the last period of starvation, their average daily loss of carcass
      energy exceeded their pre-starvation energy requirements. This suggests the
      increased fat mass of these rats may have led to increased fuel availability and
      to an increased metabolic rate during starvation. If these results are applicable
      to humans, the more obese subjects are likely to show greater total loss of
      energy than lean subjects, but show a lesser loss of lean body mass, at least
      initially. If protein requirements are reflected by the ability to mobilize
      protein during food restriction, protein requirements would be substantially
      lower in the dietary obese rats than in controls. In summary, diet-induced
      obesity leads to preferential loss of body fat and conservation of lean mass
      during starvation.

PMID- 1745108
TI  - Lack of alcohol dehydrogenase isoenzyme activities in the stomach of Japanese
      subjects.
AB  - Alcohol dehydrogenase (ADH) isoenzymes different from those of the liver were
      shown to be present in the human gastric mucosa. Two ADH activity bands present
      in the gastric mucosa of surgical specimens from all 7 black and 11 white
      Americans studied were absent in 14 and barely detectable in 3 of 21 Japanese
      subjects evaluated. Similar ethnic differences pertained to both genders and were
      independent of the gastric pathology. The mobility of these bands on starch gel
      electrophoresis corresponded to those recently reported and named mu-ADH or sigma
      ADH. The absence of these bands was associated with a 70% decreased capacity to
      reduce m-nitrobenzaldehyde, a preferred substrate for sigma-ADH, suggesting that
      the bands missing from the Japanese stomachs comprise this isoenzyme.

PMID- 1745109
TI  - Handouts: making the lecture portable.
AB  - Previous medical literature on preparing lecture handouts has focused on their
      use in student education, where as part of a course there is a series of lectures
      followed by an examination. Conversely, resident and practising physicians
      usually attend single lectures on individual topics in order to update and
      improve their clinical skills. Handouts designed for the latter type of lecture
      can serve as a useful resource in subsequent day-to-day teaching and patient
      care. This article examines the purpose, distribution, structure, and substance
      of such handouts. Guidelines to assist the speaker in preparing lecture handouts
      are discussed.

PMID- 1745110
TI  - Managing the initial period of implementation of educational change.
AB  - Three years ago the Universiti Kebangsaan Malaysia medical school changed its
      curriculum from the traditional discipline based curriculum to the integrated
      organ-system approach. Once change was effected a process of 'refreezing' had to
      be initiated whereby new responses had to be reintegrated into the ongoing
      personality or emotional relationships of important people so that the change
      process will endure and become stable. During this refreezing process the faculty
      encountered several problems which could thwart further development of the new
      curricula if left unresolved. The nature of the problems seemed to indicate that
      curricular change involves more than just efforts at bettering the what and ways
      of student learning and assessment. A lot of energy was also spent on keeping
      things going, keeping people motivated, making sure the work was done (at least
      as well as it has in the past), looking for better ways to do things, weighing
      new solutions and to be alert to new problems. In ensuring the continuance of
      change it was important to ensure, from the outset the institutionalization of
      policies, programmes, procedures and practices for continuing reward,
      routinization, structural integration into the system, continuing evaluation and
      providing for continuing maintenance.

PMID- 1745111
TI  - A novel perspective on medical education.
AB  - Participants on a course entitled 'Planning and Evaluating a Course' generated a
      theoretical framework to simplify consideration of the essential components of
      clinically skilled behaviour. Five superordinate facets were elucidated and
      elaborated with reference to specific teaching situations. This paper illustrates
      the effective use of buzz-groups to encourage active participation of individual
      group members. The exercise revealed some serious shortcomings in the current
      teaching of clinical skills.

PMID- 1745112
TI  - Teaching health promotion and illness prevention to trainee general
      practitioners.
AB  - This study demonstrates that the provision of feedback based on the observation
      of videotaped consultations can be used to increase self-awareness of
      deficiencies in health promotion and illness prevention skills. Trainee general
      practitioners were found to have some awareness of deficiencies in this important
      aspect of general practice, and this awareness increased as a result of self
      observation and the feedback. Performance was self-evaluated to be better at the
      end of the general practice term than at the beginning.

PMID- 1745113
TI  - Reflection in clinical teaching: an analysis of reflection-on-action and its
      implications for staffing residents.
AB  - In order to improve clinical teaching in the ambulatory care setting, clinical
      teachers need to know the range of instructional strategies available to them.
      One potentially useful strategy is that of reflection. In this paper, reflective
      practice will be described in the context of the professional training of
      physicians, with the purpose of improving clinical teaching. An example of
      reflective practice--a transcript of a video tape of an attending physician and a
      resident in a general internal medicine clinic--will be analyzed. In this
      transcript, reflective comments by both the attending physician and resident are
      integrated into the original dialogue.

PMID- 1745114
TI  - Teaching mental handicap to medical students.
AB  - An innovative approach to the teaching of mental handicap to pre-clinical medical
      students as part of their Behavioural Sciences course is first described. The
      teaching is organized around a number of extended placements which allow students
      to interact with people with a mental handicap on a basis of equality and
      reciprocity. Students respond positively to the seminar, regarding it as
      enjoyable, interesting and relevant to their future work as doctors.
      Questionnaires administered to students participating in the seminar suggest that
      they have a generally positive image of mentally handicapped people and hold
      vaguely liberal views as to how they should be treated by Society. Few, however,
      wish to work in the mental handicap area. There is no evidence that the
      experience of the seminar leads to any significant change in these attitudes.

PMID- 1745115
TI  - What is missing from patient histories?
AB  - Second year students' proficiency in history taking was evaluated by the
      Objective Structured Clinical Examination (OSCE) and a written test, with
      particular attention to Risk Factors and Psychosocial Data. Students concentrated
      on obtaining Diagnostic Information on both tests, but those students who worked
      with preceptors in the community, (PCC program), included a wider range of data.
      Overall performance was higher on the OSCE which emphasized diagnostic
      information. Student histories tend to exclude Risk Factors and Psychosocial Data
      unless their inclusion is modeled and expected by faculty.

PMID- 1745116
TI  - The use of the objective structured clinical examination as an audit of teaching
      and student performance.
AB  - A four year experience of the Objective Structured Clinical Examination in Child
      Health of 301 students in 18 separate examination diets was analysed to determine
      student competence in several clinical examinations including cardiovascular and
      central nervous system, developmental examination, history of asthma and in
      answering multiple choice questions relating to factual information. Using
      criterion reference assessment, student performance was related to individual
      knowledge, quality of teaching, examination design and teacher expectation.
      Variable levels of expectation and achievement were noted for different clinical
      items. Staff expectation of student performance was found to be higher than
      achieved in 39%, the same in 55% and in only 6% did students perform better than
      was anticipated. The value of using Criterion Reference Assessment System, based
      on a standard comprehensive examination, is discussed in relation to influencing
      examination design and efficiency of teaching medical students.

PMID- 1745117
TI  - An analytical model for the design of RF resonators for MR body imaging.
AB  - A closed form, analytical solution describing the RF fields generated by an RF
      body coil resonator for MR imaging at 1.5 and 4.0 T is presented. This solution
      extends the results of earlier studies of RF penetration in the body by
      explicitly including the RF coil, the RF shield, and the field variation along
      the z axis for high-pass bird cage coils. A salient feature of this treatment is
      the calculation of the axial propagation constant, kz, which determines the z
      dependence of the RF field. We have determined the relative power deposition in
      the body, the B1 field homogeneity, and coil losses, which are functions of the
      coil-to-shield separation and body size. The relative power deposition in the
      body has been calculated to vary as the 1.58 power of the body radius. The
      calculations have also predicted that the field homogeneity in the z direction
      exhibits greater degradation at higher frequencies in a high-pass coil than in a
      low-pass coil. The model predicts an increase in coil losses by a factor of 2.8
      as the coil-to-shield separation is reduced from 5 to 2 cm in a standard body
      resonator. Although the results for only a homogeneous cylindrical object or body
      are presented, the theory can be extended to a multilayered heterogeneous object
      of varying permittivity and conductivity.

PMID- 1745118
TI  - Evaluation of energy metabolism in brain using epimerization of 2-deoxy-2-fluoro
      D-glucose by 19F NMR: the effect of anesthesia.
AB  - The effect of anesthesia on the epimerization of 2-deoxy-2-fluoro-D-glucose(-6
      phosphate) to 2-deoxy-2-fluoro-D-mannose(-6-phosphate) in mice was demonstrated
      with 19F NMR spectroscopy of excised tissue specimens from heart, muscle, and
      brain. Spectra from each of six excised organs confirmed that pretreatment with
      an anesthetic suppressed the conversion ratio, FDM/(FDG + FDM), in brain at 3 h
      from 52 +/- 5 to 30 +/- 6% under the dose of 100 mg/kg. We propose potential
      applications for NMR monitoring of FDG-FDM conversion, including the assessment
      of regional brain metabolism and the evaluation of various pharmacologic agents.

PMID- 1745119
TI  - Human auditory system response to pulsed radiofrequency energy in RF coils for
      magnetic resonance at 2.4 to 170 MHz.
AB  - The threshold conditions for an auditory perception of pulsed radiofrequency (RF)
      energy absorption in the human head have been studied on six volunteers with RF
      coils for magnetic resonance (MR) imaging. For homogeneous RF exposure with MR
      head coils in the 2.4- to 170-MHz range and pulse widths 3 microseconds less than
      or equal to Tp less than 100 microseconds, the auditory thresholds were observed
      at 16 +/- 4 mJ pulse energy. Localized RF exposure with optimized surface coils
      positioned flush with the ear lowers the auditory threshold to only 3 +/- 0.6 mJ.
      The hearing threshold of RF pulses with Tp greater than 200 microseconds occurs
      at more or less constant peak power levels of typically 150 +/- 50 W for head
      coils and as low as 20 W for surface coils. The results from this study confirm
      theoretical predictions from a thermoelastic expansion model and compare well
      with reported thresholds from near field antenna measurements at 425 to 3000 MHz.
      Details of the threshold dependence on RF pulse length reveal primary sites of RF
      to acoustic energy conversion at the mastoid and temporal bone region and the
      outer layer of the brain from where thermoelastically generated pressure
      transients excite audible pressure waves at the resonance modes of the skull
      around 1.7 kHz and of the brain around 11 kHz. If not masked by usually
      dominating noise from switched gradients, the conditions for hearing RF pulses,
      as applied to head coils in MR studies with flip angle alpha at main field B0, is
      given by Tp/ms less than or equal to 0.4 (alpha/pi)B0/[T]. At peak power levels
      up to 15 kW presently available in clinical MR systems, there is no evidence
      known for detrimental health effects arising from the RF auditory phenomenon
      which is a secondary cause associated with primary RF to thermal energy
      conversion in body tissues. To avoid the RF-evoked sound pressure levels in the
      head rising above the discomfort threshold at 110 dB SPL, an upper limit of 30 kW
      applied peak pulse power is suggested for head coils and 6 kW for surface coils.

PMID- 1745120
TI  - Toward fully automatic estimation of in vivo 31P spectra.
AB  - Fitting a model to an experimental spectrum is a difficult nonlinear estimation
      problem. The solution presented here is to start an iterative search procedure
      sufficiently close to the optimal model parameter set. This is achieved by
      providing tissue-dependent a priori peak information and by a novel correlation
      method to get good primary estimates of the resonance and phase offset
      parameters. The resulting estimation procedure is fully automatic and has proven
      to be robust for 31P data.

PMID- 1745121
TI  - A lineshape fitting model for 1H NMR spectra of human blood plasma.
AB  - A lineshape fitting model was constructed for classifying the overlapping
      information in the 1H NMR spectrum of human blood plasma. A reliable assignment
      of the overlapping fatty acid (-CH2-)n and -CH3 resonances of the various
      lipoproteins (VLDL, very low density lipoprotein; LDL, low density lipoprotein;
      HDL high density lipoprotein) is introduced, and for the first time detailed
      characteristics (chemical shifts, half linewidths, and relative intensities) of
      the individual lipoprotein components were obtained directly from the whole
      plasma spectrum. This was achieved by combining the constructed lineshape fitting
      model and the proper 400 MHz proton NMR measurements from blood plasma of a
      healthy donor, from fractions of the different lipoproteins, and from plasma
      samples in which the lipoprotein fractions were separately added. The results
      suggest fair promise of future applications of the rapid and easy NMR analysis of
      lipoprotein distribution in various research and clinical situations.

PMID- 1745122
TI  - Quantitative determination of the partial oxygen pressure in the vitrectomized
      rabbit eye in vivo using 19F NMR.
AB  - We have quantitatively determined the PO2 within the vitreous space of the
      vitrectomized rabbit eye in vivo using 19F NMR and perfluorotributylamine (FTBA).
      The results of the present work are in good agreement with previous measurements
      of PO2 within the nonvitrectimized rabbit eye obtained using oxygen
      microelectrodes. In this study, good precision and accuracy were achieved by: (1)
      having minimal flow effects present, (2) optimizing the signal-to-noise through
      the use of neat FTBA and surface coil transmission and detection, and (3)
      performing an inversion-recovery pulse sequence, with adiabatic pulses, to
      optimize the dynamic range of the T1 experiment. Possible deleterious effects on
      the measured T1 due to the vitreal temperature gradient are discussed. To the
      best of our knowledge the results of this study demonstrate, for the first time,
      a quantitative determination of intraocular PO2 in vivo using 19F NMR and FTBA.

PMID- 1745123
TI  - Quantitative measurement of blood flow using cylindrically localized Fourier
      velocity encoding.
AB  - A procedure for the quantitative measurement of blood velocity was developed and
      evaluated in the portal vein, aorta, and vena cava of healthy volunteers. This
      procedure utilizes Fourier velocity encoding and can be performed with or without
      cardiac gating. The accuracy of velocity measurements is determined by the
      accuracy of the gradient subsystem. Flow measurements derived from the velocity
      measurement are further limited in their accuracy by the luminal cross-section
      measurement. Spatial localization is accomplished with an excitation pulse having
      a cylindrical rather than slab geometry. Data are acquired in the presence of a
      readout gradient to provide resolution along the cylindrical axis.

PMID- 1745124
TI  - Spoiling of transverse magnetization in steady-state sequences.
AB  - A detailed analysis is presented of a method to eliminate transverse
      magnetization prior to each rf excitation in pulse sequences with TR less than
      T2. It is shown that artifact-free images with high T1 contrast can be obtained
      only if a phase shift that is incremented during each TR interval is applied to
      the transverse magnetization. Computer simulations are used to show that when
      this phase increment is 117 degrees, the steady-state transverse magnetization
      prior to each rf pulse is nulled over a wide range of T1, T2, and rf tip angles,
      resulting in optimal T1 contrast. Such nulling of steady-state transverse
      magnetization cannot be obtained by using large gradient pulses, or gradients of
      random or linearly incremented amplitude. Images of phantoms and human subjects
      confirm the theoretical predictions.

PMID- 1745125
TI  - Pulsed NMR relaxometry of striated muscle fibers.
AB  - The longitudinal (T1) and transverse (T2) proton (1H) nuclear magnetic resonance
      (NMR) relaxation of fast- and slow-twitch muscle fibers are examined using rat
      muscle tissues in which one fiber type predominates. Both continuum and discrete
      exponential component fits are made to Carr-Purcell-Meiboom-Gill (CPMG) and
      inversion recovery pulse sequence measurements. In addition, experiments which
      illustrate the large sources of variability that have led to apparent conflicts
      in the literature are presented. Based on the results of this study, unique NMR
      features that distinguish fast- and slow-twitch muscle fibers are presented. The
      feasibility of differentiating fast- and slow-twitch muscle fibers using magnetic
      resonance (MR) imaging is briefly discussed.

PMID- 1745126
TI  - Snapshot imaging using a FLARE sequence.
AB  - We have implemented a snapshot FLARE sequence using a scan time of 320 ms for a
      64 x 128 image. As in the conventional FLARE sequence the T2 weighting of the
      image can be altered by manipulating the phase encoding scheme with the position
      of the zeroth phase encoding effectively determining the amount of T2 weighting.
      Reducing the flip angle of the refocusing pulse reduces both the RF power
      deposition and the blurring in images of short T2 samples, at the expense of
      reduced signal and contrast.

PMID- 1745127
TI  - Filtering noise from images with wavelet transforms.
AB  - A new method of filtering MR images is presented that uses wavelet transforms
      instead of Fourier transforms. The new filtering method does not reduce the
      sharpness of edges. However, the new method does eliminate any small structures
      that are similar in size to the noise eliminated. There are many possible
      extensions of the filter.

PMID- 1745128
TI  - Hexagonal surface gradient coil for localized MRS of the heart.
AB  - A surface gradient coil designed to obtain localized magnetic resonance
      spectroscopy of the heart in vivo is described. Images and 31P spectra from
      phantoms and both pig and dog hearts in vivo are shown. The coil was used in
      conjunction with a rf surface coil to obtain 31P spectra from transmural sections
      of the left ventricular wall of a dog heart in vivo to demonstrate differences
      between normal and ischemic tissue.

PMID- 1745129
TI  - Localized proton NMR observation of [3-13C]lactate in stroke after [1-13C]glucose
      infusion.
AB  - To assess whether elevated lactate in stable stroke is being actively produced
      from blood glucose localized 1H NMR stimulated echo spectra were obtained from a
      patient in the region of a 32-day-old cortical infarct before and 60-100 min
      after infusion of [1-13C]glucose. Prior to the infusion the spectrum from the
      region of the infarct contained an elevated resonance from C3 lactate and a
      greatly reduced resonance from N-acetyl groups relative to an unaffected
      contralateral region. After the infusion two additional resonances were observed
      at 62 and -64 Hz relative to the unlabeled resonance of C3 lactate which were
      assigned on the basis of chemical shift and relative intensity to [3-13C]lactate.
      The [3-13C]lactate fractional enrichment in the infarct region was measured to be
      32% which is within error one-half the average [1-13C]plasma glucose enrichment
      during the postinfusion NMR measurement. The result suggests that the stroke
      lactate pool was completely derived from infused glucose.

PMID- 1745130
TI  - Sensitivity enhancement and reduction of Gibbs artifact in T2-weighted imaging
      using variable tip angle excitation.
AB  - Introduction of a Gaussian weighting function into the phase encoding of the spin
      echo imaging method via variable tip angle excitation, with concomitant
      optimization of the recycle delay, is shown to increase the sensitivity of T2
      weighted imaging by up to 40%. In addition, the Gibbs artifact associated with
      sharp boundaries is reduced considerably without the need for postprocessing of
      the data.

PMID- 1745131
TI  - In vivo measurement of cerebral oxygen consumption and blood flow using 17O
      magnetic resonance imaging.
AB  - We used 17O NMR imaging techniques to measure the H2(17)O concentration in a 0.8
      ml voxel in the cat brain following injection of an arterial bolus of enriched
      H2(17)O and during inhalation of enriched 17O2. We also measured the H2(17)O
      concentration in arterial blood during 17O2 inhalation. The data from the first
      measurement were used to calculate the blood flow in the voxel. The data from all
      three measurements were combined to calculate the oxygen consumption in the
      voxel. The values of cerebral blood flow and oxygen consumption calculated with
      17O NMR techniques agree reasonably well with values calculated for a similar
      region of the cat brain using autoradiographic techniques.

PMID- 1745132
TI  - A clinically viable technique of fat suppression for abdomen and pelvis.
AB  - Chemical-shift selective imaging with an improved selective presaturation pulse
      can be used to suppress the fat signal uniformly across the entire abdominal
      cavity. The required magnetic field homogeneity is no higher than for a routine
      diagnostic scan. Therefore, no extra setup time for shimming is needed. The
      technique has been implemented on our clinical system for routine fat suppression
      scans.

PMID- 1745133
TI  - Expenditures and sources of funds for mental health organizations: United States
      and each state, 1988.
AB  - Expenditures. Expenditures by the 8 types of mental health organizations covered
      in this report totaled $23.1 billion in 1988 in the United States and
      territories. Three States (California, New York, and Pennsylvania) accounted for
      30 percent of this total. Nationally, State and county mental hospitals
      (hereafter called State mental hospitals) accounted for the largest proportion of
      all expenditures (30 percent, down from 34 percent in 1986). Private psychiatric
      hospitals and multiservice mental health organizations had the next largest
      expenditures, each accounting for 20 percent of the total, followed by the
      separate psychiatric services of non-Federal general hospitals at 16 percent.
      Department of Veterans Affairs (VA) mental health services, residential treatment
      centers (RTCs) for emotionally disturbed children, freestanding psychiatric
      outpatient clinics, and freestanding psychiatric partial care organizations
      accounted for 6 percent, 6 percent, 3 percent, and less than one-half percent of
      total expenditures, respectively. State mental hospitals represented the largest
      expenditures of any single type of mental health organization in 23 States;
      expenditures of private psychiatric hospitals were largest in 12 States; and
      expenditures of multiservice mental health organizations were the largest in 10
      States. The $23.1 billion total for 1988 represented a 25 percent increase over
      the 1986 figure but, when adjusted for inflation, the estimated increase
      (expressed in constant dollars) was only 10 percent overall and 8 percent on a
      per capita basis. Constant dollar expenditures of most types of mental health
      organizations increased between 1986 and 1988, with the largest increase
      occurring among private psychiatric hospitals (54 percent). In contrast, constant
      dollar expenditures decreased for State mental hospitals and VA mental health
      services. Sources of Funds In 1988, the funds received by mental health
      organizations totaled $23.4 billion. Of this total, $8.8 billion (38 percent) was
      provided directly by State governments, predominantly by State mental health
      agencies. Direct Federal funds, plus Medicare and Medicaid (including the State
      and local share of Medicaid), provided $6.5 billion (28 percent) of total
      funding. Fees from clients (including private insurance) provided $5.2 billion
      (22 percent); direct local government funds provided 7 percent; and all other
      sources, 5 percent. State governments provided 77 percent of the funds received
      by State mental hospitals and were also the largest single source of funds for
      multiservice mental health organizations (51 percent) and freestanding
      psychiatric partial care organizations (44 percent). VA mental health services
      were funded by the Federal government, while 62 percent of funding for private
      psychiatric hospitals came from client fees (including private
      insurance).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1745134
TI  - Outpatient care programs of mental health organizations, United States, 1988.
AB  - In 1988, 2,989 (60 percent) of the 4,961 mental health organizations in the
      United States (including the territories) offered outpatient care programs. A
      total of 5.8 million patient care episodes were generated by these organized
      outpatient programs. These episodes included 3.1 million outpatient additions,
      produced 54 million outpatient visits, and represented 67 percent of all patient
      care episodes in mental health organizations in 1988. Although the number of
      mental health organizations with outpatient care programs increased by less than
      one percent between 1986 and 1988, the number of outpatient additions showed an
      11 percent gain during this period. Multiservice mental health organizations were
      the primary locus of outpatient care in 1988, accounting for 41 percent of the
      2,989 mental health organizations providing this care. Ranking next in this
      respect, were free-standing psychiatric outpatient clinics, and the separate
      psychiatric outpatient services in non-Federal general hospitals, with 25 and 16
      percent, respectively, of the total outpatient care programs. In general, these
      three organization types had similar rankings with respect to the volume of the
      outpatient caseload. By definition, all of the freestanding psychiatric
      outpatient clinics provided outpatient care, and almost all of the VA mental
      health programs and multiservice mental health organizations also offered this
      care (99 and 92 percent, respectively). In contrast, psychiatric outpatient care
      was available in only 37 percent of non-Federal general hospitals with separate
      psychiatric services, 36 percent of private psychiatric hospitals, 29 percent of
      State mental hospitals, and 22 percent of RTCs for emotionally disturbed
      children. Outpatient care was available in mental health organizations in all
      States in 1988, with every State having at least two or more organization types
      providing this service. In general, the most populous States had the largest
      number and the greatest variety of mental health organizations with outpatient
      care programs. Of the 2.87 million clients receiving outpatient care in mental
      health organizations at the end of 1988, 23 percent were under 18 years of age,
      68 percent were 18 to 64, and 9 percent were 65 and older. Male outpatient
      clients slightly outnumbered female clients. The majority (77 percent) of the
      outpatient clients were white, with blacks representing 21 percent; native
      Americans and Asians/Pacific Islanders, the remaining two percent. Eleven percent
      of the total client population were reported to be of Hispanic origin.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1745135
TI  - Characteristics of persons served by private psychiatric hospitals, United
      States: 1986.
AB  - Overall about 71,000 persons were under care in the inpatient, outpatient, and
      partial care programs of private psychiatric hospitals in the United States on
      April 1, 1986, and about 300,000 persons were admitted to these programs during
      1986. Inpatient programs served the largest number of people, 223,851; outpatient
      programs served 133,217; and partial care programs served a much smaller
      population, only 13,541. The relative distribution of persons admitted, versus
      persons under care, differed considerably by type of program. Although the number
      of those admitted was larger than the number of those under care for both
      inpatient and outpatient programs, the difference between the two populations was
      much more pronounced within inpatient programs (chart A). Most of the persons
      admitted to private psychiatric hospitals in 1986 were admitted to inpatient
      programs, 207 thousand or 69 percent of all admissions, while most of those under
      care were outpatients, 47 thousand or 66 percent of all those under care on a
      single day. Children and youth under age 18 comprised the largest percentage of
      persons under care in inpatient programs, while persons in the 25-44 age group
      comprised the largest percentage of those admitted to inpatient programs.
      Approximately 41 percent of all persons under care in inpatient programs were
      under 18 years of age, compared with only 20 percent of all persons admitted to
      inpatient programs. The large number of children and youth found in the
      population under care within inpatient programs indicates the high median length
      of inpatient stay for persons within this age group (41 days compared with 24
      days overall). Children and youth and the 25-44 year group each represented over
      one-third of those admitted to outpatient programs. The 25-44 age group made up
      the largest percentage of persons under care in outpatient programs and among
      those admitted to partial care programs. Among those under care within partial
      care programs, differences among age groups were not statistically significant.
      Of persons admitted to partial care programs, 92 percent had a history of some
      type of prior mental health treatment; for those admitted to inpatient and
      outpatient programs, the corresponding percentages were 70 percent and 48
      percent, respectively. Affective disorders were a frequently occurring diagnostic
      grouping, comprising almost half of all persons admitted to and under care in
      inpatient programs, approximately one-third of those admitted and those under
      care in partial care programs, and around one-fourth of those admitted to and
      under care in outpatient programs.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1745136
TI  - The failure of prevention.

PMID- 1745137
TI  - Mental retardation: new realities, new challenges.

PMID- 1745138
TI  - Use and impact of a cash subsidy program.
AB  - The use and impact of a $256.74 monthly cash subsidy by 1,283 families with
      children who have severe disabilities were examined. Families reported a variety
      of uses, including the purchase of clothing, toys, sitters, diapers, special
      foods, adaptive equipment, and professional services. Families at lower income
      levels used the subsidy to meet basic needs more often than did families at
      higher income levels. Families indicated that the subsidy was very helpful in
      meeting special needs and had improved family life, eased financial worries, and
      reduced stress. The influence of the availability of the subsidy on continuing
      family-based care was examined.

PMID- 1745139
TI  - Historical look at nursing in the field of mental retardation in the United
      States.
AB  - An account of nursing in the field of mental retardation was examined.
      Educational preparation, professional identity, workday, and salaries were
      discussed. The influence of attitudes towards persons with mental retardation on
      this nursing specialization was emphasized.

PMID- 1745140
TI  - Language analysis skills of children with mental retardation.
AB  - The ability of children with moderate mental retardation to analyze orally
      presented sentences into words and words into syllables and phonemes was studied.
      The subjects, aged 10 to 15, were grouped by method of reading instruction. All
      of them could analyze spoken sentences into words and words into syllables
      equally well. However, subjects receiving code-emphasis reading instruction
      performed significantly better on the more difficult phoneme manipulation tasks
      than did subjects receiving whole-word instruction. Results suggest that code
      emphasis reading instruction for some subjects with mental retardation should be
      used. Further research on linguistic analysis skills and the use of code-emphasis
      reading instruction in conjunction with linguistic awareness training with this
      population is warranted.

PMID- 1745141
TI  - Reimbursement of ICFs/MR program costs based on client resource use.
AB  - In this article we have described the impetus, research, and recommendations for
      a new reimbursement system based on client resource use for ICFs/MR in Minnesota.
      Research to develop a targeted reimbursement strategy has been completed and a
      proposal for basing program rates on client resource use developed. Residents (N
      = 913) in a stratified sample of 65 facilities were assessed and staff resource
      use determined. Results showed that although predictors in the area of personal
      interaction, integration, and independence, activities of daily living, special
      treatment/medical complexity, and behavior accounted for a significant amount of
      variation in resource use, the unaccounted for variation was sufficiently large
      to support recommending a system that will base program rates on individual
      client resource use and the historical costs of individual facilities. Key design
      issues were also discussed.

PMID- 1745142
TI  - Permanency planning by older parents who care for adult children with mental
      retardation.
AB  - In a study of 57 older parent caregivers of adult children with mental
      retardation, more than half had not planned for their child's future care.
      Income, race, child's gender and level of adaptive behavior, and degree of
      parental interaction with relatives and friends were significantly related to
      future care-planning activity.

PMID- 1745143
TI  - [Photodamage of gram-positive and gram-negative bacterial cells in the presence
      of chlorin e6 derivatives].
AB  - The kinetics of photoinduced damage sensitized by chlorine e6 and its derivatives
      was studied in Escherichia coli and Bacillus subtilis. The effectiveness of E.
      coli photoinactivation in the presence of chlorines was 100-200 times lower as
      compared with that of B. subtilis. The structural organisation of bacterial cell
      walls apparently played an essential role in the penetration of tetrapyrrole
      pigments into the cell and in their binding.

PMID- 1745144
TI  - [Detection of a wild population of yeast of the biological species Saccharomyces
      cerevisiae in Siberia].
AB  - A wild yeast population of Saccharomyces cerevisiae was found for the first time
      in Siberia, as was confirmed by hybridological analysis. The European cultivated
      S. cerevisiae strains were demonstrated to take their origin from Asia.

PMID- 1745145
TI  - [Determination of the immune potency of lymphocyte-promoting factor (LPF) and
      filamentous hemagglutinin (FHA) molecules by intranasal challenge in mice].
AB  - All mice immunized with toxoid LPF and FHA molecules were found to be protected
      against infections by intranasal instillation of Bordetella pertussis. While a
      significant weight loss was observed in control mice within ten days following
      challenge, immunized mice were found to gain weight. Mice immunized with 20
      micrograms doses of toxoid LPF were found to be also protected against
      intracerebral infection. FHA did not protect mice against such an infection.

PMID- 1745146
TI  - [Staphylococcal protein A, bacteriocin, DNase and lactamases of methicillin
      resistant Staphylococcus].
AB  - 231 Methicillin-Resistant Staphylococcus (MRS) and 76 Methicillin-Susceptible
      Staphylococcus (MSS) strains were investigated for Staphylococcal Protein A,
      bacteriocin, DNase and beta lactamase production properties. It was found that
      73.6% of the strains of MRS were positive for protein A, 3.8% for bacteriocin,
      76.2% for DNase and 84.4% for beta lactamase production. And it was found that
      61.8% of MSS strains were positive for protein A, 11.8% for bacteriocin, 55.2%
      for DNase and 57.9% for beta lactamase production. Staphylococcal protein A,
      DNase and lactamase production. Staphylococcal protein A, DNase and lactamase
      production were found to be significantly higher in MRS strains than MSS strains
      and bacteriocin production was found to be higher in MSS strains than MRS strains
      according to Chi Square Test.

PMID- 1745147
TI  - [Comparison of two different media-atmosphere combinations on the isolation of
      group A beta-hemolytic streptococci from throat cultures].
AB  - In this study effects of incubation of sheep blood agar medium in aerobic
      conditions and incubation of sulfamethoxazole-trimethoprim containing sheep blood
      agar medium in 5 to 10% CO2, of the isolation of group A beta hemolytic
      streptococci from throat cultures were compared. 608 throat swab specimens were
      studied. Each agar medium was evaluated after 24 and 48 hours of incubation
      period. The aerobic incubation of sheep blood agar plates for 24 hours yielded
      108 (17.7%) strains of beta hemolytic streptococci, of these 96 (15.8%) strains
      being group A. 113 (18.5%) strains of beta hemolytic streptococci were isolated
      after 48 hours of incubation and 100 (16.4%) of these were group A. The number of
      beta hemolytic streptococci isolated in 5 to 10% CO2 atmosphere for 24 hours was
      62 (10.2%), and 57 (9.3%) of these were group A. When the incubation period was
      prolonged to 48 hours, the total number of beta hemolytic streptococci isolated
      increased to 82 (13.5%) and 76 (12.5%) of these were determined as group A. The
      difference between these two combinations was significant for 24 hours of
      incubation, but not significant for 48 hours of incubation. The highest isolation
      rate for group A streptococci was achieved in aerobic incubation of sheep blood
      agar plates for 48 hours.

PMID- 1745148
TI  - [The value of laboratory tests for the early diagnosis of newborn sepsis].
AB  - In our study, laboratory tests were evaluated in the early diagnosis of newborn
      sepsis. The study consisted of 53 newborn infants with the diagnosis of suspected
      sepsis. Of the 53 newborn infants twenty seven were excluded from the study,
      because of negative blood culture. Remaining 26 newborns with positive blood
      culture and 15 healthy newborns comprised the study (sepsis group) and control
      group respectively. Total mature neutrophil count, immature/total neutrophil and
      immature/matur neutrophil ratio, toxic granulation changes, serum level of C
      reactive protein and haptoglobin were found statistically higher in sepsis group
      than control group. Thrombocyte count and serum level of IgG were significantly
      lower in sepsis group. Average total white blood cell count, result of nitroblue
      tetrazolium tests erythrocyte sedimentation rate and serum level of IgM was
      similar in both groups. We emphasized that hematological scoring system, serum
      level of C-reactive protein and haptoglobins can be used in the early diagnosis
      of newborn sepsis.

PMID- 1745149
TI  - [Effect of antisperm antibodies in male infertility].
AB  - Antisperm antibodies and their relationship with infertility has been
      investigated in semen and serum samples of 100 infertile and 25 fertile males.
      The investigation of antisperm antibodies has been done by latex agglutination
      test in semen samples and by ELISA procedure in serum samples. In addition, the
      semen samples have been investigation for several characteristics. Antisperm
      antibodies have been found 7% positive in blood and 30% positive in semen. In
      28.5% of the patients with positive antisperm antibodies in blood, antisperm
      antibodies in semen have also been found to be positive. For cases with
      infertility of unknown cause the antisperm antibodies ratio has been found to be
      significantly high (p less than 0.002). These results have shown the importance
      of further investigation of antisperm antibodies in cases with infertility of
      unknown reasons.

PMID- 1745150
TI  - [Distribution characteristics of hepatitis B surface antigen positivity in
      Bursa].
AB  - The ratio of HBsAg positivity among 9978 healthy blood donors by indirect
      hemagglutination (IHA) method was 4.8%. Positivity was 4.4% among donors coming
      from districts in Bursa. Positivity was higher among donors coming from boarding
      societies and villages (6.1% and 8.1%), they were significant (p less than 0.05
      and p less than 0.001). The highest positivity was found at the age group between
      16-25 years (6%). With older ages, positivity becomes less (at the age over 46
      ratio was 2.5%) and it was significant (p less than 0.001).

PMID- 1745151
TI  - [E. coli strains producing heat labile enterotoxin on Vero cells].
AB  - In this study heat-labile toxin (LT) producing strains of Enterotoxigenic
      Escherichia coli (ETEC) have been investigated by using Vero cell-line, which
      were isolated predominantly from the cultures of stool samples of 100 infants,
      aged between 0-2, with diarrhea. Among these strains 3% were found as toxin
      producers. These 3 strains were also detected as toxin producers and serotyped as
      O?:H12,LT(+); O?:H53,LT(-); (0126):H27,(LT)(-) at Statens Serum Institute
      (Denmark) International Escherichia and Klebsiella Centre.

PMID- 1745152
TI  - [Staphylococcus aureus nasal carriage in the normal population and hospital
      laboratory personnel].
AB  - Hospital personnel may be nasal carriers of S.aureus in a higher percentage of
      cases than in the general population. The aim of the present study was to compare
      the rate of nasal carriage of S.aureus in general population and hospital
      laboratory personnel. 144 of patients sent to our Microbiology laboratory for
      other reasons (i.e., Urine Culture, serology, etc.) were taken as general
      population, and 38 person from Microbiology, Biochemistry, Hematology, Immunology
      and Pathology Laboratories of our hospital were included the study as hospital
      laboratory personnel. S.aureus nasal carriage rates were found 28% (41/144) in
      normal population, and 31.5% (12/38) in hospital laboratory personnel. These
      figures are between normal population range. Therefore the rate of nasal carriage
      of S.aureus in our hospital, reflects probably normal population carrier rate,
      not the hospital colonization.

PMID- 1745153
TI  - [Salmonella enteritidis serovar tarshyne strains isolated from fecal specimens].
AB  - Seven Salmonella enteritidis serovar tarshyne strains were isolated from fecal
      specimens in 1989 and 1990 summer months.

PMID- 1745154
TI  - [A new respiratory tract pathogen].
AB  - Chlamydia pneumoniae strain TWAR, a newly described Chlamydia organism is a
      common cause of pneumonia and other acute respiratory tract infections. Most TWAR
      infections are mild or asymptomatic, but occasionally severe pneumonia in elderly
      patients or with on going chronic diseases has been observed. Population antibody
      prevalence has shown that TWAR infection is world-wide infection and an important
      health problem since under-developing countries where the high rate of child
      death is predominant, TWAR infections cause acute respiratory tract infection in
      children who are less than 5 yrs of age. Re-infection during life-time emphasizes
      the importance of Chlamydia pneumoniae.

PMID- 1745155
TI  - [Identification and treatment of group A beta-hemolytic streptococcus].
AB  - We examined the current developments and studies on identification, treatment and
      carrier states of group A beta haemolytic streptococcus, depending on the
      literature.

PMID- 1745156
TI  - The past, present and future of medicine.

PMID- 1745157
TI  - Doctors and genetic manipulation.

PMID- 1745158
TI  - Malaria prevention for travellers.

PMID- 1745159
TI  - The case for graduate schools of medicine in Australia.
AB  - The present length of the medical curriculum in Australia is, with one exception,
      six years. It is argued that the time is ripe for the development of some four
      year graduate schools from among the existing ten medical schools. Selection from
      a pool of university graduates would permit a greater degree of self-selection of
      motivated students able to perform well in tertiary studies. At present admission
      to medicine occurs mainly direct from secondary school. It is argued that
      graduate students entering medicine would be more broadly educated, more mature
      and more self-directed in their studies and career selection. The curricula of
      such graduate schools could foster better integration of scientific knowledge and
      clinical practice. Such graduate schools would be concordant with current
      priorities of national policies on higher education.

PMID- 1745160
TI  - The new pathway in general medical education at Harvard Medical School.

PMID- 1745161
TI  - Workshop on evaluating the undergraduate medical curriculum.

PMID- 1745162
TI  - The Flinders experiment in medical education revisited.
AB  - OBJECTIVE: The undergraduate medical curriculum of the Flinders University of
      South Australia is reviewed and evaluated against American recommendations for
      the basic education of doctors practising in the 21st century. DATA SOURCES: Two
      previous articles in The Medical Journal of Australia describing earlier versions
      of the Flinders curriculum and the report on General Professional Education for
      the Physician of the Association of American Medical Colleges. DATA SYNTHESIS:
      The Flinders curriculum attempts to fully integrate the teaching of medical
      science and clinical disciplines. The earliest version of the curriculum
      emphasised horizontal integration of normal structure and function of body
      systems, followed by abnormalities of these systems, and finally clinical
      practice. The second version introduced vertical integration of basic science and
      clinical medicine within a body system. The present version attempts to balance
      the demands of horizontal and vertical integration. An important feature of all
      versions is the large proportion of time allowed for elective studies in most
      years of the course. CONCLUSIONS: The Flinders curriculum has been able to adapt
      to the changing needs of medical education because its organisation is relatively
      free from the constraints of departmental rivalry over resources.

PMID- 1745163
TI  - Lead poisoning--a family study.
AB  - OBJECTIVE: A family study is used to highlight the varied manifestations of lead
      poisoning and difficulties in diagnosis and treatment. CLINICAL FEATURES: A 42
      year-old Italian woman with a known beta-thalassaemia trait presented with a two
      year history of disabling pains and symptomatic anaemia, which were found to be
      caused by lead poisoning. INTERVENTION AND OUTCOME: Screening for lead poisoning
      among her immediate family members identified two others with different
      manifestations of plumbism. All three needed active chelating, which resulted in
      resolution of their symptoms. CONCLUSIONS: The similar haematological findings of
      beta-thalassaemia and lead poisoning may lead to a delay in diagnosis and
      treatment of lead poisoning when these two conditions coexist.

PMID- 1745164
TI  - Acoustic neuroma.
AB  - OBJECTIVES: To present the clinical features, the diagnostic methods, and the
      techniques and results of surgical removal of acoustic neuromas, and to
      illustrate the lowered mortality and morbidity derived from improved imaging and
      the improved surgical results from a teamwork approach. DESIGN, SETTING AND
      PATIENTS: We review our consecutive series of 106 patients undergoing 119
      operations for acoustic neuroma at Royal Prince Alfred Hospital in Sydney between
      1977 and 1988. RESULTS: Forty-two operations were standard posterior fossa
      craniectomies. The mortality was 9.5%, preservation of facial nerve function was
      achieved in 48% of patients, and complete removal of tumour in 66% (42% of
      patients had a tumour larger than 3.5 cm). A translabyrinthine approach was used
      in 27 patients, with a mortality of 14% and no improvement in preservation of
      facial nerve function. The middle cranial fossa approach was used in six patients
      without mortality but with no better result in preservation of nerve function.
      The retrosigmoid approach was used in 44 patients with no mortality and
      preservation of facial nerve function in 86% of patients. CONCLUSIONS: Improved
      imaging and earlier diagnosis have led to improved surgical results, both in
      terms of reduced mortality and morbidity and in the preservation of function,
      particularly of the facial nerve, and at times also of hearing (mostly in
      patients with small tumours). The surgical results have been substantially
      improved by the formation of a cohesive and effective neuro-otology team to
      perform this intricate and protracted surgery.

PMID- 1745165
TI  - Imported malaria in Australia.
AB  - OBJECTIVE: To obtain information on imported malaria in Australia. DESIGN AND
      SETTING: Patients with malaria diagnosed by microscopy by laboratories in
      southeast Queensland and northern New South Wales between October 1987 and
      December 1988 were included in this study. The chi 2 test was used to analyse
      data. PATIENTS: Blood films, details of prophylactic regimens and clinical
      history were received from 146 patients. MAIN OUTCOME MEASURES: This study was to
      determine the percentage of patients infected with each malaria species, where
      they contracted their infections, whether they had taken appropriate prophylactic
      agents and to determine the relationship between parasitaemia and previous
      exposure, symptoms and prophylaxis. RESULTS: One hundred patients (68.5%) had
      Plasmodium vivax malaria and 33 patients (22.6%) had Plasmodium falciparum
      malaria, with 3 (2.1%) infected with both of these malaria species. Ten cases
      (6.8%) were presumptively diagnosed as infections but diagnosis by microscopy was
      uncertain. Seventy-four per cent of the P. vivax infections and 85% of the P.
      falciparum infections were contracted in Papua New Guinea. Patients presented
      with a range of blood parasite concentrations that did not correlate with their
      symptoms, previous infection with malaria (P greater than 0.25) or the regular
      taking of prophylactic drugs (P greater than 0.1). Only 41% of the patients took
      any prophylactic drugs; the figure for temporary visitors to malarious areas was
      54%. Only 11.6% of patients were taking the recommended drugs for the malarious
      areas they visited or were resident in. CONCLUSIONS: Constant monitoring of
      malarial infections is needed to ensure that appropriate advice is given to the
      traveller. Our study supports the dogma that malaria should be suspected in all
      patients who have been to malarious areas, regardless of previous malarious
      attacks, prophylaxis, treatment or the time which has elapsed since leaving the
      area.

PMID- 1745166
TI  - Heart attacks and the Newcastle earthquake.
AB  - OBJECTIVE: To test the hypothesis that stress generated by the Newcastle
      earthquake led to increased risk of heart attack and coronary death. DESIGN: A
      natural experiment. SUBJECTS: People living in the Newcastle and Lake Macquarie
      local government areas of New South Wales, Australia. INTERVENTION: At 10.27 a.m.
      on 28 December 1989 Newcastle was struck by an earthquake measuring 5.6 on the
      Richter scale. OUTCOME MEASURES: Myocardial infarction and coronary death defined
      by the criteria of the WHO MONICA Project and hospital admissions for coronary
      disease before and after the earthquake and in corresponding periods in previous
      years. Well established, concurrent data collection systems were used. RESULTS:
      There were six fatal myocardial infarctions and coronary deaths among people aged
      under 70 years after the earthquake in the period 28-31 December 1989. Compared
      with the average number of deaths at this time of year this was unusually high (P
      = 0.016). Relative risks for this four-day period were: fatal myocardial
      infarction and coronary death, 1.67 (95% confidence interval [Cl]: 0.72, 3.17);
      non-fatal definite myocardial infarction, 1.05 (95% Cl: 0.05, 2.22); non-fatal
      possible myocardial infarction, 1.34 (95% Cl: 0.67, 1.91); hospital admissions
      for myocardial infarction or other ischaemic heart disease, 1.27 (95% Cl: 0.83,
      1.66). There was no evidence of increased risk during the following four months.
      CONCLUSION: The magnitude of increased risk of death was slightly less than that
      previously reported after earthquakes in Greece. The data provide weak evidence
      that acute emotional and physical stress may trigger myocardial infarction and
      coronary death.

PMID- 1745167
TI  - Admissions for suspected snake bite to the Perth adult teaching hospitals, 1979
      to 1988.
AB  - OBJECTIVE: To describe the epidemiology of snake bite in Perth, and the
      likelihood of envenomation. DESIGN: Information from case notes was
      retrospectively analysed. SETTING: Emergency medicine, teaching hospitals.
      PATIENTS: All patients admitted to the three adult teaching hospitals in Perth
      for suspected snake bite from 1979 to 1988. MAIN OUTCOME MEASURE: Systemic
      envenomation, was accepted as present if there were definite symptoms, signs or
      laboratory evidence (vomiting, abdominal pain, ptosis, convulsions, difficulty
      with breathing or swallowing, coagulopathy, haemolysis, rhabdomyolysis or renal
      failure). RESULTS: Ninety-nine patients were definitely bitten, with 53
      envenomed, including three snake handlers. Thirty others may have been envenomed.
      Nearly half (44%) of the 82 patients with witnessed snake bite were envenomed.
      The dugite (Pseudonaja affinis) caused most cases of envenomation, most often
      producing coagulopathy only. The remainder were probably due to bites by the
      tiger snake (Notechis after occidentalis) and gwardar (Pseudonaja nuchalis), with
      one by a sea snake. The Commonwealth Serum Laboratories Snake Venom Detection Kit
      (VDK) enabled identification of the genus in 36% of definite cases of snake bite,
      and in 51% of cases of envenomation. It may occasionally produce false-positive
      results. The VDK is of greatest value in establishing the genus of snake in
      envenomed patients. CONCLUSIONS: It is suggested that a mixture of brown and
      tiger snake antivenom be used to treat patients envenomed by an unidentified
      snake in the Perth metropolitan area. This does not apply to patients bitten
      elsewhere in Western Australia or transferred to Perth from country regions where
      other snakes are more prevalent.

PMID- 1745168
TI  - The children of Chernobyl.
AB  - During the past twelve months much media attention has been focused on the plight
      of the children affected by the Chernobyl nuclear disaster in the Soviet Union.
      The visit to Australia by several groups of these children during 1991 has
      heightened community interest in the innocent victims of the world's worst
      nuclear accident. As medical adviser for one of these visits, I saw how some of
      the children of Chernobyl benefited from their holiday away from radioactivity.

PMID- 1745169
TI  - Radio aid to ships at sea.
AB  - OBJECTIVE: To review the first 30 months' experience in providing medical advice
      by radio to the masters of vessels in the Indian and Southern Oceans. The
      Department of Emergency Medicine at Fremantle Hospital has provided this service
      since October 1987. DESIGN: Details of all cases were collected prospectively.
      SETTING: The master of the ship communicates with the senior medical staff in the
      Department of Emergency Medicine by telex or radio-telephone. RESULTS: Seventy
      five patients were discussed in 30 months. They were aboard 68 ships from 17
      nations. Forty-eight patients has spontaneous illnesses, of which 41 were
      classified as medical and 7 surgical. Twenty-seven patients sustained injury. The
      most frequent medications advised by the doctor were analgesics and antibiotics.
      In 12% of cases, the doctor recommended that the ship change course significantly
      in order to discharge the patient to medical care. In another 11% of cases the
      patient was discharged at an unscheduled but nearby port, although not all of
      these diversions were urgent. CONCLUSIONS: Despite the difficulties in assessing
      a patient one cannot see, most illnesses can be diagnosed with a reasonable
      degree of certainty and useful treatment can be instituted aboard ship. Improving
      communication systems make the task easier, but variation in the contents of the
      pharmaceutical cabinets aboard ships is a problem.

PMID- 1745170
TI  - Murray Griffin and his Changi clinical paintings.

PMID- 1745171
TI  - The Order of Saint Lazarus of Jerusalem.

PMID- 1745172
TI  - Stains on the caring mantle. Doctors in aboriginal Australia have a history.
AB  - Doctors new to Aboriginal Australia are not infrequently surprised that their
      choice to work with the needy and underprivileged is not cause for unconditional
      positive regard. The naivete of this position reflects the assumption that the
      nature of medical work somehow separates doctors from other less caring Europeans
      who have intruded into Aboriginal Australia. In this paper the ambivalence with
      which medical professionals are viewed by Aborigines is explored through an
      examination of particular historical instances drawn from northern Australia,
      particularly the Kimberley region of Western Australia. It may be that a
      willingness to interrogate preconceived notions of privileged access will be in
      the best interests of the profession, and of doctors choosing to work in
      Aboriginal Australia.

PMID- 1745173
TI  - Doctors and opera.

PMID- 1745174
TI  - Nineteenth century masters of general practice.

PMID- 1745175
TI  - Male homosexuality.

PMID- 1745176
TI  - Tour of duty: studying tropical diseases in Thailand.

PMID- 1745177
TI  - Developments in surgical oncology--past, present, and future trends.
AB  - The historical development of integrated treatment programs for locally advanced
      or aggressive cancers, for which the results of surgical excision or radiotherapy
      are unsatisfactory, is reviewed. Chemotherapy should be used first (induction
      chemotherapy), while tumour vasculature is intact; intra-arterial infusion gives
      a greater regional effect. Central residual tumour may be eradicated by
      subsequent radiotherapy and/or surgery. Regional induction chemotherapy is
      particularly useful in treating locally advanced stage III breast cancer, locally
      advanced head and neck cancer, gastric cancer, and locally advanced sarcomas and
      melanomas of the limbs. A team approach, involving surgical and medical
      oncologists, radiotherapists, immunologists, and others should improve the
      results in these patients.

PMID- 1745178
TI  - Operation Habitat. Humanitarian aid to the Kurdish refugees in northern Iraq.

PMID- 1745179
TI  - The Royal Commission into Aboriginal Deaths in Custody. Aspects of medical
      interest.
AB  - The Royal Commission into Aboriginal Deaths in Custody was established in a
      climate of deep suspicion about the treatment of Aboriginal detainees in
      Australian prisons and police lock-ups. Three and a half years of exhaustive
      enquiry have resulted in a mammoth report which not only deals with the problems
      in the criminal justice system that contribute to these deaths but also discusses
      in detail the current state of Aboriginal society in Australia. It is the
      Commission's view that improvements in the lives of Aboriginal people will only
      occur if they are given the power to bring about those improvements themselves.
      The Commission's report inevitably has much to say about health matters. This
      review concentrates on these health matters as they affect Aboriginal people
      generally, and more specifically, after they arrive within the criminal justice
      system. The Commission's views about the medical aspects of the investigations of
      the deaths once they occurred are also summarised as are some of the issues which
      are at the root of why Aboriginal people are grossly over-represented in custody.

PMID- 1745180
TI  - Newborn screening in Australia and New Zealand 1984-1990. Human Genetics Society
      of Australasia/Australian College of Paediatrics Committee on Newborn Metabolic
      Screening.

PMID- 1745181
TI  - Successful limb salvage with prostaglandin infusion: a review of ergotamine
      toxicity.
AB  - OBJECTIVE: A case of severe acute peripheral arterial insufficiency secondary to
      ergotamine toxicity treated successfully with intravenously administered
      prostaglandin is presented to highlight the features of this condition and to
      demonstrate the efficacy of treatment with prostaglandin infusion. CLINICAL
      FEATURES: A 35-year-old unemployed Caucasian woman with a background of
      polypharmacy abuse and recurrent migraines presented to St Vincent's Hospital
      Emergency Department with limb-threatening ischaemia of both legs secondary to
      chronic ergotamine overuse. INTERVENTION AND OUTCOME: A prostaglandin infusion
      was started and a dramatic and rapid improvement of her peripheral circulation
      occurred within six hours. CONCLUSION: Ergotamine toxicity is an uncommon but
      well documented cause of peripheral vascular insufficiency that should be
      recognised and treated aggressively because its sequelae can be disastrous.
      Intravenously administered prostaglandin proved to be successful in this case and
      is a logical choice as first-line therapy for ergotamine toxicity.

PMID- 1745182
TI  - A surgeon on the Kokoda Trail.

PMID- 1745184
TI  - Inflammatory terminology.

PMID- 1745185
TI  - Three months in a hothouse.

PMID- 1745186
TI  - Optimisation of respiratory function.
AB  - OBJECTIVE: To apply pathophysiological principles in the management of patients
      with acute and chronic respiratory impairment. CONCLUSIONS: Knowledge of the
      pathophysiology of respiratory disorders is a key element in treatment of
      patients with impending or established respiratory failure. Therapies to improve
      and support abnormal gas exchange will minimise the complications of hypoxia and
      interventions to optimise ventilation and work of breathing may obviate the need
      for mechanical ventilation.

PMID- 1745187
TI  - The battle of the couches and the rats.

PMID- 1745188
TI  - Psychotherapy: from Freud to cognitive science.
AB  - A change in paradigm has occurred in psychotherapy. Dynamic psychotherapy has
      still not been shown to be better than placebo treatment or good clinical care.
      As harm can occur, patients should enter such therapy with caution. The cognitive
      behaviour therapies are newer and more efficient. They have been demonstrated to
      be better than placebo or good clinical care for anxiety and depression, and are
      of benefit in many less common disorders. Informative clinical trials are
      identified. Clinicians who treat patients with mental disorders should acquaint
      themselves with these techniques.

PMID- 1745189
TI  - Hepatic artery cytotoxic perfusion therapy after cryotherapy: a single patient
      control trial?

PMID- 1745190
TI  - Malignant Munchausen's.

PMID- 1745191
TI  - Sea snake envenomation.

PMID- 1745192
TI  - Taipan envenomation.

PMID- 1745193
TI  - Anaphylactoid reactions and vitamin K.

PMID- 1745194
TI  - Cardiac risk factor management.

PMID- 1745195
TI  - Danazol-carbamazepine interaction.

PMID- 1745196
TI  - Can infant death from child abuse be prevented?

PMID- 1745197
TI  - Asthma problems with Turbuhalers.

PMID- 1745198
TI  - Bricanyl overdose.

PMID- 1745199
TI  - Household electric shocks.

PMID- 1745200
TI  - Thrush in the ducts?

PMID- 1745201
TI  - Exposure to high tension power lines and childhood leukaemia.

PMID- 1745202
TI  - Pseudomonas fluorescens pseudobacteraemia.

PMID- 1745203
TI  - Pleurectomy for mesothelioma.

PMID- 1745204
TI  - Potential focus of fetuses unprotected against rubella.

PMID- 1745205
TI  - The war against drugs.

PMID- 1745206
TI  - Anesthesia and chronic hypertension.

PMID- 1745207
TI  - Cutaneous reactions to drugs.

PMID- 1745208
TI  - Treatment of the fetus in utero.

PMID- 1745209
TI  - Surfactant and surfactant replacement.

PMID- 1745210
TI  - Incidence of pulmonary embolism in total knee arthroplasty.
AB  - The end-tidal carbon dioxide concentration (ETCO2) of 47 patients undergoing
      prosthetic knee operations was monitored to detect pulmonary embolism during the
      anthroplasties. The ETCO2 of one patient dropped suddenly following the release
      of the tourniquet and insertion of the bone cement. Intracardiac aspiration did
      not reveal any air. At autopsy there was massive pulmonary thromboembolism and
      the deep veins of the right leg contained old formed thrombi. Patients undergoing
      such procedures should be investigated to exclude the presence of deep vein
      thrombosis so that measures to prevent pulmonary thromboembolism must be taken
      well in advance. As regards the occurrence of air embolism it is believed that
      insertion of the bone cement is the most important single factor in the
      prevention of air embolism during knee arthroplasty.

PMID- 1745211
TI  - Confirmation of correct tracheal intubation by a self-inflating bulb.

PMID- 1745212
TI  - Diffusion of an innovation: the first public demonstrations of general
      anesthesia.

PMID- 1745213
TI  - A taste of the matter.

PMID- 1745214
TI  - Hazard communication: what is it?

PMID- 1745215
TI  - Defending the use of laboratory animals.

PMID- 1745216
TI  - Ham operators respond.

PMID- 1745217
TI  - Support for vaginal surgery.

PMID- 1745218
TI  - Pharmacology woes.

PMID- 1745219
TI  - The failure of ciprofloxacin to prevent the progression of Streptococcus
      pneumoniae infections to meningitis.

PMID- 1745220
TI  - Pediatric knee pyarthrosis presenting as a calf abscess.

PMID- 1745221
TI  - Cancer of prostate metastatic to the skin diagnosed by immunoperoxidase staining.
AB  - The authors present a case in which the diagnosis of prostate cancer metastatic
      to the skin was made by skin biopsy with immunoperoxidase stains for prostatic
      specific antigen and prostatic acid phosphatase. These are tests that should be
      performed when the location of the primary malignancy is not otherwise evident.

PMID- 1745222
TI  - The mechanism of extrachromosomal homologous DNA recombination in plant cells.
AB  - By cotransfecting plasmids carrying particular mutations in the beta
      glucuronidase (GUS) gene into Nicotiana plumbaginifolia protoplasts and by
      monitoring the recombination rates using a recently developed transient assay, we
      were able to obtain insights into the mechanism of extrachromosomal recombination
      operating in plant cells. An exchange of flanking markers takes place in over 90%
      of the recombination events. In most of the remaining cases two consecutive,
      independent single crossover events occur. These events involve the same DNA
      substrate and lead to two successive exchanges of flanking markers, thus
      mimicking a presumed double crossover intermediate. A comparison of the outcome
      of our experiments with the predictions of two recombination models originally
      proposed for mammalian cells indicates that extrachromosomal recombination in
      plant cells is best described by the single strand annealing model. According to
      this model all recombination events result in an exchange of flanking markers.
      Our results rule out the double strand break repair model which predicts that
      flanking markers are exchanged in only half of all events.

PMID- 1745223
TI  - Pathogenesis-related protein 4 is structurally homologous to the carboxy-terminal
      domains of hevein, Win-1 and Win-2.
AB  - The extracellular, acidic pathogenesis-related protein, PR-4, was purified to
      homogeneity from leaves of Nicotiana tabacum infected with tobacco mosaic virus
      (TMV) and characterized by partial amino acid sequencing. Complementary DNA
      clones encoding PR-4 were isolated using an oligonucleotide probe based on the
      sequence of one of the peptides. The deduced PR-4 protein sequence was found to
      be related to a family of proteins including hevein and Win-1, which have an
      amino-terminal lectin domain and a carboxy-terminal domain of unknown function.
      PR-4 is homologous to the carboxy-terminus of these proteins but does not contain
      the lectin domain. Thus, the organization of the PR-4 family of proteins is
      similar to that of the plant chitinase family, in that both contain structural
      subclasses characterized by the presence or absence of an amino-terminal lectin
      domain. This observation is consistent with the proposal that the DNA encoding
      the lectin domain may be capable of transposing to form new genes encoding
      proteins of more complex, multi-domain structure. The expression of PR-4 mRNA was
      found to increase dramatically in response to TMV infection and the time course
      of RNA accumulation was similar to that of other PR proteins.

PMID- 1745224
TI  - Genetic analysis of a mutant class of Physcomitrella patens in which the polarity
      of gravitropism is reversed.
AB  - In the moss Physcomitrella patens, single-cell protonemata and multicellular
      gametophores respond to reorientation relative to the gravity vector by growing
      negatively gravitropically. A mutant class in which the protonemata, but not the
      gametophores, respond by growing towards gravity has been identified. In this
      paper, we describe the isolation of additional mutants of this class.
      Complementation and segregation ratio analyses were carried out on these mutants,
      which indicate that a single gene may mutate to switch the polarity of
      gravitropism.

PMID- 1745225
TI  - The yeast IMP1 gene is allelic to GAL2.
AB  - We have found that many laboratory strains of yeast are defective in galactose
      metabolism owing to a recessive mutation in the previously characterized nuclear
      gene, IMP1. This defect leads to a requirement for mitochondrial function for
      growth on, and metabolism of, galactose. Genetic background affects the degree to
      which cells are defective. In particular, alleles of GAL3 affect the ability to
      score the Imp phenotype. We have found that in imp1 strains, transcriptional
      induction of the galactose inducible genes (GAL1, 2, 7 + 10, MEL1) is normal, but
      galactose transport is reduced in both rho+ and rho0 cells. This phenotype is
      normally associated with mutations in GAL2, the galactose permease. Although the
      growth phenotypes of gal2 and imp1 mutants are distinct, we found that the
      transformation of imp1 rho0 strains with a plasmid containing the GAL2 gene
      allows these strains to grow on galactose. Initial genetic analyses did not
      demonstrate linkage between the GAL2 and IMP1 genes owing to the effects of an
      unlinked gene on the Imp phenotype. By disrupting the GAL2 gene in an Imp+
      background, we have shown that IMP1 and GAL2 segregate as tightly linked genes.
      Based on these data, we believe that imp1 is a partially defective allele of the
      GAL2 gene.

PMID- 1745226
TI  - Molecular cloning and nucleotide sequence of the glycogen branching enzyme gene
      (glgB) from Bacillus stearothermophilus and expression in Escherichia coli and
      Bacillus subtilis.
AB  - The structural gene for the Bacillus stearothermophilus glycogen branching enzyme
      (glgB) was cloned in Escherichia coli. Nucleotide sequence analysis revealed a
      1917 nucleotide open reading frame (ORF) encoding a protein with an Mr of 74787
      showing extensive similarity to other bacterial branching enzymes, but with a
      shorter N-terminal region. A second ORF of 951 nucleotides encoding a 36971 Da
      protein started upstream of the glgB gene. The N-terminus of the ORF2 gene
      product had similarity to the Alcaligenes eutrophus czcD gene, which is involved
      in cobalt-zinc-cadmium resistance. The B. stearothermophilus glgB gene was
      preceded by a sequence with extensive similarity to promoters recognized by
      Bacillus subtilis RNA polymerase containing sigma factor H (E - sigma H). The
      glgB promoter was utilized in B. subtilis exclusively in the stationary phase,
      and only transcribed at low levels in B. subtilis spoOH, indicating that sigma
      factor H was essential for the expression of the glgB gene in B. subtilis. In an
      expression vector, the B. stearothermophilus glgB gene directed the synthesis of
      a thermostable branching enzyme in E. coli as well as in B. subtilis, with
      optimal branching activity at 53 degrees C.

PMID- 1745227
TI  - Growth phase-dependent modification of RNA polymerase in Escherichia coli.
AB  - During the transition of Escherichia coli cultures from exponential growth to
      stationary phase, the pre-existing RNA polymerase was found to be converted into
      at least three different holoenzyme forms, which could be separated by
      phosphocellulose column chromatography. The relative levels of these three
      holoenzyme forms changed depending on the phase of cell growth. The altered
      stationary phase forms of RNA polymerase showed promoter recognition properties
      that were different from those of the holoenzyme from exponentially growing
      cells. Enzyme reconstitution experiments showed that the altered promoter
      selectivity was due to modification of the core enzyme. We propose that
      modulation of RNA polymerase plays a role in the global switch of gene expression
      during the transition from exponential growth to stationary phase.

PMID- 1745228
TI  - Association of cytochrome b translational activator proteins with the
      mitochondrial membrane: implications for cytochrome b expression in yeast.
AB  - The products of the nuclear genes CBS1 and CBS2 are both required for
      translational activation of mitochondrial apocytochrome b in yeast. We report the
      intramitochondrial localization of both proteins by use of specific antisera.
      Based on its solubilization properties the CBS1 protein is presumed to be a
      component of the mitochondrial membrane; the detergent concentrations needed to
      release CBS1 from mitochondria are almost the same as for cytochrome c1. In
      contrast, CBS2 behaves like a soluble protein, with some characteristics of a
      membrane-associated protein. A model is presented for translational activation of
      cytochrome b, which might also be applicable to translational regulation of other
      mitochondrial genes.

PMID- 1745229
TI  - Concurrent transcription from the gid and mioC promoters activates replication of
      an Escherichia coli minichromosome.
AB  - The origin of replication of the Escherichia coli chromosome (oriC) is located in
      an intercistronic region between the gidA and the mioC genes. The possibility
      that transcription from the promoters of these two genes is involved in
      minichromosome replication was examined. Inactivation of the gid promoter led to
      a reduction in transformation frequency with an oriC plasmid but inactivation of
      the mioC promoter did not. The decrease in transformation frequency was most
      pronounced when both promoters were inactive. Under conditions that selected for
      plasmid-harboring cells, mutation of the gid promoter caused efficient
      multimerization or integration of oriC plasmids into the chromosomal oriC region
      and loss of free plasmid molecules. These changes in plasmid structure were also
      observed, albeit less frequently, with some plasmids defective in mioC promoter
      activity. In an in vitro DNA replication system for oriC DNA, plasmids with a
      defective gid promoter had greatly reduced template activity and essentially no
      replication occurred when both promoters were inactive. These results suggest
      that coupled transcription starting from the gid as well as the mioC promoter
      activates initiation of plasmid replication, the major contribution being made by
      gid transcription. These two promoters are suggested to be under stringent
      control.

PMID- 1745230
TI  - Homologous recombination between plasmid DNA molecules in maize protoplasts.
AB  - The requirements for homologous recombination between plasmid DNA molecules have
      been studied using the PEG (polyethylene glycol)-mediated transformation system
      of maize (Zea mays L.) protoplasts coupled with the transient expression assay
      for beta-glucuronidase (GUS). Two plasmids were introduced into maize
      protoplasts; one plasmid (pB x 26) contained a genomic clone of the Adh1 maize
      gene; the other plasmid (piGUS) was a promoterless construction containing part
      of intron A of the Adh1 gene fused to the gusA coding sequence. Thus, the two
      vectors shared an effective homologous region consisting of a 459 bp (HindIII
      PvuII) fragment of the Adh1 intron A sequence. An active gusA fusion gene would
      result upon homologous recombination between the plasmids within the intron A
      sequence, and indeed GUS activity was observed in extracts following co
      transformation of maize protoplasts with the two plasmids. The presence of
      recombinant DNA molecules in protoplast DNA isolated 1 day after co
      transformation was verified using polymerase chain reactions (PCR) and Southern
      blots. For efficient homologous recombination, both plasmids had to be
      linearized. The recombination reaction was induced by restriction of the plasmid
      molecules either inside the effective homologous region or at the borders of the
      intron sequence. However, the presence of even small, terminal, nonhomologous
      sequences at the 3' end of the pB x 26 fragment inhibited the recombination
      reaction. Also, both ends of the linearized piGUS DNA molecules were involved in
      the recombination reaction. The results revealed some features of homologous
      recombination reactions occurring in plant cells which cannot be accommodated by
      mechanisms postulated for similar reactions in animal system and in lower
      eukaryotes.

PMID- 1745231
TI  - Investigation of cis-acting sequences regulating expression of the gene encoding
      yolk protein 3 in Drosophila melanogaster.
AB  - The regulatory sequences leading to the ovarian and fat body expression of yolk
      proteins 1 and 2 (YP1 and 2) of Drosophila melanogaster have been characterised
      in some detail. These genes (yp1 and yp2) share many enhancer elements, and some
      important regulatory sequences lie within the coding regions. We have begun to
      investigate the cis-regulation of the gene encoding yolk protein 3 (yp3). We
      describe a system for P element transformation using the complete and unaltered
      yp3 gene rather than reporter genes and describe sequences conferring correct
      expression in the ovary and carcass.

PMID- 1745232
TI  - TFS1: a suppressor of cdc25 mutations in Saccharomyces cerevisiae.
AB  - The TFS1 gene of Saccharomyces cerevisiae is a dosage-dependent suppressor of
      cdc25 mutations. Overexpression of TFS1 does not alleviate defects of temperature
      sensitive adenylyl cyclase (cdc35) or ras2 disruption mutations. The ability of
      TFS1 to suppress cdc25 is allele specific: the temperature-sensitive cdc25-1
      mutation is suppressed efficiently but the cdc25-5 mutation and two disruption
      mutations are only partially suppressed. TFS1 maps to a previously undefined
      locus on chromosome XII between RDN1 and CDC42. The DNA sequence of TFS1 contains
      a single long open reading frame encoding a 219 amino acid polypeptide that is
      similar in sequence to two mammalian brain proteins. Insertion and deletion
      mutations in TFS1 are haploviable, indicating that TFS1 is not essential for
      growth.

PMID- 1745233
TI  - Highly bioluminescent Bacillus subtilis obtained through high-level expression of
      a luxAB fusion gene.
AB  - Bioluminescence levels comparable to those achievable in Escherichia coli have
      yet to be obtained from luxAB expression in gram-positive bacteria. In this
      communication we describe the gene engineering required to generate a highly
      bioluminescent derivative of Bacillus subtilis. The combination of a powerful
      promoter, Pxyn, a fusion derivative of luxAB from Vibrio harveyi and
      translational coupling have overcome the previously reported limitations in luxAB
      expression. The implications for highly bioluminescent gram-positive organisms
      are discussed.

PMID- 1745234
TI  - Comparison of the sequences of the nagE operons from Klebsiella pneumoniae and
      Escherichia coli K12: enhanced variability of the enzyme IIN-acetylglucosamine in
      regions connecting functional domains.
AB  - The nagE operon, encoding the enzyme II specific for N-acetylglucosamine
      (EIINag), and adjacent DNA from the chromosome of Klebsiella pneumoniae were
      sequenced and compared with the corresponding sequence from Escherichia coli K12.
      The deduced EIINag sequences differ in 72 out of 651 amino acids, the K.
      pneumoniae sequence being three residues longer. The amino acid differences were
      distributed unevenly, and were most frequent in regions connecting the three
      functional domains of the protein. In the nagE-nagB intergenic region, two
      promoter, two operator, and one CAP consensus sequence with regulatory functions
      were highly conserved. The nag structural genes from both species were very
      similar (83% DNA similarity; 89% amino acid similarity) except for frequent AT to
      GC exchanges in the wobble base of codons in K. pneumoniae DNA relative to the E.
      coli DNA.

PMID- 1745235
TI  - Nuclear migration in Saccharomyces cerevisiae is controlled by the highly
      repetitive 313 kDa NUM1 protein.
AB  - We have isolated a novel gene (NUM1) with unusual internal periodicity. The NUM1
      gene encodes a 313 kDa protein with a potential Ca2+ binding site and a central
      domain containing 12 almost identical tandem repeats of a 64 amino acid
      polypeptide. num1-disrupted strains grow normally, but contain many budded cells
      with two nuclei in the mother cell instead of a single nucleus at the bud neck,
      while all unbudded cells are uninucleate. This indicates that most G2 nuclei
      divide in the mother before migrating to the neck, followed by the migration of
      one of the two daughter nuclei into the bud. Furthermore, haploid num1 strains
      tend to diploidize during mitosis, and homozygous num1 diploid or tetraploid
      cells sporulate to form many budded asci with up to eight haploid or diploid
      spores, respectively, indicating that meiosis starts before nuclear
      redistribution and cytokinesis. Our data suggest that the NUM1 protein is
      involved in the interaction of the G2 nucleus with the bud neck.

PMID- 1745236
TI  - Carbon-starvation induction of the ugp operon, encoding the binding protein
      dependent sn-glycerol-3-phosphate transport system in Escherichia coli.
AB  - The gene products of the ugp operon of Escherichia coli are responsible for the
      uptake of sn-glycerol-3-phosphate and certain glycerophosphodiesters. The
      regulation of ugp is mainly phoBR-dependent. Significant expression, however, can
      be observed even in the presence of high concentrations of phosphate, a condition
      which normally completely represses pho expression. Pho-independent ugp
      expression was found to be derepressed during the late logarithmic growth phase
      due to carbon starvation. Among different carbon sources tested, glucose caused
      the most complete repression. Addition of cAMP prevented glucose repression,
      indicating that a cAMP-CRP control mechanism may be directly or indirectly
      involved in the carbon-starvation response. This conclusion is supported by the
      fact that pho-independent ugp expression correlated with the presence of the cya
      and crp gene products.

PMID- 1745237
TI  - Codon usage in Aspergillus nidulans.
AB  - Synonymous codon usage in genes from the ascomycete (filamentous) fungus
      Aspergillus nidulans has been investigated. A total of 45 gene sequences has been
      analysed. Multivariate statistical analysis has been used to identify a single
      major trend among genes. At one end of this trend are lowly expressed genes,
      whereas at the other extreme lie genes known or expected to be highly expressed.
      The major trend is from nearly random codon usage (in the lowly expressed genes)
      to codon usage that is highly biased towards a set of 19-20 "optimal" codons. The
      G + C content of the A. nidulans genome is close to 50%, indicating little
      overall mutational bias, and so the codon usage of lowly expressed genes is as
      expected in the absence of selection pressure at silent sites. Most of the
      optimal codons are C- or G- ending, making highly expressed genes more G + C-rich
      at silent sites.

PMID- 1745238
TI  - Characterization of the supervirulent virG gene of the Agrobacterium tumefaciens
      plasmid pTiBo542.
AB  - The virG gene of the Agrobacterium tumefaciens Ti plasmid pTiBo542 has previously
      been reported to elicit stronger vir gene expression than its counterpart in the
      pTiA6 plasmid, a property we call the "superactivator" phenotype. The DNA
      sequence of the pTiBo542 virG gene was determined and compared to that of the
      pTiA6 gene. The DNA sequences of these genes differ at 16 positions: two
      differences are in the promoter regions, 12 are in the coding regions, and two
      are in the 3' untranslated regions. The 3' end of the pTiA6 virG gene also
      contains a probable insertion sequence that is not found downstream of the
      pTiBo542 gene. The base pair differences, in the two coding regions result in
      only two amino acid differences, both in the amino-terminal halves of the
      proteins. Five hybrid virG genes were constructed and used to activate the
      expression of a virB::lacZ gene fusion. Differences in the coding regions of
      these genes accounted for most of the superactivator phenotype, while differences
      at the promoter and 3' untranslated regions also contributed. These findings
      suggest that the properties of these VirG proteins and their quantities are
      important for vir gene induction, and also suggest a long-term selective pressure
      for mutations contributing to differences between these two genes.

PMID- 1745239
TI  - Isolation of mutants of Arabidopsis thaliana in which accumulation of tobacco
      mosaic virus coat protein is reduced to low levels.
AB  - We have found that Arabidopsis thaliana is susceptible to infection with a
      crucifer strain of tobacco mosaic virus (TMV-Cg); the coat protein of TMV-Cg
      accumulated to a high level in uninoculated rosette leaves several days after
      inoculation. As a first step in the search for host-coded factors that are
      involved in virus multiplication, we isolated mutants of A. thaliana in which the
      accumulation of TMV-Cg coat protein was reduced to low levels. Of 6000 M2 plants
      descended from ethyl methanesulfonate-treated seeds, two such lines (PD114 and
      PD378) were isolated. Genetic analyses suggested that the PD114 phenotype was
      caused by a single nuclear recessive mutation, and that PD114 and PD378 belonged
      to the same complementation group. The coat protein accumulation of a tomato
      strain of TMV (TMV-L) was also reduced in PD114 plants compared to that in the
      wild-type plants. In contrast, PD114 plants infected with turnip crinkle or
      turnip yellow mosaic viruses, which belong to taxonomic groups other than
      Tobamovirus, expressed similar levels of these coat proteins as did infected wild
      type plants.

PMID- 1745240
TI  - Molecular analysis of the Escherichia coli hns gene encoding a DNA-binding
      protein, which preferentially recognizes curved DNA sequences.
AB  - We previously demonstrated that the E. coli protein, H-NS (or H1a), encoded by
      the gene hns (or osmZ or bglY) preferentially recognizes curved DNA sequences in
      vitro. In order to gain further insight into the complex function of H-NS and the
      significance of DNA curvature, we constructed a structurally defined hns deletion
      mutant on the E. coli chromosome. The hns deletion mutant thus obtained showed a
      variety of phenotypes previously for other lesions in hns. It was further
      demonstrated that, in this hns deletion background, numerous E. coli cellular
      proteins were either strongly expressed or remarkably repressed, as compared to
      their expression levels in wild-type cells.

PMID- 1745241
TI  - Cloning and expression analysis of a potato cDNA that encodes branching enzyme:
      evidence for co-expression of starch biosynthetic genes.
AB  - One of the key enzymes involved in the formation of amylopectin, which is the
      major component of starch, is branching enzyme. A cDNA for potato branching
      enzyme was cloned by screening a tuber-specific cDNA expression library using an
      antiserum directed against a denatured preparation of the protein.
      Complementation of an Escherichia coli strain deficient in branching enzyme was
      achieved using a construct derived from this clone. Analysis of the expression of
      the gene in potato revealed a close association with conditions favouring starch
      biosynthesis. The expression pattern of the gene coding for potato branching
      enzyme, as analyzed at the mRNA level, closely resembles that of AGPase S, a gene
      coding for one of the subunits of ADP-glucose pyrophosphorylase, which is the key
      regulatory enzyme in the starch biosynthetic pathway. This raises the possibility
      that enzymes involved in the pathway are coordinately regulated at the
      transcriptional level.

PMID- 1745242
TI  - Evidence for binding of at least two factors, including T-rich strand-binding
      factor(s) to the single-stranded ARS1 sequence in Saccharomyces cerevisiae.
AB  - To study the mechanism of initiation of eukaryotic chromosomal replication, we
      examined protein factors interacting with the ARS1 region located near the
      centromere of chromosome IV in Saccharomyces cerevisiae. Using the gel shift
      assay, we found protein factor(s) which specifically bound to the T-rich strand
      of the region containing the core consensus and its flanking sequences in ARS1,
      but not to the opposite strand. We designated this factor ATS (ARS1, T-rich
      strand-binding factor(s]. Similar specific complexes were also detected with
      oligonucleotide probes specific for the H4 or C2G1 ARS. As we have previously
      identified another binding factor, we conclude that at least two factors bind to
      the single-stranded ARS1 sequence.

PMID- 1745243
TI  - Targeted disruption of chloroplast genes in Chlamydomonas reinhardtii.
AB  - We have developed an efficient procedure for the disruption of Chlamydomonas
      chloroplast genes. Wild-type C. reinhardtii cells were bombarded with
      microprojectiles coated with a mixture of two plasmids, one encoding selectable,
      antibiotic-resistance mutations in the 16S ribosomal RNA gene and the other
      containing either the atpB or rbcL photosynthetic gene inactivated by an
      insertion of 0.48 kb of yeast DNA in the coding sequence. Antibiotic-resistant
      transformants were selected under conditions permissive for growth of non
      photosynthetic mutants. Approximately half of these transformants were initially
      heteroplasmic for copies of the disrupted atpB or rbcL genes integrated into the
      recipient chloroplast genome but still retained photosynthetic competence. A
      small fraction of the transformants (1.1% for atpB; 4.3% for rbcL) were
      nonphotosynthetic and homoplasmic for the disrupted gene at the time they were
      isolated. Single cell cloning of the initially heteroplasmic transformants also
      yielded nonphotosynthetic segregants that were homoplasmic for the disrupted
      gene. Polypeptide products of the disrupted atpB and rbcL genes could not be
      detected using immunoblotting techniques. We believe that any nonessential
      Chlamydomonas chloroplast gene, such as those involved in photosynthesis, should
      be amenable to gene disruption by cotransformation. The method should prove
      useful for the introduction of site-specific mutations into chloroplast genes and
      flanking regulatory sequences with a view to elucidating their function.

PMID- 1745244
TI  - Specificity of recA441-mediated (tif-1) mutational events.
AB  - To investigate the impact of SOS induction on the distribution of spontaneous
      mutation, 111 recA441-mediated mutations were characterized at the DNA sequence
      level in the lacI gene of Escherichia coli. A 2.6-fold enhancement in lacI-
      mutation frequency was observed after induction of the SOS system in the absence
      of mutagenic treatment, and specific classes of mutational events were induced.
      G:C----C:G, G:C----T:A and A:T----T:A transversion events were specifically
      enhanced after SOS induction. A preferential 5'-Y-Purine-3' neighbouring base
      specificity for these transversion events is reported here (normalised for
      mutation of the purine residue). In addition, a preference for transversion
      events at 5'-C/GTGG-3' sequences is also observed. Fifty events were recovered at
      the lacI "frameshift hotspot site" and were equally represented by 4 bp addition
      and deletion events. This 1:1 ratio deviates significantly from the 4:1
      distribution characteristic of spontaneous frameshift mutation in the RecA+
      background and is a consequence of the fourfold induction of the (-)4 event. This
      abberrant distribution was confirmed by oligomeric probing of 474 independent
      recA441-mediated spontaneous lacI- mutations.

PMID- 1745245
TI  - Ribosomal protein S14 is not responsible for the Minute phenotype associated with
      the M(1)7C locus in Drosophila melanogaster.
AB  - A locus associated with a severe Minute effect has been mapped at 7C on the X
      chromosome of Drosophila melanogaster. Previous work has suggested that this
      Minute encodes ribosomal proteins S14A and S14B. We have made a chromosomal
      deficiency that removes the S14 ribosomal protein genes, yet does not display the
      Minute phenotype. These data suggest that the S14 genes do not actually
      correspond to the Minute locus.

PMID- 1745246
TI  - Alteration of an amino acid residue outside the active site of the ricin A chain
      reduces its toxicity towards yeast ribosomes.
AB  - Yeast transformants containing integrated copies of a galactose-regulated, ricin
      toxin A chain (RTA) expression plasmid were constructed and used in an attempt to
      isolate RTA-resistant yeast mutants. Analysis of RNA from mutant strains
      demonstrated that approximately half contained ribosomes that had been partially
      modified by RTA, although all the strains analysed transcribed full-length RTA
      RNA. The mutant strains could have mutations in yeast genes giving rise to RTA
      resistant ribosomes or they could contain alterations within the RTA-encoding DNA
      causing production of mutant toxin. Ribosomes isolated from mutant strains were
      shown to be susceptible to RTA modification in vitro suggesting that the strains
      contain alterations in RTA. This paper describes the detailed analysis of one
      mutant strain which has a point mutation that changes serine 203 to asparagine in
      RTA protein. Although serine 203 lies outside the proposed active site of RTA its
      alteration leads to the production of RTA protein with a greatly reduced level of
      ribosome modifying activity. This decrease in activity apparently allows yeast
      cells to survive expression of RTA as only a proportion of the ribosomes become
      modified. We demonstrate that the mutant RTA preferentially modifies 26S rRNA in
      free 60S subunits and has lower catalytic activity compared with native RTA when
      produced in Escherichia coli. Such mutations provide a valuable means of
      identifying residues important in RTA catalysis and of further understanding the
      precise mechanism of action of RTA.

PMID- 1745247
TI  - Genetic and biochemical characterization of little isoxanthopterin (lix), a gene
      controlling dihydropterin oxidase activity in Drosophila melanogaster.
AB  - Dihydropterin oxidase catalyses the oxidation of 7,8-dihydropteridines into their
      fully oxidized products, and is involved in the biosynthesis of isoxanthopterin.
      Fifteen Drosophila melanogaster mutants, selected for their low pterin and
      isoxanthopterin content, were assayed for dihydropterin oxidase activity. The
      activity was around 100% in most mutants tested, slightly reduced in red, g and
      dke, and undetectable in lix. In flies carrying various doses of the lix+ allele,
      a correlation was found between enzyme activity and the number of lix+ copies in
      the genome. The results suggest that lix is the structural gene for the
      dihydropterin oxidase enzyme. Isoxanthopterin was quantitated in strains carrying
      deficiencies for the region in which lix has been mapped by recombination. This
      allowed us to assign the lix locus to the 7D10-7F1-2 segment of the X chromosome.

PMID- 1745248
TI  - [Effect of intermittent catheterization on urinary tract infections and
      incontinence in children with spina bifida].
AB  - Although the primary objective of clean intermittent (self) catheterization (CIC)
      was to regain continence in (older) children with myelomeningocele (MMC), we used
      the method also in the very young with detrusor-sphincter dyssynergia, to prevent
      future damage from the combined effects of obstruction and urinary tract
      infection (UTI). The results, in terms of incidence of UTI and degree of
      incontinence before and during CIC, were assessed in 61 children with MMC who had
      started CIC between 1985 and 1988. Mean follow up was 45.3 +/- 27.3 months, mean
      age at the start of CIC was 6.9 +/- 4.6 years. The incidence of UTI during CIC
      proved significantly lower than before CIC (chi 2 = 20.92, p less than 0.001),
      and the improvement in incontinence was also statistically significant (chi 2 =
      45.16, p less than 0.001). In children with MMC, CIC seems ideally suited to
      prevent damage to the kidneys from the life-long problem of recurrent UTI's. It
      will also help in preventing bladder wall fibrosis--an important cause of loss of
      detrusor compliance--secondary to repeated UTIs.

PMID- 1745249
TI  - [Occupational training measures for adolescents with asthma and allergy: one-year
      vocational education].
AB  - The "Forderungslehrgang" in our asthma center is a special training program for
      adolescents handicapped by asthma or allergic diseases who are therefore not able
      to start apprenticeship. The course takes one year. Besides vocational guidance
      and tryout of different occupations, medical and psychological diagnostics are
      performed. Medical service is provided all day, and a hospital with emergency
      unit is within the area. Though 41% of the participants did finish school without
      any qualified graduation after their compulsory school attendance, 79% were able
      to start apprenticeship after the course.

PMID- 1745250
TI  - [Atypical pathogen spectrum in community-acquired infections of the lower
      respiratory tract in childhood].
AB  - Over a period of 14 months, we obtained nasal and throat swabs for virological
      examinations from patients, admitted to hospital with suspected pneumonia. Fifty
      five cases of perihilar bronchitis and 103 cases of pneumonia were diagnosed
      based on radiological criteria. In 36% (n = 57) of the children, a pathogen could
      be determined by antigen ELISA. We found the following spectrum: Respiratory
      syncytial virus: 42%; Influenza A: 8%; Influenza B: 10%; Parainfluenza 1: 3%;
      Parainfluenza 2: 10%; Parainfluenza 3: 2%; Chlamydia: 17%; and Mycoplasma
      pneumoniae (serology only): 7%. In a control group of 59 healthy children, only
      one child showed a pathogen. In the past, viruses and Chlamydia have been
      underestimated as causes of lower respiratory tract infections. Antigen
      determination by ELISA has proved to be a reliable and rapid method for their
      detection.

PMID- 1745251
TI  - [Evaluation of the bilirubinometer Hico-Bilimat A 700].
AB  - The Hico-Bilimeter A 700 is a simple filter photometer for the determination of
      total bilirubin in neonatal serum, reading the absorbance of the undiluted sample
      at two wavelengths. Precision of the measurements is good, with linearity
      acceptable up to a concentration of 18 mg/dl. Compared to the values obtained
      with the reference method the results below 18 mg/dl are 16% too high on average;
      above 18 mg/dl the scatter of results is markedly increased. Even a moderate
      hemolysis shows a distinct influence on the measurements. Using the instrument
      tested no reliable results could be obtained, especially in hemolytic samples.

PMID- 1745252
TI  - [Therapy of hyperammonemia in carbamyl phosphate synthase deficiency with
      peritoneal dialysis and venovenous hemofiltration].
AB  - Inborn errors of metabolism with hyperammonaemia cause emergency situations with
      unconsciousness, convulsion, hyperpnoea and hyperpyrexia. Therefore
      hyperammonaemia has to be treated immediately after diagnosis to avoid
      irreversible damage. Two newborns with carbamylphosphates synthetase deficiency
      are described. Both, continuous peritoneal dialysis and venovenous
      haemofiltration have proved to be effective methods to reduce serum ammonia
      concentration to values of less than 300 mu/l. Because of the severity of the
      enzyme defect in both cases, (carbamylphosphate synthetase was not detectable in
      liver tissue), treatment finally had to be stopped, and both patients died.

PMID- 1745253
TI  - [Clinical aspects and allergy-immunologic parameters in 40 children 0-7 years of
      age with atopic dermatitis].
AB  - Forty children with atopic dermatitis were evaluated for history, clinical
      features and allergologic-immunologic parameters. Lichenoid skin lesions were
      found in 67.5%, follicular lesions in 57.5%, and eczematoid lesions in 50% in
      children. 25% of children suffered from associated food allergy, 15% from
      respiratory atopy, and 5% from contact urticaria. The diagnostic efficiency to
      show specific sensitization was 93% for Pediatric Phadiatop, 90% for Food
      Multidisc (fx5 Pharmacia), 88% for skin tests (Prick), 73% for elevated total
      serum IgE, 65% for Phadiatop, and 60% for family history. The classification of
      atopic dermatitis into an extrinsic type with specific sensitizations to
      allergens and into an intrinsic type without specific sensitizations appears to
      be useful because specific sensitizations significantly correlate with severer
      skin condition and disease course.

PMID- 1745254
TI  - [Hallervorden-Spatz syndrome. Indicative findings in cranial computerized and
      magnetic resonance tomography for intra vitam diagnosis].
AB  - We report the case of a female patient with a progressive therapy-resistant
      extrapyramidal movement disorder. Cranial computed tomography showed symetrical
      hyperdensities in the globus pallidus. The same areas are of decreased signal
      intensity in magnetic resonance imaging. These findings suggest an increased iron
      accumulation. The clinical symptoms and the radiological findings of the cerebrum
      are highly indicative for a Hallervorden-Spatz disease.

PMID- 1745255
TI  - [Laryngeal atresia in an infant with chondrodysplasia punctata, rhizomelic type].
AB  - Laryngeal atresia had to be unexpectedly detected and treated in a newborn baby.
      The outer appearance with symmetric shortening of humeri and femora and
      radiological features with epiphysial and extraepiphysial calcifications led to
      the diagnosis of rhizomelic chondrodysplasia punctata. This disease is described
      as a peroxisomal disorder with a poor prognosis on the basis of
      pathophysiological and diagnostic features.

PMID- 1745256
TI  - [Cystic space occupying lesion of the upper pole of the kidney in a newborn
      infant. Case report and differential diagnosis].
AB  - In a newborn female infant a cystic lesion in the upper pole of the right kidney
      was detected by sonography 4 weeks before an uneventful delivery. In the
      postnatal period the sonographic examination, IVP, CT, and the biochemical data
      as well were not able to classify definitely this lesion as a benign cyst,
      adrenal hemorrhage or cystic malignoma. Therefore a laparatomy was performed,
      which revealed a cystic neuroblastoma.

PMID- 1745257
TI  - [Linear IgA dermatosis in childhood].
AB  - In a six-year-old girl with linear IgA dermatosis of childhood there were lesions
      with typical rosette like configuration, crusted erosions and isolated bullae on
      apparently normal skin. The histopathology revealed subepidermal blister and
      superficial perivascular lymphohistiocytic infiltrate with many neurophils and
      some eosinophils. Direct immunofluorescence examination showed linear deposits of
      IgA along the basal membrane zone. Circulating antibodies were absent. Therapy
      with dapsone in a dose of 25 mg/day was effective.

PMID- 1745258
TI  - [Risk of recurrent seizures after the first afebrile grand mal seizure in
      childhood].
AB  - A cohort of 74 children three months to 16 years-old who presented with a first
      unprovoked seizure were followed for five years to assess the risk of recurrence.
      Children with febrile convulsions, immediate posttraumatic seizures, meningitis
      and encephalitis were not included. The risk of recurrence was 68% for a second
      seizure. 47% of the patients developed an epilepsy. 85% of recurrences occurred
      within the first 6 months and 100% within 2 1/2 years. A history of epilepsy in a
      first degree relative, age at first seizure, duration of seizure, initial EEG or
      neurologic status were not associated with significantly higher risk of
      recurrence.

PMID- 1745259
TI  - [Toxicity of mercury in dental amalgam fillings].

PMID- 1745260
TI  - [Features of the interaction of Escherichia coli and Francisella tularensis RNA
      polymerases with hybrid plasmids bearing fragments of Francisella tularensis
      chromosomal DNA].
AB  - Hybrid plasmids containing the fragments of Francisella tularensis chromosomal
      DNA and capable of tet-gene expression both in Escherichia coli and Francisella
      tularensis cells were constructed. The regions of francisella chromosomal DNA
      binding the RNA-polymerases of Escherichia coli and Francisella tularensis were
      found by the electron microscopy technique. Interconnection of those regions with
      the expression of tet-gene of the hybrid plasmids was demonstrated.

PMID- 1745261
TI  - [Biochemical, antigenic and protective properties of the outer membrane of
      tularemia pathogens].
AB  - The outer membranes of Francisella tularensis were studied. The membranes were
      identified morphologically, immunologically and biochemically. They contained 12
      20% of protein, 15-30% of carbohydrates, up to 40% of lipids. The main integral
      proteins of the outer membranes were the 47, 43, 17 and 12 kD proteins. The main
      protein 63 kD was not integral. The lipopolysaccharides isolated from the outer
      membranes and acetone-dried cells did not possess the protective properties in
      experimental tularemia. The preparations of outer membranes possessed the
      protective properties for mice infected with the virulent strain 503. Chitosan
      amplified the protective properties of outer membranes.

PMID- 1745262
TI  - [Determination of the initial rate of antimutagenic repair in UV-irradiated WP2
      Escherichia coli cells].
AB  - The initial rates of antimutagenic dark repair were measured in Escherichia coli
      WP2 trpE65 cells irradiated by UV-light (11 J/m2) and then incubated in liquid
      media of various compositions. Samples were taken from suspension of incubated
      bacteria every 5 min following irradiation, mixed with acriflavine to block
      further repair and plated onto the selective medium containing acriflavine (1
      micrograms/ml) to score the Trp+ mutations. The initial rate of antimutagenic
      repair was estimated from the kinetics of disappearance of mutations in several
      successive probes. It appeared to depend on the composition of a medium, to
      establish just after placing irradiated bacteria onto the medium and to decrease
      significantly in irradiated cells incubated under conditions favourable for
      growth. The decrease was not due to inhibition of postreplicative repair and was
      not caused by casaminoacids as such, but by combination of growth factors that
      provided the intensive protein synthesis. The decrease could be responsible for a
      strong mutational response of bacteria to irradiation because it secures the
      survival of premutagenic lesions in DNA till mutation fixation. It is suggested
      that metabolic regulation of the antimutagenic repair activity exists, based on
      an active switch of the energy flows required for several parallel metabolic
      pathways that proceed in irradiated cells.

PMID- 1745263
TI  - [Subcloning and study of the GTP-cyclohydrolase gene of Bacillus subtilis].
AB  - Bacillus subtilis GTP-cyclohydrolase gene and its deletion derivatives were
      subcloned in Escherichia coli cells. The position of the gene within the
      riboflavine operon was defined. The deletion of the 14 kDa fragment from the N
      end of GTP-cyclohydrolase gene did not affect the enzyme activity.

PMID- 1745264
TI  - [Cloning and inactivation of a chromosomal copy of the imidazole glycerophosphate
      dehydratase (HIS) gene from Hansenula polymorpha].
AB  - A gene for imidazole glycerophosphate dehydratase (HIS) has been selected from
      the library of Hansenula polymorpha genes by complementation of Escherichia coli
      hisB mutations or his3 mutation of Saccharomyces cerevisiae. Inactivation of the
      gene in Hansenula polymorpha strain 48V, as well as Leu(-)-Leu+ conversion of
      phenotype and arising of antibiotic G418 resistance resulted from transformation
      of the strain by the linear DNA molecules of the cloned HIS-gene with the in
      vitro inserted LEU2 gene from Saccharomices cerevisiae and KmR gene. The Southern
      hybridization analysis of the Leuf+His- G418R clones representing 1-2% of
      transformants population together with the DNA analysis of the monospore clones
      from the hybrid Leu+His-G418R transformant tetrad and tester strain have revealed
      the locus specific nature of the clones.

PMID- 1745265
TI  - [Sensitizing properties of Brucella protein antigens synthesized in K12
      Escherichia coli cells].
AB  - The sensitizing properties of brucella 31 kD and 31+15 kD protein antigens
      produced by Escherichia coli cell carrying and expressing the corresponding
      brucella genes were compared. In experiments evaluating the test of mouse feet
      oedema in CBA line animals the property of the 31 kD antigen preparation to
      induce the specific oedema effect was demonstrated on the level comparable with
      the one produced by the brucella outer membrane proteins preparation. The
      obtained data were confirmed in the experiments on adoptive transfer of prolonged
      type hypersensitivity via the spleen cells from the sensitized donors to intact
      recipient animals. The future of molecular cloning technique usage for obtaining
      the homogeneous stable preparations of brucella antigens with low reactivity and
      high specificity is discussed.

PMID- 1745266
TI  - [Diaminopimelate pathway for lysine synthesis in Escherichia coli and bacilli].
AB  - The diaminopimmelate (DAP) pathway for lysine biosynthesis in Escherichia coli
      and some species of Bacillus are presented in the review. It was shown that the
      major variations of the DAP pathway of Bacillus subtilis from that described and
      extensively studied in Escherichia coli exist.

PMID- 1745267
TI  - [Saccharomyces cerevisiae mutants with increased mitotic stability of plasmids
      isolated during long-term culturing of transformants under selective conditions].
AB  - Analysis of the plasmid containing clones of transformants of Saccharomyces
      cerevisiae in the population cultivated under the nonselective conditions has
      shown their vast heterogeneity in the mitotic stability of the plasmids Yep13 and
      Yep91. For instance, the clones were obtained with the different types of the
      hereditary plasmid stabilization: integration with the chromosome and genotype or
      plasmid mutations increasing the vector copy number. The increased expression
      level was registered in the mutants for the heterologous genes AmpR of
      Escherichia coli and HBsAg of hepatitis B. The clones were found with the
      considerably varying mitotic stability of the plasmids of the modification type
      variability, the latter expressing the fluctuations of plasmid copy number at the
      change of cultivation conditions.

PMID- 1745268
TI  - [Analysis of deletion mutations of the dystrophin gene by the multiplex
      polymerase chain reaction method in the diagnosis of Duchenne muscular
      dystrophy].
AB  - The 33 patients suffering from the Duchenne muscular dystrophy (DMD), 7 healthy
      donors and a DMD risk family were studied by means of polymerase multiplex chain
      reaction (MPCR) with 6 oligoprimer pairs for 6 different exons of dystrophin
      gene. The deletions varying in sizes from 1 to 6 exons were detected in 12 out of
      33 DMD patients studied (36.3%). The prenatal diagnosis of DMD was carried out by
      chorionic villus biopsy on the 1st trimester of pregnancy. Contrary to earlier
      findings, in elder brother with sever DMD manifestation, no visible deletion was
      detected in the DNA sample from the male foetus and thus the diagnosis of DMD in
      foetus was rejected. The perspectives of MPCR in pre and postnatal diagnosis of
      DMD are discussed.

PMID- 1745269
TI  - [Mobilization transfer of the pUB110 plasmid between gram-positive bacteria].
AB  - The three factor crosses between the donor strain Bacillus subtilis 168
      harbouring the plasmid pUB102-4, Bacillus thuringiensis strain carrying the
      mobilizing plasmid pAM beta 1 and recipient strain Lactobacillus fermenti were
      conducted in order to elaborate the optimal conditions of the plasmid pUB102-4
      mobilization for transfer into gram-positive microorganisms and to elucidate the
      possible expression of endogluconase genes in a lactobacillus strain. The
      Lactobacillus fermenti transconjugants carrying the pUB102-4 plasmid were
      obtained in the three factor reciprocal crosses with the streptococcus recipient
      strain and Bacillus subtilis recipients. The presence of the plasmids in
      transconjugants was confirmed by colony hybridization with the [32P]-labelled
      plasmid DNA and KMC-ase activity in transconjugant cells. The proposed system of
      crosses using the high copy number plasmid derivatives of pUB110 mobilized with
      high frequency by the pAM beta 1 plasmid demonstrates the possibility to increase
      the circle of gram-positive host bacteria avoiding time and labour consuming
      operations.

PMID- 1745270
TI  - [Behavior of Sa plasmid in tularemia pathogen cells].
AB  - The genome of Sa plasmid is shown to be a subject of genetical rearrangements in
      Francisella tularensis cells. The rearrangements either result in plasmid
      integration into the host cell genome or intramolecular amplification of cat-gene
      with the subsequent excision and recombination of the derivative plasmids. Stable
      inheritance of the plasmid is registered after integration while plasmid
      elimination occurs in case of extrachromosomal localisation.

PMID- 1745271
TI  - [Study of CAT gene expression in Sa and pC194 plasmids in Escherichia coli,
      Francisella tularensis, and Bacillus subtilis cells].
AB  - The unit activities were defined for chloramphenicol-acetyltransferases coded for
      by the cat-genes of the plasmids Sa and pC194 in Francisella tularensis,
      Escherichia coli and Bacillus subtilis cells. Francisella tularensis cells were
      shown to hold intermediate position between Escherichia coli and Bacillus
      subtilis cells in their ability to express the genes of the different taxonomic
      origin. The direct dependence was found between the dose of the gene coding for
      chloramphenicol-acetyltransferase synthesis and efficiency of the gene
      expression, minimal inhibiting concentration of the antibiotic and colony size on
      the media containing chloramphenicol.

PMID- 1745272
TI  - [Transfer of bacteriophage PRD1 genes into modified plasmid Sa of Escherichia
      coli and Francisella tularensis cells].
AB  - The donor specific bacteriophage PRDI has been shown to mediate the genes
      transfer into Escherichia coli and Francisella tularensis cell under certain
      conditions. It is necessary for the process that the recipient cells inherit the
      plasmids determining absorbtion of bacteriophages on the cellular surface while
      the transferred genes are able to be expressed. The frequencies of the tet-gene
      transfer from the plasmid pSKFT5 into Escherichia coli and Francisella tularensis
      15 cells inheriting the plasmid Sa are, correspondingly, 10(-6) and 10(-7) clones
      per bacteriophage plaque.

PMID- 1745273
TI  - [A simple method of purifying staphylococcal alpha-toxin and a study of its
      properties].
AB  - The simple method is proposed for isolation and purification of staphylococcal
      alpha-toxin that permits one to obtain the homogeneous toxic protein with high
      activity. The time necessary for maximal toxin production at cultivation has been
      defined. The thermostability and interferonogenic characteristics of the obtained
      alpha-toxin were studied.

PMID- 1745274
TI  - [Synthesis of the E-antigen of the hepatitis B virus (HBeAg) in eukaryotic cells
      by a recombinant strain of the vaccinia virus].
AB  - The recombinant plasmids containing the gene for hepatitis B viral core-antigen
      with the pre-core-sequence controlled by the early-late promoter of the 7.5' K
      protein gene were constructed. The recombinant strains of vaccinia virus were
      obtained on their basis (vHBe42-1 and vHBe42-3) selectively expressing HBeAg of
      hepatitis B virus. The kinetics of HBeAg synthesis was studied in infected cells
      as well as secretion of the protein into culturing medium. Three proteins were
      found by blotting technique in the cells infected by vHBe42-3 that react with the
      specific antiserum to HBeAg and have the mol. masses 25, 22 and 17 kD. The
      completely processed HBeAg 17 kD was found in the culturing medium. The rabbit
      serums from the animals immunized by recombinant vHBe42-3 contained antibodies to
      HBeAg but not to HBcAg. This makes it possible to study the structural and
      functional organization, immunological properties and role of this antigen in
      pathogenesis of hepatitis virus B and to construct the specific test systems for
      screening HBeAg and corresponding antibodies.

PMID- 1745275
TI  - [Characteristics of the R-plasmid pM3 (IncP-9) of a broad circle of hosts].
AB  - A new broad host range plasmid pM3 (IncP-9) was found in a facultative
      methylotrophic bacteria Pseudomonas putida and described. The pM3 plasmid is
      characterized by thermo-instability in Enterobacteriaceae family of bacteria at
      36 degrees C or higher temperatures. It is also unable to be inherited as an
      autonomous element in the obligate methylotrophic bacteria Methylobacillus M75.
      The peculiarities of plasmid inheritance make possible to use it as a tool for
      genetic research, for instance, to construct the donor strains in Methylobacillus
      M75 able to mobilize the chromosomal genes for conjugational transfer in isogenic
      systems of crosses.

PMID- 1745276
TI  - AAEM minimonograph #37: facial and limb myokymia.
AB  - Myokymia is a clinical phenomenon associated with characteristic
      electromyographic activity referred to as myokymic discharges. These are
      spontaneously generated bursts of individual motor unit potentials with each
      burst recurring rhythmically or semirhythmically, usually several times per
      second. It involves facial muscles more commonly than those of the extremities,
      and is most often seen in association with Guillain-Barre syndrome, multiple
      sclerosis, radiation plexopathy, pontine tumors, and timber rattlesnake
      envenomation. An alteration in the biochemical microenvironment of axon membranes
      at one of the various sites along the motor axon is the likely basis for the
      altered membrane excitability that underlies the myokymic discharges in most
      cases. The similarity of these discharges to those seen with hypocalcemic tetany,
      and the ability to manipulate myokymic discharges by altering serum-ionized Ca++,
      suggests that decrease in the ionized Ca++ in the microenvironment of the axon
      may play an important role.

PMID- 1745277
TI  - Muscular dystrophy with separate clinical phenotypes in a large family.
AB  - This report describes a large consanguineous family with muscular dystrophy in 23
      patients showing intrafamilial variation of clinical expression. One main variant
      appeared in the first decade with proximal muscle weakness progressing over the
      next 20 years to wheelchair confinement, and appeared compatible with classical
      limb-girdle muscular dystrophy. The other main variant showed onset of distal
      muscle weakness in lower limbs in the third or fourth decade, progressing very
      slowly without greater disability throughout the lifetime. Tibial muscle weakness
      and wasting were clinical landmarks in this variant, but computed tomography of
      skeletal muscle revealed focal areas of fatty degeneration also in truncal,
      pelvifemoral, and distal leg muscles in a way not previously reported in distal
      myopathy. The overall difference in clinical findings between these main variants
      would suggest 2 separate genetic entities, genealogical data makes a common
      genetic background possible.

PMID- 1745278
TI  - Comparison of vibrotactile thresholds with physical examination and
      electrophysiological assessment.
AB  - Measurement of cutaneous vibrotactile thresholds may be useful for assessment of
      the functional integrity of the somatosensory system. To validate a rapid method
      of determining vibrotactile thresholds that uses a commercially available
      electromechanical device, vibrotactile thresholds were compared with standardized
      physical examination findings of sensory function and electrophysiological
      parameters in 79 patients referred to the Mount Sinai Hospital Neurophysiology
      Laboratory for clinical electrophysiological evaluation. A statistically
      significant monotonic association between graded physical examination of
      vibration perception and vibrotactile threshold was observed for all digits
      tested in the upper and lower extremities. Statistically significant associations
      were also observed between vibrotactile thresholds and a variety of
      electrophysiological measures of the median, ulnar, tibial, peroneal, and sural
      nerves. The strongest associations were observed between great toe vibrotactile
      thresholds and late response latencies measured in nerves in the lower
      extremities. Determination of vibrotactile thresholds may be useful in settings
      where quantitative measures of large fiber nerve function are desirable and
      electrophysiological study is not feasible.

PMID- 1745279
TI  - Muscle histology in Becker muscular dystrophy.
AB  - Twenty patients with Becker muscular dystrophy (BMD), confirmed by dystrophin
      tests, were studied histologically. There were several morphological differences
      between younger (less than or equal to 15-year-old) and older (greater than 15
      year-old) patients. In the younger patients, active muscle fiber necrosis
      followed by a regenerating process was conspicuous. In the older patients, the
      active degenerative changes appeared less prominent and, instead, more chronic
      myopathic changes such as moth-eaten fibers, fiber splitting, and hypertrophic
      fibers were evident. These age-dependent differences in the pathology of BMD were
      irrespective of the duration of clinical symptoms, i.e., BMD patients of a
      similar age showed a similar morphological feature regardless of age at onset.
      Although the presence of mild fiber type grouping and some small angulated
      atrophic fibers suggested a certain degree of neurogenic involvement, none of
      biopsies showed significant grouped atrophy as seen in neuropathic disorders.
      There was no correlation between the histological changes and the specific
      dystrophin abnormality.

PMID- 1745280
TI  - Central conduction and autonomic nervous function in HMSN I.
AB  - CNS conduction and autonomic nervous function were investigated in 15 patients
      with HMSN I. Central motor conduction time (CMCT) was estimated with magnetic
      brain stimulation and electrical nerve root stimulation. Somatosensory evoked
      potential (SEP) and visual evoked potential (VEP) were used for assessment of
      central sensory and visual conduction. Autonomic effector organ functions were
      assessed with the R-R variation test for parasympathetic function, and the
      sympathetic skin response test (SSR) for skin sympathetic sudomotor activity.
      Five of the patients had prolonged CMCT. Central sensory conduction was normal in
      3, and slightly prolonged in 1 of the patients, but could not be estimated in 11
      due to lack of response from the cervical recording. VEP was abnormal in 2
      patients. R-R variations during normal breathing were low in 8 of 15 patients,
      and low also during deep breathing in 1 of 15. The SSR test was pathological in 5
      of 15 patients. Thus, impaired central conduction and/or autonomic dysfunction
      was not an uncommon finding in patients with HMSN I.

PMID- 1745281
TI  - Autonomic function in hereditary motor and sensory neuropathy (Charcot-Marie
      Tooth disease)
AB  - Autonomic tests of heart rate and blood pressure control using both invasive and
      noninvasive techniques were performed on 11 patients with hereditary motor and
      sensory neuropathy (HMSN) types 1, and 4 patients with HMSN type 2. The results
      were compared with those of 76 control subjects. No significant difference was
      found between the patient and control groups. Impairment of sweating on the
      extremities was found in patients with HMSN types 1 and 2, consistent with distal
      degeneration of sympathetic fibers in peripheral nerves, but there were no
      abnormalities of cardiovascular reflex control mechanisms.

PMID- 1745282
TI  - Effect of statistical methodology on normal limits in nerve conduction studies.
AB  - Mean +/- 2 standard deviations (SD), which relies on a Gaussian distribution, has
      traditionally been used to derive normal limits for nerve conduction studies. Our
      purpose was to examine skew in nerve conduction study (NCS) parameters, and to
      compare normal limits derived by several alternative methods. We examined 22 NCS
      parameters from 75 asymptomatic, nondiabetic men (controls). The coefficient of
      skewness (g1) was significantly positive (P less than 0.10, two-tailed test) in 5
      of 8 amplitude and 6 of 8 latency measurements. Transformation reduced g1 in 19
      of 22 parameters, and was optimal when g1 was closest to zero. For each
      measurement, ideal normal limits were defined as mean +/- 2 SD of the optimally
      transformed data of the control subjects. The percentage of 66 diabetic subjects
      classified as abnormal by the raw data, but normal by the ideal normal limits,
      was the positive misclassification rate; while the percentage considered normal
      by the raw data, but abnormal by the ideal normal limits, was the negative
      misclassification rate. Mean +/- 2 SD of the raw data produced up to 11% positive
      misclassifications and 12% negative misclassifications. When the range of
      observed values was used, up to 6% positive misclassifications and 13% negative
      misclassifications were found, while the 2.5 or 97.5 percentile values produced
      up to 10% positive misclassifications and 13% negative misclassifications. We
      conclude that analyses using the raw data to derive normal limits result in an
      unacceptable rate of misclassification. Normal limits should be derived from the
      mean +/- 2 SD of the optimally transformed data.

PMID- 1745283
TI  - Canine X-linked muscular dystrophy studied with in vivo phosphorus magnetic
      resonance spectroscopy.
AB  - Duchenne muscular dystrophy (DMD) is an X-linked disease characterized by
      progressive muscle weakness and degeneration. Dystrophin is the product of the
      missing gene in this disorder. However, the cause of the dystrophic process is
      not understood. Transient muscle injury is normally seen after muscle exercise,
      and may be a necessary process in muscle growth and preservation. We, therefore,
      chose to evaluate the role of exercise in Duchenne dystrophy by studying the
      canine X-linked animal model (CXMD). These dogs also lack dystrophin and have
      clinical signs similar to humans. Exercise was initiated by electrical
      stimulation, and muscle metabolism was monitored with phosphorus magnetic
      resonance spectroscopy (P-MRS). Dogs with CXMD had abnormal muscle pathology and
      markedly elevated serum CK. The inorganic phosphate (Pi) to phosphocreatine (PCr)
      ratio was increased in CXMD dogs at rest compared with normal dogs (Pi/(Pi + PCr)
      = 0.166 +/- 0.054 for CXMD and 0.073 +/- 0.017 for normals, mean +/- SE). No
      changes in resting ATP, pH, phosphomonoesters (PME), and phosphodiesters (PDE)
      were seen. The mean Pi/(Pi + PCr) and pH values during stimulation were normal in
      the CXMD dogs. Two to three days after electrical stimulation, resting Pi/(Pi +
      PCr) ratios were significantly increased in the CXMD dogs (0.127 +/- 0.029
      compared with 0.172 +/- 0.054, mean +/- SD). Normal dogs showed no increase in
      Pi/(Pi + PCr) following stimulation. There was a 50-fold greater increase in
      serum CK in CXMD compared with normal dogs following exercise. These results
      indicate greater muscle injury in CXMD muscle, and suggest that in the absence of
      dystrophin, exercise-induced muscle injury may play a role in the dystrophic
      process.

PMID- 1745284
TI  - Martin-Gruber anastomosis and unusual sensory innervation of the fingers: report
      of a case.
AB  - We report the electrophysiological study of a patient with carpal tunnel syndrome
      who, besides the features of median nerve entrapment at the wrist, showed an
      aberrant motor innervation of Martin-Gruber type and an unusual distribution of
      the sensory innervation of the fingers. Studies based on collision between
      sensory volleys showed that the fibers supplying the anomalous innervation did
      not follow the same path as the aberrant motor fibers. This finding is consistent
      with the hypothesis that Martin-Gruber anastomosis is made up of motor axons
      only, and supports the idea that other abnormalities of innervation may be found
      in patients with Martin-Gruber anastomosis.

PMID- 1745285
TI  - Interobserver agreement in the assessment of muscle strength and functional
      abilities in Guillain-Barre syndrome.
AB  - In studies of Guillain-Barre syndrome, functional deficit is usually assessed
      according to a functional scale consisting of several categories. The level of
      interobserver agreement in this scoring method is not known; furthermore, this
      method seems to be insensitive when applied to bedridden and artificially
      ventilated patients. We have developed an additional score (MRC-sumscore),
      reflecting muscle strength in general. Both scoring methods, tested in Guillain
      Barre patients, have an almost perfect interobserver agreement. For the
      functional score kappa = 0.85, and for the MRC-sumscore r2 = 0.96. The MRC
      sumscore is easily assessed and more sensitive than the functional score when
      patients are bedridden or artificially ventilated.

PMID- 1745286
TI  - Maximal and minimal motor nerve conduction velocities in patients with motor
      neuron diseases: correlation with age of onset and duration of illness.
AB  - We measured the maximal and minimal motor nerve conduction velocities of the
      ulnar nerve in 17 patients with spinal muscular atrophy (SMA), 27 patients with
      amyotrophic lateral sclerosis (ALS), and 40 age-matched control subjects. Crude
      values of the maximal and minimal motor nerve conduction velocities were reduced
      in both patient groups, but their difference in each patient was not
      statistically different from that of a control subject. The conduction velocities
      adjusted according to each patient's age were faster in SMA patients than in ALS
      patients. Among patients with either ALS or SMA, the age-adjusted conduction
      velocities were larger in those who had developed the disease at younger ages and
      suffered from it for shorter periods of time. These findings suggest that the
      motor nerve fibers regenerate more in younger patients in the early stages of the
      disease, particularly in SMA.

PMID- 1745287
TI  - Changes in nerve fiber numbers distal to a nerve repair in the rat sciatic nerve
      model.
AB  - Changes in nerve fiber numbers distal to a nerve repair in the sciatic nerve of
      48 rats were evaluated over a 1- to 24-month period. The results of the
      morphometric evaluation in the sciatic nerve distal to the nerve repair
      demonstrated an increase in nerve fiber counts as early as 1 month following the
      nerve repair. The number of nerve fibers in the distal nerve was greatest at 3
      months and did not return to normal levels until 24 months. The results of this
      study will influence the timing of experimental studies in which nerve fiber
      counts are critical for evaluation, and provides a better understanding of the
      clinical events occurring following nerve repair.

PMID- 1745288
TI  - The numbers and relative sizes of motor units estimated by computer.
AB  - A fully automated system is described for estimating the numbers and relative
      sizes of functioning motor units in proximal and distal muscles of the arm and
      leg. In this system, a computer controls the motor nerve stimulation, and
      analyzes the potentials evoked from the muscles; a subprogram searches for
      instances of "alternation." In 33 healthy volunteers, aged 21 to 56 years, the
      median-innervated thenar muscles of one hand were tested 2 to 3 times; the mean
      motor unit estimate was 228 +/- 93 SD. For similar numbers of biceps brachii,
      extensor digitorum brevis, and vastus medialis muscles, the respective mean
      values were 113 +/- 40, 131 +/- 45, and 229 +/- 108 units. The reproducibility of
      the method was such that the overall coefficient of variation, for the normalized
      results from the 121 muscles studied, was 22%. The reliability of the automated
      method was doubled if 3 estimates, rather than one, were performed on each
      muscle. Comparisons of the results obtained by automated and "manual" methods
      indicated that the computer-derived values tended to be lower by approximately
      33%.

PMID- 1745289
TI  - Uni- and bipolar surface recordings of human nerve responses.

PMID- 1745290
TI  - Schwartz-Jampel syndrome with dominant inheritance.

PMID- 1745291
TI  - Ryan White HIV C.A.R.E. program.

PMID- 1745292
TI  - "The brown bag" and other approaches to decreasing polypharmacy in the elderly.

PMID- 1745293
TI  - Understanding Medicare.

PMID- 1745294
TI  - I live by the color of thin plastic strips. Managing a case of hard-to-control
      diabetes.

PMID- 1745295
TI  - Wrinkles.

PMID- 1745296
TI  - The difficulty of deciding why children die. A review and some recommendations.

PMID- 1745297
TI  - Achilles and his evil squeeze. Colchicine poisoning.

PMID- 1745298
TI  - Affirming physicians' professionalism against the destructive influence of
      private third party relations. Durham-Orange County resolutions.

PMID- 1745299
TI  - Comment on cocaine-induced mesenteric ischemia article.

PMID- 1745300
TI  - Comment on DWI (driving while impaired) article.

PMID- 1745301
TI  - [Dental ethics, esthetics and cosmetics].
AB  - By means of adhesive dentistry sound teeth can be made more beautiful without
      damaging tooth structure. This is called cosmetic dentistry. Within the dental
      profession there is a discussion about the following questions: is cosmetic
      dentistry real dentistry? Is it ethical to render cosmetic services to patients?
      In this article arguments are displayed to answer this question in a positive
      manner.

PMID- 1745302
TI  - [Cosmetic aspects of dental treatment].
AB  - Communication between the dentist and his patient is an absolute condition for
      successful cosmetic dentistry. The patient must have possibilities to explain his
      wishes and expectations to the dentist (and if an indirect technique is used, to
      the dental laboratory). In this article methods are described and hints are given
      to arrange this in dental practice.

PMID- 1745303
TI  - [Shape and/or colour anomalies of anterior teeth].
AB  - Many esthetically unpleasant positions of teeth can be improved by orthodontic
      treatment but can also be camouflaged by built-ups with composite resins in
      combination with grinding of enamel. With this method orthodontic results can
      also be improved and relapses corrected. The technique and different
      possibilities are described and demonstrated with clinical examples.

PMID- 1745304
TI  - [Guidelines for treatment of missing anterior teeth].
AB  - The orthodontic treatment of patients with missing incisors should be directed to
      avoid prosthetic solutions. Specific rules have to be applied for the closure of
      spaces due to missing teeth to reduce the occurrence of papillae retraction and
      to place the substituting teeth in such a position that their crowns can be built
      up to look like the ones they replace. To realize these goals the mesiodistal
      angulations should deviate from the standard ones, a proper distribution of crown
      width should be achieved and finally a permanent retention with a palatally
      bonded thin multi-stranded wire should be installed in most cases.

PMID- 1745305
TI  - [Periodontology and esthetics: the gingival recession].
AB  - Gingival recessions are regarded by many people as an esthetical problem.
      Successively the etiology, the significance and the indications for therapy are
      discussed. Different kinds of therapy such as oral hygiene instruction, the free
      gingival graft and various pedicle grafts are explained. Finally it is advocated
      that surgical kinds of therapy have to be applied with reservedness.

PMID- 1745306
TI  - [Bleaching of teeth: a review].
AB  - Bleaching of vital and non-vital teeth is becoming a routine procedure in
      esthetic dentistry. In a relative safe way many types of discoloration can be
      treated. Four treatment systems are available at present. For an appropriate
      choice it is essential to know the cause of the discoloration. Long term results
      are still scarce. Most treatment systems show slight to moderate side-effects,
      varying from demineralisation of enamel to soft tissue problems.

PMID- 1745307
TI  - [Cosmetic dentistry and adhesive prosthodontics].
AB  - A better chemical bonding to metals offers the opportunity to bind composites
      onto metal and metals onto tooth structures. This may lead to an increase of
      adhesive prosthetic and cosmetic treatments. In this article some applications of
      this modern treatment method are described, anterior and posterior, in solitary
      elements as well as multiple bridge constructions.

PMID- 1745308
TI  - [Esthetic aspects of crowns and bridges].
AB  - By means of discussing several guiding principles a protocol is suggested and
      treatment procedures are outlined which will result in optimum esthetics in the
      fabrication of crowns and bridges. Some important considerations in restoring an
      occlusion with porcelain are discussed.

PMID- 1745309
TI  - [Etched porcelain].
AB  - Porcelain is an outstanding material for tooth restoration with splendid cosmetic
      results. With the introduction of porcelain it is possible to restore teeth with
      minimal loss of healthy tissue. This results in strong and beautiful
      restorations.

PMID- 1745310
TI  - [Longevity of restorations in composite and etched porcelain].
AB  - Due to continuing alterations in composition of dental products and materials,
      prognoses about longevity of restorations in composite or etched porcelain are
      extremely difficult to make. Strength, wear resistance and resistance against
      disintegration determine durability of stress bearing restorations. Elasticity in
      combination with bond strength are determinant for prevention against premature
      leakage. Indication, cavity form and careful handling of the materials are
      prerequisites for longevity of the restoration. The prognosis of the favourably
      located but stress bearing class IV is far better than that of the unfavourable
      located, non stress bearing class V-composite restoration. For the etched
      porcelains, the veneers offer the best perspectives with respect to durability
      thanks to the favourable shrinkage pattern.

PMID- 1745311
TI  - [Results of hemisections and root amputations in a general practice].
AB  - A retrospective study is presented of the treatment of furcation problems and
      deep, localized periodontal pockets by means of root-resection and the subsequent
      restorative treatment. The study incorporates 69 teeth in 53 patients, treated in
      the period 1970-1986. The results indicate that well-indicated root-resections
      may produce good long-term results. Most of the treated teeth have a survival
      rate of 10 years. Indications, possibilities and specific restorative problems
      are discussed.

PMID- 1745312
TI  - [Pain and painkillers. 3. Psychic component].
AB  - Psychic factors, for instance anxiety and the social and cultural environment,
      affect the tolerance for pain, amongst others due to an influence on the 'gate
      control' mechanism. Therefore psychopharmaca, which affect the brain, but also a
      placebo may be used to fight pain. Through three types to distinguish in
      learning, chronic pain may result in illness-behaviour.

PMID- 1745313
TI  - [The dental profession in The Netherlands before 1865].
AB  - The dental profession before 1865 has been described with the help of sources
      from the 19th century, in combination with prosopographical research. During this
      period, dentists had no exclusive rights in dentistry: other surgical professions
      were also involved both with its theory and practice. Their specialised
      colleagues comprised a group of 137 dentists, largely related to a few Jewish
      families. This characteristic, underlined by their intensive migration and
      training within the family, had been responsible for the divergent position of
      the dentists in Dutch medical legislature of the 19th century. While in the
      medical profession the organisation and structure (1865) was the first te be
      revised, followed by a reorganisation of education (1876); in dentistry the
      recruitment and education had to be reformed (1865-1876) before the building up
      of a new professional structure. This process speeded up by the rapid
      mortification of the ancient group of dentists.

PMID- 1745314
TI  - [The history of pain control in dentistry in The Netherlands].
AB  - Pain control in The Netherlands used to be in the hands of surgeons. Dentists
      were not allowed to use any drugs which could have a general effect. In the Anglo
      Saxon countries dentists and anaesthesiologists working together since 1846 have
      achieved a high standard of pain control. Anaesthesiology has been recognised in
      The Netherlands only since 1948. The advantages of a sequence of possibilities
      for pain control have since become available for dentistry in The Netherlands.

PMID- 1745315
TI  - [Esser (1877-1946) and the dawn of maxillofacial prosthetics in The Netherlands].
AB  - A short historical review is presented of the development from simple facial
      plates towards complex maxillofacial prostheses. There was an impetuous demand
      for extended development of this type of prostheses during World War I. The Dutch
      plastic surgeon Esser developed the skin-graft-inlay technique facilitating in a
      relative easy way extensive maxillofacial reconstructions. The technique was
      published in English and German and was soon used by surgeons on both sides. The
      combined training of Esser in medicine and dentistry was advantageous for the
      development of the technique.

PMID- 1745316
TI  - [The founding and the first years of the first Dutch Dental Association:
      Nederlandsch Tandheelkundig Genootschap].
AB  - During the last half of the 19th century dentistry in the Netherlands met little
      social appreciation. The charismatic leader of Dutch dentistry, Dr. Theodore
      Dentz, dentist and physician, took the initiative to found the first Dutch dental
      organisation in 1880. His goals were to improve the image of his profession, to
      strive for better education and to strengthen the bond between the best dentists
      in the country. After about 1910 changes in society and dentistry forced 'het
      Genootschap' to delegate their work in the field of social and professional
      representation to the newly founded Dutch Dental Association. After that time
      'het Genootschap' converted itself into a scientific invitation society.

PMID- 1745317
TI  - Clinical significance of computed tomography in early aneurysm surgery.
AB  - The significance of computer tomographic findings for the analysis of
      complications or the course and prognosis after early aneurysm surgery was
      analyzed on the basis of 100 patients consecutively operated on for ruptured
      cerebral aneurysms. Intracerebral or extended intraventricular hematomas were a
      poor prognostic sign. An acute hydrocephalus had a negative effect only on the
      early course but not on the final results. Nearly all (94) of the patients
      presented postoperatively with a cerebral volume increase either by CSF release,
      edema, and/or vasoparalysis. A correlation with the final result could not be
      observed. Twenty-two patients presented with ischemic infarction in the
      postoperative CT scan, one had hemorrhagic infarction. In 19 of the 22 cases the
      cause of the infarction could be related to the surgical trauma. In 10 cases it
      remained asymptomatic. In only one case vasospasm was responsible for a
      symptomatic infarction. The findings show that early surgical repair of a
      ruptured cerebral aneurysm is an effective method to prevent rebleeding and
      ischemic infarction by vasospasm. The hemorrhage and the operation, however, are
      followed by a large number of visible morphological lesions in the CT scan.

PMID- 1745318
TI  - The effect of tranexamic acid on bleeding time and haemostasis.
AB  - The effect of tranexamic acid (TXA) on platelet function was examined in 37
      patients with ruptured intracranial aneurysms. TXA was administered in a double
      blind, placebo controlled manner to 37 patients with ruptured intracranial
      aneurysms. TXA was given to 17 patients in a dose of 9 g/24 hours, to another 6
      patients in a dose of 6 g/24 hours; 14 patients were given a placebo. The effect
      of TXA on certain haemostatic function tests was evaluated between the treatment
      groups. We conclude that patients receiving TXA do not appear to be at risk of
      recurrent haemorrhage due to abnormal haemostasis.

PMID- 1745319
TI  - The role of sinus thrombosis in occipital dural arteriovenous malformations-
      development and spontaneous closure.
AB  - Two cases of dural arteriovenous malformations are presented. Both were
      associated with thrombosis of the sigmoid sinus. Without any treatment,
      recanalization of the sinus occurred in one case, while the dural arteriovenous
      malformation was persisting. In the second case, recanalization of the sinus
      coincided with the spontaneous closure of the malformation. The interrelationship
      of sinus thrombosis and dural arteriovenous malformations, and the possible
      mechanism of spontaneous closure are discussed.

PMID- 1745320
TI  - Clinical pattern of chronic subdural haematoma.
AB  - To assess the clinical manifestation of chronic subdural haematoma (CSH) the
      authors retrospectively analysed the files of 131 adult patients treated in the
      Department of Neurosurgery Medical Academy of Lodz. In 14 patients the illness
      had a sudden onset, suggesting cerebral stroke. 50% of patients had symptoms of
      raised ICP, there were no differences between young and older patients. In
      patients older than 40 years focal neurological deficits were more frequent, and
      in 13% of them focal signs were homolateral to CSH. In 9 patients the lesion
      produced symptoms of transtentorial herniation within a very short period. The
      authors think that despite the great progress in neuroradiology and neurosurgery,
      the condition may still be overlooked if the clinical picture does not suggest an
      intracranial space-occupying growth.

PMID- 1745321
TI  - Spinal subarachnoid hematoma of unknown etiology. A case report.
AB  - A case of spinal subarachnoid hematoma at T3-T7 level is reported in a 60-year
      old hunter, who developed progressive spinal cord impairment after receiving the
      recoil of his shotgun. Both clinical and neuroradiological investigations,
      including the selective spinal angiography, failed to demonstrate the origin of
      the bleeding. The combination of an apparently trivial spinal trauma with
      temporary increase of the intrathoracic pressure might be considered as possible
      etiologic factor.

PMID- 1745322
TI  - Balloon occlusion of carotid-cavernous fistula via subtemporal transdural
      approach.
AB  - This is a report on a patient with traumatic carotid-cavernous sinus fistula
      (CCF). She gradually noticed noise in her head and suffered from partial
      ophthalmoplegia. Angiography demonstrated a left high flow CCF. She underwent a
      direct surgical treatment with a detachable balloon because an endovascular
      balloon embolisation for the CCF had been unsuccessful. Immediate disappearance
      of the bruits after surgery was noted and the patient recovered progressively her
      ophthalmoplegia. Follow angiograms 3 months after surgery revealed the
      disappearance of the fistula and an appearance of a false aneurysm. She is
      asymptomatic and periodically monitored in the outpatient clinic.

PMID- 1745323
TI  - Nimodipine evoked dilation of cerebral arteries early during the development of
      late vasospasm in subarachnoid hemorrhage.
AB  - In subarachnoid hemorrhage (SAH) late cerebral ischemia may develop without
      significant visible narrowing of arteries at angiography, but in severe ischemic
      conditions "vasospasm" invariably seems to be present. The majority of patients
      with aneurysm rupture develop some degree of vasospasm, whereas relatively few
      suffer from ultimate brain infarction. The prophylactic use of the calcium
      antagonist Nimodipine is linked to a beneficial anti-ischemic effect in SAH,
      although narrowing of large bore arteries still seems to develop despite
      administration of this drug. Attenuation of vascular spasm, mainly in the
      arterioles has been implicated as the major mechanism of action, although a
      neuronprotective effect of Nimodipine has been suggested as well. The present
      paper presents fragmentary evidence that Nimodipine does elicit a vasoactive
      response in the cerebral vasculature early during the development of late
      cerebral vasospasm, and that this response seems closely linked to reversal of
      attendant ischemic symptoms.

PMID- 1745324
TI  - [Abscess of the pyramidal apex].
AB  - The authors report on one case of an abscess at the pyramidal apex. The 52-year
      old male patient presented with pareses of the fifth and seventh cranial nerves
      and hypacusis on the right side. After diagnostic procedures (CT-scan, carotid
      angiography), a tumor at the apex of the right pyramid was expected. During
      surgery a large encapsulated mass was found containing pus. A bacterial agent
      could not be isolated. The abscess bordered on the mucosal lining of the sphenoid
      sinus and on the cells of mastoid bone. The starting point of an abscess at the
      pyramidal apex is most commonly an otitis media, most frequently caused by
      staphylococcus. Sterile abscesses are seen in almost 20%. Of differential
      diagnosis on has to keep in mind other space-occupying lesions especially
      epidermoid or dermoid cysts.

PMID- 1745325
TI  - Ganglioside therapy and Guillain-Barre syndrome. A historical cohort study in
      Ferrara, Italy, fails to demonstrate an association.
AB  - We investigated an alleged association between ganglioside therapy and the risk
      of developing the Guillain-Barre syndrome (GBS) in a historical cohort study.
      Using official medical records of the Local Health Unit No. 31 of Ferrara
      Province, northern Italy, we linked data on sales of gangliosides with
      information regarding hospital admissions and discharge diagnoses between January
      1, 1988, and May 31, 1990. The number of incidence cases of GBS observed within
      30 days of gangliosides administration in a cohort of 13,373 treated subjects
      (0.0 cases) was not significantly different from that expected in the general
      population (0.014). Our study suggests that patients receiving gangliosides are
      not at increased risk of developing GBS. However, because of sample size
      limitations, these findings should be confirmed in a larger cohort study.

PMID- 1745326
TI  - Amyotrophic lateral sclerosis in southern Greece: an epidemiologic study.
AB  - All amyotrophic lateral sclerosis cases hospitalized over a 25-year period in the
      University Department of Neurology in Athens were surveyed, with emphasis given
      to the occupation of the patients and the geographic distribution of the disease.
      The results showed an overrepresentation of farmers among patients and an
      aggregation of cases in the region of Cephalonia. These findings might suggest
      that environmental factors could be involved in the etiology of the disease.

PMID- 1745327
TI  - Risk factors in motor neuron disease: a case-control study.
AB  - A case-control study of risk factors in 512 cases of motor neuron disease (MND)
      and 512 controls, affected by other neurological diseases, was performed.
      Clinical history showed a significant increase in gastric ulcer and mechanical
      injuries among MND cases, whereas the frequencies of operations, poliomyelitis,
      malignancies and autoimmune diseases were similar for cases and controls. The
      women affected by MND had a later menarche and an earlier menopause; therefore,
      the reproductive period was significantly shorter, supporting a possible role of
      sexual hormones in the pathogenesis of MND. The analysis of occupations showed an
      increased number of farmers and also of subjects exposed to chemical products
      among MND cases.

PMID- 1745328
TI  - Epidemiology of progressive muscular dystrophy in Okinawa, Japan. Classification
      with molecular biological techniques.
AB  - We studied the prevalence of various types of progressive muscular dystrophy
      (PMD) in Okinawa, Japan on December 31, 1989 and the incidence of Duchenne
      muscular dystrophy (DMD) in 5-year periods from 1957 to 1985. We classified
      patients with PMD clinically, electrophysiologically, molecular biologically and
      immunohistochemically with antidystrophin antibody, especially for sporadic cases
      of DMD, Becker muscular dystrophy (BMD) and limb-girdle muscular dystrophy (LG).
      The prevalence for all PMD in Okinawa was 7.13 X 10(-5) for DMD, 1.82 X 10(-5)
      for BMD in the male population, 1.55 X 10(-5) for LG, 1.14 X 10(-5) for
      congenital muscular dystrophy, 2.03 X 10(-5) for facioscapulohumeral muscular
      dystrophy (FSH), and 9.13 X 10(-5) for myotonic dystrophy (MD) in the total
      population. The incidence of DMD in the period 1957-1985 was 15.41 X 10(-5) live
      born males (LBM) and 3.21 X 10(-5) LBM for BMD. The incidence has apparently
      declined in Okinawa since 1975. The prevalence of BMD, FSH and MD was rather high
      in Okinawa compared with previous reports. Molecular biological techniques for
      classifying patients were indispensable for the epidemiological study of PMD.

PMID- 1745329
TI  - Multiple sclerosis in Galion, Ohio: prevalence and results of a case-control
      study.
AB  - An investigation of the occurrence of multiple sclerosis (MS) was undertaken in
      the City of Galion, Ohio, USA, because of a report of an increased number of
      cases. As of June 1, 1987, there were 18 living cases of MS in Galion and Polk
      Township, for a prevalence rate of 112 cases per 100,000 population. The expected
      rate is approximately 65-170 cases per 100,000. In a case-control study,
      residents of Galion or Polk Township who had MS were compared to residents who
      did not have MS. The controls were matched to the cases on age and sex and had
      lived in Galion for at least as long as their matched case. The cases and
      controls did not differ in the distribution of their present or past Galion
      addresses, occupational histories or workplace exposures. Cases were more likely
      to have graduated from high school and college than controls. Cases were more
      likely than controls to report a history of allergies, to recall two or more
      relatives who had neurologic diseases that began before their first MS symptoms,
      to report owning a cat that died of unexplained causes and to recall having
      received oral polio vaccine. Cases and controls had similar levels of antibodies
      to measles, chickenpox, cytomegalovirus and the human T-cell lymphotrophic virus
      I.

PMID- 1745330
TI  - Epidemiology of lissencephaly type I.
AB  - In a cooperative study in The Netherlands 22 patients with lissencephaly type I
      were collected. In the period 1980-1988, the prevalence of lissencephaly type I
      in the Netherlands was 11.7 per million births (12.2 for females and 11.0 for
      males). The 5-year survival rate of patients with a complete or nearly complete
      agyria (grade 1 or 2) in this study was 54% compared to 91% in patients with a
      mixture of agyria with pachygyria or complete pachygyria (grade 3 or 4).

PMID- 1745331
TI  - Regional disparities in the annual prevalence rates of Parkinson's disease in
      Canada.
AB  - Parkinson's disease (PD) rates were examined by province and by sex for Canada
      for the years 1979-1984. As seen with other studies, PD displayed an uneven
      geographic distribution in the average annual prevalence rates for both males and
      females. The distribution of prevalence rates indicated a higher prevalence of PD
      in the western-most provinces. Nationally, males had a statistically
      significantly higher prevalence than females. Three provinces displayed a
      statistically significant sex difference with 2 provinces having a higher
      prevalence rate among males and 1 with a higher prevalence among females. The
      uneven distribution of prevalence rates offers some support for the involvement
      of environmental influences in the etiology of PD.

PMID- 1745332
TI  - Smoking and stroke.
AB  - The purpose of this review is to evaluate literature published since 1978 on the
      association between smoking and stroke. Two cohort studies found a dose-response
      relationship between the amount of cigarettes smoked per day and the relative
      risk of stroke. Also, two of the cohort studies found that when smoking ceased,
      the risk of stroke lessened (p less than 0.001). Nine case-control studies found
      a significant association between smoking and stroke for men and women. The
      biological association between smoking and stroke is plausible and several
      epidemiologic studies are supportive of this thesis. Additional, well-designed
      epidemiologic studies with a sufficient sample size to detect reasonably small
      odds ratios or relative risks (thus providing adequate statistical power) are
      warranted.

PMID- 1745333
TI  - Reflections on the difficult task of the Academic Medical Center.

PMID- 1745334
TI  - [Structure and function of receptors for C3 cleavage fragments].
AB  - Most of the biological effects derived from complement activation depends on
      interactions between cleavage fragments of complement components and cells
      bearing specific receptors. This review overviews structure and function of
      receptors for C3 cleavage fragments. Genes encoding for CR1, CR2 and CR3 have
      been cloned and they code for integral transmembrane glycoproteins which function
      as cellular receptors for human C3b, C3dg/C3d and C3bi fragments respectively.
      These receptors have a wide cellular distribution and participate in transport of
      immune complexes, phagocytosis and regulation of immune response. Alterations of
      expression of these molecules are observed in pathology.

PMID- 1745335
TI  - [Double profile dialysis: ultrafiltration and sodium variable description and
      clinical validation in the child].
AB  - Despite significant technical improvements (bicarbonate dialysate, volumetric
      ultrafiltration control) high intradialytic ultrafiltration is troublesome in
      children, specially in the proportion of patients presenting a normal or low
      blood pressure even with overweight. We used, in this group of children
      (overhydratated without vascular repercution) a modelling of both sodium and
      ultrafiltration during dialysis, in order to achieve dry body weight without
      increasing session time despite hypotension risks. The usefulness and
      practicability of sodium and ultrafiltration modelling together during dialysis
      in children is analysed in a short time study (for plasma volume changes
      calculation) and in a long term follow up study over a year (for clinical
      tolerance). Today, we reserve this form of dialysis only for a single session
      needed by overhydratation (more than 5% of dry body weight) in order to achieve
      dry body weight maintaining dialysis session time constant without increasing
      side effects (hypotension).

PMID- 1745336
TI  - [Extramembranous glomerulonephritis induced by lithium].
AB  - We report the case of a patient who developed a nephrotic syndrome after lithium
      carbonate therapy. The nephrotic syndrome disappeared after withdrawal of therapy
      and recurred when the patient was rechallenged with the same drug. This seems a
      convincing argument to believe that lithium was the causal agent. Renal biopsy
      specimens showed membranous nephropathy, suggesting that immune-complex formation
      was involved in the reaction to the drug. Membranous nephropathy is an
      exceptional and benign hazard during lithium therapy, and underlines the need for
      periodic urinalysis in patients treated with the drug.

PMID- 1745337
TI  - [Comparison of calcium acetate and calcium carbonate for the control of
      predialysis hyperphosphatemia].
AB  - The present study was conducted to determine whether half the dose of elemental
      calcium given as acetate (Ca Ac) could control on medium term the predialysis
      plasma phosphate as well as calcium carbonate (CaCO3) while inducing less
      frequent hypercalcemia. This was evaluated in a cross-over study of 3 periods of
      10 weeks according to the sequence Ca Ac, CaCO3, Ca Ac, in 12 compliant patients
      on chronic dialysis previously treated by Ca CO3. Because of poor tolerance of Ca
      Ac during the first period 4 patients were excluded and the results have been
      assessed only on the 8 patients who completed the study. For half the doses of
      elemental calcium (620 +/- 250 mg versus 1310 +/- 560 mg versus 710 +/- 200
      mg/day) Ca acetate allowed the same control of predialytic hyperphosphatemia
      (1.67 +/- .34; 1.74 +/- .32; 1.75 +/- .38) with paradoxically comparable normal
      mean plasma calcium concentration (2.61 +/- .14; 2.56 +/- .13; 2.55 +/- .14
      mmol/l). Plasma alkaline phosphatases and intact PTH concentrations remained also
      stable during the 3 periods. The frequency of hypercalcemia greater than 2.75
      mmol/l (12; 9; 20%) and of hyperphosphatemia greater than 2 mmol/l (17; 22; 27%)
      were comparable with the 2 treatments. We conclude that calcium acetate controls
      predialytic hyperphosphatemia as efficiently as CaCO3 for half the dose of
      elemental calcium without however decreasing the frequency of hypercalcemia.

PMID- 1745338
TI  - Neurologists--1990.
AB  - The American Medical Association Physician Masterfile for 1990 contains 13,705
      physicians who consider neurology their primary, secondary, or tertiary
      specialty. Of these, 7,036 are board certified and 10,065 designated neurology as
      their primary specialty. Although there has been a steady increase in the number
      of women, the vast majority of neurologists are men and less than 50 years old.
      Two-thirds provide direct patient care as their major activity and 15% are in
      training. There are almost as many neurologists employed by hospitals, medical
      schools, and government entities (40%) as there are working alone or in group
      practice (48%). The actual number of neurologists is compared with earlier
      projections of neurology needs for 1990. Since forecasts, in the absence of more
      detailed information, can become the reality of public policy decisions,
      neurologists will need to become increasingly informed about the many unique
      benefits they provide to their patients.

PMID- 1745339
TI  - The biologic basis for the treatment of acute stroke.
AB  - This is a review of therapeutic modalities that have been utilized in the
      treatment of stroke. Each is based upon data obtained from the study of the
      biologic events that occur during experimentally induced cerebral ischemia in
      animals. The type of information obtained from these studies could not have been
      obtained in any other manner. Despite the apparent effectiveness of some of these
      modalities in modifying stroke in animals, their application to humans with
      stroke has been disappointingly ineffectual. The delay between onset of stroke
      symptoms and initiation of treatment is usually several hours or more, which may
      be too late to rescue ischemic neurons. In order to be effective, treatment will
      have to be initiated as early as possible (preferably within 1 hour) to take
      advantage of the biologic window of opportunity. There is evidence that this can
      be accomplished by proper planning and training of personnel.

PMID- 1745340
TI  - Long-term benefit from prednisone therapy in Duchenne muscular dystrophy.
AB  - Two successive, 6-month, randomized, double-blind, controlled trials of
      prednisone showed that 0.75 mg/kg/d was the optimal dose to improve strength in
      boys with Duchenne muscular dystrophy (DMD). We attempted to maintain 93 boys on
      that dose for an additional 2 years. During the 3 years of observation, the
      decline in average muscle strength scores of all boys taking prednisone was 0.072
      units/yr, as compared with an expected decline of 0.341 units/yr from natural
      history controls. The occurrence of side effects in some boys prevented
      maintenance of the full dose, which may have lessened the response. At the time
      of last visit, dosages ranged from 0.15 mg/kg to 0.75 mg/kg. In addition to
      maintaining their strength, several of the boys actually improved their
      performance in lifting kilogram weights and in some timed function tests.
      Treatment of DMD with prednisone significantly slows the progression of weakness
      and loss of function for at least 3 years.

PMID- 1745341
TI  - Hearing loss in facioscapulohumeral muscular dystrophy.
AB  - The coincidence of facioscapulohumeral muscular dystrophy (FSHD) with
      sensorineural hearing loss and retinal abnormalities might imply genetic
      heterogeneity of FSHD. We performed screening audiometry in 56 patients with
      autosomal dominant FSHD and in 72 healthy family members, and found that the
      difference in hearing level between 4,000 Hz and 6,000 Hz was significantly
      greater in FSHD patients than in controls, independently both for the left and
      right ear. We conclude that this change of hearing function is part of the
      disease and may lead to severe hearing loss in some patients. The fact that it
      was present in all families is another argument against genetic heterogeneity.

PMID- 1745342
TI  - Clinical discriminators of lobar and deep hemorrhages: the Stroke Data Bank.
AB  - Of the 1,805 patients with acute stroke enrolled in the Stroke Data Bank, 237 had
      parenchymatous hemorrhage. After excluding 34 secondary intracerebral and 31
      infratentorial hemorrhage patients, a logistic regression analysis of the 172
      patients with primary supratentorial intracerebral hemorrhage (ICH) elucidated
      clinical factors that distinguished the 65 patients with lobar hemorrhage (LH)
      from the 107 patients with deep hemorrhage (DH) located in the basal ganglia and
      thalamus. In LH, severe headache was more common than in DH, while hypertension
      and motor deficit were significantly less common. Patients with either LH or DH
      had a similar prognosis and mean Glasgow Coma Scale (GCS) scores, despite the
      hematoma volume measured on the initial CT being significantly greater for LH
      than DH. The presence of intraventricular extension (IVH) was more frequent in
      DH. The frequency of IVH increased with hematoma volume in LH, but remained
      constant for DH. Two CT variables (IVH and hematoma volume) that differed in
      these two hemorrhage groups were important predictors of coma (GCS less than or
      equal to 8) in a logistic regression model. Differences in the frequency of IVH
      may help explain why the degree of impairment in consciousness was similar in the
      two groups. Among patients with supratentorial ICH, location of the hematoma is
      related to both volume and IVH, which are important determinants of the level of
      consciousness.

PMID- 1745343
TI  - Prevalence of Alzheimer's disease and other dementias in an elderly urban
      population: relationship with age, sex, and education.
AB  - We studied the prevalence of different types of dementia in an elderly population
      in Stockholm, Sweden, in relation to age, sex, and education. The study confirmed
      Alzheimer's disease (AD) as the most frequent type of dementia and the positive
      association of dementias with age, even in the most advanced ages. In contrast to
      previously reported data, we found the same proportion of AD and vascular
      dementia in the different age strata, and no sex differences regarding the
      prevalence of different dementia types. Finally, less educated people had a
      higher prevalence of all dementias, due essentially to a higher prevalence of
      alcoholic dementia and unspecified type of dementia. The prevalence of AD was
      similar across different levels of education.

PMID- 1745344
TI  - Accelerated intracranial occlusive disease, oral contraceptives, and cigarette
      use.
AB  - We report clinical and angiographic features of accelerated intracranial
      occlusive disease resembling moyamoya vasculopathy in five young women who used
      oral contraceptives (OCs) and smoked cigarettes, but generally had no other
      obvious risk factors for cerebrovascular disease. Three women had been on OCs for
      at least 4 years, one woman each had been on OCs for 3 months and for 2 weeks.
      All five women had smoked cigarettes for at least eight pack-years. Intermittent
      and progressive multifocal cognitive, visual, motor, or sensory hemispheric
      symptoms and signs developed in all. All patients developed strokes, four
      preceded by transient ischemic attacks. Cerebral angiography demonstrated
      bilateral supraclinoid internal carotid artery stenosis in four patients and
      proximal posterior cerebral artery stenosis in one. Additional features included
      rete mirabile, telangiectasias, prominent lenticulostriate collaterals, and
      multifocal distal cerebral branch occlusions. Three had mild abnormalities of
      serum fibrinogen, antinuclear antibody, erythrocyte sedimentation rate, or CSF
      IgG. After discontinuing OCs and reducing cigarette use, four women have not had
      further strokes over a mean follow-up of approximately 5 years. In certain young
      women, clinical and angiographic features resembling moyamoya may develop with
      the use of OCs and cigarettes. We speculate that an immunologically mediated
      vasculopathy may explain, in part, this unusual cerebrovascular syndrome in
      otherwise healthy young women.

PMID- 1745345
TI  - Transcranial Doppler ultrasound identifies patients with right-to-left cardiac or
      pulmonary shunts.
AB  - We performed transcranial Doppler ultrasound (TCD) and transesophageal contrast
      echocardiography simultaneously in four patients. In one patient with a patent
      foramen ovale and another patient with pulmonary A-V fistulae, we detected micro
      air bubbles in the right middle cerebral artery three to five cardiac cycles
      after their appearance in the left atrium following intravenous injection of
      contrast. In two patients without right-to-left shunts, we did not detect air
      bubbles in the left atrium or middle cerebral artery following injection of
      contrast. These results show that TCD can identify patients with right-to-left
      cardiac or pulmonary shunts.

PMID- 1745346
TI  - HIV-1 infection and nervous system abnormalities among a cohort of intravenous
      drug users.
AB  - A group of 109 HIV seropositive and 51 seronegative intravenous drug users was
      evaluated for the presence of HIV-1-related neurologic disease using clinical,
      neurologic, neuropsychological, and electrophysiologic evaluations. About 80% of
      HIV seropositive subjects had less than two constitutional symptoms. CD4 cell
      counts were less than 500/mm3 among 56% of seropositive participants; three
      individuals were receiving zidovudine. Neurologic abnormalities were found
      frequently among the cohort, independently of HIV-1 serostatus;
      electrophysiologic abnormalities were uncommon. Participants from both serologic
      groups scored significantly lower on neuropsychological tests as compared with
      norms established for a cohort of homosexual men, and there was no clear
      association between HIV-1 serostatus and performance on these tests. This study
      suggests that HIV infection was not the dominant cause of neurologic
      abnormalities among the study cohort.

PMID- 1745347
TI  - Is the prevalence of dementia changing?
AB  - We compared the point prevalence rates of dementing illnesses in the population
      of Rochester, Minnesota, on January 1, 1980, with the previously published rates
      of January 1, 1975, by using extensive health care records available from all
      sources of care in the community, in order to identify and classify cases with
      standard diagnostic criteria derived from DSM-III. The overall age- and sex
      adjusted prevalence rate per 100,000 population for dementia on January 1, 1980,
      was 402.5 compared with 388.4 on January 1, 1975; for Alzheimer's disease it was
      259.8 in 1980 and 259.5 in 1975. The stability of the rates suggests no change in
      the incidence and mortality associated with these conditions. The prevalence
      rates for Rochester, Minnesota, are similar to many other rates estimated in
      other North American communities, but they differ from two other population-based
      estimates from East Boston and California. Case definitions and methods of
      assessment probably account for the differences in estimated prevalence.

PMID- 1745348
TI  - Visual loss in tuberous sclerosis.
AB  - Of 11 patients with tuberous sclerosis complex (TSC) treated from 1980 to 1990
      for obstructive hydrocephalus secondary to subependymal giant-cell astrocytoma,
      four had adequate documentation to determine visual outcome. Despite surgical
      relief of elevated intracranial pressure in all cases, two patients sustained
      further visual loss. In one patient, visual loss was arrested, and in one
      patient, it was prevented. Although hydrocephalus is uncommon in TSC, its effects
      on the optic nerves are serious and eventually irreversible. Because TSC patients
      may not be able to express early symptoms of increased intracranial pressure,
      periodic ophthalmologic examination and brain imaging may be advisable when a
      subependymal lesion has been identified.

PMID- 1745349
TI  - Hemianopia, hemianesthesia, and spatial neglect: a study with evoked potentials.
AB  - We recorded somatosensory or visual evoked potentials (SEPs, VEPs) to stimuli
      contralateral and ipsilateral to the lesion in three right-brain-damaged patients
      with left spatial hemineglect and in three left-brain-damaged patients without
      evidence of neglect, as assessed by visual exploratory tasks. All patients had
      contralateral homonymous hemianopia or hemianesthesia. The three neglect patients
      showed normal SEPs or VEPs to stimuli delivered to the left half-field or to the
      left hand, without conscious perception and verbal report of the stimulation. By
      contrast, the three left-brain-damaged patients without neglect showed no
      recognizable cortical evoked response to contralateral visual or somatosensory
      stimuli. In all patients, the cortical evoked responses to ipsilateral
      stimulation were normal. In patients with spatial hemineglect, hemianopia and
      hemianesthesia may be manifestations of the neglect syndrome (visual and
      somatosensory hemi-inattention), rather than representing primary sensory
      deficit. Visual and somatosensory hemi-inattention may be due to defective access
      to the neural processes subserving conscious perception by information that has
      undergone early sensory processing.

PMID- 1745350
TI  - Familial spinal neurofibromatosis: clinical and DNA linkage analysis.
AB  - We studied two families with an unusual variant of neurofibromatosis (NF). The
      first family had spinal neurofibromas and cafe au lait spots (CLS), the second
      spinal neurofibromas without CLS. Other signs of NF1 or NF2, such as cutaneous
      tumors, Lisch nodules, or acoustic tumors, were absent. The inheritance pattern
      in both pedigrees was consistent with autosomal dominant inheritance. Using
      genetic linkage analysis with DNA markers tightly linked to the NF1 and NF2 loci,
      we determined that the likely location for the mutation in the first family was
      in the NF1 gene with odds of 97:1, whereas the mutation in the second family was
      excluded from the NF1 locus with odds greater than 100,000:1. Families such as
      these, in which a defined subset of the NF phenotype is passed on, are important
      for understanding the functional consequences of particular mutations in the NF
      genes.

PMID- 1745351
TI  - Plasmapheresis in children with Guillain-Barre syndrome.
AB  - Between 1987 and 1989, we plasmapheresed six children with Guillain-Barre
      syndrome (GBS). None of the children could walk independently at the start of the
      treatment, and one was being ventilated. Five patients showed clinical
      improvement during pheresis, and no significant side effects occurred. The median
      time from onset of weakness to independent walking for these six children was 17
      days. This compares with 43 days for 18 children with GBS in this institution who
      were given supportive measures only.

PMID- 1745352
TI  - Differential action of amitriptyline on neurons in the trigeminal nucleus.
AB  - We studied the effect of amitriptyline (AMI) on neurons in the spinal trigeminal
      nucleus caudalis in cats anesthetized with alpha-chloralose. The IV injection of
      1.0 to 4.0 mg/kg AMI had a differential effect on the inhibitory mechanisms
      controlling the responses of these neurons. AMI significantly enhanced the
      segmental inhibition (SI) of wide dynamic range (WDR) neurons but had little or
      no effect on low-threshold mechanoceptive neurons. AMI also facilitated the SI of
      some nociceptive specific (NS) neurons and the periventricular inhibition of some
      WDR and NS neurons, but these effects were not statistically significant. Our
      observations suggest that AMI exerts its antineuralgic effect by enhancing the
      ability of SI to prevent excessive firing of WDR neurons. This supports the
      notion that neuropathic pain is caused by dysfunction of inhibitory mechanisms in
      the CNS.

PMID- 1745353
TI  - Systemic lymphoblastoid interferon therapy in chronic progressive multiple
      sclerosis. II. Immunologic evaluation.
AB  - Immunologic functions are studied in conjunction with a placebo-controlled trial
      of lymphoblastoid interferon (IFN) in patients with chronic progressive (CP)
      multiple sclerosis. Prior to treatment, CD4+ cells are significantly increased
      and CD8+ cells decreased in the blood of MS patients. Both CD5+ and CD4+ cells
      increase significantly with IFN therapy early during the treatment phase of the
      trial, while the number of CD8+ cells decreases steadily, becoming significant at
      6 months. CNS IgG synthesis rates increase with IFN treatment and maximize at 3
      months. Serum antiviral activity also increases with IFN treatment. In the IFN
      treated group, a trend toward improvement, determined clinically and by MRI,
      likely reflects the influence of a subpopulation of 10 patients. This
      subpopulation is now further characterized by an early increase in CNS IgG
      synthesis and numbers of CD5+ cells in the blood. Although these immune functions
      may identify a number of CP MS patients who might benefit from IFN, it is
      unlikely that these mechanisms actually mediate the potentially beneficial
      effects of this cytokine.

PMID- 1745354
TI  - Self-sustaining limbic status epilepticus. I. Acute and chronic cerebral
      metabolic studies: limbic hypermetabolism and neocortical hypometabolism.
AB  - Regional cerebral glucose utilization (RCGU) increases during seizures whereas
      hypometabolism occurs in postictal and interictal states. Recently, we developed
      a model of nonconvulsive, self-sustaining limbic status epilepticus (SSLSE) in
      which electrographic seizures persist 12 to 24 hours after 90 minutes of
      continuous hippocampal stimulation. The present studies define the functional
      anatomy of SSLSE and the states thereafter. RCGU was studied by 2-deoxyglucose
      autoradiography in (1) a group of rats acutely (1 hour after induction) during
      SSLSE, and (2) two groups of rats chronically (1 week or 1 month) after SSLSE.
      RCGU measurements in these groups were compared with those obtained in naive and
      electrode-implanted control rats. In the acute group, there were bilateral
      increases in RCGU in the hippocampus, retrohippocampal structures, and associated
      limbic and subcortical nonlimbic regions; hypometabolism was found in several
      neocortical structures. Chronically, RCGU was elevated in certain limbic areas at
      7 days but returned to control values at 30 days. On the basis of our findings,
      we postulate a feedback network involving the hippocampus and neighboring
      parahippocampal structures (the hippocampal-parahippocampal "loop") as a critical
      substrate for establishing limbic system status epilepticus. In addition, the
      results indicate that metabolic responses can persist long after the cessation of
      status epilepticus and that both increases and decreases in RCGU can be seen in
      acute limbic status epilepticus.

PMID- 1745355
TI  - Self-sustaining limbic status epilepticus. II. Role of hippocampal commissures in
      metabolic responses.
AB  - In prior work, we developed a model of self-sustaining limbic status epilepticus
      (SSLSE) induced by continuous hippocampal stimulation (CHS). Previous
      electrographic studies showed that SSLSE was synchronized between the cerebral
      hemispheres. On the basis of this initial work, we postulated that hippocampal
      commissures were critical for the initiation and maintenance of SSLSE. In the
      current experiments, we tested this hypothesis by applying CHS in animals with
      (CMX) or without (-CMX) hippocampal commissurotomies. In the -CMX group,
      electrographic SSLSE was synchronized between the stimulated and contralateral
      sides. In the CMX group, SSLSE developed only on the stimulated sides. Regional
      cerebral glucose utilization (RCGU) was also studied acutely (1 hour) after CHS
      using 2-deoxyglucose autoradiography. In the -CMX group, there was symmetrically
      increased RCGU in the hippocampus, retrohippocampal structures, and associated
      limbic and subcortical nonlimbic regions. In the CMX group, a similar pattern was
      found, but confined to the side of stimulation. CMX alone did not change RCGU
      values from those in control (-CMX, nonstimulated) brain in any of the regions
      studied. Areas of bilateral neocortical hypometabolism were found in both (CMX
      and -CMX) SSLSE groups. These results lead to rejection of the hypothesis that
      hippocampal commissures play an essential role in the initiation and maintenance
      of SSLSE. Instead, a feedback circuit involving the hippocampus and its adjacent
      structures seems to be the critical anatomic substrate for SSLSE. The presence of
      neocortical hypometabolism after CMX indicates that the structures other than the
      hippocampal commissure (eg, the thalamus or other forebrain commissures) mediate
      this effect.

PMID- 1745356
TI  - Changes in muscle sympathetic nerve activity during sleep in humans.
AB  - We microneurographically recorded muscle sympathetic nerve activity (MSA) during
      sleep in 12 healthy volunteers while simultaneously recording EEG, EOG, ECG,
      respiration, and blood pressure and determined the number of pulse-synchronous
      MSA bursts per minute (burst rate) for non-rapid eye movement (nonREM) sleep and
      rapid eye movement (REM) sleep. MSA decreased during nonREM sleep with
      progressively deeper sleep stages. During REM sleep, the burst rate of MSA
      increased and was associated with marked fluctuations in arterial blood pressure.
      During sleep stage 2, MSA bursts occurred approximately 1 second after
      spontaneous K-complexes. We conclude that (1) the decreases in MSA during nonREM
      sleep stages may indicate sleep-stage dependent central suppression of MSA
      activity; (2) increases in MSA during REM sleep suggest instability of the
      autonomic nervous system; and (3) a common pathway may exist for MSA bursts and K
      complexes.

PMID- 1745357
TI  - The effect of stimulus rate upon common peroneal, posterior tibial, and sural
      nerve somatosensory evoked potentials.
AB  - We examined the effect of stimulus rate on somatosensory evoked potentials (SEPs)
      following stimulation of the common peroneal nerve (CPN) at the knee, and the
      posterior tibial nerve (PTN) and sural nerve (SN) at the ankle. We measured the
      amplitude of P40-N50 and N50-P60 in the PTN-SEP and corresponding amplitude of
      CPN-SEP and SN-SEP at the rate of 2.3, 3.4, 4.1, and 5.1 Hz. When the stimulation
      rate was increased from 2.3 to 5.1 Hz, the P40-N50 amplitude decreased by 50% for
      the CPN-SEP and 20% for the PTN-SEP. Also, the N50-P60 amplitude was reduced by
      30% in the CPN-SEP and 20% in the PTN-SEP. In contrast, this change in stimulus
      rate produced no significant amplitude decline in the SN-SEP. Blocking the
      peroneal nerve with lidocaine just distal to the stimulating electrodes
      eliminated the descending peroneal nerve volley and abolished the amplitude
      attenuation observed with the faster stimulus rate. The findings suggest that at
      higher rates of stimulation, the afferent volleys induced by the movements that
      follow mixed nerve stimulation interfere with the SEP produced by electrical
      activation of the sensory afferents. The interference is greater when the more
      proximal site of the mixed nerve is stimulated.

PMID- 1745358
TI  - Progressive depletion of fast alpha-actinin-positive muscle fibers in Duchenne
      muscular dystrophy.
AB  - In normal human muscle, a monoclonal antibody against alpha-actinin recognizes an
      isoform that is only expressed in a population of fast fibers histochemically
      identified as type IIb or fast-twitch glycolytic. Immunohistochemical studies of
      muscle biopsies from patients with Duchenne muscular dystrophy (DMD) showed that
      the number of alpha-actinin-positive type IIb fibers was essentially normal in
      preclinical patients. Symptomatic patients between the ages of 3 and 5 years
      showed depletion of these fibers, which were not seen in patients older than 5
      years. ATPase histochemistry showed that a few type IIb fibers were present in
      muscle from symptomatic DMD patients but lacked the fast isoform of alpha
      actinin. The data suggest that type IIb fibers are affected early in DMD.

PMID- 1745359
TI  - Is essential tremor benign?
AB  - We analyzed the results of the Sickness Impact Profile, a self-reporting measure
      of sickness-related dysfunction in 753 essential tremor (ET) patients, 87
      controls from the general population, and 145 patients with Parkinson's disease
      (PD). Compared with the general population, ET patients had significantly greater
      dysfunction in all but one category. Communication, Work, Emotional Behavior,
      Home Management, and Recreation and Pastimes were particularly impaired in ET.
      The PD patients had significantly higher dysfunction in all categories as
      compared with ET patients. We conclude that significant disability can occur in
      ET and, compared with PD, ET tends to be less severe but causes relatively
      greater psychosocial dysfunction.

PMID- 1745360
TI  - Exacerbation of Gilles de la Tourette's syndrome associated with thermal stress:
      a family study.
AB  - Gilles de la Tourette's syndrome (TS) is a familial disorder that is often
      exacerbated by stress or fatigue. Here we present a family of a TS proband that
      has several members with obsessive-compulsive symptoms, a bleeding disorder, and
      an unusual sensitivity to heat. The proband, who is affected by all of these
      traits, was challenged with heat or exercise in climate-controlled conditions and
      showed a marked increase in the frequency of tics.

PMID- 1745361
TI  - Superficial siderosis of the spinal cord: a rare cause of myelopathy diagnosed by
      MRI.
AB  - Repeated bleeding into CSF spaces may cause superficial siderosis with
      progressive neurologic impairment. The unique physical properties of MRI provide
      a basis for the in vivo diagnosis of this entity.

PMID- 1745362
TI  - HTLV-I-associated myelopathy: clinicopathologic correlation with localization of
      provirus to spinal cord.
AB  - A 49-year-old South African man developed a rapidly progressive myelopathy 14
      months after blood transfusion and died 1 year after the onset of symptoms.
      Detailed pathologic examination of the spinal cord was consistent with the
      diagnosis of HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP).
      Although no HTLV-I viral particles, antigens, or nucleic acids were detected in
      situ, polymerase chain reaction assays revealed HTLV-I proviral DNA in cervical,
      thoracic, and lumbar levels of the spinal cord, with the greatest amount being
      detected at the thoracic level. These findings suggest that the pathogenesis of
      HAM/TSP depends on direct infection of neural or immune elements within the
      spinal cord.

PMID- 1745363
TI  - Granulomatous amebic encephalitis in an AIDS patient.
AB  - A 39-year-old man with AIDS died after developing a variety of neurologic
      symptoms and signs. CT showed multiple enhancing lesions in the cerebral
      hemispheres and cerebellum. Postmortem examination revealed parenchymal
      hemorrhagic and necrotizing lesions with a thrombo-occlusive vasculitis due to
      Acanthamoeba, which was typed as Acanthamoeba group 2, probably A rhysodes, by
      immunofluorescence.

PMID- 1745364
TI  - EMG spectral shift- and 31P-NMR-determined intracellular pH in fatigued human
      biceps brachii muscle.
AB  - We have simultaneously recorded human biceps brachii intracellular pH, estimated
      by 31P-NMR, and EMG spectral shift, during isometric contraction and recovery in
      six subjects. This method allows us to concurrently study several components of
      muscle fatigue. The results show a clear dissociation between the recovery of
      intracellular pH, force-generating capacity, and the shift to low frequency of
      the EMG power spectrum induced by fatiguing exercise.

PMID- 1745365
TI  - Ipsilateral neglect in a patient following a unilateral frontal lesion.
AB  - Using a crossed-response task, it has been demonstrated that as a patient with
      unilateral frontal lesion recovers from visual inattention, he or she may
      inappropriately saccade to contralateral stimuli (visual grasp). We report a
      patient with a right frontal lesion who showed a similar phenomenon on sequential
      line bisection tasks. On day 1, he showed left-sided neglect on line bisections
      that enhanced with sequential trials. On day 5, he exhibited right-sided neglect
      (ipsilateral neglect) on line bisection tasks that also enhanced with repeated
      trials.

PMID- 1745366
TI  - Contribution of concurrent Doppler and EEG in differentiating occipital epileptic
      discharges from migraine.
AB  - In a young woman, episodes of visual symptoms were accompanied by simultaneous
      nonspecific EEG alterations. Concurrent Doppler sonography showed increased blood
      flow velocity with latency of a few seconds in the posterior cerebral arteries
      only. This is typical for local autoregulatory hyperperfusion due to increased
      neuronal activity, thus indicating focal epileptic discharges and excluding
      migrainous attacks.

PMID- 1745367
TI  - Truncal asterixis associated with ceftazidime, a third-generation cephalosporin.

PMID- 1745368
TI  - Factitious status epilepticus as a particular form of Munchausen's syndrome.

PMID- 1745369
TI  - Glucose and infarct size.

PMID- 1745370
TI  - Erythrocyte transketolase.

PMID- 1745371
TI  - HLA expression in myoblasts.

PMID- 1745372
TI  - [Informatics in medicine: drug monitoring in the elderly. Software for clinical
      procedures].
AB  - The Author describes the main procedure for the clinical control of
      pharmacokinetics and therapeutical programmes in medical practice, taking the use
      of digitalic alkaloids as an example. The procedure entails: a) Data records:
      this comprises a system for loading the patient's data into three different
      structures. The first record contains general information regarding the patient
      and it is used independently during the therapeutic regimen selection phase. The
      second record contains details of previous therapy, while the third concerns the
      input of digitalemic vales. b) The programme: it elaborates the main
      pharmacokinetic constants (Ka, Kcp, Kpc, Kslope, VC) of the predicted two
      compartment model and Sheiner's expression is used to correct it for the
      reference statistical population. c) Distribution values in the compartments: the
      chapter illustrates the mean values of alkaloid tissue distribution in normal
      subjects, the mean value of digoxin with protein binding, the importance of
      circulating pharmacological ranges and the digitalisation load in relation to
      tissue deposits. d) Print-out: this represents the observation and therapy
      selection phase. A typical example of digoxin therapy is illustrated using a dot
      matrix plotter and the methods are discussed for interpreting the results of this
      print-out.

PMID- 1745373
TI  - [Immune reaction in von Recklinghausen's neurofibromatosis].
AB  - A multidisciplinary study was performed on cases of neurofibromatosis to
      highlight the immunological reaction using broad-spectrum hematic tests and
      multiphase evaluation together with clinical and instrumental monitoring. The aim
      of the study was to focus attention on this rare disease and prompt further
      sequential immunological studies. A greater knowledge of the disease would allow
      the promising potential of new drugs to be exploited, in particular selective
      immunomodulatory drugs, in the hope of controlling the symptoms of disease (and
      overcoming further obstacles to the surgical removal of any neurofibromas that
      the patient wishes.

PMID- 1745374
TI  - [Prognostic value of serum immunoglobulins in patients with hepatic cirrhosis].
AB  - Immunoglobulin (Ig) serum levels have been assayed in 729 patients with liver
      cirrhosis of different etiologies, in order to evaluate their prognostic value.
      Serum levels of three classes of Ig resulted mainly elevated in the three
      etiological groups (post-hepatitic, post-alcoholic, cryptogenetic) and they were
      significantly related to the severity of the liver disease, evaluated according
      to the Child-Turcotte score. The computerized analysis of the survival curves of
      patients with IgG, IgM, IgA values normal or elevated demonstrated an adverse
      prognostic rate in those with elevated Ig values. The difference among the
      survival curves, compared by the Lee-Desu method, was statistically significant
      (p less than 0.001). Our data suggest that the Ig levels can be considered as a
      prognostic index in liver cirrhosis patients.

PMID- 1745375
TI  - [Cefixime. Microbiologic, kinetic and clinical profile].
AB  - The microbiological, kinetic and clinical profile of cefixime, a IIIrd generation
      cephalosporin, administered orally, is presented. Cefixime is highly active
      versus Gram-negative aerobic bacteria while, with respect to Gram-positive
      bacteria, it is only active against Str. pneumoniae, Str. pyogenes, Str.
      agalactiae, and Str. bovis. It has no action against anaerobics. Endowed with
      good kinetics, cefixime possesses a favourable tissue distribution. Cefixime is
      highly indicated in infections of the upper and lower airways where the
      aethiology is prevalently due to Str. pneumoniae, H. influenzae and B.
      catarrhalis, that are extremely sensitive to the antibiotic. It is concluded that
      the therapeutic armamentarium has been enriched by a new, highly active
      antibiotic that, administered in a monodese/die, ca satisfy patient compliance.

PMID- 1745376
TI  - [Comparison of the efficacy of pantethine, acipimox, and bezafibrate on plasma
      lipids and index of cardiovascular risk in diabetics with dyslipidemia].
AB  - Atherosclerotic manifestations are more common and precocious in diabetics than
      in the general population. Due to the increased cardiovascular risk, a primary or
      secondary (to diabetes mellitus) lipoprotein disorder in diabetics has to be
      carefully considered. 27 diabetics (15 NIDDM and 12 IDDM) with dyslipidemia (14
      type IV, 8 type IIa and 5 type IIb) were divided in 3 groups and treated with 3
      different hypolipemic drugs (Group A: pantethine 600 mg/day; Group B: acipimox
      500 mg/day; Group C: bezafibrate 600 mg/day) to test their efficacy and
      acceptancy. Body weight, Hb A1-c, serum lipoproteins have been measured before
      and during the 6 months treatment. A significant variation of lipidemic pattern
      was observed in Group C: a decrease of cholesterol (-20%), triglycerides (-40%),
      LDL (-24.4%) and apo B (-26.8%) with an increase of HDL (+23.6%). Pantethine and
      acipimox were more effective on triglycerides (-37.7% and -23.3% respectively).
      Cardiovascular risk (CT tot/CT HDL) was significantly reduced with acipimox and
      normalized with bezafibrate.

PMID- 1745377
TI  - [The heart, the elderly, and diabetes mellitus. Epidemiologic study of 333
      ambulatory clinical cases].
AB  - The paper proposes a new classification to describe the normal senile heart and
      its pathological forms: "small aortic heart" (nonhypertrophic-dilatative
      myocardiopathy and its ischemic form) and "large aortic heart" (hypertrophic
      dilatative myocardiopathy and its ischemic form). The statistical distribution of
      241 elderly patients with diabetes mellitus using this classification was
      compared to a control group of 92 elderly non-diabetic subjects. The results
      reveal the significant epidemiological incidence of ischemic cardiopathy with
      small aortic heart in diabetic patients compared to the control group in which
      more ischemic hypertrophic-dilatative cardiopathies were present. This
      observation supports the hypothesis that senile diabetic cardiopathy begins with
      a metabolic block with reduced contractile energy, and the overlying important
      ischemic component leads to the development of the small-size clinical phenotype.

PMID- 1745378
TI  - [Mortality and HIV infection in a group of intravenous heroin addicts from 1985
      to 1989].
AB  - One hundred and eighty-seven heroin addicts resident in Valle Seriana Superiore
      were monitored from July 1985 to July 1989. This sample was representative of a
      total population of drug addicts estimated at some 350 subjects, 90 of whom
      (48.1%) were HIV-positive in Elisa assays and Western blot control tests. Six
      patients (3.2%) died; 3 of whom (3%) were HIV-positive and 3 (3.3%) were HIVab
      negative. The most frequent cause of death (59%) was heroin overdose, which
      occurred in both HIV-positive and negative subjects, showing that the fear of
      contracting the disease or its possible evolution is not a deterrent in modifying
      risk behaviour. During the four years of the study, 5 (5.5%) of the HIV-positive
      patients developed confirmed AIDS. Only one patient died from AIDS, thus
      confirming the current risk of death as being 1.1% in seropositive patients. An
      increase in mortality due to AIDS is expected in the future, in line with the
      current prevalent mortality rate due to heroin overdose.

PMID- 1745379
TI  - [Cutaneous tumor metastasis. A possible first clinical event of visceral
      neoplasms].
AB  - Two cases of visceral malignant tumours due to cutaneous metastases (stomach
      adenocarcinoma and left pulmonary adenocarcinoma). Are reported in both cases the
      cutaneous lesions represent the first clinical phenomenon of the disease.

PMID- 1745380
TI  - [Complete endocardial cushion defect and bone malformations of the hands. Holt
      Oram syndrome].
AB  - A 44 year old woman with upper limb skeletal malformations and endocardial
      cushion defect is described. This congenital heart disease was rarely reported in
      association with Holt-Oram syndrome.

PMID- 1745381
TI  - [Topical therapy with beta-interferon in a case of neoplastic pleuro-pericardial
      effusion].

PMID- 1745382
TI  - [Marked hematic hypereosinophilia caused by Giardia Lamblia infestation in a
      subject with Churg-Strauss syndrome].
AB  - We report a Churg-Strauss syndrome case complicated by Giardia Lamblia infection
      which increased markedly the number of blood eosinophils with appearance of
      eosinophils able to form rosettes with unsensitized sheep red blood cells.
      Metronidazolo therapy reduces markedly the blood hypereosinophilia. The strong
      relationship between blood hypereosinophilia and Giardia Lamblia in this patient,
      suggests that there is an interaction between different eosinophilopoietic
      stimuli.

PMID- 1745383
TI  - Insights into the complex aluminium and iron relationship.

PMID- 1745384
TI  - Amelioration of gentamicin nephrotoxicity by phospholipids.
AB  - The effect of phospholipids on gentamicin-induced nephrotoxicity was studied in
      Sprague-Dawley rats. Group 1a (5 rats) were given daily intraperitoneal
      injections of 100 mg/kg of gentamicin and sacrificed on day 7. Group 1b (10 rats)
      were similarly treated but were sacrificed on day 14. Group 2a (5 rats) were
      given 30 mg/kg of phospholipids for 6 days and sacrificed on day 7, serving as
      phospholipid controls. Group 2b (5 rats) were similarly treated, and from day 7
      onwards daily intraperitoneal injections of 100 mg/kg of gentamicin were given
      while oral phospholipids were continued until the rats were sacrificed 7 days
      after gentamicin treatment. Group 2c (10 rats) were treated in the same manner as
      group 2b but the animals were sacrificed on day 28 after gentamicin treatment.
      Group 3 (10 rats) were given 30 mg/kg of phospholipids concurrently with
      intraperitoneal gentamicin injections and were sacrificed on day 28. Protein
      concentrations, N-acetyl-beta-glucosaminidase (NAG) activities and creatinine
      were measured in 24-h urine samples. Serum creatinine concentrations were
      measured in blood samples and 24-h creatinine clearance calculated. Gentamicin
      concentrations were determined in kidney tissues from which sections were also
      taken for light- and electron-microscopy. Results showed that gentamicin induced
      a marked increase in NAG and protein excretion, and a marked decrease in
      creatinine clearance with six rats succumbing to uraemia. Phospholipid treatment,
      whether started before or concurrently with gentamicin injections, reduced
      gentamicin-induced nephrotoxicity. The rats did not lose weight. Urinary
      excretion of NAG and protein was significantly reduced.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1745385
TI  - Experimental gold-induced autoimmunity.
AB  - The pathogenesis of gold-induced autoimmunity and membranous glomerulopathy is
      not well understood. HgCl2 and D-penicillamine, other chemicals known to trigger
      membranous glomerulopathy in humans, induce autoimmune manifestations in Brown
      Norway (BN) rats but not in Lewis (LEW) rats. These chemicals trigger T-cell
      clones which are specific for self class II molecules from the major
      histocompatibility complex and are probably responsible for the polyclonal B-cell
      activation observed. The aim of this work was to test the effects of
      aurothiopropanolsulphonate (ATPS) in BN and LEW rats. In BN rats, ATPS induced a
      polyclonal B-cell activation marked by lymphoproliferation,
      hyperimmunoglobulinaemia affecting mainly IgE, and by the production of numerous
      autoantibodies. A glomerulonephritis occurred, initially due to anti-glomerular
      basement membrane antibody deposition, and later to the formation of granular
      deposits, occasionally resulting in a typical membranous glomerulopathy. Self
      class-II-specific T-cells were found that might be responsible for the polyclonal
      B-cell activation. Lewis rats were free of glomerulopathy but, like BN rats,
      exhibited an interstitial nephritis and some degree of polyclonal B-cell
      activation. These findings demonstrate that, depending on the strain, ATPS
      triggers different B-cell clones inducing different degrees of autoimmunity.

PMID- 1745386
TI  - The reflex control of vasopressin in haemodialysis patients.
AB  - We studied the reflex arginine vasopressin (AVP) response to hypotensive,
      isosmotic fluid subtraction (by isolated UF) in 14 uraemic patients on renal
      dialysis treatment: five with normal autonomic function and nine with autonomic
      involvement of various degrees. Fluid subtraction caused a comparable mean
      arterial pressure (MAP) decrease in the two groups. The reduction in right atrial
      pressure was inversely related with the severity of autonomic neuropathy (rs = 
      0.72, P = 0.004), being distinctly attenuated in the second group (P = 0.006).
      Plasma arginine vasopressin increased similarly in patients with normal autonomic
      function and in those with autonomic involvement. The response of patients with
      haemodialysis hypotension was similar to that of other patients. Reflex control
      of arginine vasopressin is preserved even in the presence of afferent/central
      neuropathy or more advanced, widespread autonomic damage in uraemic man. The data
      suggest that it is unlikely that altered release of arginine vasopressin is
      involved in the pathogenesis of haemodialysis hypotension.

PMID- 1745387
TI  - Iron uptake in aluminium overload: in vivo and in vitro studies.
AB  - In this study we have evaluated the haematological consequences of chronic
      aluminium (Al) overload. We have also investigated 'in vivo' whether aluminium
      overload may modulate gastrointestinal iron (Fe) absorption and 'in vitro'
      whether the presence of aluminium may influence the cellular uptake of iron. The
      in vivo studies were performed in rats with normal renal function and the in
      vitro experiments were done using the rat intestinal epithelial cell line RIE-1.
      The results demonstrate that aluminium deposit in tissues even with normal renal
      function. The intraperitoneal aluminium loading resulted in serum and tissue
      aluminium increases comparable with concentrations found in aluminium-intoxicated
      renal patients. The aluminium intoxication was accompanied by a microcytic
      anaemia with a haematological pattern similar to that observed in iron-deficiency
      anaemia. Nevertheless, iron absorption was significantly reduced despite an
      increased total iron binding capacity (TIBC). In addition, aluminium was also
      able to reduce in vitro cellular uptake of iron in the RIE-1 intestinal cell
      line. These experimental results demonstrate that aluminium interferes with iron
      absorption and iron transfer, and suggest that these mechanisms may be
      responsible for maintaining and even increasing the anaemia observed in aluminium
      overload.

PMID- 1745388
TI  - Epidemiology of CAPD-associated peritonitis caused by coagulase-negative
      staphylococci: comparison of strains isolated from hands, abdominal Tenckhoff
      catheter exit site and peritoneal fluid.
AB  - We identified twenty patients maintained on continuous ambulatory peritoneal
      dialysis who suffered repeated episodes of peritonitis caused by coagulase
      negative staphylococci. We documented hand and exist-site coagulase-negative
      staphylococcus-associated peritonitis over a total period of 32 months, and
      compared hand and exit-site strains with strains isolated from dialysate fluid
      using three typing methods: biotyping using the API Staph kit plus antibiograms,
      immunoblotting using sera raised in rabbits to three standard strains of
      coagulase-negative staphylococci, and 35S-methionine-labelled coagulase-negative
      staphylococcal profiles separated on sodium dodecylsulphate polyacrylamide gel
      electrophoresis and visualised by autoradiography (radioPAGE). In 5 of 84
      episodes, strains isolated from skin were indistinguishable by all three typing
      methods from the dialysate strain. In a further two episodes, hand or exit-site
      isolates were indistinguishable by all three typing methods from the dialysate
      strain isolated in the subsequent, but not the same, episode. Thus in the
      majority of episodes, no inference of hand or exit-site origin of dialysate
      infection could be drawn.

PMID- 1745389
TI  - Ocular complications in renal allograft recipients.
AB  - Ocular complications in renal allograft recipients are a significant cause of
      morbidity. Of 80 renal transplant recipients, 42 (52.5%) developed ocular
      complications. These included posterior subcapsular cataract in 22 patients
      (27.5%), opportunistic ocular infections by CMV, cryptococcus, mucormycosis,
      herpes simplex and herpes zoster in five (6.25%), steroid-induced raised
      intraocular pressure in four (5%) and primary disease-related vascular
      complications in ten (12.5%). Our findings highlight the importance of regular
      ocular examination of all allograft recipients in the post-transplant period.

PMID- 1745390
TI  - Rhinocerebral mucormycosis in haemodialysis patients treated with
      desferrioxamine: possible role of recent surgery as an additional risk factor.

PMID- 1745391
TI  - Chylous ascites and continuous ambulatory peritoneal dialysis.

PMID- 1745392
TI  - Arachidonate cyclo-oxygenase and lipoxygenase products in the mediation of
      glomerular immune injury.

PMID- 1745393
TI  - Late leaks in peritoneal dialysis patients.
AB  - A series of eight patients with leakage of dialysate around the exit site of
      their peritoneal dialysis catheters is reviewed. In all cases the leak occurred
      at least 1 month after catheter placement. There were no risk factors allowing
      prediction of leakage. Four cases required surgical intervention, and all
      patients returned to CAPD.

PMID- 1745394
TI  - Aluminium uptake by intestinal cells: effect of iron status and precomplexation.
AB  - The investigation of different aluminium-binding agents and metabolic conditions
      that might act as critical factors in modulating aluminium absorption could yield
      valuable information in the understanding of aluminium gastrointestinal
      absorption. We evaluated the effect of iron depletion in aluminium uptake and the
      role of transferrin and citrate in aluminium incorporation by the intestinal
      epithelial cell line RIE1. Both complex, aluminium-citrate and aluminium
      transferrin were prepared in a molar ratio of 2:1; both facilitated the aluminium
      uptake although a greater aluminium incorporation was found when aluminium was
      administered as aluminium-transferrin. This difference became even greater in the
      iron-depleted cells (normal cells vs iron-depleted cells): 7.7 +/- 1.4 versus 30
      +/- 5.6 ng Al/micrograms DNA (P less than 0.05). From these and previous data it
      is possible to speculate that iron status could modulate the intestinal uptake of
      aluminium and that both transferrin and citrate would act as effective carriers
      in the incorporation of aluminium into mucosal cells.

PMID- 1745395
TI  - Erythrocytosis after renal transplantation.

PMID- 1745396
TI  - Polyvalent immunoglobulins in sensitised renal transplant recipients.

PMID- 1745397
TI  - Sympathetic innervation of the male feline urethral rhabdosphincter.
AB  - Sympathetic innervation of the male feline urethral rhabdosphincter was
      investigated by means of electromyography (EMG). Hypogastric nerve stimulation
      elicited responses in the rhabdosphincter, the latencies and amplitudes ranged
      from 40 to 107 ms and 6 to 40 microV, respectively. These hypogastric nerve
      evoked responses in the rhabdosphincter were not affected by whether the urinary
      bladder was empty or full. The results suggest that hypogastric nerve-evoked
      responses in the rhabdosphincter are not dependent on somatic nerve, but are
      produced through a rather direct effect of sympathetic nerve on the
      rhabdosphincter.

PMID- 1745398
TI  - Blockade of 5-HT2 receptors protects against impairment of working memory
      following transient forebrain ischemia in the rat.
AB  - The effects of the 5-HT2 receptor antagonists pirenperone, cinanserin and
      ritanserin on impairment of working memory in an animal model of cerebral
      ischemia were investigated, using a three-panel runway task. A 5-min period of
      ischemia caused a significant increase in the number of errors (attempts to pass
      through two incorrect panels of the 3 panel gates at 4 choice points).
      Pirenperone at 0.32 and 1.0 mg/kg, cinanserin 10 mg/kg and ritanserin 3.2 mg/kg
      administered i.p. immediately after blood flow reperfusion significantly reduced
      the increase in errors expected to occur 24 h after the 5 min of ischemia. These
      results suggest that the blockade of 5-HT2 receptors prevents the impairment of
      working memory following transient forebrain ischemia.

PMID- 1745399
TI  - Frequency of occurrence of perforated synapses in developing rat neocortex.
AB  - The frequency of occurrence of perforated synapses in the molecular layer of rat
      parietal cortex has been determined using the disector method. Perforated and non
      perforated synapses were examined in electron micrographs, all quantitative
      procedures being carried out on adjacent sections, as required by the disector
      procedure. The numerical densities of perforated, non-perforated and all synapses
      were determined at nine ages, ranging from 0.5 to 22 months of age. The
      frequencies of perforated synapses were subsequently calculated. These ranged
      from 18.1% at 0.5 months to a peak of 37.2% at 10 months of age, and remained at
      around 34% up to 19 months. A frequency of 26.7% was found at 22 months of age.
      The mean projected height of the total perforation increased from 66 nm at 0.5
      months to 133 nm at 22 months of age. These results suggest that perforated
      synapses are present throughout the life-span of the animal, and increase in
      complexity with increasing age.

PMID- 1745400
TI  - Electrical stimulation of visceral afferent pathways in the pelvic nerve
      increases c-fos in the rat lumbosacral spinal cord.
AB  - Electrical stimulation (20-35 Hz, 2-5 V, 1.5 h) of the pelvic nerve in urethane
      anesthetized rats increased the expression of c-fos protein-immunoreactivity
      primarily in neurons in the L6-S1 segments of the spinal cord. The neurons were
      localized to areas receiving afferent input from the pelvic viscera including the
      superficial dorsal horn, the dorsal commissure, and lateral laminae V-VII in the
      region of the sacral parasympathetic nucleus. These experiments indicate that (1)
      electrical stimulation of abdominal nerves following surgical exposure is a
      useful method for tracing visceral afferent pathways and (2) afferent information
      from the pelvic viscera is received by neurons in specific areas of the dorsal
      horn.

PMID- 1745401
TI  - Apomorphine induces ejaculation in chronic decerebrate rats.
AB  - Chronically maintained supracollicular decerebrate (CD) rats, but not rats with
      midthoracic (T10) spinal transections (SPI) or neurologically intact controls,
      displayed erection and ejaculation following systemic administration of the
      dopamine (DA) agonist, apomorphine (APO). The response was blocked by
      pretreatment with the DA receptor antagonist, cis-flupentixol. CD rats, like
      intact controls, failed to display erections or penile cupping in response to the
      same mechanical stimulation that elicited short-latency responses in SPI rats.
      The present results demonstrate excitatory and inhibitory mechanisms of relevance
      to the copulatory behavior of the male rat that are endemic to the caudal
      brainstem neurally isolated from forebrain influence.

PMID- 1745402
TI  - REM sleep-associated hemoglobin oxygenation in the monkey forebrain studied using
      near-infrared spectrophotometry.
AB  - The oxygenation state of hemoglobin (Hb) in the monkey forebrain was monitored
      continuously throughout nocturnal sleep using a near-infrared spectrophotometric
      technique. During rapid eye movement (REM) sleep, an increase in oxygenated Hb
      occurred concomitantly with a decrease in deoxygenated Hb, while no significant
      changes in Hb oxygenation were observed during slow wave sleep (SWS). A gradual
      increase in total Hb content was also observed to occur during each REM sleep
      episode but not during SWS.

PMID- 1745403
TI  - Sequential expression of JUN B, JUN D and FOS B proteins in rat spinal neurons:
      cascade of transcriptional operations during nociception.
AB  - Expression of the immediate-early gene encoded proteins JUN B, JUN D and FOS B
      was investigated by immunocytochemistry in rat L5 spinal cord up to 24 h
      following stimulation of hind limb somatosensory nociceptors by noxious heat or
      injection of formalin. In both experimental protocols, JUN B, which did not show
      basal expression, reached maximum expression after 2 h and thereafter slowly
      decreased. In contrast, the expression of JUN D, which was present before
      stimulation in many spinal neurons, was increased after 4 h, reached its maximum
      after 8 h and thereafter remained elevated. FOS B which was absent under basal
      conditions reached its maximum between 4 h and 8 h and thereafter declined but
      was still present after 24 h. All immunoreactivities were restricted to the
      ipsilateral dorsal horn except JUN D which was also induced in the contralateral
      side after 8 h. The results are discussed in respect to their meaning for
      transcriptional operations of JUN and FOS proteins.

PMID- 1745404
TI  - Synaptic effects in lumbar alpha-motoneurones evoked from group II muscle
      afferents via two different interneuronal pathways in the cat.
AB  - Conditioning of monosynaptic reflexes was used to investigate group II excitation
      from quadriceps (Q) and sartorius (Sart) in posterior biceps-semitendinosus
      (PBSt) motoneurones and different lesions were made to analyze the interneuronal
      pathways. The purpose of the investigation was to find if the excitation from
      group II Q and Sart afferents, which enter the spinal cord in L4-L6, is relayed
      to motoneurones by interneurones located in these segments and/or in the same
      segments (L7-S1) as the PBSt motoneurones. In some experiments a transection of
      the dorsal column in L6, which interrupts the group II input from Sart and Q to
      interneurones in the L7-S1 segments, resulted in a marked decrease (by about 2/3)
      of group II excitation from these nerves. In other experiments the same lesion
      did not reduce the group II effect. In the latter cases the effect could be
      abolished by a second lesion of the lateral funiculus (LF) in L5-L6. It is
      postulated that potent effects from Q and Sart group II afferents can be evoked
      by interneurones located in L7-S1, i.e. in the same segments as the PBSt
      motoneurones (L7-S1), and/or via interneurones in more rostral segments. The
      axons of the more rostrally located group II interneurones appear to descend
      mainly in the middle part of the LF.

PMID- 1745405
TI  - The effect of calcium channel antagonists on the release of [3H]noradrenaline in
      the human neuroblastoma, SH-SY5Y.
AB  - The effect of calcium channel antagonists on depolarization and carbachol evoked
      release of [3H]noradrenaline in the human neuroblastoma, SH-SY5Y, was
      investigated. Nifedipine, verapamil and diltiazem completely inhibited the
      depolarization evoked release of [3H]noradrenaline with IC50 values of 0.44 +/-
      0.1 microM, 3.6 +/- 0.24 microM and 5.6 +/- 0.2 microM respectively. In addition,
      nickel, cobalt and cadmium, all at 2 mM, inhibited depolarization evoked release
      by 89.2 +/- 2.3%, 72.6 +/- 1.6% and 102.5 +/- 1.4% respectively. Furthermore,
      omega-conotoxin resulted in at least 20% inhibition of potassium evoked release,
      suggesting a role of N-type calcium channels. Carbachol evoked release of
      [3H]noradrenaline was inhibited by 10(-4) M nifedipine, diltiazem and verapamil
      by 15.6 +/- 1.1%, 14.6 +/- 3.2% and 23.6 +/- 1.8% respectively and by 2 mM
      nickel, cobalt and cadmium by 13.8 +/- 3.2%, 34 +/- 2.1% and 6.5 +/- 3.7%
      respectively. These results suggest that depolarization evoked release of
      [3H]noradrenaline is mediated via L- and N-type calcium channels, whereas,
      carbachol evoked release does not appear to be coupled an L-, T- or N-type
      voltage sensitive calcium channel.

PMID- 1745406
TI  - Excitability changes in C fibers of rat sciatic nerve following impulse activity.
AB  - Three phases in the oscillatory changes of both threshold and conduction velocity
      were identified following impulse activity in single C fibers of rat sciatic
      nerves. These after-oscillations, occurring after the refractory period, varied
      with the number and timing of preceding 'conditioning' impulses. The excitability
      changes differed both qualitatively and quantitatively among fibers, thus
      implying underlying variation among C fibers in the density and distribution of
      voltage-gated channels and ion pumps.

PMID- 1745407
TI  - Entorhinal neurofibrillary tangles in Alzheimer disease with Lewy bodies.
AB  - Entorhinal cortex is the major source of hippocampal afferents. Its neurons,
      especially in layer 2, develop neurofibrillary tangles (NFTs) in Alzheimer
      disease (AD). We quantified entorhinal NFTs in cases of AD, elderly controls, and
      in brains with both AD pathology and subcortical and neocortical Lewy bodies, (a
      Lewy body variant, LBV). A nosologic controversy hinges on whether LBVs are a
      form of AD or a different disease, since they have few neocortical NFTs and their
      neuritic plaques often lack paired helical filament immunoreactivity. The LBVs
      had more entorhinal NFTs than controls (P less than 0.001), but fewer than ADs (P
      less than 0.02), despite comparable numbers of neuritic plaques. AD pathology in
      LBVs is of moderate severity, or perhaps in an earlier developmental stage.

PMID- 1745408
TI  - Effect of repeated immobilization stress on the uptake of exogenous [3H]dopamine
      in adrenal chromaffin cells of mice.
AB  - Uptake of [3H]dopamine in adrenal chromaffin cells of the mouse during repeated
      immobilization was examined by autoradiography. Repeated daily immobilization of
      mice resulted in an increased uptake of [3H]dopamine to the level of denervated
      chromaffin cells. The increase was observed only in adrenaline-storing (A) cells,
      not in noradrenaline-storing (NA) cells. The results indicate that sympathetic
      outflow to the adrenal gland, especially to A cells, is ceased or blocked during
      the adaptation to stress.

PMID- 1745409
TI  - A high glucose environment improves survival of diabetic neurons in culture.
AB  - Dorsal root ganglia neurons from streptozotocin-induced diabetic and normal C57BL
      mice were cultured in serum-containing and serum-free media. The ratio of dead
      cells was higher in diabetic neurons than in controls in the early stages of
      culture. The effect of glucose concentration on survival in the culture medium
      was also measured for 1 week. Treatment with high glucose concentrations improved
      the survival of diabetic neurons, which was enhanced by duration of diabetes in
      the animal. These results indicate that exposure to hyperglycemia in vivo might
      adapt neurons to a high glucose environment in vitro.

PMID- 1745410
TI  - Ontogenesis of the axonal circuitry associated with the olfactory system of the
      rat embryo.
AB  - The prenatal development of axonal connections in the rat olfactory system was
      studied using DiI. On day 16 (E16), the olfactory and vomeronasal nerves extended
      from the olfactory epithelia to the olfactory bulb (OB), the terminal nerve to
      the telencephalic septum, while axons of mitral and tufted cells reached the
      anterior olfactory nucleus (AO). Axons from the AO were also seen in the anterior
      commissure. On day E16(8) (at 16 days, 8 h), axons were anterogradely followed
      from the dorsal OB through the lateral olfactory tract (lo) to the bed nucleus of
      the accessory olfactory tract. At E18(0), crystals implanted in the olfactory
      epithelium labeled the mitral cell layer and the lo.

PMID- 1745411
TI  - Specialized presynaptic dendrites in the stratum cellulare externum of the optic
      tectum of an elasmobranch, Scyliorhinus canicula L.
AB  - Electron microscopy of the stratum cellulare externum of the optic tectum of an
      elasmobranch revealed the presence of two types of presynaptic dendrites in the
      neuropil as well as axo-dendritic synapses. In the dendro-dendritic or dendro
      axonic synapses, the presynaptic process was a beaded dendrite. These findings
      support the view that the synaptic organization of the tectum in elasmobranchs is
      basically similar to that of higher vertebrates, rather than the classical
      opinion that it is less highly organized.

PMID- 1745412
TI  - Magnetoencephalographic 10-Hz rhythm from the human auditory cortex.
AB  - Spontaneous magnetoencephalographic activity was recorded with a 24-SQUID
      gradiometer over the lateral aspects of the head in 3 healthy adults. All
      subjects displayed 8-10 Hz rhythmic activity which was not affected by opening of
      the eyes but was occasionally dampened by auditory stimuli. The equivalent
      sources of the rhythm were in the supratemporal auditory cortex, and the activity
      may therefore represent 'idling' of the auditory cortex. Obviously each sensory
      projection cortex has its own local spontaneous rhythm.

PMID- 1745413
TI  - Elevated circulating tumor necrosis factor levels in Alzheimer's disease.
AB  - Recent investigations have demonstrated a local inflammatory response in
      Alzheimer's disease (AD), including microglia and cytokines. Levels of the
      cytokine tumor necrosis factor alpha (TNF-alpha) in sera from patients with AD
      and age-matched controls were measured by an enzyme-linked immunoassay and a
      cytotoxicity bioassay. Significantly elevated levels of TNF were found in AD sera
      compared to controls. Elevated circulating TNF may be derived from the local CNS
      inflammatory reaction in AD, and may account for some systemic manifestations of
      AD such as weight loss. Future studies may determine if, in the absence of
      complicating disorders which may elevate TNF, circulating TNF could be a marker
      of AD inflammatory activity.

PMID- 1745415
TI  - Women in organized medicine: side by side.

PMID- 1745414
TI  - AIDS issues.

PMID- 1745416
TI  - The athletic team physician's medical bag.
AB  - Physicians are called upon to provide sideline coverage for athletes, as well as
      to travel with the team. The physician must be equipped with tools to handle a
      wide array of problems. The bag's contents allow the physician to manage medical,
      surgical, and orthopedic problems.

PMID- 1745417
TI  - The sports preparticipation evaluation.
AB  - The best sports preparticipation program requires an initial comprehensive
      evaluation, interim care, central reporting, and an appropriate followup
      examination. The preparticipation examination, when properly carried out, can
      meet the needs of our adolescents.

PMID- 1745418
TI  - Children and sports medicine in the 1990s.
AB  - Sports participation is an opportunity for children of all ages to improve their
      fitness, level of maturation, and physical and psychologic condition. A primary
      physician can play a significant role in promoting enhanced physical fitness in
      the office or as a team doctor.

PMID- 1745419
TI  - Recreational sports and the weekend athlete.
AB  - It is important to design an exercise program that provides an adequate amount of
      activity to attain maximal benefits at the lowest risk to the participant.
      Permanent lifestyle changes in eating and activity habits should be included in
      the primary goals of all programs.

PMID- 1745420
TI  - Sports injuries in the female athlete.
AB  - Women are successfully participating in a variety of sports in increasing
      numbers, both recreationally and competitively. There are certain anatomic and
      physiologic differences between men and women that make each sex unique, but
      there also are multiple external factors that significantly influence athletic
      performance. The nature of injuries seems to be more sports-specific than gender
      specific. Even the increased susceptibility to overuse syndromes found in women
      may be reduced by increasing awareness and redefining conditioning and coaching
      techniques. Further epidemiologic studies of women's athletic injuries will be
      needed to better define injury patterns and to suggest preventive measures.

PMID- 1745421
TI  - Sports medicine for the diabetic athlete.
AB  - Exercise can be a useful therapy for patients with type II diabetes mellitus.
      Improvements in body composition, glucose tolerance, insulin sensitivity,
      cardiovascular profile, and psychological state are some benefits. The benefits
      of exercise will enrich the lives of diabetics.

PMID- 1745422
TI  - Exercise and arthritis in the 1990s.
AB  - Arthritis sufferers want to share in the benefits of exercise without increasing
      their pain. Too much physical activity can increase the inflammatory response in
      arthritic joints. Walking is the ideal form of exercise, as it is fun, simple to
      do, and beneficial.

PMID- 1745423
TI  - Update on sports nutrition.
AB  - Adequate nutrition is vital to peak athletic performance. Insufficient energy and
      fluids can hinder ability to compete. Physicians and dietitians must emphasize
      nutrition's importance to athletes. Sports nutrition follows the same principles
      as good nutrition.

PMID- 1745424
TI  - Anabolic steroids: performance enhancers?
AB  - Physicians must discourage steroid use in those who have not yet begun and must
      treat those patients already on anabolic steroids. Physicians cannot encourage
      anabolic steroid use by their patients or by themselves. Anabolic steroids are
      bad for the user.

PMID- 1745425
TI  - Doctors' notebook.

PMID- 1745426
TI  - Neurotoxins and degeneration in the central nervous system.
AB  - Numerous examples exist where neurotoxins have been shown to induce selective
      death of certain groups of nerve cells. While the peripheral nerves are
      particularly vulnerable, neurotoxins are also capable of generating models of the
      major degenerative disorders of the central nervous system: dementia of
      Alzheimer's type, Parkinsonism, and amyotrophic lateral sclerosis. Important
      organic toxins, in this context, include certain pyridines, amines, aminoacids,
      nitriles, hexacarbons, and sulphides. Inorganic toxins include free radicals and
      certain metals. Toxins may also be classified according to their origin-
      exogenous or endogenous. This review will not consider neurological damage that
      can result from exposure to alcohol, or neurological adverse reactions to
      medications.

PMID- 1745427
TI  - Delayed expression of neurotoxicity: the problem of silent damage.
AB  - A prolonged period of latency between toxic exposure and disease is a recognized
      phenomenon in oncology, but is a relatively new concept in neurotoxicology.
      Suggestions that exposure to neurotoxic compounds may be followed years or
      decades later by clinically evident neurological disease have received
      considerable anecdotal support but little empirical evidence. In recent years,
      evidence has emerged linking environmental factors to several neurodegenerative
      diseases, including amyotrophic lateral sclerosis and the Parkinsonism-dementia
      complex. While these diseases have not been definitively demonstrated to arise
      from exposure to toxins or toxicants, nevertheless the possibility exists that
      xenobiotic exposure could lead to neurological conditions possessing a period of
      clinical "silence" prior to expression. Detection of such damage using standard
      toxicology testing protocols poses a major challenge. Lessons learned from
      neurodegenerative diseases can be profitably applied to the study of the long
      term effects of xenobiotics on the brain and elucidation of the role of aging on
      the expression of neurotoxicity.

PMID- 1745428
TI  - Pacific paradigms of environmentally-induced neurological disorders: clinical,
      epidemiological and molecular perspectives.
AB  - During the past quarter century biomedical scientists have begun to recognize the
      unique opportunities for studying disease etiology and mechanisms of pathogenesis
      in non-Western anthropological populations with focal, endemic diseases. Such
      natural experiments as they are called, are important paradigms for solving
      etiological and epidemiological problems of widespread medical significance, with
      an ultimate goal towards treatment and prevention. The systematic search for
      etiological factors and mechanisms of pathogenesis of neurodegenerative disorders
      is perhaps nowhere better exemplified than in the western Pacific. During the
      past three decades, the opportunistic and multidisciplinary study of hyperendemic
      foci of amyotrophic lateral sclerosis and parkinsonism-dementia which occur in
      different cultures, in different ecological zones and among genetically divergent
      populations have served as natural models that have had a major impact on our
      thinking and enhanced our understanding of these and other neurodegenerative
      disorders such as Alzheimer disease and the process of early neuronal aging. Our
      cross-disciplinary approach to these intriguing neurobiological problems and the
      accumulated epidemiological, genetic, cellular and molecular evidence strongly
      implicates environmental factors in their causation, specifically the role of
      aluminum and its interaction with calcium in neuronal degeneration. As a direct
      consequence of our studies in these Pacific populations, we have undertaken the
      long-term development of experimental models of neuronal degeneration, in an
      attempt to understand the cellular and molecular mechanisms by which these
      toxicants affect the central nervous system. Our experimental studies have
      resulted in the establishment of an aluminum-induced chronic myelopathy in
      rabbits and the development of neurofilamentous lesions after low-dose aluminum
      administration in cell culture. These studies clearly demonstrate the philosophy
      that chronic rather than acute experimental models of toxicity are necessary in
      order to enhance our understanding of human neurodegenerative disorders with long
      latency and slow progression. Finally, the ultimate significance of these Pacific
      paradigms may well depend on our ability to comprehensively evaluate and
      synthesize the growing body of relevant scientific data from other human
      disorders and from widely divergent academic fields, as well as our ability to
      recognize emerging new models in nature.

PMID- 1745429
TI  - Cancer and the dynamics of neurodegenerative processes.
AB  - The term neurodegenerative denotes a process rather than a state. In contrast,
      most research on such disorders, whether clinical or experimental, represents
      only a slice of time. Their progressive nature is mostly confined to speculation
      instead of being codified in research protocols. Research on cancer, also a
      degenerative disease, is much more often framed in terms of process. Part of the
      difference is accounted for by the impact of quantitative modeling, which enjoys
      a long history in both basic and clinical cancer research and which originated in
      attempts to describe and understand tumor development. Analogous questions are
      posed by neurodegenerative disorders such as Parkinson's disease and Alzheimer's
      disease. Among the issues that modeling could help to clarify are the properties
      and sources of the age-specific incidence rate, which resembles that for cancer,
      and the pharmacokinetics governing the toxic products of neurotransmitter
      metabolism. Neurodegenerative disorders maintain a research advantage because
      functional measures, mostly inaccessible to cancer investigators, serve as the
      ultimate index of progression. Their exploitation, however, in longitudinal
      studies remains inadequate.

PMID- 1745430
TI  - A pilot study of occupational and environmental risk factors for Parkinson's
      disease.
AB  - Increasingly, the etiology of Parkinson's disease (PD) has been linked to
      exposures to environmental toxicants. This epidemiologic pilot study used a self
      administered questionnaire among 34 PD cases and 22 other neurology clinic
      control patients. All subjects were at least 40 years old. Risk factors
      investigated included occupation, well-water use, pesticide use, metal exposures,
      medical history, smoking, alcohol consumption, and drug use. Twenty-six percent
      of the male PD cases reported having been employed in farming versus eleven
      percent for male controls (OR = 3.1, 95% C.I. = 0.3 to 35). Sixteen percent of
      male cases versus none of the controls reported employment as welders. No clear
      trends involving exposure to either occupational or home pesticides emerged. In
      assessing occupational exposures to metals, aluminum and copper exposures tended
      to be more common among male cases than male controls. Additionally, as reported
      in other studies, smoking showed an inverse relationship with PD. Although the
      findings reported here are provocative, these results are statistically imprecise
      and must be interpreted cautiously because of the small number of subjects
      included in the study.

PMID- 1745431
TI  - Longterm neurological complications of chronic, habitual cocaine abuse.
AB  - We review and expand the results of several previously published studies on
      computed tomographic and electroencephalographic correlates of chronic, habitual
      cocaine abuse in order to present a complete spectrum of the longterm
      neurological complications of cocaine abuse. We argue that prolonged and frequent
      cocaine abuse leads to biochemical and vascular cerebral insults that eventually
      may cause functional and structural abnormalities affecting predominantly the
      fronto-temporal areas.

PMID- 1745432
TI  - Animal test systems to study behavioral dysfunctions of neurodegenerative
      disorders.
AB  - The Eighth International Neurotoxicology Conference, Role of Toxicants in
      Neurological Disorders (1990), evaluated the evidence that chemical exposures may
      play a role in the development of neurodegenerative disorders. This article
      describes the major neurodegenerative disorders (Amyotrophic Lateral Sclerosis,
      Huntington disease, Parkinson disease, and Alzheimer disease) addressed at the
      conference, followed by a description of test systems or models developed to
      study behavioral aspects of these disorders in animals. However, due to the
      complexity of the disorders and the species in which they are found, fully
      developed models in animals of neurodegenerative disorders are lacking. This
      suggests the need for a clear strategy for selecting behavioral tests in animals
      to study aspects of any neurodegenerative disorders. Such a strategy is here
      exemplified for Alzheimer disease (AD) as a prototypical neurodegenerative
      disorder. Since an animal model cannot provide the full range of effects of human
      neurodegenerative diseases, particularly AD which produces incompletely
      characterized cognitive deficits, a rodent model must at this time be drawn from
      multiple sources, including: (1) Tests currently used to identify in rodents
      deficits associated with AD; (2) tests to identify Alzheimer-related signs in
      patients; and, (3) tests that relate to theoretical constructs of human and
      animal cognition. A battery that draws from those sources could include tests of:
      (a) Spatial learning and memory (Morris Water Maze and Radial Arm Maze), (b)
      delayed recall match-to-sample; (c) serial response learning; and, (d) visual
      discrimination (e.g., vertical vs. horizontal stimuli). This battery will
      identify behavioral changes characteristic of early-, middle- and late-stage AD,
      afford the potential to relate the findings to theoretical constructs of
      cognition, and evaluate learning capabilities not previously studied in rodent
      models of neurodegenerative disorders.

PMID- 1745433
TI  - Potentiation in the neurotoxic induction of experimental chronic
      neurodegenerative disorders: N-butyl benzenesulfonamide and aluminum chloride.
AB  - Repeated monthly intracisternal inoculations of N-butyl benzenesulfonamide
      induced a chronic, slowly progressive myelopathy in young adult New Zealand white
      rabbits that was manifested by hyperreflexia, spasticity, hypertonia, gait
      impairment and altered tonic immobility responses. The neuropathological features
      consisted of scattered neuroaxonal spheroids, fusiform distention of the
      intramedullary portions of the spinal cord ventral roots and, as defined by
      microtubule-associated protein-2 (MAP 2) immunoreactivity, an initial distention
      and subsequent loss of dendritic processes in neurons of the nucleus motoris
      lateralis with the perikaryon of these cells remaining intact. A similar chronic
      progressive myelopathy was induced by repeated low dose intracisternal
      inoculations of aluminum chloride in New Zealand white rabbits. However, the
      neuropathological changes were more extensive and consisted of dendritic, axonal
      and perikaryal inclusions of phosphorylated and nonphosphorylated neurofilament
      localized to spinal motor neurons in the nucleus motoris medialis, substantia
      grisea intermedia and select brainstem nuclei with only minimal involvement of
      the nucleus motoris lateralis. The co-administration of these two neurotoxins
      over the course of 8 months induced striking behavioral changes as well as a
      fulminant myelopathy. This was accompanied by a loss of neuronal perikarya in the
      nucleus motoris accompanied by a loss of neuronal perikarya in the nucleus
      motoris lateralis and topographically extensive neocortical neurofilamentous
      degeneration. These features suggest that potentiation occurs when the two toxins
      are co-administered, a view supported by an estimation of the co-neurotoxicity
      coefficient (CNC greater than 1). Our results have implications for understanding
      human neurodegenerative disorders in which potentiation of insults may occur,
      producing a clinical and neuropathological disease state not expected from either
      agent alone.

PMID- 1745434
TI  - Anatomical and behavioral sequelae of fetal brain transplants in rats with
      trimethyltin-induced neurodegeneration.
AB  - The effect of transplants of either fetal hippocampal or dorsal ventricular ridge
      (DVR) tissue into the brains of adult male rats exposed to TMT was determined for
      two behavioral tasks. Administration of TMT produced deficits in acquisition and
      performance of an operant differential reinforcement of low response rates (DRL)
      schedule and learning in the Morris water maze. The fetal transplants developed
      well within the TMT-damaged brains of the adult rats and numerous axons could be
      shown to cross the host-transplant interface. The transplants significantly
      reduced the DRL deficit produced by exposure to TMT. However, the TMT-induced
      deficit in water maze acquisition was made significantly worse by the hippocampal
      transplants. The improvement in DRL performance is attributed to the effect on
      the host brain of an unidentified trophic substance produced by the transplants.
      However, this positive effect may not protect the brain sufficiently to produce
      recovery in tasks demanding more complex neural computations than are required to
      withhold lever-press responses. The transplant-induced deficit observed in some
      aspects of water maze acquisition and performance may be attributable to either a
      tumor-like deleterious effect of the mass of the transplant or to abnormal
      neuronal activity transmitted from the transplant to the host brain. The results
      of the present study, and those from other similar studies, suggest that
      transplants of fetal tissue may be useful in producing changes in the brain of an
      animal exposed to an environmental neurotoxin, but that research should be
      focused upon development of transplant methodology that will minimize adverse
      effects of the grafts.

PMID- 1745435
TI  - Impaired tunnel-maze behavior in rats with sensory lesions: vestibular and
      auditory systems.
AB  - Maze behavior of rodents provides insight into processes of learning and memory
      and also serves to assess cognitive functions in neurotoxicity tests. Neurotoxic
      agents may impair maze behavior by acting upon different parts of the nervous
      system. To assess the dependence of maze learning upon vestibular and/or auditory
      input, the two systems were lesioned. Daily treatment of rat pups with
      streptomycin (400 mg/kg sc) on postnatal day 11 to 22 caused irreversible
      impairment of vestibular and auditory functions, whereas, 20 injections of
      neomycin in adult rats (100 mg/kg sc, postnatal weeks 8 to 11) led to hearing
      loss only. Hearing loss was assessed by absence of Preyer's reflex and impaired
      vestibular function by loss or shortened duration of postrotatory nystagmus.
      Learning in the unbaited 6-arm radial maze was tested at the age of 2 to 3 mon
      using a maze configuration that allowed to assess order of arm entries ("working
      memory") and left-right discrimination within each arm ("reference memory").
      Treatment with streptomycin but not with neomycin led to impaired order of arm
      entries. Since treatment with streptomycin failed to induce any signs of brain
      lesions, impaired maze learning is considered to result from destruction of
      vestibular hair cell receptors with subsequent vestibular impairment and not from
      hearing loss or cognitive impairment.

PMID- 1745436
TI  - In vitro use of Schwann cells to elucidate neurotoxic injury.
AB  - Schwann cells are responsible for the maintenance of the peripheral myelin sheath
      and neurotoxic insult directed against these cells can result in demyelination
      with a concomitant loss of neural function. We have utilized several in vitro
      techniques to investigate the effects of neurotoxins on the complex interactions
      between SC and axons. SC may be isolated from fresh neonatal sciatic nerves and
      used to examine the effect of neurotoxins on the axonal membrane induction of SC
      proliferation and specific myelin protein mRNA expression. We have recently
      devised a method to obtain SC from frozen sciatic nerves. This method allows
      pooling of neonatal nerves to generate enough cells for subsequent study. We have
      also transfected primary Schwann cells with a plasmid containing the large T
      antigen to obtain a SC line suitable for neurotoxicology studies. The functional
      status of cultured SC may also be studied via expression of SC specific antigens
      such as glial fibrillary acidic protein, CNPase, S100, laminin, P0 and myelin
      basic protein. We also propose culturing SC with dorsal root ganglion neurons to
      investigate the effect of neurotoxins on all stages of SC maturation, from
      proliferation to the in vitro synthesis of a compact myelin sheath. These
      strategies will allow us to investigate the cellular mechanisms of neurotoxicity
      in the PNS.

PMID- 1745437
TI  - New opportunities with neuronal cultures to study the mechanisms of neurotoxic
      injuries.
AB  - Clonal lines of murine neuroblastoma (NBP2) and rat glioma (C6) were used to
      investigate the effects of methylmercuric chloride (CH3HgCl). Glioma cells were
      more sensitive to CH3HgCl than NB cells on the criterion of growth inhibition,
      but these cells were equally sensitive to inorganic mercury (HgCl1), Tri-n-butyl
      lead acetate and acrylamide on the same criterion. Alpha-tocopherol, alpha
      tocopheryl++ succinate and inhibitors of cAMP phosphodiesterase protected glioma
      cells against the growth-inhibitory effect of CH3HgCl, but they failed to protect
      NB cells in culture. Glioma factors, sodium ascorbate, non-inhibitory
      concentrations of prostaglandins E1 (PGE1), and glutamate enhanced the growth
      inhibitory effect of CH3HgCl on both NB and glioma cells in culture. The levels
      of certain specific cAMP-dependent and -independent protein phosphorylations
      appear to be very sensitive to CH3HgCl, and can be altered in both cell types by
      concentrations of CH3HgCl which do not affect growth or morphology of these
      cells.

PMID- 1745438
TI  - Nutrition, neurotoxicants and age-related neurodegeneration.
AB  - The National Institute on Aging supports a program of investigation of
      "biomarkers" of aging (biological parameters that change in magnitude with age),
      some of which may be among the, as yet unknown, causes of Alzheimer's disease.
      Exposure to neurotoxicants can also produce symptoms similar to Alzheimer's
      disease and has been proposed as a causative factor. We have examined the role of
      dietary factors and age on Alzheimer's disease-like neurohistological and
      behavioral symptoms as well as on the neurochemical effects of treatment with a
      prototypical neurotoxicant, trimethyltin (TMT). We found that aging greatly
      increased the susceptibility of hippocampal neurons to TMT-induced
      neurodegeneration. Limiting the dietary intake of calories, which has been
      reported to slow the aging process, also reduced the neurotoxic effects of a
      given dose of TMT. Our current research focuses on the use of neurotoxins to
      model neurodegenerative conditions of aging in animals. We propose that by
      identifying an age-amplified biomarker or biomarkers somewhere along the chain
      from neurotoxic stimulus to neuronal necrosis we may also discover an up- or down
      regulated gene, via it's gene product, that contributes to the etiology of human
      dementias. Our preliminary data suggest that up-regulated synthesis of post
      synaptic glutamate receptors of the kainic acid-preferring subtype may be such a
      biomarker.

PMID- 1745439
TI  - Cerebral and peripheral neurotoxicity of chlorpromazine and ethanol interaction:
      implications for alcohol and aldehyde dehydrogenase.
AB  - The effects of certain experimental variables on rodents brain and liver alcohol-
      (ADH) and aldehyde-dehydrogenase (LALDH) were evaluated. The in vivo and in vitro
      effect of chlorpromazine on these enzymes was determined. Short-term housing
      under complete darkness differentially inhibited ADH and ALDH in distinct brain
      regions with ADH showing more sensitivity than ALDH. The hepatic enzymes studied
      were not affected by such housing conditions but a non-competitive inhibition of
      L-ALDH occurred as a consequence of exposure to UV lighting for 3 consecutive
      weeks. Short-term treatment with chlorpromazine inhibited striatal ADH which was
      not affected by experimentally-induced hypothermia. Likewise, both hepatic and
      testicular ADH were noncompetitively inhibited in vitro by chlorpromazine. The
      results suggest sensitivity of brain and hepatic ADH to environmental housing
      conditions and indicate a similarity between peripheral and cerebral ADH
      responses to chlorpromazine. The modulation of ADH and/or ALDH may facilitate the
      formation of endogenous biogenic amines derived alkaloids which have been
      implicated in alcohol and extrapyramidal side effects.

PMID- 1745440
TI  - Neurotoxicity of chlorpromazine and modulation by amantadine as a function of
      mouse strain.
AB  - The separate and combined effects of successive administration of amantadine, 100
      mg/kg, i.p., and chlorpromazine, 0.2 mg/kg, i.p., on motor activity and whole
      brain levels of certain biogenic amines and major metabolites were studied in
      four strains of mice. These were the albino ICR, the inbred BALB/C, C57BL/6 and
      the hybrid CDF-I mice. Amantadine produced a strain-dependent behavioral
      stimulation subsequent the fourth dose. This was apparent in ICR and C57BL/6
      mouse strains and was followed by a behavioral depression phase occurring during
      the night in C57BL/6 mice which was antagonized by chlorpromazine. Administration
      of chlorpromazine alone affected only CDF-1 mouse mobility. Chlorpromazine
      reduced only ICR mouse brain dopamine without concomitant changes in major acid
      metabolites. Repeated administration of amantadine prior to chlorpromazine
      negated this effect. Chlorpromazine enhancement of BALB/C brain serotonin and 5
      hydroxyindoleacetic acid was antagonised by pretreatment with amantadine. This
      antagonism was also evident in BALB/C mouse brain dihydroxyphenylacetic acid. The
      results suggest genotypic-dependent behavioral and cerebral effects by the drugs
      studied. The antagonism between amantadine and chlorpromazine on brain amines may
      explain the therapeutic efficacy of amantadine in modulating chlorpromazine
      induced extrapyramidal disorders.

PMID- 1745441
TI  - Enhanced neurotoxicity of 3,3'-iminodipropionitrile following carbon
      tetrachloride pretreatment in the rat.
AB  - The consequences of 3,3'-iminodipropionitrile (IDPN) exposure in animals merits
      attention both because of its unique neurotoxic effects and as a potential model
      compound of human dyskinetic disorders. An important question that remains to be
      determined is whether IDPN itself or a putative active metabolite is responsible
      for the neurotoxic actions of the chemical in vivo. The present work tested the
      hypothesis that IDPN must be metabolized by the liver to an active metabolite to
      become neurotoxic. Thus a reduction in IDPN neurotoxicity would be expected when
      liver function is compromised. Male Long-Evans rats were given ip injections of
      saline, 100 (IDPN1) or 200 (IDPN2) mg/kg of IDPN for three days. Half of the
      animals in each IDPN dose group received corn oil po and the other half 1 g/kg of
      the hepatotoxicant carbon tetrachloride (CCl4) for three days, starting one day
      before IDPN administration. Body weights were obtained regularly after exposure.
      Horizontal and vertical motor activity, and acoustic startle response were
      monitored prior to, and 1,3,9 and 16 weeks after IDPN exposure. An observational
      rating score was obtained at 1, 3 and 9 weeks. Auditory thresholds for 5- and 40
      kHz tones were estimated by reflex modification procedures at 10 weeks. Animals
      receiving IDPN2 alone displayed the overt behavioral signs characteristic of IDPN
      intoxication (postural disturbances, head dyskinesias, backward walking,
      circling, increased motor activity, and decreased startle response). They also
      showed weight loss, hyperactivity, a transient rearing deficit, decreased startle
      amplitudes and elevated auditory thresholds for low- and high-frequency tones.
      None of these symptoms were observed in the animals treated with CCl4 alone, and
      only a mild transient effect on the observational rating score was shown by the
      IDPN1 alone animals. In contrast, IDPN1/CCl4 resulted in the same or higher
      toxicity than the IDPN2 treatment. IDPN2/CCl4 resulted in severe toxicity (38%
      mortality over a two-week period) and enhanced body weight and behavioral effects
      compared to IDPN2 alone group. Impairment of xenobiotic biotransformation was
      confirmed by elevated pentobarbital sleeping time in animals under the same CCl4
      dosing regimen. In conclusion, pretreatment with hepatotoxic dosages of CCl4
      leads to increased toxicity of IDPN. This suggests that hepatic transformation of
      the chemical is not required for the manifestation of IDPN-induced neurotoxicity,
      but instead may be involved in the detoxification of this compound.

PMID- 1745442
TI  - Modulation of protein kinase C activity by amiodarone and desethylamiodarone.
AB  - Protein Kinase C (PKC), a Ca(2+)-dependent and phospholipid activated enzyme,
      regulates a variety of intracellular and extracellular signals across the
      neuronal membrane. A number of Ca(2+)-dependent enzymes are PKC substrates. PKC
      activity is modulated by lipophilic compounds including calmodulin inhibitors.
      Amiodarone, an antiarrhythmic drug is associated with some neurologic and
      pulmonary side effects and has been shown to interact with calmodulin. The
      present study describes the effects of amiodarone and desethylamiodarone, a major
      metabolite of amiodarone, on PKC activity. PKC was partially purified from rat
      brain on an anion exchange column (DE-52). The interaction of amiodarone and
      desethylamiodarone with PKC was studied as a measure of altered protein
      phosphorylation and 3H-phorbol 12, 13-dibutyrate (PDBu) binding.
      Desethylamiodarone significantly inhibited phosphatidylserine, diacylglycerol and
      Ca2+ stimulated PKC activity with IC50 of 30 microM. However, amiodarone had no
      significant effect on PKC activity. Both amiodarone and desethylamiodarone
      altered the 3H-PDBu binding to PKC and the effect was biphasic. The Scatchard
      analysis of 3H-PDBu binding to PKC revealed that at lower concentrations (5
      microM), amiodarone and desethylamiodarone increased 3H-PDBu binding to PKC with
      decreased affinity. Whereas, at higher concentrations (greater than 30 microM)
      these drugs decreased the 3H-PDBu binding. In the presence of Ca2+,
      phosphatidylserine and PDBu (120 nM) no significant stimulation was observed with
      low concentrations of amiodarone and desethylamiodarone. However, at high
      concentrations (50 microM), desethylamiodarone inhibited the PDBu stimulated PKC
      activity. These data clearly demonstrate that desethylamiodarone a metabolite of
      amiodarone is a potent inhibitor of PKC activity.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1745443
TI  - Evaluation of magnesium, calcium and aluminum metabolism in rats and monkeys
      maintained on calcium-deficient diets.
AB  - The epidemiology of amyotrophic lateral sclerosis (ALS) in the Western Pacific
      indicates that low concentrations of calcium (Ca) and magnesium (Mg) and high
      levels of aluminum (Al) in soil and water in these foci are etiologically
      important. To determine the biochemical derangements and metal deposition induced
      by chronic dietary deficiencies of Ca, we maintained experimental animals on
      several regimens. Male Wistar rats, weighing 100g, were fed either a standard
      diet, low Ca diet, low Ca-Mg diet, or low Ca-Mg diet with high Al for 90 days.
      Ca, Mg and Al content was determined in central nervous system (CNS) tissues and
      bone using inductively coupled plasma emission spectrometry (ICP). In separate
      studies, five male Japanese macaques (Macaca fuscata), weighing 3.5 to 5 kg, were
      fed alternately with diets, normal in Ca, low in Ca, low in Mg, low in Ca-Mg, or
      low in Ca-Mg with added Al for four-week periods. Serum Ca, Mg, Al, parathyroid
      hormone (PTH), bone Gla-protein (BGP) and alkaline phosphatase (ALP) were
      measured after feeding each dietary regimen. Ca and Mg levels in lumbar vertebrae
      and femur were significantly reduced and bone Al levels were significantly
      increased in rats fed diets deficient in Ca alone or diets low in Ca-Mg with or
      without added Al. Al content in bones was also higher in rats fed the Ca
      deficient diets. In monkeys fed the low Ca-Mg diet with added Al, reduced levels
      of serum Ca and Mg, serum PTH, BGP, and ALP were apparent. Our data support the
      conjecture that deranged bone mineralization induced by chronic dietary
      deficiency of Ca accelerates mobilization of Ca and Mg from bone and deposition
      in brain.

PMID- 1745444
TI  - Aluminum deposition in the central nervous system of patients with amyotrophic
      lateral sclerosis from the Kii Peninsula of Japan.
AB  - Chronic dietary deficiency of calcium (Ca) and magnesium (Mg) with excessive
      intake of aluminum (Al) and manganese (Mn) has been implicated in the
      pathogenesis of high incidence amyotrophic lateral sclerosis (ALS) in the Western
      Pacific. We report two cases of ALS from the Kii Peninsula of Japan with markedly
      elevated concentrations of Al in central nervous system (CNS) tissues. Six
      pathologically verified cases of ALS and five neurologically normal controls were
      studied. Levels of Al, Ca and phosphorus (P) were determined simultaneously by
      neutron activation analysis (NAA), and Mg concentration was measured by
      inductively coupled plasma emission spectrometry (ICP) in 26 CNS regions. Al
      concentrations in the precentral gyrus, internal capsule, crus cerebri and spinal
      cord were significantly increased in two ALS patients, compared with those of
      controls. Mean Al concentrations of the 26 CNS regions in these two patients were
      also higher than those of controls and of the four other ALS cases (p less than
      0.01). By contrast, Mg concentrations in the 26 CNS regions were markedly reduced
      in the ALS cases, compared with controls (p less than 0.01), and the Ca/Mg ratios
      were significantly increased in the ALS cases (p less than 0.01). Our data
      indicate that high-incidence ALS in the Western Pacific may result from Ca-Mg
      dysmetabolism with resultant deposition of Al.

PMID- 1745445
TI  - Epileptogenic properties of cocaine in humans.
AB  - Ninety-eight of 945 patients admitted to Hennepin County Medical Center with
      acute medical complications of cocaine intoxication presented with seizures
      within 90 min of cocaine ingestion. Cocaine-related seizures were most frequently
      single, generalized convulsions, and these individuals all had normal cranial CT
      and EEG. Of the 945 patients, 18.4% of the women presented with seizures,
      compared with only 6.2% of the men. All subjects who presented with new onset
      focal seizures following cocaine ingestion had acute cocaine-related cerebral
      strokes or hemorrhages. Individuals with a history of cocaine-unrelated seizures,
      had their typical convulsions precipitated with "recreational" doses of cocaine.
      All four subjects with status epilepticus had ingested massive doses of cocaine,
      were resistant to medical treatment, and had significant morbidity and mortality.
      We were able to characterize four subgroups of subjects at risk for cocaine
      related convulsions. First, individuals who had ingested massive doses of cocaine
      (2-8 gms) in whom cocaine induced seizures by its direct, dose-related convulsant
      effects. Second, individuals with a history of epilepsy had their typical
      seizures precipitated by lowering the seizure threshold. Third, females are at
      greater risk for cocaine-related compared to males. Fourth, years of chronic,
      habitual cocaine abuse may result in "chemical" kindling of epilepsy.

PMID- 1745446
TI  - Challenges facing the medical profession.

PMID- 1745447
TI  - Recommendations for influenza vaccination: from clinical piety to clinical
      practice.

PMID- 1745448
TI  - Breaking the chain of HIV transmission.

PMID- 1745449
TI  - Achievable influenza immunization rates in the elderly.
AB  - We sought to determine achievable rates of influenza immunization in a large
      internal medicine practice in which free vaccination was vigorously promoted. A
      list of 1,230 patients over 65 years of age constituted the target population.
      Seven hundred ninety patients (64%) were immunized in the office from September
      to December 1989. In early 1990, questionnaires were sent to 67 patients who had
      refused vaccination and to an equal number of age- and sex-matched controls who
      had either accepted the vaccine or whose immunization status was unknown. Seventy
      four percent returned the questionnaires. Of the 67 unimmunized patients, 39
      (53%) reported that they might be persuaded to accept immunization, whereas 22
      (33%) said that nothing could convince them to be immunized. When we added
      persons who might accept influenza vaccine and persons who had received the
      vaccine in public clinics to the total number of patients immunized in the office
      setting, we reached a total of 1,059 patients (86.1% of the total), which we
      would propose as the maximal achievable immunization rate in this setting.

PMID- 1745450
TI  - S. Weir Mitchell, Charlotte Perkins Gilman's "The yellow wallpaper," and Capgras'
      syndrome.

PMID- 1745451
TI  - Primary care in New York State: report and recommendations of the associated
      medical schools of New York.
AB  - Medical education in New York is unique in the country in its scope and its
      diversity. It is important, as we go forward, that these strengths be neither
      eroded nor compromised. The AMS member institutions are making a collective
      commitment to work together to promote changes that will improve medical
      education for all students by providing them with enriched experience in primary
      care. Our major resource is faculty. To whatever degree medical schools can
      influence career choice, it is essential to this aim that the best possible
      people are placed in the settings in which primary care is taught. The schools
      will intensify their efforts to recruit and retain such faculty and, in whatever
      way is appropriate to each institution, provide them with the stature needed to
      emphasize the value which the school places on primary care. The schools will
      also work to provide exposure to primary care early in a student's academic
      career given anecdotal evidence, at least, that such early experience can
      influence subsequent specialty choice. Finally, the medical schools will assume
      greater responsibility for graduate medical education. If, with state support,
      ambulatory teaching sites are developed, the schools will make every effort to
      assure that they are staffed with high-quality faculty. Residents and students
      must see primary care practiced with total commitment to quality. It is hoped
      that, with state-initiated improvements in the practice environment, the ultimate
      outcome will be an increase in the number of our graduates selecting primary care
      disciplines for their practices and locating in areas in need of physicians.2+
      Corporation, and the Greater New York Hospital Association. We are ready to work
      with others toward our common objectives, and we call on all of those who share
      these concerns to participate with us.

PMID- 1745452
TI  - Epithelioid sarcoma presenting as lymph node metastasis from an unknown primary
      lesion.

PMID- 1745453
TI  - Spurious neutropenia: ethylenediaminetetraacetate-dependent in vitro neutrophil
      agglutination.

PMID- 1745454
TI  - Sesame seed anaphylaxis.

PMID- 1745455
TI  - Hospital-specific mortality rates for cardiac surgery.

PMID- 1745456
TI  - Medical abbreviations and acronyms.

PMID- 1745457
TI  - Scrotal wall edema presenting as the initial manifestation of nephrotic syndrome.

PMID- 1745458
TI  - Cancer and health screening in Canterbury general practices.
AB  - The general practitioners in the Canterbury Area Health Board area were surveyed
      for their screening policies for cancer and medical conditions. Responses were
      obtained from 210 (79%), 55% of whom had age/sex registers. Ninety-seven percent
      provided cervical smears, usually at 1-2 year intervals; 62% offered a female
      smear taker. Smears were initiated opportunistically by 76%, by age/sex register
      (47%) or on request by 27%. Breast cancer was screened by 69% using mammography
      and by 59% using breast physical examination; 73% taught breast self examination.
      Mammography was recommended every two years for women aged 50-64 years by 45% of
      responders, and annually to women aged 40-50 years by 19%. Mammography was
      initiated opportunistically by 88%, on request by 70% and using an age/sex
      register by 21%. Melanoma was screened by 66%, colorectal cancers in those at
      high risk by 42%. Testicular self examination was promoted by 43%. Ninety-one
      percent screened for hypertension, and 51% for hyperlipidaemia, 54% for diabetes
      mellitus in people without risk factors. Smoking (97%) and alcohol intake (82%)
      were usually inquired for, and safe sex practices by 59%. Established screening
      modalities were recommended by most practitioners, but the frequency exceeded
      current guidelines in many cases; opportunistic screening predominated.

PMID- 1745459
TI  - Cost analysis of a major burn.
AB  - A retrospective review was undertaken of 26 patients admitted to Middlemore
      Hospital between January 1986 to July 1989 with burns totalling more than 30% of
      total body surface area. An attempt was made to estimate the total cost of
      successful inpatient management of a major burn using known and assumed values.
      The new schedule of interboard hospital charges was also employed for greater
      accuracy. The 20 survivors had a mean initial hospital stay of 68.7 days at a
      cost of between $37,077 and $40,702 (1989 values) and $46,069 (1991 values). This
      latter figure equates to an average cost of $647 per patient per day or,
      alternatively, $927 per % burn. Suggestions to reduce costs and improve treatment
      include: earlier excision and grafting; the establishment of a regional skin bank
      and keratinocyte culture facility to aid wound closure; and guidelines on
      antibiotic prescribing.

PMID- 1745460
TI  - Simvastatin and side effects.
AB  - OBJECT: to investigate the symptomatic and biochemical side effect profile of
      simvastatin (a new cholesterol lowering drug) following routine use in a
      specialist hospital outpatient clinic. METHODS: all patients (n = 110) newly
      commenced on simvastatin at the lipid disorders clinic at the Princess Margaret
      Hospital in the first ten months of prescription availability were asked to
      complete a side effects questionnaire and biochemical evaluation at six months of
      therapy. RESULTS: 76.4% of patients reported experiencing no side effects with 8%
      of patients spontaneously reporting feeling better since commencing therapy.
      Nineteen point one percent of patients reported experiencing symptoms they
      attributed to simvastatin but had continued therapy, while a further 4.5% of
      patients had withdrawn from therapy because of side effects. The most frequently
      reported side effects were muscle ache (13.6%), and gastrointestinal symptoms
      (4.5%). No abnormalities in biochemical safety tests occurred. CONCLUSIONS: the
      rate of side effects reported with prescription use exceeds that previously
      encountered in clinical trials. Since simvastatin is considered effective and
      well tolerated it is likely to receive wide acceptance in the management of high
      risk hypercholesterolaemic patients. However, this study indicates the need for
      continued physician awareness of the main symptoms and their frequency amongst
      those treated with simvastatin.

PMID- 1745461
TI  - Unit dose calendar packaging and elderly patient compliance.
AB  - A controlled trial of the effect of a unit dose system of tablet/capsule calendar
      packaging (Webster-Pak) on the rate of successful self medication both in
      hospital and after discharge to the community has been completed in a geriatric
      assessment and rehabilitation unit. Eighty-four elderly patients, 45 using
      calendar packs (study), and 39 using conventional bottles or packs (control),
      were followed for three months after discharge. There was a significant
      improvement in patient compliance in the study group over controls on discharge
      (86.7% vs 66.7%), 10 days (68.8% vs 41.0%), one month (64.4% vs 38.5%) and three
      months (48.9% vs 23.1%) after discharge. Unit dose packaging is a cost effective
      method of improving the delivery of medicine in elderly patients, and should be
      available as part of the health budget.

PMID- 1745462
TI  - Direct patient telephone access to the coronary care unit: its use and impact on
      admission delays.
AB  - Direct telephone access for patients to the Hutt Hospital coronary care unit
      (CCU) was established in 1989. This paper describes initial experience of 200
      consecutive calls and a subsequent study of its impact on admission delays in a
      further 295 patients. The majority of calls were received between 4 am and noon.
      Those relating to chest pain made between 4 and 8 am were more likely to be
      followed by admission than at other times, p less than 0.001. Use of the direct
      line was associated with quicker admission, 212 (SE 23.2) min compared with 359.2
      (23.0), p less than 0.001. For patients with myocardial infarction the difference
      was even greater, 115 (28.9) (median 90 min) compared with 344.9 (18.9) (median
      212 min), p less than 0.001. We conclude that free telephone access to the CCU is
      a valuable aid to acute coronary care.

PMID- 1745463
TI  - HIV-1 infection status in two HIV-1 antibody positive infants determined using
      the polymerase chain reaction.
AB  - The HIV-1 infection status of two HIV-1 antibody positive infants born to HIV-1
      infected mothers was determined using the polymerase chain reaction. HIV-1
      genomic sequences were not detected in the white blood cells of either infant
      suggesting that they were not infected. HIV-1 genomic sequences were detected in
      the white blood cells of the mothers of both infants and in cells from the one
      surviving father. These results confirm the value of the PCR detection method for
      assessing the HIV-1 infection status of infants born to HIV-1 antibody positive
      mothers.

PMID- 1745464
TI  - No association between fluoridation of water supplies and sudden infant death
      syndrome.

PMID- 1745465
TI  - Pricers thumb.

PMID- 1745466
TI  - Medical manslaughter.

PMID- 1745467
TI  - Melanoma patients consume more polyunsaturated fat than people without melanoma.

PMID- 1745469
TI  - AIDS worldwide.

PMID- 1745468
TI  - The American Medicare system--disincentive for physicians.

PMID- 1745470
TI  - Autoimmune diseases in pregnancy: their effect on the fetus and newborn.
AB  - A variegated group of autoimmune disorders tend to occur in women during
      childbearing years. Autoantibodies, often of IgG type, directed against the
      mother's (self) antigens has been well characterized in a number of these
      disorders. Transplacental transfer of IgG autoantibodies has been frequently
      demonstrated without demonstrable ill effects of offspring of affected mothers.
      However, transient neonatal autoimmune syndromes have been described in a subset
      of infants born with circulating autoantibodies. The time course of clinical
      symptomatology often parallels the presumed half life IgG immunoglobulins. This
      review details the clinical manifestations of different transient neonatal
      autoimmune syndromes and describes possible pathogenic mechanisms. Autoimmune
      disorders reviewed include connective tissue disorders, thyroid autoimmune
      disorders, myasthenia gravis, idiopathic thrombocytopenic purpura, and other
      uncommon disorders.

PMID- 1745471
TI  - Intraamniotic infection in patients with intact membranes and preterm labor.
AB  - The purpose of this review was to determine the frequency of intraamniotic
      infection in women with preterm labor and intact membranes and to assess the need
      for amniocentesis in these patients. We reviewed reports in the English language
      literature from the past 10 years in which the frequency of intraamniotic
      infection was determined by transabdominal amniocentesis. The 16 studies reviewed
      demonstrated frequencies of positive cultures that varied from 0 to 61 per cent.
      This extreme variability seems to be the result of diverse patient populations,
      dissimilar microbiologic techniques, and different definitions of preterm labor.
      Advanced cervical dilation and poor response to tocolytic agents were two factors
      associated with a higher frequency of intraamniotic infection. We conclude that
      each institution must determine the frequency of intraamniotic infection
      associated with preterm labor in their patient population. In populations with a
      high frequency of infection, amniocentesis for microbiologic evaluation is
      recommended for management of preterm labor, especially in patients who have
      advanced cervical dilatation or who are unresponsive to tocolytic therapy.

PMID- 1745472
TI  - Are city sun parlor ordinances necessary?

PMID- 1745473
TI  - The real cause of infant mortality.

PMID- 1745474
TI  - Another look at the ER.

PMID- 1745475
TI  - Physician behavior and the family.

PMID- 1745476
TI  - One way to serve the post-menopausal patient.

PMID- 1745477
TI  - Teens will listen to this message about AIDS.

PMID- 1745478
TI  - Ohio physicians speak out on Medicare.

PMID- 1745479
TI  - Association of epirubicin, etoposide and cisplatin in gastric cancer. A phase II
      study.
AB  - Cisplatin-based drug combinations are now currently investigated in an attempt to
      surpass the results obtainable by 5-FU alone or by 5-FU-containing regimens. We
      evaluated 29 patients with advanced and measurable gastric adenocarcinoma treated
      with etoposide, epirubicin and cisplatin. One patient had complete response (3 +/
      7%); 9 patients had partial response (31 +/- 17%); 5 patients (17 +/- 14%) were
      considered stable (S) and 14 (48 +/- 18%) were classified as progressive. The
      average survival time for the entire group was 11 months with 25% of the patients
      alive at 24 months. We feel that cisplatin-containing regimens are promising and
      deserve further investigations. To clearly explore the potential innovative role
      of these regimens randomized trials versus FAM or 5-FU alone are mandatory.

PMID- 1745480
TI  - Acute gastroduodenal mucosal injury after cisplatin plus etoposide chemotherapy.
      Clinical and endoscopic study.
AB  - The effects on gastric and duodenal mucosa induced by cisplatin plus etoposide
      (PE) chemotherapy were investigated in 32 patients with lung cancer. They were
      submitted to gastroduodenoscopy before receiving cisplatin 100 mg/m2 (day 1) plus
      etoposide at a mean dose of 107 mg/m2 (days 1, 3 and 5). Endoscopic examination
      was repeated on day 8. Before chemotherapy, 22 patients showed normal endoscopic
      appearance and 10 minimal lesions (3 or fewer erosions). After chemotherapy, 16
      remained normal, 1 had minimal lesions and 15 developed major lesions: 11 gastric
      or duodenal multiple erosions, 1 diffuse erosive gastritis, 2 gastric and 1
      duodenal ulcer (p less than 0.001). No difference was observed in the number of
      vomiting episodes nor in severity of upper gastrointestinal symptoms between the
      patients who remained normal and those who developed mucosal injury. We conclude
      that PE chemotherapy can have a properly called gastroduodenal toxicity, leaving
      nausea and vomiting out which are rather due to central than peripheral
      mechanisms. Some trials are necessary to investigate which kind of drugs (H2
      receptor blockers, sucralfate, prostaglandin E analogues) may be useful in
      preventing acute gastroduodenal mucosal injury induced by PE chemotherapy.

PMID- 1745481
TI  - Combined chemotherapy and radiotherapy for lymphomas of Waldeyer's ring.
AB  - The management of 47 patients with stage I and II Waldeyer's ring lymphomas was
      reviewed. Twenty-one of them received radiotherapy only, and the other 26
      received combined chemotherapy and radiotherapy. Patients with primary disease in
      the nasopharynx, high-grade histology or advanced age were associated with poorer
      survival. Although the complete response rates were similar, the patients
      receiving combined chemotherapy and radiotherapy had significantly fewer relapses
      and a better disease-free survival. However, their survivals were similar. The
      lack of improvement in the overall survival might be due to the effectiveness of
      salvage chemotherapy in treating some of the radiotherapy failures and the
      occasional chemotherapy-related mortality.

PMID- 1745482
TI  - Role of recombinant alpha-interferon in the treatment of advanced cutaneous
      malignant melanoma.
AB  - A total of 65 patients with advanced cutaneous malignant melanoma (MM) have now
      been treated with interferon alpha-2b (Intron A) at a dose of 10 million IU/m2
      administered subcutaneously thrice weekly. Fifty-one patients were evaluable for
      response, and 4 of these (7.8%) achieved complete remission; 2 of these 4 remain
      so at 37 + and 54 + months. Six additional patients achieved a partial remission.
      All responders had subcutaneous, lymph node and/or pulmonary metastases only. In
      all responders, therapy was continued for a total of 12 months. The vast majority
      of patients experienced side effects, largely flu-like symptoms, mild leukopenia
      and mild hepatocellular dysfunction. No evidence of cumulative toxicity was
      observed. Our experience indicates that interferon alpha-2b is active in patients
      with advanced cutaneous MM.

PMID- 1745483
TI  - Intermediate dose of intravenous melphalan in advanced multiple myeloma.
AB  - Eighteen patients with advanced multiple myeloma resistant to VAD chemotherapy
      (vincristine, Adriamycin, dexamethasone) were treated with intravenous melphalan
      in a single-pulse dose of 50-70 mg/m2. Objective response (greater than or equal
      to 50% reduction of the monoclonal protein) was observed in 9 patients. The
      median duration of remission in the responding patients was 6 months and the
      median survival 11.5 months. The main toxicity noted was bone marrow suppression.
      We conclude that intermediate doses of intravenous melphalan are a useful
      therapeutic modality in refractory or relapsing myeloma patients.

PMID- 1745484
TI  - Influence of serum derived from patients with head and neck cancer on natural
      killer cell activity.
AB  - The influence of serum from 23 patients with head and neck cancer on natural
      killer (NK) cell activity was analyzed using a double-layer agar assay, in which
      NK cells show an activity to inhibit the colony growth of K562 cells. In contrast
      to normal serum (or no treatment), serum from cancer patients reduced the
      inhibitory activity of NK cells, not only of autologous NK cells but also of
      allogeneic NK cells. These results suggest that the serum of patients with head
      and neck cancer may have some inhibitory factors on NK cell activity and may be
      involved in host resistance to tumor growth in vivo.

PMID- 1745485
TI  - Diagnosis of anal carcinoma--doctor's finger still the best?
AB  - Symptoms, delay in diagnosis, tumour stage and the clinical value of a follow-up
      programme were studied in 107 patients admitted to the Norwegian Radium Hospital
      for anal canal carcinoma. Sixty percent of the patients had advanced tumours (T3
      or T4) at the time of diagnosis, while 1/4 presented with metastases to the
      pelvic lymph nodes and 5% with distant metastases. The most frequent initial
      symptoms were anal bleeding and pain (38 and 23%, respectively). About 3/4 of the
      patients experienced more than 1 month's delay of diagnosis, either because of
      the patient himself (1/2 of the cases), doctor (1/5 of the cases) or hospital
      (1/10 of the cases). About 1/3 of the patients had more than 6 months' total
      delay. The follow-up after treatment (chemoradiotherapy) shows that frequent
      digital rectal examination is the most important procedure. Some patients may
      benefit from serum carcino-embryonic antigen measurement, liver ultrasonography
      or chest X-ray.

PMID- 1745486
TI  - Hyperimmunoglobulinemia D following cancer chemotherapy.
AB  - Five classes of serum immunoglobulin levels were investigated in 107 children
      with malignant or benign tumors. Hyperimmunoglobulinemia D (hyper-IgD) was
      observed in 31 of 82 children who were in complete remission off chemotherapy
      with a median follow-up of 4.5 years after cessation of chemotherapy. On the
      other hand, hyper-IgD was not found among 12 children with malignant or benign
      tumors treated with chemotherapy and a low incidence of hyper-IgD was observed
      during chemotherapy (1 of 13 cases). The result indicates that hyper-IgD is not
      uncommon in children off chemotherapy, suggesting that dysregulation of IgD
      synthesis persists long after cessation of antineoplastic drugs.

PMID- 1745487
TI  - Acute and delayed emesis after cisplatin-based regimen: description and
      prevention.
AB  - Lorazepam, dexamethasone and high-dose metoclopramide were given to 54 patients
      to prevent emesis induced by cisplatin (50-120 mg/m2) on day 1, while
      prochlorperazine and dexamethasone were administered on days 2 and 3 for control
      of delayed emesis. Nausea and emesis were recorded from day 1 to day 8. This
      combination was well tolerated. Prevention on day 1 was complete for 72% of
      patients and satisfactory (less than or equal to 2 emeses on day 1) in 85%. From
      days 2 to 8, no emesis, less than or equal to 2 and greater than 2 episodes
      occurred in 70, 11 and 19%, respectively. Overall control (days 1-8) was complete
      in 55.5% and satisfactory (less than or equal to 2 emeses on day 1 and/or less
      than or equal to 2 emeses from days 2 to 8) in 74%. Delayed emesis started on
      days 2-5. Mean duration was 2.6 days. Delayed nausea or emesis were more frequent
      when emesis occurred on day 1. Based on data previously reported and on these
      observations, better ways to prevent delayed events are discussed. Further trials
      must record systematically delayed side effects.

PMID- 1745488
TI  - Randomized trial for the control of acute vomiting in cisplatin-treated patients:
      high-dose metoclopramide with dexamethasone and lorazepam as adjuncts versus high
      dose alizapride plus dexamethasone and lorazepam. Study of the incidence of
      delayed emesis.
AB  - This study investigated the antiemetic activity of two different acute antiemesis
      regimens in patients receiving cisplatin-based chemotherapy. Seventy-four
      patients were treated with high-dose metoclopramide, dexamethasone and lorazepam
      (MDL) and 71 patients received high-dose alizapride, dexamethasone and lorazepam
      (ADL). Complete protection from vomiting was 50% in MDL-treated patients as
      compared with 30% in the ADL arm (p = 0.04). Incidence of delayed emesis was
      assessed in the first 82 patients accrued for the 120 h postcisplatin, being 69
      and 60% in MDL and ADL, respectively.

PMID- 1745489
TI  - Dairy products and the risk of prostatic cancer.
AB  - Dietary indicators of prostatic cancer risk were analyzed in a case-control study
      conducted in Northern Italy on 96 histologically confirmed cases and 292 controls
      in hospital for acute, nonneoplastic or genital tract diseases. There was a
      significant trend in risk as regards frequency of milk consumption: compared with
      nondrinkers or occasional milk drinkers, the relative risk (RR) was 1.2 (95%
      confidence interval, Cl, 0.7-1.9) for 1 or 2 glasses per day and 5.0 (95% Cl 1.5
      16.6) for 2 or more glasses per day. By contrast, no consistent association was
      observed with measures of cheese or butter intake. This might, at least in part,
      be attributable to the lower measurement errors for milk (which tends to be
      consumed in regular and uniform patterns) as compared with other dairy products.
      However, the interpretation of these findings is not clear, since other sources
      of animal fat, like eggs or meat, as well as a summary fat score, were unrelated
      to prostatic cancer. Although these limitations and uncertainties are
      substantial, this study provides further evidence that elevated milk consumption
      may be an indicator of prostatic cancer risk.

PMID- 1745490
TI  - Results of a nationwide study on the three-field lymph node dissection of
      esophageal cancer.
AB  - In order to determine the operative indications of three-field lymph node
      dissection of esophageal cancer, attempts were made to collect data concerning
      procedures performed between 1983 and 1989 in major institutions in Japan, and
      the results from institutions performing three-field or two-field lymph node
      dissection were compared. The treatment results of three-field lymph node
      dissection were better than those after two-field dissection, except for early or
      advanced cancer. The survival rate improved by the three-field as compared with
      the two-field lymph node dissection; however, since surgery was invasive, some
      complications such as recurrent nerve paralysis were frequent. The results show
      that the indication of three-field lymph node dissection has to be carefully
      determined for each patient.

PMID- 1745491
TI  - Immunohistochemical detection of estrogen receptors in paraffin sections of human
      thyroid tissues.
AB  - The optimal demonstration of estrogen receptor binding in thyroid tissues was
      made under conditions of 10% protease in 50 mM Tris-HCl buffer (pH 7.6) for 10
      min as the pretreatment digestion step, incubation of primary antibody (ER-ICA
      monoclonal kit; Abbott Laboratories) at 37 degrees C for 2 h and incubation of
      secondary antibody (ABC kit; Vector) at 37 degrees C for 40 min. Thyroid tissues
      used for assessing the reaction were 17 cases of goiter, 25 adenoma cases, 27
      cases of papillary carcinoma, 14 cases of follicular carcinoma and 10 latent
      cancer cases. Incidences of positive estrogen receptor reaction were 22% (11/51)
      for all thyroid cancers, 20% (5/25) for the thyroid adenomas and 59% (10/17) for
      goiters. 15% (4/27) of papillary carcinomas, 21% (3/14) of follicular carcinomas
      and 40% (4/10) of latent cancers proved positive, the estrogen receptor reaction
      being limited to the nuclei of thyroid follicular/papillary type cells.

PMID- 1745492
TI  - Pregnancy-induced cytotoxicity of splenocytes against mammary tumor cells in
      rats.
AB  - Our earlier observations indicate the possibility of involvement of a 'host
      factor' in pregnancy-induced protection against mammary carcinogenesis. The
      present investigation is an attempt to determine if this "host factor" is of
      immunological nature. Rat mammary tumors induced by 7,12
      dimethylbenz[a]anthracene were used as target, and splenocytes from parous rats
      of the same strain were used as effector cells. The parous rats were divided into
      two groups according to the time period after parturition. Group 1 contained rats
      which were 5-13 days after delivery, group 2 had rats 14 or more days after
      parturition. In vitro cytotoxicity was determined by incubating the tumor cells
      with spleen cells in the target:effector ratios of 1:3, 1:10 and 1:30. Both
      groups 1 and 2 showed significant lysis of mammary tumor cells. These results
      were confirmed by the trypan blue exclusion test. The results showed a
      significantly higher cytotoxic capability of the spleen cells from parous rats
      against mammary tumor cells as compared to spleen cells from age-matched
      nulliparous rats.

PMID- 1745493
TI  - Differentiated practice: today, tomorrow and the future.

PMID- 1745494
TI  - Esthesiometry as an indicator of corneal health.
AB  - We review the literature regarding changes in the structure and function of the
      cornea as an index of the physiological status of the tissue. Accurate
      measurement of corneal sensitivity may be the most reliable test of long-term
      corneal compromise inasmuch as the edema response, the most popular test of
      corneal physiological integrity, shows "adaptation". Although reduced sensitivity
      has been associated with corneal hypoxia, decreased corneal pH may also play a
      major role. Certainly, small departures of pH from normal levels in the body can
      lead to major depression of neural function. Traditionally, mechanical
      sensitivity of the cornea has been measured with procedures based on the von Frey
      hair. More recently, esthesiometry has been performed with the use of a puff of
      air, a chemical stimulant, and heat. Results from early trials with these
      procedures are encouraging in terms of the development of a viable clinical
      method for assessing metabolic effects on the cornea from contact lens wear.

PMID- 1745495
TI  - The significance of the microcyst response: a review.
AB  - Epithelial microcysts have been identified as a significant corneal response to
      contact lens wear. The characteristics of the microcyst response are outlined and
      factors which influence the level of microcysts including lens type, oxygen
      transmissibility (Dk/L), and wear schedule are discussed. Understanding of the
      morphology, pathology, etiology, and clinical significance of microcysts is
      currently incomplete and various hypotheses are discussed.

PMID- 1745496
TI  - Posterior corneal surface toricity and total corneal astigmatism.
AB  - The influence of posterior corneal surface toricity upon total corneal
      astigmatism was investigated in 60 young subjects (mean age 22.04 +/- 3.24
      years). Both surfaces were found to be flatter horizontally than vertically.
      Astigmatism arising from the anterior corneal surface was therefore reduced by
      astigmatism of the opposite sign arising from the posterior surface. Had the
      toricity of the posterior corneal surface been purely governed by that of the
      anterior surface this reduction would have amounted to about 5%. However, the
      posterior surface was found to exhibit additional toricity bringing about a
      greater reduction of total corneal astigmatism amounting to approximately 14%.

PMID- 1745497
TI  - Retinal eccentricity of fusion detail affects vergence adaptation.
AB  - Adaptation of tonic vergence ("vergence adaptation" or "prism adaptation") may be
      produced by sustained accommodative, disparity, or proximal vergence innervation.
      Phoria measures were used in the present study as indices of tonic vergence
      adaptation to convergence and divergence stimuli in five subjects. Amblyoscope
      targets stimulated fusion either over the central or peripheral retina while
      holding accommodative and proximal stimuli constant. The magnitude and rate of
      tonic vergence adaptation were greater under the central fusion condition than
      under the peripheral fusion condition, even though the vergence stimuli were
      matched between central and peripheral fusion conditions. These results show that
      tonic vergence adaptation is influenced by the retinal eccentricity of target
      fusional patterns. However, additional work is required to identify the
      mechanism(s) underlying this eccentricity effect.

PMID- 1745498
TI  - Efficacy of chlorine disinfection of soft contact lenses.
AB  - We evaluated the chlorine system SOFTAB (Alcon) for the disinfection of soft
      contact lenses. The results indicate that a 1000-fold reduction in microorganisms
      was achieved within 6 h. Even with the slight interference of residual cleaner
      and the more significant interference of organic matter disinfection was still
      achieved.

PMID- 1745499
TI  - Chemical inactivation of microorganisms on rigid gas permeable contact lenses.
AB  - The efficiency of four contact lens disinfectant formulations was tested against
      three types of bacteria (Pseudomonas aeruginosa, Staphylococcus aureus, and
      Serratia marcescens) and one fungus (Aspergillus niger). The bacteria were tested
      both as free suspensions and after attachment on surfaces of rigid gas permeable
      contact lenses (RGPCL). The disinfection data were used to calculate the death
      rates and decimal reduction times for the test organisms. P. aeruginosa was the
      most sensitive and A. niger was the most resistant organism to the disinfectants.
      Scanning electron micrographs showed that P. aeruginosa occurred mostly as single
      cells, with little extracellular material, on the lens surface. In contrast, S.
      marcescens produced copious amounts of capsular material layered on the lens
      surface, promoting cell aggregation. Transmission electron micrographs revealed
      that bacterial cells were physically separated from the lens surface by a space
      barricaded with capsular material.

PMID- 1745500
TI  - Vistech VCTS 6500 charts--within- and between-session reliability.
AB  - The aim of the study was to measure the reliability of the Vistech VCTS 6500
      charts, in test score units, in order to allow clinicians to derive estimates of
      what constitutes a clinically meaningful change in performance over time. The
      reliability of a more familiar test, Bailey-Lovie high contrast visual acuity,
      was also measured to provide a comparison. Patients with normal vision and with
      early or subtle eye disease were recruited so that the results would be
      representative of the population likely to present for primary vision screening.
      Patients were tested on all three VCTS charts on two separate occasions at least
      3 weeks apart to give estimates of within- and between-session reliability.
      Reliability was found to be low in all circumstances; between-session reliability
      could be improved by using the mean score for the three charts, but the 95% range
      of difference scores still encompassed at least one-half of the total performance
      range of the test. It was concluded that Vistech charts are unlikely to be of use
      for clinical measurements or for research studies.

PMID- 1745501
TI  - An ophthalmic survey of African patients presenting at rural eye clinics in South
      Africa.
AB  - The records of 10,254 people attending rural eye clinics in South Africa during
      1984-85 were analyzed to determine the reasons for presentation. The main reasons
      for presentation were refractive error, conjunctivitis, and cataract. It is
      expected that population growth plus the increased vocational needs for the
      correction of refractive errors will result in an increased demand for optometric
      services in rural eye clinics. It is suggested that optometry has a major role to
      play in providing primary eye care services to the underserved populations of the
      South African homelands.

PMID- 1745502
TI  - Bilateral monocular diplopia secondary to occult diabetes mellitus.
AB  - A 68-year-old man presented with transient, bilateral, vertical, monocular
      diplopia as an initial manifestation of diabetes mellitus. The diplopia was
      determined to be of lenticular origin, but was not found to be secondary to the
      usual refractive changes. Rather, it is presumed to be due to prismatic
      alterations caused by index of refraction differences within the crystalline
      lenses. It is not known what other factors relate to the development of this type
      of diplopia in the diabetic patient.

PMID- 1745503
TI  - Congenital retinal macrovessel.
AB  - Congenital retinal macrovessel is a rare condition in which anomalous retinal
      vessels cross the macula. Visual impairment can result if the anomalous vessels
      pass across the foveola, if foveolar cysts form, or if hemorrhage occurs. A now
      17-year-old African-American female has an anomalous retinal vein that crossed
      the macular region beyond the horizontal raphe in her left eye. This patient
      exhibited the classic characteristics of congenital macrovessels. Her visual
      acuity remained unaffected after a 5-year follow-up and therefore treatment was
      not required.

PMID- 1745504
TI  - Tinted lenses and the ANSI standards for traffic signal transmittances.
AB  - The transmittance properties of 96 tinted lenses were examined to determine
      whether these lenses met the American National Standards Institute (ANSI) Z80.3
      standards for traffic signal transmittances and color shifts. Transmission
      functions of the lenses were measured using a Zeiss Spectrophotometer, and the
      luminous transmittances and color shifts were calculated according to the ANSI
      guidelines. Approximately 50% of the sampled tinted lenses failed to meet at
      least 1 of the ANSI requirements. Lenses that failed to meet several ANSI
      requirements were often special purpose sun lenses. Although the special purpose
      tinted lenses do not have transmittance requirements for traffic signals, it is
      not always clear from the manufacturers' brochures that the lenses may be
      unsuitable for driving.

PMID- 1745505
TI  - Root agenesis in developing canines as a complication of intranasal antrostomy.
AB  - A case is reported in which the roots of both maxillary canines failed to
      develop, a defect that could be traced to antral surgery when the patient was 8
      years of age. The differential diagnosis of such a finding is proffered. The
      maxillary antrum is described, and aspects of the surgical procedure, the nasal
      antrostomy, used in this patient are discussed. A brief outline of current
      thought on the mechanisms of eruption of teeth is appropriate, and treatment of
      the symptomatic tooth is mentioned.

PMID- 1745506
TI  - Temporomandibular joint dysfunction syndrome: a close association with systemic
      joint laxity (the hypermobile joint syndrome)
AB  - Sixty-two patients admitted for elective reconstructive surgery of the
      temporomandibular joint (TMJ) and eight seen as outpatients with a chief
      complaint of TMJ dysfunction during the same time interval were evaluated for
      possible etiologic factors contributing to the disease. All hospitalized patients
      had severe, end-stage degenerative changes within the TMJ, whereas outpatients
      had less severe disease and did not require surgery. TMJ dysfunction in some
      patients was said to be a result of established causes including bruxism,
      malocclusion, and trauma. No patient in this series had evidence of a systemic
      inflammatory polyarthritis. Of the 70 patients, 38 (54%) met criteria, based on
      those of Carter and Wilkinson, as modified by Beighton et al., sufficient to
      warrant a diagnosis of the hypermobile joint syndrome. Five patients had classic
      Ehlers-Danlos syndrome and therefore were not patients with "benign
      hypermobility," and an additional two cases were described as "marfanoid" and as
      possible Ehlers-Danlos syndrome, respectively. Radiographs showed TMJ
      hyperextensibility in four hypermobile patients. Long-term surgical outcome was
      identical in the hypermobile and nonhypermobile groups. The incidence of
      hypermobility in this series is strikingly higher than the expected incidence in
      an otherwise population. Magnetic resonance images of the TMJs on separate groups
      of asymptomatic normal and hypermobile women identified excessive anterior
      movement in the hypermobile group, together with abnormal anterior disk position
      in some. We hypothesize that hypermobility within the TMJ may cause accelerated
      disk destruction and degenerative disease.

PMID- 1745507
TI  - Effect of fascia repair of the temporomandibular joint disk of sheep.
AB  - The effects of temporal fascia graft repair of temporomandibular joint disk
      perforation on intra-articular structure were examined on four sheep. Four sheep
      had bilateral disk perforations. At 20 weeks the perforation in the right joint
      was repaired with a temporal fascia graft. At 40 weeks the sheep were killed and
      the joints were examined radiologically and histologically. It was found that the
      temporal fascia graft did not survive and the disks remained perforated. However,
      histologically and radiologically there were fewer changes than in the joints
      where the perforated disks were not repaired.

PMID- 1745508
TI  - Evaluation of 0.12% chlorhexidine rinse on the prevention of alveolar osteitis.
AB  - A double-blind study evaluated the ability of 0.12% chlorhexidine rinse to
      decrease the incidence of localized alveolar osteitis after the removal of
      mandibular third molar teeth. One hundred sixty extraction sites in 80 patients
      were evaluated. A statistically significant decrease in the incidence of dry
      socket was seen in patients using the chlorhexidine rinse with no significant
      adverse reactions. Thus a 0.12% chlorhexidine rinse is shown to be an effective
      means of decreasing alveolar osteitis that may follow removal of third molar
      teeth.

PMID- 1745509
TI  - Validity of a risk-related patient-administered medical questionnaire for dental
      patients.
AB  - In this study the validity of a patient-administered risk-related medical
      questionnaire for dental patients was tested. The answers given on the
      questionnaire were compared with the results of a verbal history taken by a
      physician. This verbal history was considered the "gold standard." The
      sensitivity and specificity of the medical questionnaire appeared to be
      sufficiently high, and the kappa values of the separate questions were
      satisfactory. The questionnaire was found to be valid in the registration of
      medical problems in dental patients, but combination of the two methods is
      recommended.

PMID- 1745510
TI  - Ewing's sarcoma of the temporal bone. A case report.
AB  - An 11-year-old girl with a primary Ewing's sarcoma in the squamous temporal bone
      is described, and differential diagnosis and management are discussed. The
      membranous bones of the skull are rare sites for a primary Ewing's sarcoma; the
      squamous temporal bone has not been previously described as a primary site.

PMID- 1745511
TI  - Viruses and chronic disorders involving the human oral mucosa.
AB  - Viruses have been implicated in the etiology of several chronic disorders of the
      oral mucosa. Most of these associations have been with DNA viruses, particularly
      certain herpesviruses, which are associated, for example, with some cases of
      erythema multiforme and with hairy leukoplakia. Papillomaviruses are associated
      with various papillomatous lesions, focal epithelial hyperplasia, and possibly
      with some carcinomas. Viruses may possibly be associated with recurrent aphthae,
      Behcet's syndrome, and some dermatoses. The literature concerning these possible
      associations is reviewed. However, much more research needs to be done before the
      full story of viral associations with oral mucosal disorders can be written.

PMID- 1745512
TI  - Effects of pilocarpine on salivary flow in patients with Sjogren's syndrome.
AB  - Pilocarpine, a muscarinic-cholinergic agonist drug, has been reported to
      stimulate salivary flow in patients with salivary gland dysfunction. Previous
      studies involved heterogeneous groups of patients with salivary gland dysfunction
      and examined the short-term, single-dose, tablet form of pilocarpine. In this
      single-blind, placebo-controlled study we examined the long-term effects of
      pilocarpine administration on patients with definitively diagnosed Sjogren's
      syndrome (SS). Nine subjects with SS who received pilocarpine, and nine age- and
      sex-matched SS control subjects who received a placebo, participated. Baseline
      predosing sialometric and clinical data were obtained for all subjects. The study
      group used 2% pilocarpine as a liquid ophthalmic drop preparation, four drops
      three times per day, for 6-weeks. Identically appearing placebo solution with the
      same dosing schedule and duration was used for the control subjects. Sialometric
      and clinical examinations were performed. The results indicated a significant
      overall increase in both whole unstimulated salivary flow (0.15 +/- 0.03 ml/min
      in study subjects vs 0.02 +/- 0.001 ml/min in control subjects; p less than
      0.001) and parotid stimulated salivary flow (0.14 +/- 0.04 ml/min in study
      subjects vs 0.009 +/- 0.002 ml/min in control subjects; p less than 0.001) in the
      pilocarpine group as compared with the placebo group. The results of this study
      support the use of pilocarpine to increase salivary flow in patients with SS.

PMID- 1745513
TI  - Are there psychologic predictors of treatment outcome in temporomandibular joint
      pain and dysfunction?
AB  - This study explores the relationship between diverse psychologic factors and
      treatment outcome in temporomandibular joint pain and dysfunction (TMJPD). During
      assessment, 178 patients with TMJPD were given a pressure pain threshold and
      tolerance task and completed the Basic Personality Inventory, the Illness
      Behavior Questionnaire, the Multidimensional Health Locus of Control, the
      Perceived Stress Scale, and the Ways of Coping Checklist. Subjects also answered
      questions pertaining to TMJPD symptomatology, including chronicity and severity.
      After conservative treatment with simple jaw exercises and ultrasound, patients
      were contacted again at 5 months to complete a follow-up questionnaire package
      similar to the initial questionnaire battery. Percent reduction in average pain
      intensity and perceived TMJPD severity were used as outcome criteria. The data
      were analyzed with discriminant function analyses. One hundred patients responded
      to the follow-up questionnaire. Patients who reported more than a 50% reduction
      in average pain intensity tended to be less inclined to accept responsibility for
      their problems and were slightly better able to distance themselves from their
      problems than the less improved groups. Those who reported more than a 50%
      reduction in TMJPD severity indicated that the condition was not associated with
      an identifiable onset event and that the condition had become moderately worse
      between onset and first seeking help.

PMID- 1745514
TI  - Recurrent aphthous ulceration with zinc deficiency and cellular immune
      deficiency.
AB  - Zinc deficiency (serum zinc level 65 micrograms/dl) and cellular immune
      deficiency (confirmed by lymphoblastic transformation assay) were found in a 15
      year-old boy who had had recurrent aphthous ulceration for 6 years. Despite the
      previous therapy (orally administered steroid, isoprinosine, interferon,
      lysozyme, and local treatment), the ulcers recurred monthly. After 3 months of
      zinc therapy (50 mg zinc sulfate orally three times daily) the aphthae
      disappeared and did not reappear for 1 year. The lymphoblastic transformation
      activity and serum zinc levels were also normalized with this treatment.

PMID- 1745515
TI  - Occurrence of oral mucosal necrosis in a patient with barbiturate-induced coma.
AB  - Although dermal lesions in patients with drug poisoning have been widely
      documented, similar oral conditions are seldom reported. A case of cutaneous and
      oral mucosal necrosis related to barbiturate-induced coma is reported.

PMID- 1745516
TI  - Oral Crohn's disease with late intestinal manifestations.
AB  - Oral Crohn's disease has been reported frequently in the last two decades with
      and without intestinal manifestations. In the latter case it is considered one of
      the orofacial granulomatoses. This reference is claimed to eliminate the
      patient's distress caused by the term Crohn's disease. There has been much doubt
      whether intestinal Crohn's disease will eventually develop in these patients. A
      case is reported in a 10-year-old West Indian girl in whom oral Crohn's disease
      developed at the age of 10 years and was followed by rectal Crohn's disease 9
      years later. In this article the term Crohn's disease is used to describe those
      patients with intestinal manifestations with or without oral disease whereas oral
      Crohn's disease is used for those who have only oral manifestations.

PMID- 1745517
TI  - Choristomas of the oral cavity: a review.
AB  - The choristoma is a tumorlike mass of normal cells in an abnormal location.
      Intraoral choristomas have been reported under a wide variety of names. This
      comprehensive review of the English-language literature on oral choristomas
      offers a classification of these lesions, analyzes their clinical and histologic
      features, and discusses possible pathogeneses and treatment.

PMID- 1745518
TI  - Characterization of the enamel ultrastructure and mineral content in hypoplastic
      amelogenesis imperfecta.
AB  - Amelogenesis imperfecta (AI) comprises a diverse group of hereditary enamel
      disorders that are characterized by hypoplastic and in some cases hypomineralized
      defects. The specific biochemical abnormalities remain unknown for all AI types,
      making histologic and chemical analyses of affected dentitions essential for
      resolving the etiology of AI. The purpose of this investigation was to
      characterize the ultrastructure and mineral content of smooth hypoplastic AI
      enamel. The AI enamel showed no evidence of surface pitting and was uniformly
      reduced in thickness by approximately 60% compared with control enamel.
      Imbibition studies indicated that the AI enamel was generally porous. The first
      30 microns of AI enamel adjacent to the dentinoenamel junction was translucent
      with poorly formed prisms. Abnormal prism structure was seen throughout the AI
      enamel. Amorphous, presumably organic material that may have been retained enamel
      protein was also seen. Although the crystallite widths were similar in both AI
      and normal enamel, the AI teeth showed areas where the crystallite order and
      continuity appeared disrupted. The mean mineral content was similar for all
      variables measured except sodium, which was significantly lower in the AI teeth.
      The calcium concentration was very low in the AI enamel directly adjacent to the
      dentinoenamel junction and showed a steeper concentration gradient moving from
      the dentin to the surface compared with control teeth. It may be concluded that
      the ameloblasts in smooth hypoplastic AI produce a tissue of reduced thickness,
      which is excessively porous and displays alterations in its ultrastructural
      organization.

PMID- 1745519
TI  - In vitro determination and quantification of 30% hydrogen peroxide penetration
      through dentin and cementum during bleaching.
AB  - Bleaching pulpless teeth with 30% hydrogen peroxide was reported to cause
      external cervical root resorption. It was hypothesized that H2O2 penetrated open
      dentin tubules to initiate an inflammatory response that could result in root
      resorption. No direct experimental evidence was provided to support this theory.
      An in vitro model for determination and quantification of H2O2 penetration during
      bleaching procedures is suggested. Artificial defects of the cementum covering
      the cementoenamel junction were performed in 22 extracted human premolars. After
      15 minutes of thermocatalytic bleaching, H2O2 could be detected in the medium
      surrounding all the tested teeth. Cervical root permeability to 30% H2O2 could
      reach up to 82% of the total amount applied.

PMID- 1745520
TI  - External root resorption after bleaching: a case report.
AB  - An external root resorption occurred after bleaching and was diagnosed
      radiographically in a 26-year-old female dental assistant. The resorption was
      noticed 6 months after bleaching. The involved tooth had no history of trauma. An
      attempt to stop the resorption by using calcium hydroxide failed. The perforation
      was corrected surgically with amalgam.

PMID- 1745521
TI  - Localization of anatomic structures before endodontic surgery with tomograms.
      Report of a case.
AB  - Tomograms taken before endodontic surgery can demonstrate the location of root
      apices relative to adjacent anatomic structures. This buccolingual perspective is
      not depicted on conventional periapical or panoramic radiographs. Accurate length
      determination from the root apex to the inferior alveolar canal is simplified,
      and the relationship of root surfaces to the buccal and lingual plates is well
      visualized on the tomographic images.

PMID- 1745522
TI  - Digitally subtracted linear tomograms: three techniques for measuring condylar
      displacement.
AB  - Using digital subtraction enhancement, we compared the accuracy of three
      tomographic technique variations for quantifying small changes of condylar
      position. A phantom made of skeletal material and an adjustable mechanical stage
      provided 0.1 mm positioning accuracy of the condylar segment. Linear tomographic
      images were made with the condyle in a centered position and at each of three 1
      mm increments of displacement in two of three directions (inferior, and posterior
      or lateral). Variations for frontal views included arbitrary (+20 degrees) and
      individualized (+10 degrees) horizontal correction of the condylar axis.
      Variations for lateral views included the arbitrary and individualized correction
      and a fully corrected vertical (+5 degrees) and horizontal (+10 degrees)
      adjustment. Blinded observers made repeated measurements on randomized
      subtraction images with a digitizing tablet. Film images were subtracted twice,
      and each subtraction was read twice by two examiners. The study was repeated with
      a second series of films treated in an identical manner. Mean values for
      measurements, standard deviations, and absolute values of differences between
      measured and expected values were calculated for each subtraction. Analysis of
      variance identified statistically significant sources of variation in
      repositioning the phantom and producing exact displacements of the condyle.
      Average absolute value of differences from expected values were similar for the
      three techniques and for frontal and lateral orientations and increments of
      displacement. Typical absolute value of difference for any technique was 0.2 mm
      for posterior, 0.2 mm for lateral, and 0.1 mm for inferior displacements.
      Significantly greater accuracy of inferior displacement measures was attributed
      to greater accuracy of registration of the fossa in its cranio-caudal
      dimension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745523
TI  - Radiographic detection of occlusal caries in noncavitated teeth. A comparison of
      conventional film radiographs, digitized film radiographs, and RadioVisioGraphy.
AB  - The aim of this study was to compare the accuracy of conventional film
      radiographs, digitized radiographs, and RadioVisioGraphy (RVG) for the detection
      of dentinal caries in occlusal surfaces of noncavitated extracted teeth. Eighty
      one fully erupted extracted third molars were assessed by four observers using
      five radiographic methods: conventional film radiographs, digitized radiographs
      with contrast enhancement and with a filtering procedure, and RVG with contrast
      enhancement and with x function. Scoring criteria were dichotomous. Histologic
      sections (500 to 600 microns thick) served as the validation criterion. The two
      digital methods with contrast enhancement tended to perform more accurately than,
      although not significantly different from, the other three methods (p greater
      than 0.05). Average likelihood ratios (true positive/false positive) were 4.3
      (conventional film radiographs), 4.4 (RVG with contrast enhancement), 3.6 (RVG
      with x function), 4.9 (digitized radiographs with contrast enhancement), and 3.7
      (digitized radiographs with filtering procedure). Observers 1 and 2 (oral
      radiologists) performed better than observers 3 and 4 with all five methods (p
      less than 0.005).

PMID- 1745524
TI  - Evaluation of the new RadioVisioGraphy system image quality.
AB  - A comparison of the physical properties of a new charge-coupled device-based
      direct digital intraoral radiographic system, its predecessor, and high-speed
      silver halide intraoral radiographic films is reported. The new system proved to
      have a higher dose dynamic than the former device. The resolving power of the new
      system is 11 line pairs/mm compared with a maximum of 14 line pairs/mm for
      intraoral film.

PMID- 1745525
TI  - Regrowth of mandibular coronoid processes.

PMID- 1745526
TI  - Postpermanent dentition.

PMID- 1745527
TI  - Maxillary canine: present or not?

PMID- 1745528
TI  - Monoclonal antibodies for septic shock: in or out of the barn door?

PMID- 1745529
TI  - External review in the brave new world of continuous quality improvement.

PMID- 1745530
TI  - Can an external quality review system avoid the inspection model?

PMID- 1745531
TI  - Medicare: a strategy for quality assurance, IV: Medicare conditions of
      participation and quality assurance.
AB  - This article, the fourth of a series, summarizes the conclusions of the review of
      the Medicare conditions of participation and accreditation conducted by the
      Institute of Medicine (IOM). Difficulties in measuring outcomes of care,
      limitations in survey information, attitudes toward sanctions, and variation in
      survey procedures are discussed.

PMID- 1745532
TI  - Expanding on the role of patient as consumer.

PMID- 1745533
TI  - The merging of quality paradigms--meeting patient needs while staying true to
      science.

PMID- 1745534
TI  - Quality improvement in health care: is the patient still left out?
AB  - Quality improvement methodologies as applied to health care reflect a traditional
      practitioner-centered approach to defining and improving quality of services.
      However, health care must reconcile the values, needs, and preferences of
      providers with those of consumers if effective quality improvement programs are
      to be developed.

PMID- 1745535
TI  - The second generation of quality review?

PMID- 1745536
TI  - Developing, assessing, and refining quality of care criteria for a CHAMPUS mental
      health services demonstration.
AB  - CHAMPUS established a contracted provider arrangement demonstration in the
      Norfolk, Virginia area. This article describes the development, assessment, and
      refinement of the quality monitoring criteria used to assess quality of care. Of
      3,303 cases reviewed, 66% failed one or more criteria in two levels of review by
      nonphysician reviewers and were referred to peer reviewers. The referral problem
      was confirmed by the peer reviewer in at least 57% of the 2,177 cases. The
      criteria should undergo complete specificity and sensitivity testing, be expanded
      to include more outcome measures, and be applied to other geographic areas before
      use by other third party payors.

PMID- 1745537
TI  - [Introduction to the theme. Current knowledge in shoulder surgery--II].

PMID- 1745538
TI  - [Assessment of shoulder function].
AB  - In 1980, a major study began on the recovery of shoulder function following
      injuries of various kinds. In order to try and assess shoulder function and it's
      recovery following injury, it became apparent that diagnostic assessments of the
      shoulder were of little value, and the Author worked on designing a method of
      shoulder functional assessment what would allow easy and repeated assessment of
      shoulder function at various intervals following injury. This method of shoulder
      functional assessment is now used as a standard practice in many centres,
      throughout the world, and this paper aims to present the clinical method of
      functional assessment, as used by the Author, in plotting progress following
      injury over a number of years. The method has been extensively used by the author
      and others over the past ten years, in studying the recovery of shoulder function
      in different disease processes, after injuries and after various treatments,
      including surgery.

PMID- 1745539
TI  - [Examination of the non-injured shoulder].
AB  - Modern imaging methods are undeniably very attractive. They should make possible
      an easy study of the musculotendinous rotator cuff of the shoulder joint, lesions
      of which are the cause of most painful or stiff shoulder syndromes. However, not
      all shoulder symptoms are due to rotator cuff lesions. Also, not all methods of
      imaging are equally suited to showing the different cuff lesions. Further, one
      cannot consider the treatment of a symptomatic shoulder without having an
      assessment of the present condition upon which to gauge the functional
      improvement due to the treatment. Hence clinical examination of the painful
      shoulder remains essential. This makes it possible (1) to exclude an extra
      articular pathology, (2) to choose the method of imaging most suited to showing
      the suspected lesion, and finally (3) to quantify the functional state of the
      shoulder.

PMID- 1745540
TI  - [Relationship of acromial architecture and diseases of the rotator cuff].
AB  - Variations in the architecture of the coraco-acromial arch can lead to a
      clinically symptomatic rotator cuff lesion. Differences in the shape and slope of
      the acromion, anterior acromial spurs and inferior protruding acromio-clavicular
      osteophytes decrease the volume of the subacromial space, leading to impingement.
      Recent anatomic, radiographic, biomechanic and stereophotogrammetric studies have
      confirmed these architectural variations and their effect on the contents of the
      subacromial space. Abnormal contact between the acromion and these soft tissues
      can result in pathological lesions. Surgical procedures should be aimed at
      increasing the space beneath the coraco-acromial arch to reduce wear on the
      rotator cuff.

PMID- 1745541
TI  - [2 roentgen projections for the subacromial space before and following
      acromioplasty. Results of a study series of 40 patients].
AB  - It is suggested that two radiological projections of the scapula, an AP view and
      a lateral (tunnel) view, be obtained in order to estimate the form and size of
      the acromion before and after acromioplasty. In order to evaluate the
      standardized films precisely, a film must have been taken for comparison before
      the surgery. As the method described is easily reproducible, it can be used to
      evaluate the effect of an acromioplasty irrespective of whether the procedure was
      an open or an arthroscopic one. The radiological results can be correlated with
      the functional results at the beginning of rehabilitation and at the end of this
      period. More sophisticated studies might require a more elaborate X-ray technique
      than the one proposed in this article.

PMID- 1745542
TI  - [Reconstruction of massive rotator cuff rupture using a deltoid muscle flap].
AB  - In extensive rotator cuff tears with rupture of the supra- and infraspinatus
      muscles, we have obtained good and very good results persisting for 3 years or
      longer only in 40% of cases treated by resection and debridement, and in 25% of
      our cases the head of the humerus was found to be no longer centrally located in
      the joint socket on X-ray examination 10 years after treatment. It was therefore
      proposed that an active muscle flap taken from the anterior part of the deltoid
      muscle (part III according to Fick) should be used to span the trophic defect in
      the rotator cuff, being sutured into healthy tissue following freshening up. This
      seems logical, since the transferred muscle flap remains innervated and
      vascularized and also works synergistically with the rest of the rotator cuff.
      The flap interposed in this way between the greater tubercle of the humerus and
      the acromion functions in the same way as a double-bellied muscle and prevents
      displacement of the head of the humerus. In this way an active rotator cuff is
      produced, which also takes over the function of stabilizing the humeral head.
      After follow-up of at least 1 year (average 19 months), the result is
      aesthetically satisfactory in all 50 shoulders treated in this way; 47 are free
      of pain or painful only some of the time; in 32 active elevation of over 120
      degrees is possible; 21 have symmetrical force ratios in elevation and 15 for
      outward rotation in 90 degrees abduction. All reconstructed shoulders were
      characterized by fatigability in elevation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745543
TI  - Shoulder arthroplasty today.

PMID- 1745544
TI  - The adaptation of three isolates of Babesia divergens to continuous culture in
      rat erythrocytes.
AB  - Three isolates of Babesia divergens have been cultured continuously for 6 months
      in rat erythrocytes using the candle jar technique (Trager & Jensen, 1976). One
      isolate was already rat-adapted, the other two became adapted to rats through
      continuous culture in rat erythrocytes. Parasites were cultured in rat
      erythrocytes in RPMI medium supplemented with 20% foetal calf serum. The highest
      parasitaemia obtained was 35% and multi-parasitization of red blood cells was
      often observed. Cultures of B. divergens remained infective to splenectomized
      rats. Cultures with high parasitaemias contained a large number of extracellular
      merozoites. When separated from the red blood cells, these extracellular
      merozoites retained their infectivity.

PMID- 1745545
TI  - Transfer of Eimeria apionodes from wood mice (Apodemus sylvaticus) to laboratory
      mice (Mus musculus).
AB  - Transfer of Eimeria apionodes from wood mice directly into untreated laboratory
      mice was unsuccessful but transfer into corticosteroid-treated animals produced
      an oocyst output, about 1000 times less than that observed from wood mice after a
      similar inoculum. Repeated passage through corticosteroid-treated laboratory mice
      resulted in a line adapted to survival in untreated animals. This line was
      compared with the parent strain maintained in wood mice and some features of the
      oocyst output patterns, notably the pre-patent period, appeared to be controlled
      by the host species. The oocyst production of each population was higher in the
      host species to which it was adapted than in the other host species (P less than
      0.001). Once adapted to laboratory mice, the line produced insignificantly
      different levels of oocysts in corticosteroid-treated and untreated animals (P
      greater than 0.05).

PMID- 1745546
TI  - Ultrastructural changes associated with reversal of chloroquine resistance by
      verapamil in Plasmodium chabaudi.
AB  - Reversal of chloroquine (CQ) resistance by verapamil, a Ca2+ antagonist, has been
      shown in CQ-resistant human and rodent malaria parasites. Here, we report
      ultrastructural changes associated with this phenomenon in CQ-resistant
      Plasmodium chabaudi (AS strain) after infected mice were administered CQ and
      verapamil. At parasitaemias of 5-7%, CQ at 6 mg/kg caused little morphological
      effect on CQ-resistant parasites. In contrast, co-administration of CQ and
      verapamil at 50 mg/kg induced swelling of food vacuoles with clumped pigment at
      2.5 h. Morphological changes other than food vacuole enlargement occurred at 21
      and 45 h: disappearance of endoplasmic reticulum, formation of myelin structures,
      focal cytoplasmic vacuolization and coarse clumping of electron-dense material in
      nuclei. These structural changes appeared to be very similar to those observed in
      CQ-sensitive P. chabaudi in mice injected with CQ alone or CQ plus verapamil. On
      the other hand, verapamil at 50 mg/kg alone did not induce any effect on both CQ
      sensitive and CQ-resistant P. chabaudi. These results suggest that swelling of
      the food vacuoles is an initial event associated with reversal of CQ-resistance
      by verapamil.

PMID- 1745547
TI  - Evidence for translational control of beta-tubulin synthesis during
      differentiation of Leishmania donovani.
AB  - Tubulin biosynthesis was rapidly induced during transformation of the mammalian
      (amastigote) stage of the kinetoplastid parasite Leishmania donovani to
      flagellated promastigotes. However, transcription of beta-tubulin genes occurred
      constitutively, as judged by nascent RNA synthesis in isolated nuclei and
      Northern blotting of steady-state mRNA. Two mRNA species of 2.2 and 2.4 kb were
      shared by the two cell-types, while a third 2.6 kb species, constituting about
      20% of the total, was present in large amounts in promastigotes. RNase protection
      experiments demonstrated sequence microheterogeneity in the 5'-untranslated
      region, the pattern of which was identical in promastigotes and amastigotes. By
      primer extension assays, heterogeneity in the 5'-terminal cap structure of
      amastigote beta-tubulin mRNA and differential pausing of reverse transcriptase
      within the mini-exon leader region were detected. These differences correlated
      with enhanced translational efficiency of tubulin mRNA from promastigotes in a
      rabbit reticulocyte lysate system. The results indicate that translational
      control plays a major role in tubulin induction during L. donovani
      differentiation.

PMID- 1745548
TI  - The purification, characterization, serological activity and hepatotoxic
      properties of two cationic glycoproteins (alpha 1 and omega 1) from Schistosoma
      mansoni eggs.
AB  - T cell-deprived mice acutely infected with S. mansoni suffer microvesicular
      hepatocyte damage which is not seen in infected, immunological intact animals. A
      cationic fraction (CEF6) of the PBS-soluble portion of S. mansoni eggs (SEA)
      induces antibodies which, on passive transfer, prevent hepatocyte damage. CEF6
      contains 2 antigens, omega 1 and alpha 1, and has also been shown to be a useful
      serodiagnostic reagent. This paper describes the purification and
      characterization of the 2 antigens present in CEF6. omega 1 is a monomeric
      glycoprotein with a pI greater than 9.0 and a molecular weight of 31 kDa. Alpha 1
      consists of two immunologically cross-reactive dimers, 41 and 36 kDa in non
      reducing conditions, each of which consists of one unique and one common
      glycoprotein subcomponent. In ELISA with mouse and human infection sera omega 1
      is shown to be S. mansoni specific and is better able to distinguish S. mansoni
      infections from other schistosome infections than are unfractionated SEA, CEF6 or
      alpha 1. Passive transfer of monospecific anti-omega 1 sera into S. mansoni
      infected, T cell-deprived mice completely prevented the occurrence of
      microvesicular hepatocyte damage in these animals. Monospecific anti-alpha 1
      serum had no hepatoprotective capacity.

PMID- 1745549
TI  - Culture characteristics of Trypanosoma catostomi and Trypanosoma phaleri from
      North American freshwater fishes.
AB  - Culture characteristics of two species of piscine trypanosomes were compared.
      Trypanosoma catostomi from Catostomus commersoni was isolated in hypo-osmotic
      blood agar media but not in hyper-osmotic media. However, T. phaleri from Amia
      calva was isolated in both media. Only T. catostomi was stimulated to divide by
      diluting infected blood with water. The maximum number of T. phaleri and
      percentage of trypomastigotes were not affected by NaCl concentration. The
      maximum number of T. catostomi was inversely related to osmotic pressure and the
      percentage of trypomastigotes was directly related to osmotic pressure. This was
      confirmed by using equi-osmotic concentrations of NaCl, NaBr, Na acetate, KCl,
      choline-Cl or sucrose. Supplementation with urea had no effect on the number or
      morphology of trypanosomes. The survival of T. catostomi following
      cryopreservation was enhanced by prior incubation in hyper-osmotic media.
      Differential culture characteristics of these species may reflect adaptation to
      different host-vector systems.

PMID- 1745550
TI  - Reduced accumulation of isometamidium by drug-resistant Trypanosoma congolense.
AB  - The accumulation of the trypanocide isometamidium chloride (Samorin, RMB Animal
      Health Ltd., UK) by a range of clones of Trypanosoma congolense with varying
      sensitivity to the drug, was measured by methods based on the fluorescence of
      isometamidium. Fluorescence microscopy and flow cytometry showed a reduction in
      drug accumulation by resistant clones. Fluorescence spectrophotometry
      demonstrated an inverse correlation between the intensity of cell-associated
      fluorescence and the level of resistance of the clones expressed in vivo. The
      addition of the metabolic inhibitor SHAM/glycerol to the incubation medium
      resulted in a reduction of this apparent difference in drug accumulation between
      the clones; those clones which were sensitive to isometamidium showed a reduction
      in fluorescence while a percentage increase in fluorescence was observed as
      clones became more resistant to the trypanocide. These observations may be of
      value for the in vitro detection of resistant T. congolense populations and may
      also be used to estimate the mean level of resistance in a given sample. The
      results also imply that decreased accumulation of isometamidium by drug-resistant
      clones of the parasite may be responsible for the reduction in sensitivity.

PMID- 1745551
TI  - Intra-uterine larval development of the polystomatid monogeneans,
      Pseudodiplorchis americanus and Neodiplorchis scaphiopodis.
AB  - Larvae of the monogeneans Pseudodiplorchis americanus and Neodiplorchis
      scaphiopodis develop within egg capsules retained in the uterus of the parent
      parasite. This study reveals adaptations for the storage and nutrition of
      infective stages which have no known precedent amongst other platyhelminths. The
      vitelline system is greatly reduced and appears to contribute little to embryo
      nutrition. An electron-dense 'shell' which encloses the newly formed embryos is
      subsequently replaced by a thin flexible sac composed of concentric layers of
      membranes which are derived from the uterus wall. Further membranes are added to
      this multi-laminate structure as the encapsulated embryos pass along the uterus,
      and this enables the sac to expand continuously as the larva inside it grows. The
      capsule lining extends into fine cytoplasmic processes which 'plumb in' to the
      larval tegument between ciliated cells. These connexions are packed with glycogen
      and appear to perform a placenta-like function. The unique adaptations correlate
      with the demands of the life-cycle. Large numbers of oncomiracidia (up to 300)
      can be packed, in membranous sacs, within the storage capacity of the uterus;
      direct transfer of nutrients from parent to offspring enables resources to be
      supplied over an extended period; and infective larvae can be maintained in
      readiness for an unpredictable opportunity for transmission.

PMID- 1745552
TI  - Ultrastructure and microanalyses of the protoscolex hooks of Echinococcus
      granulosus.
AB  - The rostellar distal cytoplasm of Echinococcus granulosus protoscoleces is
      characterized by extensive basal membrane infolding, prominent hemidesmosomes and
      is subtended by a lamina reticularis with microfibrils of approximately 10 nm
      diameter that occasionally show a 55 nm banding periodicity. The rostellar hooks,
      in 2 rows, each have a blade, guard and handle region and possess a central
      amorphous pulp, a middle microfibrillar medulla with microfibrils of
      approximately 4 nm diameter, and a complex outer cortex in all but the proximal
      region of the guard and the base of the handle. In these regions additional
      material, of similar electron density to the medulla, but lacking the fibrillar
      substructure, occurs and gives the areas a lobed appearance. Energy-dispersive X
      ray microanalysis of whole hooks demonstrated the presence of sulphur and trace
      quantities of phosphorus. X-ray near-edge absorption spectra resembled those of
      cystine, feather and hair and showed the sulphur to be predominantly in the form
      of disulphide linkages. X-ray diffraction patterns of whole hook preparations
      revealed 2 diffuse rings with equatorial spacings of 7.99 A and 15.22 A, thus
      differing from vertebrate keratins.

PMID- 1745553
TI  - Immunocytochemical and radioimmunometrical demonstration of serotonin- and
      neuropeptide-immunoreactivities in the adult rat tapeworm, Hymenolepis diminuta
      (Cestoda, Cyclophyllidea).
AB  - Standard indirect immunocytochemical techniques have been interfaced with
      confocal scanning laser microscopy (for whole-mount preparations) and
      epifluorescence microscopy (for cryosections) to investigate the occurrence and
      distribution of serotoninergic and peptidergic nerve elements in adult H.
      diminuta. Serotonin (5-HT)-immunoreactivity (IR) was widespread throughout the
      worm, occurring in the paired cerebral ganglia, transverse commissure, the 10
      longitudinal nerve cords and in a plethora of small nerve fibres of the
      peripheral nervous system. An abundance of serotoninergic nerve cell bodies was
      found in association with the lateral nerve cords. The genital atrium and
      accessory reproductive ducts were richly innervated with serotoninergic nerve
      fibres. Thirty-five antisera to 20 vertebrate regulatory peptides and 1
      invertebrate peptide (FMRFamide) were used to screen the worm for neuropeptide
      IR. Immunostaining was obtained with antisera raised to pancreatic polypeptide
      (PP), peptide YY (PYY), neuropeptide Y (NPY), substance P (SP), peptide histidine
      isoleucine (PHI), xenopsin (XP) and FMRFamide. The most extensive pattern of IR
      occurred with antisera to PP and PYY, IR being evident in the cerebral ganglia,
      transverse commissure, longitudinal nerve cords and in small nerve fibres that
      ramified throughout the parenchyma. A series of bipolar nerve cell bodies between
      the median nerve cords displayed PP/PYY-IR. The distribution of FMRFamide-IR was
      reminiscent of the PP/PYY pattern but was less extensive. Comparison of the
      serotoninergic and peptidergic nervous systems has revealed general similarities
      and some distinct differences, especially with regard to the distribution of
      immunoreactive nerve cell bodies. Quantitative data are presented on the levels
      of PP-, SP-, PHI-, and gastrin-releasing peptide (GRP)-immunoreactivities
      demonstrable in acid-alcohol extracts of whole worms. The highest level of
      peptide IR determined was recorded for PP.

PMID- 1745554
TI  - Community control of Ascaris lumbricoides in rural Oyo State, Nigeria: mass,
      targeted and selective treatment with levamisole.
AB  - A study to compare effects of mass, targeted and selective chemotherapy with
      levamisole (Ketrax) as an action for the control of Ascaris lumbricoides was
      carried out in three communities in rural Oyo State, Nigeria. Selective treatment
      was applied in one village by treating the most heavily infected 20% of the
      inhabitants, targeted treatment in the second village involved children aged 2-15
      years, while mass treatment was offered to all inhabitants excluding infants
      under 1 year and pregnant women in the third village. Recommended doses of
      levamisole were given in the villages, as described above, at 3-monthly intervals
      during a period of 1 year. Prevalence and intensity (epg) of A. lumbricoides
      infection were determined immediately before and 3 months after the period of
      intervention using a modified Kato-Katz technique. In the selective treatment
      village, no significant differences were found between the pre- and post
      treatment egg counts (mean (+/- S.D.) epg 6776 +/- 10,791 versus 4259 +/- 10,909
      respectively) of A. lumbricoides in the total population. In the targeted
      treatment village, significant differences were recorded in pre- and post
      treatment egg counts for the total population (9057 +/- 15,797 versus 2579 +/-
      6529) among the children alone (10,935 +/- 20,094 versus 992 +/- 3175) and among
      the untreated adults (7742 +/- 9782 versus 4561 +/- 8798). In the mass treatment
      village, significant differences in pre- and post-treatment egg count values were
      also recorded (11,907 +/- 17,220 versus 1489 +/- 5165). The intensity of
      Trichuris trichiura and hookworm infections among the villagers before and after
      intervention were not observed to have changed significantly regardless of
      selective, targeted or mass treatment.

PMID- 1745555
TI  - Evidence for the presence of quinone methide isomerase in the metacercarial cyst
      of Microphallus sp. (Trematoda: Microphallidae).
AB  - The white colour of the cyst wall of the metacercaria of Microphallus sp., even
      in the presence of dihydroxy phenol and phenoloxidase, is due to proteins
      generated through a possible quinone methide interaction. The quinone methide
      isomerase converts the phenoloxidase mediated quinone into beta-hydroxy catechol.
      Formation of catechol from quinone by cyst extracts was observed
      spectrophotometrically and chromatographically. This enzyme is involved in
      detoxification of excess quinone and beta-sclerotization of the cyst wall.

PMID- 1745556
TI  - Characterization of proteolytic enzymes from larval and adult Nippostrongylus
      brasiliensis.
AB  - Proteases from infective larval (L3) and adult stages of Nippostrongylus
      brasiliensis were investigated with a combination of techniques involving gelatin
      degradation and cleavage of fluorogenic substrates. Analysis of L3 excretory
      secretory (ES) products revealed enzymes of Mr 51, 58, 79, approximately 150 and
      approximately 250 kDa. Inhibition profiles indicate that the major 51 kDa
      protease is a metallo-enzyme. Significantly, little activity was present in
      larval somatic extracts, suggesting the synthesis of zymogens or precursor forms
      prior to secretion. Adult ES contained a distinct enzyme, of 50 kDa, and a number
      of other proteases were detected in somatic extracts of this stage, ranging from
      51 to greater than 300 kDa. The largest of these adult somatic enzymes is also a
      putative metallo-protease. While nearly all enzymes from both L3 and adult are
      heat labile, incubation at 100 degrees C generated a previously unobserved
      activity at 20 kDa. Furthermore, a protease of similar size may be found in
      uninfected rat intestinal tissue, suggesting specific uptake of a host-associated
      enzyme by the parasite in the form of an inactive, heat-labile complex.

PMID- 1745557
TI  - A species-specific oligonucleotide DNA probe for the identification of
      Meloidogyne incognita.
AB  - A genomic library of Meloidogyne incognita Race 1 has been prepared in the
      bacteriophage lambda gt10 and screened for specific DNA sequences by
      hybridization with radio-isotope labelled total genomic DNA from a number of
      Meloidogyne species. One clone isolated (MR1 #15), although not totally species
      specific, clearly showed preferential hybridization to M. incognita. Following
      subcloning and sequencing of the 255 bp insert, four stretches of the sequence
      corresponding to oligonucleotides of approximately equal length (approximately 70
      bp) were synthesized and examined for specificity. One of them, MR1 #15.2, showed
      the necessary specificity to be used as a diagnostic tool.

PMID- 1745558
TI  - Restrictions on 'multiple biochemical analyses' profiling decreases usage of
      biochemistry test requests.
AB  - One hundred and forty two thousand near-consecutive pathology episodes in a
      private practice laboratory were reviewed. During this period, a new government
      Medical Benefits Schedule (Pathology Services Table) was introduced which
      restricted the usage of the 'Multiple Biochemistry Analyses' (MBA) test profile.
      We found that requesting practitioners, when deprived of the use of the MBA
      profile, altered their biochemical requesting patterns and that usage of other
      permitted biochemical profiles increased. However, the overall use of biochemical
      tests decreased over the survey period, and the cost to the community of
      biochemical tests performed was lowered.

PMID- 1745559
TI  - Analgesic nephropathy in Fischer 344 rats: comparative effects of chronic
      treatment with either aspirin or paracetamol.
AB  - This study has compared the relative nephrotoxicity of chronic treatment with
      aspirin or paracetamol in an animal model. Changes in renal structure and urinary
      concentrating ability were examined in female Fischer 344 rats after continuous
      treatment with either aspirin (120-230 mg/kg body wt/day), or paracetamol (140
      210 mg/kg body wt/day), and were compared with age-matched untreated control
      rats. Renal morphological changes were examined after 40-83 weeks of analgesic
      treatment, using light and electron microscopy. Aspirin caused renal papillary
      necrosis and a decrease in urinary concentrating ability, whereas paracetamol
      alone did not cause significant renal damage. Aspirin produced damage to the
      interstitial cells and matrix, particularly in the mid-papillary region, followed
      by changes to the thin limbs of the loop of Henle and medullary capillary
      endothelium. These structural changes were similar to those described previously,
      when continuous treatment with combined aspirin and paracetamol was studied in
      the same animal model.

PMID- 1745560
TI  - The indirect estimation of hemoglobin concentration in whole blood.
AB  - The present conventional methods for determination of Hemoglobin (Hb)
      concentration in whole blood depend on the direct colorimetric measurement of
      chemically modified Hb following its release from red cells by lysis. This paper
      examines an alternative, indirect method which does not require initial red cell
      lysis, corrects for the falsely elevated Hb due to the lipemic plasma and
      determines whether elevated WBC count effects a change in the Hb value, without
      the tedious laboratory manipulations currently required to correct for these
      artifacts. The method is simple, uncomplicated and is based on the observation of
      a constant ratio (2.98) between the Mean Corpuscular Volume (MCV) and the Mean
      Corpuscular Hemoglobin (MCH) indices obtained from standard electronic counters
      in use in most laboratories. The Hb concentration is calculated by the equation:
      [formula: see text]. The resultant Hb measurements show an acceptable degree of
      accuracy and precision when compared with the direct measurements obtained from a
      Coulter Model S + I, even in the presence of a high WBC or lipid.

PMID- 1745561
TI  - Quality assurance of immunodiagnostic tests in Australasia.
AB  - A Royal College of Pathologists of Australasia (RCPA) sponsored Quality Assurance
      Program (QAP) in Clinical Immunology, involving 128 laboratories over a 1 yr
      period, revealed the following: successful participation in the program by 16
      overseas laboratories (distant from Australia); only 30% of laboratories
      succeeded in returning their results by the scheduled date on every occasion;
      quantitation of urinary total protein and Bence Jones protein was poor and varied
      over a log scale; immunofixation was more successful in characterizing urinary
      paraprotein than immunoelectrophoresis; densitometry of protein electrophoresis
      appeared the method of choice in quantitating serum paraproteins accurately;
      nephelometric techniques gave better concordance between laboratories than
      turbidometric, radial immunodiffusion or agglutination techniques; poor
      concordance between laboratories in detecting weakly positive antinuclear
      antibodies (ANA); some laboratories had difficulties in identifying ANA patterns
      (only 60% of laboratories correctly identified the anticentromere pattern); few
      laboratories could correctly identify antibodies to extractable nuclear antigens
      (ENA); flow cytometry gave a smaller dispersion of lymphocyte subpopulation
      percentages than microscopy. A method was established to rank laboratory
      performance of selected tests over the 1 yr period. Such a comparative ranking
      scheme may alert laboratories in identifying specific or generalized deficiencies
      in performance.

PMID- 1745562
TI  - Tuberculosis in Australia: an analysis of cases identified in reference
      laboratories in 1986-88.
AB  - The Special Interest Group in Mycobacteria within the Australian Society for
      Microbiology has carried out a collaborative study of cases of tuberculosis
      diagnosed in Australian reference laboratories in the years 1986, 1987 and 1988.
      Annual totals of 574, 584 and 613 respectively, suggest that the incidence of
      bacteriologically-positive tuberculosis is continuing at 3-4 cases per 100,000
      population. The highest rates were detected in males over 50 and females over 65
      years of age. Three-quarters of the total cases relate to pulmonary disease.
      Resistance to at least 1 anti-tuberculosis drug was detected in 78 (12.7%) of
      isolates tested in 1988. The negligible decline in incidence of tuberculosis in
      Australia, the high prevalence in S.E. Asian countries, and the fact that HIV
      infection is an important risk factor, make it imperative that Australia's
      diagnostic and management programmes be maintained.

PMID- 1745563
TI  - Susceptibility of urine isolates of Staphylococcus saprophyticus to antimicrobial
      agents.
AB  - The minimum inhibitory concentrations (MICs) of 10 antimicrobial agents for 96
      urinary isolates of Staphylococcus saprophyticus cultured from symptomatic
      females in the Western Australian general community are reported. All
      antimicrobial agents tested showed good activity, with the exceptions of
      norfloxacin (MIC90 8 mg/L) and ampicillin (MIC90 0.5 mg/L). Eighty-three of 96
      isolates were susceptible to all antimicrobial agents tested. One isolate was
      resistant to both tetracycline and trimethoprim. The remainder were resistant to
      a single antimicrobial agent; 10 to tetracycline and 2 to trimethoprim. None of
      the isolates exhibited any detectable beta-lactamase activity when tested by the
      chromogenic cephalosporin method. Synergy between trimethoprim and sulphafurazole
      against Staph. saprophyticus was demonstrated in only 2 of 5 strains having an
      increased MIC of one or both of these agents.

PMID- 1745564
TI  - The hemolytic and cytolytic activity of group B streptococcal hemolysin and its
      possible role in early onset group B streptococcal disease.
AB  - The in vitro and cytolytic properties of the hemolysin of group B streptococcus
      (GBS) were investigated using sheep erythrocytes and McCoy cells adapted for
      growth in a serum-deficient medium. The relationship between the hemolysin,
      various carrier molecules and phospholipids was examined. Starch-based carriers
      interfered with the inhibitory activity of phospholipids and solvents for the
      phospholipids reduced the activity of the hemolysin. These technical problems
      were resolved by use of an albumin-based carrier, a strain producing large
      amounts of hemolysin and sonication of the phospholipid. The hemolysin was
      cytolytic for McCoy cells and this activity and its hemolytic action on sheep
      erythrocytes were inhibited by a number of phospholipid components of surfactant.
      It is possible that GBS hemolysin has a direct or indirect role in the
      pathogenesis of the pneumonitis of early onset GBS infection.

PMID- 1745565
TI  - Longitudinal studies of virulence factors of Pseudomonas aeruginosa in cystic
      fibrosis.
AB  - Among 111 strains of Pseudomonas aeruginosa from 49 children with cystic
      fibrosis, duration of colonization correlated with bacterial phenotype. We
      confirmed that P. aeruginosa from chronically colonized patients tended to be
      less motile, produce lower levels of protease and elastase, to be more sensitive
      to normal serum and to be polyagglutinating or untypable with standard antisera.
      We also showed that phospholipase and heat-stable hemolysin, concerned in
      metabolism of inorganic phosphate, and exotoxin A, were lower in these isolates.
      In longitudinal studies there was a decrease in virulence properties when
      isolates from the same patient were compared. No reversion from altered phenotype
      to 'wild-type' characteristics was found.

PMID- 1745566
TI  - Is primary sensitivity testing on urine samples valid?
AB  - One thousand eight hundred urine specimens were examined prospectively to
      determine the validity of primary sensitivity testing. Microscopic criteria
      assessing pyuria and microorganisms were developed for predicting the presence of
      urinary tract infection and thus suitability for direct sensitivity testing. The
      criteria selected gave a positive predictive value of 74.6% and a negative
      predictive value of 99.5%. Zone diameters by primary and standardized secondary
      methods were compared for each urinary pathogen to each antibiotic tested.
      Percentage agreement between primary and secondary sensitivity results varied
      between 100% for Enterobacteriaceae tested against Gentamicin to 95.2% for
      Enterococcus faecalis tested against Ampicillin. Seventeen discrepancies between
      primary and secondary test results were observed (error 2.0%) with only 3 of
      potential clinical significance (primary sensitive, secondary resistant).
      Although primary sensitivity testing has limitations, our study indicates that
      the results are, in the vast majority of cases, in agreement with secondary
      testing, and are probably adequate for the clinical management of uncomplicated
      urinary tract infections. Furthermore, as primary testing rarely produces false
      resistant results it may permit earlier modification of initial empiric therapy.

PMID- 1745567
TI  - Relationship between clinical and milk isolates of Yersinia enterocolitica.
AB  - In the summer of 1987-1988, an outbreak of 11 cases of Yersinia enterocolitica
      enteritis caused by 2 serogroups (0:3, 0:6,30) occurred prompting an
      investigation into possible environmental sources. Symptoms were present for a
      mean of 9 days and occurred in 2 distinct age groups--toddlers (7) who presented
      with diarrhea, and young adults (4), 3 of whom presented clinically with
      appendicitis. In a survey of 39 randomly chosen pasteurized milk samples, 9 were
      positive for growth of Y. enterocolitica and 1 each for Y. fredericksenii and Y.
      intermedia. An association between clinical and milk isolates of Y.
      enterocolitica was thus sought by comparison of biogroups, serogroups, virulence
      markers and biochemical and outer membrane profiles. All milk isolates belonged
      to biogroup 1, serogroup 0:6,30. Pathogenicity studies on the 0:6,30 serogroup
      isolates from feces and milk were performed with 3 in-vitro tests (Ca2+
      dependency, autoagglutination, & serum resistance). The human isolates were
      positive in most of the 3 tests whilst none of the milk isolates were positive.
      Outer membrane protein analysis of 0:6,30 from human and milk isolates showed
      similar profiles suggesting a possible association, however the environmental
      source of the majority of isolates (0:3) remains unknown.

PMID- 1745568
TI  - Utility of the polymerase chain reaction (PCR) for prenatal diagnosis of genetic
      disease.
AB  - Gene amplification by the polymerase chain reaction (PCR) has been applied to
      prenatal diagnosis for alpha and beta thalassemias (1 and 5 cases respectively),
      Hemoglobin (Hb) Lepore/beta thalassemia (1 case) and cystic fibrosis (14 cases).
      Chorionic villus samples were obtained in the tenth week of pregnancy and DNA
      analysed in parallel with conventional gene mapping. Direct diagnosis of the
      common Mediterranean beta-thalassemia mutations (IVS-1-110 and codon 39), Hb
      Lepore, and the delta F508 mutation causing cystic fibrosis was achieved by
      hybridization of amplified material with pairs of allele-specific oligonucleotide
      (ASO) probes or by restriction enzyme digestion of PCR products. Results were
      confirmed by DNA mapping. Definitive diagnosis or exclusion of an affected fetus
      was possible in 17 of 21 cases thus examined. PCR reduces the time required for
      prenatal diagnosis. DNA contamination is a potential source of error.

PMID- 1745569
TI  - Ovarian follicular non-Hodgkins lymphoma.
AB  - Non-Hodgkins Lymphoma presenting in and confined to the ovaries is a rare
      occurrence. A follicular histological pattern has been reported only occasionally
      in this setting. A case of follicular mixed small cleaved and large cell
      lymphoma, discovered incidentally and limited to the ovaries is reported.
      Immunological marker studies revealed a monoclonal population of B lymphocytes
      with surface Ig A Kappa. A review of cases in the literature suggests that
      follicular histology in stage I ovarian disease confers an outcome similar to
      that for follicular nodal disease.

PMID- 1745570
TI  - Poems syndrome.
AB  - A 40 year old Chinese woman presented with anasarca and later developed features
      of POEMS syndrome. These are peripheral neuropathy (P), organomegaly (O),
      endocrine dysfunction (E), monoclonal gammopathy (M), and skin changes (S) which
      are usually associated with plasma cell dyscrasia. In our patient, monoclonal
      gammopathy was not detected on immunofixation electrophoresis and was revealed
      only after analysis of kappa/lambda light chain ratio of the raised serum IgA
      immunoglobulin. Needle liver biopsy of her grossly enlarged liver showed marked
      accumulation of glycogen and presence of giant mitochondria in the hepatocytes, a
      feature not previously reported.

PMID- 1745571
TI  - A tree-structure model for analyzing laboratory test costs.
AB  - A method of costing clinical laboratory tests is described in which total
      laboratory costs are apportioned into 3 components: an 'organizational overhead
      cost' to describe the cost of running an organization; a 'cost per episode' to
      describe the costs incurred per request; and a 'cost per test' to describe the
      actual analytical costs of tests performed. A tree-like structural model is
      described which allows for distribution of this 'cost per test' component to the
      contributing tests and the calculation of the true 'cost per test'. The
      implementation of this model on a computer spreadsheet has been achieved. When
      combined with the other cost components, the true total costs of laboratory
      testing can be determined for any particular test. The model also allows
      calculation of the incremental and marginal costs of a test and permits
      optimization of laboratory test frequencies and work-load to minimize laboratory
      analytical costs.

PMID- 1745572
TI  - Should we bury the autopsy?

PMID- 1745573
TI  - Adrenal cortical tumors in childhood--clinicopathological features of six cases.
AB  - Six cases of adrenal cortical tumors are presented with a discussion of the
      clinical features and histological findings. Five of the 6 children, aged between
      6 mths and 6 yrs, presented with symptoms of hyperadrenalism, 4 with virilization
      and 1 with Cushingoid features. The remaining infant presented with an
      asymptomatic abdominal mass. In each case there was a unilateral tumor separated
      from the residual adrenal gland by a thin fibrous capsule. Surgical resection was
      the treatment employed and, in the 5 cases with functional tumors, perioperative
      hydrocortisone was given. None of the children received post-operative
      chemotherapy or radiotherapy. Bizarre cellular morphology, a high mitotic count
      and extensive necrosis were all seen in clinically benign disease, demonstrating
      not only the efficacy of local resection but also the difficulty in applying the
      usual histological criteria of malignancy to these pediatric adrenal tumors. At
      follow-up, 5 of the 6 patients are alive with no evidence of recurrent disease.
      The only death resulted from measles pneumonitis in the 1 child who presented
      with Cushing's syndrome.

PMID- 1745574
TI  - Effect of smoking cessation on serum apolipoprotein A-I and A-II concentrations.
AB  - This study investigated the effects of 6 weeks' smoking cessation on serum levels
      of total-cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C)
      and apolipoproteins A-I and A-II (apo A-I and apo A-II) in 64 subjects of both
      sexes. Smoking cessation was associated with an increase in levels of apo A-II.
      Concurrent changes in weight and alcohol consumption during attempted smoking
      cessation, together with change in thiocyanate level, were entered as predictor
      variables into a multiple regression analysis. The change in apo A-II was found
      to be best accounted for by change in plasma thiocyanate level, and, in women,
      change in HDL-C and apo A-I by change in weight. The changes induced by smoking
      cessation may be due, at least in part, to associated changes in alcohol
      consumption and/or dietary intake, but in the case of apo A-II there is evidence
      of a more direct effect.

PMID- 1745575
TI  - [Descriptive epidemiology from autopsies at the Ospedale Maggiore di Milano from
      1986 to 1987].
AB  - Descriptive epidemiology of autopsies performed at Ospedale Maggiore in Milan
      1986-87. With the aim of setting up an autopsy database we have processed and
      stored data relating to diagnoses from autopsies performed over the two-year
      period 1986-1987 at Ospedale Maggiore in Milan. We used a program developed on
      the basis of indications provided by a group of pathologists working in various
      centres in Italy. The program is designed to include the storage of personal
      details, clinical diagnoses, autopsy diagnoses, and a semi-automatic procedure
      for apposition of SNOMED codes. Using this stored material, statistical studies
      have been carried out on the sample of autopsy subjects and the incidence of the
      various types of pathology; also, a comparative evaluation has been made between
      the clinical diagnoses of the cause of death and those derived from autopsy. It
      appears that clinicians tend to overdiagnose neoplastic diseases and
      underestimate the significance of cardiocirculatory pathologies. Our data confirm
      that in spite of the advances in diagnostic technology, autopsy maintains its
      value and importance as a diagnostic tool, especially for its quality-control
      role in the public health field; moreover it can also play a significant part in
      epidemiological studies.

PMID- 1745576
TI  - [Atheroembolism: a form of systemic vascular disease].
AB  - Atheroembolism, a systemic vascular disease. Cholesterol crystal embolization
      (CCE) is an infrequent but serious disorder that is often an unrecognized medical
      problem. CCE may occur spontaneously from eroded atherosclerotic plaques or most
      frequently following procedures such as angiography, angioplasty, cardiac
      catheterization, anticoagulant therapy and aortic surgery. CCE predominantly
      affects elderly males with a frequent history of hypertension, atherosclerotic
      vascular diseases and renal insufficiency. CCE may result in protean clinical
      manifestations and may produce a spectrum of functional impairment. Confusion
      over the disease's natural history arises because the difficulty of establishing
      an antemortem diagnosis, and because the laboratory findings are non-diagnostic
      and non-specific. The mortality was 81% and the causes of death was most often
      due to multiorgan failure especially renal involvement. The definitive diagnosis
      depends upon finding the presence of intravascular cholesterol crystal in biopsy
      or autopsy specimens. The skin, muscle and kidney were the three most common
      sites for obtaining a premortem diagnostic biopsy.

PMID- 1745577
TI  - [Comparative morphological study of the structure of the normal and
      arteriosclerotic internal mammary, coronary, and renal artery wall].
AB  - Morphological comparative study of the normal anatomy of the internal mammary
      artery, coronary artery and renal artery, and their atherosclerotic alterations.
      We report in this paper the comparative results of a morphological and
      morphometrical study of the normal anatomy of the Left Coronary Artery
      (interventricular descending branch) (LCA), Internal Mammary Artery (IMA) and
      Renal Artery (RA) and their atherosclerotic alterations in 27 unselected people
      of both sexes aging from 19 to 76 years (average 59 +/- 14.3). Sections from
      three different segments of each vessel were examined by measuring the thickness
      of the intima and media calculated at the maximum intimal thickening. The lumen
      was also measured at the level of its highest pathological reduction; the same
      measurements were carried out on sections free from atherosclerotic damage. Then
      the intima to media ratio was assumed as major indicator of atherosclerosis
      involvement according to the literature. All these parameters were statistically
      analysed. With these procedures we found that LCA displayed more severely
      atherosclerotic changes than IMA. The degree of damage in RA fell in between when
      compared to the other arteries. The intima to media ratio average was 0.061 mm.
      (+/- 0.084) in I.M.A.; 0.882 mm. (+/- 0.753) in L.C.A. and 0.272 (+/- 0.315) in
      RA with statistically significant differences between IMA and LCA (p less than
      0.001) and between IMA and RA (p less than 0.001). In the lesion free sections
      intima to media ratios were 0.178 (+/- 0.90) in LCA, 0.053 (+/- 0.28) in IMA and
      0.082 (+/- 0.127) in RA. The difference was statistically significative between
      LCA and IMA, but not between RA and IMA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745578
TI  - [Histopathological parameters and lymphatic metastasis in supraglottic laryngeal
      carcinoma].
AB  - Histopathologic parameters in predicting lymph node metastasis of supraglottic
      laryngeal carcinoma. A systematic clinical-pathological study was performed on
      fifty-three resected cases of supraglottic laryngeal squamous cell carcinoma,
      followed up for at least 5 years. The aim of the research was to evaluate
      histopathologic parameters in predicting lymph node metastasis (N+) as expression
      of biological malignancy of the neoplasm. The following neoplastic microscopical
      features were studied: histopathologic and cytologic grading, pattern of growth,
      peritumoral inflammatory infiltrate, stromal reaction, tumoral necrosis. The
      results are as follows: stromal reaction and cytologic grading are not useful to
      identify N+ and N- cases. Cases with high and low degree of differentiation
      (Broder's grading) are significantly correlated respectively to low (14.3%) and
      high (70%) incidence of lymph node metastasis (p less than 0.03). A clear
      correlation is present between the pattern of growth "pushing" and lacking of
      node metastasis (84.6%). A favorable prognosis significance seems to be linked
      with the presence of peritumoral lymphoplasmocytic infiltrate, which results to
      be a marker of cases in which lymph node metastasis incidence is very low (5.5%;
      p less than 0.001). On the contrary lymph node metastasis incidence increase when
      tumoral necrosis is present (76.5%; p less than 0.001).

PMID- 1745579
TI  - [Ovarian metastases of extragenital tumors. Anatomo-pathological contribution to
      their interpretation].
AB  - Ovarian metastases from extragenital malignant tumours. An anatomohistopathologic
      approach. 102 cases of ovarian metastases from extragenital malignant non
      hematopoietic primaries have been studied in the Institute of Anatomy and
      Histopathology of the Trieste University. Breast cancers, followed by colonic,
      gastric and pancreatic tumours are the most frequent spreading primaries to the
      ovaries. Generally speaking the ovarian metastases seems to be closely related to
      the lower age at the tumour onset and to the width of metastatic spreading; this
      is true mainly for breast and colorectal cancer. These features should suggest
      that tumour aggressiveness, rather than some tropism of malignant cells, could
      play the most important role in the metastatic involvement of ovaries. A double
      behaviour should be instead suggested for gastric cancer: the first one is
      consistent with those previously described for the other tumours, the second one
      is related to a less aggressive gastric cancer, arising in the elderly (mean age
      73 years old) with isolated involvement of the ovary showing the features of
      Krukenberg tumours.

PMID- 1745580
TI  - [Recurrent benign intrahepatic cholestasis. Description of 3 cases].
AB  - Benign recurrent cholestasis. Report of three cases. 3 cases of benign
      intrahepatic recurrent cholestasis are reported. The disease is very rare and
      both clinical and pathological features are necessary for the right diagnosis.
      The value of liver biopsy in excluding other icteric diseases is stressed;
      clinical and serological findings are also important for the diagnosis and for
      the management of the patient.

PMID- 1745581
TI  - Cytological features of a craniopharyngioma.
AB  - The fine needle aspiration cytology of a cystic suprasellar lesion, which caused
      bilateral hemianopia in a woman aged 63, resulted to be consistent with a
      craniopharyngioma and was confirmed by tissue diagnosis. The cytological pattern
      showed macrophages and debris with calcifications indicating the presence of a
      cyst. Furthermore squamous cells of basal type and ghost cells were identified.
      These findings together with the seat of the lesion allowed for the diagnosis of
      craniopharyngioma and for the differentiation from other cystic lesions of the
      same region. The case confirms the value of the fine needle aspiration cytology
      in the detection of craniopharyngioma and points out cytological peculiarities of
      this not rare neoplasm.

PMID- 1745582
TI  - [Primary rhabdomyosarcoma of the cerebellum. Histopathological and
      immunohistochemical study of an autopsy case].
AB  - Primary rhabdomyosarcoma of the cerebellum. Histopathological and
      immunohistochemical study: a necropsy case. A necropsy case of primary cerebellar
      rhabdomyosarcoma occurred in a 38-year-old man has been investigated by
      histological and immunohistochemical techniques. In the most differentiated
      rhabdomyoblasts microscopic analysis showed obvious cross-striations and
      immunohistochemical reactivity for myoglobin (PAP method). Many tumor cells were
      positive for vimentin and muscle-specific intermediate filament protein desmin,
      but neither for glial fibrillary acidic protein nor neuron-specific enolase. The
      diagnostic role of the immunohistochemistry in this tumor is pointed out. The
      clinicopathological features of 30 cases of primary rhabdomyosarcoma of the
      central nervous system previously reported in the literature are briefly
      reviewed, and the histogenesis is discussed.

PMID- 1745583
TI  - Primary malignant lymphoma of the central nervous system. Case report.
AB  - We report a case of primary malignant lymphoma of the central nervous system
      found in a 69-year old woman suffering from Parkinson's disease and hypertension.
      The CAT scan revealed an ill defined lesion in the left frontal lobe which at
      surgery appeared as a brownish-black friable neoformation. The histologic exam
      revealed a proliferation of voluminous round lymphoid cells with 2 or 3 nucleoli
      often apposed to the nuclear membrane. At the immunohistochemical investigation
      they were positive for LC and L26 monoclonal antibodies. Malignant centroblastic
      B-cell lymphoma was diagnosed. All post-surgery investigations excluded the
      presence of neoplasms in other sites.

PMID- 1745584
TI  - Acute idiopathic interstitial giant cell myocarditis. A histological and
      immunohistological study of a case.
AB  - The Authors report on a case of acute idiopathic giant cell myocarditis, which
      occurred in a young man without previous history of immunodeficiency or tumours,
      and displayed a rapidly fatal clinical course. Autoptic examination showed
      diffuse damage to the myocardium, with myocytolysis, granuloma formation and
      abundant giant cell reaction. No significant changes were observed in the other
      organs and systems . Immunohistochemistry revealed that the giant cells strongly
      reacted with the antibody KP1--raised to the macrophage-associated antigen CD68-
      whereas they did not stain with the monoclonal against the muscle-specific marker
      desmin. In the light of their findings and previous reports in the literature,
      the Authors discuss the possible origin of giant cells, along with the
      pathogenesis of the condition.

PMID- 1745585
TI  - Bizarre angiomyomas of superficial soft tissues.

PMID- 1745586
TI  - Michael Faraday--putting perception in its place.

PMID- 1745587
TI  - Perceived depth scales with disparity gradient.
AB  - Perceived difference in depth between two adjacent stimuli decreases with
      increasing disparity gradient even if the disparity stays constant, ie when the
      stimuli approach each other along paths within fronto-parallel planes. This depth
      scaling effect is more pronounced with line stimuli than with two isolated points
      or two small symbols and is insignificant for easily discriminable symbols. The
      decrease in perceived depth is more pronounced for horizontal orientation than
      for oblique or vertical orientation. The ratio of perceived depth difference to
      displayed disparity difference also decreases when the distance between the
      stimuli increases at a constant gradient in depth. This is to say that we are
      more correct in our depth estimates for steep gradients in depth when the
      euclidean distance between the stimuli is short.

PMID- 1745588
TI  - Conflicting figure--ground and depth information reduces moving phantom
      visibility.
AB  - Moving phantom visibility was measured in two experiments where the global figure
      ground and depth relations within phantom-inducing patterns were manipulated. The
      local inducing environment where the illusion occurred was identical for all
      patterns. Phantom visibility was significantly reduced when occlusion cues
      specified the phantom-inducing parts of a pattern as ground. These results
      suggest conflicting figure-ground and depth information interferes with the
      representation and perception of phantoms as figure regions.

PMID- 1745589
TI  - Similarity of tactual and visual picture recognition with limited field of view.
AB  - Subjects attempted to recognize simple line drawings of common objects using
      either touch or vision. In the touch condition, subjects explored raised line
      drawings using the distal pad of the index finger or the distal pads both of the
      index and of the middle fingers. In the visual condition, a computer-driven
      display was used to simulate tactual exploration. By moving an electronic pen
      over a digitizing tablet, the subject could explore a line drawing stored in
      memory; on the display screen a portion of the drawing appeared to move behind a
      stationary aperture, in concert with the movement of the pen. This aperture was
      varied in width, thus simulating the use of one or two fingers. In terms of
      average recognition accuracy and average response latency, recognition
      performance was virtually the same in the one-finger touch condition and the
      simulated one-finger vision condition. Visual recognition performance improved
      considerably when the visual field size was doubled (simulating two fingers), but
      tactual performance showed little improvement, suggesting that the effective
      tactual field of view for this task is approximately equal to one finger pad.
      This latter result agrees with other reports in the literature indicating that
      integration of two-dimensional pattern information extending over multiple
      fingers on the same hand is quite poor. The near equivalence of tactual picture
      perception and narrow-field vision suggests that the difficulties of tactual
      picture recognition must be largely due to the narrowness of the effective field
      of view.

PMID- 1745590
TI  - Retinal mechanisms in the perception of subjective contours: the contribution of
      lateral inhibition.
AB  - One mechanism frequently proposed for the creation of subjective contours and
      their related brightness effects involves lateral neural interactions on the
      retina, such as the lateral inhibitory effects that underlie brightness contrast.
      Subjective contour stimuli were displayed under an intermittent light source,
      with rapid onset and slow offset as has been shown to increase lateral inhibitory
      interactions by allowing summation of neural onset transients. A sample of forty
      subjects, using magnitude estimates, reported increased subjective contour
      clarity and brightness effects under these exposure conditions. The effects were
      larger for relative brightness differences than for contour visibility. It
      appears that this technique may have applications in exploring retinal
      contributions to other aspects of the perception of subjective contours.

PMID- 1745591
TI  - Figural conditions affecting the formation of anomalous surfaces: overall
      configuration versus single stimulus part.
AB  - Two kinds of figural condition affecting the formation of anomalous surfaces were
      examined in three experiments. The strengths of two factors (figural
      incompleteness and width of the inducing areas) were compared in order to
      determine: i) which of the two factors is more effective in the creation of the
      illusion, and ii) whether the inducing-area width is so important that it can
      also destroy the illusion when the inducers are clearly incomplete or 'gappy'.
      The results show that the inducing-area width seems to predominate over figural
      incompleteness in the formation of anomalous surfaces.

PMID- 1745592
TI  - Anomalous contours and illusion of angularity: phenomenal and theoretical
      comparisons.
AB  - Many experimental comparisons between real and anomalous contours have proven the
      functional equivalence of the two conditions; however, there are some
      contradictory findings. One of these is obtained by analyzing the anomalous
      contours in the light of a new illusion, called the 'illusion of angularity'. A
      circle becomes a polygon when it covers the centre of a radial arrangement of
      black stripes, and a polygon changes its perceptual shape depending on its
      orientation with respect to the same radial arrangement. Phenomenally, it appears
      like a very pointed polygon, in which every side is concave or, alternatively, a
      shape that looks like a circle with angles added in the spaces between the radial
      stripes, or a polygonal shape in which every side is convex. The reciprocal
      anomalous counterparts of these conditions, obtained by removing the
      geometrical/polygonal contours, reveal different results. In the first case, one
      sees a perfect circle; in the second case, a polygon with blunted vertices, or a
      circular shape with angular protrusions; in the third case, a deformed circle.
      These results are inconsistent with some theoretical models proposed to explain
      the emergence of anomalous contours, namely, all the top-down models expressed in
      terms of cognitive constructions and perceptual hypotheses, or in terms of global
      figural organizations. Rather, these comparisons suggest a different
      interpretation for the two phenomena (the illusion of angularity and anomalous
      contours). This interpretation is based on dynamic interactions or on network
      computations that synthesize both real and anomalous contours.

PMID- 1745593
TI  - A dynamic model for anomalous figures: the shape of line-induced brightness
      modifications.
AB  - It is recognized that a fundamental role in the perception of anomalous figures
      is played by the intensity and shape of brightness modifications induced by line
      ends. The aim of this work was to study the structure of these modifications
      experimentally, by using variously arranged dots as probes. It was thus assumed
      that dots can measure activations generated inside abrupt line ends. The results
      show distribution of activation which differs according to dot distance and angle
      with respect to the continuation of the line near its end. These data do not
      agree with the predictions of information processing models in the literature on
      anomalous figures, which are based on perceptually postulated figures accounting
      for unlikely gaps. However, they do agree with the dynamic model proposed here,
      which is based on the idea that certain figure characteristics, eg the
      differential brightness of anomalous figures, depend on activation distribution
      which in turn depends on the organization of the forces in play. This idea is
      rooted in Gestalt theory. Another model supported by our experimental data is
      Grossberg's neural dynamic approach. In this case too, the basic idea is that of
      activation distribution which depends on the interaction of complex neural
      networks functioning according to special algorithms.

PMID- 1745594
TI  - Evidence for independent processing of subjective contour brightness and
      sharpness.
AB  - Subjective contours have been of considerable interest because of their
      importance to theories and physiological models of form perception. In
      particular, they have recently been characterized as the result of magnocellular
      cortical processing. There is, however, a paucity of parametric data relating to
      basic psychophysical parameters in this field. Two experiments are reported in
      which the roles of subjective contour size, retinal eccentricity, and flicker
      rate in subjective contour salience were investigated. Eleven observers estimated
      subjective contour magnitude using an Ehrenstein configuration. Configurations
      ranging in size from 0.25 to 3 deg were presented to three retinal loci (fovea, 2
      deg, and 4 deg) at flicker rates ranging from 5 to 15 Hz. Subjective contour
      brightness and distinctness were measured separately. Brightness was greatest at
      a subjective contour size of about 1.25 deg, at flicker rates of 5-7 Hz, and at 3
      deg peripheral for all flicker rates and all but the smallest stimulus sizes.
      Distinctness decreased with eccentricity and flicker, but remained high at small
      diameters (thus implicating spatially sensitive mechanisms). Taken together, the
      results support a magnocellular processing of subjective contours with respect to
      brightness, but also suggest that there is a parvocellular contribution to
      subjective contour sharpness.

PMID- 1745595
TI  - Visual illusory productions with or without amodal completion.
AB  - A new type of illusory contour is presented whose appearance is generated by the
      graphic representation of groups of human figures interacting in a coordinated
      manner with external reality. When numerous pictorial indicators of cause-effect
      relationships are provided, and appropriate techniques and sufficiently ambiguous
      observation conditions are used, hallucinatory objects congruent with
      expectations linked to the meaning of the configurations appear. There is thus a
      high-level semantic component that is active in the formation of visual illusory
      contours and is even capable of interacting with other known factors: brightness
      contrast, the number of elements, the degree of alignment of the elements, etc.
      This new type of illusory contour fits current definitions and can be
      experimentally modified. The variations in subjective clarity scores are
      presented for a study in which twenty subjects observed nineteen experimental
      figures, certain variables of which were manipulated. The issue is worthy of
      further experimental investigation.

PMID- 1745596
TI  - Illusory figures based on local kinematics.
AB  - A new type of motion-induced illusory figure determined by local kinematic
      information is investigated. The new figure is induced by radial line patterns
      subjected to either figure motion (the lines change as if they were stationary
      and a triangle was rotating in front of them) or background motion (the lines
      change as if they were being rotated behind a stationary triangle). Although the
      two kinds of motion are equivalent from the viewpoint of relative displacements,
      perceptually they yield very different results. With background motion, observers
      tend to perceive rigid figures that have a triangular shape. With figure motion,
      observers report seeing deforming figures with shapes that vary depending on the
      number of lines in the display. We consider two alternative accounts for this
      asymmetry which we term the background superiority effect (BSE). The first
      account proposes that the effect is due to retinal persistence and to figure
      stability. Against this line of explanation, we demonstrate that observers also
      see rigid triangular shapes in displays where both the figure and the radial
      lines rotate (double motion displays). The second account proposes that the
      effect depends on the availability of local kinematic information constraining
      contour orientation. This second line of explanation is consistent with
      observers' reports of bowed edges in double motion displays rotating in phase or
      in counterphase. Candidate mechanisms for extracting local kinematic information
      are discussed.

PMID- 1745597
TI  - Effects of chronic hypoxia and endurance training on muscle capillarity in rats.
AB  - Skeletal muscle capillarity expressed as capillary density (CD), and number of
      capillaries per fibre (C/F), as well as the mean fibre cross-sectional area
      (FCSA), were determined in the extensor digitorum longus (EDL), plantaris (PLA)
      and soleus (SOL) muscles of four groups of eight rodents trained on a swimming
      exercise programme (T) or maintained sedentary (S), at sea level (SL) or at
      simulated altitude (HA), barometric pressure 61.7 kPa (463 torr) for 12 weeks. It
      was shown that both HA exposure and endurance training decreased body and
      skeletal muscles weights (P less than 0.001). However, neither HA exposure nor
      endurance training induce any variation in relative importance in the skeletal
      muscle mass. Altitude exposure and endurance training had increasing effects on
      CD in all muscles studied (P less than 0.001). This study confirms the fact that
      altitude exposure has no direct effect on capillary development. On the other
      hand, the capillary supply of the several slow- and fast-twitch skeletal muscles
      studied is increased by endurance training. This real enhancement in capillary
      network is ascertained by an increase in the C/F ratio (+7%, +26%, +16%, in PLA,
      EDL, and SOL muscles, respectively at sea level, and +19.5%, +30%, and +14%
      respectively at HA). These results indicate that the effects of chronic exercise
      on skeletal muscle capillarity estimated by the C/F ratio, are greater in an
      hypobaric environment than in a SL environment.

PMID- 1745598
TI  - Lactate dehydrogenase activity and isoform distribution in normal and
      hypertrophic smooth muscle tissue from the rat.
AB  - The lactate dehydrogenase (LDH) activity and isoform distribution of LDH were
      investigated in tissue samples from the rat portal vein, aorta and urinary
      bladder. In addition, samples were obtained from hypertrophic urinary bladder.
      The total LDH activity per unit smooth muscle volume was higher in the urinary
      bladder compared to that in portal vein and aorta. Five LDH isoforms, reflecting
      different combinations of the two polypeptide chains denoted H and M, could be
      separated by agarose gel electrophoresis. The aorta contained more of the H form
      compared to the portal vein and urinary bladder. This difference suggests that
      the aorta, which is a slow smooth muscle, is more adapted for aerobic metabolism
      than the faster muscles of portal vein and urinary bladder. In the hypertrophic
      urinary bladder a shift in LDH isoform pattern towards less of the H form was
      found, which correlates with a better maintenance of contraction in anoxia in
      this type of hypertrophic smooth muscle.

PMID- 1745599
TI  - Glomerular ultrafiltration in rabbits with superficial glomeruli.
AB  - The determinants of glomerular ultrafiltration in superficial glomeruli of a
      strain of English cross-breed rabbits have been studied using micropuncture
      techniques. Mean arterial blood pressure in the anaesthetised rabbits was 70 +/-
      2 mmHg. The glomerular filtration rate in the kidney prepared for micropuncture
      was 4.4 +/- 0.4 ml/min, the filtration fraction was 22 +/- 1% and renal blood
      flow was 33 +/- 3 ml/min, and these values were comparable to values in conscious
      rabbits. Glomerular capillary pressure (Pgc) averaged 31 +/- 1 mmHg, the single
      nephron glomerular filtration rate (SNGFR) averaged 25 +/- 2 nl/min, and the mean
      ultrafiltration pressure (calculated using the whole-kidney filtration fraction)
      averaged 7 +/- 1 mmHg. A net positive pressure at the efferent end of the
      glomerular capillaries (4.4 +/- 0.9 mmHg) indicated that a state of filtration
      pressure disequilibrium existed, under the experimental conditions of this study,
      in rabbit glomeruli. The calculated glomerular ultrafiltration coefficient (Kf)
      was 0.08 +/- 0.01 nl s-1 mmHg-1. Thus, compared to the Munich-Wistar rat, SNGFR
      is lower in the rabbit. This reflects the substantially lower glomerular
      ultrafiltration pressure in the rabbit, although this was offset partially by a
      higher Kf.

PMID- 1745600
TI  - Glucose transporters do not serve as water channels in renal and intestinal
      epithelia.
AB  - Glucose carriers have been shown to serve as water channels in macrophages and in
      oocytes injected with messenger ribonucleic acid (mRNA) encoding the glucose
      carrier protein (Fischbarg et al. The contribution, therefore, of glucose
      carriers to osmotic water permeability (Pf) in renal and intestinal epithelial
      cells was investigated. Pf of brush border membrane vesicles (BBMVs) and of
      basolateral membrane vesicles (BLMVs) was studied using stopped-flow
      spectrophotometry. Osmotic shrinkage of renal vesicles exhibited fast and slow
      components at 4 degrees C and 37 degrees C. The fast component could be inhibited
      by HgCl2 or dimethylsulphoxide (DMSO) at these temperatures, whereas the slow
      component was inhibited only at 4 degrees C. Osmotic shrinkage of intestinal
      BBMVs and BLMVs was homogeneous at 4 degrees C and 37 degrees C and was slightly
      inhibitable by HgCl2 or DMSO at 4 degrees C but not 37 degrees C. In both
      tissues, vesicle uptake of glucose was sensitive to HgCl2, but not to DMSO.
      Phlorizin and phloretin inhibited D-glucose uptake in BBMVs and BLMVs
      respectively, but had no significant effect on Pf. In membrane vesicles of kidney
      origin, Pf was tenfold higher than in membranes from intestine. This difference
      was not reflected by the phlorizin- and phloretin-sensitive D-glucose uptakes.
      Our study concludes that glucose transporters do not serve as water channels in
      kidney or intestine. Although membrane proteins contribute slightly to Pf at 4
      degrees C, this contribution is insignificant at 37 degrees C. A membrane protein
      serving specifically as a water channel could only be demonstrated in renal
      cortical membranes.

PMID- 1745601
TI  - Functional asymmetry of phosphate transport and its regulation in opossum kidney
      cells: phosphate "adaptation".
AB  - The polarity (apical vs basolateral cell surface) of the up-regulatory response
      ("adaptation") to low medium phosphate (Pi) concentration on apical and
      basolateral Pi transport systems was investigated in opossum kidney (OK) cell
      monolayers grown on permeant supports. Incubation of cultures in low-Pi medium,
      given either only to the apical or simultanously to the apical and basolateral
      compartments, increased the rate of transport of both the apical and the
      basolateral Na/Pi cotransport systems. The basolateral Na-independent, 4,4
      diisothiocyanatostilbene-2,2'-disulphonic-acid-sensitive Pi transport system was
      unaffected by Pi deprivation. Incubation with low-Pi medium from only the
      basolateral side failed to elicit any "adaptive" response in Pi transport. When
      cells were Pi-limited either apically or on both sides for short periods of time,
      adaptation was apparent within 2 h and close to maximal by 6 h, and the
      alteration in Pi transport was consistant with an increase in Jmax for both the
      apical and basolateral Na/Pi cotransport systems. These data suggest that apical
      Na-dependent Pi influx is important in signalling the adaptive response to low
      extracellular Pi.

PMID- 1745602
TI  - Dihydropyridines interact with calcium-independent potassium currents in
      embryonic mammalian sensory neurons.
AB  - Early embryonic sensory neurons have two K currents resembling delayed rectifier
      and transient K currents of mature neurons. However, in contrast to those of
      adult neurons, the embryonic currents can hardly be separated either by
      electrophysiological or pharmacological methods, limiting their characterisation
      at these developmental stages. Using the whole-cell recording technique, we found
      that dihydropyridines (DHPs) inhibit the noninactivating component of the Ca
      independent K currents of 13-day mouse embryo dorsal-root ganglion (DRG) cells.
      The inhibitory effect of nicardipine began around 0.5 microM and was nearly
      complete at 5 microM while Na currents were not altered. This effect was
      reversible and voltage-dependent. The same results were obtained using another
      DHP Ca antagonist, nimodipine, whereas Bay K 8644, a DHP Ca agonist, had no
      effect. Kinetic properties of the DHP-insensitive K current have been described
      and compared with those of transient K currents found in differentiated neurons.
      These results suggest that both Ca and K channels have DHP sites, possibly
      homologous, at this developmental stage. The DHP inhibition of Ca-independent K
      channels provides a new tool with which to study K channels both at a molecular
      level and during DRG development.

PMID- 1745603
TI  - Postsynaptic inhibition by adenosine in hippocampal CA3 neurons: Co(2+)-sensitive
      activation of an inwardly rectifying K+ conductance.
AB  - The properties of the current underlying the membrane hyperpolarization evoked by
      adenosine (50-100 microM) were investigated in hippocampal CA3 neurons in vitro
      using current-clamp and single-electrode voltage-clamp techniques. In voltage
      clamp measurements, the adenosine-induced current (IAdo) was outward at rest and
      reversed at membrane potentials close to the equilibrium potential of K+ (EK),
      indicating that IAdo was carried by K+ ions. Determination of IAdo at several
      membrane potentials revealed a nonlinear current/voltage (I/V) relationship of
      the current displaying inward rectification in the hyperpolarizing direction.
      Similarly, adenosine increased the membrane slope conductance only at membrane
      potentials negative to rest, whereas the slope of the neuronal I/V curve remained
      unchanged when determined at potentials positive to rest. Since the
      electrophysiological properties of IAdo were very similar to those described for
      K+ conductances activated by other neuroactive substances like serotonin, opioid
      peptides and gamma-aminobutyric acid B receptor (GABAB) agonists, we conclude
      that IAdo belongs to a family of ligand-operated, inwardly rectifying K+ currents
      which apparently share a common mechanism to reduce postsynaptic excitability. As
      an additional feature, the postsynaptic adenosine response was reduced by bath
      application of Co2+ or Ni2+. The adenosine-induced membrane hyperpolarization was
      not affected by low-Ca2+ or low-Mg2+ solutions, nor by buffering of intracellular
      Ca2+, but a gradual decline of IAdo was observed following superfusion with Co2+
      or Ni2+. In contrast, Mn2+ caused only a weak attenuation of the adenosine
      response.

PMID- 1745604
TI  - Effects of intracellular Ca2+ chelating compounds on inward currents caused by
      Ca2+ release from sarcoplasmic reticulum in guinea-pig atrial myocytes.
AB  - Ca2+ release from the sarcoplasmic reticulum (SR) of mammalian cardiac myocytes
      occurring either due to activation by a depolarization or the resulting
      transmembrane Ca2+ current (ICa), or spontaneously due to Ca2+ overload has been
      shown to cause inward current(s) at negative membrane potentials. In this study,
      the effects of different intracellular Ca2+ chelating compounds on ICa-evoked or
      spontaneous Ca(2+)-release-dependent inward currents were examined in dialysed
      atrial myocytes from hearts of adult guinea-pigs by means of whole-cell voltage
      clamp. As compared to dialysis with solutions containing only a low concentration
      of a high affinity ethylene glycol-bis(beta-aminoethylether) N,N,N',N'
      tetraacetic acid (EGTA) like chelator (50-200 microM), inward membrane currents
      (at -50 mV) due to evoked Ca2+ release, spontaneous Ca2+ release or Ca2+ overload
      following long-lasting depolarizations to very positive membrane potentials are
      prolonged if tne dialysing fluid contains a high concentration of a low affinity
      Ca2+ chelating compound such as citrate or free adenosine 5'-triphosphate (ATP).
      Without such a non-saturable Ca2+ chelator in the dialysing fluid, Ca(2+)-release
      dependent inward currents are often oscillatory and show an irregular amplitude.
      With a low affinity chelator in a non-saturable concentration, discrete inward
      currents with constant properties can be recorded. We conclude that the
      variability in Ca(2+)-release-dependent inward current seen in single cells
      arises from spatial inhomogeneities of intracellular Ca2+ concentration ([Ca2+]i)
      due to localized saturation of endogenous and exogenous high affinity Ca2+
      buffers (e.g.). This can be avoided experimentally by addition of a non-saturable
      buffer to the intracellular solution.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745605
TI  - Exercise-induced muscle damage in the rat: the effect of vitamin E deficiency.
AB  - Rats, fed a vitamin-E-deficient diet for 6 weeks, performed treadmill exercise
      for 2 h. Muscle damage was assessed by measuring the creatine kinase (CK)
      activity in plasma before and after exercise, and by studying semi-thin
      longitudinal sections of the soleus muscle 48 h after running. Vitamin-E
      deficient male and female rats showed an increased post-exercise CK activity when
      compared to matched controls, but male rats showed a larger CK response than
      females. This rise in plasma CK activity was caused mainly by an increased
      activity of the muscle-specific CK-isoenzyme, CK-MM (males + 1238%; females +
      540%, P less than 0.05). In a parallel histological study we observed in vitamin
      E-deficient male rats a dramatic and significant disturbance of the normal cyto
      architecture of the muscle fibres after exercise (focal necrosis, phagocytosis
      and cellular infiltrates), whereas in females only minor, non-significant,
      changes were seen. We conclude that vitamin E deficiency enhances the
      susceptibility to exercise-induced muscle damage in male rats more than in female
      rats. This difference between the sexes is attributed to the protective effect of
      oestradiol that remains operative in female rats when the vitamin E status is
      disturbed: male rats lack such hormonal protection.

PMID- 1745606
TI  - Combined inhibitory actions of acidosis and phosphate on maximum force production
      in rat skinned cardiac muscle.
AB  - Possible interactions between the effects of pH and phosphate (Pi) on the maximum
      force development of cardiac myofibrils were investigated in rat skinned
      trabeculae in solutions of different pH (7.4-6.2) and [Pi] (where [] denote
      concentration). At pH 7.0 there was an inverse linear relationship between force
      and log [Pi] over the [Pi] range 0.2-20 mM; its slope (-0.46/decade) was twice
      that found previously for skeletal muscle [21]. Acidosis depressed force
      substantially, but the relative change of force was unaffected by Pi addition (0,
      5, 20 mM); there was no evidence for the synergism between acidosis and Pi that
      would be expected if some of the inhibition by acidosis was due to protonation of
      Pi to the putative inhibitory form, H2PO4-. It was taken into account that even
      without Pi addition, there was enough Pi inside the muscle from various sources
      to produce significant changes in [H2PO4-] as the pH was varied. The results
      suggest that H+ and Pi inhibit maximum force development of cardiac myofibrils
      independently, by different mechanisms. From this it is argued that H+ and Pi may
      be released at different steps in the crossbridges cycle. In the myocardium Pi
      and H+ probably exert tonic inhibitory influences on cardiac myofibrils under all
      conditions.

PMID- 1745607
TI  - Adaptation of rat extensor digitorum longus to overload and increased activity.
AB  - Rat extensor digitorum longus (EDL) muscles were overloaded by removal of the
      synergist tibialis anterior (TA). The weight of the overloaded muscle was
      increased 15 days after the initial operation and remained higher throughout the
      period studied (153 days). The times to peak twitch tension and half relaxation
      remained unaltered, but the twitch and tetanic tensions developed by the
      overloaded EDL muscles increased. The overloaded EDL muscles became significantly
      more fatigue resistant. In a separate group of animals the overloaded EDL muscle
      was also chronically stimulated at 10 Hz. The additional stimulation altered the
      response of the EDL to overload in that the time to peak twitch tension of the
      muscle was slightly prolonged. There was no increase in twitch or tetanic tension
      in spite of the increase in muscle weight, but the electrical stimulation led to
      a further increase in fatigue resistance above that seen in overloaded muscles.
      The histochemical and immunocytochemical examination of the muscle revealed that
      there was a moderate increase in succinate dehydrogenase activity in the muscles
      overloaded only, but a considerable increase in those overloaded muscles that
      were also stimulated. There was no obvious change in the number of muscle fibres
      that reacted with an antibody to slow myosin in either overloaded only or
      overloaded and stimulated EDL muscles. Thus the addition of continuous activity
      to overload induced a slowing of contraction and prevented the increase of force
      usually induced by overload.

PMID- 1745608
TI  - Effects of Ca2+ removal and of tetraethylammonium on membrane currents induced by
      carbachol in isolated cells from the rat parotid gland.
AB  - In freshly dispersed rat parotid acinar cells, 10 microM carbachol increased
      outward currents at 0 mV and also inward currents at -70 mV recorded with the
      wholecell clamp method using patch pipettes containing 1 mM EGTA. When EGTA in
      the pipette was increased to 2.4 mM, carbachol increased only outward currents
      and a further increase of EGTA to 4 mM blocked the carbachol response. Effects of
      changes in external K+ and Cl- concentrations suggested that outward currents
      were carried by K+ and inward by Cl-. Effects of Ca2+ removal from the medium
      differed between experiments with 0 and 5 mM ATP in the patch pipettes. When
      pipettes contained no ATP, responses evoked by repeated applications of 10 microM
      carbachol (0.5-1 min) at 1.5-4 min intervals decreased only slowly after Ca2+
      removal, outward currents being reduced to 90 +/- 6% and inward currents to 47 +/
      11% (n = 6) in 10 min. On the other hand, when 5 mM ATP was included in the
      electrodes, Ca2+ removal abolished the carbachol responses in about 5 min (n =
      4). It was also found that tetraethylammonium (5 mM) strongly reduced both
      currents, by blocking muscarinic receptors, while Ba2+ (2.4 mM) inhibited only
      the outward K+ current.

PMID- 1745609
TI  - A simple method for monitoring changes in cell height using fluorescent
      microbeads and an Ussing-type chamber for the inverted microscope.
AB  - In this study, we report two developments for studies of ion transport in
      cultured epithelial cells. First, a convenient method is presented for measuring
      apparent cell height using fluorescent microbeads as high-contrast landmarks of
      the apical and basal cell surfaces. The apparent cell height is then used as an
      indicator to monitor the time course of changes in cell volume in response to
      osmotic perturbations. Second, an Ussing-type chamber design for the inverted
      fluorescence microscope is presented, which allows determination of
      transepithelial electrical properties. Using these two methods, we obtained
      simultaneous measurements of cell height and transepithelial electrical
      parameters for cultured renal (A6) epithelium. Cell height was measured by
      alternately focusing the microscope between microbeads marking the apical and
      basal surfaces. The distance between these two surfaces was measured electrically
      from the voltage output of a potentiometer that was mechanically coupled to the
      fine-focusing knob of the microscope. Following decreases in the bathing solution
      osmolality, the cell height and transepithelial Na+ transport rate (measured as
      short-circuit current, ISC) increased. The increase in cell height preceded
      changes in ISC by several minutes, suggesting a lack of direct linkage between
      changes in cell volume and transepithelial Na+ transport. Both the fluorescent
      microbead cell height method and the Ussing-type chamber can be used in
      conjunction with patch-clamp techniques, intracellular microelectrode
      impalements, or fluorescent probes of intracellular composition. Therefore, this
      system may be advantageous for studies of epithelial cell volume and channel
      regulation.

PMID- 1745610
TI  - Electrophysiological properties of membrane currents in single myometrial cells
      isolated from pregnant rats.
AB  - The whole-cell voltage-clamp method was applied to single smooth muscle cells
      prepared from the longitudinal layer of the pregnant rat myometrium (17-20 days
      of gestation). It was found that the transient inward current mainly consists of
      Ca2+ current, because the removal of Ca2+ ions from the external medium and 10
      microM nifedipine eliminated this inward current. Its steady-state inactivation
      curve was obtained by the standard method, in which the membrane potential of
      half inactivation and the slope factor were estimated to be -58.0 +/- 4.9 mV (n =
      11) and 8.9 +/- 1.4 mV (n = 11), respectively. In a small number of preparations
      (in 2 out of 30 preparations), there remained a very fast inward current in
      Ca(2+)-free medium containing Mg2+. Tetrodotoxin (TTX, 10 microM) can can abolish
      this current, suggesting that the channel for this current is equivalent to the
      Na+ channel in nerve cells. Two major phases of outward currents were identified
      by voltage jumps from negative holding levels to more positive levels. The first
      phase was a fast transient outward current. This current remained intact after
      external tetraethylammonium (TEA, 20 mM) was added. Following the transient
      current, a large delayed rectified outward current reached its peak over a period
      of 50 ms and then decayed. The reversal potential for this outward current was
      determined by observing the change of polarity of the tail currents with the
      change in extracellular K+ concentration [( K+]o). The slope for the change of
      reversal potential per ten-fold change in [K+]o is 57.7 mV at more than 23.2 mM
      [K+]o, indicating that this current is mostly carried by K+ ions. Voltage
      dependent inactivation of the delayed rectified outward current was determined by
      the standard method. The membrane potential for half inactivation and the slope
      factor were estimated to be -42.8 +/- 3.9 mV (n = 3) and 10.1 +/- 1.5 mV (n = 3),
      respectively. External TEA (20 mM) effectively eliminated the delayed rectified
      outward currents. Nifedipine (10 microM) suppressed not only Ca2+ current but
      also outward K+ currents.

PMID- 1745611
TI  - Influence of noradrenergic input into the hypothalamic paraventricular nucleus on
      fever in the guinea-pig.
AB  - The febrile response of guinea-pigs to a bacterial pyrogen was tested under
      different experimental conditions: (1) during electrical stimulation of the
      hypothalamic paraventricular nucleus (PVN), (2) after destruction of
      noradrenergic afferents into the PVN by 6-hydroxydopamine (6-OHDA), (3) during a
      microinfusion of noradrenaline (NA) into the PVN. Electrical stimulation of the
      PVN neurons by implanted microelectrodes reduced the febrile response to 45% of
      the control values. This confirmed the proposed antipyretic function of these
      neurons. Chronic destruction of noradrenergic afferents to the PVN by
      microinjected 6-OHDA also resulted in a significant reduction of febrile
      responses to 38% of the control values. A microinfusion of NA into the PVN
      enhanced the febrile responses to bacterial endotoxin by 39% in comparison to
      animals microinfused with the solvent (0.9% NaCl). Immunoreactivity to an
      antiserum against arginine vasopressin (AVP) was compared in PVN neurons of 6
      OHDA-treated and of control animals. The number of AVP-immunoreactive perikarya
      and the intensity of immunoreactivity were increased in the animals treated with
      6-OHDA, especially in the medial part of the PVN. Since fever was increased by
      microinfused NA and decreased by 6-OHDA treatment, we assume an inhibitory
      influence of noradrenergic brain stem afferents on the proposed antipyretic
      vasopressinergic system of the PVN.

PMID- 1745612
TI  - Monitoring exocytosis from single mast cells by fast voltammetry.
AB  - We have used fast differential ramp voltammetry with carbon-fibre electrodes to
      monitor exocytotic secretion in single rat mast cells. The oxidation peak and
      other aspects of the electrochemical profile of the substance released were
      similar to those of 5-hydroxytryptamine (5-HT) and the signals were increased by
      preloading the secretory granules with exogenous 5-HT. Metabolic blockade
      inhibited both visible degranulation and the electrochemical signal. For
      comparison, quinacrine, which is fluorescent and accumulates in secretory
      vesicles, was used as an alternative means of detecting secretion in single
      cells. The amplitude of the electrochemical signals observed during degranulation
      correlated well with the loss of quinacrine fluorescence. Both methods were used
      to record successive rounds of secretion in single mast cells in response to
      repeated applications of compound 48/80.

PMID- 1745613
TI  - Alkaline stress transforms Madin-Darby canine kidney cells.
AB  - Similar to growth factors aldosterone stimulates Na+/H+ exchange in renal target
      cells leading to cytoplasmic alkalinization. An alkaline intracellular pH reduces
      the H+ bonds between repressor proteins and DNA leading to the destabilization of
      the nuclear chromatin. We observed that sustained alkaline stress "per se" can
      lead to malignant transformation of Madin-Darby canine kidney (MDCK) cells. Cells
      grown for two weeks in alkaline culture medium (pH 7.8) developed multiple "foci"
      composed of spindle-shaped pleomorphic cells lacking contact inhibition and
      exhibiting poor adhesion to the culture support, typical characteristics of
      dedifferentiated tumor cells. "Focus" cells were cloned and grown in standard
      medium (pH 7.4). Cells maintained their abnormal growth pattern, indicating
      stable pH-induced genetic transformation. Cells were fused with polyethylene
      glycol to giant cells and impaled with microelectrodes. In contrast to non
      transformed giant MDCK cells the plasma membrane potential showed spontaneous
      oscillations that could be virtually abolished by the omission of extracellular
      Ca2+ or by the addition of the K+ channel blocker Ba2+. We conclude that
      sustained alkaline stress can induce malignant transformation in MDCK cells
      indicated by an abnormal growth pattern and by membrane potential oscillations
      most likely due to Ca2+ activated K+ channels in the plasma membrane.

PMID- 1745614
TI  - Inwardly rectifying currents in human term placental cells.
AB  - Using the whole cell voltage clamp technique, inwardly rectifying currents were
      observed in most cells isolated from human term placentas. Reversal potentials,
      estimated by extrapolation, as well as those estimated by tail currents, were
      found to be between -80mV and -90mV. These potentials are close to the potassium
      equilibrium potential (theoretical value: -82 mV). In addition, the inwardly
      rectifying currents were blocked by 1 mM CsCl. The elevation of [K]e increased
      the current amplitudes. Furthermore, the holding currents were inwardly shifted
      when the holding potential was kept at -70mV. The extrapolated reversal
      potentials changed linearly on a semilogarithmic graph with a slope of 57
      mV/decade of [K]e. This value is close to the theoretical calculation (58
      mV/decade). Consequently, it is suggested from these studies, that inwardly
      rectifying currents observed in human term placental cells are carried mainly by
      potassium ions.

PMID- 1745615
TI  - [Surgical tooth retention].

PMID- 1745616
TI  - Management of drug interactions with cyclosporine.
AB  - Major advances in transplantation and in the treatment of autoimmune disorders
      have been achieved with the use of cyclosporine (CsA). During the past 10 years a
      variety of drug interactions have been reported to occur with CsA. These may be
      classified as either pharmacokinetic or pharmacodynamic in origin.
      Pharmacokinetic interactions are manifested by either an increase or decrease in
      the CsA concentration. The predominant mechanism of interaction is alteration in
      the cytochrome P-450 metabolism of CsA, however, some of the drugs may also
      affect its absorption, distribution, and elimination. Pharmacodynamic
      interactions include enhanced nephrotoxicity. Management of these events mandates
      proactive measures such as assessing the interactive potential of each new agent,
      measuring CsA concentrations more frequently when either initiating or
      discontinuing other agents, adjusting the dosage of CsA as necessary, and
      monitoring patients' clinical status to ensure efficacy and minimize the risk of
      toxicity.

PMID- 1745617
TI  - Complications associated with immunosuppressive therapy and their management.
AB  - Besides general complications of immunosuppression such as increased
      susceptibility to opportunistic infections or malignancy, individual
      immunosuppressive agents are associated with specific side effects.
      Nephrotoxicity is the major side effect of cyclosporine (CsA). Various attempts
      have been made to minimize this toxicity, such as monitoring drug blood levels,
      modifying the protocol, and coadministering other agents. Other side effects
      caused by CsA are hepatotoxicity, hyperkalemia, hypertension, tremor, gum
      overgrowth, and hirsutism. Azathioprine (AZA) causes dose-related bone marrow
      suppression, commonly leading to leukopenia. Careful monitoring of complete blood
      cell count and dosage adjustment according to white blood cell count are usually
      adequate to prevent serious leukopenia. The side effects of corticosteroids are
      numerous and include slow wound healing and de novo insulin-dependent diabetes
      mellitus. Many complications are dose related, and with low dosage or
      discontinuation of steroids, their frequency rapidly decreases. Antilymphoblast
      and antithymocyte globulins (P-ALG) are foreign antibodies and may cause allergic
      type reactions such as fever, chill, and hypotension. The initial side effect of
      monoclonal antibody (muromonab-CD3, OKT3) is similar to that of P-ALG. It
      includes high fever, shaking chills, headache, rigors, and hypotension. To
      prevent it, acetaminophen, an antihistamine, and a steroid usually are
      administered before injection. Because this agent is also associated with high
      frequency of pulmonary edema, it should not be given to any patient who has more
      than 3% body weight gain during the week prior to therapy. In rare case, it
      causes aseptic meningitis or encephalopathy, which is manifested by fever, severe
      headache, and seizure.

PMID- 1745618
TI  - Fixed-rate reimbursement fails to cover costs for patients with delayed graft
      function.
AB  - Medicare uses a fixed reimbursement schedule to pay the initial hospital costs
      for renal transplantation. This creates the potential to underpay for patients
      who develop the common complication of delayed graft function. We undertook a
      pilot study to determine if delayed graft function resulted in higher hospital
      charges and thus a loss in revenue when caring for these patients. Of 34 patients
      who experienced delayed graft function between October 12, 1987 and July 7, 1989,
      9 (group 1) were randomly selected for study. During this same period 136
      patients had immediate graft function; from them, another 9 (group 2) were
      selected by matching age, sex, and date of transplantation. The average (+/- SD)
      hospital stays for groups 1 and 2 were 17 +/- 8 and 10 +/- 2 days, respectively
      (p less than 0.001). The average time on dialysis for group 1 was 10.3 +/- 6.3
      days (range 2-22 days). All dollars values were adjusted to a 1989 level, and we
      excluded kidney acquisition costs and professional fees. The average per patient
      charges for group 1 were $41,474 +/- 15,211 (range $21,926-$66,311), compared
      with $23,774 +/- 3245 (range $19,317-$29,702) for group 2 (p less than 0.001). We
      adjusted the charge values to estimate actual costs by using our hospital's
      average cost:charge ratio of 0.90 for 1987 and 1988, and 0.85 for 1989; the group
      1 and group 2 average patient costs were $37,157 +/- 13,836 and $21,397 +/- 2921,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745619
TI  - Recent advances in cyclosporine pharmacokinetics.
AB  - Although cyclosporine has been in clinical use for more than a decade, many
      questions persist concerning its pharmacokinetics. Gastric emptying, bile acids,
      and gastrointestinal motility can influence drug absorption after oral
      administration, but the relative importance of each of these factors and their
      interactions as determinants of absorption are not clear. The fraction unbound in
      plasma has been determined in several studies and may be associated with clinical
      effects. Biochemical and molecular studies have identified the specific
      cytochrome P-450 enzymes that metabolize cyclosporine to its primary metabolites.
      The drug's basic pharmacokinetic profile has been defined and many factors have
      been identified that can influence clearance, such as age, hepatic function,
      hematocrit, and lipoprotein concentrations. With the development of sensitive and
      specific analytical methods, many new cyclosporine metabolites have been
      identified in humans. The major metabolites are present in relatively high
      concentrations in human blood and have some immunosuppressive activity in vitro,
      but their contribution to in vivo immunosuppression is not clear.

PMID- 1745620
TI  - Analysis of cefepime tissue penetration into human appendix.
AB  - Cefepime is a new extended-spectrum cephalosporin with gram-positive and gram
      negative coverage including Staphylococcus aureus and Pseudomonas aeruginosa. We
      evaluated the drug's plasma, peritoneal fluid, and appendix tissue concentrations
      in patients with a postoperative diagnosis of perforated or gangrenous
      appendicitis. Patients 18 years of age or older were randomly assigned to receive
      either cefepime 2 g every 12 hours plus metronidazole 500 mg every 6 hours
      intravenously, or gentamicin 1.5 mg/kg plus clindamycin 900 mg every 8 hours
      intravenously. During surgery, appendix tissue, plasma, and peritoneal fluid
      samples were obtained, and frozen at -70 degrees C for high-pressure liquid
      chromatographic analysis. Thirty-five patients with perforated (26) or gangrenous
      (9) appendicitis had concentrations acceptable for analysis. The mean time
      between the administration of cefepime and the time of sampling (referred to as
      delta time) was 5.99 +/- 3.75 hours (mean +/- SD). The values for plasma (n =
      34), tissue (n = 33), and peritoneal fluid (n = 25) concentrations were 16.27 +/-
      21.87 micrograms/ml, 4.84 +/- 6.15 micrograms/g, and 14.4 +/- 22.84
      micrograms/ml, respectively. The appendix tissue:plasma ratio was 0.66 +/- 0.52
      and the peritoneal fluid:plasma ratio was 0.66 +/- 0.51. Spearman rank
      correlations indicated statistically significant correlations between plasma
      concentration (r = -0.889; p less than 0.0001), peritoneal fluid concentration (r
      = -0.783; p = 0.0002), and appendix tissue concentration (r = -0.704; p = 0.0016)
      versus delta time.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745621
TI  - Pharmacokinetic evaluation of ethionamide suppositories.
AB  - The absorption and elimination of ethionamide (ETA) after oral tablets and rectal
      suppositories were determined in 12 healthy, adult male volunteers. A randomized,
      double-blind, double-dummy, crossover design was used. Treatments compared 250-mg
      ETA tablets and a placebo suppository to a 500-mg ETA suppository and two placebo
      tablets, given 7 days apart. Blood samples were collected at predetermined
      intervals for 12 hours after the dose. Serum concentrations of ETA were
      determined using high-performance liquid chromatography. The area under the serum
      concentration-time curve was used to compare the relative bioavailability of ETA
      from the two preparations. Relative bioavailability after rectal administration
      was 57.3% of that after oral administration. The maximum serum concentration
      after rectal administration was 33% of that after oral administration. Higher
      doses of ETA and serum concentration monitoring are recommended whenever the
      suppositories are used.

PMID- 1745622
TI  - Analgesic efficacy of acetaminophen 1000 mg, acetaminophen 2000 mg, and the
      combination of acetaminophen 1000 mg and codeine phosphate 60 mg versus placebo
      in acute postoperative pain.
AB  - Acetaminophen (APAP) 1000 mg, APAP 2000 mg, the combination of APAP 1000 mg plus
      codeine phosphate 60 mg (APAPCOD), and placebo (PBO) were compared in a 6-hour,
      randomized, single-dose, double-blind, parallel-group analgesic trial. All active
      treatments were statistically superior (p less than 0.05) to placebo for 4 hours
      after medication with respect to pain intensity (PI) and pain intensity
      difference (PID), and up to 3 hours regarding pain relief (PAR). The combination
      scored better than all other treatments on the summary analgesic efficacy
      measures sum PI (SUMPI), sum PID (SPID), and total PAR (TOTPAR). The combination
      was statistically superior to APAP 1000 mg on SUMPI, TOTPAR and maximum PAR
      (MAXPAR). Acetaminophen 2000 mg showed marginal numerical superiority over 1000
      mg for SUMPI, but was not statistically superior for any summary efficacy
      measure. The 2000-mg dose was numerically inferior to APAPCOD for every summary
      efficacy measure and statistically inferior regarding SPID and MAXPAR. We
      concluded that codeine 60 mg added to acetaminophen 1000 mg offers analgesic
      advantages, and acetaminophen reaches an analgesic ceiling effect at 1000 mg
      using the dental pain model.

PMID- 1745623
TI  - Effects of acetaminophen after bilateral oral surgery: double dose twice daily
      versus standard dose four times daily.
AB  - We compared acetaminophen (APAP) double dose 2000 mg twice a day on the day of
      oral surgery, decreasing to 1000 mg twice a day for the next 2 days, to a
      standard dose 1000 mg 4 times a day then 500 mg 4 times a day for 2 days.
      Compared to the double dose, there was 19% (p = 0.03) less edema after the
      standard regimen on the third postoperative day. No statistical difference was
      seen between the two treatments with respect to ability to open the mouth,
      temperature on the nonoperated versus operated side, or summary analgesic
      efficacy measures. However, pain intensity scores indicate that APAP double dose
      gave less analgesia toward the end of the dosing interval than the standard
      regimen. It is proposed that double-dose APAP twice daily does not have any
      analgesic and antiedematous advantages over the standard dose 4 times a day. The
      analgesic and antiphlogistic efficacies of APAP apparently do not coincide.

PMID- 1745624
TI  - Ampicillin-sulbactam and ticarcillin-clavulanic acid: a comparison of their in
      vitro activity and review of their clinical efficacy.
AB  - Sulbactam (SB) and clavulanic acid (CA) are irreversible inhibitors of the beta
      lactamases in the Richmond and Sykes classes II-VI. When combined with ampicillin
      and ticarcillin, SB and CA, respectively, extend the spectrum of activity of
      these penicillins to include some beta-lactamase-producing aerobes
      (Enterobacteriaceae, Hemophilus influenzae, staphylococci) and anaerobes
      (Bacteroides fragilis group) which would otherwise be resistant. Neither
      effectively inhibits the class I beta-lactamases frequently produced by
      Pseudomonas aeruginosa, Enterobacter, and Serratia, in part explaining the
      resistance observed with these organisms. Clinically, both agents were as
      effective as the comparative therapies in all but two of the trials reviewed.
      Given the current data, the decision to add these agents to the formulary should
      be based on hospital resistance patterns and on the cost of these antimicrobials
      in comparison to conventional therapies.

PMID- 1745625
TI  - Fatal hepatotoxicity induced by hydralazine or labetalol.
AB  - Antihypertensive agents have been associated with adverse reactions that, if
      unrecognized by health practitioners, may have devastating consequences. The
      pattern of hepatotoxicity observed during therapy with the vasodilator
      hydralazine is highly variable, often making its diagnosis difficult. Serious
      hepatic injury induced by the alpha- and beta-adrenergic receptor antagonist
      labetalol has only recently been reported and therefore, many clinicians may be
      unaware of this adverse effect. Familiarity with the clinical features and course
      of hydralazine- and labetalol-induced hepatic injury is necessary to ensure
      prompt recognition and discontinuation of the agent.

PMID- 1745626
TI  - Eosinophilic pustular folliculitis (Ofuji disease) in childhood: a review of four
      cases.
AB  - Four children under 2 years of age were treated at our hospital in the last three
      years with a recurrent vesiculopustular eruption of the scalp, variably extending
      to the face and limbs. All cases followed a cyclical pattern. Three of the
      children had a moderate response to topical steroids, and one went into remission
      after a two-month course of erythromycin. Ethnic origin may be an important
      predisposing factor. Histologically, all patients showed a moderate mixed
      inflammatory infiltrate with numerous eosinophils centered around hair follicles.
      Peripheral white blood cell count showing leukocytosis with eosinophilia was
      observed in those cases measured, but no consistent immunologic abnormalities
      could be identified.

PMID- 1745627
TI  - Cutaneous and oral lesions in 32 children after renal transplantation.
AB  - A variety of skin and oral mucosal lesions appearing in patients after renal
      transplantation have been reported in the literature. Because most of these data
      pertain to adults, we studied a group of children with kidney transplants to
      investigate the occurrence of skin and/or oral mucosal lesions, compare them with
      those observed in adults, and contribute to the knowledge of the pathogenesis of
      these disorders. Our series consisted of 32 patients aged 5 to 18 years, all of
      whom had skin and/or oral mucosal lesions that were classified as being either
      drug induced, probably related to uremia, or due to other causes. A possible
      relationship between drug-induced lesions and the therapeutic immunosuppressive
      regimen in use was investigated. In addition, two formerly unreported lesions
      were seen in these patients: hypertrophy of lingual fungiform papillae and
      onychoschizia. The former occurred only in children receiving cyclosporine.
      Compared with adults, the frequency of gingival hypertrophy was higher and that
      of infectious disease was lower.

PMID- 1745628
TI  - Progressive early dermatologic changes in Hutchinson-Gilford progeria syndrome.
AB  - We describe evolving dermatologic findings in a male with progeria from age 1
      month to 21.5 months. At 18 months of age, irregular pigmentary changes of the
      abdomen, early occipital alopecia, superficial scalp veins, glyphic nasal tip,
      absent ear lobules, coarse hair that stands on end, crowded dentition with
      delayed tooth development, and dystrophic nails permitted the diagnosis of
      progeria. Radiographs showed evidence of resorption of the distal ends of the
      clavicles, attenuation of the terminal phalanges, diffuse osteopenia, and
      fishmouth vertebral bodies, which are typical of this syndrome. Appreciation of
      the evolution of early dermatologic findings may permit earlier diagnosis of this
      condition in infants with skin changes.

PMID- 1745629
TI  - Spray-induced frostbite in a child: a new hazard with novel aerosol propellants.
AB  - A case of deep frostbite occurred in an 8.5-year-old child. The lesion was due to
      the improper use of a toilet air freshener and was severe enough to require a
      skin graft. The propellants contained in the spray were propane and butane. We
      measured the temperature of this aerosol during spraying (-40 degrees) in
      comparison with an ethyl chloride spray (-3 degrees) widely used for local skin
      anesthesia. This difference is mainly due to the much lower evaporation
      temperature of propane (-42.2 degrees) and butane (-0.6 degrees) compared with
      ethyl chloride (12.5 degrees). This child aimed the spray directly toward his
      skin, thus producing a deep frostbite. We wish to draw the attention of
      clinicians to this potential hazard with new propellants, since they should soon
      replace chlorohydrofluorocarbons throughout the world for ecologic reasons.

PMID- 1745630
TI  - Subcutaneous fat necrosis in two infants after hypothermic cardiac surgery.
AB  - Two infants experienced subcutaneous fat necrosis (SCFN) at a relatively late age
      after cardiac surgery with induced hypothermia. The condition resolved in both
      patients over four weeks without treatment. The appearance of SCFN after the
      newborn period is very unusual, and in these patients was probably related to the
      hypothermia.

PMID- 1745631
TI  - Langerhans cell histiocytosis masquerading as lichen aureus.
AB  - We report a 13-year-old boy with localized Langerhans cell histiocytosis. The
      lesion was restricted to the skin of the mons pubis and clinically resembled
      lichen aureus. Histopathologic and electron microscopic examinations of a skin
      biopsy specimen of the lesion showed typical features of Langerhans cell
      histiocytosis. Extensive examination revealed no other organ involvement.

PMID- 1745632
TI  - Juvenile pemphigus vulgaris: efficacy of moderate doses of deflazacort.
AB  - A 13-year-old girl with pemphigus vulgaris (PV) had clinical features of chronic
      stomatitis. The histologic and immunologic findings were typical of a diagnosis
      of PV. Good therapeutic results were obtained with moderate doses of deflazacort,
      1 mg/kg/day slowly tapered to 0.1 mg/kg every other day. The patient had no
      significant side effects.

PMID- 1745633
TI  - Papular acrodermatitis of childhood (Gianotti-Crosti disease).
AB  - An 11-year-old boy had lentil-sized lichenoid papules, localized to the limbs and
      trunk, together with acute, nonicteric, hepatitis B surface antigen-positive
      hepatitis. The clinical picture and course were typical of Gianotti-Crosti
      disease. Monoclonal antibodies were used to study the lymphocyte subpopulations
      and surface antigens in the inflammatory infiltrate in frozen sections of a skin
      biopsy specimen. The results provide data on the pathogenic mechanism of the
      papular exanthem.

PMID- 1745634
TI  - Discrete pigmentation after chemotherapy.
AB  - Discrete areas of cutaneous hyperpigmentation were seen in two children with
      metastatic sarcoma who received chemotherapeutic bone marrow ablation with
      cyclophosphamide, etoposide, and carboplatin prior to autologous bone marrow
      transplantation. The hyperpigmented patches occurred only in areas of skin
      occluded by tape, electrocardiogram pads, or elastic bandages. Identical skin
      findings were reported in five adult women who received intravenous thiotepa and
      cyclophosphamide. Measurable levels of thiotepa were detected in these patients'
      serum, skin, sweat, and occluded gauze, suggesting that the chemical was excreted
      onto the skin surface in sweat and accumulated under occlusive dressing, thus
      producing some toxic effect on the epidermis or melanocytes resulting in abnormal
      pigmentation. We suspect that a similar mechanism was operative in our patients
      to produce the unusual patterned hyperpigmentation, and suggest that this
      complication may be prevented by minimizing sweat accumulation in areas occluded
      by adhesive materials.

PMID- 1745635
TI  - Oral acyclovir therapy for varicella and zoster infections in pediatric and
      pregnant patients: a brief review.
AB  - Oral acyclovir recently was approved for the treatment of herpes zoster and has
      been shown to be effective in the treatment of varicella. Studies of the use of
      high-dose oral acyclovir in the management of varicella-zoster infections in
      immunocompetent pediatric patients are reviewed. Guidelines are provided for the
      drug's use in immunocompetent children and adolescents, pregnant patients, and
      pediatric atopic patients receiving systemic steroids.

PMID- 1745636
TI  - Scissor excision plus electrocautery of anogenital warts in prepubertal children.
AB  - Nineteen prepubertal children with anogenital (AG) warts were treated by scissor
      excision plus electrocautery under general anesthesia. Median posttreatment
      follow up was nine months. Minor clinical recurrences were seen in five (26.3%)
      children, all within three months after treatment. Recurring warts responded in
      all cases to home application of 0.5% podophyllotoxin (Condyline). Surgery plus
      electrocautery was well tolerated with no notable side effects. It is simple,
      safe, and efficacious, and is a suitable second-line treatment for AG warts in
      children.

PMID- 1745637
TI  - Wiskott-Aldrich syndrome.

PMID- 1745638
TI  - Multiple cutaneous ulcers in a premature neonate.

PMID- 1745639
TI  - Defining the sudden infant death syndrome (SIDS): deliberations of an expert
      panel convened by the National Institute of Child Health and Human Development.

PMID- 1745640
TI  - Pulmonary veins in total anomalous pulmonary venous connection with obstruction:
      demonstration using silicone rubber casts.
AB  - We studied the postmortem vascular anatomy of four patients with total anomalous
      pulmonary venous connection (TAPVC) with obstruction using a silicone rubber
      casting method. Two patients were studied clinically but died before therapeutic
      intervention, one died after corrective surgery, and another was not diagnosed
      before death. The morphologic types were supracardiac (2), infracardiac (1), and
      mixed (1). One of the supracardiac forms had a stenosis at the left vertical vein
      by a bronchoarterial vise, and a collateral channel to the right superior caval
      vein was also present. In the other supracardiac case, a left upper pulmonary
      vein was connected to the left vertical vein above the stenotic portion,
      resulting in postoperative pulmonary hemorrhage into the left upper lobe. The
      patient with infracardiac TAPVC had a tree-shaped descending vertical vein and
      small opening at the inferior caval vein. In the mixed type, a right upper
      pulmonary vein ran between the pulmonary artery and bronchus draining into the
      superior caval vein, and the rest of the drainage was to the portal vein.

PMID- 1745641
TI  - Anomalies of the brain and congenital heart disease: a study of 52 necropsy
      cases.
AB  - During routine autopsy examinations several macroscopic anomalies of brains were
      noted in children with congenital heart disease (CHD). To define these
      observations 52 autopsies of cases with CHD as well as 52 controls were compiled.
      Cases were divided into two groups according to the absence (group I) or presence
      (group II) of a multimalformative syndrome (MMS). Fifty percent of the sample was
      associated with MMS. Brain anomalies were classified into grades I, mild and
      focal; II, intermediate, focal or diffuse; and III, severe and diffuse. Group I
      was associated with brain anomalies (mainly of grades I and II with altered gyri)
      in 19 of 28, whereas in Group II the brains frequently had compromise of lobes,
      gyri, and fissures, 18 of 24. The relationship between the types of CHD, grade of
      brain anomalies, and MMS is delineated. The high frequency of brain anomalies
      associated with CHD but without other malformations (67.8%) suggests a clinical
      counterpart of these lesions.

PMID- 1745642
TI  - Sudden death in an infant with central nervous system abnormalities.
AB  - Some deaths during the first year of life are classified as sudden infant death
      syndrome (SIDS), the diagnosis of which requires a complete autopsy without
      adequate explanation for the death. We report a 1-month-old infant whose clinical
      history was fairly typical for SIDS. Postmortem examination was remarkable in
      revealing clinically unsuspected central nervous system (CNS) abnormalities,
      including lobar holoprosencephaly, absence of the olfactory tracts and grooves
      (arhinencephaly), subependymal gray matter heterotopias, and delayed myelination.
      Although the CNS findings do not adequately explain the patient's sudden death,
      this case illustrates the need for a complete autopsy to include careful CNS
      evaluation, especially in any presumed SIDS death.

PMID- 1745643
TI  - Cortical dysgenesis in a variant of phenylketonuria (dihydropteridine reductase
      deficiency).
AB  - The neuropathology of a 2 1/2-year-old patient with dihydropteridine reductase
      deficiency showed diffuse demyelination throughout white matter and spongy
      vacuolation in the long tracts of the brain stem. These changes are
      characteristic neuropathologic observations in untreated phenylketonuria. In
      addition, extensive neuronal loss, calcification and abnormal vascular
      proliferation were noted in the cerebral cortex, white matter, basal ganglia, and
      thalamus. Golgi studies demonstrated an abnormal orientation of neurons together
      with abnormalities of dendrites and dendritic spines. The pathogenesis of the
      vascular abnormalities in this condition is unknown, although folate deficiency
      may be involved. The secondary deficiency of serotonin and dopamine occurring
      during neuronal growth and differentiation may also affect the terminal stages of
      neuronal maturation.

PMID- 1745644
TI  - A historical view: diethylstilbestrol use during pregnancy: a 30-year historical
      perspective.

PMID- 1745645
TI  - Arteriopathy in children with AIDS: microscopic changes in the vasa vasorum with
      gross irregularities of the aortic intima.

PMID- 1745646
TI  - [The effect of various culture parameters on the yield of restriction
      endonuclease Sfa NI].
AB  - A simple technique is proposed for testing the restriction endonuclease Sfa NI
      activity in lysates of Streptococcus faecalis cells. The technique was used to
      study the effect of inorganic phosphate and the growth phase on the enzyme yield.
      Conditions were chosen that provide a high yield of the Sfa NI activity and a
      significantly reduced level of nucleases in the cells.

PMID- 1745647
TI  - [Adsorption immobilization of alkaline lipase].
AB  - A polyamide with the covalently coupled phosphatidyl ethanolamine was used for
      affinity adsorption of an alkaline lipase from Pseudomonas aeruginosa. The
      immobilization resulted in increase of the enzyme specific activity. Some
      properties of native and adsorbed enzyme were compared. The temperature optima,
      heat and pH stability, KM and Vmax values were determined for both native and
      immobilized enzymes.

PMID- 1745648
TI  - [Various lipases for producing products enriched with polyenic acids in fish fat
      hydrolysis].
AB  - The enzymic hydrolysis of fish with lipases from various sources was studied. The
      lipase from the fungus Rhizopus microsporus preferentially removes saturated
      fatty acids, while lipase from the pyloric caeca of salmon unsaturated fatty
      acids upon hydrolysis of fish fats. The enzymes can be used to obtain fatty
      products enriched with eicosanopentaenoic acid, mono- and diacylglycerols by
      enzymic hydrolysis of the ivasi fat.

PMID- 1745649
TI  - [Role of the energy status of Escherichia coli in cell membrane phospholipid
      composition changes during aerobic-anaerobic transitions].
AB  - The aerobic to anaerobic transition of E. coli is accompanied with interrelated
      changes of the adenylate pool, energy charge, respiration rate, as well as the
      phospholipid content of the cell membranes and the activity of the polyamine
      synthesizing system. The role of the cellular energy status in the control of the
      relative content of membrane phospholipids is discussed. The control is based
      either on energy redistribution in phospholipid metabolism or on the effect on
      the activity of the polyamine synthesizing system.

PMID- 1745650
TI  - Monthly prostaglandin bibliography prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 1745651
TI  - The effect of adjuvant-induced arthritis on rat leukocyte membrane phospholipid
      fatty acid levels following fish oil feeding.
AB  - Inflamed rats with adjuvant-induced polyarthritis showed similar incorporation of
      dietary eicosapentaenoic acid (EPA) into peritoneal exudate cell (PEC) membrane
      phospholipids compared to pair fed non-inflamed control rats. Arachidonic acid
      (AA) content was similar in PEC phospholipids of inflamed and control rats
      whereas the linoleic acid content was consistently higher in inflamed rats.

PMID- 1745652
TI  - Blood pressure reduction by fish oil in adult rats with established hypertension-
      dependence on sodium intake.
AB  - The effects of fish oil combined with dietary sodium restriction on blood
      pressure and mesenteric vascular resistance were examined in a series of
      experiments with adult normotensive (WKY) and stroke-prone spontaneously
      hypertensive rats (SHRSP). Rats were fed normal or low sodium diets containing
      fish oil, olive oil or safflower oil. Small but significant reductions of blood
      pressure (measured directly in conscious rats) were seen in SHRSP but not in WKY
      after 8 weeks on a fish oil/low sodium diet, compared with rats fed olive or
      safflower oil diets with normal sodium content. This antihypertensive effect was
      not dependent on neurally mediated vasoconstriction but was associated with a
      reduction of basal resistance in the blood-perfused mesenteric artery.
      Subcutaneous injection of fish oil reduced blood pressure in adult SHRSP on a
      normal sodium diet. However, there was a further fall in blood pressure when
      sodium intake was reduced. The results indicate the antihypertensive effect of
      fish oil can be enhanced by restricting sodium intake.

PMID- 1745653
TI  - Dietary fish oil administration retards the development of hypertension and
      influences vascular neuroeffector function in the stroke prone spontaneously
      hypertensive rat (SHRSP).
AB  - An influence of fish oils (rich in eicosapentaenoic acid, EPA) in modulating (a)
      the development of hypertension in the stroke prone spontaneously hypertensive
      rat (SHRSP) and (b) vascular neuroeffector mechanisms in the SHRSP was explored.
      Rats (SHRSP) were placed on a series of diets for a period of 13 weeks from 4
      weeks of age. The fatty acid composition of the diets was derived from fish oil,
      olive oil, safflower oil or beef fat. After 13 weeks, rats fed diets containing
      fish oil (at a total dietary fat level of either 5% or 15%) had mean blood
      pressures approximately 20-25 mmHg lower than other SHRSP rats maintained on
      diets containing either olive oil, safflower oil or beef fat. The dietary
      schedules providing fish oil depressed the contractile responses mediated by
      sympathetic nerve stimulation in the mesenteric vascular bed preparation. The
      results suggest that the n-3 polyunsaturated fatty acids retard the development
      of hypertension in the SHRSP rat and modulate the contractile responses of blood
      vessels mediated by sympathetic nerves in the isolated perfused mesenteric
      vascular bed preparation.

PMID- 1745654
TI  - Interactions between n-3 and n-6 essential fatty acids (EFAs) in the regulation
      of cardiovascular disorders and inflammation.
AB  - Much attention has recently been paid to the possible benefits of increasing the
      intake of eicosapentaenoic acid (EPA) by consuming fish oil. However, this can
      have adverse effects such as raising cholesterol levels in patients with
      hyperlipidaemia and causing a deterioration in glucose tolerance. High doses of
      EPA given to Westerners also lower levels of dihomogammalinolenic acid (DGLA), a
      substance with a wide range of desirable cardiovascular and antiinflammatory
      actions. This lowering of DGLA does not occur in Eskimos who consume large
      amounts of EPA, indicating that there may be differences in essential fatty acid
      metabolism between Westerners and Eskimos. Therapeutic strategies are required
      which raise both EPA and DGLA and which do not raise EPA at the cost of lowering
      DGLA.

PMID- 1745655
TI  - Release and effects of prostaglandins in ocular tissues.

PMID- 1745656
TI  - Inhibition of PGE2 production in macrophages from vitamin E-treated rats.
AB  - Rat peritoneal macrophages from vitamin E-treated rats (5 mg per rat for 6
      successive days) contained 403.3 +/- 90.7 ng alpha-tocopherol/10(6) cells,
      whereas control macrophages contained 1.2 +/- 0.4 ng. PGE2 production in the
      macrophages from vitamin E-treated rats was significantly suppressed when
      stimulated with PMA and calcium ionophore A23187. The mechanism of vitamin E
      inhibition of PGE2 production in macrophages was investigated. The release of
      (14C)-arachidonic acid from pre-labeled macrophages and the conversion of (14C)
      arachidonic acid to PGE2 by the homogenate of the cells were remarkably reduced.
      These results strongly suggested that the inhibition of PGE2 production by
      vitamin E results from the inhibition of the activities of both phospholipase A2
      and cyclooxygenase.

PMID- 1745657
TI  - Influence of dietary fatty acids on phospholipid composition and prostaglandin E
      synthesis in rat kidneys.
AB  - The effects of oils with different amounts of n6 and n3 fatty acid precursors and
      derivatives were evaluated on phospholipid composition and PGE2 synthesis of rat
      kidneys. Dietary lipids were: olive oil, an olive-blackcurrant-fish oil mixture
      and a blackcurrant-fish oil mixture. We observed in the kidneys of rats fed the
      blackcurrant-fish oil mixture a significant decrease in PGE2 synthesis, while
      arachidonate values did not show significant variations. A decrease of PGE2
      synthesis could be due to competitive and inhibitory effects of fatty acids other
      than arachidonate, observed in the kidney phospholipid composition in our dietary
      conditions.

PMID- 1745658
TI  - Dietary factors in the fall in coronary heart disease mortality.
AB  - The role of dietary change in the fall in heart disease mortality has been hotly
      debated. Three countries, Australia, USA and UK with equal 'care' and
      sophistication of surgical techniques have shown different timing in the
      beginning of the decline of this 'epidemic'; around the mid 1960s in the first
      two countries, but not until the late 1970s for the UK. The cause of this
      difference may be the changing food habits of their populations. Using food
      disappearance data, apparent consumption of butter and margarine show opposite
      trends (butter down and margarine up) predating the decline in mortality in both
      the USA and Australia by at least 7 years and also in the UK, but at a later
      time, (about 1970). Changes in adipose tissue linoleate, a marker for
      polyunsaturated fat intake, support this indirect evidence, with depot levels
      rising in the USA from the 1960s and 10 years later in the UK. Other evidence
      support the view of decreasing saturated fat intake and increasing
      polyunsaturated intake prior to 1960 in the USA. Although many factors must
      contribute to the decline in mortality from CHD, change in dietary P/S ratio
      would seem to be the major dietary contributor.

PMID- 1745659
TI  - Neural network modelling.

PMID- 1745660
TI  - The use of narrowband ultrasound for characterization of tissue in a thin layer.
AB  - Most tissue characterization methods use RF data originating from backscattering
      processes in the insonified tissue. Characterization of the tissue of a thin
      layer (e.g., an artery wall) poses problems because of the small amount of data
      available. The tissue layer may be so thin that there are no RF data that are not
      corrupted by the reflections from nearby interfaces. An alternative approach may
      be to compare the spectra of the reflections at the boundaries of the layer for
      the characterization of the tissue in between. To avoid problems that arise from
      the use of short (broadband) pulses the method proposed here uses long and almost
      monochromatic pulses. The frequency dependence of the acoustic parameters can be
      assessed by using different central emission frequencies. A deconvolution
      algorithm is used to separate overlapping reflections from closely spaced tissue
      interfaces. Wiener inverse filtering together with correlation of deconvolved
      signals results in an accurate determination of the position of specular
      reflectors. The accuracy of the peak values detected in the envelope signal is
      not sufficient for quantitative determination of tissue parameters, but still
      much better than results from the analysis of short waveforms.

PMID- 1745661
TI  - The interaction of ultrasound with cancellous bone.
AB  - The Biot theory is used in an attempt to explain the frequency dependence of
      ultrasonic attenuation, f(alpha), in cancellous bone. Measurements of f(alpha) in
      samples of cancellous bone are compared with values calculated using parameters
      established from bone samples by statistical histomorphometry. Ultrasonic
      attenuation in cancellous bone correlates with trabecular bone volume but the
      Biot theory, although producing qualitative agreement produces quantitative
      results which are significantly deviant using parameters presently available. At
      the present time, too many of the Biot parameters are insufficiently defined for
      cancellous bone, to allow a complete test of the model.

PMID- 1745662
TI  - Treatment planning optimization using constrained simulated annealing.
AB  - A variation of simulated annealing optimization called 'constrained simulated
      annealing' is used with a simple annealing schedule to optimize beam weights and
      angles in radiation therapy treatment planning. Constrained simulated annealing
      is demonstrated using two contrasting objective functions which incorporate both
      biological response and dose-volume considerations. The first objective function
      maximizes the probability of a complication-free treatment (PCFT) by minimizing
      the normal tissue complications subject to the constraint that the entire target
      volume receives a prescribed minimum turmourcidal dose with a specified dose
      homogeneity. Probabilities of normal tissue complication are based on published
      normal tissue complication probability functions and computed from dose-volume
      histograms. The second objective function maximizes the isocentre dose subject to
      a set of customized normal tissue dose-volume and target volume dose homogeneity
      constraints (MVDL). Although the PCFT objective function gives consistently lower
      estimates of normal tissue complication probabilities, the ability to specify
      individualized dose-volume limits, and therefore the individualized probability
      of complication, for an individual organ makes the MDVL objective function more
      useful for treatment planning.

PMID- 1745663
TI  - A total body nitrogen facility for paediatric use.
AB  - The design, calibration and evaluation of a facility for in vivo prompt gamma
      neutron capture analysis of total body nitrogen in children is described. The
      patient is scanned in both supine and prone positions, across a vertically
      collimated beam from a 1 GBq 252Cf fission source. Two NaI(T1) detectors are
      placed on either side of the patient, perpendicular to both the neutron beam and
      the scanning direction. The effective dose equivalent delivered to a child during
      an 840 s scan is approximately 0.14 mSv (QF = 10). Correction factors for
      nitrogen background (width-dependent), hydrogen background (1-4% of hydrogen
      gamma ray peak) and the differential attenuation of nitrogen and hydrogen gamma
      rays (width-dependent) can be applied to the measured nitrogen-to-hydrogen gamma
      ray counts ratio. By using the mass of hydrogen (based on body mass and fat mass)
      as an internal standard, the nitrogen mass can then be determined. Measurements
      with a urea-containing box phantom show that the current precision (CV) of the
      net nitrogen counts and of the nitrogen-to-hydrogen counts ratio is +/- 2.0% and
      +/- 1.5%, respectively. Using small anthropomorphic and other phantoms,
      estimation of the mass of nitrogen has a precision of +/- 1.4 to 5.4% and an
      accuracy of 97.1 to 101.5%.

PMID- 1745664
TI  - X-ray computed tomographic (CT) phantom designed for the development of
      techniques for measurement of myocardial perfusion.

PMID- 1745665
TI  - An articulatory study of consonant-induced vowel duration changes in English.
AB  - The effects of voicing, manner, and number of consonants on the duration of
      previous vowels in English can be created in three ways: by planned expansion or
      contraction of the entire vowel, by changing the relative timing of consonant and
      vowel gestures, or by modifying the duration of the closing movement for the
      consonants. An X-ray microbeam data base of 2 speakers of American English
      reciting monosyllabic words, which differed in their final consonants and in
      their position in the accentual structure of the utterance, was studied to
      evaluate these three accounts. In this data base, vowel duration differences due
      to the voicing of the following consonants were amplified by the presence of
      accent. Also, many of the duration differences associated with the following
      consonants are localized in the later portion of the opening movement, suggesting
      that subjects often create vowel duration changes by initiating the consonant
      closing gesture at an earlier or later time relative to the opening gesture.

PMID- 1745666
TI  - The representation of stop consonants in three-dimensional acoustic space.
AB  - An acoustic study of English initial voiced stops showed that the three place
      categories are well distinguished on the basis of three properties: second
      formant onset frequency (F2 onset), second-formant frequency of the vowel nucleus
      (F2), and third-formant onset frequency (F3 onset). Ten male and 10 female
      subjects produced multiple tokens of /bVt/, /dVt/, and /gVt/ with ten different
      medial vowels. Three-dimensional scatterplots were generated using the above
      acoustic properties as coordinates. Three nonoverlapping clusters corresponding
      to the three place categories were evident across all subjects. Discriminant
      analyses based on F2 onset, F2 vowel, and F3 onset as predictor variables showed
      a mean correct categorization rate of 84.5% when tested within gender groups. The
      graphic and statistical results are interpreted as indicating that phonetic
      categories may be defined and represented in purely acoustic terms if variably
      valued multiple acoustic properties are relationally examined.

PMID- 1745667
TI  - The stop/glide boundary shift: modelling perceptual data.
AB  - Research in speech perception has suggested that listeners often adjust category
      boundary locations for differing contexts. The stop/glide (e.g.,/ba/vs./wa/)
      boundary shift occurring with changes in syllable duration has been interpreted
      as reflecting 'rate normalization' by some, whereas others have suggested an
      auditory basis for the shift. Clarification of both the causes and the effects of
      the stop/glide shift is being sought through experimentation intended to expand
      our knowledge of variations in the shift across different experimental
      treatments. The present study extends research on the stop/glide shift by (1)
      showing that the shift is not an artifact of a particular stimulus pattern that
      had been present in all the previous studies of the effect, (2) further
      demonstrating the nonlinear character of the identification shift, (3) providing
      additional evidence of the role of presentation format (mixed vs. blocked) in the
      identification shift, and (4) exploring boundary locations in various
      discrimination paradigms. The complex outcomes of the studies reported here as
      well as a variety of previous results are interpreted as compatible with expanded
      versions of the durational contrast hypothesis. Two versions are considered, one
      in which the shift is seen as due to a mechanism of contrastive perception that
      applies to events of comparable duration, and one in which the shift is seen as a
      perceptual error that occurs when the auditory system attempts to track frequency
      trajectories that change (i.e., pivot) over time.

PMID- 1745668
TI  - Neurological correlates of unilateral and bilateral "strokes" of the middle
      cerebral artery in the rat.
AB  - Rats with unilateral lesions of the middle cerebral artery (MCA) were tested for
      the ability to detect (touch) and remove a square of adhesive tape from each
      forepaw, and for performance on a number of neurological tests (e.g., placing and
      hopping reflexes, activity). Rats with MCA damage showed deficits in both
      touching and removing the tape from the paw contralateral to the damage, but not
      ipsilateral to the damage, while performing within normal limits on the other
      tests. After scores of the MCA rats dropped into the control group range on the
      adhesive tape test, they sustained damage to the opposite MCA. This did not
      reinstate the original deficit, suggesting that the recovery seen after the
      unilateral lesion was not mediated by the opposite cortex. The second lesion,
      however, caused a deficit in removing the adhesive tape from the limb opposite
      the new stroke. Some of the rats that originally had sham operations received
      bilateral MCA lesions at this time. These animals showed much more severe
      deficits on the adhesive tape test than the rats with sequential strokes. Rats
      with bilateral MCA damage (simultaneous or sequential) also slipped on a long
      narrow plank more often than control animals. Nimodipine did not enhance recovery
      on any of the behavioral measures.

PMID- 1745669
TI  - Sociophysiology of relationships in squirrel monkeys. I. Formation of female
      dyads.
AB  - Physiological and behavioral consequences of formation of female-female
      relationships were investigated in adult squirrel monkeys. Plasma cortisol, heart
      rate, and behavior were evaluated during confinement in a test cage while animals
      were housed alone, during the first hour of isosexual pair formation, and while
      animals were housed as isosexual dyads. In addition, basal cortisol levels were
      assessed both before and after pair formation, as were behavioral and
      cardiovascular responses to social and nonsocial stimulus presentations. Basal
      cortisol levels underwent a marked and sustained reduction following formation of
      pairs, independent of both dominance status and the quality of social
      interactions between pairmates. In contrast, adrenocortical responsiveness was
      not altered by social conditions, apart from a modest and transitory difference
      between dominant and subordinate females in their initial response to pair
      formation. Heart rate declined sharply during each test session, but did not
      reliably differentiate social conditions, stimulus conditions, or dominance
      status. These findings contrast with results of a parallel study of male squirrel
      monkeys and suggest that isosexual relationships in males and females are
      associated with different sociophysiological processes.

PMID- 1745670
TI  - Brood patch innervation and its role in the onset of incubation in the turkey
      hen.
AB  - The source of innervation to the brood patch in turkey hens was determined by
      recording the electrophysiological activity of cutaneous nerves while manually
      stimulating various regions of the skin. The entire area of the brood patch was
      innervated by eight nerves, arising from thoracic vertebra 3 to synsacrothoracic
      vertebra 1. To determine whether afferent input from the brood patch influenced
      egg production or incubation behavior, hens were bilaterally denervated prior to
      photoinduced egg production. Denervated hens visited nests the same number of
      times, but stayed on the nest for less total time than controls by the fourth
      week of photostimulation. Serum prolactin levels rose in control hens but not in
      denervated hens. Egg production was maintained in the denervated hens but not in
      controls. None of the denervated hens displayed incubation behavior. This
      experiment supports the view that peripheral nervous input plays a role in the
      onset of incubation behavior.

PMID- 1745671
TI  - Individual variation in the neural timing of infanticide and parental behavior in
      male house mice.
AB  - In male house mice (Mus domesticus and M. musculus), the act of coital
      ejaculation provides a fail-safe neural signal for timing the birth of their
      offspring. A unique aspect of this phenomenon is the extraordinary latency that
      can occur between the stimulus (ejaculation) and its adaptive neural response
      (male mice cease killing pups and behave parentally toward them). Thus the
      inhibition of infanticide is routinely time-delayed for many days after mating.
      In the absence of mating, cohabitation with a female will not inhibit infanticide
      in CF-1 stock males (M. domesticus), whereas the birth of pups in the male's home
      cage will inhibit infanticide. But with regard to the ejaculatory phenomenon,
      which also includes the spontaneous reemergence of infanticide 50-60 days after
      mating, this entire behavioral cycle toward pups can occur in the total absence
      of regular time cues from a light/dark cycle following ejaculation. However,
      exposure to photoperiodic (L:D 12:12) or constant light (LL) accelerated the
      transition time from infanticide to parenting after ejaculation, while in
      constant dark (DD), the transition time to parenting was significantly prolonged.
      The time interval between ejaculation and the inhibition of infanticide, which
      varied among individuals first mated at 6 months of age, was repeatable when the
      same males were remated at 9 months of age; however, when males were again mated
      at 18 months of age, the time interval between ejaculation and parenting was
      dramatically prolonged. In general, coital ejaculation triggers a neural timing
      system that cannot be explained by any presently known physiological mechanism.
      Our results do suggest, however, that the neural timing variation observed among
      individuals is influenced by sex steroid exposure during late fetal development.

PMID- 1745672
TI  - Effect of dietary protein and environmental factors on lactation performance in
      rats.
AB  - The effects of dietary protein and environmental conditions on lactation
      performance in rats were evaluated. Female rats were fed from conception until
      day 9 of lactation diets containing 21% wheat protein (21W), 21% casein +
      methionine (21CM) or 11% casein + methionine (11CM). At parturition, dams were
      kept in their normal environment (20 degrees C) or were exposed to crowded
      conditions or an elevated ambient temperature (30 degrees C). Feeding poor
      quality protein (21W) or a lower amount of high-quality protein (11CM) reduced
      day 8 pup weights and average daily gains (ADG). Pup ADG's nursed by crowded dams
      fed either 11CM or 21CM were greater than those of pups nursed by noncrowded
      dams. Pup ADG's were reduced by heat exposure in dams fed 21CM but not in pups
      raised by dams fed diets reduced either in protein quality (21W) or protein
      quantity (11CM). Thus lactation performance was not further reduced by heat
      exposure in dams fed poor-quality wheat protein in spite of reduced food
      consumption and increasing lactation weight loss in these dams. The study
      indicates that lactating rats have considerable ability to raise their litters
      under potentially adverse conditions.

PMID- 1745673
TI  - Tectectomy in the cyclopean salamander.
AB  - In an Ambystoma larva with both natural eyes removed and one eye grafted atop the
      head (Cyclops preparation), vision-dependent behavior usually recovers from the
      enucleation inherent in the operation, but the optically activated skin blanching
      reaction reappears in a very small number of instances. In the present studies,
      while the latter trend continued for the conventional Cyclops preparation,
      tectectomy concurrent with the ectopic eye transplantation resulted in a several
      fold increase in the recovery of blanching competency. Some 60 percent of the
      tectectomized Cyclops animals exhibited the same Hogben-Slome pigmentation
      indices as larvae with one natural eye intact (controls). As measured
      planimetrically with an image analyzer, the pigment spots (melanosome containing
      portions of dermal melanocytes) contracted to the same extent in the blanch
      competent Cyclops animals as in controls with a single natural eye.

PMID- 1745674
TI  - Endocrinological and behavioral changes associated with the onset of incubation
      in the duck.
AB  - Plasma levels of prolactin were measured during the onset of incubation in ducks.
      A rapid rise in prolactin levels from a mean of 5.7 to 33.1 ng/ml occurred during
      the formation of the final 20% of the clutch; during which the females increased
      their nest-box occupancy from 9.9 to 22.2 hours per day. A pronounced decrease in
      plasma progesterone levels, but not estradiol, occurred in females in the days
      immediately preceding the onset of incubation and termination of egg laying. A
      similar decrease in plasma LH occurred. Plasma corticosterone levels also
      decreased during the transition from egg laying to incubation. In male ducks, who
      play no role in incubation, LH remained constant until well into incubation when
      it decreased. Changes in plasma levels of prolactin are discussed in relation to
      tactile stimulation from the clutch and nutritional stress.

PMID- 1745675
TI  - Metabolic changes of several adipose depots as caused by aging.
AB  - In this study, metabolic changes of several adipose depots as caused by aging
      were investigated. Key enzyme activity of glutaminolysis, pentose-phosphate
      pathway and Krebs cycle were measured. The rates of lipogenesis from 3H2O,
      lipoprotein lipase (LPL) activity and rate of lipolysis in vitro were also
      determined. The results obtained indicate a reduced capacity for lipogenesis in
      several adipose depots by aging. The authors concluded that hypertrophy of
      adipose tissue reported during aging is possible due to increased LPL activity
      and reduced rate of lipolysis.

PMID- 1745676
TI  - Serum corticosterone in fetal mice: sex differences, circadian changes, and
      effect of maternal stress.
AB  - The serum concentration of corticosterone was examined in control and stressed
      pregnant female mice (Mus domesticus) as well as male and female fetuses due to
      our interest in the behavioral effects of material stress on offspring in mice.
      Pregnant females were restrained under flood lights (2 sessions/day, 45
      min/session) from Day 13-17 of pregnancy. On Day 17 of pregnancy a significant
      increase in maternal serum corticosterone was exhibited 1 h after the onset of a
      stress session, and serum corticosterone did not return to baseline until 16 h
      later. We also observed a significant increase in serum corticosterone in male
      fetuses during the first 4 h after maternal stress, while no significant change
      in serum concentration of corticosterone was observed in female fetuses
      throughout 24 h after maternal stress. Daily variation in serum concentration of
      corticosterone was also determined at 4-h intervals in pregnant mice and their
      fetuses from Day 16-18 of pregnancy. Pregnant females maintained on a 12 L:12 D
      cycle exhibited peak serum corticosterone concentrations at and just before the
      onset of the darkness. Daily fluctuations in serum concentrations of
      corticosterone in male and female fetuses reflected the pattern observed in the
      mothers. A sex difference in serum corticosterone in fetuses was observed at
      some, but not all times of the day, with the difference being greatest during the
      dark phase of the mother's light:dark cycle.

PMID- 1745677
TI  - The effect of cholecystokinin-octapeptide on food intake and consummatory
      behavior in lactating rats.
AB  - Rats are less sensitive to the satiating effect of CCK-8 during some reproductive
      states such as estrus and proestrus, and in ovariectomized rats following the
      administration of estradiol and progesterone. The sensitivity of rats to CCK-8's
      effect on food intake decreases as lactation progresses. During lactation,
      prolactin and progesterone levels are elevated. Implantation of ectopic
      pituitaries increases prolactin levels in males and females as well as
      progesterone levels in females. To evaluate whether or not prolactin elevation
      modifies CCK's effect on feeding, we studied the effect of CCK-8 on food intake
      during the early dark cycle in male and female rats implanted with ectopic
      pituitaries. As previously demonstrated, prolactin levels were elevated in both
      male and female pituitary-implanted rats and progesterone levels were elevated in
      the female rats. CCK-8 inhibited food intake in sham-operated male rats, but did
      not reliably decrease early dark cycle food intake in sham-operated or pituitary
      implanted female rats or pituitary-implanted male rats. Thus an elevation in
      prolactin levels does not appear to modify the effect of CCK-8 on food intake in
      female rats. We also evaluated the effect of CCK on consummatory and maternal
      behavior in lactating rats. CCK-8 altered the meal patterns of lactating rats
      primarily by decreasing the rate of food consumption and increasing the latency
      to the first meal. The latency to the first meal of rats receiving CCK was
      increased during early and mid-lactation and the PW period, but not during late
      lactation compared to that of the saline-injected rats. CCK-8 did not modulate
      any of the maternal behaviors studied.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745678
TI  - Fasting-induced rise in locomotor activity in rats coincides with increased
      protein utilization.
AB  - The aim of this study was to investigate the possible relation between the
      modifications in locomotor activity (on running wheel) which occur during
      prolonged fasting and changes in the utilization of energy reserves. In 18-week
      old rats, we found that the rate of body mass loss reflects the changes in
      nitrogen excretion that occur over three phases of fasting: (I) initially
      decreasing, (II) maintained at a low level and (III) increasing. Locomotor
      activity started to increase during phase II without a change in its nycthemeral
      pattern. By contrast, the 10-fold higher daily locomotor activity that occurred
      in phase III was marked by a higher proportion of diurnal activity. Using 9-, 18
      , and 33-week-old rats, in order to obtain a different timing in the metabolic
      changes during fasting, we could confirm the coincidence between the later rise
      in locomotor activity and the occurrence of phase III. Refeeding of rats of
      either age in phase III rapidly suppressed fasting-induced changes in locomotor
      activity. These data accord with the idea that behavioral changes reflecting the
      search for food are triggered by a later and reversible change in the utilization
      of body protein vs. lipid stores during prolonged fasting.

PMID- 1745679
TI  - Refeeding after the late increase in nitrogen excretion during prolonged fasting
      in the rat.
AB  - Recovery of body mass, food intake and body composition was studied in the
      laboratory rat after the late increase in nitrogen excretion that characterizes
      prolonged fasting in mammals and birds. The rats lost 43% of their body mass
      during 13 days of food deprivation. They all regained their prefasting body mass
      within a shorter period of 11 days of refeeding. These results confirm that the
      late increase in nitrogen excretion in rats, as in spontaneously fasting birds,
      is reversible and is a part of the physiological adaptations to long-term food
      deprivation. Water intake of the rats continuously decreased during fasting, and
      the animals virtually stopped drinking as protein utilization increased. On
      refeeding, changes in water intake paralleled those in food intake. The refed
      rats progressively increased their daily food intake, that was always higher than
      the prefasting value (8.0-10.4 vs. 6.7% of body mass). The comparison of organ
      weights between fed and ad lib refed rats of similar body weight indicates that
      muscle mass was regained earlier than body fat during refeeding. The laboratory
      rat therefore appears to be a good experimental model to investigate the
      metabolic and behavioural changes that occur during spontaneous anorexia and
      refeeding in wild animals.

PMID- 1745680
TI  - The effects of short day exposure on seasonal and circadian reproductive rhythms
      of female golden hamsters.
AB  - Four groups of female golden hamsters were exposed to short photoperiods (SP, LD
      10:14) for 4, 14, 20, or 27 weeks and tested for physiological markers (uterine
      weight and estrous cycles) and behavioral (lordosis, approach and aggressive
      behaviors) measures while in contact with a stud male. After behavioral testing,
      females were ovariectomized and, during the next 2 weeks, were tested twice more
      (with a stud male) after replacement with 0.33 microgram (low dose) and 1.0
      microgram (high dose) EB plus progesterone (500 micrograms). Results show that,
      after 14 weeks of SP conditions, uterine weights and percentage of females
      showing normal estrous cycles are at a minimum. This is mirrored by minimal
      levels of lordosis and maximal levels of aggressive and approach behavior at week
      14. Physiological measures did not fully recover (to preregression levels) until
      week 27; however, behavioral measures show an earlier recovery by week 20. SP
      exposure also affects the circadian patterning of behaviors: Females that show
      lordosis at week 14 did so later in the day than did females tested at other
      weeks. Females in the regressed state also fail to show a significant decrease in
      approach behaviors (and a significant increase in receptive behaviors) over the
      course of the circadian day, a pattern seen in nonregressed females. Following
      hormone replacement with the low EB (+P) dose, females do not become receptive;
      however, at the higher dose, all but the week 14 group show increased
      receptivity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745681
TI  - The effects of preexposure to the drug on state dependent retention.
AB  - The present experiment examined whether previous experience with a drug would
      decrease the potential of the drug to produce state dependent retention (SDR) for
      a passive avoidance response in rats. In the first experiment, a single injection
      of sodium pentobarbital (20 mg/kg) given on six consecutive days before the
      training day slightly reduced, but did not block, pentobarbital-induced SDR. In
      Experiment Two, four preexposure injections of 5 IU/kg insulin reduced the
      magnitude of memory loss produced by administration of the hormone prior to
      training. As with pentobarbital, however, preexposure to insulin did not
      completely block the amnestic effect of the hormone. A subsequent experiment
      demonstrated that the decrease in the strength of insulin-induced SDR in insulin
      preexposed rats was not the result of enhanced acquisition. Collectively, these
      data indicate that noncontingent preexposure to an amnestic treatment may
      decrease the magnitude of memory loss that would normally result from the
      administration of that treatment during training.

PMID- 1745682
TI  - Influence of running wheel activity on free-running sleep/wake and drinking
      circadian rhythms in mice.
AB  - Previous studies have indicated that manipulation of activity levels can modify
      characteristics of sleep/wake and activity rhythms. The generality of these
      observations was evaluated by simultaneously measuring drinking and sleep/wake
      rhythms while mice had free or no access to a running wheel in constant
      conditions (DD). Robust circadian rhythms in all parameters were observed in the
      "wheel free" (unrestricted) condition. When wheels were locked, the peak
      amplitude of the sleep/wake circadian rhythm decreased by approximately 50%
      without affecting the amplitude of the drinking rhythm. Total wake time decreased
      11% per circadian day when wheels were locked with increases in both NREM and REM
      sleep. Whereas the amplitude of the drinking waveform was unaffected, wheel
      restriction caused an equivalent increase in period length (tau) for both
      rhythms. These results indicate that, unlike the generalized effects of activity
      on tau, activity restriction influences on rhythm amplitude do not generalize to
      all behavioral and/or physiological variables. This work also supports the notion
      that activity influences on sleep/wake rhythm amplitude reflect behavioral
      "masking" rather than a fundamental change in the direct coupling mechanisms of
      the biological clock.

PMID- 1745683
TI  - Male saliva cues and female social choice in Mongolian gerbils.
AB  - Adult female Mongolian gerbils (Meriones unguiculatus) are preferentially
      attracted to saliva from adult nonsibling males when paired with saliva from male
      siblings. The focus of the present study was to evaluate the potential role of
      saliva in the formation of reproductive units. In Experiment 1, olfactory
      directed investigations and mate choices of estrous females housed with their
      brothers and unrelated males were examined. Females sniffed unrelated males more
      frequently than siblings and were more interested in sniffing the mouth area than
      other body areas. Importantly, they also solicited and mated exclusively with
      unrelated males. The purpose of Experiment 2 was to ascertain the origin of the
      behaviorally active components of saliva by transecting the parotid salivary duct
      (PDT). When either sibling saliva or water was paired with saliva from a
      nonsibling PDT male, females did not show the typical preference for saliva from
      nonsiblings. When social preferences were examined in Experiment 3, virtually all
      females preferred intact nonsibling males to either PDT nonsibling males or
      siblings. Results from this study support the hypothesis that saliva is an
      important oral cue used by females in the selection of sociosexual partners.
      Furthermore, the parotid gland appears to be a significant source of salivary
      chemosignals.

PMID- 1745684
TI  - Does starch taste like Polycose?
AB  - Rats are capable of tasting or detecting maltooligosaccharides (e.g., Polycose)
      and starch in water, two substances that are bland to humans. Because both
      substances are glucose polymers, it has been suggested that they may be detected
      by the same mechanism. The present experiments examined whether rats conditioned
      to avoid one of these substances also avoid the other. Rats were injected with
      lithium chloride after being allowed to drink a 3% corn starch suspension. These
      rats subsequently avoided corn, potato, rice, and waxy maize (high-amylopectin)
      starch but did not avoid 0.1-3% Polycose Rats treated with lithium chloride after
      ingesting 3% Polycose avoided 3% and 0.5% Polycose, but they did not avoid 3%
      corn starch, 6% corn starch, or 3% waxy maize starch. These results indicate that
      rats can discriminate between starch and Polycose (maltooligosaccharides). It
      therefore seems likely that Polycose and starch have different sensory qualities.

PMID- 1745685
TI  - Duration of mating relates to fertility in mice.
AB  - In normal mating, house mice vary dramatically in the number and duration of
      intromissions that precede ejaculation. Also, some proportion of inseminations
      typically fails to yield litters. The present studies involved systematic
      observations of matings of females in natural estrus with males of proven
      fertility. After standardized observation of mating behavior culminating in
      ejaculation and a sperm plug, females were allowed to produce litters in
      undisturbed conditions. In two replications, greater numbers of intromissions and
      a longer latency from first intromission to ejaculation both correlated
      positively with litter size.

PMID- 1745686
TI  - A system for automated recording and analysis of feeding behavior.
AB  - We have designed and implemented a system that utilizes a network of top-loading
      balances digitally interfaced to a Macintosh computer. The system simultaneously
      collects two forms of data which allow the evaluation of the animal's biting
      and/or licking behavior in addition to cumulative food intake and meal patterns.
      The system is capable of resuming data acquisition following a power failure
      without user intervention. Plexiglas cages utilized with the system features
      adjustable tunnel feeders and are appropriate for use with small rodents. Given
      appropriate caging, the system may be utilized to evaluate the feeding behavior
      of other species.

PMID- 1745687
TI  - Differential effects of unilateral optic tract transections and visual cortical
      lesions upon a pattern discrimination in albino rats with removal of one eye at
      birth.
AB  - Previously we have demonstrated that adult rats with one eye removed at birth
      (OEB) relearn a black-white discrimination faster than control rats monocularly
      enucleated at maturity (OET), when relearning is conducted after lesions of the
      visual cortex contralateral to the remaining eye. This faster relearning
      phenomenon is considered to be one behavioral expression of the functioning of
      the expanded uncrossed visual pathways resulting from monocular at birth. The
      present study was concerned with the question of whether the same phenomenon can
      be observed in the discrimination between alternating black and white stripes
      oriented horizontally and vertically. Two experiments were carried out. In the
      first experiment, which is a replication of one of our previous studies,
      relearning was conducted after the visual cortical lesions contralateral to the
      remaining eye. The results were consistent with those of the previous one in
      which neither OEBs nor OETs were found able to relearn the discrimination. In the
      second experiment, relearning was conducted after transections of the optic tract
      contralateral to the remaining eye. It was shown that under this condition both
      OEBs and OETs could relearn the discrimination, and furthermore, that OEBs
      restored the habit faster than OETs. Possible mechanisms underlying the
      difference in the results from the two experiments were discussed.

PMID- 1745688
TI  - Cholecystokinin promotes sleep and reduces food intake in diabetic rats.
AB  - It has been reported that systemic injections of cholecystokinin (CCK) elicit the
      behavioral characteristics of satiety, including sleep, in rats. CCK is a potent
      stimulator of insulin secretion, and insulin is hypothesized to be involved in
      sleep and feeding regulation. The purpose of the current experiments was to study
      the possible role of endogenous insulin in the food-intake-reducing and
      hypnogenic effects of intraperitoneally (IP) administered CCK. Normal and
      streptozotocin (STR)-diabetic rats were injected with isotonic saline or CCK (10
      and 50 micrograms/kg) at dark onset, and sleep-wake activity was determined for
      the next 12 h. There were no significant differences between the baseline sleep
      wake activity of normal and diabetic rats. IP injection of CCK elicited a
      selective increase in nonrapid-eye-movement sleep in both groups during the first
      postinjection hour. In a separate experiment, the effects of CCK (10
      micrograms/kg) on food intake were determined in control and diabetic rats; CCK
      suppressed the 1-h food intake in both groups. In a third experiment, the effects
      of CCK treatment (50 micrograms/kg) on plasma insulin levels were determined. In
      normal rats, CCK elicited a two-fold increase in plasma insulin concentration,
      whereas diabetic rats had a significantly lower basal insulin level which was not
      affected by CCK treatment. We conclude that hypnogenic and food-intake-reducing
      effects of exogenously administered CCK are closely associated; however,
      pancreatic insulin does not play a significant role in either of these effects.

PMID- 1745689
TI  - Possible interaction between the inferior colliculus and the substantia nigra in
      audiogenic seizures in Wistar rats.
AB  - Male Wistar rats were tested for sensitivity to audiogenic seizures (AS; 110 dB),
      using an audiogenic severity index (SI). Sensitive (S) animals were subjected to
      bilateral lesion of the inferior colliculus (IC) and/or the lateral lemniscus
      (LL). Resistant (R) animals were subjected to bilateral lesions of the IC,
      unilateral sequential lesions of the substantia nigra reticulata (SN) and/or IC
      (contralateral to one another), and unilateral thalamic and sham lesions.
      Bilateral lesions of the IC and LL abolish AS in S rats. Lesion of the SN
      resulted in more pronounced sensitivity to AS than unilateral lesion of IC, in R
      rats. When the SN lesion was contralateral to a previous IC lesion, the effect
      was not only an increase in the SI, but also a reversal of the asymmetry
      generated by IC lesion. Although the behavioral effects resulting from IC lesions
      are due to alterations in the primary structures involved in the origin of AS,
      unilateral SN lesions can alter critical substrates of sensorimotor integration
      involved in the control and expression of AS.

PMID- 1745690
TI  - Antide (Nal-Lys GnRH antagonist) suppression of pituitary-testicular function and
      sexual behavior in group-living rhesus monkeys.
AB  - The ability of a Nal-Lys gonadotropin releasing-hormone antagonist (Antide) to
      suppress pituitary-testicular function and male sexual behavior was studied in
      seven group-living adult male rhesus monkeys. Each male received a single 15
      mg/kg b.wt. subcutaneous injection of Antide dissolved in equal volumes of
      propylene glycol and sterile water. Prior to Antide treatment, and at two, four,
      and eight weeks after Antide, males received an IV bolus of GnRH (50 ng/kg) to
      assess pituitary and testicular function. For four weeks before and eight weeks
      after Antide treatment, blood samples and behavioral observations were collected
      three times weekly in a 74-member heterosexual group. Antide levels increased to
      more than 150 ng/ml 24 h postinjection and remained above 15 ng/ml for 30 days
      postinjection. Circulating LH and T were significantly reduced within 24 h
      following Antide, and remained significantly lower than pretreatment levels in
      all males for 5 weeks after Antide. T levels rose above 1 ng/ml while Antide
      levels were still significantly elevated in four males. Both LH and T returned to
      pretreatment levels by seven weeks post-Antide and then showed a second
      significant decrease during the eighth study week. Pituitary responsiveness to
      exogenous GnRH was reduced by Antide and remained below pretreatment levels eight
      weeks after Antide treatment. Testosterone secretion in response to exogenous
      GnRH was significantly reduced at two and four weeks post-Antide, but was at
      pretreatment levels by eight weeks after Antide. Male sexual behavior declined
      significantly within one week after Antide treatment, almost ceased completely by
      four weeks after Antide, and returned to pretreatment levels by seven weeks post
      Antide.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745691
TI  - Thermal stress modulates temporal patterns of responding on a multiple DRL-FR
      schedule.
AB  - To investigate temporal changes in behavior induced by moderate cold
      temperatures, rats performing on a multiple differential-reinforcement-of-low
      rate (DRL) fixed-ratio (FR) schedule were exposed to ambient temperatures of 2,
      8, 16, and 24 degrees C. DRL response rates markedly increased with decreasing
      cold temperatures, while FR response rates remained unchanged. In addition, as
      ambient temperatures decreased, the interresponse time (IRT) distribution of DRL
      responses shifted toward shorter times and short IRT bursts increased. Compared
      with cold effects, exposure to 38 degrees C heat induced decreases in both DRL
      and FR response rates which were associated with increases in long IRTs.
      Decreases in reinforcement frequency was associated only with the DRL schedule in
      cold, and with both DRL and FR schedules during heat exposures. The distinct
      effects of cold and heat on both DRL and FR responding suggest that the increases
      in DRL response rates and shifts in IRT distribution are unique to cold, and are
      not due to general effects of nonspecific thermal change in the ambient
      environment.

PMID- 1745692
TI  - Rapid reentrainment of the circadian clock itself, but not the measurable
      activity rhythms to a new light-dark cycle in the rat.
AB  - Experiments were performed to determine if the circadian clock reentrains more
      quickly to an 8-hour phase shift in light-dark (LD) cycles than does the overt
      rhythm of activity. To investigate the reentrainment of the clock itself to an 8
      hour advance or delay in the LD cycle, the rats were released into constant
      darkness only two or three days after a shift in LD cycle, and the amount of the
      phase shift of the clock itself was estimated from where free-running rhythm
      started by backward extrapolation. If the circadian clock could rapidly reset
      itself to the new LD cycle, it was predicted that the free-running rhythm of
      activity would start from near the dark period of the new LD cycle rather than
      the preceding one. When rats were released into constant darkness three days
      after the LD cycle was advanced by 8 hours, the activity of the free-running
      rhythm started near time of dark period of the new LD cycle in all rats (n = 16).
      When rats (n = 24) were released into constant darkness two days after the LD
      cycle was advanced by 8 hours, 12 rats started the activity near time of dark
      period of the new LD cycle, while 9 rats started the activity near time of dark
      period of the preceding LD cycle. The remaining 3 rats showed the activity of the
      free-running rhythm near intermediate phase (transient phase). On the other hand,
      when the rats were not released into constant darkness after LD cycle was
      advanced by 8 hours, it took 6.4 days for activity rhythm to reentrain to the
      advanced LD cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745693
TI  - Maintenance and decline of the suppression of infanticide in mother rats.
AB  - Virgin female rats kill foster neonates, whereas newly parturient mothers do not.
      We demonstrated previously that this tendency to kill is suppressed shortly
      prepartum, presumably by physiological factors. In this study, we show that a)
      suppression of infanticide is maintained through the first two weeks of
      lactation; b) the mothers that do not kill foster neonates are not necessarily
      the same mothers that respond maternally toward older foster pups, and those that
      kill neonates are not necessarily the same ones that are nonmaternal to older
      pups, the two behaviors being somewhat independent; and c) some virgins can be
      induced to be noninfanticides by prolonged exposure to young, but only under
      special testing conditions not required by actual mothers, which are nonkillers
      of foster young. This suggests that the maintenance of the suppression of
      infanticide in mothers owes something to the special circumstances of lactation
      other than continued exposure to young.

PMID- 1745694
TI  - Rapid odor conditioning in newborn rabbits: amnesic effect of hypothermia.
AB  - Rabbit pups are completely dependent on a maternal pheromone for the release of
      suckling behavior. However, if the mother is perfumed prior to nursing, pups will
      learn to respond to the novel odor with the characteristic nipple-search behavior
      in just one 3-4 min nursing episode. In a first investigation of the processes
      underlying this recently developed learning paradigm, time-dependent effects of
      hypothermia on retention of the task could be demonstrated. Thus pups whose whole
      body was cooled to a mouth temperature of 7 degrees C immediately after
      conditioning (n = 10) and tested 24 h later for 3 min on a perfumed fur did not
      differ significantly in their search response from naive, untreated controls (n =
      10). In contrast, pups cooled 4 h after conditioning (n = 10) demonstrated clear
      retention of the learned response and searched as vigorously as conditioned but
      uncooled animals (n = 10). As pups of all groups demonstrated normal nipple
      search behavior when tested on a lactating doe, the deficits associated with
      immediate cooling appear to have been specific to the learning task and time of
      treatment.

PMID- 1745695
TI  - Lipopolysaccharide increases ambient temperature preference in C57BL/6J adult
      mice.
AB  - The hypothesis was tested that animals exposed to a potentially dangerous
      endotoxin would attempt to behaviorally elevate their body temperature, perhaps
      in an effort to engage those immunological mechanisms which would counter the
      adverse effects of the endotoxin. Lipopolysaccharide (LPS) from Escherichia coli
      injected subcutaneously (100 micrograms) in adult C57BL/6J mice increased
      gradient temperature preference by 2.4 degrees C over saline controls. The
      increase in body temperature of 1.1 degrees C after LPS injection was due to the
      preference for higher ambient temperatures and was not the result of a systemic
      reaction to LPS (animals not exposed to the gradient did not differ in body
      temperature). In summary, our data indicate that adult mice self-induce a febrile
      response, perhaps as an attempt to compensate for the physiological impact of the
      endotoxin.

PMID- 1745696
TI  - Community-based psychiatry: long-term patterns of care in South-Verona.
AB  - Community-based psychiatry has attracted a wide interest in the last 20 years.
      However, the evidence in the literature on monitoring and evaluating community
      psychiatric services for a long period of time is scanty. The aim of this
      monograph is to present the results of a number of evaluative studies, covering a
      ten-year period, conducted in South-Verona, an area of 75,000 inhabitants in
      Northern Italy, where a new community-based system of care, the South-Verona
      Community Psychiatric Service (CPS), has operated since 1978. This system, which
      is based on the provisions of the Italian psychiatric reform, is alternative to
      the old hospital-centred system of care, and provides care and support to all
      types of patients, without back-up from the mental hospital, where only a few old
      long-stay in-patients continue to reside. In the first part of the monograph,
      trends in the provision of psychiatric care in the period 1979-1988 are
      presented, using the South-Verona Psychiatric Case Register (PCR). Both one-day
      and one-year prevalence figures and incidence rates are lower than in other
      register areas outside Italy, partly because of the smaller number of specialized
      out-patient services available in South-Verona and partly because of less use of
      in-patient care in our area. Moreover, there is a tendency in Italy to care for
      elderly patients in geriatric institutions outside the psychiatric system. Most
      of the patients seen in any year are treated without in-patient care. This
      applies to all diagnostic groups, except affective psychosis. Rates of compulsory
      admission dropped dramatically after the reform. The total number of admissions
      to all in-patient psychiatric facilities (including private hospitals) in 1988 is
      only 8.4% lower than that found in 1977 (one year prior to the reform), while the
      mean number of occupied beds in 1988 was 47% lower than in 1977. In South-Verona
      point-prevalence of long-stay in-patients has slowly decreased over the years and
      there is a negligible build-up of new long-stay in-patients. The South-Verona CPS
      is now taking care of most psychiatric patients who, before the reform, would
      have been admitted to the mental hospital and become long-stay. These patients,
      who may be defined as long-term patients in the community, have consistently
      accumulated since 1981 and are making high use of psychiatric community
      services.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1745697
TI  - Testicular function, social rank and personality among wild baboons.

PMID- 1745698
TI  - Cortisol escape from suppression by dexamethasone during depression is strongly
      predicted by basal cortisol hypersecretion and increasing age combined.
AB  - We determined baseline 0800h plasma cortisol concentrations, 24-hr urinary free
      cortisol (UFC) excretion, the post-dexamethasone cortisol values at 0800h and
      1600h, and the 0800h dexamethasone concentrations in 60 depressed patients
      categorized according to the DSM-III. Up to 59% of the variability in the 0800h
      post-dexamethasone cortisol values could be explained by the multiple regression
      on UFC, 0800h basal plasma cortisol, age (all positively related), and
      dexamethasone concentrations (negatively related). The 1600h post-dexamethasone
      cortisol data were best explained (i.e., 55% of the variance) by the multiple
      regression on basal plasma cortisol, UFC (positive) and dexamethasone (negative).
      After controlling for UFC, baseline plasma cortisol, and age no significant
      effects of the depressive state (diagnostic classification or severity of
      illness) on the post-dexamethasone cortisol values could be detected. It can be
      deduced that cortisol non-suppression during depression is related strongly to
      baseline cortisol hypersecretion and increasing age. These factors are additive
      and contribute independently towards cortisol escape from suppression by
      dexamethasone.

PMID- 1745699
TI  - The relationship between testosterone levels and cognitive ability patterns.
AB  - The cognitive performance of normal men and women was studied, grouped according
      to whether the subjects had relatively high or low salivary testosterone (T)
      concentrations. Men with lower T performed better than other groups on measures
      of spatial/mathematical ability, tasks at which men normally excel. Women with
      high T scored higher than low-T women on these same measures. T concentrations
      did not relate significantly to scores on tests that usually favor women or that
      do not typically show a sex difference. These results support suggestions of a
      nonlinear relationship between T concentrations and spatial ability, and
      demonstrate some task specificity in this respect.

PMID- 1745700
TI  - Psychological and serum homovanillic acid changes in men administered androgenic
      steroids.
AB  - We report a difference in the response of serum homovanillic acid (HVA) and in
      the performance of some psychological tasks before and after the administration
      of testosterone enanthate (TE, 100 or 300 mg/wk) or nandrolone decanoate (ND, 100
      or 300 mg/wk) for 6 wk to healthy men. Serum HVA was significantly increased in
      both the low- and high-dose ND groups, from 8.4 +/- 1.0 and 8.7 +/- 0.5 pmol/ml
      (mean +/- SE) to 11.6 +/- 1.7 and 10.7 +/- 1.1 pmol/ml respectively. No
      significant changes in HVA were observed for the groups administered TE, nor in 5
      HIAA for any of the groups. The influence of ND on the dopaminergic system, which
      is reflected in increased serum HVA, appears to be independent from the
      psychological effects which were produced by both androgens. The only change in
      psychomotor test performance was an improvement in the first trial of a pegboard
      task. All subjects except those receiving ND (100 mg/wk) were significantly more
      optimistic in the prediction of their own performance for all nondominant hand
      tasks (pegboard and finger tapping). The "hostility" and "resentment and
      aggression" subscales of the MMPI increased significantly in all groups, more so
      in the high-dose groups.

PMID- 1745701
TI  - Two studies of menstrual synchrony: negative results.
AB  - In 1971 McClintock reported menstrual synchrony in pairs and groups of women who
      spent time together. The two studies reported herein, based on the methods and
      research design introduced by McClintock, fail to replicate her results. The
      first study is of a sample of 132 women who were sorority members or roommates of
      sorority members living on the campus of a large coeducational state university.
      The second study is of a sample of 24 women who were members of a cooperative
      house near the same university. In the subjects from both studies, the final mean
      onset absolute difference is greater than the initial mean onset absolute
      difference, and there are more nonsynchronous pairs of subjects than synchronous
      pairs. The sample from the sorority study was progressively reduced to exclude
      those subjects with irregular menstrual cycle lengths and those pairs in which
      one subject was taking oral contraceptives. Menstrual synchrony did not emerge in
      the reduced sample. Thus, whether or not menstrual synchrony occurs among women
      who spend time together should still be considered a hypothesis requiring further
      investigation.

PMID- 1745702
TI  - GH response to GHRH before and after meals at different hours of the day in obese
      patients.
AB  - In normal subjects several factors are involved in the regulation of the GH
      response to GHRH, such as nutritional status, metabolic fuels and
      neurotransmitters. We previously have shown a paradoxical increase in the GH
      response to GHRH after meals in obese patients, in contrast to the blunted GH
      response observed after feeding in normal subjects. We have further investigated
      this phenomenon, studying the GH response to GHRH before and after meal at three
      different hours during the day in 10 obese patients, aged 18-35 yr, in comparison
      to that in eight normal women, aged 20-35 yr. GHRH was injected in a fasting
      state or 1 hr after a standard meal (800 KCal). In obese subjects, after food
      ingestion the peak GH response to GHRH was increased at 0900h and 1300h and was
      significant when the patients were tested after lunch (1300h). On the contrary,
      in the evening the GH response to GHRH remained unchanged, both before and after
      feeding. These data point to an altered sensitivity of GH secretion to metabolic
      signals in patients with obesity.

PMID- 1745703
TI  - Chronic opioids impair acquisition of both radial maze and Y-maze choice escape.
AB  - Chronic morphine impaired acquisition of two dissimilar behavioral tasks. In the
      radial maze, the performance of saline-treated and morphine-treated groups
      diverged with the latter failing to improve despite extensive training. In
      contrast, rats treated with naltrexone became skilled in the procedure 2-4 times
      as rapidly as saline controls. Withdrawal of treatment significantly improved
      performance of morphine-treated rats, with no change for rats treated with saline
      or naltrexone. When a second group of rats was extensively trained prior to
      instituting chronic morphine treatment, performance scores were not affected,
      suggesting that morphine does not impair spatial working memory despite
      subjective evidence of other gross behavioral effects, such as ataxia. In the Y
      maze choice escape task, acquisition of a response strategy was significantly
      impaired in rats that had been previously treated with morphine for 17-21 days,
      despite clear indications that morphine-treated rats were sensitive to the
      aversive stimulus.

PMID- 1745704
TI  - Does metergoline selectively attenuate 5-HT mediated prolactin release?
AB  - Administration of the non-selective 5-HT receptor antagonist metergoline (0.5
      mg/kg) to male rats attenuated the prolactin response to the 5-HT releasing agent
      d-fenfluramine (7.5 mg/kg) but not to the dopamine receptor antagonist
      haloperidol (1.5 mg/kg). In contrast, in healthy male volunteers, pretreatment
      with metergoline (4 mg orally) abolished the prolactin response to intravenous
      haloperidol (5 micrograms/kg). The findings suggest that in humans blockade of a
      prolactin response by a conventional oral dose of metergoline cannot be taken as
      evidence of involvement of 5-HT-mediated mechanisms.

PMID- 1745705
TI  - Evidence that genetic differences in habituation and GABAergic mechanisms may be
      related to sensitivity to ethanol and development of ethanol tolerance in mice.
AB  - Habituation to a test environment following daily exposure for 5 days was
      examined in three genetically different strains of mice. C57 animals showed
      significant habituation to the new environment already on the second day. The
      habituation of NMRI mice was significant on the third day, whereas CBA mice
      showed no habituation at all during the experimental period. There was no
      difference between the animal strains in learning capacity in a passive avoidance
      test, but CBA mice displayed a significant increase in latency in their
      performance. When tested for sensitivity to the convulsant actions of GABAergic
      antagonists, picrotoxin produced seizures at lower doses in CBA as compared to
      NMRI and C57 mice, whereas there was no difference between the strains in the
      seizure activity produced by the specific GABA receptor antagonist bicuculline.
      When the animals were tested for sensitivity to ethanol in a horizontal wire
      test, ethanol (2 g/kg, IP) produced muscle relaxation in CBA mice whereas the
      performance of NMRI and C57 was not affected. A large dose of ethanol (4 g/kg,
      IP) produced a significantly longer sleeping time in CBA mice as compared to NMRI
      and C57 animals. Ethanol-produced hypothermia was, however, similar in all
      animals. Environment-dependent development of tolerance to ethanol following
      daily injections of ethanol for 4 days was examined. C57 mice showed the most
      rapid development of tolerance towards ethanol's hypnotic actions, whereas CBA
      mice showed no tolerance to this effect of ethanol. No difference between the
      strains to the development of tolerance to ethanol's hypothermic effects was
      observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745706
TI  - Reversal by tetrahydroaminoacridine of scopolamine-induced memory and performance
      deficits in rats.
AB  - The effects of the cholinesterase inhibitors physostigmine and
      tetrahydroaminoacridine (THA) on memory and performance deficits induced by
      scopolamine were studied using an operant delayed non-matching to position task.
      No effect was seen on the performance of rats when treated with either
      physostigmine (0.1 mg/kg IP) or THA (1 mg/kg IP) alone. However, the performance
      deficits induced in the task by scopolamine (0.03 mg/kg SC) were reversed by the
      same doses of the cholinesterase inhibitors.

PMID- 1745707
TI  - Differential effects of caffeine on free recall after semantic and rhyming tasks
      in high and low impulsives.
AB  - The effects of caffeine on free recall after acquisition on semantic and rhyming
      tasks were examined. Following a between-subjects design, high and low impulsive
      male postgraduate students were administered placebo and four doses of caffeine
      citrate (1, 2, 3 and 4 mg/kg body weight) in a laboratory situation. A double
      blind procedure was adopted for drug administration. The study supports the
      following conclusions: (1) under no drug condition, high impulsives recall more
      after semantic acquisition while their counterparts, the low impulsives, recall
      more after rhyming acquisition; (2) caffeine facilitates recall in high
      impulsives after rhyming acquisition but hinders it after semantic acquisition;
      (3) caffeine does not reliably influence recall of low impulsives.

PMID- 1745708
TI  - The Hillside Akathisia Scale: a reliability comparison of the English and German
      versions.
AB  - Akathisia usually consists of two components, subjective restlessness and typical
      movements such as shuffling of the legs, pacing, shifting weight from one leg to
      the other, and rocking movements of the trunk. The ability to measure akathisia
      reliably is essential for the assessment of treatments for akathisia and for the
      evaluation of drug-induced side effects in general. To date, investigators have
      generally used self-constructed assessment scales without reporting data about
      reliability or validity. The Hillside Akathisia Scale (HAS) has two subjective
      and three objective items for which anchored rating points are provided.
      Reliability was 0.89 for the HAS total score. Reliability for rating subjective
      symptoms ranged from 0.86 to 0.92, and the objective scores ranged from 0.51 to
      0.89. The correlation between HAS and a global assessment of akathisia (modified
      CGI) was 0.87. These values compare favorably with the original report on the
      scale indicating that the Hillside Akathisia Scale can validly quantify akathisia
      with a satisfactory degree of interrater reliability.

PMID- 1745709
TI  - Effects of nifedipine pretreatment on subjective and cardiovascular responses to
      intravenous cocaine in humans.
AB  - The effects of oral nifedipine pretreatment on subjective and cardiovascular
      responses to intravenous cocaine infusions were studied in cocaine-using
      volunteers. Nifedipine, 10 mg or placebo, was administered 20-25 min before
      placebo, 20 mg, or 40 mg cocaine, using a repeated measures randomized double
      blind design. The variables measured were self-reported subjective effects,
      general behavior rated by two observers, blood pressure and heart rate. Cocaine
      produced the expected dose-related effects on subjective and cardiovascular
      measures. Nifedipine pretreatment attenuated some subjective effects of cocaine.
      Nifedipine directly reduced blood pressure but did not antagonize the effects of
      cocaine on blood pressure. These findings suggest that dihydropyridine calcium
      channel modulators may be useful compounds in the clinical management of cocaine
      users.

PMID- 1745710
TI  - Perphenazine decanoate and cis(z)-flupentixol decanoate in maintenance treatment
      of schizophrenic outpatients. Serum levels at the minimum effective dose.
AB  - Two groups of schizophrenic outpatients were treated with perphenazine decanoate
      (N = 20) and cis(z)-flupentixol decanoate (N = 24) respectively. Every 3 months
      the dose was gradually reduced until symptoms appeared that were suggestive of a
      prodromal phase of a psychotic episode. A slightly higher dose was then promptly
      reinstituted (the minimum effective dose). At each dose level, two blood samples
      were drawn for determination of serum concentration. The mean minimum effective
      dose of perphenazine decanoate was 99.3 mg/2 weeks (range 21.6-270.5), while the
      mean minimum effective dose of cis(z)-flupentixol decanoate was 60 mg/2 weeks
      (range 20-250). The corresponding mean serum level of perphenazine decanoate was
      7.3 nmol/l (range 2.0-18.1) and of cis(z)-flupentixol decanoate 7.8 nmol/l (range
      1.2-37.0). There was a significant correlation between the administered doses and
      the corresponding serum levels for both drugs (r = 0.87, P less than 0.01). A
      weak positive correlation was found between serum levels at the minimum effective
      dose and symptom intensity (BPRS total score) (r = 0.53, P less than 0.02) for
      perphenazine, but not cis(z)-flupentixol. No correlation was found between serum
      levels and side effects or length of neuroleptic treatment. It is concluded that
      the serum drug concentrations corresponding to the lowest effective dose are so
      variable that routine serum level monitoring may be of limited value in the long
      term maintenance treatment of schizophrenia.

PMID- 1745711
TI  - Effect of sucrose consumption on alcohol-induced impairment in male social
      drinkers.
AB  - Two studies were conducted to examine the interaction between sucrose and ethanol
      in normal young fasting adult males. The first experiment employed a 3 (100 g
      sugar, 35 g sugar, 0 g sugar) x 3 (alcohol, placebo and sober) factorial design,
      which was carried out double-blind using aspartame to ensure that all the drinks
      were equally sweet. Subjects were tested for mood, memory, subjective
      intoxication and psychomotor performance at baseline and at times up to 3.5 h
      after ingestion of the drinks. An alcohol by sugar interaction was seen at 0.5
      after drinking. Sugar attenuated alcohol intoxication at this time without
      influencing blood alcohol levels. Contrary to previous reports, the combination
      of alcohol and sugar failed to produce significant hypoglycemia, or any of the
      adverse behavioral effects associated with hypoglycemia, at later times after
      drink ingestion. The second experiment involved a simpler design, carried out
      single-blind in which the subjects receiving no sugar did not get aspartame. This
      was to rule out the possibility that aspartame was exacerbating alcohol
      intoxication instead of sugar attenuating it. The second experiment also showed
      that sugar can attenuate alcohol intoxication in fasting humans without altering
      blood alcohol levels significantly.

PMID- 1745712
TI  - Naloxone modulates the behavioral effects of cholinergic agonists and
      antagonists.
AB  - Peripheral glucose administration enhances memory in rodents and humans. Recent
      findings suggest that glucose may affect behavior, in part, by augmenting central
      cholinergic functions and by attenuating central opiate functions. The present
      experiments examined interactions between an opiate antagonist, naloxone, and
      cholinergic agents to determine whether the effects would parallel those found
      with glucose. Three behavioral measures were assessed: tremors, hyperactivity,
      and spontaneous alternation. Naloxone (1 mg/kg) significantly augmented tremors
      elicited by physostigmine (0.3 mg/kg). Naloxone (1 mg/kg) also attenuated
      increases in locomotor activity and impairments in spontaneous alternation
      performance elicited by scopolamine (1 and 3 mg/kg for activity and alternation
      measures, respectively). Thus, across three diverse measures, naloxone produced
      effects similar to those previously reported for glucose. These findings are
      consistent with the hypothesis that release of cholinergic activity from opiate
      inhibition may contribute to glucose effects on behavior.

PMID- 1745713
TI  - Sensitivity and tolerance to nicotine in smokers and nonsmokers.
AB  - We studied the responses of smokers and lifelong non-smokers to transdermal
      nicotine patches over 24 h in three groups of subjects: non-smokers on a 15 mg
      patch (n = 8), non-smokers on a 30 mg patch (n = 8) and smokers on a 30 mg patch
      (n = 8). Unexpectedly, the non-smokers appeared to absorb nicotine more rapidly.
      The increase in blood nicotine concentrations of non-smokers over the first 2 h
      of patch use was double that of the smokers, with mean increases of 4.5 (SD =
      3.7), 10.9 (SD = 4.2) and 4.1 (SD = 2.7) ng/ml in the three groups, respectively
      (P less than 0.005). The smokers had no pleasant or unpleasant effects from the
      30 mg patch (X Cmax 13.9 ng/ml, SD = 4.9; Tmax 8.75 h) but all eight non-smokers
      experienced mild nausea and lightheadedness (P less than 0.01) within the first
      hour, and seven dropped out (P less than 0.01) at 3-8 h due mainly to severe
      nausea, vomiting or headache (X Cmax 18.4 ng/ml, SD = 4.9; Tmax 5.25 h). Only one
      non-smoker dropped out on the 15 mg patch, but five had transient nausea in the
      first hour (X Cmax 7.9 ng/ml, SD = 3.0; Tmax 8.0). Our study provides evidence of
      chronic pharmacodynamic nicotine tolerance in smokers, but does not address
      whether this is acquired or innate. The higher rate of transdermal nicotine
      absorption in non-smokers is unexplained and requires replication.

PMID- 1745714
TI  - Dissociation of multiple effects of acute LSD on exploratory behavior in rats by
      ritanserin and propranolol.
AB  - Rats tested for 1 h in the Behavioral Pattern Monitor (BPM) after injection of
      the mixed serotonergic agonist d-lysergic acid diethylamide (LSD) exhibit a
      behavioral profile similar to that produced by various hallucinogenic 5HT-2
      agonists. The characteristic effects of the hallucinogens include suppression of
      locomotor and exploratory behavior and a preferential decrease in entries into
      the center of the BPM during the initial half of the test session. After LSD, the
      initial suppression of responding is followed by a subsequent increase in
      locomotor activity that is not observed with other serotonergic agonists. In the
      present studies, the 5HT-1 and beta-adrenergic antagonist d,l-propranolol and the
      5HT-2 antagonist ritanserin were administered individually or in combination
      prior to the acute administration of LSD to test for the involvement of these
      receptor subtypes in the mediation of the effects of LSD in the BPM paradigm.
      Propranolol (20 mg/kg) abolished the initial suppression of activity induced by
      60 micrograms/kg LSD without affecting the subsequent increase in locomotion.
      Conversely, 2.0 mg/kg ritanserin failed to block the initial suppressive effects
      of 60 or 120 micrograms/kg LSD, but attenuated the LSD-induced increases in
      activity during the second half of the session. The combination of propranolol
      and ritanserin prevented both these effects of LSD. By contrast, the more
      selective 5HT-2 agonist 2,5-dimethoxy-4-iodoamphetamine (DOI) (0.27 mg/kg)
      produced an initial suppression of activity in the BPM that was blocked by 2.0
      mg/kg ritanserin and was not followed by a subsequent increase in activity.
      (ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745715
TI  - Dose-dependent effects of intravenous lorazepam on cardiovascular activity,
      plasma catecholamines and psychological function during rest and mental stress.
AB  - Dose-dependent effects of intravenously administered lorazepam on
      psychophysiological activity during rest and mental stress were studied in order
      to examine differential responses to doses which may induce anxiolysis or
      sedation. In a double-blind randomized cross-over study, nine male volunteers
      participated in a placebo and a lorazepam session, during which the subjects
      repeatedly performed a 10-min version of the Stroop Color Word Test (CWT), with
      10 min of rest between the CWTs. Lorazepam was administered before each rest
      period in increasing doses of 0.0, 0.6, 0.13, 0.25 and 0.5 mg (total cumulative
      dose: 0.94 mg). Heart rate showed a dose-dependent decrease during rest with an
      ED50 of 0.13 mg lorazepam, while lorazepam had no effect on the cardiovascular
      and plasma catecholamine response magnitudes to the CWT. Subjective fatigue and
      reaction time increased significantly after 0.94 mg lorazepam, while at the same
      dose vigor decreased; state anxiety after the CWT was not influenced by
      lorazepam. These data show differential effects of lorazepam on cardiovascular,
      biochemical and psychological function. While heart rate was suppressed at low
      doses during rest and reaction time and subjective fatigue increased at doses
      which induced sedation, state anxiety and physiological response patterns to the
      CWT were not influenced by lorazepam.

PMID- 1745717
TI  - Scopolamine attenuates the motor disruptions but not the attentional disturbances
      induced by haloperidol in a sustained attention task in the rat.
AB  - Rats were trained to perform a sustained attention task that required the subject
      to insert its head into a cylindrical "observation tunnel" and wait for the
      presentation of one of three spatially separated visual stimuli located on the
      upper portion of the tunnel circumference. Detection of a briefly (0.125 s)
      presented "correct" stimulus, followed by the rats' forward nose poke, resulted
      in access to a reinforcement dipper lifted through the orifice in the floor of
      the tunnel. Nose pokes to the two incorrect stimuli resulted in a 5-s time-out
      period. The task maximized attention and minimized movement requirements.
      Performance was characterized in terms of accuracy (i.e. errors of omission, and
      errors of commission), time on task, and latency to respond to the stimuli (i.e.,
      reaction time). Haloperidol (0.04, 0.08, and 0.16 mg/kg) increased errors of
      omission and reaction time. However, lack of significant correlations between
      these two measures suggested that attentional accuracy may be independent of
      motor slowing produced by this neuroleptic. Scopolamine (0.2 mg/kg) alone
      increased both errors of omission and commission, but did not affect reaction
      time to correct stimuli. The sustained attention task as implemented here may be
      useful in the simultaneous study of classical neuroleptics desirable and
      undesirable CNS effects.

PMID- 1745716
TI  - Assessment of ethanol's hedonic effects in mice selectively bred for sensitivity
      to ethanol-induced hypothermia.
AB  - Mice selectively bred for sensitivity (COLD) or insensitivity (HOT) to the
      hypothermic effect of ethanol were tested in three tasks purported to assess
      ethanol's hedonic properties: place conditioning, taste conditioning, and ethanol
      drinking. In the place conditioning task, distinctive tactile (floor) stimuli
      were differentially paired with injection of ethanol (2.25 g/kg) or saline, and
      preference for the tactile stimuli was assessed during a choice test without
      ethanol. In the taste conditioning task, fluid-deprived mice were given repeated
      access to saccharin followed by injection of ethanol (2.25 g/kg). In the drinking
      task, mice were given access on alternate days to a single drinking tube
      containing water or ethanol in a concentration that gradually increased from 1 to
      12% (v/v) over days. HOT mice showed greater conditioned preference for ethanol
      paired flavor cues, and greater aversion for ethanol-paired flavor cues, and
      drank less ethanol at concentrations above 5% than COLD mice. HOT mice also
      showed higher levels of ethanol-stimulated activity than COLD mice. Control
      experiments indicated that the lines did not differ in initial preference for the
      tactile and flavor stimuli used in the conditioning tasks. Because the same line
      differences were seen in mice selected from two genetically independent
      populations, these studies offer strong evidence of genetic correlations between
      ethanol's thermal effect and its effect on activity, place conditioning and taste
      conditioning. Evidence of a genetic correlation between ethanol's thermal effect
      and ethanol drinking, however, is weaker since it is based on a line difference
      observed in only one of the genetic replicates. (ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745718
TI  - A model of cardiovascular activation components for studies using autonomic
      receptor antagonists.
AB  - Alpha-adrenergic, beta-adrenergic, and cholinergic responses are often considered
      important activation components when conceptual and empirical analyses are made
      of single physiological variables and of patterns of cardiovascular reactivity;
      these autonomic distinctions are also of particular significance in autonomic
      blockade studies. A Model of Cardiovascular Activation Components is introduced
      that relates these components to both the measured cardiovascular variables and
      the protocol of autonomic blockade studies. It is pointed out that a restricted
      form of the complete model is often implicitly used in cardiovascular
      psychophysiology. The differential consequences of an erroneous employment of the
      restricted model are discussed for single and dual blockade protocols. Critical
      evaluations of autonomic blockade as a tool in cardiovascular psychophysiology
      are examined and are proposed to be often the consequence of the restricted model
      assumptions. Lastly, the utility of the Activation Components Model for a
      componential description of tasks and for componential intertask relationships is
      illustrated with data from the literature.

PMID- 1745719
TI  - Behavioral modulation patterns fit an animal model of vagus-cardiac pacemaker
      interactions.
AB  - The present study used a computer model of the dynamic interaction between the
      vagus nerve and the sinoatrial pacemaker membrane potential in the heart of the
      rabbit to reconstruct heart rate changes under vagal excitation conditions. We
      asked whether a hypothetical pattern of vagal acetylcholine (ACh) release, which
      was based on human heart rate results in a reaction time task, could be fit to
      this model. The reconstructed heart rate results showed changes that were highly
      consistent with experimental human heart rate changes. The model reliably
      reproduced effects of parameters such as intrinsic heart rate level, ACh stimulus
      intensity, and ACh stimulus duration. In addition, the effects of anticipatory
      vagal ACh release, stimulus-induced ACh, and subsequent blocking of ACh, which
      usually interact in human cardiac cycle time functions, could be untangled in the
      reconstructed heart rate results. We concluded that the mathematical model may be
      useful for formulating hypotheses and constructing experimental task designs for
      studies of human heart rate.

PMID- 1745720
TI  - The relationship between menstrual phase and the P3 component of ERPs.
AB  - Event-related potentials (ERPs) and behavioral ratings were collected from 30
      female subjects who were exposed to picture slides. The slides belonged to five
      affective categories whose content was babies, dermatological cases, ordinary
      people, male models, and female models. Based on the day of testing relative to
      their menstrual cycle, the subjects were grouped according to their expected
      levels of androgens, estrogen, or progesterone. The data were examined to
      determine whether any ERP component or behavioral rating (non-erotic/erotic,
      unpleasant/pleasant, simple/complex, and low arousal/high arousal) varied as a
      function of subjects' hormone defined menstrual phase. Only the P3 component was
      sensitive to menstrual phase. The P3 to babies and male models was largest when
      progesterone levels were high. High progesterone was also associated with a
      decrease in the complexity and eroticism of all slide categories. An increase in
      the pleasantness of all categories was evident when estrogen levels were high.
      The results are interpreted as support for an "adaptive context updating" theory
      of the P3 component of ERPs.

PMID- 1745721
TI  - The relationship between skin conductance orienting and the allocation of
      processing resources.
AB  - Information processing models of autonomic orienting suggest that the elicitation
      of an orienting response is associated with either the call for, or the actual
      allocation of, limited attentional processing resources. However, Dawson, Filion,
      and Schell (1989) reported a directional dissociation between elicitation of the
      skin conductance orienting response and resource allocation, as indexed by
      reaction time slowing on a secondary task. Although larger skin conductance
      responses were elicited by a task-relevant stimulus than by a task-irrelevant
      stimulus, reaction time showed the opposite pattern (i.e., greater slowing to
      secondary task probes presented shortly following the onset of the task
      irrelevant stimulus). In the present report, we describe three experiments which
      examine the generality of this dissociation effect and test specific hypotheses
      regarding its nature. Results of the first two experiments revealed that the
      dissociation effect is observed reliably when the task-relevant and task
      irrelevant stimuli consist of left ear and right ear tones or high and low
      pitched binaural tones, across a range of secondary task probe presentation
      times. However, the third experiment demonstrated that when task-relevant and
      task-irrelevant stimuli are presented to different sensory modalities (auditory
      and visual), orienting and resource allocation are both greater during the task
      relevant than the task-irrelevant stimuli, thus eliminating the dissociation
      effect. These results support the hypothesis that the dissociation effect is due
      to a switch of attention initiated because of the physical similarity of the task
      relevant and task-irrelevant stimuli, and suggest that there is a fundamentally
      positive relationship between skin conductance orienting and resource allocation
      under selective attention conditions.

PMID- 1745722
TI  - Task versus component consistency in the development of automatic processing: a
      psychophysiological assessment.
AB  - A study was conducted to examine the role of consistency in the development of
      automatic processing. Subjects performed a memory search task in which consistent
      and inconsistent attending and responding were factorially combined. The task was
      performed with memory set sizes of two and four items. Results indicated that
      automaticity developed with consistent attending regardless of whether responding
      was consistent or inconsistent. However, measures of reaction time, P300 latency,
      and P300 amplitude revealed costs for inconsistent responding that were
      attributed to both stimulus evaluation and response related processes. The
      results suggest that total task consistency is not necessary for the development
      of automatic processing. Instead, it appears that automaticity can develop for
      consistent task components even when stimulus-response consistency is not
      maintained across the entire task.

PMID- 1745723
TI  - Haemodynamic adjustments to mental stress in normotensives and subjects with
      mildly elevated blood pressure.
AB  - Cardiac output, heart rate, stroke volume, pre-ejection period, total peripheral
      resistance, systolic and diastolic blood pressure, and oxygen consumption were
      monitored or derived in young men with mildly elevated casual blood pressures and
      unambiguously normotensive control subjects before, during, and after exposure to
      a mental arithmetic stress. Measurements were also taken while subjects underwent
      graded dynamic exercise. This permitted cardiac output-oxygen consumption
      regression equations to be calculated and, as a consequence, cardiac output
      during mental stress to be represented as additional cardiac output. Systolic and
      diastolic blood pressure were higher during all phases of the study in the mildly
      elevated blood pressure group. An overall groups effect during the mental stress
      phase of the experiment was observed for cardiac output and pre-ejection period,
      and the effect for stroke volume was close to significance. Significant Groups X
      Periods interactions were found for cardiac output and additional cardiac output,
      and the heart rate effect was nearly significant. Post-hoc comparisons here
      indicated that, in the main, group differences in these cardiac variables were
      more evident during the mental arithmetic stress than during the pre- and post
      task baseline periods. Total peripheral resistance did not differ reliably
      between groups and the cardiac effects were specific to the mental stress phase
      of the study.

PMID- 1745724
TI  - Children's cardiovascular reactivity: stability of racial differences and
      relation to subsequent blood pressure over a one-year period.
AB  - After measuring blood pressure and heart rate at rest and during a video game
      procedure in 477 children enrolled in 3rd grade, 434 (91%) children had these
      measurements repeated a year later in 4th grade. Black children demonstrated
      greater blood pressure and heart rate reactivity than White children in both
      years, and an increase in heart rate reactivity from 3rd to 4th grade. Gender
      effects were inconsistent. Systolic and diastolic blood pressures during the
      video game were more highly correlated from year-to-year than were the resting
      measures. Regression analysis indicated that systolic reactivity was
      significantly related to subsequent systolic pressure at rest, particularly among
      Black girls. Diastolic reactivity was associated with subsequent resting
      diastolic pressure only among White children. Associations between reactivity and
      future blood pressure were independent of initial resting blood pressure. This
      study suggests that cardiovascular reactivity to psychological stress may be one
      important factor in future level of blood pressure and that the increased heart
      rate reactivity of Black children may be associated with the prevalence of
      hypertension among Black adults.

PMID- 1745725
TI  - Temperature, time-of-night of testing, and responsiveness to stimuli presented
      while sleeping.
AB  - The present study examined how time-of-night of testing and body temperature
      related to responsiveness to stimuli presented in sleep. Nine males slept for two
      nonconsecutive nights in the sleep laboratory. On Night 1, tympanic temperature
      was assessed at 30-min intervals. On Night 2, responsiveness was assessed with an
      incremental series of tones (5dB steps) presented in sleep stages 2, 3/4, and REM
      throughout the night (0030-0800 h). Subjects were instructed and given practice
      prior to sleep to make a microswitch closure to the tones. Results showed a
      curvilinear pattern of responsiveness across the night in that the intensity of
      tones required for a response increased until about 0530 h, then decreased
      thereafter. This pattern of responsiveness was positively related to the
      circadian rhythm of body temperature. A close correspondence was also found
      between the temperature trough and the performance trough (both occurred at about
      0530 h). A greater emphasis on circadian factors may help understand previously
      reported but contradictory findings. The present results also suggest that
      measures of responsiveness follow a circadian pattern regardless of the
      sleep/wake state.

PMID- 1745726
TI  - The waltzing oddball.
AB  - We investigated whether task relevance and probability interact to influence P3
      amplitude. High and low tones were presented in random order with equal
      probability. In the control condition (standard oddball), every high tone had to
      be counted. In the waltz condition, high tones had to be counted only if they
      were preceded by two other high tones. It was predicted that the P3s evoked by
      targets in the waltz condition would be larger than the P3s evoked by the same
      sequence of targets in the oddball condition. That is, the frequency of
      occurrence of the targets should have an effect on P3, in addition to effects of
      the frequency of stimulus occurrence and stimulus task relevance
      (target/nontarget). This prediction was upheld. However, the largest P3s were
      evoked by nontargets following two high tones in the waltz condition. These P3s
      had a more anterior topographic maximum than usual. We contend that these
      anterior P3s reflect the interruption of an ongoing task and cannot be easily fit
      into the framework of the two concepts of task relevance and probability.

PMID- 1745727
TI  - Mismatch negativity outside strong attentional focus: a commentary on Woldorff et
      al. (1991)
AB  - Several previous papers have suggested that the mismatch negativity (MMN), an
      event-related potential (ERP) component specific to stimulus change after
      repetition, is fully automatic, that is, not affected by attention. Woldorff,
      Hackley, and Hillyard (1991), however, report that the MMN elicited by an
      intensity decrement of a repeating stimulus is considerably attenuated when
      attention is strongly focused on other stimuli. The present commentary attributes
      most of this effect to attention effects on ERP components other than the MMN but
      also admits that some attentional reduction of the MMN component indeed occurred.
      This attenuation was interpreted by Woldorff et al. as indicating suppression of
      early sensory processing in unattended channels, but this is contraindicated by
      some very recent data from the present author's laboratory and elsewhere showing
      that the MMN to frequency change is not attenuated outside a strong attentional
      focus. Consequently, an alternative explanation is proposed for Woldorff et al.'s
      important finding.

PMID- 1745728
TI  - Parasites and sexual selection: a macroevolutionary perspective.
AB  - The Hamilton-Zuk hypothesis postulates a causal link between parasitism and the
      evolution of epigamic traits by intersexual selection. Oversimplified assumptions
      about basic parasite biology, ambiguous formulation of the hypothesis, and poor
      communication between ethologists and parasitologists have hampered its testing.
      The hypothesis is supported at the microevolutionary level if females show
      significant preference for lightly or uninfected males, if intensity of infection
      reflects host resistance to parasites that depress host fitness by causing
      disease, and if intensity of infection is related to the degree of epigamic
      development. It must be shown that particular parasites cause disease, that the
      host population is polymorphic for resistance to infection by those species, and
      that female hosts are capable of distinguishing male hosts with low parasite
      loads due to heritable aspects of host resistance from males that are uninfected
      due to chance. The macroevolutionary prediction of the hypothesis, that species
      displaying strongly developed epigamic characters should host "more parasites"
      than species with weakly developed epigamic traits, contradicts the
      microevolutionary dynamic of the hypothesis, and is too ambiguous. We propose a
      macroevolutionary prediction based on understanding the evolutionary origin of
      epigamic traits and the evolutionary origin of each host-parasite association.
      Associations originating in the ancestor in which the epigamic trait appeared
      corroborate the hypothesis most strongly; those originating prior to the
      evolution of the epigamic trait corroborate it weakly; those beginning after the
      origin of the epigamic trait could not have been involved in the origin and
      spread of the epigamic trait.

PMID- 1745729
TI  - Ecological frames of mind: the role of cognition in behavioral ecology.
AB  - Cognitive psychology is the study of how information, from the senses and from
      memory, is used in the production of behavior. Investigation of the specifics of
      behavioral adaptation has already led some behavioral ecologists into the domain
      of animal cognition. I make several arguments for the benefits and the necessity
      of a sophisticated assessment by ecologists of the cognitive aspects of
      behavioral adaptation. First, because cognition typically serves to produce
      adaptive behavior, cognitive structure and function should reflect ecological
      demands; studies of cognition in ecological contexts are opportunities to
      understand adaptation. Furthermore, constraints on cognitive properties may help
      determine how behavior meets the environment. Studies of spatial memory in food
      caching corvids exemplify how cognitive aspects of behavior may both reflect and
      determine specifics of adaptation. Second, many models in behavioral ecology
      assume certain cognitive abilities, such as timing or counting. Cognitive theory
      and methodology should be used to determine whether animals possess these
      abilities. I have provided examples. Third, consideration of cognitive function
      can lead to original ideas about the details of behavioral adaptation. Without a
      thorough integration of cognitive psychology with behavioral ecology, our
      understanding of the relation between behavior and selective pressures will be
      compromised.

PMID- 1745730
TI  - [Allergic reactions in dental practice--clinical and therapeutic
      recommendations].

PMID- 1745731
TI  - [Probond--proven easy technique in crown and bridge prosthetics. 1. Principles
      and preparation results].

PMID- 1745732
TI  - [Causal contribution to the question of repairability of synthetic resins].

PMID- 1745733
TI  - [Vital microscopical study of microcirculation in dental pulp].

PMID- 1745734
TI  - [Galvano-outer telescope by direct technique].

PMID- 1745735
TI  - [Orthodontic and oral surgical treatment planning by computer, for example, the
      Dentofacial Planners (1)].

PMID- 1745736
TI  - [Interpretation of radiographs].

PMID- 1745737
TI  - [ABC of practice management: K-communication].

PMID- 1745738
TI  - [Clinical and microbiological findings, that can cause failure of dental
      implants].

PMID- 1745739
TI  - [Edema therapy in dental interventions with hydrolytic enzymes].

PMID- 1745740
TI  - [Clinical investigation of a posterior composite materials after 5 and 8 years].

PMID- 1745741
TI  - [Prosthetic construction principles in periodontally reduced dentition].

PMID- 1745742
TI  - [Joint oriented arrangement of maxilla with "Condyle-Positioning apparatus" in
      frame of orthodontic surgery].

PMID- 1745743
TI  - [Apically placed flaps for treatment of advanced cases of marginal periodontitis-
      case example (1)].

PMID- 1745745
TI  - [ABC of practice management: P-patient oriented practice].

PMID- 1745744
TI  - [Interpretation of radiographs].

PMID- 1745746
TI  - [Psychophysiological stress and requirements in dental practice].

PMID- 1745747
TI  - [Kindergarten--an institution for group prophylaxis].

PMID- 1745748
TI  - [Mercury content of saliva].

PMID- 1745749
TI  - [The biological effects in animals related to the accident at the Chernobyl
      Atomic Electric Power Station. 1. The experimental model. The radiation loads on
      animals kept continuously under external and internal radiation exposure in the
      area of the Chernobyl Atomic Electric Power Station].
AB  - Irradiation conditions in which laboratory animals were kept in experimental
      laboratories of Chernobyl and Kiev after the accident at the Chernobyl A.P.S. are
      described. The data are presented on the spectral structural and activity of
      radionuclides in the diet as well as in the organs and tissues of the animals.
      The radiation loads have been estimated with regard to an external gamma
      component and the internal one contributed by the incorporated radionuclides. It
      has been shown that radiation doses received by the animals during their lifetime
      due to these contributions do not exceed units of cGy.

PMID- 1745750
TI  - [The biological effects in animals related to the accident at the Chernobyl
      Atomic Electric Power Station. 2. The state of bone marrow hematopoiesis in
      rats].
AB  - It has been shown that rats born during the first months after the Chernobyl
      A.P.S. disaster exhibit essential changes in the peripheral blood and bone marrow
      haemopoiesis throughout the entire lifetime. Rats brought up in Chernobyl from
      the age of three months on display even more pronounced changes. It is assumed
      that the changes in the haemopoiesis develop due to the continuous influence of
      low-level radiation of different quality and are attributed to the effect of the
      incorporated radionuclides.

PMID- 1745751
TI  - [The biological effects in animals in relation to the accident at the Chernobyl
      Atomic Electric Power Station. 3. The morphological and ultrastructural changes
      in the lungs of rats].
AB  - The morphological and ultrastructural changes revealed in the lungs of rats kept
      within the Chernobyl accident zone during the period of 6 to 24 months were shown
      to be uniform and multicomponent. The changes were found both in the respiratory
      and the vascular connective tissue. The inflammatory processes occurred with
      formation of pneumonic foci, hypo- and disatelectasis, emphysematous changes,
      impairment of interalveolar septa, and connective tissue cell proliferation. In
      the lung tissue, focal and diffuse lymphoid proliferates and, at later stages,
      lymphomatous changes were revealed.

PMID- 1745752
TI  - [The biological effects in animals in relation to the accident at the Chernobyl
      Atomic Electric Power Station. 5. Longevity and the carcinogenic effects].
AB  - Remote effects in laboratory animals living in conditions of exposure to a
      mixture of external and internal radiation resulted from the Chernobyl A.P.S.
      disaster have been investigated. It has been found that the rate of deaths from
      non-tumor illnesses grows, the incidence of neoplasms increases and their latency
      time decreases. The redistribution within the spectrum of benign and malignant
      tumors and the increase in the multiplicity coefficient have been revealed. It is
      concluded that chronic exposure of animals to low-level radiation from the
      radionuclides, resulted from the accident, brings about a much larger number of
      negative stochastic and nonstochastic remote effects as compared to those
      expected from the extrapolation of the effects produced by high radiation doses.

PMID- 1745753
TI  - [The biological effects in animals related to the accident at the Chernobyl
      Atomic Electric Power Station. 6. The physiological development and cytogenetic
      indices of the progeny of rats].
AB  - Certain alterations have been revealed in the postnatal ontogenesis parameters of
      albino mongrel rats and their descendants constantly kept within the thirty
      kilometer zone of the Chernobyl A.P.S. Structural disturbances have been found in
      bone marrow cell chromosomes.

PMID- 1745754
TI  - [The biological effects in animals in relation to the accident at the Chernobyl
      Atomic Electric Power Station. 7. The content of lipid peroxidation products and
      free fatty acids and the catalase activity in a number of organs and tissues of
      rats].
AB  - The content of malonic dialdehyde, dienic conjugates and free fatty acids, and
      catalase activity were determined in some organs and tissues of chronically
      irradiated rats. Certain regularities were found in lipid metabolism changes. The
      MIGI-K preparation was shown to normalize some indices under study.

PMID- 1745755
TI  - [The biological effects in animals in relation to the accident at the Chernobyl
      Atomic Electric Power Station. 8. The status of cellular immunity in different
      generations of rats].
AB  - In studying immunity in laboratory rats of different generations (P, F1 and F2)
      brought up in Chernobyl in 1989-1990 the authors have revealed the development of
      leuko- and lymphopenia; decrease in the absolute content of immunocompetent cells
      bearing Fc receptors to IgG; stable and long-lasting suppression of blood NK cell
      activity; reduction of antibody-dependent cytotoxicity; and changed ability of
      blood lymphocytes to interact contactly with allogenic mast cells. The most
      considerable disorders have been found in 6- and 9-month-old F1 rats and in 3-
      and 6-month-old F2 rats.

PMID- 1745756
TI  - [The biological effects in animals in relation to the accident at the Chernobyl
      Atomic Electric Power Station. 9. The morphofunctional indices of the
      immunocompetent organs in mice].
AB  - The permanent action of small doses of low-intensity radiation on the immune
      status of 2.5-3.5 month CC57W mice has been investigated. Total doses of internal
      and external irradiation were about few cGy. The permanent action of low-level
      radiation on the experimental animals of the first and fourth generations was
      shown to change spleen and lymph nodes weights and the count of lymphocytes
      isolated from these organs. Cellularity and DNA synthesis in the lymph-node
      lymphocytes and their proliferative response to polyclonal mitogens also changed.
      The alterations in the parameters that characterized T-lymphocyte population were
      statistically significant.

PMID- 1745757
TI  - [The biological effects in animals in relation to the accident at the Chernobyl
      Atomic Electric Power Station. 10. Cooperative immune reactions in different
      generations of mice].
AB  - The immune status of mice has been assessed by the whole complex of data. The
      permanent action of low-level radiation has been shown to suppress considerably
      the rate of reactions of the delayed-type hypersensitivity and "graft versus
      host" disease, as well as NK and specific cytolytic T-lymphocyte activity. The
      dynamics of accumulation and the levels of antiviral antibodies in the serum,
      lung and trachea extracts are virtually invariable. The resistance of
      experimental animals to influenza is lower than that of non-irradiated mice of
      the same line and age. The data obtained indicate that the immune disturbances
      revealed are connected not only with the alteration of lymphoid cell populations,
      but also with the alteration of the immune regulation mechanisms.

PMID- 1745758
TI  - [The biological effects in animals in relation to the accident at the Chernobyl
      Atomic Electric Power Station. 11. The ultrastructure of the bone marrow cells in
      different generations of rats].
AB  - In studying the bone marrow cell ultrastructure in male rats (F0-F2 generations)
      aged 3 months, which were brought up within the thirty kilometer Chernobyl A.P.S.
      disaster area, considerable submicroscopic changes have been revealed in the
      cells at all stages of maturation, including undifferentiated blasts and mature
      forms of cells of the neutrophilic, eosinophilic, monocytic and erythroid
      haemopoiesis series, as well as stromal elements of the microenvironment,
      megakaryocytes and endothelium. The severity of these changes increases, as the
      number of generations grows, displaying frequently a destructive character.

PMID- 1745759
TI  - [The effect of the accident at the Chernobyl Atomic Electric Power Station in
      1986 on the fish population of a cooling pond].
AB  - The cytogenetic analysis of Cyprinus carpio eyes, developing Blicca bjoerkna L.
      eggs, and eggs and larvae of Hypophtalmichthys molitrix Val. has demonstrated
      that the yield of cells with chromosome aberrations in the fish species under
      study is normal, while the level of variability of morphometric indices in
      offspring is considerably higher than that in parent fish.

PMID- 1745760
TI  - [Micronucleus formation in the bone marrow cells of chronically irradiated mice
      with subsequent acute gamma irradiation].
AB  - With the use of the micronuclear test method it has been shown that mice
      preirradiated with gamma rays at a low dose rate exhibit a decreased frequency of
      chromosome aberrations induced in bone marrow cells by subsequent acute exposure
      to gamma radiation as compared to mice not subjected to preliminary irradiation.
      Such animals have a higher radioresistance with respect to the survival rate. The
      results obtained suggest the possibility of induction by ionizing radiation, at a
      low dose rate, of adaptive repair response at the organism level.

PMID- 1745761
TI  - [The enhanced radioresistance (adaptive response) in vivo of splenic colony
      forming units (CFU-S) following the exposure of mice to 60Co gamma rays at low
      doses].
AB  - An increase of resistance to radiation damage of human lymphocytes previously
      exposed to low doses of ionizing radiation from incorporated tritiated thymidine
      was observed by G. Olivieri et al. in 1984. The phenomenon was named adaptive
      response and its occurrence was reported by others for many animal and plant
      cells. In this research we studied the adaptive response of spleen colony
      formation at different time after previous irradiation of mice with low doses of
      60Co gamma rays. Our results suggest that the pretreatments protect spleen colony
      formatting units (CFU-S) from the second damaging radiation dose of 1.5 Gy during
      long time (as many as one month).

PMID- 1745762
TI  - [The phenomenon of adaptive immunity in exposure to nonionizing microwave
      radiation].
AB  - In experiments with albino rats exposed to microwaves (500 microW/cm2), a model
      of adaptive immunity was developed by transferring lymphoid cells of exposed
      animals. The effect of microwave radiation was shown to cause autoimmune
      disorders that were displayed against the background of the structural and
      functional disturbances of the hematoencephalic barrier.

PMID- 1745763
TI  - [DNA damages in individual mammalian cells].
AB  - The method of alkaline microelectrophoresis of nucleoid DNA of isolated cells
      built in an agar gel was used to study the harmful effect of radiation on the
      genome of mouse peripheral blood lymphocytes. The yield of the lymphocyte DNA
      structure damages in irradiated animals and in the in vitro exposed lymphocytes
      was a linear function of radiation dose within the dose range from 0.5 to 5 Gy
      and 0.27 to 1 Gy respectively. A study was made of the dynamics of DNA structure
      damages in cells NIH 3T3 exposed to 3 Gy radiation, and in mouse lymphocytes
      exposed to 4 Gy radiation.

PMID- 1745764
TI  - [The effect of low doses of external gamma irradiation on the chromatin structure
      and activity of the histone-specific proteinases of rat brain cells].
AB  - Irradiation of rats with doses of 0.5 to 2 Gy was shown to cause dose-dependent
      changes in the sensitivity of brain cell chromatin to the effect of DNAase I that
      were manifested by the increased level of DNA hydrolysis and a high content of
      the chromatin soluble fractions. The chromatin structure was only partially
      restored 24 h after irradiation. Changes in the chromatin structure were
      accompanied by the increase in the histone-specific proteinase activity.

PMID- 1745765
TI  - [The content of cyclic nucleotides, free cytoplasmic Ca2+ and malondialdehyde in
      the splenic lymphocytes and thymocytes of rats under the action of moderate doses
      of radiation].
AB  - It has been shown that the malonic dialdehyde (MDA) content in spleen lymphocytes
      of rats increases after whole-body X irradiation with a dose of 0.5 Gy to reach
      the maximum level in 24 h. Simultaneously, the concentration of cGMP and free
      cytosol Ca2+ increases. With a dose of 1 Gy MDA content of cells increases 6 h
      following irradiation. The maximum drop of the release of viable lymphocytes from
      the spleen and thymus, observed 24 h and 3 days after irradiation respectively,
      coincides with the appearance of the second peak of the MDA content. The level of
      cGMP remains decreased throughout the period of about 6 days. The onset of
      lymphocyte repopulation in the spleen on day 6 coincides with the decrease in the
      MDA level and increase in the cytosol Ca2+ concentration.

PMID- 1745766
TI  - [The effect of chronic gamma irradiation in small doses on the adenylate cyclase
      activity of lung tissue plasma membranes in rats].
AB  - A study was made of the response of adenylate cyclase of cytoplasmic membranes of
      pulmonary tissue to chronic gamma irradiation of rats at a low-dose rate (0.036
      cGy/day). The adenylate cyclase complex receptors were shown to respond to such
      exposure by activation of the enzyme they control and by being more sensitive to
      their specific effector, isoproterenol. The role of receptors in the
      manifestation of radiation hormesis is discussed.

PMID- 1745767
TI  - [The mechanisms determining the course and outcome of the exposure of the body to
      ionizing radiation].

PMID- 1745768
TI  - [The way to molecular cell genetics].

PMID- 1745769
TI  - [Cultured cell lines--materials for molecular cell genetics].

PMID- 1745770
TI  - [Human cells in culture--aging and immortalization].

PMID- 1745771
TI  - [Human hereditary diseases].

PMID- 1745772
TI  - [Cancer cells and carcinogenesis].

PMID- 1745773
TI  - [Embryonic stem cell, early development and cell differentiation].

PMID- 1745774
TI  - [DNA replication and DNA repair].

PMID- 1745775
TI  - [Analysis of the cell cycle].

PMID- 1745776
TI  - [Genetic marker of somatic cell].

PMID- 1745777
TI  - [Genetic analysis of somatic cells].

PMID- 1745778
TI  - [Genetic recombination in somatic cells].

PMID- 1745779
TI  - [Experiment for lyonization and genomic imprinting].

PMID- 1745780
TI  - [Fundamentals of cell cultivation].

PMID- 1745781
TI  - [Establishment of cell strains].

PMID- 1745782
TI  - [Preparation of synchronized cells].

PMID- 1745783
TI  - [Frequency and induction of mutation].

PMID- 1745784
TI  - [Concentration and specific selection of mutants].

PMID- 1745785
TI  - [Isolation of mutant cells by a replica method].

PMID- 1745786
TI  - [Isolation of temperature-sensitive mutant cells].

PMID- 1745787
TI  - [Isolation of mutant cells requiring various nutrients].

PMID- 1745788
TI  - [Isolation of drug-resistant mutant cells].

PMID- 1745789
TI  - [Isolation of mutant cells sensitive to radiation or similar physical agents].

PMID- 1745790
TI  - [Isolation of mutant cells for the studies of cell architecture, biological
      transport, and cellular responses].

PMID- 1745791
TI  - [Complementation test].

PMID- 1745792
TI  - [Analysis of reverse mutant cells].

PMID- 1745793
TI  - [methods for gene transfer].

PMID- 1745795
TI  - [Gene targeting].

PMID- 1745794
TI  - [Transfer and recovery of genes].

PMID- 1745796
TI  - [Preparation of chromosomal panels and chromosome mapping].

PMID- 1745797
TI  - [Detection of chromosomal aberrations].

PMID- 1745798
TI  - [Analysis of mitochondrial DNA as plasmagene].

PMID- 1745799
TI  - [Anorexia nervosa: current considerations].

PMID- 1745800
TI  - [Sarcoidosis. Retrospective study of 30 cases in Salamanca and comparison with
      other national series].
AB  - Sarcoidosis is a disease which presents important clinical differences according
      to its geographical distribution. Thus, the objective of this study was to
      evaluate the epidemiologic, clinical, radiologic, and diagnostic characteristics
      in a series of 30 sarcoidosis patients in the province of Salamanca (representing
      the Castilla-Leon region). The most relevant results are the following: a) in our
      region, sarcoidosis predominates in females and furthermore, the presenting age
      in females is greater than in males; b) there is a clear predominance of the
      disease in the rural area; c) the prevalence of smoking habit in these patients
      is low (10%); d) the clinical manifestations are similar to other Spanish series
      with the exception, however of a high incidence of hypercalciuria; e) there is no
      correlation between the increase in sedimentation rate and the degree of
      sarcoidosis activity; f) there is a predominance of the radiologic type 11 of the
      disease and there is a high number of atypic radiologic patterns. The results
      obtained are with regard to the pathogeny are discussed as well as the
      differences and similarities of this series with other preceding from other
      regions.

PMID- 1745801
TI  - [Uric acid calculi: infrequent cause of acute renal failure].
AB  - We reviewed the clinical histories of 14 patients diagnosed of acute obstructive
      renal failure due to bilateral or unilateral uric calculi in patients with only
      one functioning kidney for a period of 14 years (1974-1987). Urine was
      alkalinized in all patients. The increase in urine pH was effective in resolving
      the obstruction in 12 patients. The alkalinizing methods which succeeded in
      permeabilizing the urinary tract, considering each functioning kidney
      independently were: intravenous in 5/21, upstream urethral catheterism in 9/21
      and by nephrostomy catheter in 5/21. Surgery was performed in 2 patients. In the
      later the calculi were of double composition. The most frequent complications
      were: urinary infection in 7/14 patients, chronic renal failure in 4/14 patients,
      sepsis in 3/14 patients and bacteremia in 2/14 patients. None of the patients
      died.

PMID- 1745802
TI  - [Use of DNA probes labelled with radioisotopes in the mycobacteria laboratory].
AB  - We have studied 540 mycobacterial strains isolated in Lowestein-Jensen medium and
      133 samples of different pathologic products against commercialized 125I-DNA
      Mycobacterium tuberculosis complex, Mycobacterium avitum-intracellulare and
      Mycobacterium gordonae. The sensitivity, specificity and positive and negative
      predictive values against isolated strains was 100% for the 3 studied probes. The
      125I-DNA probe specific for M. tuberculosis complex is studied in samples with
      positive bacciloscopy; statistic values vary according to the cutting point of
      the different percentages of hybridization: at 1.5% the sensitivity, specificity
      and predictive negative and positive values are 38.6%, 71.4%, 97.5%, and 9.4%
      respectively, while if the cutting point percentage is 3% these values are:
      33.1%, 100%, 100%, and 7.8% respectively. We believe that with these probes the
      identification time is limited to time needed for the incubation of prime
      cultures, and in some cases it can be performed on the day the samples reach the
      laboratory.

PMID- 1745803
TI  - [Pattern of plasma lipids and insulin blood levels in male patients with non
      insulin-dependent diabetes mellitus and moderate obesity].
AB  - The goal of the present work is the study of the plasmatic lipid profile in non
      insulin dependent diabetes mellitus (NIDDM) patients with abdominal obesity (AO),
      comparing them the NIDDM patients without AO and with OA persons without NIDDM.
      For that purpose we developed a methodology in which we have studied the body
      mass index (BMI: kg/m2) the hip-waist index (HWI) (0.95 = AO), lipid parameters,
      hydrocarbon, titers and serum insulin levels. The results are referred to four
      groups where we can throw into relief a statistically significant increase in
      triglycerides and a marked decrease in HDL cholesterol in OA and DM patients when
      compared to the group with AO without MD or to the group with MD without AO.
      Based on the results obtained the conclusions can be summarized as follows: The
      presence of abdominal obesity is a factor that favors the appearance of high
      levels of serum triglycerides and low levels of HDL-cholesterol in NIDDM. On the
      other hand, DM is a factor that increases the levels of triglycerides with low
      levels of HDL-cholesterol which already exist in AO.

PMID- 1745804
TI  - [Post-traumatic hemoperitoneum: a rare complication of peritoneal splenosis].
AB  - Peritoneal splenosis is a frequent condition after traumatic spleen fracture,
      which, given that it is usually asymptomatic, is often not diagnosed unless a
      laparotomy is performed for some other reason. The case is presented of a 9 year
      old boy splenectomized a few years earlier because of traumatism, who again
      suffers abdominal injury with the development of hemoperitoneum, observing during
      surgery multiple splenosis foci disseminated all over the abdominal cavity, some
      of which present rupture and hemorrhage, constituting the cause of
      hemoperitoneum.

PMID- 1745805
TI  - [Late recurrence in pheochromocytoma: need for a long term follow up].
AB  - Pheochromocytoma is a catecholamine secreting tumor which has been traditionally
      considered as a potentially curable cause of hypertension. However, the existence
      of malignant pheochromocytomas as well as the problem which the recurrence of
      benign pheochromocytomas present, make the eradication of this tumor more
      complicated. It is note worthy the difficulty in localizing recurrent
      pheochromocytomas as well as the prognostic interest that presents the
      possibility of differentiating between recurrence and metastasis. We refer the
      case of a female patient suffering benign adrenal pheochromocytoma, who, 10 years
      it was surgically removed, presented a relapse of symptoms, and was diagnosed of
      extra-adrenal pheochromocytoma, in Zuckerkandl organ. The importance of
      performing a long term post-surgical follow-up in these patients is stressed.

PMID- 1745806
TI  - [Granular cell laryngeal tumor].
AB  - Granular cell tumor is a rare benign tumor which when affects the larynx, it
      characteristically affects the vocal cords, causing dysphonia as the main
      clinical manifestation. The term granular cell myoblastoma proposed and
      extensively used seems to be inadequate since all the observations suggest its
      origin in Schwann cells, with no relation to muscle cells. Although the existence
      of malignant granular cell tumors has been reported, the vast majority show a
      benign behaviour, reaching its cure after complete surgical removal of the
      lesion.

PMID- 1745807
TI  - [Primary hyperparathyroidism: pathogenic and therapeutic dilemmas].

PMID- 1745808
TI  - [54-year-old man with headache, nasal obstruction and cranial nerve involvement].

PMID- 1745809
TI  - [Pancreatic cystadenoma during gestation].

PMID- 1745810
TI  - [Septic lesions due to Escherichia coli].

PMID- 1745811
TI  - [Severe hypercalcemia in adolescence: a rare presentation of primary
      hyperparathyroidism].

PMID- 1745812
TI  - [Epidermal growth factor behavior in breast cyst fluid. Differences as a function
      of the three existing types].

PMID- 1745813
TI  - [Pleural tuberculosis].

PMID- 1745814
TI  - [Benign parotid lymphoepithelial cyst in a patient with HIV infection].

PMID- 1745815
TI  - [Amenorrhea secondary to obesity].

PMID- 1745816
TI  - [Solitary cranial metastasis as an initial manifestation of renal carcinoma].

PMID- 1745817
TI  - [Spontaneous pneumomediastinum as a complication of a sports competition].

PMID- 1745818
TI  - Molecular mechanism of action of a steroid hormone receptor.

PMID- 1745819
TI  - Gonadotropin-releasing hormone pulses: regulators of gonadotropin synthesis and
      ovulatory cycles.
AB  - The data reviewed present evidence that the pattern of GnRH secretion is an
      important factor in the regulation of gonadotropin subunit gene expression,
      gonadotropin synthesis, and secretion. The information on regulation of mRNA
      expression by GnRH pulses should be considered with some caution, as the
      experiments were performed in male rats and may not accurately reflect events in
      female primates or humans. However, an overall pattern emerges which suggests
      that common factors may be involved in all mammalian species. If current evidence
      is correct, and only a single gonadotropin-releasing hormone exists, then
      mechanisms to differentially regulate the three gonadotropin genes may involve
      changes in GnRH secretion. Alterations in GnRH pulse frequency and amplitude are
      recognized by the pituitary gonadotrope cell and could be the mechanism used to
      effect differential expression of the gonadotropin subunit genes. Differential
      regulation of subunit gene expression would be expected to be critically
      important in the establishment of pubertal maturation, and subsequently in the
      maintenance of ovulatory cycles in women. Our hypotheses, proposing a major role
      of pulsatile GnRH secretion in the regulation of human reproduction, are
      summarized in schematic form in Fig. 14 for men and Fig. 15 for women. In utero
      and during the first few months of life, GnRH is secreted at a relatively fast
      frequency (approximately 1 pulse/hour). During the first year, GnRH secretion is
      inhibited and both the amplitude and apparent frequency of pulsatile release is
      markedly reduced. The mechanisms involved in inhibiting GnRH release remain
      unclear in humans. Similarly, the mechanisms involved in the disinhibition of
      GnRH secretion, which first occurs during sleep at the initiation of puberty, are
      unclear, but in humans do not appear to involve opiates. In males, the increased
      frequency and amplitude of GnRH secretion favor LH synthesis and release, which
      in turn stimulates testosterone secretion (Fig. 14). Testosterone acts at the
      hypothalamus, perhaps through opioid mechanisms, to inhibit GnRH pulse frequency
      and to maintain a regular pattern of pulses occurring approximately every 90-110
      min in adult males. In females, the mechanisms involving alterations in the
      patterns of GnRH secretion to regulate reproduction appear more complex. This may
      reflect the need to differentially synthesize and secrete FSH and LH at different
      times during reproductive cycles to allow orderly follicular maturation and
      ovulation. As shown in Fig. 15, we hypothesize that the events during the first
      decade of life and through the initiation of nocturnal GnRH secretion at puberty
      are similar in both sexes.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1745820
TI  - Steroids, receptors, and response elements: the limits of signal specificity.

PMID- 1745821
TI  - Molecular biology of human renin and its gene.
AB  - This article describes investigations of several aspects of the molecular biology
      of the human renin gene and the three-dimensional structure of renin and its
      precursor, prorenin. Because of the importance of the RAS in hypertension, heart
      failure, renal failure, and possibly other disorders such as atherosclerosis, it
      is critical to understand the detailed control of this system. This control
      involves regulation at the transcriptional level, folding of prorenin, sorting of
      prorenin to a regulated pathway where it is proteolytically cleaved to renin and
      released in response to secretogogues, constitutive release of uncleaved
      prorenin, and nonproteolytic activation of prorenin. Currently there is great
      interest not only in the control of renin in the kidney, the sole source of
      circulating renin, but also at extrarenal sites where RAS activity may regulate
      cardiovascular functions. The renin gene was found to be expressed significantly
      in the renal juxtaglomerular cells and several other cell types. Most tissue
      culture cells did not express the gene; exceptions were cultured SK-LMS-1 cells
      and cAMP-stimulated human lung fibroblasts. Cultured human uterine-placental
      cells expressed the human renin gene at levels higher than in other cell types
      assessed. Renin mRNA had the same start site in the placental cells as the kidney
      and was regulated by calcium ionophores and cAMP. Thus, these cells provide
      primary nontransformed human cells to study the homologous human promoter.
      Transfected renin promoters showed cell type-specific expression and cAMP
      responsiveness in these cells in constructs containing as few as 102 bp of 5'
      flanking DNA. DNA upstream from this appears to contain an inhibitory element(s)
      that may have some tissue specificity in its distribution. The cAMP response is
      not due to cAMP induction of a transcription factor that secondarily affects the
      renin promoter. A novel element may be involved, since the promoter does not
      contain a CRE element that mediates many cAMP responses, and the cells do not
      appear to respond to another known cAMP-responsive transcription factor, AP-2.
      Studies with transfected vectors expressing a mutant cAMP-responsive protein
      kinase A regulatory subunit suggest that cAMP is not responsible for basal renin
      promoter activity in the placental cells. By contrast, cAMP induces in essence
      gene activation in WI26VA4 transformed human lung fibroblasts in which renin mRNA
      levels increase by up to 150-fold in response to forskolin. Thus, cAMP may
      activate renin gene expression under certain circumstances and tissue-specific
      renin gene expression may be directed by more than one mechanism.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1745822
TI  - Cellular and molecular analysis of pancreatic islet cell lineage and
      differentiation.

PMID- 1745823
TI  - Neuroendocrine control of human reproduction in the male.
AB  - The traditional difficulty in studying the neuroendocrine control of reproduction
      in the human male has been the inability to tease out the hypothalamic from the
      pituitary component of this neuroendocrine system. The use of multiple models,
      each with its own strength and weakness, represents an overlapping approach that
      has permitted further insights to be gained into the hypothalamic control of the
      neuroendocrine regulation of gonadotropin secretion in the human. Such an insight
      is an important prerequisite to the understanding of the pathophysiology of
      various disease states, the unraveling of a control of FSH secretion by GnRH vs
      other modulators, and the subsequent design of rational therapies for male
      reproductive disorders.

PMID- 1745824
TI  - Complex hormone response unit regulating transcription of the phosphoenolpyruvate
      carboxykinase gene: from metabolic pathways to molecular biology.

PMID- 1745825
TI  - Mammalian glucose transporters: structure and molecular regulation.

PMID- 1745826
TI  - Immortalization of neuroendocrine cells by targeted oncogenesis.

PMID- 1745827
TI  - Neuroendocrine regulation of the luteinizing hormone-releasing hormone pulse
      generator in the rat.
AB  - We have analyzed the mechanisms by which several known regulators of the LHRH
      release process may exert their effects. For each, we have attempted to determine
      how and where the regulatory input is manifest and, according to our working
      premise, we have attempted to identify factors which specifically regulate the
      LHRH pulse generator. Of the five regulatory factors examined, we have identified
      two inputs whose primary locus of action is on the pulse-generating mechanism-
      one endocrine (gonadal negative feedback), and one synaptic (alpha 1-adrenergic
      inputs) (see Fig. 29). Other factors which regulate LHRH and LH release appear to
      do so in different ways. The endogenous opioid peptides, for example, primarily
      regulate LHRH pulse amplitude (Karahalios and Levine, 1988), a finding that is
      consistent with the idea that these peptides exert direct postsynaptic or
      presynaptic inhibition (Drouva et al., 1981). Gonadal steroids exert positive
      feedback actions which also result in an increase in the amplitude of LHRH
      release, and this action may be exerted through a combination of cellular
      mechanisms which culminate in the production of a unique, punctuated set of
      synaptic signals. Gonadal hormones and neurohormones such as NPY also exert
      complementary actions at the level of the pituitary gland, by modifying the
      responsiveness of the pituitary to the stimulatory actions of LHRH. The LHRH
      neurosecretory system thus appears to be regulated at many levels, and by a
      variety of neural and endocrine factors. We have found examples of (1) neural
      regulation of the pulse generator, (2) hormonal regulation of the pulse
      generator, (3) hormonal regulation of a neural circuit which produces a unique,
      punctuated synaptic signal, (4) hormonal regulation of pituitary responsiveness
      to LHRH, and (5) neuropeptidergic regulation of pituitary responsiveness to LHRH.
      While an attempt has been made to place some of these regulatory inputs into a
      physiological context, it is certainly recognized that the physiological
      significance of these mechanisms remains to be clarified. We also stress that
      these represent only a small subset of the neural and endocrine factors which
      regulate the secretion or actions of LHRH. A more comprehensive list would also
      include CRF, GABA, serotonin, and a variety of other important regulators.
      Through a combination of design and chance, however, we have been able to
      identify at least one major example of each type of regulatory mechanism.

PMID- 1745828
TI  - [Clinico-pathological evaluation of patients with homozygous familial
      hypercholesterolemia].
AB  - The authors have studied 8 patients with Homozygous Familial Hypercholesterolemia
      (FHO) an autosomal genetic dominant disease due to mutation of the gene encoding
      a cell surface receptor for LDL. Anatomic and pathologic abnormalities caused by
      LDL-cholesterol and B-Apolipoprotein high plasma levels were found. We also
      measured malondialdehyde levels in plasma and atherosclerotic plaques of the only
      autoptic case observed. MDA-levels are an index of lipid peroxidation. Cutaneous
      xanthomatosis lesions and severe cardiovascular disease were also present.

PMID- 1745829
TI  - [Hypersensitivity of the carotid sinus in syncope and its diagnostic role:
      therapeutic implications and follow-up].
AB  - Our aim was to assess the incidence and clinical characteristics of carotid sinus
      hypersensitivity in a group of subjects suffering from syncope. The total number
      of patients was 118. Twenty-four of them (20%) were diagnosed as epileptics
      (first attack) and 38 (32%) as vasodepressors. 56 patients with unexplained
      syncope underwent carotid sinus massage during electrocardiographic registration
      and pressure monitoring. 41 patients were found to have carotid sinus
      hypersensitivity. 34 of these 41 patients received implantation of a pacemaker.
      Abnormal sinus node function was noted in 30, abnormal atrioventricular node
      function in 3 and combined abnormal sinus node and AV node function in 1.
      Furthermore three other patients who were negative to massage were implanted with
      a pacemaker because they had an organic heart disease and recurrent syncope.
      Different tests as 24-hour monitoring ecg and electrophysiologic study showed no
      better results in the diagnosis of syncope. Our data demonstrates the diagnostic
      importance of carotid sinus massage in the diagnosis of syncope. The validity of
      this method is confirmed by the 24 month follow-up.

PMID- 1745830
TI  - [24-hour blood pressure: effects of sports in aged subjects].
AB  - The present study deals with the blood pressure (BP) and heart rate (HR) 24-h
      pattern in aged people of both sexes ranging in age from 66 to 75 years. 20
      subjects were active in agonistic sports (running and swimming), 20 others had
      sedentary habits. BP and HR were studied by non-invasive monitoring along with
      chronobiometric analysis. The BP and HR 24-h pattern was seen to preserve its
      circadian rhythm in both aged athletes and sedentary elderly. The analysis
      reveals that the aged athletes show a higher mesor for systolic BP and a lower
      mesor for diastolic BP and HR. The daily pressure load, as the integral of the BP
      24-h values multiplied by the HR mesor, is lower in aged people practising sport
      as compared to age-matched individuals with sedentary habits. The spectral
      analysis reveals that physical exercise acts to change the time structure of BP
      and HR 24-h patterns. The conclusion is drawn that active sport plays beneficial
      effects in aged people because of a lower pressure load.

PMID- 1745831
TI  - [24-hour blood pressure: noninvasive monitoring and biometric analysis in
      relation to age].

PMID- 1745832
TI  - [Isoniazid-induced vasculitis. Description of a case of pericarditis with cardiac
      tamponade and multisystemic involvement].

PMID- 1745833
TI  - Detection of normotension, borderline and hypertension cutoffs in a population
      evaluated by non invasive blood pressure monitoring.
AB  - The 24-hour blood pressure (BP) average value in normotensive and hypertensive
      subjects is not defined. In 329 subjects three occasional blood pressure data
      were measured. The same day a non invasive 24-hour blood pressure monitoring was
      performed. The average of the occasional blood pressure and the average of the 24
      hour blood pressure data were compared. In many cases the occasional blood
      pressure average was not strictly linked with the 24-hour blood pressure average.
      A statistical procedure (K-Means Cluster Analysis) was performed separately on
      occasional blood pressure values and on the hourly blood pressure average of the
      whole day. By this method three clusters of subjects were selected to evaluate
      the occasional and the 24-hour blood pressure cluster's cutoffs. The cluster's
      blood pressure cutoffs evaluated on occasional blood pressure values were not
      dissimilar from the blood pressure values suggested by literature for
      normotensive, borderline and hypertensive groups. The K-Means Clusters Analysis
      seems an interesting statistical method to research the subsets in a population
      evaluated by 24-hour blood pressure monitoring. We suggest that the 24-hour BP
      cutoffs evaluated in the three cluster groups may be considered as indicative for
      a clinical diagnosis of normotensive, borderline and hypertensive state.

PMID- 1745834
TI  - [Current aspects of the diagnosis of arterial hypertension].
AB  - Arterial blood pressure (BP) is widely believed to be a main risk factor for
      cardiovascular diseases. The chance to develop some kind of vascular injury is
      almost exponentially and continuously related to BP values at a given age. In
      accordance, the WHO stated the upper limits for diastolic and systolic BP beyond
      which it is reasonable to anticipate a clear statistic advantage from the
      hypotensive treatment (of either pharmacologic or other kind). However many
      studies have shown that the relation coefficient between BP values and the
      occurrence of cardiovascular diseases is on the whole quite weak, even under
      rigorously controlled conditions. This could be, at least in part, due to the
      fact that the severity of the cardiovascular damage depends on the "global"
      hypertensive load continuously charging the patient's cardiovascular system along
      the whole life: the "random" measurement of the BP is indeed a poor statistical
      index of such load because of the wide variability of BP with time. Thus many
      sources of BP variability have been studied, in order to develop multiple
      measurement methods of BP monitoring hopefully with more prognostic power. In
      this article we review the major problems inherent to the methodological
      development of the serial full-automatic sphygmomanometric ambulatory BP
      monitoring, such as its concordance with different more traditional techniques,
      the statistic effectiveness of intermittent (versus continuous) sampling, the
      psychological impact of multiple cuff inflations during the day and the
      night.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745835
TI  - [Ion transport in erythrocytes: a universal physiological model. Reflections on
      the pathogenesis of hypertension].
AB  - The red cell represents a useful model for the study of general
      pathophysiological mechanisms, because of its availability and the relative
      easiness of the methodological approach due to the absence of nucleus and
      organelles. Particularly, most of the transmembrane ion transport systems, which
      control the homeostasis of intra- and extracellular electrolytes, have been
      firstly discovered in the red cell membrane. The pathophysiological importance of
      these transport systems is often extended to non haematological diseases like
      essential hypertension. Several reports from different laboratories have
      established that the red cell Na+/Li+ countertransport is stimulated in patients
      with essential hypertension. The regulation of Na+/Li+ countertransport,
      relationship with plasma and membrane lipids and the possibility of modulating
      its activity by dietary interventions, are focused in the last part of this
      review.

PMID- 1745836
TI  - [Cerebral infarction: lacunae].
AB  - Lacunae are small deep cerebral infarcts which are believed to occur in
      hypertensive patients, producing characteristic clinical syndromes. Previous
      reports suggested to differentiate this type of stroke from other cerebrovascular
      diseases, but failed to provide any evidence that this classification is useful
      in clinical practice. We reviewed the present literature concerning pathogenesis,
      clinical features, diagnostic, and therapeutic aspects of lacunae and we
      established that current concepts in lacunar stroke are inadequately supported.
      Although lacunar syndromes are reported to be correlated with lacunar infarcts,
      these syndromes are also described in patients with different pathological
      findings. The assumption that lacunae always result from a distinct and specific
      small-vessel arteriopathy is not confirmed; in fact, an atheroma may occlude a
      single perforating artery at the base of the brain as well as larger arteries.
      Lipohyalinosis, initially referred to as the underlying pathologic vascular
      lesion specific for lacunae, is found most commonly in a subset of patients with
      severe hypertension associated with multilacunar dementia. Large infarcts and
      hemorrhages are reported to coexist with lacunae in autoptic and
      neuroradiological studies; intracranial atherosclerosis is associated with
      lacunae as well as with large superficial infarcts. The percentage of patients
      with hypertension is approximately the same regardless of type of the infarct,
      lacunar or cortical. Diagnostic criteria are not clear-cut: clinical onset,
      neurological examination, and assessment of risk factors are unable to take
      lacunae apart from other infarcts; the size of the lesion, but not the site or
      the pathogenesis, determines clinical course, degree of motor deficit, and
      prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745837
TI  - [Minor donor of bone marrow graft: medico-legal aspects].
AB  - Bone marrow transplantation can provide long-term disease-free survival when used
      as therapy for a variety of lethal disorders. Authors discuss about the underage
      donor consent and review the literature. In conclusion they consider that Bone
      Marrow donation is too important to leave its decision only to parents; they
      suggest to institute professional committees that consider donor will and verify
      on which basis he expresses his consent.

PMID- 1745838
TI  - Growth factors and the control of human teratoma cell proliferation.

PMID- 1745839
TI  - Role of heparin-binding growth factors in embryonic tumors.

PMID- 1745840
TI  - Cytogenetic investigation of gonadal carcinomas in situ in syndromes of abnormal
      sexual differentiation.

PMID- 1745841
TI  - Role of bromhexine in exacerbations of bronchiectasis. Double-blind randomized
      multicenter study versus placebo.
AB  - The effectiveness of bromhexine in the treatment of patients with bronchiectasis,
      in a stage of clinical exacerbation, was assessed in a double-blind, placebo
      controlled trial involving 88 in-patients. Bronchiectasis was diagnosed by
      bronchography and/or CT scan. Bromhexine or matched placebo was administered as
      30-mg capsules three times daily per os. Ceftazidine, 1 g i.m., was given to all
      patients once a day for the first week only. Bromhexine seemed to improve the
      clinical picture, with significantly positive trends for expectoration, quantity
      of sputum and auscultatory findings. It also increased the FEV1 and was well
      tolerated. Both patients and investigators judged it efficacious.

PMID- 1745842
TI  - Effect of standing versus sitting position on spirometric indices in healthy
      subjects.
AB  - This study examined the effect of the standing versus the sitting position on
      spirometric indices in 94 healthy non-obese adult subjects (41 men and 53 women)
      with the order of testing randomised. On average all the spirometric indices
      examined, except the peak expiratory flow rate, were higher in the standing
      compared to the sitting position although the change was only significant at the
      5% level for FEV1 in women. The fall in FEV1 with the change in position was
      statistically related to the ponderal index but not to age, height or the initial
      lung function level. A uniform posture for spirometry is recommended in
      epidemiological studies examining longitudinal trends in lung function, as well
      as in cross-sectional aetiological studies examining, for instance, the effects
      of environmental and/or occupational exposures. A uniform posture is also
      recommended for clinical studies which involve repeated measurements over time,
      for instance to measure the effect of treatment or the natural history of airways
      disease.

PMID- 1745843
TI  - Evolution of physiological variables in patients with chronic obstructive
      pulmonary disease before and during long-term oxygen therapy.
AB  - In 24 patients with severe chronic obstructive pulmonary disease (COPD), we
      investigated the evolution of pulmonary volumes, arterial blood gases (ABG) and
      mean pulmonary artery pressure (PAP), before (T0-T1) and during (T1-T2) long-term
      oxygen therapy (LTO). LTO was initiated at T1 on usual criteria (PaO2
      persistently less than or equal to 55 mm Hg) and was given during greater than or
      equal to 16 h/day. The T0-T1 period ranged from 12 to 186 months (mean 53 +/- 41
      months) and the T1-T2 period from 12 to 120 months (mean 44 +/- 30 months). There
      was a significant worsening of the obstructive pattern (FEV1 decreasing from
      1,084 +/- 326 to 879 +/- 318 ml, p less than 0.005) and of ABG (PaO2 decreasing
      from 58.2 +/- 9.2 to 51.6 +/- 6.5 mm Hg, p less than 0.01) before the onset of
      LTO, whereas there was a rather good stability of ABG during LTO and the changes
      in pulmonary volumes were modest and statistically nonsignificant (FEV1 decreased
      from 879 +/- 318 to 809 +/- 247 ml). PAP tended to increase from T0 to T1 and to
      decrease from T1 to T2, but these changes only reached the level of statistical
      significance when they were expressed as changes per year (+1.0 +/- 2.7 vs. -1.3
      +/- 4.5 mm Hg, p less than 0.05). The evolution of physiological variables was
      nearly identical in subgroups of patients who had died (n = 13) or were still
      alive (n = 11) at the time of data collection (T3) and this held particularly
      true for PAP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745844
TI  - Bilateral bronchoalveolar lavage in progressive systemic sclerosis: interlobar
      variability, lymphocyte subpopulations, and functional correlations.
AB  - Bilateral bronchoalveolar lavage (BAL) was carried out in right middle and left
      upper lobes of 22 nonsmoking females suffering from progressive systemic
      sclerosis in order to assess interlobar differences and functional correlation of
      the BAL composition. The patients' age ranged from 20 to 66 years, and the mean
      disease duration was 10.4 years. The most frequent finding was a mild BAL
      lymphocytosis (right in 11 of 22 patients; left in 8 of 22), but eosinophilic
      (right in 11 of 22; left in 5 of 22 patients) and neutrophilic (right in 9 of 22
      patients; left in 1 of 22) alveolitis was recognized as well. Differential counts
      suggestive of alveolitis limited to one of the lavaged lobes were demonstrated in
      about one fourth of the cases. Including increased cellularity among the criteria
      of pathological BAL fluid composition, 14% of the subjects showed bilateral BAL
      results within the normal range. OKT8-positive lymphocytes were significantly
      increased in 3 patients, but the mean values were not. Total lung capacity, vital
      capacity, and forced expiratory volume in 1 s correlated inversely with BAL
      neutrophil (p less than 0.05) and granulocytic (p less than 0.01) differential
      counts; the strongest, positive correlation was demonstrated regarding the
      lymphocyte/granulocyte ratios (p less than 0.0005). In conclusion, several
      patterns of alveolitis as well as a bilaterally normal BAL composition were found
      in our series; moreover, even if inhomogeneous alveolitis did occur, a single
      lavage performed in the right middle lobe correctly detected or excluded the
      presence of an alveolitis in 95% of our patients.

PMID- 1745845
TI  - Long-term low-dose administration of erythromycin to patients with diffuse
      panbronchiolitis.
AB  - Although diffuse panbronchiolitis (DPB) has carried a poor prognosis, long-term
      low-dose administration of erythromycin (EM) is very effective. We administered
      EM at a daily dose of 400-600 mg to 19 DPB subjects for more than 2 months.
      Sixteen subjects were relieved from productive cough and dyspnea, and their chest
      X-ray pictures were improved. We performed a pharmacokinetic study of EM in 11
      DPB subjects (8 responders; 3 nonresponders) after the long-term low-dose
      administration. The maximal serum and sputum levels of EM were below the MICs of
      clinically pathogenic H. influenzae and P. aeruginosa which were often isolated
      from the sputum of DPB patients. No difference was observed in the absorption of
      EM between responders and nonresponders. The results suggested that DPB patients
      might respond favorably to EM due to mechanisms other than antibacterial
      activity. Individual variation in the absorption of EM was observed. As EM was
      effective at very low serum and sputum levels, it was suggested that even 200
      mg/day of EM would be effective in DPB patients who had high serum and sputum EM
      levels and it was necessary to monitor the concentrations of EM in serum and
      sputum for the treatment of DPB to determine the appropriate dose of EM
      individually.

PMID- 1745846
TI  - Immunotherapy with an oral bacterial extract (OM-85 BV) for upper respiratory
      infections.
AB  - The efficacy of Broncho-Vaxom/Imocur (OM-85 BV), an orally administered
      lyophilized bacterial extract, for recurrent respiratory and ear, nose and throat
      (ENT) infections was evaluated in 116 children aged 6 months to 19 years by
      comparing its activity in 61 children with that of a placebo in 55 children. The
      study was randomized, double-blind, and comprised a 90-day treatment period
      followed by a 90-day follow-up period without test drugs. Over the 180 days,
      39.5% of patients taking OM-85 BV remained free from infection compared with
      16.5% on placebo (p less than 0.01). 44% on OM-85 BV did not need antibiotics
      compared with 23.5% on placebo (p less than 0.05). These differences were even
      greater in the subgroup of children aged 6 years and less (34 vs. 3.5% for the
      absence of infections, p less than 0.01 and 37 vs. 10% for the need of
      antibiotics, p less than 0.05). Tolerance to OM-85 BV was excellent, and
      laboratory investigations showed no abnormalities attributable to this product.
      This work confirms that the immunomodulator OM-85 BV is an effective
      immunotherapy for recurrent respiratory and ENT infections in children.

PMID- 1745847
TI  - Accuracy and response time of a portable pulse oximeter. The Pulsox-7 with a
      finger probe.
AB  - We studied the performance of a portable pulse oximeter in 123 consecutive adult
      patients by spot-checking with a finger probe and by spectrophotometry of oxygen
      saturation on a simultaneous arterial blood sample. 88 patients were overtly
      hypoxemic (HbO2 less than 90%) and 26 showed severe hypoxemia (HbO2 36-70%). The
      differences between the two methods showed a skewed distribution with a positive
      tail due to the over-estimation of lower saturation values by the pulse oximeter.
      Overall, the 95% confidence interval for the median difference ranged from -0.6
      to +0.5%. The limits of agreement (distribution-free 95% confidence interval for
      the sample) were -5.8 to +11.6%. Pulse oximetry can be recommended as a first
      assessment of the respiratory balance only if a cut-off value of HbO2 equal to
      90% in nonsmoking, air-breathing subjects is acceptable. The finger probe implies
      a response delay of approximately 30 s, making the instrument rather insensitive
      to short hypoxemic transients. With a predictive value around 90%, the pulse
      oximeter may be a useful portable screening tool.

PMID- 1745848
TI  - Reproducibility of the vesicular breath sounds in normal subjects.
AB  - Nonfiltered (NF) lung sounds from the apical area of the heart along with lung
      volumes and ECG signals were recorded from 5 normal subjects. The signals were
      digitized and subjected to three methods of heart sound cancellation: 75-Hz high
      pass filtering (75 HF), ECG-triggered blanking (BL) and adaptive noise cancelling
      (AF) [IEEE Trans. Biomed. Engng 33: 1141-1148, 1986]. The sound signals were then
      subjected to the fast Fourier transform algorithm to obtain power spectra. Five
      breaths from each subject were analyzed, and their spectra were similar and
      slightly skewed to the right. The average values of mean, median and mode
      frequencies of the whole breath of 5 subjects, respectively, were for NF: 64.62
      +/- 3.74, 44.57 +/- 2.06 and 36.75 +/- 1.79 Hz; for 75 HF: 150.42 +/- 17.49,
      114.02 +/- 6.43 and 86.16 +/- 3.13 Hz; for BL: 81.76 +/- 6.02, 52.36 +/- 2.79,
      41.10 +/- 3.15 Hz; for AF: 96.87 +/- 11.58, 68.23 +/- 10.44 and 52.25 +/- 8.97
      Hz. These values showed no differences between subjects. The F values obtained by
      the two-way analysis of variance of all breaths of all subjects (mean, median,
      mode) were: NF: 0.161, 0.341, 0.089; 75 HF: 0.455, 0.042, 0.085; BL: 0.108,
      0.082, 0.057; AF: 0.130, 0.204, 0.113 (all p greater than 0.1). The data revealed
      a remarkable lack of variation within and between subjects, suggesting similar
      sites and mechanisms of production and transmission.

PMID- 1745849
TI  - Effect of exercise on lung transfer factor for CO in smokers.
AB  - The lung transfer factor for carbon monoxide was studied in 24 apparently healthy
      smokers and in 24 well-matched non-smokers at rest and during exercise. Single
      breath and steady state (TLcoss) transfer factors for carbon monoxide, the Krogh
      constant, and the capillary blood volume were significantly lower in smokers.
      Exercise increased minute ventilation to a similar extent in both groups, but
      significantly lower values of TLcoss were measured in smokers than in non-smokers
      during mild and moderate grades of exercise (p less than 0.001). This difference
      in TLcoss may be attributed either to the difference in capillary blood volume or
      to increased inhomogeneities with regard to alveolar ventilation and perfusion
      due to airway damages in smokers, or to both factors.

PMID- 1745850
TI  - Clinical and pathological features of tuberculous pleural effusion and its long
      term consequences.
AB  - A retrospective study of 83 cases of tuberculous pleural effusion showed that the
      mean age of the patients was 44 years and 10 patients (12%) were over the age of
      70. Pleural fluid was smear positive for tubercle bacilli in none but culture
      positive in 23% of the cases. Pleural biopsy was a more sensitive method of
      diagnosis with granulomatous inflammation seen in 97% of cases. Five patients
      developed significant pleural thickening during chemotherapy requiring
      decortication. Twenty-two patients with tuberculous effusion diagnosed and
      treated over 2 years previously were traced for reassessment. None of them had
      significant pleural thickening and lung function tests did not show significant
      impairment compared to matched control subjects.

PMID- 1745851
TI  - Thrombosis-inducing activity in plasma of patients with acute respiratory tract
      infection disappears after treatment.
AB  - Thrombosis-inducing activity (TIA) was identified in plasma from 16 of 27
      patients (59%) with acute respiratory tract infections. On the other hand, it was
      present in only 9 of 79 subjects (11%) with chronic lung diseases and 4 of 49
      healthy volunteers (8%). In the patients with acute respiratory tract infections,
      there were significant elevations in plasma fibrinogen, C-reactive protein and
      erythrocyte sedimentation rate in the TIA-positive group compared with the
      negative group. Plasma TIA disappeared in all of the 8 patients who were retested
      for TIA 2-5 weeks after they became disease free. Pneumonia was induced in
      rabbits by transbronchial injection of viable Escherichia coli. TIA was not
      present in plasma from normal rabbits, but it appeared in plasma collected 3 days
      after injection. It then disappeared after 1-2 weeks of treatment with
      antibiotics. TIA may serve as a marker for inflammatory responses and be a factor
      responsible for elevated blood coagulation activity in patients with acute
      infectious diseases.

PMID- 1745852
TI  - Effects of chronic acid-base changes on the rebreathing hypercapnic ventilatory
      response in man.
AB  - The CO2 rebreathing method can be very useful to test the hypercapnic ventilatory
      response in patients, including those with chronic acid-base changes (e.g.
      chronic metabolic acidosis due to renal failure). The ventilatory response to
      hypercapnia (CO2-R) was measured in 4 normal men by the rebreathing method under
      control conditions (CaCO3: 0.1 g.kg-1.day-1) and with induced metabolic acidosis
      (NH4Cl: 0.3 g.kg-1.day-1) and alkalosis (NaHCO3: 0.7 g.kg-1.day-1). The slope of
      the CO2-R did not change as a result of the acid-base alterations, but was
      shifted to the left of normal by metabolic acidosis, and to the right by
      metabolic alkalosis. These results compare favorably with previous reports on the
      CO2-R as measured by the steady-state technique, and validate the rebreathing
      method as a reliable and useful technique for evaluating CO2-R in man with
      altered acid-base states.

PMID- 1745853
TI  - Effects of nifedipine on diffusing capacity and pulmonary capillary blood volume
      in chronic obstructive pulmonary disease. A controlled study.
AB  - The acute dose-dependent effects of nifedipine on the pulmonary diffusing
      capacity for CO and other lung function indices were investigated in patients
      with chronic obstructive pulmonary disease (COPD) in a randomized double-blind,
      cross-over, placebo-controlled trial. Seventeen successive, clinically stable,
      moderate COPD patients with pulmonary hypertension and 15 control subjects were
      included in the study. The diffusing capacity of the lungs for carbon monoxide
      (DLCO) was measured with the single-breath method. Nifedipine (10 and 20 mg) and
      placebo were administered sublingually at room air. Nifedipine (10 and 20 mg)
      increased DLCO and DLCO/alveolar volume; however, a larger effect was observed
      with 10 mg. In addition, nifedipine increased the pulmonary capillary blood
      volume dose-dependently while arterial oxygenation was improved only with 10 mg
      nifedipine. Venous shunt was significantly increased with 20 mg nifedipine
      whereas spirometric parameters were unaffected. The percent DLCO change with 10
      or 20 mg nifedipine was inversely correlated with baseline DLCO, but not with the
      severity of obstruction. Nifedipine did not have any effect in the control group,
      except for mild hypotension and a reflex increase in the heart rate. It is
      concluded that 10 mg nifedipine probably has an effect on the pulmonary
      circulation in moderate COPD patients with pulmonary hypertension.

PMID- 1745854
TI  - Inhaled and oral salbutamol: how effective in the prophylaxis of asthma?
AB  - Inhaled and oral salbutamol were compared in 12 asthmatic patients for
      prophylaxis in antigen-induced asthma. The patients were pretreated with 0.2- and
      1.0-mg doses of inhaled salbutamol and with the standard oral 4- and 8-mg slow
      release (SR) salbutamol preparations. Bronchodilatation was monitored over the
      ensuing 3 h and protection against antigen challenge at the end of the period. On
      each study day the degree of baseline airway hyperreactivity was determined by
      histamine challenge. Precautions were taken during the antigen challenge to
      ensure a reproducible response. Blood levels of salbutamol were monitored at
      hourly intervals for the 3 h after treatment and during the asthmatic reaction
      subsequent to challenge. Both the 0.2- and 1.0-mg inhalations caused immediate
      bronchodilation as compared to a placebo (p less than 0.05), but only the 1.0-mg
      dose protected subjects against antigen challenge (p less than 0.05). In
      comparison to the placebo, no bronchodilatation was achieved with the standard 4
      mg oral preparation in spite of measurable blood levels, nor were the patients
      protected against antigen challenge at 3 h after pretreatment. However, the 8-mg
      SR salbutamol caused significant bronchodilatation within 2 h and suppressed
      antigen challenge responses as compared to placebo (p less than 0.05). It can be
      concluded that doses of inhaled salbutamol higher than the conventional 0.2- or
      the standard 4-mg oral preparations are required to protect asthmatics against
      inadvertent antigen exposure. In patients who are unable to use inhalers
      effectively, the SR preparation can be considered as an alternative.

PMID- 1745855
TI  - Impaired pulmonary function in schoolchildren exposed to passive smoking.
      Detection by questionnaire and urinary cotinine levels.
AB  - Pulmonary function was evaluated by FEV1, FVC, PEF, MEF50%FVC, MEF25%FVC and MMEF
      in relation with passive smoking exposure in 143 children aged 6-11 years (mean
      age = 8.5 +/- 1.6). Passive smoking exposure was evaluated by a questionnaire and
      by measurement of urinary cotinine levels. Children were divided into different
      groups: no exposure, low exposure and high exposure. The mean values of each
      pulmonary function test were compared between the groups and between the
      different evaluations by Student's test. The evaluation of passive smoking
      exposure by questionnaire and by urinary cotinine levels separated homogeneous
      groups of children. The urinary cotinine levels were significantly lower in the
      non-exposed children than in the other groups (p less than 0.001). Pulmonary
      function tests, especially MEF50%FVC, MEF25%FVC and MMEF were significantly
      reduced in exposed subjects (p less than 0.05). These alterations are an index of
      early involvement of the small airways also in passive smokers. The greater the
      exposure to passive smoking, the lower the values of the pulmonary function
      tests.

PMID- 1745856
TI  - Metastatic laryngeal carcinoma mimicking pleural mesothelioma.
AB  - We describe an unusual case of metastatic poorly differentiated laryngeal
      carcinoma to the pleura resembling pleural mesothelioma in a patient with a
      positive history of exposure to asbestos. This case not only describes an unusual
      presentation of metastatic laryngeal carcinoma, but also highlights the need for
      special pathological techniques to distinguish nonmesothelial tumors from primary
      pleural mesotheliomas.

PMID- 1745857
TI  - Tracheobronchomegaly associated with interstitial pulmonary fibrosis.
AB  - Tracheobronchomegaly (TBM) is the syndrome of enlarged trachea and main bronchi
      associated with recurrent and chronic respiratory tract infections. A 42-year-old
      man with TBM and diffuse interstitial pulmonary fibrosis is described. The
      possible relationship between the two entities is discussed and the etiology,
      pathogenesis, clinical manifestations, prognosis and treatment of TBM are
      reviewed.

PMID- 1745858
TI  - Pneumoperitoneum in a patient with lymphangiomyomatosis.
AB  - A 32-year-old Japanese housewife with a 2-year history of retroperitoneal and
      pulmonary lymphangiomyomatosis had a sudden onset of severe abdominal pain. Chest
      X-ray and plain abdominal films showed free air under the diaphragm and a small
      pneumothorax in the left lower pleural space. Emergency laparotomy revealed no
      perforated viscera, but there was a rupture in the mid-portion of the left
      diaphragm. It appears that increasing pressure in the left pneumothorax burst the
      left diaphragm leading to pneumoperitoneum.

PMID- 1745859
TI  - Lymphangioleiomyomatosis: the effectiveness of radiotherapy-induced ovarian
      function annulment. A case report.
AB  - Lymphangioleiomyomatosis is an unusual disease characterized by atypical smooth
      muscle hyperplasia especially of the lymphatic system and affecting females in
      their child-bearing years. We present a case in which ovarian function was
      annuled through radiotherapy, instead of resorting to the most commonly used
      oophorectomy, since the patient's severe respiratory dysfunction made surgery
      inadvisable. The clinical, radiological and functional characteristics of this
      entity are discussed, and the therapeutic possibilities are reviewed.

PMID- 1745860
TI  - Subpleural silicotic nodule radiographically resembling to small bronchial
      carcinoma.
AB  - A 65-year-old woman had a solitary nodule radiologically appearing as a coin
      lesion with pleural indentation, suggesting primary lung cancer. Operative
      findings and histological examination revealed it to be a silicotic nodule.
      Despite the rarity of this condition, silicotic nodules should be considered
      among the causes of solitary or small numbers of peripheral pulmonary nodules in
      adults.

PMID- 1745861
TI  - Severe anaerobic necrotizing pneumonia complicated by pyopneumothorax and
      anaerobic monoarthritis due to Peptostreptococcus magnus.
AB  - A rare case of a severe anaerobic necrotizing pneumonia complicated by
      pyopneumothorax and monoarthritis due to anaerobic Peptostreptococcus magnus is
      described in a 20-year-old soldier. The patient's immunological status was
      normal. There were no predisposing underlying factors, and he was treated
      successfully without any residual damage. To our knowledge, a similar case has
      never been reported in the literature.

PMID- 1745862
TI  - Adenocarcinoma and squamous cell carcinoma in the same lobe of the lung. A case
      report.
AB  - Multiple primary lung cancers, either synchronous or metachronous, are unusual.
      We treated a 70-year-old man with double synchronous lung cancers in the right
      upper lobe, an adenocarcinoma and a squamous cell carcinoma. As multiple
      malignant lesions in an early stage may be curable, those patients in whom a lung
      cancer has already been detected, and who have an increased risk, such as long
      history of heavy smoking or of exposure to some carcinogens, an aggressive check
      up should be performed and should be closely watched.

PMID- 1745863
TI  - Endobronchial actinomycosis associated with a foreign body.
AB  - We describe our findings in a 58-year-old mentally retarded patient with
      endobronchial actinomycosis surrounding an aspirated chicken bone foreign body.
      To our knowledge, this is the first report of such an occurrence.

PMID- 1745864
TI  - Removal of a large endobronchial foreign body with a fiberoptic bronchoscope.

PMID- 1745865
TI  - [Predisposition and sudden death of children].

PMID- 1745866
TI  - [Rapid freezing of a beating heart].

PMID- 1745867
TI  - [Exercise induced precordial T wave normalization associated with U wave
      inversion in detection of left anterior descending artery stenosis].
AB  - Although normalization of inverted T wave is not an uncommon finding during
      exercise tests, it's clinical significance is still unclear. Exercise 12-lead
      electrocardiograms (ECGs) were recorded by using Master's 2-step or ergometer. T
      wave normalization in the anterior chest leads was found in 20 patients with, and
      14 patients without coronary artery disease (CAD). Coronary angiography and/or
      exercise Tl-201 myocardial imaging were also performed in every patient. Exercise
      induced T wave normalization was defined as "inverted T wave at rest becoming
      upright during exercise". ST segment, T and U wave amplitudes were measured
      before and immediately after exercise. 1) All of the 20 patients (100%) with CAD
      demonstrated critical stenosis of the left anterior descending artery (LAD). 2)
      ST deviation was noted in none of the 14 patients (0%) without CAD, and in only 4
      of the 20 patients (20%) with CAD. 3) T wave amplitude increased equally in
      patients both with and without CAD. 4) Exercise-induced U wave inversion was
      found in 16 of the 20 patients (80%) with CAD, whereas it was found in only 1 of
      the 14 patients (7%) without CAD. 5) The sensitivity of "U wave inversion" in
      detection of LAD stenosis was 80%, and the specificity was 93%. We conclude that
      exercise-induced T wave normalization associated with U wave inversion in
      anterior chest leads is highly indicative of the specific presence of critical
      LAD stenosis.

PMID- 1745868
TI  - [Changes in cardiac output during exercise in patients with hypertrophic
      cardiomyopathy: the study of these influences on exercise intolerance].
AB  - In order to investigate the relation between exercise intolerance and cardiac
      output (CO) increase during exercise in patients with hypertrophic cardiomyopathy
      (HCM), submaximal treadmill exercise (Sheffield protocol) with simultaneous
      measurement of CO and oxygen uptake (VO2) by acetylene rebreathing method were
      performed in twelve patients with HCM who had no demonstrable left ventricular
      outflow obstruction and fifteen control men. The measurements were made at rest,
      during exercise and recovery. 1) At rest cardiac index (CI) in patients with HCM
      was significantly less than in control subjects but the difference was small
      (HCM: 1.9 +/- 0.35 l/min/m2 vs control: 2.2 +/- 0.38, p less than 0.05), and was
      almost the same during light exercise (stage 1-3), but clearly increased during
      middle to submaximal stages (stage 4 and 5) (stage 5: 4.5 +/- 1.25 vs 8.0 +/-
      1.30, p less than 0.01). 2) Heart rate was not different in both groups at rest,
      during exercise and recovery, which was considered to explain that the difference
      of CI was derived from that of stroke index (SI). 3) The change of VO2 showed the
      same tendency as that of CI. The difference increased considerably during the
      middle to submaximal stages (Stage 5: 15.3 +/- 1.42 ml/min/kg vs 25.4 +/- 4.42, p
      less than 0.01). 4) During recovery, CI and VO2 in patients with HCM indicated a
      delay of beginning to decrease toward the rest level, compared with control
      subjects. 5) VO2 was closely related to CI (r = 0.90, p less than 0.01).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1745869
TI  - [A case of lupus erythematosus preceded by right heart failure due to pulmonary
      hypertension].
AB  - A 40-year-old woman was admitted because of increasing exertional dyspnea. Right
      heart failure was suggested by the presence of hepatomegaly, pretibial edema and
      also echocardiographic findings. Physical examination and echocardiography showed
      no evidence of valvular disease or congenital heart disease except for right
      ventricular dilatation and tricuspid regurgitation. The ventricular septum
      deviated toward the left ventricle throughout the cardiac cycle, but left
      ventricular function was preserved. Severe pulmonary hypertension averaging 44
      mmHg was revealed by cardiac catheterization. Digital subtraction angiography and
      pulmonary blood flow scintigraphy showed no evidence of pulmonary artery
      embolism, and no interstitial pulmonary lesions that might have caused pulmonary
      hypertension were recognized. Hypergammaglobulinemia suggested an autoimmune
      disorder, and signs of systemic lupus erythematosus (SLE), such as pleural
      effusion, proteinuria, lymphocytopenia, LE cell phenomenon and antinuclear
      antibodies were present. Several autoimmune diseases are known to be causative
      factors of pulmonary hypertension. However, only ten cases of SLE complicated by
      pulmonary hypertension have been reported the present one. These cases were
      characterized by a high incidence of Raynaud's phenomenon and positivity for anti
      RNP antibody. In our present case, SLE activity was suppressed using
      prednisolone, but pulmonary hypertension persisted and the patient eventually
      died due to right cardiac failure. Judging from the clinical course of the ten
      reported cases of SLE-pulmonary hypertension, there seems to be no hope of
      improving the pulmonary hypertension once it has become established. Therefore it
      is important to detect and cure pulmonary hypertension as early as possible.

PMID- 1745870
TI  - [A case of anomalous origin of circumflex artery from right sinus of valsalva
      recognized by transesophageal echocardiography].
AB  - A 56-year-old man visited our hospital for further examination of resting
      electrocardiographic abnormality. Positive exercise stress resulted in mild chest
      discomfort and 1.5 mm ST depression in II.III.aVF leads. Myocardial imaging
      perfusion with thallium-201 was normal and an anomalous origin of the left
      circumflex coronary artery from the right aortic sinus was observed by coronary
      angiography. MRI showed that the vessel running behind the aorta was connected to
      the right Valsalva's sinus. Furthermore, transesophageal echocardiography
      revealed that the vessel connected to the lateral wall of the left ventricle was
      running from the right Valsalva's sinus between the aorta and left atrium. The
      above results indicated that this vessel was the left circumflex artery. Although
      myocardial infarction or sudden death in patients with coronary anomaly has been
      discussed, the mechanism is still unknown. The present case is a rare one in
      which the anatomical relation between the anomalous coronary and the great
      vessels was directly detectable by transesophageal echocardiography.
      Transesophageal echocardiography is useful for the assessment of this type of
      coronary anomaly.

PMID- 1745871
TI  - [A case of ventricular septal defect associated with active infective
      endocarditis which was successfully treated by triple valve replacement and
      ventricular septal defect patch closure].
AB  - A 47-year-old man was hospitalized in May, 1990, because of breathlessness and
      continuous fever which appeared about 4 weeks after he had had his periodontic
      tooth removed in December, 1989. He had been diagnosed as having ventricular
      septal defect (VSD) at the age of 6 years. When he was hospitalized, he was in a
      condition of class IV by NYHA classification, with a white blood cell count of
      17,300/mm3, an increase in CRP, a red blood cell sedimentation rate of 108 mm/hr,
      and positive alpha-streptococcus in blood culture. His cardiothoracic ratio was
      64% with signs of pulmonary congestion on a chest X-ray film. Echocardiography
      revealed the presence of VSD and huge vegetations on the tricuspid, mitral and
      aortic valves. He was considered to have active infective endocarditis (AIE)
      which had presumably been provoked by VSD and the tooth removal. Penicillin G at
      a daily dose of 20 million units and gentamicin at a daily dose of 80 mg were
      intravenously administered to treat the alpha-streptococcus infection for about 4
      weeks. Furosemide was used for congestive heart failure. Since, although his
      cardiac function appeared to have been improved, the signs and symptoms of the
      infection persisted, triple valve replacement for the tricuspid, mitral and
      aortic valves and patch closure of the VSD were performed 4 weeks after the
      hospitalization. The operation revealed inflammatory lesions extending from the
      endocardium of the right ventricle to the mitral valves through the VSD, and huge
      vegetations on the tricuspid, mitral and aortic valves. The operation was
      successful and the inflammatory areas gradually disappeared.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1745872
TI  - [A case of complete absence of the left pericardium coexisting with straight back
      syndrome].
AB  - A case of complete absence of the left pericardium coexisting with straight back
      syndrome in a 30-year-old female is presented. She had been asymptomatic, but was
      referred to our hospital because of an abnormal finding on a chest X-ray obtained
      during a routine physical examination. The posteroanterior view of the chest X
      ray showed displacement of the right and left cardiac border to the left and
      bulging of the left cardiac border. The lateral view showed loss of normal
      thoracic curvature and also demonstrated the straight back syndrome.
      Echocardiography showed paradoxical movement of the ventricle septum,
      hyperkinetic movement of the free wall of the left ventricle and enlargement of
      the right ventricle. Computed tomography and magnetic resonance imaging with an
      artificial pneumomediastinum clearly showed rotation of the heart into the left
      hemithorax, prominence of the pulmonary trunk and pneumopericardium. Hence the
      diagnosis of the complete absence of the left pericardium coexisting with
      straight back syndrome was made. Congenital defect or absence of the pericardium
      are rarely reported. Only about 120 cases have been described in Japan. Only a
      few cases have been diagnosed antemortem. Most of them were found by chance
      during operations or on installation of an artificial pneumothorax. We suggest
      that an artificial pneumomediastinum as well as a pneumothorax is useful for the
      diagnosis of the absence of the pericardium. This is the first reported case of a
      complete absence of the left pericardium coexisting with straight back syndrome.

PMID- 1745873
TI  - [Pulmonary vascular changes in the collagen vascular diseases].

PMID- 1745874
TI  - [Effect of acid rain on respiratory system].

PMID- 1745876
TI  - [Laser angioplasty].

PMID- 1745875
TI  - [Respiration and circulation under weightlessness].

PMID- 1745877
TI  - [pH correction].

PMID- 1745878
TI  - Role of the renal nerves in hypertension.

PMID- 1745879
TI  - Insulin resistance and hyperinsulinemia: implications for the pathogenesis and
      treatment of hypertension.

PMID- 1745880
TI  - The kidney in the pathogenesis of hypertension.

PMID- 1745881
TI  - Antihypertensive therapy and the progression of chronic renal disease. Are there
      renoprotective drugs?
AB  - The pathogenesis of hypertensive glomerular injury is complex, involving both
      hemodynamic and nonhemodynamic factors. One can therefore confidently predict
      that a wide variety of disparate therapeutic interventions, pharmacologic and
      nonpharmacologic, may be effective in arresting or slowing progressive glomerular
      injury. Based on the experimental and clinical literature available to date, it
      is clear that glomerular capillary hypertension is an important pathogenetic
      factor in this disease and that lowering of Pgc with antihypertensive drugs is
      associated with prevention of glomerular injury. Furthermore, the CEI may have a
      special renoprotective effect compared to other antihypertensive agents, most
      likely due to their unique renal hemodynamic actions. Pending the results of well
      designed clinical trials, converting enzyme inhibitors represent the
      antihypertensive agents most likely to arrest the progressive decline in renal
      function observed in patients with hypertension and chronic renal failure. The
      calcium channel blockers are effective antihypertensive agents in patients with
      chronic renal failure, but whether they confer specific renoprotective effects
      remains uncertain. Since a large number of patients with chronic renal failure
      require more than one antihypertensive drug for adequate blood pressure control
      it may be of interest to evaluate the benefits of drug combinations. In this
      regard, it is possible that a combination of a CEI and a CCB may have
      complimentary effects in protecting the kidney. The development of these new
      classes of antihypertensive agents has had a major impact on the treatment of
      patients with chronic progressive renal failure. Future studies will hopefully
      clarify the optimal antihypertensive therapeutic regimen and allow us to move
      closer to the goal of eliminating end-stage renal failure.

PMID- 1745882
TI  - Renal consequences of salt and hypertension.

PMID- 1745883
TI  - Hypertension and diabetes.

PMID- 1745884
TI  - Resistant hypertension.

PMID- 1745885
TI  - Hypertension in pregnancy.

PMID- 1745886
TI  - [What is your diagnosis? Ewing sarcoma of the radius with lung metastases].

PMID- 1745887
TI  - [Type 1 or Type 2 diabetes: diagnostic aids in clinically uncertain cases].

PMID- 1745888
TI  - [Neurosurgery in old age. I: Significance of the problem--herniated disk, spinal
      canal stenosis--craniocerebral injuries--chronic subdural hematoma--resorptive
      hydrocephalus].
AB  - The relative percentage of patients over 60 years who underwent operations in our
      clinic has greatly increased from 18% in 1874 to 27% in 1989. Postoperatively,
      difficulties may also result from additional medical problems, which may be
      cardiovascular, pulmonary, metabolic (especially diabetes mellitus), increased
      thromboembolism in origin as well as from the reduced tendency to neurological
      recovery in elderly patients. On the other hand, advances in diagnostics and
      surgical treatment often make it possible to help even these patients effectively
      today. The clinical pictures which are especially frequent in our hospital are
      specified below. Disc herniations: Soft nucleus-pulposus herniations occur in
      every age group. In elderly patients, the osseous constriction of the lumbar
      canal (especially by spondylarthrosis) often leads to spinal claudication.
      Functional myelography with myelograms taken in the sitting and the standing
      position is important for preoperative appraisal. On the basis of the
      clinical/neuroradiological findings, it may be decided whether a selective or an
      extended decompression is necessary. Larger-scale decompressions are mostly
      possible in this age group without postoperative instability, with good results
      in more than 80% of the cases. In our clinic, anterior microsurgical
      decompression without graft is the most frequently used procedure in cervical
      disc herniations/spondylosis, a method which is well tolerated by spinal cord and
      nerve roots: 75% simple anterior discectomies/spondylectomies compared to only
      25% classical Cloward operations with bone grafts. We use intervertebral bone
      grafts only in severe spondylosis and/or instabilities, if necessary in
      combination with metal plates (e.g. in the context of cervical myelopathy).
      Craniocerebral injuries: Epidural hematomas and CSF fistulae, but also
      circumscribed space-occupying contusions have a relatively favorable prognosis in
      every age group. The older the patient, the more serious is the acute subdural
      hematoma, which is often associated with extensive contusions, although
      surprisingly good recoveries are occasionally possible postoperatively even here.
      Detailed scrutiny of all prognostically relevant factors is important. In
      borderline situations we give the patient a chance in order to take later action,
      depending on the course. Chronic subdural hematomas are especially frequent and
      readily dealt with surgically in patients over 60 years. The simple borehole
      drainage to the outside is often sufficient. In extensive excreting membranes,
      which are especially frequent in elderly patients, we prefer today a subdural
      peritoneal drainage for six to eight weeks to the very much more burdensome
      craniotomy: The relatively simple operation allows an early mobilization and
      almost always a prompt healing. Hydrocephalus male resorptivus is also very much
      more frequent in this age group.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1745889
TI  - [Orthotopic liver transplantation--indications and results].
AB  - Indications for and results of orthotopic liver transplantation (OLT) were
      modified over the past ten years by new immunosuppressive agents, earlier timing
      of transplantation and better knowledge of potential complications. In 1990, OLT
      appears justified in the treatment of all liver disease threatening life, in the
      absence of contraindications and other possible treatments. Between July 1987 and
      December 1990, 21 patients were transplanted at the Geneva University Hospital.
      Three children received part of an adult liver (two or three segments), using the
      reduced-size liver transplantation technique. Four OLTs had to be performed in an
      emergency situation. Two patients died within six months of transplantation, one
      after 7.5 months, and the last patient died after one year from cancer
      recurrence. 17 patients are presently alive (81%) at 4 to 39 months (median 14
      months) following OLT. More than the mere survival, however, the quality of life
      regained after transplantation prompts us to consider transplantation early in
      the progress of the disease.

PMID- 1745890
TI  - [A case from practice (232). Stage I sarcoidosis with erythema nodosum and
      febrile arthropathy (Lofgren syndrome)].

PMID- 1745891
TI  - [Principles of gene technology and potentials of DNA diagnosis].
AB  - Gene technology offers new potentialities for medicine in the diagnosis,
      treatment and also prevention of disease. DNA diagnostic procedures are already a
      cornerstone of genetic counselling. The number of mutated genes identified and,
      as a consequence, the number of disorders diagnosable with a molecular genetic
      approach, is steadily increasing. Since a given gene is present in practically
      all somatic cells, it can, irrespective of its expression, be analyzed using
      white blood cells or chorionic vili as a source of DNA. This results in an
      extension of disorders diagnosable before birth (prenatal diagnosis) or before
      its clinical manifestation (presymptomatic diagnosis) as well as in the reliable
      recognition of clinically healthy carriers of defective genes. DNA diagnostic
      procedures have already gained practical application in oncology, immunology or
      forensic medicine. The methodology of molecular biology allows the analysis of
      infectious agents in tissues or body fluids that are only present in a latent
      state. We are only at the dawn of the century of molecular medicine. However, our
      knowledge of the cause and the nature not only of rare single genetic diseases
      but also of common multifactorial disorders, such as cardiovascular diseases,
      cancer or autoimmune diseases, is increasing through gene technology. Therefore,
      on the one hand the new genetics holds out numerous promises and hopes, while on
      the other hand, a future characterized by exorbitant genetic testing increases an
      irrational fear of this technology in the public. Members of the medical
      profession must interest themselves in molecular genetics in order to be able to
      follow the development of modern medicine but also to inform their patients and
      the general public about the new possibilities and limitations, as well as any
      risks, of genetic testing. This is the only way to ensure proper use of gene
      technology in medicine without irrational legal restrictions imposed by an ill
      informed public.

PMID- 1745892
TI  - [Diagnosis and treatment of pulmonary infection due to Mycobacterium malmoense].
AB  - To date more than 150 patients with Mycobacterium malmoense disease have been
      reported. These infections are rare and only in one case, so far not published,
      is this species associated with Aids. Most reported cases were seen in northern
      Europe. We present three pulmonary cases from Switzerland. M. malmoense causes
      lung disease resembling tuberculosis clinically and in chest X-ray. Disease is
      considered to be present when two and more sputums or bronchial washings are acid
      fast bacilli smear-positive and culture-positive. M. malmoense grows slowly on
      egg-based bacteriological media; the incubation time is at least 6 weeks and the
      use of special solid or liquid media is recommended. Person-to-person
      transmission is rare and, in contrast to tuberculosis, isolation of the patient
      is not necessary and subsequent close contact persons do not need to be
      evaluated. It seems that a combination of isoniazid, rifampicin and ethambutol
      given for more than 12 months is the best regimen.

PMID- 1745893
TI  - [The need of providing a comprehensive civil service for the management of
      geriatric health care problems in the coming decades].
AB  - From (1) the Swiss population census 1980, (2) the calculations of the Swiss
      Federal Office of Statistics, referring to the probable age composition of the
      stable Swiss population from 1990 to 2025 (scenario 2A-86), (3) the meta-analysis
      of Jorm et al. [8] on the prevalence of dementia, and (4) a study of the Swiss
      Federal Office of Statistics on the nursing personnel employed by inpatient
      institutions for the care of the aged, it is concluded that the number of elderly
      patients suffering from moderate to severe dementia will increase in Switzerland
      from 48,000 to 92,000 during the years 1980-2020. In 1990 the nursing staff for
      the ambulatory and inpatient care of 62,900 patients with dementia numbered
      17,100 full-time positions. The calculated need for such positions was 37,700 in
      1990 and will be 55,200 in 2020. This major shortfall in nursing capacities, now
      and in the near future, can probably not be covered by an extension of
      extrahospital services and certainly not by increased training of nursing
      personnel. By analogy with the obligatory military service for young men in
      Switzerland, an obligatory civilian service for men and women, for the care of
      the aged, is therefore proposed.

PMID- 1745894
TI  - Common horse sense.

PMID- 1745895
TI  - The danger from Kuwait's air pollution.

PMID- 1745897
TI  - Sharper image. Picosecond photography may reveal tumors.

PMID- 1745896
TI  - Crossed lines. Eve's family tree may have a few branches from Adam.

PMID- 1745898
TI  - Digital dyslexia. Neural network mimics the effects of stroke.

PMID- 1745899
TI  - Profile: Gertrude Belle Elion. The satisfaction of delayed gratification.

PMID- 1745900
TI  - Iron deficiency.

PMID- 1745901
TI  - The Assessment Unit of the Epilepsy Centre, Quarriers Homes.
AB  - The work of the Assessment Unit in the Epilepsy Centre, Quarriers Homes, Scotland
      is described. One hundred and thirty patients with severe epilepsy were admitted
      over a three year period for investigation of seizures and rationalisation of
      therapy. The degree of psychomotor impairment due to epilepsy itself, or to anti
      epileptic drugs was estimated. Cognitive functioning and levels of ability with
      interpersonal relationships were measured and plans were drawn up for
      rehabilitation. A plea is made for NHS funding to support the provision of this
      service for people with epilepsy.

PMID- 1745902
TI  - Decisions to limit treatment in a neurosurgical unit: an aspect of audit of
      mortality.
AB  - The monthly audit of deaths in this regional neurosurgical unit notes decisions
      to limit treatment recorded in the case-sheet. In 1988 a treatment-limiting
      decision was noted in 67 of 131 deaths (51%). In 40% of these the decision was
      made soon after admission; in these patients the mean time to death was 1.5 days
      (median one day). When the decision was made later, the mean time for admission
      to death was 6.8 days (median five days). Regular audit provides an opportunity
      to discuss the appropriateness of such decisions in various circumstances.

PMID- 1745903
TI  - Unplanned re-attendance in the accident and emergency department.
AB  - The notes of patients who re-attended the Accident and Emergency Department with
      a problem for which they had already been seen and treated were reviewed over a
      five-week period. Such patients comprised 2.5% of total attendances. The
      commonest reason for re-attendance was persistent pain following an injury and of
      such patients, about a half required a significant change in management. It was
      estimated that two-thirds of re-attendances were unavoidable. Twenty patients
      were admitted following re-attendance, and of these, two had serious medical
      conditions which were missed on initial presentation. The role of senior Accident
      and Emergency doctors is discussed in the light of these findings.

PMID- 1745904
TI  - What do Scots die of when abroad?
AB  - Information was obtained on 952 persons who travelled from Scotland between 1973
      and 1988 and who died while abroad. In the older age group cardio-vascular
      disease was the major cause of death whereas in the younger group traumatic
      deaths were commonest. Most died in the holiday resorts bordering the
      Mediterranean and the question is posed on the need for specific advice to those
      who are most vulnerable before embarking on overseas travel.

PMID- 1745905
TI  - Two coronary artery fistulae in a patient with temporal arteritis and chest pain.
AB  - A 59-year-old woman with a history of cardiac sounding chest pain was
      investigated by coronary arteriography. Two unsuspected fistulae were found. The
      fistulae originated from the distal right coronary artery and the diagonal branch
      of the left coronary artery. Both drained into the left ventricle. She was also
      found to have temporal arteritis, treatment of which abolished the chest pain.

PMID- 1745906
TI  - Politics, society and medicine in the 18th century.
AB  - Medical theory and practice in the 18th century reflected the thought and culture
      that the Renaissance had fashioned. This article draws attention to the political
      and social changes of the period and notes their inter-relationship with the
      changes that occurred in medicine.

PMID- 1745907
TI  - Chronic chest pain in a 16-year-old girl from the Middle East.

PMID- 1745908
TI  - Hand injuries in adults.
AB  - The radiologist plays an important role in the evaluation of hand injuries.
      Although the detection of fractures is important, recognition and delineation of
      soft tissue damage is equally vital. If only soft tissue injuries exist, plain
      film findings are often nonspecific. Nevertheless, they can give helpful clues in
      evaluating ligaments and tendons. It is especially important for the radiologist
      to be knowledgeable of these soft tissue injuries because, in an emergency room
      setting, the radiologist may be the physician most familiar with the spectrum of
      injuries and possible complications.

PMID- 1745909
TI  - Radiographic evaluation of wrist trauma.

PMID- 1745910
TI  - Trauma to the elbow and forearm.
AB  - Elbow and forearm trauma constitute a significant percentage of upper extremity
      injuries. A thorough understanding of the anatomy and mechanism of injury is
      necessary for obtaining the most accurate radiographic interpretation in both the
      pediatric and adult populations. Proper radiographic positioning and choice of
      the best imaging modality are crucial to ensure the best orthopedic treatment and
      reduce the incidence of post-treatment complications.

PMID- 1745911
TI  - Trauma to the shoulder girdle.

PMID- 1745912
TI  - Anthropology rediscovers sex. Introduction.

PMID- 1745913
TI  - Sex, culture and the anthropologist.
AB  - The apocalyptic threat of AIDS, combined with recent ethnological developments,
      is promoting an anthropological "rediscovery of sex." If this rediscovery is to
      have important and lasting effects on the development of theory, a stock-taking
      is in order--one which examines anthropology's historical, methodological, and
      practical relationship to the study of sexual behavior. Parallel theoretical
      directions taken in both American and British anthropology, starting in the late
      1920's, resulted in a disciplinary departure from the study of sexuality, as
      such; sexual behavior became shielded from analytic view by a more abstract,
      propositional approach to society and culture. In addition to reviewing these
      historical trends, the paper considers elements of personal privacy and
      intrasocietal variation in the anthropology of sex and, with illustrations taken
      from the Ilahita Arapesh of northeastern Papua New Guinea, proposes that the
      locus of sexual behavior and experience lies in the interaction of cultural ideas
      and psychobiological impulses.

PMID- 1745914
TI  - Anthropology rediscovers sexuality: a theoretical comment.
AB  - Despite its reputation for openness to research on sexuality, anthropology as a
      discipline has only reluctantly supported such work. Anthropological research and
      theory developed slowly, sharing a stable theoretical paradigm (the cultural
      influence model) from the 1920s to the 1990s. Moving beyond determinist and
      essentialist frameworks still common in biomedicine, anthropological work
      nevertheless viewed important aspects of sexuality as universal and
      transcultural. Social construction theory has offered a challenge to traditional
      anthropological models and has been responsible for a recent burst of innovative
      work in sexuality, both in anthropology and in other disciplines, since 1975. The
      theoretical roots and implications of constructionist theory are explored. The
      intensifying competition between cultural influence and constructionist paradigms
      has been altered by the appearance of AIDS and the subsequent increased support
      for research on sexuality. On the one hand, the expansion in funding threatens to
      strengthen essentialist models in biomedical contexts and cultural influence
      models in anthropology. On the other hand, the complexities and ambiguities
      inherent in the sexuality under study may both reveal the strengths of
      constructionist approaches and spur the development of research and theory in
      anthropology.

PMID- 1745915
TI  - Sex and respectability in an age of fertility decline: a Sicilian case study.
AB  - The paper examines two aspects of coitus interruptus as a sexual practice: (1)
      how, in the age of fertility decline in Western Europe, its meaning was
      reinterpreted from an earlier theological view that condemned it as licentious to
      a nineteenth century view that emphasized restraint, and (2) how it was actually
      experienced by a socially stratified birth-controlling population in rural
      Sicily, ca 1900-1970. The sequential experiences of gentry, artisans, and
      peasants in the Sicilian case study of transition from high to low fertility are
      consistent with late twentieth-century interpretations of coitus interruptus by
      Foucault and others as sexually restraining yet empowering. In each group,
      adoption of the practice enhanced access to respectability in a context of
      cultural and economic change. Moreover, those who adopted the practice
      increasingly stigmatized married couples with high birth parities as overly
      dominated by their sexual instincts and unworthy of respect.

PMID- 1745916
TI  - Social psychology of the immune system: a conceptual framework and review of the
      literature.
AB  - The literature on psychosocial factors affecting the immune system is reviewed.
      The literature is summarized in terms of a provisional model accounting for
      immunosuppression in terms of four mutually influential explanatory constructs
      (dysphoric responses; immunosuppressive behaviors; adverse life experiences; and
      vulnerability) and the relationships among the diverse manifestations of the
      constructs. The literature and the summary provisional model point to directions
      for future research that should establish the intervening role of
      immunosuppression in the relationships between psychosocial factors and the
      disease process.

PMID- 1745917
TI  - The European Health and Behaviour Survey: rationale, methods and initial results
      from the United Kingdom.
AB  - The aim of this study was to assess a wide range of health-related behaviours,
      beliefs concerning the importance of behaviours for health, and health knowledge,
      using a standardized protocol suitable for translation and administration in
      different countries of Europe. An inventory was developed from previous
      literature for the assessment of substance use, positive health practices, diet
      and eating habits, driving behaviour and preventive health care, beliefs
      concerning the importance of 25 activities for health, and knowledge about the
      influence of seven factors (including smoking, alcohol and diet) on major
      diseases. The first phase of the study involved administration of the inventory
      to approximately 200 male and 200 female university students aged 18-30 in 20
      European countries. This report concerns data collected from 419 students in the
      U.K., together with analyses of short-term response stability. The inventory
      showed adequate short-term stability. Sex differences were observed in a number
      of behaviours, including consumption of fats and cholesterol, salt and fibre,
      dieting, exercise, sun-protection, driving speed, regular dental check-ups,
      frequency of brushing teeth, access to doctor and blood pressure measurement.
      Beliefs about the importance of behaviours for health were closely associated
      with the occurrence or frequency of the behaviours both within and between health
      behaviour categories. Little relationship was observed between health behaviour
      and awareness of the role of these same factors in disease. Important gaps in
      health knowledge were identified. Data concerning the frequency of health-related
      behaviours is crucial to the planning of health education and primary prevention
      programmes. The close association between beliefs and behaviour emphasises the
      importance of cognitive factors, while health knowledge appears to play a less
      direct role.

PMID- 1745918
TI  - Relationship between water quality and human health: a case study of the Linggi
      River Basin in Malaysia.
AB  - Due to the increasingly documented prevalence of diarrhoeal diseases in Malaysia,
      a number of water-related programmes have been implemented in an attempt to
      improve health status through the reduction of incidence of waterborne
      communicable diseases associated with poor public water supplies. The implicit
      assumption underlying these projects is that the enhancement of the physical
      infrastructure, and subsequent improvements in the quality of the water supply,
      will substantially reduce water-related disease. The present study questions this
      hypothesis and uses a socio-ecological model as a framework to assess risk
      factors associated with the increased probability of waterborne disease. Research
      is centred on Port Dickson, a district which typifies existing water and
      sanitation conditions in much of semi-rural Malaysia. Health services utilization
      data and a 268-household diarrhoeal morbidity survey were used to measure the
      burden of illness of waterborne disease within the district and to identify
      predictors of morbidity. It was concluded that although treatment facilities will
      reduce the health burden in the region, a number of behavioural and sanitation
      factors may be more important and could act to minimize the potential impacts of
      improved water quality.

PMID- 1745919
TI  - Finding meaning after the fall: injury narratives from elderly hip fracture
      patients.
AB  - Hip fractures occur frequently among the elderly, often with severe medical,
      psychological and social repercussions. This research takes a new look at hip
      fracture rehabilitation, focusing on meanings and post-fracture prognostic
      indicators. An innovative methodological approach to narrative analysis is
      employed which combines ethnographic and epidemiologic techniques. Analyses of
      injury narratives from 80 elderly subjects interviewed soon after initial
      hospitalization are presented, focusing on three categories of meaning:
      explanatory models, sense of disability, and futurity. Insights from these
      narratives, as well as from questionnaires and observations, shed light on the
      experience of hip fracture for the elderly. In addition, aspects of the initial
      narratives are considered in relation to ambulation outcomes at 3 and 6 months.
      Those individuals who perceive their problem in a more external or mechanical
      fashion (caused by the environment) show greater improvement in ambulation at 3
      and 6 months relative to those who show no evidence of this thinking or who
      perceive it as an internal or organic problem (in terms of disease or illness).
      Greater improvement in ambulation at 3 and 6 months is also noted for subjects
      whose perception of disability was consistent with more autonomy, independence,
      and a sense of connection with the world around them. The present study
      demonstrates the potential utility of narrative analysis as a data reduction
      approach. It also suggests the possibility of new psychosocial prognostic factors
      for hip fracture rehabilitation.

PMID- 1745920
TI  - Jidda: the traditional midwife of Yemen?
AB  - Contrary to what is assumed, traditional birth attendants (TBAs) do not appear to
      be a clearly defined category of women with specialized knowledge and experience
      of assistance at deliveries in the local cultural situation at village level in
      the Anis region of the central highlands in Yemen. In the actual design of
      training for TBAs in Yemen, this results in problematic provision of basic mother
      and child health care, in particular safe and clean deliveries to all women at
      village level.

PMID- 1745921
TI  - Do prostitutes need more health education regarding sexually transmitted diseases
      and the HIV infection? Experience in a Belgian city.
AB  - From December 1988 till April 1989 154 women who worked in clubs (120) and behind
      windows (34) in and around Ghent, Belgium, were interviewed about knowledge,
      attitudes and practices regarding Sexually Transmitted Diseases (STD) and Human
      Immunodeficiency Virus (HIV) infection in their professional life. Television
      scored best (98%) as a source of information for AIDS. A leaflet posted in every
      door in 1987 was mentioned in 60%. Less than half the women gave more than 7
      correct answers on 11 questions about safety of sex techniques. Intercourse with
      condom, the sexual act mostly done, was considered safer than deep kissing,
      masturbation and even massage. In 10 to 20% of the professional sex contacts no
      condoms were used, which leads to 1000 to 4000 unprotected contacts every week in
      the sex industry in Ghent (population 500,000). Condom use with the private
      partner is exceptional. Proposals for condom use almost invariably come from the
      women themselves instead of from their clients. We conclude that up till now
      health education efforts to prostitutes and their clients were not sufficient and
      that they should be intensified.

PMID- 1745922
TI  - The Amelia Stern syndrome: a diagnosis of a condition among female physicians?
AB  - Numerous studies have provided numerical portraits of some of the difficulties of
      women physicians at work in a field that traditionally has been the preserve of
      men. These studies, like much of recent feminist literature, often focus on the
      tension between maintaining a career and being a wife and mother. They usually
      provide aggregate data but fail to convey compellingly the nuances and emotions
      involved in the issues they address. Perri Klass's recent novel, Other Women's
      Children, the center point of this article, provides a case study of the thoughts
      and feelings attached to the issues addressed by the scientific inquiries. The
      book deals with the experiences of a woman pediatrician in a Boston hospital, a
      woman who uncertainly juggles her career and family responsibilities.

PMID- 1745923
TI  - The Camberwell Community Survey: a summary of results.
AB  - The Camberwell Community Survey was carried out during 1978 and 1979 on a random
      sample of the population of Camberwell in south London. This is an inner city
      area with high deprivation indices. 800 members of the community and a random
      sample of 74 out-patients with affective symptoms were interviewed using the
      Present State Examination (PSE) and Life Events and Difficulties Schedule (LEDS)
      of Brown and Harris. The survey has resulted in many publications. The present
      paper summarises its aims, methods and results.

PMID- 1745924
TI  - The 12-year clinical course of schizophrenia.
AB  - A sample of 46 schizophrenic night-clinic patients (N patients), was matched with
      a sample of 46 hospital patients (H patients) for diagnosis, age, and sex. They
      were followed up from 1971/73 until 1983 on the basis of a personal interview and
      by review of all the case histories and other documents. Their average age at the
      time of the follow-up examination was 40 years. The average duration of the
      illness was 18 years in the night-clinic patients and 15 years in the hospital
      patients. Seven of the 46 N patients (1.4% per year) and two of the 46 H patients
      (0.4% per year) died during the 12 years. Of the surviving patients one-third had
      inconspicuous psychopathology. In one-fifth, psychopathology was only conspicuous
      to a psychiatrist. Only in one-quarter was it very conspicuous even to the
      layman. The N patients had already shown clearer signs of a chronic, insidious
      clinical course during the first four years of their illness than the H patients.
      Although substantially fewer were hospitalised at the time of the follow-up
      examination (17.6% cf 28.6% respectively), far more of them were receiving either
      outpatient or semi-inpatient care. Unsatisfactory social integration was
      revealed, their strong tendency to self-isolation and their inadequate work
      rehabilitation: 71.8% of the N patients and 62% of the H patients were dependent
      on a disability pension, and only 15.4% of the N patients and 20% of the H
      patients were employed at work in keeping with their training and experience.
      Just under half of the patients were living alone. Some 30-40% of them had no
      contacts with friends or acquaintances. Predictors of a somewhat favourable
      clinical course included an acutely phasic course during the first few years of
      the illness, a low level of parental education, and a greater age at the time of
      the manifestation of the illness. In particular, patients whose illness ran an
      acute phasic course during the four years after onset had less lengthy
      hospitalisations in the second stage of the clinical course than patients
      exhibiting signs of chronicity in the early stage.

PMID- 1745925
TI  - Subjective stress in schizophrenic patients.
AB  - The relationship of major life events and daily stressors to subjective stress
      was investigated in outpatients suffering from schizophrenia. Daily stressors or
      hassles were found to be more predictive of subjective stress than were major
      life events. These findings were not influenced by whether a cross sectional or
      prospective analysis was used. The implications for future research on stress and
      schizophrenia are discussed.

PMID- 1745926
TI  - Transfer between psychiatric hospitals: symptom, social function and patient
      attitude changes in long-term patients.
AB  - This study followed up a ward group of long-term, mainly schizophrenic patients
      after transfer from Bexley Hospital, a large institution in South East London, to
      small purpose built rehabilitation unit in a distant hospital, and used a matched
      control group of patients remaining in Bexley Hospital for comparison. There was
      no pattern of symptomatic improvement or deterioration with time in either group,
      but social functioning and behaviour did improve in those transferred. The
      patients transferred were well informed about the process, became more favourable
      about the medical advice offered to them but remained sure, as did patients in
      the control group, that they wanted to leave hospital eventually. We suggest that
      the successful transfer of patients between hospitals must involve clear
      information to prepare patients and relatives, the consent of patients, staff
      enthusiasm, the provision of a full range of services after transfer, including
      occupational therapy, and staff continuity.

PMID- 1745927
TI  - The Ryle Marital Patterns Test as a predictor of symptoms of anxiety and
      depression in couples in the community.
AB  - The associations between marital relationships, as measured by the Ryle Marital
      Patterns Test, and symptoms of anxiety and depression as measured by the Interval
      General Health Questionnaire (I-GHQ), were assessed in 98 married couples in the
      community. Logistic regression analyses showed that symptoms of anxiety and
      depression in wives were best predicted by low ratings of affection exchange.
      Occupational class interacted with husbands' affection ratings, suggesting that
      in the nonmanual class only lower affection ratings were significantly associated
      with more symptoms. Anxiety in men was best predicted by low affection ratings
      while depression was best predicted by unemployment, by an affection discrepancy
      score indicating that more affection is given than received, and by a marriage
      which was rated as relatively more wife-dominated by wives and as relatively more
      husband-dominated by husbands.

PMID- 1745929
TI  - Occupational stress among mental health professionals. The relationship between
      work and recreational pursuits.
AB  - A sample of 111 medical and allied staff in a large child and adolescent
      psychiatric hospital responded to a survey assessing work- and leisure-related
      attitudes. Gender, marital status, parenthood, and length of employment were
      among the demographic variables found to be associated with various facets of
      occupational stress and job satisfaction. Men were somewhat more stressed,
      complained more about their relationships with coworkers and displayed greater
      'negative spill' than women; Married employees were particularly susceptible to
      the adverse effects of work; Parenthood had little effect on work-related stress,
      although there is some indication that being a mother prevented one recuperating
      as effectively as desired during leisure-time; and tenure of employment at the
      hospital was related to increased feelings job pressure without affecting job
      satisfaction levels, and to lower levels of career motivation. The implications
      of these findings are discussed: Suggestions are provided for improving working
      climate and job satisfaction amongst mental health professionals.

PMID- 1745928
TI  - Factors affecting service utilization for depression in a white collar
      population.
AB  - The present study examines rates of mental health service utilization among
      depressed individuals in a large white collar cohort. Clinical and psychosocial
      features of a recent depressive episode, as well as preexisting psychiatric and
      psychosocial characteristics, are examined for their ability to distinguish
      between individuals who (a) did and did not seek help during their episode and
      (b) chose to consult one professional source rather than another. Results showed
      that approximately one-third of the sample sought professional help. Respondents
      consulting mental health specialists were more clinically impaired and had poorer
      work performance and fewer psychosocial assets than both those consulting
      nonpsychiatric physicians and those seeking no help. Respondents in the latter
      two groups were indistinguishable from one another on many of the assessed
      variables.

PMID- 1745930
TI  - [High-resolution CT of the lung].

PMID- 1745931
TI  - [Radiologic diagnosis of pulmonary embolism].

PMID- 1745932
TI  - [The therapeutic modification of euthyroid goiter by thyroid nodule changes using
      thyroid hormones].

PMID- 1745933
TI  - [Diagnosis and interventional aspects in cystic lesions of the liver].

PMID- 1745934
TI  - [The potentialities of MRT in radiation planning for rectal cancer].

PMID- 1745935
TI  - The Human Genome Project--does South Africa have a role to play?

PMID- 1745936
TI  - [A look into the future of inter-species organ transplantation].

PMID- 1745937
TI  - Malabsorption of carbohydrate foods by urban blacks.
AB  - Prevalences of non-infective bowel diseases are very low in South African urban
      blacks compared with the white population. In seeking elucidation, using breath
      hydrogen measurements in series of black and white subjects, small-bowel transit
      time was determined, and the malabsorption of maize, wheat, and rice
      investigated. Median transit times in both ethnic groups were similar. Rice was
      fully, but wheat incompletely absorbed by both groups. Maize, the staple food of
      blacks, was incompletely absorbed by them, although completely absorbed by the
      white subjects. Carbohydrate consumption is high in the black population (60-65%
      of total energy intake). It is probable that in blacks, despite their now eating
      a low-fibre diet, an expected increase in large-bowel diseases has been inhibited
      in part by the protective mechanism of fermentation of malabsorbed maize and
      wheat.

PMID- 1745938
TI  - Glycaemic responses to different carbohydrate foods in healthy and diabetic
      blacks in Soweto.
AB  - Diabetes mellitus is uncommon in rural southern African blacks. With urbanisation
      and lifestyle changes, incidence rises to that in western populations. To assess
      associated changes in carbohydrate metabolism, glycaemic responses to glucose,
      refined maize, refined rice and bread were studied in 8 healthy and 8 non-insulin
      dependent diabetic urban blacks. Additionally, in the healthy group serum insulin
      responses were measured. In the healthy, maize (the staple food of blacks)
      elicited the highest glucose response (207 mmol/l/min) and bread the lowest (107
      mmol/l/min). The glycaemic indices of maize and glucose were similar. Serum
      insulin responses to maize were significantly lower than that of bread at 90
      minutes (maize 66 muU/ml; bread 93 muU/ml; P = 0.02). In diabetics, maize and
      glucose elicited similar glycaemia (928 mmol/l/min and 921 mmol/l/min
      respectively). The high glucose response to maize could relate to its processing
      and physical form. The low insulin secretion could be due to inadequate
      stimulation by the 'entero-insular' axis. Moreover, variability in glucose
      insulin responses could stem from ethnic or genetic reasons. In the dietary
      management of black diabetics, refined maize should be replaced by other cereals.

PMID- 1745939
TI  - Outpatient compliance with theophylline and phenytoin therapy.
AB  - Poor compliance with prescribed medication is a significant problem in chronic
      disease states and is often responsible for the apparent failure of therapy. The
      determinants and extent of non-compliance are commonly incorrectly perceived by
      doctors. During routine therapeutic drug monitoring of epileptic and asthmatic
      outpatients at a local day hospital, non-compliance was identified as a
      significant problem. A compliance study was conducted on 80 epileptic and
      asthmatic patients to determine the nature and extent of this problem. Non
      compliance was measured using four different methods, which were then compared
      using chi 2 tests. Overall incidence of non-compliance was found to be 63%. Age,
      sex, standard of education and duration of disease were found to have no
      association with non-compliance. The most clinically significant finding was that
      almost half the patients were unaware of the necessity of taking their medication
      on a continuous basis. No significant differences existed between assessing non
      compliance using tablet counts, patient interview and clinic attendance, whereas
      the method using blood levels gave significantly different results from all the
      other methods used.

PMID- 1745940
TI  - [Expenditures on medicines at provincial hospitals in the Cape. A comparative
      analysis from 1982-1989].
AB  - Total expenditure on medicines at various hospitals within the Cape Provincial
      Administration (CPA) branch of hospital and health services has increased
      minimally in relation to the consumer price index of 1982 (CPI-1982). However,
      the calculated cost of medication per patient unit differed greatly between the
      hospitals studied. Calculations based on CPI-1982 showed the increase at
      Tygerberg Hospital (TBH) to be 24.3% lower than the increase in CPI. Based on the
      CPI-1985, the increase at TBH was 4.01% higher than the CPI increase. At another
      academic hospital the increase based on CPI-1982 was 35.78%, at two large non
      academic hospitals it was 45.31% and 17.71% respectively, and for the CPA as a
      whole it was 18.83%. Direct comparisons of cost per patient unit between
      hospitals are inappropriate, because of the varying patient profiles and
      consequent differences in required treatments. However, a cost awareness
      programme seems to have been at least partially responsible for the variance in
      cost increase at TBH. A more intensive and sustained programme to encourage cost
      awareness in the prescribing of medicines is called for.

PMID- 1745941
TI  - Market fallacies in health economics.
AB  - Serious methodological errors that plague studies in health economics are
      examined with the focus on misconceptions about the nature and functions of
      markets. The belief that market economics do not apply to the medical marketplace
      involves circular reasoning that treats man-made laws and regulations as though
      they were unchangeable laws of nature. Arguments against the market provision of
      health care are questioned and the 'information gap' problem is shown to be
      aggravated, if not caused, by regulations that prevent normal information flows
      in the market. Similarly, the contention that health care insurance pushes up
      costs is criticised on the basis of both theory and empirical evidence. The
      apparent failure to contain costs may be blamed on legal restrictions, government
      spending and pressure from medical associations. Confusion between normative
      theory and positive theory is also examined.

PMID- 1745942
TI  - Women doctors in South Africa. A survey of their experience and opinions.
AB  - The proportion of women entering medical school has increased at some faculties
      but remains at around 20% at others. A postal survey of 2,626 women on the
      Medical Register of the South African Medical and Dental Council was conducted to
      investigate aspects related to their work. Fifty-five per cent responded, with a
      possible bias towards older doctors and graduates from Afrikaans-language
      faculties. Although a significant majority (86.5%) are in practice, about one
      third (33.4%) are employed part-time and nearly one-third (29.4%) reported that
      they had experienced an interruption of their careers for periods of more than 5
      years. Major factors relating to this wastage of medical resources identified by
      this study were the women's dual responsibility at home and at work, the one-time
      joint taxation system and discrimination in the workplace, in particular with
      regard to housing loans. Few women find their way into specialist practice
      (10.8%) [corrected], although 68.2% indicated that they would have liked to
      specialise. Home responsibilities (48.2%) and the structure of the curriculum
      (31.5%) were the commonly reported difficulties experienced with further study.
      In addition, the lack of part-time training and the geographical location of such
      facilities also played a role.

PMID- 1745943
TI  - The MEDUNSA Stroke Data Bank. An analysis of 304 patients seen between 1986 and
      1987.
AB  - Stroke is a major cause of mortality and morbidity in black Africans. The MEDUNSA
      Stroke Data Bank (MSDB) was established in 1984. Its goal is to gather data on
      all aspects of cerebrovascular disease in South African blacks, and it is
      supported by modern investigative techniques such as computed tomography
      (utilised in 82.2% of cases). The majority of the patients (71.2%) had cerebral
      infarction. Certain features, such as the importance of hypertension and
      increasing age as risk factors, were found to be similar to Western stroke
      populations; also, probable or definite cardiac source for cerebral embolism was
      present in 46% of the patients. In contrast, however, other features, such as
      transient ischaemic attacks, peripheral vascular disease, coronary artery disease
      and lacunar strokes, occurred far less frequently than is reported in Western
      patients. It is hoped that the MSDB will lead to a better understanding of
      cerebrovascular disease in blacks and possibly to in-depth comparative studies of
      the ubiquitous problem of atherosclerosis.

PMID- 1745944
TI  - Real-time sector compression ultrasonography v. contrast venography in
      femoropopliteal thrombosis.
AB  - Compression ultrasonography with a 5 MHz sector transducer was compared
      prospectively with contrast venography in 61 patients for the diagnosis of deep
      vein thrombosis (DVT) in the femoropopliteal segment (63 legs). The
      ultrasonographic procedure was found to be sensitive (84%) and specific (100%) in
      diagnosing femoropopliteal thrombosis. The results using a sector transducer are
      comparable with results obtained from the use of linear transducers. The wide
      availability of 5 MHz sector transducers in radiology departments makes
      compression ultrasonography a widely applicable alternative to contrast
      venography for diagnosis of DVT of the femoropopliteal segment. The procedure is
      less costly, less invasive and less time-consuming than contrast venography.

PMID- 1745945
TI  - Sacral nerve root entrapment demonstrated on computed tomography--'the winking
      ogre'.
AB  - Pictorial analogies are a descriptive modality often employed to convey
      radiological (as well as clinical and pathological) appearances. Examples of this
      useful descriptive device abound and many anatomical terms take their origin from
      such analogies. The cauda equina (horse's tail) and the uvula (grape) are but two
      classic examples. A radiographic appearance resembling a 'winking ogre' on
      computed tomography of the lumbosacral junction is described. This appearance is
      encountered in cases scanned following myelography, where one of the (left or
      right) first sacral nerve roots is compressed by herniated disc material.

PMID- 1745946
TI  - Evaluation of various laboratory techniques to diagnose Helicobacter pylori in
      patients with upper gastro-intestinal tract symptoms.
AB  - Helicobacter (Campylobacter) pylori is strongly associated with type B gastritis.
      The detection of H. pylori, which entails histological examination and culture of
      gastric biopsy specimens, takes several days. There has been much interest in
      developing more rapid tests, including non-invasive ones. Using histology and/or
      culture as the 'gold standard', several methods to detect H. pylori were compared
      and evaluated. The organism was detected in 84 of 100 consecutive patients
      attending the Gastrointestinal Unit of King Edward VIII Hospital for upper
      gastrointestinal tract endoscopy. Histological examination was the most sensitive
      (98%) and specific (100%) method used in detecting H. pylori in gastric biopsy
      specimens. An enzyme-linked immunosorbent assay to detect specific IgG antibodies
      to whole H. pylori organisms is a moderately sensitive (82%), non-invasive method
      but it is nonspecific (38%). Although culture was specific (100%), it was less
      sensitive (68%) than histological examination. The 'conventional' urease assays
      must be performed under controlled conditions (37 degrees C) for optimal results
      (sensitivity, 71%).

PMID- 1745947
TI  - Impact of a measles immunisation campaign on measles admissions to a Natal
      hospital.
AB  - During May and June 1990, a national mass measles immunisation campaign was
      undertaken in South Africa. This study is an assessment of the impact of the
      campaign on measles admissions to a provincial referral hospital that has
      specifically designated wards for children with communicable diseases. Data from
      the measles ward admissions book for the 18 months before the campaign (1 January
      1989-30 June 1990) and 6 months after the campaign (1 July 1990-31 December 1990)
      were compared. Since the campaign, the average number of measles admissions has
      declined by 64.4% from 87 to 31 per month (P less than 0.01). Before the
      campaign, 21.3% of measles patients admitted were aged 7-9 months compared with
      27.6% after the campaign, highlighting the urgent need to improve the measles
      vaccination coverage in this age group. An analysis of the geographical source of
      patients showed that measles continued to occur after the campaign in most of the
      areas where it existed before the campaign. It is concluded that important gains
      have been achieved by the campaign. These will be rapidly eroded and epidemics of
      measles may occur if measles vaccination efforts wane and slump back to pre
      campaign levels. It is important to capitalise on the momentum generated through
      the campaign by continuing to support efforts of existing health care services to
      improve and maintain high levels of measles immunisation coverage.

PMID- 1745948
TI  - Botshabelo's vaccination survey.
AB  - This community-based survey evaluates vaccination coverage of small children and
      socio-economic status of their households in a randomly selected sample of a
      black South African township. It reveals a poverty-stricken community, where only
      19% of the children surveyed were fully vaccinated. It is suggested that
      expansion of health infrastructures together with a co-ordinated strategy of
      immunisation would result in a spectacular increase in vaccination coverage.

PMID- 1745949
TI  - Reproductive health care in the Gelukspan Health Ward.
AB  - Reproductive health care, namely family planning, antenatal care (ANC), labour
      care and postnatal care, was studied in the Gelukspan health ward of
      Bophuthatswana in 1985-1986. Only a minority of the women interviewed (20%) had
      planned their last pregnancy, but most had attended for ANC (93%) and had had
      supervised deliveries in a hospital or clinic (80%). Most (97%) knew of modern
      methods of fertility control but only a minority (37%) were using them. Planned
      pregnancies were more likely to be reported by married women (73% of 37 v. 9% of
      173; P = 0.0000) who left school at an earlier age (16.0 +/- 5.9 years v. 17.0 +/
      3.9 years; P = 0.0462). If unmarried, women who had planned their pregnancy were
      more likely to be maintained by the father of the child (15% v. 4%; P = 0.0134).
      They were also less likely to have left school because of the pregnancy (20% v.
      50%; P = 0.0001). Unmarried women with supervised deliveries are more likely to
      have financial support from the father of the child. Maternal school education is
      positively related to attendance for ANC, attendance for supervised labour and
      utilisation of modern methods of fertility control. There seems to be an
      intricate relationship between the different outcomes measured. ANC attenders
      were more likely to have supervised deliveries. Both groups were more likely to
      start attending for child health care earlier and more frequently. Our results
      are discussed.

PMID- 1745950
TI  - Early life nutrition in the Gelukspan Health Ward.
AB  - Breast-feeding, supplementary feeding and weaning practices as well as nutrition
      during the second year of life were studied in 210 black primiparas, who had
      cared for their own children through the first year, in a poor, one-crop (maize)
      rural area in Bophuthatswana. The sampling strategy was similar to the one
      recommended by UNICEF for assessment of vaccination coverage. Only 1 child had
      never been breast-fed and 60% were still breast-fed at the time of the interview
      during the second year of life. A number of factors were detected that seem
      important determinants of breast-feeding behaviour, e.g. marital status and level
      of formal education. Early supplementary feeding and early weaning were
      identified as major problems. Children were weaned onto commercial feeds or low
      energy-dense staples, and there was also an obvious lack of energy-dense foods
      (e.g. butter, coconut oil) during the second year of life. Some determinants of
      these practices were recorded. The data have implications for the health services
      and should influence social and educational policy for the area. If properly
      implemented, the recommendations could result in significant financial saving for
      the study population. The health services should promote appropriate nutritional
      education, starting with antenatal care, early and frequent attendance at child
      health services should be encouraged and education concerning nutrition should be
      strengthened, and health education should encourage prolonged breast-feeding,
      discourage the use of commercial weaning foods, and encourage the use of natural
      multimixes (e.g. bananas, beans, cooking oil) for weaning. The importance of
      energy-dense foods should be emphasised to mothers and to health workers.

PMID- 1745951
TI  - Human T-lymphotropic virus type I-associated myelopathy. A case report.
AB  - Tropical spastic paraparesis (TSP) has been reported from various parts of the
      world for several decades. Recently reports have emerged from Japan and also
      countries in tropical zones associating endemic TSP with abnormally high titres
      of antibodies to human T-lymphotropic virus type I (HTLV-I). Data indicate that
      this lymphotropic retrovirus is neuropathogenic, either by direct invasion or via
      immunopathological mechanisms. A South African man is described who met the
      diagnostic criteria of TSP. Both serum and cerebrospinal fluid were antibody
      positive for HTLV-I. It is possible that HTLV-I infection may be implicated in
      the 'myelopathies of undetermined cause' that form a substantial subgroup of
      spinal cord disease occurring in black South Africans.

PMID- 1745952
TI  - Severe fetal tachycardia after administration of hexoprenaline to the mother. A
      case report.
AB  - A fetus developed extreme supraventricular tachycardia (210/min) after
      intravenous hexoprenaline 10 micrograms was administered to the mother for
      intrapartum fetal distress. Urgent caesarean section resulted in the birth of a
      male baby with a reduced Apgar score; the infant survived after being ventilated
      for 24 hours.

PMID- 1745953
TI  - Haemostasis by angiographic embolisation in exsanguinating haemorrhage from
      facial arteries. A report of 2 cases.
AB  - Life-threatening exsanguinating haemorrhage from arteries of the face following
      trauma is uncommon. When it occurs it is often located in the relatively
      inaccessible parts of the vessels and requires deep face or neck exploration and
      ligation of the main feeding vessel. The procedure requires expert head and neck
      vascular surgery performed under general anaesthesia, which is often not suitable
      in these haemodynamically unstable patients. In addition, surgery is often
      rendered more difficult by the associated post-traumatic swelling and
      disfigurement. Because of these considerations, angiographic embolisation of the
      bleeding vessels was performed as an alternative to surgical exploration. This
      report illustrates its use in achieving haemostasis in 2 patients.

PMID- 1745954
TI  - Tertiary role of critical care in academic hospitals.

PMID- 1745955
TI  - Danger of inhaling trichloro-ethane.

PMID- 1745956
TI  - Innovative medicine?

PMID- 1745957
TI  - Cognitive recovery correlates with long-term increases of cerebral perfusion
      after head injury.
AB  - Prospective measurements of cerebral blood flow (CBF) and Cognitive Capacity
      Screening Examination (CCSE) were obtained following head injury among 42
      patients for a mean total follow-up interval of 10 years. Clinical data obtained
      at the time of injury and detailed neurological examinations at each follow-up
      visit were correlated with serial CBF and CCSE scores. Comparisons of the group
      of patients who cognitively improved (n = 32) were made with the group that did
      not (n = 10). Of the total group, 76% showed cognitive improvements for as long
      as 10 years after injury, with CBF increases toward normal. Predictors for long
      term cognitive improvements include: higher initial Glasgow Coma Scales, earlier
      recovery from coma, absence of signs of brain stem injury, and improvements of
      cerebral perfusion and autoregulation. Failure to improve correlated with low
      initial Glasgow Coma Scales, signs of brain stem injury, and persistent
      impairments of cerebral perfusion.

PMID- 1745958
TI  - Perioperative complications of encephalo-duro-arterio-synangiosis: prevention and
      treatment.
AB  - We performed encephalo-duro-arterio-synangiosis on 169 sides of 81 Moyamoya and 8
      non-Moyamoya patients in the past 10 years. The advantage of this operation is
      its minimal operative invasion, giving rise to few operative complications.
      During 10 years of practice, however, we encountered some perioperative problems.
      Perioperative cerebral infarction of varying severity was seen in six Moyamoya
      patients. Severe hyperventilation with crying was the main trigger of infarction.
      Two patients developed wound infection with Gram-negative rods. Removal of an
      infected bone flap was necessary. One Moyamoya patient developed malignant
      hyperthermia during the operation. One acute epidural hematoma necessitated an
      emergency hematoma removal. Five patients showed a temporary aggravation of
      involuntary movements. Prolonged mild fever and temporary and limited hair loss
      around the wound were often observed. Cases and their treatment are presented
      with discussion of preventive measures.

PMID- 1745959
TI  - Anatomical variations of the straight sinus on magnetic resonance imaging in the
      infratentorial supracerebellar approach to pineal region tumors.
AB  - Anatomical variations of the straight sinus (SS) were examined on magnetic
      resonance imaging (MRI) in 108 control cases and five cases with a pineal region
      tumor. The data of the latter were compared with the operative findings in the
      infratentorial supracerebellar approach. In the 108 control cases, the length of
      the SS was 51 +/- 5.2 mm. The angle of the SS to the nasion-tuberculum sellae
      line, the tuberculum sellae-inion line, and the nasion-inion line was 51 +/- 6.7
      degrees, 44 +/- 5.0 degrees, and 47 +/- 5.0 degrees, respectively. The SS was
      inclined 1.4 +/- 4.5 degrees posteriorly to the bregma-inion line. The anatomical
      relationship between the SS and the corpus callosum was subgrouped into three
      types: in the common type (63%), the extended line of the slope of the SS is
      tangential to the upper aspect of the splenium of the corpus callosum; in the
      high-angle type (26%), the extended line is far above the tangent line; and in
      the low-angle type (11%), the extended line is far below the tangent line. The
      operative field was restricted by the steeply inclined tentorium in the case of
      the high-angle type, and the tumor was located much lower than the direction of
      the operative approach. In contrast, the tumor was easily exposed in the center
      of the wide operative field in the cases of low-angle type. The present study
      suggests that the preoperative MRI analysis of the angle of the SS is
      indispensable before taking the infratentorial supracerebellar approach to the
      pineal region tumors.

PMID- 1745960
TI  - Reconstruction of the skull base using a silicone plate during transsphenoidal
      surgery.
AB  - Our operative experience of reconstruction of the skull base using a silicone
      plate during rhinoseptoplastic transsphenoidal surgery is described. A suitably
      shaped plate can be easily and quickly made from a large silicone block of the
      type that is widely used in cosmetic surgery. The plates can be distinguished on
      magnetic resonance images postoperatively. We consider that this technique is of
      use not only for repairing the sellar floor, but also for closing a wide defect
      of the skull base.

PMID- 1745961
TI  - Intracranial cerebrovascular vasa vasorum associated with atherosclerosis and
      large thick-walled aneurysms.
AB  - Atherosclerotic plaques that develop in the extracranial circulation are usually
      extensively vascularized by vasa vasorum. However, human vasa vasorum associated
      with intracranial atherosclerosis has not been adequately addressed. Anterior and
      posterior circulation specimens from fresh autopsy material were studied under
      the magnification of a dissecting microscope and proliferative vasa vasorum was
      found to be frequently associated with intrinsic atheromatous plaques. Vasa
      vasorum associated with an incidental large aneurysm supports the radiological
      literature demonstrating that many large and giant thick-walled aneurysms exhibit
      vascularized walls on contrast computed tomography scans. This information may
      aid in the preoperative assessment and possible repair of these aneurysms.

PMID- 1745962
TI  - A national survey of neurosurgical care for penetrating head injury.
AB  - We report results of a survey on the management patterns of penetrating head
      injury (PHI). American neurosurgeons (N = 2969) were asked to participate in a
      mail survey. One thousand one hundred twenty-eight responded, providing detailed
      information about their practices, their opinions concerning diagnostic testing,
      nonoperative therapy, and surgical debridement for PHI. Although there was
      agreement on some areas of management and care, including the use of computed
      tomography scanning, antibiotics, anticonvulsants, and a few surgical
      indications/contraindications, there was wide variation on a significant number
      of points. These included testing for coagulopathy; use of corticosteroids,
      intracranial pressure monitoring, and barbiturate coma; and surgical indications
      including debridement of contusions, removal of fragments, location of injury,
      and Glasgow Coma Score 5-8. Many nonoperative decisions were influenced by the
      presence of neurosurgical residents, whereas the decision to operate was based
      primarily on judgment of patient salvageability. This survey uncovered
      disagreement on several crucial issues in the care of patients with penetrating
      head injury and the need for continued research in this area of patient care.

PMID- 1745963
TI  - New division of neurosurgery at Toronto Hospital.

PMID- 1745964
TI  - Benign nasal polyposis presenting as an intracranial mass: case report.
AB  - An interesting case of benign nasal polyposis with intracranial extension and
      subsequent abscess formation is described. Its diagnosis and treatment are
      presented and the pathology is demonstrated. The literature related to this rare
      disease process is discussed in detail.

PMID- 1745965
TI  - Intracranial lipoma in the medulla oblongata.
AB  - Intracranial lipoma in the medulla oblongata has been rarely reported. Only two
      cases have been documented in the literature. This report concerns a patient who
      complained of nuchal soreness and an unstable gait for 6 months. An olivelike
      lipoma, arising from the posterior aspect of the medulla oblongata and embedded
      in the lower cranial nerves, was found at suboccipital craniectomy and posterior
      laminectomy of C1-2. Partial removal of the lipoma was performed for
      decompression; radical removal would have been hazardous. The clinical symptoms
      subsided postoperatively. The computed tomography scan and magnetic resonance
      image proved useful for properative diagnosis.

PMID- 1745966
TI  - Hemangioma of the temporalis muscle: case report and review of the literature.
AB  - A 51 year-old man presented with a 10-year history of a painless, slowly growing
      mass (35 x 25 x 15 min) in the right temporal fossa. The T1-weighted image on
      magnetic resonance imaging demonstrated a partial, low-signal intensity lesion
      with high intensity in the lower part and significant enhancement with contrast
      medium. The tumor, which lay within the temporal muscle, was totally excised, and
      histological examination confirmed the lesion to be an intramuscular, cavernous
      type of hemangioma. The therapeutic options are described.

PMID- 1745967
TI  - Abdominal cyst formation following ventriculoperitoneal shunt in a case of
      hydrocephalus due to cryptococcal meningitis. Case report: completely cured by
      surgical removal of the cyst and treatment with a newly developed anti-fungal
      drug (Difulcan).
AB  - A 54-year-old woman was admitted to the hospital for evaluation of meningitis.
      Tuberculous meningitis was suspected initially because of general findings and a
      high adenosine deaminase activity (ADA) value in the cerebrospinal fluid.
      Administration of antituberculous drugs was not effective. Computed tomography
      scanning revealed progression of ventricular enlargement. A ventriculo-peritoneal
      shunt was placed upon diagnosis of hydrocephalus due to meningitis. The presence
      of a large abdominal cyst formation was demonstrated. Cryptococcus was detected
      in the cyst fluid, leading to a diagnosis of cryptococcal meningitis. Intravenous
      administration of fluconazole (400 mg/day) was begun. Excision of the cyst was
      performed when Cryptococcus was no longer detected in the cyst fluid. The patient
      recovered uneventfully.

PMID- 1745968
TI  - Difficult to determine the origin of neuromas in jugular foramen.

PMID- 1745969
TI  - Eastern Cooperative Oncology Group study 1879: mitotane and adriamycin in
      patients with advanced adrenocortical carcinoma.
AB  - From November 1979 to July 1986, 52 patients (27 women and 25 men; median age 52
      years) with advanced adrenocortical carcinoma entered a prospective,
      nonrandomized study evaluating moderate-dose mitotane and doxorubicin
      hydrochloride (Adriamycin). Thirty-two tumors (62%) were well differentiated and
      evidence of hormone production was present in 24 patients (46%). Patients with
      well-differentiated or functional tumors received mitotane, 6 gm daily; patients
      for whom mitotane failed or those with poorly differentiated, non-hormone
      producing tumors received Adriamycin, 60 mg/m2 every 3 weeks. Initially, 36
      patients were treated with mitotane and 16 patients with Adriamycin. Eight
      patients (22%) responded to mitotane and three (19%) responded to Adriamycin. No
      response was noted in the 15 patients for whom mitotane failed and who then
      received Adriamycin. Severe toxicity occurred in 36% of patients who received
      mitotane and in 26% who received Adriamycin. Overall median survival after onset
      of treatment was 14 months. We conclude that mitotane or Adriamycin used
      initially can induce tumor regression in about 22% and 19% of selected patients,
      respectively. However, Adriamycin is ineffective as second-line chemotherapy for
      patients with well-differentiated or functioning tumors for whom mitotane is
      ineffective.

PMID- 1745970
TI  - Incidentally discovered adrenal tumors: an institutional perspective.
AB  - With the aim of developing guidelines for investigation and management of adrenal
      incidentalomas, 2066 patients with adrenal masses were analyzed from a total of
      61,054 computerized tomographic (CT) scans done from 1985 through 1989. Excluding
      patients with previous or concurrent malignancies, adrenal tumors localized after
      biochemical documentation of disease, and adrenal nodules less than 1 cm, 259
      patients (0.4%) remained for analysis. Added to these were 83 patients (total
      342) in whom the adrenal tumor had been found elsewhere before referral. There
      were 136 men and 206 women with a mean age of 62 years. Tumor diameter ranged
      from 1 to 11 cm (average 2.5 cm). Studies to evaluate biochemical hyperfunction
      were performed in 172 patients (50%), 2 of whom were found to have cortisol
      producing tumors and 5 pheochromocytomas. Histologic proof of diagnosis was
      obtained in 55 patients at the time of adrenalectomy. Malignancy was discovered
      in five patients (four primary and one metastatic), the smallest malignant tumor
      measuring 5 cm. In the 287 patients without histologic diagnoses, a minimum of 1
      year of clinical follow-up was obtained in 251 (88%), including repeat CT scan in
      156 (54%). None of these patients had clinical or biochemical adrenal
      abnormalities. We suggest (1) biochemical screening in patients with
      incidentalomas larger than 1 cm, (2) surgical excision of tumors 4 cm or greater,
      and (3) a comparison CT scan approximately 3 months after diagnosis in patients
      with tumors less than 4 cm in whom observation has been chosen.

PMID- 1745971
TI  - Primary hyperparathyroidism during pregnancy.
AB  - Historically, primary hyperparathyroidism during pregnancy was associated with
      significant risk of maternal morbidity and fetal death. Maternal hypercalcemia
      results in fetal hypercalcemia, leading to suppression of fetal parathyroid gland
      function. Neonatal hypocalcemia with tetany is a common occurrence after birth
      when maternal calcium flow is interrupted. From 1930 to 1990, 109 cases of women
      with primary hyperparathyroidism associated with pregnancy have been reported, 39
      of whom were treated surgically before delivery. Although fetal mortality rates
      for medically treated women have improved, fetal morbidity continues to remain
      higher than in women who undergo surgical treatment of parathyroid disease during
      pregnancy. Of 850 patients treated surgically for primary hyperparathyroidism
      since 1960, 12 were pregnant. Four of the patients were treated medically during
      pregnancy and underwent surgery after delivery; all four infants had neonatal
      hypocalcemia and tetany. The remaining eight patients were treated surgically
      during pregnancy: six in the second trimester and two (one with associated
      pancreatitis and one with hypercalcemic crisis) during the first trimester. There
      was no fetal or maternal morbidity or death in the surgical group. Parathyroid
      adenomas were present in 10 of the patients, hyperplasia in one, and parathyroid
      carcinoma in one. The management of maternal primary hyperparathyroidism
      diagnosed during pregnancy should be based on the patient's symptoms and severity
      of disease. Hyperparathyroidism characterized by progressive symptoms should be
      treated surgically, preferably during the second trimester. Symptom-free patients
      and those with mild hypercalcemia diagnosed in the third trimester may be managed
      medically, postponing operation until after delivery.

PMID- 1745972
TI  - Usefulness and limits of quick intraoperative measurements of intact (1-84)
      parathyroid hormone in the surgical management of hyperparathyroidism: sequential
      measurements in patients with multiglandular disease.
AB  - This study was designed to assess whether reliability of quick intraoperative
      assay of intact (1-84) immunoreactive parathyroid hormone (iPTH) could allow us
      to quit after removing one (or several) enlarged parathyroid gland(s) and
      obtaining a normal iPTH level. Intact iPTH was assayed during surgery before
      removal of enlarged parathyroid gland(s) and 5, 10, and 20 minutes afterward.
      Forty-seven patients entered the study: 40 with primary hyperparathyroidism (32
      with uniglandular disease and eight with multiglandular disease) and seven with
      secondary hyperparathyroidism; all underwent bilateral neck exploration. Among 32
      patients with uniglandular disease, five had normal basal intraoperative levels,
      25 demonstrated a clear-cut drop from supranormal to normal levels, and two had
      elevated levels. Among the eight patients with multiglandular disease, two had
      undetectable levels and two had normal levels after removal of the first enlarged
      gland. The seven patients with secondary hyperparathyroidism demonstrated a
      decline in PTH levels, suggesting hormone clearance similar to that of patients
      with primary hyperparathyroidism. In conclusion, quick intraoperative assay with
      intact (1-84) iPTH (1) is not hampered by renal insufficiency, (2) may overlook a
      second enlarged gland after removal of a first adenoma and obtaining normal iPTH
      levels, and (3) should not be used as a substitute for bilateral neck
      exploration.

PMID- 1745973
TI  - Relevance of vitamin D metabolite concentrations in supporting the diagnosis of
      primary hyperparathyroidism.
AB  - We compared the relationships between 25-hydroxyvitamin D [25(OH)D] and 1,25
      dihydroxyvitamin D [1,25(OH)2D] levels in patients with primary
      hyperparathyroidism (PHPT) and 38 volunteer blood donors. There was no
      significant difference in mean 25(OH)D levels between patients with PHPT (34 +/-
      21 nmol/L; n = 21) and the donor samples (41 +/- 19 nmol/L; n = 38). Serum
      1,25(OH)2D levels were higher in the patients with PHPT compared with the donors
      (122 +/- 61 pmol/L vs 56 +/- 41 pmol/L; p less than 0.001). The 95th percentile
      1,25(OH)2D value for the donors was exceeded in 65% of the patients with PHPT.
      There was a significant correlation between serum 1,25(OH)2D versus 25(OH)D in
      the patients with PHPT (r = 0.50; p less than 0.05) but not in the donors (r =
      0.02). We conclude from the distinct elevation in 1,25(OH)2D levels in the
      majority of our patients with PHPT that the concentration of this parathyroid
      hormone-dependent hormone can be of critical value in corroborating the diagnosis
      of PHPT.

PMID- 1745974
TI  - The role of circulating N-terminal parathyroid hormone fragments in the early
      postparathyroid adenomectomy period.
AB  - Calcium metabolism and hormonal control after parathyroid adenomectomy are poorly
      understood. During the first postoperative hours, biologically active intact
      parathyroid hormone (PTH) (hPTH 1-84) levels are subnormal and, in spite of down
      regulation of PTH peripheral receptors (caused by hypercalcemia before surgery),
      total and ionized calcium concentrations are maintained in the normal range.
      Serum samples from 20 patients with primary hyperparathyroidism were collected in
      the immediate preoperative period and 4 and 48 hours after excision of one
      parathyroid adenoma. Total and ionized calcium, intact (iPTH), midregion (mrPTH)
      specific PTH (hPTH 53-68), and N-terminal PTH (N-PTH) serum concentrations were
      determined. Levels of N-PTH were obtained with a radioimmunoassay by a modified
      reverse immunoextraction procedure that measures N-PTH fragments after exclusion
      of the interfering iPTH. No significant correlation was found between ionized and
      total calcium, mrPTH, and iPTH. However, total and ionized calcium levels
      correlated well with N-PTH (r = 0.9999, p = 0.0054, and r = 0.9993, and p =
      0.0226, respectively). The data suggest that the relatively moderate decrease in
      calcium levels, in spite of marked decrease in circulating iPTH during the first
      postoperative hours, may be attributable to the minimal decrease of the bioactive
      N-PTH epitope concentrations. We would hypothesize that hPTH (1-34) fragments may
      play a significant role in regulating serum calcium levels in the early
      postoperative period.

PMID- 1745975
TI  - High phosphate diet-induced primary hyperparathyroidism: an animal model.
AB  - Primary hyperparathyroidism (PHPT) is increasing in incidence and detection,
      primarily because of the aging of our population and the widespread use of
      automated serum calcium determination. As a result, a substantial number of
      "early" cases or "biochemical" PHPT are being detected. The indications for
      parathyroidectomy in such early cases of PHPT are currently under debate,
      primarily because of economic issues. These factors underscore the importance of
      research into the basic mechanisms and natural history of PHPT. We investigated
      an animal model of diet-induced PHPT that retains two crucial aspects of PHPT:
      elevation of endogenously produced parathyroid hormone (PTH), accompanied by
      gross and microscopic changes in the native parathyroid glands. Female Long-Evans
      rats were divided into six groups of 15 each and fed a control diet (Ca/P of 1:2)
      or a high-phosphate diet (Ca/P of 1:7) for 1-, 2-, or 3-month intervals. Compared
      with the control animals, serum PTH levels were elevated at all three time
      intervals in the experimental group, whereas serum calcium levels were decreased
      at all time intervals. Serum creatine levels were also elevated at all time
      intervals, whereas serum phosphorus levels did not change. Parathyroid
      histopathologic studies demonstrated no change at 1 month, whereas nine of 15
      experimental animals showed mild hyperplasia at 2 months and 13 of 14 showed mild
      to moderate hyperplasia with gland enlargement at 3 months compared with control
      animals. Histopathologic examination of the kidneys showed no change at 1 month
      but focal parenchymal inflammation with calcium deposition at 2 and 3 months in
      the experimental groups. In conclusion, the high-phosphate diet successfully
      induced the earliest changes of PHPT: elevated PTH levels and parathyroid
      hyperplasia. However, because renal function was mildly compromised early on,
      some element of early secondary (renal) hyperparathyroidism may have supervened
      quickly. Because this model is simple, it may be useful to investigate this
      complex syndrome further, as well as its natural history and the complications it
      produces in other organs such as the kidneys.

PMID- 1745976
TI  - Lithium effects on dispersed bovine parathyroid cells grown in tissue culture.
AB  - It is not clear whether hypercalcemia and hyperparathyroidism associated with
      lithium therapy are the result of an unmasking of preexisting disease or a direct
      effect of lithium on the parathyroid glands. To investigate this phenomenon,
      parathyroid hormone (PTH) secretion and cytosolic calcium concentrations [( Ca]i)
      were measured in normal and lithium-treated dispersed bovine parathyroid cells
      grown in tissue culture and incubated with varying concentrations of
      extracellular calcium [( Ca]e) (0.5 to 2.5 mmol/L). Results indicate that lithium
      has two effects on parathyroid secretory response: (1) a decrease in low calcium
      stimulated PTH release and (2) a potentiation of PTH release at physiologic
      concentrations of extracellular calcium. [Ca]i was assessed by use of fura-2, a
      calcium-sensitive fluorescent indicator. Resting [Ca]i levels were unaffected by
      lithium (103 +/- 13 nmol/L in controls vs 101 +/- 5 nmol/l in lithium-treated
      cells, mean +/- SE). Subsequent increases in [Ca]i in response to increases in
      [Ca]e were significantly less in lithium-treated cells, with no difference at
      maximal [Ca]e. Increases in [Ca]i in response to a submaximal concentration of
      extracellular magnesium were also blunted in cells pretreated with lithium. In
      conclusion, our data suggest that, at physiologic calcium concentrations, lithium
      decreases parathyroid cell sensitivity to changes in [Ca]e, reducing [Ca]i levels
      and increasing PTH secretory response.

PMID- 1745977
TI  - Location, incidence, and malignant potential of duodenal gastrinomas.
AB  - Duodenal gastrinomas are increasingly found at surgery, yet information about
      their location and characteristics is based on the results of either pooled
      series or retrospective reviews of small numbers of selected cases. To address
      these issues we have analyzed the location, incidence, and malignant potential of
      duodenal gastrinomas in 65 consecutive patients who underwent removal of all
      tumor as part of a 10-year prospective study to resect gastrinomas in patients
      with sporadic Zollinger-Ellison syndrome. The primary gastrinoma was located in
      the duodenum in 24 patients (37%). There were 19 men and five women aged 32 to 69
      years (mean 49.4 years), with symptoms for 0.6 to 35 years (mean 7.9 years).
      Preoperative studies included serum gastrin levels of 114 to 35,798 pg/ml (mean
      2060 pg/ml), basal acid output of 7 to 95 mEq/hr (mean 37.6 mEq/hr), and a
      positive secretin test result in 22 patients. Preoperative imaging studies
      identified tumor in the duodenal area in 11 patients (46%), but most positive
      imaging findings were metastatic gastrinoma in lymph nodes, and the primary
      duodenal tumor itself was identified in only two patients. Portal venous sampling
      had a localizing gastrin gradient in the inferior or superior pancreaticoduodenal
      vein in 17 of 23 patients (74%). Each of the 24 patients had a single, small
      duodenal wall tumor of 2.8 to 10.1 mm diameter (mean 6 mm). Each tumor stained
      positive for gastrin by immunohistochemistry. Seventeen tumors (71%) were located
      in the first portion of the duodenum, five (21%) in the second, and two (8%) in
      the third. Each tumor originated in the submucosa, and 13 (54%) were limited to
      the submucosa, whereas 11 (46%) were locally invasive, four (16%) extending into
      the muscularis mucosa and seven (29%) into the muscularis propria. Thirteen
      patients (54%) had spread to regional lymph nodes, whereas two (8%) had liver
      metastases. Lymph node metastases were seen with larger duodenal tumors (mean 7.1
      vs 5.4 mm; p less than 0.01). The data suggest that a single duodenal wall
      gastrinoma is a common cause of Zollinger-Ellison syndrome (37%). These small
      (less than 1 cm) tumors are located in the submucosal layer of the proximal
      duodenum (92%) and are malignant more often than previously thought (54%).

PMID- 1745978
TI  - Primary bilateral adrenocortical causes of Cushing's syndrome.
AB  - Nontumorous primary adrenal causes of Cushing's syndrome are exceedingly rare.
      Herein we review our results with seven patients in whom there is biochemical
      evidence of a primary (adrenocorticotropin independent) bilateral adrenal cause
      of endogenous hypercortisolism. Each patient had low plasma adrenocorticotropin
      levels. All patients had elevated 24-hour urinary free cortisol levels and 17
      hydroxycorticosteroids that were not suppressed by high-dose dexamethasone.
      Plasma levels of adrenocorticotropin and cortisol were not elevated by ovine
      corticotropin-releasing factor. No patient had a gradient between petrosal and
      peripheral adrenocorticotropin levels. No pituitary tumors were detected by
      magnetic resonance imaging or computed tomography. Five of six patients who
      underwent iodocholesterol scanning showed bilateral adrenal activity. Computed
      tomographic and magnetic resonance imaging of the abdomen demonstrated bilateral
      small adrenal glands in three patients, an adrenal mass in one patient with
      Carney's complex, and massively enlarged glands in three patients. Each patient
      underwent bilateral adrenalectomy and was given glucocorticoid and
      mineralocorticoid replacement. Pathologic examination of four of these bilateral
      adrenal specimens revealed primary pigmented micronodular adrenocortical disease,
      with adrenal gland weights between 2.5 and 13.4 gm (mean 5.2 gm). However, the
      remaining three patients had primary adrenocorticotropin-independent bilateral
      macronodular adrenocortical disease with adrenal gland weights between 32 and 81
      gm (mean 52 gm). Although each of the patients with primary pigmented
      micronodular adrenocortical disease was cured by bilateral adrenalectomy through
      a posterior approach, two of the three patients required an anterior approach. We
      conclude that Cushing's syndrome can arise through two distinct forms of primary
      bilateral adrenal cortical disease. Computed tomography is important in
      evaluation of these patients because the size of the adrenal glands influences
      the surgical approach.

PMID- 1745979
TI  - Presidential address: Beyond surgery. American Association of Endocrine Surgeons.

PMID- 1745980
TI  - Thyroglossal duct carcinoma.
AB  - Thyroglossal cysts are common developmental abnormalities of the thyroid gland.
      The malignant form of these cysts, however, is extremely rare, with fewer than
      100 cases reported since 1915. Here we add 10 cases of malignant thyroglossal
      cysts, nine women and one man, encountered at M.D. Anderson Cancer Center, based
      on a retrospective review of 51 recorded cases of thyroglossal cysts between 1950
      and 1990. All 10 patients underwent a primary Sistrunk procedure. Histologic
      findings showed nine papillary and one follicular carcinoma. Based on review of
      the histopathologic material, four patients required no additional therapy. Five
      patients underwent total thyroidectomy; three of the five also underwent neck
      dissection. A single microscopic focus of carcinoma in the thyroid gland was
      found in only two instances. No evidence of nodal metastases was found. One
      patient with an abnormal thyroid scan is awaiting further treatment. Based on
      these findings, the Sistrunk procedure is an effective form of therapy for
      malignant thyrogloassal cysts.

PMID- 1745981
TI  - Second operations for "completion" of thyroidectomy in treatment of
      differentiated thyroid cancer.
AB  - The role of elective completion thyroidectomy after lobectomy for differentiated
      thyroid cancers remains controversial. The potential benefit of tumor removal by
      the second procedure is considered by some to be overbalanced by a prohibitive
      operative morbidity rate. During a 20-year period at the University of Chicago
      Medical Center, 26 patients underwent completion thyroidectomy within a 6-month
      period of the original thyroid operation. This group represents 8% of the 326
      patients who underwent surgery during that time for differentiated thyroid cancer
      (269 papillary and 57 follicular). Of the 26 patients, 18 had papillary and eight
      had follicular cancers. The average size was 2.5 cm, with 24 of 26 being greater
      than 1 cm in diameter. At the first operation, 81% of tumors were intrathyroidal.
      Eight percent had lymph node metastases and 12% manifested local invasion. Tumor
      was found in eight (31%) of 26 of the reoperative specimens. The incidence of
      tumor did not vary by histologic type but did differ according to the extent of
      the original operation. Cancer was found in 50% (three of six) of those who had
      undergone previous partial lobectomy, in 33% (five of 15) of those after a total
      lobectomy, and in none of five who had undergone a prior bilateral (although
      incomplete) thyroid resection. One permanent recurrent nerve injury occurred at
      the first operation. No additional recurrent nerve injuries or hypoparathyroidism
      occurred as a result of the second operation. Finally, no disease characteristic
      of the initial tumor (e.g., size, clinical class, tumor capsular invasion,
      multifocality, thyroiditis, or extrathyroidal tumor invasiveness) predicted the
      presence or absence of tumor on the second side. We conclude that completion
      thyroidectomy is appropriate for patients with lesions 1 cm or greater who have
      undergone lobectomy or less at the original operation, because 40% of such
      patients would be expected to have residual cancer. With care, this operation can
      be performed with minimal morbidity.

PMID- 1745982
TI  - Genetic markers in thyroid tumors.
AB  - Tissue from nine patients with malignant tumors and two with benign tumors was
      cultured briefly before cytogenetic analysis. The tumors included one goiter and
      one Hurthle cell adenoma, one lymphoma, one medullary carcinoma, two Hurthle cell
      cancers, and five papillary cancers, varying widely in clinical staging and
      histologic differentiation. When assessed, DNA content was aneuploid in two of
      six malignant tumors. Various culture conditions (oxygen levels, dissociation
      methods, and media) were evaluated; the end points were growth, cell
      differentiation, and time to first harvest. Clonal aberrations were detected in
      one of four successfully harvested papillary cancers: they consisted of trisomy 7
      and a rearrangement of chromosome 10. The rea (10) seen in 22 of 27 cells
      involved bands q11-21. Two other papillary tumors and a medullary cancer (a
      family member with multiple endocrine neoplasia type IIA) showed tetraploidy and
      nonclonal numerically aberrant cells. A lymphoma and two benign lesions showed no
      cytogenetic abnormality. The tumor with rea (10) is of special interest because
      abnormalities of 10q have been reported repeatedly in thyroid tumors, including
      two cases of papillary thyroid tumors with a structural aberration similar to
      that of the presented case. This rearrangement could affect the ret-proto
      oncogene, localized to 10q11.2 which is activated in some papillary thyroid
      carcinomas.

PMID- 1745983
TI  - Anaplastic thyroid carcinoma: risk factors and outcome.
AB  - Anaplastic thyroid carcinoma, in contrast to well-differentiated thyroid
      carcinoma, has a dismal prognosis, and little progress has been made in improving
      survival for this disease. We reviewed our experience during a 23-year period to
      identify risk factors and possible methods to improve outcome. Between 1966 and
      1989, 340 patients with thyroid carcinoma underwent operation. Of these, 17 (5%)
      were undergoing operative treatment of anaplastic or undifferentiated thyroid
      carcinoma. The female/male ratio was 3.5:1, and mean age at presentation was 63
      years. The most common presenting symptoms included neck mass, voice change, or
      dysphagia. Unusual presentations included symptomatic bradycardia from
      compression of the vagus nerve and superior vena cava syndrome. Four patients had
      a history of well-differentiated thyroid carcinoma. Nine patients had been
      diagnosed or treated in the past for "goiter" or a neck mass, and four patients
      had concurrent differentiated thyroid carcinoma associated with the anaplastic
      tumor. Thus 13 (76%) of 17 patients had a previous thyroid disorder, benign or
      differentiated malignant, and eight (47%) of 17 patients had previous or
      concurrent differentiated thyroid carcinoma. At the time of presentation, six
      patients had unilateral true vocal cord paralysis. At operation, 14 patients had
      local extension of the tumor and four required tracheostomy. Only five of 12
      patients showed response to postoperative radiation therapy. Overall median
      survival was 12 months, and 13 (76%) of 17 patients died. The two patients alive
      longer than 12 months had only small foci of anaplastic carcinoma in association
      with well-differentiated carcinoma. Anaplastic thyroid carcinoma is a locally and
      systemically aggressive disease, with long-term survival seen only in those with
      well-localized anaplastic tumor. The major risk factor in this series is a
      history of previous benign or malignant thyroid disease. Because of this, a more
      aggressive approach to thyroid masses may be warranted. Long-standing goiters or
      benign nodules should be followed carefully and considered for resection if they
      grow or do not respond to medical therapy, and total thyroidectomy for malignant
      disease may obviate the subsequent development of anaplastic carcinoma. This
      method of early diagnosis and resection of abnormal thyroid tissue seems to be
      the only method currently available to improve the nearly uniform fatality of
      this disease.

PMID- 1745984
TI  - Prognostic significance of calcitonin immunoreactivity, amyloid staining, and
      flow cytometric DNA measurements in medullary thyroid carcinoma.
AB  - The proven power of DNA ploidy to predict mortality risk in medullary thyroid
      carcinoma (MTC) may be weakened when analyzed in conjunction with calcitonin
      immunoreactivity (CI) and amyloid staining (AS) of tumors. In this study 12
      prognostic variables, including DNA ploidy, CI, and AS, were studied in 65
      patients with MTC (57 sporadic; mean age 51 years) treated during 1946 through
      1970. Cause-specific mortality rates at 10 and 15 years were 15% and 26%,
      respectively. By univariate analysis, TNM stages III or IV (p less than 0.0001),
      tumor unresectability (p less than 0.0001), male sex (p = 0.019), negative AS (p
      = 0.032), and low CI (p = 0.033) were significant predictors of increased
      mortality rates. DNA ploidy (p = 0.058) and inheritance pattern (p = 0.25) were
      nonsignificant. By multivariate analysis, only TNM stage, tumor resectability,
      and AS were independently significant (p less than 0.005). A prognostic model was
      created, based on presence or absence of these independent risk factors, and four
      risk groups were defined, capable of predictably defining mortality rates in MTC
      (p less than 0.0001). The model requires validation in larger series and
      independent verification by others. However, we believe that a risk-group scheme
      for MTC based on AS, disease stage, and completeness of tumor resection may have
      wide applicability and prove relevant to clinicians treating this disease.

PMID- 1745985
TI  - Effect of tumor necrosis factor on growth and function in FRTL5 cells.
AB  - Tumor necrosis factor (TNF) is a cytokine produced by inflammatory macrophages
      and monocytes. FRTL5 cells are a continuous line of functional, nontransformed
      rat thyroid cells that depend on thyroid-stimulating hormone (TSH) for sustained
      growth. The following experiments characterize the effects of TNF on growth and
      differentiated functions in FRTL5 cells. Cells were incubated with different
      concentrations of TNF (1 to 100 ng/ml), alone or with TSH. FRTL5 cell
      proliferation was assessed by 3H-thymidine incorporation assays. Differentiated
      functions were studied by measuring radioactive iodine uptake (RAI) and
      triiodothyronine (T3) production. TNF inhibited FRTL5 cell growth both in basal
      conditions and after cells had been exposed to TSH. TNF caused small inhibition
      of both basal RAI uptake and T3 release but greatly decreased TSH-stimulated RAI
      uptake and T3 secretion. In summary, TNF appears to affect both growth and
      differentiated functions in the FRTL5 cell line. Although it is difficult to
      extrapolate these in vitro results to the human disease state, we postulate that
      TNF production in septic states may contribute to the pathogenesis of the low T3
      syndrome; moreover, locally produced TNF may modulate thyroid function in
      autoimmune thyroid diseases.

PMID- 1745986
TI  - Metastatic parathyroid carcinoma: dilemmas in management.
AB  - The incidence of parathyroid carcinoma in patients surgically treated for primary
      hyperparathyroidism at the University of Michigan Hospital was 0.4% during an 18
      year period. The courses of the five patients with metastatic disease are
      described. Histologic reevaluation and assessment of the DNA ploidy pattern were
      performed in each case. Localization studies preceded all reexplorations. The
      number of operative procedures in each patient ranged from two to 10. Two
      patients are living with recurrent disease and one has been disease free for 42
      months. Two patients died after 2 and 12 years, respectively. Three patients had
      aneuploid tumors; one had a diploid tumor. One patient had both aneuploid and
      diploid cell populations. Dilemmas in diagnosis, localization, and medical and
      surgical management were encountered in patients with metastatic carcinoma. The
      chosen treatment should be evaluated individually in each case because of the
      variability in aggressiveness of this malignancy. Surgical resection proved most
      effective in some of these patients for both local and distant recurrences.
      Bisphosphonates and gallium nitrate have been reported to be effective in
      controlling hypercalcemia. Only the former had some effect in one of our
      patients.

PMID- 1745987
TI  - Results of a prospective strategy to diagnose, localize, and resect insulinomas.
AB  - Since 1982, 25 consecutive patients with benign sporadic (non-multiple endocrine
      neoplasia type I) insulinomas have been studied. Most were referred because
      either the tumor was not identified at the referring institution or the diagnosis
      was unclear. Each patient suffered severe neuroglycopenic symptoms for a median
      of 24 months before diagnosis of insulinoma, and 32% had hypoglycemic seizures.
      Eighteen patients (72%) had a confirmed weight gain. Each patient underwent a
      supervised fast until 72 hours or the onset of significant neuroglycopenic
      symptoms (median duration 16 hours), with serum levels of glucose (median 35
      mg/dl; range 24 to 46 mg/dl), insulin (median 21 microU/ml; range 11 to 230
      microU/ml), C-peptide (median 2.5 ng/ml; range 1.0 to 7.2 ng/ml), and proinsulin
      fraction (median 55%; range 14% to 86%) measured at the termination of the fast.
      Preoperative imaging with ultrasonography, computed tomography, magnetic
      resonance, and angiography visualized tumor in a minority of patients (26%, 17%,
      25%, and 35%, respectively); in 48% of patients one or more imaging study results
      was positive. Selective portal venous sampling for insulin was the most
      informative localizing test (77% positive; no false-positive results). Tumor was
      resected for cure in 24 of 25 patients. Intraoperative ultrasonography identified
      nonpalpable tumor in seven patients and was crucial to the achievement of this
      high rate of surgical cure. We conclude that the diagnosis of insulinoma can be
      made by the results of a supervised fast, portal venous sampling is the most
      sensitive preoperative test for localizing insulinomas, and intraoperative
      ultrasonography is essential for intraoperative detection of insulinomas.

PMID- 1745988
TI  - [The development of anesthesia in german-speaking regions in the 19th century].
AB  - Following the first public demonstration of ether anaesthesia by W.T.G. Morton on
      October 16, 1846, the pioneers to perform ether anaesthesia in German speaking
      countries were H. A. Demme, surgeon at the University Hospital Bern, Switzerland,
      on January 23, 1847, the German surgeon J. F. Heyfelder at Erlangen on January
      24, and the Austrian surgeon F. Schuh in Vienna on January 27, 1847. The first
      books in German language referring to clinical experience with and experimental
      research on sulphuric ether were published in March/April 1847. After the
      introduction of chloroform the use of ether anaesthesia rapidly decreased.
      Chloroform administration was smoother and much more easier not requiring any
      special apparatus. Chloroform remained the preferred anaesthetic till the end of
      the century although there happened significantly more deaths due to this agent
      than to ether. Since 1863 nitrous oxide again was propagated for pain relief in
      dental practice. German investigators provided pioneering contributions to the
      development of local and regional anaesthesia. C. Koller, Vienna, was the first
      to operate on a patient in local anaesthesia with cocaine. The next steps were
      the introduction of infiltration anaesthesia by C. L. Schleich in 1892/1894 and
      of spinal anaesthesia by A. Bier in 1899. The ultimate success of local and
      regional anaesthesia was made possible by using adrenaline with the local
      anaesthetic (1901) and by the introduction of novocaine in 1905.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1745989
TI  - [Cardiac risk patients in anesthesia].
AB  - Cardiac complications are the major cause of morbidity and mortality in patients
      undergoing noncardiac operations. The perioperative risk of adverse cardiac
      events is particularly high in patients with significant coronary artery disease,
      heart failure or critical aortic stenosis. Prolonged intraperitoneal and
      intrathoracic operations, major vascular surgery, emergency procedures, and
      intraoperative hypotension and tachycardia promote and increase incidence and
      severity of cardiac complications. Recent experience has shown, however, that
      elective noncardiac operations can be performed with justifiable risk even in
      patients with endstage cardiac disease awaiting heart transplantation. Surgery,
      if indicated, can thus nowadays hardly be denied even in the presence of high
      cardiac risk. Successful anesthetic management requires detailed information
      about the cause and severity of the underlying disease, thorough understanding of
      its specific hemodynamic particularities, indepth knowledge about hemodynamic
      effects and interactions of anesthetic drugs, and experience with extended
      hemodynamic monitoring. Anesthetic choice by itself appears to be of minor
      significance. Cardiac surgery prior to major elective noncardiac procedures is
      advocated in patients with significant coronary artery disease or severe valve
      lesions. The incidence of life-threatening cardiac complications is particularly
      high in the postoperative period; prolonged hemodynamic monitoring in an
      intensive care unit is therefore mandatory.

PMID- 1745990
TI  - [Preparation of children for anesthesia].
AB  - Children are not born as little adults, and more important than the difference in
      size are psychic, physiological and pharmacological aspects. Intense preparatory
      information and training will be necessary to avoid or reduce psychic trauma due
      to hospitalization, narcosis and operation. Basic laboratory findings as
      hemoglobin, hematocrit, urinalysis and blood-group are supplemented by special
      examinations if indicated. Preoperative fasting shouldn't be prolonged respecting
      poor metabolic and fluid reserves. Adequate oral or rectal premedication is as
      important as careful induction.

PMID- 1745991
TI  - [Anesthesia for ambulatory procedures].
AB  - Ambulatory surgery and anesthesia continued to grow and develop over the last few
      years: Longer lasting and more complex diagnostic and therapeutic procedures are
      being performed on an outpatient basis. In addition, outpatient procedures, being
      less disruptive to the patient's everyday life, are of potential benefit
      especially for children and elderly patients. The proper selection and evaluation
      of these patients from the anesthesiological and surgical points of view are very
      important with regard to successful ambulatory interventions. The preoperative
      assessment is obviously essential. Good communication and teamwork between
      anesthesiologists, surgeons and admitting doctors are necessary. Patients should
      be informed early, i.e. before the day of operation, about the planned procedures
      (fasting periods, adult person necessary to accompany the patient home, etc.),
      and their written consent should be there. During the preoperative personal
      interview, the anesthesiologist identifies risk factors which may influence the
      management and outcome of the anesthetic procedure. Outpatients profit from a
      short-acting anxiolytic and sedative premedication before entering the operation
      room. The choice of the anesthetic procedure itself is made individually. An
      adequate intra- and postoperative monitoring is essential. A checklist with exact
      discharge criteria is helpful in practice.

PMID- 1745992
TI  - [Goals and methods of patient monitoring].
AB  - Monitoring during and after anaesthesia is aimed at recording changes in
      physiological functions including the patient's response to the anaesthetic and
      surgery, and identifying avoidable critical incidents caused by human error or
      equipment failure. Assessment and control of the depth of anaesthesia would be
      desirable but cannot yet be accomplished in clinical practice. For every
      anaesthetic, some degree of primary, basic or minimal monitoring is essential and
      is, in a number of countries, prescribed or recommended by regulations or
      guidelines. Besides an alert anaesthetist constantly observing the patient and
      monitoring the function of the anaesthesia machine, these minimal standards
      include an ECG, noninvasive blood pressure measurement, pulse oximetry, and end
      tidal CO2 recording (capnography). ECG, blood pressure, and pulse oximetry also
      have to be employed during regional anaesthesia and in the post-anaesthesia care
      unit. The question as to whether further monitoring techniques need to be added
      (extended or secondary monitoring) will depend upon the medical problems of the
      individual patient and on the nature and duration of the surgical and anaesthetic
      procedures. For this purpose, invasive methods are preferentially used, in
      particular central venous and arterial pressure recording, and a pulmonary artery
      catheter for measuring pulmonary artery and pulmonary capillary wedge pressures
      and cardiac output, all in combination with blood gas analysis.

PMID- 1745993
TI  - [Regional or general anesthesia in patients with pulmonary risks?].
AB  - Such partial functions of the respiratory system as ventilation, gas exchange,
      bronchomotor tone, respiratory regulation, secretion within the airways,
      mucociliary clearance, etc., are less impaired by such procedures as peridural or
      spinal anaesthesia than by general anaesthesia. As a result, it is often
      concluded that regional anaesthesia should always be used preferentially in the
      case of patients with a pulmonary risk. However, comparative studies have shown
      that pulmonary morbidity and mortality are little influenced by the anesthetic
      procedure. For, in the first instance, the incidence of post-operative
      complications affecting respiration are determined by previous lung pathologies,
      the age of the patient, and the location and duration of the surgical procedure.
      These are factors that cannot readily be influenced by anaesthesiological
      measures. For this reason, the pre-operative diagnostic evaluation and
      preparation, post-operative prophylaxis and treatment, including the components
      pain elimination, physiotherapy, respiratory therapy, broncholysis and
      secretolysis, are more important than the anaesthetic procedure itself.

PMID- 1745994
TI  - [Role of the anesthetist in the recovery stage].
AB  - Surveillance of the patient in the particularly critical phase immediately
      following operation and anaesthetic must be considered a purely
      anaesthesiological task. Today, it is no longer considered sufficient merely to
      keep the patient under observation until his protective reflexes have returnded;
      rather, appropriate postoperative therapeutic measures must be initiated already
      during the recovery phase to enable the patient to be returned to the nursing
      ward with his or her vital functions optimal and stabilised. The tasks of the
      anaesthetist in the recovery phase are as follows: safeguarding of the
      transportation phase of the patient from the operating room to the recovery unit;
      hand-over of the patient to the recovery staff; monitoring for possible
      complications in the recovery phase, collection of suitable diagnostic parameters
      to determine the current state of the patient; initiation of optimised treatment
      as dictated by the state of the patient; documentation of all findings as well as
      all therapeutic measures instituted, and deciding on the further transfer of the
      patient.

PMID- 1745995
TI  - [Case of the month: severely injured motorcycle rider].

PMID- 1745996
TI  - The effect of flow on hemostasis and thrombosis.
AB  - While dilution of procoagulants has generally been proposed as the mechanism by
      which flow reduces coagulation at surfaces, such a mechanism has never been
      verified experimentally and, in fact, there are theoretical grounds for
      suspecting the validity of such a hypothesis (29). It is quite plausible that
      flow may have direct effects on certain enzyme or polymerization kinetics
      involved in thrombosis, in addition to the well-defined effect that flow has an
      enhancing transport of reactants and products to and from the vessel wall. Such
      effects of flow on immobilized enzymes have occasionally been observed, but never
      studied with respect to coagulative processes (30). The study of the effects of
      flow on hemostasis and thrombosis, while numerous, are still in their infancy. As
      noted above, increasing shear increases the rate of formation of factor Xa in a
      tubular reactor. In the presence of factors VIII and IX, there is also a shear
      induced enhancement of Xa production (31). These studies indicate that at least
      some coagulation reactions are accelerated in the presence of high shear.
      However, it has been observed that fibrin formation is diminished at increasing
      shear rates (20). This implies that at least one step of the coagulation cascade
      is being inhibited by high shear. One possibility is that fibrin monomer is being
      removed by the high local flow conditions, although the concomitant reduction in
      fibrinopeptide A argues against this interpretation. Another possibility, not yet
      tested, is that thrombin itself is removed by flow.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1745997
TI  - Dose finding study of a low molecular weight heparin, Innohep, in haemodialysis.
AB  - A pilot investigation was performed with Innohep, a low molecular weight (LMWH)
      preparation (peak maximum molecular mass 3,000-6,000), to determine possible dose
      regimens for patients undergoing regular maintenance haemodialysis for chronic
      renal failure. Results from this study suggested that suppression of macroscopic
      clot formation and fibrinopeptide A (FPA), a marker of fibrin formation, could be
      achieved following bolus injections rather than bolus injections and an infusion.
      On the basis of these preliminary findings, a randomised crossover study was
      performed in eight patients undergoing regular maintenance haemodialysis for 5-7
      h to determine the effective antithrombotic dose of this LMWH. Single i.v. bolus
      doses of 1,250 AFXa u, 2,500 AFXa u and 5,000 AFXa u (n = 7-8) were compared to
      an UFH regime of 5,000 iu + 1,500 iu/h. Excessive clot formation in the dialyser
      bubble trap, necessitating additional UFH to enable completion of a prolonged (up
      to 7 h) dialysis, was observed in all patients on the 1,250 AFXa u dose (mean
      duration of dialysis prior to UFH, 3 h) but in a single patient only receiving
      the other LMWH doses. A dose-related response in the AFXa activity, measured by
      chromogenic substrate (CS) assay was seen in the three LMWH groups, with levels
      declining significantly (p less than 0.05) from 1-7 h. This contrasted with the
      constant levels maintained during dialysis with UFH. FPA levels were
      significantly elevated after 2 h following the 1,250 AFXa u bolus and after 4 h
      following the 2,500 AFXa u bolus. There was no significant difference in FPA
      levels between the 5,000 AFXa u bolus and UFH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745998
TI  - Extrinsic activation of human coagulation factors IX and X on the endothelial
      surface.
AB  - In previous kinetic studies, the catalytic efficiency of the activation of human
      coagulation factors IX and X by factor VIIa in the presence of purified tissue
      factor apoprotein was found to be essentially equal. These activation reactions
      were now studied on the surface of human umbilical vein endothelial cells. The
      cells were stimulated with endotoxin to express tissue factor. This tissue factor
      activity was saturable with factor VIIa and could be inhibited by rabbit
      antibodies against human tissue factor apoprotein. Only stimulated cells
      supported factor VIIa activity. No difference in the reactivity of factor VII and
      VIIa was observed in the presence of factor X, due to rapid feedback activation
      of factor VII by factor Xa. However, the activation of factor IX by factor VII
      shows a 10 min lag-phase, which reflects that the activation of factor VII by
      factor IXa is a less efficient process. The kinetic parameters for the factor
      VIIa dependent activation of factor IX and factor X on the endothelial surface
      were: Km 0.09 microM, Vmax 0.13 pmol/min, and Km 0.071 microM, Vmax 0.41
      pmol/min, respectively. The same ratio between the Vmax for factor X and factor
      IX activation was observed as in a cell free system. However, the Km of factor IX
      was 4-fold higher on the endothelial surface than in the cell free system.
      Together, these kinetic parameters will favour factor X activation 5-fold over
      factor IX activation at physiological concentrations of these proteins. The
      activation of factor X by factor VIIa on the endothelial surface was
      characterized by a short lag-phase, which was absent in factor IX
      activation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1745999
TI  - Coagulation and fibrinolytic activity in Behcet's disease.
AB  - Coagulation and fibrinolytic activities were studied in 18 subjects with Behcet's
      disease and compared with results from 14 matched control patients suffering from
      sero-negative arthritis. Significantly higher plasma concentrations (median and
      range) were found in Behcet's patients for the following variables: fibrinogen
      3.7 (1.7-6.9) vs 3.0 (2.0-5.1) g/l, p less than 0.05; von Willebrand factor
      antigen, 115 (72-344) vs 74 (60-119)%, p less than 0.002; plasminogen activator
      activity (10(6)/ECLT2) 219 (94-329) vs 137 (78-197) units, p less than 0.002;
      tissue plasminogen activator inhibitor (t-PA-I) activity, 9.1 (5.5-19.3) vs 5.1
      (1.8-12.0) IU/ml, p less than 0.002; and PAI-1 antigen, 13.9 (4.5-20.9) vs 6.4
      (2.4-11.1) ng/ml, p less than 0.002. Protein C antigen was significiantly lower:
      97 (70-183) vs 126 (96-220)%, p less than 0.02. No differences were observed in
      antithrombin III activity or antigen, factor VIII coagulant activity,
      fibrinopeptides A and B beta 15-42, plasminogen, alpha-2-antiplasmin, functional
      and immunological tissue-plasminogen activator, thrombin-antithrombin complexes
      and D-dimer. Levels of tissue plasminogen activator inhibitor (activity and
      antigen) correlated with disease activity while fibrinogen and von Willebrand
      factor concentrations did not. Seven of the 18 subjects with Behcet's disease had
      suffered thrombotic events but it was not possible to distinguish these from the
      11 patients without thrombosis using the assays performed. The results suggest
      the abnormal fibrinolytic activity in Behcet's disease is due to increased
      inhibition of tissue plasminogen activator. No abnormality of coagulation or
      fibrinolytic activity specific to Behcet's disease was detected.

PMID- 1746000
TI  - Effect of the hirudin carboxy-terminal peptide 54-65 on the interaction of
      thrombin with platelets.
AB  - The carboxy-terminal region of hirudin (residues 54-65) has previously been shown
      to inhibit thrombin clotting activity without binding to the catalytic site of
      the enzyme. In the present study, the effect of hirudin 54-65 on thrombin
      interaction with specified platelet proteins has been investigated. Hirudin 54-65
      was found to inhibit thrombin-induced platelet aggregation and secretion in a
      dose-dependent manner. Substitution of either Phe56, Glu57, Ile59, Pro60 or Leu64
      showed that these residues were critical for inhibition of thrombin-induced
      platelet activation whereas sulfation of Tyr63 increased the inhibitory potency
      of the peptide. Hydrolysis of glycoprotein V, a platelet membrane substrate for
      thrombin, was only partially inhibited by hirudin 54-65. Although hirudin 54-65
      did not decrease the amount of thrombin bound to platelets during cross-linking
      experiments, it was found to inhibit the specific binding of thrombin to platelet
      glycoprotein Ib. Since the carboxy-terminal region of hirudin has previously been
      reported to bind near the trypsin-catalyzed beta cleavage site, we have analyzed
      the consequences of alpha to beta-thrombin conversion on both thrombin-hirudin 54
      65 interaction and thrombin activity toward platelets. The beta cleavage induced
      a decrease in the affinity of thrombin for both glycoprotein Ib and hirudin 54
      65. Altogether, our results indicate that thrombin recognition sites for hirudin
      54-65 and platelet membrane glycoprotein Ib share common structures located near
      the beta cleavage site at Arg 73 on the thrombin B chain.

PMID- 1746001
TI  - Factor IX a inhibition contributes to the heparin effect.
AB  - We investigated whether the inactivation of factor IXa contributes to the partial
      inhibition of thrombin formation that is observed at therapeutic concentrations
      of heparin. The action of standard unfractionated heparin (0.05 U/ml) on thrombin
      formation in the intrinsic system was compared to that of a mixture of dermatan
      sulfate (DS) and a synthetic pentasaccharide (PS). DS enhances the action of
      heparin cofactor II which inhibits thrombin only. PS specifically enhances the
      anti-factor Xa activity of antithrombin III (AT III). The concentrations of DS
      and PS were chosen so as to obtain equal anti-thrombin and anti-factor Xa
      activities as in 0.05 U/ml heparin. An extra inhibitory effect of heparin over
      the mixture is observed in situations where free factor IXa, not bound to factor
      VIIIa and phospholipid, limits the rate of thrombin formation, notably in contact
      activated plasma. We conclude that the inactivation of free factor IXa by heparin
      contributes importantly to the inhibition of thrombin formation in the intrinsic
      system such as e.g. measured in the activated partial thromboplastin time.

PMID- 1746002
TI  - Molecular cloning, characterization and expression of cDNA for rabbit brain
      tissue factor.
AB  - Tissue factor (TF) is a membrane anchored glycoprotein that initiates blood
      coagulation by forming a complex with circulating factor VII or VIIa. TF has been
      identified in atherosclerotic plaques and may possibly trigger thrombosis after
      spontaneous plaque rupture as seen in acute myocardial infarction or angioplasty.
      We have previously developed an atherosclerotic rabbit model for study of the
      acute and chronic outcomes following angioplasty. As a first step in developing
      inhibitors of TF, we have isolated and characterized a rabbit cDNA coding for the
      mature TF. The sequence comparison of rabbit TF cDNA with those of human and
      mouse TFs show considerable similarity at both the nucleotide and amino acid
      levels. The TF cDNA when expressed in E. coli demonstrates a procoagulant
      activity comparable to that of native rabbit brain TF. The TF activity can be
      blocked by a polyclonal antibody against rabbit TF.

PMID- 1746003
TI  - A kinetic model of the circulatory regulation of tissue plasminogen activator.
AB  - A computer simulation was developed to study the regulation of active tissue
      plasminogen activator (t-PA) levels in plasma by kinetically modeling t-PA
      secretion, t-PA inhibition by plasminogen activator inhibitor type 1 (PAI-1), and
      hepatic clearance of t-PA, PAI-1 and t-PA/PAI-1 complex throughout a simplified
      human circulatory system. The model indicates that as the active PAI-1
      concentration increases, the percent of t-PA in the active form decreases
      exponentially. Further, the reaction between t-PA and PAI-1 substantially reduces
      the half-lives of both active factors. By adjusting the t-PA and PAI-1 secretion
      rates to provide the best fit between simulated and measured circadian variations
      in t-PA, PAI-1 and complex, the model predicts that the diurnal rhythm in active
      t-PA levels is principally due to changes in the rate of PAI-1 secretion and not
      to variations in the t-PA secretion rate. In conclusion, the model predicts that
      PAI-1 is an important regulator of the concentration, half-life and circadian
      variation of active t-PA.

PMID- 1746004
TI  - 125I-fibrinogen binding to platelets in myeloproliferative disease.
AB  - Recent reports have suggested a variation in the density and affinity of
      fibrinogen binding sites in platelets from patients with myeloproliferative
      disorders (MPD) which may reflect platelet functional abnormalities in these
      subjects. We have investigated the binding of 125I-fibrinogen (125I-Fb) to gel
      filtered platelets from a large relatively homogeneous group of patients with MPD
      compared to normal age matched controls. Twenty-two of the patients investigated
      had polycythaemia vera and four essential thrombocythaemia. The maximal density
      and affinity (Kd) of 125I-Fb binding was assessed by saturation analysis in gel
      filtered platelets (GFP) stimulated with either 10 microM ADP or 150 mU thrombin.
      In addition the functional significance of the binding sites was studied by
      evaluating the response of GFP from the two experimental groups by assessing the
      effects of increasing concentrations of added fibrinogen on the response to 10
      microM ADP using standard light transmission aggregometry. In both groups the
      density of fibrinogen binding sites expressed in response to thrombin stimulation
      was significantly higher (approximately 2-3 fold) than that found in response to
      ADP. However, fewer binding sites were detected in the MPD group as compared with
      the control group in response to both ADP and thrombin. The Kd for 125I-Fb was
      similar for both agonists in normal controls and was significantly lower than
      that found in the MPD subjects. Although the 125I-Fb binding study results
      indicate a significant reduction in both the number and affinity of fibrinogen
      binding sites in patients with myeloproliferative disorders, the clinical and
      functional significance of these findings remain uncertain.

PMID- 1746005
TI  - Rapid aequorin loading into platelets in the presence of DMSO--characteristics of
      the responses (changes in light transmission and in calcium) to various agonists.
AB  - We have looked at different parameters which could modify platelet behaviour
      during and after aequorin loading in the presence of DMSO. There is a decreased
      platelet reactivity in response to ADP, PAF and A-23,187 which appears to be
      mainly due to the exposure to EGTA during washing and loading and the 1 ml volume
      of the test suspension. All the studied agonists (including PMA) which elicit
      aggregation are able to induce an intracellular Ca2+ change detected with the
      aequorin probe. By contrast, epinephrine alone induces neither aggregation nor
      Ca2+ rise, but potentiates the responses to ADP. Different consecutive phases in
      Ca2+ changes after stimulation with ADP, PMA and A-23,187 can be evidenced. In
      the presence of external Ca2+, the second component of the Ca2+ change evoked
      with ADP is dependent on aggregation and the subsequent TXA2 synthesis. When the
      external medium is Ca2+ depleted, the two Ca2+ peaks induced by ADP disappear
      whereas a Ca2+ rise persists (endogenous mobilization) with the other agonists,
      being independent of TXA2 and ADP release. Ca2+ mobilization parallels activation
      with A-23,187 but not with low concentrations of thrombin.

PMID- 1746006
TI  - Dipyridamole potentiates platelet inhibition by nitric oxide.
AB  - In a placebo-controlled double blind cross-over experiment the adenosine uptake
      inhibitor dipyridamole (400 mg/day) did not affect ex vivo platelet aggregation
      induced by collagen or adenosine-diphosphate (ADP) in an electronic whole blood
      aggregometer (WBA). Dipyridamole was also inactive in vitro, unless red blood
      cell injury was deliberately enhanced, thereby increasing the level of free
      adenine nucleotides. Since dipyridamole also inhibits cyclic guanosine
      monophosphate (GMP) phosphodiesterase (PDE), we used platelet rich plasma (PRP)
      to study its interaction with authentic and endothelium-derived nitric oxide
      (NO). The latter inhibits platelets by increasing cyclic GMP. Dipyridamole (1 to
      30 microM), either alone or in combination with a subthreshold concentration of
      prostacyclin (PGI2), was inactive. However, when combined with a subthreshold
      concentration of NO, dipyridamole caused a concentration-dependent platelet
      suppression, which became more pronounced when PGI2 was present as well. It is
      concluded that dipyridamole could reduce the threshold for platelet suppression
      by NO through inhibition of cyclic GMP PDE.

PMID- 1746007
TI  - Loss of thrombin-induced Ca2+ mobilization in a subpopulation of platelets during
      storage.
AB  - Thrombin-induced changes in cytosolic free Ca2+ ([Ca2+]i) were studied in human
      platelets that had been stored for up to 6 days. Changes in [Ca2+]i were measured
      with Indo-1-loaded platelets and quantitated with two different methods: (i)
      measurement of the changes in total fluorescence; (ii) measurement of the [Ca2+]i
      changes in individual platelets in a flow cytometer, allowing the detection of
      non-responding platelets. The maximal concentration of [Ca2+]i after stimulation
      with 0.5 U of thrombin/ml decreased from 544 +/- 58 nM (mean +/- SEM, n = 6) on
      day 0, to 276 +/- 9 nM on day 3 and to 203 +/- 23 nM on day 6. The percentage of
      platelets responding to 0.5 U of thrombin/ml declined from 90 +/- 2% on day 0 to
      72 +/- 4% on day 3, and to 47 +/- 8% on day 6. Nevertheless, also the responding
      platelets showed a decreased rise in [Ca2+]i. The study shows that during
      platelet storage a decrease in the rise in [Ca2+]i upon thrombin stimulation
      occurs. This decrease is partly due to the formation of a subpopulation of
      platelets that is completely unresponsive and partly due to a decreased
      responsiveness in the remainder of the platelets; it is not due to a gradual
      decline in [Ca2+]i rise in all platelets. This phenomenon provides new insight in
      the functional defect of stored platelets.

PMID- 1746008
TI  - LY53857, a 5HT2 receptor antagonist, delays occlusion and inhibits platelet
      aggregation in a rabbit model of carotid artery occlusion.
AB  - The present study was designed to evaluate the effectiveness of the ergoline 5HT2
      receptor antagonist, LY53857 in a rabbit model of vascular arterial occlusion.
      LY53857 (1 and 10 microM) inhibited serotonin amplified platelet aggregation
      responses to threshold concentrations of ADP in rabbit platelets in vitro.
      LY53857 (1 microM) not only inhibited the serotonin component of rabbit platelet
      aggregation, but also inhibited in vitro aggregation induced by ADP (48.7 +/-
      16.7% inhibition), collagen (76.1 +/- 15.9% inhibition) and U46619 (65.2 +/-
      12.3% inhibition). The effectiveness of this ergoline 5HT2 receptor antagonist in
      blocking aggregation to ADP, collagen and U46619 may be related to its ability to
      inhibit a serotonin component of platelet aggregation since rabbit platelets
      possess high concentrations of serotonin that may be released during aggregation
      produced by other agents. Based on the effectiveness of LY53857 to inhibit rabbit
      platelet aggregation, we explored the ability of LY53857 to extend the time to
      carotid artery occlusion in rabbits following electrical stimulation of the
      artery. Reproducible carotid artery occlusion was induced in rabbits by moderate
      stenosis coupled to arterial cross clamping, followed by electrical stimulation.
      With this procedure, occlusion occurred at 47.0 +/- 7 min (n = 30) after
      initiation of the electrical stimulation. Animals pretreated with LY53857 (50 to
      500 micrograms/kg i.v.) showed a delay in the time to carotid artery occlusion
      (at 100 micrograms/kg i.v. occlusion time extended to 164 +/- 16 min).
      Furthermore, ex vivo platelet aggregation from animals treated with LY53857 (300
      micrograms/kg i.v.) resulted in 40.5% inhibition of platelet aggregation in
      response to the combination of ADP (1 microM) and serotonin (1 microM).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1746009
TI  - Characterization of epitheloid cells from human omentum: comparison with
      endothelial cells from umbilical veins.
AB  - Capillary cells represent 95% of the vascular bed, and cells from large and micro
      vessels do not express identical functions. In order to study the hormonal
      regulation of plasminogen activator inhibitor 1 (PAI-1) secretion by human
      capillary cells we used epithelial cells from omental tissue (HOTMEC). As their
      endothelial origin is subject to controversy, we attempted to determine their
      characteristics by comparing them to human umbilical vein endothelial cells
      (HUVEC). Morphological and biological criteria were studied. By phase contrast
      microscopy HOTMEC elicited a cobblestone pattern similar to HUVEC. Weibel-Palade
      bodies were not found in the cytoplasm with electron microscopy. Fluorescence
      microscopy studies indicated that HOTMEC took up acetylated-LDL more intensely
      than HUVEC, and showed no staining for von Willebrand factor. The phenotype of
      HOTMEC was studied by flow cytometry using monoclonal antibodies (mo Ab) directed
      against epitopes either specific for endothelial cells or for mesothelial cells.
      We showed that in our preparations only 10% of cells reacted with mo Ab specific
      for endothelial cells. About 60% of the HOTMEC were labelled with an antibody
      directed against mesothelial cells. HOTMEC expressed fibrinolytic factors. Tissue
      plasminogen activator (t-PA) levels in HOTMEC conditioned medium were 50 fold
      higher than those of HUVEC, and the PAI-1 secretions were identical in both cell
      types. Insulin which is known to increase PAI-1 synthesis by hepatocytes did not
      enhance the PAI-1 level either in HOTMEC or in HUVEC conditioned media. Our
      results suggested that morphological and functional methods did not allow
      discrimination between the cell types present in the omentum tissue.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1746010
TI  - Registry of multicenter clinical trials. Eleventh report--1989.

PMID- 1746011
TI  - The design and analysis of half-life and recovery studies for factor VIII and
      factor IX. Factor VIII/Factor IX Scientific and Standardization Committee of the
      International Society for Thrombosis and Haemostasis.

PMID- 1746012
TI  - An artefact related to the ratio of sample volume to the blood collection vial
      size which effects the APTTs of specimens taken to monitor heparin therapy.

PMID- 1746013
TI  - The effect of lupus anticoagulant (LA) on clotting assay for plasma protein C
      (PC)

PMID- 1746014
TI  - Experience of surgical treatment for craniofrontonasal dysplasia.
AB  - We present a case of a 5-year-old girl diagnosed as having craniofrontonasal
      dysplasia (CFND), which was first reported by Cohen in 1979. CFND is very rare
      and reports concerning this syndrome have never been found in Japan. In our case,
      frontal plagiocephaly, third degree orbital hypertelorism and clefting nasal tip
      coexisted. At 10 months after birth when she visited our hospital, signs of
      craniostenosis were not recognized and cosmetic improvement was considered the
      main purpose of the treatment. We performed supraorbital bar reshaping,
      ethmoidectomy and orbitotomy for reconstruction in one-stage at the age of five.
      The operation produced marked improvement in her exotropia before entering a
      primary school. Past reports dealing with abnormalities of the central nervous
      system in this syndrome are few, but agenesis of the splenium was noted in our
      case. This paper is a report of our findings together with some discussions in
      reference to the literature.

PMID- 1746015
TI  - Serum level of interferon-gamma in autoimmune diseases.
AB  - Interferon-gamma is one of the cytokines which have various immunoregulatory
      functions. In the present study, the serum interferon-gamma level was determined
      in autoimmune diseases. It was increased in the active cases of systemic lupus
      erythematosus (SLE) and mixed connective tissue disease (MCTD). Since there was a
      positive correlation between the serum interferon-gamma level and the rate of
      peripheral mononuclear cells positive for HLA-DR antigen in systemic lupus
      erythematosus, circulating interferon-gamma might have a biological functions as
      suggested by many in vitro studies. In rheumatoid arthritis and Sjogren's
      syndrome, there was no correlation between the serum interferon-gamma level and
      the clinical findings. These data suggest that interferon-gamma might be
      associated with the pathogenesis of autoimmune diseases such as SLE and MCTD, and
      it can be one of the indices for their disease activity.

PMID- 1746016
TI  - Cost-effectiveness analysis of screening for colorectal cancer in Japan.
AB  - To clarify the best cost-effective screening strategy for colorectal cancer in
      Japan, the cost-effectiveness ratio was compared among six currently performed
      procedures. The analysis was made using a simulation model to estimate long-term
      cost and effectiveness of the screening programs. In the screening by the
      immunological fecal occult blood test (FOBT), a comparison between the one- and
      two-day fecal collection methods indicated that the latter was more cost
      effective than the former. A comparison was also made on the four workup methods:
      barium enema (BE) alone, a combination of BE and sigmoidoscopy (BE + SIG), total
      colonoscopy (TCF) alone, and a combination of BE and TCF (BE + TCF). The cost
      effectiveness ratio was the lowest in the method using TCF alone, followed by
      those based on BE alone and BE + TCF, and the highest in the BE + SIG method. The
      superiority of TCF alone strategy was stable over a range of estimates such as
      the sensitivity of diagnostic tests, the probability of complications due to TCF,
      etc. It is concluded that a combination of the two-day FOBT and TCF yields the
      best cost-effectiveness.

PMID- 1746017
TI  - Cost-effectiveness analysis of screening for gastric cancer in Japan.
AB  - Cost-effectiveness analysis of gastric cancer screening in Japan was performed,
      and the cost-effectiveness ratio was compared with that of colorectal cancer
      screening. The analytical model was the same as that adopted in our previous
      study on colorectal cancer screening (Tsuji et al. 1991). The results indicated
      that the cost per case-fatality prevented by colorectal cancer screening was 5.5
      and 2.7 times more expensive for males and females, respectively, than that by
      gastric cancer screening. The age of the population influenced the cost
      effectiveness of screening programs. The cost-effectiveness ratio in gastric
      cancer screening became negative among males older than the age of 65 years,
      suggesting that the total cost for prevention and control of deaths by gastric
      cancer in these age populations is saved by the screening program.

PMID- 1746018
TI  - Effect of S-8666 on Cl- transport in the rabbit connecting tubule perfused in
      vitro.
AB  - S-8666, [6, 7-dichloro-5-(N, N-dimethylsulfamoyl)-2, 3
      dihydrobenzofurancarboxylic acid] is a potent diuretic with uricosuric action.
      Although the major site of action of S-8666 has been proven by the in vitro
      microperfusion study to be the thick ascending limb of Henle's loop, clearance
      studies in the rat suggested that this drug has an additional thiazide-like
      action. To provide direct evidence that S-8666 acts also on distal nephron
      segments, we examined effect of S-8666 on Cl- flux across the rabbit connecting
      tubule perfused in vitro. The drug suppressed the lumen-to-bath Cl- flux by 96 +/
      41 (S.E.)pmol.mm-1.min-1 (n = 9) without affecting transmural voltage. To
      demonstrate that S-8666 acts on the connecting tubule cell, the target of
      thiazide diuretics, we compared effects of S-8666 and trichlormethiazide on the
      basolateral membrane voltage of the connecting tubule cell. Both drugs added to
      the lumen caused a small but significant hyperpolarization of the basolateral
      membrane without affecting transmural voltage. We conclude that S-8666 is a
      unique uricosuric diuretic having actions on both thick ascending limb of Henle's
      loop and connecting tubule.

PMID- 1746019
TI  - A continuously rotating passive agglutination method using rapidly precipitable
      latex particles and its application.
AB  - A new passive agglutination method is reported. Large, very heavy, uniform latex
      particles coated with antigens or antibodies were mixed with corresponding
      antibodies or antigens in reacting wells of an appropriate shape and size.
      Agglutination results were read after 30 min of continuous rotation at a suitable
      speed. With this simple and rapid continuously rotating passive agglutination
      method, we could detect anti-dinitrophenol monoclonal antibodies, natural anti
      dinitrophenol antibodies, rheumatoid factor, allergic antibody to tick, human
      chorionic gonadotrophin and human IgE. This method is suitable to detect weak and
      small quantities of antibodies in a brief time.

PMID- 1746020
TI  - Association between cadmium-induced renal dysfunction and mortality: further
      evidence.
AB  - Our previous follow-up study, carried out from 1979 to 1989, on 256 residents of
      Sasu, a cadmium (Cd)-polluted area located on Tsushima Island, Nagasaki
      Prefecture, Japan, showed a significant relationship between urinary beta 2
      microglobulin (beta 2-m) excretion and mortality in men. To investigate the
      association between Cd-induced renal dysfunction and mortality more precisely,
      275 residents in the same area aged 40-92 years, who had participated in a health
      survey conducted in May 1982, were followed to February 1989. The expected number
      of deaths was calculated on the basis of the sex- and 5-year-age-specific
      mortality rates for Tsushima Island in 1985. In both men and women with urinary
      beta 2-m concentrations greater than 1,000 micrograms/g creatinine, observed
      deaths were greater than the expected. However, the P value of the difference was
      less than 0.05 only in women. Analysis by the Cox proportional hazards model
      showed that, in both men and women, serum beta 2-m and creatinine, as well as
      urinary total protein and beta 2-m were significantly or marginally significantly
      related to mortality independent of age. In men, serum beta 2-m was more strongly
      related to mortality than urinary beta 2-m. The results provide further evidence
      for the causal association between Cd-induced renal dysfunction and mortality.
      The present report also discusses the role played by decreased glomerular
      filtration rate in the excess mortality of subjects with Cd-induced renal
      dysfunction.

PMID- 1746021
TI  - Electroencephalographic patterns related to hemodynamic changes at the onset of
      cardio-pulmonary bypass circulation.
AB  - Electroencephalographic (EEG) changes in relation to hemodynamic changes at the
      onset of cardio-pulmonary (C-P) bypass circulation in 31 cases undergoing open
      heart surgeries were studied. Rapid and extensive changes in systemic
      circulation, which were followed by abnormal EEGs, appeared within the first five
      minutes of C-P bypass. Abnormal EEG patterns including disappearance of fast
      waves, slowing under 6 Hz in frequency with high voltage and flattening were
      observed in 64% of the cases. The relations between the appearance of these
      abnormal EEGs and hemodynamic factors such as mean arterial pressure (mAP),
      central venous pressure (CVP), rate of decrease in mAP and rate of change in CVP,
      were analyzed in order to elucidate causes of development of the abnormal EEGs.
      Only the rate of decrease in mAP at the onset of C-P bypass had a high
      correlation (p less than 0.01) with the appearance of abnormal EEGs. The findings
      suggest that rapid circulatory changes in the first five minutes of C-P bypass
      may induce disruption of cerebral autoregulation.

PMID- 1746022
TI  - Thiobenzamide-induced hepatotoxicity: effects of substituents and route of
      administration on the nature and extent of liver injury.
AB  - Differences in the nature and extent of hepatic injury were examined after
      administration of para-substituted thiobenzamides to rats. In accordance with
      previous studies, the extent of hepatotoxicity varied with the electron-donating
      ability of the substituent. There was also a good correlation between the extent
      of hepatic necrosis and the amount of substituted thiobenzamide sulfoxide found
      in the plasma after intraperitoneal dosing. The nature of the hepatic lesion,
      characterized as a combination of hepatic necrosis, ballooning degeneration, and
      biliary dysfunction, varied qualitatively with each thiobenzamide analog. When
      the hepatotoxicity of thiobenzamide was compared after either intraperitoneal or
      oral dosing, differences in the extent of hepatic necrosis, ballooning
      degeneration, transaminase elevation, and biliary dysfunction were observed.
      Intraperitoneal dosing with thiobenzamide gave less severe necrosis and more
      pronounced elevations in bile acids, while oral dosing led to more severe
      necrosis along with impaired biliary function. The route of administration was
      shown to dramatically affect the pharmacokinetics of thiobenzamide and
      thiobenzamide sulfoxide. Intraperitoneal administration of thiobenzamide gave
      high plasma and liver levels of both thiobenzamide and thiobenzamide sulfoxide,
      whereas oral administration gave slightly lower levels of the sulfoxide but much
      lower levels of thiobenzamide. The reason for greater hepatic necrosis after oral
      administration may be due to a greater ability to further metabolize the
      sulfoxide to a reactive metabolite in the absence of high levels of
      thiobenzamide.

PMID- 1746023
TI  - Regional increases in rat nasal epithelial cell proliferation following acute and
      subchronic inhalation of formaldehyde.
AB  - Short-term studies (9 days) in the rat have demonstrated that formaldehyde
      induced nasal epithelial lesions are associated with increases in surface
      epithelial cell proliferation rates. The present studies were designed, in part,
      to investigate cell proliferation rates in the nasal epithelium of rats exposed
      to formaldehyde for a longer duration in order to determine if correlations exist
      between (1) the concentration-response in cell proliferation rate with the
      previously published formaldehyde bioassay tumor response; (2) sites of increased
      cell proliferation and the regions of the nasal passages that exhibit
      formaldehyde-induced cytotoxicity; and (3) sites of increased cell proliferation
      and the regions of the rat nasal passages previously determined to be most
      susceptible to neoplasia (i.e., the lateral meatus and nasal septum of the
      anterior nasal passages). Another important endpoint of this study was to provide
      data for a comparison of formaldehyde-induced responses in rats with previous
      findings in rhesus monkeys. Fischer-344 rats were exposed to 0, 0.7, 2, 6, 10, or
      15 ppm formaldehyde for up to 6 weeks and pulse labeled with tritiated thymidine
      prior to each scheduled termination. Exposure to formaldehyde at 6 ppm or higher
      induced site-specific lesions in the nasal respiratory epithelium and was
      associated with increases in cell proliferation rate which remained statistically
      elevated throughout the 6 weeks. While a direct correlation between sites
      susceptible to formaldehyde-induced nasal cancer and increased cell proliferation
      was not evident, results from the present studies did demonstrate a clear
      correlation between sites of cellular injury and increases in cell proliferation
      and a concentration-dependent response which correlated with the previously
      published formaldehyde bioassay tumor response. Furthermore, this work
      demonstrated that formaldehyde-induced responses in rats exposed to 6 ppm were
      morphologically similar to those reported in the rhesus monkey; however, the
      distribution of lesions between the two species differed significantly.

PMID- 1746024
TI  - 2,5-Hexanedione exposure alters the rat Sertoli cell cytoskeleton. I.
      Microtubules and seminiferous tubule fluid secretion.
AB  - 2,5-Hexanedione (2,5-HD) is a testicular and nervous system toxicant with an
      unknown mechanism of action. In this study, the effects of 2,5-HD on seminiferous
      tubule fluid (STF) secretion, testis morphology, and tubulin distribution were
      examined. Charles River CD rats (200 g) were exposed to 1% 2,5-HD in the drinking
      water for 5 weeks followed by a 3-week recovery period. STF secretion was
      measured by efferent duct ligation, and testis cross sections were prepared at 2,
      3, 3.43, 3.57, 3.86, 4, and 8 weeks after beginning exposure. A dramatic
      inhibition of STF secretion was observed between Weeks 3 and 4. The inhibition of
      STF secretion occurred following simultaneous changes in Sertoli cell and
      elongate spermatid morphology but prior to changes in round spermatid morphology.
      Also, alterations in seminiferous tubule tubulin distribution were observed with
      kinetics similar to those for changes in seminiferous tubule morphology. This
      temporal sequence suggests a model of 2,5-HD-induced injury in which populations
      of germ cells are differentially sensitive to impairment of Sertoli cell
      function.

PMID- 1746025
TI  - 2,5-Hexanedione exposure alters the rat Sertoli cell cytoskeleton. II.
      Intermediate filaments and actin.
AB  - The effects of 2,5-hexanedione (2,5-HD) exposure on the expression of
      intermediate filament and actin proteins in adult rat testis was examined during
      progressive stages of testicular injury. The distribution of vimentin within
      testis cross sections was examined using immunohistochemistry while rhodamine
      labeled phalloidin was used to localize filamentous actin. Keratin was not
      detected in immunoblots of intermediate filament proteins tested with an
      antikeratin antibody to investigate the possible reexpression of the prepubertal
      intermediate filament protein keratin in 2,5-HD-exposed adult testes. However,
      2,5-HD exposure did result in a progressively abnormal distribution of actin and
      vimentin within the seminiferous epithelium with the appearance of a high
      molecular-weight protein which was vimentin immunoreactive and not present in
      control testes.

PMID- 1746026
TI  - Cadmium accumulation and metallothionein concentrations after 4-week dietary
      exposure to cadmium chloride or cadmium-metallothionein in rats.
AB  - The distribution of cadmium was examined in rats fed diets containing either
      cadmium-metallothionein (CdMt) or cadmium chloride (CdCl2) for 4 weeks. The test
      diets contained 3, 10, or 30 mg Cd/kg diet (3, 10, or 30 ppm) as CdMt or 30 mg
      Cd/kg diet (30 ppm) as CdCl2. A second study was performed to establish the Cd
      content in liver and kidneys after exposure to low doses of both CdMt and CdCl2
      (1.5 and 8 ppm Cd). The feeding of CdMt resulted in a dose- and time-dependent
      increase of the Cd concentration in liver, kidneys, and intestinal mucosa. Rats
      fed 30 ppm CdMt consistently showed less Cd accumulation in liver and intestinal
      mucosa than did rats fed 30 ppm CdCl2. However, renal accumulation in rats fed 30
      ppm was similar until Day 28 regardless of Cd form. At lower dietary Cd levels
      (1.5 and 8 ppm), relatively more Cd is deposited in the kidneys, although even at
      these doses the kidney/liver ratio of Cd is still higher with CdMt than with
      CdCl2. Tissue metallothionein (Mt) levels in the intestinal mucosa were
      relatively constant but always higher after CdCl2 exposure than after CdMt
      exposure. Mt levels in both liver and kidney increased after CdCl2 or CdMt
      exposure during the course of study. Although Mt levels in liver were higher
      after CdCl2 intake (30 ppm) than after CdMt intake (30 ppm), renal Mt
      concentrations were the same for both groups. In fact on Day 7, CdMt
      administration resulted in slightly higher Mt levels than CdCl2 administration,
      suggesting a direct accumulation of exogenous CdMt in the kidneys. In conclusion,
      after oral exposure to CdMt in the diet there is a relatively higher Cd
      accumulation in the kidneys. However, the indirect renal accumulation via
      redistribution of Cd from the liver might be lower than after CdCl2 exposure.
      Which of these two phenomena is decisive in the eventual level of renal toxicity
      of Cd after long-term oral intake could determine the toxicological risk of the
      chronic intake of biologically incorporated Cd.

PMID- 1746027
TI  - Effects of cigarette smoke on the immune response. II. Chronic exposure to
      cigarette smoke inhibits surface immunoglobulin-mediated responses in B cells.
AB  - We have previously reported that chronic exposure of rats to cigarette smoke
      inhibits the antibody-forming cell (AFC) response to both T-dependent and T
      independent antigens and may reflect B cell dysfunction. In this communication we
      extend these studies to show that T cell functions are normal in chronically
      smoke-exposed rats (SM) as judged by their responses to mitogens and "nominal" or
      alloantigens. While B cells from SM respond significantly to the B cell mitogen
      lipopolysaccharide (LPS), they fail to proliferate in response to anti-IgM (anti
      mu) or to produce significant AFC response to sheep red blood cells. On the basis
      of the number of rosettes formed with trinitrophenylated (TNP) horse red blood
      cells; the frequency of TNP-binding cells (TNP-ABC) in the spleens of SM is
      comparable to sham control rats. However, the proliferation of TNP-ABC to TNP
      Brucella abortus is significantly decreased in SM. These differences in SM B cell
      responses, i.e., between LPS and anti-mu/antigen, may to be related to the
      ability of LPS to bypass a portion of the membrane signal transduction cascade.
      These results suggest that cigarette smoke affects an early step(s) in the
      antigen-dependent B cell signal transduction pathway.

PMID- 1746028
TI  - Iatrogenic gangrene in the Third World.

PMID- 1746029
TI  - Xerophthalmia in malnourished Sudanese children.
AB  - Two hundred and thirteen Sudanese children (4-60 months old) with malnutrition
      were examined for signs of xerophthalmia. Sixty-three (29%) of these children
      were found to have varying stages of xerophthalmia. These included 35 (56%)
      patients with conjunctival xerosis, 12 (19%) with Bitot's spots, seven (11%) with
      corneal xerosis, seven (11%) with corneal ulceration and two (3%) with corneal
      scar. Direct questioning of the parents of these children revealed evidence of
      night blindness in nine (4%) of all patients. All nine patients had signs of
      xerophthalmia which showed good response to vitamin A therapy.

PMID- 1746030
TI  - An experience in the control of plague in Botswana.
AB  - In October 1989, cases of human plague started to occur in Boteti district of
      Botswana. One hundred and seventy cases were recorded in total from 15 October
      1989 to 6 April 1990. There were 12 deaths, giving a case fatality rate of 7%.
      All cases were of the bubonic type. A concerted control strategy based on
      sentinel surveillance, involving public education, flea and rodent control,
      chemotherapy and chemoprophylaxis controlled the epidemic.

PMID- 1746031
TI  - A hospital study of the complications of female circumcision.
AB  - During one year 118 patients were admitted to the operative gynecological ward of
      Banadir Maternity Hospital, Mogadishu, Somalia, with diseases related to the
      practice of female circumcision. Fifty-five per cent of the patients were
      suffering from a dermoid cyst at the site of the excised clitoris. Thirty-six per
      cent had a vaginal stenosis and 9% an abscess at the site of the excised
      clitoris. These patients occupied the beds of the hospital for a total period of
      1967 days which posed a significant constraint to the health services of the
      hospital.

PMID- 1746032
TI  - Management of bowel perforation in typhoid fever.
AB  - The best survival rates after ileal perforation in typhoid fever are to be found
      in patients undergoing operation within 24 h. Conservative management of typhoid
      perforation, which was widely advocated after the introduction of
      chloramphenicol, appears to be associated with a substantially increased
      mortality compared to surgery, although randomized comparisons have never been
      conducted. Clinical, radiological and ultrasound examination assist in the
      diagnosis of perforation. After vigorous resuscitation, simple surgical closure
      of the perforation and abdominal irrigation will suffice for most cases.
      Antibiotics effective against S. typhi, coliforms and anaerobes are required.

PMID- 1746033
TI  - Recurrent haemoptysis? Think of paragonimiasis.

PMID- 1746034
TI  - Anaesthesia training in Malawi.

PMID- 1746035
TI  - Appropriate management of femoral neck fractures in Nepal.
AB  - The management of femoral neck fractures in the Third World has always been a
      problem. Its management in Nepal reflects the level of available treatments for
      other orthopaedic conditions, as well as for medical care in general. The most
      successful methods of fracture treatment have remained the simple ones,
      consistent with the available resources. Adherence to this philosophy of
      management, carried out with attention to the needs of the people, reduces the
      incidence of iatrogenic complications. Six years of experience in the management
      of femoral neck fractures by traction, plaster, McMurray's osteotomy, modified
      Girdlestone's excision arthroplasty and Austin Moore prosthetic replacement have
      been reviewed, along with the relevant literature. Non-operative management has
      been found to be the most satisfactory method of treatment when related to the
      overall medical resources in Nepal.

PMID- 1746036
TI  - How well are hospitals preventing iatrogenic HIV? A study of the appropriateness
      of blood transfusions in three hospitals in the Ashanti region, Ghana.
AB  - A study on the appropriateness of blood and blood product transfusions took place
      in three hospitals over a 3-week period in July/August 1990 in the Ashanti region
      of Ghana. Clinical records of all blood transfusion recipients within the period
      were examined for the appropriateness of the transfusions based on preset
      criteria. Nearly 1 in 5 (17%) of all blood transfusion episodes in the hospitals
      were avoidable according to these criteria. Surgical practices were associated,
      perhaps habitually, with many more avoidable blood transfusions than non-surgical
      medical practices. The need to minimize the use of transfusion therapy is
      reemphasized since human immunodeficiency virus screening is imperfect. There is
      the need for hospitals to develop reasonable, practical guidelines for
      transfusions in all departments.

PMID- 1746037
TI  - Value of fibreoptic oesophago-gastro-duodenoscopy: experience with 4000
      procedures at Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
AB  - The paper presents the results of a retrospective study and the experiences with
      4000 fibreoptic oesophago-gastro-duodenoscopies (EGD), which were performed at
      Kilimanjaro Christian Medical Centre (KCMC) between 1985 and 1989 in an open
      access service. Seventy per cent of all patients examined had abnormal findings
      with duodenal ulcer as the most frequent diagnosis (22%). Pyloric stenosis was
      seen in 6%, gastric ulcer in 5% and esophageal varices in 4% of all patients.
      High figures were found for carcinoma of the esophagus (4%) and malignancy of the
      stomach (5%). Gastritis was diagnosed in 11%. We consider fibreoptic EGD a cost
      effective and appropriate technology. Because of its high diagnostic yield, we
      advocate its use in certain centres in developing countries.

PMID- 1746038
TI  - Bacterial agents in neonatal septicaemia in Calabar, Nigeria: review of 100
      cases.
AB  - This study of bacterial isolates in 100 cases of proven neonatal septicaemia has
      shown Staphylococcus aureus and coliform bacteria as the dominant Gram-positive
      and Gram-negative organisms respectively. Most Gram-negative bacteria and
      Staphylococcus aureus were sensitive to gentamicin, while streptococci were
      sensitive to ampicillin and penicillin. On the basis of this antimicrobial
      sensitivity pattern, the combination of gentamicin with either ampicillin or
      penicillin appears appropriate in initial therapy of neonatal septicaemia.

PMID- 1746039
TI  - Use of loupe in paediatric bronchoscopy.

PMID- 1746040
TI  - High dose oral diazepam and early full alimentation in neonatal tetanus.

PMID- 1746041
TI  - Relative sensitivity of blood and bone marrow cultures in typhoid fever.
AB  - In a prospective study of typhoid fever in Ahmadu Bello University Hospital,
      Zaria, the relative diagnostic sensitivities of blood culture and bone marrow
      culture were studied. The results in 64 patients with proved diagnosis of typhoid
      fever (either by recovery of S. typhi from stool, blood and/or bone marrow or by
      a positive Widal agglutination test) are presented. Forty-four per cent and 59%
      of the patients yielded S. typhi on blood and bone marrow cultures, respectively.
      In 31 patients who were investigated by both blood and bone marrow cultures, the
      yields of S. typhi were 35% and 61% respectively. This difference is
      statistically significant (P less than 0.05). In this study bone marrow culture
      proved to be the most sensitive diagnostic test for typhoid fever. A simple
      technique of bone marrow aspiration is described and its use is recommended for
      large general teaching hospitals.

PMID- 1746042
TI  - Short-stay hernia surgery with local analgesia.
AB  - This article documents the management of hernia operations in a Zambian General
      Hospital. Over a period of 28 months between 1979 and 1982, 146 patients were
      operated upon; 16 were managed under a general anaesthetic, eight with ketamine
      hydrochloride and 22 with spinal analgesia. The rest--100 patients--underwent
      repair with local analgesia. There were two surgical readmissions; the few who
      were readmitted for various other reasons have not been included. No recurrences
      were noted during the period of study. Morbidity was minimal and known surgical
      mortality was nil.

PMID- 1746043
TI  - Childhood tuberculosis.

PMID- 1746044
TI  - Safety pin in the urethra.

PMID- 1746045
TI  - Snake bite on the penis.

PMID- 1746046
TI  - Pig-bel in Nepal.

PMID- 1746047
TI  - Complications of methods of fracture treatment used by traditional healers: a
      report of three cases necessitating amputation at Ihiala, Nigeria.
AB  - Three fracture cases treated by immobilization with bamboo sticks by traditional
      bone setters ended up with amputation in a rural hospital, two for gangrene and
      the third for diaphyseal sequestration. Venous occlusion, followed by
      interruption of arterial blood supply and immobilization in a dependent position
      are responsible for the gangrene. Overwhelming sepsis accounted for diaphyseal
      sequestration in the third patient. These cases illustrate the need for more
      emphasis to be placed on primary surgical care, centred on rural hospitals, in
      the developing world.

PMID- 1746048
TI  - Chloroform bioactivation leading to nucleic acids binding.
AB  - Chloroform was bound covalently to DNA, RNA and proteins of rat and mouse organs
      in vivo after i.p. injection. Covalent Binding Index values of rat and mouse
      liver DNA classify chloroform as a weak initiator. Labelings of RNA and proteins
      from various organs of both species were higher than that of DNA. In an in vitro
      cell-free system, chloroform was bioactivated by cytochrome P450-dependent
      microsomal fractions, by cytosolic GSH-transferases from rat and mouse liver, and
      particularly by the latter enzymes from mouse lung. This observation suggests
      that GSH plays a role in the binding of chloroform metabolites to DNA. The
      presence of both microsomal and cytosolic enzymatic systems in the standard
      incubation mixture generally led to an additive or synergistic bioactivating
      effect for rat and mouse, respectively.

PMID- 1746049
TI  - Kaposi's sarcoma: a clinico-pathologic overview.
AB  - A careful overview of the classical appearances of Kaposi's sarcoma (KS) as well
      as of its variants were reviewed from the clinical and pathological point of
      view. The growth phases (stages) and the cellular patterns were
      histopathologically compared with emphasis on the developmental progression of
      disease as well as mitotic activity. Other morphological aspects were also
      assessed such as the features of the early phases and the incidence of hyaline
      bodies. One hundred and forty-three lesions from 96 patients mostly of the
      Italian sporadic type were investigated. A complete list of those entities which
      should be considered in differential diagnosis is shown and the dilemma of
      whether KS is a neoplasia or a hyperplasia is discussed.

PMID- 1746050
TI  - A hospital survey of hypocalcemia and hypophosphatemia in malignancy.
AB  - We evaluated the incidence of hypo- versus hypercalcemia and hypo- versus
      hyperphosphatemia in a survey of 158 patients with malignancy; 55/158 had bone
      metastases. When serum calcium levels were corrected for albuminemia, the
      incidence of hypo- and hypercalcemia was respectively 10.8% and 10.1%.
      Hypophosphatemia was found in 29.7% patients, hyperphosphatemia in 2.5%. The
      incidence was slightly different in presence of bone metastases. Hypocalcemia and
      hypophosphatemia prevailed in osteoblastic metastases and hypercalcemia in
      osteolytic metastases. The incidence of hypocalcemia and hypophosphatemia in
      malignancy was therefore surprisingly high, even apart from the presence of bone
      metastases. Both hypo- and hypercalcemia were associated with elevated serum
      alkaline phosphatase levels. Moreover, a calcium-phosphorus product reduction was
      observed in osteoblastic metastases, suggesting a condition of secondary
      hyperparathyroidism.

PMID- 1746051
TI  - Preliminary study on auxiliary value of serum basic fetoprotein in diagnosing
      lung cancer.
AB  - To characterize basic fetoprotein (BFP) as a new tumor marker, we measured serum
      levels of BFP and 5 other tumor markers (CA19-9, CEA, NSE, SCC, and TPA)
      concomitantly in 65 patients with lung cancer, 57 patients with benign pulmonary
      disease, and 40 healthy volunteers. The sensitivity of BFP was 43%, the
      specificity 82% and the accuracy 61%. The positivity increased in relation to
      stage of the disease. There was no correlation between positivity of BFP and
      histologic type. On the whole, BFP appeared to be analogous to TPA in terms of
      broad spectrum and to have an auxiliary value in diagnosing lung cancer.

PMID- 1746052
TI  - Leukemia and liver disease in childhood: clinical and histological evaluation.
AB  - Seventy-two consecutive patients with acute lymphocytic leukemia (ALL) who had
      undergone liver biopsy within 3 months of completing chemotherapy were studied to
      evaluate histological features after 2 to 3 years of chemotherapy and to
      correlate liver disease to the treatment schedule, the number of transfused blood
      units, and the identified etiology. Fibrosis due to antiblastic drugs was the
      most frequent histological finding. Histological liver disease was not related
      either to the chemotherapy schedule or the number of transfused blood units. HBV
      with or without delta virus and HCV infections were related to a more severe
      histological liver disease. In about 40% patients with chronic liver disease, no
      etiology was demonstrated. Immunohistochemistry revealed HBcAg in the liver of 3
      HBsAg-negative patients. In conclusion, liver biopsy could be useful in patients
      with persistent abnormal liver function tests after the completion of
      chemotherapy and in patients with markers for hepatotropic virus infection.

PMID- 1746053
TI  - Central neurocytoma. A clinico-pathologic study of five cases.
AB  - Five cases of central neurocytomas are described. The tumors occurred in
      relatively young patients (range 14 to 43 years; mean age, 27) with no
      predilection for sex. All the lesions were located in the anterior portion of the
      lateral ventricles or in the third ventricle, involving the septum pellicidum or
      the fornix. Histologically, they were composed of uniform cells with round nuclei
      and clear cytoplasm resembling oligodendrogliomas or, to a lesser extent,
      ependymomas. In 4 tumors, protein cell nuclear antigen immunostaining showed a
      low cell proliferation rate. All cases were positive for neuron-specific enolase.
      Four of the 5 cases were strongly immunoreactive for synaptophysin. The
      immunohistochemical data were consistent with neuronal differentiation. Resection
      was subtotal in 4 cases and total in one. Postoperative radiotherapy was given in
      only one case. The follow-up revealed a good prognosis: 4 patients were alive and
      had a long survival (from 2 to 8 years). Only one patient died after 14 months
      for causes unrelated to the neoplasm. The authors emphasize the importance of
      immunohistochemistry to recognize this benign intraventricular tumor.

PMID- 1746054
TI  - Response of primary breast cancer to tamoxifen alone in elderly women.
AB  - The authors report on a consecutive series of 62 evaluable, elderly (age greater
      than 69 years) women with primary operable breast cancer treated only with
      tamoxifen. The treatment schedule was 160 mg on day 1 followed by a daily
      maintenance dose of 20 mg. Compliance to treatment was excellent, and subjective
      side effects were minimal. The best response achieved after at least 6 months of
      treatment was complete in 7, partial in 22 and minor in 3, whereas stable disease
      or progression was observed in 28 and 2 patients, respectively. The response rate
      decreased and progressions increased with time. At 6, 12, 24, 36 and 48 months of
      treatment, the complete + partial response rates were 30.6%, 45%, 45.6%, 38.7%
      and 25% and the progressive disease rates 4.8%, 19.6%, 34.8%, 45.2% and 66.6%,
      respectively. These results do not confirm some previous reports of a high
      response to tamoxifen. This difference is only partially explained by the use of
      mammography, which is more sensitive than palpation, to assess tumor size and
      treatment response. The present study does not support primary hormone therapy as
      a current alternative to surgery, which should be the standard treatment in
      otherwise healthy elderly patients with operable breast cancer.

PMID- 1746055
TI  - Inflammatory component: a worsening factor in locally advanced breast cancer
      treated by radiotherapy and systemic therapy.
AB  - Locally advanced and inflammatory carcinomas of the breast are two distinct
      entities with clear differential clinical criteria. We described a particular
      type of locally advanced breast cancer which, during its evolution, developed
      inflammatory characteristics limited to a small area of the skin. It, therefore,
      did not meet the common diagnostic criteria of inflammatory carcinoma. In our
      series, studied from December 1977 to January 1987, we treated 59 cases of
      locally advanced breast cancer and 105 cases of locally advanced breast cancer
      with an inflammatory component. The actuarial overall survival was 53.3% at 5
      years and 38.4% at 7 years. Differences were observed when the two tumor types
      were compared. Specifically, locally advanced breast cancer with an inflammatory
      component had a worse prognosis, poorer survival and poorer disease-free rates
      than locally advanced breast cancer.

PMID- 1746056
TI  - Interstitial brachytherapy for carcinomas of the lower lip. Results of treatment.
AB  - From 1973 to 1988 47 patients with previously untreated T1 and T2 squamous cell
      carcinomas of the lower lip received a definitive course of interstitial
      brachytherapy by iridium 192 wires. The disease stage was T1 in 21 cases (44.7%)
      and T2 in 26, and N0 in all cases except 2 of N1. Radiation therapy dose ranged
      between 6000 and 8000 cGy. Local control was obtained in 44 patients (93.6%).
      Treatment failure in the neck was observed in 3 patients (6.7%). The 5- and 10
      year actuarial disease-free survival rates were 92% and 85%, respectively. A
      surgical salvage was attempted in 3 patients, with postoperative definitive
      control of the disease in 2. The 10-year actuarial overall survival was 95%. The
      incidence of complications was acceptable (10.6% of mucosal necrosis). An
      excellent or good cosmetic result was obtained in 91.7% of patients.

PMID- 1746057
TI  - Autoimmune thyroiditis following interleukin-2 and LAK cell therapy for
      metastatic renal cell carcinoma: correlation with tumor regression.
AB  - A 63-year-old woman receiving recombinant interleukin-2 (rIL-2) + lymphokine
      activated killer cells for metastatic renal cell carcinoma developed autoimmune
      thyroiditis with clinical hypothyroidism and high titer anti-thyroglobulin and
      anti-microsomal antibodies. The onset of thyroid dysfunction was associated with
      tumor regression and resulted in complete response at the end of the treatment.
      Cytologic and cytofluorimetric studies on thyroid tissue showed two distinct
      populations, mainly consisting of small lymphocytes and large thyrocytes, and the
      latter expressed MHC class II antigens. After completion of rIL-2 treatment,
      hypothyroidism gradually decreased until resolution; complete tumor remission
      lasted 18 months. Mechanisms underlying the association between autoimmune
      thyroiditis and cancer regression are discussed.

PMID- 1746058
TI  - Definitive irradiation of nasopharyngeal carcinoma: analysis of results and
      failures in 103 cases.
AB  - During the period 1975-1984, 103 patients were treated for nasopharyngeal
      carcinoma. Most of them presented with an advanced stage: 64 stage IV and 26
      stage III. Sixty-one patients presented with neck nodes, which was the most
      frequent symptom of presentation. The histologic subtypes included 64 squamous
      cell carcinoma and 39 undifferentiated carcinoma. All patients were treated by
      high energy sources with portals encompassing the primary and the whole neck.
      Doses ranged from 50-55 Gy in T1 patients to 65-70 Gy in T4 patients. The mean
      survival was 58.5 months, and 31 patients were alive and disease free at 60
      months from treatment. A clear difference in survival emerged among T1, T2-3, and
      T4 patients (p greater than 0.01), whereas there was no significant difference
      between T2 and T3 patients. Also, N0 and N1 showed no significant difference in 5
      year disease-free survival (38% and 41%, respectively); only 20% of N2 and 7% of
      N3 patients survived for more than 5 years. As regards histology, 25% of patients
      with a squamous cell carcinoma and 36% of those with an undifferentiated
      carcinoma were alive at 5 years. The presence of distant metastases (in 20
      patients) was not correlated with T stage but was strongly correlated with N
      stage; histology did not affect the development of metastases. There clearly was
      no correlation between T and N stage, a behavior which probably constitutes a
      characteristic of these tumors. From our analysis we can affirm that N stage has
      a greater influence on prognosis and final outcome than T stage, at least using
      the UICC staging criteria.

PMID- 1746059
TI  - Pattern and determinants of diagnostic interval in cancers of the prostate,
      bladder and kidney.
AB  - The present study examined the pattern of presentation and diagnostic interval,
      i.e. number of months between first cancer symptom or sign and first medical
      visit, in 444 cases of urological cancer (122 of prostate cancer, 187 of bladder
      cancer and 135 of kidney cancer). The mean diagnostic interval was 7.6 months for
      prostate, 5.6 for bladder and 4.5 kidney cancer. A chance diagnosis, i.e. in
      absence of any symptom or sign, was reported by 16%, 8% and 18% of patients with
      cancer of the prostate, bladder and kidney respectively. We observed on
      significant differences in diagnostic intervals according to patients'
      demographic, sociocultural, and life-style characteristics, or tumor stage.
      Better quantitative and qualitative data on the pattern and determinants of delay
      in cancer diagnosis are clearly warranted, and the present study, although
      largely negative, shows the possibility of using large-scale epidemiological
      investigations for this purpose.

PMID- 1746060
TI  - Carcinosarcoma of the stomach with endocrine differentiation. A case report.
AB  - An unusual tumor was observed in a 67-year-old man. Microscopically, the tumor
      was composed of epithelial cells forming glands (CEA, EMA-positive) and spindle
      shaped cells (vimentin-positive). A third component was a cell population
      ultrastructurally characterized by intracytoplasmic granules surrounded by a
      membrane; these proved to be chromogranin A-positive in the immunoperoxidase
      study.

PMID- 1746061
TI  - Xanthogranulomatous cholecystitis associated with gallbladder adenocarcinoma. A
      clinicopathological study of 5 cases.
AB  - The simultaneous presence of xanthogranulomatous cholecystitis and adenocarcinoma
      of the gallbladder has rarely been reported. A review of 53 cases of gallbladder
      adenocarcinoma in a 15-year period revealed 5 cases in which a concomitant
      diffuse xanthogranulomatous disease was observed. Clinical and pathologic
      features of these cases are commented and the diagnostic importance stressed.
      Both inflammatory and neoplastic components were closely mixed in 3 cases, thus
      making a prompt diagnosis difficult. Etiologic factors implicated in the
      development of both entities are considered.

PMID- 1746062
TI  - Interferon-related leukoencephalopathy in a patient with renal cell carcinoma.
AB  - A 75-year-old patient with metastatic renal cell carcinoma was treated with
      recombinant interferon alpha-C and thereafter developed a neurologic syndrome of
      dementia, ataxia, confusional state, loss of concentration ability and cortical
      blindness. CT scan findings were compatible with leukoencephalopathy, which is
      reported as being a toxic effect of interferon.

PMID- 1746063
TI  - Fibrosarcoma of the thymic region. A case report.
AB  - Fibrosarcoma of the mediastinum is an unusual tumor and only few cases have been
      reported. We describe the clinical and pathologic findings of a case of
      mediastinal mass in a 34 year old woman. The histologic, histochemical,
      immunocytochemical and ultrastructural features of the tumor were consistent with
      a diagnosis of fibrosarcoma. Furthermore, the tumor displayed evidence of close
      relations with the thymus capsule; the possibility that it may arise from the
      thymic stroma is considered. The differential diagnosis of spindle cell tumors of
      the mediastinum is also discussed.

PMID- 1746064
TI  - Effect of He-O2, O2, and N2O-O2 breathing on injected bubbles in spinal white
      matter.
AB  - Injected air bubbles in spinal white matter in the rat were studied at 1 bar
      after decompression from an exposure to air at 3.1 bar (absolute) for 4 h. During
      air breathing all injected bubbles grew for the first 2 h of the observation
      period. Thereafter three of nine bubbles began to shrink and one of them
      disappeared. During breathing of heliox (80:20) bubbles consistently shrank and
      disappeared from view. If the breathing gas was changed from heliox to N2O-O2
      (80:20), while bubbles still had an appreciable size, they started growing again.
      If the change to N2O-O2 was done after a bubble disappeared from view, it did not
      reappear. During breathing of 100% oxygen, all bubbles initially grew.
      Subsequently they all shrank and disappeared at about the same time after gas
      shift, as during heliox breathing. The effect of heliox treatment on CNS
      decompression sickness after air dives is discussed.

PMID- 1746065
TI  - Assessment of inter-rater agreement on the grading of intravascular bubble
      signals.
AB  - Transcutaneous Doppler ultrasonic bubble detectors are widely used in
      decompression research. However, interpretation of the complex acoustic signals
      from the bubble detectors involves a degree of subjectivity, and the
      comparability of grades assigned by different raters must be assessed.
      Hypothetical data were used to determine an appropriate method for evaluating the
      comparability of Doppler raters and to illustrate the limitations of many
      nonparametric statistics. Two sets of real data were then used to evaluate this
      procedure, the first from a training exercise carried out by Kisman and Masurel
      (1978, unpublished) and the second from a test tape that was independently scored
      by five Defence and Civil Institute of Environmental Medicine Doppler
      technicians. The results were analyzed by a two-stage approach. First, they were
      entered into contingency tables and checked for large disagreements, a tendency
      for one rater to grade higher than the other, and the degree of variability.
      Second, the results were analyzed with the nonparametric weighted kappa
      statistic. These studies have led to a practical, efficient method for the
      evaluation of Doppler raters.

PMID- 1746066
TI  - Psychophysiologic changes in sleep during simulated 200-m heliox saturation
      dives.
AB  - The standard polysomnogram and questionnaire were measured from 4 subjects during
      2 simulated 200-m heliox saturation dives. These measurements were performed for
      1 precompression night, bottom nights, 4 or 5 nights during decompression, and 1
      postdecompression night. Although the subjects reported a marked decrease in
      quantity and quality of sleep at the bottom, only a slight degree of sleep
      disturbance caused by frequent awakenings was found in polysomnograms. Throughout
      the dive period, latency of each sleep stage, quantity of REM sleep, and the REM
      NREM cycle showed no changes, whereas quantity of slow wave sleep remained at a
      low level. From these results it was inferred that basic sleep mechanisms were
      not affected under 200-m heliox environment. Unusual physiologic phenomena were
      observed during the dive period. Intermittent diffuse rhythmic theta activity was
      found in 1 subject at sleep stage REM during the bottom. Rhythmic contraction of
      facial muscles, which was similar to bruxism, increased, particularly at sleep
      stage 2 in all subjects during decompression.

PMID- 1746067
TI  - Effects of four drugs on 4-aminopyridine seizures: a comparison with their
      effects on HPNS.
AB  - The effects of two i.v. anesthetics, Saffan and methohexitone (MHX) and two N
      methyl-D-aspartate receptor antagonists, MK-801 (Dizocilpine) and 2
      aminophosphonoheptanoate (AP7), were tested for activity against the motor
      excitation (tremor, whole body jerks, and seizures) produced by the K+ channel
      blocker 4-aminopyridine (4-AP). Saffan increased the dose of 4-AP required for
      all three endpoints; MHX had no effect on tremor but reduced the 4-AP required to
      produce jerks and seizures. MK-801 also reduced the 4-AP dose required to produce
      jerking but did not affect tremor or seizures. In contrast, AP7 increased the
      amount of 4-AP required to produce all endpoints. The effects of these drugs on 4
      AP-induced excitation are similar to their actions on hyperbaric excitation,
      reported by us previously, and suggest that blockade of K+ channels may
      contribute to the high pressure nervous syndrome.

PMID- 1746068
TI  - Case control study of cerebral perfusion deficits in divers using 99Tcm
      hexamethylpropylene amine oxime.
AB  - In a preliminary report, Adkisson et al. (Lancet 1989; 2:119-121) used 99Tcm
      hexamethylpropylene amine oxime (HMPAO) single photon emission computed
      tomography (SPECT) to provide evidence for cerebral perfusion deficits in 28
      cases of dysbarism. The report caused concern because these deficits were found
      even in cases in which the clinical manifestations were limited to the spinal
      cord. To address this issue further, a case-control study of cerebral perfusion
      using 99Tcm-HMPAO SPECT is reported. Four groups of 10 subjects were studied: a)
      divers scanned on average 11 days after treatment of neurologic decompression
      illness, b) divers scanned 3-5 yr after treatment for neurologic decompression
      illness, c) diver controls, and d) population controls. All groups were matched
      for age, and the divers were further matched for general diving experience. The
      scans were randomized and reported blind to history. Despite a trend toward
      larger numbers of deficits in individuals with decompression illness, the 4
      groups were statistically indistinguishable. Furthermore, no correlation was
      found between the location of the perfusion deficits and the clinical
      presentation. These results indicate that 99Tcm-HMPAO SPECT scanning requires
      further evaluation before clinical significance can be ascribed to perfusion
      deficits found in divers.

PMID- 1746069
TI  - Daily diving pattern of Korean and Japanese breath-hold divers (ama).
AB  - Daily diving patterns and thoracic skin and sea-water temperatures were recorded
      during the entire work shift of Korean female unassisted (cachido) and Japanese
      male unassisted and partly assisted (funado) divers using Underwater
      Physiological Data Loggers developed in Buffalo and Japan. All 3 groups of divers
      were studied during the summer of 1989 and 1990. Additional studies were
      conducted during the winter of 1991 on Korean female divers who, unlike Japanese
      divers, dive all year round. The water temperature of the diving grounds in
      summer was 24 degrees C in both Korea and Japan, and 10 degrees C during winter
      in Korea. Both Korean female and Japanese male cachido divers made 113-138 dives
      a day and stayed in the water a total of 170-200 min.day-1, of which only 52-63
      min were spent diving submerged, and the remaining time at the water surface.
      These diving patterns were not different between female and male cachido divers.
      Compared with Japanese male divers, Korean female divers dived to a shallower
      depth (3.7 vs. 6.9 m) with shorter dive time (29 vs. 37 s) and shorter bottom
      time (14 vs. 18 s). Velocities of descent (0.72 vs. 0.47 m.s-1) and ascent (0.77
      vs. 0.56 m.s-1) were also slower in female divers than in male divers. The diving
      pattern of Korean female divers was similar in both summer and winter. Although
      all cachido divers wore wet suits and thus were protected from severe cold
      stress, thoracic skin temperature decreased during a work shift by 7 degrees C in
      winter (vs. 1 degree C in summer) in Korean divers. Compared with Japanese male
      cachido divers, Japanese male funado divers stayed in the diving ground
      (including time in the boat) longer (201 vs. 305 min.day-1) but performed only 23
      dives per day. The average diving depth (9.7 m), duration (69 s), and bottom time
      for each dive (45 s), however, were significantly greater in funados. The
      velocity of vertical descent (1.0 m.s-1) was also significantly greater in
      funados because they descend with a weight (8-12 kg). The rate of ascent was not
      different.

PMID- 1746070
TI  - [First national Enantone Symposium. Progress in therapy of prostatic cancer.
      Multicenter study: long-term follow-up].

PMID- 1746071
TI  - [LHRH analogs as monthly depot preparations in treatment of advanced prostate
      cancer].

PMID- 1746072
TI  - [Epidemiologic and morphogenetic aspects of prostate cancer].

PMID- 1746073
TI  - [Value of imaging systems in prostate cancer].

PMID- 1746074
TI  - [Galenic innovation: Enantone monthly depot preparations].

PMID- 1746075
TI  - [Hormone kinetics in suppression with monthly Enantone depot preparations].

PMID- 1746076
TI  - Surgical ureteral injuries.

PMID- 1746077
TI  - Is the neodymium:YAG laser effective therapy for invasive bladder cancer?
AB  - The neodymium:YAG (yttrium-aluminum-garnet) laser can cause transmural
      coagulation necrosis of bladder tumor or bladder wall. Pathologic specimens of 18
      patients prospectively treated with the neodymium:YAG laser before radical
      cystectomy were reviewed to compare the initial clinical stage of bladder tumor
      with the final pathologic stage and to assess the destructive tissue effects of
      neodymium:YAG laser therapy. Eleven of 18 patients were unchanged pathologically
      in stage of tumor or had tumor progression. Seven patients had a lower pathologic
      tumor stage; 3 of these patients had pathologic Stage T0 with no residual tumor,
      with the remainder of patients showing superficial disease. One asymptomatic
      small bowel injury was discovered at operation. Healing lesions showed marked
      granulation tissue, coagulation necrosis, and persistent ulceration.

PMID- 1746078
TI  - Transvaginal needle suspension procedures for recurrent stress incontinence.
AB  - The results of transvaginal needle suspension in 36 patients with stress urinary
      incontinence who failed previous operation were reviewed. Eighteen patients
      underwent a Stamey endoscopic needle suspension, and a Peyrera-Raz
      cystourethropexy was performed on the remainder. Recurrent stress incontinence
      was confirmed by history, physical examination, and urodynamic studies. Cure
      rates of 78 percent for the Stamey procedure and 83 percent for the Raz operation
      were achieved. Excluding patients with voiding dysfunction or urge incontinence
      postoperatively due to bladder instability, the failure rates were 6 percent and
      11 percent, respectively. Analysis of the results according to the preoperative
      maximal urethral pressures demonstrated that low-pressure urethras if accompanied
      with urethrovesical hypermobility have no impact on the results if the anatomic
      abnormality was corrected adequately by the needle suspension. Thus, the
      transvaginal needle suspension was found to be highly effective in patients with
      low-pressure urethras, who failed previous operation, but had persistent bladder
      neck hypermobility, and suggests that this method of surgical repair should be
      the first choice in this selected group.

PMID- 1746079
TI  - Extent of bladder and ureteric involvement and urologic management in patients
      with enterovesical fistulas.
AB  - A retrospective review of hospital charts from 1978-1989 identified 21 patients
      with acquired enterovesical fistulas. Nine patients with fistulas secondary to
      benign inflammatory processes required extensive bladder resection; 2 of these
      had ureteric involvement. Of the 9 patients requiring extensive bladder
      resection, necrotic and severely inflamed bladder was excised and the bladder was
      closed in a multilayered fashion with absorbable sutures. An omental flap was
      used when possible. Postoperative bladder drainage was maintained for seven to
      fourteen days. Ureteral involvement was managed by stenting in 1 case and
      ureteroureterostomy in another. No postoperative bladder leaks or recurrent
      fistulas were reported. Extensive inflammatory involvement of the bladder wall
      may necessitate a large vesical resection. Excision of diseased bladder tissue,
      multilayered closure, and the use of omental interposition may help reduce
      postoperative complications and the risk of recurrence. Associated ureteral
      involvement may be present in these patients and requires urologic management.

PMID- 1746080
TI  - Efficacy and morbidity of "channel" TURP.
AB  - Transurethral resection of the prostate (TURP) is necessary in a significant
      proportion of men with a diagnosis of carcinoma of the prostate. Often, "channel"
      TURP (resection of visually obstructing tissue without extension to the prostatic
      capsule in a patient with metastatic or locally advanced disease to improve
      voiding symptoms) is required. Although several theoretical concerns regarding
      the efficacy and morbidity of this procedure have been voiced, data to support
      these contentions are lacking. In a review of 41 patients undergoing channel
      TURP, all were able to void following the procedure. Two patients in whom the
      resection was carried through the external urinary sphincter, which had been
      invaded by tumor, were incontinent postoperatively. Two patients had mild stress
      incontinence. There were no perioperative deaths. These data suggest that
      incontinence is higher than expected with TURP for benign disease but that
      results may be acceptable to the patient with significant outlet obstructive
      symptoms.

PMID- 1746081
TI  - Penile carcinoma: a twenty-five-year experience.
AB  - The treatment of 34 patients with carcinoma of the penis was reviewed during a
      twenty-five-year period (1958-1983). There were 26 patients with Stage I disease,
      7 patients with Stage II, and 1 patient with Stage III disease. Among the Stage I
      group, 12 patients underwent partial/total penectomy and immediate ilioinguinal
      lymphadenectomy; 14 patients were treated with partial/total penectomy and
      observation of clinically nonpalpable nodes. Within the observation period, 10 of
      the 26 patients died, with a mean survival time of one hundred thirty-three
      months (standard error = 20.4), and a median of one hundred twenty months. Both
      the Mantel-Cox and Breslow test statistics showed the survival distribution of
      these groups of patients not to be significantly different from each other. All 7
      patients with Stage II penile cancer died, with a mean survival time of 10.6
      months (standard error = 2.1) which is significantly different from the Stage I
      group and the reported survival of 30-60 percent in the literature. A plan of
      management for the primary lesion and the role of ilioinguinal lymphadenectomy
      are presented.

PMID- 1746082
TI  - Inflatable penile prosthesis: effect of device modification on functional
      longevity.
AB  - The Scott inflatable penile prosthesis has undergone a continual evolution since
      its introduction in 1973. A review of 266 patients at Duke University Medical
      Center who received primary implantation of AMS inflatable penile prostheses from
      1979 to 1988 revealed the modifications in the prosthesis have increased the
      functional longevity and hence the reliability of this surgical treatment for
      erectile impotence.

PMID- 1746083
TI  - Nerve conduction velocity of dorsal nerve of penis: a modified technique.
AB  - The dorsal nerve of the penis is involved in sexual function. Until now, the
      nerve conduction velocity (NCV) of the dorsal nerve of the penis has been
      measured by dividing the distance between the stimulating and the recording
      electrodes by the latency to the negative peak of the action potential. With the
      penis stretched with a 1 lb weight, the NCV in normal men was 33 m/sec +/- 3.8.
      Measuring the NCV in this way, we became aware that when we decreased the
      distance between the stimulating and the recording electrodes, the velocity
      decreased. Furthermore these different measurements were linearly related. Taking
      this into account, we calculated the NCV with mathematical formula. In normal
      people, it turned out to be faster than reported previously.

PMID- 1746084
TI  - Sperm quality in men with chronic abacterial prostatovesiculitis verified by
      rectal ultrasonography.
AB  - Semen analyses were performed on 50 men with chronic abacterial
      prostatovesiculitis (CPV) and 25 asymptomatic control subjects. All subjects had
      had symptoms of at least three months' duration, and the diagnosis was verified
      by rectal ultrasonography and after microbiologic culture of seminal plasma.
      Fifty-eight percent had increased concentrations of leukocytes (greater than 1 x
      10(6)/mL) in the ejaculate compared with 15 percent in the controls. Only 10
      percent of the CPV subjects could be classified as normospermic compared with 60
      percent in the controls. The incidence of severe disturbances in sperm quality
      and azoospermia was also four times greater in the CPV group. Neither the degree
      of leukospermia nor the ultrasonographic findings could predict the extent of the
      disturbance in sperm quality.

PMID- 1746085
TI  - Ten "pearls" from my practice of penile prosthesis implantation.

PMID- 1746086
TI  - Traumatic stricture of prostatic urethra in ten-year-old boy.
AB  - Stricture of the midprostatic urethra resulted from a pelvic fracture injury in a
      ten-year-old boy. The stricture was successfully managed by core-through
      urethrotomy and transurethral resection of the scarred area in the prostate. The
      possible mechanism of traumatic stricture formation at such a rare anatomic
      location and the therapeutic options are reviewed.

PMID- 1746087
TI  - Modification of flip-flap technique for correction of distal penile hypospadias.
AB  - Flip-flap is a popular technique used for correction of distal penile
      hypospadias. When the flap length is more than 2 cm, meatal stenosis may develop
      postoperatively. This stenosis is probably due to the ischemia at the tip of the
      flap. We have used flaps with wide base to ensure good blood supply to avoid this
      complication. The results were excellent in all of the cases in which this
      modification was used.

PMID- 1746088
TI  - Crossed solitary renal ectopia.
AB  - A boy being followed for cardiovascular anomalies was found at age fourteen to
      have a solitary right kidney which drained to the left side of the bladder. We
      have reviewed the reports of 33 patients with solitary crossed renal ectopia
      which describe many associated congenital anomalies especially in the
      genitourinary and skeletal systems. We found no description of associated cardiac
      anomalies. We review the literature on solitary crossed renal ectopia and
      describe an additional case.

PMID- 1746089
TI  - Hemorrhagic myelolipoma of adrenal gland after blunt trauma.
AB  - A case of adrenal myelolipoma is reported in a patient in whom symptoms of
      hematuria and flank pain developed after the patient had sustained blunt trauma.
      Adrenal myelolipomas are usually found incidentally at autopsy. However, the
      symptomatic presentation of this patient was probably caused by traumatic
      intratumor hemorrhage. The etiology and pathogenesis of these tumors are
      discussed in relation to their occasional symptomatic presentation and to their
      differential diagnosis.

PMID- 1746090
TI  - Type IX Ehlers-Danlos syndrome: bladder diverticula with transitional cell
      carcinoma.
AB  - Patients with type IX Ehlers-Danlos syndrome have a tendency for development of
      diverticulae of the urinary bladder, and these often recur after surgical
      excision. We report on a patient with this syndrome in whom an extensively
      infiltrating transitional cell carcinoma developed in a diverticulum. To our
      knowledge, this is the first reported case of malignancy developing in a patient
      with type IX Ehlers-Danlos syndrome. The highly aggressive nature of the neoplasm
      is discussed in relation to the dampened desmoplastic response to the tumor,
      observed in this patient.

PMID- 1746091
TI  - Fatal transitional cell carcinoma of bladder in renal transplant recipient.
AB  - The risk of development of a malignancy as a consequence of long-term
      immunosuppression is well documented. Herein, we report the course of a renal
      allograft recipient in whom a fatal transitional cell carcinoma of the bladder
      developed eighteen years following transplantation.

PMID- 1746092
TI  - Effects of high-energy shock waves on murine renal cell carcinoma.
AB  - The effects of high-energy shock waves (HESW) on a murine renal cell carcinoma
      (RenCa) was investigated. In vitro exposure of tumor cells to HESW resulted in a
      dose-dependent reduction in cell viability as determined by trypan blue dye
      exclusion, plating efficiency, growth curve, and soft agar clonogenic assays.
      Activity of lactic dehydrogenase (LDH) was detected in the supernatant after the
      HESW treatment due to cellular destruction, and a dose-dependent increase in
      cytocidal effect was demonstrated. Ultrastructural changes with swelling and
      distorted cristae of mitochondria, vacuolation, ribosomal lysis, and
      chromatinolysis were observed in HESW-treated RenCa cells. Flow cytometric (FCM)
      study revealed that DNA content of RenCa cells diminished after 200 HESW
      treatment, and RNA content of tumor cells decreased markedly after 400 HESW
      treatments. Partial or complete inhibition of tumor growth was shown in both
      animal modalities of subcutaneous inoculation and intravenous injection with
      sequential lung metastases. This study stressed again that HESW may play a role
      in combinational protocol for the treatment of human renal cell carcinoma in
      certain circumstances.

PMID- 1746093
TI  - Seventy-eight-year-old woman with hematuria, hypertension, and flank bruits.

PMID- 1746094
TI  - Simultaneous renal and transitional cell carcinomas in same kidney with
      subsequent lymph node metastasis: DNA flow cytometric study.
AB  - We report the DNA content in simultaneous renal and papillary transitional cell
      carcinomas in the same kidney with a subsequent metastasis of the transitional
      cell carcinoma to a left supraclavicular lymph node. The flow cytometric DNA
      analysis revealed aneuploid stemlines with identical DNA indices in both the
      transitional cell carcinoma and the metastatic lesion and a diploid pattern in
      the renal cell carcinoma. A discussion of these findings and the potential
      implication of DNA ploidy analysis in similar situations is presented.

PMID- 1746095
TI  - Efficacy and tolerance of norfloxacin in treatment of complicated urinary tract
      infection in outpatients with neurogenic bladder secondary to spinal cord injury.
AB  - We studied the efficacy of a fourteen-day course of the fluoroquinolone,
      norfloxacin, in a group of 69 catheter-free spinal cord injury (SCI) outpatients
      who experienced a total of seventy-nine urinary tract infection (UTI) episodes. A
      total of 114 bacterial strains representing twenty species, including sixteen
      Pseudomonas aeruginosa, all susceptible to norfloxacin, were isolated from
      initial urine cultures. Mid-treatment cultures in 58/79 (73%) cases were
      negative. Cultures taken five to seven days after completing treatment in 42
      cases (53%) were negative. In the remaining 37 there was persistence of initial
      or superinfecting pathogen(s), or early reinfection with new organisms. Cultures
      eight to twelve weeks later in 32 cases with initial eradication showed that 27
      (84%) had either relapsed and/or become reinfected. Clinical cure occurred in 4/6
      (67%) symptomatic episodes. Side effects occurred in 6 of 73 (8%) patients who
      received norfloxacin, 4 of whom required withdrawal from the study. Twenty of one
      hundred twenty-two (16%) bacterial strains isolated during or after treatment
      were resistant to norfloxacin. Given the limited oral treatment options and the
      constant risk of reinfection in the SCI population, norfloxacin appears to be a
      reasonable choice in many patients. However, as with other antimicrobials, when
      using norfloxacin in SCI patients, the emergence of resistant bacteria must be
      carefully monitored.

PMID- 1746096
TI  - [Relation between cervical mucus sperm toxicity and pregnancy in cows].
AB  - Cervical secretion was collected from 99 dairy cows of the Black Pied Lowland
      breed at an age of 24 to 109 months with a minimum performance of 4000 kg of milk
      annually in spontaneous oestrus 42 days post partum at the minimum. It was
      demonstrated by the radioimmunological determination of progesterone in skim milk
      that from all the breeding cows (n = 99) the oestral secretion was collected
      during an optimum insemination time (x = 0.19 ng.ml-1 progesterone). Of the
      statistical set of 99 cows, 55 (i.e. 56.57%) got in calf and 43 (i.e. 43.43%)
      remained barren. As found, the conception results were not influenced by the rank
      of the insemination after parturition and the conception capacity of the cows was
      not influenced by the length of time from parturition to the respective
      inseminations. It was demonstrated in our investigation that the conception
      capacity of the cows increases as the time of sperm survival prolongs in the
      cervical secretion in vitro. The highest conception capacity (80%) was recorded
      in the cows whose cervical secretion was free of spermiotoxic action. In such
      cases the motility of the spermatozoa in the oestral mucus was maintained at a
      temperature of 38 degrees C for longer than 300 minutes. On the other hand, it
      was demonstrated that the conception capacity of the cows declines with
      shortening time of sperm survival in the cervical mucus.

PMID- 1746097
TI  - [Glycemia and glycosuria in the search for new energy sources for calves].
AB  - Monosaccharide (glucose), disaccharide (saccharose hydrolysate) and
      polysaccharide (maltodextrin KMS-X 70) were administered perorally to the calves
      of three age categories (pre-rumination, transition, rumination period) after 12
      hour fasting. The following characteristics were investigated: glycaemia,
      glycosuria, lactic acid concentration, plasma osmolality, hematocrit value, net
      acid-base secretion and excrement dry matter. The degree of saccharide
      utilization was evaluated from glycaemia, glycosuria and clinical condition. The
      administration of maltodextrins to calves at the age of two to three weeks was
      not found convenient. The absorption of saccharose (hydrolyzate depended strongly
      on age. The saccharose hydrolyzate dose of 2.5 g per kg l. w. was calculated with
      respect to glycaemia and glycosuria, but not to the excrement dry matter content.
      In comparison with glucose absorption, saccharose hydrolyzate seems to be a
      convenient energy source for calves of different age categories.

PMID- 1746098
TI  - [Dynamics of changes in thyroxine levels in castrated newborn calves].
AB  - Changes in thyroxin levels were studied in calves castrated just after birth. The
      changes in thyroxin concentration in the blood serum were studied until the
      eighth day of life of the calves and the weight gains were monitored until
      weaning at an age of 90 days. In the experimental group, lower thyroxin levels
      were first recorded in the third hour post natum and were observed to persist
      until the eighth day; except for three hours the decrease was not statistically
      significant. Neither were any significant differences observed in the average
      daily gains in both groups of calves. Treatments like non-surgical castration in
      newborn calves do not elicit extreme stress reactions that would be conducive to
      disorders of health and vitality.

PMID- 1746099
TI  - [Use of chick embryos for prediction of embryotoxic effects of mycotoxins in
      mammals].
AB  - Embryotoxic effects of 25 mycotoxins were investigated in two-, three- and four
      day chick embryos; the results were evaluated on the eighth day of development.
      The embryotoxicity ranged from 0.0001 to 0.1 microgram per embryo in T-2 toxin,
      aflatoxin B1, G1, B2 and M1, cytochalasin E, ochratoxin A and PR-toxin; from 0.1
      to 1.0 microgram per embryo in sterigmatocystin, aflatoxin G2, vomitoxin
      (4deoxynivalenol), patulin, rubratoxin B, secalonic acid D, mycophenolic acid,
      and from 1.0 to 100 micrograms per embryo in penicillic acid, cyclopiazonic acid,
      tenuazonic acid, citrinine, brevianamide A, zearalenone, fusaric acid,
      griseofulvin, kojic acid and 8-methoxypsolaren. Acute cardiotoxic effects were
      observed in PR-toxin, patulin, rubratoxin B, penicillic acid, citrinine and
      zearalenone. Teratogenic effects with a spectrum of different embryonal
      malformations occurred in T-2 toxin, ochratoxin A, PR-toxin, patulin, secalonic
      acid D, mycophenolic acid and citrinine. The embryotoxic effects demonstrated in
      chick embryos correlated with the well-know literary data on mammals. Considering
      the different chemical composition and biological effects of mycotoxins, we
      suppose that the embryotoxicity test of chick embryos will also be suitable for
      testing other biologically active substances in the environment.

PMID- 1746100
TI  - [Pathogenicity of Tetratrichomonas gallinarum].
AB  - Eight axenic strains of Tetratrichomonas gallinarum were isolated from the caeca
      or cloacae of ducks and geese. Different growth curves were determined for each
      of the strains and the generation times were calculated, ranging from 2 h 36 min
      to 4 h 44 min. The axenic cultures of seven T. gallinarium strains were subjected
      to the Honigberg test on inbred mice. The average volumes of the six-day-old
      subcutaneous abscesses ranged from 129.98 to 185.63 mm3. Selected strains of
      trichomonads were used for experimental infection of ducks and geese. Neither the
      macroscopis examination nor the microscopic analysis did find any greater
      pathological changes in the mucosa of the caecum of the birds, though the
      Trichomonas organisms were observed in large quantities among the villi in the
      crypts. It is believed on the basis of the results that the species T.
      gallinarium carries no primary pathogenicity to the specific hosts.

PMID- 1746101
TI  - Isolation of Actinobacillus seminis from rams in the United Kingdom.
AB  - Actinobacillus seminis was isolated from the semen of five rams on four farms.
      Four of the rams had abnormal semen and three were also infertile. The isolates
      of A seminis showed similar phenotypic profiles and electrophoretic protein
      patterns to the type strain of A seminis but were distinct from Histophilus ovis
      previously isolated from rams with epididymitis in Scotland. The infection
      appeared to be subclinical but two of the five rams had palpable abnormalities of
      their testes. Three rams were treated with antibiotics but the infection
      persisted. No gross lesions were found in the genitalia of two of three rams
      examined post mortem but one had necrotic abscesses in the testes and epididymis.
      A seminis was isolated from the seminal vesicles and epididymis of one ram
      without gross lesions but not from the genitalia of the other two. On one farm
      the infection in a recently purchased ram led to the detection of another case as
      a result of the bacteriological screening of 11 stock rams not in contact with
      the initial case. These five subclinical cases, which included a supposedly
      healthy stock ram, suggest that A seminis infection may be widespread and should
      be considered in cases of infertility.

PMID- 1746102
TI  - An atypical case of lymphosarcoma (sporadic bovine leukosis) in a heifer.
AB  - An 18-month-old Friesian heifer had several unusual, raised, black, cutaneous
      plaques, some of which were up to 20 cm in diameter, on its head and neck, limbs,
      thorax and perineum. There was also generalised lymphadenopathy. A clinical
      diagnosis of lymphosarcoma (sporadic bovine leukosis) was derived from a fine
      needle aspiration of a skin lesion. Post mortem and histological examinations
      confirmed a multicentric lymphosarcoma with widespread infiltration into many of
      the tissues recognised as predilection sites for this type of tumour. However, in
      the authors' experience, the presence of tumour masses in the trachea and the
      right mainstem bronchus was atypical.

PMID- 1746103
TI  - Poisoning of cattle fed ergotised silage.

PMID- 1746104
TI  - Microscopic agglutination: a rapid test for identification of Treponema
      hyodysenteriae.

PMID- 1746105
TI  - Experimental inoculation of sheep with Borrelia burgdorferi.

PMID- 1746106
TI  - Enterococcus hirae infection and focal necrosis of the brain of chicks.

PMID- 1746107
TI  - Origin and eradication of the North African outbreak of New World screw-worm.

PMID- 1746108
TI  - Withdrawal of terodiline hydrochloride.

PMID- 1746109
TI  - Cardiac failure in beef cattle fed dried poultry litter.

PMID- 1746110
TI  - Feline miliary dermatitis.

PMID- 1746111
TI  - Videoendoscopic laser surgery in horses.

PMID- 1746112
TI  - Controls on blue-eared disease relaxed.

PMID- 1746113
TI  - Risks of sheep vaccination explained.

PMID- 1746114
TI  - Analgesic and spasmolytic effects of dipyrone, hyoscine-N-butylbromide and a
      combination of the two in ponies.
AB  - The analgesic and spasmolytic effects of dipyrone (Novalgin) (2500 mg/100 kg
      bodyweight) hyoscine-N-butylbromide (Buscopan) (20 mg/100 kg bodyweight) and a
      combination of both drugs were evaluated in a balloon-induced model of colic,
      using five ponies with caecal fistulae. The drugs were given intravenously and
      0.9 per cent sodium chloride solution (5 ml/100 kg bodyweight) was used as a
      control. The physiological saline solution and dipyrone had no effect on caecal
      contractions. After the injection of hyoscine-N-butylbromide and the drug
      combination caecal contractions ceased within 30 seconds and for 20 and 24
      minutes, respectively (P less than 0.05). The results on pain relief were not
      statistically significant for any of the drugs. Dipyrone had a good analgesic
      effect in only two of the ponies, starting after eight to 10 minutes and lasting
      for 50 minutes. The drug combination relieved pain within 30 seconds after
      injection and the relief lasted for 50 minutes in three of the ponies and for 20
      minutes in the other two. Hyoscine-N-butylbromide alone produced an analgesic
      effect within 30 seconds after injection which lasted for 20 minutes.

PMID- 1746115
TI  - Aortic valvular dysplasia in a calf.
AB  - Aortic valvular dysplasia, a congenital abnormality not previously reported in
      cattle, was diagnosed in a calf with a pulsating mass at the base of its neck, an
      enlarged area of cardiac dullness and a loud (grade IV/V) systolic cardiac
      murmur. Electrocardiography and thoracic radiography demonstrated that the left
      atrium and ventricle were enlarged. Dysplasia of two aortic valve cusps and post
      stenotic dilatation of the ascending aorta were identified by echocardiography
      and confirmed post mortem.

PMID- 1746116
TI  - Sensitisation of cattle to bovine and avian tuberculins with Mycobacterium
      cookii.

PMID- 1746117
TI  - Ovine and caprine babesiosis in Iran: treatment with imidocarb.

PMID- 1746118
TI  - Mitochondrial alterations in skeletal muscle in a bovine encephalopathy.

PMID- 1746120
TI  - Tattooing pit bull terriers.

PMID- 1746119
TI  - Homoeopathic remedies.

PMID- 1746121
TI  - Toxocariasis campaign.

PMID- 1746122
TI  - BSE and potential risks to slaughtermen.

PMID- 1746123
TI  - Additional algal toxicosis hazard.

PMID- 1746124
TI  - Enterotoxaemia in dogs.

PMID- 1746125
TI  - Enterococcus hirae in different animal species.

PMID- 1746126
TI  - Control of bird leeches.

PMID- 1746127
TI  - Facial swelling in cattle.

PMID- 1746128
TI  - A simple test for mothball component differentiation using water and a saturated
      solution of table salt: its utilization for poison information service.
AB  - All 651 cases of mothball ingestion received by a poison information center were
      studied. At each time of inquiry, the staff member asked the caller to test
      whether the mothball floated or sank in water and a saturated solution of table
      salt. With the results of the test the staff member identified the mothball
      ingredient. Though most of the callers were housewives with little knowledge of
      medicine, the differentiations were each completed within 5 min. Later, gas
      chromatographic analyses revealed that no errors in differentiations had been
      made. Our method proved a quick preliminary test for mothball component
      differentiation in poison information service.

PMID- 1746129
TI  - Effects of prenatal pyrethroid insecticide exposure on the sexual development of
      rats.
AB  - The prenatal effects of exposure to the insecticide cyhalothrin on the sexual
      maturation and sexual behavior of rats were investigated. Female rats were
      dermally treated with 1 ml/day of 0.02% (w/v) aqueous cyhalothrin solution or its
      vehicle throughout pregnancy. This insecticide administration delayed the age of
      testicle descent but did not modify the age of vaginal opening. In adulthood,
      both male and female rat sexual behaviors were not different from vehicle-treated
      animals. It was concluded that prenatal exposure to cyhalothrin can induce
      alterations in the development of certain physical characteristics of rats which
      are not correlated with functional deficiencies in the animals' later life.

PMID- 1746130
TI  - Cardiovascular effects in bonnet monkeys (Macaca radiata) of a cassava-based
      protein-deficient diet.
AB  - Bonnet Monkeys (Macaca radiata) were maintained for up to 5 mo on protein
      deficient diets that contained tapioca starch (cassava starch) as the source of
      carbohydrate. The animals developed mucopolysaccharidosis of blood vessels and
      cardiomyopathic changes in the heart. These changes were similar to the mucoid
      vasculopathy and cardiomyopathy seen in Kerala where tapioca is consumed as a
      staple diet by a large proportion of the people. The lesions were enhanced by
      longer duration of feeling the diet and in protein-deficient animals given
      additional amounts of tapioca starch. This indicates that protein-carbohydrate
      malnutrition does play a role in the induction of such cardiovascular disorders.

PMID- 1746131
TI  - Mineral profile of serum in experimental copper intoxication of sheep from
      industrial emissions.
AB  - We studied the dynamics of Cu, Fe, Zn, Mo, As, Cd, Pb and Se in the serum of
      sheep during experimental copper (Cu) intoxication from emissions from a Cu
      factory. From the food and the dosed emission, the daily intake was 466.8 mg Cu,
      1253.93 mg Fe, 11.67 mg Zn, 0.74 mg Mo, 34.75 mg As, 0.091 mg Cd, 2.13 mg Pb, and
      2.57 mg Se/experimental ewe. After the onset of Cu intoxication the first ewe
      died on the 65th d and the last one on the 84th d of the experiment.
      Hypercupremia was observed from the 50th d after the beginning of emission
      administration. Significant changes were observed in serum Cu on the 50th, 70th
      and 77th d (P less than 0.01). Changes in the dynamics of the other elements were
      recorded at the end of the cumulative phase and during the hemolytic crisis by
      also determining Fe, Zn, Mo, As, Cd, Pb and Se in serum of the Cu-poisoned sheep.

PMID- 1746132
TI  - 2,4-D toxicosis. I: A pilot study of 2,4-dichlorophenoxyacetic acid- and dicamba
      induced myotonia in experimental dogs.
AB  - English Pointer dogs dosed po with encapsulated 2,4-dichlorophenoxyacetic acid
      (2,4-D) or 2-methoxy-3,6-dichlorobenzoic acid (dicamba) developed varying degrees
      of myotonia. Dogs given 175 or 220 mg of 2,4-D/kg body weight rapidly developed
      clinical and electromyographic (EMG) manifestations consistent with a diagnosis
      of myotonia or pseudomyotonia. Dogs given 2,4-D at 86.7, 43.7 or 8.8 mg/kg body
      weight developed subclinical manifestations of myotonia detectable only with an
      electromyograph. The administration of 2,4-D at 1.3 or 1.0 mg/kg body weight
      failed to produce detectable EMG changes. One dog given dicamba at 86.7 mg/kg
      body weight developed clinical and EMG manifestations of myotonia similar to
      those induced by the highest doses of 2,4-D.

PMID- 1746133
TI  - Increased serum sulfate concentrations in man due to environmental factors:
      effects on acetaminophen metabolism.
AB  - Serum sulfate concentrations were determined in volunteers consuming municipal
      drinking water with varying sulfate contents--77 ppm in Saskatoon and 1157 ppm in
      Rosetown. The serum sulfate concentrations were subsequently monitored after the
      administration of single or multiple-dosing regimens of acetaminophen, which
      undergoes sulfoconjugation, to determine whether sulfate concentrations in serum
      changed. Average serum sulfate concentrations were 0.35 mmol/L (Saskatoon) and
      0.50 mmol/L (Rosetown). Saskatoon volunteers had a significant fall in serum
      sulfate concentrations during the multiple-dosing regimen. This was not seen in
      the Rosetown participants. The rates of urinary excretion and renal clearance of
      sulfate were significantly higher in the Rosetown volunteers. Except for the
      multiple-dosing t1/2 levels, the Cmax, tmax, AUC and Cl/f of acetaminophen were
      not significantly different within or between the 2 groups. The excretion of
      sulfate and glucuronide conjugates of acetaminophen was not significantly
      different between the 2 groups, but there was a difference within each group with
      respect to single and multiple-doses. Excretion of the sulfate conjugate fell
      significantly in the Saskatoon volunteers during the multiple-dose portion of the
      study, whereas the percentage excreted as the glucuronide increased. The
      consumption of 15-fold greater sulfate levels in drinking water increased the
      sulfate concentration in serum. However, this increased concentration did not
      significantly alter the sulfoconjugation of acetaminophen.

PMID- 1746134
TI  - 2,4-D toxicosis.II: A pilot study of clinical pathologic and
      electroencephalographic effects and residues of 2,4-D in orally dosed dogs.
AB  - English pointer dogs dosed po with encapsulated 2,4-dichlorophenoxyacetic acid
      (2,4-D) at 1.3, 8.8, 43.7, 175 or 220 mg/kg body weight failed to exhibit
      abnormalities in hematologic, serum biochemical, urinalysis, or
      electrocardiographic parameters. At the 3 lowest doses, no changes were noted in
      electro-encephalograms (EEGs). In the dog given 175 mg/kg, at 24 h postdosing
      mild sedation was accompanied by excessive slowing in the EEG with loss of low
      voltage fast activity. In the dog given 220 mg/kg, nonspecific alterations in the
      EEG suggestive of irritation and mild seizure activity was detected 7 h, but the
      EEG returned to normal by 24 h. A maximum 2,4-D concentration in serum of 1075
      ppm was detected 5 h after a po dose of 220 mg/kg. A maximum 2,4-D, concentration
      in urine of 1792 ppm was detected 2 h after a po dose of 175 mg/kg, while 25 h
      after that dose kidney issue contained 271 ppm.

PMID- 1746135
TI  - Modification of an automated method for determining plasma and erythrocyte
      cholinesterase activity in laboratory animals.
AB  - By altering the analytical parameters on an automated analyzer, analytical
      precision for measuring cholinesterase (ChE) activity in hemolysates was markedly
      improved in samples from several species. Manual and automated spectrophotometric
      analyses of plasma and erythrocyte ChE activity were optimized for use in rats,
      mice and dogs. Replicate ChE analyses were performed on plasma samples and on
      hemolysates made from whole blood or packed erythrocytes to determine the
      precision of the manual ChE method and 4 modifications of the automated method.
      Large method-related differences in precision were observed for the erythrocyte
      assay, but not the plasma assay. The addition of a nonionic detergent to make
      hemolysates was beneficial in determining erythrocyte ChE activity in the rat,
      but not in the mouse or dog. Species specific temperature conversion factors were
      necessary for comparing results from methods using different analytical
      temperatures. Analysis of whole blood hemolysates provided similar or better
      precision for determining erythrocyte ChE activity compared to using hemolysates
      made from packed erythrocytes. Comparisons of erythrocyte ChE results obtained
      from assays with even minor methodological differences should be approached with
      caution because of the many analytical factors which can affect results.

PMID- 1746136
TI  - 2,4-D toxicosis.III: An attempt to produce 2,4-D toxicosis in dogs on treated
      grass plots.
AB  - Eighteen English pointer dogs were randomly assigned to 3 outdoor grass-plot
      enclosures (6/enclosure) uniformly sprayed once with either the 2,4
      dichlorophenoxyacetic acid (2,4-D) dimethylamine formulation (DMA-4) at the
      maximum recommended application rate, DMA-4 at 4 times the maximum recommended
      application rate, or the DMA-4 vehicle alone at 4 times the maximum recommended
      application rate. A heavy rain shower occurred 24 h after application. The dogs
      were observed for clinical signs and evaluated using an electroencephalograph,
      electrocardiograph (lead I), and electromyograph prior to exposure, and either 1
      or 7 d after continuous exposure. Clinical examination, hematologic and serum
      biochemical data were obtained, and serum, urine and kidney 2,4-D were
      quantified. Half of the dogs from each group were killed after 1 d of continuous
      exposure, while the other half were killed after 7 d. Gross postmortem and
      histologic examinations were conducted on each dog. No obvious 2,4-D effects were
      detected in any of the dogs.

PMID- 1746137
TI  - Pharmacological reactivity of rat vas deferens in chronic and subacute lead
      intoxication.
AB  - The influence of subacute and chronic lead intoxication on the responsiveness of
      the rat was deferens was investigated by determining pD2 and relative
      responsiveness ratio (p) values for noradrenaline and for acetylcholine. Thus,
      the pD2 values of noradrenaline and acetylcholine from vas deferens of lead
      treated rats were greater than those from normal rats, indicating that lead, in
      the dose and periods of treatment utilized, provoked a rise in vas deferens
      sensibility to noradrenaline and acetylcholine. Since it is known that the
      chirurgical or chemical denervation of the sexual ducts also provokes
      hypersensitivity, it may be suggested that this would be a possible mechanism for
      the observed alterations. A local lead toxic effect on the smooth muscle or at
      the level of androgen receptors should also be considered.

PMID- 1746138
TI  - Brachiaria decumbens toxicity--grass or fungus?

PMID- 1746139
TI  - Neuropathological effects and deaths of cattle and sheep in Argentina from
      Phalaris angusta.
AB  - Neuropathological disorders and mortality occurred in cattle and sheep grazing P
      angusta. This native plant of South America is frequently found as a good quality
      component of natural pastures. Cattle and sheep feeding in pastures where P
      angusta was dominant started dying or showing signs 3 to 5 d after rain-falls
      started following a period of drought. Some animals died suddenly, while others
      nervous effects( incoordination, inability to walk normal, recumbency) and death
      for up to 2 w after the beginning of the signs. Postmortem findings were
      bilaterally symmetrical, greenish pigmented areas in the grey matter of the brain
      stem and diencephalon. A greenish tinge was also noted between the cortex and the
      medulla of the kidneys. Granules of a brown pigment were noted within the
      cytoplasm of neurons. An alkaloid substance was detected in the plant. Morbidity
      was 2.3 to 10.5% in herds B and A, and 0 to 3.4% in flocks D and C, respectively.
      Mortality was 0.8 to 1.0% in herds B and C, and 3.4 to 11.7% in flocks D and C,
      respectively. P angusta behaves, in terms of toxicity, as other Phalaris spp. Its
      widespread distribution in areas of extensive grazing poses a threat to cattle
      and sheep production in Argentina.

PMID- 1746140
TI  - Snake venom constituents: biochemistry and toxicology (Part 1).
AB  - Complicated and mystifying as the snake envenomation process may appear, the
      toxic principles of snake venoms are biochemical entities that could be isolated,
      purified and characterized. In this review, the toxicological process of
      envenomation and the biochemical basis of venom toxicity are presented for those
      not directly involved in venom research but who nevertheless have an interest in
      snake venom poisoning.

PMID- 1746141
TI  - Collective human food poisonings by clenbuterol residues in veal liver.
AB  - Twenty-two patients were reported to complain of tremor, headaches, tachycardia
      and dizziness 1-3 h after eating veal liver. As clinical symptoms were not
      suggestive of an infectious cause, the presence of veterinary drug residues was
      suspected. Clenbuterol, a beta 2-agonist, was being illegally used in cattle
      because of its anabolizing properties and may explain the observed effects.
      Assays of clenbuterol in samples of veal liver showed concentrations of 0.375 and
      0.500 micrograms/g. To our knowledge, this is one of the first reports of
      clinical symptoms in humans associated with the consumption of veterinary drug
      residue-containing food.

PMID- 1746142
TI  - Acid-base balance in alcohol users seen in an emergency room.
AB  - Over 10% of emergency room patients are diagnosed as having alcohol (6.0%) or
      drug intoxication. In the present study 196 alcohol intoxications treated in a
      hospital were studied retrospectively; 49.2% of the patients had abnormal acid
      base values, alcoholics more often than non-alcoholics (p = 0.04). Mean blood
      ethanol concentration (BAC) was 310 mg/dl (SD 120); alcoholics had higher
      concentrations of alcohol. BAC was the higher the lower the serum pH was (p less
      than 0.002, r = -0.45). The deeper the coma the lower the serum pH (p less than
      0.05) and the higher the BAC (p less than 0.0001). Respiratory acidosis (31.7%)
      was an important finding in those intoxicated. Metabolic acidosis (7.9%) could be
      explained by the presence metabolites of ethanol in the serum and by decreased
      extra-cellular fluid volume. Metabolic alkalosis related to vomiting and an extra
      cellular fluid volume decrease was found in 7.9% of the patients. Respiratory
      alkalosis was a rare finding (1.6%). Hypokalemia (22.5%) and hypernatremia
      (15.3%) were the most important electrolyte changes. Chronic alcoholics had lower
      serum potassium than had non-alcoholics; 3.6% (n = 7) of the patients had to be
      intubated. Acid-base disturbances were frequent in adults with alcohol
      intoxication. Serum pH correlated well with the state of consciousness and the
      BAC.

PMID- 1746143
TI  - Correlation of serum ibuprofen concentration with clinical signs of toxicity in
      three canine exposures.
AB  - The clinical signs and serum concentrations of ibuprofen are reported for 3
      canine exposures. No adverse clinical signs or abnormal laboratory parameters
      were observed when serum ibuprofen concentrations were less than 31
      micrograms/mL. Melena and 38 mg blood urea nitrogen/dL (normal 7-26 mg/dL) were
      present in an animal with a serum ibuprofen of 138 micrograms/mL.

PMID- 1746144
TI  - Interactions between copper and selenium in sheep in the course of experimentally
      produced copper intoxication.
AB  - This work evaluated the effect of interactions between copper (Cu) and selenium
      (Se) in the course of experimentally-produced Cu intoxication with industrial
      emissions on the animals' life spans and the Cu and Se concentrations in serum,
      liver and kidneys. We selected 15 Valaska ewes 1.5 y old. After the morning
      feeding all the animals were given emissions from a nearby Cu plant that
      contained 16.5% Cu and 0.0093% Se. Seven of the animals (group B) were given 5 ml
      SELEVIT injectable (Biotika, Slovenska Lupca)/head before starting the experiment
      and again on days 30 and 60. In the animals without Se supplementation (group A)
      the daily Cu and Se intakes from the emission and food were 466.0 mg and 2.56 mg,
      respectively. The average life span of the sheep in group A was 77 d and in group
      B it was 79.83 d. The first death due to intoxication occurred on the day 65 in
      group A and on day 69 in group B. During the emission feeding period no
      statistically significant differences were observed in cupraemia between the ewes
      with Se supplementation and those without it. Hypercupraemia was found in both
      groups from day 50 till death. Only at the end of the experiment was the serum Cu
      of group A statistically lower than that in group B. Cu concentrations in the
      liver and kidneys (dry matter) of the sheep that died with Cu intoxication in
      group A was 2138 +/- 1090.96 mg/kg and 272.94 +/- 197.16 mg/kg, and in group B
      they were 2603 +/- 1332.9 mg/kg and 341.65 +/- 307.45 mg/kg,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746145
TI  - An outbreak of lupinosis in sheep.
AB  - Lupinosis is a mycotoxicosis caused by the ingestion of toxins produced by the
      fungus phomopsis leptostromiformis which grows on lupin plants. An outbreak of
      natural lupinosis in lambs occurred in Caceres, Spain. Clinical signs were
      inappetence, depression, constipation, weakness and different degrees of
      jaundice. Blood samples were analysed every 7 d for 5 w for hematocrit, total
      protein, glucose, total bilirubin, and GOT, GPT and alkaline phosphatase
      activities. The last 4 parameters were increased and returned to normal values
      after 2-3 w. The liver was swollen and a bright yellow color; microscopically
      fatty metamorphosis, necrotic areas and infiltration of polymorphonuclears were
      observed. This is the first time that lupinosis is described in Spain.

PMID- 1746146
TI  - Eosinophilia, lead poisoning and Toxacaris canis infection in children.
AB  - This report identifies Toxacaris canis infestation as a frequent cause of
      eosinophilia in both lead-poisoned and nonlead-poisoned children. An overall
      prevalence of 23% was recorded. Literature reveals a vast difference in regional
      prevalence of T canis infestations and emphasizes the need for the practitioner
      to be aware of the community in which he/she practices. Because of the adverse
      neuropsychological effects from T canis infestations, doctors in areas where
      there is a high prevalence of the disease should consider screening for
      infestations and conducting psychological testing of infested children.

PMID- 1746147
TI  - Investigating oiled birds from oil field waste pits.
AB  - Procedures and results of investigations concerning the oiling of inland raptors,
      migratory water-fowl and other birds are presented. Freon washings from the oiled
      birds and oil from the pits were analyzed by gas chromatography. In most
      instances the source of the oil could be established by chromatographic
      procedures. The numbers of birds involved (including many on the endangered
      species list) suggested the need for netting or closing oil field waste pits and
      mud disposal pits. Maintaining a proper chain of custody was important.

PMID- 1746148
TI  - Subchronic toxicity studies of tri-n-butyltin and triphenyltin acetates in rats.
AB  - The effects of a moderate but prolonged exposure of rats to tri-n-butyltin
      acetate (TBTA) and triphenyltin acetate (TPTA), as might be encountered as
      residues in yam peel diets, were investigated in rats. These subchronic toxicity
      studies (16, 8, or 4 mg TBTA/kg and 20, 10 or 5 mg TPTA/kg) showed
      histopathologic lesions in lungs, liver, intestine and kidney. The hematologic
      parameters in the groups treated with either compound fell within the normal
      range for the rats. However, there was a reduction in mean lymphocyte count for
      rats receiving 10 or 20 mg TPTA/kg, and a reduction in monocyte count in the 20
      mg TPTA/kg group. These data indicate a need for further toxicologic studies and
      cautionary measures to avoid ingestion, inhalation or contamination of dietary
      materials by these fungicides.

PMID- 1746149
TI  - Livestock poisoning from oil field drilling fluids, muds and additives.
AB  - The use and potential toxicity of various components of oil well drilling fluids,
      muds and additives are presented. Many components are extremely caustic resulting
      in rumenitis. Solvent and petroleum hydrocarbon components may cause aspiration
      pneumonia and rumen dysfunction. Some additives cause methemoglobinemia. The most
      frequently encountered heavy metals are lead, chromium, arsenic, lithium and
      copper. Considerations for investigating livestock poisoning cases and several
      typical cases are reviewed.

PMID- 1746150
TI  - Venomous arthropods.

PMID- 1746151
TI  - Evaluation of a commercial immunoassay system for sulfamethazine and aflatoxin
      detection in biological fluids and feeds.
AB  - Commercial immunoassay systems produced by International Diagnostics to analyze
      for sulfa drugs and aflatoxin residues have been evaluated with milk, urine, feed
      and serum samples. Neither system produced satisfactory results with feeds. The
      sulfa test reproducibility was good enough to provide semiquantitative results on
      milk (40 ul sample) and urine, but should be regarded as qualitative on urine or
      feed. The reproducibility of the aflatoxin test was acceptable for
      semiquantitative use on serum, but should be regarded as qualitative on urine and
      semiquantitative on milk with a solid phase concentration. The overall
      reproducibility was at least +/- 10% if the test was used semiquantitatively. The
      sensitivity of the test was 10 ng for both sulfamethazine and aflatoxin B1. The
      range of the color change was very narrow (0-20 ng). The aflatoxin test was
      designed for aflatoxin B1 and was roughly twice as sensitive to B1 as to M1
      aflatoxin. These procedures can be used on appropriate matrices at suitable
      sensitivities to rapidly screen samples for sulfa drugs and aflatoxin residues.
      The use of proper standards to demonstrate effectiveness in each matrix is very
      important.

PMID- 1746152
TI  - Histopathology of the early phase during experimental Corynebacterium
      pseudotuberculosis infection in lambs.
AB  - Histological responses during experimental Corynebacterium pseudotuberculosis
      infection in lambs were investigated in parotid lymph nodes for ten days
      following inoculation. Lambs were infected by the subcutaneous route into the
      right eyelid with a virulent strain of C. pseudotuberculosis. Multiple
      microscopic acute abscesses, predominantly infiltrated with polymorphonuclear
      (PMN) leucocytes, were seen in the right parotid lymph node on the 1st day post
      inoculation (PI). This massive PMN infiltration coincided with a peripheral blood
      granulocytosis. On day 3 PI, an influx of histiocytes was observed, while the
      microabscesses became confluent. From day 3 to day 10 PI, these lesions became
      enlarged and transformed into typical pyogranulomas with a central necrosis and a
      peripheral mantle of mononuclear cells composed of macrophages, epithelioid cells
      and lymphocytes; these histological changes were associated with a bacterial
      dissemination limited to the superficial lymph nodes. A lymphoid hyperplasia with
      prominent germinal centers was observed in the draining lymph nodes from day 3
      PI. These results illustrate the dual role of granulomatous lesions in chronic
      bacterial infections: although they limit bacterial dissemination, the granulomas
      do not impair the persistence of infectious organisms in the host, leading to
      focal tissue damage.

PMID- 1746153
TI  - Survival of Dermatophilus congolensis in tropical clay soils submitted to
      different water potentials.
AB  - The survival of a rifampicin-resistant mutant of Dermatophilus congolensis in
      vertisol and oxisol soils from Guadeloupe and in their constitutive clays was
      studied using a pneumatic device for controlling water potentials (pF).
      Experiments were carried out at two pF values simulating the wet season and the
      dry season. Survival time depended on the type of soil and its water content.
      Organic matter had a protective effect on the microorganism in oxisol but not in
      vertisol. The pathogenicity of D. congolensis was preserved in the soils which
      could therefore act as temporary reservoirs of this pathogen. Long-term survival
      of this organism in soils mixed with water suggests that ponds and dipping tanks
      may constitute sources of infection for cattle.

PMID- 1746154
TI  - Factors involved in immunity against Actinobacillus pleuropneumoniae in mice.
AB  - Active and passive immunization studies in mice were undertaken to examine the
      protective efficiency of vaccines prepared from different components of
      Actinobacillus pleuropneumoniae, or combinations thereof. Subcutaneous
      immunization using either washed formalinized whole cells, capsular
      polysaccharide, lipopolysaccharide or purified hemolysin I (105 kDa protein)
      partially protected mice against intranasal challenge with a lethal dose of
      homologous or heterologous A. pleuropneumoniae serotypes. However, full
      protection was obtained if the formalinized whole cells were supplemented with
      purified hemolysin. Similar protection was obtained when mice were immunized
      simultaneously with a sublethal dose of live cells by the intranasal route and
      with formalinized whole cells subcutaneously. Passive immunization using rabbit
      hyperimmune serum against formalinized whole cells provided almost total
      protection whereas hyperimmune serum against capsular polysaccharide,
      lipopolysaccharide or hemolysin alone provided only a partial protection. Cell
      mediated immunity as detected by the foot pad test may not be implicated
      significantly in the protein against acute A. pleuropneumoniae infection.
      However, humoral immune response seems to play an important role in protection.
      All the antigenic components examined may contribute to the protection to some
      extent. However, heat-labile components such as hemolysin and outer membrane
      proteins may play a crucial role in protection against acute challenge infection.

PMID- 1746155
TI  - Phenotypic variation in the outer membrane protein composition of Actinobacillus
      (Haemophilus) pleuropneumoniae: non-specific effect of exogenous pyridine
      nucleotide supply.
AB  - Actinobacillus pleuropneumoniae, grown in batch culture, was provided with
      pyridine nucleotides at concentrations that limited the final growth yield
      (pyridine nucleotide-deficient cultures) or did not determine the final extent of
      growth (pyridine nucleotide-sufficient cultures). Sarkosyl-extracted outer
      membranes from stationary phase, pyridine nucleotide-sufficient organisms
      contained 23,000 Mr and 43,000 Mr polypeptides that were absent (23,000 Mr) or
      barely detectable (43,000 Mr) in outer membranes from stationary phase, pyridine
      nucleotide-deficient organisms or exponential phase organisms. When growth ceased
      due to exhaustion of pyridine nucleotide, the ratio of the major outer membrane
      polypeptides (31,000, 38,000 and 69,000 Mr) was altered, becoming more like the
      ratio found with exponential phase organisms. Similar results were obtained when
      growth ceased due to glucose exhaustion at low biomass concentrations
      demonstrating that diverse nutrient deprivations can induce similar changes in
      outer membrane protein profile. All of these polypeptides were recognized by
      porcine immune sera indicating their production by A. pleuropneumoniae growing in
      vivo.

PMID- 1746156
TI  - Tetracycline resistance determinants in streptococcal species isolated from the
      bovine mammary gland.
AB  - Seventy-one streptococci isolated from dairy cows with clinical mastitis were
      tested for tetracycline resistance. Twenty-one (30%) isolates were tetracycline
      resistant (Tcr), and eight hybridized with the Tet O, one hybridized with the Tet
      L, and one hybridized with both the Tet L and Tet K determinants. The remaining
      Tcr isolates did not hybridize with any of the 5 Gram-positive Tet determinants
      tested. The Tet O determinants were plasmid-mediated, and four selected strains
      transferred the Tet O determinant at frequencies of 10(-6) to 10(-8). Strains
      which did not hybridize with known probes were tested for resistance to
      minocycline. All of the Streptococcus dysgalactiae had low minimum inhibitory
      concentrations (MICs) for minocycline, while the S. agalactiae and the one S.
      uberis showed high MICs to minocycline. This suggests that at least two different
      uncharacterized Tet determinants exist in these isolates, one conferring high
      resistance to both tetracycline and minocycline and one conferring only
      tetracycline resistance.

PMID- 1746157
TI  - Generation of aromatic-dependent Salmonella havana and evaluation of its
      immunogenic potential in mice and sheep.
AB  - The generation of aromatic-dependent (aro-) Salmonella havana (Group G2, 01, 13,
      23) from a smooth wild-type parent strain by transduction with phage P1 is
      reported. Mice immunized with this live aro- S. havana strain (CS234) by the
      intraperitoneal (i.p.) route were protected against challenge with wild-type S.
      havana, whereas those immunized by the oral route were not. Mice immunized with
      two doses of formalin-killed aro- S. havana by the i.p. route were also
      unprotected, in spite of high antibody titers. However, only those mice immunized
      with live aro- S. havana by the i.p. route developed significant delayed-type
      hypersensitivity. Following i.p. inoculation in mice, the aro- S. havana strain
      CS234 was detected in the liver, spleen and mesenteric lymph nodes on day 9 but
      not on day 15 post-inoculation (p.i.). On the other hand, when mice were
      inoculated with the parent wild-type strain (CS4) or the aro- derivative strain
      CS234 by the oral route, the organisms were recovered from the mesenteric lymph
      nodes and intestine only on day 3 but not on day 6 post-inoculation. In sheep
      inoculated with the aro- strain CS234 in the gastroc muscle, organisms were
      recovered from the muscle, and popliteal and medial iliac lymph nodes for up to
      21 but not 28 days p.i. However, no mutant organisms were recovered from liver,
      spleen, mesenteric lymph nodes or faeces. In orally-inoculated sheep, the mutant
      organisms were recovered from the mesenteric lymph nodes, rumen, intestinal
      contents, and faeces up to 14-21 days post-inoculation but not at 28 days. When
      sheep immunised with the aro- S. havana strain CS234 by the intramuscular or oral
      route were challenged with the parent wild-type S. havana strain CS4 by the oral
      route, the latter strain was detectable in the mesenteric lymph nodes and faeces
      of immune sheep up to 14 days post-challenge in contrast with the non-immune
      sheep, where the challenge strain was detectable even at 28 days post-challenge.
      Only sheep immunized by the intramuscular route developed high antibody levels
      and delayed-type hypersensitivity.

PMID- 1746158
TI  - Isolation of enterotoxigenic Escherichia coli from camels with diarrhoea.
AB  - E. coli serogroups 02, 08, 083, 0103 and 0120 were isolated from seven camels
      with diarrhoea of which 02, 08, and 083 were found to be enterotoxigenic on
      rabbit ligated ileal loop test. Out of 125 apparently healthy camels, 75 strains
      of E. coli were isolated. The majority of isolates were susceptible to
      gentamycin, nitrofurantoin, trimethoprim plus sulphonamide, neomycin, kanamycin
      and chloramphenicol.

PMID- 1746159
TI  - National Survey of Family Growth: design, estimation, and inference.
AB  - The purpose of this report is to document the procedures used in the 1988
      National Survey of Family Growth (NSFG) to select the sample, weight the data to
      produce national estimates, impute missing data, and estimate sampling errors.
      Therefore, this report necessarily contains a great deal of technical detail. For
      readers who do not need this level of detail, this summary briefly describes the
      procedures used. The National Survey of Family Growth is conducted every few
      years by the National Center for Health Statistics (NCHS), a part of the U.S.
      Department of Health and Human Services. The purpose of the survey is to collect
      and publish data from a national sample of women on childbearing, factors
      affecting childbearing (such as contraception, sterilization, and infertility),
      and related aspects of maternal and infant health. Interviewing for Cycle IV of
      the survey was done in 1988 by Westat, Inc., under a contract with NCHS. Personal
      interviews were conducted between January and August of 1988 with a national
      sample of 8,450 women in the civilian noninstitutionalized population of the
      United States. Interviews were conducted in person by trained female interviewers
      and lasted an average of 70 minutes. The interview focused on the woman's
      pregnancies, if any; her use of contraception; her ability to bear children
      (fecundity and infertility); her use of medical services for family planning,
      infertility, and prenatal care; her marriage and cohabitation history, if any;
      and a wide range of demographic and economic characteristics. This report
      describes some of the main methodological aspects of the survey, including the
      sample design, weighting, sampling errors, and imputation of missing data. These
      topics will be described briefly and less technically in this summary. Each topic
      is discussed in more detail in the rest of the report.

PMID- 1746160
TI  - Incidence and impact of selected infectious diseases in childhood.
AB  - This report provides estimates of the lifetime and annual incidence of selected
      infectious diseases for children in various demographic groups. The social and
      health care impact of these diseases in terms of limitation in activity, bed
      days, school days lost, physician contacts, hospitalizations, surgery, and use of
      medication is also presented. The data are from the 1988 National Health
      Interview Survey on Child Health.

PMID- 1746161
TI  - Pantothenic acid in health and disease.
AB  - In summary, the vitamin pantothenic acid is an integral part of the acylation
      carriers, CoA and acyl carrier protein (ACP). The vitamin is readily available
      from diverse dietary sources, a fact which is underscored by the difficulty
      encountered in attempting to induce pantothenate deficiency. Although pantothenic
      acid deficiency has not been linked with any particular disease, deficiency of
      the vitamin results in generalized malaise clinically. In view of the fact that
      pantothenate is required for the synthesis of CoA, it is surprising that tissue
      CoA levels are not altered in pantothenate deficiency. This suggests that the
      cell is equipped to conserve its pantothenate content, possibly by a recycling
      mechanism for utilizing pantothenate obtained from degradation of pantothenate
      containing molecules. Although the steps involved in the conversion of
      pantothenate to CoA have been characterized, much remains to be done to
      understand the regulation of CoA synthesis. In particular, in view of what is
      known about the in vitro regulation of pantothenate kinase, it is surprising that
      the enzyme is active in vivo, since factors that are known to inhibit the enzyme
      are present in excess of the concentrations known to inhibit the enzyme. Thus,
      other physiological regulatory factors (which are largely unknown) must
      counteract the effects of these inhibitors, since the pantothenate-to-CoA
      conversion is operative in vivo. Another step in the biosynthetic pathway that
      may be rate limiting is the conversion of 4'-phosphopantetheine (4'-PP) to
      dephospho-CoA, a step catalyzed by 4'-phosphopantetheine adenylyl-transferase. In
      mammalian systems, this step may occur in the mitochondria or in the cytosol. The
      teleological significance of these two pathways remains to be established,
      particularly since mitochondria are capable of transporting CoA from the cytosol.
      Altered homeostasis of CoA has been observed in diverse disease states including
      starvation, diabetes, alcoholism, Reye syndrome (RS), medium-chain acyl CoA
      dehydrogenase deficiency, vitamin B12 deficiency, and certain tumors. Hormones,
      such as glucocorticoids, insulin, and glucagon, as well as drugs, such as
      clofibrate, also affect tissue CoA levels. It is not known whether the abnormal
      metabolism observed in these conditions is the result of altered CoA metabolism
      or whether CoA levels change in response to hormonal or nonhormonal perturbations
      brought about in these conditions. In other words, a cause-effect relation
      remains to be elucidated. It is also not known whether the altered CoA metabolism
      (be it cause or result of abnormal metabolism) can be implicated in the
      manifestations of a disease. Besides CoA, pantothenic acid is also an integral
      part of the ACP molecule.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1746162
TI  - Expression and function of the calcitonin gene products.

PMID- 1746163
TI  - Management of patients with sexually transmitted diseases. Report of a WHO Study
      Group.

PMID- 1746164
TI  - Control of Chagas disease. Report of a WHO Expert Committee.

PMID- 1746165
TI  - Evaluation of methods for the treatment of mental disorders. Report of a WHO
      Scientific Group on the Treatment of Psychiatric Disorders.

PMID- 1746166
TI  - [Malignant lymphoma of the spleen. Histological and immunohistochemical studies
      of morphology and differential diagnosis].
AB  - 450 splenectomy specimens showing involvement by all save a few very infrequently
      occurring types of malignant lymphomas (ML) recognized by the updated Kiel
      classification of ML were investigated by conventional histologic and
      immunohistochemical methods. The results confirm and augment the findings of
      previous studies and facilitate a comparison of infiltration patterns of
      different ML in the spleen. These studies in conjunction with immunohistochemical
      detection of neoplastic cells may thus contribute to the diagnosis of minimal,
      i.e. early, splenic infiltration by ML and to the differential diagnosis of ML
      with advanced splenic involvement. Initially, most low grade NHL lead to nodular
      involvement of the splenic white pulp which may evolve into larger tumor nodules
      and/or diffuse red pulp involvement by invasion of adjacent red pulp structures.
      As a rule, the infiltrates are angiotropic, i.e. neoplastic cells accumulate in
      the vicinity of arterial and venous blood vessels both in the white and in the
      red pulp. Sinus involvement is frequently associated with leukemic generalisation
      of the neoplasm. High grade NHL are also localized predominantly in the splenic
      white pulp. However, their intrasplenic spread is characterized by the formation
      of large nodular and/or diffuse infiltrates which may efface the splenic
      architecture. Hodgkin lymphomas (HL), in contrast, cause coalescing tumor nodules
      which show expansive growth rather than progressive infiltration of the splenic
      parenchyma. These infiltration patterns of ML in the spleen are a constant
      finding. In conjunction with cytologic features and immunophenotype of the
      neoplastic cells they thus constitute reliable criteria for the differential
      diagnosis of ML in the spleen, although their anatomical and functional basis has
      not yet been fully elucidated. B and T cell lymphomas initially tend to show
      selective involvement of the original B and T cell areas of the spleen. Most high
      grade ML exhibit a similar behavior, although the size of the splenic lesions
      usually does not permit an exact identification of the ML's primary manifestation
      in the spleen. They thus exhibit a "homing phenomenon" to the two large lymphoid
      compartments of the spleen which is most conclusively illustrated by the
      "organoid" ML such as CB-CC or T zone lymphoma. This behavior has been
      interpreted to reflect the histogenesis of the neoplastic cells of the ML under
      study. In addition, specialised types of accessory cells such as CD35+ FDC and
      CD1/S100+ IDRC appear to be essential for the creation of conditions which are
      suitable for B and T lymphocytes, respectively. Progressive infiltration by
      neoplastic cells will lead to destruction of the normal microenvironment, i.e.
      alterations of FDC networks.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1746167
TI  - [Musculoskeletal manifestations in patients after bone marrow transplantation.
      Initial clinical rheumatologic observations].
AB  - From January 1986 through January 1989 69 adult patients received bone marrow
      transplants--20 with autologous, and 49 with allogeneic bone marrow. Ten patients
      after autologous and 33 patients after allogeneic transplantation (TX) could be
      examined for rheumatological complaints. None of the patients after autologous TX
      displayed rheumatological manifestations; 8/33 patients after allogeneic TX
      developed bone necrosis and they had to be treated for several months with high
      daily doses of prednisolon (mean: 55 mg/day). In 18/33 patients an
      oligoarthropathy of large joints could be observed after a significant reduction
      of prednisolon dosage over a period of 5 months. In addition 15/18 of these
      patients later developed a chronic g-v-h-disease. The TX arthropathy may be
      induced by cortico-steroid therapy (resp. reduction), but most important, it is a
      clinical sign for an imminent chronic g-v-h-disease.

PMID- 1746168
TI  - Toxoplasmosis and systemic lupus erythematosus. Comparative serological studies.
AB  - There are still controversial views as to the relation between SLE and
      toxoplasmosis. Therefore, we looked for serological markers in both diseases. In
      patients with SLE (17), toxoplasmosis (28), and in normal controls (28) anti
      Toxoplasma gondii antibodies, anti-nuclear antibodies of different specificities,
      anti-histone and anti-cardiolipine antibodies, as well as antibodies against most
      common public idiotypes were measured. Significant increases in antinuclear
      antibodies and other SLE-related antigens were observed in patients with SLE. On
      the contrary, low levels of these antibodies were found in toxoplasmosis patients
      and in controls. The same was true for 16/6 anti-DNA idiotype antibodies. The
      incidence of anti-Toxoplasma antibodies in SLE sera did not differ in comparison
      with that in the normal population. Our data suggest that subacute and chronic
      toxoplasmosis do not play essential roles in generating the antibodies that are
      important to the pathogenetic mechanism operating in SLE.

PMID- 1746169
TI  - [Panhypogammaglobulinemia: a rare complication of parenteral gold therapy].
AB  - Secondary antibody deficiency is one of the rare adverse effects of chrysotherapy
      in rheumatoid arthritis. The plasma levels of all immunoglobulins fall into
      ranges significantly lower than the tolerable physiological minimum. The long
      lasting panhypogammaglobulinemia can increase the risk of infection in the
      patient and, therefore, should be closely monitored. Hence, a record of
      immunoglobulin levels before and during therapy with gold compounds seems to be
      mandatory.

PMID- 1746170
TI  - [The medical computer as a diagnostic aid in joint pain--attitude of patients and
      results].
AB  - 409 unselected outpatients were asked standardized expert system questions on the
      medical history of joint complaints. An average number of 30.4 +/- 6.6 out of 60
      questions with 346 different answers were asked in a mean time of 20.1 +/- 6.6
      min. This time, required for the questions to be displayed on the computer screen
      and input assistance from a staff-member, proved to be comparable to the time
      required for a medical history to be taken on the same patients by a physician.
      In 75% of the cases the computer was able to predict the correct diagnosis on
      behalf of information of the medical history only. Using only medical history as
      a source of information, computer and physician had the same rate of wrong
      diagnoses. Before and after the standardized medical history on the computer
      screen all patients were asked about their opinion of the computer as a
      diagnostic aid. Male and younger patients more often appreciated computerized
      diagnosing. Just a few patients felt that their relation to the physician was
      disturbed by the computer or were inconvenienced themselves. Most patients stated
      they did not believe that physicians could ever be replaced by computers. Only a
      few of them had resignations about storage and statistical utilization of
      personal data.

PMID- 1746171
TI  - [Arthritis in lambliasis intestinalis (giardiasis) in the adult].
AB  - Joint involvement in giardiasis is reported in children and young persons only
      with one exception. We present two cases of adult patients (a thirty-year-old
      woman, 26-year-old man) who developed a slowly aggravating arthritis in PIP
      joints, ankles and knees with a tendency to chronification or relapse. Giardiasis
      was diagnosed by examination of feces. Treatment with ornidazole was effective in
      arthritic and gastrointestinaly symptoms. The patients had neither ESR elevation
      nor any other signs of inflammatory processes. The arthritis factor was negative.
      HLA-typing showed no phenotypes associated with arthritides.

PMID- 1746172
TI  - [Fungus-induced arthritis caused by Scedosporium apiospermum (Pseudallescheria
      Boydii)].
AB  - Scedosporium (monosporium) apiospermum is the most common causative agent of
      maduro mycosis. Recent research reports claim that this fungus can also induce
      arthritis. We report on the disease in a woman from a rural area who was admitted
      to our clinic because of arthritis symptoms. We were able to detect Scedosporium
      apiospermum, i.e., it was probably a fungus-induced arthritis which had developed
      after an intraarticular steroid injection.

PMID- 1746174
TI  - Dosage of alpha tocopherol in osteoarthritis.

PMID- 1746173
TI  - [Progressive multifocal leukoencephalopathy as a cause of neurologic symptoms in
      Sharp syndrome].
AB  - Progressive multifocal leukencephalopathy (PML) is a very rare complication of
      immunosuppressive or cytostatic treatment of rheumatic diseases. We describe a
      patient with a mixed connective tissue disease (MCTD) existing for more than 15
      years, who had polyarthritis, myositis, scleroderma-like symptoms, pulmonary
      involvement, and psychosis of undetermined origin. After a 12-year low-dose
      corticosteroid therapy and a 4-year azathioprin therapy a quickly progressive PML
      developed; symptoms included: difficulty in urinating, bladder, articulation,
      spastic hemiplegia, eye movement malfunction. The patient died after after a few
      months. PML is an important consideration in the differential diagnosis when a
      patient with MCTD develops neurologic symptoms.

PMID- 1746175
TI  - [Peritoneal lavage in the diagnosis of blunt injuries of hollow intra-abdominal
      organs].
AB  - In some cases of blunt abdominal trauma lesions of gastrointestinal tract are
      occasionally found. The difficulty with these injuries lies in establishing the
      diagnosis. Clinical examination alone does not reliable evidence, particularly if
      the patient is unconscious and therefore unable to respond subjectively. Although
      abdominal sonography ist becoming increasingly important in the diagnosis of
      blunt abdominal trauma lesions of the gastrointestinal tract frequently remain
      undetected or are diagnosed to late where this method of examination is used
      exclusively. In the retrospective analysis of our patients we have encountered
      serious complications such as peritonitis and even cases resulting in death. On
      the other hand when peritoneal lavage was employed, no false negative results
      occurred. Consequently the value of this method in the diagnosis of blunt
      abdominal trauma and possible lesions of the gastrointestinal tract is
      indisputable.

PMID- 1746176
TI  - [Analysis of the frequency of blood transfusion in surgery].
AB  - For the period from 1985 to 1987 were analysed the blood transfusions, which were
      carried out in seven surgical wards, within the scope of a study for quality
      assurance. 7.6% of the patients, treated in surgical ward and 5.4% of the
      patients, treated in traumatological ward, were given blood transfusion. The
      average was 3.6 transfusional units per treated patient. The biggest differences
      were to be remarked at cases of breast cancer and at thyroid gland surgery. The
      average transfusion frequency at breast cancer was 16% with a difference between
      5 and 63%. In thyroid gland surgery the average transfusion frequency was 11%,
      differing between 1 and 54%. At these operation groups the blood transfusion were
      usually given once. Transfusional reactions, costs and responsibility towards the
      donor demand a turning away from scientifically non-established transfusion
      habits. The components concept by Lundsgaard should serve as an orientation.

PMID- 1746177
TI  - [Fibronectin content in wound secretions as a criterion of the course of wound
      healing].
AB  - The content of soluble immunoreactive fibronectin in wound exudate in 104
      patients after appendectomy, laparotomy and thermal injuries was studied both in
      non-complicated and purulent postoperative wounds. It was shown that in the case
      of non-complicated wound healing fibronectin reached maximum level at the 2nd and
      3rd postoperative days. At the following days the fibronectin content decreased
      and returned at the 4th-5th days to the first day level. In the purulent wound
      the amount of fibronectin in the exudate remains low in the hydratation phase
      rising significantly in the phase of dehydration. The described changes correlate
      well with the clinical signs of wound healing. The data suggest that the
      fibronectin content in wound exudate can be used in evaluation of wound healing,
      prediction of possible complications as well as in control of treatment
      efficiency.

PMID- 1746178
TI  - [Our surgical heritage. Ambroise Pare (1510-20 December 1590). His life and
      work].

PMID- 1746179
TI  - [Diverticular disease. Pathology and clinical aspects based on 368 autopsy
      cases].
AB  - There were found 368 cases (4.5 percent) of diverticulosis of the intestine based
      on 8124 autopsies in the years of 1979 till 1988 with regard to their
      localisation, complications and accompanied diseases. In 174 of 368 cases
      clinical files could be examined and integrated in the evaluation. Sigmoid
      diverticula were most frequently followed from duodenal diverticula chiefly in
      the immediate vicinity of the "Papilla of Vateri". Constipation, stomachache,
      haemorrhoids and spasm of the anal sphincter were typical complaints. One during
      lifetime known diverticulosis was noted only approximately half on the autopsy
      application as a second disease. The autopsy results a complication of
      diverticula (mostly with a peritonitis) in 39 percent as the primary cause of
      death. Most frequently complication was a diverticulitis (in 16.8 percent refer
      to the total number). Arteriosclerosis, hypertension and/or diabetes (so called
      "civilization diseases") were in the main accompanied diseases, which were found
      too. Surgical intervention took place principal under suspicion of malignoma or
      as an "acute abdomen". Non-characteristic complaints (protraction by the
      physician) and the ignorance of the illness among the population (protraction by
      the patients) are disadvantageous to the identification of the diverticulosis.
      Because the diverticulosis as a disease of the economic developed countries
      represents a growing problem ought to direct more attention to prevention, which
      consists in application of food rich in ballast-substances and the treatment of
      the constipation.

PMID- 1746180
TI  - [Surgical therapy of complicated diverticular disease].
AB  - From 1975-1989 55 patients were operated on for complicated diverticular disease
      at our unit. Intraoperative we found the following complications: 21 walled of
      perforations, 22 stenosis of the sigmoid colon combined with obstruction of the
      small and/or large bowel, 8 free perforations with generalized, faecal
      peritonitis, 7 diverticular fistulae (5 colovesical, 1 colojejunal and 1
      colocutaneous fistula) and diverticular bleedings. In 33 cases we performed a
      resection with primary anastomosis (8 times with protecting stoma). 17 times the
      Hartmann's procedure was carried out and 5 times a transverse colostomy and
      drainage was elected. Lethality was 20% and morbidity came to 25%. We consider
      the primary resection with primary anastomosis to be the procedure of choice for
      complicated diverticulitis except for free perforation with generalized and
      faecal peritonitis where we prefer the Hartmann's procedure.

PMID- 1746181
TI  - [Is prevention of pre-eclampsia possible?].

PMID- 1746182
TI  - [Polycystic ovary syndrome: central or peripheral disorder of regulation?].
AB  - Survey about the reasons of PCO-syndrome. Possible are central or peripheral
      disturbances of regulation, but the reason is not known because of multifactorial
      disease. Therefore there is no causal treatment, too.

PMID- 1746183
TI  - [Induced abortion--a critical life change event].
AB  - In the present survey the psychic and physical mastering of abortion is
      considered to be a subject of the research of a "critical life-event". Special
      interest was devoted to the consequences of the process of mastering before and
      after abortion on the mental and physical condition of the examined human females
      (n = 39). The diagnosis showed that especially before abortion in a time of a
      serious state of inner conflict, interference concerning the physical condition
      and psyche of women arise, while actually after abortion the mood is more
      euphoric. The inconvenience increased in dependence on experience of social
      welfare and support. Three months after abortion specific complaints such as
      pains in the lower abdomen, bleeding and sudden urge to cry occur. The
      administration of contraception after abortion is becoming significantly safer.

PMID- 1746184
TI  - [Preoperatively as adnexa tumor diagnosed mucocele of the appendix].
AB  - In a 51 year old woman a cystic in the right lower abdomen was diagnosed by
      ultrasound. The patient underwent laparotomy assuming the tumor to be a right
      adnexal mass. Intraoperatively, a pathological appendix was found. Histologic
      evaluation of the appendix showed a mucinous cystadenoma with mucocele.

PMID- 1746185
TI  - [Hygroma colli--sonographic indication of fetal chromosome abnormality. A case
      report].
AB  - Transvaginal sonography has been developed as an useful tool to recognize and
      define structural defects in the first trimester fetus. Fetal cystic hygromas as
      an manifestation of malformation of the lymphatic system are often the only sign
      of an severe fetal anomaly. In 70-80% of cases cystic hygroma is associated with
      a Turner-Syndrome (45,XO). We report a case in which transvaginal sonography has
      been the only instrumental in the prenatal diagnosis of a nuchal cystic hygroma.
      Based on this sonographic finding the pregnancy has been terminated. We point to
      the value of early and subtle ultrasound examination as an excellent method in
      finding hints for chromosome abnormalities.

PMID- 1746186
TI  - [Defense mechanisms exemplified by repressed pregnancy].
AB  - Case report on a repressed pregnancy in a 19 year old women. Her short biography
      is demonstrated. For explaining this phenomenon theoretical models of defense
      behaviour from the perspective of psychoanalysis and information psychology had
      been described. These considerations are discussed connected with the case
      report.

PMID- 1746187
TI  - [Learning at the bedside of pregnant patients. On the typology of the birthing
      center in Germany (1728-1840)].
AB  - The process of institutionalization of obstetrics in the German universities is
      investigated on the basis of contemporary accounts and archival documents. The
      inauguration of the "school for midwives" by Johann Jakob Fried at Strasbourg
      (1728) was followed after 1750 by the foundation of numerous other obstetric
      departments and lying-in hospitals, in which midwives and medical students could
      attend a regular and systematic bedside-teaching for the first time. As to the
      architectural types, four basic structures have to be distinguished: Whereas in
      big cities the teaching centres were integrated in pre-existing hospitals (type
      A), the setting up of lying-in hospitals in regional universities took place in
      decaying old buildings (type B). The organizing of an obstetric ward in the
      former "clinicum" together with the medical and surgical department (type C) was
      rather seldom. Before 1850 the construction of expensive new buildings for lying
      in hospitals (type D) was only realized at few places. In conclusion the emphasis
      is put on the political intentions and tendencies of the enlightenment philosophy
      which influenced considerably the creation and the development of the first
      teaching centres for obstetrics.

PMID- 1746188
TI  - [Frankfurt Toxoplasmosis Symposium. 14 June 1990 in Frankfurt (Oder)].

PMID- 1746189
TI  - [IV. Symposium on Anlage and Disorders of the Differentiation of Genital Organs
      31 August-1 September 1990 in Greifswald].

PMID- 1746190
TI  - [CIN--what influence do smoking and socioeconomic factors have?].

PMID- 1746191
TI  - [10th Congress of the Urogynecology Section 11-13 October 1990 in Greifswald and
      Sellin/Rugen].

PMID- 1746192
TI  - [25th National Congress of Obstetrics and Gynecology of the Democratic Republic
      of Korea 1-3 August 1990 in Pyongyang].

PMID- 1746193
TI  - [Pregnancy following organ transplantation].
AB  - Pregnancies following organ transplantation are high-risk pregnancies for mother
      and fetus. There are many reports concerning pregnancies following renal
      transplantation whereas only few reports are published about pregnancies in
      recipients of liver, heart and bone marrow transplants. During the pregnancy
      after kidney transplantation pregnancy-induced hypertension can develop or the
      renal function can decrease. Risks for the fetus are prematurity, growth
      retardation and prenatal infections. A higher incidence of complications for
      mother and fetus is observed in patients with renal insufficiency or severe
      hypertension prior to conception. The risks can be reduced by an
      intradisciplinary cooperation of gynecologist, transplant specialist and
      paediatrician. The paediatrician. The experiences with pregnancies in women after
      organ transplantations in the Medical School of Hannover are analyzed and
      compared with the reports in the literature. The management of these patients is
      described on current state of knowledge.

PMID- 1746194
TI  - [Degree of DNA ploidy and steroid hormone receptors as prognostic factors in
      endometrial carcinoma].
AB  - In a prospective investigation the concentration of DNA (ploidy) and of steroid
      hormone receptors (ER and PgR, resp.) were studied in endometrial carcinoma and
      related to each other, to established morphological prognostic criteria (stage,
      typing, grading, relative invasion of myometrium), and to the clinical progress
      of disease, respectively. The microscopic spectrophotometric analysis of DNA
      showed diploid main lines in 2/3 of investigated endometrial carcinoma. It could
      be demonstrated a relationship between heteroploidy, decreased mean
      concentrations of ER and PgR, unfavourable prognostic factors (stage II-IV, G3,
      myometrial invasion of greater than 2/3) and clinical progress of disease. The
      mean value of ER and PgR was higher in diploid carcinoma than in heteroploid
      ones. Significant differences were found both in the relation of the PgR
      concentration to different tumor stages (stage I vs. II-IV) and of the
      concentration to the different types of ploidy. Exceeding the histological
      differentiation, the determination of DNA and ER/PgR receptors can results in
      additional prognostic informations for a scientific proved, adjuvant or curative
      strategy of therapy after the operation.

PMID- 1746195
TI  - [The menopause--a sociopsychological interpretation].
AB  - The psychological situation of climacteric women is determined by social economic
      and cultural changes. The educational backgrounds and family life are factors to
      a high degree of life stress, too. Psychosocial analysis and more informations
      about the conflicts in this time are preconditions for a successful treatment of
      menopausal complaints before hormone replacement in the gynecological praxis.

PMID- 1746196
TI  - [Plasma level and metabolism of vitamin A (Vitadral) in women of reproductive
      age].
AB  - Using a sensitive HPLC method, plasma concentrations of vitamin A and metabolites
      were measured from 6 female volunteers who had taken once daily 0.46 mg/kg BW
      retinol palmitate (Vitadral) for 10 days. The metabolites all-trans- and 13-cis
      retinoic acid were increased significantly (2- and 5-fold, resp.) 6 h after the
      ist intake. 13-cis-4-oxo retinoic acid the 10th intake in the morning of the 10th
      day (9.22 +/- 2.77 ng/ml, 4-fold increase). The results show continuous increase
      of retinoic acids, which have to be considered as potential teratogens, after
      administration of vitamin A. The plasma concentration of retinol itself did not
      change, whereas only short-term increases were observed for retinol esters.

PMID- 1746197
TI  - [Micturition and incidence of postoperative urinary tract infections in surgical
      gynecology].
AB  - In a retrospective analysis postoperative courses of 879 patients (1987-1989)
      have been analysed with respect to micturition behaviour and incidence of
      postoperative urinary tract infections. 58.5 per cent urinary tracts infections
      could be registered following uro-gynecology operations and 48.9 per cent after
      radical hysterectomies according to Wertheim-Held. The lowest rate of 15.9 per
      cent we found after simple interventions at the adnexas. Within the uro
      gynecological operations vaginal plastic procedures had a higher rate (66.4 per
      cent) than colposuspensions with 41.5 per cent. Because of the different extent
      of the bladder preparation there were distinct differences with regard to first
      spontaneous micturition and lack of residual urine.

PMID- 1746198
TI  - [Sonographic diagnosis of fetal lung maturity--a new method].
AB  - First results are presented to determine the maturity of fetal lung by
      sonography. Using the fetal liver as a reference-organ we are avoiding the known
      pitfalls which made it impossible in the past to standardize the fetal lung
      changes depending on the age of gestation. We examined 104 patients between week
      27 and week 41. In one ultrasound section cut we depicted as well lung and liver.
      According to the known A-mode we registered frequencies in both organs. The
      registered frequencies were entered digitally into a computer and checked for f
      mean, f max and f min. Afterwards the frequencies of the lung were divided by
      those of the liver. Of all weeks of gestation the mean value and standard
      deviation were calculated. We found the liver as an adequate reference-organ,
      since there is no change of the reflection pattern between the different weeks of
      gestation, while there are significant changes to be registered in the fetal
      lung, a cutting line being week 35. A quotient of f mean lower than 1.1 hints to
      lung maturity while values over 1.1 point to immaturity. This was confirmed by
      several cases of analysis of amniotic fluid (L/S-ratio). Further comparisons with
      amniotic fluid results will have to validate these findings.

PMID- 1746199
TI  - [Multiple coagulation disorders following cesarean section].
AB  - We refer to a case report describing the diagnostic and therapeutic problems
      resulting in multiple intra- and postoperative coagulation disorders.
      Differential diagnostic indications respecting to the most important disorders
      within the coagulation system are described especially. Local hyperfibrinolysis
      is accounted in detail; besides we inform about our own therapeutic experiences.

PMID- 1746200
TI  - [Coexistence of endometroid carcinoma of the ovary and endometrial carcinoma in a
      32-year-old woman].
AB  - At our hospital a 32 year old patient with a cystic ovarian had been operated.
      Because sonography was without pathological findings and the patient showed a
      sterility type, laparoscopy was indicated. Histological findings showed invasive
      growth of a tubulopapillary carcinoma. Laparotomy with hysterectomy, bilateral
      adnexa removal, omentectomy as well as pelvic and para-aortic lymphadenectomy was
      examined. Histologic and immunohistochemical investigations led to coexistence of
      ovarian endometroid carcinoma and to an endometrial carcinoma, both tumors being
      of different antigenicity.

PMID- 1746201
TI  - Human cervical mucus: its enzymes.

PMID- 1746202
TI  - Monitoring ovulation by ultrasound and hormonal parameters.

PMID- 1746203
TI  - Antispermatozoon antibodies and cervical factor of sterility.

PMID- 1746204
TI  - Simultaneous dosage of oestrone-3-glycuronide and pregnanediol-3-glycuronide in
      urines to monitor the fertile period in the woman.

PMID- 1746205
TI  - The simplicity of the Ovulation Method and its application in various
      circumstances.

PMID- 1746206
TI  - The canalization of cervical mucus in the human fertility.

PMID- 1746207
TI  - Changes in fatty acids sebum composition during human menstrual cycle: possible
      relationships with fertile period.

PMID- 1746208
TI  - Natural contraceptive methods.

PMID- 1746209
TI  - The anatomical bases of human fertility.

PMID- 1746210
TI  - The validation of the Billings ovulation method by laboratory research and field
      trials.

PMID- 1746211
TI  - Human leukocyte antigen compatibility and failure to achieve a viable pregnancy
      with assisted reproductive technology.
AB  - Many couples fail to achieve a viable pregnancy with multiple attempts of
      Assisted Reproductive Technology (ART). Immunologic rejection of the embryo may
      be a factor in these couples. We evaluated shared human leukocyte antigen (HLA)
      antigenicity in 10 couples who failed multiple ART cycles and compared them with
      10 couples who achieved a viable pregnancy with their first ART attempt. Study
      couples shared a statistically significant greater number of HLA antigens than
      control couples. Leukocyte immunotherapy is discussed. We conclude that couples
      who share multiple HLA antigens may have an immunologic basis for failing to
      achieve a viable pregnancy with multiple ART cycles.

PMID- 1746212
TI  - Computer assisted sperm motility analysis.
AB  - The CellSoft system was employed to study its reliability in the evaluation of
      seminal data in fertile and infertile subjects. In addition new motility data
      were introduced and added to the classic parameters. Various clinical and
      experimental applications are reported. The system is valid and extremely useful
      in seminal research. In order to obtain the above mentioned benefits it is
      necessary for the users to have extensive experience of seminology and computer
      technology.

PMID- 1746213
TI  - Pericentric inversion of chromosome 5: a possible threat to male fertility?
AB  - Pericentric inversion of chromosome 5 (inv(5)(p12,q13] was diagnosed in two
      unrelated men with normal phenotype referred for infertility. The spermatogenic
      damage in these patients may be explained on the basis of the X-Y bivalent
      behaviour in cases of some balanced structural rearrangements of the chromosomes.
      The Authors propose a possible negative action of inv(5) in male gamete
      production and suggest a larger use of the chromosome analysis in the study of
      male infertility.

PMID- 1746214
TI  - Antibodies to spermatozoa. XII. The critical performance of the Gelatin
      Agglutination Test (GAT).
AB  - The Gelatin Agglutination Test for detection of sperm antibodies was critically
      studied and evaluated. This fundamental technique for the detection of sperm
      antibodies was now modified in a number of details. The new procedure, termed GAT
      II, is more convenient, economical, and reliable than the older form of this
      procedure; the volumes used are half as much, thus using less serum and less
      antigen, the mixtures are prepared within each Kibrick tube, thus requiring fewer
      transfer steps, and the foam problem is prevented, thus making observation more
      accurate. Secondly, an extensive study was made of the effect of the time of
      incubation in this procedure, comparing 30, 60, and 120 minutes for each test
      mixture. It was found that only 7 of the 50 tested sera (14%) showed a positive
      result at 30 minutes, although all 50 were positive at 120 minutes. Various
      details of this sort must be carefully considered, in order to make this test
      fulfill its potential and have maximum reliability for clinical significance.

PMID- 1746215
TI  - Artificial insemination for oligospermia. A critical review.
AB  - The study concerns the review of the literature concerning the effectiveness of
      artificial insemination in cases of oligospermia. Differences in AIH techniques,
      the lack of standardized methodology explain the wide range of discrepancies in
      the resulting pregnancy rates. Still, in the course of time, a few certainties
      have been acquires: A detailed and thorough investigation of the female partner
      is mandatory. The use of fresh ejaculates is today totally obsolete, even with
      the help of cups, intra-cervical or eventual intra-uterine insemination. The
      standardization of seminal parameters still remains an unsolved problem. At the
      present time, intrauterine insemination with capacitated sperm is the method of
      choice. Still a basic condition is mandatory: a minimum of 1 M motile capacitated
      spermatozoa is required. Timing of insemination determined by the LH peak seems
      the most valuable procedure. The overall benefit is low, +/- 5% conception rate
      per cycle, and short lived because of the strain involved in an optimalized
      procedure. The policy to plan 3 to 6 AIH cycles before going over to an IVF
      procedure is the more debatable.

PMID- 1746216
TI  - The use of the Salt Stored Zona Assay in the study of the sperm function:
      methodological approach.
AB  - The authors mention many tests to study sperm function. On their opinion, the
      best model to evaluate spermo-oocyte interaction is the in vitro fertilization
      but it cannot be considered a test for ethical and practical problems. To
      overcome these problems they propose the Salt Stored Zona Assay to evaluate the
      spermatozoa.

PMID- 1746217
TI  - Echoguided transvaginal oocyte retrieval: effective and easy to learn technique.
AB  - Echoguided transvaginal oocyte retrieval gives good results even when carried out
      after a short training course. This study compares the results obtained by a
      group of physicians with long experience and a newly-trained group. No
      significant differences were found in the percentages of follicles punctured
      (87.9% vs 91.9%), of oocytes recovered (62.8 vs 70.6%), in the mean number of
      follicles aspirated (4.5 vs 4.1) or in duration of the procedure (33.9 min vs
      34.2 min). No complications occurred in the retrieval and the patients, pain was
      very slight.

PMID- 1746218
TI  - Medical treatment of ectopic pregnancy.
AB  - Methotrexate is an alternative to surgical treatment of unruptured tubal
      pregnancy. Among 39 women with the diagnosis of tubal pregnancy there were ten10
      cases without rupture of salpinx. Nine9 out of these treated with Methotrexate.
      In one1 case there was rupture immediately after the termination of the
      treatment. There were no experiences of major side effects from the treatment
      with Methotrexate. The passage through the tubes was examined laparoscopically 3
      months after the treatment. There was passage through all affected tubes.

PMID- 1746219
TI  - Vertebral artery tortuosity with concomitant erosion of the foramen of the
      transverse process of the axis. Possible clinical implications.
AB  - Thirty-six vertebral arteries were examined for the presence of tortuosity in
      their trajectory through the neck. Of these, 18 vessels (14 bilateral) showed
      various degrees of tortuosity of their proximal segment. Four arteries had marked
      kinking of the tortuous vessel at the foramina of the transverse process of the
      axis. These foramina presented with marked erosion of the underlying bone. Four
      other axes presented with moderate erosion of the F/Tp. The etiology and clinical
      significance of tortuosity of the vertebral artery, and erosion of the F/Tp of
      the axes, are discussed in light of the extreme range of rotation occurring at
      the C1-C2 segmental level.

PMID- 1746220
TI  - Subepithelial elastic system fibers of oblique mucosal folds in the rat proximal
      colon.
AB  - The proximal colon of the rat is characterized by a 'herring bone' pattern of
      oblique mucosal folds (OMF) which are arranged in a parallel array. By light and
      electron microscopy the OMF exhibited rich subepithelial elastic system fibers
      which bound the epithelial basement membrane and the smooth muscle cells of the
      lamina propria together. The elastic system fibers usually consist of elastic,
      elaunin and oxytalan fibers. However, the subepithelial elastic system fibers of
      the OMF were composed of relatively thin elastic fibers with a few microfibrils,
      and elaunin and oxytalan fibers which were almost indiscernible. Areas other than
      the OMF were quite poor in subepithelial elastic system fibers. The
      interpositions between each of the OMF were composed of typical components:
      elastic, elaunin and oxytalan fibers. The composition of the subepithelial
      elastic system fibers of the OMF does not correspond to that of any other organs
      previously reported. The present study suggests that the OMF of the rat proximal
      colon might be equipped in such a way to resist to distension or compression.

PMID- 1746221
TI  - Are Ranvier's nodes artifacts by preparation?
AB  - To avoid artifacts, native nerve fibers were investigated by phase contrast light
      microscopy. It was shown that Ranvier's nodes cannot be seen. At the sites at
      which they can be produced by thermal and chemical effects, a tight joint of the
      tube ends of the 'internodes' inverted to the inside are to be found. Some
      structures of Ranvier's nodes do not exist in intact living nerves. This fact can
      also be proved by electron micrography.

PMID- 1746222
TI  - Ramification pattern of intermetacarpal branches of the deep branch (ramus
      profundus) of the ulnar nerve in the human hand.
AB  - The branching pattern of the deep branch (ramus profundus) of the ulnar nerve and
      its relation with the target were analyzed in the human hand by an improved
      dissection method. After sending off branches to the hypothenar muscles, the r.
      profundus branched off an ulnar stem and a radial stem to the fourth, to the
      third and to the second intermetacarpal spaces, respectively, in this order, and
      an ulnar stem to the first to become terminal branches. The ulnar stems included
      an ulnar interosseous branch and a superficial articular branch in addition to a
      lumbrical branch in the third and fourth intermetacarpal spaces. The radial stems
      included only a radial interosseous branch. The branching pattern of the ulnar
      stems as well as its topographical relationship with the radial stems indicated a
      fundamental spatial arrangement of the branches in the intermetacarpal spaces:
      the lumbrical, superficial articular, ulnar interosseous and radial interosseous
      branches were arranged fundamentally in this order from ulnar to radial in each
      space; the first three branches may form a common trunk. The present observations
      demonstrate that individual nerves in the extremities may have a regular
      branching pattern, contrary to most of the previous observations.

PMID- 1746223
TI  - Ultrastructure of the red pulp in spleen innervation in horse and pig.
AB  - The innervation of the red pulp in the spleen of horse and pig was investigated
      by electron microscopy. In addition, the neurilemma was studied by
      immunohistochemistry specific for S-100 protein. In the pig, a large population
      of smooth-muscle cells extending from the smooth-muscle trabeculae was present in
      the red pulp. The cytoplasmic processes of reticular cells enwrapped the smooth
      muscle cells, and nerve fibres were distributed between the smooth-muscle cells
      and the reticular cells. The nerve terminals clustered toward the facing of the
      smooth-muscle cells. Nerve fibres and terminals were not disclosed within the
      sheathed artery. Immunohistochemically the neurilemma showed a reaction positive
      for S-100 protein. In the horse, no smooth-muscle cells were noted in the red
      pulp. The nerve fibres terminated around the cytoplasmic processes of the
      reticular cells. Nerve fibres and terminals were disclosed within the sheathed
      artery, and the terminals contained both large and small dense-cored vesicles.
      Immunohistochemically the neurilemma showed a reaction negative for S-100
      protein. These findings support the presence of the axon-bearing reticular cells
      described earlier in the horse spleen.

PMID- 1746224
TI  - Left superior vena cava with atrial displacement.
AB  - Two cadavers were dissected showing persistence of left-sided superior vena cava
      with atrial displacement and inversion of the venous drainage from the body wall
      (azygos system of veins). The presence of atrial displacement in relation to a
      persistent left superior vena cava observed in this study lends support to the
      view that haemodynamic factors influence the morphogenesis and development of the
      heart. The development of an asymmetrical venous pattern from a symmetrical
      venous drainage may be influenced by the same factors which influence the
      arterial end of the primitive heart tube.

PMID- 1746225
TI  - Experimental study of the origin of the parathyroid glands.
AB  - The origin of the parathyroid glands was investigated in chick embryos (Gallus
      domesticus). Pieces of the third branchial arch were grafted, and its ectodermal
      layer formed a new structure (parathyroid III), which became separated from the
      placodial ectoderm. This structure continued to develop until, together with
      neural crest cells which gave rise to the mesenchyme, it formed a distinct
      parathyroid III gland by stage 28 of Hamburger and Hamilton.

PMID- 1746226
TI  - Changes in prolactin cells caused by partial hepatectomy in the rat.
AB  - In order to study ultrastructure alterations in prolactin (PRL)-secreting cells,
      PRL cells of the anterior pituitary glands of partially hepatectomized female
      rats were observed by the protein A-gold procedure with the electron microscope.
      Simultaneously, their serum PRL and estradiol (E2) levels were measured by
      radioimmunoassay. After about 70% hepatectomy PRL cells were remarkably changed,
      that is active granule extrusion, prominent Golgi vesicles and a hypertrophic
      rough endoplasmic reticulum were observed. These changes were most remarkable on
      day 3 after the operation. Significant increases in serum PRL and E2 were also
      seen following partial hepatectomy. It may be assumed that the morphological
      changes in PRL cells and the elevation of serum PRL were probably due to surgical
      stress and to the diminution of E2 receptors in the liver after partial
      hepatectomy in the rat.

PMID- 1746227
TI  - Tibial dimensions before and during the recovery phase in the osteopetrotic
      mutant mouse.
AB  - Osteopetrosis is a genetic bone disease characterized by excessive bone mass and
      'clubbing' of long bones. In the osteopetrotic (op) mouse, remission of the
      disease begins at 45 days of age. This study attempted to describe changes in the
      op tibia before and during remission. Osteopetrotic and normal littermates were
      killed at intervals from 10 to 120 days of age. Left tibiae were processed for
      transmission electron microscopy. Microradiographs of right tibiae were projected
      and drawn. Bone dimensions were compared between mutants and controls by ANOVA
      and bones were viewed in a scanning electron microscope. Differences between
      mutants and controls were: at all ages mutant tibiae were shorter than those of
      controls; 10-day distal shafts of mutant tibiae were significantly narrower; 30
      day proximal shafts of mutant tibiae were wider, distal shafts were narrower, and
      there was no bone resorption along the external proximal metaphysis. At 48 days,
      resorption was seen along the proximal metaphyses of the mutant tibiae and by 60
      days, extensive resorption areas were evident. However, proximal shafts of mutant
      tibiae were still significantly wider than those of controls. These results
      indicated that before remission there was an unequal deposition of bone on the
      mutant tibia. After remission, resorption occurred along the external proximal
      shaft, but was not enough to remove significant amounts of bone from the proximal
      metaphyses of mutant tibiae by 120 days of age.

PMID- 1746228
TI  - Is exencephaly the forerunner of anencephaly? An experimental study on the effect
      of prolonged gestation on the exencephaly induced after neural tube closure in
      the rat.
AB  - Exencephaly is said to precede anencephaly resulting from failure of the rostral
      neuropore closure. In order to verify if the exencephaly induced after neural
      tube closure would also lead to anencephaly, exencephaly was induced in rat
      fetuses by maternal administration of a single dose (15 mg/kg) of
      cyclophosphamide on day 12 of gestation and pregnancy was prolonged by uterine
      ligation until postconception (PC) day 24. Fetal death was found to increase with
      prolongation of gestation and no sign of recovery from growth retardation was
      observed. Alizarin red-S-stained skeletal preparations substantiated the
      persistence of skull malformations in the exencephalic fetuses. Histological
      observations of the mesenchyme and the brain indicated degenerative changes that
      were intensifying with time. The ventricular system expanded progressively; the
      ependyma was denuded and neural mass lay free in the ventricle. The choroid
      plexus appeared to be elaborate and extensive. The haemorrhagic capillary network
      around the brain tissue was highly proliferative and appeared to penetrate the
      former from the exterior. Tissue necrosis seemed to progress unabated. Cystic
      spaces appeared beneath the base of the brain and became progressively large and
      it appeared as if the brain was being pushed out of the shallow cranial fossae.
      By PC day 24, most of the brain tissue had degenerated, thus giving clearly the
      appearance of the anencephalic condition.

PMID- 1746229
TI  - Morphological studies of the foramen caecum linguae of the human and guinea pig
      tongue.
AB  - A three-dimensional study of the development of the thyroid gland in human and
      guinea pig embryos was made together with a histological investigation of the
      foramen caecum of the human adult tongue. In the human embryo, an epithelial
      depression was not seen between the first and second branchial arches except a
      shallow sulcus. Ciliated cells were observed on the dorsal surface of the tongue
      in all embryos which exceeded 18 mm in crown-rump length. The presence of a
      foramen caecum was observed in 18 (51%) cadavers from 35 human adults. Several
      circumvallate papillae were found in a 10-mm-deep foramen caecum on the side
      adjacent to the anterior two thirds of the tongue. In all specimens serous glands
      open into the foramen caecum.

PMID- 1746230
TI  - Expression of plasma membrane alkaline phosphatase in normal and regenerating
      choriocapillaris in the rabbit.
AB  - Ultrastructural histochemistry for plasma membrane nonspecific alkaline
      phosphatase was performed on the normal and regenerating choriocapillaris (CC) of
      rabbits. In normal animals the CC endothelium expressed little or no staining,
      whereas in regenerating CC the endothelium exhibited staining. The staining was
      most intense at the unfenestrated plasma membrane. As the capillaries matured and
      the fenestrated plasma membrane became more extensive, the staining was reduced
      and eventually eliminated. Pericytes did not stain in normal or regenerating CC.

PMID- 1746231
TI  - Anatomical basis for the clinical application of the arterial supply of musculus
      pectoralis major.
AB  - The pattern of arterial supply to the various parts (clavicular, sternocostal and
      aponeurotic) of the pectoralis major muscle was studied in 7 cadaver dissections
      and 10 angiograms by injecting a radio-opaque substance. Three main arteries
      supplied the muscle, i.e. the pectoral branch of the thoracoacromial trunk (TAT
      PB), the lateral thoracic artery and the perorating branch of the internal
      thoracic artery, supported by other branches of the TAT and the superior thoracic
      artery. It is observed that the TAT-PB, a chief vascular pedicle, anastomoses
      freely with other arteries and supplies most parts of the muscle. The present
      study is mainly focussed on the exclusion of the chief vascular pedicle of muscle
      to eliminate the confusion of previous studies and prevent the unnecessary
      hindrance and complications of the muscle flap.

PMID- 1746232
TI  - Immunohistochemical localization of basic fibroblast growth factor in ependymal
      cells of the rat lateral and third ventricles.
AB  - The presence of basic fibroblast growth factor (bFGF) in the third and the
      lateral ventricular ependyma of the rat has been investigated under the light
      microscope using a polyclonal antibody against bFGF, through the unlabelled
      peroxidase-antiperoxidase procedure; bFGF-immunoreactivity (bFGF-IR) is observed
      in the entire ependymal cell layer of ventricles. Also ependymal tanycytes within
      the inferior portion of the wall and floor of the third ventricle show bFGF-IR.
      Tanycytic processes are in close contact with hypothalamic capillaries. The
      present study strongly suggests that brain ependymal bFGF plays unidentified
      roles unrelated to its angiogenic or mitogenic capacities.

PMID- 1746233
TI  - Characterization of the cytoskeleton in human normal and otosclerotic osteoblast
      like cells.
AB  - The localization and distribution of some cytoskeletal protein components were
      studied by immunostaining methods in normal and ostosclerotic osteoblast-like
      cells. The protein components investigated were microtubules (beta-tubulin),
      intermediate filaments (vimentin), microfilaments (actin and myosin) and
      structural proteins (alpha-actinin and fibronectin). Although the mechanism is
      not yet clear, the alterations observed in the pathological cells could well play
      a role in the expression of otosclerosis.

PMID- 1746234
TI  - Morphometric analysis of compartments concerned with secretion of parathyroid
      hormone in male and female rats.
AB  - Parathyroid cells responded to estradiol application in rats by increment in
      surface area of the compartments concerned with parathyroid hormone secretion,
      i.e. the rough endoplasmic reticulum, Golgi complex and secretory granules. We
      thus compared the morphology of parathyroids of male rats with those of females
      of the same age and same weight, respectively. Morphometric analysis revealed
      that (i) the mean cell volume was significantly larger and, consequently, the
      number of parathyroid cells lower expressed per 1 mm3 tissue and (ii) the surface
      area of the Golgi complex was larger expressed per mean parathyroid cell volume
      and per 1 mm3 tissue in female rats than in males. Diversity in cell volume seems
      to depend on age rather than on sex, whereas diversity in the Golgi complex is
      considered to be sex related. The physiological implications remain to be
      clarified.

PMID- 1746235
TI  - Effects of physical training during the growth on the granulation of myo
      epithelioid cells of the rat kidney.
AB  - The behaviour of the granulation of the myo-epithelioid cells of the
      juxtaglomerular apparatus of the kidney and its relationship with the plasma
      concentrations of renin, sodium and potassium, and plasma osmolality have been
      studied in male and female Wistar rats that have been subjected to a programme of
      moderate physical exercise throughout their period of growth. In the trained rats
      a significant increase in the juxtaglomerular granulation index and a significant
      decrease in plasma renin concentration has been observed, the changes being more
      prominent in the female animals. Moreover in the trained rats significant
      increases in plasma sodium, potassium and osmolality have been observed.

PMID- 1746236
TI  - Morphological study of the development of the disseminate prostate in intact and
      castrated male pigs aged two to six months.
AB  - The light-microscopical and ultrastructural differentiation of the disseminate
      prostate was studied in 12 boars and 8 barrows, ranging in age from 8 to 28 and
      12 to 27 weeks, respectively. The barrows had been castrated at the age of 8
      weeks. In young boars the prostate is organized in an inner zone and an outer
      zone. The glandular tubules of the latter are more differentiated than those in
      the inner zone. Sexual maturation in the prostate is characterized by almost
      complete reduction of the inner zone and concomitant enlargement of the outer
      zone. This differentiation of the inner zone occurs progressively and is
      manifested by a higher density of the glandular tubules, by a decrease in the
      number of basal cells and by an increase in the secretory tubular cells
      containing more microvilli, organelles and secretory vesicles. A few weeks after
      castration, the characteristic morphology of the undifferentiated inner zone is
      found throughout the entire glandular layer. The number of glandular tubules in
      barrows has decreased, and their cells show minimal secretory activity, nuclear
      indentations and a decrease in their organelles. A further castration effect is
      vacuolization of the perinuclear cytoplasm in numerous glandular cells.

PMID- 1746237
TI  - Morphometric study of ventricular myocardial cells in the bat (Pipistrellus
      pipistrellus), hamster (Mesocricetus auratus) and Wistar rat.
AB  - A comparative morphometric study of ventricular myocardial cells of the West
      African insect-eating the Pipistrellus pipistrellus, the hamster and the rat
      revealed significant differences in volume fractions of mitochondria myofibrils,
      lipid bodies and T tubules. In the cells of the bat, mitochondria constitute 35%
      of cytoplasmic volume compared with 29 and 30% in the hamster and rat,
      respectively. Notably, crista density is much higher in the bat cells (3.58 x
      10(5) cm-1) than in those of the hamster (2.59 x 10(5) cm-1) and of the rat (2.48
      x 10(5) cm-1). Myofibril concentration is 40% in the bat, 53% in the hamster and
      55% in the rat. There is greater numerical density of lipid bodies in the bat
      (212.27 x 10(9) cm-3) than in the hamster (139.20 x 10(9) cm-3) and in the rat
      (114.00 x 10(9) cm-3). The volume occupied by T tubules is 0.02 in the bat and
      hamster, and 0.009 in the rat. These differences suggest structural design for
      efficient metabolic activity in the bat which, among mammals, has high exercise
      tolerance.

PMID- 1746238
TI  - Kinetics of spermatogenesis in the wild squirrel Funambulus palmarum (Linnaeus).
AB  - The paper describes in detail the morphology and kinetics of germ cell
      associations, pattern of mitotic divisions, frequency distribution of different
      cellular associations (stages) and percent degeneration of various germ cells in
      the squirrel in which spermatogenesis in adults occurs all year round. Eighteen
      steps of spermiogenesis were identified based on the development of the acrosomal
      system using PAS-haematoxylin. These were appropriately divided into Golgi,
      acrosome, cap and maturation phases. Thirteen types of cellular associations or
      stages (I-XIII) were characterized along the length of the seminiferous tubule
      which repeated itself in space and time constituting the seminiferous epithelial
      cycle (CSE). Of the 18 steps of spermiogenesis, the first 13 were associated with
      stages I-XIII, respectively, and the rest with the first 9 stages. Spermiation
      occurred in stage IX. Seven types of spermatogonia [A0, A1, A2, A3, A4,
      intermediate (In) and B type] were identified based on their shape, size and
      nuclear morphology. A0 spermatogonia are pale in appearance with homogeneously
      distributed chromatin surrounded by a thin nuclear membrane. These are present in
      all stages. A1 are oval in shape and possess a thicker nuclear membrane. They are
      found in stages VI-X. The chromatin material undergoes progressive condensation
      from A1 to A4 making the last generation of spermatogonia appear darker. The In
      spermatogonia which are derived from A4 are morphologically similar to them but
      smaller in size. The B-type spermatogonia derived from the In types possess a
      typically round nucleus with uniformly condensed chromatin material underneath
      the nuclear membrane. The spermatogonia divide mitotically at fixed stages of the
      CSE giving rise to their next generations. Thus, A-type spermatogonia divide at
      stages X, XIII/I, IV and V, while In divide at stage VI. During each CSE of the
      squirrel, 5 peaks of mitosis occur. There is a single generation of B-type
      spermatogonia. These differentiate into primary spermatocytes and undergo meiosis
      or maturation divisions which enter to form spermatids. The A4 which divide
      differentially in stage VI give rise to In- and A1-type spermatogonia. Therefore,
      A4 spermatogonia form renewing stem cells. Based on the above pattern of
      spermatogonial mitosis a model for stem cell renewal in the squirrel is proposed.
      The percentage degeneration of germ cells varied with the cell type. During a
      single CSE of the squirrel, a total of 42.09% germ cells were found to
      degenerate. An attempt is made to compare and contrast the kinetics of
      spermatogenesis in the wild squirrel with that of the other rodents studied so
      far.

PMID- 1746239
TI  - Identification of point scores at stage 23 in the rat according to the system of
      scoring in the human embryo.
AB  - The 8-point scores, evidenced in the human embryo of stage 23, were analysed in
      the rat at the end of the embryonic period. Eleven OFA rat embryos-crown-rump
      length 16 mm, 16th postcoital day--were submitted to serial histological sections
      with graphic reconstruction. The 8 internal key structures, previously observed
      in man by O'Rahilly--i.e. the cornea, optic nerve, cochlear duct,
      adenohypophysis, vomeronasal organ, submandibular gland, metanephros and humerus-
      were readily recognizable. The identification of these anatomical features
      permits to determine the end of the embryonic period and to obtain a clear
      distinction between this and the fetal period. The similarity and the presence of
      the same organs in man and rats at this period of development permits to consider
      the rat as a good experimental model of teratology.

PMID- 1746240
TI  - Correlation of myosin isoforms with anatomical divisions in equine musculus
      biceps brachii.
AB  - The biceps brachii of horses is subdivided into a lateral and medial head.
      Electrophoresis of samples from the lateral head revealed three slow-migrating
      native myosin isoforms, including one that does not correspond to slow myosin
      isoforms described for other mammalian muscles. In contrast, the medial head
      contained a single slow isoform. Both the lateral and medial heads contained
      three fast-migrating isoforms corresponding with the FM-2, FM-3 and FM-4 isoforms
      reported for other mammalian fast-twitch muscle fibers. Electrophoresis of myosin
      heavy chains (MHCs) revealed only two MHC bands, one fast-migrating band that
      comigrates with rat type I MHC and a second slower-migrating band that comigrates
      with rat type IIa MHC. Quantitation of the histochemical data is correlated with
      densitometric analysis of MHCs in the medial and lateral heads of biceps brachii
      and is consistent with previously hypothesized functional specializations of this
      muscle.

PMID- 1746241
TI  - Predicting beneficial response to a protein-redistribution diet in fluctuating
      Parkinson's disease.
AB  - To identify factors that might help in predicting the benefit to be gained from a
      protein-redistribution diet (PRD) we subjected 26 parkinsonian patients with
      motor fluctuations refractory to optimal timing and dosage of levodopa plus
      bromocriptine to a 2,000-2,500 Kcal., 65-80 g/d protein containing diet
      maintained for 8-12 weeks. Fifteen patients were eligible for evaluation, 10 of
      whom being benefited by the PRD (79 percent reduction in the mean "off" time in
      "on-off" charts). When the duration and pattern of the fluctuations were compared
      in the 10 diet-benefit patients with those in 5 diet-failure patients only dose
      failures consistently occurring postprandially were resolved by the PRD. Wearing
      off failures responded unpredictably while random "on-off" fluctuations were
      present only in the diet-failure group. Nocturnal akinesia and peak-dose
      dyskinesias often worsened. In no patient "on"-time quality was modified by the
      diet. In addition, the diet-failure group was characterized by a younger mean age
      at onset (p less than 0.05) and by longer duration in their fluctuations (p less
      than 0.001). Though requiring confirmation in a larger series, our results
      suggest that parkinsonian patients showing fluctuations over prolonged periods,
      particularly those having a pattern of random "on-off" oscillations in motor
      performance and dose-failures unrelated to meals are unlikely to benefit from a
      PRD.

PMID- 1746242
TI  - Acute hemorrhagic leukoencephalitis.
AB  - We report an autopsy proven case of acute hemorrhagic leukoencephalitis. There
      was a very rapid evolution leading to death in less than 24 hours. CT of the
      brain revealed widespread hypodensities in both frontal lobes. In the
      cerebrospinal fluid as well as in the peripheral blood, there was a moderate
      leucocytosis. The literature is reviewed.

PMID- 1746243
TI  - Sympathetic skin response versus maximum motor and sensory conduction velocity to
      detect subclinical neuropathy in non-insulin-dependent diabetics.
AB  - Conventional motor (MCV) and sensory conduction velocity (SCV) of the ulnar (UN),
      peroneal (PN) and median nerves (MN) and the areas of sympathetic sudomotor
      response (SSR) recorded from the middle finger were measured on both sides in 20
      normal and 20 non-insulin-dependent diabetic (NIDD) subjects. Conventional
      statistical tests (t test, linear correlation coefficient r) and discrimination
      analysis were applied to the above electrophysiological parameters. To evaluate
      the capability of the tests to separate NIDD diseased from normal nerves, the
      results were represented as generalized distances, i.e., difference between mean
      discriminant normalized combinations adjusted for intra-group variability. The r
      values were 0.92 (P less than 0.01) for the UN, 0.40 (P greater than 0.05) for
      the PN, and 0.86 (P less than 0.01) for the MN sensory action potential (SAP)
      amplitudes. No significant differences were found for normalized latencies. The r
      values of the SSR areas were 0.62 (P less than 0.01) at the right and 0.77 (P
      less than 0.01) at the left, homolaterally to the side of stimulation. SR and MCV
      generalized distances were 1.35 and 1.39, respectively. The discriminating power
      of SSR, MCV and SCV considered together was higher (2.40) than that of MCV and
      SCV (1.70). Since motor, sensory and autonomic alterations often did not coexist
      in NIDD, it was possible to find at least one type of involvement in most of the
      diabetic subjects.

PMID- 1746244
TI  - Familial hemangioblastoma and von Hippel-Lindau's disease: case report.
AB  - Thirty-five members of a family affected with von Hippel-Lindau's disease (VHL)
      were examined and lesions were found in nine of them. Four of the lesions were
      located in the central nervous system; two cerebellar, one spinal, one cerebral.
      Eye lesions were present in eight of the nine patients and complications
      developed in seven; six unilateral and one bilateral blindness. Both mortality
      and morbidity were found to be higher than in other series. This is attributed to
      insufficient screening of the patients with familial VHL, the late diagnosis was
      established only after the onset of complications. The importance of screening
      tests in VHL risk patients is emphasized.

PMID- 1746245
TI  - Intraneural ganglionic cyst of the common peroneal nerve: case report and review
      of the literature.
AB  - The authors report a case of compression of the peroneal nerve by an intraneural
      ganglionic cyst. The chief complaint is generally a lateral upper leg pain
      occasionally associated with foot drop and swelling of the upper tibiofibular
      joint. In our case, the disease was revealed by a tentative intraarticular
      injection of betamethasone. Early microsurgical treatment remains the only way to
      avoid permanent motor sequellae.

PMID- 1746246
TI  - Tribute to a global research programme on reproductive health.

PMID- 1746247
TI  - The Swedish Insemination Act.

PMID- 1746248
TI  - Endothelin--a potent constrictor of small myometrial arteries of term pregnant
      women.
AB  - This study was performed to evaluate the in vitro effects of a new polypeptide,
      endothelin-1 (ET-1) on small intramyometrial vessels in comparison with the
      action of noradrenalin (NA). In connection with cesarean section, myometrial
      biopsies were obtained and small arteries (100-500 microns in diameter) were
      excised. Cylindrical segments of these vessels were used for registration of
      contractile activity after administration of ET-1 and NA. ET produced
      vasoconstriction and was approximately three times as powerful and 70-fold as
      potent as NA. It is suggested that ET may be involved in the regulation of human
      utero-placental blood flow.

PMID- 1746249
TI  - Prediction of fetal outcome by Doppler examination and by the non-stress test.
AB  - Ninety-four women with high-risk pregnancies were referred to the Aker University
      Hospital, Department of Obstetrics, and monitored by Doppler velocimetry and
      conventional cardiotocography. The peak systolic/end diastolic (A/B) ratio was
      measured in the velocity waveform obtained in the umbilical artery blood flow.
      The non-stress test (NST) was classified according to the Fischer scores. In this
      mixed group of high-risk pregnancies, the sensitivity of the A/B ratio to predict
      fetal growth retardation was 71%, predictive value 57% and specificity 77%. The
      corresponding values for NST were 39%, 65% and 90%. It is concluded that Doppler
      velocimetry is more sensitive than cardiotocography for identifying fetal growth
      retardation. In an attempt to further improve the detection rate of fetal
      pathology, the cases with abnormal NST scores were added to those with high A/B
      ratios and collectively defined as abnormal. In consequence, only an
      insignificant improvement in sensitivity (79%) could be achieved. When the A/B
      ratio is normal, there seems little justification for expending time, effort and
      resources in routine use of cardiotocography.

PMID- 1746250
TI  - Evaluation of fetal and neonatal mortality at the University Hospital of Tromso,
      Norway, from 1976 to 1989.
AB  - To investigate developments in perinatal care, all fetal and neonatal deaths
      among those born after at least 24 weeks of gestation at the University Hospital
      of Tromso, Norway from 1976 to 1989, were subjected to medical audit. A decrease
      in total mortality rate was found when based on maturity (greater than or equal
      to 24 weeks; 19.9-13.4%; p less than 0.01), and/or birth weight (greater than or
      equal to 500 g; 19.2-13.4%; p less than 0.05). This was mainly due to a decrease
      in fetal deaths (14.8-6.6%; p less than 0.0001). Deaths during labor (5.4-1.1%; p
      less than 0.001), and deaths before the onset of labour (9.4-5.5%; p less than
      0.05) declined. The neonatal death rate remained virtually constant (5.2-6.8%).
      The incidence of conditions affecting the placenta and the umbilical cord,
      causing asphyxia and intra-uterine growth retardation, declined, from 9.2 to 5.0%
      (p less than 0.01), as did that caused by immaturity (2.8-1.3%; p less than
      0.05). The rates of death caused by cerebral hemorrhage, respiratory distress
      syndrome, infections, and malformations did not change. There was no significant
      proportional change in the causes of death from the first to the last period. The
      rate of fetal death following suboptimal care declined (2.4-0.4%; p less than
      0.01), while the corresponding neonatal death rate remained unchanged (0.9-1.1%).
      The proportions of both fetal and neonatal deaths occurring after suboptimal care
      were low (fetal: 16.2, 8.8, and 5.6%; neonatal: 17.1, 23.5, and 16.2%). These
      differences did not reach statistical significance.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1746251
TI  - Pericardial effusion in normal pregnant women.
AB  - Fifty-two normally pregnant women underwent echocardiography to examine their
      pericardium in the first, second and third trimester. Pericardial effusion was
      noted in 15.3% of the women (n = 8) in the first trimester, 19.2% (n = 10) in the
      second trimester and 44.2% (n = 23) in the third trimester of pregnancy.
      Pericardial effusion during pregnancy was found to be completely resolved in all
      patients who underwent an echocardiogram 6 weeks post delivery (n = 11). There
      was no statistically significant difference in age, hemoglobin, total protein,
      albumin/globulin ratio or mean blood pressure during pregnancy between those who
      developed pericardial effusion and those who did not. The frequency of occurrence
      of pericardial effusion in primigravidas at 69.2% (9/13) was higher than that in
      multigravidas, with a ratio of 35.9% (14/39), the difference being statistically
      significant (p less than 0.025). The frequency of occurrence of pericardial
      effusion in patients who gained more than 12 kg during pregnancy at 67.7% (11/17)
      was higher than in patients who gained less than 12 kg, with a ratio of 34.3%
      (12/35), the difference being statistically significant (p less than 0.025).

PMID- 1746252
TI  - Incidence of fetal chromosome abnormalities in insulin dependent diabetic women.
AB  - In order to screen for fetal neural tube defects and chromosome abnormalities,
      amniocentesis was carried out in 334 women with insulin-dependent diabetes
      mellitus (IDDM) between 1979 and 1987. Two cases (0.6%; 95% confidence limits 0.1
      2.2%) of fetal chromosome abnormality were found: one case of Klinefelter's
      syndrome and one case of de novo translocation. This is comparable to the overall
      incidence of chromosome abnormality found at birth and is also comparable to the
      incidence of fetal chromosome abnormality (1.0%) found by amniocentesis at our
      Department in a group of 2,264 young non-diabetic women with little risk of
      contracting genetic disorders. The results suggest that maternal IDDM does not
      increase the risk of fetal chromosome abnormality and consequently screening by
      amniocentesis for chromosome abnormalities among diabetic women does not seem to
      be indicated.

PMID- 1746253
TI  - Pregnancy outcome in patients undergoing long-term hemodialysis.
AB  - Three uremic patients receiving hemodialysis for more than 5 years became
      pregnant and proceeded to the third trimester. A variety of complications were
      noted, including threatened abortion, vanished twin, preterm premature rupture of
      membranes, polyhydramnios, intra-uterine fetal death, intra-uterine growth
      retardation, premature labor and hypertension. Two of these 3 mothers gave birth
      to healthy babies under the management of the high-risk pregnancy team.

PMID- 1746254
TI  - The relationship between alcohol consumption during pregnancy and infant
      birthweight. An epidemiologic study.
AB  - Heavy alcohol consumption during pregnancy has been consistently associated with
      inhibited intra-uterine growth; however, the effect of social drinking is not yet
      clear. The relationship between moderate drinking and low birth weight (less than
      2,500 g) among a nationally representative sample of white married mothers who
      gave birth to singletons infants in the National Natality Survey (1980) is
      analysed here. Alcohol consumption during pregnancy was significantly associated
      with birth weight (p less than 0.02). Moreover, there was a gradient of risk in
      low birth weight associated with increasing amount of alcohol ingestion during
      pregnancy. There was a significant association between the mean birth weight of
      the singletons across different categories of alcohol intake (p less than
      0.0001). The difference between the mean birth weight of the singletons among
      moderate drinkers compared with nondrinkers was also statistically significant (p
      less than 0.005). These relationships remained after simultaneously adjusting
      effects of the confounding variables gestational age, parity, smoking, weight
      gain, maternal age and education in multiple regression analyses. These findings
      confirm earlier reports of a relationship between alcohol use during pregnancy
      and decreased birth weight. Additionally, it is shown here that for moderate
      alcohol use during pregnancy, there is an adverse effect on the birth weight.

PMID- 1746255
TI  - Smoking cessation in pregnancy. Mode of intervention and effect.
AB  - Three groups (n = 50 each) of pregnant smokers wanting to quit the habit were
      assigned to three different intervention programs around their 18th week in
      pregnancy. Group 1 participated in a smoking cessation program offering several
      self-help methods; group 2 attended a doctor's information meeting at the
      hospital; and group 3 received a pamphlet on the deleterious effects of smoking
      in pregnancy. For Group 4, the control group, there was no intervention. In all
      three intervention groups, more than one-third reduced their smoking to almost
      half, while 38% quit altogether in group 1, compared with less than 10% in groups
      2 and 3. Twelve months later, 16%, 6% and 8% respectively, remained abstinent in
      the three groups. In groups 2 and 3, abstinence proved to be of the same
      magnitude as in the control group. We conclude that smoking in pregnancy, being
      one of the few amenable to risk factors affecting the perinatal death statistics,
      demands an active smoking cessation program during pregnancy led by specially
      trained health professionals.

PMID- 1746256
TI  - The influence of epidural blockade and pethidine administered during delivery on
      neonatal myocardial performance.
AB  - The aim of the present study was to investigate whether obstetric analgesia with
      an epidural blockade (Marcaine, bupivacaine hydrochloride, 141.5 +/- 56.8 mg) and
      pethidine (95.0 +/- 30.7 mg) influenced neonatal myocardial function following
      vaginal delivery. Left ventricular output and other left ventricular function
      indices were measured 5.6 +/- 4.3 h postpartum with Doppler and M-mode
      echocardiography in a group of healthy, full-term, appropriate-for-gestational
      age infants (n = 10) whose mothers had received both bupivacaine and pethidine
      during delivery, and in a similar group of newborn infants (n = 10) whose mothers
      had received only nitrous oxide/oxygen analgesia. In 7 of the 10 infants in each
      groups, a second assessment of myocardial function was performed 21.7 +/- 4.6 h
      post partum. There were no significant differences in any of the variables used
      to assess left ventricular function at either of the measurement points between
      the group of infants whose mothers had received bupivacaine/pethidine during
      delivery, and the group of infants whose mothers had received nitrous
      oxide/oxygen analgesia only.

PMID- 1746257
TI  - Oxytocin or saline injected intra-umbilically did not influence the third stage
      of labor.
AB  - The injection of varying volumes of normal saline solution, alone or with
      oxytocin, into the umbilical vein immediately after delivery was studied in 125
      normal women delivered at term. Thirty seconds after cord clamping, either 20 ml
      (group 1, n = 25 women), 30 ml (group 2, n = 25) or 40 ml (group 3, n = 25) of
      normal saline solution alone, or oxytocin 10 units in 20 ml saline solution
      (group 4, n = 25) or oxytocin 10 units in 40 ml saline solution (group 5, n = 25)
      were injected into the umbilical vein 1 cm from the introitus just proximal to
      the umbilical clamp. The mean (+/- SD) duration of placental expulsion was
      similar in the five study groups. We conclude that neither the volume of the
      solution nor the oxytocin injected intra-umbilically has any effect on the
      duration of the third stage of normal labor.

PMID- 1746258
TI  - The use of episiotomy in primiparas in Sweden. A descriptive study with
      particular focus on two hospitals.
AB  - This study has examined the use of episiotomy (Ep) in primiparas on all labor
      wards (65) in Sweden, focusing on two hospitals in particular. The information
      was obtained by means of a questionnaire and from original medical records at the
      two hospitals. Whereas the mean incidence of Ep for the whole country was 30%, we
      found a wide variation (9-77%) from hospital to hospital. When delivery positions
      were compared, the lowest Ep rate was reported from those hospitals where women
      frequently used "alternative positions". The results suggest that efforts should
      be directed to a more restrictive use of Ep in normal delivery.

PMID- 1746259
TI  - Heterotopic pregnancy following in vitro fertilization.
AB  - We report 4 cases of heterotopic pregnancy following in vitro fertilization. All
      4 patients were treated by surgical removal of the ectopic pregnancy products. In
      3 patients, the intra-uterine fetus was alive prior to surgery. Two of the 3 gave
      birth to a healthy baby while the third pregnancy has progressed uneventfully for
      12 weeks since the operation.

PMID- 1746260
TI  - Experience with GnRH agonists in an in vitro fertilization (IVF) program.
AB  - The experience using pre-treatment with GnRH-agonists in an IVF-program are
      reported. 55 patients having a 'poor response', premature LH surge, or follicular
      luteinization in previous treatment cycles were treated for a total of 68 cycles.
      Therapy with GnRH agonists was initiated in the midluteal phase, and given by
      self-administration subcutaneously. Stimulation started with exogenous
      gonadotropins on a fixed day (Saturday) after pituitary desensitization had first
      been obtained, and resulted in all follicular punctures being performed on
      weekdays. Five treatment cycles (7.4%) were cancelled because of 'poor response'.
      Where the indication for GnRH-agonist therapy was previous 'poor response', a
      cancellation rate of 36.4% was observed, whereas a cancellation rate of only 1.8%
      was found in the other indication groups (p less than 0.001). Altogether 26
      clinical pregnancies were achieved, five of these ending in a spontaneous
      abortion. The rate of deliveries was 33% per oocyte retrieval, and 40% per pre
      embryo replacement.

PMID- 1746261
TI  - Ultrasonically guided retrieval of occult IUD in early pregnancy.
AB  - The risk of spontaneous abortion and intra-uterine infections in pregnancies
      associated with an intra-uterine conceptive device (IUD) is well documented.
      There is a general agreement regarding the desirability of removing the IUD as
      soon as the pregnancy is diagnosed. When the string is not visible, the proper
      management is controversial. This study reports the successful retrieval of
      occult IUD in early pregnancy under ultrasonic guidance in 8 out of 9 women. In
      the one case where we failed to remove the IUD, the women chose to terminate the
      pregnancy by legal abortion. Seven women completed their pregnancy, while one
      experienced a spontaneous abortion. We consider the removal of the occult IUD in
      pregnancy under ultrasonic guidance to be a useful procedure.

PMID- 1746262
TI  - Concomitant endocervical curettage and cervical conization.
AB  - We present a series of 94 endocervical curettages (ECC) performed directly after
      cutting a cervical cone specimen. In 7 patients the ECC gave insufficient
      material for a histological diagnosis, but in 9 patients it contained CIN. The
      top of the cone contained CIN in 17 cases. The correlation between the
      histological results from the top of the cone and the ECC was poor. The presence
      of persistent disease after conization was studied in relation to both the status
      of the top of the cone and to the ECC. For the latter we found a sensitivity of
      0.50 and a specificity of 0.95. The top of the cone showed a sensitivity of 0.80
      and a specificity of 0.88. It is concluded that ECC is of little additional value
      in predicting persisting disease.

PMID- 1746263
TI  - Transcervical resection of endometrium and fibroids. Initial complications.
AB  - Transcervical resection of endometrium--and of submucous fibroids when present-
      seems to represent a new alternative to hysterectomy for patients with
      uncontrolled bleeding disorders. In the present study, we report our initial
      experience with the first 20 patients treated with a standard, rigid urological
      resectoscope. Resection of endometrium--and of fibroids when present--was carried
      out under general anesthesia. The uterine cavity was distended and irrigated with
      glycine 1.5%. Two perforations occurred, but damage to neighboring organs was not
      seen. In one patient, copious bleeding was encountered and hysterectomy became
      necessary the following day. Clinical signs of postoperative infection occurred
      in 3 patients. Otherwise, no major morbidity was seen during or after the
      procedure. In 2 patients with persistent metrorrhagia, re-resection was performed
      after 2-3 months and satisfactory bleeding control achieved. At the 3-month
      follow-up, 2 further patients complained of persistent bleeding and had an
      abdominal hysterectomy performed. In the remaining patients, satisfactory
      bleeding control was reported at the 6-month follow-up. Although large series are
      needed to assess the complications associated transcervical resection of the
      endometrium, the technique may be applied in departments with experience in
      routine hysteroscopy, and the approach seems to represent an attractive
      alternative to hysterectomy.

PMID- 1746264
TI  - Hemodialysis rescued the mother in a case of severe chronic renal failure
      accompanied by perirenal hematoma due to HELLP syndrome.
AB  - We present a case of severe maternal renal failure, accompanied by HELLP syndrome
      (hemolysis, elevated liver enzymes, and low platelet count). Since her renal
      function deteriorated in addition to the anemia and thrombocytopenia from 25
      weeks' gestation, hemodialysis was performed three times a week. Unfortunately
      intra-uterine fetal death suddenly occurred at 30 weeks' gestation, and maternal
      right perirenal hematoma was diagnosed after delivery. The anemia and
      thrombocytopenia improved dramatically and the perirenal hematoma resolved
      uneventfully by late puerperium. The management of severe maternal renal failure
      with HELLP syndrome is described.

PMID- 1746265
TI  - Severe ovarian hyperstimulation syndrome complicated by ectopic pregnancy.

PMID- 1746266
TI  - Twin pregnancy with a fetus in each half of a uterus didelphys.
AB  - A rare case of a twin pregnancy with a fetus in each half of a uterus didelphys
      (double uterus, double cervix and septate vagina) is reported. A longitudinal
      vaginal septum and two portios were detected during the first labor of this
      patient. During her second pregnancy ultrasonography was performed in the 16th
      week, and pregnancy was detected in each half of the double uterus. Both fetuses
      were of similar size and corresponded to the gestational age. A completely
      separated double uterus was confirmed by ultrasonography. In the 38th week a
      female and a male infant were delivered by cesarean section. The follow-up of
      this pregnancy and the management of the labor are reported.

PMID- 1746267
TI  - Psychotic exacerbation attributed to low-dose bromocriptine treatment of
      galactorrhea and hyperprolactinemia.
AB  - Low-dose bromocriptine administered for antipsychotic drug-induced
      hyperprolactinemia and galactorrhea precipitated an acute psychotic state in a
      female patient. Discontinuation of the bromocriptine and increase in
      antipsychotic dosage resulted in complete remission. We advise caution in the use
      of bromocriptine especially in patients with a pre-existing psychiatric history
      and recommend monitoring for changes in mental status when bromocriptine is
      prescribed.

PMID- 1746269
TI  - Ultrasound in the diagnosis and treatment of ovarian tumors.

PMID- 1746268
TI  - Monochorionic monoamniotic twins--the most precarious of twin pregnancies.
AB  - Monochorionic monoamniotic twins have a high perinatal mortality rate. Death
      usually occurs before 24 weeks' gestation, mainly because of cord entanglement,
      prematurity, congenital anomalies or twin-to-twin transfusion. These
      possibilities should be taken into account when twin pregnancies are detected at
      the ultrasound screening between 17 and 20 weeks' pregnancy. We report here a
      case where monochorionic monoamniotic twins were born at 34 weeks, with massive
      cord entanglement and we describe the antenatal care at our clinic.

PMID- 1746270
TI  - Human sperm characteristics before and after preparation for in vitro
      fertilization.

PMID- 1746271
TI  - Doppler ultrasound recordings of placental blood velocity waveforms.

PMID- 1746272
TI  - Phenotype of the arterial smooth muscle cell during fetal development, ageing,
      and atherosclerosis.

PMID- 1746273
TI  - Hormonal influences in women, as reflected in cognitive function, libido, sexual
      behaviour and premenstrual symptoms.

PMID- 1746274
TI  - Androgen hyperfunction and excessive heterosexual hair growth in women, with
      special attention to the polycystic ovarian syndrome.

PMID- 1746275
TI  - Prognostic factors in ovarian carcinoma. A clinicopathologic study with special
      reference to mitotic counts, nuclear morphometry and DNA cytometry.

PMID- 1746276
TI  - Nordic symposium on gynecological oncology, Svalbard, Norway 1990. Consensus
      statements.

PMID- 1746277
TI  - Violence among psychiatric inpatients.
AB  - A considerable body of evidence suggests increasing levels of violence among
      psychiatric inpatients. The literature on the subject is reviewed, highlighting
      correlates of violence among psychiatric patients and methodological flaws in the
      published literature. Improvement in the definition of violence and the
      methodology as well as future areas of research are discussed.

PMID- 1746278
TI  - Standardized Assessment of Depressive Disorders: a replicated study from northern
      India.
AB  - A total of 91 subjects with depressive disorder have been studied using the WHO
      standardized Standardized Assessment of Depressive Disorders (SADD). The 10 most
      frequently reported symptoms were sadness, anxiety, joylessness, lack of energy,
      hopelessness, loss of interest, disruption of social functioning, irritability,
      loss of ability to concentrate and lack of appetite. The results of this study
      are compared with other available work on SADD.

PMID- 1746279
TI  - Comparative study of affective disorders in three Asian countries. II.
      Differences in prevalence rates and symptom presentation.
AB  - This study used standardized diagnostic criteria and method to investigate both
      prevalence rates and nature of symptoms of depressive disorders in three Asian
      centres--Nagasaki, Shanghai and Seoul. Of the patients who visited a psychiatric
      clinic in each of the 3 centres for the first time, over 20% suffered from
      depression. Unlike previous reported prevalence rates for Asian countries, these
      results suggest that rates in Asia may not be much lower than those reported in
      Western countries. Although prevalence rates of depression were similar in all 3
      centres, differences in symptoms were noted.

PMID- 1746280
TI  - Differences between schizophrenics born in winter and summer.
AB  - A total of 1814 patients were studied from the Mississippi State Hospital with a
      DSM-III diagnosis of schizophrenia and aged 15-39 years at the time of admission.
      The 634 schizophrenics with a birth date between 1 December and 31 March were
      compared with the 1180 born between 1 April and 30 November for age of admission,
      race, sex, marital status, duration of initial admission and clinical subtype.
      The only significant difference between the variables was the duration of the
      first admission: winter-born patients had a shorter psychiatric hospitalization
      than summer-born schizophrenics. These findings are discussed in accord with
      similar studies.

PMID- 1746281
TI  - Validation of the Hospital Anxiety and Depression Scale in Arab patients.
AB  - The Hospital Anxiety and Depression Scale (HADS) was administered to psychiatric
      outpatients with various diagnoses to assess its validity. The study was also
      designed to find out whether HADS can differentiate between diagnostic groups
      based on depression and anxiety symptoms. HADS was able to discriminate patients
      from controls at a sensitivity of 79% and specificity of 87%. HADS was much less
      sensitive, specific and diagnostically accurate in identifying anxiety and
      depressive disorders in the experimental group at a cut-off point of 13 and 10
      respectively for both conditions. Possible psychological, social and psychiatric
      reasons for the results are discussed.

PMID- 1746282
TI  - Gender differences in depression: historical changes.
AB  - Depression has been widely reported to be more prevalent among females than among
      males. In this study we demonstrate that gender differences in depression occur
      only among individuals born during particular historical periods, and test the
      utility of a model focusing on changes in women's opportunities for academic and
      professional achievement in predicting periods of significant gender differences
      in depression. Based on reanalysis of data reported by Klerman et al., we find
      gender differences in depression among people 40 years of age and older to be
      high among cohorts that reach adolescence during periods of increasing
      opportunities for female achievement. Among cohorts that reach adolescence during
      periods of stable or decreasing opportunities for women, gender differences in
      depression are not significant at any age.

PMID- 1746283
TI  - Reliability of the draft diagnostic criteria for research of ICD-10 in comparison
      with ICD-10 and DSM-III-R.
AB  - The reliability and ease of use of DSM-III-R and the clinical and research
      versions of ICD-10 were assessed by 5 psychiatrists working in pairs. They
      diagnosed 60 patients. All 3 systems showed similar and high interrater and
      intersystem agreement for major diagnostic categories but not for subcategories.
      A number of implications of these results are discussed.

PMID- 1746284
TI  - Premorbid personality and positive and negative symptoms in schizophrenia.
AB  - The relationship between premorbid personality and schizophrenic symptoms
      assessed by the Scales for the Assessment of Positive and Negative Symptoms was
      explored in 115 DSM-III-R schizophrenics. The frequencies of normal, schizoid
      schizotypal and other DSM-III-R personality disorders were 44%, 39% and 17%.
      Affective flattening and alogia were significantly more frequently present and
      severe in the schizoid-schizotypal group than in the rest of the patients. There
      were no differences in positive symptoms. It is suggested that, in some cases,
      negative symptoms are merely the persistence or exacerbation of schizoid traits
      present prior to the emergence of schizophrenic symptoms. These results should be
      cautiously interpreted because the premorbid personality was diagnosed in a
      retrospective way and the negative symptoms were assessed cross-sectionally.

PMID- 1746285
TI  - Effect of medical school stress on the mental health of medical students in early
      and late clinical curriculum.
AB  - Earlier research has shown that medical students in the United Kingdom and the
      United States report a higher level of nervous symptoms than the general
      population. To better understand how medical students in Norway compare with
      these findings, 299 male and female students in the clinical curriculum at the
      University of Oslo were asked to complete a questionnaire about themselves and
      their mental health. Medical students in Norway do not differ from the general
      population in mental health. However, the students report a lower level of
      general self-esteem than the general population. The male students had more
      nervous symptoms and a less general self-esteem than the female students compared
      with the general population. This research also shows that medical school stress
      is a good predictor of nervous symptoms even when psychosocial variables such as
      marital or cohabitation status, confident other and general self-esteem are taken
      into consideration.

PMID- 1746286
TI  - Patterns of outcome in schizophrenia in Hong Kong.
AB  - A total of 153 schizophrenic subjects were included for outcome assessment in
      different aspects of their life functions. The same group of subjects was
      followed-up 1 year later to assess the consistency of their outcome pattern. A
      factor analysis on the outcome measures was conducted, and 5 independent factors
      were noted. Outcome on symptomatic control was most favourable but less
      consistent over time. Psychosocial deficits, on the other hand, were more
      enduring and noted in a significant proportion of the subjects.

PMID- 1746287
TI  - Involuntary commitment in Greenland, the Faroe Islands and Denmark.
AB  - Greenland, the Faroe Islands and Denmark have common legislation and registration
      for involuntary commitment. Commitment rates were calculated based on information
      from the Danish psychiatric register for 1984-1988. Direct standardization with
      the Danish male and female population as a standard population (1984-1988) was
      carried out to evaluate differences in rates. An increased risk of commitment was
      found in Greenland, where the crude commitment rate was 43.5 commitments per
      100,000 inhabitants. The commitment rate on the Faroe Islands was 19.2 per
      100,000 and 24.2 per 100,000 in Denmark. The relative risk of commitment in
      Greenland vs Denmark was 2.0 (1.6-2.4) and increased to the same extent for both
      sexes. Young men constituted a high-risk group for commitment in Greenland. Males
      between 15 and 34 years accounted for 55% of the total number of commitments in
      Greenland. The high relative commitment risk in Greenland is related to higher
      homicide rates, lower psychiatric bed availability, reduced access to psychiatric
      treatment, small settlements and increased alcohol consumption and violence than
      in Denmark.

PMID- 1746288
TI  - A modern therapeutic approach for chronically mentally ill patients--results of a
      four-year prospective study.
AB  - A 4-year prospective study was carried out on 53 chronically mentally ill
      patients living in a differentiated complementary residential complex. Our main
      question was how the lives of these patients develop, as reflected in their
      psychological wellbeing, working capacity, therapeutic requirements and any
      necessary periods of rehospitalization. At the end of a 4-year rehabilitation
      period, 50% of the patients were living in sheltered communities and about 25% on
      their own. Only 10% had returned to the psychiatric hospital as long-term
      patients. The psychological findings were characterized by apathetic, depressive
      and psycho-organic syndromes (AMDP system) and were subject overall to minimum
      variation. Very few patients succeeded in obtaining work on the general labour
      market, but the work available on the sheltered labour market was suitable for a
      large proportion (40%) of them. All patients were undergoing medical care after 4
      years. Patients suffering from chronic mental disorders can be cared for in the
      community even after long-term hospitalization. Special success has been achieved
      with rehabilitation in the residential sphere. Adequate care implies numerous
      services to ensure that patients are integrated into the labour market, to help
      establish contacts and to enable chronically ill patients to take part in social
      and cultural life. Most patients retain a considerable degree of psychological
      disturbance and are permanently dependent on psychiatric therapy or psychosocial
      care. On the other hand, they benefit from the fact that their living
      circumstances are largely normal and that they have higher degree of personal
      autonomy.

PMID- 1746289
TI  - Reliability and validity of the Chinese versions of the Scales for Assessment of
      Positive and Negative Symptoms.
AB  - This 4-center study assesses the reliability and validity of the Chinese versions
      of the Scale for Assessment of Positive Symptoms and the Scale for Assessment of
      Negative Symptoms. Interrater reliability, short-term test-retest reliability,
      and internal consistency were excellent; intraclass correlation coefficients and
      Cronbach alphas for the overall scores were all over 0.8. The strong correlation
      of the scales with an independently assessed parallel measure (the Chinese
      version of the Brief Psychiatric Rating Scale) and the separate positive and
      negative factors found with principal components analysis confirm the construct
      validity of the instruments. These findings demonstrate the importance of
      culturally sensitive revision and rigorous psychometric evaluation of Western
      instruments prior to their use in non-Western cultures.

PMID- 1746290
TI  - Greek version of the General Health Questionnaire: accuracy of translation and
      validity.
AB  - The purpose of this study was to examine the accuracy of translation and to test
      the validity of the Greek version of the General Health Questionnaire (GHQ). In
      the translation study, the English and the Greek versions of the GHQ were
      administered to a sample of 50 bilingual respondents. The internal consistency,
      item-by-item and the subject-by-subject analysis have shown that the 2 versions
      are equivalent and therefore the Greek translation is highly accurate. In the
      validity study, 100 consecutive patients attending an internal medicine
      outpatient clinic completed the Greek version of the GHQ-60 and were interviewed
      independently using the Present State Examination (PSE). The validity of the
      shorter forms of the questionnaire (GHQ-30 and GHQ-28) was tested by disembedding
      the relevant items from the larger set. The correlations obtained between the
      scores of the questionnaire and the PSE ratings, as well as all the validity
      indices (sensitivity, specificity, positive predictive value, negative predictive
      value and overall misclassification rate) were quite satisfactory for all the GHQ
      forms, thus confirming the validity of the questionnaire in its Greek version.
      The best cut-off points as found by receiver-operating characteristics analysis
      were 11/12 for the GHQ-60, 5/6 for the GHQ-30 and 4/5 for the GHQ-28. The revised
      (CGHQ) scoring system for the GHQ-30 has not been proved superior to the
      conventional scoring method. The above results are discussed in relation to the
      pertinent literature and especially the studies carried out in similar settings
      and in countries with similar cultural backgrounds.

PMID- 1746291
TI  - Depression-related disturbances in mitogen-induced lymphocyte responses and
      interleukin-1 beta and soluble interleukin-2 receptor production.
AB  - In an attempt to delineate the pathophysiology underpinning the previously
      reported blunted lymphocyte responses to mitogenic stimulation in depressed
      patients, we measured the following immune variables in 28 depressives and 10
      healthy controls: pre- and postdexamethasone (1 mg orally) lymphocyte responses
      to various mitogens, such as phytohaemagglutinin (PHA), and the PHA-induced
      accumulation of interleukin-1 beta (Il-1 beta) and soluble interleukin-2
      receptors (sIl-2Rs) in culture supernatants. In the predexamethasone state, we
      found significantly more mitogen-stimulated blastogenesis in minor depressives vs
      healthy controls and major depressives. In depressed subjects there was a
      significant inverse relationship between the severity of illness and the mitogen
      induced lymphocyte responses. Melancholics exhibited significantly more Il-1 beta
      accumulation in PHA culture supernatant than healthy controls. In healthy
      controls--but not in depressed patients--the sIl-2R accumulation perfectly
      reflects the magnitude of the PHA-induced lymphocyte stimulation. Dexamethasone
      administration significantly suppressed the lectin-induced blastogenesis and the
      Il-1 beta production rate in normal volunteers, whereas depressives exhibited
      dexamethasone nonsuppression in those factors. Healthy controls exhibited
      significantly less postdexamethasone blast transformation, Il-1 beta and sIl-2Rs
      accumulation in culture supernatant than the depressed patients.

PMID- 1746292
TI  - Eating behaviour, drug use, psychopathology and parental bonding in adolescents
      in Norway.
AB  - A 12-item version of the Eating Attitudes Test (EAT-12) was constructed and
      applied at 1-year intervals in a non-referred cohort of 1193 adolescents in
      Norway aged 13-18 years. Eight percent of the girls scored beyond the chosen cut
      off point of 9/10 the first time and 9% the second time. Factor analysis
      demonstrated 3 factors--dieting, bulimia and food preoccupation and oral control.
      Both the total scores on the EAT-12 and the 3 different factor scores showed a
      significant relationship between eating behaviour and smoking, level of alcohol
      consumption, alcohol intoxication, psychopathology and parental bonding.

PMID- 1746293
TI  - Latent class analysis of organic aspects of obsessive-compulsive disorder in
      children and adolescents.
AB  - Organic aspects of obsessive-compulsive disorder (OCD) have previously been
      described and hypotheses of biological etiology have been suggested. Sixty-one
      patients, 8-17 years of age, who fulfilled the DSM-III criteria for OCD in a
      review of the records were compared with 117 matched control patients for organic
      features. The indicators chosen for an organic concept were neurological signs,
      more than mild electroencephalographic abnormality, specific developmental
      disorder and attention deficit, and their defining property of an organic concept
      was confirmed by latent class analysis. Neurological signs was the most sensitive
      and specific indicator. Significantly fewer OCD children than control patients
      were assigned to the organic class. Almost all the types of obsessive-compulsive
      symptoms were more related to the non-organic class. Such extroverted symptoms as
      behavioral problems and loss of temper were significantly more frequent in
      patients assigned to the latent organic class, whereas symptoms of phobia and
      depressive mood were more often present in patients belonging to the nonorganic
      class. No difference was found between OCD patients and controls as to frequency
      of birth complications. The findings do not support the evidence of OCD having
      signs of major cerebral disturbance found by conventional neuropediatric methods.

PMID- 1746294
TI  - A comparative study of immune status in panic disorder patients and controls.
AB  - Alterations of immunocompetence in various mental disorders have been reported.
      We studied white blood cell counts and immunoglobulin levels in 59 panic disorder
      patients and 30 controls. The significantly increased IgA levels and tendency
      toward increase in other immunoglobulins in panic disorder patients suggest an
      immune dysfunction.

PMID- 1746295
TI  - Historical and psychiatric aspects of multiple sclerosis.

PMID- 1746296
TI  - Low high-density lipoprotein cholesterol and other coronary heart disease risk
      factors in patients with total cholesterol levels greater than 5.17 mmol/L (200
      mg/dL) in family practice. A report from CEN.
AB  - BACKGROUND: A multisite, open-label, prospective study in 327 family practices
      across the United States analyzed the demography of a large population of
      dyslipidemic patients and examined the effects of diet and exercise, as well as
      of gemfibrozil therapy, on serum levels of total cholesterol, high-density
      lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and
      triglycerides. METHODS: The 3328 patients enrolled comprised a heterogenous
      population who had wide age range (20 to 88 years), were of both sexes and
      various ethnic backgrounds, and had multiple cardiac risk factors. All had a
      history of serum cholesterol levels of 5.17 mmol/L (200 mg/dL) or more, and some
      may have been previously identified as having an HDL of 1.03 mmol/L (40 mg/dL).
      After determining their cardiac risk factor and lipid profiles, eligible patients
      were assigned to a protocol of diet and exercise, followed by concomitant
      gemfibrozil therapy, if warranted. Treatment efficacy data will be reported in a
      subsequent paper. RESULTS: The study population was 60 percent men. Ninety-four
      percent of the patients were white, 4.1 percent were black, and 1.9 percent were
      of other races. Women patients tended to be more overweight, and elderly women
      had more hypertension; they were less likely to have angina pectoris or to have
      had previous myocardial infarctions, angioplasty, or bypass surgery. The
      prevalence of low HDL cholesterol (less than 1.03 mmol/L [40 mg/dL]) was
      substantially higher in men. Statistically significant differences between men
      and women were observed for mean values of total cholesterol, 6.47 versus 6.84
      mmol/L (250.3 versus 264.4 mg/dL); HDL cholesterol, 0.94 versus 1.18 mmol/L (36.3
      versus 45.5 mg/dL); LDL cholesterol, 4.62 versus 4.76 mmol/L (178.7 versus 184.2
      mg/dL); non-HDL cholesterol, 5.54 versus 5.66 mmol/L (214.1 versus 218.9 mg/dL);
      and the total cholesterol-HDL ratio, 6.84 versus 5.64. CONCLUSIONS: Current
      National Cholesterol Education Program (NCEP) guidelines suggest lipoprotein
      analysis at cholesterol levels between 5.17 and 6.21 mmol/L (200 and 240 mg/dL)
      only if two or more risk factors are also present. Persons whose total
      cholesterol values are less than 6.21 mmol/L (240 mg/dL) can still be at risk
      because of the presence of other cardiovascular risk factors or a low level of
      HDL cholesterol. In this study, 74.3 percent of men and 41.3 percent of women
      with total cholesterol greater than or equal to 5.17 mmol/L (200 mg/dL) were also
      found to have a low HDL level, less than 1.03 mmol/L (40 mg/dL). The prevalence
      of other risk factors in this patient population was also high: 40.5 percent had
      hypertension, 9.6 percent had diabetes, and 20.3 percent smoked. These data
      suggest that routine lipoprotein analysis in the family practice setting could
      reveal low HDL cholesterol as an additional risk factor in a patient population
      where other risk factors have already been identified.

PMID- 1746297
TI  - Neonatal mortality clusters: a new tool for classifying neonatal outcomes.
AB  - BACKGROUND: A method for assessing general hospital neonatal care performance is
      needed that is simple, is easy to use, and requires minimal data. METHODS: All
      neonatal deaths in Washington State obstetric hospitals from 1980 to 1983 were
      assigned to 10 mutually exclusive neonatal mortality clusters, a new
      classification method derived from information available on the death
      certificate. RESULTS: More than one-third (35.3 percent) of all neonatal deaths
      fell within one of the seven clusters considered to represent potentially
      preventable causes of death. The rate of possibly preventable deaths was much
      higher in level III hospitals than in level II or level I hospitals, a finding
      similar to that observed in other states using different analytic approaches.
      CONCLUSIONS: Neonatal mortality clusters offer a less complex method of
      classifying neonatal deaths and assessing hospital performance than other
      currently used techniques.

PMID- 1746298
TI  - The epidemiology of bacterial meningitis.
AB  - BACKGROUND: The incidence by age and causative organism of bacterial meningitis
      are not known on a community basis. METHODS: The epidemiology of bacterial
      meningitis in a metropolitan county was studied by identifying all cases admitted
      to a hospital from 1983 through 1987. RESULTS: The overall incidence of bacterial
      meningitis was 5 per 100,000 person-years, but numbers of cases ranged from 40
      per 100,000 for children younger than 5 years to 1.0 per 100,000 in adults aged
      between 16 and 64 years. No significant excesses of cases were found in male
      patients or in blacks. The predominant causative organism varied with age.
      Overall, Haemophilus influenzae was the most common causative organism, but 32
      percent of cases were due to Streptococcus pneumoniae. Case fatality rates were
      high for S. pneumoniae (12.5 percent) and very high for the small number of
      elderly patients suffering from bacterial meningitis. CONCLUSIONS: Significant
      declines have occurred in the last decade in the incidence of bacterial
      meningitis in children, particularly in those younger than 5 years, and in
      disease caused by H. influenzae and group B streptococcus.

PMID- 1746299
TI  - A rural-urban comparison of prehospital emergency medical services in Nebraska.
AB  - BACKGROUND: Provision of emergency medical services (EMS) in the rural United
      States presents a unique challenge. While rural and urban EMS outcomes have been
      compared, differing urban-rural population characteristics and roles for rural
      ambulance teams can confound such comparisons. METHODS: A year-long study of the
      prehospital EMS was conducted in rural Richardson County, Nebraska. Data were
      collected on the age, sex, and race of patients, response time, transport
      distance, medical problems encountered, and treatment rendered enroute. These
      data compared with those from an urban Lancaster County comparison group and
      statistical data from the Nebraska State Health Department. RESULTS: In the rural
      county, 70 percent of calls involved the elderly, whereas 38 percent of the urban
      calls and 36 percent of the Nebraska State calls involved the elderly. The rural
      ambulance service was more likely to provide for routine transfers, to involve
      patients with fractures and cardiorespiratory and neurologic problems, and twice
      as likely to result in hospital admission than was the urban ambulance service.
      The frequency with which advanced life support measures were applied in the rural
      area was similar to that in the urban area. The rural area response times were
      equivalent to the urban area response times after the rural area long-distance
      transfers were excluded. The location of service in the rural area was more
      likely to be the hospital or nursing home, whereas the urban location was more
      likely to be a home, on a highway, or in a public setting. CONCLUSIONS:
      Prehospital EMS in this rural location involved a predominantly elderly
      population with a large number of routine transfers linking the nursing home and
      community hospital. Further comparisons of rural and urban EMS outcomes should
      account for possible differences in type and severity of illness and type and
      location of service.

PMID- 1746300
TI  - The SAGE-PAGE trial: do family genograms make a difference?
AB  - BACKGROUND: Despite enthusiastic promotion of family genograms, the impact of
      routine use of this tool on clinical practice has not been systematically
      examined. The present study investigated whether doing a genogram, or having one
      available, makes physicians more sensitive to psychosocial issues or in other
      ways affects the physician-patient relationship or the process of clinical care.
      METHODS: In a randomized clinical trial, patients visiting 5 physicians at an
      academic family practice center (n = 189) received a physician-administered
      genogram (PAGE); a self-administered genogram (SAGE), which the patient completed
      before seeing the physician; or no genogram. A fourth (baseline) group was tested
      without genograms prior to the randomized trial. RESULTS: Analyses of patients'
      and physicians' postencounter questionnaires showed no impact of genograms on how
      physicians think about and deal with clinical problems or how patients view the
      encounter with their physicians. Compared with control groups, neither patient-
      nor physician-administered genograms increased the physician's (self-defined)
      understanding of the patient or the importance the physician attached to
      psychosocial issues in the case. A positive finding was that physicians
      considered genograms more relevant when they did them themselves. On the other
      hand, physician-administered genograms also increased the length of the encounter
      and were substantially less complete (conveying less information) than genograms
      completed by patients. CONCLUSIONS: THe results leave open the possibility that
      genograms do make a difference when used routinely by residents or experts or in
      difficult cases when family assessment is indicated. While enthusiasm about
      genogram applications in family medicine is understandable, the clinical utility
      of this tool remains to be demonstrated scientifically.

PMID- 1746301
TI  - Variations among family physicians' management strategies for lower urinary tract
      infection in women: a report from the Washington Family Physicians Collaborative
      Research Network.
AB  - BACKGROUND AND METHODS: This study surveyed a random sample of Washington State
      family physicians regarding their attitudes toward and usual practices in
      providing care to women with lower urinary tract infection. RESULTS: Based on a
      70 percent response rate, wide variations in diagnostic testing, treatment, and
      follow-up strategies were identified. For example, a patient vignette presenting
      an uncomplicated infection prompted 82 separate management strategies among the
      137 replies. Attitude questions also showed wide variations in spite of stated
      physician confidence and comfort in evaluating and managing urinary tract
      infection. Associated estimated costs ranged from negligible to more than $250
      per case. CONCLUSIONS: These findings demonstrate significant physician
      variability in managing women's lower urinary tract infections.

PMID- 1746302
TI  - An approach to difficult management problems in otitis media in children.
AB  - BACKGROUND: Otitis media is one of the most common pediatric diseases encountered
      by family physicians. While isolated, acute episodes pose little clinical
      difficulty, recurrent infections and persistent middle ear effusions can be
      perplexing problems. METHODS: This review presents a clinical approach to the
      management of recurrent and persistent middle ear disease. RESULTS AND
      CONCLUSIONS: Recurrent infections can be treated with a trial of daily
      prophylactic antibiotics to decrease the rate of recurrence. Should infections
      continue to recur despite the daily prophylaxis, polyethylene tube placement is
      warranted to drain surgically the middle ear effusions that give rise to the
      recurrent infections. Acute episodes of otitis media are commonly followed by
      prolonged, asymptomatic periods of middle ear effusion. Patients with this
      disease have decreased hearing leading to potential deficits in their speech and
      academic development. If such effusions do not spontaneously resolve within 2
      months, repeated courses of antibiotics with the possible addition of a course of
      oral steroids are warranted to speed resolution of the effusion before proceeding
      to placement of polyethylene tubes.

PMID- 1746303
TI  - Postpartum urinary retention.
AB  - BACKGROUND: Urinary retention is a common and frustrating complication in women
      during the immediate postpartum period. Physiologic changes in the bladder that
      occur during pregnancy predispose patients to develop symptomatic retention of
      urine during the first hours to days after delivery. METHODS: The incidence and
      characteristics of postpartum urinary retention were researched through a
      literature review and are illustrated by a case report. RESULTS AND CONCLUSIONS:
      Postpartum urinary retention has a reported incidence ranging from 1.7 to 17.9
      percent. Factors associated with postpartum urinary retention include (1) first
      vaginal delivery, (2) epidural anesthesia, and (3) Cesarean section. Treatment
      begins with supportive measures to enhance the likelihood of micturition, such as
      ambulation, privacy, and a warm bath. If these measures are not successful,
      catheterization can be performed. If the bladder contains more than 700 mL of
      urine, prophylactic antibiotics may be warranted, because prolonged or repeated
      catheterization may be necessary.

PMID- 1746304
TI  - Cat-scratch disease associated with erythema nodosum.

PMID- 1746305
TI  - Transient cerebrospinal fluid rhinorrhea, blurred vision, and headache as
      presenting symptoms of pituitary adenoma.

PMID- 1746306
TI  - Penile fracture.

PMID- 1746307
TI  - Being there: on the place of the family physician.

PMID- 1746308
TI  - Current report--HIV. Counseling patients about HIV test results.

PMID- 1746309
TI  - Probing the mystery of clinical work.

PMID- 1746310
TI  - Outcomes research, patient preference, and the primary care physician.

PMID- 1746311
TI  - Toward reduction of neonatal mortality.

PMID- 1746312
TI  - Management of streptococcal pharyngitis.

PMID- 1746313
TI  - Cognition dysfunction.

PMID- 1746314
TI  - Preemployment evaluations.

PMID- 1746315
TI  - Release kinetics of ATP in cells exposed to nonionic detergents.
AB  - We have previously shown that the protein binding of intracellular ATP could be
      examined by monitoring the ATP release kinetics from Triton X-100 and Brij 58
      nonionic detergent permeabilized cells. We have now analysed the protein binding
      of ATP in an isotonic medium using intact and partially ATP depleted Brij 58
      treated human erythrocytes. The effects of Triton X-100 below the critical
      micelle concentration (CMC) was studied in normal and tumorous tissue culture
      cells and human red blood cells. Our results showed that the protein association
      of ATP was altered in the partially ATP depleted erythrocytes. Below the CMC
      value, but above a critical level Triton X-100 treatment was effective in
      mobilizing the intracellular ATP in both cell types. The ATP release curves were
      sigmoidal and an 'all or none' type of response was observed, especially in
      erythrocytes. The use of Triton X-100 (less than CMC) delays the detergent
      induced cell decomposition time thus providing a new approach to investigating
      the physical state of intracellular ATP.

PMID- 1746316
TI  - Green flavoprotein from P. leiognathi: purification, characterization and
      identification as the product of the lux G(N) gene.
AB  - A green flavoprotein (GFP) was isolated and purified to homogeneity from
      Photobacterium leiognathi, strain 208. GFP is a homodimer of molecular weight
      54,000 and contains two molecules of an unusual flavin per molecule of protein.
      Various biochemical characteristics including isoelectric point, trypsin and
      chymotrypsin degradation, SDS and temperature influence on subunit dissociation
      and the dissociation of the flavin chromophore, were investigated. The sequence
      of 23 N-terminal amino acids was determined and found to be concurrent with the N
      terminal amino acid sequence encoded by the lux G(N) gene of P. leiognathi. This
      fact suggests that GFP is a structural component of the Photobacterium
      luminescence system.

PMID- 1746317
TI  - Expression and quantification of firefly luciferase under control of Rhizobium
      meliloti symbiotic promoters.
AB  - We have tested the use of firefly luciferase for monitoring regulated symbiotic
      nitrogen fixation gene expression. Broad-host-range plasmids carrying
      translational fusions of Rhizobium meliloti nifH, fixA and nifA promoters were
      constructed. Despite low levels of promoter activity the absence of Escherichia
      coli endogenous luminescence and the high sensitivity of the bioluminescent assay
      for firefly luciferase allowed rapid screening for functional luciferase
      expression. Plasmids containing symbiotic promoter-luc fusions were established
      in R. meliloti. Luciferase activity was detected and measured in both vegetative
      and symbiotic cells giving comparable results with those obtained by beta
      galactosidase assays. In addition, the luciferase assay was quicker, more
      sensitive and could be carried out with unrestricted cells. Furthermore,
      bioluminescence was high enough in alfalfa nodules containing nifH-luc fusion to
      be observed by a dark-adapted eye and photographed.

PMID- 1746318
TI  - Extra-weak chemiluminescence of drugs. XII. Effect of the molar ratio of amino
      acid to sugar on extra-weak chemiluminescence in the Maillard reaction.
AB  - The extra-weak chemiluminescence in the Maillard reaction caused by the reaction
      between L-lysine and D-arabinose was measured, and a linear relationship was
      found between the chemiluminescence and the amount of L-lysine added. After a 1
      hour reaction equimolar amounts of D-arabinose and L-lysine were consumed
      regardless of the initial concentration of D-arabinose. The chemiluminescence of
      the Maillard reaction originates from Maillard reaction products formed by the
      equimolar reaction between sugar and amino acid and depends on the concentration
      of amino acid.

PMID- 1746319
TI  - Chemiluminescence intensities and spectra of luminol oxidation by sodium
      hypochlorite in the presence of hydrogen peroxide.
AB  - Hydrogen peroxide amplifies the chemiluminescence in the oxidation of luminol by
      sodium hypochlorite. A linear relationship between concentration of hydrogen
      peroxide and light intensity was found in the concentration range 5 x 10(-8)-7.5
      x 10(-6) mol/l. At 7.5 x 10(-6) mol/l H2O2 the chemiluminescence is amplified 550
      fold. The chemiluminescence spectra of these reactions have a wavelength maximum
      at 431 nm independent of the concentration of hydrogen peroxide. The results
      indicate that hydrogen peroxide is a necessary component in the chemiluminescent
      oxidation of the luminol by sodium hypochlorite.

PMID- 1746320
TI  - Bioluminescence and chemiluminescence literature. The 1990 literature: Part I.

PMID- 1746321
TI  - Hydration phenomena: an update and implications for the food processing industry.
AB  - The past decade has witnessed major revisions in our perception of the manner in
      which water affects the physical, chemical, and microbiological attributes of all
      manner of food-related systems. The growing realization that, during processing,
      most such systems are brought to, and maintained in, a state of thermodynamic
      instability is focussing attention on the dynamics of the various components in
      such systems. Older, equilibrium-based concepts, such as "water activity,"
      equilibrium moisture sorption, and "bound" water are being discarded in favour of
      more appropriate descriptions, in terms of diffusion, nucleation, crystallization
      and relaxation rates, glass/rubber transitions, and steady states. It is being
      realized that food processing, materials science, and polymer technology have
      much in common, with water being the universal plasticizer of naturally occurring
      organic materials which form the basis of food products.

PMID- 1746322
TI  - Water relationships in foods. Advances in the 1980s and trends for the 1990s.
      197th National Meeting of the American Chemical Society in Dallas, Texas, April
      10-14, 1989.

PMID- 1746323
TI  - Studies of reaction kinetics in relation to the Tg' of polymers in frozen model
      systems.
AB  - The rates of diffusion-controlled processes in a frozen system can be influenced
      by the presence of glassy states. One characteristic of cryostabilization by this
      mechanism is a change in the temperature dependence of reaction rates at the Tg'
      of the system. The cryostabilization behavior of solutes such as maltodextrin,
      carboxymethylcellulose (CMC), and sucrose was studied. Three different model
      reaction systems (enzyme hydrolysis, protein aggregation, and non-enzymatic
      oxidation) were used. Maltodextrin had a consistent pattern of cryostabilization
      behavior at temperatures ranging from -3 degrees C to -20 degrees C for all three
      model systems. Significant retardation effects were evident in the temperature
      range corresponding to its glassy states. Sucrose did not show a stabilizing
      effect in the non-proteinaceous model system (the non-enzymatic oxidation
      reaction). This could partly be due to the absence of the glassy state, since the
      storage temperatures were above its Tg'. However, in the protein aggregation
      model system, sucrose was an excellent stabilizer in protecting actomyosin from
      aggregation. This may be explained by a "solute exclusion" mechanism. CMC did not
      show any stabilizing effect in the protein aggregation and non-enzymatic
      oxidation model systems studied, even though it has a Tg' as high as that of
      maltodextrin. These results demonstrated that although the presence of a glassy
      state may well have a retarding effect on the rates of diffusion processes, just
      knowing the Tg' of a polymer is not sufficient for prediction of its
      stabilization effect in a frozen system.

PMID- 1746324
TI  - DSC studies and stability of frozen foods.
AB  - This paper discusses the role played by the "WLF decrease in viscosity" above the
      temperature of the glass transition (Tg) in the temperature dependence of the
      stability of frozen foods. In the first part, the complex features observed
      before the melting endotherm on DSC/DTA thermograms of sugar-water solutions are
      examined; they are suggested to be representative of a glass transition
      associated with enthalpy relaxation. In the second part, the values of Tg for
      some complex foods are discussed. It is shown that ice melting adds an important
      contribution to the WLF effect on the decrease of the viscosity of the freeze
      concentrated phase. The temperature dependence of the deterioration processes
      observed in frozen food products is generally smaller than that expected from
      this viscosity decrease. Several hypotheses are presented to account for the
      discrepancy.

PMID- 1746325
TI  - Effects of water on diffusion in food systems.
AB  - A number of operations in food processing, and the stability of stored foods, are
      affected by diffusional properties of food systems, which include the foods
      themselves, their immediate environment within a package, and any barriers
      (packaging or coating) used with the foods. Water content and "water activity"
      affect these diffusional properties dramatically, by plasticizing food and/or
      packaging polymers and affecting glass transition temperatures of components, and
      in some cases, water may serve as an internal transport medium. The present paper
      reviews the current state of knowledge of effects of water on diffusion in food
      systems, and in particular, changes in diffusivity above glass transition
      temperatures. The complexity of resultant effects on food stability in dry and
      frozen foods is discussed. Examples of potential effects of glass transitions on
      stability of frozen foods are provided by computer simulation of shelf life using
      specified assumptions.

PMID- 1746326
TI  - Calorimetric and thermodielectrical measurements of water interactions with some
      food materials.
AB  - A new thermoanalytical method, which allows the measurement of complex
      dielectrical permittivities as a function of temperature in the microwave
      frequency domain, is described and compared to Differential Scanning Calorimetry
      (DSC) with respect to the characterization of water in food materials. Ice
      crystallization temperatures and melting enthalpies, measured by DSC dynamically
      on the same sample, allowed precise determination of the amount of frozen water
      and its enthalpy as a function of total water content, especially at low water
      contents near the unfrozen water limit. Thermal and Dielectrical Analysis (TDA)
      measurements provide immediate information about water interactions in food
      materials, even down to the lowest water contents, which are generally difficult
      to assess by other techniques. Dielectrical behaviour of eight glucose-water
      melts, containing from 0 to 24% water, has been examined as a function of
      temperature. The dependence of the observed dielectric relaxations on water
      content and temperature are discussed, and the results obtained by TDA are
      compared to those from conventional frequency sweeping determinations. The
      influence of temperature, hydration, and state of the material on dielectrical
      relaxation determinations are also discussed, with reference to glucose and
      sorbitol behaviour. The variations in dielectric constant during starch heating
      and dehydration are presented and analysed, with the aim of understanding the
      microwave drying process.

PMID- 1746327
TI  - Effect of solute on the nucleation and propagation of ice.
AB  - Using the emulsion technique, we have studied nucleation of ice in aqueous
      solutions containing silver iodide or Pseudomonas syringae. Using a Differential
      Scanning Calorimeter (DSC), we determined characteristic temperatures of
      nucleation, and also rates of nucleation at selected temperatures. The freezing
      point depression induced by added solute is linearly related to the lowering of
      both homogeneous and heterogeneous nucleation temperature. Nucleation kinetics
      depend on a fifth power function of the temperature. Solute is found to affect
      the parameters of this relationship in different ways, dependent upon the nature
      of the catalytic site for ice nucleation. We have also studied the effect of
      composition on the linear propagation velocity (LPV) of ice in undercooled
      solutions contained in a U-tube. We have determined velocities in a range of
      concentrations of sugar solution at the same undercooling, and also as a function
      of undercooling. The role of added polymer has also been investigated. It is
      affected by the sugar concentration.

PMID- 1746328
TI  - Thermal analysis of water-containing systems.
AB  - Thermal analytical techniques offer many advantages in investigations of water
      containing systems. This paper will review some of the methodologies used by us
      in studying food systems: 1) Differential Scanning Calorimetry (DSC): for
      determining freezable water, melting point, Tg' (see text), etc. 2)
      ThermoMechanical Analysis (TMA): for determining softening points as a function
      of water content, dilatometry and glass transition temperatures. 3)
      ThermoGravimetric Analysis (TGA): for investigating water uptake curves and water
      content determination. 4) Dynamic Mechanical Analysis (DMA): for the
      determination of low-energy transitions.

PMID- 1746329
TI  - Food-water relations: progress and integration, comments and thoughts.

PMID- 1746330
TI  - Thermomechanical analysis of frozen aqueous systems.
AB  - Thermomechanical Analysis (TMA), using the parallel-plate-rheometer mode of the
      DuPont 943 TMA, was used to evaluate the softening properties of frozen aqueous
      carbohydrate model systems. A sample (of fixed dimension) of frozen solution was
      placed between the parallel plates and cooled to -80 degrees C. The sample was
      then heated at a linear heating rate of 2 degrees C/min to +15 degrees C. The
      dimension change was plotted as a function of temperature or time, and an
      estimate was made of the glass transition point and of the thermal softening
      behavior of the system. Good agreement was found with previously published glass
      transition data for similar frozen carbohydrate model systems measured by
      differential scanning calorimetry (DSC) and dynamic mechanical analysis (DMA).

PMID- 1746331
TI  - Vitreous domains in an aqueous ribose solution.
AB  - Aqueous solutions containing d-ribose demonstrate the ability to form more than
      one vitreous domain when exposed to low temperatures. Differential scanning
      calorimetry revealed two glass transitions (at Tgs of -63 and -43 degrees C) upon
      cooling and warming at a constant rate of 5 degrees C.min-1. The bulk water of
      the solution crystallizes at -18 degrees C (Tc). Heat capacity and enthalpy
      changes, and the derivatives for each thermal event, are calculated. Relaxation
      studies on the observed Tgs produced anticipated overshoots characteristic of the
      presence of glassy states.

PMID- 1746332
TI  - Effect of sugars and polyols on water in agarose gels.
AB  - Effects of ribose, glucose, sucrose, ethylene glycol, glycerin, propylene glycol,
      and sorbitol on water in concentrated agarose gels were studied by differential
      scanning calorimetry at low temperatures. Changes in the phase transition
      temperatures of 40% agarose gels, induced by the addition of these chemical
      reagents, are discussed, together with rheological and thermal data for the same
      systems at ambient and higher temperatures. Both sugars and polyols are believed
      to reduce the amount of freezable water and to promote plasticization and
      molecular mobility of agarose chains in gels, thus shifting the glass transition
      temperatures to lower temperatures. However, the effects of decreasing freezable
      water, and the direct effect on the junction zones, produced by sugars seem to be
      different from the effects produced by polyols.

PMID- 1746333
TI  - Non-equilibrium phase transitions of aqueous starch systems.
AB  - Experimental data on phase transitions of aqueous starch systems, obtained by
      thermal analysis (TA) methods, are often indicative of irreversible (non
      equilibrium) processes involving various metastable states. The thermal responses
      usually reflect composite effects from contributions of several opposing
      processes [e.g. annealing, melting, and (re)crystallization] taking place
      concurrently during TA. It is important, therefore, to recognize the temperature-
      and time-dependence of the structure of starch materials, if non-isothermal
      techniques are used for their characterization. Identifying the pertinent
      morphological features (supermolecular structure) of each particular system, as
      well as recognizing the role of water as a plasticizer which depresses the Tg of
      the amorphous domains, is essential to predict heat/moisture-mediated
      transformations of this biopolymer. The phase transition behaviour of granular
      starch and amylose-lipid complexes, as revealed by Differential Scanning
      Calorimetry and Thermomechanical Analysis, and the metastability of these
      materials are considered herein with respect to the effects of water and low
      molecular weight solutes.

PMID- 1746334
TI  - Mechanism of misoprostol stabilization in hydroxypropyl methylcellulose.
AB  - The stability of misoprostol oil is significantly improved in a hydroxypropyl
      methylcellulose (HPMC) dispersion (1:100). In order to understand the enhanced
      stability of misoprostol oil in HPMC, the physical state of misoprostol oil in
      HPMC films was investigated using differential scanning calorimetry (DSC),
      dynamic mechanical analysis (DMA), and transmission IR (TIR). Further, to
      determine the effect of polymer structure and the mobility of both water and
      misoprostol on misoprostol stability, the rate of misoprostol degradation was
      investigated in the misoprostol/HPMC dispersion (1:100) at 55 degrees C. The
      water sorption isotherm of the dispersion at 55 degrees C was determined, at
      seven different relative humidities, ranging from zero to 81%. The DSC and DMA
      measurements indicated that misoprostol oil, up to 29% in dry weight, is
      molecularly dispersed in the glassy HPMC. The TIR studies showed no evidence of
      complexation between misoprostol and HPMC. Stability studies of the
      misoprostol/HPMC (1:100) dispersion indicated that the first-order rate constants
      for misoprostol degradation increased in a concave-up fashion as the water
      content of the dispersion increased. Below two percent water content, the rate of
      misoprostol degradation was found to be minimal. Overall, it is suggested that
      misoprostol is stabilized in the dispersion by being molecularly dispersed in
      HPMC. Further, the glassy state of HPMC should reduce the mobility of misoprostol
      and water, leading to a minimal rate of degradation for misoprostol at low
      moisture levels.

PMID- 1746335
TI  - A food polymer science approach to structure-property relationships in aqueous
      food systems: non-equilibrium behavior of carbohydrate-water systems.
AB  - Descriptions of the functional significance of carbohydrates based on the
      familiar equilibrium thermodynamics of very dilute solutions fail for pragmatical
      time scales and conditions, which are far from equilibrium. This is not too
      surprising, since limiting partial-molar properties reflect the independent
      behavior of solute in the limit of infinite dilution where free volume is maximum
      at a given temperature, while Tg'-Wg' properties reflect the cooperative behavior
      of solute-plasticizer blends at the limiting minimum value of free volume to
      observe relaxation within experimental time scales. Carbohydrate-water systems,
      with well-characterized structure and MW above and below the entanglement limit,
      provide a unique framework for the investigation of non-equilibrium behavior.
      Thermal analysis by DSC reveals the central role of water as a plasticizer for
      carbohydrates and of the glass transition as a physicochemical parameter that
      governs their properties, processing, and stability. A classical polymer science
      approach is used to study structure-property relationships of carbohydrates as
      water-compatible food polymers, which are treated as homologous systems of
      polymers, oligomers, and monomers with their plasticizers and solvents.
      Mechanical relaxation behavior is described by a "transformation map" of the
      critical variables of moisture content, temperature, and time. The glass curve is
      a reference contour, which represents the limiting isogram for free volume, local
      viscosity, relaxation rates, and rotational and translational mobility. Map
      domains are discussed as aspects of "water dynamics," to dispel the myth of
      "bound water," and "glass dynamics," to relate to macroscopic structure and
      collapse phenomena. A particular glass with invariant composition and Tg
      (prepared by freeze-concentration) is identified as a pivotal and practical
      reference state. The Tg observed during DSC analysis is often an effective Tg,
      resulting from instantaneous relative relaxation rates and non-uniform
      distribution of total sample moisture. Non-equilibrium melting, annealing, and
      gelation/recrystallization of kinetically metastable, partially crystalline
      carbohydrate systems exhibit non-Arrhenius kinetics which depend on the magnitude
      of delta T above the appropriate Tg, as defined by WLF relaxation
      transformations. Thermally reversible aqueous gels (crystallized from an under
      cooled, rubbery melt) are described by a "fringed micelle" structural model for a
      three-dimensional polymer network, composed of microcrystalline junction zones
      crosslinking plasticized amorphous regions of flexible-coiled, entangled chain
      segments.

PMID- 1746336
TI  - The prediction of water activities in multicomponent systems.
AB  - The molecular bases of the equilibrium water activity concept are discussed and
      illustrated using some simplified examples. It is shown, using a relatively
      refined treatment, that at the moment we are not in a position to predict water
      activities, even for simple systems. A method is described which allows the
      prediction of the water activity of multicomponent systems from the properties of
      solutions containing one and two solutes. The method can also be used to predict
      solubilities in systems containing more than one solute, and this is illustrated
      with an example.

PMID- 1746337
TI  - Trends in research related to the influence of "water activity" on microorganisms
      in food.
AB  - The use of humectants and drying to make foods safe and stable has been one of
      the underlying principles of food preservation for centuries. With the more
      recent discovery that the ratio of water vapor pressure to that of pure water
      (aw) is a useful parameter when related to microbial growth and other stabilizing
      factors in foods, a valuable means of predicting stability factors based on water
      limitation has become available. Microorganisms have been categorized with
      respect to their capacity to grow and produce metabolites in various conditions
      of limited aw. In addition, the metabolic basis for microbial inhibition has now
      been determined and schemes for its genetic control have been uncovered. The
      implications that these discoveries have in a wide variety of applications are
      far-reaching.

PMID- 1746338
TI  - Effects of order of mixing and solute interactions on the "water activity" of
      concentrated solutions.
AB  - Experimental results indicate that order-of-mixing effects in concentrated sugar
      salt solutions are functions of salt:sugar concentrations, types of sugars and
      salts, time after mixing of clear solutions, and solute interactions. Visual
      clarity of the solutions after preparation and at least 16 hours of storage may
      not be a sufficient indicator of complete solvation. The order of mixing solutes
      may cause differences in their rates of hydration, resulting in differences in
      "Aw" at non-equilibrium conditions, whereas Aw is only meaningful at
      thermodynamic equilibrium. Determining a thermodynamic equilibrium Aw in
      diffusion-resistant foods may take much more time and be more difficult to
      measure than in the solutions reported in this paper.

PMID- 1746339
TI  - Aspartame degradation as a function of "water activity".
AB  - The incorporation of aspartame into an increasing number of foods necessitates
      evaluation of its degradation kinetics as a function of "water activity" (aw).
      The kinetics of degradation were followed in model systems as a function of
      initial pH, temperature, and aw. An increase in aw, for each 0.1 units in the 0.3
      to 0.7 range, resulted in about a 30-80% increase in degradation rate, which then
      decreased only slowly up to dilute solution. The presence of oil increased the
      degradation rate at high aw, but glucose had no effect on the rate of aspartame
      loss. The activation energies for loss ranged from 25 to 20 kcal/mole, decreasing
      as aw increased, as expected. The rates as a function of pH showed that the
      actual pH of the water in the condensed phase, based on the Bronsted
      relationship, may be very different than the initial pH. This caused a shift in
      the pH at which the fastest rate of degradation occurred, as aw increased.

PMID- 1746340
TI  - Volume effects of starch-water interactions.
AB  - Volume changes arising from the sorption of water by three starches have been
      determined by dilatometry. By a recently described method, parameters of the
      G.A.B. equation have been used to resolve the volume changes into contributions
      from strongly sorbed water molecules in contact with the surface and from weakly
      sorbed water molecules in the remaining water layers. The latter produced only
      small volume effects. In contrast, the contact sorption caused very large volume
      decreases. Changes in these decreases with changing water content indicated two
      types of sorption sites, possibly crystalline and amorphous. In the case of waxy
      maize starch, for which literature data concerning its degree of crystallinity
      were available, the contact sorption could be quantitatively resolved into
      contributions from the presumably crystalline and amorphous portions, with the
      former exhibiting both higher affinity and larger volume changes for water
      molecules than the latter.

PMID- 1746341
TI  - Water diffusivity in starch-based systems.
AB  - The objective of this study was to investigate the influence of structure, and
      component interactions, on the sorption and transport properties of water in
      starch-based systems. We compared the effective diffusivity (Deff) of water in
      two starches, with differing amylose-amylopectin ratios, using either kinetics of
      water adsorption or analysis of drying curves (water desorption) to estimate
      Deff. The effect of incorporating small sugar molecules into the granular or
      gelatinized starch matrices on Deff was measured by drying curve analysis. To
      investigate the possible mechanisms of water transport, the porosity and
      microscopic appearance of the samples at different stages of drying were
      determined. In a complementary study, sorption isotherms and the number of
      accessible "binding" sites in the starch and starch-sugar systems were determined
      using gravimetric analysis and inverse gas chromatography (IGC) 'probe analysis'.
      In the case of the starch-sugar systems, the measurements were made after the
      components had been 'mechanically mixed', or after more intimate mixing had been
      achieved by a co-freeze-drying process. The Deff of the starches was found to
      depend, in a complex way, on the moisture content of the samples. At relatively
      high moisture contents, the predominant mode of water transport was by liquid
      diffusion. As the samples became drier, their porosity increased, and the
      predominant mode of moisture transport was by vapor phase diffusion. As the
      samples became very dry (less than 10% water content), Deff fell significantly.
      Incorporation of sugars, in general, led to a reduction of Deff, which was
      correlated with a corresponding fall in porosity. In agreement with the findings
      of other workers, for the starches studied, the value of Deff determined from
      water adsorption measurements was significantly less than Deff determined from
      water desorption (drying curve analysis). The form of the Deff versus moisture
      content relationship was, however, independent of the method of measurement
      (adsorption or desorption). The water sorption and IGC probe analysis results
      indicated that some physicochemical interaction was expedited by the freeze
      drying process. This interaction was manifested by a reduction in water sorption
      at a given relative vapor pressure, and by major changes in the accessibility of
      the co-freeze-dried samples to organic probe molecules. Taken together, the
      results indicate that water transport (diffusion) in starches and in starch-sugar
      mixtures is dependent significantly on gross structural features (development of
      porosity during drying), but that specific molecular, physico-chemical
      interactions must also be considered.

PMID- 1746342
TI  - Kinetics of water sorption in packaging materials for food.
AB  - The water content of paper and its time dependence are of great importance for
      the use of paper and cardboard as packaging materials. The physical process of
      water sorption and the mechanisms of water "binding" in paper, as fundamental
      principles of the kinetics, are discussed. Water exists in up to four different
      "states" (i.e. domains of mobility) in paper: the first layer at the primary
      sites on the surface of the fibers; the multimolecular layers, with less
      "binding" energy, on these inner surfaces; condensed water in the voids; and
      dissolved water in the cellulose fibers. All these "states" influence the shape
      of the sorption isotherm and correspond to a different water content and to
      different transport mechanisms. The various types of water "binding" on paper
      were studied by measuring the transversal relaxation rate, T2, using a pulsed
      Nuclear Magnetic Resonance spectrometer (minispec pc 120). In addition, a non
      destructive, fast method of determining the water content in packaging materials
      with NMR spectroscopy is described.

PMID- 1746343
TI  - Use of NMR and MRI to study water relations in foods.
AB  - Water is the most important component of a food system, because it influences so
      many process variables, product characteristics, and stability attributes. Some
      of the most successful techniques used to probe the behavior of water in food
      systems are Nuclear Magnetic Resonance (NMR) spectroscopy and, more recently,
      pulsed-field gradient NMR and Magnetic Resonance Imaging (MRI). The purpose of
      this chapter is to review the theory underlying these techniques and to present
      several examples of how they have been applied to study water relations in foods.

PMID- 1746344
TI  - The effect of mechanical deformation on the movement of water in foods.
AB  - This study has shown the importance of relating NMR spectroscopic information on
      the water in model food structures to the mechanical properties of those
      structures. Analysis of the NMR relaxation data can be used to examine the
      distribution of water domain sizes, and this has been related to the mechanical
      properties of the samples. A novel NMR probe-head has been designed, which allows
      both the NMR and the mechanical data to be simultaneously measured during
      compression of the sample. This probe-head allows compressive stress/strain data
      to be obtained directly from the NMR sample, allowing changes in the distribution
      of the water to be directly correlated to changes in mechanical properties.

PMID- 1746345
TI  - Molecular behavior of water in a flour-water baked model system.
AB  - The molecular behavior of water in complex food systems, via bonding and
      solvation reactions with low molecular weight solutes or high molecular weight
      macromolecules, is intimately linked with both the palatability and storage
      stability of those systems. Due to the difficulty in interpreting data derived
      from multicomponent finished food products, water behavior in a baked flour-water
      "matzo" model system was studied. Water behavior was assessed from high
      resolution [1H] nuclear magnetic resonance (NMR) spin-spin relaxation studies and
      differential scanning calorimetric (DSC) measurements of unfreezable water
      content. The unfreezable water capacity of "matzo" model crackers, as measured by
      DSC, ranged from ca. 24-30% (w/w). These results were corroborated by NMR data.
      Only one exponent (less than 0.46 msec greater than) is required to fit spin-echo
      evolution curves below a total moisture content of ca. 20% (w/w), whereas two
      exponents (less than 0.46 greater than and 1.6 msec) are observed when the
      moisture content exceeds 20% (w/w). Expert sensory texture assessments parallel
      unfreezable (= total) water contents between 2.9% (w/w) and 20.1% (w/w). This
      relationship may be explained by the known tendency for water to plasticize
      biological polymers, e.g. wheat starch and proteins, and to render these
      macromolecules incrementally more mobile with increasing water concentration. The
      similarities (if any) between water of plasticization, immobile water, and
      "bound" water are discussed, in terms of theoretical physicochemical "states" of
      water and the various techniques utilized to assess (define) those "states."

PMID- 1746346
TI  - 1H and 2H NMR studies of water in work-free wheat flour doughs.
AB  - Proton and deuterium NMR relaxation methods were used to characterize water
      compartmentalization and hydration in work-free wheat flour doughs. Transverse
      (spin-spin) relaxation measurements define three motionally unique water
      compartments in the work-free dough preparations. The apparent occupancy fraction
      and relative mobility of each water domain are found to be functions of moisture
      content, temperature, and flour type. Additionally, the number of relaxation
      resolved water compartments and their characteristic relaxation rate constants
      are found to depend critically on both moisture content and the interpulse-delay
      employed for the multi-pulse relaxation experiments. Under controlled
      experimental conditions, dynamics between the three water compartments can be
      observed to be consistent with the onset of flour hydration. The most notable
      observation during the initial period of hydration is a loss of "free" or
      "loosely bound" water to environments characterized by less mobility. Freezing
      studies show that hard wheat doughs have slightly less amorphous, non-freezable
      water than do soft wheat flour doughs prepared under similar conditions.

PMID- 1746347
TI  - Magic-angle 13C NMR analysis of hard wheat flour and dough.
AB  - Samples of hard wheat flour and dough are analyzed by magic-angle spinning 13C
      NMR spectroscopy. Cross-polarization magic-angle spinning (CPMAS) 13C NMR spectra
      of the dry flour allow its starch and protein content to be accurately measured.
      These two components are phase-separated. Spectra of hydrated hard wheat doughs
      are collected under both CPMAS and single-pulse carbon with low-power 1H
      decoupling conditions. The former report on the macromolecular components of the
      dough, while the latter reveal small molecules which are solubilized by the
      water. Results of the present study are interpreted as indicating that the
      protein is largely unaffected by the added water and remains phased-separated
      from the starch, while water causes significant changes in polymer dynamics of
      the starch component.

PMID- 1746348
TI  - Molecular dynamics of water in foods and related model systems: multinuclear spin
      relaxation studies and comparison with theoretical calculations.
AB  - A review of recent studies of molecular dynamics of water in foods and model
      systems is presented, and the theoretical results are compared with experimental
      data obtained by several techniques. Both theoretical and experimental approaches
      are discussed for electrolytes, carbohydrates, and food proteins in solution.
      Theoretical results from Monte Carlo simulations are compared with experimental
      NMR relaxation data for quadrupolar nuclei such as those of deuterium and oxygen
      17. Hydration studies of wheat, soybean, corn, and myofibrillar proteins by
      multinuclear spin relaxation techniques are discussed, and several new approaches
      to the analysis of the experimental data are considered. Correlation times of
      water motions in hydrated food systems are determined from NMR and dielectric
      relaxation data. The values of the correlation times for dilute solutions of
      electrolytes and carbohydrates estimated by NMR are in good agreement with those
      calculated from dielectric relaxation data, but seem to differ significantly from
      those proposed from Monte Carlo simulations. Several new and important results
      concerning the hydration of potato and cereal starches are presented, showing the
      very different hydration behaviors of these two major groups of starches. The
      combination of molecular dynamics computations with NMR relaxation techniques
      will hopefully stimulate novel technological developments in food engineering
      based on such fundamental studies.

PMID- 1746349
TI  - Protein-water interactions from 2H NMR relaxation studies: influence of
      hydrophilic, hydrophobic, and electrostatic interactions.
AB  - The importance of water interactions with proteins in food systems is well
      documented. A controversy exists, however, as to the nature of these interactions
      and the effect of protein structural changes on them. To clarify these questions,
      a method has been developed for determining hydration from the protein
      concentration-dependence of deuteron resonance relaxation rates. Measurements
      were made in D2O on beta-lactoglobulin A to study effects of hydrophilic
      interactions, and on both casein micelles and submicelles to study hydrophobic
      and electrostatic effects. From the protein concentration-dependent relaxation
      rates, the second viral coefficients of the proteins were obtained by nonlinear
      regression analysis. Using either an isotropic tumbling or an intermediate
      asymmetry model, hydrations, upsilon, and correlation times, tau c, were
      calculated for the protein-associated water; from tau c, the Stokes radius, R,
      was obtained. Variations in upsilon and R were in accord with known structural
      changes in molecular states of the proteins. The NMR results are compared with
      hydrations and structural information derived independently from small-angle X
      ray scattering.

PMID- 1746350
TI  - Solute-polymer-water interactions and their manifestations.
AB  - This paper reviews recent work on the interactions among solutes, polymers, and
      water in model food systems. Four possible combinations of ionic or non-ionic
      solutes and polymers are discussed in terms of their water sorption behavior.
      Comparisons between experimental values and values calculated by a mass balance
      equation are made. The salt-protein, sucrose-starch, and salt-starch combinations
      sorbed less water than that predicted by calculated sorption values. This was
      attributed to the inability of the interacted solutes to sorb their full
      complement of water. On the other hand, the sucrose-protein combination exhibited
      an increase in the amount of water sorbed over that calculated by the mass
      balance equation. This was attributed to the increased hydration of the protein
      component, due to an effect of the sucrose. One of the major factors involved in
      these solute-polymer interactions is the competition for water among the solutes
      and polymers. This competition, in turn, is greatly influenced by the "state" of
      the water associated with these components. Lastly, examples of how biological,
      chemical, and physico-chemical phenomena in foods are affected by these factors
      are also given. The phenomena discussed include mold germination, the Maillard
      reaction, ascorbic acid oxidation, protein functionality, starch gelatinization
      and retrogradation, and the complication of the order of mixing.

PMID- 1746351
TI  - Deuterium nuclear magnetic resonance studies of potato starch hydration.
AB  - Deuterium Nuclear Magnetic Resonance (NMR) measurements at 4.7 Tesla were used to
      study the hydration properties of potato starch suspensions as a function of the
      starch-to-water ratio. The deuterium NMR spectrum of potato starch suspensions
      consisted of a relatively tall, single Lorentzian (D2O) peak and a resolved
      doublet ('powder' pattern) of about 1 kHz quadrupole splitting and low amplitude.
      The deuterium NMR transverse relaxation rate (R*2) was measured for the single
      Lorentzian, deuterium oxide peak; this rate increased with increasing starch-to
      water ratio. Deviations of such R*2 dependences from linearity were observed only
      at high ratios of starch-to-water, above approximately 40% solids. In addition to
      the 'free' or bulk population (which has a very fast rotational correlation time
      of 5 ps), a second population of water weakly sorbed on the starch granule
      surface was monitored and found to be in fast exchange with the bulk water; this
      second water population has a rotational correlation time of 17 ps at 298 K, only
      about three times slower than that of bulk water. Additionally, a third
      population of slowly exchangeable water is present, which is "anisotropically
      bound" and has a highly restricted motion within the potato starch granule
      structure; well-defined quadrupole splittings are observed from this latter
      population of water in potato starch. Potato starch exhibits unique hydration
      properties that have not been found in cereal starches.

PMID- 1746352
TI  - Determination of moisture content by pulsed nuclear magnetic resonance
      spectroscopy.
AB  - Water is vital to all life processes. In foods, water is often the key component
      which determines the extent and rate of several chemical reactions, as well as
      the growth of microorganisms. There are several methods available to measure
      water content in foods; however, one of the most successful methods is Nuclear
      Magnetic Resonance (NMR) spectroscopy. The NMR method is rapid and accurate and,
      most importantly, non-destructive to the sample. The purpose of this chapter is
      to discuss the use of NMR, both as a research tool and as a quality control (off-
      and on-line) method, to measure moisture content in food components and food
      systems.

PMID- 1746353
TI  - Phase volume measurements using magnetic resonance imaging.
AB  - The phase distribution of components in both model and actual food systems has
      been quantified using Magnetic Resonance Imaging. We present measurements of
      effective moisture diffusivities, vertical mass distributions in foams, and
      crystallization of water and lipid components. The interpretation of this
      information allows one to quantify the interactions of various components and
      structural features within a sample. These measurements are made noninvasively
      and nondestructively and can be repeated over time to obtain information on the
      dynamics of the system.

PMID- 1746354
TI  - Thermoplastic starch.

PMID- 1746355
TI  - Crystallization from concentrated sucrose solutions.
AB  - When concentrated aqueous solutions of sucrose are cooled, ice or sucrose
      crystals separate, depending on the concentration and temperature. The state
      diagram of the sucrose-water system describes both the equilibrium and non
      equilibrium behaviour. A detailed account is given of the effect of sucrose
      concentration and various, principally polysaccharide, stabilizers on the
      processes of homogeneous and heterogeneous nucleation, as well as the kinetics of
      crystal growth. Increasing concentrations of sucrose reduce the diffusion
      coefficient of water molecules and the linear growth velocity of ice crystals.
      Polysaccharide stabilizers have relatively little effect until incipient gelation
      occurs. Thereafter, there is a gross change in crystal form and growth rate. A
      careful analysis of the impact of sucrose concentration on the rate of ice
      crystal growth has not permitted satisfactory matching of theoretical predictions
      with actual behaviour. Recent studies of the rate of growth of sucrose crystals
      in sucrose glasses of varying water contents are recorded. There is no simple
      relationship between the moisture content (in the 2-12 w/w % H2O range) and the
      rate of growth of the sucrose crystals.

PMID- 1746356
TI  - Wheat gluten: rheological and gas retaining properties.
AB  - Three general properties of the gluten proteins appear to be responsible for
      gluten's ability to product unique light products. First is the ability to form a
      cohesive dough. This probably results from the low charge density of the
      proteins, which allows for strong hydrogen and hydrophobic bonding. The second
      factor is the ability of the dough to retain gas. This appears to result from the
      slow diffusion of low molecular weight molecules, including carbon dioxide,
      through the gluten matrix. The third factor is the transformation of dough to
      bread. Little is known about this transformation.

PMID- 1746357
TI  - Leaching of amylose from wheat and corn starch.
AB  - Wheat starch gave a 21% yield (based on starch) of amylose (AM) when leached at
      3% solids under mild agitation, and at a heating rate of 10 degrees C/min to 95
      degrees C followed by holding at least 10 min. Annealing wheat starch prior to
      leaching at 95 degrees C or using a heating rate of 1 degrees C/min during
      leaching, increased AM yield from 21% to 23% at 3.0% starch solids, and 8% to 16%
      at 4.5% starch solids. At 0.5% solids, almost all wheat AM (29% of starch) was
      solubilized into the continuous phase at 95 degrees C, but only one-half of the
      lipid in the starch co-leached with AM. Corn starch behaved similarly to wheat
      starch during leaching below 1.5% starch solids, while at 3.0% almost 40% more AM
      was obtained from wheat than corn starch. Wheat AM molecules isolated by leaching
      were larger than those obtained by crystallizing its n-butanol complex, and they
      gave a different size-distribution as evidenced by high-performance size
      exclusion chromatography. A triangular phase diagram was useful in depicting the
      overall process of leaching AM from starch. The critical concentrations of wheat
      (5.4%) and corn (5.2%) starches were determined using phase diagrams.

PMID- 1746358
TI  - Ionic diffusion in frozen starch gels.
AB  - Quality changes in food frozen by different conditions and at different storage
      temperatures were demonstrated using a model system. A frozen starch gel
      represents a frozen food matrix, and ions in the external medium represent the
      reactant molecules. We determined the effective diffusion rates of Zn+2 ions into
      frozen starch gel cylinders that were frozen at different freezing rates. The
      diffusion was performed at -8 degrees and -15 degrees C. The amounts of ion
      diffused were determined by atomic absorption, whilst the structure of the frozen
      samples could be simultaneously determined by scanning electron microscopy. The
      effective diffusion rates were found to correlate with the amount of unfrozen
      portion of the samples. This suggests that ions move mainly through the unfrozen
      portion around the ice crystals. Fast- and slow-frozen samples exhibited
      significantly different effective diffusion rates at -15 degrees C, which might
      be due to differences in size and orientation of ice crystals. Zn+2 ions moved
      slower at -15 degrees C than at -8 degrees C.

PMID- 1746359
TI  - Resistance of lipid films to transmission of water vapor and oxygen.
AB  - Various lipids, present as thin films on polar filter paper supports, were
      evaluated for resistance to the transmission of water vapor (rH2O) and oxygen
      (rO2). Beeswax exhibited the largest r(H2O), followed in order by fully
      hydrogenated soy-rapeseed oil, stearyl alcohol, acetylated monoglycerides,
      hexatriacontane, tristearin, and stearic acid. Most of the lipids exhibited
      negative activation energies, E, for resistance to transmission of water vapor
      and positive Es for resistance to transmission of oxygen. The type of lipid
      support (hydrophobic or hydrophilic) also influenced E for resistance to water
      vapor transmission. Differences in r(H2O) for the various lipids, comparative
      r(H2O) and r(O2) values, and the temperature dependence of these values can be
      explained, in part, by the degree of hydrophilicity of the lipid molecule.
      Tempering at 48 degrees C of stearyl alcohol caused a substantial decrease in its
      permeability to oxygen and water vapor. The polymorphic form of a blend of fully
      hydrogenated soybean and rapeseed oil had a moderate influence on its
      permeability to oxygen and water vapor. This information will be useful for
      formulating lipid-containing films with controlled barrier properties to the
      passage of water vapor and oxygen.

PMID- 1746360
TI  - Compression of foods during freeze-drying: water plasticization at the ice-dry
      layer interface.
AB  - The compressive mechanical properties of freeze-dried green beans show a
      pronounced decrease in rigidity when moisture content and/or temperature are
      increased. There exist several temperature and moisture combinations which give
      common values for mechanical properties. These combinations also give a common
      compressive behavior. Using this information on mechanical properties, it is
      possible to predict a stress-strain relationship, if given either a temperature,
      a moisture content, or the value of a pertinent mechanical property. It is shown
      that the moisture contents and temperatures that exist in the dry layer during
      freeze-drying result in mechanical properties that are suitable for compression
      of the dry layer. From studies on compression behavior during freeze-drying, it
      is shown that applied compressive pressure is the main determinant of final
      degree of compression. Increasing the compressive pressure gave a higher
      compression effect and gave a more rapid drying, presumably due to improved heat
      transfer in the compressed dry layer. From the above information, a simple method
      to predict compression behavior during freeze-drying was developed.

PMID- 1746361
TI  - Molecular dynamics simulation of the aqueous solvation of sugars.
AB  - Recently, several molecular dynamics simulations of the aqueous solvation of
      carbohydrates have been reported. These studies represent the first theoretical
      picture available of the microscopic character of sugar solutions, and may
      provide explanations of the unusual and complex behavior of this class of
      molecules in solution. This paper will discuss two MD simulations of D
      glucopyranose, including a free energy perturbation calculation of the anomeric
      free energy difference. Solvation was found to have little effect upon the mean
      conformational structure of the pyranoid rings, but the presence of solvent
      significantly affected the motions and orientations of the exocyclic groups.
      Adjacent functional groups of the sugar rings were found to mutually perturb one
      another's hydration, depending upon the local stereochemistry, which may prove to
      play a part in the observed anomeric preferences of the sugars. From a component
      analysis of the free energy of solvation of the two anomers of D-glucopyranose,
      it was found that a large solvation term favors the beta anomer, which is the
      form found to be preferred in aqueous solution.

PMID- 1746362
TI  - Flexibility of globular proteins in water as revealed by compressibility.
AB  - In order to elucidate the flexibility-structure-function relationships of
      proteins, the adiabatic compressibility of about 30 globular proteins, including
      food proteins, was determined by means of sound velocity and density measurements
      in aqueous solutions. Most proteins studied showed positive compressibility,
      indicating the large internal flexibility of the molecules. The volume
      fluctuation was in the range of 30-200 ml/mol, which corresponded to about 0.3%
      of the total protein volume. From the statistical analyses of the compressibility
      data, it was found that the flexibility of proteins is closely related to
      structural factors such as hydrophobicity, helix element, and amino acid
      composition, and to functional properties such as digestibility and foaming
      capacity. These results indicate that the dynamics of protein structure should be
      taken into account in predicting precisely the functions and properties of a
      protein from its primary or tertiary structure.

PMID- 1746363
TI  - Interactions of ordered water and cations in the gel-forming polysaccharide
      gellan gum.
AB  - Gellan gum, useful to the food industry, is chosen as a model system for the
      investigation of the structural role of water molecules and cations in its gel
      forming properties. X-ray fiber diffraction technique has been used to determine
      the crystal structure of potassium gellan. This gives the three-dimensional
      structure of the polysaccharide, the locations of ordered water molecules, and of
      potassium ions. The precise interactions among the three components at molecular
      level reveal that the water molecules are essential for the stability of the
      polysaccharide chains, for the binding of cations with the polymer molecules, and
      for the aggregation of the polymers, all of which are crucial for the gelation
      process. Computer modeling shows how the calcium ions can directly crosslink
      adjacent gellan molecules, but the potassium ions cannot, and this explains the
      stronger gelation properties of calcium gellan, even at very low ionic
      concentrations. L-glycerate, but not acetyl, groups interfere with the
      intermolecular association of native gellan molecules and are thus responsible
      for its weak and rubbery gels.

PMID- 1746364
TI  - Ordered water in hydrated solid-state polysaccharide systems.
AB  - Water molecules within a monolayer or so of macromolecular surfaces are often
      located in well-defined positions and have restricted mobility. These ordered
      water molecules play a role in stabilizing polysaccharide ordered structures and
      intermolecular interactions that are the basis of the rheological properties
      utilized in food systems. X-ray fiber diffraction can be used to determine the
      three-dimensional structures of polysaccharides in solid, but well-hydrated,
      polycrystalline fibers. In favorable cases, difference Fourier synthesis can be
      used to locate ordered water molecules in these systems, allowing one to
      visualize their functionally important interactions. These studies provide
      relevant evidence regarding water interactions in more hydrated systems and in
      solution. The functionality of ordered water in some polysaccharides used in food
      systems, as well as in some connective tissue glycosaminoglycans where the
      ordered water has been defined in considerable detail, as determined by fiber
      diffraction, is described in this chapter. These structures allow one to derive
      some general features of the role of ordered water in such systems.

PMID- 1746365
TI  - [Visual evoked potential and relative afferent pupillary defect in patients with
      unilateral optic neuritis].
AB  - The relationships between relative afferent pupillary defect (RAPD) and visual
      evoked potential (VEP), visual acuity or visual field in 14 patients with
      idiopathic unilateral optic neuritis, were investigated during the period of
      recovery from an acute episode. Grading of RAPD into four steps mainly based upon
      an escape phenomenon in a swinging flashlight test, was used to determine the
      degree of RAPD. The degree of RAPD significantly correlated with a reduction in
      VEP amplitude, visual acuity and loss of central visual field, while it did not
      correlate with delay in VEP latency. These results suggest that RAPD is mainly
      related to the integrity of central vision, and that grading of RAPD, as well as
      a comparison of VEP amplitude between the affected and contralateral eyes, is
      useful for an objective evaluation of visual functions of the affected eyes in
      patients with unilateral optic neuritis.

PMID- 1746366
TI  - [Long-term changes in the corneal endothelium after intraocular lens
      implantation].
AB  - The characteristics of the corneal endothelium of 134 eyes which underwent
      extracapsular cataract extraction and intraocular lens implantation from 1984 to
      1990 were studied. We classified the initial 29 eyes as group 1 and the most
      recent 105 eyes as group 2. Endothelial cell loss of group 1 was much larger than
      that of the latter group, reflecting the degree of surgical damage. Endothelial
      cell of both groups decreased with index functions. The coefficient of variation
      of both groups showed no significant change during the observation period. The
      hexagonal cells of both groups decreased once after surgery, and it increased
      after one year in group 1, and after three months in group 2. However the late
      phase of the change of hexagonal cells appeared to have no relation to the degree
      of surgical damage. The change of hexagonal cells was supplemented by the
      appearance of pentagonal cells and heptagonal cells.

PMID- 1746367
TI  - [Retinochoroidopathy and systemic state in toxemia of pregnancy].
AB  - We carried out a retrospective study of 74 patients with toxemia of pregnancy
      with reference to retinochoroidal complications. Thirty-two patients (43.2%) had
      overt retinochoroidal disease; 23 cases (group A) showed retinal hemorrhages and
      cotton-wool spots compatible with hypertensive retinopathy, while 9 cases (Group
      B) had widespread serous retinal detachment associated with choroidal
      vasculopathy. There was no significant difference between the two groups in the
      severity of toxemia of pregnancy, in the hematologic examinations or in the fetal
      prognosis, although Group A showed a higher rate of fetal mortality, and Group B
      had a more significantly decreased platelet count and lower concentration of
      fibrinogen that may indicate a mild form of chronic disseminated intravascular
      coagulopathy.

PMID- 1746368
TI  - [Optic neuritis].

PMID- 1746369
TI  - [Effects of cigarette smoking on ocular circulation chronic effect on choroidal
      circulation].
AB  - The effects of long-term smoking on choroidal circulation were studied. For this
      purpose, Wistar rats were made to inhale mainstream smoke for 30 minutes daily.
      After periods of inhalation (16 weeks and 25 weeks), choroidal blood flow (CBF)
      was measured by the hydrogen clearance method and the index of choroidal vascular
      resistance (systolic tail arterial pressure/CBF) was calculated. There was no
      significant difference in CBF between either smoking group (16 weeks and 25
      weeks) and controls. However the index of choroidal vascular resistance increased
      significantly after inhalation of smoke for 25 weeks. No histopathological
      abnormalities were detected in the choroid and outer layer of the retina. The
      results suggested that long-term smoking might induce disturbance of choroidal
      circulation.

PMID- 1746370
TI  - [The distribution of actin on cultured oligodendrocytes from rat optic nerve].
AB  - Two types of cultured oligodendrocytes (OLs) from rat optic nerve were analyzed
      for the distribution of actin, a major contractile protein, using
      immunocytochemistry. Type 1 OLs showed extensive network of processes and type 2
      OLs showed elaborate membranous expansion along an extensive network. Actin was
      diffusely stained on an extensive network of processes in type 1 OLs and on the
      distal portion of membranous expansion in type 2 OLs, but some oligodendrocytes
      were not stained. It was demonstrated that the distribution of actin in type 1
      OLs and type 2 OLs varied with development in oligodendrocyte differentiation and
      maturation. Our results suggest that undifferentiated and immature
      oligodendrocytes display remarkable cell movement to search for target axons, and
      differentiated and mature oligodendrocytes do not require cell movement when
      myelination has finished. In conclusion, it is considered that actin plays an
      important role in myelinogenesis.

PMID- 1746371
TI  - [Studies on the ultrastructure of the inner limiting membrane of the retina-
      distribution of anionic sites in the inner limiting membrane of the retina].
AB  - For demonstrating ultrastructurally the distribution of anionic sites (AS) in the
      inner limiting membrane (ILM) of the rabbit's retina, the immersion method with
      cationic tracer, polyethyleneimine (PEI) was applied. This method was found to be
      simple and useful for the observation of AS in the ILM. In the posterior pole of
      the eyeball (visual streak and medullary ray), PEI particles were arranged evenly
      in the lamina rara (LR) of the ILM. The mean diameter of PEI particles was 20 nm,
      and intervals between them (40-50 nm) were the same as those of fine strands in
      the LR. However, the peripheral retina, the distribution of PEI particles were
      sparse and random, while in the lamina densa (LD) of each ILM, PEI particles were
      absent. AS stained with PEI were present in the residual vitreous fibers. These
      results may provide the morphological basis for the theory that AS of the ILM act
      as a charge barrier between the retina and the vitreous cavity.

PMID- 1746372
TI  - [A morphological classification of retinal ganglion cells in Chinese hamsters].
AB  - Retinal ganglion cells in Chinese hamsters were morphologically classified into
      alpha, beta and gamma cells by the horseradish peroxidase labeling method. The
      alpha cells had large somatic and dendritic fields. The beta cells were small to
      medium in somatic size and had small dendritic field size. The gamma cells had
      small to medium somatic and large dendritic fields. Each cell type had either
      symmetrical or asymmetrical dendrites arising from the soma. The dendrites of
      alpha, beta and gamma cells extended into either the internal or external stratum
      of the inner plexiform layer.

PMID- 1746373
TI  - [Intraocular light transmission characteristics using a microfiber system].
AB  - There have been some reports about light transmission into the vitreous, but few
      that have been measured directly in vivo. The author attempted to measure visible
      light and ultraviolet light using a microfiber system in the vitreous.
      Microfibers 0.6 mm in diameter were made. The microfiber system can be inserted
      into the vitreous at the pars plana and can measure the characteristics and
      intensity of the transmitted light. We used rabbit, monkey and aphakic rabbit
      eyes in this study. The light transmission into the vitreous of normal rabbits
      and monkey eyes gradually decreased from 400 nm to 360 nm, but the light
      transmission of the aphakic rabbit eyes did not distinctly decreased. This
      tendency was found in vivo and in vitro. It was considered that this system is
      useful to determine the light transmission characteristics of various eye
      conditions.

PMID- 1746374
TI  - [Analysis of electrically evoked response (EER) in relation to the central visual
      pathway of the cat (2). Response characteristics of the lateral geniculate
      neurons].
AB  - To analyze the electrically evoked response (EER) in relation to the central
      visual pathway, the response characteristics of the lateral geniculate neurons
      (LGNs) of the EER in 35 anesthetized adult cats were studied. Responses of the
      LGNs showed interindividual variation of more than one log unit in terms of the
      stimulus threshold for electrical stimuli. As the stimulus intensity increased,
      the spikes with constant latencies were recorded, which showed bursts with much
      stronger stimuli. The latencies of the spikes were closely correlated with those
      of negative components of EER. The LGNs were divided into two major groups by the
      latency. The periodical and alternative excitation of these neurons contributed
      to form the first negative wave of EER. The latency of these two major groups of
      LGNs was reversed when the electrode polarity was changed. At higher stimulus
      intensities, the components with short latency became dominant and those with
      longer latency were suppressed. The above results suggested that the periodical
      excitation of LGNs and the formation of the prominent EER components may result
      from the interaction between on- and off-type retinal ganglion cells and amacrine
      cells. It was also suggested that the origins of the wavelets in negative waves
      of EER at strong stimuli are the bursts of the spikes of the visual cortex
      neurons.

PMID- 1746375
TI  - [Recovery of visual field defects in ischemic optic neuropathy and idiopathic
      optic neuritis].
AB  - Fifty-four eyes of 41 patients with optic nerve disease demonstrating acute
      visual field defects without any traumatic, compressive, or other known etiology
      were classified into four categories. Those showing poor recovery of visual field
      defects were ischemic optic neuropathy which was subclassified into either
      anterior ischemic optic neuropathy (AION) or posterior ischemic optic neuropathy
      (PION) according to the ophthalmoscopic changes in the optic nerve head. Those
      showing good recovery of visual field defects were idiopathic optic neuritis
      which was subclassified into either papillitis or retrobulbar neuritis according
      to the ophthalmoscopic pathology of the optic disc. Patients with ischemic optic
      neuropathy were significantly older than those with optic neuritis. All eyes with
      optic neuritis showed good recovery of vision, whereas those with ischemic optic
      neuropathy showed varying outcomes of vision. With regard to the pattern of field
      defect, central or paracentral scotoma was predominant in all but eyes with AION
      in which altitude defect predominated. Pale swelling of the optic nerve head and
      angiographic evidence of circulatory disturbance in the optic disc or adjacent
      choroid were common findings in eyes with AION, whereas such findings were never
      observed in eyes with papillitis. The amplitude of pattern visual evoked
      potential was significantly lower in eyes with PION than in those with
      retrobulbar optic neuritis. Four patients classified as optic neuritis developed
      into multiple sclerosis in the follow-up study. It was concluded that poor
      recovery of visual field defect is one of the most convincing evidences for the
      diagnosis of ischemic optic neuropathy.

PMID- 1746376
TI  - [Visual functions of optic neuritis in children caused by demyelinating disease].
AB  - Optic neuritis in childhood caused by demyelinating disease is very rare, and its
      effect on visual function has not been well documented. The visual function of 11
      patients treated in the last 11 years was retrospectively studied and the results
      were compared with 15 cases of optic neuritis of unknown etiology. Optic neuritis
      in children with demyelinating disease was characterized as follows. 1. abnormal
      visual evoked cortical potentials (VECP) and color vision were found not only in
      the affected eye but also in the non-affected fellow eye, 2. VECPs became normal
      long after the recovery of visual acuity, 3. full recovery of visual function
      took longer, 4. at onset, vision was more severely affected, but showed a good
      outcome. These findings provide useful information to make a diagnosis of
      multiple sclerosis even at the first attack of optic neuritis.

PMID- 1746377
TI  - Beyond critical care: appearance-related afflictions.
AB  - There is no reason to believe that humans will not continue in their never-ending
      quest for self-fulfillment, for in it mankind carries forward the purpose of life
      itself. Through the art and science of aesthetics, specialists throughout the
      various health professions are cooperating to help individuals from all socio
      economic backgrounds overcome appearance-related afflictions and improve the
      quality of life. (Figure 10).

PMID- 1746378
TI  - AHCPR estimates cost of treating HIV infection.

PMID- 1746379
TI  - The odd couple.

PMID- 1746380
TI  - Bicycling and ulnar tunnel syndrome.

PMID- 1746382
TI  - Domestic violence hotline.

PMID- 1746381
TI  - Pregnant patients with HSV infection.

PMID- 1746383
TI  - Shoulder manipulation by DOs.

PMID- 1746384
TI  - AAFP white paper on proprietary relationships: just do the right thing.

PMID- 1746385
TI  - The National Screening Initiative and the family physician.

PMID- 1746386
TI  - Common oral mucosal lesions in adults.
AB  - Patients often present to family physicians with oral lesions. According to a
      recent study, the 10 most common oral mucosal lesions comprise almost three
      quarters of oral lesions. The most common oral lesions are leukoplakia, tori,
      inflammatory lesions, fibromas, Fordyce's granules, hemangiomas, ulcers,
      papillomas, epuli and varicosities.

PMID- 1746387
TI  - Acute sinusitis: diagnosis and treatment update.
AB  - Acute sinusitis in adults is manifested by fever, facial pain and purulent
      rhinorrhea, but children--who rarely have headache or facial tenderness--have
      persistent cough in addition to fever and purulent rhinorrhea. Sinus
      transillumination is diagnostically useful only in adults. In children, maxillary
      sinus radiographs are indicated. New studies show ultrasound examination to be
      less sensitive than plain radiographs. Cultures obtained by aspiration of the
      maxillary sinuses are useful in complicated cases. Amoxicillin is still effective
      as first-line treatment, but treatment failure requires a prompt change to
      trimethoprim-sulfamethoxazole or ciprofloxacin. Nosocomial sinusitis requires
      coverage for gram-negative bacteria, including Pseudomonas aeruginosa.
      Immunocompromised patients, including those with acquired immunodeficiency
      syndrome, require treatment for fungal organisms. Decongestants are of unproven
      value. Referral for irrigation and surgical drainage is indicated for recurrent
      or recalcitrant sinusitis. Flexible endoscopy allows visualization and
      debridement of diseased tissue in cases of chronic sinusitis.

PMID- 1746388
TI  - Psychosocial issues in symptomatic HIV infection.
AB  - Psychosocial issues are a major factor in the quality of life of a patient with
      advanced human immunodeficiency virus infection. To provide effective, supportive
      care, the physician must assess the patient's psychosocial needs, with an
      understanding of the patient's sociocultural background. Good communication and a
      multidisciplinary team approach are essential aspects of successful management.
      Unconditional emotional support and both verbal and nonverbal expressions of
      caring increase patient compliance and comfort. Appropriate treatment of
      neuropsychiatric syndromes and debilitating physical symptoms also add
      significantly to the patient's quality of life. Most importantly, the patient
      must be given the opportunity to be an active participant in decisions about
      treatment and lifestyle.

PMID- 1746389
TI  - Risk factors for poor nutritional status in older Americans.
AB  - Inappropriate dietary intake and chronic disease or disability place a
      substantial number of older adults at high risk of malnutrition. Malnutrition
      often results in considerable dysfunction and disability, reduced quality of life
      and, in some instances, premature or increased morbidity and mortality. Nutrition
      screening should prevent nutrition-related problems or allow early intervention.
      The elements that contribute to nutritional problems in the elderly must be
      clearly identified and prioritized. The desired goal of nutrition screening is a
      more vigorous older population able to maintain optimal nutrition, resulting in
      improved health and quality of life.

PMID- 1746390
TI  - Anticoagulants, iliopsoas hematoma and femoral nerve compression.
AB  - A case of bilateral compression femoral neuropathy due to iliopsoas muscle
      hematomas during anticoagulant therapy is described. Diagnosis was confirmed with
      computed tomographic scan. The right hematoma was larger than the left and caused
      a more severe femoral neuropathy. The hematoma on the right side was surgically
      evacuated, and the left-sided one was treated conservatively. The patient had a
      complete recovery.

PMID- 1746391
TI  - Weight-training injuries in children and adolescents.
AB  - Thousands of children and adolescents participate in weight lifting for
      recreation or as a means of training for sports. Weight lifting can cause serious
      musculoskeletal injuries, such as ruptured intervertebral discs, spondylolysis
      and spondylolisthesis, fractures and meniscal injuries of the knee. Deaths
      related to weight lifting have been reported. Although the incidence of weight
      lifting injuries is not well documented in children and adolescents, several
      reports indicate that few injuries occur in carefully supervised programs. The
      most common cause of injury appears to be loss of form when heavy weights are
      lifted. Proper technique, good supervision and training programs appropriate to
      the athlete's level of physical and emotional maturity are important.

PMID- 1746392
TI  - An introduction to tympanometry.
AB  - The tympanogram is an objective measure of middle ear effusion or eustachian tube
      dysfunction. It provides information about the compliance or mobility of the
      tympanic membrane, the pressure within the middle ear and the volume of the
      external ear canal. Tympanograms are classified as type A (normal), type B
      (indicating fluid behind the tympanic membrane) or type C (indicating eustachian
      tube dysfunction). The objective data obtained by tympanometry are a useful
      adjunct in the diagnosis and follow-up of middle ear disease.

PMID- 1746393
TI  - Commonly used suture materials in skin surgery.
AB  - The ideal suture is strong, handles easily and forms secure knots. It causes
      minimal tissue inflammation and does not promote infection. It stretches,
      accommodates wound edema and recoils to its original length with wound
      contraction. Ideally, it is also inexpensive. Although no single suture material
      possesses all of these features, proper selection of sutures helps achieve better
      results in skin surgery. Among the absorbable sutures are catgut and treated
      catgut (both are used infrequently) and the synthetic sutures, which are designed
      for good tensile strength, easy handling and low tissue reactivity. Nonabsorbable
      sutures include silk (now infrequently used) and several synthetic materials
      designed for elasticity, easy handling, good knot security and minimal tissue
      irritation.

PMID- 1746394
TI  - CPR in hospitalized patients: when is it futile?
AB  - When cardiac or pulmonary arrest occurs in hospitalized patients, cardiopulmonary
      resuscitation (CPR) is often futile. Although "do-not-resuscitate" orders are
      widely used and presumably screen out many patients who are poor candidates for
      CPR, recent studies have shown that an average of only 13 percent of patients
      receiving CPR in the hospital survive to discharge. An average of 4 percent of
      patients receiving CPR in general ward settings survive. Of those who do survive
      after CPR, many are in a persistent vegetative state or a chronic dependent
      condition. Patients with malignancy, sepsis, pneumonia, renal failure, diabetes
      or advanced age have a low chance of surviving after CPR. It is important for
      both patients and physicians to make a realistic appraisal of the likely outcome
      of CPR.

PMID- 1746395
TI  - Treatment of bacterial prostatitis.
AB  - Bacterial prostatitis can be distinguished from nonbacterial prostatitis on the
      basis of the symptoms, the findings on physical examination and the results of
      microbiologic testing. Evaluation of fractionated urine specimens, including
      expressed prostatic secretions, is helpful in making the diagnosis. Bacterial
      prostatitis may be acute or chronic. Acute prostatitis can be a serious illness
      requiring inpatient treatment with parenteral antibiotics. Chronic prostatitis is
      difficult to cure, and prolonged antibiotic therapy is required for eradication
      of symptoms. The most useful agents for the treatment of prostatitis include
      trimethoprim-sulfamethoxazole and the fluoroquinolones. Evidence indicates that
      fluoroquinolones may result in superior symptom control and microbiologic cure.

PMID- 1746396
TI  - Patient-controlled analgesia.
AB  - It has become increasingly obvious that traditional narcotic dosage schemes are
      not optimally effective in relieving pain. Inadequate relief of pain results in
      increased patient morbidity, probably due to adverse effects on the neurologic,
      endocrine, pulmonary and cardiovascular systems. Insufficient pain relief also
      contributes to patient dissatisfaction. Patient-controlled analgesia allows a
      patient to balance analgesic levels with the degree of pain relief required. This
      analgesic technique is easy to use and is well accepted by patients, physicians
      and nurses. Significant benefits include earlier ambulation, decreased overall
      narcotic use, improved postoperative pulmonary function, shorter hospital stay
      and reduced health care costs.

PMID- 1746397
TI  - Update on breast implants.

PMID- 1746398
TI  - AAFP Congress approves statement on ethics of proprietary relationships.

PMID- 1746399
TI  - AAFP age charts for periodic health examinations: 19 months to six years.

PMID- 1746400
TI  - Combination test for HIV-1 and HIV-2 licensed.

PMID- 1746401
TI  - Didanosine approved for advanced AIDS.

PMID- 1746402
TI  - Graphical description of health threat defeats parent company opinion.

PMID- 1746403
TI  - Confusion regarding asbestos data and censoring.

PMID- 1746404
TI  - Hexamethylenetetramine: a review.

PMID- 1746405
TI  - Guideline for chemical exposure to the skin.

PMID- 1746406
TI  - A transportable, remote sensing, infrared air-monitoring system.
AB  - A transportable, remote sensing instrument has been built that is capable of
      performing real-time quantitative analysis of gas and vapor contaminants of
      workplace air. The emphasis in this system is on simplicity and sensitivity for
      use over pathlengths of up to 40 m. A method was developed to overcome the effect
      of nonanalyte species present in the background spectrum on the quantitation of
      analytes in the sample spectrum. In addition, results demonstrated that
      instrument response was proportional to the beam pathlength under homogeneous
      concentration conditions. The application of software capable of qualitative
      analysis was also demonstrated.

PMID- 1746407
TI  - Modeling a worker's exposure from a hand-held source in a uniform freestream.
AB  - The phenomenon of boundary layer separation can be an important factor in
      determining a worker's exposure to toxic airborne pollutants. A conceptual model
      was developed to understand this phenomenon and to predict the average
      concentration in the reverse flow region downstream of a worker in a uniform
      freestream. Subsequently, the assumptions of this model were tested
      experimentally in wind tunnel studies. On the basis of these results, a revised
      model is presented and validated by using a tracer gas method. The revised model
      provides a reasonable estimate of the average concentration in the reverse flow
      region of the mannequin. Empirical models are presented that relate both the
      average concentration in the reverse flow region and the breathing zone
      concentration to the body dimensions and the freestream air velocity.
      Applications and limitations of the results are discussed.

PMID- 1746408
TI  - Evaluation of the acute toxicity of silahydrocarbon.
AB  - Silahydrocarbon (SHC) is a base stock for a candidate high-temperature hydraulic
      fluid. Because United States Air Force personnel working with SHC may be exposed
      to potential health hazards, a complete battery of acute toxicity tests was
      performed with the fluid. A single neat dose of 0.1 mL SHC into New Zealand White
      (NZW) rabbit eyes resulted in slight conjunctival irritation 1 hr after treatment
      in all unflushed eyes and one of three flushed eyes. Conjunctival irritation
      persisted through 24 hr but dissipated by 48 hr. Rinsing the eyes after treatment
      was of questionable benefit. A single treatment of 0.5 mL neat SHC to rabbit skin
      produced negative results for all but a single animal, which had very slight
      erythema at the test site 48 hr after treatment. Guinea pigs failed to exhibit a
      sensitization response following repeated application of SHC. A single oral dose
      of 5 g SHC/kg body weight given to five male and five female F-344 rats and a
      single dermal dose of 2 g SHC/kg body weight applied to five male and five female
      NZW rabbits resulted in no deaths or signs of toxic stress. Five male and five
      female F-344 rats were exposed to 4.8 mg/L (near limit concentration) of
      aerosolized SHC for 4 hr. All male rats and four female rats survived. During
      exposure, the animals exhibited signs of eye and upper respiratory irritation.

PMID- 1746409
TI  - Muconic acid determinations in urine as a biological exposure index for workers
      occupationally exposed to benzene.
AB  - Urinary phenol determinations have traditionally been used to monitor high levels
      of occupational benzene exposure, but the same technique cannot be used to
      monitor low-level exposures because of the high background of phenol resulting
      from its presence in many foods and from metabolism of aromatic amino acids.
      Thus, new biological indexes for exposure to low levels of benzene are needed.
      Animal studies indicate that muconic acid is a metabolite of benzene that is
      excreted in the urine as an increasing fraction of the total benzene metabolites
      with decreasing dose of benzene. Thus, urinary muconic acid is potentially useful
      as a monitor for low levels of exposure to benzene. It is also of interest to
      determine the level of muconic acid in the urine of humans exposed to benzene for
      comparison with animal data as an aid for use of the animal studies in risk
      assessments for humans. This report describes the development of a gas
      chromatography/mass spectrometry assay to detect and quantitate the benzene
      metabolite, muconic acid, in urine. The internal standard used in the assay,
      muconic acid-d4, was biosynthesized by F344/N rats administered benzene-d6 by
      gavage; the muconic acid was isolated from the rat's urine. Muconic acid was
      measured in experimental urine samples by adding the internal standard, followed
      by extraction and derivatization. Phenol was also measured in urine after
      extraction and derivatization. The assays were applied to the urine samples from
      14 workers occupationally exposed to benzene and 8 workers with no known benzene
      exposure. Muconic acid could be detected in all of the urine samples at levels
      greater than 100 ng/mL.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746410
TI  - Exposure to airborne asbestos associated with simulated cable installation above
      a suspended ceiling.
AB  - Installing cable above a suspended ceiling in the presence of asbestos-containing
      fireproofing is an example of an activity that may disturb in-place asbestos and
      associated dust and debris. Two simulations of cable installation were conducted
      in a room of an unoccupied school to test the extent of such disturbance and
      resulting elevations in airborne asbestos. Average airborne asbestos
      concentrations in the room increased over 500-fold during the simulations, with
      several samples exceeding 50 structures per cubic centimeter (s/cm3), as measured
      by transmission electron microscopy (TEM) with an indirect preparation technique.
      Elevated concentrations persisted during a subsequent cleaning of horizontal
      surfaces in the room and for several hours thereafter. Personal samples collected
      on the cable installers yielded TEM measurements averaging approximately 68 s/cm3
      for the two simulations.

PMID- 1746411
TI  - Wood dust exposure during furniture manufacture--results from an Australian
      survey and considerations for threshold limit value development.
AB  - A survey of time-weighted average (TWA) personal inhalable dust exposures for
      woodworkers in 15 Australian furniture factories was undertaken. There was
      significant variation in the individual dust measurements with mean exposures of
      3.2, 5.2, and 3.5 mg/m3 for wood machinists, cabinetmakers, and chair
      framemakers, respectively. Hardwoods, softwoods, and reconstituted woods are used
      in the industry, but only minor differences in mean exposures or particle size
      distributions were found for the broad categories. In addition, a modified
      British Medical Research Council respiratory questionnaire was used to obtain
      information about work-related symptoms and job activities. Compared with a
      control group, the woodworkers reported more eye, ear, and nasal problems, with
      the differences being statistically significant. However, among the woodworkers
      themselves, with the exception of several nasal symptoms, the prevalences of
      reported symptoms were poorly correlated with gravimetric measurements of
      personal dust exposure. The problem of selection bias in cross-sectional studies
      is discussed. For a mean TWA personal exposure of about 3 mg/m3, hardwood users
      were more likely to report nasal symptoms than users of reconstituted wood. The
      question of appropriate exposure standards for woods in general is addressed by
      reference to those important health effects, besides sino-nasal cancer, that have
      been investigated. Further exposure guidelines should be formulated for groups of
      woods that are known to cause a common health effect, such as nasal/respiratory
      sensitization.

PMID- 1746412
TI  - A measure of goodness-of-fit for the lognormal model applied to occupational
      exposures.
AB  - The lognormal distribution is often applied to occupational exposures, yet the
      assumption of lognormality is rarely verified. This lack of rigor in evaluating
      the appropriateness of the lognormal model has resulted, in part, from the
      difficulty of applying formal goodness-of-fit tests. When evaluation of model fit
      has been attempted, occupational hygienists have relied upon probability plotting
      of exposures rather than upon formal statistical methods. The goal of this work
      was to develop for the occupational hygienist a simple quantitative evaluation to
      supplement the probability plot. A measure of goodness-of-fit to the lognormal
      model based on the ratio of two estimators of the mean of the distribution, the
      simple or direct estimate of the mean and the maximum likelihood estimate of the
      mean of a lognormal distribution, is described. This new measure, the ratio
      metric, is a simple extension of calculations made routinely by many occupational
      hygienists. Results from using the ratio metric were compared to probability
      plotting and to two traditional measures of goodness-of-fit, the Lilliefors test
      and the W test, for two occupational exposure data sets. The results of the ratio
      and W tests are comparable for a variety of occupational exposure data, but the
      Lilliefors test is overly conservative and does not detect several cases of gross
      deviations from lognormality. The ratio metric is an effective alternative to the
      Lilliefors test and is easier to perform than the W test for the range of data
      usually encountered by occupational hygienists. Occupational hygienists are
      encouraged to use the ratio metric in conjunction with the probability plot in
      evaluating the lognormal assumption.

PMID- 1746413
TI  - Ventricular remodeling and unloading following myocardial infarction. A
      symposium. April 5-6, 1991, Barbados.

PMID- 1746414
TI  - Early treatment of acute myocardial infarction with angiotensin-converting enzyme
      inhibition: safety considerations. SMILE pilot study working party.
AB  - The use of angiotensin-converting enzyme (ACE) inhibitors in acute myocardial
      infarction (AMI) is based on their capacity to limit ventricular enlargement and
      dysfunction. To date, the safety profile of administration of ACE inhibitors
      early in the course of AMI has not been established. In-hospital and long-term
      consequences of treatment with the ACE inhibitor zofenopril initiated within 24
      hours of the onset of symptoms were compared with those of standard treatment in
      an open-label trial involving 204 patients with AMI who were not undergoing
      thrombolytic treatment. Zofenopril promptly blocked ACE activation. Blockade was
      almost complete (91 +/- 6%) after 72 hours and paralleled decreases in systolic
      blood pressure. Systemic blood pressure was acutely reduced by zofenopril, and
      severe but reversible hypotension occurred in 15% of hospitalized patients and in
      3% of those treated over the long term. No adverse clinical or biochemical events
      were reported during the course of zofenopril therapy. Overall cardiovascular
      mortality was not significantly reduced by early zofenopril compared with placebo
      therapy (7.8% vs 10.7% [difference not significant]). The inhospital incidence of
      acute left ventricular failure and ventricular arrhythmias decreased by 63% and
      39%, respectively, among zofenopril-treated patients, who also reported fewer
      anginal episodes both acutely (68% reduction) and over the long term (56%
      reduction) and did not require as much drug treatment (i.e., diuretics, digoxin,
      and/or anti-ischemic agents) during the follow-up phase. Left ventricular size
      decreased and ejection fraction (EF) increased in patients who received
      zofenopril, and the improvement was greater among patients with poorer
      ventricular function (EF less than 40%). Early administration of ACE inhibitors
      may therefore constitute a safe form of therapy for patients with AMI,
      particularly when the event is complicated by clinical signs or evidence of
      ventricular dysfunction.

PMID- 1746415
TI  - Early intervention with angiotensin-converting enzyme inhibitors during
      thrombolytic therapy in acute myocardial infarction: rationale and design of
      captopril and thrombolysis study. CATS investigators group.
AB  - The adjunctive use of angiotensin-converting enzyme (ACE) inhibitors with
      thrombolytic therapy early during acute myocardial infarction offers theoretic
      advantages. In the acute phase, captopril may scavenge free radicals, blunt the
      catecholamine response, elicit coronary vasodilation, and increase prostacyclin
      and bradykinin levels. In the chronic phase, ventricular remodeling may be
      attenuated. At present, a large number of controlled clinical trials mainly
      focusing on the effects of ACE inhibition in the chronic phase are underway. Only
      a few studies concentrate on the effect of acute intervention with ACE inhibitors
      in ischemia-reperfusion, i.e., thrombolysis in myocardial infarction. In April
      1990 under auspices of the Interuniversity Cardiology Institute of the
      Netherlands, a large nationwide acute intervention trial with captopril in 280
      patients receiving thrombolytic therapy was started, the Captopril and
      Thrombolysis Study (CATS). The primary hypothesis of CATS supposes a very early
      effect of ACE inhibition on evolving myocardial damage due to ischemia and the
      consequences of early reperfusion. This will be evaluated by serial
      echocardiography, Holter monitoring and neurohumoral measurements immediately on
      thrombolysis and during the first year after myocardial infarction.

PMID- 1746416
TI  - Influence of severity of heart failure on the efficacy of angiotensin-converting
      enzyme inhibition.
AB  - Angiotensin-converting enzyme (ACE) inhibition slowed the progression of
      congestive heart failure (CHF) in 170 patients who were randomly assigned to
      either captopril or placebo in the Munich Mild Heart Failure Trial. The two major
      end points were progression from New York Heart Association (NYHA) functional
      classes I, II, or III to class IV, despite optimal, adjusted standard therapy,
      and death due to CHF. The relative risk for progressive CHF with captopril
      therapy was 0.34 (95% confidence interval = 0.17-0.68; p = 0.01). A total of 52
      prerandomization variables were tested to determine their contribution to disease
      progression. Logistic regression analysis revealed 5 independent risk factors for
      progressive CHF: NYHA class, left ventricular end-systolic diameter, need for
      diuretic, age, and cardiothoracic ratio. The presence of greater than 2 of these
      risk factors increased the odds ratio for progression to 8.13 (p less than 0.001)
      compared with the presence of 0-2 risk factors. However, the effectiveness of
      captopril in preventing progression was higher within the subgroup of patients
      who had less severe CHF: the odds ratio was 0.12 (95% confidence interval = 0.03
      0.45; p less than 0.01) for patients in NYHA class I or II on captopril and was
      0.83 for those in class III. We conclude that the severity of CHF, as represented
      by the above-defined risk factors, is directly related to the likelihood for the
      development of progressive heart failure. However, the less severe the heart
      failure, the more effective the treatment with captopril will be in preventing
      disease progression. Thus, ACE inhibition has considerable potential for
      improving the prognosis of patients with mild heart failure.

PMID- 1746417
TI  - Effects of captopril on contractility after myocardial infarction: experimental
      observations.
AB  - After large myocardial infarction, compromised left ventricular (LV) function and
      changes in the peripheral circulation result in the syndrome of chronic
      congestive heart failure. Although treatment with angiotensin-converting enzyme
      inhibitors improve cardiovascular function, it is difficult to determine whether
      this benefit is due to changes in organ versus muscle function. The rat model of
      heart failure, created by ligating the left coronary artery, results in
      pathophysiology that is similar to that seen in patients, i.e., increased LV end
      diastolic pressure and volume, hypertrophy of the noninfarcted myocardium,
      prolongation of the time constant of LV relaxation, decreased venous compliance,
      and increased total blood volume. In noninfarcted papillary muscles, isolated
      from rats with heart failure, maximal developed tension and peak rate of tension
      rise (+dT/dt) are decreased, time to peak tension is prolonged, and myocardial
      stiffness is increased. Morphologic changes include an increase in papillary
      muscle myocyte cross-sectional area and an increase in myocardial hydroxyproline
      content. Captopril (2 g/liter drinking water) alters LV loading by decreasing
      arterial pressure, increasing venous compliance, and decreasing blood volume.
      This results in a decrease in LV end-diastolic pressure and volume. In the
      noninfarcted myocardium, time to peak tension is shortened, whereas developed
      tension, +dT/dt, and muscle stiffness remain abnormal. Captopril decreases
      myocyte cross-sectional area, but collagen content remains elevated. Thus, in the
      rat infarct model of heart failure, treatment with captopril alters LV remodeling
      and hypertrophy but produces only modest improvement in muscle function.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1746418
TI  - Fourth International Study of Infarct Survival: protocol for a large simple study
      of the effects of oral mononitrate, of oral captopril, and of intravenous
      magnesium. ISIS-4 collaborative group.
AB  - The fundamental aim of the International Studies of Infarct Survival (ISIS)
      collaborative group is to assess reliably the balance of any benefits and risks
      for widely practicable treatments that might produce moderate but worthwhile
      mortality reductions in patients with suspected acute myocardial infarction.
      Substantial numbers of lives might be saved by such treatments, but benefits of
      the size that can realistically be expected may be reliably detected only by
      randomized trials involving some tens of thousands of patients. In order to
      recruit such numbers, ISIS involves almost no extra work for collaborators:
      hence, busy general hospitals--where the majority of acute myocardial infarction
      patients are actually treated--can take part easily. The ability of the ISIS
      trials to yield clear, reliable answers depends entirely on the collaboration of
      many doctors and nurses in the participating hospitals. For this reason,
      publication of the final results is in the names of all the collaborators. All
      patients, high risk as well as low risk, presenting within 24 hours of the onset
      of suspected acute myocardial infarction are eligible for ISIS-4, provided that
      the responsible physician does not initially consider there to be any clear
      indications for, or clear contraindications to, any one of the trial treatments-
      nitrate, angiotensin-converting enzyme inhibitor, or magnesium. Patients are
      randomized between 1 month of oral controlled-release mononitrate or placebo;
      between 1 month of oral captopril or placebo; and between 24 hours of intravenous
      magnesium or open control (i.e., no infusion). (Patients who are to be given
      intravenous or other non-trial nitrate for just a few days can still be entered).
      In this trial, 3 quite different treatments will each be evaluated. At first
      glance, this may appear to complicate the results, but in fact appropriate
      statistical analysis of this "factorial" design will allow all patients to
      contribute fully to assessment of the separate effects of each treatment (while
      also providing important information about the combined effects). Apart from
      giving the trial treatments, all other aspects of individual patient management
      are left entirely to the responsible physician to decide. For example, previous
      trials in suspected acute myocardial infarction have shown that, for many
      categories of patients, antiplatelet and fibrinolytic therapy can save lives.
      Hence, most collaborating doctors will wish to give antiplatelet therapy
      routinely and to start fibrinolytic therapy in many of their patients before
      randomizing them in ISIS-4.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1746419
TI  - Relation between acute ventricular arrhythmias, ventricular late potentials and
      mortality in acute myocardial infarction.
AB  - The relation between ventricular late potentials and the occurrence of acute (in
      hospital) and hyperacute (before hospital admission) ventricular tachycardia or
      fibrillation was studied in 281 consecutive patients with uninterrupted acute
      myocardial infarction. The prevalence of late potentials was significantly higher
      in patients with than without ventricular tachycardia/fibrillation (65 vs 22%; p
      less than 0.01). These relations persisted among patients with left bundle branch
      block, although a different definition was used for identifying late potentials
      in these patients. Multivariate analysis showed that presence of late potentials
      and peak creatine kinase enzyme level were the only 2 independent variables
      associated with early ventricular tachycardia/fibrillation. Total in-hospital
      mortality, as well as in-hospital cardiac mortality, was significantly higher
      among patients with than without acute ventricular tachycardia/fibrillation.
      However, at 1 year, mortality rates did not differ between the 2 groups. The
      following conclusions were drawn from this study: (1) Late potentials are closely
      related to ventricular tachycardia/fibrillation in hyperacute and acute phases of
      infarction. (2) Presence of left bundle branch block does not mitigate against
      the finding of late potentials in these patients. (3) Early ventricular
      tachycardia/fibrillation in acute infarction is related to large infarctions and
      to a high in-hospital mortality rate.

PMID- 1746420
TI  - Importance of myocardial infarct artery patency on the prevalence of ventricular
      arrhythmia and late potentials after thrombolysis in acute myocardial infarction.
AB  - Sustained infarct artery patency is an important determinant of survival in
      patients with acute myocardial infarction. We studied 61 patients with acute
      myocardial infarction who received intravenous recombinant tissue-type
      plasminogen activator, aspirin or heparin within 6 hours of symptom onset, to
      determine if infarct artery patency after intravenous thrombolytic therapy
      influences myocardial electrical stability as measured by the prevalence of
      spontaneous ventricular ectopy or late potential activity. Infarct artery patency
      was determined by angiographic evaluation 2.5 +/- 3 days after infarction. Forty
      eight patients (79%) had a patent infarct-related artery and 13 (21%) patients
      had an occluded vessel. The mean number of ventricular premature complexes
      (VPCs)/hour (p less than 0.01) and the prevalence of late potentials (54 vs 19%;
      p less than 0.03) were significantly higher in patients with an occluded versus
      patent-infarct related vessel. Although VPC frequency and late potentials were
      not influenced by the time to thrombolytic treatment, patients with a patent
      infarct-related artery had a lower prevalence of late potentials regardless of
      whether treatment was initiated less than or equal to 2 hours (25% patent vs 50%
      occluded; p = not significant) or 2 to 6 hours (16% patent vs 55% occluded; p
      greater than 0.03) after symptom onset. Thus, successful thrombolysis decreases
      the frequency of ventricular ectopic activity and late potentials in the early
      postinfarction phase. The reduction in both markers of electrical instability may
      help explain why the prognosis after successful thrombolysis is improved after
      acute myocardial infarction.

PMID- 1746421
TI  - Usefulness of QRST time-integral values of 12-lead electrocardiograms in
      diagnosing healed myocardial infarction complicated by left bundle branch block.
AB  - The usefulness of QRST time-integral (IQRST) values of 12-lead electrocardiograms
      for diagnosing a prior myocardial infarction complicated by left bundle branch
      block (LBBB) was determined. The study consisted of 25 patients with LBBB (11
      with and 14 without myocardial infarction). The IQRST values in each lead point
      of 12-lead electrocardiograms were calculated. Data from 607 normal subjects were
      used as controls and mean +/- 2 standard deviations was regarded as the normal
      range. The following parameters were derived: number of leads less than the
      normal range of IQRST values (nQRST) and sum of the differences between the
      normal mean IQRST value and IQRST value of a given patient in leads where this
      value was less than the normal range (sigma QRST). The criteria of nQRST (12
      lead) greater than or equal to 5 and sigma QRST (12-lead) greater than or equal
      to 500 microV in 12-lead electrocardiograms were selected on a relative
      cumulative frequency distribution and demonstrated the presence of a myocardial
      infarction in LBBB with a sensitivity of 82% and a specificity of 100% for each.
      With regard to the localization of the myocardial infarction, the criterion of
      sigma QRST (V1-6) greater than or equal to 300 microV in leads V1-6 of 12-lead
      electrocardiograms demonstrated the presence of an anterior myocardial infarction
      in the LBBB with a sensitivity of 88% and a specificity of 77%. It was difficult
      to localize an inferior myocardial infarction in patients with LBBB by using
      IQRST values of inferior leads.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746422
TI  - Effects of high-density lipoprotein on acetylcholine-induced coronary
      vasoreactivity.
AB  - Recent evidence suggests that high-density lipoprotein (HDL) cholesterol has
      important vasoactive properties which may contribute to its beneficial effects on
      atherosclerotic coronary artery disease. The endothelium-dependent vasodilator
      acetylcholine has been used in a number of experimental studies to assess
      endothelial function. The relation between serum lipoproteins and acetylcholine
      induced coronary vasoreactivity was investigated in patients (n = 27) undergoing
      elective coronary arteriography. Mean serum cholesterol, low-density lipoprotein
      cholesterol, HDL cholesterol and triglyceride levels were 189 +/- 7 (4.84 +/-
      0.18 mmol/liter), 134 +/- 6 (3.47 +/- 0.15 mmol/liter), 41 +/- 3 (1.06 +/- 0.08
      mmol/liter) and 106 +/- 30 mg/dl (1.20 +/- 0.03 mmol/liter), respectively. After
      a baseline arteriogram, acetylcholine was infused into the left main coronary
      artery and percent change from baseline dimension was determined in 27
      angiographically smooth coronary artery segments and in 14 arterial segments with
      evidence of mild atherosclerotic disease. Intact vascular smooth muscle function
      was then confirmed in all segments by dilation to intracoronary nitroglycerin.
      Acetylcholine produced significant vasoconstriction of both angiographically
      smooth (13 +/- 4%, p less than 0.05 vs baseline) and diseased (19 +/- 4%, p less
      than 0.05 vs baseline) coronary segments. A positive correlation was observed
      between HDL cholesterol and normal acetylcholine-induced coronary vasoreactivity
      in both angiographically smooth (r = 0.59, p less than 0.001) and diseased (r =
      0.62, p less than 0.02) coronary segments. No significant correlation was
      observed, however, between total and low-density lipoprotein cholesterol, or
      between total cholesterol to HDL ratio and the response of coronary artery
      diameter to acetylcholine infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746423
TI  - Effects of serum lipid levels on restenosis after coronary angioplasty.
AB  - Although the association of serum lipid levels with the risk of atherosclerosis
      is well-recognized, the relation between these levels and restenosis after
      coronary angioplasty is uncertain. This study examines 186 patients enrolled in a
      trial of fish oil for prevention of restenosis. Fasting lipid levels
      (cholesterol, high density lipoprotein (HDL) cholesterol and triglycerides) were
      measured before angioplasty, and in 90 patients repeated at 6-month follow-up.
      Fifty-nine patients (32%) developed clinical restenosis confirmed by angiography.
      Patients who went on to develop restenosis underwent multivessel angioplasty (p
      less than 0.05) and were more likely to be on lipid-lowering therapy at baseline
      (27 vs 13%; p less than 0.05). In addition, they had higher baseline
      cholesterol/HDL ratios (6.5 +/- 2.2 vs 5.9 +/- 2.0; p less than 0.05) and
      triglyceride levels (233 +/- 210 vs 183 +/- 112 mg/dl; p less than 0.05).
      Multiple logistic regression analysis confirmed cholesterol/HDL ratios at
      baseline (p = 0.021) and follow-up (p = 0.0008) to be independent predictors of
      risk for restenosis. Using these data, regression lines have been developed that
      predict risk of restenosis based on type of procedure and on lipid values. These
      results suggest that serum lipid levels may be associated with the risk of
      clinical restenosis after coronary angioplasty.

PMID- 1746424
TI  - Rationale and design of a secondary prevention trial of lowering normal plasma
      cholesterol levels after acute myocardial infarction: the Cholesterol and
      Recurrent Events trial (CARE)
AB  - Recent clinical trials of primary and secondary prevention of cardiovascular
      disease have demonstrated that lowering plasma cholesterol decreases the
      incidence of coronary heart disease in patients with elevated plasma cholesterol.
      However, it is not known whether patients with established coronary artery
      disease and normal plasma cholesterol can be benefited. Several previous
      prevention trials reviewed in this report found that patients who had plasma
      cholesterol levels at baseline in the upper portion of the eligibility range
      (e.g., greater than 240 mg/dl) received greater benefit from hypolipidemic diet
      or drug therapy than patients who had lower plasma cholesterol levels at
      baseline. The recent availability of drugs that are more potent and less prone to
      cause adverse reactions than previous regimens permits this important question to
      be addressed. The Cholesterol and Recurrent Events trial is testing whether
      pravastatin, a hydroxymethylglutaryl coenzyme A reductase inhibitor, will
      decrease the sum of fatal coronary heart disease and nonfatal myocardial
      infarction (MI) in patients who have recovered from a MI and who have normal
      total cholesterol levels. Fatal cardiovascular disease and total mortality are
      important secondary end points. The trial is enrolling 4,000 men and women from
      80 centers throughout North America, age 21 to 75 years, who have survived MI for
      3 to 20 months, who have plasma total cholesterol less than 240 mg/dl (6.2
      mmol/liter) and low-density cholesterol of 115 to 174 mg/dl (3.0 to 4.5
      mmol/liter), and who are representative of the general population of patients
      with MI. Patients are randomized to either active or inactive drug therapy.
      Active therapy consists of pravastatin, 40 mg/day, designed to achieve an average
      decrease in low-density lipoprotein cholesterol of approximately 30%, and an
      increase in high-density lipoprotein of 5%. The average duration of follow-up
      will be greater than or equal to 5 years. To protect against a lower than
      expected rate of recurrent events, the trial will be continued until a
      predetermined fixed number of coronary heart disease events occurs in the entire
      cohort so that the original sensitivity of the trial will be maintained.

PMID- 1746425
TI  - Causes and correlates of death after unsupported coronary angioplasty:
      implications for use of angioplasty and advanced support techniques in high-risk
      settings.
AB  - To better understand the factors predisposing a patient to death after elective
      percutaneous transluminal coronary angioplasty (PTCA) and to gain insight into
      indications for high-risk PTCA both with and without adjunctive use of support
      devices, the outcomes of 8,052 consecutive procedures were reviewed. Death
      occurred after 32 procedures (0.4%) and was directly related to coronary artery
      closure in 26 (81%) of these cases. Left ventricular failure due to vessel
      closure at the dilated site, the most common cause of death, was independently
      correlated with female sex (p less than 0.001), "jeopardy score" (p less than
      0.001) and PTCA of a proximal right coronary artery site (p = 0.002), but not
      with left ventricular ejection fraction or presence of multivessel disease. Right
      ventricular failure after closure of the proximal right coronary artery, and left
      main coronary dissection accounted for the majority of the remaining deaths.
      Systolic blood pressure immediately after coronary artery closure was also
      closely correlated with jeopardy score, and cardiogenic shock was frequent in
      women with scores greater than or equal to 3.5 and in men with scores greater
      than or equal to 5.0. These data highlight the superiority of the jeopardy score
      versus ejection fraction in the determination of risk, stress the importance of
      gender in determining outcome and point to the need for better means of right
      ventricular protection from severe ischemia. Therefore, an initial framework for
      rational use of PTCA and support devices in the high-risk setting is established.

PMID- 1746426
TI  - Value of transesophageal echocardiography during complex or high-risk coronary
      interventions in the cardiac catheterization laboratory.
AB  - The increasing complexity of coronary intervention and the limitations of
      hemodynamic and electrocardiographic monitoring have facilitated the introduction
      of new imaging techniques in the cardiac catheterization laboratory.
      Transesophageal echocardiography (TEE) has proved valuable for left ventricular
      (LV) monitoring during high-risk surgery, but its reported use in the cardiac
      catheterization laboratory has been limited. Accordingly, we assessed the
      feasibility and value of TEE during complex or high-risk coronary intervention in
      the catheterization laboratory. The TEE probe was successfully introduced in 53
      of 54 (98%) attempted cases. The primary imaging goals were LV monitoring in 39
      (74%), left main coronary artery (LMCA) imaging in 9 (17%) and both in 5 (9%)
      cases. LV monitoring was successful in 43 of the 44 (98%) attempted cases. In 25
      (58%) of these, additional important observations were made by TEE that were not
      apparent by symptoms, or hemodynamic, electrocardiographic or radiographic
      monitoring. These included unexpected changes in regional myocardial function (n
      = 20), alteration in LV size (n = 2), exclusion of considered pericardial
      tamponade (n = 2) and detection of unsuspected mitral regurgitation (n = 1).
      Management of the interventional procedure was directly influenced by the
      findings of TEE in 11 of the 43 (26%) monitored cases. The LMCA was successfully
      visualized in 13 of the 14 (93%) attempted cases. In 11 of these, measurement of
      the stenotic lesion diameter by TEE correlated well with quantitative angiography
      both before (r = 0.83, standard error of the estimate = 0.01, p less than 0.002)
      and after (r = 0.80, standard error of the estimate = 0.03, p less than 0.005)
      intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746427
TI  - Effects of cardiac denervation on atrioventricular nodal accommodation and
      hysteresis.
AB  - Conduction through the atrioventricular (AV) node is significantly altered by
      changes in autonomic tone. AV nodal accommodation (time-dependent changes in AV
      nodal conduction after a sudden change in atrial cycle length) and AV nodal
      hysteresis (asymmetry of AV nodal accommodation after directionally opposite
      atrial pacing cycle length changes) have been characterized in humans. Studies in
      dogs after cardiac transplantation suggest that the rapid phase of AV nodal
      accommodation is altered following ablation of neural input to the AV node. To
      determine if cardiac denervation alters AV nodal accommodation and hysteresis in
      humans, 13 patients after orthotopic cardiac transplantation and 12 control
      patients with normal AV nodal function were studied. Atrial pacing was performed
      for 1 minute at different pacing cycle lengths and AH or AV intervals were
      measured after cycle length changes. The rapid phase of accommodation is defined
      as the time required for the AV interval to reach 75% of the final AV interval.
      During abrupt changes from long to short pacing cycle lengths, the rapid phase of
      accommodation took 3.2 +/- 1.0 and 4.3 +/- 1.0 beats in control subjects and
      transplant patients, respectively (p = not significant [NS]). When going from
      short to long pacing cycle lengths, the rapid phase of accommodation took 1.7 +/-
      1.2 and 2.1 +/- 1.8 beats in control subjects and transplant patients,
      respectively (p = NS). Hysteresis of 1.5 +/- 1.3 and 2.1 +/- 1.4 beats was noted
      in the control and transplant groups, respectively (p = NS).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1746428
TI  - Initial blood pressure response to enalapril in hospitalized patients (Studies of
      Left Ventricular Dysfunction [SOLVD]).
AB  - Studies of Left Ventricular Dysfunction (SOLVD) is a randomized trial of
      enalapril versus placebo in reducing mortality in patients with cardiac
      dysfunction (defined as left ventricular ejection fraction less than or equal to
      35%). Before randomization, patients at risk for hypotension were hospitalized
      for a test dose of 2.5 mg of enalapril administered orally at baseline and again
      12 hours later. As of February 1989, 89 of 7,539 (1.2%) patients had been studied
      during hospitalization. Baseline systolic and diastolic blood pressures were 115
      +/- 18 and 73 +/- 10 mm Hg, respectively. After enalapril, systolic blood
      pressure decreased slightly but significantly 8 to 20 hours after the initial
      dose (mean reduction 8 to 11 mm Hg). In this highly selected group of 89
      patients, symptoms relating to decrease in blood pressure were noted in 13 (15%).
      It is emphasized that most patients with cardiac dysfunction readily tolerate
      enalapril. However, the agent should be administered with caution to patients
      with advanced congestive failure and diminished baseline blood pressure, owing to
      a significant incidence of symptomatic hypotension.

PMID- 1746429
TI  - Systemic and left ventricular responses to exercise stress in asymptomatic
      patients with valvular aortic stenosis.
AB  - Patients with heart disease may have myocardial ischemia or left ventricular (LV)
      dysfunction without symptoms. The exercise responses of 14 asymptomatic patients
      with valvular aortic stenosis (AS) were studied using treadmill testing, thallium
      201 scintigraphy and radionuclide angiography. Compared with age- and gender
      matched control subjects, patients with AS demonstrated reduced exercise
      tolerance (10.7 +/- 2.5 vs 13.3 +/- 4.2 min; p = 0.06) and maximal oxygen
      consumption (26.7 +/- 6.3 vs 36.3 +/- 9.5 ml O2/min/kg; p = 0.004) associated
      with decreased peak systolic blood pressure response to exercise (177 +/- 18 vs
      214 +/- 42 mm Hg; p less than 0.004). Ten of 14 patients developed ST-segment
      depression during exercise, only 3 of whom had reversible thallium defects.
      Patients with AS tended to have greater LV ejection fractions at rest (65 +/- 11
      vs 58 +/- 7; p = 0.08) and significantly decreased early peak filling rates (4.8
      +/- 1.3 vs 6.1 +/- 0.6 stroke volume/s; p = 0.003) compared with those of control
      subjects. During maximal supine exercise, patients with AS had less of an
      increase in ejection fraction (2 +/- 9 vs 15 +/- 7%; p less than 0.001)
      associated with a decrease in end-diastolic (-7 +/- 15 vs +5 +/- 16%; p = 0.06)
      and stroke (-6 +/- 17 vs +30 +/- 13%; p less than 0.001) volumes from baseline
      measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746430
TI  - Doppler echocardiographic findings in adults with severe symptomatic valvular
      aortic stenosis. Balloon Valvuloplasty Registry Echocardiographers.
AB  - Baseline echocardiographic data in 680 adults (mean age 78 years) undergoing
      balloon aortic valvuloplasty at 24 medical centers were analyzed to describe the
      degree of outflow obstruction in patients with symptomatic aortic stenosis.
      Maximal aortic jet velocity ranged from 2.3 to 6.6 m/s (mean 4.4 +/- 0.8) and
      continuity equation valve area ranged from 0.1 to 1.4 cm2 (mean 0.6 +/- 0.2). Of
      note, 36% had a jet velocity less than or equal to 4.0 m/s but only 3% had a
      valve area greater than 1.0 cm2 due to a high prevalence of impaired systolic
      function (54%). Outflow tract diameter was poorly correlated with body surface
      area (p = 0.26), although the group mean diameter was smaller in women than in
      men (1.9 +/- 0.2 vs 2.1 +/- 0.3 cm, p = 0.0001). Mean pressure gradient was
      related closely to maximal gradient (r = 0.92) and to maximal jet velocity (mean
      delta P = 2.4 V2 + 0.75 mm Hg). Simpler measures of aortic stenosis severity were
      correlated with Doppler and invasive valve area as follows: maximal jet velocity
      (r = -0.36 and -0.32), mean gradient (r = -0.33 and -0.29), outflow tract to jet
      velocity ratio (r = 0.67 and 0.40), and the fractional shortening velocity ratio
      (r = 0.29 and 0.22). This study demonstrates marked variability in stenosis
      severity in symptomatic adults referred for balloon aortic valvuloplasty. The
      absence of a predictable relation between outflow tract diameter and body size
      emphasizes the importance of this measurement in each patient if definition of
      valve area is needed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746431
TI  - Doppler echocardiographic estimation of mitral valve area during changing
      hemodynamic conditions.
AB  - Patients with mitral stenosis often present during periods of hemodynamic stress
      such as pregnancy or infections. The Doppler pressure half-time method of mitral
      valve area (MVA) determination is dependent on the net atrioventricular
      compliance as well as the peak transmitral gradient. The continuity equation
      method of MVA determination is based on conservation of mass and may be less
      sensitive to changes in the hemodynamic state. To test this hypothesis, 17
      patients admitted for catheterization with symptomatic mitral stenosis and no
      more than mild regurgitation underwent Doppler echocardiography at rest and
      during supine bicycle exercise targeted to an increase in heart rate by 20 to 30
      beats/minute. Net atrioventricular compliance was also estimated noninvasively.
      Cardiac output and transmitral gradient increased significantly during exercise
      (p less than 0.001), while net atrioventricular compliance decreased (p less than
      0.001). MVA by the pressure half-time method increased significantly during
      exercise from 1.0 +/- 0.2 to 1.4 +/- 0.4 cm2 (p less than 0.001). There was no
      significant difference in MVA estimation using the continuity equation comparing
      rest to exercise, with the mean area remaining constant at 0.8 +/- 0.3 cm2 (p =
      0.83). Thus, during conditions of changing hemodynamics, the continuity equation
      method for estimating MVA may be preferable to the pressure half-time method.

PMID- 1746432
TI  - Late results (30 to 35 years) after operative closure of isolated ventricular
      septal defect from 1954 to 1960.
AB  - This study was designed to determine the clinical status, cause of death, and
      effects of pulmonary vascular disease and conduction abnormalities 30 to 35 years
      after surgery in 296 consecutive surviving patients of closure of ventricular
      septal defect. Of the 296 patients, current status was determined by contact with
      patient and physician in 290 cases, with 6 (2%) lost to follow-up (7,912 patient
      years are included). Cardiac catheterization after surgery in 168 patients showed
      complete closure of the defect in 80%. Death occurred in 59 patients (20%), with
      higher mortality rates in those operated on after the age of 5 years, those with
      pulmonary vascular resistance greater than 7 units (51%), and those with complete
      heart block (78%). Of 37 patients with transient heart block after surgery, 8
      (22%) have died (3 pulmonary vascular disease, 2 sudden death, 2 unknown causes
      and 1 complete heart block). Twenty other patients had a dysarrhythmia after
      surgery, and none of these died. Nine episodes of endocarditis occurred
      (11.4/10,000 patient years). Nine of 296 (3%) offspring had cardiac malformation.
      Most patients are in New York Heart Association class I, 57% attended college and
      15% received an advanced degree. The data show good results for this group of
      patients operated on during an early era (1954 to 1960) of open cardiac surgery.
      They support the current trend toward operation in patients with ventricular
      septal defects at an early age and with low pulmonary vascular resistance.

PMID- 1746433
TI  - Comparison of transcranial Doppler ultrasound and transesophageal contrast
      echocardiography in the detection of interatrial right-to-left shunts.
AB  - Transesophageal contrast echocardiography is an effective but semiinvasive
      technique for the detection of interatrial right-to-left shunts. Transcranial
      Doppler ultrasound is an alternative noninvasive method, but may be limited by
      false-positive diagnoses due to intrapulmonary shunting. This study examined the
      accuracy of transcranial Doppler for the detection of shunt lesions. Transcranial
      Doppler of the right middle cerebral artery was performed simultaneously with
      transesophageal and transthoracic contrast echocardiography in 32 patients using
      agitated saline contrast during normal respiration and Valsalva. Transesophageal
      contrast echocardiography diagnosed an interatrial right-to-left shunt in 13
      patients and intrapulmonary shunting in 6 patients. Transcranial Doppler
      identified all 13 interatrial right-to-left shunts and an intrapulmonary shunt in
      3 of 6 patients. Absence of a shunt was confirmed by transcranial Doppler in 12
      of 12 patients. Transcranial Doppler had a sensitivity of 100% (13 of 13),
      specificity of 100% (18 of 18) and accuracy of 100% (31 of 31) for prediction of
      an interatrial right-to-left shunt by transesophageal contrast echocardiography.
      In comparison, transthoracic contrast echocardiography had a sensitivity of 54%
      (7 of 13), specificity of 94% (17 of 18) and accuracy of 77% (24 of 31). Thus,
      transcranial Doppler is highly accurate for detection of an interatrial right-to
      left shunt and not compromised by physiologic intrapulmonary shunts, whereas
      transthoracic contrast echocardiography lacks sensitivity. Transcranial Doppler
      may be useful as an alternative to transesophageal study, where the primary
      indication for transesophageal echocardiography is exclusion of an interatrial
      right-to-left shunt.

PMID- 1746434
TI  - Effect of digoxin on ST-segment changes detected by ambulatory
      electrocardiographic monitoring in healthy subjects.
AB  - Digoxin causes false-positive ST depression during exercise stress testing, but
      it is unknown if digoxin produces ST depression during ambulatory
      electrocardiographic monitoring. Fifty healthy volunteers underwent both exercise
      stress testing and ambulatory electrocardiographic monitoring before and after 14
      days of digoxin (0.25 mg/day) administration. Significant ST depression was
      defined as greater than or equal to 1 mm of horizontal or downsloping ST
      depression 80 ms after the J point lasting for greater than or equal to 60
      seconds. During therapy, 13 subjects (26%) had at least 1 episode of ST
      depression and 5 subjects (10%) had multiple episodes of ST depression detected
      by ambulatory monitoring. Ten subjects (20%) had ST depression that occurred
      during exercise that was detected by both stress test and ambulatory monitoring.
      Three subjects (6%) had ST depression that was detected on the ambulatory
      recording only at times other than during the stress test. Stratification of
      demographic and clinical variables did not predict digoxin-induced ST depression.
      Thus, digoxin causes false-positive ST depression detected by ambulatory
      monitoring. The incidence is similar to that observed during stress testing, but
      also occurs at heart rates lower than that achieved during stress tests.
      Ambulatory electrocardiographic monitoring will be less useful in the noninvasive
      assessment of coronary artery disease in patients receiving digoxin.

PMID- 1746435
TI  - Two-dimensional contrast echocardiography in the detection and follow-up of
      congenital pulmonary arteriovenous malformations.
AB  - Pulmonary arteriovenous (A-V) malformation is frequently a manifestation of Osler
      Weber-Rendu syndrome (hereditary hemorrhagic telangiectasia). We identified 14
      patients (9 men and 5 women) with A-V malformation by contrast echocardiography;
      10 patients with atrial right-to-left shunt served as control subjects. Agitated
      saline solution (10 ml) was injected through a peripheral vein during
      echocardiographic imaging. The delay in the appearance of microcavitations in the
      left atrium was measured (in number of frames) after right atrial appearance. The
      degree of left ventricular opacification was graded 1 to 4+ (where 4+ = intense
      left ventricular endocardial outline, and 1+ = minimal opacification). Results
      indicated patients with A-V malformation had a significant delay (p less than
      0.001) in left atrial appearance of microcavitations compared with those with
      atrial right-to-left shunt (66 +/- 27 vs 21 +/- 7 frames, mean +/- 1 standard
      deviation). In the group with A-V malformation, abnormal blood gases were present
      in only 6 of 14 patients and chest x-ray was positive in 7. Pulmonary angiography
      was performed in 11 of 14 patients with positive contrast echocardiography, and
      all 11 had A-V malformation identified. In patients with 3 to 4+ left ventricular
      opacification (n = 8), large (greater than 5 mm feeding vessel) or multiple
      malformations were present, whereas patients with small or isolated malformation
      had 1 to 2+ left ventricular opacification. Balloon occlusion of malformations
      was performed in all 11 of these patients; repeat contrast echocardiography
      revealed significant diminution of right-to-left shunt in 9, and 2 required
      repeat embolotherapy for an additional previously undetected A-V
      malformation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746436
TI  - Cardiac myocytes and dendritic cells harbor human immunodeficiency virus in
      infected patients with and without cardiac dysfunction: detection by multiplex,
      nested, polymerase chain reaction in individually microdissected cells from right
      ventricular endomyocardial biopsy tissue.
AB  - Two hundred fifteen patients infected with human immunodeficiency virus (HIV)
      participated in a prospective longitudinal study of HIV-related heart disease.
      Evaluation included signal-averaged electrocardiography and echocardiography.
      Fifteen patients underwent endomyocardial biopsy, 5 had cardiovascular symptoms
      and 10 did not. Cardiac myocytes or dendritic cells were prepared by individual
      cell microdissection to sort them from other cell types such as interstitial
      cells or circulating blood elements. HIV proviral sequences were amplified in
      samples of 15 to 20 cells of each type by multiplex, nested, polymerase chain
      reaction and hybridized to 32P-labeled probes specific for regions within the gag
      and pol genes of HIV-1. The results showed the presence of HIV sequences in
      myocytes of 2 of 5 patients with cardiac symptoms and in 6 of 10 without. Thus,
      symptomatic HIV cardiomyopathy did not appear to be a direct consequence of the
      virus on myocardial cells. In dendritic cells, HIV sequences were detected in 5
      of 5 patients with cardiac symptoms and in 8 of 10 with apparently normal
      ventricular function. Furthermore, dendritic cells were somewhat more numerous in
      the myocardium of symptomatic than asymptomatic patients. Our studies are the
      first to directly detect the HIV genome in purified cardiac myocytes from
      patients with and without cardiac dysfunction. Our findings do not support a
      direct role of the virus in myocardial dysfunction. However, the results do
      suggest that the interstitial dendritic cells may be involved in some manner in
      the development of cardiac dysfunction observed in HIV-infected patients.

PMID- 1746437
TI  - Moricizine (ethmozine HCl)--a new antiarrhythmic drug: is it unique?

PMID- 1746438
TI  - Medical, ethical and legal issues regarding thrombolytic therapy in the Jehovah's
      Witness.

PMID- 1746439
TI  - Coronary artery surgery in octogenarians.

PMID- 1746440
TI  - Prevalence and significance of ST-segment alternans during coronary angioplasty.

PMID- 1746441
TI  - Echocardiographic documentation of splenic anatomy in complex congenital heart
      disease.

PMID- 1746442
TI  - Frequency of positive blood cultures during transesophageal echocardiography.

PMID- 1746443
TI  - Prevalence of cardiac abnormalities early in the course of systemic lupus
      erythematosus.

PMID- 1746444
TI  - Focal myocardial necrosis associated with multiple sclerosis of the medulla.

PMID- 1746445
TI  - Thrombolytic therapy. Introduction.

PMID- 1746446
TI  - Overview of patency as an end point of thrombolytic therapy.
AB  - Underlying the use of thrombolytic therapy is the hypothesis that reestablishment
      and maintenance of coronary blood flow (coronary patency) are the primary
      mechanisms of therapeutic benefit in patients with acute myocardial infarction.
      Early achievement and maintenance of adequate coronary blood flow (patency) in
      the infarct-related artery are the primary goals of thrombolytic therapy. One
      third of patients may achieve spontaneous patency within a few days following
      acute myocardial infarction. When antithrombotic therapy (i.e., heparin) is
      administered, this rate increases to greater than 50%, but patency is achieved
      only gradually and mortality reductions comparable to thrombolytic therapy are
      not achieved. After administration of a thrombolytic agent, early (90-minute)
      patency rates are greater with alteplase or anistreplase than with streptokinase.
      However, patency rates for alteplase decline by 10-30% if intravenous heparin is
      not given concurrently. When patency is assessed greater than 24 hours following
      thrombolytic therapy, no significant difference exists among the agents. A single
      angiographic observation of the artery at 90 minutes, although useful, may be
      inadequate to distinguish among the beneficial clinical effects of different
      thrombolytic regimens. The overall reperfusion or patency profile is probably a
      better basis for assessing relative benefits. Intravenous thrombolytic regimens
      that are increasingly effective in rapidly achieving and maintaining coronary
      patency are now available and in further development.

PMID- 1746447
TI  - Thrombolysis, anticoagulation, and reocclusion.
AB  - Based on apparent higher recanalization rates of the infarct-related artery,
      preferential use of thrombolytic agents with high clot specificity has been
      proposed for treating patients with acute myocardial infarction. In the
      Thrombolysis in Myocardial infarction (TIMI-I) and European Cooperative Group
      studies, higher reperfusion rates were observed with alteplase compared with
      streptokinase, causing many to assume that the former would achieve a greater
      reduction in early hospital mortality. However, the Gruppo Italiano per lo Studio
      della Streptochinasi nell'Infarto Miocardico (GISSI-2) and its associated
      International Study Group failed to show any differences in 15-day mortality
      between these agents in more than 20,000 patients. This apparent lack of
      correlation between reperfusion rates and early mortality may be explained in
      part when one considers that recanalization or patency rates measured at a given
      point in time, such as 90 minutes after onset of therapy, fail to define the
      subsequent vessel status. Early reocclusion is the major reason for this and is a
      major limitation to the clinical efficacy of thrombolytic drugs. Following
      recanalization, residual fibrin-bound thrombin adherent to the site of arterial
      injury from plaque rupture strongly promotes rethrombosis. Although antiplatelet
      and antithrombin agents such as aspirin and heparin help to decrease
      rethrombosis, these agents are far from ideal. Thrombolytic agents that produce a
      significantly prolonged systemic thrombolytic state, such as streptokinase and
      anistreplase, are likely to result in less rethrombosis. Therefore, a systemic
      fibrinolytic state would appear to be an advantage rather than a disadvantage,
      particularly because the incidence of intracerebral hemorrhage does not appear to
      be greater with their use compared with agents producing less systemic
      fibrinolysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746448
TI  - Use of left ventricular function as an end point of thrombolytic therapy.
AB  - In recent acute myocardial infarction, early reperfusion of the infarct-related
      artery by intracoronary or intravenous thrombolytic therapy induces a significant
      limitation of infarct size, provided reperfusion occurs within a time frame that
      myocardial salvage can still be expected. Limitation of infarct size reduces scar
      tissue formation, aneurysm formation, infarct zone expansion, left ventricular
      volume enlargement, and eventually results in higher left ventricular ejection
      fraction. Infarct size limitation and left ventricular function preservation
      occur with all thrombolytic agents currently in clinical use: streptokinase,
      alteplase and, more recently, anistreplase. When anistreplase is compared with
      conventional heparin therapy, a 31% reduction in infarct size is found (estimated
      from single photon emission computed tomography, or SPECT). This translates into
      a significant preservation of left ventricular ejection fraction as observed in
      anistreplase-treated patients compared with heparin-treated patients (0.53 +/-
      0.13 vs 0.47 +/- 0.12, p less than 0.002). In comparative trials of 2
      thrombolytic agents, anistreplase was demonstrated to be as efficient as
      alteplase on left ventricular ejection fraction preservation and infarct size
      limitation.

PMID- 1746449
TI  - Importance of the pharmacological profile of thrombolytic agents in clinical
      practice.
AB  - Three thrombolytic agents are frequently used in the United States for treating
      patients with acute myocardial infarction: streptokinase, alteplase (tissue
      plasminogen activator [t-PA]), and anistreplase (anisoylated plasminogen
      streptokinase activator complex [APSAC]). A fourth agent, urokinase, is
      occasionally used but clinical experience is considerably more limited with this
      agent. Streptokinase, alteplase, and anistreplase differ in a number of
      pharmacologic properties, which include half-life, enzymatic efficiency, and
      induction of platelet aggregation; these differences may be clinically important.
      For example, anistreplase and alteplase have high affinity for fibrin and bind to
      intravascular thrombi after intravenous administration, which may result in
      higher clot specificity. Anistreplase has the longest half-life of the 3 agents
      and, therefore, can be administered conveniently and quickly. Alteplase has a
      shorter half-life and heparin is generally a necessary adjunctive agent. These
      differences can be clinically significant in various settings and application of
      such theoretical advantages is just beginning.

PMID- 1746450
TI  - Comparative safety of thrombolytic agents.
AB  - Three available thrombolytic agents, streptokinase, alteplase, and anistreplase,
      have been shown to have similar effects on preservation of left ventricular
      function and mortality reduction after acute myocardial infarction (AMI). The
      agents are, however, quite different with respect to their safety profiles.
      Clinical trials to date suggest that alteplase (tissue plasminogen activator) or
      anistreplase administration is associated with a high incidence of cerebral
      hemorrhage. In contrast, streptokinase is associated with a low rate of cerebral
      hemorrhage. Streptokinase and anistreplase are associated with a higher risk of
      allergic reaction when compared with alteplase. Hypotension is also more common
      with streptokinase and anistreplase, but occurs significantly with alteplase as
      well. Alteplase is associated with a lower reinfarction rate when compared with
      streptokinase and anistreplase. The Third International Study of Infarct Survival
      (ISIS-3), a direct comparison of 3 thrombolytic agents (streptokinase,
      anistreplase, and duteplase), may provide some insight regarding the safety of
      these agents. Because these agents have been shown to be equally effective,
      selection of an appropriate agent for an individual patient may depend more on
      assessment of the likelihood of an adverse event or other factors, such as cost
      or convenience of administration, rather than assessment of the probability of
      greater benefit with a particular agent.

PMID- 1746451
TI  - Comparative analysis of long-term mortality after thrombolytic therapy.
AB  - In patients with acute myocardial infarction, thrombolytic therapy has a
      demonstrable and favorable impact on a range of clinical indicators, including
      left ventricular function, infarct size, coronary arterial patency, and symptom
      relief. However, these indicators have not provided a reliable basis for the
      comparison of thrombolytic regimens; mortality provides the "gold standard." One
      year mortality obviates the differences in the timing of short-term comparisons
      (in-hospital, 30-day, or 5-week). In addition, late effects of differences in
      patency, including the impact of reocclusion, infarct healing, and remodeling,
      will be evident by 1 year. Meta-analysis of data from previous major mortality
      studies shows that differences in design and the overlap of confidence intervals
      of mortality studies suggest that no thrombolytic agent is superior in terms of
      short-term mortality. Long-term survival may provide a more meaningful basis for
      comparison of efficacy of the thrombolytic regimens. Long-term mortality has been
      evaluated for anistreplase in acute myocardial infarction in a composite
      analysis, similar to a meta-analysis. From the pooled life table analysis of all
      anistreplase studies, the odds reduction in mortality at 1 year was approximately
      48%.

PMID- 1746452
TI  - Brief overview of the end points of thrombolytic therapy.
AB  - In addition to mortality, several measurable end points of thrombolytic therapy
      have been studied. These include coronary arterial patency, left ventricular
      function, reocclusion, reinfarction, and bleeding complications. Current wisdom
      dictates that recanalization of occluded arteries in the early phases of acute
      myocardial infarction should be attempted to preserve viable cardiac muscle, with
      the ultimate goal of decreasing mortality. Unfortunately, the number of patients
      eligible for thrombolytic therapy far exceeds the number receiving it, despite
      the clear benefits that have been demonstrated.

PMID- 1746453
TI  - Early detection of acute myocardial infarction by measurement of mass
      concentration of creatine kinase-MB.
AB  - The diagnostic sensitivity and performance of immunoenzymometric measurements of
      creatine kinase (CK)-MB mass concentrations in the early diagnosis of acute
      myocardial infarction (AMI) were examined and compared with the sensitivities and
      performances of CK and CK-MB activity, in the context of simultaneous
      measurements of CK, CK-MB activity, and CK-MB mass concentrations in serially
      drawn blood samples obtained immediately from 36 patients with AMI and 126
      patients with chest pain on admission to the emergency room of the department of
      internal medicine. In the 36 patients with AMI, who were all admitted no later
      than 4 hours after the onset of chest pain, pathologic increase occurred
      significantly earlier in CK-MB mass than in both CK and CK-MB activity, with a
      median difference of 1 hour each. In patients coming to the emergency room (51
      with AMI, 51 with angina pectoris and 24 with chest pain not related to coronary
      artery disease), CK-MB mass was the best diagnostic measurement for AMI of all
      markers tested (significantly higher efficiency, Youden index and likelihood
      ratio than both CK and CK-MB activity). Before initiating thrombolytic therapy,
      the sensitivity of CK-MB mass is significantly higher than CK-MB activity during
      the 0- to 6-hour period and significantly higher than CK activity during the 2-
      to 4-hour period after the onset of chest pain. Consequently, it is often
      possible to diagnose an AMI on the basis of increased CK-MB mass concentrations
      even at a time when CK and CK-MB activities are still within the reference
      interval.

PMID- 1746454
TI  - Comparative quantitative angiographic analysis of directional coronary
      atherectomy and balloon coronary angioplasty.
AB  - An attempt to assess the "utility" of directional atherectomy was made using a
      new quantitative angiographic index. This index can be subdivided into an initial
      gain component and a restenosis component. The initial gain index is the ratio
      between the gain in diameter during intervention and the theoretically achievable
      gain (i.e., reference diameter). The restenosis index is the ratio between the
      decrease at follow-up and the initial gain during the procedure. The net result
      at long-term follow-up is characterized by the utility index, which is the ratio
      between the final gain in diameter at follow-up and what theoretically could have
      been achieved. For this purpose, 30 coronary artery lesions were selected from a
      consecutive series of successfully dilated primary angioplasty lesions and were
      matched with the initial 30 successfully treated primary atherectomy lesions.
      Matching by location of stenosis and reference diameter resulted in 2 comparable
      groups with identical preprocedural stenosis characteristics. Atherectomy
      resulted in an increase in minimal luminal diameter 2 times larger than
      angioplasty (1.53 vs 0.77 mm; p less than 0.0001). However, at follow-up there
      was a significant decrease in minimal luminal diameter and a significant increase
      in percent diameter stenosis in the groups with atherectomy and angioplasty (1.69
      +/- 0.58 vs 1.57 +/- 0.58 mm, p = not significant [NS], and 37 +/- 18 vs 47 +/-
      18%, p = NS, respectively). The decrease in minimal luminal gain was more
      pronounced in the group with atherectomy than in that with angioplasty (0.92 +/-
      0.69 vs 0.35 +/- 0.51 mm; p = 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746455
TI  - Clot-selective coronary thrombolysis with low-dose synergistic combinations of
      single-chain urokinase-type plasminogen activator and recombinant tissue-type
      plasminogen activator. The Pro-Urokinase for Myocardial Infarction Study Group.
AB  - The effect of simultaneous infusions of low-dose recombinant tissue-type
      plasminogen activator (t-PA) and single-chain urokinase-type plasminogen
      activator (scu-PA, pro-urokinase) on coronary arterial thrombolysis was
      investigated in 23 patients treated within 6 hours (mean 2.6 +/- 1.1, range 1.2
      to 5.9) of symptoms of an acute myocardial infarction. Infarct artery patency at
      90 minutes was achieved in 16 (70%, 95% confidence limits of 0.47 to 0.87) of 23
      patients after a 1-hour intravenous infusion of 20 and 16.3 mg of t-PA and scu
      PA, respectively. At 90 minutes, the fibrinogen concentration decreased from 369
      +/- 207 to 316 +/- 192 mg/dl (p = not significant), while plasminogen decreased
      to 69 +/- 24% (p = 0.001) and alpha-2-antiplasmin to 77 +/- 24% (p = 0.001) of
      pretreatment values. Although no bleeding requiring termination of drug infusion
      or transfusion occurred, 1 patient with cerebrovascular amyloidosis had a fatal
      intracerebral hemorrhage. These findings suggest that combination therapy may
      allow substantial reductions in total thrombolytic doses while still achieving
      effective fibrin-specific coronary thrombolysis.

PMID- 1746456
TI  - Effectiveness of double bolus alteplase in the treatment of acute myocardial
      infarction.
AB  - Fifty-nine consecutive patients presenting within 6 hours of the onset of
      symptoms of an acute myocardial infarction were treated with 150 mg of soluble
      aspirin orally, and either 70 or 100 mg of alteplase divided into 2 intravenous
      bolus injections separated by 30 minutes. Dosage regimens were either 20 followed
      by 50 mg (group A), 50 followed by 20 mg (group B), or 50 followed by 50 mg
      (group C). Coronary angiography 60 minutes after the first bolus showed infarct
      related coronary artery patency (Thrombolysis in Myocardial Infarction score 2 or
      3) in 13 of 16 (81%) patients in group A, 12 of 17 (71%) in group B, and 10 of 11
      (91%) in group C (overall patency rate at 60 minutes: 35 of 44 [80%] patients;
      95% confidence interval 68 to 91%). At 90 minutes, patency rates were 15 of 20
      (75%) patients in both groups A and B, and 18 of 19 (95%) in group C (overall
      patency rate 48 of 59 [81%] patients; 95% confidence interval 72 to 91%).
      Residual thrombus was identified with the 90-minute angiogram in 7 patients in
      group A, 5 in group B, and 3 in group C. Although there was no statistically
      significant difference in patency between the 3 dosage regimens at either 60 or
      90 minutes there was a trend toward increased patency and more complete
      thrombolysis at 90 minutes in group C. No episodes of bradyarrhythmia,
      hypotension or cerebrovascular bleeding were observed after double bolus therapy.
      There were 7 episodes (12%) of reocclusion, and 3 deaths (5%) within 1-month
      follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746457
TI  - Prognostic significance of silent myocardial ischemia in variant angina pectoris.
AB  - The present study investigates the prognostic significance of silent myocardial
      ischemia in variant angina. Forty-eight-hour Holter monitoring and coronary
      angiography were performed in 54 patients with transient ST elevation and no
      history of myocardial infarction admitted to the coronary care unit for worsening
      of symptoms. Coronary artery spasm was documented in most of these patients. Over
      the subsequent month, 20 patients (group 1) had a major coronary event (2 died, 6
      had nonfatal myocardial infarction and 12 had urgent coronary revascularization),
      and the remaining 34 patients (group 2) had a good clinical outcome. From 2,578
      hours of recording, 547 ischemic episodes were identified of which only 9% were
      associated with angina. The mean daily number of ST elevation in group 1 was
      similar to that in group 2 (4.8 +/- 5.1 vs 4.1 +/- 4.6; p = not significant).
      Conversely, the mean daily duration of such ischemic episodes was consistently
      greater in group 1 than in 2 (79 +/- 36 vs 37 +/- 25 minutes; p less than 0.005).
      The occurrence of greater than or equal to 1 long-lasting (greater than or equal
      to 10 minutes) episode of ST elevation was observed in 18 of 20 patients in group
      1 (sensitivity 90%), but only in 4 of 34 in group 2 (specificity 88%).
      Significant coronary atherosclerosis (greater than 50% stenoses) was found at
      angiography in 18 of 20 patients in group 1, and in 18 of 34 in group 2.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1746458
TI  - Felodipine (once daily) versus nifedipine (four times daily) for Prinzmetal's
      angina pectoris.
AB  - In 30 consecutive patients with Prinzmetal's angina pectoris, the antiischemic
      effect of felodipine, a new long-acting vasoselective calcium antagonist,
      administered at doses of 10 and 20 mg once daily was compared with that of the
      well-established therapeutic regimen with nifedipine administered at a dose of 20
      mg 4 times daily. Twenty-four-hour Holter monitoring was performed during a 2-day
      placebo run-in and at the end of each of 3 consecutive 6-day periods during which
      the 3 active treatments were administered in randomized sequence. Three patients
      withdrew, whereas 27 completed the study. The therapeutic regimens tested proved
      to be similarly effective; primary end points (ischemic episodes recorded by
      Holter monitoring, and anginal attacks reported on diary cards) occurred in 5
      patients (19%) during nifedipine treatment, and in 7 (26%) and 3 (11%) during
      felodipine treatment with 10 and 20 mg, respectively (p = not significant). The
      distribution of residual ischemic episodes demonstrated that treatment with
      felodipine once daily provides 24-hour antiischemic protection. Twenty-six
      patients were followed up with 20 mg of felodipine once daily for a mean of 6 +/-
      5 months, and 21 of them (81%) remained free of symptoms and Holter-recorded
      ischemic attacks. It is concluded that for Prinzmetal's angina pectoris, 24-hour
      antiischemic protection may be achieved with administration of felodipine once
      daily. The availability of a simplified therapeutic approach may constitute a
      real advantage in terms of patient compliance and improving the quality of life.

PMID- 1746459
TI  - Effects of daily high-intensity exercise on myocardial perfusion in angina
      pectoris.
AB  - Forty male patients with chronic stable angina pectoris and no prior myocardial
      infarction were studied by planar thallium scintigraphy with use of
      circumferential profile analysis. Ischemic defects were assessed by measuring
      degrees of circumference involved and area of defect. Data were collected for 3
      vascular regions in each of 3 views (anterior, 45 degrees and 65 degrees left
      anterior oblique projection). Patients were then randomized to exercise and
      control groups, the former training for a period of 1 year using the Canadian
      Airforce plan for physical fitness. After 1 year, both groups were restudied.
      Exercise training produced a 34% reduction in degrees of ischemia overall (p less
      than 0.02), the most significant change being seen on the anterior view (72
      degrees +/- 59 degrees before vs 30 degrees +/- 35 degrees after training).
      Regional analysis showed markedly improved perfusion anterolaterally and apically
      on the anterior view and anteroseptally on the 65 degrees left anterior oblique
      view. These improvements support the hypothesis that exercise training improves
      myocardial perfusion by enhanced collateral function.

PMID- 1746460
TI  - Silent versus symptomatic ischemia during a thallium-201 exercise test.
AB  - One hundred thirty-four patients with redistribution on a thallium-201 exercise
      test who did not experience angina (group 1) were compared with 134 patients also
      having redistribution who had angina during the test (group 2). The groups were
      matched by age, sex, and peak exercise heart rate. Although patients in both
      groups achieved an equivalent exercise level, patients in group 1 had less
      frequent (53 vs 71%, p less than 0.005) and less severe (0.15 +/- 0.13 vs 0.20 +/
      0.13 mV, p less than 0.005) ischemic ST-segment depression. Group 1 also had
      less ischemic thallium-201 images in terms of the number of redistributing
      defects, the severity of the worst redistributing defect, and an ischemic index
      composite of both extent and severity. Patients in group 1 were less likely to
      undergo early revascularization (12 vs 29%, p less than 0.005), but in the
      remaining patients the occurrence of adverse cardiac events was similar (21% vs
      29%, p = not significant). By multivariate analysis, only the ischemic index
      correlated with early revascularization in group 1 (p = 0.0017), whereas the
      percent maximal predicted heart rate correlated best in group 2 (p = 0.0003). In
      group 1 the ratio of lung/heart thallium-201 uptake correlated best with an
      outcome of nonfatal myocardial infarction or cardiac death (p = 0.0024); in group
      2 the presence of fixed left ventricular dilatation did (p = 0.0022). Thus,
      patients with exercise-induced thallium-201 redistribution without angina have
      less ischemia than patients experiencing angina.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746461
TI  - Experience with low-dose intracoronary recombinant tissue-type plasminogen
      activator for nonacute total occlusions before percutaneous transluminal coronary
      angioplasty.
AB  - The primary success rate for angioplasty of total occlusions is significantly
      worse than for subtotal lesions. Pharmacologic recanalization of total occlusions
      before angioplasty has the potential to improve the primary success rate. To
      determine the ability of recombinant tissue-type plasminogen activator (rt-PA) to
      recanalize occlusive thrombi before elective percutaneous transluminal coronary
      angioplasty, 12 patients with total occlusions, 100% obstruction and Thrombolysis
      in Myocardial Infarction (TIMI) grade 0 flow, and 5 with functional total
      occlusions, severe stenoses and TIMI grade 1 flow received an intracoronary
      infusion of rt-PA. The first 10 patients received 0.2 mg/min for 90 minutes, and
      the next 7 patients received 0.4 mg/min for 60 minutes. Flow improved by greater
      than or equal to 1 TIMI grade in 11 patients. Mean TIMI flow improved from 0.3 +/
      0.5 to 1.5 +/- 1.2 (p less than 0.0001). There was a significant improvement in
      severity of stenosis after rt-PA infusion by both digital caliper (99 +/- 2 vs 84
      +/- 16%; p less than 0.0001) and quantitative videodensitometric area assessment
      (99 +/- 3 vs 94 +/- 6%; p less than 0.004). Angioplasty was successful in 16 of
      17 patients (94%). There were 2 out-of-laboratory abrupt closures at 4 days; both
      were medically treated and 1 had a small myocardial infarction. Only 1 patient
      had a bleeding complication significant enough to need a transfusion. It is
      concluded that low-dose intracoronary rt-PA is effective at lysing thrombi less
      than 3 weeks old. This approach warrants further investigation since it may
      significantly improve the primary success rate of percutaneous transluminal
      coronary angioplasty in patients with occlusive thrombus.

PMID- 1746462
TI  - Comparison of angiographic findings and demographic variables in patients with
      coronary artery disease presenting with acute pulmonary edema versus those
      presenting with chest pain.
AB  - One hundred nineteen patients admitted to the coronary care unit with pulmonary
      edema were retrospectively reviewed to identify the demographic characteristics
      and underlying cardiac disorders of this population. The patients with pulmonary
      edema were compared with 119 patients admitted to the coronary care unit with
      chest pain. Cardiac catheterization in 71 patients with pulmonary edema and 93
      with chest pain showed left main and 3-vessel coronary artery diseases to be
      equally common in both groups, although anginal pain was infrequent in patients
      with pulmonary edema (n = 28, 24%). Left ventricular function was reduced in the
      patients with pulmonary edema compared with those with chest pain (mean ejection
      fraction 42 vs 59%; p less than 0.001). More patients with pulmonary edema were
      black, and had diabetes and preexisting hypertension than those with chest pain.
      The results of cardiac catheterization were the same for black and white patients
      with pulmonary edema. In conclusion, patients with pulmonary edema have a high
      incidence of cardiac disease, and pulmonary edema may be 1 manifestation of
      silent myocardial ischemia. Important demographic differences exist between
      patients admitted with pulmonary edema and those who present with chest pain.

PMID- 1746463
TI  - Significance of signal-averaged P-wave changes during exercise in patients with
      coronary artery disease and correlation with angiographic findings.
AB  - The maximal P-wave duration in all time-aligned leads, and the maximal P-wave
      amplitude in leads V5 and V6 were measured on a 12-lead, signal-averaged
      electrocardiogram during the recovery period of an exercise stress test (EST).
      The study group consisted of 75 patients with coronary artery disease (CAD)
      documented by greater than or equal to 50% diameter stenosis in 1 or more
      arteries and a control group of 47 subjects, 15 of them young volunteers and 32
      with no or minimal coronary atherosclerosis and normal left ventricular function.
      All subjects underwent a symptom limited EST, with use of the Ellestad protocol.
      Signal-averaged P waves recorded before exercise, and for the first 6 minutes in
      recovery were measured using a 5x magnifier. The mean P duration before exercise
      in the control group was 107 +/- 16 ms (+/- 1 standard deviation) and 111 +/- 15
      ms at the third minute of recovery, (p less than 0.001). In patients with CAD it
      was 112 +/- 12 and 129 +/- 19 ms (+/- 1 standard deviation), p less than 0.001,
      respectively. Differences in P-wave duration were found to be statistically
      significant (p less than 0.001) throughout recovery in the group with CAD when
      compared with control and maximal values at the third minute. The increase in P
      wave duration (greater than or equal to 20 ms) was used as an additional
      parameter to exercise-induced ST-segment depression, ST elevation, or anginal
      pain for the test interpretation. The sensitivity increased from 57 to 75% and
      the specificity decreased from 85 to 77%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746464
TI  - Assessment of medial thinning in atherosclerosis by intravascular ultrasound.
AB  - This study investigated the in vitro (40 MHz) and in vivo (30 MHz) feasibility of
      intravascular ultrasound to document the influence of atherosclerotic lesions on
      the typical 3-layered appearance of muscular arteries. The in vitro images of 39
      arteries were compared with the corresponding histologic sections. Media and
      lesion thickness were measured at the areas of minimal and maximal lesion
      thickness. The median media thickness was 0.8 mm in the absence of a lesion,
      decreasing to 0.3 mm in the area of maximal atherosclerosis. The ultrasonic data
      correlated closely with histologic measurements (0.6 and 0.3 mm, respectively).
      The in vivo study was performed in 29 patients undergoing coronary or peripheral
      vascular procedures. A total of 150 still-frames were selected for quantitative
      analysis. The median media thickness was 0.6 mm in the absence of a lesion,
      decreasing to 0.1 mm in the area with maximal atherosclerosis. This study
      revealed that intravascular ultrasound imaging accurately determines that media
      thickness of muscular arteries is inversely related to lesion thickness. In vitro
      data, verified with histology, can be translated to humans in vivo.

PMID- 1746465
TI  - Coronary hemodynamics and coronary flow reserve after intracoronary diltiazem in
      humans.
AB  - To analyze the effect of the calcium antagonist diltiazem on coronary
      hemodynamics, epicardial coronary artery diameter, coronary blood flow and
      coronary blood flow velocity were assessed at baseline and after a 0.5 mg
      intracoronary bolus of diltiazem in nonstenotic coronary arteries of awake
      humans. Patients (n = 20) were first randomized to pretreatment with either
      placebo (n = 10) or isosorbide dinitrate (0.5 microgram/kg/min infusion; n = 10),
      and coronary flow reserve was measured before and after administration of
      diltiazem. There were significant increases in epicardial coronary artery
      diameter (10%; p = 0.0001) and coronary blood flow (30%; p = 0.0001) in all
      patients after administration of diltiazem. Whereas basal coronary blood flow
      velocity increased only slightly (7%; p = not significant), there was a
      significant decrease in coronary flow reserve (10%; p = 0.004). Increases in
      coronary diameter and blood flow after diltiazem were comparable in patients
      pretreated with placebo or nitrates. However, the decrease in coronary flow
      reserve was significant only in patients pretreated with placebo (19%; p =
      0.0008). This reduction in coronary flow reserve could be due to "raising the
      floor" (increased baseline coronary blood flow) or "lowering the ceiling"
      (reduction of maximal coronary blood flow).

PMID- 1746466
TI  - Regional myocardial perfusion and metabolism assessed by positron emission
      tomography in children with Kawasaki disease and significance of abnormal Q waves
      and their disappearance.
AB  - To clarify the significance of newly appearing abnormal Q waves and their
      disappearance in patients with Kawasaki disease, regional myocardial perfusion
      and glucose metabolism at rest in the fasting condition were assessed by positron
      emission tomography (PET) with 13N-ammonia and 18F-fluorodeoxyglucose (FDG), and
      regional wall motion by left ventriculography in regions with persistent and
      transient abnormal Q waves in 14 patients. PET identified 3 groups of abnormal
      myocardial segments: segments with hypoperfusion without increased FDG uptake,
      those with hypoperfusion and increased FDG uptake, and those with normal
      perfusion and increased FDG uptake. Almost all the segments with persistent or
      transient abnormal Q waves had abnormal PET findings. PET demonstrated evidence
      of metabolic activity in 57% of segments with persistent abnormal Q waves and 67%
      of those with transient abnormal Q waves. Regional wall motion, scored from 0
      (normal) to 4 (dyskinesia), was not significantly different between segments with
      persistent and transient abnormal Q waves (2.3 +/- 1.3 vs 2.2 +/- 1.2). The
      persistence of abnormal Q waves on serial electrocardiograms was significantly
      shorter in metabolically active than in inactive segments (19 +/- 17 vs 92 +/- 27
      months). In conclusion, in patients with Kawasaki disease, the new appearance of
      abnormal Q waves is a reliable clue to the presence of ischemic myocardial injury
      and a high proportion of them are associated with metabolically active myocardial
      regions. The disappearance of abnormal Q waves does not necessarily mean the
      normalization of regional myocardial perfusion, metabolism or function, and their
      early disappearance may imply "viability" in the associated myocardial region.

PMID- 1746467
TI  - Usefulness of the total cholesterol to high-density lipoprotein cholesterol ratio
      in predicting angiographic coronary artery disease in women.
AB  - To investigate the relation between lipids and angiographic coronary artery
      disease (CAD) in women, fasting lipid profiles were obtained on 108 women
      undergoing coronary angiography (group I). CAD, defined as greater than or equal
      to 25% luminal diameter narrowing in a major coronary artery, was present in 57
      (53%). Neither serum total cholesterol nor triglyceride levels correlated with
      the presence of CAD. Mean total/high-density lipoprotein (HDL) cholesterol ratio
      was higher among women with than without CAD (5.5 +/- 0.3 vs 4.2 +/- 0.2, p less
      than 0.0001). Multiple regression analyses identified a higher total/HDL
      cholesterol ratio as the variable most predictive of the presence (p less than
      0.001), extent (number of narrowed arteries) (p less than 0.0001), and severity
      (% maximum stenosis) (p less than 0.001) of CAD. Age and lack of estrogen use
      were also independently associated with the presence of CAD, age and low-density
      lipoprotein cholesterol level were additional indicators of extent, and age was
      the only other discriminator of severity of CAD. In 56 women with total
      cholesterol less than 200 mg/dl (group II), mean total/HDL cholesterol ratio was
      higher in women with (n = 24) than without CAD (4.3 +/- 0.2 vs 3.5 +/- 0.2, p =
      0.01). Higher total/HDL cholesterol ratio was the variable most predictive of the
      presence of CAD (p = 0.01), and the lone variable associated with severity (p
      less than 0.001) after adjustment for other risk factors. Age was independently
      associated with presence and extent, and hypertension was also independently
      related to extent.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746468
TI  - Radiofrequency catheter ablation of accessory pathways: a learning experience.
AB  - Success rates of approximately 90% have recently been reported with
      radiofrequency catheter ablation of accessory pathways. This study determined
      whether this success could be repeated using a conservative approach generally
      limiting fluoroscopy time to 1 hour. Consecutive patients referred for management
      of arrhythmias associated with accessory atrioventricular pathways were included
      over a 9-month period. Ablation was attempted in 75 patients with 84 pathways.
      Overall success rate (including second attempts in 9 patients) was 60 of 84
      accessory pathways (71%). Success rates for the first 3 months (n = 23) were 52%,
      the second 3 months (n = 23) 60% and the last 3 months (n = 38) 90%. Success rate
      varied with pathway location, with left lateral pathways having the best early
      success rates. Mean fluoroscopy time for successful procedures of 33 +/- 21
      minutes was shorter than the time for unsuccessful procedures of 63 +/- 24
      minutes (p = 0.001). There were no major complications and no patients with
      successful procedures (n = 53) have had recurrence of accessory pathway
      conduction or reciprocating tachycardia (follow-up 1 to 10 months). A
      conservative approach can yield success rates approaching 90% in a short time.
      The absence of major complications supports earlier reports suggesting that
      radiofrequency catheter ablation of accessory pathways is a reasonable first-line
      therapy in the Wolff-Parkinson-White syndrome.

PMID- 1746469
TI  - Reduction in medical care cost associated with radiofrequency catheter ablation
      of accessory pathways.
AB  - The cost of definitive therapy was compared in 25 patients who underwent
      radiofrequency catheter ablation of accessory pathways in 1990 and 25 patients
      who underwent surgical ablation of accessory pathways in 1989. In the
      radiofrequency group, 23 of 25 patients had a single accessory pathway and the
      remaining 2 patients each had 2 accessory pathways. In the surgical group, 20
      patients had a single accessory pathway and 5 patients each had 2 accessory
      pathways. The success rate was 96% in each group. The mean duration of
      hospitalization was 3 +/- 1 days in the radiofrequency group and 9 +/- 4 days in
      the surgical group (p less than 0.0001). All the cost data are expressed in
      fiscal year 1990/1991 dollar values. The total cost of therapy in the
      radiofrequency group was $14,919 +/- $6,740 compared with $53,265 +/- $12,755 in
      the surgical group (p less than 0.0001). The cost of radiofrequency ablation
      consisted of a hospital charge of $7,753 +/- $3,472 and physician fees of $7,166
      +/- $3,439. The hospital charge included charges for use of the electrophysiology
      laboratory, hospital stay, electrocardiograms, echocardiograms and blood studies.
      The cost of surgery consisted of a hospital charge of $37,708 +/- $10,179 and
      physician fees of $15,557 +/- $3,149. The hospital charge in the surgical group
      included the costs of a baseline electrophysiology study, in-hospital care and a
      follow-up office visit. In conclusion, radiofrequency catheter ablation of
      accessory pathways results in a dramatic reduction in the cost of definitive
      therapy in patients with the Wolff-Parkinson-White syndrome.

PMID- 1746470
TI  - Reproducibility and relation to mean heart rate of heart rate variability in
      normal subjects and in patients with congestive heart failure secondary to
      coronary artery disease.
AB  - Before heart rate (HR) variability can be used for predictive purposes in the
      clinical setting, day-to-day variation and reproducibility need to be defined as
      do relations to mean HR. HR variability and mean HR were therefore determined in
      2 successive 24-hour ambulatory electrocardiograms obtained from 33 normal
      subjects (age 34 +/- 7 years, group I), and 22 patients with coronary disease and
      stable congestive heart failure (CHF) (age 59 +/- 7 years, group II). Three
      measures were used: (1) SDANN (standard deviation of all mean 5-minute normal
      sinus RR intervals in successive 5-minute recording periods over 24 hours); (2)
      SD (the mean of the standard deviation of all normal sinus RR intervals in
      successive 5-minute recording periods over 24 hours); and (3) CV (coefficient of
      variation of the SD measure), a new measure that compensates for HR effects.
      Group mean HR was higher and HR variability lower in group II than in group I (80
      +/- 10 vs 74 +/- 9 beats/min, p less than 0.04). Mean group values for HR and HR
      variability showed good correlations between days 1 and 2 (mean RR, r = 0.89,
      0.97; SDANN, r = 0.87, 0.87; SD, r = 0.93, 0.97; CV, r = 0.95, 0.97 in groups I
      and II, respectively). In contrast, considerable individual day-to-day variation
      occurred (group I, 0 to 46%; group II, 0 to 51%). Low HR variability values were
      more consistent than high values. SDANN and SD correlated moderately with HR in
      both groups (r = 0.50 to 0.64). The CV measure minimizes HR effects on HR
      variability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746471
TI  - Comparison of transthoracic and transesophageal echocardiography for assessment
      of left-sided valvular regurgitation.
AB  - To compare transthoracic and transesophageal echocardiography in the clinical
      assessment of left-sided valvular regurgitation, 118 patients who underwent both
      transesophageal and transthoracic echocardiographic studies within a 24-hour
      period were included in this study. Presence or absence of aortic regurgitation
      was identified concordantly by both techniques in 93 patients (79%). Complete
      agreement between both techniques was found in 88 patients (75%). Presence or
      absence of mitral regurgitation was identified concordantly by both techniques in
      89 patients (75%). Complete agreement in grade was found in only 74 patients
      (63%). Twenty-nine patients (25%) had mitral regurgitation detected by
      transesophageal echocardiography, but not by transthoracic echocardiography. Four
      of these patients (14%) had significant (2 to 3+) mitral regurgitation.
      Differences between transesophageal and transthoracic echocardiography do not
      appear to be clinically important in patients with aortic regurgitation. In
      mitral regurgitation, significant differences exist between these 2 techniques,
      with transesophageal echocardiography being much more sensitive.

PMID- 1746472
TI  - Pulmonary valve-moderator band distance and association with development of
      double-chambered right ventricle.
AB  - Double-chambered right ventricle (DCRV), a form of right ventricular outflow
      obstruction that sometimes accompanies a ventricular septal defect (VSD), is
      associated with superior and rightward displacement of the septal insertion of
      the moderator band. It was hypothesized that this superior displacement is
      present and identifiable by echocardiography in patients with a VSD even before
      right ventricular outflow tract obstruction develops. Eight patients who had a
      previous echocardiographic study showing a VSD alone were echocardiographically
      diagnosed as having DCRV. Their initial echocardiographic studies were reviewed,
      and superior displacement of the moderator band was quantified by measuring the
      distance between the pulmonary valve and moderator band, normalized to tricuspid
      anulus diameter. These measurements were compared with those from the initial
      studies of the following 3 other groups: (1) an age-matched group of 10 patients
      with no structural heart disease; (2) an age-matched group of 10 patients with a
      VSD who did not develop DCRV; and (3) a group (not age-matched) of 10 patients
      with VSD and DCRV in whom subpulmonary obstruction was present on the initial
      study. The 8 patients who eventually developed subpulmonary obstruction had
      significant superior displacement of the moderator band at the time of their
      initial echocardiogram compared with that of the 2 age-matched control groups (p
      less than 0.01). In contrast, there was no significant difference in moderator
      band displacement between these patients and the 10 with DCRV who already had
      right ventricular outflow obstruction at their initial study (p = not
      significant).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746473
TI  - Acute and long-term effects of nifedipine on pulmonary and systemic hemodynamics
      in patients with pulmonary hypertension associated with diffuse systemic
      sclerosis, the CREST syndrome and mixed connective tissue disease.
AB  - Ten patients with pulmonary hypertension associated with diffuse systemic
      sclerosis (1 patient), the CREST syndrome (calcinosis cutis, Reynaud's
      phenomenon, esophageal dysmotility, sclerodactyl, telangiectasia) (6 patients)
      and mixed connective tissue disease (3 patients) were studied to assess the
      effect of oral nifedipine on pulmonary and systemic hemodynamics. Each patient
      underwent right-sided cardiac catheterization just before nifedipine
      administration. Thereafter, oral nifedipine was administered in 10 mg increments
      every 90 minutes until pulmonary vascular resistance normalized or a total dose
      of 30 mg was achieved. Hemodynamic measurements were obtained at 30-minute
      intervals for 3 hours, then hourly for 9 hours (acute study). Hemodynamic studies
      were repeated 3 to 6 months after the initial catheterization with the minimum
      dose of oral nifedipine (administered every 8 hours) required to achieve maximal
      reduction of pulmonary vascular resistance in the acute study (long-term study).
      In the acute study, oral nifedipine produced a significant decrease in mean
      pulmonary vascular resistance from 6.3 +/- 3.8 to 4.3 +/- 3.6 U (p less than
      0.001). Similar changes in pulmonary vascular resistance were noted in the long
      term study (n = 6). The results indicate that oral nifedipine is capable of
      producing an acute and sustained reduction in pulmonary vascular resistance in
      patients with pulmonary hypertension associated with diffuse systemic sclerosis,
      the CREST syndrome and mixed connective tissue disease.

PMID- 1746474
TI  - Echocardiographic assessment of left ventricular function and wall motion at high
      altitude in normal subjects.
AB  - To understand the effects of high-altitude hypoxia on cardiac function and the
      change in cardiac function during high-altitude acclimatization, precise studies
      were first performed at greater than 5,000 m of altitude in Himalaya by 2
      dimensional echocardiography. In addition to examining well-known indexes of
      cardiac function, the centerline method was used to assess regional wall motion,
      which has not been examined under conditions of high-altitude hypoxia. The
      subjects were 11 climbing members (aged 21 to 43 years) of the Kyoto University
      Medical Research Expedition of Xixabangma (8,027 m) in 1990. Examinations were
      performed at sea level, at the base camp (5,020 m), and twice at the advanced
      base camp (5,650 m). Heart rate, left ventricular (LV) end-diastolic volume,
      cardiac output, mean rate of circumferential fiber shortening, ejection fraction,
      % fractional shortening, and regional LV wall motion were measured. At high
      altitude, heart rate increased to 136% of the sea level value, but gradually
      decreased in the degree of increment at the early and late advanced base camp
      measurements. LV end-diastolic volume decreased significantly by 70%. At base
      camp there were significant increases in ejection fraction, mean rate of
      circumferential fiber shortening, and % fractional shortening, which showed
      little change during the long-term stay at high altitude. Regional wall motion at
      high altitude (measured by the center-line method) decreased at the septal wall
      and increased at the posterolateral wall. These results demonstrate that: (1) LV
      cardiac performance at high altitude is enhanced significantly in spite of
      reduced preload. After good acclimatization, cardiac performance remains
      augmented, but there is a tendency to decrease the degree of augmentation. (2) In
      regional LV wall motion, septal wall motion is impaired, but LV posterolateral
      wall motion shows a compensatory increase.

PMID- 1746475
TI  - Coronary adrenergic hyperreactivity in patients with syndrome X and abnormal
      electrocardiogram at rest.
AB  - Syndrome X is characterized by an abnormal vasomotility of coronary microvessels.
      It is unknown whether the presence of an ischemic-like pattern in the
      electrocardiogram at rest (T-wave inversion) reflects a more severe vasomotion
      disturbance. Changes in coronary sinus flow (thermodilution) and epicardial
      vessel diameter (quantitative angiography) during adrenergic activation were
      measured with a standard cold pressor test in patients with syndrome X whose
      electrocardiogram at rest was normal (group 1: 17 patients) or showed stable,
      symmetrically inverted T waves (group 2: 22 patients). Cold pressor test
      increased mean blood pressure and rate-pressure product to a similar extent in
      both groups, increased coronary sinus flow in group 1 (88 +/- 29 to 119 +/- 36
      ml/min; p less than 0.05) and not in group 2 (109 +/- 37 vs 104 +/- 36 ml/min; p
      = not significant), and decreased coronary resistance in group 1 (1.38 +/- 0.42
      to 1.19 +/- 0.38 mm Hg/ml/min; p less than 0.05) and augmented it in group 2
      (1.06 +/- 0.32 to 1.28 +/- 0.43 mm Hg/ml/min; p less than 0.02). During cold
      stimulus, the proximal and middle segments of epicardial arteries showed
      negligible changes in their lumen, whereas the distal segment dilated in group 1
      (1.81 +/- 0.27 to 2.01 +/- 0.32 mm; p less than 0.05) and constricted in group 2
      (1.82 +/- 0.12 to 1.62 +/- 0.20 mm; p less than 0.05). Differences in coronary
      hemodynamic and angiographic responses between the groups were statistically
      significant (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746476
TI  - Cost-effectiveness analysis of the use of digoxin immune Fab (ovine) for
      treatment of digoxin toxicity.
AB  - Each year many people have digitalis toxicity severe enough to require extensive
      hospital treatment. Digoxin immune Fab[ovine]-Fab fragments (Digibind) have been
      shown to reverse digitalis toxicity and substantially reduce the risk of death.
      Data were used from uncontrolled studies of patients treated with Fab fragments
      as well as clinical, medical care and pharmacokinetic data from symptomatically
      treated patients to derive estimates of the difference in clinical outcomes and
      medical care costs when treating with this new drug. Estimates are derived
      separately for treatment of patients with toxicity that is immediately life
      threatening and patients whose manifestations are not immediately life
      threatening. Treatment with Fab fragments reduces the probability of dying more
      for the seriously toxic than for the less seriously toxic patient. Such treatment
      is generally associated with an increase in total medical care costs for the
      seriously toxic patients because more of them survive the toxic episode and
      require additional medical care before discharge from the hospital. For these
      patients, the estimated cost per life-year saved is between $1,900 and $5,400.
      When Fab fragments are used to treat less seriously toxic patients, total medical
      care costs decrease because of an estimated decreased number of days in the
      coronary care unit and decreased use of pacemakers and other aggressive
      treatments.

PMID- 1746477
TI  - Limitations of testing methods for evaluation of dual chamber versus single
      chamber adaptive rate pacing.

PMID- 1746478
TI  - Usefulness of coronary angiography in patients requiring repeat cardiac valve
      surgery.

PMID- 1746479
TI  - Effectiveness of balloon percutaneous valvuloplasty for stenotic bioprosthetic
      valves in different positions.

PMID- 1746480
TI  - Clinical spectrum of venous thrombi in the Fontan patient.

PMID- 1746481
TI  - Clinical characteristics of patients with acute pulmonary embolism.

PMID- 1746482
TI  - Lymphoproliferative disorder early after cardiac transplantation.

PMID- 1746483
TI  - Appearance of or persistence of severe mitral regurgitation without left
      ventricular outflow obstruction after partial ventricular septal myotomy-myectomy
      in hypertrophic cardiomyopathy.

PMID- 1746484
TI  - Alkaline paper and preserving the record.

PMID- 1746485
TI  - Sorting out heightened interactions between platelets and von Willebrand factor.
      "IIB or not IIB?" is becoming an increasingly answerable question in the
      molecular era.

PMID- 1746486
TI  - DNA measurement by image analysis of paraffin-embedded breast carcinoma tissue. A
      comparative investigation.
AB  - Measurement of cellular DNA content may provide useful prognostic information in
      several human neoplasms. The DNA content by image analysis of fresh tissue has
      been compared with flow cytometry with good correlation, but the use of paraffin
      embedded tissue for image analysis has not been studied widely. This study
      reports the DNA content of 54 breast carcinomas and compares the results of image
      analysis of paraffin-embedded tissue and results of image analysis and flow
      cytometry of corresponding fresh tumors. Image analysis of paraffin blocks and
      fresh tumors showed comparable results in 51 tumors (94%), whereas 47 tumors
      (87%) were similar by all three methods. The DNA indices from image analysis of
      fresh and paraffin-embedded tumors showed significant correlation by linear
      regression analysis (r = 0.96; P less than 0.001). Discordances between image
      analysis of fresh and paraffin-embedded tumors are the result of technical
      problems, such as staining and tissue preservation. Discordances between image
      analysis and flow cytometry reflect the advantages and pitfalls of the two
      techniques. These data suggest that image analysis of paraffin-embedded tissue is
      a viable technique that will permit the performance of retrospective studies with
      long-term follow-up data for the evaluation of the prognostic significance of DNA
      content.

PMID- 1746487
TI  - Large cell calcifying Sertoli cell tumor of the testis. A clinicopathologic,
      immunohistochemical, and ultrastructural study of two cases.
AB  - The clinicopathologic, immunohistochemical, and electron microscopic study of two
      patients with large cell calcifying Sertoli cell tumors (LCCSCT) of the testis is
      reported to elucidate the histogenesis of this rare tumor. Both tumors occurred
      in young individuals (16 and 32 years); case 1 was found incidentally, and the
      patient in case 2 presented with a 3-4-week history of testicular pain. Evidence
      of testosterone production was demonstrated in one case. In the same case, at the
      ultrastructural level Charcot-Bottcher crystalloids were observed. These data
      support previous reports that LCCSCT shows Sertoli cell differentiation.

PMID- 1746488
TI  - The rapid differentiation of type IIb von Willebrand's disease from platelet-type
      (pseudo-) von Willebrand's disease by the "neutral" monoclonal antibody binding
      assay.
AB  - The differentiation of type IIb von Willebrand's disease from other variants of
      von Willebrand's disease, especially platelet-type (pseudo-) von Willebrand's
      disease, poses a significant clinical problem because, although they are similar
      in the clinical and diagnostic laboratory settings, the therapy of type IIb von
      Willebrand's disease is different from the therapy of platelet-type von
      Willebrand's disease. This discrimination has required cumbersome assays using
      fresh platelet-rich plasma that often yielded equivocal results. Because it was
      shown by other researchers that type IIb von Willebrand factor binds to normal
      platelets with increased avidity at low concentrations of ristocetin, it was
      reasoned that von Willebrand factor from patients with type IIb von Willebrand's
      disease would also bind to formalin-fixed washed platelets at low concentrations
      of ristocetin. Using the radiolabeled "neutral" monoclonal antibody AVW1 to label
      plasma von Willebrand factor, the binding of von Willebrand factor to formalin
      fixed washed platelets was studied as a function of ristocetin concentration.
      These studies demonstrated that the 125I-AVW1 von Willebrand factor from 13
      patients with type IIb von Willebrand's disease binds to formalin-fixed washed
      platelets at significantly lower concentrations of ristocetin than plasma von
      Willebrand factor from 18 normal individuals, 3 patients with platelet-type von
      Willebrand's disease and 8 patients with other variant forms of von Willebrand's
      disease. This radiolabeled "neutral" monoclonal antibody technique provides a
      rapid, simple method for the differentiation on frozen plasma samples of type IIb
      von Willebrand's disease from platelet-type and other variants of von
      Willebrand's disease.

PMID- 1746489
TI  - The estimation of whole blood viscosity by a porous bed method.
AB  - A significant impediment in determining the relative contribution of whole blood
      viscosity to the pathogenesis of cardiovascular and cerebrovascular disease has
      been the lack of an uncomplicated method to measure whole blood viscosity. To
      address this problem, a simplified porous bed viscometer has been developed to
      measure whole blood viscosity. Whole blood is passed through a porous bed of
      branching channels with a mean pore diameter of 69.6 +/- 20.2 microns and an
      estimated mean shear rate of 19.6 seconds-1. The effects of sample collection,
      sample storage, and temperature are described. The mean whole blood viscosity of
      242 healthy persons was 22.7 +/- 5.3 seconds, which, when corrected to centipoise
      using Darcy's equation, corresponds to an apparent viscosity of 5.7 +/- 1.3 cp.
      There was a significant difference in the whole blood viscosity of normal men and
      women related to their different packed cell volumes. Platelets and granulocytes
      influenced whole blood viscosity in proportion to their contribution to the total
      packed cell volume. Fibrinogen levels did not significantly influence measured
      whole blood viscosity, which is consistent with the disaggregating conditions and
      the mean shear rate of the instrument. The porous bed viscometer is a convenient
      means to measure whole blood viscosity and it should be useful as a screening
      test for clinical and epidemiologic studies.

PMID- 1746490
TI  - Diversity of organ site involvement among malignant lymphomas of mucosa
      associated tissues.
AB  - Fifteen cases of low-grade B-cell lymphoma involving unusual extranodal sites
      have been studied in comparison to cases reported or observed arising in typical
      mucosa-associated lymphoid tissues. In every case, histopathologic features
      conformed to those characteristic for lymphomas of mucosa-associated lymphoid
      tissues, including the production of lymphoepithelial complexes. Immunoglobulin
      light chain restriction was demonstrated by immunocytochemistry in 14 cases.
      Sites of involvement included the breast (6), skin (5), kidney (1), prostate (1),
      gallbladder (1), and uterine cervix (1). In three cases there was simultaneous or
      previous lymphoma of mucosa-associated lymphoid tissues identified in a more
      common mucosal site. It is concluded that the unifying concept of lymphomas of
      mucosa-associated lymphoid tissues applies to extranodal organs less commonly
      associated with mucosa-associated lymphoid tissues, as well as to those mucosal
      organ sites described in earlier series.

PMID- 1746491
TI  - Immunoglobulin gene rearrangement in abnormal lymph node hyperplasia.
AB  - The histologic designation "abnormal lymphoid hyperplasia" is applied to lymph
      nodes demonstrating varying degrees of architectural effacement and/or cytologic
      atypia. Although some of these cases may be suggestive of non-Hodgkin's lymphoma,
      a definitive diagnosis is not possible despite careful morphologic and
      immunophenotypic studies. Because the demonstration of immunoglobulin and T-cell
      receptor gene rearrangements by Southern blot analysis provides a sensitive
      marker of lineage and clonality in lymphoid malignant conditions, the frequency
      with which such gene rearrangements could be identified in abnormal hyperplasia
      and their significance were studied. DNA samples from lymph node biopsy samples
      of 11 patients with abnormal lymphoid hyperplasia were analyzed for
      rearrangements of immunoglobulin and T-cell receptor genes by Southern blot
      hybridization. Six of these patients had monoclonal B-cell populations identified
      by immunoglobulin gene rearrangements; all were found subsequently to have non
      Hodgkin's lymphoma by repeated biopsy from 8 days to 46 months later. Two
      patients with negative Southern blot studies also developed lymphoma, one a T
      cell non-Hodgkin's lymphoma and one a cutaneous B-cell non-Hodgkin's lymphoma.
      Three patients without detectable gene rearrangements showed no evidence of
      malignant lymphoma at 36-, 45-, and 60-month follow-up evaluations. Southern blot
      analysis thus identified monoclonal B-cell lymphoid populations in a subset of
      patients with abnormal lymphoid hyperplasia; the presence of clonal
      immunoglobulin gene rearrangement predicted progression to overt non-Hodgkin's
      lymphoma.

PMID- 1746492
TI  - Evaluation of four coagulation tests to detect plasma lupus anticoagulants.
AB  - Lupus anticoagulant was detected in 205 newly diagnosed, untreated patients with
      systemic lupus erythematosus by the following tests: kaolin clotting time,
      activated partial thromboplastin time, plasma prothrombin time, and, in the last
      99 patients, by dilute Russell's viper venom time. In 10 patients, lupus
      anticoagulant was detected by kaolin clotting time prolongation, corrected by
      inosithin but not by normal plasma; 12 and 6 of them had prolonged activated
      partial thromboplastin time and partial plasma prothrombin time, respectively.
      Only 10 patients had a history of recurrent abortions and/or thrombosis, nine of
      whom had lupus anticoagulant as shown by the kaolin clotting time test. Of the 99
      patients studied by all four tests, 9 showed lupus anticoagulant by both kaolin
      clotting time and dilute Russell's viper venom time; 7 had a history of abortion
      and/or thrombosis. The dilute Russell's viper venom time test is easy to perform
      and not affected by inhibitors to factor VIII or IX. It is recommended as a
      primary screening test for lupus anticoagulant detection in a hospital clinical
      laboratory.

PMID- 1746493
TI  - TestPack Strep A kit for the rapid detection of group A streptococci on 11,088
      throat swabs in a clinical pathology laboratory.
AB  - Results obtained with Abbott Laboratories' TestPack Strep A, a rapid test kit to
      detect group A streptococcal antigen on throat swabs, were compared with the
      culture results. All tests were performed by American Society of Clinical
      Pathology-registered technologists in a large clinical laboratory. A total of
      11,088 throat swabs were tested; 9,161 belonged to pediatric patients and 1,927
      to adults. For TestPack Strep A, the study demonstrated a sensitivity value of
      0.91 and a specificity value of 0.96; positive predictive value and negative
      predictive values were 0.82 and 0.98, respectively. These data indicate that even
      when performed by experienced technologists, in a laboratory setting,
      approximately 1 of 10 patients with group A streptococcal tonsillopharyngitis
      will be missed if physicians rely solely on this direct antigen test. A backup
      culture on all patients who are negative by a rapid antigen detection test is
      recommended.

PMID- 1746494
TI  - Rejuvenation of erythrocytes preserved with AS-1 and AS-3.
AB  - Rejuvenation of erythrocytes (biochemical modification of adenosine triphosphate
      and 2,3-diphosphoglycerate) preserved with currently available nutrient additive
      solutions has not been licensed or adequately studied. The ability of the
      commercially available solution PIPA to modify erythrocytes preserved with AS-1
      or AS-3 for 35 and 42 days was studied. Use of PIPA produced greater-than-normal
      levels of adenosine triphosphate in the preserved erythrocytes. Restoration of
      2,3-diphosphoglycerate was suboptimal at both periods. (PIPA treatment produces
      normal levels of 2,3-diphosphoglycerate in erythrocytes preserved for 35 days
      with citrate-phosphate-dextrose-adenine-1.) In erythrocytes preserved with AS-1
      or AS-3 for 42 days, 2,3-diphosphoglycerate returned to normal levels after a
      second PIPA rejuvenation. This study demonstrates that biochemical modification
      is possible in erythrocytes preserved with AS-1 or AS-3 for 42 days.

PMID- 1746495
TI  - Laboratory hemostatic abnormalities in massively transfused patients given red
      blood cells and crystalloid.
AB  - Most of the literature on massive transfusion concerns whole blood replacement,
      whereas clinically, packed red blood cells are commonly given. To determine when
      hemostatic abnormalities occur in patients resuscitated primarily with packed red
      blood cells and crystalloid, the cases of 39 consecutive patients who were
      transfused with 10 or more red blood cell units of any kind within 24 hours were
      reviewed. After transfusion with 20 or more units of red blood cell products of
      any kind (packed red blood cells, cell-saver units, or whole blood), 75% (3 of 4)
      of patients had platelet counts less than 50 x 10(9)/L, compared to 0 of 29
      patients given less than 20 units (P less than 0.001). After transfusion of 12
      units of relatively plasma-free red blood cell products (packed red blood cells
      or cell-saver units), 100% (8 of 8) of patients had prothrombin time prolonged by
      more than 1.5 times mid-range of normal, compared to 36% (5 of 14) of patients
      given less than 12 units (P = 0.012). These data confirm that patients massively
      transfused with red blood cells of any kind develop significant thrombocytopenia
      after 20 units. Importantly, probably clinically significant prothrombin time and
      partial thromboplastin time prolongations occurred consistently after transfusion
      of 12 units of relatively plasma-free red blood cells in unselected patients at
      an urban trauma hospital. These data suggest that coagulation factor replacement
      is necessary in patients who receive 12 or more units of packed red blood cells
      or cell-saver blood, and platelet replacement is necessary in patients who
      receive 20 or more units of any red blood cell product. A prospective study is
      needed to determine whether the expected abnormal clinical bleeding indeed occurs
      in patients with such laboratory coagulation abnormalities and to determine when
      plasma transfusion is indicated in patients massively transfused with red blood
      cells.

PMID- 1746496
TI  - The mystique of the mistake. With proposed standards for validating proficiency
      tests in anatomic pathology.
AB  - Variability in classification in anatomic pathology does not necessarily indicate
      that a mistake has been made. It is usually an artifact, created when
      pathologists choose a single category from among two or more justifiable
      alternatives. This is most common when standard classifications with uniform
      terminology are not used. It also can occur when classification systems are not
      constructed so as to insure mutual exclusivity of categories. It is proposed that
      a proficiency test in anatomic pathology should not be considered scientifically
      valid until a professional organization primarily concerned with anatomic
      pathology has endorsed its proposed classification system as having categories
      that are close to 100% mutually exclusive in the hands of expert pathologists not
      involved in developing the system. All possible precautions should be taken to
      insure that the "right answers" for any proficiency test are generated in a way
      that excludes the possibility of multiple justifiable alternatives.

PMID- 1746497
TI  - The range of small cell tumors of the bone: yet more phenotypic variants.

PMID- 1746498
TI  - Multilocular cystic renal cell carcinoma.

PMID- 1746499
TI  - Metaplastic carcinomas and sarcomas of the breast.

PMID- 1746500
TI  - Underdiagnosis of alcohol dependence in psychiatric inpatients.
AB  - Alcoholism is prevalent among psychiatric inpatients, and accurately diagnosing
      alcohol problems is a critical step in treatment planning. The authors diagnosed
      alcohol dependence in 35 psychiatric inpatients by blind review of interview
      protocols and hospital records. They then examined the frequency with which
      admitting and attending clinicians diagnosed alcohol abuse and dependence in
      these patients. Alcoholism was underdiagnosed; 24% of the clinicians' diagnoses
      included no alcoholism diagnosis, 39% were alcohol abuse, and only 37% were
      alcohol dependence. Underdiagnosis was strongly associated with the presence of a
      comorbid psychosis, as well as with patients' denial of alcoholism and with less
      severe alcoholism. The authors discuss the patient and clinician variables which
      may contribute to underdiagnosing alcoholism and recommend educational and
      administrative measures to improve clinicians' diagnostic sensitivity.

PMID- 1746501
TI  - Substance abuse in an inpatient psychiatric sample.
AB  - The relationship between psychoactive drug abuse and psychopathology is complex.
      There have been few systematic explorations of substance abuse in psychiatric
      populations since the recent epidemic of cocaine abuse. To update and further
      explore the relationship between psychiatric illness and substance abuse, 100
      consecutively admitted patients to an inpatient psychiatry unit were administered
      a drug and alcohol use/abuse questionnaire. Sixty-four percent endorsed current
      or past problems with substance abuse and 29% met DSM-III-R criteria for
      substance abuse in the 30 days prior to admission. For the major diagnostic
      categories, there were no significant differences between groups in percentages
      of patients with substance abuse disorders. There was a trend (p less than or
      equal to .2) toward an increased number of lifetime psychiatric hospitalizations
      in the substance-abusing group. Alcohol was the most common drug of choice
      followed by stimulants, cannabis, and sedative hypnotics. Differences in drug
      choices between diagnostic categories are discussed. Forty-three percent of urine
      drug screens obtained were positive, and of those with positive urine drug
      screens, 42% denied drug use upon admission. Only 40% of patients with current or
      past substance abuse problems had received treatment for their chemical
      dependency. In our sample, while substance abuse was very prevalent, it was
      underreported and undertreated.

PMID- 1746502
TI  - Drug abuse risk among pregnant adolescents attending public health clinics.
AB  - The drug abuse risk status and characteristics of pregnant adolescents (under 21
      years) were evaluated at public maternal health clinics in Prince George's
      County, Maryland. During the project period (March 1988 to September 1989), 403
      young women were interviewed. Based on those interviews, one of four risk
      judgments, scaled for increasing severity of risk, was assigned. Twenty percent
      of the sample was found to be either at high risk or current abusers of alcohol
      or other drugs. Risk was equally represented across both the age range (14-20
      years) and marital status of the sample, but Whites were overall at significantly
      higher risk than Blacks (P less than .0001). Post-hoc examination of risk
      correlates identified drug use in the home and past or current cigarette smoking
      to be strongly predictive of risk (gamma = .92). While parental drug use was the
      most frequently reported social environment drug influence factor, as risk status
      of the young women increased in severity, the parental influence factor declined
      and the significant-other influence factor increased. A separate sample of adult
      women (21 years and older) was interviewed for comparison to the youth sample.

PMID- 1746503
TI  - Combined substance abuse and psychiatric disorders in homeless and domiciled
      patients.
AB  - Although homelessness in patients with combined addictive and psychiatric illness
      is a common problem, little has been reported about the epidemiology of
      homelessness in this patient population. The authors, in a study of 100 dually
      diagnosed patients admitted to a large metropolitan psychiatric hospital, found
      that a large portion of patients (N = 46) were homeless at the time of admission.
      Alcohol and crack/cocaine were the most frequently used drugs. Interestingly,
      there were no significant differences on most parameters between those who were
      homeless and those who were not. The authors observed that among the
      disadvantaged, inner-city dually diagnosed, many move in and out of the homeless
      state, seriously compromising their chances for recovery. Self-help treatment
      programs were more commonly used by homeless than domiciled patients. The
      homeless population may therefore be amenable to treatment in 12-step groups, as
      are domiciled patients.

PMID- 1746504
TI  - Effect of cocaine on thyroid functions.
AB  - Results of routine thyroid function tests in heavy cocaine abusers at the time of
      treatment admission were not statistically different from normal values for our
      laboratory or from a similar group of other substance abuse patients in
      treatment. This suggests that heavy cocaine use per se does not affect thyroid
      function. Therefore, if the thyroid function tests are abnormal in a cocaine
      abuser, then a true thyroid dysfunction should be considered and completely
      evaluated. In addition, nonspecific alterations in thyroid function tests in
      nonthyroidal illnesses should be kept in mind.

PMID- 1746505
TI  - The intoxication power of alcoholic beverages: image and reality.
AB  - Because of the newness of wine coolers and their youthful appeal, questions have
      arisen of whether consumers have a realistic understanding of coolers'
      intoxication power. Questionnaires were given to 459 undergraduates to determine
      how accurately they could estimate the number of drinks (beer, light beer, wine,
      wine coolers, and whiskey) they would have to consume to become legally
      intoxicated. Results indicate that, although responses differ by race and gender,
      respondents have a poor understanding of the intoxication power of alcohol in
      general and of hard liquor and wine coolers in particular. Whereas liquor's
      intoxication power was overestimated, the intoxication power of wine coolers was
      underestimated relative to other types of drinks by the total sample and
      underestimated in absolute terms by females.

PMID- 1746506
TI  - Risk factors associated with alcohol abuse in college students.
AB  - A survey of 989 college students was conducted to investigate risk factors-
      gender, family history of alcohol abuse, family history of depression and mental
      illness, childhood hyperactivity, and antisocial personality-associated with
      alcohol abuse. Two hundred ninety-four subjects (29%) completing the alcohol
      subscale of the Diagnostic Interview Schedule met lifetime DSM-III criteria for
      alcohol abuse. Utilizing a loglinear model, expression of childhood and early
      adolescent deviant behavior, family history of depression, and gender were shown
      to be significantly associated with alcohol abuse among students.

PMID- 1746507
TI  - Buprenorphine for pain relief in a patient with drug abuse.
AB  - Buprenorphine is a mixed opioid agonist/antagonist which appears to produce less
      physical dependence and respiratory depression than typical mu-agonist opioids.
      These effects suggest its use for analgesia for drug abusers. However,
      buprenorphine may precipitate withdrawal from other opioids. The present case
      illustrates the utility of buprenorphine and describes a method to transfer a
      patient from a mu-agonist to buprenorphine without precipitating withdrawal or
      interrupting analgesia.

PMID- 1746508
TI  - Improving the people's health: some Hopkins' contributions.

PMID- 1746509
TI  - The Washington County Training Center: an exemplar of public health research in
      the field.

PMID- 1746510
TI  - Adapting to specialization: the founding, growth, and transformation of the
      American Journal of Hygiene.

PMID- 1746511
TI  - American Journal of Epidemiology: its evolution since 1965.

PMID- 1746512
TI  - Seventy years ago in the Journal.

PMID- 1746513
TI  - Epidemiology is the study of "epidemics" and their prevention.

PMID- 1746514
TI  - Epidemiology and public policy.

PMID- 1746515
TI  - Statistical reasoning in epidemiology.

PMID- 1746516
TI  - Case investigation in epidemiology.

PMID- 1746517
TI  - The interaction of basic science and population-based research: autoimmune
      thyroiditis as a case history.
AB  - This brief commentary illustrates how laboratory research compliments
      populational research. The finding that susceptibility to autoimmune thyroid
      disease in animals is due to the additive effects of a number of unrelated genes
      led to a field study of a genetically predisposed population. In humans, as in
      animals, the major histocompatibility complex plays a preeminent role. Unlike
      many other autoimmune diseases, however, different HLA haplotypes predominate in
      different families, just as different H-2 haplotypes determine susceptibility in
      different strains of mice. Like the predisposed chicken, humans have a number of
      other genes that act independently to influence autoimmune susceptibility.
      Insight into the nature and action of the additional genes depends upon renewed
      studies of the animal models. Thus, we see a symbiotic relation between basic
      science as practiced in the laboratory and population-based research in the
      field.

PMID- 1746518
TI  - "Race" in the epidemiologic literature: an examination of the American Journal of
      Epidemiology, 1921-1990.
AB  - The routine presentation of epidemiologic data by "race" has been challenged as
      impeding identification of modifiable risk factors and fostering an
      unsubstantiated belief in the biologic distinctness of the "races." This study
      examines the past and current uses of "race" in US epidemiologic research. The
      authors reviewed every paper published in the 1921, 1930, 1940, 1950, and 1960
      volumes of the American Journal of Hygiene and in the 1965, 1970, 1975, 1980,
      1985, and 1990 volumes of the American Journal of Epidemiology. Of the total of
      1,200 papers published during the sample years, 558 reports of original
      epidemiologic research conducted in the United States were identified. The
      proportion of these papers containing a reference to "race" rose steadily from
      1975. However, the proportion of papers reporting inclusion of "nonwhite"
      populations did not show a parallel increase. Exclusion of "nonwhite" subjects
      and description of predominantly "white" study populations increased instead.
      Recommendations for future epidemiologic practice include the following: 1)
      greater inclusion of "nonwhite" populations in epidemiologic research and 2)
      vigorous investigation of the root causes of observed "race"-associated
      differences.

PMID- 1746519
TI  - Migration, blood pressure pattern, and hypertension: the Yi Migrant Study.
AB  - Rural-urban migration provides an ideal opportunity to examine the effects of
      environment and genes on blood pressure. The effect of migration on the Yi people
      of China was studied. The Yi people live in a remote mountain area in
      southwestern China. In 1989, blood pressure was measured in 14,505 persons (8,241
      Yi farmers, 2,575 urban Yi migrants, and 3,689 Han urban residents) aged 15-89
      years. Different patterns were seen for men and women. Among the men, Yi farmers
      had the lowest mean blood pressure, the least rise in blood pressure with age
      (systolic blood pressure, 0.13 mmHg/year; diastolic blood pressure, 0.23
      mmHg/year), and the lowest prevalence of hypertension (0.66%). In contrast, both
      Yi migrant men and Han men had higher levels of mean blood pressure, rise in
      blood pressure with age (Yi migrants: systolic pressure, 0.33 mmHg/year;
      diastolic pressure, 0.33 mmHg/year; Han: systolic pressure, 0.36 mmHg/year;
      diastolic pressure, 0.23 mmHg/year), and prevalence of hypertension (Yi migrants,
      4.25%; Han, 4.91%). Among the women, however, mean systolic pressure was higher
      in Yi farmers than in Yi migrants or in Han. Diastolic pressure was similar among
      the three groups. However, the Yi farmer women's age-related rise in blood
      pressure (systolic pressure, 0.06 mmHg/year; diastolic pressure, 0.14 mmHg/year)
      and their prevalence of hypertension (0.33%) were lower than those in the other
      two groups. Yi migrant women had an intermediate rise in blood pressure with age
      (systolic pressure, 0.37 mmHg/year; diastolic pressure, 0.23 mmHg/year) and
      prevalence of hypertension (2.40%). Han women had the greatest rise in blood
      pressure with age (systolic pressure, 0.56 mmHg/year; diastolic pressure, 0.36
      mmHg/year) and the highest prevalence of hypertension (4.76%). For both men and
      women, the above differences were only partially explained by age, body mass
      index, heart rate, smoking, and alcohol use. This study, using standardized
      methods, demonstrates an important effect of migration on rise in blood pressure
      with age and on the prevalence of hypertension.

PMID- 1746520
TI  - A population-based evaluation of glaucoma screening: the Baltimore Eye Survey.
AB  - The Baltimore Eye Survey was a population-based survey conducted from January
      1985 to November 1988 among residents of east Baltimore, Maryland, who were 40
      years of age or older. A total of 5,308 black subjects and white subjects
      received a comprehensive screening examination for glaucoma including tonometry,
      visual fields, stereoscopic fundus photography, and a detailed medical and
      ophthalmic history. Based on a definitive examination, a diagnosis of glaucoma of
      any type was made for 196 persons. Tonometry, cup:disc ratio, and narrowest
      neuroretinal rim width were evaluated for their ability to correctly classify
      subjects into diseased or nondiseased states. There were no cutoff values at
      which these variables provided a reasonable balance of sensitivity and
      specificity, separately or in combination. Logistic regression models were fit
      that included demographic and other risk factors. Sensitivities and specificities
      were calculated for varying cutoff levels on the distribution of predicted
      probabilities. There was no cutoff for which reasonable sensitivity and
      specificity were obtained. The authors conclude that the effectiveness of current
      techniques for glaucoma screening is limited.

PMID- 1746521
TI  - Age- and sex-specific incidence rates of migraine with and without visual aura.
AB  - Age- and sex-specific incidence rates for the onset of migraine headache with and
      without preceding visual aura were estimated from a population-based telephone
      interview survey conducted between March 1986 and June 1987 of 10,169 randomly
      selected residents of Washington County, Maryland, between the ages of 12 and 29
      years. A total of 392 males and 1,018 females were identified as having a history
      of migraine. Of these, 27% of male cases and 28% of female cases were defined as
      having migraine with visual aura. Among both males and females, the incidence
      rate for migraine with visual aura appears to have peaked as much as 3-5 years
      earlier than the age peak for migraine without aura. For males, the age-specific
      incidence for migraine with visual aura appears to have peaked on or before 5
      years of age at 6.6/1,000 person-years, or possibly higher. In contrast, the
      highest incidence for migraine without aura occurred between 10 and 11 years of
      age at 10.1/1,000 person-years. New cases of migraine were uncommon among males
      in their late 20s. The initial onset of migraine headache begins at a later age
      among females than among males. For females, the highest incidence of migraine
      with aura occurred between 12 and 13 years of age at 14.1/1,000 person-years; the
      highest incidence for migraine without aura occurred between 14 and 17 years of
      age at 18.9/1,000 person-years. In contrast to males, new onset of migraine was
      relatively common among females in their late 20s.

PMID- 1746522
TI  - Factors associated with osteoarthritis of the hand in males: data from the
      Baltimore Longitudinal Study of Aging.
AB  - The association of metabolic and physiologic factors with hand osteoarthritis was
      studied in 888 Caucasian male subjects aged 17-102 years in the Baltimore
      Longitudinal Study of Aging. Left-hand radiographs taken between 1958 and 1975
      were read by one investigator for grade of osteoarthritis using Kellgren-Lawrence
      scales. Possible risk factors, assessed at the same visit as the last radiograph
      during this interval, included age and measures of bone mass, body composition,
      muscle mass, and muscle strength. Results of bivariate analyses of these cross
      sectional data showed that increasing grade of hand osteoarthritis was associated
      with increasing age; greater mean levels of waist/hip ratio and percentage of
      body fat; and lower mean levels of percentage of cortical area, grip strength,
      and forearm circumference. After adjustment for age using residuals from best-fit
      quadratic regression models, none of these independent variables remained
      significantly associated with grade of hand osteoarthritis. These data fail to
      support hypotheses that metabolic and physiologic factors are associated with
      hand osteoarthritis independent of their known age-related changes.

PMID- 1746523
TI  - Hip fractures among the elderly: factors associated with in-hospital mortality.
AB  - Factors associated with mortality were examined for 27,370 hip fracture patients
      aged 65 years or older in Maryland hospitals, using discharge data for 1979-1988.
      Variables of interest included sociodemography, principal medical and injury
      diagnoses, E-code, year, disposition, and hospital. For both white males and
      white females, the hip fracture rate doubled with each 5-year increment in age.
      The overall proportion who died during hospitalization was 4.9% (n = 1,339).
      After multivariate adjustment, there remained a substantially increased risk of
      death for males. The relative odds (RO) of dying for males versus females were
      1.6. Other factors associated with high relative odds of dying during
      hospitalization included the diagnosis of septicemia (RO = 12.3),
      pneumonia/influenza (RO = 4.9), and digestive system disorder (RO = 3.6). The RO
      of dying doubled in the presence of cardiac, neoplastic, or cerebrovascular
      disease. Patients with diagnoses of nervous system or mental disorder,
      hypertension, anemia, musculoskeletal system disease, or urinary tract infection
      were at decreased risk of dying. Results of the study suggest that the prevention
      or early diagnosis and treatment of serious infections in the elderly patient
      with a hip fracture remain an important challenge to clinicians.

PMID- 1746524
TI  - The driver's role in fatal two-car crashes: a paired "case-control" study.
AB  - This population-based study examines drivers' characteristics associated with
      driving errors that resulted in fatal motor vehicle crashes. Routinely collected
      data from the Fatal Accident Reporting System were used to assess whether a
      driver initiated the crash (case) or was passively involved (control) in 6,506
      two-car collisions (81% of 7,993 eligible events). A paired comparison of cases
      and controls avoided confounding by environmental factors, exposure to traffic,
      and differences in case fatality. The strongest predictor of crash initiation is
      alcohol (odds ratio (OR) = 11.5; 95% confidence interval (CI) 9.57-13.9). Odds
      ratios are elevated even at the lowest blood alcohol concentration levels and
      increase dramatically as alcohol levels rise. Drivers aged 40-49 years are least
      likely to initiate crashes; odds ratios rise in a U-shaped manner to 3.35 in
      teenagers (95% CI 2.72-4.13) and to 22.1 in drivers over 80 years (95% CI 14.2
      34.5). Other risk factors for initiating a fatal crash are the following: not
      wearing a seat belt (OR = 1.54; 95% CI 1.35-1.75), driving without a valid
      driver's license (OR = 2.16; 95% CI 1.72-2.73), and having had a crash within the
      last year (OR = 1.21; 95% CI 1.07-1.38). Driving errors leading to fatal crashes
      do not occur at random, but are associated with specific driver characteristics.
      The risk factors for crash initiation among crash-involved drivers are similar to
      risk factors for crash involvement found in other studies. These findings suggest
      that driving errors often explain high rates of crash involvement, invite further
      use of crash initiation in traffic injury research, and underscore the value of
      population-based registries for analytic epidemiology.

PMID- 1746525
TI  - Methodological issues in using hospital discharge data to determine the incidence
      of hospitalized injuries.
AB  - Estimates of the incidence of hospitalized injuries based on hospital discharge
      data are inconsistent because of variations in 1) the definition of injury and 2)
      the criteria for excluding repeat admissions for the same injury event. Using
      1983 data from the Uniform Hospital Discharge Data Set for the state of Rhode
      Island, the authors demonstrate the effects on injury incidence rates associated
      with the various definitions and exclusion criteria used in previous studies. The
      overall injury rate (11.9/1,000 population) was substantially reduced (rate
      difference, 1.7; 95% confidence interval 1.2-2.1) when adverse effects or
      complications of medical and surgical care ("medical injuries"), not usually
      defined as injuries by injury researchers, were excluded. Estimates of the
      incidence of "true" injury hospitalizations (excluding medical injuries, late
      effects, and complications of care) ranged from 9.9/1,000, when repeat admissions
      identified as transfers from another acute facility were excluded, to 7.2/1,000,
      when repeat admissions identified as elective admissions were excluded. Marked
      variability in incidence rate estimates by age, sex, nature of injury, and state
      of residence of victim was also noted. The addition to hospital discharge data
      sets of a separate variable to identify readmissions for the same problem would
      result in more valid incidence estimates for injury research and surveillance.

PMID- 1746526
TI  - Interpartner reliability of reporting of recent sexual behaviors.
AB  - Epidemiologic studies exploring risks for sexually transmitted diseases,
      including human immunodeficiency virus infection, typically rely on self-report
      of sexual behaviors. Estimates of the incidence and prevalence of sexual
      practices are important measures for assessment of behavioral interventions as
      well as for examining disease transmission. This study examined the degree of
      agreement within heterosexual couples reporting frequency and type of sexual
      behaviors, including condom use. Self-reports were obtained from 71 couples
      attending Baltimore sexually transmitted disease clinics in 1989-1990 regarding
      the number of days and number of episodes of three specific sexual practices (any
      type of sexual activity, vaginal sex, and vaginal sex with condom use) over a 30
      day period. Paired t test analysis revealed both sexes to be very consistent in
      their reporting of recent sexual experiences. Multivariate analysis showed that
      agreement did not vary by socioeconomic status, by whether the partners were
      married to each other, or by age. These findings suggest that reliable
      information regarding sexual behaviors may be obtained from men or women.

PMID- 1746527
TI  - Race, family income, and low birth weight.
AB  - The relations among race, family income, and low birth weight were examined using
      information obtained from the National Longitudinal Survey of Youth, which
      conducted yearly interviews with a nationally representative sample of young
      women identified in the late 1970s. Data were available for these women and their
      offspring from 1979 through 1988. Maternal education, maternal age, age/parity
      risk, marital status, and smoking during pregnancy served as covariates in cross
      sectional and longitudinal analyses. The risk of low birth weight among births to
      black women and white women who were poor was at similarly high levels regardless
      of whether poverty was determined prior to study entrance or during the study
      period. Longitudinal analyses showed an exceptionally large increase in risk of
      low birth weight among children born to women whose prior pregnancy ended in a
      low-birth-weight infant. These two findings emphasize the importance of factors
      antecedent to the pregnancy in the genesis of low birth weight.

PMID- 1746528
TI  - New evidence on intravenous cocaine use and the risk of infection with human
      immunodeficiency virus type 1.
AB  - To examine whether recent intravenous use of cocaine might be associated with
      increased risk of human immunodeficiency virus type 1 (HIV) infection, the
      authors studied 2,597 active intravenous drug users: 2,399 with recent cocaine
      injection and 198 with recent injection of heroin or other drugs but not cocaine.
      These subjects were adult residents of Baltimore City and the surrounding
      Maryland counties, recruited via outreach into the community between February
      1988 and March 1989. In contrast to the first report on the cocaine-HIV
      association, the present study sample was not recruited solely from drug
      treatment programs. In the present study, estimated HIV seroprevalence was 26.4%
      for recent cocaine injectors as compared with 10.6% among all other recent
      intravenous drug users; the relative odds estimate was 3.03. In the untreated
      segment of the sample, HIV seroprevalence was 26.0% for recent cocaine injectors
      as compared with 8.9% among others (relative odds (RO) = 3.61). The estimated
      degree of association did not change appreciably when multiple logistic
      regression was used to hold constant potentially confounding and/or mediating
      variables such as receptive anal intercourse, number of sex partners, and use of
      injection equipment obtained at shooting galleries (RO = 2.64). Augmenting these
      cross-sectional data, preliminary prospective data showed excess risk of HIV
      seroconversion among recent cocaine injectors (estimated relative risk = 2.11).
      While other research has examined the cocaine-HIV association, the present study
      differs in that it has allowed a test for whether the association was a spurious
      artifact of studying drug users recruited solely from drug treatment programs, a
      broad array of alternative determinants of HIV infection have been held constant,
      and the association has been examined with seroconversion data. The results lend
      support to the abiding concern about the risk of HIV infection among cocaine
      users.

PMID- 1746529
TI  - Estimating the 1978-1990 and future spread of human immunodeficiency virus type 1
      in subgroups of homosexual men.
AB  - The authors studied the historical spread of human immunodeficiency virus type 1
      (HIV-1) infection in homosexual/bisexual men and projected its future spread in
      these men using data from an AIDS-free cohort recruited during late 1984 in
      Baltimore, Maryland; Chicago, Illinois; Los Angeles, California; and Pittsburgh,
      Pennsylvania. Dates of preentry seroconversion in HIV-1 seroprevalent men were
      estimated using study entry values of hematologic variables influenced by HIV-1
      infection. The authors used survival methods incorporating truncation to
      determine numbers/dates of seroconversion for men with a pre-1984 AIDS diagnosis
      who were selectively excluded by design from the 1984 AIDS-free cohort. Overall,
      the annual seroconversion hazard rose progressively from 0.4% in 1978 to 13.8% in
      1983, dropped to 4.6% in 1985, and remained relatively stable at 1.1-2.2% from
      1986 to 1990. By January 1990, almost 46% of men who were seronegative in 1978
      had seroconverted. The authors estimated historical rates of spread by city, age,
      education, and ethnicity to examine the effects of these factors in the early and
      continuing stages of the HIV-1 epidemic. There were striking differences among
      cities with respect to pre-1985 seroconversion rates but not with respect to post
      1985 seroconversion rates. Age, education, and ethnicity were all associated with
      1978-1990 seroconversion rates. Future seroconversion among homosexual men was
      predicted assuming that the "stabilized" 1986-1990 hazards (stratified by age)
      observed here will be representative of future rates. Truncated Kaplan-Meier
      methods gave the probability of a seronegative 20-year-old man's remaining
      seronegative in subsequent years. Such a man has a 20.2% chance of seroconverting
      before reaching the age of 25 years (a 4.4% yearly hazard). The annual hazard
      drops to 2.5% between 25 and 30 years, to about 1.5% between 30 and 45 years, and
      to 1.0% between 45 and 55 years. The overall probability of seroconversion prior
      to age 55 years is about 50%, with seroconversion still continuing at and after
      age 55. Given that this cohort consists of volunteers receiving extensive anti
      HIV-1 transmission education, the future seroconversion rates of the general
      homosexual population may be even higher than those observed here.

PMID- 1746530
TI  - Effects of age, breast feeding, and household structure on Haemophilus influenzae
      type b disease risk and antibody acquisition in Alaskan Eskimos.
AB  - Invasive Haemophilus influenzae type b (Hib) disease occurs with unusually high
      incidence in Alaskan Eskimos. In 1983, the authors evaluated the unique
      susceptibility of the Yupik-speaking Eskimo population in southwest Alaska. A
      matched case-control design was used to assess the influence of age, breast
      feeding, and household composition on disease risk, with a historical cohort
      design to evaluate their effects on acquisition of Hib anticapsular antibody. The
      authors studied 103 cases with known invasive Hib disease that occurred at a mean
      age of 8.7 +/- 8.6 months; healthy controls were matched for age and village of
      residence. Living in extended families at the time of disease onset was
      significantly associated with Hib disease (p less than 0.04; odds ratio = 1.8;
      95% confidence interval 0.87-3.25). The authors found that breast feeding was
      significantly less common among cases than controls (p less than 0.03; odds ratio
      = 0.53; 95% confidence interval 0.27-0.98). Although there was a positive
      correlation between age and acquired level of total anticapsular antibody (r =
      0.59; p less than 0.0001), previous exposure to invasive Hib disease did not
      influence these levels. Household crowding and breast feeding also did not appear
      to affect Hib antibody acquisition.

PMID- 1746531
TI  - Applicability of industrial sampling techniques to epidemiologic investigations:
      examination of an underutilized resource.
AB  - In carrying out surveys to estimate disease prevalence or health services
      coverage in a region, investigators are often interested in identifying
      communities or other subareas in which the problem of interest is especially
      severe. In view of the large number of subareas to be examined, the investigator
      seeks rapid methods of assessment that require minimum sampling in each. Lot
      quality assurance sampling, developed more than 60 years ago to meet industrial
      quality control needs, has been found to serve public health purposes as well.
      Curiously, other more recent and more powerful industrial techniques have not
      received the recognition they deserve. Several of them are discussed in this
      paper and likely applications are cited. They fall into two categories: 1) lot
      acceptance methods to depict static conditions in a population and 2) more
      dynamic process monitoring methods for continuous surveillance. Under the first
      category, techniques of double sampling and sequential sampling are described.
      Reduced and tightened scrutiny, control charts, and exponential smoothing are
      highlighted as especially promising approaches under the process control
      category.

PMID- 1746532
TI  - Differential misclassification arising from nondifferential errors in exposure
      measurement.
AB  - Misclassification into exposure categories formed from a continuous variable
      arises from measurement error in the continuous variable. Examples and
      mathematical results are presented to show that if the measurement error is
      nondifferential (independent of disease status), the resulting misclassification
      will often be differential, even in cohort studies. The degree and direction of
      differential misclassification vary with the exposure distribution, the category
      definitions, the measurement error distribution, and the exposure-disease
      relation. Failure to recognize the likelihood of differential misclassification
      may lead to incorrect conclusions about the effects of measurement error on
      estimates of relative risk when categories are formed from continuous variables,
      such as dietary intake. Simulations were used to examine some effects of
      nondifferential measurement error. Under the conditions used, nondifferential
      measurement error reduced relative risk estimates, but not to the degree
      predicted by the assumption of nondifferential misclassification. When relative
      risk estimates were corrected using methods appropriate for nondifferential
      misclassification, the "corrected" relative risks were almost always higher than
      the true relative risks, sometimes considerably higher. The greater the
      measurement error, the more inaccurate was the correction. The effects of
      exposure measurement errors need more critical evaluation.

PMID- 1746533
TI  - Intravenous immunoglobulin in the treatment of human immunodeficiency virus
      related thrombocytopenia.
AB  - Fourteen patients with sexually transmitted human immunodeficiency virus (HIV)
      related immune thrombocytopenia were treated with intravenous gammaglobulin
      (IVIG). The patients were treated with a uniform program consisting of 1 g/kg of
      IVIG on day 1 and day 2, followed by 1 g/kg on day 15. Most patients had
      pretreatment bleeding symptoms, which included petechiae, spontaneous and
      traumatic ecchymoses, gum bleeding, and epistaxis. Median baseline platelet count
      was 17,000/mm3 (range 3-61,000/mm3). After the infusion of the IGIV, all patients
      had a resolution of their bleeding by day 8. The median maximum platelet count
      achieved with the IGIV was 220,000/mm3 (range 76-426,000/mm3). No patient
      achieved either a sustained complete or partial remission after the conclusion of
      the IVIG therapy. Toxicities were minimal with the majority being headache and
      nausea. In conclusion, patients with sexually transmitted HIV infection and
      immune thrombocytopenia respond favorably to IVIG. This treatment should be
      considered as first-line therapy for patients with HIV-related immune
      thrombocytopenia who require immediate but temporary increase in their platelet
      count, attributable to symptoms or signs of clinical bleeding or because of the
      need for an invasive procedure.

PMID- 1746534
TI  - Epirubicin and cytosine arabinoside for the induction therapy of childhood acute
      nonlymphocytic leukemia.
AB  - Epirubicin, a new anthracycline, was used in combination with cytosine
      arabinoside for the induction therapy of de novo acute nonlymphocytic leukemia in
      childhood. The treatment consisted of epirubicin 20 mg/m2/day for 3 days and
      cytosine arabinoside 100 mg/m2/day for 7 days. The treatment could be repeated
      every 3 weeks. Remission induction rate was 80% (20/25). Moreover, in 13
      patients, the remissions were obtained after a single course. In general, the
      side effects of epirubicin and cytosine arabinoside were tolerable. However, the
      main causes of all the three deaths were infections. Our study suggests that
      epirubicin is acceptable and effective for the induction therapy for de novo
      acute nonlymphocytic leukemia in childhood.

PMID- 1746535
TI  - Lupus anticoagulant associated with primary malignant lymphoplasmacytic lymphoma
      of the spleen: a report of four patients.
AB  - Primary lymphoma of the spleen is characterized by predominant splenomegaly.
      Lymphoplasmacytic malignant lymphoma of the spleen, of low malignancy in the Kiel
      classification, low and intermediate grade in the National Cancer Institute
      Working Formulation (NCIWF), is rare. It is often associated with a monoclonal
      immunoglobulin M (IgM). Four patients presenting with primary splenic lymphoma of
      plasmacytic type associated with a high level of monoclonal IgM and a lupus
      anticoagulant (LA) are described. This association has not previously been
      reported. In contrast with the usual heterogeneity of LA, this LA is relatively
      homogeneous with an important prolongation of the prothrombin time (greater than
      18 sec for a control of 12), more prolonged partial thromboplastin time (PTT) of
      the mixture patient + control plasma than PTT of the patient plasma. Despite the
      important coagulation abnormalities, none of these four patients has presented
      any hemorrhagic or thrombotic complications, even during major surgery such as
      splenectomy. The lupus-like anticoagulant effect ran parallel with the monoclonal
      IgM. Survival, after splenectomy and chemotherapy, appears to be favourable:
      three patients are alive with survivals of greater than or equal to 7 years. The
      follow-up is as yet too short for the last patient.

PMID- 1746536
TI  - Hemoglobin constant spring in Bangkok: molecular screening by selective enzymatic
      amplification of the alpha 2-globin gene.
AB  - Hemoglobin Constant Spring (Hb CS) is a hemoglobin variant with an elongated
      alpha-globin chain secondary to a chain termination mutation. The diagnosis of
      HbCS by electrophoresis is difficult because it is present in very low amounts in
      the red cells of heterozygotes. Selective enzymatic amplification of the alpha 2
      globin gene and allele-specific hybridization for Hb CS gene provided accurate
      diagnosis of Hb Constant Spring. We have used this approach to detect the alpha
      cs mutation in the cord blood that contained all four alpha-globin genes but had
      Hb Bart on electrophoresis. The alpha cs mutation was found in six subjects whose
      Hb Bart levels were 3.0, 3.2, 3.7, 4.0, 4.9, and 9.8%. The latter also had -alpha
      mutation on the other chromosome, giving rise to the genotype alpha cs alpha/
      alpha, which produced high Hb Bart. The gene frequency for alpha cs in the Thai
      calculated from a total of 406 cord blood studied in Bangkok was found to be
      approximately 0.008.

PMID- 1746537
TI  - An effective acute graft-vs.-host disease prophylaxis with minidose methotrexate,
      cyclosporine, and single-dose methylprednisolone.
AB  - Cyclosporine and methotrexate at standard doses (15 mg/m2 on day 1 and 10 mg/m2
      on days 3, 6, and 11, total 45 mg/m2) are effective in the prophylaxis of acute
      graft-vs.-host disease. However, the combination has significant early toxicities
      with delayed engraftment, increased mucositis, and hepatotoxicity. We modified
      the combination by adding single-dose methylprednisolone and lowered the total
      dose of methotrexate to 35 mg/m2 (5 mg/m2 on days 1, 3, and 6, and then 10 mg/m2
      on days 11 and 18) and then to 20 mg/m2 (5 mg/m2 on days 1, 3, 6, and 11) in an
      attempt to decrease these side effects in two sequential consecutive groups of
      patients. We demonstrated that the modified regimens maintained the efficacy with
      reduced toxicities. The rate of engraftment was comparable to cyclosporine alone
      and the hepatotoxicity was reduced with reduced doses of methotrexate. Factors
      such as early immunosuppression of the host, intravenous immunoglobulin, the
      timing of steroid administration, nucleotide free diet and germ free environment
      may contribute to the effectiveness of the combination and permit reduction of
      methotrexate dose.

PMID- 1746538
TI  - Characterization of novel platelet and endothelial cell target antigens in a
      family with genetic susceptibility to autoimmunity.
AB  - This report describes a French Canadian family whose members exhibit a high
      incidence of allo- and autoantibodies to antigens present on both platelets and
      endothelial cells. This is correlated with various HLA specificities known to be
      associated with autoimmunity, such as A1, B8, DR3, and, in some cases, with
      clinical disorders, including nephritis, hypertension, and thrombocytopenia.
      Immunoblot analysis using platelet and endothelial cell lysates showed serum
      antibodies to a 75 kDa endothelial cell surface polypeptide and to polypeptides
      with apparent mass of 115 kDa and 26 kDa found on both platelets and endothelial
      cells. This 115 kDa internal platelet protein was also found in a variety of
      other cell types, such as mononuclear cells, and increased following cell
      activation. Monoclonal antibody immunobilization assays were used to characterize
      the 26 kDa polypeptide; in three of the four patients tested, an antibody to
      leukocyte differentiation antigen CD9 was identified. The asymptomatic child of
      the propositus also exhibited an autoantibody against an 80 kDa platelet protein
      which was sensitive to thrombin digestion, suggesting that this polypeptide may
      be platelet glycoprotein V. In addition, P1A1 alloantibody was identified in one
      sister who had given birth to a severely thrombocytopenic boy and who herself had
      a severe vascular rejection to a cadaver kidney 2 years prior to this study. The
      propositus also developed hypertensive renal disease following a pregnancy and
      became dialysis dependent. Thus, members of this family have developed a variety
      of antibodies, particularly to platelet and endothelial cell antigens. Some
      subjects have remained asymptomatic in spite of having autoantibodies. However,
      others have been seriously ill, and their immune response to these antigens is
      believed to have played a role in the pathogenesis of their neonatal alloimmune
      thrombocytopenic purpura, hypertensive renal disease, renal graft rejection, and
      thrombocytopenia.

PMID- 1746539
TI  - The single zeta globin gene rearrangement: hematologic phenotype and its frequent
      occurrence in Polynesian Niueans.
AB  - The single zeta globin gene rearrangement (-zeta/) is an unusual mutation
      associated with the alpha globin gene cluster on chromosome 16p13.3. It has been
      detected regularly among West Africans (gene frequency approximately 0.05) and
      sporadically among other populations. DNA samples from 186 Polynesian Niueans
      living in Auckland, New Zealand, were studied. Eighteen (gene frequency 0.05)
      were shown to have the -zeta/gene arrangement, which results from loss of the psi
      zeta 1 gene. Hematological phenotypes in six cord blood samples and 12 affected
      adults were normal. The high frequency for -zeta/in Niueans may represent another
      example of genetic drift and a founder effect in Polynesians or may reflect a
      different founding population.

PMID- 1746540
TI  - Simple method for differentiating between HLA and platelet-specific antibodies by
      flow cytometry.
AB  - Since platelets express both platelet-specific and class I HLA antigens, serum
      antiplatelet reactivity assessed by most platelet antibody techniques could be
      due to antibodies with either or both specificities. Flow cytometric analysis of
      sera for detection of antiplatelet antibody commonly employs a purified platelet
      preparation as target cells. A method is described for investigating sera for
      platelet antibodies by flow cytometry using a mixture of platelets and
      lymphocytes. The mixture of lymphocytes and platelets as target cells has the
      advantage of confirming the presence of the HLA antibodies in reactive sera. The
      concomitant use of platelets and lymphocytes treated with citric acid, pH3, or
      with chloroquine (to remove or alter surface HLA antigens without affecting
      platelet specific antigens) may further assist in identifying antiplatelet
      antibodies in alloimmunized patients. These techniques may also be useful in
      platelet crossmatching procedures.

PMID- 1746541
TI  - Hemophagocytic syndrome associated with aggressive natural killer cell leukemia.
AB  - We describe a patient who had aggressive natural killer cell leukemia with
      profound hemophagocytosis. This combination must be underscored as one of several
      hemophagocytic syndromes. Activated phagocytes in the bone marrow appeared
      morphologically normal and could possibly be proliferating in response to some
      cytokine(s) such as interferon-gamma produced by leukemic cells, whose serum
      level was found to be extremely elevated in this case.

PMID- 1746542
TI  - Disseminated toxoplasmosis in a severely immunodeficient patient: demonstration
      of cysts in bone marrow smears.
AB  - A 30-year-old woman was treated with unrelated HLA-compatible bone marrow
      transplantation for acute myeloid leukemia. Examination of her bone marrow smears
      because of fever and pancytopenia revealed the presence of Toxoplasma cysts.
      Although Toxoplasma cysts are rarely found in the bone marrow, bone marrow
      examination in the immunocompromised patient offers rapid diagnosis of systemic
      toxoplasmosis.

PMID- 1746543
TI  - Immunologic thrombocytopenia followed by thrombotic thrombocytopenic purpura in
      two HIV1 patients.
AB  - Two homosexual HIV1-positive male patients with thrombotic thrombopenic purpura
      (TTP) were found to have past history of immune thrombocytopenia (ITP). The first
      patient had ITP 10 months prior to TTP and was successfully treated by
      splenectomy. The second patient had ITP 32 months before TTP. No specific
      treatment was given for his asymptomatic ITP. Association of HIV infection to TTP
      seems to be frequent. These two types of purpura have different pathogenic
      mechanisms but share a common altered immune response to antigenic challenge. The
      occurrence of ITP and TTP in HIV-positive patients may lead to errors in
      diagnosis and therapy.

PMID- 1746544
TI  - Aplastic anemia associated with systemic lupus erythematosus.
AB  - Hematologic complications of systemic lupus erythematosus (SLE) usually involve
      peripheral destruction of blood cells. We report a case of aplastic anemia
      associated with SLE observed during the remission phase of SLE 3 months after the
      beginning of treatment. CD8+ T cells in the patient's bone marrow may have
      suppressed maturation of hematopoietic progenitor cells, which may have induced
      the aplastic anemia associated with SLE. Repeated therapy with high-dose
      methylprednisolone resulted in lasting remission.

PMID- 1746545
TI  - Vitamin E treatment in triplicated alpha-globin gene-heterozygous beta
      thalassemia.

PMID- 1746546
TI  - Hemostasis in malignancy.

PMID- 1746547
TI  - Dengue virus infection-associated hemophagocytic syndrome.

PMID- 1746548
TI  - Dissecting the genetic contribution to coronary heart disease.

PMID- 1746549
TI  - Role of apolipoprotein E and B gene variation in determining response of lipid,
      lipoprotein, and apolipoprotein levels to increased dietary cholesterol.
AB  - A large segment of the population is modifying its dietary cholesterol intake to
      achieve a healthier life-style. However, all individuals do not respond equally.
      We have investigated the effects that that two physiologically important
      polymorphisms in the apolipoprotein (apo) E and B genes have on the responses of
      plasma lipid, lipoprotein, and apolipoprotein levels to a high-cholesterol diet.
      Over a 6-wk period, individuals were prescribed two diets, one consisting of 300
      mg dietary cholesterol/d for 3 wk and one consisting of 1,700 mg dietary
      cholesterol/d for 3 wk. Total cholesterol, low-density-lipoprotein cholesterol
      (LDL-C), and apo B levels were significantly increased on the high-cholesterol
      diet. Average total cholesterol (numbers in parentheses are SDs) went from 167.6
      (23.4) mg/dl on the low-cholesterol diet to 190.8 (36.2) mg/dl on the high
      cholesterol diet; LDL-C went from 99.9 (24.8) mg/dl to 119.2 (33.4) mg/dl, and
      apo B went from 74.9 (24.5) mg/dl to 86.8 (29.5) mg/dl. In 71 individuals, the
      frequencies of the apo epsilon 2, epsilon 3, and epsilon 4 alleles were .09, .84,
      and .07, respectively. The frequency of the longer, apo B signal peptide allele
      (5'beta SP27) was .68. Apo epsilon 2/3 individuals had significantly lower LDL-C
      levels than did epsilon 3/3 homozygotes, on both the low-cholesterol diet (LDL-C
      lower by 21 mg/dl) and the high-cholesterol diet (LDL-C lower by 27 mg/dl).
      Average triglyceride levels were significantly different among apo B signal
      peptide genotypes, with the 5'beta SP27/37 homozygotes having the lowest levels
      (70 mg/dl). When individuals were switched from the low-cholesterol diet to the
      high-cholesterol diet, in no case were the average responses in lipid levels
      significantly different among apo E or B genotypes. Therefore, these gene loci do
      not have a major effect on the response of lipid levels to increased dietary
      cholesterol.

PMID- 1746550
TI  - Genetic studies of human apolipoproteins. XX. Genetic polymorphism of
      apolipoprotein J and its impact on quantitative lipid traits in normolipidemic
      subjects.
AB  - Apolipoprotein J (apo J) is a newly identified member of a growing family of
      proteins associated with various lipoprotein particles. Apo J is a glycoprotein
      which exists in the plasma associated with high-density lipoprotein subfractions
      which also contain apo A-I and cholesteryl ester transfer protein (CETP). We have
      investigated the possible existence of genetic polymorphism at the apo J
      structural locus and have evaluated its role in lipid metabolism. By employing
      isoelectric focusing and immunoblotting techniques, we have screened plasma or
      serum samples from six population groups: U.S. whites, Amerindians, Eskimos, New
      Guineans, U.S. blacks, and Nigerian blacks. Apo J revealed a common two-allele
      polymorphism only in populations with African ancestry and was found to be
      monomorphic in all other population groups tested. The genetic basis of the two
      alleles designated--APO J*1 and APO J*2, at a single structural locus, apo J--
      was confirmed in a large number of segregating families. In the U.S. blacks, the
      frequencies of the APO J*1 and APO J*2 alleles were .76 and .24, respectively,
      and in the Nigerian blacks these values were .72 and .28, respectively. In
      addition, a single example of a rare allele designated APO J*3 was also
      encountered in the U.S. black sample. In Nigerian blacks, the apo J
      polymorphism's impact on seven quantitative lipid traits--total cholesterol, LDL
      cholesterol, HDL-cholesterol, HDL3-cholesterol, HDL2-cholesterol, VLDL
      cholesterol, and triglycerides--was investigated. No significant impact of the
      apo J polymorphism was observed for any of these lipid traits.

PMID- 1746551
TI  - Statistical methods for multipoint radiation hybrid mapping.
AB  - On the basis of the earlier work of Goss and Harris, Cox et al. introduced
      radiation hybrid (RH) mapping, a somatic cell genetic technique for constructing
      fine-structure maps of human chromosomes. Radiation hybrid mapping uses X-ray
      breakage of chromosomes to order a set of genetic loci and to estimate distances
      between them. To analyze RH mapping data Cox et al. derived statistical methods
      that employ information on sets of two and four loci, to build an overall locus
      order. Here we describe alternative nonparametric and maximum-likelihood methods
      for the analysis of RHs that use information on many loci simultaneously,
      including information on partially typed hybrids. Combination of these multipoint
      methods provides a statistically more efficient solution to the locus-ordering
      problem. We illustrate our approach by applying it to RH mapping data on 14
      markers in 99 radiation hybrids for the proximal long arm of human chromosome 21.

PMID- 1746552
TI  - Molecular analysis of the Smith-Magenis syndrome: a possible contiguous-gene
      syndrome associated with del(17)(p11.2).
AB  - We undertook clinical evaluation (32 cases) and molecular evaluation (31 cases)
      of unrelated patients affected with Smith-Magenis syndrome (SMS) associated with
      an interstitial deletion of band p11.2 of chromosome 17. Patients were evaluated
      both clinically and electrophysiologically for peripheral neuropathy, since
      markers showing close linkage to one form of Charcot-Marie-Tooth disease (CMT1A)
      map to this chromosomal region. The common clinical findings were broad flat
      midface with brachycephaly, broad nasal bridge, brachydactyly, speech delay, and
      hoarse, deep voice. Fifty-five percent of the patients showed clinical signs
      (e.g., decreased or absent deep tendon reflexes, pes planus or pes cavus,
      decreased sensitivity to pain, and decreased leg muscle mass) suggestive of
      peripheral neuropathy. However, unlike patients with CMT1A, these patients
      demonstrated normal nerve conduction velocities. Self-destructive behaviors,
      primarily onychotillomania and polyembolokoilamania, were observed in 67% of the
      patients, and significant symptoms of sleep disturbance were observed in 62%. The
      absence of REM sleep was demonstrated by polysomnography in two patients.
      Southern analysis indicated that most patients were deleted for five 17p11.2
      markers--FG1 (D17S446), 1516 (D17S258), pYNM67-R5 (D17S29), pA10-41 (D17S71), and
      pS6.1-HB2 (D17S445)--thus defining a region which appears to be critical to SMS.
      The deletion was determined to be of paternal origin in nine patients and of
      maternal origin in six patients. The apparent random parental origin of deletion
      documented in 15 patients suggests that genomic imprinting does not play a role
      in the expression of the SMS clinical phenotype. Our findings suggest that SMS is
      likely a contiguous-gene deletion syndrome which comprises characteristic
      clinical features, developmental delay, clinical signs of peripheral neuropathy,
      abnormal sleep function, and specific behavioral anomalies.

PMID- 1746553
TI  - Molecular confirmation of Wolf-Hirschhorn syndrome with a subtle translocation of
      chromosome 4.
AB  - Wolf-Hirschhorn syndrome is a clinically recognizable, multiple congenital
      anomaly syndrome usually associated with terminal deletion of the short arm of
      chromosome 4. A girl with clinical features of Wolf-Hirschhorn syndrome did not
      show an obvious deletion of chromosome 4, and a molecular defect was suspected.
      RFLPs of genomic DNA from the proband and her parents were studied using DNA
      probes from the distal region of chromosome 4p. Fluorescence in situ
      hybridization using a cosmid p847.351 containing the fragment 847 E-C was
      performed to investigate the possibility of a subtle translocation. Cytogenetic
      analyses done on the child and on both parents did not conclusively reveal
      abnormalities of chromosome 4. Molecular studies using two probes mapped to
      distal 4p showed the absence of the maternal haplotype in the child. These
      findings are thus consistent with a molecular deletion of 4p and confirm the
      diagnosis of Wolf-Hirschhorn syndrome. Cytogenetic experiments involving
      fluorescence in situ hybridization showed that the mother carried a subtle
      translocation between chromosomes 4 and 19, 46,XX,t(4,19)(p16.3; p13.3), which
      resulted in an unbalanced form in the child. Chorionic villus sampling for
      prenatal diagnosis in a subsequent pregnancy showed the fetus to be unaffected.
      This provides the first evidence, in chromosome 4p, of a molecular deletion due
      to a subtle, inherited translocation leading to the Wolf-Hirschhorn phenotype.
      Such subtle translocations may become an important mechanism for some recurrent
      genetic defects.

PMID- 1746554
TI  - The genetic and environmental sources of body mass index variability: the
      Muscatine Ponderosity Family Study.
AB  - The role of genetic and environmental factors in determining the variability in
      body mass index (BMI; kg/m2) was investigated in 1,302 relatives identified
      through 284 schoolchildren from Muscatine, IA. BMI levels were first adjusted for
      variability in age, by gender and by relative type. There was significant
      familial aggregation of adjusted BMI in the pedigrees, as indicated by inter- and
      intraclass correlation coefficients significantly different from zero. A mixture
      of two normal distributions fit the adjusted BMI data better than did a single
      normal distribution. Genetic and environmental models that could explain both the
      familial aggregation and the mixture of normal distributions were investigated
      using complex segregation analysis. There was strong support for a single
      recessive locus with a major effect that accounted for almost 35% of the adjusted
      variation in BMI. Polygenic loci accounted for an additional 42% of the
      variation. Approximately 23% of the adjusted variation was not explained by
      genetic factors. For spouses living in the same household, their shared
      environment accounted for 12% of their variation. For siblings living in the same
      household, their shared environment accounted for 10% of their variation. While
      shared environments contributed to variation in adjusted BMI, more than 75% of
      the variation was explained by genetic factors that include a single recessive
      locus. Approximately 6% of the individuals in the population from which these
      pedigrees were sampled are predicted to have two copies of the recessive gene,
      while 37% of the individuals are predicted to have one copy of the gene.

PMID- 1746555
TI  - Localization of an ataxia-telangiectasia locus to a 3-cM interval on chromosome
      11q23: linkage analysis of 111 families by an international consortium.
AB  - Linkage of at least two complementation groups of ataxia-telangiectasia (AT) to
      the chromosomal region 11q23 is now well established. We provide here an 18-point
      map of the surrounding genomic region, derived from linkage analysis of 40 CEPH
      families. On the basis of this map, 111 AT families from Turkey, Israel, England,
      Italy, and the United States were analyzed, localizing the AT gene(s) to an 8-cM
      sex-averaged interval between the markers STMY and D11S132/NCAM. A new Monte
      Carlo method for computing approximate location scores estimates this location as
      being at least 10(8) times more likely than the next most likely interval, with a
      support interval midway between STMY and D11S132 that is either 5.2 cM (sex
      averaged and conservatively based on 3 lod scores from the maximum-location
      score) or 2.8 cM (male specific, based on a 2.72:1 interval-specific female-to
      male distance ratio.

PMID- 1746556
TI  - Prenatal hemoglobinopathy screening. IV. Follow-up of women at risk for a child
      with a clinically significant hemoglobinopathy.
AB  - To determine the benefits and burdens of prenatal hemoglobinopathy carrier
      identification and genetic counseling and its impact on subsequent reproductive
      behavior, we recontacted women whom we had previously identified as at risk for
      having a child with a clinically significant hemoglobinopathy, regardless of
      whether they had accepted the offer of prenatal diagnosis. Of the 46 such women,
      31 were available for interview. These 31 women had received offers of prenatal
      diagnosis in 47 pregnancies. Seventeen had been accepted, and 30 had been
      declined. The proportion of patients accepting the offer of prenatal diagnosis
      was higher for the index pregnancy (50%) than for subsequent pregnancies (22%).
      The mean interval between the initial counseling of the patient and the follow-up
      interview was 43 mo (standard error +/- 2.7 mo). Ninety-four percent of those
      interviewed recalled having received information from the screening program; 74%
      recalled the name of their condition; 90% knew that trait did not affect their
      health; 84% recalled the name of the condition for which their fetus had been at
      risk; and 77% could state at least one symptom of the disease. Of the 29 women
      asked whether they intended to use prenatal diagnosis in future pregnancies, 13
      said yes and 16 said no. Of the 26 patients asked about satisfaction with their
      previous decision about prenatal diagnosis, all were satisfied with their
      decision. Eighteen said they would make the same decision in their next
      pregnancy, but seven patients said they would not, and one was
      undecided.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746557
TI  - Identification of a single missense mutation in the adenine
      phosphoribosyltransferase (APRT) gene from five Icelandic patients and a British
      patient.
AB  - We have completely sequenced the adenine phosphoribosyltransferase (APRT) gene
      from each of six patients--five (I-V) from Iceland and one (VI) from Britain.
      Cases I and II shared a common ancestor six and seven generations ago, and cases
      I and V shared a common ancestor seven generations ago, but cases III and IV were
      unrelated to the above or to each other, over seven generations. Genomic DNA was
      amplified by PCR, subcloned into M13mp18, and sequenced. Genomic and PCR
      amplified DNAs were also analyzed by restriction-enzyme digestion and Southern
      blotting. The same missense mutation was identified in all six patients. This
      mutation leads to the replacement of asp (GAC) by val (GTC), at amino acid
      position 65. The gene sequences from all patients were otherwise identical to our
      wild-type sequence. The homozygous nature of the mutation was confirmed by
      sequencing the PCR product directly. All six patients were homozygous for the
      1.25-kb TaqI RFLP. The Icelandic patients were also homozygous for the 8-kb SphI
      RFLP, but the British patient was heterozygous at this site. These studies
      suggest that a founder effect is likely to be responsible for APRT deficiency in
      the Icelandic population. The finding of the same mutation in a patient from
      Britain suggests that this mutation may have originated in mainland Europe.

PMID- 1746558
TI  - Linkage of the gene for an X-linked mental retardation disorder to a
      hypervariable (AGAT)n repeat motif within the human hypoxanthine
      phosphoribosyltransferase (HPRT) locus (Xq26).
AB  - We recently reported a new X-linked mental retardation (XLMR) disorder in a four
      generation family of Dutch descent. Features included Dandy-Walker malformation,
      basal ganglia disease, and seizures. Twenty-six family members, including two
      living affected males and two obligate carriers, were available for study. No
      evidence of linkage was observed between the disease locus and RFLPs from several
      X-chromosome regions, including Xp21-p22 (13 markers), proximal Xq (four
      markers), and Xq28 (three markers). However, a new hypervariable short tandem
      repeat (STR) within the HPRT gene at Xq26 showed positive linkage to the disease
      locus, with a maximum lod score of 2.19 at a recombination fraction of 0. A
      second hypervariable marker in Xq26, the dinucleotide repeat XL90A3 (DXS425),
      showed a lod score of .84 at a recombination fraction of .11. Both the HPRT and
      DXS425 markers were typed in 40 CEPH families, and subsequent multipoint linkage
      analysis showed the following order: Xcen-DXS425-(HPRT,XLMR)-F9-qter. HPRT and
      these flanking markers are therefore useful for carrier detection and prenatal
      diagnosis in this family. This study illustrates that hypervariable STRs will be
      powerful tools for linkage analysis and genetic diagnosis, particularly when
      relatively small families are involved.

PMID- 1746559
TI  - A random walk method for computing genetic location scores.
AB  - Calculation of location scores is one of the most computationally intensive tasks
      in modern genetics. Since these scores are crucial in placing disease loci on
      marker maps, there is ample incentive to pursue such calculations with large
      numbers of markers. However, in contrast to the simple, standardized pedigrees
      used in making marker maps, disease pedigrees are often graphically complex and
      sparsely phenotyped. These complications can present insuperable barriers to
      exact likelihood calculations with more than a few markers simultaneously. To
      overcome these barriers we introduce in the present paper a random walk method
      for computing approximate location scores with large numbers of biallelic
      markers. Sufficient mathematical theory is developed to explain the method.
      Feasibility is checked by small-scale simulations for two applications permitting
      exact calculation of location scores.

PMID- 1746560
TI  - Consistent linkage of the long-QT syndrome to the Harvey ras-1 locus on
      chromosome 11.
AB  - The long-QT syndrome (LQT; Ward-Romano syndrome) is a cardiac disorder that is
      inherited as an autosomal dominant trait. Affected family members suffer from
      recurrent syncope and sudden death due to ventricular arrhythmias. Recently, we
      identified a DNA marker on the short arm of chromosome 11 (the Harvey ras-1 locus
      [H-ras-1]) that was completely linked to the LQT locus in one large family. In
      the study presented here, we performed linkage investigations on six new and
      unrelated families with LQT. The LQT locus was again completely linked to the H
      ras-1 locus in all families examined, with a combined lod score of 5.25 at a
      recombination fraction of 0. This work confirms our previous assignment of the
      LQT locus to chromosome 11p and supports the hypothesis that LQT is genetically
      homogeneous. As no obligate recombinants were identified in either this or our
      previous study, the H-ras-1 protooncogene remains a candidate for the LQT disease
      gene. Identification of LQT families with locus homogeneity is an important step
      in the development of a refined genetic map of this locus and will help determine
      whether the H-ras-1 marker would be of general use for presymptomatic diagnosis
      of this potentially fatal, but treatable, disorder.

PMID- 1746561
TI  - Adrenoleukodystrophy: a complex chromosomal rearrangement in the Xq28 red/green
      color-pigment gene region indicates two possible gene localizations.
AB  - We have characterized a complex chromosomal rearrangement in band Xq28, in an
      adrenoleukodystrophy patient who also has blue-cone monochromacy. A 130-kb region
      upstream from the color-vision pigment genes was isolated as yeast artificial
      chromosome or cosmid clones. Another Xq28 sequence, not included in the above
      region, was obtained by cloning a deletion breakpoint from the patient. Using
      probes derived from the cloned sequences, we have shown that the rearrangement
      affects the color-pigment genes and includes two deletions, most likely separated
      by a large (greater than 110-kb) inversion. One deletion encompasses part of the
      pigment gene cluster and 33 kb of upstream sequences and accounts for the
      patient's blue-cone monochromacy. If this rearrangement also caused ALD, the
      disease gene would be expected to lie within or close to one of the deletions.
      However, deletions were not detected in a 50-kb region upstream of the red-color
      pigment gene in 81 other ALD patients. Two CpG islands were mapped, at 46 and 115
      kb upstream from the pigment genes.

PMID- 1746562
TI  - Regional mapping of the Batten disease locus (CLN3) to human chromosome 16p12.
AB  - The gene for Batten disease (CLN3) has been mapped to human chromosome 16 by
      demonstration of linkage to the haptoglobin locus, and its localization has been
      further refined using a panel of DNA markers. The aim of this work was to refine
      the genetic and physical mapping of this disease locus. Genetic linkage analysis
      was carried out in a larger group of families by using markers for five linked
      loci. Multipoint analysis indicated a most likely location for CLN3 in the
      interval between D16S67 and D16S148 (Z = 12.5). Physical mapping of linked
      markers was carried out using somatic cell hybrid analysis and in situ
      hybridization. A mouse/human hybrid cell panel containing various segments of
      chromosome 16 has been constructed. The relative order and physical location of
      breakpoints in the proximal portion of 16p were determined. Physical mapping in
      this panel of the markers for the loci flanking CLN3 positioned them to the bands
      16p12.1----16p12.3. Fluorescent in situ hybridization of metaphase chromosomes by
      using these markers positioned them to the region 16p11.2-16p12.1. These results
      localize CLN3 to an interval of about 2 cM in the region 16p12.

PMID- 1746563
TI  - Interpreting nonsignificant outcomes of heterogeneity tests in gene mapping.

PMID- 1746564
TI  - Locked storage of refrigerated controlled substances.

PMID- 1746565
TI  - Resolving problems in the use of omeprazole.

PMID- 1746566
TI  - Do we know what we are really looking for?

PMID- 1746567
TI  - The theory of ADD-MORE.

PMID- 1746568
TI  - Pharmacists should initiate as well as prevent.

PMID- 1746569
TI  - Comment on stability of ranitidine hydrochloride in total nutrient admixtures.

PMID- 1746570
TI  - Pharmacy manager need not be pharmacist.

PMID- 1746571
TI  - Upgrading quality assurance for pharmacy-prepared sterile products.

PMID- 1746572
TI  - ASHP invitational conference on quality assurance for pharmacy-prepared sterile
      products.

PMID- 1746573
TI  - National survey of quality assurance activities for pharmacy-prepared sterile
      products in hospitals.
AB  - The results of a survey of pharmacy department activities for quality assurance
      in the preparation of sterile drug products in short-term, nonfederal hospitals
      are reported. A questionnaire was mailed in March and April 1991 to pharmacy
      directors at hospitals that had indicated in ASHP's 1990 national survey of
      pharmaceutical services that they had formal quality assurance processes for
      intravenous admixture preparation. The adjusted gross sample size was 465. The
      net response rate was 71% (330 usable replies). Nearly all respondents indicated
      that sterile drug products were prepared extemporaneously in their departments;
      61% reported batch preparation of such products. Both pharmacists and pharmacy
      technicians prepared sterile products. Respondents identified which guidelines
      were used in developing departmental policies and procedures for sterile product
      preparation. Specific areas were identified in which educational programs for
      pharmacists are needed; the most frequently indicated area (85%) was principles
      of aseptic technique. A majority of respondents used the following means for the
      orientation and training of personnel who prepare sterile products: aseptic
      technique lectures or videotapes, on-the-job training, written policies and
      procedures, and direct observation of technique. Almost all of the respondents
      (99%) had laminar-airflow hoods in their departments. Three fourths of those
      respondents indicated that laminar-airflow hoods were located in a limited-access
      room. Half of the respondents reported that laminar-airflow hoods were located
      certified every six months and that prefilters were changed monthly. Less than
      one third sampled environmental areas for microbial contamination. Less than one
      third of the surveyed hospitals routinely sampled sterile products for microbial
      contamination or pyrogens. Almost half indicated the absence of policies and
      procedures for testing chemical purity, drug concentration, sterility,
      pyrogenicity, or the environment for sterile preparations. Few respondents
      indicated the use of sterilization techniques other than microbial filtration,
      which was used by 32% of pharmacies involved in extemporaneous preparation and
      16% of those involved in batch preparation. About 90% of the respondents used
      published references and manufacturers' recommendations to determine expiration
      dating. This survey revealed that certain quality assurance procedures related to
      pharmacy-prepared sterile products need major improvement.

PMID- 1746574
TI  - Sterility testing of antimicrobial-containing injectable solutions prepared in
      the pharmacy.
AB  - The need for sterility testing of antimicrobial-containing injectable solutions
      is discussed and specific testing methods are described. Despite their
      antimicrobial activity, antimicrobial-containing injectable drug products are not
      necessarily self-sterilizing and can become contaminated. In addition to
      practicing aseptic technique, pharmacists must perform end-product sterility
      testing on intravenous solutions to ensure their sterility. The United States
      Pharmacopeia provides guidelines for the performance and validation of two
      sterility test methods: membrane filtration and direct transfer to culture media.
      Membrane filtration is the method of choice for sterility testing of many
      antimicrobial-containing injectable solutions. After the test article is
      filtered, the membrane is rinsed with sterile fluid to remove residual
      antimicrobial agent, cut into two portions, and immersed in two types of culture
      medium. Visible turbidity of a sample within the appropriate incubation period
      indicates the presence of a contaminating microorganism. Closed filtration
      systems minimize false-positive results. In the direct transfer method, samples
      of the test article are directly inoculated into vessels of culture media, and
      antimicrobial activity is eliminated by dilution or by deactivation with chemical
      or enzymatic agents. Sterility testing as well as aseptic technique is needed to
      ensure the sterility of antimicrobial-containing injectable solutions.

PMID- 1746575
TI  - Sterility testing of a total nutrient admixture with a biphasic blood-culture
      system.
AB  - The ability of a biphasic blood-culture system to detect microbial contamination
      of a total nutrient admixture (TNA) was studied. A TNA consisting of amino acids,
      dextrose, lipid emulsion, electrolytes, and trace elements was prepared under
      aseptic conditions. Septi-Chek blood-culture bottles were then injected with a
      TNA sample and with one of various dilutions of five bacterial or fungal
      suspensions, and an agar slide unit was attached to each bottle. One bottle was
      injected only with a TNA sample. The bottles were incubated and examined once
      daily. Each bottle was inverted immediately after inoculation and at each
      observation time to allow the broth to wash over the agar slide unit. Because the
      lipid contained in the TNA caused the broth in all bottles to become turbid, it
      was impossible to determine whether microbial growth was present in the broth.
      Microbial growth, however, became evident in 24-72 hours on all slide units
      except the one attached to the bottle that had been injected only with TNA. The
      Septi-Chek biphasic blood-culture system appears to be useful in evaluating the
      sterility of TNAs.

PMID- 1746576
TI  - Method for evaluating drip-rate accuracy of intravenous flow-regulating devices.
AB  - The effects of patient movement and position on the drip-rate accuracy of several
      i.v. flow-regulating devices were investigated. Intravenous infusion sites were
      established in 20 healthy adult volunteers. All the subjects received 5% dextrose
      injection through the same type of i.v. tubing from 500-mL bags hung from
      standard i.v. fluid poles. The flow-regulating devices tested were the IVAC 280,
      which served as the control device; a roller clamp; the Dial-A-Flo; the Exacdrop;
      and the 3M IV Flow Regulator. Drip rates were present at 40 drops/min and were
      measured before and after the subjects moved among the supine, sitting, and
      standing positions and walking. The drip rate was reset to 40 drops/min after
      each position change. Changing position from supine to sitting did not affect
      mean drip rates for the IVAC 280 and 3M IV Flow Regulator devices but
      significantly decreased the rates for the roller clamp, Dial-A-Flo, and Exacdrop.
      The change from sitting to standing did not affect the IVAC 280 and 3M IV Flow
      Regulator drip rates but significantly decreased the rates for the other devices.
      None of the rates was dramatically affected when the subjects went from standing
      to walking, although the effect achieved significance for the roller clamp and
      Exacdrop devices. The change from walking to the supine position did not affect
      the drip rates for the IVAC 280 and 3M IV Flow Regulator but significantly
      increased the rates for the other devices. The drip-rate accuracy of the roller
      clamp, Dial-A-Flo, and Exacdrop devices was significantly affected when subjects
      changed positions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746577
TI  - Irreversibility of procainamide-dextrose complex in plasma in vitro.
AB  - The extent to which the procainamide-dextrose complex reverts to free
      procainamide hydrochloride in plasma was studied in vitro. The procainamide
      dextrose species was formed, isolated using preparative liquid chromatography,
      and then added to six different lots of pooled plasma that were maintained at
      physiological temperature (37 +/- 0.1 degrees C). At zero, four, and eight hours
      after preparation of the samples, 1-mL portions were removed from each sample,
      extracted, and assayed for procainamide hydrochloride using high-performance
      liquid chromatography. The mean procainamide hydrochloride concentrations at
      zero, four, and eight hours after preparation were 2.67, 4.81, and 1.38 g/mL,
      respectively. Each lot of pooled plasma was statistically analyzed to determine
      if a significant amount of procainamide hydrochloride reappeared. Analysis of
      variance showed significant difference between the concentrations of free
      procainamide hydrochloride in the samples at zero, four, and eight hours (p less
      than 0.02). Follow-up with Duncan's multiple comparisons test determined that the
      mean procainamide hydrochloride concentrations immediately after preparation were
      not significantly different from those at eight hours, but the mean procainamide
      hydrochloride concentrations at four hours were significantly different from
      those at eight hours (p less than 0.01). A paired Student's t test comparing the
      data from zero and eight hours showed a significant reduction in mean
      procainamide hydrochloride concentrations with time (p less than 0.05). The
      procainamide-dextrose complex in vitro does not revert to free procainamide
      hydrochloride in plasma at physiological temperature during the first eight
      hours.

PMID- 1746578
TI  - Stability of amphotericin B in four concentrations of dextrose injection.
AB  - The stability of amphotericin B in 5%, 10%, 15%, and 20% dextrose injection was
      investigated. The dextrose solutions were prepared in triplicate from sterile
      water for injection and 70% dextrose injection and placed in empty 50-mL
      polyvinyl chloride bags. The pH of each solution was determined before
      amphotericin B was added to a concentration of approximately 100 micrograms/mL.
      The bags were stored at 15-25 degrees C and protected from light. Three 1-mL
      samples were taken from each bag at various times up to 24 hours. One sample was
      analyzed for precipitation and color and pH changes. Two samples were analyzed in
      duplicate by stability-indicating high-performance liquid chromatography. No
      visual changes were observed, and pH did not change substantially. The mean
      amphotericin B concentration was greater than 90% of the initial concentration at
      each sampling time. However, the drug concentration in 3 of the 27 samples from
      the admixtures with 10% dextrose injection and 5 of the 27 samples from the
      admixtures with 20% dextrose injection fell below 90% of the initial
      concentration. Amphotericin B 100 micrograms/mL was stable in 5%, 10%, 15%, and
      20% dextrose injection when stored for up to 24 hours at 15-25 degrees C and
      protected from light.

PMID- 1746579
TI  - Medicare and Medicaid fraud and abuse regulations.
AB  - Specific business arrangements that are protected under legislation and
      regulations governing parties doing business with Medicare or Medicaid are
      discussed. Regulations implementing the Medicare and Medicaid Patient Protection
      Act of 1987 specify practices and activities that are not subject to criminal
      penalties under the antikickback provisions of the Social Security Act or to
      exclusion from Medicare or state health-care programs. As of July 29, 1991, all
      organized health-care settings that receive payments from either Medicare or
      state health-care programs must comply with these regulations. The final rule
      sets forth "safe harbors"--exceptions to prohibitions against (1) kickbacks,
      bribes, rebates, and other illegal activities involving remunerations for patient
      referrals and (2) inducements to purchase or lease goods paid for by Medicare or
      state health-care programs. The safe harbors comprise 11 broad categories-
      investment interests, space rental, equipment rental, personal services and
      management contracts, purchase of a medical practice, referral services,
      warranties, discounts, employees, group purchasing organizations, and waiver of
      deductibles and coinsurance. Implications for pharmacy are discussed. These
      regulations will affect the purchase of pharmaceuticals by institutional
      pharmacies. Each institution should review its current practices to determine
      whether they are within the safe harbors.

PMID- 1746580
TI  - Guidelines for the preparation of sterile ophthalmic products.

PMID- 1746581
TI  - Impact of treatment guidelines on the use of aerosolized pentamidine for
      prevention of Pneumocystis carinii pneumonia.

PMID- 1746582
TI  - Visual compatibility of indomethacin sodium trihydrate with drugs given to
      neonates by continuous infusion.

PMID- 1746583
TI  - Cardioplegia solutions.
AB  - The mechanism of action, characteristics and components, dosage and
      administration, and adverse effects of cardioplegia solution are described. The
      pharmacist's role in the formulation, preparation, and quality control of
      cardioplegia solution is also discussed. The use of cardioplegia solution has
      substantially increased the safety of cardiac surgery. It protects the myocardium
      by inducing a rapid and complete diastolic arrest, minimizing myocardial energy
      requirements and preventing ischemic damage during the arrest phase, and
      minimizing or preventing reperfusion injury once coronary blood flow is restored.
      Chemical components added to the cardioplegia solution, such as potassium and
      glucose, are largely responsible for this protective effect. Basic
      characteristics of cardioplegia solutions include temperature, osmolarity, and
      pH. Crystalloid solution has traditionally been used as a vehicle for
      cardioplegia solution; however, laboratory and clinical studies have demonstrated
      favorable effects of blood-based cardioplegia solution. Single-pass and
      recirculating delivery systems can be used to administer either crystalloid or
      blood cardioplegia solutions. Pharmacists can play a major role in the
      formulation, preparation, distribution, and quality control of cardioplegia
      solutions; these solutions prevent myocardial injury during the arrest and
      reperfusion phases of cardiac surgery.

PMID- 1746584
TI  - Epidural analgesia.
AB  - The process of nociception, the anatomy of the epidural space, and the placement
      of the epidural catheter are reviewed, and the pharmacology and pharmacokinetics,
      analgesic efficacy, and potential adverse effects of epidurally administered
      narcotics and local anesthetics are discussed, as well as patient monitoring
      standards and solution preparation guidelines for these agents. The epidural
      space is located between the dura mater (the outer-most membrane surrounding the
      spinal cord) and the vertebral canal. The site of catheter placement is
      determined by the dermatomes corresponding to the site of desired analgesia. The
      primary factors that differentiate epidural narcotics are related to their
      pharmacokinetic profiles. Morphine, which is hydrophilic, has a slower onset of
      action and a longer duration of analgesia than lipophilic compounds such as
      fentanyl; morphine also results in less segmentalization (the degree to which
      analgesia is limited to discrete dermatomal segments corresponding to the level
      of the epidural narcotic injection) than is seen with lipophilic compounds.
      Studies have shown that epidural narcotics provide superior pain relief compared
      with systemic narcotics. Common adverse effects associated with therapeutic doses
      of intraspinal narcotics include itching, nausea and vomiting, urinary retention,
      and sedation; respiratory depression is uncommon after epidural administration of
      narcotics. The most bothersome adverse effect encountered with analgesic doses of
      local anesthetics is paresthesia. Solutions for epidural administration must be
      sterile and preservative free. Epidural administration of narcotics and local
      anesthetics seems to provide better pain relief than conventional methods but may
      be associated with more bothersome adverse effects.

PMID- 1746585
TI  - Pediatric pharmacy practice guidelines. Pediatric Pharmacy Administrative Group
      Committee on Pediatric Pharmacy Practice.
AB  - Pediatric patients are unique because of age-specific differences in metabolic
      capacity, disease processes that may make commercially available pharmaceutical
      preparations unacceptable for use, a lack of published information on the effects
      of many new pharmacotherapeutic agents in this population, and changes in
      population demographics caused by new diseases (e.g., AIDS) and new technologic
      applications. Comprehensive pharmaceutical services are essential for maximizing
      the benefits--while avoiding or minimizing adverse effects--of pharmacotherapy
      and new technologies. Comprehensive pharmaceutical services can help maximize the
      use of health-care resources in the pediatric population and assist in the
      development, implementation and evaluation of new methods of treatment that will
      benefit children everywhere.

PMID- 1746586
TI  - Megestrol acetate in AIDS-related cachexia.

PMID- 1746587
TI  - Antiretroviral activity of naloxone and naltrexone.

PMID- 1746588
TI  - Proceedings of a symposium. Acquired factor VIII inhibitors in the
      nonhemophiliac: historical perspectives, and future approaches. November 30,
      1990, 32nd American Society for Hematology Annual Meeting Boston, Massachusetts.

PMID- 1746589
TI  - An introduction to factor VIII inhibitors: the detection and quantitation.
AB  - Spontaneous development of autoantibodies against factor VIII:C (FVIII:C) protein
      in a nonhemophiliac is a rare but significant clinical occurrence that frequently
      is associated with life-threatening hemorrhagic complications. These
      autoantibodies often arise as an epiphenomenon of various disease states that are
      autoimmune or manifest a component of immune dysfunction. The present symposium
      reviews the immunochemistry of FVIII:C auto-antibodies and describes ways in
      which this knowledge has been applied to gain insight into the structure-function
      relationship of the FVIII:C protein. Also discussed are the etiology and natural
      history of acquired FVIII:C inhibition as well as evolving approaches to its
      treatment. Therapeutic options for this condition continue to expand, and choice
      of the optimal regimen for each patient is based on many considerations,
      including the level of the inhibitor, the underlying disease state, clinical
      responses to previous treatment, and degree of antibody interaction with
      heterologous purified FVIII:C protein. Acquired FVIII:C autoantibodies isolated
      from nonhemophiliacs are characterized as heterogeneous, noncomplement-fixing,
      nonprecipitating immunoglobulins directed against functional epitopes (antigenic
      sites) of FVIII:C in a time- and temperature-dependent manner. The clinical
      significance of these inhibitors is determined qualitatively by studying in vivo
      survival of FVIII:C activity with infused replacement materials or quantitatively
      by laboratory mixing tests that measure the capacity of the inhibitor to
      neutralize FVIII:C activity. In the United States inhibitor potency is expressed
      most commonly in Bethesda Units (BU), where 1.0 BU is the reciprocal dilution of
      patient test plasma, permitting detection of 50% residual FVIII:C activity in a
      mixture with normal pooled plasma. In Europe, FVIII inhibitors are now often
      quantitated in New Oxford Units, which are derived from neutralizing-mixing
      studies of patient test plasma with diluted FVIII concentrate. One Oxford unit is
      equivalent to approximately 0.83 BU. Although analyses that measure functional
      inhibition of FVIII:C activity by the autoantibody provide a useful tool to
      assess clinical efficacy of therapeutic regimens, these assays may not recognize
      nonactivating antibodies. These immunoglobulins may bind to alternative epitopes
      and significantly influence plasma clearance, survival times, and circulating
      levels of infused FVIII:C protein. Finally, this symposium will speculate on the
      potential application of innovative approaches to inhibitor therapy, based on
      results from numerous provocative studies on the nature of the human immune
      response.

PMID- 1746590
TI  - Cytotoxic suppression of acquired factor VIII:C inhibitors.
AB  - Autoantibodies directed against factor VIII:C (FVIII:C) are associated with
      serious and often fatal bleeding. Efforts to suppress or abolish these antibodies
      with cytotoxic agents are frequently successful if antibody titer is not too high
      or there is an associated disease that undergoes remission. Corticosteroids alone
      may hasten antibody disappearance in almost half of patients, and
      cyclophosphamide is useful in those who are resistant to steroids administered
      alone or in combination. Patients refractory to these regimens may respond to a
      more aggressive approach using combination chemotherapy with cyclophosphamide,
      prednisone, and vincristine. Unfortunately, because of the rarity of this
      disorder, randomized, controlled trials have not been conducted either to compare
      treatments directly or to examine the factors presaging favorable outcomes.
      Recently, however, a multicenter trial comparing prednisone, cyclophosphamide,
      and the combination has been initiated, and some preliminary data from this
      investigation are presented. Approaches to the recognition and clinical
      management of this disorder also are described.

PMID- 1746591
TI  - Rationale and evolution of therapy with porcine factor VIII:C.
AB  - Highly purified porcine factor VIII:C (FVIII:C) concentrate prepared by
      polyelectrolyte fractionation has been available for therapeutic use since 1980.
      Over the last decade substantial international experience has confirmed the value
      of porcine FVIII:C in management of hemophilia with inhibitors, and recent
      studies have underlined its particular effectiveness in treating patients with
      the acquired form of the disease. The rationale for use of porcine FVIII:C is
      based on a twofold premise. First, most inhibitors interact less strongly with
      porcine FVIII:C than they do with the human factor; cross-reactivity is
      especially low, and often negligible, among patients with acquired disease.
      Second, when measurable levels of circulating FVIII:C can be achieved, the
      likelihood of clinical hemostasis is maximized. In a variable proportion of
      patients with the congenital disease, anamnestic rises in titers of the inhibitor
      against human FVIII:C may follow treatment with the porcine factor, and this
      phenomenon may constrain therapy. These events seem to occur rarely in persons
      with acquired inhibitors, however, thus broadening therapeutic application of
      porcine FVIII:C to these patients. Although anamnesis often is perceived as a
      limitation, significant untoward transfusion reactions are highly unusual after
      porcine FVIII:C therapy. Although early experience with this form of treatment
      centered on management of major bleeding episodes and hemostatic crises, use of
      porcine FVIII:C has more recently been extended to more routine bleeding
      problems, immune tolerance induction regimens, prophylaxis, and home therapy.
      These and other advances are discussed.

PMID- 1746592
TI  - The use of porcine factor VIII in the treatment of patients with acquired
      hemophilia: the United Kingdom experience.
AB  - Data have been collected by questionnaire on 15 acute bleeding episodes in 12
      patients with acquired hemophilia, treated with porcine factor VIII (FVIII). The
      median initial anti-human FVIII inhibitor level was 40 Bethesda Units (BU)/ml,
      whereas that against porcine was 1 BU/ml. The mean initial dose of porcine FVIII
      infused was 54 micrograms/kg, which resulted in a rise of 0.57 IU/mL in the FVIII
      concentration. Therapy was continued for a mean of 8.5 days, during which time
      the average number of infusions was 11. Clinical response was rated as good or
      excellent in 82% of recipients. Side effects were uncommon; only one patient
      experienced a severe reaction. Following therapy, no increase in antihuman
      antibody levels was noted; increased levels of antiporcine antibody was detected
      in only two patients. One patient bled on three further occasions and was
      successfully retreated with porcine FVIII. Porcine FVIII is a safe and clinically
      effective treatment for bleeding episodes in acquired hemophilia and should be
      considered as first-line therapy for patients with low antiporcine FVIII levels.

PMID- 1746593
TI  - Innovative use of porcine factor VIII:C for immune tolerance induction.
AB  - Of all nonhemophilic patients with acquired factor VIII:C (FVIII:C) inhibitors,
      as many as 87% suffer from hemorrhagic complications, and approximately 22% die
      as a result. Immunosuppressive therapy reduces or eradicates the inhibitor in 50
      80% of patients, but a significant proportion remain refractory to such treatment
      and have a continued need for replacement therapy to manage bleeding
      complications. The possibility that porcine FVIII:C might fulfill this role has
      not been thoroughly investigated although limited data are available for patients
      with congenital hemophilia, which may offer some guidance. We recently reported
      the successful treatment with porcine FVIII:C over 2-8.5 years in five congenital
      hemophilia patients with high-level inhibitors initially lacking measurable cross
      reactivity to porcine FVIII:C. One of four patients who developed transient,
      specific antiporcine inhibitors became refractory to treatment. Three further
      patients' antibodies demonstrated as much as 30% cross-reactivity but tolerated
      porcine FVIII:C therapy on demand for 18-24 months, with good clinical effect and
      no significant anamnesis or other untoward reactions. All five of these patients
      with non-cross-reacting antibodies began therapy with porcine FVIII:C and
      eventually lost their original inhibitors against human FVIII:C during treatment
      with the porcine factor. Surprisingly, when human FVIII:C was then reintroduced
      in three patients there was no recurrence of inhibitor activity during 3-4
      subsequent years. This finding suggests that porcine FVIII:C, when administered
      over some interval to congenitally hemophilic patients, can induce a state of
      specific immune-tolerance to the human factor. On the other hand, porcine FVIII:C
      therapy may not suppress acquired inhibitors in nonhemophiliacs, since there is
      no evidence that administration of human FVIII:C causes immune-tolerance in this
      group. Porcine FVIII:C can be administered safely for a period of years.
      Anamnestic responses are unusual in acquired hemophilia, and only 20% of patients
      develop specific antiporcine antibodies. Porcine FVIII:C may play an important
      part in the long-term management of inhibitors in either congenital or acquired
      hemophilia.

PMID- 1746594
TI  - Perspectives on the use of factor IX complex concentrates in the treatment of
      bleeding in persons with acquired factor VIII inhibition.
AB  - In contrast to the type of bleeding encountered in congenital hemophilia with
      inhibitors, the diathesis toward bleeding exhibited by patients with
      spontaneously acquired factor VIII (FVIII) inhibitors often is severe and life
      threatening. Large hematomas and retropharyngeal or central nervous system
      hemorrhage may appear suddenly. Thus, a high premium is placed on rapid
      therapeutic intervention. Several treatment options are at the physician's
      disposal. The role of factor IX (FIX) complex concentrates, both standard and
      purposely activated, is discussed. The FIX products are also known as prothrombin
      complex concentrates (PCCs). Prudent choice of any treatment modality requires
      weighing its benefits and shortcomings. Advantages of PCCs--particularly the
      activated products--include availability, ease of reconstitution and
      administration, and at least partial efficacy; control of bleeding episodes can
      be achieved with PCCs in many (but not all) instances. One salient disadvantage
      of therapy with FIX complex concentrates is that they are not subjected to such
      rigorous viral-attenuation processes as are most of the currently marketed FVIII
      products. Therefore, a small but definite risk of infection with hepatitis B or C
      (HBV, HCV) remains. An assay that detects antibodies against HCV has been
      licensed and is being used to screen blood donors. Nevertheless, up to the
      present time the U.S. Food and Drug Administration (FDA) has ruled that HCV
      screening of plasmapheresis donors should not be performed for plasma collections
      destined to be pooled for fractionation and that units of HCV-positive source
      plasma (e.g., that provided by American Red Cross donors) found to be HCV
      positive be sent for fractionation. The starting plasma from which FIX complex
      concentrates and human FVIII concentrates are made thus contains some HCV and may
      also contain some HBV. Because nonhemophiliacs with acquired antibodies against
      FVIII are unlikely to have had prior exposure to blood products and are unlikely
      to have been vaccinated against HBV, they are at risk of viral hepatitis and its
      sequelae when treated with FIX complex concentrates. Furthermore, therapy with
      FIX complex concentrates is not always effective in controlling bleeding in
      persons with FVIII inhibitors, its mechanism of action in bypassing the need for
      FVIII remains unclear, very large doses are required, and it has an attendant
      risk of several adverse effects when used in large, repeated doses. These include
      disseminated intravascular coagulation, thromboembolism, and acute myocardial
      infarction. Thus, FIX complex concentrates may play a useful role in the
      treatment of bleeding in nonhemophiliacs with acquired inhibitors against FVIII,
      but one must carefully consider their disadvantages profile.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1746595
TI  - Intravenous immunoglobulin in the treatment of spontaneously acquired factor
      VIII:C inhibitors.
AB  - Intravenous immunoglobulin (IV Ig) is useful in most patients with spontaneous
      factor VIII:C (FVIII:C) inhibitors, but some complete failures also are observed.
      Among patients responding to this therapy, decreases in FVIII:C autoantibody
      titer occurs within 24-48 hours and may lead to suppression of inhibitor
      activity. The prolonged response observed in some cases suggest an effect on
      autoantibody synthesis. The immediate decrease in FVIII:C inhibitory activity
      after IV Ig infusion indicates a direct interaction between IV Ig and the
      autoantibody. This effect is reproducible in vitro by mixing the patient's plasma
      and Ig at an appropriate molar ratio, which differs in each patient. Similarly,
      incubation of Ig with F(ab)'2 fragments of a patient's IgG and Ig reproduces
      inhibition, and this result indicates that the interaction is mediated by antigen
      binding sites (epitopes) on the immunoglobulins. The suggestion is that an
      idiotype- anti-idiotype mechanism must be at work. The origin of such anti
      idiotypes in Ig prepared from pooled plasma of several thousand blood donors is
      unclear. The F(ab)'2 fragments were prepared from individual blood donors and
      tested in similar experiments with F(ab)'2 fragments of three distinct
      spontaneous FVIII:C inhibitors. The plasma level of anti-idiotypic antibodies
      reacting with FVIII:C inhibitors varied according to age and gender.

PMID- 1746596
TI  - Future approaches to factor VIII inhibitor therapy.
AB  - Future progress in our ability to treat acquired factor VIII (FVIII) inhibitors
      must be based on advances in knowledge of both the FVIII molecule and the nature
      of the human immune response. New therapeutic approaches to patients with
      acquired FVIII inhibition likely will emphasize modifications of the immune
      response. This concept holds considerable promise, because studies have
      characterized the critical steps leading to tolerance of self-antigens.
      Development of FVIII inhibitors represents a loss of self-tolerance, which any
      successful therapy must restore. Conceivably, restoration of self-tolerance can
      be accomplished in many ways: prevention of antigen binding to helper T
      lymphocytes, deletion of self-antigen-reactive T cells, inhibition of major
      histocompatibility complex (MHC) recognition, or enhancement of the antigen
      specific suppressor T lymphocyte population. Recent data have demonstrated that
      highly specific methods can suppress ongoing immune responses against defined
      autoantigens. Antibodies that inhibit T-cell activation, peptides that block self
      antigen binding, and antibodies that inhibit MHC recognition all have been
      successful in modifying experimentally induced autoimmune diseases. Whether any
      of these immunotherapeutic approaches will be effective in the treatment of
      acquired FVIII inhibition remains to be determined. Until data from animal model
      systems establish the feasibility of immune intervention, scrutiny of other new
      therapeutic approaches to patients with spontaneous inhibitors will continue to
      be important. Administration of FVIII-bypassing procoagulant proteins shows
      promise, as does removal of inhibitors by affinity reagents, such as FVIII
      peptides containing relevant epitopes (antigenic sites). Farther on the horizon
      is development of recombinant FVIII molecules so modified as to remove antigenic
      determinants while preserving procoagulant function. Articles in this supplement
      summarize several avenues for treatment of patients with acquired FVIII
      inhibitors. Alternatives include treatment with sufficient human or porcine FVIII
      to offset inhibitors, use of materials that reestablish hemostasis even though
      FVIII levels are not increased (the so-called FVIII-bypassing agents),
      manipulation of immune responses through physical depletion of inhibitor by
      plasmapheresis or affinity chromatography, and administration of intravenous
      immunoglobulin or immunosuppressive cytotoxic drugs. Thus, the heterogeneous
      clinical presentation is paralleled by the wide range of available therapeutic
      approaches.

PMID- 1746597
TI  - Acquired inhibitors in malignant and nonmalignant disease states.
AB  - Acquired inhibitors against factor VIII:C (FVIII:C) arise in nonhemophilic
      patients who have many associated disease states, both malignant and benign. This
      review emphasizes knowledge of the association with malignant diseases and places
      particularly close attention on the hematologic malignancies, including plasma
      cell dyscrasias and lymphoproliferative disorders. Characteristics of postpartum
      inhibitors are examined, as well as the association of inhibitor with certain
      drugs and dermatologic conditions. Also discussed is the experience amassed by
      one center over the past decade in the treatment of patients with inhibitors
      against FVIII:C.

PMID- 1746598
TI  - Premutation for the Martin-Bell syndrome analyzed in a large pedigree segregating
      also for G6PD-deficiency. I: A working hypothesis on the nature of the FRAX
      mutations.
AB  - A large Sardinian family including 13 Martin-Bell syndrome (MBS) patients,
      several instances of normal transmitting males or females, and the G6PD
      Mediterranean mutant segregating in some of its branches, has been thoroughly
      investigated with the hope of gaining further insight on the nature of the FRAX
      mutation. All the MBS patients and the 15 obligate heterozygous women present in
      the pedigree could be traced back through their X-chromosome lineage to the same
      ancestress, who must have been heterozygous for a silent premutation at the FRAX
      locus. This premutation appears to have turned into a true FRAX-mutation at least
      9 times during the gametogenesis of the ancestress' X-related descendants of whom
      four are males. This finding alone suggests that the transition from the FRAX
      premutation to the true mutation can be the result of intra- as well as
      interchromosomal events. This conclusion is supported by the additional
      observation that the genetic phase between the FRAX and the G6PD loci remained
      unaltered when the transition occurred in a repulsion double heterozygote for the
      premutation and the G6PD-Mediterranean mutant. The data described are compatible
      with the hypothesis that MBS patients and normal transmitting males are,
      respectively, hemizygous for deletion or duplication products generated by
      aberrant recombination events at a highly recombinogenic site of the region Xq27
      Xqter. The overall message stemming from this report is that no firm conclusion
      can be drawn on the genetic linkage between the FRAX-locus and other markers of
      this region until the nature of the FRAX-mutations and the mechanism of their
      occurrence are fully understood.

PMID- 1746599
TI  - Extending the Pallister-Hall syndrome to include other central nervous system
      malformations.
AB  - Hall-Pallister syndrome is defined by specific facial anomalies, post axial
      polydactyly, imperforate anus, and brain anomalies including a rare diencephalic
      mass, hypothalamic hamartoblastoma. In this article, two patients are described
      with the usual features of Hall-Pallister syndrome, including diencephalic
      anomalies, but without hamartoblastomas. These patients may suggest an
      appropriate extension of the definition of the Hall-Pallister syndrome.

PMID- 1746600
TI  - Delayed spontaneous pubertal growth spurt in girls with the Ullrich-Turner
      syndrome.
AB  - By means of an appropriate mathematical model (Sager's 2-components-concept) a
      delayed spontaneous pubertal growth spurt can be demonstrated in girls with 45,X
      Ullrich-Turner syndrome (UTS) (n1 = 45) as well as in those with 45,X/46,XX
      mosaicism (n2 = 14) never treated with any growth stimulating drug. On the
      average, this growth spurt begins later and its extent is smaller (mean growth
      rate = 3.10 and 2.79 cm, respectively, in the 15th year of chronological age)
      than in normal girls. The delay in acute growth spurt corresponds very well to
      the delay of skeletal maturation in the UTS (on the average 2 to 3 years of
      chronological age).

PMID- 1746601
TI  - New X-linked syndrome of mental retardation, gynecomastia, and obesity is linked
      to DXS255.
AB  - We describe 14 males from 3 successive generations in a family who have X-linked
      mental retardation (XLMR), obesity, gynecomastia, speech difficulties, emotional
      lability, tapering fingers, and small feet. Linkage analysis using markers spread
      along the X chromosome demonstrated a gene localisation close to the centromere.
      Maximum lod scores for markers near the centromere, all at theta = 0.00, were
      1.36 for DXS72, and 1.46 for DXYS1. The closest flanking markers which showed
      recombination were DXS84 and DXS94, defining the physical localisation within
      Xp21.1-q22. DXS255 was fully informative with lod-1 confidence interval for theta
      of 0.00-0.12. Clinical findings and linkage data in this family distinguish it
      from the Borjeson-Forssman-Lehmann syndrome and other previously described XLMR
      syndromes.

PMID- 1746602
TI  - Ectrodactyly, retrognathism, abnormal ears, highly arched palate, spina bifida,
      congenital heart defect, single umbilical artery.

PMID- 1746603
TI  - Dominantly inherited syndrome comprising partially absent eye muscles,
      hydrocephaly, skeletal abnormalities, and a distinctive facial phenotype.

PMID- 1746604
TI  - Hepatic dysfunction in Alstrom disease.
AB  - Alstrom disease is a rare disorder; less than 20 cases have been reported. An 11
      year-old girl is described with this condition. She has pigmentary retinopathy,
      sensory neural deafness, obesity, Type II diabetes mellitus, hyperlipidemia, and
      acanthosis nigricans. However, in addition she developed hepatic dysfunction,
      pathologically similar to chronic active hepatitis. This may be a further,
      previously undescribed systemic manifestation of Alstrom disease.

PMID- 1746605
TI  - Presymptomatic testing for adult onset polycystic kidney disease in at-risk
      kidney transplant donors.
AB  - Autosomal dominant adult-onset polycystic kidney disease (ADPKD) is estimated to
      have an incidence of 1/1,000 and accounts for approximately 10% of all end-stage
      renal disease in the United States. While relatives are attractive as renal
      donors due to their availability and the improved transplant success associated
      with living-related donors, they may coincidentally be at risk for ADPKD.
      Accurate presymptomatic testing for at-risk potential donors is critical for both
      the donor and the recipient. We report here 2 families in which presymptomatic
      testing for ADPKD was accomplished by DNA linkage analysis on several potential
      renal donors prior to transplant. This resulted in the protection of both donors
      and recipients by preventing the transplantation of a kidney affected by ADPKD.
      Thorough counseling prior to DNA analysis (including discussion of accuracy and
      possible testing outcomes of presymptomatic diagnosis of ADPKD, diagnosis of
      noncarrier status, false paternity, and non-informative study) was essential to
      provide informed consent and preserve confidentiality within the family.
      Confidentiality for potential donors found presymptomatically to be affected
      (with a 94% or greater probability) was especially difficult to maintain.

PMID- 1746606
TI  - Severe anomalies associated with ring chromosome 7.
AB  - A newborn infant with the polyasplenia sequence, intrauterine growth retardation,
      cutaneous nevi, and minor anomalies was found to have mosaicism for ring
      chromosome 7. This patient's anomalies are markedly different from those of
      previous patients reported with this cytogenetic anomaly.

PMID- 1746607
TI  - Uniparental disomy, isodisomy, and imprinting: probable effects in man and
      strategies for their detection.
AB  - The concept of uniparental disomy--the presence of a chromosome pair derived
      solely from one parent in a diploid offspring--was introduced in 1980 as a
      probable consequence of the high rate of germ cell aneuploidy in man, and has now
      been convincingly demonstrated through molecular analyses in several families. A
      most likely mechanism for the production of uniparental disomy is the chance
      reunion, and complementation, of 2 gametes aneuploid for the same chromosome
      member; uniparental disomy could also occur through other mechanisms including
      postzygotic non-segregation in a trisomic conceptus. Uniparental disomy may
      result in isodisomy, i.e., homozygosity of a series of contiguous alleles in a
      pair of homologues. The presence and degree of isodisomy in an offspring depend
      in turn on the occurrence, timing, and extent of the meiotic recombination that
      had occurred in the chromosome pair of the disomic gamete involved. Uniparental
      disomy with or without isodisomy can explain a number of unusual observations,
      such as the unexpected pattern of transmission of a genetic disorder. The two may
      be associated with an imprinting effect to produce pathological phenotypes, as
      has been observed in the mouse, and may be the basis for a number of syndromes of
      as yet unclear cause. The evidence for uniparental disomy, isodisomy, and
      imprinting in man is reviewed, and strategies for their detection presented.

PMID- 1746608
TI  - Chromosome 7p--syndrome: craniosynostosis with preservation of region 7p2.
AB  - Deletion of a portion of the short arm of chromosome 7 is associated with a
      recognizable phenotype which often includes craniosynostosis. Recent reports have
      suggested that craniosynostosis occurs only if there is a deletion involving band
      7p21 or the segment distal to that band. We report on a boy who had an
      interstitial deletion of 7p, not involving band 7p21 or the segment distal to
      that band, who nevertheless had craniosynostosis. Thus, it appears that the
      determination of craniosynostosis in this syndrome is more complicated than has
      been suggested previously.

PMID- 1746609
TI  - Opitz trigonocephaly syndrome.
AB  - We report on a patient with Opitz trigonocephaly syndrome. The girl was the first
      born child of consanguineous parents and had trigonocephaly, apparent
      hypertelorism, upslanted palpebral fissures, strabismus, small nose with broad
      root, abnormally modeled ears, high palate, short neck with loose skin,
      polysyndactyly, and prominent clitoris and labia majora. In addition, a complex
      cardiovascular defect (Eisenmenger disease) was observed. The patient was
      mentally retarded.

PMID- 1746610
TI  - Hypomelanosis of Ito associated with chromosomal translocation involving Xp11.
AB  - We report on a 3-year-old girl with hypomelanosis of Ito (HI). She has typical
      skin lesions and mild CNS involvement characterized by impaired walking and
      borderline mental retardation. Cytogenetic investigation showed a 18/X
      translocation with breakpoint on Xp11. This is the sixth case of HI in which this
      breakpoint has been reported, underlining that this event cannot be considered
      coincidental. Further studies are needed to understand the etiologic and
      pathogenetic meaning of this finding.

PMID- 1746611
TI  - Ring chromosome 15 and 15qs+ mosaic: clinical and cytogenetic behaviour spanning
      29 years.
AB  - A phenotypic female with mild mental retardation, minor facial anomalies, and
      short stature has been evaluated clinically and cytogenetically over 29 years. At
      age 59, she remains physically well and shows no signs of dementia. Cytogenetic
      analysis, performed on peripheral blood specimens on 10 occasions between 1961
      and 1990, showed mosaicism with one cell line containing a large stable ring (15)
      chromosome and another cell line without the ring but with a 15qs+. The different
      cell lines remained constant. The case provides information on the natural
      history of the ring chromosome 15 syndrome.

PMID- 1746612
TI  - Trisomy 9 confined to the placenta: prenatal diagnosis and neonatal follow-up.
AB  - Chorionic villus sampling (CVS), performed on a woman in the 23rd menstrual week
      because of bilateral fetal hydronephrosis and suspected intrauterine growth
      retardation (IUGR), documented trisomy 9 in all cells examined. Chromosomes of
      amniocytes and fetal blood lymphocytes were normal. The ongoing pregnancy was
      monitored closely, and at 37 weeks, a phenotypic normal male infant was
      delivered. Multiple placental biopsies showed 47,XY,+9, while a repeat chromosome
      analysis of the infant and biopsies from the amniotic membrane were normal
      (46,XY). This case further emphasizes the association between placental
      aneuploidy and IUGR. To our knowledge, nonmosaic trisomy 9 in CVS confined to the
      chorionic villi and later confirmed in the placenta has not been reported
      previously.

PMID- 1746613
TI  - San Luis Valley recombinant chromosome 8 and tetralogy of Fallot: a review of
      chromosome 8 anomalies and congenital heart disease.
AB  - Tetralogy of Fallot, the most common cyanotic heart defect, has not been closely
      associated with a specific chromosome defect. The San Luis Valley Recombinant
      Chromosome 8 [SLV Rec(8)] syndrome is strongly associated with congenital heart
      disease, particularly tetralogy of Fallot. This article reviews SLV Rec(8)
      syndrome and other chromosome 8 aberrations to suggest locations for cardiogenic
      genes. SLV Rec(8) [rec(8),dup q,inv(8)(p23q22)] syndrome has been found in
      Hispanic families in the southwestern United States. Congenital heart disease is
      found in 93.3% of SLV Rec(8) individuals (n = 45), with tetralogy of Fallot
      constituting 40.5% of all lesions and conotruncal defects, 55.6%. These
      frequencies exceed the incidence of tetralogy of Fallot (10%) and conotruncal
      defects (20%) among all children with heart defects (P less than 0.003 for both).
      Review of patients with deletion 8p (n = 13) showed heart defects in 84.6% with
      27.3% being conotruncal defects. Among duplication 8q patients (n = 20), 45% had
      heart defects with conotruncal defects constituting 44%. Neither group differed
      significantly from expected in its incidence of conotruncal defects. Among
      patients with mosaic trisomy 8 (n = 47), 12 had heart abnormalities including one
      conotruncal defect. Among 3 patients with other rec(8) chromosomes, one had a
      ventricular septal defect. The cause of heart defects in SLV Rec(8) cannot be
      assigned to either the deletion of 8p or the duplication of 8q. The lack of an
      association between other chromosome 8 abnormalities and tetralogy of Fallot
      suggests that genes at the SLV Rec(8) breakpoints or an interaction between genes
      on both arms of chromosome 8 are important.

PMID- 1746614
TI  - Retrospective survey of urea cycle disorders: Part 2. Neurological outcome in
      forty-nine Japanese patients with urea cycle enzymopathies.
AB  - We analyzed neurological data, including DQ or IQ, EEG, and CT scan, in 49
      patients with urea cycle enzymopathies, all of whom were included in a
      retrospective survey from 1978-1988 in Japan. We classified 3 groups depending on
      age-at-onset: group 1 (0-28 days, N = 11), group 2 (29 days-5 years, N = 31), and
      group 3 (greater than 5 years, N = 7). The least DQ or IQ score and the highest
      CT score, representing the most severe brain damage was found in group 1, and the
      highest DQ or IQ and the least CT score was found in group 3. Intermediate scores
      of both parameters were found in group 2. There was a negative correlation
      between these 2 parameters (r = -0.82, P less than 0.01). Abnormal EEG during the
      attack-free period was predominantly observed in patients with CT abnormalities
      compared to those with a normal CT scan (P less than 0.01). Approximately 40% of
      the patients, mostly in groups 2 and 3 (92.8%) had normal findings in all 3
      parameters. Thus, the magnitude of developmental abnormalities is clearly related
      to the degree of brain damage and to the age-at-onset of these diseases.

PMID- 1746615
TI  - Autosomal dominant transmission of congenital erythroid hypoplastic anemia with
      radial abnormalities.
AB  - We describe a mother and son with congenital hypoplastic anemia. The mother has
      apparently normal thumbs and forearms but her son has bilateral radial
      hypoplasia. They provide a further example of dominant inheritance of Diamond
      Blackfan anemia/Aase syndrome and suggest that thumb and radial abnormalities are
      a component of this syndrome.

PMID- 1746616
TI  - Blepharophimosis sequence and de novo balanced autosomal translocation
      [46,XY,t(3;4)(q23;p15.2)]: possible assignment of the trait to 3q23.
AB  - We report on a boy with the blepharophimosis sequence and de novo, apparently
      balanced reciprocal translocation between 3q23 and 4p15.2
      [46,XY,t(3;4)(q23;p15.2)de novo]. Possible assignment of this autosomal dominant
      disorder is discussed. A 3q23 band is a more preferable gene locus of the
      belpharophimosis sequence, based on the comparison of clinical manifestations
      between 4p- and 3q-syndromes.

PMID- 1746617
TI  - Neurological aspects of del(1q) syndrome.
AB  - We have studied three children with de novo terminal deletion of the long arm of
      chromosome 1 (46,XX,del(1)(q43)). They all have minor anomalies and neurological
      signs (severe psychomotor developmental delay, generalized hypotonia, and
      seizures) that have been described previously. In addition, all of these three
      patients have autistic-like behavior. They avoid eye contact, show no interest in
      people, express little emotion, and repeat stereotypic movements such as head
      nodding and purposeless finger manipulation. They also spend excessive time in
      making unusual sounds consisting of a high-pitched shrill cry with little
      intonation in infancy and a harsh, strained, and glottal stridency in later life.
      They make no labial, lingual, or nasal sounds. We suggest that these observations
      may be unique clinical manifestations of certain terminal 1q deletions.

PMID- 1746618
TI  - Quantitative analysis of associations between birth defects and suspected human
      teratogens.
AB  - Case series of infants with certain birth defect patterns and putative
      teratogenic exposures should be interpreted with caution since the presence of
      birth defects and the exposure among the same infants could be entirely due to
      chance. In the absence of other epidemiologic data, the plausibility for a causal
      association is strengthened by 1) rarity of the defect pattern, 2) rarity of the
      exposure in the population, 3) small source population, 4) short time period for
      the study, and 5) biologic plausibility for the association. These concepts are
      illustrated using case reports of putative teratogenicity of cocaine and
      etretinate. In the presence of epidemiologic data, the concept of attributable
      fraction in exposed (AFE) can be used to evaluate the likelihood that the defect
      pattern among infants with a particular exposure is attributable to the exposure.
      This quantity is related to the strength of the epidemiologic association between
      the defect pattern and the exposure, as measured in terms of relative risk R (or
      odds ratio), and is equal to (R-1)/R. Even for strong teratogens such as maternal
      diabetes and isotretinoin, where R is about 7, in more than 14% (1-AFE) of
      exposed infants with birth defects, the pattern of defects is not attributable to
      the exposure. Furthermore, AFE can be used to "correct" crude measures of
      sensitivity (the proportion of exposed malformed infants with a defect pattern
      attributable to the exposure) and positive predictive value (the proportion of
      malformed infants who have the exposure and have the defect pattern attributable
      to the exposure).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746619
TI  - Absence of fetal cells in maternal circulation at a level of 1 in 25,000.
AB  - A dual polymerase chain reaction (PCR) technique is developed which enables the
      detection of one part male DNA in 25,000 parts female DNA. The technique
      amplifies a part of the X-Y homologous amelogenin gene in which the Y counterpart
      has a 189 bp deletion within one of the introns. This deletion has made it
      possible to identify individual X and Y counterparts based on the difference in
      size between them. None of the 18 pregnant women studied showed a positive Y
      signal although eight of them bear male fetuses excluding the presence of fetal
      cells at one in 25,000 maternal cells. The results presented here show that a
      sensitivity of greater than one in 25,000 is required for detection of fetal
      genetic disease using maternal peripheral blood.

PMID- 1746620
TI  - De novo inv(2)(p21q31) associated with isolated bilateral microphthalmia and
      cataracts.
AB  - We report on a patient with bilateral microphthalmia and unusual cataracts with a
      de novo pericentric inversion of chromosome (2)(p21q31). A literature review of
      previous associations of eye abnormalities and anomalies of chromosome 2 suggests
      probable gene locations for eye development.

PMID- 1746621
TI  - "Snail-like pelvis" chondrodysplasia: a further case report.
AB  - Chondrodysplasia with snail-like pelvis (Schnechenbecken dysplasia) is a rare
      distinct, lethal, short-limbed dwarfism. We describe the clinical and
      radiological features of a new case in an Italian family.

PMID- 1746622
TI  - Risk calculations in the fragile-X syndrome.

PMID- 1746623
TI  - The illusion of progress.

PMID- 1746624
TI  - The mental health professional and social action.

PMID- 1746625
TI  - The prevalence of abuse among homeless and housed poor mothers: a comparison
      study.
AB  - The history of physical and sexual abuse among 50 homeless and 50 housed poor
      mothers was compared, with particular attention to details of prevalence, type,
      and severity. No significant differences were found except in higher reported
      rates of sexual abuse in adulthood among housed mothers. However, 89% of the
      total sample reported experiencing some form of abuse in their lifetimes. The
      unexpected lack of differential and the high prevalence rates are discussed in
      terms of service delivery and social policy implications.

PMID- 1746626
TI  - Caregiver burden: gender and the psychological costs of caregiving.
AB  - The psychological costs of providing care for a parent with Alzheimer's disease
      are examined, together with the consequences of depression, anxiety, guilt, and
      resentment in relation to the caregiver's coping style, social support, and sense
      of control. The use of fantasy by women as a coping mechanism was associated with
      greater anxiety and depression, adequate social support was somewhat more helpful
      for men, and a sense of control was more helpful for women.

PMID- 1746627
TI  - Acute versus chronic grief: the case of pregnancy loss.
AB  - Conceptual and measurement problems in identifying those at risk of chronic grief
      are reviewed, and results are presented of a longitudinal study of people who
      have experienced pregnancy loss. Coping resources, particularly prior mental
      health and social support, were the best predictors of low scores on subscales of
      the Perinatal Grief Scale that indicate chronic grief reactions. Results also
      offer some evidence of delayed grief responses, especially among men and those
      who experienced early losses.

PMID- 1746628
TI  - Preventing birth injury among women in Africa: case studies in northern Nigeria.
AB  - Among the most serious maternal injuries from childbirth in Africa is
      vesicovaginal fistula (VVF). Case studies of 55 VVF patients in northern Nigeria
      showed them to be poor, underage village women without sufficient access to
      modern health facilities at the time of the injury. Suggestions for short-term
      and long-term preventive measures are presented and discussed.

PMID- 1746629
TI  - Statutory emancipation of minors: use and impact.
AB  - Interviews with 18 adolescents who petitioned for emancipation under a California
      statute revealed that the decision to seek emancipation was often based on the
      concerns of adult family members, and that those adults sometimes facilitated the
      actual legal process. The study also revealed that the statute's prerequisites
      for emancipation were frequently not fulfilled.

PMID- 1746630
TI  - The parent-child interview: use in evaluating child allegations of sexual abuse
      by the parent.
AB  - The practice of using parent-child interviews to determine whether children have
      been sexually abused by the parent is called into question. The relevant
      literature is reviewed, and practical and ethical reasons for eschewing such
      interviews are discussed. Three case examples in which parent-child interviews
      were attempted or employed are described and discussed.

PMID- 1746631
TI  - The frog prince: tale and toxicology.
AB  - Bufotenin is a substance present in the skin of some common species of frogs, and
      its ingestion (such as would occur in licking or kissing a frog) can result in
      vivid hallucinations. This biological property offers an explanation for the
      portrayal of frogs in folklore as creatures of transformation, or as
      intermediaries with other worlds.

PMID- 1746632
TI  - Psychotherapy as an approach to special education prevention: perceptions of
      student behavior.
AB  - This study investigated the impact of one year of psychotherapy, used in an
      attempt to avoid special education referral, on teachers' and psychotherapists'
      perceptions of student disruptiveness and withdrawal. Results indicated that
      psychotherapists perceived improvement in both types of behavior, while teachers
      did not. Possible reasons for this perceptual difference are discussed.

PMID- 1746633
TI  - Mandated leave: an analysis of federal and state legislation.
AB  - Results of a survey of federal and state legislation on family and medical leave,
      based on proposed legislative activities in 1986 and 1987 and on the outcome of
      these activities from 1986 to 1991, are presented. Major variations in employee
      provisions and employer protections are outlined and discussed, and likely
      directions for future legislation identified.

PMID- 1746634
TI  - The elusive search for certainty in child welfare: introduction.

PMID- 1746635
TI  - Issues in foster family care: where do we stand?
AB  - An overview of recent findings about children and families in foster care
      describes the population, reviews positive and negative results of foster care,
      and raises such clinical and policy issues as the beneficial outcomes of long
      term foster care, the economic crisis for foster parents, and the vulnerability
      of minority children and families. Implications for research are discussed.

PMID- 1746636
TI  - Whose child is this? Assessment and treatment of children in foster care.
AB  - Clinicians who treat children in foster care must continually balance the
      development and therapeutic needs of the foster child with the expectations of a
      complex network of caretakers and professionals with whom the child interacts. A
      model that integrates individual and systemic issues in the assessment and
      treatment of children in foster care is proposed.

PMID- 1746637
TI  - Child welfare and the role of women: a feminist perspective.
AB  - Linked by caretaking, the major stakeholders in the child welfare system are
      women and children. Contrary to general assumption, however, their rights and
      needs are not equally satisfied by the same service systems. A feminist
      reanalysis of basic policy aims, and of caretaking roles and functions, is
      crucial to the development of a more satisfactory child welfare system.

PMID- 1746638
TI  - The delivery of child welfare services to African American clients.
AB  - African Americans have historically suffered inequities in the delivery of child
      welfare services. The necessity for awareness of cultural contexts is examined,
      particularly in decision making about maintenance in the child's home, out-of
      home placement, reunification of child and parents, other permanency planning
      options, and mental health referrals. The implications of such awareness for
      service delivery, administration, and policy making in the child welfare system
      are discussed.

PMID- 1746639
TI  - The optimism of policy choices in child welfare.
AB  - That the desire for sure answers to problems in child welfare has led to
      acceptance of programs on the basis of faith rather than realism is illustrated
      by examination of some current programs. The need for rational choices in policy,
      program, and practice that respond to the basic human requirements of vulnerable
      families is highlighted.

PMID- 1746640
TI  - Crafting a federal legislative framework for child welfare reform.
AB  - The nature and scope of the problems plaguing child welfare systems across the
      country make federal solutions especially urgent. A decade after enactment of the
      Adoption Assistance and Child Welfare Act (PL 96-272), legislation is pending
      that builds on its framework to enhance services and supports for vulnerable
      children and their families. The legislation reflects a growing consensus about
      the nature of the child welfare crisis and about the reform strategies that will
      be effective.

PMID- 1746641
TI  - Compact bone distribution and biomechanics of early hominid mandibles.
AB  - This investigation explores the effects of compact bone distribution on the
      biomechanical properties of the postcanine mandibular corpus of the fossil
      hominid taxa Australopithecus africanus and Paranthropus robustus. The mandibles
      of extant great apes, modern humans, and the fossil hominids are examined by
      computed tomography (CT), and compact bone contours are used to calculate cross
      sectional biomechanical properties (cortical area, second moments of area, and
      Bredt's formula for torsional strength). The relative amount of compact bone is
      comparable in the modern and fossil mandibles, but the mechanical properties of
      A. africanus and P. robustus jaws are distinct in terms of the ratio of minimum
      to maximum second moments of area. This difference most likely represents a
      structural response to elevated torsional moments in the fossil hominids.
      Although the relative amount of compact bone in cross-section does not differ
      significantly between taxa by statistical criteria, A. africanus utilizes less
      cortical bone than P. robustus in the same manner in which Pongo is separated
      from the condition in other extant large-bodied hominoids. It has been suggested
      that the phenomenon of mandibular "robusticity" (expressed as an index of corpus
      breadth/corpus height) may be an effect of postcanine megadontia and/or reduced
      canine size in the australopithecines. Results presented here, however, indicate
      that it is unlikely that either factor adequately accounts for mandibular size
      and shape variation in early hominids.

PMID- 1746642
TI  - Increased vital and total lung capacities in Tibetan compared to Han residents of
      Lhasa (3,658 m).
AB  - Larger chest dimensions and lung volumes have been reported for Andean high
      altitude natives compared with sea-level residents and implicated in raising lung
      diffusing capacity. Studies conducted in Nepal suggested that lifelong Himalayan
      residents did not have enlarged chest dimensions. To determine if high-altitude
      Himalayans (Tibetans) had larger lung volumes than acclimatized newcomers (Han
      "Chinese"), we studied 38 Tibetan and 43 Han residents of Lhasa, Tibet Autonomous
      Region, China (elevation 3,658 m) matched for age, height, weight, and smoking
      history. The Tibetan compared with the Han subjects had a larger total lung
      capacity [6.80 +/- 0.19 (mean +/- SEM) vs 6.24 +/- 0.18 l BTPS, P less than
      0.05], vital capacity (5.00 +/- 0.08 vs 4.51 +/- 0.10 1 BTPS, P less than 0.05),
      and tended to have a greater residual volume (1.86 +/- 0.12 vs 1.56 +/- 0.09 1
      BTPS, P less than 0.06). Chest circumference was greater in the Tibetan than the
      Han subjects (85 +/- 1 vs 82 +/- 1 cm, P less than 0.05) and correlated with
      vital capacity in each group as well as in the two groups combined (r = 0.69, P
      less than 0.05). Han who had migrated to high altitude as children (less than or
      equal to 5 years old, n = 6) compared to Han adult migrants (greater than or
      equal to 18 years old, n = 26) were shorter but had similar lung volumes and
      capacities when normalized for body size. The Tibetans' vital capacity and total
      lung capacity in relation to body size were similar to values reported previously
      for lifelong residents of high altitude in South and North America. Thus,
      Tibetans, like North and South American high-altitude residents, have larger lung
      volumes. This may be important for raising lung diffusing capacity and preserving
      arterial oxygen saturation during exercise.

PMID- 1746643
TI  - Characteristics of hamadryas-like male baboons living in anubis baboon troops in
      the Awash hybrid zone, Ethiopia.
AB  - In the twenty-two years since the Awash baboon hybrid zone was first described,
      about 25-30 hamadryas or hamadryas-like hybrid males have taken up residence in
      anubis baboon groups. Most enter as mature adults, though some may immigrate as
      juvenile followers. Long-term tracking of known immigrants indicates that they
      may reside for four years or more in their adopted troop, during which time they
      establish a series of comparatively short-term harems, and probably sire hybrid
      offspring. "Abductions" of anubis females to hamadryas troops, as postulated by
      early observers, were not seen, though their occurrence cannot be ruled out.
      Younger, more recent immigrants tend to be "purer" hamadryas in phenotype,
      perhaps reflecting a more distant origin, or a change in the composition of
      neighboring hamadryas populations. Coexisting hamadryas and anubis show no signs
      of reproductive isolation by behavioral barriers, and evidently belong to a
      single "recognition species."

PMID- 1746644
TI  - Interspecific perspective on mechanical and nonmechanical models of primate
      circumorbital morphology.
AB  - Linear dimensions and angular orientations of the browridge, postorbital bar, and
      postorbital septum were obtained from a representative series of primates and
      compared with variables associated with several nonmechanical and
      biomechanical/mechanical models put forward to explain the form and function of
      the circumorbital region. Analyses of the results indicate that face size is the
      primary determinant of variation in primate circumorbital morphology.
      Anteroposterior browridge thickness is correlated with neural-orbital disjunction
      among anthropoid primates, but not among prosimians. This difference appears
      related to differences in the construction of the upper face and anterior cranial
      fossa between prosimians and anthropoids. Little support is demonstrated for the
      anterior dental loading model of browridge development. Mediolateral postorbital
      bar width and (to a lesser degree) browridge height are correlated with
      neurofacial torsion during mastication and variation in masticatory muscle size.
      These analyses further suggest that since circumorbital structures (especially
      the browridges) are located the farthest away from the chewing apparatus, they
      are least affected by masticatory stresses.

PMID- 1746645
TI  - Articular and diaphyseal remodeling of the proximal femur with changes in body
      mass in adults.
AB  - Proximal femoral dimensions were measured from radiographs of 80 living subjects
      whose current body weight and body weight at initial skeletal maturity (18 years)
      could be ascertained. Results generally support the hypothesis that articular
      size does not change in response to changes in mechanical loading (body weight)
      in adults, while diaphyseal cross-sectional size does. This can be explained by
      considering the different bone remodeling constraints characteristic of largely
      trabecular bone regions (articulations) and largely compact cortical bone regions
      (diaphyses). The femoral neck shows a pattern apparently intermediate between the
      two, consistent with its structure. When the additional statistical "noise"
      created by an essentially static femoral head size is accounted for, the present
      study supports other studies that have demonstrated rather marked positive
      allometry in femoral articular and shaft cross-sectional dimensions to body mass
      among adult humans. Body weight prediction equations developed from these data
      give reasonable results for modern U.S. samples, with average percent prediction
      errors of about 10%-16% for individual weights and about 2% for sample mean
      weights using the shaft dimension equations. When predicting body weight from
      femoral head size in earlier human samples, a downward correction factor of about
      10% is suggested to account for the increased adiposity of very recent U.S.
      adults.

PMID- 1746646
TI  - Euclidean distance matrix analysis: a coordinate-free approach for comparing
      biological shapes using landmark data.
AB  - For problems of classification and comparison in biological research, the primary
      focus is on the similarity of forms. A biological form can be conveniently
      defined as consisting of size and shape. Several approaches for comparing
      biological shapes using landmark data are available. Lele (1991a) critically
      discusses these approaches and proposes a new method based on the Euclidean
      distance matrix representation of the form of an object. The purpose of this
      paper is to extend this new methodology to the comparison of groups of objects.
      We develop the statistical versions of various concepts introduced by Lele
      (1991a) and use them for developing statistical procedures for testing the
      hypothesis of shape difference between biological forms. We illustrate the use of
      this method by studying morphological differences between normal children and
      those affected with Crouzon and Apert syndromes and craniofacial sexual
      dimorphism in Cebus apella.

PMID- 1746647
TI  - Brief communication. on the problem of immunological detection of antigens in
      skeletal remains.
AB  - A detailed investigation with affinity-chromatography-purified fractions of
      antihemoglobin serum from rabbit shows that the hemoglobin content of human bones
      dating back 15 to 3,000 years may be very small. Some of the previous results
      (Ascenzi et al., 1985) indicating a high hemoglobin titer were +vitiated because
      of an unexpected cross-reactivity of bone extracts with the hemoglobin-unreactive
      fraction of the antiserum.

PMID- 1746648
TI  - Strategies to prevent HIV infection in the United States.

PMID- 1746649
TI  - Health for all: a public health vision.
AB  - The approach of a millennial passage invites public health to a review of past
      performance and a preview of future prospects toward assuring a healthy public.
      Since the 1974 Canadian Lalonde report, the best national plans for health
      progress have emphasized disease prevention and health promotion. WHO's
      multinational Health for All by the Year 2000 promotes basic health services
      essential to leading a socially and economically productive life. Healthy People
      2000, the latest US guide, establishes three goals: increase healthy life span,
      reduce health disparities, and achieve universal access to preventive services.
      Its objectives can be used to excite public understanding, equip program
      development, evaluate progress, and encourage public accountability for health
      initiatives. Needed is federal leadership in defining requisite action and
      securing necessary resources. Elsewhere a "new public health" emphasizes
      community life-style and multisectoral "healthy public policy." In the United
      States, a national health program is needed to achieve equity in access to
      personal health care. Even more essential is equitable sharing in basic health
      determinants in society--nutritious food, basic education, safe water, decent
      housing, secure employment, adequate income, and peace. Vital to such a future is
      able and active leadership now from governments and public health professionals.

PMID- 1746650
TI  - Lessons from London: the British are reforming their national health service.
AB  - In an effort to keep abreast of the changing needs of a more affluent society and
      to ensure better value for money, the British are reforming their National Health
      Service. They are promoting competition and entrepreneurship, and directing
      funding to follow a patient rather than flowing directly to institutions. British
      physicians are resisting these changes. The United States, in the middle of a
      health care crisis of its own, can learn a great deal from Britain, especially in
      the area of controlling expenditures. The low cost of the National Health Service
      can be attributed to four major factors: (1) It is general practitioner driven
      and no patient accesses a specialist or hospital directly. (2) Hospitals, which
      employ all the specialists and supply most of the technology, operate on very
      tight, cash-limited budgets. (3) Administrative costs are very low. (4) The
      expense of malpractice is not (yet) a major concern. Changes occurring in both
      countries foretell a future wherein our health care systems may look very much
      alike.

PMID- 1746651
TI  - Injury-related medical care utilization in a problem drinking population.
AB  - BACKGROUND: Population-based data on the overall risk of injury among problem
      drinkers are extremely limited. METHODS: We conducted an eight-year study of
      injury-related medical care utilization for a group of problem drinkers (n = 3
      729) enrolled in the health insurance plan of a large manufacturing firm with
      plants in a number of midwestern states. A comparison non-problem drinking cohort
      matched on age, gender, and number of years of enrollment with the same company
      plan was also utilized. RESULTS: Problem drinkers utilized injury-related medical
      care at a rate 1.6 times that of the comparison group and experienced injury
      related medical care costs which were three times as high. Increased risks were
      found for both men and women and for all ages studied. CONCLUSIONS: This study is
      one of the few to examine the overall incidence of fatal and non-fatal injuries
      among a large population of problem drinkers and provides evidence that higher
      medical care costs are associated with chronic alcohol use.

PMID- 1746652
TI  - HIV infection, genital ulcer disease, and crack cocaine use among patients
      attending a clinic for sexually transmitted diseases.
AB  - BACKGROUND: Recently there has been a rise in genital ulcer disease (GUD) in
      urban minority heterosexuals in the United States. The impact of these increased
      GUD rates on HIV transmission patterns in this population is unknown. METHODS:
      Sexually transmitted disease (STD) diagnoses were correlated with HIV antibody
      status and risk factor history in 194 patients who consented to HIV testing at an
      STD clinic in central Brooklyn. RESULTS: Of 36 HIV-positive patients, 23 (64%)
      denied HIV risk factors other than heterosexual contact with persons of unknown
      HIV status. HIV antibody was associated with GUD (odds radio [OR] = 2.72, 95%
      confidence interval [CI] = 1.20-6.24), multiple concurrent STDs (OR = 2.51, 95%
      CI = 1.08-5.81), and a history of crack cocaine use (OR = 2.98, 95% CI = inexact
      9.61). Crack use was also associated with GUD (OR = 15.15, 95% CI = 3.27-inexact)
      and multiple simultaneous STDs (OR = 13.87, 95% CI = 4.62-inexact). In a log
      linear model analysis, HIV infection was independently associated with GUD and
      crack use. HIV infection, genital ulcer disease, and crack cocaine use were more
      common in women than men. CONCLUSIONS: The association between HIV infection and
      GUD seen here may be secondary to high-risk sexual behavior, which in turn may be
      partially attributable to crack cocaine use and drug-related prostitution. The
      high rate of coinfection with HIV and GUD raises a concern about the increased
      efficiency of sexual transmission of HIV in this population.

PMID- 1746653
TI  - Reduction of high-risk sexual behavior among heterosexuals undergoing HIV
      antibody testing: a randomized clinical trial.
AB  - BACKGROUND: We evaluated the effect of HIV antibody testing on sexual behavior
      and communication with sexual partners about AIDS risk among heterosexual adults
      at a clinic for sexually transmitted diseases. METHODS: We randomized 186
      subjects to receive either AIDS education alone (the control group) or AIDS
      education, an HIV antibody test, and the test results (the intervention group).
      These subjects were then followed up 8 weeks later. RESULTS: At follow-up, mean
      number of sexual partners decreased, but not differently between groups. However,
      compared with controls, HIV antibody test intervention subjects, all of whom
      tested negative, questioned their most recent sexual partner more about HIV
      antibody status (P less than 0.01), worried more about getting AIDS (P less than
      0.03), and tended to use a condom more often with their last sexual partner (P =
      0.05): 40% of intervention subjects vs 20% of controls used condoms, avoided
      genital intercourse, or knew their last partner had a negative HIV antibody test
      (P less than 0.005). CONCLUSION: HIV antibody testing combined with AIDS
      education increases concern about HIV and, at least in the short term, may
      promote safer sexual behaviors. Additional strategies will be necessary if
      behaviors risky for HIV transmission are to be further reduced.

PMID- 1746654
TI  - Behavior changes after notification of HIV infection.
AB  - BACKGROUND: To learn more about how people who did not volunteer for testing
      react to information about HIV infection, we assessed short-term behavior changes
      in HIV-positive blood donors. METHODS: Blood donors who were notified at the New
      York Blood Center that they were HIV positive were asked to participate in a
      study. A nurse elicited a medical history, performed a limited medical
      examination, and asked participants to complete a questionnaire that included
      questions about drug use, sexual behavior, and psychological characteristics.
      Participants were asked to return in 2 weeks to complete another questionnaire.
      RESULTS: Many fewer men and women reported engaging in unsafe sexual behaviors in
      the 2 weeks preceding the follow-up visit than had reported such behaviors prior
      to notification. These changes were greater than those other investigators have
      reported, but about 40% of the participants still reported unsafe sexual activity
      at the follow-up interview. CONCLUSIONS: To make nonvolunteer screening programs
      for HIV infection more effective in reducing the spread of HIV infection, we need
      to learn more about how to help people change their high-risk behaviors.

PMID- 1746655
TI  - Knowledge about AIDS and HIV in the US adult population: influence of the local
      incidence of AIDS.
AB  - BACKGROUND: Accurate information about acquired immunodeficiency syndrome (AIDS)
      and human immunodeficiency virus (HIV) is important for prevention. This study
      determined whether AIDS knowledge varied among populations residing in areas with
      a low, medium, or high incidence of AIDS. METHODS: Respondents to the 1988
      National Health Interview Survey of AIDS Knowledge and Attitudes, which is based
      on a nationally representative sample of 29,659 adults, were rated on their
      knowledge about modes of HIV transmission, general knowledge about AIDS, and
      misperceptions about HIV transmission through casual contact. RESULTS: Persons 50
      years of age or older, Blacks, Hispanics, and persons with less than a high
      school education had lower knowledge scores and higher misperception scores.
      Residents of the high-incidence area had more misperceptions than those who lived
      in the medium- or low-incidence areas. Sociodemographic determinants of scores
      were important factors overall and within each AIDS incidence area. CONCLUSIONS:
      These data suggest that the ability of educational messages to reach and be
      absorbed by individuals nationwide is less dependent on whether they live in an
      area with a high incidence of AIDS and more dependent on other demographic
      variables. New and continued efforts are needed to improve knowledge in older
      persons, minorities, and the less educated in all parts of the country.

PMID- 1746656
TI  - HIV instruction, HIV knowledge, and drug injection among high school students in
      the United States.
AB  - BACKGROUND: The prevalence of HIV-related behaviors and determinants of these
      behaviors among adolescents in the United States have not been well studied.
      METHODS: To determine the prevalence of HIV-related drug behaviors and to assess
      the effects of HIV-related school-based instruction and HIV knowledge on these
      behaviors, data were analyzed from a 39-item, self-administered questionnaire
      completed by a probability sample of all students in grades 9 through 12 in the
      United States. RESULTS: Usable responses were obtained from 8098 students. Of
      these, 2.7% (95% confidence interval [CI] = 2.3-3.2) and 1.7% (95% CI = 1.3-2.1)
      reported injecting illicit drugs ever and during the past year, respectively.
      Corresponding prevalences of needle sharing were 0.8% (95% CI = 0.5-1.1) and 0.5%
      (95% CI = 0.3-0.7). Regression analysis revealed that students with higher
      knowledge scores were less likely and males more likely to have ever injected
      drugs. HIV knowledge was similarly associated with other outcome measures of drug
      injection behavior. Although HIV instruction did not directly influence drug
      injection behavior independently of demographic characteristics, it was
      positively associated with HIV knowledge. CONCLUSIONS: While these results do not
      establish a causal relationship, they suggest that HIV knowledge and school-based
      instruction may play a role in maintaining low levels of drug-injection behavior
      among high school students.

PMID- 1746657
TI  - Needle sharing in The Netherlands: an ethnographic analysis.
AB  - BACKGROUND: Needle sharing has been reported to be the main cause of the rapid
      spread of the human immunodeficiency virus (HIV) among injecting drug users. Risk
      behaviors such as needle sharing are, however, the end result of complicated
      interaction patterns in drug user networks, which have their specific rules and
      rituals, and larger social structures and official drug policy. METHODS: To study
      these interaction patterns we examined the drug administration rituals of heroin
      addicts in Rotterdam, The Netherlands. Intensive ethnographic descriptions were
      collected by participant observation. RESULTS: In less than 10% of the observed
      self-injections unsafe syringes were used. In 68% of the self-injections new,
      sterile syringes were used. Needle sharing as a planned sequence was not
      observed. Sharing was determined primarily by the availability of syringes,
      experience with the injecting ritual, and drug craving. In all observed needle
      sharing events, subjects were aware of the risks involved and undertook efforts
      to clean the injection equipment. CONCLUSIONS: In contrast to psychological
      approaches aimed at reducing individual "risk behavior," these findings suggest
      that HIV prevention can be made more effective if active drug injectors are
      organized to help themselves and their peers prevent high-risk exchange
      situations.

PMID- 1746658
TI  - Socioeconomic status and electrolyte intake in black adults: the Pitt County
      Study.
AB  - BACKGROUND: Although the inverse association between socioeconomic status (SES)
      and blood pressure has often been observed, little is known about the
      relationship between SES and dietary risk factors for elevated blood pressure.
      Therefore, this study described the distribution of dietary intakes of sodium,
      potassium, and calcium and examined the association between electrolyte intake
      and SES among 1784 Black men and women aged 25 to 50 residing in eastern North
      Carolina. METHODS: Household interviews were conducted in 1988 to obtain
      information on psychosocial and dietary correlates of blood pressure. Electrolyte
      intake (mg/day) was assessed using a food frequency questionnaire adapted to
      reflect regional and ethnic food preferences. SES was categorized into three
      levels defined by the participant's educational level and occupation. RESULTS:
      After adjustment for age and energy intake, potassium and calcium intake
      increased with increasing SES for both sexes. Sodium intake was high for all
      groups and did not vary markedly with SES, but sodium to potassium and sodium to
      calcium ratios decreased with increasing SES. In addition, high SES individuals
      were more likely to believe that diet affects risk for disease and to report less
      salt use at the table and less current sodium consumption than in the past.
      CONCLUSION: These data indicate that nutritional beliefs as well as the
      consumption of electrolytes are associated with SES in Black adults.

PMID- 1746659
TI  - An evaluation of the impact of maternity care coordination on Medicaid birth
      outcomes in North Carolina.
AB  - BACKGROUND: Care coordination is an important component of the enhanced prenatal
      care services provided under the recent expansions of the Medicaid program. The
      effect of maternity care coordination services on birth outcomes in North
      Carolina was assessed by comparing women on Medicaid who did and did not receive
      these services. METHODS: Health program data files, including Medicaid claims
      paid for maternity care coordination, were linked to 1988 and 1989 live birth
      certificates. Simple comparisons of percentages and rates were supplemented by a
      logistic regression analysis. RESULTS: Among women on Medicaid who did not
      receive maternity care coordination services, the low birth weight rate was 21%
      higher, the very low birth weight rate was 62% higher, and the infant mortality
      rate was 23% higher than among women on Medicaid who did receive such services.
      It was estimated that, for each $1.00 spent on maternity care coordination,
      Medicaid saved $2.02 in medical costs for newborns up to 60 days of age. Among
      the women who did receive maternity care coordination, those receiving it for 3
      or more months had better outcomes than those receiving it for less than 3
      months. CONCLUSIONS: These results suggest that maternity care coordination can
      be effective in reducing low birth weight, infant mortality, and newborn medical
      care costs among babies born to women in poverty.

PMID- 1746660
TI  - The importance of assessing the fit of logistic regression models: a case study.
AB  - BACKGROUND: The logistic regression model is being used with increasing frequency
      in all areas of public health research. In the calendar year 1989, over 30% of
      the articles published in the American Journal of Public Health employed some
      form of logistic regression modeling. In spite of this increase, there has been
      no commensurate increase in the use of commonly available methods for assessing
      model adequacy. METHODS: We review the current status of the use of logistic
      regression modeling in the American Journal of Public Health. We present a brief
      overview of currently available and easily used methods for assessing the
      adequacy of a fitted logistic regression model. RESULTS: An example is used to
      demonstrate the methods as well as a few of the adverse consequences of failing
      to assess the fit of the model. One important adverse consequence illustrated in
      the example is the inclusion of variables in the model as a result of the
      influence of one subject. CONCLUSIONS: Failure to address model adequacy may lead
      to misleading or incorrect inferences. Recommendations are made for the use of
      methods for assessing model adequacy and for future editorial policy in regard to
      the review of articles using logistic regression.

PMID- 1746661
TI  - Overcoming denial and increasing the intention to use condoms through the
      induction of hypocrisy.
AB  - Feelings of hypocrisy were induced in college students to increase condom use.
      Hypocrisy was created by making subjects mindful of their past failure to use
      condoms and then having them persuade others about the importance of condoms for
      AIDS prevention. The induction of hypocrisy decreased denial and led to greater
      intent to improve condom use relative to the control conditions. The implications
      of these findings for AIDS prevention are discussed.

PMID- 1746662
TI  - Knowledge about HIV and behavioral risks of foreign-born Boston public school
      students.
AB  - In 1990, 3049 Boston public middle and high school students were surveyed
      anonymously in English, Spanish, Vietnamese, Chinese, French, or Haitian Creole.
      Significantly fewer immigrant students, 35% of those surveyed, knew the principal
      modes of human immunodeficiency virus transmission. Fewer immigrants reported
      having sexual intercourse (31% vs 53% of nonimmigrants), but among the sexually
      active only 38% always used condoms, and more immigrants reported intercourse
      with intravenous drug users (4% vs 1% of non-immigrants). AIDS education should
      be taught to immigrant students in their native languages.

PMID- 1746663
TI  - HIV infection and risk behaviors among intravenous drug users in low
      seroprevalence areas in the Midwest.
AB  - We studied behavioral factors that place intravenous drug users at risk for the
      acquisition and transmission of the human immunodeficiency virus (HIV) in a
      sample of 855 individuals not in drug treatment, living in central and
      southwestern Ohio. The HIV seropositivity rate for the sample was 1.5%. Three
      factors were significantly related to HIV infection: homeless shelter residence
      (odds ratio [OR] = 7.7, 95% confidence interval (CI) = 3.0-20.0), travel to
      northeastern HIV hyperendemic areas (OR = 5.2, 95% CI = 1.8-15.4), and recent
      male homosexual or bisexual behavior (OR = 11.2, 95% CI = 2.9-43.9).

PMID- 1746664
TI  - Frequency and thoroughness of STD/HIV risk assessment by physicians in a high
      risk metropolitan area.
AB  - The US Preventive Services Task Force recommends that all primary care physicians
      assess the sexually transmitted disease/human immunodeficiency virus (STD/HIV)
      risk of all adolescent and adult patients. To determine whether factors amenable
      to change through continuing medical education are associated with frequent and
      thorough STD/HIV risk assessment, a telephone survey of primary care physicians
      in the Washington, DC metropolitan area was conducted (n = 961). Thirty-seven
      percent of physicians reported regularly asking new adult patients about their
      sexual practices; 60% asked new adolescent patients. STD/HIV risk questioning was
      associated with physicians' confidence in their ability to help prevent HIV,
      comfort with discussing patients' sexual practices, and perception of a large
      STD/HIV problem in their practice. These findings suggest that continuing medical
      education should target improvement in physicians' sexual practice questioning
      skills.

PMID- 1746665
TI  - Changes in AIDS case reporting after hospital site visits.
AB  - In an effort to improve AIDS case reporting, site visits (meetings with hospital
      staff to encourage reporting) were made to all Philadelphia hospitals.
      Comparisons of hospitals visited during a 7-week period with hospitals not
      visited during that period indicated that the site visits were followed by a
      marked increase in case reports. No similar increase was observed at the
      comparison hospitals. The increased reporting was accompanied by an increased lag
      time from diagnosis to report, suggesting that the additional reports at visited
      hospitals were the result of the identification of previously missed cases rather
      than a speedup of reporting. Cases reported after the visits were more likely to
      have white-collar occupations or private medical insurance than were those
      reported before the visits.

PMID- 1746666
TI  - Patterns of breast and cervical cancer screening at three public health centers
      in an inner-city urban area.
AB  - In an effort to examine breast and cervical cancer screening patterns among poor
      African-American urban women, medical records were abstracted at three public
      health centers located in the inner city of Chicago. The proportions of eligible
      women at these three centers who received Pap smears, breast examinations, and
      mammograms were computed. These proportions were notably low and differed
      significantly among the three centers. Because the literature is now suggesting
      that an appropriate sequence best defines adequate screening, sequences of
      screenings were also determined and were found to be lacking. All of these
      screening histories fall far below the screening objectives set by the National
      Cancer Institute for the year 2000. This information suggests that interventions
      are needed that will help health centers serving poor women to deliver more
      frequent cancer screening.

PMID- 1746667
TI  - The impact of vitamin A supplementation on morbidity: a randomized community
      intervention trial.
AB  - A randomized community trial investigated the impact of vitamin A supplementation
      on symptoms of respiratory and enteric infections among Indonesian children aged
      1 to 5 years. A sample of 450 villages had been randomized into 229 villages that
      received vitamin A distribution and 221 that were observed as controls. The
      prevalence rates of cough, fever, and diarrhea were reduced in the treatment
      villages compared with the control villages by 8%, 5%, and 11%, respectively, but
      the reduction was not statistically significant. These results indicate that
      vitamin A supplements did not produce a substantial reduction in these symptoms,
      in spite of a reported reduction in all-cause mortality.

PMID- 1746669
TI  - Hooray for health! A health education program for day-care home providers.

PMID- 1746668
TI  - Epidemiology and the law: courts and confidence intervals.
AB  - Beginning with the swine flu litigation of the early 1980s, epidemiological
      evidence has played an increasingly prominent role in helping the nation's courts
      deal with alleged causal connections between plaintiffs' diseases or other harm
      and exposure to specific noxious agents (such as asbestos, toxic waste,
      radiation, and pharmaceuticals). Judicial reliance on epidemiology has high
      lighted the contrast between the nature of scientific proof and of legal proof.
      Epidemiologists need to recognize and understand the growing involvement of their
      profession in complex tort litigation.

PMID- 1746670
TI  - Lazy eyes and public vision: health department focus on preschool vision testing.

PMID- 1746671
TI  - Study on PMS and caffeine consumption flawed.

PMID- 1746672
TI  - Outbreak of Coxsackievirus A16 hand, foot, and mouth disease in a child day-care
      center.

PMID- 1746673
TI  - Liquid scintillation versus gamma ray counting in Radon measurements with
      charcoal.

PMID- 1746674
TI  - Homicide trends in New York State, 1980 to 1988.

PMID- 1746675
TI  - Suicides at Niagara Falls.

PMID- 1746676
TI  - Let's not "blame the victim"--exercise does protect against heart disease.

PMID- 1746677
TI  - Differences in biological responses to cigarette smoking remain unexplained.

PMID- 1746678
TI  - Histologic classification of the combined nevus. Analysis of the variable
      expression of melanocytic nevi.
AB  - The designation combined nevus gives recognition to mixed cytologic patterns. In
      the common variant, plump, pigmented spindle cells form fascicles among nests of
      ordinary nevus cells. In other variants, one or several cellular components that
      share cytologic features with either a blue nevus or a Spitz nevus are
      represented. Ninety-five cases, 49% of which were of the common type, were
      studied. Grossly, most of the lesions were darkly pigmented papules or nodules.
      The clinical diagnosis in three-fourths of the cases was nevus, blue nevus, or
      melanoma. Fifteen percent had concomitant histologic features of melanocytic
      dysplasia, and most of these lesions were of the common type. For the common
      variant, the cytologic features, pattern of apparent infiltration, and variable
      representation of the features of a premalignant melanocytic dysplasia often
      mislead a pathologist in interpreting and predicting biologic potential. In
      combined nevi, the phenotypic diversity and genetic lability of melanocytic nevus
      cells is manifested.

PMID- 1746679
TI  - Diffuse laminar endocervical glandular hyperplasia. A benign lesion often
      confused with adenoma malignum (minimal deviation adenocarcinoma).
AB  - We report seven examples of a hitherto undescribed pseudoneoplastic glandular
      lesion of the uterine cervix that we have designated "diffuse laminar
      endocervical glandular hyperplasia." The patients ranged in age from 22 to 48
      (mean 37) years. Only one of them had a history of hormone intake. All the
      lesions were incidental findings in hysterectomy specimens performed for
      dysfunctional uterine bleeding (five cases) or symptomatic leiomyomas (two
      cases). Microscopic examination revealed a proliferation of moderate-sized,
      evenly spaced, differentiated endocervical glands within the inner one-third of
      the cervical wall, sharply demarcated from the underlying cervical stroma.
      Reactive atypia was seen in some cases but significant cytologic atypia was
      absent. A marked inflammatory response was present in five of the seven cases.
      The main consideration in differential diagnosis was adenoma malignum (minimal
      deviation adenocarcinoma). Major features that helped in this distinction were a
      lack of irregular stromal infiltration and a desmoplastic stromal response, and
      an absence of focal malignant cytologic features. Follow-up for an average of 6.5
      years in five of the seven cases was uneventful.

PMID- 1746680
TI  - Sinusoidal hemangioma. A distinctive benign vascular neoplasm within the group of
      cavernous hemangiomas.
AB  - Twelve cases of sinusoidal hemangioma, a distinctive subset of the group of
      lesions known as cavernous hemangioma, are described. All presented as solitary
      subcutaneous/deep dermal lesions in adults, predominantly females. Five arose on
      a limb and five on the trunk; two of the latter were situated in mammary
      subcutaneous tissue. Histologically they were characterized by dilated,
      interconnecting, thin-walled vascular channels that frequently showed a
      pseudopapillary pattern. These vessels had a predominantly lobular architecture
      but peripherally showed focally ill-defined spread into subcutaneous tissue. The
      lining endothelium was single-layered but showed focal pleomorphism and
      hyperchromasia, which, combined with the pseudopapillae and apparent infiltrative
      pattern in areas, raised the possibility of angiosarcoma in four cases, most
      notably in the breast lesions. This possibility was further suggested by the
      presence of pseudonecrotic central infarction in two cases. Follow-up in eight
      cases, however, has revealed no tendency for either local recurrence or
      metastasis.

PMID- 1746681
TI  - Epithelioid variant of malignant peripheral nerve sheath tumor (malignant
      epithelioid schwannoma).
AB  - Twenty-six cases of malignant peripheral nerve sheath tumor with a predominant
      epithelioid pattern were studied to determine the range of its histologic
      patterns, immunophenotype, and biologic behavior. The tumor presented as an
      asymptomatic mass either in superficial (16 cases) or in deep soft tissue (10
      cases) of the extremity. Characteristically, those in deep soft tissue were
      composed of vague nodules of varying cellularity made up of cords or strands of
      rounded epithelioid cells with prominent nucleoli. Those in superficial soft
      tissue were uninodular masses composed of tight clusters of cells showing cell-to
      cell molding but possessing the same prominence of nuclei and mitotic activity as
      those in deep soft tissue. Several were associated with a preexisting benign
      nerve sheath tumor. A number of cases deviated from the above description,
      including cases that resembled a clear cell carcinoma, a malignant rhabdoid
      tumor, and a pleomorphic sarcoma. The majority of cases (80%) strongly expressed
      S-100 protein and neuron-specific enolase, but all lacked a melanoma-associated
      antigen (as defined by HMB-45) and cytokeratin. Stains for type IV collagen
      defined linear immunoreactivity around single cells and groups of cells. This
      pattern did not differ substantially from that of melanomas and therefore did not
      serve as a reliable discriminant. Follow-up information indicated a more
      favorable course for those in superficial soft tissue compared with those in deep
      sites. Two of 16 patients in the former group developed metastatic disease
      compared with three of 10 in the latter group. Tumors in superficial soft tissue
      may be eminently treatable and curable, depending on size.

PMID- 1746682
TI  - Inflammatory fibrosarcoma of the mesentery and retroperitoneum. A tumor closely
      simulating inflammatory pseudotumor.
AB  - We report 38 cases of inflammatory fibrosarcoma occurring in 23 females and 15
      males, 2 months to 74 years of age (median, 8.5 years; mean, 15 years) with
      symptoms of abdominal pain (17 cases), anemia (21 cases), fever (14 cases), mass
      (16 cases), and gastrointestinal obstruction (7 cases). Primary tumor sites
      included mesentery and retroperitoneum (31 cases), omentum (two cases),
      mediastinum (two cases), liver (one case), diaphragm (one case), and abdominal
      wall (one case). Sizes ranged from 2.4 cm to 20 cm (mean, 9.6 cm). Follow-up data
      in 27 cases revealed local recurrences in 10 patients, with multiple local
      recurrences in three and histologically proven distant metastases to lung (two
      cases) and brain (one case). Five patients died from their disease (median, 20
      months). All tumors, including metastases, consisted of fibroblasts,
      myofibroblasts, and plasma cells, with variable degrees of fibrosis and
      calcification. Immunostains indicate myofibroblastic differentiation; 18 of 20
      (90%) stained for actin, 15 of 18 (83%) for vimentin, and 10 of 13 (77%) for
      keratin (primarily in a submesothelial location). Ultrastructural studies also
      disclosed myofibroblastic features. The locally aggressive, recurrent nature of
      these neoplasms, as well as the occurrence of metastases and tumor deaths,
      indicate that they are potentially malignant neoplasms that we believe are better
      classified as inflammatory fibrosarcomas, not as cellular inflammatory
      pseudotumors.

PMID- 1746683
TI  - Histologic grade, DNA ploidy, and intraglandular tumor extent as indicators of
      tumor progression of clinical stage B prostatic carcinoma. A direct comparison.
AB  - Histologic grade, DNA ploidy, and percentage tumor area were assessed in
      prostatectomy specimens from 73 patients with clinical stage B adenocarcinoma of
      the prostate and analyzed for their value as predictors of tumor progression.
      Further, the relationship between percentage tumor area and DNA ploidy was
      studied. Percentage tumor area was the indicator most strongly associated with
      the likelihood of tumor extension beyond the capsule of the prostate and of tumor
      progression as assessed in a logistic regression model. Grade was slightly
      superior to percentage area in predicting time to progression in a Cox model
      analysis. Increasing percentage tumor area was associated with an increased
      likelihood of aneuploidy. Little additional predictive ability was obtained with
      the concurrent use of two indicators in multivariate analysis, suggesting a high
      degree of interrelatedness of percentage tumor area, histologic grade, and DNA
      ploidy. DNA ploidy was not an independent predictive factor, and from a practical
      standpoint histologic grade and percentage tumor area were more important
      predictors of tumor progression than DNA ploidy.

PMID- 1746684
TI  - Assessment of ampulla of Vater pathology. An endoscopic approach.
AB  - One hundred eighty-nine endoscopic biopsies of the papilla of Vater were obtained
      from 125 patients during a 10-year period. Chronic inflammation was the most
      common histologic change identified. Of the 44 patients with papillary neoplasia,
      42 were diagnosed by endoscopic biopsy. Sixteen of the 18 patients with invasive
      carcinoma were diagnosed by biopsy. Follow-up biopsies in patients endoscopically
      managed demonstrated recurrent tumors in 6 of 11 patients. With advances in
      instrumentation and techniques, pathologists can expect to see increasing numbers
      of ampullary biopsies. When multiple biopsy fragments are obtained and step
      sectioned, the diagnostic reliability of endoscopic biopsies in patients with
      tumors and carcinoma is greater than 90%. The morphologic spectrum of papillary
      lesions is similar to that seen in the colon with some significant exceptions.
      Tumor morphology varied considerably from area to area. Variations were seen in
      the basic architecture (villous-tubular), grade of dysplasia, presence of
      malignancy, and invasion from fragment to fragment, and in some cases from
      microscopic field to field. Another notable difference between the ampulla and
      colon is the rich mucosal lymphatic network of the ampullary region. Thus, any
      carcinoma invading the lamina propria was diagnosed as invasive carcinoma.

PMID- 1746685
TI  - Pleomorphic fibroma of tendon sheath.
AB  - We report an example of fibroma of tendon sheath with pleomorphic bizarre cells
      without mitoses. The tumor appears to be morphologically identical to a similar
      tumor in the skin and represents yet another example of a benign soft-tissue
      neoplasm with disturbing morphological features.

PMID- 1746686
TI  - Sarcomatoid neoplasm of monocytic lineage.

PMID- 1746687
TI  - [Features of the endometrial steroid receptor system in habitual abortion with
      high risk of infectious complications].
AB  - Analysis of microbiologic and histologic findings and measurements of estrogen
      and gestagen receptors in the endometrium have shown manifest shifts in the
      endometrial steroid receptor system in women with asymptomatic chronic
      endometritis. The authors claim that disordered reception of steroid hormones may
      be regarded as one of the causes of spontaneous, abortions.

PMID- 1746688
TI  - [Several aspects of management of women with abortions in a women's clinic].
AB  - Comprehensive instrumental examinations including hysteroscopy, tonometry,
      ultrasonic scanning were carried out in 190 women with symptoms of threatened
      abortion in pregnancy terms of 13-14 to 36-37 weeks. The findings evidenced that
      the presence of subjective signs of threatened abortion was not always supported
      by the results of objective instrumental examinations. Therapy of threatened
      abortions with commonly used drugs was monitored by instrumental methods; electro
      relaxation (non-medicinal physiotherapeutic method for correction of the uterine
      contractility) was carried out in 117 cases at the maternity center. The
      detection in these women of preclinical signs of threatened abortions permitted
      an early start of adequate therapy and was conducive to a reduction of the
      incidence of preterm deliveries.

PMID- 1746689
TI  - [Systemic lupus erythematosus and pregnancy: specific features of gestation and
      course of the disease].
AB  - The authors analyze the course and outcomes of 33 pregnancies in 26 women
      suffering from systemic lupus erythematosus (SLE). In patients with active SLE
      the incidence of gestoses and abnormalities of the newborns is significantly
      higher than in those with inactive SLE, whose gestational and neonatal
      complication rate is almost the same as in healthy women. Pregnancy course and
      outcomes are particularly unfavorable in cases with lupus glomerulonephritis.

PMID- 1746690
TI  - [Homeostasis disorders in chronic hypoxia in pregnant women with heart defects].
AB  - Central hemodynamics, free-radical lipid oxidation, anti-oxidant system,
      activities of lysosomal enzymes, and homeostasis system were studied in 86
      pregnant women with congenital and acquired heart diseases. The studies have
      revealed a hypodynamic circulation type, activated lipid peroxidation processes,
      reduced level of alpha-tocopherol, a natural antioxidant, and activated
      coagulating and depressed anticoagulating system of the blood. These pathologic
      processes results in development of a mixed form of chronic hypoxia, augmenting
      with the progress of the heart condition. Assessment of these parameters helps
      timely start differentiated intensive care and improve labor outcome for the
      mother and fetus.

PMID- 1746691
TI  - [Functional state of the hepatobiliary system and immune status of pregnant women
      who have had viral hepatitis].
AB  - Hepatobiliary function and immune status were evaluated in 92 pregnant women who
      had had viral hepatitis A (group 1) and in 35 who had suffered from viral
      hepatitis B. A control group included 102 healthy pregnant women. In group 1
      there appeared clinical symptoms suggesting impairment of hepatobiliary system.
      It is suggested that pregnant women with the history of hepatitis should consult
      specialist on infections or gastroenterologist to specify the pathological
      process in order to correct it adequately.

PMID- 1746692
TI  - [Age-related features and possibilities of prognostication of the development of
      the reproductive system in girls living in the Amur Region].
AB  - Physical and genital status of 2473 girls aged 12-16 was studied and factors of
      risk of development of the reproductive system in puberty detected. A scale for
      individual prediction of the reproductive function development, based on the
      girls' health status, body mass, exercise, was derived.

PMID- 1746693
TI  - [Pregnancy and labor in minor girls in the Ukraine].
AB  - Analysis of the data on pregnancy and labor in girls under age in the Ukraine has
      shown a growing incidence of abortions, including criminal ones, in this
      population. Since these women come to consult a doctor too late, no necessary
      prophylactic measures can be taken, this being particularly hazardous in cases
      with extragenital diseases. Abortions in the third pregnancy trimester can be
      allowed only by vital indications after a consultation of several physicians. The
      author emphasizes the necessity of health-educating work at schools and
      vocational schools, as well as with parents, and of developing methods to prevent
      unplanned pregnancy.

PMID- 1746694
TI  - [Biological properties of peritoneal fluid in health and in pathology of the
      reproductive system].

PMID- 1746695
TI  - [Features of the course of pregnancy and labor in students of higher education
      schools].
AB  - Analysis of the course of pregnancy and labor in 50 students has revealed that
      half of these women suffered from gestoses and threatened abortions and more than
      half of them developed labor complications. These values were significantly lower
      in the reference group of age-matched women.

PMID- 1746696
TI  - [Coagulation parameters characterizing features of physiological course of
      pregnancy in primiparas and multiparas].

PMID- 1746697
TI  - [Relations of the functional state of the visual analyzer and abnormalities of
      uterine contraction].

PMID- 1746698
TI  - [Diagnosis of disorders of the fetal status using computer-assisted
      cardiotocography].
AB  - The diagnostic system of cardiotocogram analysis in real time scale is described,
      and the diagnostic data of computer cardiotocography in various periods of os
      dilatation presented. Analysis of correlations and regressions of the parameters
      reflecting disorders of the fetal status has shown that the most significant
      parameter in the diagnosis of fetal status abnormalities is variability from beat
      to beat.

PMID- 1746699
TI  - [Effects of prenatal factors on the colloid-osmotic status of the newborn].
AB  - Studies of prenatal factor effects on the newborns' colloid-osmotic status, a
      pressing problem in present-day obstetrics, were carried out in 2 groups of
      women: Group 1 consisted of 50 women with spontaneous delivery and Group 2, also
      consisting of 50 women, who delivered via cesarean section, 25 of them because of
      a cicatrix on the uterus and the rest because of severe gestoses characterized by
      nephropathy and Stage III pre-eclampsia. Blood samples were collected directly
      after delivery from the mother's vein and from the newborn's umbilical vein, and
      the colloid-osmotic status of the plasma was analyzed. The results permitted
      singling out a number of prenatal factors influencing the newborns' colloid
      osmotic status. These factors are as follows: obstetrical abnormalities, gestosis
      among other things; intensive care of the mother during delivery or after
      surgery, administration of diuretics, delivery mode, etc. These results have
      brought the authors to a conclusion that standardized infusion therapy without
      due consideration for the colloid-osmotic status is inadmissible, for it may
      result in iatrogenic complications in the newborns.

PMID- 1746700
TI  - [Clinical-morphological aspects of suppurative inflammatory diseases of the
      adnexa uteri].
AB  - Draining of pyo-inflammatory foci of the uterine tubes, monitored by transvaginal
      echography, computer-aided tomography and laparoscopy, or surgery were carried
      out in 169 patients. Morphologic analysis helped define the characteristic
      features of the most prevalent clinical forms of pyo-inflammatory conditions of
      the uterine appendages and thus promoted a more accurate diagnosis of such
      conditions and their differentiated therapy. Immediate and late results of
      therapeutic draining of the pyo-inflammatory foci in the uterine tubes, monitored
      by the afore-said methods, are analyzed.

PMID- 1746701
TI  - [Hypothalamo-hypophyseal-thyroid system in patients with dysfunctional uterine
      bleeding].

PMID- 1746702
TI  - [Pulsed secretion of gonadotropins in polycystic ovary syndrome].
AB  - Pulsed secretion of gonadotropins was studied in 8 women suffering from
      polycystic ovarian syndrome, aged 23-28. Data on the time course of LH and FSH
      levels were processes by Santen and Bardin's method and by harmonic analysis. The
      results evidence that regular ejections of LH at a frequency higher than
      circahoralian rhythm (about 2 impulses per h) in such patients may be the cause
      of the development of the polycystic ovarian syndrome. Therapy with norcolut,
      carried out for 3 months, resulted in development of a trend to normalization of
      LH secretion, FSH secretion remaining unchanged.

PMID- 1746703
TI  - [Clinical course of the disease in familial and non-familial forms of serous
      cystadenocarcinoma of the ovary].
AB  - A retrospective analysis of the case histories of patients with familial and
      nonfamilial ovarian carcinomas has shown that patients with the familial
      condition develop a higher resistance of the body to tumor dissemination and
      their survival rate is better. This conclusion may be of interest for those who
      research carcinogenesis mechanisms.

PMID- 1746704
TI  - [Biologically active agents associated with the placenta].

PMID- 1746705
TI  - [Significance of tumor-associated CA-125 antigen in the diagnosis and monitoring
      of ovarian cancer].
AB  - Blood serum levels of CA 125 were measured by enzyme immunoassay in 60 patients
      with ovarian carcinoma during the diagnosis and treatment of the condition. The
      level of this antigen was found correlating with the disease stage and surpassing
      the normal value in 18% of cases with Stage II, in 62.2% of those with Stage III,
      and in 91% of those with Stage IV condition. Therefore, measurements of CA 125
      may be used in the diagnosis of ovarian carcinoma, identification of the origin
      of ascitic fluid, and objective evaluation of the therapeutic effect. CA 125 is a
      IVth Stage marker in cancer of the stomach or rectum. Measurements of this
      antigen improve the accuracy of ovarian carcinoma diagnosis by 15%.

PMID- 1746706
TI  - [Experimental and clinical studies of the causes of the rise of blood pressure
      during pregnancy].

PMID- 1746707
TI  - [Modification of the ovary demedullation method in sclerocystic ovary syndrome].

PMID- 1746708
TI  - [Early invasive cancer of the endometrium].

PMID- 1746709
TI  - [Obstetrical tactics in patients who had undergone heart surgery].

PMID- 1746710
TI  - [Use of polymer materials in surgical gynecology].

PMID- 1746711
TI  - [The effect of acid-base management on the oxygen uptake of the human body during
      hypothermic extracorporeal circulation].
AB  - The effects of two different systems of acid-base management on whole-body oxygen
      consumption during and following hypothermic cardiopulmonary bypass were
      investigated in 42 patients undergoing coronary artery bypass grafting or valve
      replacement surgery. In group I (22 patients) pH-stat management and in group II
      (20 patients) alpha-stat management was used. METHODS. Anesthesia was performed
      with fentanyl, midazolam, and pancuronium bromide. Halothane was added whenever
      MAP exceeded 100 mmHg. Cardiopulmonary bypass was conducted with a membrane
      oxygenator and a roller pump. Pump flow varied between 2 and 2.5 l/min per m2
      body surface area. Once patients had been initially cooled down to a venous blood
      temperature of 27 degrees C they were kept stable between 28 degrees C and 30
      degrees C during the ischemic phase. Measurements were performed after sternotomy
      during normothermia (control values) and every 15 min from the start until
      termination of bypass. RESULTS AND DISCUSSION. Neither hemodynamic parameters
      (MAP, CI, SVR) nor rectal or skin temperatures differed significantly between the
      two groups during the entire study period. Although at 27 degrees C oxygen
      availability fell by 43% and 35% in groups I and II, respectively, mixed venous
      oxygen saturation was significantly elevated compared with the control value,
      because of a decrease of 60% and 51%, respectively, in the arterio-venous oxygen
      content difference and of 62% and 55%, respectively, in oxygen consumption.
      Rewarming led to normalization of the metabolic parameters except for oxygen
      availability, which was still decreased as a result of low hemoglobin content.
      After termination of the bypass oxygen consumption increased steadily, which may
      have been due either to the beginning of shivering or to repayment of an oxygen
      debt caused by hypothermic bypass. As statistically significant differences were
      detected between the two groups in metabolic parameters during the course of the
      investigation, the hypothesis of Rahn and Reeves [2, 3], according to which
      oxygen consumption must be expected to be higher with alpha-stat than with pH
      stat management, could not be verified by this study.

PMID- 1746712
TI  - [The combination of general anesthesia and interscalene block in shoulder
      surgery].
AB  - Surgery on the shoulder often causes severe pain and, therefore, requires high
      doses of opiates. As postoperative pain is frequently treated inadequately, it is
      desirable to seek alternatives for providing effective analgesia. In a
      prospective study we examined the efficacy of balanced anesthesia consisting of
      general anesthesia combined with interscalene brachial plexus blockade for intra-
      and postoperative analgesia for operations on the shoulder. METHODS. Using the
      technique described by Winnie, interscalene block (ISB) was performed in 100
      awake patients. After location of the brachial plexus by means of a peripheral
      nerve stimulator, we injected 40 ml bupivacaine 0.375%, after which general
      anesthesia (GA) was induced. At three predetermined points in time (recovery
      room, 8 h, and 24 h after the end of surgery), pain was evaluated by a visual
      analogue scale ranging from 0 to 10 and the extent of sensory blockade was tested
      by the pinprick method. The results of the pain scores and individual demands for
      analgesics were compared with a group of 22 patients who received only GA. Both
      groups were comparable in age, sex, and type of surgical procedure. RESULTS. We
      noted technical failure of the ISB in 8% of our patients. Side effects such as
      Horner's syndrome (18%), phrenic nerve paralysis (10%), and recurrent laryngeal
      nerve block (1%) were only temporarily observed during the action of the local
      anesthetics. During the surgical procedure, the group with ISB received a mean
      dose of 0.13 +/- 0.07 mg fentanyl versus 0.29 +/- 0.08 mg in the GA group (P less
      than 0.01) with equipotent doses of volatile anesthetics (1.0 to 1.5 MAC
      enflurane). Postoperative pain occurred for the first time in 39% of the patients
      given ISB later than 12 h after the end of surgery (average 8.7 +/- 5.9 h). In
      contrast, 95% of the patients with GA complained of pain in the recovery room.
      Pain measurement by the analogue scale clearly demonstrated the advantages of
      balanced anesthesia directly and 8 h after the operation (P less than 0.01). Even
      24 h after the end of the surgical procedure the patients had better pain relief
      (P less than 0.05) in spite of the decreasing effect of the ISB. These
      significant differences led to the following results for postoperative treatment:
      35% of the patients with ISB did not require additional analgesics during the
      first 24-h period after surgery, whereas 95% of those with GA requested
      analgesia. Only 32% of the ISB patients required opioids versus 86% with GA. The
      average duration of stay in the recovery room was reduced by 25% in the group
      with ISB (86 vs 134 min). In a final assessment, 84% of the patients were
      satisfied with the balanced anesthesia and only 5% were disappointed with the
      method. CONCLUSION. The combination of ISB and GA allows a reduction in
      intraoperative doses of opiates and facilitates postoperative pain management.
      Because of the low incidence of side effects, the lack of complications, and the
      high degree of patient acceptance, we recommend this type of balanced anesthesia
      for patients undergoing shoulder surgery.

PMID- 1746713
TI  - [The potentialities of EEG analysis using the Lifescan in anesthesiology].
AB  - In 87 patients a new computerized EEG monitor was used in clinical anesthesia.
      Following aperiodic analysis, the Lifescan shows the computerized EEG in a
      striking color visualization allowing recognition of changes in the course of the
      EEG and of interhemispheric differences. The computerized EEG can be read after a
      brief training period. The changes caused by different clinical situations are
      visualized in detail. Different changes were observed with the anesthetics used.
      During induction with thiopentone a sudden increase in activity was obvious.
      During a lighter level of anesthesia with thiopentone beta activity was easily
      recognizable. During induction with high-dose fentanyl frequency was slowed over
      a long period and activity was increased. The monitor shows the changes in the
      lower frequency range in detail. A bimodal pattern occurred with a higher dosage
      of enflurane. During lightening of anesthesia with enflurane a typical pattern
      indicated return to consciousness. When nitrous oxide was administered during
      anesthesia with halothane, and to a lesser degree during anesthesia with
      enflurane or isoflurane, remarkable slowing and decrease in activity occurred.
      The monitor allowed detailed recognition of the different patterns obtained with
      the various anesthetics. In some cases it was possible to say what dosage of the
      anesthetic used had been given or what depth of anesthesia had been achieved. The
      effect of combined anesthesia, however, was difficult to judge. In carotid artery
      surgery a quick unilateral decrease in activity and slowing of frequency
      indicated cerebral ischemia and quickly disappeared after insertion of a shunt.
      This change was particularly obvious with the new monitor.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1746714
TI  - [Comments on the article by D. Jooss et al. Bronchial rupture. Diagnosis and
      therapy of a rare complication of the use of a double-lumen tube].

PMID- 1746715
TI  - Fine structure of the human synovial lining cell in osteoarthritis: its prominent
      cytoskeleton.
AB  - The cytoskeleton of the human osteoarthritic synovial lining cell (SLC) consists
      of an extensive number of vimentin intermediate filaments (IFs) in addition to
      microfilaments and microtubules. The IFs are especially prevalent in the SLC
      processes, but are commonly seen in a paranuclear arrangement. Processes, ending
      in numerous microvilli and blebs, project into the joint space. Scanning electron
      microscopy (SEM) further reveals the processes that may parallel the synovium
      surface for a short distance. IFs extend to the termination of such Numerous
      pinocytotic vesicles and extensive rough endoplasmic reticulum (rER) are
      characteristic of the type B cells. Lysosomes and long microvilli identify the
      type A cell. Punctate adherens, gap junctions, and cilia are the cell membrane
      specializations of the osteoarthritis (OA) synovium. A comparison with synovium
      from rheumatoid arthritis (RA) patients is made in order to assess the effect o
      this inflammatory disease on the SLC cytoskeleton, cell type relationship, and
      cell arrangement. The prominent cytoskeleton appears to play an important role in
      the architecture of the synovium. Our findings are further presented in the form
      of a drawing which in some aspects could describe the morphology of the normal
      synovium.

PMID- 1746716
TI  - Formation and release of vesicles from the basal surfaces of rat eye non
      pigmented ciliary epithelial cells: a novel secretory mechanism?
AB  - When rat ciliary body is processed by high pressure freezing and freeze
      substitution, numerous membrane-bound vesicle profiles are seen in the vitreous
      associated with the pars plana and in the valleys between the ciliary processes.
      They consist of a homogeneously distributed fine granular matrix and varying
      numbers of ribosome-like structures. The mechanism by which these vesicles are
      secreted appears to follow an apocrine-type pattern, albeit at the basal cell
      surface. Matrix material accumulates between the basal plasma membrane of non
      pigmented ciliary epithelial cells and a cortical layer of cytoskeletal
      components; the blebs thus formed protrude through a discontinuity in the basal
      lamina and, by a progressive narrowing of the neck region, are eventually pinched
      off, giving rise to free vesicles. Under conventional aqueous chemical fixation
      conditions, most of these vesicles are washed away or their contents solubilized
      and extracted, which accounts for their not having been identified hitherto as
      genuine morphological structures. They are nonetheless apparent, albeit in
      reduced numbers and mostly empty. Such vesicles are also observed in tissue
      processed according to several other chemical fixation techniques, namely,
      conventional fixation in the presence of the cationic dye ruthenium hexamine
      trichloride, simultaneous glutaraldehyde/osmium tetroxide fixation, and microwave
      fixation. In the latter instance, comparable vesicle preservation to that
      obtained by high pressure freezing/freeze substitution may be achieved if
      fixation is followed by cryoprotection, plunge freezing, and freeze substitution
      instead of conventional post-fixation and dehydration procedures.

PMID- 1746717
TI  - Cell and matrix biology of the suprapatella in the rat: a structural and
      immunocytochemical study of fibrocartilage in a tendon subject to compression.
AB  - The structure, ultrastructure, histochemistry, and immunohistochemistry of the
      suprapatella have been described in the rat. The suprapatella is a
      fibrocartilaginous sesamoid within the tendon of quadriceps femoris that
      articulates with the femoral condyles during flexion of the knee joint and
      reduces the amount of bending required at the tendon-bone junction. The cells of
      the suprapatella were much larger and more numerous than those in the associated
      tendon and were packed with vimentin-containing, intermediate filaments. The
      tendon cells contained far fewer filaments. The cells of both regions contained
      actin and tubulin. Histochemical and immunohistochemical studies showed that the
      suprapatellar cells were embedded in a matrix that is rich in chondroitin
      sulphate, but does not contain keratan or heparan sulphate. The fibrocartilage of
      the adjacent attachment zone of the quadriceps tendon also contained chondroitin
      sulphate, but in addition was rich in type II collagen. The structure of the
      suprapatella was similar to that of the fibrocartilaginous regions of tendons
      that pass around bony pulleys. However, there were differences in matrix
      composition that could reflect functional differences between the
      fibrocartilages.

PMID- 1746718
TI  - The anionic charge barrier in the renal corpuscle of the pronephros in the
      lamprey, Petromyzon marinus L.
AB  - The charge barrier within the renal corpuscle of the pronephric kidney of the
      lamprey, Petromyzon marinus, was investigated at two life cycle intervals using
      cationized ferritin and polyethyleneimine. In the larval renal corpuscle the
      endothelium of the glomerular capillaries and the laminae rarae externa and
      interna of the glomerular basement membrane show regularly-spaced deposits of the
      tracers. The lamina densa remains unstained. Concomitant with a loss of major
      processes of the visceral epithelial podocytes and development of an extensive
      mesangial matrix in late adult life are alterations in the distribution of the
      anionic sites. The lamina rara interna is no longer a distinct entity and the
      mesangium contains irregularly-distributed anionic sites surrounding electron
      dense deposits. The results indicate that the distribution of the anionic sites
      during adult life most likely affects the ability of the renal corpuscle to act
      as an efficient filtration device. This charge distribution is consistent with
      that seen during some renal pathologies of higher vertebrates.

PMID- 1746719
TI  - Interactions between rat epididymal epithelium and spermatozoa.
AB  - We studied in the rat epididymis the presence of membrane-bounded vesicles in the
      stereociliar areas of the epithelial cells. The intimate contact between
      principal cell stereocilia and luminal spermatozoa was also explored. The
      epididymidis of adult male albino rats were fixed with Mollenhauer's fixative via
      the thoracic aorta; they were removed and the caput and the cauda were separated
      and fixed for 4 additional hours at 4 degrees C. After fixation, the samples were
      processed with routine techniques for transmission and scanning electron
      microscopy. The study showed membrane-bounded vesicles in the lumen of the caput
      and cauda epididymidis. They are present between stereocilia, in the most
      peripheral regions of the epididymal lumen, and in a stereocilia-free zone in the
      apical plasma membrane of the principal cells. The smaller vesicles are located
      near the apical surface of the latter, and the larger ones are located near the
      tips of the stereocilia. Their contents are electron lucent in some images and
      electron dense in others. In several thin sections some of the vesicles are
      observed to have a stalk. This suggests that the possible mode of production may
      be an exocytotic process. Some membrane-bounded vesicles were found to be in
      contact with the head or the tail of maturating spermatozoa. Moreover, an
      intimate contact was found to exist in the epididymidis between the plasma
      membranes of the spermatozoa and the stereocilia. These observations seem to
      suggest two possible mechanisms for sperm-epididymal cell relations: 1) release
      of a secretion product via the membrane-bounded vesicles and 2) direct contact
      between stereocilia and spermatozoa.

PMID- 1746720
TI  - Morphometric study of the human neonatal ovary.
AB  - A morphometric analysis, based on mathematical evaluations and stereological
      methods, has been used to study five left neonatal ovaries, removed from full
      term neonates with a 46,XX karyotype free from malformations of the genital
      apparatus. Each ovary was completely cut obtaining serial sections and one 1
      micron-thick section every 1,000 microns was examined. Ovarian length ranged from
      9 to 17 mm (mean 13 mm), width from 3.5 to 7 mm (mean 5.7 mm), thickness from 2.5
      to 5 mm (mean 4 mm), and volume from 82.23 to 198.3 mm3 (mean 125.88 mm3). In the
      ovarian cortex, primitive cortical tissue accounted for 10-20% of the total
      volume, follicles for 10-25% and interstitium for 35-45%; 10-30% of the organ
      consisted of inner medulla. The total follicle number ranged from 130,000 to
      385,000 per ovary, with an average of 266,000 with 95% being represented by
      primordial follicles. In all ovaries examined follicular growth was still in
      process, with follicles at different stages of development.

PMID- 1746721
TI  - Application of stereological analysis of cell volume to isolated myocytes in
      culture with and without adrenergic innervation.
AB  - A three-dimensional analysis to evaluate structural changes in cultured cardiac
      myocytes following adrenergic innervation was performed using stereological
      techniques formerly limited to cells in tissue and organs. Cell volumes were
      calculated for two groups of cells at 96 hours in culture: isolated myocytes and
      myocytes innervated with adrenergic neurons. Relative and absolute volumes of the
      nucleus, cytoplasm, and cell were quantified by systematically sampling sections
      throughout the cell and by point count sampling techniques. Volumetric estimates
      were similarly determined for the mitochondria, sarcomeres, and other cellular
      components in the cytoplasm. Data were analyzed with ANOVA and randomized block
      design to control for variation among the cultures. Adrenergic innervation
      produced a 44% increase in cell volume, X +/- SEM, (3,344 +/- 196 microns3 to
      4,816 +/- 400 microns3, P = 0.007). The absolute volume of mitochondria
      significantly increased after innervation (521 +/- 42 microns3 to 744 +/- 54
      microns3, P less than 0.01). Absolute sarcomere volume did not change
      significantly (750 +/- 92 microns3 to 642 +/- 1061 microns3, P = 0.14). Other
      cellular components, defined as all cytoplasmic components except mitochondria
      and sarcomeres, significantly increased with innervation (1,739 +/- 166 microns3
      to 3,097 +/- 338 microns3, P = 0.02). The relative volume of the nucleus and the
      cytoplasm in the cell remained unchanged following innervation. However, the
      relative volume of mitochondria decreased by 6%, the percent of the cytoplasm
      occupied by the sarcomeres decreased by 44%, and the volume occupied by the other
      cellular components increased by 22%. These findings support the use of
      stereological analysis as a means to quantify cell volumes of cultured
      myocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746722
TI  - Immunochemical localization of extracellular materials in bone marrow of rats.
AB  - The distribution of type I collagen, fibronectin, laminin, and heparan sulfate
      was studied in marrow of rats by indirect immunofluorescence. Most of the type I
      collagen of marrow is associated with large blood vessels and connective tissue
      trabeculae, but type I collagen was also localized in a delicate meshwork
      throughout the marrow and in the basement membrane of the sinusoidal endothelium.
      Fibronectin is partially co-distributed with type I collagen, but is much more
      widely distributed. Sheets or septa of fibronectin-rich material divide the
      marrow into small compartments that contain and appear to separate clusters of
      developing blood cells. These septa may serve as a substrate for anchorage and
      migration of blood cells. Labeling of laminin was observed in the basement
      membranes of blood vessels, of fat cells, and of the sinusoidal wall, but only
      scattered labeling was seen in other extracellular materials. Heparan sulfate
      proteoglycan was poorly labeled in the extracellular matrix of marrow.

PMID- 1746723
TI  - Organization of the membrane skeleton in spreading mouse blastomeres. I.
      Morphological analysis.
AB  - Differentiation in the mouse embryo begins at the 8-cell stage when the
      blastomeres spread against each other in a process called compaction. The
      spreading behavior of blastomeres on lectin-coated coverslips mimics that of
      blastomeres in the embryo, and we have utilized this model system to obtain an en
      face view of the membrane skeleton in the spreading blastomeres. Embryos were
      cultured on the coverslips for periods ranging from 20 sec to 6 hr, and the cells
      were disrupted to expose the cytoplasmic face of the adherent membranes and their
      associated filaments. The "membrane lawn" preparations were fixed, critical point
      dried, rotary shadowed, and the replicas examined by transmission electron
      microscopy. Using this technique we found that the plasmalemma of rounded
      blastomeres is associated with a lacy 3-dimensional filamentous meshwork that is
      transformed into a thin mat of densely woven filaments when the cells flatten.
      The overall organization of the membrane skeleton is similar in flattening 2- and
      8-cell embryos, but there are significant differences in the time required for
      spreading to take place, in the means whereby the membrane skeletons are
      reorganized, and in the extent of maximal flattening. The significance of these
      observations for the compaction process is discussed.

PMID- 1746724
TI  - Changes in glycoconjugate expression during early chick embryo development: a
      lectin-binding study.
AB  - A selection of lectins was used to investigate developmentally regulated changes
      in the distribution of cell surface oligosaccharides during the gastrulation and
      neurulation stages of early chick embryo development. Lectins from three
      specificity classes were used: glucose/mannose specificity (concanavalin A [Con
      A], Lens culinaris agglutinin [LCA], Pisum sativum agglutinin [PSA]); N
      acetylglucosamine specificity (Lycopersicon esculentum agglutinin [LEA], wheat
      germ agglutinin [WGA], succinylated WGA [sWGA]); N-acetylgalactosamine/galactose
      specificity (Dolichos biflorus agglutinin [DBA], soybean agglutinin [SBA],
      Sophora japonica agglutinin [SJA], Bandeiraea (Griffonia) simplicifolia lectin I
      [BSL I], peanut agglutinin [PNA], Artocarpus integrifolia lectin [Jacalin],
      Ricinus communis agglutinin-1 [RCA-1], Erythrina cristagalli lectin [ECL]). At
      gastrulation stages, patterns of lectin binding could be distinguished in the
      epiblast, mesoderm, and endoderm cell layers. The primitive streak failed to bind
      any of the lectins, but LEA and WGA bound to the epiblast in regions lateral to
      the streak, indicating the loss of some glucosamine residues medially in
      preparation for the ingression movements of gastrulation. Several lectins showed
      marked binding to the mesoderm cells after their passage through the primitive
      streak; these were LCA, PSA, WGA, sWGA, BSL, and most particularly PNA.
      Therefore, the epithelial-mesenchymal transformation from epiblast to mesoderm at
      the primitive streak is accompanied by cell surface oligosaccharide changes in
      the epiblast and mesoderm that involve all classes of lectins including the PNA
      binding sequence Gal beta 1-3GalNAc. Ultrastructurally, PNA was shown to bind
      extracellularly to matrix fibrils. Jacalin, having the same sugar specificity as
      PNA, but binding to serine/threonine linked chains rather than asparagine linked
      chains showed no binding to the mesoderm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746725
TI  - Talpid2 mutant chick limb has anteroposterior polarity and altered patterns of
      programmed cell death.
AB  - The talpid2(ta2) chick mutant is of interest for the study of limb pattern
      formation. Talpid2 is a simple Mendelian recessive lethal mutation which affects
      the mesoderm and results in short, spade-like, polydactylous wings and legs.
      Here, we describe ta2 limb development with particular attention to those aspects
      of ta2 which may illuminate the process of normal limb development. From the
      onset of budding, ta2 limb buds are significantly wider than normal buds along
      the anteroposterior axis. They lack the normal anterior and posterior necrotic
      zones and have variable development of the central opaque patch. Interdigital
      programmed cell death is variable and may result in development of distal
      phalanges without more proximal ones. Talpid2 wing vasculature is similar to that
      of normal wings; but ta2 legs are supplied by four large blood vessels. Feathers
      form regular, parallel rows, similar to normal feathers, but ta2 embryos lack the
      loose mesenchyme which separates the feather buds. Finally, and most
      significantly, ta2 wings and legs display anteroposterior polarity. Anterior and
      posterior limb skeletal elements can be clearly distinguished from one another
      within the ta2 phenotype. Our observations suggest that the ta2 mutant may be
      useful in analyzing programmed embryonic cell death and anteroposterior limb
      pattern formation.

PMID- 1746726
TI  - Sectional anatomy of the pelvis in the male rat with ultrasound correlations.
AB  - Ten-week-old male Wistar rats were used for sectional anatomy and ultrasonic
      diagnosis of the pelvis. The prostate and the urinary bladder were identified
      easily on longitudinal section by ultrasound examination. The prostate (ventral,
      lateral, and dorsal lobes) was located in the midline of the pelvis cavity on
      transverse sections and the caudal side of the urinary bladder on longitudinal
      sections. The urinary bladder was positioned at the cranial side of the prostate
      on longitudinal sections and in the midline of the pelvis cavity on transverse
      sections. The seminal vesicles were located at right and left positions of the
      urinary bladder. Ultrasonic diagnosis was estimated to be useful for experimental
      studies and we hope that ultrasound techniques may reduce the number of rats used
      for the treatment of prostate and urinary bladder cancers.

PMID- 1746727
TI  - Inflated, dried whole lung specimens.
AB  - A method is described for preparing fully-inflated whole lung specimens that are
      suitable for instruction or research purposes. Undamaged lungs are removed from
      the body and then tracheally cannulated and lavaged with tap water more than 250
      times. The treatment also includes rinsing blood from vessels with water. A final
      filling of the lung with alcohol is optional. The multiply rinsed lung is drained
      and inflated to 30 cm of H2O pressure with dehumidified air and held at that
      pressure until the tissue is completely dry. The resulting specimens are light in
      color and appear to be permanent if stored properly.

PMID- 1746728
TI  - Magnetic resonance imaging in minor head injury.
AB  - STUDY OBJECTIVES: To investigate the role of cranial magnetic resonance (MR)
      imaging in evaluating patients discharged from the emergency department after
      minor head injury. DESIGN: A prospective blinded cohort study. SETTING:
      University hospital ED. TYPE OF PARTICIPANTS: Fifty-eight patients with minor
      head injury who were discharged from the ED with written head injury
      instructions. Patients admitted to the hospital were excluded. INTERVENTIONS:
      Ultra-low-field cranial MR scans were performed on patients within 24 hours of
      discharge. Scans were read blindly by two radiologists. MEASUREMENTS AND MAIN
      RESULTS: Fisher's exact test was used to compare symptoms in patients with
      abnormal and normal MR scans. There was no significant difference in symptoms
      between patients with abnormal and those with normal scans (P greater than .10).
      The proportion of abnormal MR scans was analyzed using the binomial distribution.
      Six of the 58 patients (10.3%) had traumatic intracranial abnormalities
      (proportion, 0.103; SD, 0.04; 95% CI, 0.04-0.21). Three had cortical contusions,
      and three had small subdural hematomas. Two of the six patients with abnormal MR
      scans, both with small subdural hematomas, had normal computed tomography scans.
      CONCLUSION: Ten percent of patients discharged from the ED after minor head
      injury had abnormal ultra-low-field cranial MR scans. Additional research is
      needed to establish the clinical importance of this unexpected observation.

PMID- 1746729
TI  - Is routine computed tomography scanning too expensive for mild head injury?
AB  - OBJECTIVE: To compare relative costs of treating mildly head-injured patients by
      routine admission or by using skull radiographs or cranial computed tomography
      (CT) scanning to screen patients for admission. DESIGN: Retrospective record
      review, hypothetical costs based on actual patient course and requirements.
      SETTING: Southern New Jersey Regional Trauma Center at Cooper Hospital/University
      Medical Center. PARTICIPANTS: 658 consecutive mildly head-injured patients
      admitted from 1986 to 1988. All were given cranial CT scans. MEASUREMENTS:
      Records were reviewed retrospectively and hypothetical costs were calculated
      based on actual length of hospitalization, surgical intervention, etc. These
      costs were compared for different treatment protocols. MAIN RESULTS: The average
      cost if every patient had been admitted for observation given skull radiographs,
      with CT scans done on those exhibiting skull fracture or later deterioration, was
      $1,207. If the CT scan had been used to identify patients with intracranial
      lesions and the others had been discharged, costs would have been almost 10%
      less. Had skull radiography been used to screen admissions, costs would have been
      22% below those of routine CT scanning. However, these small savings are likely
      to be reduced by additional expenses related to missed intracranial lesions.
      CONCLUSIONS: Every patient with loss of consciousness or post-traumatic amnesia
      should have routine CT scanning. If the scan is normal and there are no other
      reasons for admission, the patients can be discharged safely from the emergency
      department. This represents optimal care from a medical standpoint and is
      justified from a cost-effectiveness point of view.

PMID- 1746730
TI  - Randomized, prospective comparison of open and closed peritoneal lavage for
      abdominal trauma.
AB  - STUDY OBJECTIVE: The study was designed to determine if open peritoneal lavage is
      superior to closed peritoneal lavage. DESIGN AND PARTICIPANTS: Patients who were
      admitted to a trauma center and needed peritoneal lavage were assigned to
      alternate trauma teams. Team 1 performed only open lavages one month and then
      switched to closed lavages; team 2 did only closed lavages and then switched to
      open lavages. MEASUREMENTS: The incidences of positive lavages and lavage
      complication were noted. Also measured were the length of time for catheter
      insertion, length of time of fluid retrieval, volume of effluent, technical
      difficulty of lavage, training level of the operator, effluent RBC count, and
      material cost. RESULTS: Two hundred twenty patients were randomized. No
      differences were noted in complication rate, volume of effluent, or length of
      time for fluid retrieval. Significant differences were noted for catheter
      insertion time (3.6 minutes for closed lavage and 6.9 minutes for open), ease of
      catheter insertion (closed technique is favored), and material cost ($96.26 for
      open lavage and $69.70 for closed lavage). CONCLUSION: Closed peritoneal lavage
      is superior to open peritoneal lavage in abdominal trauma; it is faster, easier
      to use, cheaper, and as safe as open lavage.

PMID- 1746731
TI  - The efficacy and safety of methohexital in the emergency department.
AB  - STUDY OBJECTIVE: To determine the efficacy and safety of methohexital sodium
      (MTX) in emergency department patients. DESIGN: A consecutive case series; all ED
      patients who received MTX from July 1989 through July 1990 were studied in a
      prospective manner. SETTING: A university hospital ED. PARTICIPANTS: All 102
      adult and pediatric patients who received MTX. INTERVENTIONS: Emergency
      physicians trained in the use of MTX administered the drug. A study form was
      completed that provided data on dosage and response, indications for use, final
      diagnosis, hemodynamic and respiratory parameters, and an efficacy survey.
      RESULTS: Average cumulative dose of MTX was 1.6 +/- 1.3 mg/kg. The average
      duration of action per dose was 7.6 +/- 5.0 minutes. Leading indications for use
      were orthopedic procedures (54), endotracheal intubation (18), head computed
      tomography scan (ten), and wound care (eight). Hemodynamic changes were minimal;
      the average change in systolic blood pressure five minutes after MTX was -1.8 +/-
      20 mm Hg. Average heart rate change was 3.0 +/- 20 beats. Percent respiratory
      depression was 17 +/- 24%. There was no correlation between MTX dose and the
      degree of respiratory depression. Narcotics and/or benzodiazepines were given
      with MTX in 92 cases, with no significant increase in respiratory depression. No
      major complications attributable to MTX were identified. CONCLUSION: MTX, when
      used by trained personnel who adhere to an established protocol, appears to be a
      safe and effective drug in selected ED patients.

PMID- 1746732
TI  - The impact of injury severity and prehospital procedures on scene time in victims
      of major trauma.
AB  - STUDY OBJECTIVE: To evaluate the relationship among injury severity, prehospital
      procedures, and time spent at the scene by paramedics for victims of major
      trauma. DESIGN: Retrospective study of 98 consecutive patients with an Injury
      Severity Score of more than 15 who were brought to a trauma center by fire
      department paramedics. SETTING: A medium-sized metropolitan emergency medical
      services (EMS) system and a Level I trauma center. RESULTS: There were 66 male
      and 32 female patients with a mean age of 34 years. Thirty-two patients (32.6%)
      died. Blunt and penetrating trauma accounted for 68.4% and 31.6% of cases,
      respectively. Thirty-three patients (33.7%) had successful advanced airway
      procedures, and 81 (82.7%) had at least one IV line started in the field.
      Analysis of scene time, prehospital procedures, and injury severity parameters
      revealed that more procedures were performed in the field on the more severely
      injured cases; that despite this, there was a trend toward shorter scene time for
      more severely injured patients; and that there was a mean scene time of 8.1
      minutes. This is the shortest scene time reported to date for prehospital trauma
      care in an EMS system. CONCLUSION: Extremely short scene times can be attained
      without foregoing potentially life-saving advanced life support interventions in
      an urban EMS system with strong medical control. In such a system, the most
      severely injured victims may spend less time at the scene although more
      procedures are performed on them.

PMID- 1746733
TI  - Effect of standing orders on paramedic scene time for trauma patients.
AB  - STUDY OBJECTIVE: To determine if a protocol change that allowed paramedics to
      perform certain procedures before base station contact (standing orders) would
      decrease scene time in trauma patients. DESIGN: Retrospective review of case
      series. SETTING: A single-tiered, all advanced life support emergency medical
      services system. INTERVENTION: Implementation with standing orders for invasive
      procedures. TYPE OF PARTICIPANTS: All physiologically unstable trauma patients
      transported to a Level I trauma center by ambulance. MEASUREMENTS AND MAIN
      RESULTS: One hundred ninety-seven patients met the inclusion criteria--87 before
      and 110 after the initiation of standing orders. Mean scene times for the control
      group (15.3 +/- 8.4 minutes) and for the standing orders group (15.1 +/- 7.6
      minutes) were similar (P = .18). The power of the study to detect a two-minute
      difference in scene time was .92. Scene time was not influenced by mechanism of
      injury, and the number of procedures performed on patients was similar between
      the two groups. CONCLUSION: Standing orders did not decrease scene time in
      physiologically unstable trauma patients. Further study is necessary to delineate
      the factors that actually contribute to on-scene time and the factors that are
      important in determining whether standing orders or on-line medical contact
      should be used.

PMID- 1746734
TI  - Prospective study of manikin-only versus manikin and human subject endotracheal
      intubation training of paramedics.
AB  - STUDY OBJECTIVES: To determine the effect of manikin-only training on field
      success of endotracheal intubation by paramedics. DESIGN: Prospective evaluation
      of individual field endotracheal intubation success rates for paramedics after
      they participated in a manikin-only or a manikin-plus-cadaver training program.
      TYPES OF PARTICIPANTS: Paramedics responding to emergency calls involving adult
      medical or trauma victims. INTERVENTIONS: All participants were trained using a
      controlled manikin training program; then, half were randomly selected for
      additional instruction using fresh human cadavers. MEASUREMENTS AND MAIN RESULTS:
      Individuals trained using only the manikin program had mean +/- SD individual
      success rates of 82 +/- 32%, and individuals who received additional cadaver
      training had mean individual success rates of 83 +/- 31%. Overall success rates
      for the two groups were 86% for the manikin-only group and 85% for the manikin
      plus-cadaver-trained group. The sample size was not adequate to allow rejection
      of the null hypothesis. CONCLUSION: Paramedics trained in endotracheal intubation
      using a systematic manikin-only teaching program can attain acceptable individual
      success rates in the actual field setting.

PMID- 1746735
TI  - Monitoring EMS protocol deviations: a useful quality assurance tool.
AB  - STUDY OBJECTIVE: To determine the incidence, type, and outcome of protocol
      deviations in an emergency medical services (EMS) system. DESIGN: Retrospective
      consecutive case series. SETTING: Seven advanced life support ambulance services
      servicing five area hospital emergency departments. PATIENTS: 1,246 patients
      requiring advanced life support care. INTERVENTIONS: None. MEASUREMENTS AND MAIN
      RESULTS: Advanced life support ambulance runs during a two-month period were
      examined for protocol deviations. Of 1,246 runs examined, 16% had deviations.
      Approximately 55% of these deviations were minor, 38% were serious, and 7% were
      very serious in nature. The effects of the errors were evaluated using hospital
      records. Results showed that 89.5% of patients were unaffected, 5.0% improved,
      and 5.5% suffered complications from deviations. Emergency medical technicians
      committed 69% of the deviations without the consent of medical control, medical
      control committed an additional 18%, and both were responsible in 13% of cases.
      Incomplete histories were found in 8% of cases. CONCLUSION: Protocol deviations
      committed in prehospital care do not usually cause direct harm to patients. On
      review of these deviations, however, several disturbing trends were uncovered,
      including misconceptions in the use of IV therapy, a number of serious deviations
      in advanced cardiac life support protocols, and lack of communication with
      medical control. This type of quality assurance study has the ability to identify
      areas of strength and weakness in an EMS system, allowing planning of ongoing
      educational efforts in the system.

PMID- 1746736
TI  - An optically scanned EMS reporting form and analysis system for statewide use:
      development and five years' experience.
AB  - Analysis of emergency medical services (EMS) systems data is crucial to planning,
      education, research, and quality assurance programs. Currently, comparative
      analysis of EMS data between regions or states is virtually impossible due to
      wide variations in data collection and analysis methods. To devise a practical
      and uniform EMS reporting system, we referenced the minimum data set (MDS)
      established by the federal government in 1974 and surveyed 22 states known to be
      using uniform reporting systems. In developing our final data set, elements were
      added based on inclusion in the MDS, national survey results, a review of current
      EMS literature, and consensus of local EMS providers. This set of 48 elements
      then was incorporated into a reporting form using narrative and optically scanned
      formats, allowing automated data collection for computer analysis. After a pilot
      study, the system was improved to allow high-speed ink reading and large volume
      data storage and analysis using a microcomputer. This system has subsequently
      been adopted by seven states. The combined data base exceeds 250,000 cases. Error
      screening algorithms ensure data integrity and are also used for quality
      assurance. Customized output reports can be generated within minutes and have
      assisted in EMS quality assurance, planning, and research. We believe that the
      successful performance of this system supports the use of the suggested data
      elements as well as optical scanning and microcomputer analysis of EMS data.

PMID- 1746737
TI  - Lights and siren: a review of emergency vehicle warning systems.
AB  - Emergency medical services providers routinely respond to emergencies using
      lights and siren. This practice is not without risk of collision. Audible and
      visual warning devices and vehicle markings are integral to efficient negotiation
      of traffic and reduction of collision risk. An understanding of warning system
      characteristics is necessary to implement appropriate guidelines for prehospital
      transportation systems. The pertinent literature on emergency vehicle warning
      systems is reviewed, with emphasis on potential health hazards associated with
      these techniques. Important findings inferred from the literature are 1) red
      flashing lights alone may not be as effective as other color combinations, 2)
      there are no data to support a seizure risk with strobe lights, 3) lime-yellow is
      probably superior to traditional emergency vehicle colors, 4) the siren is an
      extremely limited warning device, and 5) exposure to siren noise can cause
      hearing loss. Emergency physicians must ensure that emergency medical services
      transportation systems consider the pertinent literature on emergency vehicle
      warning systems.

PMID- 1746738
TI  - The role of military emergency physicians in an assault operation in Panama.
AB  - The December 1989 assault in Panama provided an opportunity to examine the role
      of emergency physicians in low-intensity military operations. Emergency medicine
      specialists accompanied the assault forces and established casualty collection
      points (CCPs) at each target. Emergency physicians played a role in triage,
      resuscitation, and aeromedical evacuation. More than 275 casualties were
      resuscitated and stabilized at the CCPs. Two died after reaching a CCP.
      Casualties were flown from each CCP to a joint casualty collection point (JCCP).
      Surgical stabilization was required for 21 casualties at the JCCP. A team at the
      JCCP coordinated evacuation of casualties to the United States. The first
      casualties arrived at hospitals in Texas within 12 hours of the assault. From the
      drop zones through hospitalization in the United States, emergency physicians
      cared for combat casualties at every level of the evacuation system. The success
      of the medical plan for the assault suggests that the role of emergency
      physicians in military operations extends from the front lines to fixed medical
      facilities in the United States.

PMID- 1746739
TI  - Management guidelines for health care workers exposed to blood and body fluids.
AB  - The purpose of this article is to propose specific management guidelines for the
      immediate emergency department and subsequent occupational health treatment of
      health care workers (HCWs) following accidental exposures to blood or body
      fluids. These guidelines are based on a collective review of the literature and
      the recommendations of the Advisory Committee on Immunization Practices (ACIP)
      and authorities expert in this knowledge domain. Guidelines are needed to assure
      appropriate treatment and coordinated efforts by ED and occupational health
      providers. Although numerous infections can potentially be transmitted by
      exposure to blood and body fluids, these guidelines are intended only for
      evaluation and postexposure prophylaxis of hepatitis B, hepatitis C, and
      infection with HIV.

PMID- 1746740
TI  - Prophylaxis with zidovudine (AZT) after exposure to human immunodeficiency virus:
      a brief discussion of the issues for emergency physicians.
AB  - Sound scientific information with which to determine the true efficacy of
      zidovudine for prophylaxis will probably not be available soon. Physicians should
      educate themselves thoroughly on the issues. It is highly recommended that
      thoughtful discussions of the issue of transmission of HIV from health personnel
      to patients as well as the key articles cited in this discussion be read. The
      details of a prophylaxis program, including laboratory evaluation, are provided
      in an article by Henderson and Gerberding and in greater detail in the article by
      Go et al. (Health care workers exposed to HIV can be enrolled in the Centers for
      Disease Control surveillance program by calling 404/639-1644. To enroll persons
      with large exposures to HIV in the zidovudine prophylaxis study, call 800/537
      9978.) ED directors should work closely with local infectious disease specialists
      to determine if such a program is needed and how to implement it. Further details
      regarding the implementation of a prophylaxis program should be obtained from the
      literature and the Centers for Disease Control. All of the details of such a
      program should be worked out well in advance so that knowledgeable and immediate
      counseling can be provided to health care workers within one or two hours of
      exposure. Highly qualified individuals and institutions vary in their
      recommendations on prophylaxis, although most provide them. Zidovudine probably
      does not provide very effective protection, if it provides any. However, the
      medical, social, and economic consequences of HIV infection of health care
      workers are very real, and the serious irreversible adverse effects of zidovudine
      are very rare.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746741
TI  - Hemorrhagic shock and encephalopathy syndrome.
AB  - Hemorrhagic shock and encephalopathy syndrome (HSES) is a devastating symptom
      complex that affects previously healthy infants and is associated with
      significant mortality and neurologic morbidity. The syndrome was first reported
      less than ten years ago, and there continues to be debate regarding whether HSES
      actually represents a distinct clinical entity or instead is a manifestation of
      heat illness, occult sepsis or endotoxic shock, or perhaps toxic ingestion.
      Nevertheless, the signs and symptoms described as HSES present in a typical
      fashion in the emergency department with sudden onset of shock, encephalopathy,
      seizures, and coagulopathy. Even with the initiation of intensive support in the
      ED, the outcome is probably dismal. We describe a case of HSES and review the
      presentation, proposed etiologies, and management of this catastrophic illness.

PMID- 1746742
TI  - Isolated intraperitoneal bladder rupture in patients with alcohol intoxication
      and minor abdominal trauma.
AB  - Rupture of the urinary bladder secondary to abdominal trauma is uncommon and is
      usually associated with visceral or bone injuries; less than 10% of all cases
      occur without associated injuries. We present two cases of bladder rupture in
      intoxicated patients after minor abdominal trauma and without evidence of
      associated injuries. Given the absence of any symptoms in either case, we did not
      initially suspect bladder rupture. One of the two patients also presented with an
      intravesical herniation of the rectosigmoidal junction.

PMID- 1746743
TI  - Unstable occult cervical-spine fracture.
AB  - Recognition of injuries to the cervical spine is of critical importance. Such
      injuries may be difficult to recognize in patients who have an altered level of
      consciousness or other significant injuries. We present the case of an alert
      ambulatory patient with no complaint of neck pain, no tenderness of the neck on
      physical examination, and no history of trauma who, while being evaluated for
      fever, was found to have an unstable cervical-spine fracture that was not present
      on radiographs done one year earlier.

PMID- 1746744
TI  - Female urethral injury secondary to blunt pelvic trauma.
AB  - Urethral injury after blunt pelvic trauma is rare in women. We report a case of
      urethral injury and vaginal laceration secondary to blunt pelvic trauma. Pelvic
      examination should be performed in any female patient who has sustained blunt
      pelvic trauma to avoid the morbidity associated with delayed diagnosis of
      urethral injury.

PMID- 1746745
TI  - HIV-infected health care providers: legal rights and protections.

PMID- 1746746
TI  - EMS data collection: filling in the dots.

PMID- 1746747
TI  - The role of neuroimaging in minor head injury.

PMID- 1746748
TI  - Emergency care guidelines. American College of Emergency Physicians.

PMID- 1746749
TI  - Questions & answers: statistical tests & consent.

PMID- 1746750
TI  - Preventing prescription fraud.

PMID- 1746751
TI  - RN copes with HIV infection: she was infected while providing emergency care.
      Interview by Terry Selby.

PMID- 1746752
TI  - New rules expand role of NPs, CNSs.

PMID- 1746753
TI  - Fassbinder testifies on personal struggle.

PMID- 1746754
TI  - RNs oppose mandatory HIV testing.

PMID- 1746755
TI  - AIDS report urges health care for all.

PMID- 1746756
TI  - Position statement on HIV testing.

PMID- 1746757
TI  - Position statement on personnel policies and HIV in the workplace.

PMID- 1746758
TI  - HIV exposure demands immediate action. Position statement on post-exposure
      programs in the event of occupational exposure to HIV/HBV.

PMID- 1746759
TI  - HIV client won't tell sex partners.

PMID- 1746760
TI  - Payment reforms will affect RNs' practice.

PMID- 1746761
TI  - Small victories count in cancer fight.

PMID- 1746762
TI  - Needlestick leads Chicago RN to form peer support system.

PMID- 1746763
TI  - Testing alone won't stop HIV spread. As I see it.

PMID- 1746764
TI  - Know your value, what you want.

PMID- 1746765
TI  - Mid-Atlantic offers urban, rural opportunities.

PMID- 1746766
TI  - RNs, consumers--a natural alliance.

PMID- 1746767
TI  - Nurses and HIV.

PMID- 1746768
TI  - New ANA will move to D.C.

PMID- 1746769
TI  - A reconsideration of testing for competence rather than for intelligence.
AB  - David C. McClelland's 1973 article has deeply influenced both professional and
      public opinion. In it, he presented five major themes: (a) Grades in school did
      not predict occupational success, (b) intelligence tests and aptitude tests did
      not predict occupational success or other important life outcomes, (c) tests and
      academic performance only predicted job performance because of an underlying
      relationship with social status, (d) such tests were unfair to minorities, and
      (e) "competencies" would be better able to predict important behaviors than would
      more traditional tests. Despite the pervasive influence of these assertions, this
      review of the literature showed only limited support for these claims.

PMID- 1746770
TI  - Transforming the debate about child care and maternal employment.
AB  - Over the past two decades, the large-scale entrance of women into the work force
      has fundamentally changed the fabric of work and family life. Unlike 75 other
      nations, the United States has no comprehensive family policy that helps families
      cope with the competing demands of work and family. Research within psychology
      has not been helpful in pointing out the need for a major shift in public policy.
      This article argues that both governmental policy and psychological research
      reflect the popular culture's idealized myth of motherhood. It suggests an
      interruption of the research agenda that searches for negative consequences of
      maternal employment and alternative child care. A new agenda is proposed that
      would document the negative consequences of not providing high-quality,
      affordable day care. This new agenda would also acknowledge the centrality of
      fathers and family process to developmental outcomes in children.

PMID- 1746771
TI  - Co-occurring disorders among mentally ill jail detainees. Implications for public
      policy.
AB  - Studies have demonstrated that police often arrest the mentally ill when
      treatment alternatives would be preferable but are unavailable. Thus, jails may
      contain disproportionate numbers of severely mentally ill persons who have co
      occurring disorders. Data on the co-occurrence of severe mental disorder,
      substance abuse, and antisocial personality disorders were gathered from 728
      randomly selected male urban jail detainees. Using difference of proportions
      tests and loglinear analysis, the authors demonstrated that most subjects with a
      severe mental disorder (schizophrenia or a major affective disorder) also meet
      criteria for a substance abuse or antisocial personality disorder. These findings
      suggest several changes in public policy regarding health care delivery in
      correctional settings and for the general population.

PMID- 1746772
TI  - Resolving legal questions with psychological data.
AB  - Psychologists are ever finding new legal arenas for their psychological data and
      concepts. Findings about the character and operation of stereotyping have been
      introduced in sex discrimination litigation in the United States. Findings about
      conformity, obedience to authority, and bystander apathy have been introduced
      into death penalty cases in South Africa. These concrete and detailed
      applications of psychological science demonstrate the expanding role that
      psychology is playing in the legal world.

PMID- 1746773
TI  - Crowd psychology in South African murder trials.
AB  - South African courts have recently accepted social psychological phenomena as
      extenuating factors in murder trials. In one important case, eight railway
      workers were convicted of murdering four strike breakers during an industrial
      dispute. The court accepted conformity, obedience, group polarization,
      deindividuation, bystander apathy, and other well-established psychological
      phenomena as extenuating factors for four of the eight defendants, but sentenced
      the others to death. In a second trial, death sentences of five defendants for
      the "necklace" killing of a young woman were reduced to 20 months imprisonment in
      the light of similar social psychological evidence. Practical and ethical issues
      arising from expert psychological testimony are discussed.

PMID- 1746774
TI  - Endometriosis mimics general surgical disease.
AB  - Endometriosis is rarely encountered by the general surgeon but may on occasion
      mimic general surgical disease. Although usually diagnosed easily because of
      cyclic symptoms and typical physical findings, six atypical cases are presented.
      These cases were diagnosed as appendicitis (2), subcutaneous mass (2), pelvic
      wall malignancy, and lower gastrointestinal hemorrhage. Diagnosis was ultimately
      made by laparotomy or excisional biopsy in five cases and by fine needle
      aspiration in one. Resection of the lesion, if feasible, is often curative. If
      resection is not feasible, therapy depends on the severity of the symptoms, and
      the patient's desire for fertility. Recognition of the typical appearance of an
      endometrioma may avoid mistaking it for cancer.

PMID- 1746775
TI  - Adverse surgical outcomes among patients with cognitive impairments.
AB  - To determine the factors that contributed to adverse outcomes, the records of 59
      cognitively impaired patients with nonfatal complications (n = 23) or death (n =
      36) on a general surgery teaching service over a 30-month period were examined
      retrospectively. Specific complications are reported. Patient, disease, and
      management factors related to mortality and morbidity are identified. Patients
      with cognitive impairments had a higher mortality rate (9.6 vs 6.3%) and
      approximately the same rate of nonfatal complications (6.1 vs 7.6%) when compared
      with general surgery patients as a whole. Patient characteristics including age
      over 70, dementia, nursing home residence, contractures, inability to
      communicate, need for total care, and gross malnutrition were associated with
      fatal outcomes. Vascular, colonic, esophageal, gastric, or duodenal conditions,
      emergency admission, urgent operation, and admission APACHE II scores greater
      than or equal to 15 were disease-related factors associated with mortality.
      Management risk factors were prehospital or inpatient diagnostic delays and
      technical or judgmental errors of surgical management. Twenty-four of 36 deaths
      were directly related either to a diagnostic delay (11), an operative technical
      error (11), or a judgmental error of postoperative airway management (2). Eighty
      five per cent of diagnostic delays (11/13) and 37 per cent (11/30) of technical
      errors resulted in mortality. Suggestions for improving the care of these
      patients are discussed.

PMID- 1746776
TI  - Measurement issues in evaluating physicians' practice patterns using hospital
      billing and surgeon's self-report data.
AB  - The availability of computerized case mix data, which merge medical records
      information and patient billing data, provide opportunity for measuring physician
      specific practice patterns. However, the validity of physician comparisons is a
      concern when total patient charges are measured at two points in time. In this
      physician-initiated multicenter study, comparisons using samples of
      uncomplicated, baseline cases, as determined from medical records chart reviews
      of five surgical procedures at three institutions, demonstrated a statistically
      significant reduction in average length of stay (ALOS) from 0.8 to 2.8 in seven
      of the 15 studies while total patient charges increased in 11 of the studies from
      one to 29 per cent. Billing data were useful in measuring ALOS and the frequency
      of specific laboratory tests ordered and then comparing these to physicians' self
      report practice.

PMID- 1746777
TI  - Successful use of subcutaneous recombinant human erythropoietin before
      cholecystectomy in an anemic patient with religious objections to transfusion
      therapy.
AB  - Use of recombinant human erythropoietin has been advocated for therapy in anemic
      patients with end-stage renal disease and to enhance the harvesting of autologous
      red blood cells from healthy patients scheduled for elective orthopedic surgery.
      The authors report the case of a diabetic patient with moderate chronic renal
      failure and cholelithiasis but whose religious beliefs forbade the use of
      transfusion therapy. She underwent successful cholecystectomy only after
      treatment with recombinant human erythropoietin.

PMID- 1746778
TI  - Strategies in the management of pyogenic psoas abscesses.
AB  - The presentation and management of eight patients with pyogenic psoas abscesses
      treated at the National Naval Medical Center, Bethesda, Maryland, between January
      1986 and July 1989 are presented. The psoas abscesses were secondary to
      underlying gastrointestinal disease in six patients and sacral osteomyelitis in
      one patient. In one patient, the etiology of the abscess could not be determined.
      The average duration of symptoms in these patients was 16 days. Computed
      tomography was useful in identifying the abscess, defining its complexity, and
      planning therapy in all eight patients. Seven patients had complex,
      multiloculated abscesses, and one patient had a simple abscess. Extraperitoneal
      drainage was used in all patients. The patients with multiloculated abscesses had
      open surgical drainage, while the patient with the simple abscess had
      percutaneous catheter drainage. Most patients with a gastrointestinal etiology
      for their abscess underwent staged resection 3 to 6 weeks after the drainage
      procedure. There were no deaths, recurrent abscesses, or fistulae in these
      patients. Two patients developed thromboembolic complications postoperatively.
      Extraperitoneal drainage with staged resection of underlying gastrointestinal
      pathology is a safe and effective way of treating patients with psoas abscesses.

PMID- 1746779
TI  - Transderm scopolamine for the control of perioperative nausea.
AB  - A randomized prospective study of 201 patients in two institutions was performed
      to evaluate the efficacy of a transderm scopolamine patch in the control of
      postoperative nausea. Of 201 patients, 180 successfully completed the protocol.
      Demographically, the groups were similar in age, sex, and surgical procedures.
      Adverse effects were noted in both treatment and control groups. Forty-seven per
      cent of the placebo and 49 per cent of the transderm scopolamine group did not
      experience postoperative side effects. The most common adverse reactions were
      urinary retention, dry mouth, agitation, nausea, and vomiting. There was a
      reduction in the number of vomiting episodes in the transderm scopolamine
      treatment group from the control group (21% transderm scopolamine vs. 36%
      placebo). These differences became more significant among the subgroups in
      surgery, especially after orthopedic procedures. Thirty-five per cent of the
      transderm scopolamine group experienced nausea compared with 65 per cent from the
      placebo, 11 per cent of the transderm scopolamine experienced vomiting compared
      to 26 per cent. Transderm scopolamine was effective in reducing but not
      eliminating postoperative nausea.

PMID- 1746780
TI  - The influence of preoperative radiation therapy on morbidity and mortality for
      transhiatal esophagectomy.
AB  - To assess the morbidity and mortality of preoperative radiation therapy (RT), the
      authors reviewed 37 consecutive patients who underwent transhiatal esophagectomy
      for carcinoma of the esophagus. Twelve patients received no RT, 13 patients
      received RT only to the neck, and 12 received RT to the chest (three of these
      received radiation therapy to the chest and neck). Preoperative chest RT did not
      significantly increase postoperative fistula formation but was associated with
      significantly higher operative mortality, overall complication rate, and time on
      ventilators than either the patients receiving neck RT alone or no RT (P less
      than 0.05). Postoperative hospital stay was longer and intraoperative blood loss
      greater for the chest RT group compared to those with no RT (P less than 0.05).
      Neck RT did not result in these complications (P = NS). The authors conclude that
      preoperative chest RT is associated with significant postoperative morbidity and
      mortality.

PMID- 1746781
TI  - Ureteroinguinal hernia: a rare companion of sliding inguinal hernias.
AB  - Ureteroinguinal herniation is a rare occurrence with only 54 reported cases in
      the English literature. This article reviews the literature and reports on a case
      that typifies the problems posed by ureteroinguinal herniation. General surgeons
      should be aware of the potential of this condition so that they can prevent
      ligation or severance of the involved ureter.

PMID- 1746782
TI  - Esophageal obstruction and mediastinitis: a hard pill to swallow for drug
      smugglers.
AB  - Ingestion of foreign bodies is a common cause of esophageal laceration and
      obstruction. Mediastinitis may occur if the problem is not managed expediently. A
      case of upper thoracic esophageal obstruction resulting from an attempted
      transenteric smuggling of illicit drugs is presented.

PMID- 1746783
TI  - A traumatic splenic rupture in a healthy adult.
AB  - Splenic rupture in blunt and penetrating trauma is well documented. Other
      etiologies include hematologic and inflammatory disorders. The case presented
      documents occult splenic rupture. There was no history of trauma. Furthermore, no
      evidence of systemic disease or pathology could be found. Occult, spontaneous
      splenic rupture is rarely diagnosed, although the associated mortality/morbidity
      is high. The astute clinician must have a high index of suspicion relying on
      clinical and roentgenographic study for rapid diagnosis and management.

PMID- 1746784
TI  - Twenty questions about hernioplasty.
AB  - The twenty most asked and answered questions about advances in hernia surgery are
      enumerated. These inquiries have been collected over 20 consecutive years of
      exhibiting at a scientific booth at the American College of Surgeons conventions.
      The questions generally are concerned with synthetic patches, the use of local
      anesthesia, and, more recently, the "tension free" hernia repairs. The treatment
      of hernial sacs, the diagnosis, prevention and treatment of postoperative pain,
      the Shouldice Clinic repair, the importance of Cooper's ligament, and the cause,
      prevention, and treatment of recurrences are also examined.

PMID- 1746785
TI  - Is colonoscopy safe in the early postcolectomy period?
AB  - Colonoscopy was performed preoperatively and 1, 2, 3 and 7 days following a left
      hemicolectomy with a primary anastomosis in 11 dogs. The remaining colon and
      anastomosis were adequately visualized. Maximal intraluminal pressures achieved
      were from 15 to 35 mmHg. No leakage of air or intra-abdominal abscesses were
      present. In ten patients undergoing colonoscopy for lower gastrointestinal
      symptoms, the pressures were similarly measured. Although pressures were slightly
      higher in patients, averaging 30 mmHg, the results suggest that colonoscopy can
      be safely performed during the early postcolectomy period.

PMID- 1746786
TI  - Evaluation of a comprehensive algorithm for blunt and penetrating thoracic and
      abdominal trauma.
AB  - The objective was to develop a single branched-chain decision tree for both blunt
      and penetrating thoracic and abdominal trauma and to test its feasibility to
      track clinical decisions. The algorithm consisted of 14 specific patient
      management loops and 31 decision nodes. During a 4-month period, the management
      decisions and clinical course of 434 trauma patients were prospectively observed.
      Thirty-four patients had no signs of life on arrival to the emergency department
      (ED) and were excluded from the statistical evaluation; the remaining 400
      patients constituted the study group. The mean Injury Severity Score (ISS),
      Penetrating Abdominal Trauma Index (PATI), and Trauma Score (TS) scores in the
      series were 21 +/- 10, 34 +/- 12, and 13 +/- 3. The overall patient mortality of
      the study group was 17 per cent; it was 61 per cent in those patients with major
      deviations from the algorithm and 6 per cent in patients who complied with the
      algorithm. The ISS, PATI, and TS scores were 29 +/- 9, 32 +/- 12, and 13 +/- 2 in
      patients with deviations and 20 +/- 10, 37 +/- 12, and 14 +/- 2 in patients who
      complied with the algorithm. Of the 37 patients who died with major deviations
      from the algorithm, the deviation was directly contributory to death in 21 cases
      (57%) and probably contributory in another 14 cases (38%). There were 108
      patients with ISS scores between 20 and 50. In this group, mortality was 55 per
      cent when a major deviation occurred and 5 per cent without major deviations from
      the algorithm. The authors conclude that the survival of trauma patients may be
      improved by following the specific management criteria outlined by the algorithm.

PMID- 1746787
TI  - Superoxide dismutase polyethylene glycol improves survival in hemorrhagic shock.
AB  - Oxygen free radicals are known to form after reperfusion of ischemic tissue. To
      test the role and importance of oxygen free radicals in hemorrhagic shock, an
      animal model of hemorrhagic shock and resuscitation was utilized. Sprague-Dawley
      rats were anesthetized with halothane and then subjected to approximately 50 per
      cent blood volume hemorrhage (30 cc/kg), followed by a 60 min shock period.
      Resuscitation was performed over 1 hour with lactated ringers (LR) at a volume of
      two times blood loss (60 cc/kg). This model results in a survival rate of 25 per
      cent over 72 hrs. Using this model, animals were randomized to receive either LR,
      Superoxide Dismutase-Polyethylene Glycol (SOD-PEG) (15,000 units/kg) with LR or
      Catalase-Polyethylene Glycol (CAT-PEG) (175,000 units/kg) with LR. The group
      treated with SOD-PEG demonstrated significantly increased survival rates vs the
      group treated with LR (67% vs 25%, P = 0.02). The group treated with CAT-PEG
      demonstrated no significant improvement in survival when compared to the LR
      treated group (20% vs 24%). These data suggest that treatment directed toward
      oxygen free radicals and reperfusion injury may play an important role in
      hemorrhagic shock resuscitation.

PMID- 1746788
TI  - Three dimensional vascular ultrasound imaging.
AB  - Intravascular ultrasound (IVUS) is a new catheter-based system that produces two
      dimensional (2D) images of vascular structures. Existing systems produce real
      time, cross-sectional "slices" of vessels using 5.0 French (Fr) (30 MHz) and 8.0
      Fr (20 MHz) IVUS catheters containing ultrasound transducers at the tip.
      Computerized, three-dimensional (3D) reconstruction of these 2D images using a
      personal computer- (PC) based image analysis system is described. A set (n = 90)
      of longitudinally aligned, consecutive images is sampled from a 5.0 cm vessel
      segment, and computerized processing creates rendered 3D images. By adjusting
      image density threshold and viewing angle, the morphology, location, and spatial
      distribution of arterial pathology can be seen. Refinements in computer hardware
      and software have reduced processing time and improved image resolution to the
      point where 3D IVUS imaging is a clinically applicable tool. Possible
      applications include diagnosis of complex arterial pathology, guidance of
      intraluminal instruments, and assessment of the effects of endovascular
      interventions.

PMID- 1746789
TI  - A review of carotid endarterectomy at a large teaching hospital.
AB  - Before 1981, the neurologic morbidity and mortality associated with carotid
      endarterectomy (CEA) in the Los Angeles County/USC Medical Center public teaching
      institution was 20 per cent, similar to results from other hospitals. In 1981, a
      standardized protocol was adopted in an attempt to improve surgical outcome
      following CEA. Between 1981 through 1990, 89 patients with a mean age of 60.9
      years (range 38 to 80 yrs) had 100 consecutive CEAs. Atherosclerotic risk factors
      included hypertension in 57 patients (61.8%), tobacco use in 57 (64.0%), and
      diabetes mellitus in 28 (31.5%). Forty-nine patients had a history of ischemic
      heart disease. Indications for CEA were stroke in 40 cases, transient ischemic
      attack in 33 cases, and asymptomatic, high-grade stenosis of the internal carotid
      artery (greater than 85 per cent) in 19. Perioperative and surgical management
      are detailed in the authors' protocol. Intraluminal shunts were routinely used
      (99 cases) and 24 arteriotomies were patched. Completion arteriograms were
      performed in 99 cases, four of which were revised because of arteriographic
      abnormalities. Three patients sustained postoperative ipsilateral neurologic
      events. Ten patients had cranial nerve palsies, six of which were transient. Two
      patients had nonfatal postoperative myocardial infarctions. There were no deaths.
      The combined stroke and transient ischemic attack (TIA) mortality rate was 3 per
      cent. In conclusion, the audit and quality assurance process identified
      unacceptable results following CEA. A protocol was developed that addressed pre,
      intra, and postoperative details of patient selection, operative technique, and
      postoperative care. By adhering to the protocol, the major neurologic morbidity
      and mortality rate has been reduced to 3 per cent.

PMID- 1746790
TI  - Early absorption of enteral ranitidine after major laparotomy.
AB  - Thirty-six patients were studied following abdominal aortic surgery to determine
      if a commonly used medication could be absorbed from the gastrointestinal (GI)
      tract in the early postoperative period. Patients were randomized into two
      groups: Group I received ranitidine elixir 3 mg/kg via nasogastric tube every 12
      hours; Group II received intravenous (IV) ranitidine 1 mg/kg every 8 hours.
      Ranitidine serum levels were measured with high performance liquid chromatography
      1 hour after administration of the first three doses. Gastric pH was measured
      every 4 hours. It was found that serum ranitidine levels generally regarded as
      clinically effective were achieved in both groups. Although the levels were
      significantly higher following intravenous (IV) administration (Group II), there
      were no differences in average gastric pH. The authors conclude that within 24
      hours of aortic surgery enterally administered ranitidine is effectively absorbed
      and provides prophylaxis equivalent to IV administration of the drug at lower
      cost. Other medications might be deliverable via the GI tract in the early
      postoperative period.

PMID- 1746791
TI  - The role of Yersinia enterocolitica in appendicitis in the southwestern United
      States.
AB  - Infection with Yersinia enterocolitica had been associated with acute
      appendicitis in approximately six per cent of patients in northern European
      countries. However, the incidence of Y. enterocolitica in patients with
      appendicitis in this country is uncertain. Therefore, this study was undertaken
      to ascertain whether Y. enterocolitica is a possible infectious agent in
      appendicitis in the southwestern United States. Fifty prospective patients (35
      men and 15 women) with an average age of 22.3 years (range 3 to 62 years)
      underwent appendectomy for presumed appendicitis. Portions of each specimen were
      cultured for Y. enterocolitica with highly selective media (Cefsulodin-Irgasan
      Novobiocin [CIN] agar). Pathologically, 44 of the patients had appendicitis and 6
      patients had normal appendices. Four of the 44 patients (9.1%) with appendicitis
      were found to be culture positive for Y. enterocolitica, while it was recovered
      from none of the normal appendices. This indicates that Y. enterocolitica may
      represent the major pathogen in acute appendicitis in a small, but distinct,
      portion of indigent patients within Los Angeles County as it does elsewhere in
      the world.

PMID- 1746792
TI  - Adjunctive antimicrobials in surgery of soft tissue infections: evaluation of
      cephalosporins and carbapenems.
AB  - The authors report three trials of B-lactams and carbapenems for soft tissue
      infections treated on a surgical service: 1) cefmetazole versus cefoperazone, n =
      44; 2) cefotetan versus cefoxitin, n = 24; and 3) meropenem versus imipenem, n =
      44. A total of 138 hospitalized patients were enrolled with 112 meeting
      evaluability criteria. Four hundred twenty-three isolates were cultured (mean,
      three/patient) of which 67 per cent were aerobes and 33 per cent anaerobes. Cure
      rates for each trial were: 1) 93 per cent; 2) 92 per cent; 3) 100 per cent.
      Failures were caused by resistant organisms (Streptococcus group D, Bacteroides
      fragilis and Pseudomonas) appearing in incompletely drained infection sites.
      Three patients receiving meropenem had adverse effects (headache, nausea) and one
      receiving cefoxitin (truncal rash). Operative drainage and debridement remain the
      critical elements in therapy. Agents with longer half lives allowing twice daily
      dosing (cefmetazole and cefotetan) were as effective and less expensive than
      multiple doses of short-acting agents. The extended spectrum carbapenems are most
      useful for severe infections or resistant organisms.

PMID- 1746793
TI  - Early diagnosis and treatment of sinusitis in the critically ill trauma patient.
AB  - Sinusitis is an important cause of sepsis in the critically ill patient and may
      be difficult to diagnose. Four patients admitted to the surgical intensive care
      unit with closed head trauma were found to have sinusitis as the cause of
      persistent bacteremia. All patients received pharmacologic doses of
      corticosteroids for treatment of head injury and had prolonged nasotracheal
      and/or nasogastric intubation. A bedside procedure was used for diagnosis and
      management. Under local anesthesia, a 16-gauge angiocatheter was inserted under
      the inferior turbinate and into the maxillary sinus. After purulent fluid was
      aspirated, the sinuses were irrigated with normal saline. All four patients
      defervesced within 24 to 48 hours of this procedure, and facial x rays
      demonstrated clearing of the maxillary sinus. It was concluded that: 1) Sinusitis
      is a complication of closed head trauma in critically ill patients and should be
      included in the differential diagnosis when persistent bacteremia occurs; 2) The
      use of corticosteroids in the treatment of head injury may increase the risk of
      sinus infection; 3) Facial x rays showing air-fluid levels and/or opacification
      are a valuable screening test for paranasal sinusitis; and 4) bedside aspiration
      of the maxillary sinus is an effective diagnostic and therapeutic technique for
      management of sinusitis in the critically ill.

PMID- 1746794
TI  - Survival in trauma victims with pulmonary contusion.
AB  - The author evaluated 203 consecutive patients with severe chest trauma admitted
      to the trauma center between 1985 and 1989. The goal was to identify risk factors
      that play a significant role in mortality of patients with pulmonary contusion.
      There were 160 men and 43 women. The average was 33 years (range 2 to 92 years);
      178 patients were younger than 60 years and 25 were older. There were 183 motor
      vehicle or motorcycle accidents, five gun shot wounds, one stab wound, five falls
      from height, three industrial accidents, one altercation, and five other
      undetermined causes. One hundred and fifty-nine patients survived; 44 died (22%).
      Their injury severity scores averaged 27 (range 9 to 59) for the survivors and
      43.5 (range 17 to 75) for the nonsurvivors. Fifty-seven per cent of the patients
      required mechanical ventilation. The average time on the ventilator was 4.4 days
      (range 1 to 47 days) for the survivors and 14.2 days for the nonsurvivors (range
      1 to 126 days). Of the patients less than 60 years old, 34 (20%) died, but 10
      (40%) of the 25 patients older than 60 years died. Average blood loss was 1,047
      cc (range 0 to 14,300 cc), but the difference was not statistically significant
      between survivors and nonsurvivors in the authors' series. Injuries to the
      central nervous system were present in 80 (40%) of the patients and were
      associated with death in 30 (68%) of the cases. Age, severity of injury,
      associated head trauma, and shock were the most important factors affecting
      survival in the authors' patients with pulmonary contusion.

PMID- 1746795
TI  - The relationship between ARDS, pulmonary infiltration, fluid balance, and
      hemodynamics in critically ill surgical patients.
AB  - Hypervolemia from fluid overload with resultant pulmonary edema is thought to be
      a frequent cause of Adult Respiratory Distress Syndrome (ARDS). However, ARDS may
      also occur as a result of the hypovolemic shock of surgery or trauma. To develop
      an appropriate rationale for fluid therapy in high-risk surgical patients, the
      relationship between fluid balance, hemodynamics, the onset of ARDS by
      physiologic criteria (shunt greater than or equal to 20%, and/or PaO2/FiO2 ratio
      less than 250) and the onset of pulmonary infiltration (PI) associated with ARDS
      were examined. Fifty patients were prospectively followed from admission
      throughout their hospitalizations; 38 (76%) had trauma and 12 (24%) were
      postoperative. Cardiac index, central venous pressure (CVP), wedge pressure (WP),
      and shunt (Qsp) were measured. All chest x rays were read by one staff
      radiologist who was blinded to the patients' identities. PI was graded from "0"
      to "4" (0 = no PI, 4 = maximum PI). The first x ray reading of "2" or greater was
      used as the time of onset of PI. ARDS by physiologic criteria occurred in 29 of
      50 (58%) patients; 27 of these 29 (94%) also developed +2 or greater PI. The mean
      onset times of ARDS and of +2 PI were 40 +/- 41 hours and 40 +/- 38 hours,
      respectively. The ARDS patients had a significantly smaller net positive fluid
      balance than the non-ARDS patients over the first 40 hours after admission
      (+6,831 ml +/- 4,909 ml vs 12,440 ml +/- 7,817 ml, (P less than 0.01)).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1746796
TI  - The socioeconomic impact of assault injuries on an urban trauma center.
AB  - In 1983, Los Angeles County designated 23 level I or II trauma centers. During
      the subsequent 7 years, ten centers closed because of adverse financial impact.
      To analyze the causes of this trend, hospital admissions for gunshot and stabbing
      injuries were reviewed for two separate 1-year periods at a level I urban trauma
      center. Of 1,160 patients arriving with injuries meeting county triage criteria
      from January 1, 1986 through December 31, 1986, 323 (27%) sustained penetrating
      assault, of which 96 were with firearms (30%). From January 1, 1988 through
      December 31, 1988, 1,213 met triage criteria; 301 (25%) were intentional, of
      which 179 (59%) were due to firearms. Epidemiologic and clinical data from the
      two periods is similar with 90 per cent of the patients being men ages 25 to 30
      and of minority ethnic background. Seventy-five per cent of the patients required
      a truncal operative procedure and needed about 5.5 days of hospitalization.
      Overall, mortality averaged 4.7 per cent and morbidity 14.5 per cent. Complete
      financial data was available on 561 of the 624 intentionally injured patients for
      which costs totaled $2,481,346 (mean = $5,260 for gunshots; mean = $3,640 for
      stab wounds). The total collections were $545,896 (22% of total charges). Only 5
      per cent of the charges were reimbursed from insurance; MediCal reimbursed 13 per
      cent and only 1 per cent was from Medicare. Eighty-one per cent of the patients
      had no financial resources, resulting in a hospital deficit of $1,861,009 (75% of
      the total charges).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746797
TI  - Impact of ICU nosocomial infections on outcome from surgical care.
AB  - The authors studied the impact of intensive care unit (ICU) acquired nosocomial
      infections on surgical patients stratified by severity of illness before
      acquisition of the infection. Data were analyzed from 2,122 consecutive patients
      admitted to a 20 bed surgical intensive care unit (SICU) from January 1, 1988 to
      December 31, 1988. The simplified acute physiology score (SAPS), a measure of
      illness severity that correlates with mortality, was calculated for all patients
      on their first SICU day. Ninety-seven nosocomial infections from various sites
      were documented in 54 patients. Patients who acquired a nosocomial infection were
      significantly more ill upon admission to the SICU than patients who did not
      acquire such an infection (control patients). Stratified by admission severity of
      illness, patients acquiring one or more nosocomial infections had a significantly
      longer SICU stay, averaging 25.3 days compared to 2.3 days in control patients (P
      less than 0.001). Hospital stay was also significantly increased at 59.9 days,
      compared to 15.0 days in control patients (P less than 0.001). However, the
      overall mortality rate for patients developing nosocomial infections was
      significantly higher than control patients only in the middle range of admission
      SAPS measurements. The authors found that the monthly incidence of isolates of
      Xanthomatous maltophilia, a multiply-resistant nosocomial organism, reflected the
      overall incidence of nosocomial infections in the SICU. They observed a decline
      in the number of new X. maltophilia isolates and nosocomial infections
      concomitant with the introduction of gown and glove contact isolation procedures.
      The authors conclude that nosocomial infections in the SICU setting are directly
      related to increased patient morbidity and mortality depending, in part, on
      severity of illness upon admission.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746798
TI  - Wound infection in patients with traumatic small intestinal injuries.
AB  - Delayed closure has been the traditional management of wounds in patients with
      traumatic colon injury, whereas small bowel injury has generally been treated
      with primary wound closure. Sixty-seven patients with traumatic hollow viscus
      injury isolated to jejunum and ileum were reviewed to determine the incidence of
      septic wound complications. Fifty-eight patients underwent primary wound closure
      with 15 (26%) developing wound infections. Nine patients had their wounds left
      open because of major intraperitoneal contamination with no resulting wound
      infection. In patients with primary closure of their wounds, there was no
      difference between these developing wound infections and those without with
      regard to the presence of hypotension, amount of spill, type of repair, site of
      injury, or antibiotic given. Significant difference was present regarding time
      between injury and surgery (8.6 vs 17.7, P = .025). Results suggest that delayed
      wound closure should be performed in patients with traumatic small bowel injury.

PMID- 1746799
TI  - The hepatorenal syndrome in liver transplant recipients.
AB  - The hepatorenal syndrome (HRS) is a well-known complication of liver failure, and
      medical treatment is usually not successful unless liver function can be
      improved. The authors review their experience with 130 adults undergoing
      orthotopic liver transplantation (OLT) over a 20-month period to determine the
      incidence of HRS and its effects on patient outcome, need for hemodialysis (HD),
      and the degree of recovery of renal function. The clinical diagnosis of HRS
      preoperatively was made by using criteria to exclude prerenal azotemia, acute
      tubular necrosis, and primary renal diseases. Nineteen patients were identified
      as having the HRS for a preoperative incidence of 15.1 per cent. Overall, 41 of
      the 126 patients reviewed required postoperative HD, and the mortality in this
      group was 54 per cent. Fifty-eight per cent of the HRS patients were dialyzed
      postoperatively vs 28 per cent of non-HRS patients. The mean posttransplant
      creatinine improved over time in the HRS patients while it worsened slightly in
      the non-HRS group. At 12 weeks posttransplant, there was a significant difference
      in the mean creatinine levels (1.8 +/- 0.3 mg/dl vs 1.2 +/- 0.04 mg/dl, P =
      .001). However, at 24 weeks the small difference was not statistically
      significant between the two groups (1.6 +/- 0.15 mg/dl vs 1.3 +/- 0.06 mg/dl, P =
      NS). The current survival of the hepatorenal group is comparable to the
      nonhepatorenal patients at a follow-up of 6 to 25 months: 68 per cent vs 78 per
      cent, P = NS. The authors conclude that liver transplantation reverses the HRS,
      and that hepatorenal patients can undergo liver transplantation with outcomes
      comparable to nonhepatorenal patients.

PMID- 1746800
TI  - Diaphragmatic injuries: recognition and management in sixty-two patients.
AB  - Between 1979 and 1989, 62 patients were treated for traumatic injury of the
      diaphragm. Forty-five had penetrating injuries following stab wounds or gunshot
      wounds, and 17 had diaphragmatic tears from motor-vehicle and auto-pedestrian
      accidents. Forty-one patients sustained left-sided injuries; 20 patients
      sustained right sided injuries; and one patient sustained bilateral ruptures. All
      patients underwent exploratory laparotomy and diagnosis was confirmed at surgery.
      Diaphragmatic injury was suspected in only 17 (27%) patients preoperatively. The
      chest radiograph showed nonspecific abnormalities in 48 (77%) patients and was
      diagnostic in 15 (24%) patients. Six patients had diagnostic peritoneal lavage;
      five were positive and one was negative. Computerized tomography (CT) of the
      lower thorax and abdomen was performed on 11 (18%) patients, but not one scan was
      diagnostic. Fluoroscopy in two patients was helpful. All patients had other
      associated injuries. The liver, spleen, or stomach were frequently injured in
      association with penetrating diaphragmatic lacerations. Bony fractures, splenic
      injuries, and head trauma were more commonly found with blunt diaphragmatic
      ruptures. The average hospital stay for the penetrating injuries was 11 days and
      for blunt trauma was 16 days. The operative mortalities was 2 per cent for
      penetrating injuries and 12 per cent for blunt injuries.

PMID- 1746801
TI  - Diffuse bile duct tumors: guidelines for management.
AB  - The majority of patients with bile duct cancer have small focal adenocarcinomas
      localized to the upper, middle, or lower third of the bile duct. In contrast, a
      small subgroup of patients have been identified with bile duct tumors that are
      diffuse, involving multiple segments of the extrahepatic biliary tract. Among 186
      patients with documented bile duct cancer treated at the UCLA Medical Center
      between 1954 and 1988, 13 patients (7%) had diffuse lesions. Patients with
      diffuse tumors had markedly poorer survival rates than did those with focal
      lesions. As diffuse tumors are not amenable to resection, surgical management
      consists primarily of establishing suitable biliary drainage. All patients with
      bile duct cancer should undergo careful intraoperative evaluation to exclude a
      diffuse lesion before tumor resection.

PMID- 1746802
TI  - Xanthogranulomatous cholecystitis: a chronic inflammatory pseudotumor of the
      gallbladder.
AB  - Xanthogranulomatous cholecystitis is a benign chronic inflammation of the
      gallbladder that can morphologically mimic carcinoma. In severe cases, the
      diagnosis is made intraoperatively using frozen section histology and pathologic
      consultation. Once the diagnosis of xanthogranulomatous cholecystitis is
      confirmed, cholecystectomy should be performed. Occasionally, the inflammatory
      reaction and fibrosis within the gallbladder is so severe that conventional
      cholecystectomy is unsafe. In these instances, a subtotal cholecystectomy is
      required.

PMID- 1746803
TI  - Acalculous candida cholecystitis: a complication of critical surgical illness.
AB  - Four patients with underlying diseases including multiple trauma, aortic graft
      infection, and complex fistulae developed acute acalculous cholecystitis with
      bile cultures positive only for Candida albicans. The primary site of the candida
      infection included urinary tract, gastrointestinal tract, and an aortic graft in
      one patient each and was undetermined in the trauma victim. All had received
      broad-spectrum antibiotics; three of the four were in the intensive care unit
      (ICU) with organ failure. Ultrasonography showed a thickened gallbladder wall in
      three patients and sludge in one. Hepato-iminodiacetic acid scans were
      nonvisualizing in these three patients. Operative findings included gangrenous
      cholecystitis in two patients and edematous cholecystitis in one. The fourth
      patient was treated with percutaneous cholecystostomy and interval
      cholecystectomy. The interval from the onset of symptoms to recognition of the
      need for operation was an average of 7 days. Two of the four patients died of
      ongoing sepsis. Candida cholecystitis is a life-threatening complication of
      critical surgical illness. Risk factors are similar to those for candida
      infection elsewhere and include antibacterial therapy, complex fistulae,
      disseminated malignancy, immunosuppression, and prolonged ICU stay. A high index
      of suspicion for this fungal pathogen and aggressive surgical therapy offer the
      only chance for a favorable outcome.

PMID- 1746804
TI  - Transfusion therapy in cardiac surgery: impact of the Paul Gann Blood Safety Act
      in California.
AB  - The Paul Gann Blood Safety Act became law in California on January 1, 1990,
      mandating that patients be informed of the risks and alternatives of blood
      transfusions. To evaluate the impact of this legislation, the authors compared
      transfusion therapy in patients undergoing cardiac surgery during 1990 to
      previous years (1986 to 1987 and 1989). Surgical techniques were unchanged.
      Homologous component usage was 8.7 +/- 0.6 (mean +/- SE) units/patient in 1986 to
      1987 (n = 373), 8.2 +/- 0.9 in 1989 (n = 219) and 4.3 +/- 0.6 in 1990 (n = 222),
      P less than .001 by ANOVA. Erythrocyte transfusions were 3.5 +/- 0.2, 3.2 +/-
      0.2, and 2.2 +/- 0.2 units/patient (P less than .001); platelet/plasma usage was
      5.2 +/- 0.5, 4.9 +/- 0.7 and 2.1 +/- 0.4 units/patient (P less than .001). The
      number of patients not requiring transfusions increased from 28 per cent in 1989
      (61 of 219) to 47 per cent in 1990 (104 of 222). A slight but significant
      decrease in cardiopulmonary bypass time and perioperative blood loss occurred.
      The authors conclude that this legislation stimulated the surgical team to
      control blood loss during surgery and to avoid the anticipatory use of component
      transfusions.

PMID- 1746805
TI  - Time-course of cardiopulmonary effects tumor necrosis factor and endotoxin are
      similar.
AB  - Tumor necrosis factor (TNF) is a postulated proximal septic mediator. The authors
      compared the time course and extent of the cardiopulmonary effects of recombinant
      human TNF (rTNF) in swine vs those of Escherichia coli endotoxin (ETX).
      Intravenous boluses of either rTNF (n = 4), ETX (n = 2), or saline (n = 4) were
      given to swine. Mean pulmonary artery pressure and extravascular lung water
      (EVLW) were increased at 60 minutes for rTNF and ETX to 31 +/- 2 mmHg and 33 +/-
      3 mmHg and 6.3 +/- 0.9 ml/kg and 7.1 +/- 1.6 ml/kg, while saline animals were
      unchanged. The authors conclude that rTNF mimics ETX both in time course and
      magnitude of effects. Right-sided cardiopulmonary effects predominate in both
      with minimal left-sided effects at these dosages. The time course of early
      increased EVLW suggests an initial hydrostatic influence on pulmonary edema
      formation in this septic model.

PMID- 1746806
TI  - Health, hygiene, work and wealth--Warner Lecture 1991.

PMID- 1746807
TI  - Studies on the cytotoxicity of ceramic respirable dusts using in vitro and in
      vivo test systems.
AB  - The effect of a number of ceramic raw materials and airborne samples in
      workplaces has been investigated in vitro [erythrocyte haemolysis, macrophage TTC
      (2,3,5-triphenyl-tetrazolium chloride) reduction and LDH (lactate dehydrogenase)
      activity] and in vivo (protein, LDH and phospholipid in cell-free
      bronchopulmonary lavage). In the in vitro experiments described we were able to
      distinguish between the dusts causing different types of reaction in the lung.
      Dusts classified as 'quartz type' in vitro were also cytotoxic in vivo. Dusts
      have also been divided into three groups according to their degree of hazardous
      nature, taking into consideration the time before an inflammatory reaction is
      detected and the degree of inflammatory response as characterized by biochemical
      parameters. One feature of the test systems which is of practical significance is
      that in vitro experiments require only 15 mg of dust, and in vivo experiments
      only 100 mg.

PMID- 1746808
TI  - Comparison of measured respirable dust sampler penetration curves with sampling
      conventions.
AB  - Measured sampler penetration curves are presented for British personal cyclone
      samplers and the MRE 113A static horizontal elutriator in calm air. These curves
      are compared with previous results for these instruments, and with theoretical
      models of sampler behaviour. The sampling efficiency of the elutriator when
      facing a moderate wind is discussed. The penetration curves are assessed by
      comparison with standard sampling conventions for respirable dust.

PMID- 1746809
TI  - Posture control and the risk of industrial accident: a stabilographic
      investigation in a naval shipyard.
AB  - In a previous case-control study on the effect of impaired perceptual acuity on
      the risk of industrial injuries at a naval shipyard, three factors which might
      influence the perception and processing of sensory impressions--alcohol
      consumption, hearing loss exceeding 20 decibels (dB) and exposure to noise
      exceeding 82 dB(A)--were found to contribute to the risk of injury. According to
      recent reports, these factors can all lead to impaired posture control. Because
      in general about 40% of all accidents are associated with falling, tripping,
      slipping and the like, a supplementary study has been carried out to unravel
      possible confounding effects of posture control on these three risk factors.
      Cases (who had suffered two or more accidents during the preceding 4 years) and
      controls (who had been accident-free in the same period) were compared as regards
      posture control measured during silence or noise. No significant difference in
      posture control was found between cases and controls, either in silence or during
      exposure to heavy noise.

PMID- 1746810
TI  - Study of the count-to-mass conversion factor for asbestos fibres in samples
      collected at the emissions of three industrial plants.
AB  - Count-to-mass conversion factors for asbestos fibres in the stack emissions of
      three industrial plants were calculated. Dust samples deriving from different
      working processes were collected downstream from the fabric-based filtration
      systems. Gravimetric measurements were carried out utilizing an X-ray diffraction
      procedure based on the use of a silver filter that permits the correction for X
      ray absorption by the sample. The number of fibres covered by regulations
      ('Regulated fibres') (F) was counted by phase-contrast optical microscopy (PCOM)
      on a section of the same filter as had been used for gravimetric measurements.
      The values of the conversion factors vary widely, ranging from 0.4 x 10(3) to 4.9
      x 10(3) fibers per microgram (F microgram -1) according to the working process
      involved. They are always less than 20 x 10(3) F microgram -1, the value
      specified in the EEC Directive 217/87 concerning the prevention of asbestos
      pollution in the environment.

PMID- 1746811
TI  - The effect of environmental factors on the pharmacokinetic behaviour of organic
      solvent vapours.
AB  - A review of the literature concerning environmental factors affecting
      toxicokinetic behaviour of organic solvents revealed that alcohol consumption and
      exposure to other organic solvents are of great importance among such factors. An
      insight into how environmental factors affect the toxicokinetic behaviour of
      organic solvents is discussed by modelling (a) the effect of alcohol consumption
      on the toxicokinetics of trichloroethylene (TRI), and (b) the effect of the
      metabolic interaction between benzene and toluene. In general, hepatic metabolism
      of an organic solvent (substrate) is assumed to follow the Michaelis-Menten
      equation, v = Vmax.S/(Km + S), where v is the rate of substrate metabolism, Vmax
      and Km the maximum velocity and Michaelis constant for the metabolism,
      respectively, and S the substrate concentration in the liver. On the assumption
      of competitive inhibition, inhibition of the substrate metabolism by the
      simultaneous presence of ethanol or other organic solvents (inhibitors) can be
      expressed as follows: v = Vmax.S/[Km + (Km/Ki)I + S] where I is the inhibitor
      concentration in the liver and Ki the inhibitor constant toward the substrate
      metabolism. An increase in Vmax without a change in Km can represent enzyme
      induction due to alcohol consumption or previous repetitive exposure to other
      solvents. A simulation study on the effect of alcohol consumption on the
      metabolism of TRI revealed that the lower the exposure concentration, the larger
      the inhibitory effect of ethanol. In contrast, the effect of enzyme induction
      following alcohol consumption makes its full appearance only when the exposure
      concentration is high. Another simulation study on the mutual metabolic
      interaction between benzene and toluene suggested that at low exposure
      concentrations of both benzene and toluene where enzymes are supposed to have in
      reserve some capacity to catalyse the metabolism of both solvents, each solvent
      inhibits only slightly the metabolism of the other. On the other hand, at high
      exposure concentrations where enzymes have little or no capacity in reserve, the
      simultaneous presence of benzene and toluene notably suppresses the metabolism of
      each other.

PMID- 1746812
TI  - Pharmacokinetic models in the development of exposure indicators in epidemiology.
AB  - Physiological pharmacokinetic (PK) models can estimate tissue levels from data on
      blood solubility, partition coefficients and metabolic rate(s) of a chemical
      agent. Use of these models in epidemiological studies has been limited. PK models
      can be useful if four conditions are met: (1) potential causal agents are
      identified; (2) groups of subjects with substantially different profiles of
      exposure intensity are identified; (3) a physiological PK model is available to
      extrapolate target tissue concentrations for potential agents; and (4)
      mechanistic hypotheses predict substantially different risk for different time
      profiles of tissue concentration. An example of this approach is presented for
      cancer risk from mixed hydrocarbon exposures, including the development of three
      practical dose indices. This use of PK models produces dose-response
      relationships useful for risk assessment, and it permits epidemiological
      evaluation of mechanistic hypotheses derived from laboratory studies.

PMID- 1746813
TI  - Ocular thrombosis associated with antiphospholipid antibodies.
AB  - Four patients with isolated acute ocular ischemic syndromes also had circulating
      antiphospholipid antibodies. Two patients had vaso-occlusive retinopathy and two,
      anterior ischemic optic neuropathy (which was successive in one). Extensive
      clinical laboratory evaluation identified vascular risk factors in two patients.
      One patient had essential thrombocytosis, confirmed by bone marrow biopsy; the
      other had stable hypertension and a history of coronary artery disease. These
      cases suggest that small vessel thrombosis in situ may be a mechanism for
      antiphospholipid-associated ocular and cerebral ischemia.

PMID- 1746814
TI  - Recurrent uveitis after influenza vaccination.
AB  - A 77-year-old woman had complicated cataract surgery with resultant uveitis. Four
      months after an apparently complete recovery, she was vaccinated with influenza
      vaccine. Within two weeks, she had a recrudescence of her inflammation
      accompanied by cystoid macular edema and reduced vision. We discuss the
      mechanisms of this reaction.

PMID- 1746815
TI  - Effect of topical corticosteroids on goblet-cell density in an alkali-burn model.
AB  - Conjunctival alkali burns result in a loss of goblet cells in the acute
      postinjury period. A deficiency of goblet cells and their primary product, mucin,
      is associated with both short- and long-term ocular sequelas. We evaluated the
      effect of topical corticosteroids on goblet-cell density in a prospective,
      randomized, controlled trial using 24 eyes of 12 adult albino rabbits in which a
      standard conjunctival burn was made. The treatment group was found to have 97.38
      goblet cells per unit area of conjunctiva; the control group had 65.81 goblet
      cells per unit area of conjunctiva. This was a statistically significant
      difference (P less than .02). These results suggest that topical steroids are
      beneficial in suppressing goblet-cell loss after a conjunctival alkali burn.

PMID- 1746816
TI  - Regulating the dose of 5-fluorouracil to prevent filtering bleb scarring.
AB  - Repeated doses of 5mg of 5-fluorouracil (5-FU) were injected subconjunctivally in
      25 poor-prognosis glaucomatous eyes after filtering surgery to prevent filtering
      bleb scarring. The frequency (1-2 times a day) and duration (minimum, 7 days) of
      injections were determined by the degree of the anterior chamber reaction and/or
      conjunctival hyperemia at the filtering bleb site. Punctate corneal erosions or
      filaments were not considered a contraindication to continuation of 5-FU
      treatment. After 12 months, intraocular pressure (IOP) of 16 mmHg or less without
      medical treatment was found in 19 (76%) eyes. In 16 of these (64%), the IOP was
      12 mmHg or less. In two (8%) other eyes, it was 20 mmHg or less with medication.
      We believe that the comparatively low IOP levels achieved without medical
      treatment in 76% of the eyes in our study can be attributed in part to our
      therapeutic approach with 5-FU.

PMID- 1746817
TI  - Orbital and sinus inflammation with secondary optic neuropathy.
AB  - Optic neuropathy with simultaneous orbital and sinus inflammation is a diagnostic
      dilemma. Although sinus inflammation was described previously as causative in
      some cases of optic neuritis, the relatively high rate of asymptomatic sinus
      opacification in radiologic studies of the general population (as high as 13%)
      makes this a diagnosis of exclusion. We describe a patient who had optic
      neuropathy associated with simultaneous orbital and sinus inflammation. Although
      definitive determination of etiology may not be made without tissue biopsy, cases
      suspected of having a bacterial etiology may benefit from an initial 48-hour
      trial of intravenous antibiotics before initiation of systemic corticosteroids.

PMID- 1746818
TI  - Infectious keratitis in Baltimore.
AB  - One hundred thirty cases of ulcerative keratitis occurring from 1985 to 1989 at
      Sinai Hospital of Baltimore were reviewed. Positive corneal cultures were
      obtained from 40% of cases. The most common isolates were Staphylococcus
      epidermidis (28%), S. aureus (16%), and Pseudomonas aeruginosa. P. aeruginosa was
      the most common in contact lens wearers. Antibiotic pretreatment did not affect
      the rate of positive cultures significantly. Bilateral conjunctival and eyelid
      margin cultures also were examined. An association was found between corneal and
      ipsilateral conjunctival isolates (P = .05). Gram stains were consistently
      negative. Most patients were treated successfully as outpatients. The value of
      simultaneous conjunctival and eyelid margin cultures and Gram stains was
      questioned.

PMID- 1746819
TI  - Psychological change following 18 months of cochlear implant use.
AB  - Consecutive recipients of multichannel cochlear implants participated in
      preimplant as well as 9-month and 18-month psychological evaluations. Before
      receiving a cochlear implant, psychological tests indicated that the implant
      recipients were more depressed, suspicious, socially isolated, lonely, and
      socially anxious than was the general population. After 18 months of implant use,
      there was a significant reduction in depression, loneliness, social anxiety,
      social isolation, and suspiciousness. These changes in psychological state did
      not correlate with improved performance on audiological measures. The data
      suggest that although cochlear implants can have a positive effect on the
      emotional and behavioral status of persons with acquired postlingual profound
      deafness, the psychological outcome of implants is not simply a function of the
      audiological benefit assessed with standardized speech-based audiological tests.

PMID- 1746820
TI  - Effect of age at onset of deafness on children's speech perception abilities with
      a cochlear implant.
AB  - The speech perception abilities of 37 children with cochlear implants (single
      channel or multichannel) were examined as a function of age at onset of deafness.
      There was no significant difference in the speech perception abilities of
      implanted children who were born deaf and those of implanted children who lost
      their hearing during the first 3 years of life. In contrast, the performance of
      children whose age at onset of deafness was 5 years or later was significantly
      better than that of the children with congenital or early-acquired deafness on
      tests of stress pattern categorization, closed-set word identification, open-set
      identification of common phrases, and lipreading enhancement.

PMID- 1746821
TI  - Round window versus promontory stimulation: assessment for cochlear implant
      candidacy.
AB  - Electrical stimulation of the cochlea is a part of the preliminary evaluation
      protocol for cochlear implant candidacy at many centers. Typically, a
      transtympanic needle electrode is placed on the promontory of the ear under
      consideration and electrical current is presented to measure auditory percepts
      and psychophysical-electrophysiologic measures. Since 1984, we have used a ball
      electrode placed directly on the round window (via a tympanotomy) for
      stimulation, with 27 subjects being so tested to date. Nine additional subjects
      have had stimulating electrodes placed on both the round window and the
      promontory. Seven of these subjects yielded complete data. For measurements of
      threshold, maximum acceptable loudness level, and dynamic range, promontory
      testing mean values were higher than round window measurements. However, the
      differences were not significant.

PMID- 1746822
TI  - Indication of a relation between speech perception and temporal resolution for
      cochlear implantees.
AB  - In order to better understand the reasons for success or failure of a cochlear
      implant system for various patients, it appears necessary to analyze the
      patients' basic psychophysical capacities in relation to speech perception. Five
      patients with intracochlear multichannel Ineraid implants were studied in terms
      of their performance on temporal analysis in relation to their perception of
      consonants. For temporal analysis we measured the detection of a silent gap in
      noise and of an interval between two clicks. For consonant perception we
      established a confusion matrix based on 12 consonants presented in a vowel
      consonant-vowel context using the vowel /a/. The results showed a correlation
      between temporal resolution for two successive clicks at the most basal cochlear
      electrode used, and the perception of place of articulation of consonants. This
      finding indicates that delivering fine temporal coding can be crucial for the
      success of an implant and that for a given subject, optimal capacity for temporal
      resolution may serve as a criterion for choosing a basal electrode.

PMID- 1746823
TI  - Prediction of behavioral threshold and comfort values for Nucleus 22-channel
      implant patients from electrical auditory brain stem response test results.
AB  - We have studied the prediction of behavioral threshold and comfort values for 11
      patients who use the Nucleus 22-channel cochlear implant by means of the results
      of electrical auditory brain stem response (EABR) procedures. For prediction
      purposes, EABR and behavioral testing were done in the same electrode mode
      configuration for three specific electrodes. The results of this investigation
      suggest that EABR threshold current level is consistently near the behavioral
      comfort current level, rather than the patient's behavioral threshold level.

PMID- 1746824
TI  - Laryngeal manifestations of gout.
AB  - Gout is a disorder of purine metabolism characterized by hyperuricemia with rare
      involvement of the head and neck. We present a 72-year-old woman with a known
      history of gout who presented with hoarseness and a lesion suspicious for
      carcinoma of the larynx. Endoscopic biopsy revealed a tophus of the true vocal
      cord with characteristic birefringent crystalline deposits and giant cell
      granuloma. There have been limited reports of gouty involvement of the larynx,
      more commonly involving cricoarytenoid arthritis. Tophi of the laryngeal soft
      tissues are exceedingly rare. In this paper we will discuss the pathophysiology
      and management of this interesting clinical entity.

PMID- 1746825
TI  - Causes of childhood deafness at a Dutch school for the hearing impaired.
AB  - This study was conducted on 162 hearing-impaired school pupils who were
      investigated as to the cause of their hearing loss. In 64 pupils (40%) a
      hereditary cause was recognized, and in 43 (27%), an acquired cause; in 55 (34%)
      the cause remained unknown, according to the criteria we used for defining a
      cause. Special attention was paid to the differences between the hereditary and
      acquired forms of deafness in relation to the degree of hearing loss. The study
      population therefore was divided into groups per 10 dB of hearing loss. Using
      this method we found that an autosomal dominant hearing loss occurred
      significantly more frequently among the less severe hearing disorders. This
      finding, which has not been seen in the literature, is important in genetic
      counseling for the deaf. Another remarkable finding was that Usher's syndrome,
      especially type 2 with a moderate hearing loss, was more frequent among the
      hearing-impaired subjects than we had expected.

PMID- 1746826
TI  - Abnormalities of lateral cartilaginous lamina and lumen of eustachian tube in
      cases of cleft palate.
AB  - Development of the lateral lamina (LL) of the eustachian tube (ET) cartilage was
      investigated in cleft palate (CP) cases and controls by measuring the areas of
      the LL and medial lamina (ML) of the ET cartilage in histologic cross section,
      and comparing the ratio of the area of LL to that of ML (LL/ML) in CP cases and
      controls. The degree to which the ET lumen appeared straight or C-shaped in cross
      section was also measured. Thirty temporal bones with the entire ET--10 CP cases
      and 20 controls--were studied. The ratio of the areas of the ET cartilage was
      significantly smaller (t = 2.903, p less than .01) and the curvature of the ET
      lumen was significantly less (t = 2.080, p less than .05; chi 2 = 3.936, p less
      than .05) in CP cases than in controls. In addition, in all 30 CP cases and
      controls, the ratio of the areas of cartilage was significantly less in specimens
      with straight ET lumens than in those with C-shaped lumens (t = 2.713, p less
      than .02). The results appear to show that the ET cartilages and lumens are
      anomalous in CP cases. These anomalies are considered to be important factors in
      active ventilatory dysfunction of the ET.

PMID- 1746827
TI  - Evaluation of the temporal bones of a multichannel cochlear implant patient.
AB  - In this report we detail the temporal bone findings of a 57-year-old patient who
      underwent placement of a Nucleus 22-channel electrode 7 months prior to his
      death. Audiometric testing postoperatively demonstrated suprasegmental speech cue
      discrimination only. Histologic evaluation of the cochleas revealed significant
      sensorineural survival except in the region of the basal turn of the implanted
      cochlea adjacent to the implant. There was no significant pathologic condition
      attributable to the operation or the electrode in areas remote from the basal
      turn of the cochlea.

PMID- 1746828
TI  - Airway obstruction and high-frequency jet ventilation during laryngoscopy.
AB  - High-frequency jet ventilation has been reported as an effective method of
      ventilation during laryngoscopy, but may expose the patient to the risks of
      barotrauma or alveolar hypoventilation. The aim of the study was to evaluate the
      determining factors of pulmonary complications under high-frequency jet
      ventilation in 83 patients undergoing laryngoscopy for upper airway cancer.
      Pulmonary distention was mainly influenced by upper airway obstruction score (p =
      .0001), while patients with chronic obstructive pulmonary disease (COPD) did not
      suffer from gas trapping. Impaired gas exchange was predicted by increased weight
      (p = .0001), smaller injector diameter (p = .02), and lower airway obstruction (p
      = .001). Hypercapnia occurred in both upper and lower airway obstruction, while
      hypoxemia was principally observed in COPD patients. Emphasis is placed on
      monitoring by pulse oximetry, end-expiratory pressure, and PCO2 measurement,
      especially in patients with obesity, COPD, or upper airway obstruction.

PMID- 1746829
TI  - Congenital conductive or mixed deafness, preauricular sinus, external ear
      anomaly, and commissural lip pits: an autosomal dominant inherited syndrome.
AB  - Branchiogenic syndromes such as branchio-oto-renal syndrome, Treacher Collins
      syndrome, and hemifacial microsomia are well delineated. From a clinical study in
      a large family spanning three generations, it can be concluded that the
      association of conductive deafness, commissural lip pits, preauricular sinuses,
      and external ear anomalies can be differentiated from the above-mentioned
      syndromes and is a separate autosomal dominant syndrome.

PMID- 1746830
TI  - Glycoconjugates in the chinchilla tubotympanum.
AB  - Various biotinylated lectins were used to characterize and semiquantitate
      glycoconjugate residues in the tubotympanum. Epithelial goblet cells were stained
      predominantly by WGA, LFA, SNA, RCA-I, Con-A, LCA, SBA, PHA-E, and UEA; this
      finding suggests they contain alpha-neuraminic acid, beta-galactose, alpha
      mannose, N-acetyl alpha-galactosamine, and alpha-fucose. Glandular mucous cells
      were stained predominantly by WGA, LFA, SNA, and RCA-I; this finding suggests
      that they contain alpha-neuraminic acid and beta-galactose. The glandular serous
      cells were stained predominantly by Con-A, WGA, and LFA; this finding suggests
      that they produced alpha-mannose and alpha-neuraminic acid that represented serum
      type glycoprotein. The positive staining of epithelial goblet cells and glandular
      mucous cells with PNA after neuraminidase digestion suggests that they produced
      mucin-type glycoproteins. The staining of the mucous blanket by WGA, LFA, SNA,
      RCA-I, LCA, PNA, SBA, PHA-E, and UEA suggests the presence of alpha-neuraminic
      acid, beta-galactose, N-acetyl alpha-galactosamine, and alpha-fucose. The
      epithelial cell (nonsecretory) surface was stained largely by WGA, LFA, SNA, RCA
      I, Con-A, and LCA; this finding suggests the presence of alpha-neuraminic acid,
      beta-galactose, and alpha-mannose.

PMID- 1746831
TI  - Afferent activity in the external branch of the superior laryngeal and recurrent
      laryngeal nerves.
AB  - We investigated the presence of respiratory-modulated receptors in the recurrent
      laryngeal nerve (RLN) and the external branch of the superior laryngeal nerve
      (ExtSLN) in anesthetized, spontaneously breathing dogs. Of 39 receptors recorded
      from the ExtSLN, the vast majority responded with a slowly adapting discharge to
      compression of the cricothyroid muscle, and only 1 responded to probing of the
      laryngeal mucosa. Ten receptors showed a respiratory modulation. All 30 receptors
      recorded from the RLN responded to probing of the laryngeal lumen, most of them
      (60%) with a rapidly adapting response. Seven of the slowly adapting receptors
      exhibited a respiratory modulation; 38% of the receptors tested were stimulated
      by water, and only 15% by smoke. No receptors stimulated by laryngeal cooling
      were identified in either nerve. Our study indicates that in the RLN and the
      ExtSLN there are relatively few afferents responding to changes in transmural
      pressure and mechanical irritation, as compared to the internal branch of the
      SLN. The relative scarcity of receptors responding to transmural pressure and
      irritant stimuli is consistent with previous observations in dogs that indicate a
      preponderant role for afferents in the internal branch of the SLN in the reflex
      responses to laryngeal stimulation.

PMID- 1746832
TI  - Pulsatile tinnitus from a dural arteriovenous fistula.

PMID- 1746833
TI  - Salivary neoplasms of the jaw bones with particular reference to central
      mucoepidermoid carcinomas.
AB  - Intragnathic salivary-type neoplasms are few in number, are of debated
      histogenesis, and are most often classified as mucoepidermoid carcinomas. Two
      generating tissues have been proposed for the origin of these central
      (intraosseous) tumors: enclaves of salivary tissue and a metaplasia of the
      linings of odontogenic cysts. They are not mutually exclusive. Although most
      mucoepidermoid carcinomas have been low grade, these neoplasms nonetheless have a
      very respectable recurrence rate and can be fatal.

PMID- 1746834
TI  - Facial nerve and medially invasive petrous bone cholesteatomas.

PMID- 1746835
TI  - Further morphologic studies on collagen injected into canine vocal folds.
AB  - We compared the morphologic fate of three types of soluble bovine collagen
      injected into vocal folds of dogs: 1) Zyderm collagen implant containing 35 mg/mL
      of collagen (ZCI I), 2) Zyderm collagen implant containing 65 mg/mL of collagen
      (ZCI II), and 3) GAX collagen containing 35 mg/mL of collagen minimally cross
      linked with 0.0075% glutaraldehyde. Light and electron microscopy showed good
      host tolerance and a long-term persistence of the three types of collagen at the
      site of injection. The collagen implants were progressively colonized by
      fibroblasts and capillaries accompanied by host collagen deposition. No
      inflammatory process or foreign body reaction occurred, in contrast to the
      typical host reaction to injected Teflon. The colonization of GAX collagen was
      slower than for ZCI I and ZCI II. No other significant difference was evident
      among the three types of injectable collagen. All three appear to be very
      suitable materials for laryngeal implants; moreover, they seem to best meet
      accepted requirements for a good implant: they are easy to inject, they are well
      tolerated, and they persist for a long time. We prefer GAX collagen for clinical
      use because of its lower reactivity and higher stability, and because
      overinjection is not necessary (GAX shrinks less than ZCI I and ZCI II).

PMID- 1746836
TI  - Cochlear bone erosion: effects on cochlear hair cells. A scanning electron
      microscopy study.
AB  - Cochleae from gerbils with normal middle ears were compared with cochleae from
      gerbils with experimentally induced cholesteatomas that were in contact with the
      cochlear wall (stage III cholesteatomas). Cochleae from gerbils with stage III
      cholesteatomas were further divided into two groups: one without erosion of
      cochlear bone, and one with cholesteatoma-induced bone erosion but without
      cochlear fistulae. The cochleae with bone erosion showed significant loss of
      outer hair cells in the middle and apical turns, but not in the basal turn. The
      cochleae with stage III cholesteatomas but without bone erosion did not differ
      from normal controls. These results suggest that an ototoxic agent, involved in
      the process of bone erosion, acts through the bony cochlear wall.

PMID- 1746837
TI  - Serial culture and characterization of the chinchilla middle ear epithelium.
AB  - We have successfully cultured a fibroblast-free chinchilla middle ear epithelium
      up to the 10th passage by using conditioned medium or using irradiated 3T3 cells
      as feeder cells. The cultured epithelial cells assumed a polygonal shape with a
      cobblestone appearance, indicating tight junction formation. A small number of
      the cells began to show abnormal morphology, such as indistinct cell boundaries,
      fibroid appearance, or giant cell formation, as the passage increased,
      particularly after the 5th passage. These morphologically transformed cells
      showed positive labeling with an anticytokeratin antibody, which indicated the
      epithelial origin of these cells. Neither ciliated nor secretory cells were
      observed in the serially cultured cells. The rate of cell growth slowed after the
      7th passage, and after the 11th passage the cells no longer proliferated. Even
      with the above limitations, these cultured cells can be used for a number of in
      vitro experiments.

PMID- 1746838
TI  - Perineural extension of squamous cell carcinoma.

PMID- 1746839
TI  - Stensen's duct carcinomas.
AB  - Stensen's duct is rarely a primary site for a salivary neoplasm (11 examples in
      the English-language literature from 1927 to 1984). Bereft of myoepithelium, the
      neoplasms are histologically malignant and have been of mucoepidermoid, squamous,
      or undifferentiated types. Surgical management is predicated on the location and
      stage of the carcinoma.

PMID- 1746840
TI  - Microbiology of 'normal' tonsils.

PMID- 1746841
TI  - Hearing gain after stapedotomy, partial platinectomy, or total stapedectomy for
      otosclerosis.
AB  - The differences in hearing gain 1 year after stapedotomy, partial platinectomy,
      or total stapedectomy for otosclerosis were studied separately at 0.5, 1, 2, 4,
      and 8 kHz with the data available from 311 consecutive primary operations
      performed between 1980 and 1982 in the University of Nijmegen Department of
      Otorhinolaryngology. Three groups of patients were matched for age, sex, clinical
      type of otosclerosis, and type of 0.6-mm all-Teflon piston. The hearing gain for
      air conduction was significantly better by an average of 7.4 dB for all
      frequencies combined after either stapedotomy or partial platinectomy compared to
      total stapedectomy.

PMID- 1746842
TI  - Blood flow in expanded tissue treated with an anticontractile agent.
AB  - The present study investigates blood flow at several stages of expansion with and
      without enhancement by anticontractile agents (papaverine). Twelve 1-kg guinea
      pigs were divided into two groups. In group 1 were six animals undergoing tissue
      expansion without anticontractile agents, and in group 2 were six animals treated
      with a saturated solution of papaverine prior to expansion. Laser-Doppler
      velocimetry was used to monitor the changes in blood perfusion that occurred with
      each expansion. Animals pretreated with papaverine (group 2) maintained higher
      blood flow following inflation of the expander than untreated animals (group 1).
      This study provides physiologic evidence of the benefits of pharmacologic
      enhancement of the expansion process. Agents of this type may have a future role
      in the prevention of ischemic complications.

PMID- 1746843
TI  - Utricle, saccule, and cochlear duct in relation to stapedotomy. A histologic
      human temporal bone study.
AB  - This study was performed to determine the area in which and the circumstances
      under which stapedotomy can be relatively safely performed. Measurements were
      made from central areas of the medial surface of the stapedial footplate to the
      utricle, the saccule, and the cochlear duct in 10 normal and 11 otosclerotic
      temporal bones. The mean distances to the utricle ranged from 1.9 to 2.4 mm, and
      those to the saccule from 1.7 to 2.1 mm. The minimal distance to the utricle was
      measured from the posterior (0.58 mm) and superior (0.62 mm) borders of the
      stapedial footplate. The minimal distances to the saccule were from the anterior
      (0.76, 0.86, and 1.00 mm) border of the stapedial footplate. All other
      measurements were of more than 1 mm. The shortest distance between the cochlear
      duct and the inferior border of the footplate was 0.2 mm. Statistical analysis
      has shown no significant differences for the mean values obtained in normal and
      otosclerotic temporal bones. Fathoming of the vestibule below the central and
      inferior thirds of the footplate surface has shown that there is no likely danger
      to the vestibular end organs or cochlear duct if manipulations are carried out no
      deeper than 1 mm below the surface. The safest place for a stapedotomy opening is
      in the central and inferior-central thirds of the footplate. A stapedotomy piston
      of 0.4 mm in diameter can be introduced relatively safely to a depth of 0.5 mm in
      the vestibule over the entire surface of the stapedial footplate.

PMID- 1746844
TI  - Orthostatic postural control in vestibular neuritis: a stabilometric analysis.
AB  - Posturographic data for 182 vestibular neuritis patients were recorded on a
      static posturographic platform (stabilometry) with the patients' eyes both open
      and closed. Three of the parameters studied are presented here: mean position of
      the center of pressure, area of the statokinesigram, and Romberg's quotient.
      Vestibular neuritis modifies the performance of the fine-postural system in
      unpredictable ways, varying with the subject. It may disturb either the mean
      position of the center of pressure or the integration of visual input. Sixty of
      the patients in this study did not use visual input to stabilize their position
      in relation to their surroundings. The value of stabilometry as a method for
      observing the integration of visual input in the control of orthostatic posture
      is discussed.

PMID- 1746845
TI  - Tullio phenomenon and postural stability: experimental study in normal subjects
      and patients with vertigo.
AB  - The effect of low-frequency sound (LFS) on postural stability was studied in 55
      healthy volunteers and in 152 patients with vertigo due to different types of
      inner ear disease. The sound pressure levels ranged from 130 to 132 dB and were
      given at frequencies of 25, 50, and 63 Hz. The duration of each stimulation
      lasted 30 seconds. The postural responses were measured with a force platform.
      The LFS stimulation improved the postural stability of the healthy subjects
      through the alerting response. We did not observe any difference in the body sway
      according to whether the LFS was delivered with monaural or binaural stimulation.
      Twenty-six percent of the patients with Meniere's disease, 40% with chronic
      otitis media with vertigo, and 26% with vertigo of peripheral origin experienced
      significant postural instability at least at two of the three test frequencies
      during stimulation with LFS. The results demonstrate that in subjects with
      different types of inner ear disease the vestibular system starts to respond to
      LFS. The activation of vestibulospinal responses by LFS seems to be an expression
      of the Tullio phenomenon.

PMID- 1746846
TI  - Inexpensive cochlear implant device.
AB  - We have developed a cochlear implant (CI) device modified from the House/3M
      cochlear implant device. The cost of raw materials was about $25. We used a new
      and simple technique for coating the implanted coil. We modified the circuit and
      removed the amplitude-modulated circuit. With this modification, the device uses
      less electricity and fewer transistors. There are slightly more than 3,000
      patients using CI devices all over the world. Millions of profoundly deaf
      patients are poor and cannot afford the CI device that is now commercially
      available. Any university with well-trained otolaryngologists and physicists or
      electrical engineers can perform this technique.

PMID- 1746847
TI  - Bone destruction mechanisms in chronic otitis media with cholesteatoma: specific
      production by cholesteatoma tissue in culture of bone-resorbing activity
      attributable to interleukin-1 alpha.
AB  - To clarify specific mechanisms underlying cholesteatoma-induced bone destruction,
      surgical specimens of middle ear inflammatory granulation tissue with or without
      cholesteatoma were maintained in vitro and the bone-resorbing activity in their
      culture supernatants was analyzed by means of calcium release from mouse
      calvaria. Almost the same levels of bone-resorbing activity and prostaglandin
      (PG) E2 were found in the supernatants of both types of tissue. By contrast,
      aural polyp tissue yielded hardly any such activity or PGE2. Under the influence
      of indomethacin, however, only tissue with cholesteatoma produced considerable
      bone resorption activity, whereas PGE2 production was suppressed completely. Such
      activity in the cholesteatoma culture supernatant was not due to contamination of
      endotoxin and proved to be blocked by the introduction of anti-interleukin (IL)-1
      alpha antibody into the calvarial assay system. Anti-IL-1 beta antibody had no
      effect on such activity. Interleukin-1 alpha was detected only in cholesteatoma
      tissue culture supernatants by means of enzyme-linked immunosorbent assay and by
      bioassay. These data suggest that the bone destruction in otitis media with
      cholesteatoma may be attributed to IL-1 alpha in addition to PGE2.

PMID- 1746848
TI  - [Antibiotic therapy in pediatrics].

PMID- 1746849
TI  - [Antibiotic treatment of cystic fibrosis].
AB  - Lower respiratory tract superinfection is nearly constant in cystic fibrosis and
      has a significant impact on mortality. The three organisms which most often
      colonize the bronchial tree are Staphylococcus aureus, Haemophilus influenzae and
      Pseudomonas aeruginosa. The latter organism is found in 70% to 90% of older
      cystic fibrosis patients. P. aeruginosa infections are remarkably persistent and
      cause severe, extensive lung damage. Antimicrobial therapy is indicated in
      patients with clinical symptoms (fever, weight loss, changes in sputum and
      auscultation) and should be selected on the basis of cytobacteriologic studies of
      sputum. Oral antibiotics are usually successful in eradicating S. aureus and H.
      influenzae. Conversely, intravenous therapy is required in most cases of P.
      aeruginosa infection. Fifteen-day courses are given repeatedly, either on a
      routine basis every three months, or whenever new clinical symptoms develop.
      Antimicrobials usually fail to eradicate P. aeruginosa even when significant
      clinical improvement occurs. Two-drug therapy and judicious use of the various
      available anti-microbial agents should delay development of resistant strains, an
      event which is nearly inevitable as antimicrobial treatments are repeated.

PMID- 1746850
TI  - [Treatment of bacterial meningitis in children].
AB  - The initial treatment of infantile and childhood bacterial meningitis is now well
      standardized, but three current aspects are discussed in this paper. Although
      classically, ampicillin can still be given as the initial treatment of bacterial
      meningitis in children, current epidemiologic data demonstrate the emergence of
      resistant strains of Haemophilus and Pneumococcus, and consequently use of a
      third-generation cephalosporin should be preferred. Concerning duration of
      treatment, 4 to 5 days seem adequate for meningococci and 7 days for Haemophilus
      influenzae and pneumococci. Lastly, the usefulness of adjunctive antiinflammatory
      treatment is considered. The purpose of this treatment is to lower the risk of
      cerebral complications and neurosensory impairment. Current data suggest that use
      of corticosteroids as early as possible may be helpful. Improved understanding of
      the pathophysiology of pediatric bacterial meningitis has led to other forms of
      treatment being proposed, but their value remains to be proven.

PMID- 1746851
TI  - [Antibiotic therapy in maternal-fetal infections].
AB  - The selection of first-line antimicrobial therapy in neonates with maternofetal
      infection is based on probability data from epidemiologic studies of bacterial
      infections. Because of the high prevalence of ampicillin-resistant E. coli
      strains and of the lack of susceptibility of Listeria and group D streptococci to
      cephalosporins, combined use of two complementary drugs, such as amoxicillin and
      cefotaxime with an aminoglycoside, is recommended. Each dose should be increased
      twofold in patients with meningeal involvement. The interval between
      aminoglycoside doses depends on the degree of renal maturity and therefore on
      gestational age. Discontinuation of treatment on the third day when clinical and
      biologic monitoring disproves the suspected infection avoids the occurrence of
      untoward effects, especially on the intestinal flora. In other cases,
      administration of two drugs selected on the basis of bacteriologic findings is
      needed beyond the third day. Specific therapy is required in infrequent
      infections (Candida, tuberculosis, syphilis, Helicobacter). The dosage of
      antimicrobials with narrow therapeutic margins (vancomycin, aminoglycosides)
      should be adjusted on the basis of serum assays performed at four-day intervals.
      Duration of therapy is usually ten days but may reach 21 days in neonates with
      meningitis. Prevention, in the absence of specific vaccines, rests on antenatal
      and perinatal treatment of women at high risk for infection. Management of
      neonates with group B streptococcal infection is controversial; close clinical
      and biologic monitoring over 48 hours may allow to reduce the use of
      antimicrobials.

PMID- 1746852
TI  - [Antibiotic treatment of pharyngitis].
AB  - Antimicrobial therapy of pharyngitis focuses mainly on eradicating group A
      streptococci and treating recurrent pharyngitis. The French strategy rests on
      routine treatment of all cases of childhood pharyngitis; in the United-States,
      rapid tests are used to identify group A streptococci in the throat before
      treating. Antibiotics used against group A streptococci include beta-lactams and
      macrolides. Among beta-lactams, the reference drug is still penicillin, e.g.,
      penicillin V for 10 days. However, numbers of carriers with positive throat
      cultures for Streptococcus pyogenes seem to be growing in the United States, with
      a 10-20% increase over the last twenty years. Duration of therapy could be
      reduced from 10 to 5 days with the new oral cephalosporins but these drugs are
      more expensive than penicillin. Recurrent pharyngitis is caused by a variety of
      organisms which are often penicillinase-producers. It follows that penicillin
      should not be used in these cases, which require oral cephalosporins or the
      amoxicillin-clavulanic acid combination. Maintenance antimicrobial therapy
      between acute episodes should be considered.

PMID- 1746853
TI  - [Antibiotic treatment of acute otitis media].
AB  - The strategy of antimicrobial therapy in acute otitis media rests on
      bacteriologic and pharmacokinetic data. Pneumococci and Haemophilus are still the
      two most prevalent pathogens in acute otitis media and raise problems regarding
      susceptibility: 25% of Haemophilus beta-strains produce beta-lactamases and 6 to
      12% of pneumococci are intermediate or resistant to penicillin. Pharmacologic
      features required of antimicrobials used in acute otitis media include good
      penetration in the ear and sustained supra-MIC levels in middle ear fluid.
      Kinetics of drugs in the ear are still often incompletely understood. The last
      selection criterion is analysis of comparative trials. Available data do not
      point to superiority of any drug over the others. Amoxicillin should no longer be
      given as first-line therapy. Amoxicillin combined with clavulanic acid
      (Augmentin) is effective on the entire spectrum of causative organisms. Higher
      levels of amoxicillin may be needed (concomitant use of amoxicillin and
      (Augmentin). First-generation cephalosporins are effective but may prove
      unsuccessful in patients with large inocula. Pediazole is clinically effective
      although penetration of erythromycin in the ear is delayed. The new oral third
      generation cephalosporins are effective in infections due to beta-lactamase
      producing Haemophilus strains. A bacteriologic study should be performed
      routinely whenever otitis media occurs in an infant under three months of age.

PMID- 1746854
TI  - [Treatment of urinary tract infections].
AB  - Urinary tract infection (UTI) is common in pediatric age groups and may cause
      permanent renal damage. Because UTI may occur as the first manifestation of
      urinary tract malformation, evaluation, of urinary tract morphology should be
      routine. Variables influencing selection of the most appropriate therapy include
      the causative organism, location of the infection to the distal and/or proximal
      urinary tract, severity of constitutional symptoms, age, and history for prior
      urologic disease. Treatment of pyelonephritis requires bactericidal antimicrobial
      agents capable of achieving rapid sterilization of the renal parenchyma. Animal
      experiments have shown that the most effective agents are third-generation
      cephalosporins and aminoglycosides. Antibiotics are selected on the basis of age
      and severity of infectious symptoms. In infants under 18 months of age and in
      patients with severe constitutional symptoms, parenteral administration of both a
      third-generation cephalosporin and an aminoglycoside is recommended. Patients
      above 18 months of age who are not severely ill can be given a single oral drug,
      e.g., a cephalosporin, amoxicillin with clavulanic acid, or cotrimoxazole.
      Therapy should be continued for ten days in patients with infection of the
      proximal urinary tract, whereas 5 to 7 days are adequate in patients with
      cystitis and normal urinary tract morphology.

PMID- 1746855
TI  - [Counseling for the prevention of HIV infections in pediatric situations].
AB  - Health care professionals who are not adequately informed may have irrational
      attitudes when caring for HIV-infected pediatric patients. Prevention of
      contamination rests on thorough knowledge of high-risk pediatric groups and of
      potentially contaminating situations. In the delivery room and in intensive care
      settings, a broad set of measures for preventing contamination by blood is
      needed, whereas in maternity wards preventive steps are needed only during cord
      stump care. In pediatric departments, care should be taken to avoid injuries with
      sharp, blood-soiled instruments and to cover all skin lesions. HIV-infected
      children should be allowed to participate in group activities if they are healthy
      enough to do so. If an injury should occur, management includes immediate
      disinfection, reporting, and serial serologic testing, as well as early AZT
      therapy.

PMID- 1746856
TI  - [Bilateral newborn testicular torsions].
AB  - A case of bilateral spermatic cord tension in a neonate is reported. Clinical
      findings are compared with those in 22 previously published cases. Obstetrical
      history is usually unremarkable. Torsion occurs prior to birth or immediately
      after birth. The two cords are involved simultaneously or successively. Edema of
      the scrotum is found in recent spermatic cord tension, whereas subsequently the
      tests are extremely hard and occasionally severely atrophied. Prognosis is poor
      since castration or poor testicular viability was the outcome in most cases.

PMID- 1746857
TI  - [A rare and little known cause of cyanosis: pulmonary arteriovenous aneurysm].
AB  - Cyanosis with digital clubbing and a systolic murmur were found in a five and a
      half-year-old. The usual causes of cyanosis, including congenital heart disease,
      were discussed. Correct diagnosis was, however, arteriovenous aneurysm of the
      lung which was seen on the pulmonary angiogram. The lung density on chest films
      and lack of echocardiographic evidence of congenital heart disease might have
      suggested this infrequent malformation. Permanent cure was achieved by removing
      the lower and middle lobes of the right lung.

PMID- 1746858
TI  - [Arterial blood pressure in Moroccan children and adolescents].
AB  - To develop blood pressure reference values for Maroccan children, a survey was
      carried out in 1987-88 in a group of 10,000 children 4 to 18 years of age. Study
      subjects were randomly selected among schoolchildren from the Great Casablanca
      Wilaya. There were 4,818 boys and 5,182 girls. To ensure optimal reliability of
      data, a precise, standardized methodology was used; blood pressure was measured
      in the supine position after at least five minutes rest, two cuffs of different
      sizes were available and selected according to age and body weight, and diastolic
      blood pressure was defined as Korotkow phase V. Distribution of blood pressure
      values was studied by age, sex and stature. Results were expressed as means +/-
      standard deviations and as percentiles. Blood pressure values were found to
      increase gradually with age, with sex-specific variations. Values were higher in
      post-pubertal girls. A linear positive correlation between arterial blood
      pressure and stature was found. This correlation was stronger than the blood
      pressure-age correlation. These data were compared with previous reports in the
      literature, although this analysis proved difficult because of variations in
      methods and results across studies.

PMID- 1746859
TI  - Why aesthetic plastic surgery became popular in Brazil.

PMID- 1746860
TI  - Orbicularis oris muscle: a double-breasted suture for its repair in the
      unilateral cleft lip.
AB  - The release of abnormal insertions of orbicularis oris muscle from the columella
      and ala base, and from their inferior attachments along the labial margin,
      provides muscle flaps for a double-breasted suture in cleft lip repair. Using the
      muscle flaps for double-breasted sutures realigns the orbicularis oris muscle
      fibers to achieve an anatomical and functional repair that is characterized by a
      symmetrical lip length, nostrils, philtral column, and philtral dimple. Double
      breasted sutures also increase muscle thickness surrounding the lip and
      consequently provides better symmetry for the nostril floor.

PMID- 1746861
TI  - Flankplasty: a specific treatment to improve body contouring.
AB  - A complete study of the flank region's unaesthetic distortions is reported.
      Comments regarding and illustrations of the different clinical appearances of
      local skin turgor and fat deposits are also noted. A classification of the
      different types of flank distortions, whether or not combined with similar
      problems of the surrounding regions, complete the study for the indication of
      correct treatment. Liposuction, surgery, or both, combined in the same or
      different stages, complete the main steps of the procedure.

PMID- 1746862
TI  - Subcutaneous pedicle flaps in facial repair.
AB  - This study shows the importance of rotating subcutaneous pedicle flaps for a wide
      range of possibilities in face and nose reconstruction. The method described was
      studied and developed over 10 years in 305 patients with basocellular carcinoma
      of the face. This method uses areas with natural depressions and provides good
      aesthetic results, which are sometimes difficult to obtain using conventional
      reconstruction methods. Because of their circulatory nature, subcutaneous pedicle
      flaps can be performed on most parts of the face. The flap can be prepared from
      skin where there is cellular subcutaneous soft tissue (randomized
      vascularization), in which the facial circulation is tangential and vertical to
      the skin surface (i.e., like perforating arteries). These characteristics can be
      found in nasogenian wrinkles, the malar region, the upper and lower lips, and the
      chin. The flaps can not be prepared, however, from a region corresponding to the
      front of the face, the cervical, or the nose, where the necessary circulatory
      details and soft tissue are not available.

PMID- 1746863
TI  - Calf augmentation.
AB  - I present my experience with calf augmentation surgery for improvement of the
      contour of so-called "thin legs" due to hypotrophy of the gastrocnemius muscles
      and the local skin covering. A special type of silicone-gel prosthesis is placed
      between the muscle and its fascia. The space is created by a specific instrument
      I developed to perform the dissection. The introduction of the prosthesis is done
      through a 3-cm transverse skin incision on the popliteal line.

PMID- 1746864
TI  - Extended dissection of the mental area in face-lift operations.
AB  - Extended dissection of the mental area has been used successfully in the last 15
      years, in the routine rhytidectomy, to solve the problem of the senile mental,
      also called the "witch's chin." After the face and neck dissection, the chin skin
      is completely dissected at the same anatomical level of the face and finally
      molded with micropore into its new position. Ancillary procedures on the neck,
      face, and chin can be combined and performed in the same stage. The technique and
      combined procedures in the last 500 patients, from a total of 4,856 patients with
      rhytidectomy, are evaluated and analyzed.

PMID- 1746865
TI  - Omphaloplasty.
AB  - Two different omphaloplasty procedures are presented. The first procedure,
      resulting in a four-point, star-shaped navel and indicated for patients with
      classic abdominoplasties, aims at preventing widening of the navel, as well as
      stenosis, later on, postoperatively. The second procedure, based on the rotation
      of the remaining navel and indicated for both patients with midi or mini
      abdominoplasties and patients with secondary omphaloplasty, also aims at
      preventing stenosis and widening of the umbilical scar; however, no external
      scars remain after this procedure.

PMID- 1746866
TI  - Micrografts and minigrafts: a new approach for baldness surgery.
AB  - The main problem in conventional operations for baldness has certainly been the
      resultant scar. The scar stigmatizes the patient's forehead and frequently gives
      an unaesthetic and unnatural appearance. Any observer would say the patient is
      wearing a "hairpiece" or some other artificial element. To minimize this problem,
      we introduced and improved a new procedure for the treatment of pattern baldness
      by using microsurgical hair grafts taken from the occipital region. These are
      inserted, one by one, into the bald area through a small microsurgical knife and
      with the help of a jeweler's forceps. This technique is based on works of Marrit
      and Nordstrom, who made use of these micrografts for the first time to hide the
      anterior line of the forehead after surgery.

PMID- 1746867
TI  - Nasal tip treatment by lengthening of the short columella in bilateral cleft lip
      sequelae.
AB  - The mobilization of two muco-chondrocutaneous flaps obtained by two parallel
      incisions along the nasal dorsum may elevate and elongate the columella in
      patients with bilateral cleft lips. The nose tip is also modulated by a
      triangular tissue resection right above the alar segment in both sides. Thirty
      four patients have been treated with this method.

PMID- 1746868
TI  - Treatment of the Negroid nose without nasal alar excision: a personal technique.
AB  - A new procedure is used for surgery of the Negroid nose. It is based on the
      elevation of the columella, rebuilding the nose tip and the nostril entrance, and
      bialar diameter reduction, leaving no external scars. The technique requires an
      almost all subperiosteal undermining of the soft tissues of the mid-one-third of
      the facial level. This procedure is performed through the Caldwell-Luck incision.
      Special stitches are placed on the bialar line and the columella, narrowing the
      nose base to the desired dimensions. No recurrency has been observed in all the
      patients who underwent surgery.

PMID- 1746869
TI  - [Ultrasound-guided fine-needle punctures of abdominal masses: cytology or
      histology? Comparative prospective study].
AB  - The aim of this study has been for one part to assess the obtaining of
      cytological and histological material from the same patients with the minimum
      amount of injections using a fine needle (diameter less than 1 mm) and also to
      evaluate the histological and cytological supply, individually and jointly in the
      diagnosis of abdominal tumors. Seventy lesions of which 58 hepatic have been
      punctured with fine needles of 20 (0.9 mm) to 22 G (0.7 mm). Material has been
      obtained in 98.6 per cent of cases for cytology and 54 per cent of cases for
      histology. Their respective sensitivity in the diagnosis of malignant tumors was
      96.8 per cent and 86.8 per cent and was not improved by adjoint analysis. The
      specificity was 1 for cytology. The differential diagnosis in malignant hepatic
      tumors between hepatocarcinoma and metastasis was existent in 94.3 per cent of
      cases for cytology and 90 per cent for histology with no benefit coming from the
      association of two. In the group having hepatic metastasis without known primary
      cancer having found histological confirmation of the primary lesion, the cellular
      type has been revealed in exactitude in 94.4 per cent of cases with cytology and
      in 63.6 per cent with histology. No complications have been observed. The fine
      needle cytological aspiration ponction gives very satisfying results, comparable
      with regard to the diagnosis contribution to results of published studies,
      obtained with the use of coarse needle biopies. We suggest that fine needle
      ponction should be used preferentially and that coarse needle biopsy should be
      restricted to the few cases in which the former does not yield sufficient
      information.

PMID- 1746870
TI  - [Obstructive jaundice in Yaounde. Value of echography and transhepatic
      cholangiography in determining the cause].
AB  - The purpose of the study was to assess the clinical value of ultrasonography (US)
      and percutaneous transhepatic cholangiography (PTC) in the workup of obstructive
      jaundice in Yaounde. From 3,000 ultrasonographic studies done between September
      1987 and February 1990, the authors drew 37 cases of obstructive jaundice. 22 of
      them were explored with both US and PTC. The cause of obstruction was tumor for
      14, inflammation or malformation for 4 and biliary stone for 4. US could predict
      the cause in 55 p. cent of cases and PTC in 77 p. cent of cases. PTC was
      particularly helpful in case of non tumoral causes. The authors conclude that, in
      their setting where computed tomography is scarce and expensive, the combination
      of both US and PTC is rewarding, when the problem is the determination of the
      nature of obstruction.

PMID- 1746871
TI  - [Mesenteric carcinoid tumor presenting as an intra-abdominal abscess].
AB  - The authors describe a case of mesentery primitive carcinoid tumor presenting as
      an abdominal abscess. The clinical findings and the physiopathological mechanisms
      are discussed.

PMID- 1746872
TI  - [Secondary tuberculous infection of a pilonidal sinus].
AB  - The authors report the case of a pilonidal sinus which was the site of active
      tuberculosis. They stress the rarity of this condition. Particular emphasis is
      placed upon the need for histopathological examination of all operative specimens
      resulting from excision of a perianal lesion.

PMID- 1746873
TI  - [Giant cystadenocarcinoma of pancreatic origin and supra-mesocolic topography].
AB  - The authors report a case of pancreatic cystadenocarcinoma developed within a few
      days as a voluminous cyst of the left hypochondriac region, pushing away the
      organs of the supramesocolic zone. The tumor removal is easily performed because
      it was surrounded by a fibrotic capsule and their was no precise attach to the
      neighbouring organs. Diagnosis is carried out by microscopic examination
      revealing a tubulo-papillary cystadenocarcinoma of the pancreas. Quasi
      synchronous apparition of disseminated hepatic metastases advocates for heavy
      malignancy and justifies intrahepatic chemotherapy.

PMID- 1746874
TI  - [Crohn's disease and pregnancy].

PMID- 1746875
TI  - [Helicobacter pylori gastritis: a new infectious disease. Reflections from
      personal experience].
AB  - To determine the relationship of microscopic chronic antral gastritis to
      Helicobacter pylori, 69 consecutive patients were studied. In a prospective
      longitudinal study, at least 2 successive gastroscopies with antral biopsies were
      performed (177 investigations on the whole). Sixty six of the 69 patients were
      treated with various therapeutic regimens i.e. antiulcer drugs and/or
      antibiotics. The type and intensity of inflammation (as based on whole
      inflammatory infiltrate density, polymorphonuclear cells presence or absence and
      IgA and IgM plasma cells counts) were correlated with H. pylori status (Giemsa
      staining and/or biopsy culture). The presence of the organism (Hp) and the
      gastritis were significantly correlated (high grade of whole inflammatory
      infiltrate Hp + ve: 98/109 90 p. cent, Hp-ve: 9/61 15 p. cent, p less than 0.001-
      presence of neutrophil PMNC Hp + ve: 80/109 73 p. cent, Hp-ve: 1/61 2 p. cent; p
      less than 0.001--IgA and IgM plasma cells respectively Hp + ve: 7.6 +/- 6.6, 10.6
      +/- 7.1, Hp-ve 1.9 +/- 2.9, 4.2 +/- 4.5; p less than 0.005). Clearance and/or
      eradication of H. pylori after antibiotic treatment were associated with the
      disappearance of chronic gastritis activity and a statistically significant
      decrease of whole inflammatory infiltrate density (p less than 0.001) and IgA (p
      less than 0.005) and IgM (p less than 0.01) plasma cells counts. Mucosal
      inflammation was unchanged in case of H. pylori persistence and inflammation
      worsening occurred in case of infection relapse. H. pylori gastric mucosa
      colonization seemed to be responsible for the antral chronic inflammation
      associated with its presence. This study documents that antral chronic gastritis
      is a microbial disease associated with infection by H. pylori, against which
      there is an inflammatory response characterized by a significant mucosal
      infiltration with granulocytes and IgA and IgM secreting plasma cells.

PMID- 1746876
TI  - [The history of the Zollinger-Ellison syndrome].
AB  - In 1955, the concept that an ulcerogenic islet cell tumor was responsible for a
      marked ulcer diathesis that led to gastric hyperacidity was proposed by myself
      and Ellison. Recently is was suggested that this concept marked the beginning of
      modern gastrointestinal endocrinology. Although these pancreatic ulcerogenic
      tumors are relatively uncommon, a survey in 1987 stated that inquiries about the
      tumor were the most common references requested from surgical journals. The
      original diagnostic triad proposed included a fulminating ulcer diathesis (12-hr
      secretion 2-3 liters), rapidly recurring ulceration despite adequate medical,
      surgical, and radiation therapy, and identification of a non-beta islet cell
      tumor of the pancreas. The non-beta islet cell was considered to be different
      from the cells producing insulinoma, which up to that time was thought to be the
      only type of islet cell tumor produced by the pancreas.

PMID- 1746877
TI  - [Lactitol in the treatment of constipation in the adult. Open, non-comparative
      study of its efficacy and its clinical and biological tolerance].
AB  - To study clinical and biological tolerability, 114 chronically constipated
      patients of both sexes, aged 18-70, without any organic alteration of the colon,
      received lactitol over a period of one or two months. Clinical tolerability was
      found to be good by 80 per cent of patients and biological tolerability
      excellent. Clinical efficacy was found correct for 80 per cent of patients with a
      dosage of 20 g (single dose in the evening). All patients, except one, agreed
      with the packaging and the taste of the product.

PMID- 1746878
TI  - Effect of mitomycin C and bromodeoxyuridine on Fanconi anemia lymphocytes.
AB  - The authors studied the effect of mitomycin C (MMC) and bromodeoxyuridine (BrdU)
      on the induction of chromosome aberrations on lymphocytes of four patients with
      Fanconi anemia (FA) and of one normal subject. A control culture and six
      experiments were designed to test the possible synergic effect of MMC and BrdU.
      Their results revealed no evidence of MMC-BrdU synergism on the induction of
      chromosome aberrations in FA lymphocytes. However, chromosomes showed more damage
      when FA cells were harvested 24 h after MMC stress than when cells were harvested
      shortly after treatment. This can be explained by a DNA repair defect or by a
      toxic effect of oxygenation of cells during the procedure.

PMID- 1746879
TI  - Pure 4p trisomy due to a de novo 4q;22p dicentric translocated chromosome
      karyotype 46,XX,-22,+t(4;22)(q1200;p13).
AB  - A de novo t(4;22)(q1200;p13) is reported in a girl with a florid 4p trisomy
      phenotype. The abnormal chromosome was identified by high resolution, C-bands and
      confirmed by 5-BrdU as de novo dicentric translocated chromosome.

PMID- 1746880
TI  - Segregation analysis of autosomal fragile sites in three families with the
      fragile X chromosome.
AB  - Fragile sites on chromosomes 9, at 9p21, 10, at 10q25 and 12, at 12q24, were
      found in the lymphocytes of some members of three families during the study for
      detection of a fragile X chromosome. The sites were found to be heritable and
      folato-sensitive. The genetic implications of these results are discussed.

PMID- 1746881
TI  - Four cases of trisomy 9p syndrome with particular chromosome rearrangements.
AB  - The authors present four children, two males and two females, with a 9p
      duplication, derived from various chromosome rearrangements, diagnosed using
      clinical, cytogenetic and biochemical evaluations. In particular, GALT dosage
      allowed them to define with accuracy the different chromosome break-points.

PMID- 1746882
TI  - Assessment of X bends in patients with atypical X chromosome phenotypes.
AB  - Several patients with X chromosome structural abnormalities have been more
      severely affected clinically than expected. Since bends at Xq13-21 have been
      associated with inactivation, the authors scored bends retrospectively in 62
      patients with X chromosome aneuploidy and 21 cases with structural abnormalities
      of the X chromosome. They found that patients with 2 X inactivation sites where
      one X was structurally abnormal had significantly fewer cells with X bends than
      normal 46,XX. In addition, these patients also showed X bends on the normal X
      more often than would be expected if non-random X inactivation of the abnormal X
      chromosome was occurring. Five of the 6 patients with a short or long arm
      deletion or paracentric inversion of Xq were mentally retarded or had other
      congenital anomalies not usually associated with Turner syndrome. This suggests
      to them that these clinical findings may be related to interference with X
      inactivation patterns in cells with a structurally abnormal X chromosome.

PMID- 1746883
TI  - Slide Flask direct amniotic fluid cultures.
AB  - Slide Flask direct amniotic fluid culture enabling: to decrease the risk of
      abnormalities caused by the technique itself, to facilitate laboratory work, to
      shorten culture time (8 to 13 days).

PMID- 1746884
TI  - Prune-belly anomaly and large interstitial deletion of the long arm of chromosome
      6.

PMID- 1746885
TI  - [Two novel reciprocal translocations involving chromosome 6 in the domestic pig].
AB  - In the present study 2 new reciprocal translocations are described in two
      hypoprolific boars. The first one, a Gascon/Meishan boar, has produced a mean
      value of 7.37 +/- 0.69 piglets, vs 12.41 +/- 0.22 piglets per litter in
      contemporaries. The second one, a Pietrain/Large-White boar, has produced a mean
      of 5.42 +/- 0.69 vs 12.41 +/- 0.22 piglets per litter in contemporaries. Each of
      these animals carries a new chromosome translocation involving chromosomes 6, 8
      and 15, respectively. The first translocation seems to be a de novo occurring
      abnormality. The economic consequences of these abnormalities are discussed.
      Carrier of the gene HAL, the abnormal chromosomes 6 involved in these
      translocations are important, and could useful markers in gene mapping and flow
      cytometry studies in pigs.

PMID- 1746886
TI  - [Frequency and distribution of aneuploidy in human gametes: differences as a
      function of sex].
AB  - The frequency and the distribution of aneuploidies were analysed in both
      spermatozoa and mature oocyte. The present study has pooled 13,975 human sperm
      chromosome complements and 1,897 oocyte chromosome complements examined to date.
      The overall frequency of aneuploidy is 10% in spermatozoa and 22.4% in oocytes.
      Human sperm is characterized by a significant excess of hypo-haploidies and an
      equitable distribution of aneuploidies among all chromosome groups, whereas
      mature oocytes display an equal ratio of hypo-haploidies: hyper-haploidies and a
      high variability in the distribution of non-disjunctions; in the A, B, C and
      especially in D and G groups, there is a significant difference between the
      observed and estimated rates of non-disjunction and the frequencies expected from
      an equal partitioning of non-disjunctions among all chromosomes. This indicates
      that non-disjunction is not a random event in female meiosis, and consequently
      that there are differences in the meiotic process between the sexes.

PMID- 1746887
TI  - Routine autoradiographic analysis of DNA excision-repair. Report of prenatal and
      postnatal diagnosis in eleven families.
AB  - DNA excision-repair of UV induced damages was investigated by unscheduled DNA
      synthesis and quantitative autoradiography. The method has been routinely used on
      lymphocytes for postnatal diagnosis of xeroderma pigmentosum and PIBIDS syndrome.
      Ten XP-families including 13 clinical XP patients and 9 XP-risk children, and one
      family with one clinical PIBIDS case and one PIBIDS-risk child were screened.
      Each of the 14 affected patients were biologically ascertained with a significant
      excision-repair defect. Among the 9 XP-risk children without clinical
      manifestations, the DNA excision-repair was defected in 4 cases considered as
      biological XP, and normal in 5 cases considered as biologically normal subjects.
      Likewise the PIBIDS-risk child exhibited a normal excision-repair. According to
      the age of the XP or PIBIDS-risk children, and the delay of appearance of
      clinical manifestations, the method should not present neither false positive nor
      false negative results and allows the infraclinical diagnosis. The protocol was
      extended for prenatal diagnosis on amniocytes and fetal cord blood. Excision
      repair analysis on normal cultivated chorionic villi cells has been performed
      allowing a further first trimester prenatal diagnosis.

PMID- 1746888
TI  - Lethal progeroid syndrome with osteolysis. Case report.
AB  - A particular progeroid syndrome with severe acro-osteolysis, cutaneous changes,
      failure to thrive, and early death is described in a young boy. Progeria and
      mandibulo-acral dysplasia are discussed, but early death is unusual in these two
      syndromes. This observation raises the question of a large spectrum including all
      of these syndromes.

PMID- 1746889
TI  - Interstitial deletion of 16(q13q22) in a newborn resulting from a paternal
      insertional translocation.
AB  - A dysmorphic newborn showed an interstitial deletion of the long arm of a
      chromosome 16 due to a balanced paternal insertional translocation
      46,XY,ins(14;16)(q23;q13q22). The insertion was confirmed by chromosomal in situ
      suppression (CISS-) hybridization. Clinical features considered to be typical for
      a 16q- phenotype are demonstrated in this patient. Similar observations described
      in the literature are compared and discussed with reference to the phenocritical
      region.

PMID- 1746890
TI  - Ring chromosome 8 associated with microcephaly.
AB  - A two-year-old mental defective girl with microcephaly and minor dysmorphic
      features had a 46,XX,r(8) karyotype. Low birth weight, short stature, and mental
      retardation were common features in the four known patients with r(8).

PMID- 1746891
TI  - Ring chromosome 14 syndrome. Report of two cases, including extended evaluation
      of a previously reported patient and review.
AB  - A case of r(14) chromosome is described and new information is added to a
      previously reported patient. The r(14) syndrome is reviewed on the basis of 37
      known patients. The major features include prenatal and postnatal growth
      retardation, mental retardation, seizures, microcephaly, and distinct facial
      dysmorphism, including elongated face, narrow palpebral fissures, epicanthus, and
      broad nasal bridge. Other characteristic anomalies found only in some patients
      are retinal anomalies, lymphoedema of hands and feet, and prones to pulmonary
      infections.

PMID- 1746892
TI  - Pericentric inversion of the X chromosome: presentation of a case and review of
      the literature.
AB  - A large pericentric inversion of the X chromosome [inv(X)(p22.31q26.3)] was found
      to be transmitted in four generations through phenotypically normal males and
      females. In one female carrier, the inv(X) was late replicating in 70% of
      lymphocytes and 46% of skin fibroblasts. Steroid sulfatase (STS), an enzyme which
      normally escapes inactivation has been located to Xp22.32 and, in our case, has
      been moved to an aberrant position. We have assayed its activity in clones with
      the inv(X) inactive or the normal X inactive and found no significant
      differences. Thus, the STS locus escaped X inactivation in both the normal and
      the inverted X chromosomes. A review of the literature shows that almost half of
      the breakpoints on the short arm are found at region p22 and we propose that low
      copy repetitive DNA segments along the X chromosome are responsible for non
      homologous pairing and production of inversions.

PMID- 1746893
TI  - A peptide from the GAP-binding domain of the ras-p21 protein and azatyrosine
      block ras-induced maturation of Xenopus oocytes.
AB  - The ras-oncogene-encoded p21 protein causes malignant transformation of NIH 3T3
      cells and maturation of Xenopus oocytes when microinjected into these cells. P21
      is known to interact with GTPase activating protein (GAP) intracellularly.
      Residues 32-45 of p21 have been implicated in interacting with GAP. In a previous
      study, we demonstrated that a synthetic peptide containing residues 35-47 from
      the GAP-binding region of p21 could block in vivo the effects of oncogenic p21
      protein. It has also been found that an antibiotic, azatyrosine, blocks ras
      initiated cell transformation. We now demonstrate that both of these agents
      inhibit the ras-p21 protein-induced maturation of Xenopus oocytes in a dose
      related manner when microinjected into oocytes. The effects of each of these
      agents is specific. Both agents block insulin-induced maturation of oocytes, a
      process which is known to involve activation of endogenous normal p21 protein. On
      the other hand, neither agent inhibited oocyte maturation induced by
      progesterone, which is known to initiate oocyte maturation by ras-independent
      pathways. The inhibitory effects of the peptide were not mimicked by a control
      peptide from the CD4 receptor protein. Furthermore, the effect of azatyrosine was
      not mimicked by L-tyrosine. These results suggest that both the peptide and
      azatyrosine have potent anti-ras effects intracellularly.

PMID- 1746894
TI  - Distribution, DNA damage and cytotoxic effects of etoposide in human tumor
      xenografts in vivo.
AB  - Mechanisms of resistance to VP-16 in vivo were studied using sensitive and
      multidrug resistant human breast tumor (MCF-7) cells, implanted bilaterally in
      nude mice. Administration of VP-16 (40 mg/kg, i.p.) indicated that there were no
      significant differences in either accumulation and retention of VP-16 or in the
      drug-induced bulk DNA damage in sensitive or resistant solid xenografts.
      Furthermore, under these conditions, no differential cytotoxic response to VP-16
      was observed in solid tumors.

PMID- 1746895
TI  - Clinical evaluation of the new tumor marker TAG-72.
AB  - Tumor-associated glycoprotein-72 (TAG-72) is a high molecular weight glycoprotein
      found in the sera of patients diagnosed with gastrointestinal and other
      malignancies. TAG-72 was detected in the serum of a significant percentage of
      patients whose CEA levels were negative which underscores the possibility of
      exploiting the complementarity of the two tumor markers in the diagnosis of
      gastrointestinal (G.I.) carcinoma. Moreover, the measurement of TAG-72 may also
      be clinically useful in discriminating malignant from benign effusions. Serum TAG
      72 and CEA levels were evaluated longitudinally in a series of patients following
      resection of primary G.I. carcinomas. A consistent relationship between efficacy
      of the surgery and serum TAG-72 clearance was observed, and TAG-72 alone or in
      combination with CEA accurately predicted recurrence of malignant disease in
      greater than 90% of the patients. The results indicate that TAG-72 is a new human
      serum tumor marker which, measured alone or in combination with other well
      established markers, may improve the diagnosis and/or clinical management of
      malignant disease.

PMID- 1746896
TI  - Hypoxia and acidity increase the cytotoxicity of mitomycin C and carboquone to
      human tumor cells in vitro.
AB  - To clarify the influence of hypoxic and acidic environments on the cytotoxicity
      of mitomycin C (MMC) and carboquone (CQ), the cytotoxicity was assessed based on
      decreases in intracellular ATP levels of HeLa cells exposed to the drugs at
      various acidic pH (pH 5.8-6.8) and low oxygen tension (5% and 0% O2) in vitro.
      Hypoxia and acidity individually increased the cytotoxicity of MMC, although
      hypoxia no longer increased it under acidic conditions. On the other hand, the
      cytotoxicity of CQ was enhanced in the presence of hypoxic and acidic conditions,
      and even more so with their combination. We conclude that acidity is a
      determining factor and excels hypoxia in influencing the cytotoxicity of MMC and
      that these two factors act synergistically on CQ.

PMID- 1746897
TI  - The initial steps of tumor progression in melanocytic lineage: a histochemical
      approach.
AB  - Antigen expression was studied by immunohistochemistry in 133 human melanocytic
      skin lesions to gain insight into the initial steps of tumor development, i.e. in
      particular the change from melanocytes to benign nevi. We refer to the proposed
      progression model of Clark and co-workers. The following types of antigens were
      investigated: (i) intermediate filament antigens (vimentin), (ii) melanoma
      associated antigens (HMB-45, NKI/C3, MA-930, LS59), (iii) proliferation
      associated antigens (S-100, Ki67, Ro/SSA, calmodulin), (iv) progression
      associated antigens (HLA-DR, ICAM-1), and (v) basal membrane antigens (bullous
      pemphigoid antigen, laminin, fibronectin, collagen type IV). The intensity of
      expression and the topography of immunoreactive pigment cells were compared with
      the stage of tumor progression. Special attention was paid to the early steps of
      this process, i.e. the disturbance of the epidermal melanin unit and the
      development of melanocytic ("nevocellular")nevi. A dramatic shift of antigen
      expression (antigen types [i] to [v]) was noted in benign nevi compared with
      melanocytes. Nevi with cellular atypia disclosed a tendency towards an increased
      percentage of tumor cells reactive for melanoma- and progression-related antigens
      (types [ii] and [iv]). However, there was no clear cut level of distinction of
      antigen expression (types [i] to [v]) between benign and primary malignant
      melanocytic tumors. So-called dysplastic nevi resembled benign tumors or
      melanocytes rather than malignant melanoma. Metastatic melanoma of skin showed a
      relatively high number of Ki67-positive, cycling melanoma cells. The results have
      a bearing on the concepts of melanocytic nevus ontogenesis and "maturation". It
      appears that melanocytes lose maturity on their way down to the dermis in
      contrast to traditional concepts (Abtropfung); this might be of importance for
      our understanding of melanoma development in association with melanocytic nevi.
      Our findings are discussed with regard to Clark's model of tumor progression.

PMID- 1746898
TI  - p53 expression in cytologic specimens from benign and malignant breast lesions.
AB  - This study was undertaken to determine the expression of p53 gene in cytologic
      specimens from benign and malignant breast lesions. To detect p53 an
      immunocytochemical assay with p53 (pAb421) monoclonal antibody was used.
      Abnormalities in p53 expression were found in 19 out of 40 Fine Needle Aspiration
      (FNA) smears with infiltrating ductal breast carcinomas. Benign epithelial breast
      cells obtained from fibroadenomas, fibrocystic disease and smears from nipple
      discharge reacted negatively for p53 in 38 out of 39 cases. Moderate positive
      reaction, confined to a few clusters of epithelial cells, was observed in one
      smear of fibroadenoma with cellularity. The results recorded in this study show
      that no significant association was found between p53 staining and stage of
      disease, tumor size or nodal status and that the immunocytochemical assay
      represents a simple method for the detection of p53 associated proteins in breast
      lesions.

PMID- 1746899
TI  - A monoclonal antibody which discriminates between sub-types of astrocytoma.
AB  - A monoclonal antibody, M2, was produced by somatic cell hybridisation of
      splenocytes, from mice immunised with human fetal brain, with the murine myeloma
      cell line NS-1. Indirect immuno-peroxidase staining of formalin-fixed, paraffin
      embedded tissue sections showed that, whilst the monoclonal antibody gave a
      positive reaction with 32/39 astrocytomas from adult patients and 33/36 of
      children's astrocytomas of the adult histological type, only 17/39 of juvenile
      astrocytomas were stained. A Chi-squared test showed that the difference in
      staining between the two groups (adult versus juvenile) was highly significant (p
      less than 0.0001). In contrast, using a polyclonal antiserum to GFAP, a
      significantly larger proportion of juvenile astrocytomas than adult astrocytomas
      stained positively (p less than 0.05). Thus, whereas the distribution of GFAP
      accorded with the general finding that the degree of malignancy of a tumour
      correlates with the loss of cell type specific markers, the distribution of M2
      reactivity was similar to that of some oncogene products which increase with
      malignancy. From the flow cytometry data it is apparent that the antigen
      recognised by M2 is not cell cycle dependent.

PMID- 1746900
TI  - Implication of the ras and myc oncoproteins in the pathogenesis of mycosis
      fungoides.
AB  - In the present work, we studied the expression of the c-myc oncoprotein p-62 and
      the ras oncoprotein p-21 in the dermal cellular infiltrate of paraffin embedded
      skin specimens, obtained from patients suffering from Mycosis Fungoides and
      Sezary syndrome. Nineteen specimens from early stage Mycosis Fungoides, nineteen
      from advanced stage Mycosis Fungoides and four from Sezary syndrome were included
      in the study. The oncoprotein detection was achieved immunohistochemically, using
      the mouse monoclonal antibody myc 1-9E10 and the rat monoclonal antibody Y13-259
      for p-62 and p-21 respectively. Increased detection of both p-62 and p-21 in
      atypic lymphoid cells was shown in advanced stages of Mycosis Fungoides (third
      stage plaques and tumors) as compared to early stages (premycotic erythema,
      second stage plaques). In advanced stages, however, the percentage of P-62+
      atypic cells proved to be higher than that of p-21+ atypic lymphoid cells. The
      implication of increased p-62 and p-21 oncoprotein expression in the process of
      lymphomagenesis in cutaneous T-cell lymphomas is discussed.

PMID- 1746901
TI  - Predictive value of some clinical and pathological parameters on upper level
      axillary lymph node involvement in breast cancer.
AB  - The role of radical axillary dissection in breast cancer management is presently
      under discussion. In this study we have evaluated the relationship between the
      pattern of metastatic axillary lymph node involvement by level and some of the
      main prognostic factors (age of the patient, size, grading, estrogen receptor and
      progesterone receptor status of the primary tumor) in 185 patients with operable
      breast cancer. The III level appeared to be involved in 31 (16.8%) out the 108
      patients with axillary lymph nodes positive for metastases. A discontinuous
      pattern of axillary involvement (skip metastases) was observed in about 10% of
      cases. Logistic regression analysis of the data shows that only G3 is
      significantly correlated with the risk of III level invasion (p less than 0.05).
      We conclude that, at present, a selection of possible candidates for a less than
      radical axillary dissection is not as yet feasible. Since the risk for III level
      invasion cannot be sufficiently defined.

PMID- 1746902
TI  - Characterization of multiple cathepsin B mRNAs in murine B16a melanoma.
AB  - We have previously shown that the highly metastatic murine B16a melanoma
      expresses a high level of cathepsin B mRNA which is associated with three
      transcripts of 2.2, 4.0 and 5.0 kb, while in contrast only a single 2.2 kb
      cathepsin B RNA was detected in normal murine tissues. Using recombinant DNA
      techniques, cDNAs corresponding to these three transcripts have been isolated
      from a B16a melanoma cDNA library. Sequence analysis indicates that all three
      mRNA transcripts contain identical coding sequences for normal preprocathepsin B.
      However, the 4.0 and 5.0 kb transcripts contain unusually long extended 3'
      untranslated regions. These results suggest that the post-transcriptional
      processing pathway of the cathepsin B gene is modified in B16 melanomas. The
      results also indicate that the increased extracellular secretion of larger forms
      of cathepsin B by tumors is most likely due to post-translational mechanisms and
      does not involve alternative splicing or a coding mutation in the gene.

PMID- 1746903
TI  - Cancer growth and progression in the framework of comparative oncology. A new
      approach to cancer therapy.
AB  - The influence of comparative oncology is most timely in view of the fact that
      there are significant intra- and interspecies differences in tumor development,
      tumor behavior and tumor reaction to various types of treatment, chemotherapy,
      radiotherapy, immunotherapy and multimodality-therapy. A comparison of the
      diverse processes which occur under normal, physiological, neoplastic and
      therapeutic conditions will result in a clearer understanding of tumor growth and
      progression. Similarly, it can be applied for selection of suitable treatment by
      enriching our knowledge about the progression of neoplastic diseases. Such a
      course will also enhance a general acceptance of the value of comparative
      oncology.

PMID- 1746904
TI  - Effects of gossypol on the cell cycle phases in T-47D human breast cancer cells.
AB  - Since gossypol, a naturally occurring component of cottonseed oil, exhibits a
      broad spectrum of activities, we have examined it as an antitumor agent on breast
      cancer. The effects of different concentrations of gossypol on the T-47D human
      breast cancer cell cycle phases were studied using cytometric image processing on
      Feulgen stained nuclei. The proportion of cells at different cell cycle phases
      was determined by discriminate analysis of the image parameters and gave good
      classification ranging from 86 to 100%. Gossypol was found to increase the G0/G1
      fraction of the T-47D cells. This cell kinetic alteration by gossypol was shown
      to be dose dependent and reversible. Complete reversal of the effect of gossypol
      was observed after four days with a simple change to gossypol-free medium. The
      cells then progressed into S and G2/M phase, thus indicating that gossypol
      treated cells remain viable. Gossypol was shown to have a strong inhibitory
      effect on cellular proliferation in T-47D cells. It was also found that this
      agent is only toxic to cells at the highest dose tested (10 microM). The results
      of this study may be of clinical significance in the treatment of breast cancer,
      since gossypol shows strong antiproliferative properties.

PMID- 1746905
TI  - Chromosome and oncogene studies in human rectal and colon carcinomas.
AB  - Cytogenetic examinations of 48 rectal and 17 colon carcinomas and analyses of
      proto-oncogene activation on 67 of the former and 8 of the latter tumors were
      performed. Besides a general considerable heterogeneity of chromosome counts,
      some chromosomes were found to contribute non-randomly to hypersomies (# 2, 3, 7,
      9, 19, 20 and 6) and to hyposomies (# 14, 15, Y, 21, and 18) in this material.
      Chromosomal markers non-randomly involved breakpoint clusters on 17p11, 13q11,
      7p, 1p11, and 1p36 and on the centromeric regions of chromosomes 1, 8, 14, 15 and
      21. Cytogenetic equivalents of gene amplification ("double minutes") were present
      in only rather small cell fractions (less than 20%) of 50% of the studied tumors.
      Using a cDNA technique and a battery of respective probes, proto-oncogene
      overexpression was screened for in the tumor samples, but also in 24 samples of
      inconspicuous mucosae of tumor patients and in two mucosae of healthy
      individuals. Simultaneous overexpression of several proto-oncogenes was the most
      characteristic finding in the tumor cells. However several of the mucosa samples
      obtained from tumor patients also just exhibited clear signals of proto-oncogene
      overexpression, which were not found in epithelial cells from non-tumor patients.

PMID- 1746906
TI  - Loss of heterozygosity at selective sites on chromosomes 13 and 17 in human
      breast carcinoma.
AB  - Four chromosomal regions were tested for loss of constitutional heterozygosity in
      primary tumours from 85 Icelandic breast cancer patients. Loss of heterozygosity
      and other types of gene rearrangements were observed in 37% of informative cases
      at the retinoblastoma locus, RB1, on chromosome 13q. Allele losses on chromosome
      17 were tested with two polymorphic probes on 17p and two on 17q. Loss of
      heterozygosity or other types of genetic rearrangement were detected in 43.5% of
      cases on 17p near the p53 gene and 40.5% on 17q. In our study abnormalities at
      the RB1 locus and on chromosome 17 frequently occurred together, indicating that
      the coincident inactivation of more than one tumour suppressor gene may, in some
      cases, play a part in tumour formation. No significant correlation was found
      between these losses and clinico-histological parameters. Family history of
      breast cancer was found to be more common among patients with RB1 deletions and
      this trend was strengthened in cases where there were deletions at both the RB1
      locus and on chromosome 17.

PMID- 1746907
TI  - Determination of TNF alpha, interferon alpha, interleukin 2 and reactivity in the
      leucocyte migration inhibition test in breast cancer patients.
AB  - To date, the results concerning the prognostic importance of parameters of cell
      mediated immunity in breast cancer patients are very contradictory; moreover, in
      most of them the results are hardly comparable due to methodological differences
      and heterogeneous groups of patients. In 123 patients with nonmetastatic breast
      carcinoma TNF alpha, INF alpha, IL 2 and reactivity in the leucocyte migration
      inhibition test (LMI-Test) against autologous tumor tissue were determined and
      the results correlated with the clinical course of the disease up to a maximum of
      108 months. In breast cancer patients TNF alpha-serum levels were significantly
      (p less than 0.05) elevated compared to healthy controls. We also found that
      patients with progressive disease had higher levels than patients without
      recurrences. There were no differences concerning the IL-2 and IFN alpha serum
      levels between cancer patients and controls, nor did we find a correlation with
      the clinical course of the disease. In 38% of all breast cancer patients
      examined, a MIF production against tumor tissue could be demonstrated in the LMI
      test. There was no difference concerning the LMI-reactivity between the groups of
      lymph-node negative and positive patients, but the observation that those
      patients with an unfavourable clinical course respond more frequently with an
      enhanced macrophage migration and rarely with migration inhibition was considered
      of notable prognostic significance. According to these results, it is possible
      that determination of TNF alpha and delayed type hypersensitivity reaction
      against tumor tissue in the LMI-test is of clinical value for the determination
      of risk groups.

PMID- 1746908
TI  - Cremophor EL inhibits 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced protein
      phosphorylation in human myeloblastic leukemia ML-1 cells.
AB  - Cremophor EL, a polyloxyethylene castor oil derivative used clinically as a
      parenteral vehicle, inhibits protein kinase c activity in vitro. The tumor
      promoting agent TPA (12-0-tetradecanoylphorbol-13-acetate) activated protein
      kinase C and induced phosphorylation of cellular proteins of human myeloblastic
      leukemia ML-1 cells. Polypeptides of 56 KDa, 44 KDa, 37 KDa, 35 KDa and 31 KDa
      were particularly phosphorylated in response to TPA activation. However, the
      phosphorylations of these polypeptides, especially that of 37 KDa, were greatly
      reduced by treatment of the TPA-activated ML-1 cells with Cremophor EL. Cremophor
      EL also inhibited the growth of ML-1 cells. On the other hand, the TPA-induced
      cell differentiation in ML-1, which is considered a separate event from protein
      kinase C activation, was not affected by Cremophor EL. These studies suggest
      biological implications for the observed in vitro activity of Cremophor EL. The
      studies may also provide a mechanism for the Cremophor EL-associated
      cytotoxicities observed when it is used clinically as a parenteral vehicle.

PMID- 1746909
TI  - Expression analysis of EGF-R and TGFa in human ovarian carcinomas.
AB  - Differences in the tumor biology of ovarian carcinomas probably influence
      operability and response to chemotherapy which are the most relevant prognostic
      factors. The phenotype of different malignant epithelial tumors including ovarian
      carcinomas is obviously associated with an activation of the EGF/TGFa signal
      pathway. When we analysed the expression of EGF-R and TGFa with biochemical,
      molecular-chemical and immunohistochemical methods in 29 different ovarian
      carcinomas, we found a correlation between the mRNA and protein levels of EGF-R
      as well as TGFa for tumors with low or high expressing rates. However, the
      concentration of measurable free EGF-Rs seems to depend on the amount of TGFa
      expression by the tumors. The EGF-R binding ligand TGFa is produced by the tumor
      cells; stromal cells are TGFa negative as shown by immunohistochemistry. By the
      use of an immunostaining index the TGFa protein concentration was measured
      semiquantitatively, classifying tumors according to their TGFa production rate.
      The comparison of TGFa mRNA amounts and staining index supports the hypothesis
      that TGFa is modified posttranslationally. EGF-R or TGFa expressing ovarian
      carcinomas had a high response rate to chemotherapy, whereas the EGF-R or TGFa
      negative tumors mostly exhibit a no change or progressive disease behaviour.
      These findings are the basis for our assumption that ovarian carcinomas with the
      basis for our assumption that ovarian carcinomas with an activated EGF-TGFa
      system are tumor biologically different compared to the EGF-R/TGFa negative
      tumors.

PMID- 1746910
TI  - Induction of tumor degeneration by sodium benzylideneascorbate.
AB  - Intravenous administration of sodium benzylideneascorbate (SBA) rapidly
      necrotized inoperable human lung cancer, and induced degeneration of 3'-methyl-4
      dimethylaminoazobenzene-induced rat hepatocellular carcinoma (vacuolar,
      eosinophilic degeneration, nuclear debris) without affecting the serum glutamic
      oxaloacetic transaminase, gamma-glutamyl transpeptidase and total protein levels.
      Cultured normal human lung and skin fibroblasts, and human glioma and
      glioblastoma cell lines were relatively resistant to SBA, when compared to human
      myelogenous leukemic cell lines. SBA had no apparent host immunopotentiation
      activity such as stimulation of cytokine action or production; activation of
      monocyte or polymorphonuclear cells; or modulation of poly (ADP-ribose)
      glycohydrolase activity. The data suggest that the antitumor activity of SBA
      might be produced by direct action of authentic SBA or its metabolized form(s),
      rather than by immunopotentiation of the hosts.

PMID- 1746911
TI  - Dipyridamole potentiates adriamycin cytotoxicity by a mechanism other than
      inhibiting nucleoside uptake.
AB  - Nitrobenzylthioinosine (NBTI) and dipyridamole (DP) are competitive inhibitors of
      cellular nucleoside uptake. Although combined treatment of HeLa cells with
      adriamycin (ADM) and DP enhanced ADM cytotoxicity in cell growth and clonogenic
      assays, the combination of ADM and noncytostatic levels (less than 1 microM) of
      NBTI did not change the cytotoxic potential of ADM in vitro. DP enhanced the
      inhibition of clonogenicity by ADM, even in nucleoside-enriched mediums. These
      results suggest that the synergy between ADM and DP was hardly due to the
      inhibition of nucleoside uptake by DP, but was due to the enhancement of
      intracellular ADM accumulation by DP.

PMID- 1746912
TI  - Cepharanthine potentiates the antitumor effect of methylglyoxal bis
      (cyclopentylamidinohydrazone) on human leukemia cells.
AB  - Antiproliferative effects of cepharanthine, a biscoclaurine alkaloid, in
      combination with methylglyoxal bis (cyclopentylamidinohydrazone) (MGBCP), an
      inhibitor for polyamine biosynthesis, were investigated. The antitumor activity
      of MGBCP on human leukemic cells was potentiated by cepharanthine. Cellular
      polyamine levels in the leukemic cells treated with both MGBCP and cepharanthine
      were much lower than those of the cells treated with MGBCP alone. On the
      contrary, the cellular MGBCP concentration was much higher in the cepharanthine
      treated leukemic cells. Thus cepharanthine was considered to enhance the
      incorporation of MGBCP into the leukemic cells. The combination of MGBCP and
      cepharanthine resulted in a greater suppression of macromolecule synthesis in the
      cells that might have caused the greater suppression of tumor cell growth.

PMID- 1746913
TI  - Efficacy of pentoxifylline as a modulator of alkylating agent activity in vitro
      and in vivo.
AB  - Pentoxifylline, a methylxanthine that is used to treat veno-occlusive disease,
      can increase perfusion in undervascularized tissues. Addition of high
      concentrations, like caffeine, causes progression through radiation or drug
      induced G2 phase blocks, thereby limiting time for repair of DNA breaks and
      crosslinks. We have examined the potential of pentoxifylline to augment the
      effects of antitumor alkylating agents in vitro and in vivo. In MCF-7 human
      breast cancer cells in vitro, pentoxifylline (2 mM) present for 24 h was only
      slightly cytotoxic (approximately 10% cell kill at 2 mM), but when present prior
      to and during AA it increased the cytotoxicity of CDDP by 2 logs at 250 microM.
      With L-PAM in vitro, pentoxifylline was much less effective and only at a
      concentration of 250 microM L-PAM did 2 mM pentoxifylline increase cytotoxicity
      (approximately 0.3 logs). In the FSaIIC murine fibrosarcoma system, 100 mg/kg of
      pentoxifylline i.p. immediately prior to the alkylating agent or 50 mg/kg x 5 of
      pentoxifylline over 24 h with the alkylating agent given immediately after the
      third dose increased the tumor cell kill achieved by CDDP, carboplatin,
      cyclophosphamide, and thiotepa. The increase in tumor cell killing was modest
      (2.9-fold). Pentoxifylline in the multiple dose regimen (50 mg/kg x 5 over 24 h)
      was more effective than in the single dose (100 mg/kg) protocol. In the EMT6
      mouse mammary adenocarcinoma, pentoxifylline (100 mg/kg daily x 5) improved the
      tumor growth delay produced by CDDP (3.3 mg/kg alternate days x 3), carboplatin
      (25 mg/kg daily x 5), cyclophosphamide (100 mg/kg alternate days x 3) and
      thiotepa 5 mg/kg (daily x 5). Only with cyclophosphamide, however, did the
      interaction appear to be large, as a 2.4-fold increase was observed.

PMID- 1746914
TI  - Control of the growth of leukemic cells (L1210) through manipulation of trace
      metals.
AB  - Trace metals have a role in the activity of the enzyme ribonucleotide reductase
      (RR) which is essential for the synthesis of DNA and the growth of lymphocytes.
      Manipulation of the intracellular metals of leukemic cells has been proposed for
      the therapeutic control of cell growth. We studied the effects of prolonged metal
      deprivation (Fe, Cu, Zn) on cell growth and RR activity of murine leukemic
      lymphocytes in culture in metal-depleted media. Intracellular metals, cell growth
      and RR activity were decreased in related and interdependent ways. A metal
      chelator (deferoxamine, DFX) had similar effect. In all cases these effects were
      reversible by metal supplementation. We conclude that it is possible to control
      RR activity and growth of leukemic cells in vitro by exposing them to a metal
      poor environment (eg. through the action of a chelator). These effects are not
      permanent, but might be beneficial if integrated with more conventional measures
      (chemotherapy).

PMID- 1746915
TI  - Monoclonal antibody characterization of sarcoma-associated antigen p102.
AB  - A membrane protein of Mr 102,000 Da (p102) was detected in 51 out of 53 human
      sarcomas, using a murine IgG1 monoclonal antibody 23-26. Antigen expression in
      sarcoma histologic subtypes appeared dependent on the amount of fibrous tissue
      matrix present in the original specimen. High levels of p102 antigen were also
      found in all sarcoma, carcinoma cell lines and neonatal skin fibroblasts tested.
      Low levels of p102 were also expressed in membranes from some specimens of
      melanoma, lung and colorectal carcinoma, first trimester fetus, fat, lung and
      liver while skin specimens expressed slightly higher levels of antigen. Lectin
      affinity absorption indicated p102 was mannose containing glycoprotein,
      isoelectric point (pI) 4.7 and affinity constant of 2.3 x 10(9) M-1, with 5.9 x
      10(5) binding sites per cultured human HT-1080 fibrosarcoma cell. The
      overexpression of p102 in sarcomas and other neoplastic tissues suggests that
      this protein may be associated with the neoplastic state.

PMID- 1746916
TI  - Effects of various growth factors on growth of a cloned human esophageal squamous
      cancer cell line in a protein-free medium.
AB  - In order to investigate molecular mechanisms of the growth of human esophageal
      cancer in relation to growth factors, we have recently established a protein-free
      culture system [Ham's F-12: Eagle's minimum essential medium (1:1, v/v)] of TE-3
      OS cells (a cloned cell line from human esophageal squamous cancer, TE-3). In the
      present study, we first examined effects of exogenous growth factors on the
      growth of TE-3-OS cells. The growth of TE-3-OS cells in the protein-free medium
      was significantly stimulated by insulin and insulin-like growth factor (IGF)-I or
      IGF-II, and less effectively stimulated by epidermal growth factor (EGF) or
      transforming growth factor (TGF)-alpha; platelet-derived growth factor, TFG-beta,
      acidic fibroblast growth factor (FGF) or basic FGF had no effects. TE-3-OS cells
      contained specific IGF-I binding sites (110,000 sites/cell), with a Kd value of
      800 pM. Moreover, the growth induced by IGF-I, IGF-II or insulin was markedly and
      similarly (70-80%) inhibited by anti-IGF-I receptor antibody IgG. These data
      suggest that IGF-I, IGF-II and insulin, as well as EGF and TGF-alpha, are
      important mitogens for human esophageal cancer cells and that effects of IGFs and
      insulin are mediated predominantly via IGF-I receptors.

PMID- 1746917
TI  - Relationship of the epidermal growth factor-receptor to the growth fraction (Ki
      67 antibody) and the flow cytometric S-phase as cell kinetics parameters, in
      human mammary carcinomas.
AB  - Epidermal growth factor (EGF) has been shown to have a mitogenic effect on some
      breast cancer cells lines in vitro. The growth of the subclass of human breast
      tumors which expresses the specific receptor for EGF seems to be mediated by
      autocrine mechanisms rather than steroid hormones. The expression of EGF
      receptor, as detected by an immunocytochemical method, was compared with the
      Growth Fraction (GF) by the Ki-67 monoclonal antibody and the S-phase content as
      tumor proliferative activity indexes, and with DNA ploidy and some pathologic
      features in 86 stage I-II breast carcinomas. Overall 52 out of 86 (60%) of the
      tumors were EGF-receptor positive. There was no correlation between the cell
      kinetics parameters and the EGF-receptor status, suggesting that its expression
      may be unrelated to the proliferative activity of the tumor in these clinical
      stages and that the EGF-receptor GF and S-phase may be independent variables in
      breast cancer. In our series 57% of tumors were DNA aneuploid and only a trend
      was found towards EGF-receptor positivity (P = 0.08). There was no correlation
      between EGF-receptor expression and grading or node-status. The overall picture
      is that of an independent relationship between EGF-receptor with the cell
      kinetics parameters and ploidy, confirming the complex and heterogeneous biology
      of breast carcinoma. These results suggest the possibility of better recognition
      of subsets of patients with diverse tumor aggressiveness, combining together EGF
      receptor status, cell kinetics and ploidy, with a better stratification for
      treatment options.

PMID- 1746918
TI  - Induction of c-myc oncoprotein and of cellular proliferation by radiation in
      normal human urothelial cultures.
AB  - Normal urothelial cultures were established from transplant ureters and
      irradiated or exposed to nitrosamines. The cells which survived the treatment
      were monitored for expression of c-myc oncoprotein. The cultures were also
      exposed to tritiated thymidine (3HTdR) to determine the total number of cells
      synthesizing DNA. The area of explant outgrowth was also measured. Proliferation
      is considered to be a fundamental precondition which has to be present before
      malignant change can take place or which has to accompany this change. The
      results indicate that the overall growth rate of the carcinogen-treated cultures
      is relatively faster than that of the controls. This is particularly true one to
      two weeks after carcinogen exposure. Certain areas of the culture develop
      abnormally, cells are different in size and shape to the normal uroepithelial
      cell and have the capacity to pile up and form characteristic foci. These foci
      continue to proliferate after senescence of control cultures and after senescence
      of normal areas of treated cultures. The cells in these foci express high levels
      of c-Myc oncoprotein. Control and treated but normal cells are negative for this
      antigen under the conditions used. N-ethyl nitrosamine (NEN) (0.005-0.05
      micrograms/ml) and radiation (2.5-10.0 Gy) are both able to induce the changes
      described. The results suggest that radiation and/or nitrosamine treatment can
      induce uroepithelial cells to divide at a faster rate than usual. Certain cells
      within this fast growing culture attain the capacity to pile up and acquire a
      different morphology. These cells do not senescence at the usual time and are c
      myc positive. They may represent a subpopulation which has undergone some pre or
      early malignant changes.

PMID- 1746919
TI  - A feasibility study of cisplatin administration with low-volume hydration and
      glutathione protection in the treatment of ovarian carcinoma.
AB  - Glutathione (GSH) is a sulfur-containing nucleophile that protects against
      cisplatin-induced renal toxicity without reducing the antitumor activity of the
      cytotoxic agent. To document further the clinical role of GSH in improving the
      outcome of cisplatin-containing regimens, the feasibility of the GSH/cisplatin
      combination using a low-volume hydration protocol was evaluated in untreated
      ovarian cancer patients. Twelve patients at stage III (minimal residual disease)
      and 23 with localized disease at high risk for recurrence were treated with
      cisplatin (90 mg/m2, i.v. in 250 ml of normal saline over 30 min) and
      cyclophosphamide (600 mg/m2 i.v.) every 3 weeks. GSH (5 g in 200 ml of normal
      saline) was administered by a short-term infusion (15 min) prior to cisplatin.
      The hydration protocol consisted of 1 liter of fluids without diuretics. The
      treatment was well tolerated; no nephrotoxic or neurotoxic manifestations were
      observed. The renal excretion of cisplatin (23%) at 24 hours following infusion
      was lower than expected using a standard i.v. hydration protocol. No reduction of
      renal elimination of cisplatin could be detected in subsequent courses, thus
      suggesting a minimal degree of impairment in renal function. In the series of
      evaluable patients (11) with stage III disease, 9 had complete pathological
      response. In the series of patients with no clinically detectable disease
      initially, all were disease-free at treatment completion. Taken together with
      previous observations, these results support the view that the use of GSH is a
      successful approach in the attempt to optimize cisplatin treatment, providing a
      new modality of drug administration for out-patient treatment.

PMID- 1746920
TI  - Conservative surgery and irradiation (QUART) in the treatment of 243 stage I-II
      breast cancer patients.
AB  - From 1980 to 1987, 243 evaluable patients with pT1, pT2 (less than 3 centimeters
      in diameter), N0, M0, invasive breast cancer were treated with "quadrantectomy"
      with axillary dissection followed by electron beam radiation therapy (QUART) at
      the St. Bortolo Hospital, Vicenza. Stage II patients received adjuvant
      chemotherapy (CMF) if preperimenopausal or hormonotherapy (tamoxifen) if
      postmenopausal. The median follow-up was 54 months (26 to 116 months). The 4.5
      year overall survival (OS) and disease-free survival (DFS) were respectively 91%
      and 85%; the 10-year actuarially estimated OS and DFS was 77%. Thirty-three
      patients relapsed, 11 of whom had local recurrence, and 23 developed distant
      metastases. A significantly longer OS and DFS were observed in stage I versus
      stage II (p = 0.0008) and in pT1 versus pT2 (p = 0.001) tumors. No difference was
      found regarding menopausal status and histotype. The local control of disease was
      very high (95.5%), with a significantly higher local recurrence rate in
      premenopausal women compared to postmenopausal (10/117 versus 1/126; p = 0.009).
      Tumor size did not influence the frequency of local recurrence. No major
      complications occurred but a significantly higher rate of reversible radiation
      pneumonitis occurred in patients treated with higher energies of electrons (17 to
      20 MeV) compared with lower (6 to 13 MeV) (33/177 versus 7/66; p less than 0.05).
      Cosmetic results were judged as excellent in 20%, satisfactory in 68%,
      unsatisfactory in 6% and not evaluable in 6% of cases. We conclude first, that
      small pT2 breast carcinomas may also be safely treated with QUART, second, that
      the electron beam is a radiotherapeutic technique able to produce a good cosmetic
      result and to assure a satisfactory local control and, finally, that the use of
      tamoxifen in postmenopausal stage II breast carcinomas is safe and easy to
      combine with radiotherapy in the conservative management of early breast cancer
      due to the lower toxic effects, compared to those observed in premenopausal women
      treated with chemotherapy.

PMID- 1746921
TI  - Intraperitoneal chemotherapy with carboplatin and interferon alpha in the
      treatment of relapsed ovarian cancer: a pilot study.
AB  - In ovarian cancer patients intraperitoneal chemotherapy confers pharmacokinetic
      advantages and appears an attractive way to improve the efficacy of certain
      antineoplastic agents. Intraperitoneal carboplatin and interferon alpha have been
      separately evaluated in ovarian cancer "with promising results". We report a
      phase I-II pilot trial of intraperitoneal carboplatin 400 mg/sqm plus interferon
      alpha 25 x 10(6) U q 28 d in 16 patients (pts) previously treated with
      intravenous cisplatin based chemotherapy. All the patients had relapsed (11 pts)
      or refractory (5 pts) disease; residual tumors were less than 2 cm in 10 pts and
      greater than 2 cm in 6 pts. Local and general toxicities were moderate, with
      neither WHO grade 4, nor neurotoxicity and ototoxicity. Myelotoxicity was the
      most frequent side effect. Among 14 evaluable pts, objective responses were
      observed in 6 pts (42.8%) including 3 pts with pathologically confirmed complete
      response (21.4%); six more pts presented prolonged disease-free survival.
      Response occurred in both categories of pts with greater than or less than 2 cm
      residual disease, also in pts refractory to prior intravenous cisplatin. The
      proper role of intraperitoneal treatment cannot be exactly defined without large
      randomized trials designed to compare intraperitoneal to intravenous drug
      administrations.

PMID- 1746922
TI  - The significance of nuclear morphometric variables as prognostic predictors in
      breast cancer.
AB  - The preoperative biopsies from primary breast carcinomas of 504 women were
      subjected to interactive morphometric analysis of a) the mean nuclear area (NA),
      b) standard deviation of nuclear area (SDNA), c) mean area of the 10 largest
      nuclei (NAl0), d) nuclear perimeter (PE), e) standard deviation of nuclear
      perimeter (SPDE), f) largest nuclear diameter (Dmax) and g) shortest nuclear
      diameter (Dmin), h) histological grade and i) classical prognostic variables. The
      above data were correlated with the disease outcome during the mean follow-up
      period of 11.2 years. Tumor size (p less than 0.0001), morphometric variables (p
      = 0.0001-0.005) and histological grade (p = 0.03) predicted axillary lymph node
      metastasis at the time of diagnosis. According to multivariate analysis, tumour
      size and NA predicted the axillary lymph node metastasis independently. Axillary
      lymph node status (p less than 0.0001) and histological grade (p = 0.01)
      predicted the tumour recurrence and recurrence-free survival, whereas the
      morphometric variables had no significant predictive value. Axillary lymph node
      status (p less than 0.0001), tumour size (p less than 0.0001), histological grade
      (p = 0.0012) and morphometric variables (p = 0.003-0.035) predicted the disease
      related survival. Of the morphometric variables, NA and the Dmin were the two
      most important predictors of tumour-related survival in univariate analysis. Dmax
      had independent prognostic information in multivariate survival analysis. In the
      same analysis, tumour size and axillary lymph node status were more important
      predictors. In conclusion, the morphometric variables analysed have independent
      predictive value in female breast cancer. Their value is, however, inferior to
      that of the tumour size and axillary lymph node status, but equal to that of the
      histological grade.

PMID- 1746923
TI  - [Interferon and interleukin 2 in metastatic cancer of the kidney. Apropos of 18
      cases].
AB  - Eighteen patients with advanced renal cancer received a combination of IFN alpha
      10 x 10(6) U/m2/Day (D) x 5D followed by Interleukin 2 (IL2) 18 x 10(6) UI/m2/D x
      5 D. The median follow-up is 10 months. Four partial responses were observed
      lasting 7 to 13 months (22.2%). The clinical safety was satisfactory. The
      survival for responding patients is 12 months (median). The safety of treatment
      is an argument in favour of future trials in an attempt to demonstrate the
      benefit of combinations of biomodulators.

PMID- 1746924
TI  - Uretero-ileocecocapsuloplasty. Preliminary reports.
AB  - A uretero-ileocecocapsulaplasty and ileal patch operation was performed on seven
      patients following cystectomy. All the patients were carefully selected cases of
      unifocal T2, T3 vesical carcinoma localized at least 2-3 cm from the bladder
      neck. Vesical mapping and intraoperative histological examination of resection
      edges were negative. The operative technique is described together with early
      clinical and urodynamic findings.

PMID- 1746925
TI  - [Reversal of urinary diversion after radical surgery for rhabdomyosarcoma of the
      bladder].
AB  - The authors report a case of reversal of urinary diversion in a 14 year old boy
      who had presented, three years previously with an embryonal rhabdomyosarcoma of
      the base of the bladder. The initial treatment had consisted of preoperative and
      postoperative chemotherapy combined with radical cystoprostatectomy with urinary
      diversion via a colonic conduit. The principle of the technique of reversal of
      urinary diversion are discussed in the light of this unusual case.

PMID- 1746926
TI  - [Cancer of the prostate: curative radiotherapy preceded by lymphadenectomy in 20
      patients. Follow-up over 10 years].
AB  - Twenty patients with prostatic cancer were treated by external beam radiotherapy
      after ilioobturator lymphadenectomy. The patients could be divided into two
      groups: Group I: no lymph node invasion and Group II: presence of lymph node
      metastases. In Group I, only one death was due to cancer and the 6-year survival
      was 90%. In Group II, 7 deaths were due to cancer and the 6-year survival was
      20%. Secondary endocrine treated administered at the time of recurrence appeared
      to significantly prolong survival in comparison with the stage D1 cancers treated
      immediately by endocrine therapy.

PMID- 1746927
TI  - [Treatment trials of prostatic adenoma using local hyperthermia induced by
      microwaves].

PMID- 1746928
TI  - [Unusual tumors of the testis. Apropos of 22 cases].
AB  - The authors report their experience of rare non-germ-cell tumours of the testis
      over a period of 10 years. The criteria of benign disease, justifying testicular
      preservation in 5 out of 7 cases of epidermoid cysts, are defined. Four cases of
      Leydig cell tumours, including 3 with gynaecomastia, are described. Three cases
      of adenomatoid tumours with conservative surgery, 3 lymphomas, 2 mature teratomas
      and 2 cysts of the rete testis are also reported. The place of ultrasonography is
      defined and the possibility of conservative surgery is discussed in relation to a
      review of the recent literature.

PMID- 1746929
TI  - [Is sucrose a risk factor in calculus formation?].
AB  - The addition of sucrose to drinking water of rats at the rate of 2.5 or 5 grams
      per 100 ml, for one month, induced hypercalciuria which appeared to be dependent
      on the degree of supplementation. In spite of these disorders, calcium deposits
      were not observed in treated animals. This protection against renal calculi was
      probably due to high urinary excretions of magnesium, phosphorus, zinc and
      copper. These lithogenesis inhibitors varied, like oxaluria and calciuria, in
      parallel with dietary sucrose intake.

PMID- 1746930
TI  - A museum showcase. Developing a special OR nurse week project.

PMID- 1746931
TI  - Discharge instructions. Advice for knee, shoulder arthroscopy outpatients.

PMID- 1746932
TI  - Procuring a laser system.

PMID- 1746933
TI  - The nurse as an expert witness.

PMID- 1746934
TI  - Cardiopulmonary resuscitation drug therapy.

PMID- 1746935
TI  - Mandatory HIV testing cures no one.

PMID- 1746936
TI  - Goals, benefits, costs, member involvement with Project Teams.

PMID- 1746937
TI  - Situational leadership. A tool for OR staff development.

PMID- 1746938
TI  - Pediatric endoscopic sinus surgery. A new approach to chronic sinus disease.

PMID- 1746939
TI  - Tributyltin-resistant bacteria from estuarine and freshwater sediments.
AB  - Resistance to tributyltin (TBT) was examined in populations from TBT-polluted
      sediments and nonpolluted sediments from an estuary and from fresh water as well
      as in pure cultures isolated from those sediments. The 50% effective
      concentrations (EC50s) for populations were higher at a TBT-polluted freshwater
      site than at a site without TBT, suggesting that TBT selected for a TBT-resistant
      population. In contrast, EC50s were significantly lower for populations from a
      TBT-contaminated estuarine site than for those from a site without TBT,
      suggesting that other factors in addition to TBT determine whether populations
      become resistant. EC50s for populations from TBT-contaminated freshwater
      sediments were nearly 30 times higher than those for populations from TBT
      contaminated estuarine sediments. We defined a TBT-resistant bacterium as one
      which grows on trypticase soy agar containing 8.4 microM TBT, a concentration
      which prevented the growth of 90% of the culturable bacteria from these
      sediments. The toxicity of TBT in laboratory media was influenced markedly by the
      composition of the medium and whether it was liquid or solid. Ten TBT-resistant
      isolates from estuarine sediments and 19 from freshwater sediments were
      identified to the genus level. Two isolates, each a Bacillus sp., may be the
      first gram-positive bacteria isolated from fresh water in the presence of a high
      concentration of TBT. There was a high incidence of resistance to heavy metals:
      metal resistance indices were 0.76 for estuarine isolates and 0.68 for freshwater
      isolates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746940
TI  - Effects of time and watershed characteristics on the concentration of
      Cryptosporidium oocysts in river water.
AB  - Water samples were collected from four locations on two rivers in Washington
      State and analyzed by membrane filtration-immunofluorescence assay to establish
      Cryptosporidium oocyst concentrations. Sampling locations were selected to
      evaluate effects of watershed character, from pristine mountain to downstream
      agricultural, on oocyst concentrations. Samples were collected at six biweekly
      intervals from late June to early September, with two additional sets of five
      samples taken on separate days (one set taken at bihourly intervals and one set
      taken simultaneously). Cryptosporidium oocysts were found in 34 of 35 samples at
      concentrations ranging from about 0.2 to 65 oocysts per liter. Oocyst
      concentrations were highest early in the sampling period, when they were
      influenced by postrainfall runoff, and decreased through the summer months.
      Oocyst concentrations found in ten samples collected on two days (5 samples per
      day) showed no short-term variations. Oocyst concentrations and oocyst production
      per square mile (ca. 2.6 km2) of watershed found in water draining a controlled
      public water supply watershed were the lowest observed. The concentrations and
      production rates for drainage from an adjacent, comparable, but uncontrolled
      watershed were nearly 10 times higher. The concentration and production rates of
      the downstream area influenced by dairy farming were nearly 10 times higher than
      rates at the upstream stations. The data showed clearly that oocyst
      concentrations were consistently observed above the detection limit of the
      analytical method, about 0.1 oocysts per liter; that oocyst concentrations were
      continuous as opposed to intermittent; and that watershed character and
      management affected surface water oocyst concentrations significantly.

PMID- 1746941
TI  - Metabolic engineering of Klebsiella oxytoca M5A1 for ethanol production from
      xylose and glucose.
AB  - The efficient diversion of pyruvate from normal fermentative pathways to ethanol
      production in Klebsiella oxytoca M5A1 requires the expression of Zymomonas
      mobilis genes encoding both pyruvate decarboxylase and alcohol dehydrogenase.
      Final ethanol concentrations obtained with the best recombinant, strain M5A1
      (pLOI555), were in excess of 40 g/liter with an efficiency of 0.48 g of ethanol
      (xylose) and 0.50 g of ethanol (glucose) per g of sugar, as compared with a
      theoretical maximum of 0.51 g of ethanol per g of sugar. The maximal volumetric
      productivity per hour for both sugars was 2.0 g/liter. This volumetric
      productivity with xylose is almost twice that previously obtained with
      ethanologenic Escherichia coli. Succinate was also produced as a minor product
      during fermentation.

PMID- 1746942
TI  - Identification of putative insect brush border membrane-binding molecules
      specific to Bacillus thuringiensis delta-endotoxin by protein blot analysis.
AB  - Binding sites for insecticidal toxins of Bacillus thuringiensis are located in
      the brush border membranes of insect midguts. Two approaches were used to
      investigate the interactions of B. thuringiensis subsp. kurstaki HD-73 CryIA(c)
      toxin with brush border membrane vesicles from sensitive and naturally resistant
      insects: 125I-toxin-vesicle binding assays and protein blots probed with 125I
      CryIA(c) toxin. In bioassays, Manduca sexta and Heliothis virescens larvae were
      highly sensitive, Helicoverpa zea larvae were moderately sensitive, and
      Spodoptera frugiperda larvae were resistant to CryIA(c) toxin. Studies of binding
      of 125I-CryIA(c) toxin to brush border membrane vesicles from the larval midguts
      revealed that all insects tested had high-affinity, saturable binding sites.
      Significantly, S. frugiperda larvae bind but are not killed by CryIA(c) toxin.
      Labeled CryIA(c) toxin incubated with protein blots identifies a major binding
      molecule of 120 kDa for M. sexta and 148 kDa for S. frugiperda. H. virescens and
      H. zea are more complex, containing 155-, 120-, 103-, 90-, and 63-kDa proteins as
      putative toxin-binding molecules. H. virescens also contains a minor toxin
      binding protein of 81 kDa. These experiments provide information that can be
      applied toward a more detailed characterization of B. thuringiensis toxin-binding
      proteins.

PMID- 1746943
TI  - Intermediates and products of synthetic lignin (dehydrogenative polymerizate)
      degradation by Phlebia tremellosa.
AB  - Agitated, nitrogen-limited cultures of Phlebia tremellosa caused substantial
      changes in the distribution of 14C-labelled synthetic lignin (dehydrogenative
      polymerizate [DHP]) between water-soluble, dioxane-soluble, alkali-soluble, and
      insoluble fractions before much lignin carbon was metabolized to CO2. First, the
      insoluble form increased at the expense of the dioxane-soluble form. Later, the
      amounts of alkali-soluble and water-soluble 14C increased, and release of 14CO2
      began. The molecular weight distribution of the dioxane-soluble lignin remained
      constant during degradation, but that of the water-soluble fraction changed to
      higher molecular weights. Culture agitation accelerated the attachment of
      suspended DHP to the mycelia and stimulated production of water-soluble 14C and
      14CO2. The nonionic detergent Tween 80 also hastened release of 14CO2 and
      increased the early conversion of dioxane-soluble DHP to the alkali-soluble and
      insoluble forms. Oxidative polymerization is suggested as the first step in
      degradation of DHP by P. tremellosa.

PMID- 1746944
TI  - Transformation of 25- and 1 alpha-hydroxyvitamin D3 to 1 alpha, 25
      dihydroxyvitamin D3 by using Streptomyces sp. strains.
AB  - To enzymatically synthesize vitamin D derivatives, we screened about 300
      Streptomyces sp. strains. Streptomyces sclerotialus FERM BP-1370 and Streptomyces
      roseoporus FERM BP-1574 were found to have the ability to convert 25
      hydroxyvitamin D3 and 1 alpha-hydroxyvitamin D3, respectively, to 1 alpha, 25
      dihydroxyvitamin D3. The average rates of 1 alpha hydroxylation of 25
      hydroxyvitamin D3 were 6.9 micrograms liter-1 min-1 with FERM BP-1370 and 7.0
      micrograms liter-1 min-1 with FERM BP-1574. The specific cytochrome P-450
      inhibitors carbon monoxide, SKF-525-A, and metyrapone inhibited the hydroxylation
      of 1 alpha- and 25-hydroxyvitamin D3 to 1 alpha, 25-dihydroxyvitamin D3 by FERM
      BP-1370 and FERM BP-1574. The cytochromes P-450 of these strains were detected by
      reduced CO difference spectra in the whole-cell suspensions. The appearance of
      cytochrome P-450 suggests that the cytochromes P-450 of FERM BP-1370 and FERM BP
      1574 carry out the hydroxylation of 25- and 1 alpha-hydroxyvitamin D3 to 1 alpha,
      25-dihydroxyvitamin D3.

PMID- 1746945
TI  - Biodegradation of dichloromethane and its utilization as a growth substrate under
      methanogenic conditions.
AB  - Biodegradation of dichloromethane (DCM) to environmentally acceptable products
      was demonstrated under methanogenic conditions (35 degrees C). When DCM was
      supplied to enrichment cultures as the sole organic compound at a low enough
      concentration to avoid inhibition of methanogenesis, the molar ratio of CH4
      formed to DCM consumed (0.473) was very close to the amount predicted by
      stoichiometric conservation of electrons. DCM degradation was also demonstrated
      when methanogenesis was partially inhibited (with 0.5 to 1.5 mM 2
      bromoethanesulfonate or approximately 2 mM DCM) or completely stopped (with 50 to
      55.5 mM 2-bromoethanesulfonate). Addition of a eubacterial inhibitor (vancomycin,
      100 mg/liter) greatly reduced the rate of DCM degradation. 14CO2 was the
      principal product of [14C]DCM degradation, followed by 14CH4 (when methanogenesis
      was uninhibited) or 14CH3COOH (when methanogenesis was partially or completely
      inhibited). Hydrogen accumulated during DCM degradation and then returned to
      background levels when DCM was consumed. These results suggested that
      nonmethanogenic organisms mediated DCM degradation, oxidizing a portion to CO2
      and fermenting the remainder to acetate; acetate formation suggested involvement
      of an acetogen. Methanogens in the enrichment culture then converted the products
      of DCM degradation to CH4. Aceticlastic methanogens were more easily inhibited by
      2-bromoethanesulfonate and DCM than were CO2-reducing methanogens. When DCM was
      the sole organic-carbon and electron donor source supplied, its use as a growth
      substrate was demonstrated. The highest observed yield was 0.085 g of suspended
      organic carbon formed per g of DCM carbon consumed. Approximately 85% of the
      biomass formed was attributable to the growth of nonmethanogens, and 15% was
      attributable to methanogens.

PMID- 1746946
TI  - Degradation of organochlorine compounds in spent sulfite bleach plant effluents
      by actinomycetes.
AB  - Actinomycetes isolated from different soil samples were tested for their
      abilities to utilize spent sulfite bleach effluents from a paper mill.
      Degradation and dechlorination of the chlorinated compounds in the effluents of
      the first two bleaching stages, i.e., chlorination stage [(C + D)red.] and
      alkaline extraction stage (E1O), were monitored by determining total organic
      carbon (TOC) and activated-carbon-adsorbable organic-bound halogen (AOX). The
      isolates showed increased degradation rates after repeated incubations in the
      effluent-containing medium. Separation of the culture supernatants by
      ultrafiltration into three fractions of different molecular weights revealed
      substantial AOX and TOC reductions in the low-molecular-weight fraction. The AOX
      values of the higher-molecular-weight fractions were also reduced. Extracellular
      peroxidase and cell wall-bound catalase activities were produced during growth of
      the microorganisms on bleach effluents.

PMID- 1746947
TI  - Effect of 2-hydroxybenzoate on the maintenance of naphthalene-degrading
      pseudomonads in seeded and unseeded soil.
AB  - The addition of specific nontoxic inducers of catabolic operons to contaminated
      sites is an approach that may enhance the efficiency of in situ biodegradation.
      We determined the genetic response of six pseudomonads to salicylate (also known
      as 2-hydroxybenzoate) added directly to 50 g of nonsterile soil samples. The
      strains, isolated from a polyaromatic hydrocarbon-contaminated soil, metabolized
      naphthalene as the sole source of available carbon, and their DNA sequences show
      significant homology to the nahAB genes of the degradative plasmid NAH7.
      Duplicate nonsterile soil cultures were incubated for up to 30 days. Experimental
      soil cultures were seeded with naphthalene-degrading strains (10(8) CFU g-1)
      originally isolated from the soil and amended with salicylate (16 or 160
      micrograms g-1). Soil samples were analyzed periodically for the population
      density of heterotrophic bacteria and naphthalene degraders and for the abundance
      of the naphthalene-degradative genotype in the bacterial community. At 160
      micrograms g-1, salicylate sustained the density of naphthalene degraders at the
      introduced density for 30 days in addition to producing a two- to sixfold
      increase in the occurrence in the bacterial community of DNA sequences homologous
      to the nah operon. No change in recoverable bacterial population densities was
      observed when soil samples were amended with 16 micrograms of salicylate g-1, but
      this concentration of salicylate induced a significant increase in the level of
      nah-related genes in the population.

PMID- 1746948
TI  - Subcloning of bph genes from Pseudomonas testosteroni B-356 in Pseudomonas putida
      and Escherichia coli: evidence for dehalogenation during initial attack on
      chlorobiphenyls.
AB  - The bphA, -B, -C, and -D genes from Pseudomonas testosteroni B-356 were mapped to
      a 5.5-kb DNA fragment of cloned plasmids pDA1 and pDA2 by use of deletion and
      insertion mutants of these plasmids. The expression of each of these genes was
      evaluated in Escherichia coli and in Pseudomonas putida, and it was found that
      the bphC and bphD genes are well expressed in both E. coli and P. putida cells
      while the bphA and bphB genes are very poorly expressed in E. coli, even when
      placed downstream of a tac promotor. P. putida clones carrying the bphA gene were
      used to study the metabolites produced from 4,4'-dichlorobiphenyl, 2,2'
      dichlorobiphenyl, and 2,4'-dichlorobiphenyl. It was shown that dehalogenation of
      4-Cl and 2-Cl occurs in the course of the initial oxygenase attack on these
      molecules, which always occurs on carbons 2 and 3, independently of the positions
      of the chlorine atoms. Our data also suggest that in the case of
      polychlorobiphenyl congeners carrying chlorine atoms on both rings, it appears
      that, depending on the chlorine positions, dioxygenation will occur predominantly
      on one ring over the other. However, attack of the more resistant ring is not
      excluded, resulting in multiple conversion pathways.

PMID- 1746949
TI  - Site-specific mutagenesis method which completely excludes wild-type DNA from the
      transformants.
AB  - A highly efficient site-specific mutagenesis method has been devised to exclude
      wild-type DNA from incorporation into the transformed cells. Two complementary
      oligonucleotides, corresponding to a target sequence of a DNA molecule and
      containing an insertion mutation which created an endonuclease restriction site,
      were synthesized. By using the wild-type DNA molecule flanked by two restriction
      sites on each side of the target region as a template, the two oligonucleotide
      primers were extended, enriched, and isolated. The extended products, in turn,
      were used as templates in a polymerase chain reaction to obtain a mutagenized
      double-stranded DNA fragment which was conveniently cloned into plasmids by using
      the flanking restriction sites. Escherichia coli cells transformed by these
      plasmids were subject to large-scale analysis. One hundred percent of the
      transformants examined by colony hybridization, restriction enzyme analysis, and
      DNA sequencing were found to contain the mutant DNA sequence.

PMID- 1746950
TI  - 7-Mercaptoheptanoylthreonine phosphate substitutes for heat-stable factor (mobile
      factor) for growth of Methanomicrobium mobile.
AB  - Methanomicrobium mobile requires a heat-stable factor present in ruminal fluid
      and in boiled cell extract from Methanobacterium thermoautotrophicum for growth.
      By comparing the growth of M. mobile with boiled cell extract with that observed
      with various methanogenic cofactors, we found that 7-mercaptoheptanoylthreonine
      phosphate (HS-HTP) supported sustained growth of M. mobile, at an optimal
      concentration of 100 microM. No derivatives or possible biosynthetic precursors
      of HS-HTP could replace HS-HTP as the sole source of growth factor. Results
      suggest that the growth requirement might be satisfied by 7-mercaptoheptanoic
      acid plus a second, unidentified heat-stable factor.

PMID- 1746951
TI  - Expression of the Escherichia coli beta-glucuronidase gene in Pseudocercosporella
      herpotrichoides.
AB  - The plant-pathogenic fungus Pseudocercosporella herpotrichoides has been
      successfully transformed by using two different positive selection systems in
      combination with the Escherichia coli gusA gene. The selectable markers used in
      this study were the hygromycin B phosphotransferase gene (hph) from E. coli and
      the gene (bml) for beta-tubulin from a benomyl-resistant mutant of Neurospora
      crassa. A lower transformation rate was obtained with the bml system than with
      the hph system. Conversely, cotransformation frequencies, as determined with
      medium plates containing the chromogenic substrate 5-bromo-4-chloro-3-indolyl
      beta-D-glucuronic acid, were higher with bml than with hph as the selectable
      marker. The hygromycin-resistant transformants were mitotically stable, and both
      the selectable gene and gusA were maintained through conidiation. The vector DNA
      was integrated into the genome, and the number and sites of insertion varied
      among transformants. Enzyme assays of mycelial extracts showed that beta
      glucuronidase activity was highest in transformants with a high gusA copy number.
      Expression of gusA during growth of the fungus on plants was easily detectable
      and did not affect pathogenicity. These results form the basis for construction
      of a versatile and sensitive reporter gene system for P. herpotrichoides.

PMID- 1746952
TI  - Aflatoxin production via cross-feeding of pathway intermediates during
      cofermentation of aflatoxin pathway-blocked Aspergillus parasiticus mutants.
AB  - Cofermentation of Aspergillus parasiticus strains (SRRC 163 and SRRC 2043)
      blocked at different steps in the aflatoxin B1 (AFB1) biosynthetic pathway in a
      synthetic liquid medium or on seeds (cottonseed, corn kernels, and peanuts)
      resulted in production of AFB1. Strain SRRC 2043 accumulated O
      methylsterigmatocystin (OMST), a late precursor in AFB1 biosynthesis, whereas
      SRRC 163 accumulated averantin, an early precursor in the pathway. Strain SRRC
      2043 secreted large amounts of OMST in culture relative to the amounts of several
      other pathway intermediates secreted into media (by other AFB1 pathway-blocked
      strains). AFB1 production occurred even when colonies of SRRC 163 and SRRC 2043
      strains (producing no detectable AFB1) were grown together on an agar medium
      while physically separated from each other by a filter membrane (0.22-micron pore
      size). In addition, when mycelia of strain SRRC 163 were added to culture
      filtrates (containing no mycelia but containing secreted OMST) of strain SRRC
      2043, AFB1 production occurred. The results suggested a chemical (rather than
      genetic) mechanism of complementation for AFB1 production between AFB1 pathway
      blocked strains, since no mycelial contact was required between these strains for
      AFB1 production. The mechanism for chemical complementation involves secretion of
      OMST by SRRC 2043 and subsequent absorption and conversion of OMST to AFB1 by
      mycelia of strain SRRC 163.

PMID- 1746953
TI  - Possible mechanisms underlying the slow lactose fermentation phenotype in
      Shigella spp.
AB  - A Southern hybridization analysis revealed that the region homologous to
      Escherichia coli lacZ was present on the chromosomal DNAs of beta-galactosidase
      positive Shigella strains, such as Shigella dysenteriae serovar 1 and Shigella
      sonnei strains, whereas this region was absent from chromosomal DNAs of beta
      galactosidase-negative strains of Shigella flexneri and Shigella boydii. We found
      that the lacY-A region was deficient in S. dysenteriae serovar 1 and believe that
      this is the reason for the slow fermentation of lactose by this strain. S. sonnei
      strains possessed the region which hybridized with E. coli lacY-A despite their
      slow hydrolysis of lactose. The whole lactose-fermenting region was cloned from
      S. sonnei and compared with the cloned lac operon of E. coli K-12. Both clones
      directed the synthesis of beta-galactosidase in an E. coli K-12 strain lacking
      indigenous beta-galactosidase activity (strain JM109-1), and we observed no
      difference in the expression of beta-galactosidase activity in S. sonnei and E.
      coli. However, E. coli JM109-1 harboring the lactose-fermenting genes of S.
      sonnei exhibited the slow lactose fermentation phenotype like the parental
      strain. S. sonnei strains had no detectable lactose permease activities. E. coli
      JM109-1 harboring the lactose-fermenting genes of S. sonnei had a detectable
      permease activity, possibly because of the multicopy nature of the cloned genes,
      but this permease activity was much lower than that of strain JM109-1 harboring
      the lac operon of E. coli K-12. From these results we concluded that slow lactose
      fermentation by S. sonnei is due to weak lactose permease activity.

PMID- 1746954
TI  - Distribution of Legionella spp. in hydrothermal areas in continental Portugal and
      the island of Sao Miguel, Azores.
AB  - Nineteen aquatic environment sites from three hydrothermal areas on continental
      Portugal and one area on the island of Sao Miguel, Azores, were examined for the
      recovery of Legionella spp. Physicochemical and bacteriological parameters were
      also determined for each site. Water temperatures varied between 22 and 67.5
      degrees C, although the majority had temperatures above 40 degrees C; the pH
      varied between 5.5 and 9.2. The number of Legionella spp. recovered varied
      between 5.0 x 10(2) and 2.3 x 10(6) CFU/liter. A total of 288 isolates from 14
      sites were identified by indirect immunofluorescence assay. The majority of the
      isolates belonged to Legionella pneumophila (74.3%), of which most belong to
      serogroup 1, but the relative proportion of L. pneumophila serogroups varied
      considerably. L. pneumophila serogroup 1 constituted 96.2% of the isolates in
      area 2 from central Portugal, but no isolates of this serogroup were recovered
      from Sao Miguel, where serogroup 6 strains were the predominant isolates. Ninety
      six percent of the L. pneumophila serogroup 1 isolates belonged to monoclonal
      antibody subgroups OLDA and Bellingham. Other species identified were L.
      bozemanii serogroup 2, L. dumoffii, L. micdadei, L. moravica, L. oakridgensis, L.
      sainticrucis, and L. sainthelensi. Two undescribed species, which react by
      indirect immunofluorescence assay to antisera to "L. londoniensis" and "L.
      nautarum" and a group of isolates with strong cross-reaction to L.
      cincinnatiensis/L. sainticrucis/L. longbeachae by indirect immunofluorescence
      assay were also recovered. The latter were the only isolates recovered from area
      3, in east central Portugal, over a period of 1 year.

PMID- 1746955
TI  - Detection and production of verotoxin 1 of Escherichia coli O157:H7 in food.
AB  - Verotoxin 1 (VT1) is a recognized virulence factor of Escherichia coli O157:H7, a
      cause of severe food-borne disease. The public health significance of preformed
      verotoxin in food is unknown, and relatively little research has been done to
      determine the production of VT1 in food. The purposes of this study were to
      develop a sensitive method to detect VT1 in milk and in ground beef and to
      determine the conditions for VT1 production in these foods. A sandwich enzyme
      linked immunosorbent assay in which we used VT1-specific monoclonal antibody
      9C9F5 as the capture antibody and a rabbit polyclonal antibody raised against VT2
      as the detection antibody was developed for the detection and quantification of
      VT1 in milk and in ground beef. The enzyme-linked immunosorbent assay was
      sensitive to a minimum of 0.5 ng of VT1 per ml of milk and 1.0 ng of VT1 per g of
      ground beef. The greatest amount of VT1 detected in milk (306 ng/ml) was detected
      in samples that were incubated at 37 degrees C with agitation (160 rpm) for 48 h.
      Very little toxin (1 ng/ml) was produced at 25 or 30 degrees C within 96 h. VT1
      production was greater in ground beef than in milk; 452 ng of VT1 per g was
      produced in beef at 37 degrees C in 48 h. Relatively little VT1 was produced in
      beef within 96 h at 25 and 30 degrees C (2.1 and 9.8 ng of VT1 per g,
      respectively). Our results indicate that ground beef is a better medium for VT1
      production than milk.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1746956
TI  - Inhibition of pure cultures of methanogens by benzene ring compounds.
AB  - The inhibition of methane production by Methanosaeta concilii GP6,
      Methanospirillum hungatei GP1, Methanobacterium espanolae GP9, and
      Methanobacterium bryantii M.o.H. during short-term (6-h) exposure to eight
      benzene ring compounds was studied. The concentration that caused 50% inhibition
      of the methane production rate (IC50) was dependent on the species and the
      toxicant. Pentachlorophenol was the most toxic of the tested compounds, with an
      IC50 of less than 8 mg/liter for all species except M. hungatei. Abietic acid was
      the next most toxic compound for all the species, with an IC50 in the range of
      21.4 to 203 mg/liter. Sodium benzoate was generally the least toxic, with an IC50
      in the range of 1,225 to 32,400 mg/liter. 3-Chlorobenzoate was substantially more
      toxic (IC50, 450 to 1,460 mg/liter) than benzoate. The inhibition by benzene,
      phenol, vanillic acid, and toluene was intermediate to that of pentachlorophenol
      and benzoate. Long-term incubation (days) studies to determine effect on growth
      indicated that all eight compounds were usually much more toxic than predicted
      from the short-term data. In these latter studies, there was generally a good
      correlation in the observed inhibition as determined from growth and methane
      production.

PMID- 1746957
TI  - Taxonomic relationships among strains of the anaerobic bacterium Bacteroides
      ruminicola determined by DNA and extracellular polysaccharide analysis.
AB  - DNA and extracellular polysaccharide (EPS) analyses were performed on 14 strains
      of Bacteroides ruminicola. The guanine-plus-cytosine (G+C) base contents,
      determined from the buoyant densities of chromosomal DNAs, showed a broad range
      of values, from 37.6 to 50.9 mol%. DNA hybridization showed generally low DNA
      relatedness among the strains. Seven strains formed two groups of closely related
      bacteria consisting of five (group 1) and two (group 2) strains, and another
      strain, E42g, showed moderate relatedness to group 1 strains. However, the
      remaining six strains were not related to any of the other strains. DNA
      reassociation indicates that the strains constitute a genetically diverse group
      representing as many as nine separate species. EPS analysis showed that the
      strains produced EPS with rather uniform sugar compositions, which did not
      correlate with strain relationships determined by DNA analysis. Four strains had
      EPS with acidic sugars or unknown compounds. The EPS of strain 20-63 contained
      the unusual acidic sugar 4-O-(1-carboxyethyl)-rhamnose. This monosaccharide has
      been shown to occur in nature in only one other bacterial species.

PMID- 1746958
TI  - Substrate interactions of benzene, toluene, and para-xylene during microbial
      degradation by pure cultures and mixed culture aquifer slurries.
AB  - Benzene, toluene, and p-xylene (BTX) were degraded by indigenous mixed cultures
      in sandy aquifer material and by two pure cultures isolated from the same site.
      Although BTX compounds have a similar chemical structure, the fate of individual
      BTX compounds differed when the compounds were fed to each pure culture and mixed
      culture aquifer slurries. The identification of substrate interactions aided the
      understanding of this behavior. Beneficial substrate interactions included
      enhanced degradation of benzene and p-xylene by the presence of toluene in
      Pseudomonas sp. strain CFS-215 incubations, as well as benzene-dependent
      degradation of toluene and p-xylene by Arthrobacter sp. strain HCB. Detrimental
      substrate interactions included retardation in benzene and toluene degradation by
      the presence of p-xylene in both aquifer slurries and Pseudomonas incubations.
      The catabolic diversity of microbes in the environment precludes generalizations
      about the capacity of individual BTX compounds to enhance or inhibit the
      degradation of other BTX compounds.

PMID- 1746959
TI  - Deletion of pgi alters tryptophan biosynthesis in a genetically engineered strain
      of Escherichia coli.
AB  - Deletion of the structural gene for phosphoglucose isomerase (pgi) of Escherichia
      coli dramatically alters the path of glucose catabolism by diverting carbon into
      the hexose monophosphate shunt. The effect of this genetic alteration on the
      conversion of glucose to tryptophan by strains optimized for the biosynthesis of
      this amino acid was determined by using 13C-nuclear magnetic resonance
      spectroscopy in vivo. Pgi- strains converted glucose to tryptophan almost twice
      as efficiently as did their Pgi+ counterparts.

PMID- 1746960
TI  - Selection and application of Streptococcus bovis as a silage inoculant.
AB  - Three strains of Streptococcus bovis, a homolactic bacterium capable of utilizing
      starch, were evaluated for growth kinetics and ability to decrease the pH of
      alfalfa silage. A selected strain was evaluated for its competitiveness as an
      inoculant with Enterococcus faecium, an organism used in inoculants, and for its
      ability to enhance the effect of a commercial inoculant. Testing was completed
      over three studies using wilted alfalfa (28 to 34% dry matter) ensiled into
      laboratory silos. Treatments were control, E. faecium, E. faecium and commercial
      inoculant, S. bovis, and S. bovis and commercial inoculant. Replicate silos were
      emptied and analyzed at 0.5, 1, 2, 4, 8, and 40 days for pH, fermentation
      products, and nitrogen fractions. S. bovis alone lowered the pH quicker and
      improved silage parameters early in the fermentation compared with E. faecium,
      the commercial inoculant, and control treatments. When combined with a commercial
      inoculant, S. bovis lowered pH more quickly than the commercial inoculant alone
      and E. faecium plus commercial inoculant. At 40 days, S. bovis combination had
      lower pH and ammonia nitrogen and acetate contents than the E. faecium
      combination. Starch in the silage was not utilized by S. bovis as had been
      anticipated. Results indicate that S. bovis was more effective than E. faecium as
      a silage inoculant and could enhance a commercial inoculant on low-dry-matter
      alfalfa.

PMID- 1746961
TI  - Phenotypic characterization of CO2-requiring strains of Streptococcus bovis from
      koalas.
AB  - We examined phenotypic characteristics of six mannitol-fermenting strains of
      Streptococcus bovis, including two unusual CO2-requiring strains isolated from
      koala feces. These strains did not grow in air, but grew in air supplemented with
      CO2 and under reduced oxygen conditions. All six strains had the same biochemical
      characteristics, except that the CO2-requiring strains did not produce beta-N
      acetylglucosaminidase.

PMID- 1746962
TI  - Enumeration of Flexibacter canadensis in environmental samples by using a
      bacteriophage isolated from soil.
AB  - The denitrifier Flexibacter canadensis, in the presence of sulfide, can reduce
      N2O in the presence of concentrations of C2H2 which normally inhibit N2O
      reduction. Most-probable-number estimates of naturally occurring F. canadensis
      populations in various soils and sediments were made with a bacteriophage which
      is active against and specific for a strain of denitrifying F. canadensis (Is
      11). Our survey suggests that F. canadensis is common in the natural environment.

PMID- 1746963
TI  - Development of an improved chemically defined minimal medium for Listeria
      monocytogenes.
AB  - A chemically defined minimal medium for Listeria monocytogenes has been developed
      by modification of Welshimer's medium. The growth factors required by L.
      monocytogenes Scott A are leucine, isoleucine, arginine, methionine, valine,
      cysteine (each at 100 mg/liter), riboflavin and biotin (each at 0.5
      micrograms/ml), thiamine (1.0 micrograms/ml), and thioctic acid (0.005
      micrograms/ml). Growth was stimulated by 20 micrograms of Fe3+ per ml as ferric
      citrate. Glucose (1%) and glutamine (600 mg/liter) are required as primary
      sources of carbon and nitrogen. Glucose could not be replaced by various organic
      acids or amino acids. Of several sugars tested, fructose, mannose, cellobiose,
      trehalose, maltose (weak), glycerol (weak), and the amino sugars glucosamine, N
      acetylglucosamine, and N-acetylmuramic acid supported growth in the absence of
      glucose. Evidence was found that chitin and cell walls of starter bacteria
      (Lactococcus lactis) supported survival of L. monocytogenes, which suggests that
      the pathogen may obtain carbon and energy sources during colonization of some
      foods, such as cheeses, by assimilating bacteria or molds that are present.

PMID- 1746964
TI  - Kinetics of Saccharomyces cerevisiae elimination from the intestines of human
      volunteers and effect of this yeast on resistance to microbial colonization in
      gnotobiotic mice.
AB  - When healthy volunteers were given a daily dose of 3 x 10(8) life-dehydrated
      Saccharomyces cerevisiae cells for 5 days, the volunteers excreted 10(5) living
      yeast cells per g of feces at first, but the yeast cells disappeared within 5
      days of the end of treatment. In gnotobiotic mice, S. cerevisiae administered
      alone colonized the intestinal tract but did not interfere with previous or
      subsequent colonization by a variety of potentially enteropathogenic
      microorganisms. When these microorganisms were present, the intestinal counts of
      S. cerevisiae were greatly reduced.

PMID- 1746965
TI  - [Outpatient cancer chemotherapy employing implantable systems].
AB  - Outpatient cancer chemotherapy (OCC) employing implantable systems was introduced
      and the objects, conditions and problems of OCC were discussed based on
      experiences in 324 cases. The aims of OCC are improved QOL and the continuation
      of chemotherapy. Our requirements are safety, effectiveness, easy management and
      non-disturbance of activity. Implantable systems are very useful for OCC,
      especially continuous infusion combined with ambulatory pumps. However, the
      improvement of ambulatory pumps and the establishment of methods to evaluate OCC
      are required to further develop OCC.

PMID- 1746966
TI  - [Evaluation of induced hypertension chemotherapy (IHC) in ambulatory cancer
      patients].
AB  - To evaluate ambulatory cancer chemotherapy (ACC), the clinical response, dose
      intensity of anticancer drugs, toxicities, ambulatory periods (AP) and survival
      days (SD) were analysed among 20 outpatients with various types of advanced
      cancer who were continuously treated by angiotensin II-IHC for the past 10 years.
      ACC was assessed with a questionnaire by the patients themselves or their
      families. In advanced cancer, at first, it was essentially to obtain a get
      clinical response or to stabilize the condition for a while, and secondly, to
      upgrade the performance status in better grade. Although AP and SD were so
      differed with the individuals: AP/SD = 1692.2 +/- 1450.2 days/2075.0 +/- 1348.0
      days for CR (n = 5); 1086.0 +/- 1160.2 days/1344.3 +/- 1143.7 days for PR (n =
      10); and 197.3 +/- 129.2 days/471.7 +/- 362.5 days for PD (n = 3). Alopecia,
      nausea/vomiting and appetite loss were the most frequent side effects, though
      these were almost completely controllable by ACC. Patients and their families
      could be cooperated and allow receiving ACC. The key in fighting cancer is the
      formation of good human relationship between medical oncologists and patients
      (including their families) mutual confidence, and giving a sufficient explanation
      for therapies.

PMID- 1746967
TI  - [Maintenance of housewife activity and the quality of familiar interactions by
      home continuous infusion chemotherapy in patients with recurrent gynecological
      cancer].
AB  - Sixteen patients with recurrent gynecologic cancer were studied to evaluate
      maintenance of housewife activity and the quality of familiar interactions by the
      home continuous infusion of CDDP at a daily dose of 5 mg/body. A total dose of
      CDDP in one course was 100 mg/body, and more than one course was performed in
      every patient. Eight patients underwent intra-arterial infusion of CDDP by the 20
      day continuous infusion and another 8 patients intra-venous infusion by 5-day
      continuous infusion every other week. The average caloric intake was 2201 kcal
      measured by the record of a three-day food intake during the treatment. 88% of
      the patients arouse between 6 and 7 in the morning, and all the patients cooked
      breakfast and supper, went shopping for food materials, cleaned a house and did
      the washing with the help of her family. All the patients accepted the treatment
      and were satisfied with it but appeared anxious about recurrence. Information or
      advice by the doctor was important to relieve their anxiety. Their husbands also
      accepted the treatment and tolerated well their wives, continuation of home
      therapy.

PMID- 1746968
TI  - [Total parenteral nutrition for home therapy in cancer patients].
AB  - Home parenteral nutrition (HPN) was used in 14 cancer patients within a 4-yr and
      4-month period. Indications included severe malabsorption, short bowel syndrome,
      radiation enteritis, and malignancies. The mean duration of HPN was 184 days
      (range: 21-706 days). HPN duration for patients with benign causes (BP) was
      longer [427 days (range: 176-706 days)] than for cancer-related patients (CP) [49
      days (range: 21-121 days)]. The mean catheter life spans to date for BP and CP
      have been 596 days (range: 187-1173 days) and 127 days (range: 73-278 days),
      respectively. Serious catheter problems occurred 4 times in BP with the external
      catheter. Metabolic complications with clinical symptoms occurred in one BP who
      had short bowel syndrome. We followed with an evaluation of the quality of life
      of HPN patients. Three in 14 cases returned to work, two of them part time, and
      two others did most of the housekeeping, but 9 remained at home receiving only
      outpatient treatment. Some physical distress was recorded in all but one case. We
      concluded that HPN for cancer patients is a relatively safe, effective means of
      improving and maintaining the nutritional status, and it can reduce the length of
      hospitalization. We attempted to evaluate whether these patients were able to
      achieve a meaningful and satisfactory social and familial life. Our study was not
      sufficient to assess the psychological and social problems. We should establish
      criteria for quality of life to evaluate overall satisfaction with conditions of
      life under HPN.

PMID- 1746969
TI  - [Nutritional support for cancer bearing patients].
AB  - A care system for cancer bearing patients at a highly advanced stage should be
      informed by a better quality of life based on a life style of the patients and
      their families. These patients are suffering from various types of trouble
      including pain, loss of appetite and nausea, which preclude oral intake.
      Radiotherapy or chemotherapy can be another factor aggravating their nutritional
      state. In terms of nutritional management, intravenous or enteral alimentation is
      indispensable, but these conventional alimentary supports generally lead to
      prolonged hospitalization and re-admission. If parenteral nutritional care can be
      given to patients at home and not in the hospital, it is leading to the improved
      quality of life would result. We focus on the issue of home alimentary care,
      especially intravenous alimentation, for cancer patients at the terminal stage
      from the nursing standpoint.

PMID- 1746970
TI  - [A comparative clinical study of adjuvant chemotherapy of tumors in the head and
      neck areas by means of HCFU].
AB  - In order to evaluate the efficacy of HCFU as an adjuvant chemotherapy agent for
      squamous cell carcinoma of the head and neck areas, a randomized comparative
      study was performed with cooperative facilities. 191 patients who had undergone
      radical therapy were randomly assigned to the following two groups: Group A was
      the control group, which underwent radical therapy only, and Group B was a group
      which received long-term HCFU administration (300-600 mg/day x 12 weeks or more).
      In the comparison of non-recurrence rate in both groups, Group B had better
      results among patients who were at the advanced clinical stages such as N1
      through N3, Stage II (p = 0.0583) and Stage III (p = 0.0970). The adverse
      reactions to HCFU included pollakiuria, feverishness, and digestive symptoms, but
      these were mild and the recovery was possible.

PMID- 1746971
TI  - [Pharmacokinetics of KRN 8602 in cancer patients].
AB  - The pharmacokinetic properties of KRN 8602, an anthracycline compound, was
      studied by HPLC following intravenous administration of KRN 8602 to cancer
      patients. The results were as follows. (1) The plasma concentration-time curve
      declined as a triphasic function (alpha, beta, gamma) (t1/2 (alpha) = 0.02910, +/
      0.0054 hr, t1/2 (beta) = 0.704 +/- 0.319 hr, t1/2 (gamma) 8.37 +/- 1.37 hr). The
      blood cell concentration was higher than that in plasma. (2) The distribution
      volumes of the tissue compartment were larger than those of the central
      compartment. This result suggested that KRN 8602 would be easily transferred into
      the tissues. (3) The area under the curve (AUC) of KRN 8602 increased in
      proportion to the increase of dosage. (4) The metabolites of KRN 8602 were
      detected in plasma, blood cell and urine. (5) Urinary excretion of KRN 8602 and
      its metabolites were extremely low.

PMID- 1746972
TI  - [Inhibitory effect of UFT on rat hepatocarcinogenesis induced by 3'-methyl-4
      dimethylaminoazobenzene and phenobarbital promotion].
AB  - Inhibitory effect of UFT on hepatocarcinogenesis in rats induced by 3'-methyl-4
      dimethylaminoazobenzene (3'-MeDAB) and phenobarbital (PB) promotion was studied.
      Donryu male rats were divided into four groups. Group A was fed a diet containing
      0.06% 3'-MeDAB for 3, 5, or 7 weeks, and then fed normal diet for 2 weeks,
      subsequently received a diet containing 0.05% PB. Group B was given UFT (20
      mg/kg/5 days a week) simultaneously with feeding 3'-MeDAB. Group C was given UFT
      simultaneously with feeding PB. Group D was given 3'-MeDAB alone. In all groups,
      the development of hepatocellular carcinoma was investigated 37 weeks later and
      the number and area per mm2 of induced glutathione S-transferase placental form
      (GST-P) positive foci were measured using an image processor. The number and area
      of GST-P positive foci in group B and group C were markedly decreased as compared
      with those in group A. These results seem to show that the administration of UFT
      inhibited the production of GST-P positive foci and that stronger inhibitory
      effect of UFT was observed by simultaneous administration of an initiator than by
      that of a promoter.

PMID- 1746973
TI  - [Complete response in a case of rectal carcinoma with multiple liver metastasis
      treated by infuse-a-port].
AB  - Much effort has been developed to control of multiple liver metastases of colo
      rectal cancer, but the results of various therapies are not necessarily
      satisfactory. We report here a 73-year female with advanced rectal cancer and
      multiple liver metastases (H3), who showed a complete response to hepatic
      arterial infusion of mitomycin C using "Infuse-a-port". Hepatic arterial infusion
      of chemotherapeutic agents using totally implantable reservoir might be one of
      the most potent therapies for non-resectable liver metastasis of colo-rectal
      cancer.

PMID- 1746974
TI  - [A case of colon cancer with severe anal bleeding caused in a preoperative
      chemotherapy].
AB  - UFT was orally administered at a dose of 600 mg/day as a preoperative
      chemotherapy for a 44-year old male with colon cancer. On the seventh day of the
      administration, severe anal bleeding occurred, and an emergent colectomy was
      performed. The macroscopic findings of the resected tumor were different from the
      first endoscopic picture, and the histopathological findings showed the
      significant effects of preoperative chemotherapy.

PMID- 1746975
TI  - [Studies on a slow releasing anticancer agent for prevention of peritoneal
      recurrence of advanced gastrointestinal carcinomas (experimental study)].

PMID- 1746976
TI  - [Effects of urinastatin on prevention of cisplatin induced nephrotoxicity].

PMID- 1746977
TI  - Transmission and epidemiology of newly transmitted falciparum malaria in the
      central highland plateaux of Madagascar.
AB  - The recent reappearance of Plasmodium falciparum in the central highland plateaux
      of Madagascar has led to an important increase in both morbidity and mortality in
      the population. To understand the phenomena that originated this outbreak, and to
      evaluate the clinical and biological reactions of the population, we conducted
      entomological surveys during the whole malaria transmission season of 1988. In
      parallel, 41 individuals presenting with a malaria attack in January were given a
      curative antimalarial treatment and were followed weekly for 20 weeks, until the
      end of the transmission season, in June. During the follow-up, individuals
      presenting with a clinical malaria attack or with a parasite density above 5000
      per mm3 of blood were again given antimalarial treatment. Overall, individuals
      presented with an average of 5.6 thick blood smears positive for P. falciparum,
      and 1.4 malaria attacks requiring treatment. Plasmodium falciparum prevalence
      rates gradually increased to 53.8% in April, one to two months after the observed
      peak of transmission, then decreased to 15.4% at the end of follow-up. The
      proportion of P. falciparum infections with clinical symptoms did not follow a
      similar temporal evolution and was significantly lower than at enrollment.
      Splenic rates gradually decreased from 29.3-2.6%, while anti-P. falciparum and
      anti-Pfl55/RESA antibodies increased. For the whole transmission season
      individuals experienced a mean 1.5 infective bites; the malaria vectors were
      Anopheles gambiae s. 1 and An. funestus. This study demonstrates that, in this
      population newly exposed to P. falciparum infections, almost all sporozoite
      inoculations lead to blood parasite infection requiring treatment.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1746978
TI  - Anaplasmosis in Uganda. II. Prevalence of bovine anaplasmosis in Uganda.
AB  - The prevalence of bovine anaplasmosis was studied in 320 Zebu cattle randomly
      selected from three regions of Uganda: (Central, Southwestern and Northwestern)
      using dot-ELISA, Western immunoblotting, rapid card agglutination test (RCAT),
      capillary tube agglutination test (CAT), complement fixation test (CFT), and
      parasitological techniques. Dried blood on Whatman filter paper No. 1 was eluted
      in PBS 0.05% Tween 20 prior to testing at an initial dilution of 1:25. The
      prevalences of parasitaemia were 25% in the central region, 28% in the
      southwestern region, and 35% in the northwestern region, and the serological
      prevalence was lowest in the central region and highest in the northwest.
      Overall, prevalence rates obtained by dot-ELISA (61.9%) and Western
      immunoblotting (62.5%) were 1.5 times those obtained by RCAT (41%) and three
      times those obtained by CAT (22.5%). The overall prevalence rates obtained by dot
      ELISA and Western immunoblotting compared favourably with the CFT data. The
      present data utilizing dried blood on filter papers indicate that there is a high
      prevalence of anaplasmosis in those regions of Uganda surveyed, and confirm our
      observations and those of others that collecting blood on filter papers is a
      suitable technique for large scale screening and for seroepidemiological studies.

PMID- 1746979
TI  - Description of a mono-screen trap for Glossina fuscipes fuscipes Newstead in
      Uganda.
AB  - A low-cost mono-screen trap for Glossina fuscipes fuscipes suitable for use by a
      rural community in Uganda is described. The trap has a single blue/black screen
      and a cone made from mosquito netting. The supporting framework is made from
      indigenous plant materials. The differences in trap catches between the mono
      screen, biconical, pyramidal and vavoua traps were highly significant (P less
      than 0.001). Taking the standard biconical trap as control, the mono-screen trap
      was 1.25 times as efficient and the pyramidal trap was 0.04 times as efficient.
      The cost of one mono-screen trap is estimated as 1800 Uganda shillings (= U.S.
      $4.7), about half the cost of a pyramidal trap and one-quarter the cost of a
      biconical trap. The prospects for the use of the mono-screen trap by the
      community are discussed.

PMID- 1746980
TI  - A new approach to community participation in tsetse control in the Busoga
      sleeping sickness focus, Uganda. A preliminary report.
AB  - A process is described by which trapping technology is being taught to a rural
      community which has been affected continuously by an epidemic of sleeping
      sickness for over a decade. Through a systematic health education programme,
      people are actively involved in making and setting traps and in learning about
      the general characteristics of the tsetse fly and the disease. A mono-screen trap
      has been developed for community use and is being used to trap flies. This is the
      first time that this kind of community participation has been attempted in tsetse
      control--and this approach is discussed in relation to other approaches.

PMID- 1746981
TI  - Leishmania major: resistance of promastigotes to paromomycin, and susceptibility
      of amastigotes to paromomycin-methylbenzethonium chloride ointment.
AB  - Cutaneous lesions caused by Leishmania major in BALB/c mice were cured completely
      when treated topically with an ointment comprising 15% paromomycin sulphate and 1
      2% methylbenzethonium chloride ointment in soft white paraffin twice daily for 10
      days. No parasites were detected in tissue smears or in cultures from treated
      cutaneous lesions. Re-developing lesions, considered to be resulting from the
      migration of parasites from internal organs, showed almost the same response to
      topical treatment. Promastigotes of the virulent clone 121 of L. major LRC-L137
      which were exposed to 100 micrograms ml-1 of paromomycin in RPMI medium at 28
      degrees C developed resistance to the drug over 10 passages of exposure. Enzyme
      analysis of susceptible and resistant promastigotes of this clone showed no
      differences with regard to their profiles based on 11 enzymes.

PMID- 1746982
TI  - The development of Onchocerca dukei and O. ochengi microfilariae to infective
      stage larvae in Simulium damnosum s.l. and in members of the S. medusaeforme
      group, following intra-thoracic injection.
AB  - Neonate Simulium females from an endemic area of human and bovine onchocerciasis
      in North-Cameroon were injected in one set of experiments with microfilariae
      (mff) of Onchocerca dukei and in another with mff of O. ochengi. Onchocerca dukei
      was found to develop to infective third-stage larvae in Simulium flies: 148 third
      stage larvae (28.1% of injected mff) were recovered in S. hargreavesi, seven
      (10.4% of injected mff) in S. vorax, and 12 (1.3%) in S. damnosum s.l. Onchocerca
      ochengi mff developed in S. hargreavesi at a rate of 17.3% and in S. damnosum
      s.l. at 16.1%, yielding a total of 77 and 32 third-stage larvae respectively.
      Onchocerca dukei infective larvae had a mean length of 717.3 microns and a mean
      maximum diameter of 17.5 microns, and were slightly shorter and conspicuously
      thinner than those of O. ochengi (748.3 microns x 20.4 microns). All larval
      stages of O. dukei typically had an attenuated anterior end. The implications of
      these findings for the epidemiology of human onchocerciasis are discussed.

PMID- 1746983
TI  - Human cutaneous myiasis due to mixed infestation in a drug addict.
AB  - Soft tissue infestation by maggots of flies (myiasis) is a well-recognized
      complication of neglected wounds. Mixed infestation by larvae of more than one
      species of fly is a rarity. We report, for the first time in India, one such case
      of cutaneous myiasis due to mixed infestation--in this instance by Chrysomya
      bezziana and Sarcophaga sp. in a drug addict.

PMID- 1746984
TI  - Enhancement of virulence of Entamoeba histolytica by in vitro liver treatment.
AB  - Enhancement of the virulence of five strains of Entamoeba histolytica (three
      xenically maintained and two axenically maintained) was studied after in vitro
      incubation with normal hamster liver. Increased virulence was shown by the
      ability of a small number of liver-treated trophozoites to produce liver lesions
      in hamsters. Enhancement of virulence was positively correlated with increased
      resistance to normal hamster serum complement in vitro.

PMID- 1746985
TI  - Serum cholinesterase levels of vector control workers in Trinidad, West Indies
      (1979-1987).
AB  - During 1979-1987 studies were carried out in vitro on the serum cholinesterase
      levels of 46 vector control workers exposed to insecticides on a daily basis but
      without clinical manifestations of insecticide poisoning. The results were
      compared with those of a control group of workers who had not been exposed to
      insecticides at home or at work. Cholinesterase levels of both groups were
      determined by a standard colorimetric method. Suppressed serum cholinesterase
      levels were detected in all 46 workers exposed to insecticides, 25 of whom were
      aged 30-39 years. Four persons from the control group showed suppressed levels of
      enzyme; one of these had a genetically low level, and the other three were on
      medication when the low levels were recorded.

PMID- 1746986
TI  - Sero-epidemiological studies of cysticercosis in school children from two rural
      areas of Transkei, South Africa.
AB  - Anticysticercus antibody titre levels were measured in the sera of 1352 school
      children from two rural areas of Transkei with different climatic conditions, in
      the southeastern seaboard of South Africa. The overall seropositivity rate was
      5.5%, while the rates for children with good and poor nutritional status were
      7.3% and 3.3% respectively. The rates for the two geographical areas did not
      differ. However, the mean antibody titre level in the 'dry' area (Cofimvaba) with
      extreme temperature regimes was higher than that in the 'wet' area (Umtata), and
      well-nourished children from the Cofimvaba area were significantly the most
      likely to be seropositive. On the other hand, undernourished children from
      Cofimvaba, and undernourished male children generally, were more likely to be
      seronegative (Odds Ratio 2.78 and 3.62 respectively). The implications of the
      findings for the treatment and control of cysticercosis are discussed.

PMID- 1746987
TI  - Sodium azide: ineffective as a faecal preservative for parasitological diagnosis.
AB  - Sodium azide was compared with 10% formalin to evaluate sodium azide's
      effectiveness as a faecal preservative for intestinal helminths and protozoa.
      Faecal specimens collected from Haiti were preserved in sodium azide and in 10%
      formalin and analysed after 1.5, 6.5 and 11.5 weeks by examining direct wet-mount
      preparations. Sodium azide did not preserve the morphology of either helminths or
      protozoa as well as 10% formalin did. However, sodium azide prevented
      embryogenesis of helminth eggs, while some helminth eggs in 10% formalin
      contained living larvae. Biosafety guidelines regarding the toxicity, reactivity,
      and disposal of sodium azide were strictly followed. Use of 10% formalin is a
      significantly better choice than sodium azide for preserving parasites when
      accurate identification of parasites and biosafety are the main concerns.

PMID- 1746988
TI  - Bacterial infection of hydatid cyst following albendazole treatment.

PMID- 1746989
TI  - Immunological diagnosis of amoebic liver abscess.

PMID- 1746990
TI  - Calcium antagonists and diabetic nephropathy.

PMID- 1746991
TI  - Medical therapy for gastroesophageal reflux disease. Not all treatments are
      equal!

PMID- 1746992
TI  - A perspective on converting enzyme inhibitors and calcium channel antagonists in
      diabetic renal disease.
AB  - Hypertension and renal disease are major causes of morbidity and mortality in the
      diabetic population, with the presence of microalbuminuria established as a
      predictor of excess mortality. Numerous attempts, both pharmacologic and
      nonpharmacologic, have been made to intervene in the disease process.
      Experimental and clinical evidence suggests that the converting enzyme inhibitors
      and, more recently, certain calcium antagonists have beneficial effects on renal
      function above and beyond those simply due to blood pressure control. These
      effects are likely attributable to favorable systemic and renal hemodynamic
      changes as well as to direct cellular effects. However, intervention with these
      agents in various rat models of diabetes or hypertension is initiated very early.
      Hence, some of the beneficial renal effects may not be as dramatic in clinical
      practice because of the more commonly advanced stage seen at the time of
      intervention. We present an overview of the histologic, renal hemodynamic, and
      antiproteinuric effects of these agents in the experimental setting, as well as
      the clinical evidence supporting the use of angiotensin-converting enzyme
      inhibitors and certain classes of calcium antagonists in diabetic renal disease.

PMID- 1746993
TI  - Silent myocardial ischemia. A clinical perspective.
AB  - Silent myocardial ischemia has been shown to occur far more frequently than
      anginal episodes in patients with coronary artery disease. Both an increase in
      myocardial oxygen demand and abnormalities of coronary vasomotor tone appear to
      play a significant role in the genesis of silent ischemia. Recent data show that
      in excess of 40% of patients with stable angina have frequent episodes of silent
      ischemia. The presence of silent ischemia predicts an increased risk of coronary
      events and cardiac death. Based on these data, it has been proposed that anti
      ischemic therapy should be directed toward control of total ischemic burden.
      Although several recent studies have demonstrated efficacy of various antianginal
      drugs in reducing the number and duration of silent ischemic episodes, none has
      demonstrated beneficial effect on the associated adverse prognosis.

PMID- 1746994
TI  - Hepatic hydrothorax. Cause and management.
AB  - Significant pleural effusions are infrequently noted in patients with cirrhosis
      of the liver. A large effusion (hepatic hydrothorax) occasionally appears during
      the course of the disease. The fluid in the pleural space is believed to be
      derived from ascitic fluid that may accompany hepatic cirrhosis. Although the
      exact mechanism is somewhat controversial, it appears that the ascitic fluid is
      transported directly into the pleural space. A therapeutic thoracentesis, usually
      accompanied by a paracentesis, may be necessary to relieve acute symptoms. Long
      term management, however, centers around eliminating or reducing the formation of
      ascites. When this is not successful, tube thoracostomy followed by chemical
      pleurodesis, primary repair of diaphragmatic defects with pleural sclerosis, or
      peritoneovenous shunting in conjunction with chemical pleurodesis may be
      attempted. These interventions may or may not be successful. Management of
      hepatic hydrothorax remains a clinical challenge.

PMID- 1746995
TI  - Raynaud's phenomenon. The French tricolor.
AB  - Recent epidemiologic surveys indicate that episodic vasospasm of arterioles
      (Raynaud's phenomenon) is a common finding in the general population. In a small
      minority of these individuals, an underlying, often reversible cause or systemic
      disease associated with vasospasm can be identified. The range of these so-called
      secondary forms of vasospasm is broad and includes systemic rheumatic syndromes,
      vibration-induced vascular injury, drug-induced vasospasm, and infectious
      disorders. Several different physiologic mechanisms may be responsible for
      vasospasm; hyperactivity of the sympathetic nervous system and abnormal
      adrenergic receptor function appear to be most important.

PMID- 1746996
TI  - Famotidine relieves symptoms of gastroesophageal reflux disease and heals
      erosions and ulcerations. Results of a multicenter, placebo-controlled, dose
      ranging study. USA Merck Gastroesophageal Reflux Disease Study Group.
AB  - We conducted a double-blind, placebo-controlled, multicenter trial comparing the
      efficacy of famotidine 40 mg administered at bedtime (HS), 20 mg given twice
      daily (BID), and placebo to relieve heartburn and to heal endoscopically
      documented esophageal erosions or ulcerations. A total of 338 patients were
      randomized: 135 to receive famotidine 40 mg HS, 137 to receive famotidine 20 mg
      BID, and 66 to receive placebo. In the group given famotidine 20 mg BID, there
      was a significantly greater proportion of patients with complete relief of
      daytime heartburn, and both famotidine groups demonstrated statistically
      significant advantages over placebo in global scores or by successful outcome.
      Antacid consumption was significantly reduced in the group given famotidine 20 mg
      BID as compared with placebo. Both famotidine regimens resulted in a
      significantly greater proportion of patients with complete endoscopic healing
      than placebo, with the BID dosing being numerically superior to the 40-mg HS
      dose.

PMID- 1746997
TI  - The impact of diuretic therapy on reported sexual function.
AB  - BACKGROUND: --Thiazide diuretics are the most commonly prescribed
      antihypertensive agent in the treatment of hypertension. No studies to date have
      isolated conclusively the effect of diuretic therapy on patient quality of life,
      and particularly on sexual dysfunction. METHODS: --We carried out a randomized
      placebo-controlled trial of the effect of thiazide diuretics on quality of life
      in mildly hypertensive men between the ages of 35 and 70 years. After a 1-month
      washout period off diuretic therapy, the men were randomized to a 2-month trial
      of a thiazide treatment or placebo. At the end of the trial, 176 men completed a
      confidential self-administered questionnaire assessing aspects of social
      performance, general well-being, and emotional and physiologic states. RESULTS: -
      Patients taking diuretics reported significantly greater sexual dysfunction than
      control subjects, including decreased libido, difficulty in gaining and
      maintaining an erection, and difficulty with ejaculation. Multivariate analysis
      suggested that the findings were not mediated by low serum potassium levels or by
      low blood pressure. Sexual dysfunction was noted more often in the confidential
      self-report questionnaire than in response to direct questions from clinicians.
      We found no differences between diuretic and placebo groups in measures of mood,
      general sense of well-being, ability to work, alertness, and social/recreational
      activities. CONCLUSIONS: --Thiazide diuretic use is associated with male sexual
      dysfunction but does not appear to adversely affect other aspects of quality of
      life.

PMID- 1746998
TI  - The autonomic and hemodynamic effects of oral theophylline in patients with
      vasodepressor syncope.
AB  - Adenosine appears to be an important mediator of hypotension and bradycardia in
      certain subsets of patients with vasodepressor syncope. Adenosine receptor
      blockage with methylxanthines may hypothetically prevent the vasodepressor spell.
      We studied the chronotropic, hemodynamic, and cardiac autonomic responses to head
      up tilt in patients (mean age 40.7 +/- 18.1 years) with vasodepressor syncope
      before and after treatment with oral theophylline. At baseline, hypotension and
      syncope or near syncope were induced at 11.7 +/- 2.3 minutes of 60 degrees head
      up tilt in all patients. Cardiac vagal and sympathetic tone showed biphasic and
      directionally opposite changes during tilt. Repeat tilt during oral theophylline
      therapy (6-12 mg/kg/day for 14 +/- 6 days) did not provoke symptomatic
      hypotension in 82% of patients. During 10.7 +/- 6.1 months of follow-up, seven
      patients had no recurrence of vasodepressor syncope and seven patients
      discontinued theophylline because of adverse reactions. Low-dose theophylline
      prevents tilt-induced vasodepressor syncope and may prevent spontaneous
      vasodepressor syncope in selected patients who can tolerate theophylline.

PMID- 1746999
TI  - Primary pulmonary hypertension in the elderly.
AB  - Primary pulmonary hypertension is usually considered a disease of younger adults.
      We reviewed the natural course of primary pulmonary hypertension in patients aged
      65 years or greater. During an 8-year period, 63 elderly patients were discharged
      from our hospital with a diagnosis of pulmonary hypertension. In eight instances,
      an elevated mean pulmonary arterial pressure (greater than 25 mm Hg) could not be
      explained by secondary causes. These elderly patients with primary pulmonary
      hypertension had symptoms common to younger patients with this disease, including
      dyspnea (eight patients), chest pain (five), pedal edema (four), and fatigue
      (one). In all but one patient, the initial diagnosis was incorrect, and the
      patients were thought to have more common diseases of the elderly that cause
      similar symptoms. Coexisting medical problems were common and further obscured
      the correct diagnosis. Survival was significantly shorter in those patients with
      symptoms of less than 6 months' duration. Primary pulmonary hypertension should
      be considered in the differential diagnosis in elderly patients with unexplained
      dyspnea and chest pain.

PMID- 1747000
TI  - High frequency of human immunodeficiency virus-associated autonomic neuropathy
      and more severe involvement in advanced stages of human immunodeficiency virus
      disease.
AB  - We conducted a controlled trial to determine frequency and severity of autonomic
      neuropathy in patients infected with the human immunodeficiency virus (HIV). We
      studied 25 HIV-seropositive patients and 10 seronegative controls in HIV risk
      groups by means of five cardiovascular tests, and autonomic neuropathy was graded
      with a scoring system. The overall autonomic test score differed between patients
      and controls and was higher in patients with advanced (Centers for Disease
      Control class IV) disease than in those with earlier (class II or III) HIV
      disease. Of the patients, 60% had findings of autonomic dysfunction. Our data
      demonstrate a high prevalence of autonomic neuropathy in HIV-infected patients.
      Advanced HIV disease is associated with more severe involvement than earlier
      disease states.

PMID- 1747001
TI  - Decrease in reported posttransfusion hepatitis. Contributions of donor screening
      for alanine aminotransferase and antibodies to hepatitis B core antigen and
      changes in the general population.
AB  - Blood donor screening for hepatitis B core antibody and elevation of serum
      alanine aminotransferase level, surrogate markers of hepatitis C/non-A, non-B
      (NANB) infection, was implemented in 1986. Reported cases of posttransfusion
      hepatitis (PTH) from 1985 to 1988 were reviewed to ascertain the effect of
      surrogate testing on the number and character of cases and to compare any changes
      with those in the incidence of hepatitis in the general population. The reports
      of all PTH, NANB PTH, and type B PTH decreased 61.5%, 75.4%, and 84.5%,
      respectively. The rates of reported cases of NANB hepatitis and hepatitis B in
      the general community also fell during the period of review. The decrease in PTH
      and background hepatitis was similar between 1985 and 1986. In 1987, the first
      complete year of surrogate testing, the incidence of PTH decreased at a greater
      rate, to levels 50% below what would have been projected on the basis of
      background changes alone for NANB PTH, and to 35% below projected for type B PTH.
      There appears to have been a substantial decrease in the risk of both type B PTH
      and NANB PTH in the northeastern United States between 1985 and 1988 due to a
      combined effect of donor surrogate testing and a decrease in the background rates
      of hepatitis in the donor population.

PMID- 1747002
TI  - A reappraisal of the causes of hemoptysis.
AB  - We reviewed the records of 264 patients who underwent fiberoptic bronchoscopy for
      unexplained hemoptysis to determine the various causes of hemoptysis.
      Bronchogenic carcinoma (29%), bronchitis (23%), and idiopathic hemoptysis (22%)
      accounted for the majority of causes of hemoptysis. In contrast to older studies,
      the incidence of hemoptysis secondary to tuberculosis and bronchiectasis has
      decreased. Although our patient population is predominantly male and elderly, our
      data may well be representative of more recent epidemiologic trends in causes of
      hemoptysis.

PMID- 1747003
TI  - The provision of physical activity to hospitalized elderly patients.
AB  - Physical activity has been recognized as an important aspect of patient care for
      nearly 50 years. Yet, deconditioning and functional decline of hospitalized
      elderly patients continue to be reported. Such outcomes suggest that a good
      system for providing activity in hospitals is lacking. In this retrospective
      study we assessed the provision of physical activity to 500 elderly patients (100
      in each of five hospitals) during the first 7 days of hospitalization. No
      activity order was in effect on 13% of the 3500 patient days reviewed. When
      activity was ordered, patient activity was different from the activity permitted
      by the physician orders on 41% of the days. Patients who remained in bed or in a
      chair rarely received physical therapy, never had physician orders for exercises,
      and never performed exercises with the nurses. These findings demonstrate that
      the current practices for the provision of physical activity in hospitals are
      ineffective.

PMID- 1747005
TI  - What should house officers know about medical ethics?

PMID- 1747004
TI  - Thrush can be prevented in patients with acquired immunodeficiency syndrome and
      the acquired immunodeficiency syndrome-related complex. Randomized, double-blind,
      placebo-controlled study of 100-mg oral fluconazole daily.
AB  - Recurrent oropharyngeal candidiasis is common in patients with acquired
      immunodeficiency syndrome and the acquired immunodeficiency syndrome-related
      complex. It causes local pain and discomfort, loss of taste, and aversion to food
      and may lead to secondary complications. We examined, in a double-blind study,
      whether recurrent thrush could be prevented by prophylaxis. Twenty-five patients
      with one to four previous thrush episodes who had no thrush at the outset of the
      study were randomized to receive 100 mg of fluconazole or placebo daily for 12
      weeks. If thrush occurred, prophylaxis was stopped and patients were treated
      conventionally, after which prophylaxis was resumed. After the randomized study,
      some patients were given continuous fluconazole (open phase). In the randomized
      study, thrush occurred in eight of 13 placebo-treated patients and none of 12
      fluconazole-treated patients. Possible side effects were not different between
      the groups. Dermatophytosis and onychomycosis and cryptococcuria also improved in
      the fluconazole-treated patients, and fungal colonization was significantly
      decreased. One episode of thrush occurred in the open phase in an intermittently
      compliant patient (group total, 71.5 patient-months of fluconazole treatment); in
      contrast, the 25 patients also had had two episodes of Candida esophagitis, three
      of cryptococcosis, and 13 of dermatophytosis before entry. Subsequent to entry in
      the randomized trial, in 92.3 patient-months without fluconazole, there were 35
      episodes of thrush, one of esophagitis, one of cryptococcemia, and one of
      dermatophytosis, and preexisting dermatophytosis and onychomycosis were unchanged
      or worsened. Individual patients observed with and without fluconazole treatment
      also showed its efficacy. In conclusion, thrush can be prevented in patients with
      acquired immunodeficiency syndrome and the acquired immunodeficiency syndrome
      related complex with negligible toxic effects. Larger trials to confirm
      prevention of all mycoses with prophylaxis should be considered.

PMID- 1747007
TI  - Categories of patients with gastroesophageal reflux.

PMID- 1747006
TI  - Pneumothorax following feeding tube placement.

PMID- 1747008
TI  - Decision analysis for isoniazid chemoprophylaxis.

PMID- 1747009
TI  - Respiratory syncytial virus pneumonia in hospitalized adults.

PMID- 1747010
TI  - Health promotion and nurses.

PMID- 1747011
TI  - Drug interaction with quinolone antibiotics in intensive care unit patients.

PMID- 1747012
TI  - Sonography-guided thoracentesis.

PMID- 1747013
TI  - Which categories of patients are known to benefit from aspirin?

PMID- 1747014
TI  - Hippocampal neuron number in schizophrenia. A stereological study.
AB  - Neuropathologic and neuroradiologic studies have reported hippocampal
      abnormalities in schizophrenics. We estimated the total number of neurons in the
      hippocampus of schizophrenics and controls to elucidate the neuronal basis of
      such changes. Thirteen brains of schizophrenics and 13 control brains closely
      matched for sex and age were studied. A new stereological method was applied to
      serial coronal sections through the whole hippocampus. Total hippocampal volume
      was reduced in the schizophrenic sample, more pronounced on the left side, but
      mean differences were not significant. The volumes of the pyramidal cell layer in
      the four subdivisions subiculum and cornu Ammonis sectors CA 1, CA 2/3, and CA 4
      were almost identical in both groups. Schizophrenics did not differ from controls
      with regard to nerve cell density in any of the four subdivisions. The estimates
      of the total number of neurons in the hippocampal subdivisions were not different
      between schizophrenics and controls. The data do not support the hypothesis that
      hippocampal abnormalities are caused by neuronal cell loss. However, they are
      consistent with the suggestion that white matter changes in the hippocampus may
      play a role in the pathogenesis of schizophrenia.

PMID- 1747015
TI  - Alterations in Alzheimer's disease-associated protein in Alzheimer's disease
      frontal and temporal cortex.
AB  - Alzheimer's disease (AD)-associated protein is present in brain and cerebrospinal
      fluid of patients with AD but not in adult, nondemented, normal controls. This
      protein may represent an abnormal epitope of the "tau" microtubule-associated
      protein and has been detected before the appearance of senile plaques and
      neurofibrillary tangles. The amount of AD-associated protein in the frontal and
      temporal cortices in 93 cases of neuropathologically confirmed AD was compared
      with the amount that was present in 20 cases without AD. The amount of AD
      associated protein was significantly increased in the cases of AD for both brain
      regions compared with that in the cases without AD. The presence of high levels
      of this protein is a useful adjunct, postmortem marker of the presence of AD and
      may eventually lead to tests that allow early detection of individuals at risk
      for this disease.

PMID- 1747016
TI  - Brain anatomic effects of electroconvulsive therapy. A prospective magnetic
      resonance imaging study.
AB  - To determine prospectively whether electroconvulsive therapy (ECT) produces
      structural brain changes, 35 inpatients with depression underwent magnetic
      resonance imaging before and twice after (at 2 to 3 days and at 6 months)
      completion of a course of brief-pulse, bilateral ECT. The magnetic resonance
      images were analyzed blindly for evidence of changes in brain structure using two
      approaches: measurement of regional brain volumes and a pairwise global
      comparison. Structural brain abnormalities were present in many patients before
      ECT. The course of ECT produced no acute or delayed (6-month) change in brain
      structure as measured by alterations of the total volumes of the lateral
      ventricles, the third ventricle, the frontal lobes, the temporal lobes, or the
      amygdala-hippocampal complex. In five subjects, the pairwise global comparisons
      revealed an apparent increase in subcortical hyperintensity, most likely
      secondary to progression of ongoing cerebrovascular disease during follow-up. Our
      results confirm and extend previous imaging studies that also found no
      relationship between ECT and brain damage.

PMID- 1747017
TI  - Volunteers for biomedical research. Recruitment and screening of normal controls.
AB  - We examined the process of accruing healthy control subjects for biomedical
      research on brain function. Of 1670 responders to newspaper advertising, 23.1%
      were uninterested when learning more about the studies, and 50.9% of those
      remaining were found by structured telephone screening to meet exclusionary
      criteria for having a history of psychiatric, neurologic, or medical disease that
      might affect brain function. Of 312 volunteers passing the telephone screening
      who came to an in-person evaluation by a physician and agreed to participate,
      49.7% were found to meet exclusionary criteria, and only 157 were admitted to the
      study. This underscores the importance of attending to the issue of screening and
      assessment of "normal volunteers." Alternative strategies should be considered
      for enriching the pool.

PMID- 1747018
TI  - The emergence of suicidal ideation and behavior during antidepressant
      pharmacotherapy.

PMID- 1747019
TI  - Genetic factors in stuttering confirmed.

PMID- 1747020
TI  - Natural history of schizophrenia subtypes. I. Longitudinal study of paranoid,
      hebephrenic, and undifferentiated schizophrenia.
AB  - To explore the validity of different approaches for subtyping schizophrenia, the
      conditions of 187 schizophrenic patients from the Chestnut Lodge follow-up study
      were rediagnosed with the use of classic subtype criteria. Independently
      collected data allowed construction of a longitudinal profile of the natural
      history of illness for patients who met operational criteria for paranoid (n =
      78), hebephrenic (n = 26), and undifferentiated (n = 83) schizophrenia. Paranoid
      schizophrenia had an older age at onset, often developed rapidly in individuals
      with good premorbid functioning, tended to be intermittent during the first 5
      years of illness, and was most associated with good outcome or recovery.
      Hebephrenia had an earlier age at onset, often developed insidiously, and was
      associated with a greater family history of psychopathology, poor premorbid
      functioning, and, frequently, a continuous illness with a poor long-term
      prognosis. While also early and insidious in onset, unlike hebephrenia,
      undifferentiated schizophrenia was poorly distinguished from the patients'
      premorbid state, associated with an early history of behavioral difficulties, and
      often resulted in a continuous but stable disability. We discuss implications for
      nosology. Although distinctive patterns were discernible, the considerable
      heterogeneity within subtypes calls for continued efforts to develop and explore
      alternate classification schemes.

PMID- 1747021
TI  - Natural history of schizophrenia subtypes. II. Positive and negative symptoms and
      long-term course.
AB  - The natural history and long-term course of schizophrenia divided by
      pervasiveness of positive and negative symptoms was explored among 187
      schizophrenic patients from the Chestnut Lodge follow-up study. Schizophrenia
      with many negative symptoms was associated with poor premorbid functioning,
      insidious onset, partial or no remissions during the first several years of
      illness, and in most cases a progressive course leading to permanent disability.
      Schizophrenia with few negative symptoms was associated with good premorbid
      functioning, acute onset, intermittent early course, and a better prognosis.
      Positive symptoms predicted future hospitalizations but were less powerful and
      specific as indicators of differential illness history, course, and long-term
      functional incapacity. As predictors of long-term outcome, negative symptoms were
      of greater value measured at index admission several years after illness onset
      than at first hospital admission. Multivariate analyses indicated that two
      negative symptoms (anhedonia and affective flattening) contribute significantly
      to outcome variance independent of their association with premorbid functioning
      or positive symptoms. Patients with the poorest long-term outcome tended to show
      an increase in negative symptoms during the early years of their illness.
      Progressive negative symptoms early in the course of schizophrenia may thus
      reflect or signal a process leading to long-term functional disability.

PMID- 1747022
TI  - Altered modulation of prefrontal and subcortical brain activity in newly
      diagnosed schizophrenia and schizophreniform disorder. A regional cerebral blood
      flow study.
AB  - To measure prefrontal and subcortical activity during a cognitive task, we
      examined 19 newly diagnosed schizophrenics and patients with schizophreniform
      psychosis. Seven healthy volunteers served as controls. The patients were drug
      naive or had received neuroleptics for a few days only. Cerebral blood flow
      distribution was depicted by single photon emission computed tomography at rest
      and during activation with the Wisconsin Card Sorting Test. A significant
      relative activation deficit in the left inferior-prefrontal region was revealed
      during the Wisconsin Card Sorting Test in the patient group. Furthermore, the
      patients had impaired striatal suppression on the left side during the cognitive
      task. The test performance was significantly impaired in the patients. The
      inability to reduce striatal activity may be due to a lack of corticostriatal
      feedback during prefrontal activation.

PMID- 1747024
TI  - Papillary endothelial hyperplasia in the thyroid.

PMID- 1747023
TI  - Deficits in small interneurons in prefrontal and cingulate cortices of
      schizophrenic and schizoaffective patients.
AB  - A recent report suggested that neurons in the prefrontal, anterior cingulate, and
      primary motor cortex of the brains of schizophrenic subjects may be less dense
      than those in the brains of nonschizophrenic subjects. We have determined whether
      pyramidal neurons and/or interneurons are preferentially reduced in schizophrenic
      subjects. Twelve control subjects and 18 schizophrenic subjects were studied in a
      blind, quantitative analysis of the density of pyramidal cells, interneurons, and
      glial cells in each of the six layers of the anterior cingulate and prefrontal
      cortex. The results showed that numbers of small neurons (interneurons) were
      reduced in most layers of the cingulate cortex in schizophrenic subjects compared
      with nonschizophrenic subjects, with the differences being greatest in layer II.
      In the prefrontal area, interneuronal density was also lower in layer II and, to
      a lesser extent, in layer I in schizophrenic subjects compared with control
      subjects. In most cases, the differences were similar, although more significant,
      in schizophrenic subjects who had had superimposed mood disturbances than in
      schizophrenic subjects who had not had such comorbidity. Numbers of pyramidal
      neurons generally were not different between control and schizophrenic subjects,
      except in layer V of the prefrontal area, where schizophrenic subjects showed
      higher densities of these neurons. Glial numbers did not differ between the
      control and schizophrenic subjects, suggesting that a neurodegenerative process
      did not cause the reduced interneuronal density observed. Using multiple
      regression analysis and analysis of covariance, decreases in the density of layer
      II interneurons could not be adequately explained by the effects of various
      confounding variables, such as age, postmortem interval, duration of specimen
      fixation, or administration of neuroleptic agents.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1747025
TI  - Reducing the number of routine preoperative screening bleeding time tests.

PMID- 1747026
TI  - Quality of laboratory performance in testing for human immunodeficiency virus
      type 1 antibody. Variables associated in multivariate analyses.
AB  - In May 1988, the Centers for Disease Control's Model Performance Evaluation
      Program (Atlanta, Ga) surveyed 1092 laboratories that performed enzyme
      immunoassays and Western blot tests for human immunodeficiency virus type 1
      antibody on mailed plasma samples of known human immunodeficiency virus type 1
      antibody reactivity and that described their laboratory characteristics and
      testing practices. The study objective was to evaluate the quality of laboratory
      performance in testing for human immunodeficiency virus type 1 antibody. After
      identifying relevant variables in univariate analyses, multivariate analyses were
      performed using stepwise logistic models. Human immunodeficiency virus type 1
      antibody test performance was independently associated with analytic variables
      such as commercial test kit used and with nonanalytic variables such as
      experience, training, and degree requirements of laboratory personnel. These
      results validate the importance of nonanalytic variables to the quality of
      outcomes in laboratory testing.

PMID- 1747027
TI  - Recruitment of pathology trainees. Recent trends from the 1989 Association of
      Pathology Chairmen's Survey of first-year pathology residents.
AB  - The evolving pathology manpower shortage requires that we examine recruitment
      issues closely. We present data from the 1989 Association of Pathology Chairmen
      residents' questionnaire and analyze the most important recruitment patterns. Of
      685 first-year pathology residents in 1989, 451 (66%) responded to the survey.
      When compared with other specialties, 1989 pathology residents are older (mean
      age, 30.1 years), more frequently women (38%), more often foreign medical
      graduates (23%), and more commonly have MD/PhD degrees (7.8%). Among pathology
      residents, the fifth year of required training is the most important negative
      factor in choosing pathology. Over 50% of 1989 first-year pathology residents
      changed their mind about another specialty to enter pathology; 37% chose
      pathology only after graduating from medical school. In 1988 and 1989, 63% of
      first-year pathology residents responding to the Association of Pathology
      Chairmen residents' questionnaire indicated that role models were an important
      factor in their specialty choice. The most typical role model was a male
      pathologist, approximately 47 to 48 years old. Role model influence tended to be
      greater for those residents who decided to enter pathology earlier in medical
      school. Nevertheless, over 50% of those residents who decided to enter pathology
      after medical school claimed that role model influence was important in their
      choice. Role models remain a valuable resource for improved recruitment into
      pathology.

PMID- 1747028
TI  - How can hospital autopsy rates be increased?
AB  - Autopsy studies have provided the foundation of our knowledge of clinical
      medicine. Despite the acknowledged value of this postmortem procedure, hospital
      autopsy rates have fallen to only 10% of deaths. New diseases and therapeutic
      modalities are in danger of not being properly evaluated. A number of proposals
      have been made to increase autopsy rates. While many of these proposals are
      excellent, the key to increasing autopsy rates is direct reimbursement by third
      party payers.

PMID- 1747029
TI  - The neuropathology of human immunodeficiency virus infection. The Dallas, Texas,
      experience.
AB  - Postmortem neuropathologic changes were evaluated in 141 consecutive patients
      dying with human immunodeficiency virus infection at publicly supported hospitals
      affiliated with the University of Texas Southwestern Medical Center in Dallas,
      between August 1984 and September 1990. Morphologic abnormalities were identified
      in 112 cases (79%). Cytomegalovirus was the most common opportunistic infection
      encountered, with characteristic viral inclusions identified in 23 patients, and
      presumptive evidence of infection in six additional patients. Progressive
      multifocal leukoencephalopathy was present in four patients. Gram-positive
      bacterial infections were identified in six patients, and mycobacterial
      infections in three patients. Opportunistic fungal infections included
      cryptococcosis (13 cases), histoplasmosis (two cases), and coccidioidomycosis
      (one case). Toxoplasmosis was uncommon, with active or quiescent lesions
      identified in five patients. Lymphoma was present in nine patients and was
      primary in the central nervous system in five patients. Multinucleate giant cell
      (human immunodeficiency virus) encephalitis was identified in 28 patients. In an
      additional 26 patients, microglial nodules and/or more generalized white-matter
      abnormalities were encountered in the absence of multinucleate giant cells,
      cytomegalovirus inclusions, or systemic cytomegalovirus infection. Vacuolar
      change was present in 21% of spinal cords, and was highly correlated with
      cytomegalovirus infection in the nervous system. Mixed infections and/or
      neoplasms were identified in 24 patients. This survey documents a high frequency
      of neuropathologic abnormalities in human immunodeficiency virus-infected
      individuals in a geographical region of the United States not represented in
      previous series. Variations noted in the frequencies of specific central nervous
      system disorders between this and other study populations reinforce the need for
      continuing documentation of geographical trends in human immunodeficiency virus
      associated disorders.

PMID- 1747030
TI  - Bone marrow examination for the diagnosis of mycobacterial and fungal infections
      in the acquired immunodeficiency syndrome.
AB  - In a series of 342 bone marrow examinations from 314 patients with human
      immunodeficiency virus infection, 70 examinations (20%) detected opportunistic
      mycobacterial or fungal infections. One hundred eleven of the 314 patients had
      such infections, and, hence, 63% (70/111) were detected by bone marrow
      examination. Special stains for microorganisms detected 16 (32%) of 50
      Mycobacterium avium complex infections, 10 (22%) of 45 Mycobacterium tuberculosis
      infections, eight (73%) of 11 Histoplasma capsulatum infections, and five (83%)
      of six Cryptococcus neoformans infections. Bone marrow cultures detected 36 (72%)
      of the 50 M avium complex infections, 13 (29%) of the 45 M tuberculosis
      infections, and 63% of the fungal infections. Marrow examination revealed
      infection in only one of the 70 specimens (1%) collected to evaluate
      thrombocytopenia alone or hematologic malignancy, but in 69 (25%) of 274 with
      fever, neutropenia, anemia, or miscellaneous other indications for marrow
      examination. Granulomas were detected in 102 (30%) of the biopsy specimens,
      including 71 (64%) of those in cases with mycobacterial or fungal infection. The
      granulomas showed caseous necrosis in nine cases, all in patients with
      tuberculosis, and the 27 cases with tuberculosis-associated granulomas tended to
      show large, tightly cohesive granulomas. The presence of granulomas correlated
      with opportunistic infection in 82 (80%) of 102 cases. Without granulomas,
      special stains were positive in only eight (3%) of 240 specimens. These results
      suggest that (1) bone marrow granulomas are a common and valuable histologic clue
      to opportunistic infection; (2) without them, special stains may not be a cost
      efficient way to diagnose such infection; and (3) bone marrow examination can be
      a useful method of diagnosing opportunistic mycobacterial and fungal infections
      in patients with fever, anemia or neutropenia, and underlying human
      immunodeficiency virus infection.

PMID- 1747031
TI  - Blastomycosis and opportunistic infections in patients with acquired
      immunodeficiency syndrome. An autopsy study.
AB  - Patients with acquired immunodeficiency syndrome (AIDS) are subject to a host of
      opportunistic infections, but to our knowledge a predisposition to blastomycosis
      has not previously been established. Autopsies of two patients with AIDS revealed
      disseminated blastomycosis with massive pulmonary involvement, Blastomyces
      meningoencephalitis, and widespread dissemination. The massive systemic
      involvement and rapid terminal course in both cases may reflect the state of
      acquired immunodeficiency. An analysis of an autopsy series showed that the
      incidence of blastomycosis was increased in patients with AIDS, although some
      other opportunistic organisms were more common (eg, Pneumocystis carinii,
      Mycobacterium avium-intracellulare, and Candida species). Thus, the diagnosis and
      treatment of blastomycosis must be pursued in patients with AIDS. Additional data
      are needed to further determine the incidence of blastomycosis in the population
      of patients with AIDS.

PMID- 1747032
TI  - Disseminated pneumocystosis without pulmonary involvement during prophylactic
      aerosolized pentamidine therapy in a patient with the acquired immunodeficiency
      syndrome.
AB  - Pneumocystosis, the most common opportunistic infection associated with the
      acquired immunodeficiency syndrome, is usually restricted to the lungs and
      results in severe bilateral pneumonia, which is fatal unless vigorously treated.
      Rare cases have been reported in which involvement of other organs or
      disseminated disease occurred in addition to the pulmonary lesions. Pentamidine,
      an efficient drug used intravenously for the treatment of pulmonary
      pneumocystosis, has also recently been used in aerosolized form for the
      prevention of Pneumocystis infection in patients with the acquired
      immunodeficiency syndrome. In the present case, widely disseminated, though
      symptomless, pneumocystosis developed in a human immunodeficiency virus-positive
      individual treated prophylactically with aerosolized pentamidine. Despite heavy
      multiorgan infection with Pneumocystis carinii, the lungs revealed no
      microorganisms or characteristic inflammatory lesions. This case indicates that
      aerosolized pentamidine, while efficient against the pulmonary infection, may not
      produce fungicidal blood levels sufficient for the prevention of disseminated
      pneumocystosis.

PMID- 1747033
TI  - Herpes simplex virus infection of the placenta. The role of molecular pathology
      in the diagnosis of viral infection of placental-associated tissues.
AB  - Herpes simplex infections of the placenta and its associated tissues are rarely
      seen and, consequently, the pathologic features are not well understood. We
      describe the occurrence of herpes simplex virus infection of the placenta that
      was limited to maternal-derived cells of the subchorionic tissue. The microscopic
      findings were remarkable for both the absence of inflammation and characteristic
      viral inclusions. However, in situ DNA hybridization, as well as
      immunohistochemistry using antibody to herpes simplex virus type 2, revealed
      herpes virus infection of decidualized cells in the decidua capsularis. The
      significance of this finding, and the importance of molecular techniques for the
      diagnosis of herpes virus infection in placental pathology, are discussed.

PMID- 1747034
TI  - Human immunodeficiency virus-related Kaposi's sarcoma of the appendix and acute
      appendicitis. Report of a case and review of the literature.
AB  - We describe a case of acute appendicitis precipitated by human immunodeficiency
      virus-related Kaposi's sarcoma of the appendix. This presentation in an otherwise
      asymptomatic homosexual man led to the establishment of a diagnosis of acquired
      immunodeficiency syndrome. Immediate follow-up revealed multicentric
      gastrointestinal involvement by Kaposi's sarcoma, and skin involvement ensued in
      2 months. Salient features of this case and two other similar reports in the
      literature are highlighted.

PMID- 1747035
TI  - Respiratory and enteric cryptosporidiosis in humans.
AB  - A 24-year-old homosexual man with acquired immunodeficiency syndrome presented
      with intractable diarrhea and fever. Examination of a rectal biopsy specimen and
      stool revealed Cryptosporidium. Approximately 4 months after admission he
      developed respiratory failure and died. Postmortem examination revealed
      cryptosporidiosis involving the entire gastrointestinal tract as well as the
      tracheobronchial tree. To our knowledge, this is one of the rare presented cases
      of tracheobronchial cryptosporidiosis documented histologically.

PMID- 1747036
TI  - Lymphadenopathic tumor exhibiting intermingled features of Kaposi's sarcoma,
      malignant lymphoma, and angiofollicular hyperplasia.
AB  - A 56-year-old man presented with an inguinal lymph node enlargement. Histologic
      study of the tumor revealed three intermingled pathologic lesions: a nodular
      small cell lymphoma, an angiofollicular hyperplasia of vasculohyaline type, and a
      vascular neoplasia closely resembling Kaposi's sarcoma. The patient was
      immunocompetent and denied any homosexual relationships, transfusions, or drug
      use. The serum was negative for the presence of human immunodeficiency virus
      antibody. Computed tomographic scan and ultrasound examination revealed no other
      lymphadenopathies. This case shows that both hyperplastic and neoplastic lymphoid
      proliferations can occur simultaneously with vascular neoplasia. It thereby
      suggests that the neoplastic populations might interact to favor the tumor
      growth, the sequence and the nature of the stimulating events remaining unclear.

PMID- 1747037
TI  - Pseudofungi in a lymph node. A case report with energy dispersive X-ray elemental
      analysis.
AB  - A case of pseudofungi in axillary lymph nodes is presented. They resembled
      septate hyphae and were stained with a periodic acid-Schiff stain. Gomori
      methenamine silver stain failed to stain them. Because of morphologic similarity
      to true septate fungi and positive staining with periodic acid-Schiff stain,
      these structures can be misinterpreted as septate hyphae forming true fungal
      organisms. Further studies, some of which included energy-dispersive x-ray
      elemental analysis and special stains, revealed that they were composed of iron,
      phosphorus, and calcium. The relationship of these pseudofungi to previously
      published cases and clues that enable one to make a correct diagnosis are
      described.

PMID- 1747038
TI  - Urethral T-cell lymphoma as the initial manifestation of the acquired immune
      deficiency syndrome.
AB  - We report the first case (to our knowledge) of a primary urethral T-cell lymphoma
      as the initial manifestation of the acquired immune deficiency syndrome. A 36
      year-old white homosexual man with antibodies to human immunodeficiency virus
      type 1 was evaluated for a hemorrhagic urethral discharge. A 2-cm fleshy,
      polypoid mass in the bulbous urethra was removed, and the diagnosis of small non
      cleaved cell (non-Burkitt's) lymphoma was made. Immunohistochemical analysis
      confirmed that the tumor was of T-cell lineage. Patients with the acquired
      immunodeficiency syndrome have an increased incidence of lymphomas, particularly
      extranodal high-grade non-Hodgkin's lymphomas. Primary urethral lymphomas are
      extremely rare, with only a handful of cases reported in the literature. This
      rare form and site of lymphoma should be considered in patients with the acquired
      immunodeficiency syndrome who have genitourinary symptoms.

PMID- 1747039
TI  - The attitudes of second- and third-year medical students to the autopsy. A survey
      by postal questionnaire.
AB  - Questionnaires were mailed to medical students in the cohorts who had just
      completed the second and third years of their courses. These included 52 attitude
      statements to which students indicated their responses on five-point Likert
      scales. Significant differences were found between the responses of the two
      cohorts to 18 statements. The results indicate a good general acceptance of the
      principle of autopsy in both groups, but the senior cohort was more reluctant to
      become personally involved, despite being more aware of the value of the autopsy
      in clinical audit, more aware that the autopsy has nonforensic uses, and more
      aware that autopsies remain useful in elderly subjects. Additionally, they were
      considerably less likely to want autopsies on close relatives.

PMID- 1747040
TI  - Self-reports of "positive" childhood and adolescent sexual contacts with older
      persons: an exploratory study.
AB  - An exploratory, descriptive study of 37 male and 26 female subjects reporting
      childhood or adolescent intergenerational sexual contacts about which subjects
      maintained, at least in part, "positive" feelings is reported. An informal
      comparison group of 7 female victims of sexual abuse also participated. Subjects
      were administered a 21-page, 130-item questionnaire designed to explore and
      evaluate childhood functioning and development, the nature of the sexual
      experience, and its possible impact on adult life. Eight subjects also
      participated in subsequent in-depth telephone interviews. A wide range of
      characteristics and possible effects of the experiences were reported, suggesting
      that intergenerational sexual contacts may represent a continuum of experience
      rather than a unitary and discrete pathological phenomenon.

PMID- 1747041
TI  - Development of male gender identity/role and a sexual orientation towards women
      in a 46,XY subject with an incomplete form of the androgen insensitivity
      syndrome.
AB  - Transsexualism and homosexuality have been theorized to originate in the male
      from insufficient androgenization of the brain. For verification of this
      hypothesis clinical science must rely on subjects with an abnormal
      prenatal/perinatal endocrine history. A case of a 33-year-old 46,XY subject with
      an incomplete form of androgen insensitivity syndrome (AIS) is presented. In
      adulthood the only genital sign of masculinization is a clitoris of 4 cm; the
      vagina is normal size. The diagnosis AIS was verified by androgen receptor
      studies. At birth there was confusion as to the sex of the newborn. Originally,
      the subject was assigned to the male sex, but this decision was reversed 5 days
      after birth and the subject was reared as a girl. At age 30 the subject applied
      for gender reassignment treatment to the male sex. Upon psychological evaluation
      the gender identity was unambiguously male and the sexual orientation was
      exclusively towards women. The estrogen feedback effect on LH, regarded by some
      as a marker of the sexual differentiation of the neuroendocrinium was negative
      before orchiectomy but positive after orchiectomy. Our observation demonstrates
      that in 46,XY subjects a male gender identity and a sexual orientation towards
      women can develop with a strikingly lower-than-normal level of biological action
      of androgens.

PMID- 1747042
TI  - Examining predictors of sex guilt in multiethnic samples of women.
AB  - Previous research has shown that attitudes, including sex guilt, may influence
      the nature and type of sexual practices in which a person engages. This study
      examined the relationship of socioeconomic status (SES), ethnicity, and
      religiosity to sex guilt and aspects of sexual permissiveness that relate to
      sexual attitudes. Subjects were random samples of 126 African American women and
      122 white American women in Los Angeles County. They were interviewed face-to
      face and completed the Mosher Forced Choice Sex Guilt subscale. Results indicated
      that while the association between church attendance and sex guilt was stronger
      for white than for black women, no significant differences in sex guilt across
      attendance levels was found for black women. Overall, contrary to previous
      reports, black women had higher levels of sex guilt than their white peers. The
      importance of understanding factors including SES and religiosity as they relate
      to African American and white American women's sexual attitudes and behaviors is
      discussed.

PMID- 1747043
TI  - Homosexual mounting in free-ranging female Hanuman langurs (Presbytis entellus).
AB  - Female-female mounting was studied for 3233 hr in a bisexual one-male troop of
      free-ranging Hanuman langurs in northwestern India over a period of 6 years. The
      population breeds throughout the year and female-female mounts (n = 524) occurred
      during all months. All 15 adult females mounted and were mounted, although only
      20% of the individuals exhibited more than half of all mounter activity and 33%
      more than half of all mountee activity. Various similarities with heterosexual
      mounting suggest that sexual arousal is a stimulus of the activity. Cycling,
      pregnant, and lactating females acted as mounters as well as mountees. However,
      ovulating individuals were greatly overrepresented concerning their likelihood of
      mounting and being mounted. Females of any given rank in the dominance hierarchy
      showed mounter as well as mountee activity, although mounters were higher ranking
      than mountees in 84% of cases. Young mounters were overrepresented and middle- to
      old-aged mounters underrepresented, whereas no such differences existed for
      mountees. Mounting relations among four young adult paternal half-sisters who
      occupied top positions in the dominance hierarchy were significantly
      overrepresented. Although the ultimate function of homosexual female mounting is
      not fully understood, it is suspected to be connected with intrasexual
      competition: If "pseudocopulations" induce mountees to reduce the number of
      solicitations addressed to the male, the probability of insemination decreases
      and mounters thus reduce the number of future competitors.

PMID- 1747044
TI  - Who speaks for general surgery?

PMID- 1747045
TI  - The demise of general surgery: deja vu.

PMID- 1747046
TI  - Total axillary lymphadenectomy in the management of breast cancer.
AB  - The optimal extent of axillary dissection in patients with breast cancer remains
      unclear. We report 278 total axillary lymphadenectomies (levels I, II, and III
      and Rotter's [interpectoral] nodes) that were performed in 264 closely followed
      up private patients. There have been no axillary recurrences to date (mean follow
      up, 50 months). If only level I and II nodes had been removed, the false-negative
      staging error would have been only 2.6%. However, 29 (31.5%) of 92 pathological
      node-positive axillae contained apical and/or Rotter's metastases. The incidence
      of complications was comparable with that reported for partial lymphadenectomy.
      Arm lymphedema developed in 6% of nonirradiated patients; postoperative
      radiotherapy and gross nodal disease were significant risk factors for
      lymphedema. Total axillary lymphadenectomy largely prevents axillary, recurrence,
      eliminates the small staging error inherent in partial lymphadenectomy, and has
      acceptable morbidity, provided radiotherapy to the regional nodal areas is
      avoided.

PMID- 1747047
TI  - Breast biopsy techniques and adequacy of margins.
AB  - The change toward breast-conserving surgery for cancer has altered the role of
      the initial biopsy. We retrospectively analyzed two methods, traditional
      excisional biopsy (n = 47) and lumpectomy (n = 44) to evaluate their usefulness
      as the initial procedure for breast-conserving surgery. Lumpectomy required more
      time (mean +/- SEM, 53 +/- 3 minutes) than traditional biopsy (37 +/- 2 minutes).
      Margins were verified by microscopic examination to be clear in 73% of the
      patients in the lumpectomy group and in only 17% of patients in the traditional
      biopsy group. Patients in the lumpectomy group subsequently underwent more
      axillary dissections than patients in the traditional biopsy group (31% vs 4%,
      respectively) and fewer modified radical mastectomies (49% vs 71%, respectively).
      A correlation between extensive intraductal components and positive margins was
      found in the lumpectomy group. These data suggest that as the initial biopsy
      method, lumpectomy more often provides adequate margins and may decrease the
      number of subsequent procedures on the breast for breast-conserving surgery.

PMID- 1747048
TI  - Malignant melanoma in black Americans. A trend toward improved survival.
AB  - A search of patients seen at the Duke University Melanoma Clinic (Durham, NC)
      identified 79 black patients. Five- and 10-year survival was 35% and 26%,
      respectively. Patients presenting in the recent decade had less advanced disease,
      resulting in an improved 5-year survival of 49%. Five-year survival for white
      patients was 74%. Black patients had more negative prognostic indicators when
      compared with white patients. In a multivariate analysis, however, race was not a
      prognostic indicator, suggesting melanoma is not inherently more aggressive in
      black patients. The trend during the past decade has been for black patients to
      present with less advanced disease, with improved survival. This may be related
      to better appreciation of the disease by patients and physicians alike. Continued
      emphasis on education and early diagnosis may result in further improvement for
      black patients with melanoma.

PMID- 1747049
TI  - A prospective randomized trial of perioperative cefazolin treatment in axillary
      and groin dissection.
AB  - One hundred thirty-four patients undergoing axillary or inguinal lymph node
      dissection were randomized to receive perioperative treatment with either
      cefazolin or placebo. Risk factors for wound complications (age greater than 60
      years, open wound, obesity, smoking, extremity edema, diabetes, arteriosclerotic
      cardiovascular disease) were recorded. The rate of complications was 36% in 97
      patients (72%) with any risk factor present, compared with 14% in patients with
      no risk factors. Complications were seen in 30% of patients: in 14% after
      axillary lymph node dissection, and in 64% after inguinal lymph node dissection.
      The risk of complications was 23% in the group administered antibiotic treatment
      compared with 36% in that administered placebo treatment. This trend toward fewer
      complications was seen only after axillary lymph node dissection, when the rate
      of complications was 8% in the antibiotic-treated group compared with 20% in the
      placebo-treated group. After inguinal lymph node dissection, the rate of
      complications was 69% in the antibiotic-treated group compared with 62% in the
      placebo-treated group.

PMID- 1747050
TI  - Depletion of dietary arginine inhibits growth of metastatic tumor.
AB  - The effects of dietary arginine on the growth of a murine colon tumor metastatic
      to the liver were examined in a model of advanced neoplastic disease. Tumor
      growth was influenced by arginine both in vivo and in vitro. An arginine
      supplemented diet stimulated tumor growth by 55% compared with controls.
      Conversely, an arginine-depleted diet inhibited tumor growth by 78% compared with
      controls. In vitro culture of both murine and human colon tumor cells confirmed
      that arginine was necessary for cell growth. Flow-cytometric analysis using
      propidium iodide and bromodeoxyuridine suggested that colon tumor cells cultured
      without arginine enter a quiescent S phase and depend on arginine for further
      growth and cell cycle progression. The potential roles for selective dietary
      arginine modulation in patients with cancer with advanced disease are discussed.

PMID- 1747051
TI  - Oncogene-mediated transformation. An in vitro model for colon carcinogenesis.
AB  - Evaluation of molecular events in human colon polyps and tumors has revealed
      constitutive elevated expression of c-myc, activation of both ras and src proto
      oncogenes, and allelic deletion events involving inactivation of putative
      regulatory genes, including p53. To evaluate the contribution of each of these
      events to colon carcinogenesis, it is desirable to establish epithelial cell
      lines representing different stages of neoplastic progression. Such in vitro
      models can be used to establish a primary role for different genes implicated in
      neoplastic transformation, identifying events involved in multistep
      carcinogenesis and delineating the factors modulating cellular transformation. We
      present herein a summary of such an in vitro model for colon carcinogenesis using
      the introduction of relevant genetic elements into normal mucosa to identify the
      molecular steps and accompanying cellular events underlying neoplastic
      progression in the colon.

PMID- 1747052
TI  - Treatment of abdominal malignant neoplasms using regional chemotherapy with
      hemofiltration.
AB  - The regional delivery of high-dose chemotherapy for malignant neoplasms of the
      limb with the isolated regional perfusion technique was first described in the
      late 1950s. Recently, the use of concomitant hemofiltration for rapid systemic
      drug removal permits the use of higher regional drug levels in treating patients
      with advanced abdominal malignant neoplasms without complete vascular isolation.
      Twenty-five patients successfully underwent 42 treatments of high-dose intra
      arterial chemotherapy with concomitant hemofiltration at Tulane University
      Medical Center Hospital, New Orleans, La, from 1989 through 1990. One patient
      (4%) achieved a complete response. Two patients (8%) had partial responses
      following high-dose intra-arterial chemotherapy with concomitant hemofiltration
      and their residual disease was resected for cure. Seven patients (28%) achieved a
      partial response, 11 (44%) had stable disease, and four (16%) had progression of
      disease.

PMID- 1747053
TI  - Intraoperative gamma detection probe with presurgical antibody imaging in colon
      cancer.
AB  - In this study, presurgical gamma camera imaging and an intraoperative gamma
      detection probe were used in 12 consecutive patients 6 to 22 days after infusion
      with indium 111-labeled anticarcinoembryonic antigen monoclonal antibody (111In
      MoAb). In three of 11 patients who underwent laparotomy, clinical management was
      affected by the probe findings: localization of occult retroperitoneal disease,
      identification of an occult cecal lesion, and localization of residual disease at
      a site of local recurrence. Of all intra-abdominal lesions seen using any method,
      the probe identified 18 (86%) of 21, compared with 14 (67%) of 21 with the 111In
      MoAb scan, 10 (48%) of 21 by computed tomographic scan, and 16 (76%) of 21 after
      surgical exploration. Uptake of 111In-MoAb in the portal (n = 3) and mediastinal
      (n = 3) lymph nodes was not associated with histologic findings of malignant
      neoplasms. For all pathologically confirmed extrahepatic and nonportal sites of
      cancer, the probe localized nine of nine, compared with five of nine by 111In
      MoAb scan, two of nine by computed tomographic scan, and six of nine by surgical
      exploration. Important clinical uses of the intraoperative probe included occult
      lesion identification, localization of areas with 111In uptake shown with MoAb
      scanning, and verification of complete resection of areas with 111In-MoAb uptake.

PMID- 1747054
TI  - Surgical oncology--a specialty or just special? James Ewing Lecture.

PMID- 1747055
TI  - Paranasal sinusitis in burn patients following nasotracheal intubation.
AB  - Paranasal sinusitis is a complication of nasotracheal intubation. Of 99 nasally
      intubated adult patients who survived 48 hours after being burned, 22 who were
      intubated for more than 7 days underwent a computed tomographic scan of all
      paranasal sinuses, with timing dictated by the patient's clinical condition.
      Eight patients had computed tomographic and clinical findings consistent with
      sinusitis. Treatment consisted of removal of all nasal tubes, oral and topical
      nasal decongestants, and, when appropriate, culture-specific antibiotics. A
      subgroup of patients with preexisting sinus disease made up 50% of the patients
      with sinusitis; early conversion to an oral airway or a tracheostomy should be
      considered in such patients. Only one patient required surgical drainage of the
      sinuses. The frequency and morbidity of sinusitis in nasotracheally intubated
      burn patients does not justify the risk of routine conversion to an oral airway.

PMID- 1747056
TI  - Gastric emptying after fundoplication with and without proximal gastric vagotomy.
AB  - Fifty-four patients having antireflux surgery (20 fundoplication alone [group 1]
      and 34 fundoplication with proximal gastric vagotomy [group 2], had their gastric
      emptying assessed preoperatively and postoperatively. At 3 years after operation,
      in group 1, the emptying of a solid meal was significantly accelerated. In
      contrast, no such acceleration in solid emptying was observed in group 2. Liquid
      emptying was significantly accelerated in both groups of patients
      postoperatively. No consistent relationship was found between symptomatic outcome
      and gastric emptying in either group of patients. We conclude that proximal
      vagotomy interferes with reflex pathways that are involved in the acceleration of
      solid gastric emptying after fundoplication.

PMID- 1747057
TI  - The effect of the Angelchik prosthesis on esophageal and gastric function.
AB  - The effects of the Angelchik prosthesis on esophageal and gastric function were
      investigated in 17 patients (11 men and six women; median age, 57 years; age
      range, 36 to 88 years) who underwent surgery for treatment of gastroesophageal
      reflux disease. All patients demonstrated unequivocal reflux, either at endoscopy
      or 24-hour pH testing. There was a significant increase in lower esophageal
      sphincter pressure after surgery, and no patient demonstrated abnormal reflux on
      pH testing. Gastric emptying of liquids and solids was not altered by surgery.
      Six months after surgery, all symptoms except dysphagia had significantly
      improved. Thirty-three months after surgery, six patients described symptoms as
      severe as or worse than those before surgery. Four patients had the prosthesis
      removed, two because of dysphagia alone, one because of reflux and dysphagia, and
      one because of flatulence and bloating. The patients who required removal of the
      prosthesis because of dysphagia had gross delay of esophageal emptying. We
      conclude that the Angelchik prosthesis is an effective antireflux device, but it
      interferes with esophageal function in some patients, requiring removal of the
      prosthesis. We think the rate of removal of the prosthesis is too high for its
      routine use in the treatment of gastroesophageal reflux disease.

PMID- 1747058
TI  - Trauma experience of a rural hospital.
AB  - We sought to evaluate the ability of a small rural hospital with level 2 trauma
      capability to provide adequate care to the patient with multiple trauma. Using
      the TRISS method, we reviewed 163 patients with trauma admitted to our
      institution over 2 years. An outcome equivalent to those level 1 centers that
      contributed to the Major Trauma Outcome Study is documented. The clinical
      commitment and institutional resources necessary are discussed.

PMID- 1747060
TI  - Identification and quantitative determination of a carboxylic and a mercapturic
      acid metabolite of etridiazole in urine of rat and man. Potential tools for
      biological monitoring.
AB  - Etridiazole, 5-ethoxy-3-trichloromethyl-1,2,4-thiadiazole, was orally
      administered to rats and human volunteers. Two metabolites of etridiazole were
      synthesized: 5-ethoxy-1,2,4-thiadiazole-3-carboxylic acid (ET-CA) and N-acetyl-S
      (5-ethoxy-1,2,4-thiadiazol-3-yl-methyl)-L-cysteine (ET-MA). Selective and
      sensitive analytical procedures to determine etridiazole, the carboxylic acid ET
      CA and the mercapturic acid ET-MA in urine were developed. The detection limit of
      etridiazole, applying GC with nitrogen selective detection (GC-NPD), was 36
      micrograms/l urine (CV = 15.4%, n = 3). The detection limit of ET-CA, applying GC
      with sulphur selective detection (GC-FPD), was 100 micrograms/l urine (CV = 9.8%,
      n = 3). In urine of rats orally treated with etridiazole, ET-CA and ET-MA were
      identified as metabolites of etridiazole, whereas in urine of humans given oral
      etridiazole, only ET-CA was identified. Unmetabolized etridiazole was excreted
      for less than 0.1% of the administered dose in rats. ET-CA, however, accounted
      for 22 +/- 9% of the administered dose of etridiazole in rats and for 13 +/- 6%
      in humans. ET-MA appeared to be a minor urinary metabolite of etridiazole. ET-CA
      is proposed as a possible biomarker for the biological monitoring of etridiazole.

PMID- 1747059
TI  - AIDS, drugs of abuse and the immune system: a complex immunotoxicological
      network.
AB  - Two of the most interesting questions often asked about AIDS is why many people
      do not become immunodeficient or get complicating disease when first infected
      with Human Immunodeficiency Virus (HIV) and what are the "risk factors" making
      some individuals more susceptible to the disease. A large majority of people with
      AIDS have a well established history of drug and alcohol abuse. Both drugs of
      abuse and alcohol have immunotoxic properties as evidenced by a number of
      studies. These include marked changes in the cellular, humoral and other
      components of the immune defense mechanism. Such a compromise of the immune
      system can render it susceptible to the development of AIDS after HIV infection.
      This paper reviews the evidence suggesting possible links between substance abuse
      and its immunotoxicology, and their possible roles in the pathogenesis of AIDS.

PMID- 1747061
TI  - DNA binding, adduct characterisation and metabolic activation of aflatoxin B1
      catalysed by isolated rat liver parenchymal, Kupffer and endothelial cells.
AB  - In vitro studies with rat liver parenchymal, Kupffer and endothelial cells
      isolated from male Sprague-Dawley rats were undertaken to investigate cell
      specific bioactivation of aflatoxin B1, DNA binding and adduct formation. In the
      mutagenicity studies, using homogenates of all three separated liver cell
      populations (co-incubated with NADP+ and glucose-6-phosphate as cofactors for the
      cytochrome P-450 monooxygenase system) parenchymal, Kupffer and endothelial cells
      were able to activate aflatoxin B1 to a metabolite mutagenic to Salmonella
      typhimurium TA 98. In the case of nonparenchymal cells (i.e. Kupffer and
      endothelial cells) 10-fold higher concentrations of aflatoxin B1 had to be used
      to obtain a similar number of revertants to that observed with parenchymal cells.
      Induction studies with Aroclor 1254 led to a striking decrease in the activation
      of aflatoxin B1 in parenchymal cells, whereas nonparenchymal cells had a slightly
      enhanced metabolic activation capacity for aflatoxin B1. Metabolism studies with
      microsomes from induced and noninduced cells using testosterone as substrate
      revealed comparable results: after induction with Aroclor 1254, parenchymal cells
      showed a 60% decrease in the formation rate of 2 alpha-hydroxytestosterone,
      whereas the formation rate of this metabolite remained unchanged in
      nonparenchymal cells; 2 alpha-hydroxytestosterone is specifically formed by
      cytochrome P-450 IIC11, which also catalyses the activation of aflatoxin B1 to
      its epoxide. When freshly isolated, intact cells were incubated with tritiated
      aflatoxin B1, a dose-dependent aflatoxin B1 binding to DNA in parenchymal and
      nonparenchymal cells was observed. HPLC analysis of DNA acid hydrolysates of all
      three cell types showed the major adduct to be 8,9-dihydro-8-(N7-guanyl)-9
      hydroxy-aflatoxin B1.

PMID- 1747062
TI  - Suppression of sodium arsenite-potentiated cytotoxicity of ultraviolet light by
      cycloheximide in Chinese hamster ovary cells.
AB  - Post-treatment with sodium arsenite synergistically increased the cytotoxicity of
      ultraviolet (UV) light. The potentiation of UV cytotoxicity by sodium arsenite
      was apparently suppressed by cycloheximide (CHM), a protein synthesis inhibitor.
      The protective effect of CHM against sodium arsenite-potentiated UV cytotoxicity
      was well correlated to its activity in inhibiting the synthesis of stress
      proteins, particularly a small polypeptide with a molecular weight of 8500
      dalton. This small stress protein was demonstrated as ubiquitin by
      immunoprecipitation. Our results also showed that neither ubiquitin induction nor
      potentiation of UV cytotoxicity by post-treatment with sodium arsenite was
      observed in the stationary cells. Thus, we suggested that ubiquitin is possibly
      involved in the action of arsenite in potentiating UV-induced cell killing.

PMID- 1747063
TI  - Bioavailability of bismuth from 205Bi-labelled pharmaceutical oral Bi
      preparations in rats.
AB  - The bioavailability of 205Bi from various 205Bi-labelled pharmaceutical oral
      bismuth preparations was studied in rats. The intestinal absorption, calculated
      from 205Bi whole body retention and accumulated 205Bi urinary excretion, was
      small in general, but significantly higher (0.26-0.33% of dose) from oral bismuth
      citrates (basic bismuth citrate, colloidal bismuth subcitrate) as compared to
      basic bismuth nitrate, salicylate, gallate, and bismuth aluminate (0.04-0.11% of
      dose). After oral administration, the retained bismuth was mainly accumulated in
      the kidney, followed by bone, red blood cells and the lung. The whole body
      retention, faecal and urinary excretions of 205Bi were described by a three
      compartment model. Biological 205Bi half-lives of 10, 36 and 295 h were derived
      in rats.

PMID- 1747064
TI  - Corneal edema induced by bis (tributyltin) oxide.
AB  - Corneal edema induced by bis (tributyltin) oxide (TBTO) was studied with an
      electron microscope and the accumulation sites of tin were determined with an X
      ray microanalyzer. Male Wistar rats received an intramuscular injection of 0.5
      ml/kg TBTO. After time intervals of 2, 4, 6, 8, 10, 12 h after injection, corneas
      were isolated and provided for electron microscopy. Corneas from untreated rats
      served as controls. Marked swelling of mitochondria in the corneal endothelial
      cells occurred at 4 h after TBTO injection. The corneal edema appeared in the
      endothelial layer and the stroma at 6 h after injection. By X-ray microanalysis,
      Sn peaks were obtained from swollen mitochondria in the endothelial cells. At 12
      h after TBTO injection, edematous swelling of the corneal tissue became more
      advanced. These results indicated that parenterally administered TBTO accumulated
      in the mitochondria of corneal endothelial cells. The direct toxic effects of
      TBTO on the mitochondria might cause the interference with active pump function
      of endothelial cells and induced the corneal edema.

PMID- 1747065
TI  - Polyhalogenated dibenzo-p-dioxins and dibenzofurans and the immune system. 3. No
      immunosuppressive effect of 2,3,7,8-TCDD in the popliteal lymph node assay (PLNA)
      in rats.
AB  - We used a modified version of the popliteal lymph node assay in rats to
      investigate the immunosuppressive potential of 2,3,7,8-tetrachlorodibenzo-p
      dioxin (TCDD). In 10 months we conducted 3 experimental series. Animals were
      treated with single s.c. injections of TCDD and 7 days later human red blood
      cells (HRBC) were injected s.c. into the right hind footpad of the rat. Another 7
      days later, both popliteal lymph nodes were prepared, weighed, the cell number
      was counted and the quotients ("index") of these variables from the treated and
      the untreated side were determined. The doses applied in three experimental
      series were 600', 60, 6, 0.6, and 0.06 ng TCDD/kg body wt. In the first
      experimental series only the three highest doses were tested, in a second
      experimental series doses of 60, 6, 0.6, 0.006 ng TCDD/kg body wt were applied.
      Combining the results of these two experimental series, a statistically
      significant difference was found in the cell number index between the controls
      and the two highest doses tested (60 and 600 ng/kg body wt; p less than 0.01).
      This result was recently published as an abstract (Korte et al. 1990). However,
      with slight methodological changes in the third series of experiments (doses
      applied: 600, 60, 6, 0.6, and 0.06 ng TCDD/kg body wt) and using a greater number
      of animals we could not confirm these preliminary results. No difference was seen
      in the immune response to the antigen challenge in controls and in any of the
      treatment groups. We conclude that TCDD does not clearly influence the immune
      response as observed in the popliteal lymph node assay under our experimental
      conditions.

PMID- 1747066
TI  - Distribution and effects on cytochrome P450 system of two hexachlorobiphenyl
      isomers in the rat.
AB  - Tissue distribution and effects induced by 2,2',4,4',5,5'-hexachlorobiphenyl (245
      HCB) on cytocrome P450 isozymes were compared with those of 2,2',3,3',6,6'
      hexacholorobiphenyl (236-HCB). Male Wistar rats were given a single intragastric
      dose (23 mg/kg body wt) of either isomer, and killed after 72 h. At termination
      the tissue concentrations of 245-HCB were considerably higher than those of 236
      HCB, suggesting a more effective metabolism of the latter. The binding affinity
      of 236-HCB to cytochrome P450 was higher and the magnitude of binding greater
      than of 245-HCB. 245-HCB-treatment elevated the hepatic concentration of
      cytochrome P450 and also the activities of 7-pentoxyresorufin O-depentylase (50
      fold), aniline p-hydroxylase (2-fold) and 7-ethoxycoumarin O-deethylase (2-fold),
      a response typical of phenobarbital-type inducers. In the Western immunoblot of
      liver microsomes from 245-HCB treated rats, an increased amount of P450IIB 1/2
      was detected by a monoclonal antibody 2-66-3, which specifically detects
      phenobarbital inducible isoenzymes. The minimum molecular mass of the P450
      isozyme induced was 52 kDa. After 236-HCB administration, a weak inducing effect
      was observed.

PMID- 1747067
TI  - Protective effect of O-phenanthroline against mechlorethamine toxicity in the rat
      liver slice system and in the guinea pig skin.
AB  - The effect of O-phenanthroline (OP) on mechlorethamine hydrochloride (HN2)
      toxicity was studied in in vitro and in vivo experiments. Incubation of HN2 with
      the in vitro rat liver slice system resulted in leakage of alanine
      aminotransferase (ALT) in a time-dependent manner. Exposure of the slices to HN2
      for 4 h caused 79.2% ALT leakage. In the presence of OP enzyme leakage was
      reduced to 28.7%. OP-induced protection was shown to be dose dependent. Other
      metal chelators such as dithiothreitol (DTT) and EDTA (ethylenediaminetetraacetic
      acid) had a weak effect on HN2 cytotoxicity. The protective activity of OP was
      also demonstrated in in vivo skin toxicity studies in the guinea pig. The
      ulcerative effect of topically applied HN2 was inhibited by OP even when applied
      10 min following the alkylator. Histology of NH2-treated skin showed epidermal
      ulceration associated with a covering layer of encrusted exudate. However, only a
      slight diffuse acanthosis of the epidermal layer was observed when OP was applied
      for 10 min after the vesicant. It is suggested that OP may be used for the
      prevention of tissue damage caused by antineoplastic treatment with nitrogen
      mustard. It might also be employed in military medicine as an antidote to the
      chemical weapon sulfur mustard.

PMID- 1747068
TI  - Respiratory effects of trimellitic anhydride aerosols in mice.
AB  - Groups of mice were exposed to trimellitic anhydride (TMA) aerosols for 30 min at
      concentrations ranging from approximately 2 to 150 mg/m3. The sensory and
      pulmonary irritating properties of TMA were assessed during these exposures.
      Sensory irritation, as evidenced by a lenghthening of the time of expiration
      (TE), was not evoked in any exposure. However, TMA aerosols evoked other rapid,
      reversible alterations of respiratory cycle timing, suggestive of pulmonary
      irritation. The time of inspiration (TI) and expiration (TE) decreased as TMA
      exposure concentration was increased. Also, characteristic pauses (i.e., apneic
      periods) occurred between breaths. The length of these pauses (TP) increased as
      TMA exposure concentration was raised. Respiratory frequency (f) was dependent
      upon the magnitude of increase in TP. At lower TMA concentrations, TP was short
      and f was elevated, whereas at higher concentrations, TP was long and f was
      reduced. Interestingly, there was no other evidence of pulmonary irritation
      besides the alterations in respiratory cycle timing. Histopathological evaluation
      of the respiratory tracts of TMA-exposed animals revealed no changes from those
      of controls. Finally, there was no evidence of cumulative or delayed pulmonary
      effects in mice repeatedly exposed to TMA aerosols. These acute changes in
      respiratory cycle timing may have occurred as a result of stimulation of vagal
      nerve endings along the conducting airways and in the deep lung, directly
      produced by TMA aerosols.

PMID- 1747069
TI  - Chronic intoxication with acetaldehyde stimulates collagen biosynthesis in rat
      liver.
AB  - It was found that chronic intoxication of rats with acetaldehyde results in a
      distinct, progressive increase of 5(3)H-proline incorporation into collagen
      synthesized by liver. At the same time, biosynthesis of other proline-containing
      (noncollagenous) proteins does not change significantly. The effects are similar
      to those induced by chronic intoxication of rats with ethanol. Since acetaldehyde
      is an intermediary metabolite formed during ethanol oxidation in liver, it may be
      concluded that acetaldehyde is a factor responsible for alcohol-induced liver
      fibrosis.

PMID- 1747070
TI  - Potential tolerance against bromobenzene-induced acute hepatotoxicity due to
      prior subchronic exposure.
AB  - Groups of adult male Sprague-Dawley rats were treated i.p. with 0, 0.3 and 0.5
      mmole bromobenzene (BB)/kg per day in corn oil, 5 days a week for 4 weeks.
      Thereafter, one half of each of these groups was treated i.p. with a single acute
      toxic dose of 2.5 mmole BB/kg. Urines were then collected for 24 h and the
      animals were then sacrificed. The hepatotoxicity induced by an acute dose of BB
      was significantly reduced due to prior subchronic exposure to BB at 0.5 mmol/kg,
      but not so at 0.3 mmol/kg. These data indicate a potential tolerance against
      acute hepatotoxicity of BB due to prior subchronic exposure. A significant
      increase in the urinary excretion of thioethers or mercapturic acids of BB
      combined with a significant increase in the urinary level of p-bromocatechol due
      to prior subchronic treatment with 0.5 mmol BB/kg relative to those due to acute
      treatment alone was observed. Thus enhanced bromobenzene metabolism could partly
      explain such potential tolerance against its acute hepatotoxicity. Such
      protection may also be related to certain cellular events which might occur
      subsequent to metabolic activation of BB.

PMID- 1747071
TI  - Gastrointestinal absorption of Cd-metallothionein and cadmium chloride in mice.
AB  - CdCl2 or Cd-metallothionein (MT) (6 micrograms Cd with 2.25 muCi (83.25 KBq)
      109Cd) was given orally to mice, which were sacrificed at 30 min and 2 h after
      intubation. Although 109Cd in Cd-MT was excreted rapidly into the urine, its
      absorption was found to be significantly less than that of CdCl2. The poor
      absorption was due to a decrease of Cd-MT uptake into the intestine. Cadmium
      chloride taken up into the mucosa could stimulate MT synthesis even 30 min after
      its intubation. However, the percentage of MT-bound Cd in the Cd of intestinal
      supernatants was lower with CdCl2 (62% at 30 min and 2 h) than with Cd-MT (78%
      and 84% at 30 min and 2 h, respectively). These results suggest that the
      transport mode of lumenal Cd-MT to mucosal cells is different from that of
      lumenal CdCl2. Lumenal Cd-MT is probably internalized into intestinal cells in an
      intact form. Furthermore, the Cd-MT may pass through the basolateral membrane in
      this form. This hypothesis was supported by the different distributions of Cd in
      the liver and kidney after Cd-MT and CdCl2 intubations.

PMID- 1747072
TI  - Crevicular IgG antibodies and Streptococcus mutans on erupting human first
      permanent molars.
AB  - The specific IgG antibody activity against indigenous Streptococcus mutans in
      gingival crevicular fluid (GCF) was determined in 25, 6-7-yr-old children.
      Samples of plaque and GCF were collected from all erupting first permanent
      molars. Plaque samples were also collected from the adjacent second primary
      molars. The presence of clinical caries was scored as defs. In the same
      individual a highly significant correlation (p less than 0.005) was found between
      the level of specific antibody activity in GCF when comparing first permanent
      molars with each other. No correlation was found between the specific antibody
      activity in GCF and the number of indigenous Strep. mutans colonizing the buccal
      surfaces of the first permanent molars. Caries-free children had significantly
      less specific antibody activity in GCF than children with caries experience (p
      less than 0.05). In the same child a highly significant correlation (p less than
      0.0001) was found between the level of colonization by mutans streptococci on the
      permanent molars and the adjacent second primary molars.

PMID- 1747073
TI  - Subcellular co-localization and co-variations of two vitamin D-dependent proteins
      in rat ameloblasts.
AB  - The immunocytochemical patterns of calbindin-D9k (CaBP 9k) and calbindin-D28k
      (CaBP 28k) were compared by light and electron microscopy throughout
      amelogenesis. Labelling on serial sections and co-localization of CaBPs confirmed
      that the two proteins were restricted to a single cell type, the ameloblasts.
      Their quantity increased during presecretion, was stable during secretion and
      alternately high and low during the cyclic modulation of ameloblasts which occurs
      during maturation. Ruffle-ended ameloblasts contained the highest apparent
      concentration. Investigations with several fixatives indicated that the CaBPs
      were present in the cytosol and the nucleus, although there were slight
      differences with various fixatives by light microscopy. Their concentrations in
      these compartments varied in parallel throughout amelogenesis. However,
      mitochondria contained only immunoreactive CaBP 9k. While the distribution of
      CaBP 9k in zones containing Golgi apparatus and rough endoplasmic reticulum was
      similar, CaBP 28k concentration has, in another paper, been shown to be higher
      near the rough endoplasmic reticulum.

PMID- 1747074
TI  - Morphological and immunocytochemical characterization of cultured rat incisor
      cervical epithelial cells.
AB  - Epithelial cells from the cervical loop of the rat incisor were isolated by co
      culture of apical explants with growth-arrested 3T3 fibroblasts. The epithelial
      phenotype of the expanding outgrowths was confirmed 10 days after the seeding of
      the explants by phase-contrast microscopy and immunocytochemical identification
      of cytokeratins. After 3 weeks in culture, the epithelial cells covered the
      entire surface of the coverslips and were then passaged. Subcultures gave rise to
      a confluent sheet within 10-12 days. Light and electron microscopy showed that
      confluent cervical epithelial cells generally reconstituted a bi-layered
      structure similar to Hertwig's epithelial sheath. Epithelial cells from the rat
      palate, cultured and subcultured according to the same procedure, organized
      themselves in 5-6 cell layers, the upper cells having generally a squamous
      morphology. Synthesis of extracellular matrix molecules by rat incisor cervical
      epithelial cells was studied with specific antibodies. These cells failed to
      produce type I collagen, but synthesized all the major basement membrane
      components (type IV collagen, laminin, heparan sulphate proteoglycan and
      fibronectin). These observations suggest that the culture conditions allowed the
      reconstitution of a typical Hertwig's epithelial sheath by rat incisor cervical
      epithelial cells.

PMID- 1747075
TI  - Degradation of collagen types I, III, IV and V by extracellular proteinases of an
      oral flagellate Trichomonas tenax.
AB  - Proteinases secreted by an axenic strain of Trichomonas tenax were active against
      native types I, III, IV and V collagens when evaluated by polyacrylamide gel
      electrophoresis. Degradation of all four collagen types was temperature
      dependent. Basement membrane type IV collagen was digested most effectively. An
      inhibition of all collagenolytic activities by a specific inhibitor of cysteine
      proteinases, E-64, and activation by a reducing agent, dithiothreitol, indicated
      the involvement of cysteine proteinases of the oral flagellate in the cleavage of
      collagen.

PMID- 1747076
TI  - A histochemical study on the distribution of melanin in human oral epithelium at
      six regional sites.
AB  - Oral mucosa from six sites in 95 autopsies was tested for melanin using the
      Masson-Fontana silver reduction method. Melanin was detected in 51.6% of labial,
      46.3% of palatal, 45.3% of buccal, 28.4% of mandibular gingival, 25.3% of lingual
      and 21.1% of maxillary gingival samples. 93.7% of epidermal samples from the same
      population were positive. In 24.2% of the subjects there was no detectable
      melanin at any intraoral site and 4.2% showed activity in all six sites. The mean
      number of positive oral sites per individual was 2.2. There are thus regional
      differences in oral epithelial melanocyte activity, but no parallel with the
      known regional incidence of primary oral melanoma.

PMID- 1747077
TI  - The extent and distribution of intratubular collagen fibrils in human dentine.
AB  - Dentine of 27 permanent human teeth was examined by scanning electron microscopy.
      The teeth were incisors, canines, premolars and molars, ranging in age from 18 to
      54 yr. Intratubular collagen was found in 65% of the dental tubules in inner
      dentine (closest to the pulp) with 16% of the tubules containing large collagen
      bundles occupying more than one-fifth of the lumen. In middle dentine the
      corresponding figures were 42 and 7%, and for outer dentine, 12 and 0% This
      pattern of distribution was the same for all tooth families examined and appeared
      to be unrelated to age.

PMID- 1747078
TI  - An instrument to monitor physiological and environmental parameters associated
      with heat stress on an ambulatory subject.
AB  - This paper outlines the development and construction of an instrument for use on
      an ambulatory subject which monitors selected physiological and environmental
      parameters that are a reflection of the degree of physiological strain associated
      with heat stress. The resulting instrument is rugged, reliable, and uses existing
      practical technology for in-the-field ambulatory monitoring, and provides minimal
      restriction to subject movement. The physiological parameters monitored (heart
      rate and skin temperature) were selected following examination of systemic, skin,
      and psychoneurotic heat disorders, with the environmental parameters (wind
      velocity, ambient temperature and relative humidity) based on existing heat
      stress indices' correlation with physiological parameters. A microprocessor is
      utilized for data acquisition, mathematical computation and long term storage,
      and software for downloading the data to a large mainframe computer is provided.
      Following calibration of the transduction circuits, the instrument was assembled
      and tested. Improvements are required to obtain the reliability originally
      envisaged. Additional field trials would see the collection of data to establish
      criteria to determine the values of the parameters monitored enabling prediction
      of the onset of heat stress in hot, humid environments.

PMID- 1747079
TI  - Distribution of expired air in carry cots--a possible explanation for some sudden
      infant deaths.
AB  - A possible explanation for the cause of some cot deaths is examined by placing an
      appropriate cot death model on a cold wet sheet so that its "breath" is directed
      downwards across the sheet, thereby being cooled and becoming heavy enough to
      stay trapped in the hollow of the mattress. The breath is then available for
      rebreathing by the model. The level of carbon dioxide (CO2) "inhaled" is showed
      to be lower in nostril breathers, singletons and in bassinets and higher with
      mouth breathing models, in "twins", and in carry cots, especially if the model's
      head is accidentally covered. Under these conditions a living infant would become
      progressively acidotic due to inability to adequately excrete its metabolic CO2.
      This must inevitably be accompanied by increasing hypoxia. If left undisturbed in
      this predicament, it would rebreathe its own breath for the period of time
      between feeds and develop increasing degrees of asphyxia, depending on the
      circumstances outlined.

PMID- 1747081
TI  - College membership standards.

PMID- 1747080
TI  - Management and autopsy of a radioactive cadaver.
AB  - A 69 year old male was treated with an ablative dose of 3.7 GBq (100 mCi) of I131
      for carcinoma of the thyroid and died 10 days after administration. The
      requirement for an autopsy and the level of radiation still present in the body
      necessitated the intervention of Radiation Safety Personnel to minimise support
      staff radiation exposure and area contamination. Preventative measures were taken
      in accordance with the ALARA principle and a detailed procedure is presented as a
      suggested model for any future occurrence.

PMID- 1747082
TI  - Recent developments in time-dose modelling.
AB  - Two recent innovations in time-dose models are reviewed: the linear-quadratic (L
      Q) and the variable-exponent Time-Dose Factor (TDF) models. The basic L-Q
      equations for fractionated and continuous (brachytherapy) regimes are presented
      as well as those for incomplete repair and short half life radionuclides. None of
      these equations has provision for a repopulation factor, so a "wasted ERD"
      parameter is introduced, which is a linear function of overall treatment time,
      with incorporation of a lag time if desired. For low dose rate therapy, an
      effective treatment time is defined, at which the ERD reaches its maximum value
      when the rate of increase due to irradiation equals the rate of decrease due to
      repopulation. The variable-exponent TDF model has a volume-effect parameter and
      scaling factors which make TDFs of 100 correspond to tolerance for all volumes of
      tissue treated, for both fractionated and continuous therapy. These, as well as
      the exponents, are all tissue-specific. Volume-effect and scaling factors are
      also appropriate for the L-Q equations. With these it is possible to apply the
      TDF and L-Q models to problems which involve inhomogeneous dose distributions.
      Several examples of the use of these models are presented.

PMID- 1747083
TI  - A mathematical study of non-Newtonian blood flow through elastic arteries.
AB  - Existing models of blood flow through arteries are revisited. Non-Newtonian and
      viscous properties are also considered. Treating blood as a non-Newtonian,
      pseudoplastic fluid obeying the power law, the flow equations are rigorously
      derived, using the same principles applied in existing models. An appropriate and
      more physically and physiologically correct model is obtained. Another model in
      exponential form is also derived. The resulting equations are solved numerically
      for a range of parameters and the various graphs are compared.

PMID- 1747084
TI  - Optical design in a flow system for imaging cells.
AB  - The imaging flow cytometer is an instrument that acquires the images of cells in
      a flow system. These images are analyzed for real-time cell classification and
      sorting. The optical units in the system perform the functions of laser beam
      focusing, cell detection, and cell imaging. The glass nozzle in which the cell
      stream flows introduces air-glass optical interfaces, resulting in optical
      aberrations that impair performance. This report describes the analysis of the
      optical aberrations in nozzles fabricated from a cylindrical glass capillary
      tube. Flat surfaces could be machined on the originally cylindrical surface to
      reduce the severity of these aberrations. The analysis shows that a nozzle with
      three flat surfaces is a feasible low-cost solution.

PMID- 1747085
TI  - The temperature for fusing blood vessels using a copper vapour laser.
AB  - Specimens of canine femoral or carotid artery were preserved at the temperature
      of liquid nitrogen and restored to room temperature before use. Fusing
      experiments were performed by repeatedly scanning along cuts of 1.0 cm long using
      a copper vapour laser at a power level of 500 mW. The laser was delivered via a
      0.2 mm diameter optical fibre, 10 cm from the specimen, providing a beam spot
      area of 0.125 mm2 (a power density of 400 W cm-2). Drops of saline solution were
      applied to the irradiated areas for cooling at a rate of one drop every five
      seconds. At a scanning rate of 1 cm s-1, about 300 s were taken to successfully
      fuse a cut of 1 cm long with minimum tissue damage. Direct measurement of tissue
      temperatures whilst the beam was applied was not possible because of the
      interference of the laser, therefore the fusing temperature was estimated by the
      method of extrapolation. Time dependence of the surface temperature at the centre
      of the target area immediately after exposure and the spatial distribution of the
      surface temperature around the target area during exposures were measured using a
      thermocouple thermometer. The fusing temperature was estimated to be 62 degrees C
      by extrapolation of the time dependence and spatial distributions.

PMID- 1747086
TI  - Computer generation of random deviates.
AB  - The need for random deviates arises in many scientific applications, such as the
      simulation of physical processes, numerical evaluation of complex mathematical
      formulae and the modeling of decision processes. In medical physics, Monte Carlo
      simulations have been used in radiology, radiation therapy and nuclear medicine.
      Specific instances include the modelling of x-ray scattering processes and the
      addition of random noise to images or curves in order to assess the effects of
      various processing procedures. Reliable sources of random deviates with
      statistical properties indistinguishable from true random deviates are a
      fundamental necessity for such tasks. This paper provides a review of computer
      algorithms which can be used to generate uniform random deviates and other
      distributions of interest to medical physicists, along with a few caveats
      relating to various problems and pitfalls which can occur. Source code listings
      for the generators discussed (in FORTRAN, Turbo-PASCAL and Data General
      ASSEMBLER) are available on request from the authors.

PMID- 1747087
TI  - Mammography in New Zealand: radiation dose and image quality.
AB  - The mean glandular doses to the breast, image quality and machine performance
      have been determined for all mammographic x-ray facilities in New Zealand, during
      1988-89. For 30 mm and 45 mm phantoms the mean doses per film were 1.03 +/- 0.56
      mGy and 1.97 +/- 1.06 mGy. These doses are within international guide-lines.
      Image quality (detection of simulated microcalcifications, and contrast-detail
      performance) was found to depend on focal spot size/FFD combination, breast
      thickness, and film processing. The best machines could resolve 0.2 mm aluminium
      oxide specks with the contact technique. The use of a grid improved image quality
      as did magnification. Extended cycle film processing reduced doses, but the
      claimed improvement in image quality was not apparent from our data. The machine
      calibration parameters kVp, HVL and timer accuracy were in general within
      accepted tolerances. Automatic exposure controls in some cases gave poor control
      of film density with changing breast thickness.

PMID- 1747088
TI  - Environmental events and psychopathology. Restoring the balance.

PMID- 1747089
TI  - The effects of divorce on children's adjustment. Review and implications.
AB  - Divorce has become one of the most frequent environmental stressors experienced
      by children. This article reviews present conceptualizations of children's
      adaptation to divorce. Most notably, researchers have moved away from the view
      that family structural variables, such as single-parent status, necessitate the
      development of psychopathology in children. In recent years, investigators have
      shifted their attention to events that accompany marital dissolution, rather than
      the event of divorce per se. Such process variables have been identified as more
      salient correlates of children's adjustment. Additionally, the article examines
      children's short- and long-term adjustment to divorce, specific problem areas
      that are common among children from divorced families, and directions for future
      investigations.

PMID- 1747090
TI  - Depression in pediatric illness.
AB  - Depression is a major complication of medical illness in adults and is
      increasingly being recognized as a complication of pediatric illness. The author
      reviews issues in the assessment and diagnosis of depression in pediatric illness
      and reviews recent studies on the prevalence of and risk factors for depression
      in different illnesses. Pediatric illness may be a major stressor that
      precipitates depression in children vulnerable because of life events, family
      dysfunction, or predisposition to affective illness.

PMID- 1747091
TI  - Effects of unemployment on mental health in the contemporary family.
AB  - This article summarizes research conducted in the past 20 years concerning mental
      health effects of involuntary job loss. The majority of studies and previous
      reviews focus on unemployment effects on men. Although these studies are also
      reviewed, this article highlights studies of (a) the involuntarily unemployed
      woman, (b) the spouse of the unemployed person, and (c) their children. Within
      each of these research areas, the authors consider studies grouped according to
      their methodological strength for drawing causal inferences about the impact of
      job loss on psychological status, ranging from cross-sectional to longitudinal to
      prospective studies. The implications of the unemployment literature not only for
      future research but also for clinical practice are addressed. Knowledge of family
      effects of this stressful life circumstance is critical to developing effective
      treatment plans for patients who, although perhaps not the direct victims of job
      loss themselves, may nevertheless present with problems indirectly caused or
      exacerbated by unemployment within the family.

PMID- 1747092
TI  - Homicide as a risk factor for PTSD among surviving family members.
AB  - In this National Institute of Justice-funded study, random digit dialing
      telephone survey methodology was used to screen a large, nationally
      representative sample (N = 12,500) of the noninstitutionalized U.S. adult
      population to identify surviving family members and friends of victims of
      criminal homicide and alcohol-related vehicular homicide. A total of 9.3% of the
      national sample had lost a family member or friend to homicide. Immediate family
      survivors (n = 206) completed an interview assessing demographic characteristics
      and DSM-III-R criteria for homicide-related post-traumatic stress disorder
      (PTSD). The interview participation rate was 84%. Among immediate family
      survivors, 23.3% developed PTSD at some point in their lifetimes, and 4.8% met
      full diagnostic criteria for PTSD during the preceding 6 months. Survivors of
      criminal and vehicular homicide victims were equally likely to develop PTSD.
      Survivors who experienced the homicide during their childhood, adolescence, or
      adulthood also showed equal likelihood of PTSD. Clinical implications of findings
      are discussed.

PMID- 1747093
TI  - Child, adolescent, and adult victims of residential fire. Psychosocial
      consequences.
AB  - Behavior of children, adolescents, and adults during and after a residential fire
      was objectively assessed. Antecedents, behaviors, and consequences of the
      nighttime residential fire immediately and 1 month following the fire were
      obtained. Also, the extent of agreement between children/adolescent and adult
      functioning was determined. Eight children and adolescents and 12 adults were
      individually interviewed. Results showed that individuals' reactions to
      residential fire could be assessed, and several PTSD-related symptoms were
      expressed. A follow-up study in which 25 adolescent boys whose dormitory had been
      totally destroyed by fire were compared to 13 boys who had not experienced the
      fire showed similar findings. These findings add to the dearth of literature
      concerning children and adolescents in fire-related disasters.

PMID- 1747094
TI  - Molecular identification and comparison of the starch synthase bound to starch
      granules between endosperm and leaf blades in rice plants.
AB  - Normal (nonglutinous) rice plants (Oryza sativa and O. glaberrima) contain more
      than 18% amylose in endosperm starch, while waxy (glutinous) plants lack it in
      this starch. In contrast, leaf starch contained more than 3.6% amylose even in
      waxy plants. SDS-PAGE analysis of proteins bound to endosperm starch granules in
      the normal plants revealed a single band with a Mr of 60 kd, whereas waxy plants
      did not exhibit a similar band. The activity of starch synthase (NDP-glucose
      starch glucosyltransferase) was completely inhibited by antibody against the 60
      kd protein. Thus, we conclude that the 60-kd protein is the waxy protein encoded
      by the Wx allele, which also plays a role in the synthesis of nonglutinous starch
      in endosperm tissue. In leaf blades, the proteins bound to starch granules
      separated into five bands with Mr's of 53.6 to 64.9 kd on SDS-PAGE. Analysis of
      these proteins by immunoblotting using antiserum against Wx protein and
      inhibition of starch synthase activity by the synthase antibody revealed that
      none of these proteins was homologous to Wx protein. We suggest that the
      synthesis of amylose in leaf blades is brought about by a protein encoded by a
      gene(s) different from the Wx gene expressed in the endosperm.

PMID- 1747095
TI  - Isolation of Caenorhabditis elegans mutants lacking alcohol dehydrogenase
      activity.
AB  - Alcohol dehydrogenase (ADH) and the genes encoding this enzyme have been studied
      intensively in a broad range of organisms. Little, however, has been reported on
      ADH in the free-living nematode Caenorhabditis elegans. Extracts of wild-type C.
      elegans contain ADH activity and display a single band of activity on a native
      polyacrylamide gel. Reaction rate for alcohol oxidation is more rapid with higher
      molecular weight alcohols as substrate than with ethanol. Primary alcohols are
      preferred to secondary alcohols. C. elegans is sensitive to allyl alcohol, a
      compound that has been used to select for ADH-null mutants of several organisms.
      Allyl alcohol-resistant mutant strains were selected from ethylmethanesulfonate
      (EMS)-mutagenized nematode populations. ADH activity was measured in extracts
      from eight of these strains and was found to be low or nondetectable. These
      results form a basis for molecular and genetic characterization of ADH expression
      in C. elegans.

PMID- 1747096
TI  - Genetics and polymorphism of a duplicated malate dehydrogenase (MDH) locus in the
      grasshopper Oxya japonica japonica (Orthoptera:Acrididae:Oxyinae).
AB  - A biochemical genetic study of the enzyme malate dehydrogenase (MDH) was
      conducted in the grasshopper Oxya j. japonica. Analysis of MDH electrophoretic
      variation in this species of grasshopper shows that one of the two autosomal loci
      for MDH in grasshoppers, the Mdh-2 locus, controlling the anodal set of MDH
      isozymes, is duplicated. Results of breeding studies confirm this and the
      observed polymorphism at the Mdh-2 locus in the two populations of Oxya j.
      japonica studied can be attributed to three forms of linked alleles at the
      duplicated locus in equilibrium in both populations. In this respect, all
      individuals of this species possess heterozygous allelic combinations at the
      duplicated Mdh-2 locus, which may account for the spread of the duplicated locus
      in the populations of this species of grasshopper.

PMID- 1747097
TI  - Conservation genetics of the koala (Phascolarctos cinereus). II. Limited
      variability in minisatellite DNA sequences.
AB  - We have examined variability in TaqI and EcoRI restriction fragment sizes of DNA
      from the koala (Phascolarctos cinereus) using six HVR (hypervariable region)
      probes which reveal complex, individual-specific restriction patterns in humans
      and other species. Frequency of band-sharing among unrelated koalas was extremely
      high. This result is likely to be a consequence of the history of near-extinction
      and artificial recolonization of the populations we have studied, rather than a
      general marsupial or koala-wide phenomenon.

PMID- 1747098
TI  - Biochemical and physiological studies of soluble esterases from Drosophila
      melanogaster.
AB  - Twenty-two soluble esterases have been identified in D. melanogaster by combining
      the techniques of native polyacrylamide gel electrophoresis and isoelectric
      focusing. The sensitivity of each isozyme to three types of inhibitors
      (organophosphates, eserine sulfate, and sulfydryl reagents) identified 10 as
      carboxylesterases, 6 as cholinesterases, and 3 as acetylesterases. Three isozymes
      could not be classified and no arylesterases were identified. The carboxyl- and
      cholinesterases could each be further divided into two subclasses on the basis of
      inhibition by organophosphates and sulfhydryl reagents, respectively. Choline-
      and acetylesterases have characteristic substrate preferences but both subclasses
      of carboxylesterases are heterogeneous in substrate utilization. Subclass 2
      carboxylesterases exhibit diverse temporal expression patterns, with subclass 1
      carboxylesterases generally found in larvae and subclass 1 cholinesterases and
      acetylesterases more characteristic of pupae and adults. Tissues showing the
      greatest number of isozymes are larval body wall (eight) and digestive tract (six
      in larvae, six in adults). Carboxylesterases are distributed across a wide range
      of tissues, but subclass 1 cholinesterases are generally associated with neural
      or neurosecretory tissues and subclass 2 cholinesterases with digestive tissues.

PMID- 1747099
TI  - Genetic differentiation of Drosophila melanogaster populations as assessed by two
      dimensional electrophoresis.
AB  - Seven populations of Drosophila melanogaster, representing a worldwide
      distribution, were compared using two-dimensional protein gel electrophoresis. A
      total of 611 protein spots was scored, which probably represent a sample of over
      500 loci that were surveyed. Of the protein spots scored, 521 spots were found to
      be invariant, but another 90 spots were found to be variable among the
      populations. Of these variable protein spots, 12 were found to be present in only
      one population. All the populations, except one, had at least one protein spot
      restricted to itself. However, the Japanese population had by far the most, with
      five protein spots restricted to this one population, which has been observed in
      previous studies of private alleles in oriental populations. The mean genetic
      similarity (F) found among the seven populations was 0.965, with a range of
      between 0.956 and 0.977. This is similar to previous reports of lower variation
      found in population genetic surveys using two-dimensional electrophoresis. It was
      found that the historical relationships among these populations was somewhat
      congruent with the geographic distribution of the populations, but as in previous
      studies, it was not exactly coincident.

PMID- 1747100
TI  - Two-dimensional electrophoresis of 1D-encoded B and D glutenin subunits in common
      wheats with similar omega gliadins.
AB  - Gli-D1-encoded omega gliadins of bread wheats show little variation; their
      electrophoretic patterns can be classified into two main groups which broadly
      resemble the patterns found in the cultivars Chinese Spring and in Cheyenne. B
      and D subunits of low molecular weight glutenin encoded by the chromosome 1D loci
      Glu-D3 and Gli-D1, respectively, also showed little variation. D subunits were
      found only in bread wheats with "Chinese Spring-type" omega gliadins and they all
      exhibited the same electrophoretic pattern. This material also showed very
      similar B subunits. "Cheyenne-type" bread wheats displayed the same
      electrophoretic distribution of chromosome 1D-encoded B subunits, although they
      were slightly different from that found in Cheyenne itself.

PMID- 1747101
TI  - Regulation of arachidonic acid release in vascular endothelium. Ca(2+)-dependent
      and -independent pathways.
AB  - Ca2+ metabolism and its relationship to arachidonic acid release were studied in
      cultured pig aortic endothelial cells. When cells were treated with bradykinin, a
      rapid rise in intracellular Ca2+ concentration ([Ca2+]i) occurred. Arachidonic
      acid release from cells prelabelled with [3H]arachidonic acid and subjected to
      flow-through conditions closely followed the changes in [Ca2+]i. Attenuation of
      the Ca2+ response by chelating extracellular and intracellular Ca2+ or by
      desensitization of receptors led to comparable attenuation of arachidonate
      release. Activation of protein kinase C inhibited Ca2+ mobilization in response
      to bradykinin and stimulated arachidonic acid release. Inhibition of protein
      kinase C had no effect on bradykinin-stimulated arachidonic acid release,
      suggesting that protein kinase C does not mediate the bradykinin response. The
      role of GTP-binding regulatory proteins (G-proteins) in mediating the bradykinin
      response was also investigated. Bradykinin-stimulated arachidonic acid release
      was not diminished by preincubation with pertussis toxin. Treatment with the G
      protein activator AlF4- resulted in the release of a large pool of arachidonic
      acid and the formation of lysophospholipids. Combined treatment with AlF4- and
      bradykinin resulted in a greater than additive effect on arachidonic acid
      release. In contrast with bradykinin, AlF(4-)-stimulated arachidonic acid release
      was not dependent on the presence of extracellular Ca2+ or the mobilization of
      intracellular Ca2+. These results demonstrate Ca(2+)-dependent (bradykinin) and
      Ca(2+)-independent (AlF4-) pathways of phospholipase A2 activation.

PMID- 1747102
TI  - Polyamine catabolism in rodent and human cells in culture.
AB  - N1-Acetylspermidine (N1AcSpd) accumulates in late exponential phase, or after
      certain stresses such as heat shock, in both human tumour (A549) and rodent (HTC,
      CHO) cells, grown in medium containing an inhibitor of the FAD-dependent
      polyamine oxidase (PAO). Inhibition of PAO has little effect on cell growth or on
      the cellular content of the major polyamines, putrescine, spermidine or spermine,
      found in proliferating cells in culture, but decreases cellular putrescine
      content in heat shocked cells. Putrescine and spermidine are generated when
      N1AcSpd or N1-acetylspermine (N1AcSpm) respectively is added to either human or
      rodent cells depleted of the former amines by alpha-difluoromethylornithine.
      N1AcSpm is formed in polyamine-depleted human A549 cells when N1AcSpd is added to
      cultures treated with the PAO inhibitor. This reaction does not occur in either
      rodent line, suggesting that N1AcSpd can be converted directly into N1AcSpm in
      human, but not rodent, cells under specific conditions. The data presented
      demonstrate that a variety of human and rodent cells express PAO activity and
      catabolize polyamines by a mechanism which includes PAO. PAO activity is of
      little consequence to proliferating A549, HTC or CHO cells in culture, but does
      produce new putrescine in both late-exponential-phase and heat-shocked cells.
      These findings suggest that polyamine catabolism is part of a general response of
      both rodent and human cells to a variety of environmental and physiological
      stresses.

PMID- 1747103
TI  - Determination of the intracellular sites and topology of glucosylceramide
      synthesis in rat liver.
AB  - We examined the intracellular site(s) and topology of glucosylceramide (GlcCer)
      synthesis in subcellular fractions from rat liver, using radioactive and
      fluorescent ceramide analogues as precursors, and compared these results with
      those obtained in our recent study of sphingomyelin (SM) synthesis in rat liver
      [Futerman, Stieger, Hubbard & Pagano (1990) J. Biol. Chem. 265, 8650-8657]. In
      contrast with SM synthesis, which occurs principally at the cis/medial Golgi
      apparatus, GlcCer synthesis was more widely distributed, with substantial amounts
      of synthesis detected in a heavy (cis/medial) Golgi-apparatus subfraction, a
      light smooth-vesicle fraction that is almost devoid of an endoplasmic-reticulum
      marker enzyme (glucose-6-phosphatase), and a heavy vesicle fraction. Furthermore,
      no GlcCer synthesis was detected in an enriched plasma-membrane fraction after
      accounting for contamination by Golgi-apparatus membranes. These results suggest
      that a significant amount of GlcCer may be synthesized in a pre- or early Golgi
      apparatus compartment. Unlike SM synthesis, which occurs at the luminal surface
      of the Golgi apparatus, GlcCer synthesis appeared to occur at the cytosolic
      surface of intracellular membranes, since (i) limited proteolytic digestion of
      intact Golgi-apparatus vesicles almost completely inhibited GlcCer synthesis, and
      (ii) the extent of UDP-glucose translocation into the Golgi apparatus was
      insufficient to account for the amount of GlcCer synthesis measured. These
      findings imply that, after its synthesis, GlcCer must undergo transbilayer
      movement to the luminal surface to account for the known topology of higher-order
      glycosphingolipids within the Golgi apparatus and plasma membrane.

PMID- 1747105
TI  - A low-temperature method for the isolation of small-intestinal epithelium along
      the crypt-villus axis.
AB  - A variety of enzymic and non-enzymic methods to isolate epithelium from the small
      intestine have been previously published. Sequential fractionation of cells from
      the villus to the crypt has been reported in some of these papers, which allows
      the comparative study of terminally differentiated and proliferative cell
      phenotypes. However, these methods often involve the incubation of tissues at 37
      degrees C, which may affect the structural and biochemical integrity of the
      cells. We have developed a rapid low-temperature (4 degrees C) method for
      isolating purified populations of crypt and villus cells from mouse and rat
      intestines. The fractionated cells have been partially characterized, and the
      potential value of the procedure has been indicated by the ability to analyse the
      comparative protein and mRNA expression along the crypt-villus axis.

PMID- 1747104
TI  - A classification of glycosyl hydrolases based on amino acid sequence
      similarities.
AB  - The amino acid sequences of 301 glycosyl hydrolases and related enzymes have been
      compared. A total of 291 sequences corresponding to 39 EC entries could be
      classified into 35 families. Only ten sequences (less than 5% of the sample)
      could not be assigned to any family. With the sequences available for this
      analysis, 18 families were found to be monospecific (containing only one EC
      number) and 17 were found to be polyspecific (containing at least two EC
      numbers). Implications on the folding characteristics and mechanism of action of
      these enzymes and on the evolution of carbohydrate metabolism are discussed. With
      the steady increase in sequence and structural data, it is suggested that the
      enzyme classification system should perhaps be revised.

PMID- 1747106
TI  - Fluoroaluminate treatment of rat liver microsomes inhibits GTP-dependent vesicle
      fusion.
AB  - 1. Inhibition of GTP-dependent membrane fusion of rat liver microsomes requires
      preincubation of the membranes with GDP (17 microM) and relatively high Mg2+
      concentration (0.5 mM) as well as AlCl3 (30 microM) and KF (5 mM). Preincubation
      is required for maximal inhibition (75%). 2. Vesicle fusion in rat liver
      microsomes has been demonstrated in the absence of polyethylene glycol (PEG).
      Further, inhibition by AlF4- of GTP-dependent vesicle fusion in the absence of
      PEG has been demonstrated. 3. Under similar preincubation conditions AlF4- can
      bring about inhibition (80%) of the high-affinity PEG-stimulated GTPase activity
      in rat liver microsomes, previously described by Nicchitta, Joseph & Williamson
      [(1986) FEBS Lett. 209, 243-248]. 4. Preincubation of small-Mr GTP-binding
      proteins (Gn proteins) on nitrocellulose strips with GDP (20 pM), AlCl3 (30
      microM) and KF (5 mM) results in inhibition of binding of guanosine 5'-[gamma
      [35S]thio]triphosphate to Gn proteins. The extent of inhibition of this binding
      differs for different Gn proteins.

PMID- 1747107
TI  - Large-scale purification and characterization of the major phosphoproteins and
      mucins of human submandibular-sublingual saliva.
AB  - The major components of human submandibular-sublingual saliva (HSMSL) are mucins,
      amylases, cystatins, proline-rich proteins and statherin. Structure-function
      studies of these molecules have been hampered by the small amounts of purified
      materials that can be isolated from human secretions. The present study describes
      an integrated purification protocol for the large-scale preparation of many of
      these molecules. To dissociate partially heterotypic complexes among salivary
      molecules, HSMSL was initially fractionated into four pools by gel filtration
      with 6 M-guanidine hydrochloride. Subsequent fractionation of these four pools by
      gel-filtration and ion-exchange chromatography resulted in the purification of
      high- and low-Mr mucins, neutral and acidic cystatins, acidic and basic proline
      rich proteins and statherin. Many variants or isoforms of these salivary
      molecules have been identified and biochemically characterized. Biochemical
      studies indicated that the low-Mr mucin exists as two isoforms which vary in
      their sialic acid to fucose ratios. Three isoforms of acidic cystatin S were
      characterized which differ in their phosphate content. Two isoforms of a basic
      proline-rich peptide were identified; the smaller peptide was a truncated form
      missing the first seven amino acids.

PMID- 1747108
TI  - Selective uptake of cholesteryl esters from apolipoprotein-E-free high-density
      lipoproteins by rat parenchymal cells in vivo is efficiently coupled to bile acid
      synthesis.
AB  - [3H]Cholesteryl ester-labelled human high-density lipoprotein (HDL) was injected
      into rats and its decay, intrahepatic cellular distribution and the kinetics of
      biliary secretion were determined. At 10 min after injection the hepatic uptake
      of cholesteryl esters from HDL was 3-fold higher as compared with the
      apolipoprotein. Selective uptake was exerted only by parenchymal cells (5.6-fold
      more cholesteryl esters than apolipoprotein) and not by liver endothelial or
      Kupffer cells. The kinetics of biliary secretion of processed cholesteryl esters
      initially associated with HDL or low-density lipoprotein (LDL) were compared in
      unrestrained rats, equipped with permanent catheters in bile duct, duodenum and
      heart. At 72 h after injection of [3H]cholesteryl oleate-labelled HDL, 51.0 +/-
      2.5% of the injected dose was recovered as bile acids, which is about twice as
      high as the secretion of biliary radioactivity after injection of [3H]cholesteryl
      oleate-labelled LDL. Oestradiol treatment stimulated only liver uptake of LDL
      cholesteryl esters, and resulted in a 2-fold higher liver uptake than with HDL.
      However, the rate of radioactive bile acid formation from [3H]cholesteryl oleate
      labelled HDL was still more rapid than for LDL. It is concluded that the
      selective uptake pathway for cholesteryl esters from HDL in parenchymal cells is
      more efficiently coupled to the formation of bile acids than is the cholesteryl
      ester uptake from LDL. This efficient coupling may facilitate the role of HDL in
      reverse cholesterol transport.

PMID- 1747109
TI  - Regulation of cholesterol and bile acid homoeostasis in bile-obstructed rats.
AB  - We examined how total blockage of biliary excretion, the major pathway through
      which cholesterol and bile acids are removed from the body, affects liver
      function, cholesterol and bile acid metabolism and homoeostasis. After 4 weeks of
      bile-duct ligation, rats showed impaired liver function, as documented by
      elevations in serum bilirubin and alkaline phosphatase activity. Moreover, bile
      duct ligation decreased by about 30% both the amount of microsomal cytochrome P
      450 in the liver and the elimination of aminopyrine in vivo, a reliable index in
      vivo of microsomal mixed-function oxidase activity. Cholesterol and bile acid
      contents in livers of bile-duct-ligated rats were doubled compared with sham
      operated controls. Despite the increase in the contents of cholesterol and bile
      acids in liver, activities of the respective rate-limiting enzymes, 3-hydroxy-3
      methylglutaryl-CoA reductase and cholesterol 7 alpha-hydroxylase, were doubled.
      Serum concentrations of bile acids and free cholesterol increased 25- and 4-fold
      respectively. The large increase in serum bile acids was associated with a 380
      fold increase in the urinary excretion of bile acids. Although there is a general
      decrease in cytochrome P-450 content and drug metabolism involving cytochrome P
      450-containing hydroxylases, the activity of cholesterol 7 alpha-hydroxylase,
      also a cytochrome P-450-containing enzyme, is actually increased. These data show
      that complete obstruction of the bile duct results in the selective impairment of
      microsomal cytochrome P-450. Increased activity of 7 alpha-hydroxylase, bile acid
      synthesis and urinary excretion provides an alternative excretory pathway that
      helps to maintain cholesterol homoeostasis when the biliary excretory pathway is
      eliminated.

PMID- 1747110
TI  - Studies on the activation of human neutrophil 5-lipoxygenase induced by natural
      agonists and Ca2+ ionophore A23187.
AB  - By using exogenous substrates, activation of human neutrophil 5-lipoxygenase can
      be investigated independently of the release of endogenous arachidonic acid. We
      have developed a sensitive assay to measure 5-LO activation which takes advantage
      of the 5-LO-mediated conversion of 15S-hydroperoxy-5,8,11,13(Z,Z,Z,E)
      eicosatetraenoic acid (15-HpETE) into 5S,15S-dihydroxy-6,8,11,13(E,Z,Z,E)
      eicosatetraenoic acid (5,15-DiHETE). When resting neutrophils were incubated with
      low micromolar concentrations of 15-HpETE, a minor dose- and time-dependent
      formation of 5,15-DiHETE was observed. In contrast, co-addition of 15-HpETE with
      Ca2+ ionophore A23187 or with the neutrophil agonists platelet-activating factor
      (PAF), fMetLeuPhe or complement component C5a resulted in a sizeable
      concentration-dependent synthesis of 5,15-DiHETE, while lyso-PAF and phorbol
      myristate acetate were without effect on 5,15-DiHETE formation from 15-HpETE.
      This stimulation of 5,15-DiHETE synthesis by A23187 or by natural agonists was
      effectively inhibited by MK-886, a compound that has recently been reported to
      inhibit the A23187-induced translocation of 5-LO to membrane structures.
      Furthermore, natural-agonist-induced activation of the 5-LO-mediated
      transformation of 15-HpETE was inhibited by pertussis toxin, indicating the
      involvement of a GTP-binding protein in the 5-LO activation process.

PMID- 1747111
TI  - Interaction of LY171883 and other peroxisome proliferators with fatty-acid
      binding protein isolated from rat liver.
AB  - Fatty-acid-binding protein (FABP) is a 14 kDa protein found in hepatic cytosol
      which binds and transports fatty acids and other hydrophobic ligands throughout
      the cell. The purpose of this investigation was to determine whether LY171883, a
      leukotriene D4 antagonist, and other peroxisome proliferators bind to FABP and
      displace an endogenous fatty acid. [3H]Oleic acid was used to monitor the elution
      of FABP during chromatographic purification. [14C]LY171883 had a similar elution
      profile when substituted in the purification, indicating a common interaction
      with FABP. LY171883 and its structural analogue, LY189585, as well as the
      hypolipidaemic peroxisome proliferators clofibric acid, ciprofibrate, bezafibrate
      and WY14,643, displaced [3H]oleic acid binding to FABP. Analogues of LY171883
      that do not induce peroxisome proliferation only weakly displaced oleate binding.
      [3H]Ly171883 bound directly to FABP with a Kd of 10.8 microM, compared with a Kd
      of 0.96 microM for [3H]oleate. LY171883 binding was inhibited by LY189585,
      clofibric acid, ciprofibrate and bezafibrate. These findings demonstrate that
      peroxisome proliferators, presumably due to their structural similarity to fatty
      acids, are able to bind to FABP and displace an endogenous ligand from its
      binding site. Interaction of peroxisome proliferators with FABP may be involved
      in perturbations of fatty acid metabolism caused by these agents as well as in
      the development of the pleiotropic response of peroxisome proliferation.

PMID- 1747112
TI  - Heterogeneous distribution of antithrombin-binding sites in rat brain heparan
      sulphate proteoglycans.
AB  - Heparan sulphates with high binding affinity for antithrombin (HA-HS), labelled
      in vivo with [35S]sulphate, were extracted from rat brains and purified by
      chromatography on DEAE-cellulose and on antithrombin-agarose. HA-HS proteoglycans
      (HA-HSPG) were then separated from HA-HS chains on Sepharose CL-6B. The total HA
      HSPG product was rechromatographed on antithrombin-agarose. Six HA-HSPG
      subfractions with differing degrees of affinity for antithrombin were recovered
      and treated with NaOH to release their chains. Rechromatography of these six 35S
      labelled HS chain preparations on antithrombin-agarose showed that their
      proportions of chains with no affinity for antithrombin (NA-HS chains) ranged
      from 36 to 71%. There was a reciprocal relationship between the proportion of NA
      HS chains in each HA-HSPG subfraction and the degree of affinity for antithrombin
      of the rest of its chains (assessed relative to 3H-labelled HA-heparin chains
      with which they were co-chromatographed). Similar characteristics of antithrombin
      binding-site distribution apply to HA-heparin proteoglycans from rat skin studied
      previously [Horner (1987) Biochem. J. 244, 693-698]. The data suggest that the
      sites at which 3-O-sulphation of some glucosamine N-sulphate residues occurs in
      the Golgi complex of brain cells (probably endothelial cells) which synthesize HA
      HSPGs (as in mast cells, which synthesize HA-heparin PGs) are distributed
      sparsely but not randomly.

PMID- 1747113
TI  - Immunohistochemical distribution of isoenzymes of glutathione transferase in
      adult rat adrenal gland before and after hypophysectomy.
AB  - The distribution of glutathione transferase subunits 1, 2, 3, 4, 7 and 8 in the
      different cells of the female and male rat adrenal and the effects of
      hypophysectomy on these isoenzymes were studied using immunohistochemical
      methods. All these glutathione transferase subunits, with the exception of
      subunit 1, were present in the adrenal. Each subunit showed, however, its own
      characteristic distribution pattern. After hypophysectomy, increased staining for
      these isoenzymes was generally observed, and this effect was also cell-specific.
      Staining for subunit 2 increased in intensity in the zona fasciculata and
      reticularis after hypophysectomy, whereas a decrease was observed in the zona
      glomerulosa. Staining for subunit 8 was increased in the borderline between the
      capsule and zona glomerulosa, as well as in medullary chromaffin cells after
      hypophysectomy. The Mu subunits 3 and 4 increased markedly in fascicular and
      reticular cells after hypophysectomy and staining for subunit 3 was also
      increased in the medullary cells. A slight, but more general, increase was
      observed for subunit 7. We conclude from these experiments that the increases in
      glutathione transferase subunits observed in the rat adrenal after hypophysectomy
      are due to increased protein synthesis and/or increased protein stability and not
      to a selective destruction of cells lacking, or with low levels of, the
      isoenzymes.

PMID- 1747114
TI  - Kinetic mechanism of Clostridium perfringens phospholipase C. Hydrolysis of a
      thiophosphate analogue of lysophosphatidylcholine.
AB  - The hydrolysis of S-[2-(hexadecanoyloxy)ethyl]thiophosphocholine (I), an analogue
      of lysophosphatidylcholine, by Clostridium perfringens phospholipase C, was
      followed at pH 7.5, 37 degrees C and I 1.0 (maintained with KCl), in a continuous
      assay, by monitoring the reduction of 5,5'-dithiobis-(2-nitrobenzoic acid) at 412
      nm. Simple saturation kinetics are observed with linear mixed-type slope
      intercept effects for the hydrolysis of compound (I) with variable [Ca2+] at
      fixed concentrations of compound (I) and a simple slope effect as [compound (I)]
      is varied at fixed concentrations of Ca2+. These data are consistent with a
      simple ordered rapid-equilibrium mechanism in which Ca2+ binds to the enzyme
      first followed by substrate. The observed kinetic constants at pH 7.5, 37 degrees
      C and I 1.0 are K1 = 12.0 mM (Ca2+ dissociation), K2 = 36 microM [compound (I)
      dissociation] and Vmax. = 552 microM.min-1.mg-1. Alkane diammonium salts inhibit
      the enzyme by a non-competitive mechanism that involves binding to free enzyme,
      E.Ca2+ and E.Ca2+.S. The use of the simple micellarized substrate under these
      conditions allows the determination of kinetic and inhibition constants without
      complications arising from enzyme-micelle interactions.

PMID- 1747115
TI  - Interaction of the small proteoglycan decorin with fibronectin. Involvement of
      the sequence NKISK of the core protein.
AB  - Decorin, an interstitial small proteoglycan, was shown to interact with
      fibronectin via its core protein. In a solid-phase assay, both high-affinity (KD
      values between 10 and 20 nM) and low-affinity (KD values between 110 and 130 nM)
      binding sites were found. The central position of decorin core protein is made up
      of several repeats containing NKISK in positions 85-89 and similar sequences in
      other repeats. The pentapeptide inhibited, albeit not completely, the high
      affinity interaction between decorin and fibronectin in a specific charge
      independent manner. Half-maximal inhibition occurred at a peptide concentration
      of 10 microM. Core-protein-derived peptides that had been produced by
      endoproteinase Lys-C digestion were not inhibitory, but endoproteinase Arg-C
      generated peptides served as inhibitors of binding. These results suggest that
      NKISK as a component of repetitive sequences of decorin is involved in the
      interaction between the proteoglycan and fibronectin.

PMID- 1747116
TI  - Effects of lactate on pathways of glycogen formation in the perfused rat liver.
AB  - In order to investigate the roles of lactate as substrate and regulator of
      hepatic glycogen synthesis, two groups of rat livers were perfused with
      oxygenated blood for 2 h. The initial perfusate glucose and lactate
      concentrations of Group I and II were 245 +/- 6.8 and 254 +/- 12.9 mg/dl and 49
      +/- 2.6 and 54 +/- 2.2 mg/dl respectively. Labelled glucose was added to the
      perfusate to assess direct glycogen formation. Either additional glucose (Group
      I) or lactate (Group II) was added (1 mg/min) to a recirculating liver-perfusion
      system. Initial lactate uptake and glucose formation was identical in the two
      groups of studies. For Group I, both glucose and lactate uptake by the liver fell
      to nearly zero, in spite of increasing glucose concentrations. However, with
      lactate infusion (Group II), its uptake by the liver was maintained at 0.89 +/-
      0.14 mg/min after 120 min. In total, 6.2 +/- 0.7 mg (Group I) or 20.2 +/- 3.9 mg
      (Group II) of glycogen was formed, 4.0 +/- 0.7 mg or 9.2 +/- 2.0 mg by direct
      synthesis from glucose and 2.2 +/- 0.3 mg or 11.0 +/- 2.1 mg by gluconeogenic
      formation, in Groups I and II respectively. With the provision of additional
      lactate, its uptake by the perfused liver tripled, as did glycogen synthesis.
      Glucose production doubled when lactate was added instead of glucose.
      Gluconeogenic formation of glycogen increased by 400%. Surprisingly, direct
      synthesis from glucose also rose by 130%. These data indicate that continued
      lactate uptake by the liver with gluconeogenic glycogen formation determines the
      amount of glycogen formed not only by this route, but also by direct synthesis
      from glucose.

PMID- 1747117
TI  - Fluorimetric assay of the neurotensin-degrading metalloendopeptidase,
      endopeptidase 24.16.
AB  - Mcc-Pro-Leu-Gly-Pro-D-Lys-Dnp (Mcc = 3-carboxy-7-methoxycoumarin; Dnp =
      dinitrophenyl), a quenched fluorimetric substrate originally designed as a probe
      to measure Pz-peptidase (also called endopeptidase 24.15), was examined as a
      putative substrate of the neurotensin-degrading neutral metalloendopeptidase,
      endopeptidase 24.16. During the purification of endopeptidase 24.16 the
      neurotensin(1-10) and neurotensin(11-13) formation due to this enzyme was
      coeluted with Mcc-Pro-Leu-Gly-Pro-D-Lys-Dnp-hydrolysing activity. By both
      fluorimetric and h.p.l.c. analyses, we observed that the latter activity was dose
      dependently and completely abolished by neurotensin with an IC50 value (2.6
      microM) that closely corresponds to the affinity of purified endopeptidase 24.16
      for neurotensin (Km = 2.5 microM). Furthermore, Mcc-Pro-Leu-Gly-Pro-D-Lys-Dnp
      hydrolysis was inhibited by a series of dipeptides with a rank of order of
      potencies that parallels that observed in competition experiments of tritiated
      neurotensin hydrolysis by brain and intestinal endopeptidase 24.16. Altogether,
      these data clearly demonstrate that, in addition to Pz-peptidase, Mcc-Pro-Leu-Gly
      Pro-D-Lys-Dnp also behaves as a substrate of endopeptidase 24.16, with a Km of
      about 26 microM. In addition, we show that, even in crude membrane preparations,
      Mcc-Pro-Leu-Gly-Pro-D-Lys-Dnp behaves as a useful tool to monitor and accurately
      quantify endopeptidase 24.16.

PMID- 1747118
TI  - Synthesis and secretion of a cobalamin-binding protein by HT 29 cell line.
AB  - An HT 29 cell line derived from human colonic carcinoma was shown to synthesize
      and release a cobalamin-binding protein. The cobalamin-binding protein was
      classified as transcobalamin (TC). By gel filtration on Sephacryl S200 HR, we
      observed that the secreted protein bound to cobalamin had the same size as plasma
      transcobalamin. Like transcobalamin, the cobalamin-binding protein bound
      cobalamin but not cobinamide. Purification of the cobalamin-binding protein was
      performed by heparin-Sepharose affinity chromatography and by Sephacryl S200 gel
      filtration. The molecular mass of the purified protein was estimated at 44 kDa by
      SDS/PAGE. The isoelectric point was determined to be 6.4. The purified cobalamin
      binding protein reacted with an antiserum produced against human transcobalamin.
      A 44 kDa band was also identified by SDS/PAGE of an immunoprecipitated homogenate
      from HT 29 cells labelled with [35S]methionine and in a Western blot of cell
      homogenates. The secretion of the cobalamin-binding protein was maximal between
      10 and 12 days of cell culture and was inhibited by cycloheximide.

PMID- 1747119
TI  - The regulation of phospholipase D activity and its role in sn-1,2-diradylglycerol
      formation in bombesin- and phorbol 12-myristate 13-acetate-stimulated Swiss 3T3
      cells.
AB  - Addition of the phorbol ester phorbol 12-myristate 13-acetate (PMA) to quiescent
      Swiss 3T3 cells resulted in a sustained increase in sn-1,2-diradylglycerol (DG)
      mass and [3H]DG in [3H]palmitate-labelled cells where phosphatidylcholine was the
      major labelled phospholipid. This occurred in the absence of inositol phosphate
      accumulation. In [3H]palmitate-labelled cells both bombesin and PMA stimulated
      the formation of phosphatidylbutanol ([3H]PtdBut) in the presence of 0.3% (v/v)
      butan-1-ol. The kinetics of [3H]PtdBut formation were consistent with
      phospholipase D (PLD) activation preceding sustained DG formation. The inclusion
      of butan-1-ol inhibited 70% of PMA-stimulated DG formation but only 30% of the
      bombesin response. The ability of bombesin and PMA to stimulate the accumulation
      of [3H]PtdBut was completely abolished in Swiss 3T3 cells which had been pre
      treated with 400 nM-PMA for 48 h to down-regulate protein kinase C activity. PMA
      stimulated [3H]PtdBut formation was inhibited by 90% by the protein kinase C
      inhibitor Ro-31-8220 (10 microM), but bombesin-stimulated PtdBut accumulation was
      inhibited by at most 50% by the same concentration of inhibitor. Cyclic AMP
      elevating agents, i.e. forskolin, dibutyryl cyclic AMP and
      isobutylmethylxanthine, did not inhibit bombesin stimulation of PLD activity.
      Bombesin-stimulated PLD activity was inhibited by 50% by buffering of the
      extracellular Ca2+ concentration to 150 nM, but combination of this treatment
      with Ro-31-8220 addition was less than additive. Ionophore A23187 alone was able
      to stimulate PLD activity, but this response was inhibited 50% by Ro-31-8220.
      Thapsigargin was unable to stimulate PLD activity and had no modulatory effect
      upon bombesin-stimulated PLD activity at any agonist concentration. The results
      are discussed in terms of the role of PLD in DG generation and the regulation of
      PLD activity both by bombesin and by PMA.

PMID- 1747120
TI  - Mutagenesis of arginine residues in the catalytic cleft of Escherichia coli
      porphobilinogen deaminase that affects dipyrromethane cofactor assembly and
      tetrapyrrole chain initiation and elongation.
AB  - Substitutions of conserved arginine residues in the catalytic cleft of
      Escherichia coli porphobilinogen deaminase were constructed by site-specific
      mutagenesis of the hemC gene. Mutant proteins exhibited a range of defects
      including the failure to assemble the dipyrromethane cofactor and the inability
      to initiate and propagate the tetrapolymerization reaction. Mutations of arginine
      residues at positions 11, 131, 132 and 155, all of which interact with the
      carboxylic acid side chains of the dipyrromethane cofactor, were the most
      disruptive.

PMID- 1747121
TI  - The Enterococcus hirae R40 penicillin-binding protein 5 and the methicillin
      resistant Staphylococcus aureus penicillin-binding protein 2' are similar.
AB  - The penicillin-resistant Enterococcus hirae R40 has a typical profile of membrane
      bound penicillin-binding proteins (PBPs) except that the 71 kDa PBP5 of low
      penicillin affinity represents about 50% of all the PBPs present. Water-soluble
      tryptic-digest peptides were selectively produced from PBP5, their N-terminal
      regions were sequenced and synthetic oligonucleotides were used as primers to
      generate a 476 bp DNA fragment by polymerase chain reaction. On the basis of
      these data, the PBP5-encoding gene was cloned in Escherichia coli by using pBR322
      as vector. The gene, included in a 7.1 kb insert, had the information for a 678
      amino acid-residue protein. PBP5 shows similarity, in the primary structure, with
      the high-molecular-mass PBPs of class B. In particular, amino acid alignment of
      the enterococcal PBP5 and the methicillin-resistant staphylococcal PBP2'
      generates scores that are 30, for the N-terminal domains, and 53, for the C
      terminal domains, standard deviations above that expected for a run of 20
      randomized pairs of proteins having the same amino acid compositions as the two
      proteins under consideration.

PMID- 1747122
TI  - Purification and characterization of cephalosporin 7 alpha-hydroxylase from
      Streptomyces clavuligerus.
AB  - Cephalosporin 7 alpha-hydroxylase, which catalyses the conversion of
      cephalosporins into their 7 alpha-hydroxy derivatives, was purified nearly 390
      fold from Streptomyces clavuligerus through ion-exchange chromatography,
      (NH4)2SO4 fractionation, gel filtration and dye chromatography, with the use of
      h.p.l.c. to monitor enzyme activity. The nearly pure enzyme migrates as a single
      major band, with an Mr of 32,000 in SDS/PAGE. Its optimum pH is in the range 7.3
      7.7. Under our conditions the reaction was fastest at temperatures in the range
      20-30 degrees C. The Km for cephalosporin C is 0.72 mM, and the Vmax. is 15.4
      mumol of cephalosporin C hydroxylated/min per mg. Cephalosporin 7 alpha
      hydroxylase did not show any deacetoxycephalosporin C synthase or
      deacetoxycephalosporin C hydroxylase activity.

PMID- 1747123
TI  - Methanol oxidation and assimilation in Hansenula polymorpha. An analysis by 13C
      n.m.r. in vivo.
AB  - The metabolism of methanol was monitored in whole cells of the methylotrophic
      yeast Hansenula polymorpha by using [13C]methanol and n.m.r. in vivo. The main
      products observed under normal conditions were trehalose and glycerol, whereas
      cells that were starved before exposure to [13C]methanol also accumulated
      glutamate, glutamine and alanine; formate was also more prominent in spectra from
      starved cells. Cells exposed to high methanol concentration together with high
      oxygenation oxidized methanol extensively, leading to formaldehyde accumulation;
      label was not found in any subsequent metabolic products, indicating possible
      cell inactivation. [13C]Formate was incorporated into metabolic products in
      glucose-grown cells exposed to 150 mM-methanol for 3 h, but not in cells starved
      for 3 h, in which it was oxidized. At 21 degrees C such 3 h-starved cells showed
      a slower metabolism of [13C]methanol compared with those at 37 degrees C, and
      also converted methanol into formate rather than into assimilation products. The
      labelling pattern in trehalose from starved cells at 37 degrees C was consistent
      with methanol assimilation via the pentose phosphate pathway. Lack of appearance
      of labelled formaldehyde and formate during metabolism under normal conditions
      suggests that the linear oxidation pathway is not a major contributor to methanol
      oxidation; their appearance in extreme conditions suggests instead a more likely
      role in detoxification.

PMID- 1747124
TI  - Characterization and chromatin distribution of the H1 histones and high-mobility
      group non-histone chromosomal proteins of trout liver and hepatocellular
      carcinoma.
AB  - The H1 histones serve as general repressors of gene expression by inducing the
      formation of a compact chromatin structure, whereas the high-mobility-group (HMG)
      non-histone chromosomal proteins have roles in maintaining the structure and
      function of transcriptionally active chromatin. The distribution of the H1
      histone subtypes and HMG proteins among various trout tissues (liver,
      hepatocellular carcinoma, testis and erythrocyte) was determined. Histone H1b was
      present in the chromatin of liver, but not in the chromatin of hepatocellular
      carcinoma, testis or erythrocyte. Nuclease-resistant regions of liver chromatin
      had elevated levels of histone H1b. Histone H1b was isolated, and the N-terminal
      amino acid sequence of histone H1b was found to be highly similar to that of
      mammalian histone H1(0) and duck H5. HMG proteins T1, T2, T3, H6, C, D and F were
      associated with liver and hepatocellular-carcinoma chromatin, with hepatocellular
      carcinoma containing higher levels of HMG T1 and F. Testis and erythrocyte had
      HMG T2 and H6 as their predominant HMG proteins. Most of the HMG H6 of
      hepatocellular carcinoma, but not of liver, was located in a chromatin fraction
      that was soluble at physiological ionic strength and enriched in
      transcriptionally active DNA. These alterations in the chromatin distribution and
      content of hepatocyte HMG proteins and H1 histone subtypes may contribute to
      aberrant hepatocyte gene expression in the hepatocellular carcinoma.

PMID- 1747125
TI  - Accumulation of acyl-enzyme in DD-peptidase-catalysed reactions with analogues of
      peptide substrates.
AB  - Thioester substrates can be used to study the hydrolysis and transfer reactions
      catalysed by beta-lactamases and DD-peptidases. With the latter enzymes,
      accumulation of the acyl-enzyme can be detected directly. The efficiency of
      various amines as acceptor substrates was in excellent agreement with previous
      results obtained with peptide substrates of the DD-peptidases. The results
      indicated the presence of a specific binding site for the acceptor substrates.
      Although most of the results agreed well with a simple partition model, more
      elaborate hypotheses will be needed to account for all the data presented.

PMID- 1747126
TI  - Ricinoleic acid biosynthesis and triacylglycerol assembly in microsomal
      preparations from developing castor-bean (Ricinus communis) endosperm.
AB  - Microsomal membrane preparations from the developing endosperm of castor bean
      (Ricinus communis) catalysed the transfer of oleate from [14C]oleoyl-CoA to
      phosphatidylcholine (PtdCho). In the presence of NADH, radioactive ricinoleate
      (12-hydroxyoctadec-9-enoate) was synthesized from [14C]oleate, and this was
      largely recovered in PtdCho and as free fatty acid. The addition of unlabelled
      ricinoleoyl-CoA to these incubation mixtures did not increase the low
      [14C]ricinoleate concentration found in the acyl-CoA fraction nor decrease the
      [14C]ricinoleate concentration in PtdCho and free fatty acid, and thus no
      evidence was obtained for a hydroxylation with oleoyl-CoA as a substrate. The
      addition of NADH, necessary for the formation of ricinoleate, caused a decrease
      of the total radioactivity in PtdCho with a corresponding increase in the amount
      of label in free ricinoleic acid. This increase was due to the action of a
      phospholipase A, which released ricinoleic acid but not oleic acid from PtdCho.
      Such a phospholipase activity, attacking ricinoleoyl-PtdCho but not oleoyl
      PtdCho, was also demonstrated in microsomal preparations from developing
      cotyledons of safflower and oil-seed rape. An analysis of the acyl groups at
      different positions in microsomal PtdCho of castor bean showed that ricinoleate
      was almost entirely associated with position sn-2. Likewise the [14C]ricinoleate
      in [14C]PtdCho formed after incubations with microsomal preparations with NADH
      and [14C]oleoyl-CoA resided in position sn-2 with none in position sn-1. In
      contrast, the [14C]linoleate formed by desaturation of [14C]oleoyl-PtdCho was
      present at both positions. In the presence of ATP, CoA and Mg2+, the ricinoleate
      acid released from PtdCho was activated to ricinoleoyl-CoA. The ricinoleoyl-CoA
      was an efficient acyl donor in the acylation of glycerol 3-phosphate (Gro3P) to
      yield phosphatidic acid and triacylglycerols. In microsomal preparations
      incubated with an equimolar mixture of [14C]oleoyl-CoA and [14C]ricinoleoyl-CoA
      in the presence of Gro3P, only a minor amount of [14C]ricinoleate entered PtdCho,
      and this was believed to be via the exchange of phosphocholine groups between a
      diacylglycerol pool and the PtdCho. On the basis of our results, a scheme of
      ricinoleate formation and its incorporation into triacylglycerols in castor-bean
      endosperm is proposed.

PMID- 1747127
TI  - Inhibition by pertussis toxin of the activation of Na(+)-dependent uridine
      transport in dimethyl-sulphoxide-induced HL-60 leukaemia cells.
AB  - The effects of pertussis toxin on the Na(+)-dependent transport of uridine were
      studied in HL-60 leukaemia cells induced to differentiate along the granulocytic
      or monocytic pathways by dimethyl sulphoxide (DMSO) or phorbol 12-myristate 13
      acetate (PMA) respectively. Pertussis toxin at 50 ng/ml completely inhibited the
      activation of Na(+)-dependent uridine transport and consequently prevented the
      formation of intracellular pools of free uridine which occurs in HL-60 cells
      induced to differentiate by DMSO. The inhibition of Na(+)-dependent uridine
      transport by pertussis toxin in cells exposed to DMSO was associated with a 14
      fold decrease in affinity, with no change in Vmax. Pertussis toxin, however, had
      no effect on Na(+)-dependent uridine transport in PMA-induced HL-60 cells.
      Furthermore, 500 ng of cholera toxin/ml had no effect on the Na(+)-dependent
      uptake of uridine in DMSO-treated HL-60 cells. These results suggest that the
      activation of the Na(+)-dependent transport of uridine in HL-60 cells induced to
      differentiate along the granulocytic pathway by DMSO is coupled to a pertussis
      toxin-sensitive guanine-nucleotide binding protein (G-protein).

PMID- 1747128
TI  - Aluminium transport in blood serum. Binding of aluminium by human transferrin in
      the presence of human albumin and citrate.
AB  - The binding of Al3+ by human serum transferrin has been investigated by u.v.
      visible difference spectroscopy. In the presence of 25 mM-HCO3- at pH 7.4, the
      apparent association constants were found to be 1.69 x 10(12) M-1 and 5.36 x
      10(11) M-1. These association constants are pH-dependent, reducing with both
      increasing and decreasing pH. The apparent pKa values were found to be 6.7 and
      8.2. Competitive assays of binding of Al3+ to transferrin in the presence of
      citrate and human serum albumin at molar ratios corresponding to those found in
      normal plasma showed that a considerable amount of Al3+ was not bound to
      transferrin. Taking a concentration of 5 microM as a typical value observed for
      the plasma of patients on haemodialysis [Harris & Sheldon (1990) Inorg. Chem. 29,
      119-124] the competitive binding assay indicate that approximately 60% of it is
      bound to transferrin, approximately 34% to albumin and the remainder to citrate.
      These results therefore suggest that, although transferrin at pH 7.4 is the major
      Al(3+)-binding component of plasma, an appreciable amount of Al3+ present in
      patients on haemodialysis may be bound to albumin.

PMID- 1747129
TI  - Effects of platelet-activating factor on lipid metabolism in rats in vivo. Origin
      of the hypertriglyceridaemia.
AB  - Administration of platelet-activating factor (1-O-alkyl-2-acetyl-sn-glycero-3
      phosphocholine; PAF) did not alter the rate of triacylglycerol entry into the
      plasma. The gastrointestinal absorption of [1-14C]triolein was, however,
      inhibited by PAF, yet there was increased accumulation of [14C]lipid in the
      plasma and hypertriglyceridaemia. The half-life of injected [9,10(n)-3H]triolein
      in the plasma increased by 47%, and there was decreased accumulation of [3H]lipid
      in brown adipose tissue. This was accompanied by a decrease in lipoprotein lipase
      activity. The hypertriglyceridaemia induced by PAF appears to be mainly due to
      decreased peripheral removal, one important site affected being brown adipose
      tissue.

PMID- 1747130
TI  - Progressive suppression of muscle glucose utilization during pregnancy.
AB  - Glucose utilization indices (GUIs) were measured in heart and a range of skeletal
      muscles in conscious, unrestrained, virgin or pregnant rats in the absorptive and
      post-absorptive phases. A clear effect of pregnancy to diminish muscle GUIs was
      identified, the magnitude of which was greatest in late gestation in the
      absorptive phase. Differences in the time courses and magnitudes of the response
      to pregnancy were observed between individual muscles. The effects of pregnancy
      are discussed in relation to an increased availability of lipid fuels and to
      decreased insulin and glucose concentrations.

PMID- 1747131
TI  - Anomalous behaviour of a protein during SDS/PAGE corrected by chemical
      modification of carboxylic groups.
AB  - The 29,000-Mr Actinomadura R39 beta-lactamase exhibited a remarkably low
      electrophoretic mobility on SDS/PAGE, yielding an Mr value almost twice that
      computed from the corresponding gene sequence. We showed that chemical
      modification of the carboxylic groups of glutamic acid and aspartic acid residues
      restored a normal electrophoretic mobility and that the anomalous behaviour of
      that protein on SDS/PAGE was due to its very large negative charge at neutral pH.
      We also compared the behaviour of the same enzyme on gel filtration in the
      presence of SDS with those of other class A beta-lactamases (Mr approx. 30,000).
      These experiments suggested that the very low electrophoretic mobility of the
      Actinomadura R39 beta-lactamase upon SDS/PAGE was more probably due to a low
      degree of SDS binding rather than to an unusual shape of the SDS-protein complex.

PMID- 1747132
TI  - Allosteric regulation of phosphonoacetaldehyde hydrolase by n-butylphosphonic
      acid.
AB  - The effect of n-butylphosphonic acid on the activity of phosphonoacetaldehyde
      hydrolase from Pseudomonas aeruginosa was investigated: at low concentrations
      this compound appeared as an activator of the enzyme activity, whereas at higher
      concentrations it exhibited inhibitory properties. The experimental results were
      modelled according to an allosteric model involving two different classes of
      sites for n-butylphosphonic acid.

PMID- 1747133
TI  - Influence of antihyperuricemic therapy on the clinical and radiographic
      progression of gout.
AB  - Ten years ago, we studied the clinical and radiographic manifestations of gout in
      60 patients and described 3 patterns of disease. To determine the consequences of
      management over a 10-year period, we recently reassessed the 39 available
      patients of this population. We found that although reduced tophaceous deposition
      on physical examination correlated with normalization of the serum urate
      concentration, no correlation existed between radiographic changes and mean serum
      urate concentrations. Progression of gouty changes on radiography reflected
      progressive deformity on physical examination. We have described the radiographic
      changes that occurred in a well-characterized population of subjects with gout
      over 10 years and determined that serum urate concentrations alone may not
      provide an effective means of monitoring the progression of tophaceous disease in
      bone.

PMID- 1747134
TI  - Rheumatoid arthritis in women. Incidence rates in group health cooperative,
      Seattle, Washington, 1987-1989.
AB  - As part of a prospective case-control study of newly diagnosed rheumatoid
      arthritis (RA) in women, we identified all cases of probable, definite, or
      classic RA diagnosed in 1987-1989 in 18-64-year-old women who were members of a
      health maintenance organization based in the Seattle, Washington area. Using both
      the 1958 and the 1987 American Rheumatism Association criteria for the diagnosis
      of RA and enrollment data from the health maintenance organization, we calculated
      the incidence by age and diagnostic class. Rates of RA incidence in women
      increased steadily with age. The incidence of probable, definite, or classic RA
      ranged from 13.1 per 100,000 person-years at risk for 18-29-year-old women to
      82.1 per 100,000 person-years for 60-64-year-old women. The overall incidence
      rate, age-adjusted to the 1980 US female population, was 27.9/100,000 person
      years. The overall incidence rate for definite/classic RA, age-adjusted to the
      1980 US female population, was 23.9 per 100,000 person-years. When compared with
      adjusted rates of incidence of definite RA in Rochester, Minnesota, in 1950-1974,
      the incidence rates we found were 44.7% lower. Methodologic differences, changes
      in diagnostic criteria, and a declining incidence of RA among women over time may
      all be partial explanations for these results. The possible effects of
      reproductive factors, including oral contraceptives use, are discussed.

PMID- 1747135
TI  - A comparative study by morphometry of the microvasculature in normal and
      rheumatoid synovium.
AB  - Vascularity is said to be increased (subjectively) in rheumatoid arthritis, yet
      synovial fluid is hypoxic and acidotic. Morphometry by image analysis was used to
      quantify vascularity in normal and rheumatoid synovium from the knee joint.
      Capillaries were distributed more deeply in the rheumatoid synovium (93.3
      microns, compared with 32.5 microns in normal synovium) and were significantly
      less densely arranged (80.2/mm2 rheumatoid, 241.5/mm2 normal). The blood volume
      fraction fell from 2.9% in normal knee synovium to 1.2% in rheumatoid synovium.
      These results imply that there is impairment of O2 transfer, which contributes to
      the intraarticular hypoxia, in rheumatoid arthritis.

PMID- 1747136
TI  - Aspirin alters methotrexate disposition in rheumatoid arthritis patients.
AB  - Intravenous methotrexate (MTX) (10 mg), either alone or with oral aspirin (ASA)
      (3,900 mg/day), was administered to 15 patients with rheumatoid arthritis.
      Systemic and renal clearance of MTX were lower, and the unbound fraction of MTX
      was higher when patients were also receiving ASA than when taking MTX alone. No
      acute hematologic, renal, or hepatic toxicity was observed with either treatment.
      The findings of this study therefore indicate that concomitant aspirin therapy
      acutely alters the clearance of low-dose MTX in patients with rheumatoid
      arthritis.

PMID- 1747137
TI  - Absorbed dose profiles for radionuclides of frequent use in radiation
      synovectomy.
AB  - Absorbed dose profiles are presented for radionuclides of frequent or potential
      use in radiation synovectomy, an intraarticular technique aimed at treating
      rheumatoid arthritis through direct and highly selective irradiation of inflamed
      synovium. The radionuclides investigated were 198Au, 165Dy, 32P, 186Re, 90Y, and
      166Ho. These profiles reveal the absorbed dose imparted per unit activity of
      injected radionuclide (Gy/mCi) as a function of penetration distance (mm) to
      major components of the arthritic synovial joint. Their usefulness is twofold:
      they can be employed to select the radionuclide best suited to achieving the
      proper depth of penetration in tissue (approximating the thickness of the
      inflamed synovium) and to determine, a priori, the necessary dose of
      radioactivity (delivering an absorbed dose sufficient to effectively treat all
      the diseased tissue). The extent of radiation of other synovial joint components,
      such as bone and articular cartilage, and how the advancing rheumatoid arthritis
      can be expected to alter the extent and pattern of absorbed dose penetration in
      the joint are also discussed.

PMID- 1747138
TI  - Synovial fluid levels of complement SC5b-9 and fragment Bb are elevated in
      patients with rheumatoid arthritis.
AB  - To determine whether complement turnover in synovial fluids of patients with
      rheumatoid arthritis (RA) reflects activation by the classical or alternative
      pathway, we used novel immunoassays to measure products of complement activation
      (the membrane attack complex SC5b-9 and the cleavage fragments Bb and C4d). Mean
      synovial fluid levels of SC5b-9 were more than 8 times higher in RA than in
      crystal-induced arthritis (gout and pseudogout) and over 16 times higher than in
      degenerative joint disease (DJD). Similarly, Bb levels were more than 3 times
      higher in RA synovial fluids than in crystal-induced arthritis and over 7 times
      higher than in DJD. Levels of C4d did not differ among the groups. SC5b-9 levels
      correlated with synovial fluid C3 anaphylatoxin (C3a), Bb, and C4d levels (r =
      0.81, 0.62, and 0.51, respectively). In patients with RA, synovial fluid SC5b-9
      levels correlated with C3a and Bb (r = 0.6 and 0.56, respectively) but not with
      C4d. Therefore, novel assays for complement activation indicate that both
      classical and alternative pathways are involved in complement turnover and that
      the alternative pathway contributes more to complement activation in RA than in
      DJD or crystal-induced arthritis.

PMID- 1747139
TI  - Continuous removal of anti-DNA antibody, using a new extracorporeal
      immunoadsorption system, in patients with systemic lupus erythematosus.
AB  - We performed selective and continuous immunoadsorption of anti-DNA antibodies
      from the blood of 6 patients with systemic lupus erythematosus, using a newly
      developed extracorporeal immunoadsorption system equipped with twin dextran
      sulfate-cellulose columns with an automated regenerating unit. Levels of anti
      DNA, which were initially high, were rapidly diminished after 2-4 apheresis
      procedures in each patient; in 3 patients with proteinuria and 4 patients with
      lymphocytopenia, these symptoms also improved. Analysis of the kinetics and the
      adsorbed amounts of anti-DNA during the apheresis indicates that both the
      intravascular and the extravascular pool of anti-DNA are reduced with this potent
      apheresis technique.

PMID- 1747140
TI  - Malignant histiocytosis as a fatal complication of systemic lupus erythematosus.
AB  - We present the case of a 26-year-old Caucasian woman with systemic lupus
      erythematosus (SLE) of 9 years duration, mainly involving the kidney. Her
      clinical course was complicated in the last year by several infectious and
      noninfectious events, and after pancytopenia, fever, and extremely high levels of
      lactate dehydrogenase developed, the woman died. Light and electron microscopy of
      bone marrow, together with immunophenotyping, disclosed malignant histiocytosis,
      a complication of SLE that has not been reported.

PMID- 1747141
TI  - Osteoarthritic changes in canine articular cartilage, subchondral bone, and
      synovium fifty-four months after transection of the anterior cruciate ligament.
AB  - Anterior cruciate ligament transection (ACLT) in the dog results in osteophyte
      formation and in morphologic, metabolic, biochemical, and biomechanical changes
      in the articular cartilage of the unstable knee that mimic those of human
      osteoarthritis (OA). However, in dogs studied up to 2 years after ACLT, the
      changes have appeared to be self-limiting, which has led to the suggestion that
      this is a model of cartilage damage and repair, rather than of OA. To ascertain
      whether changes in articular cartilage and subchondral bone of dogs subjected to
      ACLT lead to progressive changes of OA, we studied 3 dogs for 54 months after
      ACLT. Arthrotomy was performed in the dogs to visualize and then transect the
      anterior cruciate ligament. When the dogs were killed, full-thickness ulceration
      of the articular cartilage was seen on the medial femoral condyle and tibial
      plateau of the unstable knee, while cartilage in other regions was thicker than
      that of the contralateral knee, consistent with hypertrophic cartilage repair.
      Synovial infiltration by mononuclear cells was not more severe than that seen in
      dogs killed at earlier intervals after ACLT, although gross fibrotic thickening
      of the capsule was apparent in each dog. Histomorphometric studies revealed a
      marked increase in subchondral bone volume and active bone formation. These
      findings show that the changes that develop in the canine knee joint after ACLT
      are progressive and are unambiguously those of OA.

PMID- 1747142
TI  - Temporal arteritis with low erythrocyte sedimentation rate: a review of five
      cases.
AB  - We compared 5 patients who had biopsy-proven temporal arteritis and erythrocyte
      sedimentation rates (ESR) less than 50 mm/hour with 25 patients who had temporal
      arteritis and high ESR and with 10 patients who had negative temporal artery
      biopsy results and low ESR. Patients with low-ESR temporal arteritis were similar
      to the other groups, except that they had a higher mean hemoglobin level than the
      high-ESR group and a significant increase in the percentage of patients (4 of 5)
      who had a previous diagnosis of polymyalgia rheumatica or had received steroid
      therapy compared with either of the other groups. The latter finding suggests
      that even low-dose steroid therapy can lower the ESR in patients with temporal
      arteritis. We conclude that the ESR is low in only a small percentage of patients
      with temporal arteritis, and that most of these patients have a history of
      polymyalgia rheumatica or steroid therapy.

PMID- 1747143
TI  - Primary pulmonary hypertension in a patient with systemic-onset juvenile
      arthritis.
AB  - We describe a 16-year-old girl with systemic-onset juvenile arthritis who
      presented with pulmonary hypertension, without evidence of pleural or parenchymal
      involvement of the lung, pulmonary vasculitis, or immune deposition in the
      pulmonary vasculature. Pleuropulmonary involvement occurs occasionally in
      juvenile arthritis, but primary pulmonary hypertension has not, to our knowledge,
      been previously reported. Histocompatibility typing showed positivity for HLA-DR3
      and DRw52, both of which are associated with idiopathic pulmonary hypertension in
      children, and with pulmonary hypertension among patients with systemic sclerosis.
      Treatment with cyclosporine and corticosteroids resulted in a marked improvement
      in the clinical findings and pulmonary function in our patient.

PMID- 1747144
TI  - Serial magnetic resonance imaging in juvenile dermatomyositis.
AB  - Magnetic resonance imaging (MRI) was used to follow the course of juvenile
      dermatomyositis from the onset of disease through resolution of a primary
      relapse. The signal intensity of the T2-weighted image of involved muscles was
      elevated during periods of disease activity, and returned to approximately normal
      levels with effective suppression of disease activity. T1-weighted images of
      involved muscles remained approximately normal despite disease activity.

PMID- 1747145
TI  - Erosive arthritis in monoclonal gammopathy of uncertain significance: report of
      four cases.
AB  - We report 4 case histories in which an erosive arthritis was associated with the
      presence of a monoclonal gammopathy of uncertain significance. In all 4 cases,
      the appearance of paraprotein was noted either before or during the development
      of the arthritis. Two patients had a rather atypical oligoarthritis, while the
      others had a rheumatoid-like, symmetric polyarthritis. A synovial amyloid deposit
      was present in 2 patients, while mild mixed mononuclear infiltrates were the main
      pathologic finding in the others. In 2 patients, immunohistochemical
      investigation demonstrated deposits of immunoglobulin-derived material of the
      same isotype as the monoclonal component in the synovial tissue.

PMID- 1747146
TI  - Induction of arthritis in rats by soluble peptidoglycan-polysaccharide complexes
      produced by human intestinal flora.
AB  - Peptidoglycan-polysaccharide complexes were isolated from feces of a healthy
      subject and from ileostomy fluid from 5 patients. Peptidoglycan-polysaccharide
      complexes were tested for arthritogenicity in a rat model, by subcutaneous
      injection in Freund's incomplete adjuvant. Complexes from the healthy subject did
      not induce arthritis, but those from ileostomy fluid of 1 of the patients induced
      severe, chronic joint inflammation. We concluded that peptidoglycan
      polysaccharide complexes from intestinal flora are potentially arthritogenic in
      rats. This arthritogenicity may be influenced by the content of muramic acid and
      rhamnose in these complexes.

PMID- 1747147
TI  - Development of rheumatoid arthritis after hepatitis C virus infection.

PMID- 1747148
TI  - Multicenter double-blind trial of interferon-gamma versus placebo in the
      treatment of rheumatoid arthritis.

PMID- 1747149
TI  - Soluble interleukin-2 receptor in patients with ankylosing spondylitis.

PMID- 1747150
TI  - Reconsideration of the risk of post-arthroplasty infection in patients treated
      with methotrexate.

PMID- 1747151
TI  - Who pays for nonprofit?

PMID- 1747152
TI  - Why choose a nonprofit community speech and hearing center setting?

PMID- 1747153
TI  - Keeping the promise to those who serve. The VA Healthcare System.

PMID- 1747154
TI  - Third-party billing for school services. The schools' perspective.

PMID- 1747155
TI  - Hodgkin's disease. Treatment of the young child.
AB  - Age of a patient when afflicted with Hodgkin's disease is an important prognostic
      factor. Although there are histologic and stage differences as a function of age,
      the younger a patient is when diagnosed, the better the cure rate. Youngsters
      less than age 10 years have a freedom from relapse of 80% at 26 years follow-up
      examination; adolescents in the 11 to 16 age group have a freedom from relapse or
      74%; and adults aged 17 years or older have a freedom from relapse of 64%. These
      differences translate into significant survival differences as well, with
      children aged 10 years or younger and those aged 11 to 16 years having a 26-year
      survival of 74%, as compared to adults, who have a 37% survival (P = 0.003).
      These differences remain significant when comparing those with stage I and II
      disease, as opposed to those with advanced stage III and IV disease. Children
      present the greatest challenges with respect to staging and treatment. The older
      child with localized disease can be managed appropriately as an adult. However,
      for the younger child the use of low-dose radiation and multiagent chemotherapy
      is widely accepted. Using this approach, survival rates of 85% or greater are
      reported from many large institutional and cooperative group experiences. The
      goals of treatment today are cure of disease, with maximal quality of life and
      minimal complications from the treatment. The late effects of greatest importance
      to the youngest children are skeletal and bone growth abnormalities, sterility,
      and malignant tumor induction. Treatment programs today should be directed
      towards refining therapy to minimize sequelae while maximizing quality of life.
      These goals are best achieved when children are managed in regional centers with
      demonstrated expertise in the management of children with Hodgkin's disease.
      Whereas cure can be achieved in a large majority of children diagnosed with
      Hodgkin's disease, our challenge is cure, with the least sequelae and the
      greatest quality of life. "Children are not simply micro-adults, but have their
      own specific problems."

PMID- 1747156
TI  - Temporal behavior of peripheral organ distribution volume in mammillary systems.

PMID- 1747157
TI  - Crystallization and preliminary X-ray diffraction data of the Fab fragment of a
      monoclonal antibody against apamin, a bee venom neurotoxin.
AB  - Fab fragments of anti-apamin monoclonal antibodies have been purified to
      homogeneity and crystallized. The crystals belong to the monoclinic space group
      P21 with cell dimensions a = 99.0 +/- 0.3 A, b = 137.1 +/- 0.4 A, c = 76.0 +/-
      0.2 A and beta = 92.9 +/- 0.9 degrees. They most likely contain four molecules in
      the asymmetric unit (Vm = 2.39 A3/Da). The possibility of the existence of non
      crystallographic symmetry is discussed.

PMID- 1747159
TI  - A multidisciplinary approach to cardiac rehabilitation.
AB  - As health care professionals we believe rehabilitation and patient education
      should commence on admission and continue through to discharge. Ideally it should
      be started from birth, with education by the family, school, GPs and well person
      clinics. This should include family screening an awareness of health and factors
      which may affect this. When patients develop angina, support should be given so
      that they can control the effects more adequately and reduce potential risk
      factors. There should be no exclusion criteria for patients accepted on these
      programmes as those who would probably be excluded are those who would require
      rehabilitation the most. Every individual can participate in discussion and any
      form of exercise can be tailored to meet the individual's needs. Many benefits
      have been mentioned, but the most important one is the improved quality of life
      for the patient and her or his family. Cardiac rehabilitation programmes and self
      help groups may provide additional support to the patient and family during
      convalescence. Group programmes through their dynamics help to overcome feelings
      of isolation. Patients feel they gain support from their peer-group and they in
      turn can help each other overcome residual symptoms and practical difficulties.
      This 'social' rehabilitation is often the most beneficial aspect of the course;
      the group really helps them succeed. Rehabilitation must be accepted as part of
      the treatment and not a luxury for a few patients. This is a very exciting time
      when interest in this area is developing and research is examining the quality of
      life. We need to evaluate continually and undertake research to improve nursing
      practice.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1747158
TI  - Neuropeptide Y inhibits nicotinic cholinergic currents but not voltage-dependent
      calcium currents in bovine chromaffin cells.
AB  - The effects of neuropeptide Y (NPY; 1-36) and NPY fragment (16-36) on nicotinic
      currents (IACh) and voltage-dependent calcium currents (ICa) were studied in
      bovine chromaffin cells using the whole-cell patch-clamp technique. The peak
      amplitude of inward nicotinic currents was markedly depressed by both NPY (1-36)
      and NPY (16-36). In contrast, ICa was unaffected by either NPY (1-36) or NPY (16
      36). Both pertussis toxin pretreatment and including GDP [beta-S] in the patch
      pipette solution completely abolished the inhibitory effect of NPY on IACh. It is
      concluded that inhibition of IACh probably represents the mechanism by which NPY
      decreases catecholamine release from adrenal medulla. This effect appears to be
      mediated by a G-protein-coupled Y2 receptor.

PMID- 1747160
TI  - The mouse proline-rich protein MP6 promoter binds isoprenaline-inducible parotid
      nuclear proteins via a highly conserved NFkB/rel-like site.
AB  - Proline-rich protein (PRP) gene MP6 was isolated from a mouse BALB/c genomic DNA
      library in lambda EMBL3, characterised by hybridisation and restriction mapping
      and the promoter region, from -162 to +72 around the PRP consensus cap-site, was
      sequenced. In gel shift assays this region formed complexes C1 and C2 with
      parotid nuclear proteins which were induced by the beta-adrenergic agonist
      isoprenaline. DNA competition studies and direct binding assays of promoter
      subfragments showed that it was the sequence from -157 to -91 that was forming
      the isoprenaline-dependent complexes. All PRP genes conserve a 23bp. sequence,
      termed PRP Box1, with ets and NFkB/rel binding site-like elements, upstream of
      their promoters. In the MP6 promoter, PRP Box1 was within the region forming the
      complexes. Further gel shift assays using PRP Box1 oligonucleotides as
      competitors and targets indicated that the NFkB/rel binding site-like element was
      important in formation of the isoprenaline-inducible complexes. HeLa nuclear
      extracts also formed complexes with PRP Box1 similar to C1 and C2 but nuclear
      extracts from spleen, submandibular gland and liver did not. These complexes are
      thus candidate regulators for the isoprenaline-dependent and tissue-specific
      transcription of PRP genes.

PMID- 1747161
TI  - Clozapine and loxapine for schizophrenia.

PMID- 1747162
TI  - The IgM-associated protein mb-1 as a marker of normal and neoplastic B cells.
AB  - Recent evidence indicates that the transmembrane form of IgM on murine and human
      B lymphocytes is physically associated with at least two proteins, forming a
      disulfide-linked dimer, which may control cell surface expression of IgM and also
      play a role in signal transduction after Ag binding (by analogy with the TCR
      associated CD3 components in T lymphocytes). We have used mAb and polyclonal
      antibodies against an intracytoplasmic epitope on one of these polypeptides
      (previously identified in murine B cells as the product of the B cell specific mb
      1 gene) to study the distribution of the IgM-associated dimer in human cells. By
      immunocytochemical staining of normal and neoplastic B cells, we show that the
      human mb-1 protein appears early in B cell differentiation, probably before
      expression of cytoplasmic mu-chain, and persists until the plasma cell stage,
      where it is seen as an intracytoplasmic component. According to immunohistologic
      analysis of reactive lymphoid tissue and lymphoma samples, mb-1 protein is
      completely B cell specific. Anti-mb-1 also labels B cell areas in tissues from
      seven different mammalian species. Finally, the Ig-associated dimer could be
      isolated from human hairy-cell leukemia cells in high purity and yield by
      affinity chromatography using anti-mb-1 antibody. Mice immunized with this
      material have produced a strong polyclonal response, so that it should now be
      possible to prepare a panel of new mAb reactive with different epitopes on both
      mb-1 and on its associated polypeptide(s).

PMID- 1747163
TI  - Work stress after smoking cessation.
AB  - 1. Since smoking relapse occurs most frequently during the first 3 to 6 months
      after cessation, worksite maintenance sessions during this critical time may
      promote long term abstinence. 2. Uncertainty or ambiguity about what is expected
      of the worker on the job is a consistent predictor of relapse during the first
      year postcessation. 3. A worker's perception of workload is related to smoking
      status. Workers who perceived a heavier load at 3, 6, and 12 months postcessation
      were likely to have resumed smoking.

PMID- 1747164
TI  - Self-Efficacy Theory. Implications for the occupational health nurse.
AB  - 1. Self-efficacy, a concept derived from Social Learning Theory, provides a
      theoretical framework for behavior change. This framework can be used by the
      occupational health nurse to develop programs designed to effect behavior change.
      2. Research studies focusing on behavior change (e.g., smoking cessation, weight
      control, exercise and cardiac rehabilitation, work resumption) employing the
      concept of self-efficacy are reviewed. 3. Self-efficacy predicts modification and
      maintenance of behavior.

PMID- 1747165
TI  - Shiftwork. Consequences and considerations.
AB  - 1. The shiftworker's inability to adapt to shiftwork schedules can lead to a loss
      of physical and psychological well being, and can produce negative safety and
      performance consequences. 2. The factors that contribute to the intolerance of
      working shiftwork schedules are complex and interrelated and include host
      variables (i.e., circadian rhythms) and environmental variables (i.e., type of
      shifts worked). 3. The most direct and consistent effect of working shiftwork is
      the impairment of the quality and quantity of sleep. 4. Interventions should
      include a program that monitors workers' tolerance to shiftwork and provides
      information and recommendations for employees to effectively manage a lifestyle
      that incorporates nighttime work schedules.

PMID- 1747166
TI  - Occupational stress and burnout in the nursing profession. A model for
      prevention.
AB  - 1. Work overload, lack of control over one's work, non-supportive work
      environment, limited job opportunity, role ambiguity, rotating shift work, and
      machine paced work are occupational stressors that have been suggested as factors
      contributing to psychological disorders. 2. The model of occupational stress
      defined in this article utilizes organizational social support and coping
      strategies as buffering agents with the potential to decrease occupational stress
      and burnout. 3. Although this model and suggested methods for measurement of
      components in the model were developed for the investigation of stress in health
      care populations, the model can be applied to other work settings.

PMID- 1747167
TI  - Carpal tunnel syndrome among employees at a window hardware manufacturing plant.
      Health hazard evaluation series.

PMID- 1747168
TI  - Strategies to develop "interconnectedness". Part I: Connections within the
      organization.

PMID- 1747169
TI  - Forty years of litigation involving residents and their training: I. General
      programmatic issues.
AB  - An analysis of reported state and federal adjudication from 1950 through 1989 was
      undertaken to identify issues and trends in litigation involving residents and
      their training. Of the 174 decisions cited, 38 (22%) involved disputes over
      general programmatic issues. The great majority of these addressed academic
      administration, especially issues arising from dismissals of residents. During
      more recent periods, residency programs have accommodated to judicial scrutiny of
      dismissals and have prevailed more often than claimants in litigation. Successful
      accommodation by residency programs has apparently not operated as a disincentive
      to further litigation, however.

PMID- 1747170
TI  - Involvement of health maintenance organizations in graduate medical education.
AB  - Prepaid health care plans are likely to play an important part in the current
      transition from inpatient to ambulatory care training of physicians, because such
      plans enroll one in seven Americans. In the spring of 1990, the Group Health
      Association of America conducted a survey of health maintenance organizations
      (HMOs) to assess their level of involvement in graduate medical education (GME).
      A questionnaire was sent to the 481 HMOs in the United States that had been
      operational for at least four years; 58% responded. Fifteen percent (42 HMOs)
      indicated that they were directly involved in GME. The majority of these 42
      indicated that they had an agreement with an academic medical center (AMC) or a
      teaching hospital to serve as an ambulatory care rotation site. About one-sixth
      of the 42 HMOs had been approved by the Accreditation Council for Graduate
      Medical Education to serve as a sponsoring organization. HMOs directly involved
      in GME were more likely to be staff model and group model HMOs; older plans with
      an enrollment of 50,000 or more; not-for-profit plans; and those owned or
      sponsored by an AMC.

PMID- 1747171
TI  - The potential of the academic medical center to shape policy-oriented rural
      health research.
AB  - Rural communities continue to have problems in gaining access to basic health
      care services, a problem exacerbated by persistent shortages of physicians,
      financially threatened rural hospitals, and weak local economies. Academic health
      centers can help to address these issues, not only by increasing the flow of
      their graduates to rural areas, but also by supporting health services research
      designed to shape public policy that affects the rural United States. Examples of
      such research include experiments designed to influence the locational decisions
      of medical students and residents, studies of the quality and cost-effectiveness
      of care in rural hospitals, and the testing of new ways to provide emergency
      medical care in rural areas. Such policy-oriented research is compatible with
      both the intellectual and the service missions of most medical schools; in
      addition, lessons learned in rural areas may be relevant in more urbanized areas.

PMID- 1747172
TI  - An elective course in medical history.

PMID- 1747173
TI  - The fee schedule and academic medicine.

PMID- 1747174
TI  - The Veterans Health Administration: a health care model for the nation.

PMID- 1747175
TI  - Credit and responsibility in authorship.

PMID- 1747176
TI  - Affirmative action for women and promotion of academic excellence.

PMID- 1747177
TI  - Physicians as human engineers.

PMID- 1747178
TI  - A student-organized nutrition course.

PMID- 1747179
TI  - Teacher definition.

PMID- 1747180
TI  - Where physicians practicing in Appalachia in 1978 to 1990 were trained and how
      they were distributed in urban and rural Appalachia.
AB  - Medical school graduates who graduated from 1978 to 1986 were analyzed to
      determine the health professions' ability worldwide to educate and place primary
      care physicians in rural areas of Appalachia. These data indicate that the
      University System of West Virginia--consisting of the West Virginia School of
      Osteopathic Medicine, West Virginia University Medical School, and Marshall
      University Medical School--produced the most primary care physicians who began
      practicing in rural Appalachia during the 1980s. The West Virginia School of
      Osteopathic Medicine successfully retained 106 (26%) of its graduates in primary
      care practices throughout rural Appalachia, with 77 of them in rural West
      Virginia, making the institution the nation's leading provider of primary care
      physicians practicing in rural Appalachia and West Virginia during this eight
      year study period. With the exception of West Virginia, these and additional data
      support concerns of medical educators and public health officials that physicians
      in Appalachia are distributed disproportionately, more to urban than to rural
      counties.

PMID- 1747181
TI  - A review of studies concerning effects of sleep deprivation and fatigue on
      residents' performance.
AB  - Possible effects of sleep deprivation and fatigue on the performance and well
      being of residents have received little scientific examination until recently.
      This article is a review of the studies on this topic published since 1970. All
      those studies that dealt with residents' moods and attitudes demonstrated
      deleterious effects of sleep deprivation and fatigue. The implications of this
      finding for patient care deserve exploration. Residents' acuity on performance
      tests requiring prolonged vigilance tended to deteriorate with acute sleep loss,
      while their performances on most brief psychomotor tests measuring manual
      dexterity, reaction times, and short-term recall were not adversely affected. The
      data presently available suggest that sleep-deprived or fatigued house officers
      can compensate for sleep loss in crises or other novel situations. However, sleep
      deprived residents may be more prone to errors on routine, repetitive tasks and
      tasks that require sustained vigilance, which form a substantial portion of
      residents' workload. The authors concur with the recommendation of the Executive
      Council of the Association of American Medical Colleges that the total working
      hours for residents should not exceed 80 hours per week averaged over four weeks.

PMID- 1747182
TI  - Impact of physicians' part-time status on inpatients' use of medical care and
      their satisfaction with physicians in an academic group practice.
AB  - Inpatients' use of medical care and their satisfaction with their physicians were
      examined comparing the patients of three part-time physicians and five full-time
      physicians in an internal medicine group practice at the Columbia-Presbyterian
      Medical Center. In one study, by chart review over a seven-month period in 1988,
      each patient's length of stay and severity of illness were measured. A total of
      58 cases were reviewed: 34 from full-time physicians and 24 from part-time
      physicians. When matched for severity of illness, there was no difference in
      lengths of stay between the patients of the part-time and those of the full-time
      physicians. In a second study, on interviewer-administered questionnaires
      completed over a ten-month period in 1986-1987, 60 patients gave satisfaction
      ratings of their primary physicians: 36 with full-time physicians and 24 with
      part-time physicians. Patients' satisfaction was equally high for both groups of
      physicians. The authors suggest that since more women physicians in internal
      medicine are demanding part-time work, and since part-time arrangements have been
      criticized as having adverse effects on patient care, their findings may
      contribute to more enlightened attitudes towards physicians who choose part-time
      status.

PMID- 1747183
TI  - Residency directors' assessments of which selection criteria best predict the
      performances of foreign-born foreign medical graduates during internal medicine
      residencies.
AB  - In the summer of 1990, 102 directors of internal medicine residency programs from
      nine areas of the country with the largest numbers of foreign-born foreign
      medical graduates (FFMGs) were surveyed by mail to determine what criteria used
      to select FFMGs for residency positions best predicted performance. The directors
      felt that the most important predictors were performance on the Foreign Medical
      Graduate Examination in the Medical Sciences or the National Board of Medical
      Examiners examinations; performance during the interview; and postgraduate
      clinical experience in the United States. Recent graduation from medical school
      was felt to be a better predictor than postgraduate clinical experience in a
      foreign country. Seventy-three percent of the directors found letters of
      recommendation from a foreign country to be useless. The author suggests the
      results of this study may be useful to residency programs in evaluating FFMG
      applicants and to FFMGs in assessing their own credentials.

PMID- 1747184
TI  - Association between third-year medical students' abilities to organize hypotheses
      about patients' problems and to order appropriate diagnostic tests.
AB  - The authors studied the abilities of three groups of third-year medical students
      (a total of 310) at two schools to order appropriate diagnostic tests and
      procedures for four cases studies. Each student was classified as "organized,"
      "mixed," or "non-organized" based on the degree of organization of the approach
      the student used to list hypotheses for the two cases he or she was assigned.
      Analysis of variance revealed that the students in the organized and mixed groups
      spent significantly fewer dollars for inappropriate diagnostic evaluations than
      did the students in the non-organized group for three of the four cases (p less
      than .05). Analyses of the mean expenditures for all cases revealed that the
      students in the organized and mixed groups spent significantly fewer dollars for
      inappropriate evaluations than did the students in the non-organized group (p
      less than .05). The medical school that was teaching its students to organize
      hypotheses had more students in the organized group than expected for every case.
      The authors conclude that the ability of students to organize hypotheses is
      directly related to their ability to avoid increased expenditures for
      inappropriate diagnostic tests and procedures, and that organized thinking about
      patients' problems is a skill that can be taught.

PMID- 1747185
TI  - Internal medicine residents' monitoring of their colleagues' moonlighting
      activities at the University of Cincinnati.
AB  - The University of Cincinnati Department of Internal Medicine instituted in 1989
      90 a peer review moonlighting committee of residents to (1) design departmental
      guidelines for work activities and number of work hours, (2) confidentially
      document work activities of fellow residents, (3) identify discrepancies between
      the recommended guidelines and residents' work activities, and (4) initiate
      control policies. Quarterly self-report questionnaires documenting moonlighting
      activities were given to each of the 35 residents in the second and third
      postgraduate years (20 and 15 residents, respectively). There was a 98%
      compliance rate by the residents through the initial 12 consecutive months. The
      completed questionnaires indicated that there were four first-time violators of
      established guidelines. The authors suggest that a peer review moonlighting
      committee may help in establishing mutually acceptable work activity guidelines
      while maintaining the accountability of the residency review committee and the
      program director.

PMID- 1747186
TI  - Estimating impacts on developing countries of the decrease in U.S. training
      opportunities for foreign medical graduates.
AB  - Between 1973 and 1983, the number of foreign nationals from developing nations
      who entered the United States for graduate medical education decreased by
      approximately 90%. Many of those who would have studied in the United States if
      this decrease had not occurred would have returned home to serve their countries.
      To estimate the impact of this loss, a survey was conducted in six major cities
      in Latin America between 1983 and 1989. Selected local medical students
      interviewed 554 physicians who had returned home after U.S. training and 60 of
      their classmates who had not trained there. The findings indicate that the
      returned physicians had given approximately twice as much time to teaching,
      research, and medical administration as did those who had not left home. The
      authors maintain that this and related findings show how the curtailment of
      opportunities for training foreign nationals in the United States is detrimental
      to both the aspirations of developing nations and the influence of the United
      States in world affairs.

PMID- 1747187
TI  - Investigating whether timing of students' third-year internal medicine clerkships
      affects their performances as seniors on the NBME examination.

PMID- 1747188
TI  - Comparing the resource use of sympathetic and empathetic physicians.

PMID- 1747189
TI  - Computer simulations of electron-transfer reactions in solution and in
      photosynthetic reaction centers.

PMID- 1747190
TI  - New methods for electronic structure calculations on large molecules.

PMID- 1747192
TI  - Generation of high-resolution protein structures in solution from
      multidimensional NMR.

PMID- 1747191
TI  - Electrode reactions of well-characterized adsorbed molecules.

PMID- 1747193
TI  - Vibrational energy relaxation and structural dynamics of heme proteins.

PMID- 1747194
TI  - Characterization of service intervals and frequency of short oestrus cycles in
      Zebu (Bos indicus) cows in Ethiopia.
AB  - Data collected over a 10-yr period on 1,778 service intervals in 1,111 Arsi (Bos
      indicus), cows at the Ethiopian Ministry of Agriculture ranch were analyzed.
      Conception rate to first service was 48%, cows calving from June to February
      being more likely to conceive at first oestrus. Overall interval between services
      in animals returning for insemination averaged 53 +/- 40 (SD), range 6-262 d.
      There were (6%) "short" cycles of less than 17 d, mostly during the first (69%)
      and second (30%) intervals (P less than 0.01). A quarter of service periods (24%)
      were within the normal length of 18-24 d, 52% were its multiples while 18% were
      abnormal and probably indicative of embryonic mortality. First oestrus cycle
      length was affected by year (P less than 0.01) and season of calving (P less than
      0.05). Second oestrus cycle length was influenced by season of calving and first
      oestrus onset (P less than 0.05). It is concluded that the low frequency of
      normal cycles is to a large extent due to heats which remained undetected by
      visual observation in Arsi cows under artificial insemination programmes.

PMID- 1747195
TI  - Ca2+ as a messenger of dorsal--ventral polarity formation in frog (Rana
      temporaria) eggs.
AB  - Three methods of Ca2+ administration were used to influence the location of the
      grey crescent and the dorsal lip of blastopore in R temporaria eggs, ie a Ca2+
      microinjection into the subcortical cytoplasm, egg pricking in high Ca2+
      solutions and Ca2+ ionophore A23187 microinjection and application. The
      treatments all induced grey crescent and dorsal lip of blastopore formation near
      the Ca2+ administration site. Inositol trisphosphate injections gave similar
      results. Colchicine injections into the eggs inhibited the appearance of both
      natural and Ca(2+)-induced grey crescents.

PMID- 1747196
TI  - [Refeeding after ingestion of diets containing 10% soybean protein associated
      with various concentrations of alginate or sodium carrageenan. Effects on growth
      and lipid parameters in the rat].
AB  - Male 21-d-old Wistar rats were fed over 3 experimental periods. During the first
      period of 4 wk, diets contained 10% casein or defatted soy flour proteins, with
      or without 0.5, 1, 2 or 3% sodium alginate or sodium carrageenan, and were
      heated. During the second period, they were fed a standard diet for 16 wk with
      17% proteins, and during the third period, they received the same diet as in the
      first period, but with 20% proteins. Rat body weights were measured throughout
      the study period; plasma lipid levels were then determined after fasting.
      Presence of sodium alginate in the diet had no effect on growth, but rats fed
      carrageenan presented growth retardation at the end of the experimental period,
      which was not altered by refeeding the standard diet. Sodium alginate did not
      modify rat triglyceridemia, except at the 1% level. Carrageenan had a
      hypotriglyceridemic effect. Alginate and carrageenan had no effect on blood
      cholesterol. Compared to soybean protein, casein intake did not increase plasma
      cholesterol levels as generally described. The effect of carrageenans on growth
      and plasma triglyceride levels could be a result of their physico-chemical
      properties.

PMID- 1747197
TI  - Insulin and glucose in neonatal calves after peroral insulin and intravenous
      glucose administration.
AB  - Effects of peroral insulin on plasma concentrations of immunoreactive insulin
      (IRI) and glucose in newborn calves were studied. Bovine insulin was administered
      in amounts of 0.5 mg/kg body weight immediately preceding first colostrum.
      Thereafter, neither an increased IRI response nor a lowering of blood glucose
      level were observed, indicating that insulin was either not absorbed from the
      intestine or possibly retained in the liver. Feeding of whole milk was followed
      by a higher rise in IRI and glucose concentrations than feeding of colostrum
      after po insulin. However, when compared with 1-3-month old calves, IRI responses
      to feeding and to iv infused glucose were markedly smaller on the first and
      second day of life respectively, while glucose responses were similar. This
      indicates that insulin secretory mechanisms are not fully developed in the
      newborn calf.

PMID- 1747198
TI  - [Transport of amino acids in the splanchnic bed by blood plasma and blood in the
      preruminant calf].
AB  - Three preruminant calves were fitted with catheters in portal and hepatic veins
      and in a mesenteric artery. Two electromagnetic flowmeter probes were clipped
      around the portal vein and the hepatic artery. The calves were fed either a diet
      with a low (L) or a high (R) abomasal emptying rate for dietary proteins. Blood
      flow and free amino acid levels in plasma (P) and blood (S) were determined
      before the morning meal and during the following 7 h. In the portal vein, for
      most amino acids P/S ratios were correlated to the net amino acid balance of the
      digestive tract measured in plasma. By contrast in the hepatic vein, these ratios
      were mainly correlated to hepatic balance measured in whole blood. Correlations
      between digestive tract and hepatic balance calculated using either plasma or
      whole blood pool were different for some amino acids. This suggests that amino
      acid exchange between plasma and blood cells is low and absorbed amino acids are
      mainly transported to the liver by plasma, whereas whole blood rather than plasma
      is concerned in amino acid exchanges in the liver.

PMID- 1747199
TI  - Intestinal absorption of calcium from yogurt in lactase-deficient subjects.
AB  - Fractional intestinal absorption of calcium (FACa) was measured using radioactive
      calcium and 200 mg of calcium carrier provided either by yogurt or by CaCl2 in 7
      lactase-deficient (L(-] and 7 normal (L(+] subjects. During the control period
      prior to yogurt consumption, mean calcium intake was 819 mg per day in L(-) and
      931 mg per day in L(+) subjects (NS). In both groups of subjects yogurt increased
      FACa from 20.8 +/- 3.9% to 26.9 +/- 7.2% (P = 0.065) in L(+) subjects and from
      20.2 +/- 5.6% to 23.5 +/- 6.4% (P = 0.050) in L(-) subjects. The significant
      increase in FACa observed in L(-) subjects indicates that yogurt, which is an
      autodigesting source of lactose, does not impair calcium absorption. FACa
      increase could reflect the lower dietary calcium intake in L(-) subjects when
      compared with L(+) subjects, due to avoidance of milk and non-fermented dairy
      products which could cause intestinal discomfort. It is concluded that yogurt is
      a well-tolerated and efficient source of calcium in subjects with lactase
      deficiency.

PMID- 1747200
TI  - Relationships between plasma lipoproteins and glucose in fasted chickens selected
      for leanness or fatness by three criteria.
AB  - In order to identify the mechanisms which underlie fattening in commercial birds,
      lean and fat broiler chickens have been selected according to 3 different
      criteria: abdominal fat content, plasma glucose level and plasma concentration of
      very-low-density lipoproteins (VLDL), the latter being the main substrate from
      which bird adipose tissues accumulate triglycerides. Chickens selected for high
      abdominal fat content displayed a higher level of VLDL and a lower level of
      glucose than their lean counterparts. Conversely, selection for high plasma VLDL
      or low plasma glucose resulted in 2 fat lines of chickens. The differences in
      intermediate- and low-density lipoproteins reflected a different balance in
      synthesis and catabolism of VLDL among the lines, whereas there was no difference
      in high-density lipoproteins. These data clearly demonstrate the relationship
      between lipid and carbohydrate metabolism and their role in the susceptibility to
      fattening. They suggest a greater use of carbohydrate for hepatic lipogenesis in
      fat chickens, resulting in a higher synthesis and secretion of VLDL and of their
      subsequent accumulation of triglycerides in the adipose tissue.

PMID- 1747201
TI  - Thyrotropin-releasing hormone (TRH) is not thyrotropic but somatotropic in fed
      and starved adult chickens.
AB  - Adult fed and starved Warren chickens, 2 yr of age, and approaching the end of
      the second laying year, were injected iv with 1 of the following products: 10
      micrograms of thyrotropin releasing hormone (TRH); 100 micrograms of bovine
      thyrotropin (bTSH); 100 micrograms of ovine growth hormone (oGH); saline. The
      influence on plasma concentrations of thyroxine (T4), triiodothyronine (T3) or
      chicken GH (cGH) were followed. Prior to injection, it was clear from the control
      values that starvation for 3 d decreased plasma levels of T3 and increased cGH,
      whereas 7 d of fasting increased T4 and cGH. The plasma levels of cGH were
      elevated greater than 10-fold at 15 min following the TRH challenge in food
      deprived chickens compared to a less than 4-fold increase in normal fed hens.
      This increase was followed by a rise in T3 after 1 h, which was also more
      pronounced in the starved animals, whereas T4 decreased or remained unaffected.
      Increases in T4 can, however, be obtained with 100 micrograms TSH in normal fed
      (2-fold) or starved animals (greater than 3-fold). Following injection of 100
      micrograms oGH, a significant increase in T3 levels was observed which in fed
      animals was already present at 30 min, but the higher levels persisted for 1 and
      2 h in fed and starved hens. At the same time, a decrease in T4 was observed in
      both groups of GH-treated chickens. It is concluded that TRH at the dose used is
      not thyrotropic but has a somatotropic effect and is responsible for the
      peripheral conversion of T4 into T3.

PMID- 1747202
TI  - Microscopic investigation of changes in histology and digestibility in the rumen
      of a forage grass and a forage legume during the first growth stage.
AB  - An Italian "Dalita" ryegrass (Lolium italicum) and a European lucerne (Medicago
      sativa) were harvested at 5 different growth stages to determine the anatomical
      factors limiting their digestibility and in particular the effects of
      lignification of the tissues. In vitro digestibility, cell wall contents of the
      whole plant and stem of lucerne and of the whole plant, stem and leaf blade of
      ryegrass were determined. The rate and the extent of degradation in the rumen of
      the different tissues were observed by scanning electron microscopy. This
      degradation occurred very rapidly with the lucerne stems; the xylem of lucerne
      was the only undegradable tissue whatever the stage. The collenchyma was degraded
      in the rumen although with acid phloroglucinol it stained positive for the
      presence of phenolic compounds. Ryegrass stems were digested more slowly than
      lucerne stems, and the sclerenchyma and xylem of ryegrass were indigestible
      whatever the stage. The parenchyma located close to the sclerenchyma became
      indigestible as the cell walls lignified progressively from the third stage.
      These results contribute to the understanding of the decrease in digestibility
      over the first growth stage and the variation in rate of digestion of lucerne and
      ryegrass in the rumen.

PMID- 1747203
TI  - Differential effects of T4 and T3 on TRH- and GRF-induced GH secretion in the
      domestic fowl.
AB  - The in vivo growth hormone (GH) response of immature domestic fowl to
      thyrotrophin-releasing hormone (TRH) and GH-releasing factor (GRF) was suppressed
      in birds fed diets supplemented (1 ppm) with triiodothyronine (T3) or given bolus
      intraperitoneal (ip) injections (100 micrograms/kg for 10 d) of T3.
      Supplementation (ppm) of the diet with T4 had no effect on secretagogue- induced
      GH release. Exogenous T3 or T4 suppressed basal, TRH- and GRF-induced GH release
      2 h after daily ip administration (100 micrograms/kg for 10 d). 24 h after the
      last injection, only T3 was effective in inhibiting basal and stimulated GH
      secretion in vivo. The systemic administration of T3 was followed 2 h and 24 h
      later by a downregulation of pituitary TRH binding sites. T4 administration had
      no effect on pituitary TRH binding. When chicken pituitary glands were incubated
      in vitro, basal GH release was unaffected by the addition of 10(-9)-10(-5) M T3
      or T4 to the incubation media. The in vitro GH response to TRH (10(-6) M) or GRF
      (10(-6) M) challenge was, however, suppressed in a dose-related manner by T3 but
      was unaffected by the coincubation of T4. These results demonstrate inhibitory
      effects of T3 and T4 on basal and secretagogue-induced GH secretion in fowl. T4
      is less active than T3 and probably exerts some of its effects via T3-independent
      mechanisms.

PMID- 1747204
TI  - Light- and electron-microscopic observations on the relationship between
      prelampbrush oocytes and surrounding granulosa cells in the laying Japanese quail
      (Coturnix coturnix japonica).
AB  - Transmission electronmicroscopic (TEM) observations demonstrated that the most
      superficial region of quail oocytes during the prelampbrush stage differs locally
      from the deeper ooplasm and is an active zone which forms exooplasmic cones,
      ridges or knob-like protrusions in the direction of/or in the granulosa cells.
      This exooplasm, in which no mitochondria were seen, is separated from the
      endooplasm, by a narrow interrupted filamentous layer. Using a lipid-preserving
      method of fixation, morphological evidence was found for the transport of lipid
      material from the granulosa cells into the exooplasm of the oocyte. Open
      intercellular bridges between exooplasm and granulosa cell cytoplasm were also
      seen. Differences between the electronmicroscopic aspect of clear and dark
      granulosa cells have been described.

PMID- 1747205
TI  - First reflection: a special transcultural experience.

PMID- 1747206
TI  - Transcultural nursing: providing culturally congruent care to the Hausa of
      Northwest Africa.
AB  - Research around the world is now beginning to validate the theory of Cultural
      Care as an important means to provide culturally congruent care to clients,
      families, and groups of diverse cultures. Knowledge of Leininger's Theory of
      Cultural Care Diversity and Universality can provide meaningful care to clients
      who have different traditional and current beliefs and values. The Leininger
      Sunrise Model can serve as a valuable guide to discover care meanings and
      practices related to the theory, and to provide practical and meaningful culture
      specific care decisions and actions by nurses. The three major modes of action,
      namely, cultural care maintenance or preservation, accommodation or negotiation,
      and repatterning or restructuring, are important differential means to provide
      culturally congruent care to clients within their own cultural setting. This
      article considers the application of such care for the Hausa of Northwest
      Africa.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1747207
TI  - Second reflection: comparative care as central to transcultural nursing.

PMID- 1747208
TI  - Transcultural care principles, human rights, and ethical considerations.
AB  - During the past three decades, the author has developed and used some general
      principles to guide transcultural instruction, practice and research. These
      principles were developed from my transcultural care theory, research studies and
      direct clinical experiences, consultation and general writings on the subject
      [Leininger 1967, 1970, 1973, 1976, 1978, 1979, 1980, 1981, 1984a, 1984b, 1988,
      1989, 1990]. The principles include some assumptive premises with regard to
      universal and diverse considerations of human beings with the importance to know
      and respect the cultural rights of people in order to provide meaningful,
      satisfying and appropriate culture care to people. Through the years, a number of
      nursing students, faculty, and clinicians have used these principles, rights and
      ethical considerations to guide them in their thinking and to protect client's
      human and ethical rights. Since many nurses frequently request copies of these
      statements for teaching, consultation and clinical work, they are published below
      with this intent in mind.

PMID- 1747209
TI  - Response to published article: nursing diagnosis.

PMID- 1747210
TI  - Transcultural nursing in South Africa: prospects for the 1990's.

PMID- 1747211
TI  - Harmonizing: a North American Indian approach to management of middle ear disease
      with transcultural nursing implications.
AB  - In a grounded theory study of Canadian Indian family management of persistent
      middle ear disease, harmonizing was identified as the major strategy employed in
      the process of learning to manage. This finding resulted in a recasting of the
      substantive theory of management identified in an earlier study of Caucasian
      families. Although families from both cultures advance and retreat on the
      continuum of learning to manage in response to the relationship with the health
      care system, the effects of the disease on the child, and the amount of
      disruption in family life, culture was found to influence the ways in which these
      families learned to manage. In general, native families harmonized by integrating
      the experience into their reality in contrast with their Caucasian counterparts
      who attempted to direct or take charge of the experience. Factors that influenced
      native Indian management included autonomy of the child, perceptions of health
      and illness, expectations of the health care system, orientation to present and
      past time, and listening skills. These findings significantly contributed to the
      development of transcultural nursing knowledge.

PMID- 1747212
TI  - Variation in apparent serum digitalis-like factor levels with different digoxin
      antibodies. The "immunochemical fingerprint".
AB  - Increased levels of a circulating digoxin-like factor (DLF) occur in a number of
      physiologic states in which sodium homeostasis is altered, and may contribute to
      the pathogenesis of hypertension. We exploited the different affinities for DLF
      of seven antisera directed at digoxin to develop an immunochemical profile, and
      then employed this index to address two questions: does the same DLF species
      exist in several conditions associated with increased DLF levels, including
      pregnancy, renal failure, hepatic failure, and neonatal cord blood? Will this
      approach prove useful in assessing candidates proposed to be DLF? An identical
      profile was identified in serum from pregnant women and patients with renal or
      hepatic failure, and a highly significant correlation existed between DLF levels
      measured with antisera of high and intermediate affinity in 42 subjects with
      increased levels (r = 0.93; P less than .001). In patients with renal failure,
      when endogenous DLF levels were too low to assess the profile, concentration of
      the serum resulted in measurable DLF levels that had an identical profile. The
      profile was somewhat altered in umbilical cord blood, perhaps reflecting an
      influence of increased steroid hormone levels. Among agents suggested as
      candidates for DLF, neither lysophosphatidylcholine nor ouabain showed a profile
      resembling DLF. Progesterone, 17-OH-progesterone, and bufalin, on the other hand,
      did show substantial similarity, perhaps providing a clue to the structure of
      DLF. The normal plasma levels of progesterone and 17-OH-progesterone are 100- to
      1000-fold too low to be candidates for DLF and bufalin was sufficiently
      dissimilar not to be a candidate. DLF in at least three different patient
      populations probably represents identical chemical species.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1747213
TI  - Parathyroid hypertensive factor is present in DOCA-salt but not two-kidney-one
      clip hypertensive rats.
AB  - In order to determine whether the expression of parathyroid hypertensive factor
      (PHF) is secondary to hypertension or whether it is specifically related to low
      renin hypertension, PHF levels were measured in DOCA-salt and two-kidney-one-clip
      (2K-1C) hypertensive rats. Despite equivalent elevations of blood pressure, PHF
      was detected in the DOCA-salt rats, but not in the 2K-1C rats (17.5 +/- 3.1 mm
      Hg, P less than .0001 v 0.9 +/- 2.8 mm Hg, P = NS, respectively). Moreover, PHF
      levels correlated with mean arterial pressure in the DOCA-salt group (r = 0.91, P
      less than .0001). We conclude that PHF expression is not a secondary phenomenon
      caused by hypertension, but rather may be causally related to the development of
      low-renin forms of hypertension.

PMID- 1747214
TI  - Rapid smooth muscle cell growth and endogenous prostaglandin system in
      spontaneously hypertensive rats.
AB  - Vascular smooth muscle cells (VSMC) from spontaneously hypertensive rats (SHR)
      exhibit rapid cell growth. In this study, to reveal the mechanisms of the quick
      VSMC growth, we analyzed the alterations in the respective periods of the
      proliferating cell cycle, and investigated the role of the endogenous
      prostaglandin system in this rapid cell growth. The VSMC from SHR showed
      increased [3H]thymidine uptake and shortened doubling time, compared with Wistar
      Kyoto rats (WKY). These properties were mainly due to both shortened transition
      time from G0/G1 to S and shortened G2 duration. There was a difference neither in
      the DNA-replication rate nor in the mitotic period. Generating capacity for
      vasodepressor prostaglandins was significantly reduced in the VSMC from SHR,
      particularly in the G0/G1 period. When the endogenous prostaglandin synthesis was
      inhibited by 10(-5) mol/L indomethacin, the transition from G0/G1 to S was
      shortened. This alteration was eliminated by supplementation with OP41483, a
      stable prostacyclin analog. In contrast, the alteration in the G2 duration was
      unaffected by indomethacin. These data indicate that the rapid VSMC growth in SHR
      is mainly due to the shortening of both the G0/G1 and G2 period, and that the
      impaired prostaglandin system is responsible, at least in part, for the shortened
      G0/G1 duration.

PMID- 1747215
TI  - Influence of sex and body weight on forearm hemodynamics in patients with
      sustained essential hypertension.
AB  - Forearm hemodynamics using pulsed Doppler flowmeter measurements were studied in
      60 hemodynamics men (30 nonobese and 30 obese) and in 45 hypertensive women (15
      nonobese and 30 obese subjects). Age and blood pressure of nonobese and obese
      patients were identical in men as well as in women. Blood flow, expressed in
      milliliters/minute or corrected for body surface area, was significantly higher
      in obese hypertensive patients. When blood flow was expressed per unit liter of
      forearm volume, the difference was no longer present. The increased blood flow in
      milliliters/minute in obese hypertensive patients was due to an increased blood
      velocity, while arterial diameter was similar in nonobese and obese hypertensive
      patients. Forearm vascular resistance, expressed either in absolute values or in
      normalized values was significantly higher in nonobese than in obese hypertensive
      patients. When men and women with similar body weight and mean arterial pressure
      were compared, women were characterized by lower values of arterial diameter,
      body surface area and forearm volume, whereas vascular resistance in absolute
      value or corrected for body surface area was higher. This increase was no longer
      present when vascular resistance was normalized for forearm volume. This study
      provides evidence that body composition and body mass index evolve as
      determinants of arterial blood velocity whereas the gender of the patient seems
      to influence the arterial diameter.

PMID- 1747216
TI  - Angiotensin converting enzyme inhibitors as initial monotherapy in severe
      hypertension. Quinapril and captopril.
AB  - This 6-week, double-blind, parallel-group study compared the efficacy and safety
      of the angiotensin converting enzyme (ACE) inhibitors quinapril and captopril as
      initial monotherapies in patients with severe hypertension (diastolic blood
      pressure [DBP] greater than or equal to 115 and less than or equal to 130 mm Hg).
      A total of 97 patients, aged between 18 and 70 years, were randomized to 5 mg
      oral quinapril twice daily or 25 mg captopril twice daily with maximum titration
      to 20 mg quinapril twice daily or 100 mg captopril twice daily. With the morning
      dose 25 mg hydrochlorothiazide (HCTZ) could be added at week 4 of the double
      blind phase or earlier if required for safety considerations. For the monotherapy
      phase, mean reductions in DBP of 12.1 mm Hg were achieved with both treatments.
      Clinical response rates (reduction in DBP greater than or equal to 10 mm Hg) were
      58% for quinapril and 44% for captopril. At the end of therapy, with optional
      HCTZ, mean reductions in DBP were 19.0 mm Hg for the quinapril-treated group and
      16.2 mm Hg for the captopril-treated group. None of the differences achieved
      statistical significance. Headache was the most frequently reported adverse event
      in both treatment groups with 8 reports each. No clinically significant changes
      in laboratory data were observed in any parameter for either treatment group.
      Quinapril and captopril provide comparable efficacy and safety in treatment of
      severe hypertension when used as initial monotherapy and with the addition of
      optional HCTZ.

PMID- 1747217
TI  - Calcium treatment of essential hypertension in elderly patients evaluated by 24 H
      monitoring.
AB  - We used 24-h monitoring of blood pressure (BP) to evaluate the effect of calcium
      supplementation on mild to moderate essential hypertension in elderly
      hospitalized patients for the first time in a controlled crossover study. The
      mean systolic and diastolic BP over a period of 24 h declined by 13.6 mm Hg (P
      less than .005) and 5.0 mm Hg (P less than .05) respectively in patients whose
      diet was supplemented with 1 g of elemental calcium in the form of oystershell
      electrolysate (AA calcium). Serum ionized calcium and urinary calcium and sodium
      excretion increased (serum Ca2+ 0.16 +/- 0.03 mEq/L, P less than .05; FECa 0.5 +/
      0.2%, P less than .05; FENa 0.4 +/- 0.1%, P less than .05) and plasma
      parathyroid hormone was suppressed (12.2 +/- 2.3 pg/mL, P less than .005). These
      data suggest that supplementation of dietary calcium may contribute to a
      reduction of BP in elderly patients with essential hypertension.

PMID- 1747218
TI  - Altered expression of inhibitory guanine nucleotide regulatory proteins (Gi
      alpha) in spontaneously hypertensive rats.
AB  - We have recently shown that the stimulatory effects of guanine nucleotides and
      some agonists on adenylate cyclase activity were diminished in aorta and heart
      sarcolemma (SL) of spontaneously hypertensive rats (SHR). In the present studies
      we have examined the activity of GTP-binding proteins (G-proteins) at ADP
      ribosylation level, by using pertussis toxin (PT) and cholera toxin (CT) at
      protein level, by using specific antibodies against Gi (inhibitory) and at mRNA
      level, by using cDNA probes encoding G-proteins. The labeling of Gi by PT was
      significantly increased in the aorta and heart SL from SHR as compared to their
      Wistar-Kyoto control rats (WKY). However, no change in the labeling of Gs
      (stimulatory) by CT was observed in SHR. Furthermore, immunoblotting experiments
      using AS/7 antibody which reacts with both Gi alpha-1 and showed an increased
      immunoprecipitation of Gi alpha-2 in heart SL from SHR. In addition, when the
      expression of G-proteins was probed at the mRNA levels by Northern blot analysis
      using cDNA probes, the mRNA levels of Gi2 alpha and Gi3 alpha were significantly
      enhanced in aorta and heart from SHR. However, the mRNA levels of Gs alpha were
      not altered in SHR. These results indicate that the gene of Gi and not of Gs is
      overexpressed in heart and aorta from SHR.

PMID- 1747219
TI  - White coat phenomenon in patients receiving antihypertensive therapy.
AB  - The occurrence of the white coat phenomenon in hypertensive patients receiving
      drug therapy was determined in a consecutive series of 71 patients undergoing
      ambulatory blood pressure (ABP) recordings because of suspected differences
      between office and ambulatory values. Overall mean (+/- SEM) office blood
      pressure (BP) was 166 +/- 2/95 +/- 1 v awake ABP 139 +/- 2/86 +/- 1 mm Hg. The
      white coat phenomenon [(office BP - ABP) greater than or equal to 20/10 mm Hg]
      was present in 52 of 71 patients: office BP 170 +/- 3/96 +/- 2 v ABP 135 +/- 2/83
      +/- 1 mm Hg. A marked white coat effect [(office BP - ABP) greater than or equal
      to 40/20 mm Hg] was seen in 22 patients with office BP being 178 +/- 4/98 +/- 3 v
      ABP 131 +/- 3/79 +/- 2 mm Hg. The frequent occurrence of white coat phenomenon in
      these patients suggests that office BP readings may not always represent usual
      ABP in patients receiving chronic antihypertensive therapy.

PMID- 1747220
TI  - Verapamil and nifedipine in combination for the treatment of hypertrophy heart
      disease.

PMID- 1747221
TI  - Associated effect of hepatic hydroxymethylglutaryl coenzyme A reductase +
      angiotensin converting enzyme inhibitors on the progression of renal failure in
      hypertensive subjects.

PMID- 1747222
TI  - Proceedings of the 38th scientific session, Japanese College of Cardiology.
      Hiroshima, October 4-6, 1990. Abstracts.

PMID- 1747223
TI  - A recent advance in auricular reconstruction.

PMID- 1747224
TI  - Long-term survival after surgical resection for recurrent nasopharyngeal cancer
      after radiotherapy failure.
AB  - Results are reported of transpalatal, transcervical, and transmaxillary resection
      in 15 patients with recurrent nasopharyngeal cancer after failure of primary
      radiotherapy. Seven patients treated for cure have been followed up for more than
      3 years (mean, 55 months; range, 40 to 82 months), with three (43%) remaining
      free of disease. Two patients are living with local disease (59 and 40 months
      postoperatively), while two have died of their local and regional recurrence (40
      and 17 months postoperatively). Two additional patients underwent
      nasopharyngectomy for palliation. One of these patients died of uncontrolled
      disease 12 months postoperatively; the other remains alive with disease 70 months
      after resection. Six patients have been followed up for less than 3 years (mean,
      22.3 months; range, 16 to 32 months). Of this group, one (17%) is without
      evidence of disease, four are living with local disease (13, 16, 17, and 27
      months postoperatively), and one has died of disease (13 months postoperatively).
      Recurrence (10 of 13 patients) has occurred an average of 8 months after surgery
      (range, 4 to 17 months). Complications include transient marginal mandibular
      nerve weakness (one), permanent cranial nerve paralysis (two), nasopharyngitis
      and/or osteomyelitis of the cervical vertebrae or base of skull requiring
      intravenous antibiotics (two), aspiration pneumonia (two), prolonged nasogastric
      tube feeding (two), and intraoperative thyroid storm (one). No cerbrospinal fluid
      leaks or perioperative deaths occurred. The long-term cure rate and disease-free
      interval of transpalatal nasopharyngectomy lead us to believe that this technique
      is probably only slightly better than reirradiation in the appropriately selected
      patient.

PMID- 1747225
TI  - Parathyroid exploration. A review of 125 cases.
AB  - Cervical exploration was performed in 106 patients with primary
      hyperparathyroidism and in 19 patients with chronic renal failure. Initial
      exploration for primary hyperparathyroidism was successful in 97% of the cases.
      Single adenomas were found in 84, double adenomas in six, and multiple-gland
      hyperplasia in 12 patients. Two of the four patients in whom cervical exploration
      failed were ultimately given the diagnosis of benign familial hypocalciuric
      hypercalcemia. Thirteen adenomas were ectopic. Preoperative thallium-technetium
      scans and ultrasound correctly localized only 63% of the adenomas. Only 45% of
      the ectopic adenomas were correctly localized. All four glands should be examined
      at initial exploration. Because of the occurrence of double adenomas,
      contralateral exploration is always indicated regardless of whether an enlarged
      gland and a normal one are found on the first side. All enlarged parathyroids
      should be removed when dealing with single or multiple adenomas; subtotal
      parathyroidectomy (3 1/2 glands) should be performed in multiple-gland
      hyperplasia. Frozen section confirmation of excised parathyroid tissue is
      essential. If exploration is unsuccessful, ectopic locations such as the
      retroesophageal areas, thymus, anterior and posterior mediastinum, carotid
      sheath, and thyroid lobe must be searched carefully. Preoperative localization
      studies are not as reliable as an experience parathyroid surgeon.

PMID- 1747226
TI  - The combined latissimus dorsi-scapular free flap in head and neck reconstruction.
AB  - Microvascular free tissue transfer techniques offer great versatility in the
      selection of tissue for reconstruction of head and neck defects. The system of
      flaps based on the subscapular artery and vein provides the widest array of
      composite free flaps. The possible flaps that can be harvested based on this
      single vascular pedicle include the scapular and parascapular skin flaps, the
      serratus anterior and latissimus dorsi muscle flaps, and the lateral scapular
      bone flap. In addition, a segment of vascularized rib can be transferred with the
      serratus anterior and latissimus dorsi muscles. Large cutaneous defects can be
      resurfaced by combining the latissimus dorsi and scapular flaps. Another
      advantage of this combined flap is the independent vascular pedicles of its
      components, which allow freedom in orientation of the various tissue segments.
      Thus, the combined flap can be helpful in reconstructing complex three
      dimensional composite defects of the head and neck. In addition, by reinnervating
      the muscle portions of this flap, bulk can be preserved and an improved
      functional reconstruction of the oral cavity achieved. A review of the literature
      shows three previous reports utilizing this combination of flaps in five
      patients. We report the use of the combined latissimus dorsi-scapular free flap
      in six patients to reconstruct massive composite defects of the oral cavity,
      midface, and scalp. There was one flap failure, which was successfully
      reconstructed with the contralateral latissimus dorsi-scapular flap. The anatomy
      of this flap is reviewed, and the indications for its application are discussed.

PMID- 1747227
TI  - Prognostic variables in parotid gland cancer.
AB  - We performed a retrospective review of 178 previously untreated patients with
      primary malignant neoplasms of the parotid gland treated at our institution
      between 1960 and 1985. Patients were followed up for a median of 7.5 years. Fifty
      nine percent underwent surgery alone, and 40% underwent surgery and radiation
      therapy. Univariate and multivariate analyses established the prognostic
      influence of cancer stage, cancer grade, histologic type, presence of lymphatic
      invasion, perineural invasion, tumor size, extension beyond the parotid gland
      fascia, cervical adenopathy, quality of margins, and patient age and gender.
      Survival was influenced most by tumor grade, tumor size, presence of positive
      cervical lymph nodes, and facial nerve invasion. The risk of local-regional
      recurrence was most affected by cervical adenopathy and tumor size. Distant
      metastases were predicted by tumor grade and size. At last contact, 39% of
      patients were alive and free of disease, while 26% had died of the disease. We
      analyzed the optimal surgical procedure and the rationale for the selection of
      combined treatment.

PMID- 1747228
TI  - Elevated levels of soluble interleukin 2 receptor and tumor necrosis factor in
      nasopharyngeal carcinoma.
AB  - Depressed cell-mediated immunity as a measure of the mitogenic response of
      mononuclear cells in patients with nasopharyngeal carcinoma is well documented,
      but the mechanism is still unclear. The enzyme-linked immunosorbent assay was
      used to measure soluble interleukin 2 receptor and tumor necrosis factor levels
      in 295 patients with nasopharyngeal carcinoma and 97 age-matched control
      subjects. Soluble interleukin 2 receptor levels in patients with nasopharyngeal
      carcinoma were elevated and correlated with clinical staging. Higher soluble
      interleukin 2 receptor levels were found in patients with bone metastasis but not
      in patients with intracranial involvement. The levels of tumor necrosis factor in
      nasopharyngeal carcinoma were higher than in control subjects but did not
      correlate with clinical staging. These data suggest that soluble interleukin 2
      receptor levels might be more useful than soluble tumor necrosis factor levels
      that indicate tumor bulk. Soluble interleukin 2 receptor serves as a blocking
      factor that competes with interleukin 2 function, resulting in a decreased
      mitogenic response in patients with nasopharyngeal carcinoma. The usefulness of
      the levels of soluble interleukin 2 receptor to monitor the efficacy of treatment
      in patients with nasopharyngeal carcinoma with bone metastasis requires further
      study.

PMID- 1747229
TI  - Sutureless vascular anastomosis with biocompatible heat-shrink tubing.
AB  - We have tested a new method of vascular repair using biocompatible, low
      temperature, heat-shrinkable tubing on canine carotid arteries. All of 16 canine
      carotid arteries were patent immediately after the anastomosis. None of the
      anastomoses leaked after the clamps were released. Average time from severing the
      vessel to releasing the clamps was 12 minutes. At 2 weeks, nine of 12 vessels
      were patent; the three failures were attributed to infection of a seroma that
      occurred in all of the dogs' necks. Histologic evaluation of the uninfected cases
      showed no inflammatory exudate around the prosthesis. Macroscopic and electron
      microscopic examination confirmed healing of the endothelium across the
      anastomoses. Sutureless vascular anastomosis with biocompatible heat-shrink
      tubing is a potential new modality for the acute repair of severed vessels.

PMID- 1747230
TI  - The effect of postoperative radiation therapy on pharyngoesophageal
      reconstruction with free jejunal interposition.
AB  - Free tissue transfer of a jejunal segment was undertaken for
      laryngopharyngoesophageal reconstruction in 20 patients who received
      postoperative irradiation therapy. Treatment consisted of 1.8- to 2-Gy-fractions,
      the average total dose was 55.57 Gy (range, 40 to 66 Gy). Anastomotic strictures
      (six) were encountered early in the series and associated with stapled
      anastomoses. Hand-sewing the jejunoesophagostomy eliminated the problem. Enteric
      cutaneous fistula, bowel necrosis, and hemorrhagic enteritis were not observed.
      We conclude that the application of postoperative irradiation therapy to patients
      requiring jejunal interposition grafts is feasible.

PMID- 1747231
TI  - The effect of hyperbaric oxygen on growth of human squamous cell carcinoma
      xenografts.
AB  - Hyperbaric oxygen is an important adjunct to the treatment of patients with head
      and neck cancer with existing or recurrent wound healing problems. Anecdotal
      clinical observations and a recent study of chemically induced oral cancer in
      hamsters have raised concern that hyperbaric oxygen therapy may accelerate tumor
      growth in such patients. This study evaluated the effect of hyperbaric oxygen
      therapy on the growth of human squamous cell carcinoma xenografts in a proved
      animal model. Fresh tumor specimens from three patients with head and neck
      squamous cell carcinoma of varying degrees of differentiation were first
      subcutaneously transplanted into a nude mouse host. Growing xenografts were then
      transplanted into one of three mouse groups. Half of the mice in each group were
      given hyperbaric oxygen therapy. The transplant volume as an index of tumor
      growth was measured in controls and mice given hyperbaric oxygen therapy six
      times during the 3-week course. Xenograft growth was almost linear in all mice.
      No statistical difference in overall group mean growth rates was observed in mice
      given hyperbaric oxygen or control mice regardless of the degree of tumor
      differentiation. Xenograft tissue from all mice was microscopically examined for
      tumor mitotic indices and degree of differentiation. This study suggests that
      hyperbaric oxygen therapy has no effect on established tumor xenograft growth.

PMID- 1747232
TI  - Long-term problems in patients with tracheoesophageal puncture.
AB  - Two hundred forty-seven patients, followed up a mean of 18 months and up to 108
      months, were retrospectively studied for problems related to or affecting
      tracheoesophageal puncture for voice restoration. Active cases, as well as those
      inactive and decreased, were included. There were 154 patients with primary and
      93 with secondary tracheoesophageal puncture. Problems were encountered at least
      once in 137 cases (55%). The 20 types of problems identified occurred in
      frequencies ranging from 0.4% to 21%. Most difficulties developed within the
      first 6 months and in general were easily managed. However, problems such as
      recalcitrant leakage, difficulty with changing the prosthesis, and dislodgment of
      the prosthesis led to permanent tracheoesophageal puncture tract closure in 18
      patients (7%).

PMID- 1747233
TI  - Intrathecal narcotics for relief of pain from head and neck cancer.
AB  - We describe our experience with nine patients with head and neck pain of
      malignant origin who were treated with continuous low-dose intrathecal morphine
      via a lumbar catheter and implantable subcutaneous drug delivery pump. All
      patients had failed prior attempts at oral narcotic pain control due to either
      poor pain control or intolerable side effects. Using a visual analogue scale
      where the most severe pain is rated as 10 and no pain is rated as 0, the mean
      visual analogue scale was reduced from 7.6/10 (range, 5 to 10/10) before
      implantation to 1.9/10, 2.0/10, and 0.5/10 at 1 week, 1 month, and 2 months after
      implantation, respectively. Complications were acceptable. We conclude that
      intrathecal administration of morphine is a safe and effective means of pain
      control. This method deserves serious consideration in patients with intractable
      pain secondary to head and neck malignancy.

PMID- 1747234
TI  - Intracellular calcium changes associated with in vitro lymphokine-activated
      killer and natural killer cell cytotoxicity.
AB  - Interleukin 2-activated peripheral blood lymphocytes (lymphokine-activated killer
      [LAK] cells) have been shown to lyse tumor cells in a nonspecific fashion.
      Although the mechanisms involved in this cell-mediated lysis are unknown,
      previous work has shown that T-lymphocyte-mediated cytolysis is associated with
      massive fluctuations in the intracellular calcium concentration within target
      cells. Studies were undertaken to determine whether intracellular calcium
      concentration changes were associated with LAK-mediated cytotoxicity and to
      determine the effects of calcium channel blockade on in vitro cell-mediated
      cytotoxicity. Natural killer (NK) and LAK cell cytotoxicity in vitro were
      measured against head and neck squamous cell carcinoma (UMSCC-11a and UMSCC-38)
      and Daudi cell lines. Assays were performed in parallel with flow cytometry to
      measure changes in intracellular calcium concentration within the target cells.
      Compared with NK cells, LAK cells showed enhanced cytotoxicity against the UMSCC
      11a and Daudi lines but not the UMSCC-38 cell line. Both NK and LAK cell
      cytotoxicity against all the target cell lines directly paralleled significant
      increases in calcium concentration in the target cells. The addition of verapamil
      hydrochloride inhibited the rise in intracellular calcium concentration in the
      sensitive target cells and significantly inhibited both NK and LAK cell
      cytotoxicity in all the cell lines. The NK cell activity was more sensitive than
      LAK cell activity to verapamil inhibition. These data suggest that changes in the
      target cell calcium concentration are early and important events in both NK and
      LAK cell cytotoxicity in vitro.

PMID- 1747235
TI  - Detection of squamous cell carcinoma xenografts in nude mice by radiolabeled
      monoclonal antibody E48.
AB  - We recently produced the monoclonal antibody E48 as a specific reagent for
      squamous cell carcinomas. In our ongoing investigations to use E48 for clinical
      tumor detection and therapy, fundamental aspects of the antigen have to be
      elucidated and practical applications of the antibody have to be tested in a
      preclinical model. Immunoelectron-microscopic studies localized the E48 antigen
      along the cell surface and in between desmosomes, suggesting that the antigen
      serves as an adhesion molecule. To evaluate the usefulness of E48 for
      radioimmunodetection of neck node metastases, nodes from 20 neck dissection
      specimens were tested. A strong reactivity was observed. Furthermore, F(ab')2
      fragments of E48 were compared with the complete IgG E48 for selective tumor
      detection in an animal model. It was demonstrated that E48 F(ab')2 fragments
      localize faster and reach higher tumor-nontumor ratios than the whole molecule.

PMID- 1747236
TI  - Effect on cochlear potentials of lateral semicircular canal destruction.
AB  - Recording of the cochlear potentials was successfully performed during
      experimental labyrinthectomy in the guinea pig and in three patients with
      acoustic neuromas during translabyrinthine removal of the tumors. In the guinea
      pig, complete interruption of the duct of the lateral semicircular canal
      including the endolymphatic canal caused little change in the endocochlear DC
      potential of the first cochlear turn and input-output function curve of the N1
      component of the compound action potential elicited by 8-kHz tone bursts. Further
      drilling of the vestibular labyrinth in the guinea pig caused decline of these
      potentials when the vestibular was opened. In patients with acoustic neuromas,
      the interruption of the duct of the lateral semicircular canal hardly altered the
      N1 input-output function curve and N1 input-latency function curve during the 1
      hour observation period. Consistent preservation of cochlear function even after
      interruption of lateral semicircular canals suggests the possibility of partial
      surgical labryrinthectomy with preservation of hearing for lesions involving
      semicircular canals.

PMID- 1747237
TI  - HLA frequency in patients with recurrent acute otitis media.
AB  - Clinical data suggest the involvement of hereditary factors in children
      susceptible to recurrent acute otitis media. That relationships of varying degree
      exist between the frequencies of certain HLA antigens and various disease
      entities is well established. In the present study, we investigated the
      frequencies of a number of HLA antigens in 45 patients with clinical recurrent
      acute otitis media and compared these frequencies with those in a control group
      from the same district. The HLA-A2 antigen occurred in 80% (36/45) of the group
      with recurrent acute otitis media, as compared with 56% of controls. Of a
      subgroup of 11 children with recurrent acute otitis media who were prospectively
      followed up, 10 (91%) were HLA-A2 positive. The HLA-A3 antigen occurred in only
      11% (5/45) of the group with recurrent acute otitis media as a whole (n = 45) in
      comparison with 28% of controls. Among 22 prospectively followed up children
      without any episode of acute otitis media during the first 3 years of life, the
      frequency of HLA-A2 was 45% (10/22) and that of HLA-A3, 32% (7/22). The results
      indicate the existence of a relationship between recurrent acute otitis media and
      the HLA-A locus, suggesting the involvement of genetic factors in the disease.

PMID- 1747238
TI  - Protracted Lhermitte's sign following head and neck irradiation.
AB  - Lhermitte's sign is a rare complication of head and neck irradiation involving
      the delivery of dose to the cervical spinal cord. Although uncommon, symptoms of
      lightning-like electric sensations spreading into both arms, down the dorsal
      spine, and into both legs on neck flexion following head and neck irradiation,
      causes great concern in both the patient and the physician. This spontaneously
      reversible phenomenon is important for the otolaryngologist and radiation
      oncologist to recognize and discuss. A particularly severe and protracted case of
      Lhermitte's sign involving a patient recently completing a radical course of
      radiation for nasopharyngeal carcinoma is described in detail, including a review
      of the literature surrounding the cause and management of this condition.

PMID- 1747239
TI  - Anterior ischemic optic neuropathy causing blindness in the head and neck surgery
      patient.
AB  - Anterior ischemic optic neuropathy is an uncommon and devastating event that can
      result in unilateral or bilateral blindness. It has been reported as a
      complication of ophthalmologic or general surgical and cardiothoracic procedures
      as well as a spontaneous event in severe systemic disease. Aggravating
      intraoperative factors include anemia, hemorrhage, hypotension, preexisting small
      vessel disease, and increased intraocular pressure. We present a case of anterior
      ischemic optic neuropathy as a complication in a 48-year-old man undergoing
      extensive resection of recurrent carcinoma of the head and neck. Possible
      contributing risk factors in our patient include preexisting hypertension,
      intraoperative blood loss, previous radical neck dissection with venous
      compromise, intraoperative head and neck edema, and the use of tightly adherent
      plastic bubble-type intraoperative eye protection. The possible pathogenesis of
      this devastating complication and recommendations for prevention and management
      of anterior ischemic optic neuropathy are described.

PMID- 1747240
TI  - Corticosteroid treatment of otitis media with effusion.

PMID- 1747241
TI  - Treatment of facial paralysis.

PMID- 1747242
TI  - A physical study of vibrating membranes in developing a middle ear prosthesis.
AB  - We present a prosthesis meant to replace the tympano-ossicular set as well as the
      measuring apparatus for developing and characterizing this prosthesis. Such
      biocompatible materials as silicone elastomer and Teflon are used. Effects due to
      aging and sterilization have been negligible. Comparisons with anatomic specimens
      have yielded good results. Furthermore, the first clinical trials with this
      prosthesis have been promising.

PMID- 1747243
TI  - Laryngeal configuration of 99 dysphonic patients.
AB  - The aim of this investigation was to study a wide range of dysphonic patients and
      determine the best matches among the laryngeal configurations on phonation for
      each patient and those previously established for control data, which were
      obtained from a professional voice user producing the whole range of voice
      qualities. Ninety-nine patients were selected and laryngeal photographs were
      produced for each patient. Fifteen laryngeal parameters were quantified and
      normalized. The data were sorted, scalar values assigned and a measure of
      similarity between configurations applied. The best, second-best, third-best and
      worst matches between each patient separately and the control data were then
      examined. Although 41% of the patients did not have particularly unusual
      configurations, 59% exhibited a narrowing of the laryngeal vestibule caused by
      epiglottic retraction, cuneiform fronting and/or false fold adduction. This
      suggests that clinical reports for patients with dysphonia should contain
      information not only on any lesions present but also on laryngeal configurations
      and, in particular, vestibular narrowing.

PMID- 1747244
TI  - Antidiuretic-hormone-induced morphological changes in the ampullary epithelium of
      the frog semicircular canal.
AB  - Morphological changes induced by in vitro treatment with arginine-vasotocin, the
      frog antidiuretic hormone, were studied in the ampullary epithelium of the frog
      semicircular canal. Morphological changes appeared only in the apical side of the
      dark cells, while the basal part of these cells and the other cells lining the
      semicircular canal did not show any change. Changes consisted of the appearance
      of numerous small vesicles in the apical cytoplasm and the development of
      microvilli on the apical plasma membrane of the dark cells. These results suggest
      that arginine-vasotocin could play a role in the regulation of endolymph section.

PMID- 1747245
TI  - Normal wound healing of the paranasal sinuses: clinical and experimental
      investigations.
AB  - Twenty-two patients underwent partial or complete ethmoidectomies and were
      subjected to standardized postoperative follow-ups including endoscopic
      photography of healing tissues. Sequential biopsies were also taken from the
      regenerating mucosa and compared with endoscopic findings. On this basis wound
      healing could be divided into four different phases, allowing for the diagnosis
      of healing disturbances and clinical planning of stage-dependent therapy.
      Additionally, a model of wound healing in the maxillary antrum of the rabbit was
      developed for better understanding the clinical observations. Regeneration of
      standardized mucosal defects was studied with three-dimensional
      histomorphological analysis. Circular wounds were found to regenerate
      concentrically, with wound closure starting by epithelial migration. Within 120
      h, granulation tissue covering the wound surface started to become hyperplastic
      and bone apposition occurred with the formation of osteoid. The systemic
      application of prednisolone (2 mg/kg per day i.m.) and topical 5% dexpanthenol
      ointment resulted in an acceleration of late epithelial wound closure together
      with a reduction in hyperplastic granulation tissue. Local applications of
      "epidermal growth factor" had no significant effect.

PMID- 1747246
TI  - The reaction of the guinea pig cochlea to perforations of the round window
      membrane with and without perilymph aspiration.
AB  - The influence of simple opening of the round window (RW) membrane and the effect
      of aspiration of perilymph on the electrophysiological characteristics of the
      cochlea was tested in guinea pigs by measurement of the compound action
      potentials. We found that perforations of the RW membrane failed to lead to
      either short-term or long-term damage in cochlear function. There was only a
      slight spontaneous escape of perilymph but without measurable functional loss.
      Additional aspiration of perilymph led to entry of air into the basal turn and to
      an immediate loss of function of the cochlea. This regressed within 4 weeks in
      the middle- and low-frequency ranges. Measurable long-term damage persisted only
      in the high-frequency ranges. We attribute contradictory results of other authors
      to methodological errors which we avoided by a specific selection of healthy
      animals and the development of standardized operation, recording and measurement
      procedures.

PMID- 1747247
TI  - The surgical treatment of atelectatic ears and retraction pockets in children and
      adults.
AB  - Eighty-four ears which underwent tympanoplasty because of an atelectasis of the
      tympanic membrane were followed up. Thirty-six involved children (4-13 years
      old). On the average, 50-55 months of postoperative follow-up showed that
      atelectasis, once operated, shared the same pattern and prognosis in the children
      as in the adults.

PMID- 1747248
TI  - The value of fentanyl/diazepam anesthesia for experimental operations and
      recordings of compound action potentials in the guinea pig cochlea.
AB  - Fentanyl/diazepam anesthesia is an appropriate combination for surgical
      operations on the guinea pig, since it ensures definitive anesthesia and
      analgesia without respiratory depression. Comparative investigations with
      pentobarbital and urethane were carried out to check their applicability for
      electrocochleographic recordings. We found that fentanyl/diazepam combination
      anesthesia is more suitable for electrocochleographic investigations than
      pentobarbital. We were thereby able to prove that pentobarbital has an
      attenuating effect on electrocochleographic recordings in contrast to the
      findings reported in the available literature. For this reason, and because the
      lowest rates of animal morbidity occurred with fentanyl/diazepam, this
      combination anesthesia should be used preferentially for electrophysiological
      experiments in guinea pigs.

PMID- 1747249
TI  - A technique for quantitative cytology of nasal secretions.
AB  - To quantitatively analyze cellular elements in mucopurulent nasal secretions from
      patients with chronic paranasal sinusitis, we studied five mucus-liquefying
      agents--dithiothreitol (DTT), ethylenediaminetetraacetic acid tetrasodium salt,
      propylene glycol, serratio peptidase and urea--with Hanks' balanced salt solution
      used as a control. Agents were compared for the number of cells, the mucus
      liquefying effect and the staining characteristic of cells in cytocentrifuge
      prepared smears. The results indicated that the treatment of nasal secretions
      with 10 mM DTT provides more clear and detailed cytological preparations for
      quantitative cytology of nasal secretions.

PMID- 1747250
TI  - Short- and long-term effects of transection of the ophthalmic nerve on
      optokinetic nystagmus in the rabbit.
AB  - The role of extraocular proprioception in optokinetic nystagmus (OKN) was
      examined, using adult pigmented rabbits following transection of the ophthalmic
      branch of the trigeminal nerve. OKN was induced by rotation of a drum at an
      angular velocity of 0.85 and 3.7 degrees/s. The eye on the operated side showed a
      delay in the transition from the OKN-induced quick phase to the slow phase
      regardless of closure of the eye on either the operated or unoperated side. In
      addition, the eye on the operated side showed an anticompensatory response in the
      vestibulo-ocular reflex (VOR) with an unstable drift in the dark. The above
      abnormalities in OKN and VOR following rhizotomy disappeared after 1-1.5 months.
      These results suggest that proprioception in the extraocular muscle plays an
      important role in the fine regulations of eye position for gaze accuracy. The
      recovery demonstrated appears to be due to a compensatory mechanism in the
      central nervous system.

PMID- 1747251
TI  - Measurements of perilymphatic oxygen tension in guinea pigs exposed to loud
      sound.
AB  - Using different types of custom-made oxygen-sensitive microelectrodes, the
      perilymphatic oxygen partial pressure (PO2) was determined in anesthetized guinea
      pigs. Cochlear temperature, heart rate, and arterial blood pressure and acid-base
      status were monitored. The PO2 in the basal scala tympani perilymph (200 microns
      below the round window membrane) was found to be 53 +/- 17 mmHg (mean +/- SD) in
      33 normal animals. In 11 guinea pigs exposed to loud sound for 15 min (10 kHz
      pure tone, 125 dB SPL) there was on average a continuous decline in the
      perilymphatic PO2, which was significant only 30 min post-exposure. A
      considerable variation in response was found in individual animals. Mean arterial
      blood pressures showed a slightly increasing time course, while heart rates did
      not change significantly during the whole period of the experiment. Arterial acid
      base status and PO2 values remained within normal limits and did not change
      significantly. Cochlear microphonics and compound action potentials were
      substantially decreased after acoustic overstimulation. The results are discussed
      with due consideration of sources of error.

PMID- 1747252
TI  - Auditory-evoked brain-stem responses and auditory disorders in patients with
      Bell's palsy.
AB  - Out of 121 patients examined with acute unilateral facial paralysis, 93 were
      determined to have idiopathic facial palsy (Bell's palsy). The examination
      included pure-tone and speech audiometry, stapedial reflex recordings, temporal
      bone radiography and auditory-evoked brain-stem response testing (ABR). If a
      retrocochlear lesion was suspected, computed tomography or magnetic resonance
      imaging was performed. Patients with sensorineural hearing loss affecting all
      frequencies were compared to one group with hearing loss affecting only high
      frequencies and to another group with ABR findings suggesting a cochlear lesion.
      No association could be made between the etiology of these pathological results
      and the concurrent facial paresis. Most of them were probably caused by unrelated
      disorders of the auditory system. In cases with prolonged inter-peak latencies
      representing brain-stem responses, abnormal ABRs could be caused by the same
      pathology as the paralysis. This might well suggest the presence of a neuropathy
      in both the central auditory system and the facial tracts.

PMID- 1747253
TI  - The Hannover auditory brainstem implant: a multiple-electrode prosthesis.

PMID- 1747254
TI  - Cavernous sinus thrombosis following odontogenic and cervicofacial infection.
AB  - Cavernous sinus thrombosis (CST) is rarely seen clinically as a complication of
      infectious processes since the discovery of penicillin. At the present time,
      dental abscess is an uncommon cause of CST. We now report our experiences with a
      60-year-old diabetic male, who developed CST 38 days after extraction of an
      infected upper third molar tooth. The importance of eradicating regional
      cervicofacial foci of infection is stressed.

PMID- 1747255
TI  - [Therapy of congestive cardiac insufficiency. A challenge].

PMID- 1747256
TI  - [Transcutaneous pacemaker in cardiovascular emergencies].
AB  - OBJECTIVES AND DESIGN OF THE STUDY: Retrospective study to evaluate the efficacy
      and tolerance of the transcutaneous cardiac pacemaker in the urgent treatment of
      asystole or severe bradycardia. SETTING: Coronary Care Unit (CCU) and emergency
      area of the central reference Hospital. PATIENTS: 24 patients, 20 males and four
      females, aged between 57 and 84 years (mean 70.4 +/- 7.9). Five pts were in
      asystole and 19 in severe bradycardia. INTERVENTIONS: The transcutaneous
      pacemaker used, was the "Cardio Aid Zoll NTP" model. The intensity of the
      electrical stimulation was increased progressively, until electrical capture or
      intolerable discomfort by the patients was achieved. We defined by electric
      efficacy, the visualization of pacing spike followed by a deflection due to
      ventricular depolarization; and by hemodynamic efficacy, the evidence of
      myocardial contraction, defined as a palpable pulse, synchronous with the pacing
      artefact. MAIN RESULTS: Stimulation threshold ranged from 30 to 140 mA (mean 67.7
      +/- 23.4). The duration of pacing was from 15 minutes to 13 hours, being more
      than one hour in only four situations. From the 20 conscious patients, or the
      ones who got conscious, 15 (75%) tolerated well the stimulation. It was
      intolerable in five pts (25%). No significative side effects due to the use of
      transcutaneous pacemaker were observed. CONCLUSIONS: The transcutaneous pacemaker
      was efficient in the electric and hemodynamic stabilization in the majority of
      patients. It was generally well tolerated and without important side effects. We
      think that it may be a valid alternative to transvenous pacing technics in the
      treatment of asystole and severe bradycardia situations.

PMID- 1747257
TI  - [Rupture of the intraventricular septum and free wall of the left ventricle
      secondary to non-penetrating thoracic injury. Doppler echocardiography
      diagnosis].
AB  - The heart is often injured in the setting of blunt chest trauma with a broad
      spectrum of cardiac lesions. We present a twenty-nine years old man with
      interventricular septal and rupture and left ventricular free wall rupture
      following chest trauma. Doppler echocardiography was essential in the diagnostic
      and therapeutic procedure. We concluded that Doppler-echocardiography must be
      performed in all patients with suspicion of cardiac affectation after blunt chest
      trauma.

PMID- 1747258
TI  - [Myocardial infarct in a young man with normal coronary vessels: apropos of a
      clinical case treated with streptokinase].
AB  - The authors report a case of a 31 year old young man who suffered acute
      myocardial infarction and was subjected to early treatment with streptokinase.
      The immediate follow-up showed a complete recanalization of the infarct-related
      vessel, without any identifiable obstructive lesion on coronary arteriography.
      Related to this angiographic finding, common in myocardial infarction in the
      young adult, the authors debate the implicated mechanisms, focusing essentially
      in the relation endothelium-platelets-vasomotricity. The issue of cigarette
      smoking as a risk factor and its possible pathogenic implication, even in the
      absence of atherosclerotic plaque, is also approached.

PMID- 1747259
TI  - [Surgical therapy of infectious endocarditis].

PMID- 1747260
TI  - [Arterial hypertension, insulin resistance, and disorders of membrane
      permeability].

PMID- 1747261
TI  - [Antithrombin III. Physiologic, physiopathologic and laboratory aspects].
AB  - Hemostatic control is based in a delicate balance between the activities of
      activator enzymes and their inhibitors, each one depending on a large number of
      proteins. Plasma Antithrombin III (ATIII) is one of the most important
      coagulation inhibitors and the fundamental enzyme for the therapeutical action of
      heparin. In the last years it was well established that ATIII deficiency accounts
      for a thrombotic state and inefficiency of heparin therapy. In this work, the
      authors review the biology of ATIII including its biochemical nature, its
      physiology, physiopathology and mechanism of action, analysing the implications
      of its deficiency. The authors draw the attention on clinical and laboratory
      studies that analyse the prevalence and importance of congenital and acquired
      deficiency of ATIII, in relation to the prevalence of venous thrombosis. Finally,
      the laboratory methods applied to the study of ATIII and to the biological
      control of heparin therapy are described with emphasis on the importance of the
      ATIII concentrates on this type of treatment. Also the fundamental aspects of
      heparin resistance are specially mentioned.

PMID- 1747262
TI  - General practice and the future of obstetric care.

PMID- 1747263
TI  - Stroke and the carer.

PMID- 1747264
TI  - Putting on the style: what patients think of the way their doctor dresses.
AB  - The aim of this study was to determine how acceptable patients found different
      styles of doctors' dress and whether patients felt that a doctor's style of dress
      influenced their respect for his or her opinion. A total of 475 patients from
      five general practices in Lothian were surveyed using photographs of different
      styles in a male and female doctor and questions about their attitudes to
      doctors' dress in general. Overall, patients seemed to favour a more formal
      approach to dress, with the male doctor wearing a formal suit and tie and the
      female doctor in a white coat scoring the most high marks. This was particularly
      true of older patients and those in social classes 1 and 2. The male doctor
      wearing a tweed jacket and informal shirt and tie scored fewer low marks and this
      was therefore the least disliked of the outfits. There was a marked variation
      between preferences of patients registered with different practices. When asked,
      28% of patients said they would be unhappy about consulting one of doctors shown,
      usually the ones who were informally dressed. However, some patients said they
      would dislike their doctor wearing a white coat. Although there are more
      important attributes for a general practitioner than the way he or she dresses, a
      majority of patients (64%) thought that the way their doctor dressed was very
      important or quite important. Given that 41% of the patients said they would have
      more confidence in the ability of one of the doctors based on their appearance it
      would seem logical for doctors to dress in a way that inspires
      confidence.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1747265
TI  - Study of the management of chlamydial cervicitis in general practice.
AB  - The role of the general practitioner in the detection and management of Chlamydia
      trachomatis infections of the cervix is uncertain. The management by the primary
      care team of women presenting with lower genital tract symptoms has therefore
      been studied in one suburban practice. Of 386 women presenting with lower genital
      tract symptoms over the two year study period 25 (6%) had a positive cervical
      MicroTrak (Syva) test for Chlamydia trachomatis. Twenty four of these chlamydia
      positive patients were given their results and treatment by the practice. Twenty
      two women returned for a follow-up MicroTrak test after treatment and two of
      these patients (9%) had a positive test following treatment. A review of the
      patients' notes indicated that contact tracing had been discussed with 22 of the
      25 chlamydia positive patients. The results of the management of chlamydial
      cervicitis by this primary health care team are acceptable when compared with
      studies from hospital clinics. Provided the primary care team has access to
      facilities for the diagnosis of C trachomatis and can follow up non-attenders to
      ensure they receive their results, provide information about contact tracing and
      follow up positive patients then chlamydial cervicitis can be managed in general
      practice.

PMID- 1747266
TI  - Survey and audit of diabetes care in general practice in south London.
AB  - A survey was made of the diabetic care given by general practitioners in six
      family practitioner committee areas. Replies were received from 388 practices,
      representing 1034 principals (effective response rate 69%), serving over two
      million patients. Fourteen per cent of practices offered mini-clinic facilities
      for their diabetic patients, although a much greater proportion professed to give
      either full or shared care to patients in ordinary surgery time. One quarter of
      practices kept a diabetes register, but fewer had a system of recall for patients
      to ensure anticipatory care. The barriers which general practitioners most often
      perceived in the provision of adequate care for diabetics were: lack of time,
      absence of a recall system and deficiency in their own clinical skills. Seventy
      seven of the doctors responding to the initial questionnaire participated in an
      audit of the level of supervision provided for 378 of their diabetic patients.
      Better levels of supervision of non-insulin dependent diabetics were shown in
      those practices where diabetes registers were kept, and where special
      arrangements were made for caring for diabetes. The levels of care provided by
      those doctors setting aside specific clinic times were not demonstrably superior
      to those who did not. The findings suggest that provision of support services,
      particularly expertise in dietetics, would help to increase general
      practitioners' confidence and enable more of them to improve their care of
      diabetic patients.

PMID- 1747267
TI  - Long-term follow up of patients with gastritis associated with Helicobacter
      pylori infection.
AB  - The aim of this study was to evaluate the long-term prognosis for patients
      suffering from gastritis associated with Helicobacter pylori infection, and in
      particular the proportion of cases progressing to peptic ulcer. The study was
      carried out in one urban general practice. One hundred and three patients who had
      presented with dyspepsia over the 1973-80 period and who were found to have a
      macroscopically normal endoscopy were reassessed between seven and 14 years
      later. Gastric antral biopsies had been taken routinely at endoscopy and were
      subsequently re-examined for the presence of H pylori. The patients' medical
      records were examined to establish their consulting rates over the follow-up
      period and whether they suffered from any other medical conditions. Patients were
      interviewed to assess the course of their dyspeptic symptoms. Comparison of
      patients who were unequivocally H pylori positive with those who were negative
      revealed no significant differences in the consultation rate for
      gastroenterological symptoms, in the proportion of patients referred to a
      hospital consultant or for further gastroenterological investigations or in the
      proportion reporting that their symptoms had improved. However, a statistically
      highly significant relationship was found between H pylori infection and
      hypertension. The results of this study have shown that there is a good prognosis
      for non-ulcer dyspepsia whether or not H pylori infection is present. The
      association between H pylori gastritis and hypertension clearly merits further
      investigation.

PMID- 1747268
TI  - Patient education about cough: effect on the consulting behaviour of general
      practice patients.
AB  - The aim of this general practice study was to examine how the consulting
      behaviour of patients with a cough was affected when the tasks and
      responsibilities of patients, practice nurses and general practitioners were
      reorganized. In four 'average' single-handed general practices the effects on the
      consulting behaviour of patients of a rational practice policy on cough and the
      provision of systematic patient education on cough were compared with patient
      behaviour in four matched control practices. Changes of behaviour were measured
      in 548 patients who consulted for cough at least twice, in two successive autumn
      winter periods. Significantly more patients in the experimental practice changed
      their behaviour to follow the practice guidelines than did patients in the
      control practices (56% versus 30%, P less than 0.001). The proportion of patients
      who continued to consult in the approved manner was greater among patients
      receiving intervention (66% versus 29%, P less than 0.001). This was equally true
      for patients who had suffered less than four episodes of cough or more than four
      episodes. The more often the patients received the education, the more effective
      it was. All patients who consulted the general practitioner for cough during the
      first autumn-winter period filled in a cough diary during the second period. From
      this it appeared that the intervention did not result in patients delaying
      consultation when they had a cough lasting longer than three weeks or one with
      'serious' symptoms. It would appear that a rational practice policy and the
      provision of patient education can stimulate patients to modify their consulting
      behaviour. This could result in a reduction in the costs of health care.

PMID- 1747269
TI  - How well do family practitioner committee and general practice records agree?
      Experience in a semi-rural practice.
AB  - General practice notes may be inaccurate for various reasons. A study was carried
      out in one semi-rural practice to investigate the agreement between records held
      by the family practitioner committee and those kept in the practice. Details on
      the practice notes and the family practitioner committee list were compared for
      800 patients. The details examined included name, sex, date of birth, address and
      National Health Service number. While 58% of records agreed, discrepancies
      occurred in 339 records (42%). The most common discrepancies concerned the
      patient's address (30.6%), date of birth (9.4%) and NHS number (8.0%). Nearly 5%
      of the practice notes appeared to be for patients who were no longer on the
      practice list or dependent on its care. These findings have implications under
      the new general practitioner contract where screening programmes, target related
      payments, and increased capitation fees require accurate practice records.

PMID- 1747270
TI  - William Pickles Lecture 1991. My brother's keeper.

PMID- 1747271
TI  - Hepatitis B transmission within families.

PMID- 1747272
TI  - Assessment of cognitive impairment in the elderly.

PMID- 1747273
TI  - Which antidepressant?

PMID- 1747274
TI  - Using skeletal muscle to assist the heart.

PMID- 1747275
TI  - Vascular tone in heart failure: the neuroendocrine-therapeutic interface.

PMID- 1747276
TI  - Relation between cyclic variation in echo amplitude and segmental contraction in
      normal and abnormal hearts.
AB  - OBJECTIVE: To study the relation between cardiac systolic activity and cardiac
      cycle dependent variation in the ultrasound signal arising from within the
      myocardium. DESIGN: Regional echo amplitude was used as a measure of the
      myocardial ultrasound signal. Relative echo amplitude values were assigned by
      standardising echo gain using the posterior parietal pericardium as an in-vivo
      calibration. M mode measurements of the left ventricle were used to assess
      cardiac systolic activity. Subjects were studied prospectively. Analysis of echo
      amplitude was performed by investigators who were blinded to the results of the M
      mode analysis. The influence of impaired left ventricular performance and
      abnormal wall motion were assessed. PATIENTS: 11 cardiomyopathy patients with
      impaired ventricular function, eight patients with severe pulmonary hypertension
      and reversed septal motion, and 19 healthy controls. SETTING: All subject studies
      were performed at Harefield Hospital. Echo amplitude analysis was performed at
      the Royal Brompton Hospital. MAIN OUTCOME MEASURES: Cyclic variation in echo
      amplitude was determined as the change in echo amplitude from end diastole to end
      systole. Additionally, an index of cyclic variation defined as the ratio of the
      cyclic change in echo amplitude to end diastolic echo amplitude was measured.
      Both cyclic variation and the cyclic variation index were analysed to see whether
      they correlated with left ventricular dimensions, fractional shortening, and
      systolic wall thickening. RESULTS: Stepwise regression analysis showed systolic
      wall thickening to be the most significant independent variable that correlated
      with the cyclic variation index for both the septum and posterior wall (r = 0.68,
      p = 0.0001, septum; r = 0.69, p = 0.0001, posterior wall). The slopes and
      intercepts for both regression equations were similar (y = 0.005x + 0.006,
      septum; y = 0.006x + 0, posterior wall). Subgroup analysis showed that the
      healthy controls, patients with cardiomyopathy, and patients with pulmonary
      hypertension had similar slopes and intercepts for their individual regression
      equations. CONCLUSIONS: These data support the hypothesis of a quantitative
      relation between the extent of cyclic variation of echo amplitude and the degree
      of segmental myocardial shortening, as measured by systolic wall thickening,
      which is not significantly influenced by location within the myocardium, left
      ventricular performance, or wall motion. They provide further evidence of the
      usefulness of quantitative analysis of myocardial echo amplitude in the study of
      regional myocardial function in both normal and injured myocardium.

PMID- 1747277
TI  - Responsiveness of raised pulmonary vascular resistance to oxygen assessed by
      pulsed Doppler echocardiography.
AB  - OBJECTIVE: To assess whether changes in Doppler echocardiographic indices in the
      pulmonary artery correlated with changes in pulmonary vascular resistance.
      DESIGN: Acceleration time, ejection time, maximal flow velocity, and velocity
      time integrals were measured at the same time as pressure and oxygen saturation
      measurements in room air and during 10 minutes of oxygen breathing in the
      catheterisation laboratory. Pulmonary vascular resistance and pulmonary blood
      flow (Qp) were calculated from catheterisation data by use of the Fick principle.
      PATIENTS: 14 consecutive patients with a congenital heart defect and a left to
      right shunt associated with raised pulmonary artery pressure who underwent
      routine diagnostic cardiac catheterisation to assess their pulmonary vascular
      resistance. RESULTS: Though pulmonary vascular resistance and systolic pulmonary
      artery pressure fell significantly during oxygen administration, there was no
      significant change in the acceleration time or ejection time. Peak velocity
      increased significantly during oxygen administration. During oxygen breathing
      Doppler derived measurements of pulmonary flow showed a significant increase in
      Qp similar to the increase in Qp measured by the Fick principle. There was no
      significant correlation between the fall in pulmonary vascular resistance and the
      increase in acceleration time or ejection time, increase in peak velocity,
      increase in pulmonary artery diameter, or increase in Doppler derived pulmonary
      blood flow. CONCLUSIONS: Measurements of acceleration and ejection time by
      Doppler echocardiography did not predict the response of pulmonary artery
      pressure and resistance to oxygen. Though changes in maximal flow velocity across
      the pulmonary artery and in Doppler derived pulmonary blood flow measurements
      became significant during oxygen breathing, the correlation of these changes with
      fall in pulmonary vascular resistance was poor.

PMID- 1747278
TI  - Transoesophageal echocardiographic assessment of fixed subaortic obstruction in
      children.
AB  - OBJECTIVE: To evaluate the clinical usefulness of transoesophageal
      echocardiography in the assessment of children with fixed left ventricular
      outflow tract stenosis. PATIENTS AND METHODS: Eight consecutive children, aged
      over 5 years, with fixed subaortic stenosis and one child with fixed subpulmonary
      left ventricular outflow tract stenosis were prospectively assessed by precordial
      and transoesophageal echocardiography. RESULTS: Transoesophageal images of the
      left ventricular outflow tract were much clearer than precordial images in all
      patients except one with a prosthetic mitral valve. Improved visualisation
      provided further information on the nature of the lesion (additional chordal
      attachment of the mitral valve in one, accessory atrioventricular valve tissue
      with aneurysm formation in one), on the extent of the lesion (circumferential in
      three), and on the very close relation of a ridge to the aortic valve leaflets in
      one. Transoesophageal Doppler did not provide any additional information on
      aortic regurgitation and was unreliable for gradient estimation across the left
      ventricular outflow tract. CONCLUSIONS: Transoesophageal imaging provides an
      excellent means of visualising lesions in the left ventricular outflow tract and
      can be useful in a few children and adolescents in whom precordial
      echocardiography does not provide adequate information. The technique can also be
      used intraoperatively to define the full extent of the obstructive lesion and to
      assess residual lesions after surgery.

PMID- 1747279
TI  - Assessment of right and left ventricular function in terms of force development
      with gestational age in the normal human fetus.
AB  - OBJECTIVE: To assess right and left ventricular systolic function in normal human
      fetuses by cross sectional Doppler echocardiography to calculate the force
      developed by myocardial shortening. DESIGN: Cross sectional echocardiographic
      images of the aorta and pulmonary arteries were obtained prospectively in order
      to measure great vessel diameters and calculate their cross sectional areas.
      Doppler velocity signals were recorded from the proximal aorta and the proximal
      pulmonary artery and digitised to obtain peak velocity, acceleration time, flow
      velocity time integral during acceleration, and the flow velocity time integral
      for the whole of ejection. Right and left ventricular force development was
      estimated by Newton's equation in which force is defined as the product of mass
      and acceleration. PATIENTS: 58 normal human fetuses at a gestational age of from
      20 to 42 weeks. RESULTS: The cross sectional area of the pulmonary artery was 20%
      greater than that of the aorta. Aortic acceleration time was longer than that in
      the pulmonary artery, and peak blood flow velocity in the aorta was consistently
      greater than that in the pulmonary artery. Right ventricular stroke volume was
      significantly greater than left ventricular stroke volume. The force developed by
      the right and left ventricles was, however, similar throughout the gestational
      period studied, increasing tenfold from 20 weeks' gestation to term (r = 0.74, p
      less than 0.0001; r = 0.75, p less than 0.0001) respectively. CONCLUSION: The
      development of right and left ventricular force in the human fetus is similar in
      spite of the greater volume handled by the right ventricle. This index of
      ventricular performance does not require calculation of ventricular volume and
      because it varies independently of ventricular geometry and heart rate it should
      prove useful in assessing cardiac function in the normal human fetus and in
      fetuses with ventricular dysfunction.

PMID- 1747280
TI  - Non-invasive measurement of the regurgitant fraction by pulsed Doppler
      echocardiography in isolated pure mitral regurgitation.
AB  - OBJECTIVE: To assess the usefulness of pulsed Doppler echocardiography as a
      method of measuring the regurgitant fraction in patients with mitral
      regurgitation. PATIENTS AND METHODS: Twenty controls and 27 patients with
      isolated mitral regurgitation underwent Doppler studies. In the patients the
      study was performed within 48 hours of cardiac catheterisation. Aortic outflow
      was measured in the centre of the aortic annulus, and mitral inflow was derived
      from the flow velocity at the tip of the leaflets and the area of the elliptical
      mitral opening. The regurgitant fraction was calculated as the difference between
      the two flows divided by the mtiral inflow. RESULTS: In the 20 controls the two
      flows were almost identical (mitral inflow, 4.44 (SD 0.88) l/min; aortic outflow,
      4.58 (SD 0.84) l/min), with a mean regurgitant fraction of 4.2 (SD 8.4)%. In
      patients with mitral regurgitation, the mitral inflow was significantly higher
      than the aortic outflow (8.8 (3.6) v 4.3 (1.1) l/min). In most patients the
      Doppler-derived regurgitant fraction (45.8 (19.2)%) accorded closely with the
      regurgitant fraction (41.3 (SD 17.8)%) determined by the haemodynamic technique.
      CONCLUSION: Pulsed Doppler echocardiography, with an instantaneous velocity-valve
      area method for calculating mitral inflow, reliably measured the severity of
      regurgitation in patients with mitral regurgitation.

PMID- 1747281
TI  - Reduced exercise capacity in patients with tricuspid regurgitation after
      successful mitral valve replacement for rheumatic mitral valve disease.
AB  - OBJECTIVE: To determine how severe tricuspid regurgitation influences exercise
      capacity and functional state in patients who have undergone successful mitral
      valve replacement for rheumatic mitral valve disease. DESIGN: 9 patients in whom
      clinically significant tricuspid regurgitation developed late after mitral valve
      replacement were compared with 9 patients with no clinical evidence of tricuspid
      regurgitation. The two groups were matched for preoperative clinical and
      haemodynamic variables. Patients were assessed by conventional echocardiography,
      Doppler echocardiography, and a maximal treadmill exercise test in which expired
      gas was monitored by mass spectrometry. SETTING: University Hospital of Wales,
      Cardiff. SUBJECTS: 18 patients who had been reviewed regularly since mitral valve
      replacement. MAIN OUTCOME MEASURE: Objective indices of exercise performance
      including exercise duration, maximal oxygen consumption, anaerobic threshold, and
      ventilatory response to exercise. RESULTS: Mitral valve prosthetic function was
      normal in all patients and estimated pulmonary artery systolic pressure and left
      ventricular function were similar in the two groups. Right ventricular diameter
      (median (range) 5.0 (4.3-5.6) v 3.7 (3.0-5.4) cm, p less than 0.01) and the
      incidence of paradoxical septal motion (9/9 v 3/9, p less than 0.01) were greater
      in the group with severe tricuspid regurgitation. Exercise performance--assessed
      by exercise duration (6.3 (5.0-10.7) v 12.7 (7.2-16.0) min, p less than 0.01),
      maximum oxygen consumption (11.2 (7.3-17.8) v 17.7 (11.8-21.4) ml min-1 kg-1, p
      less than 0.01), and anaerobic threshold (8.3 (4.6-11.4) v 0.7 (7.3-15.5) ml min
      1 kg-1, p less than 0.05)--was significantly reduced in the group with severe
      tricuspid regurgitation. The ventilatory response to exercise was greater in
      patients with tricuspid regurgitation (minute ventilation at the same minute
      carbon dioxide production (41.0 (29.9-59.5) v 33.6 (26.8-39.3) l/min, p less than
      0.01). CONCLUSIONS: Clinically significant tricuspid regurgitation may develop
      late after successful mitral valve replacement and in the absence of residual
      pulmonary hypertension, prosthetic dysfunction, or significant left ventricular
      impairment. Patients in whom severe tricuspid regurgitation developed had a
      considerable reduction in exercise capacity caused by an impaired cardiac output
      response to exercise and therefore experienced a poor functional outcome. The
      extent to which this was attributable to the tricuspid regurgitation itself or
      alternatively to the consequences of right ventricular dysfunction was not clear
      and requires further investigation.

PMID- 1747282
TI  - Quinine and quinidine.

PMID- 1747283
TI  - Role of transoesophageal echocardiography in evaluation of cardiogenic embolism.
AB  - OBJECTIVE: To determine the value of transoesophageal echocardiography in the
      assessment of selected patients at risk of cardiogenic embolism or after it.
      DESIGN: Prospective comparison of the results of transoesophageal and
      transthoracic echocardiography. Transoesophageal echocardiography was performed
      with a 5 MHz single plane phased array transducer. SETTING: University teaching
      hospital. PATIENTS: 100 patients referred for transoesophageal echocardiography
      after a cerebral ischaemic event or peripheral arterial embolism (n = 63), before
      percutaneous balloon dilatation of the mitral valve (n = 23), or before
      electrical cardioversion of atrial fibrillation (n = 14). RESULTS: Transthoracic
      echocardiography showed potential sources of embolism in four patients including
      left ventricular thrombus in two patients (with one false positive), left atrial
      appendage thrombus (n = 1), and patent foramen ovale (n = 1). Transoesophageal
      echocardiography showed 59 potential embolic sources in 45 patients including
      left atrial spontaneous echo contrast (n = 33), left atrial appendage thrombus (n
      = 13), left ventricular thrombus (n = 5), patent foramen ovale (n = 3), left
      ventricular spontaneous echo contrast (n = 2), mitral valve prosthesis thrombus
      (n = 1), mitral valve prolapse (n = 1), and pronounced aortic atheroma (n = 1).
      Transoesophagal echocardiography showed potential embolic sources in 36/53 (68%)
      patients with atrial fibrillation compared with 9/47 (19%) patients in sinus
      rhythm. Percutaneous balloon dilatation of the mitral valve was performed without
      embolic complications in 18 patients without left atrial thrombi and in three
      patients with small fixed thrombi in the left atrial appendage. It was cancelled
      in two patients with large thrombi in the left atrial appendage. Cardioversion
      was performed without embolic complications in 14 patients without left atrial
      thrombi. CONCLUSIONS: Transoesophageal echocardiography detects potential sources
      of embolism better than transthoracic echocardiography in selected patients at
      risk of cardiogenic embolism or after it.

PMID- 1747284
TI  - DiGeorge syndrome with isolated aortic coarctation and isolated ventricular
      septal defect in three sibs with a 22q11 deletion of maternal origin.
AB  - DiGeorge syndrome was diagnosed in an infant who had an interrupted aortic arch,
      hypoparathyroidism, and low T lymphocyte numbers. Two siblings had heart defects
      that are not commonly described in DiGeorge syndrome (a membranous ventricular
      septal defect and coarctation of the aorta respectively). These siblings did not
      have evidence of thymic dysfunction or hypoparathyroidism. Chromosome analysis
      showed that the mother, whose cardiovascular examination was normal, and her
      three offspring with heart defects had a 22q11 interstitial deletion, which was
      confirmed by molecular analysis. This family suggests that 22q11 deletions can
      cause apparently isolated heart defects and that the range of these defects may
      be wider than previously recognised. Once the genes that are deleted in this
      family are characterised they will be useful candidate genes in the investigation
      of isolated cardiac malformations.

PMID- 1747285
TI  - Silent ischaemia in diabetic men with autonomic neuropathy.
AB  - Autonomic neuropathy is associated with an increased incidence of silent
      myocardial infarction and sudden death. The purpose of this study was to
      investigate the prevalence of silent myocardial ischaemia in diabetic patients
      with autonomic neuropathy and without. Five standard autonomic function tests
      were performed on 41 men with diabetes: postural change in blood pressure,
      postural change in heart rate, heart rate response to deep breathing, heart rate
      response to Valsalva's manoeuvre, and blood pressure response to sustained
      handgrip. There were 17 patients with autonomic neuropathy (group A) and 24 with
      normal autonomic function (group B). All patients underwent 24 hour ambulatory
      electrocardiographic monitoring to detect silent ischaemia. There was no
      significant difference in risk factors for coronary artery disease or history of
      angina pectoris between these groups. The prevalence of silent ischaemia was
      64.7% in group A (95% confidence interval (95% CI) 38.33 to 85.79%) and 4.1% in
      group B (95% CI 0.11 to 21.12%). This represents a relative risk of 42.2 (95% CI
      4.5 to 39.4, p less than 0.001). These results are consistent with the concept
      that autonomic neuropathy may prevent the development of anginal pain and thus
      obscure the presence of ischaemic heart disease. Twenty four hour ambulatory
      electrocardiographic monitoring may identify a subgroup of diabetic patients with
      autonomic neuropathy who have myocardial ischaemia and to whom treatment may be
      offered.

PMID- 1747286
TI  - Myocardial ischaemia and ventricular arrhythmias precipitated by physiological
      concentrations of adrenaline in patients with coronary heart disease.
AB  - The clinical and haemodynamic effects of adrenaline infusion (30 ng kg-1 min-1)
      producing plasma adrenaline concentrations in the range seen during acute
      myocardial infarction and of placebo were investigated in a crossover design in
      14 patients with stable coronary heart disease. Adrenaline infusion resulted in
      electrocardiographic evidence of myocardial ischaemia (greater than or equal to 1
      mm (0.1 mV) horizontal or downsloping ST segment depression) in 10 patients and
      angina in four, although the mean (SEM) increase in heart rate was modest (14 (2)
      beats/min) and mean coronary vascular resistance fell from 1.56 (0.21) to 1.16
      (0.14) mm Hg min ml-1 (p less than 0.005). New or increasingly frequent or
      complex ventricular arrhythmias occurred in five patients. Placebo infusion had
      no effect on the variables measured. Supine bicycle exercise during infusion of
      the saline placebo was associated with a similar degree of ST segment depression
      (0.9 (0.2) mm) as adrenaline infusion at rest (0.9 (0.1) mm) but exercise
      performed during adrenaline infusion (10 patients) resulted in more pronounced ST
      segment depression (1.9 (0.3) mm) (p less than 0.005) than either intervention
      alone. Angina occurred in three of 11 patients during control exercise and in six
      of 10 during the combination of adrenaline infusion and exercise. Such
      potentially adverse consequences of low dose adrenaline infusion in patients with
      stable coronary heart disease are consistent with the suggestion that adrenal
      activation is detrimental during acute myocardial infarction, being both
      arrhythmogenic and proischaemic.

PMID- 1747287
TI  - Paradoxical embolisation of a catheter fragment to a coronary artery in an infant
      with congenital heart disease.
AB  - Six weeks after cardiac catheterisation via the right femoral vein an infant
      underwent an anatomical correction for transposition of the great vessels and
      closure of a large ventricular septal defect. The patient died intraoperatively
      as a result of severe left ventricular dysfunction. Necropsy showed an old
      myocardial infarction associated with thrombosis of the circumflex coronary
      artery. Electron probe x ray analysis showed that foreign refractile material
      within the thrombus contained bismuth, an element used in the construction of
      some cardiac catheters. This is believed to be the first report of "paradoxical"
      coronary embolisation of catheter-derived material and highlights the usefulness
      of electron probe x ray analysis.

PMID- 1747288
TI  - John Fothergill and angina pectoris.

PMID- 1747289
TI  - Coronary angioplasty in the United Kingdom. Report of a Working Party of the
      British Cardiac Society.

PMID- 1747290
TI  - Management of patients with Bjork-Shiley prosthetic valves.

PMID- 1747291
TI  - Heart valve surgery in the United Kingdom: present practice and future trends.

PMID- 1747292
TI  - Short and long term results after intracoronary stenting in human coronary
      arteries: monocentre experience with the balloon-expandable Palmaz-Schatz stent.
AB  - OBJECTIVE: Intracoronary stenting was designed to overcome acute complications
      after percutaneous transluminal coronary angioplasty and to achieve a reduced
      rate of restenosis, both of which are major limitations of this well accepted
      method for treating coronary heart disease. This report describes the experience
      at one centre with the implantation of balloon-expandable Palmaz-Schatz stents
      and focuses on device related complications and the short and long term
      angiographic outcome. DESIGN: A retrospective data analysis. PATIENTS: Stenting
      was attempted in 50 patients. Restenosis after an initially successful
      angioplasty procedure, inadequate postangioplasty results, saphenous coronary
      bypass stenoses, and bail-out situations were regarded as indications. MAIN
      OUTCOME MEASURES AND RESULTS: In 49 of 50 attempted patients 61 stents (1-4 per
      patient) were implanted. Delivery problems occurred in three patients and were
      successfully overcome in two patients. Bail-out situations were successfully
      managed in 16 patients. Complications included acute thrombus formation within
      the stent immediately after implantation in one patient, which was successfully
      treated by thrombolysis. One patient was sent for bypass surgery the day after
      implantation; another died 10 days after implantation for unknown reasons.
      Subacute stent thrombosis occurred in seven patients 5-9 days after implantation
      and was successfully treated by thrombolysis or balloon angioplasty in five
      patients. Bleeding complications occurred in nine patients, five of whom required
      blood transfusions. Angiography showed long term vessel patency after 4-6 months
      in 31 (76%) of the 41 patients who were followed up, restenosis in six (14%), and
      reocclusion in four (10%). Late restenosis or reocclusion was found in five (15%)
      of 33 patients with a single stent in contrast to five (63%) of eight patients
      with multiple stents. CONCLUSIONS: Balloon-expandable intracoronary stenting is a
      feasible method for treating the acute complications of balloon angioplasty. It
      reduced the rate of restenosis for single stent implantation. Subacute thrombotic
      events must be regarded as previously unknown and serious complications.

PMID- 1747293
TI  - Changes in Doppler indices of cardiac function during and after percutaneous
      transluminal coronary angioplasty.
AB  - OBJECTIVE: To assess the sensitivities of Doppler indices to changes in global
      cardiac function during and after controlled myocardial ischaemia induced by
      coronary angioplasty. DESIGN: Continuous wave Doppler signals of aortic flow were
      recorded during coronary angioplasty. The following Doppler indices of cardiac
      function were measured before, during, and after balloon inflation: V (peak
      velocity), MA (mean acceleration), V2/T (T = time from onset to peak ejection),
      and MD (minute distance corrected for baseline heart rate). SETTING: A tertiary
      care cardiological unit in a university hospital. PATIENTS: Sixteen patients
      undergoing coronary angioplasty of the left anterior descending coronary artery.
      Eight patients had multivessel disease. MAIN OUTCOME MEASURES: The primary
      outcome measures were planned before data collection began. RESULTS: 12 patients
      showed a significant fall of three or more Doppler indices from their baseline
      values during balloon inflation. This occurred in all patients with multivessel
      disease. The Doppler indices V2 T, MD, V, and MA fell by 43.7%, 37.7%, 27.4%, and
      23% respectively from their baseline values (p less than 0.0001). The relative
      sensitivities of the Doppler indices to ischaemia were V2/T greater than MD (p
      less than 0.02), MD greater than (p less than 0.001), and V greater than MA (p
      less than 0.01). The impairment of global left ventricular function resulting
      from brief balloon inflation during single vessel angioplasty was reversible in
      all the patients. CONCLUSIONS: The Doppler indices V2/T, MD, V, and MA are all
      sensitive, in order of magnitude, to falls in global cardiac function resulting
      from ischaemia. They may prove useful for assessing cardiac function during
      ischaemia in the clinical setting.

PMID- 1747294
TI  - von Willebrand factor in plasma: a novel risk factor for recurrent myocardial
      infarction and death.
AB  - OBJECTIVE: To evaluate as predictors of reinfarction and mortality tissue
      plasminogen activator antigen and activity before and after venous occlusion,
      plasminogen activator inhibitor, von Willebrand factor, and established risk
      factors. DESIGN: Prospective study with a mean observation time of 4.9 years.
      SETTING: Secondary referral centre, the Department of Internal Medicine,
      University Hospital of Umea. PATIENTS: 123 consecutive survivors of myocardial
      infarction under the age of 70 years. MAIN OUTCOME MEASURES: Reinfarction and
      deaths from all causes. RESULTS: 23 patients died and 36 patients had at least
      one reinfarction. High concentrations of von Willebrand factor were independently
      associated with both reinfarction and mortality. A history of angina at entry
      into the study was also independently associated with reinfarction and mortality.
      Hypertension was independently associated with mortality but not with
      reinfarction. None of the fibrinolytic or lipid variables was associated with
      reinfarction or death. CONCLUSION: A high concentration of von Willebrand factor
      was a novel index of increased risk for reinfarction and mortality in survivors
      of myocardial infarction.

PMID- 1747295
TI  - Increased concentrations of tumour necrosis factor in "cachectic" patients with
      severe chronic heart failure.
AB  - OBJECTIVE: To ascertain whether patients with cardiac failure and reduced body
      weight ("cardiac cachexia") have increased circulating concentrations of tumour
      necrosis factor (cachectin). DESIGN: Patients with cardiac failure were
      prospectively identified as "cachectic" (body fat less than 27% in men and less
      than 29% in women measured by skinfold thickness callipers) or "non-cachectic".
      Tumour necrosis factor was assayed blind to patient group. SETTING: Cardiology
      unit in a tertiary referral centre. PATIENTS: 26 consecutive patients (10 women)
      (mean age 61) admitted for investigation or treatment of chronic heart failure.
      All were in New York Heart Association class III or IV. RESULTS: In nine of the
      16 cachectic patients the concentration of tumour necrosis factor was increased
      (mean (SEM) 74 (20) pg/ml) compared with one of the 10 "non-cachectic" patients
      (22 pg/ml, p less than 0.001). Patients with a raised circulating concentration
      of tumour necrosis factor weighed significantly less (55.6 (3.5) kg) than those
      in whom the concentration of tumour necrosis factor was normal (69.0 (4.1) kg) (p
      = 0.02). CONCLUSIONS: Circulating concentrations of tumour necrosis factor were
      increased in a significant proportion of patients with chronic heart failure and
      low body weight. Tumour necrosis factor stimulates catabolism experimentally and
      it may be a factor in the weight loss seen in patients with "cardiac cachexia".

PMID- 1747296
TI  - Myocardial bridges: morphological and functional aspects.
AB  - OBJECTIVE: To assess the arrangement of myocardial bridges. DESIGN: A necropsy
      study of 90 consecutive hearts (56 male, 34 female). RESULTS: Myocardial bridges,
      either single or multiple, were seen in 50 (55.6%) of the 90 hearts. The left
      anterior descending artery was the most commonly affected artery. Thirty five of
      the 50 hearts which contained in total 41 muscle bridges were dissected further
      with a magnifying glass. Two different types of muscle bridges could be
      identified. Thirty one of these 41 myocardial bridges were superficial, crossing
      the artery transversely towards the apex of the heart at an acute angle or
      perpendicularly. The remaining 10 myocardial bridges crossed the left anterior
      descending coronary artery and surrounded it by a muscle bundle that arose from
      the right ventricular apical trabeculae and crossed the artery transversely,
      obliquely, or helically before terminating in the interventricular septum.
      CONCLUSIONS: The superficial type of myocardial bridge does not seem to constrict
      the artery during systole but the deep muscle bridges, by virtue of their
      relation with the left anterior descending coronary artery, could twist the
      vessel and thus compromise its diastolic flow. This may result in ischaemia.

PMID- 1747297
TI  - Pregnancy outcome and Ebstein's anomaly.
AB  - BACKGROUND: Ebstein's anomaly is an uncommon congenital cardiac abnormality that
      may be associated with cyanosis and arrhythmias. For those female patients with
      the anomaly who survive to adult life there is little information available about
      pregnancy, maternal complications, and fetal outcome. This study was designed to
      address this issue so that these patients can receive appropriate advice and
      management. METHODS AND RESULTS: Forty two pregnancies in 12 women with Ebstein's
      anomaly were studied. The mothers' cardiac lesions were assessed on the basis of
      symptoms, the presence of cyanosis or arrhythmia, and by echocardiographic
      grading of severity. In the absence of important maternal cyanosis or arrhythmia,
      pregnancy was well tolerated. Neonatal outcome was good though there was an
      increased risk of prematurity and dysmaturity in the babies born to mothers with
      cyanosis. CONCLUSIONS: This study indicates that women with Ebstein's anomaly who
      reach child-bearing age can be advised that pregnancy is likely to be well
      tolerated with good fetal outcome. Maternal arrhythmia or cyanosis are
      indications for closer maternal and fetal observation.

PMID- 1747298
TI  - Doppler echocardiographic evaluation of pulmonary blood flow after the Fontan
      operation: the role of the lungs.
AB  - OBJECTIVE: To document whether the act of respiration influences pulmonary blood
      flow in patients after the Fontan operation. DESIGN: Prospective study in which
      patients acted as their own controls. SETTING: Supraregional paediatric
      cardiology centre. PATIENTS: Sixteen patients who had undergone atriopulmonary
      anastomosis (Fontan operation) for the treatment of congenital heart disease.
      INTERVENTION: Doppler assessment of pulmonary artery flow patterns with a
      simultaneous respirometer, electrocardiogram and phonocardiogram. RESULTS: Total
      (mean (1SD) ) forward pulmonary flow was 63.6 (35)% higher during inspiratory
      cardiac cycles than during expiratory ones. CONCLUSIONS: The act of breathing
      provides an additional energy supply to pulmonary blood flow in patients after
      the Fontan operation.

PMID- 1747299
TI  - Abnormal patterns of intraventricular flow and diastolic filling after the Fontan
      operation: evidence for incoordinate ventricular wall motion.
AB  - OBJECTIVE: To assess whether regional abnormalities of ventricular function are
      present in patients after the Fontan operation and to explore the implications of
      any such abnormalities for ventricular filling. DESIGN AND PATIENTS: Prospective
      study in which 25 patients after the Fontan operation were compared with 25
      healthy controls and 12 patients with a univentricular atrioventricular
      connection, before the Fontan operation. INTERVENTIONS: Doppler echocardiography,
      with simultaneous electrocardiogram, phonocardiogram, and respirometer. RESULTS:
      Isovolumic relaxation time was significantly longer in patients after the Fontan
      operation than in normal children (p less than 0.001) or the preoperative
      patients (p = 0.001). Systolic intraventricular flow was detected in 60% of
      patients after the Fontan operation and in 42% of preoperative patients. After
      the Fontan operation 80% of patients showed intraventricular flow during
      isovolumic relaxation compared with 8% of normal children and none of the
      preoperative patients. CONCLUSIONS: Incoordinate ventricular relaxation is common
      after the Fontan operation. This may have important implications for ventricular
      diastolic filling, pulmonary blood flow, and cardiac output in these patients.

PMID- 1747300
TI  - Echocardiographic and angiographic diagnosis of Ebstein's anomaly of the mitral
      valve.
AB  - A rare case of Ebstein's anomaly of the mitral valve was diagnosed by cross
      sectional echocardiography and angiography.

PMID- 1747301
TI  - Double outlet left ventricle: diagnosis with magnetic resonance imaging.
AB  - A complex congenital cardiac malformation in a female patient was evaluated
      several times by angiocardiography and echocardiography in childhood but a
      definite diagnosis was not established. Segmental analysis of the heart and the
      great vessels by magnetic resonance imaging when the patient was 34, however,
      showed a double outlet left ventricle in which the aorta was situated anterior to
      and to the left of the pulmonary trunk and an associated subaortic ventricular
      septal defect with pulmonary valve stenosis. This is the first time that this
      extremely rare cardiac malformation has been diagnosed by magnetic resonance
      imaging.

PMID- 1747302
TI  - Physical activity and ischaemic heart disease in middle-aged British men.
AB  - OBJECTIVE: To assess the relation between reported physical activity and the risk
      of heart attacks in middle aged British men. DESIGN: Prospective study of middle
      aged men followed for a period of eight years (The British Regional Heart Study).
      SETTING: One general practice in each of 24 British towns. PARTICIPANTS: 7735 men
      aged 40-59 years at initial examination. END POINT: Heart attacks (non-fatal and
      fatal). MEASUREMENTS AND MAIN RESULTS: During the follow up period of eight years
      488 men suffered at least one major heart attack. A physical activity score used
      was developed and validated against heart rate and lung function (FEV1) in men
      without evidence of ischaemic heart disease. Risk of heart attack decreased
      significantly with increasing physical activity; the groups reporting moderate
      and moderately vigorous activity experienced less than half the rate seen in
      inactive men. The benefits of physical activity were seen most consistently in
      men without preexisting ischaemic heart disease and up to levels of moderately
      vigorous activity. Vigorously active men had higher rates of heart attack than
      men with moderate or moderately vigorous activity. The relation between physical
      activity and the risk of heart attack seemed to be independent of other
      cardiovascular risk factors. Men with symptomatic ischaemic heart disease showed
      a reduction in the rate of heart attack at light or moderate levels of physical
      activity, beyond which the risk of heart attack increased. Men with asymptomatic
      ischaemic heart disease showed an increasing risk of heart attack with increasing
      levels of physical activity, but with a progressive decrease in case fatality.
      Overall, men who engaged in vigorous (sporting) activity of any frequency had
      significantly lower rates of heart attack than men who reported no sporting
      activity. However, when all men reporting regular sporting activity at least once
      a month were excluded from analysis, there remained a strong inverse relation
      between physical activity and the risk of heart attack in men without pre
      existing ischaemic heart disease. CONCLUSION: This study suggests that the
      overall level of physical activity is an important independent protective factor
      in ischaemic heart disease and that vigorous (sporting) exercise, although
      beneficial in its own right, is not essential in order to obtain such an effect.

PMID- 1747303
TI  - Staffing in cardiology in the United Kingdom 1990. Sixth biennial survey: with
      data on facilities in cardiology in England and Wales 1989.
AB  - The Sixth Biennial Survey of Staffing in Cardiology was conducted in July 1990.
      This report summarises the data that were collected, together with the results of
      a survey of facilities in cardiology made in 1989. The total number of
      cardiologists in the United Kingdom, defined as individuals trained in the
      specialty and spending at least 40% of their time working in it, is now 323. Six
      individuals work part time only, making 320 whole time posts. This number has
      increased over the two years from 1988 to 1990 by 32, of which 23 work only in
      the specialty and nine as general physicians with a major interest in cardiology.
      The rate of increase in numbers over the past decade has been reasonably
      consistent with an average of approximately 4.4% per year. Thirty one districts
      in England and Wales still have no cardiologist and 13 other districts have
      little provision with an average of three (visiting) sessions each per week. The
      population in these 44 districts is 8.3 million. Scotland also has an inadequate
      distribution of service in the specialty. If recommendations for cardiac surgery
      and angioplasty made in the Fourth Report of a Joint Cardiology Committee of the
      Royal College of Physicians of London and the Royal College of Surgeons of
      England are to be met, we calculate that we need 63 more cardiologists in our
      major centres. To provide one cardiologist in every district hospital and two for
      larger districts would require 94 more specialists, making a total shortfall of
      157 individuals. We have no excess of senior registrars to provide for a major
      expansion at consultant level. Time spent within the senior registrar (or
      academic equivalent) grade has tended steadily to decline and very few now reach
      the end of their contracts. The need for more individuals to pass through the
      senior registrar grade will be met in part by a planned reduction in the training
      period to three years. This will be inadequate, however, because projected
      retirements show that the number of consultant vacancies will increase sharply
      from 1997. We believe that additional senior registrar posts must be created if a
      serious shortfall in service provision by consultants is to be avoided. The
      provision of non-invasive facilities in cardiology is reasonable. The need for
      additional equipment for invasive cardiology has not been assessed. The number of
      physiological measurement technicians varies considerably between regions and is
      generally inadequate.

PMID- 1747304
TI  - Endothelium in control.

PMID- 1747305
TI  - Novel exercise protocol suitable for use on a treadmill or a bicycle ergometer.

PMID- 1747306
TI  - Back school for patients with vertebral fractures.
AB  - Back school is behavior training for the prevention and treatment of back
      problems arising from faulty body posture and muscular dysfunction. This paper
      describes the conception and evaluation of a back school program for patients
      with vertebral fractures. The curriculum includes the provision of detailed
      information as well as physiotherapy, training in the right way to perform
      activities of everyday life, counseling, relaxation training, and self
      monitoring. From October 1987 to June 1990 214 patients with vertebral fractures
      completed the back school program. The effectiveness of the program was measured
      by a knowledge test and a behavior test. The results suggest that this back
      school is an effective addition to conventional concept using physiotherapy
      exclusively.

PMID- 1747307
TI  - Long-term results of tibial plafond fractures treated with open reduction and
      internal fixation.
AB  - In this study a series of 41 consecutive cases of operatively treated fractures
      of the tibial plafond was retrospectively analysed. The fractures were classified
      into types I (9.75%), II (41.5%) and III (48.75%) as defined by Ruedi. The 10
      year average follow-up revealed 66% good and 24% fair objective results overall.
      The recent literature uniformly reports good results in operatively treated type
      I and -II fractures. In this series, these essentially low-velocity injuries
      resulted in a satisfactory outcome in 86% of cases. Controversy exists in reports
      of operative treatment of type-III fractures. The incidence of satisfactory
      results in the present series in type-III fractures was 95% good and fair
      results, which appears to be better than in other authors' experience. This can
      be partially explained by the relatively few high-velocity injuries (50% of the
      type-III fractures) and also by certain technical procedures used in surgery to
      stabilise these fractures. The initial type of fracture and articular cartilage
      damage are directly related to late arthrosis. There is clear evidence that the
      quality of reduction correlates with later development of arthrosis. However,
      anatomical reduction may still be followed by significant joint arthrosis because
      of articular cartilage damage. Severe arthrosis present at late follow-up did not
      correlate with poor subjective or objective results. With adequate open reduction
      and internal fixation, satisfactory results can be obtained in severe tibial
      plafond fractures. Meticulous soft tissue care and handling at surgery are
      important. Various fixation devices may need to be incorporated to ensure optimal
      soft tissue status for fracture healing.

PMID- 1747308
TI  - Acceleration of wound healing by local application of fibronectin.
AB  - The process of wound healing under the influence of locally applied fibronectin,
      heparin and thrombin was studied in adult rabbits. Using immunofluorescence
      microscopy, a higher concentration of fibronectin within the wound area was found
      on the 1st day after fibronectin treatment. The tensile strength of the wounds
      was tested on the 6th, 9th and 12th day after operation. On the 9th day the
      tensile strength of the fibronectin-treated wounds was significantly higher than
      that of the control wounds on the 12th day after operation. The addition of
      heparin and thrombin, each in combination with fibronectin, did not show any
      significant effect on wound healing.

PMID- 1747309
TI  - Anterior ankle pain in sports medicine: aetiology and indications for
      arthroscopy.
AB  - Persistent pain and swelling in the anterior part of the upper ankle are
      encountered very frequently in sports traumatology. Classically, in the patient
      with a long history of typical anterior ankle pain there is no instability, but
      pinching effects, a sense of impingement, blocking and a feeling of unsteadiness
      combined with a certain restriction of movement due to the pathology. By analogy
      with the anatomical structures, various pathologic changes can lead to the
      classic clinical symptoms: adhesions, cicatrices, meniscoid-type lesions,
      osteophytes with synovitis, folds, fibrotic subcutaneous fatty tissue, free
      arthroliths, osteochondral lesions and arthrotic changes. When long-term
      conservative therapy has not provided a cure for the clinical syndrome surgical
      intervention becomes necessary. Arthroscopic interventions were carried out in a
      total of 21 patients, with follow-up times between 6 and 36 months. About two
      thirds of all the patients showed good or very good results, while in one-third
      the results were unsatisfactory, mainly because of degenerative changes. An
      precise diagnosis is essential, but the significance of a pathologic change as
      the cause of symptoms can be problematical.

PMID- 1747310
TI  - Lateral band release for post-traumatic extension contracture of the proximal
      interphalangeal joint.
AB  - In the patient with scarring of just the central band and lateral bands, there is
      a loss of active and passive flexion of the proximal interphalangeal (PIP) joint
      because the lateral bands have lost their normal volar shift. Surgical freeing of
      the lateral bands from the central band using parallel incisions may be required
      to allow full flexion of the PIP joint. This study reports on 10 patients with
      post-traumatic extension contracture of the PIP joint treated by lateral band
      release. All operations were successful, with an average gain in range of motion
      of 47.5 degrees. This technique is simple, quick, and can be performed
      effectively on an out-patient basis.

PMID- 1747311
TI  - Trauma involving the proximal tibial epiphysis.
AB  - Thirty injuries involving the proximal tibial epiphysis were treated during a
      period of 28 years. The epiphysis was displaced in 16 cases (53%). Three patients
      presented with peripheral ischemia on admission, and one patient with associated
      ipsilateral femoral fracture developed delayed thrombosis of the popliteal
      artery. The treatment results were satisfactory in 21 of the 27 (74%) who were
      reassessed according to Shelton's evaluation criteria after an average post
      traumatic interval of 11.6 years. Three of the six patients with unsatisfactory
      outcome had a discrepancy in leg length of more than 2.5 cm after concomitant
      ipsilateral fracture of the femur or the tibia. One patient had a positive 3-cm
      anterior drawer sign, one patient had a 10 degree valgus deformity of the tibia,
      and one had to undergo above-knee-amputation because of delayed diagnosis of the
      vascular lesion.

PMID- 1747312
TI  - Biomechanical analysis of the dynamic hip screw in the treatment of
      intertrochanteric fractures.
AB  - A prospective study was performed in 148 elderly patients (over 60 years old)
      whose intertrochanteric fractures were caused by moderate trauma. The patients
      were treated with dynamic hip screws and followed up for at least 2 years
      (average 34 months). The lag screw was placed as the biomechanical analysis
      favored. Follow-up showed that the majority achieved good union and were without
      mechanical failure. The authors conclude that a lag screw should ideally be
      placed inferiorly toward the medial margin in the frontal plane and centrally in
      the sagittal plane. The length of the lag screw should be such as to extend from
      1.0 cm beneath the subchondral bone to the lateral femoral cortex. At least four
      cortical screws (piercing the cortex at eight points) should be inserted on the
      distal femoral fragment.

PMID- 1747313
TI  - Venous air embolism during knee arthrography. A case report.
AB  - A 34-year-old man developed a nonfatal venous air embolism during arthrography of
      his post-traumatically contractured knee joint. From the arthrographic findings,
      injected air was assumed to have entered the great saphenous vein via the venous
      opening in the knee joint. Venous air embolism is an extremely rare complication
      of knee arthrography, but can occur. As it is potentially fatal, prompt
      recognition and appropriate positional and supportive therapy are essential.

PMID- 1747314
TI  - Bilateral stress fracture of the scaphoid. A case report.
AB  - Bilateral stress fractures of the scaphoid bones in a gymnast are reported and
      discussed with special consideration of the possible differential diagnoses;
      bipartite scaphoid and pseudarthrosis of the scaphoid bone. The relevance of the
      mechanical factors involved and the abduction and dorsiflexion of the wrist in
      gymnastics are suggested as likely pathomechanisms.

PMID- 1747315
TI  - Sports-related two-plane fractures of the distal tibia. Report of two cases.
AB  - Two cases of sports-related two-plane fractures of the distal tibia, their
      operative treatment and the result of therapy after hardware removal are
      reported. The incidence and mechanism of this type of fracture in adolescents are
      shown as well as the indication for surgical reconstruction depending on the gap
      in the joint surface of the distal tibia.

PMID- 1747316
TI  - Transplant continuing care nurse: a pilot project to integrate inpatient and
      ambulatory care settings.

PMID- 1747317
TI  - Peripheral vascular accesses: a 13-month study of clotting trends and survival.

PMID- 1747318
TI  - Hemolytic uremic syndrome (HUS): nursing experience at the Hospital for Sick
      Children, Toronto.

PMID- 1747319
TI  - Effectiveness of renal peer resource consultation.

PMID- 1747320
TI  - Noncompliance in chronic hemodialysis patients: an assessment approach for care
      planning.
AB  - Noncompliance is a nursing diagnosis frequently encountered by nephrology nurses
      in their practice. Patient assessment, as part of the nursing process, gives us
      insight into the numerous factors contributing to noncompliance. An assessment
      approach has been developed to assist nurses in acquiring the knowledge, empathy
      and understanding to plan effective care for the noncompliant patient.

PMID- 1747321
TI  - CAPD in Canada.

PMID- 1747322
TI  - Role of plasma exchange in renal disease.

PMID- 1747323
TI  - Heparin kinetics.

PMID- 1747324
TI  - [Hypothalamo-pituitary-adrenal function in liver cirrhosis of viral etiology].
AB  - With the aim of evaluating the glucocorticoid function and the role of the
      adrenal gland in hypogonadism and feminization of cirrhotic patients, we examined
      11 patients with virus-induced liver cirrhosis and 8 normal subjects as controls.
      In each subject serum levels of cortisol (C), progesterone (P),
      dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), delta 4
      androstenedione (A), estrone (E1), testosterone (T), luteinizing hormone (LH)
      were assayed in basal conditions and after adrenocorticotropic hormone (ACTH)
      stimulation. Serum levels of ACTH, C, E1, estradiol (E2), T were assayed in basal
      condition and after dexamethasone suppression test. Moreover, a circadian study
      of ACTH, C and corticosteroid-binding globulin (CBG) was performed, with blood
      samples drawn at 8:00 and 20:00 on two consecutive days. Our results demonstrate
      that in cirrhosis: 1) normal levels of C, when metabolism is altered and CBG
      levels are reduced, are maintained by inhibition of ACTH secretion; 2) circadian
      rhythmicity of the pituitary-adrenal axis is well preserved; 3) in non-alcoholic
      cirrhosis, too, there is a reduction of androgens (T, DHEA, DHEAS, A) and a rise
      of estrogens (E2 and, more markedly, E1) and P; 4) in cirrhotic men E1 is mainly
      of adrenal origin and contributes, through negative feedback on LH secretion, to
      low levels of T.

PMID- 1747325
TI  - [Heart involvement in anorexia nervosa: an electrocardiographic, functional and
      morphological study].
AB  - Mental anorexia (MA) is the most frequent condition of malnutrition in
      industrialized countries. Sudden death in MA is not infrequent. Furthermore, the
      role of nutritional state as an important determinant of myocardial function is
      known. Cardiovascular function was studied in 9 patients with MA. Blood
      electrolytes and thyroid function were assessed, basal and dynamic ECG, chest
      roentgenogram, M-mode echocardiography, ergometric test, cardiac output
      measurement and, in two cases, magnetic nuclear resonance (MNR) were performed.
      Our data confirm the ECG changes which were preeminent in the clinical context,
      as predictors of possible major, life-threatening arrhythmic events. The correct
      QT interval was normal in all patients. In 4 cases with heart rate less than 40
      b/min, Holter ECG showed ventricular and atrial extrasystolic beats. In one case
      S-A blocks with idioventricular substitutive beats were recorded; the normal
      performance under maximal strain stands for a normal functional reserve. Blood
      electrolytes were in the normal range. The hypothalamic-pituitary axis can be
      considered as a cocausal factor by means of autonomic nervous system modulations.
      Echocardiography revealed only a mild reduction of ventricular wall thickness.
      Scattered degenerative myocardial involvement as shown by MNR imaging, could be
      the anatomical counterpart of a clinically emerging cardiomyopathy with
      potentially severe arrhythmias.

PMID- 1747326
TI  - [Immunogenetics: clinical and population aspects. The HLA system: clinical
      correlations. II. (3d of 5 parts)].

PMID- 1747327
TI  - [Digitalis and heart failure].
AB  - The authors first discuss the predominant cardiovascular mechanisms of the action
      of digitalis from a historical point of view. They then deal with different
      clinical situations in which the use of digitalis is limited, such as cardiac
      insufficiency resulting from altered diastolic function, although further studies
      dealing with the ratio of digitalis to diastolic function are necessary to gain a
      better insight into this problem. Finally, the discussion focuses on various
      clinical trials (including recent studies) on the use of digitalis in cardiac
      compensation in subjects with sinus rhythm. While the drug seems useless, if not
      risky in the majority of patients, in others with cardiomegaly, III tone and
      fluid overload the effects of the drug still seem beneficial at the clinical
      level. In this case, however, improved cardiac performance could not be
      demonstrated. The extra-inotropic types of digitalis action are thus reexamined,
      and some are correlated with favourable clinical effects which can be encountered
      in some forms of chronic heart failure.

PMID- 1747328
TI  - [Myxedematous coma due to transitory secondary hypothyroidism. Description of a
      case].
AB  - Myxedema coma is a rare manifestation of hypothyroidism, and its prognosis is
      usually poor. We report a case of myxedema coma due to transient pituitary
      hypothyroidism with complete clinical and endocrinological recovery. The possible
      vascular origin of the syndrome is discussed.

PMID- 1747329
TI  - Association of the Budd-Chiari syndrome with lupus anticoagulant. Case report and
      critical review.
AB  - The Budd-Chiari syndrome (BCS) was diagnosed in a 30-year-old male hospitalized
      with hepatomegaly, abdominal collateral vessels and hepatic veins and inferior
      vena cava thrombosis (IVC) in 1988. The presence of circulating lupus
      anticoagulant (LAC) was suspected and demonstrated on this occasion in view of an
      earlier diagnosis of systemic lupus erythematosus (SLE) and recurrent vein
      thrombosis dating from 1981. There are sporadic reports of an association of BCS
      with SLE and other autoimmune diseases. The recent literature also describes
      associations with hypercoagulability due to LAC. These are reviewed together with
      the personal case to provide the rationale for correct diagnosis and therapy.

PMID- 1747330
TI  - Magnetic resonance imaging in the evaluation of congenital heart disease.
AB  - Magnetic resonance imaging is a powerful tool for studying patients with
      congenital heart disease. Its phenomenal contrast resolution, improved spatial
      resolution, and large field-of-view allow for graphic depiction of a wide array
      of congenital defects. Although this method was originally handicapped by the
      time it took to perform an exam and by poor image quality, advances in hardware
      and software coupled with attention to technique have led to a reliable
      diagnostic imaging modality. Although the technology is still evolving, it is not
      unreasonable to hope that the noninvasive imaging modalities of magnetic
      resonance and echocardiography will ultimately replace angiography in the
      evaluation of congenital heart disease.

PMID- 1747331
TI  - Magnetic resonance imaging in the diagnosis and evaluation of myocardial
      infarction.
AB  - Magnetic resonance (MR) imaging with the aid of MR contrast agents may be helpful
      to assess myocardial infarct size, the area at risk, and myocardial viability. MR
      contrast agents may also prove useful for evaluating myocardial perfusion with
      ultrafast MR imaging techniques. Dynamic cine MR imaging is an accurate method to
      assess regional myocardial dysfunction in ischemic heart disease. In addition,
      myocardial contraction can be determined by MR imaging under pharmacological
      stress or by direct tracking of wall motion with MR myocardial tagging. Combining
      the information from these MR imaging techniques provides a comprehensive
      evaluation of patients with coronary artery disease.

PMID- 1747332
TI  - Magnetic resonance approaches to the evaluation of pulmonary vascular anatomy and
      physiology.
AB  - MR imaging offers the potential for combined anatomic and flow-related
      information about the pulmonary circulation. Although conventional spin-echo
      sequences have provided an accurate and noninvasive means of evaluating the
      anatomy of the central pulmonary arteries and veins, newer MR techniques-
      including cine MR, velocity-encoded phase-contrast scans, spatial modulation of
      magnetization (SPAMM), fast scan techniques with breath-holding, and echo planar
      imaging in combination with computer-based post-processing--are providing
      physiological information superimposed on the anatomic maps. This paper reviews
      these new MR approaches to the integrated anatomic and physiologic imaging of the
      pulmonary vasculature.

PMID- 1747333
TI  - Medical records: a question of access.

PMID- 1747334
TI  - Shattered dreams.

PMID- 1747335
TI  - Pay and conditions: nurses' work and worth.

PMID- 1747336
TI  - Who should teach nurses?

PMID- 1747337
TI  - Health economics in psychiatric nursing.
AB  - The potential benefits to psychiatric nursing of the new science of health
      economics are explored in this article, which stems from more extensive research
      carried out by the authors. It is suggested that an analysis of the relationship
      between costs and clinical outcomes of community psychiatric nursing
      interventions will enable an objective ratification of the costs and benefits of
      treatment to emerge. The new discipline must be incorporated into evaluative
      research processes to allow psychiatric nursing to have an influence over future
      changes in health care provision.

PMID- 1747338
TI  - The process of continuing education.

PMID- 1747339
TI  - Non-steroidal anti-inflammatory drugs.

PMID- 1747340
TI  - Assessing the cost of nursing.

PMID- 1747341
TI  - Setting standards.

PMID- 1747342
TI  - Health promotion: head lice to heart disease.

PMID- 1747343
TI  - The meeting game.

PMID- 1747344
TI  - Ethics: professional accountability.

PMID- 1747345
TI  - Alternative therapy: complementary compliments.

PMID- 1747346
TI  - Practising nursing practice.

PMID- 1747347
TI  - Lateral thinking. Order from chaos.

PMID- 1747348
TI  - Lateral thinking. Thinking straight?

PMID- 1747349
TI  - Iatrogenic arterial injuries resulting from invasive procedures.
AB  - The many invasive arterial procedures that require cannulation of an artery with
      a large or traumatic catheter can be expected to produce iatrogenic injuries in a
      certain number of patients. While almost all arterial cannulation procedures are
      performed by physicians, nurses play a major role in performing baseline
      assessment of arterial blood flow, monitoring indwelling catheters, and detecting
      evidence of arterial injury. Clinical manifestations may appear during a
      procedure, while an indwelling arterial catheter is in place or after the
      catheter has been removed. Vigilant attention is essential to prevent serious
      injury or death due to a complication of an iatrogenic arterial injury.

PMID- 1747350
TI  - Commentary on carotid endarterectomy.

PMID- 1747351
TI  - Preoperative arteriogram revealed this "string" sign.

PMID- 1747352
TI  - Blue toe syndrome.
AB  - Taking a precise history from a patient who presents with a "bruised" toe in the
      absence of trauma requires sharp assessment skills and an investigative nature.
      Looking beyond the obvious in an otherwise healthy appearing individual calls for
      knowledge of many different disease processes including blue toe syndrome. Rapid
      identification, proper diagnosis, and correct medical and nursing management are
      essential for a positive outcome.

PMID- 1747353
TI  - Presidential address.

PMID- 1747354
TI  - Discharge planning for the vascular patient: where does home care fit in?

PMID- 1747355
TI  - Extracavitary vascular trauma.
AB  - Extracavitary vascular injuries involving the cervical area and the extremities
      constitute about 50% of all vascular injuries. Initial evaluation and
      resuscitation of patients with vascular injuries should follow standard Advanced
      Trauma Life Support protocols. Diagnosis of the injury is heavily reliant on
      physical examination, supplemented by arteriography in specific instances.
      Intraoperative management utilizes all the basic principles of vascular surgery.
      Postoperative nursing care focuses on the entire patient including the detection
      of early complications of vascular repair. Recent advances in transportation,
      resuscitation and operative techniques have lead to a decrease in mortality and
      morbidity.

PMID- 1747356
TI  - Esophageal atresia, tracheomalacia and arterial compression: role of aortopexy.
AB  - Between 1985 and 1990, we treated 46 cases of esophageal atresia in the pediatric
      surgery department in Marseille. In 17 of these patients atresia was associated
      with tracheomalacia. The most common respiratory manifestations were acute apneic
      attacks, cyanotic spells and recurring pneumopathy. The underlying cause was
      arterial compression of the airways by the innominate artery in 6 cases, the
      aortic arch in 2 cases, and a common origin of the innominate and left carotid
      arteries in 2 cases. Eleven patients underwent surgery to relieve arterial
      compression: suspension of the aorta from the under surface of the sternum (10
      cases) and reimplantation of the innominate artery (1 case). Results in terms of
      tracheal caliber and symptomatic relief were excellent in 10 cases including 1
      case requiring redo, and poor in 1 case. For diagnosis, our experience shows the
      importance of endoscopy, nuclear magnetic resonance and recognition of
      gastroesophageal reflux which is often associated (9/11). The role of
      tracheomalacia is discussed. On the basis of our results and those previously
      reported, aortopexy appears to be an effective surgical technique in patients
      with esophageal atresia presenting respiratory complications due to arterial
      compression.

PMID- 1747357
TI  - Clinical findings in middle lobe syndrome and other processes of pulmonary
      shrinkage in children (atelectasis syndrome).
AB  - Processes of atelectasis and pulmonary shrinkage are not confined to the right
      middle lobe. This fact is illustrated by case reports of five of our nine such
      patients. All cases shared common clinical and morphologic similarities:
      congenital malformations of the bronchial skeleton, compression, and chronic
      inflammation produce comparable pulmonary morphology that always includes
      atelectasis. Atelectasic processes of longer duration require surgical resection;
      this led to cures in all the authors' patients.

PMID- 1747358
TI  - Morbidity and mortality of short bowel syndrome in infancy and childhood.
AB  - This report concerns 59 infants and children with short bowel syndrome, most
      commonly caused by necrotizing enterocolitis in this study. Resection of atretic
      or gangrenous bowel was performed in 53 patients, tapering enteroplasty and
      primary anastomosis was performed in 13 patients, and temporary enterostomies
      were performed in 40 patients. Second-look laparotomy was useful in two of four
      cases of questionable bowel viability. The ileocecal valve was resected in 32
      patients and remained intact in 27. The mean length of the remaining bowel was
      58.4 cm. All patients received total parenteral nutrition and early enteral
      feedings. Home hyperalimentation was attempted when 50 per cent of the calorie
      intake was enteral. Intestinal adaptation required from 3 to 14 months. Frequent
      setbacks were related to catheter sepsis, rotavirus infection, carbohydrate
      intolerance, and liver dysfunction. The overall survival rate was 80 per cent
      with mortality due to sepsis associated with total parenteral nutrition and liver
      failure.

PMID- 1747359
TI  - Chronic recurrent appendicitis. A clinicopathologic study of 47 cases.
AB  - As part of a retrospective study 47 appendices from patients with a clinical and
      morphologic diagnosis of chronic recurrent appendicitis were studied by
      morphologic and immunohistochemical methods. Appendices with chronic recurrent
      appendicitis histologically show chronic active inflammation with increased
      numbers of immunocompetent cells, mostly T lymphocytes and subsequent scarring.
      In addition, there is an increase in the number of neural cells. Apparently the
      secretion of neurotropic inflammatory mediators, especially by activated and
      degranulating eosinophils, leads to a stimulation of nociceptive receptors and
      thus to the clinical symptoms. The diagnosis of recurrent chronic appendicitis is
      thus warranted in these cases not only clinically but also on the basis of
      histologic and immunohistochemical findings.

PMID- 1747360
TI  - High and intermediate imperforate anus: functional results and postoperative
      manometric assessment.
AB  - Between 1983 and 1989, 21 patients with high (12) and intermediate (9)
      imperforate anus were operated on according to the author's procedure. The
      anatomical results are satisfactory (20/21). The records of the clinical and
      paraclinical assessments of 13 of these patients with a follow-up of at least 5
      years, is reported. The patient history demonstrates that 12 out of 13 are clean
      at night, with 1 to 3 bowel movements during the day. The intermediate forms have
      no accidental defecation and almost no soiling. Conversely, the high forms often
      soil but usually do not wear thick protections. Criteria of successful
      reconstruction as rectal examination, defecogram, CT scan or MRI, yield limited
      data but no formal conclusions. Manometric studies provide a better understanding
      of the bowel function after pull-through procedures, by studying the rectoanal
      inhibitory reflex threshold (RAIRT), the maximal anal resting closure (MARCP),
      the conscious rectal sensitivity threshold (CRST) and the maximal rectal
      compliance (MRC). Technical aspects of these recordings are detailed. Manometric
      recording from 13 of these 21 patients show that RAIRT is present in 3 out of 6
      intermediate forms and 3 out of 7 high forms. CRST is normal in all the cases
      except 1. MARCP was normal in 5 out of 6 intermediate lesions and 5 out of 7 high
      lesions. MRC is good in 5 intermediate forms and 3 high forms.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1747361
TI  - Single-stage correction of posterior hypospadias (178 cases). Comparison of three
      techniques: free skin graft, free bladder mucosal graft, transverse pedicle
      preputial graft.
AB  - Three techniques have been developed for single-stage repair of posterior
      hypospadias: free skin grafts, free bladder mucosal grafts, and pedicle preputial
      grafts. This multicenter retrospective study of 178 children who underwent
      surgery for posterior hypospadias was designed to compare the results achieved
      with these procedures. Free skin grafts (15 cases) resulted in the most frequent
      complications, and in particular the most severe strictures; in our opinion this
      technique should be abandoned. Pedicle preputial grafts (133 cases) gave the
      greatest number of successes from the outset, and should be preferred whenever
      the dimensions of the prepuce are sufficient for urethroplasty. Results with
      bladder mucosal grafts (30 cases) were not as good as with preputial grafts, but
      this technique remains the only solution when the meatus is in a very posterior
      position, and for children who have already undergone multiple operations.

PMID- 1747362
TI  - Importance of morphological findings in the progress and treatment of chest wall
      deformities with special reference to the value of computed tomography,
      echocardiography and stereophotogrammetry.
AB  - Patients with chest wall deformities have many particular anatomical,
      physiological, genetic, biomechanical and psychological characteristics. It is
      generally recognized that surgical correction of funnel chest and pigeon breast
      may be done for psychosocial reasons alone. Morphological and dynamic
      investigations are done to identify the function of the deformed chest wall and
      to permit objective assessment of the cosmetic and functional outcomes of the
      operation. There is no universally agreed standard for the diagnosis of funnel
      chest and pigeon breast. Non-invasive investigations, such as computed tomography
      (CT), echocardiography (ECG) and stereophotogrammetry (SP), improve the quality
      of the diagnostic assessment, including evaluation of its functional aspects,
      without directly influencing the decision to operate, which is still made mainly
      on subjective grounds. The value of these techniques in the diagnosis of chest
      wall deformities is assessed and the results of our personal experience are
      presented.

PMID- 1747363
TI  - Origin and treatment of fractures in spina bifida.
AB  - Children with spina bifida cystica have a high risk of fracturing their
      paraplegic legs. During the last fifteen years we observed 261 fractures and
      epiphyseal injuries in 173 children out of 1,400 (12.2%) patients with spina
      bifida. The increased risk of fracture seems to be due to reduced muscle activity
      in the paralysed limb with insufficient axial loading of the legs. A large
      proportion of fractures occurs after orthopedic interventions. Fractures are less
      common after urologic or neurosurgical procedures. Breaks are extremely frequent
      after operations in association with cast immobilization. Early standing and
      short immobilization times are the best defence mechanisms against fractures. If
      plasters are needed postoperatively one should preferably use the "Max and
      Moritz" standing cast. Fractures in spina bifida children heal quickly as
      compared to those in non-paralyzed children. In 30% excessive callus is seen.
      Immobilization for fracture care can be done in a standing cast even in the very
      early phase of treatment. In spite of the swelling and elevated temperature axial
      loading in the standing cast should continue. Splints and braces can be used
      instead of the plaster cast. By any means, the vicious circle of Fracture-Plaster
      Fracture-Plaster should be avoided. Repeated stress on the growth plate causes a
      mechanism of loosening. The most common site is the distal tibia and femur, less
      often loosenings occur in the proximal tibia and proximal femur. Epiphyseal
      loosening is a nosological entity seen in spina bifida and also in congenital
      absence of sensation. Distal tibial epiphyseal loosening is frequently seen in
      adolescents who have learned to walk only after muscle balancing procedures in
      the hips.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1747364
TI  - Uncommon torticollis in children.
AB  - We report on one case of uncommon torticollis in children caused by a pencil cap
      lodged in the neck. Diagnosis had been established two months after the trauma,
      during a screening for oro-pharyngeal cancer. The foreign body had pierced the
      posterior wall of pharynx without damaging the spine and large vessels.

PMID- 1747365
TI  - Gastric duplication communicating with an aberrant pancreas.
AB  - A case of gastric duplication in connection with an aberrant pancreas in a 14
      months old boy is related. The non-specificity of signs and symptoms explains why
      the diagnosis of these lesions has been often mislead and usually made at
      laparotomy. Ultrasound and technetium scan could adequately characterize these
      anomalies pre-operatively. Simple excision is the treatment of choice.

PMID- 1747366
TI  - Renal oncocytoma in a child.
AB  - Oncocytoma is an exceptionally rare renal tumor in children. We report on one
      case of a twelve-year-old girl treated by nephrectomy.

PMID- 1747367
TI  - Identification of a ferryl intermediate of Escherichia coli cytochrome d terminal
      oxidase by resonance Raman spectroscopy.
AB  - The 680-nm-absorbing "peroxide state" of the Escherichia coli cytochrome d
      terminal oxidase complex, obtained by addition of excess hydrogen peroxide to the
      enzyme, is shown to be a ferryl intermediate in the catalytic cycle of the
      enzyme. This ferryl intermediate is also created by aerobic oxidation of the
      fully reduced enzyme. Resonance Raman spectra with 647.1-nm excitation show an
      FeIV = O stretching band at 815 cm-1, a higher frequency than noted in any other
      ferryl-containing enzyme to date. The band shows an 16O/18O frequency shift of 
      46 cm-1, larger than that observed for any porphyrin ferryl species. The FeIV = O
      formulation was unambiguously established by oxidations of the reduced enzyme
      with 16O2, 18O2, and 16O18O. Only the use of a mixed-isotope gas permitted
      discrimination between a ferryl and a peroxo structure. A catalytic cycle for the
      cytochrome d terminal oxidase complex is proposed, and possible reasons for the
      high v(Fe = O) frequency are discussed.

PMID- 1747368
TI  - Large-scale stable opening of supercoiled DNA in response to temperature and
      supercoiling in (A + T)-rich regions that promote low-salt cruciform extrusion.
AB  - We have studied the properties of (A + T)-rich sequences derived from ColE1 that
      promote cruciform extrusion at low ionic strength in supercoiled plasmids. We
      compared the chemical reactivity of the sequences in negatively supercoiled DNA
      (using osmium tetroxide and bromoacetaldehyde) with the results of two
      dimensional gel electrophoresis performed under the same conditions. Taken
      together, the results indicate the occurrence of cooperative helix-coil
      transitions in the (A + T)-rich DNA at low ionic strength, to form stable,
      denatured regions. The extent of the open region is a function of temperature and
      superhelix density, with an additional local destabilization brought about by the
      presence of cruciform structures. We present a simple statistical mechanical
      model of the helix-coil transition in the (A + T)-rich DNA, from which we have
      obtained estimates of the free energy for average base-pair opening of 0.31 kcal
      mol-1 and that for the formation of a helix-coil junction of 4.9 kcal mol-1, in
      45 mM Tris-borate, pH 8.3, 0.5 mM EDTA. The results offer a model for the C-type
      mechanism of cruciform extrusion. Inverted repeats that are incorporated into the
      melted region undergo hairpin loop formation below 50 degrees C, and upon closure
      of the melted region, by reduction of temperature or increased ionic strength,
      they remain as a fully extruded cruciform structure.

PMID- 1747369
TI  - The mechanism of adenosine to inosine conversion by the double-stranded RNA
      unwinding/modifying activity: a high-performance liquid chromatography-mass
      spectrometry analysis.
AB  - We have used directly combined high-performance liquid chromatography-mass
      spectrometry (LC/MS) to examine the mechanism of the reaction catalyzed by the
      double-stranded RNA unwinding/modifying activity [Bass & Weintraub (1988) Cell
      55, 1089-1098]. A double-stranded RNA substrate in which all adenosines were
      uniformly labeled with 13C was synthesized. An LC/MS analysis of the nucleoside
      products from the modified, labeled substrate confirmed that adenosine is
      modified to inosine during the unwinding/modifying reaction. Most importantly, we
      found that no carbons are exchanged during the reaction. By including H2(18)O in
      the reaction, we showed that water serves efficiently as the oxygen donor in
      vitro. These results are consistent with a hydrolytic deamination mechanism and
      rule out a base replacement mechanism. Although the double-stranded RNA
      unwinding/modifying activity appears to utilize a catalytic mechanism similar to
      that of adenosine deaminase, coformycin, a transition-state analogue, will not
      inhibit the unwinding/modifying activity.

PMID- 1747370
TI  - Structural and thermodynamic consequences of burying a charged residue within the
      hydrophobic core of T4 lysozyme.
AB  - To determine the energetic and structural consequences of placing a charged group
      within the core of a protein, two "buried charge" mutants, Met 102----Lys (M102K)
      and Leu 133----Asp (L133D) were constructed in phage T4 lysozyme. Both proteins
      fold at neutral pH, although they are substantially less stable than wild type.
      The activity of M102K is about 35% that of wild type, while that of L133D is
      about 4%. M102K could be crystallized, and its structure was determined at high
      resolution. The crystal structure (at pH 6.8) of the mutant is very similar to
      that of wild type except for the alpha-helix that includes residues 108-113. In
      wild-type lysozyme, one side of this helix is exposed to solvent and the other
      contacts Met 102. In the M102K structure this alpha-helix becomes much more
      mobile, possibly allowing partial access of Lys 102 to solvent. The stability of
      M102K, determined by monitoring the unfolding of the protein with CD, is pH
      dependent, consistent with the charged form of the substituted amino acid being
      more destabilizing than the uncharged form. The pKa of Lys 102 was estimated to
      be 6.5 both by differential titration and also by NMR analysis of isotopically
      labeled protein with 13C incorporated at the C epsilon position of all lysines.
      As the pH is lowered below pH 6.5, the overall three-dimensional structure of
      M102K at room temperature appears to be maintained to pH 3 or so, although there
      is evidence for some structural adjustment possibly allowing solvent
      accessibility to the protonated form of Lys 102.

PMID- 1747371
TI  - Alboaggregin-B: a new platelet agonist that binds to platelet membrane
      glycoprotein Ib.
AB  - A new protein, called alboaggregin-B (AL-B), has been isolated from Trimeresurus
      albolabris venom by ion-exchange chromatography. It agglutinated platelets
      without the need for Ca2+ or any other cofactor. The purified protein showed an
      apparent molecular mass on SDS-PAGE and gel filtration of about 23 kDa under
      nonreducing conditions. Ristocetin did not alter the binding of AL-B to platelets
      or affect AL-B-induced platelet agglutination. Agglutinating activity was not
      dependent on either proteolytic or lectin-like activity in AL-B. Binding analysis
      showed that AL-B bound to platelets with high affinity (Kd = 13.6 +/- 9.3 nM) at
      approximately 30,800 +/- 14,300 binding sites per platelet. AL-B inhibited the
      binding of labeled bovine von Willebrand factor (vWF) to platelets. Monoclonal
      antibodies against the 45-kDa N-terminal domain of platelet glycoprotein Ib
      inhibited the binding both of AL-B and of bovine vWF to platelets, and also
      inhibited platelet agglutination induced by AL-B and bovine vWF. Specific removal
      of the N-terminal domain of GPIb by treatment of the platelets with elastase or
      Serratia marcescens protease reduced the binding of labeled AL-B and bovine vWF
      to platelets and blocked platelet agglutination caused by both agonists.
      Monoclonal antibodies to glycoprotein IIb/IIIa, to bovine vWF, and to bovine
      serum albumin did not show any effect on the binding of AL-B to platelets. Our
      results indicate that the binding domain for AL-B on platelet GPIb is close to or
      identical with the one for vWF. This new protein may be a very useful tool for
      studying the interaction between platelets and vWF.

PMID- 1747372
TI  - Interaction of microtubule-associated proteins with microtubules: yeast lysyl-
      and valyl-tRNA synthetases and tau 218-235 synthetic peptide as model systems.
AB  - The respective contributions of electrostatic interaction and specific sequence
      recognition in the binding of microtubule-associated proteins (MAPs) to
      microtubules have been studied, using as models yeast valyl- and lysyl-tRNA
      synthetases (VRS, KRS) that carry an exposed basic N-terminal domain, and a
      synthetic peptide reproducing the sequence 218-235 on tau protein, known to be
      part of the microtubule-binding site of MAPs. VRS and KRS bind to microtubules
      with a KD in the 10(-6) M range, and tau 218-235 binds with a KD in the 10(-4) M
      range. Binding of KRS and tau 218-235 is accompanied by stabilization and
      bundling of microtubules, without the intervention of an extraneous bundling
      protein. tau 218-235 binds to microtubules with a stoichiometry of 2 mol/mol of
      assembled tubulin dimer in agreement with the proposed binding sequences
      alpha[430-441] and beta[422-434]. Binding stoichiometries of 2/alpha beta S
      tubulin and 1/alpha S beta S tubulin were observed following partial or complete
      removal of the tubulin C-terminal regions by subtilisin, which localizes the site
      of subtilisin cleavage upstream residue alpha-441 and downstream residue beta
      434. Quantitative measurements show that binding of MAPs, KRS, VRS, and tau 218
      235 is weakened but not abolished following subtilisin digestion of the C
      terminus of tubulin, indicating that the binding site of MAPs is not restricted
      to the extreme C-terminus of tubulin.

PMID- 1747373
TI  - Cytochalasin B interferes with conformational changes of the human erythrocyte
      glucose transporter induced by internal and external sugar binding.
AB  - To gain insight into the mechanism of facilitated sugar transport and possible
      mechanisms by which glucose transporter intrinsic activity might be altered, we
      have investigated conformational changes of the human erythrocyte glucose
      transporter induced by internal and external sugar binding and by the transporter
      inhibitor, cytochalasin B. Changes in the ability of thermolysin to digest
      glucose transporters present in erythrocyte ghosts were used to monitor
      conformational changes of the glucose transporter. The degree of protease
      digestion was determined by the amount of undigested glucose transporter
      remaining after the protease treatment, as assessed in Western blots using the
      glucose transporter specific monoclonal antibody 7F7.5. D-Glucose, the
      physiological substrate of the transporter, increased the transporter's
      susceptibility to cleavage by thermolysin. Nontransportable glucose analogues
      which bind specifically to either an internal or external glucose transporter
      sugar binding site also altered susceptibility of the transporter to thermolysin.
      Both methyl and propyl glucoside, which preferentially bind the internal sugar
      site, increased thermolysin susceptibility of the glucose transporter in a manner
      similar to that of D-glucose. In contrast, 4,6-O-ethylideneglucose, which
      preferentially binds the external sugar site, protected the transporter from
      thermolysin digestion. These results suggest that sugar binding to internal and
      external sugar sites induces distinct conformational changes and that the
      observed D-glucose effect on the susceptibility of the glucose transporter to
      thermolysin is due to D-glucose at equilibrium predominantly forming a complex
      with the internal sugar site. The protection from cleavage by thermolysin caused
      by external sugar binding is attenuated by the addition of an internally binding
      sugar.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1747374
TI  - Development of affinity labeling agents based on nonsteroidal anti-inflammatory
      drugs: labeling of the nonsteroidal anti-inflammatory drug binding site of 3
      alpha-hydroxysteroid dehydrogenase.
AB  - Nonsteroidal anti-inflammatory drugs (NSAIDs) exert their effect by inhibiting
      the target enzyme cyclooxygenase (prostaglandin H2 synthase); however, little is
      known about the peptides comprising its NSAID binding site. Hydroxyprostaglandin
      dehydrogenases also bind NSAIDs, but their NSAID binding sites have not been well
      characterized. Using existing synthetic strategies, we have incorporated the
      bromoacetoxy affinity labeling moiety around the perimeter of two potent NSAIDs,
      indomethacin and mefenamate, a N-phenylanthranilate. The compounds synthesized
      were 1-(4-(bromoacetamido)benzyl)-5-methoxy-2-methylindole-3-acetic acid (1), 3
      (2-(2-bromoacetoxy)ethyl)-1-(4-chlorobenzyl)-5-methoxy-2-methylindole (2), 4
      (bromoacetamido)-N-(2,3-dimethylphenyl)anthranilic acid (3), N-(3
      (bromoacetamido)phenyl)-anthranilic acid (4), and N-(4
      (bromoacetamido)phenyl)anthranilic acid (5). To access whether these compounds
      have general utility in labeling NSAID binding sites, the compounds were
      evaluated as affinity labeling agents for 3 alpha-hydroxysteroid dehydrogenase (3
      alpha-HSD) from rat liver cytosol. This enzyme displays 9-, 11-, and 15
      hydroxyprostaglandin dehydrogenase activity, is inhibited potently by NSAIDs, and
      is homologous to bovine lung prostaglandin F synthase. Compounds 1-5 were shown
      to affinity label the NSAID binding site of 3 alpha-HSD. They inactivated 3 alpha
      HSD through an E.I complex in a time- and concentration-dependent manner with
      t1/2 values ranging from seconds to hours. Ligands that compete for the active
      site of 3 alpha-HSD (NAD+ and indomethacin) afforded protection against
      inactivation, and the inactivators could demonstrate competitive kinetics against
      3 alpha-hydroxysteroid substrates by forming an E.NAD+.I complex.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1747375
TI  - Transport and metabolism of glucose in an insulin-secreting cell line, beta TC-1.
AB  - Kinetic characteristics of glucose transport and glucose phosphorylation were
      studied in the islet cell line beta TC-1 to explore the roles of these processes
      in determining the dependence of glucose metabolism and insulin secretion on
      external glucose. The predominant glucose transporter present was the rat
      brain/erythrocyte type (Glut1), as determined by RNA and immunoblot analysis. The
      liver/islet glucose transporter (Glut2) RNA was not detected. The functional
      parameters of zero-trans glucose entry were Km = 9.5 +/- 2 mM and Vmax = 15.2 +/-
      2 nmol min-1 (microL of cell water)-1. Phosphorylation kinetics of two hexokinase
      activities were characterized in situ. A low-Km (0.036 mM) hexokinase with a Vmax
      of 0.40 nmol min-1 (microL of cell water)-1 was present along with a high-Km (10
      mM) hexokinase, which appeared to conform to a cooperative model with a Hill
      coefficient of about 1.4 and a Vmax of 0.3 nmol min-1 (microL of cell water)-1.
      Intracellular glucose at steady state was about 80% of the extracellular glucose
      from 3 to 15 mM, and transport did not limit metabolism in this range. In this
      static (nonperifusion) system, 2-3 times more immunoreactive insulin was secreted
      into the medium at 15 mM glucose than at 3 mM. The dependence of insulin
      secretion on external glucose roughly paralleled the dependence of glucose
      metabolism on external glucose. Simulations with a model demonstrated the degree
      to which changes in transport activity would affect intracellular glucose levels
      and the rate of the high-Km hexokinase (with the potential to affect insulin
      release).

PMID- 1747376
TI  - Analysis of hydride transfer and cofactor fluorescence decay in mutants of
      dihydrofolate reductase: possible evidence for participation of enzyme molecular
      motions in catalysis.
AB  - A remarkable correlation has been discovered between fluorescence lifetimes of
      bound NADPH and rates of hydride transfer among mutants of dihydrofolate
      reductase (DHFR) from Escherichia coli. Rates of hydride transfer from NADPH to
      dihydrofolate change by a factor of 1,000 for the series of mutant enzymes. Since
      binding constants for the initial complex between coenzyme and DHFR change by
      only a factor of 10, the major portion of the change in hydride transfer must be
      attributed to losses in transition-state stabilization. The time course of
      fluorescence decay for NADPH bound to DHFR is biphasic. Lifetimes ranging from
      0.3 to 0.5 ns are attributed to a solvent-exposed dihydronicotinamide
      conformation of bound coenzyme which is presumably not active in catalysis, while
      decay times (tau 2) in the range of 1.3 to 2.3 ns are assigned to a more tightly
      bound species of NADPH in which dihydronicotinamide is sequestered from solvent.
      It is this slower component that is of interest. Ternary complexes with three
      different inhibitors, methotrexate, 5-deazafolate, and trimethoprim, were
      investigated, along with the holoenzyme complex; 3-acetylNADPH was also
      investigated. Fluorescence polarization decay, excitation polarization spectra,
      the temperature variation of fluorescence lifetimes, fluorescence amplitudes, and
      wavelength of absorbance maxima were measured. We suggest that dynamic quenching
      or internal conversion promotes decay of the excited state in NADPH-DHFR. When
      rates of hydride transfer are plotted against the fluorescence lifetime (tau 2)
      of tightly bound NADPH, an unusual correlation is observed. The fluorescence
      lifetime becomes longer as the rate of catalysis decreases for most mutants
      studied. However, the fluorescence lifetime is unchanged for those mutations that
      principally alter the binding of dihydrofolate while leaving most
      dihydronicotinamide interactions relatively undisturbed. The data are interpreted
      in terms of possible dynamic motions of a flexible loop region in DHFR which
      closes over both substrate and coenzyme binding sites. These motions could lead
      to faster rates of fluorescence decay in holoenzyme complexes and, when
      correlated over time, may be involved in other motions which give rise to
      enhanced rates of catalysis in DHFR.

PMID- 1747377
TI  - Kinetics of extension of O6-methylguanine paired with cytosine or thymine in
      defined oligonucleotide sequences.
AB  - The frequency of extending m6G.C or m6G.T pairs, when the 3' and 5' flanking
      neighbors of m6G are either cytosines or thymines, was investigated using primed
      25-base-long oligonucleotides and the Klenow fragment of Escherichia coli DNA
      polymerase I (Kf). The efficiency, Vmax/Km, of extension to the following normal
      base pair was up to 40-fold greater than for the formation of the m6G.T or m6G.C
      pair. The frequencies of inserting either dCMP or dTMP opposite these m6G bases
      did not appear to be different in the two sequences, C-m6G-C and T-m6G-T, but
      extension was favored in the C-m6G-C sequence. The m6G.T pair extended to a C.G
      pair most efficiently, indicating that it was not a strong block to continued
      replication past the template lesion. Thus, m6G.T flanked by cytosines replicates
      more readily than when flanked by thymines, increasing G----A transitions. These
      data lend further support to the importance of sequence context in mutagenesis.

PMID- 1747378
TI  - What educational requirements for a nursing executive?
AB  - A review of the literature, interviews with nursing executives in community and
      tertiary care facilities, and consideration of courses at one Canadian university
      are the basis for the development of a sample graduate level nursing program with
      an administration major. Course inclusion was predicated by the defined roles of
      practising nursing executives. Future trends in health care were considered as
      they affect needs for programming.

PMID- 1747379
TI  - Interviewing for a deanship in nursing--an informed process.
AB  - This article has been written to assist those individuals who aspire to
      administration in nursing education. Being interviewed for a Deanship is an
      exacting experience during which the candidate must make an impression, as well
      as, collect enough data upon which an informed decision can be made. Good
      preparation for the process is essential. Data is gathered about the School, the
      people in the School (faculty, students and staff), the position (and the
      University and the professional community), as well as, the community. No one
      School of Nursing is perfect but the informed candidate will be more able to
      decide which risks are worth taking.

PMID- 1747380
TI  - The staff nurse employment interview selection process: judgment and decision
      errors and how to avoid them. Part I.
AB  - The employee interview is a complex decision-making process which has a potential
      effect on the future of the organization. It is in the organization's best
      interest to ensure that the interview process results in the selection of
      candidates who most clearly meet predetermined selection criteria. Reliable and
      valid interviews improve the probability of selecting candidates who are most
      likely to succeed. A review of employment interview literature is discussed
      relating to judgement and decision errors, and the reliability and validity of
      the employment interview. Part II will review the development of a
      semistructured, employment interview questionnaire which was based on College of
      Nurses of Ontario Standards of Practice (1984) and staff nurse position
      description.

PMID- 1747381
TI  - The staff nurse employment interview: predicting performance outcomes. Part II.
AB  - The Employment Standards Act of Ontario and Labour Relations policy in health
      care organizations require that employment decisions be based on the comparative
      level of knowledge, skills, abilities, and experience of job applicants. Reliable
      and valid employment interviews guide employers in that process. A semistructured
      staff nurse employment interview tool was developed and tested for reliability
      and validity (content and predictive) on a medical unit in an acute-care hospital
      setting. Of 25 interview questions evaluated as having content validity based on
      comparison with the job analysis and Standards of Practice, five (holistic care,
      assessments of patient's ability to cope, teaching, collaboration, and problem
      solving) were identified as having statistically significant relationships with
      performance outcomes evaluated one year after the initial interview. Total
      interview test scores were predictive of overall competency in job performance.
      Those questions evaluated as content valid and as attaining predictive validity
      were used as the basis for the development of a structured staff nurse employment
      interview questionnaire.

PMID- 1747382
TI  - A barometer for nursing education: the health of Canadian universities.

PMID- 1747383
TI  - The head nurse: perceptions of stress and ways of coping.
AB  - Head nurses occupy an important position in hospitals, but there have been few
      studies of the stress experienced by these first line managers. The purpose of
      this research was to investigate patterns and sources of workplace stress and how
      head nurses coped with it. Twenty-one head nurses from four teaching hospitals
      were interviewed. Major sources of stress were lack of resources including
      nursing staff, work load and powerlessness. Events were seen as stressful because
      the head nurse lacked control or did not feel competent. Length of time in
      position affected perceptions of stress. Coping with stress was generally through
      problem-focused strategies. The findings may reflect the impact of role changes
      on head nurses.

PMID- 1747384
TI  - Cholesterol-induced alteration of apolipoprotein A-I conformation in reassembled
      high density lipoprotein.
AB  - Recent reports have shown that apolipoprotein A-I (apo A-I), the major protein of
      high density lipoprotein (HDL) may exist in different conformational states. We
      studied the effects of apolipoprotein A-II and/or cholesterol on the conformation
      of apo A-I in reassembled HDL. Analysis of tryptophan fluorescence quenching in
      the presence of iodine suggested that cholesterol increased the number of apo A-I
      tryptophan residues accessible to the aqueous phase, but decreased their mean
      degree of hydration. These observations cannot be totally explained on the basis
      of the effect of cholesterol on phospholipid viscosity as determined by
      fluorescence anisotropy of diphenyl hexatriene. We did not observe any effect of
      apo A-II on the conformation of apo A-I.

PMID- 1747385
TI  - Characterization of an osmoregulated periplasmic glycine betaine-binding protein
      in Azospirillum brasilense sp7.
AB  - Azospirillum brasilense is able to use glycine betaine as a powerful
      osmoprotectant; the uptake of this compound is strongly stimulated by salt
      stress, but significantly reduced by cold osmotic shock. Non-denaturing PAGE in
      the presence of [methyl-14C] glycine betaine and autoradiography demonstrated the
      presence of one glycine betaine-binding protein (GBBP) in periplasmic shock fluid
      obtained from high-osmolarity-grown cells. The binding activity was absent in
      periplasmic fractions from cells grown at low osmolarity. SDS-PAGE analysis
      showed that the osmotically inducible GBBP has an apparent molecular weight of
      32,000. The isoelectric point was between 5.9 and 6.6, as determined by
      isoelectric focusing. This protein bound glycine betaine with high affinity (KD
      of 3 microM), but had no affinity for either other betaines (proline betaine,
      gamma-butyrobetaine, pipecolate betaine, trigonelline, homarine) or related
      compounds (choline, glycine betaine aldehyde, glycine and proline). Optimum
      binding activity occurred at pH 7.0 to 7.5, and was not altered whether or not
      the binding assays were done at low or high osmolarity. Immunoprecipitation and
      Western blotting showed that immunoadsorbed anti-GBBP antibody from E coli cross
      reacted with the GBBP produced by A brasilense cells grown at high osmolarity.

PMID- 1747386
TI  - Kinetic properties of normal human erythrocyte glucose-6-phosphate dehydrogenase
      dimers.
AB  - The steady-state kinetics of normal human erythrocyte glucose-6-phosphate
      dehydrogenase (D-glucose-6-phosphate: NADP+ oxidoreductase, EC 1.1.1.49) dimers
      were studied as a function of pH and temperature. Inhibition studies using
      glucosamine 6-phosphate, NADPH and p-hydroxymercuribenzoate (P-OHMB) were also
      carried out at pH 8.0. The existence of two binding sites on the enzyme with a
      transition from low to high affinity for NADP+ when NADP+ concentration is
      increased is indicated by the nonlinear Lineweaver-Burk plots and sigmoid kinetic
      patterns. NADPH inhibition was found to be competitive with respect to NADP+ and
      non-competitive with respect to glucose-6-phosphate. Logarithmic plot of Vmax
      against pH and inactivation by P-OHMB indicate the participation in the reaction
      mechanism of imidazolium group of histidine and sulhydryl groups. The initial
      velocity and product inhibition data gave results which are consistent with the
      dimeric enzyme following an ordered sequential mechanism. A possible random
      mechanism is ruled out by the inhibition results of glucosamine 6-phosphate.

PMID- 1747387
TI  - Mechanogenetic regulation of transcription.
AB  - In many biological systems mechanical forces regulate gene expression: in
      bacteria changes in turgor pressure cause a deformation of the membrane and
      induce the expression of osmoregulatory genes; in plants gravity regulates cell
      growth ('geotropism'); in mammals stretching a muscle induces hypertrophy which
      is accompanied by qualitative changes in protein synthesis. Consequently, the
      term 'mechanogenetic control' seems to be a suitable common name for all these
      processes. The mechanism by which mechanical factors modulate transcriptional
      activity is still unknown. The purpose of this review is to bring together data
      from different fields in order to obtain a better understanding of the
      mechanogenetic control of cell growth.

PMID- 1747388
TI  - Structure and biological activity of crustacean gastrointestinal peptides
      identified with antibodies to gastrin/cholecystokinin.
AB  - Four gastrin/cholecystokinin-like peptides (G/CCK) which cross-react with a
      specific C-terminal gastrin/CCK antiserum have been isolated from the stomach of
      the marine crustacean Nephrops norvegicus. The molecular weight of the four
      peptides was estimated between 1000 and 2000 Da by molecular sieving. By
      radioimmunoassay, the cross-reactivity of these peptides with human gastrin 17-I
      was found to be around 0.03%. Pure peptidic fractions were recovered after four
      successive steps of HPLC. Amino-acid analysis suggested a similarity between the
      four peptides identified which may belong to a new family. A limited homology
      between the C-terminus of one Nephrops peptide and vertebrate G/CCK was found
      after sequencing. Two of the peptides exhibited secretagogue effects on
      crustacean isolated midgut glands. The Nephrops peptides, although structurally
      distinct from the vertebrate G/CCKs, appear to serve similar biological functions
      in crustaceans.

PMID- 1747389
TI  - The initiation codon AUG binds at a hydrophobic site on yeast 40S ribosomal
      subunits as revealed by fluorescence studies with bis (1,8
      anilinonaphthalenesulfonate).
AB  - Binding studies of yeast 40S ribosome with bis (1,8-anilinonaphthalenesulfonate)
      (bis-ANS) revealed the binding of 3-4 molecules of bis-ANS per ribosome with a
      dissociation constant (Kd) of 1.45 microM. Binding of AUG to the 40S subunits
      resulted in a concentration-dependent decrease in the bis-ANS fluorescence
      without displacing all of the bound bis-ANS from the ribosomes. The residual bis
      ANS fluorescence at saturation with AUG corresponds to about 3 molecules of bis
      ANS per ribosome. Thus AUG displaces one of the bound bis-ANS molecules. The data
      suggest that AUG binds at a hydrophobic site on the yeast 40S subunit.

PMID- 1747390
TI  - Purification and characterization of a germ cell-specific form of elongation
      factor 1 alpha (EF-1 alpha) from Xenopus laevis.
AB  - Elongation factor 1 alpha (EF-1 alpha) was purified to homogeneity from full
      grown oocytes of Xenopus laevis. This protein is encoded by a gene previously
      shown to be expressed in male and female germ cells, and repressed in somatic
      cells. The purified protein was identified with EF-1 alpha on criteria of
      molecular mass, cross-reaction with antibodies raised against Artemia salina EF-1
      alpha, affinity for guanine nucleotides, and ability to promote the mRNA
      dependent binding of aminoacyl tRNA to 80S ribosomes.

PMID- 1747391
TI  - Pineal gland transplants into the cerebral hemisphere of newborn rats: a study of
      the blood brain barrier and innervation.
AB  - Pineal glands from neonatal (0-1 day) Long-Evans black-hooded rats were
      transplanted into the cerebral hemispheres of litter mates for periods of 1 to
      5.5 months. Grafts exhibited differentiated pinealocytes that were intensely
      immunoreactive for serotonin. Transplant vasculature was permeable to endogenous
      IgG, comprised fenestrated endothelia with wide pericapillary spaces typical of
      in situ glands, and had a volume density intermediate to that of surrounding
      cortex and in situ pineals. Along the periphery, transplant capillaries tended to
      have continuous endothelia similar to those of host cortex. This peripheral zone
      was impermeable to endogenous IgG and appeared to increase in size in older
      grafts. The presence of noradrenergic-like fibers within the perivascular
      compartment suggested that transplants were innervated by peripheral sympathetic
      neurons from the superior cervical ganglia. In animals which had been superior
      cervical ganglionectomized, noradrenergic-like fibers were absent or
      degenerating. Neural regulation of transplant metabolic activity was suggested by
      the increased frequency of pinealocyte synaptic ribbons in denervated grafts.
      These findings are consistent with the hypothesis that factors from both graft
      and host influence vasculature physiology and differentiation in neural
      transplants. Furthermore, grafts appeared to receive appropriate neural input
      from the peripheral sympathetic system.

PMID- 1747392
TI  - Electrophysiological and morphological properties of embryonic neocortical grafts
      developing in different regions of the host rat brain.
AB  - Parallel morphological and electrophysiological studies of embryonic neocortical
      tissue (primordia of anterior parietal--presumptive sensorimotor--cortex) grafted
      into different regions of the host adult brain (sensori-motor cortex, caudate
      putamen, septum or thalamus) were carried out to investigate to what extent the
      properties of transplanted embryonic neocortex--an advanced organizational form
      of neuronal tissue--are affected by homotopic or heterotopic surroundings. The
      results point to the importance of the host tissue environment as it influences
      both the size, the morphological and functional properties of the implanted
      embryonic cortical plate tissue. The cortical grafts were smaller in size when
      developed homo-topically in sensorimotor cortex and grew larger in heterotopic
      environment (caudate-putamen, septum, thalamus). The orientation of neuronal
      dendrites in the grafts tends to follow that seen in the surroundings. The
      homotopic grafts showed a better structural integration into the host brain.
      Differences were seen between intracortical and subcortical transplants in the
      spontaneous firing rate of neurons and in the ratio of units with various types
      of spontaneous discharge.

PMID- 1747393
TI  - Intraocular retinal transplantation: a review.
AB  - This review covers intraocular transplantation of retinal tissue. This has
      importance both for theoretical understanding of retinal and neural development
      and for possible future clinical application. Transplantation sites have ranged
      from the anterior chamber through the retina to the subretinal space.
      Transplanted tissue has ranged from whole retina to specific retinal layers or
      specific types of retinal cells. Both within-species and inter-species
      transplants have been performed, and donor age has ranged from embryonic to
      adult. The ability of transplanted tissue to be accepted and to differentiate in
      host eyes has been studied. The conditions under which successful transplants are
      obtained, host-graft interactions, and transplantation methodologies have been
      explored. Morphological, and to a small extent, also functional characteristics
      of the transplants have been studied.

PMID- 1747394
TI  - Survival and synapse formation of transplanted rat rods.
AB  - Isolated rods enzymatically removed from normal adult rat retina have been
      transplanted to the subretinal space of adult rats with a retinal dystrophy which
      has destroyed almost all the photoreceptors. These transplanted rods survive for
      months after transplantation during which time they form synapses with other
      retinal cells. Rod spherules with large amounts of synaptic vesicles and synaptic
      ribbons are found forming discreet contacts with pre- and post-synaptic densities
      in arrangements closely resembling those seen in the normal retina.

PMID- 1747395
TI  - A comprehensive method validation strategy for bioanalytical applications in the
      pharmaceutical industry--2. Statistical analyses.
AB  - The first paper in this two-part series described [Lang and Bolton, J. Pharm.
      Biomed. Anal. 9, 357-361 (1991)] an overall validation strategy for bioanalytical
      methods. This second paper focuses on the statistical analyses performed on the
      validation data that will allow the analyst to evaluate the reliability and
      reproducibility of a bioanalytical method. Based on the validation results,
      acceptance criteria for the quality control concentrations are established and
      used during the study proper to determine if the analytical run is valid. After
      analysing the clinical study samples and accepting the analytical runs, the
      quality control results are incorporated into databases to update their
      acceptance limits. This continuous validation process enables the analyst to
      monitor the method's performance over time and be confident that accurate sample
      concentrations are being reported. It is important to emphasize that the
      statistical analyses of the data provide information that should be considered
      from a practical point of view by the analyst. The analyst should use sound
      judgement in evaluating the reliability of the method.

PMID- 1747396
TI  - Photostability testing of drug substances and drug products in UK pharmaceutical
      laboratories.
AB  - Results of a survey on photostability testing of drug substances and products by
      UK pharmaceutical laboratories are presented. The results indicate diverse
      practices in the form of presentation of the product and particularly in exposure
      to light (as measured in lx days), although there was more consistency in
      analytical methods and in the analytical criteria used to classify products as
      stable or unstable for those laboratories adopting this type of classification. A
      majority of laboratories use daylight in addition to artificial light sources for
      tests on drug substances and products. Artificial daylight fluorescent tubes and
      xenon lamps are the most widely used sources of artificial light and both should
      provide a reasonable simulation of natural light. All laboratories intend their
      photostability tests to represent light exposure which exceeds that expected to
      occur in practice but the tests actually applied vary widely in severity as shown
      in the wide range in light exposure (8-4500 klx days). Therefore the
      classification of products as stable or unstable needs to be considered carefully
      in relation to the severity of the test used. Testing procedures for drug
      substances are broadly similar to those used for drug products. It is concluded
      that the variation in testing procedure is the result of differing perceptions
      regarding product exposure in practical usage and the absence of regulatory
      guidelines.

PMID- 1747397
TI  - Solubility and acid-base behaviour of midazolam in media of different pH, studied
      by ultraviolet spectrophotometry with multicomponent software.
AB  - The solubility of midazolam is less than 0.1 mg ml-1 at neutral pH and it
      increases considerably in acidic media. A pKa value of 6.04 at 24 +/- 1 degree C
      was calculated from the solubility data. In acidic media midazolam is reversibly
      converted to the corresponding benzophenone (open-ring form). The extent of this
      reaction was investigated by assaying the two compounds simultaneously by UV
      spectrophotometry with multicomponent software. The structure of the benzophenone
      derivative was verified by IR, MS and 1H and 13C NMR spectrometry.

PMID- 1747398
TI  - Synthesis and identification of pilocarpic acid diesters, prodrugs of
      pilocarpine.
AB  - A series of new pilocarpic acid diesters were synthesized to obtain prodrugs for
      pilocarpine with varying physico-chemical properties. Thermospray liquid
      chromatography-mass spectrometry (TSP-LC-MS), liquid chromatography with UV
      detection (LC-UV) and NMR-spectroscopy were used for the identification of the
      synthetic products and for evaluation of their purity including typical
      impurities (pilocarpic acid monoester, pilocarpine). TSP-LC-MS-analysis was
      performed in the reversed-phase mode using acetonitrile (60%)-0.2 M ammonium
      acetate (40%) as mobile phase. In LC-UV-analysis chromatographic separation was
      carried out on a reversed-phase column and the mobile phase consisted of methanol
      (71%) and 0.02 M potassium dihydrogen phosphate, pH 4.5 (29%). Electron
      ionization-mass spectrometry (EI-MS) was used for elucidation of structures.
      Elemental compositions of the substances were verified with high resolution-mass
      spectrometry (HR-MS). The complete establishment of structures presented was
      based on 1H-, and COSY-NMR-spectroscopy joined to TSP-LC-MS-analysis.

PMID- 1747399
TI  - Use of normal-phase microcolumn high-performance liquid chromatography for the
      study of hydrolytic stability, metabolic profiling and pharmacokinetics of an
      antiepileptic drug, benzonal.
AB  - A normal-phase microcolumn HPLC method is proposed for the quantitative
      determination of the most frequently used antiepileptic drugs and some compounds
      developed recently. The main advantage of this method, in comparison with other
      micro-scale HPLC techniques for antiepileptic drugs, is that it is used under
      isocratic conditions at room temperature (22 degrees C). The hydrolytic stability
      of benzonal (BZ) has been studied using this method together with mass
      spectrometry (MS), and IR, UV and NMR spectroscopy. Three pathways of hydrolytic
      degradation were established in alkaline conditions, whereas in an acid medium
      only one of these routes was followed. An investigation of the metabolic
      profiling of BZ in guinea-pigs showed that the drug undergoes fast hydrolysis in
      the intestinal tract forming phenobarbitone (PB) and benzoic acid (BA). Only PB
      was detected in brain tissue and it is probably responsible for the whole
      therapeutic effect. The pharmacokinetic parameters of this metabolite (PB) were
      determined in guinea-pigs, and their identity with the pharmacokinetic parameters
      of PB as the parent drug was confirmed.

PMID- 1747400
TI  - Analysis of nifedipine and its pyridine metabolite dehydronifedipine in blood and
      plasma: review and improved high-performance liquid chromatographic methodology.
AB  - A reversed-phase HPLC method is described for the simultaneous determination of
      nifedipine and its primary pyridine metabolite dehydronifedipine in blood and
      plasma, that involves UV detection and neutral (blood) or alkaline (plasma)
      extraction. The limit of reliable determination is found to be 3 ng ml-1 with an
      inter-assay RSD of below 11%. In the presence of haemoglobin, nifedipine is
      unstable at pH greater than 10, necessitating neutral extraction for the
      measurement of nifedipine in haemolysed blood. Published methods for analysis of
      nifedipine are reviewed, emphasizing the lack of specificity and sensitivity
      which render many of them unsuitable for the investigation of nifedipine
      disposition in man.

PMID- 1747401
TI  - Determination of clenbuterol in urine of calves by high-performance liquid
      chromatography with in series ultraviolet and electrochemical detection.
AB  - A method for the determination of clenbuterol in calf urine is described. After a
      simple two-step sample pretreatment, involving an Extrelut-3 column and a solid
      phase extraction column (C2), the separation of clenbuterol from interfering
      compounds present in urine samples was performed with ion-pair chromatography on
      a LiChrospher RP-Select-B column with a mixture of acetonitrile and sodium
      dodecyl sulphate/acetate buffer (pH 3.5) as mobile phase. To obtain a higher
      specificity, two different physico-chemical detection techniques, i.e. UV
      absorption (244 nm) and electrochemical detection (+1250 mV), were applied in
      series. The lowest limit of determination was 0.5 ng ml-1 and the mean recovery
      of clenbuterol spiked at 10 ng ml-1 level was 79.9% (RSD = 6.3%; n = 9). The
      analysis of one urine sample, including sample preparation, took less than 2 h.
      Results obtained with this method correlated well with GC-MS analysis. With the
      described method about 400 urine samples were analysed. In a pilot experiment, in
      which a calf received orally 4 micrograms clenbuterol.HCl per kilogram body
      weight twice a day (five times the therapeutic dose for oral application) for 5
      days, the highest concentration of clenbuterol found in urine was 73 ng ml-1. In
      a second experiment, in which two calves received the therapeutic dose of
      clenbuterol.HCl twice a day over a period of 2 weeks, the highest concentration
      of clenbuterol was 75 ng ml-1 of urine. Eight days after the final application,
      concentrations of clenbuterol were lower than 0.5 ng ml-1. From this excretion
      study for clenbuterol a half-life value of approximately 1.5 days was calculated.

PMID- 1747402
TI  - Derivatized beta-cyclodextrins combined with high field NMR for enantiomer
      analysis: application to ICI 185,282 (5(Z)-7- ([2RS,4RS,5SR]-4-o-hydroxyphenyl-2
      trifluoromethyl-1,3-dioxan-5-yl) heptenoic acid).

PMID- 1747403
TI  - Stability of adrenaline pH-adjusted solutions of local anaesthetics.

PMID- 1747404
TI  - The determination of 2,6-diisopropylphenol (propofol) in an oil in water emulsion
      dosage form by high-performance liquid chromatography and by second derivative UV
      spectroscopy.

PMID- 1747405
TI  - Rapid simultaneous determination of trimethoprim, sulphamethoxazole and
      acetylsulphamethoxazole in human plasma and urine by high-performance liquid
      chromatography.

PMID- 1747406
TI  - Determination of (3-[1-(4-chlorobenzyl)-3-t-butyl-thio-5-isopropylindol-2- yl]
      2,2-dimethylpropanoic acid), a novel leukotriene biosynthesis inhibitor, in human
      plasma and urine by liquid chromatography.

PMID- 1747407
TI  - [Analysis of the structure of prolactin terminal fragments as potential
      substrates of serine and proline-specific proteinases].
AB  - The biochemical mechanism of action of prolactin is unknown. This hormone enters
      the blood stream and binds to receptors predominantly in the monomeric form. A
      structural analysis of mammalian and piscine prolactin based on the present-day
      concepts of proteolytic processing of the hormone molecules in target tissues has
      been carried out. The experimental data suggest that prolactin molecules are
      protected from exopeptidase influence by their terminal cyclic peptides. The
      highly conservative proline-2 residues increase the resistance of the mammalian
      hormone N-terminal fragment to the effects of many aminopeptidases. Structurally
      the C-terminal cyclic peptides of prolactin, growth hormone and placental
      lactogen were shown to be homologous to peptides inhibiting trypsin-like
      proteinases. A structural analysis of the N-terminal domain of mammalian
      prolactin revealed the important role of Pro-2 and Pro-4 residues at positions
      adjacent with and inside the disulfide moiety. It is assumed that these proline
      residues and the cyclic structure are necessary for the manifestation of the
      inhibiting effect of the mammalian prolactin N-terminal dodecapeptide on proline
      specific proteinases. It is assumed that proteolytic degradation of prolactin
      molecules in target tissues may induce the secretion of functionally active
      peptides.

PMID- 1747408
TI  - [Inhibition of Fc-receptor dependent platelet aggregation by monoclonal
      antibodies against the glycoprotein IIb-IIIa complex].
AB  - A murine monoclonal antibody (MoAb) VM16a specifically binding to human platelets
      has been produced. Approximately 56,000 molecules of VM16a bound per platelet at
      saturation (Kd = 7.9 nM) but no binding to platelets from Glanzmann's
      thrombasthenia patients was detected. VM16a precipitated two proteins with
      molecular masses corresponding to those of glycoproteins (GP) IIb and IIIa from
      solubilized surface-labelled platelets. However, after dissociation of the GPIIb-
      IIIa complex with EDTA VM16a did not bind to platelets and precipitated nothing
      from their lysate, thus evidencing that its determinant is complex-dependent.
      VM16a had no effect on ADP-, thrombin- and ristocetin-induced platelet
      aggregation but inhibited the aggregation induced by collagen. This inhibitory
      effect was more pronounced in the presence of plasma. VM16a completely blocked
      the Fc-receptor-mediated aggregation induced by aggregated human IgG, aggregated
      murine IgG1 and the previously described MoAb VM58. F(ab')2 fragments of VM16a
      were also able to inhibit this aggregation by decreasing the rate of aggregation
      induced by aggregated IgG and by extending the lag phase of VM58-induced
      aggregation. These results suggest that the platelet Fc-receptor may be
      topographically associated with the GPIIb-IIIa complex.

PMID- 1747409
TI  - [Substrate specificity of T4 RNA-ligase. The role of phosphate nucleotide
      residues in the formation of a covalent AMP-RNA-ligase complex].
AB  - The inhibiting effect of adenosine, AMP, ADP, ATP, gamma-thio ATP (I), beta,gamma
      imine ATP (II), beta,gamma-methylene ATP (III), P1,P3-di(adenosine-5')
      triphosphate (IV), P1,P4-di(adenosine-5') tetraphosphate (V) and adenosine 5'
      tetraphosphate (VI) on the first step of the T4 RNA ligase reaction was studied.
      All the compounds tested, with the exception of adenosine, appeared to be
      competitive inhibitors of the first step of the enzymatic reaction. The
      inhibition constants (Ki) for the ATP analogs were determined. The data obtained
      suggest that the efficiency of inhibition depends on the number of phosphate
      groups and on the structure of ATP analogs. All the compounds under study (I-VI),
      except for AMP and ADP, form covalent AMP-RNA ligase complexes.

PMID- 1747410
TI  - [Metabolism of cholesterol esters in cultured macrophages under the action of the
      calcium antagonists verapamil and nifedipine].
AB  - Using mouse macrophage cultures, the effects of verapamil and nifedipine on
      cholesterol ester metabolism were studied with special reference to the following
      parameters: i) incorporation of 14C-oleate into cholesterol esters (ChE), ii)
      contents of common and free cholesterol (FCh), iii) removal of 14C-oleate from
      ChE and incorporation of 3H-FCh into ChE and, iiii) excretion of 3H-Ch from the
      cells. Verapamil and nifedipine (10-100 microM) decreased the incorporation of
      14C-oleate into ChE, increased the concentration of FCh but had no appreciable
      effect on the concentration of common Ch in macrophages cultured in the presence
      of acetylated low density lipoproteins. The drugs stimulated the removal of 14C
      oleate from cellular ChE. The pharmacological concentrations (25-75 microM) of
      verapamil and nifedipine increased the excretion of 3H-Ch from ChE of macrophages
      in the presence of serum and high density lipoproteins. The results obtained
      suggest that verapamil and nifedipine mediate the antiatherosclerotic effect via
      reduction of intracellular synthesis of ChE, stimulation of ChE hydrolysis and
      cholesterol excretion from the cells.

PMID- 1747411
TI  - [Interconnection between the structure and protective action of normal and
      pathological ceruloplasmin preparations in copper-induced erythrocyte lysis].
AB  - It was found that the differences in the protective effects of ceruloplasmin (CP)
      isolated from the blood of healthy donors and of the ceruloplasmin-like protein
      (pat-CP) isolated from the blood of patients with hepatovertebral dystrophy (HCD)
      during Ca(2+)-induced lysis of erythrocytes (RBC) result from significant changes
      in the carbohydrate fragment of pat-CP, the bulk of which (65%) is devoid of
      mannose and acetylglucosamine residues. According to the data from lentil-lectin
      Sepharose chromatography, only 4% of pat-CP molecules contain the [formula; see
      text] fragment necessary for the binding to ER receptors. The curves reflecting
      the Cu2+ accumulation in healthy donor ER and in pat-CP during the Cu(2+)-induced
      lysis were found to differ significantly. The ability of pat-CP to prevent the
      accumulation of Cu2+ in ER and pat-ER was markedly decreased compared with CP.
      Besides, CP prevented the diminution of reduced glutathione (GSH) in ER in a
      greater degree than pat-CP, whereas pat-ER, in contrast with CP, had no effect on
      the GSH concentration in pat-ER. It is suggested that the reactions occurring in
      the cell during Cu(2+)-induced lysis of ER and pat-ER are different.

PMID- 1747412
TI  - [Oxidative iodination of rabbit IgG: localization of markers in an Fc-fragment
      and effects of modification].
AB  - A comparative study of rabbit IgG, both native and modified ones, designed to
      assess the functional activity of these proteins under oxidative iodination
      conditions has been carried out. Polyclonal IgG, its antigen-specific fraction
      and Iodogen as an oxidant were used. Polyclonal antibodies directed against the
      CH2 domain of IgG, protein A targeted at the CH-2-CH3 domain interface and
      ferritin testing the conformation of the antigen-binding Fv fragment, were
      applied as conformational probes for assessing the changes in the IgG
      conformation. By taking advantage of pepsin proteolysis of [125I]-IgG, from 80%
      to 92% of the label was found to be localized within the CH3 domain, thus
      implying the domain-selective nature of iodination, when the degree of
      modification was below 0.1 atom of iodine per IgG molecule. Yet, when the three
      above-mentioned conformational probes were used, considerable alterations in the
      conformation of not only the CH2 domain and CH2-CH3 domain interface, but in the
      Fv domain being a part of the Fab fragment, were observed. By using competitive
      enzyme immunoassay for the straightforward comparative evaluation of functional
      properties of "cold" (native) and 125I-modified IgG, the deleterious effect of
      the oxidant (Iodogen) rather than iodine atom substitution at the phenolic ring
      of Tyr residues was shown to be the major determinant of alterations in the IgG
      molecule.

PMID- 1747413
TI  - [Membrane reception of thyroid hormones].
AB  - Comparative and competitive analyses of thyroxine (T4) and triiodothyronine (T3)
      binding to highly purified rat liver, brain and lung cell plasma membranes were
      carried out. The dependence of hormone binding on the time, temperature and
      concentration was studied. The effects of trypsin and partial delipidation on the
      binding parameters of thyroid hormones were investigated. Two thyroid hormone
      binding sites were detected in cell plasma membranes of all tissues under study.
      The maximal binding of T4 to rat liver membranes and the maximal binding of T3 to
      rat brain membranes was observed in all experiments, the affinity for T3 being
      higher than that for T4. An important role of both protein and lipid components
      of plasma membranes in the membrane reception of thyroid hormones is proposed.

PMID- 1747414
TI  - [Kinetics of immunoglobulin G transport through the multi-layer epithelial
      hematic barrier of the respiratory tract].
AB  - A new class of drugs is now utilized for in vivo diagnoses and therapy of many
      widespread diseases. In these pharmacological and diagnostic preparations the
      active substance is conjugated with a vector which transports the drug to
      specific biological targets. Monoclonal antibodies are the most commonly used
      vectors: estimation of their permeability through multilayer and unilayer
      biomembranes is an important step in the analysis of efficiency of vector drugs.
      Experiments with Sprague-Dawley rats (mature females weighing 500 to 160 g) have
      demonstrated the ability of immunoglobulins G to penetrate through the
      respiratory epithelial-hematic barrier. Using solid phase ELISA, it was found
      that 5-25% of the total amount of mouse antiinsulin immunoglobulins G1 injected
      into the trachea under hexenal anesthesia can penetrate into the blood plasma.
      Accumulation of antibodies in the blood begins 4 hours and ceases 32 hours after
      the drug application in a dose of 400 micrograms. The kinetics of transmembrane
      transport is described by an S-like saturation function: C(t) = Cmax/(1+e-(at-b].
      Penetration of monoclonal antibodies into the blood is accompanied by their
      distribution in the organs and tissues as well as by their clearance from the
      blood plasma. The clearance of monoclonal antibodies is characterized by a 24
      hour half-life and is described by an exponential equation: C(t) = C0 x exp-kt.
      An algorithm for the interaction of these processes which should be taken into
      account during measurements of the transport of monoclonal antibodies and their
      complexes through biomembranes is proposed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1747415
TI  - [Comparison of lipid metabolism in rat liver cells and nuclei during
      cycloheximide-induced superinduction of nuclear oncogenes].
AB  - Using a model of cycloheximide (CHI)-induced expression of nuclear oncogens, a
      comparative study of metabolism of the major lipid classes in rat liver nuclei
      and cells was carried out. A short-term activation of sphingomyelinase which
      preceded on a time scale the maximal accumulation of c-fos and c-myc transcripts
      was observed both in the cells and in the nuclei. In contrast with the whole
      cell, the level of phospholipase C activity in the nuclei did not change under
      conditions of oncogene activation. It was found that the maximal expression of
      nuclear oncogens coincided in time with cyclic changes in the content of
      practically all phospholipids and neutral lipids with simultaneous activation of
      their synthesis both in the cells and in the nuclei. However, in the nuclei the
      sphingomyelin metabolism activation was predominant. It is concluded that in the
      nucleus sphingomyelin and its metabolites may influence oncogene expression via
      nuclear protein kinase C.

PMID- 1747416
TI  - [Study of sphingomyelinase activity and sphingomyelin and ceramide levels in
      comparison with other lipid fractions of the cell nucleus in regenerating rat
      liver].
AB  - The changes in the activity of cell nuclear sphingomyelinase at different times
      of activation of RNA and DNA syntheses in regenerating rat liver were studied. A
      comparative analysis of the intranuclear content of sphingomyelin and the primary
      product of the sphingomyelinase reaction, ceramide, as well as of other classes
      of phospholipids and neutral lipids, was carried out. The changes in the
      sphingomyelin and ceramide content in the nuclei during the induction of
      synthetic processes were more conspicuous as compared with other phospholipid
      classes. Neutral lipids of cell nuclei were also shown to undergo substantial
      changes. The mechanism of possible involvement of sphingomyelin and other lipids
      in the regulation of replication and transcription processes is discussed.

PMID- 1747417
TI  - [The effect of insulin on the catalytic efficacy of rat skeletal muscle
      hexokinase isoenzyme II].
AB  - The effect of insulin on the intracellular localization of rat skeletal muscle
      hexokinase isozyme II (hexokinase II) was studied in vivo. It was found that
      after injection of the hormone the glucose concentration in the muscle gradually
      increases in parallel with the hexokinase II redistribution between the cytosol
      and the mitochondrial fraction in the direction of the bound form of the enzyme.
      This effect of insulin is due to glucose, an indispensable participant of the
      complex formation between the enzyme and the mitochondrial membrane. It was shown
      that the effect of glucose as a hexokinase II adsorbing reagent is a highly
      specific one. The hexokinase II binding to mitochondria in the presence of
      glucose is accompanied by changes in some kinetic properties of the enzyme. A
      kinetic analysis of catalytic efficiency of the free and bound hexokinase II
      forms revealed that the catalytic efficiency of hexokinase II within the
      composition of the enzyme-membrane complex exceeds by two orders of magnitude
      that of the free enzyme. The data obtained are discussed in the framework of an
      adsorption mechanism of hexokinase activity regulation in the cell.

PMID- 1747418
TI  - [Modifying effect of concanavalin A and diamide on erythrocyte sensitivity to
      cold shock].
AB  - The temperature (0 degrees C and 37 degrees C) and the medium tonicity (0.15-1.20
      M NaCl) were shown to affect erythrocyte agglutination by concanavalin A.
      Treatment of cells with lectin caused no significant decrease in the erythrocyte
      hemolysis upon cooling. Diamide, unlike concanavalin A used at concentrations
      above 2.0 M decreases the cell sensitivity to the cold shock. The changes in the
      erythrocyte susceptibility to cooling within the temperature range of 37-0
      degrees C correlate with changes in the electrophoretic spectrum of membrane
      proteins. The progressive decrease in the spectrin bands intensity with a
      simultaneous formation of high molecular weight protein aggregates not included
      in the gel composition was observed after diamide treatment. The diamide effect
      depends on the medium tonicity, at which the treatment was performed, being
      especially well pronounced in hypertonic media with 0.8-1.2 M NaCl
      concentrations, the maximal spectrin aggregation being observed under these
      conditions. It is suggested that the main factor of the mechanism underlying the
      erythrocyte hypertonic cold shock is the increase in the association of
      peripheral cytoskeleton proteins with plasma membrane in osmotically dehydrated
      cells which limits the ability of lipids to adapt during cooling and results in
      the stabilization of defects in the membrane structure at low temperatures.
      Diamide eliminates these unfavourable changes eventually resulting in the
      dissociation of peripheral proteins from the cytoplasmic surface of the membrane
      on the protein aggregation.

PMID- 1747419
TI  - [Quaternary structure of uridine phosphorylase from E. coli K-12].
AB  - Uridine phosphorylase was isolated from E. coli K-12 cells in a homogeneous
      state. The molecular mass of the enzyme as determined by gel filtration
      corresponds, approximately, to a hexamer made up of 27.5 kDa monomers. Evidence
      for the hexameric structure of uridine phosphorylase was obtained by electron
      microscopy with numerical treatment of the images. The six monomers within the
      enzyme molecule are arranged in two layers, three monomers in each, at the apices
      of a triangular antiprism with a point group symmetry of 32.

PMID- 1747420
TI  - [Participation of the ATP/ADP antiporter and fatty acids in oxidative
      phosphorylation uncoupling in squirrel liver mitochondria during winter
      hibernation and awakening].
AB  - The parameters of energy coupling of mitochondria isolated from the livers of
      hibernating and awakening gophers were studied. The ATP/ADP-antiporter inhibitor
      carboxyatractylate slowed down the respiration rate, increased delta psi and
      decreased the ionic conductivity of the inner mitochondrial membrane as measured
      by the rate of the delta psi decline after addition of cyanide (in the presence
      of oligomycin and EGTA). A similar effect was produced by BSA, carboxyatractylate
      being fairly ineffective in the presence of BSA. In hibernating gophers the
      maximal rate of the uncoupled respiration and the ionic conductivity of the inner
      mitochondrial membrane were markedly decreased as compared with awakening
      gophers. The data obtained suggest that in awakening animals fatty acids induce
      the uncoupling of oxidative phosphorylation by the ATP/ADP-antiporter, this
      process being simultaneous with the activation of the respiratory chain.

PMID- 1747421
TI  - [Myosin head structure].
AB  - The current data and concepts of the structural organization of the head of
      myosin, one of the major muscle proteins, are reviewed. The primary structure of
      the isolated myosin head (myosin subfragment-1) heavy chain and localization in
      it of sites and groups responsible for the binding and hydrolysis of ATP and
      myosin interaction with actin, are considered. Evidence is given of reciprocal
      spatial distribution of these sites and their localization on the myosin head
      surface. Some present-day concepts on the domain organization of the myosin head
      and its changes occurring during binding and hydrolysis of ATP, are discussed. A
      model describing the folding of the heavy and light chains in the myosin head is
      proposed.

PMID- 1747422
TI  - [Factors in rat liver cytosol, inhibiting chemiluminescence during nonenzymatic
      lipid peroxidation].
AB  - The effect of normal rat liver cytosol on the level of Fe/ADP-ascorbate-induced
      lipid peroxidation in the total particulate fraction (mitochondria plus
      microsomes) has been studied. The intensity of lipid peroxidation was measured
      using the chemiluminescence technique and by malonic dialdehyde (MDA) production.
      Dialyzed cytosol significantly decreased the level of chemiluminescence and, to a
      much lesser extent, the rate of MDA production. Gel filtration on a Sephadex G
      200 column led to the appearance of at least three cytosolic fractions which
      suppressed the low-level chemiluminescence. These fractions differed from one
      another by their molecular masses, kinetics of chemiluminescence inhibition and
      effects on the intensity of MDA production. The putative functional role of
      antioxidative defence factors from rat liver cytosol is discussed.

PMID- 1747423
TI  - [Activation of (ADP-ribose) polymerase by DNA fragmented by micrococcal nuclease
      and DNAase I].
AB  - Activation of (ADP-ribose) polymerase by DNA fragments obtained by digestion of
      calf thymus DNA with micrococcal nuclease and DNAase I was studied. It was found
      that activation of the enzyme is due to its interaction with the terminal parts
      of double-stranded DNA fragments, the level of activation being independent of
      the size of DNA fragments.

PMID- 1747424
TI  - [Age changes in the level of pyridinoline cross-linking and ratio of soluble and
      insoluble collagen in human rib collagen].
AB  - The changes in the content of mature crosslinks with pyridinoline structure and
      soluble/insoluble collagen ratio in the costal cartilage tissue of human beings
      aged from 1 month to 57 years were found to be age-dependent. The effect of the
      pyridinoline crosslink content on the soluble/insoluble collagen ratio in human
      costal cartilage tissue may constitute no less than 67% of the total influence of
      the sum of all factors. The pronounced nonlinearity of the studied dependencies
      points to a possible involvement of a factor(s) other than the pyridinoline
      crosslink content.

PMID- 1747425
TI  - [Changes in the lipid and protein components of thymus cell membrane during lipid
      peroxidation].
AB  - Nonenzymatic lipid peroxidation in thymus cell plasma membranes was studied. The
      composition of lipid and protein components, intensity of fluorescence of the
      membrane probes (1-anilinonaphthalene-8-sulfonate, 4-dimethylaminochalcon, eosin,
      pyronin and rhodamine), fluorescence polarization of tryptophan residues of
      membrane proteins and quenching by acrylamide of intrinsic fluorescence of
      proteins were determined. Induction of lipid peroxidation by the Fe(2+)-ascorbate
      system caused changes in the composition and structure of lipids. This was
      paralleled with changes in the structural-dynamic organization of membrane
      proteins, transition of some peripheral proteins to the water phase and increased
      solubilization of integral proteins by Triton X-100.

PMID- 1747426
TI  - [Immunoenzyme determination of the total level of ceruloplasmin in the serum from
      patients with hepatocerebral dystrophy].
AB  - An immunoenzymatic method for ceruloplasmin analysis (IEA) based on the use of
      horseradish peroxidase-labelled monospecific antibodies as markers has been
      developed. IEA can be used for direct measurements of ceruloplasmin in blood
      serum, as can be evidenced from the coincidence of calibration plots obtained
      after the use of potassium-phosphate buffer and ceruloplasmin-free sera. The
      procedure allows the determination of the total content of ceruloplasmin present
      in the blood sera of patients with hepatocerebral dystrophies both in the active
      and inactive forms. The minimum ceruloplasmin concentration detectable by this
      method is 5 x 10(-9) g/ml. The method was used to determine ceruloplasmin levels
      in the blood of patients with various grades of hepatocerebral dystrophy.
      Analysis of blood sera from 6 patients revealed that the ceruloplasmin
      concentrations determined by IEA were very close, whereas the oxidase activities
      of this protein differed more than 7-fold. The amount of enzymatically active
      ceruloplasmin as determined from the oxidase activity made up to 10-68% of the
      total ceruloplasmin content in the sera, depending of the severity of the
      pathology.

PMID- 1747427
TI  - [Change in energy metabolism of ascites cancer cells with a decrease in pH].
AB  - In Hank's balanced salt solution EL-4 ascites thymoma cells possessed endogenous
      respiration which was sufficient for the maintenance of their ATP level: pH
      decrease down to 6.0 had no effect either on endogenous respiration or the ATP
      level. Glucose had no influence on the respiration of EL-4 cells but inhibited
      that of Ehrlich ascites carcinoma (EAC) cells by 40% (Crabtree effect);
      respiration of the both cell lines was strongly (4-fold) inhibited after
      simultaneous addition of glucose, lactate and pH decrease. EL-4 cells had no
      endogenous glycolysis; EAC cells showed a low level of glycolysis only after pH
      decrease. Glucose addition led to activation of glycolysis (both inhibited 2-fold
      after a decrease of pH down to 6.0. The respiration inhibition at pH 7.3 and 6.0
      caused no decrease of ATP depletion when glucose was present in the medium; this
      result may be due to suppression of ATP consumption. Incubation of EL-4 cells
      under respiration and glycolysis deficiency conditions resulted in a sharp ATP
      depletion; pH decrease delayed this depletion.

PMID- 1747428
TI  - [Kinetics of NADH oxidation of NAD+ reduction by mitochondrial complex I].
AB  - The kinetics of the NAD: artificial acceptor-oxidoreductase and delta mu H(+)
      dependent succinate: NAD(+)-oxidoreductase reactions (reverse electron transfer)
      reactions catalyzed by the membrane-bound complex I was studied. The values of
      apparent rate constants of dissociation of complexes of the oxidized and reduced
      enzyme with NAD+ and NADH were determined. It was shown that the apparent
      affinity of NADH for the oxidized complex I is by nearly three orders of
      magnitude as high as that of the reduced one; a reverse correlation is found for
      NAD+. A kinetic scheme of complex I functioning in the forward and reverse
      reactions, according to which the free reduced enzyme is not an intermediate of
      the forward (NADH-oxidase) reaction and the free oxidized enzyme is not an
      intermediate of the reverse (NAD(+)-reductase) reaction, is proposed.

PMID- 1747429
TI  - The evolution of a claim in a medical malpractice case.

PMID- 1747430
TI  - General form for requesting hospital documents.

PMID- 1747431
TI  - Tax benefits of being self-employed.

PMID- 1747432
TI  - Liability issues.

PMID- 1747433
TI  - The seven habits of highly effective people.

PMID- 1747434
TI  - Unravelling your malpractice insurance policy [continuing education credit].

PMID- 1747435
TI  - Biological research in geriatric psychiatry.

PMID- 1747436
TI  - Positron emission tomography and magnetic resonance imaging: a review and a local
      circuit neurons hypo(dys)function hypothesis of schizophrenia.
AB  - A review of brain imaging (PET and MRI) studies on schizophrenia and recent data
      from neuroanatomy, neurophysiology, neuropathology, neurochemistry,
      neuropsychology, and cortical organization theory is integrated with the concept
      of local circuit neurons (LCNs) in a new hypothesis--the local circuit neurons
      hypo(dys)function hypothesis of schizophrenia--that attempts to explain the
      pathogenesis and pathophysiology of schizophrenia through a hypofunction (or
      dysfunction) of the local circuit neurons in prefrontal and limbic-temporal
      areas. This hypofunction (dysfunction) is then related to the neurocircuitry,
      neuropsychology, and psychopathology of schizophrenia.

PMID- 1747437
TI  - Lack of a bimodal distribution of ventricular size in schizophrenia: a Gaussian
      mixture analysis of 1056 cases and controls.
AB  - The finding of clinical and laboratory differences between schizophrenic patients
      with large and small cerebral ventricles has led to the widespread assumption
      that large ventricles are a marker that characterizes a subgroup of patients with
      schizophrenia. We reviewed all published English language ventricle-to-brain
      ratio (VBR) studies in which individual data points were available
      (schizophrenics: n = 691, medical controls; n = 205, normal volunteers: n = 160).
      Using a univariate normal mixture model to examine the distribution of
      ventricular size in each group, we found no evidence of a mixture of Gaussian
      distributions (i.e., "bimodality") within any of the three groups. The same
      analysis was then performed on the combined sample of schizophrenic patients and
      normal and medical controls, respectively. In each case the improvement in fit of
      a mixture of normal distributions compared to a single component normal
      distribution was significant. The data do not support the notion that ventricular
      enlargement is a discontinuous marker of a subtype of schizophrenia.

PMID- 1747438
TI  - Pretreatment EEG predicts short-term response to haloperidol treatment.
AB  - This study analyzed the relationship between pretreatment electroencephalogram
      (EEG) and response to haloperidol medication in a group of acutely exacerbated
      schizophrenic patients (n = 34). Improvement was assessed after 3 and 6 weeks of
      treatment; it was measured globally, as decrease in the total score on the Brief
      Psychiatric Rating Scale (BPRS), as well as multidimensionally through the
      individual BPRS factors. Relative powers from four clinical EEG frequency bands
      were employed as predictor variables. Baseline alpha activity was significantly
      related to clinical response. Higher alpha values were associated with poorer
      response to treatment. Specifically, improvements on the "thought disturbance"
      and "hostility-suspiciousness" factors underlied the relationship between the
      pretreatment EEG and outcome.

PMID- 1747439
TI  - The effect of tetrahydroaminoacridine (THA) on P300 in Alzheimer's disease.

PMID- 1747440
TI  - Draft guideline on detection of toxicity to reproduction for medicinal products.

PMID- 1747441
TI  - Proposal for international guidelines for reproductive and developmental toxicity
      testing for pharmaceuticals.
AB  - 1. A Workshop was organized by the Centre for Medicines Research in London, 13th
      15th May 1991 to discuss the current situation concerning tests for reproductive
      and developmental toxicity required for new drug development, and whether a
      unified series of guidelines could be developed which would satisfy Regulatory
      Authorities and Scientists worldwide. 2. The international group of experts
      invited to participate in this meeting reached a consensus regarding the
      desirability of developing new and flexible guidelines. An approach was proposed
      based on the state of the art of scientific knowledge in the field of
      reproductive and developmental toxicology coupled with the minimum use of
      experimental animals, and taking into consideration the European proposal for a
      new guideline which has been open for discussion since 1989. 3. Although time did
      not permit detailed discussion of all study designs, several which are considered
      to provide acceptable tests for reproductive and developmental toxicity of new
      therapeutic candidates have been proposed for further discussion. These include
      the possibility of considerable reduction in duration and size of studies, and
      numbers of animals used where there is an indication that a low hazard potential
      exists. 4. Whichever of the combinations are ultimately used in the premarketing
      assessment, it is most important that the investigators justify in detail the
      rationale underlying the choice of studies undertaken. This should take into
      account the specific properties of the drug molecule and its proposed clinical
      use. 5. This paper reflects the discussions which took place at the Workshop and
      its publication has been agreed to by the participants. It is intended that it
      could be used as the basis for discussions of a harmonized approach to
      reproductive and developmental toxicity testing of pharmaceuticals. As such, it
      will be made available to regulatory agencies, trade associations and other
      appropriate groups for their consideration and acceptance, modification or
      scientific augmentation.

PMID- 1747442
TI  - Animal toxicology studies on new medicines and their relationship to clinical
      exposure: a review of international recommendations.
AB  - Written guidance on the toxicology studies which should be completed to support
      an application to market a new medicinal product in the EEC, Japan, and the USA
      is readily available, although the recommendations can vary significantly between
      the three markets. Less clear are the regulatory authorities' expectations
      concerning the timing of these studies relative to the clinical development
      programme. All available guidelines for premarketing toxicology requirements, and
      the portions thereof needed to support various stages of the clinical trials
      programme will be reviewed. Significant differences among the three markets and
      between written guidance and customary practice will be highlighted. The
      practical implications for the clinical development programme will be identified.

PMID- 1747443
TI  - The safety of angiotensin-converting enzyme (ACE) inhibitors in moderate
      hypertension.

PMID- 1747444
TI  - Androgen in the treatment of refractory anemia.
AB  - We retrospectively evaluated the efficacy of androgen in the treatment of
      refractory anemia (RA) and compared patient characteristics and the probability
      of survival in androgen-responder and nonresponder groups. Forty patients with RA
      were treated in our hospital between 1975-1989, and 27 were treated with various
      derivatives of androgen. Eleven of the latter responded effectively to androgen
      therapy, representing an efficacy rate of 40.7%, higher than that of any other
      treatments thus far reported. The probability of 10-year survival estimated by
      the Kaplan-Meier method was 75.0% for the responder group and 41.3% for
      nonresponders, with a median follow-up of 1202 and 1272 days, respectively. In
      addition, the percent probability of transformation-free survival was higher
      among androgen-responders than among nonresponders, though the difference was not
      significant. Transformation from RA to RAEB or overt leukemia was seen in only
      one case among the former group, but in six among the latter. With respect to
      patient characteristics, only the percentage of marrow myeloblasts differed
      significantly between the groups.

PMID- 1747445
TI  - Enzyme histochemical, immuno histochemical and electron microscopic studies of
      two cases of leukemic malignant histiocytosis.
AB  - Two cases of leukemic malignant histiocytosis had similar morphologic and enzyme
      histochemical findings. Large blasts with low nuclear/cytoplasmic ratios,
      occasional azurophilic granules, and immature nuclei with nucleoli were seen in
      peripheral blood and bone marrow smears. Case 1 had occasional
      erythrophagocytosis, while in Case 2 it was rare. They were peroxidase negative,
      and very strongly positive by alpha-naphthyl butyrate esterase stain, the latter
      being inhibited by sodium fluoride. Acid phosphatase stains were also very
      strongly positive and were inhibited with tartaric acid. They were also stained
      granularly with PAS. Surface marker analysis revealed myeloid surface antigens,
      CD11+, CD13+ and HLA-DR+ in Case 1, and CD11+, CD13+, CD33+ and HLA-DR+ in Case
      2. Immunoperoxidase stains of bone marrow biopsies revealed that lysozyme was
      positive in both cases. S-100 protein was strongly positive in Case 1, but weakly
      so in the skin tumor and negative in the bone marrow of Case 2. Electron
      microscopy showed both cases to be myeloperoxidase negative and rich in
      cytoplasmic organelles, such as lysosomes, mitochondria, and endoplasmic
      reticuli. Nuclei were irregularly shaped and nucleoli were present in virtually
      all the cells. These findings suggest that the malignant histiocytes in these two
      cases derive from bone marrow macrophages, and S-100 protein can also be detected
      in monocyte-macrophage derived histiocytes.

PMID- 1747446
TI  - Gene amplification of Japanese non-Hodgkin lymphoma with involvement of the BCL2
      gene.
AB  - Twenty cases of Japanese non-Hodgkin's lymphoma with B cell markers were studied
      with respect to their immunoglobulin heavy (IgH) chain gene loci on chromosome 14
      and BCL2 loci on chromosome 18. All of the 20 cases showed IgH gene rearrangement
      on at least one of the alleles. Molecular analysis using two chromosome 18
      specific DNA probes (pFL1 and pFL2) showed rearrangement of the BCL2 region in
      three of 20 cases. As these three samples showed the rearranged allele of the IgH
      gene comigrating with that of the BCL2 gene, polymerase chain reaction (PCR) was
      carried out to amplify the juncture between IgJH on chromosome 14 and BCL2 on
      chromosome 18. In all of these three cases, gene amplification between the two
      loci was found to occur, indicating that molecular mechanisms involved in this
      type of chromosomal translocation in Japan might be similar to cases in the
      United States (U.S.) in a limited number of cases. Furthermore, this
      amplification technique revealed minimal tumor cells circulating in peripheral
      blood, even though lymphoma cells could not be identified morphologically. Thus,
      the PCR technique is useful for both the detection of minimal tumor cells as well
      as for the determination of the molecular nature of chromosomal translocation in
      some of Japanese cases.

PMID- 1747447
TI  - Establishment and characterization of a new human Bence Jones-type myeloma cell
      line, NOP-2.
AB  - A new human myeloma cell line NOP-2, producing immunoglobulin (Ig)-lambda-light
      chain was established from a patient with Bence Jones-type multiple myeloma.
      Morphologically, the cell line had plasmacytoid characteristics by light- and
      electron-microscopic examination. Phenotypic studies of NOP-2 cells revealed no
      surface Ig, but they were positive for cytoplasmic Ig-lambda, OKT10 (CD 38), and
      PCA-1. Epstein-Barr nuclear antigen was not detected. Chromosomal abnormalities
      of t(11;14) and t(8;22) were found in both NOP-2 cells and the original myeloma
      cells obtained from the patient. NOP-2 cells produced and secreted Ig-lambda
      light chain, but lacked immunoglobulins of any heavy chains. Rearrangements of
      both immunoglobulin heavy- and light-chain genes were observed in NOP-2 cells,
      though the cells expressed detectable mRNA only for Ig-lambda light chain. This
      cell line may serve as a useful model for understanding the hierarchy of human
      immunoglobulins and the pathophysiology of Bence Jones-type multiple myeloma.

PMID- 1747448
TI  - Expression of H-related antigen on human megakaryocytes and megakaryocytic
      leukemia cells.
AB  - A mouse monoclonal antibody (MoAb), MG-2, was produced by immunizing a
      characterized human megakaryoblastic cell line, MEG-01. Since MG-2 reacted with
      erythrocytes of all ABH blood groups except Oh (O Bombay), and since anti-H MoAb
      inhibited MG-2 binding to MEG-01 cells, MG-2 is considered to recognize a
      molecule closely related to blood group antigen H. MG-2 reacted more strongly
      with normal smaller sized megakaryocytes than with larger sized ones, and not
      with platelets. The expression of the intrinsic H-related antigen on MEG-01 cells
      decreased concomitant to megakaryocytic differentiation induced by phorbol
      esters. This H-related antigen was expressed on leukemia cells with the
      megakaryocytic features from blast crisis of chronic myelogenous leukemia and
      acute megakaryoblastic leukemia.

PMID- 1747449
TI  - Thrombopoietic factor enhances murine megakaryopoiesis induced by recombinant
      erythropoietin.
AB  - Partially purified thrombopoietic factor (TPF) potentiated in vitro murine
      megakaryopoiesis induced by recombinant human erythropoietin (rh-Epo). High doses
      (2.5-10 units) of rh-Epo generated a considerable number of megakaryocytes in a
      dose-dependent manner in a serum-free liquid culture, whereas low doses of rh-Epo
      (0.5-1 units) failed to generate megakaryocytes. The addition of high doses of rh
      Epo and TPF caused a significant increase of megakaryocytes in comparison with
      high doses of rh-Epo alone. Furthermore, low doses of rh-Epo with TPF caused
      generation of a small number of megakaryocytes, although TPF alone did not
      generate megakaryocytes. In addition, TPF enhanced the acetylcholinesterase (Ach
      E) activity of megakaryocytes induced by rh-Epo. The potentiating effects of both
      factors, rh-Epo and thrombopoietic factor, may play an important role in
      thrombocytopenic states in vivo as well as in in vitro megakaryopoiesis.

PMID- 1747450
TI  - Long-term cultivation of an interleukin-3-producing cell line in a chemically
      defined protein-free medium.

PMID- 1747451
TI  - Transport of ferritin from Kupffer cells to liver parenchymal cells.
      Morphological and immunocytochemical observations.
AB  - In attempting to determine the pathway of ferritin from Kupffer cells to liver
      parenchymal cells, anionic iron colloid particles of a ferric hydroxide-potassium
      polyvinyl sulfate complex (Fe-PVS) were injected intravenously into blood
      depleted anemic rats. After iron loading, the process of ferritin formation and
      the daily change in the latter's distribution in the liver were studied by
      ultrastructural-immunocytochemical techniques. Three days after Fe-PVS injection,
      a mass of reaction products of ferritin was found in Kupffer cells, though not in
      the sinusoidal endothelial or parenchymal cells. Four days post-Fe-PVS injection,
      however, reaction products in Kupffer cells disappeared, while appearing in
      parenchymal cells. Observations at 3.5 days after the injection revealed heavy
      deposition of reaction products in the sinusoid and Disse's spaces as well.
      Electron microscopic observation of tissue sections treated with bismuth
      subnitrate taken at this stage revealed diffuse dispersion of ferritin particles
      in the cytoplasmic matrix of parenchymal cells as well as in the sinusoid and
      Disse's spaces. Ferritin particles were not found in the coated pits and vesicles
      of the Kupffer cells and parenchymal cells. Four days after injection, ferritin
      particles were found in clusters in the cytoplasm of the parenchymal cells and
      also in their lysosomal bodies. The results indicate that ferritin synthesized in
      Kupffer cells is released into sinusoidal and Disse's spaces and then accumulated
      in parenchymal cells.

PMID- 1747452
TI  - Effects of iron on lipid peroxidation.
AB  - To elucidate the effects of iron on lipid peroxidation, three kinds of assays
      were done. (i) The effects of intravenous injection of single doses of iron
      dextran (100 mg iron) on lipid peroxidation in various tissues and the blood
      plasma of rats were examined by the thiobarbituric acid reaction. Malondialdehyde
      concentrations were significantly elevated in the spleen, heart, and plasma 3 h
      after injection, whereas significant increases were observed in the liver and
      adipose tissue at 24 and 48 h, respectively. In the liver and spleen, the
      elevated malondialdehyde concentrations persisted until Day 28. In contrast,
      levels were reduced in the heart and adipose tissue within 4 weeks after iron
      injection. Plasma malondialdehyde concentrations were 70-times that of controls
      at 24 h after iron injection. The level subsequently decreased sharply by Day 6.
      In red blood cells, lipid peroxidation was not affected by iron. Malondialdehyde
      levels were correlated with the iron contents of the liver, spleen, heart,
      adipose tissue, and plasma (r value range 0.39-0.88, p less than 0.05).
      Furthermore, there was a strong correlation in the liver and spleen at iron
      levels below 2,000 micrograms/g (r = 0.94, p less than 0.0001; r = 0.94, p less
      than 0.0001, respectively). (ii) In vitro experiments demonstrated that the
      addition of iron as ferric chloride, iron dextran, ferritin, and hemosiderin to
      normal liver homogenate accelerated malondialdehyde production. However, such
      increases were less than 10% of those caused by equivalent iron in the liver
      homogenate of iron treated rats. (iii) Compared to controls, spleens from eight
      thalassemia patients showed a high level of malondialdehyde and iron.

PMID- 1747453
TI  - Successful 0 degree C liquid preservation of red blood cells.
AB  - In an effort to determine the lowest acceptable temperature for liquid
      preservation of red blood cells, the latter were stored at 5, 0, -2 and -5
      degrees C. When polyvinylchloride (PVC) bags plasticized with di(2
      ethylhexyl)phthalate (DEHP) were used as containers, hemolysis of red cells
      stored for 42 days at 0 degree C was lower than at the other three temperatures.
      Adenosine triphosphate (ATP) levels, morphology scores, and deformability indices
      were also best maintained at 0 degree C, and erythrocyte osmotic fragility did
      not increase at that temperature. On the other hand, when blood was stored in
      glass bottles at 0 degree C, hemolysis and erythrocyte osmotic fragility
      increased. The addition of DEHP to red cells stored in glass bottles at 0 degree
      C decreased hemolysis and erythrocyte osmotic fragility to levels equal to those
      in PVC bags. Thus, storage of red cells can be done at temperatures as low as 0
      degree C, if PVC bags are used as the container. Previous negative assessments of
      storage temperatures below 4 degrees C, may be due to the use of glass bottles as
      containers for blood preservation.

PMID- 1747454
TI  - Iron balance following recombinant human erythropoietin therapy for anemia
      associated with chronic renal failure.
AB  - Erythrokinetic changes before and after rHuEPO therapy in 15 anemic patients with
      chronic renal failure undergoing maintenance hemodialysis were analyzed by means
      of ferrokinetics and measurement of red cell mass and survival. To estimate the
      change in iron status no exogenous iron was administered during the observation
      period unless a lack of response due to iron deficiency was confirmed. During 13
      29 weeks of therapy there was an increase in red cell mass from 12.5 +/- 1.7
      mg/kg to 20.1 +/- 3.6 ml/kg, compatible with the increase in hematocrit from
      21.5% to 31.8%. In ferrokinetics the plasma iron disappearance time (t1/2)
      shortened from 163 +/- 44 min to 92 +/- 24 min. The plasma iron turnover rate
      rose from 0.39 +/- 0.10 mg/dl per day to 0.56 +/- 0.11 mg/dl per day. Serum
      ferritin levels were decreased from 160 +/- 115 ng/ml to 26 +/- 22 ng/ml,
      although there was only one patient showing poor response to rHuEPO because of
      iron deficiency. The increase in red cell volume correlated with the decrease in
      serum ferritin levels (p less than 0.02). There was no significant difference in
      these ferrokinetic parameters between transfused and non-transfused patients not
      only before, but also after, rHuEPO therapy. It is suggested that an elevation of
      about 8 ml/kg of red cell mass (approx. 10% as hematocrit) exhausts iron stores
      in the majority of patients.

PMID- 1747455
TI  - The role of diferric transferrin in iron absorption and transferrin concentration
      in rat pancreatic juice and milk.
AB  - Transferrin (Tf) was found immunologically in pancreatic juice of normal rats at
      a concentration of 0.28 +/- 0.10 mg/ml but was found to be approximately 4-times
      higher in iron-deficient rats. Iron saturation of pancreatic Tf of normal rats
      was 40% and similar to that of serum Tf. Approximately 27% of a dose of iron from
      59Fe-diferric Tf was absorbed through the ligated segments of proximal intestine
      in normal rats. The iron absorption ratio of 59Fe-diferric Tf was higher from the
      duodenal and jejunal segments than the ileum and significantly inhibited by
      monodansylcadaverine (MDC) or 20-times excess of unlabeled diferric Tf. The
      presence of Tf receptors was demonstrated by specific binding of 125I-diferric Tf
      to the brush border membrane vesicles of the small intestine in normal rats. The
      binding was not inhibited by the presence of albumin or IgG. The association
      constant (Ka) was 1.03 +/- 0.50 x 10(8) M-1 and number of binding sites was 5.10
      +/- 0.96 x 10(12) sites/mg protein in the proximal intestine. The number of
      binding sites for Tf was higher in the proximal intestine than in the distal one.
      These results suggested that some iron was absorbed as diferric Tf into
      enterocytes through receptor-mediated endocytosis.

PMID- 1747456
TI  - Spontaneous remission in pure red cell aplasia associated with thymoma.
AB  - A 57-year-old woman with thymoma-associated pure red cell aplasia (PRCA)
      manifested spontaneous recovery of erythropoiesis. Anemia recurred before the
      surgical removal of her thymoma, however, and the second anemic remission
      following surgery did not occur promptly. In this report, we describe a rare
      occurrence of spontaneous remission in PRCA.

PMID- 1747457
TI  - In vitro chemosensitivity of lymphoblasts at relapse in childhood leukemia using
      the MTT assay.
AB  - Lymphoblasts from 21 previously untreated patients with acute lymphoblastic
      leukemia (ALL) and 31 patients in relapse were tested for chemosensitivity. Blast
      cells were cultured with 22 anticancer drugs for 4 days and assayed by MTT dye
      using a scanning microplate photometer. The percent cytotoxicity index (%CI) and
      LD50 (micrograms/ml) were calculated for each drug. The mean absorbances (+/-
      S.D.) of 1 x 10(5) cells in the untreated group and relapsed groups in control
      wells were 0.219 (+/- 0.126) and 0.385 (+/- 0.147), respectively (p less than
      0.01). Cells in the untreated group were more sensitive in vitro to vincristine,
      prednisolone, L-asparaginase (L-ASP), vinblastine, 5-fluorouracil, epirubicin,
      bleomycin (BLM), and etoposide (VP16) with respect to the %CI value and to L-ASP,
      VP16, BLM, and mitoxantrone with respect to the LD50 value than those in the
      relapsed groups. In contrast, no significant differences were observed for the
      other 13 drugs. There was also a significant difference in sensitivity within the
      relapsed group--13 having good clinical response and 15 showing no response to
      chemotherapy--with regard to four drugs, mitomycin C, neocarzinostatin, L-ASP,
      and teniposide. Cells in the relapsed group had more heterogeneous
      chemosensitivity than those in the untreated group, and divided into sensitive
      and resistant types, but large interindividual differences existed. The MTT assay
      and LD50-drug resistance percentile curves are useful for the selection of
      effective drugs in both untreated and relapsed patients with acute leukemia.

PMID- 1747458
TI  - Hypereosinophilic syndrome evolving to acute lymphoblastic leukemia.
AB  - We report a case of hypereosinophilic syndrome (HES) which later evolved into
      acute lymphoblastic leukemia (ALL). A 37-year-old man showed typical clinical
      manifestations of HES: pulmonary infiltrates, erythematous skin rash, deep vein
      thrombosis, endomyocardial fibrosis, and diffuse central nervous system
      dysfunctions. Although he was treated with prednisolone and hydroxyurea, marked
      eosinophilia persisted and lymphoblasts gradually increased in the bone marrow.
      He died of severe disseminated fungal infection after anti-leukemic therapy.
      Autopsy revealed marked fibrous thickening of the endocardium, bilateral common
      iliac vein thrombosis, and chronic hepatitis with fibrosis. Neither eosinophilic
      nor leukemic cell infiltration was seen in any tissue at autopsy. Including this
      case, 24 patients with ALL and hypereosinophilia have been reported in English
      language literature. We discuss the relationship between eosinophilia and ALL,
      and the mechanisms, particularly the role of eosinophil cationic protein (ECP),
      in causing various organ system dysfunctions in HES.

PMID- 1747459
TI  - Non-Hodgkin's lymphoma in patients under twenty years of age. A
      clinicopathological study.
AB  - A retrospective clinicopathological study was performed on 149 patients who
      developed malignant lymphoma at under 20 years of age and were diagnosed and
      treated at the National Cancer Center Hospital between 1962-1986. Using the
      Japanese Lymphoma Study Group classification (and Working Formulation), we
      reclassified the 84 evaluable tissue specimens as follows: follicular large and
      mixed lymphoma (two cases), diffuse lymphoblastic lymphoma (40 cases), Burkitt's
      lymphoma (small noncleaved, SNC) (12 cases), diffuse large and mixed cell
      lymphoma (25 cases), and unclassified (five cases). The age of the patients
      ranged from 6 months to 20 years, with a median of 11 years. The clinical
      characteristics were found to depend upon the histological diagnosis, as reported
      previously. To evaluate the influence of various clinical and morphological
      parameters on survival, univariate analysis was performed for each histological
      subtype. In lymphoblastic lymphoma, patients with a mediastinal mass had
      significantly earlier development of leukemic conversion and a shorter survival
      than patients without a mass. Because of the small number of patients and their
      short survival, no significant prognostic factors were found in Burkitt's
      lymphoma (SNC). In large and mixed cell lymphoma, response to therapy was the
      most significant prognostic factor. As therapy became more intense and systematic
      throughout the study period, the complete remission rate and survival improved
      steadily. Autopsy findings confirmed that lymphoblastic lymphoma and Burkitt's
      lymphoma (SNC) spread systemically earlier than large and mixed cell lymphoma.

PMID- 1747460
TI  - Ph1-positive acute lymphoblastic leukemia associated with an isochromosome 17q.
AB  - We report a patient with Ph1-positive acute lymphoblastic leukemia (ALL) having
      i(17q) in whom bony lesions were the initial clinical manifestation. The patient
      was a 53-year-old male who began to have pains in his left hip early in March
      1985. Relevant findings on admission included: WBC 21,300/microliters; blast
      cells 73.5%; peripheral blood blast cells, peroxidase (-), PAS (-) and esterase (
      ); cytoimmunologic markers, Ia(+) cells 49.1%, CD10(+) cells 67.1%, CD20(+) cells
      75.1%; positivity for TdT, and Ph1(+); and i(17q) upon chromosomal analysis.
      These findings led to a diagnosis of ALL with Ph1(+),i(17q). This case seems to
      represent an exceedingly rare instance of Ph1(+),i(17q) ALL in which the
      differential diagnosis between blast transformation of CML and Ph1(+) ALL was
      initially difficult to make.

PMID- 1747461
TI  - Aplastic anemia in a patient receiving tamoxifen.

PMID- 1747462
TI  - [Microvesicles in the developing synapses].
AB  - The sensomotor cortex and nucleus caudatus of the embryonal (14-22 days) and
      newborn rats have been investigated by electron microscopic method. There were
      described two groups of microvesicles (10-20 nm in diameter) with smooth and
      rough external surface. They differ from other vesicular components of the
      developing synapses (such as synaptic vesicles, vesicles of growing conus and
      other) by the minimal size, structure and localization. Microvesicles with the
      rough external surface are found only at that moment when the membranous
      specialization of the further synapse from desmosomes begins to form. They are
      found along the membranes of active contact zone and are correlated with the
      degree of differentiation of these membranes. Microvesicles with the smooth
      external surface are found during the all period of synaptogenesis. They are
      found either in presynaptic terminal freely or they are attached to presynaptic
      membrane where they form cluster of microvesicles and they can be found on the
      surface of synaptical vesicles too. In this article the functional role and
      genesis of microvesicles are discussed.

PMID- 1747463
TI  - [Adrenergic nature of vagal acceleration of heart beat in frogs].
AB  - Acceleration of heartbeats occurring during the irritation of vagal nerve was
      discovered as early as in 1846. Many hypotheses about mechanisms of its
      appearance proved to be not confirmed. Some authors (researchers) considered that
      the accelerated effect resulted from secreting a small amount of acetylcholine by
      vagal nerve. We discovered the cause of this groundless opinion and determined
      that vagal acceleration of heartbeats in frogs was accomplished, partially, by
      sympathetic fibres of vagal nerve, partially, by catecholamines secreted,
      probably, from chromaffin cells.

PMID- 1747464
TI  - [Effects of endogenous opioids on the development of reproductive function in
      rats].
AB  - The influence of opioid peptide on the process of formation of reproductive
      function in rats was studied. Administration of beta-endorphin to neonatal female
      rats did not affect the concentrations of oestrogen and androgen receptors in the
      hypothalamus and pituitary, whereas the content of testosterone receptors was
      significantly higher in both hypothalamus and pituitary. Chronic administration
      of beta-endorphin to both female and male rats does not affect the concentration
      of sex hormones. The results obtained indicate that chronic administration of
      beta-endorphin to neonatal female rats lead to formation of instable contacts in
      the mechanism of regulation of hypophysis gonadotropic function.

PMID- 1747465
TI  - [Characteristics of formation of the generator of pathologically increased
      excitation (epileptic focus) in the sensorimotor cortex of the brain in rats
      during its rhythmic electric stimulation].

PMID- 1747466
TI  - [Lipid peroxidation in the kidneys of rats with nephritis induced by nephrotoxic
      serum and proteinuria induced by albumin overload].
AB  - Lipid peroxidation (LPO) stimulated by ascorbate was studied in renal cortex of
      20 rats with nephrotoxic nephritis (NTN) and of 9 rats with proteinuria induced
      by a 3-day course of i. p. injections of the human serum albumin. At the early
      stages of NTN (0.5 h. and 3 h.) LPO activities were of the same values as in
      control rats. A small decrease in renal cortex LPO was found on the 4-th day of
      NTN when nephrotic syndrome has been developed. A significant reduction in LPO
      activity was observed on the 16-th day of NTN characterized by a more pronounced
      nephrotic syndrome. LPO activity in renal cortex of the rats with albumin
      overload proteinuria was also reduced. An inhibitory effect of proteinuria on LPO
      activity in kidney is discussed.

PMID- 1747467
TI  - [Corazol kindling in rats with different tolerance to hypoxia].
AB  - Research was conducted studying the peculiarities of development of
      pharmacological kindling in rats with different tolerance to hypoxia. Kindling
      was evoked by injecting subconvulsive doses of corazol (25 mg per kg) every day.
      Intensity of convulsions was expressed in points. Reliable distinction in
      intensity of convulsion between low-tolerant rats and high-tolerant rats to
      hypoxia was found on the 17th day of stimulation; amongst the group of low
      tolerant rats the intensity of convulsions was found to be 2.46 + 0.30 points,
      and amongst the group of high-tolerant rats--1.20 + 0.22 points (p 0.05). On the
      23rd day of injection the preparation convulsions in the group of low-tolerant
      rats reached up to 4.00 + 0.20 points and in the group of high-tolerant rats 2.28
      + 0.45 points (p 0.01). The changes of violation of behavior were found to be
      different. Thus, the higher the individual resistance to hypoxia, the more is the
      resistance of the animal to the effect of epileptogens.

PMID- 1747468
TI  - [Possibilities of using peripheral blood erythrocytes of rats and man in the
      detection of long-term action mutagens].

PMID- 1747469
TI  - [Combined effects of desialylated and glycosylated low density lipoproteins on
      lipid content of human aortic intima cells in vitro].
AB  - We have studied a combined effect of glycosylated low density lipoproteins (LDL)
      on the cholesterol content of cells cultured from unaffected human aortic intima.
      Native LDL did not alter the intracellular cholesterol level while glycosylated
      LDL taken in the concentration of 50 and 100 mg/ml increased the cell cholesterol
      content by 30 and 70 percent, respectively. The effect of the same concentrations
      of glycosylated LDL treated with neuraminidase (desialylated-glycosylated LDL)
      was twice as powerful. Desialylated LDL in the concentration of 50 and 100 mg/ml
      raised the cholesterol level by 1.4- and 2.1-fold, respectively. Simultaneous
      incubation of cells with glycosylated (50 mg/ml) and desialylated (50 mg/ml) LDL
      brought about a 3.4-fold increase in intracellular cholesterol. The obtained data
      suggest that intensive development of atherosclerosis in diabetes mellitus may be
      partially explained by synergic effects of desialylated and glycosylated
      lipoproteins as well as LDL with both types of modification.

PMID- 1747470
TI  - [Calcium-binding properties of tissue proteins after kidney allotransplantation].
AB  - The kinetics of calcium binding to tissue substrates in hypercalcaemia, induced
      by intravenous constant rate infusion of calcium gluconate were studied in 19
      patients after renal transplantation and in 14 healthy volunteers. Langmuir,
      Scatchard and Hill analysis revealed the positive cooperative mechanism of
      calcium binding to tissue in all patients and in healthy volunteers. These
      results provide indirect evidence of binding of calcium to tissue proteins. The
      significant decrease of the values of specific buffer capacity of tissue
      proteins, pool of exchangeable calcium and also the effective Ka were observed in
      37% of patients. These changes are proposed to play a role in the pathological
      calcification of vessels and soft tissues in patients after renal
      transplantation.

PMID- 1747471
TI  - [Respiration of rat brain mitochondria in hyperoxia and normoxia].

PMID- 1747472
TI  - [Antiepileptic effects of nifedipine].
AB  - In experiments on freely moving male Wistar rats it was shown that nifedipine in
      a dose 10 mg/kg (i.p.) suppressed the penicillin-induced focal epileptic activity
      in cerebral cortex. A similar suppressing effect of nifedipine was shown on acute
      generalized tonic-clonic pentylenetetrazol (PTZ) seizures (75 mg/kg, i.p.).
      Nifedipine in the same dose was not effective on chronic PTZ administration (PTZ
      kindling, 30 mg/kg i.p. during 28 days): when injected 30 min before each PTZ
      administration it didn't delay the development of kindling induced seizure
      susceptibility and had no effect on the severity of seizures. The administration
      of nifedipine in a dose of 10 or 30 mg/kg to control kindled animals which had
      not been treated with nifedipine had no influence on the severity of seizures
      provoked by a testing dose of PTZ (30 mg/kg i.p.): its intensity was similar to
      that of caused by PTZ injection along.

PMID- 1747473
TI  - [Interactions of neurotropic drugs with phosphatidylcholine bilayer. Effects on
      sorption of polyvalent cations].
AB  - It is found that neurotropic drugs, whose molecules have positively-charged amino
      groups and a considerable hydrophobic region (in size), can be incorporated into
      the phospholipid bilayers. This results in a decrease of the lifetime of Pr3+
      cations in the membrane-associated state. No correlation was found to exist
      between local anaesthesia activity of the study drugs and its capability of
      displacement polyvalent cations from the membrane surface.

PMID- 1747474
TI  - [Interrelations of cellular and humoral immune response and different doses of
      sheep erythrocytes in mice].
AB  - In experiments on CBA and C57BL/6 mice the generation of antibody-forming cells
      respectively either in the popliteal lymph nodes or spleen as well as a rate of
      delayed type hypersensitivity response (DTHR) on the background of subcutaneous
      (into foot) or intraperitoneal injection of different doses of sheep erythrocytes
      (from 10(4) to 10(8)) have been studied. In so doing two types of immune response
      can be isolated on the dependence upon the sensitivity threshold to antigen of
      DTHR and humoral immunity. Thus in C57BL/6 mice the antigen threshold for DTHR is
      of one time (in intraperitoneal immunization) or of a two times (in subcutaneous)
      lower order than for antibody response. In CBA line mice under subcutaneous
      immunization there can be seen quite an opposite picture while intraperitoneal
      immunization causes exact correlation of antigen threshold for cellular and
      humoral immune response.

PMID- 1747475
TI  - [Functional activity of natural killers and T-killers in transplantation of the
      ovary in mice].
AB  - The activities of natural killer (NK) cells and T-killers of mice after
      transplantation of allogeneic ovaries were studied. It was shown that during
      first month after transplantation cytotoxic and membrano-toxic activities of
      these effector cells were increased. Activation of NK and T-killers depends on
      tension of transplantation immunity and may serve as prognostic criteria of
      rejection.

PMID- 1747476
TI  - [Immunomorphological changes in the mouse brain after intracerebral
      administration of a neurotropic strain of influenza virus].
AB  - The work dealt with intracerebral inoculation of 150 mice with neurotropic strain
      of influenza virus A/WSN/33. Virological and immunohistochemical study of virus
      localization in the mice brain was carried out. It was shown that virus
      reproduction in ependymal lining cells and plexus choroideus epithelium is
      followed by destruction of cells and uptake of disintegration products by
      macrophages. Since the influenza infection is followed by a large number of
      macrophages involved in gene expression of the main histocompatibility complex,
      the development of autoimmune reaction with the formation of autoantibodies to
      brain specific antigens can't be ruled out.

PMID- 1747477
TI  - [Immunocytochemical analysis of interleukin-1 beta production by human
      monocytes].
AB  - IL-1 was localized within the cytoplasm of human blood monocytes by indirect
      immunofluorescence using polyclonal rabbit antibodies. After LPS stimulation
      first IL-1-positive cells appeared at 2 hours and maximal intracellular IL-1
      concentration was observed at 10-24 hours when nearly 90% monocytes were labeled
      with subsequent decline at 48 hours. The highest intracellular IL-1 content
      preceded its maximal level in cell supernatants.

PMID- 1747478
TI  - [Activation of phospholipase hydrolysis in the process of oxidative cell damage].
AB  - Effect of tert-butyl hydroperoxide toxic action on phospholipase A2 activity and
      the changes in phospholipid composition from mastocytoma P815 cells were
      investigated. Oxidative damage of tumor cell membranes was accompanied by the
      release of arachidonic acid from membrane phospholipids and the accumulation of
      lysophosphatidylcholine, the product of phospholipase A2 reaction and a potent
      detergent. Tert-butyl hydroperoxide also increased relative contents of
      sphingomyelin, phosphatidylserine and phosphatidic acid in tumor cell membranes.
      It is possible that phospholipase A2 activation and the changes of phospholipid
      molecular species contents may cause the damage of cell membrane stability.

PMID- 1747479
TI  - [Synthesis of tumor necrosis factor-alpha (TNF-alpha) by human monocytes in
      vitro].
AB  - The presence of TNF-alpha mRNA and protein in circulating human blood monocytes
      isolated by continuous Percoll gradient fractionation was studied. The technique
      of RNA isolation from the blood samples was used to study TNF-alpha mRNA
      expression. It was shown that human blood monocytes of healthy donors contained
      no presynthesized pool of TNF-alpha mRNA as well as no TNF-alpha protein.

PMID- 1747480
TI  - [Use of liposomes for the association of foreign genetic material to
      spermatozoa].
AB  - The binding of liposomes of different composition with sperm cells and their
      effect on cell behaviour were studied. Experiments have demonstrated, that
      liposomes, containing positively charged phospholipids, had maximal degree of
      association with sperm cells. Besides, liposomes seem to be nontoxic for sperms
      and do not change the functional activity of the latter. Theoretically, sperm
      cells may serve as a natural vector for transfer of liposome-encapsulated DNA
      into the ovary cells of animals for obtaining transgenic animals.

PMID- 1747481
TI  - [Formation of cointegrates between F-like conjugate plasmids].

PMID- 1747482
TI  - [Prevention and correction with nonopiate analog of leu-enkephalin of disorders
      induced in the liver of newborn white rats by prenatal hypoxia].
AB  - The newborn rats after 48 hours after the birth were used in the study. The
      prenatal hypoxia caused the development of hypotrophy. Index of labeled 3H
      thymidine nuclei decreased 1.5 fold, mitotic index decreased 1.4 fold. The
      content of aberrant figures of mitosis increased 2.6 times. Hexapeptide injection
      before hypoxia reduced the alterations caused by hypoxia, the data of body and
      liver weight did not differ from the control level.

PMID- 1747483
TI  - [Hepatocytes from the liver of mice with experimental post-toxic cirrhosis
      stimulate in heterokaryons DNA synthesis in the nuclei of resting fibroblasts of
      the NIH 373 line].
AB  - Hepatocytes from mouse liver with experimental post-toxic cirrhosis (received by
      means of 10-12 inhalations with CCl4) were fused with serum-deprived (0.2%)
      resting NIH 3T3 mouse fibroblasts to elucidate mechanisms of liver stroma cells
      proliferation at cirrhosis. After fusion, nuclei of fibroblasts in such
      heterokaryons were found to enter into S-period without any exogenous stimulation
      of cell proliferation (in the medium with low content of serum). The obtained
      data allow us to suggest that hepatocytes from mouse liver with experimental post
      toxic cirrhosis can produce and secrete into the medium (blood) factor (s)
      capable of stimulating the mesenchymal origin cell proliferation.

PMID- 1747484
TI  - [Thermal effect existing in the action of carbon dioxide laser on the bone
      tissue].
AB  - In the experiments in vitro we have studied the influence of carbon dioxide laser
      radiation on bone tissues of man. We have found out the range and thermal effect
      dependence on the density of laser energy, the character and thickness of
      radiated tissues. We have determined the dynamics of temperatures at any time.
      The received results give us the possibility to differentiate the optimum regimen
      of radiation.

PMID- 1747485
TI  - [Role of mast cells in reactions of the blood system in inflammation].
AB  - On the model of the acute infectious peritonitis in mice it is shown that the
      previously osmotic disruption of the peritoneal mast cell population remarkably
      affects the inflammatory focus, blood and bone-marrow leukocytic reactions. The
      initial neutrophil accumulation increase and the earlier and more intensive
      leukocytosis and activation of granulo-monocytopoiesis are established. At the
      same time the kinetics of monocytes in inflammatory focus is expressed weaker and
      testifies to the prolongation of the inflammatory response. Thus, in the natural
      inflammatory conditions mast cells of the inflammatory focus directly or
      indirectly modulate leukocytes and hematopoiesis.

PMID- 1747486
TI  - [Participation of peptide hydra morphogen in the regulation of proliferation
      processes in different tissues of white rats].
AB  - The PMH influence on proliferation processes in some tissues of white rats was
      studied. PMH injections in doses 10.0 mkg/kg and 100.0 mkg/kg stimulated the
      processes of DNA--synthesis after 24 hours in corneal and tongue epithelium. The
      direct dose-dependent effect was revealed. PMH in dose 10.0 mkg/kg activated the
      proliferative processes in the stomach epithelium and thymus cortex. after 24
      hours too. The given dose of PMH caused trustworthy decreasing of proliferative
      activity in thymus after 4 hours. The stimulation of DNA-synthesis and
      acceleration of mitosis were found after 5-times application on white rat's
      corneal with 100 nM PMH solution.

PMID- 1747487
TI  - [Reaction of cell population of the rat nucleus tractus solitarius to disorders
      of carbohydrate metabolism].
AB  - Cell responses in disparate subnuclei of the nucleus tractus solitarius (NTS) to
      experimental alloxan diabetes were studied using light microscopic morphometric
      methods. Histophysiological features in seven of fourteen cell divisions
      distinguished in the rat NTS, demonstrated their dependence on impaired
      carbohydrate metabolism. The data obtained are consistent with the hypothesis of
      the NTS involvement in the control of carbohydrate homeostasis.

PMID- 1747488
TI  - [A morphofunctional study of an experimental staphylococcal and Pseudomonas
      aeruginosa infection in rats with the background of administration of a synthetic
      analog of endogenous opioids--dalargin].

PMID- 1747489
TI  - [Autoradiography of protein synthesis as a method of assessment of
      morphofunctional changes in brain structures].
AB  - A combination of two groups of autoradiography technique (for a hole brain and
      individual cells) was applied with using 3H-leucine to evaluate the changes of
      brain functional activity on the level as anatomical structures and as different
      type neurons. It was found that Wistar rats with lowered motor activity induced
      by 3-4 weeks treatment with L-DOPA 100 mg/kg displayed the motor nuclei of the
      brain stem the cerebellum as highly labelled structures and the motor cortex and
      n. caudatus as feebly ones in comparison with control. However, a quantitative
      assessment of silver grains over the neurons of layers III and V of motor cortex
      and n. caudatus showed not only a significant increase of labelling, especially
      in neurons of layer V on 174%, in comparison with control but revealed unequal
      labelling of different type neurons. It was concluded that the applied two groups
      of autoradiography technique can be a useful approach to assess the brain
      functional activity.

PMID- 1747490
TI  - [Use of the procedure of photo-oxidation of fluorescent preparations of autopsy
      material of the human brain for light and electron microscopy].
AB  - Neurons and fibers from human autopsy material were labeled by application of
      Lucifer Yellow or diI. Dye-filled neurons and fibers were immersed in a
      diaminobenzidine and potassium cyanide solutions and irradiated with
      epifluorescent illumination until all visible fluorescence had faded. This simple
      photo-oxidation procedure resulted in the autopsy human tissue of a stable,
      nonfading, brown reaction product, visible with the light microscope providing a
      Golgi-like image, and EM level. This methodological procedure was successfully
      used for revealing detailed morphology of neurons with dendritic spines, axons
      with collaterals and varicosities in the human cortical areas and hippocampus.

PMID- 1747491
TI  - [Ultrastructure of liver cells of shrews].
AB  - It was established that the hepatocytes of least shrew (Sorex minutissimus)
      contained 1-2 nucleus with wide nuclear pores and big nucleolus. There are
      abundant mitochondria with numerous crists in their matrix (many organelles were
      divided along the crists). Each mitochondrion was surrounded by the cistern of
      granular endoplasmic reticulum. The ultrastructure of Golgi complex (1-2 flat
      cisterns, small vesicles] indicated that the bile was secreted often, by small
      portions, that was the adaptation to repeated fractional feeding. There were many
      peroxisomes in the cytoplasm of hepatocytes. Lipid droplets were absent, glycogen
      granules were not at all hepatocytes. Sinusoidal cells had the usual structure.
      All sinusoids were open and consisted of the erythrocytes, fragments of
      hepatocyte cytoplasm and myelin figures in its lumen.

PMID- 1747492
TI  - [Suppression of epithelial cell proliferation in mice by splenocytes from
      unilaterally sialoadenectomized syngeneic donors].
AB  - Partially hepatectomized CBA mice immediately after the operation were intra
      orbitally injected with splenocytes of intact (I), Sham-operated (SH-0) or
      unilaterally sialadenectomized (USAE) syngenic donors. It was shown that
      splenocytes from USAE donors in contrast to their types of splenocytes acutely
      suppress the mitotic activity of hepatocytes in the regenerating liver 48 and 72
      h after their transfer. Splenocytes isolated 17, 144 and 168 h after removal of
      submandibular (together with sublingual) gland had the biggest inhibiting
      ability. Similar effect was obtained in respect of corneal epithelium due to
      administration of USAE mice splenocytes 17, 48 and 72 h after surgery. Operated
      recipients are more susceptible to the action of splenocytes from USAE donors,
      than the non-operated ones.

PMID- 1747493
TI  - Clinical efficacy and safety of cisapride and clebopride in the management of
      chronic functional dyspepsia: a double-blind, randomized study.
AB  - The clinical efficacy and the safety of chronic oral administration of cisapride,
      a new gastrointestinal prokinetic agent, (10 mg tid) and clebopride (0.5 mg tid)
      was assayed in 48 outpatients affected with functional dyspepsia, in a randomized
      double-blind study. Each of the drugs induced a significant reduction in
      dyspeptic symptoms after 2 and 4 weeks (p less than 0.001). Two patients, given
      clebopride, dropped out of the study because of severe side effects during the
      first week of treatment. Mild adverse reactions were reported in 6 out of 23
      cisapride-treated patients and in 10 out of 20 clebopride-treated patients who
      completed the study. The most common side effect of cisapride was diarrhoea and
      that of clebopride was drowsiness. Cisapride appears to be as effective as
      clebopride in reducing dyspeptic symptoms and seems to induce less severe side
      effects.

PMID- 1747494
TI  - Combined therapy with 5-aminosalicylic tablets and enemas for maintaining
      remission in ulcerative colitis.
AB  - A combined therapy with 5-aminosalicylic (5-ASA) tablets (1.6gr/day) and 5-ASA
      enemas (4gr/twice weekly) was evaluated for maintaining remission of ulcerative
      colitis in 40 patients. All patients were in complete remission which had been
      maintained for at least 1 month. The remission was assessed by clinical,
      endoscopic and histological criteria. Clinical and endoscopical evaluations were
      performed at intervals of 2 and 6 months, respectively. The relapse-rate
      associated with this combined therapy was 7.5% at 6 months and 16% at 12 months.
      In comparison with previous investigations using continuous sulphasalazine, our
      study showed that the combination of 5-aminosalicylic tablets and enemas provided
      low relapse rates both at 6 and 12 months, suggesting a potential effectiveness
      in this form of treatment. Further studies are needed to confirm this result with
      controlled clinical trials.

PMID- 1747495
TI  - Hepatic damage after danazol treatment.
AB  - A case of liver damage following treatment with Danazol for fibrocystic breast
      disease is reported. The findings are based on liver histology and the exclusion
      of other causes of liver damage.

PMID- 1747496
TI  - Bacterial N-nitrosation and gastric carcinogenesis in humans.
AB  - It has been hypothesized that bacterially produced N-nitroso compounds cause the
      progression from chronic atrophic gastritis through intestinal metaplasia and
      dysplasia to gastric cancer. If this is true then various consequences follow.
      These consequences are discussed, together with the evidence for or against them.
      The conclusion is that there is much to support the hypothesis.

PMID- 1747497
TI  - Cell proliferation kinetics as a marker of gastric cancer risk.
AB  - Although cell proliferation studies on gastric mucosa are relatively few compared
      to the results obtained in the large bowel, they brought important contributions
      to our knowledge of the mechanisms involved in the development and progression of
      neoplasia. In normal gastric mucosa, the proliferative zone is limited to the
      neck region of the glands. In diseases at risk for gastric cancer, such as
      chronic atrophic gastritis, two main features have been observed: an increased
      cell proliferation rate and expansion or upward displacement of the proliferative
      compartment. However, while a high cell turnover rate can be due to many stimuli
      such as inflammation or the effect of hormones (i. e. gastrin), the expansion of
      the proliferative compartment is more evident with the development and
      progression of neoplasia. It could be due to an error in the control of cell
      proliferation and maturation. This kinetic pattern is probably a marker of
      gastric cancer risk. Application of these observations in clinical investigations
      are the search for proliferative abnormalities and other phenotypical markers in
      order to define an individual profile of cancer risk, and to evaluate the effects
      of xenobiotics or dietary intervention in controlled trials.

PMID- 1747498
TI  - Liver transplantation for chronic viral hepatitis.
AB  - Liver transplantation remains a problem for end stage liver disease due to
      chronic viral hepatitis, in contrast to the success with fulminant hepatitis B, D
      and C in which recurrence of viraemia is relatively rare. Following
      transplantation for chronic HCV disease recurrence of hepatitis C is infrequent
      and does not appear to be an important clinical problem. The complete picture
      will only be described when a suitable HCV-RNA test becomes routinely available.
      Patients with cirrhosis due to hepatitis B, with low levels of viraemia, or
      patients with hepatitis D are less likely to develop reinfection than those with
      high levels of HBV viraemia. The use of hepatitis B immunoglobulin in high doses
      for prolonged periods delays rather than prevents recurrence. It is a very
      expensive ancillary treatment. Patients with chronic hepatitis D related
      cirrhosis in whom levels of hepatitis B replication are suppressed, have a low
      recurrence rate even without immunoglobulin prophylaxis although HDAg remains in
      the liver. Hepatitis only reoccurs with recurrence of HBV infection.
      Unfortunately transplantation of HBV DNA and HBeAg positive patients has many
      shortcomings, and reinfection of the engrafted liver and subsequent development
      of hepatitis B is common. Survival rates are reduced in this latter group. At
      present there are no firm recommendations that can be given to prevent
      recurrence: HBIG in large doses and for prolonged periods would appear to be
      insufficient to prevent reinfection and these patients often die of recurrent
      disease. A major challenge for transplant groups will be the prevention of viral
      reinfection particularly in this latter group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1747499
TI  - Liver cirrhosis in Italy. A multicentre study on presenting modalities and the
      impact on health care resources. National Project on Liver Cirrhosis Group.
AB  - A cross-sectional multicentric study was carried out over a six-month period as
      part of the "Progetto Nazionale Cirrosi Epatica", in order to update information
      about: a) the prevalence of different aetiologic factors and various nosological
      varieties of cirrhosis in Italy, as well as its presenting modalities; b) the
      currently used approach either to the diagnosis or the treatment of complications
      of cirrhosis; c) the impact of liver cirrhosis on medical care in terms of number
      of hospitalizations and length of hospital stay, instrumental procedures and
      management, and d) the size of patient's population referred to the participating
      centers, in order to help design further studies. From February 1st through July
      31st 1987, 1,386 forms relative to 1,101 patients were collected. In 320 patients
      the diagnosis of cirrhosis was first made during the investigation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1747500
TI  - Mycobacteria and subgroups of patients in Crohn's disease.
AB  - Some recent studies have proposed a subclassification of Crohn's Disease (CD) on
      the basis of the pathological picture. In fact CD is a heterogeneous disease, and
      it is probable that the clinical and pathological disorders we now consider as CD
      may in the near future be divided into several conditions, probably with
      different causes as well, including environmental factors. Clinical and
      pathological similarities to mycobacterial disease, along with recent isolation
      of mycobacteria from tissues taken from patients with CD, and the recognition of
      atypical mycobacteria as causative agents of an enteritis pathologically similar
      to CD, all go to strengthen the hypothesis that these organisms are one of the
      above environmental factors. Researchers should therefore seek to identify and
      characterize this subgroup of CD patients who may have mycobacterial disease and
      to perform trials of antimycobacterial therapy. Analysis of the literature gives
      some suggestions for identifying this subgroup of patients: i) isolation of
      atypical mycobacteria from the tissues; ii) presence of high specific antibody
      levels and increase of same after antimycobacterial therapy; iii) presence of
      granulomas, and iv) strong suspicion of an environmental factor.

PMID- 1747501
TI  - Omeprazole vs. ranitidine in short-term treatment of Helicobacter pylori positive
      duodenal ulcer patients.
AB  - Forty-three patients with active duodenal ulcer and Helicobacter pylori
      positivity in gastric antrum were randomly assigned to either omeprazole
      treatment (20 mg once a day) or ranitidine treatment (300 mg once a day) for 28
      days. Re-evaluation of the patients (clinical and endoscopic examination and
      assessments for H pylori detection) was repeated after 2 weeks and at the end of
      the treatment. Healing rates in the omeprazole group were 40% after 2 weeks and
      90% after 4 weeks, in the ranitidine group ulcer healing was recorded in 20% of
      patients after 2 weeks and in 80% after 4 weeks. Differences between treatments
      at 2 and 4 weeks were not statistically significant. Clinical response
      (disappearance of ulcer-related symptoms) was better in the omeprazole group at 2
      weeks (p less than 0.05) but not at 4 weeks. At the end of the trial H pylori
      positivity in gastric antrum disappeared in 95% of the patients treated with
      omeprazole and in 5% of the patients who received ranitidine (p less than 0.001).
      The results confirm the effectiveness of omeprazole in short-term treatment of
      duodenal ulcer and re-emphasize the powerful activity of the drug on H pylori
      infection.

PMID- 1747502
TI  - What is new on cancer research.

PMID- 1747503
TI  - Role of sulphydryl compounds in the defense of rat gastric epithelial cells
      against oxygen reactive metabolite-induced damage.
AB  - This study evaluated the role of endogenous and exogenous sulphydryl compounds in
      the defense of rat gastric epithelial cells against damage brought about by
      oxygen reactive metabolites in vitro. Toxic oxygen species were generated by
      xanthine oxidase in the presence of xanthine. Cell damage was assessed by 51
      chromium release assay. Our data confirm that xanthine oxidase, in the presence
      of xanthine damages cultured rat gastric cells in a dose dependent manner (r =
      0.0885, p less than 0.05). Depletion of endogenous thiols by N-ethylmaleimide
      significantly increases the amount of damage induced by oxygen radicals causing,
      at the concentration of 0.005 mM, a 60% increase in 51 chromium release (p less
      than 0.001). The sulphydryl agent cysteamine did not prevent cell damage induced
      by oxygen reactive metabolites. In conclusion, 1) depletion of endogenous thiols
      significantly increases the susceptibility of rat gastric epithelial cells to
      oxygen radical-induced damage; 2) this damage is not prevented by an exogenous
      agent containing a SH group.

PMID- 1747504
TI  - Investigations on caffeine passage into the canine gastric juice.
AB  - Two caffeine boluses (5 and 10 mg/kg) were i.v. administered to four gastric
      fistula dogs. Gastric secretion was collected before and during pentagastrin
      stimulation (1, 2 and 4 micrograms/kg/h). Caffeine concentration in serum and
      gastric juice was determined by HPLC. Mean serum caffeine concentrations were
      clearly dose-dependent: 4.88 +/- 0.73 (n = 72) and 10.18 +/- 0.98 mg/l (n = 70).
      After each bolus, the time course of serum concentration was described by a
      single exponential, yielding an estimation of caffeine half-life: 310 +/- 46 (n =
      9) and 453 +/- 59 min (n = 9), respectively. In both cases the same apparent
      volume of distribution: 0.87 +/- 0.02 l/kg (n = 9) was found. In gastric juice,
      caffeine concentration depended on the caffeine dose: 2.51 +/- 2.15 (n = 66) and
      6.04 +/- 2.57 mg/l (n = 62); outputs were found to be linearly related to juice
      output, the slope being controlled by the caffeine dose. It was concluded that
      caffeine passage into gastric juice was governed by a solvent drag mechanism.

PMID- 1747505
TI  - Famotidine vs ranitidine h.s. in acute duodenal ulcer. A multicentre endoscopic
      trial.
AB  - A double-blind, randomized, active drug-controlled study was conducted in order
      to evaluate the efficacy and safety of famotidine vs ranitidine h.s. in promoting
      the healing of acute duodenal ulcers. Two hundred and eighty patients
      participated in the trial and received either famotidine 40mg h.s. or ranitidine,
      300mg h.s. The two groups were not significantly different with regard to sex and
      risk factors such as alcohol consumption and family history of peptic ulcer
      disease, while in the famotidine group, there was a slightly higher number of
      patients who smoked. Endoscopy was performed at the end of 4 and 6 weeks in 248
      patients (128 in the famotidine group and 120 in the ranitidine group). The
      healing rate in those receiving famotidine was 73.4% at the end of 4 weeks and
      increased to 93% at the end of 6 weeks, while in the ranitidine group, the rate
      was 75.8% and 92.5% respectively. Day and night pain markedly reduced in both
      groups and therapy was generally well tolerated.

PMID- 1747506
TI  - Epithelial dysplasia in atrophic gastritis. Bioptical follow-up study.
AB  - Fifty-nine cases of gastric dysplasia (46 of which were mild, 11 moderate and 2
      severe) were studied in relation to their association with atrophic gastritis and
      intestinal metaplasia. Atrophic gastritis was found in 39 cases (28 of which were
      mild, 10 moderate and 1 severe). Dysplasia was considered "persistent" when found
      of the same degree in at least two consecutive check-ups after initial diagnosis
      (13 cases); it was considered "progressive" if found more severe or evolving as
      cancer (5 cases) or "regressive" if detected in a lesser degree or no longer
      detected (13 cases). Sixteen of the 18 persistent or progressive cases of
      dysplasia were associated with atrophic gastritis, whereas 10 of the 13 cases
      with regressive dysplasia revealed no concomitant pattern of gastric mucosa
      atrophy (p less than 0.005). These findings suggest that dysplasia represents a
      truly pre-neoplastic change particularly when associated with atrophic gastritis
      and which must therefore be more carefully monitored.

PMID- 1747507
TI  - Effect of physical exercise on one-sample antipyrine clearance.
AB  - Moderate physical exercise for a few hours is not expected to reduce the hepatic
      elimination of drugs exhibiting capacity-limited metabolism (low-clearance drugs
      such as antipyrine). However, previous studies have shown that antipyrine half
      life, measured by the multiple-sampling technique, is increased by exercise. A
      simplified one-sample procedure for antipyrine clearance determination is
      increasingly being used as a liver function test. The effects of exercise on this
      measurement have never been evaluated. We measured antipyrine clearance, using
      the one-sample, simplified procedure in a group of 50 young Italian army
      soldiers, while at rest and during a 6 hour march in the mountains (extra energy
      expenditure: 7.43 kjoule per min). Mean antipyrine clearance was on average 46.6
      (SD 10.2) ml/min (range 30.5-65.4) while resting, and 46.2 (10.5) (range 25.5
      64.8) while exercising (not different). No specific advice regarding physical
      exercise is needed whenever liver function is measured in outpatients by the one
      sample, simplified antipyrine clearance test.

PMID- 1747508
TI  - Abdominal ultrasonography in the diagnosis of extrinsic endoscopic compressions
      of stomach and duodenum.
AB  - Extrinsic compressions of stomach or duodenum (ECSD) are occasionally found
      during endoscopic examination. Ultrasonography is usually performed in order to
      explain the significance of this feature. We have prospectively assessed the
      prevalence of ECSD and the diagnostic role of US in this context. ECSD were found
      in 37 out of 6604 gastroduodenoscopies. An abdominal US was performed after
      endoscopy in all these patients. The extrinsic compressions were in the gastric
      anterior wall in 7 patients in the gastric posterior wall in 10 patients, and in
      the lesser curvature in 9 patients and in the duodenum in 11 patients. In 20
      patients the compression was due to neoplastic lesions, in another 15 non
      neoplastic conditions were found (hepatomegaly, splenomegaly, gallbladder
      hydrops, pancreatic pseudocyst, vascular malformations). Ultrasonography was
      demonstrated to have an elevated sensitivity (87.5%) and an elevated specificity
      (100%) when technically adequate. We conclude that extrinsic compressions of
      stomach and duodenum detected at endoscopy are frequently associated to
      neoplastic lesions. Abdominal ultrasonography is an accurate tool, when
      technically adequate, as an initial screening test for such lesions.
      Endosonography, CT scan or other invasive tests must be performed in doubtful
      cases.

PMID- 1747509
TI  - Eosinophilic gastroenteritis: report of two atypical cases.
AB  - Eosinophilic Gastroenteritis (EG) is a poorly understood disorder defined by
      eosinophilic infiltration of the bowel wall, eosinophilia and gastrointestinal
      symptoms. The disease's aetiology, course and treatment are not well known. We
      report two atypical cases of EG: one involving the mucosal layer and another
      involving the serosal and muscularis layer. The first shows how EG may present
      with a long history of episodes of intestinal obstruction and malabsorption and
      how the disease could take a severe course and may be unresponsive to treatment.
      The second case shows EG presenting as acute abdomen and which subsequently
      became asymptomatic without therapy, regardless of the fact that peripheral
      eosinophilia remained present. This case raises the problem of how to treat an
      asymptomatic patient, what parameters should be considered in order to assess the
      progress of the disease and the indications for treatment.

PMID- 1747510
TI  - Gastrospirillum Hominis associated chronic active gastritis: the first report
      from Italy.
AB  - Recently a spiral bacterium different from Helicobacter Pylori (HP) was observed
      in the human stomach and the name of Gastrospirillum Hominis (GH) was proposed
      for this organism. GH presence is reported to be not associated to HP but related
      to chronic active gastritis. We describe the case of a 31 year old male suffering
      from upper abdominal symptoms, who underwent oesophagogastroduodenoscopy, which
      revealed a picture of duodenal hyperemia. Gastric body showed a normal mucosa and
      absence of HP, while active chronic gastritis associated with HP was found in the
      antrum. In addition few spiral bacteria showing 4-5 spirals, larger than HP were
      observed within the gastric crypts and beneath the mucus layer in this site. This
      case represents the first report from our geographic area (Southern Italy) of the
      possibility of finding bacteria different from HP in the human stomach. The
      simultaneous HP presence does not allow us to relate the chronic active gastritis
      of the patient with the GH like bacteria. Our finding, however, suggests the
      possibility that HP and GH may be simultaneously present in the course of type B
      antral chronic inflammation. This association was not observed in previous
      investigations.

PMID- 1747511
TI  - Acquired factor VIII inhibitor in a patient with adenocarcinoma of the colon
      rectum.
AB  - The presence of a circulating inhibitor of factor VIII was observed and described
      in several pathological conditions. In the present study we describe the case of
      a patient with a severe haemorrhagic syndrome caused by the presence of a
      circulating inhibitor of factor VIII discovered following abdominal surgery for
      an adenocarcinoma of the colon rectum. The haemorrhagic syndrome evolved
      independently from the course of the neoplastic disease.

PMID- 1747512
TI  - Iatrogenic haemobilia: ultrasound appearance of intragallbladder haemorrhage. A
      report of two cases.
AB  - Ultrasound appearance of intragallbladder haemorrhage in two patients with
      haemobilia is presented. Gallbladder lumina were occupied by non-shadowing, firm
      masses of mixed echogenicity representing blood clots. In both cases iatrogenic
      trauma following percutaneous transcholecystic cholangiography and blind hepatic
      biopsy caused bleeding in the biliary tree.

PMID- 1747513
TI  - Sensory nerves in the gastrointestinal tract: changing concepts and new
      perspectives.
AB  - In recent years great interest has been directed to study the function of
      capsaicin-sensitive primary afferents in the gastrointestinal tract. It has been
      demonstrated that these fibers not only have a sensory role but also play a local
      efferent function through direct and indirect effects of released
      neurotransmitters. Peptides released by capsaicin-sensitive nerves are involved
      in several functions modulating either the local blood flow or the
      gastrointestinal motility. The analysis of the action of released transmitters
      may serve to understand the physiology and pathophysiology of the
      gastrointestinal tract. All data here reported demonstrate that the study of
      capsaicin-sensitive primary afferents may be helpful to develop new
      pharmacological treatment of various human disease of the gastrointestinal tract.

PMID- 1747514
TI  - [Public health in very low fertility era].

PMID- 1747515
TI  - [A review on mental health and psychiatric services in England].
AB  - Psychiatric care in Japan has received criticism not only within Japan but from
      other parts of the world. By contrast, the services for mentally ill in England
      is considered to be superior and is therefore presented briefly to benefit the
      development of better community psychiatric care in Japan. The history of
      psychiatric services in England is described briefly. After World War II,
      deinstitutionalization has been occurring and the in-patient rate per 100,000
      population which was 354 in 1954 and has decreased to 120 in 1990. Despite a
      decrease in the in-patient rate, the admission rate per 100,000 population has
      been increasing gradually during this period. Deinstitutionalization process and
      the development of community care services are summarized. Among these are
      alternative services such as primary care, day care and residential services in
      the community which are considered to be important elements. Problems associated
      with deinstitutionalization process are also discussed. In developing community
      care services in Japan, lessons can be learned from the success and failures of
      England's attempt over the last 30-years to build a better, more community-based
      system.

PMID- 1747516
TI  - [Relationship of self-rated health to mortality among the community elderly].
AB  - The purpose of the present study is to examine the relationship of self-rated
      health to mortality. Subjects consisted of 1096 elderly (471 men, 625 women) aged
      65 years and over in 1983, living in the town of Yuwa in Akita Prefecture. They
      were followed to determine survivorship status and relocation for 7 years after
      the baseline survey in 1983. The relationship of self-rated health to mortality
      was tested using a logistic model. The results obtained were as follows: (1) Poor
      self-rated health was significantly related to higher mortality in a graded
      fashion by univariate analyses. (2) The significant relationship of self-rated
      health to mortality was still observed after controlling for sex, age, education,
      drinking, smoking, physician visits, history of stroke, and activities of daily
      living. (3) The contribution of self-rated health to mortality differed by sex,
      age group (65-74, 75-), and period of follow-up (early, late). The contribution
      was greater in men, aged 75 and over, and during the latter part of the follow
      up.

PMID- 1747517
TI  - [A population based epidemiological study of senile cataracts].
AB  - A population based study on senile cataracts was conducted on 295 participants in
      an ophthalmologic examination in a rural area of Ishikawa prefecture. Subjects
      were above 40 years of age and received an ophthalmologic examination and were
      personally interviewed. The following results were obtained. 1) Prevalence of
      senile cataracts increased with age. 2) For eyes with lens opacity grade III
      66.3% showed a visual acuity below 0.7, while about 45% with lens opacity grade I
      or II was a visual acuity below 0.7. 3) Among those determined to have senile
      cataracts by this study the proportion with a prior diagnosis of senile cataracts
      was low, i.e., 36% even in advanced cataracts with lens opacity grade III. The
      proportion improved with worsened visual acuity and having a personal
      ophthalmologist. 4) Of those already diagnosed with senile cataracts, 56.7%
      failed to visit an eye specialist after than. This proportion tended to be lower
      in persons with worsened visual acuity. 5) About a half of those who continued to
      visit an eye doctor utilized anti-cataract medication. 6) The level of knowledge
      regarding senile cataracts was statistically lower with age.

PMID- 1747518
TI  - [Effect of intensive vacuum cleaning in reducing house dust mite antigen in bed
      rooms of asthmatic children].
AB  - House dust mite (Dermatophagoides farinae) antigen was measured by enzyme-linked
      immunosorbent assay in house dust samples obtained from the bed rooms of
      asthmatic children and normal controls. In 37 rooms where regular vacuum cleaning
      was performed, the mean of D.f. antigen was 4.42 +/- 7.55 micrograms/m2. In the
      24 bed rooms of asthmatic children, mean levels of D.f. antigen decreased
      significantly (p less than 0.05) after intensive cleaning (systematic cleaning)
      was continued for 4 weeks (0.78 +/- 0.93 micrograms/m2) compared to prior to
      initiation of systematic cleaning (4.12 +/- 6.31 micrograms/m2). Symptom scores
      decreased in 65% of the asthmatic children. In 8 bed rooms of normal controls,
      mean levels of D.f. antigen also showed a decrease after systematic cleaning
      (0.43 +/- 0.62 micrograms/m2) compared to before (5.59 +/- 12.46 micrograms/m2).
      However there was no significant difference in D.f. antigen between the bed rooms
      of asthmatic children and normal controls. Intensive cleaning markedly decreased
      the allergen in both groups, clearly suggesting effectiveness in the reduction of
      asthmatic attacks in patients and perhaps also in preventing sensitization of
      healthy children.

PMID- 1747519
TI  - [Studies on the dynamics of Salmonella organisms in raw sewage treatment plants].
AB  - The dynamics of Salmonella organisms in raw sewage treatment plants was studied
      over a period from July 1987 to August 1989. An experiment where Salmonella ser.
      Havana NAr was introduced into raw sewage was also performed over 2 days during
      this period. The results are as follows. 1) A number of strains of Salmonella
      could be isolated usually from samples drawn from raw sewage influent and up to
      the activated sludge stage of sewage processing. 2) After Salmonella ser. Havana
      NAr was introduced into raw sewage, the number of the organisms decreased in the
      activated sludge process to 1/1000 and the organisms were not found in the
      treatment plants after about forty days. 3) These results suggest that
      Salmonellas are adsorbed to activated sludge or other sludges, and are not
      discharged into rivers from this treatment plant. 4) The possibility of being
      able to determine the strain of Salmonella in regional epidemics by serovars of
      Salmonella detected in raw sewage treatment plants was suggested.

PMID- 1747520
TI  - [Isolation of Yersinia, campylobacter, Plesiomonas and Aeromonas from
      environmental water and fresh water fishes].
AB  - Yersinia, Campylobacter, Plesiomonas and Aeromonas are known causative agents in
      waterborne diseases. For about 10 years, outbreak of diarrhea has been observed,
      especially among children, in the mountain areas of Okayama. Y.
      pseudotuberculosis recently isolated from non-chlorinated drinking water sources
      such as mountain streams and wells has been suspected to be the causative
      bacteria of the disease. Attempts were made to isolate Yersinia and Campylobacter
      from water samples from rivers in rural areas and Plesiomonas and Aeromonas from
      samples of well water and fresh water fishes in Okayama prefecture from 1987 to
      1990. The isolation rate of Yersinia from river water samples was 7.5% with a
      higher rate in the mountain areas than in the nonmountain areas. While Y.
      enterocolitica was isolated throughout the year, Y. pseudotuberculosis was only
      seen during the winter. Various serogroups including human types of Y.
      enterocolitica and serogroup 2B, 4A and UT of Y. pseudotuberculosis were
      detected. Campylobacter was isolated from 0.5% of river water samples.
      Plesiomonas from 1.5% of fresh water fishes, and Aeromonas was isolated from 6.9%
      of well water samples and 47.1% of fresh water fishes.

PMID- 1747521
TI  - [Tuberculosis epidemic in a mental hospital].

PMID- 1747522
TI  - [Japan's official development assistance in medicine and public health].

PMID- 1747523
TI  - [Mental and physical condition group characteristics of disabled elderly living
      at home and principal diseases related to them].
AB  - A survival study over a period of one thousand days from July 1985 was performed
      on 177 cases of disabled elderly (aged 65 and over) living in Moriguchi-city,
      Osaka, who were enrolled as recipients of solatia for the disabled elderly. At
      the start of this study, subjects or family members were questioned regarding
      physical and mental status, clinical history and social environment of these
      elderly and their family. On the basis of these findings, the level of disability
      of the elderly was estimated by applying scores to identify physical and mental
      conditions: The score on physical status, named Total Functional Capacity (TFC),
      is equivalent to the dependent level of ADL: mental status was scored by
      assessing seven typical psychiatric questions relating to dementia (Mental Status
      Score: (MSS]. The following findings were obtained. 1) It was confirmed that
      mortality probability tended to increase by degrees in proportion to lower level
      of independent ADL which was indicated by high scores of TFC, and a greater
      number of psychiatric symptoms such as often observed in the case of dementia
      (i.e. high scores of MSS) in either sex. 2) For males, among the major diseases
      precipitating disability, the proportion for stroke was about 50%. In females,
      disability causes were distribute into various categories of diseases, but
      orthopedic diseases (e.g. accident or a fracture), contributed a large
      proportion. The percentage of elderly who became disabled due to stroke was
      higher in the lower age categories for females. 3) TFC scores did not correlate
      with age among either sex. 4) More than 40% had more than one psychiatric symptom
      included in the MSS score. The proportion of elderly having any one symptom
      tended to increase with age for either sex, and was especially significant for
      females. 5) Correlation was seen between TFC and MSS for only female.

PMID- 1747524
TI  - [The relationship of chewing ability to nutrient and food intakes in the
      community elderly].
AB  - The purpose of the present study is to investigate the relationship of chewing
      ability to nutrient and food intakes in the community elderly. Subjects consisted
      of 145 elderly residents (56 males, 89 females) ranging in age from 65 to 79
      years, living at home in a village of Okinawa Prefecture. Chewing ability was
      divided into two categories: being able to chew ordinary foods was defined as
      "good", and being able to chew only soft foods as "bad". To determine
      quantitative food intakes 24-hour dietary records were utilized which were
      confirmed by nutritionists during interviews. Good chewing ability was found in
      82.1% for males and 83.1% for females with no statistically significant
      difference concerning age or sex. Teeth status was significantly related to
      chewing ability. For both males and females, protein intake was lower in the
      group with bad chewing ability than in the good group. Only in males intakes of
      total energy, fats, Ca, and Fe were lower in the group with bad chewing ability.
      Concerning food items, intakes of dark green and yellow vegetables and fat in
      males, and intake of rice in females, were lower in the group with bad chewing
      ability.

PMID- 1747525
TI  - [Standardization of definitions concerning smoking behavior among Japanese
      adolescents--results from the Japan Adolescent Smoking Survey (JASS)].
AB  - The aim of the Japan Adolescent Smoking Survey (JASS) is to standardize the
      definitions of smoking behavior among Japanese adolescents together with
      measurement methods and questionnaires concerned. A study of 9921 school children
      aged 9 to 18 years in 17 elementary schools, 16 junior high schools and 18 senior
      high schools in 9 prefectures, was conducted between June and July of 1989, to
      determine the relationship between actual smoking behavior during the past month
      or year and the "self-referent label" concerning their smoking status. The main
      results were as follows: 1) The percentage of those who smoked at least one
      cigarette during the past month showed a high degree of similarity to the
      percentage of those who referred to themselves as "regular smokers" or
      "occasional smokers". 2) Less than 10% of students who identified themselves as
      "never smokers" or "ex-smokers" smoked at least one cigarette during the past
      month, while more than 80% of students who referred to themselves as "regular
      smokers" or "occasional smokers" smoked during the past month. 3) On the whole,
      those who smoked 20 or more cigarettes during the past month referred to
      themselves as "regular smokers"; those who smoked between 2 and 19 cigarettes as
      "occasional smokers"; those who smoked 1 cigarette as "ex-smokers"; those who did
      not smoke during the past month as "never smokers". 4) The definition where
      students who smoked one cigarette during the past month are classified as a
      category of smoker, displayed a high level of sensitivity and specificity for all
      school-level groups and for both sexes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1747526
TI  - [Survey on international health related education in preventive medicine
      curricula of medical school in Japan].
AB  - A nation-wide survey of the 150 active members of the Japan Association of the
      Directors of the Departments of Hygiene and Public Health at Medical Schools (80
      medical schools) in Japan was conducted regarding international health related
      education for the 1990 academic year. The survey questionnaire used 6 basic
      questions, including some space for free answers. There were 105 effective
      responses (70.0%). Among them 61 answered that educational courses related to
      international health were provided in their curriculum; 16 out of 39 (41.0%) in
      the department of hygiene, 34 out of 48 (70.8%) in the department of public
      health, and 11 out of 18 (61.1%) in others. However, there were 24 that had the
      same title of "International Health". The most prevalent key-word was WHO (41),
      with international exchange and cooperation (15), JICA (14), PHC (12), ILO (12)
      following in that order. These results suggest a need for curriculum improvement
      in the near future for implementing international health education. Some
      strategies for developing international health related education in the broader
      context of the whole medical curriculum in collaboration with other departments
      are discussed.

PMID- 1747527
TI  - [Survey on international health related education in the schools of public health
      nurses in Japan].
AB  - A nation-wide survey of directors of 60 schools for public health nurse education
      in Japan was made from April and May of 1990 regarding international health
      related education for the 1990 academic year. The survey questionnaire utilized 3
      questions, and a column for free answers. An effective response rate of 76.7%
      from a total of 46 schools was obtained: 4 year colleges-4; 3 year junior
      colleges-4; and 37 schools with a 1 year course. Among them 27 schools (67.9%)
      responded that related courses was available in their curriculum. Except for 2
      key-words (WHO, Alma-Ata Declaration-PHC) which are found in all schools,
      quarantineable diseases were taught in 34 schools, international exchange and
      cooperation in 23, JICA (Japan International Cooperation Agency) in 10, NGO in
      10, health care for the Japanese in foreign countries in 6. Free answers were
      provided by 22 schools. From these results, the need for a changing role of the
      public health nurses in the internationalizing of Japan's society and for future
      curriculum development is seen.

PMID- 1747528
TI  - [A method of interval estimation for number of patients in the nationwide
      epidemiological survey on intractable diseases].
AB  - A method for estimating the intervals for the number of patients with intractable
      diseases from nationwide epidemiological surveys was developed under the
      assumption that response is independent of frequency of patients. This method is
      based on data utilizing the number of response hospitals classified by their
      reported number of patients. The approximate 95% confidence intervals of numbers
      of several intractable diseases patients were estimated using this method.

PMID- 1747529
TI  - [Measures for problems concerning community dental health plan].

PMID- 1747530
TI  - [Seasonal variation of mortality from cerebro-cardiovascular diseases--effect of
      ambient temperature on death].
AB  - A study to clarify the relationship between seasonal variations in mortality from
      cerebro-cardiovascular diseases and ambient temperature (maximum/minimum
      temperature and daily range) was performed using time series analysis, and the
      role of ambient temperature as an associated factor in cerebro-cardiovascular
      disease caused death was discussed. The following results were obtained: 1) The
      seasonality factor associated with the monthly variation for mortality was of
      greater magnitude for heart diseases more than for cerebral diseases. There was a
      tendency for mortality from cardiac diseases to decline gradually from
      February/March to July/August, and to increase in October/November, with a
      maximum peak in the curve of seasonal variation observed in January/February. 2)
      The seasonal factor associated with maximum/minimum temperature and daily
      temperature range showed a stable variation in magnitude from January to
      December, with temperatures displaying a single peak in August. Daily temperature
      range was lowest during summer and highest during the late fall, winter or early
      spring. 3) A statistically significant negative correlation was seen between
      mortality from cerebro-cardiovascular diseases and seasonality and temperature,
      while a positive correlation was seen between mortality and daily temperature
      range, suggesting that low environmental temperatures may operate indirectly as a
      factor that affects cerebro-cardiovascular disease mortality.

PMID- 1747531
TI  - [Clustering of suicides under age 20--seasonal trends and the influence of
      newspaper reports].
AB  - The existence of temporal clustering of suicides was analyzed by comparing the
      distribution of weekly numbers of suicides under age 20 in Japan (1982-1987) with
      a Poisson distribution. The linkage between newspaper reports about teenage
      suicides and these clusters of suicides was examined in an ecologic study. The
      following results were obtained: 1) The distribution of weekly numbers of
      suicides under age 20 was not consistent with a Poisson distribution. The
      observed numbers for weeks with clustering was higher than the expected numbers.
      Therefore it is suspected that teenage suicides was not an independent occurrence
      but clustered in specific weeks with clustering observed in April and between the
      15th and 25th weeks in 1986. 2) The age and sex characteristics of those who
      committed suicide during the observed clusters every April did not differ from
      that of suicide victims for the rest of the year. The incidence ratio for suicide
      between 15th and 25th weeks in 1986 compared to the same period for other years
      was higher in girls than in boys, and higher in younger teenagers than older
      teenagers. Analysis by prefecture of suicides which occurred between the 15th and
      25th weeks in 1986 showed high incidences for Hokkaido, Tohoku, Chugoku, and
      Shikoku blocks, and low incidences for the Kanto and Kinki blocks. 3) Twenty news
      articles reporting teenage suicides with headings much larger than four columns
      appeared in the Asahi Newspaper in 1982-87. Significant linkage between newspaper
      reports about teenage suicides and trend of weekly numbers of suicides in 1985
      and 1986 was not observed. 4) Weekly numbers of suicides significantly increased
      following newspaper reports on January 23rd 1985 and on April 8th 1986,
      describing a suicide caused by battering, and a jumping suicide of a young singer
      who was popular among teenagers, respectively. However no increase in the number
      of suicides was observed following other newspaper reports.

PMID- 1747532
TI  - [Subjective health and related factors among middle-aged men living in Tokyo--a
      comparative study].
AB  - Random samples of middle-aged (35-64) male residents of two different areas in
      Tokyo, Bunkyo-ku, a low-mortality area (n = 767) and Koto-ku a high mortality
      area (n = 790) were interviewed between March and April in 1988, concerning
      health and life style. The two populations were compared regarding, 1) health
      status which was examined from the view point of fatigue, symptoms and self-rated
      health, 2) factors related to the three health indices. The main results were as
      follows: 1. No significant differences were seen between the two populations in
      the gross means for health indices. However when the health indices were
      stratified by age group, mental fatigue and minor symptoms were more prevalent in
      Bunkyo-ku than Koto-ku among young people, while prevalence of physical fatigue
      and major symptoms was higher in Koto-ku among old people. 2. The relationship
      between the health indices and job type, income, education and marital status was
      examined. In Bunkyo-ku, no relationship was seen after controlling for age,
      working conditions and life style. On the other hand, in Koto-ku, significant
      relationships were seen with age, job type and marital status, and health
      problems were prevalent not only among those with low socioeconomic status but
      also in other socioeconomic groups. These results were maintained even after
      controlling for age, working conditions and life style, similar to the analysis
      for Bunkyo-ku, indicating that health problems in this population do not appear
      to be solely the result of working conditions or life style.

PMID- 1747533
TI  - [A cohort study on deaths from SMON in Japan].
AB  - Causes and risk factors of deaths from subacute myelo-optico neuropathy (SMON)
      were studied in a prospective cohort of 4,329 SMON patients followed for 3 years
      and 7 months (Sept. 1985-March 1989) with the following findings: (1) Recent
      excess deaths of SMON patients was estimated as 4% from ratio of O/E (SMR = 104)
      and deaths due to SMON itself was 6.4%. (2) The ratio of O/E was significantly
      higher for deaths from cancer of colon/rectum in females, cancer of pancreas in
      males, hypertension in males, pneumonia/influenza in females, chronic obstructive
      pulmonary diseases in males, tuberculosis and intestinal obstructive disease in
      males and females. (3) The ratio of O/E was 1.8 times or greater for those SMON
      patients with complications of cerebrovascular disease, severe blindness,
      complete loss of ambulation, and who were bedridden, and who are unable to
      receive home care from family members or trained home helpers.

PMID- 1747534
TI  - [Trends in length of stay of psychiatric inpatients based on "patient survey"].
AB  - The average length of occupancy for psychiatric beds in Japan has been pointed
      out to be among the longest in the world. However, neither the average length of
      occupancy since admission of psychiatric resident patients present at a facility
      at a given point of time (e.g. at the end of every October) nor the average
      length of stay of psychiatric patients until discharge have been reported in
      national health statistics. Using data from the "Patient Survey (1974-1984,
      1987)" by the Ministry of Health and Welfare, estimates of trends for 1) length
      of hospitalization since admission of resident patients at the end of every
      October and 2) length of hospital stay from admission to discharge in patient
      cohorts admitted each year from 1974 to 1984, were determined. A remarkable
      difference in distribution was observed in the length of hospitalization in
      psychiatric residents and length of stay until discharge. For psychiatric
      residents surveyed at the end of October 1987, 13% had been resident for less
      than 3 months, 27% within one year, and 54% within 5 years. On the other hand,
      33% of the patient cohort admitted in 1984 were discharged within one month, 59%
      within 3 months, and 85% within one year. Six percent of the cohort, however, had
      remained hospitalized for more than 3 years, some of whom were potential 'new'
      long-stay patients. The proportion of patients staying more than ten years shows
      an increase from 17% in 1974 to 30% in 1987, with the distribution of length of
      hospitalization in residents demonstrating a definite shift to increased length.
      On the other hand, length of stay until discharge shows a slight shortening.

PMID- 1747535
TI  - [Fatty acid composition of foods (report 2)--substituted dairy products].

PMID- 1747536
TI  - [Risk evaluation of changes in global environment on human health].

PMID- 1747537
TI  - [Survey of attitudes among general practitioners regarding the introduction of a
      personal computer medical network system in community health care].
AB  - General practitioners (GPs) play an important part in community health care.
      Their opinion regarding introduction of a medical information network system
      using a personal computer and factors influencing the decision to introduce such
      a system were surveyed among 977 randomly sampled GPs. A response from 727 GPs
      was obtained. Based on a two stage selection method, 20 factors were selected as
      effective factors among the 73 factors surveyed, with the following results: (1)
      Responses to the question concerning the approval of system introduction were
      classified into three groups: "not necessary + too early to make a decision (DA)"
      (DA group), "approve (A)" (A group) and "undecided (UD)" (UD group). Each group
      had nearly equal numbers of respondees. (2) Significant effective factors were
      "experience with personal computers", "a desire to use a personal computer", "a
      desire to use a computer-diagnosis-system", "cost", and "a volition to operate a
      computer by himself". (3) The "A group" had high experience and affirmative
      opinions, while the "DA group" had low experience and negative opinions. The "UD
      group" also tended to respond with "do not know" regarding the factors. (4)
      Approval of system introduction requires providing basic knowledge on computers,
      opportunities for positive experience with computers, and practical examples of
      problem solutions in a general practitioner's work.

PMID- 1747538
TI  - [Evaluation of methods for measuring daily physical activity in terms of energy
      expenditure].
AB  - Various methods exist for measuring daily physical activity and daily energy
      expenditure and daily pedometer readings are most commonly used for the amount of
      physical activity. In this study, three methods for measuring energy expenditure
      24-hr heart rate method (HR), time study method, and caloric expenditure
      accumulator (CC)-, and the feasibility of a pedometer for the assessment of
      energy expenditure were examined under laboratory conditions and during normal
      daily life. Daily physical activity was measured by four methods (HR, Time study,
      CC, Pedometer) in a field study of 14 young, healthy and sedentary women, and
      compared. Laboratory validation of the three methods with measurement of oxygen
      uptake was performed with 5 young men and 1 woman walking and running at
      different speeds and grades on a treadmill. In addition validation tests of
      whether pedometer readings reflect differences in energy expenditure due to speed
      and grade and whether pedometer counts steps exactly were also conducted. The 24
      hr energy expenditure derived from CC was significantly lower than that derived
      from HR and Time study, due to lower estimation of energy expenditure from
      activities compared to other methods. In the laboratory study, the energy
      expenditure measured at 5% grade was low by CC and differences in energy
      expenditure for changes in grade could not be differentiated. Time study revealed
      a significant relationship between CC and HR in field study. These results
      suggest that CC tends to underestimate the 24-hr energy expenditure from
      activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1747539
TI  - [Cigarette smoking and mortality among Japanese males in a prospective cohort
      study].
AB  - The relationship between smoking and disease was studied in a prospective cohort
      study among a Japanese male working population. The relative risk of cigarette
      smoking was positively associated with mortality for all diseases and major
      neoplasms. In current smokers consuming 25 to 34 cigarettes per day, relative
      risk for all diseases, major neoplasms, and lung cancer compared to nonsmokers
      was 1.38, 2.04, 2.36, respectively. These data suggest that there is a positive
      relation between smoking and disease mortality in this male working population.
      As for ex-smokers, estimated relative risk for all neoplasms was between that of
      current smokers and nonsmokers.

PMID- 1747540
TI  - [A study of dental status and its contributing factors in mentally retarded
      persons institutionalized in welfare facilities].
AB  - Two hundred and forty-one mentally retarded persons, institutionalized in three
      private welfare facilities in Oita Prefecture, were assessed for dental status
      and tooth brushing ability. Information on their life style was also obtained by
      a questionnaire completed by their supervisors in the facilities. 1) Dental
      status of mentally retarded subjects was found to be inferior compared to the
      general Japanese population studied in the survey of dental disease in 1987 by
      the Ministry of Health and Welfare. Inferior dental status was characterized by a
      low score for filled teeth and a high score for missing teeth. 2) Both low tooth
      brushing ability and low intelligence quotient were associated with their poor
      dental status. 3) Discrepancy between supervisor assessment of tooth brushing
      ability and actual ability was observed. 4) Periodontitis was observed in young
      epileptics taking antiepileptic medication at a high rate. However there was no
      association between the taking of antiepileptic medication and missing teeth
      score. These results indicate a necessity for more active dental services
      including the teaching of tooth brushing and early treatment by dentists and
      supervisors.

PMID- 1747541
TI  - [Mutagenicity of rice-straw and -husk ashes by Ames test].
AB  - In the rice-producing district of Japan, environmental pollution by smoke from
      burnt rice straws has become a matter of concern. The mutagenicity of fly- and
      bottom-ashes of rice-straw and -husk was assayed by the Ames test, TA100 +/- S9
      and TA98 +/- S9, and the relationship of combustion temperature to mutagenicity
      was investigated. Fly ash showed weak mutagenicity at 300 degrees C, with no
      remarkable change in mutagenic activity between 300 degrees C and 500 degrees C.
      Above 500 degrees C the mutagenic activity increased with a rise of temperature.
      The increasing rate of mutagenicity was much higher in the test system with S9
      mix than that without S9. Moreover, the mutagenicity with TA100 was stronger than
      with TA98. With respect to bottom ash, weak mutagenic activity was observed at
      300 degrees C, but at 400 degrees C decreased and at 500 degrees C or above could
      not be observed. Fly ash derived from burning 1 g of rice straw at 600 degrees C
      showed about 14 times and 2.5 times higher mutagenicity than main stream smoke
      condensates from the burning of 1 g of cigarette in TA100 + S9 and TA98 + S9 test
      systems respectively.

PMID- 1747542
TI  - [A study of victims of methylmercury poisoning outbreaks by age and sex in
      Minamata, Niigata and Iraqi outbreaks].
AB  - To investigate features of the incidence of methylmercury poisoning cases
      presumably caused by intake of polluted foods in Japan and Iraq, several
      populations exposed to polluted foods were analyzed by geography and/or
      occupation. Ratios of confirmed cases to the corresponding number by age and sex
      in the defined exposed population were calculated. The distribution of the ratios
      showed a unimodal age distribution for both males and females in the Japanese
      Minamata and Niigata population. On the contrary, in the Iraqi population, ratios
      distributed equally by age and sex groups, having no peaks. This difference
      between the two countries is probably due to the difference of ingestion by age
      and sex in fish and wheat, which was the primary source of methylmercury
      exposure.

PMID- 1747543
TI  - [Descriptive epidemiology of 30 intractable disease patients receiving financial
      aid for treatment].

PMID- 1747544
TI  - [Epidemiology and civil trials].
AB  - The role epidemiology in courts has become increasingly important both in the
      United States and in Japan, especially in the field of product liability. In the
      United States, attributable risk percent (AR%) is used in civil trials as a
      measure to judge whether alleged factors caused health disturbances of
      plaintiffs. Most epidemiologists believe that an AR% of more than 50%, ie,
      relative risk more than 2, supports causality of alleged factors, because
      "preponderance of evidence" is regarded as a fundamental legal rule in the United
      States. In Japan, judges in courts require a more strict standard for proof of
      facts, which means that a much higher AR% may be needed to convince judges. The
      role of epidemiologists in courts may be to show a plausible range of AR%, based
      on design, execution, and analysis of quoted epidemiologic studies. Standards for
      accepting plaintiffs' allegation should be discussed in the legal framework of
      Japan.

PMID- 1747545
TI  - [A study of family support, health state and medical care among functionally
      dependent elderly in Shanghai, China].
AB  - The effect of family caregiver's attitudes to elderly on health conditions of
      functionally dependent elderly, relationships between family support and
      perceived burden among family caregivers, and factors related to family support
      were analyzed. Support in this study was defined as help directed at helping
      functionally dependent elderly achieve independence or self-care. In 1989, a
      survey was conducted of family caregivers in Shanghai. Functionally dependent
      elderly were collected by screening of people aged 65 years old and over, and
      family caregivers who were able to provide support as defined above were included
      as subjects (n = 468). The following results were obtained: 1. Caregivers with
      positive attitudes for support had a higher proportion having the ability to
      obtain physician care compared to those with low family support. The proportion
      of persons with bedfast condition, cognitive impairment, and abnormal behaviors
      did not appear to have a relationships to level of family support. 2. There was
      only a weak relation between family support and perceived burden scale of
      caregivers. 3. Among all factors, the strongest relationship to family support
      was with educational background. The health of caregivers and the family
      relationship between caregivers and functionally dependent elderly were also
      related to level of family support.

PMID- 1747546
TI  - [Relationship between senile dementia and findings of an initial health
      examination--a 20 year retrospective cohort study of Kamo Village (1965 to
      1985)].
AB  - The correlation between incidence of senile dementia and variables determined in
      baseline health examinations was analyzed in a retrospective cohort study. The
      study cohort was assembled in 1965 and followed up to 1985. A survey of dementia
      was performed on those alive in 1985, and on the decreased through their families
      who were queried about his or her condition just before death. The survey was
      conducted by public health nurses and assistants. The results obtained were as
      follows: 1. There was a slightly higher incidence in women and incidence for both
      sexes demonstrated an increase with age. 2. Analysis by cause of death showed
      increased death by cerebrovascular diseases for both men and women, and by
      cardiovascular disease for women, but decreased death from cancer. 3.
      Correlations of senile dementia with high blood pressure and albuminuria findings
      at the initial examination were seen. In addition, results of fundus oculi
      examination in men, and electrocardiography in women were also regarded as risk
      factors for the occurrence of senile dementia. 4. Comparative analysis showed
      higher incidence among farmers rather than fishermen, and in drinkers rather than
      nondrinkers, while no relation was found to smoking habits.

PMID- 1747547
TI  - [Prediction of 24-hour urinary creatinine excretion from age, body weight and
      height of an individual and its application].
AB  - Equations to predict 24-hour urinary creatinine excretion (UcrV) from age, body
      weight (W) and body height (H) were developed based on the data for UcrV
      determined by collecting 24-hour urine for 3-5 days in 256 male and 231 female
      clinically healthy subjects, aged from 20 to 84 years. By regression analysis a
      regression equation was developed. Multiple regression analysis revealed that
      age, W and H contributed most to the measured value of UcrV. The regression
      equations to predict UcrV from age, W and H were as follows: Predicted value of
      UcrV (PRCr) = -12.63 x Age + 15.12 x W + 7.39 x H - 79.90 (male: mg/day) PRCr = 
      4.72 x Age + 8.58 x W + 5.09 x H - 74.50 (female: mg/day) The multiple
      correlation coefficients were 0.87 for males and 0.73 for females, respectively.
      The difference between PRCr and measured UcrV (residual) was +0.81 +/- 154 (SD)
      mg/day on the average. An analysis of residuals by means of plotting of
      standardized residuals and predicted standardized dependent variables showed no
      remarkable deviations in both sexes, suggesting that these equations are
      applicable to the prediction of UcrV. These equations were applied to 38 Japanese
      men and women who were asked to collect 24-hour urine for 14 days on average, and
      also to 47 foreigners (American, Nepalese and Italian). The average residual in
      the former was +27 +/- 87 mg/day and that in the latter -3 +/- 85 mg/day,
      suggesting that these equations can be applied not only to the Japanese but also
      to the foreigners as a useful index in predicting 24-hour urinary creatinine
      excretion.

PMID- 1747548
TI  - [A report of the state of health in Zimbabwe].
AB  - The health state in Zimbabwe is reported in terms of currently significant
      diseases, health statistics and hygiene and health care system in conjunction
      with the author's experiences as a visiting doctor in the country between June
      and September in 1989. Since independence in 1980 the government has transformed
      the colonial and racial health system and attempted to redistribute health care
      resources to the rural population. Similar to many countries in Central and East
      Africa, the accumulative number of AIDS cases in Zimbabwe is increasing rapidly
      despite the vigorous governmental campaigns launched in the early stage. The
      incidence of tuberculosis has also been rising since 1986 apparently in
      association with HIV spread in the country. On the other hand Zimbabwe is unique
      among the countries in Africa because rural clinics and preventive medicine such
      as immunization, basic sanitation and health education have been well-established
      throughout the country. As a result various communicable diseases common to the
      tropics and subtropics have been successfully controlled. The country now needs
      to improve quality and quantity of hospital medicine. While hospital facilities
      are available, the number of doctors, particularly in the district, is far below
      demand. Zimbabwe is one of the few countries in Africa where doctors trained in
      Japan could work efficiently and therefore it is suggested that it be considered
      as a country amenable to international medical cooperation.

PMID- 1747549
TI  - [Nurse's leadership to the primary care-giver in community setting].

PMID- 1747550
TI  - [A manual for community mental health activities for a public health center in
      Japan].
AB  - A system for treatment of persons with chronic mental disease such as
      schizophrenics in the present structure of the Japanese public Health Center is
      proposed. Presently, while cases are handled by responsible staff members,
      incorporation into the health center system with full utilization of its
      personnel and resources is seldom accomplished. There is a necessity for a
      systems approach in order to organize essential programs that would provide care
      for the mentally diseased. Health centers would have three main roles in this
      system: as a coordinator of mental health resources in the community, as a
      specialized agency for case management, and responsibility for public relations
      in its service area. For proper administration of its system, health centers
      should follow a team concept. The team would consist of a director of health
      centers, physicians, part-time psychiatrists, public health nurses, psychiatric
      social workers and clerical staff. At case conferences discussion of whether a
      prospective case should be registered, assessment of the needs, and development
      of management plans for all of the registered cases would be conducted. The files
      and documents of each case would be deleted or re-registered 5 years after
      initial registration. Cases would have a case-manager to coordinate public health
      care, including home visits, family care, psycho-educational consultation and
      crisis intervention. Health centers would be responsible for bringing together
      available social resources such as sheltered workshops and transient residential
      programs. The goal of health centers' mental health activities would be to
      facilitate the normalization of the mentally diseased within the community.

PMID- 1747551
TI  - [Incidence of and circumstances related to falls among the elderly in a Japanese
      community].
AB  - In order to determine incidence of and the circumstances related to falls among
      the elderly in a community in Japan, general health surveys were carried out in
      1988 and in 1989. Subjects for the first survey were 685 elderly residents (276
      men, 409 women) aged 65 years and over, living in a rural village of Akita
      Prefecture. Subjects who were confined to bed almost all day were excluded from
      analysis. Subjects were interviewed regarding falls at both surveys. Results
      obtained were as follows; 1) Incidence of falls were 19.2% for men, and 20.3% for
      women at the first survey. There was no significant difference in incidence
      between sexes. 2) Age had no significant effect on incidence in either sex. 3)
      The incidence at the follow-up survey was significantly higher among those who
      had reported falls at the first survey than in those who had not (relative risk;
      men; 2.71, women 2.40, p less than 0.05). 4) Most falls occurred during the
      daytime in either sex, with approximately 90% of falls for men and 60% of falls
      for women occurring outdoors. The cause of falls was mainly extrinsic. Compared
      to men, falls of women had a greater tendency to lead to major injury.

PMID- 1747552
TI  - [A study of falls experienced by the aged among users of preventive health
      examination services].
AB  - In order to determine what factors are related to falls and the effect on the
      aged, a study was conducted on subjects aged 60 years and over who had undergone
      preventive health examinations in the western region of Shizuoka Prefecture.
      Subjects (n = 305) had an average age of 64.4 +/- 3.8 years, and all were
      interviewed regardless of their history of falls. For the 66 cases who had
      experienced falls, further questions prepared in advance, were included. The
      following results were obtained: 1) There were 66 subjects (21.6% of the
      subjects) who had experienced falls with some experienced multiple falls for a
      total count of 91 falls. 2) The frequency of falls of female subjects was
      significantly higher than that of males. Further, with respect to the type of
      injuries suffered, in the case of many of the female subjects, these took the
      form of contusions. 3) The majority of subjects who experienced falls were
      engaged in farming and most of the falls were work-related. 4) Results of this
      study showed that, while not statistically significant, cerebrovascular diseases
      are closely connected to falls and increases the falls coefficient among the
      aged.

PMID- 1747553
TI  - [A community-based education program for serum cholesterol reduction in urban
      hypercholesterolemic persons--comparison of intensive and usual education
      groups].
AB  - A community-based education program was conducted for persons found to be
      hypercholesterolemic by screening during cardiovascular surveys, in an urban
      population, to evaluate the feasibility and effect of the program in primary
      prevention of coronary heart disease. The subjects were men and women aged 40-64
      living in the suburbs of Osaka whose serum total cholesterol was between 240 and
      299 mg/dl in both the 1988 and the 1989 surveys. Persons with hypothyroidism,
      those taking medication for hypercholesterolemia or hypertension, and with a
      history of stroke and coronary heart disease were excluded. Of the 111 persons
      who were eligible, 104 persons were recruited for the program on March, 1989. The
      104 persons were randomly assigned to either an intensive education group (n =
      51) or a usual education group (n = 53). For the intensive education group, seven
      education classes were held from April to November, 1989. Lectures, practice
      sessions, interviews, and spot cholesterol measurements were conducted in a local
      community center. The usual education group received a letter with results from
      the 1989 survey and dietary instruction in April 1989 and an education class in
      September 1989. Mean serum cholesterol in the intensive education group showed a
      10.0 mg/dl greater reduction in September 1989 and a 9.0 mg/dl greater reduction
      in March 1990 than in the usual education group (p less than 0.05) while mean HDL
      cholesterol did not change in either groups. The intensive education group
      reported a larger decrease in the dietary frequency of chicken egg, poultry skin
      and small fishes, foods which are rich in saturated fat and cholesterol. The
      frequency of fatty meat, butter and fish eggs was low in both groups and did not
      differ between the two groups after the one-year program. These results indicate
      that a population-based education program is feasible and effective in reducing
      serum total cholesterol of hypercholesterolemic persons.

PMID- 1747554
TI  - [Asbestos concentration and fiber size in lungs of the urban residents].
AB  - Asbestos fiber concentrations and fiber size distribution in lung tissues of 53
      urban residents (males: 34, female: 19) were analyzed by low temperature ashing
      analytical transmission electronmicroscopy. The following findings were obtained.
      1. Pulmonary asbestos fibers were found in 51 out of 53 patients. The types of
      asbestos fibers were chrysotile, amosite, crocidolite, actinolite and tremolite.
      2. Thirty-six of 53 patients had no history of occupational asbestos exposure,
      and their geometric mean concentration of asbestos fibers was 1.67 x 10(6)
      fibers/g dry lung. Most of these asbestos fibers are probably attributable to
      general environmental contamination. Thirteen patients who had a history of
      occupational asbestos exposure showed a geometric mean of their pulmonary
      asbestos concentrations (5.82 x 10(6) fibers/g dry lung) which was significantly
      higher than that of patients without occupational asbestos exposure (p less than
      0.01). 3. The geometric mean concentration of asbestos fiber in males (2.70 x
      10(6)) was higher than in females (1.59 x 10(6)), probably due to a difference in
      the occupational asbestos exposure between males and females. 4. Regardless of
      the patient's sex, the geometric mean concentration of asbestos fibers in
      patients without a history of smoking (male: 4.91 x 10(6), female: 1.78 x 10(6))
      was higher than that in patients with a smoking history (male: 2.76 x 10(6),
      female: 1.37 x 10(6)). The difference, however, was not statistically
      significant, and no correlation was seen between the concentration of asbestos
      fibers and smoking history. 5. Although most asbestos fiber utilized in Japan is
      chrysotile, the geometric mean concentration of chrysotile (0.87 x 10(6)) was
      almost identical to that of amphibole asbestos fiber (0.90 x 10(6)). 6. Of the
      asbestos fibers observed, 95% of chrysotile and 85% of amphibole asbestos were
      less than 5 microns in length and 93% of the total asbestos fibers were too small
      to be visible by light microscopy.

PMID- 1747555
TI  - [Indications and value of endosonography of the upper gastrointestinal tract].
AB  - Endoscopic ultrasound (EUS) has been used in the diagnosis and staging of
      gastroenterologic tumors for about ten years. High accuracy rates of EUS in
      staging of esophageal, gastric and pancreatic carcinoma (T-stage: 80-95%, N
      stage: 75-85%) have been reported. EUS is therefore a valuable diagnostic tool
      fur assessment of prognosis as well as for planning of therapy of these tumors.
      Its value in benign gastroenterologic disease is unclear. EUS seems to be much
      less reliable in the differentiation between benign and malignant changes (e.g.
      esophageal stenoses, gastric ulcers, pancreatic mass lesions).

PMID- 1747556
TI  - [Endosonography of the rectum].
AB  - Endorectal ultrasound is proving to be a very accurate method for the
      preoperative staging of cancer. The tumor penetration depth is assessed with an
      accuracy of more than 90% for all T stages. The preoperative endosonographic
      evaluation of lymph nodes is superior to other imaging modalities, being more
      than 80% accurate in comparison to CT and lymphoscintigraphy. It is relatively
      easy to perform and inexpensive compared with other imaging modalities. It has
      proved its influence on decision making, selection for local therapy, planning of
      radiotherapy and reoperation of early tumor recurrencies.

PMID- 1747557
TI  - [Improvements in 3-D ultrasonic imaging].
AB  - The problem of gaining a coordinated sequence of section cuts by ultrasound is
      solved by rotating the plane section around a vertical and a horizontal axle.
      There are two possibilities in presenting the 3D image of the examined organ:
      ring structure image or transparent image. Precondition in the ring structure
      image is time consuming and defective since it has to be done by hand using a
      cursor. These pitfalls can be avoided when using a method without contouring by
      showing the 3D image transparently. Each section cut has to be calculated
      transparently. Both methods are presented in this paper and compared as to their
      applicability in medicine. The problem of the transparent 3D presentation lies in
      the fact that it cannot be well presented on printed paper, as is done her. The
      moving picture on the computer screen gives an optimal 3D image. This new method
      seem to be useful in tumor diagnostic and diagnostic of malformations in early
      pregnancies.

PMID- 1747558
TI  - [Use of the 3D procedure in nuclear magnetic resonance tomography in ENT
      diagnostics].
AB  - The use of 3D-gradient-echo sequences improved the diagnosis of malignant tumors
      of the skull base, the nasopharynx, the nasal cavities, the paranasal sinuses and
      the upper parts of the parapharyngeal space with relation to the skull base.
      Therefore the tumor extent and infiltration may be better appreciated than in
      conventional 2D-spin-echo or gradient echo sequences. Using this method, the
      examinations of 22 patients with carcinomas could be compared. Precise tumor
      delineation was achieved in six of these patients when compared with surgical and
      histological findings. The 3D sequences most frequently used were FLASH 40
      degrees with TR of 40 ms and the shortest TE (5 to 6 ms). 3D turbo-FLASH (MPRage)
      with Gad-DTPA was applied in order to shorten the acquisition time by half and
      especially to reduce motion artefacts.

PMID- 1747559
TI  - [Para-pleural lung lesions: diagnostic value of sonography versus computerized
      tomography].
AB  - 45 patients with pleural and/or peripheral lung lesions detected by chest
      radiography were examined by chest ultrasound. A chest CT-scan was obtained as a
      reference method afterwards. In 43 pleural or peripheral lung lesions we found
      corresponding results comparing size, invasivity and nature comparing the two
      diagnostic methods. In 35 of 41 cases an ultrasound (US)-guided needle biopsy
      confirmed the preliminary diagnosis suspected after sonography of the chest. Six
      needle biopsies allowed no definite diagnosis. Two patients developed a
      pneumothorax that required drainage after US-guided needle biopsy. CONCLUSION:
      Real-time sonography of the chest and chest CT-scans are complementary methods
      examining pleural and peripheral lung lesions, corresponding results are
      demonstrated in respect of location, size, invasivity and nature of the lesions.

PMID- 1747560
TI  - [Tumors of the oropharynx, hypopharynx and larynx--diagnosis with magnetic
      resonance imaging].
AB  - 312 patients with neoplasms of the oropharynx, hypopharynx and larynx--301 of
      these suffered from malignancies--were examined with use of magnetic resonance
      imaging (MRI) and--in most cases--with computed tomography (CT) for comparison.
      MRI yielded better results than CT in the case of oropharyngeal tumors. With
      regard to hypopharyngeal tumors, however, slight discrepancies in the diagnostic
      capacities of both methods were observed. MRI afforded a clearer tumor definition
      through sagittal and coronal slice orientations. In the case of laryngeal
      neoplasms in the glottic region, CT is currently superior to MRI. This could
      change in the future as a result of improvement in signal behavior of the 2D
      gradient echo (2D GE) sequences and of the use of phonation studies (Turbo
      FLASH). MRI, on the other hand, is superior to CT in the definition of sub-,
      supra- and panglottic tumors.

PMID- 1747561
TI  - Dysphagia of the treated laryngeal cancer--detection of functional and
      morphological changes by cineradiography.
AB  - After treatment of laryngeal cancer 35 patients with dysphagia have been examined
      by high speed cineradiography. When compared to normal swallowing patterns, the
      following abnormalities were observed: Excursion of the posterior pharyngeal wall
      during swallowing is twice as intensive as normal. The function of the base of
      the tongue becomes more important for pharyngeal emptying--a fact that surgeons
      should take into consideration when planning laryngeal resection. Timing of
      pharyngeal constriction and function of the upper esophageal sphincter are
      definitively altered. In view of these changes we think that cineradiography can
      help to find better methods for functional surgery of the pharynx and the
      adjacent structures.

PMID- 1747562
TI  - Ectopic pregnancy in an uncommon location revealed by ultrasound.
AB  - We report the case of extrauterine intraovarian pregnancy of a young woman. The
      patient was preoperatively examined by ultrasound which revealed extrauterine
      pregnancy of the fourth lunar month. Histologically, intraovarian gravidity of
      four months was proven.

PMID- 1747564
TI  - [8th International Symposium. Endoscopic ultrasonography, Munich 15 June 1991].

PMID- 1747563
TI  - CT appearance of shearing injuries of the brain.
AB  - Shearing injuries, also called diffuse axonal injuries, are a special kind of
      severe head trauma, usually caused by a motor vehicle accident, in which
      disruption of white matter axons takes place. Twelve cases of shearing injuries
      were diagnosed by computed tomography (CT). The typical CT findings were small
      hemorrhagic lesions in the cerebral white matter, most often in cerebral
      hemispheres and internal capsules. In most patients, hemorrhagic foci were
      multiple. Single lesions were found in only two patients. Features of brain edema
      were found in eight of ten early studies, and subarachnoidal hemorrhage only in
      three. Two patients also had subdural hematomas. CT appearance of the shearing
      injuries is characteristic, especially in connection with clinical data
      indicating a history of head trauma and severe state of the patient.

PMID- 1747565
TI  - A serum substitute promotes osteoblast-like phenotypic expression in cultured
      cells from chick calvariae.
AB  - The effects of medium supplements were tested on embryonic chick calvarial cells
      in culture. Isolates were divided among four treatment groups: Nu-Serum, chicken
      serum, fetal bovine serum, or calf serum. Expression of the osteoblastic
      phenotype was assessed by cell morphology, DNA content, [3H]thymidine
      incorporation, lactate production, cellular and medium alkaline phosphatase
      activities, and collagen synthesis. Cells grown in Nu-Serum demonstrated
      increased alkaline phosphatase activity and a six-fold higher rate of collagen
      synthesis compared to chicken serum. These cells displayed a polygonal profile,
      abundant rough endoplasmic reticulum, Golgi apparati, and elaborated an extensive
      matrix of banded collagen which was well mineralized by day 10 of culture.
      Although highly mitogenic, chicken serum promoted a more fibroblastoid
      morphology. Compared to the sera tested, Nu-Serum preferentially promoted the
      osteoblast-like phenotype in chick calvarial cells in culture.

PMID- 1747566
TI  - Estrogens reduce bone loss in the ovariectomized, lactating rat model.
AB  - Estrogen treatment of ovariectomized, lactating rats improved retention of bone
      mineral mass by 15-25% compared to ovariectomized, lactating rats receiving
      vehicle only. On the second day postpartum all lactating rats were ovariectomized
      and were placed along with age-matched non-mated controls on a whole-wheat flour
      based diet with 0.1% calcium and 0.4% phosphorus. On day 6 postpartum estrogen
      treatment was begun with either implantation of a slow-release 17 beta-estradiol
      pellet or with the first of daily subcutaneous injections in sesame oil
      (vehicle). Increasing doses of estrogen resulted in decreased food consumption
      and decreased litter weight gain, both well-known effects of estrogens.
      Ovariectomized, lactating rats implanted with a slow-release pellet containing
      0.35 mg 17 beta-estradiol had mean serum estradiol levels of 113.5 pg/ml. At the
      end of 21 days of lactation, femurs of dams with placebo pellets showed loss of
      54% of bone ash weight compared with the non-mated controls versus only 42% loss
      by rats receiving estradiol treatment. Rats were also injected with estradiol
      benzoate in a sesame oil vehicle at 3 dose levels of 1.6, 5, or 16
      micrograms/day. Only the 5 and 16 micrograms/day doses significantly improved
      retention of bone mineral mass during lactation (+17% and +18%, respectively, vs
      vehicle-injected, lactating rats). Estrone administered by subcutaneous injection
      also improved retention of bone during lactation; however, injection of 50
      micrograms/day of estrone was required to produce an equivalent bone retention
      compared to 5 micrograms/day of estradiol. Thus, treatment of ovariectomized,
      lactating rats with estrogens results in a significant reduction of the loss of
      bone mineral mass associated with lactation.

PMID- 1747567
TI  - Long-term anabolic effects of prostaglandin-E2 on tibial diaphyseal bone in male
      rats.
AB  - The effects of long-term prostaglandin E2 (PGE2) on tibial diaphyseal bone were
      studied in 7-month-old male Sprague-Dawley rats given daily subcutaneous
      injections of 0, 1, 3 and 6 mg PGE2/kg/day for 60, 120 and 180 days. The tibial
      shaft was measured by single photon absorptiometry and dynamic histomorphometric
      analyses were performed on double-fluorescent labeled undecalcified tibial
      diaphyseal bone samples. Exogenous PGE2 administration produced the following
      transient changes in a dose-response manner between zero and 60 days: 1)
      increased bone width and mineral density; 2) increased total tissue and total
      bone areas; 3) decreased marrow area; 4) increased periosteal and
      corticoendosteal lamellar bone formation; 5) activated corticoendosteal lamellar
      and woven trabecular bone formation and 6) activated intracortical bone
      remodeling. A new steady-state of increased tibial diaphyseal bone mass and
      elevated bone activities were observed from day 60 onward. The elevated bone mass
      level attained after 60 days of PGE2 treatment was maintained at 120 and 180
      days. These observations indicate that the powerful anabolic effects of PGE2 will
      increase both periosteal and corticoendosteal bone mass and sustain the transient
      increase in bone mass with continuous daily administration of PGE2.

PMID- 1747569
TI  - Selected bibliography.

PMID- 1747568
TI  - The prevention of corticosteroid-induced osteoporosis with nandrolone decanoate.
AB  - The effects of nandrolone decanoate (ND; 50 mg IM every three weeks) on calcium
      metabolism and forearm bone density were studied in a randomized trial in 35
      women receiving long-term therapy with corticosteroids (CST) for rheumatic
      disease. The 17 patients who served as controls were on CST therapy for less
      years and their bone density was higher. Thus a second control group, pair
      matched with the active treatment group for age, duration of CST therapy and bone
      density, was selected retrospectively. At the end of the 18 months' treatment
      course with ND, forearm bone density was increased by 5.1% (P less than 0.01) but
      fell by 11.3% (P less than 0.01) and 6.7% respectively in the first and second
      control group. The patients on ND differed significantly from both control groups
      in the changes at 6, 12 and 18 months (P less than 0.01). Urinary excretion of
      hydroxyproline fell significantly in patients receiving ND, whereas the
      biochemical indices of bone formation did not change (alkaline phosphatase) or
      increased (osteocalcin; P less than 0.01). In conclusion, nandrolone decanoate
      therapy may be used in the prevention of CST-induced osteoporosis. It also seems
      to exert mild inhibition of bone resorption without affecting or even stimulating
      bone formation.

PMID- 1747570
TI  - How will the single European market affect health care?

PMID- 1747571
TI  - Rugby injuries.

PMID- 1747572
TI  - Neonatal vitamin K.

PMID- 1747573
TI  - Salt substitutes and potassium intake.

PMID- 1747574
TI  - More radiotherapists, please.

PMID- 1747575
TI  - General practitioners' pay.

PMID- 1747576
TI  - Criminal charges over HIV in French blood transfusions.

PMID- 1747577
TI  - beta blockade and intermittent claudication: placebo controlled trial of atenolol
      and nifedipine and their combination.
AB  - OBJECTIVE: To determine the effects of the beta 1 selective adrenoceptor blocker
      atenolol, the dihydropyridine calcium antagonist nifedipine, and the combination
      of atenolol plus nifedipine on objective and subjective measures of walking
      performance and foot temperature in patients with intermittent claudication.
      DESIGN: Randomised controlled double blind four way crossover trial. SETTING:
      Royal Hallamshire Hospital, Sheffield. SUBJECTS: 49 patients (40 men) aged 39-70
      with chronic stable intermittent claudication. INTERVENTIONS: Atenolol 50 mg
      twice daily; slow release nifedipine 20 mg twice daily; atenolol 50 mg plus slow
      release nifedipine 20 mg twice daily; placebo. Each treatment was given for four
      weeks with no washout interval between treatments. MAIN OUTCOME MEASURES:
      Claudication and walking distances on treadmill; skin temperature of feet as
      measured by thermistor and probe; blood pressure before and after exercise;
      subjective assessments of walking difficulty and foot coldness with visual
      analogue scales. RESULTS: Atenolol did not significantly alter claudication
      distance (mean change -6%; 95% confidence interval 1% to -13%), walking distance
      (-2%; 4% to -8%), or foot temperature. Nifedipine did not alter claudication
      distance (-4%; 3% to -11%), walking distance (-4%; 3% to -10%), or foot
      temperature. Atenolol plus nifedipine did not alter claudication distance but
      significantly reduced walking distance (-9%; -3% to -15% (p less than 0.003)) and
      skin temperature of the more affected foot (-1.1 degrees C; 0 to -2.2 degrees C
      (p = 0.05)). These effects on walking distance and foot temperature seemed
      unrelated to blood pressure changes. CONCLUSIONS: There was no evidence of
      adverse or beneficial effects of atenolol or nifedipine, when given singly, on
      peripheral vascular disease. The combined treatment, however, affected walking
      ability and foot temperature adversely. This may have been due to beta blockade
      plus reduced vascular resistance, which might also explain the reported adverse
      effects of pindolol and labetalol on claudication.

PMID- 1747578
TI  - Haemorrhagic disease of the newborn in the British Isles: two year prospective
      study.
AB  - OBJECTIVE: To determine the incidence of haemorrhagic disease of the newborn in
      the British Isles, study risk factors, and examine the effect of vitamin K
      prophylaxis. DESIGN: Prospective survey of all possible cases of haemorrhagic
      disease of the newborn as reported by consultant paediatricians using the monthly
      notification cards of the British Paediatric Surveillance Unit and a follow up
      questionnaire for each case to validate the diagnosis and accrue further data.
      SETTING: Britain (England, Scotland, and Wales) and Ireland (Northern Ireland and
      the Irish Republic) during December 1987 to March 1990. PATIENTS: 27 infants
      classified as having confirmed (n = 25) or probable (n = 2) haemorrhagic disease
      of the newborn. RESULTS: 24 of the 27 infants were solely breast fed. 10 suffered
      intracranial haemorrhage; two of these died and there was clinical concern about
      the remainder. 20 infants had received no vitamin K prophylaxis, and seven had
      received oral prophylaxis. Relative risk ratios for these groups compared with
      babies who had received intramuscular vitamin K were 81:1 and 13:1 respectively.
      Six infants had hepatitis (alpha 1 antitrypsin deficiency in four), unsuspected
      until presentation with haemorrhagic disease of the newborn, of whom four had
      received oral prophylaxis. One other baby had prolonged jaundice. One mother had
      taken phenytoin during pregnancy. CONCLUSIONS: All newborn infants should receive
      vitamin K prophylaxis. Intramuscular vitamin K is more effective than oral
      prophylactic regimens currently used in the British Isles.

PMID- 1747579
TI  - Vitamin K prophylaxis against haemorrhagic disease of the newborn in the United
      Kingdom.

PMID- 1747580
TI  - Potassium concentrations in irradiated blood.

PMID- 1747581
TI  - Children seen frequently out of hours in one general practice.
AB  - OBJECTIVE: To identify reasons why some children receive more out of hours visits
      than most. DESIGN: A one year prospective study to identify the study group. This
      was followed by a case-control study involving a record search and personal
      interviews. SETTING: One three doctor urban general practice in West Lothian with
      4812 patients. SUBJECTS: 40 children aged under 10 years identified as high users
      of the out of hours service (more than two visits a year) and 40 age and sex
      matched controls. MAIN OUTCOME MEASURES: Numbers of visits; social factors such
      as lone motherhood, low educational attainment; score for management response to
      clinical vignette. RESULTS: 147/756 (19%) out of hours visits in the study year
      were to children aged under 10 years; 109 (74%) to 41 children (6%). Problems
      seen were mainly minor, and little active management was required. Family and
      social factors which were significantly more common for the cases than for the
      controls included a lone mother (15 v 4), low educational attainment by the
      mother (25 v 14), receipt of income support (22 v 7), and non-ownership of the
      home (45 v 22) or a car (19 v 9). Mothers of the cases were more likely to choose
      to contact a doctor when presented with vignettes describing common childhood
      illnesses (median score for 16 vignettes 16.5 for cases v 14.5 for controls,
      Wilcoxon signed rank test, p = 0.01). CONCLUSIONS: Children seen more frequently
      than expected out of hours came from more socially disadvantaged families and
      their mothers were more likely to seek medical advice about minor childhood
      illness. Maternal education, to promote confidence in managing minor illness, may
      reduce their use of the out of hours service.

PMID- 1747582
TI  - The Health of the Nation: responses. Strategy full of good intentions.

PMID- 1747583
TI  - What the government should do.

PMID- 1747584
TI  - Using the potential of all staff.

PMID- 1747585
TI  - Importance of a healthy environment.

PMID- 1747586
TI  - ABC of vascular diseases. Treating aortic aneurysms.

PMID- 1747587
TI  - General practitioners' awareness of COSHH regulations.

PMID- 1747588
TI  - Health of the nation.

PMID- 1747589
TI  - Seafarers and HIV infection.

PMID- 1747590
TI  - Monkey business over AIDS vaccine.

PMID- 1747591
TI  - Routine testing for HIV infection at fertility clinics.

PMID- 1747592
TI  - Counselling patients before an HIV test.

PMID- 1747593
TI  - Hypertension and non-insulin dependent diabetes.

PMID- 1747594
TI  - Inner city psychiatry.

PMID- 1747595
TI  - Management of convulsions with fever.

PMID- 1747596
TI  - Incentives to fundholding.

PMID- 1747597
TI  - Preventing coronary heart disease in primary care.

PMID- 1747598
TI  - Informed consent.

PMID- 1747599
TI  - We may never understand each other.

PMID- 1747600
TI  - Junior doctors' hours.

PMID- 1747601
TI  - Outpatient physicians.

PMID- 1747602
TI  - Burning down their houses.

PMID- 1747603
TI  - Avoiding autocannibalism.

PMID- 1747604
TI  - Patient's charter.

PMID- 1747605
TI  - Surgical pathology and general practice.

PMID- 1747606
TI  - Preventing AIDS now.

PMID- 1747607
TI  - AIDS surveillance in Africa.

PMID- 1747608
TI  - Parent support groups.

PMID- 1747609
TI  - Auditing AIDS spending.

PMID- 1747610
TI  - French will compensate for infected blood.

PMID- 1747611
TI  - Relation of coronary heart disease and apolipoprotein E phenotype in patients
      with non-insulin dependent diabetes.
AB  - OBJECTIVES: To examine the relation between coronary heart disease and the
      apolipoprotein E phenotypes in patients with non-insulin dependent diabetes
      mellitus. DESIGN: Cross sectional study. SETTING: District around Kuopio
      University Central Hospital, East Finland. SUBJECTS: 138 men with non-insulin
      dependent diabetes and 64 men without diabetes as controls. MAIN OUTCOME MEASURE:
      Apolipoprotein E phenotype, electrocardiographic abnormalities, other signs of
      coronary heart disease. RESULTS: The prevalences of definite myocardial
      infarction and ischaemic electrocardiographic changes were highest in the
      diabetic men with the phenotypes E4/4 or E4/3 (25% (95% confidence interval 18%
      to 32%) and 50% (42% to 58%) respectively), although the difference between the
      phenotype groups was not significant. The prevalence of angina pectoris was 69%
      (61% to 77%) in men with the phenotypes E4/4 or E4/3 (p = 0.005 compared with
      other phenotypes), 41% (33% to 49%) in men with phenotype E3/3, and 47% (39% to
      55%) in those with phenotypes E2/2 or E2/3. Similarly, the simultaneous presence
      of angina pectoris and ischaemic electrocardiographic changes was highest in the
      diabetic men with the phenotypes E4/4 or E4/3 (42% v 22% in those with E3/3 and
      29% in those with E2/2, E2/3; p = 0.038). Overall, the prevalence of any evidence
      of coronary heart disease among the diabetic subjects with the phenotypes E4/4 or
      E4/3 was 81% (p = 0.011 compared with other phenotypes), 58% in those with
      phenotype E3/3, and 53% in those with phenotypes E2/2 or E3/3. CONCLUSION:
      Apolipoprotein E phenotypes E4/4 and E4/3 modulate the risk of coronary heart
      disease in men with non-insulin dependent diabetes.

PMID- 1747612
TI  - Predictive value for coeliac disease of antibodies to gliadin, endomysium, and
      jejunum in patients attending for jejunal biopsy.
AB  - OBJECTIVE: To investigate the extent to which the detection of antibodies to
      gliadin, endomysium, and jejunum predicts the eventual diagnosis of coeliac
      disease according to the revised ESPGAN diagnostic criteria in a group of
      patients in whom there is a high suspicion of coeliac disease. DESIGN: Clinical
      assessment and laboratory analysis of patients with suspected coeliac disease.
      SETTING: Gastroenterology department of teaching hospital. PATIENTS: 96 adults
      with suspected coeliac disease attending for jejunal biopsy. MAIN OUTCOME
      MEASURES: Diagnosis of coeliac disease with the revised criteria of the European
      Society of Paediatric Gastroenterology and Nutrition in patients with and without
      antibodies associated with coeliac disease. RESULTS: 28 patients had a clinical
      diagnosis of coeliac disease, seven of other gastrointestinal diseases, and 12 of
      miscellaneous diseases; 49 had no diagnosis. Gliadin IgA detected by ELISA was
      found in all patients with coeliac disease and none of those without, giving a
      sensitivity, specificity, positive and negative predictive values, and predictive
      efficiency of 100% for diagnosing coeliac disease within the group. Endomysial
      IgA was found in 25 (89%) patients with coeliac disease and jejunal IgA in 21
      (75%); neither IgA was found in patients without coeliac disease. CONCLUSION:
      Detection of gliadin IgA by ELISA and to a lesser extent the endomysial IgA
      should allow better selection of patients for jejunal biopsy and thus make
      diagnosing coeliac disease simpler and more efficient.

PMID- 1747613
TI  - Effectiveness of routine ultrasonography in detecting fetal structural
      abnormalities in a low risk population.
AB  - OBJECTIVE: To review the efficacy of routine prenatal ultrasonography for
      detecting fetal structural abnormalities. DESIGN: Retrospective study of the
      ultrasonographic findings and outcome of all pregnancies in women scanned in 1988
      9. SETTING: Maternity ultrasonography department of a district general hospital.
      SUBJECTS: 8785 fetuses. MAIN OUTCOME MEASURES: Correlation of prenatal
      ultrasonographic findings with outcome in the neonate. RESULTS: 8733 babies were
      born during 1988-9, and 52 pregnancies were terminated after a fetal malformation
      was identified. 8432 (95%) of the fetuses were examined by ultrasonography in the
      second trimester. 130 fetuses (1.5%) were found to have an abnormality at birth
      or after termination of pregnancy, 125 of which had been examined in the second
      trimester. In 93 cases the abnormality was detected before 24 weeks (sensitivity
      74.4%, 95% confidence interval to 66.7% to 82.1%. Two false positive diagnoses
      occurred, in both cases the pregnancies were not terminated and apparently normal
      infants were born. This gives a specificity of 99.98% (99.9% to 99.99%). The
      positive predictive value of ultrasonography in the second trimester was 97.9%
      (92.6% to 99.7%). Of the 125 abnormalities, 87 were lethal or severely disabling;
      72 of the 87 were detected by the routine screening programme (sensitivity 82.8%,
      73.2% to 90.0%). CONCLUSION: Routine fetal examination by ultrasonography in a
      low risk population detects many fetal structural abnormalities but can present
      several dilemmas in counselling.

PMID- 1747614
TI  - Can morbidity associated with untreated asthma in primary school children be
      reduced?: a controlled intervention study.
AB  - OBJECTIVE: To determine whether an intervention programme based on existing
      school and community resources can reduce school absence and improve
      participation in games lessons and sport in children with unrecognised or
      undertreated asthma. DESIGN: Parallel group controlled intervention study.
      SETTING: 102 primary schools in Nottingham: 49 were randomised to receive the
      intervention and 53 to be control schools. SUBJECTS: All children aged 5 to 10
      years with parent reported absence from school because of wheezing in the
      previous year and taking no treatment or beta agonists only. INTERVENTIONS:
      Children with asthma were referred to their general practitioner for assessment
      of symptoms and treatment. Teachers were given education on asthma by the school
      nurse in 44 of the 49 intervention schools. MAIN OUTCOME MEASURES: Changes in
      school absence and missed games and swimming lessons because of wheezing, and
      schools' policy towards management of asthma in school. RESULTS: Of 17,432
      children screened, 451 met the entry criteria--228 in intervention schools and
      223 in control schools. 152 (67%) children in intervention schools visited their
      general practitioner, of whom 39 (26%) were given a new diagnosis of asthma and
      58 (38%) had treatment for asthma increased or changed. Over the next academic
      year mean (SE) parent reported school absence due to wheezing fell significantly,
      but to a similar extent, in both intervention and control schools (0.82 (0.11)
      and 1.09 (0.21) weeks respectively). There was little change in school recorded
      absence or participation in games lessons and swimming lessons in either group.
      At the end of the study intervention schools were more likely to have improved
      aspects of management of asthma in school. CONCLUSION: The intervention resulted
      in a majority of children being assessed by their general practitioner and
      improved teachers' understanding and management of asthma, but it did not result
      in any appreciable reduction in morbidity.

PMID- 1747615
TI  - Surveillance of antibody to rubella virus in Grampian: closing the immunity gap.
AB  - OBJECTIVES: To identify causes for the continuing deficit of rubella immunity in
      women of childbearing age with a view to further reducing the risk of the
      congenital rubella syndrome. DESIGN: A questionnaire was sent to the general
      practitioner and a laboratory follow up study conducted in a one year cohort of
      women found on screening to have inadequate protection against rubella. SETTING:
      Virus laboratory of the department of medical microbiology, Aberdeen, serving the
      health board areas of Grampian, Orkney, and Shetland. PATIENTS: 239 women whose
      concentration of antibodies to rubella virus was either absent or below standard
      (15,000 IU/l) and whose general practitioner could be contacted to supply a
      history of infection, immunisation, pregnancy, and antibody testing. MAIN OUTCOME
      MEASURES: Whether rubella vaccination was given and whether those vaccinated were
      tested for seroconversion. RESULTS: Only 122 (55%) of the women for whom
      information was available received the recommended vaccine; only 74 (61%) of
      these were tested for seroconversion. Oversight was the reason given for not
      vaccinating 64 (65%) of the women who remained at risk. Women who were pregnant
      when tested were significantly less likely to receive vaccine (odds ratio 3.36)
      than women who were not pregnant, and even if vaccinated were less likely to have
      a follow up antibody test (odds ratio 1.94). CONCLUSION: Once women are
      identified as being unprotected against rubella they are often overlooked and not
      vaccinated. Prompting mechanisms aimed at general practitioners, such as the one
      recently set up in Grampian, should reduce the immunity gap and help to eradicate
      rubella in pregnancy.

PMID- 1747616
TI  - Performance of skin biopsies by general practitioners.
AB  - OBJECTIVE: To evaluate and appraise skin biopsies performed by general
      practitioners and compare their performance with that of hospital doctors.
      DESIGN: Retrospective analysis of histology records. SETTING: University
      hospital. SUBJECTS: Records of 292 skin biopsy specimens obtained by general
      practitioners and 324 specimens obtained by general and plastic surgeons. MAIN
      OUTCOME MEASURES: Clinical and pathological diagnoses and completeness of
      excision. RESULTS: The number of specimens received from hospital surgeons and
      general practitioners increased over the study period; the proportion of
      specimens from general practitioners rose from 17/1268 (1.3%) in 1984 to 201/2387
      (8.7%) in 1990. The range of diagnoses was similar among hospital and general
      practitioner cases, although malignancy was commoner in hospital cases (63/324
      (19%) v 14/292 (5%) in general practitioner cases; chi 2 = 28, p less than
      0.00001). Completeness of excision was less common among general practitioners
      than hospital surgeons (150/233 (3/15 malignant) v 195/232 (57/63); chi 2 = 22, p
      less than 0.00001). CONCLUSIONS: The increase in minor surgery has implications
      for the staffing and finance of histopathology departments. General practitioners
      must be given proper training in performing skin biopsies, and all specimens
      should be sent for examination.

PMID- 1747617
TI  - Skin biopsy in general practice.

PMID- 1747618
TI  - Effect of general practitioner contract on referral of specimens for histological
      examination.

PMID- 1747619
TI  - Continuity of care: influence of general practitioners' knowledge about their
      patients on use of resources in consultations.
AB  - OBJECTIVE: To examine the relation between general practitioners' knowledge about
      their patients and the use of resources in consultations. DESIGN: A cross
      sectional evaluation of consultations. SETTING AND SUBJECTS: A representative
      sample of 133 Norwegian general practitioners were each asked to record 30
      consecutive consultations. 131 did so, and of 3990 possible registrations, 3918
      (98%) were evaluated. MAIN OUTCOME MEASURES: The influence, as assessed by the
      doctor, of accumulated knowledge on the use of laboratory tests, expectant
      management, prescriptions, sickness certification, referrals, and time spent in
      the consultation. RESULTS: Accumulated knowledge was a substantial factor in
      saving time, especially in consultations with children, the elderly, patients
      with psychosocial problems, and those with chronic diseases. It also influenced
      the overall use of laboratory tests, expectant management, sickness
      certification, and referrals, and to a lesser degree the use of medication.
      CONCLUSION: The findings imply strong but complex associations between
      accumulated knowledge and the use of resources in the consultation.

PMID- 1747620
TI  - For debate. AIDS surveillance in Africa: a reappraisal of case definitions.

PMID- 1747621
TI  - What use is a clinical case definition for AIDS in Africa?

PMID- 1747622
TI  - ABC of vascular diseases. Peripheral arteriovenous malformations.

PMID- 1747623
TI  - Health and the environment. Population: more than a numbers game.

PMID- 1747624
TI  - Health of the nation.

PMID- 1747625
TI  - Fluoxetine and suicide.

PMID- 1747626
TI  - Omeprazole.

PMID- 1747627
TI  - Topical anaesthesia in upper gastrointestinal endoscopy.

PMID- 1747628
TI  - Adenoma screening and colorectal cancer.

PMID- 1747629
TI  - Orthopaedic surgeons and thromboprophylaxis.

PMID- 1747630
TI  - Haemophilus influenzae type b invasive disease.

PMID- 1747631
TI  - Corticosteroids and tuberculosis.

PMID- 1747632
TI  - Lies, damned lies, and waiting lists.

PMID- 1747633
TI  - Changing patterns of work.

PMID- 1747634
TI  - Winter pressure on hospital beds.

PMID- 1747635
TI  - The RCGP approaches 40.

PMID- 1747636
TI  - Auditing necropsies.

PMID- 1747637
TI  - Reforming health care in the United States.

PMID- 1747638
TI  - Does triamterene cause renal calculi?

PMID- 1747639
TI  - Manslaughter convictions for making mistakes.

PMID- 1747640
TI  - Trials of HIV vaccine planned for developing countries.

PMID- 1747641
TI  - Group cognitive and behavioural treatment for hypochondriasis.
AB  - OBJECTIVE: To assess the feasibility of carrying out group cognitive and
      behavioural treatment for hypochondriasis in a general hospital setting. DESIGN:
      Assessment of patients referred for therapy. SETTING: District general hospital.
      PATIENTS: Six patients aged 35 to 55 (mean 43) years with a mean duration of
      symptoms of 12 years who fulfilled the Diagnostic and Statistical Manual for
      Mental Disorders (DSM III-R) criteria for hypochondriasis. MAIN OUTCOME MEASURES:
      Number of visits to their doctors, time spent thinking about illness, and scores
      on the hospital anxiety and depression scales. RESULTS: The mean number of visits
      to a doctor fell significantly after treatment (3 before treatment v 0.8 after
      treatment; p = 0.03) as did the time spent thinking about illness (57.3 v 40.6; p
      = 0.14). The depression and anxiety scores also fell, although the differences
      were not significant (depression: 9.5 before v 8.5 after; anxiety: 13 before v 12
      after). CONCLUSION: It is feasible to carry out group cognitive and behavioural
      treatment in patients with hypochondriasis, and controlled studies are now
      indicated.

PMID- 1747642
TI  - Detention of British citizens as hostages in the Gulf--health, psychological, and
      family consequences.
AB  - OBJECTIVE: To describe the physical, psychological, and family consequences of
      the detention of British subjects as hostages in Kuwait or Iraq, or both, after
      the invasion of Kuwait on 2 August 1990 and to investigate the relation between
      types of trauma experienced and these reactions. DESIGN: Postal questionnaire.
      SUBJECTS: 381 respondents. RESULTS: Many health, social, and psychological
      sequelae were identified. Problems with present finance, accommodation, and work
      are important causes of distress. Many hostages coped well and gained self
      esteem. CONCLUSIONS: A minority of respondents require further support and
      treatment. Expatriates in risk areas should retain assets in their home country.

PMID- 1747643
TI  - Caffeine restriction: effect on mild hypertension.
AB  - OBJECTIVE: To determine the effects on blood pressure of modifying dietary
      caffeine intake in patients with mild and borderline hypertension by monitoring
      ambulatory and clinic blood pressure. DESIGN: Four way, randomised, crossover
      trial of four consecutive two week dietary regimens: normal diet, caffeine free
      diet alone, caffeine free diet with decaffeinated instant coffee, caffeine free
      diet with caffeinated instant coffee (instant coffee phases conducted double
      blind). SETTING: Hospital hypertension clinic, Scotland. PATIENTS: 52 patients
      (23 men; aged 26-67 years) with untreated borderline or mild hypertension
      (diastolic blood pressure 90-105 mm Hg) who normally drank a minimum of three
      cups of coffee daily. MAIN OUTCOME MEASURES: Mean ambulatory blood pressure over
      24 hours; mean morning, daytime, and night time ambulatory blood pressure;
      sitting clinic blood pressure at 1700; plasma caffeine concentration at 1700 on
      the last day of each regimen. RESULTS: Mean 24 hour ambulatory blood pressure was
      not different between regimens. There was no difference in blood pressure
      variability between regimens. During the caffeine free diet alone morning
      ambulatory diastolic blood pressure was higher (2.8 mm Hg) than during the
      caffeine free diet with caffeinated coffee. Mean sitting clinic systolic blood
      pressure was higher at 1700 (4.7 mm Hg) with a caffeine free diet than with the
      caffeine free diet with caffeinated coffee (p less than 0.05). Dietary compliance
      as assessed by plasma caffeine concentration was excellent. There was no
      significant correlation between plasma caffeine concentration and blood pressure.
      CONCLUSIONS: Drinking caffeinated instant coffee over a two week period does not
      adversely influence blood pressure in patients with borderline or mild
      hypertension; abstinence is of no benefit.

PMID- 1747644
TI  - Eradicating Helicobacter pylori and symptoms of non-ulcer dyspepsia.
AB  - OBJECTIVE: To examine the effect of eradication of Helicobacter pylori on
      symptoms of non-ulcer dyspepsia. DESIGN: Four week prospective study. SETTING:
      One hospital outpatient and endoscopy department. PATIENTS: 90 adults with
      persistent symptoms typical of non-ulcer dyspepsia but no clinical or endoscopic
      evidence of other peptic, biliary, pancreatic, or malignant disease; all had
      histological and microbiological evidence of infection with H pylori. 83 patients
      completed the treatment regimen. INTERVENTION: Colloidal bismuth subcitrate 120
      mg four times a day for four weeks (27 patients); metronidazole 400 mg and
      amoxycillin 500 mg each three times a day for one week (27); and bismuth
      subcitrate 120 mg four times a day for four weeks, metronidazole 400 mg three
      times a day for one week, plus amoxycillin 500 mg three times a day for the first
      week (29). MAIN OUTCOME MEASURES: Change in symptom scores determined with
      questionnaire; histological evidence of gastritis and microbiological evidence of
      presence of H pylori in biopsy specimens. RESULTS: Overall, H pylori was
      eradicated in 41 (49%) patients. Although gastritis scores improved significantly
      in only patients in whom H pylori had been eradicated (from 1.56 to 0.61, p less
      than 0.01 v from 1.83 to 1.07, p = 0.52) mean symptom scores after treatment were
      similar in patients in whom H pylori had or had not been eradicated (3.0 v 2.3,
      NS). Similarly the mean symptom score improved whether or not gastritis improved
      (2.8 v 3.1 respectively, p = 0.72). The observations were similar for treatment
      groups analysed individually. CONCLUSION: Antral infection with the organism does
      not seem to have an important aetiological role in non-ulcer dyspepsia short
      term.

PMID- 1747645
TI  - Relation between Glasgow coma scale and the gag reflex.

PMID- 1747646
TI  - Pre-eclampsia: discordance among identical twins.

PMID- 1747647
TI  - Safety of thrombolysis in association with cardiopulmonary resuscitation.

PMID- 1747648
TI  - Anal human papillomavirus infection in heterosexuals with genital warts:
      prevalence and relation with sexual behaviour.

PMID- 1747649
TI  - Communication of results of necropsies in north east Thames region.
AB  - OBJECTIVE: To evaluate the adequacy of reporting of results of necropsy to
      referring clinicians and to general practitioners. DESIGN: Questionnaire survey
      of referring clinicians and general practitioners of deceased patients in four
      districts in North East Thames region. Patients were selected by retrospective
      systematic sampling of 50 or more necropsy reports in each district. SETTING: One
      teaching hospital, one inner London district general hospital, and two outer
      London district general hospitals. PARTICIPANTS: 70 consultants and 146 general
      practitioners who were asked about 214 necropsy reports; coroners' reports were
      excluded. MAIN OUTCOME MEASURES: Time taken for dispatch of final reports after
      necropsy, consultants' recognition of the reports, general practitioners'
      recognition of the reports or of their findings, and consultants' recall of
      having discussed the findings with relatives. RESULTS: Only two hospitals
      dispatched final reports including histological findings (mean time to dispatch
      144 days and 22 days respectively). 42 (60%) consultants and 83 (57%) general
      practitioners responded to the survey. The percentage of reports seen by
      consultants varied from 37% (n = 13) to 87% (n = 36); in all, only 47% (39/83) of
      general practitioners had been informed of the findings by any method.
      Consultants could recall having discussed findings with only 42% (47/112) of
      relatives. CONCLUSIONS: Communication of results of necropsies to hospital
      clinicians, general practitioners, and relatives is currently inadequate in these
      hospitals. IMPLICATIONS AND ACTION: A report of the macroscopic findings should
      be dispatched immediately after necropsy to clinicians and general practitioners;
      relatives should routinely be invited to discuss the necroscopic findings. One
      department has already altered its practice.

PMID- 1747650
TI  - Medical audit: the Spanish experience.

PMID- 1747651
TI  - Effectiveness and efficiency under competition: the Cochrane test.

PMID- 1747652
TI  - Health implications of climatic change.

PMID- 1747653
TI  - Booked admissions as a replacement for waiting lists in the new NHS.

PMID- 1747654
TI  - Edit a staff round.

PMID- 1747655
TI  - ABC of vascular diseases. Thrombosis and pulmonary embolism.

PMID- 1747656
TI  - Human insulin.

PMID- 1747657
TI  - Aging and rationing.

PMID- 1747658
TI  - Chemotherapy in advanced ovarian cancer.

PMID- 1747659
TI  - Developing new drugs for cancer.

PMID- 1747660
TI  - Sudden deafness after dental surgery.

PMID- 1747661
TI  - Necropsy as a monitor of clinical diagnosis performance.

PMID- 1747662
TI  - Disasters in the inner city.

PMID- 1747663
TI  - Postoperative feeding.

PMID- 1747664
TI  - The rise of post-traumatic stress disorders.

PMID- 1747666
TI  - Voluntary confidential audit of outcome of surgery.

PMID- 1747665
TI  - Seven stages of audit.

PMID- 1747667
TI  - Oral iron chelation is here.

PMID- 1747668
TI  - Camelford revisited.

PMID- 1747669
TI  - Tomorrow's biotechnology.

PMID- 1747670
TI  - Restraint of children in cars.

PMID- 1747671
TI  - Vision screening in preschool children: comparison of orthoptists and clinical
      medical officers as primary screeners.
AB  - OBJECTIVE: To see if there were differences in referral rates and abnormalities
      detected from two areas that were operating different preschool vision screening
      programmes. DESIGN: Cohort study using case notes of referrals. SETTING:
      Community based secondary referral centres in the county of Avon. PATIENTS: 263
      referrals from a child population of 7105 in Southmead district, an area that
      used orthoptists as primary vision screeners; 111 referrals from a child
      population of 2977 in Weston-super-Mare, an area that used clinical medical
      officers for screening. MAIN OUTCOME MEASURES: Amblyopia and squint detection
      rates, together with false positive referral rates. RESULTS: The amblyopia
      detection rate in Southmead district was significantly higher than in Weston
      super-Mare (11/1000 children v 5/1000), as was the detection rate of squint
      (11/1000 v 3/1000). However, the false positive referral rate from Southmead was
      significantly lower than that from Weston-super-Mare (9/1000 v 23/1000).
      CONCLUSION: Preschool vision screening using orthoptists as primary screeners
      offers a more effective method of detecting visual abnormalities than using
      clinical medical officers.

PMID- 1747672
TI  - Dynamics of spread of HIV-I infection in a rural district of Uganda.
AB  - OBJECTIVE: To define the geographical distribution of HIV infection and the
      community characteristics associated with HIV prevalence in a rural population of
      Uganda. DESIGN: Seroprevalence survey and interviews of the population aged 13
      years and older in 21 randomly selected clusters. SETTING: Rural population of
      Rakai district, south west Uganda. SUBJECTS: 1292 adults, of whom 594 men and 698
      women gave a blood sample and answered the questionnaire. MAIN OUTCOME MEASURES:
      HIV status determined by ELISA and western blotting in relation to community
      characteristics. RESULTS: The weighted seroprevalence of HIV for the district was
      12.6% with prevalence by cluster varying from 1.2% to 52.8%. Seroprevalence was
      highest in main road trading centres (men 26%, women 47%), intermediate in rural
      trading villages on secondary roads (men 22%, women 29%), and lowest in rural
      agricultural villages (men 8%, women 9%). For both men and women, multiple
      regression showed a strong negative association between cluster seroprevalence
      and the proportion of the population employed in agriculture (beta = -0.677 for
      men, -0.807 for women). Among women, cluster seroprevalence increased with a
      higher proportion of the population reporting multiple sex partners (beta =
      0.814), external travel (beta = 0.579), and injections (beta = 0.483).
      CONCLUSIONS: Community characteristics, particularly the proportion of the
      population in agriculture, are associated with HIV prevalence and can be used for
      targeting interventions. The seroprevalences of HIV suggest spread of infection
      from main road trading centres, through intermediate trading villages, to rural
      agricultural villages.

PMID- 1747673
TI  - Serum sialic acid concentration and smoking: a population based study.

PMID- 1747674
TI  - Surveillance of antibiotic resistance in clinical isolates of Neisseria
      gonorrhoeae.

PMID- 1747675
TI  - Urinary incontinence: prevalence, need for treatment, and effectiveness of
      intervention by nurse.
AB  - OBJECTIVE: To measure the unmet need of patients with regular urinary
      incontinence (incontinence twice or more a month) treatable by a nurse. DESIGN:
      Self completed postal questionnaire and randomised controlled trial of assessment
      and intervention by a nurse. SETTING: One urban and one rural general practice in
      Somerset. SUBJECTS: 7300 adults randomly selected from 10,300 aged 35 and over on
      the combined practice lists. 515 women and 185 men with regular incontinence were
      offered assessment and treatment, of whom 134 women and 49 men had no
      intervention for three months (historical controls). They then joined the
      assessment and treatment programme. INTERVENTION: Four sessions of pelvic floor
      exercises and bladder retraining supervised by non-specialist nurse who had taken
      a three week course on assessing and treating uncomplicated incontinence. MAIN
      OUTCOME MEASURES: Number of patients desiring treatment; self reported cure,
      improvement, or deterioration in continence after three months. RESULTS: The
      questionnaire achieved a 79% response. Validated responses showed a prevalence of
      4.4% in men and 16.4% in women aged 35-64. 315 (45%) of the 700 patients offered
      assessment refused it and seven had moved away or died, 64 men and 41 women were
      referred to their general practitioner. 197 of 292 treated women (68%) reported
      cure or improvement compared with seven (5%) of controls. 22 of the 86 men
      desiring treatment were suitable for intervention by the nurse. Seventeen were
      cured or improved compared with none of the men in the control group.
      CONCLUSIONS: About half the people with regular urinary incontinence took up the
      offer of treatment (9.2% of women and 3.4% of men in the study population). This
      condition can be effectively managed by a nurse with limited training.

PMID- 1747676
TI  - Unstable asthma and theophylline.

PMID- 1747677
TI  - Medicine in Europe. 1992 and all that.

PMID- 1747678
TI  - ABC of vascular diseases. Assessment of leg ischaemia.

PMID- 1747679
TI  - Dangers of ozone depletion.

PMID- 1747680
TI  - Impact resistance of drinking glasses.

PMID- 1747681
TI  - Dietary reduction of serum cholesterol concentration.

PMID- 1747682
TI  - Health of the nation.

PMID- 1747683
TI  - Estimating the risk of heart attack.

PMID- 1747684
TI  - Community care for patients with schizophrenia.

PMID- 1747685
TI  - Threatening miscarriages and new advice on anti-D immunoglobulin.

PMID- 1747686
TI  - Advertising infant formulas in hospitals.

PMID- 1747687
TI  - Education on AIDS during biology classes.

PMID- 1747688
TI  - Privatisation on parade.

PMID- 1747689
TI  - A gauntlet for senior house officers.

PMID- 1747690
TI  - US lowers lead limits.

PMID- 1747692
TI  - Visiting other departments.

PMID- 1747691
TI  - Joint replacement in the 1990s.

PMID- 1747693
TI  - Outcome of parenteral gold therapy in RA patients: a comparison between two
      periods using life-table analysis.
AB  - Tolerance and outcome of parenteral gold therapy were compared using life-table
      analysis and ARA remission criteria between 151 rheumatoid arthritis (RA)
      patients treated in 1983 and in 210 patients treated in 1985. The total risk of
      termination of therapy was significantly higher in patients treated in 1983 than
      those treated in 1985. The most common causes were mucocutaneous reactions (41
      and 25% in 1983 and 1985, respectively), unsatisfactory effect (15 and 25%) and
      practical problems (14 and 26%). The outcome regarding all ARA remission criteria
      except for fatigue (not systematically registered) was significantly more
      favourable in patients treated in 1985 than in those treated in 1983.

PMID- 1747694
TI  - How should I treat a 24-year-old female with a 6-year history of relapsing
      polychondritis, mainly affecting the nasal cartilage, and to a lesser extent the
      auricular cartilages?

PMID- 1747695
TI  - Insidious loss of renal function in patients with anticardiolipin antibodies and
      absence of overt nephritis.
AB  - Circulating anticardiolipin antibodies are associated with recurrent thrombosis,
      fetal loss and thrombocytopenia. We have identified four patients with SLE or
      lupus-like disease who have high circulating levels of ACLA, repeated thrombosis
      and evidence of renal disease. Their clinical signs and symptoms of lupus
      activity were minimal, yet all had renal insufficiency with GFR 50 ml/min or less
      despite no history nor evidence of overt nephritis (proteinuria less than 0.5
      g/day and no haematuria). Renal biopsy specimens showed focal ischaemic lesions
      with no evidence of active lupus nephritis. We describe a new lesion of renal
      ischaemia secondary to non-inflammatory vascular pathology associated with
      circulating ACLA.

PMID- 1747696
TI  - Joint space in radiologically normal knees.
AB  - Joint space loss is a characteristic feature of rheumatoid arthritis and
      osteoarthritis. It cannot be fully evaluated, however, without knowledge of the
      normal variability of joint space size. We have measured joint space size using
      digital image analysis in a population of radiologically normal individuals.
      Anteroposterior films of the knee were studied from 685 consecutive patients
      attending Casualty with unexplained knee pain or following trauma, but with no
      clinical or radiological evidence of arthritis. Results show that in a
      radiologically normal population, men have larger joint spaces than women and
      there is a steady decline in joint space size with age. We found no significant
      difference in joint space size between weight bearing and non-weight bearing
      women. There was also no difference in patients presenting with pain and those
      presenting following an injury. Normal joint space size was not related to
      height, weight or body mass index in a subgroup of 213 patients. We suggest that
      patients lose joint space with increasing age and eventually reach a 'pain
      threshold' at which symptoms of osteoarthritis occur. This explains the increase
      in joint symptoms in those who begin with smaller joint spaces; that is in women
      and in the elderly.

PMID- 1747697
TI  - Antinuclear antibodies in first-degree relatives of patients with polymyositis
      dermatomyositis: analysis of the relationship with HLA haplotypes.
AB  - Antinuclear antibodies (ANA), as detected by indirect immunofluorescence on HEp-2
      cells, have been investigated in five spouses and 41 first-degree relatives of
      nine probands with polymyositis-dermatomyositis (PM-DM) and in 41 sex- and age
      matched controls. ANA were detected in 12 out of the 41 first-degree relatives
      and in two controls (chi 2 = 6.97; P less than 0.01). HLA typing was done in four
      out of the nine families; in two of them only, ANA segregated with a haplotype.
      ANA positivity was not correlated either to sex or to age or to household
      contact. Our results show that ANA occur in a significant percentage of first
      degree relatives of patients with PM-DM. The finding seems to be genetically
      conditioned.

PMID- 1747698
TI  - Factor VIII von Willebrand factor antigen levels correlate with symptom severity
      in patients with Raynaud's phenomenon.
AB  - We have previously documented raised levels of factor VIII von Willebrand factor
      antigen (FVIII vWF Ag), an endothelial product, in patients with vascular
      diseases and suggested that levels of this relate to disease activity. No one has
      yet investigated patients with Raynaud's phenomenon (RP) alone to see if the
      severity of vasospastic attacks relates to FVIII vWF Ag. We studied 22 patients
      with RP. None of these patients fulfilled diagnostic criteria for a connective
      tissue disease but all had severe symptoms which warranted referral to hospital.
      We measured the FVIII vWF Ag and the procoagulant factor VIII (FVIII:c) levels in
      these patients. FVIII:c is not an endothelial product and is released by
      different mechanisms, thus it forms an active control to FVIII vWF Ag. FVIII vWF
      Ag measurements were carried out using the Laurell method and FVIII:c was
      assessed using the technique described by Nilsson. Patients were asked to
      complete diaries over a 2-week winter period. The frequency and duration of all
      Raynaud's attacks were recorded. There were significant positive correlations
      between FVIII vWF Ag and the total number and duration of RP attacks over the 2
      week period (P less than 0.005, r = 0.67 and P less than 0.05, r = 0.40,
      respectively; Spearman's rank correlation). No correlation was found between
      levels of FVIII:c and the same clinical parameters. It has been suggested that
      patients with clinical evidence of vascular damage have elevated plasma levels of
      FVIII vWF Ag. Our present study has demonstrated correlations between FVIII vWF
      Ag levels and the clinical severity of vasospasm in patients with RP.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1747699
TI  - Is there a place for corticosteroid injection in the management of Achilles'
      tendon lesions?

PMID- 1747700
TI  - Primary Sjogren's syndrome in north east England--a longitudinal study.
AB  - We have documented the initial clinical features of 100 patients with primary
      Sjogren's syndrome (SS) together with the results of their baseline
      investigations. The evolution of the disease in these patients has been followed
      for a median of 34 months (range 3-84 months). The majority of patients were
      females aged 40-60 years, and common clinical features included eye symptoms
      (100%), xerostomia (100%), polyarthralgia (94%), Raynaud's phenomenon (81%) and
      salivary gland swelling (47%). Thyroid disease was relatively common (14%) while
      other endocrine disease was rare. Four patients died during follow-up, and three
      cases of lymphoma were detected. Other serious complications included
      pericarditis (10%), pleuroparenchymal lung disease (9%), renal tubular acidosis
      (3%) and cerebrovascular accidents (2%). The presence of anti-Ro antibodies
      identifies patients with more severe systemic disease. Spontaneous improvement
      occurred in 12 patients, while steroids were required for specific complications
      in 18. Overall, although lymphoma was found to excess in our group, the high
      mortality reported with primary SS elsewhere was not seen.

PMID- 1747701
TI  - Single cell imaging reveals abnormal intracellular calcium signals within
      rheumatoid synovial neutrophils.
AB  - Intracellular calcium (Ca2+) signalling in synovial fluid (SF) polymorphonuclear
      leucocytes (PMN) from patients with rheumatoid arthritis (RA) was compared to RA
      and normal circulating blood PMN using single cell imaging. RA SF PMN stimulated
      by the peptide f-Met-Leu-Phe (FMLP) showed a striking difference in the release
      of Ca2+ from the intracellular store compared to RA and normal circulating blood
      PMN. Stimulation caused the release of a very dispersed, nonrestricted 'cloud' of
      Ca2+ in 60% of RA SF PMN compared to the highly localized and restricted 'cloud'
      observed in only 30% of normal circulating PMN. In the presence of extracellular
      Ca2+, both RA SF and normal blood PMN showed heterogeneity in both the timing and
      magnitude of their cytosolic free Ca2+ signalling. These observations imply that
      the Ca2+ signalling mechanism in RA SF and RA blood PMN has been primed in a way
      which could exacerbate the release of inflammatory mediators. This may have
      serious implications for explaining the aberrant behaviour of SF PMN in RA.

PMID- 1747702
TI  - Should disease-modifying agents be used in mild rheumatoid arthritis?
AB  - A 12-month double-blind controlled study comparing hydroxychloroquine 400 mg
      daily with placebo in 104 patients with mild RA was conducted to see whether
      patients with mild rheumatoid arthritis (RA) benefit from treatment with disease
      modifying agents. Mild RA was defined as synovitis limited to the hands and feet,
      an ESR less than 30 mm/h and C-reactive protein less than 20 mg/l, a situation
      where accepted clinical practice is to use a non-steroidal anti-inflammatory
      agent alone. By 6 months, the improvement of clinical and laboratory parameters
      in the hydroxychloroquine treated patients was significant compared with
      pretreatment levels and significantly greater than the control group. This
      improvement was maintained at 12 months. In addition, fewer patients withdrew
      through lack of efficacy, eight on hydroxychloroquine versus 18 on placebo. The
      implications of treating this well defined group of patients is discussed.

PMID- 1747703
TI  - Arthritis artefacta: factitious disease in rheumatology.
AB  - Self-induced disease can be difficult to diagnose and costly of time and money to
      investigate. The key is to think of the possibility. Five patients in whom the
      evidence for factitious rheumatological illness was strong are discussed and
      their histories, physical signs and family backgrounds are explored in
      relationship to factitious disease presenting in other fields. Young immature
      individuals seem most at risk and the discrepancy between physical signs and
      understandable pathological mechanisms may suggest the diagnosis. The outlook
      seems frequently poor.

PMID- 1747704
TI  - A preliminary study of magnetic resonance relaxation times (T1 and T2) in
      inflammatory and degenerative synovial fluids.
AB  - Multiple synovial fluid samples from 21 patients were analysed using standard
      synovial analysis techniques and by nuclear magnetic resonance spectroscopy.
      Significant negative correlations were noted between both T1 (P less than 0.01)
      and T2 (P less than 0.0006) relaxation times and synovial fluid total protein. No
      differences in T1 or T2 relaxation times were noted in synovial fluid between 16
      patients with inflammatory forms of arthritis and five patients with degenerative
      arthritis. In a single rheumatoid arthritis patient with concurrent
      staphylococcal arthritis, T1 and T2 relaxation times did not vary between the
      active phase and the recovery phase. The lack of any significant differences in
      the measured relaxation times as a function of joint condition suggest that in
      vivo magnetic resonance measurements of T1 or T2 for joint analysis may not
      reveal information of either a diagnostic or pathophysiological nature.

PMID- 1747705
TI  - Carpal tunnel syndrome complicated by reflex sympathetic dystrophy syndrome.
AB  - This report describes three patients with reflex sympathetic dystrophy
      complicating carpal tunnel syndrome. Pain disproportionate and more diffuse than
      that commonly associated with carpal tunnel syndrome suggested the associated
      diagnosis in each patient and facilitated prompt management.

PMID- 1747706
TI  - Malignant hypertension and antiphospholipid antibodies as presenting features of
      SLE in a young woman using oral contraceptives.
AB  - A 24-year-old woman developed malignant hypertension while on oral contraceptives
      (OCs). She was found to have incomplete systemic lupus erythematosus (SLE) with
      DNA antibodies and high levels of antiphospholipid antibodies (APLA). She later
      developed SLE and has had three miscarriages and a cerebellar infarction.

PMID- 1747707
TI  - Transient erosion of the ulnar styloid process.
AB  - A patient with polyarthritis had radiographs of the wrists taken at presentation
      and again at 6 months. At presentation radiographs were normal, but repeat X-rays
      at 6 months showed complete erosion of both ulnar styloid processes. This did not
      correlate with the clinical picture of a mild synovitis. A third X-ray showed
      normal wrists, revealing the cause to be a positional artefact during the X-ray
      procedure. Clinicians should be aware of this 'catch'.

PMID- 1747708
TI  - Reiter's syndrome and reactive arthritis.

PMID- 1747710
TI  - Role of prolactin in autoimmune diseases and autoimmunity.

PMID- 1747709
TI  - Pneumocystis carinii pneumonia causing hypertrophic osteoarthropathy.

PMID- 1747711
TI  - Genetics of rheumatoid arthritis.

PMID- 1747713
TI  - Does the weather affect the osteoarthritic patient?

PMID- 1747712
TI  - Assessment of disability in male and female rheumatoid patients.

PMID- 1747714
TI  - Psoriatic spondylitis presenting as chronic torticollis.

PMID- 1747715
TI  - The investigation of impotence.

PMID- 1747716
TI  - Hyperoxaluria in patients with recurrent calcium oxalate calculi: dietary and
      other risk factors.
AB  - The presence of mild hyperoxaluria in recurrent calcium oxalate stone formers is
      controversial. The aim of this study was to identify recurrent stone formers with
      mild hyperoxaluria and to classify them further by assessing their response to a
      low oxalate diet. In addition, the prevalence of other risk factors for stone
      formation in this group of patients was investigated. A total of 207 consecutive
      patients with recurrent renal calculi were screened and 40 (19%) were found to
      have mild hyperoxaluria. Of these, 18 (45%) responded to dietary oxalate
      restriction by normalising their urinary oxalate. The remaining 22 patients were
      classified as having idiopathic hyperoxaluria and were subdivided into those in
      whom urinary oxalate excretion was consistently elevated in all specimens
      measured and those in whom the elevation was intermittent in nature. Dietary
      oxalate restriction had a partially beneficial effect in lowering oxalate
      excretion in the patients with persistent hyperoxaluria. No difference in urinary
      oxalate excretion was found after dietary restriction in the patients with
      intermittent hyperoxaluria. Other risk factors, including dietary, absorptive and
      renal hypercalciuria and hypocitraturia, were documented, the prevalence of which
      (65%) was not significantly different from that (62.5%) found in 40 age- and sex
      matched calcium stone formers without hyperoxaluria. The prevalence of
      hyperuricosuria was significantly greater in patients with hyperoxaluria when
      compared with stone controls. Further studies are required to elucidate the
      underlying mechanisms of hyperoxaluria in recurrent stone formers.

PMID- 1747717
TI  - Renal function after partial nephrectomy with the Nd-YAG laser. Experimental
      study in piglets.
AB  - Twelve partial nephrectomies were performed in 12 piglets using either the
      combination (contact and non-contact) Nd:YAG laser technique or a steel scalpel.
      Additional haemostasis was attempted with ligatures. The renal artery was not
      clamped and renal cooling was not attempted. Total nephrectomy was performed on
      the contralateral side. Serum creatinine and urea levels were measured, and 99mTc
      DTPA renography was performed pre-operatively and 1 and 2 weeks post-operatively.
      One week post-operatively the mean serum creatinine level was 35% higher than the
      pre-operative level in the laser group and 30% higher in the steel scalpel group.
      Two weeks post-operatively the respective differences were 34 and 24%. The mean
      urea level 1 week after operation was 50% higher than the pre-operative level in
      the laser group and 17% higher in the steel scalpel group. Two weeks post
      operatively the respective differences were 38% in the laser group and 20% in the
      steel scalpel group. The mean DTPA disappearance rate was 34% lower 1 week after
      operation in the laser group and 23% lower in the steel scalpel group when
      compared with the preoperative state. Two weeks post-operatively the respective
      changes were 48 and 25%. These data indicate that there is no significant
      difference in renal function when the Nd: YAG combination laser technique is used
      in partial nephrectomy as compared with the steel scapel.

PMID- 1747718
TI  - Pyonephrosis and renal abscess associated with kidney tumours.
AB  - Whilst the diagnosis of pyonephrosis and renal abscess is fairly easy, the source
      of obstruction and infection is an important indicator of treatment. The
      association of kidney tumours with these inflammatory manifestations has not
      previously been emphasised. Reviewing our cases of pyonephrosis and renal
      abscesses, we report 4 patients with concomitant tumours of the kidney and
      discuss their management.

PMID- 1747719
TI  - Renal hydatid disease.
AB  - Hydatid disease is caused by the larval form of Taenia echinococcus (Echinococcus
      granulosus) in humans, the most common sites being the liver and the lungs.
      Involvement of the kidneys is uncommon and can be asymptomatic for long periods.
      Renal hydatid disease has no pathognomonic signs except for hydatiduria. Because
      of the risk of fatal anaphylaxis, puncture of the cyst should be avoided, and
      partial or total nephrectomy is still the preferred treatment. We present 10
      patients with renal hydatid disease treated in the Department of Urology, Ankara
      University.

PMID- 1747720
TI  - Comparison of clinical and pathological characteristics in incidentally detected
      and suspected renal carcinoma.
AB  - In a study of the clinical and pathological characteristics of incidentally
      detected and suspected renal carcinoma, we reviewed the manner of presentation,
      serum immunosuppressive acidic protein (IAP), tumour stage and size in 112
      consecutive patients with renal carcinoma who were diagnosed clinically and
      surgically between 1980 and 1989. The results showed an increase in the
      proportion of incidentally diagnosed cases. The routine use of radiological
      imaging, especially ultrasound and computed tomography (CT), has led to tumours
      being diagnosed earlier than when IAP is used as a tumour marker in patients with
      incidentally detected renal carcinoma. Tumours were lower stage and smaller in
      patients with incidentally detected renal carcinoma than in patients in whom the
      diagnosis was suspected.

PMID- 1747721
TI  - Sex distribution of adult idiopathic detrusor instability in relation to
      childhood bedwetting.
AB  - The urodynamic case records of 1000 consecutive men and women were reviewed to
      study the link between idiopathic detrusor instability (DI) and childhood
      nocturnal enuresis and to determine whether a sex difference in this relationship
      may exist. Idiopathic DI was found in 10% of the men, 63% of whom had suffered
      from childhood bedwetting; 29% of the women had idiopathic instability, of whom
      38% had been nocturnal enuretics. Thus the link between adult idiopathic DI and
      childhood bedwetting appeared to be stronger for men than for women. The sex
      distribution of subjects is not always reported in urodynamic studies of
      bedwetters and adults with an unstable bladder. We suggest that this should
      become routine practice as it may help to shed light on the aetiology of
      idiopathic detrusor instability.

PMID- 1747722
TI  - Subtrigonal phenol injection. How safe and effective is it?
AB  - A series of 24 patients underwent 27 transtrigonal phenol injections for the
      treatment of bladder instability. Only 2 of 18 patients with detrusor instability
      and 2 of 6 with detrusor hyperreflexia continued to derive benefit from the
      procedure 6 months after it was carried out. Serious complications attributable
      to phenol were seen in 2 patients in this series and in a further 4 patients
      referred for complications resulting from this therapy in other centres. These
      results and a review of the literature lead us to suggest that transvesical
      phenol injection should not be used except in the hyper-reflexic bladder when no
      alternative treatment is possible. Particular care should be exercised in
      patients who have undergone extensive prior surgery or radiotherapy.

PMID- 1747723
TI  - Clam ileocystoplasty.
AB  - Clam enterocystoplasty has been used successfully in the treatment of refractory
      urge incontinence. We report 31 patients who underwent ileocystoplasty between
      1982 and 1989. The majority of patients were pleased with the outcome of the
      operation. The main post-operative complication was voiding dysfunction due to
      relative bladder outflow obstruction. Urinary tract infection and mucus
      production were significant long-term problems.

PMID- 1747724
TI  - Neoadjuvant chemotherapy with methotrexate and cisplatin prior to radiotherapy
      for invasive transitional cell carcinoma of the bladder. Assessment of
      feasibility and toxicity.
AB  - A prospective study has been performed to assess the feasibility and toxicity of
      administering neoadjuvant chemotherapy with methotrexate (200 mg/m2) and
      cisplatin (100 mg/m2) prior to radical radiotherapy. Twenty patients with
      advanced transitional cell carcinoma of the bladder were assessed after each of 3
      courses of chemotherapy, after radiotherapy and 6 months following treatment. Of
      particular concern was whether neoadjuvant chemotherapy compromised the ability
      to give potentially curative radical radiotherapy, delayed effective palliation
      of distressing urinary symptoms, or allowed local tumour progression prior to
      definitive treatment. It was concluded that this chemotherapy regimen was well
      tolerated, did not compromise the ability to give radical radiotherapy and
      resulted in the prompt palliation of urinary symptoms. This treatment, however,
      did not stop the development or progression of metastatic disease in some
      patients. In only 1 patient was there local progression during chemotherapy.

PMID- 1747725
TI  - How effective is topical alpha-2b interferon in preventing recurrence of
      superficial bladder cancer?
AB  - A total of 44 patients with low and intermediate grade superficial urothelial
      bladder cancer Ta and T1 were randomised into a controlled, long-term, phase III
      trial on topical instillation therapy with high dose alpha-2b interferon (100 x
      10(6) IU versus low dose alpha-2b interferon (10 x 10(6) IU) versus ethoglucid.
      Thirteen patients in the low dose group, 11 in the high dose group and 10 in the
      ethoglucid group completing the trial were evaluable (median follow-up 36.5
      months) and were followed up for 3 years. They were treated weekly for 10 weeks
      and then monthly for a total of 1 year. The aim of the trial was to establish the
      prophylactic efficacy and the toxic side effects, if any, of alpha-2b interferon
      in the topical treatment of superficial bladder cancer. Recurrence rate and
      disease-free survival were chosen as study end-points. The recurrence rate was
      4.4 in the low dose interferon group, 2.76 in the high dose interferon group and
      3.08 in the ethoglucid group. In the low dose interferon group the time to the
      first recurrence was 22.23 months versus 22.36 in the high dose group and 21.76
      months in the ethoglucid group. No differences of statistical significance were
      noted between the 3 groups. Progression occurred in 5 patients on interferon but
      was not seen in those on ethoglucid. Neither systemic nor local side effects were
      seen in the interferon groups, but 3 patients had to be taken off ethoglucid
      because of severe chemocystitis. In superficial bladder cancer, topical
      instillation therapy with interferon is as effective as conventional chemotherapy
      and has no side effects.

PMID- 1747726
TI  - Relationship between clinical stage and histological zone of origin in early
      prostate cancer: morphometric analysis.
AB  - A detailed morphometric analysis of 96 radical prostatectomy specimens (13
      clinical stage A1, 29 A2, 34 B1 and 20 B2) was undertaken to examine the
      relationship of zone of origin to volume, grade and extraprostatic extension of
      cancer. In patients with stage A disease, transition zone (TZ) cancer (present in
      81%) was significantly larger but of lower grade than peripheral zone (PZ) cancer
      (present in 90%). The total volume of cancer in stage A1 patients averaged 1.55
      ml with 72% of TZ origin. In patients with stage A2 disease, tumour volume
      averaged 5.83 ml with only 57% of TZ origin. Specimens taken during transurethral
      resection of the prostate (TURP) revealed TZ cancer in 82% and PZ cancer either
      alone or with TZ cancer in 22%. The 9 patients with PZ cancer in the TURP
      specimen included 5 of the 11 with extracapsular extension and all 5 of those
      with seminal vesicle invasion. Every patient with stage B disease had PZ cancer
      which, in all except 3 cases, was of significantly larger volume and higher grade
      than any TZ cancer (present in 43%) in the same gland. In patients with stage B
      cancer, total tumour volume was 5.13 ml with 91% of PZ origin. TZ cancer tended
      to be well differentiated in all patients, even at large volumes, whereas PZ
      cancer was often moderately or poorly differentiated even at low volumes. In
      patients with stage B disease, TZ cancer appeared to be incidental and of no
      clinical importance, while in stage A patients PZ cancers were sometimes large,
      poorly differentiated and extended outside the prostate. Progression of a stage A
      cancer seems more likely to result from PZ cancer than TZ cancer, and the finding
      of PZ cancer in a TURP specimen should probably preclude its classification as
      stage A1.

PMID- 1747727
TI  - Unusual foreign bodies in the urethra and bladder.
AB  - We report 8 cases of self-inserted unusual foreign bodies in the lower urinary
      tract, all being treated from 1976 to 1990. Three of them were located in the
      urethra and 5 in the bladder. Several objects were found (electric cable,
      tweezers, hairpin, drawing pin, pebbles, paper clip). In 4 cases the objects were
      inserted for masturbatory purposes. Five of the patients were psychologically ill
      or handicapped. The most common reason for consultation was dysuria, and the
      treatment procedures were endoscopy in 5 patients and cystotomy in the other 3.

PMID- 1747728
TI  - Surgical technique for inguinal surgery and its effect on fertility in the Wistar
      rat model.
AB  - This study has explored the relatively neglected effects of operative
      manipulation of the vas deferens on fertility. Following unilateral vasectomy the
      contralateral vasa of 52 4-week-old Wistar rats were subjected to 7 different
      manipulations. After 7 weeks a fertility trial was conducted. All sham operated
      rats (n = 18) were fertile. Of the remaining 34 rats, 22 (65%) were sterile. All
      of those with tight ring reconstruction (n = 6) were sterile, due initially to
      venous obstruction. Nine of 14 rats with acute clip trauma (65%) remained fertile
      but 11 of 14 (78%) with full mobilisation were sterile owing to extensive
      avascular fibrosis of the vas deferens. These results suggest that overzealous
      cord handling and operative technique in the immature animal is counterproductive
      and leads to vasal occlusion. This may have important repercussions in paediatric
      inguinal surgery, with a subsequent higher incidence of azoospermia and male
      subfertility.

PMID- 1747729
TI  - Microsurgical epididymovasostomy by loop intussusception. A new technique in the
      rat model.
AB  - A new technique, epididymal loop intussusception into the vas deferens, is
      offered as an improved form compared with the side-to-end method. Loop
      intussusception has been experimentally studied bilaterally in 15 adult male
      rats. This report provides details of the technique. A 3-month anatomical and
      histological follow-up showed a 100% patency rate, no anastomotic stricture, and
      reabsorption of the blind intussuscepted loop in all but 3 cases. Macroscopic
      sperm granulomas were present in only 10% of the anastomoses examined. Advantages
      and disadvantages of microsurgical epididymovasostomy techniques are discussed.

PMID- 1747730
TI  - Animal models for epididymoepididymostomy. Development of an alternative
      microsurgical procedure for vasoepididymostomy.
AB  - The present success rate for high level microsurgical vasoepididymostomy in
      patients with obstructive azoospermia is generally poor in comparison with more
      distal vasoepididymal bypasses, suggesting that the development of a high level
      bypass method which preserves the distal maturation and storage functions of the
      epididymis might increase the fertility success rate. To achieve this we have
      developed a segmental bypass of the distal caput-proximal corpus regions of the
      epididymis (epididymoepididymostomy) using the rat and rabbit as animal models.
      In this procedure the epididymides of 11 adult male Sprague-Dawley rats were
      exposed through a scrotal incision and a convolution of the duct in the proximal
      corpus region was attached to an opened convolution in the mid-caput epididymides
      using a standard microsurgical technique. Each male was rested for at least 3
      months after the microsurgical bypass operation to allow the preoperative sperm
      contents of the caudal storage region to be replaced by post-bypass spermatozoa.
      Six of the 11 rats were proven fertile after surgery by siring litters from
      mating trials up to 11 months later. The patency of anastomoses was confirmed in
      3 animals by laparotomy and recovery of large numbers of sperm with normal
      motility from the cauda epididymidis distal to the anastomosis site and also from
      the vas. Similar unilateral surgery in 2 adult male rabbits resulted in normal
      post-operative semen profiles in 1 and an in vivo fertilisation rate of 100% from
      1 mating trial 8 months after surgery. The successful development of a reliable
      animal model for epididymoepididymostomy provides an experimental tool for
      studying the function of the epididymis. This technique may also have clinical
      application as an alternative to high level vasoepididymostomy in selected
      patients with obstructive azoospermia.

PMID- 1747731
TI  - Seminal white blood cells in men with urethral tract infection. A monoclonal
      antibody study.
AB  - Monoclonal antibodies were used to detect seminal leucocytes in 19 men with
      urethritis. A wide range in the number and type of leucocytes between individuals
      was documented (median 2.06 x 10(6)/ml, range 0.6-29.89 x 10(6)/ml); 22% of the
      men had less than 1 x 10(6) leucocytes/ml. The results suggest that the threshold
      of greater than or equal to 1 x 10(6)/ml proposed by the World Health
      Organisation to indicate genital tract infection is unsuitable for men with
      urethritis.

PMID- 1747732
TI  - The role of colour duplex ultrasonography in the diagnosis of vasculogenic
      impotence.
AB  - Colour duplex ultrasonography was used to obtain peak systolic velocity (PSV)
      readings from cavernosal arteries at rest and during papaverine-induced
      tumescence. Results from 31 men with vasculogenic impotence were compared with
      those from 17 men with non-vasculogenic impotence and a control group of 6 potent
      men. In the flaccid state no significant differences in PSV readings were found
      between the vasculogenic and control groups. Following the injection of
      papaverine, men from the vasculogenic group without venous leakage were alone in
      having significantly lower PSV readings compared with the potent controls. All 23
      men with normal penile haemodynamics had a mean PSV greater than or equal to 20
      cm/s during tumescence. This was also the case for 19 (61%) of the vasculogenic
      group, including 9 (69%) of the 13 patients with venous leakage. The remaining 12
      men in the vasculogenic group (39%) had a mean PSV less than 20 cm/s, this being
      diagnostic of an inadequate arterial inflow. Colour duplex ultrasonography can
      identify patients who have marked arterial insufficiency as the major cause of
      their impotence and hence allows more rational selection for angiography and
      revascularisation. Lesser degrees of arterial deficit are difficult to
      characterise using mean PSV readings alone.

PMID- 1747733
TI  - Urinary stone formation in children with prenatally diagnosed uropathies.
AB  - Among a series of 312 patients with prenatally diagnosed uropathies, 4 male
      children developed urinary calculi at ages varying from 2 to 5 years. All had
      upper urinary tract dilatation not associated with vesicoureteric reflux or with
      renographically defined obstruction; 3 followed Proteus urinary infections.
      Strategies for prevention are discussed.

PMID- 1747734
TI  - Surgical management of incontinence in bladder exstrophy.
AB  - Between 1978 and 1990, 86 patients with previously closed classical bladder
      exstrophy and 10 patients seeking undiversion have presented for continence
      management and have undergone selective reconstruction designed for voiding
      and/or intermittent urethral catheterisation. The reconstruction in these 96
      patients has been reviewed. Eight of the 10 patients undergoing undiversion
      achieved a satisfactory state of continence but 4 required Mitrofanoff procedures
      to enable catheterisation. Of the other 86 patients, 2 reached a satisfactory
      state of continence without further surgery; 79 underwent bladder neck surgery
      for continence either without augmentation (n = 32) or with augmentation (n =
      47). Twenty of the 32 patients who were treated by bladder neck reconstruction
      alone were later found to require augmentation. Five patients had very early
      augmentation either to facilitate neonatal closure or on account of severe upper
      tract dilatation. Of these, 1 became continent without further surgery and 4
      demonstrated the need for bladder neck reconstruction. Thus 12 children achieved
      successful continence (n = 6) or are evolving satisfactorily with potential
      success (n = 6) as a result of bladder neck reconstruction. Of the 71 patients
      requiring bladder neck reconstruction and augmentation, 68 have completed their
      surgery. The current status of these patients is: satisfactory in 57 (80%) (42
      void/urethral clean intermittent catheterisation (CIC), 7 waiting to learn CIC, 5
      Mitrofanoff, 3 artificial urinary sphincter (AUS]. Of the remaining 11 patients
      (20%), 8 are unsatisfactory to varying degrees and the status of the other 3 is
      unknown.

PMID- 1747735
TI  - Unusual presentation of a testicular tumour.

PMID- 1747736
TI  - Candida albicans infection in solitary kidney presenting as anuria.

PMID- 1747737
TI  - Primary lymphoma of the bladder arising from an area of Malakoplakia.

PMID- 1747738
TI  - Priapism in haemodialysis patient due to prazosin?

PMID- 1747739
TI  - Partial extraction of double-J stent during nephrostomy tube removal and its
      prevention.

PMID- 1747740
TI  - Filling defects of infectious origin in the cystogram of a 6-year-old child.

PMID- 1747741
TI  - Chronic urinary retention masquerading as meralgia paraesthetica.

PMID- 1747742
TI  - Urinary tract infections: the need for pure culture technology in clinical
      laboratory diagnosis.

PMID- 1747743
TI  - Electrophysiological responses to muscarinic receptor stimulation in cultured
      hippocampal neurons.
AB  - Electrophysiological recordings of responses to muscarinic receptor stimulation
      in cultured embryonic hippocampal neurons have been largely unsuccessful to date.
      In this study muscarinic receptor binding was demonstrated in 2-week-old
      embryonic rat hippocampal cultures. Using whole-cell patch-clamp recording we
      found that 1-5 microM carbachol produced multiple effects including
      depolarization, increased action potential firing rate, increased synaptic
      activity and a reduction in the amplitude of medium-duration
      afterhyperpolarizations. Voltage-clamp analysis revealed a time-dependent current
      relaxation with hyperpolarizing steps from a holding potential of about -40 mV
      which was inhibited by 10 microM muscarine or 50 microM carbachol and had
      characteristics similar to those of the m-current. Both atropine and pirenzepine
      inhibited all of these effects indicating that these cholinergic actions were
      mediated by muscarinic receptors. This study shows that muscarinic responses
      obtained classically in hippocampal brain slices can also be produced in cultured
      hippocampus.

PMID- 1747744
TI  - Inhibition of NMDA-induced protein kinase C translocation by a Zn2+ chelator:
      implication of intracellular Zn2+.
AB  - The role of intracellular Zn2+ in the translocation of protein kinase C from
      cytosol to membrane fractions was examined by the [3H]phorbol 12,13-dibutyrate
      (PDBu) binding method in guinea pig cerebral synaptoneurosomes. N-methyl-D
      aspartate (NMDA, 100 microM) and calcium ionophore A23187 (0.3-30 microM)
      decreased the binding activity in the cytosol with a concomitant increase in the
      membrane fractions. Pretreatment of synaptoneurosomes with a heavy metal
      chelator, N,N,N',N'-tetrakis-(2-pyridylmethyl)ethylenediamine (TPEN), inhibited
      the NMDA- and A23187-induced changes of the distribution of [3H]PDBu binding
      sites in cytosol and membrane fractions. The inhibitory effect of TPEN was
      negated by a preincubation of TPEN with equimolar Zn2+ but not by that with Ca2+.
      The addition of 500 microM Zn2+ to the lysate of synaptoneurosomes induced an
      increase of [3H]PDBu binding activity in the membrane fraction with a concomitant
      decrease in the cytosol fraction, as did 100 microM Ca2+. Low concentrations of
      Zn2+ (10 microM), which alone had no effect on the distribution of the binding,
      significantly enhanced the effect of 10 microM Ca2+ in the lysate. Under those
      conditions TPEN inhibited the Zn(2+)-potentiated Ca(2+)-dependent changes in the
      binding. These results suggest that intracellular Zn2+ is essential for the
      agonist-induced translocation of protein kinase C in guinea pig
      synaptoneurosomes.

PMID- 1747745
TI  - Age effects on monoamine turnover of the rat substantia nigra.
AB  - Measurement of turnover of dopamine (DA), noradrenaline (NA) and serotonin (5
      hydroxytryptamine (5-HT), and their metabolites has been performed in 6- and 24
      month-old rats. Dopamine synthesis in 24-month-old rats did not show any change
      with respect to 6-month-old rats. However, our results seem to indicate decreased
      DA release in 24-month-old rats. This hypothesis could be supported by the
      changes found in the 3-methoxytyramine (3-MT) accumulation rate after monoamine
      oxidase inhibition with pargyline. The turnover of NA and its main metabolite, 3
      methoxy-4-hydroxyphenylglycol (MHPG) decreased in 24-month-old rats compared with
      6-month-old rats. Serotonin synthesis did not change in 24-month-old rats with
      respect to 6-month-old rats. However, the metabolism of 5-HT quantified as
      turnover of 5-hydroxy-3-indoleacetic acid (5-HIAA) increased in 24-month-old rats
      with respect to 6-month-old rats. The monoamine oxidase B:monoamine oxidase-A
      ratio increased in 24-month-old rats. The significance of these changes is
      discussed.

PMID- 1747746
TI  - Chronic ethanol ingestion decreases vasopressin mRNA in hypothalamic and
      extrahypothalamic nuclei of mouse brain.
AB  - Endogenous arginine vasopressin was previously shown to modulate the rate of loss
      of functional (CNS) tolerance to ethanol, suggesting that chronic ethanol
      ingestion might alter vasopressin synthesis and/or release. Since
      extrahypothalamic vasopressin is believed to be involved in the CNS effects of
      the peptide, we determined the effect of ethanol on vasopressin mRNA in the bed
      nucleus of the stria terminalis (BST), as well as in several hypothalamic nuclei.
      Chronic ethanol ingestion, that produced functional tolerance and physical
      dependence in mice, resulted in decreased vasopressin mRNA levels in all areas
      examined. In contrast, as expected, dehydration resulted in increases in
      vasopressin mRNA in the BST and in all hypothalamic nuclei except the
      suprachiasmatic nucleus. In the BST, both ethanol ingestion and dehydration
      affected cells in the central region of the nucleus, while cells in the caudal
      portion were only affected by ethanol treatment. The results indicate that
      chronic ethanol ingestion generally reduces the synthesis of vasopressin, and
      that increased vasopressin synthesis is not necessary in order for the peptide to
      affect ethanol tolerance.

PMID- 1747747
TI  - Asymmetric sigmoid non-linearity in the rat olfactory system.
AB  - The statistical relationship between multi-unit spike activity and simultaneously
      recorded local dendritic field potentials in the olfactory system of the waking
      rat was studied with chronically placed electrodes. The relationship had the form
      of a sigmoid increase in axonal firing probability conditional on the amplitude
      of dendritic potentials. These data were fitted with an asymmetric sigmoid curve
      previously derived from the Hodgkin-Huxley equations. The curve was fitted using
      non-linear regression to optimize its parameter: the maximal firing rate. The
      maximal rate also gave the steepness of the slope of the sigmoid. Pulse trains
      were recorded from excitatory and inhibitory neurons in the olfactory cortex
      (including the anterior olfactory nucleus, the prepyriform cortex and the lateral
      entorhinal area) as identified by the phase relations of the pulse probability
      and the dendritic potentials, and from the excitatory neurons in the bulb (the
      inhibitory granule cells do not give extracellularly detectable action
      potentials). All these neurons are known to interact in disynaptic negative
      feedback loops giving rise to oscillations. The same sigmoid function fit the
      data from both types of neurons in all locations. The curves for neurons in all
      parts of the olfactory cortex had a 3-fold higher slope and maximal value than
      the curves from bulbar neurons. The significances of this difference and of the
      asymmetric sigmoid are discussed in terms of models for olfactory oscillatory
      dynamics and pattern recognition.

PMID- 1747748
TI  - Sympathetic neuron factors involved in bradykinin-induced plasma extravasation in
      the rat.
AB  - Previous studies have demonstrated that bradykinin (BK) produces a
      sympathetically dependent plasma extravasation into the rat knee joint which is,
      in part, dependent upon the production of a prostaglandin. In the present study,
      co-administration of the specific prostaglandin, PGE2, markedly enhanced the BK
      induced plasma extravasation. In this study we also report that after chemically
      induced sympathectomy, by chronic pretreatment with 6-hydroxydopamine (6-OHDA),
      both the plasma extravasation produced by BK and the enhancing effect of PGE2 are
      markedly attenuated. Plasma extravasation induced by PGE2 alone was small and was
      not significantly attenuated by sympathectomy. We conclude that BK-induced
      extravasation involves production of at least two sympathetic postganglionic
      neuron (SPGN) terminal-dependent factors, one of which is a cyclo-oxygenase
      product of arachidonic acid metabolism, probably PGE2, (Coderre et al., J.
      Neurophysiol., 62 (1989) 45-58) and another that is unidentified.

PMID- 1747749
TI  - Inhibition of growth hormone-releasing factor suppresses both sleep and growth
      hormone secretion in the rat.
AB  - To study the possible involvement of hypothalamic growth hormone-releasing factor
      (GRF) in sleep regulation, a competitive GRF-antagonist, the peptide (N-Ac-Tyr1,D
      Arg2)-GRF(1-29)-NH2, was intracerebroventricularly injected into rats (0.003,
      0.3, and 14 nmol), and the EEG and brain temperature were recorded for 12 h
      during the light cycle of the day. Growth hormone (GH) concentrations were
      determined from plasma samples taken at 20-min intervals for 3 h after 14 nmol
      GRF-antagonist. The onset of non-rapid eye movement sleep (NREMS) was delayed in
      response to 0.3 and 14 nmol GRF-antagonist, the duration of NREMS was decreased
      for one or more hours and after 14 nmol EEG slow wave amplitudes were decreased
      during NREMS in postinjection hour 1. The high dose of GRF-antagonist also
      suppressed REMS for 4 h, inhibited GH secretion, and elicited a slight biphasic
      variation in brain temperature. These findings, together with previous
      observations indicating a sleep-promoting effect for GRF, support the hypothesis
      that hypothalamic GRF is involved in sleep regulation and might be responsible
      for the correlation between NREMS and GH secretion reported in various species.

PMID- 1747750
TI  - Psychological stress increases dopamine turnover selectively in mesoprefrontal
      dopamine neurons of rats: reversal by diazepam.
AB  - The effects of psychological stress on catecholamine and indoleamine metabolism
      were examined in various brain regions of rats. Psychologically stressed rats
      were exposed to emotional responses of foot-shocked rats, but were themselves
      prevented from receiving foot-shock. Psychological stress for 30 min resulted in
      significant increases of both 3,4-dihydroxyphenylacetic acid (DOPAC) and
      homovanillic acid (HVA) levels in the medial prefrontal cortex (MPFC), but not in
      other dopamine (DA) terminal fields. The levels of noradrenaline (NA), serotonin
      (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) were unaffected in all brain
      regions examined after 30 min of psychological stress. A small but significant
      increase of DOPAC levels in the ventral tegmental area (VTA) was observed after a
      shorter (10 min) duration of stress. Moreover, an increase of DOPAC levels in the
      MPFC 30 min after psychological stress was attenuated by diazepam (5 mg/kg), and
      this attenuating effect was antagonized by Ro 15-1788 (15 mg/kg). These results
      suggest that mesoprefrontal DA neurons are selectively activated by psychological
      stress, and that the activation of the A10 cell body site (VTA) may precede that
      of the terminal field (MPFC). Moreover, diazepam was found to possess an
      inhibitory effect on the activation of mesoprefrontal DA neurons induced by
      psychological stress, and this effect may be partly mediated by benzodiazepine
      (BZD) receptors and implicated in the specific anxiolytic action of BZDs.

PMID- 1747751
TI  - Inhibitory effects of phrenic afferent fibers on primate lumbosacral
      spinothalamic tract neurons.
AB  - Studies were conducted to determine if electrical or mechanical stimulation of
      phrenic afferent fibers (PHR) would inhibit the activity of lumbosacral
      spinothalamic tract (STT) neurons. Twelve monkeys were anesthetized, paralyzed,
      and artificially ventilated. Extracellular action potentials were recorded from
      78 STT neurons located in L2-S3 spinal segments. Electrical stimulation of PHR
      reduced the activity of 65%, did not affect 33%, and excited 1% of STT neurons.
      Mechanical stimulation of the diaphragm reduced the activity of 63%, did not
      effect 34%, and excited 1% of lumbosacral STT neurons. Distention of the urinary
      bladder (UBD) inhibited 52%, did not affect 23%, excited 23%, and elicited a
      biphasic response in 1% of STT neurons. However, there was no correlation between
      the effect of PHR and UBD or somatic classification of the neurons. We conclude
      that electrical or mechanical stimulation of PHR can produce a generalized
      inhibition of lumbosacral STT neurons. This inhibitory effect of PHR is similar
      to inhibitory effects reported for a variety of other afferent systems.

PMID- 1747752
TI  - Patterns of cerebellar foliation in recombinant inbred mice.
AB  - Morphometric analysis of cerebellar foliation patterns at the midsagittal plane
      was done in the inbred strains BALB/cByJ, C57BL/6ByJ and their 7 recombinant
      inbred strains in order to assess possible major gene influences. The cerebellum
      was dissected away from the brainstem and weighed prior to histology so that
      measures of the depth of fissures and sulci could be related to overall size of
      the brain and cerebellum. Results for 177 mice revealed that many brains had
      extra sulci present within the central lobe, the culmen, the declive and the
      uvula, and that patterns within a genetically uniform inbred strain were highly
      variable. The measure of sulcus depth was continuous, showing no evidence of a
      normal versus abnormal dichotomy. Furthermore, the frequency and depth of extra
      sulci were greater in mice with larger cerebella. Strain differences in size of
      the whole brain and cerebellum clearly resulted from several genetic loci. This
      was also true of the extra sulci, except for the declival sulcus which revealed a
      single gene influence. The gene symbol 'declival sulcus of cerebellum' (dsc) is
      proposed.

PMID- 1747753
TI  - Distribution and origin of noradrenergic and serotonergic fibers in the cochlear
      nucleus and inferior colliculus of the rat.
AB  - We examined the monoaminergic innervation of the rat cochlear nucleus (CN) and
      the inferior colliculus (IC) by using retrograde transport of the fluorescent dye
      Fluoro-Gold combined with immunohistochemistry. We used antisera against the
      catecholamine synthesizing enzymes tyrosine hydroxylase (TH), dopamine-beta
      hydroxylase (DBH) and phenylethanolamine-N-methyltransferase (PNMT), and one
      against the transmitter serotonin (5-HT). Each substance revealed a distinct
      pattern of immunoreactive staining in the CN and the IC. In the CN, DBH
      immunoreactive (-ir) fibers were present in all subnuclei. The molecular layer of
      the dorsal CN and the granular layer of the ventral CN, however, were largely
      devoid of DBH-ir fibers. In contrast, 5-HT-ir fibers were abundant in the
      molecular layer and the granular cell layer of the CN. In the dorsal CN and the
      postero- and anteroventral CN, however, this innervation was less dense and
      evenly distributed across subnuclei. In the IC, the DBH-ir fibers were slightly
      more numerous in layer 2 of the dorsal cortex than in other subnuclei, while the
      layer 1 of both the dorsal and the external cortex contained only a few fibers.
      In contrast, the 5-HT-ir fibers formed a dense network in both the dorsal and
      external cortices of the IC, while they were less abundant in the remaining
      subnuclei. PNMT-ir fibers were not found in any of the auditory brainstem nuclei.
      Following Fluoro-Gold injections into the CN or IC, retrogradely labeled DBH-ir
      neurons were found in the A6 noradrenergic cell group (locus coeruleus). The CN
      received additional projections from the A5 noradrenergic cell group, as well as
      sparse projections from the A4 and A7 cell groups. The serotonergic innervation
      of the CN and IC originated largely in the B7 serotonergic cell group (dorsal
      raphe nucleus). Serotonergic neurons in other groups of the raphe nuclei were
      only occasionally labeled. Our data indicate that both noradrenaline and
      serotonin may play a role in central auditory processing. Their differential
      distribution in the IC and CN subnuclei suggests that these transmitter systems
      might influence different functional circuits.

PMID- 1747754
TI  - Cerebral oxygen metabolism and cerebral blood flow in man during light sleep
      (stage 2).
AB  - We measured cerebral blood flow (CBF) and cerebral metabolic rate of oxygen
      (CMRO2) during light sleep (stage 2) in 8 young healthy volunteers using the Kety
      Schmidt technique with 133Xe as the inert gas. Measurements were performed during
      wakefulness and light sleep as verified by standard polysomnography. Unlike our
      previous study in man showing a highly significant 25% decrease in CMRO2 during
      deep sleep (stage 3-4) we found a modest but statistically significant decrease
      of 5% in CMRO2 during stage 2 sleep. Deep and light sleep are both characterized
      by an almost complete lack of mental activity. They differ in respect of arousal
      threshold as a stronger stimulus is required to awaken a subject from deep sleep
      as compared to light sleep. Our results suggest that during non-rapid eye
      movement sleep cerebral metabolism and thereby cerebral synaptic activity is
      correlated to cerebral readiness rather than to mental activity.

PMID- 1747755
TI  - Modulation of synaptic plasticity in the dentate gyrus of the rat by electrical
      stimulation of the median raphe nucleus.
AB  - The effects of median raphe nucleus (MRN) stimulation on the induction of long
      term potentiation (LTP) was investigated in the dentate gyrus (DG) of urethane
      anaesthetized rats. LTP of both DG population spike amplitude and population EPSP
      slope was induced when tetanic electrical stimulation (100 Hz, 1 s) of the
      perforant path (PP), at an intensity which did not produce significant LTP alone,
      was presented concurrently with tetanic stimulation of the MRN. Tetanic
      stimulation of either the PP alone or of the PP and MRN together did not affect
      the short-term enhancement of population spike amplitude produced by single
      stimuli to the MRN. These findings suggest that serotonergic afferents from
      brainstem raphe nuclei may modulate the induction of LTP in the dentate gyrus.

PMID- 1747756
TI  - Characterization of 4 light-responsive putative motor neurons in the pedal
      ganglia of Hermissenda crassicornis.
AB  - As part of the analysis of the circuitry underlying phototaxis, 4 light
      responsive pedal neurons were identified and characterized. The 4 newly
      identified neurons have been designated as pedal neurons P7, P8, P9 and P10.
      Pedal cell P7 has an inhibitory response to light, lasting several minutes. Pedal
      cells P8, P9 and P10 exhibit excitatory 'on' responses to light that last for a
      few seconds after light onset. Lucifer yellow fills showed that each identified
      pedal cell has only one process which exits the nervous system through one of the
      pedal nerves. Various procedures were used to investigate the responses to
      illumination expressed by the 4 identified pedal neurons. The results indicate
      that: (1) the light responses are not intrinsic, but are due to synaptic input
      from other light-responsive cell(s), and (2) the sources of the synaptic input to
      the pedal cells are the photoreceptors of the eye, and not extraocular
      photoreceptors or light sensitive neurons within the circumesophageal nervous
      system.

PMID- 1747757
TI  - Intramedullary connections of the rostral nucleus of the solitary tract in the
      hamster.
AB  - The rostral nucleus of the solitary tract (NST) figures prominently in the
      gustatory system, giving rise to ascending taste pathways that are well
      documented. Less is known of the local connections of the rostral NST with sites
      in the medulla. This study defines the intramedullary connections of the rostral
      NST in the hamster. Small iontophoretic injections of horseradish peroxidase
      (HRP), confined to the rostral NST, resulted in Golgi-like filling of axons that
      exited the NST or that interconnected cytoarchitectonic subdivisions within the
      NST complex. The NST efferent axons terminated sparsely in the trigeminal, facial
      and hypoglossal motor nuclei, but axons and endings were heavily distributed in
      the parvicellular reticular formation ventral to the NST. HRP injections centered
      in this part of the reticular formation resulted in heavy projections to the
      orofacial motor nuclei. Intranuclear connections, labelled after NST injections,
      linked NST subdivisions that receive primary afferent taste inputs to
      subdivisions involved in (1) projections to the preoromotor reticular formation,
      (2) projections to swallowing motor neurons, (3) activation of preganglionic
      parasympathetic neurons, and (4) general viscerosensation. In general, the
      connections defined in the present study provide anatomical details about the
      substrate for gustatory-motor and gustatory-visceral interactions.

PMID- 1747758
TI  - Calcium deficiency enhances cadmium accumulation in the central nervous system.
AB  - Weanling male rats were administered 1 of 4 diets for 40 days: control (CONT),
      low Ca (LOCA), control plus Cd (CONT + Cd) or low Ca plus Cd (LOCA + Cd). After
      40 days, Cd was analyzed in 7 brain regions, spinal cord, serum, liver, kidney,
      muscle and femur by atomic absorption spectrophotometry with Zeeman background
      correction. No significant difference in Cd between CONT and LOCA was found
      except in femur, where it was increased. In CONT + Cd rats, peripheral tissues
      showed an increase in Cd of 30-71 fold above CONT rats. Brain regions exhibited a
      more modest 7-10 fold change, and serum Cd was 8.5 times above control. LOCA + Cd
      rats showed a 25-fold increase of Cd above LOCA in serum, 25-100 fold in
      peripheral tissues, and a 14-20 times in brain. These findings show that brain Cd
      is increased during Ca deficiency, but that central nervous system Cd changes
      less than peripheral tissue Cd. This increase in brain Cd could alter brain
      function.

PMID- 1747759
TI  - Melatonin modifies calmodulin cell levels in MDCK and N1E-115 cell lines and
      inhibits phosphodiesterase activity in vitro.
AB  - The interaction between melatonin and calmodulin was explored. Calmodulin cell
      levels in MDCK and N1E-115 cells cultured with 10(-9) M melatonin were increased
      after 3 days but decreased after 6 days. Melatonin inhibited calmodulin-dependent
      phosphodiesterase and when either melatonin or [3H]melatonin was preincubated
      with calmodulin and separated by electrophoresis, comigration of calmodulin with
      the radioactivity as well as modification of the Ca2+ calmodulin shift were
      observed. The results point out that one of the mechanisms of action of melatonin
      is a calmodulin-melatonin interaction.

PMID- 1747760
TI  - Effects of sciatic nerve transplants after fimbria-fornix lesion: examination of
      the role of nerve growth factor.
AB  - At two weeks post-transplantation, sciatic nerves inserted into the lesioned
      septo-hippocampal pathway contain NGF levels more than twice that of normal
      nerves. These transplanted nerves also contain regenerating cholinergic axons.
      Moreover, transplanted animals exhibit septal NGF levels that are significantly
      greater than in animals with lesions only. These results suggest a role for NGF
      in the ingrowth of axons into the transplants and in the increase in ChAT(+)
      septal neurons previously observed at this post-transplant time.

PMID- 1747761
TI  - Evidence that sensitivity to steroid anesthetics appears late in evolution.
AB  - The effects of pregnanolone, a steroid anesthetic, were compared with diethyl
      ether and short chain alkanols in 21 aquatic species from 7 phyla. Loss of
      righting reflex and escape response were used as indicators of anesthesia. All
      organisms were anesthetized by diethyl ether and short chain alkanols, but
      pregnanolone affected only organisms belonging to the phylum Chordata. It is
      probable that pregnanolone exerts its effect on the gamma-aminobutyric acid
      (GABA) receptor. Because many invertebrates do possess GABA receptors, our
      results suggest that a binding site at which steroid binding causes organismal
      anesthesia appeared early in chordate evolution on a previously existing GABA
      receptor. The results also appear to exclude a primary lipid bilayer site for
      steroid anesthetic action.

PMID- 1747762
TI  - Behavioral and anatomical consequences of unilateral fornix lesions and the
      administration of nimodipine.
AB  - Male Wistar rats subjected to unilateral fimbria-fornix transection by mechanical
      knife cut or to sham operations were tested in a water maze and in an open field.
      Half the animals in each group were treated with either 0.06 mg/kg nimodipine or
      vehicle, administered i.p. for 7 days, beginning the day of surgery. Animals were
      sacrificed and brains were processed for acetylcholine esterase (AChE)
      histochemistry. In the water maze, lesioned rats showed a significant impairment
      relative to the sham-operated animals. Nimodipine treatment did not improve
      performance. There were no differences among the groups in the observed
      frequencies of the open field behaviors of locomotion, hole-poke, rearing and
      grooming. A significant reduction of AChE-positive cell bodies was found in the
      medial septal region on the side of the lesion. There were no differences in
      water maze performance among groups of rats treated with 0.0, 0.5, 1.0, or 5.0
      mg/kg nimodipine for 7 days, beginning the day of fimbria-fornix transection, in
      an attempt to determine any dose-dependent effect of the drug.

PMID- 1747763
TI  - Increased activity of superoxide dismutase in kindled brain and suppression of
      kindled seizure following intra-amygdaloid injection of superoxide dismutase in
      rats.
AB  - The possible role played by superoxide dismutase (SOD), a major defense system
      for counteracting the toxic effects of oxygen free radicals, in amygdaloid (AM)
      kindling was examined in rats. A significant increase of total SOD activity in
      the whole brain was observed 30 days after completion of AM kindling. Intra-AM
      injection of 3 ng of one of the 2 SOD enzymes present in mammalian brain, i.e.
      cytosolic SOD containing copper and zinc (CuZn-SOD) caused suppression of kindled
      seizure. These results suggest that SOD participates in the persistence of AM
      kindled seizure susceptibility and the initiation of kindled AM seizure.

PMID- 1747764
TI  - Cytokine-induced activation of the neuroendocrine stress axis persists in
      endotoxin-tolerant mice.
AB  - Chronic administration of lipopolysaccharide (LPS) to mice markedly reduced
      activation of the neuroendocrine stress axis elicited by an acute challenge dose
      of LPS. LPS-induced elevation in norepinephrine turnover in the hypothalamus
      showed complete tolerance whereas elevation of plasma corticosterone showed only
      partial tolerance. Challenge-induced increased turnover of dopamine in
      hypothalamus persisted in LPS-tolerant animals. Neuroendocrine activation
      persisted following acute challenge with interleukin-1 and tumor necrosis factor
      following chronic LPS exposure.

PMID- 1747765
TI  - Stimulation-induced setting of postural muscle tone in the decerebrate rat.
AB  - These studies demonstrate the presence of pontomedullary areas in the rat
      brainstem which, when stimulated electrically, serve to set postural muscle tone
      in the hindlimbs. Low amplitude stimulation of the dorsal tegmental field (DTF)
      was found to inhibit postural muscle tone and, in some rats, was found to
      decrease mean arterial pressure. Low amplitude stimulation of the ventral
      tegmental field (VTF) was found to increase postural muscle tone and, in all
      cases tested, was found to increase mean arterial pressure.

PMID- 1747766
TI  - Repeated injection of cocaine potentiates methamphetamine-induced toxicity to
      dopamine-containing neurons in rat striatum.
AB  - Rats were treated with daily injections of saline or cocaine (20 mg/kg i.p. x 15
      days) and, beginning 24 h after the last injection, administered saline or
      methamphetamine (6.25-50 mg/kg s.c., BID x 4 days) and sacrificed two weeks
      later. Repeated daily administration of cocaine potentiated the long-lasting
      striatal dopamine depletions caused by methamphetamine. The results suggest that
      human use of cocaine may increase the likelihood of neurotoxicity resulting from
      ingestion of high doses of methamphetamine.

PMID- 1747767
TI  - Responses of neurons in the rat ventrolateral orbital cortex to phasic and tonic
      nociceptive stimulation.
AB  - Responses of ventrolateral orbital cortex (VLO) neurons to innocuous touch and
      pressure, and noxious pinch and cold were examined by extracellular recordings.
      Eight neurons increased their firing rate in a graded fashion to all stimuli
      applied, 4 units decreased their discharges, and 6 neurons remained unaffected.
      All responsive units displayed the greatest change in firing rate during noxious
      cold, and all exhibited whole-body receptive fields. These data further implicate
      the VLO in nonciception.

PMID- 1747768
TI  - Afferent influences on brainstem auditory nuclei of the chick: nucleus
      magnocellularis neuronal activity following cochlea removal.
AB  - Elimination of presynaptic elements often results in marked changes, such as
      atrophy and death, in postsynaptic neurons in the central nervous system. These
      transneuronal changes are particularly rapid and profound in young animals. In
      order to understand the cellular events underlying transneuronal regulation it is
      necessary to explore changes in the local environment of neurons following
      manipulations of their afferents. In previous investigations we have documented a
      variety of rapid and marked cellular changes in neurons of the cochlear nucleus
      of neonatal chicks (n. magnocellularis) following cochlea removal. In adult
      chickens, however, these transneuronal changes are either absent or minor. The
      goals of the studies presented here were to examine changes in the electrical
      activity of nucleus magnocellularis cells and their afferents following removal
      of the cochlea and to determine if these changes were similar in adult and
      neonatal animals. Two measures of electrical activity were used; multiunit
      recording with microelectrodes and incorporation of radiolabeled 2-deoxyglucose
      (2-DG). Microelectrode recordings revealed high levels of spontaneous activity in
      n. magnocellularis and n. laminaris, the binaural target of n. magnocellularis
      neurons. Neither puncturing of the tympanic membrane nor removal of the columella
      causes significant changes in spontaneous activity, although the latter results
      in a profound hearing loss (40-50 dB). Removal of the cochlea, on the other hand,
      results in immediate cessation of all extracellular electrical activity in the
      ipsilateral n. magnocellularis. Recordings from the same location for up to 6 h
      failed to reveal any return of spontaneous activity. When the electrode tip was
      placed in n. laminaris, unilateral cochlea removal had no discernible effect on
      extracellularly recorded spontaneous activity, probably due to the high levels of
      excitatory input from the intact ear. Bilateral cochlea removal, however,
      completely eliminated activity in n. laminaris. 2-DG studies conducted 1 h to 8
      days following unilateral cochlea removal revealed marked decreases in 2-DG
      incorporation in the ipsilateral n. magnocellularis and bilaterally in the n.
      laminaris target of the ablated cochlea. No compensatory return of 2-DG
      incorporation was observed for up to 8 days. Comparisons of adult and neonatal
      chicks failed to reveal significant differences in the effects of cochlea removal
      on multiunit activity or 2-DG incorporation, suggesting that age differences in
      transneuronal regulation are due to intrinsic biochemical differences in young
      and adult neurons rather than differences in the proportion of synaptic input
      that has been abolished.

PMID- 1747769
TI  - Effects of tetrahydroaminoacridine (THA) on functional recovery after sequential
      lesion of the entorhinal cortex.
AB  - Unilateral lesions of rat entorhinal cortex produce a transitory performance
      deficit on spatial learning tasks, such as reinforced alternation in a T-maze.
      Tetrahydroaminoacridine (THA), a cholinesterase inhibitor, was administered to
      determine its effects on behavioral recovery using a reinforced alternation task
      in a T-maze. Rate of recovery after unilateral entorhinal lesion was not affected
      by a low dose of THA (0.05 mg/kg), while a higher dose (5.0 mg/kg) impaired
      recovery. Behavioral recovery was subsequently evaluated in the same rats
      following lesions to the contralateral entorhinal cortex. Serial bilateral
      lesions of the entorhinal cortex are known to produce a prolonged performance
      deficit on the alternation task. The 0.05 mg/kg THA group exhibited an
      intermediate rate of recovery, between the undamaged control group and bilateral
      lesion-saline injected groups. The group receiving 5.0 mg/kg of THA after
      bilateral lesion did not differ from the bilateral lesion-saline group. The
      failure of THA to significantly improve functional recovery in rats with lesions
      of the entorhinal cortex indicates that the compound may have limited
      applicability in treating human neurodegenerative disorders such as Alzheimer's
      disease.

PMID- 1747770
TI  - Time-dependent variations of central norepinephrine and dopamine following
      antigen administration.
AB  - Administration of sheep red blood cells (10(6) cells, i.p.) resulted in central
      norepinephrine (NE) and dopamine (DA) changes which corresponded with the time of
      the peak immune response. These amine variations, however, appeared to be
      specific to certain brain regions. The increased accumulation of the NE
      metabolite, 3-methoxy-4-hydroxyphenylethylene glycol, was evident in
      hypothalamus, locus coeruleus and hippocampus and a moderate reduction of NE was
      evident in the hypothalamus. Alterations of DA levels or utilization appeared in
      mesocorticolimbic structures (i.e. nucleus accumbens and prefrontal cortex) but
      not in striatum. This profile of transmitter changes was reminiscent of that
      previously shown to be induced by uncontrollable stressors and the possibility
      was offered that antigenic challenge is interpreted as a stressor by the central
      nervous system.

PMID- 1747771
TI  - Identification of the midbrain locomotor region and its relation to descending
      locomotor pathways in the Atlantic stingray, Dasyatis sabina.
AB  - The midbrain locomotor region (MLR) in the Atlantic stingray, Dasyatis sabina,
      was identified and characterized. Stimulation (50-100 microA, 60 Hz) of the
      midbrain in decerebrated, paralyzed animals was used to elicit locomotion
      monitored as alternating activity in nerves innervating an antagonist pair of
      elevator and depressor muscles. Effective sites for evoking locomotion in the
      midbrain included parts of several nuclei: the caudal portion of the interstitial
      nucleus of the medial longitudinal fasciculus and the caudomedial parts of the
      cuneiform and subcuneiform nuclei. This region did not include the red nucleus,
      any parts of the optic tectum or the medial or lateral mesencephalic nuclei.
      Electrical stimulation in the MLR evokes locomotion in either the ipsi- or
      contralateral pectoral fin, whereas stimulation in the medullary reticular
      formation evokes locomotion only in the contralateral fin. Lesion experiments
      were performed to identify the location of descending pathways from the midbrain
      to the medullary reticular formation. To abolish locomotion evoked by electrical
      stimulation in the MLR, the medial reticular formation in the rostral medulla had
      to be lesioned bilaterally, or the ipsilateral medial medullary reticular
      formation and fibers projecting from the MLR to the contralateral midbrain had to
      be disrupted. Injections of HRP into the magnocellular/gigantocellular reticular
      formation confirmed that this area received bilateral projections from the MLR.
      The MLR of the Atlantic stingray appears to be similar to the lateral component
      of the mammalian MLR and to the MLR in other non-mammalian vertebrates.

PMID- 1747772
TI  - The electrophysiological basis of epileptiform magnetic fields in neocortex:
      spontaneous ictal phenomena.
AB  - In a previous report (Barth, D.S. and Di, S., Brain Research, 530 (1990) 35-39),
      electrical measurements of epileptiform cellular currents produced by
      physiologically evoked interictal penicillin spikes in rat somatosensory cortex
      were directly compared to the extracranial magnetic fields these currents
      generate. The present study uses the same methodology to extend these
      observations to spontaneous interictal and ictal phenomena in rat auditory
      cortex, and provides a more realistic empirical foundation for physical models
      with which to interpret non-invasive neuromagnetic recordings of human focal
      seizures. These data indicate that seizure foci under 1 x 1 cm2 in cortical
      surface area are capable of producing magnetic fields that may be recorded at
      extracranial distances similar to those used in humans. Furthermore, physical
      models based on the dipole approximation appear to be appropriate for the
      interpretation of ictal magnetic field phenomena in neocortex.

PMID- 1747773
TI  - Designing a neural network simulator--the MENS modelling environment for network
      systems: I.
AB  - During recent years, the field of neural network research has increasingly
      attracted the interest of workers from a large number of different disciplines.
      Current research topics include aspects as different as detailed simulations in
      brain physiology, predictions of protein structure in biochemistry, database
      organization in computer science, or various technical applications. The common
      scheme behind these different approaches is the use of distributed networks of
      simple computational elements that communicate with each other by means of
      weighted links. Computer simulations of neural networks require an appropriate
      software environment. Due to the computational similarities of many classes of
      such networks, simulation software can be structured into modular components
      that, to a large degree, are independent of specific applications. The aim of
      this and the following paper is to discuss some of the design considerations
      concerning software for neural network simulations. The aspects presented are
      interesting for both the development of new simulation software and the efficient
      use and modification of existing programs. Therefore, the general user as well as
      the software designer may hopefully benefit from this material. This paper
      briefly introduces some of the basic principles of neural networks. After a short
      discussion of different approaches to software design, two simple example
      applications are presented in order to demonstrate a conceptual framework common
      to many network simulations. The transfer of these considerations to the design
      of simulation software is then shown by example of the MENS network simulator
      developed in the Max-Planck-Institute for Brain Research. The paper gives a
      general introduction to the layout of data structures and different software
      components. Using the two introductory examples some aspects of network analysis
      are demonstrated. The following paper then considers further details of the
      design of a neural network simulator with respect to performance, implementation,
      and testing.

PMID- 1747774
TI  - Designing a neural network simulator--the MENS modelling environment for network
      systems: II.
AB  - During recent years, neural network research has been extended to a large number
      of different fields, increasingly attracting the interest of workers from various
      disciplines. The computer simulations carried out with this research require an
      appropriate software environment. The computational similarities of many kinds of
      simulations allow the design of software components that are largely independent
      of the specific application. These considerations are reflected, for example, by
      the general layout of the MENS network simulator, as described in the
      accompanying first paper. This paper presents the design considerations for the
      simulator's different software components in more detail. In particular, design
      and implementation are discussed with respect to computational and memory
      efficiency. The discussion includes, for example, the representation of a network
      by the simulator's data structure, the file-driven configuration and
      initialization of a network, the simulator's stimulus and monitor system, and the
      simulator's control structures. In addition, the separation and interaction of
      application-specific and application-independent software components are
      addressed. Particular performance aspects comprise the implementation of synaptic
      delays, the dynamic deletion of synaptic links in network learning, and the
      preprocessing of stimulus films. In addition, some general aspects of simulator
      performance and testing are considered. The material presented in this paper
      concerns both the development of new simulation software and the efficient use of
      existing programs. Therefore, both the general user as well as the software
      designer may hopefully benefit from this presentation.

PMID- 1747775
TI  - Improved algorithms for searching restriction maps.
AB  - We present algorithms for searching a DNA restriction enzyme map for a region
      that best matches a shorter 'probe' map. Our algorithms utilize a new model of
      map alignments, and extensive experiments prove our model superior to earlier
      approaches for certain applications. Let M be the number of map sites and P be
      the number of probe sites. Our first algorithm, which optimizes only over a
      restricted class of alignments, requires O(MP log P) worst-case time and O(M + P)
      space. Our second algorithm, which optimizes over all alignments, runs in O(MP3)
      time and O(M + P2) space, under reasonable assumptions about the distribution of
      restriction enzyme cleavage sites. Combining the algorithms gives a map-searching
      method that optimizes over all alignments in O(MP log P) time in practice. The
      algorithms' effectiveness is illustrated by searches involving a genomic
      restriction map of Escherichia coli.

PMID- 1747776
TI  - A menu-shell for the GCG programs.
AB  - We provide a menu-driven integration of the genetic programs of the Genetics
      Computer Group (GCG). This allows in-experienced users a very simple access to
      all GCG programs regardless of the system environment. No modifications to the
      GCG package are necessary.

PMID- 1747777
TI  - Investigation of an expert systems approach to bacterial identification.
AB  - An investigation was carried out to assess the feasibility of using an expert
      systems approach to assist in the identification of unknown isolates of bacteria.
      A system was developed using Lisp which utilized the knowledge stored in standard
      bacteriological texts. A comparison of the expert systems approach and the
      probabilistic approach based on Bayes Theorem was made together with the
      advantages and disadvantages of each approach.

PMID- 1747778
TI  - Structural interpretation of fluorescence resonance-energy transfer measurements.
AB  - Fluorescence resonance-energy transfer (FRET) has been widely used to determine
      distance information in macromolecular systems. However, little has been written
      about methods for combining FRET distances into coherent structural models. I
      argue that the methods used so far are inappropriate. This paper describes an
      algorithm specifically tailored for finding structures from FRET measurements.
      This algorithm finds structures which fit the experimentally measured parameter,
      the efficiency of energy transfer, rather than derived distances. The algorithm
      was implemented in Mathematica and applied to FRET distances obtained for the
      contractile protein actin. The approach used is applicable to other experimental
      techniques which measure distances between a relatively small number of loci.

PMID- 1747779
TI  - A novel randomized iterative strategy for aligning multiple protein sequences.
AB  - The rigorous alignment of multiple protein sequences becomes impractical even
      with a modest number of sequences, since computer memory and time requirements
      increase as the product of the lengths of the sequences. We have devised a
      strategy to approach such an optimal alignment, which modifies the intensive
      computer storage and time requirements of dynamic programming. Our algorithm
      randomly divides a group of unaligned sequences into two subgroups, between which
      an optimal alignment is then obtained by a Needleman-Wunsch style of algorithm.
      Our algorithm uses a matrix with dimensions corresponding to the lengths of the
      two aligned sequence subgroups. The pairwise alignment process is repeated using
      different random divisions of the whole group into two subgroups. Compared with
      the rigorous approach of solving the n-dimensional lattice by dynamic
      programming, our iterative algorithm results in alignments that match or are
      close to the optimal solution, on a limited set of test problems. We have
      implemented this algorithm in a computer program that runs on the IBM PC class of
      machines, together with a user-friendly environment for interactively selecting
      sequences or groups of sequences to be aligned either simultaneously or
      progressively.

PMID- 1747780
TI  - Improving signal peptide prediction accuracy by simulated neural network.
AB  - The accuracy of distinguishing amino-terminal signal peptides from cytosolic
      proteins has been improved to 95% by combining a neural network classifier with
      von Heijne's statistical prediction, the latter is itself 85-90% reliable. The
      network processed not the cleavage site, but amino-terminal 20-residue segments
      by the 'tiling' algorithm. Concordant positive predictions of both methods led to
      the safe identification of 496 novel signal peptides from the Protein
      Identification Resources.

PMID- 1747781
TI  - A simple algorithm for averaging multiple cycles of waveforms having varying
      cycle periods.
AB  - We present a simple method for averaging multiple cycles of a waveform having
      cycles with varying periods. This averaging process preserves the morphology of
      the waveform by converting fixed time per point data into fixed fraction of cycle
      data. The algorithms are implemented using the ASYST system, which provides
      efficient code for performing the computations and permits straightforward
      integration of the data acquisition and analysis tasks. An example is given of
      the results of the program in processing cyclical waveforms obtained in
      respiratory research.

PMID- 1747782
TI  - A new method for finding long consensus patterns in nucleic acid sequences.
AB  - We describe a fast computer algorithm for identifying consensus patterns in DNA
      sequences. The method requires no prior assumptions about the consensus pattern
      other than its length. In particular no previous knowledge of the frequency or
      spacing of consensus patterns is required. However, a priori information about
      the shape of the consensus pattern, or invariability of individual positions, or
      the overall conservation level, can be utilized to enhance the selectivity and
      sensitivity of search. As the number of all possible consensus words increases
      very rapidly with length, comprehensive searches have usually been restricted to
      a maximum of 10-12 nucleotides, even when large mainframes are used. Our
      algorithm enables searching for consensus patterns of this order on current mid
      range and powerful microcomputers. Searches may be conducted on single, long
      sequences or a set of possibly aligned shorter sequences. We give examples of
      identified consensus patterns in both prokaryotic and eukaryotic DNA sequences,
      along with some typical program timings.

PMID- 1747783
TI  - A simple approach for the distribution of computationally intense tasks in an
      heterogeneous environment: distribution of the MDPP image-processing package.
AB  - A method has been developed to link the display ability of a high-resolution
      graphics workstation with the computational power of a local mainframe or a
      remote supercomputer via an electronic data network. The method allows this link
      to be established in a manner largely transparent to the user. The application of
      the method is illustrated by our successful distribution of the computationally
      intensive portions of an imaging program (MDPP) from a small VAX workstation to a
      VAX mainframe and Cray Y-MP8/832 using a simple message-passing technique. This
      technique can be applied to almost any configuration of networked machines.

PMID- 1747784
TI  - 'Size leap' algorithm: an efficient extraction of the longest common motifs from
      a molecular sequence set. Application to the DNA sequence reconstruction.
AB  - We propose a new method, called 'size leap' algorithm, of search for motifs of
      maximum size and common to two fragments at least. It allows the creation of a
      reduced database of motifs from a set of sequences whose size obeys the series of
      Fibonacci numbers. The convenience lies in the efficiency of the motif
      extraction. It can be applied in the establishment of overlap regions for DNA
      sequence reconstruction and multiple alignment of biological sequences. The
      method of complete DNA sequence reconstruction by extraction of the longest
      motifs ('anchor motifs') is presented as an application of the size leap
      algorithm. The details of a reconstruction from three sequenced fragments are
      given as an example.

PMID- 1747785
TI  - The application of SSADM to modelling the logical structure of proteins.
AB  - A logical design that describes the overall structure of proteins, together with
      a more detailed design describing secondary and some supersecondary structures,
      has been constructed using the computer-aided software engineering (CASE) tool,
      Auto-mate. Auto-mate embodies the philosophy of the Structured Systems Analysis
      and Design Method (SSADM) which enables the logical design of computer systems.
      Our design will facilitate the building of large information systems, such as
      databases and knowledgebases in the field of protein structure, by the derivation
      of system requirements from our logical model prior to producing the final
      physical system. In addition, the study has highlighted the ease of employing
      SSADM as a formalism in which to conduct the transferral of concepts from an
      expert into a design for a knowledge-based system that can be implemented on a
      computer (the knowledge-engineering exercise). It has been demonstrated how SSADM
      techniques may be extended for the purpose of modelling the constituent Prolog
      rules. This facilitates the integration of the logical system design model with
      the derived knowledge-based system.

PMID- 1747786
TI  - A Macintosh Hypercard stack to simulate the pharmacokinetics of infusion of
      intravenous anesthetic drugs (NarSim).

PMID- 1747787
TI  - PRIMEGEN, a tool for designing primers from multiple alignments.

PMID- 1747788
TI  - Automated protein sequence pattern handling and PROSITE searching.
AB  - The protein sequence searching program Scrutineer has been modified to search for
      targets from a file. We are distributing a reformatted file of PROSITES which can
      be read by Scrutineer. In addition, Scrutineer still accepts targets typed in
      interactively but can now write them out in the format required as input. Since
      the input format is the same as the output format, target management and re-use
      is simple.

PMID- 1747789
TI  - Psychosocial correlates of physician-patient communication at time of informed
      consent for bone marrow transplantation.
AB  - In obtaining informed consent for bone marrow transplantation (BMT) oncologist
      investigators may feel that they engender emotional distress in patients due to
      the disclosure of potentially lethal complications associated with BMT. However,
      little is known regarding the psychological profile of BMT patients at the time
      of informed consent or what impact the consent process has upon the physician
      patient relationship. The purpose of this study was to assess (1) the
      psychological symptom profile of patients consenting to BMT and (2) the
      relationship of behavioral and psychological factors to patients' perceptions of
      the quality of communication between physician and patient. The results indicated
      that adult BMT patients experienced significant psychological distress at the
      time at which they provided written consent for BMT. Two factors were positively
      related to perceived quality of communication between physician and patient:
      problem-focused coping style and perceived autonomy in decision making. These
      findings are interpreted in relation to the goals of informed consent and its
      implications for the physician-patient relationship.

PMID- 1747790
TI  - Pharmacokinetics of cis-diammine-dichlor-platin in a hemodialysis patient.
AB  - Cisplatin (CDDP) was administered to a 49-year-old dialysis female patient with
      advanced uterine cervical cancer. Analysis of the pharmacokinetics of CDDP in the
      patient with renal failure and at hemodialysis were compared with that of
      patients without renal impairment. CDDP at 30 mg was administered by drip
      infusion. The samples were ultrafiltrated and measured its concentration of both
      free (F-P) and total CDDP (T-P) by atomic absorption method. The effect of
      hemodialysis on the concentration of CDDP was analyzed. For the control, three
      patients without renal impairment were administered CDDP using the same method
      and its concentration was measured. The T-P clearance registered no difference
      between dialysis patients and controls, but F-P clearance in the HD patient was
      almost 5-fold lower than those in control patients, showing that F-P exposure to
      HD patients was 5-fold greater as a consequence of delayed disposition. The
      protein binding rate of CDDP was more gradual than that of the controls. The T-P
      and F-P removal rates positively correlated to the shunt side blood F-P.

PMID- 1747791
TI  - 5-Fluorouracil by protracted venous infusion: a review of recent clinical
      studies.
AB  - The pharmacokinetics of continuous infusion 5-fluorouracil make it an ideal drug
      to administer as a protracted infusion (continuous infusion more than 30 days).
      During the last decade numerous clinical studies have been conducted to evaluate
      the efficacy of 5-fluorouracil (5FU) administered as a protracted venous
      infusion. Phase II studies in metastatic colorectal cancer in 345 patients have
      demonstrated an average response rate of 36% (range 15-59%) and a prospective
      randomized study performed by the Mid-Atlantic Oncology Program (MAOP) has
      confirmed a higher response rate with 5FU infusion compared with a bolus
      schedule. Phase II studies in refractory carcinoma of the breast in 177 patients
      have demonstrated a 30% response rate (range 17-50%); studies in pancreatic,
      gastric, and refractory prostate cancer have also demonstrated clinical utility.
      The major toxicities of 5FU infusion are mucositis and hand-foot syndrome; life
      threatening myelosuppression is rare and treatment-related deaths have not been
      reported. 5FU infusion is a useful palliative treatment for many adult patients
      with advanced malignancies.

PMID- 1747792
TI  - Age, phenotype, and curability in acute myelogenous leukemia.

PMID- 1747793
TI  - Paying for expensive new technologies: Medicare's experiences with recombinant
      erythropoietin.

PMID- 1747794
TI  - In vitro evaluation of chemotherapeutic agents.

PMID- 1747795
TI  - Radionuclide detection of occult infection: current strategies.
AB  - A number of new radionuclide techniques are available for diagnosing infection.
      These include the radiolabeling of neutrophils and lymphocytes with a variety of
      chelating agents and isotopes, and the use of antibodies directed against
      bacteria in the inflammatory exudate. Other new techniques include radiolabeled
      nanocolloids, chemotactic peptides, and liposomes. This article reviews the
      evolving role of these techniques in the detection of sites of occult infection.

PMID- 1747796
TI  - Fraudulent research in science: the responsibility of the peer reviewer.

PMID- 1747797
TI  - Funding for cancer research.

PMID- 1747798
TI  - Cardiorespiratory alterations during normal pregnancy.
AB  - Maternal cardiorespiratory changes can hinder satisfactory evaluation of gravid
      women. Alterations in the maternal cardiorespiratory system may be further
      modified by pain, labor, surgery, maternal posture, and gestational age. Critical
      illness during pregnancy demands an aggressive multidisciplinary approach by
      health care professionals who are familiar with these changes. This article
      reviews pertinent issues that should assist physicians treating complex medical
      complications during pregnancy.

PMID- 1747799
TI  - Obstetric emergencies.

PMID- 1747800
TI  - Cardiac disease in pregnancy.
AB  - The pregnant patient with normal cardiac function can accommodate many
      significant alterations in the cardiovascular system without difficulty.
      Pregnancy in a patient with significant cardiac disease, however, can be
      extremely hazardous, resulting in decompensation and even death. these conditions
      account for up to 30% of maternal mortality. This article reviews the interaction
      between cardiac disease and pregnancy.

PMID- 1747801
TI  - Acute fatty liver of pregnancy.
AB  - AFLP is a syndrome that occurs in the last trimester or postpartum, characterized
      by jaundice, coagulopathy, and central nervous system disturbances. Renal
      insufficiency is common. Clinical and laboratory findings are nonspecific.
      Diagnosis is based primarily on histologic examination of the liver. The cause of
      AFLP is unknown. The illness has been associated with a high maternal and fetal
      mortality; with increased awareness and more liberal use of liver biopsy,
      however, milder forms of the disease are now recognized. Some speculate that AFLP
      is part of the spectrum of preeclampsia. Liver histology shows microvesicular fat
      and little or no inflammation or hepatocellular necrosis. Treatment consists of
      expeditious delivery and maximal supportive care, which may include intensive
      care unit monitoring, blood component therapy, glucose infusion, sodium
      restriction, diuretic agents, mechanical ventilation, and dialysis. The role of
      hepatic transplantation in AFLP appears limited. The risk of mortality during
      AFLP must be compared with the short- and long-term morbidity and mortality
      associated with liver transplantation.

PMID- 1747802
TI  - Clinical management of thromboembolic disorders in pregnancy.
AB  - Early diagnosis, treatment, and appropriate prophylaxis may prevent serious
      maternal sequelae of thromboembolism. Objective techniques for diagnosis should
      be used aggressively. Heparin is the preferred anticoagulant. Although the risks
      and benefits of prophylaxis are currently debated, it appears most prudent to
      consider subcutaneous heparin prophylaxis beginning in the first trimester.

PMID- 1747803
TI  - Management of severe preeclampsia and eclampsia.
AB  - Pregnancy-induced hypertension is a disorder of unknown etiology unique to
      pregnant women. Classic clinical manifestations include hypertension,
      proteinuria, and edema. Early recognition and proper management of this disease
      may serve to avoid serious maternal complications. Ultimate maternal treatment
      depends on delivery of the fetus and placenta. Advanced stages of this disease
      result in multi-organ system dysfunction that may be life-threatening to the
      mother and her fetus. Such maternal complications of PIH include severe
      hypertension, oliguria or anuria, HELLP syndrome, eclamptic seizures, liver
      rupture, pulmonary edema, cerebral edema, and abruptio placentae. A
      multidisciplinary approach of the critical care team often will effect a
      reduction in maternal morbidity and mortality.

PMID- 1747804
TI  - Intrapartum obstetric emergencies.
AB  - Shoulder dystocia, uterine inversion, and prolapse of the umbilical cord are
      three uncommon complications of the intrapartum period. These complications share
      several common characteristics in that they are rare, difficult to predict, and
      can result in significant morbidity and mortality. This article describes the
      etiology, predisposing factors, and methods of management of these complications.

PMID- 1747805
TI  - Abruptio placentae.
AB  - Despite our heightened awareness of placental abruption, this condition remains
      largely unpreventable. The incidence of placental abruption may actually be on
      the rise due to increasing use of cocaine and "crack" and a greater contribution
      from abdominal trauma. Whether recurrence of abruption associated with
      hypertension can be prevented with low-dose aspirin is yet to be determined.
      Unfortunately, although our recognition of this condition may have improved,
      placental abruption remains a high cause of perinatal morbidity and mortality.

PMID- 1747806
TI  - Amniotic fluid embolism.
AB  - Amniotic fluid embolism remains an enigmatic and often lethal condition. The
      pathophysiology is complex, however, from a clinical standpoint. Right or, more
      commonly, left heart failure is the dominant physiologic aberration. Disseminated
      intravascular coagulation is often present. The detection of squamous cells in
      the central circulation of living patients can no longer be considered
      pathognomonic for this condition.

PMID- 1747807
TI  - Postpartum hemorrhage.
AB  - Early PPH remains a significant cause of maternal morbidity and mortality. Many
      cases occur in women with antecedent risk factors and can thus be anticipated,
      promptly diagnosed, and promptly treated. Postpartum hemorrhage is most commonly
      due to uterine atony and often responds to medical treatments such as ecbolic
      medications, uterine massage or bimanual compression, and blood and fluid
      replacement. Appropriate laboratory studies should be obtained promptly. Women
      with significant bleeding should receive blood product transfusions. Patients who
      do not promptly respond to these conservative measures should be considered and
      counseled for operative procedures. Surgical intervention, either to repair
      lacerations, transiently reduce pelvic pulse pressure, or remove the uterus, can
      be life-saving.

PMID- 1747808
TI  - Critical care obstetrics: management of the fetus.
AB  - Whenever a critically ill gravida presents for care, consideration should be
      given to consulting an obstetrician or a maternal-fetal medicine specialist. The
      technological advances of the past two decades permit these critical care
      obstetrical specialists to immediately assess fetal health with ultrasonography
      or a fetal monitor. By so doing, maternal and fetal care can be optimized through
      a team approach.

PMID- 1747809
TI  - Incentives and profit-sharing revisited.

PMID- 1747810
TI  - Cosmetic imaging: the new wave of co-diagnosis.

PMID- 1747811
TI  - Negotiating the road to financial success.

PMID- 1747812
TI  - Dr. Gordon Christensen at the CDA Convention.

PMID- 1747813
TI  - The future is now, seven steps for making it happen.
AB  - These seven key areas form a foundation on which a practice can build a solid
      structure to prepare for the future. In today's world, it is necessary for a
      dentist, as an employer, to become a risk taker. As the old saying goes "nothing
      ventured, nothing gained." Sometimes even the wrong move or action can be more
      positive than no action at all. Because of training and natural inclination, a
      majority of dentists are perfectionists, which can result in risk taking being a
      stressful aspect of management, growth and change.

PMID- 1747814
TI  - Dentistry for the future.

PMID- 1747815
TI  - Hepatitis & HIV: prevalence of infection and changing attitudes toward infection
      control procedures in British Columbia.
AB  - Dental professionals attending the annual meeting of the College of Dental
      Surgeons of British Columbia in June 1990 were involved in a survey to assess the
      prevalence of infection with Hepatitis B, Hepatitis C and Human Immunodeficiency
      viruses, the acceptance of vaccination for protection against Hepatitis B virus,
      and the compliance with infection control guidelines. Participation was voluntary
      and anonymous and required completion of a questionnaire and donation of a blood
      sample. Four hundred one of 1,995 convention attendees participated. Fourteen
      were found to have markers of Hepatitis B infection; 13 had antibodies to both
      Hepatitis B surface antigen and Hepatitis B core antigen, and one was positive
      for Hepatitis B surface antigen. One individual had markers for both Hepatitis C
      and Hepatitis B viruses. None tested positive for antibody to Human
      Immunodeficiency virus. Vaccination against Hepatitis B virus was reported
      overall by 67 percent of the participants, but dentists and hygienists had a
      higher rate of vaccination (82 percent and 81 percent, respectively) when
      compared to dental assistants (41 percent; P less than .001). Acceptance of
      infection control procedures was high, with 92 percent of participants reporting
      use of gloves for all patients and 82 percent reporting use of masks and eye
      protection.

PMID- 1747816
TI  - The issues of chemical dependency in dentistry.
AB  - The problem of chemical dependency is a topical issue in society today. With the
      increase in the number and types of prescription drugs, the proliferation of
      illegal drugs, and easy access to alcohol, chemical dependency has no
      socioeconomic boundaries. Professionals, blue collar workers and students, both
      male and female, are susceptible to the problem. The purpose of this paper is to
      review the literature on chemical dependency as it relates to the profession of
      dentistry. It will also look at the definition, prevalence, etiology,
      recognition, treatment and prevention of chemical dependency. Most of the
      evidence from the literature indicates that chemical dependency is a disease; it
      is treatable and can be prevented. The treatment of the disease requires the
      input of support groups at the professional level as well as at student level.
      The prevention of chemical dependency must begin in the curricula of dental
      schools with emphasis on the pharmacology and interaction of drugs.

PMID- 1747817
TI  - Utilization of dental services by older adults in four Ontario communities.
AB  - The elderly tend to use dental services less than most younger age groups. While
      the elderly's utilization rates may be rising, very low utilization by edentulous
      people depresses the overall rate for the group. We use data from the Ontario
      Study of the Oral Health of Older Adults to identify the variations in the use of
      dental services in the four study sites of Toronto, North York, Simcoe County and
      Sudbury and District. We reached 3,033 subjects by telephone and conducted dental
      examinations and a multi-item personal interview with 907 of them. The 907
      subjects ranged in age from 50 to 87 years, 57 percent were female and two-thirds
      were born in Canada. Overall, 60.5 percent had seen a dentist or denturist in the
      previous year, but this was much lower among the edentulous (17 percent) when
      compared to the dentate (72 percent) (Chi-square test; p less than .0001). Of the
      357 who did not visit a dentist or denturist in the previous year, nearly half
      (48 percent) felt they had nothing wrong and 20 percent reported they could not
      afford care. A high proportion (94 percent) of the edentulous reported visiting
      only for pain or trouble compared to 26 percent of the dentate (Chi-square test;
      p less than .0001). Using logistic regression, we found dental status
      (edentulous), community of residence (Sudbury), income (up to $20,000) and dental
      insurance coverage (none) were important factors in not making a dental visit in
      the last year. These same factors, plus education (elementary) were important
      where subjects reported visiting a dentist or denturist only when there was pain
      or trouble.

PMID- 1747818
TI  - Interactive videodisc: its place in today's nursing curricula.
AB  - The need for nurse educators to realistically assess interactive videodisc
      technology is readily apparent when one considers the analyzed educational
      benefits of that medium. Skills of discrimination, generalization, and sequencing
      are particularly targeted for the population of nursing students because these
      abilities are necessary for problem solving, analysis, nursing diagnosis, and
      conceptual learning. However, in these times of limited resources one must
      carefully evaluate the necessary expenditures versus the perceived advantages of
      the technology. This article reviews the literature on educational applications
      of videodisc technology and reports on a survey of videodisc use at 504 National
      League of Nursing (NLN) accredited baccalaureate programs. Results of this study
      validate the current cautious approach to implementing interactive videodisc
      technology in nursing programs.

PMID- 1747819
TI  - Computer conferencing: the "nurse" in the "Electronic School District".
AB  - As computer-based instructional technologies become increasingly available, they
      offer new mechanisms for health educators to provide health instruction. This
      article describes a pilot project in which nurses established a computer
      conference to provide health instruction to high school students participating in
      an electronic link of high schools. The article discusses computer conferencing,
      the "Electronic School District," the design of the nursing conference, and the
      role of the nurse in distributed health education.

PMID- 1747820
TI  - Application of a computer-based zero-one methodology to the assignment of nurses
      to a clinical rotation schedule.
AB  - This article discusses the application of a zero-one approach to the development
      of a total program schedule that assigns students to all required clinical
      courses in an academic nursing program. The approach is based on an operations
      research technique, zero-one programming. Unlike zero-one programming, the
      objective function in this formulation is arbitrary; any solution that meets the
      constraints of the system is acceptable. Also described in this article are the
      constraints that limit flexibility of student assignments (i.e., available
      clinical sites and units, instructors, day or evening, maximum class sizes, order
      of courses), a solution to the scheduling problem at Saint Joseph's (which
      involves 1,067 equations), and suggestions for the general utility of a zero-one
      approach for similar administrative problems.

PMID- 1747821
TI  - Computer graphics for slide presentations.
AB  - This applications article describes the use of a computer to generate high
      quality presentation materials. Different programs and methodologies are
      discussed.

PMID- 1747822
TI  - The use of machine learning program LERS-LB 2.5 in knowledge acquisition for
      expert system development in nursing.
AB  - LERS-LB (Learning from Examples using Rough Sets Lower Boundaries) is a computer
      program based on rough set theory for knowledge acquisition, which extracts
      patterns from real-world data in generating production rules for expert system
      development. From LERS-LB evaluation of an SPSS-X data file containing data for
      recovery room patients, it was concluded that both statistical data files and
      existing databases can be converted to decision-table format needed by LERS-LB,
      but it is less desirable to work with statistical files than a well-developed
      database. It was also concluded that choosing a well-developed database and
      checking it thoroughly for accuracy and completeness should be done before
      running LERS-LB, or other learning programs, to avoid problems with data errors.
      Using rough set theory and a technique called 'dropping conditions' LERS-LB
      offers, at least in theory, a possible method for identifying which data items
      are critical to nursing practice. Further research and continued LERS-LB program
      enhancements still may help with identifying critical data items versus redundant
      data for nursing practice. LERS-LB, and other learning programs, offer techniques
      which will help reduce the knowledge acquisition bottleneck in nursing expert
      system development. It is doubtful, however, that learning programs will
      eliminate the need for involving domain experts in evaluating rules and expert
      systems for clinical decision support.

PMID- 1747823
TI  - Polyethylene wear debris.

PMID- 1747824
TI  - Arthroscopic debridement of the knee.

PMID- 1747825
TI  - Cecal ulceration in a neutropenic child.

PMID- 1747826
TI  - Canadian Association of General Surgeons presidential address 1990.

PMID- 1747827
TI  - The future of vascular surgery in Canada.

PMID- 1747828
TI  - Choledochocholecystojejunostomy: a quick, effective method of biliary
      decompression for carcinoma of the pancreas.
AB  - The frequency of pancreatic carcinoma appears to be increasing. Effective
      treatment is essential for most patients whose tumours are unresectable.
      Definitive treatment by stenting techniques are currently limited to those
      patients who are high surgical risks, elderly, present with metastatic disease or
      refuse the surgical option. Surgical bypass offers the best palliation and should
      reliably decompress the biliary obstruction caused by the tumour with the least
      surgical trauma. Roux-en-Y choledochojejunostomy (CDJ), with or without a
      gastroenterostomy, is usually the preferred method of bypass; however, for
      patients with a distended gallbladder this procedure is often made easier by its
      removal. Even then providing a proximal, tension-free anastomosis can be
      challenging. In 13 consecutive patients who still had a gallbladder and required
      a biliary bypass for carcinoma of the pancreas, the authors interposed the
      gallbladder between the proximal bile ducts and a Roux-en-Y loop. This procedure
      could be done more quickly than CDJ and performed well.

PMID- 1747829
TI  - Antimicrobial prophylaxis in general surgery.
AB  - When used appropriately, antimicrobial prophylaxis is highly beneficial and cost
      effective. Antibiotics are not indicated for "clean procedures" such as hernia
      and breast surgery. A single preoperative dose will suffice, followed by an
      intraoperative dose if the operation takes more than 3 hours. For vascular
      (prosthesis or groin wound), head and neck (pharynx entered), thoracic
      (gastrointestinal or respiratory entrance) and high-risk gastroduodenal and
      biliary procedures, cefazolin, 1 g intravenously, is indicated. For procedures
      involving small intestine, appendix or penetrating abdominal trauma, cefoxitin or
      cefotetan, 2 g intravenously, is indicated. For colorectal procedures, either
      oral neomycin plus erythromycin or intravenous aminoglycoside plus clindamycin
      (or metronidazole) are effective. If valvular heart disease is present,
      endocarditis prophylaxis should be administered.

PMID- 1747830
TI  - Prophylaxis of deep venous thrombosis and pulmonary embolism.
AB  - Clinically silent deep venous thrombosis (DVT) develops in up to 25% of patients
      who undergo general surgical procedures. Approximately 10% of these thromboses
      are complicated by potentially fatal pulmonary embolism. Two recent meta-analyses
      of more than 70 published trials of DVT prophylaxis in general surgery have
      demonstrated conclusively that prophylaxis significantly reduces rates of DVT and
      fatal pulmonary embolism and results in improved overall survival. Physical
      methods of prophylaxis, including compression stockings and intermittent
      pneumatic compression, are as effective as pharmacologic prophylaxis (the most
      common regimen being heparin, 5000 units subcutaneously ever 8 to 12 hours).
      Bleeding complications are increased with the use of heparin, although they are
      clinically minor. Deep venous thrombosis prophylaxis should be routinely
      instituted for all general surgical patients who undergo major operative
      procedures.

PMID- 1747831
TI  - Prophylactic nutrition.
AB  - The potential clinical benefits of preoperative and postoperative enteral or
      parenteral nutritional support are reviewed. Special consideration is given to
      the problem of nutritional support for the cancer patient and to immunonutrition,
      a new research avenue in modular nutritional treatment. In the absence of
      uniformly accepted data regarding the use of prophylactic nutritional support,
      sound clinical judgement is still important. The simplest indications for the use
      of perioperative nutritional support are the following: patients without
      nutrition for 7 to 10 days; duration of illness anticipated to be longer than 10
      days; malnutrition--more than 10% acute loss of usual body weight.

PMID- 1747832
TI  - Preventive measures in the elderly surgical patient.
AB  - The death rates associated with all forms of surgical illness increase
      consistently with age but appear more closely related to physiologic and medical
      status than to age per se. Changes in physiologic function with advancing age are
      marked by a decreased sensitivity to perturbations and a decreased efficiency of
      homeostatic mechanisms. Recognition of the heterogeneity of the aging process is
      fundamental to appropriate decision-making in the elderly surgical patient and
      thus to avoiding complications. Careful preoperative assessment of medical
      problems and potential age-related changes in physiologic function, preoperative
      orientation and teaching, consideration of deep venous thrombosis prophylaxis,
      effective pain management, early postoperative mobilization and careful attention
      to drug and fluid and electrolyte therapy are essential in management of the
      elderly surgical patient.

PMID- 1747833
TI  - The surgical stress response: should it be prevented?
AB  - Postoperative complications such as myocardial infarction, pulmonary infection,
      thromboembolism and fatigue are probably related to increased demands,
      hypermetabolism, catabolism and other physiologic changes included in the global
      "surgical stress response." Strategies have been developed to suppress the
      detrimental components of the stress response so as to improve postoperative
      outcome. Of the various techniques to reduce the surgical stress response,
      afferent neural blockade with regional anesthesia to relieve pain is the most
      effective, although not optimal. Data from numerous controlled clinical trials
      have demonstrated a reduction in various aspects of postoperative morbidity by
      such a nociceptive blockade. Although a causal relationship has still to be
      demonstrated, these findings strongly argue the concept of "stress-free
      anesthesia and surgery" as an important instrument in improving surgical outcome.

PMID- 1747834
TI  - Noninvasive assessment of cardiac transplant rejection. A critical look at the
      approach to acute rejection.
AB  - The diagnosis of acute rejection remains a key issue in the management of the
      heart transplant recipient. Myocardial biopsy for tissue examination is the basic
      step for screening and diagnosis of acute rejection. Although endomyocardial
      biopsy is reliable, it is an inefficient approach to screening after
      transplantation and yielded only a 14% rate of positive results in the author's
      experience, from 1983 to 1990, of 568 biopsies. A reliable noninvasive method for
      screening acute rejection is therefore needed. Numerous noninvasive methods have
      been studied to monitor the systemic immune process against the allograft or to
      evaluate the effect of rejection on graft function and status. For 13 methods of
      evaluating immune process against the allograft the sensitivity and specificity
      ranged from 13% to 95% and 19% to 94% respectively. For nine methods of
      evaluating allograft function, sensitivity and specificity ranged from 60% to 93%
      and 65% to 97% respectively. Overall, methods monitoring allograft function and
      status have better results in predicting acute rejection. Nevertheless, the
      author estimated that 15 episodes of acute rejection would have been missed by
      these monitoring methods in his group of patients.

PMID- 1747835
TI  - [Pediatric heart transplantation 1990].
AB  - In this presentation the author updates the progress made in pediatric cardiac
      transplantation through a review of the results obtained at Ste-Justine Hospital
      (SJH) and of the recent literature. Of 56 children referred to SJH for cardiac
      transplantation, 27 met the selection criteria; 10 died before receiving a new
      heart and 2 are still awaiting transplantation. Fifteen children, aged 3 to 16
      years, have received a transplant. Ten of them had 32 birth defects, all of which
      were repaired at the time of transplantation thanks to improved graft removal
      methods and innovative surgical techniques. This study demonstrates that birth
      defects are not a contraindication to cardiac transplantation in children. Triple
      drug immunosuppression was used, and the cyclosporine blood levels were
      maintained in the range of 100 to 200 ng/mL. Survival at 2 years was 78%.
      Episodes of acute rejection occurred at a rate of 0.5 per patient, 85% of them
      within the first 3 months after transplantation. Adequate renal function was
      preserved (creatinine clearance between 89 and 102 mL/min.m-2). The use of low
      dose cyclosporine might explain in part the lack of significant nephrotoxicity.
      Reversible high blood pressure was observed in 5 of 13 patients during the first
      6 months postoperatively. Multifactorial analysis identified, as a likely cause,
      a higher dose of steroids and cyclosporine during this period. Annual coronary
      angiography did not reveal any lesion, and apart from the acute rejection
      episodes, cardiac function was normal at rest, and the transplanted children have
      maintained an excellent level of activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1747836
TI  - Mechanical bridge to cardiac transplant: where do we stand in 1990?
AB  - Various mechanical devices have been used to support the circulation in patients
      requiring cardiac transplantation who are in cardiogenic shock. The devices
      produce either a pulsatile or nonpulsatile blood-flow pattern. Of the former, the
      intra-aortic balloon pump is the most frequently used. However, it augments but
      does not replace the function of the left ventricle. At the Ottawa Heart
      Institute, orthotopic replacement of both ventricles with a total artificial
      heart has proven a reliable and effective bridge to transplantation in selected
      patients. Heterotopic ventricles, known as ventricular assist devices, may also
      be used to replace the function of one or both ventricles and are increasingly
      being used to maintain the circulation. The future of nonpulsatile devices for
      mechanical support remains unclear because the long-term effects of this
      unphysiologic flow pattern are unknown. As refinements in circulatory support
      devices continue and as patient selection and timing of device insertion become
      more clearly defined, the results in these patients will likely approach those of
      elective cardiac transplantation.

PMID- 1747837
TI  - Management of fistula-in-ano: 1990 Roussel Lecture.
AB  - Fistulas-in-ano may be classified as simple or complex, or according to their
      anatomy--intersphincteric, transsphincteric suprasphincteric or extrasphincteric.
      Most of them are treated surgically. Simple fistulas may be treated by
      fistulotomy, but complex or high fistulas require careful evaluation and often
      require alternative surgical procedures. In all instances, the objective should
      be to eradicate the fistula without compromising continence. Perianal disease may
      be present in 10% to 80% of patients with Crohn's disease. In these patients
      treatment must be individualized. Important considerations are the presence or
      absence of rectal disease, the complexity of the fistula and the strength of the
      anal sphincter muscle. Treatment options include fistulotomy, simple drainage or
      unroofing of abscesses and fistulas, use of medical agents, bowel rest,
      construction of a loop ileostomy and, ultimately, proctectomy.

PMID- 1747838
TI  - Value of urologic investigation in a targeted group of women with recurrent
      urinary tract infections.
AB  - According to the conclusions of clinical studies, excretory urography and
      cystoscopy are of no value in managing the majority of women who have a history
      of recurrent urinary tract infection (UTI). Of 475 women with recurrent UTIs, 186
      were prospectively targeted for evaluation by cystoscopy and ultrasonography or
      excretory urography from selection criteria based on the degree of complicating
      factors, to determine the value of urologic investigation. Thirty-nine patients
      had significant detectable abnormalities, and 20 of them required surgical
      intervention. Definite indications for urologic evaluation include hematuria
      (gross hematuria and persistent microscopic hematuria between infections),
      pyelonephritis and a presentation that is not typical for simple uncomplicated
      UTIs (obstructive symptoms, infection with urea-splitting bacteria, clinical
      impression of persistent infection or urinary calculi). Diabetes itself does not
      warrant urologic evaluation. The findings from this study suggest that cystoscopy
      and upper urinary tract evaluation do play a role in the management of a selected
      group of women with UTIs.

PMID- 1747839
TI  - Arthroscopic debridement of the knee for osteoarthrosis.
AB  - To evaluate outcome after arthroscopic debridement, the records of 171 patients
      with osteoarthrosis of the knee were reviewed. All patients were unresponsive to
      conservative management and were treated arthroscopically. Procedures included
      lavage, meniscectomy, chondrectomy, removal of free bodies and removal of limited
      osteophytes. Outcome assessment was retrospective, evaluating the need for
      further surgery, control of pain, improved function and patient satisfaction.
      Sixty-five percent of patients felt their symptoms were improved. There was
      excellent control of pain in 38% and improved function in 22%. Subsequent
      surgical procedures were required in 12% at an average follow-up of 25 months. No
      factors were identified that correlated with the outcome, including the extent of
      degenerative changes and of debridement and patient profile. Arthroscopic
      debridement is a temporizing procedure with good patient satisfaction. Marked,
      but unpredictable, improvement in symptoms is seen in one patient out of three.

PMID- 1747840
TI  - Aseptic loosening in total hip implants: the role of polyethylene wear debris.
AB  - Radiologic and routine histologic examinations, transmission electron microscopy
      and scanning electron microscopy were carried out on membranes retrieved from the
      following hip implant prostheses: loose cemented metal-on-polyethylene,
      resorptive cysts around fixed cemented metal-on-polyethylene, cemented without
      polyethylene (Thompson), noncemented without polyethylene (Moore), loose ceramic
      on-ceramic and loose noncemented metal-on-polyethylene. From histologic analysis
      the most common factor in the membranes reviewed, in terms of production of
      multinucleated giant cells, is the presence of polyethylene wear debris. Neither
      loosening of the implant nor the presence or absence of bone cement produces such
      cells within the membrane.

PMID- 1747841
TI  - [A utilization review program of cefoxitin].
AB  - A drug utilization review program of cefoxitin was conducted in a 714-bed
      teaching hospital. Health records of all 43 in-patients who received cefoxitin
      during the month of November 1987 were reviewed retrospectively. The use of
      cefoxitin (47 courses) was evaluated on the basis of "appropriate use" criteria
      developed from the literature and the physician's clinical experience. Of the 47
      courses evaluated, cefoxitin was prescribed for prophylaxis in 47%, and its use
      was considered inappropriate in 86% of these. Overall, 66% of total cefoxitin
      usage was deemed inappropriate in this hospital. The cost associated with
      inappropriate use was estimated at $2672 for the period of the study. Corrective
      measures were then implemented to rectify the identified problems. A second study
      was conducted 2 years later to assess the impact of the corrective measures. This
      utilization review program of cefoxitin showed that optimal use of a drug
      requires not only close collaboration between pharmacists and physicians but a
      continuous and not a sporadic process of surveillance of the prescription for the
      drug being studied.

PMID- 1747842
TI  - Cervical esophageal diverticulum associated with an impacted denture: a case
      report.
AB  - The authors describe the case of a 19-year-old man who had swallowed his three
      toothed radiolucent upper denture 2 years before the current admission. Although
      radiologic examination of the soft tissues of the neck and the results of barium
      meal examination were reported as normal immediately after the event, a barium
      meal examination 2 years later revealed formation of a cervical esophageal pouch,
      within which the denture was found at operation. The swallowing and possible
      impaction of a foreign body within the esophagus should prompt upper
      gastrointestinal endoscopy despite a negative result of a barium meal
      examination. Endoscopic removal is the treatment of choice, but surgery is
      appropriate in selected cases.

PMID- 1747843
TI  - Osteomyelitis of the pelvis due to Fusobacterium nucleatum.
AB  - Anaerobic pelvic osteomyelitis occurs rarely in children. A case of Fusobacterium
      nucleatum osteomyelitis of the right ilium [correction of ileum] in a child
      without apparent risk factors is described. This case emphasizes the value of
      diagnostic aspirates. Therapy with a combination of intravenous and oral
      clindamycin led to successful resolution of the infection.

PMID- 1747844
TI  - Internal jugular vein reconstruction using a superficial femoral vein graft.
AB  - Numerous methods of venous reconstruction have been described to help prevent the
      many complications related to bilateral ligation of the internal jugular veins.
      The authors report a case in which the superficial femoral vein was used as the
      donor graft for reconstruction of the internal jugular vein in a 61-year-old man
      who underwent a tonsillar commando procedure for cancer. The advantages of using
      this donor vein for reconstruction of the internal jugular vein are summarized.

PMID- 1747845
TI  - Failure of a titanium endoprosthesis--a case report.
AB  - A titanium-head Thomson endoprosthesis was revised 2.5 years after insertion.
      Metallosis with burnishing of the head and acetabular erosion were noted. The
      stem and the cement mantle were in perfect condition. Because this is not an
      isolated case, the author recommends that a titanium-stem endoprosthesis have a
      cobalt-chrome or ceramic bearing surface.

PMID- 1747846
TI  - Overview of new dermatopathology techniques.

PMID- 1747847
TI  - Gene rearrangement analysis in lymphoid neoplasia.
AB  - Current uses for gene rearrangement analysis in clinical dermatology are listed
      in Table 3. This technique is useful for determining the existence of clonal
      populations within a background of polyclonal lymphoid cells; therefore, it is
      helpful in the diagnosis and staging of patients with CTCL and PTCL. Although
      dual genotypes do occur, this technique is usually capable of determining lineage
      in a clonal lymphoid infiltrate and elucidating and characterizing the
      etiopathogenesis of certain neoplasms. On the basis of this review of the
      literature and our own experience, we conclude that gene rearrangement analysis
      shows great promise for monitoring response to therapy and detecting progression
      or relapse in patients with CTCL and PTCL. With the recent technology of PCR, it
      is possible to amplify specific sequences of DNA, detect molecular alterations in
      individual malignant T cells, and even identify exogenous retroviral gene
      sequences in tissues of patients with CTCL. Although gene rearrangement analysis
      has supported or established the clonal nature of lymphomatoid papulosis, pre
      Sezary syndrome, granulomatous slack skin syndrome, and follicular mucinosis, the
      clinical significance of these findings is not yet clear. In the case of primary
      cutaneous B-cell lymphoma and its benign counterpart, B-cell pseudolymphoma,
      further investigation will be needed to determine the clinical significance of
      clonal rearrangements.

PMID- 1747848
TI  - In situ hybridization.

PMID- 1747849
TI  - The polymerase chain reaction.
AB  - In a short time the PCR techniques has revolutionized research technology in many
      areas of medicine. Because of the ease and rapidity of the technique it is
      quickly becoming a standard clinical test for many diseases. Clinical
      applications continue to emerge from research labs and should rapidly expand to
      facilitate rapid medical diagnosis.

PMID- 1747850
TI  - Diagnosis with oligonucleotides.

PMID- 1747851
TI  - Flow cytometry in the evaluation of dermatology patients.

PMID- 1747852
TI  - Analysis of cutaneous foreign bodies.
AB  - Foreign materials from exogenous sources pose a constant challenge to the
      diagnostic skills of practicing dermatologists. Depending upon circumstances,
      radiologic, histologic, and ultrastructural techniques can be of assistance in
      ascertaining the presence and nature of the substance in question. With
      technologic advancements, identification of small-sized particles is no longer
      limited to morphologic study alone. Ultrastructural analytic techniques now
      permit identification of minute particles or quantities of material in tissues
      with relative ease. No doubt, further application of currently available and
      newly evolving analytic systems will expand our limits of detection and enhance
      our scientific knowledge.

PMID- 1747853
TI  - Immunoelectron microscopy and immunofluorescence antigenic mapping: diagnostic
      applications.
AB  - In selected situations, direct and indirect IEM may provide important diagnostic
      information for the clinician, as pertains to the diagnosis and therefore
      prognosis in a given patient. As discussed, however, all of the more conventional
      approaches should be pursued before consideration is given to the performance of
      IEM, knowing its relative cost and technical difficulty. In contrast, we consider
      immunofluorescence antigenic mapping to be the diagnostic method of choice for
      the determination of the type of inherited EB present in affected individuals.
      When additional ultrastructural or morphometric data is required, then TEM can be
      performed as an adjunct study once it is determined by mapping technique that
      additional useful information may be derived.

PMID- 1747854
TI  - Ultrastructural morphometry in the diagnosis of mycosis fungoides and Sezary's
      syndrome.

PMID- 1747855
TI  - New ways to demonstrate pathogenic organisms.

PMID- 1747856
TI  - Immunohistochemistry in the diagnosis of malignant melanoma.

PMID- 1747857
TI  - Immunohistochemical evaluation of vascular neoplasms.
AB  - Immunohistochemistry is of proven value in the evaluation of cutaneous vascular
      neoplasms. Nonetheless, the lack of sensitivity and specificity demonstrated by
      some endothelial markers requires that a panel of antibodies to other lineage
      related determinants be applied in this context. Compared with electron
      microscopy, enzyme-linked antibody techniques can be applied in a cost-effective
      manner, with a satisfactory diagnostic result in most cases. The efficacy of
      these methods will likely improve as more sensitive and specific markers of
      endothelial differentiation are characterized. For the time being, the exclusion
      of non-endothelial proliferations remains an important aspect of the differential
      diagnosis of vascular tumors.

PMID- 1747858
TI  - Recent advances in the study of the taxonomy, pathogenicity, and infectious
      syndromes associated with the genus Aeromonas.
AB  - Over the past decade, the emergence of Aeromonas species as bona fide human
      pathogens and their probable role as etiologic agents of bacterial
      gastroenteritis have resulted in an explosion of scientific interest in the
      genus. Major accomplishments occurring in this field during that interval include
      a more refined taxonomy, identification of new cell-associated factors (surface
      layers, pili), and the molecular analysis of selected extracellular gene products
      that may play a critical role in pathogenesis (hemolysins, enterotoxins). This
      review provides an updated overview of recent systematic, clinical, and
      pathophysiologic advances and defines key areas of medical and scientific
      interest in which major questions remain unanswered.

PMID- 1747859
TI  - Histoplasma variation and adaptive strategies for parasitism: new perspectives on
      histoplasmosis.
AB  - This review summarizes the biology of Histoplasma capsulatum in relation to a
      wide variety of corresponding pathologies in histoplasmosis. Features of these
      disease syndromes can be explained in part by natural variations within the
      fungal population and adaptations made by individual organisms to specific
      environments. H. capsulatum grows as mycelia and conidia in the soil; once
      inhaled, the organism undergoes a dramatic morphological and physiological
      conversion to a yeast form. The yeasts proliferate within the phagolysosomes of
      macrophages, using a variety of specific strategies for intracellular survival.
      Even avirulent strains or variants are able to avoid being killed by macrophages
      and instead establish inapparent or persistent infections. The ingested avirulent
      organisms assume enlarged shapes similar in appearance to those seen in
      histological sections of tissues from patients with histoplasmosis. Respiratory
      tract epithelial cells also appear to play a role in persistence: within them
      yeasts undergo phenotypic switching akin to the phase variation observed in other
      pathogens. This particular change involves the loss or modification of cell wall
      alpha-(1,3)-glucan, which is also correlated with the spontaneous appearance of
      avirulent variants. The repertoire of adaptive responses and natural variations
      within this species probably evolved from the need to adjust to a wide range of
      dynamic environments. In combination with the immune status of the host, these
      characteristics of H. capsulatum appear to influence the epidemiology, extent,
      and persistence of histoplasmosis.

PMID- 1747860
TI  - Applications of cellular fatty acid analysis.
AB  - More than ever, new technology is having an impact on the tools of clinical
      microbiologists. The analysis of cellular fatty acids by gas-liquid
      chromatography (GLC) has become markedly more practical with the advent of the
      fused-silica capillary column, computer-controlled chromatography and data
      analysis, simplified sample preparation, and a commercially available GLC system
      dedicated to microbiological applications. Experience with applications in
      diagnostic microbiology ranges from substantial success in work with
      mycobacteria, legionellae, and nonfermentative gram-negative bacilli to minimal
      involvement with fungi and other nonbacterial agents. GLC is a good alternative
      to other means for the identification of mycobacteria or legionellae because it
      is rapid, specific, and independent of other specialized testing, e.g., DNA
      hybridization. Nonfermenters show features in their cellular fatty acid content
      that are useful in identifying species and, in some cases, subspecies. Less
      frequently encountered nonfermenters, including those belonging to unclassified
      groups, can ideally be characterized by GLC. Information is just beginning to
      materialize on the usefulness of cellular fatty acids for the identification of
      gram-positive bacteria and anaerobes, despite the traditional role of GLC in
      detecting metabolic products as an aid to identification of anaerobes. When
      species identification of coagulase-negative staphylococci is called for, GLC may
      offer an alternative to biochemical testing. Methods for direct analysis of
      clinical material have been developed, but in practical and economic terms they
      are not yet ready for use in the clinical laboratory. Direct analysis holds
      promise for detecting markers of infection due to an uncultivable agent or in
      clinical specimens that presently require cultures and prolonged incubation to
      yield an etiologic agent.

PMID- 1747861
TI  - Immunodiagnosis of aspergillosis.
AB  - Aspergillus species are ubiquitous fungi and have been implicated as the
      causative agents of a variety of lung disorders in humans. These disorders
      include allergic, saprophytic, and systemic manifestations. The allergic
      disorders mainly affect atopic persons, and invasive or systemic diseases affect
      immunosuppressed individuals. Immunodiagnosis can help the practitioner diagnose
      these diseases. Demonstration of circulating antibodies is a useful criterion,
      but the lack of dependable and standardized antigens is a limiting factor in the
      diagnosis of most Aspergillus-induced diseases. Despite this limitation, however,
      immunodiffusion and enzyme-linked immunosorbent assays have been widely used for
      the detection of antibodies in the sera of patients with aspergillosis.
      Similarly, crude and semipurified antigens are being used to demonstrate skin
      hypersensitivity in patients, and several methods have been useful in the
      detection of antigenemia in patients with invasive aspergillosis. With a growing
      number of reports on the incidence of aspergillosis and an increase in the number
      of immunosuppressed individuals in the population, more rapid methods and more
      reliable reagents for immunodiagnosis are needed. With recent attempts at
      obtaining reliable reagents for through hybridoma technology and molecular
      biological techniques, substantial progress toward efficient immunodiagnosis may
      be achieved.

PMID- 1747862
TI  - Serodiagnosis of parasitic diseases.
AB  - In this review on serodiagnosis of parasitic diseases, antibody detection,
      antigen detection, use of monoclonal antibodies in parasitic serodiagnosis,
      molecular biological technology, and skin tests are discussed. The focus at the
      Centers for Disease Control on developing improved antigens, a truly quantitative
      FAST-enzyme-linked immunosorbent assay, and the very specific immunoblot assays
      for antibody detection is highlighted. The last two assays are suitable for field
      studies. Identification of patient response in terms of immunoglobulin class or
      immunoglobulin G subclass isotypes or both is discussed. Immunoglobulin isotypes
      may asist in defining the stage of some diseases. In other instances, use of a
      particular anti-isotype conjugate may increase the specificity of the assay.
      Monoclonal antibodies have played important roles in antigen purification and
      identification, in competitive antibody assays with increased sensitivity and
      specificity, and in assays for antigen detection in serum, body fluids, or
      excreta. Molecular biological technology has allowed significant advances in the
      production of defined parasitic serodiagnostic antigens.

PMID- 1747863
TI  - Susceptibility testing of anaerobic bacteria: myth, magic, or method?
AB  - The demand for susceptibility testing of anaerobes has increased, yet consensus
      as to procedure and interpretation in this area has not been achieved. While
      routine testing of anaerobic isolates is not needed, certain isolates in specific
      clinical settings should be tested. Also, laboratories may monitor their local
      antibiograms by doing periodic surveillance batch testing. The National Committee
      for Clinical Laboratory Standards has published a protocol of methods approved
      for susceptibility testing of anaerobic bacteria. Both agar and broth
      microdilution are included; however, the broth disk elution method is no longer
      approved by the National Committee for Clinical Laboratory Standards because of
      method-related interpretive errors. A number of newer methods are undergoing
      evaluation and seem promising. Clinicians and microbiologists reviewing
      susceptibility reports should be aware of sources of variability in the test
      results. Variables in susceptibility testing of anaerobes include the media and
      methods used, organisms chosen for testing, breakpoints chosen for
      interpretation, antibiotic, and determination of endpoint. Clustering of MICs
      around the breakpoint may lead to significant variability in test results.
      Adherence of testing laboratories to approved methods and careful descriptions of
      the method and the breakpoints used for interpretation would facilitate
      interlaboratory comparisons and allow problems of emerging resistance to be
      noted. A variety of resistance mechanisms occurs in anaerobic bacteria, including
      the production of beta-lactamase and other drug-inactivating enzymes, alteration
      of target proteins, and inability of the drug to penetrate the bacterial wall.
      Antimicrobial resistance patterns in the United States and abroad are described.

PMID- 1747865
TI  - Genetic abnormalities in myelodysplastic syndrome.

PMID- 1747866
TI  - Alu family variations in neoplasia.
AB  - Human chromosomes contain about one million copies of dispersed repeats of the
      Alu family which are distributed non-randomly. In this study we have compared the
      pattern of hybridization of tritiated Alu-probes on chromosomes of PHA-stimulated
      lymphocytes of normal donors and of non-stimulated bone marrow cells of acute
      leukemia patients, and found regular differences in this pattern over some
      chromosome bands (3q26, 8p11-p12, 14q24, 15q21, 6q22) between normal individuals
      and leukemia patients. These data were interpreted as indicative of somatic
      variation of the Alu family in acute leukemia. Possible mechanisms of the
      variation and the role of the Alu family in chromosome rearrangements in
      neoplasia are discussed.

PMID- 1747864
TI  - Bacterial vaginosis.
AB  - Bacterial vaginosis (BV) is the most common of the vaginitides affecting women of
      reproductive age. It appears to be due to an alteration in the vaginal ecology by
      which Lactobacillus spp., the predominant organisms in the healthy vagina, are
      replaced by a mixed flora including Prevotella bivia, Prevotella disiens,
      Porphyromonas spp., Mobiluncus spp., and Peptostreptococcus spp. All of these
      organisms except Mobiluncus spp. are also members of the endogenous vaginal
      flora. While evidence from treatment trials does not support the notion that BV
      is sexually transmitted, recent studies have shown an increased risk associated
      with multiple sexual partners. It has also been suggested that the pathogenesis
      of BV may be similar to that of urinary tract infections, with the rectum serving
      as a reservoir for some BV-associated flora. The organisms associated with BV
      have also been recognized as agents of female upper genital tract infection,
      including pelvic inflammatory disease, and the syndrome BV has been associated
      with adverse outcome of pregnancy, including premature rupture of membranes,
      chorioamnionitis, and fetal loss; postpartum endometritis; cuff cellulitis; and
      urinary tract infections. The mechanisms by which the BV-associated flora causes
      the signs of BV are not well understood, but a role for H2O2-producing
      Lactobacillus spp. in protecting against colonization by catalase-negative
      anaerobic bacteria has been recognized. These and other aspects of BV are
      reviewed.

PMID- 1747867
TI  - Establishment of a rhabdoid tumor cell line with a specific chromosomal
      abnormality, 46,XY,t(11;22)(p15.5;q11.23).
AB  - The malignant rhabdoid tumor is a rare, poorly understood tumor which occurs
      primarily in children. The kidney is a frequent primary site of origin, but the
      tumor has arisen in other mesodermally derived tissues as well. Controversy
      exists regarding the embryonic origin of the rhabdoid tumor and recent
      histopathologic studies suggest that it may be of neuroepithelial origin. Our
      immunohistochemical and electron micrographic studies support this theory. No
      consistent chromosome abnormalities have been reported in this tumor and no cell
      lines are available for study. We have established and characterized the first
      rhabdoid tumor cell line. It possesses a specific chromosomal abnormality,
      46,XY,t(11;22)(p15.5;q11.23). The translocation may provide an important clue to
      the pathogenesis of the tumor as well as an opportunity for further study of the
      involved chromosome regions.

PMID- 1747868
TI  - Trisomy 13 as a primary chromosome aberration in acute leukemia.
AB  - Four patients with acute leukemia displayed trisomy 13 as the primary chromosome
      abnormality. The two patients with acute nonlymphocytic leukemia FAB-type M1
      (ANLL-M1) had the karyotypes 47,XY,+13/48,XY,+13,+13 and 47,XX,+13, a patient
      with the hypogranular form of ANLL M3 had 47,XX,+13, and the fourth patient, who
      had acute undifferentiated leukemia (AUL), had the karyotype
      47,XY,+13/48,XY,+8,+13. Including these four cases, a total of 24 hematologic
      neoplasms with an extra chromosome 13 as the sole aberration have now been
      reported. Except for the AUL, all have been of myeloid origin--20 ANLL, one
      myelodysplastic syndrome, and two chronic myeloproliferative disorders. Trisomy
      13 as the sole acquired karyotypic abnormality therefore seems to be strongly
      associated with myeloid differentiation of the neoplastic cells and with a
      differentiation block leading to acute leukemia.

PMID- 1747869
TI  - Loss of amplification and appearance of a novel translocation site of the c-myc
      oncogene in HL-60 leukemia cells.
AB  - The chromosomal localization of c-myc sequences was determined by in situ
      hybridization in HL-60 cells (HL-60a) which contain an amplified c-myc locus and
      in an HL-60 subline (T-HL60) which has lost the amplification and has
      proportionately lower levels of c-myc RNA. While in HL-60a cells amplified c-myc
      sequences were found on the M3q+ marker chromosome, in T-HL60 cells one or few
      residual c-myc copies were found on a novel 4q+ marker chromosome. Comparative
      phenotypic analysis of HL-60a and T-HL60 cells show that the decrease in c-myc
      amplification/expression is not accompanied by changes in the malignant
      phenotype, namely in doubling time and clonogenic capability in semi-solid media.
      The significance of these results is discussed in the context of the role of c
      myc amplification in the establishment and/or maintenance of the leukemic
      phenotype in HL-60 cells. In general, these results further underscore the
      utility of in situ hybridization analysis in identifying oncogene translocations
      which are not detectable by conventional karyotypic analysis.

PMID- 1747870
TI  - Unstable chromosome aberrations in bladder and renal cell carcinoma.
AB  - Structural chromosome aberrations were investigated in 18 bladder carcinoma and
      14 renal cell carcinoma patients. Unstable chromosome aberrations, such as
      breaks, gaps, minutes, and fragments, appeared in varying proportion. Double
      minutes (dmin) were also observed. In bladder carcinoma, 10 kinds of aberration
      were observed in 38.8% of the metaphase analyzed, and, in renal cell carcinoma, 7
      kinds of aberrations were observed in 15.0%. The frequency of chromosome
      aberrations observed, and the occurrence of dmin and of aneuploidy, were
      correlated positively with histopathological grade and stage. From the results
      obtained here, we conclude that study of chromosome aberrations should be added
      as one of investigations for evaluating the malignant potential of the tumors.

PMID- 1747871
TI  - Translocation (Y;2) in childhood acute lymphoblastic leukemia.
AB  - A case of ALL in a 2 1/2-year-old boy with fatal outcome is presented.
      Cytogenetic analysis revealed a hypodiploid karyotype: 45,X-Y,-2,+der (2)t(Y;2),
      12,i(17q),+mar. Some metaphases represented a sideline with 44 chromosomes and
      monosomy 8 was a consistent anomaly. These findings are rather uncommon in ALL.
      Hypodiploidy and the translocation, however, indicated poor prognosis in this
      case.

PMID- 1747872
TI  - Cytogenetic variability and kinetochore proteins. Comparison among populations
      derived from single-cell cultures.
AB  - This study reports comparative changes in five sub-lines obtained from a
      transformed culture of rat cerebral origin. Two of the lines were obtained from
      the original cell population while three others were raised from single-cell
      cultures. The comparative study was carried out on the DNA content and several
      cytogenetic parameters including variability in chromosome number, anaphase
      bridges, acentric fragments, chromosomes without detectable kinetochore proteins,
      and the frequency of micronuclei in these five lines. All cell lines, including
      the single-cell-derived clones expressed considerable variability in all aspects.
      One interesting aspect is the evolution of a chromosome with compound centromere,
      which is present only in two cell lines. The data indicate that the clone derived
      from a single cell does not maintain uniformity and even single cells have some
      sort of inherent potential to generate extreme variability. Some numerical
      variability may be attributed to a new phenomenon of a lack of kinetochore
      proteins seen on some chromosomes.

PMID- 1747873
TI  - Cytogenetic study of acoustic neuroma.

PMID- 1747874
TI  - Acute effects of amiodarone on ultrastructure and electrical activity of isolated
      guinea pig hearts.
AB  - STUDY OBJECTIVE: The aim was to evaluate the effects of tissue concentration of
      amiodarone on ultrastructure and electrical activity in isolated spontaneously
      beating Langendorff perfused guinea pig hearts. DESIGN: Group 1: The influence of
      10 microM amiodarone over a period of 1 h in a non-recirculated perfusate on
      conduction intervals, heart rate, creatine kinase concentration in the coronary
      effluent, coronary flow, and drug accumulation was determined. Group 2:
      Ultrastructural changes after 30 min and 60 min perfusion with amiodarone were
      examined. Group 3: Cardiac refractoriness was evaluated following 30 min and 60
      min of perfusion with amiodarone. EXPERIMENTAL PREPARATIONS: Isolated hearts of
      guinea pigs (200-300 g) were used: group 1, n = 6 animals; group 2, n = 3 for
      each time span; and group 3, n = 6 for each time span. MEASUREMENTS AND MAIN
      RESULTS: A steady state for the effects of amiodarone on atrioventricular and
      intraventricular conduction [+31(SEM 5)%, p less than 0.01% +47(12)%, p less than
      0.01, respectively] and on heart rate [-30(9)%, p less than 0.01] was reached
      after 15 min, and on His bundle conduction [+38(17)%, p less than 0.01] after 30
      min. QT duration was not affected throughout the duration of the experiment.
      Cardiac refractoriness was significantly prolonged following 30 min perfusion
      with 10 microM amiodarone, and was further significantly increased following 60
      min perfusion. Amiodarone tissue concentration increased to 365(39) nmol.g-1 wet
      weight, and this was accompanied by an increase in creatine kinase concentration
      in the coronary effluent. Coronary flow stayed constant throughout the whole
      experiment. At the end of the experiment electron microscopic examination of the
      myocardium of the left ventricle showed accumulation, fusion, and vacuolisation
      of mitochondria, and perinuclear oedema. CONCLUSIONS: These observations suggest
      that amiodarone, as well as exerting acute electrophysiological effects, creates
      ultrastructural changes which probably contribute to its effectiveness in
      arrhythmias caused by scarred myocardium.

PMID- 1747875
TI  - Absence of xanthine oxidoreductase activity in human myocardium.
AB  - STUDY OBJECTIVE: The aim was to examine whether or not xanthine oxidase activity
      may be a significant source of oxygen derived free radicals in the human heart.
      DESIGN: Xanthine oxidoreductase activity of human myocardium was assayed in
      vitro. In addition, tests were performed to assess whether or not endogenous
      inhibitors of the enzyme were present in myocardial homogenates. The enzyme assay
      was based on high performance liquid chromatography with electrochemical and/or
      radiochemical detection of hypoxanthine, xanthine, and urate. SUBJECTS:
      Measurements were done on (a) isolated perfused rat myocardia and (b) left
      ventricular needle biopsies and papillary muscles obtained during elective
      cardiac surgery (chiefly aortic and/or mitral valve replacement and aortocoronary
      bypass) (n = 105 patients). MEASUREMENTS AND MAIN RESULTS: Homogenisation of
      human papillary muscles in buffer caused significant accumulation of hypoxanthine
      but not xanthine or urate. In addition, during incubation of crude myocardial
      homogenates with exogenous xanthine or hypoxanthine in the presence of NAD+
      and/or O2 no production of urate was detected. Likewise, following aerobic
      incubation of papillary muscle homogenates with 14C-hypoxanthine neither 14C
      xanthine nor 14C-urate were formed. Absence of xanthine oxidising activity was
      also observed with human papillary muscle extracts that were subjected to either
      ultrafiltration or gel filtration. In contrast, the rat heart was found to
      contain abundant xanthine oxidoreductase activity. The rat heart enzyme was
      inhibited by both allopurinol and oxypurinol but remained active when mixed with
      human papillary muscle homogenates. CONCLUSIONS: These findings show absence of
      xanthine oxidase and xanthine dehydrogenase activities in human myocardium,
      indicating that xanthine oxidase is not a source of oxygen derived free radicals
      in the human heart.

PMID- 1747876
TI  - Release of endothelium derived nitric oxide in relation to pressure and flow.
AB  - STUDY OBJECTIVE: Endothelium derived nitric oxide (NO) is an important modulator
      of resting vascular tone. The aim of the study was to investigate the extent by
      which the rate of NO release is modulated by the two determinants of vascular
      conductance: pressure and flow. DESIGN AND EXPERIMENTAL MATERIAL: Porcine
      macrovascular endothelial cells cultured on microcarrier beads were used as a
      model in which the rate of NO release was determined photometrically. Columns
      packed with endothelial cell covered beads were perfused at different flow rates
      (2, 10, 20 ml.min-1) and perfusion pressures (ranging from 6 to 200 mm Hg).
      MEASUREMENTS AND MAIN RESULTS: Release of endothelial cell derived NO was
      continuously quantified under basal and ATP stimulated conditions using a
      specific difference spectrophotometric assay. Increasing flow flow from 2 to 20
      ml.min-1 enhanced the basal NO release from endothelial cells fivefold. ATP (10(
      4) M) augmented the NO release from endothelial cells more than 10-fold at each
      flow level studied. The ATP induced NO release rapidly increased by a factor of
      5.8 when flow was enhanced from 2 to 20 ml.min-1 (greater than 180 pmol.min-1.mg
      endothelial cell protein). Raising perfusion pressure from 6 to 200 mm Hg in
      endothelial cells did not affect the rate of basal NO release. CONCLUSIONS: (1)
      The rate of NO release from endothelial cells increases when flow is enhanced.
      (2) Endothelial cells possess a high capacity for NO production, permitting a
      rapid adjustment of NO release to changes in flow. (3) The rate of NO release is
      not causally related to changes in perfusion pressure.

PMID- 1747877
TI  - Coronary pressure-flow, pressure-function, and function-myocardial oxygen
      consumption relations in postischaemic myocardium.
AB  - STUDY OBJECTIVE: The aim was to study coronary pressure-flow, pressure-myocardial
      wall motion and myocardial wall motion-myocardial oxygen consumption relations in
      postischaemic myocardium with prolonged myocardial dysfunction (stunned
      myocardium) in comparison with normal myocardium. DESIGN: Regional myocardial
      wall thickening was measured with ultrasonic crystals, and postischaemic
      myocardial dysfunction was achieved by occlusion of a carotid-left anterior
      descending coronary artery bypass (15 min) and reperfusion (30 min). Coronary
      perfusion pressure was decreased in 10 mm Hg steps by constricting the bypass
      before and after producing postischaemic myocardial dysfunction. At each
      constriction step, coronary flow, regional wall thickening, and regional
      myocardial oxygen consumption in the area perfused by the left anterior
      descending artery were measured. EXPERIMENTAL MATERIAL: 12 anaesthetised open
      chest mongrel dogs, weighing 12-16 kg, were studied. MEASUREMENTS AND MAIN
      RESULTS: At the basal level, myocardial wall thickening of postischaemic
      myocardium was depressed compared to normal myocardium, at 18.5(SD 8.9)% v
      1.3(7.1)%, p less than 0.01. With coronary stenosis, wall thickening gradually
      decreased at a coronary pressure below 60 mm Hg in normal myocardium, but
      remained unchanged until mean coronary pressure was reduced to 50 mm Hg in
      postischaemic myocardium. Myocardial wall thickening of postischaemic myocardium
      was always more depressed than normal myocardium. At any level of coronary
      pressure, coronary flow in postischaemic myocardium was not different from normal
      myocardium. There was no difference in regional myocardial oxygen consumption
      between normal and postischaemic myocardium at any level of coronary pressure.
      However, regional myocardial oxygen consumption in postischaemic myocardium was
      higher than in normal myocardium performing similar levels of myocardial wall
      thickening. CONCLUSION: The coronary pressure-function relation but not the
      pressure-flow relation changed in postischaemic myocardium after a 15 min
      coronary occlusion. Regional myocardial oxygen consumption was relatively
      increased in postischaemic myocardium.

PMID- 1747878
TI  - Evaluation of factors influencing myocardial infarct size in unconscious dogs.
AB  - STUDY OBJECTIVE: The aim was to evaluate the factors determining myocardial
      infarct size in unconscious dogs. DESIGN: In anaesthetised open chest dogs, the
      left anterior descending coronary artery was occluded either by ligation or by
      thrombosis for different time periods (1.5 h, 4 h, 24 h), with or without
      reperfusion. Haemodynamic variables were recorded throughout the experiment.
      Radioactive microspheres (15 microns) were injected at the end of the ischaemic
      period to measure regional myocardial blood flow. Infarct size and area at risk
      were determined by the Evans blue triphenyltetrazolium staining technique
      followed by planimetry. SUBJECTS: Mongrel dogs of either sex (n = 16-42 per
      experiment), weight 18-25 kg, were used. MEASUREMENTS AND MAIN RESULTS: A large
      interindividual variability in infarct size was observed after occlusion of the
      left anterior descending coronary artery at a standardised location for a well
      defined period. An examination of the factors responsible for this variability
      was carried out in order to develop a statistical model which would make it
      possible to predict infarct size. Using multiple regression analysis, it was
      found that in most protocols (except 90 min thrombosis) more than 85% of the
      variability in infarct size could be explained by the size of the area at risk
      and the amount of collateral flow. Thus, knowing the area at risk and the
      collateral flow, a fairly accurate prediction can be made of the size of the
      infarct that the dog will develop after a defined occlusion period. Furthermore,
      it was found that the infarct size increased with duration of occlusion, while
      duration of reperfusion had no effect. In the 90 min occlusion group thrombosis
      induced a larger final infarct than ligature. CONCLUSIONS: A correction for
      baseline variables is necessary in order to compare infarct size between
      experimental groups. The usefulness of this procedure is shown by an example of
      an experimental intervention, i.e., R 56,865, a drug with known cardioprotective
      effects.

PMID- 1747879
TI  - A multivariate analysis of cardiac growth in human embryos: endocardial cushions
      and ventricular myocardium.
AB  - STUDY OBJECTIVE: In view of the controversy about the morphological significance
      of the endocardial cushion tissue and ventricular myocardium during cardiac
      development, the aim was to carry out quantitative studies of these structures.
      DESIGN: Endocardial cushion tissue and ventricular myocardium were quantified by
      point count planimetry. The relative growth of the volume of these structures,
      and also the embryonic crown-rump length, was studied by multivariate allometry
      (principal components analysis) with the covariance matrix calculated from
      natural logarithms of the data. EXPERIMENTAL MATERIAL: 27 serially sectioned
      human embryos were studied, ranging from stage 15 to stage 23 (Paris collection).
      MEASUREMENTS AND MAIN RESULTS: The relative growth of endocardial cushion tissue,
      ventricular myocardium, and crown-rump length was discontinuous during the
      postsomitic period. The first component in principal components analysis measures
      overall size and, in the present analysis, accounts for 88.6% of the total
      variance. The growth vector isometry hypothesis was checked with the chi 2 test.
      This showed that differences in growth between cardiac structures and crown-rump
      length were allometric (p less than 0.01). Endocardial cushion tissue volume and
      crown-rump length grew with negative allometry during the second month of
      gestation, while ventricular myocardium volume grew with positive allometry.
      CONCLUSIONS: The results agree with those researchers who consider that
      endocardial cushion tissue functions only in causing initial cardiac fusion and
      partitioning, with little influence on the formation of definitive cardiac
      structures.

PMID- 1747880
TI  - Haemodynamic effects of arterial compliance, total peripheral resistance, and
      glyceryl trinitrate on regurgitant volume in aortic regurgitation.
AB  - STUDY OBJECTIVE: Afterload reduction is known to reduce regurgitant flow in
      patients with aortic regurgitation. Both arterial compliance and total peripheral
      resistance are determinants of afterload. The aim of this study was to evaluate
      the influence of arterial compliance and total peripheral resistance on the
      regurgitant volume. DESIGN: The values of arterial compliance and total
      peripheral resistance were assessed during aortic regurgitation at different
      regurgitant orifice areas in eight pigs before and after a bolus of glyceryl
      trinitrate. In a computer model the importance of arterial compliance and total
      peripheral resistance on the regurgitant volume was assessed by keeping each of
      them constant while the other variable was changed. MEASUREMENTS AND MAIN
      RESULTS: In both the experimental and computer models a very strong correlation
      was found between decreased total peripheral resistance and decreased regurgitant
      volume. Arterial compliance was of hardly any importance. A bolus of glyceryl
      trinitrate reduced regurgitant volumes and regurgitant fractions significantly.
      CONCLUSIONS: Total peripheral resistance is an important factor in influencing
      the regurgitant volumes at a given regurgitant orifice area in aortic
      regurgitation, while arterial compliance is of less importance. Glyceryl
      trinitrate effectively reduces the regurgitant volumes by its effect on
      peripheral resistance.

PMID- 1747881
TI  - Demineralization of human dentine compared with enamel in a pH-cycling apparatus
      with a constant composition during de- and remineralization periods.
AB  - A comparison was made between the demineralization of enamel and dentine with and
      without abraded surfaces. This was done in a pH-cycling experiment for different
      demineralization/remineralization ratios--in the range from 1:1 to 1:4--and for
      different fluoride additions (up to 2 ppm) in solution. A new automatic pH
      cycling system, in which the de- and remineralization solutions have a constant
      composition during the de- and remineralization cycles, was used to create
      mineral loss in human dentine and enamel. Changes in mineral content were
      monitored by means of longitudinal microradiography. A linear correlation was
      found between the amount of mineral lost and the total demineralization time for
      both dentine and enamel. The demineralization rates were comparable for abraded
      enamel and dentine and for polished enamel and dentine, and this rate was roughly
      doubled by the removal of the outer surface for both tissues. This showed that
      the presence of the outer surface is equally important to dentine and enamel.
      Under the pH-cycling conditions used, a logarithmic relation was found between
      the addition of fluoride and the decrease in demineralization for both enamel and
      dentine. The inhibitory effect of fluoride on demineralization was most
      pronounced on abraded enamel, followed by pumice-polished enamel, abraded dentine
      and pumice-polished dentine. About 2 ppm fluoride was needed under the conditions
      used to stop enamel demineralization completely; in the case of dentine, however,
      this amount of added fluoride did not inhibit demineralization.

PMID- 1747882
TI  - Fluoride, calcium and inorganic phosphorus concentrations in approximal plaque
      collected from young adults 1 and 24 h after toothbrushing with fluoride
      toothpastes.
AB  - A within-subject double-blind cross-over study was carried out to examine whether
      the chemical composition of approximal plaque was altered 1 and 24 h after
      brushing with fluoride toothpaste. Three fluoride toothpastes were tested,
      containing either sodium monofluorophosphate with calcium glycerophosphate
      supplement and calcium carbonate abrasive, a combination of sodium
      monofluorophosphate and sodium fluoride with the same supplement and abrasive or
      sodium fluoride with a silica abrasive. A fluoride-free toothpaste with a silica
      abrasive acted as the control. 19 subjects used the toothpastes separately in
      randomised order for 1 week each prior to collection of plaque. Contralateral
      half-mouth approximal plaque samples were collected 1 and 24 h after the last use
      of each toothpaste. Fluoride, calcium and inorganic phosphorus concentrations of
      plaque were estimated. The results indicated that brushing with toothpastes
      containing fluoride and/or calcium supplements resulted in increased
      concentrations of these constituents in approximal plaque 1 h after brushing.
      These elevated levels of inorganic ions were not observed in the samples
      collected 24 h after brushing. It was concluded that the potentially beneficial
      effect of a raised concentration of fluoride and calcium in approximal plaque
      observed soon after brushing is lost during the following 24 h.

PMID- 1747883
TI  - Optical quantification of approximal caries in vitro.
AB  - A fluorescent dye was applied to extracted premolars with either early artificial
      lesions or natural white-spot lesions. The teeth were placed in an approximal
      geometry, and with a specially designed fibre-optic probe the fluorescence of the
      dye was measured in the lesions. The same fibre-optic probe was used to measure
      the transmission of light at a wavelength where the dye does not absorb. This
      transmission of light was used to correct the fluorescence for attenuation by the
      intermediate layer of sound enamel situated between the probe and the lesion.
      Both signals varied with time because of the necessary addition of ethanol during
      the measurement. The mineral loss from the lesions was measured with wavelength
      independent microradiography (WIM) for the artificial lesions, and the optical
      caries monitor (OCM) for the natural white-spot lesions. The correlation
      coefficient between corrected fluorescence and mineral loss was r = 0.86. The
      results indicate that measurement of dye uptake may be a very sensitive method to
      diagnose early approximal caries lesions and may enable quantification of these
      lesions.

PMID- 1747884
TI  - Caries susceptibility in inbred mouse strains and inheritance patterns in F1 and
      backcross (N2) progeny from strains with high and low caries susceptibility.
AB  - We studied dental caries susceptibility in various inbred mice strains infected
      with Streptococcus mutans and the inheritance pattern in the F1 and the N2
      backcross animals. A high caries score was observed in four laboratory strains,
      BALB/cAJcl, C57BL/6NJcl, C57BL/10Slc and DBA/2NJcl. Three strains, C3H/HeNJcl,
      AKR/JSlc and CBA/JNCrj, showed less caries. Males of strain C57BL/10Slc (mean
      caries score = 112.2) and females of strain C3H/HeNJcl (mean caries score = 24.0)
      were chosen for examinations of the inheritance of the caries susceptibility. The
      mean caries score in (C57BL/10Slc x C3H/HeNJcl) F1 hybrids was 98.4,
      demonstrating that F1 progenies were susceptible. A number of N2 mice were
      obtained by mating the F1 male and the C3H/HeNJcl female. The caries scores of
      these N2 male mice had an extensive range, from 14 to 194. Assuming that a caries
      score over 74 (median of the scores between C57BL/10Slc and C3H/HeNJcl) belonged
      to the highly caries-susceptible group, N2 mice could be divided into groups with
      low or high caries susceptibility. Furthermore, the effect of nu/nu mutation on
      caries susceptibility in mice was also examined.

PMID- 1747885
TI  - Cariogenicity of Milchschnitte (Ferrero GmbH) and apple in program-fed rats.
AB  - The cariogenicity of Ferrero Milchschnitte and apple was tested in rats using a
      frequency-controlled feeding machine. Twelve litters of Osborne-Mendel rats
      orally infected with Streptococcus sobrinus OMZ-176 and Actinomyces viscosus Ny-1
      were used. Four treatment groups were tested: (1) cooked starch/sucrose 1:1 as
      positive control; (2) Ferrero Milchschnitte; (3) apple; (4) gastric intubation
      only as negative control. Groups 1-3 were additionally fed by gastric intubation
      with essential nutrients. Rats on Milchschnitte and apple had less fissure and
      smooth-surface caries than rats on a starch/sucrose diet, but significantly more
      than the negative controls. The Milchschnitte group exhibited less plaque extent
      than the positive and the negative control. The apple group showed a higher
      plaque extent and massively extended erosions on molar surfaces. The CFU means of
      S. sobrinus were decreasing from treatment 1-4. Although differences between
      treatments were not significant, they were associated by concomitantly decreasing
      caries incidence. The test foods were also assessed using intraoral plaque-pH
      telemetry in 6 human volunteers. Both Milchschnitte and apple were acidogenic in
      human telemetry. They can therefore not be regarded as safe for teeth.

PMID- 1747886
TI  - Optical quantitation and radiographic diagnosis of incipient approximal caries
      lesions.
AB  - The objectives of this study were to test the applicability of photocell
      measurements in approximal caries diagnosis and to evaluate the use of
      radiographs as validating criterion. Forty extracted premolars were selected, and
      the progression of the approximal lesions was graded clinically and
      radiographically by three examiners. Each tooth was transilluminated from the
      occlusal surface, and the throughput of light at the approximal surface was
      measured by a photocell. Together with clinical examination, the results of
      microradiographic analysis served as validating criterion in this study. The
      results indicate that photocell measurements can be useful in the diagnosis of
      incipient approximal caries lesions. Radiographs have a restricted value as
      validating criterion in diagnostic studies pertaining to incipient caries.

PMID- 1747887
TI  - Detection of occlusal caries without cavitation by visual inspection, film
      radiographs, xeroradiographs, and digitized radiographs.
AB  - The study compared visual inspection, conventional film radiographs,
      xeroradiographs, and digitized radiographs for the detection of caries in
      occlusal surfaces without cavitation. 166 extracted premolars and permanent
      molars without macroscopic cavitation were included. Eight observers assessed
      five grades of occlusal caries by visual inspection and by the three imaging
      techniques. Histologic sections (700-1,000 microns) served as validating
      criterion for the presence and depth of carious lesions, 82 teeth being found
      carious (27 with deep dentinal involvement) and 84 being scored as sound.
      Approximately 20% of the dentinal carious lesions were detected by visual
      inspection and 40% by conventional film radiography (both with a minimal number
      of false-positive observations). By xero- and digital radiography, an increasing
      number of false-positive scorings was seen. By digital radiography the true
      positive detection rate was similarly increased to 60%. The predictive values of
      a positive test were, on average, 0.85 for visual inspection, 0.89 for film, 0.78
      for xero-, and 0.82 for digital radiography and for a negative test 0.56, 0.61,
      0.61, and 0.69, respectively. However, digital radiography was able to detect
      over 70% of deep dentinal lesions in contrast to 45% by the other two imaging
      methods, without an increase in false-positive diagnoses of truly caries free
      teeth, compared with the other techniques.

PMID- 1747888
TI  - Caries prediction on the basis of past caries including precavity lesions.
AB  - The purpose of the present work was the construction of statistical models which
      allow the prediction of future high caries increments on the basis of the state
      of primary teeth and first molars taking into account both precavity lesions and
      DF experience. A child was considered to be experiencing 'high caries increment'
      when it had at least four new lesions (new DFS) 4 years after the first
      examination. Two data sets of children aged 7-10 years were analysed: (1) 803
      children examined in 1980 and in 1984. The proportion of children with 'high
      caries increment' was 25.0%. (2) 477 children examined in 1984 and in 1988. In
      this group, the proportion of children with high caries increment was 16.6%. In
      the first group with higher prevalence of caries, sensitivity and specificity
      were found to be on average at 70%. In the second group, sensitivity and
      specificity were 77% on average. This results shows that caries prediction may be
      at least as successful when a 'refined' set of clinical data is used instead of a
      less extensive set of caries data complemented by salivary buffering capacity and
      microbiological data.

PMID- 1747889
TI  - Factors associated with active and inactive root caries in patients with
      periodontal disease.
AB  - The aim of this study was to analyze a number of microbial, salivary, and dietary
      factors in patients with clinically active and inactive root caries. 147
      patients, aged 30-78 years, referred for specialist treatment of periodontal
      disease, were randomly selected. 645 decayed and 539 filled root surfaces were
      found. Out of the carious lesions, 372 (58%) were recorded as clinically active
      and 273 (42%) as inactive. 30 patients showed no lesions (group 1), 46 had only
      fillings or inactive lesions (group 2), and 35 showed 1-2 (group 3) and 36
      greater than or equal to 3 active lesions (group 4). The lactobacillus count
      differed significantly between all groups, except group 1 vs. 2, and the mutans
      streptococcus count between groups 1 vs. 4 and 2 vs. 3 and 4. Group 4 differed in
      plaque score from the other groups, and the salivary buffer effect differed
      between the inactive groups 1 and 2 and the active group 4. By stepwise multiple
      regression analysis, it was shown that lactobacillus count, plaque index,
      salivary buffer effect, dietary habit index, and number of exposed root surfaces
      contributed significantly to the coefficient of determination.

PMID- 1747890
TI  - Active and inactive root surface caries lesions in a selected group of 60- to 80
      year-old Danes.
AB  - In 90, 60- to 80-year-old patients with teeth retained in both jaws (mean 20.4 +/
      4.3), a total of 1,092 root surface lesions were recorded. Of these 156 were
      diagnosed as active caries lesions, whereas 509 were considered inactive, and 427
      were filled. About 60% of the elderly had one or more active lesions and 79% had
      fillings. Seventy percent had more than 8 filled or carious (active or inactive)
      surfaces. The percentage of carious and filled root surfaces in relation to
      surfaces at risk demonstrated that the buccal surfaces of lower molars and
      premolars and upper canines were the most severely affected (RCI = 70%) with
      fillings predominating on easily accessible surfaces. A constant relationship
      between active and inactive lesions was found on all other surfaces but third
      molars and upper incisors. The data suggest that active and inactive root caries
      lesions must be diagnosed as separate entities if the dynamic nature of root
      surface caries is to be explored in epidemiological studies and clinical trials.

PMID- 1747891
TI  - Effect of intensified caries prevention on approximal caries in adolescents with
      high caries risk.
AB  - The aim of this study was to evaluate the effect of two preventive programs
      carried out in Public Dental Clinics for children with high caries risk. From all
      the 13-year-olds living in Kuopio (n = 871), 323 (37%) were selected as a high
      risk group on the basis of the level of salivary mutans streptococci or DS score.
      They were randomly divided into two groups. The first group continued with the
      preventive care they had received before the study. The dentists treating the
      children in the second group were specifically informed about their high caries
      risk, and instructions concerning intensified prevention were given. For
      comparison, half of the 13-year-olds with low caries risk were included in the
      study (group 3, n = 248). No special instructions concerning these children were
      given. After 2 years, approximal caries increment in the two risk groups was
      three times that of the low-risk group (2.6, 2.3 and 0.7 in groups 1-3,
      respectively). There was no significant difference between the two risk groups in
      spite of the fact that significantly more preventive procedures were provided for
      group 2 than for group 1. The results indicate that assessment of the subjects as
      high and low-risk groups was successful, but caries prevention targeted for the
      risk groups failed to lower the rate of caries to the same level as that of the
      children with an anticipated low risk. For children at high risk, the intensified
      prevention program monitored by dental authorities was no more successful than
      prevention planned by individual dentists.

PMID- 1747892
TI  - Plasma membrane phospholipid translocation in the mouse peritoneal macrophage:
      differential response to stimulation of eicosanoid production.
AB  - The metabolism and translocation of exogenously introduced plasma membrane
      phosphatidylcholine (PC) having the fluorescent fatty acid analog aminocaproyl
      NBD (N-nitrobenzo-2-oxa-1,3 diazole) (NBD-PC), in the sn2 position was studied in
      cultured murine peritoneal macrophages using biochemical and morphological
      techniques. Following labeling of the cell plasma membrane at 2 degrees C by
      vesicle lipid exchange, macrophages were warmed in the presence or absence of
      pharmacological stimuli of eicosanoid production and release. Fluorescence
      microscopy indicated that the phospholipid was translocated to an internal
      cellular pool upon stimulation with zymosan. In contrast, the membrane PC analog
      was primarily metabolized and released after being found diffusely associated
      with the cytoplasm in macrophages stimulated with the calcium ionophore A23187.
      Evidence obtained by double labeling zymosan-treated macrophages with NBD-PC and
      a monoclonal antibody directed against a lysosomal membrane protein demonstrated
      that the fluorescent lipid is internalized in association with the zymosan
      particles and both are found in lysosomes. The results suggest that multiple
      pathways exist in peritoneal macrophages which target plasma membrane PC into
      different cellular compartments for hydrolysis and conversion to eicosanoid
      products and release from cells.

PMID- 1747893
TI  - Morphological characteristics of the endocrine pancreas in alloxan diabetes after
      cyclosporin A administration.
AB  - Histological, immunocytochemical, morphometric and electron microscope studies
      were carried out on the pancreas of alloxan diabetic rats pretreated with
      cyclosporin A. High mortality, severe destruction of pancreatic B-cells and
      presence of sporadic mononuclear infiltrations in islets and around excretory
      ducts were observed. The results obtained show that cyclosporin A potentiates the
      toxic effect of alloxan on the pancreatic B-cells.

PMID- 1747894
TI  - Effects of steroids on human normal and otosclerotic osteoblastic cells:
      influence on thymidine and leucine uptake and incorporation.
AB  - Steroid hormones are able to influence the metabolism of bone tissue in vivo, but
      reports regarding their direct action on bone cells fail to agree. In this study,
      in vitro administration of 17 beta-estradiol, testosterone and corticosterone to
      normal and otosclerotic osteoblastic cells induced a drop in DNA synthesis in
      both populations, an increase in the neosynthesis of endocellular proteins in
      normal cells and a rise, mainly in proteins secreted into the medium, in
      otosclerotic cells. The fact that 3H-thymidine and 3H-leucine uptake were lower
      in otosclerotic than in normal cells suggests that the membrane permeability
      differs in the two populations and that steroids exert an influence on both
      isotope uptake and directly modulate DNA and protein synthesis.

PMID- 1747895
TI  - Protein synthesis in the livers of aging mice studied by electron microscopic
      radioautography.
AB  - The application of 3H-leucine results in labeling of the liver cells of mice in
      which protein is synthesized at various ages of the animals. Quantitative changes
      of protein synthesis in the hepatocytes of aging mice were studied by electron
      microscopic radioautography. The silver grains in the hepatocytes were mainly
      located over the rough surfaced endoplasmic reticulum, mitochondria, Golgi
      apparatus, cytoplasmic matrix, and a few over the nuclei. The number of silver
      grains in the cytoplasm and nuclei of the hepatocytes gradually increased after
      birth, reached the maximum at 1 month after birth, thereafter it continued to
      decrease with aging until the 24th month. The number of silver grains in the
      hepatocyte cytoplasm was more than that in nuclei at various ages. The number of
      silver grains in the rough surfaced endoplasmic reticulum and mitochondria
      gradually increased from embryo to 1 month after birth, thereafter it continued
      to decrease with aging until the 24th month. The number of silver grains in the
      Golgi apparatus showed almost no change from fetal stage to 6 months after birth,
      thereafter it continued to decrease with aging until the 24th month. The number
      of silver grains in the cytoplasmic matrix gradually increased from fetal stage
      to 2 months after birth, then decreased with aging until the 24th month. These
      changes reflect the quantity of protein synthesized in each cell organelle at
      various ages of animals.

PMID- 1747896
TI  - Vitellogenin gene transcription is not under strict estrogen control in winter
      flounder.
AB  - Although it is almost axiomatic that vitellogenin gene expression is under
      exclusive control of estrogen in oviparous animals, our results with winter
      flounder demonstrate that vitellogenin gene transcription in females can continue
      independent of estradiol. Winter flounder were hypophysectomized in January, i.e.
      several months after the onset of vitellogenesis. Thirty or more days after
      hypophysectomy, all fish had negligible levels of estradiol in the serum, and yet
      vitellogenin gene transcription was quite active in the liver. Our results also
      suggest that a pituitary factor may be involved in the normal repression of the
      vitellogenin gene.

PMID- 1747897
TI  - Appearance of lectin binding affinity to the zona pellucida during hamster oocyte
      maturation.
AB  - In our previous study, a drastic change in terminal saccharides of
      glycoconjugates of the hamster zona pellucida associated with oocyte maturation
      was observed using light microscopic methods of lectin cytochemistry. To
      understand the mechanism of this change, in the present study, the correlation
      between the cytochemical appearance of saccharide residues in the zona pellucida
      and nuclear maturation was examined. Immature hamsters were treated with PMSG and
      hCG to induce follicular development and ovulation. The animals were euthanized 0
      to 26 hrs. after the injection of PMSG or 0,1,2,3,4,5,7,9 or 11 hrs. after the
      injection of hCG, and ovaries were dissected out, fixed, paraffin embedded and
      sectioned serially. Every other paraffin section was stained with hematoxylin to
      observe the status of nuclei and to classify follicular growth and only the fully
      developed preovulatory follicles were examined in experiments. The peroxidase
      labelled lectin-diaminobenzidine procedure was applied to sections. The lectins
      employed were WGA, SBA, MPA, UEA-I, LotusA and AAA. Germinal vesicle breakdown
      was observed within 3 hrs. after the administration of hCG. A positive reaction
      of WGA, SBA or MPA for zonae pellucidae in the fully developed preovulatory
      follicles appeared 1 hr. after hCG injection, and remained so for the next 10
      hrs. UEA-I, Lotus A and AAA reactions were negative for all of the zonae
      pellucidae observed. The data indicate that the synthesis of saccharide residues
      such as GlcNAc and GalNAc forming zona components in the follicles is not
      triggered by germinal vesicle breakdown.

PMID- 1747898
TI  - Multivariate data analysis in biochemistry: a new integrative approach to
      metabolic control in brain aging.
AB  - The principal component analysis (PCA) allows to obtain a quantitative measure of
      the state of metabolism as a whole. In this paper we applied this method to the
      study of energy metabolism during aging process and of the effect of a drug
      (Acetyl-1-carnitine, ALCAR) on the aging brain.

PMID- 1747899
TI  - Localization of yolk proteins and their possible precursors using polyclonal and
      monoclonal antibodies, in Helix aspersa.
AB  - Three major yolk proteins of 140, 100, 80 KD and a faint band of 440 KD were
      determined by gradient gel electrophoresis in the mature eggs of Helix aspersa.
      Polyclonal and monoclonal antibodies were raised against mature oocyte extracts.
      The binding sites of these rabbit and hybridoma antibodies with the different
      yolk protein components were identified with a combination of WESTERN blotting,
      ELISA, immunofluorescence and immunogold staining. All these techniques
      demonstrated materials immunologically similar to vitellins in the hemolymph and
      in the glandular cells of the digestive gland. The data suggest that, for its
      vitellogenesis, the garden-snail utilizes a heterosynthetic mechanism similar to
      that known in oviparous animals. The vitellogenins would be produced by the
      digestive gland.

PMID- 1747900
TI  - Diabetes mellitus in sand rats (Psammomys obesus): microangiopathy during
      development of the diabetic syndrome.
AB  - The purpose of the study was to investigate the development of microangiopathic
      complications in North African sand rats with diabetes induced by a long-term
      standard laboratory diet. Hyperinsulinaemic rats, whether non-diabetic obese or
      diabetic, developed capillary basement membrane (CBM) thickening in the skin; in
      insulin-dependent animals, this change was diffuse. Many PAS positive areas were
      demonstrated in skeletal muscle and myocardium, together with evidence of
      microangiopathy; the primary myocardial lesion in insulin-dependent disease was
      ischaemic fibrosis. The kidney was also affected with marked basement membrane
      thickening in Bowman's capsule and glomerular capillaries; glomerulosclerosis and
      tubular changes were found in insulin-dependent disease. No evidence of diabetic
      retinopathy was found, and there was a high incidence of cataract.

PMID- 1747901
TI  - [Tobacco addiction and its treatment using replacement therapy].
AB  - Tobacco or nicotine dependence is now established as a disease and listed by
      several countries and by the World Health Organization. The characteristics and
      mechanisms of tobacco dependency will be described as well as its assessment and
      implications for treatment.

PMID- 1747902
TI  - [Differential diagnosis of pleural effusions. Experience from a clinical study
      1986-1990].
AB  - In a group of 171 patients with pleural effusions included in a perspective study
      at the Second Clinic for Tuberculosis and Respiratory Diseases in Prague in 1986
      1990, the authors evaluated the asset of examination methods for the diagnosis of
      different types of effusions. They compared differences between the group of
      patients with effusions associated with neoplastic diseases (group 1-108
      subjects) with a group of patients with other types of effusions (group 2-63
      subjects). They compared data in the case-history, physical examination,
      examination of the effusions and other auxiliary examinations. For significantly
      different parameters of blood examination (CEA, TPA, IgM, LDH) and the effusions
      (CEA, IgM, ALP) liminal values, specificity and sensitivity were assessed for
      differentiation of tumourous and other types of exudates. The authors compared
      also the required time and method of diagnosis in the two groups of patients. In
      group 1 cytology of the exudate, biopsy of the pleura and bronchoscopy were most
      valuable. In patients of group 2 in addition to the cytology of the exudate,
      biochemistry and bacteriology and auxiliary examinations were most important. The
      number of necessary diagnostic "steps" for assessment of the aetiology of
      exudates differed. Fewer steps were necessary for assessment of tumourous
      exudates. The groups differed as to treatment and survival of the patients.

PMID- 1747903
TI  - [Possibilities of psychotherapy in the comprehensive treatment of bronchial
      asthma].
AB  - Asthma bronchiale, as all long-lasting diseases with unpleasant subjective
      complaints, has a considerable psychic superstructure. It is known that in
      chronic asthmatic patients psychic influences alone can provoke an attack. The
      extent and severity of mental factors in the pathogenesis of asthma can be
      revealed by psychological examination. By aimed psychotherapy the patient's
      complaints can be mitigated and it is possible to improve his quality of life.
      The authors give an account of principles they apply during psychotherapy and
      problems they encounter. The results are documented by selected case-histories.
      The patients' tolerance of physical work increases, the drug consumption declines
      as well as the number of sickness days and the length of hospitalization. The
      authors recommend therefore that psychological examination should be part of
      examinations of asthmatics and that in selected patients treatment should be
      supplemented by psychotherapy.

PMID- 1747904
TI  - [Energy requirements in women during pedalling on a bicycle ergometer].
AB  - The bicycle ergometer is the most frequently used equipment for loading tests for
      the purpose of functional diagnosis and for the purpose of locomotor
      rehabilitation. The energy required to meet this locomotor activity is within a
      wide range of load intensities which depends linearily on the intensity of
      pedalling. The steepness of this linear relationship which characterizes the
      degree of adaptation of the organism to this type of locomotor activity is the
      smaller the more the investigated subjects are adapted to the load. In general it
      depends on the degree of training, age, sex, strength, pedalling frequency, on
      the load protocol and on the biomechanical conditions during pedalling (e.g. the
      height of the saddle). Based on our measurements in a group of untrained women of
      different age and in trained women of different age it can be demonstrated that
      all individual relations between energy characterized by means of VO2 and the
      intensity of the load - P is within the zone where the upper borderline is formed
      by the equation VO2(ml) = 11.00.P (W) + 403 and the lower borderline by VO2(ml) =
      9.90.P (W) + 252. The basic relationship, independent on the degree of training,
      age and strength, valid in the zone of pedalling frequencies of 60-80 rot. min-1
      and in the zone of load intensities of 75-325 W has the shape of VO2(ml) =
      10.60.P(W) + 269. The maximum error of assessment of VO2 by means of the load
      intensity is 9% or less.

PMID- 1747905
TI  - [Mechanism of growth of giant intracranial vascular aneurysms. Its demonstration
      using computer tomography and angiography].
AB  - The authors demonstrate three patients with gigantic intracranial aneurysms
      diagnosed by computed tomography (CT) and angiography (AG). The aneurysm was
      visualized on the CT as an expansive isodense to slightly hyperdense focus with a
      sharp hypodense borderline. After administration of the contrast substance the
      small focus was stained centrally or the slightly excentrically located focus
      (non-thrombotized portion of the aneurysm); the thrombotized portion of the
      aneurysm does not change, borders of the aneurysm are more marked
      (pseudomembrane, highly vascularized fibrous tissue). A number of authors
      describe findings confirmed on surgery or necropsy where haemorrhage into
      aneurysmal wall is apparent. Those findings suggest a similar mechanism of growth
      of the gigantic arterial aneurysm, as assumed in chronic subdural haematomas and
      encapsulated growing intracranial haematomas. It is assumed that haemorrhage into
      the aneurysmal wall is covered by a fibrous membrane into which further
      haemorrhage may occur, the entire cycle is repeated and thus the aneurysm grows.
      The clinical symptoms are due to the expansive character manifested only when the
      aneurysm has reached a certain size.

PMID- 1747906
TI  - [Evaluation of research, educational and therapeutic-preventive activity of
      medical school faculty members].

PMID- 1747907
TI  - Fine structure of the glomerular basement membrane of the rat kidney visualized
      by high-resolution scanning electron microscopy.
AB  - The fine structure of the glomerular basement membrane (GBM) of the rat kidney
      was studied by means of high resolution scanning electron microscopy. Specimens
      were taken from kidneys perfused with paraformaldehyde, freeze-fractured and then
      processed with conductive staining. The fractured surface of glomerular tufts
      exhibited the inner and outer surface of the GBM uncovered by endothelial and
      epithelial cells. The lamina densa was composed of densely packed granular
      material together with scattered fibrils. The laminae rarae interna and externa
      were composed of a meshwork that showed some structural heterogeneities. The
      meshwork composing the lamina rara interna contained 5- to 9-nm-thick fibrils,
      had pores 11-30 nm wide, and was associated with granular material except in
      those places that corresponded with endothelial fenestrae. The meshwork of the
      lamina rara externa was made up of 6- to 11-nm-thick fibrils, and had smaller
      pores under the foot processes (10-24 nm wide) than those near the filtration
      slits (16-32 nm wide). In addition to the meshwork, the lamina rara interna
      contained microfibrils that were arranged differently depending on the topography
      of the capillary wall: scattered fibrils had no predominant orientation at the
      convex side, circumferential bundles lay at the concave side of the peripheral
      capillary wall, and had a circumferential arrangement in the paramesangial wall.

PMID- 1747908
TI  - Structural heterogeneity of the basement membrane in the rat proximal tubule.
AB  - The ultrastructure of the basement membrane of the rat proximal tubule was
      observed by transmission electron microscopy after the use of a cold dehydration
      technique. The basement membrane of the P1 segment is thick and possesses several
      structural specializations that are rare in other basement membranes; these
      include intraepithelial ridges, dense bars, and basement membrane vesicles. The
      intraepithelial ridges are found in the intercellular spaces between
      interdigitating processes of the proximal tubule cells. The ridges and the
      interdigitating processes run circumferentially around the tubule. The dense bars
      are frequently found in the intraepithelial ridges. They are especially prominent
      on the concave side of the tubular bends and to a lesser extent near sites where
      intracellular actin filaments anchor onto the basal cell membranes. The basement
      membrane vesicles are bounded by unit membranes; they are variable in both their
      electron density and their size. They are usually found in association with dense
      bars, and the grade of their accumulation is positively correlated with the
      development of the dense bars. These three specializations have no topographical
      relationship with the interstitial structures, such as fibroblasts and collagen
      fibrils. The specializations are best developed on the concave side of tubular
      bends where the circumferential stresses caused by the intraluminal hydraulic
      pressure are presumably the largest; we therefore propose that they are an
      adaptation to, or a manifestation of, the increased wall stress in the proximal
      tubule.

PMID- 1747909
TI  - Convertible adipose tissue in mice.
AB  - Ability to express uncoupling protein (UCP) and establish UCP-dependent
      thermogenesis was analyzed in anatomical areas of mice that are generally
      considered to be white adipose tissue: mesenterial, perimetral, epididymal,
      inguinal, and superficial layer of interscapular white adipose tissue. The mice
      were acclimatized for 1 week to 4 degrees C; the following week they were exposed
      to cold stress (1 h at -20 degrees C, 2-3 times daily). In such conditions in
      inguinal adipose tissue, slot-blot analysis detected significant amount of UCP
      mRNA and lipoprotein lipase mRNA. Immuno-electron-microscopic localization of UCP
      showed that developed mitochondria of cold-stressed inguinal adipocytes contained
      UCP in the same amount as uncoupled (UC)-mitochondria of brown adipocytes.
      Morphological and morphometrical analysis showed that such inguinal adipose
      tissue appeared as brown adipose tissue. Since in control mice, inguinal adipose
      tissue was UCP-negative and tissue appeared as white adipose tissue, the duration
      of this white-to-brown adipose tissue conversion was analyzed. Mice, cold
      stressed for 1 week, were rewarmed at 28 degrees C and their inguinal adipose
      tissue was analyzed in comparison with interscapular brown adipose tissue and
      epididymal white adipose tissue for another 37 days. During that time inguinal
      adipocytes ceased expressing UCP mRNA; UC-mitochondria in inguinal adipocytes
      were destroyed and replaced with common, C-mitochondria; and UCP was undetectable
      immunohistochemically. Adipocytes accumulated lipids, and the tissue
      morphologically once again resembled white adipose tissue. Described changes
      showed that besides typical brown and white adipose tissue in mice, there existed
      a third type of adipose tissue described as convertible adipose tissue.

PMID- 1747910
TI  - Three-dimensional architecture of the human myosalpinx isthmus. Scanning electron
      microscopy after NaOH digestion and ultrasonic microdissection.
AB  - The three-dimensional architecture of the human isthmic myosalpinx is directly
      visualized by means of scanning electron microscopy after removal of interstitial
      connective tissue through NaOH maceration and ultrasound microdissection. These
      investigations show that the myosalpinx is composed of irregularly running
      bundles of smooth muscle cells, changing their orientation within the myosalpinx
      and displaying longitudinal, oblique and circular directions. The muscular
      bundles anastomose and intermingle with other bundles running at different levels
      in the oviduct wall, and actually give rise to a wide and complex muscular
      network in which no distinct layers are readily discernible. These morphological
      data are consistent with the physiological findings that the transport of gametes
      and embryo in very early stages in the isthmic portion of the oviduct tube is the
      result of a discontinuous pattern of forward and backward movements.

PMID- 1747911
TI  - Immunohistochemical distribution of sulfhydryl oxidase in the human testis.
AB  - Sulfhydryl oxidase (SOx) is an enzyme that catalyzes the oxidation of sulfhydryl
      compounds. It is present in mitochondria of certain testicular cells at specific
      stages of functional activation. In the mature human testis moderate SOx
      immunoreactivity is found in Leydig cells, and lacking in Sertoli and in
      peritubular cells. The Adark spermatogonia usually contain immunoreactive
      mitochondria, while in Apale spermatogonia immunoreactivity is mostly low. In
      stage V of spermatogenesis, Apale spermatogonia were found containing
      immunoreactive material. Leptotene (stages IV and V) and zygotene (stage VI)
      primary spermatocytes display a moderate immunoreaction. It is strongest in
      pachytene spermatocytes of stages I-IV, decreases in stage V, and is low during
      diakinesis and in secondary spermatocytes. Late spermatids usually show a
      stronger immunoreactivity than early spermatids. At stage V of spermatogenesis
      the late spermatids contain only few immunoreactive particles. Spermatozoa are
      free of SOx-immunoreactive mitochondria. In residual bodies small amounts of SOx
      immunoreactive particles are seen. Compared to rat and hamster testis, SOx
      immunoreactivity of the human testis is less clearly stage-dependent and it is
      not confined to certain germ cell stages. As deduced from the findings in
      patients with spermatogenic disorders, the SOx immunoreactivity of spermatogonia
      in human testis seems to be of diagnostic relevance.

PMID- 1747912
TI  - Morphological alteration of gut-associated lymphoid tissue after long-term total
      parenteral nutrition in rats.
AB  - The morphological alteration of gut-associated lymphoid tissue (GALT) induced by
      long-term absence of dietary stimulation was investigated. Male Wistar rats
      weighing approximately 230 g were maintained with total parenteral nutrition
      (TPN). Control rats were allowed to have the same amount of the solution orally.
      After two weeks, the morphological alteration of GALT was examined. Although no
      significant difference in weight gain was noted between the two groups, the area
      comprised by Peyer's patches was decreased in TPN rats. The number of transported
      lymphocytes and the ratio of helper T (Th) cells to suppressor/cytotoxic T (Ts/c)
      cells in intestinal lymph were lowered after TPN treatment. In an
      immunohistochemical study of the rat ileum, the number of T cells and the Th/Ts/c
      ratio were decreased both in the intraepithelial spaces and in the lamina propria
      of TPN rats. The percentage of interleukin-2 receptor-positive cells and the
      number of IgA-containing cells in the lamina propria were significantly reduced
      in TPN rats. These results suggest that dietary stimulation might play a role in
      the maintenance of GALT function and morphology.

PMID- 1747913
TI  - Diversity of ultrastructure in different phenotypes of cultured microvessel
      endothelial cells isolated from bovine corpus luteum.
AB  - Five different types of cultured microvessel endothelial cells defined by use of
      light microscopy and scanning electron microscopy in a preceding study were
      investigated by transmission electron microscopy. Type-1 cells displayed a deep
      invagination of the cell membrane or a single cilium. Granules of low electron
      density were abundant. A perinuclear ring of intermediate filaments occurred.
      Cultures of type-2 cells were subdivided into phenotype A, reminiscent of cell
      type 1, and into phenotype B, assumed to be vascular smooth muscle cells. Many
      highly electron-dense granules appeared in late postconfluent cultures of both
      phenotypes. Cell-type 3 was conspicuous because of a large intracytoplasmic
      vacuole. Lysosomes with curvilinear bodies were found in cell-types 3 and 4. Both
      cell types developed a peripheral regular network of microfilaments. Cell-type 5
      showed vesiculation of the rough endoplasmic reticulum, lipid droplets and a
      peripheral felt-like belt of microfilaments. Tubular forms seen in late
      postconfluent cultures of cell-types 1 to 3 displayed a core of extracellular
      matrix. Pseudotubular forms of cell-type 4 contained apoptotic bodies. Thus, as
      seen at the ultrastructural level, different features are maintained by cultured
      microvessel endothelial cells, suggesting that they have different inherent
      properties.

PMID- 1747914
TI  - Light- and electron microscopy of isolated vestibular hair cells from the guinea
      pig.
AB  - Cells isolated from the guinea-pig vestibular sensory epithelia were studied
      using light- and electron-microscopic techniques. The cells maintained their
      characteristic shapes when they had been separated. Mammalian vestibular cells
      are traditionally divided into two classes, type-I and type-II hair cells. It
      was, however, found that the population of isolated cells consisted of hair cells
      with a striking variability in shape and size. This was most conspicuous for the
      type-I hair cells. Isolated hair cells processed for electron microscopy showed
      that the isolation process caused minor ultrastructural damage but that the
      separation often was incomplete in that the large calyx-like nerve endings were
      still attached to type-I cells. The results suggest that the distinction of only
      two classes might be insufficient to describe mammalian vestibular hair cells.

PMID- 1747915
TI  - Formation of hair follicles from a single-cell suspension of embryonic rat skin
      by a two-step procedure in vitro.
AB  - A technique for culturing skin was devised whereby hair follicles in a normal
      state were generated from a single-cell suspension of embryonic rat skin.
      Dissociated cells obtained by trypsinization of the day-15 embryonic lip were
      cultured by a two-step procedure in vitro. Reorganization of hair-follicle
      rudiments was accompanied by reaggregation of the cells during a 24-hour initial
      culture with rotation, and the rudiments differentiated into hair follicles
      within a week during subsequent subculture of the cell aggregates by floatation.
      The light-microscopic features and the size of the follicles were similar to
      those of day-18 vibrissa follicles during normal development in vivo.
      Furthermore, the stratification of cells, including subcellular differentiation,
      and the ultrastructure of the hair follicles generated in vitro were similar to
      those of normal hair follicles with well-keratinized hair shafts. The present
      system appears to be a useful model for analytical studies in vitro on the
      formation of hair follicles and for studies designed to facilitate the
      transplantation of human hair.

PMID- 1747916
TI  - Anatomical mapping of choline acetyltransferase (ChAT)-like and glutamate
      decarboxylase (GAD)-like immunoreactivity in outer hair cell efferents in adult
      rats.
AB  - The distribution of choline acetyltransferase (ChAT)-like and glutamate
      decarboxylase (GAD)-like immunoreactivity in the cochleae of 15 adult Wistar
      white rats was investigated using the peroxidase-antiperoxidase (PAP) technique.
      A monoclonal antibody to ChAT and a polyclonal antiserum to GAD were used.
      Immunoreaction was investigated quantitatively, in the electron microscope, on
      tangential sections of the tunnel of Corti and the rows of outer hair cells. ChAT
      like and GAD-like immunoreactivity was found in all efferent nerve fibres in the
      tunnel of Corti and in all efferent synapses on the outer hair cells. A
      coexistence of ChAT and GAD in the efferent system to the outer hair cells of the
      rat is therefore assumed.

PMID- 1747917
TI  - Developments and perspectives on the role of cytochrome P450s in chemical
      carcinogenesis.

PMID- 1747918
TI  - Enhanced lipid peroxidation in rat gastric mucosa caused by NaCl.
AB  - The effects of NaCl on lipid peroxidation levels in gastric mucosa and urine were
      investigated in male Wistar rats. The animals were fed NaCl-supplemented diet at
      concentrations of 4.0, 2.0, 1.0, 0.5, 0.25 and 0% (control) for 5 weeks. Further
      groups were maintained on the 4.0 or 0% NaCl diets and simultaneously
      administered 20 p.p.m. indomethacin dissolved in the drinking water. When the
      rats were killed, a dose-related increase of malondialdehyde (MDA) was found in
      both gastric mucosa and urine, the urinary MDA levels clearly correlating with
      those for stomach tissue. Cell proliferation of fundic mucosa was also
      significantly increased in rats fed 4.0 or 2.0% NaCl-supplemented diet.
      Indomethacin suppressed the 4% NaCl-associated MDA increase in both gastric
      mucosa and urine as well as the elevation in cell proliferation. The results
      clearly show that administration of NaCl, a gastric tumor promoter, is associated
      with enhanced lipid peroxidation in the gastric mucosa.

PMID- 1747919
TI  - Benzo[a]pyrene-globin adducts detected by synchronous fluorescence
      spectrophotometry: method development and relation to lung DNA adducts in mice.
AB  - A simple synchronous fluorescence spectrophotometry (SFS) to detect
      benzo[a]pyrene-7,8-diol-9,10-epoxide (BPDE)-globin adducts is described. SFS for
      BPDE-DNA, which measures detached benzo[a]pyrene (B[a]P)-tetrols after acid
      hydrolysis of DNA, was applied for BPDE-globin adducts in B[a]P-treated C57BL/6
      (B6) mice. Unlike DNA samples, globin is not measurable as such after acid
      hydrolysis because proteins give a background in SFS. Furthermore, proteinase
      incubation before acid hydrolysis of globin gave too much background even after
      purification to be useful in this assay. Of several purification procedures tried
      after acid hydrolysis (protein precipitation, elution through Sep-Pak C18,
      filtration, ether extraction of tetrols), the lowest background fluorescence was
      obtained with ether extractions of B[a] moieties. Ether phases were evaporated to
      dryness and the remainder dissolved in distilled water (1 ml), which was measured
      by SFS. Compared to DNA, somewhat milder hydrolysis conditions were optimal for
      globin samples (0.05 M HCl, 1.5 h, + 90 degrees C). Globin samples from B[a]P
      treated mice gave a peak at the same wavelength (345 nm excitation) as the
      hydrolysis products of BPDE-DNA adducts, indicating B[a]P-tetrols and triols in
      the sample. Less than half of B[a]P measured in globin was from covalently bound
      BPDE. In mice injected i.p. with 1-160 mg/kg of B[a]P there was a dose-dependent
      increase in the amount of BPDE adducts in globin and a positive correlation with
      lung and liver DNA. Globin adducts were a more sensitive indicator of B[a]P
      exposure than DNA adducts because more globin can be used for the assay. Although
      both covalently and non-covalently bound BPDE in globin are detected by SFS, this
      method is the simplest described so far, reproducible and theoretically sensitive
      enough for human biomonitoring.

PMID- 1747920
TI  - A three-dimensional molecular template for substrates of human cytochrome P450
      involved in debrisoquine 4-hydroxylation.
AB  - A three-dimensional molecular template has been generated for substrates of human
      debrisoquine 4-hydroxylase cytochrome P450 (CYP2D6). This template defines the
      stereochemical requirements for CYP2D6 substrates in terms of the volume occupied
      and positions of key atoms. The modelling was based on the X-ray crystallographic
      coordinates of the location of the attacked C5 atom of camphor in relation to the
      haem in cytochrome P450 cam. Interactive molecular graphics combined with energy
      calculations were used to identify allowed conformers to superpose known CYP2D6
      substrates to yield a molecular template. This model takes into account the site
      of attack of the known substrates and the requirement for a protonated nitrogen
      atom to interact with an anion site of the protein. A nitrogen-anion distance of
      between 2.5 and 4.5 A was allowed for the interaction. The substrates modelled
      were cardiovascular drugs (debrisoquine, sparteine, guanoxan and perhexiline),
      beta-adrenergic blocking agents (bufuralol and propranolol), tricyclic anti
      depressants (desipramine, amitriptyline and nortriptyline) and other
      miscellaneous compounds (phenformin, methoxy-amphetamine, codeine and
      dextromethorphan). The template generated in this manner was then used to
      determine the likelihood that certain other compounds were substrates for CYP2D6.
      A carcinogenic protein pyrolysate product, 2-amino-1-methyl-6-phenylimidazo[4,5
      b]pyridine (PhIP), did not fit the template and is therefore unlikely to be
      activated by this enzyme. A potent carcinogen in tobacco smoke, 4-(N-methyl-N
      nitrosamino)-1-(3-pyridyl)-1-butanone (NNK), fitted the template but could not be
      modelled to form a favourable nitrogen-anion interaction. Experimental substrate
      competition studies also showed that NNK is unlikely to be a CYP2D6 substrate. It
      was also shown that the widely used drug for treatment of breast cancer, trans-1
      (4-beta-dimethylaminoethoxyphenyl)-,2-diphenyl-1-ene (tamoxifen), did not fit the
      molecular template and is unlikely to be metabolized by CYP2D6. Coordinates of
      the template are available.

PMID- 1747921
TI  - The crystal and molecular structure of ellagic acid dihydrate: a dietary anti
      cancer agent.
AB  - The crystal and molecular structure of ellagic acid dihydrate has been determined
      by X-ray diffraction techniques. This acid inhibits the carcinogenic properties
      of a variety of chemical compounds including benzo[alpha]pyrene-7,8-diol-9,10
      epoxide, aflatoxin B1, N-methyl-N-nitrosourea, 3-methyl-cholanthrene and 7,12
      dimethylbenz[alpha]anthracene. Ellagic acid dihydrate forms triclinic crystals
      with unit cell dimensions: a = 7.656(1) A, b = 9.563(1)A, c = 4.623(1) A, alpha =
      97.88(1) degrees, beta = 103.2(1) degrees, gamma = 102.22(1) degrees, V = 315.9
      A3, space group = P1. There is a center of symmetry in the crystal coinciding
      with the center of the molecule, so that there is only one molecule in the unit
      cell. Ellagic acid is planar and molecules are interconnected by hydrogen bonds
      to water, giving rise to layers of molecules throughout the crystal. Its activity
      and anti-cancer properties are compared with those of a similar naturally
      occurring compound, quercetin.

PMID- 1747922
TI  - Evaluation of the in vivo genotoxicity of the structural analogues 2,6
      diaminotoluene and 2,4-diaminotoluene using the rat micronucleus test and rat
      liver UDS assay.
AB  - The two structural isomers 2,4- and 2,6-diaminotoluene (DAT) differ in their
      carcinogenic properties; the 2,4-isomer is carcinogenic in rats and mice, whereas
      the 2,6-isomer has been reported to be non-carcinogenic. Both isomers were
      reported to be mutagenic in Salmonella typhimurium in the presence of S9, which
      was confirmed in the present study before in vivo assays were commenced. Both
      isomers were tested in the rat bone marrow micronucleus test and the rat liver
      UDS test to investigate how well these assays discriminate between the
      carcinogenic and the non-carcinogenic isomer. In the micronucleus test both
      isomers gave weakly positive results; however, with the carcinogen 2,4-DAT this
      weak effect was only detectable at very toxic doses and therefore the biological
      relevance of this result is questionable. Thus, the micronucleus test did not
      discriminate correctly between the carcinogen and the non-carcinogen. With the
      liver UDS test, discrimination was achieved but the positive effect seen for the
      carcinogenic isomer was weak and dependent on the method of preparation of the
      dosing suspensions. The results are discussed in relation to the carcinogenicity
      data on both compounds. It is concluded that although both isomers are potent
      genotoxins in vitro they exert their genotoxic potential only weakly in vivo and
      convincing discrimination between the carcinogenic and non-carcinogenic isomer
      was not demonstrated.

PMID- 1747923
TI  - Formation of a glutathione conjugate and a semistable transportable glucuronide
      conjugate of N2-oxidized species of 2-amino-1-methyl-6-phenylimidazo[4,5
      b]pyridine (PhIP) in rat liver.
AB  - We have previously shown that 2-hydroxamino-1-methyl-6-phenylimidazo[4,5
      b]pyridine(2-h ydroxamino-PhIP) is the principal metabolite leading to mutations
      in Salmonella typhimurium TA98 and DNA damage in mammalian cells. In rat
      hepatocytes this metabolite can be further conjugated to 2-(N-beta-D
      glucuronopyranosyl (hydroxamino)-1-methyl-6-phenylimidazo[4, 5-b]pyridine[N(OH)
      gluc-PhIP]. Its rate of formation was increased in hepatocytes from
      polychlorinated biphenyl (PCB)-pretreated animals. This metabolite is the main
      metabolite of PhIP in bile and it is hydrolyzed both by human and rat intestinal
      bacteria. Smaller amounts are excreted into urine. The evidence for the proposed
      structure is based on 1H- and 13C-NMR, beta-glucuronidase-lability giving 2
      hydroxamino-PhIP upon hydrolysis and on the results obtained by using biochemical
      enzyme inhibitors. N(OH)-gluc-PhIP may be important for genotoxic lesions and
      tumors of 2-amino-1methyl-6-phenylimidazo [4,5-b]pyridine (PhIP) in extrahepatic
      tissue. In hepatocytes and bile from PCB-pretreated rats a PhIP-glutathione
      conjugate, 2-glutathionyl-1-methyl-6-phenylimidazo[4,5-b]pyridine (GSH-PhIP) was
      also found. The evidence for the proposed structure is based on 1H-NMR and high
      resolution mass spectrometry. The metabolite can also be produced by a direct
      nucleophilic substitution of the nitro group in 2-nitro-PhIP by glutathione (GSH)
      in vitro. The metabolite did not form from 2-hydroxamino-PhIP and GSH either
      directly or in the presence of glutathione S-transferase. The formation of GSH
      PhIP in rat liver and isolated cells only at a high rate of 2-hydroxamino-PhIP
      formation (PCB-treated animals) indicates that 2-nitro-PhIP may be formed in the
      liver during such N-oxidation of PhIP.

PMID- 1747924
TI  - Role of DNA replication in carrier-ligand-specific resistance to platinum
      compounds in L1210 cells.
AB  - L1210 cell lines have been described that are sensitive to most platinum
      compounds (L1210/0), resistant to ethylenediamine (en)-Pt but sensitive to
      diaminocyclohexane (dach)-Pt (L1210/DDP), and resistant to dach-Pt but sensitive
      to en-Pt (L1210/DACH). We have examined the effect of the dach and en carrier
      ligands on the ability of Pt-DNA adducts to inhibit DNA replication. Alkaline
      sucrose gradient sedimentation was used to determine the influence of both
      carrier ligands on the inhibition of replicon initiation and DNA chain
      elongation. Initiation of replicons was inhibited by Pt-DNA adducts to a greater
      extent than chain elongation in all three cell lines. Inhibition of replicon
      initiation was affected by the nature of the platinum carrier ligands only in the
      L1210/DACH cells in which 7.8-fold more dach-Pt adducts than en-Pt adducts were
      required to reach 63% inhibition. However, a strong carrier ligand effect was
      observed on the inhibition of DNA chain elongation in both the L1210/DDP and
      L1210/DACH cell lines. The L1210/DDP cell line required 4-fold more en-Pt adducts
      than dach-Pt adducts to inhibit DNA chain elongation by 63%. In the L1210/DACH
      cell line, 2.7-fold more dach-Pt adducts than en-Pt adducts were required for 63%
      inhibition. The L1210/0 cell line demonstrated no carrier ligand specificity for
      inhibition of chain elongation. Significant replicative bypass of Pt-DNA adducts
      was observed even in the L1210/0 cell line in that greater than 50 Pt-DNA adducts
      per 100 kb were required for 63% inhibition. The same level of inhibition was
      reached with 1.25 adducts of benzo[a]pyrene diolepoxide I per 100 kb. These data
      suggest that L1210 cells are capable of substantial replicative bypass of Pt-DNA
      adducts. Furthermore, the bypass of Pt-DNA adducts is increased in resistant
      L1210 cells and is markedly dependent on the nature of the platinum carrier
      ligand.

PMID- 1747925
TI  - Distribution of cytochrome CYP2E1 in murine liver after ethanol and acetone
      administration.
AB  - The effects of acetone and ethanol administration on cytochrome CYP2E1 in murine
      liver were investigated. A monoclonal antibody (Mab 1-98-1) specific to rat
      ethanol-inducible P450 recognized a major band of Mr 51,000 in Western
      immunoblots of mouse liver microsomes. This band was increased 1.8-fold by 10%
      ethanol in drinking water for 2 weeks, 4.7-fold by 1% acetone in drinking water
      for 1 week, and 2.5-, 2.1- and 6.8-fold by ethanol in a liquid diet for 9 days, 2
      weeks and 3 weeks respectively. Immunohistochemical staining experiments with the
      same antibody showed specific localization in centrilobular regions of liver
      lobules, with variations in intensity that corresponded to differences detected
      in Western immunoblots. Uniform cellular increases in centrilobular staining
      occurred with all ethanol treatments, whereas a more heterogeneous increase in
      individual cells was noted after acetone. Lipid accumulation in hepatocytes was
      pronounced after 3 weeks on the ethanol liquid diet but was less so in other
      treatment groups, and thus did not consistently correlate with enzyme induction.
      Microsomal aniline p-hydroxylase activity was also induced by the acetone and
      ethanol treatments, with a progressive increase from 9 days to 3 weeks on the
      ethanol liquid diet. Changes in this activity in general paralleled those found
      with immunohistochemistry and immunoblotting. The results demonstrate that (i)
      the mouse is a good model for correlative biochemical and histochemical studies
      of CYP2E1 induction, (ii) in the mouse liver, this P450 is preferentially
      localized in centrilobular regions constitutively as well as in induced states,
      (iii) the centrilobular pattern varies under different induction conditions, and
      (iv) there is a progressive inductive increase in CYP2E1 protein and enzyme
      activity with chronic ethanol treatment over at least 3 weeks.

PMID- 1747926
TI  - Glutathione S-transferase mu in human lymphocyte and liver: role in modulating
      formation of carcinogen-derived DNA adducts.
AB  - Glutathione transferase (GT) activity towards trans-stilbene oxide (tSBO),
      benzo[a]pyrene-4,5-oxide (B[a]PO) and 1-chloro-2,4-dinitrobenzene (CDNB) was
      measured in human liver and lymphocytes. GT-tSBO activity is catalyzed by GT mu
      which has polymorphic expression in human lymphocytes. Our results show that
      activity of GT-tSBO in lymphocytes correlates with its activity in liver (r =
      0.7, P less than 0.001). GT activity towards BPO (GT-BPO) also correlated with GT
      tSBO in lymphocytes and liver. However, interindividual variation of GT-BPO is
      less than that of GT-tSBO, suggesting that BPO may not be as specific a substrate
      for GT mu and therefore other GT isozymes may contribute to BPO conjugation.
      Conjugation of CDNB by GT was not different using cytosols from either high or
      low GT mu individuals. The functional significance of the GT-mu polymorphism was
      evaluated by measuring its effect on benzo[a]pyrene (B[a]P)- and aflatoxin B1
      (AFB1)-DNA adduct formation in vitro. Human liver cytosols prepared from persons
      having low or high GT-tSBO activity were incubated with human liver microsomes,
      calf thymus DNA and B[a]P or AFB1. HPLC analysis revealed that the major B[a]P
      adduct was dG(N2)-7 beta, 8 alpha-trihydroxy-7,8,9,10-tetrahydrobenzo[a]pyrene
      (BPDE-dG). BPDE-dG adducts were decreased equally by cytosols from either low or
      high conjugators. In contrast, AFB1-DNA binding was inhibited to a greater extent
      in high conjugators than low conjugators. HPLC analysis demonstrates that adducts
      formed were AFB1-FAPyr and AFB1-N7-Gua. The correlation between AFB1-DNA adduct
      concentrations and GT mu activity was highly significant with a correlation
      coefficient of r = 0.88 at P less than 0.001. These results suggest that GT mu
      plays an important role in detoxifying DNA reactive metabolites of AFB1 and this
      enzyme may be a susceptibility marker for AFB1 related liver cancer. Moreover,
      our data demonstrate that lymphocytes are a reliable surrogate tissue for
      detecting liver GT mu polymorphisms.

PMID- 1747927
TI  - Metabolism of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) by cytochrome
      P450IIB1 in a reconstituted system.
AB  - Several previous studies have suggested that cytochrome P450IIB1 is involved in
      the bioactivation of the tobacco-specific carcinogen, 4-(methylnitrosamino)-1-(3
      pyridyl)-1-butanone (NNK), in rats as well as in mouse lung microsomes. The
      present investigation was undertaken to study the metabolism of NNK by purified
      cytochrome P450IIB1 in a reconstituted system. The metabolites 4-hydroxy-4-(3
      pyridyl) butyric acid (hydroxy acid), 4-oxo-4-(3-pyridyl) butyric acid (keto
      acid), 4-oxo-4-(3-pyridyl) butanol (keto aldehyde), 4-(methylnitrosamino)-1-(3
      pyridyl-N-oxide)-1-butanone (NNK-N-oxide) and 4-oxo-4-(3-pyridyl)-1-butanol (keto
      alcohol) were quantitated by HPLC. The results showed that, in addition to alpha
      hydroxylations, cytochrome P450IIB1 also catalyzed the formation of NNK-N-oxide
      efficiently, and to a certain extent, the conversion of NNK primary hydroxylation
      metabolites (keto aldehyde and keto alcohol) to secondary metabolites (keto acid
      and hydroxy acid). Cytochrome b5 at a ratio of 1:1 or 2:1 to P450IIB1 had no
      significant effect on the metabolic activities and profiles of NNK. The apparent
      Km values for the formation of keto aldehyde, NNK-N-oxide and keto alcohol were
      respectively 191.2, 131.4 and 318.0 microM with corresponding apparent Vmax
      values of 89.7, 295.5 and 333.3 pmol/min/nmol P450, indicating that hydroxylation
      at the alpha-methyl position is preferred over the alpha-methylene position.
      Measurement of formaldehyde, a product derived from the alpha-methyl
      hydroxylation, was developed as a convenient method to study NNK metabolism.
      Thiourea activated cytochrome P450IIB1-catalyzed NNK metabolism significantly.
      Phenethyl isothiocyanate, an inhibitor of NNK-induced lung carcinogenesis,
      inhibited P450IIB1-catalyzed NNK demethylation in a concentration-dependent
      manner. This work demonstrates that purified P450IIB1 can catalyze the conversion
      of NNK to most of its oxidative metabolites.

PMID- 1747928
TI  - 3-Methyladenine mutagenesis under conditions of SOS induction in Escherichia
      coli.
AB  - Under conditions of the induced error-prone SOS response in Escherichia coli, N
      methyl-N-nitrosourea (MNU) was found to produce a majority of mutations at A.T
      base pairs. These mutations included mainly A.T----G.C transitions, followed by
      A.T----T.A transversions and (-1)A.T frameshifts. The possibility that 3
      methyladenine (3-MeAde) significantly contributed to these mutations was
      investigated. MNU mutagenesis under SOS conditions was studied in E. coli strains
      deficient in 3-MeAde-DNA glycosylase I (TagI), which is the major constitutively
      expressed repair enzyme for 3-MeAde. In SOS uninduced cells, the lack of 3-MeAde
      repair did not increase mutagenesis, suggesting that 3-MeAde does not contribute
      to mutagenesis under these conditions. In SOS-induced cells, by contrast, MNU
      induced a 5-fold higher mutation frequency in the TagI-deficient cell strains,
      suggesting that 3-MeAde is indeed an SOS-dependent premutagenic lesion. Although
      3-MeAde is mutagenic under SOS conditions, it is possible that its fast repair in
      repair-proficient cells might result in the loss of the lesion before its
      mutagenic properties could be realized. Hence, the contribution of 3-MeAde to SOS
      dependent mutagenesis in fully repair-proficient cells was also investigated. 3
      MeAde lesions were removed from MNU-treated DNA by the purified TagI protein.
      This prior removal of 3-MeAde had little effect on mutagenesis in SOS-induced or
      SOS-uninduced cells. Thus, in repair-proficient cells, 3-MeAde is efficiently
      removed from DNA and does not contribute in a major way to mutagenesis. These
      results indicate that some other A or T adduct(s) are responsible for the bulk of
      the mutagenesis observed under SOS-induced conditions.

PMID- 1747929
TI  - The effect of dose and enzyme inducers on the metabolism of 2-amino-1-methyl-6
      phenylimidazo[4,5-b]pyridine (PhIP) in rats.
AB  - Male Fischer 344 rats were given a single dose of 0.03-30 mg/kg of [2-14C]2-amino
      1-methyl-6-phenylimidazo[4,5-b]pyridine ([14C]PhIP), the radioactivity in urine
      and feces was determined over 48 h, and the major metabolites were identified and
      quantified. Dose had little effect on the profile of metabolites in the urine but
      did influence the profile in the feces. PhIP was more efficiently metabolized at
      higher doses. In addition, rats were pretreated with Aroclor 1254 (PCB), 3
      methylcholanthrene (MC), phenobarbital (PB), PhIP and corn oil prior to a single
      dose of [14C]PhIP, and compared with a control group receiving [14C]PhIP only.
      The major metabolites in the urine and feces were quantitated for each group, as
      well as PhIP binding to serum proteins, hemoglobin and selected tissues.
      Pretreatment with MC and PCB resulted in an increase in the amount of 4'
      hydroxylation of PhIP and a decrease in the amount of N-hydroxylated metabolites
      in the urine. Pretreatment with PB resulted in an increase in the amount of N
      hydroxylated metabolites, but a decrease in 4'-hydroxylation. Pretreatment with
      either MC or PCB resulted in an increase in PhIP binding to the liver and kidney,
      while reducing the binding in other tissues. Animals pretreated with PhIP showed
      few significant differences from the untreated group, while pretreatment with PB
      in general resulted in a decrease of PhIP binding in tissues.

PMID- 1747930
TI  - Effects of glucose on the formation of PhIP in a model system.
AB  - The effect of glucose on the formation of the food mutagen PhIP (2-amino-1-methyl
      6-phenylimidazo[4,5-b]pyridine) was studied in a model system. When a mixture of
      creatine (0.9 mmol), phenylalanine (0.9 mmol) and glucose (0.45 mmol) was heated
      in diethylene glycol and water (3 ml, 5:1) for 10 min at 180 or 225 degrees C
      several mutagens were produced. Identification by HPLC, UV absorption
      spectroscopy and mass spectrometry revealed the presence of PhIP as well as 2
      amino-3,8-dimethylimidazo[4,5-f]quinoxaline and minor amounts of 2-amino-3,4,8
      trimethylimidazo[4,5-f]quinoxaline. Heating the system without glucose produced
      PhIP as a single mutagen, but in considerably lower amount. An inhibiting effect
      of glucose in high concentrations was demonstrated. When glucose was added in
      more than or equimolar amounts of the other two reactants, the formation of
      mutagens was markedly reduced. Tyrosine heated under the same conditions, with
      creatine and glucose, showed mutagenic activity. However, no PhIP nor any other
      known food mutagen was identified from the tyrosine mixture.

PMID- 1747931
TI  - Antiproliferative effects of the Ca2+/calmodulin antagonist B859-35 and the
      Ca(2+)-channel blocker verapamil on human lung cancer cell lines.
AB  - We have recently demonstrated that the dihydropyridine-derivative B859-35 has a
      selective chemotherapeutic effect on experimentally induced neuroendocrine lung
      tumors in hamsters. These tumors resembled human atypical lung carcinoids
      morphologically and expressed mammalian bombesin, calcitonin and neuron-specific
      enolase. In the hamster model, B859-35 had no antiproliferative effect on
      pulmonary adenomas of Clara cell origin. In this study, we have tested the
      antiproliferative effects of B859-35 and of the Ca(2+)-channel blocker Verapamil
      in vitro on three human lung cancer cell lines. The neuroendocrine cell line NCI
      H727 is derived from a lung carcinoid and expresses mammalian bombesin and
      calcitonin. Two non-neuroendocrine cell lines are derived from peripheral
      pulmonary adenocarcinomas, with line NCI-H322 expressing features of Clara cells
      while line NCI-H358 expresses features of alveolar type II cells. B859-35 was a
      potent antiproliferative agent in the neuroendocrine line NCI-H727 at
      concentrations as low as 0.001 pM, while it inhibited cell proliferation in the
      two other cell lines at concentrations of 100 nM and above. Verapamil inhibited
      cell proliferation in the neuroendocrine line NCI-H727 at concentrations of 1 nM
      and above.

PMID- 1747932
TI  - Comparison of the inactivation of mammalian and bacterial O6-alkylguanine-DNA
      alkyltransferases by O6-benzylguanine and O6-methylguanine.
AB  - The inactivation of human and Escherichia coli O6-alkylguanine-DNA
      alkyltransferase by O6-methylguanine and O6-benzylguanine was compared. When HT29
      cell extracts or E. coli Ada protein were incubated in the presence of 200 microM
      O6-methylguanine for 1 h, alkyltransferase activity was reduced to 44 and 39% of
      control levels respectively. However, under the same conditions O6-benzylguanine
      completely depleted alkyltransferase activity in the extract from human cells but
      had virtually no effect on the Ada protein. Incubation of the HT29 cell
      alkyltransferase with O6-benzyl[3H]guanine resulted in a time-dependent
      production of [3H]guanine. No similar production of [3H]guanine was observed in
      the presence of the Ada protein. In CHO cells transfected with the bacterial ada
      gene (CHO-ada) or the human alkyltransferase cDNA (CHO-MGMT), treatment with 500
      microM O6-methylguanine inhibited both alkyltransferases by greater than 85%. In
      contrast, 2 microM O6-benzylguanine inhibited human alkyltransferase expressed in
      CHO-MGMT cells by greater than 99% though concentrations as high as 25 microM for
      24 h had no inhibitory effects on the bacterial alkyltransferase expressed in CHO
      ada cells. This selective inhibition was also observed in vivo in transgenic mice
      expressing ada in the liver where O6-benzylguanine caused a decrease of only 40%
      in total hepatic alkyltransferase activity compared to 95% in non-transgenic
      mice, consistent with inhibition of only the mammalian alkyltransferase and
      maintenance of bacterial alkyltransferase activity in these animals. Thus, while
      O6-methylguanine at high concentrations inactivates both bacterial and mammalian
      alkyltransferases, O6-benzylguanine is a substrate only for the mammalian protein
      and is unable, perhaps due to steric hindrance, to inhibit the Ada protein.

PMID- 1747933
TI  - Reduction of aberrant crypt formation in the colon of CF1 mice by potential
      chemopreventive agents.
AB  - Carcinogen-induced aberrant crypts (AC) of the colon are a precancerous state
      that leads to malignancy. The inhibition of AC formation by chemopreventive
      agents was evaluated in this study. Colon AC were induced by 1,2
      dimethylhydrazine (DMH) in 3 weeks in CF1 mice. The cecum of the large intestine
      of CF1 mice did not produce more than one AC focus per animal. The effect of DMH
      and that of the inhibitors in this part of the large bowel were essentially
      similar to the vehicle control and inhibitor-only controls. The response of DMH
      treatment in the colorectal portion of the large bowel was found to be different
      from that of the cecum. The DMH treated mice had 13-17 foci per animal in three
      different experiments. The average number of AC per focus was greater than one in
      all three experiments performed. None of the inhibitor-only control animals nor
      the cottonseed oil vehicle control animals developed AC focus in the colorectal
      or the cecal part of the large bowel. The known inhibitor of colon carcinogenesis
      3-butyl-4-hydroxyanisole reduced DMH-induced average AC formation by 10 and 46%
      at 1 and 4 mg per dose, respectively. The inhibitors 2-n-butylthiophene and
      phenylpropylisothiocyanate reduced DMH-induced average AC formation greater than
      34 and greater than 40% respectively. The postulated inhibitor 2-n
      octylthiophene, which is an eight-carbon homolog of 2-n-butylthiophene, similarly
      reduced DMH-induced AC formation. The known colon carcinogenesis inhibitor
      dehydroepiandrosterone, in contrast, has no effect. The inactivity of
      dehydroepiandrosterone to inhibit colon AC formation was attributed to its
      mechanism of inhibitory action, which differs from that of the phenol,
      isothiocyanate and thiophenes. The short duration that is required to produce
      quantifiable results suggests that the reduction of carcinogen-induced AC
      formation may be developed into a useful prescreening assay for potential
      chemopreventive agents against colon cancer.

PMID- 1747934
TI  - S9-mediated metabolism of 1-nitropyrene to a mutagen in Chinese hamster ovary
      cells by ring-oxidation under aerobic conditions and by nitroreduction under
      anaerobic conditions.
AB  - Both nitroreduction and ring-oxidation appear to be important pathways for the in
      vivo metabolic activation of 1-nitropyrene (1-NP), a tumorigenic environmental
      contaminant. Previous studies, however, suggest that ring-oxidation is primarily
      responsible for the S9-mediated mutagenicity of 1-NP in Chinese hamster ovary
      (CHO) cells. In this study, an anaerobic rat liver S9 metabolizing system was
      used to facilitate the nitroreduction of 1-NP to a mutagen in repair-proficient
      CHO-K1-BH4 cells and excision-repair-deficient CHO-UV5 cells, and results using
      this system were compared with those obtained from the aerobic S9 metabolism of 1
      NP. Anaerobic S9 metabolism of 2.5-15 micrograms/ml of 1-NP produced 15 +/- 3
      mutants/10(6) cells/microgram 1-NP/ml with CHO-UV5 cells and 3 +/- 1
      mutants/10(6) cells/microgram 1-NP/ml with CHO-K1-BH4 cells (different at P less
      than 0.001). When the assays were conducted with CHO-K1-BH4 cells, the number of
      mutants produced by 1-NP using aerobic treatment conditions was similar to that
      found using anaerobic conditions. In contrast, the aerobic incubations resulted
      in significantly fewer 1-NP-induced mutants than the anaerobic treatments when
      the assays were conducted with CHO-UV5 cells. Examination of the metabolites
      produced during these incubations indicated that under anaerobic conditions 1-NP
      was efficiently converted to 1-aminopyrene, while aerobic metabolism resulted in
      the formation of 1-NP phenols and dihydrodiols. DNA adduct analysis by 32P
      postlabeling revealed that 1-NP treatment using the anaerobic procedure produced
      CHO-cell adducts by the reduction of 1-NP to N-hydroxy-1-aminopyrene, while
      aerobic incubations resulted in adducts produced by other metabolic pathways,
      probably involving ring-oxidation. These findings indicate that the S9-mediated
      metabolism of 1-NP under anaerobic conditions produces mutations and DNA adducts
      in CHO cells that are the result of nitroreductive metabolism. The results with
      aerobic S9 metabolism were consistent with the previous conclusion that this
      system mediated the mutagenicity of 1-NP in CHO cells mainly through the
      generation of ring-oxidized metabolites. The combination of the anaerobic and
      aerobic S9 metabolism procedures provides a new approach for evaluating the
      mutagenicity of nitropolycyclic aromatic hydrocarbons in mammalian cells.

PMID- 1747935
TI  - All-trans retinoic acid protects against conversion of chemically induced and
      ultraviolet B radiation-induced skin papillomas to carcinomas.
AB  - It is becoming increasingly clear that cutaneous carcinogenesis in murine skin is
      a stepwise process comprising of initiation, promotion and progression. Most of
      the papillomas induced by an initiation-promotion protocol regress, while a few
      of them progress to malignant carcinomas. Progression of benign tumors into
      malignant cancer is critical since the latter lesions are capable of metastatic
      spread and eventual death. Inhibitors of the conversion process are therefore
      likely to be useful as cancer chemopreventive agents. All-trans retinoic acid
      (RA) is a known regulator of cellular proliferation and differentiation, and a
      known inhibitor of tumor promotion in murine skin. In this study we assessed the
      effect of topical application of RA on conversion of benign skin papillomas to
      malignant carcinomas. Papillomas were induced in SENCAR mice by topical
      application of 7,12-dimethylbenz[a]anthracene (DMBA) as tumor initiator followed
      by 12-O-tetradecanoylphorbol-13-acetate (TPA) as tumor promoter. In SKH-1
      hairless mice papillomas were induced by thrice weekly exposure to ultraviolet B
      (UVB) radiation. At 18 (DMBA/TPA group) and 25 (UVB group) weeks papilloma yield
      stabilized and no new tumors developed. Beginning at the 20th week (DMBA/TPA
      group) and at the 27th week (UVB group), malignant conversion was achieved by
      twice weekly topical application of TPA or free radical-generating compounds
      benzoyl peroxide (BPO), 2,2-azobis(2-amidinopropane) (ABP) and tert-butyl
      peroxybenzoate (BPB). Application of RA (10 micrograms/animal) 1 h prior to skin
      application of TPA, BPO, ABP or BPB afforded significant protection (up to 70%)
      only against malignant conversion mediated by free radical-generating compounds
      in both chemically induced and UVB-induced benign skin papillomas. On the other
      hand, preapplication of RA was less effective in the suppression of spontaneous
      malignant conversion in vehicle-treated animals. These results suggest that, in
      addition to their anti-tumor promoting effects, retinoids may also act as anti
      carcinogens by inhibiting the process of malignant conversion induced by free
      radical-generating compounds.

PMID- 1747936
TI  - Analysis of the Ha-ras oncogene in C3H/He mouse liver tumours derived
      spontaneously or induced with diethylnitrosamine or phenobarbitone.
AB  - In a study of the mechanisms involved in the induction of tumours by chemicals,
      the Ha-ras oncogene was analysed in liver tumours induced by the genotoxic
      carcinogen diethylnitrosamine (DEN), or the non-genotoxic agent phenobarbitone
      (PB) in C3H/He mice. Mutations were detected using the polymerase chain reaction
      and oligonucleotide hybridization. Codon 61 mutations were detected in 41% of DEN
      induced tumours (19/46), either in the first base (CG----AT, 12/19), a
      transversion, or the second base (AT----GC, 7/19), a transition. Codon 61
      mutations were also found in 29% of spontaneous tumours (all CG----AT, 6/21) but
      none were detected in PB-induced tumours (0/15) or in normal liver tissue of
      untreated mice (0/30). No mutations were detected at codon 12. Low and variable
      expression of the Ha-ras gene was detected in all liver tissues with moderately
      raised levels (175-200%) in spontaneous, DEN and PB-induced tumours as compared
      to normal liver tissue. The H-ras gene was methylated to some extent in all liver
      tissues, with no discernible difference between the treatments. The frequency of
      the Ha-ras mutation at codon 61 in DEN-induced tumours is greater than in
      spontaneously arising tumours. This increase is not accompanied by any specific
      alteration in the expression or methylation of the gene. Since PB-induced tumours
      do not possess mutations in the Ha-ras gene at codons 12 or 61, the data suggest
      that the non-genotoxic agent PB induces tumours in the C3H/He mouse liver with a
      mechanism distinct from that of spontaneous tumours or those that result from
      treatment with a potent genotoxic carcinogen such as DEN.

PMID- 1747937
TI  - Assessment of the antioxidant/prooxidant status of murine skin following topical
      treatment with 12-O-tetradecanoylphorbol-13-acetate and throughout the ontogeny
      of skin cancer. Part I: Quantitation of superoxide dismutase, catalase,
      glutathione peroxidase and xanthine oxidase.
AB  - The activities of several enzymes involved in reactive oxygen production and
      detoxification were quantified in murine skin during the ontogeny of chemically
      induced skin cancer. Relative to solvent-treated controls, the specific
      activities of epidermal superoxide dismutase (SOD), catalase (CAT) and
      glutathione peroxidase (GPX) were reduced approximately 45, approximately 60 and
      approximately 24% respectively, 24 h after the fourth or tenth topical
      application of 1 microgram of 12-O-tetradecanoylphorbol-13-acetate (TPA) to the
      dorsal skin of SENCAR mice. The specific activity of epidermal xanthine oxidase
      (XO) increased approximately 350% during the same period. SOD and CAT specific
      activities in papillomas and carcinomas generated in an initiation-promotion
      protocol were approximately 15 and approximately 40% respectively of the
      activities measured in age-matched, non-treated mice. CAT and SOD activities were
      also significantly suppressed in the skin adjacent to the papillomas for several
      weeks following the cessation of TPA promotion, but eventually recovered to the
      levels measured in age-matched controls. XO specific activities in papillomas and
      squamous cell carcinomas (SCC) were approximately 85-350% greater than the
      activities determined in skin adjacent to the tumors. The increases in XO and the
      decreases in SOD and CAT activities measured in the tumors were independent of
      continued treatment with TPA, and thus characteristic of the tumor phenotype. GPX
      activities in papillomas were comparable to normal, untreated skin, but reduced
      approximately 22-41% in SCC. Collectively, these studies demonstrate that TPA
      orchestrates changes in the activities of several enzymes involved in reactive
      oxygen metabolism that are characteristic of the papilloma and SCC phenotype.

PMID- 1747938
TI  - Assessment of the antioxidant/prooxidant status of murine skin following topical
      treatment with 12-O-tetradecanoylphorbol-13-acetate and throughout the ontogeny
      of skin cancer. Part II: Quantitation of glutathione and glutathione disulfide.
AB  - Tissue glutathione (GSH) and glutathione disulfide (GSSG) contents were
      quantitated in the skins of female SENCAR mice following the topical application
      of 12-O-tetradecanoylphorbol-13-acetate (TPA), and in the skin tumors generated
      by an initiation-promotion protocol. Total epidermal GSHt (GSH + GSSG) and GSSG
      contents were not reproducibly and significantly altered 0.5, 4 or 24 h after one
      or four topical applications of 1 microgram TPA, relative to the values obtained
      in age-matched, solvent-treated mice. Similar findings held for dermal GSHt at
      all times of analyses, and for dermal GSSG contents 0.5 and 4 h after TPA
      application. However, dermal GSSG contents were slightly elevated 24 h after TPA
      application. The GSHt and GSSG contents of skins initiated with 10 nmol 7,12
      dimethylbenz[a]anthracene (DMBA) and harvested 17, 29 and 37 days after the
      cessation of chronic treatment with acetone (14 weeks, twice a week) were
      comparable to the values measured in age-matched, non-treated skins. In contrast,
      GSHt contents of papillomas harvested 17, 29 and 37 days after the cessation of
      chronic treatment with 1 microgram TPA (14 weeks, twice a week) were 2- to 4-fold
      greater than the values measured in non-treated mice, and DMBA-initiated, acetone
      promoted mice, and the non-tumorous tissue adjacent to the papillomas. Comparable
      changes did not occur in papilloma GSSG contents. GSHt contents in squamous cell
      carcinomas (SCC) were twice the values measured in papillomas and 5- to 8-fold
      greater than the values measured in non-treated skins, and the non-tumorous
      tissue adjacent to SCC. Similarly, GSSG contents in SCC were elevated multifold
      relative to papillomas, non-treated skin and the non-tumorous tissue adjacent to
      SCC. Epidermal cell suspensions prepared by the trypsin-flotation procedure
      retained less than 2% of their original GSHt content and had reduced GSHt/GSSG
      ratios. Collectively these studies suggest that (i) if promoting doses of TPA
      induce oxidative stress in murine epidermis, it cannot be detected by
      measurements of GSH/GSSG; (ii) the antioxidant capacity of epidermal cells
      prepared by the trypsin-flotation procedure is severely compromised; and (iii)
      GSHt contents progressively increase during skin tumor ontogeny.

PMID- 1747939
TI  - Immunochemical localization and functional characterization of cytochrome
      P450IIE1 in rat hepatocyte foci and nodules.
AB  - P450IIE1 was studied in rat hepatocyte foci and nodules from male Wistar rats,
      treated for 7 weeks with N-nitroso-morpholine (20, 40 and 80 mg/ml of drinking
      water). Livers were examined after 15, 23 and 31 weeks. Using specific anti
      P450IIE1 IgG, different phenotypes of P450IIE1-altered foci were observed: (i)
      positive foci, predominant at early times and at the two lower dosages, (ii)
      negative foci and (iii) mixed-type foci consisting of P450IIE1-positive and 
      negative hepatocytes which were preponderant at 31 weeks. Immunoblotting of
      microsomes from livers containing foci and nodules obtained at week 31 of the
      experiment revealed a decrease in P450IIE1 level, which was correlated to
      decreased high affinity dimethylnitrosamine demethylase activity. The results
      suggest phenotypic heterogeneity of P450IIE1-altered foci with predominantly
      negative foci at later stages.

PMID- 1747940
TI  - Characterization of the mouse homolog of the XPBC/ERCC-3 gene implicated in
      xeroderma pigmentosum and Cockayne's syndrome.
AB  - The human XPBC/ERCC-3 DNA repair gene specifically corrects the repair defect of
      xeroderma pigmentosum (XP) complementation group B and rodent repair mutant cell
      lines of group 3. The gene encodes a presumed DNA- and chromatin-binding helicase
      involved in early steps of the excision repair pathway. To study the evolution of
      this gene, its expression in different tissues and stages of development and to
      permit the generation of a mouse model of XP by targeted gene replacement in
      mouse embryonal stem cells, we have isolated the mouse XPBC/ERCC-3 homolog.
      Sequence comparison of the predicted protein revealed a 96% amino acid identity
      with the human gene product. Notably, all postulated functional domains were
      strictly conserved. The mouse XPBC/ERCC-3 promoter is--like its human counterpart
      -devoid of classical promoter elements such as TATA and CAAT boxes and contains
      several conserved segments with unknown function. One of these conserved regions,
      consisting in part of a polypyrimidine track, is also present in the ERCC-1
      promoter. The mouse XPBC/ERCC-3 gene is expressed constitutively at low levels in
      all tissues examined except for testis, where its expression is significantly
      enhanced.

PMID- 1747941
TI  - Incidence of Harvey ras oncogene point mutations and their expression in
      methylbenzylnitrosamine-induced esophageal tumorigenesis.
AB  - Activation of the ras oncogene was investigated in esophageal tumors induced by
      methylbenzylnitrosamine (MBN) in the Sprague-Dawley rat. DNA was extracted from
      grossly visible carcinogen-induced tumors. H-ras and K-ras gene sequences were
      then amplified by the polymerase chain reaction. Point mutations in the ras genes
      were then identified by selective hybridization to allele-specific
      oligonucleotide probes. A guanine to adenine transition at the 35th nucleotide in
      the H-ras coding sequence (GGA to GAA in the 12 codon) was observed in 67% (10 of
      15) of the papillomas examined. This mutation codes for glutamate instead of
      glycine as the 12th amino acid of the ras p21 protein. No other H-ras or K-ras
      mutations were observed. To determine the distribution of this H-ras mutation in
      esophageal tissues, histological sections of MBN-treated esophagi were stained
      with a monoclonal antibody (E184) which selectively recognizes the mutated ras p
      21 with glutamate substituted for glycine as the 12th amino acid. Expression of
      the mutant ras p21 protein was observed in 20% of the squamous papillomas, 13.6%
      of hyperplastic lesions and 10% of dysplastic lesions. Thus, activation of the H
      ras oncogene as a result of guanine to adenine point mutation is a frequent event
      in esophageal tumors induced by MBN, occurring in 67% of squamous papillomas, but
      expression of the corresponding mutant ras p21 protein is observed in a much
      smaller proportion of the tumors in this animal model.

PMID- 1747942
TI  - Comparative metabolism of 7,12-dimethylbenz[a]anthracene by the perfused liver
      and liver microsomal preparations from Sprague-Dawley rats.
AB  - The metabolism of DMBA by microsomes and various cell cultures has been widely
      studied. However, the biotransformation of this compound by intact organs has not
      been well characterized. In order to compare the metabolism of DMBA in the whole
      liver with that in subcellular preparations, we used an in situ single-pass rat
      liver perfusion system and rat liver microsomes. [14C]DMBA was infused into the
      livers of Sprague-Dawley rats during the first 60 min of a 120 min perfusion.
      HPLC analysis of extracts of perfusate samples indicated that DMBA was rapidly
      oxidized in this system to a series of metabolites. The major products were polar
      metabolites including the trans-5,6- and the trans-10,11-dihydrodiols (46%), the
      trans-3,4-dihydrodiol (5%) and the 7-OHM-12-MBA and the 12-OHM-7-MBA metabolites
      (12%) of DMBA. Microsomes prepared from livers of corn oil treated rats were
      incubated with [14C]DMBA for 60 min, then extracted. In the microsomal system the
      major DMBA metabolites were the trans-8,9-dihydrodiol (6%), the 7- and 12
      hydroxymethyl (20%), and the 3- and 4-hydroxy (11%) of DMBA with the more polar
      metabolites and the trans-3,4-dihydrodiol present at lower levels (12 and 3%
      respectively). This is the first report of DMBA metabolism in a whole liver
      preparation and the results are clearly different from those obtained in
      subcellular preparations in our laboratory and in cell culture systems elsewhere.
      These results have important implications for understanding DMBA
      biotransformation in vivo.

PMID- 1747943
TI  - Immunohistochemical localization of glutathione S-transferases alpha, mu, and pi
      in normal tissue and carcinomas from human colon.
AB  - Analysis of the heterogeneity of glutathione S-transferase (GST) isozyme
      expression was carried out by immunohistochemical evaluation of human colon
      biopsy tissue from 30 patients. Using polyclonal antibodies specific for the GST
      alpha, mu and pi families of isozymes, an increased expression of pi was found in
      21/30 carcinoma specimens compared to their pair-matched controls. This isozyme
      was the most prevalent in all colon samples. GST mu was expressed at reduced
      levels in 20/30 carcinoma specimens when compared to normal. GST alpha showed no
      consistent change. Analysis of the immunostaining in different cell types showed
      that the highest intensity stain for all isozymes was in the columnar epithelial
      cells. These cells were primarily responsible for the proportional changes in GST
      pi and mu between carcinoma and normal tissues. In addition, goblet (crypt),
      endothelial and muscle cells stained positively. In the lamina propria,
      lymphocytes and phagocytes stained positively, while fibroblasts, plasma cells
      and leukocytes were negative. Endocrine cells were also negative. The
      differential expression of GST pi and mu, confirming biochemical data, supports
      the potential utility of GST pi as a carcinoma marker.

PMID- 1747944
TI  - Specific reduction of I-compound levels in DNA from spontaneous hepatomas of 22
      24 month old male C3H mice.
AB  - As previously shown by 32P-postlabeling, I-compound levels are reduced in target
      tissue DNA of animals exposed to one of several non-genotoxic hepatocarcinogens,
      e.g. 2,3,7,8-tetrachlorodibenzo-p-dioxin, carbon tetrachloride, peroxisome
      proliferators and choline-devoid diet. I-compound levels are further reduced,
      sometimes to undetectable levels, in chemically induced, transplantable rat
      (Morris) hepatomas and hepatocellular carcinomas induced by peroxisome
      proliferators or choline-devoid diet. The current study investigated I-compounds
      in spontaneous hepatic adenomas of genetically susceptible male C3H mice. DNA
      samples from individual tumors, background livers (non-tumor bearing lobe from
      tumor bearing mouse) and non-tumor bearing normal livers taken from 22-24 month
      old animals were analyzed by 32P-postlabeling. I-compound profiles were
      qualitatively comparable among the three types of tissues. However, levels of
      most I-compounds were 2.6-5.0 times lower in tumors than in background liver and
      non-tumor bearing normal liver. There were virtually no differences between
      background liver and normal liver. Taken together with the previously reported I
      compound deficiency in carcinogen-induced hepatomas, the present observations on
      genetically initiated neoplasms suggest that this phenomenon may play a role in
      hepatocarcinogenesis and maintenance of neoplasia.

PMID- 1747945
TI  - Autoimmunity to a 28-30 kD cell membrane DNA binding protein: occurrence in
      selected sera from patients with SLE and mixed connective tissue disease (MCTD).
AB  - Previous experiments have established the presence of a 30-kD DNA binding protein
      on the surface of human leukocytes. Herein we report that selected sera from
      patients with systemic lupus erythematosus (SLE) and MCTD are reactive with a 28
      30 kD protein on immunoblots of peripheral blood mononuclear cells (PBMC) cell
      membrane preparations; the reactivity is abolished by prior incubation of the
      blot with DNA. Antibodies eluted from the 28-30 kD strip inhibited the binding of
      3H. DNA to human PBMC. An immunomatrix of 28-30 kD reactive immunoglobulins was
      able to extract a 29-kD DNA binding protein from a PBMC cell membrane
      preparation. Flow cytometry experiments confirmed the cell surface IgG reactivity
      of sera with T lymphocytes. Additional experiments indicated that cell surface
      IgG binding was not due to antibodies binding to cell surface DNA, DNA anti-DNA
      immune complexes reacting with a DNA binding protein, anti-histone antibodies or
      anti-Sm antibodies. It is hypothesized that this autoimmune response could be one
      component of an idiotypic network involving anti-DNA antibodies.

PMID- 1747946
TI  - Transforming growth factor-beta 1 in rheumatoid synovial membrane and
      cartilage/pannus junction.
AB  - Transforming growth factor (TGF)-beta has been shown to promote tissue repair and
      have immunosuppressive actions, and has been proposed to have a role in
      rheumatoid arthritis (RA). Using immunohistochemical techniques with rabbit
      F(ab')2 antibodies raised against recombinant human TGF-beta 1, we have detected
      TGF-beta 1 in the synovial tissue and cartilage/pannus junction (CPJ) from 18/18
      patients with RA. TGF-beta 1 was found predominantly in the thickened synovial
      lining layer in RA, but also detected in a perivascular pattern in the synovial
      interstitium as well as in occasional cells in the lymphoid aggregates. At the
      CPJ it was found both in cells at the distinct junction as well as in the
      transitional region of the diffuse fibroblastic zone. The cells staining for TGF
      beta 1 were identified by double immunofluorescence staining as being from the
      monocyte/macrophage series as well as the type B synovial lining cells. TGF-beta
      1 was also detected in the synovial membrane sections from 4/4 patients with
      systemic lupus erythematosus/mixed connective tissue disease and 5/8 patients
      with osteoarthritis, in a similar distribution to that seen in RA, and in the
      lining layer of 1/7 normal synovial membranes. These results add to histological
      evidence confirming that TGF-beta 1 is present in RA synovial cells and those
      from other arthritides. The distributions of TGF-beta 1 in RA synovial membrane
      reflects its known actions, as it can be detected at the CPJ, where it could
      induce repair, and close to activated cells upon which it may exert an
      immunosuppressive action.

PMID- 1747947
TI  - Detection of IL-2 at mRNA and protein levels in synovial infiltrates from
      inflammatory arthropathies using biotinylated oligonucleotide probes in situ.
AB  - A non-radioactive in situ hybridization method for IL-2 mRNA detection based on
      the use of four biotinylated oligonucleotide probes, plus appropriate positive
      and negative control probes was developed and applied to synovial surgical and
      needle biopsies from rheumatoid arthritis (RA), spondyloarthropathy (SpA),
      psoriatic arthritis (PsA) and juvenile chronic arthritis (JCA) patients. In eight
      surgical biopsies (six RA, one SpA, one PsA) this non-radioactive system showed
      similar sensitivity to that of a previously described 32P-labelled probe system,
      and in addition detected IL-2 mRNA in five out of seven biopsies from SpA and PsA
      patients and in two out of two JCA needle biopsies. IL-2 mRNA was found in the
      absence of IL-2 protein in RA biopsies (six surgical, 12 needle), but variable
      amounts of IL-2 protein were detected in six out of seven needle biopsies from
      SpA, PsA and JCA patients, where CD3+ lymphoid infiltrates were present. These
      data suggest differences in IL-2 regulation and expression in RA and non-RA
      inflammatory arthropathies.

PMID- 1747948
TI  - Molecular mimickry between HLA B27 and Yersinia, Salmonella, Shigella and
      Klebsiella within the same region of HLA alpha 1-helix.
AB  - Two new examples of amino acid homology between HLA B27 and microbes triggering
      HLA B27-associated diseases are described. An outer membrane protein YadA
      (Yersinia adhesin, previously called Yop1) of Yersinia enterocolitica and Y.
      pseudotuberculosis shares a linear tetrapeptide with HLA B27. A cationic outer
      membrane protein OmpH of Salmonella typhimurium shares homology with five amino
      acids of HLA B27 in a non-linear fashion. The four amino acids of YadA are also
      notably included in the hexapeptide identical between Klebsiella pneumoniae
      nitrogenase and HLA B27, and three of them occur in the pentapeptide shared by a
      Shigella flexneri protein and HLA B27. Antibodies against synthetic peptides
      including HLA B27 homologues sequences of YadA and OmpH were observed in one
      third of the patients with HLA B27 associated diseases. Antibodies were directed
      against a flanking sequence next to the amino acid sequences shared by arthritis
      triggering microbes and HLA B27. The area of identity in each example of this
      molecular mimicry (Yersinia, Salmonella, Shigella and Klebsiella) is located in
      the same place on the HLA B27 molecule: between amino acids 70 to 78 in the
      variable region of alpha 1-helix. This area of HLA B27 molecule includes sites
      predicted to be important for binding processed antigens.

PMID- 1747949
TI  - Inhibition of autoimmune diabetes in NOD mice with serum from streptococcal
      preparation (OK-432)-injected mice.
AB  - We have recently reported that systemic and chronic administration of recombinant
      tumour necrosis factor alpha (TNF-alpha), as well as streptococcal preparation
      (OK-432), inhibits development of insulin-dependent diabetes mellitus (IDDM) in
      NOD mice and BB rats, models of IDDM. In this study we examined whether serum
      containing endogenous TNF induced by OK-432 injection could inhibit IDDM in NOD
      mice. Treatment twice a week from 4 weeks of age with OK-432-injected mouse
      serum, which contained endogenous TNF (75U), but not IL-1, IL-2 and interferon
      gamma (IFN-gamma) activity, reduced the intensity of insulitis and significantly
      inhibited the cumulative incidence of diabetes by 28 weeks of age in NOD mice, as
      compared with the incidence in non-treated mice (P less than 0.01) and in mice
      treated with control serum (P less than 0.02). This inhibitory effect of the
      serum was diminished, although not significantly, by neutralization of serum TNF
      activity with anti-mouse TNF antibody. In the mice treated with the serum from OK
      432-injected mice, Thy-1.2+ or CD8+ spleen cells decreased (P less than 0.01) and
      surface-Ig+ (S-Ig+) cells increased (P less than 0.05), whereas the proliferative
      response of spleen cells to concanavalin A (P less than 0.01) and
      lipopolysaccharide (P less than 0.05) increased. The results indicate that the
      inhibition by OK-432 treatment of IDDM in NOD mice was partially mediated by
      serum factors including endogenous TNF.

PMID- 1747950
TI  - Regulation of experimental autoimmune uveitis in rats--separation of MHC and non
      MHC gene effects.
AB  - Experimental autoimmune uveitis (EAU) is an organ-specific autoimmune disease and
      has served as a model of certain ocular inflammatory conditions in man. The
      present study was aimed at separating the effects of MHC and non-MHC genes on the
      development of EAU in the rat. EAU-susceptible LEW (RT1l), EAU-resistant WKAH
      (RT1k), and WKAH.1L (RT1l) MHC congenic strain of WKAH background rats were
      immunized with retinal soluble antigen (S-Ag) in Freund's complete adjuvant
      (FCA). LEW rats showed typical EAU, while neither WKAH nor WKAH.1L congenic rats
      developed EAU. However, when an additional i.v. injection of Bordetella pertussis
      was given, all rat strains developed EAU. Furthermore, when immunized with
      peptide M, an 18-mer synthetic peptide, which corresponds to amino acid positions
      303-320 of bovine S-Ag, and given an additional i.v. injection of B. pertussis,
      LEW and WKAH.1L rats developed EAU, whereas WKAH did not. When ACI (RT1avl), BUF
      (RT1b), LEJ (RT1j), W (RT1k), F344 (RT1lvl), BN (RT1n), NIG-III (RT1q), TO
      (RT1t), and SDJ (RT1u) rats were immunized with peptide M or S-Ag and then B.
      pertussis, all strains developed EAU by immunization with S-Ag plus B. pertussis,
      but only F344 and NIG-III developed EAU by immunization with peptide M. These
      findings suggest that susceptibility to EAU in rats is controlled by both MHC and
      non-MHC genes; and that in the absence of B. pertussis adjuvant, the form of
      disease induced by native S-Ag in FCA is governed by non-MHC gene(s). However,
      this effect of non-MHC gene(s) could no longer be observed when the rats were
      also injected with B. pertussis adjuvant at sensitization.

PMID- 1747951
TI  - Suppression of human lymphocyte responses to specific and non-specific stimuli in
      human onchocerciasis.
AB  - Characterization of in vitro lymphocyte responsiveness was performed on selected
      groups of onchocerciasis patients from Sudan and Sierra Leone. These patients
      manifested a very broad range of clinical signs and showed widely divergent
      parasite infection intensities. Lymphocyte proliferative responses to soluble
      Onchocerca volvulus antigen (sAg) were poor in infected persons; mitogen and PPD
      responses were maintained in the normal range in one group of patients from
      southwestern Sudan, but were profoundly depressed in a group from N.E. Sudan.
      Proliferative responses and interferon-gamma (INF-gamma) secretion were very
      significantly depressed in the presence of live microfilariae of O. volvulus or
      secretions/excretions (S/E) from microfilariae (mf) or from female, but not male,
      adult parasites. Lymphocyte responses were maintained near normal when exogenous
      IL-2 was added to these cultures. The results indicate that O. volvulus infection
      and its clinical consequences are not consistently associated with systemic
      deficits in immune responsiveness. However, suppression of lymphocyte reactivity
      by mf and S/E in vitro suggests that direct parasite intervention in host cell
      responses could be taking place in vivo, perhaps at the local microenvironment
      level; mediated by effects on cytokine production.

PMID- 1747952
TI  - Contact sensitivity in the murine oral mucosa. I. An experimental model of
      delayed-type hypersensitivity reactions at mucosal surfaces.
AB  - We have examined in a murine model, the potential of the oral mucosa (OM) to
      serve as inductive and/or expression site(s) of delayed-type hypersensitivity
      (DTH) reactions. The expression of DTH reactions in the murine buccal mucosa was
      studied after topical application of oxazolone or picryl chloride onto the OM of
      animals previously sensitized with either hapten. Irrespective of the site of
      priming (skin or buccal mucosa), inflammatory cells appeared in the OM following
      buccal elicitation with the pertinent hapten. The density of infiltrating cells
      peaked at 24 h after hapten elicitation. Such inflammatory reactions, which
      comprised mainly mononuclear cells at 24 h, were preceded by an early
      inflammatory reaction that developed only in animals previously sensitized at
      skin sites. This early reaction, comprising mainly PMN neutrophils, peaked at 6-8
      h, declined by 8-16 h, and was not observed in mice previously sensitized in the
      buccal mucosa. The 24 h reactions failed to develop in nude mice similarly
      treated, in intact unsensitized mice, as well as in animals sensitized with an
      irrelevant hapten. These reactions could be adoptively transferred to naive
      animals by LN cells but not by serum from sensitized syngeneic donors.
      Furthermore, LN cell suspensions depleted of T cells failed to transfer
      sensitization for subsequent OM DTH. Topical application of contact sensitizing
      haptens onto OM induced priming for subsequent DTH reactions elicited with recall
      antigen applied at a distant skin site or at a local buccal site. These results
      demonstrate that the OM has the capacity to serve both as an inductive and as an
      expression site for T cell-mediated inflammatory reactions, be these expressed or
      induced at local mucosal sites or at remote systemic (skin) sites. This animal
      model should be valuable for studying the regulation of T cell-mediated
      inflammatory responses at mucosal surfaces.

PMID- 1747953
TI  - Restricted specificity of the autoantibody response in Goodpasture's syndrome
      demonstrated by two-dimensional western blotting.
AB  - The autoantigen in Goodpasture's syndrome is known to be contained within the non
      collagenous (NC1) domain of type IV collagen. We have examined the specificity of
      autoantibodies to glomerular basement membrane (GBM) using the technique of 2-D
      electrophoresis followed by Western blotting. Protein stains of 2-D gels of
      collagenase-digested human GBM revealed extensive charge and size heterogeneity.
      Major components were of mol. wt 24-30 kD and 43-56 kD, corresponding to
      monomeric and dimeric subunits of NCl. Western blotting of 2-D gels with IgG from
      patients with anti-GBM disease demonstrated that the most antigenic components
      migrated as cationic 28-kD monomers (pI 10) and similarly charged dimers,
      although other components were recognized less strongly. The mobility of the
      strongly antigenic polypeptides was different to that of the known alpha 1 and
      alpha 2 chains of type IV collagen. Autoantibodies from all 20 patients studied
      showed the same pattern of reactivity, regardless of their clinical features (in
      particular, the presence or absence of pulmonary haemorrhage) or HLA type. A
      monoclonal antibody (P1) to human GBM bound in a similar pattern, particularly
      recognizing the cationic components. 2-D gels of affinity-purified GBM from a P1
      column showed enrichment of the 28-kD monomers, which were recognized by human
      autoantibodies on Western blotting. These results demonstrate that the autoimmune
      response in Goodpasture's syndrome is of restricted specificity, and support the
      suggestion that the major autoantigenic determinant is present on the novel alpha
      3 chain of type IV collagen.

PMID- 1747954
TI  - Vascular deposition of complement-split products in kidney allografts with cell
      mediated rejection.
AB  - Complement activation in 73 renal transplant biopsies was investigated by
      indirect immunoperoxidase staining using MoAbs reactive with complement-split
      products. Intense deposition of complement fragments C4d and C3d in peritubular
      capillaries, indicating activation of the classical pathway, could be detected in
      the majority of transplanted kidneys with cell-mediated rejections. Abundant
      deposition of complement-split products was observed in 22 early biopsies from
      patients with high 'immunological risk' (i.e. previous, rejected transplants
      and/or circulating antibodies against HLA-antigens). Despite negative results in
      the crossmatch before transplantation and paucity of immunoglobulins in
      transplant biopsies, antibodies directed against endothelial cell antigens should
      be considered as a possible cause of classical complement activation.

PMID- 1747955
TI  - Surface charge distribution is a determinant of antigen deposition in the renal
      glomerulus: studies employing 'charge-hybrid' molecules.
AB  - The deposition of antigens and immune complexes (IC) in the renal glomerulus is
      charge-dependent. The demonstration that molecules of net anionic charge, but
      with discrete positively charged regions, exhibit affinity for the glomerular
      basement membrane (GBM) extends this concept. Charge hybrid (polar) molecules
      were constructed by covalently coupling small polycations (lysozyme or linear
      poly-L-lysine chains with a mean of 17 and 20 residues) to larger polyanions
      (ovalbumin or human serum albumin (HSA]. Although the products were of overall
      net anionic charge they still bound to glomerular structures. Immunofluorescence
      studies performed after i.v. injection of the samples into rats revealed that
      HSA:poly-L-lysine had the highest affinity. Radioisotopic measurements showed
      uptake of HSA:poly-L-lysine to be a function of the number of lysine residues;
      binding of HSA:poly-L-lysine20 was 2.5 times higher than HSA:poly-L-lysine17 (P
      less than 0.01). Prior injection of a small competing polycation
      (polyethyleneimine 1200) reduced uptake of HSA:poly-L-lysine by 75%, indicating
      the charge-based nature of the interaction. HSA:poly-L-lysine20 alone was
      effectively eliminated from the glomeruli within 72 h. Administration of HSA:poly
      L-lysine followed by anti-HSA antibody induced immune complex formation in the
      capillary wall, giving rise to a granular immunofluorescence pattern and discrete
      subendothelial and subepithelial deposits. Molecules with polar structure do
      occur naturally and may contribute to immune complex formation in
      glomerulonephritis.

PMID- 1747956
TI  - Autoantibodies against Forssman glycolipids in Graves' disease and Hashimoto's
      thyroiditis.
AB  - Sera from patients with Graves' disease and Hashimoto's thyroiditis have been
      shown to react with the Forssman glycolipid antigen (Gb5) using the techniques of
      high performance thin-layer chromatography (HPTLC) immunostaining and ELISA.
      Human monoclonal antibodies (MoAbs) have been prepared by fusion of human myeloma
      with peripheral lymphocytes from patients with Graves' disease. A MoAb, TRMo-4,
      reacted strongly and specifically with Gb5. These results suggest that anti
      Forssman antibody may be involved in the pathogenesis of these autoimmune
      diseases. The detection of anti-Forssman glycolipid antibody may provide a useful
      means for clinical diagnosis and therapy.

PMID- 1747957
TI  - Normal and sarcoid alveolar macrophages differ in their ability to present
      antigen and to cluster with autologous lymphocytes.
AB  - Human bronchoalveolar macrophages from normal individuals function poorly as
      accessory cells for the presentation of common recall antigens. In sarcoidosis,
      alveolar macrophages (AM) are reported to be effective accessory cells for the
      presentation of such antigens. In this study normal and sarcoid AM were compared
      with blood monocytes for their ability to act as accessory cells in presenting
      tuberculin purified protein derivative (PPD) and streptokinase-streptodornase
      (SKSD) to autologous T lymphocytes, or to form spontaneous, antigen- or mitogen
      induced clusters with the T cells. When compared to autologous monocytes, normal
      AM failed to present the two recall antigens effectively. Likewise normal AM
      formed very few clusters with T lymphocytes when compared to monocytes, even in
      the presence of antigens or the mitogen phytohaemagglutinin (PHA). In contrast,
      sarcoid AM presented both antigens as effectively, and were equally effective as
      monocytes in forming clusters with T lymphocytes, spontaneously and in further
      response to antigen or mitogen. The results suggest that in sarcoidosis enhanced
      accessory cell function and enhanced cluster formation may be related features of
      bronchoalveolar macrophage populations.

PMID- 1747958
TI  - Cytotoxicity against human peripheral blood mononuclear cells and T cell lines
      mediated by anti-T cell immunotoxins in the absence of added potentiator.
AB  - Several in vitro assays have indicated that anti-T cell immunotoxins (IT),
      composed of monoclonal antibodies (MoAbs) conjugated to ricin A chain (RTA), are
      maximally effective against T cells only in the presence of potentiators. It was
      thought that such IT might not be sufficiently cytotoxic to deplete T cells in
      vivo upon administration to patients. Therefore, we have re-evaluated the in
      vitro assays and report herein that even with a short exposure time (2 h), the
      two anti-T cell IT, H65-RTA (anti-CD5 MoAb coupled to RTA) and 4MRTA (anti-CD7
      MoAb coupled to RTA30), were specifically cytotoxic for peripheral blood
      mononuclear cells (PBMC) in the absence of potentiators. Moreover, as has been
      reported for IT when tested against T cell lines, prolonging the exposure time of
      the IT with PBMC from 2 h to as long as 90 h, without added potentiators,
      enhanced their cytotoxicity from 2- to 40-fold. In contrast, most T cell lines
      were more sensitive to IT in the presence of potentiator, and IT cytotoxicity was
      much less enhanced by prolonging the exposure time. Thus, T cell lines may not
      serve as accurate models to determine the efficacy of IT against PBMC in vitro or
      in vivo. We conclude that IT-induced cytotoxicity of PBMC can be demonstrated in
      vitro at pharmacologically achievable concentrations in the absence of added
      potentiators.

PMID- 1747959
TI  - Immunochemical characterization of human antibodies to lymphoblastoid interferon.
AB  - Antibodies produced in recurrent respiratory papillomatosis (RRP) patients
      treated with lymphoblastoid interferon (lyIFN) may neutralize antiviral activity
      or may only bind to lyIFN. These antibodies were characterized for immunoglobulin
      class, IgG subclass, and light chain type by an indirect immunoassay. Serum
      dilutions were incubated on lyIFN-coated plates and the presence of antibody
      detected using peroxidase-conjugated goat antibodies to each human immunoglobulin
      class and light chain isotype, or using MoAbs to each human IgG subclass.
      Neutralizing activity was measured as the inhibition of lyIFN antiviral activity
      for Vervet monkey cells challenged with Semliki Forest Virus. Among antibody
      positive patients, 12% produced IgM coincident with IgG, and 25% produced IgA
      coincident with IgG. Thus, antibody responses in patients treated with lyIFN are
      not exclusively of IgG class. The predominant lyIFN-specific subclasses were IgG1
      and IgG3, which occurred in 70% and 83% of patients, respectively. An IgG4
      response was detected in two patients who also had antibody of other isotypes; no
      IgG2 antibody was detected in any patient. Antibodies were not IgG subclass
      restricted, a trend which was more pronounced in patients having neutralizing
      antibody than non-neutralizing antibody. Light chain molecules of lyIFN-specific
      antibody were of both kappa and lambda isotypes, with kappa chains occurring most
      frequently. Among patients having non-neutralizing antibodies, monotypic light
      chains occurred in 65% of the patients, whereas no patient with neutralizing
      antibody had monotypic light chain antibody. Sera from 599 normal human
      volunteers were assayed for antibody, and seven were found to be immunoreactive
      to lyIFN. Only one serum of the seven was positive for neutralizing activity.

PMID- 1747960
TI  - Inhibition of immune reactions in vivo by liposome associated transforming growth
      factor (TGF) type beta 1.
AB  - In view of its potent inhibitory capacity on immune cells in culture, we wished
      to determine the ability of transforming growth factor (TGF) beta 1 to down
      regulate immune responses in vivo. Preliminary experiments suggested that, at the
      doses used, systemic injection of soluble TGF beta 1 could not affect bacterial
      induced spleen enlargement in mice. Therefore, we sought to utilize a
      physiochemical property of this molecule, namely its high pI, to determine
      possible association between the ligand and preformed liposomes possessing an
      opposite charge. TGF beta 1 was preferentially associated with negatively
      charged, but not with neutral, liposomes. These TGF beta 1 associated liposomes
      were able to deliver a suppressive signal to indicator cells in vitro.
      Intravenous injection of TGF beta 1, associated with liposomes possessing an
      opposite charge, into mice immunized with heat-killed Corynebacterium parvum
      significantly reduced the size of the spleen as well as the number of
      splenocytes. Systemically administered TGF beta 1 associated liposomes could also
      inhibit delayed type hypersensitivity reactions to Listeria monocytogenes. These
      data suggest that appropriately administered, TGF beta 1 can inhibit immune
      responses in vivo.

PMID- 1747961
TI  - Extracellular organelles (prostasomes) are immunosuppressive components of human
      semen.
AB  - Numerous reports have ascribed immunosuppressive activity to human seminal plasma
      and there is growing agreement that much of this activity can be accounted for by
      the very high levels of E series prostaglandins present (up to 300 microM 19
      hydroxy prostaglandin E). However not all suppressive activity is due to
      prostaglandin since several reports have appeared of high molecular weight active
      substances and we have found that stripped seminal plasma is still effective in
      inhibiting the mitogen-induced proliferation of lymphocytes. In this study such
      immunosuppressive activity has been separated by molecular size fractionation and
      the activity has been found to be particulate and corresponded to the previously
      reported prostasomes. These are trilaminar to multilaminar vesicles (150 nm
      diameter) which are secreted by the prostate. Pure preparations of prostasomes
      inhibited mitogen-induced lymphoproliferation in a dose-dependent manner with a
      concentration of prostasomes equivalent to 40% of that seen in seminal fluid
      giving 69% suppression of thymidine incorporation. The suppressive activity
      survived boiling and therefore was unlikely to be due to enzymatic action
      associated with these organelles. Interaction with the accessory cells, involved
      in full development of the lymphoproliferation induced by mitogen, was indicated
      and this possibility was supported by the demonstration of a direct effect of
      prostasomes on macrophage function using a mouse macrophage cell line. The
      prostasomes in semen may play a complementary role to the prostaglandins in
      neutralizing the immune defences of the female reproductive tract. This
      combination would allow the alloantigenic spermatozoa the best chance of
      achieving fertilization, but at the same time leave the recipient open to any
      infection present in the semen.

PMID- 1747962
TI  - Transesophageal ultrasound: "invasive" noninvasive cardiology.

PMID- 1747963
TI  - Perspectives on therapeutic interventions in patients with acute myocardial
      infarction: viewpoints after the GISSI-2 results.

PMID- 1747964
TI  - Ambulatory blood pressure monitoring in clinical practice.
AB  - Ambulatory blood pressure monitoring provides a more reliable estimate of blood
      pressure and its diurnal variability than casual blood pressure measurement.
      However, the data supporting the link between cardiovascular risk and blood
      pressure are based almost entirely on casual, or office-based, blood pressure
      readings, and this form of measurement continues to be the primary factor in
      clinical decision making. In recent years, compelling evidence from research
      centers around the world has shown that ambulatory blood pressure measurements
      correlate more closely with the target organ complications of hypertension and
      predictions of future cardiovascular events than either casual office or home
      blood pressure measurements. Improvements in the technology have resulted in
      ambulatory blood pressure monitors that are increasingly accurate and
      unobtrusive. As evidence supporting its use continues to mount, the role of
      ambulatory blood pressure monitoring in clinical medicine can be expected to
      increase significantly.

PMID- 1747965
TI  - Silent myocardial ischemia after percutaneous transluminal coronary angioplasty
      and its prognostic significance.
AB  - A cohort of 175 patients who underwent successful percutaneous transluminal
      coronary angioplasty (PTCA) were subjected to a treadmill exercise test to
      determine the prognostic significance of silent and symptomatic myocardial
      ischemia during the follow-up (average 11.7 months). The cardiac events during
      the follow-up were defined as cardiac death, nonfatal myocardial infarction,
      class III angina, and need for repeat angioplasty or coronary artery bypass
      surgery. During exercise, 39 patients (22%) had abnormal exercise-induced ST
      depression without chest pain (Group I). A group of 22 patients (13%) had both
      exercise-induced chest pain and ST-segment depression (Group II), and 114
      patients (65%) had normal exercise test and no chest pain (Group III). The groups
      were similar in sex distribution, history of previous myocardial infarction,
      distribution of vessel disease, and presence of left ventricular dysfunction.
      Group III included more patients with complete revascularization. Follow-up data
      revealed that cardiac event rates in Groups I and II were significantly higher
      than in Group III (41%, 41%, vs. 16%) (p less than 0.01). The event rates in
      Groups I and II with multivessel angioplasty also were significantly higher than
      in Group III (58%, 61%, vs. 21%) (p less than 0.01). Exercise-induced silent
      myocardial ischemia is frequently seen early after successful PTCA and is more
      prevalent in patients undergoing multivessel angioplasty and incomplete
      revascularization. Both silent and symptomatic ischemia early after PTCA are
      predictors of an unfavorable prognosis.

PMID- 1747966
TI  - Changes in arterial levels and myocardial metabolism of catecholamines during
      pacing-induced angina pectoris.
AB  - In order to elucidate the effects of atrial pacing on cardiac catecholamine
      metabolism, 11 patients were studied during cardiac catheterization. Blood
      samples were drawn from a peripheral artery and the coronary sinus for estimation
      of catecholamine concentrations. Heart rate was increased by 10 beats/min each
      minute, and all patients experienced chest pain at maximal pacing rate. Coronary
      sinus blood flow rose from 122 +/- 19 at rest to 208 +/- 25 ml/min at final
      pacing rate, and myocardial lactate extraction ratio decreased. There was no
      significant change in arterial epinephrine levels, whereas the extraction ratio
      decreased (p less than 0.05). The norepinephrine arterial levels increased at the
      final pacing rate (p less than 0.01). The calculated myocardial release increased
      as well, but not to a statistically significant degree. The exact mechanisms of
      the rise in sympathetic activity and arterial norepinephrine levels cannot be
      ascertained with the present study design. Myocardial ischemia with subsequent
      chest pain seems to be a probably cause for the increased sympathetic outflow.

PMID- 1747967
TI  - Global and regional abnormalities of left ventricular diastolic filling in
      hypertrophic cardiomyopathy.
AB  - Left ventricular diastolic filling was studied by left ventriculography in 17
      patients with hypertrophic cardiomyopathy (HCM). In 8 patients this manifested as
      a spadelike shape (HCM-S type) on the left ventriculogram, and in 9 patients as a
      banana shape (HCM-B type). Seven patients were studied as controls. Left
      ventricular end-diastolic pressure was higher in HCM than in controls. In HCM,
      peak filling rate was decreased from 1.57 +/- 0.28 of the control to 1.28 +/-
      0.20 (p less than 0.05), and the time to peak filling rate was prolonged from 27
      +/- 6%DT of the control to 37 +/- 7%DT (p less than 0.01). Serial volume analysis
      in diastole showed filling fraction was also significantly decreased to 8.2 +/-
      4.1 (p less than 0.001) at the 25% diastole time and 29.6 +/- 7.2 (p less than
      0.01) at half time, compared with 19.8 +/- 6.3 and 32.8 +/- 5.8 for controls,
      respectively. In HCM-S type, the rate of distention of left ventricular radial
      axes at the apical area was lower at early and mid-diastole. In HCM-B type, the
      rate at the basal area was lower at early and mid-diastole. Results suggest that
      the left ventricular diastolic filling in HCM was impaired not uniformly but
      regionally in the hypertrophic area at early and mid-diastole.

PMID- 1747968
TI  - Effects of atrioventricular block on ventricular fibrillation threshold in dog.
AB  - The effects of complete atrioventricular block (CAVB) on ventricular
      vulnerability were studied 1 week after a transcatheter electrical ablation of
      the AV junction in 18 closed-chest dogs. All dogs exhibited CAVB and a stable
      ventricular escape rhythm with a mean cycle length of 1795 +/- 600 ms. Although
      QT interval during CAVB was significantly prolonged compared with that during the
      sinus rhythm, QTc interval was significantly shortened. The ventricular
      fibrillation threshold was significantly elevated after creation of the block
      (from 9.35 +/- 2.28 to 12.3 +/- 3.69 mA, p less than 0.01). Thus, CAVB which is
      not associated with QTc prolongation would be even less likely to play an
      important role in producing ventricular fibrillation presumably including
      torsades de pointes or polymorphous ventricular tachycardia.

PMID- 1747969
TI  - The atrioventricular plane displacement as a means of evaluating left ventricular
      systolic function in acute myocardial infarction.
AB  - Displacement of the atrioventricular (AV) plane toward the cardiac apex in
      systole was studied quantitatively by echocardiography in 37 patients with first
      time acute myocardial infarction (MI) in order to evaluate left ventricular
      systolic function. The amplitude of AV plane displacement was recorded from the
      apex at four different sites corresponding to the septal, lateral, anterior, and
      posterior walls of the left ventricle from apical 4- and 2-chamber views. The
      patients had a decreased displacement of the AV plane compared with controls
      which was more pronounced at the sites of infarction. The mean value of the AV
      plane displacement (AV mean) correlated linearly with the left ventricular (LV)
      ejection fraction calculated by radionuclide angiography (r = 0.87, p less than
      0.001, SEE = 6.2). An AV mean of 10 mm or more had a high sensitivity (95%) and
      specificity (82%) in defining a normal ejection fraction (greater than or equal
      to 50%). A high correlation coefficient was found between LV wall motion index
      and the AV plane displacement. Thus, in acute MI the LV function can be assessed
      noninvasively using AV plane displacement.

PMID- 1747970
TI  - High-energy catheter ablation of cardiac arrhythmias: an outmoded technique in
      the 1990s.
AB  - Catheter ablation has become an accepted technique for creating complete heart
      block in patients with drug refractory supraventricular tachycardias. However, it
      remains experimental for other indications, such as ablation of accessory pathway
      or ventricular tachycardia. The use of high energy defibrillator discharges is
      associated with adverse effects which greatly contribute to the limitations of
      the technique. Advances in technology have led to newer methods, such as
      radiofrequency and low energy capacitive discharge, which hold significant
      advantages over the conventional high energy technique, to the extent that the
      use of defibrillator discharges should now be considered outmoded and potentially
      damaging. Radiofrequency is the technique of choice for accessory pathway
      ablation and modification of AV conduction, and low energy capacitive discharge
      is the preferred method for creation of complete heart block. There are currently
      no acceptably safe and efficacious catheter techniques for treating ventricular
      tachycardia, and more research needs to be done in this area. The potential for
      the success of these techniques depends to an extent on the creation of new
      standards of practice for catheter ablation. There has been no unbiased
      comparative assessment of the different techniques, and consequently no consensus
      exists on the preferred technique and technologies which should be used. Only
      within the framework of these standards can the technique achieve significant
      clinical utility.

PMID- 1747971
TI  - Improved diagnosis and characterization of postinfarction left ventricular
      pseudoaneurysm by cardiac magnetic resonance imaging.
AB  - A patient with a ruptured left ventricular pseudoaneurysm complicating an acute
      posteroinferior myocardial infarction is described. Left ventricular
      pseudoaneurysms are a rare complication of acute myocardial infarction, usually
      occurring with inferior and/or posterior infarction. In contrast to true
      aneurysms, pseudoaneurysms are much more likely to rupture, regardless of size,
      causing hemopericardium and death. Therefore, once the diagnosis has been
      confirmed, prompt surgical resection is the current accepted treatment. The most
      accurate noninvasive diagnostic method has been echocardiography, with recent
      reports suggesting improved diagnosis with color flow Doppler echocardiography.
      Ventriculography confirms the diagnosis with more accurate anatomic detail, but
      is an invasive procedure. In our patient, two-dimensional and color Doppler
      echocardiography could not demonstrate the suspected pseudoaneurysm, which was
      demonstrated by ventriculography. However, magnetic resonance imaging (MRI)
      demonstrated the pseudoaneurysm, showing detailed anatomy not obvious on
      ventriculography. Before surgery could be performed, the patient died and was
      autopsied. Heart sections corresponding to MRI planes confirmed the MRI findings.
      A review of the literature has revealed no similar reports using MRI in the
      diagnosis of postinfarction pseudoaneurysms. Major advantages of MRI are
      generation of three-dimensional soft tissue images noninvasively, and generation
      of tissue contrast by rapid imaging sequences, obviating the need for contrast
      injection. Major disadvantages of MRI are the high cost of instrumentation,
      nonportability, and a requirement for patient immobility during the study. In
      cases of suspected pseudoaneurysm with equivocal echocardiography findings, MRI
      could provide early diagnosis, leading to early surgical intervention and
      increased patient survival.

PMID- 1747972
TI  - Thrombolytic therapy in spontaneous coronary artery dissection.
AB  - A 42-year-old female with no cardiac risk factors had an acute anterolateral
      myocardial infarction treated with intravenous (IV) tissue plasminogen activator
      (t-PA). Selective coronary cineangiography a week later revealed extensive
      dissection of the left anterior descending coronary artery (LAD) and its second
      diagonal branch. Sixteen months later, she is asymptomatic. This is the fifth
      reported case of spontaneous coronary artery dissection treated with thrombolytic
      therapy during the acute event with uneventful recovery.

PMID- 1747973
TI  - Thrombolytic therapy in acute myocardial infarction following prolonged
      cardiopulmonary resuscitation.
AB  - Thrombolytic therapy was administered to a 49-year-old woman with an acute
      anterior wall myocardial infarction after having prolonged cardiopulmonary
      resuscitation for 13 minutes. On admission, there was no clinical or radiographic
      evidence of gross trauma. There was no significant morbidity and the patient
      recovered to a completely functional status. The literature of thrombolytic
      therapy after cardiopulmonary resuscitation is reviewed. In the absence of gross
      trauma from cardiopulmonary resuscitation, thrombolytic therapy in acute
      myocardial infarction should not necessarily be excluded because of the duration
      of resuscitation. Further experience with such patients will shed additional
      light on efficacy and safety.

PMID- 1747974
TI  - Paul Dudley White: the father of American cardiology.

PMID- 1747975
TI  - Ingestion of fluoride from dentifrices by children aged 12 to 24 months.
AB  - The increase of dental fluorosis is largely imputable to the ingestion of dietary
      fluoride supplements and fluoride toothpastes. However, the toothbrushing habits
      of very young children is poorly documented. The purpose of this pilot study was
      to determine the toothbrushing habits of 12- to 24-month-old children and to
      estimate the quantity of fluoride ingested during toothbrushing. Fifty-nine
      parents completed a questionnaire regarding the toothcleaning habits of their
      children. When a dentifrice was used, a dental hygienist scheduled a meeting with
      the parents in order to observe and measure the amount of toothpaste used. Of the
      36 parents who cleaned the teeth of their children, 69% used a toothpaste.
      Furthermore 20% of the children ingested more than 0.25 mg of fluoride per day by
      toothbrushing alone. Therefore the practice of toothbrushing and the use of
      fluoridated dentifrices are widespread among 12- to 24-month old children, and
      the amount of fluoride ingested from toothpaste could constitute a substantial
      proportion of the total daily intake of fluoride. Several measures are suggested
      to enhance the safe use of fluoride dentifrices.

PMID- 1747976
TI  - Neonatal vein of Galen malformations: experience in developing a
      multidisciplinary approach using an embolization treatment protocol.
AB  - A multidisciplinary team approach using a staged transcatheter embolization and
      neurosurgical protocol was applied to 22 patients with neonatal presentation of
      vein of Galen malformations over a 12 year period. Aggressive medical therapy was
      combined with interventions including: ventricular shunting, transcatheter
      embolization, retrograde transtorcular embolization, and neurosurgical
      obliteration. There was a high frequency of high output cardiac failure, multiple
      organ system dysfunction, seizures, hydrocephalus, visual, developmental and
      neurological disability. Of the first 11 patients, five survived; four with
      seizures and three with marked retardation. Of the last 11 patients, six
      survived; five with seizures but only one with retardation. Despite persistently
      high morbidity and mortality, our continuously evolving protocol offers these
      otherwise hopeless patients some chance of survival.

PMID- 1747977
TI  - Normal and pathologic laughter in children.
AB  - Laughter is a partly involuntary act involving complex pathways in the central
      nervous system. Laughter normally has positive effects on emotions; however,
      pathologic laughter is not related to emotion and occurs independent of a
      stimulus in the environment. This paper outlines normal laughter and the etiology
      of pathologic laughter, considering both congenital and acquired causes.

PMID- 1747978
TI  - Polyuria in childhood.
AB  - Polyuria may result from either a water or a solute diuresis. Although the
      history and physical examination may provide clues to the cause of the polyuria,
      the definitive diagnosis requires laboratory tests which focus on the osmolality
      of the urine and serum in combination with the urine volume and the rate of
      excretion of osmoles. An isoosmolar or hyperosmolar urine is found in children
      with a solute diuresis or in normal children, whereas a hypoosmolar urine is
      found in children with a water diuresis. In the latter case, a low serum
      osmolality suggests primary polydipsia whereas a high serum osmolality suggests
      antidiuretic hormone (ADH) deficiency or insensitivity. A water deprivation test
      is necessary when the initial evaluation fails to establish the cause of
      polyuria. A vasopressin test enables the differentiation between neurogenic and
      nephrogenic diabetes insipidus (DI).

PMID- 1747979
TI  - Parental request for a "drug test": what should the caring pediatrician do?

PMID- 1747981
TI  - Early meningitis.

PMID- 1747980
TI  - Congenital complete arterio-ventricular block with aneurysms of the ascending
      aorta and main pulmonary artery.

PMID- 1747983
TI  - Smoking cessation.

PMID- 1747982
TI  - Cigarettes and cigarette smoking.
AB  - Tobacco use was widespread in the New World by the time of the first voyage of
      Columbus; however, it is only in the last century that the use of tobacco as
      cigarettes has been prevalent. The milder tobacco and more acidic smoke of
      cigarettes lead to the deeper inhalation of tobacco into the lung with resultant
      deposition and absorption of the addicting, toxic, and carcinogenic components of
      the smoke. More than 4000 individual constituents have been identified in
      cigarette smoke, and the relative concentrations of these constituents vary
      widely between brands of cigarettes. Tar yield, a measure of the total
      particulate matter of the smoke, varies markedly with the characteristics of the
      cigarette manufacture and with the pattern of inhalation. As a result, tar is not
      a good measure of the dose of toxic or carcinogenic agents received by the
      individual smoker. The particle size of cigarette smoke is in the range that will
      lead to deposition in the airways and alveoli of the lung, and many of the gas
      phase constituents are absorbed across the alveolar capillary membrane. The
      irritant agents in the smoke cause acute and chronic changes in lung structure
      and function that may result in greater retention of carcinogens within the lung
      and increased vulnerability of the lung to the effects of these carcinogens.
      Carcinogens and other constituents of cigarette smoke are also absorbed into the
      blood and metabolized to active forms through microsomal enzyme systems induced
      by cigarette smoke. The cellular influx of neutrophils and alveolar macrophages
      that is part of the inflammatory response may be the precursor of the alveolar
      wall destruction that results in emphysema. The prevalence of smoking is not
      uniformly distributed across the population. Men began smoking in large numbers
      very early in the century, but women began to smoke in large number only at the
      time of the Second World War. Men born after 1930 have been less likely to take
      up smoking than their older counterparts. The prevalence of smoking is currently
      declining in both men and women.

PMID- 1747984
TI  - Health effects of cigarette smoking.
AB  - Cigarette smoking is associated with increased overall morbidity and mortality.
      Smoking is a cause of cancer of the lung, oral cavity, larynx, bladder, and renal
      pelvis and a contributing factor in the development of cancer of the pancreas,
      stomach, cervix, liver, penis, and rectum. Smokers are at greater risk for
      coronary artery disease, cerebrovascular disease, and atherosclerotic peripheral
      vascular disease. Cigarette smoking is the single most important risk factor for
      chronic obstructive pulmonary disease and is associated with lower levels of FEV1
      and increased respiratory symptoms and infections. Women who smoke during
      pregnancy have an increased incidence of complications, especially intrauterine
      growth retardation. Peptic ulcer disease is more common in smokers than in
      nonsmokers. Finally, involuntary smoke exposure is associated in adults with an
      increased incidence of lung cancer and possibly greater mortality rates from
      ischemic heart disease and in children with more frequent lower respiratory tract
      illnesses and reduced lung growth.

PMID- 1747985
TI  - Identification of the high-risk smoker.
AB  - The burden of smoking-related disease can be reduced through smoking prevention
      and cessation. While physicians should counsel all patients who smoke, disease
      risks are not uniform among smokers. The smokers of the largest numbers of
      cigarettes are at greatest risk, as are those who started at younger ages. In
      addition, other factors determined the likelihood of developing a smoking-related
      disease. Physicians can use the combination of smoking with these additional risk
      factors to target smokers for intervention, whether education, cessation, or
      appropriate screening.

PMID- 1747986
TI  - Health benefits of smoking cessation.
AB  - Extensive evidence has now accumulated on the health consequences of smoking
      cessation. With few exceptions, disease risks are reduced after smoking cessation
      and continue to drop as abstinence is maintained. The review of the evidence in
      the 1990 Report of the Surgeon General led to major conclusions that establish
      smoking cessation as a clear priority for health care providers.

PMID- 1747987
TI  - Basic and clinical psychopharmacology of nicotine.
AB  - Nicotine acts on nearly every physiological system of the human body. While the
      actions of nicotine on the autonomic nervous system may be of interest in
      understanding possible deleterious long-term effects of smoking on the
      cardiovascular system, the actions of nicotine on the central nervous system are
      of the most interest in understanding why people smoke. Many studies of the
      effects of nicotine on human cognitive function have been performed. Improvement
      in attention, learning, reaction time, and problem solving have been reported.
      However, most of the results are inconclusive owing to methodologic problems.
      Whether the enhanced performance observed after smoking is attributable to relief
      of symptoms of abstinence or to a primary effect of nicotine on the brain is not
      clear. The pharmacodynamic effects of nicotine must be considered in the design
      of studies of the effects of nicotine on human performance. It is not known if
      the effects of nicotine on performance are subject to tolerance. The facilitation
      of performance, perceived as a reinforcement, may tend to lessen throughout the
      day, as do other effects of nicotine. Studies of chronic tolerance to the
      behavioral effects of nicotine are needed; comparisons between regular smokers
      and occasional smokers may be helpful. At present, the facilitatory actions of
      nicotine on human performance have been explained in terms of arousal. However,
      nicotine actions cannot be explained in terms of this single concept. Different
      processes, including attention, stimulus evaluation, and response selection,
      appear to be involved in the effect of nicotine on human information processing.
      Finally, one must consider that the predominant effects of nicotine may differ
      among individuals, as different people smoke for different reasons, and the
      motives for (rewards of) smoking may vary in different situations.

PMID- 1747988
TI  - Cigarette smoking and addiction.
AB  - Tobacco use is a form of drug addiction, as shown by studies assessing the abuse
      liability of tobacco and nicotine in humans and animals. Tobacco experimentation
      frequently leads to daily use, which is characterized by a highly consistent
      pattern of drug intake. Such a pattern is controlled by the biologic
      concentrations of nicotine, a psychoactive constituent of tobacco smoke. Nicotine
      is a euphoriant, self-administered by humans as well as by animals in laboratory
      settings. Nicotine controls smokers' behavior in such a way that reducing or
      suppressing tobacco consumption produces a withdrawal syndrome characterized by
      irritability, difficulty concentrating, cognitive impairments, and weight gain.
      Nonpharmacologic factors are also important determinants of tobacco addiction
      that interfere with successful cessation. Strategies to treat tobacco addiction
      are comparable to those developed for other drug addictions. For example, therapy
      may include the use of alternate forms of nicotine and possibly also nicotine
      antagonists and medications targeted to alleviate specific withdrawal symptoms,
      if such therapies become available. As in all drug addiction treatment
      strategies, behavioral intervention is important whether or not a medication is
      used.

PMID- 1747989
TI  - Determinants of cigarette smoking.
AB  - Smoking is a complex process influenced by social, environmental, psychologic,
      and biologic factors. This article explores the multiple determinants of smoking
      and how these variables interact to promote the persistence of smoking. Further
      examination of how smoking persistence varies in relation to several specific
      diseases is discussed.

PMID- 1747990
TI  - Process of smoking cessation. Implications for clinicians.
AB  - The process of smoking cessation involves progression through five stages of
      change: precontemplation, contemplation, preparation, action, and maintenance.
      Most patients are not prepared to take action on their smoking, yet most smoking
      cessation programs are designed for smokers who are so prepared. Small
      percentages of smokers register for action-oriented cessation programs. How much
      progress patients make after an intervention is directly related to what stage
      they are in prior to intervention. The stages of change can be quickly assessed
      with four questions. Physicians can then be more effective with a broader range
      of patients by matching their interventions to the patients' stage of change.
      Helping patients progress just one stage can double their chances of not smoking
      6 months later. Providing personalized information about the cons of smoking,
      asking affect-arousing questions, and encouraging patients to re-evaluate
      themselves as smokers are interventions physicians can use to help patients who
      are not prepared to quit smoking. Behavioral interventions, such as providing
      substitutes like nicotine gum and removing or altering cues for smoking, are most
      helpful for patients who are ready to take action. The use of a stage-matched,
      patient-centered counseling intervention can help physicians to feel less
      frustrated and more effective in their efforts to help a broad range of their
      patients.

PMID- 1747991
TI  - Methods for smoking cessation.
AB  - Smoking cessation treatment consists of three phases: preparation, intervention,
      and maintenance (support and coping strategies). Although most people who quit
      smoking do so without going through a formal program, many people act on the
      advice of a health professional. Self-help techniques appear to be cost effective
      in terms of their minimal use of professionals. The popularity of hypnosis and
      acupuncture as quitting methods are not warranted by their quit rates. Quit rates
      can be improved if physicians provide more help to their patients than just
      simple advice and warnings.

PMID- 1747992
TI  - The physician's role in smoking cessation.
AB  - Physicians have many opportunities to facilitate smoking cessation among
      individual patients, and this could be complemented by efforts to curb smoking at
      the community level. If every physician advised all smokers to quit, there would
      be considerable public health benefit from the additional 5% to 10% of smokers
      who followed the advice. The benefits would be substantially greater if the
      interventions were targeted to the smoker's stage of change and with ongoing
      participation by the physician in the smoking cessation process. Possibly as
      important as the physician's active role with individual smokers are community
      wide efforts to curb tobacco smoking. These efforts are essential to the
      prevention of the initiation of cigarette smoking among children and adolescents.
      Changing societal norms regarding cigarette smoking will not only decrease the
      numbers of future smokers but will also assist current smokers in cessation
      efforts.

PMID- 1747993
TI  - Pharmacologic approaches to smoking cessation.
AB  - Only 25 years ago, tobacco dependence was believed to be a simple overuse
      problem. Research in the last 5 years has demonstrated a much more complex and
      profound neurochemical and behavioral disorder. Nicotine receptors in the locus
      coeruleus and the midbrain mesolimbic dopaminergic system activate both arousal
      state and enhance cognitive functioning (locus coeruleus) and activate the
      brain's "pleasure center" (mesolimbic system). Pharmacologic treatments, which
      must be completely integrated into the behavioral treatment plan, alter these
      profound central nervous system nicotine effects. Currently the only agent with
      clear scientific evidence for treatment efficacy is nicotine itself. Available
      only in a transmucosally delivered ion-exchange resin as nicotine polacrilex
      (Nicorette), nicotine should soon be available in other delivery forms that will
      have different absorption kinetics: transdermal patch, nasal spray, and vapor
      inhaler. Other agents in various phases of preclinical and clinical evaluation
      include 5-HT1A partial agonists such as buspirone; alpha 2-noradrenergic agonists
      such as clonidine; tricyclics such as doxepin; serotonin re-uptake antagonists
      such as fluoxetine; ACTH; 5-HT2 antagonists such as ritanserin; central
      excitatory amino acid inhibitors such as kynurenate; and calcium channel
      blockers.

PMID- 1747994
TI  - Maintenance of smoking cessation.
AB  - Relapse is a frequently encountered problem in smoking cessation. With a
      cognitive-behavioral model of the relapse process, we can describe high-risk
      situations where smoking first recurs, the process by which people end up in
      these situations, and typical responses to violations of abstinence. The model
      posits that individuals are actively coping with situation-specific urges to
      smoke that result from prior conditioning. Individuals' beliefs in their ability
      to cope with urges are critical. Clinical strategies based on the model include
      assessment of risk profiles, understanding and anticipating high-risk situations,
      debriefing and reinterpreting lapses in abstinence, and limiting risk through
      lifestyle changes. These strategies can be incorporated into brief medical office
      visits. Recommended procedures include systematic but brief assessment,
      encouragement, goal setting, planning for risk, reinterpreting lapses,
      recommendations for lifestyle changes, and follow-up appointments.

PMID- 1747995
TI  - Community-based programs for smoking cessation.
AB  - Overall, there is a wide range of programs offered at the community level. Most
      of the group cessation clinics, both nonprofit and commercial, typically offer
      group support, behavior modification, and stress and weight management, with
      similar emphases in their companion self-help manuals. It often is difficult to
      distinguish between the various methods employed by the diverse programs, with
      those that offer maintenance and relapse prevention components faring the best.
      In general, the multiple-component programs, whether group or self-help packages,
      seem to hold the most promise for achieving and maintaining abstinence; however,
      there is some evidence that overwhelming the smoker with too many new behaviors
      and skills lowers the effectiveness of otherwise successful components. The
      challenges for community-based programs will be to modify and adapt their
      materials and sessions to address the needs uncovered in the recent emphasis on
      the process of smoking cessation. Specifically, program content must address the
      issue of recycling and relapse prevention. Smokers who have made unsuccessful
      quit attempts must be able to reframe those attempts in a positive manner, so
      that they are motivated to try again. Similarly, recent quitters need the skills
      and motivation to remain abstinent. Although some cessation programs allow
      clients to participate in future sessions or meetings for little or no extra
      cost, few have any strategies for dealing with long-term maintenance. As
      community-based programs incorporate these elements of cessation, quit rates are
      likely to increase. An additional challenge is found in the difficulty of
      reaching the hard-core, heavy smoker. There is little doubt that light-to
      moderate smokers find it easier to achieve long-term cessation. Cessation
      programs that motivate heavy smokers to attempt to quit or that include adjunct
      therapies to assist the heavy smoker (i.e., nicotine gum) to quit smoking are
      likely to be positively received. Currently, however, efforts specifically
      designed to assist heavy smokers are experimental. A final challenge is to adapt
      materials and sessions to motivate and assist the hard-to-reach smokers.
      Increasingly, smoking is becoming a habit of individuals in lower socioeconomic
      groups, including minorities, non-high school graduates, and young women. Avenues
      that have been used to reach white middle-class Americans are not easily
      transferred to such groups. Some attention is already being paid to development
      of more culturally appropriate materials (e.g., the ALA Manual oriented to blue
      collar workers and the ACS focus on pregnant women); however, it remains a
      challenge to motivate members of these groups to participate in smoking cessation
      activities.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1747996
TI  - National programs for smoking cessation.
AB  - The smoking cessation effort has made tremendous progress since the 1964 Report
      of the Surgeon General described the health hazards of smoking. The impact of
      these efforts on smoking is particularly impressive when the current smoking
      level is compared with levels of smoking projected from trends apparent before
      that 1964 report, levels that might have been reached if there had been no
      national stop-smoking campaign. Because of the campaign, an estimated 35 million
      Americans were nonsmokers in 1985 who would otherwise have been smokers. If these
      figures are projected to the year 2000, the campaign will have postponed more
      than 2 million deaths. Therefore, reducing the prevalence of smoking in adults
      from about 40% in 1964 to 29% in 1987 can be considered a tremendous public
      health achievement. Among those who did take up smoking, there is also reason for
      some optimism. By 1987, more than 38 million Americans had quit smoking; this
      figure represents nearly half of all living adults who ever smoked. The 1990
      Report of the Surgeon General gave a positive message to the 50 million Americans
      who continue to smoke by describing the health benefits of quitting for all the
      major smoking-related diseases.

PMID- 1747997
TI  - Separation of ovine IgG1 and IgG2 on protein A-sepharose.
AB  - A method using protein A-Sepharose chromatography was developed to separate and
      purify ovine IgG1 and IgG2. The IgG1 eluted from protein A-Sepharose at pH 6.8
      and IgG2 eluted at pH 4.5. This method was used to show the specific transfer of
      IgG1 from the colostrum to newborn lambs. After separation on protein A-Sepharose
      both IgG1 and IgG2 were pure as analyzed by isoelectric focusing, Western
      Blotting and SDS-PAGE. The isoelectric points for the immunoglobulins were
      calculated to be 3.5 for IgG2 and a range from 6.2 to 8.1 for IgG1. The subclass,
      IgG1, was present in the whey and was the subclass that was found in the serum of
      lambs after being fed colostrum. The ewe sera had a decrease of both IgG1 and
      IgG2 at the time of lambing compared to 2 weeks prior to parturition.

PMID- 1747998
TI  - Gonadotropin releasing hormone (GnRH) induced luteinizing hormone (LH) secretion
      from perifused equine pituitaries.
AB  - In vitro responsiveness of the horse anterior pituitary (AP) gonadotropes to
      single and multiple GnRH challenges was examined. The pituitaries were collected
      from reproductively sound mares in estrus (n = 5) and diestrus (n = 5). Uniform
      0.5 mm AP slices were subdivided using a 3 mm biopsy punch and then bisected for
      use in the perifusion chamber. Four bisected sections per chamber were perifused
      at 0.5 ml/min at 37 C for 560 min in Medium 199 saturated with 95% 0(2)/5% CO2.
      Ten minute fractions were collected after an initial 2 hr equilibration period.
      Four different treatment regimes of GnRH (10(-10) M) were evaluated: (A) three
      consecutive 10 min GnRH pulses separated by 80 and 100 min, respectively; (B) a
      single 120 min GnRH infusion; (C) a 10 min GnRH pulse followed 80 min later by a
      120 min GnRH infusion and (D) two 10 min GnRH pulses separated by 60 min followed
      80 min later by a 120 min GnRH infusion. Estimated total pituitary LH content was
      higher in estrous than diestrus mares (p less than 0.05). The total amount of LH
      released in response to GnRH tended to be greater in estrus than diestrus (p less
      than 0.1), whereas the percentage of LH released in estrus and diestrus was
      similar. An increase in the area under the LH response curve was noted with each
      successive 10 min pulse of GnRH during both estrus and diestrus (p less than
      0.05), demonstrating a self-priming effect of GnRH. In addition, a significant
      increase in the peak LH amplitude (p less than 0.05) and the slope to peak
      amplitude (p less than 0.05) were observed for the 120 min GnRH pulse in regime C
      and D indicating that prior exposure to short-term pulses of GnRH increased the
      acute LH secretory response. These results suggest that in the cycling mare (1)
      the responsiveness of the pituitary (amount of LH released as percent of total
      LH) is similar in both estrus and diestrus, however, the magnitude of the LH
      response (total microgram amount of LH released) differs with the stage of the
      estrous cycle, being highest in estrus, and appears to be related, in part, to
      pituitary LH content and (2) GnRH self-priming occurs independently of the stage
      of the estrous cycle. Furthermore, we have demonstrated that the pulsatile mode
      of GnRH can act directly on the anterior pituitary to dictate the pulsatile
      release pattern of LH in the cycling mare.

PMID- 1747999
TI  - Luteotropic influence of the ovine uterus.
AB  - Preliminary observations indicated that the ovine uterus might play a
      contributing role in the development of the corpus luteum. In order to better
      define this putative relationship, we monitored luteal function in mature ewes
      that were hysterectomized or sham-operated at different intervals following
      induction of ovulation. Corpora lutea formed following hysterectomy carried out
      immediately after ovulation were subnormal. Circulatory concentrations of
      progesterone in these animals began to ascend normally, but then achieved a
      plateau level less than that of control animals. This was attributed to reduced
      size of the luteal gland, and not to anomalies per unit tissue in morphology or
      content of progesterone. Luteal activity was not altered in ewes hysterectomized
      later in the estrous cycle (Day 5). However, when such a luteal phase was
      terminated by exogenous luteolysin, corpora lutea formed subsequently were
      defective. It appears that the ovine uterus produces a hormonal factor during
      metestrus that augments the growth potential of the corpus luteum.

PMID- 1748000
TI  - Luteinizing hormone secretion in hypophysial stalk-transected gilts given
      hydrocortisone acetate and pulsatile gonadotropin-releasing hormone.
AB  - The site within the hypothalamic-pituitary axis at which cortisol acts to inhibit
      luteinizing hormone (LH) secretion was investigated in female pigs. Six
      ovariectomized, hypophysial stalk-transected (HST) gilts were given 1 microgram
      pulses of gonadotropin releasing-hormone (GnRH) iv every 45 min from day 0 to 12.
      On days 6-12, each of 3 gilts received either hydrocortisone acetate (HCA; 3.2
      mg/kg body weight) or oil vehicle im at 12-hr intervals. Four ovariectomized,
      pituitary stalk-intact gilts served as controls and received HCA and pulses of
      3.5% sodium citrate. Jugular blood was sampled daily and every 15 min for 5 hr on
      days 5 and 12. Treatment with HCA decreased serum LH concentrations and LH pulse
      frequency in stalk-intact animals. In contrast, serum LH concentrations, as well
      as the frequency and amplitude of LH pulses, were unaffected by HCA in HST gilts
      and were similar to those observed in oil-treated HST gilts. We suggest that
      chronically elevated concentrations of circulating cortisol inhibit LH secretion
      in pigs by acting at the level of the hypothalamus.

PMID- 1748001
TI  - Effect of bovine growth hormone gene expression, sex and age on plasma
      gonadotropins, estrone and testosterone in prepuberal pigs.
AB  - Chronic supraphysiological blood levels of growth hormone (GH) may retard sexual
      maturation in swine. Pigs used in this study included four founder transgenic
      pigs (two gilts and two boars) expressing a mouse transferrin (TF) promoter fused
      to a bovine (b) GH structural gene, 13 second- or third- generation transgenic
      pigs (seven gilts and six boars) expressing a mouse metallothionein (MT) promoter
      fused to a bGH structural gene and 16 control littermates (eight gilts and eight
      boars). Blood plasma levels of LH, FSH, estrone and testosterone were measured to
      determine whether expression of bGH genes altered secretion of hormones between
      80 and 180 days of age. Presence of a bGH gene was detected by hybridization of
      DNA in dot blots of tail biopsies. Expression of a bGH gene was detected by
      radioimmunoassay of plasma bGH. In four TFbGH founder transgenic pigs bGH ranged
      from 164 to 1948 ng/ml; in one MTbGH transgenic boar of line 3104 bGH was 1211
      ng/ml; and in 12 pigs of line 3706 bGH ranged from 25 to 190 ng/ml. Expression of
      bGH in transgenic pigs lowered (P = .0192) plasma LH with no significant
      differences between sexes, had no significant effect on plasma FSH and lowered
      plasma estrone (P = .0001) and testosterone (P = .0269) in boars (but not gilts).
      Plasma estrone and testosterone were higher (P = .0001) in boars than in gilts.
      Plasma FSH was higher (P = .0001) in gilts than boars and decreased (P = .0001)
      with advancing age in gilts but not in boars.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748002
TI  - Effect of dietary intake on concentrations of insulin-like growth factor-I in
      plasma and follicular fluid, and ovarian function in heifers.
AB  - The objective of this study was to determine if alterations in dietary intake of
      heifers can influence IGF-I concentrations in plasma and(or) follicular fluid
      (FFL), size of follicles, and steroid concentrations in FFL (as an indicator of
      steroidogenic capacity). Cyclic heifers [n = 23; mean +/- SE body weight (BW) =
      373 +/- 7 kg] were individually fed for 10 weeks either: a) 1.8% of BW in dry
      matter (DM) per d (GAIN; n = 7), b) 1.1% of BW in DM per d (MAINT; n = 8) or c)
      0.7% of BW in DM per d (LOSE; n = 8). After 10 wk of treatment, heifers were
      ovariectomized 36-40 hr after the second injection of prostaglandin F2 alpha
      analog (2 injections 11 d apart), and plasma and ovaries were collected. Heifers
      weighed 444 +/- 13,387 +/- 8 and 349 +/- 9 kg in the GAIN, MAINT and LOSE groups,
      respectively, at time of ovariectomy. Mean diameter of follicles greater than or
      equal to 10 mm was greater (P less than .05) for GAIN (15.6 mm) than for MAINT
      (11.0 mm) or LOSE (12.5 mm) heifers. Numbers of follicles and concentrations of
      IGF-I in plasma and FFL did not differ (P greater than .20) between LOSE, MAINT
      and GAIN heifers. Progesterone concentrations were greater (P less than .05) in
      small and medium follicles of GAIN than MAINT or LOSE heifers, but were
      unaffected by diet in large follicles. Estradiol concentrations in FFL in small,
      medium and large follicles were unaffected (P greater than .20) by dietary
      treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748003
TI  - Bovine corpus luteum function after removal of granulosa cells from the
      preovulatory follicle.
AB  - Experiments were conducted to determine the effects of removing granulosa cells
      from bovine preovulatory follicles on subsequent corpus luteum (CL) function.
      Holstein heifers were assigned to three groups: untreated controls (n = 6),
      removal of granulosa cells (n = 9) and removal and return of granulosa cells (n =
      7). Surgery was performed 18-24 hr after the onset of estrus and in all cases
      after the preovulatory luteinizing hormone (LH) surge. Jugular venous blood was
      collected and estrous activity monitored twice daily. Corpora lutea were formed
      in six heifers in each group. Concentrations of plasma progesterone were reduced
      (P less than 0.05) on Days 7-17 in heifers from which granulosa cells were
      removed when compared to the other two groups. There were no differences in the
      lengths of the estrous cycles nor concentrations of LH in the three groups. In
      summary, these experiments support the concept that granulosa cells make a
      substantial contribution to the output of progesterone by the cyclic CL but may
      have a limited role in determining the functional lifespan of the CL. These
      experiments also establish the fact that granulosa cells develop into functional
      luteal cells after their removal and return to the preovulatory follicle.

PMID- 1748004
TI  - Changes in the concentration of mRNAs for the inhibin subunits in ovarian
      follicles after administration of gonadotropins to progestin treated ewes.
AB  - RNA was extracted from single or small groups of ovine ovarian follicles after
      treatment of ewes with FSH and/or LH. The content of mRNA for the alpha-inhibin
      and beta A-inhibin subunits was analyzed by hybridization with specific cDNA
      probes. All ewes were treated with progestin vaginal pessaries to suppress
      spontaneous preovulatory follicle maturation and ewes were given three
      intramuscular injections of gonadotropins at 8-hr intervals starting 24 hr prior
      to collection of ovaries. In experiment I, both Schering-FSH and NIDDK-oFSH-17
      (oFSH) significantly increased alpha- and beta A-inhibin mRNA per ewe in 2-5 mm
      follicles and tended to increase alpha- and beta A-inhibin mRNA in large (greater
      than 5 mm) follicles. In experiment II, oFSH and NIDDK-oLH-25 (oLH) were
      administered in a 2X2 factorial arrangement. Separate administration of oFSH or
      oLH increased (P less than .05) the alpha-inhibin mRNA concentration in large
      follicles. alpha-inhibin mRNA concentration in 4-5 mm follicles was also
      increased by oFSH but was decreased by oLH. Concomitant treatment with oFSH and
      oLH did not change alpha-inhibin mRNA concentrations from those measured in oFSH
      treated ewes. In experiment II, beta A mRNA concentrations followed a pattern
      similar to that of alpha A mRNA, but the differences were not statistically
      significant. We conclude that, in the ewe, exogenous FSH increases the
      concentration of inhibin mRNA in the whole follicle. The ability of exogenous oLH
      to alter expression of the inhibin subunit genes may depend upon the stage of
      follicle maturation.

PMID- 1748005
TI  - In situ hybridization analysis of ovarian prostaglandin endoperoxide synthase
      mRNA throughout the periovulatory period of the ewe.
AB  - Cellular alterations in level of expression of mRNA encoding for prostaglandin
      endoperoxide synthase were quantified within ovarian tissues of sheep obtained
      before, during and after induction of the preovulatory surge of LH and ovulation
      with LHRH. This was accomplished by isotopic in situ hybridization using a
      selective cRNA probe to ovine prostaglandin endoperoxide synthase mRNA. A
      significant elevation in mRNA was detected within the theca interna of the
      preovulatory follicle at 8, 16 and 24 hr following administration of LHRH. Very
      close to the time of ovulation (ie., at 24 hr post-LHRH) a marked rise in mRNA
      was observed in association with epithelial cells covering the apical surface of
      the follicle. Ovarian cyclooxygenase metabolites of arachidonic acid produced
      during the ovulatory process in the ewe originate within the thecal layer and
      germinal epithelium of the follicle destined to ovulate.

PMID- 1748006
TI  - The emergence of methicillin resistant Staphylococcus aureus in extended care
      facilities in northern Connecticut between 1986 and 1990.
AB  - Methicillin resistant Staphylococcus aureus (MRSA) is recognized as a pathogen of
      significant morbidity in hospital facilities. The microorganism can also be
      recovered from clinical specimens taken from patients who are residents of
      extended care facilities (ECFs). This report is a five-year retrospective review
      of the emergence and spread of MRSA isolates within ECFs located in north central
      Connecticut and their susceptibility profile over that time span.

PMID- 1748007
TI  - Leuprolide with flutamide for complete androgen ablation: therapeutic alternative
      for advanced prostatic cancer (stage D2).

PMID- 1748008
TI  - The leading edge?

PMID- 1748009
TI  - Taking fiduciary relationships seriously.

PMID- 1748010
TI  - Conservative treatment for myocardial infarction.

PMID- 1748011
TI  - Proteoglycans nondissociatively extracted from different zones of canine normal
      articular cartilage: variations in the sedimentation profile of aggregates with
      degree of physiological stress.
AB  - Proteoglycans were extracted and purified without dissociation (a-A1
      preparations) from superficial and deeper layers of high weight-bearing (HWA) and
      low weight-bearing (LWA) areas of dog normal articular cartilage. These
      proteoglycans were then characterized by velocity gradient centrifugation. In
      each of the 4 different topographical regions, the weight average sedimentation
      coefficients related strongly with total hexuronate content of the tissue. In the
      superficial layers, almost all aggregates had low sedimentation coefficients: the
      aggregates were smaller and less abundant in LWA than in HWA. The deeper layers
      contained an additional population of faster sedimenting aggregates which
      appeared smaller and less abundant in LWA than in HWA. Quantification and
      functional characterization of aggregates as well as in vitro aggregating studies
      showed that the topographical differences in size and content of aggregates were
      related to differences in content of hyaluronate and link protein in the a-A1
      preparations. Superficial a-A1 specimens contained twice as much hyaluronate as
      deeper a-A1 preparations and their hyaluronate content increased with degree of
      physiological stress. Deeper a-A1 specimens from weight-bearing areas did not
      differ in their hyaluronate content but experiments assessing the saturation with
      link protein of these different a-A1 preparations suggested that specimens from
      HWA contained more active link than those from LWA. In contrast, the capacity of
      aggregation of a-A1D1D1 proteoglycan monomers as well as the molecular weight (Mr
      = 5 x 10(5) and aggregating capacity of hyluronate molecules appeared very
      similar in all a-A1 preparations from areas of articular cartilage. It is
      hypothesized that the synthesis of the three constituents necessary for aggregate
      formation (i.e. proteoglycan monomers as well as hyaluronate and link protein
      molecules) increases with degree of physiological load and that aggregation helps
      to maintain within cartilage the high concentration of proteoglycans that are
      essential for its biomechanical functions. The reported topographical variations
      in the distribution of proteoglycan aggregates reflect probably a maximal
      adaptation of the physiologic and biomechanical properties of the matrix to meet
      the high stress levels experienced by the articular cartilage in vivo.

PMID- 1748012
TI  - The right ventricle: anatomy, physiology, and clinical importance.

PMID- 1748013
TI  - Social skills and antisocial conduct of delinquents.
AB  - A revised and abbreviated version of the Adolescent Problems Inventory (API) was
      used to examine the relationship between social skills deficits and antisocial
      behavior. A factor analysis of the revised API yielded three factors (Immediate
      Response Demand, Deferred Response Demand, and Antisocial Peer Influence) which
      were differentially related to specific measures of antisocial responding.
      Results are discussed in the context of a multifactorial model of juvenile
      delinquency.

PMID- 1748014
TI  - Social competence in young children's peer relations: patterns of development and
      change.
AB  - Patterns of developmental change and individual differences in social competence
      were examined in children of depressed and psychiatrically well mothers, during
      the toddler-to-late-preschool period. Forty-one children were observed in peer
      interaction at ages two and five under semi-naturalistic laboratory conditions
      intended to elicit a range of emotions and social skills. Social competence
      increased with age, but patterns of developmental change were moderated by
      maternal diagnosis. Low levels of individual stability were identified in
      children's social competence.

PMID- 1748015
TI  - The classification of conduct disorders.
AB  - Empirical data comparing DSM-III and DSM-III-R criteria on conduct disorders were
      obtained from 100 adolescent juvenile justice center residents. The importance of
      an ongoing classification of childhood and adolescent psychiatric disorders, with
      primary emphasis on the diagnosis of conduct disorders, was stressed. Demographic
      and associated features were presented. DSM-III-R seemed superior to its
      predecessor in some respects and the severity index in particular may be useful.
      Direction for further classification modification was suggested.

PMID- 1748016
TI  - Communication issues in Attention-deficit Hyperactivity Disorder.
AB  - Children with Attention-deficit Hyperactivity Disorder (ADHD) evidence a variety
      of pragmatic deficits and are particularly at risk for other speech and language
      disorders. Speech and language pathologists in educational settings have the
      special expertise needed for interpretation and treatment of communication issues
      associated with ADHD. They should contribute more directly to the multi-modality
      treatment team in creating management programs for these children.

PMID- 1748017
TI  - Separation reaction of psychiatrically hospitalized children: a pilot study.
AB  - This paper reports on the development of the Children's Separation Rating Scale
      (CSRS), its initial reliability and validity, and clinical/research utility with
      psychiatrically hospitalized children. The CSRS appears to be a reliable and
      valid instrument, and useful in distinguishing children's separation reaction
      from their general psychopathology. Findings from this pilot study support the
      notion that inpatient treatment programs should address the developmental needs
      and abilities of the various age groups and the particular deficits reflected in
      their psychopathology.

PMID- 1748018
TI  - [Case classification as a prerequisite for quality assurance measures-
      experiences with the PMC system in surgical patients].

PMID- 1748019
TI  - [Extension of employment contracts on completion of continuing education].

PMID- 1748020
TI  - [Beginning of expiration of medical fee requests only with date of medical fee
      bill?].

PMID- 1748021
TI  - [Operation of inguinal hernia. Classification, choice of procedure, techniques
      and results].

PMID- 1748022
TI  - [Surgical therapy of incisional hernias].

PMID- 1748023
TI  - [Zenker's diverticulum. Long-term results after surgical therapy].
AB  - Twenty-one patients were treated for Zenker's diverticulum in the Wurzburg
      University Department of Surgery between 1977 and 1989. Surgery was done in 15
      cases (8 single-session resections with myotomy of the upper esophageal
      sphincter, and 7 resections without myotomy). The postoperative course was
      uneventful in 73%. Wound infection developed in 2 cases, and suture insufficiency
      and transient paralysis of the recurrent nerve in one each. In 3 patients,
      postoperative x-ray prior to release from the hospital revealed retention of
      contrast medium in a discrete, pocket-like protrusion between the cricoid and the
      pharynx. Follow-up was done after a mean interval of 4 years (range: 5 months
      10.5 years) in 10 of the 15 operated patients. Two of them developed relapses
      about 1-1.3 cm in size within 8 months and 7 years, resp. Myotomy had not been
      done in either case. Neither patient had complaints. Esophageal manometry was
      performed in 6 patients. Resting tone of the upper esophageal sphincter was
      clearly diminished at 12-30 mm Hg (normal 40-50 mm Hg); maximum contraction
      pressure was also reduced at 30-75 mm Hg (normal 90-110 mm Hg). However, the
      decisive factor was the exact temporal coordination of pharyngeal contraction
      with sphincter relaxation. For this reason it is our unconditional recommendation
      that myotomy of the upper esophageal sphincter be regarded as an essential step
      in resection of Zenker's diverticula.

PMID- 1748024
TI  - [Results of surgical therapy of cervical diverticulum].
AB  - Eighteen patients with a pharyngoesophageal diverticulum were operated on at the
      University Department of Surgery, Mainz, between September 1985 and July 1990.
      Results are based on follow-up studies of 15 patients. Three patients were
      operated upon less than six months ago. All patients underwent excision of the
      diverticulum and a cricopharyngeal myotomy. The mean age was 69 (49-84) years and
      the average follow-up interval was 30 (6-52) months. Twelve of the fifteen
      patients are free of symptoms concerning the esophagus since the operation. Two
      patients who died 17 resp. 22 months after the operation were also free of
      symptoms concerning the esophagus. In all 11 patients who had a barium contrast,
      swallowing was normal and no recurrence was found. The results show excision of
      the diverticulum combined with a cricopharyngeal myotomy to be an effective
      method with low risk for the long-term removal of pharyngoesophageal
      diverticulum.

PMID- 1748025
TI  - [Surgical indications in cricopharyngeal dysfunction].
AB  - In 1989, five patients were treated for a cricopharyngeal dysfunction by cervical
      myotomy. In the past, due to extremely limited indications for surgery, repeated
      efforts of conservative treatment had been attempted in patients with idiopathic
      cricopharyngeal dysfunction and tracheopulmonary aspiration and/or permanent
      inability of oral nourishment. These patients underwent surgery after an
      interdisciplinary clinical assessment. Four out of five patients showed immediate
      improvement of their serious symptoms. Cervical myotomy is not expected to be
      successful in patients with insufficient oropharyngeal propulsion, as we could
      see in one female patient with severe upper oesophageal sphincter spasm.
      According to the literature and to our results, approximately 70 to 90% of the
      patients with idiopathic dysfunction of the cricopharyngeal muscle, who underwent
      surgery, showed significant improvement or even recovery. Due to the
      multifactoral genesis of the cricopharyngeal dysfunction it is understandable,
      that the surgical result is heavily dependent on the preoperative
      interdisciplinary diagnosis. In summary, for idiopathic cricopharyngeal
      dysfunction with complications we recommend the early and technically simple
      operation.

PMID- 1748026
TI  - [Surgical therapy of ulcer disease. Early and late results of elective and
      emergency interventions].
AB  - Between 6/1974 and 12/1988 910 patients with peptic ulcer disease have been
      treated operatively. In 523 cases a resection, gastroenterostomy resp. ligation
      of a bleeding ulcer, in 160 cases with duodenal ulcers a vagotomy, and in 227
      cases with perforated ulcers simple closure or primary resection have been
      performed. During this study the percentage of female patients rose from 32.0 to
      39.7. There was also an increase of the mean age of the patients. Operative
      mortality rate was 7.3% for resection, GE resp. ligation of a bleeding vessel,
      0.6% for vagotomies, and 16.3% for perforated ulcers. The fate of all patients
      was followed regularly. In patients operated before 1985--with a follow-up of 5
      16 years--reoperations were necessary in 6.0% following resection,
      gastroenterostomy resp. ligation, in 7.7% following vagotomy, and in 21.3%
      following simple closure or primary resection of a perforated ulcer.

PMID- 1748027
TI  - [Management of pancreatic rupture].

PMID- 1748028
TI  - [Stomach rupture caused by barotrauma].

PMID- 1748029
TI  - [Perforated ileal diverticulitis--a rare cause of peritonitis].

PMID- 1748030
TI  - Trap perches to assess the activity of pyrethrins against the poultry red mite
      Dermanyssus gallinae in cage birds.
AB  - Trap perches were utilised to quantify mite recoveries during efficacy tests of
      pyrethrin formulations against experimental infestations of Dermanyssus gallinae
      (De Geer, 1778) in budgerigars and pigeons, and to monitor mite recoveries from
      untreated canaries. Pyrethrins applied topically before infestation significantly
      reduced the mean numbers of poultry red mites found in both budgerigar and pigeon
      trap perches, over those in untreated controls (P = less than 0.01). In untreated
      control budgerigars and pigeons, and in untreated canaries, the percentage
      recoveries after 48 h were 12.6 +/- 1.6, 4.1 +/- 1.9, and 32.6 +/- 1.6%,
      respectively (geometric mean +/- SD), and the blood engorgements rates were 71.5
      +/- 1.7, 11.9 +/- 5.1, and 90.1 +/- 1.0% respectively. The recovery in trap
      perches of mites from canaries declined exponentially; 85% of the cumulative
      total recovered was collected 24 h after infestation, but small numbers were
      recovered daily up to 96 h (limit of observation). The use of the trap perches is
      discussed as a way of assessing the efficacy of acaricides, and as a laboratory
      tool in studies on mite aggregation behaviour or immune responses to mite
      infestation.

PMID- 1748031
TI  - Influence of identification ear tags on the numbers of adult Rhipicephalus
      appendiculatus (Acari: Ixodidae) on the ears of cattle.
AB  - The influence of ear tags on the number of adult Rhipicephalus appendiculatus was
      investigated. Tagged ears carried significantly more ticks than untagged ears,
      but differences decreased with time. Ticks were seen crowding under and close to
      the back of the tag, on the outside of the ear.

PMID- 1748032
TI  - Studies on the economics of ticks in Zambia.
AB  - Two herds of experimental Sanga cattle were maintained under traditional savanna
      grazing management for three years in the Central Province of Zambia. One herd
      was kept free of ticks by regular acaricide treatment, while the other was given
      no tick control. Milk production, growth rate, fertility and mortality were
      monitored throughout the trial. The tick-free herd performed significantly better
      than the tick-infested herd, but the value of the additional production was much
      less than the cost of the acaricide used. It is concluded that there is no
      economic justification for intensive tick control under these conditions.
      However, strategic tick control would be justified if the quantity of acaricide
      used could be reduced by 50% without any major reduction in benefits. The results
      indicate that treating calves below 45 days of age reduces their performance, as
      does treating cows during periods of very low tick challenge. Therefore, it seems
      likely that economically beneficial strategic tick control policies could be
      developed.

PMID- 1748033
TI  - Clinical implications of drug interactions with the cytochrome P-450 enzyme
      system associated with omeprazole.
AB  - Interactions with the hepatic cytochrome P-450 microsomal enzyme system, as
      evidenced by statistically significant changes in pharmacokinetic parameters,
      have been described with some H2-receptor antagonists. Omeprazole is the first of
      a new class of antisecretory agents inhibiting gastric secretion by blocking
      hydrogen potassium ATPase. Omeprazole contains a benzimidazole moiety and thus
      has the potential to interact with the cytochrome P-450 enzyme group. In vitro,
      in vivo and human clinical studies have assessed whether such an interaction
      occurs, and the potential clinical consequences, in patients receiving omeprazole
      therapy. In vitro studies have demonstrated that omeprazole influences O
      deethylation and N-demethylation in liver microsomes and the clearance and
      elimination half-life of antipyrine in isolated perfused liver preparations.
      Overall, the studies reviewed suggest that omeprazole has a differential affinity
      toward specific cytochrome P-450 isozymes. In vivo animal studies have
      demonstrated that omeprazole prolongs pentobarbital sleep times and half-life and
      decreases [14C]-aminopyrine elimination. Human clinical studies have not
      demonstrated the "all or none" effect of omeprazole on cytochrome P-450-mediated
      drug interactions, as is seen with cimetidine. These studies confirm in vitro
      findings that omeprazole is a differential inhibitor of drug metabolism:
      interactions have been demonstrated with the model drugs aminopyrine and
      antipyrine, and the therapeutic drugs diazepam, phenytoin, and warfarin but not
      with theophylline or propranolol. Although caution should be exercised when
      initiating omeprazole therapy in patients taking concomitant diazepam, warfarin,
      and phenytoin, clinically significant drug interactions appear unlikely.

PMID- 1748034
TI  - Applied potential tomography. Noninvasive method for measuring gastric emptying
      of a solid test meal.
AB  - Applied potential tomography (APT) is a new noninvasive, nonradioactive method of
      measuring gastric emptying, which generates profiles of emptying of liquids that
      are similar to those obtained simultaneously by scintigraphy and dye dilution.
      This study validates the ability of APT to measure emptying of a solid beefburger
      test meal from the stomach by comparing the results obtained with those obtained
      simultaneously by scintigraphy. When acid secretion was inhibited, there was a
      significant correlation between the two methods for the time taken for half the
      meal to empty from the stomach and the amount of meal emptied at different time
      intervals. Furthermore, the profiles of gastric emptying obtained by APT
      resembled those obtained by scintigraphy in most studies. If acid secretion was
      not inhibited, there was no correlation between values obtained by the two
      methods.

PMID- 1748035
TI  - Tolerance and rebound to H2-receptor antagonists: intragastric acidity in
      patients with duodenal ulcer.
AB  - Tolerance to the antisecretory effects of H2-receptor antagonists develops
      consistently in healthy volunteers. The aim of this study was to determine
      whether tolerance occurs with repeated dosing of H2-receptor antagonists in
      patients with duodenal ulcer. Continuous intragastric 24-hr pH measurements were
      performed in 12 patients with duodenal ulcer in symptomatic remission before, on
      days 1 and 29, and two days after receiving ranitidine 300 mg four times a day
      for 34 days. The 24-hr median intragastric pH (interquartile range) was 5.4 (4.4
      6.1) on day 1 and 4.6 (4.0-5.2) on day 29 of dosing with ranitidine (not
      significant). Median nighttime pH was 6.8 (6.3-7.0) on day 1 and 6.8 (6.6-7.1) on
      day 29 (not significant). During the daytime, the median pH decreased marginally
      from 4.7 (3.8-5.2) on day 1 to 3.8 (3.0-4.6) on day 29 (P less than 0.03). There
      was no difference in median intragastric pH during 24-hr, day and night periods
      before and two days after ranitidine dosing. No significant tolerance or rebound
      to H2-receptor antagonists was observed in patients with duodenal ulcer disease.
      This contrasts with data gathered in healthy volunteers and may be due to defects
      in the regulation of acid secretion in duodenal ulcer disease.

PMID- 1748036
TI  - Cisapride in treatment of Roux-en-Y syndrome.
AB  - After Roux-en-Y gastrojejunostomy patients frequently complain of upper abdominal
      pain, fullness, nausea, and vomiting. This Roux-en-Y syndrome is caused by slow
      gastric emptying, Roux-limb stasis, or both. Treatment of this syndrome is
      cumbersome. We evaluated the effect of cisapride on complaints and on transit
      through gastric remnant and Roux limb in 24 such patients. Thirteen of them had
      slow gastric emptying and 13 had stasis in the Roux limb (two patients had both).
      Symptoms and transit were evaluated before and after three weeks of treatment
      using a questionnaire and scintigraphy. Responding subjects continued therapy and
      were interviewed again after six months. Seven patients with slow gastric
      emptying and three patients with Roux-limb stasis had enduring symptomatic
      relief; all exhibited accelerated transit during therapy: mean half gastric
      emptying time in the seven patients with slow gastric emptying was 204 +/- 89 min
      before and 111 +/- 59 min during cisapride (P less than 0.05); mean percentage of
      radioactivity, emptied from the gastric remnant, which remained in the Roux limb
      at 60 min in the three patients with Roux limb stasis was 74 +/- 4% before and 25
      +/- 10% during cisapride (P less than 0.05). In patients without symptomatic
      response, transit did not improve. CONCLUSION: with cisapride long-lasting
      symptomatic relief and improved transit is achieved in about 40% of patients with
      the Roux-en-Y syndrome.

PMID- 1748037
TI  - Effect of partial gastrectomy on serum anti-Helicobacter pylori immunoglobulins
      in peptic ulcer patients.
AB  - Since biliary enterogastric reflux is suggested to eradicate gastric infection
      with Helicobacter pylori (HP), we have investigated in a prospective randomized
      study the effect of partial gastrectomy with either Billroth II or Roux-en-Y
      anastomosis on infection with HP as assessed by the titers of IgG and IgA
      antibodies against HP in serum. These antibodies were measured by ELISA in serum
      of 22 patients before and at 10 days and 6, 15, and 24 months after either
      Billroth II (N = 11) or Roux-en-Y (N = 11) gastrectomy for peptic ulcer. All
      patients had HP demonstrated in their preoperative endoscopic gastric biopsies.
      The preoperative serum IgA antibodies against HP (anti-HP IgA) were increased in
      20 of the 22 patients (range 0.21-1.69) while the IgG antibodies (anti-HP IgG)
      were increased in all 22 patients (range 0.38-1.31). Four of the Billroth II
      patients had clearance of HP from gastric biopsies accompanied by rapid and
      pronounced decrease of anti-HP IgA. In contrast, the patients with Roux-en-Y
      gastrectomy and the Billroth II patients with persistent HP infection had no
      change in anti-HP IgA after surgery. Anti-HP IgG showed variable results in the
      four patients without gastric HP infection and was not affected by gastrectomy in
      the patients with persistent HP infection. We concluded that serum anti-HP IgA,
      but not anti-HP IgG, is helpful in identifying those patients in whom HP is no
      longer demonstrable after Billroth II gastrectomy. Gastrectomy with Roux-en-Y
      anastomosis had no effect on gastric HP infection.

PMID- 1748038
TI  - Dieulafoy's lesion. Diagnosis and management.
AB  - A review of 177 cases of upper gastrointestinal hemorrhage due to Dieulafoy's
      lesion is reported. Dieulafoy's lesion is frequently responsible for severe and
      recurrent upper gastrointestinal hemorrhage. The lesion was predominantly found
      in the proximal stomach. Repeat endoscopies were needed in 33% of the patients in
      order to make the correct diagnosis. When preoperative diagnosis and localization
      were made, surgery was an effective therapeutic modality. Therapeutic endoscopy
      was successful in achieving permanent hemostasis in 85% of the reported cases. Re
      treatment was needed in an additional 10% and surgical therapy in 5% of the
      cases. Therapeutic endoscopy should be considered initially in all patients.
      Surgical intervention and angiography with embolization may be effective options
      if endoscopic therapy is unsuccessful.

PMID- 1748039
TI  - Roles of in vitro- and in vivo-administered histamine and serotonin in compound
      48/80-induced gastric acid secretion in isolated, perfused rat stomach.
AB  - In this investigation, an isolated, perfused rat stomach system was used to
      elucidate the roles of histamine, serotonin, and the action of cimetidine,
      methysergide, and propranolol in relation to the in vivo and in vitro
      administration of compound 48/80. While histamine administered both in vivo and
      in vitro stimulated acid secretion in the perfused rat stomach, serotonin, added
      in vitro, inhibited histamine-induced gastric acid secretion. Cimetidine, given
      either in vivo or in vitro, blocked histamine-induced acid secretion, and
      methysergide, but not propranolol, reversed the serotonin-induced inhibition of
      histamine-stimulated acid secretion. Compound 48/80, given in vitro, caused
      gastric acid secretion that was blocked by pretreatment with cimetidine.
      Administered in vivo, however, compound 48/80 inhibited both basal and histamine
      stimulated acid secretion. This inhibition was partially reversed by pretreatment
      with methysergide. The absence of inhibition of acid secretion by in vitro
      administered compound 48/80 may be related to the timing of the serotonin effect.
      When serotonin was given prior to histamine, it blocked acid secretion, whereas
      no inhibition occurred when serotonin was administered together with histamine.
      None of the other agents investigated affected basal acid secretion.

PMID- 1748040
TI  - Effects of stimulation and inhibition of acid secretion on gastric damage induced
      by platelet-activating factor.
AB  - Intravenous administration of platelet-activating factor (PAF) induces extensive
      damage in rat gastric mucosa. The aim of the present study was to examine whether
      the presence or absence of acid in the gastric lumen could modify the PAF-induced
      gastric damage. The effects of inhibition of basal and pentagastrin-stimulated
      acid secretion by ranitidine on the deep histological gastric damage induced by
      30 min of infusion of PAF (100 ng/kg/min) were assessed by using a histological
      score. Inhibition of basal gastric acid secretion did not prevent the
      histological gastric damage induced by PAF. Stimulation of gastric acid secretion
      by pentagastrin significantly increased PAF-induced gastric damage, and this
      effect was reversed by a dose of ranitidine that returns acid secretion to
      baseline levels. This acid-related damage was confined to the deep mucosa, since
      scanning electron microscope analysis ruled out an additional surface damage in
      PAF-infused rats when gastric acid was stimulated. The data indicate that a
      certain amount of acid may worsen the deep gastric mucosal damage induced by PAF.

PMID- 1748041
TI  - CP-66,948: an antisecretory histamine H2-receptor antagonist with mucosal
      protective properties.
AB  - CP-66,948 is a histamine H2-receptor antagonist with gastric antisecretory
      activity and mucosal protective properties. The affinity of CP-66,948 for the
      guinea pig atria histamine H2-receptor is 15 times greater than that of
      cimetidine and seven times greater than that of ranitidine. In vivo, the ED50
      value for inhibition of gastric acid secretion in pylorus-ligated rats is 2 mg/kg
      intraduodenally, and in histamine or pentagastrin-stimulated Heidenhain pouch
      dogs the antisecretory ED50 values are 0.3 mg/kg per os and 1.0 mg/kg per os,
      respectively. CP-66,948 also inhibits ethanol-induced gastric hemorrhagic lesions
      in rats following either oral or systemic administration (ED50 values of 12 mg/kg
      per os and 6 mg/kg subcutaneously). In addition, the mucosal protective activity
      is independent of prostaglandin synthesis. CP-66,948 inhibits gastric acid
      secretion in man, and its mucosal protective activity may provide additional
      benefits in peptic ulcer therapy.

PMID- 1748042
TI  - Alterations of intestinal microflora by antibiotics. Effects on fecal excretion,
      transit time, and colonic motility in rats.
AB  - The effects of intragastric antibiotics in rats were examined on fecal microflora
      and excretion and through transit time and cecocolonic myoelectric activity. A
      solution of nonabsorbable antibiotics infused into the stomach for 20 days had a
      dramatic effect on the quantity, composition, and bacterial content of rat feces.
      Both the dry weight and the water content of feces were increased. The amount of
      short-chain fatty acids in the feces was dramatically lowered. However, neither
      total nor cecocolonic transit time of solids was affected. The cyclic
      organization of cecocolonic myoelectric activity was altered by antibiotic
      treatment, and the motility index, ie, the quantity of myoelectric activity
      recorded on the colon, progressively increased. An infusion of short-chain fatty
      acids modified this motor pattern but did not restore activity to a level
      comparable to that of control animals. In conclusion, intragastric antibiotics
      dramatically reduced intestinal microflora and increased fecal excretion of dry
      matter and water but did not affect the transit time of solid gut contents,
      although they did influence cecocolonic motility.

PMID- 1748043
TI  - Pharmacokinetics of 5-aminosalicylic acid in man following administration of
      intravenous bolus and per os slow-release formulation.
AB  - The fate of 5-aminosalicylic acid (5-ASA), which is used in the treatment of
      chronic inflammatory bowel diseases, was studied in six healthy volunteers
      receiving doses of 100 mg and 250 mg intravenous bolus as well as 250 mg per os
      (slow release). Following intravenous administration, the drug was rapidly
      eliminated with a plasma half-life of about 40 min, mainly due to rapid
      metabolism. No parent drug was recovered in feces, and the total recovery
      following oral administration (30%) was significantly lower than following the
      intravenous doses (77% and 72%). Nonlinear pharmacokinetics were suggested as the
      2.5-fold increase in intravenous dose was followed by a significant relative
      increase (greater than 2.5) in the renal elimination of 5-ASA, as well as a
      significant decrease (less than 2.5) in the elimination of the metabolite N
      acetyl-5-ASA. There was also a trend towards a decreasing total body clearance
      and metabolic ratio. The present study confirms earlier findings on the
      pharmacokinetics of 5-ASA and suggests a possible saturation of the N-acetylating
      system in the dose range studied. This may be of interest in the design of
      controlled-release formulations and dosage regimes for the treatment of diseases
      of the small-bowel, where 5-ASA is easily absorbed. Further, for the first time,
      a marked difference in the intestinal fate compared to the systemic fate of the
      drug is demonstrated, suggesting alternative presystemic metabolism of 5-ASA,
      which may bear relevance to its mode of action. Further studies on the
      pharmacokinetics of 5-ASA, preferably in patients, are warranted.

PMID- 1748044
TI  - Antibodies to Mycobacterium paratuberculosis in patients with Crohn's disease.
AB  - IgG antibodies against Mycobacterium paratuberculosis protoplasmic antigen were
      looked for by an enzyme immunosorbent assay in patients with Crohn's disease,
      Ulcerative colitis, active pulmonary tuberculosis, past pulmonary tuberculosis,
      and in healthy controls. Serum reactivity for these antibodies was not correlated
      to PPD skin test positivity without history of mycobacterial disease. A cutoff
      based on the mean absorbance value of a pool of healthy blood donors was chosen.
      Positive values were found in 12/24 (50%) patients with active pulmonary
      tuberculosis and 2/10 (20%) skin-test-positive subjects with past pulmonary
      tuberculosis as expected, because antigenic sharing is common among different
      mycobacteria. The control group of blood donors showed borderline positivities in
      3/149 cases (2.01%). Positive values were found in 4/108 (3.70%) patients with
      Crohn's disease and 2/40 (5%) with ulcerative colitis. We conclude that our data
      do not support a causal relationship between the M. paratuberculosis and Crohn's
      disease, but occasional patients with inflammatory bowel diseases show unexpected
      positivities for these mycobacterial antibodies.

PMID- 1748045
TI  - Health status and health care use in persons with inflammatory bowel disease. A
      national sample.
AB  - We randomly surveyed 997 members of the Crohn's and Colitis Foundation of America
      with inflammatory bowel disease (320 ulcerative colitis and 671 Crohn's disease)
      in order to: (1) assess their health status, (2) compare members with ulcerative
      colitis and Crohn's disease, and (3) determine the correlates of health care use.
      Data collection included variables relating to physical and psychological
      symptoms, medication use, daily functional status, perceptions of health, and
      coping styles. The findings indicate that: (1) despite a number of symptoms and
      complications related to inflammatory bowel disease, the health status of this
      population is generally good and may be a result of effective coping styles; (2)
      those with Crohn's disease have more psychosocial difficulties, which appear
      related to greater symptom severity; (3) both psychosocial and physical health
      variables are related to number of physician visits, while primarily physical
      health variables are related to number of hospitalizations and surgeries. Further
      studies are needed to determine the representativeness of this self-selected
      sample with others having IBD. In this study, we have provided the basis for
      developing a more sensitive measure of health status than currently exists, and
      one which may have implications for future clinical studies.

PMID- 1748046
TI  - Breath hydrogen test using water-diluted lactulose in patients with
      gastrointestinal amyloidosis.
AB  - To investigate small bowel motility in gastrointestinal amyloidosis, lactulose
      breath hydrogen tests were performed on 16 patients with histologically proven
      amyloidosis and 12 age- and sex-matched controls. Fasting breath hydrogen
      concentration (FBHC) was not significantly different between the two groups, but
      there was a tendency for FBHC in symptomatic amyloidosis patients (median 31.5,
      range 3-78 ppm) to be higher than in asymptomatic amyloidosis patients (4, 0-34
      ppm, 0.05 less than P less than 0.1) and controls (6, 1-19 ppm, 0.05 less than P
      less than 0.1). Orocecal transit time (OCTT) was significantly delayed in the
      amyloidosis group (median 150, range 40-220 min) when compared to the controls
      (60, 20-110 min, P less than 0.01), but OCTT was not statistically different
      between symptomatic and asymptomatic amyloidosis patients. These data suggest an
      impaired motility of the stomach and small intestine in gastrointestinal
      amyloidosis and the possible role of small intestinal dysfunction such as
      bacterial overgrowth and malabsorption in the occurrence of symptoms in this
      disorder.

PMID- 1748047
TI  - Pelvic floor muscles response to graded rectal distension and cutaneous
      stimulation.
AB  - The responses of the external ani sphincter (EAS) and the levator ani (LA)
      muscles to graded rectal distension and to cutaneous and genital stimulation were
      examined in 25 cats of either sex. The animals were anesthetized with sodium
      pentobarbital (30 mg/kg, intraperitoneal) and then tested in two positions: with
      hindlimbs extended and with hindlimbs flexed simulating the straining position.
      Graded rectal distension was performed at two speeds: 1 and 10 sec. Basal levels
      of activity in the EAS were higher in the straining than in the extended position
      (P less than 0.005). The EAS responded to rapid rectal distension with inhibition
      of its activity. When changed to the straining position significant increases in
      muscular activity were observed after 35 cc of balloon insufflation (P less than
      0.005). In the same muscle, slow distension produced an initial decrease in
      activity followed by significant increases after insufflation of 40 cc in the
      extended position and of 30 cc in the straining position. Basal activity in the
      LA was similar in both positions tested. The main effects of rectal distension in
      this muscle were increases in activity, significant only after high volumes of
      air inflation in the straining position (P less than 0.0001). Cutaneous
      stimulation disclosed a receptive field that was widespread for the EAS,
      extending over lumbosacral dermatomes (L3-S2), but greatly restricted for the LA.
      Responses to vaginal and cervical stimulation were more reliably obtained from
      the LA (P less than 0.001). These differences indicate that the EAS and LA
      muscles of the cat correspond with distinct, although related neural circuits.

PMID- 1748048
TI  - Portal hypertensive colopathy. A new entity.
AB  - The aim of this paper was, first, to show in a case control study that in
      alcoholic cirrhotic patients colonic vascular ectasias (VE) are a complication of
      portal hypertension and, second, to establish in a histomorphometric study that
      colonic vascular ectasias and rectal varices (RV) are only endoscopic features of
      a new entity: portal hypertensive colopathy, the pathologic basis of which is
      colonic mucosal capillary ectasia. In the case control study, for each case,
      three age- and sex-matched controls selected from consecutive patients were used.
      Sixteen alcoholic cirrhotic patients, 12 men, 4 women (mean age +/- SD: 62 +/- 10
      years) had colonic vascular ectasias. The prevalence of esophageal varices (88%
      vs 44%, P less than 0.005), esophageal varices (greater than or equal to 5 mm)
      (44% vs 12.5%, P less than 0.01), previous history of bleeding from esophageal
      varices (44% vs 8%, P less than 0.005), and rectal varices (63% vs 6%, P less
      than 0.001) was significantly greater in cases with colonic vascular ectasias
      than in controls without colonic vascular ectasias. The relative risk of colonic
      vascular ectasias in alcoholic cirrhotic patients with esophageal varices versus
      cirrhotic patients without esophageal varices was 14.4 (95% confidence interval
      2.8-75.3). In the histomorphometric study, cirrhotic patients with vascular
      ectasias and/or rectal varices had a significantly higher mean diameter of
      vessels (20.3 +/- 1.5 microns vs 18.7 +/- 1.6 microns, P less than 0.05) and a
      higher mean cross-sectional vascular area (2143 +/- 396 microns 2 vs 1676 +/- 345
      microns 2, P less than 0.05) than cirrhotic patients without vascular ectasias
      and/or rectal varices.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748049
TI  - Ascitic fluid and serum cefotaxime and desacetyl cefotaxime levels in patients
      treated for bacterial peritonitis.
AB  - Forty-one episodes of ascitic fluid infection were treated with cefotaxime 2 g
      intravenously every 8 hr, and ascitic fluid and serum were sampled 6, 12, 24, 48,
      and 96 hr after the first dose of antibiotic. Concentrations of cefotaxime and
      desacetyl cefotaxime were measured in ascitic fluid and serum by high-performance
      liquid chromatography. There was essentially 100% penetration of cefotaxime and
      metabolite from serum into ascitic fluid at all time points. Ascitic fluid was
      sterilized in 94% of episodes after the first dose of antibiotic. The ascitic
      fluid concentration of cefotaxime 6 hr after the first dose of antibiotic was
      greater than 20 times the minimal inhibitory concentration of the drug for 90% of
      the isolated flora. This rapid ascitic fluid penetration of cefotaxime in high
      concentration explains the rapid sterilization of ascitic fluid by the drug in
      the setting of bacterial peritonitis and obviates the need to give a loading dose
      or intraperitoneal injection.

PMID- 1748050
TI  - Hepatotoxicity from paraaminobenzoic acid.

PMID- 1748051
TI  - Gallstone ileus successfully treated by shock-wave lithotripsy.

PMID- 1748052
TI  - Cyst of the gallbladder.
AB  - A cyst of the gallbladder is a very rare lesion. The possible causes of such an
      anomaly are reviewed. It may be acquired or congenital. The latter is
      particularly exceptional. A case of congenital cyst is reported and illustrated
      by various imaging techniques.

PMID- 1748053
TI  - Renal factors influencing blood pressure threshold and choice of treatment for
      hypertension in IDDM.
AB  - In this article, we analyze the blood pressure (BP) threshold for the start of
      antihypertensive treatment in insulin-dependent diabetes mellitus (IDDM)
      patients, with particular emphasis on those with persistent microalbuminuria or
      proteinuria (incipient and overt nephropathy, respectively). In such individuals,
      there is a clear increase in the prevalence of hypertension and in actual
      measured BP values that is not observed in normoalbuminuric patients. In 94 young
      healthy adults (less than 45 yr of age), average mean +/- SD arterial pressure
      (MAP; diastolic + 1/3 pulse pressure) was approximately 90.0 +/- 8.1 mmHg,
      closely corresponding to large population studies. In microalbuminuric IDDM
      patients, MAP values between approximately 105 and approximately 95 mmHg have
      been found in different studies, and the level has progressively decreased in
      various studies between 1984 and 1990 with similar BP-measuring techniques.
      Somewhat higher values are seen in patients with proteinuria, who are also
      consistently characterized by reduced glomerular filtration rate (GFR). A clear
      correlation is found between MAP plotted against the increased rate of
      microalbuminuria (%/yr) in incipient nephropathy and against fall rate of GFR
      (ml.min-1.mo-1) in proteinuric patients. In the natural history of renal disease,
      different cutoff points in MAP for start of progression are observed: greater
      than 95 mmHg for the start of progression of microalbuminuria and greater than
      105 mmHg for the decrease in GFR. During antihypertensive treatment, there is
      reduction or no progression in microalbuminuria with MAP of approximately 90-95
      mmHg and only a limited fall in GFR with MAP of approximately 100 mmHg. However,
      certain antihypertensive drugs (angiotensin-converting enzyme inhibitors) may
      have specific renoprotective actions, reducing microalbuminuria at rather low BP
      levels or even independent of BP reduction. The optimal way of monitoring BP may
      be by 24-h ambulatory recording.

PMID- 1748054
TI  - Factors influencing threshold and choice of treatment for hypertension in NIDDM.
      Cardiovascular factors.
AB  - In nondiabetic populations, there is an approximately 40% increase in stroke risk
      and a 25% increase in coronary heart disease (CHD) risk with every 6-mmHg
      increase above 75 mmHg in usual diastolic blood pressure. Diabetes increases the
      risk of both conditions by two- to threefold, and in diabetic patients,
      hypertension further increases these risks. The benefits of lowering blood
      pressure in nondiabetic subjects have been subjected to meta-analysis, which has
      demonstrated benefits equivalent to 100% reversal of the excess risk for stroke
      but with only approximately 50% of CHD risk reversible after 2-3 yr of treatment.
      In these analyses, the benefit of treating diastolic blood pressure is similar at
      all levels greater than 90 mmHg. If these results are extrapolated to diabetic
      patients, possible benefits of therapy for mild hypertension could be two to
      three times greater than in nondiabetic subjects, but this could still correspond
      to 300 person-yr of treatment to prevent one nonfatal stroke and 2500 person-yr
      of treatment to prevent one CHD death, with treatment that may deleteriously
      affect quality of life in 36% of all diabetic patients. There may also be risks
      in treating patients with mild hypertension who have existing CHD or left
      ventricular hypertrophy, which are more common in diabetes. Despite the
      theoretical risk of deleterious changes in several cardiovascular risk factors
      with thiazides or beta-blockers, most of the newer agents have not yet been
      demonstrated to produce similar benefits to the large prospective studies in
      which the aforementioned agents have been used.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748055
TI  - Relationship between insulin resistance and hypertension.
AB  - Patients with hypertension have been shown to be resistant to insulin-stimulated
      glucose uptake and to be both hyperinsulinemic and hypertriglyceridemic compared
      with matched normotensive control groups. These abnormalities are present before
      the institution of antihypertensive therapy and do not necessarily improve when
      blood pressure is effectively lowered. Insulin resistance, hyperinsulinemia,
      hypertriglyceridemia, and high blood pressure can be produced in fructose-fed
      Sprague-Dawley rats, but the development of these changes is inhibited by
      exercise training or somatostatin infusion. Furthermore, insulin-stimulated
      glucose uptake is lower in spontaneously hypertensive rats (SHRs) than Wistar
      Kyoto rats, and this is associated with higher plasma triglyceride concentrations
      and blood pressure. In addition, a defect in insulin-stimulated glucose uptake
      can be shown in adipocytes isolated from SHRs, and the greater the degree of in
      vitro insulin resistance, the higher the plasma insulin concentration and blood
      pressure. These data strongly support the view that abnormalities of insulin and
      lipid metabolism are associated with high blood pressure in both patients and
      rodent models of experimental hypertension. In the latter context, endogenous
      hyperinsulinemia and hypertriglyceridemia are risk factors for coronary heart
      disease. The fact that antihypertensive treatment has not focused on correcting
      these metabolic abnormalities may explain why it has been difficult to show that
      lowering blood pressure decreases the risk of coronary heart disease. It can be
      argued that abnormalities of carbohydrate and lipoprotein metabolism play a role
      in both the etiology of hypertension and the clinical course of hypertensive
      patients.

PMID- 1748056
TI  - Effects of antihypertensive treatment on insulin sensitivity with special
      reference to ACE inhibitors.
AB  - In 1984, the suspicion that pharmacological treatment may worsen the insulin
      resistance and associated metabolic abnormalities in lipid and carbohydrate
      metabolism and contribute to the relative failure of antihypertensive treatment
      to produce more than marginal reductions in cardiovascular morbidity and
      mortality led us to start a series of trials aimed at elucidating how
      antihypertensive drugs affect insulin sensitivity. These trials, which included
      assessment of insulin sensitivity by the euglycemic insulin clamp, showed that
      beta-adrenergic blockade and thiazide diuretic treatment (hydrochlorothiazide)
      increase insulin resistance and basal plasma insulin, whereas Ca(2+)-channel
      antagonists (verapamil and diltiazem), with the exception of the negative effect
      of nifedipine, are metabolically neutral. alpha-Adrenergic blockade with prazosin
      and angiotensin-converting enzyme (ACE) inhibition with captopril enhance insulin
      sensitivity. The mechanisms underlying the positive effects of ACE inhibition and
      beta-adrenergic blockade are largely unknown, but hemodynamic factors
      (vasodilation) may contribute by improving the access of glucose and insulin to
      skeletal muscle. The drugs, which were favorable or neutral with respect to
      insulin sensitivity, caused no changes in lipids or glucose homeostasis. In
      contrast, beta-blockers, except pindolol, had negative effects on triglycerides
      and high-density lipoprotein cholesterol, and thiazide diuretics caused adverse
      effects on total serum cholesterol, low-density lipoprotein cholesterol, and
      total and very-low-density lipoprotein triglyceride. The metabolic action of
      antihypertensive drugs is an important factor to consider in the choice of a
      proper treatment strategy in both diabetic and nondiabetic patients with
      hypertension.

PMID- 1748057
TI  - Introduction: hypertension and diabetes. Critical combination for micro- and
      macrovascular disease.

PMID- 1748058
TI  - Epidemiology of hypertension in diabetic patients and implications for treatment.
AB  - We review the epidemiology of hypertension in diabetic patients and discuss the
      implications for treatment. The relationship between coronary heart disease (CHD)
      mortality and blood pressure (BP) in the World Health Organization Multinational
      Study of Vascular Disease in Diabetics (WHO MSVDD) is evaluated. One thousand two
      hundred seventy-seven patients with insulin-dependent diabetes mellitus (IDDM)
      and 3463 patients with non-insulin-dependent diabetes mellitus (NIDDM), aged 35
      55 yr at baseline, from 10 centers throughout the world were evaluated. CHD
      mortality after a follow-up of 6-7 yr was measured. Estimates of usual diastolic
      BP were made with data from the Framingham study. The relative risk (RR) of CHD
      death was plotted against usual diastolic BP for IDDM and NIDDM, and the shapes
      of the relationship were compared with a meta-analysis of nine prospective
      studies in nondiabetic populations. For the NIDDM group, the CHD RRs were
      significantly greater than 1.0 only for the uppermost diastolic BP category (RR
      2.23, 95% confidence interval 1.14-4.40). For the IDDM group, the shape of the
      diastolic BP-CHD relationship was difficult to assess in view of the small number
      of events. In neither diabetic group was the evidence for a J-shaped
      relationship. Elevated BP is associated with increased cardiovascular/renal
      mortality in both types of diabetes. However, the efficacy of antihypertensive
      therapy in the prevention of these outcomes remains unclear. Prospective data
      from the WHO MSVDD do not provide clear evidence of benefit from treating
      diastolic BP less than 95-100 mmHg in NIDDM patients.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1748059
TI  - Islet cell antibody reactivity with human fetal pancreatic islets.
AB  - To evaluate the possibility of autoimmune processes against pancreatic islets in
      fetal life, we tested islet cell antibody (ICA) reactivity with 14 fetal
      pancreata obtained after abortion at the 15th up to the 19th week of gestation.
      Pancreatic islets positive for a monoclonal proinsulin antibody but non-reactive
      with ICA negative control serum were found in 9/14 pancreata and all (9/9) of
      them showed a positive reaction with the ICA standard. It is concluded that ICA
      reactivity may be detected in fetal human pancreata. Further studies on fetal
      islet cell antibody reactivity in the development of insulin dependent diabetes
      mellitus (IDDM) are warranted.

PMID- 1748060
TI  - Diabetes-related renal growth and IGF-I accumulation in castrated rats.
AB  - The effects of castration on diabetes-related renal growth and IGF-I regulation
      were studied. In the rat, prepubertal castration is associated with a normal or
      increased surge in plasma insulin-like growth factor I (IGF-I) at the time of
      'puberty'. In order to determine the role of sex steroids in the development of
      diabetes-related kidney growth and IGF-I regulation, Sprague-Dawley rats were
      castrated at the age of 4 weeks and streptozotocin diabetes was induced at the
      age of 13 weeks. The development of renal enlargement and kidney IGF-I levels was
      studied over the following 7 days. Kidney weight in diabetic animals was
      significantly greater than in controls, and by day 7, had increased by 27% (1.20
      +/- 0.03 vs 0.94 +/- 0.03 g, P less than 0.001). Kidney IGF-I content was
      significantly elevated in diabetic rats, peaking on day 1 (diabetic, 1159 +/- 302
      ng/g vs control, 237 +/- 53 ng/g, P less than 0.001) and remaining higher than
      control levels throughout the 7 days of the experiment. The pattern of diabetes
      related kidney growth and IGF-I regulation in castrated rats resembles that of
      age matched intact postpubertal controls, suggesting that sex steroids do not
      have a direct role in these phenomena.

PMID- 1748061
TI  - In vitro retinal and erythrocyte polyol pathway regulation by hormones and an
      aldose reductase inhibitor.
AB  - The effects of a high-glucose medium, insulin, and an aldose reductase inhibitor
      (ONO-2235) on sorbitol accumulation were compared in the human erythrocyte and
      the rabbit retina, while the effects of epinephrine on in vitro sorbitol
      accumulation were investigated in the human and rabbit retina. In both
      erythrocytes and the retina, linear increments of sorbitol accumulation were
      observed in a dose-dependent manner with 5 to 50 mM glucose. These increments
      were markedly inhibited by 100 microM ONO-2235 but not by insulin (400
      microU/ml). In the presence of 5 mM glucose, a dose-dependent increase of the
      sorbitol content of the rabbit retina was seen following epinephrine stimulation
      (0.4-4.0 microM and this was markedly reduced by 100 microM ONO-2235. Moreover,
      both 50 mM glucose and 4.0 microM epinephrine increased the sorbitol content of
      the retina from a diabetic patient, and the glucose-induced increment in sorbitol
      was significantly reduced by 100 microM ONO-2235. Our data suggested that aldose
      reductase inhibitors might be useful for the treatment of diabetic retinopathy,
      since the polyol pathway appears to be an important factor in its pathogenesis,
      and that catecholamines might have some role in the activation of the retinal
      polyol pathway.

PMID- 1748062
TI  - Low-dose octreotide is able to cause a maximal inhibition of the glycemic
      responses to a mixed meal in obese type 2 diabetic patients treated with insulin.
AB  - Short-term studies have shown that octreotide, a long-acting somatostatin analog,
      blunts postprandial glycemic responses and reduces insulin requirement in insulin
      treated diabetic patients. The aim of our study was to investigate the effects of
      three single, different doses of octreotide on the glycemic response to a mixed
      meal in eight insulin treated type 2 diabetic patients after secondary failure
      with hypoglycemic agents. Previous treatments were substituted by regular
      insulin, 0.5 U/kg/day divided into three sc injections, for at least seven days.
      All patients received: (a) regular insulin (0.1 U/kg, sc) at 7.30 am; (b)
      octreotide 25 micrograms sc or (c) 50 micrograms sc or (d) 100 micrograms sc
      simultaneously with insulin but injected at different sites. From 8.00 to 8.15
      the patients consumed a preconstituted fluid mixed meal of 250 ml. Following
      insulin alone a significant increase in blood glucose levels was observed after
      the meal. Abolished and not significantly different blood glucose responses to
      the meal after each of the three doses of octreotide were observed. Our findings
      suggest that with a low dose of octreotide (25 micrograms) it is possible to
      abolish the postprandial glycemic peak in type 2 diabetic patients treated with
      insulin.

PMID- 1748063
TI  - Insulin resistance and action in hypertriglyceridemia.
AB  - To define further the characteristics of insulin insensitivity associated with
      hypertriglyceridemia, the metabolic responses to the euglycemic insulin clamp
      were evaluated in 6 hypertriglyceridemic male patients and compared to 5 normal
      male controls. At baseline, the hypertriglyceridemic patients had elevated
      triglycerides (687 +/- 172 vs 78 +/- 7 mg/dl, P less than 0.005) and free fatty
      acids (702 +/- 36 vs 444 +/- 42 microM/l, P less than 0.005) concentrations.
      During the euglycemic insulin clamp, steady-state plasma glucose concentrations
      were similar in both groups (90.2 +/- 1.5 vs 88.8 +/- 2.3 mg/dl, ns) as were
      steady state insulin levels (142 +/- 10.1 vs 132.2 +/- 6.8 microU/ml**). The
      amount of glucose metabolized during the last hour of the clamp (M) was
      significantly reduced in the hypertriglyceridemic patient (2.9 +/- 0.4 vs 6.2 +/-
      0.7 mg.min-1.kg-1, P less than 0.001). Changes in free fatty acid, glycerol, B
      hydroxybutyrate, lactate and pyruvate during the euglycemic insulin clamp were
      similar indicating a preserved antilipolytic, antiketogenic and glycolytic
      intermediate (lactate + pyruvate) response to insulin and glucose infusion in the
      hypertriglyceridemic patients. In summary, hypertriglyceridemia is associated
      with insulin resistance as it relates to muscle glucose utilization. However,
      this is not universal, as a number of other insulin responsive pathways appear to
      be unaffected.

PMID- 1748064
TI  - One-year treatment with the aldose reductase inhibitor, ponalrestat, in diabetic
      neuropathy.
AB  - A double blind placebo controlled trial was performed to evaluate the effects of
      the aldose reductase inhibitor, ponalrestat, on symptomatic diabetic neuropathy.
      After a 4-week placebo run-in phase, 60 patients were 2:1 randomized to receive
      either 600 mg ponalrestat or placebo once daily over 12 months. Forty-six
      patients, 30 of whom were treated with ponalrestat and 16 with placebo, completed
      the study. Motor and sensory nerve conduction, thermal and vibration sensation
      thresholds, heart rate variation at rest, E/I ratio, pupillary dilation velocity
      and pupillary reflex latency were determined at baseline and after 6 and 12
      months. Neuropathic symptom scores were assessed every 3 months. Among the
      fifteen nerve function parameters studied, only trends in favour of ponalrestat
      were noted for heart rate variation and E/I ratio after 6 months (P = 0.06), but
      no significant differences between the groups could be demonstrated during the
      study. No adverse reactions were observed. It is concluded that one-year
      treatment with ponalrestat has no beneficial effects on symptoms or
      electrophysiological parameters in diabetic neuropathy.

PMID- 1748065
TI  - Correlation of glycosylated hemoglobin measured by affinity vs ion exchange
      chromatography with mean blood sugar in pediatric IDDM patients.
AB  - Affinity chromatography provides a more specific estimate of glycosylated
      hemoglobin (GlyHb) than does ion exchange chromatography (HbA1). However, whether
      GlyHb correlates closer than HbA1 with mean blood glucose has not been
      established. GlyHb and HbA1 were measured in pediatric IDDM patients attending a
      clinic (n = 285 visits) over a one year period and correlated with the mean of a
      patient's blood glucose measurements from records of home blood glucose
      monitoring. Mean GlyHb was higher than mean HbA1 (10.8% vs 9.6%) as was its
      standard deviation (2.2% vs 1.5%). While both GlyHb (r = 0.75) and HbA1 (r =
      0.65) were strongly correlated with estimates of mean blood glucose, the
      correlation with GlyHb was significantly stronger than with HbA1 for the entire
      spectrum of metabolic control (P = 0.03), as well as for a segregated group of
      'poorly controlled' patients with mean blood glucose greater than 150 mg/dl (P =
      0.04). The results suggest that GlyHb is more accurate than HbA1 for estimating
      metabolic control and that GlyHb shows greater discriminating power than HbA1,
      especially at high concentrations of blood sugar. The mean blood glucose can be
      estimated from the equation: mean blood glucose (mg/dl) = (11.3 x GlyHb) + 32.

PMID- 1748066
TI  - Activation of erythrocyte aldose reductase in man in response to glycaemic
      challenge.
AB  - Flux via the polyol pathway, which comprises the enzymes aldose reductase (AR)
      and sorbitol dehydrogenase (SDH), has been implicated in the debilitating
      complications of diabetes. Previous studies in this laboratory have indicated
      that erythrocyte AR activities are increased (by 72%) in insulin-dependent
      diabetic patients. To investigate the mechanism underlying this activation, the
      response of AR activity to oral glucose challenge was investigated in eight
      overnight-fasted human volunteers. Glucose consumption led to a transient
      activation (by 76%: P less than 0.01) of erythrocyte AR, which paralleled the
      rise and subsequent fall in blood glucose concentrations. It is concluded that
      erythrocyte AR activity is acutely modulated in response to hyperglycaemia by an
      as yet unknown mechanism.

PMID- 1748067
TI  - [The selection of spongiosa donors for a bone bank].
AB  - A prospective trial was carried out in 156 unselected patients (41 men, mean age
      67.5 years, 115 women, mean age 71.4 years) who had undergone total hip joint
      replacement because of degenerative or inflammatory arthritis or fracture of the
      neck of the femur. The excised femoral heads were subjected to three-stage bone
      bank screening so as to ascertain how many of them would pass the clinical,
      biochemical and microbiological exclusion criteria. Only 26 out of 156 femoral
      heads (17%) proved to be acceptable for the bone bank. Ninety patients (58%) were
      excluded on clinical grounds such as old age (over 80 years), malignant
      neoplasms, rheumatoid arthritis, previous intraarticular injections or long-term
      steroid medication. Positive hepatitis serology excluded 19%, and raised
      preoperative neopterin concentration excluded 25%, though three months
      postoperatively this was confirmed in only 2%. Routine neopterin assay seems to
      be a useful step towards improved bone bank screening, since neopterin
      concentration is clearly increased in recent virus infections such as HIV.
      Bacterial contamination was of no practical importance. Because of the low
      proportion of femoral heads passed as suitable for the bone bank, the existing
      exclusion criteria will have to be critically scrutinized, and alternative
      procedures for harvesting bone safe for transplantation (freeze drying,
      autoclaving, irradiation) will have to be employed.

PMID- 1748069
TI  - [A fistula between the rectosigmoid junction and the ileum as a complication of
      highly malignant AIDS-associated lymphoma].
AB  - A 29-year-old man, a known heroin addict until 1984 in whom HIV antibodies had
      been first demonstrated in 1985, was hospitalized because of fever, nocturnal
      sweating, weight loss and treatment-resistant diarrhoea. An opportunistic
      infection of the gastrointestinal tract was excluded microbiologically and
      serologically. Coloscopy and biopsy revealed a highly malignant gastrointestinal
      B-cell lymphoma, which had caused a spontaneous rectosigmoid-ileum fistula.
      Lymphoma infiltrations were also found in the duodenum, jejunum, left lung and
      brain. Because the underlying disease was far progressed (CD4/CD8 ratio: 0.04)
      and the patient was in a poor general condition neither surgery nor chemotherapy
      was undertaken. He died of cerebral lymphoma involvement. Gastrointestinal
      lymphoma should be included in the differential diagnosis of chronic diarrhoea in
      HIV-positive patients.

PMID- 1748068
TI  - [Pacemaker syndrome with AV-synchronized stimulation of the heart].
AB  - Characteristic signs of the pacemaker syndrome occurred in a 69-year-old woman
      with intermittent 3 degrees atrioventricular (AV) block after implantation of a
      dual-chamber AV-synchronized pacemaker. Cannon beats due to inappropriate atrial
      timing were the main haemodynamic finding. Their development and size depended on
      the programmed AV interval and AV-synchronized mode of stimulation. Very long AV
      intervals in the DDD mode at a heart rate of 100/min caused very unpleasant
      palpitations and pulsations in the upper thorax. The symptoms due to the cannon
      beats were avoided by changing to a short AV interval. The clinical and
      haemodynamic events were thus the consequence of preserved sinus node function
      with subsequent atrial triggering.

PMID- 1748070
TI  - [The antibiotic therapy of community-acquired pneumonias].

PMID- 1748071
TI  - [Hormonal therapy of breast carcinoma in women].

PMID- 1748072
TI  - [Insulin--a side issue or indeed the cause of hypertension?].

PMID- 1748073
TI  - [Liver biopsy].

PMID- 1748074
TI  - [A paranoid syndrome after discontinuing tuberculostatics].

PMID- 1748075
TI  - [Propranolol in portal hypertensive gastropathy].

PMID- 1748076
TI  - Influence of the fiber length on the power spectra of single muscle fiber
      extracellular potentials.
AB  - Influence of the fiber length on the power spectra of the single muscle fiber
      extracellular action potentials (SMFEAPs) as well as on the spectral changes
      under alterations in the propagation velocity (v) and intracellular action
      potential duration (Tin) was studied theoretically for a fiber-electrode distance
      typical of surface recordings. It was shown that the magnitude and distribution
      of the SMFEAP spectral power depend on the fiber length. The shorter the fiber,
      the wider the frequency region in which the total spectral power is distributed
      and the smaller the spectrum max amplitude. The fiber length affects the spectrum
      changes that are due to alterations in v or Tin, and, consequently, the spectrum
      characteristic frequencies--Fmax, Fmed and Fmean, as well as the total spectral
      amplitude (TSA) and total power (TP). Whereas for a relatively long fiber Fmax
      depends linearly on v and Fmed and Fmean increase with v increasing, for a short
      fiber the linearity of the relation between Fmax and v can be disturbed, and Fmed
      and Fmean can decrease with v increasing. Under the condition of a relatively
      short fiber, a change in Tin can cause changes not only in Fmed and Fmean, but in
      Fmax as well. It was shown, that as a result of the finite length of the muscle
      fibers as well as of the asymmetry of the end-plate location in relation to the
      fiber ends, dips can be observed in the spectrum even in a case of monopolar
      recording. Positions of the dips in the power spectra depend on propagation
      velocity.

PMID- 1748077
TI  - Electromyographic study of facial expressions during pathological laughing and
      crying.
AB  - We studied facial expressions during pathological laughing and crying in 6
      patients using EMG investigation. Increased EMG discharges of M. frontalis and M.
      corrugator supercilii are characteristic of pathological laughing and crying in
      addition to an increase of EMG discharges of M. orbicularis oculi, M. levator
      labii superiors, M. zygomaticus major, M. risorius and M. mentalis which we
      observed during natural laughing. Its patterns of facial expressions are similar
      to that of crying in normals. From the fact that normals show the same expression
      of laughing and crying in an extreme emotional outburst, we speculate that
      pathological laughing and crying is maximal manifestations of facial expressions
      caused by a release phenomenon of the upper center.

PMID- 1748078
TI  - Reversal of long-latency reflexes in first dorsal interosseous during a force
      tracking task.
AB  - Cutaneous reflexes in response to electrical stimulation of the index finger were
      recorded from first dorsal interosseous (1DI) at specified force levels under
      three conditions: during a static posture and during the incremental and
      decremental phases of a sinusoidal, force-tracking task. Under static conditions,
      while 1DI generated a steady force [10, 20 or 30% maximum voluntary contraction
      (MVC)], four reflex components could be identified: E1, I1, E2 and I2. The
      amplitudes of these components were measured as the subjects tracked a 0.5 Hz
      sine wave by gradually changing the force output of 1DI between zero and 40% MVC.
      E1 and I1 showed minimal changes from the static condition, while activity during
      the E2 period was inhibitory during the incremental phase and excitatory during
      the decremental phase of tracking. Abrupt switching from inhibition to excitation
      during the E2 period occurred around the transition from incremental to
      decremental force. Activity during the I2 period was less markedly modulated than
      that during E2. Reflex reversal during the E2 interval may function to reduce the
      rate of change of force under conditions requiring precise force-control.

PMID- 1748079
TI  - Premovement silence of EMG activity prior to movement in Parkinson patients.
AB  - Premovement silence (PMS) of tonic agonist electromyographic activity (EMG)
      preceding a maximum effort elbow extension was studied in eight bradykinetic
      Parkinson patients. The occurrence and duration of PMS have been shown to be
      significantly correlated with peak acceleration of movement in normal subjects.
      To determine if inability to silence the EMG prior to the initial agonist burst
      may contribute to bradykinesia of Parkinson's disease, patients maintained elbow
      extension against a tonic load on triceps, and in response to a tone performed a
      maximum effort elbow extension. All eight patients showed some trials (mean =
      30%) with PMS. However, neither the incidence of PMS nor its duration were
      significantly correlated with mean peak acceleration. A significant correlation
      was found between the incidence of abnormal initial agonist bursts, called
      "segmented bursts," and mean peak acceleration. We conclude that ability to
      silence the agonist muscle prior to movement is not strongly associated with
      bradykinesia in Parkinson's disease.

PMID- 1748080
TI  - Elbow torques and EMG patterns of flexor muscles during different isometric
      tasks.
AB  - This paper examines the torque responses and EMG activity levels in four muscles
      acting at the elbow joint during different combinations of one- and two- degree
      of freedom isometric torque production (single and dual tasks, respectively).
      Flexor and supinator/pronator torques and surface EMG signals from m. biceps
      brachii, m. brachialis, m. brachioradialis and m. triceps brachii were measured
      in 16 male subjects while they performed maximal effort isometric contractions of
      pure flexion, pure supination, pure pronation, combined flexion and supination
      and combined flexion and pronation. In the single tasks, the torque responses
      were consistent with task requirements, but the dual task results were surprising
      in that flexor torque levels were reduced as compared to pure flexion, while
      supinator/pronator torque levels were as high or higher than in pure supination
      or pronation. Muscle activity levels varied with task, and could not always
      explain the differences observed in torque responses. These data are discussed
      within the framework of subpopulations of task-specific motor units within each
      muscle. The implications of such task-specific muscle units are related to
      musculoskeletal modelling and previous EMG - torque relationships found at the
      elbow.

PMID- 1748082
TI  - Presentations from the twenty-second annual meeting of the Environmental Mutagen
      Society. April 6-11, 1991.

PMID- 1748081
TI  - Workshop overview: new molecular techniques in genome analysis.
AB  - An overview of the application of various molecular techniques to the analysis of
      genomic DNA is presented. For the analysis of small-scale changes, the polymerase
      chain reaction (PCR), colony probe hybridization, mismatch hybridization, and
      denaturing gradient gel electrophoresis (DGGE) are providing information on
      mutations within prokaryotic and eukaryotic genes. For large-scale changes,
      fluorescence in situ hybridization (FISH), pulsed-field gel electrophoresis
      (PFGE), Southern blotting, multiplex PCR, hybridization of linked probes, and
      restriction enzyme mapping are permitting analysis of genomic alterations that
      are larger than point mutations but below the resolution of standard cytogenetic
      analysis. Many of these techniques, either alone or in combination, produce DNA
      that can be subjected to DNA sequence analysis, which provides the most detailed
      information regarding genomic changes.

PMID- 1748083
TI  - Analysis of Salmonella typhimurium hisD3052 revertants: the use of
      oligodeoxyribonucleotide colony hybridization, PCR, and direct sequencing in
      mutational analysis.
AB  - A rapid method for determining the DNA sequences of Salmonella typhimurium
      hisD3052 revertants is presented. DNA colony hybridization was used to analyze
      revertants previously studied by Isono and Yourno [Proc Natl Acad Sci USA 71:1612
      1617, 1974]. Synthetic oligodeoxyribonucleotide probes (18-mers) were able to
      distinguish sequences that differed by a single base pair. Mutant his sequences
      not identified by probing analysis were amplified using polymerase chain reaction
      (PCR) and directly sequenced. The combined use of DNA-colony hybridization and
      direct sequencing offers a precise and rapid means for the molecular
      characterization of hisD3052 revertants.

PMID- 1748084
TI  - Rapid localization of point mutations in PCR products by chemical (HOT)
      modification.
AB  - Our studies of mutational mechanisms in mammalian cells use the AS52 Chinese
      hamster ovary cell line. AS52 mutants can be selected as 6-thioguanine resistant
      colonies and mutations are studied at a chromosomally integrated gpt locus.
      Mutant gpt sequences are amplified using the polymerase chain reaction (PCR) to
      distinguish deletions from putative point mutations. PCR is efficiently performed
      from a few thousand lysed cells or from isolated genomic DNA. Amplified mutant
      PCR fragments carrying putative point mutations are further characterized by
      localizing the site of the mutation using chemical modification. A heteroduplex
      molecule consisting of one wild-type and one mutant DNA strand is generated. A
      base mismatch will be produced at the site of the mutation. Mismatched cytosine
      or thymine residues are sensitive to modification by hydroxylamine or osmium
      tetroxide, respectively. The modified DNA heteroduplex is then sensitive to
      piperidine cleavage. If one strand is 32P-end labeled, then the cleavage product
      can be separated on a denaturing acrylamide sequencing gel and visualized using
      autoradiography. Thus, the site of a mutation can be localized to a specific
      region of the gene, thereby simplifying the DNA sequence analysis and
      facilitating the rapid generation of mutational sequence spectra.

PMID- 1748085
TI  - Use of PCR amplification of cDNA to study mechanisms of human cell mutagenesis
      and malignant transformation.
AB  - PCR is widely employed to amplify short segments of genomic DNA to determine if a
      specific change has occurred. But some investigators need to sequence the entire
      coding region of mammalian genes to determine what specific changes have
      occurred. In 1989, we [Yang et al: Gene 83:347-354] described a method to copy
      mRNA of the hypoxanthine (guanine) phosphoribosyl transferase (HPRT) gene
      directly from the lysate of a clone of 6-thioguanine-resistant mutant diploid
      human fibroblasts without the need for RNA extraction or DNA template
      purification. To avoid detecting random changes introduced by polymerases, 100 to
      500 cells from an individual clone, each containing the identical mutation, are
      lysed and the cDNA is amplified 10(10)-to 10(11)-fold to obtain 5 to 10
      micrograms of DNA. The consensus sequence of the cDNA is determined by direct
      nucleotide sequencing. Using this method, we have investigated the kinds of
      mutations induced by carcinogens in the coding region of the HPRT gene and their
      location in the gene and examined the role of DNA repair in this process. Normal
      repair-proficient human cells and cells deficient in DNA repair were exposed to
      mutagens in exponential growth or synchronized and exposed at the beginning of S
      phase or in G1 phase several hr prior to DNA replication. The kinds and location
      of mutations in the HPRT gene were determined and knowledge of the nature of the
      DNA lesions formed by the various mutagens allowed assignment of the DNA strand
      in which the premutagenic lesion that gave rise to the mutation had been located.
      Related assays involving PCR have been used to determine the nature of mutations
      in the coding region of the H-, N-, or K-ras genes of tumor-derived malignant
      human cells and to determine whether or not such cells express specific growth
      factor genes.

PMID- 1748086
TI  - Analysis of mutations using PCR and denaturing gradient gel electrophoresis.
AB  - Denaturing gradient gel electrophoresis (DGGE) separates DNA molecules based on
      primary sequence. Under the appropriate conditions, all base pair (bp)
      substitutions, frame-shifts, and deletions less than about 10 bp can be resolved
      from the wild type sequence using DGGE. Polymerase chain reaction (PCR) permits
      facile amplification of a given region of the genome. We have combined PCR and
      DGGE to: (i) Localize mutations in the X-linked human androgen receptor gene.
      PCR/DGGE was used to screen the individual exons in the 2757-bp coding region of
      the gene in afflicted individuals as well as in potential carriers. Inheritance
      of a mutant allele has been demonstrated in several cases; (ii) Analyze thousands
      of thioguanine-resistant mutants simultaneously. The in vitro mutational spectra
      of MNNG, ICR-191, and cisplatin at the human HPRT locus have been examined by
      this method. The compounds all have mutational hotspots in a GGGGGG sequence in
      exon 3; however, the particular mutations induced by the agents were different;
      (iii) Examine the fidelity of several DNA polymerases used in PCR. The fidelity
      of Thermus aquaticus DNA polymerase (Taq) is 1-2 x 10(-4)
      misincorporations/bp/replication. Problems with Taq polymerase arise in the
      analysis of complex mutant populations by DGGE because the Taq-induced errors
      reduce the sensitivity of the system. To circumvent this, it had been necessary
      to use Sequenase, a modified T7 DNA polymerase with a higher fidelity. However,
      Sequenase is not thermostable and must be added every PCR cycle. A thermostable
      DNA polymerase from Thermococcus litoralis (Vent) is now available, and we have
      examined the fidelity of Vent, Taq, and Sequenase polymerase in PCR using DGGE.
      The fidelity of Vent, Taq, and Sequenase polymerase was 2.4 x 10(-5), 8.9 x 10(
      5), and 4.4 x 10(-5) errors/bp, respectively. Vent polymerase had the highest
      fidelity of the three enzymes tested.

PMID- 1748087
TI  - A molecular geneticist's view of complex genomic lesions.
AB  - Molecular genetic techniques have been used effectively to study the DNA lesions,
      many of which are large and complex, that are responsible for human genetic
      disease. In this workshop we explore some of these techniques, how they are
      applied to study genetic lesions, and how they may be applied to the needs of
      genetic toxicology.

PMID- 1748088
TI  - DNA sequence mapping by fluorescence in situ hybridization.
AB  - Various types of DNA probes, such as total genomic DNA, repetitive sequences,
      unique sequences, and composites of chromosome-specific DNA probes, can be used
      with fluorescence in situ hybridization (FISH) techniques to address research
      questions having to do with localization, mapping, and distribution of DNA in
      situ. FISH involves the formation of a heteroduplex between such DNA probes and
      chromatin targets on a microscope slide, which can be visualized with fluorescent
      reporter molecules. Three chromatin targets--metaphase chromosomes, somatic
      interphases, and zygote interphases--offer increasingly extended states of
      chromatin which can be strategically selected, individually or in combination, to
      address specific research questions of interest.

PMID- 1748089
TI  - Analysis of human HPRT deletion mutations with X-linked probes and pulsed field
      gel electrophoresis.
AB  - Because the human hprt gene is used in numerous mutation studies, it is important
      to fully characterize this gene. Therefore, our laboratory has undertaken to map
      the region around the hprt gene at band q26 of the human X chromosome. Utilizing
      hprt mutant T-cell clones isolated using the hprt clonal assay, which have
      deletions of all or part of the hprt gene, we have ordered 5 anonymous probes
      previously known to map in Xq26. Results suggest that this region includes
      between 460 kb and 18 Mb of DNA, which is at least 10 times the size of the hprt
      gene itself (43 kb). Pulsed field gel analysis of the region is underway to
      determine the exact distances between each of the anonymous probes and hprt and
      to determine deletion sizes in the mutant T-cell clones.

PMID- 1748090
TI  - Direct DNA sequencing of PCR products.
AB  - Experiments are described which elucidate some of the technical problems
      associated with the direct sequencing of polymerase chain reaction (PCR)
      amplified DNA. Sequencing primer purity, labeling methodology, and template
      preparation were explored. Conditions are presented for the routine sequencing of
      single- and double-stranded PCR products.

PMID- 1748091
TI  - Micronuclei as an index of cytogenetic damage: past, present, and future.
AB  - The workshop was designed to present what is known about the production of
      micronuclei, what protocols are now accepted or proposed internationally, what
      new results have been obtained, and what new methods and protocols are likely to
      be forthcoming. This report is designed to convey the flavour of the workshop and
      to provide the essence of the new information. After the workshop an effort was
      made to determine what single protocol would satisfy the requirements set for the
      micronucleus test by as many regulatory agencies as possible. The result,
      reported here, includes the requirements of six regulatory authorities in Canada,
      the European Economic Community, the Organization for Economic Co-operation and
      Development, Japan, and the United States.

PMID- 1748092
TI  - Overview: industrial perspectives on existing in vivo gene mutation assays.
AB  - In vivo gene mutation assays are considered the most definitive for the
      evaluation of human health risks. Suggestions are provided here for the critical
      evaluation of the application of established in vivo gene mutation assays and
      alternative approaches in the evaluation of industrial chemicals. Objective
      evaluation of the assays and approaches based on sound science and practical
      issues will allow better application of the existing assays. Such an evaluation
      may also help illuminate areas of improvement, as well as help guide the
      development of future assays.

PMID- 1748093
TI  - EPA use of in vivo germ cell mutagenicity data.
AB  - The Toxic Substances Control Act (TSCA) provides the U.S. Environmental
      Protection Agency, Office of Toxic Substances (EPA, OTS) with the authority to
      regulate chemical use by requiring testing and use restrictions as appropriate to
      protect human health. Regulation on the basis of heritable mutation induction is
      specifically mentioned in the Test Rule section of the law and has also been
      pursued for new chemical substances. A tiered scheme of mutagenicity testing has
      been employed and recently revised to assess mutagenicity hazard. In vivo assay
      systems play key roles at all three levels in the scheme, beginning with the
      first level of determining intrinsic mutagenicity hazard. Once intrinsic
      mutagenicity has been identified, the revised scheme requires an assay or assays
      to assess chemical interaction with gonadal DNA. Finally, the scheme contains
      tests that permit risk assessment for a chemical. The recently-revised Office of
      Pesticide Programs (OPP) mutagenicity testing requirements closely parallel those
      of OTS.

PMID- 1748094
TI  - Factors that affect the molecular nature of germ-line mutations recovered in the
      mouse specific-locus test.
AB  - The morphological specific locus test (SLT), which allows the scoring of 2,000
      loci/hr/person, has been in use for four decades for measuring mammalian germ
      line mutation rates under various conditions of exposure. More recently, the
      SLT's capabilities for the qualitative characterization of mutations have been
      exploited. The large sets of mutations centered on specific loci that have been
      accumulated over the years, including sets of nested deletions, have provided
      prime material for fine-structure genetic analyses. Subsequent molecular entry to
      these regions has led to intensive physical/functional mapping of megabase
      segments of the genome. In turn, these investigations have generated genetic and
      molecular tools for analyzing individual mutations as to extent and nature of the
      genomic lesion. Using the results of such analyses, it has been shown that germ
      cell-stage at which mutagenic treatment is administered, rather than the nature
      of the mutagen used, may be the chief determinant of the nature of genomic
      lesions. These and related quantitative findings now make it possible to optimize
      conditions for the use of mutagens in providing desired types of mutations as
      tools (e.g., high incidences of deletions or other rearrangements vs. high
      incidences of point mutations).

PMID- 1748095
TI  - The biochemical specific-locus test and a new multiple-endpoint mutation
      detection system: considerations for genetic risk assessment.
AB  - The importance of studying the generation of mutations in mouse germ cells is
      emphasized, and the utility of the biochemical specific-locus test in detecting
      germinal mutations is described. All experiments performed to date using this
      test are listed. The relevance of dominant mutations to human genetic risk is
      also discussed. Finally, the value of using multiple tests for the study of in
      vivo germinal mutations is discussed, and the design for a new multiple-endpoint
      system is presented.

PMID- 1748096
TI  - Emerging technologies--the use of transgenic mice for assessing mutagenic
      potential in vivo.

PMID- 1748097
TI  - A perspective on measurement of mutations in vivo.
AB  - The development of transgenic mouse lines with target genes that are suitable for
      tissue-specific mutagenesis studies is an important contribution to the field of
      environmental mutagenesis. These models can accommodate many of the questions
      relating to metabolism, distribution and relative potency of mutagens as well as
      providing a more comprehensive system for the identification of mutagens.
      However, the lesions that the field has learned about methods, development and
      validation from the use of in vitro systems must be applied to the development
      and validation of transgenic models.

PMID- 1748098
TI  - Uniqueness of interval and continuous training at the same maintained exercise
      intensity.
AB  - The present study sought to evaluate the inconsistencies previously observed
      regarding the predominance of continuous or interval training for improving
      fitness. The experimental design initially equated and subsequently maintained
      the same relative exercise intensity by both groups throughout the program.
      Twelve subjects were equally divided into continuous (CT, exercise at 50% maximal
      work) or interval (IT, 30 s work, 30 s rest at 100% maximal work) training groups
      that cycled 30 min day-1, 3 days.week-1, for 8 weeks. Following training, aerobic
      power (VO2max), exercising work rates, and peak power output were all higher (9
      16%) after IT than after CT (5-7%). Vastus lateralis muscle citrate synthase
      activity increased 25% after CT but not after IT. A consistent increase in
      adenylate kinase activity (25%) was observed only after IT. During continuous
      cycling testing the CT group had reduced blood lactate (lab) levels and
      respiratory quotient at both the same absolute and relative (70% VO2max) work
      rates after training, while the IT group displayed similar changes only at the
      same absolute work rates. By contrast, both groups responded similarly during
      intermittent cycling testing with lower lab concentrations seen only at absolute
      work rates. These results show that, of the two types of training programs
      currently employed, IT produces higher increases in VO2max and in maximal
      exercise capacity. Nevertheless, CT is more effective at increasing muscle
      oxidative capacity and delaying the accumulation of lab during continuous
      exercise.

PMID- 1748099
TI  - The effect of exercise intensity and duration on salivary immunoglobulin A.
AB  - Two experiments were performed to examine salivary immunoglobulin A (s-IgA)
      responses to varying levels of exercise intensity and duration. For experiment 1,
      9 college men (mean age, SD = 23.56, 1.64 years) completed treadmill runs of 15,
      30, and 45 min at approximately 60% of maximum oxygen consumption (VO2max). For
      experiment 2, 9 other college men (mean age, SD = 23.67, 2.0 years) ran for 20
      min at approximately 50, 65 and 80% of VO2max. Unstimulated salivary samples were
      collected before, and immediately, 1 and 2 h after the exercise. Samples were
      assayed for s-IgA using an enzyme-linked immunosorbent assay. Mean s-IgA levels
      did not change significantly (P greater than 0.05) at any of the post-exercise
      collection times when compared to pre-exercise levels. The results of this
      investigation indicated that running at intensities of 50-80% of VO2max and for
      durations of 15-45 min did not affect s-IgA levels.

PMID- 1748100
TI  - Maximal peak torque as a predictor of angle-specific torques of hamstring and
      quadriceps muscles in man.
AB  - This study assessed the relationship between the isokinetic peak torque (PT)
      (speed of movement 1.05 and 3.14 rads-1) and the angle-specific torques (ASTs) at
      0.26 and 1.31 rad of knee flexion in multiple contractions of the quadriceps and
      hamstrings in 70 individuals with a chronic anterior cruciate ligament (ACL)
      insufficiency and 78 individuals with a chronic medial collateral ligament (MCL)
      insufficiency in one knee. At every test speed, the Pearson product moment
      correlation coefficients (r) between the PT and ASTs were highly significant (P
      less than 0.001) in the uninjured knees (r = 0.61-0.93) as well as in the knees
      with ACL (r = 0.61-0.87) and MCL (r = 0.74-0.91) insufficiency. In addition, in
      both groups the majority of the correlation coefficients exceeded 0.80, which is
      generally regarded as the threshold for the relationship to be considered
      clinically significant. Furthermore, using regression analysis, both extremities
      showed completely non-systematic distribution of the residuals. It is concluded
      that in healthy knees or knees with ACL or MCL insufficiency, the predictability
      of ASTs from PT was good, and, therefore, that AST analyses may offer little
      additional information about thigh muscle function to that obtained from a
      simpler and more commonly used measurement, the PT analysis.

PMID- 1748101
TI  - Plasma noncholesterol sterols in male distance runners and sedentary men.
AB  - Plasma lathosterol concentration is taken to be an index of the rate of
      cholesterol synthesis and plasma concentrations of plant sterols just as
      campesterol and betasitosterol are taken to be indeces of cholesterol absorption
      efficiency. These noncholesterol sterols were measured in plasma from 14 male
      distance runners and 10 sedentary men. Plasma lathosterol concentration was 30%
      lower (P less than 0.02) and plasma betasitosterol concentration was 33% higher
      (P less than 0.02) in the runners compared to the sedentary men. Plasma
      concentrations of lathosterol and plant sterols were inversely and significantly
      (P less than 0.05) correlated in both the runners and the sedentary men. Plasma
      plant sterol concentrations were correlated positively and significantly (P less
      than 0.01) with plasma high density lipoprotein cholesterol (HDL-C)
      concentrations in the runners and sedentary men combined. These findings suggest
      that more efficient cholesterol absorption may lead to higher plasma plant sterol
      concentrations and may contribute to lower cholesterol synthesis rates, reduced
      concentrations of plasma lathosterol and higher plasma HDL-C concentration in
      distance runners.

PMID- 1748102
TI  - Electromechanical response times and muscle elasticity in men and women.
AB  - The purpose of this study was to compare the delay in performance attributable to
      muscle elasticity in men and women. A group of 11 active young men age (mean, SE)
      21.9, 0.7 years, stature 1.780, 0.020 m, body mass 76.4, 3.2 kg and 11 women age
      20.9, 0.4 years, stature 1.670, 0.020 m and body mass 61.9, 2.6 kg provided
      written informed consent and were recruited to the study. In response to an
      acoustic signal delivered via headphones, the subjects performed a plantar
      flexion movement of the preferred leg as quickly as possible. A seated position
      ensured that the knee of the subject was flexed at a right angle and that the
      shank was vertical. The ball of the foot was on a force platform which was used
      detect the onset of muscle tension and the heel rested on a pressure pad which
      was used to identify movement. Surface electrodes sensed electromyographic
      activity (EMG) in the soleus muscle. Force platform output was captured by a
      digital storage oscilloscope and recorded via a y-t pen recorder or subsequent
      analysis. A separate timer was used to determine total reaction time (TRT).
      Premotor time (EMGT) was taken to be the time interval from the delivery of the
      signal to change in EMG. Electromechanical delay (EMD) was the time interval
      between the change in EMG and movement and was subdivided into force time (FT)
      i.e. the time interval between EMG and the onset of muscle tension and elastic
      charge time (CT) i.e. the time interval between the onset of muscle tension and
      movement. The subjects performed ten trials and in most cases the mean of ten
      readings was used to determine TRT, EMGT, EMD, FT and CT.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1748103
TI  - The influence of metabolic alkalosis upon exercise metabolism in the thoroughbred
      horse.
AB  - Six thoroughbred horses exercised on a motorised treadmill on two separate
      occasions at a speed of 11 or 12 m.s-1 for up to 2 min. 4 h prior to exercise
      each horse was given a 21 test solution of sodium bicarbonate (NaHCO3; 0.6 g.kg-1
      body mass) or a control solution of water by nasogastric intubation, the order of
      administration of the two solutions was randomised. Blood samples (n = 15) were
      obtained before and during the 4 h after intubation, during exercise and for 30
      min after exercise. NaHCO3 ingestion resulted in changes in pre-exercise acid
      base status. The changes in blood lactate and base excess with exercise were
      greater after NaHCO3 administration; after 1 min of exercise in the case of
      lactate (P less than 0.05) and immediately after exercise in the case of base
      excess (P less than 0.05). Plasma ammonia levels were lower during (P less than
      0.05) and immediately after (P less than 0.05) exercise following NaHCO3
      ingestion. The peak change in plasma ammonia with exercise was also lower after
      NaHCO3 ingestion (P less than 0.05). Following exercise after NaHCO3 ingestion,
      five horses demonstrated lower muscle adenosine 5-triphosphate loss (P less than
      0.05) and inosine 5-monophosphate formation (P = 0.05) and higher glycerol 3
      phosphate formation (P less than 0.05). There is evidence to suggest that
      metabolic alkalosis may delay the onset of fatigue by decreasing the extent of
      adenine nucleotide loss during high-intensity exercise.

PMID- 1748104
TI  - The validation of backward extrapolation of submaximal oxygen consumption from
      the oxygen recovery curve.
AB  - The purpose of this study was to determine the validity and practicality of
      exponential vs linear backward extrapolation of the O2 recovery curve for
      prediction of exercise oxygen consumption (VO2). Eight men and women, age 20.1,
      0.9 years, body mass 66.0, 2.5 kg (mean, SEM), completed seven bouts of cycle
      ergometer exercise at submaximal power outputs ranging from 50 to 175 W.
      Respiratory gases were collected from each subject during exercise and recovery.
      The monoexponential extrapolation of five recovery samples (r2 = 0.85) and linear
      extrapolation of one recovery sample taken during the first 20-s of recovery (r2
      = 0.83) accounted for similar amounts of variance in predicting exercise VO2. The
      linear regression equation was the most practical predictor, as only one recovery
      gas sample was necessary and it did not require the complicated mathematical
      techniques used in exponential regression.

PMID- 1748105
TI  - Altered metabolic response of iron-deficient women during graded, maximal
      exercise.
AB  - Metabolic responses during a standardized, progressive, maximal work capacity
      test on a cycle ergometer were studied in 11 women, mean age 28 (SEM 2) years, at
      admission to the study, after their body iron stores were depleted by diet,
      phlebotomy and menstruation for about 80 days and after iron repletion by diet
      for about 100 days, including daily iron supplementation (0.9 mmol iron as
      ferrous sulfate) for the last 14 days of repletion. Iron depletion was
      characterized by a decline (P less than 0.05) in hemoglobin, ferritin and body
      iron balance. Iron repletion, including supplementation, increased (P less than
      0.05) hemoglobin, ferritin and iron balance. No changes were observed in
      cardiovascular and ventilatory responses or peak oxygen uptake. Iron depletion
      was associated with a reduced (P less than 0.05) rate of oxygen utilization,
      total oxygen uptake and aerobic energy expenditure, and elevated (P less than
      0.05) peak respiratory exchange ratio and post-exercise concentration of lactate.
      Reduction of body iron stores without overt anemia affects exercise metabolism by
      reducing total aerobic energy production and increasing glycolytic metabolism.

PMID- 1748106
TI  - Effects of carbohydrate loading and underwater exercise on circulating cortisol,
      insulin and urinary losses of chromium and zinc.
AB  - The effects of carbohydrate loading on relative stress responses of eight male
      subjects performing intermittent leg exercise at 80% maximum oxygen consumption
      during headout immersion in 25 degrees C water were tested. Carbohydrate loading
      increased the number of work cycles completed, with less physical stress compared
      with that completed following the control diet period. Pre-exercise serum
      cortisol values were similar on both diets prior to exercise but following
      exercise control values were greater (1152, 94 vs 858, 77 nmol l-1; mean, SEM).
      Chromium losses, which have been shown to correlate with stress, were lower
      during the carbohydrate loading period, 8.6, 1.3 vs 12.4, 2.0 ng h-1, and were
      correlated with post-exercise serum cortisol. Urinary zinc losses were also lower
      during carbohydrate loading, while urinary losses of potassium, magnesium and
      calcium remained constant. Insulin values decreased similarly following exercise
      in both groups and were not altered by carbohydrate loading. These data
      demonstrate that carbohydrate loading increases immersion exercise output with
      less stress as determined by serum cortisol and urinary chromium losses.

PMID- 1748107
TI  - Haemodynamic responses to nonhypotensive central hypovolaemia induced by lower
      body negative pressure in men and women.
AB  - Haemodynamic responses to low levels of lower body negative pressure (LBNP) were
      investigated in two groups of healthy, normotensive volunteers (8 men and 8
      women) during two repeated experimental runs on two occasions, the latter
      determined by the different phases of the menstrual cycle in the women. The data
      consisted of systolic blood pressure (SBP), diastolic blood pressure (DBP) and
      mean blood pressure (MBP), pulse rate (fc), forearm blood flow (FBF) and forearm
      vascular conductance (FC). The resting cardiovascular status was similar in men
      and women, except that women had a significantly higher fc than men. LBNP (1.3,
      2.7 and 4 kPa) had no significant effect on any BP variable or on fc. However,
      FBF and FC were reduced at all levels of LBNP. Significant overshoots in FBF and
      FC were seen in all subjects following the release of LBNP of 2.7 and 4 kPa and,
      in most cases, after release of LBNP of 1.3 kPa. There were no significant gender
      differences in any of the responses to LBNP. Furthermore, none of the
      cardiovascular variables measured showed significant differences between the
      follicular and luteal phases of the menstrual cycle in women, either at rest or
      during exposure to LBNP, and the responses in the men on the two occasions were
      not different. These findings indicate that gender differences in responses to
      LBNP hypothesized previously are not apparent during and after exposure to low
      levels of LBNP.

PMID- 1748108
TI  - Effects of sleep disturbances on subsequent physical performance.
AB  - The purpose of the study was to compare the cardiovascular, respiratory and
      metabolic responses to exercise of highly endurance trained subjects after 3
      different nights i.e. a baseline night, a partial sleep deprivation of 3 h in the
      middle of the night and a 0.25-mg triazolam-induced sleep. Sleep-waking
      chronobiology and endurance performance capacity were taken into account in the
      choice of the subjects. Seven subjects exercised on a cycle ergometer for a 10
      min warm-up, then for 20 min at a steady exercise intensity (equal to the
      intensity corresponding to 75% of the predetermined maximal oxygen consumption)
      followed by an increased intensity until exhaustion. The night with 3 h sleep
      loss was accompanied by a greater number of periods of wakefulness (P less than
      0.01) and fewer periods of stage 2 sleep (P less than 0.05) compared with the
      results recorded during the baseline night. Triazolam-induced sleep led to an
      increase in stage 2 sleep (P less than 0.05), a decrease in wakefulness (P less
      than 0.05) and in stage 3 sleep (P less than 0.05). After partial sleep
      deprivation, there were statistically significant increases in heart rate (P less
      than 0.05) and ventilation (P less than 0.05) at submaximal exercise compared
      with results obtained after the baseline night. Both variables were also
      significantly enhanced at maximal exercise, while the peak oxygen consumption
      (VO2) dropped (P less than 0.05) even though the maximal sustained exercise
      intensity was not different.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748109
TI  - Administration of branched-chain amino acids during sustained exercise--effects
      on performance and on plasma concentration of some amino acids.
AB  - Previous studies have shown that sustained exercise in human subjects causes an
      increase in the plasma concentration ratio of free tryptophan: other large
      neutral amino acids [including the branched-chain amino acids (BCAA)]. This
      should favour the transport of tryptophan into the brain and also the synthesis
      of 5-hydroxytryptamine, which is thought to contribute to fatigue during
      prolonged exercise. A mixture of the three BCAA was given to subjects during a 30
      km cross-country race or a marathon (42.2 km) and the effects on mental and
      physical performances were measured. The mental performance, measured as the
      performance in the Stroop Colour and Word Test (CWT), was improved after, as
      compared to before the 30-km cross-country race when a BCAA supplement was given
      during the race, whereas the CWT scores were similar before and after in the
      placebo group. The running performance in the marathon was improved for the
      "slower" runners (3.05 h-3.30 h) when BCAA was taken during the race; however,
      there was no significant effect on the performance in the "faster" runners (less
      than 3.05 h). The results showed that both mental and physical performance was
      improved by an intake of BCAA during exercise. In addition, the effects of
      exercise on the plasma concentration of the aromatic amino acids were altered
      when a BCAA supplement was given during the marathon.

PMID- 1748110
TI  - Physiological responses to prolonged treadmill walking with external loads.
AB  - Limited information is available regarding the physiological responses to
      prolonged load carriage. This study determined the energy cost of prolonged
      treadmill walking (fixed distance of 12 km) at speeds of 1.10 m.s-1, 1.35 m.s-1,
      and 1.60 m.s-1, unloaded (clothing mass 5.2 kg) and with external loads of 31.5
      and 49.4 kg. Fifteen male subjects performed nine trials in random order over a 6
      week period. Oxygen uptake (VO2) was determined at the end of the first 10 min
      and every 20 min thereafter. A 10-min rest period was allowed following each 50
      min of walking. No changes occurred in VO2 over time in the unloaded condition at
      any speed. The 31.5 and 49.4 kg loads, however, produced significant increases
      (ranging from 10 to 18%) at the two fastest and at all three speeds,
      respectively, even at initial exercise intensities less than 30% VO2max. In
      addition, the 49.4 kg load elicited a significantly higher (P less than 0.05) VO2
      than did the 31.5 kg load at all speeds. The measured values of metabolic cost
      were also compared to those predicted using the formula of Pandolf et al. In
      trials where VO2 increased significantly over time, predicted values
      underestimated the actual metabolic cost during the final minute by 10-16%. It is
      concluded that energy cost during prolonged load carriage is not constant but
      increases significantly over time even at low relative exercise intensities. It
      is further concluded that applying the prediction model which estimates energy
      expenditure from short-term load carriage efforts to prolonged load carriage can
      result in significant underestimations of the actual energy cost.

PMID- 1748111
TI  - The role of fitness on VO2 and VCO2 kinetics in response to proportional step
      increases in work rate.
AB  - The purpose of this study was to determine the effect of fitness and work level
      on the O2 uptake and CO2 output kinetics when the increase in work rate step is
      adjusted to the subject's maximum work capacity. Nine normal male subjects
      performed progressive incremental cycle ergometer exercise tests in 3-min steps
      to their maximum tolerance. The work rate step size was selected so that the
      symptom-limited maximum work rate would be reached in four steps at 12 min in all
      subjects. Oxygen consumption (VO2) and carbon dioxide production (VCO2) were
      calculated breath by breath. For the group, the time (mean, SEM) to reach 75% of
      the 3-min response (T0.75) for VO2 increased significantly (P less than 0.01) at
      progressively higher work rate steps, being 53.3 (5.5) s, 63.5 (4.6) s, 79.5
      (5.0) s, and 94.5 (5.8) s, respectively. In contrast, T0.75 for VCO2 did not
      change significantly [74.9 (7.4) s, 75.6 (5.0) s, 85.1 (5.3) s, and 89.4 (6.3) s,
      respectively]. VCO2 kinetics were slower than VO2 kinetics at the low fractions
      of the subjects' work capacities but were the same or faster at the high
      fractions because of the slowing of VO2 kinetics. The first step showed the
      fastest rise in VO2. While VO2 kinetics slowed at each step, they were faster at
      each fraction of the work capacity in the fitter subjects. The step pattern in
      VO2 disappeared at high work rates for the less fit subjects.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1748112
TI  - The critical role of iron in some clinical infections.
AB  - The role of iron in certain clinical infections is revealed. In normal persons
      the antibacterial and antifungal properties of blood and other tissue fluids
      cannot be maintained unless there are exceptionally low levels of available iron.
      This is controlled by the presence of the unsaturated iron-binding proteins,
      transferrin and lactoferrin. In several clinical conditions an abnormal
      availability of iron is responsible for fatal septicaemia. This is because the
      phagocytic system is overwhelmed by rapidly growing organisms when iron is freely
      available.

PMID- 1748113
TI  - The use of lysis-based procedures for blood cultures.

PMID- 1748114
TI  - Evaluation of the new improved BHI-lysis blood culture medium for the BCB Roche
      system.
AB  - The new BHI-lysis blood culture medium for the BCB system (BCB release, Hoffmann
      La Roche), which lyses blood cells, was compared with the BHI-S broth of the same
      BCB system and the Signal system (Oxoid). A total of 2394 sets consisting of
      three bottles were each inoculated with 7 ml of blood at the bedside. In the
      laboratory agar-coated paddles were attached to the BHI-lysis and the BHI-S
      bottles, and the Signal device was mounted onto the Oxoid bottle. All systems
      were incubated at 35 degrees C for seven days. Of the 309 (13%) positive sets, 73
      (3%) were contaminated and in 242 (10%) sets a total of 250 pathogenic
      microorganisms were isolated. These could be grown significantly more often from
      the BHI-lysis bottle (n = 213) than from either the BHI-S (n = 189) or Signal
      bottle (n = 176). No significant differences in the time needed to achieve a
      positive result was noted between the BHI-lysis and BHI-S bottles, but comparison
      of the BHI-lysis and Signal bottles revealed that overall pathogens were detected
      earlier significantly more often with the BHI-lysis bottle. In view of the good
      performance of blood culture broths containing lysing agents, their wider use is
      warranted in future.

PMID- 1748115
TI  - Analysis of Escherichia coli isolates from subjects with travellers' diarrhoea
      using DNA probes and serotyping.
AB  - Escherichia coli isolated from faeces of 54 healthy volunteers who visited
      Tunisia for eight days were examined. These volunteers participated in a
      randomized double-blind placebo-controlled study to establish whether
      ciprofloxacin could prevent travellers' diarrhoea. Escherichia coli strains
      isolated before travel, during episodes of travellers' diarrhoea, immediately
      after return and five weeks after return were serotyped and tested for the
      presence of virulence genes indicating diarrheogenic properties by hybridization
      with a set of four non-radioactively labelled DNA probes. Subjects receiving
      ciprofloxacin prophylactically to prevent travellers' diarrhoea were asymptomatic
      and no Escherichia coli could be cultured shortly after return home. Sixty-four
      percent of subjects (18/28) who did not receive antibiotic prophylaxis suffered
      from travellers' diarrhoea. Hybridization tests detected 8 enterotoxigenic
      Escherichia coli strains producing heat stable toxin, 13 enterotoxigenic strains
      producing heat labile toxin and 10 strains which produced both heat labile and
      stable toxin. Of the 31 probe positive strains, 29 (94%) were cultured from 11
      volunteers with travellers' diarrhoea. A bacterial cause was thus determined in
      61% of the volunteers who experienced travellers' diarrhoea.

PMID- 1748116
TI  - Subtyping of Legionella pneumophila serogroup 1 isolates by small-fragment
      restriction endonuclease analysis.
AB  - Whole cell DNA of Legionella pneumophila isolates was examined by small-fragment
      restriction endonuclease analysis (SF-REA). Fourteen serogroup 1 isolates from
      tap water in one hospital collected before and after eradication measures had
      been taken were compared with control strains of serogroup 1 and other serogroups
      that were not epidemiologically linked. DNA was digested with EcoRI and
      electrophoresed on polyacrylamide gels. The gel patterns were made visible by
      silver staining and analysed by direct visual comparison. All 15
      epidemiologically unrelated strains of Legionella pneumophila serogroup 1 and of
      other serogroups exhibited different restriction fragment patterns. The isolates
      from the hospital could be clearly subdivided into two groups by SF-REA,
      suggesting that the hot water supply of the hospital was contaminated with two
      different strains. SF-REA performed on Legionella pneumophila serogroup 1 DNA
      enabled further subtyping of these organisms and thus appears to be a useful
      technique for investigating their epidemiology.

PMID- 1748117
TI  - Nosocomial outbreak of acute gastroenteritis in a neonatal intensive care unit in
      Tunisia caused by multiply drug resistant Salmonella wien producing SHV-2 beta
      lactamase.
AB  - In a Tunisian hospital 27 babies, including 12 who were premature, in a single
      intensive care unit suffered acute gastroenteritis in the period from January to
      May 1988. The mean age at the onset of gastroenteritis was 8.4 days; nine babies
      died. Salmonella wien was isolated from stools (all babies) and blood (4 babies).
      It was also isolated from the stools of one nurse and from a mattress. Twelve of
      the babies had received cefotaxime, which was successfully replaced by oral
      colimycin. The outbreak was stopped by the implementation of infection control
      measures. All isolates of Salmonella wien were of the same biotype, and had the
      same antibiotic resistance pattern (third generation cephalosporins, monobactams,
      aminoglycosides, chloramphenicol, trimethoprim and sulphonamides) and plasmid DNA
      restriction pattern. The isolates were all susceptible to a combination of
      cefotaxime and clavulanic acid (a beta-lactamase inhibitor), which displayed
      synergy, suggesting the presence of a beta-lactamase (geometric mean MICs 11.24
      micrograms/ml for cefotaxime alone and 0.24 micrograms/ml in combination with 0.1
      micrograms/ml potassium clavulanate). All isolates produced TEM-1 and SHV-2 beta
      lactamase which was not transferable to Escherichia coli by conjugation. The
      presence of the SHV-2 enzyme in Salmonella wien may allow it to adapt to newer
      beta-lactams which is a cause for concern in this hospital.

PMID- 1748118
TI  - Comparison of the Bactec and lysis concentration methods for recovery of Brucella
      species from clinical specimens.
AB  - In a comparison of the Bactec system and the lysis concentration procedure in the
      isolation of Brucella species in 54 patients the recovery rate was similar (60%
      and 55%, respectively). However, the recovery time was significantly shorter with
      the lysis concentration method than with the Bactec system (3.5 days versus 14
      days). The lysis concentration procedure for the culture of Brucella is simple,
      inexpensive and reliable, and produces results for the clinician relatively
      quickly.

PMID- 1748119
TI  - Quality control in antimicrobial disk susceptibility testing: a Belgian
      multicenter study.
AB  - A Belgian multicenter trial was conducted to evaluate problems encountered with
      quality control results of antimicrobial disk susceptibility testing and to
      compare the performance of BBL disks and Rosco tablets. Over a period of four
      weeks 18 laboratories daily tested three reference strains against eight
      antibiotics. A standardised method was used by all participants. For all results
      together 10.4% and 7.3% of the measurements with BBL disks and Rosco tablets,
      respectively, were outside the recommended range. Major problems were observed
      for some specific strain-antibiotic combinations. Standard deviations were
      similar for both systems; their precision was comparable. The results suggest
      that cooperation between manufacturers and some reference laboratories could be
      improved in order to establish optimal quality control limits.

PMID- 1748120
TI  - Comparison of different culture media for isolation of Chlamydia trachomatis by
      cell culture on HeLa cells.
AB  - The isolation yield and number of Chlamydia trachomatis inclusions was compared
      using DEAE-dextran pretreated HeLa cells cultured in four different media:
      Eagle's minimal essential medium (EMEM) with and without cycloheximide and
      Dulbecco's modification of EMEM (DMEM) with and without cycloheximide. Using DMEM
      without cycloheximide the number of inclusions was significantly higher than
      using EMEM without cycloheximide. In addition, the size of the inclusions was
      greatly enhanced. Use of DMEM or EMEM with cycloheximide yielded results
      comparable to those obtained with DMEM without cycloheximide.

PMID- 1748121
TI  - Detection of Chlamydia trachomatis by direct immunofluorescence improved by
      centrifugation of specimens.
AB  - During a study of women with laparoscopically investigated pelvic pain, genital
      tract specimens were examined for Chlamydia trachomatis using a direct
      fluorescent antibody (DFA) technique (MicroTrak, Syva) and culture. Some smears,
      particularly those from the upper genital tract, contained an inadequate number
      of cells when examined by the DFA technique and many cell monolayers were
      destroyed by the specimens. To obtain results for such samples, or to confirm the
      original DFA result, additional specimens which had been frozen at -70 degrees C
      or in liquid nitrogen were centrifuged at high speed and the resulting deposit
      examined by the DFA technique. By this means, 32 negative results were confirmed
      for specimens from 10 chlamydia-negative patients with pelvic inflammatory
      disease or with high chlamydial antibody titres, and 26 negative results were
      confirmed for 19 patients who were positive at other sites. In addition, three
      chlamydia-positive and six chlamydia-negative results were obtained for sites
      where the original smear for DFA testing had been inadequate (few epithelial
      cells) and six specimens that were negative originally were found to be positive.
      Thus, of 73 specimens that were either inadequate or negative by DFA testing
      originally, 9 (12%) were positive by DFA testing after centrifugation.

PMID- 1748122
TI  - Evaluation of a chemiluminometric immunoassay and a direct immunofluorescence
      test for detecting Chlamydia trachomatis in urogenital specimens.
AB  - A new chemiluminometric immunoassay (Magic Lite) and a direct immunofluorescence
      technique (MicroTrak) were compared with cell culture in the diagnosis of
      Chlamydia trachomatis infections. Both assays were evaluated using 260 genital
      specimens (89 men, 171 women), 26 of which were culture positive. The respective
      sensitivity of the chemiluminometric immunoassay and immunofluorescence technique
      was 88.5% and 84.6%, the specificity 97% and 99.6%, the positive predictive value
      76.7% and 95.6%, and the negative predictive value 98.7% and 98.3%. Both methods
      could serve as an alternative to culture in the diagnosis of urogenital
      chlamydial infections.

PMID- 1748123
TI  - Comparison of the in vitro antifungal activity of free and liposome-encapsulated
      amphotericin B.
AB  - One hundred and four pathogenic yeast isolates (32 Candida albicans, 20 Candida
      tropicalis, 20 Candida parapsilosis and 32 Cryptococcus neoformans) and 21 mould
      isolates (13 Aspergillus spp. and eight Fusarium spp.), most of which were
      isolated from patients with cancer, were tested for susceptibility to free
      amphotericin B and a small unilamellar liposomal formulation of amphotericin B
      using a microbroth dilution method. Minimal fungicidal concentrations were also
      determined for Candida spp. and Cryptococcus neoformans. The minimal inhibitory
      concentrations of liposomal amphotericin B were comparable with those of the free
      drug; furthermore, the fungicidal activity of these two drugs did not differ
      significantly.

PMID- 1748124
TI  - In vitro activity of Ro 09-1428 compared to other cephalosporins.
AB  - The in vitro activity of Ro 09-1428, a new catechol-type parenteral
      cephalosporin, was compared to that of ceftazidime, E-1040, cefpirome and
      cefepime against gram-positive and gram-negative organisms. Ro 09-1428 inhibited
      group A streptococci at less than or equal to 0.12 micrograms/ml, and group B, C
      and G streptococci and Streptococcus pneumoniae at 0.5 micrograms/ml, whereas for
      Staphylococcus aureus Ro 09-1428 had MICs of 8-16 micrograms/ml similar to
      ceftazidime and E-1040. Against Pseudomonas aeruginosa Ro 09-1428 was the most
      active agent, inhibiting isolates at less than or equal to 0.12-2 micrograms/ml,
      and inhibited ceftazidime-resistant isolates. The majority of Escherichia coli,
      Klebsiella spp., Proteus mirabilis, Citrobacter diversus, Providencia, Salmonella
      and Shigella were inhibited by less than or equal to 0.5 micrograms/ml as with
      the other cephalosporins. For most Citrobacter freundii and Enterobacter cloacae
      Ro 09-1428 had higher MICs of 4-16 micrograms/ml; most ceftazidime-resistant
      isolates of these species were resistant. Anaerobes, enterococci and Listeria
      monocytogenes were resistant to Ro 09-1428. Ro 09-1428 was not hydrolyzed by TEM
      1, TEM-2, Staphylococcus aureus PC-1, Moraxella catarrhalis Bro-1, Enterobacter P
      99, Pseudomonas aeruginosa Sabath-Abraham or Klebsiella beta-lactamases, but was
      hydrolyzed by TEM-3, TEM-7 and TEM-9. Ro 09-1428 was markedly less active at an
      acid pH.

PMID- 1748125
TI  - In vitro activity of cefcanel versus other oral cephalosporins.
AB  - Cefcanel is a new orally absorbed cephalosporin. Its activity was compared with
      that of cefuroxime, cefaclor, cephalexin, and cefixime against gram-positive and
      negative aerobic and anaerobic bacteria. Cefcanel had excellent activity against
      methicillin-susceptible Staphylococcus aureus and Staphylococcus epidermidis,
      MIC90 1 micrograms/ml, superior to the other oral cephalosporins. However,
      methicillin-resistant staphylococci were resistant, MIC greater than or equal to
      16 micrograms/ml. Streptococcus pyogenes and Streptococcus pneumoniae were
      inhibited by 0.015-1 micrograms/ml, concentrations comparable to other
      cephalosporins. Clostridium spp. were inhibited by 0.25 micrograms/ml, 8- to 128
      fold lower concentrations than were found for other agents, but the MICs were
      greater than 64 micrograms/ml for Bacteroides spp. The MIC90 for Moraxella
      catarrhalis was 1 micrograms/ml, similar to cefuroxime but 16-fold greater than
      the MICs of cefixime. Escherichia coli and Klebsiella pneumonia which were high
      beta-lactamase producers were resistant, MICs greater than 64 micrograms/ml, and
      50% of Enterobacter cloacae and Citrobacter freundii were resistant. Cefcanel was
      hydrolyzed by TEM-1, TEM-3 and Moraxella Bro-1 beta-lactamases. Escherichia coli
      containing TEM-1, 2, 3, 5, 7, and 9 had cefcanel MICs of greater than or equal to
      16 micrograms/ml. Although cefcanel inhibited gram-positive species as well as or
      at lower concentrations than other cephalosporins, it lacked activity against
      gram-negative species that produced common plasmid beta-lactamase although it
      inhibited Haemophilus influenzae carrying TEM-1.

PMID- 1748126
TI  - In vitro activity of the novel cephalosporin GR69153.
AB  - The in vitro activity of GR69153 was compared to that of ceftazidime,
      ceftriaxone, imipenem and gentamicin against a total of 702 recent clinical
      isolates. MICs were determined by a standard agar dilution procedure and two
      inocula (10(4) and 10(8) cfu) were used throughout. GR69153 inhibited 90% of
      isolates of Escherichia coli, Klebsiella pneumonia and Proteus mirabilis at less
      than or equal to 0.25 mg/l and 90% of isolates of Pseudomonas aeruginosa at less
      than or equal to 1 mg/l. Citrobacter freundii (MIC90 16 mg/l), Morganella
      morganii (MIC90 128 mg/l) and Enterobacter spp. (MIC90 greater than 128 mg/l)
      were considerably more resistant to GR69153. GR69153 was four-fold more active
      than ceftazidime against methicillin-sensitive Staphylococcus aureus but was
      inactive against methicillin-resistant Staphylococcus aureus, Enterococcus
      faecalis and Bacteroides fragilis group.

PMID- 1748127
TI  - Impact of dirithromycin on the normal oral and intestinal microflora.
AB  - Twenty healthy volunteers received 500 mg of dirithromycin orally once daily for
      seven days. The concentrations of dirithromycin in serum and saliva were low
      (less than or equal to 1.5 mg/l), while the faecal concentrations were high
      (greater than or equal to 12 mg/kg). The numbers of streptococci, Haemophilus and
      Neisseria increased in the aerobic oral microflora during dirithromycin
      treatment. In the aerobic intestinal microflora, the numbers of enterobacteria
      decreased significantly, while streptococci and staphylococci increased. New
      colonizing dirithromycin resistant enterobacteria were isolated during and after
      treatment. The anaerobic intestinal microflora was also affected; thus the
      numbers of gram-positive cocci, bifidobacteria, eubacteria and bacteroides
      decreased, while the numbers of clostridia and lactobacilli increased.
      Dirithromycin has an ecological impact on the oral and intestinal microflora.

PMID- 1748128
TI  - Actinobacillus hominis as a causative agent of septicemia in hepatic failure.

PMID- 1748129
TI  - Presumptive identification of Mycobacterium xenopi with the radiometric Bactec
      system.

PMID- 1748130
TI  - Federal early childhood special education policy: a model for the improvement of
      services for children with disabilities.
AB  - Services in early childhood special education for children with disabilities,
      birth through 5 years, and their families have expanded and improved
      substantially in the past 25 years. The federal government, through legislation,
      regulation, and a variety of incentives, has played an integral role in this
      progress. The authors review the evolution of federal education policy in early
      childhood and the accomplishments achieved, including the development of the
      Handicapped Children's Early Education Program, the Early Childhood Research
      Institutes, and Public Law 99-457, the Handicapped Infant and Toddler Program
      (Part H). This history can serve as a model for federal involvement in the
      improvement of services for other groups of individuals with special needs.

PMID- 1748131
TI  - Instruction in early childhood special education: "seeing through a glass darkly
      ... knowing in part".
AB  - This article discusses what is not known about instruction of preschoolers with
      disabilities. Knowledge gaps exist in four areas: the content of the curriculum,
      the procedures used to individualize instruction, the instructional procedures
      designed to ensure acquisition, and the strategies used to ensure skill use or
      generalization. Barriers to generating such knowledge include the fragmentation
      that results from specialization, the inadequacy of the data base, and the lack
      of training in instruction and research design and analysis. Solutions include
      training programs for early childhood special educators in the analysis,
      application, and design of research in instruction and curriculum, as well as the
      publication of multiple replications and refinements of instructional strategies.

PMID- 1748132
TI  - Mainstreaming during the early childhood years.
AB  - Issues surrounding the implementation of the integration imperative during
      infancy and early childhood present formidable challenges to education and
      community providers. Key among these issues is how professionals provide high
      quality services to young children with disabilities in mainstream environments.
      This article explores current issues related to integration and reexamines the
      concept of "best practices" as it applies to mainstreaming during the early
      childhood years. The author recommends an integrated set of indicators for high
      quality programs and describes an outcomes-based process for making
      administrative and pedagogical decisions.

PMID- 1748133
TI  - Clinical pharmacology in Europe. The WHO European Task Force on Clinical
      Pharmacology.

PMID- 1748134
TI  - Evaluation of three methods of symptom reporting in a clinical trial of
      felodipine.
AB  - 251 patients from 23 primary health care centres were recruited to a clinical
      trial in which either felodipine or placebo was added to baseline metoprolol
      treatment. Three methods of symptom reporting were used in 191 patients, namely
      two previously documented self-administered questionnaires and an adverse event
      monitoring system (spontaneous reports to treating physician). Higher frequencies
      of symptoms were seen with the questionnaires compared to spontaneous reporting.
      However, the overlap between the methods was moderate and they were found to
      complement one another. The questionnaires were completed twice during the study
      and the adverse event monitoring system was applied on five occasions. The rate
      of application had consequences for the ability of each method to detect
      transient, dose-related symptoms, e.g. headache and dizziness. Regardless of
      method, the possibility of detecting dose-related symptoms was enhanced when
      symptoms were measured not only during active treatment but also during a run-in
      or other baseline period, and both phases were considered in the analyses.

PMID- 1748135
TI  - Comparison of once daily felodipine 10 mg ER and hydrochlorothiazide 25 mg in the
      treatment of mild to moderate hypertension.
AB  - The efficacy of extended release felodipine 10 mg (ER) o.d., a new
      dihydropyridine calcium antagonist, and 25 mg hydrochlorothiazide (HCTZ) o.d.
      have been compared in a randomized, double-blind, crossover trial in 28 mildly to
      moderately hypertensive subjects (supine diastolic blood pressure, BP, greater
      than or equal to 95 mm Hg and less than or equal to 110 mm Hg on three separate
      occasions). Both drugs significantly reduced systolic and diastolic BP in the
      sitting position felodipine from 157.1/93.8 mm Hg at baseline to 133/78.9 mm Hg
      2.5 h after medication and to 138/82.7 mm Hg after 2 weeks of treatment, and HCTZ
      from 156/95.6 mm Hg to 147/88.4 mm Hg 2.5 h after medication and to 149/89.5 mm
      Hg also after 2 weeks. A decrease of the same magnitude in standing systolic and
      diastolic BP was observed after both treatment regimens with the exception of
      diastolic BP 2.5 h after dosing with HCTZ, which was not significantly lower. At
      all times (2.5 h and 2 weeks), the reduction in systolic and diastolic BP was
      greater after felodipine compared to HCTZ. Heart rate was significantly increased
      after felodipine in both the sitting and standing positions, and both 2.5 h
      following medication and after 2 weeks of treatment. The difference between the
      regimens was significant only 2.5 h after dosing. Overall, felodipine 10 mg ER
      o.d. was superior to 25 mg HCTZ o.d. in lowering BP.

PMID- 1748136
TI  - Comparison of the cardiovascular effects of nifedipine and nicardipine in the
      presence of atenolol.
AB  - A placebo controlled double blind crossover study was performed in 12 healthy
      volunteers to compare the cardiovascular effects of single oral doses of
      nifedipine (5, 10 and 15 mg) and nicardipine (20 and 30 mg) in the presence of
      atenolol 100 mg. Haemodynamic measurements were made by transthoracic electrical
      bioimpedance cardiography (TEBC) 2 h following drug administration during passive
      tilting, graded bicycle exercise (30-150 W) and recovery from exercise. In the
      absence of calcium channel blockade, atenolol reduced mean blood pressure, heart
      rate, and cardiac index, and increased stroke volume, peripheral resistance, pre
      ejection period, and ventricular ejection time, particularly during and after
      exercise. In comparison with atenolol alone, addition of nifedipine or
      nicardipine reduced peripheral resistance but did not produce significant changes
      in stroke volume, cardiac output, dZ/dt [max], pre-ejection period (PEP).
      Ventricular ejection time (VET), PEP/VET, or Heather index at any point in the
      experiment. Similar reductions in peripheral resistance were produced by
      nifedipine 10 mg and nicardipine 20 and 30 mg. These apparently equivalent doses
      of nifedipine and nicardipine had similar effects on stroke volume, cardiac
      index, PEP/VET and Heather index. Thus the increases in ventricular performance
      previously demonstrated in association with nifedipine and nicardipine therapy
      were not observed in the presence of beta-adrenoceptor blockade. Under these
      conditions no important differences have been observed in the cardiovascular
      effects of these two calcium channel blockers.

PMID- 1748137
TI  - Combined effects of nicardipine and hypocapnic alkalosis on cerebral vasomotor
      activity and intracranial pressure in man.
AB  - The effect of hypocapnic alkalosis (HA) on nicardipine-induced cerebral
      vasodilatation was studied in 2 groups of patients undergoing stereotaxic brain
      biopsy under general anaesthesia. Arterial diameter (AD) was measured in 16
      different locations on a carotid arteriogram (lateral view), and intracranial
      pressure (ICP) was recorded with an intraventricular catheter. At time T0, in
      normocapnia an arteriogram was performed in both groups. The first group (GI) was
      then studied in hypocapnia (T1) and following an injection of nicardipine (T2),
      while the second group (GII) was studied first after injection of nicardipine
      (T1) and then in hypocapnia (T2). Groups GI (n = 6; 44 y) and GII (n = 6; 46 y)
      were similar with regard to age, blood pressure, heart rate and PaO2 at all three
      phases of the study. HA caused a 9.5% decrease in AD (GI.T1) compared to baseline
      values, and a 15.2% decrease when preceded by injection of nicardipine (GII.T2).
      In the latter case the decrease was 3% in comparison with baseline. Nicardipine
      increased AD by 14.7% (GII.T1) and by 18.5% when preceded by HA (GI.T2), but the
      rise (7.3%) was not significant in comparison with the baselines value. The
      changes variations were similar whether the entire arterial trunk or only the
      supraclinoid region were studied. HA decreased ICP by 44% (GI.T1) and by 50%
      after nicardipine (GII.T2). Nicardipine did not cause an increase in ICP.
      Nicardipine and HA antagonise each others vasomotor effects, as previously shown
      in the baboon using nimodipine.

PMID- 1748138
TI  - Superior local tolerability of human versus salmon calcitonin preparations in
      young healthy volunteers.
AB  - Possible local and systemic adverse effects following administration of salmon
      (sCT) and human (hCT) calcitonin (CT) have been evaluated in a double-blind,
      within-subject, comparative trial in 30 young, healthy volunteers. Each subject
      received 0.25 and 0.5 mg hCT and 100 IU sCT s.c.. Adverse effects and
      hypocalcaemia were recorded 1, 3 and 6 h after each injection. Significantly
      fewer local adverse reactions were observed after hCT (20 or 33%) than after sCT
      (80%), possibly due to the different vehicles employed (mannitol solution and
      acetic acid). The most frequent systemic adverse effects were gastrointestinal
      (nausea, vomiting), which occurred in 80% after 1 h, independently of the CT-
      preparation used. Hypocalcaemic changes were generally small and lasted longer
      after sCT. It is concluded that the hCT preparations were better tolerated
      locally than sCT in young, healthy volunteers, and that there were no differences
      in the systemic side effects or hypocalcaemic activity.

PMID- 1748139
TI  - Effect of pentoxifylline on liver plasma flow in normal man.
AB  - In ten healthy, male subjects the acute effect of pentoxifylline (a
      methylxanthine derivative) on liver plasma flow was investigated by the
      extrarenal sorbitol clearance method and on cardiac output by impedance
      cardiography. On the placebo day liver plasma flow decreased within 4 h from 769
      to 683 ml.min-1 (P less than 0.05) and on the pentoxifylline day (300 mg i.v.) it
      increased from 764 to 801 ml.min-1 (NS). At the end of the experiment the
      difference between the groups was also significant (P less than 0.05). There was
      no significant change in cardiac output, blood pressure or heart rate and
      individual changes in those values were not correlated with liver plasma flow.
      There was no correlation either between the plasma concentrations of
      pentoxifylline or its metabolites and the changes in liver plasma flow. It is
      concluded that, relative to the spontaneous decrease in liver plasma flow at rest
      on the placebo day, pentoxifylline increased splanchnic perfusion independent of
      any change in cardiac output.

PMID- 1748140
TI  - Effect of loperamide on jejunal electrolyte and water transport, prostaglandin E2
      induced secretion and intestinal transit time in man.
AB  - Jejunal perfusion was performed in 12 healthy volunteers to evaluate the dose
      dependent effects of loperamide on intestinal absorption, stimulated secretion
      and transit. In 6 volunteers intestinal perfusion of the jejunal segment with
      isotonic NaCl solution was followed by addition of loperamide in increasing doses
      (2-8 mg.l-1). The volunteers were pretreated with 1 mg.l-1 prostaglandin E2
      (PgE2) in the perfusate before addition of 4 mg.l-1 loperamide.
      Phenolsulphonphtalein (PSP) boluses (2 ml) were given to measure mean transit
      time (MTT). Loperamide 2 mg.l-1 converted the minor secretion after perfusion
      with the standard solution (water -145 ml.min-1, Na -0.09 and Cl -0.04 mmol.min
      1) to absorption (water 0.93 ml.min-1, Na 0.23, Cl 0.25 mmol.min-1) within 15
      min. Higher doses of loperamide did not increase absorption. The addition of PgE2
      induced net secretion of water (-4.48 ml.min-1) and electrolytes (Na -0.57, Cl 
      0.51 mmol.min-1). Loperamide 4 mg.l-1 significantly diminished the PgE2-induced
      net secretion by approximately 50%. Loperamide dose dependently increased the MTT
      from 6 (2 mg.l-1) to 13.3 min (8 mg.l-1). MTT was still delayed 60 min after a
      wash out period (10.5 min). It is concluded that loperamide had a dual effect or
      intestinal activities stimulating absorption and prolonging intestinal transit
      time with rising doses.

PMID- 1748141
TI  - Interaction of ORG 10172, a low molecular weight heparinoid, and digoxin in
      healthy volunteers.
AB  - Potential pharmacokinetic and pharmacodynamic interactions between a new low
      molecular weight heparinoid Org 10172 (bolus injection of 3250 anti-Xa units) and
      digoxin (0.25 mg once daily for 8 days) were studied in 6 healthy male volunteers
      using an open, randomised three-way cross-over design. Digoxin produced a slight
      increase in clearance of anti-Xa activity from 4.3 to 4.8 ml.min-1, while plasma
      antithrombin and thrombin generation inhibiting (TG1) activity remained
      unchanged. Digoxin did not affect the actions of Org 10172 on the clotting tests.
      In the presence of Org 10172 there was a reduction in the AUC of digoxin during
      one dosing interval after the seventh digoxin tablet from 20 to 17 ng.ml-1.h, and
      a significant reduction in the average serum digoxin concentration. Since renal
      digoxin clearance was not significantly changed this probably might be due to a
      change in the non-renal clearance of digoxin. Atrio-ventricular node conduction,
      as measured by PR-time intervals, remained unchanged during all three treatments.
      In conclusion, although the pharmacokinetics of Org 10172 and digoxin were
      slightly changed by the combination, it is probably safe to administer Org 10172
      and digoxin simultaneously. The clinical relevance of the slight decrease in
      plasma anti-Xa activity levels cannot yet be defined.

PMID- 1748142
TI  - Pharmacokinetics of tiaprofenic acid in children after a single oral dose.
AB  - Twelve healthy children in three age groups anaesthetized for minor surgery were
      given a single oral dose of tiaprofenic acid (3 mg.kg-1) (TA). Seven blood
      samples and zero to 8 and 8 to 24 h urines were collected. TA concentrations in
      plasma and urine were measured by HPLC. No significant difference was found
      between the age groups in the kinetic parameters of TA and no correlation was
      found between these parameters and age: tmax = 2.12 h, Cmax = 8.78 mg.l-1, AUC(0-
      --8 h) 33.9 mg.h.l-1, AUC = 39.3 mg.h.l-1, t1/2 = 2.35 h, Vt = 0.319 l.kg-1, CL =
      0.094 l.h-1.kg-1. Renal clearance was 14 ml.h-1.kg-1.33% of the TA dose was
      recovered in the 24 h urine, 48% of which was conjugated, whereas in adults, TA
      is only found in urine as conjugates. The apparent plasma clearance was
      significantly higher (56%) than in 12 healthy adults given 1.5 mg.kg-1 TA. Volume
      of distribution and t1/2 did not significantly differ between children and
      adults. Since no relationship has been established between plasma TA and either
      efficacy or toxicity, a different dose regimen cannot be recommended in 3-11 year
      old children from that in adults.

PMID- 1748143
TI  - Ambulatory blood pressure monitoring in elderly hypertensives treated with the
      new calcium antagonist, nilvadipine.
AB  - A newly developed calcium antagonist, nilvadipine, was administered to 7
      hypertensive patients aged 75.6 y. Nilvadipine 4 mg b.d. decreased the average 24
      h blood pressure significantly from 169/89 mmHg to 152/81 mmHg after 7 to 14 days
      without any change in the pulse rate. The circadian patterns of blood pressure
      and pulse rate were not affected by nilvadipine. Although the present study was a
      preliminary one done over a short period in a small number of patients, the
      results suggest that nilvadipine exerts an antihypertensive effect without
      altering the circadian pattern or the variability of blood pressure in elderly
      hypertensive patients.

PMID- 1748144
TI  - Plasma level monitoring of mitotane (o,p'-DDD) and its metabolite (o,p'-DDE)
      during long-term treatment of Cushing's disease with low doses.
AB  - Mitotane (o,p'-DDD) can be used for the treatment of various adrenocortical
      diseases such as Cushing's syndrome, but the usual doses of 6-8 g per day are
      often associated with severe adverse effects. This paper reports the results of
      much lower doses of o,p'-DDD (0.5-2 g per day) in two patients with Cushing's
      disease over periods of 8 and 5 years, respectively, under concomitant monitoring
      of the plasma levels of the parent drug and its major metabolite, o,p'-DDE. It
      became apparent that o,p'-DDD and o,p'-DDE have a strong tendency to accumulate
      in the body due to their high lipophilicity. As a consequence, changes in dose
      regimens had long lag times before they were reflected in plasma levels and once
      an increase or decrease had started one had to be careful not to cause overshoot.
      Steady state plasma levels of o,p'-DDD between 5-10 micrograms/ml appeared
      sufficient to induce and to maintain remission of the disease, which was
      accompanied with normal cortisol levels in plasma and urine. DDD-levels below 5
      micrograms/ml for several weeks may lead to relapses, whereas DDD-levels over 10
      micrograms/ml gave rise to side effects. On the other hand, o,p'-DDE seemed
      inactive at levels up to 4 micrograms/ml in plasma.

PMID- 1748145
TI  - Prospective comparative study in NIDDM patients of metformin and glibenclamide
      with special reference to lipid profiles.
AB  - Twenty-two NIDDM patients completed an open randomized cross-over study comparing
      metformin and glibenclamide over 1 year. The drugs had an equivalent effect on
      glycaemic control, but, in contrast to glibenclamide, metformin reduced body
      weight. Neither drug affected triglycerides, total- and LDL-cholesterol or C
      peptide. Metformin caused a slight elevation of HDL-cholesterol (P less than
      0.05). No serious adverse effects were observed. The results show that oral
      hypoglycaemic agents are not associated with undesirable effects on lipids and
      lipoproteins.

PMID- 1748146
TI  - Identification of thymocyte precursors in murine fetal liver.
AB  - We have isolated thymic stem cells from murine fetal liver using a combination of
      approaches including discontinuous albumin density gradient separation and anti
      heat-stable antigen (HSA) antibody plus complement-mediated lysis. A population
      of early precursors has been identified which comprises approximately 1% of fetal
      liver, and which has the capacity to reconstitute alymphoid lobes and give rise
      to the four thymic subpopulations defined by expression of the T cell
      differentiation antigens CD4 and CD8. These early precursors express CD44 (Pgp
      1), however, they are negative for expression of Thy-1, CD4, CD8, CD3, membrane
      immunoglobulin and HSA cell surface molecules.

PMID- 1748147
TI  - Limiting dilution analysis of proliferative T cell responses to mycobacterial 65
      kDa heat-shock protein fails to show significant frequency differences between
      synovial fluid and peripheral blood of patients with rheumatoid arthritis.
AB  - Recent evidence has pointed to the mycobacterial 65-kDa heat-shock protein (hsp
      65) as an antigen that may be important in the pathogenesis of rheumatoid
      arthritis (RA). Using limiting dilution analysis the frequency of purified
      protein derivative of tuberculin (PPD) and hsp 65-responsive T cells was measured
      in paired peripheral blood and synovial fluid samples of patients with RA. There
      was no increase in the anti-PPD or anti-hsp 65 frequency in synovial fluid
      compared with peripheral blood. In addition, no difference was found between
      peripheral blood of RA patients and healthy controls. These results do not
      support the idea of an important pathogenic role of T cells responding to hsp 65,
      or a cross-reacting antigen, in RA.

PMID- 1748148
TI  - Sites of specific B cell activation in primary and secondary responses to T cell
      dependent and T cell-independent antigens.
AB  - Techniques which identify hapten-specific B cells in tissues have been used to
      determine the sites of B cell activation in rat spleens in response to T cell
      dependent (TD) antigens and T cell-independent type-1 (TI-1) antigens. Surface
      associated hapten binding by specific memory B cells and B blasts was
      distinguished from the strong cytoplasmic hapten binding by specific plasma cells
      and plasmablasts. Blast cells in S phase were identified in tissue sections by
      staining cells which had been pulse labeled in vivo with 5-bromo-2'-deoxyuridine.
      Hapten-specific B blast cells are found in three sites: (a) around
      interdigitating cells in the T cell-rich zones; (b) in the follicular dendritic
      cell network and (c) in association with macrophages in the red pulp. Hapten
      binding memory B cells, which are not in cell cycle, accumulate in the marginal
      zones and to a lesser extent the follicular mantles in response to TD and TI-1
      antigens. The hapten-specific blast response in T zones is confined to the first
      few days after antigen is given and is low for primary responses to TD antigens,
      but massive on secondary challenge, when marginal zone memory B cells migrate to
      the T zones. Both the primary and secondary T zone responses to TI-1 antigens are
      impressive and in these responses hapten-specific B blasts are also found in the
      splenic red pulp. The follicular response to TD antigens starts with a small
      number of B blasts (fewer than five) entering each follicle. These increase in
      number exponentially so that by the 4th day after immunization they fill the
      follicle. The oligoclonality of the response is shown in simultaneous responses
      to two haptens where 6%-31% of the follicles on day 3 after immunization contain
      blasts specific for only one of the two haptens. During the 4th day classical
      zonal pattern of germinal centers develops. The surface immunoglobulin-positive B
      blasts are lost from the follicle center, while one pole of the follicular
      dendritic cell network fills with surface immunoglobulin-negative centroblasts.
      Centroblasts do not increase in numbers but divide to give rise to centrocytes,
      which re-express sIg and migrate into the follicular dendritic cell network. Cell
      kinetic studies indicate that the centrocyte population is renewed from
      centroblasts every 7 h. Centrocytes either leave the germinal center within this
      time or die in situ.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1748149
TI  - Cross-linking of surface IgM activates NF-kappa B in B lymphocyte.
AB  - In B lymphocytes, cross-linking of surface IgM activates changes in both the cell
      cycle and differentiation. In normal B cells and B cell tumors, many stimuli
      induce the activation of NF-kappa B and its translocation from the cytoplasm to
      the nucleus. In this study we sought to determine if cross-linking of surface IgM
      led to the activation of NF-kappa B. Our results show that activation of B cells
      by cross-linking anti-IgM antibodies activated NF-kappa B in the murine B
      lymphoid cell lines 70Z/3 and M12, and in the dense fraction of splenic cells.
      The activation of NF-kappa B required optimal doses of anti-IgM antibodies and
      took 5 to 10 min to reach maximal levels. Cross-linking of IgM has also been
      shown to activate protein kinases including protein kinase C (PKC). To test
      whether PKC activation was required for NF-kappa B translocation, we treated
      70Z/3 cells for 18 h with phorbol 12-myristate 13-acetate, a procedure which
      depletes these cells of functional PKC. This treatment did not abrogate the
      nuclear translocation of NF-kappa B following anti-IgM cross-linking. These
      results indicate that the nuclear translocation of NF-kappa B is rapidly induced
      by surface IgM cross-linking and that this activation appears to use a pathway
      which does not require PKC.

PMID- 1748150
TI  - Immunoglobulin heavy chain cDNA from the teleost Atlantic cod (Gadus morhua L.):
      nucleotide sequences of secretory and membrane form show an unusual splicing
      pattern.
AB  - Rabbit antibodies to Atlantic cod (Gadus morhua L.) immunoglobulin were affinity
      purified and used to screen cDNA libraries from spleen and head kidney mRNA. cDNA
      clones for both the secretory and membrane-bound heavy (H) chain were isolated,
      the nucleotide and deduced amino acid sequences of which are reported here.
      Comparisons of the cod secretory H chain amino acid sequence show 24%, 27%, 30%
      identity to the mu chain of Mus, Xenopus and Ictalurus, respectively. The highest
      degree of identity was observed in the CH4 domain. The cDNA encoding the
      transmembrane form shows a novel splicing pattern where the TM1 exon is spliced
      directly onto the CH3 domain and not to the CH4 domain as in other animal groups.
      Southern blot analyses with VH and C probes on genomic DNA from cod erythrocytes
      indicate that there is a unique C gene but several V genes in the cod
      immunoglobulin H chain locus.

PMID- 1748151
TI  - Polarized expression of major histocompatibility complex class I molecules in
      human endometrial and endocervical epithelial cells.
AB  - The localization of major histocompatibility complex (MHC) class I molecules in
      human endometrial and endocervical epithelial cells was studied with an
      immunogold technique on ultrathin cryosections. At the cell surface, MHC class I
      molecules are delivered solely to the basolateral plasma membrane in human
      epithelia. Therefore, only the basolateral domain of epithelial cells is capable
      of presenting antigen to MHC class I-restricted cytotoxic T cells.

PMID- 1748152
TI  - Prolonged survival of skin grafts following treatment with an antibody to a
      putative cell triggering molecule, QCA-1.
AB  - The QCA-1 molecule (quiescent cell antigen-1) appears to be involved in the
      differentiation events undergone by T cell following occupancy of the antigen
      receptor. Here we show that modulation of the QCA-1 antigen from the surface of
      the cell normally follows activation, and that treatment of animals with the
      antibodies against the QCA-1 molecule inhibits the normal response to an
      allograft without appearing to alter the number of peripheral T cells or the
      expression by these cells of the alpha/beta T cell antigen receptor.

PMID- 1748153
TI  - Characterization of somatodendritic neuronal nicotinic receptors located on the
      myenteric plexus.
AB  - The effects of nicotine and dimethylphenylpiperazinium (DMPP) on resting and
      stimulation-evoked release of [3H]-acetylcholine ([3H]ACh) from cholinergic
      interneurons and neuro-effector neurons of the ileal longitudinal muscle and the
      responses of the smooth muscle to nicotinic agonists were studied. (-)-Nicotine
      was 15 times more effective than (+)-nicotine in releasing ACh. Since
      tetrodotoxin (1 microM) completely antagonized the effect of nicotinic agonists,
      the site of action of the nicotinic agonists studied was on the somatodendritic
      nicotinic receptors. The electrical field stimulation-evoked release was not
      affected by nicotinic agonists and antagonists, indicating that the axon
      terminals of cholinergic interneurons are not equipped with nicotinic receptors.
      This preparation proved to be useful to study the effect of nicotinic agonists on
      somatodendritic receptors, to determine the affinity constants of nicotinic
      antagonists, and to characterize these receptors. The rank order of antagonists
      was d-tubocurarine = mecamylamine greater than pipecuronium greater than
      pancuronium greater than vecuronium greater than hexamethonium; the apparent
      affinity constants (KD) were 1.15, 1.55, 3.06, 3.98, 13.59 and 32.88 microM,
      respectively. alpha-Bungarotoxin had no antagonistic activity at all. This
      finding indicates that nicotine and the endogenous ligand ACh act via a
      postsynaptic, somatodendritic nicotinic receptor that is pharmacologically
      similar to those located on the axon terminals of sympathetic neurons or in
      ganglions, but is dissimilar to those located at the postsynaptic site of the
      neuromuscular junction.

PMID- 1748154
TI  - Inhibition of the first ovulation and ovarian prostaglandin F2 alpha metabolism
      by danazol in rats.
AB  - The present study was conducted to investigate the mode of action of danazol by
      monitoring the first ovulation, serum luteinizing hormone (LH) levels and ovarian
      prostaglandin (PG) F2 alpha metabolism in pregnant mare serum gonadotropin (PMSG)
      primed immature female rats. When danazol (750 mg/kg) was given p.o. once a day
      for 5 days (day 24-28), the occurrence of the first ovulation, the increase in
      capacity to form 13,14-dihydro-PGF2 alpha and PGF2 alpha levels induced by PMSG
      (5 IU) injected on day 26 were clearly inhibited on day 29. Danazol also markedly
      suppressed the LH surge occurring on day 28. Although the danazol-induced
      blockage of ovulation was restored by injection of human chorionic gonadotropin,
      the number of oocytes was significantly decreased as compared with that of
      controls. The present data indicate that the inhibitory actions of danazol on
      ovulation and ovarian PGF2 alpha metabolism may occur via some direct effects on
      the ovary in addition to the suppression of gonadotropin release from the
      pituitary gland.

PMID- 1748155
TI  - Nonpeptide angiotensin II receptor antagonists. Studies with DuP 753 and EXP3174
      in dogs.
AB  - DuP 753 (or EXP3174) and PD123177 are nonpeptide angiotensin (AII)-specific
      ligands, which show high affinities for two AII receptor subtypes, i.e. AT1 and
      AT2 sites, respectively. In furosemide-treated conscious dogs with high renin,
      DuP 753 and EXP3714, but not PD123177, were as effective as captopril in lowering
      blood pressure. Both DuP 753 and EXP3174 exhibited selective vascular antagonism
      of AII. In conscious dogs with normal renin, DuP 753, but not captopril or
      EXP3174, caused a dose-dependent but transient decrease in blood pressure. In
      anesthetized dogs, DuP 753 and captopril caused similar renal vasodilatation and
      natriuresis. The renal hemodynamic effects of DuP 753 and captopril were more
      pronounced in dogs with sodium depletion. These results suggest that the AT1
      receptor mediates the pressor and renal effects of AII in dogs. The acute
      transient hypotensive effect of DuP 753 in normal-renin conscious dogs is
      probably unrelated to AII antagonism.

PMID- 1748156
TI  - Arginine8-vasopressin potentiates the motor incoordinating effects of
      pentobarbital.
AB  - Arginine8-vasopressin (AVP, 10 micrograms), injected s.c., potentiated the motor
      impairing effects of pentobarbital (10-20 mg/kg) injected i.p. in rats 1 h after
      AVP. Motor incoordination was assessed on the moving belt task. However, AVP (0.1
      100 nM) failed to enhance pentobarbital potentiation of GABA-mediated 36Cl-
      uptake in rat cerebral cortical or cerebellar microsacs. There was also no effect
      of a 10 micrograms s.c. injection of AVP 1 h before killing, on pentobarbital
      potentiation of GABA-mediated chloride flux in either cerebral cortical or
      cerebellar microsacs.

PMID- 1748157
TI  - Effects of propentofylline on adenosine A1 and A2 receptors and
      nitrobenzylthioinosine-sensitive nucleoside transporters: quantitative
      autoradiographic analysis.
AB  - Previous studies have demonstrated that the xanthine compound, propentofylline,
      has beneficial effects in models of cerebral ischemia and can enhance some and
      exhibit other effects of adenosine. We investigated the in vitro effects of
      propentofylline and its hydroxy metabolite, A72,0287, on the binding of
      [3H]cyclohexyladenosine ([3H]CHA), [3H]2-[p-(2-carbonyl-ethyl)-phenylethyl-amino]
      5'-N- ethylcarboxamido adenosine ([3H]CGS 21680) and [3H]nitrobenzylthioinosine
      ([3H]NBMPR) to adenosine A1 and A2 receptors and NBMPR-sensitive nucleoside
      transporters, respectively, in 10-microns coronal rat brain sections. Both
      xanthines had micromolar affinity for each of these sites with approximately 10
      fold lower affinity for A2 receptors than for A1 receptors and [3H]NBMPR binding
      sites. Saturation analysis of [3H]CHA or [3H]CGS 21680 binding in the presence of
      increasing concentrations of propentofylline produced significant increases in KD
      values without affecting Bmax values; thus propentofylline is a competitive
      inhibitor at A1 and A2 receptors. The effects on A2 receptors apparently require
      higher concentrations (Ki approximately 200 microM) than the effects on A1
      receptors (Ki approximately 20 microM). Propentofylline was also found to be a
      competitive inhibitor of [3H]NBMPR binding. Therefore we conclude that
      propentofylline interacts with adenosine-responsive systems to increase
      interstitial adenosine concentrations and to selectively inhibit A1 receptors.

PMID- 1748158
TI  - Staurosporine, a protein kinase inhibitor, attenuates intracellular Ca(2+)
      dependent contractions of strips of rabbit aorta.
AB  - The protein kinase inhibitor staurosporine was found to be a potent relaxant of
      rabbit aortic strips contracted by various agonists. This relaxing effect was
      slow, long-lasting and in a non-competitive fashion against various agonists. The
      effect of staurosporine on the KCl-induced contraction was not altered by
      atropine, propranolol, theophylline or indomethacin. Staurosporine (5-200 nM)
      inhibited the contractile responses to prostaglandin F2 alpha (3 microM),
      endothelin (0.1 microM), phenylephrine (3 microM) and KCl (30 mM), with ED50
      values of 10.8 +/- 0.6, 24.6 +/- 8.7, 48.8 +/- 7.0, 54.0 +/- 12.7 nM,
      respectively. Even in Ca(2+)-free physiological salt solution, staurosporine
      potently antagonized the contractile responses elicited by 10 microM
      prostaglandin F2 alpha and 0.1 microM endothelin; in fact it was more effective
      than it was in normal Ca2+ solution: ED50 of 11.3 +/- 3.8 vs. 21.0 +/- 4.4 nM (P
      less than 0.02), and of 10.6 +/- 3.6 vs. 24.6 +/- 4.3 nM (P less than 0.01),
      respectively. Thus, staurosporine has an equipotent inhibitory action on
      intracellular and extracellular calcium-dependent contractions of aortic tissues.

PMID- 1748159
TI  - Buspirone inhibits corticotropin-releasing factor and stress-induced cecal motor
      response in rats by acting through 5-HT1A receptors.
AB  - The effect of buspirone on corticotropin-releasing factor (CRF) and stress
      stimulated cecal motility and its antagonism by 5-HT1A (spiroxatrine) and sigma
      (BMY 14802) antagonists were evaluated by electromyography in rats equipped with
      chronically implanted electrodes on the cecum and a small catheter into the right
      lateral ventricle of the brain. Exposure to mental stress, consisting of a fear
      conditioned response, increased during 30 min the frequency of cecal spike bursts
      significantly (P less than 0.01). The frequency of cecal spike bursts was also
      increased following intracerebroventricular injection of CRF (500 ng/kg).
      Buspirone (1 mg/kg s.c.) abolished the stimulatory effects of mental stress and
      CRF on cecal motility. Whereas spiroxatrine (0.5 mg/kg s.c.) blocked the effect
      of buspirone on the colonic hypermotility induced by i.c.v. injection of CRF, BMY
      14802 at a similar dose (0.5 mg/kg s.c.) was unable to block the action of
      buspirone. It is concluded that s.c. administration of buspirone suppresses the
      stress-induced cecal motor response through 5-HT1A receptors, probably by
      inhibiting the central or peripheral pathways involved in CRF mediation of these
      effects.

PMID- 1748160
TI  - Changes in motor activity and forebrain [propionyl-3H]propionylated-CCK-8 binding
      in mice after repeated administration of drugs affecting cholecystokinin
      receptors.
AB  - The effects of acute or repeated treatment of male albino BKW mice with
      caerulein, a cholecystokinin octapeptide (CCK-8) agonist, and with devazepide (MK
      329) and L-365,260, antagonists at CCKA ('peripheral') and CCKB ('central')
      receptors respectively, on motor activity and [propionyl-3H]propionylated-CCK-8
      ([3H]pCCK-8) binding were studied. Acute treatment with a large dose of caerulein
      (100 micrograms/kg s.c.) suppressed motor activity (line crossings and rearings)
      whereas devazepide (2 mg/kg i.p.) had the opposite action. L-365,260 (2 mg/kg
      i.p.) increased only the number of rearings. Tolerance developed to the locomotor
      effects of caerulein and devazepide when these same doses were administered once
      daily (caerulein) or twice daily (devazepide) for 10 days. Twice daily
      administration of L-365,260 (2 mg/kg) for 10 days did not significantly alter the
      locomotor activity of mice. The sedative effect of caerulein (20 micrograms/kg
      s.c.) was markedly reduced in mice receiving repeated injections of either a
      larger amount of caerulein (100 micrograms/kg) or devazepide but not after L
      365,260. The stimulant effect of (+)-amphetamine (2 mg/kg s.c.) on motor activity
      was increased by subchronic administration of either devazepide or caerulein, but
      not by L-365,260. All three compounds (caerulein, devazepide and L-365,260)
      increased the number of [( 3H]pCCK-8 binding sites in mouse forebrain but the
      increase was only significant after L-365,260. The effects of long-term treatment
      with caerulein are probably related to the stimulation of CCKA receptors, whereas
      the paradoxically similar action of devazepide may be linked to the blockade of
      both subtypes of the CCK-8 receptor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748161
TI  - Colonization of R plasmid-bearing Escherichia coli strains in the mouse
      alimentary tract.
AB  - In order to examine the ability of R plasmid-bearing Escherichia coli strains to
      colonize in the mouse alimentary tract, an R plasmid-positive (R(+)) E. coli
      strain and its R plasmid-negative (R(-)) counterpart were together inoculated
      into the streptomycin-treated mouse alimentary tract, and the numbers of fecal E.
      coli strains were enumerated. The numbers of R(+) strains were always at the
      level similar to or lower than those of their counterparts and rapidly decreased
      in the fecal population. However, when R plasmids, which were originated from a
      cryptic plasmid of the host E. coli strain, were utilized, an R(+) strain
      dominated over its R(-) counterpart during the experimental period. These
      experimental results indicated that the relationship between the host strain and
      R plasmids affected the ability of the host strain to colonize in the alimentary
      tract.

PMID- 1748162
TI  - [An injection-corrosion study on the angioarchitecture of rat skin].
AB  - The angioarchitecture of the skin in the SD strain rat was investigated by
      scanning electron microscopy using resin cast. The neck part of rat skin was
      composed of 3 layers of vascular networks: the first layer (superficial layer),
      the second layer (middle layer), and the third layer (deep layer). Two types of
      capillary architectures were present around the hair follicle: small
      architectures composed of random network and large architectures composed of 3
      parts distinguished by the construction of network. The large architecture, the
      capillary of hair papilla and the capillary network of sebaceous gland was
      thought to compose one circulation unit. The afferent vessels into such units
      branched from Kandelaberarterie-Petersen occurring from the 3rd layer, ascended
      to the 2nd layer, then descended to the bottom of the network and composed the
      capillary architecture. There were 2 types of efferent vessels from such
      circulation unit. They occurred from superficial and deep part, respectively, of
      the vascular architecture around the hair follicle and descended straight to the
      3rd layer. The presence of straight vessels between the 2 nd and 3 rd layer, and
      the simple arrangement of vascular layers were thought to be characteristic of
      the angioarchitecture of the rat skin.

PMID- 1748163
TI  - Effects of methamphetamine on copulatory behavior in male rats.
AB  - Many papers have reported the effect of amphetamine and its close relative,
      methamphetamine on sexual activity in humans. The effect of these drugs on animal
      sexual behavior is unknown. The present study was done to determine whether
      methamphetamine modifies the copulatory behavior of male rats. Sexually
      experienced rats of the Wistar-Imamichi strain, 10 weeks of age, were singly
      injected intraperitoneally with methamphetamine hydrochloride at doses of 0, 1, 2
      or 4 mg/kg body weight. Tests were initiated at 19: 30 in the dark period.
      Observations were conducted for 90 min. At dosages of 1 or 2 mg/kg there were no
      changes in copulatory behavior ascribed to the administration of methamphetamine.
      At 4 mg/kg the frequencies of mounting, intromission and ejaculation were greatly
      decreased but the spontaneous motor activity and stereotypic behavior increased
      in all males. In a further experiment, males were given methamphetamine by
      intraperitoneal injection once a week for 8 weeks. The copulatory behavior was
      tested 5 times at two weeks intervals. In the 4th testing, the percentage showing
      ejaculation decreased. In the 5th testing, there was no ejaculation and the
      incidence of intromission decreased. No stereotypic behavior was displayed in any
      of the males during the testing. From these results, it was concluded that
      methamphetamine inhibits the intromitting and ejaculating behavior in male rats.

PMID- 1748164
TI  - Mortality, body weight, food and water consumption, and clinical signs in
      F344/DuCrj rats in studies of chronic toxicity and carcinogenicity.
AB  - In vivo historical control data, including mortality, body weight, food and water
      consumption, and clinical signs in F344/DuCrj rats were obtained from 11 long
      term toxicity and carcinogenicity studies conducted at the Biosafety Research
      Center, Foods, Drugs and Pesticides, (An-Pyo Center) during the last five years.
      Survival at 109 weeks of age was 80.2% (min: 74%, max: 90%) in males and 80.5%
      (min: 72%, max: 92%) in females. The maximum mean body weights of males and
      females were 443.3 +/- 15.8 g (mean +/- S. D.) and 295.7 +/- 13.3 g respectively.
      Male rats attained their maximum body weight at 82.6 +/- 5.3 weeks of age, the
      females at 103.5 +/- 2.5 weeks of age. Clinical symptoms increased with age,
      particularly after 84 weeks of age, and included: wasting, piloerection, palpable
      subcutaneous and abdominal masses, and decreased spontaneous movement. Lowered
      body temperature and auricular pallor occurred commonly in moribund animals. The
      nature and grade of toxicity in the treated animals were generally disclosed by
      comparing with the behavior and signs in the control animals. The use of in
      house, historical control data can be useful in subsequent evaluations of chronic
      toxicity and carcinogenicity studies.

PMID- 1748165
TI  - [Effects of captopril on acute phase in two-kidney Goldblatt hypertensive rats
      and spontaneously hypertensive rats].
AB  - Effects of continuous oral administration of captopril were investigated on acute
      phase in two-kidney Goldblatt hypertensive (2 KGH) rats and spontaneously
      hypertensive rats (SHR). Systolic blood pressure gradually rose throughout the
      experimental period of 7, 14, 21 and 28 days in both 2 KGH rats and SHR. These
      gradual increases of systolic blood pressure were reduced by administration of
      captopril in both rats. Plasma renin activity were markedly increased throughout
      the experimental period in both rats treated with captopril, and were modestly
      increased in 2 KGH rats. In contrast, those changes in plasma renin activity were
      not obvious in SHR. In 2 KGH rats, juxtaglomerular index (JGI) and
      juxtaglomerular cell count (JGCC) of the clipped kidneys increased whereas JGI of
      the opposite kidneys decreased. In contrast, those changes in JGI and JGCC were
      not obvius in SHR. On the other hand, JGI and JGCC of the clipped kidneys
      increased in 2 KGH rats treated with captopril and those of the both kidneys
      increased in SHR treated with captopril. These results suggested that
      juxtaglomerular cells were related to the development of hypertension in 2 KGH
      rats, but were not clear in SHR. And these results were found that captopril
      showed antihypertensive effects, in spite of rises in JGI and JGCC of both 2 KGH
      rats and SHR.

PMID- 1748166
TI  - [Cryopreservation of mouse spermatozoa].
AB  - The spermatozoa of cauda epididymis of mature mice were suspended in 3% skim milk
      in distilled water supplemented with 12, 15, 18 or 21% (W/V) raffinose. The
      suspension of spermatozoa were frozen in liquid nitrogen gas for 10 min, then
      stored in liquid nitrogen (-196 degrees C). The frozen suspensions of spermatozoa
      were thawed by rapid warming in water bath at room temperature. For removing the
      cryopreservative solution, a pair of syringes connected with a three stop cock
      and a filter unit (pore size 0.45 mu) were used. Highest sperm motility was
      obtained after 1 hr of thawing from the cryopreservative solution containing 18%
      raffinose and 3% skim milk. These cryopreserved spermatozoa were used for
      fertilization in vitro. The proportion of pronuclear oocytes was 35.9% (74/206) 6
      hr after insemination, and the proportion of 2-cell embryos was 33.6% (42/125) 28
      hr after insemination. All 2-cell embryos were transferred to the oviducts of
      pseudopregnant recipients and 45.2% (19/42) developed to normal young.

PMID- 1748167
TI  - Effect of the energy density of non-purified diets on reproduction, obesity,
      alopecia and aging in mice.
AB  - Four diets with graded levels of energy at 24% crude protein were fed to C57BL/6J
      mice for approximately 3 years to develop pelleted non-purified diets. The
      nitrogen-corrected metabolizable energy (MEn) of the diets ranged from 2.86 to
      3.73 kcal per g of dry matter (DM). Fifteen males and 30 females were assigned to
      each diet. The mice were housed together for 1 week at 7 week intervals,
      experiencing 5 matings. After the reproduction stage, they were allowed to
      complete their life span. Moribund mice after 60 weeks of age were subjected to
      histopathological examination. The highest energy diet showed the following
      results in comparison with the lowest energy diet: (1) weaning weight of pups
      increased by 31.6%; (2) males showed slight obesity even during the reproduction
      stage, but females did not; (3) both sexes developed remarkable obesity after 50
      weeks of age with 41.2% (males) and 49.6% (females) increasing in maximum body
      weight; (4) although daily feed intake decreased by approximately 18%, the MEn
      was slightly over consumed; (5) females showed higher incidence of alopecia with
      age; (6) the survival rate after 50 weeks of age decreased earlier and life span
      was shortened; (7) histopathological changes associated with aging developed
      earlier. On the other hand, the early death rate of dams at parturition increased
      with a decrease in dietary energy. It was concluded that at least 2 types of
      diets are needed throughout the life span of C57BL/6J mice; a high energy diet
      with an MEn value of 3.73 kcal/g DM for maximum reproduction and a low energy
      diet with an MEn value of 2.86 kcal/g DM for the long term stage after
      reproduction to retard obesity and aging most effectively.

PMID- 1748168
TI  - [Pituitary and plasma levels of growth hormone (GH), follicle stimulating hormone
      (FSH) and luteinizing hormone (LH) in hereditary dwarf rats (rdw/rdw)].
AB  - Koto et al found a new hereditary dwarf mutation from breeding colony of Wistar
      Imamichi rat and named 'rdw'. To characterize endocrinological functions in rdw
      rats, pituitary and plasma levels of pituitary hormones including growth hormone
      (GH), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were
      compared between rdw and normal rats. The hormone levels were estimated with
      radioimmunoassay (RIA). It was found that pituitary and plasma levels of GH of
      rdw were drastically decreased and those of FSH and LH were inclined to decrease
      but not remarkable as compared with normal. Rats of rdw were, therefore,
      considered to be useful as a model animal for endocrinological defects.

PMID- 1748169
TI  - Effects of germfree status and food restriction on longevity and growth of mice.
AB  - An investigation was undertaken to study the effects of germfree (GF) status and
      mild food restriction on life span in GF and specific pathogen-free (SPF) male
      ICR mice either full-fed (ad libitum) or on a restricted diet of 4.5 grams per
      day (equivalent to approximately 80% of full-fed intake) from five-week-old. The
      mean life span of the full-fed SPF and GF mice was 75.9 and 88.9 weeks
      respectively, while the mean life span of the food-restricted SPF and GF mice was
      117.5 and 109.6 weeks, respectively. Mice in both GF and SPF food-restricted
      groups were characterized by lower body weight and increased survival. These
      findings suggest that the cessation of growth may be importantly and perhaps
      causally related to longevity. The GF mice survived longer than the SPF mice, but
      the combination of GF status with food restriction did not seem to extend life
      span more than food restriction alone.

PMID- 1748170
TI  - Stumpy limb--an embryonic lethal mutation in Japanese quail (Coturnix coturnix
      japonica).
AB  - An embryonic lethal mutant was found in Japanese quail and named "stumpy limb
      (SL)". All SL embryos died at pre-hatching stages, showing brachycephaly, a
      thickened neck, short upper and lower beaks, and short and thick extremities,
      while their body length was similar to that of the normal embryos. Observations
      on the skeleton revealed a globular skull, unusual curvature of the Processus
      palatinus maxillaris of the upper beak, and shortening and thickening of the
      appendicular bones. Some embryos showed a bending of the humerus, femur and/or
      tibiotarsus. Abnormality was more conspicuous in the leg bones than in the wing
      bones. No conspicuous differences were observed in the vertebrae between the SL
      and normal embryos. A genetic analysis suggested that the mutation is controlled
      by an autosomal recessive gene, for which the gene symbol sl was proposed.

PMID- 1748171
TI  - Comparative studies of some functional and morphological parameters in the livers
      of germfree, conventional and ex-germfree mice.
AB  - Some parameters of hepatic function and morphology were studied to compare
      germfree (GF) and conventional (CV) BALB/c mice. The levels of lipid peroxide
      (LPO) and aniline-hydroxylase (AH) activity in the livers and the serum total
      cholesterol (TC), triglyceride (TG) and phospholipid (PL) were significantly
      lower in GF than in CV 8-week-old mice. There were no significant differences in
      the histology and lectin-histochemistry of the livers in the GF and CV mice. On
      the other hand, in ex-GF mice which were induced by housing 4-week-old GF mice
      together with age-matched CV mice, the levels of LPO and AH activity in the liver
      and the serum TC, TG and PL contents increased rapidly within the first week and
      then approached values almost identical to those in CV mice 4 weeks later (i.e.
      at 8 weeks of age). The histologic picture of the liver was similar among the GF,
      CV and ex-GF mice.

PMID- 1748172
TI  - [Marked difference in sensitivity to gamma-ray-induced cataract between BALB/c
      and CBA-C3H strain mice].
AB  - Nineteen BALB/c, 14CBA/KI, 12C3H/HeJ and 15 (CBA/Kl x C3H/HeJ) F1 female mice
      were irradiated with 850 rad gamma-rays and transferred with 10(7) syngeneic bone
      marrow cells 24 hrs later. The occurrence of cataract was examined in these
      animals. All the BALB/c mice showed visible lens opacification in both eyes
      between 113 and 149 days after irradiation. All the animals were autopsied 6
      months after irradiation and examined for opacification of their lenses. The
      proportion of opaque lenses was 100, 7.1, 16.7 and 0% in BALB/c, CBA/Kl, C3H/HeJ
      and (CBA/Kl x C3H/HeJ) F1 mice, respectively. The results indicate that BALB/c
      mice are much more sensitive to radiation-induced cataractogenesis than CBA and
      C3H mice.

PMID- 1748173
TI  - Development and growth pattern of small hepatocellular carcinomas in woodchucks-
      analysis of an animal model of human hepatocellular carcinoma by ultrasonography.
AB  - Woodchucks are very useful animal models of human hepatocellular carcinoma. It is
      important to detect carcinomas in their early stage to study the pathogenesis of
      hepatocellular carcinoma. By ultrasonography (echogram) we found tumors less than
      10 mm in diameter. Echographically all of the tumors except one were hypo-echoic
      in their early stages. One tumor showed a hyper-echoic pattern which grew very
      rapidly. Pathologically they were all well differentiated hepatocellular
      carcinoma and there were no differences between hypo- and hyper-echoic tumors.
      When volumes of tumors were less than 10 cm3 they grew very slowly but when
      tumors were larger than 10 cm3 their volume increased very rapidly. The
      ultrasonographic patterns of large tumors were iso-echoic and mosaic, as in human
      hepatocellular carcinoma.

PMID- 1748174
TI  - [Mycological examination on skin surface of cynomolgus monkeys (Macaca
      fascicularis)].
AB  - Mycological examination on skin surface of 39 female and 35 male cynomolgus
      monkeys was carried out. Fungi were detected from 73 out of 74 subjects.
      Cladosporium was mostly predominant and the moderate predominant fungi were as
      follows: Acremonium, Curvularia, Arthrinium, Trichoderma, Stachybotrys,
      Emericella, Epicoccum, Pestalotia and Aureobasidium. However, dermatophytes or
      keratinophilic fungi were not isolated in this study.

PMID- 1748175
TI  - Mammary adenocarcinoma in a young female hypercholesterolemic rat.
AB  - Pathological examination of a 12-week-old female rat with hypercholesterolemia
      revealed mammary adenocarcinoma. Grossly, one grayish-white nodule was found in
      the hypoderm near the right posterior mammary gland. Histologically, the nodule
      was composed of variable-sized epithelial cells which lined the tubules and ducts
      in one to several layers, accompanied by proliferation of connective tissue in
      the stroma. Mitotic figures, necrosis and hemorrhage appeared frequently
      throughout the lesion. The tumor cells had invaded the surrounding muscular
      tissue.

PMID- 1748176
TI  - Linkage analysis of two murine polycystic kidney disease genes, pcy and cpk.
AB  - Two murine models of polycystic kidney disease (PKD) in humans are currently
      available: the infant-type cpk in mice and the adult-type pcy mutation in mice.
      Our linkage analysis was to determine whether these genes are allelic forms of
      the same gene, or infant-type and adult-type PKD resulting from homozygous and
      heterozygous mutation, as in the rat Cy gene. We found that the pcy gene in the
      mice was linked with the d gene on chromosome 9, but the cpk gene was not. A
      segregation test indicated that the two genes are inherited independently. This
      indicates that the cpk and pcy genes are not alleles and that the genetic
      mechanism of PKD pathogenesis in the mouse is different from that in the Cy rat.

PMID- 1748177
TI  - Ejaculations induced by p-chloroamphetamine (PCA) in rats, hamsters and mice.
AB  - The ejaculatory response induced by p-chloroamphetamine (PCA) in male rats,
      hamsters and mice was observed during 2 hours after the injection. The animals
      were treated intraperitoneally with PCA at doses ranging from 0.78125 to 160
      mg/kg. The ED50 (effective dose in 50% of animals) values of PCA for the
      initiation of ejaculation in rats and hamsters were 1.3397 (1.0732-1.6725) and
      0.1105 (0.0802-0.1522) mg/kg, respectively. On the other hand, no ejaculation was
      observed in any mice at any doses examined. So we concluded that there are
      species differences in the ejaculatory response, induced by PCA, among rats,
      hamsters and mice.

PMID- 1748178
TI  - [Comparison of the two different approaches of orchiectomy in guinea pigs].
AB  - The results of orchiectomy conducted by the abdominal and scrotum routes were
      compared in guinea pigs. The operation time, surgical complication and incision
      healing were evaluated. About operation time, there was no distinct difference
      between two routes. In the abdominal route, the prognosis of this case was
      favorable. Also the healing of an incised wound was uneventful one week after the
      operation. While in the scrotum route, the tunica albuginea testis and the
      visceral vaginal tunic are thin, so that the risks of injuring the testis and/or
      scattering the contents of testis seem to be high. Inflammation of the scrotum
      was observed in 4 out of 5 guinea pigs, that were operated by scrotum route. From
      these results, the abdominal route method is highly recommended in the
      orchiectomy of guinea pigs.

PMID- 1748179
TI  - Linearity of cephalometric digitizers.
AB  - The present study aimed to develop a test procedure to diagnose and visualize
      errors in linearity of digitizing tablets. Errors of linearity are caused by the
      distortion of the x- and y-co-ordinates of the digitizing tablet. This results in
      a given object apparently having different dimensions when recorded on different
      locations of the digitizing surface. The test is performed by systematic
      recording of n equally spaced points from a calibrated test foil. Algorithms were
      developed to calculate the difference matrices DXji and DYji between expected and
      observed values of the co-ordinates. Three-dimensional mapping of the non
      linearity of the x- and y-co-ordinates was performed by the UNIRAS-geopak, a 3-D
      surface representative system. The tested digitizers showed varying degrees of
      scaling errors, fields of non-linearity, and random noise. Most digitizers allow
      for correction of scaling by setting of switches in the control unit. A method is
      suggested for correction of non-linearities by use of the DXji and DYji matrices
      in the digitizing programme.

PMID- 1748180
TI  - The aesthetic analysis of the face.
AB  - An analysis of the facial soft tissues is presented which permits aesthetic
      considerations of facial harmony and balance to be measured, and assessed
      quantitatively. The assessment is carried out in a practical and straight-forward
      manner, avoiding the measurement of angles. The visually determined Aesthetic
      Horizontal Line is used as the reference line, with more reliability than the
      Natural Head Position and more relevance to the soft tissues than Frankfort
      Horizontal. The analysis accurately predicts the correct position of the mandible
      so that the extent of orthopaedic or surgical correction necessary can be
      evaluated. The ideal position and angulation of the maxillary incisors are
      determined and established as treatment goals, to give optimal exposure of the
      dentition in expressive behaviour. Comparison of before and after treatment
      cephalograms permits quantitative assessment of aesthetic change.

PMID- 1748181
TI  - Relationships between jaw muscle cross-sections and craniofacial morphology in
      normal adults, studied with magnetic resonance imaging.
AB  - In 32 Caucasian adult males serial MRI scans of the jaw muscles were taken
      approximately perpendicular to the mean fibre direction of the jaw muscles to
      determine their cross-sectional areas. These areas are proportional to the
      maximal isometric strength of a muscle. To describe facial skeletal variation,
      nine angular and 21 linear cephalometric measurements were recorded, and
      statistically reduced by means of multiple regression and principal component
      analysis. Six components were extracted, rotated, and subsequently correlated
      with the maximal cross-sectional areas of the jaw elevators and anterior
      digastric muscle. Positive significant correlations were found between a linear
      combination of several transversal skull dimensions on the one hand, and the
      maximal temporalis and masseter cross-sections on the other. A negative
      significant correlation was found between the flexure of the cranial base and the
      temporalis cross-section. Surprisingly, no significant correlations were found
      between either anterior facial height or posterior facial height and any of the
      jaw muscles cross-sections. It was concluded that, in adult males with normal
      skull shape, relationships exist to a limited extent between craniofacial
      morphology and the cross-sectional areas of the jaw muscles.

PMID- 1748182
TI  - Cheek and lip pressure against maxillary dental arch during dummy sucking.
AB  - The sucking pattern and intra-oral negative air pressure were studied
      simultaneously with the cheek/lip pressure in 12 children when sucking a dummy.
      The cheek/lip pressure was measured at the canine and at the second primary molar
      on the right side of the upper dental arch. The cheek/lip pressure peaks followed
      the intra-oral negative air sucking pressure peaks continuously. In the canine
      region the mean value of maximum cheek/lip pressure was 54 g/cm2. The
      corresponding value at the second primary molar was 21 g/cm2. During dummy
      sucking the mean cheek/lip pressure was 3.4 times higher against the canine
      compared to the second molar (P less than 0.001). The intra-oral negative air
      pressure was approximately the same whether the cheek/lip pressure was measured
      at the canine or at the second primary molar. The results indicated that the
      circumoral muscles were especially active during dummy sucking, in addition to
      the cheek pressure in the canine region.

PMID- 1748183
TI  - Positioning control of the upper incisors in orthognathic surgery. Pre-operative
      planning with the Model Positioning Device and intra-operative application of the
      Sandwich Splint.
AB  - In orthognathic surgery a three-dimensional positioning of the maxilla is
      possible by means of the Le Fort I osteotomy and subsequent maxillary movement.
      In treatment planning and at the time of surgery it is very important to achieve
      an exact positioning of the upper incisors in relation to the upper lip and the
      rest of the skull. The Model Positioning Device described here allows three
      dimensional positioning of the upper incisors in one- or two-jaw surgery. The
      reference plane is the upper surface of the upper part of a semi-individually
      adjustable articulator. The application of the Sandwich Splint enables the three
      dimensional positioning of the maxilla in relation to the rest of the skull. The
      Sandwich Splint ensures that the vertical position of the mandible in relation to
      the rest of the skull above the osteotomy plane is exactly reproducible in the
      pre- and post-operative situation in both model surgery and at time of surgery.
      To this mandibular position the maxilla is positioned in three dimensions, as
      preplanned. The vertical dimension, which is identically reproducible before and
      after surgery is measured with a caliper. After surgery the mandible can be
      rotated into the planned new intercuspidation.

PMID- 1748184
TI  - The influence of orthodontic treatment on previously traumatized permanent
      incisors.
AB  - The reaction of previously traumatized teeth to orthodontic force application was
      investigated. Four groups of children were examined: group T comprised 56
      children who encountered trauma to their maxillary incisors; group O comprised 29
      orthodontic patients with intact incisors; group TO comprised 28 previously
      traumatized orthodontic patients; and group C served as the control group (n =
      26). Orthodontic treatment was restricted to tipping movement executed only by
      means of removable appliances. Groups T, O, and TO were followed up
      longitudinally by means of clinical and radiographic examinations. In most of the
      cases the reported trauma occurred to teeth with completed roots and affected the
      crown only. Group TO presented the highest, though relatively moderate,
      prevalence of root resorption (27.8 per cent) and was followed by groups O and T
      (6.7 and 7.8 per cent, respectively) while in the control group no resorption was
      observed. Electrical pulp testing revealed the highest prevalence of loss of
      tooth vitality in group TO (7.3 per cent) in which the highest prevalence of pulp
      obliteration was also found. It can be concluded that the combination of trauma
      with orthodontic tipping renders the teeth more susceptible to complications,
      especially to root resorption and loss of vitality.

PMID- 1748185
TI  - Relationship between craniomandibular dysfunction and pattern of speech sound
      production in a series of first-graders.
AB  - This report investigates associations between prevalence of functional
      disturbances of the masticatory system and speech disorders. The subjects were
      157 children referred for speech therapy to the hospital and a control group all
      130 first-graders at two elementary schools, mean age 7 years 6 months. During
      clinical examinations, signs and symptoms of TMJ dysfunction were recorded by the
      same dentist. Articulatory speech disorders were diagnosed by the same
      phoniatrician using the Remes Articulatory Test (Remes, 1975) for the Finnish
      language. The results showed that in the hospital referral group the mean value
      for maximal opening was smaller while laterotrusion movements and maximal
      protrusion of the mandible were larger than in the control group. The study group
      also more often had CM disorders and occlusal interferences than children of the
      first grade sample. In the present data, a higher frequency of subjective
      symptoms and several clinical signs of CMD were related to certain articulatory
      speech disorders. Risk of having too anteriorly-produced sounds, mainly 's'
      sounds, decreased with advancing age in 6-8-year-old children. In conclusion,
      expression of both craniomandibular disorder and disorders in speech sound
      production seem to a considerable extent to reflect immaturity of fine motor
      control of the orofacial muscles in 6-8-year-old children.

PMID- 1748186
TI  - Examination of Chinese NiTi wire by a combined clinical and laboratory approach.
AB  - Chinese NiTi wire was compared with Nitinol and stainless steel wires in a
      combined laboratory and clinical examination. In the laboratory test, the loading
      and unloading-deflection properties of the wires were determined in a three-point
      bending test and their surface properties were studied in a scanning electron
      microscope. This test attempts to simulate a common clinical situation. The NiTi
      material showed a non-linear force-deflection relationship. The increase in force
      from 1 mm deflection and onwards was very slow and the force delivered during
      unloading from large deflections was almost constant. This behaviour was somewhat
      different for smaller downward deflections of NiTi wires. Plastic deformation was
      insignificant. The clinical study confirmed the laboratory results obtained,
      characterizing a wire material much superior to stainless steel and even superior
      to Nitinol for alignment purposes. In clinical use, however, the rate of
      fractures of NiTi wires turned out to be unsatisfactorily high. This disadvantage
      was not predicted by the three-point bending test. Scanning electron microscopy
      revealed surface defects and non-metallic inclusions in fractured NiTi wires. A
      combination of a bending test simulating a clinical situation and surface
      examination is recommended when new wire materials are to be tested.

PMID- 1748187
TI  - Spontaneous changes in the rotation of premolar teeth from eruption until the
      established dentition.
AB  - The aim of this study was to investigate whether the rotation of teeth changed
      from the point of eruption until the established dentition. The first 50 cases
      with adequate records enrolled in the Belfast Growth Study were selected, and the
      premolar rotation was measured at the point of eruption and again at age 15 in
      the established dentition. All premolars in a quadrant with early loss of the
      deciduous predecessors, early loss of the first permanent molars or absence of
      premolars, were disregarded. The results showed that the second premolars in both
      the upper and lower arches which erupted rotated had a tendency to improve over
      the observed period. Upper and lower first premolars which erupt rotated show the
      same tendency to improve, but to a lesser extent and less frequently than the
      second premolars. There seemed to be cases where a premolar deteriorated over the
      period, especially the first premolars.

PMID- 1748188
TI  - The effect of orthognathic surgery on head posture.
AB  - Changes in resting head and neck posture were studied in 201 patients following
      five different orthognathic surgery procedures: (1) LeFort I osteotomy for
      superior repositioning (intrusion) of the maxilla (n = 45); (2) bilateral
      sagittal split ramus osteotomy for mandibular advancement (n = 78); (3)
      mandibular setback (n = 19); (4) combined maxillary intrusion and mandibular
      advancement (n = 46); (5) combined maxillary intrusion and mandibular setback (n
      = 13). Head and neck posture were measured on standardized serial cephalograms
      taken in natural head position prior to, immediately after, and 1 year after
      surgery for each subject. Immediately after surgery, there was flexion of the
      head as measured by the craniovertical and craniocervical angles in all of the
      groups except the mandibular setback group, which showed little change. By 1 year
      post-surgery, the mean craniovertical and craniocervical angles were
      approximately the same as before surgery in the groups with one-jaw surgery.
      Statistically significant head flexion at 1 year (P less than 0.05) was observed
      in the combined maxillary intrusion and mandibular advancement group, and with
      maxillary intrusion plus mandibular setback, there was a trend toward persistent
      flexion. Neck posture showed no significant short- or long-term changes in any of
      the surgical groups.

PMID- 1748189
TI  - Ankylosis of primary molars--a future periodontal threat to the first permanent
      molars?
AB  - Most infra-occluded and ankylosed primary molars with a permanent successor will
      exfoliate normally. Continuous supervision of occlusal development and
      radiographic control of normal root resorption have been recommended. The
      decreased height of the alveolar bone level at the site of the infra-occluded
      primary molar has been reported to normalize after the eruption of the permanent
      successor. However, opinions that infra-occlusion of primary molars entails a
      risk of future periodontal damage to the first permanent molars have been
      presented. The aim of this study was to perform a long-term follow-up of the
      alveolar bone level mesial to the first permanent molars after spontaneous
      exfoliation or necessary extraction of the infra-occluded second primary molars.
      The material consisted of 143 permanent molars adjacent to 119 infra-occluded
      primary molars and 24 normal contralateral primary molars in 68 individuals. The
      subjects were re-examined about 8 years after the exfoliation or extraction of
      the infra-occluded second primary molars. The subjects were examined both
      clinically and radiographically. Alveolar bone level mesial to the first
      permanent molars was measured in bite-wing radiographs. All but two permanent
      first molars showed a normal alveolar bone level mesially. In two first permanent
      molars where the primary molar was extracted, mesial approximal bone loss
      amounted to 4 and 3 mm, respectively, but no pocket formation was found. Infra
      occlusion and ankylosis of primary molars does not constitute a general risk of
      future alveolar bone loss mesial to the first permanent molars. The general
      treatment recommendation to await normal exfoliation and eruption of successors
      remains valid.

PMID- 1748190
TI  - A postero-anterior cephalometric evaluation of adult open bite subjects as
      related to normals.
AB  - Reduced nasal airflow can be the result of enlarged adenoids, hypertrophic
      turbinates, severely deviated nasal septum, or even narrow nasal cavities. The
      question of whether the width of the nasal cavity may influence certain facial
      dimensions examined on the postero-anterior cephalometric X-ray was evaluated
      through the study of two different groups of subjects. Possible intercorrelations
      between some other frontal dimensions were also examined in these subjects. The
      first group consisted of 15 males and 22 females aged from 17 to 25 years
      diagnosed as having an anterior open bite of at least 2 mm. The second group
      consisted of 20 males and 16 females aged from 19 to 25 years with a normal Class
      I skeletal and dental pattern. Postero-anterior cephalometric X-rays were taken
      for all individuals and the following dimensions were measured: facial width,
      nasal width, maxillary width, mandibular width, nasal height, and lower facial
      height. Statistical analysis was performed for the primary linear measurements as
      well as for certain ratios. Nasal height and lower facial height were found to be
      significantly increased in both males and females of the open bite group. The
      ratios of nasal width to lower face height, as well as nasal width to nasal
      height, were found to differ significantly only between open bite and normal
      females, being higher in the latter group.

PMID- 1748191
TI  - Ligature wires and elastomeric rings: two methods of ligation, and their
      association with microbial colonization of Streptococcus mutans and lactobacilli.
AB  - Twelve orthodontic patients undergoing treatment with fixed appliances took part
      in the present study. In all patients elastomeric rings were used for ligation on
      one side of the dental arch midline, whereas steel wires were used on the
      opposite side. The number of micro-organisms in samples of plaque, taken from the
      labial surface of the upper lateral incisors, was recorded on five occasions
      during treatment. In samples of saliva, the numbers of Streptococcus mutans and
      lactobacilli were recorded on the same occasions. This registration was also made
      on two occasions before insertion of the fixed appliance, and 6 weeks after the
      period of active treatment. The results showed that, in the majority of patients,
      the incisor which was attached to the arch-wire with an elastomeric ring,
      exhibited a greater number of micro-organisms in the plaque than the incisor
      ligated with steel wire. Following insertion of fixed appliances the number of S.
      mutans and lactobacilli in saliva increased significantly. Variations in the
      number of micro-organisms in the saliva during active treatment were not
      reflected in any relative increase or decrease in microbial colonization on
      either steel ligatures or elastomeric rings. The use of retainers after active
      treatment was not associated with increased numbers of micro-organisms in the
      saliva.

PMID- 1748192
TI  - An atlas of the prenatal mouse brain: gestational day 14.
AB  - A prenatal atlas of the mouse brain is presently unavailable and is needed for
      studies of normal and abnormal development, using techniques including
      immunocytochemistry and in situ hybridization. This atlas will be especially
      useful for researchers studying transgenic and mutant mice. This collection of
      photomicrographs and corresponding drawings of Gestational Day (GD) 14 mouse
      brain sections is an excerpt from a larger atlas encompassing GD 12-18. In
      composing this atlas, available published studies on the developing rodent brain
      were consulted to aid in the detailed labeling of embryonic brain structures.
      C57Bl/6J mice were mated for 1 h, and the presence of a copulation plug was
      designated as GD 0. GD 14 embryos were perfused transcardially with 4%
      paraformaldehyde in 0.1 M phosphate buffer and embedded in paraffin. Serial
      sections (10 microns thickness) were cut through whole heads in sagittal and
      horizontal planes. They were stained with hematoxylin and eosin and photographed.
      Magnifications were 43X and 31X for the horizontal and sagittal sections,
      respectively. Photographs were traced and line drawings prepared using an Adobe
      Illustrator on a Macintosh computer.

PMID- 1748193
TI  - Changes in blood-brain barrier permeability are associated with behavioral and
      neurochemical indices of recovery following intraventricular adrenal medulla
      grafts in an animal model of Parkinson's disease.
AB  - Intraventricular adrenal medulla grafts were found to produce dissociable effects
      on rotational behavior induced by amphetamine and apomorphine in rats with
      unilateral striatal dopamine depletions. Some animals showed a decrease in the
      behavioral response to apomorphine, some showed a decrease to amphetamine, and
      some showed a decrease to both amphetamine and apomorphine. Using in vivo
      microdialysis, the experiments reported demonstrate that in animals with
      decreased rotational behavior, assessed with either amphetamine or apomorphine,
      there was an increase in the permeability of the blood-brain barrier to dopamine.
      The increased blood-brain barrier permeability was visually confirmed with
      horseradish peroxidase. The extent of the blood-brain barrier disruption,
      however, was greater in animals with a decreased response to amphetamine. Animals
      that exhibited decreased amphetamine-induced turning after adrenal medulla grafts
      also had a greater amphetamine-stimulated increase in striatal dopamine and
      greater extracellular striatal dihydroxyphenylacetic acid concentrations compared
      to controls and animals with a graft-induced decrease in the response to
      apomorphine. We conclude that more than one mechanism is involved in mediating
      the behavioral effects of adrenal medulla grafts.

PMID- 1748194
TI  - Do propriospinal projections contribute to hindlimb recovery when all long tracts
      are cut in neonatal or weanling rats?
AB  - Lateral hemisection lesions separated by 1 to 3 spinal segments were made on
      opposite sides of the mithoracic spinal cord in 1-month-old (N = 15; weanling
      operates) and newborn albino rats (N = 16; neonatal operates). Hindlimb behavior
      was assessed between 1 and 6 months p.o. for both groups of operates using a
      protocol and rating system that have previously proved effective in
      differentiating behavioral recovery of the hindlimbs as a function of age of
      spinal transection. In addition, at the conclusion of behavioral testing,
      operates received spinal injections of [3H]proline and HRP caudal to the spinal
      lesions to determine if lesions were complete and if neurons within the region
      between the two lesions (interlesion zone) projected into the caudal spinal cord.
      In both groups of operates, neurons were retrogradely labeled within the
      interlesion zone bilaterally, primarily in laminae VII-VIII. When both lesions
      were complete lateral hemisections in weanling operates, little behavioral
      recovery was observed, similar to complete spinal cord transection (N = 3).
      However, much greater behavioral recovery was seen, including supporting
      reactions and locomotor responses, when one or both lesions spared axons along
      the ventrolateral rim of the white matter. Neurons were retrogradely labeled in
      the brain stem reticular formation (N = 12) in these cases. All lesions were
      complete lateral hemisections in neonatal operates but much greater behavioral
      recovery was seen than in weanling operates with the same lesions, including
      supporting, placing, and locomotor responses. In an additional group of eight
      neonatal operates, the spinal cord rostral to the spinal hemisections was
      transected at 1 month of age. Supportive, placing, and locomotor responses were
      seen immediately after recovery from anesthesia and responses returned to
      pretransection levels in six of eight operates over the 10-day survival period.
      Fink-Heimer impregnation showed that degeneration argyrophilia from the
      transection bilaterally filled the interlesion zone but little argyrophilia was
      seen caudal to this region. Our results indicate that an intact propriospinal
      circuit remains in both neonatal and weanling operates but does not appear to
      contribute to hindlimb response development or recovery. The greater behavioral
      recovery in neonatal operates appears due to intrinsic connections (doral root,
      interneuronal) continuing to be able to drive the spinal circuitry underlying the
      spared behaviors.

PMID- 1748195
TI  - Correlative electrophysiological and behavioral evaluation following L5 lesions
      in the cat: a model of spasticity.
AB  - The present work developed an animal model of hindlimb spasticity by analyzing
      the electrophysiological and behavioral consequences of L5 spinal cord lesions in
      cats. In chronically lesioned animals (1 to 6 months), the L7-S1 dorsal roots
      were stimulated and evoked potentials were recorded from hindlimb flexor and
      extensor motor nerves. Following lateral hemisection, the monosynaptic responses
      were 2-5 times larger (for voltage-time integral and for amplitude) on the
      ipsilateral side than those from the contralateral side or from control animals.
      Half-widths, rise-times, and latencies of the monosynaptic responses were the
      same on both sides. Behavioral signs of spasticity, including hypertonia and
      increased deep tendon reflexes, were displayed from the ipsilateral hindlimb
      following lateral hemisection. With lateral hemisection or with extensive dorsal
      quadrant lesions, hopping and proprioceptive placing reflexes were abolished;
      these behavioral observations impart functional significance to physiological and
      anatomical studies of a mid-lumbar center considered to be important for movement
      control. The present model represents the first demonstration of a statistically
      significant correlation between electrophysiological and behavioral observations
      of spasticity for animals with a lateral hemisection. These correlations
      demonstrate the utility of behavioral screening of animals for subsequent
      neurophysiological analyses. This facilitates the investigation of cellular
      events underlying spasticity and of strategies for its relief with tissue repair
      techniques affecting local circuitry involved in spasticity.

PMID- 1748196
TI  - Neurite outgrowth on postmortem human brain cryostat sections: studies of non
      Alzheimer's and Alzheimer's tissue.
AB  - An in vitro assay to test for regional differences in neurite growth-promoting
      and growth-inhibiting factors in tissue sections of CNS tissue has been adapted
      to the use of postmortem human brain tissue. Frozen sections of the temporal lobe
      from victims of Alzheimer's disease were used as substrates for sympathetic
      neurite outgrowth in tissue culture. Tissue sections from a non-Alzheimer's brain
      were used as a control. Both explanted chick sympathetic ganglia and dissociated
      chick sympathetic neurons were cultured for 3 to 5 days on tissue sections in the
      presence of exogenous nerve growth factor. The dichotomy between gray and white
      matter portions of the tissue sections in supporting neurite outgrowth that was
      previously reported for fresh frozen human brain tissue was also found to persist
      in postmortem tissue. In addition, the total neurite outgrowth from explanted
      sympathetic ganglia was found to be significantly less on postmortem sections
      when compared with previous results obtained from fresh frozen tissue samples of
      epileptic tissue. Dissociated neurons exhibited neurite outgrowth on Alzheimer's
      sections that showed preferential growth on blood vessel segments but no affinity
      for senile plaques. The results suggest that there is some decline in the neurite
      growth-promoting ability of cortical gray matter obtained from postmortem-derived
      brains when compared with fresh tissue and that senile plaques do not represent
      sites of neurite stimulation in this in vitro system.

PMID- 1748197
TI  - A carbohydrate polymer that effectively prevents epidural fibrosis at laminectomy
      sites in the rat.
AB  - We demonstrate that a carbohydrate polymer, designated GL402, effectively
      inhibits epidural fibrosis in a rat laminectomy model. A total laminectomy in
      Lewis rats was performed at lumbar vertebrae 3 and 5. GL402 or phosphate buffer
      solutions in gelatin sponges were applied to the laminectomy sites. Epidural
      fibrosis was measured, using a double-blind protocol, 2 weeks postoperatively
      either by gross anatomical evaluation (blunt dissection) or by histological
      evaluation. Local application of GL402 produced nearly complete inhibition of
      epidural fibrosis, whereas extensive scar formation and bone growth occurred
      after local application of buffer or other purported anti-fibrotics. In
      laminectomy sites treated with GL402 the dura mater was essentially free of
      adhering fibrosis and bone growth was dramatically decreased. With reduction of
      postlaminectomy fibrosis, the spinal nerve roots are more mobile and therefore
      may be less prone to recurrent nerve root compression. The dramatic reduction of
      epidural fibrosis by GL402 will make reoperative disc surgery safer due to
      greater accessibility of the laminectomy site. This compound may be useful in
      preventing surgical adhesions in other sites as well.

PMID- 1748198
TI  - Long-term adrenalectomy causes loss of dentate gyrus and pyramidal neurons in the
      adult hippocampus.
AB  - A growing literature suggests that the hippocampus can be damaged by
      glucocorticoids, the adrenal steroids secreted during stress. Thus, considerable
      interest was generated by recent reports that prolonged elimination of
      glucocorticoids by adrenalectomy (ADX) damages hippocampal dentate gyrus neurons.
      To date, this phenomenon has only been observed in rats of peripubertal age or
      younger; moreover, reports differ considerably as to the magnitude of the damage
      induced. Therefore, we examined this issue in rats ADXd at 5 months of age. Three
      months later, there was a significant 26% loss of dentate neurons in a subset of
      rats. In agreement with these previous reports, this subset had attenuated weight
      gain and electrolyte imbalances, suggestive of complete removal of the adrenals
      and accessory adrenal tissue. As a novel observation, we also observed
      significant (19%) loss of CA4 pyramidal neurons. Thus, both severe under- or
      overexposure to glucocorticoids can be deleterious to a number of hippocampal
      neuron types.

PMID- 1748199
TI  - Age-related sensitivity to kainate neurotoxicity.
AB  - Domoate, a glutamate analog, is believed to be responsible for a seafood
      poisoning incident that caused acute neurological disturbances and chronic memory
      impairment in some victims, with the incidence of mortality and
      neuropsychological morbidity being highest among the aged. Domoate expresses
      neurotoxic (excitotoxic) activity in vitro by an action at the kainate subtype of
      glutamate receptor, and when administered to adult rats, it mimics kainate in
      causing status epilepticus and a severe seizure-brain damage syndrome. Because
      domoate is exceedingly expensive, we explored the feasibility of using kainate to
      study the age-linked features of domoate neurotoxicity. We administered kainate
      subcutaneously in various doses to young (5-6 months), middle-aged (12-13
      months), and old (22-25 months) rats and found the middle-aged and old rats
      significantly more sensitive than young rats to the neurotoxic actions of
      kainate. Low doses of kainate, which were nontoxic to young rats, frequently
      triggered status epilepticus, associated brain damage, and precipitous death in
      old rats. Middle-aged rats were more sensitive than young rats, but less
      sensitive than old rats to kainate neurotoxicity. These results suggest that the
      kainate-treated rat may be a useful model for studying mechanisms underlying age
      related aspects of the human domoate neurotoxic syndrome.

PMID- 1748200
TI  - Induction of axon growth into Schwann cell implants grafted into lesioned adult
      rat spinal cord.
AB  - Polymerized collagen rolls enclosing Schwann cells (SCs) raised in culture were
      grafted into cystic cavities formed after lesioning the thoracic spinal cord of
      adult rats. Axons were already present within the graft by 14 days after
      implantation and both ensheathed and myelinated axons were numerous by 28 days.
      This axonal ingrowth was maintained over longer survival periods. The axons
      within the graft always appeared related to Schwann cells. Acellular collagen
      rolls did not show axonal ingrowth. These Schwann cell-collagen implants resemble
      peripheral nerve grafts in their ability to induce axonal regeneration into the
      graft.

PMID- 1748201
TI  - Relationship of glia to GnRH axonal outgrowth from third ventricular grafts in
      hpg hosts.
AB  - The homozygous mutant hypogonadal (hpg) mouse lacks a functional gene for the
      neuropeptide gonadotropin releasing hormone (GnRH). The consequence of this
      defect is an infantile reproductive tract in adulthood. This condition can be
      reversed by the implantation of normal fetal preoptic area tissue that contains
      GnRH neurons. Reversal is always preceded by the outgrowth of GnRH axons into the
      host target tissue, the median eminence, by a stereotyped pathway. In the current
      experiments we investigated the cellular nature of the path taken by early
      emerging GnRH axons focusing on their relationship with astrocytic components and
      with the specialized ependymal population of this area, the tanycytes. In control
      tissue glial fibrillary acid protein (GFAP) immunoreactivity was confined to the
      exterior of cerebral blood vessels and glial limitans. Both GFAP and vimentin,
      another intermediate filament protein, marked the specialized ependymal cells of
      this region, the tanycytes. There was a robust reactive astrocytic response to
      the injury of transplantation in both the donor and host tissue within 5 days of
      implantation and the reactive astrocytes persisted for 60 days. These cells were
      GFAP-positive and were present in many areas of the host along the cannula tract
      and not confined to the area of GnRH axonal outgrowth. Vimentin, another
      intermediate filament, marked only the specialized ependymal cells of this
      region, the tanycytes, in both control and grafted tissue. Despite the profound
      reactive gliosis, GnRH axons were shown to exit the implant as early as 5 days
      after grafting suggesting that the gliotic process did not constitute a barrier
      to this phenomenon. At the light microscopic level, double label
      immunocytochemical studies did not reveal any specific association between GFAP
      or vimentin-positive cellular processes and these pioneer GnRH fibers. However,
      since normal GnRH axons had been reported to travel in tanycytic channels through
      the medial basal hypothalamus we reinvestigated the pattern of early emerging
      GnRH axons at the ultrastructural level. With this higher resolution, GnRH axons
      were found adjacent to glial elements along their entire traverse from the graft
      host interface, through the host basal hypothalamus to their termination on the
      hypophysial portal capillaries. At the interface, GnRH-positive axons appeared to
      exit via glial channels similar to those described in other developing and
      regenerating systems. In the host, GnRH immunoreactive axonal profiles were
      surrounded by glial processes though the latter could not be further defined as
      tanycytic or astroglial. Other, immunonegative, axons were frequently seen in
      axonal bundles or fascicles and not necessarily in contact with glia.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1748202
TI  - The role of Schwann cells in the regeneration of peripheral nerve axons through
      muscle basal lamina grafts.
AB  - Evacuated muscle is a possible substitute for nerve autografts in the repair of
      damaged peripheral nerves. Previous experiments have shown that killed or
      evacuated muscle grafts are as effective as nerve autografts for bridging gaps of
      up to 4 cm between proximal and distal nerve stumps. Evacuated muscle grafts are
      made of extracellular matrix components, which are good substrates for axon
      growth in vitro. However, experiments in vivo have generally demonstrated that
      live Schwann cells are essential for successful axon regeneration. In the present
      experiments we have used immunohistochemical techniques with anti-S100 and anti
      neurofilament antibodies to visualize axon growth and Schwann cell migration into
      muscle grafts over the first 10 days following grafting. We only saw axons
      growing into grafts accompanied by Schwann cells, and most though not all Schwann
      cells were associated with axons. Schwann cell migration from the proximal stump
      in association with axons was much faster and more extensive than from the distal
      stump. We examined muscle grafts over the first 20 days after grafting by
      electron microscopy. Regenerating axons were always associated with Schwann
      cells, which were mostly in the basal lamina-lined tubes left by the evacuated
      myofibrils. A comparison between evacuated muscle grafts and grafts in which the
      muscle had been killed but not evacuated revealed that 7 days after grafting
      there were more than twice as many regenerated axons in and distal to the
      evacuated grafts, but that by 20 days the numbers of axons were similar in the
      two groups.

PMID- 1748203
TI  - Factors influencing survival of transplanted embryonic motoneurones in the spinal
      cord of adult rats.
AB  - The survival of transplanted embryonic motoneurones in the initially intact
      spinal cord of adult rats was studied and compared to that previously observed in
      the motoneurone-depleted cord. Embryonic (ED 11-12) spinal grafts prelabeled with
      5-bromo-2'-deoxyuridine (BrDUr) were placed in the intact lumbar cord of the
      hosts. To provide a target for grafted embryonic motoneurones and to guide their
      axons to it, the contralateral extensor hallucis longus (EHL) muscle with its
      nerve attached was transferred paravertebrally. The nerve stump was implanted in
      the cord at the site of transplantation. Eight to 14 weeks later BrDUr-labeled
      motoneurone-like cells had migrated outside the grafts into the host's neuropil,
      preferentially into the anterior horn. Following injection of HRP into the
      implanted EHL muscle 6-17 weeks after transplantation a few retrogradely labeled
      motoneurones were seen in the host's anterior horn around the grafts. The lumbar
      cord of the rats with neuromuscular implants but without embryonic grafts had no
      retrogradely labeled cells. However, most animals, both with and without
      embryonic grafts, had retrogradely labeled motoneurones in the thoracic cord,
      which may contribute to the reinnervation of the implanted muscle. Thus, although
      some embryonic motoneurones can survive, migrate into the proper location, and
      probably innervate a host muscle when transplanted into the intact spinal cord,
      their number was significantly fewer than that in the motoneurone-depleted cord.
      The results show that reduction of the host's motoneurone pool increases chances
      of their survival.

PMID- 1748204
TI  - Contingent tolerance to carbamazepine is associated with lowering of amygdala
      kindled seizure thresholds.
AB  - Amygdala-kindled seizure thresholds were studied in animals which were or were
      not tolerant to the anticonvulsant effects of carbamazepine. The seizure
      threshold was defined as the lowest current that elicited a major motor seizure
      (stage 3 or greater). Amygdala-kindled rats received carbamazepine, once daily,
      either before each electrical stimulation (carba-before) or after each
      stimulation (carba-after). The rats given carbamazepine before, but not after,
      each once-daily kindling stimulation became tolerant to its anticonvulsant
      effects. Following this manipulation, seizure thresholds were redetermined in
      both groups of animals while medication-free. The carba-before (i.e., tolerant)
      animals showed a decreased seizure threshold, while the carba-after (i.e.,
      nontolerant) animals showed no change. Tolerance to carbamazepine was reversed by
      giving the rats kindled seizures for a period of 7 days without drug; nontolerant
      animals received the same stimulation and seizures. When seizure thresholds were
      reevaluated, the carba-before animals (now not tolerant) had returned to their
      pretolerance values, while the carba-after group again showed no change. This
      effect of carbamazepine tolerance and its reversal being associated with
      respective decreases and increases in basal seizure threshold was replicated two
      more times. In each case the change in the generalized seizure threshold mirrored
      the change in responsivity of the animals to carbamazepine. These findings,
      consistent with the formulations of Siegel regarding conditioned compensatory
      response mechanisms mediating contingent drug tolerance, may have important
      clinical and theoretical implications.

PMID- 1748205
TI  - Effect of ischemia and reperfusion in vivo on energy metabolism of rat sciatic
      tibial and caudal nerves.
AB  - Our model of severe nerve ischemia consistently results in extinction of the
      compound nerve and muscle action potentials (NAP; CMAP) within 30 min. Since
      impulse transmission may depend on nerve energy metabolism (NEM), we studied the
      effects of ischemia with reperfusion on sciatic-tibial nerve NEM in vivo and
      compared these results with NEM of this nerve in deoxygenated Ringer's solution
      in vitro and postmortem. Ischemia for 30 min postmortem or in deoxygenated
      Ringer's solution resulted in marked depletion of adenosine triphosphate (ATP)
      and creatine phosphate (CP) and an increase in lactate (LAC) of sciatic-tibial
      nerve of adult male Sprague-Dawley rats. In vivo ischemia for up to 3 h to
      sciatic-tibial nerve was sufficient to extinguish CMAP but not NAP and did not
      deplete ATP, CP, or GLU nor did it increase LAC. Ischemia sufficient to
      extinguish NAP resulted in reduction of energy substrates to about 50% of
      resting. Muscle fails to conduct impulses before nerve and in vivo reductions of
      energy substrates are milder than in vitro changes. These changes are explainable
      in terms of energy requirements and supply. These findings support an energetic
      basis of ischemic conduction failure.

PMID- 1748206
TI  - Intraspinal sprouting of calcitonin gene-related peptide containing primary
      afferents after deafferentation in the rat.
AB  - The occurrence of sprouting in the spinal cord in response to denervation has
      been a subject of debate. To test for sprouting of primary afferent fibers after
      denervation, rats were unilaterally deafferented for 35 days (chronic side) by
      dorsal rhizotomies performed from T2 to T8 and T10 to L5, thus isolating or
      sparing the T9 root. The contralateral T9 root was spared by a similar surgery 5
      days (acute side) prior to sacrifice. The survival time on the chronic side
      presumably allows intraspinal sprouting of T9 primary afferents to occur whereas
      the time on the acute side does not. To test for sprouting of primary afferents,
      it is necessary to identify these nerve processes. Calcitonin gene-related
      peptide (CGRP) immunoreactivity has been localized to a subpopulation of primary
      afferent nerve processes and their terminals within the dorsal horn. Therefore,
      immunohistochemical methods were used to determine the distribution of CGRP
      immunoreactivity in laminae I and II on both sides of the spinal cord. Using
      image analysis, there was an increase of 153 to 704% in the density of CGRP
      immunoreaction product on the chronic side compared to the acute side in the
      spared segment. This difference is statistically significant. Furthermore, the
      increased density on the chronic side extended two segments cranial and two
      segments caudal to the spared root segment. No difference was found in the
      laminar distribution between sides. These data support the hypothesis of primary
      afferent sprouting following spinal cord denervation.

PMID- 1748207
TI  - Development of cholinesterase histochemical staining in cerebellar cortex:
      transient expression of "nonspecific" cholinesterase in Purkinje cells of the
      nodulus and uvula.
AB  - Patterns of "nonspecific" cholinesterase (ChE) and acetylcholinesterase (AChE)
      activity were studied in developing rat cerebellar cortex by enzyme
      histochemistry and light and electron microscopy. Three types of ChE
      histochemical reaction product were observed in cerebellar cortex: (i) ChE is
      found in capillary endothelium throughout the cerebellum. Capillary ChE staining
      is present by the time of birth and continues into adulthood. (ii) ChE is found
      in radial glial fibers and their parent cell bodies, the Golgi epithelial cells.
      Radial glial fiber staining is mot intense during the first 3 weeks of postnatal
      life. (iii) ChE is found in Purkinje cells of the nodulus and ventral uvula. No
      ChE staining of Purkinje cells was seen in other parts of the cerebellum. ChE
      staining of Purkinje cells appears to be transient, first appearing at Postnatal
      Day 2 (P2), reaching peak intensity at P7-9, and decreasing to adult levels by
      P16. AChE activity displays a pattern markedly different from ChE, with staining
      in deep cerebellar nuclei, in putative mossy fiber terminals, and in Golgi
      neurons of cerebellar cortex. No evidence was found for transient AChE staining
      in Purkinje cells in any part of the cerebellum. The function of transiently
      expressed ChE activity in developing Purkinje neurons is unknown, but may be
      related to reorganization of cerebellar cortical circuitry associated with growth
      of mossy fiber afferents.

PMID- 1748208
TI  - Co-grafts of embryonic dopamine neurons and adult sciatic nerve into the
      denervated striatum enhance behavioral and morphological recovery in rats.
AB  - We have recently demonstrated that a diffusible factor(s) derived from explanted
      adult rat sciatic nerve can increase the number and neurite outgrowth of
      embryonic rat dopamine (DA) neurons in culture. The present study extends this
      finding to compare DA neuron-sciatic nerve co-grafts to grafts of DA-rich neural
      tissue alone for behavioral and morphological effects in rats with unilateral
      nigrostriatal lesions of the DA pathway. Our results indicate that the presence
      of a co-grafted segment of sciatic nerve increased the likelihood of rapid
      behavioral recovery and promoted complete recovery mediated by small grafts that
      yielded only modest behavioral changes in the absence of co-grafted nerve. These
      behavioral effects were accompanied by a modest increase in survival of grafted
      tyrosine hydroxylase-positive neurons in the striatum and a more pronounced
      increase in the area and density of striatal reinnervation provided by grafted DA
      neurons in co-grafted animals. This evidence supports the view that a diffusible
      product of explanted peripheral nerve acts as a growth-promoting factor for
      embryonic DA neurons and that the presence of this factor augments the behavioral
      efficacy of grafted DA neurons.

PMID- 1748209
TI  - The effects of NGF and fetal cell transplants on spatial learning after
      intradentate administration of colchicine.
AB  - This study was performed to assess the effects of NGF infusion alone or in
      combination with fetal hippocampal transplants on recovery of function after
      damage to hippocampal dentate granule cells. Two groups of male Fischer-344 rats
      received bilateral infusions of colchicine (COLCH; 2.5 micrograms/site) or
      artificial cerebrospinal fluid (ACSF; 0.5 microliter) through chronic indwelling
      cannulae into the dentate gyrus. At the time of COLCH injection, a unilateral
      intracerebroventricular (ICV) cannula was implanted. One week later, when animals
      were tested in activity chambers for 60 min, COLCH-treated rats showed a
      significant increase in spontaneous locomotor activity. Two weeks after COLCH
      treatment, animals were assigned to various post-treatment groups and received
      1.0 microliter of rat fetal hippocampal cell suspensions (ED-17 or 18) or Earle's
      basic salt solution in the same site as previous hippocampal infusions. Modified
      Alzet miniosmotic pumps (0.25 microliter/h) containing NGF (10 ng/microliter) or
      ACSF with cytochrome C (20 ng/microliter) were implanted subcutaneously and
      attached to the previously implanted ICV cannulae. The animals were tested for
      learning ability in a Morris water maze task starting 6 or 12 weeks post-COLCH.
      During both test periods, COLCH lesions significantly impaired acquisition and
      retention. At 6 weeks postlesion, NGF treatment ameliorated this COLCH-induced
      behavioral deficit while the presence of transplants did not ameliorate the COLCH
      induced learning deficit. COLCH/transplant/NGF-treated rats performed better than
      both COLCH-lesioned rats with or without transplants. At 12 weeks postlesion
      COLCH-induced behavioral deficits were not ameliorated by NGF or transplants.
      Morphological examination performed after behavioral testing confirmed the
      presence of viable transplants and COLCH-induced granule cell loss. Exogenous NGF
      infusions appeared to have no effect on the morphological measures taken. These
      data demonstrate a time-dependent facilitative effect of exogenously applied NGF
      on functional deficiencies produced by experimentally induced neurodegeneration
      in the dentate gyrus of the hippocampus.

PMID- 1748210
TI  - Functional recovery following direct or graft repair of nerve gaps in the rat.
AB  - The tibial functional index has been employed to assess functional recovery in
      rats following nerve repair by direct coaptation under tension or by grafting.
      Recovery after direct repair of small to moderate gap sizes was better than that
      after grafting.

PMID- 1748211
TI  - Incorporation of circulating fibronectin into various tissues during sepsis:
      colocalization with endogenous tissue fibronectin.
AB  - We studied the plasma clearance and tissue incorporation of intravenously infused
      purified human plasma fibronectin into various tissues during a period of acute
      lung vascular injury induced by lethal postoperative bacteremia in sheep. Lung,
      liver, spleen, and heart tissue were examined for both endogenous sheep tissue
      fibronectin as well as the experimentally infused human fibronectin using dual
      label immunofluorescence. Awake sheep (n = 4) received a postoperative iv
      infusion of 5 x 10(9) live Pseudomonas over a 60-min infusion interval. Bacterial
      challenge was started 2 hr after starting the iv fibronectin infusion of purified
      human plasma fibronectin (100 mg iv bolus; 4 hr iv at 100 mg/hr). Human
      fibronectin displayed a biphasic rate of clearance from the plasma with entrance
      into lymph. Human fibronectin readily incorporated in all tissues studied,
      including the lung which was the focus of vascular injury. Analysis of tissue
      sections by dual-label immunofluorescence indicated that the exogenous human
      fibronectin colocalized with the endogenous sheep fibronectin. Thus, the plasma
      fibronectin concentration may influence the lung vascular barrier due to its
      incorporation into the tissue pool of fibronectin. Moreover, the plasma may serve
      as a reservoir for soluble fibronectin which can enter and colocalize with the
      insoluble tissue pool of fibronectin in various tissues.

PMID- 1748212
TI  - Macromolecular composition of the myotendinous junction.
AB  - The macromolecular composition of the myotendinous junction of the rat Achilles
      tendon was investigated. Heparan sulphate, chondroitin sulphate, and/or dermatan
      sulphate could be detected in the terminal processes of the muscle cells, but
      neither heparin nor keratan sulphate was present. The presence of hyaluronic acid
      was also questionable. High concentrations of sulphate containing
      glycosaminoglycans could be demonstrated both in the sarcolemma membranes and
      extracellular region. The main collagenous component in the myotendinous junction
      was type I collagen. Also small amounts of type III collagen was found at the
      myotendinous interface. In addition, high concentrations of fibronectin was
      present on the muscle cell surfaces of the junction. These results showed that
      myotendinous junction is histochemically and immunohistochemically a highly
      specified area rich in various polysaccharides. The high concentration of the
      polysaccharides in the myotendinous interface may increase the adhesive force
      between the muscle cell membrane and tendineal collagen fibrils and, by this way,
      it may be important in improving the elastic buffer capacity of the junction
      against loading.

PMID- 1748213
TI  - Comparative activity of doxorubicin and its major metabolite, doxorubicinol, on
      V79/AP4 fibroblasts: a morphofunctional study.
AB  - Doxorubicin (DXR), an anthracycline antineoplastic drug, is mainly metabolized to
      the C-13 dihydroderivative doxorubicinol (DXR-ol), which displays cytotoxic
      activity on various cell lines. To better characterize the cytotoxic activity of
      this metabolite, we have studied the effect of DXR (0.1-10 micrograms/ml) or DXR
      ol (1-100 micrograms/ml) on the transformed fibroblast cell line V79/AP4 by means
      of the clonogenic assay, cytofluorescence, and light and electron microscopy.
      Both DXR and DXR-ol displayed a dose-dependent inhibition of colony formation
      with an IC50 factor DXR-ol/DXR of 19.5. A striking nuclear fluorescence was
      observed after DXR but not after DXR-ol. A low number of mitoses and a decrease
      in nucleoli staining affinity were the most evident alterations induced by DXR.
      Electron microscopy showed both nuclear and cytoplasmic changes in DXR treated
      cells: nucleolar segregation, cytoplasmic vacuoles, and mitochondrial swelling
      with dense needle-shaped material were observed. Exposure to formic acid
      confirmed the calcific nature of the mitochondrial bodies. Only the highest dose
      of DXR-ol brought about nuclear and cytoplasmic ultrastructural changes similar
      to those induced by DXR. Our data describe new in vitro findings on the
      cytotoxicity and morphological alterations induced by both DXR and DXR-ol, with a
      lower activity of DXR-ol against V79/AP4 fibroblasts.

PMID- 1748214
TI  - Mechanism of liver injury following ischemia.
AB  - To clarify whether ischemic liver injury is due to ischemia itself or
      reperfusion, histopathological and functional changes in the liver were examined
      before and after liver ischemia in rats with porto-systemic collateral channels.
      Effects of oxygen-derived free radical scavengers or an inhibitor of platelet
      aggregation on development of ischemic liver injury were also examined. Liver
      ischemia was produced by ligation of the portal vein and hepatic artery at liver
      hilum for 1 hr. The primary lesion of ischemic liver injury was cloudy swelling
      of liver cells in the periportal and midzonal regions; it developed during
      ischemia. The cloudy swelling of liver cells induced uneven distribution of
      sinusoidal blood flow after reperfusion, and consequently individual liver cell
      necrosis and focal hepatocellular necrosis in the midzonal regions developed
      later. Elevation of cytoplasmic enzyme activities in the serum after reperfusion
      was due to leakage across the damaged plasma membrane of liver cells. The
      treatment with superoxide dismutase, catalase, or heparin had not altered the
      liver injury that was attributed to ischemia, biochemically and histologically.
      These results suggest that ischemic liver injury is due to liver cell damage
      developed during ischemia, and that the ischemic liver injury is not alleviated
      or prevented by superoxide dismutase, catalase, or heparin.

PMID- 1748215
TI  - Helicobacter pylori affects the quality of experimental gastric ulcer healing in
      a new animal model.
AB  - Helicobacter pylori has been implicated in the genesis of human gastritis,
      dyspepsia, and peptic ulcers. However, its influence in the quality of
      experimental gastric ulcer healing has not been previously investigated.
      Standardized gastric fundic ulcers were produced in 50 male Sprague-Dawley rats
      (150-200 g) by a 4 mm in diameter focal, serosal application of 100% acetic acid.
      Thirty rats were administered 2 ml H. pylori suspension (urease producing, ATCC
      43504) in normal saline (10(8) CFU/ml) 2x/day for 7 days. Twenty rats (controls)
      received 2 ml normal saline 2x/day for 7 days. Gastric ulcer surface area was
      measured under a dissecting microscope and mucosal specimens were obtained for
      qualitative and quantitative histology. No gross or microscopic duodenal
      abnormalities were identified at sacrifice. Ninety percent of control rats showed
      grossly and microscopically entirely healed ulcers. The remaining 10% showed
      partially reepithelialized ulcers (area, 0.78 to 1.77 mm2; mean, 1.27 +/- 0.7
      mm2). The grossly "healed" mucosa demonstrated marked dilatation of gastric
      glands lined with mature surface epithelial cells. Parietal cells were scanty (5
      10% of all cells). One hundred percent of the H. pylori-exposed rats showed
      persistence of chronic active ulcers (area, 1.76 to 19.63 mm2; mean, 8.95 +/-
      6.15 mm2). The ulcer beds were infiltrated by acute and chronic inflammatory
      cells, abundant fibroblasts, and capillary networks. The raised ulcer borders
      were characterized by dilated glands lined by mature surface epithelial cells.
      Various special stains demonstrated the presence of H. pylori in the surface
      mucus and within the crypts.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748216
TI  - Distinctive infrared spectral features in liver tumor tissues of mice: evidence
      of structural modifications at the molecular level.
AB  - Mice were treated with griseofulvin (GF) containing diet or control diet for 12
      months. The livers from mice fed griseofulvin showed large tumors that were
      excised and used for analysis. The infrared spectra from control liver tissue and
      tumor tissue from GF livers were measured and compared as a function of pressure
      up to 27 kbar. Many changes in the infrared spectral features of the tumor tissue
      were observed. Results showed that neoplasm formation involved structural
      modifications of nucleic acids, lipids, carbohydrates, and proteins in the liver
      cells, which were detected from the abnormal vibrations of the functional groups
      in these biomolecules. The amount of glycogen was dramatically decreased in the
      tumor tissue compared to the control tissue. Important changes in the strength of
      hydrogen-bondings in the phosphodiester backbone of the nucleic acids and in the
      C-O groups of tissue proteins and carbohydrates were observed. Stronger
      interchain interactions and thus close interchain packing among the lipids in the
      GF liver were evident. These results showed very close similarities with those
      obtained with other types of tumors such as human colon cancer, suggesting that a
      common pattern of molecular changes has been identified in neoplastic
      transformation.

PMID- 1748217
TI  - Effect of dietary n-3 fatty acids on atherosclerosis prone JCR:LA-corpulent rats.
AB  - Corpulent male rats of the atherosclerosis prone JCR:LA-corpulent strain were fed
      diets supplemented with 10% by weight of olive oil or red fish oil. These rats
      are obese, with VLDL hyperlipidemia and marked insulin resistance. The diets were
      maintained to 9 months of age. Olive oil-fed rats had a 45% reduction in
      triglyceride concentrations with no significant changes in cholesterol or
      phospholipids. Red fish oil caused significant reduction in all lipid classes,
      with a 65% reduction in triglycerides and 35% reduction in cholesterol
      concentrations. Olive oil caused increases in the relative concentrations of
      oleic acid-containing triglycerides, while red fish oil preferentially enriched
      the longer chain fatty acids. There were no significant changes in insulin or
      glucose metabolism. The incidence of myocardial lesions, characteristic of the
      JCR:LA-cp strain, was unaltered by either oil-supplemented diet. These results,
      in a spontaneous animal model for cardiovascular disease, are consistent with
      other studies showing that diets rich in n-3 fatty acids do not, in themselves,
      confer protection against cardiovascular disease in animal models with
      genetically or experimentally induced lipid disorders.

PMID- 1748218
TI  - Classification of perinatal deaths.

PMID- 1748219
TI  - Perinatal mortality in Norway: experience with perinatal audit.
AB  - In order to improve perinatal service, special committees have been established
      in every county in Norway. These committees are responsible for making local
      guidelines and performing inquiries (audits) of all perinatal deaths. The
      focusing upon avoidable and possibly avoidable factors and identification of
      suboptimal care seems to be valuable in improving the quality of medical work. In
      1989 the perinatal mortality was 7.8 per 1000 births.

PMID- 1748220
TI  - Perinatal mortality related to low birth weight.

PMID- 1748221
TI  - Perinatal mortality in the East Flanders Prospective Twin Survey (preliminary
      results).

PMID- 1748222
TI  - Follow-up and hormone replacement in gynecological cancer patients.

PMID- 1748223
TI  - Progestogens in reproductive endocrinology.

PMID- 1748224
TI  - Subspecialization in gynecology and obstetrics: advantages and disadvantages.
AB  - To discuss the problem of subspecialization in our discipline is presently very
      popular. Whether or not a complete separation into the three subdisciplines: (1)
      materno-fetal medicine - obstetrics (2) surgical gynecology - gynecologic
      oncology (3) gynecologic endocrinology - reproductive medicine is recommended
      remains unclear in most of the statements. Some describe forms of only a
      supplementary postgraduate education, a kind of prolongation of the basic
      gynecologic and obstetrical training concentrated on one of the three main
      fields. The complete separation, i.e., in obstetrical medicine, reproductive
      medicine, gynecologic pelvic surgery, has the advantage of a more effective
      concentration on each of the respective subdisciplines in clinical work and in
      research. On the other hand, the separation will certainly produce several
      disadvantages: (a) What is inbetween the subdisciplines will be difficult to
      integrate. (b) The principle of the gynecologist functioning as a primary health
      care physician for women will be weakened, i.e., his competence for family
      planning, pregnancy and delivery of normal cases, for cancer screening of genital
      and breast tumors, for disorders of the cycle, for pelvic inflammatory diseases
      and for the care of postmenopausal women will be less integral. (c) The lectures
      will be more than at present split or overloaded with detailed facts. (d) The
      need of general gynecologic care - as well cost-effective as widely available -
      will less frequently be met than now. (e) The opportunities for younger
      colleagues to settle with an office of their own will be restricted. The
      disadvantages outweigh the advantages.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748225
TI  - Undergraduate education and recruitment in obstetrics and gynaecology.
AB  - The extent and quality of exposure to obstetrics and gynaecology that is required
      in the undergraduate curriculum has bearing on the knowledge, clinical skills and
      behaviour that are expected from the student. How much involvement should
      clinical obstetricians and gynaecologists have in teaching human reproduction and
      basic physiology and related science to the undergraduate? Who should teach
      sexual medicine? What is the extent of practical experience which students should
      have? Should the student have an opportunity to study a particular area in the
      discipline at depth in order to encourage interest and involvement and thereby
      facilitate recruitment? These issues are being addressed in curricular changes in
      Manchester, and option teaching is considered to have the potential of enhancing
      interest in obstetrics and gynaecology as a definitive career.

PMID- 1748226
TI  - Ovarian cancer: introduction and development in the treatment.

PMID- 1748227
TI  - Detection and localization of ovarian cancer with radiolabeled monoclonal
      antibodies.

PMID- 1748228
TI  - Treatment with biologic response modifiers in patients with ovarian cancer.
AB  - The therapeutic and immunomodulating potential of biological response modifiers
      (BRM) such as OK-432 (a streptococcal preparation) and recombinant interferon
      gamma (rIFN-gamma) has been evaluated in 15 patients with advanced chemotherapy
      resistant ovarian cancer, presenting malignant ascites and/or pleural effusions.
      OK-432 was injected intracavitary in 10 patients in increasing doses from 0.2 up
      to 7.5 mg weekly. Five women were treated intracavitary with rIFN-gamma twice a
      week. The initial dose was 0.1 mg/m2 which was raised up to 12 mg/m2 over 6
      weeks. With OK-432 a complete response was achieved for 14.1 + 8.9 months in 4
      patients, a partial response for 1.7 + 0.3 months in 3 patients. The survival
      time of the 4 responders was significantly longer (21.1 + 8.3 months) than the
      survival time of the patients with partial or no response (4.9 + 2.7,4.1 + 2.3
      months, respectively). In the rIFN-gamma therapy group, we found a partial
      response in one and no response in 4 patients. Toxicity observed under OK-432 and
      rIFN-gamma was minimal in all patients, suggesting a lack of systemic effect of
      intracavitary-applied BRM. With both agents, augmentation of certain immune
      responses, especially in the peritoneal cavity and to a lesser extent in the
      peripheral blood, has been documented. In 5 patients treated with OK-432, we
      found an overall augmentation of the effusion macrophage killer activity. rIFN
      gamma augmented natural killer activity in 2 of 3 patients.

PMID- 1748229
TI  - Prevention of perinatal consequences of pre-eclampsia with low-dose aspirin:
      results of the epreda trial. The Epreda Trial Study Group.
AB  - A multicentric randomized double-blind trial was realized in order to determine
      whether a treatment with a low-dose aspirin (150 mg/day) with or without
      dipyridamole (225 mg/day) was able to prevent the perinatal consequences of pre
      eclampsia. This study demonstrated a significant difference in birthweight and
      incidence of fetal growth retardation between treatment and placebo groups. No
      difference was demonstrated between aspirin and aspirin + dipyridamole patients.

PMID- 1748230
TI  - The role of lipids in nutrition during the first months of life.
AB  - The most important functional components of dietary lipids (triglycerides,
      cholesterol esters and phospholipids) are fundamental to normal growth and
      development of infants. Fatty acids are classified according to their chain
      length and their degree of saturation. Each class of fatty acid is involved in
      specific metabolic reactions: short-chain fatty acids act as local growth factors
      in the colon; medium- and saturated long-chain fatty acids are a good source of
      energy; polysaturated long-chain fatty acids are involved in metabolic
      regulation; and very long-chain fatty acids are important structural components
      of membranes. The development of the central nervous system depends on the amount
      and the quality of the lipid supply in the last months of prenatal and the first
      months of postnatal life. Placental cord blood during foetal life and breast milk
      provide fatty acids in the correct amounts and ratios. Fats in breast milk
      provide half the infant's calorific needs and maternal dietary habits can
      influence the lipid composition of milk. The preparation of blends of fats for
      formulas is under investigation in order to improve the lipid quality and to make
      formulas more similar to breast milk. A major goal of current research is to
      define the nutritional and metabolic relationships between fatty acid groups and
      between fats and the other dietary sources of calories in order to improve the
      composition of infant formulas, in particular for premature babies.

PMID- 1748231
TI  - Thyroid function and release of thyroid-stimulating hormone and prolactin from
      the pituitary in human obesity.
AB  - Thyroid function, basal serum thyroid-stimulating hormone (TSH) and prolactin
      concentrations, and the effects of 200 micrograms TSH-releasing hormone (TRH)
      given intravenously on TSH (delta TSH) and prolactin (delta prolactin) were
      investigated in 25 euthyroid obese subjects and 20 lean controls. No significant
      differences in serum thyroid hormone concentrations, glucose metabolism
      parameters, or basal TSH and prolactin concentrations were detected between
      groups, but a significant (P less than 0.01) increase in delta TSH and a
      significant (P less than 0.01) decrease in delta prolactin were observed in obese
      subjects. No significant differences in basal TSH and prolactin were observed in
      obese men and women compared with corresponding lean controls, but delta
      prolactin decreased significantly (P less than 0.01) in obese men and women
      compared with lean controls and TSH increased significantly (P less than 0.01) in
      obese men and women. No correlation was found between delta TSH or delta
      prolactin and body mass index. The study suggests that hyper-responsiveness of
      TSH and hyporesponsiveness of prolactin to TRH in obese subjects can be related
      to changes in the central serotoninergic system.

PMID- 1748232
TI  - Memory storage and effect of repeated treatment with a new antidepressant drug:
      rubidium chloride.
AB  - Following 15 days' treatment with saline, 48 mg/kg rubidium chloride, 5 mg/kg
      imipramine hydrochloride, 10 mg/kg sodium phenobarbitone, 1000 mg/kg piracetam,
      or 0.20 mg/kg strychnine nitrate all administered intraperitoneally, mice were
      evaluated by habituation of exploratory activity using an open-field apparatus.
      In control animals a significant (P less than 0.05) decrease in open-field
      responses (ambulation, rearing and defaecation) was seen following a 1-day
      intersession interval and there was no retention of exploratory activity after a
      5-day intersession interval. Administration of imipramine or phenobarbitone for
      15 days was found to impair retention of memory after 1 day, whereas treatment
      with rubidium chloride, piracetam, or strychnine for 15 days improve retention
      after a 5-day intersession interval.

PMID- 1748233
TI  - Indole-3-pyruvic acid as a possible hypnotic agent in insomniac subjects.
AB  - In a single-blind study six male patients (mean age 39.5 years) with moderate
      insomnia were treated with placebo for three nights, 100 mg indole-3-pyruvic acid
      (IPA) for three nights, 200 mg IPA for three nights, 100 mg IPA for two nights
      and placebo for two nights. Polygraphic recordings were made and total sleep
      time, sleep efficiency, sleep latency, slow wave sleep latency, rapid eye
      movement (REM) sleep latency, number of arousals (greater than 1 min), percentage
      and duration of wakefulness after sleep onset, percentage and duration of
      wakefulness after sleep onset, percentage and duration of sleep stages 1, 2, 3, 4
      and REM were recorded. At the end of 13 days, total sleep time, duration of stage
      2 sleep and total non-REM were significantly increased when compared with
      baseline. Total sleep time and duration of stage 2 and total non-REM sleep on
      completion were significantly decreased when compared with after 200 mg IPA
      (night 9). Results suggest an action of IPA on human sleep similar to that of
      exogenous melatonin and L-tryptophan, thus confirming that IPA could be used to
      increase serotonin and melatonin turnover.

PMID- 1748234
TI  - Acute effects of alcohol ingestion on the human serum concentrations of calcium
      and magnesium.
AB  - Alcohol has been shown to reduce serum calcium concentrations in several animal
      studies. In humans, using relatively low doses of alcohol, however, the results
      were inconclusive. In addition, the effect of alcohol consumption on serum
      magnesium concentrations is controversial. To elucidate the influence of alcohol
      ingestion on serum calcium and magnesium in humans 43 intoxicated patients and
      seven healthy volunteers who had not previously ingested alcohol were studied.
      There was an inversely related diminuition of serum calcium and magnesium
      concentrations with increasing serum alcohol. These effects of alcohol may play a
      role in the metabolic and clinical disorders observed in severely intoxicated
      people.

PMID- 1748235
TI  - Antiplatelet agents and their effect on complications during or soon after
      percutaneous transluminal coronary angioplasty.
AB  - In a retrospective study, during which 179 patients had undergone percutaneous
      transluminal coronary angioplasty (PTCA), the overall initial success rate fell
      suddenly and unexpectedly from more than 90% to 70.4%: 54.9% in patients not
      receiving antiplatelet therapy and 86.4% in patients treated orally with 300 mg
      triflusal three times daily or 300 mg acetylsalicylic acid plus 75 mg
      dipyridamole three times daily. The initial success rate was similar in patients
      with unstable (66.0%) and stable (77.6%) angina. The overall incidence of severe
      complications (mainly occlusion) was 16.2% and was significantly (P less than
      0.01) greater in the patients not receiving antiplatelet therapy (23.1% versus
      9.1%). There was no significant difference between incidence according to
      antiplatelet therapy used. It is concluded that antiplatelet therapy during the
      peri-angioplasty period (from 2 days before to 2 days after) may prevent
      periprocedural events in patients undergoing PTCA.

PMID- 1748236
TI  - Acute hypertension after renal allograft rejection therapy with OKT3 monoclonal
      antibody.
AB  - Acute rejection of renal allografts was treated with the monoclonal antibody OKT3
      given intravenously. A variety of adverse events were observed on days 1 and 2
      following treatment with 5 mg/day OKT3 for 10 days including heart failure,
      pulmonary oedema and hypertension. Continuous monitoring of 19 patients treated
      with OKT3 for acute renal allograft rejection detected a transient increase,
      lasting 2 h, in systolic and diastolic blood pressures on day 1. A larger
      increase in systolic and diastolic pressures lasting 11-13 h was observed on day
      2. Treatment with 5 mg OKT3 on day 3 did not significantly increase systolic or
      diastolic pressure. It is concluded that OKT3 can aggravate hypertension and
      hypertensive emergencies may be encountered during the initial phase of OKT3
      treatment.

PMID- 1748237
TI  - 1990 overview of GDM. Accomplishments of the last decade--challenges for the
      future.

PMID- 1748238
TI  - Metabolic alterations in adulthood after intrauterine development in mothers with
      mild diabetes.
AB  - We studied the long-term effects of maternal diabetes mellitus on the offspring
      of experimentally induced diabetic Wistar rats. When stressed by an intravenous
      glucose load, the adult female offspring had impaired glucose tolerance and
      developed gestational diabetes mellitus when pregnant. Our results show that even
      mild diabetes mellitus induces an abnormal intrauterine milieu that causes
      morphological and functional changes in fetal development with consequences for
      later life.

PMID- 1748239
TI  - Islet function in offspring of mothers on low-protein diet during gestation.
AB  - A low-protein diet (8 vs. 20%) administered during pregnancy affects the
      structure and function of the endocrine pancreas of the offspring. At 21.5 days
      of gestation, we reported a reduction of cell proliferation, islet size, islet
      vascularization, and pancreatic insulin content. In this study, we demonstrated
      an impairment of insulin secretion of these fetal islets when stimulated in vitro
      with amino acids such as arginine and leucine. If the offspring is kept on the
      same low-protein diet during suckling, weaning, and adulthood, fasting insulin
      levels remain low in the presence of normal blood glucose levels. Glucose
      tolerance at 70 days is impaired, with lower insulin response. In addition,
      permanent functional damage seems to be induced in utero by a low-protein diet,
      because a normal diet given from birth to adulthood does not restore normal
      insulin response after a glucose challenge. Our experimental results stress the
      impact of a balanced diet with qualitative and quantitative amino acid
      composition for the fetal endocrine pancreas to develop normally, without lasting
      functional and structural consequences in adulthood.

PMID- 1748240
TI  - Long-term prospective evaluation of offspring of diabetic mothers.
AB  - We have suggested that altered maternal metabolism may affect the subsequent
      anthropometric and neuropsychological development of children who were in utero
      during disturbances in maternal fuel economy. This study reports the physical
      growth through 8 yr of age and the neuropsychological development through 4 yr of
      age in offspring of diabetic mothers (ODM). At birth, 50% of infants had weights
      greater than 90th percentile for gestational age. By 12 mo, length and weight
      were similar to the general population. Height remained normal until 7 yr of age,
      when it became slightly greater than average. After 5 yr of age, relative weight
      increased dramatically, and by 8 yr of age, half of the ODM had weights greater
      than 90th percentile. This childhood obesity in ODM is correlated with maternal
      prepregnant weight and independently with amniotic fluid insulin at 32-38 wk
      gestation. The Brazelton Neonatal Behavioral Assessment Scale (BNBAS) was
      administered to 185 newborn ODM. Significant correlations were found between
      poorer second- and third-trimester glycemic regulation and lower scores in three
      of four newborn BNBAS dimensions. The Stanford-Binet Intelligence Scale was
      measured in 102 ODM at 4 yr of age. We found an inverse correlation between
      childhood IQ and second- and third-trimester maternal lipid metabolism (serum
      free fatty acids and beta-hydroxybutyrate). This correlation is not explained by
      adverse perinatal events, socioeconomic status, maternal IQ, ethnicity, or
      diabetes type. These long-range associations between altered maternal metabolism
      and childhood growth and development continue to support Freinkel's hypothesis of
      fuel-mediated teratogenesis.

PMID- 1748241
TI  - Abnormal glucose tolerance during pregnancy in Pima Indian women. Long-term
      effects on offspring.
AB  - The long-term effects on offspring of abnormal glucose tolerance detected during
      pregnancy were examined in 552 Pima Indian offspring 5-24 yr of age. Fasting
      hyperinsulinemia, presumably reflecting increased insulin resistance, occurred at
      an earlier age in the offspring of women who had abnormal glucose tolerance
      during pregnancy, and these offspring were more obese and had higher rates of
      abnormal glucose tolerance. When confounding factors were controlled, a 1 mM
      higher 2-h postload glucose concentration during pregnancy resulted in a
      significantly higher prevalence of diabetes in the offspring (odds ratio = 162).
      Maternal 2-h glucose concentration during pregnancy was also a significant
      predictor of glucose concentration during pregnancy in the offspring (P = 0.011).
      Thus, the metabolic abnormalities associated with the diabetic pregnancy result
      in long-term effects on the offspring, including insulin resistance, obesity, and
      diabetes, which in turn may contribute to transmission of risk for developing the
      same problems in the next generation.

PMID- 1748242
TI  - Diabetes mellitus after GDM.
AB  - The impact of factors that influence diabetes mellitus (DM) and impaired glucose
      tolerance (IGT) incidence rates among former gestation diabetes mellitus (GDM)
      patients undermine attempts at interstudy comparisons. The recommended diagnostic
      standards for GDM by oral glucose tolerance test (OGTT) are the O'Sullivan and
      Mahan criteria and the World Health Organization (WHO) criteria for IGT, which
      result in prevalence rates of 2.5 and 7.2%, respectively, when applied to 752
      unselected pregnant women. In applying the O'Sullivan and Mahan criteria, the
      current open-ended definition of GDM without rules either to exclude overt
      diabetes uncovered by pregnancy or to require a return to a normal OGTT after
      pregnancy is shown to be a major source of differences in subsequent incidence
      rates of diabetes. For subsequent nonpregnant diagnoses, the differences between
      WHO and National Diabetes Data Group criteria and the allowable modifications
      within each of the diagnostic standards all result in different incidence rates
      of diabetes. Review of 12 worldwide studies of diabetes among former GDM patients
      indicated a wide range of incidence rates, from 19 to 87% for combined DM and IGT
      and 6 to 62% for DM. In applying WHO DM criteria to GDM patients and control
      subjects, the excess risk of diabetes among GDM patients was 18% in Copenhagen
      and 30.9% in Boston, MA. The potential impact of varying observation periods
      within studies was seen when the application of an actuarial method added a
      further 50% to the Boston incidence rates of both GDM patients and control
      subjects. Although the variability in diabetes incidence rates is wide, there is
      broad general agreement on the predictive nature of gestational blood glucose
      levels.

PMID- 1748243
TI  - Follow-up of women with previous GDM. Insulin, C-peptide, and proinsulin
      responses to oral glucose load.
AB  - Gestational diabetes mellitus (GDM) is a strong predictor of glucose intolerance
      later in life. Former GDM (n = 145) and control (n = 41) subjects were studied 3
      4 yr after the index pregnancy. They were subjected to a 75-g oral glucose
      tolerance test (OGTT) with measurements of insulin, C-peptide, and proinsulin in
      the basal state and every 30 min for 180 min. In the former GDM group, 5 subjects
      (3.4%) had developed non-insulin-dependent diabetes mellitus (NIDDM), and 32
      (22%) had developed impaired glucose tolerance (IGT; by World Health Organization
      criteria). In the control group, 2 (4%) had IGT. In the GDM group, IGT or NIDDM
      was significantly associated with obesity (body mass index [BMI] greater than or
      equal to 25 kg/m2) and earlier diagnosis of GDM during pregnancy (P less than
      0.001). Nonobese (BMI less than 25 kg/m2) GDM subjects with normal glucose
      tolerance at follow-up had significantly higher mean glucose (P less than 0.01),
      insulin (P less than 0.05), and proinsulin (P less than 0.001) values during the
      OGTT than control subjects, whereas there was no significant difference in C
      peptide values. A comparison between control subjects with normal OGTT and BMI
      less than 25 kg/m2 (n = 39) and GDM subjects (n = 39) selected to have a
      comparable area under the glucose curve, BMI, and age demonstrated no group
      differences in glucose, C-peptide, or insulin levels, whereas the proinsulin
      levels were significantly higher (P less than 0.001) during the glucose load. The
      molar ratio between proinsulin and insulin was also significantly higher among
      the former GDM subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748244
TI  - Diagnosis of gestational diabetes. What are our objectives?
AB  - International agreement is lacking with regard to diagnostic criteria for
      gestational diabetes and its treatment. Consensus is not possible without
      agreement on the objectives in making the diagnosis. The most commonly used
      criteria in North America were validated by their predictive value for the
      subsequent development of overt diabetes in the years after affected pregnancies.
      The diagnosis is also deemed by many to be important as a risk factor for adverse
      perinatal outcome in the present pregnancy. Attempts have been made, in various
      parts of the world, to derive diagnostic criteria based on pregnancy outcome;
      unfortunately, these have not been so intensively studied as the standards cited
      above. There is also a lack of agreement on whether gestational diabetes should
      be considered a disease or merely a risk factor. In addition, consensus has not
      been reached on whether population-specific criteria should be used in each
      location or universally accepted diagnostic thresholds should be applied. Many
      philosophical questions remain unanswered, and numerous opportunities for
      investigation present themselves. Many of these are dealt with in this workshop
      conference, whereas others remain as goals to be attained.

PMID- 1748245
TI  - Serum lipids within 36 mo of delivery in women with recent gestational diabetes.
AB  - We prospectively evaluated fasting serum total cholesterol (chol), low- and high
      density lipoprotein cholesterol (LDL-chol and HDL-chol), and triglycerides (TGs)
      in a large cohort of Hispanic women during the first 36 mo after pregnancies
      complicated by gestational diabetes mellitus (GDM). In 1340 women studied 6-12 wk
      postpartum (PP-GDM group), chol and LDL-chol were similar to levels in 43
      postpartum control subjects without prior GDM. Compared with control subjects
      (2.01 +/- 1.24 mM), TG was elevated in the PP-GDM women with diabetes mellitus
      (DM) (2.86 +/- 2.21 mM, P less than 10(-5)) and impaired glucose tolerance (IGT)
      (2.64 +/- 1.68 mM, P = 0.02) but not in those with normal glucose tolerance (2.00
      +/- 1.21 mM). HDL-chol was decreased in PP-GDM women with DM compared with those
      with normal glucose tolerance. A subgroup of 157 women with prior GDM returned
      for at least one annual follow-up test on nonhormonal contraception (FU-GDM: n =
      60 at 3-11 mo after delivery, n = 78 at 12-23 mo, and n = 39 at 24-35 mo). The
      cumulative prevalence of DM by 36 mo was 40%. Chol or LDL-chol levels did not
      significantly change during the 1-yr intervals in the FU-GDM group and were
      similar to a control group of 36 women without prior GDM. TG was elevated and HDL
      chol was decreased in the FU-GDM women with DM at 3-11 mo but not thereafter.
      Overall, the prevalence of moderate- and high-risk LDL-chol in the FU-GDM group
      was not different from that of control subjects. These findings suggest that
      lipid abnormalities are uncommon during the first 36 mo after delivery in women
      with recent GDM. The abnormalities found consisted of increased TG and decreased
      HDL-chol in subjects who had developed DM during the study period.

PMID- 1748246
TI  - Preconception counseling and contraception after gestational diabetes.
AB  - Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984
      were followed for on average 6 yr after the index pregnancy. Thirty percent had
      diabetes mellitus at the follow-up examination, and preliminary results indicate
      that at least another third will develop diabetes during a subsequent pregnancy.
      Therefore, family planning and contraceptive guidance should follow the lines for
      women with pregestational diabetes. When low-dose hormonal contraceptives
      containing ethinyl estradiol and levonorgestrel were given to women with previous
      GDM, glucose tolerance and lipoprotein levels remained unchanged during a 6-mo
      treatment. However, insulin response to oral glucose increased significantly
      after hormonal intake for 6 mo. A triphasic preparation resulted in a
      significantly lower insulin response than a low-dose monophasic preparation.
      However, the results indicate that low-dose oral-contraceptive compounds appear
      to be safe for women with previous GDM when administered for limited periods. At
      the follow-up examination, we found no increased risk of developing diabetes in
      women with previous GDM who used oral contraception. We consider the intrauterine
      contraceptives (IUD) a safe and effective alternative for women with previous
      GDM. Of 154 women with GDM, 33% chose IUD, 22% a combination-type oral
      contraceptive, and 16% barrier methods as their first choice of contraception 2
      mo postpartum. We conclude that family planning and qualified contraceptive
      advice are important in women with previous GDM.

PMID- 1748247
TI  - New National Academy of Sciences guidelines for nutrition during pregnancy.

PMID- 1748248
TI  - Energy requirements of pregnancy.
AB  - The energy requirements of pregnancy is a topic of considerable uncertainty
      because the apparent energy costs--to supply the energy required for the changes
      in maternal and fetal tissues and to cover the increase in basal metabolic rate
      (BMR), amounting to the equivalent of an extra 250-300 kcal/day--are rarely
      paralleled by actual findings. However, few studies have investigated this
      problem in a controlled longitudinal and statistically acceptable fashion. In
      this study, measurements of energy intake, BMR, body weight and fatness, physical
      activity, and mechanical efficiency of movement were made on 162 women in
      Scotland at 2- to 4-wk intervals throughout pregnancy, and data from 98 of these
      women were also obtained in the prepregnant state. Data from a parallel study in
      the Netherlands are also given. The gains in body weight, fatness, the fetal and
      placental weights, and the increase in BMR were all at the normal expected
      values. However, increases in energy intake were on the order of only 100
      kcal/day during the second and third trimesters. Comparatively small reductions
      in physical activity, which would be difficult to measure precisely, are
      described that could account for the difference between actual energy intake and
      the energy costs of pregnancy.

PMID- 1748249
TI  - Monitoring the severity of metabolic disturbances and effectiveness of management
      of gestational diabetes mellitus.
AB  - To monitor the severity of metabolic disturbances during gestational diabetes
      mellitus (GDM), some risk factors existing at the time of diagnosis must be
      considered, including age of the pregnant women, early gestational age at
      diagnosis, high fasting blood glucose level, high HbA1c or fructosamine levels,
      or high amniotic fluid insulin level. The degree of OGTT abnormality will also
      influence the therapeutic approach, although the insulin response to the glucose
      challenge seems to be of little discriminating value. Effectiveness of the
      treatment can be appreciated by self-monitoring of blood glucose, although the
      practical precision of these measures and their necessary repetitions will limit
      clear-cut evaluation of borderline cases. HbA1c and fructosamine are of little
      help because of lack of sensitivity and time delay between changes in blood
      glucose and associated glycosylated protein changes. Whether other parameters
      such as amino acids, growth factors, or related compounds are more specifically
      linked to the physiopathology of GDM complications remains to be established but
      would help in monitoring GDM metabolic disturbances in the future. Meanwhile,
      prophylactic insulin treatment may still constitute a pragmatic approach, taking
      into account possible and poorly appreciated drawbacks from overtreatment, e.g.,
      maternal hyperinsulinism and chronic hypoglycemia.

PMID- 1748250
TI  - Calorie restriction for treatment of gestational diabetes.
AB  - Birth weights of infants of 35 gestational diabetic mothers treated with calorie
      restriction alone (1200-1800 kcal) were compared with those of infants of 2337
      nondiabetic women, including two control groups (A and B) matched for race, body
      mass index, age, and parity. All women were screened for gestational diabetes
      with the O'Sullivan screening method, and a 3-h oral glucose tolerance test was
      performed on all abnormal results. Control group A mothers had a normal screen,
      and control group B mothers had an abnormal screen with a normal glucose
      tolerance test. Pregnancy weight gain was significantly less for the gestational
      diabetic mothers (mean +/- SD 4.6 +/- 4.9 kg) than for the general prenatal
      population (9.3 +/- 5.3 kg), group A control subjects (9.7 +/- 5.3 kg), and group
      B control subjects (9.7 +/- 5.4 kg; P less than 0.0005). No infant of a
      gestational diabetic mother was below the 10th percentile for weight, and birth
      weights were similar to those of the control groups even though weight gain after
      the 28th wk of gestation was only 1.7 +/- 1.6 kg. The frequency of macrosomia
      (birth weight greater than or equal to 4000 g) was similar among the gestational
      diabetic mothers (9.3%), the general prenatal population (7.4%), and group A
      mothers (11.6%) but significantly higher for the group B control subjects (20.9%;
      chi 2 = 8.57, P less than 0.005). This study demonstrated that gestational
      diabetic mothers who are calorie restricted have infants with normal birth
      weights and a frequency of macrosomia less than that of screen-positive
      nondiabetic women with similar macrosomic risk factors.

PMID- 1748251
TI  - Metabolic effects of hypocaloric diets in management of gestational diabetes.
AB  - Although hypocaloric diets have been advocated for the management of the obese
      gravida and the obese mother with gestational diabetes, there is no general
      agreement on how severely calories should be restricted or on how this
      therapeutic approach compares with insulin therapy. The lack of consensus is in
      part because of the lack of studies comparing insulin management with the effects
      of different degrees of hypocaloric feeding and its effects on metabolism and
      glycemic status. We review the effects of 50 and 33% calorie restriction on
      glycemic status and intermediary fuel status in obese gestational diabetic
      subjects and compare the results with the administration of 20 U NPH and 10 U
      regular insulin every morning, a therapy of proven value in reducing macrosomia
      in gestational diabetes. When the two calorie-restriction regimens were compared
      after a 9-h overnight fast, glycemic status improved 10-20% on both. Ketonuria
      increased about twofold with 50% calorie restriction, but on average no increase
      in ketonuria was seen on the 33% calorie-restriction regimen. Both calorie
      restriction programs led to a reduction in levels of plasma triglyceride, a
      correlate of infant birth weight. In contrast, the insulin regimen diminished
      ketonuria, but glycemic status improved little, and plasma triglyceride
      concentrations did not decline. Although more studies are needed to confirm these
      trends, the beneficial effect of 33% calorie restriction, which occurred without
      marked ketonuria, is consistent with previous studies in gestational diabetes. In
      addition, the simultaneous improvements observed in plasma glucose and
      triglyceride concentrations suggest that moderate calorie restriction may be
      valuable in preventing macrosomia in the offspring of the obese subject with
      gestational diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748252
TI  - Percentage of carbohydrate and glycemic response to breakfast, lunch, and dinner
      in women with gestational diabetes.
AB  - We studied the relationship between 1-h glucose response and the percentage of
      carbohydrates in a given meal in 14 gestational diabetic women who did not
      require insulin therapy and were between 32 and 36 wk gestation. Each subject was
      greater than 130% ideal body weight and was placed on a diet of 24 kcal.kg-1.24 h
      1, with 12.5% of calories at breakfast and 28% of the calories at lunch and again
      at dinner, with other calorie intake divided among three snacks. Glycemic
      response was monitored by self-monitoring of blood glucose 1 h after the start of
      each meal. Ten postprandial values for each meal were averaged for each of the 14
      women. The correlation between percentage of carbohydrates and postprandial
      glucose level at 1 h was strongest for dinner (r = 0.95, P less than 0.001), with
      more variability seen at breakfast (r = 0.75, P = 0.002) and lunch (r = 0.86, P =
      0.001). To maintain a 1-h postprandial whole-blood glucose level less than 7.78
      mM required the following percentages of carbohydrates in each meal: 45% at
      breakfast, 55% at lunch, and 50% at dinner. If 1-h postprandial whole-blood
      glucose level was to remain less than 6.67 mM, then the respective values were
      33, 45, and 40%. We conclude that the glycemic response to a mixed meal in
      subjects with gestational diabetes is highly correlated with the percentage of
      carbohydrates of the ingested meal and varies among individuals and among
      breakfast, lunch, and dinner.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748253
TI  - Exercise in the treatment of NIDDM. Applications for GDM?
AB  - Physical training is associated with lower plasma insulin concentrations and
      increased sensitivity to insulin in skeletal muscle and adipose tissue of
      individuals with non-insulin-dependent diabetes mellitus (NIDDM). The benefits of
      exercise to individuals with NIDDM in terms of increased insulin sensitivity
      could be applied to reversing the insulin resistance associated with gestational
      diabetes mellitus (GDM). Exercise may also benefit women with GDM by acting as an
      adjunct to diet in preventing excessive weight gain and preventing or decreasing
      the severity of hypertension and/or hyperlipidemia during pregnancy. Regular
      physical exercise should be considered as a potential approach to the prevention
      and treatment of GDM.

PMID- 1748254
TI  - Is exercise safe or useful for gestational diabetic women?
AB  - The mainstay of management of the gestational diabetic woman is dietary
      manipulation to achieve and maintain normoglycemia. If normoglycemia cannot be
      sustained by diet alone, then insulin therapy is initiated. We instituted a
      series of studies to observe the value and safety of a cardiovascular fitness
      program to improve glucose tolerance in gestational diabetic women. We first
      evaluated the safety for pregnant women of five aerobic exercise machines by
      observing the effect of these different forms of exercise on uterine activity
      during the third trimester. We found that upper-extremity exercise produced no
      uterine contractions, but lower-extremity exercise tended to produce
      contractions. Upper-extremity exercise, in addition to dietary therapy, was then
      assigned to 10 gestational diabetic women who were matched for amount of glucose
      intolerance to 10 gestational diabetic women managed by diet alone. The mean
      fasting plasma glucose +/- SD after 6 wk was 4.87 +/- 0.34 mM in the diet group
      versus 3.89 +/- 0.37 mM in the diet-plus-exercise group. The mean postglucose
      challenge in the diet group was 10.40 +/- 0.16 mM versus 5.9 +/- 1.1 mM in the
      diet-plus-exercise group. Thus, upper-arm exercise may provide a useful treatment
      option for gestational diabetes and may obviate the need for insulin.

PMID- 1748255
TI  - Insulin secretion and insulin resistance in pregnancy and GDM. Implications for
      diagnosis and management.
AB  - Glucose tolerance deteriorates in human pregnancy, but approximately 97-98% of
      all pregnant women retain a normal glucose tolerance, and only 2-3% develop
      gestational diabetes mellitus (GDM). Both nondiabetic pregnant women and women
      with GDM exhibit much higher insulin responses to oral or intravenous
      administration of glucose or amino acids than found in the nonpregnant state, and
      the insulin responses to a protein-rich meal are also significantly enhanced in
      pregnancy. Both quantitative and qualitative differences in insulin secretion
      exist between pregnant women with normal glucose tolerance (NGT) and women with
      GDM. Insulin responses to oral glucose and protein-rich meals are thus lower in
      pregnant women with GDM than in women with NGT, despite significantly higher mean
      plasma glucose concentrations in the women with GDM. Furthermore, peak plasma
      insulin concentrations occur later in women with GDM than in pregnant control
      subjects. Finally, a reduced first-phase insulin response to intravenous glucose
      can be observed in some women with GDM. Impairment of glucose tolerance in
      pregnancy is not related to a disproportional secretion of proinsulin nor is
      increased insulin degradation involved. These observations point to pregnancy as
      a state of peripheral insulin resistance. Because insulin-receptor binding is
      only slightly changed in pregnancy and not significantly different in pregnant
      women with NGT and women with GDM, it follows that the insulin resistance is
      located at the postreceptor level. Insulin-clamp and "minimal model" studies have
      shown that the whole-body insulin sensitivity is similarly reduced by about two
      thirds of nonpregnant values in pregnant women with NGT and women with
      GDM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748256
TI  - Exercise in gestational diabetes. An optional therapeutic approach?
AB  - Forty-one patients with gestational diabetes requiring insulin were enrolled in a
      randomized study to investigate the efficacy of an exercise program in
      normalizing glucose tolerance. Seventeen of 21 patients completed the exercise
      program while maintaining normoglycemia and obviating insulin therapy. Maternal
      and neonatal complications did not differ between the study and control groups.
      The type of program described appears to be safe and can serve as a model for
      exercise prescription for pregnant diabetic women to attain improved glucose
      tolerance.

PMID- 1748257
TI  - Rationale for insulin management in gestational diabetes mellitus.
AB  - A prospective study was undertaken to test the hypothesis that insulin treatment
      in patients with gestational diabetes mellitus (GDM) with fasting plasma glucose
      (FPG) greater than 5.3 mM significantly reduces adverse perinatal outcome.
      Assigned to insulin or diet treatment based on FPG were 471 GDM women. Four
      factors believed to be associated with infants large for gestational age (LGA)
      were evaluated: FPG, overall glycemic control, maternal weight, and treatment
      regimen. We found that when glycemic control was optimized, the key factors
      related to large infants were FPG and treatment modality. In the low-FPG group
      (less than 5.3 mM), diet therapy achieved an incidence of 5.3% LGA. When insulin
      therapy was used to optimize control, an incidence of 3.5% LGA was found.
      Patients in the mid-FPG group (5.3-5.8 mM) had a higher increased rate of LGA
      (28.6%) for diet-treated versus insulin-treated women (10.3%). In addition, a
      fourfold increased risk for LGA was found in the diet-treated obese subjects in
      the mid-FPG group compared with insulin-treated obese women. Finally, treatment
      with insulin resulted in similar incidence of LGA within all FPG groups. We
      concluded that FPG greater than 5.3 mM can be the basis for initiation of insulin
      treatment in GDM subjects with optimization of glycemic control as the goal. This
      approach may contribute significantly to reduced neonatal risk and may foster a
      standardized method for rapid and effective assignment to treatment.

PMID- 1748258
TI  - Gestational diabetes mellitus. Levels of glycemia as management goals.
AB  - In the United States, glucose tolerance test criteria for the diagnosis of
      gestational diabetes mellitus are, in plasma glucose after a 100-g challenge, as
      follows: fasting, greater than 5.8 mM; 1 h, greater than 10.6 mM; 2 h, greater
      than 9.2 mM; and 3 h, greater than 8.1 mM; any two values must be elevated. The
      Second International Workshop-Conference on Gestational Diabetes Mellitus
      recommended in 1985 that, once diagnosed, women should receive dietary therapy.
      If fasting or 2-h postprandial hyperglycemia later occurs (fasting, greater than
      5.8 mM; 2-h, greater than 6.7 mM), insulin therapy should begin. Data from others
      have suggested both that the criteria for diagnosis may be too liberal and that
      the thresholds for instituting insulin therapy may be too high. We address these
      two issues by reviewing several papers with conflicting conclusions. There is
      controversy over whether women with gestational diabetes diagnosed by glucose
      tolerance testing, but who have fasting plasma glucose levels less than 5.8 mM
      and 2-h postprandial values less than 6.7 mM, should also be insulin treated.
      Finally, the usual clinical criteria for making therapeutic decisions all rely on
      glycemia. Other fuels (amino acids, lipids, and ketones) are regulated by
      circulating insulin and have deleterious effects on fetal development. Further
      study is required to make more sound clinical decisions based not just on
      glycemia but on the entire metabolic milieu.

PMID- 1748259
TI  - Summary and recommendations of the Third International Workshop-Conference on
      Gestational Diabetes Mellitus.

PMID- 1748260
TI  - Gestational diabetes mellitus. Influence of race on disease prevalence and
      perinatal outcome in a U.S. population.
AB  - We explore whether racial differences in a United States population influence
      disease prevalence and perinatal outcome in gestational diabetes mellitus (GDM).
      The data presented are based on 3744 consecutive patients who underwent universal
      screening at 24-28 wk gestation; those with a 1-h plasma glucose greater than or
      equal to 7.2 mM underwent a 100-g 3-h oral glucose tolerance test (OGTT). The
      overall prevalence of GDM was 3.5 cases/100 with the standard O'Sullivan-Mahan
      diagnostic criteria derived for plasma, whereas use of the Carpenter-Coustan
      modification of the O'Sullivan-Mahan criteria yielded a prevalence of 5.5. The
      population was 39.1% white, 37.7% black, 19.8% Hispanic, and 3.4% Oriental/other.
      For those patients with a nondiagnostic test, mean plasma glucose at each time
      point of the OGTT was similar for all racial groups. Because of demographic and
      phenotypic heterogeneity between different racial groups, the influence of these
      different variables on the prevalence of GDM was tested by multiple logistic
      regression. Black and Hispanic race, maternal age, and percentage ideal body
      weight were found to have significant independent effects on the prevalence of
      GDM (P less than 0.05, 0.001, 0.001, and 0.001, respectively). The adjusted
      relative risk of GDM was significantly higher in black (1.81, 95% confidence
      interval [CI] 1.13-2.89, P less than 0.05) and Hispanic (2.45, 95% CI 1.48-4.04,
      P less than 0.001) patients compared with whites. The influence of race on infant
      birth weight was examined in the 92 patients with GDM controlled with
      diet.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748261
TI  - Gestational diabetes. Can epidemiology help?
AB  - Diagnostic criteria for diabetes mellitus (DM) and impaired glucose tolerance
      from oral glucose tolerance test results in adults are reviewed in the
      epidemiological context, highlighting the residual differences between World
      Health Organization (WHO) and National Diabetes Data Group (NDDG) glycemic
      criteria with respect to the diagnosis of gestational diabetes. Although the
      value of the diagnosis of DM (WHO/NDDG criteria) in pregnancy is not called into
      question, attention is drawn to the paucity of evidence linking lesser degrees of
      glucose intolerance with significant disturbance of pregnancy outcome when
      confounding variables such as maternal age, adiposity, and parity are allowed
      for. It is in the area of the detection and treatment of these lesser degrees of
      glucose intolerance in pregnancy that serious questions of the detriment-to
      benefit ratio arise. A population-based multiethnic multicultural inquiry into
      diagnostic methodology and criteria in pregnancy is proposed, jointly sponsored
      by the WHO and the International Diabetes Federation, extending, if possible, to
      a controlled clinical trial of the effects of intervention.

PMID- 1748262
TI  - Comparison of diagnostic criteria of IGT, borderline, and GDM. Blood glucose
      curve and IRI response.
AB  - A 75-g oral glucose tolerance test (OGTT) was performed in 615 nonobese pregnant
      women (mean +/- SD age 29.7 +/- 4.3 yr) who were referred to the Division of
      Internal Medicine at our diabetes center because of glycosuria. Seventy-seven
      cases were found to have urinary glucose at the first trimester, 185 at the
      second trimester, and 353 at the third trimester. With their 75-g OGTT results,
      the diagnostic criteria of borderline (formulated by the Japan Diabetes Society),
      impaired glucose tolerance (IGT; defined by the World Health Organization [WHO]),
      and gestational diabetes mellitus (GDM; determined by the Japan Society of
      Obstetrics & Gynecology standards) were compared through blood glucose (BG)
      curves and immunoreactive insulin (IRI) responses. Borderline (fasting BG greater
      than or equal to 6.1 and less than 7.8 mM and 2-h BG greater than or equal to 6.7
      and less than 11.1 mM) is neither diabetes nor normal. IGT is as referred to by
      the WHO. GDM exceeds two points of fasting BG greater than or equal to 5.6 mM, 1
      h BG greater than or equal to 10.0 mM, or 2-h BG greater than or equal to 8.3 mM.
      Diabetes mellitus (DM) is as referred to by the Japan Diabetes Society (same as
      the WHO). The prevalence of abnormal glucose tolerance among all 615 pregnant
      women was 54.6% in borderline, 24.5% in IGT, 7.3% in GDM, and 3.4% in DM. The 2-h
      BG levels in IGT during the first trimester were higher than in borderline (P
      less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748263
TI  - Incidence and severity of gestational diabetes mellitus according to country of
      birth in women living in Australia.
AB  - Gestational diabetes mellitus (GDM) was diagnosed in 1928 of 35,253 (5.5%) tested
      pregnancies at the Mercy Maternity Hospital in Melbourne between 1979 and the end
      of 1988. Compared with women born in Australia and New Zealand, the incidence of
      GDM was significantly greater in women born on the Indian subcontinent (15%); in
      women born in Africa (9.4%), Vietnam (7.3%), Mediterranean countries (7.3%), and
      Egypt and Arabic countries (7.2%); and in Chinese (13.9%) and other Asian (10.9%)
      women. There was no significant difference for women born in the United Kingdom
      and northern Europe (5.2%), Oceania (5.7%), North America (4.0%), or South
      America (2.2%). With the World Health Organization criteria as a guide to the
      severity of hyperglycemia, compared with mothers born in Australia and New
      Zealand, there were significant increases in the incidences of the more severe
      grades of GDM in parturients born in the Mediterranean region, Asia, the Indian
      subcontinent, Egypt, and Arabic countries. The incidence of GDM increased
      significantly in all racial groups, rising from 3.3% during 1979-1983 to 7.5%
      during 1984-1988.

PMID- 1748264
TI  - Insulin sensitivity in pregnancy.
AB  - Quantitation of insulin sensitivity (SI) with the insulin suppression test,
      glucose clamp, or the minimal model method has been achieved in various clinical
      circumstances. The application of these techniques to pregnancy has been limited.
      It is important to utilize sensitive and reproducible methods to study SI changes
      in pregnancy to fully understand the normal and pathological metabolic
      alterations that occur during gestation. These techniques demonstrate that
      various factors (obesity, body fat distribution, age, dietary manipulation, and
      exercise) may affect SI measures. The various pregnancy hormones have
      differential effects on insulin action. There is consensus among the limited in
      vivo studies in human pregnancy that late gestation is associated with
      significantly impaired SI compared with the nonpregnant state. Studies with
      appropriate matching between control and gestational diabetic subjects have
      failed to demonstrate a significant difference in SI between groups in the third
      trimester.

PMID- 1748265
TI  - The placenta. Not just a conduit for maternal fuels.
AB  - The placenta is a specialized organ of exchange that provides nutrients to and
      excretes waste products from the fetus. The exchange of nutrients between
      placenta and fetus involves three major mechanisms: 1) direct transfer of
      nutrients from the maternal to the fetal plasma, 2) placental consumption of
      nutrients, and 3) placental conversion of nutrients to alternate substrate forms.
      Although direct transfer has been considered the primary means by which placental
      fetal exchange controls the supply of nutrients to the fetus and thereby fetal
      metabolism and growth, the considerable metabolic activity of the placenta
      provides a large and fundamentally important contribution to both the quality and
      quantity of nutrient substrates supplied to the fetus; e.g., placental O2 and
      glucose consumption rates approach or even exceed those of brain and tumor
      tissue. Other placental metabolic activities include glycolysis, gluconeogenesis,
      glycogenesis, oxidation, protein synthesis, amino acid interconversion,
      triglyceride synthesis, and chain lengthening or shortening of individual fatty
      acids. Thus, consideration of the metabolism of the placenta is essential for a
      more complete understanding of how the placenta regulates nutrient transfer to
      the fetus, fetal energy balance, and fetal growth.

PMID- 1748266
TI  - Altered diastolic function in asymptomatic infants of mothers with gestational
      diabetes.
AB  - Left and right ventricular filling was studied prospectively in 50 full-term
      (39.4 +/- 1.3 wk) asymptomatic newborns of mothers with gestational diabetes
      mellitus (GDM). Their data were compared with those of 80 asymptomatic full-term
      (39.8 +/- 1.2 wk) infants who served as control subjects. Infants were examined
      in the immediate newborn period (less than 48 h) and then again at 2-4 and 6-9
      wk. Although mean weight, length, and gestational age did not differ, the mean +/
      SD left ventricular dimensions during diastole (1.73 +/- 0.15 vs. 1.81 +/- 0.18
      cm, P = 0.007) and systole (1.22 +/- 0.15 vs. 1.31 +/- 0.17 cm, P = 0.004) were
      significantly lower in infants of mothers with GDM compared with control infants.
      Diastolic measurements suggested a shift from the early diastolic filling of the
      ventricle to the later period of atrial systole in infants of mothers with GDM. A
      lower initial one-third area fraction and a higher peak flow velocity and
      velocity time integral during atrial systole were noted at the mitral valve in
      infants of mothers with GDM. These changes had resolved by 2-4 wk of age. The
      altered diastolic filling patterns in infants of mothers with GDM indicate poor
      myocardial relaxation and/or decreased passive compliance of the ventricular
      myocardium. These alterations were observed in asymptomatic infants in the
      absence of left ventricular or septal hypertrophy. If exposed to significant
      stress such as asphyxia or sepsis, the observed myocardial dysfunction could lead
      to higher morbidity in these infants.

PMID- 1748267
TI  - Impact of maternal fuels and nutritional state on fetal growth.
AB  - Several maternal plasma fuel abnormalities have been described in gestational
      diabetes mellitus (GDM), and all may contribute to the development of fetal
      macrosomia, generally because of the surfeit of calories they provide. Elevated
      maternal plasma glucose and amino acid concentrations represent key disturbances,
      because they are also well-known fetal pancreatic beta-cell secretagogues. Fetal
      hyperinsulinemia contributes to macrosomia in a special way by selectively
      accelerating fuel utilization and storage in insulin-sensitive fetal tissues.
      Maternal obesity intensifies the insulin resistance already present in late
      pregnancy and probably exaggerates the metabolic abnormalities attending GDM that
      impact on fetal growth and development. However, the means by which maternal
      obesity per se promotes the development of heavy babies in nondiabetic
      pregnancies remains poorly defined. Significant correlations exist between
      newborn birth weight and the levels of maternal plasma glucose, amino acids, free
      fatty acids, and triglycerides in diabetic pregnancies. However, the relative
      influence of each disturbance on fetal birth weight remains controversial and
      requires more detailed investigation.

PMID- 1748268
TI  - Sonographic measurement of fetal humeral soft tissue thickness in pregnancy
      complicated by GDM.
AB  - Sonographic measurement of fetal humeral soft tissue thickness (STT) was
      performed in 93 women with gestational diabetes mellitus during the third
      trimester. STT measurements revealed accelerated growth in large for gestational
      age infants at 31 wk gestation. This new measurement proved to be the most
      accurate predictor of excessive fetal size compared with other standard
      ultrasound parameters (sensitivity 82%, specificity 95%, positive predictive
      value 90%). Asymmetrical growth was more evident in infants with large STT
      measurements in utero. Humeral STT measurement may distinguish large fetuses with
      truncal obesity from those that are symmetrically large, thereby allowing
      prediction of risk for birth trauma before delivery.

PMID- 1748269
TI  - Neonatal hypoglycemia. Back to basics in diagnosis and treatment.
AB  - Hypoglycemia continues to be found in infants of diabetic mothers, although the
      significance of the observation remains to be defined in terms of long-term neuro
      development and behavior. Most follow-up studies no longer identify CNS problems.
      The criterion, i.e., the level of blood glucose at which the diagnosis should be
      made, has evolved and drifted toward the adult level. No single criterion can be
      used dependably to make this clinical and chemical diagnosis.

PMID- 1748270
TI  - Gestational diabetes mellitus. A survey of perinatal complications in the 1980s.
AB  - Neonatal morbidity was assessed in the offspring of 878 mothers with gestational
      diabetes mellitus (GDM), 132 mothers with pre-GDM, and 380 control subjects.
      Compared with the control group, the GDM group had a higher incidence of
      complications, including macrosomia, hypoglycemia, hyperbilirubinemia,
      hypocalcemia, polycythemia, and major congenital anomalies (P less than 0.05).
      Although our GDM patients were stringently managed with diet or diet plus
      insulin, as indicated, and maintained almost euglycemic values, these neonatal
      complications could not be eliminated. Our data may be consistent with
      observations published during the last decade that even subtle degrees of
      maternal hyperglycemia can have a detrimental effect on perinatal outcome. Most
      neonatal complications readily respond to therapy if diagnosed and treated early
      and promptly. Macrosomia can have a detrimental effect on delivery (trauma) and
      later long-term implications during childhood. Tight metabolic control with diet
      and, when indicated, insulin treatment may be advantageous in reducing fetal
      birth weight. Criteria of how tight the metabolic control should be remain to be
      accurately defined.

PMID- 1748271
TI  - Obstetric complications with GDM. Effects of maternal weight.
AB  - Obstetric complications recorded prospectively were assessed retrospectively in
      150 women with gestational diabetes mellitus (GDM) and 305 control subjects
      matched for age, parity, and ethnicity. Intensive diet therapy and self
      monitoring of capillary blood glucose were used to obtain postprandial
      euglycemia; 22% of GDM subjects required insulin. GDM and control subjects were
      grouped by body mass index to detect any influence of maternal prepregnancy
      weight on outcome. Polyhydramnios, preterm labor, and pyelonephritis were not
      more frequent in GDM, but hypertension without proteinuria (7.3 vs. 3.3%) and
      preeclampsia (8 vs. 3.9%) were more frequent in GDM. The frequency of
      hypertensive complications in GDM was not totally attributable to being
      overweight. Abnormalities of labor, birth trauma, and fetal macrosomia were not
      more common in GDM; 6.7% of the infants of mothers with GDM weighed greater than
      4200 g at birth compared with 3.6% of control infants (NS), and 10% were large
      for gestational age and sex compared with 6.6% of control infants (NS). Despite
      this, cesarean delivery was more common in GDM (35.3 vs. 22%, P less than 0.01),
      mostly due to significantly more cesarean births without labor.

PMID- 1748272
TI  - Influence of pregnancy on the 75-g OGTT. A prospective multicenter study. The
      Diabetic Pregnancy Study Group of the European Association for the Study of
      Diabetes.
AB  - This study reports the responses to a 75-g oral glucose tolerance test (OGTT) in
      1009 pregnant women from throughout Europe. We reached the following conclusions.
      1) A pregnant woman tends to have blood glucose concentrations that are elevated
      for a longer period of time after an oral glucose load. Therefore, approximately
      10% of women will reach or exceed 8 mM glucose at 2 h, but it is unlikely that
      10% of European women have disordered carbohydrate metabolism. 2) The fasting and
      1-h values should be included in any analysis of the response of the patient. By
      doing this, many fewer women will have responses regarded as abnormal; in this
      series, it reduced the 79 women with a 2-h value greater than 8 mM to 15 who were
      considered to have carbohydrate intolerance (2 with diabetes, 13 with impaired
      glucose tolerance [IGT]). 3) By increasing the 2-h cutoff value to greater than
      or equal to 9 mM, the number of women regarded as at risk would be reduced by
      greater than 50% (from 79 to 32 in this series), but 10 of the 13 women with two
      abnormal values would still have been detected, as would the 2 diabetic women. 4)
      From the obstetric viewpoint, mothers who screen positive do not have bigger
      babies, they deliver close to term, and they do not have particular stigmas such
      as a family history of diabetes or an increased tendency to smoke or to have an
      adverse obstetric outcome. However, they do tend to be older and
      heavier.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748273
TI  - Intermediary metabolism in pregnancy. First theme of the Freinkel era.
AB  - During the first half of gestation in the rat, maternal net body weight increases
      rapidly, whereas in the second half of gestation, the mass of maternal structures
      declines, coincident with the rate of maternal fat accumulation. Enhanced
      maternal food intake, extrahepatic tissue lipoprotein lipase (LPL) activity, and
      adipose tissue lipogenesis are responsible for the progressive accumulation of
      maternal fat. However, during late gestation, decreased fat synthesis in maternal
      adipose tissue, enhanced lipolytic activity, and decreased LPL activity deplete
      maternal fat depots. These changes, plus enhanced endogenous production of
      triglyceride-rich lipoproteins, are also responsible for maternal
      hypertriglyceridemia. This condition benefits the offspring in two ways: 1)
      enhanced LPL activity in maternal liver when fasting increases triglyceride
      consumption for ketone body synthesis, giving the basis for accelerated
      starvation; and 2) induction of LPL activity in the mammary gland before
      parturition diverts maternal circulating triglycerides to milk synthesis in
      preparation for lactation. The magnitude of the maternal-fetal glucose transfer
      was higher than that of any of the other substrates studied, including alanine,
      and despite actions to spare glucose, this transfer causes maternal hypoglycemia,
      which is especially intense in the fasting condition. This increases
      sympathoadrenal activity in the mother, which may contribute to her active
      gluconeogenesis. Glycerol was a more efficient glucose precursor than alanine and
      pyruvate, and whereas glycerol placental transfer is very small, it is proposed
      that the fetus benefits from this product of adipose tissue lipolysis when it is
      previously converted into glucose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748274
TI  - Functional maturation and proliferation of fetal pancreatic beta-cells.
AB  - We review some key aspects of the maturation of stimulus-secretion coupling and
      the regulation of DNA replication in the fetal beta-cell. During fetal life, the
      beta-cell shows a poor insulin response to glucose, although it responds to
      several other nonnutrient stimuli. However, chronic exposure to glucose in excess
      of basal levels can induce maturation of the stimulus-secretion coupling. Studies
      of glucose metabolism and the transmembrane flow of K+ and Ca2+ indicate that the
      attenuated glucose-stimulated insulin release is due to an immature glucose
      metabolism resulting in impaired regulation of ATP-sensitive K+ channels in the
      plasma membrane of the fetal beta-cell. In late fetal life, glucose is also a
      strong stimulus to beta-cell replication, and metabolism of glucose is a
      prerequisite for this process. Glucose stimulates proliferation by recruiting
      beta-cells from a resting state into a proliferative compartment composed of
      cells in an active cell cycle. The proliferative compartment comprises less than
      10% of the total islet cell population even at maximal stimulation. The
      proliferation of fetal beta-cells is also regulated by several peptide growth
      factors such as growth hormone, insulinlike growth factor I, and platelet-derived
      growth factor. The observation that glucose can both induce precocious maturation
      of the stimulus-secretion coupling and stimulate proliferation of the fetal beta
      cell explains the intrauterine hyperinsulinemia and beta-cell hyperplasia of the
      offspring of diabetic mothers with relatively mild hyperglycemia. However, severe
      hyperglycemia, at least when induced in rats, seems to retard rather than
      stimulate beta-cell growth.

PMID- 1748275
TI  - Diabetic embryopathy. Studies with animal and in vitro models.
AB  - Diabetic pregnancy is associated with an increased risk for fetal maldevelopment
      for a largely unknown reason. A decade ago, Norbert Freinkel suggested that the
      altered fuel mixture offered to the growing conceptus may be the key to most of
      the changes in the embryogenesis of diabetic pregnancy. He coined the term fuel
      mediated teratogenesis. During early pregnancy, periods of maternal hyper- and
      hypoglycemia may cause marked changes in the availability of glucose to the
      conceptus. Also, increased concentrations of lipids, notably ketone bodies, and
      branched-chain amino acids in the maternal circulation contribute to a changed
      fuel mixture for the embryo. In a recent experimental study of diabetic rats, it
      was found that the maternal metabolism of all three major classes of nutrients
      and maternal somatic growth during gestation covaried with the development of the
      embryo. Consequently, the maintenance of normal concentrations of metabolites
      from all nutrient classes may be important for prevention of adverse fetal
      outcome in diabetic pregnancy. In vitro, a high glucose concentration causes
      embryonic dysmorphogenesis by generation of free oxygen radicals. An enhanced
      production of such radicals in embryonic tissues may be directly related to an
      increased risk of congenital malformations in diabetic pregnancy. Thus, the
      notion that alterations in the net transfer of cellular fuels from the diabetic
      mother to her offspring may cause embryonic dysmorphogenesis, which suggests that
      combustion of the fuel may produce compounds that impair embryonic development,
      has obtained experimental support. If this is also true for human diabetic
      pregnancy, it has therapeutic implications.

PMID- 1748276
TI  - Biphasic effects of maternal metabolism on fetal growth. Quintessential
      expression of fuel-mediated teratogenesis.
AB  - More than a decade ago, Norbert Freinkel postulated that alterations in the
      maternal metabolic milieu at any time during gestation can influence intrauterine
      development and also may have long-term consequences for certain tissues such as
      adipocytes, myocytes, pancreatic beta-cells, and neurons. This review illustrates
      that metabolic alterations early in gestation, such as those that occur in
      diabetes mellitus, may impair growth of the embryo and increase the risk of
      dysmorphogenesis. Such delayed growth of the embryo may in turn influence size at
      birth. In midgestation, metabolic perturbations may accelerate functional
      maturation of fetal pancreatic beta-cells. Fetal beta-cell development is very
      sensitive to alterations in the nutrient milieu and may be enhanced in
      gestational diabetes mellitus (GDM) with only minimal elevations of plasma
      glucose and minor alterations in other nutrient fuels, including insulinogenic
      amino acids. Data are reviewed that suggest that the ensuing fetal
      hyperinsulinemia may promote the development of macrosomia even if metabolic
      control is satisfactory during late gestation. The overall potential influences
      of metabolic alterations on intrauterine growth are different in pregnancies
      complicated by diabetes mellitus throughout gestation (pregestational) and GDM.
      However, the implications in an individual pregnancy may be defined by the degree
      of metabolic control at the specific stages of gestation when growth of the
      embryo, development of fetal beta-cell function, and growth of insulin-sensitive
      tissues are most critically influenced by the metabolic milieu.

PMID- 1748277
TI  - The Drosophila segmentation gene runt acts as a position-specific numerator
      element necessary for the uniform expression of the sex-determining gene Sex
      lethal.
AB  - Female development in Drosophila is established through the activation of the X:A
      target gene Sex-lethal (Sxl) by an X:A ratio of 1. X-linked zygotic genes, termed
      numerator elements, comprise part of the X:A ratio and are primarily responsible
      for the activation of Sxl in females. We demonstrate that the X-linked
      segmentation gene runt is required for this process and has genetic and molecular
      properties of a numerator element. Genetically, runt has vital dose-dependent
      interactions with components of the X:A ratio and alterations in runt activity
      alter the sexual phenotype of triploid intersexes. Molecularly, loss of runt
      activity results in a failure to activate appropriately Sxl in the central region
      of female embryos. We also show that Sxl activation is influenced by the maternal
      anterior and terminal pattern-forming genes, bicoid (bcd) and torso (tor). These
      results indicate that the "uniform" activation of Sxl requires input from
      nonuniformly distributed products. We have demonstrated that runt is one such
      product and suggest that other genes with nonuniform input exist. runt is
      distinguished from previously identified regulators of Sxl by its nonuniform role
      and by the absence of an identifiable helix-loop-helix (HLH) motif, indicating
      that the activation of Sxl is not controlled solely by HLH proteins.

PMID- 1748278
TI  - Analysis of dominant-negative mutations of the Caenorhabditis elegans let-60 ras
      gene.
AB  - The let-60 gene of Caenorhabditis elegans controls the choice between vulval and
      hypodermal differentiation in response to an inductive signal from the gonad. let
      60 encodes a ras protein that acts downstream of the let-23 receptor tyrosine
      kinase in a signal transduction pathway. Dominant-negative mutations of let-60
      [let-60(dn)] cause a reduction of the gene activity in let-60(dn)/+ heterozygotes
      and a vulva-less mutant phenotype. We have found that nine let-60(dn) mutations
      cause replacements of conserved residues. Four are in two novel positions; others
      are in positions known previously to cause dominant-negative mutations in
      mammalian cells. The locations of these lesions suggest that they disrupt the
      ability of the ras protein to bind guanine nucleotides. Four let-60(dn) mutant
      genes were introduced into wild-type animals in the form of extrachromosomal
      arrays and were found to generate three dominant phenotypes--lethality, vulva
      less, or multivulva--depending on gene dose and alleles. The dominant lethality
      caused by high-dose transgenic let-60(dn) genes suggests a toxic effect of these
      mutant genes in early development. The dominant-negative effects of these
      mutations in heterozygotes are likely to be caused by competition between let
      60(dn) and let-60(+) protein for a positive regulator. All let-60(dn) mutations
      interfere with let-60(+) activity, but some alleles have partial constitutive
      activity, suggesting that the ability to interact with the activator is separable
      from the ability to exert a physiological effect (stimulation of vulval
      differentiation). These dn mutations might be useful for interfering with ras
      mediated signal transduction pathways in other multicellular organisms.

PMID- 1748279
TI  - Coactivators for a proline-rich activator purified from the multisubunit human
      TFIID complex.
AB  - The mechanisms of transcriptional activation directed by sequence-specific
      regulators is central to understanding gene regulation. Here, we report the
      isolation of coactivators responsible for mediating transcriptional activation by
      Gal4-Pro, a hybrid regulator containing the proline-rich activation domain of
      human CTF/NFI. Chromatographic studies indicate that endogenous human TFIID
      consists of a multisubunit complex containing the TATA-binding protein (TBP),
      coactivators, and other associated factors. A fraction containing the coactivator
      activity was separated from the endogenous TBP after disrupting the tightly
      associated complex with urea. The urea-purified TBP was active for basal level
      transcription but no longer could support activation by Gal4-Pro. However, when
      the two separated components were added together, activated levels of
      transcription were restored in the presence of Gal4-Pro. Immunoaffinity
      purification of the TFIID complex identifies several polypeptides specifically
      associated with the endogenous TBP, some or all of which function as coactivators
      when reconstituted with Gal4-Pro. The isolated coactivators also mediate
      activation by a chimeric glutamine-rich activator derived from Sp1 but not the
      Gal4-VP16 activator, suggesting distinct factor requirements for different types
      of transcriptional regulators.

PMID- 1748280
TI  - Tissue-specific expression of the gene encoding hepatocyte nuclear factor 1 may
      involve hepatocyte nuclear factor 4.
AB  - Hepatocyte nuclear factor 1 (HNF-1) is a transcriptional regulatory protein
      possibly involved in the activation of many liver-specifically expressed genes.
      HNF-1 mRNA is restricted to a small number of tissues, suggesting that the HNF-1
      gene itself is regulated at the transcriptional level. We have isolated and
      characterized the promoter region of this gene and have determined its
      transcriptional potential in several cell types by cell-free transcription and
      transient transfection experiments. In in vitro transcription assays, an HNF-1
      promoter is active in nuclear extracts from liver and kidney, two tissues that
      contain HNF-1, but silent in nuclear extracts from spleen and lung, which are
      devoid of this transcription factor. Likewise, in transfection experiments, HNF-1
      promoter-chloramphenicol acetyltransferase (CAT) fusion genes are expressed in
      Hep G2 cells, which express HNF-1, but not in mouse L cells or Hela cells, which
      do not express HNF-1. In both cell-free transcription and transient transfection
      assays, a relatively short promoter segment located between positions -82 and -40
      is necessary and sufficient to direct cell type-specific HNF-1 transcription.
      This region contains a single site for a DNA-binding protein that has been
      tentatively identified as hepatocyte nuclear factor 4, a member of the steroid
      hormone receptor family.

PMID- 1748281
TI  - Human major HSP70 protein complements the localization and functional defects of
      cytoplasmic mutant SV40 T antigen in Swiss 3T3 mouse fibroblast cells.
AB  - The CT3 cytoplasmic localization mutant of SV40 T antigen is neither properly
      transported to the nucleus nor is it functional in rodent cells. Human precrisis
      cells are able to complement this mutation, as they are fully transformed by CT3
      with wild-type efficiency. The human-specific factors responsible for this
      species-specific difference in response to CT3 were localized to human chromosome
      6 by synteny in a panel of six somatic cell hybrids. A major human HSP70 heat
      shock protein located on chromosome 6 is expressed constitutively in human cells.
      Hsp70 proteins have been reported to play a role in intracellular movement of
      newly synthesized proteins. To test whether human HSP70 played a role in the
      complementation by human cells of the defect of CT3, we constructed a series of
      mouse cell lines expressing human HSP70 and tested them for their ability to
      localize CT3 T antigen in the nucleus and for their ability to be transformed by
      CT3 DNA. Mouse cell lines expressing human HSP70 protein were able to translocate
      mutant CT3 T antigen into the nucleus and were transformed by CT3 at rates
      comparable with wild-type SV40. Mouse-inducible HSP70 protein was not able to
      translocate cytoplasmic T antigen in Swiss 3T3 mouse fibroblast cells, even after
      heat shock. Apparently human HSP70 is capable of complementing directly or
      indirectly the structural and functional alterations in SV40 T antigen introduced
      by the CT3 mutation.

PMID- 1748282
TI  - legless insertional mutation: morphological, molecular, and genetic
      characterization.
AB  - Limb morphogenesis is an excellent model system to study pattern formation during
      vertebrate development. The legless (lgl) insertional mutation can serve as a
      tool to analyze specific events in limb development at the embryologic, genetic,
      and molecular levels. Hemizygous mice of this transgenic line are phenotypically
      normal, but homozygous mutants are inviable and exhibit limb, brain, and
      craniofacial malformations, as well as situs inversus. By morphological analysis
      of mutant hindlimb buds we show absence of a normal apical ectodermal ridge, a
      structure required for limb bud outgrowth, and an unusually high degree of
      mesenchymal and ectodermal cell death. Mutant embryos are extremely sensitive to
      retinoic acid, a known teratogen with a proposed role in limb development. The
      hindlimb malformations in legless mutants are less severe when bred into the
      BALB/c background, suggesting the involvement of other strain-specific genes.
      Molecular analysis of the disrupted region indicates two tightly linked insertion
      sites. Sequences flanking the transgene insertions have been cloned and mapped to
      chromosome 12, near the iv (situs inversus viscerum) locus. Consistent with this,
      complementation tests confirm allelism of lgl and iv and suggest that the
      transgene insertion may have disrupted more than one gene. Phylogenetically
      conserved sequences flanking the transgene insertions were identified and used to
      isolate candidate lgl and iv cDNAs.

PMID- 1748283
TI  - Abnormal brown and white fat development in transgenic mice overexpressing
      glycerol 3-phosphate dehydrogenase.
AB  - Mice carrying approximately 25 copies of a transgene encoding glycerol 3
      phosphate dehydrogenase expressed from 50 to 200 times the level of enzyme
      produced by a single copy of the normal endogenous gene. The enzyme constituted
      greater than 50% of the cytoplasmic protein in the brown fat of a transgenic
      mouse. Young transgenic mice (10 days to 8 weeks of age) appeared physically and
      reproductively normal; however, at the earliest times analyzed, the amount of
      brown fat of transgenic mice was greater than that of nontransgenic littermate
      controls. In contrast, the white fat depots, both subcutaneous and peritoneal,
      were severely reduced in size. Brown fat in transgenic mice also had larger lipid
      vacuoles and lower levels of Ucp mRNA, but Ucp mRNA levels were elevated in
      response to cold. Brown fat hypertrophy and reduction of white fat were
      particularly pronounced in aged transgenic animals. The results suggest that
      development of brown and white fat is altered by overexpression of glycerol 3
      phosphate dehydrogenase.

PMID- 1748284
TI  - Acidic conditions permit effective nodulation of alfalfa by invasion-deficient
      Rhizobium meliloti exoD mutants.
AB  - Rhizobium meliloti exoD mutants are deficient in invasion of alfalfa nodules and,
      as a consequence, the nodules that exoD strains induce fail to fix nitrogen.
      These nodules appear to be arrested at the same stage as nodules induced by other
      exo mutants, which do not make an acidic exopolysaccharide called EPS I, or by
      ndv mutants, which do not produce a periplasmic cyclic beta(1,2) glucan. However
      previous genetic and biochemical evidence suggested that the nodule invasion
      defect of exoD mutants arose from a biochemical deficiency distinct from those of
      both EPS I-deficient exo mutants and ndv mutants. In this study, we characterize
      mutant phenotypes of exoD strains in both free-living and symbiotic states.
      Nodules induced by exoD mutants are generally small and empty of bacteria, and
      exhibit the same structural features as nodules induced by other invasion
      deficient mutants. Putative incipient infection threads were visible in outer
      cortical cells of these nodules but not in the plant cells in the interior of the
      nodule. We show that exoD mutants are sensitive to alkaline conditions, ceasing
      to grow at elevated pH in liquid yeast extract cultures and exhibiting decreased
      viability in alkaline medium. Interestingly, we find that buffering the plant
      growth medium at slightly acidic pH (6.0-6.5) restores the ability of exoD
      mutants to invade alfalfa nodules. exoD mutants are thus alkali sensitive for
      both free-living and symbiotic phenotypes. This result implies that the nodule
      invasion defect of exoD mutants arises from their sensitivity to alkaline
      conditions and, furthermore, that alkaline conditions may obtain in the
      developing infection thread. The deduced amino acid sequence of ExoD is extremely
      hydrophobic, suggesting that the protein is membrane associated. We propose
      models whereby absence of a putative membrane protein might lead to sensitivity
      to alkaline conditions and consequent arrest of nodule invasion.

PMID- 1748285
TI  - Nascent pre-mRNA transcripts are associated with nuclear regions enriched in
      splicing factors.
AB  - We have used in situ hybridization and immunocytochemistry to compare the nuclear
      localization of a specific nascent pre-mRNA and the essential non-snRNP splicing
      factor SC-35. Nascent c-fos transcripts were detected in serum-induced mouse
      fibroblasts by in situ hybridization with genomic c-fos probes. Prior to serum
      induction no c-fos RNA is detected, but these transcripts localize to two dots in
      the interphase nucleus after induction. The time course of appearance of the dots
      correlates with the previously determined time course of transcriptional
      activation of the gene. Upon further analysis by confocal laser scanning
      microscopy, we have determined that the dots extend through the depth of the
      nucleus, forming paths. By using high-voltage electron microscopy, we have found
      that the c-fos path extends out and comes into direct contact with the nuclear
      envelope. We have also compared the localization of c-fos transcripts with the
      speckled nuclear regions that are enriched in snRNPs and the non-snRNP splicing
      factor SC-35. Direct observations of three-dimensional rotations have revealed a
      close association between the c-fos transcripts and the nuclear speckles. This
      study demonstrates a direct link between specific nascent RNA transcripts and
      nuclear speckles that are enriched in pre-mRNA splicing factors.

PMID- 1748286
TI  - The product of the yeast UPF1 gene is required for rapid turnover of mRNAs
      containing a premature translational termination codon.
AB  - mRNA decay rates often increase when translation is terminated prematurely due to
      a frameshift or nonsense mutation. We have identified a yeast gene, UPF1, that
      codes for a trans-acting factor whose function is necessary for enhanced turnover
      of mRNAs containing a premature stop codon. In the absence of UPF1 function,
      frameshift or nonsense mutations in the HIS4 or LEU2 genes that normally cause
      rapid mRNA decay fail to have this effect. Instead, the mRNAs decay at rates
      similar to the corresponding wild-type mRNAs. The stabilization of frameshift or
      nonsense mRNAs observed in upf1- strains does not appear to result from enhanced
      readthrough of the termination signal. Loss of UPF1 function has no effect on the
      accumulation or stability of HIS4+ or LEU2+ mRNA, suggesting that the UPF1
      product functions only in response to a premature termination signal. When we
      examined the accumulation and stability of other wild-type mRNAs in the presence
      or absence of UPF1, including MAT alpha 1, STE3, ACT1, PGK1, PAB1, and URA3
      mRNAs, only the URA3 transcript was affected. On the basis of these and other
      results, the UPF1 product appears to participate in a previously uncharacterized
      pathway leading to the degradation of a limited class of yeast transcripts.

PMID- 1748287
TI  - Human SRF-related proteins: DNA-binding properties and potential regulatory
      targets.
AB  - Serum response factor (SRF) is a transcription factor that binds the sequence
      CC(A/T)6GG found in a number of growth factor-inducible and muscle-specific
      promoters. We describe the isolation and characterization of cDNA clones encoding
      a family of three human SRF-related DNA-binding proteins. Each of these RSRF
      (related to SRF) proteins contains an 86-amino-acid amino-terminal region related
      to the SRF DNA-binding domain: In RSRFC4 and RSRFC9, this region is identical,
      whereas that present in RSRFR2 differs by seven conservative amino acid
      substitutions. The DNA-binding specificity of the RSRF proteins, which recognize
      the consensus sequence CTA(A/T)4TAG, is distinct from that of SRF. The entire
      RSRF common region is required for DNA binding, and the differential sequence
      specificity of the RSRFs and SRF is the result of differences in the basic amino
      terminal part of this domain. The RSRF proteins bind DNA as dimers and can
      dimerize with one another but not with SRF. Although the RSRF mRNAs are expressed
      in many cell types, RSRFR2 mRNA is expressed at elevated levels in several B-cell
      lines. Consistent with this, extracts from many cell types form CTA(A/T)4TAG
      binding complexes that contain RSRF proteins, and oligonucleotides containing
      RSRF-binding sites function as promoter elements in transfection assays. Like SRF
      binding sites, RSRF-binding sites are found in the regulatory sequences of a
      number of growth factor-inducible and muscle-specific genes, and we show that
      RSRF polypeptides are components of previously characterized binding activities
      that interact with these elements. We discuss the potential role of RSRF proteins
      in the regulation of these genes.

PMID- 1748288
TI  - TFEB has DNA-binding and oligomerization properties of a unique helix-loop
      helix/leucine-zipper family.
AB  - The DNA-binding factor TFEB contains adjacent helix-loop-helix (HLH) and leucine
      zipper (LZ) domains flanked by an upstream basic region. This arrangement of
      interactive motifs has recently been observed in several other transcription
      factors and in the Myc family of oncogenes. TFEB was isolated by virtue of its
      binding to the major late promoter of adenovirus. DNA binding by a soluble
      protein was achieved by deleting a hydrophobic amino-terminal domain and
      permitted the structural analysis of the oligomerization and DNA-binding
      properties of TFEB. TFEB specifically bound DNA as both a homodimer and a
      heterodimer with another b-HLH-LZ protein TFE3. The LZ domain was essential for
      homo- or hetero-oligomerization and high-affinity DNA binding. In the absence of
      DNA a tetramer-sized form of TFEB was observed that dissociates to bind added DNA
      as a dimer. Binding by TFEB and TFE3 to related, but different, naturally
      occurring DNA target sequences was observed with distinct binding preferences.
      Analysis of basic domain residues in this family of proteins revealed a pattern
      of sequence conservation predictive of an interacting alpha-helical face. Common
      oligomerization and DNA-binding features suggest the b-HLH-LZ domain structure to
      define a distinct family of DNA-binding factors.

PMID- 1748289
TI  - LR1, a lipopolysaccharide-responsive factor with binding sites in the
      immunoglobulin switch regions and heavy-chain enhancer.
AB  - In nuclear extracts of primary murine B lymphocytes cultured with LPS we have
      identified an inducible DNA-binding activity that is a candidate regulator of
      isotype-switch recombination. This LPS-responsive factor, which we refer to as
      LR1, is induced in LPS-cultured primary cells with kinetics that parallel isotype
      switch recombination. LR1 binds sequences from the S gamma 1, S gamma 3, and S
      alpha switch regions, as well as the heavy-chain enhancer, and these binding
      sites define a consensus that occurs in each of the murine switch regions. LR1
      activity is present in pre-B and B-cell lines but absent from primary B cells
      that have not been cultured with mitogen and from highly differentiated B-cell
      lines. LR1-binding activity depends on phosphorylation and is lost following
      incubation of nuclear extracts with acid phosphatase. The LPS inducibility and
      phosphorylation dependence of LR1 activity suggest that this factor monitors
      kinase-dependent events in cell development and communicates them to the
      chromosome. The locations of its binding sites and the kinetics of its induction
      are consistent with a role for LR1 in regulation of isotype switching.

PMID- 1748290
TI  - Protection of plants against viral diseases by cloned viral genes and anti-genes.

PMID- 1748291
TI  - Expression of the gene encoding the coat protein of cucumber mosaic virus (CMV)
      strain WL appears to provide protection to tobacco plants against infection by
      several different CMV strains.
AB  - The gene (cp) encoding the coat protein (CP) of cucumber mosaic virus (CMV)
      strain WL (CMV-WL, which belongs to CMV subgroup II) was custom polymerase chain
      reaction (CPCR)-engineered for expression as described by Slightom [Gene 100
      (1991) 251-255]. CPCR amplification was used to add 5'- and 3'-flanking NcoI
      sites to the CMV-WL cp gene, and cp was cloned into the expression vector,
      pUC18cpexp. This CMV-WL cp expression cassette was transferred into the genome of
      tobacco (Nicotiana tabacum cv. Havana 423) via the Agrobacterium T-DNA transfer
      mechanism. R0 plants that express the CMV-WL cp gene were subcloned, propagated,
      and challenge-inoculated with CMV-WL. Several R0 plant lines showed excellent
      protection against CMV-WL infection; however, plants found to accumulate the
      highest CP levels did not show the highest degree of protection. Thus in our
      case, CP levels appear not to be a useful predictor of the degree of protection.
      Plants from the best protected CMV-WL cp gene-expressing R0 tobacco lines were
      also inoculated with CMV strains belonging to the other major CMV subgroup
      (subgroup I), CMV-C and CMV-Chi, and compared in a parallel experiment with a
      transgenic tobacco plant line that expresses the CMV-C cp gene. Plants expressing
      the CMV-WL cp gene appeared to show a broader spectrum of protection against
      infection by the various CMV strains than plants expressing the CMV-C cp gene.

PMID- 1748292
TI  - Isolation and sequence analysis of TGA1 cDNAs encoding a tomato G protein alpha
      subunit.
AB  - We have isolated cDNAs for a gene coding for a G protein alpha subunit from
      tomato (Lycopersicon esculentum, cv. VF36). This gene, named TGA1, was isolated
      using a cDNA of the Arabidopsis thaliana G protein alpha subunit-encoding gene,
      GPA1, as a DNA probe. The sequences of four cDNA clones indicate that the deduced
      amino acid (aa) sequence of the gene product (TG alpha 1) has 384 aa (44906 Da).
      The predicted TG alpha 1 protein exhibits similarity to all known G protein alpha
      subunits. The aa are 84.6% identical and 93% similar (identical and conservative
      changes) to A. thaliana GP alpha 1, and 34% identical and 59% similar to
      mammalian transducins. Furthermore, it has all of the consensus regions for a GTP
      binding protein. Finally, hybridizations of tomato genomic DNA indicate that TGA1
      is a single-copy gene.

PMID- 1748293
TI  - Tissue-specific permutations of self-cleaving newt satellite-2 transcripts.
AB  - Synthetic transcripts of satellite-2 (sat2) DNA from the newt undergo self
      catalyzed, site-specific cleavage in vitro using the conserved hammerhead (HH)
      motif found in a number of infectious plant RNAs. We have analyzed sat2
      transcripts from a variety of tissues to obtain evidence for the occurrence of
      self-cleavage in vivo. We found two distinct types of sat2 transcript
      populations. Monomeric transcripts in the tests and in somatic tissues such as
      the liver have ends that map to the in vitro self-cleavage site, and have end
      groups (5'-hydroxyls and phosphate blocked 3' ends) similar to those produced by
      self-cleavage. This is the first indication of HH-mediated self-cleavage
      occurring in animal cells. The monomeric sat2 transcripts found in the newt ovary
      have a different permutation of the basic DNA repeat sequence. These transcripts
      begin and end 47 nucleotides upstream from the in vitro self-cleavage site.
      Despite their apparent lack of utilization of the self-cleavage site, they have
      end groups which indicate that processing is involved in their formation.

PMID- 1748294
TI  - The chicken gene encoding the alpha isoform of tropomyosin of fast-twitch muscle
      fibers: organization, expression and identification of the major proteins
      synthesized.
AB  - The chicken gene alpha fTM encoding the alpha-tropomyosin of fast-twitch muscle
      fibers (alpha fTM) covers 20 kb and consists of 15 exons. From this gene, three
      types of mature transcripts (1.3 kb, 2 kb and 2.8 kb) are expressed through the
      use of alternative promoters, alternatively spliced exons and multiple 3' end
      processing. Northern analysis and S1 mapping have shown that the 1.3-kb
      transcript (exons 1a, 2b, 3, 4, 5, 6b, 7, 8, 9a-9b) is expressed in fast-twitch
      skeletal muscles and that 2-kb transcripts are expressed in smooth muscle (exons
      1a, 2a, 3, 4, 5, 6b, 7, 8, 9d) and in fibroblasts (exons 1a, 2b, 3, 4, 5, 6a or
      6b, 7, 8, 9d). These 2-kb transcripts encode distinct proteins which we have
      identified by two-dimensional (2D) gel electrophoresis. The 2.8-kb transcript
      which has not been so far characterized in birds is expressed in brain (exons 1b,
      3, 4, 5, 6b, 7, 8, 9c-9d). This transcript has been characterized by a cDNA
      polymerase chain reaction assay and by S1 nuclease mapping. It produces a major
      TM isoform of chick brain which we have identified by 2D gels.

PMID- 1748295
TI  - Cloning and characterization of the promoter of the murine lipoprotein lipase
      encoding gene: structural and functional analysis.
AB  - The enzyme lipoprotein lipase (LPL) is responsible for the hydrolysis of
      triglycerides into free fatty acids and glycerol. Its synthesis is induced as the
      murine bone marrow stromal cell clone, BMS2, undergoes adipocyte differentiation.
      The murine genomic LPL promoter has been cloned, sequenced, and characterized by
      functional and structural assays. The transcriptional start points have been
      mapped by S1 nuclease and primer extension techniques. Comparison of the 1.7-kb
      of LPL 5'-flanking sequence between mouse and man reveals 65% identity or greater
      with conservation of many potential protein-recognition motifs. Using constructs
      linking this region to the luciferase-encoding reporter gene, transient
      transfection experiments have documented the promoter function of this sequence
      in a number of cell lines. Based on a battery of restriction endonucleases, at
      least 260 bp immediately adjacent to and including the 5'-untranslated region of
      the first exon are hypersensitive to exogenous nuclease digestion, consistent
      with an altered chromatin structure. Protein-DNA interactions are detected within
      this area at the octamer binding protein 1 site and immediately 5' to the
      translation initiation site based on ExoIII footprinting and gel retention
      assays.

PMID- 1748296
TI  - Characterization of the aldose reductase-encoding gene family in rat.
AB  - Although the enzyme aldose reductase (AR) is implicated in the development of
      tissue pathology in diabetes, the exact mechanism of this involvement remains
      unclear. To better understand the role that expression of the aldose reductase
      encoding gene (ALR) may play in diabetic complications, we have begun to analyze
      the gene and its regulatory regions, and we present here the sequence of four ALR
      genes in the rat. The putative functional gene is 14.1 kb long, has ten exons
      which show perfect sequence identity to the rat lens AR RNA sequence, and nine
      introns with classical splice-site consensus sequences. Potential regulatory
      elements in the 5'-flanking region of this gene include a TATA box and two CCAAT
      boxes. Probing rat genomic Southern blots with a fragment from the first intron
      indicates that there is probably only one copy of this gene in the rat genome.
      The other three genes are processed pseudogenes which show approx. 90% identity
      to the rat lens AR RNA sequence, contain no introns, and have poly(A) regions at
      their 3' ends. Chromosomal localization studies show the presence of ALR genes on
      chromosomes 3, 4 and 6 in the rat with the putative functional gene mapped on
      chromosome 4.

PMID- 1748297
TI  - The assembly of functional preinitiation complexes and transcription of 5S RNA
      encoding genes containing point mutations.
AB  - The transcription of several Syrian hamster 5S RNA-encoding genes (5S genes)
      containing single and multiple point mutations in and around the intragenic
      control region has been analyzed in a HeLa cell-free system. Although most genes
      with point mutations displayed normal levels of transcription, several exhibited
      a three- to fivefold reduction in transcription. These mutations interfere with
      the interaction between the 5S genes and the soluble factors. The above studies
      help to establish the importance of specific nucleotides within the 5S gene for
      productive interactions of individual transcription factors in vitro.

PMID- 1748298
TI  - High-level secretion of correctly processed recombinant human interleukin-1 beta
      in Kluyveromyces lactis.
AB  - The lactose-assimilating yeast, Kluyveromyces lactis, has been developed as a
      microbial host for the synthesis and secretion of human proteins. Here, we report
      the use of multi-copy vectors based on the 2 mu-like plasmid pKD1 from
      Kluyveromyces drosophilarum [Chen et al., Nucleic Acids Res. 14 (1986) 4471-4481]
      for the secretion of recombinant human interleukin-1 beta (reIL-1 beta). High
      levels of reIL-1 beta were secreted into the growth medium when the structural
      gene was fused in-frame to a synthetic secretion signal derived from the 'pre'
      region of the K. lactis killer toxin. N-terminal sequencing of the excreted
      protein showed highly efficient (greater than 95%) maturation of the signal
      sequence. Synthesis as prepro-IL-1 beta, the 'pro'-sequence being derived from
      the human serum albumin-encoding gene, resulted in equally efficient secretion of
      mature IL-1 beta. Cytoplasmic production of Met-IL-1 beta, without a secretion
      signal, was found to be toxic to K. lactis. As in Saccharomyces cerevisiae
      [Baldari et al., EMBO J. 6 (1987) 229-234], but unlike native human IL-1 beta, K.
      lactis reIL-1 beta is glycosylated. This glycosylation led to a 95% loss of its
      biological activity. Removal of the carbohydrate chains by endo-beta-N-acetyl
      glucosamidase H treatment fully restored the biological activity. A modified form
      of IL-1 beta (Asn7----Gln7), in which the unique site for Asn-linked
      glycosylation was deleted, exhibited the same biological activity as native IL-1
      beta. The level of secretion of mature recombinant IL-1 beta ws glycosylation
      independent.

PMID- 1748299
TI  - Synthesis and functional characterization of a recombinant monoclonal antibody
      directed against the alpha-chain of the human interleukin-2 receptor.
AB  - We have determined the sequence of the light and heavy chains of mAb 3G-10
      (IgG1), a monoclonal antibody competing with interleukin 2 (IL2) for binding to
      the human IL2 receptor Tac protein. The antibody-encoding genes were chimerized
      by introducing splice donor and part of the intron sequences into the cDNA and
      subsequently linking it to the constant parts of the human IgG1 gene. The
      chimeric mAb was produced in mouse myeloma cells and purified. Murine and
      chimeric mAbs showed similar properties with respect to inhibition of T-cell
      proliferation. In contrast to its murine counterpart, the chimeric mAb exhibited
      Ab-dependent cellular cytotoxicity and, when combined with an Ab recognizing a
      different epitope on the IL2 receptor Tac protein, was able to activate human
      complement. The chimerized mAb might therefore have improved therapeutic
      efficacy.

PMID- 1748300
TI  - Cloning and characterization of the gene encoding bovine mitochondrial adenylate
      kinase isozyme 3.
AB  - The structure of the gene (AK3) encoding bovine mitochondrial (mt) adenylate
      kinase isozyme 3 (AK3) has been determined. The gene spans about 46 kb and splits
      into five exons. The 5'-flanking region of the gene lacks typical transcriptional
      regulatory elements such as TATA and CAAT boxes. The G + C content of this region
      is high (71%), and seven GC boxes are recognized. Possible sequences responsive
      to transcription factors, AP-1, AP-2, Myf-6 and MyoD1, are present in this
      region. In the 5'-flanking region, there are sequences (mt sequence) which were
      found in the genes encoding other mt proteins. Transcriptional mapping analyses
      revealed one major mRNA start point. The promoter activity measurement in Chinese
      hamster ovary cells by transient expression of the cat gene connected with the 5'
      flanking region, showed presence of a functional promoter.

PMID- 1748301
TI  - Cloning and characterization of gene TNF alpha encoding equine tumor necrosis
      factor alpha.
AB  - We report the molecular cloning and nucleotide sequence of the equine gene
      encoding tumor necrosis factor alpha. The 2610-bp genomic sequence was derived
      from three overlapping polymerase chain reaction products.

PMID- 1748302
TI  - Cloning of an activated human ret gene with a novel 5' sequence fused by DNA
      rearrangement.
AB  - By transfecting a high-Mr DNA from human stomach cancer into NIH3T3 cells, a
      transforming sequence that showed homology with the human ret gene was
      identified. The transforming sequence was found to be generated by a DNA
      rearrangement in the human ret proto-oncogene. This rearrangement was suggested
      to have occurred during the transfection procedure. The nucleotide sequences of
      cDNAs of the rearranged ret gene and deduced amino acid (aa) sequences revealed
      that the rearrangement had resulted in recombination of the 3' segment of the ret
      proto-oncogene with a segment of an unknown human sequence, and that the
      recombination had generated a novel gene encoding a fusion protein of 435 aa. The
      rearrangement was presumed to be responsible for activation of the ret gene.

PMID- 1748303
TI  - Cloning and sequencing a cDNA encoding human ribosomal protein S25.
AB  - A full-length cDNA clone has been isolated from a cDNA library prepared from mRNA
      of adriamycin-resistant human leukemia HL60 cells. The nucleotide sequence of
      this cDNA has been determined and the protein coded for by the gene identified.
      The cDNA encodes a polypeptide of 125 amino acids (aa) with a deduced Mr of
      13750. The deduced aa sequence of this protein has 56% homology to yeast
      ribosomal protein S31. Western-blot analysis using antibodies directed against a
      synthetic peptide based on the deduced aa sequence identifies the gene product as
      the human ribosomal protein S25.

PMID- 1748304
TI  - A Drosophila melanogaster H3.3 cDNA encodes a histone variant identical with the
      vertebrate H3.3.
AB  - A cDNA encoding an H3.3 histone variant in Drosophila melanogaster predicts a
      protein with an amino acid (aa) sequence identical with that in vertebrates. The
      D. melanogaster H3.3 nucleotide (nt) sequence has diverged significantly from
      that of both the H3.3 gene of vertebrates and the H3.1 gene of D. melanogaster,
      largely through third nt changes in its codons. The perfect H3.3 aa sequence
      conservation between organisms as phylogenetically divergent as vertebrates and
      flies suggests that the H3.3 histone variant itself is an important structural
      component of chromatin, apart from the value of its replication-independent
      expression pattern.

PMID- 1748305
TI  - Primary structure of the embryo-expressed gene KE2 from the mouse H-2K region.
AB  - Nucleotide (nt) sequence of the KE2 wild-type (wt) cDNA revealed a novel 669-bp
      open reading frame encoding a putative hydrophilic protein of 127 amino acids, pI
      6.17. Comparison of the wt to the genomic nt sequence from the tw5 mutant shows
      the KE2 gene is conserved and is probably a functional gene unrelated to the tw5
      lethality.

PMID- 1748306
TI  - Three pseudogenes for human U13 snRNA belong to class III.
AB  - The nucleotide sequences of three pseudogenes for the small nucleolar RNA, U13,
      were determined from three human DNA clones. The sequences are reported 50 bp 5'
      and 3' to each gene. These pseudogenes belong to class III because they contain
      dispersed mismatches when compared to the previously determined U13 RNA sequence,
      an adenine-rich region at the 3' end, and short imperfect repeats flanking the 5'
      end of the coding sequence and the 3' end of the adenine-rich region.

PMID- 1748307
TI  - Importance of the CArG box in regulation of beta-actin-encoding genes.
AB  - The beta-actin-encoding gene (Act) in carp is regulated by several cis-acting
      regulatory elements including the evolutionarily conserved CC(A/T)6GG (CArG box
      or serum-response element) sequences positioned in the promoter region between
      the CAAT and TATA boxes and in the first intron. To address the roles of the two
      CArG boxes on gene expression, we replaced them with linker sequences. The CArG
      box in the proximal promoter was not required for promoter activity in tissue
      cultured cells, but was required in conjunction with a second CArG box in the
      first intron to give full expression in transgenic embryos. Likewise, the
      geometry of cis-acting transcriptional elements in the proximal promoter was more
      important for expression of transgenic constructs in developing embryos than in
      tissue-cultured fibroblasts. Mobility-shift and exonuclease mapping experiments
      indicated that the same or similar protein factors bind around the two CArG
      boxes, suggesting that interactions between the promoter and the first intron are
      involved in Act regulation.

PMID- 1748308
TI  - DNase I-hypersensitive sites are associated, in a tissue-specific manner, with
      expression of the calbindin-D9k-encoding gene.
AB  - We have examined the chromatin structure of a 28-kb chromosomal region containing
      the gene (CaBP9k) encoding calbindin-D9k in different rat tissues. DNase I
      hypersensitive sites (HSs) were probed with DNase I using an indirect end
      labeling technique. Duodenal chromatin, where the gene is strongly expressed,
      contained one major HS (HS4) and three minor HSs (HS2, HS3 and HS5) near the
      promoter region. The HS4 was mapped just upstream from the promoter region and
      had the characteristics of a tissue-specific HS. The HS5 was located at the
      transcription start point, it included the TATA box and its presence was
      correlated with a promoter function. The duodenal chromatin contained two
      additional HSs, a major HS (HS1) located approx. 3.5 kb upstream from the cap
      site and a minor HS (HS6) in the second intron at +0.5 kb. Despite the marked
      effect of 1,25-dihydroxyvitamin D3 (DHD3) on the CaBP9k mRNA level, the pattern
      of HSs in duodenal chromatin was unchanged after stimulation with DHD3. The liver
      chromatin contained one major HS (HS1) identical to the duodenum HS1 (although
      this tissue does not express CaBP9k). It also contained a liver-specific HS (HS0)
      0.1 kb upstream from HS1. The interaction of HS0 with HS1 could explain the
      absence of CaBP9k expression in the liver. Thus, specific sets of HSs are
      associated with various functional states of CaBP9k in a tissue-specific manner.

PMID- 1748309
TI  - A novel method for generating stable high-level transfectants involving direct
      immunomagnetic selection for cell-surface epitopes: expression of HLA class-II
      genes in HeLa cells.
AB  - A versatile method that allows efficient detection and selection of both
      transient and stable transfectants expressing exogenous cell-surface molecules is
      described and used to generate stable HeLa transfectants expressing each of the
      human HLA class-II isotypes, specifically the DR1, DQw8 and DPw2 heterodimers.
      The method combines use of the strong mammalian expression vector, CDM8, and a
      highly efficient transfection protocol with the powerful technique of
      immunomagnetic selection. It offers significant advantages in comparison to
      standard procedures involving co-selection with drug-resistance markers. The
      transfection efficiency can be assessed 60 h after transfection rather than after
      three weeks of drug selection. Repeated rounds of immunomagnetic selection
      applied over the subsequent ten days result in homogeneous populations which
      express the surface marker of interest stably at high levels, making further
      subcloning or fluorescence-activated cell sorting unnecessary. Any number of
      surface products can be transfected into the same cell, the only limitation being
      the availability of specific monoclonal antibodies (a DP/DR double transfectant
      is described expressing four exogenous gene products simultaneously). The high
      sensitivity of immunomagnetic selection and its applicability to large samples
      allows rescue of transfectants present at very low frequencies. Finally, the
      technique can be used as a coselection procedure, by analogy with drug
      coselection, to achieve expression even of non-cell surface products.

PMID- 1748310
TI  - Synthesis of human initiation factor-2 alpha in Saccharomyces cerevisiae.
AB  - A human eIF-2 alpha cDNA (encoding alpha-subunit of the eukaryotic initiation
      factor-2) was expressed under the control of the galactose-regulated GAL1, 10
      promoter, in Saccharomyces cerevisiae, in order to study the possible
      interactions of human eIF-2 alpha with the yeast protein synthesis apparatus.
      Isoelectric focusing coupled with Western-blot analysis demonstrated that the
      human eIF-2 alpha subunit synthesized in yeast under a variety of growth
      conditions was detected as two bands which co-migrated with the phosphorylated
      and unphosphorylated forms of rabbit eIF-2 alpha, suggesting covalent
      modification in vivo. Cell fractionation studies further demonstrated that the
      synthesised human eIF-2 alpha protein, though present in the cytoplasm, was
      largely associated with the yeast ribosomes, but could be removed from these by
      washing with 0.3 M KCl. This possible association of the synthesised human
      subunit into a three-subunit (alpha, beta and gamma) eIF-2 complex was further
      examined by partial purification of the yeast eIF-2 complex and estimation of the
      molecular mass of this complex. Immunoreactive eIF-2 alpha was found in fractions
      with eIF-2 activity and the estimated molecular mass (130 kDa) corresponded to
      that predicted for the eIF-2 trimer. These analyses suggest that human eIF-2
      alpha subunit synthesised in yeast can become involved with the yeast protein
      synthetic apparatus, though whether this is a functional incorporation requires
      further genetic studies.

PMID- 1748311
TI  - Isolation and analysis of cDNAs encoding small GTP-binding proteins of
      Arabidopsis thaliana.
AB  - We previously isolated a DNA fragment from Arabidopsis thaliana homologous to the
      mammalian ras gene and named it ara [Matsui et al., Gene 76 (1989) 313-319].
      Screening of cDNA clones homologous to ara in A. thaliana resulted in the
      isolation of four homologous genes. The products of these genes, ARA-2, ARA-3,
      ARA-4 and ARA-5, showed conservation of amino acids (aa) in four regions, all of
      which are present in small GTP-binding proteins, and are important for GTPase/GTP
      binding activities. These products were highly homologous to those of the YPT
      genes of Saccharomyces cerevisiae and the ypt gene of Schizosaccharomyces pombe
      in the regions around aa 45, which is thought to be the site interacting with
      effector molecules. The products of these four genes showed characteristic aa
      sequence at their C termini, Cys-Cys-Xaa-Xaa. Another characteristic of this
      family is presence of Ser in place of Gly in the first conserved region (Gly12 of
      mammalian GTP-binding Ras protein).

PMID- 1748312
TI  - Characterization of potentially functional 5S rRNA-encoding genes within
      ribosomal DNA repeats of the nematode Meloidogyne arenaria.
AB  - In the plant-parasitic nematode Meloidogyne arenaria, isolated rDNA repeats show
      length heterogeneity, and are unusual in that they contain putative 5S ribosomal
      RNA pseudogenes [Vahidi et al., J. Mol. Evol. 27 (1988) 222-227]. Potentially
      functional 5S rRNA-encoding genes can also be identified in various rDNA repeats,
      which appear to be tandemly organized in the genome.

PMID- 1748313
TI  - Cloning and analysis of a cDNA encoding a human liver carboxylesterase.
AB  - A human liver carboxylesterase (CE)-encoding cDNA has been cloned using synthetic
      oligodeoxyribonucleotides (oligos) based on the known amino acid (aa) sequences
      of rabbit and rat liver CEs. The oligos hybridize specifically to DNA encoding
      liver CEs. The longest cDNA obtained from screening several cDNA libraries
      encodes about 80% of the protein and translates into an aa sequence which has a
      high degree of similarity with the sequences of liver CEs from other species. On
      hybridization to mRNA isolated from human liver, the cDNA gave a single band of
      about 2.0 kb consistent with its encoding a protein of less than 68 kDa. DNA
      obtained from a number of human livers and probed with the CE cDNA gave identical
      hybridization patterns. These patterns were moderately complex by comparison with
      published data.

PMID- 1748314
TI  - Nucleotide sequence and expression of the human gene encoding apolipoprotein H
      (beta 2-glycoprotein I).
AB  - Human apolipoprotein H (ApoH), also called beta 2-glycoprotein I, is a 50-kDa
      serum glycoprotein whose function is not clearly defined. We have cloned and
      sequenced ApoH cDNAs both from human liver and from a human hepatoma cell line
      (HepG2). Both cDNA sequences predict a protein 345 amino acids (aa) in length.
      This sequence includes a 19-aa hydrophobic, N-terminal signal sequence which is
      not present in the mature protein [Lozier et al., Proc. Natl. Acad. Sci. USA 81
      (1984) 3640-3644]. It differs from this previously reported aa sequence at two
      positions, both of which strengthen the conservation among the four short
      consensus repeats within the ApoH molecule. COS-1 cells transiently transfected
      with the ApoH cDNA in a eukaryotic expression vector produced a single species of
      ApoH mRNA and secreted in the ApoH protein. The level of ApoH mRNA expressed by
      HepG2 cells is downregulated by incubation with inflammatory mediators, implying
      that ApoH is a negative acute-phase protein.

PMID- 1748315
TI  - Nucleotide sequences of two members of the chicken H4 histone-encoding gene
      family.
AB  - The nucleotide sequences of two genes (H4-III and H4-IV) from the chicken H4
      histone-encoding gene family have been determined. The four H4 genes, including
      the previously sequenced H4-I and H4-II genes, encode the same amino acid
      sequence and possess several copies of the possible Sp1-binding sequences on the
      coding and noncoding strands within the 5'-flanking regions.

PMID- 1748316
TI  - Sequence of the chicken rig gene encoding ribosomal protein S15.
AB  - The nucleotide sequence of the chicken rig gene encoding ribosomal protein S15
      was determined. The 1.6-kb gene consists of four exons and three introns. The 5'
      flanking region of the gene lacks TATA- or CAAT-box sequences. Several GC-box
      sequences were found around the transcription start point.

PMID- 1748317
TI  - Evaluation of the improvement of cephems on the prophylaxis of pelvic infection
      after radical hysterectomy.
AB  - Antibiotics, especially cephems, have been improved remarkably in the last 20
      years. In order to evaluate the improvement of antibiotics used for the
      prophylaxis of infections after radical hysterectomy, two groups of patients
      (group A, 1978-1979, n = 54; group B, 1985-1987, n = 55) were examined in regard
      to bacteriological and clinical effects. In spite of the improvement of
      antibiotics, the positive rate of bacteriological analysis had increased from
      44.4 to 76.4%. Obvious decrease of gram-negative bacilli and increase of gram
      positive cocci (GPC), e.g. Enterococcus, were observed. In contrast, fever index
      and febrile morbidity of group B decreased significantly more than those of group
      A. These results indicate that the improvement of antibiotics has brought more
      effective prophylaxis in the postoperative infection in spite of the high
      positive rate of GPC.

PMID- 1748318
TI  - Ultrasonic Doppler flow studies of the uterine arteries in women with cervix
      cancer.
AB  - The main characteristic of malignant tumors is their capacity for local
      destructive spread as well as infiltration into the adjacent tissue. The present
      study was carried out to evaluate the hemodynamic alterations in patients with
      advanced cervix cancer. Data of 34 patients with cervix cancer are compared to 30
      healthy women with normal history. The mean pulsatility index (PI) was
      significantly lower in cancer patients (PI = 1.75 +/- 1.27) than in controls (PI
      = 3.18 +/- 0.99). Use of noninvasive Doppler ultrasound study physiology of
      uterine hemodynamics in patients with cervix cancer is of great clinical
      relevance and paves the way for further investigations in screening programs for
      cervix cancer.

PMID- 1748319
TI  - Myometrial invasion of endometrium cancer assessed by transrectal
      ultrasonography.
AB  - Transrectal ultrasonographic examinations before surgery were performed on 27
      patients with stage I endometrial cancer to assess myometrial invasion. The
      findings were compared with the histopathologic data obtained by surgery.
      Sensitivity and specificity of transrectal ultrasonography in myometrial invasion
      of endometrium cancer were 82.6 and 100%, respectively. Therefore, transrectal
      ultrasonography may be a useful diagnostic tool to determine the myometrial
      invasion, which is the most important prognostic factor in endometrial cancer.

PMID- 1748320
TI  - Consecutive pregnancies in a menopausal woman following oocyte donation.
AB  - A second pregnancy was successfully achieved by a menopausal women who had
      previously conceived and delivered an infant using donated oocytes. The same
      nonanonymous oocyte donor provided the gametes for both procedures. Prior to
      embryo transfer, the functionally agonadal recipient received exogenous steroid
      hormone replacement therapy. Both pregnancies followed the transfer of 5 embryos
      which were conceived by the in vitro fertilization of the donated oocytes with
      the recipient husband's sperm. The first pregnancy ended with an intrauterine
      fetal demise at 40 weeks gestation. The second pregnancy is proceeding
      unremarkably.

PMID- 1748321
TI  - A technique for vaginal casting utilizing vinyl polysiloxane dental impression
      material.

PMID- 1748322
TI  - Effect of zinc supplementation in a Turkish woman with two previous anencephalic
      infants.
AB  - The authors report a case of nutritional zinc deficiency in a young (18-year-old)
      Turkish woman, who previously delivered 2 anencephalic stillborn infants. The
      patient was supplemented with 22.5 mg oral zinc sulfate (100 mg ZnSO4.7H2O) for 5
      months after her second delivery prior to her third pregnancy. Her blood (plasma
      and red blood cell) and hair zinc levels returned to normal following zinc
      supplementation. Good response to Zn supplementation was another criterion of Zn
      deficiency in this particular case. After an uneventful gestational period, she
      delivered an apparently normal full-term male child who has grown normally during
      the first 12 months.

PMID- 1748323
TI  - Preoperative diagnostic imaging of primary vaginal carcinoma by transvaginal
      color Doppler and magnetic resonance imaging.
AB  - We treated a patient with primary vaginal carcinoma. Very valuable preoperative
      diagnostic imaging of the carcinoma obtained by transvaginal color Doppler and
      magnetic resonance is reported herein.

PMID- 1748324
TI  - Effects of ketanserin--a serotonin receptor antagonist--on placental blood flow,
      placental weight and fetal weight of spontaneously hypertensive rats and normal
      Wistar Kyoto rats.
AB  - Recently, ketanserin (serotonin receptor antagonist) has been reported to be
      beneficial in the treatment of preeclampsia. In this study, we investigated the
      effects of ketanserin on the placental blood flow, fetal weight and placental
      weight in spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto
      rats (WKY). We measured the rats' placental blood flow by monitoring the
      clearance of hydrogen gas generated by electrolysis. In ketanserin (12, 24, 48
      mg/kg)-treated SHR, systolic blood pressure was significantly decreased. The
      placental blood flow was significantly (p less than 0.05) reduced compared to
      that before treatment in WKY and SHR. The fetal weight decreased dose dependently
      in WKY, while in SHR it did not decrease significantly. The placental weight of
      ketanserin-treated rats decreased compared to that before treatment. These data
      suggest that ketanserin might have some reducing effects on placental blood flow,
      fetal weight and placental weight proportional to the dose.

PMID- 1748325
TI  - Outcome of ovarian response after suppression with a gonadotropin releasing
      hormone agonist in different chronological periods prior to gonadotropin
      stimulation for in vitro fertilization.
AB  - Gonadotropin-releasing hormone analogues (GnRH-a) are currently used in
      combination with gonadotropins in ovarian stimulation for in vitro fertilization
      programs (IVF). The present study aims at evaluating the treatment cycles for IVF
      for which human menopausal gonadotropin (HMG) was initiated only when pituitary
      desensitization was confirmed regardless of the time of GnRH-a administration.
      Two groups of patients were examined. Patients in group A (n = 46) were commenced
      with HMG treatment on day 15 when E2 level was less than 40 pg/ml. Group B
      patients (n = 27) comprised the cycle treatments in which E2 levels were greater
      than 40 pg/ml on day 15. In these cases HMG was first given when E2 levels
      declined to less than 40 pg/ml. The fertilization rate was similar in both A and
      B groups, 71.6 and 67.7% respectively. The pregnancy rate per transfer was 27.5
      and 34.6% in group A and B respectively. Multiple pregnancies were found at 18.1%
      in group A versus 44.4% in group B. It is concluded that postponement of HMG
      administration in patients with high levels of E2 on day 15 after GnRH-a
      administration seems to offer an improvement in embryo cleavage speed, pregnancy
      rate and multiple pregnancies.

PMID- 1748326
TI  - Second-trimester thyroid function and pregnancy outcome in mothers with
      hyperthyroidism. Birth weight related to mid-trimester triiodothyronine and RBC
      zinc.
AB  - Thyroid function at 24-28 weeks gestation was compared between 26 mothers with
      hyperthyroidism (16 on antithyroid treatment and 10 in remission without
      treatment) and 15 normal pregnant controls. There was no difference in the total
      and free thyroxine (TT4 and FT4) or in the total and free triiodothyronine (TT3
      and FT3) concentrations, but the erythrocyte zinc (RBC Zn) concentration was
      significantly lower in the study group (187.3 +/- 46.6 mumol/l RBC versus 223.6
      +/- 3.7 mumol/l RBC, p less than 0.01). In the study group, both birth weight and
      gestation at delivery were significantly correlated with TT3 (r = -0.500, p less
      than 0.02 and r = -0.460, p less than 0.05, respectively) as well as with RBC Zn
      (r = 0.473, p less than 0.02 and r = 0.573, p less than 0.01, respectively). The
      results suggest that plasma concentration of TT3 and of RBC Zn at 24-28 weeks
      gestation may be helpful prognostic factors in the management of pregnant
      patients with hyperthyroidism.

PMID- 1748327
TI  - Antenatal nutritional assessment: the value of upper arm circumference.
AB  - Nutritional indicators such as prepregnant weight or weight increase during
      pregnancy are often difficult to use in developing countries. The value of the
      mid-upper-arm circumference was therefore analyzed in a study of 833 Mozambican
      gravidae, mainly seen at community level. Arm circumference was associated with
      both the estimated prepregnancy weight (p less than 0.0001) and the arm muscle
      circumference (p less than 0.0001). Of the studied women, 4% had an arm
      circumference below 23 cm, and 69% of these women had an estimated prepregnant
      weight for height below 85% of standard. An arm circumference below 25 cm was
      encountered in 24% of the studied group, and 11 out of these 24% were below 85%
      of estimated prepregnancy weight for height. In Mozambican gravidae a mid-upper
      arm circumference below 25 cm is a warning of malnutrition and below 23 cm is a
      strong indicator of malnutrition.

PMID- 1748328
TI  - Can terbutaline be used as a nebuliser instead of intravenous injection for
      inhibition of uterine activity?
AB  - Terbutaline, a betamimetic drug, is used as bolus of 0.25 mg intravenously to
      inhibit uterine activity when encountered with uterine hyperstimulation and
      associated fetal heart rate changes. The effect of terbutaline used as a
      nebuliser in 1- and 2-mg doses on uterine activity in labor was investigated. It
      did not show any significant inhibition of the uterine activity in spontaneous
      term labor. Although convenient and easy to administer especially in an
      emergency, 1 or 2 mg terbutaline used in the form of nebuliser did not give the
      desired effect like 0.25 mg of terbutaline given intravenously for inhibition of
      uterine activity in term labor.

PMID- 1748329
TI  - Meteorological factors in hypertensive disorders, vaginal bleeding and premature
      rupture of membranes during pregnancy.
AB  - In order to determine whether there is a correlation between meteorological
      factors and the occurrence of hypertensive disorders, vaginal bleeding during
      pregnancy and premature rupture of the fetal membranes, we stratified all the
      patients hospitalized with such complications between the years 1984 and 1988 by
      the months of occurrence, weather, humidity and heat. During this period, there
      were 276 women hospitalized with exacerbation of hypertension and toxemia, 349
      because of vaginal bleeding during pregnancy and 35 women following premature
      rupture of the fetal membrane between 30 and 33 weeks of gestation. The
      occurrence of pre-eclampsia and exacerbation of pregnancy-induced hypertension
      was significantly increased in the winter months (p less than 0.001).

PMID- 1748330
TI  - Evaluation of the possible interaction of the antifungal triazole SCH 39304 with
      oral contraceptives in normal healthy women.
AB  - The possible interaction of the newly developed triazole antifungal SCH 39304
      with low-dose combined oral contraceptives (OCs) was studied in 15 healthy women.
      Serum levels of ovarian and adrenocortical steroids and sex hormone-binding
      globulin (SHBG) were analyzed in samples collected during the OC cycles
      immediately before, during and after the administration of SCH 39304. The drug
      was given as a single 400-mg oral dose on day 7 in the second cycle. SCH 39304
      did not interfere with the ovulatory inhibitory action of low-dose combined OCs
      as judged from serum progesterone values. Administration of SCH 39304 caused
      minor decreases in serum SHBG, cortisol and dehydroepiandrosterone sulfate. The
      mechanism(s) behind these minor changes is not known.

PMID- 1748331
TI  - Comparison of oral contraceptive use in women with adenocarcinoma and squamous
      cell carcinoma of the uterine cervix.
AB  - The possible link between oral contraceptives (OCs) and cervical adenocarcinoma
      was tested by a case-case study of prior and current OC use in women with
      adenocarcinoma and squamous cell carcinoma. Cases were matched by age, year of
      diagnosis, and stage of the lesion, and personal, reproductive, and contraceptive
      data were obtained by mailed questionnaires. Except for smoking, which was
      significantly more prevalent in women with squamous cell carcinoma, the two
      groups were identical, with similar OC exposure. This study does not support the
      idea that OCs modulate the expression of cervical neoplasia in favor of
      adenocarcinoma.

PMID- 1748332
TI  - [Immediate breast reconstruction with tissue expander].
AB  - The technique of immediate breast reconstruction, using the tissue expander and
      replacing it with a permanent silicone prosthesis, has been applied with
      increasing frequency during the past several years. We chose this technique for
      immediate breast reconstruction because of its simplicity, rapidity when combined
      with mastectomy, and good esthetic results. We have performed 29 immediate breast
      reconstructions in the past 1.5 years in patients ranging from 22 to 72 years
      (mean 47). The insertion of the tissue expander added only 20-30 minutes of
      operating time for the mastectomy, and did not prolong hospitalization. Before we
      began to replace the expander with a permanent silicone prosthesis there were
      complications in 4 patients (14%). These included development of a seroma in 3, 1
      of which became infected 40 days after insertion of the tissue expander, and
      capsular contraction in a patient who had previously had radiotherapy to her
      breast. The case with the infection was the only failure and the expander had to
      be removed. Immediate reconstruction of the breast is easily performed and can be
      of tremendous psychological benefit to mastectomy patients. Chemotherapy or
      radiotherapy are not contraindications to this type of reconstruction.

PMID- 1748333
TI  - [The professional historical mistake: psychiatric aspects].
AB  - The concept of the professional historical mistake (PHM) pertains to a wide
      spread, deep seated, narrow professional attitude which has prevailed for many
      years, or decades, and fails to take into consideration existing professional
      knowledge, which would broaden the narrow professional approach. 3 cases of PHM
      in psychiatry are discussed. It is believed that PHM occur in medicine, and since
      they tend to be overlooked, conscious effort to detect them is needed in order to
      prevent or to halt them.

PMID- 1748334
TI  - [Unusual presenting symptoms of hypothyroidism].
AB  - The assumption that hypothyroidism has a typical presentation can lead to error.
      Although a common disease in adults and easily treated, the diagnosis can be
      missed for years. Failure to recognize the rare signs and symptoms of
      hypothyroidism leads to unnecessary morbidity and rarely, even to death, from
      myxedema coma. We discuss a number of cases which presented over the past few
      years with less recognized symptoms, such as convulsions, acute psychosis,
      neuromuscular disturbances and deafness. Other atypical presenting symptoms that
      have been described include intestinal pseudo-obstruction and bleeding disorders.
      One should be aware of these varied presentations of hypothyroidism.

PMID- 1748335
TI  - [Subcutaneous emphysema as a complication of colonoscopy].
AB  - A 71-year-old man underwent colonoscopy and multiple poly-pectomy. A few hours
      after the procedure he developed massive subcutaneous emphysema of the abdomen,
      chest, mediastinum, scrotum and both legs. Treatment was by conservative measures
      only. The emphysema gradually disappeared and he was discharged within a few days
      without sequelae. Subcutaneous emphysema is a rare complication of colonoscopy
      which has also been described after other endoscopic and radiological
      investigations of the gastrointestinal tract. It is due to a tiny laceration of
      the mucosal wall of the colon incurred during aggressive instrumentation, through
      which pass large quantities of air. The laceration is located underneath the
      peritoneal sac and the air flows into the retroperitoneum (closed or
      extraperitoneal perforation). The appearance of subcutaneous emphysema a few
      hours later, usually after leaving the hospital, is characteristic. In contrast
      to intraperitoneal perforation (open perforation), surgical intervention is not
      indicated and treatment is usually conservative. It includes complete cessation
      of oral alimentation, insertion of a nasogastric tube, IV drip, and correction of
      hydro-electrolytic or acid-base imbalances. The overall prognosis following such
      measures is excellent.

PMID- 1748336
TI  - [Fentanyl vs alfentanil anesthesia for in vitro fertilization].
AB  - In a prospective double-blind study, 36 women undergoing ultrasonically guided
      oocyte retrieval for in vitro fertilization (IVF) were examined. Anesthesia in 19
      was based on alfentanil, up to 0.025 mg/kg and in 17, fentanyl, 0.0025 mg/kg.
      There were no significant differences between groups with regard to age, weight,
      duration of procedure and pregnancy rate. There were no complications aside from
      nausea and vomiting. Amnesia for the puncture and analgesia were always perfect.
      Induction was significantly shorter for alfentanil, 1.3 +/- 0.7 min, than for
      fentanyl, 3.4 +/- 2.2 (p less than 0.01). All who received fentanyl were drowsy
      at the end of the procedure, while those in the alfentanil group were fully awake
      and able to move from operating table to stretcher with minimal help. We
      therefore recommend alfentanil as the base for anesthesia for IVF.

PMID- 1748337
TI  - [Parathyroid adenoma in a child].
AB  - Parathyroid adenoma presenting as primary hyperparathyroidism is rare in
      childhood. We report a case in a 9-year-old Bedouin girl. The diagnosis was based
      on hypercalcemia, which was found accidentally, and elevated serum parathyroid
      levels. Ultrasonography, scintigraphy, computerized tomography and magnetic
      resonance imaging failed to detect the lesion. The diagnosis was only established
      at exploratory operation, when an adenoma was removed from the right upper pole
      of the thyroid.

PMID- 1748338
TI  - [Cytogenic accuracy of chorionic villus sampling and second trimester
      amniocentesis: is early amniocentesis an alternative?].

PMID- 1748339
TI  - [Medical malpractice in Israeli court judgements and defensive medicine: is it
      possible to restore trust between patients and physicians? Part I: Judgements
      regarding medical practice].

PMID- 1748340
TI  - ["You shall not ... incise any marks on yourselves" practical, medical and legal
      aspects of tattooing].

PMID- 1748341
TI  - [Heart-lung and lung transplantation in cystic fibrosis].

PMID- 1748342
TI  - [Therapeutic sport].

PMID- 1748343
TI  - [Primary brain lymphoma].
AB  - Between 1973 and 1989, 739 patients with non-Hodgkin's lymphoma were referred
      here for treatment, of whom 10 (1.4%) had primary brain lymphoma (PBL) and 1 had
      acquired immunodeficiency syndrome (AIDS). There were 7 females and 3 males (mean
      age 58 years, range 35-77). Duration of symptoms ranged from several days to 3
      weeks. The presenting symptoms were secondary to increased intracranial pressure.
      Computerized tomography (CT) performed in 8 revealed a solitary lesion in 7.
      Other CT scan features were various degrees of contrast enhancement, edema and
      midline shift. The most common site was the frontal lobe; infratentorially, the
      cerebellum was the most frequent site. The diagnosis was established in 8
      patients by surgery and in 2 at autopsy. The most common subtype was the diffuse,
      large cell, immunoblastic lymphoma. 5 patients were irradiated following subtotal
      excision and 2 had combined radiation therapy and high-dose methotrexate-based
      chemotherapy; only 1 had no postoperative treatment. All patients treated by
      radiotherapy alone died within 3-5 months after diagnosis. The 2 who received
      combined therapy are alive, 15 and 48 months after diagnosis, respectively.

PMID- 1748344
TI  - [Quality of life in hypertensive patients].

PMID- 1748345
TI  - [Relationship between left ventricular pressure and volume, and its relation to
      oxygen consumption].

PMID- 1748346
TI  - [Antithrombotic therapy in coronary intervention: angioplasty and coronary bypass
      surgery].

PMID- 1748347
TI  - [New molecular technology in prenatal genetic diagnosis].

PMID- 1748348
TI  - [Use of remedies--precept or option?].

PMID- 1748349
TI  - [Seasonal changes in sperm quality].

PMID- 1748350
TI  - [Bibliography--the achilles heel of medical articles].

PMID- 1748351
TI  - [Fever and splenic space-occupying lesion in a diabetic].

PMID- 1748352
TI  - [Outcome of immediate management of severe head injuries].
AB  - Immediate management of severe head injuries still poses a serious challenge. 50
      patients with severe head injuries (Glasgow Coma Scale, 8 or less) were treated
      from February 1, 1989 to April 30, 1990. The effects of age, Glasgow Coma Score
      at admission, CT findings, pupillary reactivity to light and intracranial
      pressure on outcome, were evaluated. The results of the present series match
      those of other studies and in some aspects the results are even superior. We
      attribute the high incidence of good outcome to the direct referral of the severe
      head injury patients, thus excluding delays at peripheral hospitals. In addition,
      aggressive management in the intensive care units and a broader range of
      indications for operation were also correlated with favorable outcome.

PMID- 1748353
TI  - Isomeric amphetamines--a problem for urinalysis?
AB  - Alkyl amphetamine isomers (amphetamine, 1-phenyl-2-butylamine (PBA),
      methamphetamine, N-methyl-PBA, N,N-dimethylamphetamine, N-ethylamphetamine, N
      ethyl-PBA and N,N-diethylamphetamine) were purchased or synthesized and tested by
      immunoassay and GC/MS for their detectability in urine. Some cross reactivity was
      observed with PBA, N-methyl-PBA N-ethylamphetamine, and N-ethyl-PBA when analyzed
      using a series of commercial amphetamine and methamphetamine immunoassays.
      Chromatographic co-elution problems were observed for the underivatized isomeric
      group N,N-dimethylamphetamine, N-ethylamphetamine, and N-methyl-PBA under GC/MS
      conditions used; and their GC/MS spectra were quite similar. Of the potential
      derivatives, pentafluoropropionyl (PFP) anhydride and heptafluorobutyryl (HFB)
      anhydride provided adequate separation and easily distinguishable spectra using
      the electron-impact GC/MS conditions specified.

PMID- 1748354
TI  - Postmortem magnetic resonance images of the injured brain: effective evidence in
      the courtroom.
AB  - Magnetic resonance images (MRI) of the whole, formalin-fixed brain produce
      details of pathologic changes deep within brain substance not apparent on
      external examination. Photographs of these radiographic images present pathologic
      features in a black-and-white, 2-dimensional format which has proven particularly
      effective in court before judge and jury. This pathologist has noted acceptance
      of such photographs in explaining to jurors the details of his testimony in
      selected cases where brain trauma resulted in a wrongful death. Penetrating
      missile wounds and blunt impact injuries are particularly well documented by this
      method.

PMID- 1748355
TI  - Transferrin subtyping of bloodstains and semen using isoelectric focusing and
      immunoblotting.
AB  - Transferrin (TF) subtyping was carried out on bloodstains that had been made on
      cotton sheeting and stored under a variety of conditions ranging from -20 degrees
      C to +37 degrees C. The time limit of detection was longer than 54 weeks after
      dry storage under each condition. Moreover the correlation between isoprotein
      types of the TF in blood and semen samples from the same individual was
      determined in 103 men. All three TF common types and two rare types in all semen
      samples correlated with the type found in the corresponding blood sample. A
      combination of isoelectric focusing separation and immuno-enzyme-linked detection
      may prove to be very useful for forensic TF subtyping.

PMID- 1748356
TI  - Application of automatic image analysis (IBAS system) to age calculation.
      Efficiency in the analysis of several teeth from a single subject.
AB  - In a previous paper (M. Lopez-Nicolas et al., Forensic Sci. Int., 45 (1990) 143
      150) we obtained a model of multiple regression to estimate age using
      computerized image analysis (IBAS) to study teeth. This method should provide
      more precise measurements of the parameters involved and to test this hypothesis
      we have carried out a blind study using more than one tooth from the same
      individual in order to check the diagnostic accuracy of the method. Our results
      show that individual variability introduced serious errors in tooth age
      estimation using computerized image analysis. However the study of more than one
      tooth per individual improves the accuracy of age estimation. Specific cases
      should therefore be interpreted cautiously, as a degree of variability can be
      expected using the parameters defined in this method.

PMID- 1748357
TI  - Estimation of stature from foot and shoe measurements by multiplication factors:
      a revised attempt.
AB  - Estimation of stature from foot and shoe measurements using multiplication
      factors is well known. It is a simple method and it is used very frequently as a
      ready reckoner in forensic anthropology. However the individual error is quite
      large. In the present work an attempt has been made to evolve revised
      multiplication factors to reduce this error so that this method (multiplication
      factor) can be used more effectively with smaller error.

PMID- 1748358
TI  - The ageing of bruises: a review and study of the colour changes with time.
AB  - This work was inspired by a recent case of child abuse where the question of the
      age of the bruises on the body was raised. The first part of this paper reviews
      published work on bruises. It illustrates the paucity of work in this field and
      the absence of studies of the colour changes in bruises of human skin with time.
      The second part of this paper consists of our own study of the appearance of
      bruises. The aim was to identify the colour changes which occur in bruises and
      over what time-scale, in order to determine whether bruises can be aged by
      appearance. A total of 369 photographs were obtained of bruises aged less than 6
      h and up to 21 days old, in 89 subjects aged 10-100 years. It was found that the
      development of a yellow colour was the most significant change (subjects aged
      less than 65, P less than 0.001; subjects aged greater than or equal to 65 years,
      P less than 0.001). The development of a yellow colour occurred significantly
      faster in subjects aged less than 65 years. (P less than 0.001). The appearance
      of a blue and purple/black colour was of lesser significance. The appearance of a
      red colour did not alter significantly with time. From this study it was only
      possible to conclude that a bruise with a yellow colour was more than 18 h old.

PMID- 1748359
TI  - Positive and negative ion mass spectrometry and rapid isolation with Sep-Pak C18
      cartridges of ten local anaesthetics.
AB  - The positive ion electron impact (PIEI), positive ion chemical ionization (PICI)
      and negative ion chemical ionization (NICI) mass spectra and a rapid isolation
      procedure using Sep-Pak C18 cartridges are presented for ten local anaesthetics.
      In the PIEI mode, molecular peaks were very small or missing for most compounds.
      Peaks at m/z 86 due to the diethylaminoethyl or propylaminoethyl group
      constituted base peaks in six compounds. In the PICI mode, peaks due to M + H and
      M + C2H5 appeared. The cation at m/z 86 was also observed for the six compounds.
      This ion seems useful for the screening of local anaesthetics. In the NICI mode,
      anions at m/z M - H constituted base peaks for all compounds, peaks at m/z M + 12
      appeared in many compounds. The total ion current in the PIEI and PICI modes
      generally gave higher sensitivity than in the NICI mode. Local anaesthetics
      present in whole blood or cerebrospinal fluid (CSF) could be rapidly isolated by
      use of Sep-Pak C18 cartridges with chloroform/methanol as an elution solvent.
      Their detection was possible using wide-bore capillary gas chromatography with
      SPB-1 and HP-17 wide-bore capillary columns with satisfactory separation from
      impurities.

PMID- 1748360
TI  - High performance liquid chromatographic determination of alcohols with reference
      to body distribution of methanol.
AB  - A method has been developed on reverse phase high performance liquid
      chromatography for simultaneous determination of methyl, ethyl and isopropyl
      alcohols under refractive index detection using pure water as the mobile phase. A
      good separation has been achieved between these alcohols. Detector response was
      linear with a detection limit of 5 mg/100 ml. Recovery studies were performed by
      adding known amounts of methyl and ethyl alcohols to blood, lung and liver within
      the range 80-90%. The reproducibility of the results was always greater than 90%.
      The quantitative distribution of methyl alcohol in postmortem body tissues and
      fluids has been reported in three cases of poisoning.

PMID- 1748361
TI  - Bloodgroup simulating activity in aerobic gram-negative oral bacteria cultured
      from fresh corpses.
AB  - The gram-negative aerobic oral bacterial flora of 100 consecutive corpses was
      isolated. After the identification and culturing of the isolated organisms, blood
      grouping was performed by the haemagglutination inhibition technique on dried
      culture smears, the dried culture medium and a dried ethanol extract of the
      bacteria. Forty-seven of the samples showed a gram-negative aerobic bacterial
      growth, giving 58 microorganisms of 14 different species. Positive blood grouping
      results were found in two of them (Escherichia coli and Serratia marcescens),
      both of type B. It is concluded that occasional mistyping of blood groups on
      saliva and oral material may be caused by the oral gram-negative aerobic flora,
      especially if the specimens are contaminated or putrefying.

PMID- 1748362
TI  - Enhanced genotoxicity by melphalan and hyperthermia in chronic heroin addicts.
AB  - Spontaneous melphalan- (MEL-) and MEL-hyperthermia- (MEL-HYP-) induced sister
      chromatid exchange (SCE) frequencies have been studied in 12 chronic heroin
      addicts (HER AD) and in 12 age- and sex-matched healthy controls. The incidence
      of spontaneous SCEs in lymphocytes from the HER AD was significantly greater (P
      less than 0.001) than those from the control subjects. When exposed to MEL in
      vitro, cells from both groups showed an increase in SCE frequency with yields
      from HER AD higher than those from controls. When exposed to MEL and hyperthermia
      (41.5 degrees C for 3 h) in vitro, cells from both groups showed further
      increases in SCE frequency with yields from HER AD higher than those from
      controls. We observed that hyperthermia (HYP) in combination with MEL
      synergistically enhances SCEs and cell division delays in both groups, with the
      synergistic effects in cells from HER AD higher than those from controls.

PMID- 1748363
TI  - ABO bloodgrouping on tooth material.
AB  - The ABO bloodgroup was determined on the pulp, dentin and enamel of 35 teeth
      using the adsorption-elution technique. A bloodstained compress from the
      extraction wound was used as the reference sample. Twenty teeth were examined
      within 6 weeks after extraction and fifteen teeth were examined 6-10 months after
      extraction. It was found, that bloodgrouping on pulp gives fairly good results,
      whereas the possibilities for correct bloodgrouping seem to be limited for dentin
      and debatable for enamel. Similar results were found in both groups of teeth.

PMID- 1748364
TI  - [Cancer and cytokines].

PMID- 1748365
TI  - Psychosomatic approach to patients with gynecologic cancer.
AB  - In patients with terminal cancer, there is a need for a psychosomatic approach in
      which both the patient's psychological state, including QOL, and physical
      condition are considered. We studied patients with gynecologic cancer with the
      following practical objectives: 1. To evaluate the effect of a psychosomatic
      approach to patients with terminal gynecologic cancer; 2. Using psychological
      tests and interviews, to clarify the character tendencies of cancer patients,
      which are often reported in other countries; and 3. To discuss the benefits in
      the patient's attitude toward living with cancer. In case studies, separation
      anxiety of terminal cancer patients is increased due to impending death, and
      often patients cannot deal with these feelings. When the medical staff accepts
      these emotions, the patients' feelings even in the face of death often change to
      positive feelings of gratitude to the people around them. All of the results of
      psychological testing showed model answers, close to the mean of the normal
      range. This suggests that the patients were suppressing emotions behind their
      standard responses. Patients with uterine cancer showed a type C or cancer
      character, while those with ovarian cancer showed type A or heart disease
      character. Results indicated different attitudes between patients with uterine
      cancer and those with ovarian cancer. Cancer patients with a vigorous attitude
      (high POMS-V score pattern behavior) tended to have a good prognosis. This
      investigation represents a pilot study of a psychosomatic approach to cancer
      patients. However, recent psychoneuroimmunologic studies have reported the
      influence of emotion on cancer. Further studies of this kind are needed.

PMID- 1748366
TI  - [Clinical study on bronchial hyperresponsiveness and development of bronchial
      asthma in patients with persistent cough].
AB  - The purpose of this study was to ascertain whether in patients with persistent
      cough the presence of bronchial hyperresponsiveness (BH) and development of
      asthma could be speculated based on clinical data. Only patients who met strict
      criteria excluding exogenous factors that influence BH, especially smoking or
      respiratory infection, were included in this study. The study group included 15
      males and 50 females aged 18 to 62 years (mean +/- S.D. of 44 +/- 12 years) whose
      physical findings, chest X-rays, spirometry results and peripheral leukocyte
      counts were within normal limits. Duration of cough was at least one month. The
      patients had no history of wheezing, dyspnea or previous bronchodilator therapy.
      None of them had ever been smokers. In addition, there was no history of upper
      respiratory tract infection in the preceding month. BH was assessed by
      "Astograph" using methacholine. Cmin and Dmir or SGrs/Grs cont. were measured as
      the indexes of bronchial sensitivity or reactivity respectively. A methacholine
      Cmin of 3, 125 micrograms/ml or less was taken as a positive indication of BH.
      The evaluated clinical data were age, pulmonary function (spirogram or flow
      volume curve), atopic factors (serum total IgE and family or personal history of
      atopic diseases), peripheral eosinophil count, bronchial sensitivity or
      reactivity, and clinical features of cough (induction by exercise or cold air and
      nocturnal worsening). The results were as follows. (1) Twenty-nine (45%) of 65
      patients were BH-positive (BH-positive group). (2) There was no significant
      difference in age, %FVC, IgE, and family or personal history of atopic diseases
      between the BH-positive and negative group. However, the BH-positive group had
      significantly lower FEV1.0%, %FEV1.0, PEFR, (p less than 0.05) and V25/H (p less
      than 0.01) and a higher peripheral eosinophil count (p less than 0.05) than the
      BH-negative group. (3) Seventeen (85%) of 20 BH-positive patients prescribed
      bronchodilators (beta 2 agonist/theophylline) responded to therapy within a
      month. (4) Seven (29%) of 24 BH-positive patients available for 2 years follow-up
      developed clinical asthma. (5) There was no significant difference in %FVC,
      FEV1.0%, V25/H and peripheral eosinophil count between the patients who developed
      asthma (Group A) and those who did not (Group N-A). However, The patients in
      Group A were older than those in Group N-A.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1748367
TI  - [Positron emission tomography (PET) before and after treatment of hyperammonemia
      in a patient with decompensated liver cirrhosis].
AB  - A 56 year-old-male liver cirrhosis patient was admitted because of hepatic
      encephalopathy with hyperammonemia. We measured cerebral blood flow (CBF),
      cerebral oxygen extraction fraction (OEF) and cerebral metabolic rate for oxygen
      (CMRO2) by using PET before and after treatment of hyperammonemia. At the time of
      the first PET, serum ammonia was 152 micrograms/dl and on the second PET it was
      88 micrograms/dl. The electroencephalogram and number connection test also
      improved on the second PET. CBF and CMRO2 were decreased by 25-42% in comparison
      to normal control and OEF increased 1-24% at first examination. Similar abnormal
      reduction of both CBF and CMRO2 and increase of OEF were seen at second
      examination. Reduced CBF and CMRO2 regardless of serum ammonia level suggests
      that heptic encephalopathy may be, at least in part, associated with pathological
      changes in brain tissue induced by hepatic metabolic disorder.

PMID- 1748368
TI  - [A case of liver cirrhosis associated with chronic subdural hematoma and hepatic
      encephalopathy].
AB  - A 58-year-old male liver cirrhosis patient, who had a history of recurrent
      hepatic encephalopathy, was admitted to our hospital because of clouding of
      consciousness. He had an episode of recent head trauma. On admission, he was
      drowsy and exhibited flapping tremor, fetor hepaticus and ascites. Laboratory
      data showed an increase in blood ammonia level, and a decrease in peripheral
      thrombocytes, serum albumin and prothrombin value. A ratio of branched-chain to
      aromatic amino acids was reduced. Antibody against hepatitis C virus was
      positive. His electroencephalogram showed bilaterally large synchronous slow
      waves. He was treated with intravenous branched-chain amino acids, and recovered.
      Cranial computed tomography on day 9 demonstrated a crescent shaped area of low
      density in the right frontotempoparietal subdural region. He was diagnosed as
      chronic subdural hematoma, which was treated surgically. It has been suggested
      that chronic subdural hematomas develop as a complication of hemostatic
      deficiency due to liver cirrhosis.

PMID- 1748369
TI  - [Development process of human fetal movement--special reference to REM sleep/NREM
      sleep/arousal condition].

PMID- 1748370
TI  - [Isosorbide dinitrate ameliorates myocardial ischemia after development of
      collateral function in a canine model].
AB  - The effects of i.v. administered isosorbide dinitrate (ISDN) on the reduced level
      of regional myocardial function during coronary occlusion were studied in
      conscious dogs before and after collateral development and in the absence of
      persistent coronary stenosis. The animals were instrumented during sterile
      surgery with a miniature pressure gauge for measuring left ventricular pressure
      and a cannula for aortic pressure. Two pairs of piezoelectric crystals were
      placed in normal and ischemic areas to determine regional circumferential length.
      A hydraulic cuff occluder and a Doppler flow probe were placed around the left
      circumflex coronary artery. Collaterals were induced to develop by 2 min of
      coronary occlusion applied repetitively at an interval of 32 min for 2 to 9 days,
      until the regional dysfunction produced by coronary occlusion had disappeared.
      Collateral development was estimated according to percentage of systolic
      shortening and endsystolic length area (ESL area) during the occlusion. Before
      collateral development, ISDN in a dose of 100 micrograms/kg did not affect the
      level of regional dysfunction. The ESL area was 250 +/- 54 and 248 +/- 52 mm.sec
      before and after ISDN, respectively. After collateral development, the ESL area
      was 51 +/- 13 mm.sec and it decreased by 35% after the i.v. administration of
      ISDN. The improvement by ISDN of transient myocardial dysfunction was achieved
      even during electrical tachypacing. Accordingly, the beneficial effects of ISDN
      on regional wall motion rendered ischemic during transient coronary occlusion
      were appreciable after coronary collateral development.

PMID- 1748371
TI  - A different view of queues in Ontario.

PMID- 1748372
TI  - Health care in Australia: lessons from down under.

PMID- 1748373
TI  - The 1987 revision of physician fees in Germany.

PMID- 1748374
TI  - Europe after 1992: implications for pharmaceuticals.

PMID- 1748375
TI  - Translating the U.S. HMO experience to other health systems.

PMID- 1748377
TI  - Advancing the debate on international spending comparisons.

PMID- 1748376
TI  - International health spending: comparisons with the OECD.

PMID- 1748378
TI  - Health status in east European countries.

PMID- 1748379
TI  - Spain's citizens assess their health care system.

PMID- 1748380
TI  - Health care systems in twenty-four countries.

PMID- 1748381
TI  - Canadian/U.S. health care: reflections on the HIAA's analysis.

PMID- 1748382
TI  - Importing a model of hospital quality from The Netherlands.

PMID- 1748383
TI  - International health grant making.

PMID- 1748384
TI  - Health systems in three nations.

PMID- 1748385
TI  - Impact of expanding Medicaid.

PMID- 1748386
TI  - Medicaid and the working poor.

PMID- 1748387
TI  - States and the Medicaid debate.

PMID- 1748388
TI  - Future value of pharmaceuticals.

PMID- 1748389
TI  - European view of U.S. drug policy.

PMID- 1748390
TI  - Britain's health care experiment.

PMID- 1748391
TI  - Internal market reform of the British National Health Service.

PMID- 1748392
TI  - Reforming health care in seven European nations.

PMID- 1748393
TI  - Soviet health care from two perspectives.

PMID- 1748394
TI  - Japanese health care: low cost through regulated fees.

PMID- 1748395
TI  - A comparative study of proliferation-associated parameters in B-cell non-Hodgkin
      lymphoma.
AB  - The prognostic value of three proliferation-associated parameters, the frequency
      of cells in S-phase, mitotic index (MI) and serum deoxythymidine kinase levels (S
      TK), was examined in 106 primary cases of B-cell non-Hodgkin lymphomas (NHL), 76
      'low grade' NHL and 30 'high grade' NHL and compared with morphology and clinical
      variables. All three proliferation factors displayed large differences in the
      mean values of the two groups 'low grade' and 'high grade' NHL, and all revealed
      significant prognostic information. In 'low grade' NHL, the information decreased
      with follow-up time. A correlation (r = 0.7) was noted between S-phase values and
      MI but not between S-TK and the two others. In the entire patient material and in
      the two prognostic groups defined by morphology, S-TK gave the best prognostic
      information. MI gave better prognostic information than S-phase values in the
      whole material and in 'low grade' NHL, whereas the reverse appeared to be true
      for 'high grade' NHL. In the multivariate analyses, no other parameter apart from
      S-TK provided any further prognostic importance in the cases of 'high grade' NHL,
      whereas in that of 'low grade' NHL, MI, stage, age and histology had independent
      importance.

PMID- 1748396
TI  - Treatment of terminal-phase chronic myelogenous leukemia with intermediate-dose
      cytarabine and hydroxyurea.
AB  - We used intermediate doses of Ara-C (IDAra-C) in the treatment of 15 patients
      with chronic myelogenous leukemia (CML) in blast crisis and, combined with
      hydroxyurea, in 20 CML patients in accelerated phase. Patients with blastic CML
      received intensive 5-day courses of IDAra-C 600 mg/m2 every 12 h as a 2-h
      infusion. Of 15 patients, three achieved complete response (CR) and three partial
      response (PR), for an overall response rate of 40 per cent. All patients
      developed severe leukopenia and thrombocytopenia, and two died in hypoplasia.
      Except nausea and vomiting requiring medication, other nonhematologic toxicities
      were uncommon. Median response duration was 4 months (range 1 to 7 months).
      Survival was 5 months for responders and 1.5 months for nonresponders. Patients
      with CML in accelerated phase were treated with two-day courses of IDAra-C 600
      mg/m2 every 12 h by 2-h infusion, every two-three weeks. Daily hydroxyurea 1-1.5
      g/day was administered between courses. Of 20 patients, 15 (75 per cent) achieved
      a good PR with rapid improvement of the symptoms of disease acceleration. The
      median duration of response was 11 months (range 3 to 38 months); duration was
      over 24 months in five patients. The median survival from the start of IDAra-C
      was 13 months for responders and 3.5 months for nonresponders. We conclude that
      IDAra-C is an effective approach for CML in terminal phase. Its use in 5-day
      induction courses for blast crisis CML has a response rate comparable to that
      achieved with high-dose Ara-C. In patients in accelerated phase, the combination
      of short courses of IDAra-C with hydroxyurea is a well-tolerated treatment able
      to improve substantially the clinical and hematologic symptoms of disease
      progression.

PMID- 1748397
TI  - Increased levels of circulating interleukin-6 in patients with Hodgkin's disease.
AB  - Expression of interleukin-6 (IL-6) and IL-6 receptors has been demonstrated in
      Hodgkin and Reed-Sternberg (H and RS) cells in vitro and in vivo. In order to
      evaluate the clinical significance of IL-6 serum levels in patients with
      Hodgkin's disease (HD), we tested the sera of 56 untreated patients with HD by
      means of a sensitive sandwich ELISA. While IL-6 was only rarely detectable in
      healthy controls or patients with non-Hodgkin's lymphoma, 32 of 56 patients (57
      per cent) had detectable IL-6 levels (range 12-32 pg/ml). The rates of detectable
      IL-6 levels and the median levels were not correlated with age, sex, histological
      subtype, stage or the presence of B-symptoms, nor with any of a wide spectrum of
      laboratory parameters tested, including erythrocyte sedimentation rate, total
      leukocyte and lymphocyte counts, serum levels of soluble CD8, CD25 or CD30. The
      rates of complete remissions and freedom from treatment failure were not
      different in IL-6-negative and IL-6-positive patients. Except in one of 23 follow
      up sera taken after therapy, IL-6 was no longer detectable even for patients who
      suffered from progressing disease, suggesting that the neoplastic H and RS cells
      are not the major source of circulating IL-6.

PMID- 1748398
TI  - A pilot study of epirubicin and chlorambucil in the treatment of chronic
      lymphocytic leukemia (CLL).
AB  - In a pilot study of the combination of epirubicin and chlorambucil in the
      treatment of chronic lymphocytic leukemia (CLL), 10 patients with advanced or
      progressive disease were treated in four centres. Up to a total of 15 courses in
      individual patients were given. Toxicity was relatively mild with nausea due to
      epirubicin being the most commonly reported side-effect. One patient developed a
      probable septicemia during a period of neutropenia. In another patient who died
      from probable Pneumocystis carinii pneumonia (PCP) after only one course of
      therapy, death could not be regarded as necessarily treatment-related. In seven
      previously untreated patients, one complete response and four partial remissions
      were seen. All three previously treated patients showed partial remissions.

PMID- 1748399
TI  - Quantitative study of KI-67 antibody staining in 46 T-cell malignant lymphomas
      using image analysis.
AB  - Image analysis with a SAMBA 2005 (ALCATEL-TITN, Co) was used to quantify the Ki
      67 stained area percentage in 46 T-cell malignant lymphomas (T-ML), classified
      according to the updated Kiel classification. This parameter demonstrated
      correlation with the number of Ki-67-positive cellular profiles (r = 0.88, P less
      than 0.001) and was more reproducible than cell counting. A significant
      difference was found between low and high grade T-ML (mean values +/- SEM
      respectively of 10.20 +/- 1.82 per cent and 25.63 +/- 3.15 per cent). The most
      interesting findings were that: (1) AILD-type T-ML showed an intermediate
      proliferation rate (15.55 +/- 2.72 per cent) between pleomorphic T-ML with medium
      and with large cells (respectively 12.53 +/- 3.64 per cent and 22.43 +/- 3.46 per
      cent), both of which belong to the high grade malignancy group. This finding is
      in accordance with the poor prognosis of this subtype despite its classification
      in the low grade malignancy group. (2) Subclassification of the pleomorphic MLs
      according to the predominance of small, medium or large cells, demonstrated
      significant differences between these three subtypes. However, the great overlap
      of values between pleomorphic T-ML with medium and with large cells, seems to
      indicate that the subclassification of these two subtypes is less valid. (3) A
      wide range of values with overlap was observed in AILD-type ML, in pleomorphic
      with medium or large cells and in lymphoblastic T-ML: for these T-ML with
      variable survival courses, the Ki-67 area percentage, one parameter of
      proliferative activity, appears worth studying as a prognostic factor.

PMID- 1748400
TI  - Recombinant human granulocyte macrophage colony stimulating factor following
      alternating non cross resistant chemotherapy in Hodgkin's disease.
AB  - Fourteen patients with Hodgkin's disease (two previously untreated, 12 following
      relapse or with refractory disease) were treated with a combination chemotherapy
      regimen comprising chlorambucil, vinblastine, procarbazine, prednisolone,
      etoposide, vincristine and adriamycin administered on days 1-8. Recombinant human
      granulocyte-macrophage colony stimulating factor (rhGM-CSF) (mammalian
      glycosylated, Sandoz/Schering-Plough) was administered after alternate cycles of
      chemotherapy from day 10 for 7 days by continuous intravenous (i.v.) infusion in
      12 patients in a dose finding study (dose: 2 micrograms/kg/day in four patients,
      4 micrograms/kg/day in four patients and 8 micrograms/kg/day in four patients)
      and by daily subcutaneous (s/c) injections in two patients (8 micrograms/kg/day).
      There was a rapid peripheral leucocytosis following the rhGM-CSF, reaching a peak
      at 1-2 days in 12/14 patients. The initial leucocytosis was composed of
      neutrophils followed by a rise in immature myeloid cells. There was no difference
      observed in the duration or depth of the nadir following chemotherapy or in the
      rate of recovery of peripheral white cell counts between cycles with and without
      rhGM-CSF in patients treated with 2 and 4 micrograms/kg/day. At the dose of 8
      micrograms/kg/day, 3/6 patients had a shorter nadir duration in the cycle with
      rhGM-CSF, compared with cycle without rhGM-CSF. There was no difference in
      frequency of infection in cycles with and without rhGM-CSF. Following
      chemotherapy, six patients achieved clinical remission, six partial remission and
      two had progressive disease.

PMID- 1748401
TI  - [Study of enamel caries-lesion produced by artificial plaque].
AB  - The authors used the cariogenic bacteria isolated from human dental plaque to
      produce an artificial plaque which can produce carious lesion in vitro. Lesions
      on human enamel slabs produced by artificial plaque and single bacterium were
      observed under polarized light microscope and scanning electron microscope. The
      results showed that the characters of artificial carious lesions are very similar
      to natural enamel caries. It is very difficult to differentiate them under the
      microscopes. Compared with the lesions produced by single strain, the destructive
      fashion observed in lesions produced by artificial plaque is more similar to the
      changes produced by natural dental plaque.

PMID- 1748402
TI  - [The effect of plaque fluid on demineralization of enamel powder].
AB  - The aim of this study was to explore any substance in dental plaque which might
      affect the demineralization of enamel. Plaque fluid was prepared by
      centrifugation of pooled plaque from 56 young adults without periodontal
      diseases. Enamel was separated from healthy teeth of adolescents and crushed into
      powder. The enamel powder was treated separately by plaque fluid and synthetic
      plaque fluid (as a control, with similar calcium, fluoride content and pH as the
      natural). After this, the enamel powder was washed with PBS. Both the plaque
      fluid-treated and synthetic plaque fluid-treated enamel powder were demineralized
      by mixed organic acid (pH 4.5). The calcium content in both plaque fluids, PBS
      and organic acid after treatment with enamel powder was analysed by atomic
      absorption spectrophotometer. The results showed that there was no promoting
      effect in plaque fluid on demineralization of enamel, but, on the other hand,
      some protecting action was observed which might contribute to the presence of
      proteins in plaque fluid.

PMID- 1748403
TI  - [The distribution of apolipoproteins AI, CII and CIII mRNA in rat tissues].
AB  - It was demonstrated that apo AI, CII and CIII mRNA were distributed in rat
      (Sprague Dawley) liver, intestine, brain and kidney by RNA-dot blot analysis with
      apoAI, CII and CIII cDNA probes. The relative abundances of apoAI in liver,
      intestine, brain and kidney tissues are 100%, 212%, 170% and 224%, respectively,
      those of apoCII are 100%, 61%, 163% and 214%; and those of apoCIII 100%, 65%, 70%
      and 73%, respectively. The experiment was repeated for three times. The results
      were discussed in this paper.

PMID- 1748404
TI  - [Preparation of SOKT1-RTA immunotoxin and its specific cytotoxic effect on human
      T lymphocytes].
AB  - An immunotoxin, SOKT1-RTA, was prepared successfully by conjugating a murine anti
      human T lymphocyte monoclonal antibody (McAb) SOKT1 and the ricin toxin A chain
      (RTA) with the heterobifunctional linker SPDP. At the presence of 20 mmol/L
      NH4Cl, the SOKT1-RTA conjugate killed 82% of the human peripheral blood T cells
      (PBT), and decreased their 3H-Leu incorporation to 6.2% of the untreated
      controls. The toxic effect of the immunotoxin can be partially blocked by
      unconjugated SOKT1, but not by an irrelevant McAb D51. These results indicated
      that the SOKT1-RTA conjugate still retains both functions of its component
      parts:binding to human PBT specifically, and inhibiting protein synthesis. It may
      be an effective reagent for in vitro depletion of immunocompetent T cells from
      human bone marrows.

PMID- 1748405
TI  - [Construction of gene bank of L. interrogans serovar lai and cloning of
      homological sequences of virulent leptospirosis].
AB  - A gene bank of the main pathogen of pulmonary diffuse haemorrhage type
      leptospirosis (PDH), L. interrogans serovar lai strain 017, was first constructed
      with plasmid vector pUC9, which contained 610 recombinant clones and laid the
      foundation for further investigation of molecular characteristics of leptospires
      with strong virulence. Recombinant plasmids which have homological sequences of
      pathogenic leptospires were screened from the gene bank. A recombinant plasmid,
      designated pCX7, could detect 1.7 kb fragment of strain 017, 9.0 kb of strain 601
      and 30.0 kb of strain 610 respectively without cross hybridization with
      nonvirulent leptospires such as L. biflexa strain Patoc I and Leptonema illini.
      pCX9, another recombinant plasmid, could detect 1.9 kb fragment of strain 017 and
      had no hybridization with other pathogenic or nonpathogenic leptospires. The
      results showed that the degree of homology between pathogenic and non-pathogenic
      leptospires was very low and the degree of homology was very high among the
      pathogenic leptospires.

PMID- 1748406
TI  - [Plasma PGI2 and TXA2 levels on a model of PDH in leptospirosis].
AB  - Guinea pigs were intravenously injected with icterhemorrhagiae serogroup Lai
      serovar strain 017 leptospirosis to model the pulmonary diffuse hemorrhage (PDH)
      in leptospirosis. Thirty-eight hours after the injection, the jugular arteries
      were catheterized to collect blood sample. The plasma was prepared for
      radioimmunoassay of TXB2 and 6-keto-PGF1a, the stable metabolites of TXA2 and
      PGI2 respectively. The plasma level of TXB2 in the experimental group, 107.15 +/-
      41.65 pg/ml (n = 7), almost doubled that of the control, 54.05 +/- 12.93 pg/ml (n
      = 7), with significant difference (P less than 0.01); meanwhile, no significant
      difference was observed of 6-keto-PGF1a, 67.97 +/- 16.89 pg/ml (n = 6) vs. 98.06
      +/- 40.63 pg/ml (n = 9) with P greater than 0.1. The fact that TXA2 causes
      vasoconstriction and increases vessel permeability suggests that TXA2 elevation
      should play a role in the mechanism of PDH in leptospirosis.

PMID- 1748407
TI  - [Isolation of desmosomes: a marker for epithelial tumors].
AB  - A simple method is reported for the isolation of desmosomes. The fresh
      noncornified layers of cow nose epidermis were immersed in 0.1 mol/L citric acid
      sodium citrate buffer (pH 2.3, containing 0.5 mmol/L PMSF), and then treated with
      homogenization and discontinuous sucrose density gradient centrifugation.
      Desmosomes were located at the 50-56% sucrose interface. Electron microscopy
      revealed that the characteristic desmosome structure was well preserved, and that
      a few intermediate filament bundles attached to desmosome plaque were removed by
      the solubilizing action of the buffer. Approximate 100 mg desmosomes (dry weight)
      were got from 20g wet noncornified layers of epidermic tissue.

PMID- 1748408
TI  - [Chemiluminescent immunoassay for insulin].
AB  - In this paper is reported solid phase chemiluminescent immunoassay for insulin
      with N-(4-aminobutyl)-N-ethylisoluminol (ABE1) labelled antibody and a double
      antibodies sandwich procedure. ABEI-CoCl2-H2O2 was used as the chemiluminescent
      system and the linear range of insulin was 0.3-150 microU/tube. The correlation
      coefficient of the log-log regression equation was 0.985 and the absolute limit
      of detection 0.32 microU/tube.

PMID- 1748409
TI  - [The qualitative and quantitative analyses of protein with a novel fluorescence
      agent (EPQS) by fluorescent scanning on solid substrate].
AB  - We synthesized a new fluorescence agent, EPQS, which could be soluble in water
      and was stable in the analytical process. It was characteristic of good
      fluorescence parameters. Human serum albumin (HSA) was marked with EPQS and
      purified by the paper electrophoresis dialysis. We determined the fluorescent
      spectra and excitation spectra of the marked HSA, or EPQS on the cellulose
      acetate paper by RF-510 fluorescence spectrophotometer-thin-layer
      chromatoscanner. The former lambda ex = 370nm lambda em = 470nm; the latter
      lambda ex = 382nm lambda em = 476 nm. Then we touched different quantity of EPQS
      HSA upon the cellulose acetate. The fluorescent scanning on the paper disclosed
      that the relationship between the quantity adopted and the fluorescence intensity
      is linear. These showed that the protein could be quickly determined
      qualitatively and quantitatively by this simple method, and EPQS was useful.

PMID- 1748410
TI  - [Determination of hydrocortisone and methylprednisolone in plasma by reversed
      phase HPLC].
AB  - A sensitive and rapid method for the simultaneous measurement of both
      hydrocortisone (HC) and methylprednisolone (MP) using dexamethasone (DX) as the
      internal standard was presented. High-performance liquid chromatograph Model 344
      (Beckman, USA) with a 254 nm wavelength UV detector and reversed-phase
      Ultrasphere ODS (5 microns) column was used. Sample was extracted with ethyl
      acetate and the organic layer was evaporated to dryness under an air stream in a
      37 degrees C water bath. The residue was dissolved in 30 microliters mobile phase
      and 20 microliters injected. The mobile phase of methanol and 0.01 mol/L acetate
      buffer (pH 3.0) (64:36) was pumped at 1.0 ml/min through the column. The detector
      was operated at 0.005 aufs. The retention time for HC, MP and DX was 5.43 min,
      7.7 min and 11.5 min, respectively. Standard curve was linear in the
      concentration range of 0.02 to 1.28 mg/L for HC and 0.05 to 12.8 mg/L for MP.
      Sensitivity was 1 ng for HC and 1.5 ng for MP; extraction recovery 76-83%; within
      day CV less than 4%, and inter-day CV less than 6% for both steroids.

PMID- 1748411
TI  - [Analysis of outer membrane proteins from eight strains of Campylobacter in SDS
      PAGE].
AB  - The outer membrane proteins (OMPs) from 8 strains of Campylobacter, including 5
      reference strains and 3 local strains, were isolated and examined by sodium
      dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). The results showed
      that the population distributions of molecular weight of OMPs from different
      species and sources were alike based on the Rank Sum Test analysis. The number of
      bands of major OMP was around 2-3, the molecular weight of which varied from 33
      68 kd. Moreover, three C. jejuni local strains isolated from patients in China
      showed common characteristics of OMPs to the reference strains. It is suggested
      that the OMPs of Campylobacter are of a conservative and stable structure.

PMID- 1748412
TI  - [The influence of vagotomy on stomach endocrine cells in rat].
AB  - The effects of unilateral truncal vagotomy (UTV) and bilateral truncal vagotomy
      (BTV) on antrum EC cells, G cells and oxyntic gland area argyrophil cells were
      studied in rats by using immunohistochemistry processes, Grimelius argyrophil
      stain and microscopic image analysis technique. RESULTS: (1) In UTV animals, two
      weeks postoperation, the sectional areas of EC cells were significantly smaller
      in denervated side than In the other side (17%, P less than 0.05). In the
      innervated side of antrum, the sectional areas of EC cells were larger than those
      in controls (13.5%, P less than 0.05). But, five weeks after UTV, the size of EC
      cells was not significantly different in all animals. These suggest that vagal
      denervation can inhibit relatively the functional activity in a short period, but
      this inhibition could be compensated later. (2) There were no morphological
      changes in G cells of UTV rats. In BTV animals, the quantity of G cells in antrum
      increased by 36.2% (P less than 0.05) and their sectional areas were larger than
      those in sham by 26.2% (P less than 0.05). These indicate that the function of G
      cells is more active in BTV animals and the functional change of G cells is
      related to the pH value of gastric juice. (3) In UTV rats, the oxyntic gland area
      argyrophil cells (ECL cells are dominant) were significantly reduced in two weeks
      (26.8%, P less than 0.01) and in five weeks (20.1%, P less than 0.05) in
      denervated side after UTV. The cells became smaller also. These suggest that
      vagus can influence the function, proliferation and growth of ECL cells.

PMID- 1748413
TI  - [Prophylactic effect of refined amorphophallus konjac on MNNG-induced lung
      cancers in mice].
AB  - Three hundred and seventy LACA mice of seven weeks old were used in 2 batches for
      studying the prophylactic effect of Konjaku powder on MNNG-induced lung cancers.
      These mice (within each batch) were randomly allocated to four groups, namely
      positive control (MNNG), refined Amorphophallus Konjac (R.A.K.), complex (MNNG +
      R.A.K.), and blank control (C). In MNNG group, MNNG (250 micrograms) was injected
      intravenously once five days for seven times in each mouse, the total dosage of
      MNNG was 1.75 mg. In R.A.K. group, according to w/w, 8% R.A.K. was well mixed
      into 92% common diet for long-term term breeding. In complex group, MNNG was
      given as that in MNNG group and the mice were reared as those in R.A.K. group.
      The mice in MNNG group and in C group were all reared by common diet. The results
      of experiments showed different degrees of preventive effect of R.A.K. on MNNG
      induced lung cancers in LACA mice. R.A.K. not only exerted effect on the number
      of induced cancer, causing a drop of the cancerous rate from 79.75% to 20.00% and
      the mean number of cancer in each animal, but also prolonged the survival time of
      animals. At the same time, the constituent ratio of the kinds of tumor denoted a
      decrease in malignancy (adenoma with malignant change), an absence of
      adenocarcinoma and relative increase in benign adenoma. The results of
      experiments also exhibited good duplication as well as absence of adverse
      reactions to Konjaku powder.

PMID- 1748414
TI  - [Transplacental passage of vanadium after treatment with vanadium pentoxide in
      Wistar rat].
AB  - The passage of vanadium pentoxide across the placenta into the embryo/fetus was
      investigated by analyzing the vanadium content in embryo/fetus at various
      intervals between 1 h and 48 h after treatment of pregnant Wistar rats with
      single dose of the V2O5 (5mg/kg) on days 16-18 of gestation, at 4h after
      treatment of pregnant rats with single dose of V2O5 (5mg/kg) on day 12, and at
      120 h after treatment of pregnant rats with dose of V2O5 0.33, 1.0, 3.0 mg/kg on
      days 6 through 15. The V concentration was determined by catalytic polarography.
      At after treatment on day 12, the V concentrations in maternal blood, placenta
      and embryos were elevated in comparison with those of the untreated group. At 4
      48 h after treatment on days 16-18, the V concentrations in placenta and fetuses
      were elevated in comparison with those of the untreated group. The V
      concentration at 4 h after treatment in various tissues is the highest one among
      different time points. On days 16-18, 4 h after treatment, the V concentration in
      placenta was elevated in comparison with that on day 12 of gestation, but the V
      concentration in embryo/fetus was decreased. At 120 h after treatment on days 6
      15, the V concentration in fetus is still high in comparison with that of the
      untreated group. The V content of fetus varied according to doses, suggesting
      that embryo/fetus accumulates vanadium. The results showed that vanadium can pass
      through the placental barrier and enter the embryo/fetus during the embryonal
      organogenesis in rat, but placenta accumulates vanadium, and the barrier action
      increases with placental maturity.

PMID- 1748415
TI  - [Applied anatomy of lymph drainage of lower lip mucosa].
AB  - The lymph drainage of lower lip mucosa was studied in 30 fresh cadavers of fetus
      and neonatus by submucosa injection of 30% Prussian blue of chloroform solution.
      The collecting lymphatics in lateral third of both the right and left sides of
      the lower lip mucosa ran laterally to the angles of the mouth, and then back- and
      downward between mandible and depressor muscle of angle of mouth, and finally,
      accompanying the facial vessels, emptied into submandibular lymph nodes. The
      efferent lymphatics of the latter emptied into angular lymph nodes and jugulo
      omohyoid lymph nodes. The collecting lymphatics in the middle third of the lower
      lip mucosa went superficially to the mental muscle and downward into submental
      lymph nodes. The efferent lymphatic of the latter emptied, anteriorly to the body
      of the hyoid bone, latter- and downward into right and left jugulo-omohyoid lymph
      nodes. All collecting lymphatics lie in the loose connective tissue between the
      muscles.

PMID- 1748416
TI  - [The relationship between hepatitis B and renin-angiotensin-aldosterone system].
AB  - The angiotensin II (AT II) levels in plasma were measured 68 times by using radio
      immunoassay in 30 patients with viral hepatitis B (HB) and in 35 healthy persons
      as the control group. The results showed that the AT II levels of patients with
      HB were much higher than those of the control group (P less than 0.001). They
      were 219.25 +/- 91.31 ng/L and 60.70 +/- 10.73 ng/L, respectively. These
      indicated that the renin-angiotensin-aldosterone system (RAAS) of the patients
      was in exciting state. The levels of 8 cases of severe chronic active hepatitis
      (SCAH) (AT II = 270.40 +/- 106.55 ng/L, 6 cases of subacute fulminant hepatitis
      (SFH) (AT II = 332.80 +/- 140.12 ng/L), and 4 cases of hepatocirrhosis (HC) (AT
      II = 218.50 +/- 97.64 pg/ml) were all higher than those of 8 cases of chronic
      active hepatitis (CAH) (100.50 +/- 83.81 ng/L) and those of 4 cases of acute
      icteric hepatitis (A1H) (123.33 +/- 64.97 ng/L). These findings showed that the
      levels of AT II were directly related with the severity of the illness. The AT II
      levels of 8 cases of HRS (270.50 +/- 66.31 ng/L) were higher that those without
      HRS (174.50 +/- 78.48 ng/L). After treatment with captopril (CPT), the renal
      function of the patients returned to normal and the patients got better, while
      the AT II levels decreased greatly. The results suggested that high AT II levels
      in plasma may be one of the causes aggressing the HRS. The CPT may inhibit the
      produce of AT II and there are some therapeutic effects for the HRS.

PMID- 1748417
TI  - [Clinical value of the Chengdu classification of non-Hodgkin's lymphomas].
AB  - Two hundred forty-nine cases of non-Hodgkin's lymphomas (NHL) were reviewed by
      using the working classification of NHL (Chengdu, 1985). The results showed that
      the patients of 249 cases of NHL ranging in age from 5 to 76 years, with the mean
      age of 42 of the types were separated into three major prognostic groupings as
      follows: 1. low (41 of 249 cases, small lymphocytic 27 cases, lymphoplasmacytoid
      2 cases, follicular cleaved 7 cases, follicular cleaved and noncleaved 5 cases);
      2. intermediate (58 of 249 cases, diffuse cleaved 28 cases, diffuse cleaved and
      noncleaved 27 cases, follicular noncleaved 3 cases); and 3. high grade malignancy
      (150 of 249 cases, diffuse noncleaved 49 cases, lymphoblastic 41 cases,
      immunoblastic 13 cases, polymorphic 39 cases, clear cell 2 cases, histiocytic 6
      cases). Each group was significantly different from the others (P less than
      0.05). The prognosis of patients with angioimmunoblastic lymphadenopathy like T
      cell lymphoma (9 of 249 cases) was not more significant (P greater than 0.05)
      than that of patients with other polymorphic lymphoma (30 of 249 cases). The
      results showed this Chengdu classification of NHL is good for practice and usage
      in clinical evaluation and routine surgical pathology.

PMID- 1748418
TI  - [Investigation on high risk factors of neonatal necrotizing enterocolitis].
AB  - In order to evaluate the factors in high-risk neonatal necrotizing enterocolitis
      (NEC) and predict the prognosis of NEC, a retrospective analysis of 32 factors
      was made in 42 neonates with NEC. The cases were divided into a low-risk
      (survival) group and a high-risk (death) group. Of 32 factors compared between
      these two group, eight were found to be of significance in evaluating the
      severity of NEC, and six of them were used in the development of a NEC scores (1)
      number of days before beginning of artificial feeding; (2) neonatal asphyxia or
      distress; (3) immature form in WBC differential; (4) CO2 combining power; (5)
      abdominal tenderness; (6) presence of portal vein air (PVA). All laboratory
      values and physical and radiographic signs were collected during initial
      presentation of NEC. Neonates with a score of 3 or more are at an increased risk
      of developing severe NEC with a 83% mortality.

PMID- 1748419
TI  - [Evaluation of a logistic regression model in predicting the prognosis of Graves'
      disease treated by antithyroid drugs].
AB  - One hundred and twelve new cases of Graves' disease were treated by tapazole for
      6 months and followed up for another 12 months. The initial dose was 30 mg/d.
      Clinical and biochemical euthyroidism was achieved within 1 to 3 months, then a
      maintenance was given until cessation of drugs at 6 months. One hundred and
      eleven cases completed the study. Remission and relapse were defined at the end
      of follow-up for 1 year according to the presence or absence of clinical
      manifestation of hyperthyroidism and the levels of T3 and T4. The results of the
      12-month follow-up showed that 46 of 111 cases were in remission, and the
      remaining 65 cases suffered relapse. A logistic regression model with 4 variables
      was established, which included thyroid suppression rate and goitre size by
      palpation at the end of drug treatment, the level of T3 before therapy, and the
      patients' age. The model had 81.5% sensitivity, 84.8% specificity and 82.9%
      (92/111) accuracy in predicting the outcome of Graves' disease after withdrawal
      of drug for 1 year. The results were much better than any other univariate
      analysis in this study.

PMID- 1748420
TI  - [Application of polychotomous logistic regression in the study of risk factors
      predisposed to postpartum hemorrhage].
AB  - To determine the role of history of induced abortion and pregnancy induced
      hypertension in postpartum hemorrhage, a polychotomous logistic regression method
      was introduced to analyze the data gathered in an investigation of blood loss
      among 933 parturients in some counties of Sichuan and Ningxia provinces. The
      results show that postpartum hemorrhage caused by placenta factors is related to
      a history of induced abortion and pregnancy induced hypertension with relative
      risks 2.55 (95% confidence interval = 1.2-5.3) and 4.94 (95% confidence interval
      = 1.8-13.2), respectively. An increased risk was noted for postpartum hemorrhage
      associated with pregnancy induced hypertension (relative risk = 2.58, 95%
      confidence interval = 1.3-5.2), but not with induced abortion. Suggestions were
      made for prevention of postpartum hemorrhage.

PMID- 1748421
TI  - [Intrauterine adhesion and ovulatory disorder following induced abortion].
AB  - Follicular stimulating hormone, luteinizing hormone, prolactin, estradiol and
      progesterone were measured by radioimmunoassay in 34 patients with those from 34
      normal cycling women after induced abortion. The result showed that the
      anovulatory incidence of the patients (20.6%) was significantly higher than that
      of the controls (2.8%) (P less than 0.05). Increased prolactin and premature
      ovarian failure might be responsible for the anovulatory disorder, resulting in
      unsatisfactory restoration of fertility. It is suggested that the low success
      rate in treating patients with intrauterine adhesion after induced abortion may
      be due to premature ovarian failure and hyperprolactinaemia.

PMID- 1748422
TI  - [Immunodiagnosis of ovarian cancer].
AB  - Ovarian tumor associated antigen was isolated from human serous
      cystadenocarcinomas of ovary and purified by using affinity chromatography
      columns coupled to anti-normal female serum and anti-normal ovarian tissue gamma
      globulin. Antiserum was prepared from New Zealand white rabbits. The antiserum
      was absorbed with normal female serum and extracts of normal ovarian tissue
      thoroughly. The absorbed antiserum was appraised by immunodiffusion,
      immunoelectrophoresis and counter-immunoelectrophoresis with intensifiers. The
      absorbed antiserum has a specific immune precipitin with extracts of ovarian
      tumor tissue. Counter-immunoelectrophoresis with intensifiers was used to detect
      the ovarian tumor associated antigen in the tissue and serum of various patients.
      Twenty-eight of 40 ovarian tumor extracts and 1 of 5 cervical carcinoma extracts
      showed the presence of the cancer antigen. 14/40 were positive in the sera of
      ovarian tumor patients and 6/10 positive in the sera of ovarian serous
      cystadenocarcinoma patients; 1/5 positive in the sera of cervical carcinoma
      patients and 2/10 positive in the sera of ovarian cysts patients. No positive
      result for the sera of normal females was noted. The specificity, sensitivity and
      accuracy of the method were 94.7%, 42.3% and 83.3%, respectively.

PMID- 1748423
TI  - [Consecutive study of nutritional composition of milk from mothers of preterm
      delivery].
AB  - The content of protein, fat, lactose, potassium, sodium, calcium, phosphorus,
      magnesium, copper, iron, zinc in preterm human milk was determined from the
      longitudinal samples during the first 8 weeks of lactation. Changes in content,
      over time were tested by analysis of variance. Protein, potassium, sodium,
      copper, iron, zinc content decreased significantly as lactation progressed. Based
      upon these data, a preterm infant fed 200 ml per kg per day of its own mother's
      milk would receive an excess of all substrates except calcium, phosphorus and
      iron over the estimated intrauterine accretion rates. Within 4 weeks the first in
      the postpartum period, the average intake of calcium, phosphorus, magnesium and
      copper was lower than the recommended intake. Iron intake is not adequate. After
      4 weeks, the average intake of protein, sodium and zinc was lower than the
      recommended intake. The results may offer a basic datum for establishing
      premature infant feeding and formulation of human milk fortifiers (HMF).

PMID- 1748424
TI  - [Change of T lymphocyte subsets in peripherial blood of children with
      malnutrition and zinc deficiency].
AB  - Sixty children with malnutrition were investigated in this study. The results
      showed a reduction of serum zinc in moderate and severe cases compared with the
      mild and normal groups. OKT3+, OKT4+ and OKT8+ cells in peripheral blood of mild
      malnutrition were significantly decreased in contrast to normal control. The
      reductive degree of OKT8+ and OKT4+ cells correlated with the severity of
      malnutrition. OKT8+, OKT4+ and OKT4+/OKT8+ ratio of moderate and severe
      malnutrition with infection were much lower than those without infection. Our
      findings suggested that main effective and regulative cells of cell-mediated
      immunity were impaired. OKT3+ and OKT4+ cells might be used as a sensitive index
      for early assessment of the immune function in malnutrition children.

PMID- 1748425
TI  - The nation's medical curriculum in transition: progression or retrogression?
      Reactions to the Robert Wood Johnson Foundation Commission on Medical Education.

PMID- 1748426
TI  - Iron pigment deposits, small vessel vasculitis, and erythrophagocytosis in the
      muscle of human immunodeficiency virus-infected patients.
AB  - Hemosiderin deposition and vascular inflammation were evaluated in muscle
      specimens from 50 human immunodeficiency virus (HIV)-infected individuals with
      neuromuscular symptoms. Iron deposits were detected in 25 of 50 cases, and were
      found more frequently in the distal muscles of lower limbs than in proximal
      muscles (22 of 30 cases v three of 20 cases; P less than .001). The incidence was
      higher than in controls (P less than .01). Polyarteritis nodosa was observed in
      three cases and microvascular inflammation was observed in 27. Direct
      immunofluorescence showed deposits of both immunoglobulins (mainly immunoglobulin
      M) and complement in small vessel walls of 19 of 34 patients. The p17 and p24 HIV
      antigens were detected in three of 27 cases. Both T8 lymphocytes and macrophages
      were significantly more numerous in patients with Perls'-positive material; these
      patients also showed vascular inflammation more frequently. Other findings
      included noninflammatory microangiopathy (18 cases), tubuloreticular inclusions
      in endothelial cells (one case), and free and intracytoplasmic eosinophilic
      globules likely representing digested erythrocytes (seven cases). The present
      study shows that iron pigment deposition in skeletal muscle is a nonspecific
      finding, frequently observed in the lower extremities of HIV-infected
      individuals, where it reflects immunopathologic alterations of the
      microcirculation. Erythrophagocytosis, which may be observed in the muscle of
      some HIV-infected individuals, may also be implicated.

PMID- 1748427
TI  - The macrofollicular variant of papillary thyroid carcinoma: a study of 17 cases.
AB  - We report 17 cases of a distinctive variant of encapsulated papillary carcinoma
      that is likely to be confused with macrofollicular adenoma or nodular goiter. The
      tumors showed the unusual combination of macrofollicles and foci of the
      conventional follicular variant of papillary carcinoma. Macrofollicles occupied
      over 50% of the cross-sectional areas of the tumors. The macrofollicles were
      lined either by cells with large ground-glass nuclei, cells with large but less
      pale nuclei with stippled chromatin, or cuboidal cells with hyperchromatic
      nuclei. Solid foci were present in four tumors, and a focal insular growth
      pattern was noted in a fifth tumor. All patients were females ranging in age from
      15 to 69 years (mean, 35.4 years). Despite the large size of the tumors (mean
      diameter, 4.8 cm), only two metastasized to cervical lymph nodes. One of these
      neoplasms showed extrathyroidal extension, while the other widely invaded the
      thyroid tissue through the tumor capsule. Multicentric foci of papillary
      carcinoma with a follicular nonsclerosing growth pattern were demonstrated in the
      contralateral lobe in two thyroid glands. All patients with follow-up were alive
      and symptom-free 2 months to 6 years following surgery.

PMID- 1748428
TI  - Cryptosporidiosis in the acquired immunodeficiency syndrome: a study of 15
      autopsy cases.
AB  - The pathologic changes associated with human cryptosporidiosis have not been well
      characterized. In this report, 15 cases of cryptosporidiosis in acquired
      immunodeficiency syndrome patients are described. Organisms were found in autopsy
      tissue specimens in 13 cases, and only in antemortem stool samples in two.
      Gastrointestinal/hepatobiliary distribution of organisms was as follows: small
      intestine (13 cases), extrahepatic bile ducts (eight), intrahepatic bile ducts
      (seven), large intestine (six), pancreas (five), stomach (three), and esophagus
      (one). At all sites, infection was usually associated with nonspecific reactive
      epithelial changes, architectural abnormalities such as villous flattening in the
      small intestine, and interstitial edema with mixed inflammatory cell infiltrates.
      Presence of organisms and associated mucosal injury were patchy and of variable
      severity in the intestine. In the biliary tract, injury was commonly diffuse and
      severe. Pancreatic duct injury was generally mild and often limited to
      hyperplastic squamous metaplasia. In late-stage acquired immunodeficiency
      syndrome patients with cryptosporidiosis, widespread infection in the
      gastrointestinal and biliary systems by this coccidian was more common and severe
      than previously suggested. Although the mechanisms have yet to be determined,
      infection usually is accompanied by pathologic changes that may be causally
      related to pathophysiologic abnormalities, such as diarrhea and malabsorption,
      and may account for other clinical manifestations of pancreatitis, cholangitis,
      and obstructive cholestasis.

PMID- 1748429
TI  - Lobular neoplasia of the breast: higher risk for subsequent invasive cancer
      predicted by more extensive disease.
AB  - We have stratified the cancer risk implications of lobular pattern in situ
      neoplasias of the breast by separating marked examples of this histologic
      spectrum (lobular carcinoma in situ [LCIS]) from lesser examples (atypical
      lobular hyperplasia). The lesser-developed examples have been shown previously to
      have a lower relative risk (RR) of later invasive carcinoma of the breast (IBC).
      Forty-eight examples of LCIS were found in 10,542 otherwise benign breast
      biopsies, representing an incidence of 0.5%. Nine patients were excluded from
      follow-up because of bilateral mastectomy within 6 months of entry biopsy, IBC
      within 6 months of entry biopsy, or prior IBC. Follow-up of the remaining 39
      patients was complete, averaged 18 years, and revealed an RR of subsequent IBC of
      6.9 (P less than .00001). Average overall follow-up for LCIS patients was 19
      years; it was 25 years for those alive and free of IBC at the time of their
      follow-up interview. Neither family history of IBC nor postmenopausal estrogen
      therapy further affected risk. The absolute risk of IBC after LCIS was 17% at 15
      years (adjusted for withdrawals), and the RR was 8.0 in the first 15 years of
      follow-up compared with the general population. An analysis based on a time
      dependent hazards model found that during the first 15 years following biopsy
      women with LCIS had 10.8 times the risk of breast cancer compared with biopsied
      women of comparable age who lacked proliferative disease. Some previously
      published articles reporting lobular neoplasia (LN) suggest that those series
      with the greatest incidences of LN (whether termed LN or LCIS) have the lowest RR
      of subsequent breast cancer. Those series with higher incidences of LN include
      less well-developed histologic patterns of LN (atypical lobular hyperplasia). We
      conclude that our study of LN and studies performed by others support the higher
      risk of IBC after histologically flagrant examples (LCIS, about nine times
      higher) and a relatively lower but definable risk after more histologically
      subtle examples (atypical lobular hyperplasia, four to five times lower). This
      relative cancer risk is probably not constant over more than 15 years; thus,
      cancer risk 15 to 25 years after initial diagnosis of LCIS is uncertain.

PMID- 1748430
TI  - Unusual aspects of allergic bronchopulmonary fungal disease: report of two cases
      due to Curvularia organisms associated with allergic fungal sinusitis.
AB  - We report two cases of allergic bronchopulmonary fungal disease (ABPFD) caused by
      Curvularia sp and associated with allergic fungal sinusitis (AFS). Curvularia
      lunata was cultured in one case and Curvularia senegalensis was cultured in the
      other. Based on these cases and a review of the literature, we discuss unusual
      clinical and pathologic features that can occur in ABPFD. Unusual clinical
      aspects of ABPFD include associated AFS, absence of asthma, progression to Churg
      Strauss angiitis and granulomatosis, concomitant hypersensitivity pneumonitis,
      and underlying cystic fibrosis. Atypical pathologic features that may occur in
      ABPFD include follicular bronchiolitis, xanthomatous bronchiolitis, limited
      tissue invasion, fungus balls, and association with unusual fungi. Prominent
      follicular bronchiolitis and xanthomatous bronchiolitis were misleading
      histologic features in one of our cases and led to a delay in recognition of the
      diagnosis. Both patients presented primarily with AFS; ABPFD was detected
      subsequently. This suggests that a small subset of patients with AFS may be at
      risk for ABPFD. The goal of this review is to increase awareness of unusual
      clinical and pathologic manifestations of ABPFD. It is hoped that this will
      result in accurate diagnosis and proper therapy, especially for patients who
      present with atypical features. Unusual fungal species should be considered in
      patients who have clinical findings compatible with ABPFD but who do not
      demonstrate immunologic reactivity to Aspergillus sp, especially Aspergillus
      fumigatus. In addition, ABPFD should be considered in patients with AFS who
      develop new pulmonary lesions.

PMID- 1748431
TI  - Immunohistochemistry and gene rearrangement studies in the diagnosis of malignant
      lymphomas: a comparison of 152 cases.
AB  - One hundred fifty-two cases (155 specimens) of lymphoproliferative disorders were
      studied by immunohistochemistry and gene rearrangement analysis. Ninety-five of
      96 B-cell lymphomas (99%) showed genotypic B-cell monoclonality. Of these, five
      cases had rearranged T-cell receptor (TCR) beta chain gene in addition to
      immunoglobulin heavy chain (IgH) and kappa light chain (Ig-K), one case had
      rearranged IgH and TCR-gamma chain but not Ig-K or TCR-beta, and two cases had
      only Ig-K rearrangement. One exceptional case in the B-cell lymphoma group had
      unrearranged, germline genotypes. In contrast, only 10 of 19 (53%) phenotypic T
      cell lymphomas had rearranged TCR-beta, eight with concurrent TCR-gamma
      rearrangement. Of the remaining nine cases, six had germline configuration, two
      had rearranged Ig-K only, and one had both IgH and Ig-K rearrangement. This last
      case was reclassified as T-cell predominant, B-cell lymphoma. Thirteen of 16
      cases of Hodgkin's disease had germline configuration; three cases had rearranged
      IgH and Ig-K, of which two were lymphocyte predominant with light chain
      monoclonality and one was a recurrence. Among 21 reactive lesions, 17 had
      germline configuration and four had rearranged IgH and Ig-K genes. Of these four
      cases, two were orbital lesions, one was a partially involved lymph node, and one
      developed a nodular lymphoma 9 months later. Our results indicate that almost all
      B-cell lymphomas have IgH and/or Ig-K rearrangement. In contrast, peripheral T
      cell lymphomas have greater genotypic heterogeneity, and germline patterns for
      TCR genes are not uncommon. Reactive lesions and Hodgkin's disease tend to retain
      germline configuration, and any exception is often associated with an unusual
      clinical setting and/or histology. Genotypic analysis is thus most indicated in B
      cell lymphomas with equivocal immunohistochemistry findings, T-cell lymphomas,
      and atypical cases of Hodgkin's disease and reactive lesions.

PMID- 1748432
TI  - Splenic hamartoma and capillary hemangioma are distinct entities:
      immunohistochemical analysis of CD8 expression by endothelial cells.
AB  - The histologic and immunohistologic features of two morphologically similar
      splenic tumors, a capillary hemangioma and a splenic hamartoma, are reported. The
      hemangioma was composed predominantly of small vascular channels lined by
      endothelium expressing factor VIII-related antigen and lacking T-subset antigen
      (CD8). In contrast, the splenic hamartoma was predominantly a spindle cell lesion
      with numerous vascular channels coursing through the tumor; these contained
      splenic-type endothelium expressing both CD8 and factor VIII-related antigen. Our
      results justify the concept that the splenic hamartoma is a tumor of splenic
      origin or a true hamartoma and is distinct from the splenic capillary hemangioma.

PMID- 1748433
TI  - Myxoid leiomyosarcoma of the ovary: analysis of three cases.
AB  - The first three cases of myxoid leiomyosarcoma occurring in the ovary are
      reported. Two cases in stage III were found in postmenopausal patients and a
      further case was found in stage I in a 32-year-old. All masses were large and
      gelatinous with cystic change, necrosis, and hemorrhage, but both uteri and
      ligaments and contralateral adnexa appeared normal. Microscopically, the tumors
      showed a predominantly reticular meshwork of elongated cells surrounded by
      abundant basophilic material. While electron microscopy proved inconclusive due
      to nondifferentiation, the use of monoclonal antibodies against smooth muscle
      actin demonstrated a smooth muscle type of differentiation. The differential
      diagnosis of this rare ovarian condition includes other myxoid ovarian lesions,
      such as ovarian edema, myxoma, endodermal sinus tumors, and the sarcomatous
      component of malignant mixed mullerian tumor and carcinosarcoma, as well as
      lymphovascular tumors. Since mitotic count due to decreased cellular density is
      unusually low in myxoid leiomyosarcoma, capsular rupture and clinical stage seem
      to be more reliable prognostic markers. The highly aggressive behavior of myxoid
      leiomyosarcoma parallels that of typical ovarian leiomyosarcoma. Two of the three
      patients in this series died of tumor at 13 and 24 months after diagnosis; the
      other patient is free of disease at 3 years after diagnosis.

PMID- 1748434
TI  - Ultrastructural characteristics and DNA immunocytochemistry in human
      immunodeficiency virus and zidovudine-associated myopathies.
AB  - Electron microscopic features of muscle biopsies from 13 human immunodeficiency
      (HIV)-positive patients who had myopathy while receiving zidovudine (AZT) were
      compared with biopsies from five patients with HIV-induced myopathy who were not
      treated with AZT. All specimens showed disorganization of the myofibrillar
      structures, along with a varying degree of nemaline (rod) bodies, vacuolization,
      inflammation, and endothelial tubuloreticular profiles. One untreated and all AZT
      treated patients had cytoplasmic bodies, which in the latter were abundant,
      large, and irregular. Two untreated patients had a peculiar osmiophilic
      destruction of the muscle fibers, with numerous tubuloreticular profiles in the
      endothelial cells and brisk inflammation that included lymphoplasmatoid cells.
      The AZT-treated group had ubiquitous abnormal mitochondria that complemented the
      presence of ragged red fibers seen by light microscopy. There was subsarcolemmal
      proliferation of mitochondria, with marked variation in size and shape and
      proliferation or disorganization of their cristae. Paracrystalline inclusions
      were seen in one patient. Blind re-examination of the electron micrographs showed
      abnormal mitochondria that readily distinguished patients with AZT-associated
      myopathy from those with untreated HIV-induced myopathy. Immunocytochemistry
      using antibodies to single- and double-stranded DNA revealed severe reduction of
      mitochondrial DNA compared with the normal nuclear DNA. Although the myopathies
      associated with HIV and AZT share common myopathologic features, the
      mitochondrial abnormalities are unique to the AZT-treated patients. Since
      mitochondrial DNA is specifically reduced, the structural changes noted on
      electron microscopy are probably associated with mitochondrial dysfunction.
      Zidovudine, a DNA chain terminator that inhibits the mitochondrial gamma-DNA
      polymerase, is toxic to muscle mitochondria.

PMID- 1748435
TI  - Malignant lymphoma of donor origin after renal transplantation: a case report.
AB  - A case of non-Hodgkin's lymphoma of polymorphous centroblastic type presenting in
      a renal allograft is reported. The kidney graft was explanted 10 months after
      transplantation because of chronic rejection. No other manifestations of lymphoma
      were found in the recipient. Since the human leukocyte antigen patterns of the
      renal allograft and the recipient differed at two loci, the donor origin of the
      malignancy could be clearly demonstrated by immunohistochemistry.

PMID- 1748436
TI  - Malacoplakia of liver: a case report.
AB  - This is the first reported case in the English literature of malacoplakia of the
      liver. In common with other cases of malacoplakia, the patient was
      immunosuppressed secondary to steroid therapy for underlying systemic lupus
      erythematosus. The patient died 18 months after presentation; at autopsy, the
      histologic features included those of the late or fibrous stage of malacoplakia.

PMID- 1748437
TI  - Fatal pulmonary arterial occlusive vascular disease following chemotherapy in a 9
      month-old infant.
AB  - Fatal pulmonary hypertension developed in an infant during the 7-month period in
      which he received, via a central venous catheter, combination chemotherapy for
      stage IV neuroblastoma as well as intermittent parenteral feeding. In a lung
      biopsy and at autopsy, small pulmonary arteries showed diffuse medial hypertrophy
      and peripheral muscularization, very extensive concentric intimal fibrosis, and
      focal eccentric fibrosis evolving from organizing thrombi. Pulmonary veins were
      normal. Hypothetically, chemotherapeutic drug therapy (possibly potentiated
      either by the parenteral nutrition or simply by the vehicular fluids causing
      volume loading of the pulmonary circulation) could cause occlusive pulmonary
      arterial disease by several mechanisms, but the association has not been
      described previously, although use of such drugs has been reported with pulmonary
      veno-occlusive disease.

PMID- 1748438
TI  - An unusual case of hairy cell leukemia: death due to leukostasis and
      intracerebral hemorrhage.
AB  - Hairy cell leukemia (HCL) was diagnosed in a 71-year-old Chinese man. His
      clinical presentation and the characteristics of the hairy cells were typical of
      classic HCL. However, extreme leukocytosis (195 to 323 x 10(9) cells/L) in
      peripheral blood was in striking contrast. This leukocytosis, which was much more
      pronounced than any of the reported cases of HCL with leukocytosis, was
      associated with leukostasis in the cerebral vasculature and was causally related
      to a massive intracerebral hemorrhage and death. This mode of death in HCL has
      not been reported previously.

PMID- 1748439
TI  - Dynamic polarization vector of spatially tuned neurons.
AB  - The study of the dynamic properties of otolith neurons has been difficult
      previously because of the differing response sensitivities of individual cells to
      specific stimulus directions and the lack of a general mathematical scheme that
      could explain and account for all their response features. The present paper
      describes a method for estimating both the spatial and temporal properties of
      neurons like the otolith neurons that are spatially tuned to different stimulus
      directions. At each stimulus frequency, a response elipse can be constructed from
      the neural responses elicited by stimulation along three linear independent axes.
      The semimajor axis of the ellipse will specify the neuron's direction of maximum
      sensitivity (polarization vector), whereas the semiminor axis will provide its
      sensitivity in the perpendicular direction. The predictions of the method for
      nonzero length of the semiminor axis are qualitatively the same as the
      experimentally observed dependance of response phase on stimulus orientation.

PMID- 1748440
TI  - Nonparametric identification of discriminative information in body surface maps.
AB  - A nonparametric method, based on the Kolmogorov-Smirnov (K-S) test was used to
      detect significant differences between classes of body surface maps (BSPM's). By
      systematic application of the method throughout the cardiac cycle, discriminative
      spatio-temporal information can be identified. In a second method, a Sebestyen
      linear transformation (SLT) was derived to give estimates of pairwise, linear
      separability of clinical classes. The utility of the method was illustrated by
      the pairwise comparison of 40 normal subjects (NOR), 40 patients with anterior
      myocardial infarction (AMI), and 40 with inferior myocardial infarction (IMI).
      The application examples demonstrated that: a) diagnostic information in low
      potential amplitude regions may surpass that in high amplitude regions, b)
      probability distributions of characteristic features showed small overlap in NOR
      versus AMI and NOR versus IMI dichotomies although they were not linearly
      separable, and c) the single best separating potential sample in the K-S sense
      for NOR versus AMI or NOR versus IMI dichotomies recovered 88 and 73% of the SLT
      performance, respectively.

PMID- 1748441
TI  - An assessment of variable thickness and fiber orientation of the skeletal muscle
      layer on electrocardiographic calculations.
AB  - This paper assesses the effectiveness of including variable thickness and fiber
      orientation characteristics of the skeletal muscle layer in calculations relating
      epicardial and torso potentials. A realistic model of a canine torso which
      includes extensive detail about skeletal muscle layer thickness and fiber
      orientation is compared with two other uniformly anisotropic models: one of
      constant thickness and the other of variable thickness. First, transfer
      coefficients are calculated from the model data. Then torso potentials for each
      model are calculated from the transfer coefficients and measured epicardial
      potentials. The comparison of calculated and observed torso potentials indicates
      that a simple model consisting of a uniformly anisotropic skeletal muscle layer
      of 1.0-1.5 cm constant thickness significantly improves the model. However, if
      photographic slices of the canine torso are used to introduce more detailed data
      about the variation in skeletal muscle thickness and fiber orientation into the
      model, the agreement and between calculated and measured torso potentials
      decreased, although a finite element mesh of over 5000 nodes was used to describe
      the skeletal muscle in the more detailed model. One source of error increase was
      considered to be due to numerical discretization and could be reduced with a much
      finer mesh or by utilizing higher order polynomials to represent the potential
      distribution within each finite element. However, the results presented in this
      paper show that high precision computation (64-bit word length) on the mainframe
      IBM 3081 with an attached FPS-164 gives a slow rate of improvement with reduced
      discretization intervals and that utilizing higher order polynomials within each
      finite element gives an even slower rate of improvement.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1748442
TI  - Errors in frequency parameters of EMG power spectra.
AB  - Frequency shifts in random signals, e.g., EMG or Doppler ultrasound, can be
      followed by monitoring one or more parameters of the power spectrum. When such a
      frequency parameter is determined over a finite length of the signal, a random
      error and sometimes a systematic error or bias are introduced. Approximate
      expressions, in terms of moments of the power spectrum, have been derived for
      bias and standard deviation of the estimates for mean frequency, zero-crossing
      frequency, and fractile frequency (of which the median frequency is a special
      case). Experimental results from surface EMG recordings of three human muscles in
      constant force isometric contractions were in agreement with the theoretical
      predictions. In this case the mean frequency had the smallest random error. It
      turned out that the measured values of the zero-crossing frequency can deviate
      considerably from the predictions by the Rice formula when the amplitude
      distribution is not exactly Gaussian. In the presence of noise, all frequency
      parameters show a systematic deviation, depending on the signal-to-noise ratio.
      In addition to known results on this deviation for mean and zero-crossing
      frequency, an exact and an approximate expression for the fractile frequency are
      given. In the case of EMG plus wide-band white noise, the median frequency has
      the best immunity to noise.

PMID- 1748443
TI  - Computer analysis of the electrocardiogram during esophageal pacing cardiac
      stress.
AB  - It has been estimated that 15 to 30% of patients with suspected or known coronary
      artery disease are unable to perform an adequate exercise stress test due to a
      variety of reasons such as obesity, poor physical condition, claudication, etc.
      Transesophageal atrial pacing has been proposed as a noninvasive alternative for
      inducing cardiac stress in patients who cannot exercise. Although computer
      analysis is commonly employed to analyze the electrocardiogram (ECG) during the
      conventional exercise stress test, the surface ECG recorded during
      transesophageal atrial pacing is contaminated with large pacing artifacts which
      confound beat identification by standard computer software. We report the
      development of a robust signal processing algorithm for interpretation of the
      surface ECG during transesophageal atrial pacing stress. The algorithm employs
      novel schemes using both linear and nonlinear transformations to detect and
      differentiate between the pacing artifact and QRS complex even in difficult
      situations where the pacing artifact is in proximity to or superimposed on the
      QRS complex. The algorithm uses sophisticated logic for automatic recognition of
      sustained capture. It subsequently calculates beat-by-beat and average (over five
      beats) ST segment amplitude and slope. The algorithm also reports the
      instantaneous heart rate, RR interval, pace-to-R interval, R-wave amplitude, and
      estimated sinus node recovery time upon loss of sustained capture. The
      limitations of present exercise ECG computer methods in processing the ECG during
      transesophageal atrial pacing stress are evaluated and significantly improved
      performance by our algorithm is demonstrated.

PMID- 1748444
TI  - Noninvasive estimation of cardiac output.
AB  - A noninvasive method of measuring cardiac output is described. The method uses
      adaptive aorta models in conjunction with femoral and carotid pulse contour
      waveform measurements to calculate aortic flow. Results are presented from
      measurements on dogs using internal pressure recordings made with fluid-filled
      catheters and compared with electromagnetic flow measurements taken in the
      ascending aorta. Preliminary results using external pulse measurements on
      patients are also presented and compared with thermal dilution measurements.

PMID- 1748445
TI  - Detection and imaging of electric conductivity and permittivity at low frequency.
AB  - This paper is concerned with low frequency electrical impedance imaging, which is
      the process of constructing images of the electrical impedance of a body's
      interior based upon measurements of voltage and current made at the body's
      surface. The electrical impedance accounts for both resistivity and permittivity.
      This paper shows how permittivity can be exploited to improve the performance of
      an electrical impedance imaging system. We show that explicit use of the
      independent information in the data due to the permittivity will ehance a
      system's ability to distinguish objects in the interior of a body. In addition,
      we report the results of experiments performed using the Rensselaer ACT 2 system
      on a saline bath containing various objects. These objects include both living
      tissue and metal conductors with oxide layers. We demonstrate the system's
      ability to distinguish these objects, and we exhibit gray scale images of both
      their resistivity and permittivity distributions.

PMID- 1748446
TI  - An airjet actuator system for identification of the human arm joint mechanical
      properties.
AB  - A system is described for determining the mechanical properties of the human arm
      during unconstrained posture and movement. An airjet perturbation device is
      attached to the wrist with a special cuff, and provides high-frequency stochastic
      perturbations in potentially three orthogonal directions. The airjet operates as
      a fluidic flip-flop utilizing the Coanda effect, and generates binary force
      sequences with a steady-state thrust of 4 N, a flat frequency response to 75 Hz,
      usable thrust to 150 Hz, and a rise time of 1 ms, when the static pressure at the
      nozzle inlet is 5.5 x 10(5) Pa (80 psi). These operating characteristics are
      adequate to identify the arm's mechanical properties efficiently and robustly.

PMID- 1748447
TI  - Automated 3-D reconstruction of vascular structures from high definition casts.
AB  - Three-dimensional reconstruction and computer modeling is becoming recognized as
      a powerful tool for studying vascular structures. The computational approach, as
      well as the computer hardware selected for the task, however, depend upon the
      information desired. For the modeling of surface geometry, as in the case of the
      aortic valve, a surface formation technique is favorable over the more
      computationally demanding volume rendering approach. Automated surface formation,
      however, requires good quality, high contrast images. We therefore present a
      technique for producing high contrast images from high definition casts. We also
      describe the methodology used for automatic contour tracing, generating a mesh of
      variable density, and the schemes used to reconstruct bifurcating objects. With
      this approach, 98 mbytes of imaging data could be reduced to 180 kbytes of
      polygon vertices, and manipulated at near real-time speed on a medium performance
      graphics workstation. Such a system is therefore well suited for detailed,
      quantitative analyses of the reconstructed structures. Overall, this paper
      outlines the procedures used to create a high definition, three-dimensional
      computer model of any vascular structure.

PMID- 1748448
TI  - System identification of electrically coupled smooth muscle cells: the passive
      electrical properties.
AB  - A system model approach based on a network model is used to investigate the
      passive electrical properties of coupled smooth muscle cells. This approach makes
      use of a gradient method of optimization to estimate the passive electrical
      parameters directly from the magnitude of the input impedance or voltage transfer
      function of the network model. The need for subjective measurements of parameters
      and many intermediate steps involved in the analysis using the conventional
      signal model approach are eliminated. The coupling resistance and capacitance are
      estimated with sound theoretical and mathematical grounds directly from
      experimental data. From the simulated results using SPICE, it is evident that the
      system model approach is accurate, flexible, and reproducible. These properties
      grant the new approach excellent potential for future studies of drug actions on
      smooth muscle cells and their associated electrical coupling. Also, sensitivities
      of the network model with respect to its parameters can readily be obtained. This
      may provide new insight into the coupling mechanisms of smooth muscle cells.

PMID- 1748449
TI  - Control of the cryosurgical process in nonideal materials.
AB  - A study of a controlled cryosurgical process is presented. This study is based on
      the energy equations describing the probe response and the phase change occurring
      in the medium. First-order nonlinear differential equations (state equations) are
      obtained by applying the integral-solution method. In order to obtain maximal
      cell destruction, it is desired to control a specific cooling rate at the solid
      liquid interface. This cooling rate defines the desired trajectories of the state
      variables through the state equations. In order to satisfy the cooling rate
      condition on the freezing front, a closed-loop is designed to control the probe
      temperature program. A simple analysis of the system stability employed
      linearization at several points along the desired trajectories. Ranges of
      stability were obtained for a system containing a proportional-integral
      controller. It was demonstrated that these stability ranges depend mainly on the
      selected sampling time of the discrete control loop and that the phase-change
      process does not significantly affect the stability results. A complete study of
      the nonlinear equations was performed by a computer simulation program which
      enables the selection of the final values of the controller parameters, in order
      to minimize the error and to ensure stability. In addition, the simulation
      program gives information about the effects of the A/D and D/A converters
      accuracy on the performance of the control loop. An A/D converter accuracy of 12
      bits was found necessary in order to reduce the oscillations in probe temperature
      to acceptable values. The simulation also yields a complete calculated
      temperature field in the tissue during the controlled process. From these
      simulated results it can be seen that oscillations of +/- 0.5 degrees C in the
      desired probe temperature do not significantly affect the desired cooling rate at
      the freezing front. An initial overshoot of 1.5 degrees C in the desired probe
      temperature was obtained both experimentally and theoretically from the
      simulation. When this initial overshoot occurs at the beginning of the freezing
      process, it causes an error in freezing front velocity and consequently in ice
      front position. From the numerical simulation, it can be deduced that the cooling
      rate obtained at the front deviates from the desired value by approximately 1%.
      The probe-temperature error increases at two instants: a) during the super
      cooling effect and the subsequent sudden crystallization, and b) when the probe
      temperature is below -80 degrees C and unstable boiling of the cooling medium
      causes oscillations.

PMID- 1748450
TI  - The isolation mode rejection ratio in bioelectric amplifiers.
AB  - Galvanic isolation of a patient during a bioelectric recording is necessary to
      ensure the safety of the patient. In a typical measurement situation high
      interference voltages may be present across the isolation barrier. In this paper
      the necessity of a very high isolation mode rejection ratio--the ability of the
      amplifier to suppress feed-through from voltages across the isolation barrier to
      the output--is argued and a design of a multichannel amplifier with an isolation
      mode rejection ratio of 160 dB is described.

PMID- 1748451
TI  - Voltage polarity relay--optimal control of electrochemical urea oxidation.
AB  - Voltage polarity relay (VPR) is shown to optimize the urea oxidation rate and
      urea current utilization under constant current conditions in direct
      electrochemical urea oxidation. Direct electrochemical urea oxidation is
      characterized by reversible deactivation of the working electrode due to
      oxidation products remaining on the surface and the requirement that the working
      electrode potential remain below about 1.1 V relative to Ag/AgCl in order to
      prevent undesirable secondary electrochemical oxidations. The VPR method monitors
      the potential of the working electrode relative to a suitable reference and
      changes system polarity when the upper potential set limit is reached. Thus, what
      was the working electrode becomes the counter electrode and vice versa. Since
      urea oxidation products are desorbed from the counter electrode when its
      potential drops below about -0.6 V relative to Ag/AgCl, alternating electrode
      functions between working and counter provides cyclic electrode regeneration and
      continuous urea oxidation. VPR is believed to optimize constant current control
      for any electrochemical system that exhibits behavior similar to direct
      electrochemical urea oxidation.

PMID- 1748452
TI  - Nursing for nursing's sake.

PMID- 1748453
TI  - Kitt Mayo. Interview by Marcy White.

PMID- 1748454
TI  - I dare you.

PMID- 1748455
TI  - Patients' rights and DNR decisions.

PMID- 1748456
TI  - Current bills pending.

PMID- 1748457
TI  - What's holding back the nurse practitioner movement.

PMID- 1748458
TI  - Impaired nursing practice: evolution of a professional issue.

PMID- 1748459
TI  - I found a tumour in my fellow student.

PMID- 1748460
TI  - Conquering the challenge of student chemical dependence.

PMID- 1748461
TI  - Collegial support for the addicted nurse.

PMID- 1748462
TI  - Tennessee Nurses' Peer Assistance Program.

PMID- 1748464
TI  - "Why I chose nursing as a career".

PMID- 1748463
TI  - Ethical issues related to chemical dependency.

PMID- 1748465
TI  - "Why I chose nursing as a career".

PMID- 1748466
TI  - The new nurse on the block.

PMID- 1748467
TI  - How to stay sane as a student of nursing.
AB  - Student nurses experience both developmental and situational stress. While many
      of these stressors cannot be removed the level of stress experienced is dependent
      on perception and coping. Feelings of anxiety and stress can be decreased by a
      student's choice to become actively involved in stress-reduction techniques. This
      frees the student to experience the excitement and challenge of learning and the
      joy of helping people.

PMID- 1748468
TI  - Conservation of a polyanion binding site in mammalian and avian CD4.
AB  - A polyanion binding site was identified recently on human CD4 which is distinct
      from the human immunodeficiency virus (HIV)-gp120 binding region but which
      incorporates the first two immunoglobulin (Ig)-like domains of the molecule. To
      determine if this site is conserved in other species, several polyanions that
      blocked monoclonal antibody (mAb) binding to human CD4 were examined for their
      ability to inhibit the binding of mAb to mouse, rat, pig, sheep and chicken CD4.
      It was found that aurintricarboxylic acid (ATA) was a particularly effective
      inhibitor, blocking mAb binding to human, mouse, pig, sheep and rat CD4 by
      greater than 90% and to chicken CD4 by 80-90%. The polyanions dextran sulphate
      (DxS), polyvinyl sulphate (PVS) and polyanethole sulphonate (PAS) were also
      effective inhibitors of anti-CD4 mAb binding in most species, although there were
      clear species differences in the effects obtained. The polyanions did not inhibit
      mAb binding to a variety of other cell-surface antigens in the different species,
      with the exception of sheep CD8, suggesting that the inhibitory effects observed
      were essentially CD4 specific. Collectively these data indicate that a polyanion
      binding site is conserved in mammalian and avian CD4. Comparison of the amino
      acid sequences of human, mouse and rat CD4 revealed that basic residues in human
      CD4 which could participate in a polyanion binding site are conserved in mouse
      and rat CD4. It is proposed that this conserved polyanion binding site of CD4
      interacts with a sulphated glycosaminoglycan chain which is associated with class
      II major histocompatibility complex (MHC) molecules containing recently processed
      antigen.

PMID- 1748469
TI  - Long-term maintenance of localized antibody responses in the lung.
AB  - Immune memory cells for antibody production in the lung respond to antigen
      challenges, providing an important pulmonary defence. However, studies reported
      here suggested that long-term antibody production in the lung might also be
      important in pulmonary immune memory. After localized lung immunization and
      challenges, antibody production of specific IgG and IgA continued in the
      immunized lung lobes of dogs for months after the last antigen exposure. In
      addition, the evaluation of lung immunity in dogs immunized and challenged 3
      years or 5 years previously (without additional antigen challenge) showed
      significantly higher levels of specific antibody in lavage fluid from the lung
      lobe exposed to antigen than in lavage fluids from control lung lobes. Cells from
      blood or from control lung lobes did not produce significant levels of specific
      antibody in vitro, whereas cells lavaged from the immunized lung lobes were
      producing specific antibody. Therefore, long-term antibody production by cells in
      lung lobes exposed to antigen probably contributed to antibody levels in serum
      and unexposed lung lobes. Traditionally, lymphoid tissues are believed to be
      responsible for long-term antibody production. However, antibody production in
      the lung for years without repeated antigen exposure suggested that other tissues
      might also be important in long-term antibody production. Maintenance of
      localized antibody production in the lung would be an important pulmonary defence
      against infectious agents, but might also play a key role in hypersensitivity
      lung diseases.

PMID- 1748470
TI  - Carrier-induced suppression of the antibody response to a 'self' hapten.
AB  - Immunization of male rats and monkeys with gonadotropin-releasing hormone (GnRH)
      conjugated to a carrier results in a dramatic atrophy of the prostate. GnRH,
      linked to either diphtheria toxoid or tetanus toxoid as carrier, is now being
      evaluated for its use in the immunotherapy of hormone-dependent prostate
      enlargement in men. This report deals with the phenomenon of carrier-induced,
      epitope-specific regulation in the GnRH-carrier system. In experiments designed
      to assess the influence of the carrier on antibody responses to the 'self' hapten
      GnRH, we show that preimmunization with carriers diphtheria toxoid and tetanus
      toxoid results in a strain-dependent inhibition of anti-GnRH responses in mice.
      Results of adoptive transfer experiments indicate that T cells from carrier
      presensitized mice are responsible for suppression of anti-haptenic antibodies
      and that T cells from conjugate-immunized mice, on the other hand, can actually
      help overcome hyporesponsiveness.

PMID- 1748471
TI  - Influence of cytokines and cellular interactions on the glucocorticoid-induced Ig
      (E, G, A, M) synthesis of peripheral blood mononuclear cells.
AB  - We studied the mechanisms of action leading to the glucocorticoid (GC)-induced
      synthesis of the immunoglobulins (IgE, G, A, M) by human peripheral blood
      mononuclear cells (PBMC). It is shown that the enhanced Ig synthesis of GC
      stimulated PBMC is dependent on the presence of T cells and monocytes. After
      stimulation of purified B cells with GC only a slight enhancement of IgM could be
      detected. Inhibition studies with neutralizing anti-interleukin-4 (IL-4) and anti
      IL-6 antibodies revealed that the GC-induced IgE synthesis of PBMC is not
      dependent on the presence of IL-4 or IL-6. Stimulation of membrane-separated and
      co-cultured cell fractions revealed that the GC-induced enhancement of IgA and
      IgM synthesis is mediated by T-cell derived soluble mediators. The GC-induced IgG
      and IgE synthesis is dependent upon contact of B cells with monocytes. Antibodies
      against LFA-1 and ICAM-1 are capable to suppress the GC-induced IgE and IgG
      synthesis of PBMC. Furthermore, the monocyte expression of lymphocyte function
      antigen-1 (LFA-1), intercellular adhesion molecule-1 (ICAM-1) and HLA-DR is
      modulated by GC stimulation.

PMID- 1748472
TI  - Three monoclonal antibodies identifying antigens on all equine T lymphocytes, and
      two mutually exclusive T-lymphocyte subsets.
AB  - The aim of this study was to produce monoclonal antibodies (mAb) recognizing
      equine lymphocyte surface antigens. Fusions were conducted using BALB/c mice
      hyperimmunized with equine thymocytes. Hybridoma supernatants were screened by
      flow cytometry and positive hybridomas were cloned twice by limiting dilution.
      These mAb were then characterized for tissue distribution by immunohistology and
      flow cytometry, and by precipitation and analysis of the lymphocyte antigens
      which they recognized. Three mAb (CVS5, CVS4 and CVS8) are described which
      recognize only T lymphocytes in peripheral blood. Two-colour immunofluorescent
      studies showed that CVS5 recognized all T lymphocytes and that CVS4 and CVS8
      recognized two mutually exclusive subsets of CVS5-positive cells. In the thymus
      there was a large population of CVS4/CVS8 double-positive cells.
      Immunohistochemical staining with these mAb was restricted to T-lymphocyte areas.
      CVS4 and CVS5 precipitated molecules of 58,000 and 69,000 MW, respectively, in
      both reducing and non-reducing conditions. CVS8 precipitated two molecules of
      32,000 and 39,000 MW in reducing conditions, and one molecule of 69,000 MW in non
      reducing conditions. This evidence suggests that CVS5, CVS4 and CVS8 recognize
      the equine homologues of CD5, CD4 and CD8, and that the characteristics of these
      antigens are similar to those of other species.

PMID- 1748473
TI  - Proliferation of an athymic mouse-derived T-cell clone on thymic stromal cells
      with interleukin-2.
AB  - An athymic mouse-derived CD4+8+ T-cell clone, N-9F, was established. It expresses
      both full length gamma and delta T-cell receptor (TcR) mRNA. N-9F clone was not
      maintained by interleukin-2 (IL-2) alone but required another soluble
      mediator(s), contained in concanavalin A-stimulated splenocyte culture
      supernatant, for its proliferation. By culturing N-9F on thymic stromal cells,
      [3H]thymidine incorporation was retained and expression of IL-2 receptor (IL-2R)
      was induced. This phenomenon was also observed on thymic stromal cells from H-2
      allogeneic mice, but not on other cell types such as splenic adherent cells or
      fibroblasts. After addition of recombinant IL-2 into the N-9F culture with thymic
      stromal cells, N-9F showed enhanced IL-2R expression and greatly proliferated.
      The inability to detect any soluble factors in thymic stromal cell culture
      supernatant suggests that this interaction is mediated by direct cell contact
      between T and thymic stromal cells. Because a CD2-negative subclone, N-9.23, also
      proliferated on thymic stromal cells, there might exist a type of molecule other
      than CD2/LFA3 or TcR/MHC involved with thymic stroma and T-lymphocyte
      interaction.

PMID- 1748474
TI  - The role of interferon alpha/beta in the induction of intestinal pathology in
      mice.
AB  - We have investigated the role of interferon-alpha/beta (IFN-alpha/beta) and IFN
      dependent effector cells in causing enteropathy in mice. The IFN-inducer
      polyinosinic:polycytydylic acid (poly I:C) augmented the natural killer (NK) cell
      activation normally seen in neonatal (CBA x BALB/c)F1 mice with graft-versus-host
      reaction (GVHR) and exacerbated the systemic and intestinal consequences of GVHR.
      Poly I:C itself produced a similar pattern of intestinal pathology when
      administered to normal mice. The effects of poly I:C on NK cell activity and
      intestinal architecture in normal mice could be reproduced by a single injection
      of purified IFN-alpha/beta and the intestinal lesions caused by IFN-alpha/beta
      were prevented by in vivo depletion of NK cells with anti-asialo GM1. These
      results indicate that IFN-alpha/beta may play an important role in
      immunologically mediated enteropathies by virtue of its ability to activate NK
      cells.

PMID- 1748475
TI  - IL-1, IL-2 and IFN-gamma production by Theiler's virus-induced encephalomyelitic
      SJL/J mice.
AB  - Interleukins have been postulated to exert an important modulatory and recruiting
      role in the Theiler's murine encephalomyelitis virus (TMEV)-induced demyelination
      of the central nervous system (CNS) in SJL/J mice. Using bio- and
      radioimmunoassays, we have detected and quantified some of the interleukins
      suspected to play a role in this immune-mediated process. The interleukins 1 and
      2 (IL-1, IL-2) and interferon-gamma (IFN-gamma) have been measured in homogenates
      from the CNS and sera from infected animals, as well as in supernatants from
      antigen-specific in vitro-stimulated spleen and meningeal cells. IL-1 was
      detected both in CNS tissue homogenates (approximately 20-40 fmol/ml) and in
      splenic cultures (200 U/ml). IL-2 was detected only after TMEV-specific antigenic
      stimulation in spleen cultures (approximately 120 U/ml). In vitro, IL-2 and IL-1
      synthesis appear in a dose- and time-dependent manner. IFN-gamma could not be
      found in any case. The precise nature of IL-1 and IL-2 activity was further
      assessed by HPLC. The above results strongly indicate the presence of
      functionally active macrophages in the CNS infiltrates of cells triggering this
      autoaggressive immune process. In addition, we propose a central role for IL-1 in
      augmenting the intracerebral immune response leading to the inflammatory
      demyelination induced by TMEV.

PMID- 1748476
TI  - Anti-TNF monoclonal antibodies prevent haemorrhage-induced suppression of Kupffer
      cell antigen presentation and MHC class II antigen expression.
AB  - Kupffer cells (KC), by virtue of their ability to present antigen (AP) and
      express major histocompatibility complex (MHC) class II antigen (Ia), play a
      pivotal role in the host defence system against invading micro-organisms.
      Although haemorrhagic shock depresses the above KC functions, it is not known
      whether increased KC tumour necrosis factor (TNF) production and elevated TNF
      plasma levels following haemorrhage are responsible for it. To study this,
      C3H/HeN mice were pretreated intraperitoneally with either anti-murine TNF
      antibody (anti-TNF Ab) or saline. Twenty hours later mice were bled and
      maintained at a mean blood pressure of 35 mmHg for 60 min followed by adequate
      fluid resuscitation. Two and 24 hr later, plasma was collected and KC were
      isolated. AP was measured by co-culturing KC with the D10.G4.1 Th cell clone. Ia
      expression was determined by direct immunofluorescence. Interleukin (IL)-1, IL-6
      and TNF levels in KC supernatants and plasma were measured with bioassays or
      ELISA. Haemorrhage increased circulating TNF levels by 215% at 2 hr and by 76% at
      24 hr (P less than 0.05), which was prevented by pretreatment with anti-TNF Ab.
      Haemorrhage-induced increase of circulating IL-6 was abolished (P less than 0.05)
      at 2 hr but not at 24 hr in the anti-TNF Ab group. The suppression of KC AP (P
      less than 0.05) and Ia expression (P less than 0.05) due to haemorrhage was
      attenuated (P less than 0.05) in anti-TNF Ab-treated mice at 2 and 24 hr and KC
      IL-1 and TNF synthesis was further (P less than 0.01) increased. These results
      indicate that TNF plays a critical role in the initiation and regulation of KC
      AP, Ia expression, and cytokine production following haemorrhage.

PMID- 1748477
TI  - Tumour necrosis factor-alpha decreases expression of the intestinal IgG Fc
      binding site by HT29-N2 cells.
AB  - Previously, we describe a unique binding site for the Fc region of IgG in human
      intestinal goblet cells, but regulation of the intestinal IgG Fc binding site (Fc
      gamma IBS) has not been clarified. In this work, we examined the effects of
      tumour necrosis-alpha (TNF-alpha) and interferon gamma (IFN-gamma) on expression
      of the Fc gamma IBS in HT29-N2 colonic cancer cells, which differentiate readily
      into goblet cells containing the binding site when grown in galactose-containing
      medium. Expression of the site was monitored immunocytochemically and by ELISA on
      homogenates of the cells. TNF-alpha in doses of 0.1-100 ng/ml caused a reduction
      in expression of the Fc gamma IBS and the proportion of cells positive for mucin
      (as demonstrated by Alcian blue stain), without affecting the viability of the
      cells. The effects of TNF-alpha on the FC gamma IBS and mucin production could
      not be attributed to a decreased proliferative rate of the cells, as the cells'
      incorporation of 5-bromo-2'-deoxyuridine was unaffected. By contrast with TNF
      alpha, IFN-gamma (i) did not affect the proportion of cells expressing the Fc
      gamma IBS, (ii) decreased the viability of the cells, and (iii) increased cell
      proliferation. Additional evidence of specificity of the TNF-alpha effect on the
      Fc gamma IBS was that TNF-alpha did not affect expression of the polymeric
      immunoglobulin receptor (secretory component), whereas IFN-gamma increased it. We
      conclude that TNF-alpha may suppress expression of the Fc gamma IBS by
      colonocytes and oppose differentiation of the cells towards mucin-producing
      cells.

PMID- 1748478
TI  - TNF-alpha reverses the disease-exacerbating effect of subcutaneous immunization
      against murine cutaneous leishmaniasis.
AB  - Earlier studies have demonstrated that mice injected subcutaneously or
      intramuscularly with leishmanial antigens develop significantly exacerbated
      disease compared with unimmunized controls when challenged with the cutaneous
      protozoan parasites Leishmania major. We report here that this disease
      enhancement can be prevented, and protective immunity induced, by the
      incorporation of recombinant tumour necrosis factor (TNF-alpha) in the immunizing
      inoculum. This effect of TNF-alpha is dose-dependent and is not evident when TNF
      alpha and the antigens are injected into separate sites. Furthermore, TNF-alpha
      injected together with p183, a peptide known to preferentially stimulate Th2
      cells and disease exacerbation in H-2d mice, activates spleen and lymph node
      cells secreting more interferon-gamma (IFN-gamma) and less interleukin-4 (IL-4)
      and induces a modest but significant degree of resistance against L. major
      infection in highly susceptible BALB/c mice.

PMID- 1748479
TI  - The role of the macrophage in induction of immunosuppression in Trypanosoma
      congolense-infected cattle.
AB  - Impairment of T-cell function in Boran (Bos indicus) cattle during primary
      infection with Trypanosoma congolense ILNat 3.1 was found to occur in peripheral
      blood, spleen and, in particular, the lymph nodes. Lymph node cells from infected
      cattle failed to proliferate in response to mitogenic stimulus and suppressed
      proliferation of both normal peripheral blood mononuclear cells and lymph node
      cells in co-culture assays. The addition of indomethacin, to inhibit
      prostaglandin synthesis, had no effect on the ability of lymph node cells from
      infected cattle to suppress the proliferative response of responder cells from
      uninfected cattle. The supplementation of the culture media with catalase, which
      degrades hydrogen peroxide, either alone or in combination with indomethacin,
      also did not result in restoration of proliferation. This suggested the presence
      of suppressor cells in lymph nodes of infected cattle which exert their effects
      via a prostaglandin-independent mechanism. By depleting lymph node cells from
      infected cattle of the monocyte-macrophage population using a cell sorter it was
      possible to abrogate the previously observed immunosuppression, thus indicating a
      key role for these macrophages in the induction of trypanosome-associated
      immunosuppression.

PMID- 1748480
TI  - Trypanosoma cruzi induces suppression of DNA synthesis and inhibits expression of
      interleukin-2 receptors by stimulated human B lymphocytes.
AB  - Trypanosoma cruzi, the causative agent of Chagas' disease, suppresses immune
      responses during the acute phase and has been shown to induce multiple cellular
      alterations in activated human T lymphocytes. However, no information is
      available regarding the effects of this parasite on human B cells. Using an in
      vitro culture system, in which purified T. cruzi are co-cultured with either
      peripheral blood mononuclear cells (PBMC) or B-cell-enriched preparations (BCE),
      we studied whether the organism can induce alterations in DNA synthesis after
      stimulation with Pansorbin (PS). This response was markedly reduced by the
      parasite at both suboptimal and optimal PS concentrations, and the extent of the
      inhibition was augmented as the parasite concentration was increased. Maximal
      reduction in DNA synthesis was observed when the trypanosomes were incorporated
      into the cultures at 0 time (i.e. together with PS); the effect was of a much
      lesser magnitude and undetectable when the parasites were added at 24 and 48 hr,
      respectively. These results imply that T. cruzi affects a relatively early event
      during B-cell stimulation. This inference was confirmed by the finding that the
      proportion of PS-stimulated B cells expressing interleukin-2 (IL-2) receptors was
      significantly reduced when the parasite was present in the culture. Addition of
      recombinant human IL-2 did not restore B-cell responsiveness to normal levels.
      Suppressed B-cell responses were also observed when T. cruzi was separated from
      the PBMC or the BCE by a cell-impermeable filter, indicating that a soluble
      factor(s) released by the organism mediated the effect. Accordingly, supernatants
      of T. cruzi suspensions were found to be suppressive. These results demonstrate
      for the first time that T. cruzi can affect human B-cell responses and that the
      mechanism involves inhibition of IL-2 receptor expression.

PMID- 1748481
TI  - Lack of IgG4 antibody response to carbohydrate antigens in patients with
      lymphatic filariasis.
AB  - It has been suggested that humans are genetically restricted from making IgG4
      antibody responses to carbohydrate antigens. To test this hypothesis we examined
      sera from 35 patients with bancroftian filariasis (an infection known to induce
      very high levels of IgG4 antibodies to the parasite and known to be associated
      with repeated streptococcal infections) as well as from 15 normal individuals for
      their IgG and IgG subclass responses to streptococcal protein [streptolysin-O
      (SO), deoxyribonuclease B (DB)] and carbohydrate [group A carbohydrate (GAC)]
      antigens. Levels of IgG antibodies to all three antigens were found to be
      significantly higher in the filariasis patients compared to normals (P less than
      0.01), and the subclass composition of these antibodies proved heterogenous.
      Although responses to all three antigens included IgG1, IgG2 and IgG3 antibodies
      and although IgG4 responses to the proteins SO and DB were significantly higher
      in the filariasis patients than in normals (P less than 0.001), more importantly
      there were no detectable anti-GAC IgG4 antibodies in either study group. These
      observations, coupled with our earlier finding of the absence of IgG4 responses
      to phosphocholine (PC) in patients with lymphatic filariasis, suggest that even
      the chronic antigenic stimulation of filarial helminth infection, which leads to
      very prominent IgG4 responses to protein antigens, cannot overcome the genetic
      restriction in humans for making IgG4 antibodies to carbohydrate antigens,
      whether of parasite or non-parasite origin.

PMID- 1748482
TI  - Effect of probenecid on phagocytosis and intracellular killing of Staphylococcus
      aureus and Escherichia coli by human monocytes and granulocytes.
AB  - The present study concerns the effects of probenecid on the phagocytosis and
      intracellular killing of Staphylococcus aureus and Escherichia coli by human
      monocytes and granulocytes. In both monocytes and granulocytes the inhibitory
      effect on phagocytosis was very small. Inhibition of intracellular killing of S.
      aureus by monocytes and granulocytes by probenecid was concentration dependent,
      being half-maximal at about 2 mM probenecid, and near-maximal at about 5 mM
      probenecid. The intracellular killing could also be inhibited when probenecid was
      added when this process was already started. Probenecid also inhibited the
      intracellular killing of E. coli by granulocytes, but not by monocytes. In the
      concentration range used, probenecid had no toxic effect on phagocytes or
      bacteria during the 2 hr of the experiments.

PMID- 1748483
TI  - Involvement in lupus disease of idiotypes Id.F-423 and Id.IV-228 defined,
      respectively, upon foetal and adult MRL/Mp-lpr/lpr DNA-binding monoclonal
      autoantibodies.
AB  - The derivation of a monoclonal IgG3K autoantibody, designated F-423, from a
      foetal MRL/Mp-lpr/lpr mouse is described. It has immunochemical properties
      similar to DNA-binding monoclonal antibodies derived from adult mice with lupus
      disease in that it reacts with single-stranded DNA and, to a lesser extent, with
      double-stranded DNA and some forms of RNA. Its similarities to antibodies from
      adults extend further: it carries a public idiotype, Id.F-423, that can also be
      detected on antibodies from adult MRL and (NZB x NZW)F1 mice, and F-423 itself
      expresses other idiotypes defined originally on antibodies from adult lupus mice
      of both strains. Its potential involvement in pathological processes is
      demonstrated by two observations: (i) immunization of young MRL/Mp-+/+ mice with
      antibody F-423 induced the nephritic and immunological changes associated with
      systemic lupus erythematosus; and (ii) heterologous rabbit anti-Id.F-423 anti
      idiotypic antibodies suppressed the progression of lupus disease in adult MRL/Mp
      lpr/lpr mice. Similar effects were found with monoclonal antibody IV-228, an
      antibody derived from an adult MRL mouse and previously known to be directly
      nephrotoxic, and with anti-Id.IV-228 antibodies. It is concluded that even during
      foetal life mice of lupus-prone strains have lymphocytes capable of making
      pathogenic autoantibodies long before symptoms of lupus disease appear.

PMID- 1748484
TI  - Prevention of experimental autoimmune uveoretinitis and experimental autoimmune
      pinealitis in (Lewis x Brown-Norway) F1 rats by HgCl2 injections.
AB  - Mercuric chloride (HgCl2) induces in Brown-Norway (BN) and (Lewis x Brown-Norway)
      F1 hybrid rats a transient autoimmune disease characterized by the production of
      various antibodies to self and non-self antigens and by a dramatic increase of
      serum IgE. Experimental autoimmune uveoretinitis (EAU) can be induced in Lewis
      (LEW) and (LEW x BN) F1 hybrid rats by a single immunization with retinal S
      antigen (S-Ag). Besides uveoretinitis, animals immunized with S-Ag develop an
      autoimmune pinealitis (EAP). We demonstrate in this study that (LEW x BN) F1
      hybrid rats, injected with HgCl2 7 days before S-Ag immunization, are quite
      efficiently protected against EAU and EAP. We also show that HgCl2-induced
      protection is neither due to a cytotoxic effect of HgCl2 nor to CD8+ T-cell
      dependent mechanisms nor to the HgCl2-induced increase of serum IgE
      concentration. The role of other hypothetical mechanisms, such as anti-S-Ag anti
      idiotypic antibodies and/or HgCl2-induced unbalance between T-helper cell
      subsets, is discussed.

PMID- 1748485
TI  - Effect of advanced ageing on the ability of mice to cause tumour regression in
      response to immunotherapy.
AB  - The effect of ageing on tumour immunotherapy was investigated by comparing the
      ability of aged mice (20 months old) and young mice (3 months old) to cause
      regression of an established SA1 sarcoma in response to parenteral injection of
      endotoxin, or to sublethal, whole-body exposure to ionizing radiation. It was
      found that whereas treatment with either of these agents caused T-cell-dependent
      regression of the tumour in young mice, it failed to cause regression of the
      tumour in aged mice. The results are in keeping with extensive literature showing
      that ageing is associated with a decline in immune competence.

PMID- 1748486
TI  - Structure function analysis of the H-2 Abp gene.
AB  - The gene encoding the H-2 Ap class II beta chain was isolated from a B10.P
      genomic library and sequenced. This gene was also used to construct transfectants
      of the CH12 lymphoma clone CH12.LX, which express the Abp gene product in
      association with the endogenous A alpha k chain. We present here the first report
      of the complete nucleotide coding sequence of Abp. The predicted amino acid
      sequence of Abp reveals only five residues different from Abq, four of which are
      present in the mature peptide. These four amino acid changes could account for
      the differential susceptibility of H-2q vs H-2p mice to the development of
      collagen-induced arthritis (CIA). Antibodies specific for the transfected Abp
      protein induce CH12.LX cells to secrete immunoglobulin in the presence of
      antigen. Comparison of the amino acid sequence with other A beta chains that have
      been tested in signal transduction experiments suggests that amino acid 9 may be
      important to the signaling ability of class II A molecules.

PMID- 1748487
TI  - Structure and expression of mouse germline immunoglobulin gamma 3 heavy chain
      transcripts induced by the mitogen lipopolysaccharide.
AB  - Germline immunoglobulin heavy chain gene transcription is though to direct
      isotype switching by modulating the accessibility of specific switch regions to a
      recombinase. In this study, cloned cDNA copies of mouse germline Igh-8 RNAs have
      been used to characterize the Igh-8 transcription unit. The 5' end of these
      transcripts are derived from an exon denoted Ig3, located 1 kilobase 5' of the
      Igh-8 switch region. Sequence analysis of cDNA and genomic clones reveals that
      these RNAs are noncoding. In splenic B cell cultures treated with
      lipopolysaccharide (LPS), germline Igh-8 transcript levels are upregulated after
      8 h due to increased transcription. This induction is consistent with the
      identification of a putative binding site for the LPS inducible transcription
      factor NF-kappa B approximately 150 nucleotides upstream of the sites of
      transcript initiation. Furthermore, nucleotide sequence comparisons reveal that
      the region encompassing the site of germline Igh-8 transcription initiation is
      highly homologous to part of the Ig2b exon, and is also conserved upstream of the
      Igh-1 switch region. The implications of these findings for the control of
      germline Igh-8 transcription is discussed.

PMID- 1748489
TI  - Rapid HLA-DPB typing using enzymatically amplified DNA and nonradioactive
      sequence-specific oligonucleotide probes.

PMID- 1748488
TI  - Heterogeneity in HLA-DR2-related DR,DQ haplotypes in eight populations of Asia
      Oceania.
AB  - The relative distributions of 480 DR2-related DR,DQ haplotypes have been
      determined in Australian Aborigines, Papua New Guinean Highlanders, coastal
      Melanesians, Micronesians, Polynesians, Javanese, and Southern and Northern
      Chinese. Using sequence-specific oligonucleotides (SSOs) for hybridization of
      polymerase chain reaction (PCR) products from DRB1, DRB5, DQA1, and DQB1 genes,
      15 different DR2-related haplotypes were identified. The predominant DR2
      haplotype in Oceania involved a novel combination of DRB1*1502, DRB5*0101
      alleles; this haplotype occurred sporadically in Java, but not in China. In
      Southern China, the most frequent DR2 haplotype involved the unusual arrangement
      DRB1*1602,DRB5*0101; alternatively, DRB1*1602 was associated with a new DRB5 SSO
      pattern. This study has important implications for molecular HLA-typing protocols
      that assume particular DRB1, DRB5 or DR,DQ linkage relationships. Further, the
      novel DRB1, DRB5 haplotype in Oceania suggests that the mixed lymphocyte culture
      (MLC) determinants Dw2 and Dw12 are discriminated by codon 86 at the DRB1 locus.

PMID- 1748490
TI  - Pancreatobiliary ductal union in chronic pancreatitis: is the PBDU really guilty?

PMID- 1748491
TI  - Significance of vasculitis in gut tuberculosis.

PMID- 1748492
TI  - Role of vasculitis in the natural history of abdominal tuberculosis--evaluation
      by mesenteric angiography.
AB  - To investigate the possible role of vascular changes in the pathogenesis of
      tubercular lesions of the abdomen, findings on barium studies of the bowel and
      superior mesenteric angiography in 20 patients with abdominal tuberculosis were
      correlated. Barium studies showed peritoneal lesions in seven patients, isolated
      intestinal lesions in seven and combined lesions in six. Angiograms were abnormal
      in all the patients and showed encasement of arteries (13 patients), stretching
      and crowding of vessels (13), occlusion of vasa recta (5) and hypervascularity
      (6). All the 13 patients with peritoneal lesions showed arterial stretching,
      crowding and encasement. Five of six patients with strictures had occlusion of
      vasa recta. Of seven patients with ulcerations, six had hypervascularity. Our
      observations suggest that vascular changes occur frequently in abdominal
      tuberculosis and may explain some pathological and clinical manifestations of
      this disease. Ulcerated and hypervascular lesions occur in the active and early
      stages of the disease, and occlusive lesions are associated with healing and
      'ischemic' bowel strictures.

PMID- 1748493
TI  - Upper gastrointestinal mucosal lesions in chronic renal failure.
AB  - The upper gastrointestinal mucosa was studied endoscopically in 182 patients (140
      males, 42 females) with chronic renal failure prior to hemodialysis. Endoscopy
      revealed normal mucosa in 77 patients (42.3%), inflammatory mucosal lesions in 88
      (48.4%), peptic ulcer in 16 (8.8%; duodenal 15, gastric 1) and Barrett's ulcer in
      one patient. Upper gastrointestinal bleeding was noted at presentation in 16
      (8.8%) cases and was associated with erosive gastritis, duodenitis and duodenal
      ulcer in 11, 3 and 2 patients respectively. Thus patients with chronic renal
      failure had a high prevalence of inflammatory mucosal changes.

PMID- 1748494
TI  - Use of esophagostomy in the management of corrosive esophageal strictures.
AB  - Thirty six cases of corrosive esophageal strictures seen over a period of ten
      years are presented. The primary treatment modalities followed include antegrade
      dilatation per oral (11 cases), retrograde followed by antegrade dilatation with
      endless string per oral (12), retrograde followed by antegrade dilatation with
      endless string through esophagostomy (12), and surgery (1). Per oral dilatation
      with endless string was not well tolerated by 15 patients due to friction of the
      string against the posterior 1/3rd of the tongue, and hence compliance was poor.
      Dilatation through esophagostomy was easy, and patient compliance was good.
      Furthermore, patients could be trained to do self bougienage easily through the
      esophagostomy. Esophagostomy closed within 4-6 weeks after successful distal
      dilatation was achieved.

PMID- 1748495
TI  - Misoprostol in the treatment of NSAID-induced gastroduodenal lesions.
AB  - The cytoprotective effect of misoprostol co-administered with non-steroidal anti
      inflammatory drugs (NSAIDs) was assessed in a double blind, placebo controlled
      study. Thirty-seven patients with rheumatoid arthritis receiving NSAIDs, having
      upper gastrointestinal symptoms and endoscopically confirmed gastric and/or
      duodenal lesions, were randomised to receive either misoprostol 200 micrograms or
      placebo tablets twice daily for 4 weeks. Of 31 evaluable cases, 13 of 16 (81%)
      patients receiving misoprostol showed endoscopic improvement as compared to 10 of
      15 (67%) receiving placebo (P:NS). A significant decrease in mean (+/- SEM)
      mucosal lesion score was observed with misoprostol (from 3.38 +/- 0.32 to 1.32 +/
      0.44; P less than 0.001) but no change was seen with placebo (from 2.80 +/- 0.42
      to 1.60 +/- 0.53; P:NS). Symptomatic relief was similar in both groups, being 44%
      and 40% respectively. Two patients complained of diarrhea in each group and one
      developed menorrhagia with misoprostol. It is concluded that though misoprostol
      decreased the number of NSAID-induced mucosal lesions, it was unable to relieve
      gastrointestinal symptoms.

PMID- 1748496
TI  - Hepatobiliary and pancreatic ascariasis.

PMID- 1748497
TI  - Liver transplantation in India: can we afford it now?

PMID- 1748498
TI  - Liver transplantation in India--are we ready?

PMID- 1748499
TI  - Thrombotic obstruction of inferior vena cava treated with streptokinase infusion
      and balloon dilatation.
AB  - A 35 year old male with thrombotic obstruction of the inferior vena cava
      superimposed on a membrane was treated by prolonged (48 hours) infusion of
      streptokinase followed by balloon membranotomy. The procedure produced excellent
      clinical, hemodynamic and angiographic results which are sustained at the end of
      six months.

PMID- 1748500
TI  - Giant cavernous hemangioma of liver.
AB  - An abscess forming in a giant cavernous hemangioma of the left lobe of the liver
      is reported. It was treated by lateral segmentectomy.

PMID- 1748501
TI  - Pancreatic cystadenoma associated with von Recklinghausen's disease.

PMID- 1748502
TI  - Epiphrenic diverticulum of the esophagus.
AB  - Esophageal diverticula are rarely found at the terminal portion, where they are
      called supradiaphragmatic or epiphrenic diverticula and occur in association with
      motility disorders of the terminal esophagus. We present here two cases of
      epiphrenic esophageal diverticulum, one of which was treated surgically.

PMID- 1748503
TI  - Prevalence of HBV markers in hemophiliacs and eunuchs in India.

PMID- 1748504
TI  - Intestinal malrotation in adults.

PMID- 1748505
TI  - Scoring system for portal hypertension.

PMID- 1748506
TI  - Poliomyelitis in India.

PMID- 1748507
TI  - Adverse events following immunization: 1990.
AB  - The vaccines used under the Immunization Programme are safe and effective.
      However, as no vaccine is 100% effective, none is entirely without risk. The
      benefits of immunization greatly exceed the risks because of the large number of
      complications and deaths prevented. Although, the risks of vaccine-associated
      adverse events are extremely low, the occurrence of such events in areas with
      high immunization coverage levels and low incidence of vaccine preventable
      diseases can influence public acceptance of immunization services. Moreover,
      since infections and neurological syndromes are common in the age-groups in which
      immunizations are given and there are a number of contacts with an infant under
      the programme, there is a risk of temporally-related severe adverse medical
      events being attributed to immunization. Monitoring of adverse events is
      essential to document low risks and to identify programmatic errors, if any, for
      corrective action. An important, aim of the monitoring system is to disseminate
      such information to the medical professionals and others associated with the
      immunization programme. The paper summarizes reports received in 1990, including
      reports of temporal events where the cause of death was other than immunization.

PMID- 1748508
TI  - Acute poliomyelitis in children: comparison of epidemiological and clinical
      features among immunized, partially immunized and unimmunized.
AB  - This study was conducted to compare the epidemiological and clinical features of
      acute poliomyelitis among immunized, partially immunized and unimmunized, as
      these have been postulated to be different amongst these subgroups. Of 614
      children with acute poliomyelitis admitted at the Institute of Child Health,
      Madras, 162 (26.4%) were immunized, 183 (29.8%) were partially immunized and 269
      (43.8%) were unimmunized. Poor environmental sanitation, unprotected water source
      and parental illiteracy were significantly more common among unimmunized group
      compared to the immunized group. It is concluded that there is no significant
      difference in symptoms, signs, clinical types, severity of paralysis and case
      fatality between the immunized, partially immunized and unimmunized.

PMID- 1748509
TI  - Epidemiology of poliomyelitis in a slum of Bombay.
AB  - A disease prevalence and immunization coverage survey in a typical slum in Bombay
      in the year 1988 revealed 93 children with residual poliomyelitis amongst 14,439
      children below 9 years of age, indicating high (33.0/100,000 population) annual
      incidence of poliomyelitis. Only 62 (66.6%) of these 93 lame children sought
      admission in hospital during the acute phase of illness. The high incidence was
      attributed to a low immunization (OPV) coverage level in the most vulnerable age
      group. The immunization coverage for 3 doses of oral polio vaccine below 2 years
      of age was 43.5%. A large number of children were not commencing their
      immunization schedule at the right age. The survey indicated a poor "community
      participation" in the immunization programmes due to a poor "health awareness".

PMID- 1748510
TI  - Poliomyelitis with special reference to immunization status.
AB  - One hundred ninety one children below 5 years of age suffering from poliomyelitis
      were analyzed to find out the immunization status and its correlation with the
      incidence of poliomyelitis. Effects of age, sex, immunization status and seasonal
      variation on the morbidity and mortality status were studied. The maximum number
      of cases were admitted during the months of July (23.6%) and August (23.1%). Of
      191 cases, 143 (74.9%) had no immunization and 48 (25.1%) were partially
      immunized. A total of 155 (81.2%) cases had spinal polio, 23 (12.01%) bulbo
      spinal polio, and 13 had (6.8%) bulbar polio. Serious illness (bulbospinal and
      bulbar type) was more in partially immunized children (25%) as compared to
      unimmunized children (16.8%). The mortality rate was more than two times higher
      in the partially immunized (29.6%) as compared to unimmunized children (11.2%).
      The possible explanation for high mortality in partially immunized children could
      be due to the adverse effect of OPV which has not been studied so far.

PMID- 1748511
TI  - Vaccine preventable diseases in eastern Maharashtra--a hospital based analysis.
AB  - A retrospective study of hospital admissions of six vaccine preventable diseases
      from 1982-86 was carried out to save as a baseline data for future evaluation of
      vaccination programmes. Children between 1-4 years predominated the admissions in
      all diseases except whooping cough. The frequency of admissions of tuberculosis
      showed no change. Measles showed classical cyclical trend. Male female ratio was
      1.8: 1.0. The mortality rate in meningeal tuberculosis was not influenced by the
      immunization status. Relatively small number of admissions of diphtheria and
      whooping cough indicates a decline due to natural causes or due to intervention
      programmes.

PMID- 1748512
TI  - Extent of occurrence of the six vaccine preventable diseases in
      vaccinated/unvaccinated children.
AB  - Sixty two children who were diagnosed to be suffering from any of the six vaccine
      preventable diseases were studied to know their vaccination status prior to the
      occurrence of these diseases. A total of 33.9% of these children had developed
      these diseases inspite of full immunization. Nearly 75% of immunized children had
      received the vaccine from Government sources. The break-up diseases among the
      children studied was tetanus (35.5%), poliomyelitis and pulmonary tuberculosis
      (22.6% each), measles (11.3%), diphtheria (6.4%) and pertussis (1.6%). The
      vaccinated children who developed poliomyelitis belonged to a relatively higher
      age group. Seventy one per cent of measles cases developed bronchopneumonia as a
      complication. Seventy five per cent of the mortality in the children studied was
      due to tetanus neonatorum. Since one third of the children studied had developed
      diseases inspite of full immunization, it is inferred that closer monitoring of
      the Cold Chain System and intensive surveillance at peripheral levels are
      required.

PMID- 1748513
TI  - Assessment of knowledge and skills about growth monitoring amongst child
      development project officers.
AB  - Knowledge and skills about growth monitoring (GM) amongst Child Development
      Project Officers (CDPOs) were assessed by interview technique. Majority (94%) of
      subjects had correct knowledge that GM helps in early detection of growth
      retardation while about 83% felt that a flattened growth curve indicates no
      weight gain. The percentages of CDPOs who were able to interpret and read
      correctly about what ascending descending and flattened growth curves indicate
      were 83, 71 and 50% respectively. There is thus a need of in-service training of
      CDPOs in GM activities.

PMID- 1748514
TI  - Lung puncture aspiration in the diagnosis of acute pneumonias.
AB  - The present study was carried out in 100 children of acute pneumonia to establish
      the diagnosis of etiologic agents. Clinico-radiological assessment and routine
      investigations including sputum, throat swab and blood culture did not help in
      identifying the offending micro-organisms. The bacteriological examination of
      lung puncture aspirate was the most satisfactory tool for the etiological
      diagnosis. Direct smear examination/culture were positive in 50% aspirates. On
      cytology, definite epithelioid granulomas indicated tuberculous infection.
      However, in direct smear/culture negative patients, predominant mononuclear cell
      infiltration in the aspirated material may indicate non-pyogenic infection.
      Staphylococcus aureus (22%) was the commonest organism causing pneumonia in the
      present study.

PMID- 1748515
TI  - Antilymphocyte and antithymocyte globulin.

PMID- 1748516
TI  - Toxic shock syndrome: an unforeseen complication following measles vaccination.

PMID- 1748517
TI  - Age for assessment of trivalent oral polio vaccination coverage: is there a need
      for revision in India.

PMID- 1748518
TI  - Hepatic hemangioendothelioma and neonatal hepatitis.

PMID- 1748519
TI  - Spondylo-epiphyseal dysplasia tarda with progressive arthropathy.

PMID- 1748520
TI  - Pattern of pediatric malignancies in Rajasthan.

PMID- 1748521
TI  - Cerebral cavernous angioma.

PMID- 1748522
TI  - Primary generalised lymphatic dysplasia.

PMID- 1748523
TI  - Knowledge of immunization practices in medical students.

PMID- 1748524
TI  - Cholecystitis with cholelithiasis in a male child.

PMID- 1748525
TI  - Management of malaria.

PMID- 1748526
TI  - Artificial organs--an overview.

PMID- 1748527
TI  - Peptidic uremic retention products.

PMID- 1748528
TI  - Uremic goiter: the malevolent iodide.

PMID- 1748529
TI  - Aluminum-citrate interaction in end-stage renal disease.
AB  - The influence of a sodium citrate/citric acid mixture on the gastrointestinal
      (GI) absorption of aluminum (Al) from an Al(OH)3 preparation was evaluated in six
      stable maintenance hemodialysis patients. Plasma Al concentrations were
      determined serially after each of the following treatment sequences (I) Al(OH)3;
      (II) Al(OH)3 + sodium citrate/citric acid; (III) sodium citrate/citric acid; (IV)
      Al(OH)3 + NaHCO3. AUC0-8 for plasma Al from 0 to 8 hours was significantly
      greater (p less than 0.05) for Al(OH)3 + sodium citrate/citric acid (73 +/- 23
      micrograms.hr/l; mean +/- SEM) than Al(OH)3 (16 +/- 30 micrograms.hr/l); sodium
      citrate/citric acid (-27 +/- 14 micrograms.hr/l); or Al(OH)3 + NaHCO3 (6 +/- 22
      micrograms.hr/l). The 24 hour Al level remained above baseline (p less than 0.03)
      following Al(OH)3 + sodium citrate/citric acid (31 +/- 12 (pre) vs 54 +/- 14
      micrograms/l (post), in contradistinction to study limb: l (34 +/- 14 vs 30 +/-
      12 micrograms/l); III (79 +/- 40 vs 65 +/- 35 micrograms/l); and IV (71 +/- 37 vs
      66 +/- 42 micrograms/l). We conclude that the GI absorption of Al from Al(OH)3 is
      enhanced by citrate in patients undergoing hemodialysis and that elevations of
      plasma Al persist longer. The concomitant administration of citrate and Al
      containing phosphate (PO4) binders should be avoided in patients with end-stage
      renal disease (ESRD). NaHCO3 may serve as an alternative therapy for metabolic
      acidosis with less risk of enhancing Al absorption.

PMID- 1748530
TI  - Fluid-shift during computer-modulated profile hemodialysis (CMP-HD).
AB  - Computer-modulated profile hemodialysis was examined for patients' comfort and
      fluid-shift. Fifteen patients were studied after two weeks of dialysis with each
      of the following profiles: A): constant ultrafiltration (UF) and dialysate sodium
      (138 mmol/l); B): decreasing UF; C): decreasing UF and decreasing high dialysate
      sodium (starting 10% above serum-sodium, with a gradual reduction to 138 mmol/l
      in the fourth hour). Patients with a calculated increase of intracellular volume
      (ICV) during dialysis had more complaints after dialysis than the others. ICV
      decreased in all patients with low serum-sodium (less than 136 mmol/l) during all
      profiles, whereas in patients with higher sodium, only profile C led to a
      decrease of ICV. However, interdialytic weight gain increased about 75% in
      patients with low serum-sodium under profile C. The sodium profile could help in
      preventing imbalance without side effects in patients with high sodium.

PMID- 1748531
TI  - Plasma exchange (PE) treatment in drug-induced toxic epidermal necrolysis (TEN).
AB  - Toxic epidermal necrolysis (TEN) or Lyell's syndrome is a rare fulminating skin
      disease notorious for its rapidly progressive course and high mortality rate. TEN
      is characterized by the sudden onset of epithelial necrosis of skin with
      frequently associated involvement of the gastrointestinal, genitourinary tract
      and bronchopulmonary linings. We describe the clinical course of five patients
      with severe drug-induced TEN, treated with PE. The suspected drugs were
      carbamazepine in one patient, paracetamol in one, a combination of paracetamol
      and mefenamic acid in one, allopurinol in one and ciprofloxacin in one. Three had
      a skin involvement affecting almost the entire surface of the body. In addition
      to the skin lesions, mouth, esophagus and lungs were also involved. Steroids
      proved ineffective. PE was carried out because of the rapid deterioration of the
      clinical picture. The mean number of PE sessions was 3.22 (range 1-5). Complete
      remission of the syndrome was achieved in four patients. One patient died due to
      septic shock. As so far there is no treatment of proven value for this condition,
      controlled trials should be set up in order to assess the value of PE in TEN.

PMID- 1748532
TI  - A randomized trial of plasmapheresis and subsequent pulse cyclophosphamide in
      severe lupus: design of the LPSG trial.
AB  - A group of clinics cooperating as the Lupus Plasmapheresis Study Group (LPSG) is
      starting an international multicenter study of the treatment of severe systemic
      lupus erythematosus. The primary goal of this randomized and prospective trial is
      to establish whether treatment with plasmapheresis and subsequent pulse
      cyclophosphamide improves the outcome compared to treatment with pulse
      cyclophosphamide alone. The underlying rationale assumes that plasmapheresis: a)
      eliminates pathogenic autoantibodies and immune complexes and b) induces a
      compensatory activation of pathogenic lymphocyte clones through a feed-back
      between circulating antibodies and their respective antibody-producing clones.
      Synchronization of plasmapheresis with subsequent pulse cyclophosphamide should
      enhance the deletion of pathogenic clones during the period of greatest
      vulnerability. This overview reviews the first results of treatment approaches
      based on this concept and summarizes the design of the LPSG trial.

PMID- 1748533
TI  - Calcification of chemically treated bovine pericardium.
AB  - One of the most important problems arising in cardiac bioprostheses made with
      bovine pericardium and, more generally, with biologically-derived tissues is
      tissue calcification. The present study assessed four chemical treatments on
      patches of bovine pericardium, intended to avoid or minimize calcification.
      Pericardium specimens were treated with: A) 0.5% glutaraldehyde; B) 0.5%
      glutaraldehyde + 4% formaldehyde; C) same as A, but with a further neutralization
      treatment; D) acylation of fresh bovine pericardium. Circular samples of 1 cm
      diameter were subcutaneously implanted in the abdominal region of three groups of
      six rats. The explants were retrieved after 2, 4 and 8 weeks. The calcium content
      and the histological results showed better behaviour for C and D samples than
      with the commonly used fixation methods (A and B). The lowest calcification was
      observed with treatment D, even though its morphological structures were somewhat
      modified with homogenation of collagen bundles. Among the glutaraldehyde-based
      treatments, treatment C appears to be the most promising because the pericardium
      shows slower calcium accumulation with a diffusive pattern.

PMID- 1748534
TI  - New J-3 flexible-leaflet polyurethane heart valve prosthesis with improved
      hydrodynamic performance.
AB  - The aim of this new three-leaflet valve development was to design a leaflet with
      minimum membrane stresses during performance. This is achieved by manufacturing
      the valve leaflets shaped almost flat in a medium opening position. Thus, the
      leaflets have two stable positions, one with maximum opening area and the other
      with favorable stress distribution in the closed position. The transition between
      the two end positions is achieved through a two-dimensional rolling motion
      without buckling and with minimum membrane stresses (bulge forces). The
      manufacturing technique is dip-coating in polyurethane. Hydrodynamic evaluation
      of the J-3 valve in steady and pulsatile flow showed minimum pressure drop
      compared to other commercially available valves. Laser-Doppler-anemometry studies
      indicated very low shear stresses in the flow field downstream of the valve. In
      durability tests prototypes have reached lifetimes of up to 17 years. In
      conclusion, the J-3 valve shows superior hydrodynamic performance thereby
      reducing potential thrombus formation. Minimization of stresses within the valve
      leaflets through design could reduce calcification.

PMID- 1748535
TI  - The simultaneous measurement of glomerular filtration rate (GFR) and renal plasma
      flow (RPF) following renal transplantation by use of functional imaging.
AB  - A new method for evaluating renal function using dynamic scintigraphy and
      deconvolution is described; functional images can be created from the data to
      quantitate kidney function. Our data are indicating that GFR measurements
      obtained by this method do not differ from those obtained by classical renal
      clearance methods. As was expected measurements of renal plasma flow exceed the
      values of PAH clearance. Additional studies to determine extraction ratios must
      be done along with direct flow meter measurements.

PMID- 1748536
TI  - Importance of purification on transfusional efficacy of hemoglobin solutions.
AB  - It has only been realized quite recently how important is the purification of
      hemoglobin solution for use in transfusion and several techniques have been
      published. We used ion exchange chromatography with which the main "contaminants"
      (glycoproteins, enzymes, phospholipids) are absorbed by the gel, whereas
      hemoglobin is not retained. The solutions studied here are non-modified
      hemoglobin and its homologue pyridoxylated hemoglobin (PLP-Hb). Physico-chemical
      analyses, usually undertaken to characterize hemoglobin solutions, show no
      difference before and after purification, except that the enzymatic activity
      almost disappears. In order to appreciate the benefits of purification, total
      exchange transfusions were carried out on rats. Without reperfusion, purification
      of the hemoglobin solution allowed a significantly longer survival time which was
      even more significant with PLP-Hb solution. Urinary loss did not seem to be
      affected by purification. With reperfusion in order to compensate these renal
      losses, PLP-Hb solutions gave survival times up to three days. However, the
      inevitable death of the animals poses the problem of instability of these
      purified solutions following enzyme loss.

PMID- 1748537
TI  - Relative pharmacokinetics of three oral 400 mg ibuprofen dosage forms in healthy
      volunteers.
AB  - The pharmacokinetic properties of two solid form, 400 mg ibuprofen (IP)
      preparations, a soft gelatin capsule and a film-coated tablet, were compared to
      those obtained after the administration of liquid prepared from effervescent IP
      tablets. IP was absorbed rapidly (tmax 0.6-1.9 h). The fastest absorption was
      observed after the ingestion of the soft gelatin capsule; liquid and film-coated
      tablet produced 12.2-7.8 times longer absorption half-lives, 50-39% lower peak
      concentrations of IP in serum and 3.5-3.2 times higher tmax values.
      Bioavailabilities were close to similar after all products. All products were
      tolerated without side effects in this single-dose, crossover study on 14 healthy
      volunteers. The results of this study support the earlier findings that after
      oral administration, IP is absorbed equally well from solid formulations as from
      liquid form. Liquid formulations of IP often deliver slower absorption than
      expected probably due to incomplete dissolution of the active principle. This may
      have therapeutic significance, and it should be taken into account when studies
      on the relative bioavailability of IP from pharmaceutical drug products are
      planned.

PMID- 1748538
TI  - Pharmacokinetics of intravenous metronidazole at different dosages in healthy
      subjects.
AB  - Metronidazole is effective in the treatment of trichomoniasis and serious
      anaerobic infections. Individual doses given clinically ranged from 250 mg to 2.0
      gm. Most of the available pharmacokinetic data were obtained when the drug was
      administered at the low end of the dosage range. Several other studies were done
      using assays that were subject to interference by metabolites. We therefore
      conducted this investigation to evaluate the pharmacokinetics of metronidazole at
      different dosage levels in normal subjects in a crossover manner using a specific
      HPLC assay. Nine male normal volunteers were each administered 250 mg, 1.0 gm and
      2.0 gm of intravenous metronidazole in a crossover manner. Serial blood samples
      were obtained immediately before and at 0, 15, 30, 60, 90 minutes, 2, 4, 6, 10,
      24 and 32 hours after the dose. Serum concentrations of metronidazole and its
      metabolites were determined by HPLC. The half-lives, elimination rate constants,
      volumes of distribution and areas under the concentration-time curve were
      calculated. Analysis of variance revealed a statistically significant difference
      between the low dose (250 mg) and the high dose (1.0 gm and 2.0 gm) effect on the
      calculated pharmacokinetic parameters. In addition, the production and the
      elimination of the metronidazole hydroxy metabolite were also found to be reduced
      when higher doses of the drug were administered. These findings revealed that the
      pharmacokinetics of metronidazole and its hydroxy metabolite are altered when
      higher doses of the drug are given; the metabolic transformation of the parent
      drug is also expected to be reduced.

PMID- 1748539
TI  - Lack of effect of labetalol on platelet aggregation in hypertensive patients.
AB  - To evaluate the ex-vivo effects of labetalol, at effective vasodepressor doses,
      on platelet aggregation in hypertension, 30 hypertensive patients were randomized
      to either a labetalol or control group in a ratio of two to one. For the
      labetalol group, the dosage was titrated from 400 mg to 600 mg per day to achieve
      a fall of 10 mmHg in mean arterial pressure (MAP). No drug was used in the
      control group. The study lasted for 4 to 8 weeks. At the beginning and end of the
      study, platelet aggregation to collagen, adenosine diphosphate and epinephrine
      were measured according to Born's method. In contrast to the significant
      reduction in MAP, platelet aggregation was not altered by labetalol compared with
      the control group. Our data do not support the hypothesis that labetalol, at
      effective vasodepressor doses, inhibits platelet aggregation in mild-to-moderate
      hypertensive patients.

PMID- 1748540
TI  - Cmax/AUC is a clearer measure than Cmax for absorption rates in investigations of
      bioequivalence.
AB  - In bioequivalence studies, the maximum concentration (Cmax) is shown to reflect
      not only the rate but also the extent of absorption. Cmax is highly correlated
      with the area under the curve (AUC) contrasting blood concentration with time.
      Therefore, use of the Cmax/AUC ratio is recommended for assessing the equivalence
      of absorption rates. The ratio is independent of both intrasubject variations and
      possible differences in the extent of absorption and reflects only the contrast
      between the absorption and disposition rate constants (ka/k).

PMID- 1748541
TI  - Development and present state of hormone replacement therapy.
AB  - The first therapeutic trials to evaluate the treatment of climacteric symptoms by
      the administration of ovarian tissue were reported in 1896, i.e. before the
      endocrine function of the ovary was known or estrogens had been discovered. These
      were followed by investigations using various ovarian, placental and urine
      extracts, implantation of ovarian tissue and by oral treatment with dried ovarian
      tissue. However, reasonably acceptable hormonal drugs did not become available
      until the third decade of this century, while drugs meeting modern requirements,
      including that of oral activity, have been available only since the 1940s. It
      took at least 20 more years before publications for lay people and intensive
      endocrinological research convinced both the affected women and the medical
      profession of the value and even the necessity of hormonal treatment for ovarian
      deficiency sequelae. Nowadays the treatment of climacteric and post-climacteric
      symptoms with estrogens and progestogens is a highly effective and indeed common
      practice. However, their use is of less value for the therapy of post-climacteric
      cardiovascular diseases and osteoporosis. As regards the latter, it may be said
      that androgenic-anabolic steroids and Org OD 14, a steroid related to
      norethynodrel, have usefully extended the available therapeutic armamentarium.
      Estrogens and progestogens are widely used for the prophylaxis of post
      climacteric osteoporosis and cardiovascular diseases because their exceptional
      efficacy is well proven. Intensive research has resulted in the development of
      highly effective and virtually harmless hormonal drugs that are available in a
      great variety of formulations for all possible modes of administration.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1748542
TI  - The influence of food on the absorption of diclofenac as a pure substance.
AB  - The interaction of diclofenac as a pure substance was investigated without and
      with concomitant administration of food in 8 healthy, male volunteers (age: 23-29
      years, body weight: 60-87 kg). Diclofenac was given as a pure substance by means
      of a rapid dissolving capsule in a dose of 50 mg. Paracetamol (1.5 g), a marker
      of gastric emptying rate, was administered simultaneously with diclofenac in
      order to elucidate the influence of gastric emptying rate on diclofenac
      absorption. The bioavailability was determined according to the time (tmax) of
      the concentration maximum in plasma (Cmax) and the area under the curve (AUC).
      Food significantly delays tmax of diclofenac (without food: [mean +/- SD] 0.8 +/-
      0.5 h, range: 0.5 +/- 2 h; with food: 2.4 +/- 0.9 h, range: 1.5-4 h) and
      diminishes Cmax (without food: 1,125 +/- 765 ng/ml, range: 95-2,100 ng/ml; with
      food: 434 +/- 151 ng/ml, range: 250-555 ng/ml). The AUC is not influenced
      (without food: 1,217 +/- 368 ng/ml x h; with food: 1,037 +/- 267 ng/ml x h). The
      bioavailability of paracetamol is unchanged. It is concluded that the diminishing
      of Cmax and the delay of tmax of diclofenac are possibly the consequence of an
      interaction with food and not of the delayed gastric emptying per se.

PMID- 1748543
TI  - On presentation of the Proctor Award of the Association for Research in Vision
      and Ophthalmology to Drs. Waldon Wacker and Robert Nussenblatt.

PMID- 1748544
TI  - Proctor Lecture. Experimental autoimmune uveitis: mechanisms of disease and
      clinical therapeutic indications.

PMID- 1748545
TI  - Friedenwald Award and Lecture. Introduction of R. F. Brubaker, Friedenwald Award
      winner 1991.

PMID- 1748546
TI  - Flow of aqueous humor in humans [The Friedenwald Lecture].
AB  - Based on clinical experiments with fluorophotometry, several observations can be
      made about aqueous flow through the chambers of the human eye. 1. The rate of
      flow is 2.75 +/- 0.63 microliters/min in normal subjects, as derived from
      measurements averaged during normal office hours. The normal range (95%) is 1.8
      to 4.3 microliters/min. 2. There is a circadian rhythm of flow, with the highest
      rates during morning hours, slightly lower rates during afternoon hours, and
      rates during sleep that are approximately one half of those during the morning.
      The hormonal basis for this rhythm is unknown, but it is known to be present in
      both eyes of persons with unilateral Horner's syndrome. 3. A slight decline of
      the rate occurs after age 10 yr--3.2% per decade. There is no significant
      difference in aqueous flow between men and women. 4. Of the hundreds of drugs
      that are used clinically, most are unlikely to have a significant effect on
      aqueous flow. Exceptions are the beta-adrenergic agonists that, under certain
      circumstances, are able to increase flow, the corticosteroids that may have a
      stimulating effect on flow, and three classes of drugs that have therapeutically
      useful suppressing effects on flow: carbonic-anhydrase inhibitors, beta
      adrenergic antagonists, and alpha 2-selective adrenergic agonists. 5. Timolol,
      which has a remarkably consistent suppressing effect on flow during the day, has
      no effect on the flow of sleeping subjects. By contrast, acetazolamide and
      apraclonidine are able to reduce the flow of sleeping subjects. 6. Acute doses of
      beta-adrenergic antagonists and alpha 2-agonists are not additive, but beta
      adrenergic antagonists and carbonic-anhydrase inhibitors are partly additive. 7.
      The eye adapts partly to the chronic use of timolol and recovers from its effects
      when it is discontinued. 8. The rate of disappearance of the effect of beta
      adrenergic antagonists is longer for the noncardioselective agents, such as
      timolol and levobunolol, but is relatively short for the cardioselective agent,
      betaxolol. 9. The rate of aqueous flow is insensitive to moderate changes of
      intraocular pressure. Clinical studies can provide suggestive leads for more
      basic investigations or test specific hypotheses. Biochemical, biologic, and
      pharmacologic approaches in simpler, more controlled experimental conditions are
      necessary to determine the fundamental processes that bring about aqueous
      formation in the living eye. The combination of many disciplines (eg, studying
      molecules, cells, tissues, organs, and the intact living system) has the best
      chance of furthering our understanding of the aqueous circulation.

PMID- 1748547
TI  - Transplanted photoreceptors identified in dystrophic mouse retina by a transgenic
      reporter gene.
AB  - Dissociated photoreceptor cells from a transgenic strain of mice, containing a
      bovine promoter lac Z gene construct, were transplanted to the dystrophic retinas
      of a strain of mice (C3H, rd/rd) without obvious photoreceptors. The transgenic
      photoreceptor cells expressed beta-galactosidase and were distinguishable from
      the host retinal cells by light and electron microscopy after the 5-bromo-4
      chloro-3-indolyl-beta-D-galactopyranoside histochemical reaction. These results
      showed that transplanted transgenic photoreceptor cells survived at least 1 month
      in the host retina and had a primitive outer segment and a well-developed
      synaptic terminal.

PMID- 1748548
TI  - Retinal polyol and myo-inositol in galactosemic dogs given an aldose-reductase
      inhibitor.
AB  - Galactitol and myo-inositol concentrations were measured in retinas,
      erythrocytes, and skeletal muscle of experimentally galactosemic dogs receiving a
      placebo or the aldose reductase inhibitor, sorbinil, for 5 yr. The concentration
      of galactitol was increased more than 30-fold in the retina and other tissues by
      galactosemia, and the increase was inhibited 90-96% in all tissues by sorbinil.
      The concentration of free myo-inositol was greater than normal in retinas of
      galactosemic dogs, and its concentration was not altered by the aldose-reductase
      inhibitor. The myo-inositol concentration likewise was greater than normal in the
      retinas of dogs that were diabetic for 2-4 months. The marked inhibition of
      polyol production and accumulation in the retina of sorbinil-treated galactosemic
      dogs was not associated with a comparable inhibition of retinopathy.

PMID- 1748549
TI  - Cytoskeleton in normal and reactive human retinal pigment epithelial cells.
AB  - The cytoskeleton of normal and reactive retinal pigment epithelium (RPE) was
      analyzed immunohistochemically in five light microscopically normal formalin
      fixed, paraffin-embedded human eyes enucleated because of orbital tumor and in 44
      eyes with a uveal melanoma. In 26 eyes, the RPE overlying the tumor was
      morphologically normal or atrophic; in 18 eyes, hyperplastic changes were
      present. Normal RPE cells lacked vimentin, but it was present in 35 of 44 eyes
      with uveal melanoma. Antibodies that recognize cytokeratins CK8 and CK18 labeled
      normal and reactive RPE cells in all specimens. Although CAM 5.2 and CY-90
      detected RPE cells strongly and quantitatively, clones CK5, KS-B17.2, and
      pancytokeratin antibody lu-5 reacted weakly and did not label some specimens.
      Immunoblotting supported the presence of CK8 and CK18 in human RPE. Normal RPE
      cells did not express other simple epithelial cytokeratins, but both atrophic and
      hyperplastic reactive RPE cells were labeled with antibodies to CK7 or CK19 in 24
      of the 44 eyes. Hyperplastic proliferating RPE cells that formed subretinal
      membranes reacted positively for alpha-smooth muscle actin in 13 of 18 eyes.
      Antibodies to CK8 and CK18 are valuable markers of normal and reactive human RPE
      cells, but a panel of reagents is necessary to document reactive changes in the
      cytoskeleton. Acquisition of alpha-smooth muscle actin by human RPE cells may be
      related to their ability to form periretinal membranes and contribute to
      intraocular proliferative diseases.

PMID- 1748550
TI  - Localization of alkaline phosphatase on basolateral plasma membrane of normal and
      regenerating retinal pigment epithelium. A cytochemical study in rabbits.
AB  - Ultrastructural cytochemistry was used to analyze the polarized distribution of
      alkaline phosphatase (AP) on the plasma membranes of normal and regenerating
      retinal pigment epithelium (RPE) and the ciliary body epithelium in rabbits. The
      AP activity was concentrated on the basolateral plasma membrane in normal RPE. In
      regenerating RPE (after intravenous administration of sodium iodate to damage the
      RPE), there was a differential expression of AP activity according to the site on
      the regenerating epithelial sheet. At the edge of the sheet, where cells were
      undifferentiated and immature (ie, without the polarized distribution of
      basolateral and apical plasma membrane specializations seen in normal RPE), no
      plasma membrane AP activity was observed. The AP activity was reexpressed more
      proximal in the regenerating sheet. It was first evident where contiguous cells
      formed junctional complexes and cytologic polarization again became apparent. New
      AP activity was restricted to the basolateral plasma membrane. Eventually, the
      polarized distribution of AP activity seen in normal RPE was reestablished. In
      the ciliary body, AP activity was localized to the basolateral plasma membranes
      of the outer, nonpigmented epithelial cells. It was concluded (1) that
      cytochemical activity for nonspecific AP is concentrated on the basolateral
      plasma membrane domain of normal RPE and the normal pattern of AP activity is
      lost initially and then reexpressed.

PMID- 1748551
TI  - Studies of tumor-infiltrating lymphocytes from a human choroidal melanoma.
AB  - Cell suspensions prepared enzymatically from an ocular choroidal melanoma were
      cultured in vitro in an effort to generate (1) melanoma tumor cell lines and (2)
      tumor-infiltrating lymphocytes cytotoxic for ocular melanoma cells. Even though
      histologic study of the tumor did not show "significant" infiltrating bone marrow
      derived cells, lymphocytes were generated readily in cultures to which
      interleukin-2 was added. Phenotypic analysis of the cultured lymphocytes
      indicated that T-cells, natural killer (NK) cells, and lymphokine-activated
      killer (LAK) cells were present. Moreover, functional studies of the cultured
      lymphocytes revealed NK activity, LAK activity, and most importantly, tumor
      antigen-specific cytotoxic T-cell activity. It was concluded that it is possible
      to obtain tumor cell lines and tumor-infiltrating lymphocytes from ocular tumors,
      both of which would be required if cellular immunotherapy of ocular tumors is
      contemplated. In addition, these results indicate that ocular melanomas can
      express unique tumor-specific antigens and that the immune system of a patient
      with such an ocular tumor can perceive these tumor antigens because antigen
      specific precursor cytotoxic T-cells were present in the tumor-containing eye at
      the time of enucleation. The theoretic and therapeutic implications of these
      findings are discussed.

PMID- 1748552
TI  - Pharmacokinetic study of recombinant human epidermal growth factor in the
      anterior eye.
AB  - This study investigated the pharmacokinetics of recombinant human epidermal
      growth factor (EGF) in the eyes of live rabbits and enucleated human eyes. After
      intracameral injection of 1.2 muCi (1.1 micrograms) of 125I-EGF into rabbit eyes,
      tissues in the anterior segment were analyzed for uptake of 125I-EGF after 1, 2,
      4, and 24 hr. The half-life of EGF during the initial 4 hr was 1.3 +/- 0.6 hr (+/
      the confidence limit at P = 0.05) in the cornea, 0.7 +/- 0.4 hr in the iris, 1.9
      +/- 0.9 hr in the lens, and 0.6 +/- 0.5 hr in the aqueous humor (n = 18 for each
      tissue). Between 4-24 hr, the percent retention of EGF in the tissues (relative
      to the initial amount in respective tissue) is in the order of lens greater than
      cornea greater than iris greater than aqueous humor. The kinetics of EGF uptake
      by excised human corneas was determined by incubating the endothelial surface
      with 1.2 muCi/ml (100 ng/ml) of 125I-EGF for 4 hr at 37 degrees C or 4 degrees C.
      After 4 hr, the total amount of EGF accumulated in the corneas was 2.3 +/- 0.2 ng
      (+/- standard deviation; n = 6) at 37 degrees C, and 1.4 +/- 0.1 ng at 4 degrees
      C.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748553
TI  - Tobramycin liposomes. Single subconjunctival therapy of pseudomonal keratitis.
AB  - The authors compared 24 doses of hourly topical fortified tobramycin (Group A)
      therapy with a single subconjunctival administration of multivesicular
      megaliposome-encapsulated tobramycin (Group B) and free subconjunctival
      tobramycin (Group C) in treating a rabbit model of keratitis caused by
      Pseudomonas aeruginosa. One cornea each of 50 rabbits was infected with P.
      aeruginosa for 24 hr. The animals then were divided randomly into five groups of
      ten each. Groups A, B, and C were treated as described. Group D received
      liposomes without tobramycin and Group E, hourly balanced salt solution.
      Significantly fewer Pseudomonas colonies were present in the corneas of all three
      drug-treated groups (A, B, and C) compared with the two control groups (D and E)
      at 24 hr (P less than 0.005). Significantly fewer Pseudomonas colonies were
      present in Groups A and B compared with Group C (P less than 0.02). No
      significant difference was noted between Groups A and B (P = 0.30). Tobramycin
      encapsulated in megaliposomes may be useful in treatment of pseudomonal
      keratitis.

PMID- 1748554
TI  - In vivo fibroplasia of a porous polymer in the cornea.
AB  - We have developed a melt-blown fibrous construction of polybutylene/polypropylene
      in which we previously demonstrated keratocyte ingrowth and collagen synthesis in
      vitro. In the present studies, we evaluated this material in vivo in
      interlamellar corneal pockets for periods of up to six months. By day 42, the
      porous interstices of the disc were heavily populated with keratocytes.
      Extracellular matrix deposition occurred and there was a 5000-fold increase in
      total protein and a 1000-fold increase in total collagen over background. The
      cells within the disc continued to be synthetically active for the six months of
      our study. Discs remained in corneas for periods of up to one year without any
      extrusion. This material has great promise as a porous peripheral component of a
      keratoprosthetic device.

PMID- 1748555
TI  - Correlation of chromatic, spatial, and temporal sensitivity in optic nerve
      disease.
AB  - Spearman rank-order correlations (R) were made between the color-mixture
      threshold, spatial contrast sensitivity, and flicker sensitivity measurements of
      38 patients with a variety of optic nerve disorders. Patients had to satisfy the
      following criteria: greater than 0.5 log unit loss of chromatic or achromatic
      sensitivity (compared to age-matched normals), central fixation, no congenital
      color defects, and no ocular media abnormalities. The results of the analysis
      show a significant correlation between selective losses of high spatial frequency
      sensitivity (relative to low) and selective losses of red/green and blue/yellow
      sensitivities [R = -0.680 (P less than 0.001) and R = -0.439 (P less than 0.01),
      respectively]. A mild correlation was found between selective spatial and
      selective temporal losses [r = -0.399 (P less than 0.05)] (ie, low temporal
      frequency losses correlate with high spatial frequency losses and vice versa). A
      stronger correlation was found between selective red/green and selective
      blue/yellow sensitivity losses [R = 0.657 (P less than 0.001)]. No correlation
      was found between selective temporal losses and selective chromatic losses. These
      findings can be explained in terms of differential losses of three types of
      fibers: (1) fibers that are particularly sensitive to red/green color, high
      spatial and low temporal frequencies; (2) fibers signalling blue/yellow color;
      and (3) fibers that are relatively sensitive to high temporal frequencies and low
      spatial frequencies.

PMID- 1748556
TI  - Optic nerve head blood speed as a function of age in normal human subjects.
AB  - We used the laser Doppler technique to determine the relation between age and the
      speed of blood cells moving through the capillaries of the optic nerve head. We
      studied 22 normal human volunteers ranging in age from 16-76 years. The results
      were best described by a statistically significant quadratic relationship between
      capillary blood speed and age. Blood speeds were lowest in the youngest and
      oldest subjects and highest in subjects between 27 and 35 years old. A two-phase
      linear model showed a statistically significant 20% decrease in blood speed in
      volunteers between the ages of 31 and 76. The results were not affected by
      gender, degree of refractive error, systemic blood pressure, intraocular
      pressure, cup/disc ratio of the optic nerve head, or by site-to-site differences
      in the light scattering properties of the optic nerve head tissue. Capillary
      blood speed was, on average, 15% greater from temporal sites than from nasal
      sites, corresponding to the equally greater distribution of ganglion cell axons
      within the same area. The results provide a baseline of normal age-controlled
      data that can be compared to measurements obtained from patients with disorders
      of the optic nerve head thought to have a vascular etiology.

PMID- 1748557
TI  - Identification of lectin binding proteins in human tears.
AB  - The identity of glycoproteins in stimulated normal human tears was investigated
      by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of tears
      onto minigels, blotting, and subsequent incubation with different biotinylated
      lectins (concanavalin A [Con A], peanut agglutinin [PNA], glycine max agglutinin
      [SBA], Phaseolus vulgaris agglutinin, wheat germ agglutinin [WGA, native form],
      Artocarpus integrifolia agglutinin [Jacalin], and Pisum sativum agglutinin).
      Control proteins included purified secretory immunoglobulin A (sIgA) from human
      colostrum, human milk lactoferrin, and chicken-egg lysozyme. All samples were
      prepared in a denaturing (SDS) buffer under nonreducing and reducing conditions.
      The sIgA in tears and IgA (alpha) heavy chain fragments (reduced sample) were
      identified with most of the lectins tested. A particular high molecular weight
      (greater than 200 kD) protein fraction in tears that just entered the separation
      gel on SDS-PAGE was detected with WGA and Jacalin. This fraction stain poorly
      with silver. Tear lactoferrin was identified with all lectins used, although
      binding was low with SBA. Purified milk lactoferrin showed a poor reaction with
      Jacalin, but a protein in tears of similar mobility bound this lectin (nonreduced
      samples). Under both nonreducing and reducing conditions, tear-specific
      prealbumin in tears did not bind any of the lectins tested. Tear lysozyme only
      reacted with lectin after reduction. The techniques described may provide
      additional valuable information in addition to commonly used methods for tear
      protein analysis and further knowledge concerning the role of glycoproteins on
      the ocular surface.

PMID- 1748558
TI  - Ocular hypothermia depresses the human pupillary light reflex.
AB  - Twelve human volunteers were studied to determine the effect of eye surface
      cooling on the parameters of the light reflex. Surface cooling resulted in a 38%
      decrease in the maximum constriction velocity and a 36% decrease in the maximum
      redilation velocity. These changes were thought to be the result of a "sluggish"
      response of the pupillary sphincter.

PMID- 1748559
TI  - Accommodation and ciliary muscle muscarinic receptors after echothiophate.
AB  - Twice daily topical administration of echothiophate for 2 weeks to the eyes of
      living cynomolgus monkeys produced profound subsensitivity of the accommodative
      response to pilocarpine and an approximately 50% decrease in the number of
      specific binding sites for 3H-quinuclidinyl benzilate (3H-QNB) in the ciliary
      muscle without a change in their affinity. When echothiophate treatment was
      discontinued, functional cholinergic sensitivity and the number of QNB binding
      sites both returned to normal over a similar 4-8 week period. Most animals had a
      modest overshoot of both functional sensitivity and number of binding sites for
      at least several weeks thereafter. The treated to control eye ratios for the
      number of binding sites and accommodative response to pilocarpine were correlated
      and the plot of log treated to control binding site ratio versus treated to
      control accommodation ratio resembled a dose-response curve. Similarly, the
      treated versus control eye differences for the two parameters were correlated,
      with the regression line passing through the 0-0 axis intercept. Collectively,
      these findings suggest that agonist-induced modulation of functional cholinergic
      sensitivity in the parasympathetically innervated (as opposed to denervated)
      ciliary muscle occurs by a muscarinic receptor-mediated mechanism. This system
      appears to provide a useful model to study the regulation of ciliary muscle
      cholinergic sensitivity.

PMID- 1748560
TI  - Upper eyelid movements measured with a search coil during blinks and vertical
      saccades.
AB  - Upper eyelid movements were recorded in nine human subjects by mounting a
      miniature coil of wire directly on the eyelid and subjecting the search coil to a
      vertically directed alternating magnetic field. The metrics of blinks and lid
      movements accompanying saccades were described by "main sequence" relationships,
      linking maximum velocity to amplitude and duration to amplitude. In general, lid
      movements were faster than those reported previously in the literature, but there
      was considerable intersubject variability. On average, the main sequence
      relationships for blinks were independent of either starting lid position or
      whether the blinks were generated spontaneously, reflexively, or voluntarily. For
      the down phase of the average blink, both the maximum velocity and duration
      increased almost linearly with amplitude. The maximum velocity of the down phase
      was faster than that of the up phase. For lid movements accompanying vertical
      saccades, the maximum velocities in the up and down directions were similar and
      increased nonlinearly with amplitude, saturating at about 120 mm/sec
      (approximately 450 degrees/sec). Duration increased approximately linearly with
      amplitude. The down phases of blinks were much faster than those of saccade
      related lid movements. By comparison, the maximum velocities of the up phase of
      blinks and of saccade-related lid movements were almost equal. The large
      intersubject variability suggests caution when using normative data to interpret
      abnormal lid motion for clinical purposes.

PMID- 1748561
TI  - Evaluation of sensitivity and specificity of spatial resolution and Humphrey
      automated perimetry in pseudotumor cerebri patients and normal subjects.
AB  - To determine the sensitivity and specificity of high-pass resolution perimetry
      ("ring test"), 18 patients with pseudotumor cerebri (PTC) and 18 age-matched
      controls were examined with the Humphrey program 24-2 and the ring test. Goldmann
      perimetry also was done to determine if defects found with the ring test were
      present with another method. Testing with Humphrey perimetry revealed defects in
      15 PTC patients and four control subjects; with the ring test, 13 PTC patients
      and two control subjects had abnormalities. The disturbed areas in the control
      subjects with both automated tests were not reproducible. Humphrey perimetry had
      a sensitivity of 83% and the ring test, 72%. The specificities were Humphrey
      perimetry, 78% and the ring test, 89%. These differences were not statistically
      significant. Qualitative assessment of the presence and extent of damage using
      the pointwise probability plots and graphically displayed raw data showed good
      correlation of the tests in 11 of the 18 patients. The lack of correlation in
      four of the patients was caused by the presence of a generalized depression or a
      peripheral contraction on the Humphrey test; this defect, not present on
      retesting, may have been related to fatigue or poor motivation. The ring test is
      a sensitive and specific perimetric technique in patients with PTC.

PMID- 1748562
TI  - The relationship between synthesis of secretory products and reducing capacity in
      pancreas and parotid acinar cells.
AB  - The secretory products in exocrine pancreas acinar cells in utero were found to
      reduce osmium tetroxide. This reducing capacity was also exhibited by adult
      pancreas and parotid glands in different phases of synchronized secretion, and
      after single or chronic administration of a secretagogue, pilocarpine or
      isoprenaline. In utero, the reducing capacity appeared in the pancreas
      concomitantly with the synthesis of secretory products, and was limited to the
      transitional vesicles on the cis Golgi side. After birth, osmium staining
      occurred in the cis Golgi vesicles and cisternae of both glands. In the
      chronically-treated parotid gland, where the occupational programme for secretory
      proteins had been altered, the reducing capacity was diminished, resembling that
      in embryonic exocrine pancreas.

PMID- 1748563
TI  - A quantitative cytochemical investigation of osteoclasts and multinucleate giant
      cells.
AB  - Quantitative cytochemical, immunocytochemical, autoradiographic and electron
      cytochemical investigations have been used to compare osteoclasts with
      multinucleate giant cells that had been freshly obtained from the same animal.
      The levels of beta-acid galactosidase activity, the DNA in individual nuclei and
      the cellular protein content were similar in both cell types. However,
      osteoclasts generally possessed greater acid phosphatase and NADH dehydrogenase
      activity but lower levels of fluoride-inhibited non-specific esterase activity
      than multinucleate giant cells. The acid phosphatase activity in multinucleate
      giant cells was completely inhibited by 100 mM tartrate, but in osteoclasts only
      a 20% reduction in activity was observed. Formation of multinucleate giant cells
      in a "bone microenvironment" (thin bone slices) did not increase their content of
      tartrate-resistant acid phosphatase activity. Moreover, in osteoclasts,
      endogenous peroxidase activity was undetectable but present in several granules
      within the cytoplasm of multinucleate giant cells. Osteoclasts and multinucleate
      giant cells displayed a similar microtubules distribution, but calcitonin, which
      induced rearrangement of microtubules and cellular contraction in osteoclasts,
      had no effect on multinucleate giant cells. Thus, these investigations reveal
      both similarities and differences between these two syncytia and support the
      hypothesis that osteoclasts and multinucleate giant cells are related. Possibly
      osteoclasts arise from monocyte progenitors before commitment to a macrophage
      lineage has occurred.

PMID- 1748564
TI  - Localization of the gene transcripts of 11 beta-hydroxylase and aldosterone
      synthase in the rat adrenal cortex by in situ hybridization.
AB  - Using in situ hybridization, localization of the gene transcripts of 11 beta
      hydroxylase and aldosterone synthase was investigated in order to clarify the
      sites for the synthesis of corticosterone (glucocorticoid) and aldosterone
      (mineralocorticoid) in the rat adrenal cortex. The gene transcript of 11 beta
      hydroxylase was localized in all the endocrine cells of the entire adrenal
      cortex, while that of aldosterone synthase was exclusively confined in zona
      glomerulosa cells. These results represent that every endocrine cell of all the
      cortical zones synthesizes 11 beta-hydroxylase which converts 11
      deoxycorticosterone to corticosterone, and only glomerulosa cells synthesize
      aldosterone synthase which produces aldosterone from corticosterone. Thus it is
      clearly shown that zona glomerulosa cells synthesize mineralocorticoid, while
      zona fasciculata as well as reticularis cells produce glucocorticoid.

PMID- 1748565
TI  - Undegraded chromogranin A is present in serum and enters the endocytotic
      lysosomal pathway in kidney.
AB  - Analysis of human and bovine serum by immunoblotting revealed the presence of the
      proprotein chromogranin A. By the same method chromogranin A was also found in
      rat, bovine and human kidney. However this organ did not contain any chromogranin
      A mRNA arguing against a synthesis within this organ. By immune-electron
      microscopy chromogranin A immunoreactivity was found in proximal tubule cells of
      rat kidney. Positive immunostaining was present in small vesicles within and in
      close proximity to the brush border and closer to the nucleus in typical
      lysosomal structures. These results make it likely that chromogranin A from serum
      reaches kidney tubule cells by glomerular filtration and is taken up into the
      endocytotic lysosomal pathway.

PMID- 1748566
TI  - Uptake, distribution and binding of vertebrate and invertebrate steroid hormones
      and time-dependence of ponasterone A binding in Calliphora vicina. Comparisons
      among cholesterol, corticosterone, cortisol, dexamethasone, 5 alpha
      dihydrotestosterone, 1,25-dihydroxyvitamin D3, ecdysone, estradiol-17 beta,
      ponasterone A, progesterone, and testosterone.
AB  - The presence of specific binding sites for radiolabelled vertebrate-type and
      arthropod-type steroid hormones was investigated in several organs including
      salivary gland, and central nervous system of third instar Calliphora vicina
      larvae by thaw-mount autoradiography. Ponasterone A, a 20-hydroxyecdysone agonist
      and 20-hydroxyecdysone are the only steroids which bind to nuclear high affinity
      binding sites. These binding sites are DNA associated while nucleoli show no
      tracer binding. Ecdysone, an endogenous 20-hydroxyecdysone precursor, is taken up
      by target cells but no significant nuclear binding occurs. 1,25-Dihydroxyvitamin
      D3 concentrates in cytoplasm only and its uptake is highest compared to all other
      steroids. Progesterone and testosterone show weak accumulation in the cytoplasm,
      while for cholesterol, corticosterone, cortisol, dexamethasone,
      dihydrotestosterone and estradiol-17 beta, no noticeable uptake occurs. For
      ponasterone A, a clear time dependence of uptake and intracellular distribution
      is visible, suggesting the existence and involvement of specific ecdysteroid
      uptake and transport mechanisms. These results suggest the presence of binding
      sites for various mammalian steroids in insects. Whether vertebrate steroid
      hormones or metabolites of them play a role in insects or whether the uptake and
      binding is based on chemical similarities alone without biological significance
      remains to be further investigated.

PMID- 1748567
TI  - Expression of facilitative glucose transporter in rat liver and choroid plexus. A
      histochemical study in native cryostat sections.
AB  - Two isoforms of facilitative glucose transporters (GLUT), namely the
      erythroid/brain-type GLUT 1 and the liver-type GLUT 2, were demonstrated in
      native cryostat sections of normal rat liver and brain by immunofluorescence and
      a very sensitive immunoalkaline phosphatase reaction. Fixation with 0.1%
      alcoholic periodic acid resulted in an excellent localization of GLUT 2 in liver
      and GLUT 1 in brain. GLUT 1 in liver, however, could successfully be demonstrated
      after fixation with 1% alcoholic formaldehyde. GLUT 2 occurred in all hepatocytes
      as a basolateral membrane protein with a gradient of high expression in the
      periportal area and a lower one in the perivenous part. The first layer of
      hepatocytes adjacent to the hepatic vein coexpressed GLUT 1. In addition, GLUT 1
      could be detected in the smooth muscle layer of the portal vein and in the apical
      and lateral plasma membrane of the bile duct epithelium. In brain, GLUT 1 showed
      a high expression in the microvessels, the ependyma and in the basal plasma
      membrane of choroid plexus epithelial cells. The blood capillaries associated
      with the choroidal epithelium were, however, negative for GLUT 1. The importance
      of the new findings in this study for the physiological role of the respective
      facilitative glucose transport proteins is discussed.

PMID- 1748568
TI  - Identification of lymph and blood capillaries by immunohistochemical staining for
      various basement membrane components.
AB  - In the present report we analyzed the presence and distribution of various
      basement membrane (BM) proteins in normal blood and lymph vessels with special
      emphasis on BM-associated heparan sulfate proteoglycan (HSPG) when compared to
      the BM-components collagen IV, laminin and fibronectin. We found that normal
      lymph capillaries have a BM that contains only collagen IV and small amounts of
      laminin, but almost no BM-associated HSPG and fibronectin, while blood
      capillaries showed a BM comprising of all components tested for. Larger
      lymphatics, however, were indistinguishable from blood vessels on the basis of BM
      staining. Lymphangiomas showed a BM pattern similar to that of lymph capillaries.
      Our findings provide evidence that the differential staining of BM-components may
      represent a reliable method for morphological distinction between blood and lymph
      capillaries. A comparison of these results with the BM-pattern in other
      functionally specialized blood vessels (glomerulus, sinusoids) provides evidence
      that the BM-composition may have some major impact on the functional properties.
      Thus, it is conceivable that the lack of HSPG in lymph capillaries may be
      essential for a free influx of fluid and proteins into these capillaries, which
      may have been extravasated into the interstitium.

PMID- 1748569
TI  - [ENT antibiotic therapy: therapeutic guidelines. Part I].
AB  - We discuss the variety of ear, nose and throat infections and then define the
      criteria for the choice of an adequate antibiotic. The importance of
      "supercalculated" therapy based on the results of Gram's stain is stressed, as it
      can save patients from over-treatment and adverse side-effects. Indications for
      Gram's stain in ENT as well as the value of the characteristics of the pus
      produced by different pathogens are described. The severity of the infection
      determines the choice between parenteral or oral therapy. The importance of the
      decision taken on the 1st and 3rd day of a severe infection is emphasised.
      Therapeutic principles in ENT infections are shown by grouping different
      infections with a similar spectrum of pathogens; also the indications for
      antibiotic therapy are outlined. Finally the priority of antibiotic treatment in
      some surgical infections is mentioned, and the peri-operative prophylaxis and
      treatment are described as well as the guidelines for treatment of infectious
      post-operative complications.

PMID- 1748570
TI  - [Acute inner ear deafness].
AB  - Sudden inner ear hearing loss initially might suggest a psychogenic disorder of
      hearing, particularly when it is bilateral and simultaneous. The differential
      diagnosis includes disseminated encephalitis, syphilitic labyrinthitis and
      Cogan's syndrome. The history and cause of acute bilateral deafness in meningitis
      are easy to recognise. Furthermore, unilateral acute inner ear deafness should
      not be regarded as idiopathic without further consideration. A acoustic neuroma
      is a possible cause even of a low-tone hearing loss. More controversial is
      rupture of the round window membrane as a cause of sudden deafness. The deafness
      after epidemic parotitis obviously leads to a total unilateral hearing loss in
      every case. Even labyrinthine apoplexy with loss of hearing and vestibular
      function can be caused by a tumour of the cerebellopontine angle. Idiopathic
      sudden deafness should be defined as an acute sensory hearing loss whose
      anatomical basis in an acute vascular endolymphatic hydrops of unknown cause. The
      sudden deafness affects only one ear; tinnitus and brief vertigo can be
      accompanying symptoms. A sudden hearing disorder due to other causes should be
      distinguished from idiopathic lesions.

PMID- 1748571
TI  - [Angioarchitecture of the cricoid cartilage and anterior trachea].
AB  - Two dense capillary networks have been described lying in the anterior and
      posterior parts of the human cricoid cartilage. Between these two lies an area
      supplied by a very sparse capillary network. The anterior sector is derived from
      branches of the cricothyroid and inferior laryngeal arteries, the posterior from
      branches of the superior and inferior laryngeal arteries. The tracheal cartilages
      are supplied from above downwards by circular branches derived from two parallel
      longitudinal arteries. Therefore the centre of each cartilage is very sparsely
      supplied by small arteries.

PMID- 1748572
TI  - [Endogenous tracheobronchial foreign body. An indication for emergency
      bronchoscopy with a rigid bronchoscope].
AB  - We report two patients, a 3-year-old child and a 75-year-old woman, with a
      foreign body of the trachea, and of the entire tracheobronchial system
      respectively. We emphasise the importance of rigid endoscopes for foreign body
      extraction and for respiration. Also, we describe the differentiation of
      endogenous from exogenous foreign bodies of the tracheobronchial system.

PMID- 1748573
TI  - [Semi-automatic TNM classification of malignant tumors with the ESTER system
      exemplified by the larynx].
AB  - Classification of tumours according to the TNM scheme has been accepted
      worldwide. However, vague baseline assessments and borderline cases render a
      comparison of the outcome on the basis of TNM classification impossible.
      Therefore we integrated the TNM rules as a new algorithm into an existing expert
      system for determining therapy. Thus, every tumour documented with the ESTHER
      system is automatically classified according to current TNM rules. The program is
      designed to cope with future changes of the TNM system: raw data are used for
      classification so that only the algorithms need to be modified.

PMID- 1748574
TI  - [Subglottic metastasis of multiple myeloma. Case report and review of the
      literature of laryngeal plasmacytoma].
AB  - A total of 111 cases of laryngeal plasmacytoma have now been reported. The
      disease may present either as a primary extramedullary plasmacytoma (n = 90) or
      as a metastasis of a multiple myeloma (n = 21). The distinction between these two
      types is very important in therapy and prognosis. We report a subglottic
      plasmacytoma in a 48-year-old woman. Investigations showed bone marrow
      infiltration, osteolysis and light chain expression in serum, indicating
      generalized disease. Therefore polychemotherapy was given, during which complete
      macroscopic and microscopic regression of the laryngeal plasmacytoma was
      observed. However, 14 months later, the patient died of renal failure due to
      systemic progression of the multiple myeloma.

PMID- 1748575
TI  - [Life threatening adverse effect of captopril].

PMID- 1748576
TI  - [Non-neoplastic central hearing loss--a review].
AB  - Acquired central auditory disorders not due to a tumour are unusual. The well
      known conditions such as hypoxic encephalopathy, erythroblastosis, bacterial
      meningitis and trauma are reviewed. Recent experimental and clinical studies
      contribute to progress in the understanding of the pathogenesis and etiology of
      these conditions. The pattern of presbyacusis and cortical deafness is discussed
      also. AIDS must be considered as a new cause of acquired central auditory
      dysfunction.

PMID- 1748577
TI  - [Binaural evoked brain stem potentials. Effect of sound direction on inferior
      colliculus response].
AB  - Auditory evoked brain-stem responses were recorded using binaural stimulation on
      12 test subjects. Rotation of the sound source in the horizontal plane was
      simulated digitally using a binaural mixing console. Binaural processing in the
      inferior colliculus was thus demonstrated in humans. The amplitude of the
      inferior colliculus response depends in an almost linear manner on sound
      direction and presents a typical directionality. While the amplitude is
      considered an important central code of sound direction, response latency of the
      inferior colliculus is controversial. The results confirm neuronal mechanisms
      which had been established by animal experiments for single units of the inferior
      colliculus and the auditory cortex.

PMID- 1748578
TI  - [Changes in early auditory evoked potentials in acoustic neuroma].
AB  - The auditory brain-stem responses (ABRs) of 38 patients with acoustic neuroma
      (AN) were recorded pre-operatively and evaluated with regard to pathological
      deviations from the normal. Several qualitative and quantitative features of the
      ABRs were compared statistically with the results obtained from a control group
      for age and sex, and considering patients with various cochlear pathologies
      (Meniere's disease, sudden deafness, presbycusis). Retrocochlear disorders were
      ruled out by computed tomography or magnetic resonance imaging. Statistical
      analysis yielded the following results. The central conduction time (latency
      difference between Jewett waves J1 and J5) is significantly prolonged in the AN
      group. A critical value of 4.3 ms separates the retrocochlear from the cochlear
      lesions, with a sensitivity and specificity of 90%. If conductive hearing loss
      can be excluded, and if the amount of cochlear hearing loss is taken into
      account, about the same separation effectively is achieved by evaluation of the
      sole latency of J5 and its stimulus level dependence. The interaural difference
      of the central conduction time can be a useful parameter for indicating the
      presence of acoustic tumours, unless both sides are affected. The same is true of
      the interaural differences for the J5 latency, but this quantity must be
      corrected for the effects of peripheral hearing loss. The critical interaural
      difference values are 0.3 ms for the conduction time (at any stimulus level) and
      0.5 ms for the latency of J5 (for stimulus levels above 60 dB nHL). A weaker
      distinction is provided by the amplitude of J5 and the amplitude ratio of J5 and
      J1. These quantities are only slightly smaller in cases of AN. Only the
      combination of small J5 amplitudes with large latency values can be regarded as
      being characteristic of retrocochlear lesions. This can be highlighted in an
      amplitude-latency diagram. Further hints as to the site of the lesion can be
      obtained from a distorted waveform morphology and from an abnormally large
      distance between hearing threshold and response threshold. The combined
      evaluation of all these features optimizes the effectivity of ABRs as a powerful
      tool in the diagnosis of retrocochlear disorders, but some false-positive and
      false-negative results cannot be excluded entirely.

PMID- 1748579
TI  - [Effect of venting the ear mold on speech discrimination in masking noise].
AB  - In this study the importance of in situ measurement during the fitting of a
      hearing aid is clearly emphasized. Reliable evaluation of the real ear gain can
      be achieved only with this method, and hence the assessment of the advantages of
      earmold modifications on the hearing aid. In particular, the gain can be
      evaluated by the person fitting the aid. The insertion of a vent into an earmold
      raises the listening comfort of the hearing-impaired person. The speech
      intelligibility in background noise may also improve. We analysed the effect of
      earmold venting on speech intelligibility under different background noise
      conditions. We found that venting improves the speech intelligibility, especially
      in background noise simulating modulated speech. Our example clearly demonstrates
      the importance of an exact control of the hearing aid fitting by the physician.
      In one case a vent ended at the ear canal wall so that no improvement of hearing
      comfort could be expected. A new earmold was made and the effect on insertion
      gain was demonstrated when enlarging the vent step by step.

PMID- 1748580
TI  - [Idiopathic facial paralysis and magnetic resonance tomography (MRT)].
AB  - We investigated 15 patients with unilateral facial paralysis using gadolinium(Gd)
      DTPA (diethylenetriamine pentaacetic acid) enhanced (magnetic resonance imaging
      (MRI). Eleven were idiopathic and 1 each was due to basal skill trauma, Lyme's
      disease, Foville's syndrome and herpes zoster oticus. Ten of 11 Bell's palsies
      showed a significant enhancement of the facial nerve on the paralysed side. In
      all cases enhancement was shown in the labyrinthine segment, in 9 in the meatal
      segment, in 8 in the mastoid segment and in 7 in the tympanic segment also.
      Follow-up Gd-enhanced MRI investigation was performed 3-11 months later in 8
      patients. In 1 case with incomplete return of function after 3 months MRI
      enhancement was decreased. We could not find any correlation between the
      intensity of the Gd enhancement and the course, severity or outcome of Bell's
      palsy, or stapedius reflex audiometry. The mechanisms and aetiology of the Gd
      enhancement in Bell's palsy seem to be non-specific phenomena which are also
      found in post-traumatic facial lesions, for instance. Nevertheless, the ability
      to image the facial nerve in Bell's palsy provides a new means of examination in
      this disorder. In our opinion Gd-enhanced MRI is recommended in cases of
      recurrent or "atypical" Bell's palsy and in cases with total loss of electrical
      excitability, to exclude tumours. It is further suggested that MRI may provide
      valuable information concerning areas which may require surgical exploration or
      decompression.

PMID- 1748581
TI  - Training physicians to be doctors--teachers and healers, problem-solvers and
      decision-makers.
AB  - With the scientific advances made in medicine during the past 200 years, the
      training of physicians in America has changed from that of a
      mentor/apprenticeship relationship to one in which students are part of an
      impersonal, mass production process. From a historical perspective, it is
      contended that basic science and rote memorization of medical theory have
      subsumed the art of medicine. As a result, students are overloaded with
      irrelevant facts, few of which they carry over in their professional practice of
      medicine. To alter this teaching approach and, hence, the quality of physicians,
      medical school curricula should incorporate recommendations found in the General
      Professional Education of Physicians Report, among other sources. These
      recommendations, which have been incorporated successfully in the curriculum at
      the University of New Mexico School of Medicine, for example, include:
      establishing goals that may be coordinated interdepartmentally; reestablishing
      the physician/mentor for each student; using a small-group, interactive, problem
      solving, clinically oriented approach to teaching; measuring each student's
      ability to not only retain knowledge but, more importantly, apply such
      information to actual clinical problem-solving and decision-making situations;
      admitting liberal arts graduates--not premedical students--to medical schools;
      and recruiting and training faculty members who have the time to each and the
      ability to emphasize biomedicine rather than their special discipline. These
      changes will make students more than physicians. They will be "real doctors,"
      individuals who not only possess knowledge but can apply it in their daily
      practice of medicine.

PMID- 1748582
TI  - Controlling systolic hypertension effectively and economically.

PMID- 1748583
TI  - A tissue pressure model for palpatory perception of the cranial rhythmic impulse.
AB  - A tissue pressure model was developed to provide a possible physiologic basis for
      the manifestation of the cranial rhythmic impulse (CRI). The model assumes that
      the sensation described as the CRI is related to activation of slowly adapting
      cutaneous mechanoreceptors by tissue pressures of both the examiner and the
      subject, and that the sources of change in these tissue pressures are the
      combined respiratory and cardiovascular rhythms of both examiner and subject. The
      model generates rhythmic impulses with patterns similar to those reported for the
      CRI. Also, a significant correlation was found between frequencies calculated
      from the model and published values for CRI obtained by palpation. These
      comparisons suggest that the CRI may arise in soft tissues and represents a
      complex interaction of at least four different physiologic rhythms.

PMID- 1748584
TI  - Fine needle aspiration.
AB  - The evolution of fine needle aspiration in the United States over the past three
      decades has overcome the initial concerns of clinicians regarding the accuracy of
      diagnosis and the potential for disseminating malignancy through the needle
      tract. The team approach, constant communication between interpreter and
      clinician, and acquisition of experience minimize the occurrence of false
      negative and false-positive results. The procedure is simple and easy to perform,
      it is safe with rare exceptions, it has patient acceptance, and it has unlimited
      application in the practice of medicine and patient evaluation.

PMID- 1748585
TI  - Influence of lateralized neuropsychological activities with and without
      sensorimotor components on EEG spectral power (alpha-rhythm).
AB  - Spectral analysis of the EEG (alpha-rhythm) was studied in 8 young right-handed
      men who underwent 6 experimental tasks which were compared with rest, and
      included two pure motor activities using only the right and then the left hand,
      two pure neuropsychological tasks, and two "mixed" tasks with both
      neurophysiological and motor activities. The electrophysiological parameters
      studied were the log of spectral power and an asymmetry index (RP-LP)/(RP + LP).
      In order to demonstrate lateralization of the EEG, one must associate lateralized
      motor and neuropsychological tasks (which are supposed to preferentially involve
      one of the cerebral hemispheres). These results may reconcile apparently
      divergent views published in the literature with respect to lateralized EEG
      modifications associated with cognitive activities.

PMID- 1748586
TI  - Heart rate, anxiety, anger, and arousal reactions to enforced time-wasting:
      dependence on reactive uncontrol, work involvement, and dominance factors of
      'type A'.
AB  - The factor structure of 'Type A' was examined in an experiment derived from the
      observation of Frankenhaeuser et al. (1980) that 'Type A' people are abnormally
      'aroused' when deprived of work. Questionnaire scales were used which dissected
      'Type A' (based on replicated factor analyses). The sample statistics for 21
      female volunteers approximated the parent population statistics on orthogonal
      scales of Work Involvement (WI), Reactive Uncontrol (RU) and Dominance (D). The
      laboratory session involved reading for 15 min: (a) self-chosen 'useful' work
      material and (b) material judged by subjects (Ss) to be 'useless'. Ss and trained
      observers used the same scales for rating anxiety, arousal and anger states
      during reading periods. Observers interpreted facial expressions from video
      tapes. Finger pulse amplitude and tonic heart rate (HR) were recorded during
      reading periods. RU (but not WI or D) correlated negatively with HR level and
      positively with increases in both HR and observed arousal under time-wasting
      conditions. Combination of changes in HR and observed arousal in a multiple R
      gave optimum 'prediction' of RU. While much evidence supported Frankenhaeuser's
      (1980) hypothesis, the multifactorial nature of 'Type A' was demonstrated.

PMID- 1748587
TI  - Empirical evidence against the 'cycle time dependency' assumption.
AB  - The interpretation of the 'cardiac cycle time effect', also named 'time-dependent
      primary bradycardia' by the Laceys, who first observed it, has been controversial
      in psychophysiology. Unconfounded evidence for the dependence of a vagal effect
      of psychological stimuli on time of stimulation within the cardiac cycle has been
      missing to date. An experiment in which the subjects could not anticipate the
      occurrence of the stimuli (short tones of a specific frequency that had to be
      counted) was performed. The data reduction procedure secured unambiguous
      interpretation of the data with respect to time-dependency or no time-dependency.
      No indication of any kind of cycle time dependency of the vagal effect was found.

PMID- 1748588
TI  - Autonomic, neuroendocrine, and subjective responses to emotion-inducing film
      stimuli.
AB  - The aim of the present study was to investigate differential emotional response
      patterns to film stimuli by multimodal assessment of subjective, autonomic and
      endocrine variables. Scenes of two films, chosen to induce different affective
      states, were presented to 20 male subjects. Changes in mood and perceived bodily
      sensations, autonomic activity (heart rate and skin conductance) and one
      endocrine parameter (salivary cortisol) were measured. Analyses revealed that the
      films elicited differential mood patterns. The cartoon film, which induced a
      pleasant, amused state, was accompanied by very few changes in bodily sensations,
      a temporary decrease in heart rate, and a rapid decrease in electrodermal
      activity. The suspense film, which elicited a marked reduction in joyfulness and
      relaxation together with an enhancement in irritation, differed from that pattern
      primarily by marked changes in several bodily sensations, an increase in
      electrodermal activity, and a temporary decrease in heart rate. There were no
      film-dependent cortisol changes. The results together with evidence from other
      emotion induction experiments support the usefulness of film segments in
      eliciting mild to moderate affective states and their concomitances. They
      particularly point to the relevance of bodily sensations as an emotional response
      component.

PMID- 1748589
TI  - Specific respiratory patterns distinguish among human basic emotions.
AB  - Prototypical respiratory-facial-postural actions ('emotional effector patterns')
      related to six basic emotions had been extracted from an ensemble of
      physiological reactions present in subjects reliving intense emotional situations
      (Bloch & Santibanez, 1972). Subjects reproducing these actions could evoke the
      corresponding subjective experience, which suggested their use as an experimental
      model for generating controlled emotional states. The aim of the present study
      was to quantify the respiratory parameters which characterize the emotions of joy
      laughter, sadness-crying, fear-anxiety, anger, erotic love and tenderness.
      Respiratory movements and facial/postural expressions were recorded from 36 young
      actors who had learned in previous workshops to express these emotions by
      reproducing the corresponding prototypical actions. A qualitative analysis of the
      recordings showed that as the emotional reproduction went along, both breathing
      and expression evolved from an initial 'robot-like' phase to a more natural stage
      in which spontaneous vocalizations and gestures appeared. This suggested a
      partial activation of the emotional network. The quantitative analysis of the
      respiratory movements for the fundamental cycles showed that for anger, erotic
      love and tenderness significant changes in amplitude, rate and duration of the
      'expiratory pause' were the major elements of differentiation, while for sadness,
      joy and fear inspiratory over expiratory time ratios were the elements of
      differentiation. These last three emotions were further characterized by small
      amplitude/high rate saccadic respiratory movements superposed to different phases
      of the fundamental cycles. It is concluded that quantitatively well
      differentiated sets of respiratory changes characterize each of six basic
      emotions. The bottom-up experimental model for generating such emotions based on
      the joint activation of the respiratory-facial-postural systems and its relation
      to corresponding 'real-life' emotions is discussed.

PMID- 1748590
TI  - Event-related potentials to irrelevant deviant motion of visual shapes.
AB  - Event-related potentials to visual shapes moving across the visual field were
      recorded from 10 subjects. The subjects had to respond to the appearance of one
      of the shapes, while other shapes were irrelevant. On the periphery some of the
      shapes changed their orientation or their form. Sometimes the direction of
      movement was different from the standard direction. Subjects did not detect the
      changes of the pattern on the visual periphery, and the ERPs to these non
      detected deviants were identical to the ERPs to the standard stimuli. Six
      subjects detected the irrelevant direction of movement. In these subjects the
      deviant direction of motion elicited a fronto-central positive wave (P3s) with
      322 ms mean latency. There was no such sharp positive peak in the four subjects
      who did not detect the deviant direction of movement. Unlike the non-target
      stimuli, the targets elicited a large positive wave (P3b) with 530 ms mean
      latency.

PMID- 1748591
TI  - HGM1: a research-oriented portable heart rate and galvanic skin response monitor.
AB  - A convenient portable recording device, HGM1, which allows digital field
      recording of skin conductance and heart rate data with laboratory levels of
      precision, is described. Examples of individual data are provided from a study of
      orienting response habituation, and from students participating in a study of
      examination anxiety, recorded while they sat scheduled class examinations. These
      illustrate the potential value of the device in field studies.

PMID- 1748592
TI  - Impaired eye tracking performance in patients with presenile onset dementia.
AB  - Smooth pursuit eye movements, saccades and eye blinks were
      electrooculographically recorded from 26 healthy subjects of different age and 35
      patients with presumptive presenile onset dementia (mean age 54), who had to
      track a light spot which oscillated with different speeds. Older subjects (mean
      age 51) performed the eye tracking with less accuracy and more saccades than
      younger ones (mean age 22). 16 patients with stage CDR 1 according to Washington
      University Clinical Dementia Rating performed smooth pursuit eye movements
      significantly worse with increased saccade numbers than the healthy older
      subjects and lost attention significantly more often which was measured by
      omitted trackings to presented target oscillations. Their number of eye blinks
      was partly increased. The test is found suitable for early diagnosis of dementia
      onset, supporting clinical findings and presumptive diagnosis by objective
      parameters.

PMID- 1748593
TI  - Heartbeat perception, instructions, and biofeedback in the control of heart rate.
AB  - The present study was designed to examine the possibility that individual
      differences in heartbeat perception and instructions to control heart rate (HR)
      may influence the acquisition of voluntary control. Good (n = 20) and poor (n =
      20) perceivers of cardiac activity were selected on the basis of their
      performance according to Whitehead et al. (1977) heartbeat discrimination
      procedure. Measures of state and trait anxiety (the State-Trait Anxiety Inventory
      Form X-1 and Form X-2) and Tellegen's Absorption Scale (TAS) were used to assess
      emotionality and absorptive ability. Good and poor heartbeat perceivers (a) were
      given non-motivating instructions to try to either increase or decrease their
      heart rate (HR) with, or (b) without the use of HR-feedback, and (c) were given
      motivating instructions to try to either increase or decrease their HR with, or
      (d) without HR-feedback. Heart rate, skin conductance (SC), and EMG activity were
      monitored. Subjects were also requested to indicate the cognitive strategies used
      during their HR control training. No relationship between heartbeat perception
      and state-trait anxiety measures was found. The results did not support the idea
      that individual differences in heartbeat perception are related to individual
      differences in HR-control. They did indicate, however, that motivating
      instructions improve the capacity to increase or decrease HR. Subjects were able
      to voluntarily increase or decrease their HRs with or without a feedback signal.
      However, more pronounced HR increases were obtained in the feedback as compared
      with the no-feedback condition. SC and EMG activity were in accordance with
      arousal levels demanded by HR decrease and increase tasks. Subjects used
      cognitive strategies concerning activation responses during HR-increase and
      relaxation responses during HR-decrease conditions.

PMID- 1748594
TI  - EEG alpha-wave in the visual cortex: check of the hypothesis of the scanning
      process.
AB  - In computer-controlled experiments the recognition by seven human observers of
      tachistoscopically presented geometrical figures of different size (from 0.5 to 9
      angular degrees) or of different eccentricity (from 3 up to 16 degrees) in the
      visual field was studied. The onset of figures presentation coincided with
      different phases of the EEG alpha-wave in the occipital region. According to the
      criterion of an increase of recognition probability, an inverse dependence was
      revealed between the distance of the figures contour from the gaze (up to 9
      degrees) and the succession of phases of alpha-wave. Small or more centrally
      localized figures were significantly better recognized when presented at
      relatively earlier phases of EEG alpha-wave, while bigger or relatively more
      peripherally localized figures - at earlier phases. At 16 degrees form the gaze
      no reliable dependence of recognition on the alpha-wave phases was revealed. The
      data obtained are discussed in connection with Pitts and McCulloch (1947)
      hypothesis about a periodical (with alpha-wave frequency) scanning wave spreading
      over the visual cortex. Possibility of a synchronous excitability fluctuation in
      the whole visual cortex with alpha-rhythm frequency that imitated the spreading
      process is also discussed. Data obtained and simulation of the mentioned
      possibilities confirmed the first explanation and thus confirmed Pitt's and
      McCulloch's ideas on the EEG alpha-wave as a reflection of the scanning process
      in the visual cortex.

PMID- 1748595
TI  - Motor imagination--a model for motor performances?
AB  - The effect of training competition (TC) on central nervous activation was
      investigated in order to examine whether motor imagination could serve as a model
      for complex motor skills concerning information processing and motor control. EEG
      was recorded before and immediately after the TC. The mean alpha frequency (MAF)
      was computed from the EEG power density spectra. A significant increase of MAF
      was found after the TC. Similar changes were found during motor imagination.
      Thus, motor imagination seems to be a good model to examine activation processes.

PMID- 1748596
TI  - Generalization of cardiovascular response: supportive evidence for the reactivity
      hypothesis.
AB  - Cardiovascular responses were monitored while 36 subjects completed a battery of
      laboratory stressors comprising mental arithmetic, a reaction time task, a speech
      task, and the forehead cold pressor. Inter-task consistency was assessed for each
      of 6 physiological parameters for all task pairings. Considerable inter-task
      consistency for reactivity scores was seen among the psychological stressors for
      all variables. The question of such consistency between the cold pressor and the
      psychological tasks was then addressed. The pattern of consistency was not as
      clear-cut in this case. For systolic blood pressure and pre-ejection period,
      reactivity scores to the cold pressor did not correlate with those to any of the
      psychological tasks. In contrast, cardiac output and total peripheral resistance
      responses showed considerable consistency. The importance of determining the
      nature of the relationship between psychological and physical stressors is
      discussed.

PMID- 1748597
TI  - Effects of stress management on blood pressure and other cardiovascular
      variables.
AB  - Blood pressure and impedance cardiography derived measures of heart rate, stroke
      volume, cardiac output and total peripheral resistance were measured in 16
      persons before and after participation in a comprehensive program of stress
      management that included home monitoring of blood pressure and feedback of finger
      skin temperature during relaxation. Ten of the subjects were hypertensive and six
      were normotensive. Baseline measures of systolic and diastolic blood pressure and
      heart rate decreased significantly after participation in the program. In
      addition, reactivity to a psychological stressor (oral quiz) was significantly
      lower as revealed in reduced systolic and diastolic pressure, heart rate and
      cardiac output at the second assessment. A reduction in sympathetic nervous
      system activity is postulated as a possible mechanism for the changes observed.

PMID- 1748598
TI  - P300 from auditory and somatosensory stimuli: probability and inter-stimulus
      interval.
AB  - The P300 (P3) event-related brain potential (ERP) was elicited with auditory and
      somatosensory stimuli using an easy discrimination task in two experiments.
      Experiment 1 manipulated target stimulus probability (0.20 vs. 0.80). Experiment
      2 manipulated inter-stimulus interval (2 s vs. 6 s) for both stimulus modalities
      in different conditions while keeping target probability constant. Probability
      and inter-stimulus interval had similar effects for auditory and somatosensory
      stimuli, with lower probability and longer inter-stimulus intervals producing
      larger P3 amplitudes. No statistically reliable differences in scalp distribution
      between modalities were obtained, with both modalities producing maximal
      amplitudes at Pz. The results suggest that auditory and somatosensory stimuli
      when used in a relatively easy discrimination task yield the same overall P3
      values.

PMID- 1748599
TI  - Effects of mental countermeasures on psychophysiological detection in the guilty
      knowledge test.
AB  - This study focused on the effects of mental countermeasures on
      psychophysiological detection in a guilty knowledge paradigm. Two experiments
      which utilized a 3 x 2 between subjects factorial design were conducted. Two
      types of mental countermeasures (specific dissociations from the relevant
      stimulus and continuous dissociation throughout the entire test, as well as a
      control-no countermeasure condition were used). Each group was further subdivided
      into two conditions--a high attention condition created by motivational
      instructions and a deceptive verbal response to the relevant question; and a low
      attention condition in which no motivational instructions were provided and no
      verbal response was required. The results of both experiments (one was conducted
      in a field set up, and the other utilized more standard experimental equipment
      and measurement procedures) revealed the following pattern: the item-specific
      countermeasures tended to increase psychophysiological detection, whereas the
      continuous dissociations tended to decrease detection efficiencies. The pattern
      was consistent across attention conditions and experiments but it was stronger in
      the field experiment where overall detection efficiency was relatively high. In
      other respects the present results replicated previous findings and revealed a
      significant effect for the attention factor.

PMID- 1748600
TI  - Is your practice a drug-free workplace?

PMID- 1748601
TI  - Drug and alcohol abuse can affect your practice.

PMID- 1748602
TI  - Relevance of social science to veterinary medicine.

PMID- 1748603
TI  - Attitudinal survey of Tennessee beef producers regarding evacuation during an
      emergency.

PMID- 1748604
TI  - Underachiever's guide to building a small clientele.

PMID- 1748605
TI  - Practitioner's mid-life crisis.

PMID- 1748606
TI  - Clinical evaluation of 1% cyclosporine for topical treatment of
      keratoconjunctivitis sicca in dogs.
AB  - Keratoconjunctivitis sicca (KCS) is a prevalent and often vision-threatening
      condition in dogs. In several reports, 2% cyclosporine (cyclosporin A, CsA) was
      described as effective in modulating the clinical signs of KCS. This study was
      designed to compare the efficacy of 1% CsA vs a placebo, using a randomized
      double-blind clinical trial. Topical administration of 1% CsA significantly
      improved Schirmer wetting values and subjective markers of corneal health as
      compared with the placebo. In the dogs treated with topical administration of 1%
      CsA, the clinical signs of KCS were improved in 81.8% of cases.

PMID- 1748607
TI  - Topical administration of cyclosporine for treatment of keratoconjunctivitis
      sicca in dogs.
AB  - Sixty dogs with chronic keratoconjunctivitis sicca were treated by topical
      administration of 2% cyclosporine twice daily. Causes and duration of
      keratoconjunctivitis varied. Tear production improved in 75 of 100 eyes, and
      corneal pigmentation decreased in 45 of 67 eyes. Six factors were evaluated to
      determine their influence on treatment outcome. The only significant variable was
      the initial Schirmer tear test value. Side effects were few. Evidence of burning
      in response to application of cyclosporine resolved with change in the
      formulation of the topical solution.

PMID- 1748608
TI  - Reciprocal apparatus dysfunction as a cause of severe hind limb lameness in a
      horse.
AB  - A 2-year-old Appaloosa mare was admitted because of acute, severe hind limb
      lameness (grade 4 of 5). The hock could be flexed or extended without influencing
      the position of the stifle joint, and the fetlock and proximal interphalangeal
      joints could be extended while the hock was maintained in flexion. The diagnosis
      was functional loss of the reciprocal apparatus. The differential diagnoses for
      functional loss of the reciprocal apparatus include disruption of the common
      calcaneal tendon, the gastrocnemius muscle, the peroneus tertius, or the
      superficial digital flexor muscle. In this horse, the diagnosis was disruption of
      the superficial digital flexor muscle. The horse made an excellent recovery
      following 5 months of stall confinement.

PMID- 1748609
TI  - Anterior uveal melanoma, with secondary keratitis, cataract, and glaucoma, in a
      horse.
AB  - Intraocular melanoma was diagnosed in a 13-year-old horse. Secondary clinical
      findings included keratitis, cataract, and glaucoma. The eye was enucleated.
      Follow-up information did not give an indication of metastatic disease.

PMID- 1748610
TI  - Tarsocrural joint luxation in a horse.
AB  - A 14-year-old Quarter Horse x Thoroughbred gelding was admitted to the teaching
      hospital because of inability to bear weight on its right hind limb, associated
      with a severe deviation of the tarsus. The provisional diagnosis was tarsal joint
      luxation or fracture. Radiography revealed complete luxation of the tarsocrural
      joint. The luxation was reduced, using minimal force. The horse was confined to a
      box stall and was maintained in a full-length hind-limb cast for 33 days. Box
      stall confinement was continued for 3 months after removal of the cast. On
      reexamination 18 months after the injury, the horse had only mild lameness (grade
      1 of 5), but had marked reduction in the range of motion of the tarsus.
      Radiography revealed extensive changes indicative of severe degenerative joint
      disease. The horse was still used occasionally as a light pleasure riding horse
      and maintained itself on pasture well.

PMID- 1748611
TI  - Thoracolumbar vertebral osteochondroma in a young dog.
AB  - Osteosarcoma was diagnosed in a 7-month-old female German Shepherd Dog with hind
      limb paresis. Radiography revealed a circumscribed calcified mass in the dorsal
      vertebral lamina at T13-L1 resulting in extradural compression of the spinal
      cord. Surgical excision of the mass resulted in gradual return to normal
      neurologic function. Four weeks after surgery, the dog became severely atactic
      after rolling onto its back. A chip fracture of T13 was identified, and the dog
      was euthanatized at the owners' request.

PMID- 1748612
TI  - Osteogenic sarcoma and cisplatin chemotherapy in dogs: 16 cases (1986-1989).
AB  - Sixteen dogs, given adjuvant cisplatin chemotherapy after amputation for
      osteogenic sarcoma of the appendicular skeleton, had a median survival time of
      413 days. Ten dogs (62%) were alive 1 year after amputation. Dogs were given
      cisplatin at a dosage of 50 mg/m2 of body surface every 4 weeks for a total of 6
      cisplatin treatments, or until metastatic disease was detected. Cisplatin
      chemotherapy was well-tolerated by most dogs, with only 1 dog developing serious
      gastrointestinal toxicosis, requiring hospitalization. Results of this study
      support other investigators' findings that when a cisplatin chemotherapy-based
      protocol is administered, survival times after amputation can be prolonged for
      dogs with osteogenic sarcoma.

PMID- 1748613
TI  - Hepatotoxicity of phenobarbital in dogs: 18 cases (1985-1989).
AB  - The medical records of 18 dogs that had hepatic disease and received
      phenobarbital as an anticonvulsant for 5 to 82 months were reviewed. Clinical
      signs included sedation and ataxia in all dogs, 5 dogs were also anorectic, 2 had
      coagulopathy, 3 were icteric, and 5 had ascites. Serum biochemical analysis
      revealed serum albumin concentration less than or equal to 2.2. g/dl in 12 dogs,
      serum alkaline phosphatase activity greater than or equal to 169 U/L in 18 dogs,
      serum alanine transaminase activity greater than or equal to 57 U/L in 15 dogs,
      and total bilirubin concentration greater than or equal to 1 mg/dl (in the
      absence of lipemia) in 7 dogs. Serum phenobarbital concentration was greater than
      or equal to 40 micrograms/ml in 12 of 17 dogs. Sulfobromophthalein excretion was
      prolonged in 8 of 10 dogs. Preprandial serum bile acid concentrations were high
      in 8 of 10 dogs, and 2-hour postprandial serum bile acid concentrations were high
      in 9 of 10 dogs. Two of 4 dogs tested had resting plasma ammonia concentrations
      greater than 200 mg/dl. An ammonia tolerance test was performed on 2 other dogs;
      both had ammonia concentration greater than or equal to 200 mg/dl in the plasma
      30 minutes after receiving 100 mg of ammonium chloride/kg of body weight, PO.
      Nine dogs died, 1 was euthanatized, and necropsies were performed on these 10
      dogs. Biopsies and necropsies of 6 dogs revealed chronic hepatic fibrosis with
      nodular regeneration (cirrhosis). One dog had hepatocellular carcinoma and mild
      cirrhosis. In 1 dog, after phenobarbital had been withheld, necropsy revealed
      complete recovery of the previously observed lesions.

PMID- 1748614
TI  - Myiasis in two box turtles.
AB  - Two eastern box turtles (Terrapene carolina carolina) were treated for myiasis
      caused by Sarcophaga cistudinis. The tortoises were examined because of swellings
      of the proximal cervical regions. Both fully recovered following surgical removal
      of multiple larvae.

PMID- 1748615
TI  - Suspected lead toxicosis in a captive goshawk.
AB  - Lead toxicosis was diagnosed in a 3-week-old male goshawk after evaluation of the
      history, clinical signs, radiographic lesions, and laboratory values. Treatment
      with Ca-EDTA and supportive measures was successful. The presumed source of lead
      was from birds that had been shot with a pellet gun and used for food.

PMID- 1748616
TI  - What is your diagnosis? Benign bone cyst in the distal portion of the left femur.

PMID- 1748617
TI  - Do injection site reactions induce fibrosarcomas in cats?

PMID- 1748618
TI  - Reassures that academia values interdisciplinary cooperation.

PMID- 1748619
TI  - Exploring llama reproduction.

PMID- 1748620
TI  - Legionella pneumophila in a human trophoblast cell line.

PMID- 1748621
TI  - Epidermal growth factor, DNA synthesis and human hepatocytes.

PMID- 1748622
TI  - Insect muscle cell line forms contractile tissue networks in vitro.

PMID- 1748623
TI  - Different survival of continuous cell lines transported in live or frozen form.

PMID- 1748624
TI  - Culture of fetal alveolar epithelial type II cells in serum-free medium.
AB  - A serum-free culture medium (defined medium = DM) was elaborated by adding to
      Eagle's minimum essential medium (MEM), non-essential amino acids, transferrin,
      putrescine, tripeptide glycyl-histidyl-lysine, somatostatin, sodium selenite,
      ethanolamine, phosphoethanolamine, sodium pyruvate, and metal trace elements.
      This medium was tested for its ability to support sustained surfactant
      biosynthesis in fetal alveolar epithelial type II cells. For up to 8 days,
      ultrastructure was maintained with persistence of lamellar inclusion bodies.
      Thymidine incorporation into DNA was enhanced about 50% in DM as compared with
      MEM, whereas it was enhanced 300% in 10% fetal bovine serum. With DM, the
      incorporation of tritiated choline into phosphatidylcholine (PC) of isolated
      surfactant material was about twice that with MEM. Deletion experiments evidenced
      the prominent role of pyruvate, transferrin, and selenium in the stimulation of
      surfactant PC biosynthesis. The addition of biotin to DM enhanced surfactant PC
      biosynthesis slightly and nonsurfactant PC biosynthesis markedly. The presence of
      nucleosides seemed unfavorable to the synthesis of surfactant PC. Type II cells
      responded to the addition of epidermal growth factor and insulinlike growth
      factor-I both by increased thymidine incorporation into DNA and choline
      incorporation into PC. It is concluded that DM represents a useful tool for
      cultivating type II cells without loss of their specialized properties and for
      studying the regulation of cell proliferation and surfactant biosynthesis in a
      controlled environment.

PMID- 1748625
TI  - Induction of metamorphosis by thyroid hormone in anuran small intestine cultured
      organotypically in vitro.
AB  - We have developed an organ culture system of the anuran small intestine to
      reproduce in vitro the transition from larval to adult epithelial form which
      occurs during spontaneous metamorphosis. Tubular fragments isolated from the
      small intestine of Xenopus laevis tadpoles were slit open and placed on membrane
      filters in culture dishes. In 60% Leibovitz 15 medium supplemented with 10%
      charcoal-treated serum, the explants were maintained in good condition for at
      least 10 days without any morphologic changes. Addition of triiodothyronine (T3)
      at a concentration higher than 10(-9) M to the medium could induce cell death of
      larval epithelial cells, but T3 alone was not sufficient for proliferation and
      differentiation of adult epithelial cells. When insulin (5 micrograms/ml) and
      cortisol (0.5 microgram/ml) besides T3 were added, the adult cells proliferated
      and differentiated just as during spontaneous metamorphosis. On Day 5 of
      cultivation, the adult cells rapidly proliferated to form typical islets, whereas
      the larval ones rapidly degenerated. At the same time, the connective tissue
      beneath the epithelium suddenly increased in cell density. These changes
      correspond to those occurring at the onset of metamorphic climax. By Day 10, the
      adult cells differentiated into a simple columnar epithelium which possessed the
      brush border and showed the adult-type lectin-binding pattern. Therefore, the
      larval epithelium of the small intestine responded to the hormones and
      transformed into the adult one. This organ culture system may be useful for
      clarifying the mechanism of the epithelial transition from larval to adult type
      during metamorphosis.

PMID- 1748626
TI  - Differential stabilization of cytochrome P-450 isoenzymes in primary cultures of
      adult rat liver parenchymal cells.
AB  - Cytochrome P-450 dependent hydroxylation of testosterone was measured in 7-day
      old cultures of primary rat liver parenchymal cells. Determinations were carried
      out in monocultures of parenchymal cells and co-cultures of parenchymal cells
      with rat liver nonparenchymal epithelial cells, or mouse embryo fibroblasts. In
      the monoculture system, testosterone metabolism was drastically reduced and
      hardly measurable after 7 days in culture. In the co-culture systems, individual
      P-450 isoenzymes were stabilized on different levels. P-450s p and presumably c
      were well preserved, P-450 a was reduced but clearly measurable, P-450 h was
      totally lost whereas P-450s b and e were not measurable after 7 days (the
      activities of these isoenzymes however were already low in freshly isolated
      parenchymal cells). The results were independent of the cell line used for co
      cultivation and of the method of parenchymal cell isolation, that is whether
      collagenase or EDTA was used as the agent for dissociating the cells from the
      liver. The results showed that the co-cultivation of liver parenchymal cells with
      other nonparenchymal cells significantly improved the differentiated status of
      the former. In this cell culture system however, not every parameter was equally
      well stabilized.

PMID- 1748627
TI  - Organ culture as a model for investigating the effects of antimetabolites and
      nucleoside transport inhibitors on rodent colonic mucosa.
AB  - The in-vitro effects of hydroxyurea 5-FU and 5-FUdR have been extensively studied
      in experimental systems employing cell-line techniques. In this study we
      investigated the effects of these drugs on the levels of incorporation of labeled
      nucleosides into DNA in explants of intact rat colonic mucosa maintained in organ
      culture. The effects of the nucleoside transport inhibitors
      nitrobenzylthioinosine (NBMPR) and dipyridamole--which are modulators of
      antimetabolite cytotoxicity--on the incorporation of tritiated thymidine
      ([3H]TdR) into DNA were also studied. The incorporation of tritiated TdR into DNA
      was reduced by hydroxyurea but was not altered by either 5-FU or 5-FUdR. The
      levels of tritiated deoxyuridine were reduced by 5-FU and 5-FUdR in separate
      experiments; this is in keeping with thymidylate synthase inhibition. NBMPR and
      dipyridamole also reduced 3H-TdR incorporation into DNA. These results can be
      explained in terms of the known mechanisms of action of these drugs. This
      experimental model is therefore useful in assessing the effects of
      antimetabolites and nucleoside transport inhibitors in intact colonic mucosa.

PMID- 1748628
TI  - Adhesion, spreading, and proliferation of cells on protein carpets: effects of
      stability of a carpet.
AB  - In the present report we have investigated the role that the physical properties
      of substrata play in modulating the effects which components of extracellular
      matrix (ECM) exert on adhesion, spreading, and growth of retinal pigmented
      epithelial cells. By simple modifications of conditions for protein adsorption on
      glass we obtained a set of substrata all coated with proteins of ECM (protein
      carpets) but with different physical properties. Using these protein carpets we
      have shown that their stability (desorption rate) in tissue culture conditions
      varies according to the technique with which they were prepared. Both
      semiremovable and immobilized carpets are stable, whereas removable protein
      carpets desorb readily. Therefore, the protein concentration or composition or
      both may change with time in tissue culture depending on the technique used to
      prepare the carpet. In addition, efficacy of cell attachment to given protein may
      vary depending on whether a technique used to prepare the protein carpet involves
      denaturation of the protein. Adherent cells quickly remove (clear) weakly
      adsorbed protein carpets and it seems that the carpet removal is a mechanical
      process. During the carpet removal cells are rounded, which indicates that a
      spread cell phenotype normally associated with stress fibers and focal contacts
      occurs when the substratum is rigid enough to sustain cell traction. In addition,
      substrata lacking the rigidity to support the spread phenotype do not support
      cell proliferation either.

PMID- 1748629
TI  - Concomitant proliferation and formation of a stratified epithelial sheet by
      explant outgrowth of epidermal keratinocytes from adult mice.
AB  - A chemically defined medium containing 1.2 mM Ca2+ has been developed for the
      culture of primary epidermal keratinocytes from untreated adult mice such that
      proliferation is accompanied by the formation of desmosomes and stratification.
      Cultured cutaneous explants of 1 mm2 from the backs of untreated, control, and
      carcinogen-exposed mice all demonstrated epithelial outgrowth within 1 wk, and by
      5 wk approached confluence with characteristics of terminal differentiation such
      as desmosomes and stratification. Addition of 12-O-tetradecanoylphorbol-13
      acetate (TPA) to the medium in concentrations of 0.001, 0.01, and 0.1
      micrograms/ml resulted in a delay of approximately 1 wk in the outgrowth of the
      explants compared with the acetone controls and in a 30% decrease in the diameter
      of the epithelial outgrowth at 3 wk. The inhibition in outgrowth was overcome at
      higher concentrations (0.5, 1.0, and 10 micrograms/ml TPA). No obvious
      differences in morphology or in the rate of epidermal outgrowth within a 5-wk
      interval among explants from normal untreated epidermis, epidermis from mice
      treated with acetone, or epidermis from mice treated with an initiating
      application of 7,12-dimethylbenz[a]anthracene were observed. The defined
      composition of this medium and its ability to support reproducibly and
      conveniently both proliferation and differentiation of normal as well as treated
      primary adult murine epidermal cells suggest that it should be useful for a
      number of studies not previously possible that are relevant to the biology of the
      skin, to toxicology, and to carcinogenesis in the murine model system.

PMID- 1748630
TI  - A phosphorylation site located in the NH2-terminal domain of c-Myc increases
      transactivation of gene expression.
AB  - The c-myc gene encodes a sequence-specific DNA-binding protein (c-Myc) that forms
      leucine zipper complexes and can act as a transcription factor. Growth factor
      stimulation of cells causes the phosphorylation of the c-Myc transcriptional
      activation domain at Ser62 within a proline-rich region that is highly conserved
      among members of the Myc family (Alvarez, E., Northwood, I.C., Gonzalez, F. A.,
      Latour, D. A., Seth, A., Abate, C., Curran, T., and Davis, R. J. (1991) J. Biol.
      Chem. 266, 15277-15285). This phosphorylation site is a substrate for growth
      factor-regulated MAP kinases and for the cell cycle-dependent protein kinase
      p34cdc2. We report that serum treatment of cells results in a marked increase in
      the transactivation of gene expression mediated by the c-Myc transcriptional
      activation domain. A point mutation at the site of growth factor-stimulated
      phosphorylation (Ser62) decreases the serum induction of transactivation. These
      data indicate that the c-Myc transcriptional activation domain may be a direct
      target of signal transduction pathways.

PMID- 1748631
TI  - The sequence of squash NADH:nitrate reductase and its relationship to the
      sequences of other flavoprotein oxidoreductases. A family of flavoprotein
      pyridine nucleotide cytochrome reductases.
AB  - Nucleotide sequences were determined for cDNA clones for squash NADH:nitrate
      oxidoreductase (EC 1.6.6.1), which is one of the most completely characterized
      forms of this higher plant enzyme. An open reading frame of 2754 nucleotides
      began at the first ATG. The deduced amino acid sequence contains 918 residues,
      with a predicted Mr = 103,376. The amino acid sequence is very similar to
      sequences deduced for other higher plant nitrate reductases. The squash sequence
      has significant similarity to the amino acid sequences of sulfite oxidase,
      cytochrome b5, and NADH:cytochrome b5 reductase. Alignment of these sequences
      with that of squash defines domains of nitrate reductase that appear to bind its
      3 prosthetic groups (molybdopterin, heme-iron, and FAD). The amino acid sequence
      of the FAD domain of squash nitrate reductase was aligned with FAD domain
      sequences of other NADH:nitrate reductases, NADH:cytochrome b5 reductases,
      NADPH:nitrate reductases, ferredoxin:NADP+ reductases, NADPH:cytochrome P-450
      reductases, NADPH:sulfite reductase flavoproteins, and Bacillus megaterium
      cytochrome P-450BM-3. In this multiple alignment, 14 amino acid residues are
      invariant, which suggests these proteins are members of a family of flavoenzymes.
      Secondary structure elements of the structural model of spinach ferredoxin:NADP+
      reductase were used to predict the secondary structure of squash nitrate
      reductase and the other related flavoenzymes in this family. We suggest that this
      family of flavoenzymes, nearly all of which reduce a hemoprotein, be called
      "flavoprotein pyridine nucleotide cytochrome reductases."

PMID- 1748632
TI  - Oxalate decarboxylase from Collybia velutipes. Purification, characterization,
      and cDNA cloning.
AB  - The oxalate-degrading enzyme oxalate decarboxylase (EC 4.1.1.2), which is
      inducible by oxalic acid, was purified to homogeneity from a crude extract of
      Collybia velutipes, a basidiomycetous fungus. Two forms of the enzyme were
      resolved on chromatofocusing. The two isozymes were shown to be related by amino
      acid composition, peptide mapping, and immunological cross-reactivity. Peak A,
      eluting at pH 3.3, was used for further study; the Km was found to be 4.5 mM, and
      the Vmax was 166 mumol/min/mg. The subunit molecular mass of the glycosylated
      enzyme was 64 kDa, whereas the mass of the deglycosylated protein was 55 kDa. The
      enzyme showed an acidic pl, was very stable over a wide pH range, and was
      moderately thermostable. The cDNA encoding the enzyme was obtained by
      immunoscreening a lambda gt11 expression library. In vitro translation of hybrid
      selected mRNA gave a 55-kDa protein. Genomic Southern hybridization indicated the
      oxalate decarboxylase is encoded by a single gene. The cDNA probe hybridized to a
      single 1.5-kilobase pair species of mRNA. The mRNA was shown to be induced by
      oxalic acid. A temporal relationship between enzyme activity and mRNA levels was
      observed, thus suggesting that the expression of oxalate decarboxylase is
      regulated at the transcriptional level.

PMID- 1748633
TI  - Substantial increase of the inhibitory activity of Mirabilis antiviral protein by
      an elimination of the disulfide bond with genetic engineering.
AB  - Mirabilis antiviral protein (MAP) is a rigid, heat-stable protein composed of 250
      amino acids with an intramolecular disulfide bond. MAP inhibits the in vitro
      protein synthesis of rabbit reticulocyte with approximately one-thirtieth the
      activity of the ricin A chain, a homologous protein with no such bond (Habuka,
      N., Murakami, Y., Noma, M., Kudo, T., and Horikoshi, K. (1989) J. Biol. Chem.
      264, 6629-6637; Habuka, N., Akiyama, K., Tsuge, H., Miyano, M., Matsumoto, T.,
      and Noma, M. (1990) J. Biol. Chem. 265, 10988-10992). The bond is presumed to
      induce some structural perturbation that alters the mode of interaction with the
      substrate ribosome and thus lowers the activity. To confirm this hypothesis, a
      mutant MAP gene in which the codons of both cysteines were replaced by those of
      serines was constructed and expressed in Escherichia coli, and its product
      (C36/22OS) was purified. In a sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, C36/220S showed the same mobility as that of MAP reduced by 2
      mercaptoethanol, whereas nonreduced MAP showed faster migration. The inhibitory
      activity of C36/220S was approximately 22 times higher than that of native MAP,
      that is the mutant had an IC50 of 0.16 nM for the protein synthesis of the rabbit
      reticulocyte system, whereas the native MAP had an IC50 of 3.5 nM. The results
      indicate that the activity of MAP is increased by the elimination of the
      disulfide bond, and this supports the hypothesis.

PMID- 1748634
TI  - Metabolism of 5,6-epoxyeicosatrienoic acid by the human platelet. Formation of
      novel thromboxane analogs.
AB  - Radiolabeled cis-(+-)-5,6-epoxyeicosatrienoic acid (5(6)-EpETrE) was incubated
      with a suspension of isolated human platelets in order to study its metabolic
      fate. The epoxide slowly disappeared from the suspension and was completely
      metabolized within 30 min. After extraction and analysis by reverse-phase high
      performance liquid chromatography, seven metabolites were found. Addition of
      either indomethacin (0.01 mM, cyclooxygenase inhibitor) or BW755C (0.1 mM,
      cyclooxygenase/lipoxygenase inhibitor) to the incubations blocked the formation
      of four and six metabolites, respectively, 1,2-Epoxy-3,3,3-trichloropropane
      (inhibitor of microsomal epoxide hydrolase) failed to inhibit the formation of
      5,6-dihydroxyeicosatrienoic acid (5,6-DiHETrE), a hydrolysis product of the
      precursor 5(6)-EpETrE. The metabolites were characterized by UV spectroscopy,
      negative ion chemical ionization liquid chromatography/mass spectrometry, gas
      chromatography/mass spectrometry and, in one instance, coelution with synthetic
      standard. Three primary platelet metabolites were structurally determined to be
      5,6-epoxy-12-hydroxyeicosatrienoic acid, 5,6-epoxy-12-hydroxyheptadecadienoic
      acid, and a unique bicyclic metabolite, 5-hydroxy-6,9-epoxy-thromboxane B1, which
      originated from intramolecular hydrolysis of 5,6-epoxythromboxane-B1. This
      thromboxane analog was partially separated into stereoisomers and coeluted with
      the racemic synthetic standard in gas chromatography/mass spectrometry and liquid
      chromatography/mass spectrometry. Three other metabolites were characterized as
      5,6,12-trihydroxyeicosatrienoic acid, 5,6,12-trihydroxyheptadecadienoic acid, and
      5,6-dihydroxythromboxane-B1, and resulted from the hydrolysis of the
      corresponding epoxides rather than from the metabolism of 5,6-DiHETrE. The latter
      was not metabolized by platelet cyclooxygenase or lipoxygenase. The biosynthesis
      of two cyclooxygenase metabolites indicated the formation of unstable 5,6
      epoxythromboxane-A1 as an intermediate precursor. Platelet aggregation was not
      induced by 5(6)-EpETrE, although responsiveness to arachidonic acid was reduced
      following preincubation with the epoxide. The platelet metabolites of 5(6)-EpETrE
      might be useful in assessing its in vivo production in humans.

PMID- 1748635
TI  - Oleic acid promotes changes in the subcellular distribution of protein kinase C
      in isolated hepatocytes.
AB  - The effect of oleate on the subcellular distribution of protein kinase C (PKC)
      was studied in isolated hepatocytes and in perfused rat liver in the presence of
      physiological concentrations of serum albumin. A time- and dose-dependent
      translocation of PKC from the cytosol towards the membranes was observed at
      oleate concentrations that fell within the range of concentrations reached under
      several physiological conditions. Analysis of the membrane-bound isoenzymes of
      PKC by hydroxylapatite chromatography revealed that the beta isoenzyme was
      preferentially translocated to this compartment in hepatocytes incubated with
      oleate. Activation of PKC after incubation of hepatocytes with oleate involved at
      least three different effectors of the enzyme: the fatty acid itself, the
      diacylglycerol synthesized from oleate, and the rise in the cytosolic calcium
      concentration elicited by oleate. As a result of PKC activation, protein
      phosphorylation of intact hepatocytes in response to oleate exhibited an
      enhancement in the phosphate content of a protein of 82 kDa, similar to that
      phosphorylated in the presence of phorbol dibutyrate.

PMID- 1748636
TI  - Skeletal myoblasts utilize a novel beta 1-series integrin and not alpha 6 beta 1
      for binding to the E8 and T8 fragments of laminin.
AB  - The E8 fragment of laminin stimulates myoblast attachment and locomotion.
      Myoblast attachment to laminin/E8 was blocked by anti-integrin antibodies against
      beta 1-chains but not by antibodies against alpha 6-chains. By contrast, other
      cell lines (e.g. B16, HT1080, P19, F9, Pys2, 3T3, and 3T6) were blocked both by
      anti-beta 1 and anti-alpha 6. All cells tested also bound to approximately 125
      kDa C-terminal fragments of E8 (T8 and T8'). Immunoprecipitation of surface
      iodinated myoblasts revealed beta 1-, alpha 3-, and alpha 5-integrin chains and a
      novel chain that co-precipitated with anti-beta 1 antibodies running at
      approximately 95 kDa (reduced). I125-alpha 6 beta 1 was immunoprecipitated from
      cells whose attachment to E8 was blocked by anti-alpha 6 antibodies. By contrast,
      little alpha 6 beta 1 could be immunoprecipitated from myoblasts. beta 1-Integrin
      and the novel alpha-chain (alpha'), Mr approximately 120,000/approximately 95.000
      (nonreduced/reduced), from myoblast lysates were retained during affinity
      chromatography on Engelbreth-Holm-Swarm-laminin affinity columns. beta 1, alpha
      1, and the novel alpha' were retained from Rugli cell lysates on Engelbreth-Holm
      Swarm-laminin columns. alpha 3 was not bound. When E8 was used as affinity
      matrix, only beta 1 and alpha' were retained. The N-terminal sequence of Rugli
      alpha' was homologous to alpha-chains of beta 1-series integrins and was most
      similar to alpha 6 (9 identical residues out of 14). However, there were
      distinctive differences; in particular, 2 residues were deleted in comparison
      with alpha 6.

PMID- 1748637
TI  - Drosophila 5 S RNA processing requires the 1-118 base pair and additional
      sequence proximal to the processing site.
AB  - Using an in vitro processing system, we have identified a required sequence
      surrounding the Drosophila melanogaster 5 S RNA processing site at nucleotide
      120. Mutations in this region vary the processing rate from complete inhibition
      to a level equal to or greater than wild type. Analysis of mutants at +1 and in
      the region 118-122 separates the inhibitory effect into two parts. 1) Nucleotide
      118 C, the base-paired nucleotide in helix I proximal to the processing site,
      plays an essential role. Changing it to a purine inhibits processing. The +1-118
      base pair must be intact, but this alone is not sufficient for processing, since
      compensatory changes at +1 do not restore down-processing mutants at 118 to the
      wild type level. 2) The processing site has to be pyrimidine rich; multiple
      contiguous purines inhibit processing. On the other hand, multiple pyrimidines
      can largely negate the inhibitory effect of a mutation at position 118. Thus a
      base-paired C at 118 followed by a stretch of pyrimidines is the processing
      signal, which may be recognized by the processing enzyme and/or a required
      accessory factor.

PMID- 1748638
TI  - Transport of proteins into chloroplasts. Delineation of envelope "transit" and
      thylakoid "transfer" signals within the pre-sequences of three imported thylakoid
      lumen proteins.
AB  - The targeting of cytosolically synthesized proteins into the thylakoid lumen is
      mediated by an aminoterminal pre-sequence consisting of an "envelope transit" and
      a "thylakoid transfer" signal in tandem. We have investigated the structural
      characteristics of several thylakoid transfer signals by determining the
      intermediate sites at which the stromal processing peptidase cleaves to remove
      the transit sequences. Using this approach we have found that the thylakoid
      transfer signals of Silene pratensis plastocyanin, 23-kDa oxygen-evolving complex
      protein from wheat, and 33-kDa oxygen-evolving complex protein from wheat, are
      25, 39, and 48 residues in length, respectively. All of the transfer signals
      contain hydrophobic core sequences and a "-3,-1" motif reminiscent of those found
      in signal sequences, but the amino-terminal regions of the transfer signals of
      the 23- and 33-kDa proteins are both longer and more highly charged. The net
      charge of each amino-terminal region of the transfer sequences is +1, including
      the amino-terminal amino group. In each case, the stromal processing peptidase
      cleaves immediately after a positively charged residue, but otherwise the
      cleavage sites exhibit no common elements of either primary or secondary
      structure.

PMID- 1748639
TI  - Clustering of integral membrane proteins of the human erythrocyte membrane
      stimulates autologous IgG binding, complement deposition, and phagocytosis.
AB  - Damaged or old erythrocytes are cleared rapidly from circulation. Because several
      common biochemical lesions can induce the clustering of integral membrane
      proteins, we have proposed that formation of microscopic protein aggregates in
      the membrane might constitute a cell surface marker that promotes removal of the
      defective/senescent cells. We demonstrate here that treatments that cluster
      integral membrane proteins in erythrocytes (1 mM ZnCl2, 1 mM acridine orange, and
      0.35 microM melittin) induce autologous IgG binding, complement fixation, and
      phagocytosis by human monocytes in vitro. Removal of the clustering agents prior
      to incubation in autologous serum or cross-linking of cell surface proteins
      before addition of clustering agents prohibited the above response, while cross
      linking after treatment with the clustering agents preserved the response even if
      the clustering agents were later removed. Furthermore, subsequent reversal of the
      chemical cross-link maintaining the clustered distribution also reversed the
      induction of IgG binding, complement deposition, and phagocytosis. Finally, by
      deleting or inactivating different steps in the phagocytosis pathway, the
      chronology of steps was shown to be: (i) integral protein clustering, (ii) IgG
      binding, (iii) complement deposition, and (iv) phagocytosis.

PMID- 1748640
TI  - Regulation of agonist-induced prostaglandin E1 versus prostaglandin E2
      production. A mass analysis.
AB  - Prostaglandin E1 (PGE1) and prostaglandin E2 (PGE2), derived by enzymatic
      oxidation of cellular dihomogammalinolenic acid (DHLA) and arachidonic acid (AA),
      respectively, have diverse and, at times, distinct biological actions. It has
      been suggested that PGE1 specifically inhibits a variety of inflammatory
      processes, and, in light of the potential therapeutic benefit of PGE1 and its
      fatty acid precursor in inflammatory disorders, there is growing interest in the
      biochemical mechanisms which determine the balance between PGE1 and PGE2
      synthesis. Metabolic studies in this area have been hampered by the difficulties
      in measuring the extremely small masses of these prostaglandins which are
      generated in cell culture systems. We studied the regulation of PGE1 versus PGE2
      synthesis using an essential fatty acid-deficient, PGE-producing, mouse
      fibrosarcoma cell line, EFD-1. Because EFD-1 cells contain no endogenous AA or
      DHLA, we were able to replete the cells with AA and DHLA of known specific
      activities; thus, the mass of both cellular AA and DHLA, and synthesized PGE1 and
      PGE2, could be accurately determined. The major finding of this study is that
      production of PGE2 was highly favored over production of PGE1 due to preferential
      incorporation of AA versus DHLA into, and release from, the total cellular
      phospholipid pool. Further, we correlated the selective release of AA versus DHLA
      from total cellular phospholipids with the selective incorporation of AA versus
      DHLA into specific phospholipid pools. In addition, we showed that conversion of
      DHLA to AA by delta 5 desaturase was enhanced by increasing the cellular mass of
      n-6 fatty acids and by increasing the cell proliferative activity. Together,
      these results indicate that the relative abundance of PGE2 versus PGE1 in vivo is
      not merely a function of the relative abundance of AA versus DHLA in tissues, but
      also relates to markedly different cellular metabolism of these two fatty acids.

PMID- 1748641
TI  - Proteolytic formation of either of the two prothrombin activation intermediates
      results in formation of a hirugen-binding site.
AB  - Hirugen, a synthetic dodecapeptide corresponding to the carboxyl-terminal amino
      acids 53-64 of hirudin, binds within a deep groove in thrombin that contains a
      cationic region referred to as the anion-binding exosite. This region is
      important in many of the binary interactions of thrombin with macromolecular
      substrates and cofactors. Fluorescein-labeled hirugen was used to probe which
      steps in the prothrombin activation process generate this anion-binding exosite.
      Two activation cleavage sites exist in bovine prothrombin. Cleavage at Arg274
      Thr275 releases the activation fragments to generate the thrombin precursor,
      prethrombin 2. Cleavage of prothrombin within a disulfide loop at Arg323-Ile324
      leads to formation of meizothrombin with no loss of peptide material but with
      formation of amidolytic activity. Cleavage of the same bond in prethrombin 2
      generates thrombin. Hirugen, labeled at the amino terminus with fluorescein
      isothiocyanate, does not bind to prothrombin but does bind to thrombin (Kd = 9.6
      +/- 1.2 x 10(-8) M), prethrombin 2 (Kd = 1.3 +/- 0.1 x 10(-7) M), thrombin
      fragment-2 complex (Kd = 1.1 +/- 0.2 x 10(-6) M), and meizothrombin (Kd = 1.6 +/-
      0.5 x 10(-8) M). Prothrombin fragment-2 and hirugen both bind independently to
      thrombin. A ternary complex can form with hirugen and fragment-2 and either
      thrombin or prethrombin 2, suggesting that fragment-2 and hirugen bind to
      discrete sites. Hirugen also alters the active site conformation of thrombin as
      detected by modulation of synthetic substrate hydrolytic activity. These studies
      suggest that conformational changes, rather than alleviating steric hindrance,
      are responsible for the formation of the hirugen-binding site during prothrombin
      activation. Furthermore, this conformational change can be effected by the
      cleavage of either of the two bonds required for activation of prothrombin.

PMID- 1748642
TI  - Structural and functional consequences of amino acid substitutions in the second
      conserved loop of Escherichia coli adenylate kinase.
AB  - All known nucleoside monophosphate kinases contain an invariant sequence Asp-Gly
      Phe(Tyr)-Pro-Arg. In order to understand better the structural and functional
      role of individual amino acid residues belonging to the above sequence, three
      mutants of Escherichia coli adenylate kinase (D84H, G85V, and F86L) were produced
      by site-directed mutagenesis. Circular dichroism spectra revealed that the
      secondary structure dichroism spectra revealed that the secondary structure of
      all three mutant proteins is very similar to that of the wild-type enzyme.
      However, each of the substitutions resulted in a decreased thermodynamic
      stability of the protein, as indicated by differential scanning calorimetry
      measurements and equilibrium unfolding experiments in guanidine HCl. The
      destabilizing effect was most pronounced for the G85V mutant, in which case the
      denaturation temperature was decreased by as much as 11 degrees C. The catalytic
      activity of the three mutants represented less than 1% of that of the wild-type
      enzyme. Furthermore, for the D84H-modified form of adenylate kinase, the impaired
      binding of nucleotide substrates was accompanied by a markedly decreased affinity
      for magnesium ion. These observations support the notion that Asp84 is directly
      involved in binding of nucleotide substrates and that this binding is mediated by
      interaction of the aspartic acid residue with divalent cation. The two remaining
      residues probed in this study, Gly85 and Phe86, belong to a beta-turn which
      appears to play a major role in stabilizing the three-dimensional structure of
      adenylate kinase.

PMID- 1748643
TI  - Ligand recognition by influenza virus. The binding of bivalent sialosides.
AB  - Infection by influenza virus is initiated by a cellular adhesion event that is
      mediated by the viral protein, hemagglutinin, which is exposed on the surface of
      the virion. Hemagglutinin recognizes and binds to cell surface sialic acid
      residues. Although each individual ligand binding interaction is weak, the high
      affinity of influenza virus for cells that bear sialic acid residues is thought
      to result from a multivalent attachment process involving many similar
      recognition events. To evaluate such binding we have synthesized three series of
      compounds, each containing two sialic acid residues separated by spacers of
      different length, and have tested them as ligands for influenza hemagglutinin. No
      increased binding to the bromelain-released hemagglutinin ectodomain was seen for
      any of the bivalent compounds as determined by 1H NMR titration. In contrast,
      however, a spacer length between sialic acid residues of approximately 55 A
      sharply increases the binding of these bidentate species to whole virus as
      determined by hemagglutination inhibition assays. The most effective compound
      containing glycines in the linking chain displayed 100-fold increased affinity
      for whole virus over the paradigm monovalent ligand, Neu5Ac alpha 2Me.

PMID- 1748644
TI  - Complete structure of the glycan of lipopeptidophosphoglycan from Trypanosoma
      cruzi Epimastigotes.
AB  - The lipopeptidophosphoglycan is the major cell surface glycoconjugate of the
      epimastigote forms of the parasitic protozoan Trypanosoma cruzi. A detailed
      partial structure for this molecule has been reported (Previato, J. O., Gorin, P.
      A. J., Mazurek, M., Xavier, M. T., Fournet, B., Wieruszesk, J. M., and Mendonca
      Previato, L. (1990) J. Biol. Chem. 265, 2518-2526). In this study, we complete
      the primary structure assignments and describe the microheterogeneity found in
      the lipopeptidophosphoglycan glycan, using a combination of 1H and 31P NMR, fast
      atom bombardment mass spectrometry, methylation linkage analysis, and
      exoglycosidase sequencing. The lipopeptidophosphoglycan is a glycosylated
      inositol-phosphoceramide with striking homology to glycosylphosphatidylinositol
      membrane anchors found attached to a wide variety of plasma membrane proteins
      throughout the eukaryotes.

PMID- 1748645
TI  - Methylation patterns of the human apoA-I/C-III/A-IV gene cluster in adult and
      embryonic tissues suggest dynamic changes in methylation during development.
AB  - We describe here a detailed analysis of the methylation patterns of the apoC-III
      and apoA-IV genes in adult and embryonic tissues. Together with previously
      reported data on the human apoA-I gene (4), the results presented here constitute
      a comprehensive study on the methylation pattern of the apoA-I/C-III/A-IV gene
      cluster. The two genes (apoC-III and apoA-IV) display tissue-specific methylation
      patterns that correlate with their activity. This gene-specific methylation
      pattern indicates that the apoA-I/C-III/A-IV gene cluster is not one entity with
      respect to methylation. The cluster is almost entirely methylated in tissues that
      do not express any of the genes; however, individual gene regions are
      unmethylated in the tissue of expression. A comparison of the observed
      methylation patterns in adult tissues with those in embryonic tissues suggests
      that the mature tissue-specific methylation patterns are a result of an interplay
      between demethylation and de novo methylation events in the embryo. These changes
      in DNA methylation include demethylation in the early embryo followed by de novo
      methylation at later stages. A second round of tissue-specific demethylation and
      methylation de novo occurs in the late embryo as well. Evidence presented here
      supports the idea that CpG islands are protected in general from methylation de
      novo by a built-in signal and not by CpG density per se.

PMID- 1748646
TI  - Mobility of the terminal regions of flagellin in solution.
AB  - The mobility of the disordered terminal regions of flagellin was examined in
      detail based on 1H NMR chemical shifts and spin-lattice relaxation times in the
      rotating frame. Proteolytic fragments of flagellin with terminal deletions of
      different sizes were used to compare the dynamical properties of various N- and C
      terminal segments. We found that dynamic properties of different terminal
      segments were similar to each other and were close to those of the heat-denatured
      state of flagellin. The main chain of these terminal segments undergoes rapid
      motions with effective correlation times of 1.3-4.1 x 10(-9) s. The terminal
      regions contain no large segments with well-defined structure. However,
      comparison with the random-coiled state of poly-L-lysine suggests significant
      structural constraints in the terminal regions (as well as in the heat-denatured
      flagellin) which may reflect the existence of some highly fluctuating secondary
      structure, as suggested by earlier CD studies.

PMID- 1748647
TI  - Purification of solanesyl-diphosphate synthase from Micrococcus luteus. A new
      class of prenyltransferase.
AB  - The activity of solanesyl-diphosphate synthase from Micrococcus luteus is
      stimulated by a high molecular mass fraction (HMF) which is separated from cell
      free extracts of the same bacterium by DEAE-Toyopearl chromatography followed by
      Sephadex G-100 chromatography. By employing HMF in the assay procedure, solanesyl
      diphosphate synthase was able to be purified to homogeneity and was found to be a
      homodimer with a monomeric molecular mass of 34 kDa. In contrast to hexaprenyl-
      and heptaprenyl-diphosphate synthases, which are composed of two easily
      dissociable components that are inactive unless combined, the homogeneously
      purified solanesyl-diphosphate synthase itself showed a catalytic activity,
      though weak, catalyzing the synthesis of both (all-E)-nonaprenyl-(solanesyl-) and
      (all-E)-octaprenyl diphosphate. HMF does not affect the stability of solanesyl
      diphosphate synthase or Km values for isopentenyl diphosphate and farnesyl
      diphosphate, but it markedly increases Vmax values in a time-dependent manner.
      Several lines of evidence indicate that HMF contains a factor which binds to
      polyprenyl products and removes them out of the active site of enzyme to
      facilitate and maintain the turnover of catalysis.

PMID- 1748648
TI  - Two-dimensional NMR investigation of iron-sulfur cluster electronic and molecular
      structure of oxidized Clostridium pasteurianum ferredoxin. Interpretability of
      contact shifts in terms of cysteine orientation.
AB  - A two-dimensional NMR study has been carried out on the four-iron clusters of a
      bacterial oxidized ferredoxin for the purpose of investigating the relationship
      between contact shift patterns and the orientation of the individual coordinated
      cysteines. The ferredoxin from Clostridium pasteurianum, CpFdox, was selected
      because of its extensive sequence homology, and likely close structural
      similarity, to the crystallographically characterized ferredoxin from Peptococcus
      aerogenes, Pa Fdox (Adman, E.T., Sieker, L.C., and Jensen, L. H. (1973) J. Biol.
      Chem. 248, 3987-3996). Rapid data collection rates with minimal but adequate
      acquisition time allowed the detection of numerous CpFdox cross-peaks from the
      contact-shifted and strongly relaxed coordinated cysteinyl C beta H protons in
      the resolved 10-20 ppm window. Relatively strong magnitude COSY cross peaks from
      the resolved eight cysteinyl C beta H resonance unambiguously locate the geminal
      C beta H partner for each residue; weaker cross-peaks locate the C alpha Hs from
      three of the residues. The geminal nature of the magnitude-COSY detected partners
      to the resolved C beta H peaks is confirmed by strong NOESY cross-peaks. The
      NOESY spectra, moreover, assign an additional two cysteinyl C alpha H resonances.
      The present results confirm some previous one-dimensional NOE assignments, revise
      others, and locate resonances previously undetected (Bertini, I., Briganti, F.,
      Luchinat, C., and Scozzafara, A. (1990) Inorg. Chem. 29, 1874-1880). A striking
      pairwise pseudo-symmetry in cysteinyl contact shift patterns is observed which is
      attributed to the previously recognized pseudo-symmetry in the crystal of PaFdox.
      A detailed analysis of the structural/electronic determinants of the coordinated
      cysteine C beta H contact shift pattern is made, and the NMR data necessary for
      unique interpretation are identified. It is shown that analysis of the relaxation
      properties of cysteine beta-methylene protons provides the stereospecific
      assignments necessary for comparison of shift ratios with crystallographic
      structural data. The available structural data on PaFdox (Backes, G., Mino, Y.,
      Loehr, T., Meyer, T., Cusanovich, M., Sweeney, W., Adman, E., and Sanders-Loehr,
      J. (1991) J. Am. Chem. Soc. 13, 2055-2064) are qualitatively but not
      quantitatively consistent with the observed cysteinyl contact shift pattern, with
      the NMR data reflecting more asymmetry than previous studies. A tentative
      assignment of a single pair of symmetry-related cysteines is proposed.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1748649
TI  - The role of calcium in follicle-stimulating hormone signal transduction in
      Sertoli cells.
AB  - Sertoli cells are hormonally regulated by follicle-stimulating hormone (FSH)
      acting upon a G-protein-linked cell surface FSH receptor. FSH increases
      intracellular cyclic AMP but the involvement of other signal transduction
      mechanisms including intracellular calcium in FSH action are not proven. Using
      freshly isolated rat Sertoli cells we measured cytosolic free ionized calcium
      levels by dual-wavelength fluorescence spectrophotometry using the calcium
      sensitive fluorescent dye Fura2-AM. The cytosolic calcium concentration in
      unstimulated Sertoli cells was 89 +/- 2 nM (n = 151 experiments) and was markedly
      increased by either calcium channel ionophores (ionomycin, Bay K8644) or plasma
      membrane depolarization consistent with the presence of voltage-sensitive and 
      independent calcium channel in Sertoli cell membranes. Ovine FSH stimulated a
      specific, sensitive (ED50, 5.0 ng of S-16/ml), and dose-dependent (maximal at 20
      ng/ml) rise in cytosolic calcium commencing within 60 s to reach levels of 192 +/
      31 nM after 180 s and lasting for at least 10 min. The effect of FSH was
      replicated by forskolin, cholera toxin, and dibutyryl cyclic AMP, suggesting that
      cyclic AMP may mediate the FSH-induced rise in cytosolic calcium. The FSH-induced
      rise in cytosolic calcium required extracellular calcium and was abolished by
      calcium channel blockers specific for dihydropyridine (verapamil, nicardipine),
      nonvoltage-gated (ruthenium red) or all calcium channels (cobalt). Thus FSH
      action on Sertoli cells involves a specific, rapid, and sustained increase in
      cytosolic calcium which requires extracellular calcium and involves both
      dihydropyridine-sensitive, voltage-gated calcium channels and voltage
      independent, receptor-gated calcium channels in the plasma membranes of rat
      Sertoli cells. The replication by cyclic AMP of the effects of FSH suggests that
      calcium may be a signal-amplification or -modulating mechanism rather than an
      alternate primary signal transduction system for FSH in Sertoli cells.

PMID- 1748650
TI  - Translocation of HL-60 cell 5-lipoxygenase. Inhibition of A23187- or N-formyl
      methionyl-leucyl-phenylalanine-induced translocation by indole and quinoline
      leukotriene synthesis inhibitors.
AB  - We have demonstrated translocation of HL-60 cell 5-lipoxygenase to a membrane
      compartment in response to both the calcium ionophore A23187 and the receptor
      mediated stimulus, N-formyl-methionyl-leucyl-phenylalanine (fMLP). In addition,
      we have shown inhibition of A23187- and fMLP-induced 5-lipoxygenase translocation
      by an indole and a quinoline leukotriene synthesis inhibitor, MK-886 and L
      674,573, respectively. Selectivity of inhibition of 5-lipoxygenase translocation
      in both fMLP- or A23187-challenged cells is shown using the indole L-583,916 and
      quinoline L-671,480, which neither inhibit leukotriene synthesis nor inhibit 5
      lipoxygenase translocation. The present study in HL-60 cells is the first
      demonstration of the selective inhibition of 5-lipoxygenase translocation by
      quinoline leukotriene synthesis inhibitors, exemplified by L-674,573. Also
      described here is the first demonstration of 5-lipoxygenase translocation and
      inhibition in response to a stimulus other than A23187, namely the receptor
      mediated stimulus, fMLP.

PMID- 1748651
TI  - The phosphorylation and activation of B-raf in PC12 cells stimulated by nerve
      growth factor.
AB  - Treatment of PC12 cells with nerve growth factor does not alter the levels of B
      raf mRNA, but does induce rapid phosphorylation of B-raf proteins.
      Phosphorylation was observed after 1.5 min and reached a maximum by 10-15 min. B
      raf protein was phosphorylated almost exclusively on serine residues; no tyrosine
      phosphorylation was detected. Nerve growth factor-induced phosphorylation was not
      affected by depletion of protein kinase C or by removal of extracellular calcium
      but was inhibited by K-252a. Concomitant with the increase in serine
      phosphorylation, nerve growth factor treatment also increased the
      serine/threonine kinase activity of B-raf protein within 1-2 min.

PMID- 1748652
TI  - Differential regulation of protein kinase C isozymes by thyrotropin-releasing
      hormone in GH4C1 cells.
AB  - GH4C1 cells, which express Ca(2+)-dependent alpha- and beta- as well as Ca(2+)
      independent gamma-, epsilon- and zeta-protein kinase C (PKC) isozymes, provide a
      cell culture model for studying isozyme-specific properties and functions.
      Hormonal activation of PKCs regulates the differentiated functions of these
      cells, namely secretion and synthesis of prolactin (PRL). We previously reported
      that thyrotropin-releasing hormone (TRH) selectively down-modulates epsilon-PKC
      with no effect on alpha- or beta-PKCs (Kiley, S.C., Schaap, D., Parker, P.,
      Hsieh, L.-L., and Jaken, S. (1990) J. Biol. Chem. 265, 15704-15712). We now
      extend those studies to explore the relationship between TRH-stimulated
      diacylglycerol (DAG) levels and epsilon-PKC down-modulation. TRH stimulates three
      distinct DAG phases in GH cells. Phase 1 DAG peaks at 15 s, is accompanied by a 6
      fold increase in intracellular Ca2+, and causes the redistribution of alpha-,
      beta-, delta, and epsilon-PKC isozymes from a soluble to a detergent-insoluble
      particulate compartment. Phase 2 DAG peaks at 10 min, is not associated with a
      Ca2+ signal, and does not activate PKC by any criteria tested. Phase 3 DAG peaks
      at 6 h and is sustained through 12 h. This novel DAG phase is not associated with
      increased intracellular Ca2+. The time course of phase 3 DAG formation
      corresponds to the time course of TRH-stimulated epsilon-PKC down-regulation;
      maximal effects are observed at 6-12 h for both events. Unlike alpha-, beta-, and
      delta-PKCs which are preferentially distributed in the soluble fraction of
      resting GH cells, epsilon-PKC is also distributed in the detergent-insoluble
      particulate fraction. The selective compartmentalization of epsilon-PKC in the
      particulate fraction may render this pool uniquely susceptible to proteolytic
      degradation. The time course of phase 3 DAG formation and epsilon-PKC down
      modulation corresponds to the time course of decreasing PRL message synthesis in
      GH4 cells. The data suggests that loss of epsilon-PKC may be associated with the
      down-regulation of prolactin synthesis and that regulation of PRL gene
      transcription may be an epsilon-PKC-specific function in GH cells.

PMID- 1748653
TI  - Interaction of fluorescently labeled pardaxin and its analogues with lipid
      bilayers.
AB  - Fluorescence measurements were used to monitor the interaction of the neurotoxin
      pardaxin and its analogues with membranes. Eight peptides were selectively
      labeled with the fluorophore 7-nitrobenz-2-oxa-1,3-diazole-4-yl, either at their
      N-terminal or at their C-terminal. No detectable changes in membrane permeability
      or hemolytic activity were observed upon modification. Upon the titration of
      solutions containing the different peptides with small unilamellar vesicles, the
      fluorescent emission spectra of 7-nitrobenz-2-oxa-1,3-diazole-4-yl-labeled
      pardaxin and its analogues, but not those of control peptides, displayed blue
      shifts in addition to enhanced intensities upon relocation of the probe to a more
      apolar environment. The results revealed that the N terminus of pardaxin is
      buried within the lipid bilayer while the C terminus is located at the bilayer's
      surface. Binding isotherms were obtained from the observed increases in the
      fluorescence emission yields, from which surface partition constants, in the
      range of 10(4) M-1, were in turn derived. The existence of an aggregation process
      was suggested by the shape of the binding isotherms. Furthermore, the results
      show good correlation between the incidence of aggregation and the ability of the
      different analogues to induce the release of relatively large molecules from
      vesicles. As such, our results suggest that the mechanism of pore formation
      employed by pardaxin and its analogues could be described by the "barrel stave"
      model.

PMID- 1748654
TI  - Function of glycoprotein Ib alpha in platelet activation induced by alpha
      thrombin.
AB  - We have obtained evidence that selective inhibition of high affinity thrombin
      binding sites located in the amino-terminal domain of the membrane glycoprotein
      (GP) Ib alpha results in impaired platelet activation, as shown by abrogation or
      reduction of the following responses induced in normal platelets by exposure to
      less than 1 nM alpha-thrombin: (i) increase in intracellular ionized calcium
      concentration ([Ca2+]i), (ii) release of dense granule content, (iii) binding of
      fibrinogen, (iv) aggregation. An anti-GP Ib monoclonal antibody, LJ-Ib 10, which
      does not inhibit von Willebrand factor binding to platelets, obliterated the high
      affinity alpha-thrombin-binding sites on normal platelets. Isotherms of alpha
      thrombin binding to normal platelets treated with saturating amounts of the
      antibody were virtually identical to those obtained with platelets from a patient
      with classical Bernard-Soulier syndrome. In parallel with decreased binding of
      the agonist, this antibody caused 50% inhibition of the maximal extent of
      platelet aggregation and 90% inhibition of ATP release induced by 0.3 nM alpha
      thrombin. By inhibiting alpha-thrombin binding to GP Ib, the antibody prevented
      the activation of platelets exposed to low concentrations of the agonist, as
      demonstrated by abrogation of the increase in intraplatelet ionized calcium
      concentration induced in control platelets by 0.18 nM alpha-thrombin; under these
      conditions, fibrinogen binding was inhibited by 84%. Therefore, there is a
      correlation between occupancy of the high affinity sites for alpha-thrombin on GP
      Ib alpha and platelet activation, secretion, and aggregation, suggesting that GP
      Ib alpha is part of an alpha-thrombin receptor relevant for platelet function.

PMID- 1748655
TI  - The carboxyl terminus of the S1 subunit of pertussis toxin confers high affinity
      binding to transducin.
AB  - The kinetic constants for the ADP-ribosylation of transducin were determined for
      the recombinant S1 subunit of pertussis toxin (rS1, composed of 235 amino acids)
      and two genetically derived deletion peptides, C180 and C195, which are composed
      of the 180 and 195 amino-terminal residues of the S1 subunit, respectively.
      Titration of NAD in the presence of a constant concentration of transducin (0.5
      microM) showed that the KmappNAD in the ADP-ribosylation of transducin were
      similar, approximately 20 microM, for rS1, C195, and C180. In contrast, titration
      of transducin in the presence of a constant concentration of NAD (25 nM) showed
      that rS1 possessed a lower Kmapp(transducin) and greater kcat than either C195 or
      C180. Previous studies (Cortina, G., and Barbieri, J.T. (1991) J. Biol. Chem.
      266, 3022-3030) showed that the 16 carboxyl terminal residues of the S1 subunit
      did not function in the ADP-ribosylation of transducin. It thus appears that
      residues between 195 and 219 of the S1 subunit are required for high affinity
      transducin binding and may be involved in the transfer of ADP-ribose to
      transducin. To localize the defect in the recognition of transducin by C180, rS1
      and C180 were assayed for the ability to ADP-ribosylate either transducin or the
      purified alpha subunit of transducin (T alpha). Upon saturation of the target
      protein, rS1 ADP-ribosylated equivalent moles of transducin or T alpha, with the
      linear velocity of rS1-mediated ADP-ribosylation of transducin approximately 16
      fold more rapid than the rate of ADP-ribosylation of T alpha. In contrast, the
      initial linear velocity of C180-mediated ADP-ribosylation of transducin was only
      1.7-fold more rapid than the rate of ADP-ribosylation of T alpha. These data
      indicate that the amino-terminal 180 amino acids of S1 confer the specificity for
      ADP-ribosylation primarily through the interaction with T alpha, while residues
      between 195 and 219 of S1 confer high affinity binding to transducin primarily
      through the interaction, either directly or indirectly, with T beta gamma.

PMID- 1748656
TI  - The primary structure of the subunits of carbon monoxide dehydrogenase/acetyl-CoA
      synthase from Clostridium thermoaceticum.
AB  - CO dehydrogenase/acetyl-coenzyme A synthase (CODH) is the central enzyme in the
      pathway of acetyl-coenzyme A biosynthesis in Clostridium thermoaceticum. It
      catalyzes the interconversion of CO and CO2 and the synthesis of acetyl-coenzyme
      A from the methylated corrinoid/iron sulfur protein, CO, and coenzyme A. It is a
      nickel-iron-sulfur protein and contains two subunits in the form (alpha beta)3.
      Reported here is the cloning and sequencing of the genes for both subunits of
      CODH. The gene for the alpha subunit codes for a protein with 729 amino acids and
      a molecular weight of 81,730, and the beta gene for a protein with 674 amino
      acids and a molecular weight of 72,928. The alpha subunit follows the beta
      subunit by 23 bases and the genes for both subunits are preceded by a sequence
      which is similar to the Shine-Dalgarno sequence of Escherichia coli. No
      significant amino acid sequence homology has been found to any known sequence.
      Labeling CODH with 2,4-dinitrophenylsulfenyl chloride and isolating labeled
      peptide fragments demonstrated that a tryptophan, residue 418 of the alpha
      subunit, is protected by coenzyme A and thus may be considered a potential part
      of the coenzyme A site.

PMID- 1748657
TI  - Molecular characterization of the iron transport system mediated by the pJM1
      plasmid in Vibrio anguillarum 775.
AB  - Complementation of insertion mutants showed that the polypeptides FatD, FatC,
      FatB, and FatA are essential for the iron-transport process encoded by pJM1.
      Sequence analysis followed by homology studies indicated that transport of ferric
      anguibactin into Vibrio anguillarum 775 follows the same mechanism as reported
      for transport of Fe(3+)-hydroxamates, Fe(3+)-catecholates, ferric dicitrate, and
      vitamin B12 into Escherichia coli. Homology of FatA, part of the receptor
      complex, to seven E. coli receptor proteins involved in uptake of siderophores
      and vitamin B12 supports the idea of a common ancestral gene. A "TonB-Box" was
      found in FatA suggesting the existence of a TonB-like protein function in V.
      anguillarum. A high homology in the primary structure of FatB to FhuD, FecB,
      FepB, and BtuE suggests that FatB is the anguibactin-binding protein located in
      the periplasmic space. FatD and FatC are polytopic integral membrane proteins.
      According to their homologies to other proteins from other transport systems,
      they may be involved in the translocation of ferric anguibactin across the
      cytoplasmic membrane.

PMID- 1748658
TI  - Biosynthesis of 5-hydroxybenzimidazolylcobamid (factor III) in Methanobacterium
      thermoautotrophicum.
AB  - Cultures of Methanobacterium thermoautotrophicum were supplemented with 13C
      labeled acetate or pyruvate, and the labeling pattern of the corrinoid, factor
      III, was established by 13C NMR spectroscopy. Complete 13C signal assignments
      were obtained by two-dimensional NMR experiments. The labeling pattern of factor
      III was analyzed by comparison with those of amino acids and nucleosides. The
      corrin ring system is derived from eight molecules of glutamate. The
      aminopropanol moiety is derived in a hitherto unknown pathway from pyruvate by
      reductive amination. The heterocyclic ring of hydroxybenzimidazole shares the
      labeling pattern of the imidazole ring of purines. The remaining four carbon
      atoms of the carbocyclic ring show the labeling signature of a carbohydrate with
      two of the carbons introduced from acetate and two from C-1 of pyruvate. However,
      erythrose can be ruled out as the specific precursor on the basis of a detailed
      investigation of aromatic amino acids indicating that erythrose 4-phosphate is
      obtained by reductive carboxylation of a triose precursor and not by the pentose
      phosphate cycle.

PMID- 1748659
TI  - Selective transcription of rat proenkephalin fusion genes from the spermatogenic
      cell-specific promoter in testis of transgenic mice.
AB  - The rat and mouse proenkephalin genes each contains two distinct promoters, one
      of which is utilized exclusively by spermatogenic cells. The germ cell-specific
      promoter lacks TATA sequences, is G+C rich, and contains multiple initiation
      sites. To investigate the nature of the cis-acting elements that determine
      selective transcription of the proenkephalin gene in male germ cells, two rat
      proenkephalin-chloramphenicol acetyltransferase fusion genes containing the two
      different promoter regions as well as 1.6 or 0.3 kilobases, respectively, of 5'
      flanking sequence were expressed in transgenic mice. Multiple transgenic lines
      were developed which expressed the fusion genes in testis, brain, and heart but
      not in tissues that do not normally express the proenkephalin gene. Fusion gene
      transcripts in transgenic mouse testes were localized to those spermatogenic cell
      types that utilize the spermatogenic cell promoter and were selectively and
      accurately initiated from the multiple rat germ cell start sites. Transgenic mice
      thus provide a useful model for the localization and characterization of cis
      acting elements mediating transcription of the proenkephalin gene from its germ
      cell-specific promoter.

PMID- 1748660
TI  - Crystal structure of the lysine-, arginine-, ornithine-binding protein (LAO) from
      Salmonella typhimurium at 2.7-A resolution.
AB  - A wide variety of sugars, amino acids, peptides, and inorganic ions are
      transported into bacteria by periplasmic transport systems consisting of
      substrate-specific receptors (binding proteins) and membrane-bound protein
      complexes. The crystal structure of the lysine-, arginine-, ornithine-binding
      protein (LAO) at 2.7-A resolution shows that the molecule has a bi-lobal
      structure and that its topological structure is different from other amino acid
      binding proteins but is similar to the sulfate-binding protein and maltose
      binding protein. High sequence homology between LAO and the histidine-binding
      protein (HisJ) and the fact that LAO and HisJ share the same membrane-bound
      protein complex allow one to define functional regions responsible for the ligand
      binding and for the interaction with the membrane complex.

PMID- 1748661
TI  - The K258R mutant of aspartate aminotransferase stabilizes the quinonoid
      intermediate.
AB  - Lys-258 of aspartate aminotransferase forms a Schiff base with pyridoxal
      phosphate and is responsible for catalysis of the 1,3-prototropic shift central
      to the transamination reaction sequence. Substitution of arginine for Lys-258
      stabilizes the otherwise elusive quinonoid intermediate, as assessed by the long
      wavelength absorption bands observed in the reactions of this mutant with several
      amino acid substrates. The external aldimine intermediate is not detectable
      during reactions of this mutant with amino acids, although the inhibitor alpha
      methylaspartate does slowly and stably form this species. These results suggest
      that external aldimine formation is one of the rate-determining steps of the
      reaction. The pyridoxamine-5'-phosphate-like enzyme form (330-nm absorption
      maximum) is unreactive toward keto acid substrates, and the coenzyme bound to
      this species is not dissociable from the protein.

PMID- 1748662
TI  - Epimerization of 3-hydroxy-4-trans-decenoyl coenzyme A by a dehydration/hydration
      mechanism catalyzed by the multienzyme complex of fatty acid oxidation from
      Escherichia coli.
AB  - The mechanism of 3-hydroxyacyl-CoA epimerase (EC 5.1.2.3), which is associated
      with the multienzyme complex of fatty acid oxidation from Escherichia coli, was
      studied with D-3-hydroxy-4-trans-decenoyl-CoA as a substrate. The E. coli complex
      catalyzes the rapid and direct dehydration of D-3-hydroxy-4-trans-decenoyl-CoA to
      2-trans,4-trans-decadienoyl-CoA, which is slowly hydrated to L-3-hydroxy-4-trans
      decenoyl-CoA. A kinetic analysis of the epimerase and its partial reactions
      established that epimerization of 3-hydroxyacyl-CoAs occurs solely by a
      dehydration/hydration mechanism. The results of a substrate competition study
      with L-3-hydroxy-4-trans-decenoyl-CoA and its D-isomer, together with the
      conclusion from a sequence analysis of the large subunit of the E. coli complex
      (Yang, X.-Y., Schulz, H., Elzinga, M., and Yang, S.-Y. (1991) Biochemistry 30,
      6788-6795), prompt the suggestion that a single active site is responsible for
      the dehydration of the D- and L-isomers of 3-hydroxyacyl-CoAs.

PMID- 1748663
TI  - Purification and properties of a unique flavin-containing chloroperoxidase from
      the capitellid polychaete Notomastus lobatus.
AB  - A unique flavin-containing chloroperoxidase from the marine worm Notomastus
      lobatus was purified to homogeneity. This enzyme is composed of two dissociable
      protein moieties, a flavoprotein and a heme protein, in 1:1 molar ratio. The
      flavoprotein (Mr = 120,000) consists of four identical subunits having Mr of
      30,000, and contains FAD. The heme protein (Mr = 54,000) is composed of two
      copies each of two non-identical subunits (Mr = 15, 500 and 11, 500) and contains
      ferriheme. The native N. lobatus chloroperoxidase (Mr = 174,000) therefore has a
      structure of alpha 4 beta 2 gamma 2. Neither the flavoprotein nor the heme
      protein alone has detectable chloroperoxidase activity but readily associate to
      form fully active enzyme. This enzyme is capable of oxidizing Cl-, Br-, and I-
      with optimum pH values of 4.5, 5.0, and 4.5, respectively, at 440 microM H2O2 and
      has halide-independent catalase activity in the absence of organic substrate. The
      enzyme can halogenate a wide variety of aromatic compounds, including phenol,
      from which it produces 4-bromophenol, 2,4-dibromophenol, and 2,4,6
      tribromophenol. The same compounds are found in N. lobatus. The N. lobatus
      chloroperoxidase is the first haloperoxidase to be purified to homogeneity from a
      marine polychaete, the first reported to contain flavin, and has several unusual
      physical and catalytic properties. This chloroperoxidase appears to represent a
      new class of haloperoxidases.

PMID- 1748664
TI  - Mapping of trypsin cleavage and antibody-binding sites and delineation of a
      dispensable domain in the beta subunit of Escherichia coli RNA polymerase.
AB  - We have mapped principal sites in the Escherichia coli RNA polymerase molecule
      that are exposed to attack by trypsin under limited proteolysis conditions. The
      1342-amino acid-long beta subunit is alternatively cleaved at Arg903 or Lys909.
      The cleavage occurs adjacent to a dispensable domain (residues 940-1040) that is
      absent in the homologous RNA polymerase subunits from chloroplasts, eukaryotes,
      and archaebacteria. In E. coli, this region can be disrupted with genetic
      deletions and insertions without the loss of RNA polymerase function. Insertion
      of 127 amino acids into this region introduces a new highly labile site for
      trypsin proteolysis. The dispensable domain carries the epitope for monoclonal
      antibody PYN-6 (near residue 1000), which can be used for anchoring the
      catalytically active enzyme on a solid support. We also report the identification
      of a secondary trypsin cleavage at Arg81 of the beta' subunit within a putative
      zinc-binding domain that is conserved in prokaryotes and chloroplasts.

PMID- 1748665
TI  - Mapping of the priming substrate contacts in the active center of Escherichia
      coli RNA polymerase.
AB  - The active center of DNA-dependent RNA polymerase performs the principal
      biochemical reaction of gene expression. Using cross-linkable substrate analogs
      and site-directed mutations, two evolutionarily invariant amino acids in the beta
      subunit of the Escherichia coli enzyme (Lys1065 and His1237) were mapped close to
      the binding site of the priming substrate of the reaction. Surprisingly, the
      mutational substitution of these residues (Lys1065----Arg and His1237----Ala) did
      not inactivate the catalytic function, but inhibited transition from the
      initiation to the elongation stage of transcription.

PMID- 1748666
TI  - Molecular characterization of a mammalian smooth muscle myosin light chain
      kinase.
AB  - A 5.6-kilobase cDNA clone has been isolated which includes the entire coding
      region for the myosin light chain kinase from rabbit uterine tissue. This cDNA,
      expressed in COS cells, encodes a Ca2+/calmodulin-dependent protein kinase with
      catalytic properties similar to other purified smooth muscle myosin light chain
      kinases. A module (TLKPVGNIKPAE), repeated sequentially 15 times, has been
      identified near the N terminus of this smooth muscle kinase. It is not present in
      chicken gizzard or rabbit skeletal muscle myosin light chain kinases. This repeat
      module and a subrepeat (K P A/V) are similar in amino acid content to repeated
      motifs present in other proteins, some of which have been shown to associate with
      chromatin structures. Immunoblot analysis after sodium dodecyl sulfate
      polyacrylamide gel electrophoresis, used to compare myosin light chain kinase
      present in rabbit, bovine, and chicken smooth and nonmuscle tissues, showed that
      within each species both tissue types have myosin light chain kinases with
      indistinguishable molecular masses. These data suggest that myosin light chain
      kinases present in smooth and nonmuscle tissues are the same protein.

PMID- 1748668
TI  - Purification, characterization, cloning, and amino acid sequence of the
      bifunctional enzyme 5,10-methylenetetrahydrofolate dehydrogenase/5,10
      methenyltetrahydrofolate cyclohydrolase from Escherichia coli.
AB  - We have purified the enzyme 5,10-methylenetetrahydrofolate dehydrogenase (EC
      1.5.1.5) from Escherichia coli to homogeneity by a newly devised procedure. The
      enzyme has been purified at least 2,000-fold in a 31% yield. The specific
      activity of the enzyme obtained is 7.4 times greater than any previous
      preparation from this source. The purified enzyme is specific for NADP. The
      protein also contains 5,10-methenyltetrahydrofolate cyclohydrolase (EC 3.5.4.9)
      activity. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and behavior
      on a molecular sieving column suggest that the enzyme is a dimer of identical
      subunits. We have cloned the E. coli gene coding for the enzyme through the use
      of polymerase chain reaction based on primers designed from the NH2 terminal
      analysis of the isolated enzyme. We sequenced the gene. The derived amino acid
      sequence of the enzyme contains 287 amino acids of Mr 31,000. The sequence shows
      50% identity to two bifunctional mitochondrial enzymes specific for NAD, and 40
      45% identity to the presumed dehydrogenase/cyclohydrolase domains of the
      trifunctional C1-tetrahydrofolate synthase of yeast mitochondria and cytoplasm
      and human and rat cytoplasm. An identical sequence of 14 amino acids with no gaps
      is present in all 7 sequences.

PMID- 1748667
TI  - The carboxyl terminus of the smooth muscle myosin light chain kinase is expressed
      as an independent protein, telokin.
AB  - It has been proposed that the carboxyl terminus of the smooth muscle myosin light
      chain kinase is expressed as an independent protein. This protein has been
      purified from tissues and named telokin (Ito, M., Dabrowska, R., Guerriero, V.,
      Jr., and Hartshorne, D. J. (1989) J. Biol. Chem. 264, 13971-13974). In this study
      we have isolated and characterized cDNA and genomic clones encoding telokin.
      Analysis of a genomic DNA clone suggests that the mRNA encoding telokin arises
      from a promoter which appears to be located within an intron of the smooth muscle
      myosin light chain kinase (MLCK) gene. This intron interrupts exons encoding the
      calmodulin binding domain of the kinase. The amino acid sequence deduced from the
      cDNA predicts that telokin is identical to the carboxyl-terminal 155 residues of
      the smooth muscle MLCK. Unlike the smooth muscle MLCK which is expressed in both
      smooth and non-muscle tissues, telokin is expressed in some smooth muscle tissues
      but has not been detected in aortic smooth muscle or in any non-muscle tissues.

PMID- 1748669
TI  - Presence of terminal N-acetylgalactosamine residues in subregions of the
      endoplasmic reticulum is influenced by cell differentiation in culture.
AB  - Using Helix pomatia lectin as a specific probe for terminal, nonreducing N
      acetylgalactosamine residues, glycoprotein precursors bearing newly initiated O
      linked oligosaccharides have been localized in the lumen of the endoplasmic
      reticulum and cis-Golgi cisternae. This pattern contrasts with the detection of
      the terminal disaccharide galactose beta-1,3-N-acetylgalactosamine by Arachis
      hypogaea lectin in middle and trans-Golgi compartments, which are considered
      elongation sites for O-glycosylation. Distribution of H. pomatia ligands in the
      endoplasmic reticulum is confined to specialized regions or subcompartments in
      both human colonic adenocarcinoma cells and cultured chicken chondrocytes. Since
      in cartilage, chondrocytes contain H. pomatia-binding sites exclusively
      concentrated in cis-Golgi cisternae, primary cultures of this cell type have been
      used to study those conditions that promote initiation of O-glycosylation in the
      endoplasmic reticulum. A correlation has been found between the age of the
      culture and the extent of reactivity of the endoplasmic reticulum with either H.
      pomatia lectin or antibody against the sequence GalNAc alpha-serine/threonine (Tn
      antigen). Cells showing an extensive reaction are not hindered in their secretory
      activity and still maintain the chondrocyte phenotype. Taken together the results
      suggest that the intracellular distribution of the glycosylation enzymes is not
      only cell type-specific as previously shown (Roth, J., Taatjes, D. J., Weinstein,
      J., Paulson, J. C., Greenwell, P., and Watkins, W. M. (1986) J. Biol. Chem. 261,
      14307-14312) but it might also vary depending on the stage of cell
      differentiation.

PMID- 1748670
TI  - The effect of elimination of intersubunit disulfide bonds on the activity,
      assembly, and secretion of recombinant human acetylcholinesterase. Expression of
      acetylcholinesterase Cys-580----Ala mutant.
AB  - Site-directed mutagenesis was used to study the cysteine residue involved in the
      assembly of human acetylcholinesterase (HuAChE) catalytic subunits. Substitution
      of the cysteine at position 580 by alanine resulted in impairment of interchain
      disulfide bridge formation; the mutagenized enzyme (C580A) was secreted from
      recombinant cells in the monomeric form and failed to assemble into dimers. The
      mutant monomeric HuAChE did not differ from the native oligomeric enzyme neither
      in rate of catalysis nor in affinity to acetylthiocholine. Mutant monomers were
      also shown to retain the acetylcholinesterase characteristic sensitivity to high
      substrate concentrations. The mutation did not seem to affect the efficiencies of
      either synthesis or secretion of recombinant HuAChE polypeptides, as was
      demonstrated in cell lines derived from human embryonic kidney (293 cells) as
      well as from a human neuroblastoma (SK-N-SH). Furthermore, the mutation did not
      lead to an increase in accumulation of intracellular HuAChE polypeptides,
      suggesting that export of acetylcholinesterase from cells may not be coupled to
      subunit assembly.

PMID- 1748671
TI  - The type I and type II bovine scavenger receptors expressed in Chinese hamster
      ovary cells are trimeric proteins with collagenous triple helical domains
      comprising noncovalently associated monomers and Cys83-disulfide-linked dimers.
AB  - Scavenger receptors have been implicated in the development of atherosclerosis
      and other macrophage-associated functions. The structures and processing of type
      I and type II bovine macrophage scavenger receptors were examined using
      polyclonal anti-receptor antibodies. Pulse/chase metabolic labeling experiments
      showed that both types of scavenger receptors expressed in Chinese hamster ovary
      (CHO) cells behaved as typical cell surface membrane glycoproteins. They were
      synthesized as endoglycosidase H-sensitive precursors which were converted to
      endoglycosidase H-resistant mature forms expressed on the cell surface. The
      reduced precursor and mature forms were doublets on sodium dodecyl sulfate-gel
      electrophoresis, primarily because of heterogeneous N-glycosylation. The
      approximate molecular sizes were: type I precursor, 65/63 kDa; type I mature,
      82/76 kDa; type II precursor, 57/53 kDa; and type II mature, 72/65 kDa. During
      post-translational processing, the cysteine-rich C terminus (SRCR domain) of some
      of the type I receptors was proteolytically removed to form a relatively stable,
      approximately 69-kDa degradation product. Type II receptors differ from type I
      receptors in that they do not have SRCR domains and an analogous proteolytic
      cleavage was not observed. Several experiments provided strong evidence that the
      Gly-X-Y-repeat domains in the scavenger receptors oligomerize into collagenous
      triple helices. For example, alpha,alpha'-dipyridyl, an inhibitor of the collagen
      modifying enzymes prolyl and lysyl hydroxylases, interfered with both the
      kinetics and nature of post-translational receptor processing, and both precursor
      and mature forms of the receptors in intact cells could be cross-linked with
      difluorodinitrobenzene into reduction-resistant trimers. In intact cells,
      precursor receptor trimers (type I, 198 kDa; type II, 176 kDa) were assembled in
      the endoplasmic reticulum by the noncovalent association of monomers and Cys83
      disulfide-linked dimers (type I, 129 kDa; type II, 119 kDa). When cells were
      lysed in the absence of the sulfhydryl trapping agent iodoacetamide, oxidation of
      the side chain of Cys17 in the cytoplasmic domain leads to the artifactual
      formation of reduction-sensitive covalently linked trimers. The approximate
      masses of the mature dimer and trimer forms were 162 and 237 kDa for type I
      receptors and 147 and 219 kDa for type II receptors. Cys83-disulfide-linked dimer
      formation was not required for function because mutant receptors (Cys83----Gly83)
      assembled into trimers of noncovalently associated monomers and exhibited normal
      receptor activity. Treatment of cells with difluorodinitrobenzene cross-linked
      some of the receptors into complexes larger than trimers, raising the possibility
      that the trimers may assemble into higher order oligomers.

PMID- 1748672
TI  - Site-specific DNA cleavage by antisense oligonucleotides covalently linked to
      phenazine di-N-oxide.
AB  - Site-specific degradation of DNA was achieved by the use of DNA oligonucleotides
      covalently tethered to phenazine 5,10-di-N-oxide. When annealed to a
      complementary DNA target strand, the antisense oligonucleotide effected
      alkylation of guanosine residues in proximity to the phenazine di-N-oxide
      prosthetic group. Admixture of dithiothreitol to the formed duplex resulted in
      reductive activation of the phenazine di-N-oxide moiety with concomitant
      generation of diffusible oxygen radicals; the latter effected strand scission of
      the target DNA oligonucleotide. Several parameters of DNA degradation were
      studied, including the effect on DNA degradation of chain length in the tether
      connecting the oligonucleotides and prosthetic group, the relative efficiencies
      of DNA cleavage when the prosthetic group was in the middle or at the end of the
      antisense oligonucleotide, and the effect of O2 on DNA degradation. Also studied
      was the actual chemistry of DNA oligonucleotide degradation and the ability of
      individual diastereomers of the modified oligonucleotides to mediate degradation
      of the target DNA.

PMID- 1748673
TI  - Site-directed mutagenesis and expression of PC2 in microinjected Xenopus oocytes.
AB  - The biosynthesis and post-translational maturation of PC2, a neuroendocrine
      specific Kex2-like endoprotease, following expression in Xenopus oocytes is
      described. The initial translation product was a 75-kDa membrane-associated
      protein which was released from the oocytes as a glycosylated 71-kDa protein.
      During extended chase periods, the extracellular 71-kDa protein was converted to
      a mature 68-kDa product. A deletion mutant lacking a putative COOH-terminal
      amphipathic helix was still membrane-associated, suggesting that this domain was
      not essential for attachment of PC2 to membranes. Two putative proregion cleavage
      site mutants were also constructed. Conversion of the 75-kDa peptide to the 71
      kDa peptide involved cleavage at the sequence Lys-Arg-Arg-Arg (amino acids 78
      81), since mutation of this sequence to Lys-Val-Arg-Leu resulted in the secretion
      of the 75-kDa peptide. Extracellular conversion of the 71-kDa peptide to the 68
      kDa peptide involved cleavage at the sequence Arg-Lys-Lys-Arg (amino acids 106
      109), since deletion of this tetrabasic sequence resulted in secretion of the 71
      kDa peptide without further conversion to the 68-kDa form. Finally, a mutation
      which changed a catalytically important Asp to Asn did not affect processing of
      proPC2. These results may be relevant to our understanding of mechanisms in the
      intracellular sorting and maturation of proPC2 in neuroendocrine cells.

PMID- 1748674
TI  - Use of radiation suicide to isolate constitutive and temperature-sensitive
      conditional Chinese hamster ovary cell mutants with defects in the endocytosis of
      low density lipoprotein.
AB  - A radiation suicide procedure was used to isolate cells with either constitutive
      or temperature-sensitive (ts) defects in the receptor-mediated endocytosis of low
      density lipoprotein (LDL). Mutagen-treated Chinese hamster ovary cells maintained
      at 34 degrees C (permissive temperature) were shifted to 39.5 degrees C
      (nonpermissive temperature) for 14-26 h and incubated at 39.5 degrees C for an
      additional 6-8 h with [3H]cholesteryl linoleate LDL. Wild-type cells internalized
      this lipoprotein via LDL receptors and accumulated [3H]cholesteryl linoleate (1.5
      2 dpm/cell). Radiolysis during 80 days of frozen storage killed most of these
      cells (radiation suicide). Receptor-deficient cells were identified by screening
      the surviving cells for their inability to internalize and accumulate 125I-LDL
      using a replica plating assay. From 3.6 x 10(7) tritium-labeled cells, two clones
      fell into previously defined constitutive and ts complementation groups (ldlA and
      ldlG, respectively). Another constitutive and two other ts mutants defined two
      new complementation groups, ldlI (constitutive) and ldlH (ts). This increases to
      nine the current number of recessive, LDL receptor-deficient, Chinese hamster
      ovary complementation groups. All of the mutants with ts defects in LDL
      endocytosis exhibited ts conditional-lethal phenotypes. At the nonpermissive
      temperature, the rates of loss of LDL receptor activity (t 1/2 = 10-14 h) were
      significantly faster than the rates of loss of protein synthesis (t 1/2 greater
      than 24 h), suggesting that the temperature sensitivity of receptor activity was
      not simply due to the metabolic collapse of dying cells. Detailed analysis of
      these new classes of mutants should help define gene products and functions
      required for LDL receptor activity.

PMID- 1748675
TI  - Expression of human aldose and aldehyde reductases. Site-directed mutagenesis of
      a critical lysine 262.
AB  - Human aldose reductase (EC 1.1.1.21) and aldehyde reductase (EC 1.1.1.2) are
      implicated in the development of diabetic complications by a variety of
      mechanisms, and a number of drugs to inhibit these enzymes have been proposed for
      the therapy and prevention of these complications. To probe the structure and
      function of these two enzymes, we used site-directed mutagenesis in the cDNAs of
      both enzymes to replace lysine 262 with methionine. Wild-type and mutant enzymes
      were overexpressed in Escherichia coli and purified by anion exchange and
      affinity chromatography. N-terminal sequence analysis, Western blots, and kinetic
      studies confirmed the identity of the recombinant wild-type enzymes with the
      native human placental and liver enzymes. Recombinant aldose reductase (hAR) and
      aldehyde reductase (hGR) have apparent kinetic constants virtually identical to
      their respective native enzymes. The mutant aldose reductase (hARK262 greater
      than M) shows a 66-fold increase in Km for NADPH with respect to the wild type
      (1.9 +/- 0.4 microM versus 125 +/- 14 microM), whereas the Km for DL
      glyceraldehyde increased 35-fold (20 +/- 2 versus 693 +/- 41 microM). The same
      constants for the mutant aldehyde reductase (hGRK262 greater than M) increased 97
      and 86-fold, respectively (from 2.0 +/- 0.4 to 194 +/- 16 microM and from 1.6 +/
      0.4 to 137 +/- 3 mM). These results indicate that lysine 262 in aldose reductase
      and aldehyde reductase is crucial to their catalytic activity by affecting co
      factor binding.

PMID- 1748676
TI  - Localization of UDP-GalNAc:NeuAc alpha 2,3Gal-R beta 1,4(GalNAc to Gal)N
      acetylgalactosaminyltransferase in human stomach. Enzymatic synthesis of a fundic
      gland-specific ganglioside and GM2.
AB  - A glycolipid detected in human gastric mucosa with anti-GM2 monoclonal antibody
      was characterized to be GalNAc beta 1-4[NeuAc alpha 2-3]Gal beta 1-4GlcNAc beta 1
      3Gal 1-4Glc-Cer (NGM-1), which was lost in gastric cancer tissue with
      complementary increase of GM2 sharing the same terminal carbohydrate structure as
      NGM-1 (Dohi, T., Ohta, S., Hanai, N., Yamaguchi, K., and Oshima, M. (1990) J.
      Biol. Chem. 265, 7880-7885). The study on differential expression of NGM-1 in
      gastric fundic mucosa, pyloric mucosa, gastric cancer, and various other tissues
      indicated that NGM-1 existed specifically in fundic mucosa. The content of GM3
      and sialylparagloboside (SPG), which are the substrates for the synthesis of GM2
      and NGM-1, respectively, were not significantly different in these tissues.
      Therefore, the presence of two kinds of beta 1,4GalNAc transferases having
      different substrate specificity was considered to be critical for the expression
      of NGM-1 and GM2. The activity of beta 1,4GalNAc transferase which synthesizes
      GM2 or NGM-1 was determined by detecting the products with specific monoclonal
      antibodies. The activity of beta 1,4GalNAc transfer to SPG was high in fundic
      mucosa, while it was absent in pyloric mucosa or cancer. On the other hand, the
      increased activity of beta 1,4GalNAc transfer to GM3 was observed in cancer
      tissues and cancer cell lines which were rich in GM2. Our conclusion is that the
      limited expression of NGM-1 in fundic mucosa and the increase of GM2 in cancer
      are attributed to two types of beta 1,4GalNAc transferases localized in each
      region with different substrate specificity; the one in fundic mucosa transfers
      GalNAc to SPG but not to GM3, and the other one enhanced in cancer transfers
      GalNAc to GM3 but not to SPG.

PMID- 1748677
TI  - Glucose increases the expression of the ATP/ADP translocator and the
      glyceraldehyde-3-phosphate dehydrogenase genes in Chlorella.
AB  - A presumably full-length cDNA clone of the mitochondrial ATP/ADP translocator
      (AAT) of Chlorella kessleri has been isolated and sequenced. The expression of
      the AAT gene is highly increased in the presence of D-glucose (14 mM). At least
      nine more genes are activated when autotrophically grown Chlorella cells switch
      to heterotrophic growth. Among these is the HUP1 gene coding for the hexose
      transporter (Sauer, N., Caspari, T., Klebl, F., and Tanner, W. (1990) Proc. Natl.
      Acad. Sci. U.S.A. 87, 7949-7952) and, as also shown in this paper, the
      glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene. When glucose or the
      nonmetabolizable analogue 6-deoxyglucose is added to the cells, an increased
      expression of GAPDH or AAT is observed after 10 or 30 min, respectively. Hexose
      uptake mutants (HUP1-) do not respond to sugars in this way, which indicates that
      either the inducer has to be internalized or that the HUP1 translocator is part
      of the signal transduction mechanism.

PMID- 1748678
TI  - Molecular basis of multiple UDP-glucuronosyltransferase isoenzyme deficiencies in
      the hyperbilirubinemic rat (Gunn rat).
AB  - The Gunn rat is a mutant strain of Wistar rat which has unconjugated
      hyperbilirubinemia as a result of the absence of hepatic UDP
      glucuronosyltransferase (UDPGT) activity toward bilirubin. The Gunn rat is also
      deficient in UDPGT activities toward phenol substrates, and also toward
      digitoxigenin-monodigitoxiside. We have demonstrated that the defect of the
      isoenzyme for 4-nitrophenol (4NP) in Gunn rat liver arises from a -1 frameshift
      mutation that removes 115 amino acids from the COOH terminus (Iyanagi, T.,
      Watanabe, T., and Uchiyama, Y. (1989) J. Biol. Chem. 264, 21302-21307). To
      investigate the molecular basis of defects in other UDPGT isoenzymes, we isolated
      and sequenced cDNAs from a Gunn rat liver library using mutant 4NP-UDPGT cDNA as
      a probe. Three novel cDNAs were identified that had identical 3'-regions of 1362
      base pairs containing a single-base deletion in the same position as that of the
      mutant 4NP-UDPGT cDNA. However, their 5'-regions, encoding the substrate-binding
      domain, showed no more than 40% homology to that of 4NP-UDPGT. These data provide
      evidence that defects in some UDPGT isoenzymes in the Gunn rat are caused by a
      single mutation that results in the formation of a common truncated COOH
      terminus. Furthermore, the data also suggest that these mRNAs are transcribed
      from a single gene and that the 5'-exons are transcribed independently and
      differentially spliced to common 3'-exons encoding the conserved domain.

PMID- 1748679
TI  - Genomic organization of collagenous domains and chromosomal assignment of human
      180-kDa bullous pemphigoid antigen-2, a novel collagen of stratified squamous
      epithelium.
AB  - We have recently isolated a 1.0-kilobase (kb) cDNA encoding 180-kDa bullous
      pemphigoid antigen (BPAG2), an autoantigen in blistering skin disease, bullous
      pemphigoid (Giudice, G. J., Squiquera, H. L., Elias, P. M., and Diaz, L. (1991)
      J. Clin. Invest. 87, 734-738). The deduced amino acid sequence identified two
      collagenous domains characterized by Gly-X-Y repeats. In this study we have
      elucidated the genomic organization of the corresponding segment in the human
      BPAG2 gene. Screening of a genomic lambda-phage DNA library yielded six
      overlapping clones, and the sequences corresponding to the 1.0-kb cDNA spanned
      approximately 12 kb of genomic DNA. The coding segment consisted of 19 separate
      exons varying in size from 27 to 222 base pairs. The organization of these exons
      and the splice sites at the intron-exon junctions were clearly different from
      other fibrillar and nonfibrillar collagen genes described to date. The BPAG2 gene
      was mapped by chromosomal in situ hybridization to the long arm of human
      chromosome 10, at locus 10q24.3; this location is distinct from any previously
      mapped collagens, and it also distinguishes BPAG2 from BPAG1, a 230-kDa bullous
      pemphigoid antigen, which has been mapped to chromosome 6p (Sawamura, D., Nomura,
      K., Sugita, Y., Mattei, M.-G., Chu, M.-L., Knowlton, R.G., and Uitto, J. (1990)
      Genomics 8, 722-726). These data suggest that BPAG2 is a novel collagen present
      in stratified squamous epithelia.

PMID- 1748680
TI  - Purified estrogen receptor DNA binding domain expressed in Escherichia coli
      activates transcription of an estrogen-responsive promoter in cultured cells.
AB  - The region of the Xenopus laevis estrogen receptor responsible for interaction
      with DNA, the DNA binding domain (DBD), has been cloned and overexpressed in
      Escherichia coli using a T7 RNA polymerase expression system. Extracts from cells
      transformed with the DBD expression vector contain a single protein which reacts
      with polyclonal antibodies to estrogen receptor and exhibits sequence-specific
      binding to a DNA fragment containing a consensus estrogen response element. The
      DBD protein has been purified to near homogeneity. Determination of the
      rotational relaxation time of the dansylated DBD by fluorescence polarization and
      size fractionation by Superdex column chromatography indicate that the DBD is a
      monomer in solution. The DBD forms a single protein-estrogen response element
      complex in gel mobility shift assays at DBD concentrations of 18-3,600 nM,
      suggesting that the DBD is bound to both halves of the palindromic estrogen
      response element. To investigate the ability of the DBD expressed in bacteria to
      activate gene expression, we have developed a simple liposome-based system for
      delivery of protein into cultured cells. Transfected DBD protein elicited large,
      concentration-dependent increases in transcription of an estrogen receptor
      regulated reporter gene. These data demonstrate that the bacterially expressed
      DNA binding domain, which represents a small portion of the Xenopus laevis
      estrogen receptor, retains significant ability to activate transcription of an
      estrogen-responsive promoter in vertebrate cells.

PMID- 1748681
TI  - Two additional common subunits, ABC10 alpha and ABC10 beta, are shared by yeast
      RNA polymerases.
AB  - Yeast nuclear RNA polymerases are multisubunit enzymes that contain in common
      some small subunits. We show that the smallest, a 10-kDa component of three
      enzymes (A10, B10, and C10), is heterogeneous. In each case, it can be resolved
      into two distinct polypeptides (alpha and beta) by reverse-phase chromatography.
      A10 alpha, B10 alpha, and C10 alpha were indistinguishable on the basis of their
      electrophoretic and chromatographic behaviors, characteristic silver staining,
      and tryptic peptide analysis. All three polypeptides are blocked at their amino
      termini. By the same criteria, A10 beta, B10 beta, and C10 beta were also
      indistinguishable. The amino-terminal sequence of A10 beta and C10 beta
      corresponded to that of subunit B10 recently cloned by Woychik and Young
      (Woychik, N. A., and Young, R. A. (1990) J. Biol. Chem. 265, 17816-17819). Thus,
      the three forms of RNA polymerase share two additional and distinct polypeptides,
      ABC10 alpha and ABC10 beta, that therefore can be considered bona fide subunits
      of these enzymes. Interestingly, these two subunits bind zinc.

PMID- 1748682
TI  - Early induction of ribonucleotide reductase gene expression by transforming
      growth factor beta 1 in malignant H-ras transformed cell lines.
AB  - Previous investigations have indicated that the suppression of proliferation by
      transforming growth factor (TGF) beta 1 is often lost upon cellular
      transformation, and that proliferation of some tumors is stimulated by TGF-beta.
      The present study provides the first observation of a link between TGF-beta 1
      regulation of this process and alterations in the expression of ribonucleotide
      reductase, a highly controlled rate-limiting step in DNA synthesis. A series of
      radiation and T24-H-ras-transformed mouse 10T1/2 cell lines exhibiting increasing
      malignant potential was evaluated for TGF-beta 1 induced alterations in
      ribonucleotide reductase M1 and M2 gene expression. Early increases in M1 and/or
      M2 message and protein levels were observed only in malignant cell lines. The TGF
      beta 1 induced changes in M1 and/or M2 gene expression occurred prior to any
      detectable changes in the rates of DNA synthesis, supporting the novel concept
      that ribonucleotide reductase gene expression can be elevated by TGF-beta 1
      without altering the proportion of cells in S phase. T24-H-ras-transformed 10T1/2
      cells were transfected with a plasmid containing the coding region of TGF-beta 1
      under the control of a zinc-sensitive metallothionein promoter. When these cells
      were cultured in the presence of zinc, a large induction of TGF-beta 1 message
      was observed within 1 h. Both M1 and M2 genes were also induced, with increased
      mRNA levels appearing 2 h after zinc treatment, or 1 h after TGF-beta 1 message
      levels were clearly elevated. In total, the data suggests a mechanism of
      autocrine stimulation of malignant cells by TGF-beta 1, in which early
      alterations in the regulation of ribonucleotide reductase may play an important
      role.

PMID- 1748683
TI  - A site-directed approach for constructing temperature-sensitive ubiquitin
      conjugating enzymes reveals a cell cycle function and growth function for RAD6.
AB  - We have determined the gene sequence of a temperature-sensitive allele of the
      cell cycle-related ubiquitin-conjugating enzyme CDC34 (UBC 3) from Saccharomyces
      cerevisiae. The basis of temperature sensitivity is a missense mutation resulting
      in a proline to serine substitution at a residue that is conserved in all
      ubiquitin-conjugating enzymes identified thus far. This observation raised the
      possibility that other temperature-sensitive ubiquitin-conjugating enzymes could
      be generated in the same way. We therefore created the corresponding substitution
      in the DNA repair-related ubiquitin-conjugating enzyme, RAD6 (UBC2), and examined
      the effect of temperature on the cell proliferation and DNA repair-related
      functions of this altered polypeptide. Yeast strains carrying this mutation
      proved to be temperature-sensitive with respect to cell proliferation but not
      with respect to the DNA damage-processing phenotypes exhibited by other rad6
      mutants. Upon further investigation of the proliferation defect exhibited by this
      mutant, we discovered that other rad6 gene mutants deleted for the gene undergo
      cell cycle arrest at the nonpermissive temperature, whereas the engineered
      temperature-sensitive allele showed no evidence of a cell cycle defect. From
      these findings, we conclude that the proliferation function of RAD6 can be
      subdivided into a growth component and a cell division cycle component and that
      the growth component is unrelated to the DNA repair functions of RAD6. A
      reasonable interpretation of these results is that different proteins are
      targeted for ubiquitination in each case. The conserved proline residue of RAD6
      and CDC34 is part of a turn motif common to all ubiquitin-conjugating enzymes. It
      is therefore likely that site-directed substitution of prolines located in turns
      can be generally applied for the creation of other temperature-sensitive
      ubiquitin-conjugating enzymes and possibly other proteins as well.

PMID- 1748684
TI  - Erythropoietin induces cytosolic protein phosphorylation and dephosphorylation in
      erythroid cells.
AB  - Erythropoietin, the prime regulator of red blood cell growth and differentiation,
      causes rapid changes in the phosphorylation of several integral plasma membrane
      proteins (Choi, H-S., Wojchowski, D. M., and Sytkowski, A. J. (1987) J. Biol.
      Chem. 262, 2933-2936; Choi, H-S., Bailey, S. C., Donahue, K. A., Vanasse, G. J.,
      and Sytkowski, A. J. (1990) J. Biol. Chem. 265, 4143-4148). In the present study
      we have demonstrated that erythropoietin's signal is transduced rapidly to the
      cytosol resulting in specific phosphorylation/dephosphorylation events.
      Erythropoietin treatment of Rauscher murine erythroleukemia cells previously
      labeled with [32P]orthophosphate results in a rapid increase in phosphorylation
      of two cytosolic proteins, designated pp96 and pp80, and a decrease in
      phosphorylation of another protein, designated pp90. The relative molecular mass
      and pI of pp80 are virtually identical to those reported for the protein kinase C
      substrate p80, or "MARCKS protein." Treatment of the cells with 12-O
      tetradecanoylphorbol-13-acetate also increases pp80 but not pp96 phosphorylation,
      suggesting that erythropoietin triggers a protein kinase C-dependent pathway to
      pp80 and a protein kinase C-independent pathway to pp96. The effect of
      erythropoietin on pp96 phosphorylation was also shown in nontransformed erythroid
      cells isolated from the spleens of phenylhydrazine-treated mice. In contrast,
      almost no 32P labeling of pp80 or pp90 was detected, and pp80 and pp90 protein
      were nearly absent from these normal cells. These differences in expression and
      phosphorylation of erythropoietin-sensitive phosphoproteins may be related to the
      growth factor independence or dependence of the erythroid cells.

PMID- 1748685
TI  - Protein kinase C (PKC) activation via human leucocyte antigen class II molecules.
      A novel regulation of PKC activity.
AB  - Analysis of intracellular localization of protein kinase C (PKC) in a
      lymphoblastoid B cell line shows that anti-human leucocyte antigen (HLA) class II
      antibodies induce an increase of cytosolic and membrane PKC activities. This
      phenomenon is both time- and dose-dependent. The maximal PKC activation was
      observed after exposure to 12.5 micrograms/ml antibody for 30 to 45 min. Unlike
      TPA, no translocation of the cytosolic PKC was observed at any time following
      exposure to the anti-HLA class II antibodies. We observed a good correlation
      between the [3H]phorbol dibutyrate binding activity and the enzymatic activity of
      PKC. Using a panel of antibodies specific for the HLA class II isotypes (DP, DQ,
      DR), we demonstrated that PKC activation via HLA class II molecules is not
      restricted to one isotype. We also showed by Western blot analysis that the
      increased PKC activity correlates with a quantitative increase of PKC. The
      increase of PKC activity induced by anti-HLA class II antibodies was completely
      abolished by the treatment with actinomycin D, a transcriptional inhibitor, or
      cycloheximide, a translational inhibitor. Finally, Northern blot analysis
      revealed that anti-HLA class II antibodies induce an increase of the PKC alpha
      and PKC beta mRNAs levels which are significant after 20 min of stimulation and
      rose to a maximum after 60 min. In summary, our results show that increased PKC
      activity induced by HLA class II antibody is regulated at the transcriptional
      level.

PMID- 1748686
TI  - Expression of human glycophorin A in wild type and glycosylation-deficient
      Chinese hamster ovary cells. Role of N- and O-linked glycosylation in cell
      surface expression.
AB  - Glycophorin A, the most abundant sialoglycoprotein on human red blood cells,
      carries several medically important blood group antigens. To study the role of
      glycosylation in surface expression and antigenicity of this highly glycosylated
      protein (1 N-linked and 15 O-linked oligosaccharides), glycophorin A cDNA (M
      allele) was expressed in Chinese hamster ovary (CHO) cells. Both wild type CHO
      cells and mutant CHO cells with well defined glycosylation defects were used.
      Glycophorin A was well expressed on the surface of transfected wild type CHO
      cells. On immunoblots, the CHO cells expressed monomer (approximately 38 kDa) and
      dimer forms of glycophorin A which co-migrated with human red blood cell
      glycophorin A. The transfected cells specifically expressed the M blood group
      antigen when tested with mouse monoclonal antibodies. Tunicamycin treatment of
      these CHO cells did not block surface expression of glycophorin A, indicating
      that, in the presence of normal O-linked glycosylation, the N-linked
      oligosaccharide is not required for surface expression. To study O-linked
      glycosylation, glycophorin A cDNA was transfected into the Lec 2, Lec 8, and ldlD
      glycosylation-deficient CHO cell lines. Glycophorin A with truncated O-linked
      oligosaccharides was well expressed on the surface of ldlD cells (cultured in the
      presence of N-acetylgalactosamine alone), Lec 2 cells, and Lec 8 cells with
      monomers of approximately 25 kDa, approximately 33 kDa, and approximately 25 kDa,
      respectively. In contrast, non-O-glycosylated glycophorin A (approximately 19-kDa
      monomers) was poorly expressed on the surface of ldlD cells cultured in the
      absence of both galactose and N-acetylgalactosamine. Thus, under these
      conditions, in the absence of O-linked glycosylation, the N-linked
      oligosaccharide itself is not able to support appropriate surface expression of
      glycophorin A in transfected CHO cells.

PMID- 1748687
TI  - A Chinese hamster cDNA encoding a protein essential for phosphatidylserine
      synthase I activity.
AB  - A phosphatidylserine-auxotrophic mutant of cultured Chinese hamster ovary (CHO)
      cells, PSA-3, is defective in phosphatidylserine synthase I activity.
      Transfection of PSA-3 cells with a cDNA expression library of CHO-K1 (the parent
      of PSA-3) yielded a phosphatidylserine-prototrophic transformant with normal
      phosphatidylserine synthase I activity. Using a cDNA segment retrieved from the
      transformant as a probe, a cDNA clone (pssA) responsible for phosphatidylserine
      prototrophy was isolated from the original cDNA library by colony filter
      hybridization. Introduction of the pssA cDNA into PSA-3 cells restored the
      phosphatidylserine content, and the resultant transformant exhibited 15-fold
      higher specific phosphatidylserine synthase I activity than CHO-K1 cells. The
      nucleotide sequence of the pssA cDNA contained a single long open reading frame
      capable of encoding a protein of 471 amino acid residues with several putative
      membrane-spanning domains. Our results indicated that the pssA cDNA encodes an
      integral membrane protein essential for phosphatidylserine synthase I activity.

PMID- 1748688
TI  - Identification and chemical synthesis of a substrate-binding site for factor IX
      on coagulation factor XIa.
AB  - We have previously used monoclonal antibodies to identify an epitope on the heavy
      chain of factor XIa that is a substrate-binding site for factor IX (Sinha, D.,
      Seaman, F.S., and Walsh, P.N. (1987) Biochemistry 26, 3768-3775; Baglia, F.A.,
      Sinha, D., and Walsh, P.N. (1989) Blood 74, 244-251). To define the factor XIa
      domain that binds factor IX, we have now screened a panel of factor XI heavy
      chain-derived synthetic peptides for their capacity to inhibit the formation of
      an activation peptide reflecting factor IX activation by factor XIa. Peptide
      Asn145-Ala176 (which is located in the second tandem repeat or A2 domain of the
      factor XI heavy chain) is a competitive inhibitor of factor IX activation by
      factor XIa with a Ki of 30 nM, whereas structurally similar peptides in the A1,
      A3, and A4 domains were required at 10-1000-fold higher concentrations for
      similar effects, and a synthetic peptide identical with a highly homologous
      region of the heavy chain A2 domain of prekallikrein (Tyr143-Ala176) had no
      effect on factor IX activation by factor XIa. Because detailed structural
      information is lacking, a potential three-dimensional structure for the factor XI
      A2 domain was calculated based on its sequence information in conjunction with
      previously determined structural constraints. The resulting structure depicted
      three juxtaposed beta-stranded stem-loops that, based on biological information,
      constitute a candidate surface for contact with factor IX. The A2 model was
      therefore used as a template in the rational design of three synthetic peptides
      (Ala134-Ile146 (peptide a), Leu148-Arg159 (peptide b), and Ile160-Leu172 (peptide
      c]. When peptides a and b or a and c were added together and the activation of
      factor IX by factor XIa was examined, a synergistic inhibitory effect was
      observed, compared with each peptide added individually, whereas peptides b and c
      showed additive effects. Our data suggest that the sequence of amino acids from
      Ala134 through Leu172 of the heavy chain of factor XI contains three antiparallel
      beta-strands connected by beta-turns that together comprise a continuous surface
      utilized for the binding of factor IX.

PMID- 1748689
TI  - Studies on the interaction of ribonuclease inhibitor with pancreatic ribonuclease
      involving differential labeling of cysteinyl residues.
AB  - Ribonuclease inhibitor (RI) is a protein that forms a very tight complex with
      ribonucleases (RNases) of the pancreatic type. RI contains 30 thiol groups, some
      of which are important for the enzyme-inhibitor interaction. To examine which
      thiols are affected by the binding of RNase, differential labeling experiments
      were performed. Reaction of porcine RI with the cysteine-specific labeling
      reagent 4-N,N-dimethylaminoazobenzene-4'-iodoacetamido-2'-sulfonic acid resulted
      in labeling of an average of 7.4 of the 30 cysteinyl residues. Binding of bovine
      pancreatic RNase A caused a 3.2-fold reduction in the extent of modification.
      Peptide mapping showed that in free RI, Cys-57, -371, and -404 were labeled to
      the greatest extent (yield, 0.4-0.6 mol/mol). RNase A did not protect Cys-57
      against modification, whereas the labeling of Cys-371 and -404 was reduced by
      more than 90%. A second group of residues was labeled to a lesser extent in free
      RI (yield, 0.04-0.2 mol/mol). Within this group 11 residues were protected by
      RNase A by more than 90%, 2 were not affected at all, and 7 were protected
      between 10 and 90%. Seven cysteinyl residues in RI that were protected in the
      RI.RNase A complex were no longer protected in the RI.S-protein complex. These
      residues were mainly present in the N-terminal region of RI. However, when the S
      peptide was included to yield the RI.RNase S complex, the same pattern of
      labeling was obtained as with the RI.RNase A complex. Addition of the S-peptide
      alone had no effect on the labeling. The implications of these observations with
      respect to RNase binding areas of RI are discussed in relation to the results
      obtained from the analysis of active RI molecules that contain deletions.

PMID- 1748690
TI  - Characterization of the active part of the human transferrin gene enhancer and
      purification of two liver nuclear factors interacting with the TGTTTGC motif
      present in this region.
AB  - The human transferrin gene enhancer is composed of two functional domains (A and
      B). We have previously shown that domain A is able to mediate enhancer activity
      in transient expression experiments. Here, we show that multimers of the domain A
      single enhanson coupled to a canonical TATA box are sufficient to promote
      transcription in vitro with liver nuclear extracts. Gel mobility shift assays
      reveal the binding of two liver nuclear factors to this enhanson, and methylation
      interference experiments show that the motif 5'-TGTTTGCTTT-3' is the target site
      for these factors. This was confirmed by the use of mutants in gel retardation
      assays and transient expression experiments. The two proteins interacting with
      the decanucleotide have been purified from rat liver nuclear extracts by DNA
      affinity chromatography. The purified proteins named enhancer-binding protein
      (EBP)-45 and EBP-40 appear as single polypeptide bands with respective molecular
      masses of 45 and 40 kDa on sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. The TGTTTGC motif was found to be important for the hepatocyte
      specific expression of several genes; and in some cases, it was demonstrated that
      the transcription factor CCAAT/enhancer-binding protein (C/EBP) is able to bind
      to this sequence. In vitro experiments show that EBP-45 and EBP-40 are different
      from C/EBP; they also show that the two proteins interact with the TGTTTGC motif
      present in control regions of other hepatic genes, such as the mouse albumin
      enhancer eH and hepatitis B virus enhancer E elements.

PMID- 1748691
TI  - Pharmacological characterization of muscarinic receptor subtypes in rabbit
      isolated tissue preparations.
AB  - 1 The affinity of some muscarinic antagonists for muscarinic receptors was
      determined in functional isolated tissue studies in order to compare the
      muscarinic receptor subtypes in the rabbit. 2 Our attention was specially focused
      on the question of whether the muscarinic receptors mediating vasodilatation in
      the aorta resemble or not the ones present on the jejunum of the gastrointestinal
      tract. 3 Isolated aorta, jejunum, stimulated left atrium and vas deferens
      preparations of rabbit were investigated with the following muscarinic
      antagonists: atropine, pirenzepine, methoctramine (N,N'-bis[6-92
      methoxybenzyl)amino hexyl]-1,8-octane-diamine tetrahydrochloride) and 4-DAMP (4
      diphenylacetoxy-N-methylpiperidine methiodide). 4 The results demonstrate that
      the receptors on aorta are unlike those on the other rabbit tissues: pirenzepine
      pA2 was 6.4 on aorta but 8.1 on vas deferens; methoctramine pA2 was 5.9 on aorta
      but 7.1 on heart; 4-DAMP pA2 was 8.7 on aorta and 8.0 on jejunum. This raises the
      question: what subtype might be involved?

PMID- 1748692
TI  - Effect of benzylamine and its metabolites on the responses of the isolated
      perfused mesenteric arterial bed of the rat.
AB  - 1. Semicarbazide-sensitive amine oxidase (SSAO) is an enzyme activity which can
      be found in the plasma membrane of rat vascular smooth muscle cells. We have
      investigated the possibility that the products of deamination by this enzyme,
      namely ammonia, hydrogen peroxide and the aldehyde, may be important in the
      modulation of the responses of vascular smooth muscle to extracellular stimuli.
      2. The isolated perfused mesenteric arterial bed of the rat was used and dose
      pressure response curves (DRC) to bolus injections of adrenaline (Ad) or ATP were
      plotted by non-linear curve fitting. The relaxant effects of carbachol (CCh),
      which releases endothelium dependent relaxing factor (ERDF), were studied by co
      administering CCh with Ad. The effects of including the preferred SSAO substrate,
      benzylamine (BZ; 25 microM), in the perfusion fluid throughout the experiment and
      of inhibition of SSAO by treatment of rats with (E)-2-(3',4'-dimethoxyphenyl)-3
      fluoroallylamine (MDL 72145; 1 mg kg-1) 1 h before dissection, have been studied.
      3. Neither BZ nor SSAO inhibition affected the DRC to ATP. BZ shifted Ad
      responses to the left, inhibition of SSAO increased this shift indicating that
      the amine, but not its metabolites, were responsible for the potentiation of the
      responses to Ad. DRC to CCh showed a shift to the left and a significant decrease
      in the Hill slope with BZ, indicative of a potentiation of low doses of CCh more
      than high doses. Inhibition of SSAO prevented this change and so the metabolites
      of BZ deamination appeared to be involved in the potentiation. 4. Ammonia
      generated by SSAO may contribute to the production of EDRF or hydrogen peroxide
      may sensitize guanylate cyclase to stimulation by EDRF and so explain these
      findings.

PMID- 1748693
TI  - Hydroxyapatite-coated femoral stems. Histological analysis of components
      retrieved at autopsy.
AB  - Plasma-sprayed coating of hydroxyapatite are biocompatible and, because of their
      osteoconductive properties, may contribute to the early fixation of total joint
      prostheses. To evaluate this interface, we histologically analyzed five
      hydroxyapatite-coated femoral stems which, along with the surrounding bone, were
      retrieved from three humans at autopsy. The five femoral components had been in
      situ for a mean duration of twelve months (range, almost five to twenty-five
      months) and had been inserted for osteonecrosis (two), osteoarthrosis (two), and
      as an uncermented revision for failure of a cemented stem. The three patients had
      had a good or excellent clinical result and had died of causes unrelated to the
      joint arthroplasty. A coating of hydroxyapatite was identified on each stem.
      There was a variable amount of apposition of bone (32 to 78 per cent of available
      surface per section). The deposition of bone was most prominent on the surface of
      the prosthesis that was close to the endosteal surface of the bone, especially in
      areas that are predicted by Wolff's law (anterior and medial aspects of the
      implant, and at lateral-oblique corners). There were occasional foci of bone
      remodeling around the implant, including osteoclast-mediated removal of the
      coating of hydroxyapatite along with adjacent bone. Occasional particles of
      ceramic were present within macrophages in the adjacent bone marrow. Other areas
      showed formation of new bone with a few areas of bone directly against the metal
      substrate. The over-all histological features suggest mechanically stable
      implants with bone-remodeling at the surface of the bone-implant interface.

PMID- 1748694
TI  - Use of a hinged silicone prosthesis for replacement arthroplasty of the first
      metatarsophalangeal joint.
AB  - A series of ninety consecutive total joint replacements of the first
      metatarsophalangeal joint with a flexible hinged prosthesis was reviewed after an
      average duration of follow-up of three years (range, twenty-four to sixty-one
      months). Although subjectively the results were satisfactory in most of the
      patients, and pain, the most common preoperative symptom, was reduced, mechanical
      failure of the implant was common, as determined radiographically. The frequency
      of failure of the implant and the extent to which it failed were related to the
      length of time that the implant had been in place. The range of motion of the
      metatarsophalangeal joint was decreased from normal. Dorsiflexion averaged 26
      degrees and plantar flexion, 18 degrees. Callosities under at least one
      metatarsophalangeal joint were noted in fifty (69 per cent) of the feet that had
      a physical examination. Pedobarographic analysis of the distribution of plantar
      pressure revealed that none of the patients exerted weight-bearing pressures on
      the affected great toe. However, the subjective results were not significantly
      associated with radiographic evidence of failure of the implant. Despite its
      success in relieving the symptoms in our patients, we have abandoned this
      procedure because of the high and increasing rate of failure of the implant, as
      demonstrated radiographically.

PMID- 1748695
TI  - The use of bone allografts in two-stage reconstruction after failure of hip
      replacements due to infection.
AB  - Bone allografts were used to reconstruct deficient acetabular and femoral bone in
      eighteen patients during two-stage revision of a hip arthroplasty that had failed
      due to infection. At a mean of 4.2 years after reimplantation, only two patients
      had had recurrence of the infection. Four patients needed another revision
      arthroplasty for reasons other than infection. These results suggest that
      allografts of bone are useful for the reconstruction of osseous deficiencies in
      carefully selected patients who have a hip arthroplasty after infection. The
      results do not support the concern that allografts that are used under these
      circumstances necessarily lead to a high rate of recurrence of infection.
      However, the long-term results of the use of allografts in hip arthroplasty after
      infection remain unknown.

PMID- 1748696
TI  - Metachronous infections in patients who have had more than one total joint
      arthroplasty.
AB  - Sixty-eight patients who had had 159 replacement arthroplasties of more than one
      major joint between 1975 and 1984 and who had had an infection after at least one
      of these procedures were identified in a retrospective review. Subsequent
      infection in another total joint replacement was documented in ten of these
      patients. The risk of development of an infection about another total joint
      replacement after an infection had occurred about one total joint replacement in
      a patient who had had more than one arthroplasty was 18 per cent, according to
      the survivorship-analysis method of Kaplan and Meier. Many variables that were
      previously thought to increase the risk of infection, such as rheumatoid
      arthritis, older age of the patient, previous operations, and the use of
      corticosteroids or immunosuppressive agents, or both, were not found to increase
      the risk of a subsequent infection in patients who had had more than one
      arthroplasty with infection of one of the arthroplasties. The recent occurrence
      of a major systemic infection did increase the risk of infection about the other
      total joint replacements. Eight of the ten subsequent joint infections were due
      to the same causative organism as the index infection about a total joint
      replacement and occurred within the first year after the index infection. The
      initial treatment of the index infection included specific parenteral
      antimicrobial therapy combined with debridement and excisional arthroplasty in
      forty patients, removal of the components and arthrodesis in three patients, and
      debridement with retention of the prosthesis in twenty-five patients.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1748697
TI  - Vehicle-moose accidents in Newfoundland.
AB  - During 1987 and 1988, in Newfoundland, there were 661 motor-vehicle accidents
      involving a moose; 133 people were injured and three died. This constitutes a
      major problem for the provincial health-care system. In 95 per cent of the
      patients who were involved in fifty-five primary collisions (the vehicle hit only
      the moose), the injury-severity score was less than 9 (mean and standard
      deviation, 3.2 +/- 4.6). There were thirty-six secondary collisions: in eighteen,
      the vehicle hit other objects after avoiding the moose (group A), and in the
      other eighteen, the vehicle hit the moose and then hit other objects (group B).
      In group A, the mean injury-severity score was 4.2 +/- 2.9 and in group B, it was
      19.6 +/- 27.1. The three patients who died were in group B. There were more
      injuries to the thorax, thoracolumbar spine, and abdomen in group B than in the
      single-collision groups (primary-collision group and group A).

PMID- 1748698
TI  - Interlocking intramedullary nailing for ipsilateral fractures of the femoral
      shaft and distal part of the femur.
AB  - A review of the data on 684 fractures of the femur that had been treated with
      intramedullary nailing led to the identification of twenty-three patients who had
      had a fracture of the shaft of the femur with an accompanying ipsilateral
      supracondylar fracture (twelve patients, group I) or a concomitant ipsilateral
      intercondylar fracture (eleven patients, group II). The group-I fractures had
      been treated with interlocking nailing without supplemental fixation. In group
      II, ten fractures were stabilized with interlocking nailing and supplemental
      screw fixation and one, with interlocking nailing and a supplemental plate and
      screws. The average time to union for all fractures was nineteen weeks (range,
      twelve to thirty-six weeks), and the average duration of clinical and
      radiographic follow-up was thirty months (range, nine to fifty-nine months). In
      group I, alignment of the femur was within 5 degrees of normal in ten of the
      twelve fractures. In group II, seven intra-articular fractures healed in
      anatomical alignment, three had slight articular displacement (1.0 to 3.0
      millimeters), and one had displacement of more than 3.0 millimeters. The average
      range of motion of the knee at the most recent follow-up was 0 to 120 degrees in
      group I and 0 to 115 degrees in group II. Two patients (both in group II) needed
      a reoperation for a previously unrecognized fracture of a femoral condyle in the
      coronal plane; post-traumatic arthritis developed in both. No patient in either
      group had loss of fixation or failure of the implant. We concluded that
      ipsilateral diaphyseal, supracondylar, and intercondylar fractures of the femur
      can be adequately stabilized with interlocking nailing and supplemental
      intercondylar screw fixation. The presence of a fracture in the coronal plane of
      a femoral condyle (AO type-B3 and type-C3 injuries) is a relative
      contraindication to the use of this technique.

PMID- 1748699
TI  - Pericardial tamponade secondary to perforation by central venous catheters in
      orthopaedic patients.
AB  - Pericardial tamponade from an indwelling central venous catheter developed in
      four orthopaedic patients. Two of these patients died acutely, and the other two
      sustained severe anoxic brain injury. The early signs of tamponade include
      tachycardia, hypotension, and increased central venous pressure. The outcome most
      often is fatal. When a central venous catheter has been placed incorrectly or has
      migrated, it can perforate the heart and produce pericardial tamponade. To avoid
      this complication, the tip of the catheter must be placed within the superior
      vena cava rather than the right atrium, and the position of the catheter must be
      ascertained with a radiograph of the chest. Prompt recognition and treatment of
      pericardial tamponade are imperative if a disastrous outcome is to be prevented.

PMID- 1748700
TI  - Histopathological changes preceding spontaneous rupture of a tendon. A controlled
      study of 891 patients.
AB  - We evaluated specimens obtained from the biopsy of spontaneously ruptured tendons
      in 891 patients who were treated between 1968 and 1989. The specimens, which were
      removed at the time of repair, included 397 Achilles tendons, 302 biceps brachii
      tendons, forty extensor pollicis longus tendons, eighty-two quadriceps tendons
      and patellar ligaments, and seventy other tendons. Age and sex-matched control
      specimens, from 445 tendons taken at the time of death from the cadavera of
      previously healthy individuals who died accidentally, also were obtained and
      evaluated. The histopathological analyses of the specimens included light and
      polarized light microscopy and scanning and transmission electron microscopy. A
      healthy structure was not seen in any spontaneously ruptured tendon, but two
      thirds of the control tendons were structurally healthy (p less than 0.001).
      There were characteristic histopathological patterns in the spontaneously
      ruptured tendons. Most (97 per cent) of the pathological changes were
      degenerative; they included hypoxic degenerative tendinopathy, mucoid
      degeneration, tendolipomatosis, and calcifying tendinopathy, either alone or in
      combination. These changes were also found in 34 per cent of the control tendons,
      but significantly less frequently (p less than 0.001). In the other twenty-six
      ruptured tendons (3 per cent), the pathological change was an intratendinous
      foreign body, rheumatoid tendinitis, a xanthoma, a tumor, or a tumor-like lesion
      such as an intratendinous ganglion. The findings clearly indicate that, at least
      in an urban population, degenerative changes are common in the tendons of people
      who are older than thirty-five years and that these changes are associated with
      spontaneous rupture.

PMID- 1748701
TI  - The shoulder girdle in ankylosing spondylitis.
AB  - We report the clinical findings in the shoulders of fifty-two patients who had
      ankylosing spondylitis. The three major patterns that were found included
      limitation of scapulothoracic motion (forty-one patients), acute inflammatory
      arthropathy of the sternoclavicular or acromioclavicular joint (six patients),
      and severe restriction of glenohumeral motion (five patients). Although
      radiographic abnormalities were common, they correlated with the clinical
      findings in only minor respects.

PMID- 1748702
TI  - X-chromosome inactivation in patients who have pigmented villonodular synovitis.
AB  - We performed a histological examination and DNA analysis on samples of tissue
      from a forty-seven-year-old woman who had a clinical diagnosis of pigmented
      villonodular synovitis. The histological examination confirmed the diagnosis. The
      evaluation of the samples of tissue with preferential X-chromosome inactivation
      analysis (a molecular biological method for the study of clonality in tumors)
      showed that the lesion was polyclonal in origin. We concluded, therefore, that
      pigmented villonodular synovitis is more likely to be a reactive process than a
      true neoplasm.

PMID- 1748703
TI  - Extrusion of an intervertebral disc associated with traumatic subluxation or
      dislocation of cervical facets. Case report.

PMID- 1748704
TI  - Fractures of the shaft of the femur.

PMID- 1748705
TI  - Report of the 1991 ABC Traveling Fellows. A scientific presentation.

PMID- 1748706
TI  - Perioperative blood loss associated with total knee arthroplasty. A comparison of
      procedures performed with and without cement.

PMID- 1748707
TI  - Idiopathic osteonecrosis of the patella: an unusual cause of pain in the knee. A
      case report.

PMID- 1748708
TI  - The effect of intravenous fixed-dose heparin during total hip arthroplasty on the
      incidence of deep-vein thrombosis. A randomized, double-blind trial in patients
      operated on with epidural anesthesia and controlled hypotension.

PMID- 1748709
TI  - Tests for posterolateral instability of the knee in normal subjects. Results of
      examination under anesthesia.

PMID- 1748710
TI  - Ingrowth and formation of bone in defects in an uncemented fiber-metal total hip
      replacement model in dogs.

PMID- 1748711
TI  - Indications for magnetic resonance imaging.

PMID- 1748712
TI  - Dedifferentiated chondrosarcoma. Report of an unusual case.

PMID- 1748713
TI  - Radiographic assessment of instability of the knee due to rupture of the anterior
      cruciate ligament. A quadriceps-contraction technique.

PMID- 1748714
TI  - IL-1 beta and prostaglandins regulate integrin mRNA expression.
AB  - The purpose of this study was to examine the effects of IL-1 beta on integrin
      expression in MG-63 human osteosarcoma cells. Human recombinant IL-1 beta (rIL-1
      beta) produced significant increases in both alpha 2- and alpha 5-subunit mRNA
      levels, as well as a smaller increase in alpha v-subunit mRNA. In contrast, IL-1
      beta decreased alpha 4-subunit mRNA levels by approximately 30% relative to
      untreated controls. These findings suggest that human IL-1 beta differentially
      regulates expression of integrins. When cultures were treated with both IL-1 beta
      and the cyclooxygenase inhibitor, indomethacin, the expression of alpha 2-, alpha
      5-, and alpha v-subunit mRNA levels were dramatically increased relative to
      untreated controls; co-treatment with 0.5 mM prostaglandin E2 (PGE2) partially
      reversed this effect. Indomethacin alone did not affect integrin mRNA levels.
      Treatment with IL-1 beta or IL-1 beta + indomethacin also induced significant
      changes in MG-63 morphology (i.e., increased cell elongation) and increased the
      ability of cells to contract collagen gels. PGE2 reversed the above effects on
      cell morphology and gel contraction. These findings indicate that (a) IL-1 beta
      differentially regulates the expression of integrins and (b) that PGE2, which is
      induced by IL-1 beta, may provide a negative feedback loop which counteracts the
      stimulatory effect of IL-1 beta on integrin gene expression. It is suggested that
      products of inflammation may affect cell behavior by differentially regulating
      the expression of various integrins.

PMID- 1748715
TI  - Effect of tunicamycin on glycosylation of a 50 kDa protein and thermotolerance
      development.
AB  - We investigated whether or not a 50 kDa glycoprotein might play an important role
      in protein synthesis-independent thermotolerance development in CHO cells. When
      cells were heated for 10 min at 45.5 degrees C, they became thermotolerant to a
      heat treatment at 45.5 degrees C administered 12 hr later. The thermotolerance
      ratio at 10(-3) isosurvival was 4.4. The cellular heat shock response leads to
      enhanced glycosylation of a 50 kDa protein. The glycosylation of proteins
      including a 50 kDa glycoprotein was inhibited by treatment with various
      concentrations of tunicamycin (0.2-2 micrograms/ml). The development of
      thermotolerance was not affected by treatment with tunicamycin after the initial
      heat treatment, although 2 micrograms/ml tunicamycin inhibited glycosylation by
      95%. However, inhibiting protein synthesis with cycloheximide (10 micrograms/ml)
      after the initial heat treatment partially inhibited the development of
      thermotolerance. Nevertheless, there was no further reduction of thermotolerance
      development by treatment with a combination of 2 micrograms/ml tunicamycin and 10
      micrograms/ml cycloheximide. These data suggest that development of
      thermotolerance, especially protein synthesis-independent thermotolerance, is not
      correlated with increased glycosylation of the 50 kDa protein.

PMID- 1748716
TI  - Recessive (mediator-) revertants from c-H-ras oncogene-transformed NIH 3T3 cells:
      tumorigenicity in nude mice and transient anchorage and serum independence of the
      recovered tumor cells in culture.
AB  - We have reported earlier the isolation of two recessive, serum- and anchorage
      dependent revertants (R116 and R260) from a c-H-ras oncogene-transformed NIH 3T3
      line. In both revertants, the oncogene was fully expressed and fusion of either
      revertant with (untransformed) NIH 3T3 cells, or of the two revertants with one
      another, resulted in transformed progeny. These, and other data, indicated that
      the transforming activity of the oncogene was impaired in the two revertants in
      consequence of defects in distinct genes needed to mediate this activity. We
      report here that neither revertant could be re-transformed by the K-ras or N-ras
      oncogene (though they could be re-transformed by several other oncogenes). The
      two revertants turned out to be tumorigenic in nude mice (though less so than the
      parental transformed cells). The tumor cells, as recovered, formed foci and had a
      transformed morphology and a greatly diminished serum and anchorage dependence.
      Growth of the cells in culture (for 20 passages) resulted in their regaining the
      characteristics (i.e., anchorage and serum dependence) of cultured R116 and R260
      cells. Proliferation of the cells in nude mice was not accompanied by a change in
      the level of ras oncogene expression or in gene amplification, at least as
      manifested in the lack of appearance of double-minute chromosomes. The addition
      of the growth factors TGF alpha and beta to the medium of either revertant did
      not support anchorage-independent growth.

PMID- 1748717
TI  - Dexamethasone and retinoic acid regulate the expression of epidermal growth
      factor receptor mRNA by distinct mechanisms.
AB  - Retinoic acid and dexamethasone have antagonistic effects on epidermal growth
      factor (EGF) receptor expression in fetal rat lung (FRL) cells: Receptor
      synthesis is enhanced by retinoic acid and reduced by dexamethasone. In the
      presence of actinomycin D, neither agent has the capacity to modify receptor
      synthesis or 125I-EGF binding capacity. Northern blot analysis demonstrates a
      tenfold increase in EGF mRNA following retinoic acid treatment and a 60% decrease
      in receptor message levels after dexamethasone treatment. To dissect the
      mechanisms of these effects, the expression of mRNA was separated from effects
      requiring protein synthesis by the use of cycloheximide and actinomycin D. Ligand
      binding, EGF receptor protein synthesis, and mRNA levels were measured in
      cultures of FRL cells that were incubated with retinoic acid or dexamethasone in
      the presence of cycloheximide, then washed and reincubated with fresh media
      containing actinomycin D, but not retinoic acid, dexamethasone, or cycloheximide.
      The results demonstrate that dexamethasone reduces the expression of EGF receptor
      mRNA in the absence of protein synthesis. In contrast, the mechanism by which
      retinoic acid increases the expression of EGF receptor mRNA requires protein
      synthesis. These data indicate that, in FRL cells, dexamethasone negatively
      regulates EGF receptor mRNA in a direct manner, while retinoic acid controls
      transcription of an intermediate protein, possibly a transcription factor, that
      subsequently increases transcription of receptor message.

PMID- 1748718
TI  - Insulin-like growth factor 1, insulin, and progesterone induce early and late
      increases in Xenopus oocyte sn-1,2-diacylglycerol levels before meiotic cell
      division.
AB  - After a 3 to 6 hour incubation, addition of progesterone (the most effective),
      insulin-like growth factor 1 (IGF-1; the second most effective), or insulin
      induces meiotic cell division in Xenopus oocytes. Measurement of an endogenous
      activator of protein kinase C, sn-1,2-diacylglycerol (DAG), by an enzymatic
      method recording mass demonstrates that all three hormones alter DAG levels. Five
      seconds after addition, only progesterone transiently reduces DAG levels by about
      25%. At 15 minutes after addition, all three hormones produce a peak of DAG (115%
      to 160% of control values), with the more effective hormones producing a larger
      increase in DAG. Insulin produces the smallest DAG increase, but the DAG release
      is longer lasting. Finally, all three hormones induce a second peak in DAG levels
      just before white spot appearance (at 0.85 GVBD50, where 1.0 GVBD50 is when 50%
      of the cells have divided). With these data and since an activator of protein
      kinase C, a phorbol ester, has been found to induce meiosis, the kinase may play
      a role in early proliferative events at the plasma membrane and in late events at
      the nucleus.

PMID- 1748719
TI  - Clustering of erythrocytes by fibrinogen is inhibited by carnitine: evidence that
      sulfhydryl groups on red blood cell membranes are involved in carnitine actions.
AB  - Carnitine is bound by intact red blood cells, by red blood cell ghosts, and by
      glutaraldehyde-fixed human erythrocytes in a non-saturable, temperature-dependent
      manner. Binding of carnitine by these preparations is blocked by sulfhydryl
      reagents. Incubation or preincubation of red blood cell preparations with
      carnitine inhibits the aggregation of erythrocytes otherwise elicited by
      fibrinogen. Identical effects are obtained with red blood cell ghosts. In
      contrast, choline, even at high concentrations, is inactive in preventing the
      aggregation of erythrocytes. We discuss possible mechanisms by which carnitine
      favors the dispersion of red blood cells, and we present data indicating that
      sulfhydryl groups on erythrocyte membranes are required to permit these carnitine
      actions to be manifested.

PMID- 1748720
TI  - Isoprenoids and astroglial cell cycling: diminished mevalonate availability and
      inhibition of dolichol-linked glycoprotein synthesis arrest cycling through
      distinct mechanisms.
AB  - Primary astroglial cultures were used to compare the relationships to cell
      cycling of dolichol-linked glycoprotein synthesis, and of availability of
      mevalonate, the precursor of dolichol and other isoprenoid lipids. With shift-up
      to 10% serum (time 0) after 48 h of serum depletion, the proportion of cells in S
      phase (bromodeoxyuridine immunofluorescence) remained under 15% for 12 h, then
      increased by 20 h to 72 +/- 10%; DNA synthetic rates (thymidine incorporation)
      increased 5-fold. S phase transition was prevented by addition at 10-12 h of
      tunicamycin, an inhibitor of transfer of saccharide moieties to dolichol.
      Mevinolin, an inhibitor of mevalonate biosynthesis, also blocked cycle
      progression when added at this time. However, mevinolin markedly inhibited the
      isoprenoid pathway, as reflected by over 90% reduction of sterol synthesis,
      without inhibiting net glycoprotein synthesis. Removal of mevinolin after a 24 h
      exposure delayed S phase until 48 h, following recovery of sterol synthesis, even
      though kinetics of glycoprotein synthesis were unaffected. Tunicamycin removal
      after 24 h spared sterol synthesis, but caused delay of S phase until 72 h,
      following recovery of glycoprotein synthesis. In mevinolin-treated cultures, S
      phase transition was restored by 1 h of exposure to mevalonate at 10 h, although
      cycling was thereby rendered sensitive to inhibition by cycloheximide and by
      tunicamycin. Cell cycle progression following hydroxyurea exposure and release
      was unaffected by mevinolin, tunicamycin, or cycloheximide. Thus, in these
      developing astroglia, mevalonate and its isoprenoid derivatives have at least two
      cell cycle-specific roles: dolichol-linked glycoprotein synthesis is required at
      or before the G1/S transition, while a distinct mevalonate requirement is
      apparent also in late G1.

PMID- 1748721
TI  - Sphingosine reverses growth inhibition caused by activation of protein kinase C
      in vascular smooth muscle cells.
AB  - In certain cell systems, including neonatal vascular smooth muscle (VSM) cells,
      phorbol esters are growth inhibitory. Here we show that 1,2-dioctanoyl-sn
      glycerol (DiC8), when added 2 h after alpha-thrombin, reverses by greater than
      95% the induction of DNA synthesis in VSM cells by alpha-thrombin. Sphingosine, a
      naturally occurring lysosphingolipid inhibitor of protein kinase C, and its
      synthetic analogues N-acetylsphingosine and C11-sphingosine were used to
      investigate this phenomenon further. Neither phorbol 12-myristate 13-acetate
      (PMA;200 ng/ml) nor sphingosine (up to 10 microM) alone had any effect upon basal
      DNA synthesis in VSM cells. Like DiC8, PMA totally blocked the induction of DNA
      synthesis by alpha-thrombin. This inhibitory effect of PMA was reversed by
      sphingosine in a dose-dependent manner with complete reversal at 10 microM.
      Neither N-acetylsphingosine nor C11-sphingosine exhibited any effect on DNA
      synthesis in VSM cells. The effect of sphingosine and its analogues on the
      activity of protein kinase C extracted from VSM cells was measured by histone III
      S phosphorylation. Protein kinase C activity was inhibited 50% by 300 microM
      sphingosine, but less than 15% by similar concentrations of N-acetylsphingosine
      and C11-sphingosine. To assess the effects of sphingosine and analogues on
      protein kinase C in intact cells, we examined the effect of the lipids on
      [3H]phorbol dibutyrate binding. Sphingosine (at greater than 5 microM), but not N
      acetylsphingosine or C11-sphingosine, blocked [3H]phorbol dibutyrate binding in a
      dose- and time-dependent fashion. Thus the mechanism of growth inhibition by DiC8
      and PMA in neonatal VSM cells appears to be through activation of protein kinase
      C by these compounds. Sphingosine reverses this growth inhibition through
      interference with the binding to protein kinase C of phorbol esters or other
      activators of this enzyme.

PMID- 1748722
TI  - Regulation of glucose uptake by stressed cells.
AB  - Lactate production by BHK cells is stimulated by arsenite, azide, or by infection
      with Semliki Forest virus (SFV). In the case of arsenite or SFV infection, the
      increase correlates approximately with the increase in glucose transport as
      measured by uptake of [3H] deoxy glucose (dGlc); in the case of azide, the
      increase in lactate production exceeds that of glucose transport. Hence glucose
      utilization by BHK cells and its stimulation by anaerobic and other types of
      cellular stress is controlled at least in part at the level of glucose transport.
      The glucose uptake by BHK cells is also stimulated by serum and by glucose
      deprivation. In these circumstances, as with arsenite, stimulation is reversible,
      with t1/2 of 1-2 hours; stimulation is compatible with a translocation of the
      glucose transporter protein between an intracellular site and the plasma membrane
      (shown here for serum and previously for arsenite). The surface binding and rate
      of internalization of [125I]-labelled transferrin and [125I] alpha 2
      macroglobulin was studied to determine whether changes in glucose transport are
      accompanied by changes in the surface concentration or rate of internalization of
      membrane proteins. The findings indicate that changes in glucose transport do not
      reflect a consistent and general redistribution of membrane receptors. Taken
      together, the results are compatible with the proposal that BHK cells exposed to
      stimuli like insulin or serum, or to stresses like arsenite, azide, SFV
      infection, or deprivation of glucose, respond in the same manner: namely, by an
      increased capacity to transport glucose brought about by reversible and specific
      translocation of the transporter protein from an (inactive) intracellular site to
      the plasma membrane.

PMID- 1748723
TI  - Changes in cobalamin metabolism are associated with the altered methionine
      auxotrophy of highly growth autonomous human melanoma cells.
AB  - Our aim was to identify the biochemical defect responsible for the inability of
      highly growth autonomous human tumor cells to proliferate in culture medium
      devoid of methionine, but containing homocysteine and 5-methyletrahydrofolic
      acid. We have adopted the terms "homocysteine-responsive" and "homocysteine
      nonresponsive" to describe cells which can or cannot proliferate in methionine
      free homocysteine-supplemented medium. Using a panel of genetically related
      homocysteine-responsive and -nonresponsive human melanoma cell lines, the results
      from a number of experiments indicate that acquisition of the "homocysteine
      nonresponsive phenotype" is associated with the reduced intracellular
      accumulation of methyl-cobalamin, a critical cofactor of the methionine synthase
      enzyme. When in vitro methionine synthase assays were performed in the presence
      of exogenously added methyl-cobalamin, specific methionine synthase activity in
      extracts obtained from homocysteine-responsive cells was only twofold greater
      than that observed with extracts prepared from homocysteine-nonresponsive cells.
      However, when exogenous methyl-cobalamin was omitted from the enzyme assays,
      methionine synthase activity in extracts derived from homocysteine-nonresponsive
      cells was dramatically reduced, compared with the small decrease observed with
      homocysteine-responsive cell extracts. Compared with their homocysteine
      responsive counterparts, homocysteine-nonresponsive cells exhibited increased
      levels of cobalamin efflux and decreased intracellular accumulation of methyl
      cobalamin. There was a clear relationship between the abilities of these related
      melanoma cell lines to proliferate in methionine-free homocysteine-supplemented
      medium, and the extent of cobalamin loss and capacity of exogenously added methyl
      cobalamin to stimulate in vitro methionine synthase activity. These results
      indicate a link between alterations in the intracellular trafficking and/or
      metabolism of cobalamin and the increased growth autonomy of human melanoma
      cells.

PMID- 1748725
TI  - Journal of Chromatography. Cumulative author, subject and compound indexes.
      Volumes 501-550 (1990-1991).

PMID- 1748724
TI  - Adipogenic activity produced by hepatocyte-derived cell lines and by normal
      hepatocytes in primary culture.
AB  - Culture media conditioned by several hepatocyte derived cell lines were analyzed
      for their ability to stimulate adipose differentiation of the adipogenic cell
      line 1246. The results presented here show that culture media from HepG2 and
      Hep3B cell lines contain a high level of the activity, whereas media from
      hepatoma and hepato adenocarcinoma cell lines Huh-7, PLC/PRF/5, and SK-Hep-1 do
      not contain adipogenic activity. Conditioned medium from HepG2 cells also
      stimulated differentiation of 3T3-L1 cells and of rat epididymal adipocyte
      precursors in primary culture. Partial biochemical characterization of the
      adipogenic activity carried out using HepG2 conditioned medium indicates that the
      hepatocyte derived adipogenic factor has an apparent molecular weight between 445
      and 232 kDa, is destroyed by treatment at 100 degrees C, with protease, with 2
      mercaptoethanol and in acidic conditions. The activity is stable at alkaline pH.
      Culture media conditioned by normal rat hepatocytes in primary culture also
      contained adipogenic activity. In contrast, medium conditioned by primary culture
      of nonhepatocyte cell also isolated from liver was deprived of this activity. The
      data presented in this paper suggest that hepatocytes could be a physiological
      site of production of adipogenic activity.

PMID- 1748726
TI  - Intraorbital transection of the rabbit optic nerve: consequences for ganglion
      cells and neuroglia in the retina.
AB  - Rabbit retinae were stained with antibodies to glial fibrillary acidic protein
      (GFAP) at various times up to 5 months after complete unilateral intraorbital
      optic nerve transection, which is known to induce degeneration of ganglion cell
      axons and perikarya in the retina. A transient immunoreactivity for GFAP was
      observed in Muller glial cells that normally lack this marker. Muller-cell GFAP
      immunoreactivity became detectable 4 days after the lesion, but Muller cells were
      no longer labeled 3 months later. GFAP-labeled astrocytes located in the nerve
      fiber layer showed no change in immunoreactivity at any stage after transection.
      Application of horseradish peroxidase to the left and right superior colliculus
      of a rabbit whose optic nerve had been transected unilaterally 2 years before
      confirmed the completeness of the transection. Yet electron microscopy showed the
      presence of some healthy-looking ganglion cell axons in the lesioned retina,
      although these cells were deprived of their target. Labeling retinal wholemounts
      with neurofilament antibodies confirmed the presence of some ganglion cell axons
      and perikarya in the retina more than 2 years after transection. The course of
      these axons suggested that they were remnants of axons. Using antibodies to
      galactocerebroside (GC) we found that, as in the normal rabbit, these persisting
      ganglion cell axons were myelinated in the medullary rays. Although many ganglion
      cell axons had disappeared after 2 years, the number of neuroglial cells
      (including astrocytes and oligodendrocytes) present in the medullary ray region
      was not altered. The cell bodies of some oligodendrocytes were covered with a
      myelin sheath, an aberrant feature not seen normally.

PMID- 1748727
TI  - Early development of the retinal line of decussation in normal and albino
      ferrets.
AB  - This work describes the retinal origin of the crossed and uncrossed projections
      in newborn, 9-day-old and adult normally pigmented and albino ferrets.
      Horseradish peroxidase (HRP) was injected unilaterally into the thalamic and
      midbrain visual centers of ferrets to label retinal ganglion cells retrogradely.
      In normally pigmented adults, the retinal line of decussation was sharp and
      passed through the area centralis. Ganglion cells with uncrossed axons occupied
      the entire temporal retina. In albino adults, ganglion cells with uncrossed axons
      were distributed in the periphery of the temporal retina away from the area
      centralis. In the normally pigmented adults, about 11% of the retinal ganglion
      cells had uncrossed axons compared to about 4% in the albinos. At birth, normally
      pigmented ferrets had a sharp line of decussation with most (about 98%) uncrossed
      ganglion cells found in the temporal retina. In the newborn albinos, most
      uncrossed ganglion cells were in the temporal retina (about 89%), but there were
      many fewer than in the normal neonates and, as in the albino adults, the
      uncrossed ganglion cells were distributed along the temporal most margin of the
      retina. In the normal neonates, about 11% of the ganglion cells had uncrossed
      axons, compared to about 3% in the albino neonates. The area centralis and visual
      streak were not evident until 9 days after birth. From these results we conclude
      that the retinal line of decussation is essentially mature by birth in the
      ferret, and the degree of the albino's abnormality is as extreme in neonates as
      in adults. The retinal decussation is virtually mature at a stage of development
      when the crossed and uncrossed retinal afferent axons are completely intermingled
      in their target nuclei and prior to the onset of significant retinal ganglion
      cell loss.

PMID- 1748728
TI  - Neuromuscular organization of the buccal system in Aplysia californica.
AB  - The intrinsic muscles and peripheral nerves in the buccal system of the sea hare
      Aplysia californica were studied to build a foundation on which to base future
      investigations of feeding in intact animals. A detailed description of the
      bilaterally paired intrinsic muscles is given identifying previously unreported
      muscles. Each of the six buccal nerves (n1-n6) and the cerebrobuccal connective
      (CBC) have been characterized in several respects. Cell bodies in the buccal
      ganglion with projections into each of the buccal nerves have been identified via
      the cobalt backfilling technique. All nerves contain axons of cell bodies in the
      ipsilateral as well as the contralateral ganglia. For each nerve, there is a
      consistent pattern in the distribution of cell bodies in the paired ganglia with
      the number of cell bodies in the contralateral ganglion being less than or equal
      to the number in the ipsilateral ganglion. Although the total number of
      backfilled cell bodies varies among the nerves, their size ranges are similar
      with the majority being small. Nerves 1, 2, 4, 5, and 6 provide motor innervation
      to the intrinsic buccal muscles in varying degrees with nerve 4 supplying all the
      intrinsic muscles; nerve 2 supplies only one. The axon composition of each nerve
      was scrutinized and revealed large numbers of axon profiles, the majority of
      which were less than 2 microns in diameter. The present study provides a
      framework for analysis of feeding behavior in Aplysia californica.

PMID- 1748729
TI  - Comparison of serotonin 5-HT1 receptors and innervation in the visual cortex of
      normal and dark-reared cats.
AB  - The visual cortical serotoninergic system was compared in normal and dark-reared
      cats to determine whether visual experience is necessary for its normal
      development. In vitro receptor binding of [3H]5-HT indicated an increase in 5-HT1
      receptor number in dark-reared cats with no change in affinity. This elevation
      was specific to the visual cortex and no changes were found in the frontal cortex
      as a result of dark rearing. Autoradiographic histology revealed that in the
      normal cat visual cortex, 5-HT1 receptors were present in all cortical layers and
      were slightly more dense in supragranular and infragranular layers. In dark
      reared cats, there was a marked elevation in receptor density in supragranular
      and infragranular layers and little change within layer IV. Immunohistochemical
      techniques (anti-5-HT) were used to compare serotoninergic innervation in the
      visual cortex of normal and dark-reared cats. In normal cat visual cortex,
      serotonin fibers were most dense in the superficial layers (I-III), least dense
      in layers IV and VI, and intermediate in layer V. No differences were found
      between normal and dark-reared cats in the laminar distribution or density of
      serotoninergic innervation. These results indicate that visual experience is
      necessary for the normal development of the visual cortical serotonin system. The
      findings that the effects of dark rearing were specific to the visual cortex and
      that within the visual cortex these effects were specific to supra- and
      infragranular layers are consistent with a possible role for serotonin in the
      prolonged physiological plasticity that occurs in the visual cortex of dark
      reared cats.

PMID- 1748730
TI  - Medial terminal nucleus terminals in the nucleus of the optic tract contain GABA:
      an electron microscopical study with immunocytochemical double labeling of GABA
      and PHA-L.
AB  - In this study the medial terminal nucleus (MTN) projection to the nucleus of the
      optic tract (NOT) was investigated in pigmented rats at the light and electron
      microscopical levels with a new combination of techniques. MTN terminals were
      anterogradely labeled with Phaseolus vulgaris-leucoagglutinin (PHA-L).
      Preembedding immunocytochemistry, followed by gold intensification, was used to
      visualize PHA-L. Postembedding immunocytochemistry with 15 nm immunogold
      particles was carried out to demonstrate the inhibitory neurotransmitter gamma
      aminobutyric acid (GABA). Both PHA-L and GABA labeling can be easily
      discriminated at the electron microscopical level even when present in the same
      neuronal profiles. Light microscopically MTN-NOT fibers proved to have several
      branches with many varicosities. MTN terminals were found concentrated in
      terminal fields. Electron microscopically, it was shown that MTN boutons display
      characteristics resembling F-type terminals, i.e., terminals with dark
      mitochondria, pleomorphic vesicles, and symmetrical synapses. All NOT afferents
      originating from the MTN contained GABA and made multiple contacts exclusively
      with GABA negative NOT somata and dendrites. These results indicate the existence
      of a strong and direct inhibitory input onto GABA negative projection neurons in
      the NOT. This substantiates earlier physiological and morphological reports. It
      was further demonstrated that the location and organization of MTN terminals in
      the neuropil differ from that of the retinal input: MTN terminals are largely
      separated from retinal terminals. MTN terminal fields contain large amounts of
      GABA positive F terminals in contrast to retinal terminal areas. MTN terminals
      take part in irregularly shaped agglomerations of terminals, which contain many F
      terminals and dendritic processes and are surrounded by a glial sheet. Retinal
      terminals are found grouped together in small circular arrangements contacting a
      central dendrite.

PMID- 1748731
TI  - Morphology and mosaics of VIP-like immunoreactive neurons in the retina of the
      rhesus monkey.
AB  - Vasoactive intestinal peptide (VIP) is a 28-amino acid peptide that has been
      demonstrated to reside in cells ( = VIP+ cells) of the retinae of various
      vertebrate species. In an attempt to study the morphology and distribution of
      VIP+ cells in the retina of the rhesus monkey in more detail, we subjected VIP+
      cells observed in cryostat sections or wholemounts rhesus monkey retinae to a
      quantitative analysis. VIP+ cells were found to reside in the innermost row of
      the inner nuclear layer (INL) and in the ganglion cell layer (GCL) in similar
      numbers (estimate: 50 cells/mm2 at 6-10 mm eccentricity each) and only on rare
      occasions (12% of all VIP+ cells) in varying positions within the inner plexiform
      layer (IPL). Somata of VIP+ cells were circular and had a mean diameter of 9.1
      microns. They gave rise to 1-3 main dendrites, which were usually oriented toward
      the IPL. Main dendrites ramified widely into thin fibers (dendritic field
      diameter less than = 1 mm), carrying varicose swellings. The fibers that
      contributed to one and the same plexus of VIP+ fibers preferred the middle third
      of the IPL, independent of the positions of the parent somata. A quantitative
      analysis of nearest-neighbour distances in the retinal wholemount preparation
      suggested that VIP+ cells in the GCL and in the INL might be distributed
      according to 2 independent mosaics. A comparison with Golgi-stained material
      leads to the tentative equation of VIP+ cells with the "spiny" A12 amacrine cell
      of Mariani ('90). Whereas the low density and large dendritic field size of VIP+
      cells might suggest a more widespread function, the varicose dendritic morphology
      seems to be more compatible with functionally independent dendritic subunits
      mediating localized effects.

PMID- 1748732
TI  - Functionally distinct subdivisions of the macroglomerular complex in the antennal
      lobe of the male sphinx moth Manduca sexta.
AB  - Each antennal lobe in the brain of a male moth has a distinctive neuropil
      structure, the macroglomerular complex (MGC), which is specialized for primary
      processing of information about the conspecific female sex-pheromone blend.
      Olfactory interneurons with dendritic arborizations in the MGC were examined by
      means of tandem intracellular recording and staining with Lucifer Yellow. Neurons
      that responded selectively to stimulation of the antenna with the major pheromone
      component, (E,Z)-10,12-hexadecadienal, had arborizations that were restricted to
      a toroidal subdivision (the "toroid") of the MGC. Similarly, neurons that
      responded selectively to antennal stimulation with (E,Z)-11,13-pentadecadienal, a
      more stable mimic of a second essential but chemically unstable pheromone
      component, (E,E,Z)-10,12,14-hexadecatrienal, had arborizations confined to a
      globular subdivision (the "cumulus") of the MGC situated more proximally to the
      antennal nerve input. One neuron that responded to both of these stimuli clearly
      had arborizations in both subdivisions of the MGC. These anatomically distinct
      subdivisions of the MGC thus appear also to be functionally separate regions of
      pheromone-processing neuropil.

PMID- 1748733
TI  - Somatotopy of spinal nociceptive processing.
AB  - Relatively little is known about the spatial organization of spinal nociceptive
      processing. This study has employed the expression of c-fos-like protein as a
      marker for neuronal activity and has analyzed the patterns of immunoreactivity
      seen within the rodent spinal cord following noxious mechanical stimulation of
      various portions of one hindlimb. The results indicate that noxious mechanical
      stimulation induces distinct, somatotopic patterns of immunolabeling in laminae I
      IV. Individual digits of a foot are represented medially in the dorsal horn over
      a short rostrocaudal distance, with the most lateral digit represented
      approximately one segment caudal to the most medial digit. Representation of the
      hip region is more lateral, is centered at L2, and extends rostrocaudally over
      many segments. The patterns of neuronal excitation seen in laminae V-IX following
      noxious peripheral stimulation were similar to those noted in laminae I-IV but
      were less tightly organized. C-fos-like immunoreactivity was noted both medially
      and laterally in the deeper laminae following stimulation of any portion of the
      hindlimb, but stimulation of different areas produced different columns of
      labeled cells extending from the superficial dorsal horn into lamina VII. In the
      rostrocaudal direction, immunolabeling in lamina V-IX was maximal at the same
      segmental level as in laminae I-IV, but the more ventral laminae exhibited
      increases in c-fos-like immunoreactivity over longer rostrocaudal distances.
      Experiments in spinally transected animals indicated that long, descending
      pathways contributed little or nothing to the pattern of immunolabeling. The
      results of this study imply that spinal nociceptive processing is spatially
      organized not only in laminae I-IV, but also in more ventral regions of the
      spinal cord.

PMID- 1748734
TI  - Localization and characterization of angiotensin II receptor binding sites in the
      human basal ganglia, thalamus, midbrain pons, and cerebellum.
AB  - Angiotensin II (Ang II) binding sites were localized in the thalamus, basal
      ganglia, midbrain, and pons of the human central nervous system by in vitro
      autoradiography, employing 125I-[Sar1, Ile8]angiotensin II as the radioligand.
      High-density binding occurs in the substantia nigra pars compacta, the
      interpeduncular nucleus and two of the raphe nuclei, the raphe magnus, and median
      raphe nucleus. Moderate densities occur in the caudate nucleus, putamen, bed
      nucleus of the stria terminalis, rostral linear nucleus, caudal linear nucleus,
      dorsal and paramedian raphe nuclei, locus coeruleus, and region of the
      subcoeruleus, oral dorsal paramedian nucleus, and A5/periolivary region. Low
      levels occur in the region between the subthalamic nucleus and the zona incerta,
      the mediodorsal thalamic nucleus, the central gray, the lateral and medial
      parabrachial nuclei, and the molecular layer of the cerebellum. The high density
      of Ang II receptor binding in the substantia nigra occurs over pigmented,
      presumably dopaminergic, neurons. The binding in this site, and in the striatum,
      is not observed in any of the other species we have studied. It displays similar
      pharmacological characteristics to the Ang II receptor binding site in other
      regions of the human brain. Overall we demonstrate a discrete pattern of Ang II
      receptor binding sites in the human brain, which shows a high correlation with
      the distribution observed in other mammalian species.

PMID- 1748735
TI  - Topography and ultrastructure of sensory nerve endings in the glans penis of the
      rat.
AB  - The aim of the present study was to describe the types and location of sensory
      nerve endings in the glans penis of the rat on the basis of light and electron
      microscopy. Free nerve endings are abundant throughout the glans and are derived
      from either thinly myelinated A delta or unmyelinated C fibers. The free nerve
      endings derived from A delta fibers often extend into the epidermis as far as the
      granular layer and exhibit buttonlike terminal thickenings. The distal urethra
      contains many free nerve endings from C fibers. Numerous lamellated corpuscles
      are present. Each corpuscle, innervated by one or two medium diameter myelinated
      nerve fibers, consists of 4-10 spiralling and intertwined inner cores enveloped
      by Schwann cell lamellae. The corpuscles are usually enclosed by a perineural
      capsule, although some located near the epidermis lack a capsule. Lamellated
      corpuscles in the superficial dermis are located adjacent to but not directly
      under a penile spine and change their orientation when the glans is erect. The
      dermal papillae of the penile spines are devoid of any neural structure.
      Lamellated corpuscles are also located within the trabeculae of the corpus
      spongiosum glands and in the lamina propria of the urethra. Occasionally,
      unmyelinated nerve bundles are seen inside these corpuscles. Ruffini corpuscles
      are few in number and are located in the deep connective tissue near the os
      penis. They have an incomplete connective tissue capsule and the nerve terminals
      are anchored between collagen fiber bundles. No Merkel nerve endings, Meissner,
      or Vater-Pacini corpuscles were found in any of the sections. We conclude that
      the glans penis of the rat contains a sensory receptor complement that is
      generally similar to the human glans penis but is unlike the glabrous and hairy
      skin.

PMID- 1748736
TI  - Auditory, electrosensory, and mechanosensory lateral line pathways through the
      forebrain in channel catfishes.
AB  - The forebrain auditory, electrosensory, and mechanosensory lateral line pathways
      in the channel catfish, Ictalurus punctatus, were examined by applying the
      fluorescent tracer DiI to 1) the auditory part of the torus semicircularis, 2)
      the electrosensory part of the torus semicircularis, 3) the lateral preglomerular
      nucleus, and 4) the anterior tuberal nucleus. Three distinct pathways ascend from
      the torus semicircularis to the telencephalon; they course through either 1) the
      lateral preglomerular nucleus of the posterior tuberculum, 2) the anterior
      tuberal nucleus of the hypothalamus, or 3) the central posterior nucleus of the
      dorsal thalamus. The anatomical data suggest that each of these ascending
      pathways carries information from more than one sensory modality. The lateral
      preglomerular nucleus receives an electrosensory input from nucleus
      electrosensorius in the diencephalon, but it also receives auditory and
      mechanosensory inputs directly from the torus semicircularis. The anterior
      tuberal and central posterior nuclei receive primarily auditory and
      mechanosensory, but also minor electrosensory, inputs. The efferent projections
      of the central posterior nucleus are presently unknown, but the lateral
      preglomerular and anterior tuberal nuclei project to nonoverlapping portions of
      the telencephalon. A cladistic analysis of these indirect torotelencephalic
      pathways reveals that 1) the pathway through the dorsal thalamus is probably a
      primitive character for gnathostomes, 2) a well-developed pathway through the
      posterior tuberculum is probably a derived character for actinopterygian fishes,
      3) the pathway through nucleus electrosensorius is probably a derived character
      for catfishes and gymnotoid teleosts, and 4) auditory pathways through the
      hypothalamus probably evolved independently in catfishes and frogs.

PMID- 1748737
TI  - Identity of cells produced by two stages of cytogenesis in the postnatal cat
      retina.
AB  - Cytogenesis in the postnatal cat retina was studied with the aid of 3H-thymidine
      autoradiography to identify the cell classes generated. Cells proliferate in two
      stages, which are separate spatially and temporally. Previous studies have shown
      that during Stage 1, cytogenesis occurs at high density at the ventricular
      surface of the retina, whereas Stage 2 occurs at low density in the inner retinal
      layers. At the ages studied, the progeny of Stage 1 cytogenesis are distributed
      in an annulus toward the margin of the retina, and those of Stage 2 occur central
      to the annulus, indicating that Stage 2 follows Stage 1. Cell genesis in Stage 1
      appears to cease by P16; genesis in Stage 2 persists until between P21 and P30.
      The same cell classes (amacrine cells, bipolar cells, Muller cells, and rod
      photoreceptors) are generated during both Stages 1 and 2, but there are
      significant changes in their proportions both within and between stages. The
      proportion of the Stage 1 mitoses that form bipolar cells increases from 31% at
      P0 to 62% at P14. A corresponding decrease is observed in the proportion of rods
      (from 60% at P0 to 32% at P14). The proportion of cells generated during Stage 2
      that become rods increases from 39% at P0 to 70% at P21, whereas the proportion
      of bipolar cells decreases from 50% at P0 to 23% at P21. Muller cells form a
      relatively constant proportion (8 to 15%) of the cells generated during both
      Stage 1 and 2. Thus at the end of Stage 1, mostly bipolar cells are generated; at
      the end of Stage 2, mostly rods are generated.

PMID- 1748738
TI  - Somatotopic component of the multisensory map in the deep laminae of the cat
      superior colliculus.
AB  - The topographic organization of the somatosensory representation in the deep
      layers of the cat superior colliculus was reexamined using methods previously
      used to examine the visuotopy in these layers. This technique identified the
      distribution of neurons in the superior colliculus that represent a designated
      region of the body surface (i.e., a dermal image), as well as assessed the
      differential distribution of deep layer neurons representing different body
      regions (e.g., face, forelimb, hindlimb, etc.). When the area of densest
      representation within a dermal image was considered, a well-ordered somatotopy
      was evident that was similar to the one previously described (Stein et al., '76:
      J. Neurophysiol. 39:401-419). Each region of the body surface, however, was
      represented within a surprisingly broad area of the deep layers, which often had
      considerable overlap with the representations of adjacent body regions. This
      organization was similar to that of the deep layer visuotopy and emphasizes that
      the representation of a peripheral stimulus is accomplished by the simultaneous
      activation of a large population of deep layer neurons. Furthermore, an
      examination of the convergence patterns on somatosensory-responsive neurons
      demonstrated that the somatotopy was formed primarily by multisensory neurons.
      These data indicate that the somatosensory representation is best considered as a
      component of a comprehensive multisensory functional unit that plays a critical
      role in effecting behavioral responses to a wide variety of stimuli.

PMID- 1748739
TI  - Patterns of connectivity in the cat sensory-motor cortex: a light and electron
      microscope analysis of the projection arising from area 3a.
AB  - Through its complex network of interconnections, each of the functionally
      specialized subdivisions in the cat primary somatosensory cortex may provide the
      motor cortex with different input and thus play a unique role in motor behavior.
      Areas 2 and 3a receive separate peripheral information. Cells in both regions
      project directly to the cat motor cortex but are thought to target different
      populations of neurons. In this study the morphology and distribution patterns of
      the area 3a projection to the motor cortex were compared to previous findings on
      the projection from area 2. Also, details of the projection from area 3a to area
      2 were studied. Injections of Phaseolus vulgaris leucoagglutinin were made into
      area 3a and fixed brain tissue was processed for immunohistochemical staining of
      this anterograde tracer. Tissue was examined with the light microscope to
      determine the patterns of the 3a projections to area 2 and motor cortex, area 4.
      Axons arising from cells in area 3a terminated in multiple column-like clusters
      in both motor cortex and area 2. The small number of cells labeled at the
      injection sites suggested that multiple foci of the 3a fibers are formed by
      collateral axonal branches of the same neurons. The topography of the projection
      from area 3a to the motor cortex was more clearly defined than that from area 3a
      to area 2. Electron microscope analysis determined the laminar distribution and
      types of synapses formed between area 3a efferents and their target neurons. A
      high proportion of synapses was found in layer III in both target regions.
      However, unlike in area 4, labeled terminals were sparse in laminae I and II of
      area 2. Axospinous synapses were slightly more numerous than axodendritic
      synapses, but both were distributed similarly throughout the thickness of the
      cortex. In area 2 the axospinous synapses accounted for 63% of synapses and in
      area 4 for 57% of synapses. No axosomatic synapses were detected.

PMID- 1748740
TI  - The visually related posterior pretectal nucleus in the non-percomorph teleost
      Osteoglossum bicirrhosum projects to the hypothalamus: a DiI study.
AB  - This study was done to elucidate the ancestral (plesiomorphic) condition for
      visual pathways to the hypothalamus in teleost fishes. Three patterns of
      pretectal organization can be discerned morphologically and histochemically in
      teleosts. Their taxonomic distribution suggests that the intermediately complex
      pattern (seen in most teleost groups) is ancestral to both the elaborate pattern
      (seen in percomorphs) and the simple pattern (seen in cyprinids). The pretectal
      nuclei involved can be demonstrated with acetylcholinesterase histochemistry
      selectively and reliably in different species of teleosts, suggesting that the
      same-named nuclei are homologous in representatives of the three different
      patterns. Whereas there are visual pathways to the hypothalamus in both the
      elaborate (percomorph) and the simple (cyprinid) patterns, different pretectal
      and hypothalamic nuclei are involved. Thus visual hypothalamic pathways in these
      two patterns would not appear to be homologous. In this study, circuitry within
      the third, i.e., the intermediately complex, pattern is investigated. It is
      demonstrated that visual pathways project via the pretectum to the hypothalamus
      in Osteoglossum bicirrhosum and that they are very similar to the visual pathways
      in the elaborate pattern. This suggests that the circuitry in the intermediately
      complex pattern, as represented by Osteoglossum, is plesiomorphic (evolutionarily
      primitive) and the circuitry in both the simple pattern (seen in cyprinids) and
      the elaborate pattern (seen in percomorphs) is apomorphic (evolutionarily
      derived) for teleosts.

PMID- 1748741
TI  - PNS-CNS transitional zone of the first cranial nerve.
AB  - This study examined the ultrastructure of the region of transition where
      fascicles of olfactory axons leave the peripheral nervous system (PNS) to enter
      the central nervous system (CNS), the so-called PNS-CNS transitional zone. Adult
      rats were transcardially perfused with a solution of 1% glutaraldehyde and 1%
      paraformaldehyde, decapitated, and the heads decalcified over a period of several
      weeks in a solution of 1% glutaraldehyde in 0.1 M tetrasodium ethylenediamine
      tetraacetic acid; the latter solution was changed daily. It was found that
      astrocytes did not form the glia limitans at the nerve entry zone, unlike the
      situation that exists in other cranial and spinal nerves. Rather, the glia
      limitans in this region of the olfactory bulb was formed by a special type of
      glial cell, referred to as an ensheathing cell. Ensheathing cells are found only
      in the nerve fiber layer of the olfactory bulb. They possess a mixture of Schwann
      cell and astrocytic features and are more likely to be of placodal than of CNS
      origin. The meningeal coverings of the olfactory nerve rootlets and of the
      olfactory bulb are also described and the functional implications of the findings
      discussed.

PMID- 1748742
TI  - Funicular organization of avian brainstem-spinal projections.
AB  - The purpose of this study was to determine which reticulospinal projections need
      to be preserved to allow voluntary walking and to differentiate between those
      pathways descending within the ventrolateral funiculus versus the ventromedial
      funiculus. Retrogradely transported tracers (True Blue, Fast Blue, Diamidino
      Yellow dihydrochloride, fluorescein-conjugated dextran-amines) were used alone as
      discrete funicular injections (4-5 microliters) into the lumbar cord (L1), or in
      conjunction with a more rostral subtotal lesion of the low thoracic cord, to
      determine the trajectories of brainstem-spinal projections in adult ducks and
      geese. No difference was found between the species. The major components of the
      ventromedial funiculus include projections from the medullary reticular
      formation, pontine reticular formation, raphe obscurus and pallidus, lateral
      vestibular nucleus, and interstitial nucleus, and to a minor extent from the
      locus coeruleus, lateral hypothalamus, and nucleus periventricularis hypothalami.
      The components of the ventrolateral funiculus (VLF) include projections from the
      nucleus of the solitary tract, nucleus alatus, pontomedullary reticular
      formation, raphe pallidus, raphe magnus, locus coeruleus, subcoeruleus, lateral
      vestibular, and descending vestibular nuclei. The principal descending
      projections within the dorsolateral funiculus (DLF) arose from the red nucleus,
      the paraventricular nucleus, locus coeruleus, subcoeruleus, dorsal division of
      the caudal medullary reticular formation, and raphe magnus. The functional
      implications of the distribution of these descending pathways are discussed with
      regard to locomotion. Since birds were able to walk despite bilateral lesion of
      the DLF or VMF but were unable to walk following a bilateral lesion of the VLF,
      this suggests that medullary reticulospinal pathways coursing within the VLF are
      essential for the provision of locomotor drive.

PMID- 1748743
TI  - A biomechanical evaluation of a cannulated compressive screw for use in fractures
      of the scaphoid.
AB  - The compressive force generated by a 3.5 mm ASIF cannulated cancellous screw with
      a 5 mm head was compared with that generated by a standard 3.5 mm ASIF screw (6
      mm head), a 2.7 mm ASIF screw (5 mm head), and a Herbert screw. The screws were
      evaluated in the laboratory with the use of a custom-designed load washer
      (transducer) to the maximum compressive force generated by each screw until
      failure, either by thread stripping or by head migration into the specimen.
      Testing was done on paired cadaver scaphoids. To minimize the variability that
      occurs with human bone, and because of the cost and difficulty of obtaining human
      tissue specimens, a study was also done on polyurethane foam simulated bones. The
      3.5 cannulated screw generated greater compressive forces than the Herbert screw
      but less compression than the 2.7 mm and 3.5 mm ASIF cortical screws. The 3.5 mm
      cannulated screw offers more rigid internal fixation for scaphoid fractures than
      the Herbert screw and gives the added advantage of placement over a guide wire.

PMID- 1748744
TI  - Augmented external fixation of unstable distal radius fractures.
AB  - The technique of "augmentation" of external fixation employs the use of
      percutaneous Kirschner wires to secure the radial styloid fragment as a lateral
      buttress, elevate and fix in place the depressed lunate fossa fragment, and, when
      necessary, add support to the elevated articular surface by means of subarticular
      bone grafting. A series of 51 cases of comminuted, unstable intraarticular distal
      radius fractures has been managed using this technique. Detailed evaluation has
      demonstrated precise articular reconstitution with an overall satisfactory result
      rate of 92%.

PMID- 1748745
TI  - Malunited Colles' fractures: correction with a biplanar closing wedge osteotomy.
AB  - A malunited Colles' fracture causes distortion of three anatomic features of the
      distal radius: length of the bone and the angles of its articular surface in both
      frontal and sagittal planes. The relative importance of each of these factors was
      studied in a series of 14 patients with malunited Colles' fractures and severe
      disabilities. Reversal of the normal palmar tilt of the distal radius in the
      sagittal plane was the most consistent and serious deformity of the bone, and in
      five patients it was associated with dorsal subluxation of the entire carpus.
      Correction of the malunion was achieved with a biplanar closing wedge osteotomy
      without a bone graft. Resection of the ulna head and decompression of the median
      nerve within the carpal tunnel were done to reduce the likelihood that additional
      surgery would be required in the future.

PMID- 1748746
TI  - Classification system for factitious syndromes in the hand with implications for
      treatment.
AB  - We evaluated 29 patients with factitious disorders in the hand who received
      Worker's Compensation benefits. Three types of factitious hand disorders based on
      physical presentation were self-mutilation and wound manipulation, edema, and
      finger and hand deformities. Two distinct psychological diagnoses present were
      factitious disorder with physical symptoms and conversion disorder. The Minnesota
      Multiphasic Personality Inventory revealed two personality profiles: emotionally
      dependent and angry and hostile. Behavioral treatment was implemented. The
      emotionally dependent group responded well, with 80% returning to work. The angry
      and hostile group had a much poorer response, with 21% returning to work. None of
      the self-multilating patients returned to work. We recommend a combined
      evaluation by a physician, a psychologist, and a hand therapist to achieve a
      definitive diagnosis for these disorders. The identification of psychological
      profiles assists in ascertaining which patients will be responsive to behavioral
      treatment.

PMID- 1748747
TI  - Glove perforation in hand surgery.
AB  - A survey of glove perforation in 100 consecutive hand surgery operations was
      undertaken. A total of 397 pairs of gloves were tested for punctures after the
      operation. Evidence of perforation was found in 19% of the gloves used, and only
      in 12 cases did the surgeons actually realize that a perforation had occurred.
      With a perforation rate of 43%, the surgeons were significantly more at risk of
      glove perforation than the other members of the operating team.

PMID- 1748748
TI  - The measurement of cold sensitivity of the hand.
AB  - There is no widely accepted method of measuring the severity of cold sensitivity
      of the hand. A patient-answered questionnaire was developed. This consisted of
      seven items divided into two subscales: the first to measure the severity of cold
      sensitivity, and the second to grade exposure of the hands to cold at the
      workplace. The test-retest reliability was 0.92 for the severity subscale and
      0.94 for the work exposure scale. An initial test of validity supports the use of
      the scale to measure cold sensitivity of the hand.

PMID- 1748749
TI  - Effects of cold exposure on the circulation of replanted fingers during the early
      postoperative period.
AB  - The replanted finger after a complete amputation is an excellent model for the
      study of many aspects of vascular physiology. In the present clinical study, 10
      patients were investigated to evaluate the incidence of cold-induced vasospasm in
      replanted digits during the early postoperative period. The results indicate that
      cold-induced vasospasm is not a risk factor in the early postoperative phase
      after digital-replantation surgery. It is concluded that cold-induced spasm of
      the digital arteries is primarily a central, nerve-mediated reflex.

PMID- 1748750
TI  - Pseudotumor of the palm due to an anomalous flexor digitorum superficialis muscle
      belly.
AB  - A pseudotumor of the palm was due to an anomalous flexor digitorum superficialis
      muscle belly. Magnetic resonance imaging is an excellent diagnostic tool to
      define the three dimensional extension of such an anomaly. Surgical resection of
      the anomalous muscle belly resulted in a complete relief of all symptoms.

PMID- 1748751
TI  - Locked thumb metacarpophalangeal joint caused by sesamoid entrapment.
AB  - We report an unusual case of locked thumb in a 24-year-old man, caused by
      entrapment of the radial sesamoid in the metacarpophalangeal joint. Tomography
      clearly revealed sesamoid entrapment in the joint. Surgical exploration and
      cadaver dissection demonstrated that avulsion of the proximal portion of the
      palmar plate and some dissociation of the sesamoid from the palmar plate with
      intraarticular displacement were necessary for the sesamoid to be trapped in the
      joint.

PMID- 1748752
TI  - Comparison of four objective methods of monitoring digital venous congestion.
AB  - This study sought to determine which of the four most commonly used objective
      monitoring modalities--pulse oximetry, laser Doppler flowmetry, skin surface
      temperature measurement, and skin surface fluorescence--is best able to detect
      early digital venous congestion. Digital venous congestion was induced in 12
      hands by inflating a digital cuff to 5 mm Hg above the resting diastolic
      pressure. The cuff remained inflated for 1 hour while monitoring was done at 10
      minute intervals. The baseline and experimental laser Doppler indices differed by
      at least 30% in each subject, and the laser Doppler index was always less than
      40% during venous congestion. Skin surface fluorescence gave falsely normal
      results in three of eight hands, while pulse oximetry failed to detect venous
      congestion in any hand. The difference in temperature between the control and
      experimental fingers almost always exceeded the threshold of 2.5 degrees C. The
      results indicate that both laser Doppler flowmetry and skin surface temperature
      measurement are highly accurate methods of monitoring early digital venous
      congestion that are noninvasive and easy to use. Skin surface temperature
      measurement has further advantages in that thermometers are less expensive and
      easier to transport than laser Doppler devices. In contrast, skin surface
      fluorescence is invasive and cumbersome in addition to being less sensitive to
      experimentally induced early digital venous congestion than either laser Doppler
      flowmetry or skin surface temperature measurement. Pulse oximetry is unreliable
      in detecting early digital venous congestion.

PMID- 1748753
TI  - Venous anatomy of the thumb.
AB  - The venous anatomy of 20 thumbs (10 pairs) was detailed by latex injection. The
      thumbs were studied on the dorsal, palmar, radial, and ulnar surfaces.
      Characteristic patterns were found; these included a dominant longitudinal
      network, palmar veins within the pulp, oblique veins at the interphalangeal joint
      on the radial side, and a web space vein. A layered vascular pattern with a
      superficial fine network overlying a deeper system was noted. Cross sections were
      taken at the metacarpophalangeal joint and at the proximal and distal phalanges.
      The distribution of the vessels in cross section reveals consistent dorsal veins
      at all levels, as well as palmar veins distal to the interphalangeal joint in all
      thumbs. Palmar veins were present over the length of the proximal phalanx in more
      than 65% of the thumbs.

PMID- 1748754
TI  - Acute and chronic ischemia of the hand: pathophysiology, treatment, and
      prognosis.
AB  - Fifty consecutive patients with acute and chronic ischemia of the hand were
      investigated by Allen testing, Doppler ultrasound, digital plethysmography, and
      angiography over a 4-year period. The pathophysiologic mechanism responsible for
      the ischemia was determined to be emboli in 6%, vasospasm in 10%, thrombosis or
      "sludging" in 28%, occlusive disease in 26%, and occlusive disease associated
      with either vasospasm or external compression in 30%. Ten patients required
      emergency medical treatment with intraarterial streptokinase, intravenous
      heparin, or dextran 40 and continuous stellate ganglion blocks, and three
      patients required emergency microsurgical revascularization because of radial
      artery thrombosis. Patients with chronic ischemia of the hand were maintained on
      nifedipine, 30 to 60 mg daily, and pentoxifylline, 1200 mg daily. Seven patients
      underwent digital sympathectomy and 14 patients underwent microsurgical
      revascularization as prophylactic procedures for chronic digital ischemia.
      Amputations were required in 18 patients because of end-stage gangrene. Long-term
      follow-up revealed a 20% incidence of recurrent digital ulcerations. There have
      been six deaths during follow-up, five of them due to myocardial infarction; this
      reflects the underlying systemic arteriopathy in many of these patients.

PMID- 1748755
TI  - Histologic anatomy of the triangular fibrocartilage.
AB  - The collagen arrangement of the triangular fibrocartilage complex was studied in
      20 fresh cadaver wrists by means of standard and polarized light microscopy and
      scanning electron microscopy. The collagen fibres in the articular disk are
      arranged in undulating sheets oriented at oblique angles to each other. The
      fibers of the radioulnar ligaments are oriented longitudinally from the radial
      origin to the ulnar insertion. The origin of the articular disk from the radius
      is characterized by thick fibers 1 to 2 mm in length radiating from the radius
      into the articular disk. Five specimens were also injected with india ink. The
      radioulnar ligaments and the peripheral 15% to 20% of the articular disk are well
      vascularized, whereas the central 80% of the articular disk is avascular.

PMID- 1748756
TI  - The microvasculature of the triangular fibrocartilage complex: its clinical
      significance.
AB  - The microvascular anatomy of the triangular fibrocartilage complex was
      investigated in 10 cadaver specimens by histology and tissue clearing
      (Spalteholz) techniques. It was found that the triangular fibrocartilage of the
      wrist is supplied by small vessels that penetrate the triangular fibrocartilage
      complex in a radial fashion from the palmar, ulnar, and dorsal attachments of the
      joint capsule and supply the peripheral 10% to 40%. The inner (horizontal)
      portion is avascular, and no vessels cross the radial attachment of the
      triangular fibrocartilage complex. The results of this study suggest that tears
      in the periphery of the triangular fibrocartilage complex may have sufficient
      blood supply to mount a reparative response and, in theory, can be repaired.
      However, tears that occur in the center and along the radial attachment do not
      have immediate access to a blood supply and are not likely to heal.

PMID- 1748757
TI  - The distal radioulnar ligaments: a biomechanical study.
AB  - The mechanical roles of the triangular fibrocartilage have been examined in three
      experiments. Kinematic analysis by a stereophotogrammetric method revealed that
      the palmar radioulnar ligament was taut in supination and that the dorsal
      radioulnar ligament was taut in pronation. In full pronation, the palmar
      radioulnar ligament decreased to an average of 71% of its length in tension. In
      full supination, the dorsal radioulnar ligament decreased to an average of 90% of
      its length. Mechanical testing of the triangular fibrocartilage under axial load
      disclosed a significant laxity (mean: 10.4 mm), which was decreased in pronation.
      Transverse loading tests demonstrated that the triangular fibrocartilage is less
      stiff in neutral forearm rotation. Study of the material properties of the palmar
      and dorsal parts of the triangular fibrocartilage showed these structures to be
      strong ligaments with material properties similar to those of the radiocarpal
      ligaments.

PMID- 1748758
TI  - Distal ulnar head shortening for treatment of triangular fibrocartilage complex
      tears with ulna positive variance.
AB  - Patients with a tear of the horizontal part of the triangular fibrocartilage
      complex and ulna plus variance were treated by excision of the distal part of the
      ulnar head. Three of the seven consecutive patients also had lunotriquetral
      ligament injuries and had fusions of that joint. Six of the seven patients had
      either complete relief or marked improvement of symptoms at the distal radioulnar
      joint. When ulnar shortening is indicated, ulnar head shortening should be
      considered.

PMID- 1748759
TI  - Hemiresection-interposition arthroplasty of the distal radioulnar joint
      associated with repair of triangular fibrocartilage complex lesions.
AB  - Sixteen wrists of 15 patients with traumatic triangular fibrocartilage complex
      tears were treated by hemiresection-interposition arthroplasty of the distal
      radioulnar joint combined with repair of the torn triangular fibrocartilage
      complex. The surgical procedure was performed to avoid impingement of the ulnar
      head against the reconstructed triangular fibrocartilage complex. Most of the
      wrists showed a positive ulnar variance. The average age of the patients was 39
      years. Follow-up averaged 41 months. Complete relief of pain was obtained in 10
      wrists. Slight pain persisted in 6 wrists, although it was less than before
      surgery. The range of motion of the wrist joint and forearm improved
      postoperatively. Grip strength in all wrists increased. Postoperative
      complications occurred in 7 wrists of 6 patients: reoperation in 2 wrists,
      fracture in 1, and tendinitis of the extensor carpi ulnaris in 4. All 15 patients
      subsequently returned to their previous occupations.

PMID- 1748760
TI  - The Sauve-Kapandji procedure: a salvage operation for the distal radioulnar
      joint.
AB  - The Sauve-Kapandji procedure, a distal radioulnar arthrodesis with surgical
      creation of a pseudoarthrosis in the distal ulna, was used to treat 11 patients.
      Although all patients had had at least one previous operation on the involved
      wrist, they were still having pain and functional limitations. Ten patients were
      available for follow-up, which averaged 33 months. Of the nine patients with
      posttraumatic arthritis, six had excellent results (a painless wrist that
      averaged 82 degrees of pronation and 83 degrees of supination). Three patients
      had good results (mild pain during activities with an identical range of forearm
      rotation). One patient who had rheumatoid arthritis had an excellent result for 3
      years but recently had a radiocarpal wrist fusion because of radiocarpal
      arthritis. We have found the Sauve-Kapandji procedure to be a reliable treatment
      option for intractable disorders of the distal radioulnar joint and recommend it
      as a salvage procedure when previous treatment has failed.

PMID- 1748761
TI  - Extensor mechanism of the fingers. I. A quantitative geometric study.
AB  - A close-range stereophotogrammetric measurement system was used to determine the
      three-dimensional geometric characteristics of the extensor assembly in seven
      human finger specimens and five finger configurations. The numerical data
      obtained showed that, although changes in length of the different bundles are
      small, their spatial orientation varies considerably from one to another
      position. This information should help to improve the accuracy of models derived
      to understand the extensor assembly behavior in normal and pathological
      conditions.

PMID- 1748762
TI  - Extensor mechanism of the fingers. II. Tensile properties of components.
AB  - Seven fresh human finger specimens have been studied to determine the differences
      in structural stiffness between different components of the extensor assembly.
      Differences were found to be significant, ranging from an average of 275 N/mm for
      the proximal and distal segments of the central band to an average of 40 N/mm for
      the central-to-lateral intercrossing fascicles. The terminal tendon of the
      lateral band was shown to be as stiff as the middle segment of the central band.

PMID- 1748763
TI  - The extensor medii proprius and anomalous extensor tendons to the long finger.
AB  - The extensor medii proprius is a muscle analogous to the extensor indicis
      proprius in that it has a similar origin, but inserts into the long finger. The
      extensor indicis et medii communis muscle is an extensor indicis proprius muscle
      that splits to insert into both the index and long fingers. The extensor tendons
      to the fingers were dissected in 58 adult hands to determine the incidence and
      anatomy of the extensor medii proprius and extensor indicis et medii communis.
      The incidence of the extensor medii proprius was 10.3% and the incidence of the
      extensor indicis et medii communis was 3.4% in this series. The extensor medii
      proprius and extensor indicis proprius muscles had a common origin in all cases.
      The insertion of the extensor medii proprius into the dorsal aponeurosis was
      palmar and ulnar to the extensor digitorum communis of the long finger, but in
      one case, the extensor medii proprius inserted into the deep fibrous tissue
      proximal to the metacarpophalangeal joint. The tendon slip of the extensor
      indicis et medii communis inserting into the long finger did not insert into the
      dorsal aponeurosis, but into the deep fibrous tissue near the metacarpophalangeal
      joint. Both the extensor medii proprius and the extensor indicis et medii
      communis may represent evolutionary remnants. Awareness of their potential
      presence and anatomy should be helpful in extensor identification, repair, and
      transfer.

PMID- 1748764
TI  - Results of acute zone III extensor tendon injuries treated with dynamic extension
      splinting.
AB  - Motivated by the favorable results of dynamic splinting in the treatment of more
      proximal extensor tendon injuries, we explored the use of dynamic splinting in
      the treatment of zone III extensor tendon lacerations. Twenty-two tendon repairs
      in 19 patients were available for review. On the basis of degree of extension lag
      and pulp-to-palm distance, 14 repairs were rated as excellent, 6 as good, and 2
      as fair. Using total active motion at 10 weeks, the proximal interphalangeal and
      distal interphalangeal joints averaged 170 degrees. There was one mild
      boutonniere deformity. The results of this prospective study show that carefully
      monitored dynamic splinting is safe in the treatment of zone III lacerations.
      When results were compared with the results of our method of static splinting
      used prior to this prospective study, patients returned to full activities with
      good-to-excellent results 8 weeks earlier instead of at 16 to 18 weeks.

PMID- 1748765
TI  - "Temporary ectopic implantation".

PMID- 1748766
TI  - Successful reeducation of functional sensibility after median nerve repair at the
      wrist.

PMID- 1748767
TI  - Osteoarthritis of the trapeziometacarpal joint: the pathophysiology of articular
      cartilage degeneration. I. Anatomy and pathology of the aging joint.
AB  - An anatomic study of the trapeziometacarpal joint was conducted on 47 cadaver
      thumb specimens. The superficial capsule restrained only metacarpal rotation
      about its long axis. Intracapsular anatomy was notable for a large anterior
      subthenar recess limited dorsally by the abductor pollicis longus insertion and
      palmarly by the deep palmar or "beak" ligament. This beak ligament was essential
      for translational stability of the metacarpal on the trapezium with flexion of
      the thumb ray. There was a direct correlation between the status of the articular
      surfaces and the integrity of the beak ligament. Normal surfaces were associated
      with an intact ligament confluent with the hyaline cartilage of the palmar lip of
      the metacarpal; degeneration of the palmar lip cartilage was always associated
      with attritional detachment of the beak ligament. Advanced articular disease
      occurred only in the palmar contact areas and was predicted by degeneration of
      the adjacent beak ligament; only nonprogressive chondromalacia was found on the
      dorsal portions of the articular surfaces.

PMID- 1748768
TI  - Osteoarthritis of the trapeziometacarpal joint: the pathophysiology of articular
      cartilage degeneration. II. Articular wear patterns in the osteoarthritic joint.
AB  - An anatomic and radiographic study of the osteoarthritic trapeziometacarpal joint
      was conducted on 27 surgical specimens harvested during basal joint arthroplasty.
      Surface wear patterns were analyzed by hyaline cartilage staining, and relative
      involvement of trapezium and metacarpal was calculated as the
      trapezium/metacarpal eburnation ratio. Eburnation occurred only on facing
      trapeziometacarpal surfaces in contact areas of the palmar compartment.
      Metacarpal degeneration began at the palmar joint margin adjacent to the beak
      ligament and extended dorsally, while trapezial degeneration originated on the
      central palmar slope and spread centrifugally with more advanced disease.
      Eburnation consistently involved a greater surface area on the trapezium than on
      the metacarpal in a ratio of nearly 3:1. A decreasing trapezium/metacarpal
      eburnation ratio correlated closely with worsening radiographic stage. These
      observations suggest translation of metacarpal on trapezium in the production of
      arthritic surface lesions and support a hypothesis of pathologic joint
      instability as the cause of trapeziometacarpal osteoarthritis.

PMID- 1748769
TI  - Tendon suspension sling arthroplasty for thumb trapeziometacarpal arthritis.
AB  - Forty consecutive tendon suspension sling arthroplasties for relief of
      pantrapezial osteoarthritis in 38 patients were reviewed. The procedure consists
      of excision of the trapezium and reconstitution of the tethering action of the
      first intermetacarpal and the palmar oblique carpometacarpal ligaments; 50% of
      the distally based flexor carpi radialis tendon is used. A double figure-eight
      sling suspends the first metacarpal securely, followed by distal advancement of
      the abductor pollicis longus to tighten the sling and palmarly abduct the thumb
      ray. The technique resulted in relief of pain, preservation of strength,
      maintenance of a normally contoured first web space, and functional
      carpometacarpal range of motion. Procedures were performed over a 4-year period
      (1986 to 1990), with an average follow-up of 21 months. At final follow-up, 85%
      of the patients had minimal symptoms; key pinch and grip strengths measured 76%
      and 81% of the contralateral uninvolved side, respectively. The logic of the
      mechanical design of the procedure and encouraging subjective and objective
      follow-up at 4 years make the technique of tendon suspension sling arthroplasty
      an attractive alternative to existing procedures for the surgical management of
      recalcitrant and disabling osteoarthritis of the basilar thumb joint.

PMID- 1748770
TI  - Biomechanical and functional testing of plate fixation devices for proximal
      phalangeal fractures.
AB  - Functional testing in fresh cadaver digits of a dorsally applied mini-H plate, a
      mini-straight plate, and a laterally applied mini-condylar plate demonstrated
      that all three significantly reduce (p less than 0.2) simulated active PIP joint
      flexion. The mini-condylar plate, however, provided the least reduction of any of
      the three plates. Biomechanical testing of the same three plates on proximal
      phalanx after osteotomy in apex palmar and apex dorsal direction bending showed
      all three plates to provide rigidity less than the intact bone.

PMID- 1748771
TI  - Biomechanical comparison of cannulated small bone screws: a brief follow-up
      study.
AB  - The compressive forces generated by the ASIF and Herbert small bone cannulated
      screws were measured in the laboratory with the use of simulated bones and a
      custom-designed load washer as a means of quantifying their fixation
      capabilities. Comparative data were also generated for the Herbert scaphoid bone
      screw and the ASIF 4 mm cancellous screw. The cannulated Herbert bone screw and
      the ASIF 4 mm cancellous screw were found to have nearly identical compression
      capabilities. Both generated compression forces approximately five times those of
      the Herbert scaphoid bone screw. The ASIF small cannulated screw demonstrated a
      compressive capacity 2 1/2 times that of the Herbert screw.

PMID- 1748772
TI  - Society/community expectation.

PMID- 1748773
TI  - Role of fine needle aspiration biopsy cytology in general practice.

PMID- 1748774
TI  - Clinical profile of herpes zoster ophthalmicus.
AB  - Herpes zoster ophthalmicus was seen in 22 cases out of 195 cases of herpes zoster
      (11.3% incidence). It was affecting mainly adults (90.9%). Oedema over the lids
      (81.8%) was invariably present and lead to ptosis. Mucopurulent conjunctivitis,
      predominantly mucoid (72.7%) was the commonest manifestation associated with
      vesicles over the lid margins. Sectorial (22.7%) and diffuse (9.1%) episcleritis
      appeared in later part of first week, while nodular episcleritis was observed in
      one case only on 12th day of the disease. Nummular keratitis was seen in 31.8% of
      cases between 8-10 days. Iritis and iridocyclitis was seen in 45.4% of cases out
      of which 36.3% had secondary ocular hypertension (glaucoma). Neuroparalytic
      keratitis and internal ophthalmoplegia were detected in one patient each.
      Postherpetic neuralgia occurred in 22.7% of cases and was uncommon in younger age
      group (below 40 years, 4.5%). Carbamazepine was effective in relieving the
      herpetic pain.

PMID- 1748775
TI  - Carcinoma penis.
AB  - In the present study 90 cases of carcinoma penis were studied. The disease is
      more common after the age of 40 years; phimosis was found to be most important
      predisposing factor. Most common presentation was proliferative lesion with
      commonest involvement of glans penis. All the cases were of squamous cell
      carcinoma except one case of malignant melanoma. Clinical determination of lymph
      node metastasis is falacious as there was discrepancy between clinical and
      histopathological stage of the disease in 26.67% of cases. Therefore lymph node
      biopsy at the time of primary surgery is advocated. The result of total
      amputation is better than other mode of treatment.

PMID- 1748776
TI  - Postoperative analgesia with extradural buprenorphine and pentazocine.
AB  - A randomised study of the efficacy, duration of action and side-effects of two
      analgesic regimens following lower abdominal surgery is described. Patients
      received extradural pentazocine 30 mg or extradural buprenorphine 0.3 mg to
      provide postoperative analgesia. Interval for the next analgesia was
      significantly greater after extradural buprenorphine (18.96 hours) than after
      extradural pentazocine (8.39 hours) (p less than 0.001). No serious side-effects
      were reported.

PMID- 1748777
TI  - Evaluation of different surgical procedures in filarial lymphoedema of lower
      extremity.
AB  - Ninety-six cases of different stages of lymphoedema of inferior extremity were
      taken for study. Twenty-four patients with early lymphoedema (stage II) were
      subjected to lymphonodovenous shunt (LNVS) operation; 54 patients of late
      lymphoedema with skin changes (Stage IV) were subjected to Charles' operation and
      18 patients with late lymphoedema without skin changes (stage III) were subjected
      either to Sistrunk's or Thompson's operation. All the results were studied,
      evaluated and compared. The cases subjected to LNVS operation had a rapid relief
      of lymphoedema in the early postoperative period followed by slow reduction.
      Patients subjected to Charles' operation had immediate volume and circumference
      reduction and take up of skin grafting was 84%. The cases subjected to Thompson's
      operation did not have satisfactory reduction in volume and circumference
      postoperatively. There were a few minor postoperative complications in all these
      procedure, infection being most notable in those who had undergone Charles'
      operation. It is concluded that while excisional surgery, such as Charles'
      operation becomes necessary for late stages of lymphoedema, which have progressed
      to elephantiasis, nodovenous shunt alone is sufficient to relieve early stages of
      lymphoedema due to filariasis.

PMID- 1748778
TI  - Dissolution of gall-stones in vitro.
AB  - An in vitro study on dissolution of 36 gall-stones obtained from 3 patients (12
      stones from each patient) was carried out in heparin, bile salt and clofibrate
      solutions of different strengths. Heparin was found to be a poor solvent while
      bile salt (sodium desoxycholate) proved better and clofibrate the best solvent in
      various concentrations used. In addition 3 stones, one from each patient, were
      placed in normal saline to serve as control.

PMID- 1748779
TI  - Antibacterial susceptibility of anaerobes by agar dilution method.
AB  - Of the 9 antibacterials, vancomycin alone at its break-point (optimum blood
      level) revealed highest (93.3%) efficacy on Gram-positive cocci. The remarkable
      activity of carbenicillin, chloramphenicol and vancomycin on Gram-positive cocci
      (95.4 to 96.9%), carbenicillin and chloramphenicol on Gram-positive bacilli
      (94.8% to 98.2%) and chloramphenicol on Gram-negative bacilli (95.4%) was noted
      by increasing their concentrations 1.5 to 2.5 times above their break-points.
      These (and even higher) concentration, however, showed relatively lower efficacy
      of metronidazole, rifampicin, penicillin, clindamycin and erythromycin on Gram
      positive cocci (76 to 84.1%), rifampicin, tetracycline, erythromycin, clindamycin
      and vancomycin on Gram-positive bacilli (81 to 87.9%) and clindamycin,
      metronidazole, rifampicin and carbenicillin in Gram-negative bacilli (72.7 to
      84%). By and large, rifampicin, chloramphenicol and carbenicillin are also quite
      effective (72.1 to 75.1%) at lower concentration.

PMID- 1748780
TI  - Spirometric indices of early airflow obstruction.
AB  - Thirty cigarette smokers and 25 non-smoking controls, all men were evaluated by
      history, physical examination and simple spirometry. The history and physical
      examination were not of much use in predicting airflow obstruction. Forced mid
      expiratory flow (FEF 25-75%) was abnormally low in 23 of the 30 subjects, while
      forced expiratory volume in 1 second (FEV1) and FEV1/FVC (forced vital capacity)
      were less sensitive. Thus simple spirometry is a useful screening tool to detect
      early airflow obstruction even when it is clinically undetectable.

PMID- 1748781
TI  - Clinical profile of trichotillomania.
AB  - Twenty-four cases of trichotillomania attending psychiatry outpatient department
      and child guidance clinic at Kalawati Saran Children's and Smt Sucheta Kriplani
      Hospitals over a period of 2 years from July, 1985 to November 1987 were studied.
      Females (66.7%) outnumbered the males (33.3%). Majority of cases belonged to age
      group 6-10 years (54.2%) and nuclear family (68.5%). Nail-biting (25.0%) was the
      commonest associated neurotic trait, followed by enuresis (20.9%), temper-tantrum
      (12.5%), etc. A past history of hysterical fits and neurotic depression was found
      in 3 cases (12.5%) and 2 cases (8.3%) respectively. Family history of neurosis
      was seen in mothers and fathers of 20.9% and 12.5% cases respectively.
      Trichobezoars and trichophytobezoars were found in 6 cases (25.0%) and 3 cases
      (12.5%) respectively. Majority of patients of trichobezoars presented with vague
      complaints like heaviness in the stomach (55.6%), inability to gain weight
      (44.4%), etc, while 22.2% cases were asymptomatic and detected only on screening.

PMID- 1748782
TI  - An unusual case of eventration of the diaphragm with intractable vomiting.

PMID- 1748783
TI  - Sports injuries in common rural games and their management.

PMID- 1748784
TI  - Pathogenesis of dengue haemorrhagic fever.

PMID- 1748785
TI  - Relief of chronic pain.

PMID- 1748786
TI  - Platelet adhesiveness in diabetes mellitus with relation to treatment.
AB  - To determine whether diabetes mellitus alters the function of platelets, a study
      on platelet adhesiveness in 30 controls and 75 newly diagnosed diabetics (25
      cases of type-1 and 50 cases of type-II) before and after treatment was
      undertaken. The platelet adhesiveness was 68.83 +/- 6.09% (mean + SD) in type-I
      diabetics, 72.43 +/- 6.10% in type-II diabetics and 56.31 +/- 9.62% in controls
      (p less than 0.001 for all comparisons). In complicated diabetics (54 cases) the
      platelet adhesiveness was 72.33 +/- 5.99% and in uncomplicated diabetics (21
      cases) it was 67.33 +/- 5.82% (p less than 0.05). Platelet adhesiveness was
      significantly reduced after treatment (with insulin it was 62.12 +/- 7.46%, with
      phenformin 62.10 +/- 8.63 and with tolbutamide 67.12 +/- 7.97%) when compared
      with pretreatment values. Platelet adhesiveness had no significant correlation
      with blood sugar and serum cholesterol levels. These results support the concept
      that platelet adhesiveness is high in diabetes mellitus and is reduced with
      control of diabetic state after treatment.

PMID- 1748787
TI  - Non-operative treatment of fractures of the humeral shaft: a comparative study.
AB  - Forty cases of diaphyseal fracture of humerus were treated by functional cast
      bracing (FCB). Results were compared with a series of 25 patients treated by U
      cast method. Average time taken for union was 7.5 weeks with a range of 5-14
      weeks by FCB method. Fractures treated by U cast method took on an average 10
      weeks to unite. Stiffness at shoulder and elbow was uniformly found in patients
      treated by U cast. More than 50% patients had varus angulation less than 5
      degrees after treatment by FCB. Only 16% had varus angulation less than 5 degrees
      by U cast method while 32% had varus angulation more than 15 degrees. FCB is
      distinctly superior method of treatment for diaphyseal fracture of humerus.

PMID- 1748788
TI  - A study of prolonged labour.
AB  - Two hundred and three consecutive cases of prolonged labour have been
      retrospectively reviewed from January 1984 to December 1986. The incidence of
      prolonged labour was 4.39%. It was noted that 66.5% of the patients with
      prolonged labour were unbooked emergency admissions, and 73.3% were primipara.
      The causes of prolonged labour were the occipitoposterior position (10.8%),
      relative cephalopelvie disproportion (18.2%), uterine dysfunction (44.5%), and in
      26.1% an obstructive cause was present. A spontaneous vaginal delivery occurred
      in 34.4%, a forceps delivery in 22.6% and the caesarean section rate was 29%. The
      maternal mortality, febrile and non-febrile morbidity were 9.7 per 1000 total
      births, 42.8% and 17.2% respectively, which showed a direct relation to the
      duration of labour, and a significant increase in the patients with obstructed
      labour, and after an abdominal delivery. The corrected perinatal mortality was
      165 per 1000 total births, which was also directly related to the duration of
      labour, and 74.3% of the perinatal deaths occurred in the patients with
      obstructed labour. The perinatal mortality in the study group was nearly three
      times higher than the overall hospital group. Neonatal morbidity occurred in
      48.8% of the newborns.

PMID- 1748789
TI  - Electrocardiographic changes in tetanus: a serial study.
AB  - Serial electrocardiograms (ECGs) were recorded in 20 consecutive male patients
      admitted to the Infectious Diseases Hospital, Calcutta with generalised tetanus.
      Age of patients varied from 5 to 40 years (mean age 20.4 years). Ten patients
      died. ECGs were recorded daily for the first week after admission and later every
      2nd or 3rd day. Altogether, 167 ECGs were analysed. Sinus tachycardia was present
      in 17 (85%) patients, prolonged QT interval in 12 (60%) patients, non-specific ST
      T abnormalities in 12 (60%) patients and P wave changes in 10 (50%) patients.
      Other abnormalities recorded, included short PR interval, supraventricular
      tachycardia, intraventricular conduction delay, sinus bradycardia, 1 degree A-V
      block, abnormal axis deviation, right ventricular hypertrophy and sino-atrial
      Wenckebach phenomenon, although all of the findings cannot clearly be attributed
      to tetanus. Spatial QRS-T angle was calculated in 18 of these patients to
      determine any possible change in this parameter of prognostic significance. Two
      out of 9 who survived had abnormally wide (greater than or equal to 55 degrees)
      spatial QRS-T angle on admission; the angle narrowed with recovery. In the non
      survivor group, 4 patients had abnormally wide QRS-T angles on admission; further
      widening was noted in patients on whom follow-up tracings were available. The
      difference in spatial QRS-T angle between the survivor and the non-survivor
      groups was statistically significant (p less than 0.05). Spatial QRS-T angle
      changes have not been reported in tetanus before. Although non-specific, serial
      study in individual cases would be useful in assessing prognosis.

PMID- 1748791
TI  - Vertebral artery injury: management by packing.

PMID- 1748790
TI  - Study of immunisation: knowledge, attitude and practice.
AB  - A study was conducted to find out the knowledge, attitude and practice of
      preventive health care among the industrial workers by interviewing the workers
      of Durgapur Steel Plant, Durgapur and their family members who attended the
      health unit. The study revealed that 7.98% of the industrial workers were not
      aware of preventive aspects of health care. Most of this group were illiterate,
      rural in origin with family income less than Rs 1000 per month. Female child and
      the third and fourth child were more neglected. Main source of knowledge about
      preventive health care is mass media. Trade unions did not play any role in
      health education. There is seasonal variations in number of immunisation and drop
      out. Most common reason for drop out was negligency on the part of the parent and
      the parents remaining out of station. About 1% of the workers believed in other
      than scientific system of medicine.

PMID- 1748792
TI  - Spontaneous rupture of a gravid uterus resulting in abdominal pregnancy and
      lithokelyphos formation.

PMID- 1748793
TI  - An unusual case of primary renal cell carcinoma with normal excretory urography,
      sonography and computed tomography.

PMID- 1748794
TI  - Pyoderma.

PMID- 1748795
TI  - Who is afraid of cancer?

PMID- 1748796
TI  - Aspirin and coronary artery disease.

PMID- 1748797
TI  - Chemo-immunotherapy and immunological study in carcinoma of larynx and
      laryngopharynx.
AB  - Eighteen of 25 patients had squamous cell carcinoma in the supraglottic region.
      Anergy to skin test antigen (DNCB) and T-cell mitogen (PHA) was observed in 17
      patients with laryngeal and laryngopharyngeal malignancies. Chemo-immunotherapy
      did not improve the skin reactivity to either agents. However, a rise in absolute
      T-cell counts was observed following combined therapy. Moreover, T-lymphopenia
      was detected in the patient group prior to therapy as compared to mean T-cell
      counts in normal control subjects.

PMID- 1748798
TI  - A profile of pyogenic meningitis in children.
AB  - Clinical profile of pyogenic meningitis was studied in 256 cases over a period of
      8 years. The male to female ratio was 1.46: 1 and 83.6% of the patients were less
      than 3 years of age. Fever, altered sensorium, refusal to feed, convulsions and
      vomiting were the common presenting symptoms. Six (2.3%) of them had subnormal
      temperature and the sensorium was normal in 12.5% of cases. Cerebrospinal fluid
      was clear in 9.4%, cell count was less than 100/cmm in 8.2%, sugar was more than
      40 mg% in 24.2% and protein was less than 50 mg% in 12.5% of cases. Diplococcus
      pneumoniae was the commonest causative agent. The overall mortality was 30.5%. It
      is concluded that young children suffering from this disease may not have the
      typical features and one should have the highest suspicion to make an early
      diagnosis so that the morbidity and mortality from this condition can be reduced.

PMID- 1748799
TI  - Effect of simultaneous isoniazid administration on pharmacokinetic parameters of
      pyrazinamide.
AB  - Pyrazinamide (PZN) was administered to 10 patients of pulmonary tuberculosis (for
      7 consecutive days) each day after an overnight fast. On 8th day serum levels and
      urinary elimination were measured at 2,4,6 and 8 hours. Simultaneous
      administration of isoniazid to same patients significantly decreased the peak
      serum concentration (Cmax). Although, time to peak serum concentration (Tmax)
      remained unaffected, serum half life (t1/2) prolonged, the elimination rate
      constant (Kel) and area under serum concentration time curve (AUC) decreased and
      apparent volume of distribution (Vd) and plasma clearance (Clp) of PZN increased
      significantly. However, the cumulative per cent dose of PZN excreted in urine was
      not changed significantly. Although, serum levels of PZN were decreased at 2, 4,
      6, and 8 hours, PZN levels remained above minimum effective concentration thereby
      not affecting the therapeutic status of PZN administered in combination with
      isoniazid, if PZN is administered in moderate doses.

PMID- 1748800
TI  - Cardiovascular responses to cold pressor test: a test for autonomic functions.
AB  - Circulatory dynamics during the cold pressor test, done by immersing the hand in
      water at 5 degrees C for one minute, were studied in 30 male healthy volunteers.
      All the subjects responded to the test with statistically significant increase in
      blood pressure (22.04%, p less than 0.001), heart rate (11.21%, p less than
      0.001), galvanic skin resistance (36.17%, p less than 0.001) and decrease in
      forearm blood flow (40.85%, P less than 0.001). The measurement of cardiovascular
      responses following cold pressor test constitutes another test which can be used
      to test the efficiency of the autonomic nervous system in various autonomic
      neuropathies.

PMID- 1748801
TI  - Sublingual nifedipine in hypertensive emergencies with special reference to
      cerebrovascular accident.
AB  - Effect of sublingual nifedipine was evaluated in 39 cases of hypertensive
      emergencies (diastolic blood pressure greater than or equal to 120 mm Hg with
      impending organ failure, loss of vital function or death). It was found to be
      effective (95%), safe, with prompt (with 15 minutes) and predictable response
      (lowering of systolic blood pressure, diastolic blood pressure, mean arterial
      pressure by 30% at the end of 3 hours), and few adverse effects. Its use in
      patients of cerebrovascular accident (24 cases) was found to be effective and
      safe without any significant clinical problem or increased mortality.

PMID- 1748802
TI  - Doubting atopy?
AB  - Sera of 37 patients attending the allergic clinic and of 10 normal healthy non
      allergic controls were collected and in a double blind manner they were tested
      using phadiatop RIA for differentiation of patient's symptoms as due to atopy or
      otherwise without performing other troublesome investigations. It is an easy,
      less time consuming and reliable technique.

PMID- 1748803
TI  - Multiple intervertebral disc prolapse.

PMID- 1748804
TI  - Mismatched transfusion without any untoward side-effect.

PMID- 1748805
TI  - Peptic ulcer--newer concepts.

PMID- 1748806
TI  - Dripless cholecystectomy.

PMID- 1748807
TI  - A new clinical test in gastroduodenal perforation.

PMID- 1748808
TI  - Febrile convulsion.

PMID- 1748809
TI  - Quantitation of plasma levels of 8-methoxypsoralen by competitive enzyme-linked
      immunosorbent assay.
AB  - An immunologic method for the quantitation of 8-methoxypsoralen (8-MOP) levels in
      human plasma has been developed. A monoclonal antibody recognizing 8-MOP was
      prepared by immunizing mice with an 8-MOP derivative conjugated to bovine serum
      albumin with 1-ethyl-3-(3-dimethylamino-propyl)-carbodiimide-HCl. The antibody
      was characterized by competitive enzyme-linked immunosorbent assay (ELISA) and
      recognizes 8-MOP (50% inhibition at 2 pmol) as well as structurally related
      psoralen derivatives including 4'-aminomethyl-4,5',8-trimethylpsoralen (50%
      inhibition at 50 pmol), 5-methoxypsoralen (50% inhibition at 150 pmole), and
      6,4,4'-trimethylangelicin (50% inhibition at 360 pmol). The assay has a limit of
      sensitivity of 1 ng/ml plasma. For analysis of 8-MOP levels in plasma, samples
      were first extracted using SepPak C18 cartridges. The extracts were analyzed for
      8-MOP levels both by ELISA and high-pressure liquid chromatography. There was a
      good correlation between the values determined by both methods (r = 0.92, p less
      than 0.0005). The development of immunologic methods should greatly facilitate
      the quantitation of 8-MOP levels in patient plasma.

PMID- 1748810
TI  - Structural investigations of human stratum corneum by small-angle X-ray
      scattering.
AB  - The structure of human stratum corneum was investigated with small-angle X-ray
      scattering (SAXS). At room temperature the scattering curve was characterized by
      a strong intensity at low scattering vector (Q less than 0.8 nm-1) and two
      complicated diffraction peaks originating from a lamellar structure of the
      lipids. The lamellar lipid structure in the stratum corneum transformed to a
      disordered structure between 65 degrees C and 75 degrees C, the same temperature
      region at which a thermal lipid transition occurred. After cooling down to room
      temperature a recrystallization of at least a part of the lipids took place,
      after which only one unit cell with a repeat distance of 13.4 nm could be
      detected. Comparison of the scattering curve of the stratum corneum after
      crystallization with the scattering curve of the stratum corneum before
      recrystallization leads to the conclusion that in the original curve the lipids
      are arranged in two unit cells with repeat distances of 6.4 nm and 13.4 nm. From
      model calculations it appears that the latter unit cell consists of more than one
      bilayer. The scattering curves of stratum corneum hydrated to various levels were
      measured. A change in the water content of stratum corneum between 6% w/w and 60%
      w/w (fully hydrated) did not result in swelling of the bilayers, but the
      scattering curve obtained with stratum corneum hydrated to 60% w/w differed from
      those at lower hydration levels: the scattering curve at 60% w/w showed only the
      diffraction peaks corresponding to a unit cell with a repeat distance of 6.4 nm.
      This observation implies that the ordering of a part of the lipids is reduced at
      very high water contents, which may explain the strong penetration-enhancing
      effects of water in the stratum corneum.

PMID- 1748811
TI  - Contour mapping of the cutaneous microvasculature by computerized laser Doppler
      velocimetry.
AB  - A probe holder for laser Doppler velocimetry was designed to allow a narrow (1.24
      mm) probe to be moved in increments of 1.04 mm, approximately the width of the
      probe window itself, so that four contiguous 1-mm2 spots in a 2.29 x 2.29 mm area
      could be sampled. An area as large as 2.48 x 2.48 cm can be measured with this
      device. The flux was fed into a computer by an analog/digital board, for
      visualization as a wave-form on the monitor, and for analysis by fast Fourier
      transforms and power spectrum analysis. Each spot sampled was given a unique x,y
      coordinate and the mean amplitude of the flux was designated as the z coordinate.
      With the aid of software, the values of these three coordinates were
      mathematically processed to produce contour graphs with shading that represented
      a map of the arteriolar circulation in the skin. This methodology allows for
      accurate movement and placement of the probe on the skin and the ability to
      relocate a spot within 1 mm of its original location after intervals of hours to
      days. Video images of the superficial plexus at the sites where the maps were
      made confirm the topographic appearance of these maps. Data generated by these
      maps raise the intriguing possibility that microcirculatory vessels may be
      engaged in a division of labor--some involved primarily with tissue perfusion,
      others with thermoregulation.

PMID- 1748812
TI  - Characteristics of vascular responses to endothelin-1 of simian digital arteries
      that distribute their branches to the skin.
AB  - Using the cannula-inserting method, vascular responses to endothelin-1 were
      investigated in the isolated and perfused simian digital artery. Endothelin-1
      produced a strong and sustained vasoconstriction with EC50 of 5.15 +/- 1.24 ng.
      The endothelin-1-induced vasoconstriction was significantly inhibited in the
      Ca(++)-removed perfusate. It was partly attenuated by diltiazem, a potent Ca++
      entry blocker, but not affected by alpha-adrenoceptor antagonist phentolamine,
      indicating that endothelin-1 causes vasoconstriction by either the extracellular
      Ca++ entry or intracellular movement of Ca++ from the cytosolic storage site.
      From these results, it is suspected that ET-1 is partially related to skin
      circulatory disturbances such as Raynaud's phenomenon.

PMID- 1748813
TI  - Conditioned medium from cultured human keratinocytes has growth stimulatory
      properties on different human cell types.
AB  - Evidence for growth-stimulatory properties of keratinocyte-conditioned medium
      (KCM) on human fibroblasts, endothelial cells, keratinocytes, smooth muscle
      cells, and a mouse fibroblast cell line (3T3 cells) is presented. On human
      fibroblasts KCM caused an increase of over 400% in DNA synthesis as revealed by
      3H-thymidine incorporation and autoradiography. The proliferative effect was
      comparable to that of platelet-derived growth factor (PDGF), but was not
      inhibited by PDGF antibodies and exceeded that of transforming growth factor
      alpha (TGF-alpha), epidermal growth factor (EGF), insulin-like growth factor-I
      (IGF-I), and basic fibroblast growth factor (bFGF). Furthermore, KCM was found to
      stimulate smooth muscle cells, keratinocytes, and endothelial cells more potently
      than PDGF, EGF/TGF-alpha, and bFGF, respectively. KCM was also potent in
      stimulating thymidine incorporation in 3T3 cells, whereas EGF showed a twenty
      fold weaker stimulatory effect. Because keratinocytes have been shown to secrete
      TGF-alpha, which binds to the EGF receptor, binding of factors in KCM to the EGF
      receptor was assayed. The displacement of radiolabeled EGF by KCM corresponded to
      a low concentration of EGF (0.5 ng/ml), implying that the growth-stimulatory
      effect of KCM was not mediated via activation of EGF receptors. Taken together,
      these results suggest the presence of hitherto unidentified growth-stimulatory
      factor(s), expressed and secreted by cultured human keratinocytes.

PMID- 1748814
TI  - Comparison of minimal phototoxic dose and skin type for determining initial UVA
      dose in oral liquid methoxsalen photochemotherapy for the treatment of psoriasis.
AB  - Twenty-five patients with extensive psoriasis were randomly assigned into one of
      three groups, each receiving 0.5 mg/kg of oral liquid methoxsalen
      photochemotherapy followed 1 h later by exposure to long-wave ultraviolet light
      (UVA). The sole difference between the three groups was the method used to
      determine the initial UVA dose, which was either based on skin type, 25% of the
      minimal phototoxic dose (MPD), or 50% of the MPD. All patients were treated in
      the Phototherapy Unit at the Massachusetts General Hospital. Data were obtained
      until reaching the endpoint of clearance. At clearance, the results of the number
      of treatments required to clear, final UVA dose, cumulative UVA dose, and side
      effects were tabulated, compared, and analyzed for each of the three groups. The
      25% and 50% MPD groups required a mean of 15.0 +/- 1.7 and 13.4 +/- 1.9
      treatments to clear, respectively, as compared to the skin type group, which
      needed an average of 17.6 +/- 2.5 treatments. The mean final UVA dose was 7.4 +/-
      0.9 J/cm2 and 8.4 +/- 1.4 J/cm2 for the 25% and 50% MPD groups, respectively, in
      contrast to 11.6 +/- 1.4 J/cm2 for the skin type group. The mean cumulative UVA
      dose at clearance for the 25% and 50% MPD groups was 79 +/- 16 J/cm2 and 87 +/-
      27 J/cm2, respectively, versus 136 +/- 30 J/cm2 for the skin type group. The
      comparisons between the individual MPD groups and the skin type group did not
      achieve statistical significance with the exception of a marginally significant
      difference in final dose between the skin type group and the 25% MPD group (p =
      0.06). However, the results of the two MPD groups were then pooled and the mean
      final (7.9 +/- 0.8 J/cm2) and cumulative (83 +/- 15 J/cm2) UVA doses were
      significantly (p = 0.04) and marginally significantly (p = 0.07) lower than the
      respective means of the skin type group. The number of treatments to clear,
      although lower in the pooled MPD groups (14.2 +/- 1.3) than in the skin type
      group, did not attain statistical significance (p = 0.19). Our data suggest that
      the MPD measurement may be superior to the skin-typing system when calculating
      the initial UVA dose in oral liquid methoxsalen photochemotherapy for the
      treatment of psoriasis.

PMID- 1748815
TI  - Thymidine salvage changes with differentiation in human keratinocytes in vitro.
AB  - We compared the capacity of proliferating and differentiating keratinocytes to
      salvage and catabolize extracellular thymidine. Both populations of cells
      catabolized thymidine to thymine and possessed thymidine phosphorylase activity.
      As keratinocytes differentiate, thymidine phosphorylase activity ultimately
      increased twofold. In contrast, proliferating and differentiating keratinocytes
      differed markedly in their capacity to salvage extracellular thymidine.
      Proliferating keratinocytes readily salvaged extracellular thymidine to form
      nucleotides, whereas differentiating cells rapidly lost this capacity. The
      inability of differentiating cells to form nucleotides from thymidine was not
      attributed to reduced availability of thymidine due to catabolism but rather was
      the result of the rapid loss of thymidine kinase activity. As keratinocytes
      differentiate in suspension culture, they lose 41% of thymidine kinase activity
      in 8 h and over 90% of activity in 12 h. Our data indicate that loss of capacity
      to salvage extracellular thymidine for synthesis of nucleotides closely parallels
      the onset of differentiation in keratinocytes.

PMID- 1748816
TI  - Identification of late differentiation antigens of human cornified epithelia,
      expressed in re-organized desmosomes and bound to cross-linked envelope.
AB  - Little is known about the process leading to desquamation in cornified epithelia.
      We describe late differentiation antigens (Ag) specific for human cornified
      squamous epithelia, defined by two murine monoclonal antibodies (MoAb), G36-19
      and B17-21, produced after immunization with plantar stratum corneum (SC).
      Histologically, in epidermis both Ag are cytoplasmic in the lower stratum
      granulosum (SG), become pericellular in the upper SG, and progressively disappear
      in the lower SC. In contrast, they persist up to the desquamating corneocytes in
      the palmoplantar epidermis and hard palate epithelium, as well as in the three
      cornified epithelial components of the inner root sheath (IRS) of the hair
      follicle (HF). Cytologically, both Ag are expressed as surface spots only on
      rough corneocytes. They are largely preserved on cross-linked envelopes (CLE) of
      the fragile type. Ultrastructurally, both Ag appear in keratinosome-like
      cytoplasmic vesicles in the upper stratum spinosum (SS) and the SG keratinocytes,
      then are found in both the regular and reorganizing desmosomes of the SG
      keratinocytes, and lastly in the corneocyte-specific reorganized desmosomes we
      propose to name corneodesmosomes. On CLE, the Ag are located on fibrils gathered
      over the external side of the envelope. Immunochemically, the G36-19--defined
      epitope is sequential and shared by five non-cytokeratin protein antigens of
      molecular weight 33.5, 36.5, 40, 49, and 52 kD, the higher molecular weight
      polypeptides being possibly precursors of the 33.5-kD protein. In contrast, the
      B17-21 epitope, unaccessible by immunoblotting, is probably conformational. In
      long-term cultured keratinocytes, the Ag are only expressed when epidermal sheets
      are morphologically differentiated. The expression is enhanced in the absence of
      fetal calf serum (FCS) and of epidermal growth factor (EGF). G36-19 and B17-21 Ag
      participate in a corneodesmosome-CLE superstructure that is probably involved in
      corneocyte cohesiveness and partly responsible for the mechanical resistance of
      the SC. These Ag are relevant markers for studying desmosomal maturation during
      epidermal differentiation and desquamation.

PMID- 1748817
TI  - Effect of L-dopa methylester and glutathione depletion on murine B16BL6 melanoma
      growth in vitro.
AB  - The cytotoxic and growth-inhibitory effect of levodopa methylester (LDME) in
      murine B16BL6 (BL6) melanoma cells after glutathione (GSH) depletion was studied
      in vitro. Pretreatment of BL6 cells with 50 microM buthionine sulfoximine (BSO)
      depleted GSH content by nearly 90% and enhanced the growth-inhibitory effect of
      even a minimally cytotoxic concentration of LDME. Radiothymidine incorporation
      into BL6 cells significantly increased compared to untreated controls during the
      first 4 h of exposure to 0.2 mM LDME. However, pretreatment with BSO prevented
      this LDME-induced increase in radiothymidine incorporation. Because the
      percentage of cells in S-phase of the cell cycle was not altered, these results
      suggest that BSO exposure may be inhibiting unscheduled DNA synthesis, which
      could contribute to the cytotoxic effects of LDME. In addition,
      spectrophotometric studies indicated that in a cell-free system, GSH scavenged
      dopaquinone produced by the tyrosinase-mediated oxidation of LDME, presumably by
      formation of glutathionyldopa. Thus, enhancement of LDME cytotoxicity by BSO may
      also involve depleting the amount of GSH available for the nucleophilic addition
      to the quinone.

PMID- 1748818
TI  - Relation between the incidence and level of pigment cell antibodies and disease
      activity in vitiligo.
AB  - Patients with vitiligo often have antibodies to pigment cells. To examine whether
      there is a relation between the presence of such antibodies and disease activity,
      sera of 24 patients with vitiligo (10 with active and 14 with inactive disease)
      and 19 normal individuals were tested for antibodies to pigment cell surface
      antigens using a live cell enzyme-linked immunoabsorbent assay. IgG pigment cell
      antibodies were present in 80% (eight of 10) of patients with active vitiligo but
      in none of those with inactive disease or in normal individuals. The antibody
      level of patients with active vitiligo (mean binding index [BI] 3.3 +/- 0.59) was
      significantly higher than in patients with inactive disease (BI 0.96 +/- 0.04) or
      normal individuals (BI 1.0 +/- 0.04, p less than 0.001). Antibodies present in
      eight patients with high titers of pigment cell antibodies reacted to three of
      four pigment cells but to only one of six unrelated cells. These findings
      indicate that a correlation exists between the incidence and level of pigment
      cell antibodies and the activity of vitiligo, and support the hypothesis that
      vitiligo is an autoimmune disease mediated by an immune reaction to pigment
      cells.

PMID- 1748819
TI  - Low catalase levels in the epidermis of patients with vitiligo.
AB  - Suction blister roofs taken from the involved and uninvolved epidermis of
      patients with vitiligo showed a consistent reduction in levels of catalase
      compared to normal healthy controls of matched photo-skin types (Fitzpatrick
      classification). A decrease in catalase activity is expected to increase the
      concentration of hydrogen peroxide in the epidermis of these patients. Hydrogen
      peroxide functions as a reversible inhibitor of human tyrosinase with a KI of 8 X
      10(-6) M. Also, hydrogen peroxide undergoes photochemical reduction yielding
      highly reactive hydroxyl radicals (OH.) and hydroxyl ions (OH-) mainly by the
      Haber-Weiss reaction. Hydroxyl radicals are capable of bleaching constitutional
      melanin and cause membrane lysis through lipid peroxidation reactions. Hydroxyl
      ions increase the pH in the epidermis, and as a consequence glutathione reductase
      activity is increased in patients with vitiligo compared to controls. Based on
      these new results, together with the previously reported calcium transport
      defect, a new hypothesis has been formulated for the pathogenesis of vitiligo.

PMID- 1748820
TI  - Do all epidermal keratinocytes contain parathyroid hormone related protein
      (PTHrP)?

PMID- 1748821
TI  - Comparison of methods for transfection of human epidermal keratinocytes.
AB  - Several methods for DNA-mediated cell transfection were tested to determine the
      optimal conditions for transfection of human epidermal keratinocytes. The
      following methods were compared: electroporation, lipofection, Ca3(PO4)2 co
      precipitation, DEAE-dextran, and polybrene-mediated transfection. The transfected
      DNA included human keratinocyte-specific promoter for keratin K14 as well as SV40
      and RSV viral promoters. Enzyme assays and in situ staining were used to evaluate
      both quantitative and qualitative aspects of transfection, and both subconfluent
      and post-confluent, stratifying keratinocytes were examined. Lipofection,
      Ca3(PO4)2 co-precipitation, and polybrene methods transfect very efficiently, but
      lipofection is expensive and Ca++ in the co-precipitation procedure induces
      keratinocytes to differentiate. We have found that polybrene-mediated
      transfection followed by a 27% DMSO shock is optimal for introducing DNA into
      human epidermal keratinocytes.

PMID- 1748822
TI  - Isolation, detection, and amplification of intact mRNA from dermatome strips,
      epidermal sheets, and sorted epidermal cells.
AB  - Three different strategies for isolating RNA from epidermal cells were compared.
      Starting with dermatome sections frozen or disaggregated epidermal cells purified
      by fluorescence activated cell sorting (FACS), RNA was isolated with a
      guanidinium thiocyanate technique. Specific mRNA were detected by Northern blot
      analysis (involucrin, keratin 5, actin), or by reverse transcription and
      amplification with the polymerase chain reaction (PCR), using primers specific
      for keratinocyte products (keratins 1 and 14) and Langerhans cells (CD1a).
      Messenger RNA's characteristic of Langerhans cells and of keratinocytes at
      different stages of differentiation were detected in dermatome and epidermal
      sheet preparations as well as in FACS-separated cells. The use of snap-frozen
      dermatome sections allows the isolation of RNA from epidermis that has undergone
      minimal trauma and is very close to its in vivo state, but that includes RNA from
      some dermal cells. Extraction of RNA from Dispase-separated sheets involves
      slightly more manipulation of the epidermis but provides a sample free from
      dermal contaminants. PCR analysis of sorted epidermal cells is both sensitive and
      specific, but involves still greater manipulation. This final technique, however,
      allows the investigation of mRNA produced by small groups of epidermal cells that
      are still much closer to their in vivo state than if they had been cultured. By
      combining these techniques it is possible to determine the baseline production of
      specific mRNA in the skin in vivo and to assign their production to specific
      groups of cells with a sensitivity and specificity greater than any approach
      previously described.

PMID- 1748823
TI  - Construction of a full-length murine pro alpha 2(I) collagen cDNA by the
      polymerase chain reaction.
AB  - Construction of large collagen cDNA has been hindered by the relatively large
      size and high G-C content of processed mRNA. We describe here the development of
      a rapid and efficient method for obtaining large full-length collagen cDNA. A
      full-length (4.3 kb) murine pro alpha 2(I) collagen cDNA was constructed by
      synthesis of a first-strand cDNA library with use of poly-A RNA (MC3T3-E1) and
      the oligo-dT17-adapter primer described by Frohman et al (Proc Natl Acad Sci USA
      85:8998, 1988). Pro alpha 2(I) collagen cDNA were specifically amplified by the
      polymerase chain reaction (PCR) with a pro alpha 2(I) specific primer as the 5'
      primer (20mer; corresponding to nucleotide positions 42-61 in the first exon of
      the murine pro alpha 2(I) collagen gene, COL1A2), and with the adapter sequence
      5' to the dT17 as the 3' primer. The PCR conditions were optimized to allow
      amplification of the expected 4.0-5.0-kb product; a major 4.3-kb product was
      visualized by ethidium bromide, identified by in situ gel hybridization, and
      cloned. DNA sequencing determined that it contained the correct 5' sequence and
      the 3' end had a 68 basepair (bp) 3' untranslated region. The entire sequence
      that codes the amino-terminal propeptide domain has been determined and compared
      to the human sequence. The homology between human and mouse is less in the amino
      terminal propeptide than in the triple helical domain; exon 5 of murine COL1A2
      codes for an additional six amino acids not found in human COL1A2.

PMID- 1748824
TI  - Activation of keratinocytes with psoralen plus UVA radiation induces the release
      of soluble factors that suppress delayed and contact hypersensitivity.
AB  - Exposure of mice to psoralen plus ultraviolet A (320-400 nm) radiation or
      midrange ultraviolet B (280-320 nm) radiation causes a systemic suppression of
      the immune response. Although the mechanisms involved in the induction of
      suppression are not entirely clear, recent studies have demonstrated that
      ultraviolet B--irradiated keratinocytes release soluble factors that depress
      delayed-type hypersensitivity to alloantigens and activate the suppressor cell
      pathway. The purpose of this study was to determine whether PUVA-treated
      keratinocytes could also cause the release of such immunosuppressive factors.
      Treatment of keratinocytes with psoralen and UVA radiation induced the release of
      a factor that depressed the delayed-type hypersensitivity reaction to
      alloantigen. The suppressive factor was released regardless of whether the
      psoralen formed monofunctional or bifunctional adducts with DNA and regardless of
      its phototoxicity. In addition, keratinocytes treated with psoralen and lower
      doses of UVA radiation released a factor that inhibited contact but not delayed
      type hypersensitivity, suggesting that more than one immunosuppressive factor is
      released following treatment of keratinocytes with appropriate doses of psoralen
      and UVA radiation. Our findings provide evidence that immunosuppressive factors
      released from keratinocytes may play a role in the induction of systemic immune
      suppression following PUVA treatment. Moreover, they demonstrate that PUVA
      treatment, unlike UVB treatment, can cause the release of more than one
      immunosuppressive factor from keratinocytes.

PMID- 1748825
TI  - The silent killer.

PMID- 1748826
TI  - Clinicopathological study of pancreatic carcinoma with particular reference to
      the invasion of the extrapancreatic neural plexus.
AB  - A clinicopathological study of 44 ductal carcinomas of the head of the pancreas
      revealed 39 with retroperitoneal invasion, of which 27 showed extrapancreatic
      plexus involvements. The second portion of the plexus pancreaticus capitalis was
      the most frequent site of invasion. A statistically significant correlation was
      found between neural invasion in the pancreatic tissue and plexus invasion, but
      no clear correlation was found between plexus invasion and lymphatic invasion or
      tumor size. Even small-sized tumors (t1) showed plexus invasion. The cases with
      plexus invasion had a statistically higher incidence of lymph-node involvement
      around the superior mesenteric artery than those without plexus invasion. These
      results indicate that complete dissection of extrapancreatic plexus around the
      superior mesenteric artery, including lymph nodes and soft tissue, could prolong
      the survival of patients with ductal carcinoma of the pancreas, even in cases of
      small-sized carcinomas.

PMID- 1748827
TI  - Cell-kinetic analysis of pancreatic cancers in Syrian golden hamsters.
AB  - Cell-kinetic analysis of pancreatic cancers using bromodeoxyuridine (BrdU) was
      performed on four transplantable pancreatic ductal adenocarcinomas, which were
      experimentally induced by giving N-nitrosobis (2-hydroxypropyl) amine (BHP) to
      Syrian golden hamsters. The volume-doubling time (Td) of the tumor was 0.43,
      1.03, 2.30, and 3.50 d for tumor lines J, D, B, and F, respectively. In the pulse
      labeling study, the labeling index was 15.8, 23.3, 27.9, and 31.7, respectively.
      The most rapidly growing tumor line, J, unexpectedly showed the lowest BrdU
      labeling index (LI). The further study of tumor using the cumulative-labeling
      method revealed that the duration of S phase (Ts), the generation time (Tg) and
      the growth fraction (GF) were 2 h, 14 h, and 90% for tumor J and 12 h, 37 h, and
      85% for slowly growing tumor B, respectively. Cells of limited life span (CLLS)
      of these lines did not differ from each other. These results conclude that the
      marked difference of Tg between tumor lines J and B resulted in a distinction of
      their growth rates. The disagreement of Ts/Tg also lead to a reversion of LI
      between the two lines. Furthermore, LI of BrdU with one-point pulse labeling did
      not seem to be a sufficient indicator of the growth characteristics, at least, in
      the present experiment.

PMID- 1748828
TI  - Glucose-dependent effects of pancreastatin on insulin and glucagon release.
AB  - Pancreastatin (PST), a peptide isolated from porcine pancreas in 1986, has been
      reported to inhibit insulin and to stimulate glucagon secretion. Since both of
      these effects have been questioned, we investigated the effect of PST (20, 200,
      or 2000 pM) on hormone release in the isolated perfused rat pancreas at different
      glucose levels (1.7, 5.5, 11.1, and 16.7 mM). At 1.7 mM glucose, 20 pM PST had no
      significant effect on glucagon secretion, whereas 200 pM and 2 nM PST
      significantly inhibited glucagon release. At a concentration of 5.5 mM glucose,
      insulin output was not affected by PST in any of the concentrations tested. At
      11.1 mM glucose, however, 200 pM and 2 nM PST significantly inhibited insulin
      output. At 16.7 mM glucose, insulin secretion was significantly reduced by all
      concentrations of PST tested. Unstimulated exocrine pancreatic secretion was not
      affected by PST in any of the experimental settings. We conclude that PST
      inhibits glucagon and insulin secretion dose-dependently, and these effects
      apparently are glucose-dependent. PST does not influence basal exocrine
      pancreatic secretion in vitro.

PMID- 1748829
TI  - Multifocal pancreatic serous cystadenoma with atypical cells and focal perineural
      invasion.
AB  - A case of multifocal pancreatic serous cystadenoma with atypical cells is
      reported. The patient was a 72-yr-old female who complained of jaundice. The
      distal common bile duct was obstructed, and the proximal bile duct was remarkably
      dilated on cholangiography. The main portal vein was obstructed and collateral
      vessels had developed on portal angiography. Total pancreatectomy was performed.
      The resected specimen contained one tumor in the head of the pancreas, five in
      the body, and one in the tail. The tumors of the head and body were
      morphologically the same. Microscopically, both contained spongelike multilocular
      cysts on their cut surfaces. These cysts were covered with low cuboid epithelium
      containing clear cytoplasm and abundant glycogen. Neural invasion was also found.
      The tumor cells exhibited an increased N/C ratio, variable nuclear size,
      irregular nuclear margins, and coarse nuclear chromatin. These tumors had
      aneuploid nuclear DNA with a DNA index of 1.9 and a proliferation index of 0.28.
      We feel that it is necessary to reconsider the biological concept of serous
      cystadenoma.

PMID- 1748830
TI  - Are Kentuckians using advance medical directives?
AB  - Findings of a statewide survey indicate that only 9% of Kentucky adults are
      completing Living Wills and an equal percent are designating Health Care
      Surrogates. Designed to protect patient's rights of self-determination in
      treatment decisions and protect physicians and other health care professionals
      from liability in complying with patient wishes, only 37% of the state's
      residents know about Kentucky's Living Will and 24% known about the Designation
      of Health Care Surrogate. In view of the results, it is recommended that
      educational efforts be undertaken, changes in legislation occur to ease advance
      medical directive access and use, and that, following customary medical practice,
      legislation be enacted to provide authorization of family members to serve as
      substitute health care decision makers for incapacitated patients.

PMID- 1748831
TI  - Acquired factor VIII inhibitor.
AB  - Development of a circulating inhibitor of the coagulant activity of factor VIII
      is a rare event producing a clinical picture similar to that of classic
      hemophilia. A case of autoimmune factor VIII inhibitor has been presented.
      Although a hemostatic response was rapidly achieved with the infusion of factor
      IX concentrates, immunosuppressive therapy was initiated. The inhibitor
      disappeared in less than 20 days from the initiation of therapy.

PMID- 1748832
TI  - Thoracic empyema due to Streptococcus intermedius.
AB  - With improved laboratory identification procedures, Streptococcus milleri
      (intermedius) is becoming recognized as an important human pathogen with the
      potential to form abscesses in a wide range of organs. The occurrence of a
      rapidly progressive and toxic empyema due to this organism in an otherwise
      healthy young adult without a predisposing lower respiratory tract infection
      allows us to examine the possibility that this microbe may be a significant but
      frequently unrecognized cause of adult empyema.

PMID- 1748833
TI  - Yellow nail syndrome: a perspective.
AB  - The Yellow Nail syndrome is an unusual lymphangitic disorder classically
      characterized by the presence of nail discoloration, lymphedema and pleural
      effusion. Since the recognition of the significance of these associated physical
      findings, four cases have been diagnosed at our institution in the last six
      years. This suggests that the syndrome may not be as rare as previously reported
      in medical literature. More often it may remain unrecognized in the absence of
      the classic triad of physical findings. To heighten awareness of this disorder,
      we describe our most recent patient diagnosed with YNS and provide a review of
      the current medical literature.

PMID- 1748834
TI  - Medical cost containment--the issues for 1992.

PMID- 1748835
TI  - The Kentucky Cancer Program.

PMID- 1748836
TI  - Economic disclosure and economic advocacy. New duties in the medical standard of
      care.

PMID- 1748837
TI  - Cruzan v. Director, Missouri Department of Health. Too much ado.

PMID- 1748838
TI  - The experimental treatment exclusion clause. A tool for silent rationing of
      health care?

PMID- 1748839
TI  - Dynamics of human neutrophil aggregation evaluated by flow cytometry.
AB  - In order to directly monitor neutrophil aggregation, we have developed a simple
      particle counting technique using flow cytometry. Flow times were used to
      determine aggregation from changes in the total number of particles per unit
      volume (%PA(T)), while fluorescent signals emitted from glutaraldehyde-fixed
      neutrophils were used to measure changes in the total number of singlet
      neutrophils (%PA(S)). Flow cytometrically-determined %PA values were found to be
      virtually identical to values determined from microscopy. We show that
      aggregation parameters can be evaluated and compared simply from measures of
      changes in total particle count without a need for distinguishing singlets from
      multiplets. A number of aggregation parameters are introduced and related to the
      initial cell concentration (N(o)) and stir speed (shear). Aggregation of
      neutrophils, following stimulation with 0.5 microM FMLP (N-formyl-methionyl
      leucyl-phenylalanine), showed a latent time (tl) of 4 +/- 1.5 sec independent of
      N(o) or stir speed; had a forward rate of aggregation (vf) which was proportional
      to the initial cell concentration and the stir speed; plateaued for greater than
      or equal to 60 s; and showed partial to complete reversal by 7.5 min. Above a
      critical stir speed, the extent and duration of aggregation varied inversely with
      the stir speed. The stir and N(o) dependence of the aggregation parameters
      studied suggest the existence of subpopulations of neutrophils with distinct
      efficiencies of aggregation.

PMID- 1748840
TI  - Activation of human neutrophils by phorbol ester decreases the cytoplasm
      compactness and the lactoferrin content of the granulocytes.
AB  - Human neutrophils isolated from the blood were incubated in vitro for 30 min with
      25 ng/ml of phorbol 12-myristate 13-acetate (PMA), a protein kinase C activator,
      to study its effect on the fine structure of granulocytes and on the subcellular
      distribution of lactoferrin (Lf). Flow cytometry analysis of the human
      neutrophils showed that PMA induced a decrease in size and granularity of the
      cells. By electron microscopy, the PMA-treated cells showed numerous empty
      vesicles, smoothing of the cell surface, and a marked decrease in the compactness
      of the cytoplasmic ground substance. High-resolution immunogold
      ultracytochemistry showed that neutrophils lost most of their content in Lf after
      the PMA incubation. In thin sections, the cytoplasmic compartment of PMA-treated
      neutrophils contained an average of 1.03 +/- 0.3 Lf-positive vesicles per microns
      2, whereas control granulocytes showed an average of 5.72 +/- 1.49 Lf vesicles
      per microns 2 of cytoplasm. Most of PMA-treated neutrophils kept some Lf-positive
      vesicles; a significant minority (10-15%) of the granulocytes showed cytological
      features of cell death. We conclude that the PMA-induced neutrophil activation is
      associated with microanatomical changes that include i) exocytosis of most, but
      not all, of the Lf-bearing vesicles; ii) rounding up of the cell outline; and
      iii) decrease in the compactness of the cytoplasmic ground substance.

PMID- 1748841
TI  - Kinetics of the biosynthesis of complement subcomponent C1q by murine
      macrophages: LPS, immune complexes, and zymosan alone and in combination with
      interferon-gamma.
AB  - We investigated the effects of bacterial lipopolysaccharide (LPS), immune
      complexes (IC), and C3b opsonized zymosan (AZ) alone and in combination with
      interferon-gamma (IFN-gamma) priming on macrophage synthesis and secretion of
      C1q. Our results indicated that LPS, IC, and AZ alone stimulated C1q mRNA and
      secretion in the absence of IFN-gamma. The increase in mRNA accumulation was
      detectable after 3 h, peaked at 6 h and was maintained at constitutive levels for
      24 h. There was a corresponding early burst of increased secretion of functional
      C1q after 3 to 6 h which declined rapidly after 9 to 24 h culture of LPS
      stimulated macrophages. Priming of macrophages with IFN-gamma and simultaneous
      triggering with LPS, IC, or AZ produced additive rather than synergistic
      increases in C1q mRNA accumulation. These same agents inhibited constitutive
      secretion of C1q in the absence of IFN-gamma priming as determined by
      autoradiographic analysis of metabolically radiolabeled secretory C1q. Triggering
      of IFN-gamma primed macrophages with LPS, IC, or AZ also markedly suppressed the
      increased rate of C1q secretion induced by IFN-gamma in a dose-related fashion. A
      corresponding dose-dependent increased accumulation of endogenous C1q in cell
      lysates was detected by Western blot analysis of macrophages which had been
      stimulated by LPS, IC, or AZ alone or in combination with IFN-gamma. Our findings
      indicate that LPS as well as FcR and C3bR triggering agents stimulate early and
      sustained C1q synthesis accompanied by an early and short-lived burst of C1q
      secretion which rapidly diminished and results in an increased intracellular
      accumulation of C1q due to ongoing synthesis. IFN-gamma appeared to further
      amplify the same kinetics of increased C1q mRNA accumulation and decreased
      extracellular accumulation mediated by LPS, IC, and ZM. Our results suggest that
      LPS, IC, and AZ alone or in combination with IFN-gamma stimulate early C1q
      production to modulate macrophage effector functions followed by an inhibition of
      C1q secretion when the activation process has been culminated.

PMID- 1748842
TI  - Leukocyte-endothelial cell adhesive interactions: role of xanthine oxidase
      derived oxidants.
AB  - The objective of this study was to determine whether agents that either scavenge
      or inhibit the production of oxygen radicals can alter the adhesive interactions
      between leukocytes and venular endothelium elicited by ischemia-reperfusion. Cat
      mesenteric and intestinal blood flows were reduced to 20% of baseline for 1 hr,
      followed by 1 hr of reperfusion. Sixty minutes after reperfusion, red blood cell
      velocity (Vr), leukocyte rolling velocity (Vw), and the number of adherent
      leukocytes were measured in mesenteric venules. Then, either manganese-superoxide
      dismutase (Mn-SOD), catalase, desferrioxamine, or oxypurinol was administered
      intravascularly. Ten minutes later, repeat measurements were obtained and
      compared with pretreatment values. Catalase, Mn-SOD, and oxypurinol significantly
      attenuated neutrophil adherence while neither inactivated-catalase nor
      desferrioxamine altered the reperfusion-induced leukocyte adhesion. The ratio of
      Vw to erythrocyte velocity, an index of the fracture stress between rolling
      leukocytes and venular endothelium, was not altered by any of the agents studied.
      These results and data in the literature indicate that many of the agents that
      are commonly used to either scavenge or inhibit the production of oxygen radicals
      in postischemic tissues exert a significant inhibitory influence on leukocyte
      adhesion to microvascular endothelium in vivo. Our results are also consistent
      with the view that xanthine oxidase-derived oxidants contribute to the leukocyte
      endothelial cell adhesive interactions associated with reperfusion of ischemic
      tissues.

PMID- 1748843
TI  - Involvement of cytokines in determining resistance and acquired immunity in
      murine tuberculosis.
AB  - Herein we demonstrate that continuous infusion of either TNF-alpha or IFN-gamma
      (10(4) U/day) via osmotic micropumps leads to an increased resistance of mice
      infected with a lethal dose (10(7)) of M. tuberculosis H37Rv, associated with a
      decreased microbial growth in all target organs. This result was reinforced by
      the finding that infusion of antibodies against TNF-alpha or IFN-gamma greatly
      enhanced susceptibility of naive mice to tuberculosis. In a final set of
      experiments, using neutralizing antibodies, we show that IFN-gamma, not TNF-alpha
      is involved in determining acquired resistance against murine tuberculosis, as
      seen by the fact that acquired immunity is resistant to anti-TNF-alpha
      antibodies, yet sensitive to anti-IFN-gamma antibodies. This suggests a role for
      both IFN-gamma and TNF-alpha in determining innate resistance whereas IFN-gamma
      may be the mediator of the anamnestic response.

PMID- 1748844
TI  - Independence of the pattern of early cytokine release from autoregulation by
      nitric oxide.
AB  - The L-arginine-dependent tumor cell cytotoxicity produced by activated
      macrophages (M phi) may be mediated either directly by production of nitric oxide
      (NO), or by induction of NO synthesis in the tumor cell. The influence of M phi
      NO synthesis on the release of soluble cytotoxic mediators was investigated in
      this study. The synthesis of M phi NO, measured as nitrite, was detected 6 h
      after lipopolysaccharide (LPS)-triggering and reached a peak level by 44 h. A
      concurrent decrease in M phi viability beginning at 18 h after triggering was
      detected during a period of 72 h in culture. Both the production of NO and loss
      of viability correlated with the presence of L-arginine in the incubation media
      and was inhibited by NG-monomethyl-L-arginine (NMA). The medium in which LPS
      triggered adherent peritoneal exudate cells were incubated was examined for the
      presence of tumor necrosis factor (TNF), gamma interferon (IFN-gamma), and the
      soluble mediators that induce mitochondrial respiratory inhibition in tumor
      cells. All of these effector molecules were released at peak levels into the
      conditioned supernatants within 12 h after LPS-triggering. The peak level
      obtained for each effector molecule was influenced by the media in which the M
      phi was incubated; however, no correlation was detected between the level of
      cytokines produced and the synthesis of nitrite by the M phi indicating that NO
      synthesis has no inhibiting effect on the initial burst of cytotoxic factors
      released.

PMID- 1748845
TI  - Using neural networks to diagnose cancer.
AB  - While artificial brains are in the realm of science fiction, artificial neural
      networks (ANNs) are scientific facts. An artificial neural network is a
      computational structure modeled somewhat on the neural structure of the brain;
      both have many highly interconnected processing elements. These biologically
      inspired processing elements are taught by feeding examples until the results are
      acceptable. In the past 5 years, neural networks have become successful in
      providing meaningful second opinions in clinical diagnosis. In our research, a
      prototype artificial neural network was trained on numeral ultrasound data of 52
      actual cases and then correctly identified renal cell carcinoma from renal cysts
      and other conditions without diagnostic errors. Our nonlinear artificial neural
      network was trained on software using the standard backpropagation paradigm on a
      80386 microcomputer. Our ANN learned from ultrasound data in 52 cases (17
      malignant, 30 cysts, and 5 other) at a Memphis hospital. The trained prototype
      performed without error on 47 cases which were not in the data used for training.
      This prototype must be validated by extending this study to more cases.

PMID- 1748846
TI  - Analog-to-digital clinical data collection on networked workstations with graphic
      user interface.
AB  - An innovative respiratory examination system has been developed that combines
      physiological response measurement, real-time graphic displays, user-driven
      operating sequences, and networked file archiving and review into a scientific
      research and clinical diagnosis tool. This newly constructed computer network is
      being used to enhance the research center's ability to perform patient pulmonary
      function examinations. Respiratory data are simultaneously acquired and
      graphically presented during patient breathing maneuvers and rapidly transformed
      into graphic and numeric reports, suitable for statistical analysis or database
      access. The environment consists of the hardware (Macintosh computer, MacADIOS
      converters, analog amplifiers), the software (HyperCard v2.0, HyperTalk, XCMDs),
      and the network (AppleTalk, fileservers, printers) as building blocks for data
      acquisition, analysis, editing, and storage. System operation modules include:
      Calibration, Examination, Reports, On-line Help Library, Graphic/Data Editing,
      and Network Storage.

PMID- 1748847
TI  - The use of X-terminals as clinical workstations.
AB  - The Medical Computer Facility at the Fox Chase Cancer Center has installed X
      terminals in patient examination rooms and at nursing stations for clinical data
      access by physicians and nurses. The X-terminals are connected to UNIX operating
      system RISC processors via Ethernet. The RISC processors communicate with
      databases on a minicomputer cluster. Simultaneous presentation of textual (e.g.,
      pathology and radiology reports) and graphical (e.g., clinical laboratory
      results) clinical data is provided under X-Windows. CT and MRI images can also be
      displayed in windows. Our experiences implementing X-terminal clinical
      workstations in a production environment will be discussed.

PMID- 1748848
TI  - A new teaching tool for dental and medical schools: multimedia CD-ROM on dental
      and skeletal development.
AB  - Multimedia teaching tools in Medicine are still very rare. Their presentation on
      a CD-ROM format is part of the emerging technologies in Medical Informatics. The
      Multimedia material presented here on Dental and Skeletal Development is mostly a
      Database and a Tutorial. The Database, which contains more than 2000 hand/wrist
      radiographs, is mostly intended for Pediatricians, Endocrinologists, Forensic
      Dentists and Physicians, as well as for Orthodontists and Pedodontists. The
      material is the result of 20-year of Longitudinal Growth study of children in
      Montreal. In this Multimedia CD-ROM, the research results are used for Medical
      teaching purposes.

PMID- 1748849
TI  - A model for designing intelligent tutoring systems.
AB  - A model for the design of an intelligent tutoring system is presented using
      artificial intelligence techniques and cognitive processing theories. The model
      of cognitive processing known as the Knowledge Acquisition and Recall Theory is
      derived from Anderson's Adaptive Control of Thought Theory. The model is used as
      a basis for a methodology for the design of an intelligent tutoring system that
      teaches problem-solving strategies for blood grouping discrepancies. The system
      developed was tested to determine the effectiveness of the methodology developed
      and to provide support for the concepts in the model of cognition developed. The
      preliminary results provide some evidence that an intelligent tutoring system
      designed using the methodology developed may aid in the knowledge acquisition
      process. (knowledge acquisition, artificial intelligence, computer-assisted
      instruction, cognition, intelligent tutoring system).

PMID- 1748850
TI  - Automated analysis of medical text. II. Cognitive strategy.
AB  - In a previous paper, the authors described three paradigms applicable to
      automated medical text analysis. In this paper, the relative importance of the
      three paradigms is discussed, viz. the relative value of the linguistic word
      categorization, the semantic paradigm, and the medical fact delineation. The
      strategy adopted was to limit the linguistic disambiguation and apply
      probabilistic rules, in order to speed up the analytic process.

PMID- 1748851
TI  - Pathologic elements in the planning of information systems: the case of hospitals
      in Quebec.
AB  - The existing usage of information technology for information systems in hospitals
      draws attention to the fact that: (a) health care units which operate
      sophisticated numerical instrumentation to support medical activities rarely
      employ computers for the management of their operations and (b) despite the
      availability of affordable information technologies (microcomputers, networks,
      etc.), few hospitals include such elements as health care unit management in the
      development of their information systems portfolio. Is this paradoxical situation
      a result of the planning methodologies or of factors affecting their use? Or can
      it be attributed to the failure of present planning methodologies to incorporate
      the diversity of computerization approaches of the various stakeholders involved?
      If this is the case, untapped potential computerization possibilities exist that
      could lead to the development of hospital services and increased organizational
      efficiency.

PMID- 1748853
TI  - 182nd meeting of the Society for Endocrinology. 13-15 November 1991. Abstracts.

PMID- 1748854
TI  - Atherothrombotic mechanisms in smoking.

PMID- 1748852
TI  - Iliad training enhances medical students' diagnostic skills.
AB  - Iliad is a computerized, expert system for internal medical diagnosis. The system
      is designed to teach diagnostic skills by means of simulated patient case
      presentations. We report the results of a controlled trial in which junior
      students were randomly assigned to received Iliad training on one of two
      different simulated case mixes. Each group was subsequently tested in both their
      "trained" and "untrained" case domain. The testing consisted of computerized,
      simulated patient cases for which no training feedback was provided. Outcome
      variables were designed to measure the students' performance on these test cases.
      The results indicate that students made fewer diagnostic errors and more
      conclusively confirmed their diagnostic hypotheses when they were tested in their
      trained domain. We conclude that expert systems such as Iliad can effectively
      teach diagnostic skills by supplementing trainees' actual case experience with
      computerized simulations.

PMID- 1748855
TI  - T-cell vaccination in immunological disease.

PMID- 1748856
TI  - High coronary mortality in cold regions of Sweden.
AB  - The hypothesis that cold climate is associated with high coronary mortality in
      Sweden is tested. Cold exposure was calculated in each of the 284 municipalities
      of Sweden. There was a significant association between cold exposure and coronary
      mortality in both sexes in all age groups. The strongest association was found in
      men aged 40-64 years (coefficient of determination k = 0.39). The decile of men
      aged 40-64 years who lived in the coldest municipalities had a 40% excess
      mortality. A significant association was also found between cold exposure and
      mortality from cerebrovascular diseases. We conclude that there is a strong
      regional association between cold exposure and high coronary mortality.

PMID- 1748857
TI  - Water hardness does not contribute substantially to the high coronary mortality
      in cold regions of Sweden.
AB  - Earlier studies have shown an association between cold climate and high coronary
      mortality. The aim of this study was to elucidate in more detail the effect of
      drinking water hardness on this association. Drinking water parameters were
      obtained from 259 municipalities in Sweden over a 10-year period. During the same
      period a 'cold index' was calculated for each municipality. Standardized coronary
      mortality rates in men aged 40-64 years were used. A negative association was
      found between water hardness and coronary mortality (coefficient of determination
      k = 0.080). A much stronger association was found between coronary mortality and
      cold index (D = 0.389). When coronary mortality was explained by both water
      hardness and cold index, the association was not significantly strengthened (D =
      0.391). Water hardness was negatively correlated with cold index (r = 0.55). We
      conclude that the association between cold climate and coronary mortality was
      stronger than that between drinking water hardness and coronary mortality, and
      that it persisted after stratification for water hardness.

PMID- 1748858
TI  - Cardiac left ventricular function before and during early thyroxine treatment in
      severe hypothyroidism.
AB  - In some patients with severe hypothyroidism, thyroxine replacement therapy
      precipitates or aggravates angina pectoris, whereas in other patients angina
      pectoris is ameliorated or even cured. Cardiac function in eight severely
      hypothyroid patients was studied by means of radionuclide ventriculography (RNV)
      at rest and during supine bicycle exercise before thyroxine treatment, and
      repeated during treatment before and after administration of 160 mg of oral
      verapamil. There was an exercise-induced fall in left ventricular ejection
      fraction (LVEF) in two patients before therapy, and in two additional subjects
      after 17 d on suboptimal doses of thyroxine. Verapamil attenuated the fall and
      induced a significant increase in LVEF during exercise (P less than 0.014). No
      abnormal regional cardiac wall movement (RWM) was observed. After 2 months of
      thyroxine treatment, LVEF increased significantly during exercise both before and
      after verapamil (P less than 0.012 and P less than 0.005). These findings are
      indicative of reversible coronary artery dysfunction. We recommend that, if
      feasible, thyroxine should be supplemented with verapamil during the early phase
      of treatment.

PMID- 1748859
TI  - The role of paid work in Swedish chronic dialysis patients--a nation-wide survey:
      paid work and dialysis.
AB  - The role of paid work in chronic illness has been investigated in this nation
      wide study of all Swedish-speaking patients on chronic dialysis above the age of
      16 years, who were not too tired or severely ill to participate and who had been
      treated for at least 3 months. Young age and female gender were consistently
      associated with increased prevalence of self-reported depression, poor
      psychological health, psychosomatic symptoms and sleep disturbance. In
      multivariate analyses paid work, strong emotional support, and care at
      intermediate or small units were independently associated with a good quality of
      life. Chronic dialysis patients who did paid work (19.6% of the patients below 65
      years of age) perceived their work as more socially supportive than did men and
      women in the normal working population. It may be concluded that paid work is of
      particular importance to this patient group because it may give extra social
      support to patients whose social network is in general rather poor.

PMID- 1748860
TI  - Effect of pancreas transplantation on glucose counterregulation in insulin
      dependent diabetic patients prone to severe hypoglycaemia.
AB  - Pancreatic transplantation was performed in three patients with insulin-dependent
      diabetes mellitus in whom recurrent and severe episodes of hypoglycaemia had been
      found to be due to defective glucose counterregulation. Thus in these patients
      the spontaneous blood glucose recovery after insulin-induced hypoglycaemia (0.1 U
      kg-1 h-1 i.v. insulin until blood glucose levels fell below 2.8 mmol l-1) was
      delayed, and the responses of glucagon, epinephrine and growth hormone (GH) were
      absent or diminished. After pancreas transplantation the patients exhibited
      essentially normal blood glucose control. When the insulin infusion test was
      repeated 3 months after the transplantation, the blood glucose level recovered
      rapidly after insulin withdrawal. The glucagon response was restored, and the
      responses of epinephrine and GH were improved. Plasma C-peptide was suppressed by
      approximately 50%, which is less than is observed in normal subjects. It is
      concluded that glucose counterregulation improves after pancreas transplantation.
      This appears to be mainly due to an improvement in the hypoglycaemia-induced
      glucagon response, but an amelioration of sympatho-adrenal and hypothalamic
      pituitary regulatory mechanisms may also be involved. The apparent failure to
      suppress completely the insulin release from the denervated pancreas transplant
      indicates that inhibition of beta-cell secretion during insulin-induced
      hypoglycaemia may be partly under neural control.

PMID- 1748861
TI  - Acute fungal thyroiditis in a patient with acute myelogenous leukaemia.
AB  - Acute suppurative thyroiditis of any origin is uncommon, but fungal infections of
      the gland are particularly rare. Haematogenous spread is the usual route of
      infection. We here present the case of a recently encountered patient with
      neutropenic fever and Candida thyroiditis. Fine-needle aspiration biopsy greatly
      aided the diagnosis. In immunocompromised patients, the specimens should be
      treated with special stains to detect the presence of opportunistic organisms; if
      any are found, appropriate therapy should be initiated.

PMID- 1748862
TI  - Diclofenac-induced thrombocytopenic purpura with renal and hepatic involvement.
AB  - A case of diclofenac-induced thrombocytopenic purpura in a 59-year-old woman is
      described. Unlike the majority of earlier cases, ours was associated with renal
      insufficiency and jaundice. Despite the dramatic clinical picture, with severe
      thrombocytopenia and marked renal insufficiency, the prognosis appears to be
      excellent, as is shown in our case and in similar ones reported in the
      literature. A high dose of steroids is the treatment of choice.

PMID- 1748863
TI  - The response of paraneoplastic fever of lymphomas and solid tumours to the
      administration of naproxen.

PMID- 1748864
TI  - Activity of antibiotics against various strains of clinically isolated glucose
      non-fermenting gram-negative bacteria.

PMID- 1748865
TI  - Non-functional expression of Escherichia coli signal peptidase I in Bacillus
      subtilis.
AB  - The Escherichia coli lep gene, encoding signal peptidase I (SPase I) was provided
      with Bacillus subtilis transcription/translation signals and expressed in this
      organism. When present on a low-copy-number plasmid, the amount of E. coli SPase
      I produced (per mg cell protein) in B. subtilis was half that produced in wild
      type E. coli cells. The production of E. coli SPase I in B. subtilis was
      increased approximately fivefold by cloning the lep gene into a high-copy-number
      plasmid. The expression of E. coli SPase I in B. subtilis did not appear to
      increase the rate of processing of two hybrid secretory precursor proteins. Two
      observations may explain the failure of E. coli SPase I to stimulate processing
      of exported proteins in B. subtilis. First, the E. coli SPase I was apparently
      not exposed on the outside of the B. subtilis cytoplasmic membrane, indicating
      its incorrect insertion into the membrane. Second, in vitro processing studies,
      using cell-free extracts of B. subtilis producing E. coli SPase I, suggested that
      the enzyme was not active. A further outcome of this study was that conditions
      favouring processing of precursors by SPase I in cell-free extracts of E. coli
      did not favour processing by the corresponding enzyme in B. subtilis cell-free
      extracts. This suggests that significant differences exist between the two
      enzymes. The observation that antibodies directed against E. coli SPase I did not
      cross-react with B. subtilis membrane proteins supports this idea.

PMID- 1748866
TI  - Structural organization of the Corynebacterium glutamicum plasmid pCG100.
AB  - pCG100, a 3 kb cryptic plasmid of Corynebacterium glutamicum ATCC 13058, probably
      identical with pSR1 from C. glutamicum ATCC 19223, was characterized. The minimum
      region for autonomous replication was shown to be contained on a 1.9 kb BglII
      NcoI fragment; a 380 bp HindIII-SphI fragment can replicate in the presence of
      the parental plasmid, which presumably provides a trans-acting replication
      factor. Derivatives of pCG100 are able to replicate in several Corynebacterium,
      Brevibacterium and Arthrobacter strains. pCG100 is compatible with pBL1, a
      cryptic plasmid of Brevibacterium lactofermentum. Shuttle plasmid vectors,
      containing the kanamycin-resistance gene from Tn903 or from Streptococcus
      faecalis as selectable markers and the AmpR, TetR or lacZ alpha genes for
      insertional inactivation, were constructed using the minimum replication fragment
      of pCG100.

PMID- 1748867
TI  - Identification of three gene regions associated with virulence in Dichelobacter
      nodosus, the causative agent of ovine footrot.
AB  - Dichelobacter nodosus (formerly Bacteroides nodosus) is a Gram-negative strict
      anaerobe and is the primary pathogen involved in ovine footrot. A comparative
      hybridization strategy was used to isolate recombinant clones which hybridized to
      DNA from a virulent strain of D. nodosus but not with a benign isolate. Three
      virulence-associated gene regions were identified and one of these regions was
      shown to be present in multiple copies in the D. nodosus genome. Hybridization
      studies on 101 clinical isolates of D. nodosus showed that these strains could be
      divided into three hybridization categories which could be correlated with the
      virulence of the isolates. The recombinant clones have considerable potential for
      the development of a gene-probe-based method for the differential diagnosis of
      ovine footrot.

PMID- 1748868
TI  - Lysogeny in Leuconostoc oenos.
AB  - Thirty strains of Leuconostoc oenos were exposed to mitomycin C to induce
      lysogenic bacteriophages. Lysis curves typical for lysogenic strains were
      obtained with 19 strains. Indicator strans were found for 17 of these phages.
      Five were characterized by electron microscopy, lytic spectrum, molecular masses
      of the proteins, sequencing of five N-terminal amino acids of the two major
      proteins and DNA analysis (restriction patterns, cross hybridization). The
      results revealed a very close relationship between the phages. Hybridization
      experiments between the DNAs of the temperate phages and the appropriate
      lysogenic strains revealed phage-related sequences in the DNA of the lysogenic
      strain.

PMID- 1748869
TI  - Resistance of Streptomyces cinnamonensis to butyrate and isobutyrate: production
      and properties of a new anti-isobutyrate (AIB) factor.
AB  - Butyrate and isobutyrate (after isomerization to n-butyrate) are specific
      precursors for the biosynthesis of monensin A in Streptomyces cinnamonensis. High
      concentrations of both butyrate and isobutyrate (greater than 20 and 10 mM,
      respectively) were toxic to S. cinnamonensis plated on solid medium. Spontaneous
      mutants resistant to these substances were isolated. These new strains produced
      monensins at even higher concentrations of butyrate or isobutyrate, with an
      increased yield of monensin A. S. cinnamonensis produced an anti-isobutyrate
      (AIB) factor, which was originally found to be excreted by some isobutyrate
      resistant stains growing on solid medium containing isobutyrate. On plates, the
      AIB factor efficiently counteracted toxic concentrations not only of isobutyrate,
      but also of acetate, propionate, butyrate, 2-methylbutyrate, valerate and
      isovalerate against S. cinnamonensis as well as other Streptomyces species.
      Although the AIB factor enabled normal growth, sporulation and monensin
      production on plates, it did not have positive effects on submerged cultures of
      S. cinnamonensis with isobutyrate. The partial purification of the AIB factor was
      achieved. The role of the AIB factor during spore germination on solid medium
      containing isobutyrate or its homologues is discussed.

PMID- 1748870
TI  - In vitro characterization of intra-generic inhibition of growth in Salmonella
      typhimurium.
AB  - The intra-generic inhibition of bacterial growth observed previously in vivo and
      in vitro with strains of Salmonella, Citrobacter and E. coli was studied in vitro
      using S. typhimurium strain F98. There was complete inhibition of multiplication
      of S. typhimurium when it was added to stationary-phase broth cultures of
      different Salmonella serotypes, but only partial inhibition when added to broth
      cultures of E. coli. The degree of inhibition between different mutants of F98
      was affected by the numbers of bacteria of the inhibiting strain, but this was
      not the only factor, since exponential-phase bacterial cells were less inhibitory
      than stationary-phase cells. The inhibitory effect was produced at temperatures
      between 20 degrees C and 40 degrees C. The complete inhibition of growth observed
      between F98 mutants was abolished by ampicillin, rifampicin and streptomycin, but
      not by nalidixic acid. Inhibition was also prevented by separating the two
      cultures by a dialysis membrane. A TnphoA insertion mutant of F98 was produced
      which did not show inhibition in vitro but was still inhibitory in vivo. It is
      suggested that this complete inhibition of bacterial multiplication between
      organisms of the same genus, which is greater than that produced between
      organisms from different genera, is mediated by a cell surface protein.

PMID- 1748871
TI  - Synergistic action of nikkomycin X/Z with azole antifungals on Candida albicans.
AB  - Fluconazole, ketoconazole and tioconazole were shown to act synergistically in
      vitro with the antibiotic nikkomycin X/Z on the pathogenic fungus Candida
      albicans. The phenomenon was demonstrated using a checkerboard technique and
      growth inhibition experiments. The azole antifungal agents, even at
      concentrations not affecting growth, decreased the incorporation of the 14C-label
      from [14C]glucose into chitin of the candidal cell wall. After 3 h incubation
      with tioconazole, 1 microgram ml-1, the incorporation of the radiolabelled
      glucose into chitin of intact cells and regenerating spheroplasts of C. albicans
      was inhibited by 43% and 30%, respectively. Moreover, the relative chitin content
      was approximately 45% lower than that of control cells. The chitin content
      increased after prolonged incubation with azoles, thus confirming the known
      phenomenon of azole-induced uncoordinated chitin synthesis and deposition. On the
      other hand, azole derivatives had very little effect on the rate of nikkomycin
      transport into C. albicans cells. A sequential blockade mechanism of synergism is
      proposed.

PMID- 1748872
TI  - Regulation of chitinase synthesis in Trichoderma harzianum.
AB  - The production of chitinase by Trichoderma species is of interest in relation to
      their use in biocontrol and as a source of mycolytic enzymes. Fourteen isolates
      of the genus were screened to identify the most effective producer of chitinase.
      The best strain for chitinase was Trichoderma harzianum 39.1, and this was
      selected for study of the regulation of enzyme synthesis. Washed mycelium of T.
      harzianum 39.1 was incubated with a range of carbon sources. Chitinase synthesis
      was induced on chitin-containing medium, but repressed by glucose and N
      acetylglucosamine. Production of the enzyme was optimal at a chitin concentration
      of 0.5%, at 28 degrees C, pH 6.0 and was independent of the age of the mycelium.
      The synthesis of chitinase was blocked by both 8-hydroxyquinoline and
      cycloheximide, inhibitors of RNA and protein synthesis, respectively. The mode of
      chitinase synthesis in this fungus is discussed.

PMID- 1748873
TI  - Defective mycolic acid biosynthesis in a mutant of Mycobacterium smegmatis.
AB  - A mutant of Mycobacterium smegmatis defective in mycolic acid biosynthesis was
      isolated following chemical mutagenesis. Fatty acids were extracted from the
      mutant and subjected to structural analysis by thin-layer chromatography and high
      performance liquid chromatography (HPLC) of both methyl and p-bromophenacyl ester
      derivatives. Thin-layer chromatography did not show the presence of any fatty
      acid of RF comparable to that of standard methyl mycolate. The HPLC profile
      revealed a broad peak in the standard mycolic acid ester region. No
      characteristic peaks of mycolic acid esters comparable to the wild-type could be
      resolved. Mass spectral analysis of the HPLC-purified peak demonstrated the
      presence of shorter-chain fatty acids in the mutant. These data support the idea
      that the mutant accumulates precursors of mycolic acids and is incapable of
      carrying out the final conversion to mycolic acids of 60-90 carbon atoms.

PMID- 1748874
TI  - Physiological regulation and optimization of lipase activity in Pseudomonas
      aeruginosa EF2.
AB  - Physiological regulation of extracellular lipase activity by a newly-isolated,
      thermotolerant strain of Pseudomonas aeruginosa (strain EF2) was investigated by
      growing the organism under various conditions in batch, fed-batch and continuous
      culture. Lipase activity, measured as the rate of olive oil (predominantly
      triolein) hydrolysis, was weakly induced by general carbon and/or energy
      limitation, strongly induced by a wide range of fatty acyl esters including
      triglycerides, Spans and Tweens, and repressed by long-chain fatty acids
      including oleic acid. The highest lipase activities were observed during the
      stationary phase of batch cultures grown on Tween 80, and with Tween 80-limited
      fed-batch and continuous cultures grown at low specific growth rates. The lipase
      activity of Tween 80-limited continuous cultures was optimized with respect to pH
      and temperature using response surface analysis; maximum activity occurred during
      growth at pH 6.5, 35.5 degrees C, at a dilution rate of 0.04 h-1. Under these
      conditions the culture exhibited a lipase activity of 39 LU (mg cells)-1 and a
      specific rate of lipase production (qLipase) of 1.56 LU (mg cells)-1 h-1 (1 LU
      equalled 1 mumol fatty acid released min-1). Esterase activity, measured with p
      nitrophenyl acetate as substrate, varied approximately in parallel with lipase
      activity under all growth conditions, suggesting that a single enzyme may
      catalyse both activities.

PMID- 1748875
TI  - Purification and properties of extracellular lipase from Pseudomonas aeruginosa
      EF2.
AB  - Extracellular lipase was purified from a Tween 80-limited continuous culture of
      Pseudomonas aeruginosa EF2 by ultrafiltration of the culture supernatant followed
      by anion-exchange and gel-filtration FPLC. The lipase was composed of a single
      subunit (Mr 29,000, pI 4.9), which was capable of a variable degree of
      aggregation, and which exhibited both lipase activity, measured with the
      insoluble substrate olive oil (predominantly triolein), and esterase activity,
      measured with the soluble substrates p-nitrophenyl acetate and Tween 80. Lipase
      activity was approximately eight times higher than either type of esterase
      activity (kcat approximately 3000 s-1 for the hydrolysis of olive oil). The
      enzyme showed a marked regiospecificity for the 1,3-oleyl residues of
      radiolabelled triolein, was relatively stable at moderate temperatures
      (exhibiting a biphasic loss of activity with an initial t1/2 of 17.5 min at 60
      degrees C) and was very stable to freezing and thawing. Lipase activity was only
      weakly inhibited by the serine-active reagent 3,4-dichloroisocoumarin, and was
      not inhibited by the chelating agent EDTA (1 mM). The N-terminal amino acid
      sequence of the Ps. aeruginosa EF2 lipase showed a marked similarity to those of
      several other bacterial lipases.

PMID- 1748876
TI  - Molecular genetics of Pseudomonas syringae pathovar pisi: plasmid involvement in
      cultivar-specific incompatibility.
AB  - A mutant (PF24) of the race 1 strain, 299A, of Pseudomonas syringae pv. pisi has
      been characterized in terms of its interactions with pea (Pisum sativum)
      cultivars. The mutant showed a changed reaction (avirulence to virulence) with a
      group of pea cultivars, including cvs. Belinda and Puget, previously thought to
      contain resistance genes R1 and R3. Avirulence towards cv. Puget was restored by
      transfer of any one of five cosmid clones from a race 3 (strain 870A) gene
      library to a rifampicin-resistant derivative of PF24. These observations were in
      agreement with a revised race-specific resistance genotype for Belinda and
      similar cultivars comprising a single resistance gene, R3. An incompatible
      interaction was observed between strain PF24 and cvs. Vinco (postulated to
      harbour race-specific resistance genes R1, R2, R3 and R5) and Hurst's Greenshaft
      (R4 and possibly R1), indicating that the mutant retains at least one avirulence
      gene (A1 or A1 and A4). Mutant PF24 showed loss of a cryptic plasmid (pAV212)
      compared with its progenitor, strain 299A. A subclone (pAV233) of one of the race
      3 restoration clones showed strong hybridization with similar-sized digestion
      fragments in race 3 plasmid DNA, confirming the A3 gene to be plasmid-borne.
      Strong cross-hybridization was also observed with a single 3.27 kb EcoRI fragment
      of plasmid DNA present in strain 299A but absent from strain PF24. This is
      consistent with the corresponding A3 determinant being located on pAV212 in the
      race 1 strain 299A. The novel avirulence gene corresponding to A3 in strain 870A
      is provisionally designated avrPpi3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1748877
TI  - A survey of peptidase activity in rumen bacteria.
AB  - Twenty-nine strains of 14 species of rumen bacteria were screened for their
      ability to hydrolyse Ala2, Ala5, GlyArg-4-methoxy-2-naphthylamide (GlyArg-MNA)
      and Leu-MNA. Several species, notably Megasphaera elsdenii, were active against
      Ala2, and a smaller number, including Bacteroides ruminicola, Butyrivibrio
      fibrisolvens, Ruminococcus flavefaciens, Lachnospira multipara and Ruminobacter
      amylophilus, broke down Ala5. Streptococcus bovis had an exceptionally high
      leucine arylamidase activity. However, only Ba. ruminicola hydrolysed GlyArg-MNA.
      Further investigation revealed that only Ba. ruminicola and Bu. fibrisolvens
      hydrolysed Ala5 to Ala3 and Ala2, with little ALa4 being produced, in a manner
      similar to rumen fluid. The activity of Ba. ruminicola against synthetic
      peptidase substrates, including GlyArg-MNA, LysAla-MNA, ArgArg-MNA, GlyPro-MNA,
      LeuVal-MNA, and Ala3-p-nitroanilide, was similar to that of rumen fluid, whereas
      the activity of Bu. fibrisolvens was quite different. Since the main mechanism by
      which peptides are broken down in the rumen is similar to dipeptidyl
      aminopeptidase type I, for which GlyArg-MNA is a diagnostic substrate, it was
      concluded that Ba. ruminicola was the most important single species in peptide
      breakdown in the rumen.

PMID- 1748878
TI  - Relationship of Wallerian degeneration to regrowing axons.
AB  - Because Wallerian degeneration constitutes a highly significant and unavoidable
      position in the sequence of nervous system regeneration we have extended our
      observations regarding this process as it occurs in our cryogenic model of spinal
      cord injury in the rat. In previous studies we have observed essentially no
      growth into the Wallerian zone despite a significant amount of axonal regrowth
      through the injured region. In the present study we have examined by electron
      microscopy the Wallerian degeneration and its interface with the axons from the
      injured region. In the Wallerian region our observations have not only confirmed
      those of many previous investigators but have suggested an orderly sequence of
      changes during the first 60 days post-injury, beginning with relative tissue
      preservation followed by depletion of degenerating axoplasm, extracellular
      deposition of myelin and the development of a cellular reaction. Associated with
      the cellular reaction is the development of large astrocytic cells which can be
      found adjacent to unmyelinated and thinly myelinated axons. With this limited
      evidence of support for axonal growth in the Wallerian zone it is suggested that
      further expansion of this cellular matrix should provide significant support to
      regrowing axons.

PMID- 1748879
TI  - Transperineurial arterioles in human sural nerve.
AB  - The perineurial sheath of nerve fascicles is a protective cellular layer that
      separates the endoneurium from the epineurium. Transperineurial arterioles (TPA)
      connect the endoneurial capillary plexuses to the epineurial arterial nutrient
      supply. Transperineurial arterioles are defined as any arteriole that is confined
      to a perineurial cell compartment, which would include all arterioles within the
      perineurium proper or within perineurial sleeves in the epi- or endoneurium. In
      this study of biopsied human sural nerves, three-dimensional reconstruction of
      one micron sections and ultrastructural analysis of step serials, we find that
      TPA are confined in open-ended perineurial sleeves by which they pass from the
      epineurium through the perineurial sheath proper into the endoneurium. Most TPA
      are terminal arterioles as evidenced by size (10-25 microns), morphological
      characteristics, and the fact that they connect with capillaries.
      Transperineurial arterioles gradually lose their continuous muscle coat and
      become post-arteriolar capillaries (PAC). Vascular segments that emerge into the
      endoneurium from the perineurial sleeves are generally of the PAC variety.
      Transperineurial arterioles and post-arteriolar capillaries are often associated
      with a plexus of unmyelinated nerve fibers. Axon varicosities exhibit a variety
      of morphologically distinct vesicles including dense-cored and a diversity of
      agranular vesicles. These findings suggest that TPA play a role in the neurogenic
      control of endoneurial blood flow.

PMID- 1748880
TI  - Restoration of blood-nerve barrier in neuropathy is associated with axonal
      regeneration and remyelination.
AB  - We investigated the temporal course of blood-nerve barrier (BNB) breakdown during
      the evolution of tellurium neuropathy, ricin neuropathy, and Wallerian
      degeneration following nerve transection or nerve crush. Blood-nerve barrier
      permeability was assessed with a 4,000-molecular weight fluoresceinated dextran
      from three days to 19 weeks after onset of neuropathy. Blood-nerve barrier
      breakdown was present during the first two weeks in all four models of
      neuropathy. Restoration of the BNB to the dextran began within four weeks and was
      complete by 14 weeks in tellurium neuropathy, a model of demyelinating neuropathy
      characterized by rapid remyelination, and after nerve crush, a model of Wallerian
      degeneration characterized by rapid axonal regeneration into distal stump. In
      contrast, there was persistence of BNB breakdown beyond 14 weeks in ricin
      neuropathy, a model of neuropathy with no axonal regeneration or remyelination,
      and after nerve transection, a model of Wallerian degeneration characterized by
      minimal axonal regeneration into distal stump. We conclude from these data that
      alterations in the BNB over the course of neuropathy differ among various types
      of neuropathy, and that these alterations are dependent on the form of nerve
      fiber injury. The lack of regenerating or remyelinating axons in ricin neuropathy
      and after nerve transection may be responsible for the persistent BNB breakdown
      found in these neuropathies.

PMID- 1748881
TI  - The neuropathologic basis of different clinical subgroups of Parkinson's disease.
AB  - Clinical and neuropathologic data in 45 patients with Parkinson's disease (PD)
      were compared. Twenty-seven patients suffered from marked akinesia and rigidity
      (AR-type) and 18 patients from predominant resting tremor (T-type). Dementia,
      depression, and psychosis occurred in 26, 18, and 18 patients, respectively.
      Neuronal counts were performed in defined areas of the medial and lateral
      substantia nigra (SNM, SNL), locus ceruleus (LC), and dorsal raphe nucleus (DRN).
      The AR-type (compared with the T-type) showed higher neuronal loss of LC, SNL,
      SNM, and more severe gliosis, extraneuronal melanin deposits, and neuroaxonal
      dystrophy in substantia nigra. Demented PD patients showed more intense cortical
      Alzheimer lesions and higher neuronal depletion in the SNM, whereas PD subjects
      with moderate or marked dementia differed from mildly or not demented ones only
      in the higher degree of cortical Alzheimer lesions. More severe neuronal cell
      loss of DRN was observed in PD patients with depression. Occurrence of psychosis
      was not associated with any pathologic feature. Our findings indicate that some
      major clinical features of PD are related to distinct neuropathologic lesions.

PMID- 1748882
TI  - Occurrence of lacto series gangliosides 3'-isoLM1 and 3',6'-isoLD1 in human
      gliomas in vitro and in vivo.
AB  - Monoclonal antibodies (MAb; DMAb, monoclonal antibodies derived at Duke Medical
      Center) directed against the oncofetally expressed lactotetraosyl gangliosides 3'
      isoLM1 (IV3NeuAc-LcOse4Cer) and 3',6'-isoLD1 (IV3NeuAc,III6NeuAc-LcOse4Cer) were
      produced and their reactivity spectra compared to that of the alpha-3'-isoLM1 MAb
      SL-50. The IgM MAb SL-50 defines the epitope NeuAc (or NeuGc)alpha 2-3Gal beta 1
      3GlcNAc, the terminal sequence of both gangliosides. SL-50 requires an
      unsubstituted GlcNAc residue; IgM DMAb-14 will accept the alpha 2-6 linked sialic
      acid to GlcNAc found in 3',6'-isoLD1. Immunohistochemical localization of 3'
      isoLM1 was performed on 31 biopsy specimens of human gliomas; 15 (48%) expressed
      3'-isoLM1 as defined by binding of MAb SL-50. Staining of small anaplastic cells,
      giant cells, and the glial component of gliosarcomas was observed. Neoplastic
      gemistocytes, when present, showed particularly intense staining. The 3'-isoLM1
      and 3',6'-isoLD1 distribution in cultured cell lines and derived xenografts of
      primary tumors of the human central nervous system and of embryonal or
      neuroectodermal tumor derivation was determined. Six of 29 cell lines expressed
      3'-isoLM1: 2/16 gliomas, 3/3 teratomas, 1/1 pancreatic adenocarcinoma. No cell
      line expressed detectable 3',6'-isoLD1 by immunostain analysis of ganglioside
      extracts. The 3'-iso-LM1-positive cell lines expressed it in xenograft form; in
      five xenografts, the corresponding cell lines of which were 3'-isoLM1-negative,
      it was a proportion of the monosialoganglioside fraction. 3',6'-isoLD1 was
      detected in two xenografts, D-54 MG (glioma) and PA-1 (teratoma). The
      demonstration of 3'-isoLM1 in gliomas in in vivo forms and the relatively
      infrequent expression by derived cultured cells suggest that ganglioside
      expression is modified by environmental forces. Expression of 3'-isoLM1 and 3',6'
      isoLD1 in fetal and neonatal brain, in intense reactive astrocytosis such as
      polyunsaturated fatty acid lipidosis, and in primary neoplasms of the central
      nervous system suggests their role in cell-cell attachment during development,
      migration, and neoplastic transformation.

PMID- 1748883
TI  - Localization of the CD44 glycoprotein to fibrous astrocytes in normal white
      matter and to reactive astrocytes in active lesions in multiple sclerosis.
AB  - The CD44 antigen is a proteoglycan recently implicated in several adhesion events
      including that of lymphocytes to endothelium. The CD44 antigen, reactive with
      monoclonal antibody (MAb) 44D10, has been shown previously to be expressed in
      normal human white matter homogenates and to be found at higher concentrations in
      brain homogenates of victims of multiple sclerosis (MS). The cellular
      localization of CD44 in human brain of normal individuals and in those afflicted
      with MS has now been determined. Monoclonal antibody 44D10 reacted with astrocyte
      like cells in 40 microns thick paraformaldehyde-fixed sections but not in thin (6
      microns) fixed sections. A double labeling experiment performed on a frozen brain
      section with MAb 44D10 and rabbit anti-glial fibrillary acidic protein (GFAP), a
      cytoplasmic marker of astrocytes, confirmed the co-localization of these two
      antigens. The reactivity with brain tissue sections of a rabbit antiserum
      produced against lymphocyte-CD44 could be absorbed by a preparation of the CD44
      glycoprotein, purified 2,100-fold from a white matter homogenate. The antiserum
      was shown by Western blot analysis to be specific for p80 glycoprotein in brain
      extracts derived from a normal and MS patients. This antibody reacted with
      fibrous astrocytes predominantly in white matter; staining was also noted in
      subependymal and subpial regions. Inhibition studies using a cellular
      radioimmunoassay indicated that the highest concentrations of CD44 in three MS
      victims were found in plaques, followed by periplaques and non-involved areas of
      white matter which were higher than normal white matter. Reactive astrocytes,
      identified in active lesions, expressed high levels of CD44 on their surfaces.
      Thus, CD44 is associated with astrocytes in human brain and the increased
      expression observed in MS brain may reflect activation and/or proliferation of
      astrocytes implicated in the pathogenesis of this disease.

PMID- 1748884
TI  - Periodontal health status and treatment needs for index age groups in Turkey
      based on CPITN values.
AB  - A national oral health pathfinder survey has been conducted by our research team
      in Turkey, in collaboration with the WHO European Region. Some of the data
      obtained by this survey were for CPITN values for age groups above 10 years, and
      can be summarized as follows: formula: (see text) These findings demonstrate that
      preventive periodontal therapy and community-based prophylaxis methods, will
      undoubtedly be of prime importance in future nationwide dental health service
      planning in Turkey.

PMID- 1748885
TI  - Long-term evaluation of surgical periodontal treatment with and without
      maintenance care.
AB  - A study was conducted on the effectiveness of individual maintenance recalls and
      the long-term effects of surgical therapy on pocket depth and tooth loss in 43
      patients with moderate to advanced periodontal disease. Sixteen of the patients
      had periodic control and 27 were uncontrolled. Intervals of periodic recall
      ranged from 3 to 6 months according to individual needs. Pocket depths were
      measured from four aspects of each tooth and initially classified as shallow (1-3
      mm), moderate (4-6 mm) or deep (7 mm or more). Changes in each pocket depth level
      were determined after 10 years. Tenth-year comparisons showed that the
      uncontrolled group had significantly higher mean pocket depth values. Tooth loss
      rate was 3.6% in the controlled group, and 14.1% in the uncontrolled group, and
      the mean numbers of lost teeth were 0.69 and 3.63, respectively, in the ten-year
      period. It was concluded that periodic recalls were essential for long-term
      success of periodontal surgery.

PMID- 1748886
TI  - A cephalometric study of changes in point A under the influence of upper incisor
      inclinations.
AB  - Today the ANB angle is commonly used for defining the anteroposterior apical base
      relationships of the jaws. The factors that influence the ANB angle have been
      studied by various investigators. The axial inclination of the maxillary central
      teeth is one of the factors influencing the location of point A. In this study
      the relationship between the axial inclination of the upper central incisor and
      the location of point A was studied. Four criteria that define the location of
      the maxillary central teeth were used: I (incisal point), Ap (apical point), R
      (rotation point), and I-SN (angle between I and SN plane). A significant positive
      correlation was found between the location of points A and R. We also calculated
      a regression equation for this relationship.

PMID- 1748887
TI  - Pathological study of the hyperplastic dental follicle.
AB  - Eleven specimens of hyperplastic dental follicles were studied
      clinicopathologically, with reference to the patient's sex and age at the time of
      diagnosis, site of the lesions, and histopathology. The patients comprised 6
      males and 5 females with an average age of 15.7 years (range 10 to 23 years). Two
      cases involved multiple lesions, and 9 a single lesion. The lesions were related
      to impaction of the canine, second premolar, second molar or third molar.
      Radiographically, the lesions showed various degrees of radiolucency around the
      crown of the impacted tooth. Most of the cases were diagnosed clinically as
      dentigerous cyst. The histopathological features of the lesions were similar to
      those of normal dental follicular tissue around the developing tooth. No tumorous
      features such as odontogenic fibroma, odontogenic myxoma or myxofibroma were
      evident in the lesions.

PMID- 1748888
TI  - Gingival hyperplasia induced by nifedipine.
AB  - We describe 4 cases of gingival hyperplasia induced by nifedipine, together with
      clinical and histological findings. Hyperplasia of the interdental papillae was
      observed in all cases. Histologic examination showed multilayered epithelial
      parakeratosis with variations in the width, proliferation, reticulation and
      elongation of the rete pegs. Substitution of another drug and improvement of oral
      hygiene led to reduction of the gingival overgrowth without gingivectomy. These
      treatments are essential for gingival hyperplasia induced by nifedipine.

PMID- 1748889
TI  - Broadening our perspectives.

PMID- 1748890
TI  - Assessing career commitment. The role of staff development.
AB  - Staff development and inservice educators may be called on to respond to their
      organizations' need to recruit and retain nurses. One important role is to
      promote professional commitment and loyalty. This article describes the Gardner
      Career Commitment Scale as a tool for use in human resources management and
      decision making to assess career commitment.

PMID- 1748891
TI  - Patient controlled analgesia in pediatrics.
AB  - Patient controlled analgesia is a new, upcoming method of managing pain in the
      pediatric population. Introducing it to the nursing division of a children's
      hospital requires that the nursing staff development educator assess, plan,
      implement, and evaluate its method of introduction and use. The educator must
      involve multidisciplinary team members to facilitate this change.

PMID- 1748892
TI  - Fostering decision making in nursing.
AB  - Health care organizations have focused on external nursing recruitment incentives
      such as improved pay scales, greater bonuses, and flexible scheduling.
      Frequently, they have failed to take into account a fundamental source of
      professional satisfaction: the opportunity to make decisions. It is important for
      nurse managers, nurse educators, and clinical nurse specialists to understand the
      anatomy of the decision-making process, which includes gathering patient data,
      recalling possible nursing diagnoses and interventions, analyzing, synthesizing,
      making judgments, and implementing, following through, and evaluating the
      intervention. More decision making will put more fulfillment into the role of the
      professional nurse.

PMID- 1748893
TI  - Nurses' views on sexuality. Why, what, and how to change.
AB  - What practicing professional nurses believe about the sexual functioning of their
      patients has a direct influence on the patients' psychological well being. A
      preliminary investigation identifying some of nurses' beliefs demonstrated their
      attitudes and knowledge about the effects of chronic disease on sexuality. Staff
      development educators can assist nursing staff to change attitudes and improve
      knowledge through an educational program outlined in this article.

PMID- 1748894
TI  - Assisting nursing staff to learn and conduct research. An interinstitutional
      approach.
AB  - This article describes a resource sharing and collaborative interinstitutional
      project designed to assist the nursing staff of three hospitals to gain expertise
      in research and to promote collaborative research endeavors. Information is
      provided that will help staff development educators complete a similar project
      with a group of staff nurses.

PMID- 1748895
TI  - Enhancing verbal communication skills and promoting effective socialization of
      newly hired Spanish-speaking registered nurses.
AB  - Eight Spanish-speaking registered nurses from Puerto Rico were hired at the
      Veterans Affairs Medical Center, Washington, DC. Verbal communication with
      patients and staff was difficult for these highly skilled, competent nurses. This
      article describes a program to improve English language skills provided for the
      orientees. Such a program can assist staff development educators to attract well
      qualified, professionally satisfied staff nurses during acute shortages in
      hospital settings.

PMID- 1748896
TI  - Evaluating educational materials for patients.

PMID- 1748897
TI  - AIDS Train-the-Trainer Programs work.

PMID- 1748898
TI  - Program outcome evaluation.

PMID- 1748899
TI  - The fine structure of the testis, Part I.

PMID- 1748900
TI  - Testicular differentiation in mammals under normal and experimental conditions.
AB  - Gonadal differentiation begins with the establishment of a sexually
      undifferentiated gonad, in which gonadal cords are formed by condensation of
      somatic cells and deposition of basal laminar components around the cluster of
      epithelial-like cells. The first event of sexual differentiation is the invasion
      of mesenchymal and endothelial cells into the genital ridge in the XY gonad. As a
      consequence of this event, the gonadal cords become conspicuous, recognized as
      seminiferous cords (or testis cords). Cytological differentiation of Sertoli
      cells follows these stromal changes. In the XX gonad, by contrast, the invasion
      of the mesenchyme is absent and gonadal cords remain associated with the surface
      epithelium. In the B6.YDOM XY ovotestis, seminiferous cords and ovarian gonadal
      cords are often enveloped by common basal laminae, confirming that both
      structures share the embryonic origin. It has been recently reported that
      seminiferous-like cords are formed after loss of oocytes in the rat XX ovary
      cultured in the presence of Mullerian inhibiting substance or after long-term
      culture in the basic medium alone. These results are comparable with our
      observation on the persistent gonadal cords in the ovary of busulphan-treated
      rats or W/WV mutant mice, in which oogonia are absent or scarce. Ultrastructural
      evidence for Sertoli cell differentiation from XX cells has been presented, so
      far, only in the fetal mouse ovary that has been grafted beneath the kidney
      capsule of adult male mice. Possible mechanism of gonadal sex determination is
      discussed based on these morphological studies.

PMID- 1748901
TI  - Sertoli cells and testicular differentiation in the rat fetus.
AB  - The fetal testis is not merely a precursor of the adult organ: it is indeed an
      endocrine gland whose function is the masculinization of the fetus. It differs
      physiologically and morphologically from the adult testis. In this paper, the
      first stages of testicular differentiation in the rat are described, with special
      emphasis on the ultrastructural aspects. At the stage of 13.5 days after
      fertilization, the first Sertoli cells differentiate; they are characterized by a
      voluminous and little electron dense cytoplasm, a well-developed RER formed by
      vesicles and short cisternae filled with a flocculent material. Progressively,
      they polarize and adhere to one another by adherens-like junctions and
      cytoplasmic interdigitations to form the differentiating seminiferous cords. In
      the basal part of the Sertoli cells, a mat of microfilaments differentiates under
      the plasmalemma, while cytoplasmic blebs protruding in the extracellular space
      tend to disappear. A continuous basal lamina delineating the seminiferous cords
      begins to appear on day 14.5 and becomes widespread on day 15.5. These
      observations, when compared with other data from the literature, emphasize the
      fact that the differentiation of the Sertoli cells is the first morphological
      event during testicular differentiation. A possible role of the Sertoli cells in
      the subsequent organogenesis of the testis is suggested.

PMID- 1748902
TI  - High-resolution scanning electron micrographs of freeze-cracked cells in testes
      from normal and irradiated rats at different stages of gonadal development.
AB  - Newly developed techniques in high-resolution scanning electron microscopy (SEM)
      and for tissue-processing procedures have been applied to an investigation of
      structures of various cells in rat testes at different stages of gonadal
      maturation. A series of high-resolution SEM micrographs are presented which
      survey the surfaces of different types of testis cells during normal development,
      and which also illustrate ultrastructural features of some of their intracellular
      organelles. In addition, a series of high-resolution SEM micrographs are
      presented which compare the structural features of Sertoli cells in normal testes
      with those in germ-cell-depleted testes obtained from rats killed at varying
      times after having been irradiated in utero. We describe our observations on the
      structural properties of surfaces and intracellular organelles in Sertoli cells,
      Leydig cells, peritubular myoid cells, and some classes of germinal cells. We
      also consider the possible role of Sertoli cell apical cytoplasmic processes in
      lumen formation. Similarities are pointed out between the structure of germ-cell
      depleted testes, resulting from irradiation in utero, and the structure of germ
      cell-depleted testes in seasonal breeders during periods of involution. Finally,
      we discuss advantages and disadvantages of methods employed to reveal the fine
      structure of intracellular organelles in cells of the testis.

PMID- 1748903
TI  - Ultrastructure of the seminiferous epithelium and intertubular tissue of the
      human testis.
AB  - The ultrastructural features of the human testis are reviewed with emphasis upon
      the process of spermatogenesis and the cytology of the Leydig cells. The
      seminiferous epithelium is structurally partitioned by the Sertoli cells into
      basal and adluminal compartments via the specialized tight junctions between the
      Sertoli cells. Spermatogonia reside in the basal compartment, and, via a series
      of cell divisions, produce the primary spermatocytes, which at the commencement
      of their development move into the adluminal compartment, and thus the lengthy
      process of meiotic maturation is initiated. The fine structure of primary
      spermatocytes is described together with the complex transformation of the
      spermatids into spermatozoa during the process of spermiogenesis. Earlier studies
      of the organization of the human seminiferous epithelium showed that germ cells
      at different developmental stages formed identifiable collections termed cell
      associations or stages, but since several stages were seen in a single tubule
      cross-section, this gave the impression of an extremely irregular pattern of
      spermatogenic development. When the topographic arrangement of germ cells was re
      examined with the aid of computer modelling, a highly ordered distribution was
      revealed, conforming to a helical pattern based on the geometry of spirals. Thus
      spermatogenesis in the human testis is subjected to a precise regulation in
      keeping with the ordered arrangement of the germ cells seen in other mammalian
      species. The intertubular tissue of the human testis is composed of loose
      connective tissue containing blood vessels, occasional lymph capillaries,
      macrophages, mast cells, and the Leydig cells which occur either as single cells
      or form small clusters. The Leydig cell cytoplasm contains an abundant supply of
      smooth endoplasmic reticulum and mitochondria with tubular cristae, both features
      being characteristic of steroidogenic cells. Human Leydig cells contain large
      Reinke crystalloids of variable size and number, but their function remains
      obscure. The frequent occurrence of paracrystalline inclusions within the
      cytoplasm of the human Leydig cell suggests that these elements are precursors of
      the Reinke crystalloids.

PMID- 1748904
TI  - Ultrastructure of the aging human testis.
AB  - The ultrastructure of the progressive testicular involution with advancing age in
      men is reviewed. There is no definite age at which testicular involution begins,
      and the onset and severity of testicular lesions are subjected to pronounced
      individual variations. Hormone studies also indicate great individual variations,
      and subtle changes in both the testis and the pituitary develop progressively
      with age. Testicular size, sperm quality, and numbers of all germ cell types,
      Sertoli cells, and Leydig cells decrease with age. The volume occupied by the
      seminiferous tubules decreases, whereas that occupied by the testicular
      interstitium remains constant. The most frequent histological pattern of the
      aging testis is a mosaic of different seminiferous tubule lesions, varying from
      tubules with complete, although reduced, spermatogenesis, to completely sclerosed
      tubules. The tubules with complete spermatogenesis may show numerous
      morphological abnormalities in the germ cells, including multinucleation.
      Abnormal germ cells degenerate causing Sertoli cell vacuolation. These vacuoles
      correspond to dilations of the extracellular spaces resulting from the premature
      exfoliation of germ cells. Degenerating cells that are phagocytosed by the
      Sertoli cells give rise to an accumulation of lipid droplets in the Sertoli cell
      cytoplasm. The loss of germ cells begins with the spermatids, but progressively
      affects the earlier germ cell types, and tubules with maturation arrest at the
      level of the spermatocytes or spermatogonia are observed. The Sertoli cells show
      morphological abnormalities such as dedifferentiation, mitochondrial metaplasia,
      and multinucleation. Germ cell loss is associated with thickening of the tunica
      propria. When all seminiferous epithelial cells have disappeared, only an
      intensely collagenized tunica propria with myoid cells remains (sclerosed
      tubules). The Leydig cells progressively dedifferentiate with a decrease in the
      quantity of both smooth endoplasmic reticulum and mitochondria, together with an
      accumulation of lipid droplets, crystalline inclusions, and residual bodies, and
      formation of multinucleate cells. The development of tubular involution with age
      is similar to that observed after experimental ischemia, suggesting that vascular
      lesions may play an important role in age-related testicular atrophy.

PMID- 1748905
TI  - Homogeneous embedding for orientated monolayer cell cultures.

PMID- 1748906
TI  - Nursing observations of central venous catheters. The effect on patient outcome.
AB  - The purpose of this descriptive study was to obtain information concerning rates
      of intravascular infection in patients with central lines and to identify the
      variables related to nursing care of these lines that may influence the
      development of systemic infection. The study was conducted at a large southern
      teaching hospital during a 6-week period. The sample for this study consisted of
      adult inpatients who underwent central-line insertions. The results suggested
      that careful nursing observations, combined with early recognition and
      intervention, can significantly influence a positive patient outcome.

PMID- 1748907
TI  - Clinical evaluation of Per Q Cath for both pediatric and adult home infusion
      therapy.
AB  - The use of a single-lumen silastic percutaneous catheter, Per Q Cath, in home
      pediatric and adult cases was evaluated among 54 patients. Sixty-one catheters
      were successfully placed in 54 home infusion patients. No patient demonstrated
      systemic signs of infection or sepsis. Five catheters were removed because of
      local phlebitis and four because of clotting. Per Q Cath provided long-term I.V.
      access without the trauma and expense of inserting a central venous catheter.

PMID- 1748908
TI  - Lower incidence of peripheral catheter complications by the use of elastomeric
      hydrogel catheters in home intravenous therapy patients.
AB  - A prospective study was conducted to compare the performance of a nonconventional
      short peripheral catheter made of elastomeric hydrogel material with that of the
      conventional short peripheral catheters used to administer intravenous therapy to
      patients before this study was undertaken. The catheters were inserted in home
      care patients, primarily diagnosed with Lyme disease, for the delivery of I.V.
      antibiotic therapy. The study results showed that the institutional 48-to-72-hour
      removal policy for conventional catheters is not practical for the elastomeric
      hydrogel test catheter. However, this policy indeed appears appropriate for
      conventional catheters because one half (50%) of the control catheters in this
      study and in other published studies failed within 72 hours compared with only
      19% of the test catheters. This demonstrates that catheter material significantly
      affects catheter performance because the nonconventional catheters could be kept
      in place more than twice as long before causing the complication rates seen with
      the conventional control catheters at 3 days of dwell.

PMID- 1748909
TI  - Thrombotic thrombocytopenic purpura.
AB  - Thrombotic thrombocytopenic purpura (TTP) is an uncommon disorder that was
      considered a fatal disease until the early 1960s. This syndrome is complex and
      controversial. It has been characterized by thrombocytopenic purpura, hemolytic
      anemia, neurologic symptoms, renal disease, and fever. The causative factor
      appears to be an increase of a platelet-aggregating factor or a deficiency in
      some platelet-aggregation inhibitor. The disease process seen is usually caused
      by endothelial damage mediated by a variety of stimuli. This endothelial damage
      then results in the formation of microscopic thrombi composed primarily of
      platelets and found in the small blood vessels of many organs. TTP can occur in
      any age group but is most often seen in patients 30 to 50 years of age. It is a
      very serious and potentially fatal acute disorder, but greater than 50% of the
      patients with this syndrome will have long-lasting remission if proper therapy is
      initiated and maintained. This article presents clinical findings and symptoms,
      methods of diagnosis, and appropriate therapeutic interventions for this
      disorder.

PMID- 1748910
TI  - State boards of nursing and issues of advanced practice.
AB  - Technological advances in today's health care arena and the evolution of the
      nursing profession have resulted in many questions about scope-of-practice
      issues. These questions are of a legal nature and frequently must be addressed by
      the board of nursing in each state. The results of a survey of all state boards
      of nursing are discussed along with recommendations for the preparation needed to
      approach a state board of nursing.

PMID- 1748911
TI  - Recent comparison of catheters makes unsubstantiated conclusions.

PMID- 1748912
TI  - A comparative study--manual versus computerized automated drug delivery systems.
AB  - In this study, single-channel manual pumps were compared with multiple-channel
      computerized pumps with respect to specific nursing and pharmacy procedures. The
      nursing procedures include all the steps involved in taking care of a central
      line catheter, from verifying physician's orders, performing line changes,
      administering intermittent medications, and documenting fluids and medication
      infusions. The pharmacy procedures included assembling and priming the infusion
      sets. Nurses and pharmacy technicians were observed performing these functions,
      and a total of 358 timed observations were obtained. The data revealed a greater
      time savings with the computerized multiple-channel system when complex
      intravenous therapy is necessary.

PMID- 1748913
TI  - Filtering out the confusion about leukocyte-poor blood components.
AB  - During the past decade, intensive investigation into the adverse clinical
      potential of leukocytes in red cell and platelet products has been undertaken.
      Clinical data indicated several benefits associated with the delivery of
      leukocyte-depleted blood products. These benefits include a reduction in
      nonhemolytic febrile transfusion reactions, human leukocyte antigen
      alloimmunization, and viral transmission. In response to such findings, several
      procedures and devices have been designed to remove leukocytes from blood
      components.

PMID- 1748914
TI  - Nursing perspectives on intraperitoneal chemotherapy.
AB  - During the past decade, a number of studies have established that there is a
      considerable pharmacologic advantage to direct intraperitoneal instillation of
      chemotherapy for treatment of cancer confined to the abdominal cavity. This
      article explores the history, present status, and future directions of
      intraperitoneal chemotherapy. The therapeutic advantages, various
      chemotherapeutic agents used, delivery systems, administration procedures, toxic
      effects, and nursing management are addressed.

PMID- 1748915
TI  - The immune system and intravenous administration of immune globulin. Part I, The
      immune system.
AB  - Interest in the immune response has greatly increased, mostly because of the
      discovery of the AIDS virus. An understanding of the basic function of the normal
      human immune system is vital knowledge for today's nurse. Part 1 of this article
      describes normal immune response as well as abnormal immune system function, and
      correlates this information with the clinical picture of the patient.

PMID- 1748916
TI  - Bar code systems justify staffing for i.v. teams.
AB  - This article concerns the implementation of a bar code system in an i.v.
      department. The i.v. team was disbanded in 1984 and 1985. The team was brought
      back, but it was a struggle to maintain staff and deliver quality, comprehensive
      i.v. services. With the implementation of the bar code system, nursing
      productivity could be demonstrated. The i.v. department now generates revenue of
      significant magnitude, and productivity can be proved with the new bar code
      system.

PMID- 1748917
TI  - The benefits of professional credentialing.

PMID- 1748918
TI  - Provision of intravenous therapy in a skilled nursing facility.
AB  - Intravenous therapy is one of the admission criteria for the geriatric patient to
      enter a skilled nursing facility. Because of shortened hospital stays, more and
      more geriatric patients are placed in this type of nursing home. These facilities
      are also potential alternatives to hospitalization of the nursing home resident
      who requires I.V. therapy. Multiple factors, such as the aging population,
      federal programs for the elderly, and the economic health care climate, have
      contributed to the emergence of the skilled nursing facility as a practice
      setting for I.V. therapy. As the acuity of nursing home residents continues to
      rise, I.V. therapy will become a more frequent treatment modality. Therefore,
      I.V. nurses must be aware of the impact of provision of this service in the
      skilled nursing facility setting.

PMID- 1748919
TI  - All about patient-controlled analgesia.
AB  - The goal of patient-controlled analgesia is to provide the patient with a serum
      analgesia level for comfort with minimal sedation. In light of the increased use
      of patient-controlled analgesia, this article details indications for the
      administration of pain control as well as available technology and monitoring
      parameters within the hospital and home care environment.

PMID- 1748920
TI  - Future dimensions in vascular access--peripheral implantable ports.
AB  - The development of reliable long-term intravenous access devices is both a
      blessing for patients and a challenge for nurses. The peripheral implantable port
      is a unique vascular access device that offers some new advantages over
      previously developed central venous catheters. This article includes a brief
      review of prior advances in vascular access, as well as indications, insertion
      techniques, advantages, disadvantages, and nursing management of the new
      peripheral implantable port (Port-A-Cath P.A.S. Port, Pharmacia Deltec Inc., St.
      Paul, Minn.). Additionally, a retrospective study of clinical experience and
      complications is presented.

PMID- 1748921
TI  - The immune system. Part II, Intravenous administration of immune globulin.
AB  - Part I of this article, published in the September/October 1991 issue of the
      Journal of Intravenous Nursing, reviews normal immune function, immune disorders,
      and diagnosis. The main treatment modality discussed in Part II is therapy with
      immune globulin IgG. History, indications, administration technique, and nursing
      care are highlighted.

PMID- 1748922
TI  - Immune function and nutrition. The clinical role of the intravenous nurse.
AB  - Protein-calorie malnutrition is considered to be one of the most frequent causes
      of immunosuppression in the world today. Malnutrition can affect the functioning
      of T cells, B cells, and macrophages, the principle players involved in cell
      mediated and humoral immunity. Immune function is measured by the total
      lymphocyte count and delayed cutaneous hypersensitivity reaction. Nutritional
      markers include serum albumin and transferrin levels. Immune function is affected
      by protein (especially arginine intake); the balance between omega-6 and omega-3
      fatty acid intake; and adequate amounts of vitamins A, E, and C, and the minerals
      zinc and iron. A deficiency of these nutrients puts the patient at increased risk
      of infection. Non-nutritional factors can influence immune functioning as well.
      The intravenous nurse must review the patients history, physical examination, and
      laboratory values to achieve a global view of the patient's immune function and
      nutrition status in order to be able to develop an appropriate care plan based on
      this nursing diagnosis: potential for infection secondary to alteration in immune
      function.

PMID- 1748923
TI  - Homicide: a killer of youth.

PMID- 1748924
TI  - Pediatric nurse practitioners: primary care providers and case managers for
      chronically ill children at home.
AB  - A new role has been developed for pediatric nurse practitioners that is home
      based and provides primary care and case management for chronically ill children.
      In a pilot program at Children's Hospital and Health Center in San Diego,
      pediatric nurse practitioners address the complex needs of chronically ill
      children who require comprehensive care, education, psychosocial support, and
      coordination of services. This article describes the population, program, and
      expanded role for PNPs, emphasizing case management, management of chronic
      illness, minor illnesses, and management of well child care. Clinical impressions
      of the benefits of the role to the child and family are presented.

PMID- 1748925
TI  - Childrearing knowledge, beliefs, and practices of Cambodian refugees.
AB  - Forty Cambodian women in Seattle, Washington were interviewed to learn about
      their childrearing knowledge, beliefs, practices, and information resources. It
      was found that women who once relied on family and elders for advice now turned
      to pediatric providers and other clinic staff. Most women reported accurately the
      ages at which developmental milestones occur, with the exception of vision and
      hearing milestones. Their treatment of common childhood illnesses included both
      Western and Cambodian remedies. Beliefs about children's nature, discipline,
      learning, and reincarnation were explored. Implications for providers trying to
      support the parenting efforts of Cambodian women in the United States are
      discussed.

PMID- 1748926
TI  - Physiologic sequelae of prematurity: the nurse practitioner's role. Part VI.
      Feeding difficulties and growth failure. (Prevention, intervention, parent
      teaching, and complications).
AB  - Feeding difficulties and growth failure are common problems of the premature
      infant who has been in a neonatal intensive care unit. This article, the sixth in
      a series, discusses the prevention, intervention, and parent teaching necessary
      to assist parents in coping and dealing with feeding problems in their premature
      infant.

PMID- 1748927
TI  - Vesicoureteral reflux.
AB  - Vesicoureteral reflux, the regurgitation of urine from the bladder into the
      ureters, varies in severity. Controversy persists in relation to the cause,
      diagnosis, significance, and treatment of this condition. The practitioner's role
      in early referral and treatment of urinary tract infection is important to
      prevent renal damage. Patient and family support and education about reflux,
      diagnosis, and follow-up is crucial. Early diagnosis and optimal management will
      preserve maximal renal function, and patient education will foster compliance and
      quality care.

PMID- 1748928
TI  - The future of cocaine babies: primary care and early intervention.

PMID- 1748929
TI  - Moral development.

PMID- 1748930
TI  - Growth hormone therapy for short stature.

PMID- 1748931
TI  - Abdominal mass on a well child examination.

PMID- 1748932
TI  - New pesticide policies focus on pediatrics.

PMID- 1748933
TI  - New role for PNPs in an inpatient setting.

PMID- 1748934
TI  - Association of Faculties of Pediatric Nurse Practitioner/Associates Programs.
      Update.

PMID- 1748935
TI  - NAPNAP position statements.

PMID- 1748936
TI  - Transvaginal color Doppler in the assessment of abnormal early pregnancy.
AB  - The study groups comprised 61 pregnant women whose gestational age ranged from 7
      to 12 weeks from the last menstrual period. All patients apparently had a normal
      developing pregnancy; there were no clinical symptoms of pathology e.g. bleeding
      in early pregnancy. Eighty-two patients with a clinically and
      ultrasonographically normal pregnancy whose gestational age ranged from 7 to 12
      weeks, served as a control group. When the anatomical position of investigated
      area have been obtained clearly, pulsed wave Doppler sample volume was placed on
      the structures of interest: the both uterine arteries and intervillous space.
      There is no statistically significant difference between the Resistance Index
      (RI) in the left or right uterine artery (P greater than 0.01) and among
      investigated groups of patients (P greater than 0.01). The intervillous blood
      flow RI in the case of molar pregnancy was 0.38 with SD +/- 0.03; in blighted
      ovum 0.43 with SD +/- 0.03, and in missed abortion 0.43 with SD +/- 0.02. It
      should be stressed that in nine (31%) cases of blighted ova and in five (26%)
      cases of missed abortion, intervillous space flow could not be detected. In the
      control group, intervillous blood flow was always visualized and the mean RI was
      0.45 with SD - 0.04. Statistical analysis showed significantly higher RI in
      control group in comparison with other groups of patients (P less than 0.01), and
      significantly lower RI in molar pregnancy in comparison with other groups of
      patients (P less than 0.01). There was no difference in RI between blighted ova
      and missed abortions (P greater than 0.01).

PMID- 1748937
TI  - Single dose of labetalol in hypertensive pregnancy: effects on maternal
      hemodynamics and uterine and fetal flow velocity waveforms.
AB  - The short-term effect of 0.8 mg/kg of an intravenous bolus of labetalol on
      maternal and fetal hemodynamics was investigated in ten women with pregnancy
      induced hypertension. The maximum effect occurred within 35 minutes after
      labetalol administration. At that point, the mean arterial pressure had decreased
      by 18% and there was a slight decrease in maternal heart rate. As to flow
      velocity waveforms, no significant change was found in mean systolic/diastolic
      (S/D) ratio of the uterine artery, umbilical artery or fetal middle cerebral
      artery. However, in two subjects with a marked reduction in blood pressure also
      the uterine artery S/D ratio decreased.

PMID- 1748938
TI  - Indomethacin therapy and fetal urine production in twins with polyhydramnios.
AB  - Indomethacin has been used in twins with polyhydramnios to decrease amniotic
      fluid volume. Under therapy, a marked reduction of both fetuses' urine production
      has been demonstrated within 24 hours concomitant with maternal symptomatic
      relief. Discontinuation of therapy was associated with a rapid increase in fetal
      urine production. The clinical observation indicates that the benefit of
      indomethacin in prolonging such pregnancies is most probably the result of relief
      of polyhydramnios through decreased fetal urine production.

PMID- 1748939
TI  - Auditory evoked response of the human fetus: simplified methodology.
AB  - The author presents a retrospective study where he analyzes the possibility of
      using sound-evoked movements of human fetuses to evaluate their conditions in
      utero. He uses a narrow band stimulator at 1,500 cycles/second at 125 decibels of
      sound level pressure as five pulsed stimuli lasting two seconds each and one
      second apart applied to maternal abdomen. Analysis was performed on 2,025 fetal
      electronic monitoring tests on which 1,626 auditive stimulation were applied. A
      test was considered positive when sound stimulation evoked no movements or only a
      slight, slow, not immediate movement was observed by the mother or the
      professional applying the test. A test was considered negative (fetus in good
      health) when a fetal immediate sudden, strong, Moro like reaction was observed
      clinically (starttle reflex). This test produced a sensitivity of 57.35%, greater
      than any other observed in nonstress cardiotocography. The author suggests this
      simple, easy-to-apply test should have a place as screening procedure in large
      populations or where facilities for more complete monitoring are not available.
      The combination of this simplified auditive stimulation with the conventional
      auditory evoked response offers better sensitivity and positive predictive values
      than the largely used non-stress test. In any case it would help in the detection
      of potential risk cases and should be included as a first simple procedure to be
      applied to high risk pregnancies.

PMID- 1748940
TI  - The effect of maternal oxygen administration on fetal and maternal blood flow
      values using Doppler ultrasonography.
AB  - Thirty-one pregnant women divided into three groups (AGA prepartum, SGA prepartum
      without distress, AGA in labor) were examined using Doppler ultrasonography
      before, during and after oxygen administration to mothers via a face mask. The
      aim of the study was to find out if there was any effect on the blood flow values
      in the fetal aorta, the umbilical artery, the fetal common carotid artery and the
      uterine arcuate arteries. The resistance index (RI) did not change in those
      vessels during maternal hyperoxygenation with one exception: in the group of SGA
      fetuses the RI in the fetal aorta increased significantly. Blood flow velocity
      and volume blood flow remained unchanged in the fetal aorta during oxygen
      administration.

PMID- 1748941
TI  - Significance of prenatal diagnosis in a patient with a huge neck tumor.
AB  - Due to the great advancements in fetal ultrasonography, the number of prenatal
      diagnoses are increasing, greatly contributing to improved neonatal surgery. It
      is now relatively easy to detect huge fetal cystic masses, and we have
      experienced three cases with a huge neck tumor detected in utero, one case with
      teratoma and two cases with cystic hygroma. Each case was complicated by neonatal
      asphyxia, and the neonate needed resuscitation by means of endotracheal
      intubation. The infant with teratoma unfortunately died of respiratory distress
      due to compression of the trachea before a perinatal team could be organized.
      Although the remaining cases with cystic hygroma were treated by a perinatal
      team, one died 19 hours after birth and the other has survived with the aid of
      endotracheal intubation in the hospital for three years. In addition, all four
      cases of cystic hygroma detected antenatally in our institute, which were not
      delivered, also had fetal hydrops which suggested a general lymphatic
      derangement. Cystic hygroma detected in utero is considered to be different from
      that detected after birth, since the former is associated with genetic lymphatic
      derangement. Prenatal diagnosis enables such patients to survive the perinatal
      period, but may not improve the prognosis of fetal cystic hygroma so much.

PMID- 1748942
TI  - Pressures on the fetal head during normal labor.
AB  - The pressure recordings from both parietal regions of the fetal head during the
      second stage of labor of 44 spontaneous deliveries with vertex presentation were
      evaluated and compared to the simultaneously recorded pressures in the amniotic
      cavity by calculating pressure parameters during and between uterine
      contractions. Analysis of the bearing down period revealed on the average higher
      values at the anterior side in comparison to the posterior side of the skull.
      This is explained by the complex anatomy of the curved birth canal. Overall, the
      head pressure values averaged from the recordings of both parietal regions were
      about twice as high as the corresponding amniotic pressure values. During the
      descend of the head through the birth canal, an increase of pressure on the fetal
      head was observed that is mainly due to the rising resistance of the narrowing
      pelvis and stretched tissue of the passageway. A marked interindividual deviation
      of head pressure was found that was independent from amniotic pressure variations
      thus preventing indirect deduction of head strain from internal togography.

PMID- 1748943
TI  - Predictive value of a fetal heart rate acceleration at the time of fetal blood
      sampling in labour.
AB  - It has been suggested that the fetal heart rate response to fetal stimulation in
      labour is an indication of fetal condition. This study was designed to evaluate
      scalp stimulation at the time of fetal blood sampling. All labours requiring
      fetal scalp pH measurement during one year at the John Radcliffe Maternity
      Hospital were reviewed to determine the association between pH result and the
      fetal heart rate response to the first scalp blood sample. Sixty-nine (50%) cases
      showed an acceleration and none had a scalp blood pH less than 7.20. Six (8.7%)
      of the cases which did not show an acceleration of the fetal heart rate had a pH
      less than 7.20 and this group had a greater incidence of analgesia usage and
      twice as many caesarean sections (39%). The detection rate for non-acidaemia
      using a fetal heart rate acceleration at the time of fetal blood sampling was 52
      percent but the specificity and positive predictive value were both 100 percent.
      The false negative rate was 91 percent. Thus, whilst an acceleration was
      reassuring, the absence of an acceleration at the time of fetal blood sampling
      was not a good predictor of fetal acidaemia. These results are compared with the
      data from four other published reports.

PMID- 1748944
TI  - Scalp electrode associated neonatal Escherichia coli meningitis--a case report.
AB  - A case of Escherichia coli meningitis in a newborn boy is described which seemed
      to be related to the use of a screwed top scalp electrode for perinatal
      monitoring. First a subcutaneous abscess developed at the place of the former
      electrode and the infant recovered well after surgical incision. 36 hour later
      the boy became acutely ill because of a purulent meningitis. From both the
      subcutaneous Abscess as the CSF identical E. coli (K1-strain) were cultured.

PMID- 1748945
TI  - How to assess fetal metabolic acidosis from cord samples.
AB  - The degree of metabolic acidosis at birth has been calculated in cord artery and
      vein samples from 21 term fetuses with cord artery pH less than 7.20. The aim of
      the study was to compare base deficit values calculated from either Siggaard
      Andersen alignment nomogram (BD blood) or the Acid-Base chart (BD extra cellular
      fluid, BDecf). BDblood was found to be consistently higher in the cord artery as
      compared with BDecf, 13.2 +/- 3.5 and 9.9 +/- 2.9 mmol/l (Mean +/- SD),
      respectively. A significant correlation was found between cord artery PCO2 and
      BDblood whereas BDecf appeared unaffected by PCO2. In cases with cord
      entanglement BDecf a-v differences were increased to 3.4 +/- 2.3 mmol/l as
      compared with the small a-v difference noted in acidotic cases without cord
      entanglement, 1.1 +/- 1.25 mmol/l. It is speculated that with acutely emerging,
      intermittent asphyxia due to cord compression, a cord artery and vein difference
      in metabolic acidosis may exist and where the vein captures the basal level and
      the artery the acute changes. It is concluded that BDecf in both cord artery and
      vein add valuable information on the mechanisms behind metabolic acidosis.

PMID- 1748946
TI  - Prenatal diagnosis of vein of Galen arteriovenous malformation by duplex
      sonography.
AB  - Arteriovenous malformation of the vein of Galen, a rare disorder, has been
      diagnosed in several cases by in utero sonography. A case is presented in which
      the prenatal diagnosis of this entity was made by the combined use of real-time
      ultrasound and pulsed Doppler.

PMID- 1748947
TI  - Endoscopic fetal surgery by excimer laser. An experimental study in premature
      lambs.
AB  - Fetal malformations are detected early in pregnancy by means of ultrasound
      challenging fetal therapy. While open fetal surgery has been preformed during
      preliminary clinical trials we evaluated fetoscopic therapy avoiding laparotomy
      and uterotomy. We used a laser fibre (900 mu) which was introduced into the
      uterus by an endoscope. During animal experiments in five fetal lambs with a
      gestational age of 120-122 days we used an excimer laser (Technolas, x) with a
      wave-length of 308 nm. Laser incisions were compared with the conventional
      cutting technique using a scapel. During histological evaluation the tissue
      effect was morphometricly analysed. The zone of devitalisation was characterized
      by pycnosis of the nuclei and in a change of cytoplasma volume. The excimer laser
      incisions using a frequency of 40 HZ had a mean zone of devitalisation of 50.3 +/
      4.5 mu. Using the excimer laser with a frequency of 10 HZ we found a tissue
      alteration of only 11.2 +/- 3.4 mu. The incisions by scapel showed a extended
      traumatisation with a mean tissue effect of 153.2 +/- 16.3 mu. From these results
      we conclude, that endoscopic surgery may be come a usefull additional tool for
      fetal therapy.

PMID- 1748948
TI  - School-based adolescent mental health project survey of depression, suicidal
      ideation, and anger.
AB  - This study on adolescent mental health was conducted in a school setting. Sixty
      nine subjects, aged 16-18 years, were surveyed to provide data on anger,
      depression, and suicide ideation. Suicide ideation was present in 15.9% of
      subjects and depression in 14.1%. Subjects with suicidal ideation demonstrated
      greater levels of anger and pooer anger control. Recommendations are made for
      psychiatric nurses to collaborate with school administrators to develop programs
      with specific evaluation criteria to promote adolescent mental health in the
      schools.

PMID- 1748949
TI  - Exploring the grief of adolescents after the death of a parent.
AB  - This study explored the grief of 26 adolescents after the death of a parent
      during the subjects' adolescent years. Data collection involved a one-time semi
      structured interview. In addition, the adolescents were asked to write and draw
      about death. The study identified variables and themes that appeared to have
      possible significance for how adolescents coped. The study conclusions were that
      adolescents do grieve differently from children and differently from adults;
      younger adolescents even grieve differently from older adolescents. No
      discernible differences in grieving were ascertained on the basis of sex, type of
      death, or prior loss experiences. The one adolescent who was perceived as
      grieving in an adaptive manner had the advantage of open communication with
      family members, had closure with the parent now dead, had seen the parent when
      dead, and had been involved with the rituals surrounding the death. Implications
      for future research and recommendations for adults involved with adolescents are
      included.

PMID- 1748950
TI  - Intuition in psychiatric-mental health nursing.
AB  - A descriptive study was done to explore how psychiatric-mental health nurses
      define and act on intuition in clinical practice with children and adolescents,
      and to identify supports for and barriers to taking such action. Interviews of 16
      nurses were tape-recorded, transcribed, and analyzed for manifest and latent
      content. Findings support previous studies about intuition in nursing practice
      and have implications for psychiatric-mental health nurses working with high-risk
      populations of children and adolescents.

PMID- 1748951
TI  - Infant-toddler mental health. An emerging concern.

PMID- 1748952
TI  - Communication techniques for allaying anxiety and providing support for
      hospitalized children.

PMID- 1748953
TI  - Perceived stress and stress projected into the spontaneous storytelling of two
      groups of fourth grade children.
AB  - The purpose of this descriptive correlation study was to describe stress levels
      in fourth grade children from two geographic locations: an inner city recreation
      club and a suburban parochial school. The use of spontaneous storytelling and a
      life events questionnaire provided information about the stress being experienced
      by the children. This article presents story themes and stressful life events of
      interest to adult caregivers helping children cope with stressful experiences.

PMID- 1748954
TI  - Marital strife, social support, and the development of mentally retarded
      toddlers.
AB  - The birth of a mentally retarded child is a stressful experience for the family.
      Research exploring the differences between these families based on the child's
      developmental competence is sparse. This study examined marital strife and social
      support within two groups of retarded toddlers. Data were collected through
      observation, an interview, and questionnaires. The focus of marital agreement and
      disagreement differed between the groups, as did social support. However, birth
      order and family life cycle stage were found to be important confounding
      variables.

PMID- 1748955
TI  - Evaluation of a teen parent program designed to reduce child abuse and neglect
      and to strengthen families.
AB  - The purpose of this study was to evaluate a teen parent program designed to
      increase parents' self-esteem, improve parenting skills, and increase parental
      knowledge about child development. Subjects (n = 30) in the program were referred
      from public health services. Control subjects (n = 30) were served by a local
      health department. Subjects were tested before and on completion of the program
      (or 6-9 months later for controls) using the Coopersmith Self-Esteem Inventory
      (SEI), the Inventory of Parents' Experiences (IPE), and the Denver Developmental
      Screening Test (DDST). Findings included (a) intervention subjects scored lower
      than control subjects on the pretesting in self-esteem (p less than 0.05),
      parental role satisfaction (p less than 0.05), and community support (p less than
      0.0001); (b) control subjects scored lower on satisfaction with intimate
      relationships (p less than 0.0001); (c) at post-test, there were no statistically
      significant differences, and intervention subjects recorded self-esteem scores
      had increased to control levels; and (d) no developmental delays were detected in
      newborns at either pre- or post-testing. Implications of this study include (a)
      data support effectiveness of the program in enhancing self-esteem, maintaining
      satisfaction in parental role, and increasing community support for teen parents;
      and (b) evaluation of teen parent programs' effects should be done every 3-6
      months to reduce subject attrition.

PMID- 1748956
TI  - Assessing psychotropic medication side effects among children. A reliability
      study.
AB  - The Dosage Record Treatment Emergent Symptom Scale (DOTES) is a rating scale for
      measuring the presence and intensity of psychotropic medication side effects.
      Studies to evaluate its reliability have not been published. The purposes of this
      pilot study are to (1) develop a protocol for training raters to use the DOTES,
      (2) assess inter-rater agreement, 3) examine the reasons for disagreement among
      raters to clarify training procedures and symptom definitions, and (4) further
      refine this instrument for use in clinical and research settings. Five nurses
      were trained to use the DOTES to rate the absence or presence and intensity of
      specific medication side effects. After training, Raters 1, 2, and 3 watched a
      videotape of a nurse interviewing a 13-year-old child and completed the DOTES
      rating scale. There was agreement on the intensities of 6 (67%) of the 9 symptoms
      identified as present and agreement on 17 (89%) of the 19 symptoms identified as
      absent. Process tracings were conducted on the ratings of Nurses 4 and 5 to
      elicit the criteria they used to determine their ratings. The results of the
      process tracings were used to identify ambiguities that led to disagreement among
      raters so that the training protocol and interview could be improved.

PMID- 1748957
TI  - HIV infection. Helping adolescents choose safer behaviors.
AB  - Although adolescents comprise only 1% of the diagnosed cases of acquired immune
      deficiency syndrome (AIDS), the risk of human immunodeficiency virus (HIV)
      infection among this group should not be underestimated. This article discusses
      how adolescents' behaviors place them at risk for HIV infection. One educational
      program is described that illustrates an innovative approach to use with
      adolescents. Nurses who use the Relationship Safety and Vigilance Plan can assist
      individual adolescents to assess their interpersonal relationship patterns to
      establish goals and reduce impulsive or destructive behaviors.

PMID- 1748958
TI  - Perceived seriousness of children's surgery and family adaptability and cohesion.
AB  - This study investigates the relationship between the family's perception of the
      seriousness of a child's surgery and the level of family adaptability and
      cohesion before and after the surgical event. Research hypotheses are based on
      the Family Crisis and Circumplex models of marital and family systems. Forty-one
      families were included in the pretest/posttest single group design in which a
      child underwent a tonsillectomy. Study findings do not consistently support the
      conceptual models, and implications for the testing of middle range family
      theories are described.

PMID- 1748959
TI  - Development of an adolescent risk-taking instrument.
AB  - The purpose of this research study was to estimate the reliability and content
      validity of an instrument designed to measure risk-taking in adolescents. Six
      subscales containing 69 items were developed to measure the adolescent's
      perception of risk-taking. Subjects consisted of 75 male and female adolescents
      enrolled in a vocational training program. Support for reliability was obtained
      by the use of Chronbach's alpha correlation coefficient for the subscales and the
      Risk-Taking Instrument.

PMID- 1748960
TI  - Genetic epidemiology in child psychiatric nursing. Tourette's Syndrome as a
      model.
AB  - Recent discoveries in the field of molecular biology and increased attention to
      genetic epidemiology have stimulated renewed interest in the genetics of
      psychiatric disorders. Tourette's syndrome, a neuropsychiatric disorder
      characterized by motor and phonic tics, is used as a model to describe the
      research strategies employed in the genetic epidemiology of child psychiatric
      disorders. The relevance of genetic research findings to child psychiatric
      nursing is also discussed.

PMID- 1748961
TI  - An electrodynographic study of foot function in shoes of varying heel heights.
AB  - Forty-three female test subjects had electrodynographic gait analysis performed
      in barefoot, low-heel shoe, and high-heel shoe conditions. Comparisons of
      segmental foot function, actual pressures, and pressure durations were
      determined. The findings suggest that an increased duration of forefoot loading,
      rather than an increased actual pressure, is responsible for pedal pathology
      secondary to wearing high-heel shoes. Contrary to previous reports in the
      literature, evidence of abnormal pronation in high heels was not found in this
      study.

PMID- 1748962
TI  - Isolation of a stimulatory system in an Aloe extract.
AB  - The authors' previous work on a 50% ethanol extract of Aloe vera was done to
      evaluate anti-inflammatory activity using the croton oil-induced ear swelling
      assay. The anti-inflammatory activity was found in the supernatant fraction. The
      supernatant fraction decreased inflammation, when applied topically, by 29.2%,
      and the precipitate decreased inflammation by 12.1%. However, in the present
      work, the precipitate fraction decreased the wound diameter by an average of
      47.1% (stimulatory system). Little or no wound healing activity was found in the
      supernatant. Aloe vera appears to act as a modulatory system toward wounds and
      inflammation and is a potentially valuable tool for managing lower extremity
      conditions.

PMID- 1748963
TI  - Anterior inferior tibiofibular ligament. Variations and relationship to the
      talus.
AB  - The anterior inferior tibiofibular ligament was evaluated in 46 preserved
      specimens with a mean age of 73.8 years. A classification system was devised to
      encompass the observed variations in ligamentous structure. Particular emphasis
      was placed on evaluating the extent of impingement between the inferior border of
      the ligament and the talus. It was determined that the presence of a separate
      inferior fascicle is not a prerequisite for impingement. However, a triangular,
      beveled region located anteriorly on the border between the trochlear and lateral
      surfaces of the talus was identified in association with anterior inferior
      tibiofibular ligament impingement.

PMID- 1748964
TI  - Achilles tendon rupture. A protocol for conservative management.
AB  - The authors discuss surgical versus conservative management of closed Achilles
      tendon ruptures. They favor a conservative approach in most cases and present
      arguments to support this preference. They present a protocol for conservative
      management of closed Achilles tendon ruptures, which has been developed at the
      Center for Sports Medicine, Saint Francis Memorial Hospital, San Francisco.

PMID- 1748965
TI  - Charcot-Marie-Tooth disease. Podiatric and systemic considerations.
AB  - Charcot-Marie-Tooth disease is a hereditary motor and sensory neuropathy with
      well documented manifestations in the extremities. Recent literature suggests
      systemic involvement in this neuropathy. The authors present a review of the
      literature, anesthetic considerations, and practical recommendations for the
      assessment of involved systems.

PMID- 1748966
TI  - Fracture-dislocation of the talus in the pediatric patient. An unusual injury.
AB  - Subtalar fracture-dislocations in children are unusual, perhaps because of the
      greater elasticity of bone in children. The authors have presented a case of
      medial subtalar dislocation in a 13-year-old boy, accompanied by a rare fracture
      of the entire posterior process of the talus. This particular fracture has not
      been previously reported in association with a subtalar joint dislocation, nor
      has it been reported in a child. The patient was treated successfully by closed
      reduction of both the dislocation and the fractures.

PMID- 1748967
TI  - Bilateral styloid fracture. A case report.
AB  - Styloid fractures are common, and their treatment is relatively straightforward.
      This case demonstrated delayed healing because of continuous pathologic motion
      aggravating the styloid fractures.

PMID- 1748968
TI  - Intraosseous lipoma of the calcaneus. A case report.
AB  - The intention of this report is to heighten the practitioner's clinical suspicion
      of intraosseous lipoma of the calcaneus. The apparent infrequency of this
      diagnosis may be attributed to the dependence on radiographic evaluation and the
      use of closed needle biopsy. Thus, to make a proper diagnosis, a computed
      tomography scan with the rate of attenuation and, ultimately, a large tissue
      biopsy with attentive gross and microscopic examination are necessary.

PMID- 1748969
TI  - Middle facet talocalcaneal coalition presenting with a subtalar varus deformity.

PMID- 1748970
TI  - The stepped cuboid.
AB  - The authors review a case presentation of a symptomatic cuboid metatarsal joint
      anomaly and discuss possible treatments, both conservative and surgical. The
      patient was treated conservatively and had some relief of symptoms.

PMID- 1748971
TI  - Physicians' plan for health care reform.
AB  - Numerous proposals have been made for health care reform during the last decade.
      Still, the richest health care system in the world offers little or nothing to
      millions of Americans. The quality of nursing practice is threatened by calls for
      rationing of health care resources and cost control. The Canadian system for
      national health care is frequently cited as a model for health care reform in the
      United States. Physicians for a National Health Program have designed a plan
      similar to that of Canada. This article presents an overview of the physicians'
      proposal and suggests its comparison with that of the Pepper Commission.

PMID- 1748972
TI  - In the line of duty.

PMID- 1748973
TI  - The coding of signals in the electric communication of the gymnotiform fish
      Eigenmannia: from electroreceptors to neurons in the torus semicircularis of the
      midbrain.
AB  - In the context of aggression and courtship, Eigenmannia repeatedly interrupts its
      electric organ discharges (EODs) These interruptions contain low-frequency
      components as well as high-frequency transients and, therefore, stimulate
      ampullary and tuberous electroreceptors, respectively. Information provided by
      these two classes of receptors is relayed along separate pathways, via the
      electrosensory lateral line lobe (ELL) of the hindbrain, to the dorsal torus
      semicircularis (TSd) of the midbrain. Some neurons of the torus receive inputs
      from both types of receptors and some respond predominantly to EOD interruptions
      while being rather insensitive to other forms of signal modulations. This high
      selectivity appears to result from convergence and gating of inputs from
      individually less selective neurons.

PMID- 1748974
TI  - Directional hearing in the gray tree frog Hyla versicolor: eardrum vibrations and
      phonotaxis.
AB  - 1. We used laser vibrometry to study the vibrational frequency response of the
      eardrum of female gray tree frogs for different positions of the sound source in
      three-dimensional space. Furthermore, we studied the accuracy of 3-D phonotaxis
      in the same species for sounds with different frequency contents. 2. The
      directionality of the eardrum was most pronounced in a narrow frequency range
      between 1.3 and 1.8 kHz. 3. The average 3-D, horizontal and vertical jump error
      angles for phonotactic approaches with a sound similar to the natural
      advertisement call (1.1 and 2.2 kHz frequency components) were 23 degrees, 19
      degrees and 12 degrees, respectively. 4. 3-D jump error angle distributions for
      the 1.4 + 2.2 kHz, 1.0 kHz and 2.0 kHz sounds were not significantly different
      from that for the 1.1 + 2.2 kHz sound. 5. The average 3-D jump error angle for
      the 1.4 kHz sound was 36 degrees, and the distribution was significantly
      different from that for the 1.1 + 2.2 kHz sound. Hence, phonotactic accuracy was
      poorer in the frequency range of maximum eardrum directionality. 6. Head scanning
      was not observed and is apparently unnecessary for accurate sound localization in
      three-dimensional space. 7. Changes in overall sound pressure level experienced
      by the frog during phonotactic approaches are not an important cue for sound
      localization.

PMID- 1748975
TI  - Expression of circadian rhythmicity in Djungarian hamsters under constant light:
      effects of light intensity and the circadian system's state.
AB  - Djungarian hamsters (Phodopus sungorus), were exposed to constant light with
      increasing intensities (20, 60, 350 lux), and wheel running activity was
      recorded. With increasing light intensity the percentage of hamsters showing a
      split in their daily activity pattern increased and the free running period was
      lengthened for both the unsplit and the split state. The fact that the free
      running period of both states depended on the light intensity together with the
      observation that the highest incidence of a circadian activity occurred under 350
      lux, provoked the idea that the emergence of splitting or a circadian rhythmicity
      is a direct consequence of the light induced lengthening of the free running
      period. However, analysis of the data failed to support the idea that emergence
      of a split or a circadian activity is a threshold phenomenon with respect to the
      free running period. Due to differences in circadian function some Djungarian
      hamsters do not exhibit photoinduction following short day exposure. In these
      individuals splitting also occurred but required exposure to a higher light
      intensity than in photo-responsive hamsters. This observation is in accordance
      with the idea that the two phenotypes differ in the interaction of the two
      component oscillators underlying circadian rhythmicity.

PMID- 1748976
TI  - Seismic and auditory tuning curves from bullfrog saccular and amphibian papillar
      axons.
AB  - We present seismic and auditory frequency tuning curves of individual bullfrog,
      Rana catesbeiana, saccular and amphibian papilla axons that responded to both
      seismic and auditory stimuli. In this study we found: 1) most saccular axons
      respond well to auditory stimuli with moderate signal strength (50-70 dB SPL) as
      well as to seismic stimuli; 2) most amphibian papilla axons respond well to
      seismic stimuli as well as to auditory stimuli, and their seismic sensitivities
      are comparable to those of saccular axons (responding to sinusoidal stimuli with
      peak accelerations in the range 0.001 to 0.1 cm/S2); 3) the responses to both
      seismic and auditory stimuli from both saccule and amphibian papilla are tuned,
      i.e. the strength of the response varies with the frequency of the stimulus; and
      this tuning is clearly not the result of second order resonance; 4) in individual
      axons the tuning properties for seismic stimuli often are not the same as those
      for auditory stimuli, a fact that may provide clues about how the stimulus signal
      energy is transferred to the hair cells in each case.

PMID- 1748977
TI  - Efficacy and toxicity of doxorubicin/cyclophosphamide maintenance therapy in dogs
      with multicentric lymphosarcoma.
AB  - Doxorubicin/cyclophosphamide were evaluated as maintenance drugs for dogs with
      multicentric lymphosarcoma (n = 28). Median remission time of all dogs was 173
      days. Remission duration was shorter, however, in dogs with stage IV/V disease,
      in dogs with pretreatment hypoalbuminemia, and in dogs that had received
      glucocorticoids before initiation of chemotherapy (P less than 0.04). Nineteen
      dogs were evaluable for toxicity. Dose-limiting gastrointestinal toxicosis was
      observed in three dogs, neutropenia was observed in three dogs, and
      cardiomyopathy was observed in three dogs. The doxorubicin/cyclophosphamide
      protocol described in this report is safe and effective in treating canine
      multicentric lymphosarcoma. Clinical stage, pretreatment steroid therapy, and
      hypoalbuminemia are prognostic factors for response to this protocol.

PMID- 1748979
TI  - Prognostic factors in dogs with lymphoma and associated hypercalcemia.
AB  - Lymphoma and hypercalcemia were diagnosed in 37 dogs. Twenty-six of the dogs
      received chemotherapy. The association between some prognostic factors including
      clinical stage of disease, illness status, presence of bone marrow involvement,
      and presence of an anterior mediastinal mass and remission duration and survival
      time was evaluated. Statistical analysis of the prognostic factors showed that
      the presence of an anterior mediastinal mass had an adverse effect on remission
      duration (P less than 0.03). Calcium concentration was not significantly related
      to any of the prognostic factors evaluated. Dogs that received chemotherapy were
      more likely to be self-supporting than the dogs that were not treated (P less
      than 0.005). However, initial illness status was not significantly related to
      remission duration or survival time in the 26 dogs that were treated. Six dogs
      (25% of dogs treated) survived longer than 14 months. Five of these dogs were
      female. Overall mean and median remission times were 10.4 and 6 months,
      respectively.

PMID- 1748978
TI  - Unusual patterns of serum antibodies to Streptococcus equi in two horses with
      purpura hemorrhagica.
AB  - An enzyme-linked immunosorbent assay (ELISA) was developed for use in horses to
      determine serum titers of antibodies of the immunoglobulin classes IgA, IgG, and
      IgM to Streptococcus equi M-like protein and culture supernatant protein
      antigens. Serum antibodies were determined in 28 adult horses, including 9 horses
      with recent S. equi infections, 17 horses without known exposure to S. equi, but
      without a history of respiratory disease in the preceding 4 months, and 2 horses
      with clinical purpura hemorrhagica. Serum IgA titers to culture supernatant
      protein antigen were highest in recently infected horses (P less than 0.001).
      Serial determinations of antibody titers in the horses with purpura showed that
      IgG antibodies to both S. equi M-like protein and culture supernatant protein
      antigens were undetectable initially, but later rose coincidental with clinical
      recovery from the disease. Possible mechanisms for these findings are discussed.

PMID- 1748980
TI  - Interleukins: biological properties and therapeutic potential.
AB  - Interleukins are biologically active glycoproteins derived primarily from
      activated lymphocytes and macrophages. Tremendous insight into the biochemical
      and biological properties of interleukins has been gained with advances in
      recombinant DNA technology, protein purification, and cell-culture techniques.
      The biological properties of interleukins include induction of T-lymphocyte
      activation and proliferation, augmentation of neutrophil, macrophage, and T
      lymphocyte cytotoxicity, and promotion of B lymphocyte and multilineage bone
      marrow stem-cell precursor growth and differentiation. Interleukins may play a
      role in the pathogenesis of several important diseases. Interleukin therapy is
      likely to play an important role in the treatment of cancer, infectious diseases,
      and immunodeficiency syndromes.

PMID- 1748982
TI  - Comparison of latex agglutination, indirect hemagglutination, and ELISA
      techniques for the detection of Toxoplasma gondii-specific antibodies in the
      serum of cats.
AB  - The primary purpose of this study was to determine whether commercially available
      latex agglutination and indirect hemagglutination kits for the detection of
      Toxoplasma gondii-specific antibodies were capable of detecting T. gondii
      specific immunoglobulin M (IgM) in the serum of cats. Serum samples from 35 cats
      containing either T. gondii-specific IgM, T. gondii-specific immunoglobulin G
      (IgG), or both were collected. Each serum sample was assayed using a latex
      agglutination kit, an indirect hemagglutination kit, an enzyme-linked
      immunosorbent assay (ELISA) for the detection of T. gondii-specific IgG, and an
      ELISA for the detection of T. gondii-specific IgM. When serum samples containing
      only T. gondii-specific IgM as determined by ELISA were assayed, the latex
      agglutination kit and the indirect hemagglutination kit detected antibodies in
      33.3% and 13.3%, respectively. When T. gondii-specific IgG was present in a serum
      sample, the results from the latex agglutination kit, the indirect
      hemagglutination kit, and the IgG-ELISA were similar; however, there was a wide
      variation in titer magnitude results between the three assays. It was concluded
      that the latex agglutination kit and the indirect hemagglutination kit did not
      adequately detect T. gondii-specific IgM in feline serum.

PMID- 1748981
TI  - A comparison of simultaneously collected arterial, mixed venous, jugular venous
      and cephalic venous blood samples in the assessment of blood-gas and acid-base
      status in the dog.
AB  - Blood samples were collected simultaneously from the pulmonary artery, jugular
      vein, cephalic vein, and carotid artery in awake dogs. Blood-gas and acid-base
      values were measured from these blood samples in normal dogs and in dogs after
      production of metabolic acidosis and metabolic alkalosis. The values obtained
      from each of the venous sites were compared with those obtained from arterial
      blood to determine if venous blood from various sites accurately reflected acid
      base balance and could therefore be used in the clinical patient. The results of
      this study demonstrated significant differences between the blood from various
      venous sites and the arterial site for PCO2 and pH in all acid-base states.
      Significant differences for standard bicarbonate (SHCO3) were found only when
      jugular and cephalic venous blood were compared with arterial blood in dogs with
      a metabolic acidosis. No significant differences were found for BE when blood
      from the venous sites was compared with arterial blood. The values for pH, HCO3,
      TCO2, BE, and SHCO3 measured on blood collected at the various venous sites were
      found to correlate well with those obtained from arterial blood, with a
      correlation coefficient of 0.99 for HCO3, TCO2, BE, and SHCO3. These correlation
      coefficients, together with similar values in BE at all collection sites,
      indicate that, in the dog with normal circulatory status, blood from any venous
      site will accurately reflect the acid-base status of the patient.

PMID- 1748983
TI  - Treatment of acute digoxin toxicosis with digoxin immune fab (Ovine).

PMID- 1748984
TI  - The process of becoming Board certified.

PMID- 1748985
TI  - Congenital hypothyroid dwarfism in a family of giant schnauzers.

PMID- 1748986
TI  - Interactions between viral coat protein and a specific binding region on turnip
      crinkle virus RNA.
AB  - The turnip crinkle virus coat protein binding sites in the ribonucleoprotein
      complex resulting from virion dissociation have been identified previously. In
      this study, RNA binding characteristics of viral coat protein to a region
      encompassing the protected RNA fragments Fa, Ff, and Fc (Fafc) have been
      investigated further using an RNA transcript (the Fafc fragment). These
      experiments have shown that coat protein requires no additional viral RNA
      elements to bind to this region. Such binding was shown to be specific for turnip
      crinkle virus coat protein using an ultra-violet light cross-linking assay. Gel
      mobility shift analyses demonstrated that the protein-RNA interactions produced
      two complexes: a homogeneous small ribonucleoprotein complex, and larger
      complexes which failed to migrate into gels. High salt and limiting protein
      concentrations favored the formation of the small ribonucleoprotein complex,
      whereas low salt and excess protein concentrations favored the larger complexes.
      RNA competition experiments demonstrated that small ribonucleoprotein complex
      formation coincided with specific RNA binding of the coat protein to the Fafc
      fragment. In addition, the coat protein possessed a poly(U)-binding site(s),
      which enabled it to interact with single-stranded RNA in a sequence non-specific
      manner to form large complexes. The results suggest that the coat protein
      contains both specific and non-specific RNA binding activities located at
      physically distinct sites. These results are consistent with the proposed
      assembly model for turnip crinkle virus.

PMID- 1748987
TI  - Crystallization and preliminary data for the ferric form of Lucina pectinata
      hemoglobin I.
AB  - Cytoplasmic monomeric hemoglobin I from the bacteria-harboring gill of the
      bivalve mollusc Lucina pectinata has been crystallized in a form suitable for
      atomic resolution X-ray structural investigations. The crystals have been grown
      at pH 4.8, in 0.05 M-acetate buffer, using 2.6 M-ammonium sulfate as
      precipitating agent. The crystals belong to the monoclinic space group P2(1),
      with unit cell constants a = 50.0 A, b = 38.6 A, c = 42.1 A, beta = 107.1
      degrees, and contain one molecule (14,000 Mr) in the asymmetric unit. By means of
      single crystal microspectrophotometry it has been shown that the crystals contain
      the ferric form of L. pectinata "sulfide reactive" hemoglobin I. On the other
      hand, by careful control of the buffering medium composition, it has been
      possible to obtain stable crystals of the deoxy, oxy and sulfide forms of the
      protein.

PMID- 1748988
TI  - Purification, crystallization and preliminary X-ray diffraction studies of the
      PvuII endonuclease.
AB  - The PvuII endonuclease (PvuIIR) is a restriction enzyme from a type II
      restriction-modification system of Proteus vulgaris coded on plasmid pPvu1. The
      protein recognizes the DNA sequence 5' CAG'CTG 3' and shows no sequence homology
      to other restriction enzymes. This makes PvuIIR an interesting subject for
      structural determination. A purification procedure was developed that yields
      milligram quantities of the PvuIIR from plasmids expressed in the Escherichia
      coli strain HB101. The protein was crystallized using ammonium sulphate as
      precipitant. The crystals are orthorhombic, space group P2(1)2(1)2 with cell
      dimensions: a = 84.2 A, b = 106.2 A, c = 46.9 A. The asymmetric unit contains one
      PvuIIR dimer. Diffraction extends to 2.3 A, so the crystals may permit structural
      determination at atomic resolution.

PMID- 1748989
TI  - Scanning transmission electron microscopic mass determination of in vitro self
      assembled smooth muscle myosin filaments.
AB  - We have measured the mass per unit length of in vitro self-assembled smooth
      muscle myosin filaments, using scanning transmission electron microscope
      darkfield images of freeze-dried samples. The measured values were integral
      multiples, usually 1, 2, 3 or 4, of 75 kDa per nm. The data corroborate an
      earlier proposal, that these filaments are built from monolayer sheets of
      molecules, each sheet having two antiparallel myosin molecules per 14.3 nm of its
      length.

PMID- 1748990
TI  - Crystallization and preliminary X-ray diffraction studies of the spinach
      chloroplast thioredoxin f.
AB  - Thioredoxins are low-molecular-mass proteins that function as hydrogen carriers
      in DNA synthesis and in the transformation of sulfur metabolites. They also act
      as regulatory proteins in the light-dependent enzyme activation during
      photosynthesis. F-type thioredoxin from spinach chloroplasts, a monomeric protein
      of 113 amino acid residues, has been found to specifically activate fructose-1,6
      bisphosphatase and other key enzymes of CO2 assimilation. It has been
      crystallized in the monoclinic system, space group P2(1) with a = 30.6 A, b =
      63.1 A, c = 31.6 A and beta = 110.7 degrees. The crystals are suitable for X-ray
      diffraction studies.

PMID- 1748991
TI  - Crystallization of a complex of hemoglobin components II and III of the symbiont
      harboring clam Lucina pectinata.
AB  - Diffraction data to 3.1 A resolution were collected on crystals of a complex of
      components II and III of the cytoplasmic hemoglobin of the symbiont-harboring
      clam Lucina pectinata. The crystal system is tetragonal, a = 76.3 A, c = 153.1 A
      and the space group is P42212. The asymmetric unit probably contains a dimer of
      the tetrameric complex.

PMID- 1748992
TI  - Control regions of an archaeal gene. A TATA box and an initiator element promote
      cell-free transcription of the tRNA(Val) gene of Methanococcus vannielii.
AB  - To identify the DNA sequences required for initiation of transcription in
      archaea, the 5'-flanking region of the tRNA(Val) gene of Methanococcus vannielii
      was modified by deletions, restructuring and site-directed mutagenesis, and the
      tRNA encoding sequence was replaced by a fortuitous Escherichia coli sequence.
      The effects of these mutations on promoter function were tested in an homologous
      cell-free transcription system. The DNA region from position -35 to +9 relative
      to the transcription start site was sufficient for maximal initiation of cell
      free transcription. Removal of the DNA region between -35 and -30 reduced
      initiation by a factor of 2. Deletions extending to position -24 almost
      completely abolished specific transcription. Analysis of 16 site-specific
      mutations in the region from -33 to +2 provided evidence that a conserved A + T
      rich sequence (TATA box), centered at -25, is essential for initiation of
      transcription. Single point mutations in six positions of the TATA box reduced
      initiation of transcription from 0.2 to 0.01 of wild-type levels. A second
      conserved motif at the transcription start site (consensus ATGC) could be
      replaced by some sequences containing a pyrimidine-purine dinucleotide but
      appeared necessary for a maximal rate of gene transcription. Mutations altering
      the spacing between the two conserved elements demonstrated that initiation
      occurs at a strictly defined distance of 22 to 27 base-pairs downstream from the
      TATA box. Our results support the conclusion that the TATA box is the major DNA
      region mediating promoter recognition, influencing the efficiency of
      transcription and specifying the site of transcription initiation. This
      Methanococcus promoter element closely resembles in structure and function the
      TATA box of promoters of eukaryotic protein-encoding genes transcribed by RNA
      polymerase II.

PMID- 1748993
TI  - Detailed physical map and set of overlapping clones covering the genome of the
      archaebacterium Haloferax volcanii DS2.
AB  - An integrated approach of "bottom up" and "top down" mapping has produced a
      minimal set of overlapping cosmid clones covering 96% of the 4140 kilobase-pairs
      (kbp) Haloferax volcanii DS2 genome and a completely closed physical map. This
      genome is partitioned into five replicons: a 2920 kbp chromosome and four
      plasmids, of 690 kbp (pHV4), 442 kbp (pHV3), 86 kbp(pHV1) and 6.4 kbp (pHV2). A
      restriction map for six infrequently-cutting restriction enzymes was constructed,
      representing a total of 903 sites in the cloned DNA. We have placed the two
      ribosomal RNA operons, the genes for 7 S RNA and for RNaseP RNA and 22 protein
      coding genes on the map. Restriction site frequencies show significant variation
      in different portions of the genome. The regions of high site density correspond
      to halobacterial satellite or FII DNA which includes two small regions of the
      chromosome, the plasmids pHV1 and pHV2, and half of pHV4, but not pHV3.

PMID- 1748994
TI  - By-passing immunization. Human antibodies from V-gene libraries displayed on
      phage.
AB  - We have mimicked features of immune selection to make human antibodies in
      bacteria. Diverse libraries of immunoglobulin heavy (VH) and light (V kappa and V
      lambda) chain variable (V) genes were prepared from peripheral blood lymphocytes
      (PBLs) of unimmunized donors by polymerase chain reaction (PCR) amplification.
      Genes encoding single chain Fv fragments were made by randomly combining heavy
      and light chain V-genes using PCR, and the combinatorial library (greater than
      10(7) members) cloned for display on the surface of a phage. Rare phage with
      "antigen-binding" activities were selected by four rounds of growth and panning
      with "antigen" (turkey egg-white lysozyme (TEL) or bovine serum albumin) or
      "hapten" (2-phenyloxazol-5-one (phOx], and the encoding heavy and light chain
      genes were sequenced. The V-genes were human with some nearly identical to known
      germ-line V-genes, while others were more heavily mutated. Soluble antibody
      fragments were prepared and shown to bind specifically to antigen or hapten and
      with good affinities, Ka (TEL) = 10(7) M-1; Ka (phOx) = 2 x 10(6) M-1. Isolation
      of higher-affinity fragments may require the use of larger primary libraries or
      the construction of secondary libraries from the binders. Nevertheless, our
      results suggest that a single large phage display library can be used to isolate
      human antibodies against any antigen, by-passing both hybridoma technology and
      immunization.

PMID- 1748995
TI  - Estimation of macromolecule concentrations and excluded volume effects for the
      cytoplasm of Escherichia coli.
AB  - The very high concentration of macromolecules within cells can potentially have
      an overwhelming effect on the thermodynamic activity of cellular components
      because of excluded volume effects. To estimate the magnitudes of such effects,
      we have made an experimental study of the cytoplasm of Escherichia coli.
      Parameters from cells and cell extracts are used to calculate approximate
      activity coefficients for cytoplasmic conditions. These calculations require a
      representation of the sizes, concentrations and effective specific volumes of the
      macromolecules in the extracts. Macromolecule size representations are obtained
      either by applying a two-phase distribution assay to define a related homogeneous
      solution or by using the molecular mass distribution of macromolecules from gel
      filtration. Macromolecule concentrations in cytoplasm are obtained from analyses
      of extracts by applying a correction for the dilution that occurs during
      extraction. That factor is determined from experiments based upon the known
      impermeability of the cytoplasmic volume to sucrose in intact E. coli.
      Macromolecule concentrations in the cytoplasm of E. coli in either exponential or
      stationary growth phase are estimated to be approximately 0.3 to 0.4 g/ml.
      Macromolecule specific volumes are inferred from the composition of close-packed
      precipitates induced by polyethylene glycol. Several well-characterized proteins
      which bind to DNA (lac repressor, RNA polymerase) are extremely sensitive to
      changes in salt concentration in studies in vitro, but are insensitive in studies
      in vivo. Application of the activity coefficients from the present work indicates
      that at least part of this discrepancy arises from the difference in excluded
      volumes in these studies. Applications of the activity coefficients to solubility
      or to association reactions are also discussed, as are changes associated with
      cell growth phase and osmotic or other effects. The use of solutions of purified
      macromolecules that emulate the crowding conditions inferred for cytoplasm is
      discussed.

PMID- 1748996
TI  - Refinement of the three-dimensional solution structure of barley serine
      proteinase inhibitor 2 and comparison with the structures in crystals.
AB  - The three-dimensional structure of barley serine proteinase inhibitor, CI-2, has
      been determined using nuclear magnetic resonance spectroscopy. The present
      structure determination is a refinement of the structure previously determined by
      us, using in the present case stereo-specific assignments, and a virtually
      complete set of assignments of the two-dimensional nuclear Overhauser spectrum.
      The structure determination is based on the identification of more than 1300
      nuclear Overhauser effects, of which 961 were used in the structure calculation
      as distance restraints, and on 94 dihedral angle restraints, of which 31 are for
      chi 1 angles in defined chiral centers. These have been used to calculate a
      series of 20 three-dimensional structures using a combination of distance
      geometry, simulated annealing and restrained molecular dynamics. Each of the 20
      structures was in agreement within less than 0.5 A of each of the distance
      restraints and with all dihedral angle restraints. When compared to the geometric
      average structure of the 20 refined structures the root-mean-square differences
      for the backbone atoms were 0.8 (+/- 0.2) A and for all atoms were 1.6 (+/- 0.2)
      A. By comparison, the values obtained for the structures determined previously
      were 1.4 (+/- 0.2) A and 2.1 (+/- 0.1) A, respectively. The structures were also
      compared to the structure determined in the crystalline state by X-ray
      diffraction showing root-mean-square differences of 1.6 (+/- 0.2) A and 2.8 (+/-
      0.2) A for the backbone and all atoms, respectively. Common features of the
      solution structure and the two crystal structures are the four-stranded beta
      structure, composed of a pair of parallel strands, and three pairs of
      antiparallel beta-strands flanked on one side by a 12-residue alpha-helix and on
      the other side by a loop containing the serine proteinase binding site. The new
      analysis of the structure has revealed an additional pair of antiparallel beta
      strands, consisting of residues 65 to 67 and 81 to 83, that was not seen in
      either of the crystal structures or the previous solution structure.
      Identification of this was based on nuclear magnetic resonance evidence for the
      hydrogen bond (67HN to 81CO) not reported previously. Also the presence of a
      bifurcated hydrogen bond involving Phe69 CO and HN atoms of Ala77 and Gln78 was
      observed in solution but not in crystals. Minor differences between the two
      structures were observed in the phi-angles of residues Met59 and Glu60 in the
      inhibitory site.

PMID- 1748997
TI  - DNase I-induced DNA conformation. 2 A structure of a DNase I-octamer complex.
AB  - The structure of a complex between DNase I and d(GCGATCGC)2 has been solved by
      molecular replacement and refined to an R-factor of 0.174 for all data between 6
      and 2 A resolution. The nicked octamer duplexes have lost a dinucleotide from the
      3' ends of one strand and are hydrogen-bonded across a 2-fold axis to form a
      quasi-continuous double helix of 14 base-pairs. DNase I is bound in the minor
      groove of the B-type DNA duplex forming contacts in and along both sides of the
      minor groove extending over a total of six base-pairs. As a consequence of
      binding of DNase I to the DNA-substrate the minor groove opens by about 3 A and
      the duplex bends towards the major groove by about 20 degrees. Apart from these
      more global distortions the bound duplex also shows significant deviations in
      local geometry. A major cause for the observed perturbations in the DNA
      conformation seems to be the stacking type interaction of a tyrosine ring (Y76)
      with a deoxyribose. In contrast, the enzyme structure is nearly unchanged
      compared to free DNase I (0.49 A root-mean-square deviations for main-chain
      atoms) thus providing a rigid framework to which the DNA substrate has to adapt
      on binding. These results confirm the hypothesis that groove width and stiffness
      are major factors determining the global sequence dependence of the enzyme's
      cutting rates. The nicked octamer present in the crystals did not allow us to
      draw detailed conclusions about the catalytic mechanism but confirmed the
      location of the active site near H134 on top of the central beta-sheets. A second
      cut of the DNA induced by diffusion of Mn2+ into the crystals may suggest the
      presence of a secondary active site in DNase I.

PMID- 1748998
TI  - Molecular basis of co-operativity in protein folding.
AB  - The folding/unfolding transition of proteins is a highly co-operative process
      characterized by the presence of very few or no thermodynamically stable
      partially folded intermediate states. The purpose of this paper is to present a
      thermodynamic formalism aimed at describing quantitatively the co-operative
      folding behavior of proteins. In order to account for this behavior, a
      hierarchical algorithm aimed at evaluating the folding/unfolding partition
      function has been developed. This formalism defines the partition function in
      terms of multiple levels of interacting co-operative folding units. A co
      operative folding unit is defined as a protein structural element that exhibits
      two-state folding/unfolding behavior. At the most fundamental level are those
      structural elements that behave co-operatively as a result of purely local
      interactions. Higher-order co-operative folding units are formed through
      interactions between different structural elements. The hierarchical formalism
      utilizes the crystallographic structure of the protein as a template to generate
      partially folded conformations defined in terms of co-operative folding units.
      The Gibbs free energy of those states and their corresponding statistical weights
      are then computed using experimental energetic parameters determined
      calorimetrically. This formalism has been applied to the case of myoglobin. It is
      shown that the hierarchical partition function correctly predicts the presence,
      energetics and co-operativity of the heat and cold denaturation transitions. The
      major contribution to the co-operative folding behavior arises from the solvent
      exposure of non-polar residues located in regions complementary to those that
      have undergone unfolding. This entropically uncompensated and energetically
      unfavorable solvent exposure characterizes all partially folded states but not
      the unfolded state, thus minimizing the population of partially folded
      intermediates throughout the folding/unfolding transition.

PMID- 1748999
TI  - Three-dimensional structure of a highly thermostable enzyme, 3-isopropylmalate
      dehydrogenase of Thermus thermophilus at 2.2 A resolution.
AB  - The three-dimensional structure of the highly thermostable 3-isopropylmalate
      dehydrogenase (IPMDH) from Thermus thermophilus has been determined by the
      multiple isomorphous replacement method and refined to 2.2 A resolution. The
      final R-factor is 0.185 for 20,307 reflections. The crystal asymmetric unit has
      one subunit consisting of 345 amino acid residues. The polypeptide chain of this
      subunit is folded into two domains (first and second domains) with parallel
      alpha/beta motifs. The domains are similar in their conformations and folding
      topologies, but differ from those of the NAD-binding domains of such well-known
      enzymes as the alcohol and lactate dehydrogenases. A beta-strand that is a part
      of the long arm-like polypeptide protruding from the second domain comes into
      contact with another subunit and contributes to the formation of an isologous
      dimer with a crystallographic 2-fold symmetry. Close subunit contacts are also
      present at two alpha-helices in the second domain. These helices strongly
      interact hydrophobically with the corresponding helices of the other subunit to
      form a hydrophobic core at the center of the dimer. Two large pockets that exist
      between the first domain of one subunit and the second domain of the other
      include the amino acid residues responsible for substrate binding. These results
      indicate that the dimeric form is essential for the IPMDH to express enzymatic
      activity and that the close subunit contact at the hydrophobic core is important
      for the thermal stability of the enzyme.

PMID- 1749000
TI  - Construction of new ligand binding sites in proteins of known structure. I.
      Computer-aided modeling of sites with pre-defined geometry.
AB  - We have devised a molecular model building computer program (DEZYMER) which
      builds new ligand binding sites into a protein of known three-dimensional
      structure. It alters only the sequence and the side-chain structure of the
      protein, leaving the protein backbone fold intact by definition. The program
      searches for a constellation of backbone positions arranged such that if
      appropriate side-chains were placed there, they would bind the ligand according
      to a pre-defined geometry of interaction specified by the experimentalist. These
      binding sites are introduced by the program by taking into account simple rules
      such as steric hindrance, atomic close-packing and hydrogen bond patterns, which
      are known to maintain the integrity of a protein structure to a first
      approximation. A test case is presented in this paper where the copper binding
      site found in blue-copper proteins such as plastocyanin, azurin and cupredoxin is
      introduced into Escherichia coli thioredoxin. The model building of one of the
      solutions found by the program is presented in some detail. The experimental
      construction and properties of this new protein are described in an accompanying
      paper. It is hoped that this program provides a general method for the design of
      ligand binding sites and enzyme active sites, which can then be tested
      experimentally.

PMID- 1749001
TI  - A simplified mechanical model of proteins tested on the globin fold.
AB  - It has been shown that the distribution of presently known protein loop lengths
      is consistent with even the simplest available theory of rubber-like elasticity,
      and with the idea that such loops generate an entropically derived end-to-end
      tension. It has also been asserted that the molten globule phase, just like the
      native form, must be mechanically stable, and that a simple demonstration of the
      potential for mechanical stability would be a powerful test in predictions of new
      protein folds. This paper amplifies this suggestion by explicit calculation of a
      familiar but non-trivial test case: sperm-whale myoglobin. The method used is to
      describe the protein molecule in terms of a highly simplified mechanical model
      bearing some resemblance to a pre-stressed mechanism. The alpha-helices are
      treated as rigid rods and the loops are treated as elastic strings. The entropic
      tensions exerted by the loops are imposed on the mechanism using an approximation
      proposed earlier. The helices are then held to generate frictionless reaction
      forces at their mutual points of contact. These contact forces are calculated to
      null out maximally the effects of the loop tensions, and hence stabilize the
      molecule. It is shown that the crystallographically determined structure of
      myoglobin has a significantly higher mechanical stability on this model than does
      any of a previously published set of combinatorially generated predictions.
      Amongst the predictions alone, the best is also the one with the highest
      stability. It is anticipated that this result could be of general importance in
      sorting or filtering out bad predictions. A further exciting feature of the model
      is that it offers a natural explanation for the strong conservation of the C2
      proline and the invariably long unconserved sequence from the end of the C helix
      to the start of the E helix in the globins and phycocyanins.

PMID- 1749002
TI  - Insulin increases the rate of degradation of 2-deoxy-glucose-6-phosphate in the
      perfused rat heart: a 31P NMR study.
AB  - The effect of insulin on the production and degradation of 2-deoxyglucose-6
      phosphate (2DG6P) from 2-deoxyglucose (2DG) in the Langendorff-perfused rat heart
      was studied by 31P NMR. The 2DG concentrations ranged from 0.25 to 20 mM in the 5
      mM acetate perfusion medium, and from 2 to 4 mM in the 12 mM glucose medium. With
      acetate as the carbon source, the apparent Km for the production of 2DG6P was 7
      mM and Vmax was 1.8 mumols/min/mg prot. Insulin enhanced Vmax 7-fold without
      change in Km of the transporter. With glucose perfusion, insulin had no effect on
      the initial rate of production of 2DG6P. The interpretation is that glucose
      phosphorylation is regulated by work when glucose is the energy substrate. In
      acetate-perfused hearts, in the conditions where the 2DG6P content reached a
      plateau, the rate of production of 2DG6P (equal to the measured degradation rate,
      see below) was eight times smaller than the initial rate, both with and without
      insulin. In glucose-perfused hearts, it was the same as the initial rate. The
      degradation of 2DG6P upon interruption of 2DG perfusion was exponential. The time
      constant was the same in acetate or glucose. It was strongly affected by insulin,
      being 225 +/- 60 min without, and 92 +/- 13 min with insulin. The observation
      that 2DG6P degradation is sensitive to insulin in the heart shows that its rate
      may vary. This possibility should be kept in mind in the analysis of PET studies
      of glucose metabolism.

PMID- 1749003
TI  - Evaluation of mRNA levels by the polymerase chain reaction in small cardiac
      tissue samples.
AB  - Doxurubicin is an effective and widely used chemotherapeutic agent. However, use
      of this drug is often limited by its cardiotoxic side effects. We have observed
      that an early event accompanying doxorubicin cardiomyopathy is a selective
      decrease in levels of muscle gene transcripts in cardiac tissue (Ito et al.,
      Proc. Natl. Acad. Sci. USA 87: 4275-4279). Since this decrease precedes
      ultrastructural evidence of cardiac damage, measurements of muscle transcripts
      might assist in the clinical evaluation of doxorubicin cardiotoxicity. We have
      therefore assessed the utility of the polymerase chain reaction in the
      measurement of mRNA in control and doxorubicin-treated animals. These
      measurements were performed on small tissue samples that simulate endomyocardial
      biopsies. We measured cardiac alpha-actin transcripts as a fraction of ferritin
      heavy chain transcripts using the method described by Chelly et al. (Nature 333:
      858-860, 1988). 0.5 micrograms of total RNA, an amount equivalent to that
      obtainable from a typical endomyocardial biopsy, was efficiently co-amplified
      with cardiac alpha-actin and ferritin heavy chain specific primers. The cardiac
      alpha-actin/ferritin heavy chain ratio calculated from the PCR results correlated
      well (R = 0.981) with results obtained using Northern blot analysis of 10
      micrograms RNA. The correlation was maintained over a wide range of cardiac alpha
      actin transcript abundance. These results show that mRNA from cardiac tissue can
      be estimated by the polymerase chain reaction, even from a small, endomyocardial
      biopsy-sized sample.

PMID- 1749004
TI  - Effects of acidosis and ATP depletion on cardiac muscle electron transfer complex
      I.
AB  - The loss of NADH-ubiquinone oxidoreductase activity, the activity of
      mitochondrial electron transfer complex I, underlies the loss of mitochondrial
      phosphorylating respiration with NAD-linked substrates observed during myocardial
      ischemia. In the present study the loss of complex I activity was found to be
      considerably more rapid during zero-flow ischemia in rat heart, a fast heart-rate
      heart, than in dog heart, a slow heart-rate heart. Moreover, the greater rapidity
      of the loss of complex I activity in the ischemic rat heart appeared to reflect
      the more rapid and more severe decreases in tissue pH and in tissue ATP
      characteristic of the zero-flow ischemic rat heart compared to zero-flow ischemic
      dog heart. In vitro enzyme inactivation studies on dog heart electron transfer
      complex I showed that the enzyme was approximately 40% inactivated after 1 minute
      by incubation at pH 6.0 in the absence of added ATP. The effect of low pH upon
      enzyme activity was mitigated considerably by the presence of one to two mM MgATP
      in the incubation mixtures. Moreover, a portion of the activity-sparing effect of
      MgATP was still observed in the presence of the uncoupler, FCCP. This latter
      observation suggests that part of the function-stabilizing effect of ATP was
      attributable to inner membrane energization and part appeared to have been due to
      a direct protective effect of ATP upon the complex.

PMID- 1749005
TI  - Cellular source and role of adenosine in isoproterenol-induced coronary
      vasodilatation.
AB  - The role of adenosine and its cellular source in isoproterenol-induced coronary
      vasodilatation was investigated in isolated perfused rat hearts prelabelled with
      [3H]adenosine. Time courses (times for half-maximal increase) were measured for
      changes in oxygen consumption (2.23 +/- 0.22 min), coronary flow (3.30 +/- 0.33
      min), concentrations of effluent radioactivity (3.92 +/- 0.30 min) and adenosine
      and its metabolites (inosine, hypoxanthine and xanthine) (2.00 +/- 0.23 min).
      Isoproterenol stimulation decreased the cellular energy state and increased the
      concentration of tissue adenosine and its metabolites. Coronary flow was linearly
      correlated with tissue adenosine (r = 0.85) and phosphorylation potential (r = 
      0.82) and tissue adenosine also showed a linear correlation with phosphorylation
      potential (r = -0.84) and tissue free [AMP] (r = 0.79). The specific
      radioactivities of tissue nucleotides remained constant, but those of adenosine,
      inosine and hypoxanthine + xanthine were decreased by 42%, 26% and 46%,
      respectively. Purine compound concentrations increased during isoproterenol
      stimulation from basal values of 56 +/- 23, 98 +/- 33 and 44 +/- 19 nM to 388 +/-
      173, 583 +/- 156 and 178 +/- 27 nM, respectively. The basal specific
      radioactivity ratio of adenosine:inosine:(hypoxanthine + xanthine) in the
      effluent perfusate was 1:0.5:7, but the specific radioactivities decreased
      rapidly upon isoproterenol stimulation, and at 3 min the ratio had changed to
      1:2.5:16.5. The time courses of release and the changes in the specific
      radioactivities of the nucleosides indicate that adenosine release occurred
      mainly from cardiomyocytes, and that the release of adenosine and its metabolites
      from the cardiomyocytes preceded that from the endothelium. It is also shown that
      adenosine release during catecholamine stimulation occurs concomitantly with a
      decrease in the cellular energy state and AMP accumulation. This is in accord
      with the adenosine hypothesis of coronary vasoregulation.

PMID- 1749006
TI  - The protective role of glucose on ischemic-reperfused hearts: effect of dietary
      fats.
AB  - The dietary polyunsaturated fatty acids are well known to promote the cardiac
      output and to protect the myocardium against arrhythmias. The exogenous glucose
      is generally considered as a protective agent against arrhythmias resulting from
      ischemia and reperfusion. But the effects of dietary fats, which also influence
      arrhythmias, on this beneficial effect of glucose has not been yet considered. We
      have studied the effects of a 7 days diet with or without polyunsaturated fatty
      acids on the cardiac performance and arrhythmias of isolated rat hearts, perfused
      with saline containing either glucose 5.5 mM or 11 mM. Acute regional ischemia
      was produced by ligature of the left main coronary artery with subsequent release
      to achieve reperfusion for some hearts. Previously, our results showed that the
      dietary polyunsaturated fatty acids led to an enhancement of the cardiac
      performance and to a decreased susceptibility to arrhythmias. The present data
      showed that the protective action of the exogenous glucose appeared to be
      dependent of the dietary lipid profile. Dietary polyunsaturated fatty acids
      increase cardiac performance under ischemia and decrease ventricular arrhythmias'
      occurrence under ischemia and on reperfusion. It might be related to endogenous
      substrate utilization and exogenous glucose availability which was influenced by
      the coronary flow.

PMID- 1749007
TI  - The isoproterenol-induced chloride current and cardiac resting potential.
AB  - Isoproterenol can induce potentially arrhymthogenic depolarizations of the
      resting membrane of single guinea-pig ventricular myocytes. This effect on
      resting potential of single guinea-pig ventricular myocytes differs qualitatively
      from results obtained by others from intact cardiac muscle preparations and also
      differs from our experience with single dog ventricular myocytes. We performed
      experiments on dog and guinea-pig ventricular myocytes in an attempt to clarify
      the effects of isoproterenol on the resting potential of mammalian ventricular
      myocytes. Voltage recordings with 40-60 M omega 3 M potassium chloride filled
      microelectrodes revealed an isoproterenol-induced depolarization of 4.3 +/- 1.0
      mV in guinea-pig but no depolarization in dog myocytes. Activation of an
      outwardly rectifying chloride current is responsible for the isoproterenol
      induced depolarization of guinea-pig ventricular myocytes. Our whole cell patch
      clamp recordings consistently revealed such a current in guinea-pig cells but
      always failed to demonstrate an isoproterenol-induced chloride current in dog
      myocytes under identical conditions. In contrast to single cells, isoproterenol
      did not depolarize intact guinea-pig papillary muscle when potential was recorded
      with 40-60 M omega 3 M KCl filled electrodes. Furthermore, we saw no
      depolarization in single guinea-pig myocytes when recording electrodes did not
      contain chloride. We conclude that: (1) despite activation of a chloride current,
      isoproterenol does not significantly depolarize guinea-pig ventricular muscle
      unless the driving force for the current at the resting potential is increased by
      elevating [Cl]i above physiological levels, and (2) an isoproterenol-induced
      chloride current, although demonstrable in guinea-pig ventricular cells, is not
      present in healthy dog ventricular cells.

PMID- 1749009
TI  - Reimbursement influences choice of cancer therapy.

PMID- 1749008
TI  - Choosing the right radionuclide and antibody for intraperitoneal
      radioimmunotherapy.

PMID- 1749010
TI  - Biotech industry flourishes with cancer research advances.

PMID- 1749012
TI  - NIH formulates a strategic plan.

PMID- 1749013
TI  - Twenty-one states operate cancer pain initiatives.

PMID- 1749011
TI  - Father's lifestyle can have fetal consequences.

PMID- 1749014
TI  - Heavy tobacco use in high schools needs to be addressed.

PMID- 1749015
TI  - Community Intervention Trial for Smoking Cessation (COMMIT): summary of design
      and intervention. COMMIT Research Group.
AB  - The Community Intervention Trial for Smoking Cessation (COMMIT) is a multicenter
      project created to test a comprehensive smoking control intervention. COMMIT was
      designed to effectively reach cigarette smokers, especially heavy smokers, and to
      aid them in achieving and maintaining long-term cessation of cigarette smoking.
      COMMIT was also designed to work through communities, using existing media
      channels, major organizations, and social institutions capable of influencing
      smoking behavior in large groups of people. This ongoing trial was begun in 1989
      in 11 matched pairs of communities. Each pair consists of one community
      randomized to intervention conditions and one community randomized to comparison
      conditions. A comprehensive set of mandated activities is organized around four
      task forces encompassing health care providers, work sites and organizations,
      cessation resources and services, and public education. Intervention activities
      are adapted and implemented in each community through a local community board
      that provides oversight and management of COMMIT activities. Cessation rates will
      be assessed in randomly selected cohorts of heavy cigarette smokers, identified
      at the baseline survey and tracked for 5 years, as estimators of the overall quit
      rates in both intervention and comparison communities. Various data collection
      methods will be used to provide intermediate outcome measurement and to evaluate
      implementation. These methods include cross-sectional community surveys and
      surveys of health providers, work sites, religious organizations, cessation
      resource providers, and other systems used to track smoking control activities.
      The trial will have an impact on more than 200 000 adult smokers.

PMID- 1749016
TI  - Analysis of the role of cancer prevention and control measures in reducing cancer
      mortality.
AB  - One goal of the war against cancer is to create declines in cancer mortality
      rates. A decrease in these rates can only occur in two ways: 1) a decrease in
      incidence rates and 2) a real increase in overall survival rates. Reductions in
      incidence rates can be envisioned to occur through three mechanisms (in order of
      the time course of cancer): 1) reduction or amelioration of environmental or
      lifestyle risk factors, 2) use of agents that prevent the occurrence of cancer by
      blocking the progression to cancer, and 3) early detection at a preneoplastic
      state combined with treatment that prevents or delays progression to invasive
      cancer. "True" increases in overall survival can occur by two mechanisms (in
      order of the time course of cancer): 1) early detection of cancer by screening
      tests and subsequent effective treatment and 2) advancements in treatment. Unique
      patterns or "fingerprints" of stage-specific incidence and overall incidence and
      of survival rates characterize the various cancer prevention and control
      mechanisms that can decrease mortality rates. The rates are presented for five
      organ sites that have shown reduced cancer mortality. The patterns of rates for
      breast cancer for women under the age of 65 years were most consistent with early
      detection. The testicular cancer fingerprints were most consistent with advances
      in treatment, whereas cervical cancer rates were most consistent with the
      detection of preneoplastic lesions. The stomach cancer fingerprints were
      indicative of reductions in lifestyle or environmental risks, and colorectal
      cancer rates were indicative of a combination of treatment advances and early
      detection. These fingerprint patterns can be extended to other situations in
      which mortality trends are changing in order to suggest possible causes of
      observed changes. Limitations of this model are also discussed.

PMID- 1749017
TI  - Is there evidence of a therapy-related increase in germ cell mutation among
      childhood cancer survivors?
AB  - Few studies have examined human population data for evidence of an association
      between environmental mutagens and genetic disease. Our objective was to
      determine whether study of pregnancies and offspring of childhood cancer
      survivors would show evidence that therapy potentially mutagenic to germ cells is
      associated with increased risk of miscarriage, serious congenital abnormalities,
      or altered sex ratio. We analyzed information from patients' general
      practitioners for 2286 survivors of childhood cancer (1049 females and 1237
      males) who were exposed or not exposed to direct irradiation of the abdomen or
      gonads or treatment with an alkylating agent. In addition, external control data
      based on the general population were used for some of the comparisons relating to
      congenital abnormalities and sex ratio. Data on reproductive history were
      complete for 1037 female survivors, who had 944 completed pregnancies, and 1078
      male survivors, who produced 537 offspring. For the female survivors given
      abdominal or gonadal irradiation, there was an excess of miscarriages for the
      total number of pregnancies (17%) and for first pregnancies (19%), compared with
      the proportion for the total number of pregnancies in the females with similar
      neoplasms who were not exposed to such therapy (9%) and for first pregnancies in
      these females (8%). These results show re-emergence of an association suggested
      in our previous report of an increased risk of miscarriage as well as low birth
      weight among off-spring of female survivors of childhood cancer who received
      abdominal irradiation. In that study, it was considered unlikely that the
      association was due to germ cell mutation. Data in the present study do not show
      an association of exposure to therapy potentially mutagenic to germ cells with
      sex ratio, or with occurrence of serious congenital abnormalities in the
      offspring of male or female survivors of such therapy. However, the question of a
      possible germ cell mutagenic effect of therapy will be adequately addressed only
      through an international collaborative effort.

PMID- 1749018
TI  - Nuclear magnetic resonance spectroscopy and sensitizer-adduct measurements of
      photodynamic therapy-induced ischemia in solid tumors.
AB  - Dunning R3327-AT prostate carcinomas growing in Fischer X Copenhagen rats were
      treated with interstitial photodynamic therapy (PDT--15 mg/kg Photofrin II 4
      hours before illumination with 630-nm light via four parallelly implanted optical
      fibers) at different light intensities. Forty to 60 minutes after treatment, 31P
      nuclear magnetic resonance spectra of tumors in anesthetized animals were
      obtained at 2.35 Tesla using surface coil localization. Areas under resonance
      peaks were normalized to the area under the peak of a phosphorus standard
      positioned at a fixed distance on the opposite side of the surface coil. Tumor
      concentrations of phosphomonoesters and phosphodiesters showed no change after
      tumor light doses up to 3000 J. Phosphocreatine, alpha-adenosine triphosphate
      (ATP), beta-ATP, and gamma-ATP signals decreased and inorganic phosphate signals
      increased with increasing light doses. The intratumor pH did not change
      significantly at these short times after PDT. In other R3327-AT and R3327-H tumor
      bearing animals, [3H]misonidazole was administered 30 minutes prior to PDT
      treatments of both tumors. Twenty-four hours later, the tumors were resected in
      toto, and levels of retained [3H]misonidazole were determined in lased tumor
      specimens by liquid scintillation procedures. The amount of [3H]misonidazole
      activity in tumor tissue (covalently bound after hypoxic reduction) increased
      with light doses up to 3000 J. Sensitizer-adduct formation was found to correlate
      with the ratio of the concentration of inorganic phosphate to that of beta-ATP,
      both of which are presumed measures of tumor oxygenation status. These
      measurements have high-lighted the heterogenous nature of the oxygenation status
      of these experimental tumors. The precision of each assay for estimating tumor
      oxygenation is discussed.

PMID- 1749019
TI  - Enhanced expression of interleukin-6 in primary human renal cell carcinomas.
AB  - We have demonstrated interleukin-6 (IL-6) production by human renal carcinoma
      cells. The IL-6 gene expression was detected by Northern blot analysis in 22 of
      43 primary renal cell carcinoma tissues and in five of seven renal cell carcinoma
      cell lines. Immunohistochemical analysis confirmed the expression of IL-6 by the
      tumor cells. Patients with a high-level expression of IL-6 had significantly
      greater incidences of lymph node metastasis and a larger increase in serum C
      reactive protein than those without it. We have also probed for the presence of
      IL-6 receptor by Northern blot analysis; we detected this receptor in 11 of the
      43 primary renal cell carcinoma tissues but in none of the seven renal cell
      carcinoma cell lines. However, by use of the complementary DNA-polymerase chain
      reaction, the IL-6 receptor transcript was detected in all specimens, including
      the seven cell lines. No expression of the interleukin-3 (IL-3) gene was
      identified in any of the 43 primary renal cell tumors. These data provide
      evidence that IL-6 and its receptor may play a role in promoting the
      transformation and/or proliferation of renal cell carcinomas as well as in teh
      development of symptoms.

PMID- 1749020
TI  - Antineoplastic dolastatins: potent inhibitors of hematopoietic progenitor cells.
AB  - Dolastatins 10 and 15, isolated from the shell-less marine mollusk Dolabella
      auricularia, are potent antineoplastic agents with unknown myelotoxic effects in
      vivo. The goal of this study was to determine whether the dolastatins inhibit the
      proliferation of normal hematopoietic progenitor cells. Assays to test inhibition
      of colony formation and of cell proliferation were performed in vitro with bone
      marrow cell preparations enriched for progenitor cells and with progenitor cell
      lines, respectively, using varying drug concentrations and exposure times.
      Dolastatins 10 and 15 both inhibited human and murine bone marrow cell colony
      formation in a concentration-dependent manner, with the concentration required
      for half maximal inhibition ranging from 0.1 to 1 pg/mL for dolastatin 10 and
      from 10 to 100 pg/mL for dolastatin 15. These concentrations are 25-fold to 100
      fold lower than the concentration required for antineoplastic activity. Complete
      inhibition of human bone marrow cell colony formation was observed at
      concentrations of 10-100 pg/mL for dolastatin 10 and 1000-10,000 pg/mL for
      dolastatin 15. Committed progenitor cells and multipotential progenitor cells
      were similarly inhibited. The magnitude of inhibition of human hematopoietic cell
      colony formation was dependent on pre-exposure time to dolastatins 10 and 15,
      with a reversible effect up to 8 hours and with a 24-hour preincubation resulting
      in maximal (100%) and irreversible inhibition. Dolastatin 10 at a concentration
      of 10-100 pg/mL limited the proliferation of six human and four murine
      hematopoietic progenitor cell lines, as measured by tritiated thymidine
      incorporation, to between 34% and 83% of that occurring in the absence of the
      drug. These results indicate that the dolastatins are potent inhibitors of normal
      hematopoietic progenitor cell proliferation.

PMID- 1749021
TI  - Time trends in incidence of brain and central nervous system cancers in
      Connecticut.

PMID- 1749022
TI  - An alternative hypothesis for bladder cancer among workers exposed to ortho
      toluidine and aniline.

PMID- 1749023
TI  - Proliferation rate in hereditary nonpolyposis colon cancer.

PMID- 1749024
TI  - Trauma surgery: every surgeon's specialty--presidential address, Western Trauma
      Association.

PMID- 1749025
TI  - Management of transperitoneal gunshot wounds of the spine.
AB  - To evaluate the results of a conservative approach to gunshot wounds of the spine
      with a transperitoneal trajectory, we analyzed our 4-year experience with 21
      patients. The management protocol consisted of standard treatment of the intra
      abdominal injuries, vigorous irrigation of the missile track, and a 48-hour
      course of antibiotic therapy. The lumbar spine was involved in 14 patients (67%)
      and the thoracic spine was injured in seven (33%). Eleven patients (52%) were
      paraplegic on admission and ten patients (48%) had a fixed partial neurologic
      deficit. One patient with an ISS of 75 died intraoperatively from exsanguination
      (mortality, 5%). Early morbidity correlated with ISS greater than 40 and spinal
      AIS greater than 3. Late nonneurologic morbidity was independent of ISS and
      spinal AIS. One patient required reoperation for a retroperitoneal abscess
      secondary to a leak from a repaired ureter. Another patient had a retroperitoneal
      collection on a CT scan which resolved spontaneously. There were no spinal or
      paraspinal infectious complications in the presence (five cases) or absence of a
      colonic injury. No change in neurologic status was observed in any patient during
      a mean follow-up period of 3 months. This preliminary experience suggests that a
      conservative approach consisting of irrigation of the missile track and short
      term antibiotic therapy without laminectomy or removal of fragments from the
      spinal canal yields optimal results without increasing infectious complications
      of the spine.

PMID- 1749026
TI  - Acute posttraumatic renal failure: a multicenter perspective.
AB  - Acute renal failure (ARF) following trauma is rare. Historically, ARF has been
      associated with a high mortality rate. To investigate this entity we conducted a
      retrospective review of 72,757 admissions treated at nine regional trauma centers
      over a 5-year period. Seventy-eight patients (0.098%) developed acute renal
      failure requiring hemodialysis. Detailed demographic, clinical, and outcome data
      were collected. Patients with pre-existing medical conditions (group I) had a 70%
      increase in mortality over those without pre-existing conditions (p less than
      0.004). Twenty-four patients (31%) developed ARF less than 6 days after injury
      (group II). The remainder (group III) developed late renal failure (mean time to
      first dialysis, 23 days). The predominant cause of death was multiple organ
      failure (82%). There were no differences in mortality because of multiple organ
      failure among the three groups of patients. Of the 33 survivors, six (18%) were
      discharged with renal insufficiency, three (9%) were discharged on dialysis, 23
      (70%) were discharged home or to rehabilitation, and 27 (82%) had no significant
      evidence of renal insufficiency. CONCLUSION: Posttraumatic renal failure
      requiring hemodialysis is rare (incidence, 107 per 100,000 trauma center
      admissions), but the mortality rate remains high (57%). Two thirds of the cases
      of posttraumatic renal failure develop late and are secondary to multiple organ
      failure; one third of the cases of posttraumatic renal failure develop early and
      may result from inadequate resuscitation.

PMID- 1749027
TI  - Outcome for delayed operation of penetrating colon injuries.
AB  - It has been stated that delay in operative repair of penetrating injuries to the
      gastrointestinal tract will result in a high rate of complications related to
      infection. To test this assertion, a group of patients with penetrating injuries
      to the colon were analyzed who had operative repair delayed (usually because of
      triage considerations) more than 6 hours after admission to the hospital. Nine
      hundred six patients who survived at least 48 hours after injury were divided
      into two groups. The immediate group of 769 patients was treated within 6 hours
      of admission and the delayed group of 137 patients was treated more than 6 hours
      after admission. The mortality for the immediate group was 4.0% vs. 1.5% for the
      delayed group. Colon-related infectious complications, defined as abscess or
      colon suture-line failure, occurred in 10% of the immediate group and 4.4% of the
      delayed group. To eliminate the effect of associated injuries, the group of
      patients with colon injuries only was analyzed separately. There was no mortality
      for 128 patients with colon injuries only operated on within 12 hours of injury,
      and the colon-related infectious morbidity rate was 3%. Eleven patients with
      colon injuries only were treated after 12 hours with a mortality of 9% and colon
      related infectious morbidity of 18%. These data demonstrate that even patients
      with fecal contamination can have operative repair delayed for up to 12 hours
      without undue morbidity related to infection.

PMID- 1749028
TI  - Trauma management in a war zone: the Lebanese war experience.
AB  - Lessons learned from the Vietnam and Korean conflicts have emphasized the
      necessity of an organized preparedness for optimal management of casualties. The
      present report summarizes the experience of a tertiary care center in the present
      Lebanese war. Between 1975 and 1986, approximately 30,000 war casualties were
      treated at the American University of Beirut Medical Center (AUBMC). A disaster
      plan was implemented whenever more than 25 major trauma victims were received
      within 1 hour. In-field stabilization and emergency room (ER) thoracotomy were
      not employed. The results are illustrated by an analysis of 1,500 cases of
      abdominal trauma, (1,314 high-velocity gunshot wounds, 29 stab wounds, 157 blunt
      injuries). A total of 1,420 patients were operated on within 6 hours of admission
      and 711 within the first hour. Overall mortality was 130, 8.7%; 9.5% for gunshot
      wounds, 3.4% for stab wounds, and 2.5% for blunt trauma. One hundred forty-five
      patients or 9.7% had negative findings at laparotomy. The factors affecting
      mortality were hypotension on admission (26.5% for a BP less than 90 mm Hg and
      2.8% for a BP higher than 90 mm Hg) and the presence of extra-abdominal injuries
      (14.4% with and 4.4% without). The chief causes of death were hemorrhage (3.7%),
      sepsis (2.1%), and ARDS (1.2%).

PMID- 1749029
TI  - Distal pancreatectomy for trauma: a multicenter experience.
AB  - During a 5-year period, 74 patients with pancreatic injuries were managed by
      distal pancreatic resection at nine referral trauma centers. Patient ages ranged
      from 4 to 72 years. Injury mechanism was blunt trauma in 34 (46%) patients,
      gunshot wound in 27 (36%), stab wound in 11 (15%), and shotgun blast in two (3%).
      There were 19 class II, 50 class III, and 5 class IV pancreatic injuries. The
      resection comprised up to 33% of the pancreas in 21 (28%) patients, from 34% to
      66% in 45 (61%), and greater than 67% in eight (11%). The pancreatic resection
      margin was closed with staples in 44 (59%), silk sutures in 20 (27%), and
      polypropylene sutures in eight (11%). Of 32 patients in whom the spleen was
      uninjured, the spleen was left intact in 17 (53%). There were nine (12%) deaths.
      The cause of death was irreversible shock in three patients, multiple organ
      failure in five, and severe head injury in one. Pancreas-related complications
      occurred in 32 (45%) of 71 patients who survived the initial operation. Intra
      abdominal abscess developed in 24 patients; 11 were managed by percutaneous
      drainage alone. Pancreatic fistula developed in 10 patients; eight closed
      spontaneously from 6 to 54 days. Other pancreas-related morbidity included
      pancreatitis (6), pseudocyst (2), and hemorrhage (2). Exocrine insufficiency was
      not evident in any patient and diet-controlled hyperglycemia occurred in one
      individual following 80% pancreatic resection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1749030
TI  - Hypertonic fluid resuscitation improves cerebral oxygen delivery and reduces
      intracranial pressure after hemorrhagic shock.
AB  - Prospective clinical studies have shown that hypotension from hemorrhage
      contributes to increased morbidity and mortality in patients with traumatic brain
      injury. It is implied that poorer outcome is the result of secondary brain injury
      from impaired cerebral oxygen delivery (cO2del). We studied the early and late
      effects of hypertonic sodium lactate (HSL: 500 mOsm/L) resuscitation on mean
      arterial pressure (MAP), cardiac output (CO), systemic oxygen delivery (sO2del),
      cerebral perfusion pressure (CPP), intracranial pressure (ICP), cO2del, cerebral
      blood flow (CBF), serum osmolality, and cortical water content (CWC) in a porcine
      model of hemorrhagic shock. Swine were randomized to receive a bolus (4 mL/kg) of
      either lactated Ringer's solution (LR: 274 mOsm/L) or HSL after shock, followed
      by either LR or HSL to return MAP to baseline levels. Shed blood was returned 1
      hour after resuscitation, and all animals were studied for 24 hours. Control
      animals were instrumented only. The HSL resuscitation significantly increased
      cO2del and CBF for 24 hours postresuscitation when compared with LR. The ICP in
      the HSL-treated animals was significantly lower throughout the postresuscitation
      phase when compared with the LR-treated animals (p less than 0.05). The CWC was
      significantly lower in the HSL-treated animals (p less than 0.05). We attribute
      these effects to hypertonic dehydration of both the brain parenchyma and the
      cerebrovascular endothelium. These data suggest that by decreasing ICP and
      improving cO2del after shock, HSL could decrease secondary brain injury when
      brain injury and shock occur together.

PMID- 1749031
TI  - Penetrating zone-II neck injuries in children.
AB  - Over a 4-year period, 1,237 children under 16 years of age were managed at our
      level-I pediatric trauma center, of which 24 (1.9%) had zone-II penetrating neck
      injuries. Six of these 24 children (25%) were explored surgically with positive
      findings in four and negative findings in two neck explorations; five children
      (21%) underwent radiologic or endoscopic studies and were observed; 13 (54%) were
      observed only and did not require studies or exploration. Nonoperative
      observation of penetrating zone-II neck injuries is safe and the procedure of
      choice if active observation can be performed and the facilities for immediate
      operative intervention are available.

PMID- 1749032
TI  - Minor splenic injuries: associated injuries and transfusion requirements.
AB  - To address criticisms of nonoperative management of splenic injury, we
      hypothesized that (1) patients with minor splenic injuries have a lower risk of
      associated visceral damage than patients with splenic injuries in general, and
      (2) exploration of these patients does not decrease their blood requirements. We
      reviewed charts of 182 patients who suffered blunt splenic trauma between 1983
      and 1988. Sixty-seven sustained minor injuries, defined as requiring no therapy
      or responding to topical hemostatic agents. Twenty-three were initially managed
      nonoperatively, with three subsequently explored surgically for falling
      hematocrit; no associated injury requiring therapy was found. The median
      transfusion requirement in these 23 patients was 2 units. Forty-four were
      immediately explored, 11 for readily diagnosed injuries mandating laparotomy. The
      other 33 were explored for hemoperitoneum. One had an unsuspected bowel injury.
      The median blood requirement in these 33 was 2.5 units. We conclude that patients
      with minor splenic injuries who have no other indication for laparotomy have a
      very low incidence of associated significant abdominal injury. Their transfusion
      requirements are also not reduced by exploration.

PMID- 1749033
TI  - Delayed diagnosis of cervical spine injuries.
AB  - Over a 32-month period, the cases of all patients with multiple injuries on whom
      cervical spine roentgenograms (CSRs) were obtained during blunt trauma evaluation
      in a trauma center were reviewed to determine the incidence, outcome, and
      clinical consequence of delayed diagnosis of cervical spine injuries. A total of
      1,331 patients had CSRs following blunt injury. Sixty-one (4.6%) of the patients
      had documented cervical fractures or dislocations. The patients were seriously
      injured (mean Trauma Score, 12; mean Glasgow Coma Scale score, 11; and mean
      Injury Severity Score, 30.3). Eleven of the patients died in the trauma room; 9
      with fatal atlantoaxial dislocation. Of the 50 survivors (81.9%), neurologic
      deficits were present in 15 (30%), and 8 of those had complete spinal cord
      injuries. The diagnosis of the cervical spine injury was made during the initial
      evaluation in 56 of the 61 patients (91.8%). Five patients had delayed
      recognition of their cervical spine injury (2-21 days). The reason for the delay
      was incomplete CSRs in all patients, despite multiple views (up to 13). The
      missed injuries occurred in patients in whom complete visualization of the spine
      was most difficult (i.e., severe degenerative arthritis of the cervical spine in
      two patients; previous cervical fractures in one patient; instability during
      resuscitation in one patient). Radiologic misinterpretation occurred in one
      patient. The diagnosis of cervical spine injury was pursued because of persistent
      neck pain in two patients, and the development of subtle neurologic findings in
      three. The neurologic deficits in the three patients resolved.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1749034
TI  - Management of patients with indeterminate diagnostic peritoneal lavage results
      following blunt trauma.
AB  - The management of blunt trauma victims with indeterminate diagnostic peritoneal
      lavage (DPL) findings remains controversial. We reviewed 1,196 patients
      undergoing DPL to identify patients with indeterminate DPL (red cell counts of
      20,000 to 99,999 rbc/mm3). Only 4% (48%) had indeterminate DPL results. Repeat
      DPL (R-DPL) was performed in 31 patients. Six repeat DPLs produced positive
      results (greater than 100,000 rbc/mm3), 15 produced indeterminate results, and 10
      produced negative results (less than 20,000 rbc/mm3). A review of the nine
      laparotomies performed in this group revealed only two operations that were
      therapeutic. Twelve patients had abdominal CT scans following indeterminate DPL.
      Six patients had negative CT scans and were successfully managed without
      operation. The findings were positive on six other CT scans. Four patients with
      positive CT scans, including two splenic injuries, one liver injury, and one
      renal laceration, were managed successfully without surgery. The remaining two
      patients with positive CT scans underwent laparotomy. The first had a
      renovascular injury diagnosed from the CT scan after negative findings on repeat
      DPL. The second had a minor splenic injury diagnosed from the CT scan. A
      subsequent repeat DPL produced a positive result prompting a nontherapeutic
      operation. Eleven patients were observed without repeat DPL or CT scanning. Of
      these, four eventually underwent laparotomy on the basis of clinical suspicion
      alone. Only one of these patients required therapeutic intervention at the time
      of laparotomy. Intra-abdominal injury was common in patients with indeterminate
      DPL results, however, only four (8%) of the patients required a therapeutic
      operation. Both negative repeat DPL results or negative findings on CT scans
      predicted successful nonoperative management.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1749035
TI  - Death and disability from agricultural injuries in Wisconsin: a 12-year
      experience with 739 patients.
AB  - During a 12-year period, 739 patients were admitted to a referral trauma center
      as the result of injuries incurred while farming. There were 608 (82%) male
      patients and 131 female patients. Ages ranged from 1 to 89 years including 160
      patients (22%) less than 16 years old and 78 patients (11%) more than 65 years
      old. The injury mechanism was a farm animal in 225 (30%), farm machinery in 168
      (23%), a tractor in 120 (16%), a fall in 77 (10%), a power take-off in 47 (7%), a
      cornpicker in 42 (6%), and miscellaneous in 60 (8%). There were 16 (2%) deaths
      attributable to the agricultural accident. Tractors were involved in eight of
      these deaths, falls in four, power take-offs in three, and farm machinery in one.
      Furthermore, 159 (22%) patients were left with significant permanent disability
      including orthopedic problems in 131 patients, neurologic deficits in 22, and
      pulmonary disability in 6. Agricultural trauma is frequent and diverse with
      unique injury mechanisms. Life-threatening injuries are often seen and permanent
      disability is common. Effective injury prevention must focus on farmer education,
      additional mandatory safety features on agricultural equipment, and appropriate
      design of rural trauma systems.

PMID- 1749036
TI  - Sagittally oriented fractures of the lateral masses of the cervical vertebrae.
AB  - Lateral flexion of the cervical spine may cause a sagittally oriented fracture of
      the lateral mass with shearing of all or part of the lateral mass away from the
      vertebral body. We report 22 patients with 24 sagittal fractures of the cervical
      lateral masses. Cross-table lateral roentgenograms suggested the presence of a
      sagittal lateral mass fracture in two thirds of the cases based upon malalignment
      or widening of the facet joints, displaced fracture fragments, subluxation of the
      spine, or rotation of the spine above the level of abnormality. However, the
      cross-table lateral roentgenogram was normal in one third of cases. Oblique
      roentgenograms were available in eight cases; these were positive in five,
      equivocal in one, and negative in two. Visible fracture lines, often associated
      with lateral displacement of part or all of the lateral mass, allowed all 24
      fractures to be detected on the supine anteroposterior view films. Sagittal
      lateral mass fractures were unstable in 59% (13/22) of the cases; neurologic
      deficits, including quadriplegia, hemiplegia, and radiculopathy, were present in
      45% (10/22). Computed tomography and complex-motion tomography were useful in
      confirming the sagittal lateral mass fracture and in detecting other associated
      fractures.

PMID- 1749037
TI  - Epidemiology of acute knee injuries: a prospective hospital investigation.
AB  - During a 1-year period, data on all acute injuries treated at emergency
      departments were entered into a registry; of these injuries, 6% involved the knee
      joint. The patients were followed until a definite diagnosis was established. The
      rate of anterior cruciate ligament injuries and meniscus tears was, respectively,
      0.3 and 0.7 (injuries per 1,000 inhabitants per year). The rate of dislocations
      of the patellofemoral joints was equal to the rate of anterior cruciate ligament
      injuries. Ten percent of the cases involved ligament injuries, and isolated
      ruptures of the anterior cruciate ligaments were twice as common as combined
      lesions of this ligament. Injuries of both the collateral ligament and the
      meniscus represented 6% of the cases. In most age groups male patients
      predominated, but the frequency of anterior cruciate ligament injuries was
      similar in both sexes, while the frequency of collateral ligament injuries and
      meniscus tears varied according to both gender and age. Only 27% of the injuries
      were associated with sports activities, but they were found twice as often among
      athletes than people injured in nonathletic accidents. Ruptures of the collateral
      ligament and anterior cruciate ligament were four and seven times more common
      among athletes, respectively, while athletes sustained fewer meniscus tears than
      people involved in nonathletic activities. Half of the patients needed further
      care after primary treatment, and 18% were primarily (65%) or secondarily (35%)
      admitted to in-patient care. Operative treatment, including arthroscopic
      examination, was performed in 20% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1749038
TI  - Early experience with the gamma interlocking nail for peritrochanteric fractures
      of the proximal femur.
AB  - Surgical fixation, early weight-bearing, and bony union remain a challenge in the
      treatment of peritrochanteric femur fractures, especially if the fractures are
      comminuted or unstable. Preliminary experience with the Gamma locking nail, a
      short intramedullary nail connected to a sliding compression screw augmented with
      distal locking screws, is presented. In a consecutive series of 29 patients, all
      fractures were adequately reduced and immediate weight-bearing was begun
      regardless of fracture configuration (13/27 fractures classified as unstable).
      Twenty-seven patients were reviewed at 6 months. At follow-up, all patients
      continued to be ambulatory and all fractures healed. Major complications included
      screw migration in the femoral head (two patients), difficulty in securely
      placing the distal screws (eight patients), and a femoral shaft fracture through
      the distal locking screws following a fall. The technical problems inherent in
      the device and its instrumentation are discussed. In this early experience, the
      Gamma nail appears to allow for early patient ambulation regardless of the
      fracture configuration with excellent clinical results.

PMID- 1749039
TI  - Distal femoral nonunion treated with interlocking nailing.
AB  - From December 1986 to September 1989, 24 consecutive cases of distal femoral
      nonunion in adults were treated with Grosse-Kempf interlocking nailing and
      prospectively followed for an average of 32 months. The union rate was 91.7%
      (22/24) with a union period of 4.5 +/- 1.8 months. Complications occurred in two
      patients (8.3%), who suffered nonunion because of implant failure. A cast brace
      is very useful in promoting ambulation and reducing early overactivity. The
      potential for implant failure is a result of a concentration of stress over the
      nail hole, with the most stress occurring near the fracture site (p less than
      0.05).

PMID- 1749040
TI  - Interleukin 6--a potential mediator of lethal sepsis after major thermal trauma:
      evidence for increased IL-6 production by peripheral blood mononuclear cells.
AB  - We studied the plasma levels of the acute phase mediator interleukin 6 (IL-6) in
      21 severely burned patients (burn injuries ranging from 24% to 75% total body
      surface area). The posttraumatic course of the IL-6 plasma levels was closely
      related to the clinical outcome. The nonseptic survivors as well as survivors
      with suspected sepsis (n = 14) exhibited maximal amounts of IL-6 (251 +/- 32
      pg/mL) during the first 3 days post-burn, which subsequently returned to values
      within the normal range (days 30 to 50; 26 +/- 8 pg/mL). In the nonsurvivors (n =
      7) IL-6 concentrations permanently increased (up to 1,921 +/- 356 pg/mL) until
      death (days 10 to 19) resulting from sepsis with consecutive multiple organ
      failure. Peripheral blood mononuclear cells (PBMCs) of patients expressed IL-6
      specific mRNA in vivo at high levels in contrast to the PBMCs of healthy donors.
      In addition, the spontaneous and PHA-induced in vitro production of IL-6 by
      patients' PBMCs was enhanced compared with healthy controls, whereas no
      significant differences were obtained with bacterial endotoxin (LPS). The
      findings suggest that interleukin 6 is a potential mediator of lethal sepsis
      after major thermal trauma.

PMID- 1749041
TI  - Angiographically placed balloons for arterial control: a description of a
      technique.
AB  - Obtaining proximal and distal control is essential in the repair of arterial
      injuries. Occasionally, the location of the injury makes this difficult, risks
      excessive blood loss, or requires wide exposure to obtain control. Recently, we
      have used percutaneously placed balloons as an aid to vascular control in 11
      patients who had arterial injuries identified angiographically. The balloon is
      placed under fluoroscopic guidance and is then deflated. The balloon is
      reinflated intraoperatively at the time vascular control is needed. Five balloons
      were placed for inflow control in patients with very proximal subclavian artery
      injuries. All were then able to undergo successful repair through a limited
      supraclavicular incision without sternotomy or thoracotomy. Two were placed in
      the internal carotid artery to obtain distal control in injuries located at the
      base of the skull. Both injuries were then repaired without problems. Two
      patients had balloons placed for external iliac artery injuries located at the
      inguinal ligament, one for proximal and one for distal control. Both injuries
      were then repaired through a limited incision. Two additional patients who had
      arterial injuries identified began to bleed massively while in the angiography
      suite. Balloons were placed proximally to control bleeding during transport and
      dissection. There were no complications from balloon placement. All balloons
      functioned well, greatly limited blood loss, and allowed for repair through a
      limited incision. We feel this is a technique that can be utilized in selected
      cases of angiographically identified arterial injuries in which operative
      exposure is likely to be difficult, cause significant blood loss, or require an
      extensive incision and dissection.

PMID- 1749042
TI  - Plastic deformation of the forearm: a review and case reports.
AB  - Plastic deformation of long bones can occur in any age group but it is more
      common in children. Based on our experience with this condition and the suggested
      guidelines for treatment in the literature, we believe that significant deformity
      (15 degrees or more) in children over 10 years of age should be manipulated and
      corrected. In children 6 to 10 years of age, attempts should be made to correct a
      severe deformity (20 degrees or more). Children under 5 years of age probably
      require no treatment, since remodelling most likely will restore the correct
      anatomy and function.

PMID- 1749043
TI  - Radial neck fracture complicating closed reduction of a posterior elbow
      dislocation in a child: case report.
AB  - A case of radial neck fracture complicating repeated attempts at closed reduction
      of a posterior elbow dislocation in a child is described. This case underscores
      the necessity of using proper technique when reducing posterior elbow
      dislocations. The mechanism of radial neck fracture in association with posterior
      elbow dislocation is discussed.

PMID- 1749044
TI  - Bilateral traumatic anterior/posterior dislocations of the hip joints: case
      report.
AB  - A case of simultaneous traumatic bilateral anterior/posterior hip dislocations in
      a 28-year-old man is presented. The mechanism and treatment of this injury, as
      well as its complications, are discussed.

PMID- 1749045
TI  - Posttraumatic meningococcal meningitis: case report.
AB  - A case is described of fulminant meningococcal meningitis occurring 1 day after
      serious head and facial trauma. Although meningococcus is one of the most common
      causes of bacterial meningitis in general, it is distinctly rare as a cause of
      posttraumatic meningitis. A review of the literature is included.

PMID- 1749046
TI  - Isolated injury of the coracoid process: case report.
AB  - Injuries of the coracoid process are generally rare in traumatic injuries of the
      shoulder. To our knowledge, there have been fewer than 12 cases of isolated
      injury of the coracoid process reported in the world literature. We present a
      case of isolated injury to the coracoid process and discuss its significance.

PMID- 1749047
TI  - Hepatic duct disruption from blunt abdominal trauma: case report and literature
      review.
AB  - A laceration-avulsion injury of the hepatic duct from blunt trauma is described.
      Operative findings rather than preoperative studies led to the correct diagnosis.
      A combination of suture repair, left hepatic duct ligation, and
      hepaticojejunostomy were used to primarily manage this complex injury.
      Postoperative hepatobiliary scintigraphy and clinical follow-up over 1 year
      demonstrate satisfactory biliary drainage. Principles of the management of
      hepatic duct injury are reviewed.

PMID- 1749048
TI  - Rupture of the flexor tendon secondary to osteoarthritis of the pisotriquetral
      joint: case report.
AB  - Attrition ruptures of the flexor tendons in the carpal tunnel are uncommon. A
      case of rupture of the flexor digitorum profundus tendon to the little finger
      secondary to osteoarthritis of the pisotriquetral joint is reported. Mechanical
      attrition against the radial side of the pisiform was thought to be responsible
      for the rupture.

PMID- 1749049
TI  - Chronic neuropsychological and neurological impairment following acute exposure
      to a solvent mixture of toluene and methyl ethyl ketone (MEK).
AB  - A 38 year-old laborer experienced solvent intoxication during each of two spray
      paintings of a dump truck and other heavy equipment in an enclosed, unventilated
      garage. The paint base consisted primarily of toluene and methyl ethyl ketone.
      Nausea, headaches, dizziness, respiratory difficulty and other symptoms began
      after exposures. Over the next several days he developed impaired concentration,
      memory loss and cerebellar signs including an intention tremor, gait ataxia and
      dysarthria. MRI of the brain and EGG early in the work-up were normal, although
      later MRIs demonstrated fluid collection over the left parietal area. Examination
      by a toxicologist and neurologist revealed likely toxic encephalopathy with
      dementia and cerebellar ataxia. Three formal neuropsychological assessments over
      2 1/2 years quantified cognitive, motor and behavioral changes. Despite similar
      findings in chronic exposure to these solvents, lasting sequelae following acute
      exposure have not been widely reported.

PMID- 1749050
TI  - Acetonitrile serum concentrations and cyanide blood levels in a case of suicidal
      oral acetonitrile ingestion.
AB  - Acute acetonitrile toxicity is mainly dependent on the release of cyanide via
      hepatic metabolism. Although evaluated in animals, few data are available
      concerning the toxicokinetic parameters of acetonitrile and acetonitrile
      liberated cyanide in human. This paper reports a case of suicidal oral
      acetonitrile ingestion of about 5 mL without severe symptoms of intoxication in a
      previously healthy adult male with a body weight of 60 kg. Acetonitrile serum
      concentrations as well as cyanide blood levels were determined over the whole
      hospitalization. The elimination half-lives calculated from these data were 32 h
      for acetonitrile and 15 h for cyanide. After sodium thiosulfate bolus
      application, the cyanide blood level rapidly decreased to 10% of the initial
      value, indicating that sodium thiosulfate sufficiently detoxifies acetonitrile
      liberated cyanide. Since cyanide levels again increased to maximal values about
      4.5 h after sodium thiosulfate application, continued thiosulfate therapy is
      required as predicted by the long elimination half-lives of acetonitrile and
      acetonitrile-liberated cyanide. Determination of cyanide and acetonitrile
      concentrations is recommended for the estimation of optimal individual sodium
      thiosulfate dosage.

PMID- 1749051
TI  - Mushroom poisoning in the United States--an analysis of 1989 United States Poison
      Center data.
AB  - An analysis of mushroom case exposures reported in 1989 to the American
      Association of Poison Control Centers "National Data Collection System" by poison
      centers in the United States was conducted to obtain a clearer view of mushroom
      poisoning epidemiology and outcome in the United States.

PMID- 1749052
TI  - Toxicity after self-poisoning by ingestion of potassium chloroplatinite.
AB  - A 31 year-old man ingested 10 mL of a photographic toning solution containing 600
      mg of potassium chloroplatinite in a suicide attempt. Subsequent toxic effects
      included acute oliguric renal failure, metabolic acidosis, fever, muscle cramps,
      gastroenteritis and rhabdomyolysis. Laboratory abnormalities included mildly
      elevated liver enzymes and elevated peripheral blood neutrophil and eosinophil
      counts. All symptoms and signs of toxicity resolved over a six day hospital stay
      with supportive medical management only; thereafter he was lost to medical follow
      up. A spot serum platinum concentration was 245 mcg/dL and a spot urine platinum
      concentration was 4200 mcg/L.

PMID- 1749053
TI  - Normal fetal outcome after maternal ciguateric toxin exposure in the second
      trimester.
AB  - A case of a severe episode of ciguatera poisoning in a mother during the second
      trimester is presented. The mother experienced an increase of fetal movements one
      hour after the poisonous meal. She endured multisystemic symptoms typical of
      ciguatera for eight weeks. The presence of ciguatoxin in the fish was confirmed
      by immunoassay and two bioassays. The newborn at term was normal with adequate
      respiratory and neurological reflexes. The child developed normally in his first
      10 months. This is in contrast with another report of a mother exposed to
      ciguatoxin at term who delivered an infant suffering from facial palsy and
      possible myotonia of the hands. Dose and gestational timing may explain these
      observed differences.

PMID- 1749054
TI  - Toxic neonatal effects following maternal clomipramine therapy.
AB  - Clomipramine is a chlorinated tricyclic antidepressant commonly used in the
      treatment of depression (1). The drug is widely prescribed in Europe and Canada
      and has been recently approved for use in the USA. Its safety during pregnancy
      and breastfeeding, however, has not been fully established. Very few reports on
      its effect on the fetus and neonate have been published (2,3). We report a case
      of a mother treated with clomipramine during pregnancy, and the side effects
      observed in the infant. The correlation between plasma clomipramine
      concentrations in the baby's blood and clinical effects are described.
      Subsequently, we present the pregnancy outcome of five prospectively collected
      cases.

PMID- 1749055
TI  - Philodendron/dieffenbachia ingestions: are they a problem?
AB  - Ingestions involving the philodendron/dieffenbachia members of the Arum family
      are allegedly associated with the development of intense irritation of mucous
      membranes, resulting in swelling of the tongue, lips and palate. Although
      numerous literature citations promote their toxicity, there are few case reports
      which substantiate a cause-effect relationship between ingestion and resultant
      symptomatology. To assess the toxic manifestations associated with the ingestion
      of these plants, a retrospective review of such cases reported to a Regional
      Poison Information Center was performed. 188 cases were identified and the
      integrity of the leaf had been broken in all cases. Philodendrons accounted for
      67.5% and dieffenbachias for 32.5% of the cases. 72.8% involved children aged 4
      12 months. Only 2.1% (4) of the patients were symptomatic (dieffenbachia-3;
      philodendron-1). In all cases, the symptoms occurred within 5 minutes of the
      exposure and were of short duration and the outcome was classified as minor. In
      this 24 month senses of 188 exposures, severe oral complications and the delayed
      development of symptoms were not observed.

PMID- 1749056
TI  - Diagnosis of snake venoms by a reverse latex agglutination test.
AB  - A reverse latex agglutination test using protein A column purified rabbit
      antivenom IgG-sensitized latex particles was developed for the detection of the
      six medically important snake venoms of Thailand. The detection limit of the
      reverse latex agglutination test was 0.16 to 1.2 micrograms/mL of crude venoms.
      Cross-reactions with heterologous venoms were observed at concentrations 460 to
      16000 times that of homologous venoms. Detection of various snake venoms in
      clinical specimens was carried out by the reverse latex agglutination test. The
      sensitivity was 52.5% of the 59 serum samples. There was one (1.69%) false
      positive sample. The positive detection of venom in wound swabs (26 cases) was
      38.5% and was not statistically different from that observed in paired serum
      samples. Interference from human plasma, serum and urine on the reverse latex
      agglutination test could be eliminated by adsorption with normal rabbit IgG
      coated latex suspension or by heat inactivation at 56 degrees C for 30 min.
      Prozone effect observed in some sera was eliminated by heat inactivation at 56
      degrees C for 30 min. The sensitized latex particles were stable at 4 degrees C
      and -20 degrees C for at least 3 months. Cycles of freezing-thawing and
      lyophilization did not change their reactivities. The total test time was about
      40 min.

PMID- 1749057
TI  - Rhabdomyolysis after suicidal ingestion of an overdose of caffeine, acetaminophen
      and phenazone as a fixed-dose combination (Spalt N).
AB  - Rhabdomyolysis without renal failure was noted after suicidal ingestion of 29
      tablets of Spalt N containing 7.25 g of acetaminophen, 7.25 g of phenazone and
      1.45 g of caffeine by a 29 year-old weighing 73 kg. The maximum serum creatine
      kinase was 1920 U/L, serum myoglobins were 49 to 167 ng/mL. Acetaminophen,
      phenazone and caffeine were quantified and identified in serum by gas
      chromatography and gas chromatography/mass spectrometry. It is suggested that
      rhabdomyolysis might have been caused by caffeine.

PMID- 1749058
TI  - Flumazenil for the reversal of refractory benzodiazepine-induced shock.
AB  - Benzodiazepines are known to cause central nervous system and centrally mediated
      cardiovascular depression. The benzodiazepine antagonist flumazenil has been
      shown to antagonize benzodiazepine-induced central nervous system depression. We
      report a case in which cardiovascular depression secondary to benzodiazepine use
      was reversed by this agent.

PMID- 1749059
TI  - Poison center numbers.

PMID- 1749060
TI  - Adverse drug reaction.

PMID- 1749061
TI  - Cocaine Abuscreen in the emergency room.

PMID- 1749062
TI  - Nutritional adjustments in response to reproductive stresses within Guatemalan
      women.

PMID- 1749064
TI  - Maternal malnutrition and breastfeeding: is there really a choice for policy
      makers?

PMID- 1749063
TI  - Influences of maternal nutrition and lactation on length of post-partum
      amenorrhoea.

PMID- 1749065
TI  - The implications of poor maternal nutritional status during pregnancy for future
      lactational performance.

PMID- 1749066
TI  - Treatment of torsade de pointes with intravenous magnesium in idiopathic long QT
      syndrome.
AB  - A middle aged woman with idiopathic long QT syndrome was found to have repetitive
      ventricular tachycardia of the "torsade de pointes" type. The arrhythmia was
      resistant to mexiletine and lidocaine, but was controlled by intravenous
      magnesium sulfate (MgSO4). The recurrent attacks were abolished by a bolus of 2.0
      g MgSO4, and extremely prolonged QTU interval was reduced by intravenous infusion
      of 5 mg/min MgSO4 for 36 h. This case shows the effectiveness of intravenous
      magnesium in controlling the attack of torsade de pointes in patients with
      idiopathic long QT syndrome.

PMID- 1749067
TI  - Transient segmental asynergy of the left ventricle of patients with various
      clinical manifestations possibly unrelated to the coronary artery disease.
AB  - Eight cases of transient reversible segmental asynergy of the left ventricle
      thought not to be related to coronary artery lesions are reported. Three cases
      were associated with inflammatory reactions of unknown origin, and one each with
      lactic acidosis, abdominal surgery, hypoglycemia, tetanus and pneumonia. None of
      the patients had symptoms suggestive of ischemic heart disease before or after
      these episodes. Electrocardiograms before these episodes were all normal. Two
      dimensional echocardiography was performed to evaluate abnormal
      electrocardiograms. Coronary angiography was performed in 4 of 8 cases and was
      normal in all 4 cases; 2 done as emergencies and 2 non-emergencies. Two
      ergonovine tests were negative. Left ventricular wall motion abnormalities,
      present mainly at the apex of the left ventricle, returned to normal in 1 to 4
      weeks. Giant negative T waves in the chest leads during this recovery period were
      characteristic electrocardiographic features and normalized in 6 weeks on
      average. We believe that these episodes were not related to ischemia due to
      coronary artery disease, but to some metabolic humoral factors. An excellent
      prognosis can be expected if these abnormal metabolic circumstances can be
      resolved.

PMID- 1749068
TI  - Hemodynamic efficacy of E-1020 in comparison with dopamine on acute mitral
      regurgitation in anesthetized dogs.
AB  - To evaluate the effects of a new phosphodiesterase inhibitor, E-1020 (1, 2
      dihydro-6-methyl-2-oxo-5-(imidazo [1, 2-a] pyridin-6-yl)-3-pyridine carbonitrile
      hydrochloride monohydrate), on cardiovascular hemodynamics in acute heart
      failure, we compared its effects with those of dopamine on experimentally
      produced acute mitral regurgitation in dogs. After the production of mitral
      regurgitation by transmyocardial chordal sectioning and obtaining a stable state,
      dopamine (5 micrograms/kg/min) was infused until the peak positive dP/dt (peak
      (+) dP/dt) increased to about 50% of the predopamine value. After complete
      recovery, E-1020 (30 micrograms/kg) was infused over 5 min and the data were
      obtained 10 min later. Both drugs equally increased peak (+) dP/dt, decreased
      systemic vascular resistance, and increased cardiac output. Left ventricular (LV)
      end-diastolic pressure, LV end-diastolic segment length (EDL), and mean left
      atrial (LA) pressure decreased with both drugs. The changes in EDL and mean LA
      pressure were larger with E-1020 than with dopamine (p less than .01 and p less
      than .05). Although mean inferior vena caval blood flow volume (mIVCF) increased
      and mean inferior vena caval pressure decreased with both drugs, the increment of
      mIVCF was smaller with E-1020 (p less than .001). Thus, E-1020 had not only a
      positive inotropic effect but also a vasodilatory action both on resistance
      vessels and on capacitance vessels.

PMID- 1749069
TI  - XeCl excimer laser-induced fluorescence for selective ablation of atheromatous
      tissue.
AB  - In order to develop a reliable laser-induced fluorescence (LIF) guided laser
      angioplasty system, real time, pulse-by-pulse fluorescence spectra were recorded
      and the same fiberoptic was used for both detection of the fluorescence and for
      atheromatous tissue ablation. A 308 nm XeCl excimer laser served as the laser
      source for both the induction of fluorescence and the ablation. The fluorescence
      signal was induced at high laser energies during ablation without any serious
      change in the fluorescence pattern. A new characteristic fluorescence peak at 540
      nm for atheromatous tissue was observed after treatment with chlortetracycline
      hydrochloride (CTC). This allowed the development of an algorithm and a
      subsequent index to discriminate the atheromatous tissue from the normal tissue.
      During atheromatous tissue ablation, this index changed as normal tissue was
      approached, thereby avoiding vessel perforation. Our results suggest that
      monitoring of this index through the catheter delivering the laser energy
      enhances selective ablation while simultaneously reducing the risk of vessel
      perforation.

PMID- 1749070
TI  - Contribution of calcium-activated neutral protease to the degradation process of
      ischemic heart.

PMID- 1749071
TI  - Neutrophil-induced myocardial cell damage and active oxygen metabolites.
AB  - Free radicals derived from polymorphonuclear leukocytes (PMN) have been suggested
      to play an important role in myocardial ischemia-reperfusion injury. To define
      the mechanism by which activated PMN exacerbate ischemic myocardial damage, we
      investigated the extent of cell injury, free radical generation and lipid
      peroxidation in embryo mouse myocardial cells co-incubated with activated PMN.
      The generation of free radicals derived from PMN correlated with the extent of
      myocardial cell injury. Among the cell sheets preconditioned with hypoxic and
      glucose free medium, PMN-adhered myocardial cells were initially injured after
      adding PMN activator, extending to adjacent cells. Chemiluminescence emission and
      thiobarbituric acid reactive substance in the co-incubated cells were markedly
      increased and sustained compared with those in each cell monoincubation. The
      augmented lipid peroxidation was related to the progression of myocardial cell
      injury. These results indicate that PMN-derived free radicals cause membrane
      disruption, contributing to the progression of myocardial injury.

PMID- 1749072
TI  - Cardiac muscle cell damage through autoimmune mechanism--can cardiac proteins
      provoke autoimmune myocarditis?
AB  - In this paper, the ability of human cardiac myosin to provoke autoimmune
      myocarditis was investigated. Myosin fractions were immunized into A.SW. mice,
      Lewis rats or Hartley guinea pigs. All of the immunized rats displayed overt
      symptoms of myocarditis and, in a few cases, died from it. The hearts of these
      rats were enlarged and discolored. Histologically, the muscles of the heart were
      characterized by remarkable cell infiltration, extensive myofiber necrosis and
      the appearance of polynuclear giant cells. Neither mice nor guinea pigs showed
      such disease profile. In this novel experimental model, the disease state was
      transferable by T lymphocytes. Thus, cardiac myosin was shown to provoke muscle
      cell damage through a T cell mediated autoimmune process.

PMID- 1749073
TI  - Mitochondrial DNA mutations and disturbances of energy metabolism in myocardium.
AB  - Since mitochondria occupy a pivotal position in energy metabolism, mitochondrial
      dysfunction is directly linked with disturbances in cellular function.
      Mitochondria possess their own DNA, which codes 13 subunits of the mitochondrial
      energy transducing system; the other subunits are coded by nuclear DNA. Recent
      advances in gene technology, especially the polymerase chain reaction (PCR),
      permit us to analyze mitochondrial DNA mutations in a small quantity of tissue.
      We devised rapid and accurate methods to detect mitochondrial DNA mutations,
      i.e., the primer shift PCR method and the PCR-Southern method. We also developed
      a method to determine DNA sequences directly without cloning. Using these
      methods, we revealed that multiple mitochondrial DNA mutations exist in the
      myocardium of patients with cardiomyopathy. One mutation was based on the
      following directly repeated sequence: 5'-CATCAACAACCG-3'. This sequence exists in
      both the ATPase6 gene and the D-loop region, and pseudo-recombination occurs at
      that directly repeated sequence resulting in a 7.4 kbp deletion. Accordingly,
      some subunits of the mitochondrial energy transducing system can not be
      biosynthesized by these deleted mitochondrial DNA, and energy transduction is
      substantially depleted. Even without reduction of blood supply, mitochondrial DNA
      mutations can induce a chronic ischemia-like state in the myocardium, which might
      be a factor in the genesis of cardiomyopathy.

PMID- 1749074
TI  - [Recent progress of Pseudomonas aeruginosa infections; pathological mechanisms of
      new toxic metabolites].

PMID- 1749075
TI  - [Refractory infection with Pseudomonas aeruginosa and the trend of clinical
      studies].

PMID- 1749076
TI  - [Methods for isolation, identification and serotyping of Pseudomonas aeruginosa].

PMID- 1749077
TI  - [Virulence factors of Pseudomonas aeruginosa in mice].

PMID- 1749078
TI  - [Role of phagocytes in pseudomonal infections].

PMID- 1749079
TI  - [Mechanism of susceptibility and resistance of Pseudomonas aeruginosa to
      aminoglycosides].

PMID- 1749080
TI  - [Mechanism of susceptibility and resistance of bacteria to beta-lactam
      antibiotics].

PMID- 1749081
TI  - [Chemical structure, anti-bacterial activity and pharmacokinetics of cephems].

PMID- 1749082
TI  - [Chemical structure, anti-bacterial activity and pharmacokinetics of
      monobactams].

PMID- 1749083
TI  - [Carbapenems as antibiotics against Pseudomonas aeruginosa].

PMID- 1749084
TI  - [Chemical structure, anti-bacterial activity and pharmacokinetics of
      aminoglycosides].

PMID- 1749085
TI  - [Pseudomonas aeruginosa infections of airway].

PMID- 1749086
TI  - [Pseudomonas aeruginosa pneumonia].

PMID- 1749087
TI  - [Mucoid Pseudomonas aeruginosa infection in cystic fibrosis].

PMID- 1749088
TI  - [Respiratory infections by Pseudomonas aeruginosa in the elderly].

PMID- 1749089
TI  - [Pseudomonas aeruginosa bacteremia].

PMID- 1749090
TI  - [Pseudomonas infection of severe burn patient].

PMID- 1749091
TI  - [Pseudomonas aeruginosa infections in children].

PMID- 1749092
TI  - [Pseudomonas corneal ulcer].

PMID- 1749093
TI  - [Chronic otitis media infected with P. aeruginosa].

PMID- 1749094
TI  - [Trend of resistant Pseudomonas aeruginosa from field of clinical laboratory
      medicine].

PMID- 1749095
TI  - [Changing resistance of Pseudomonas aeruginosa isolates from patients with
      respiratory tract infections].

PMID- 1749096
TI  - [Urinary tract infection caused by Pseudomonas aeruginosa].

PMID- 1749097
TI  - [Pseudomonas aeruginosa ocular infection].

PMID- 1749098
TI  - [Prophylactic effects of Pseudomonas aeruginosa vaccine on patients with chronic
      pulmonary disease].

PMID- 1749099
TI  - [Vaccine therapy against Pseudomonas aeruginosa].

PMID- 1749100
TI  - [Pseudomonas multicomponent vaccine in major burn patients].

PMID- 1749101
TI  - [Generation and protective activities of human monoclonal antibodies against
      Pseudomonas aeruginosa].

PMID- 1749102
TI  - [Therapeutic human monoclonal antibodies directed to Pseudomonas aeruginosa].

PMID- 1749103
TI  - [Functional image of local cerebral circulation using digital subtraction
      angiography].

PMID- 1749104
TI  - [A trend of molecular approaches to the mechanism of cancer metastasis].

PMID- 1749105
TI  - [On the mechanisms of retardation of aging and inhibition of mammary
      tumorigenesis by energy restriction in SHN/C3H F1 female mice].
AB  - Although it has long been known that energy restriction (ER) inhibits tumors and
      retards aging in rats and mice, its mode of action remains unknown. In rodents,
      ER alters the rate of age-related changes in physiological indices. Thus, it
      affects a broad array of age-sensitive parameters. However, present evidence does
      not indicate which parameters are primary contributors to the deceleration of
      aging. Compared to fasting or short-term underfeeding, little is known about the
      metabolic effects of long-term, life-prolonging ER. We thus investigated the
      effects of ER on hepatic enzyme activities, including drug-metabolizing enzymes
      and antioxidant enzymes such as superoxide dismutase and catalase. The catalase
      activity was found to be higher in ER mice than in control mice both at 12 and 24
      months of age. In accord with the high catalase activity, lipid peroxidation in
      liver was much less in ER mice than in age matched control mice. beta
      Naphthoflavone, known to induce P-450 related enzymes and xanthine oxidase, was
      given (ip) to increase lipid peroxidation. The ER was found to inhibit lipid
      peroxidation after beta-naphthoflavone treatment. It was, therefore, concluded
      that long-term life-prolonging ER increases antioxidant defence, supporting
      indirectly the free radical theory of aging. It is well known that ER delays
      puberty in rodents and has a profound influence on serum hormone levels,
      including those of prolactin (PRL) and thyroid hormones. However, it remains
      unknown how these effects are produced by ER. We therefore investigated the
      effects of ER on the islets of Langerhans in the pancreas and on the pituitary
      ovarian axis. In the islets of Langerhans, ER was found to increase the density
      of alpha-cells significantly both in 11- and 67-week-old mice. In the pituitary
      gland in ER mice, the cellular density of PRL-producing cells diminished
      significantly while that of growth-hormone-producing cells did not. One of the
      modes of action of ER on the endocrine system is thus concluded to be mediated by
      changing cellular population. Since ER decreased PRL-producing cells and PRL
      plays a key role in mammary tumorigenesis, we investigated whether ER decreased
      the gene expression of mouse mammary tumor virus (MMTV) in SHN/C3H mice. The SHN
      strain, which was found to have a new MMTV provirus locus, mtv-4, was used in the
      study.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1749106
TI  - [Carcinogenic heterocyclic amines in the environment].
AB  - The purpose of this report is to summarize data on carcinogenic heterocyclic
      amines mainly from the aspect of environmental medicine. Since 1977, a new series
      of heterocyclic amines has been isolated as potent mutagens and they have been
      shown to be carcinogenic to experimental animals. Among these carcinogens,
      carcinogenic amino-alpha-carbolines and amino-gamma-carbolines are widely
      distributed in such components of the environment as airborne particles, rain
      water, cigarette smoke, diesel exhaust particles and cooked foods. Moreover, most
      carcinogenic heterocyclic amines are reported to be present in cigarette smoke.
      These facts suggest that carcinogenic heterocyclic amines are likely to be
      ubiquitous environmental pollutants. These results also support the hypothesis
      that carcinogenic heterocyclic amines may be formed through combustion of various
      materials such as food, grass and petroleum.

PMID- 1749107
TI  - Effects of the consumption of cigarettes, alcohol and foods on serum
      concentrations of carotenoids, retinol and tocopherols in healthy inhabitants
      living in a rural area of Hokkaido.
AB  - The relationship between serum concentrations of carotenoids, tocopherols and
      retinol and the consumption of cigarettes, alcohol and foods was investigated in
      835 healthy inhabitants (aged 35-79 years) of a rural area of Hokkaido. Serum
      concentrations of beta-carotene (BC), alpha-carotene (AC), lycopene (LY), beta
      cryptoxanthin (BX), zeaxanthin (including lutein, ZX), canthaxanthin (CX) and
      beta-tocopherol (including gamma-tocopherol, BT) were higher in females than in
      males, while serum retinol (RE) concentrations were lower. Serum alpha-tocopherol
      (AT) concentrations were the same for both sexes. The serum values of BC, BX, AC,
      LY and ZX for males were inversely associated with the consumption of cigarettes
      in multiple-regression analysis. The serum values of BC, AC and BX for males were
      inversely associated with alcohol consumption, while serum RE values were
      positively related to alcohol consumption for both sexes. There were significant
      relations between serum values of BC, AC, and ZX and the intake frequencies of
      carrots, tomatoes, milk and/or green-leaf vegetables, especially for females, and
      between serum BX values and the intake of oranges, juices and fruits. Serum RE
      and AT concentrations were not associated with any food intake, and BT
      concentrations were associated with the intake of tomatoes and juices for males.

PMID- 1749108
TI  - [Changes of peripheral blood parameters in aerobic dance instructors after
      aerobic dance instruction].
AB  - To investigate the biological load of aerobic dance instruction on the body, a
      blood biological study was performed on 13 female instructors. The values were
      compared with 10 female healthy controls. The results obtained were as follows.
      1. A significant negative correlation was observed between the total experience
      of aerobic dancing (in years) and the levels of serum phospholipids. In addition,
      the numbers of white blood cells and the levels of serum phospholipids,
      lipoperoxide, uric acid and creatinine were significantly related to aerobic
      dance instruction time (years). 2. The levels of serum CPK, aldolase, GOT, BUN
      and creatinine in the aerobic dance instructors were significantly higher than
      those in the controls. 3. The levels of serum CPK, uric acid, BUN, creatinine and
      Ca increased significantly after an intermediate class lesson (about 60 minutes).
      In addition, the numbers of white blood cells also increased after the lesson,
      but not significantly. Moreover, Significant decreases of the mean corpuscular
      volume and serum Mg were observed after the lesson.

PMID- 1749109
TI  - [The effect of sharing medical costs for the aged 70 or more on the financial
      balance of the health insurance society].
AB  - The rapid increase of the proportion of older persons in society has made the
      problem of medical costs more important. Although medical cost-sharing for those
      aged 70 or more is decided by their medical costs and by the current proportion
      of such persons in the Society, it is not constant throughout the Society. The
      study evaluated the contribution ratio of medical cost-sharing for those aged 70
      or more to the financial balance of the Society. In addition, characteristics of
      the Society associated with medical cost-sharing for those aged 70 or more were
      analyzed. The results are as follows. 1) Medical cost-sharing for those aged 70
      or more was the greatest factor in the financial balance of the Society with a
      contribution ratio of as much as 55.2%. 2) Multiple regression analysis disclosed
      that dependent ratio, the average monthly salary, the area, the rate of those
      aged 70 or more and the average age of the Society members are significant in
      medical cost-sharing for those aged 70 or more. 3) Dependent ratio and the
      average monthly salary are the most important characteristics among those
      associated with medical cost-sharing for those aged 70 or more. A higher
      dependent ratio and a lower average monthly salary are related to higher cost
      sharing. This is also related to geographic factors as cost-sharing in western
      Japan is higher than in eastern Japan. The lower rate of those aged 70 or more
      and the higher average age of the Society members are related to the higher cost
      sharing.

PMID- 1749110
TI  - [A study on urinary tin in healthy adults: relationship between the concentration
      of urinary tin and life style].
AB  - The concentrations of urinary tin in healthy adults in Aichi prefecture were
      determined by anodic stripping voltammetry over a period of three years (1986
      1988), to obtain the normal tin level in urine and to elucidate the influence of
      environmental alterations on health conditions in the future. In addition to the
      above-mentioned method, the relationship to life style, dietary habits, smoking
      habits and living environment were studied, and the following results were
      obtained. 1) The mean +/- standard deviation of urinary tin levels for males was
      3.7 +/- 2.2 (micrograms/g creatinine), and 5.9 +/- 3.0 (micrograms/g creatinine)
      for females. The data showed logarithmic normal distributions in both sexes, and
      the mean concentration for females was significantly higher than that for males
      (P less than 0.001). The levels of urinary tin concentrations significantly
      increased according with age. 2) Significant correlations of urinary tin
      concentrations between two observations were noticed in repeated by observed
      subjects. 3) As to the dietary habits, fish intake increased the urinary tin
      concentration, but no definite association with canned-food intake was observed.
      4) Smoking habits and living environment also showed a tendency to increase the
      urinary tin concentration, but the difference was not statistically significant.

PMID- 1749111
TI  - [Study on digestibility and energy availability of daily food intake (Part 4.
      Shiitake mushroom)].
AB  - The digestibilities of nutrients and energy in Shiitke mushrooms (Lentinus
      edodes) was measured in healthy adult males. A test diet was given for 5 days
      after 5 days on a basal diet which supplied 40g/day of protein and 45kcal/kg/day
      of energy. The test diet was identical with the basal diet except that shiitake
      was incorporated. Digestibility was calculated by the difference of fecal output
      between the test period and the basal period. The results obtained were follows:
      1. Shiitake 60g/day intake level Digestibility of protein was 69.3 +/- 11.2%.
      Digestibility of fat was 66.6 +/- 24.9%. Digestibility of carbohydrate was 55.7
      +/- 10.5%. The ratio of the total available energy to intake energy (Net Energy
      Availability) was 55.4 +/- 15.4%. 2. Shiitake 40g/day intake level Digestibility
      of protein was 85.5 +/- 23.8%. Digestibility of fat was 70.0 +/- 90.1%.
      Digestibility of carbohydrate was 65.8 +/- 13.1%. The ratio of the total
      available energy to intake energy (Net Energy Availability) was 67.4 +/- 25.9%.

PMID- 1749112
TI  - [Correlation between odor thresholds and saturated vapor pressures of odorants].
AB  - The purpose of our work is to develop an estimation method for odor thresholds on
      the basis of physicochemical properties of odorous compounds. In this report, we
      examined the correlation between odor thresholds (Cth) and the saturated vapor
      pressures (Pvp) of various odorants. Results. 1) There were very good
      correlations between Pvp and k. k represents an indicator of lipid affinity. In
      our earlier report, k was obtained by the analysis of the gas chromatography with
      a column packed with a support coated by a phospholipid. Accordingly the
      correlations show that Pvp may be an indicator of solubility into the lipid
      phase. 2) It was found that correlations between Pvp and Cth were very good in
      several homologous series of aliphatic compounds. However ionized substances,
      such as acids and amines, and sulfur compounds had no good correlations. 3) In
      odorants having more than 3-5 carbon atoms, odor thresholds of normal types were
      higher than those of iso types. 4) In the series of amines, the relationship
      between Cth and Pvp depended upon the length and the number of alkyl chains
      combined with the contained nitrogen atom. 5) In the series of alcohol and
      aldehyde, the decrease of Cth in the rate became smaller with the decrease of
      Pvp.

PMID- 1749113
TI  - Lifestyle and the right to clean air in public places (RCA) (Part 3).
      Relationship between opinions concerning RCA and personal lifestyle.
AB  - As a preliminary study to evaluate the possible roles of health education
      (education to acquire a healthy lifestyle) in supporting the development of a
      smokeless society, the relationship between opinions concerning the right to
      clean air in public places (RCA) and personal lifestyle as well as the
      relationships among three aspects of RCA and personal lifestyle were investigated
      in a randomly-selected sample (n = 887) of a population using a self-administered
      questionnaire. Relationships between opinions concerning RCA and lifestyle were
      analyzed within four subgroups of subjects defined by smoking status and sex. The
      results of these analyses indicated that opinions concerning RCA among women are
      related to knowledge of RCA and personal lifestyle while male opinions concerning
      RCA bear no statistical relationship to personal lifestyle. These results imply
      the possibility that knowledge of RCA and opinions concerning RCA among women can
      be effectively promoted by health education. The results of our analyses
      concerning the three aspects of RCA and personal lifestyle also indicate that
      attitudes toward RCA are positively correlated with factors other than knowledge
      and opinions concerning RCA; this implies the possibility that health education
      has but a limited impact on attitudes toward RCA.

PMID- 1749114
TI  - [Regional distribution of sulfatide in human kidney, and anti-sulfatide
      antibodies in sera from patients with nephritis detected by TLC immunostaining].
AB  - Glycolipids were isolated from lipid extract of human kidney. The major neutral
      glycolipids have been identified as ceramide monohexoside (CMH), ceramide
      dihexoside (CDH), ceramide trihexoside (CTH), and globoside. As the major acidic
      glycolipids, Gal Cer sulfate (sulfatide), Lac Cer sulfate, GM3, sialosyl
      paragloboside, GD3, and disialosyl paragloboside were identified and the most
      abundant component was sulfatide. Sulfatide was 2 times more concentrated in
      medulla compared to cortex. In addition, the localization of sulfatide antigen
      was determined in renal sections by immunoperoxidase staining method. Strong
      positive staining with sulfatide was observed in distal tubules, limbs of Henle's
      loop and collecting tubules of normal tissue, whereas glomeruli were negative of
      staining. However, positive results of glomerular epithelial cells occurred in
      FSGS and IgA nephropathy so far. Acidic fraction of lipid extract were
      chromatographed and then tested for antigen by immunostaining. Sera from patients
      with nephritis contain antibodies to the sulfatides of human kidney as determined
      by the direct binding of antibody to thin-layer chromatograms. These results
      suggest that sulfatide antigen may play important role in the occurrence and
      aggravation of glomerular diseases.

PMID- 1749115
TI  - [Study on the assay of uremic protein-binding inhibitors: furan compound and
      hippuric acid].
AB  - Plasma levels of 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (FA) and
      hippuric acid (HA) were studied in healthy subjects, uremic patients undergoing
      continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD). Analysis
      of FA and HA in the plasma were performed by gas chromatography with capillary
      column. The mean value of FA in HD patients (16.7 +/- 6.1 micrograms/ml) was
      significantly higher than these in healthy subjects (3.6 +/- 1.0 micrograms/ml)
      and in patients on CAPD (4.1 +/- 3.7 micrograms/ml) (p less than 0.01). HA levels
      in CAPD and HD groups were higher than those in healthy controls (2.4 +/- 0.8
      micrograms/ml). In addition, the values in HD patients (46.7 +/- 53.5
      micrograms/ml) were more increased than those in CAPD (18.5 +/- 16.5
      micrograms/ml) (p less than 0.05). Approximately 95% of total FA and 25% of HA
      were bound to the plasma protein. However, the plasma level of HA was
      significantly reduced by HD therapy, whereas that of FA was not altered. In the
      previous study, it was described that no effect of HD on the percent of the
      binding of acid drugs to the plasma protein in the uremic plasma was observed.
      Therefore it is supposed that FA is more involved in the binding of drugs to the
      plasma protein in comparison with HA. The peritoneal losses of FA and HA in CAPD
      were 2.3 +/- 1.3 mg/day and 276 +/- 40 mg/day, respectively. As the duration of
      HD became longer, plasma concentrations of FA in HD patients were more increased.
      In general, they were maintained to be comparatively low in patients on
      CAPD.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1749116
TI  - [The effect of abnormal lipid metabolism to glomerular injury].
AB  - To clarify the effect of abnormal lipid metabolism and lipid deposition in
      glomerular injuries, we conducted clinical and pathological examination of
      various glomerulonephritis. There was no relationship between serum TC, TG or apo
      B and renal deposition of apo B or TG in glomerulonephritis. Apo B staining was
      intense for MCNS but was very weak for FGS. The staining was more intense in
      higher grade of glomerular injury in IgAN. Apo B demonstrated a specific pattern
      for MN, MPGN and lupus nephritis. These data suggest that apo B deposition
      reflects disturbance of glomerular permselectivity of macromolecules including
      abnormal influx, transport and endocytosis of macromolecules.

PMID- 1749117
TI  - [Intravenous cyclophosphamide therapy in patients with steroid-resistant lupus
      nephritis].
AB  - We evaluated short term clinical effects of intravenous cyclophosphamide (iv CyP)
      therapy performed by every three month in 7 patients with steroid-resistant lupus
      nephritis. Significant improvements were observed in daily urinary protein
      excretion (3.1 to 0.83 g/day), creatinine clearance (65.4 to 95.3 ml/min), CH 50
      levels (20.8 to 37.4 U/ml), and anti-DNA antibody titer (26.6 to 7.0 U/ml). In
      addition, the mean daily dose of prednisolone (PSL) could be markedly reduced
      from 38.6 mg to 13.9 mg at the final observation. Two patients suffered from
      Herpes Zoster infection at a few months after ivCyP therapy, however this
      incidence were not considered as critical side effect which reached to the
      discontinuation of this therapy. We concluded that ivCyP therapy by every three
      months were safety and achieved beneficial clinical effects on steroid-resistant
      lupus nephritis as far as short observation. On the contrary, the long term
      effect of this mode of therapy is to be defined.

PMID- 1749118
TI  - [The relationship between complement C3 receptors (CR1, CR3) on polymorphonuclear
      leukocytes and complement fragments during hemodialysis].
AB  - The expression of complement receptor type 1 (CR1) and type 3 (CR3) on
      polymorphonuclear leukocytes (PMNs) and generation of complement fragments, C3a,
      C5a, C4d, iC3b and Bb, were studied in patients during hemodialysis using
      cuprammonium rayon (Cu) membranes. Furthermore, the relation between the
      expression of CR1 and CR3 on PMNs from healthy donors and complement fragments
      was investigated. The expression of CR1 and CR3 on PMNs increased during
      hemodialysis. Plasma C3a, C5a and iC3b levels increased in the first 15 minutes
      and then decreased at 120 minutes of dialysis. But plasma Bb level remained high
      until the end of hemodialysis. Purified Bb had no effect on the expression of CR1
      and CR3 on PMNs, but C5a augmented those expression in vitro. Nafamostat
      mesilate, an artificial proteinase inhibitor, inhibited augmentation of
      complement receptors on PMNs in concentration dependent fashion. C5a generated
      through the activation of complement was thought to take an important role in the
      increased expression of CR1 and CR3 on PMNs.

PMID- 1749119
TI  - [Clinicopathological studies of renal disorders in patients with progressive
      systemic sclerosis].
AB  - The renal impairments were studied clinicopathologically in 57 patients with
      progressive systemic sclerosis (scleroderma). Proteinuria, hematuria, azotemia
      and hypertension, used as markers for renal involvements, were observed in 3
      (5.3%), 4 (7.0%), 2 (3.5%) and 6 patients (10.5%) respectively, at the initial
      examination. Hypertension was increased 2.6 times at the last observation,
      although the incidence of other three markers have not changed during the follow
      up period. Finally, 17 out of 57 patients (29.8) revealed more than one of these
      clinical markers throughout the study. The decrease of GFR (CThio) was noticed in
      3 out of 36 cases (8.3%), however that of RPF (CPAH) in 11 of 36 patients
      (30.6%), including 5 without abnormal clinical markers. Histological studies were
      performed in 12 patients. One showed crescentic glomerulonephritis, two
      membranous nephropathy, and the remaining 9 minor glomerular abnormalities. On
      the other hand, the vascular changes such as intimal proliferation of
      interlobular arteries were frequently observed. The frequency of pulmonary
      involvements, skin ulcer and gastro-intestinal involvement in the patients with
      renal lesions were not significantly different from that of the non-renal group.
      The level of RPF was significantly lower in the patients with skin ulcer than
      that of those without skin ulcer. No significant difference was noticed in the
      frequency of renal involvements between the patients with or without anti-Scl-70
      antibody.

PMID- 1749120
TI  - [A clinicopathological study of 17 cases recovered from acute tubular necrosis].
AB  - Renal biopsy specimens of 17 cases recovered from clinical acute renal failure
      (ARF) and subsequent pathological acute tubular necrosis (ATN) were analyzed
      clinicopathologically. The cases were divided into two groups: 11 patients who
      underwent hemodialysis (HD group) and 6 patients who did not need hemodialysis
      (non-HD group). The varied histopathological findings were assessed by scoring as
      parameters and were compared between the two groups and with severity of the
      clinical conditions as well. Among the histopathological parameters,
      tubulorrhexis and cell infiltration, mainly composed of lymphocytes, in the
      interstitium as well as in the tubules were significantly marked in the HD group,
      while other parameters such as necrosis, flattening, vacuolization and
      regeneration of the tubular epithelial cells and presence of casts were not
      necessarily significant. Tubulorrhexis were supposed to reflect the severity of
      the attack factors on the kidney which had caused ARF and subsequent ATN, and to
      have caused in turn prolongation of the recovery of the impaired renal function.
      Cell infiltration, which was divided into 4 types according to the corresponding
      conditions, might probably have affected the prolonged recovery in the HD group.
      In 8 cases which could be followed up for 2 years, non showed aggravation of the
      renal function.

PMID- 1749121
TI  - [A case of sarcoid granulomatous interstitial nephritis improved by steroid
      therapy].
AB  - We report a case of sarcoid granulomatous tubulointerstitial nephritis diagnosed
      by renal biopsy. A 60-year-old man presented with productive cough, and
      exertional dyspnea of 3 months duration. A chest X-ray film revealed diffuse
      reticulonodular infiltrates in both lung fields. A transbronchial lung biopsy
      specimen showed inflammation of the alveolar septum associated with non-caseating
      granulomas. The patient also had tubular proteinuria and glucosuria. Ga
      scintigraphy demonstrated an abnormal accumulation of gallium in both lungs and
      kidneys. Renal function tests revealed tubular dysfunction. Tubulointerstitial
      nephropathy was suspected. A renal biopsy specimen exhibited tubulointerstitial
      nephritis associated with numerous non-caseating granulomas, similar to the
      findings of the lung biopsy specimen. No glomerular abnormalities were evident.
      Later, a scalene node biopsy confirmed the diagnosis of sarcoidosis. Prednisolone
      therapy yielded a favorable outcome for both the renal and pulmonary involvement.
      During the corticosteroid therapy, measurement of the urinary beta-2
      microglobulin concentration proved a valuable monitoring tool for assessing the
      recovery of the tubular impairment.

PMID- 1749122
TI  - Proceedings of the 68th annual meeting of the Physiological Society of Japan.
      March 27-29, 1991 (Kyoto).

PMID- 1749123
TI  - [Effects of repeated presentation of stimuli on the learning and recognition of a
      highly structured set of stimuli].
AB  - In this article, we report the results of two experiments which investigated the
      repetition effect of stimulus presentation on recognition judgement. Each
      stimulus in sets of stimuli had five or six binary attributes. Any two stimuli
      could be mutually transformed by changing values of some attributes. In the
      experiments, subjects learned and immediately recalled stimuli, presented one
      after another. Learning was repeated several times. In the following recognition
      task, subjects were presented, one after another, the set of test stimuli
      consisted of old and new stimuli and judged whether each stimulus was old or new,
      and rated the degree of confidence of the judgement. The results showed that when
      learning of the presented stimuli progressed, the degree of the confidence of
      'old' judgement increased for the presented stimuli, while for the new stimuli,
      it increased, at first, and then decline.

PMID- 1749124
TI  - [Determinants of requesting expressions: referring to a speaker's state].
AB  - The purpose of this study is to examine situational determinants of one type of
      expressions used in situations of requests: expressions in which a speaker refers
      to his surroundings or his own condition without using conventional forms of
      requests (expressions of a speaker's state: ESSs). In four experiments subjects
      read scenarios in each of which the protagonist needed to make a request, and
      then the subjects made a note of how they would say in that situation. The
      findings were as follows: (Experiment 1) Subjects used ESSs more when it was
      obligatory for the addressee to obey the request than when it was not.
      (Experiment 2) Intimacy between the protagonist and the addressee did not
      uniformly influence subjects' use of ESSs. (Experiment 3) When the addressee made
      a previous statement which indicated his knowledge of the protagonist's goal,
      ESSs decreased. (Experiment 4) Subjects used indecisive ending expressions (
      kedo,-ga) in ESSs more when the addressee's behavior brought benefits to the
      protagonist than when it did not.

PMID- 1749125
TI  - [Interaction between visual and auditory memories in repetitive learning].
AB  - A serial recall experiment under same- and cross-modality conditions was carried
      out according to Hebb's (1961) paradigm. Subjects memorized strings of nine
      digits in 18 trials, which were divided into early trials and late ones. Under
      the same-modality condition the strings used in the 18 trials were presented
      through the same modality, i.e., visual or auditory, whereas under the cross
      modality condition the strings used in the early and late trials were presented
      through two different modalities. A repeated string and unrepeated strings were
      presented 3 and 6 times respectively in both early and late trials. The results
      showed that (1) repetitive learning in the same-modality occurred for both visual
      and auditory; (2) there was a non-additivity of cross-modal repetitive learning
      from auditory to visual, whereas there was an additivity of cross-modal
      repetitive learning from visual to auditory. We inferred that the visual inputs
      received both visual coding and auditory coding through an audio-transformation
      so as to be separately memorized in visual and auditory memories, whereas the
      auditory inputs were memorized in the auditory memory through the auditory coding
      alone.

PMID- 1749126
TI  - [Comparison of learning and concentration effects of "knowledge of results (KR)"
      in alpha-wave feedback training].
AB  - Effects of KR on biofeedback have conventionally been limited by learning factor.
      The effects of feedback on an increase in EEG alpha have been believed to be so
      limited as well. However, the effects of KR are also believed to include factors
      such as motivation and concentration. In this study, the tendencies for alpha
      rhythm to change were analysed and compared under 3 different KR conditions in
      order to demonstrate the existence of the later factors. Effects of two
      parameters, alpha index and microvolt integral value, were also compared. The KR
      conditions consisted of three types with regard to an increase in alpha rhythm:
      true-KR, false-KR, and mixed-KR. Ten female college students underwent the
      feedback task for 10 minutes under each condition. It was shown that (1) the
      degree of achievement and temporal profile under three KR conditions demonstrated
      the involvement of learning factor as well as motivation and concentration
      factors, and (2) alpha index showed the effects of learning, motivation and
      concentration in KR more distinctly than the microvolt integral value.

PMID- 1749127
TI  - [The influence of between-channel selection on the brain potentials related to
      within-channel selection in auditory attention].
AB  - Event-related potentials (ERPs) were recorded during a selective listening
      paradigm similar to a previous study (Okita, 1989). Stimuli were random sequences
      of five vowels and a tone pip in two "channels' (separated by location, left and
      right). The difficulty of between-channel selection was varied in
      discriminability of location, easy (EL) or hard (HL), whereas within-channel
      selection was manipulated by designating either tone (T), one vowel (1V), or two
      vowels (2V) as targets. Subjects were required to attend to one channel and
      detect targets therein. ERPs for the EL condition replicating the earlier study,
      confirmed the effects of within-channel selection on the early phase of attention
      related negativity (Nd): the early Nd being larger, the higher the
      target/nontarget selection load. In the HL condition, however, the 1V/2V
      difference disappeared: the early Nd effect was reduced for 2V, but prolonged in
      duration for 1V. The interaction between selection processes of the between- and
      within-channel was discussed in relation to the allocation of limited attentional
      capacity for operations rechecking outcomes of a preattentive target
      classification stage.

PMID- 1749128
TI  - [The effect of orthographic familiarity on recall of stimulus items read aloud].
AB  - The purpose of this study was to examine the effect of orthographic familiarity
      on free recall of Katakana words which were read aloud. Two experiments were
      conducted to compare Katakana items with Hiragana ones about recall performance
      in incidental learning paradigm, in which subjects were instructed to perform a
      reading aloud task. In Experiment I, an immediate recall test was used. Number of
      correct free recall for high imagery items was larger than low imagery ones. In
      Experiment II, 30-s delay was inserted between an orienting task and a recall
      test. The recall performance indicated the superiority of Hiragana items. This
      result showed that the higher orthographic familiarity of stimulus item was, the
      poorer performance of its recall. It was interpreted in terms of the effect of
      cognitive effort on recall.

PMID- 1749129
TI  - Mandatory testing and disclosure of health care workers' HIV status offers
      patients little protection.

PMID- 1749130
TI  - The Pediatric Committee: our dream is finally a reality.

PMID- 1749131
TI  - The leading edge of nursing specialty certification renewal programs.

PMID- 1749132
TI  - ED physician staffing guidelines erroneously attributed to Joint Commission on
      Accreditation of Healthcare Organizations (JCAHO)

PMID- 1749133
TI  - Case report of adenosine used for a patient with paroxysmal supraventricular
      tachycardia.

PMID- 1749134
TI  - Trauma research assistant complains of male bashing.

PMID- 1749135
TI  - Guest editorial on nursing diagnosis applauded.

PMID- 1749136
TI  - More applause for guest editorial on nursing diagnosis.

PMID- 1749137
TI  - Telling the patient about a terminal diagnosis: is it the decision of the family
      or the ED staff?

PMID- 1749138
TI  - Similar packaging for heparin, potassium chloride, and 1% lidocaine by one drug
      manufacturer causes concern.

PMID- 1749139
TI  - A 6-month-old paraplegic infant with spinal cord injury without radiologic
      abnormalities (SCIWORA)

PMID- 1749140
TI  - I am an emergency nurse: twelve hours in the pediatric emergency department.

PMID- 1749141
TI  - Atraumatic rhabdomyolysis in a 20-year-old bodybuilder.

PMID- 1749142
TI  - Improperly positioned passenger-restraint systems as associated mechanisms of
      injury in motor vehicular collisions.

PMID- 1749143
TI  - A 3-year-old with spinal cord injury without radiographic abnormality (SCIWORA).
AB  - The results of hyperextension, flexion, and traction injuries can be devastating
      and permanent; the results of treatment, dismal. Reducing the incidence of spinal
      cord injury requires education about the proper use of automobile restraint
      devices, scene of injury immobilization, selection of child-appropriate
      furniture, diving safety, and increased awareness of the risks of contact sports.
      Immediate treatment should center on strict cervical spine immobilization until
      complete neurologic and radiologic evaluations have been completed, with special
      awareness of the possibility of SCIWORA.

PMID- 1749144
TI  - Near-hanging injury: two case studies and an overview.
AB  - Near-hanging injuries result in respiratory, cardiac, neurologic, metabolic, and
      psychiatric problems. A patient surviving an attempted hanging can arrive at the
      emergency department in a comatose state, as documented in case 1, or in a
      conscious but disoriented state, as in case 2. Severe neurologic deficits are
      often reversible in cases of near-hanging. Regardless of initial findings,
      aggressive treatment of near-hanging victims should be initiated.

PMID- 1749145
TI  - The American Red Cross: a nursing-oriented overview of services.
AB  - Nurses are at the heart of many Red Cross services. Their expertise is recognized
      and often sought throughout the organization. Nurses can, through active
      participation and personal donation, assist the agency in reaching its
      humanitarian goals. The resources, services, and assistance available through the
      Red Cross give the busy emergency nurses more options in meeting the needs of
      patients. Nurses in turn can be a resource for the Red Cross. The strength,
      support, and commitment of dedicated volunteers give meaning to the endeavors of
      the American Red Cross.

PMID- 1749146
TI  - A hospital-wide approach to crisis control: one inner-city hospital's experience.

PMID- 1749147
TI  - A survey of emergency department triage in 185 hospitals: physical facilities,
      fast-track systems, patient-classification systems, waiting times, and
      qualification, training, and skills of triage personnel.

PMID- 1749148
TI  - Mnemonics for cardiac care.

PMID- 1749149
TI  - Law and the emergency nurse--pre-COBRA days.

PMID- 1749150
TI  - Acquired immunodeficiency syndrome: ten years later.

PMID- 1749151
TI  - Patient teaching in the emergency department: vaginal bleeding during early
      pregnancy.

PMID- 1749152
TI  - Immobilizing children in care safety seats--why, when, and how.

PMID- 1749153
TI  - Visual acuity testing.

PMID- 1749154
TI  - Pulse oximetry: pearls and pitfalls.

PMID- 1749155
TI  - A 19-year-old woman, four months' pregnant and with a history of headache.

PMID- 1749156
TI  - What we do.

PMID- 1749157
TI  - [Treatment of dysplasia of the gastric mucosal epithelium].
AB  - Examined were 53 patients with dysplasia of the gastric mucosal epithelium
      revealed at endoscopic and histologic study. In detection of moderately
      pronounced dysplasia, the conservative treatment of the underlying disease with
      endoscopic and histologic control every 6 mos is indicated; in severe dysplasia-
      conservative treatment with dynamic control every 3 mos; in absence of positive
      dynamics of the dysplastic process within a year, or in suspected malignant
      transformation--the operative intervention, the volume of which is determined by
      spreading of the foci of dysplasia. The patients operated on for severe dysplasia
      of the gastric mucosal epithelium should be under continuous supervision.

PMID- 1749158
TI  - [Changes in immunologic reactivity in patients with gastrointestinal bleeding].
AB  - The disorders in immunologic reactivity in acute gastrointestinal bleeding were
      studied in dynamics in 160 patients. Pronouncement of disorders in the T-system
      of immunity, activation of the reactions of specific sensibilization and
      autoallergic phenomena depend on severity of the blood loss. In ulcer location in
      the duodenum, the performance of an organ-preserving operation with vagotomy and
      elimination of the ulcer which is a source of antigen stimulation is preferable.

PMID- 1749159
TI  - [Blood flow in the gastric mucosa and components of the kallikrein- kinin system
      in patients with duodenal ulcer].
AB  - The results of study of the blood flow rate in the gastric mucosa by means of
      intraoperative rheography and content of the main components of kallikrein-kinin
      system in the systemic and regional blood flow were compared. It was established
      that increase in the volumetric blood flow rate in patients with a complicated
      duodenal ulcer disease was caused by activation of the kallikrein-kinin system in
      the regional blood flow. Blockade of the celiac plexus has a pronounced effect on
      the state of a kallikrein-kinin system.

PMID- 1749160
TI  - [Effect of suture material on the development of anastomosis reaction after
      gastric resection].
AB  - In the experiment on rabbits, response of tissues of the stomach and small
      intestine to implantation into in of the catgut, capron, capromed "DC" threads
      and an absorbable Dexon thread was studied. Catgut, when absorbing in the
      tissues, causes acute purulent-necrotic response, edema of the tissues, their
      hyperplasia with development of a deep scar. The optimal suture material in
      gastric resection is the absorbable thread--polymer of polyglycolic acid Dexon,
      which causes minimal reaction after its implantation into the wall of a stomach.
      Catgut replacement by the synthetic absorbable threads, first of all by Dexon, is
      one of the important factors in prophylaxis of anastomositis after gastric
      resection.

PMID- 1749161
TI  - [Pylorus-reconstructing operations in complicated gastric and duodenal ulcer].
AB  - The results of treatment of 185 patients with complicated gastric and duodenal
      ulcer disease have been analysed. The results of operative treatment in 132
      patients followed up for the period of from 1 to 7 years were studied. In gastric
      ulcer, resection of the stomach with preservation of the pyloric sphincter, or
      its reconstruction by means of the flaps taken from the antrum, is indicated; in
      duodenal ulcer--vagotomy, ulcer excision added by pylorus-preserving and pylorus
      reconstructing methods of drainage operations.

PMID- 1749162
TI  - [Experimental basis for the prophylactic use of litonit in acute gastroduodenal
      erosion and ulcer].
AB  - The certain indices of morphofunctional state of the cellular membranes and mass
      of the stress-competent organs of rats in acute stress and its prophylaxis by
      means of lithonit--a new native atypical tranquilizer with a neotropic action
      were studied. The immobilization-cold stress caused a statistically significant
      adrenal hypertrophy and deep degradation of the thymico-lymphatic system.
      Prophylactic administration of lithonit for 7 days had a protective action on the
      organs studied. In prophylactic administration of lithonit, the accumulation of
      membranotoxic products of peroxide oxydation of lipids reduced considerably.

PMID- 1749163
TI  - [Surgery in bleeding stenosing pyloroduodenal ulcer].
AB  - The results of surgical treatment of 147 patients with a bleeding stenosing
      pyloroduodenal ulcer are presented. The operation of choice in this pathology is
      a selective proximal vagotomy in combination with the original methods of ulcer
      excision and drainage operations, and as well a selective proximal vagotomy with
      antrectomy. Gastric resection is indicated in patients with decompensated
      stenosis of gastric outlet and pronounced disorders in motor-evacuatory function
      of the stomach. In patients with a severe, or extremely severe state, the ulcer
      excision in combination with pyloroduodenoplasty dilating the lumen is expedient.

PMID- 1749164
TI  - [Radical treatment of penetrating duodenal ulcer].
AB  - The results of treatment of 450 patients with duodenal ulcer have been analysed.
      Of them, in 198 (44%), ulcer penetration into the adjacent organs was revealed.
      An excellent and good results were noted in 80.3% of the patients. Vagotomy with
      an ulcer excision and subsequent restoration of the pyloric sphincter function in
      penetrating duodenal ulcer permits to reduce lethality and achieve stable
      recovery of the majority of patients.

PMID- 1749165
TI  - [Surgical treatment of patients with a bleeding giant ulcer of the stomach and
      duodenum].
AB  - The results of surgical treatment of 112 patients with a bleeding giant gastric,
      or duodenal ulcer, comprising 18.6% of the number of patients with acute ulcerous
      gastrointestinal bleeding operated on in the emergency order are presented. The
      use of active surgical tactics permitted to increase the specific weight of
      radical operations to 62.8%, reduce the incidence of early postoperative
      complications 1.8-fold, lethality--3.4-fold when compared with the results of the
      use of active-expectant tactics. An operation of choice in bleeding giant gastric
      ulcer is Billroth-I resection of the organ, or its suprapyloric resection; in
      ulcer location at the pyloroduodenal region--selective proximal vagotomy with
      ulcer excision, or selective vagotomy with antrectomy. To arrest bleeding in
      performance of minimal, or organ-preserving operation with vagotomy, it is
      necessary to perform ulcer excision, because after closing the bleeding ulcer, or
      suturing the bleeding vessel in an ulcer, 25.8% of the patients developed
      recurrency of the bleeding at the nearest postoperative period.

PMID- 1749166
TI  - [Combined seromuscular vagotomy in the treatment of pyloroduodenal ulcer].
AB  - The posterior truncal and anterior proximal seromyotomy were performed in 150
      patients. One and three years after the operation, 102 of the patients were
      examined. An excellent and good results were noted in 86.3%, a satisfactory one-
      in 13.7% of the patients. No unsatisfactory result was noted. The given
      modification has the following advantages: rapid elimination of the pain
      syndrome, low traumaticity, technical simplicity and short duration of the
      operation.

PMID- 1749167
TI  - [Some problems of the surgical treatment of stomach and duodenal ulcer].
AB  - The analysis of the results of surgical treatment of the gastric and duodenal
      ulcer disease in 191 patient under conditions of surgical department of the
      central district hospital was carried out. It was established that performance of
      the organ-preserving operation with vagotomy in duodenal ulcer disease permitted
      to reduce the mean duration of postoperative treatment and temporary invalidity,
      reduce the lethality. In gastric ulcer, the best result was obtained when using
      Billroth-I and stepped resection of the stomach.

PMID- 1749168
TI  - [Simultaneous operations in gastric and duodenal ulcer].
AB  - The experience with surgical treatment of 112 patients with gastric and duodenal
      ulcer disease associated with pathology of the abdominal organs is summarized.
      Most frequently in ulcer disease, sliding hiatal hernia (34.1% of cases) and
      adhesive disease (25.7%) were revealed. In all the patients, the simultaneous
      operations were performed. The incidence of postoperative complications was 13%
      and didn't exceed that in the control group of patients, who underwent only the
      operations on the stomach and duodenum.

PMID- 1749169
TI  - [Surgical treatment of multiple and associated gastroduodenal ulcers].
AB  - Operated on were 53 patients with multiple and associated gastric and duodenal
      ulcers, which were characterized by a high rate of complications (54.7%) and low
      effectiveness of the conservative treatment. Gastric resection with removal of
      the pathologically changed areas was the main operation. After the operation, 2
      (3.7%) patients died.

PMID- 1749170
TI  - [Patient's reaction to surgical trauma in surgical treatment of duodenal ulcer].
AB  - Evaluation of metabolism and state of central hemodynamics in 134 patients with
      duodenal ulcer before the operation and at the early postoperative period was
      carried out. It was established that pronouncement of postaggressive response of
      an organism to trauma in surgical treatment of a duodenal ulcer didn't depend on
      a type of the operation due to use of the modern methods of anesthesia.
      Therefore, moderate pronouncement of such a response after the organ-preserving
      operations can't be a criterium for the wide use of surgical treatment of an
      uncomplicated duodenal ulcer.

PMID- 1749171
TI  - [Prophylaxis of intestinal paresis after colon surgery].
AB  - In the clinic, a method for prophylaxis of postoperative intestinal paresis with
      the use of local consecutive electroimpulse influencing upon the zones-
      pacemakers of the small and large intestine by a current with a frequency
      corresponding to the physiologic frequency of contractions of a given intestinal
      segment at the time corresponding to the physiologic one in restoration of motor
      activity of the intestine have been developed. Electric stimulation of a
      pacemaker contributes to organization and synchronization of activity of the
      neural ganglia and amplification of their myoelectrical signal. As a result, the
      activity of proximal pacemakers predominates over that of the distal ones and
      contributes to restoration of a gradient of propulsive activity. The method was
      employed in 53 patients. The time of restoration of peristaltic and propulsive
      functions of the intestine corresponded to the physiologically substantiated
      time.

PMID- 1749172
TI  - [Methods of surgical treatment of ulcerative gastrointestinal bleeding].

PMID- 1749173
TI  - [Intragastric pH-metry in the surgical treatment of ulcers].

PMID- 1749174
TI  - [Pathogenesis, prophylaxis and therapy of Roux syndrome].

PMID- 1749175
TI  - [Urologic complications of non-specific colitis].

PMID- 1749176
TI  - [Errors and complications of pylorus-preserving gastric resection].

PMID- 1749177
TI  - [Acute gastric dilatation complicated by spontaneous rupture].

PMID- 1749178
TI  - [Perforation at gastroscopy of a gastric ulcer penetrating into the liver].

PMID- 1749179
TI  - [Method for determination of the completeness of vagotomy].

PMID- 1749180
TI  - [Electrostimulation of gastric peristalsis as a method of prevention of
      postvagotomy gastroplegia in the early postoperative period].

PMID- 1749181
TI  - [Modification of Billroth-1 gastric resection in penetrating pyloroduodenal
      ulcer].

PMID- 1749182
TI  - [A method of gastric stump suture technique].

PMID- 1749183
TI  - [Method of esophagofundophrenoplication in the surgery of gastric and duodenal
      ulcer].

PMID- 1749184
TI  - [Jejunoplasty in surgical treatment of chronic and malignant gastric ulcers].

PMID- 1749185
TI  - [Fibrosarcoma of the small intestine as a cause of repeated profuse intestinal
      bleeding].

PMID- 1749186
TI  - [Reconstructive surgery after subtotal resection of the small intestine and
      placing the intestinal anastomosis].

PMID- 1749187
TI  - [Small intestinal ulcer complicated by perforation and hemorrhage].

PMID- 1749188
TI  - [Small intestine ulcer complicated by bleeding and perforation].

PMID- 1749189
TI  - [Bleeding neurinoma of the duodenum].

PMID- 1749190
TI  - [Evaluation of the acid producing function of the stomach by pH-metry in surgical
      treatment of duodenal ulcer].
AB  - The comparative analysis of changes in acid production according to the data of
      pH-metry in 266 patients with duodenal ulcer disease after surgical treatment was
      carried out. The peculiar features of the dynamics of gastric acid production and
      dependance of the incidence of ulcer recurrences on a volume of the intervention
      performed have been established.

PMID- 1749191
TI  - [Severe complications of ulcer in an elderly patient].

PMID- 1749192
TI  - [Omental coccidioidosis as a cause of gastrostasis in a patient after vagotomy].

PMID- 1749193
TI  - [Treatment of acute Roux syndrome after vagotomy and gastric resection].

PMID- 1749194
TI  - [Postural symptom in perforative ulcer of the stomach and duodenum].

PMID- 1749195
TI  - [Repeated development of trichobezoar in the stomach].

PMID- 1749196
TI  - [Foreign body of the pleural cavity after gastric resection].

PMID- 1749197
TI  - [Asymptomatic presence of multiple metallic foreign bodies in the stomach].

PMID- 1749198
TI  - [Recovery of a child operated on for necrosis of the abnormally situated
      stomach].

PMID- 1749199
TI  - [Effectiveness of the parenteral and enteral feeding in the comprehensive
      treatment of the postoperative fistulas of the alimentary canal].

PMID- 1749200
TI  - Differences in the risk factor patterns for coronary heart disease in China,
      Japan, and Germany.
AB  - In Asia coronary heart disease mortality is almost 10 fold less frequent than in
      European countries. These findings attract interest to search for different risk
      factor patterns. From 1982 to 1985 epidemiologic surveys were carried out in
      China (n = 2047), Japan (n = 7580) and Germany (n = 6052). Healthy, male
      subjects, aged 30 to 59 years were enrolled. The prevalence rate of hypertension
      for the Germans was 20% versus 18% for the Japanese, and 11% for the Chinese.
      About 69% of Chinese, 55% of Japanese, and 37% of Germans were smokers. About 66%
      of the Germans were overweight (BMI greater than 25), 17% of the Japanese, and
      11% of the Chinese. The highest risk group with cholesterol levels of greater
      than 300 mg/dl included no Chinese subject, 0.1% of the Japanese, but 5% of the
      Germans. The lipoprotein profiles among the Japanese and the Chinese collectives
      typically showed antiatherosclerotic characteristics, whereas most Germans
      exhibited profiles which support development of atherosclerosis. About 36% of the
      participants from Germany showed 3 or more risk factors accumulated per person
      (Japan and China 5%). Multifactorial risk factor reduction for Germany is
      recommended.

PMID- 1749201
TI  - The spontaneous course of small abdominal aortic aneurysms. Aneurysmal growth
      rates and life expectancy.
AB  - Since abdominal ultrasonography has become a routine diagnostic procedure,
      increasing numbers of small asymptomatic abdominal aortic aneurysms are detected
      incidentally. Of 128 patients (108 male, 20 female) with abdominal aortic
      aneurysms, 96 patients were observed clinically and by repeated ultrasound
      studies for an average of 3.47 years, adding up to a total observation period of
      333 patient-years. Among these 96 patients, 72 had small aneurysms (averaged
      diameters less than 5 cm). Three of them were lost to follow up. None of the
      remaining 69 patients died from rupture, 20 died from other causes and 8 patients
      were successfully operated. Of the patients with a large aneurysm one was lost to
      follow up. Five patients of the remaining 23 died as a result of rupture, 7 were
      successfully operated. The average growth rate of small aneurysms was 0.18
      cm/year, whereas the larger aneurysms showed a growth rate of 0.28 cm/year
      (diameter). The survival rate of patients with small aneurysms was 94% after one
      year, 80% after 3 years, and 73% after 5 years, indicating that life expectancy
      is reduced in patients with an aneurysm of the abdominal aorta, but not because
      of complications of the aneurysm.

PMID- 1749202
TI  - Zinc levels after intravenous administration of zinc sulphate in insulin
      dependent diabetes mellitus patients.
AB  - Diabetic patients commonly have increased urinary excretion of zinc, although
      blood concentrations may be normal, lowered, or raised. We analyzed zinc levels
      in plasma and urine after an intravenous overload of zinc sulphate (8 mg) in 22
      patients with insulin-dependent diabetes mellitus (IDDM) and 22 healthy
      individuals. No significant differences were found in basal levels of serum zinc
      in either group (111 +/- 29 micrograms/dl in IDDM vs 119 +/- 19 micrograms/dl in
      controls), although urinary excretion of zinc was significantly raised in
      diabetics (1396 +/- 622 micrograms/24 h) versus controls (611 +/- 235
      micrograms/24 h). After zinc overload, both serum and urinary levels of this
      element varied between the two groups. Serum zinc in IDDM patients initially
      increased more markedly, and subsequently showed a more significant decline, than
      in controls. Urinary zinc levels in IDDM patients, in contrast to control values,
      showed no increase after overload. These alterations in serum and urinary zinc
      concentrations suggest that our diabetic patients may be zinc-deficient.

PMID- 1749203
TI  - Effects of atenolol, slow-release nifedipine, and their combination on
      respiratory gas exchange and exercise tolerance in stable effort angina.
AB  - The effects of atenolol, nifedipine, and their combination on gas exchange and
      exercise tolerance were studied in 27 patients with effort angina and normal
      global ventricular function in an open-label and randomized cross-over trial.
      Symptom-limited semi-supine exercise tests using a ramp protocol (20 W/min) with
      simultaneous breath-by-breath analysis of gas exchange were carried out after a 4
      day wash-out period and after consecutive 2-week treatment periods with atenolol
      (50 mg b.i.d.), slow-release nifedipine (20 mg b.i.d.), and their combination
      (b.i.d.). Exercise tolerance was not significantly higher with atenolol than with
      nifedipine [118(24) vs 113(23) W]. Combination therapy [120(23) W] was more
      effective than monotherapy with nifedipine (p less than 0.05) but produced no
      further increase in exercise tolerance over atenolol monotherapy. Maximum oxygen
      uptake was not significantly different among the treatments. In the range of
      light to moderate exercise, the slope of the VO2-workload regression line
      expressed as ml.min-1.W-1 was lower with atenolol than with nifedipine
      [8.64(1.59) vs 10.28(1.74), p less than 0.005] and intermediate with combination
      therapy [9.99(1.83)]. The intercept on the VO2 axis was higher with atenolol than
      with nifedipine [366(111) vs 299(113) ml.min-1, p less than 0.05]. A similar
      pattern of results was seen when the drug effects on the slope of the VCO2
      workload relation were analyzed. VE was higher with nifedipine than with atenolol
      at all points of the regression analysis [greater than 30 W].(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1749204
TI  - Thromboxane production and platelet aggregation in type 2 diabetes mellitus
      without vascular complications.
AB  - Diabetic individuals frequently have platelet hyperaggregability and increased
      thromboxane (TXB2) production. To evaluate whether improvement of metabolic
      control or changes in fatty acid composition of serum lipids might alter
      thromboxane (TXB2) formation and platelet function, we followed up 25 newly
      diagnosed type 2 diabetics without angiopathy for about 6 months. Improvement of
      metabolic control (HbA1, fell from 12.0 +/- 0.3 to 9.0 +/- 0.3%; p less than
      0.01) was associated with significant decrease in total cholesterol,
      triglycerides, and ratios of total cholesterol/HDL-cholesterol and LDL
      cholesterol/HDL-cholesterol. Palmitic acid of phospholipids decreased
      significantly, whereas eicosapentaenoic acid increased. Regardless of this, the
      ADP-induced platelet aggregability and sensitivity were not altered. There was no
      effect whatever on the TXB2 synthesis capacity of clotting whole blood (204.9 +/-
      25.0 vs 222.8 +/- 32.0 ng/ml) over 6 months of treatment. Platelet aggregability
      and TXB2 formation were not correlated to the degree of metabolic control, nor
      were there any correlations to serum lipids and their fatty acid composition.
      Thus, we are tempted to speculate that glucose metabolism in diabetes itself does
      not affect platelet aggregation or TXB2 formation in type 2 diabetes mellitus.

PMID- 1749205
TI  - Sequence analysis of the cystic fibrosis gene in patients with disseminated
      bronchiectatic lung disease. Application in the identification of a cystic
      fibrosis patient with atypical clinical course.
AB  - The diagnosis of classical cystic fibrosis (CF) is easily made by clinical
      assessment alone, but may be missed or delayed in cases with an atypical clinical
      course. In a recent major study the age at diagnosis varied between 2 months and
      47 years. For diagnostic purposes we have investigated the cystic fibrosis
      transmembrane regulator (CFTR) gene in 10 adult patients (age 18 to 45 years)
      with chronic obstructive pulmonary disease since childhood or adolescence and
      bronchiectases disseminated through both lungs. Only one subject (a 29-year-old
      male) had exocrine pancreatic insufficiency (PI); all others were pancreatic
      sufficient (PS). The first nucleotide (ATP)-binding fold of the CFTR was analyzed
      by direct sequencing of polymerase chain reaction (PCR)-amplified genomic DNA in
      these cases. Two patients with different phenotypes (one PI, one PS) were found
      to be homozygous for the common delta F508 mutation of the CFTR gene, which
      proved the diagnosis of cystic fibrosis in their cases and allowed genetic
      counselling. The PS patient had normal sweat tests and had not previously been
      recognized as having CF. Four other patients were heterozygous for delta F508,
      with no other mutation in exons 10 or 11 of the gene, and four patients had
      normal sequences of these exons. Because only about 70% of all CF chromosomes
      carry delta F508, the unexpectedly high frequency (4/8 = 50%) of heterozygosity
      for delta F508 among the non-delta F508/delta F508 patients with bronchiectases
      suggests that some of these might also have unrecognized CF with rare genotypes
      and mutations in any of the 22 exons not sequenced.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1749206
TI  - Hyperparathyroidism after kidney transplantation: a retrospective case controlled
      study.
AB  - We studied retrospectively patients with hyperparathyroidism after successful
      renal allotransplantation. Since 1972, 1119 transplantations have been performed
      in our department, and 534 patients survive with functioning grafts.
      Hyperparathyroidism requiring parathyroidectomy developed in 32 (5.9%). The
      frequency of interventions increased markedly after introduction of cyclosporine
      A treatment in our unit. The time between transplantation and parathyroidectomy
      was 22.5 months (SD 16.5, range 1-82 months). The age of the patients was 49.0
      years (SD 10.5, range 17-63 years); the group consisted of 16 female and 16 male
      patients. All patients but two (no measurement performed) repeatedly exhibited
      high serum parathormone and calcium levels and therefore underwent surgery. In
      comparison to a control group, matched for time of transplantation, age, sex, and
      cause of renal failure, the patients with hyperparathyroidism had longer dialysis
      treatment (54.2 months, range 9-132 vs 26.9 months, range 1-72) and exhibited
      lower phosphate concentrations in the early posttransplantation period. Before
      surgery, serum chemistry was different for hyperparathyroid and control subjects:
      serum calcium 2.80 +/- 0.23 mmol/l vs 2.48 +/- 0.13 mmol/l and alkaline
      phosphatase 157.4 +/- 92.0 U/l vs 85.2 +/- 51.5, respectively. We did not see any
      influence of oral phosphate binders, calcium supplementation, or vitamin D
      treatment on the development of parathyroid gland hyperactivity during dialysis
      treatment. Serum creatinine concentration did not change after parathyroidectomy.
      In four patients, long-term calcium supplementation after surgery was necessary.

PMID- 1749207
TI  - Primary malignant pericardial mesothelioma.
AB  - Malignant primary tumors of the pericardium are rare. The authors present two
      male patients, aged 44 and 67 years, not exposed to asbestos, who died from
      pericardial mesothelioma. Repeated evacuation of fluid from the pericardium due
      to cardiac tamponade failed to reveal the cause of pericarditis. In one case, the
      diagnosis was made on surgical exploration, and in the other, at autopsy. A
      significant difference between benign and malignant pericardial effusion was
      observed. In cases of pericardial mesothelioma, symptoms of epicardial
      involvement cannot be attributed solely to the hindered inflow and cardiac
      tamponade, but also to congestive heart failure due to myocardial infiltration.
      In one patient, temporary improvement was achieved, first by pronisone therapy
      and then by radiotherapy.

PMID- 1749208
TI  - The liver and inherited metabolic disorders. The 28th Annual Symposium of the
      Society for the Study of Inborn Errors of Metabolism (SSIEM). Birmingham, 1990.

PMID- 1749209
TI  - The role of the liver in metabolic homeostasis: implications for inborn errors of
      metabolism.
AB  - The mechanisms by which the liver maintains a constant supply of oxidizable
      substrates, which provide energy to the body as a whole, are reviewed. During
      feeding, the liver builds up energy stores in the form of glycogen and
      triglyceride, the latter being exported to adipose tissue. During fasting, it
      releases glucose and ketone bodies. Glucose is formed by degradation of glycogen
      and by gluconeogenesis from gluconeogenic amino acids provided by muscle. Ketone
      bodies are produced from fatty acids, released by adipose tissue, and from
      ketogenic amino acids. The major signals which control the transition between the
      fed and the fasted state are glucose, insulin and glucagon. These influence
      directly or indirectly the enzymes which regulate liver carbohydrate and fatty
      acid metabolism and thereby orient metabolic fluxes towards either energy storage
      or substrate release. In the fed state, the liver utilizes the energy generated
      by glucose oxidation to synthesize triglycerides. In the fasted state it utilizes
      that produced by beta-oxidation of fatty acids to synthesize glucose. The
      mechanisms whereby a number of inborn errors of glycogen metabolism, of
      gluconeogenesis and of ketogenesis cause hypoglycaemia are also briefly
      overviewed.

PMID- 1749210
TI  - Detoxification pathways in the liver.
AB  - The liver plays an important role in protecting the organism from potentially
      toxic chemical insults through its capacity to convert lipophiles into more water
      soluble metabolites which can be efficiently eliminated from the body via the
      urine. This protective ability of the liver stems from the expression of a wide
      variety of xenobiotic biotransforming enzymes whose common underlying feature is
      their ability to catalyse the oxidation, reduction and hydrolysis (Phase I)
      and/or conjugation (Phase II) of functional groups on drug and chemical
      molecules. The broad substrate specificity, isoenzyme multiplicity and
      inducibility of many of these enzyme systems make them particularly well adapted
      to handling the vast array of different chemical structures in the environment to
      which we are exposed daily. However, some chemicals may also be converted to more
      toxic metabolites by certain of these enzymes, implying that variations in the
      latter may be important predisposing factors for toxicity. Pharmacogenetic
      defects of xenobiotic biotransformation enzymes, a subclass of inborn errors of
      metabolism which are manifested only upon drug challenge, introduce marked
      variation into human populations for the pharmacokinetics and pharmacodynamics of
      therapeutic and toxic agents, and thus may have important clinical consequences
      for drug efficacy and toxicity.

PMID- 1749211
TI  - Hereditary variation of liver enzymes involved with detoxification and
      neurodegenerative disease.
AB  - Enzymes involved with the metabolic transformation of xenobiotics have recently
      been studied in patients with the neurodegenerative diseases, Alzheimer's
      disease, Parkinson's disease and motor neurone disease. Defects were detected in
      sulphur pathways and also, in the case of Parkinson's disease, in monoamine
      oxidase B. The possibility exists that the ability to cope safely with endogenous
      and exogenous substances which have neurotoxic properties is important in the
      pathogenesis of these diseases. Potentially such individuals could be identified
      preclinically and these diseases postponed by reduction in the load of toxin or
      modification of the relevant enzymic activity.

PMID- 1749212
TI  - Interrelationships of liver and brain with special reference to Reye syndrome.
AB  - Reye syndrome is an acute non-inflammatory encephalopathy that can be
      precipitated by toxic, infective, metabolic or hypoxic upsets. The biochemical
      changes point to mitochondrial dysfunction and this is substantiated by
      structural changes in mitochondria on electron microscopy. The toxic metabolites
      that accumulate are similar to those incriminated in hepatic encephalopathy and
      other metabolic diseases. These metabolites exert their deleterious effects by
      direct neuronal damage, neurotransmitter blockade, vascular damage, cerebral
      oedema, hypoxic ischaemic damage, demyelination, retardation of brain growth and
      neuronal storage. Brain capillary endothelial cells are very rich in mitochondria
      and mitochondrial disorders can effect the central nervous system primarily, and
      not just as a consequence of systemic metabolic upset.

PMID- 1749213
TI  - Fetal and neonatal bile acid synthesis and metabolism--clinical implications.
AB  - It has become apparent that with sophisticated technology we are now able to
      recognize defective bile acid metabolism in a wide variety of disease states.
      Recognition of specific aberrations, such as inborn errors in bile acid
      metabolism manifesting as neonatal cholestasis, offers new opportunities for
      therapeutic intervention. Future studies should determine the incidence of inborn
      errors in patients with enigmatic and unexplained liver diseases such as
      idiopathic neonatal hepatitis.

PMID- 1749214
TI  - Inborn errors of bile acid metabolism.
AB  - Cholesterol is converted to cholic acid and chenodeoxycholic acid by a series of
      reactions involving modifications to the steroid nucleus and oxidation of the
      side chain. These reactions can be affected by a number of inborn errors of
      metabolism. When this happens unusual bile acids or bile alcohols are
      synthesized; these can be identified using gas chromatography-mass spectrometry
      and fast atom bombardment mass spectrometry techniques. Two defects affecting the
      modifications to the steroid nucleus have been described; both present with
      cholestatic liver disease of neonatal onset. The better characterized of the two-
      3 beta-hydroxy-delta 5-C27-steroid dehydrogenase deficiency--leads to excretion
      of 3 beta-7 alpha-dihydroxy-5-cholenoic acid and 3 beta,7 alpha,12 alpha
      trihydroxy-5-cholenoic acid in the urine. The liver disease improves dramatically
      on treatment with chenodeoxycholic acid. Deficient activity of 3-oxo-delta 4
      steroid 5 beta-reductase is thought to be the cause of familial liver disease in
      some infants who excrete 7 alpha-hydroxy-3-oxo-4-cholenoic acid and 7 alpha,12
      alpha-dihydroxy-3-oxo-4-cholenoic acid in the urine. However, diagnosis of this
      disorder is problematical; a similar pattern of metabolite excretion can occur as
      a result of liver damage caused by viruses or inborn errors of pathways unrelated
      to bile acid synthesis. Defective side chain oxidation in patients with
      cerebrotendinous xanthomatosis (CTX) leads to synthesis of bile alcohols such as
      5 beta-cholestane-3 alpha,7 alpha,12 alpha,25-tetrol and 5 beta-cholestane-3
      alpha,7 alpha,12 alpha,23,25-pentol. Patients with CTX do not have cholestatic
      liver disease. Their major problems (neurological disease, atherosclerosis and
      xanthomata) are caused by accumulation of cholestanol and cholesterol in the
      tissues. Bile acid precursors are probably diverted into synthesis of
      cholestanol. Chenodeoxycholic acid suppresses the production of abnormal
      metabolites from cholesterol (by inhibition of cholesterol 7 alpha-hydroxylase)
      and leads to improvement in the neurological disease. Defective side chain
      oxidation also occurs in peroxisomal disorders but this time it leads to
      accumulation of C27 bile acids such as 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta
      cholestanoic acid (trihydroxycoprostanic acid, THCA). This compound is readily
      detected in the bile and plasma of patients with defects of peroxisome
      biogenesis. In patients with defects of a single peroxisomal beta-oxidation
      enzyme (the 3-hydroxyacyl-CoA component of the bifunctional protein or the
      thiolase), the major C27 bile acid in bile may be 3 alpha,7 alpha,12 alpha,24
      tetrahydroxy-5 beta-cholestanoic acid (varanic acid).(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1749215
TI  - Alpha 1-antitrypsin deficiency and liver disease: clinical presentation,
      diagnosis and treatment.
AB  - The alpha 1-antitrypsin deficient subject (protease inhibitor (PI) phenotype ZZ)
      has an increased susceptibility to liver disease. The condition is most commonly
      identified in early infancy as a conjugated hyperbilirubinaemia with hepatitis
      (11%) or a bleeding state due to vitamin K malabsorption (2%). 50% of cases have
      cirrhosis and 25% die in the first decade of life. A further 2% present with
      cirrhosis in later childhood. Adult males are at risk of hepatoma development
      with or without cirrhosis. Diagnosis is by isoelectric focussing or allele
      specific oligonucleotide hybridization. The treatment is that of cholestasis and
      cirrhosis including transplantation. The pathobiology of the deficiency state,
      the mechanism of liver damage and the vulnerability of the newborn liver are
      discussed in this review. A plea is made for a trial of infusions of alpha 1
      antitrypsin in early infancy, as is used safely but without proven efficacy in
      the emphysematous PIZZ subject. Prospects of therapy by gene modification are
      also reviewed.

PMID- 1749216
TI  - Alpha 1-antitrypsin deficiency and liver disease.
AB  - Alpha 1-antitrypsin (alpha 1AT) deficiency, one of the most common lethal
      hereditary disorders among Caucasians, is associated with emphysema in adults,
      while in children it is associated with liver disease. Produced in the liver and
      released into the plasma, alpha 1AT serves as the body's major inhibitor of
      neutrophil elastase, a powerful proteolytic enzyme capable of degrading
      extracellular structural proteins. The pathogenesis of the liver disease
      associated with alpha 1AT deficiency is not as well understood, but is clearly
      linked to specific mutations in coding exons of the alpha 1AT gene, and the
      resulting accumulation of alpha 1AT within hepatocytes. At present, therapy for
      the liver disease associated with alpha 1AT deficiency is symptomatic, with liver
      transplantation as a last resort. New strategies are being developed to suppress
      the accumulation of alpha 1AT by transferring the normal gene into the liver.

PMID- 1749217
TI  - Clinical presentation of metabolic liver disease.
AB  - Some clinical clues should alert paediatricians to the possibility of metabolic
      liver diseases. They can be classified into three categories: (i) Manifestations
      due to hepatocellular necrosis, acute or subacute, which can reveal
      galactosaemia, hereditary fructose intolerance, tyrosinaemia type I, Wilson
      disease and alpha 1-antitrypsin deficiency. Symptoms and signs suggestive of Reye
      syndrome should lead to a study of fatty acid oxidation and urea cycle enzymes.
      All these manifestations may necessitate a rapid diagnosis and treatment when
      liver dysfunction is severe. (ii) Cholestatic jaundice can reveal alpha 1
      antitrypsin deficiency, Byler's disease, cystic fibrosis, Niemann-Pick disease
      and some disorders of peroxisome biogenesis. (iii) Hepatomegaly can reveal
      disorders with liver damage but also storage diseases such as glycogen storage
      diseases, cholesteryl ester storage disease and, when associated with
      splenomegaly, lysosomal storage diseases. Appropriate investigations for
      recognizing all these entities are proposed.

PMID- 1749218
TI  - Investigation of paediatric liver disease.
AB  - The investigation of children with liver disease falls into two categories: the
      investigation of the cholestatic baby and the investigation of the older child
      (over 2 years) with hepatomegaly. The approach to investigation is directed by
      the clinical features and employs many different investigational methods
      including biochemistry, haematology, radiology, electrophysiology and histology.
      As the clinical presentation of many diseases is similar, it is appropriate to
      perform a variety of first-line tests, proceeding to more complex investigations
      only as indicated.

PMID- 1749219
TI  - The role of histochemical investigations in metabolic disorders affecting the
      liver.
AB  - The application of histochemical techniques to the study of metabolic disorders
      affecting the liver can yield considerable information, provided the methods used
      are sound and the interpretation is not over-enthusiastic. The appropriate
      methods can give insight into liver function and can identify and localize a wide
      variety of carbohydrates, lipids, proteins and enzyme activities. It is often
      thought that tissue taken for histochemical analysis cannot be used for
      morphology, but properly prepared tissue will provide the architectural and
      cytological detail necessary for histological assessment. There are several
      advantages to the histochemical approach, the main ones being economy of use of
      the valuable tissue sample (in theory about 100 sections and tests can be done on
      a 1 mm depth of tissue) and that the results of the tests can be assessed in
      relation to the structure of the liver. There are two areas in which
      histochemical investigations are used: firstly, to detect cellular constituents,
      structures and cells not otherwise visible by routine methods. In this mode,
      histochemistry is an extension of the histological approach and constitutes a
      'super haematoxylin and eosin' stain. Secondly, it is possible to assess enzyme
      activities and their localization, and in some well-defined instances to offer
      reliable indications of whether there is deficient activity, normal activity or
      enhanced activity. Although there is a body of opinion which believes that
      quantitative enzyme histochemistry is possible and reliable, the author has not
      found the data, in particular or lysosomal enzymes, to be reliable and remains
      unconvinced that this technique has a place in the study of pathological
      tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1749220
TI  - Techniques for studying hepatic metabolism in vivo.
AB  - Techniques for studying metabolic events in vivo in patients with inborn errors
      are reviewed. Loading or provocation tests that have been used widely are
      insensitive and frequently non-specific. Compounds labelled with stable isotopes
      can be used to study enzyme kinetics and substrate turnover, providing more
      detailed and specific information. Intracellular events may be studied using
      nuclear magnetic resonance spectroscopy. The results using these techniques to
      study patients with selected inborn errors are discussed, namely phenylketonuria,
      glycogen storage disease type I and propionic acidaemia.

PMID- 1749221
TI  - Tyrosinaemia type I--an update.
AB  - Tyrosinaemia type I is a recessively inherited disorder caused by a deficiency of
      fumarylacetoacetase (FAH), the last enzyme in tyrosine degradation. The presumed
      toxic agents are fumaryl- and maleylacetoacetate which are converted to
      succinylacetone (SA), a metabolite found in increased amounts in urine and plasma
      of the patients. The major clinical features are progressive liver damage and
      renal tubular defects with hypophosphataemic rickets. Renal tubular dysfunctions
      with secondary rickets may be lacking altogether, even in chronic patients.
      Hepatocellular carcinoma is a major cause of death in the chronic form. Diagnosis
      of the disorder is made by assay of SA in urine and serum and by determination of
      FAH in lymphocytes or fibroblasts. Prenatal diagnosis is performed by SA assay in
      amniotic fluid supernatant and FAH analysis in cultured amniotic fluid cells or
      chorionic villus material. Presence of a 'pseudodeficiency' gene for FAH prevents
      prenatal diagnosis by enzyme analysis in some families, and this gene also
      precludes identification of heterozygotes outside tyrosinaemia families.
      Immunoblot analyses show that acute patients and some chronic patients lack
      immunoreactive FAH protein. cDNA probes for FAH have been developed and several
      polymorphisms related to the FAH gene have been reported, which may allow
      prenatal diagnosis in families with complex genotypes. The gene for FAH has been
      mapped to chromosome 15 q23-q25. Liver transplantation is the ultimate treatment;
      most patients continue to excrete SA in urine after liver transplantation and
      therefore there is a possibility of kidney disease after transplantation.

PMID- 1749222
TI  - Investigation of the molecular basis of the genetic deficiency of UDP
      glucuronosyltransferase in Crigler-Najjar syndrome.
AB  - Liver biopsy samples were obtained from eight Crigler-Najjar patients. Bilirubin
      UDPGT activity, assayed by a microassay with HPLC analysis, was not detectable in
      type I livers, and low levels (9-26% of controls) of monoglucuronide conjugates
      only were observed in type II livers. 1-Naphthol UDPGT activity was normal in
      most patients, where membrane integrity was maintained by correct sample
      procurement and preparation. Our data on type II livers suggest that a defect in
      UDPGA transport is an unlikely cause of the hyperbilirubinaemia, but reduced
      affinity for UDPGA was observed in one sample. Analysis of four patient liver
      samples by immunoblot analysis revealed the heterogeneous nature of this
      inherited disease within the patient population, and one sample where 1-naphthol
      UDPGT activity was considerably reduced appeared to correlate with the non
      detection of a phenol UDPGT protein. Progress towards a molecular genetic
      diagnosis of Crigler-Najjar syndromes is discussed.

PMID- 1749223
TI  - Niemann-Pick disease type C: an update.
AB  - The concept of Niemann-Pick disease type C as a secondary sphingomyelin storage
      disorder (in contrast to the sphingomyelinase-deficient types A and B) has become
      more and more prevalent, in view of the complex lipid storage pattern and
      variable sphingomyelinase activities. Although the primary lesion is still
      unknown, studies conducted over the past six years have led to a breakthrough by
      showing that this disorder is characterized by unique abnormalities of
      intracellular translocation of exogenous cholesterol. In cultured fibroblasts of
      patients, this block leads to a delayed induction of the homeostatic responses to
      exogenous cholesterol, in particular cholesteryl ester formation, and to the
      accumulation of unesterified cholesterol in a vesicular, essentially lysosomal,
      compartment. The transport of endogenous cholesterol is apparently unaffected.
      The spectrum of phenotypic heterogeneity in relation to abnormal LDL-processing
      has been defined in a large patient population. Clinical presentation of the
      disease is also reviewed and biochemical correlations are discussed. This
      discovery has had immediate medical applications, by providing the first strategy
      for reliable prenatal diagnosis of the disorder and easy diagnosis of patients.
      To date, the exact implication of the cholesterol transport defect in the
      pathogenesis of Niemann-Pick type C is not known; recent observations have opened
      up new possible approaches for the understanding of this lesion. Although final
      classification of Niemann-Pick disease type C must await elucidation of the
      primary defect(s), present knowledge already establishes that the disease is a
      nosological entity distinct from Niemann-Pick disease type A and B, and suggests
      that it might be the model for a new molecular concept of neurolipidosis--and
      even of inherited metabolic disease.

PMID- 1749224
TI  - Paediatric liver transplantation: review of current experience.
AB  - During the 1980s the results of liver replacement in children improved
      dramatically, with 12-month survival rates rising from around 20% to over 85% at
      the most experienced centres. This improvement has been due to several factors,
      including better patient selection and timing of transplantation, advances in
      immunosuppressive therapy, and developments in liver preservation. Moreover, the
      learning curve effect has contributed with advances both in surgical technique
      and in the rapid diagnosis and treatment of complications, including the need to
      retransplant patients in whom the first graft has been irreversibly damaged. One
      major development is the refinement of the anatomically reduced grafts where a
      larger, usually adult, graft is cut down to fit a child. This has allowed a
      greater number of children to be grafted, including emergency cases such as
      fulminant hepatic failure in whom there is insufficient time to wait for a size
      matched donor.

PMID- 1749226
TI  - The place of fetal liver transplantation in the treatment of inborn errors of
      metabolism.
AB  - Over the last 16 years, 202 fetal tissue transplants have been performed in our
      department to treat 29 patients with severe inborn errors of metabolism without
      immunodeficiency, 26 patients with congenital and severe immunodeficiency
      diseases, and 2 patients with severe aplastic anaemia. The actuarial survival
      curve of patients with inborn errors of metabolism treated with fetal liver
      transplantation shows a 12-year survival of 77%. The condition of many of these
      patients has been improved by the treatment, but transplantation has had to be
      repeated in order to maintain clinical amelioration. Enzyme levels were not
      significantly and durably increased in peripheral blood but the quantities of
      substrates detected in sera and urines were significantly reduced and tissue
      deposits were stabilized.

PMID- 1749225
TI  - Treatment of inherited metabolic disorders by liver transplantation.
AB  - Among the worldwide accepted indications for liver transplantation, inherited
      metabolic disorders play an increasing role. In some paediatric centres this
      indication runs second after extrahepatic biliary atresia. The aim of liver
      transplantation in inherited metabolic disorders is twofold: the first is to save
      a patient's life, the second is to accomplish phenotypic and functional cure of
      his disease. These aims may be achieved in disorders presenting with cirrhosis,
      hepatoma, life-threatening progression or failure of other organs with preserved
      liver function. The timing of liver transplantation has become easier with
      development of surgical techniques of reduced-size donor livers. These techniques
      enable the performance of liver transplantation with ABO blood group compatible
      organs of almost any size if indicated either by deterioration of liver function
      or impending complications such as hepatoma or life-threatening progression. In
      comparison with other indications such as extrahepatic biliary atresia,
      postnecrotic liver cirrhosis or acute liver failure, the results of
      transplantation in patients with inherited metabolic disorders seem to be better,
      reaching up to 78-95% actuarial 1-year survival rates. However, lifelong
      immunosuppressive therapy is necessary. This seems to be acceptable even in
      disorders with only partial liver function defects.

PMID- 1749227
TI  - Screening and economics.
AB  - Screening for disease involves expenditure now in order to reap benefits in the
      future. It is important to understand why future benefits should be discounted in
      the cost-benefit calculation. The reasons are derived from a societal preference
      for consumption now over consumption tomorrow, combined with the productivity of
      capital, which enables goods today to be transformed into more goods tomorrow. It
      is also necessary to put costs and values on human lives. This is simplified at
      present in the UK because a highly restrictive immigration policy implies that
      the net value of the average additional citizen is zero (or even negative). The
      cost-benefit calculations that are presented must be carried out highly
      systematically in order to avoid double counting or omission. A computerized
      spreadsheet is ideal for this purpose.

PMID- 1749228
TI  - Economic evaluation of cost-benefit ratio of neonatal screening procedure for
      phenylketonuria and hypothyroidism.
AB  - A comparison between the cost of identification and care of patients with
      phenylketonuria (PKU) and congenital hypothyroidism (CH) and the expenditure for
      the care of untreated retarded patients has been established on the basis of the
      activity of the Nord-Pas-de-Calais regional screening centre and of interviews
      with patients' families. The analysis yields a benefit-cost ratio of 6.6 for PKU
      and 13.8 for CH prophylaxis. However, cost-benefit varies depending on the
      economic partner, i.e. the patient's family, Social Security or Administration.

PMID- 1749229
TI  - Services for thalassaemia as a model for cost-benefit analysis of genetics
      services.
AB  - Economic appraisal of genetics services is usually limited to consideration of
      financial costs and benefits, but this can generate misunderstandings about the
      aims of these services. We propose a general framework for economic analysis that
      includes non-financial costs and benefits, and the concept of genetic fitness.

PMID- 1749230
TI  - A comparison of selected phonatory behaviors of healthy aged and young adults.
AB  - Selected phonatory behaviors of healthy aged and young men and women were
      compared. Inverse-filtered air flow, electroglottograph (EGG), and intraoral air
      pressure signals were recorded as subjects phonated in each of four conditions:
      normal, soft, loud, loud/high pitched. Minimum flow offset, flow amplitude, air
      flow duty cycle, EGG duty cycle, estimated subglottal pressure, and fundamental
      frequency were derived from the recorded signals and compared among age/gender
      groups. Males had significantly greater flow amplitude than females regardless of
      age. Significant Age x Sex interactions were found for fundamental frequency and
      duty cycle measures. Duty cycles and fundamental frequency increased for males
      and decreased for females with aging. For the normal phonatory condition, aged
      men had significantly greater duty cycle measures, flow amplitude, and estimated
      subglottal pressure than young men. There were significant differences in
      fundamental frequency and EGG duty cycle between aged and young women during
      normal phonation. It was concluded that the effects of aging on phonatory
      behaviors are different in degree and kind for men and women. Fewer significant
      age-related differences in phonatory measures for women than men were consistent
      with reports of less age-related laryngeal degeneration in females than males.

PMID- 1749231
TI  - Syllabic stress and the occurrence of stuttering.
AB  - The occurrence of stuttering on stress-peak and unstressed syllables in connected
      speech was studied in 10 young adult stutterers. Results showed a significant
      coincidence of stutter events and syllabic stress peaks, particularly in
      polysyllabic words. Stuttering on the first three words of principal clauses,
      however, appeared independent of syllabic stress. Similarities between the loci
      of stutter events and segmental errors of speech are considered in relation to
      explanations that regard stuttering as evidence of failure in normal speech
      production processes.

PMID- 1749232
TI  - Slow-to-recover brain-injured patients: rationale for treatment.
AB  - Approximately 10-20% of head injury survivors sustain extensive neurological
      damage and remain minimally or inconsistently responsive to stimuli for 3-6
      months postinjury. These patients, designated as slow to recover (STR), may be
      candidates for sensory stimulation programs rather than traditional
      rehabilitation. Medical and insurance personnel have resisted referral and
      payment for treatment because of the lack of objective measures of progress, a
      theoretical basis for treatment, and evidence of treatment efficacy. A valid,
      reliable assessment tool has recently been developed (Western Neuro Sensory
      Stimulation Profile) that assesses low-level cognitive/communicative function and
      documents improvement in STR patients. This article addresses the theoretical
      rationale for treatment. Evidence from four areas--sensory deprivation, enriched
      environments, nervous system plasticity, and sensitive periods of
      neurodevelopment--suggests that sensory stimulation programs are potentially
      beneficial for STR patients. Speech-language pathologists are encouraged to study
      the recovery patterns of STR patients and to determine the efficacy of treatment
      strategies.

PMID- 1749233
TI  - The effects of minimal pairs treatment on the speech-sound production of two
      children with phonologic disorders.
AB  - Two children whose speech-sound production could be described by phonologic
      processes were administered a linguistically based treatment program that
      utilized minimal pair words. A subset of phonemes affected by a target phonologic
      process was taught consecutively. Spontaneous picture-naming probes were
      administered periodically to measure speech-sound production for all phonemes
      affected by the targeted phonologic process and several control phonologic
      processes. For both subjects, motoric components (i.e., models and phonetic
      placement cues) had to be added to the minimal pairs treatment. With the added
      motoric components, both subjects successfully passed through all treatment
      steps. However, neither subject generalized modified speech-sound production to
      treated phonemes in untreated words or to untreated phonemes affected by the
      target phonologic process.

PMID- 1749234
TI  - Young stutterers' nonspeech behaviors during stuttering.
AB  - The purpose of this study was to assess the nonspeech behaviors associated with
      young stutterers' stuttering and normally fluent children's comparable fluent
      utterances. Subjects were 28 boys and 2 girls who stutter (mean age = 54 months)
      and 28 boys and 2 girls who do not stutter (mean age = 54 months). Each child and
      his or her mother were audio-video recorded during a loosely structured, 30-min
      conversation. Sixty-six different nonspeech behaviors associated with 10 randomly
      selected stutterings per stutterer and 10 comparable fluent utterances per
      normally fluent child were assessed by means of frame-by-frame analysis of the
      audio-video recordings. Results indicate that (a) young stutterers produce
      significantly more nonspeech behaviors during stuttered words than do normally
      fluent children during comparable fluent words, (b) young stutters produce
      significantly more head turns left, blinks, and upper lip raising during
      stuttered words than do normally fluent children during comparable fluent words,
      and (c) talker group membership could be significantly determined on the basis of
      certain types of nonspeech behaviors despite considerable overlap in frequency
      and type of nonspeech behavior between the two talker groups. Findings suggest
      that children can be classified as stutterers on the basis of their nonspeech
      behaviors and that these behaviors may reflect a variety of cognitive, emotional,
      linguistic, and physical events associated with childhood stuttering.

PMID- 1749235
TI  - Effects of long-term tracheostomy on spectral characteristics of vowel
      production.
AB  - This study investigated the effects of long-term tracheostomy on the development
      of speech. Eight children who underwent tracheotomy during the prelingual period
      were compared to matched controls on selected spectral parameters of the speech
      acoustic signal and standard measures of oral-motor, phonologic, and articulatory
      proficiency. Analysis of formant frequency values revealed significant between
      group differences. Children with histories of long-term tracheostomy showed
      reduced acoustic vowel space, as defined by group formant frequency values. This
      suggests that these children were limited in their ability to produce extreme
      vocal tract configurations for vowels (a,i,u) postdecannulation. Oral motor
      patterns were less mature, and sound substitutions were not only more variable
      for this group, but also reflected a persistent overlay of maladaptive
      compensations developed during cannulation.

PMID- 1749236
TI  - Assessment of the dynamics of vocal fold contact from the electroglottogram: data
      from normal male subjects.
AB  - Electroglottographic (EGG) and acoustic records from 10 normal men prolonging the
      vowel /a/ at 60-68 dB, 70-78 dB, and 80-88 dB SPL were obtained. "Contact
      quotient" (EGG duty cycle) was shown to vary directly with vocal SPL. The mean
      contact quotient was 0.57 (SD = 0.07) and varied on the order of 1% over the
      course of a given phonation. "Contact index", a metric of EGG symmetry, also
      tended to vary with SPL. Consistent with previous qualitative descriptions of EGG
      morphology in modal register voice, the contact index averaged -0.52 (SD = 0.08),
      indicating that the EGG "closing phase" represents about 24% of the entire
      "contact phase". Contact index was more variable than contact quotient on
      consecutive EGG waves, varying by about 10% during phonation. Subjects were also
      instructed to produce a slow crescendo. Sound pressure and EGG data indicated
      that both the slope of increasing EGG contact and EGG duty cycle were
      significantly related to the amplitude of the acoustic signal. These results
      suggest that quantitative electroglottography may provide powerful insights into
      the control and regulation of normal phonation and into the detection and
      characterization of pathology.

PMID- 1749237
TI  - Accuracy of the pressure-flow method in estimating induced velopharyngeal orifice
      area: effects of the flow coefficient.
AB  - A two-part study was conducted to determine the accuracy of the pressure-flow
      method in estimating induced velopharyngeal orifice areas when the flow
      coefficient k was empirically determined. In Study 1, short tubes, 4.5 cm in
      length and with internal diameters of 3.2, 4.8, and 6.4 mm, were placed in a
      model of the vocal tract, and the associated flow coefficients were calculated.
      In Study 2, the 4.8-mm internal diameter tube was inserted into the nasopharynx
      of a normal adult subject to induce oronasal coupling during production of the
      syllable/pa/. Results for the human subject revealed that the error between the
      known and estimated orifice areas was approximately 7%. This finding indicates
      that the pressure-flow technique is accurate when the flow coefficient of the
      orifice is known. It is suggested that future research attempt to estimate flow
      coefficients associated with the geometry of the human velopharyngeal orifice in
      order to improve the accuracy of the pressure-flow technique.

PMID- 1749238
TI  - Research design issues in relationships between anxiety and stuttering: comments
      on Craig.

PMID- 1749239
TI  - Response to Perkins, "What is stuttering?".

PMID- 1749240
TI  - Responses to requests for conversational repair by adults with mental
      retardation.
AB  - This study focused on adjustments made in conversation in response to listener
      feedback. Subjects consisted of 22 community-based and 22 institutionalized
      adults with mental retardation individually matched for full-scale IQ. For each
      subject, data were collected in a dyadic conversation with an investigator.
      During the course of the conversation, the investigator introduced stacked
      sequences of three requests for clarification of the same message ("Huh?" "What?"
      "What?"). Each subject's responses to these requests were analyzed. Results
      indicated that community-based subjects used certain sophisticated repair
      strategies more often than did their institutionalized peers. However, neither
      group of subjects was as responsive to the requests for clarification as would
      have been predicted considering their general levels of intellectual and
      linguistic functioning.

PMID- 1749241
TI  - Predicting poor-communication status in preschool children using risk factors
      present at birth.
AB  - The speech and language status of 662 children between the ages of 30 months and
      5 years was determined through the use of parent report information. Twelve of
      these children were reported by their parents to have been diagnosed as having a
      speech-language disorder, and 50 of these children were found to be at or below
      the 10th percentile in language development for children of their age.
      Information about family background and birth history obtained when these
      children were born was evaluated with respect to its power to predict speech
      language status in these preschool children. A set of risk criteria was found to
      accurately predict 55% of those children with poor communication skills and 76%
      of those with normal communication development. This prediction was improved by
      the addition of data about the child's birth order. These results suggest that
      programs of preschool identification should consider the inclusion of a registry
      of children who are at risk for a communication disorder.

PMID- 1749242
TI  - The continuity of babble and speech in children with specific expressive language
      delay.
AB  - A natural language sample of babble and words was obtained for 37 two-year-olds
      with severe specific expressive language delay. Variables derived from this
      sample were used to predict individual differences in expressive language scores
      5 months later. The rate of word use was positively related to language outcome,
      whereas rate of vowel babble was negatively related to outcome. Together, these
      two variables accounted for 41% of the variance in language outcome test scores.
      The addition of one nonlinguistic variable, a measure of behavior problems,
      allowed the prediction equation to account for over 50% of the variance in
      expressive language outcome. The single strongest correlate of language outcome
      was the proportion of consonantal to vowel babble. The degree of social
      responsiveness of babble and the length of babble were not related to later
      language scores. These findings indicate that for children with specific
      expressive language delay, vowel babble competes with expressive language,
      consonantal babble facilitates expressive language, and the length and social
      responsiveness of babble are independent of expressive language. The continuity
      between babble and speech is multidimensional and multidirectional.

PMID- 1749243
TI  - Verb particle and preposition acquisition in language-impaired preschoolers.
AB  - This study examined the acquisition of verb particles and prepositions in
      language-impaired, language-matched, and age-matched preschool children. A
      videotape experimental task, in which subjects viewed and described brief action
      sequences, was implemented. The videotape task included particle, preposition,
      full noun phrase, and pronoun noun phrase items for six different
      particle/preposition words. Primary results indicated that the use of verb
      particles constituted a particularly challenging linguistic task for the language
      impaired subjects relative to both their age- and language-matched peers. These
      results suggest multiple sources of difficulty for language-impaired children in
      the acquisition of grammatical form classes. Lexical and grammatical
      difficulties, as well as possible processing limitations, are implicated.

PMID- 1749244
TI  - Redundancy enhances emotional inferencing by right- and left-hemisphere-damaged
      adults.
AB  - This study investigated the influence of enhanced textual redundancy on affective
      interpretations made by unilaterally right or left hemisphere brain-damaged
      adults and normally aging control subjects. Emotional interferences were drawn
      from linguistic or prosodic material, and redundancy effects were examined within
      and across stimulus boundaries. Results indicate that heightened semantic
      redundancy improved the accuracy of linguistic and prosodic judgements of affect
      for all groups. Correct prosodic judgements were also made more quickly by a
      subset of each group when textual redundancy was maximized. The facilitory
      influence of increased redundancy was not attributable solely to perseveration or
      response rigidity. Possible mechanisms by which semantic redundancy affects
      cognitive processing are considered.

PMID- 1749245
TI  - Family history in developmental expressive language delay.
AB  - Familial aggregation of language deficits has been demonstrated in previous
      studies. However, researchers have typically failed to differentiate subgroups of
      language-impaired children. The present study used questionnaire data to assess
      the family history of speech, language, and school problems in a group of young
      children with developmental expressive language delay (ELD) and in a sample of
      normally developing children. In contrast to previous studies of language and
      speech problems, no strong familial component of ELD was found. Further, family
      history was not predictive of later language development in ELD children. These
      findings argue against genetic and familial causes of ELD and attest to the
      importance of differentiating subtypes of early language problems.

PMID- 1749246
TI  - Otitis media in early childhood and later language.
AB  - The relationship between early otitis media with effusion (OME) experience and
      later language development was examined in a prospective cohort study of 30
      children from middle-class families and 33 children from low-income families. Ear
      status was monitored using otoscopy and tympanometry during wellness and illness
      periods between birth and 3 years of age. Language was assessed using
      standardized tests and a language sample between 4 1/2 and 6 years. Findings
      suggested no reliable relationship between early OME experience and later
      language development.

PMID- 1749247
TI  - Very-low-birthweight children and speech and language development.
AB  - Very low birthweight (VLBW) is often considered to be a risk factor for speech
      and language disorders, yet data are equivocal. The present study compared speech
      and language comprehension and production between 249 very-low-birthweight (VLBW:
      less than 1.5 kg) and 363 normal-birthweight 8-year-olds, randomly sampled in a
      geographic area. Mean performance for the entire group of VLBW children and for
      the group when 24 VLBW children with major neurologic abnormalities were
      excluded, was significantly lower than for controls on the majority of speech and
      language measures. Further analyses addressed the clinical significance of these
      statistically significant differences. Test scores were converted to standard
      scores and grouped according to standard deviation intervals, thus portraying
      each child's performance in terms of the magnitude of discrepancy from each
      test's mean. When the 24 children with major neurological abnormalities were
      excluded, no significant differences between the VLBW and control children were
      observed. Using discrepancy between WISC-R performance IQ and language to define
      specific language impairment (SLI), a higher percentage of control than VLBW
      children were identified as having SLI. Neonatal risk factors did not
      differentiate between VLBW children with or without SLI. A higher proportion of
      VLBW than control children did present subnormal language associated with IQ less
      than 85, hearing deficits, and/or major neurological impairments. Thus, SLI is
      not more common among VLBW than control children. Language deficits accompanied
      by more general developmental problems, however, are more frequent.

PMID- 1749248
TI  - Effects of different frequency response strategies upon recognition and
      preference for audible speech stimuli.
AB  - The purpose of this study was to examine whether the amount of low- versus high
      frequency amplification should change as a function of input level, as is done in
      some recently developed hearing aids. Adults with high-frequency sensorineural
      hearing loss served as subjects. Both identification performance and preference
      judgments for audible CV syllables were assessed as a function of input level for
      three different signal processing conditions both in quiet and in noise. The
      first signal processing condition was a conventional high-pass frequency response
      that did not change its transfer function as the input level increased; the
      second condition was similar to a typical adaptive frequency response (AFR)
      hearing aid: a high-pass frequency response that became increasingly high-pass as
      the input level increased; the third condition was similar to the K-Amp hearing
      aid recommended by Killion (1988): a high-pass frequency response that became
      more broadband as the input level increased. Results indicated no significant
      differences among the three different processing conditions for syllable
      recognition and a strong listener preference for the syllables presented via the
      conventional amplification scheme.

PMID- 1749249
TI  - Test-retest reliability in tympanometry.
AB  - Test-retest reliability for tympanometric measures was evaluated across five
      sessions in 20 subjects with normal hearing and normal middle-ear function.
      Tympanograms were obtained on each ear for probe frequencies of 226, 678, and
      1000 Hz using both ascending and descending directions of pressure change. Across
      all conditions, the tympanometric measure that consistently demonstrated the
      highest test-retest reliability was compensated static acoustic admittance. Test
      retest correlations for peak compensated static acoustic admittance measures were
      higher than those for ambient measures across all probe frequencies and both
      directions of pressure change; the differences in correlations for peak and
      ambient measures, however, reached significance only for 226-Hz conditions.
      Across-session correlations for tympanogram width did not differ significantly
      for measures referenced to the lowest tympanogram tail and those referenced to
      +200 daPa.

PMID- 1749250
TI  - Conductive hearing loss during infancy: effects on later auditory brain stem
      electrophysiology.
AB  - Long-term effects on auditory electrophysiology from early fluctuating hearing
      loss were studied in 27 children, aged 5 to 7 years, who had been evaluated
      originally in infancy. For controls (Group A), infant auditory brain stem
      responses (ABRs) were normal from birth to age 2 years. A second group (Group B)
      had intermittent conductive hearing loss. A third group (Group C) had more
      abnormal ABRs during infancy than Group B and more severe and frequent conductive
      hearing loss. For this follow-up study, all children had normal peripheral
      hearing at test. ABRs were obtained to monaural and binaural stimuli. Binaural
      interaction (BI) in the ABR was assessed in difference traces, derived by
      subtracting summed binaural from summed monaural waveforms. Controls differed
      from both groups with early hearing loss for wave III and wave V latencies and
      interpeak I-III and I-V latencies. There was a significant difference in the
      presence of BI. Eight of 9 A subjects and 8 of 9 B subjects, but only 4 of 9 C
      subjects, had demonstrable BI. Findings suggest that early fluctuating hearing
      loss disrupts later auditory brain stem electrophysiology.

PMID- 1749251
TI  - Clinical applications of otoacoustic emissions.
AB  - On the basis of recent advances in auditory physiology, new tests of cochlear
      function have been developed using measures of otoacoustic emissions. In the
      present report, the clinical potential for each of the four basic emission types
      is examined. In addition, the practical advantages of examining the ear with two
      specific types of evoked emissions, transiently evoked and distortion-product
      otoacoustic emissions, are reviewed in detail. Finally, the future role of tests
      of otoacoustic emissions in the diagnosis of hearing impairment is discussed. The
      current view is the evoked emissions hold promise as an essential part of the
      clinical examination of the auditory system.

PMID- 1749252
TI  - Maternal linguistic input to toddlers with slow expressive language development.
AB  - Maternal speech styles to children between 20 and 34 months of age who were slow
      to acquire expressive language were compared to those of mothers with normally
      speaking toddlers. Aspects of the mothers' speech examined included use of
      various sentence types (declaratives, negative, questions, etc.); the mother's
      lexical contingency with regard to the child's utterance; mother's use of
      pragmatic functions such as requests, comments, and conversational devices; and
      the mother's use of topic management. Results revealed that mothers of toddlers
      with slow language development are different from mothers of normal speakers only
      in their frequency of use of lexical contingency devices, specifically, expansion
      and extension. However, the proportion of expansions and extensions relative to
      the number of child utterances is not different, indicating that when late
      talkers give their mothers something to expand, the mothers do so, but that the
      late talkers do not give their mothers as much speech to work with as do the
      normal toddlers. Implications of these findings for parent training are
      discussed.

PMID- 1749253
TI  - Interobserver reliability using the Phonetic Level Evaluation with severely and
      profoundly hearing-impaired children.
AB  - This study examines whether observers reliably categorize selected speech
      production behaviors in hearing-impaired children. A group of experienced speech
      language pathologists was trained to score the elicited imitations of 5
      profoundly and 5 severely hearing-impaired subjects using the Phonetic Level
      Evaluation (Ling, 1976). Interrater reliability was calculated using intraclass
      correlation coefficients. Overall, the magnitude of the coefficients was found to
      be considerably below what would be accepted in published behavioral research.
      Failure to obtain acceptably high levels of reliability suggests that the
      Phonetic Level Evaluation may not yet be an accurate and objective speech
      assessment measure for hearing-impaired children.

PMID- 1749254
TI  - A simple model of host-parasite evolutionary relationships. Parasitism:
      compromise or conflict?
AB  - The evolutionary biology of host-parasite relationships are considered here using
      a simple game-theory model in which hosts play against parasite and vice versa.
      In this model, the players can choose between two strategies (aggressive or not
      aggressive) and the utility of the game is envisaged in terms of fitness and
      selective costs. The game solutions suggest that the two types of confrontation
      are encountered in symbiotic relationships and thus constitute two Evolutionary
      Stable Strategies (ESS). These observations lead us to discuss: (i) the status of
      different kinds of symbiotic relationships (i.e. parasitoidism; parasitism,
      commensalism and mutualism) related to selective costs and (ii) the position of
      coevolution in this game theory context.

PMID- 1749255
TI  - Counting phylogenetic invariants in some simple cases.
AB  - An informal degrees of freedom argument is used to count the number of
      phylogenetic invariants in cases where we have three or four species and can
      assume a Jukes-Cantor model of base substitution with or without a molecular
      clock. A number of simple cases are treated and in each the number of invariants
      can be found. Two new classes of invariants are found: non-phylogenetic cubic
      invariants testing independence of evolutionary events in different lineages, and
      linear phylogenetic invariants which occur when there is a molecular clock. Most
      of the linear invariants found by Cavender (1989, Molec. Biol. Evol. 6, 301-316)
      turn out in the Jukes-Cantor case to be simple tests of symmetry of the
      substitution model, and not phylogenetic invariants.

PMID- 1749256
TI  - Frequencies of codons in histones, tubulins and fibrinogen: bias due to
      interference between transcription signals and protein function.
AB  - The distribution of codons was studied in 65 proteins: 48 histones, 14 tubulins,
      and three fibrinogens, With the methodology used, (1) we confirmed that the
      preterminator state of a codon has no detectable effect on codon bias. (2) The
      well-known effect of CG suppression was visible. We also found that (3) some
      codons which are very rare, are equal to parts of known transcription signals.
      Thus, we advanced that to avoid signal interference, the use of these codons is
      suppressed when a synonymous codon is available. In addition we found that in the
      whole series of codons, transcription signals are less frequent than in a random
      sequence of equal composition. Finally we observed (4) that tryptophan is absent
      in histones. This absence was related not to the TGG codon itself, but to
      characteristics of the amino acid. We conclude that the functional constraints of
      a protein can influence, at least for synonymous codon usage, the evolution of
      its own coding sequence.

PMID- 1749257
TI  - Evolution of split genes.

PMID- 1749258
TI  - The world's current situation on development of traditional Chinese medicine and
      its prospects.

PMID- 1749259
TI  - Combined application of scalp and body acupuncture in the treatment of
      pseudobulbar paralysis.

PMID- 1749260
TI  - Treatment of headaches by acupuncture and Chinese herbal therapy--conclusive data
      concerning 1000 patients.

PMID- 1749261
TI  - Deep puncture of renying point in the treatment of cerebrovascular disease with
      sequalae--a report of 89 cases.

PMID- 1749262
TI  - Magnetic disk applied on Neiguan point for prevention and treatment of cisplatin
      induced nausea and vomiting.

PMID- 1749263
TI  - Treatment of papillo-retinitis and uveitis associated with cat-scratch disease by
      combination of TCM and modern drugs.

PMID- 1749264
TI  - Treatment of urinary retention with acupuncture and moxibustion.

PMID- 1749265
TI  - Anti-hypertensive effect of auriculo-acupoint pressing therapy--clinical analysis
      of 274 cases.

PMID- 1749266
TI  - 408 cases of urinary calculus treated by auriculoacupoint pressure.

PMID- 1749267
TI  - 42 cases of climacteric syndrome treated with auricular pellet pressure.

PMID- 1749268
TI  - Treatment of urinary retention due to postoperative anal pain.

PMID- 1749269
TI  - Massage for the treatment of voice ailments.

PMID- 1749270
TI  - Advances in researches on auriculo-acupoints.

PMID- 1749271
TI  - [Clear cell carcinoma of the female genital tract].
AB  - From 1980 to 1989 clear-cell carcinoma was diagnosed in 66(4.2%) out of 1562
      adenocarcinomas of the female genital tract: in the ovary, 2.9% in the
      endometrium, 9.8% in the uterine cervix; 4.5% in the vagina, and 1.9% in the
      Fallopian tube. The diagnosis was made at clinical stage I in 26.9% of cases
      located in the ovary, 62.5% in the endometrium, and 42.8% in the uterine cervix.
      At stages III and IV the highest percentage of cases was diagnosed in the ovary 
      42.3% and 26.9%, respectively. The material was divided into the histological
      subtypes, and the glandular papillary was found in 54.5%, the tubulocystic in
      31.8% and the solid in 13.6% of cases. The tubulocystic subtype showed the best
      prognosis, with the 50% five-year survival rate, while the glandular papillary
      subtype had 38.1%, and the solid subtype a 14.3 five-year survival rate was 66.6%
      for the ovary, 85% for the endometrium and 75% for the uterine cervix. For all
      other stages together (II, III, IV), the five-year survival rate was 0% for the
      ovary, 20% for the endometrium and 0% for the uterine cervix.

PMID- 1749272
TI  - [Bioethics in neonatology].

PMID- 1749273
TI  - [Evaluation of embryotoxicity of materials used in the IVF laboratory].
AB  - It has been established that the quality of water for the preparation of culture
      media has an essential influence on the percentage of two cell-stage mouse
      embryos developing successfully until the blastocyst stage. The quality of media
      prepared with bidistilled water (p less than 0.001) is inferior to that prepared
      with bidestilled demineralized water (p less than 0.02). Best results were
      attained by using the medium prepared with Nanopure water (Barnstead), in which
      73.2% of embryos developed into blastocysts. There was no statistically
      significant difference between this medium and the commercial liquid medium
      (Sigma), in which 83.1% of embryos developed into blastocysts. The age of the
      medium and the percentage of added serum have no statistically significant
      influence on the outcome of the test. Contact of the medium with the syringe
      containing a black rubber piston proved explicitly embryotoxic (p less than
      0.001).

PMID- 1749274
TI  - [Levels of estrogen and progesterone receptors in premalignant and malignant
      states in the endometrium].
AB  - In a prospective study conducted from 1981 to 1989, concentrations of estrogen
      (ER) and progesterone (PR) receptors were determined by the saturation analysis
      of cytosols prepared from 67 samples of human endometrial tissue. Patients over
      35 years of age who had come to the hospital because of irregular bleeding were
      included in the investigation. In the group examined it was found that 25
      patients developed endometrial carcinoma, 22 hyperplasia adenomatosa and 20
      patients had normal pathohistological findings. The median values of ER
      concentrations were 46, 99 and 31 fmol/mg of protein, with the ranges of 0-628, 0
      2348 and 0-552 fmole/mg of protein in the group with normal endometrial tissue,
      hyperplastically transformed endometrial tissue and in the group with endometrial
      carcinoma, respectively. The median values of PR concentrations were 196, 307 and
      96 fmol/mg of protein, with the ranges of 0-1714, 0-2402 and 0-582 fmole/mg of
      protein in the group with normal endometrial tissue, hyperplastically transformed
      endometrial tissue and in the group with endometrial carcinoma, respectively. In
      the group of patients with endometrial carcinoma 40% of ER+/PR+ tumors (greater
      than 50 fmole/mg of protein), 36% of ER-/PR-tumors, and 24% of ER-/PR+ tumors
      were found. The results of the median test showed that there were no
      statistically significant differences among ER concentrations (chi 2 = 2.822; P =
      0.2439), or among PR concentrations (chi 2 = 3.582; P = 0.1668) in the groups of
      patients examined.

PMID- 1749275
TI  - [Pregnancy outcome after early amniocentesis].
AB  - The indications, karyotype, and outcome of 1812 pregnancies following
      midtrimester amniocentesis (eACZ/as) performed from 1977 to 1989 are presented,
      especially regarding the risk of pathologic karyotypes and spontaneous abortion.
      There were 37 pathologic karyotypes (trisomy 21 in 24 pregnancies). The
      spontaneous abortion rate following amniocentesis was 2.8% although it was almost
      halved after direct ultrasound guidance had been introduced (1.87% versus 3.66%).
      In gravidas with previous spontaneous abortion, the preterm delivery rate and
      spontaneous abortion rates following rACZ were significantly increased. There is
      a progressive increase of the spontaneous abortion rate after eACZ with the
      number of previous spontaneous abortions; 5.83% when there was only 1 previous
      spontaneous abortion, 7.83% when there were 2, and 8.75% when there were 3 or
      more spontaneous abortions. Previous spontaneous abortions do not increase the
      risk of chromosomal aberration. In women aged 37 years or more the risk of
      trisomy 21 is 0.69%, aged 38 years 1.55% and over 39 years 0.44%. The risk is
      rapidly increasing after 40 years of age (2.25%). The proportion of pathologic
      karyotypes in these age groups was significantly higher in comparison to younger
      women. The age limit of 37-38 years as the indication of a possible appearance of
      mid-trimester ACZ is discussed.

PMID- 1749276
TI  - [Correlation between weather factors and the number of premature and yearly
      births].
AB  - In a retrospective study for a period of five years, a total of 41,760 births in
      Sarajevo were analysed. For the same period, also meteorological data, such as
      air temperature, humidity, rain, cloudiness, barometric pressure, were gathered,
      by determining the weather type for each day. Using computer analyses, daily
      weather types with the number of births were compared. On the basis the
      statistical method of Friedman's test it is concluded that there is a significant
      correlation (p less than 0.05) between the weather types and the daily number of
      births. By comparing the daily number of births with the weather type of the
      preceding day the same conclusion was drawn. A cyclic fluctuation was also
      observed in the number of human births: the increased number of births in the
      December-January period and the decreased number of births in the August
      September period. Premature births did not show any cyclic pattern.

PMID- 1749277
TI  - [Comparison of prostaglandin E2 and oxytocin infusions for induction of labor in
      primiparas at term with an unripe cervix and premature rupture of fetal
      membranes].
AB  - The study aimed at examining the effectiveness of labor induction in term
      pregnant nulliparas with the premature rupture of the membranes (PRM) and unriped
      cervix (Bishop less than 6). Each group contained 17 nulliparas. In the first
      group the labor was induced with the prostaglandin E2 (PgE2) infusion, in the
      second group the oxytocin infusion was used. The results of both groups were
      compared. PgE2 was found to be effective in labor induction; the rate of
      caesarean sections was 18.75% in the first group and 29.41% in the second group.
      The PgE2 drug was found to be safe for the fetus and also well tolerated by
      pregnant women. The effect of the drug on the ripening of the cervix has not been
      noticed. The time interval from the induction of labor to the delivery is equal
      in both groups. However, in the first group significantly less work was done by
      the uterus at the same interval. No incidence of uterine hyperactivity was
      recorded. All newborns in the first group were in good condition: in the second
      group two cases of fetal distress were recorded. The pregnancy outcome shows that
      the PgE2 drug is superior to oxytocin for labor induction in term pregnant
      nulliparas with the PRM and unriped cervix.

PMID- 1749278
TI  - [Correlation between levels of prolactin in maternal serum, fetal serum and
      amniotic fluid in childbirth at term].
AB  - In 117 parturients with 38-41 gestation weeks, prolactin was analysed by the
      radioimmunologic method in the mother serum, the umbilical cord serum and vein,
      and in the amnionic fluid. Three groups of parturients and their newborns were
      examined: the group (n = 44) with the birth having started spontaneously with the
      appearance of labour pains 1/10 minutes, the group (n = 38) with a programmed
      birth induced by the infusion of oxytocin, and the group (n = 35) with the birth
      comprising elective cesarean section. The concentration of prolactin in the
      examined sera is characterized by considerable individual oscillations. The
      highest prolactin level was in the amnionic fluid (395.6 +/- 130.1 mu/L) and the
      lowest in the mother serum (174.6 +/- 84.1 mu/L) which shows a statistically
      significant difference (p less than 0.01). Prolactin values in the umbilical
      artery (244.6 +/- 98.3 mu/L) and vein (230.4 +/- 91.7 mu/L) are significantly (p
      less than 0.001) higher than the value in the mother sera and significantly lower
      (p less than 0.001) than the prolactin concentration in the amnionic fluid. The
      difference of the prolactin values in the sera of the umbilical cord blood
      vessels has no statistical significance (p greater than 0.05). Nor is there any
      statistically significant difference between prolactin concentrations in
      spontaneous and induced deliveries versus those in deliveries terminated with
      elective cesarean section (p greater than 0.05). A correlation analysis of the
      functional connection of prolactin in the sera of the mother, fetus, and amnionic
      fluid gives the correlation coefficient values of high statistical significance
      (0.482 less than r less than 0.906; p less than 0.001).

PMID- 1749279
TI  - [Relation between fetal hypoxia, neonatal asphyxia and hypoxic-ischemic
      encephalopathy].
AB  - Clinical data, duration of labour, mode of delivery and possibilities of fetal
      heart rate monitoring in predicting perinatal asphyxia and neonatal
      encephalopathy in 143 consecutively delivered asphyxiated infants and 143 paired
      healthy infants are analyzed. Perinatal asphyxia occurred in only 2.6% of normal
      pregnancies and significantly more frequently in pregnancies complicated by
      gestosis. It is far more common in children subject to operative deliveries (15
      20%) and when labour lasts longer than 12 hours, either in vertex or breech
      presentations. The occurrence of encephalopathy is less frequent in children
      delivered by cesarean section (1.6%) and almost three times more frequent than in
      vaginal breech deliveries. In asphyxiated children delivered vaginally,
      significantly more frequently CTG scores were prepathologic (38% versus 3.4%). In
      the cesarean section group the differences are not significant in prepathologic
      CTG scores but are highly significant when CTG scores were pathologic (36% versus
      2.7%). The mean duration of the pathologic heart rate pattern is significantly
      longer in mild asphyxia in comparison to the control group (45 minutes versus
      12.5 minutes). In moderate asphyxia the pathologic CTG pattern lasted 72.1
      minutes and in severe asphyxia 52 minutes.

PMID- 1749280
TI  - [Preservation and relocation of the ovaries in an experiment on female dogs and
      the initial experience in radical hysterectomy in women].
AB  - During an experiment in bitches, the ovaries were placed sub-peritoneally beneath
      the skin of the abdominal wall preserving the infundibulo-pelvic ligament. A year
      later a relaparotomy was performed. No alterations were evidenced in the ovaries
      placed either sub-peritoneally of beneath the skin. In 7 patients of less than 36
      years of age, during radical hysterectomy performed for cervical carcinoma the
      ovaries were placed intraperitoneally at the level of the lower kidney pole,
      preserving the vascularisation of the infundibulo-pelvic ligament. In one patient
      a cystic degeneration occurred on the right side, while the ultrasound control
      did not reveal any pathology in the rest of the patients. A year later the total
      urine estrogen levels were within normal ranges.

PMID- 1749281
TI  - [Evaluation of short-term exposure to a polyacrylonitrile cervical dilator in
      preabortion preparation of the uterine cervix in adolescent girls].
AB  - Authors investigated possibilities of application of polyacryl-nitrile cervical
      dilators PCD-Dilapan in preabortion preparation of the cervix during the first
      trimester of pregnancy in 39 adolescent patients. Control of the achieved degree
      of cervical dilatation was performed by largest No Hegar dilator which did not
      show resistance during insertion. The control group comprised 35 adolescent
      patients in whom cervical dilatation was performed only by Hegar dilators till
      optimal dilatation for vacuum aspiration was achieved. Mean cervical dilatation
      in the investigated group was means = 8.85 mm (SD +/- 0.85) and in the control
      group means = 8.55 mm (SD +/- 0.78) with no statistically significant difference
      (T = 0.024, p greater than 0.05). "Analogous visual scale" was used for pain
      estimation during cervical dilatation. In the investigated group means = 2.01 (SD
      +/- 1.83) of pain degrees while means = 6.71 (SD +/- 1.89) in the control group.
      Side effects during cervical dilatation were noted in 15.38% of patients in the
      investigated group and in 51.41% of patients in the control group which
      difference was not statistically significant (chi 2 = 5.59, p greater than 0.05).

PMID- 1749282
TI  - [Sterilization--where are we and what do we want?].
AB  - According to the estimation from the mid-eighties, about 135 million people were
      sterilized, 95 million females and 40 million males. In 1977, sterilization was
      legalized in Slovenia, in 1978 in Croatia. In the period from 1978 to 1989, 4,503
      females and 654 males were sterilized in Slovenia. The majority of female
      sterilizations were performed in the interval and post partum (the third cesarean
      section), applying laparoscopy or mini-laparotomy according to Pomeroy, in some
      cases the obsolete Madlener technique, while vasectomies were performed by using
      the standard method. The accurate statistical data on complications are not
      available but are estimated to be minimal. Requests for a tubal or seminal duct
      reconstruction have been exceptional. With a higher number of sterilizations the
      incidence of induced abortions in women at the age of more than 35 years would be
      reduced and the use of contraception would be increased. Yugoslavia, besides
      Albania and the Soviet Union, was the last to resort to contraceptives.

PMID- 1749283
TI  - [The HELLP syndrome--a case report].
AB  - A 31-year-old secundipara with eclampsia developed the HELLP syndrome after
      delivery. Clinically, along with very high blood pressure values (29.3/17.3 kPa)
      and eclamptic attacks, an intense pain in the upper abdomen and nausea were
      dominant. The patient also had severe thrombocytopenia (18 x 10(9)/L), hemolysis,
      and increased liver enzymes (SGOT up to 220 U/L and SGPT up to 100 U/L). An
      intensive therapy, including--together with usual interventions in serious EPH
      gestoses--also plasmapheresis, antithrombin III substitution, freshly frozen
      plasma, and transfusion of blood and thrombocytes, proved successful in achieving
      the normalization of the blood pressure, blood count and liver enzymes, as well
      as a clinical improvement, so that 18 days after delivery it was possible for the
      patient to go home, provided with necessary instructions.

PMID- 1749284
TI  - [Malignant ovarian tumors in childhood and adolescence in Novi Sad (1946-1989)].
AB  - In the period from 1946-1989, at the Department of Gynecology and Obstetrics
      University of Novi Sad, 79 ovarian tumors in children and adolescents were
      registered. There were 10 (12.6%) malignant tumours. The most common were
      dysgerminoma and carcinoma (total 6-7.6%). The treatment depended on the extent
      of the disease at the time of diagnosis (surgery, irradiation, chemotherapy or
      combination).

PMID- 1749285
TI  - [Anterior pelvic exenteration with ileocystoplasty in advanced cancer of the
      uterine cervix].
AB  - A female patient with the IV grade cervical carcinoma without distant metastases
      is presented. The patient underwent a radical surgical intervention. An anterior
      pelvic exenteration with ileocystoplasties was successfully performed. The
      patient is alive 14 months after the initial treatment. No greater complications
      were observed during the operation and after it, but in spite of a satisfactory
      general status, the patient has had nocturnal incontinence all the time. It is
      believed that this complication is the sequel of the newly formed urinary
      bladder, as the convolution of the ileum is only 30 cm long which has proved
      insufficient.

PMID- 1749286
TI  - [Atypical cervical cytology during pregnancy in the region of Baranja].
AB  - In the period from 1985 to 1989, 2521 pregnant women, making up 18.7% of women in
      fertile age, were controlled in antenatal surgeries in the area of Baranja. In 73
      (2.9%) women a cytologic picture of cervical atypia was found: in 2.1% of them
      there was a cytologic picture of light and moderate dysplasia (group IIIA), in
      0.6% a picture of severe dysplasia (group IIIB), and in 0.2% pregnant women there
      was a picture of carcinoma in situ (group IV). Progression of cytologic findings
      into a higher stage was noted in 23.3% women, persistence was recorded in 21.9%
      and regression in 54.8% women. A total of 71.2% pregnant women with the cytologic
      atypia of the cervix were colposcopically examined. An abnormal colposcopic
      picture was found in 65.4% of them. By the end of the puerperium histologic
      verification was made in 38.4% cases and 61.6% were controlled only cytologically
      and colposcopically. By means of histologic examination of the tissue specimen,
      progression of an intraepithelial lesion into an invasive carcinoma was not found
      in any of the women. These results corroborate the point of view that in pregnant
      women with the cytologic atypia of the uterine cervix the histologic verification
      can be postponed until after the delivery without any considerable risk. Only in
      the case of a cytologic or colposcopic suspicion of invasion it is necessary to
      verify the finding histologically.

PMID- 1749287
TI  - Surgical management of hepatic hydatid disease.
AB  - The use of conservative or radical surgical procedures in the management of
      hepatic echinococcosis is controversial. A review of data on 23 patients with
      hydatid cysts of the liver that were diagnosed between 1935 and 1990 at our
      institution was undertaken to determine the safety and efficacy of various
      surgical procedures. In eight patients (group 1), the cysts were treated
      conservatively by instillation of a scolicidal agent followed by evacuation of
      the cyst, drainage, or omentoplasty of the residual cyst cavity. Thirteen
      patients (group 2) underwent radical excision of the cyst by either
      pericystectomy or hepatic resection. In addition, two patients were treated by
      combined techniques. Scolicidal agents were used in 18 patients (78%) and
      apparently resulted in caustic biliary injury and death in 2 patients. Group 1
      and group 2 patients had similar complication rates (62% and 54%, respectively)
      and mean hospital stay (24 and 23 days, respectively). Recurrent cysts, however,
      were detected in three of six patients who underwent a conservative surgical
      procedure and participated in follow-up, whereas no patients treated by a radical
      procedure had a recurrence. Because pericystectomy and hepatic resection resulted
      in a low rate of recurrence and eliminated the need for use of potentially toxic
      scolicidal agents, these procedures may be the preferred method for the surgical
      management of hepatic hydatid disease.

PMID- 1749288
TI  - Levels of lipids, lipoproteins, and apolipoproteins in a defined population.
AB  - As part of a large cross-sectional investigation--the Rochester Family Heart
      Study--plasma levels of lipids, lipoproteins, and apolipoproteins were measured
      in a sample from the general population of male and female subjects who ranged in
      age from 5 to 90 years. Polyclonal radioimmunoassays developed at the Mayo Clinic
      were used for measurement of apolipoproteins A-I, A-II, C-II, C-III, and E,
      whereas a monoclonal enzyme-linked immunosorbent assay was used for
      apolipoprotein B. On the basis of 984 subjects who reported that they were
      fasting, were not pregnant, had never smoked, and were taking no medications
      thought to influence lipid levels, we determined age- and gender-specific
      percentiles for plasma levels of cholesterol, triglycerides, high-density
      lipoprotein cholesterol, and six apolipoproteins. These percentiles will
      facilitate identification of persons who are in the highest and lowest
      percentiles for their age and gender. The levels of the apolipoproteins varied
      for both age and gender. This is the first study to provide a reference sample
      for plasma levels of these apolipoproteins for male and female subjects 5 to 90
      years of age selected from the general population.

PMID- 1749289
TI  - Magnetic resonance imaging of the hand, wrist, and forearm: utility in patients
      with pain and dysfunction as a result of trauma.
AB  - We reviewed the clinical data, results of imaging studies, and surgical
      pathologic correlations in 41 consecutive patients with pain in the hand, wrist,
      or forearm to evaluate the role of magnetic resonance imaging in comparison with
      that of other imaging techniques. Of the 41 patients, 24 had a trauma-related
      lesion. In 18 of these 24 patients, the findings on magnetic resonance imaging
      were equivalent to (6 cases) or better than (12 cases) the clinical findings or
      the findings on other imaging studies for the detection of lesions of the hand,
      wrist, or forearm. Moreover, the results of magnetic resonance imaging affected
      the clinical management in 7 of the 24 cases (29%).

PMID- 1749290
TI  - The evolution of Hodgkin's disease and necrobiotic xanthogranuloma syndrome.
AB  - We describe a woman in whom hypogammaglobulinemia and severe granulomatous
      cutaneous lesions had developed during childhood; subsequently, Hodgkin's disease
      and necrobiotic xanthogranuloma were diagnosed. This case illustrates an apparent
      association with disease activity and raises the question of a direct
      relationship of necrobiotic xanthogranuloma with lymphoproliferative disease.

PMID- 1749291
TI  - The potential for muscarinic receptor subtype-specific pharmacotherapy for
      Alzheimer's disease.
AB  - In several neurodegenerative disorders, including Alzheimer's disease, a loss of
      the cholinergic projections of the basal forebrain to the cerebral cortex and
      hippocampus occurs. Studies of the anatomic and physiologic characteristics of
      these ascending cholinergic systems suggest that they are important in processing
      information and in memory function. Muscarinic receptors are situated at various
      critical control points in these pathways. Activation of postsynaptic muscarinic
      receptors often increases the excitability of neurons; thus, the signal-to-noise
      ratio for sensory processing is enhanced. In addition, muscarinic receptors
      negatively control cholinergic tone at presynaptic sites. Molecular biologic
      methods have disclosed the existence of five muscarinic receptors, which are
      coupled to different second messenger systems. The evidence reviewed suggests
      that at least four of the five muscarinic receptor genes are expressed as
      functional receptor proteins in the neocortex and hippocampal formation. On the
      basis of the current information about their pharmacologic properties and
      coupling mechanisms in nervous tissue, drugs that selectively affect subtypes of
      muscarinic receptors could enhance cortical cholinergic function and thereby
      ameliorate certain cognitive impairments in Alzheimer's disease.

PMID- 1749292
TI  - Childhood sinusitis.
AB  - Childhood sinusitis is difficult to diagnose. It is classified on the basis of
      duration of inflammation--acute or chronic--and cause of inflammation--infectious
      or noninfectious. Infectious sinusitis is often a result of obstruction of the
      osteomeatal complex. Inflammation in noninfectious sinusitis is similar to the
      inflammatory changes detected in respiratory mucosa of patients with asthma.
      Acute sinusitis is primarily an infectious process similar to a prolonged
      infection of the upper respiratory tract. Plain radiography has limited value for
      the diagnosis of acute sinusitis in children. The most effective treatment of
      acute sinusitis is administration of a beta-lactamase-resistant antibiotic.
      Chronic sinusitis may be infectious, noninfectious, or both. Coronal computed
      tomography of the sinuses and nasal endoscopy are the preferred methods for
      determining the presence of chronic sinusitis. When physicians prescribe therapy
      for chronic sinusitis, they need to consider whether the underlying cause is
      infectious, noninfectious, or both. Treatment of chronic infectious sinusitis is
      most effective when a beta-lactamase-resistant antibiotic is administered.
      Chronic noninfectious sinusitis may respond to topically intranasally applied
      corticosteroids. If medical treatment fails to resolve the disease within 3
      months, surgical intervention may be necessary. Finally, although an association
      between asthma and sinusitis exists, a cause-and-effect relationship has not been
      established.

PMID- 1749293
TI  - Ludwik Rydygier--famous Polish surgeon.

PMID- 1749294
TI  - The fluoroquinolones.
AB  - The fluoroquinolone class of antibiotics promises to become as diverse and as
      important as beta-lactam agents. The fluoroquinolones inhibit bacterial DNA
      gyrase and are bactericidal. All fluoroquinolones have potent activity against
      most gram-negative bacteria; ciprofloxacin is the most active against Pseudomonas
      aeruginosa. Activity against gram-positive organisms is variable; methicillin
      resistant Staphylococcus aureus has acquired resistance to the fluoroquinolones
      at an alarming rate. Currently available quinolones do not have, but new
      quinolone agents likely will have, substantial activity against anaerobic
      bacteria. Some quinolones are also active against Mycobacterium, Chlamydia, and
      Mycoplasma organisms. All fluoroquinolones have excellent absorption after oral
      administration; however, this process can be impaired by the presence of aluminum
      or magnesium-containing antacids and by zinc, iron, or calcium supplements.
      Ciprofloxacin is also available for intravenous use. Although most
      fluoroquinolones do not achieve adequate cerebrospinal fluid levels, penetration
      into other tissues is excellent. Dosage adjustments for renal and hepatic
      dysfunction vary among the quinolones. Although side effects are rare,
      concomitant use of caffeine or theophylline with some quinolones may cause
      toxicity to the central nervous system. Because they may affect the development
      of cartilage, all fluoroquinolones are contraindicated in children, adolescents,
      and pregnant or breast-feeding women.

PMID- 1749295
TI  - Trimethoprim-sulfamethoxazole.
AB  - The antimicrobial combination of trimethoprim and sulfamethoxazole is active in
      vitro against various gram-positive and gram-negative bacteria. Clinically, it is
      useful for prophylaxis and treatment of selected infections of the genitourinary,
      respiratory, and gastrointestinal tracts. Trimethoprim-sulfamethoxazole by itself
      or in combination with other antimicrobial agents is indicated for most Nocardia
      asteroides infections and is the antimicrobial agent of choice for Pneumocystis
      carinii pneumonia. The drug is relatively nontoxic in patients who do not have
      the acquired immunodeficiency syndrome (AIDS) and is available in both oral and
      intravenous forms. The native compounds and the metabolites of trimethoprim and
      sulfamethoxazole are excreted primarily in the urine. When the creatinine
      clearance is less than 30 ml/min, the dosage of trimethoprim-sulfamethoxazole
      should be adjusted.

PMID- 1749296
TI  - Tetracyclines, chloramphenicol, erythromycin, clindamycin, and metronidazole.
AB  - The tetracyclines are effective in the treatment of Chlamydia, Mycoplasma
      pneumoniae, and rickettsial infections and also can be used for gonococcal
      infections in patients unable to tolerate penicillin. These drugs may cause
      gastrointestinal irritation, diarrhea, phototoxic dermatitis, and vestibular
      damage, and fatal reactions due to hepatotoxicity have occurred in pregnant
      women. Chloramphenicol has a broad spectrum of bacteriostatic activity, but its
      association with suppression of the bone marrow and aplastic anemia has relegated
      it to a historical role. Erythromycin is the drug of choice for the treatment of
      infections caused by M. pneumoniae, Legionella species, group A beta-hemolytic
      streptococci, and Streptococcus pneumoniae. The frequency of serious adverse
      effects associated with the use of erythromycin is low; dose-related epigastric
      distress may occur. Clindamycin is bactericidal to most nonenterococcal gram
      positive aerobic bacteria and many anaerobic microorganisms. Although
      historically it was a frequent cause of antibiotic-associated diarrhea and
      colitis, clindamycin is considered an excellent alternative to beta-lactam
      antibiotics for treatment of many staphylococcal infections, and it has
      therapeutic utility in anaerobic infections and in several protozoan infections
      in immunosuppressed patients. Metronidazole is efficacious for treating
      nonpulmonary anaerobic infections, various parasitic infections (trichomoniasis,
      amebiasis, and giardiasis), nonspecific vaginitis, and Clostridium difficile
      mediated colitis. With use of metronidazole, mild side effects such as epigastric
      discomfort, diarrhea, reversible neutropenia, and allergic-type cutaneous
      reactions may occur.

PMID- 1749297
TI  - Management of echinococcal cysts of the liver.

PMID- 1749298
TI  - Trends in cancer incidence, survival and mortality in northern Sweden 1960-1986.
AB  - The impact of cancer on a population may be measured in several ways. Incidence,
      relative survival and mortality are frequently utilized for this purpose.
      Incidence and relative survival are, however, often influenced by changes in the
      diagnostics of incident cancer, particularly by an altered rate of detection of
      non-fatal cancer. Mortality, as traditionally studied, is often influenced by
      changes of death causes diagnostics or of coding routines. In an attempt to
      overcome some of these difficulties, the concept of excess mortality was
      suggested, which is independent of death cause diagnoses or coding routines, as
      well as of the rate of detection of non-fatal cancer. In order to elucidate time
      trends in the overall effects of cancer we analysed incidence, survival and
      mortality from all cancer in the northern region of Sweden 1960-1986. An
      increasing age-adjusted cancer incidence was paralleled by an improvement in
      relative survival, whereas age-adjusted cancer mortality was mainly unchanged, at
      least when studied as excess mortality. We interpreted these findings as due
      mainly to an increased detection of non-fatal cancer, and to an unchanged
      occurrence rate of fatal cancer.

PMID- 1749299
TI  - Hemopoietic stem-cell differentiation in fetal liver, spleen and thymus of rhesus
      monkeys.

PMID- 1749300
TI  - Resistance of single tumor cells and their intracellular compartments to lipid
      peroxidation.
AB  - An attempt was made to analyze heterogeneity of tumor populations with respect to
      potential stability of single cells and their intracellular compartments (lipid
      containing refractory granules, RG, and cytoplasmic sites) to lipid peroxidation
      (LP). LP was initiated by a combined action of hypoxia and u.v.-light and
      measured by the level of fluorescent product of lipid peroxidation (FPLP) well
      distinguished from other fluorescent components of the cell. Irrespective of the
      cell growth stage, RG were found to make a major contribution to the total
      intensity of FPLP of the cell. However, this contribution was minimal (20 to 30%)
      in exponentially growing ascites tumor cells and maximal (70 to 90%) in the
      stationary growing ones. It is noteworthy that in both cases the heterogeneous
      tumor population has cells with a high stability to inhibitory and cytokilling
      action of LP. We believe that the approach suggested in this work is of potential
      importance for experimental and clinical practice since it is highly sensitive
      for detecting FPLP in single cells, which allows one to reveal various
      subcellular tumor populations and estimate their stability to LP.

PMID- 1749301
TI  - Interphase cell death as related to the cell cycle of melphalan-treated human
      myeloma cells.
AB  - The effect of melphalan on cell loss, cell growth and cell-cycle traverse was
      studied on the human myeloma cell line RPMI 8226. Melphalan treatment resulted in
      arrest of cells in late S- and G2-phases in a population of unsynchronized cells.
      At high concentrations of melphalan (e.g. 40 microM), cell loss was noticed
      during the first cell cycle after melphalan treatment in addition to the
      aforementioned arrest of cells in late S and G2. The cell loss after melphalan
      treatment was further analysed in cells enriched for G1-phase. Cell death in this
      population of cells occurred between 24 and 48 hr after treatment as the cells
      were in S and moving over to G2.

PMID- 1749303
TI  - 5-Fluorouracil (FU) and mitomycin C (MMC) in the management of colorectal
      carcinoma. Part II. In vitro activity of the two drugs in short-term tumor
      cultures.
AB  - Eighty-seven colorectal adenocarcinomas from untreated patients were investigated
      by short term tumor cultures to test in vitro sensitivity to 5-fluorouracil and
      mitomycin C. This study reports the preliminary results of a multistep program
      aimed at the prospective clinical application of the assay. At present this in
      vitro experience was performed in parallel with a clinical trial carried out with
      the same drugs. The in vitro activity of the two anticancer agents is in
      agreement with the response rate reported in monochemotherapy; our data would
      suggest an increase of responses using the combination of fluorouracil and
      mitomycin in comparison to single drug therapy. A low cosensitivity rate and a
      high number of cases sensitive to one drug but resistant to the other, account
      for the use of this test as screening of active drugs in the individual patient.

PMID- 1749302
TI  - 5-Fluorouracil (FU) with folinic acid (FA) and mitomycin C (MMC) in the adjuvant
      treatment of colorectal carcinoma. Part I. Evaluation of toxicity.
AB  - Ninety-six patients with colorectal cancer (stage B2-C) were randomized to the
      control arm or to receive adjuvant chemotherapy with folinic acid, FU and MMC.
      Ninety-three patients are evaluable. The median follow up is 12 months. The
      average time between surgery and the start of therapy is 28 days. Toxicity is
      evaluable in 36 of 41 treated patients. Four patients (10%) failed to complete
      the projected treatment due to toxicity. Toxicity observed in 208 courses of
      therapy was mostly gastrointestinal and hematological. No cases of treatment
      related death or cancer-associated hemolytic uremic syndrome (C-HUS) were
      reported. The average relative dose intensity (rDI) of the projected treatment
      was 82.6%. Our study is ongoing and further patients are required to achieve
      statistically significant results.

PMID- 1749304
TI  - Interaction between cytostatics and nutrients.
AB  - Cancer patients have the highest prevalence of malnutrition of any group of
      hospitalized patients. The presence of the tumor alone may lead to reduced intake
      of different nutrients and treatment modalities such as surgery, chemotherapy and
      radiation therapy may further exacerbate nutritional disturbances. Dietary
      manipulation in experimental systems has shown improvement of tumor response to
      cancer therapy. Drug pharmacokinetics has been shown to be altered by changes in
      nutritional delivery. This article reviews the present knowledge, from
      experimental and clinical standpoints, of the potential role of different
      nutritional factors on the specific cancer treatment. It is obvious that
      alteration of at least some dietary factors affect the outcome of different forms
      of cancer treatment. Indeed, although interest in the clinical significance of
      optimal dietary intake and supplementation during cancer therapy so far remain
      marginal, accumulating data indicate that this area deserves further research
      attention.

PMID- 1749306
TI  - Cranial irradiation and cerebrospinal fluid levels of 6-mercaptopurine in
      children with acute leukemia.
AB  - We measured 6-mercaptopurine levels in the cerebrospinal fluid and plasma of 15
      children undergoing treatment for acute leukemia. Plasma and cerebrospinal fluid
      samples obtained by lumbar puncture were collected before, during, and after
      cranial irradiation in order to evaluate a possible change in blood-brain barrier
      permeability to orally administered 6-mercaptopurine. Considerable interpatient
      variability has been observed in both plasma and cerebrospinal fluid 6
      mercaptopurine levels. No statistical differences in the 6-mercaptopurine
      cerebrospinal fluid levels under the three different conditions could be
      detected. Our data suggest that cranial irradiation does not significantly
      influence the cerebrospinal fluid levels.

PMID- 1749305
TI  - Inflammation amplifies the antitumor cytostasis by human peritoneal macrophages.
AB  - The effect of an inflammatory environment on the antitumor cytostatic ability of
      human macrophages was examined. Peritoneal macrophages of patients on continuous
      ambulatory peritoneal dialysis (CAPD) were collected, when CAPD was without
      complication, during an intercurrent infectious inflammation and after recovery.
      Inhibition of 3H-thymidine uptake served as a measure of cytostasis by
      macrophages co-cultured with target murine cells MOPC-315 plasmacytoma, WEHI-3B
      myelomonocytic leukemia and L929 transformed fibroblasts. Macrophages from
      inflammatory peritoneum expressed a markedly enhanced cytostasis, irrespective of
      the nature of the tumor cell. Endotoxin (LPS) challenge of inflammatory
      macrophages failed to further reinforce the cytostasis towards MOPC-315
      plasmacytoma, but reinforced the cytostasis towards WEHI-3B leukemia (sensitive
      to inhibition by IL-1) and towards L929 (sensitive to TNF alpha). Cytostasis by
      supernatants of human peritoneal macrophages against L929 was markedly inhibited
      by anti-rHuTNF alpha and against WEHI-3B by anti-rHuIL-1 beta. The results
      suggest a link between inflammatory function and antitumor cytostasis by
      macrophages. This link is constituted by mediators involved in the activation
      process of macrophages.

PMID- 1749307
TI  - Methotrexate, vinblastine, epidoxorubicin and cisplatin (M-VEC) in patients with
      locally advanced transitional bladder cancer.
AB  - M-VEC (methotrexate, vinblastine, epidoxorubicin and cisplatin), a new combined
      drug regimen in which epidoxorubicin has been substituted to adriamycin to reduce
      the toxicity of the original M-VAC chemotherapy, has been tested in 23 patients
      with locally advanced transitional cell bladder cancer (TCBC) (stage T2-T4 No
      Mo). After two to four courses, an objective response was observed in 19
      patients, with 13 clinical complete responses. Seven patients underwent
      cystectomy after chemotherapy: one patient had no residual tumor on bladder
      specimens, five patients had a surgical eradication of the disease, while one
      patient had only a partial resection. Eight relapses of bladder carcinoma were
      observed, three among the surgically treated patients and five among patients who
      did not undergo cystectomy, with a median time-to-relapse of 9.7 months.
      Progression-free survival at 24 months was 52.3%. M-VEC regimen appears to be
      effective in locally advanced TCBC, with acceptable toxicity.

PMID- 1749308
TI  - Temporal dynamics of pituitary prolactin depletion and release in three strains
      of rats.
AB  - Previous reports have shown that pituitary prolactin is rapidly transformed to a
      less soluble, but much more releasable, form prior to release from the
      lactotroph. One manifestation of this transformation is that pituitary prolactin
      depletion is significantly greater than concurrent release both in vivo and in
      vitro. The objective of this study was to compare the magnitude and temporal
      dynamics of depletion and release from pituitaries of ovariectomized estrogen
      treated rats of three different strains in vitro to assess the effect of strain
      on the transformation process. Mature ovariectomized Wistar-Furth (WF), Sprague
      Dawley (SD) and Long-Evans (LE) rats (7-10/group) were killed by decapitation 7
      days after a single s.c. injection of 100 micrograms of polyestradiol phosphate.
      The anterior pituitaries were quickly removed and cut into quarters which were
      incubated for up to 4 hrs in the absence of dopamine or other prolactin
      secretagogues. Representative fragments from each strain were not incubated but
      were snap frozen to measure pre-incubation content. Fragments from each strain
      were removed from incubation at 30, 60, 120, 180 and 240 min for prolactin
      content measurement. Medium was collected at 30 min intervals and replaced with
      fresh medium. The experiments were repeated twice. Prolactin in medium and
      pituitary homogenates was measured by radioimmunoassays using NIAMDD-RP-1 as
      standard. In all three stains release of prolactin was approximately 30-50% of
      the prolactin depleted from the pituitary in 4 hrs. Strains varied in the
      magnitude of this difference and the time course over which it occurred. WF and
      SD rats showed significantly greater depletion and release of prolactin than did
      LE rats when the data were expressed as micrograms prolactin/mg pituitary. When
      the data were expressed as a percentage of prolactin available for release, the
      differences in depletion between strains disappeared and the LE rats released a
      significantly greater percentage of the prolactin available for release than did
      the other two strains. We conclude that pituitary prolactin undergoes a process
      of transformation prior to release which causes it to disappear from the
      pituitary but not appear in culture medium. We further conclude that the
      magnitude and temporal dynamics of this process are not equivalent across all
      strains of rats.

PMID- 1749309
TI  - Acute sodium-dependent changes in membrane dynamic properties.
AB  - Na+ ions, which can play a pathogenic role in the development of high blood
      pressure, have been reported to regulate membrane enzymatic activities, receptor
      ligand interaction and coupling of G-protein receptors to their effectors. This
      study was designed to investigate the in vitro effects of Na+ ions on membrane
      dynamic properties. The fluorescence anisotropy values of TMA-DPH (trimethylamino
      diphenylhexatriene, probe selectively incorporated into the outer leaflet of the
      plasma membrane) was evaluated in platelets and erythrocytes of sodium-dependent
      hypertension-prone and -resistant rats of the Sabra Strain. Whereas no difference
      was observed between the 2 strains, TMA-DPH anisotropy was found to be strongly
      influenced in platelets by external Na+ ions. In the absence of external Na+, TMA
      DPH anisotropy increased in human and rat platelets. In contrast, Na+ ions did
      not affect the anisotropy when the probe was inserted into erythrocyte ghosts.
      This indicates that Na+ ions can acutely regulate order parameter and
      microviscosity of platelet plasma membrane in the regions explored by the probe.

PMID- 1749310
TI  - Cytoskeleton-dependent release of human platelet epidermal growth factor.
AB  - To study the source of immunoreactive epidermal growth factor (ir-EGF) released
      by thrombin formation we removed 99.9% of the leukocytes normally present in
      platelet-rich plasma and induced coagulation with 30 mM of Ca2+. The absence of
      leukocytes did not reduce the amount of ir-EGF released; thus platelets are most
      likely the only source of the ir-EGF released during aggregation. To identify the
      site of ir-EGF in platelets we exposed washed platelets to collagen or thrombin
      and compared the kinetics of releases of ir-EGF, beta-thromboglobulin (bTG, an
      alfa-granule marker), ATP (dense granule marker), N-acetyl-beta-D-glucosaminidase
      (NAGA, a lysosome marker) and lactate dehydrogenase (LDH, a cytoplasmic marker).
      Release of ir-EGF started immediately and continued linearly. The process
      differed clearly from the releases of the granule markers, which occurred
      readily, and were completed in a few minutes. The release of ir-EGF also differed
      from the leakage of LDH, the start of which was delayed greater than 5 min, but
      then proceeded linearly. Cytochalasin B inhibited the release of hEGF, but
      demecolcine had no effect. We conclude that the ir-EGF released from platelets
      during aggregation derives neither from the granules nor the cytoplasma. The
      assembly of cytoskeleton is needed for its release.

PMID- 1749311
TI  - Toxicity of "DiI" for embryonic rat motoneurons and sensory neurons in vitro.
AB  - The carbocyanine dye DiIC18(3) ("DiI") is commonly used for both anterograde and
      retrograde labeling of neurons, including live neurons in situ and in vitro. In
      the present experiments, DiIC18(3) was used to label motoneurons in the spinal
      cords and sensory neurons in the dorsal root ganglia of embryonic rats. When the
      neurons from these regions were placed in culture, the neurons labeled by the dye
      were found to die rapidly, suggesting that DiIC18(3) can be toxic to neurons of
      these types. A related dye, DiIC12(3), was found to be equally suitable for
      labeling these neurons, and was found not to have detectable toxic effects in
      vitro.

PMID- 1749312
TI  - The mechanism of low susceptibility to stress in gastric lesions of spontaneously
      hypertensive rats.
AB  - The mechanism of low susceptibility to stress in gastric lesion formation in
      spontaneously hypertensive rats (SHR) was investigated focusing on the
      sympathetic and parasympathetic nervous systems. In the gastric tissues of SHR,
      norepinephrine (NE) and dopamine (DA) contents were higher, while acetylcholine
      content and choline acetyltransferase activity were lower than those of Wistar
      Kyoto rats (WKY). Water-immersion restraint induced gastric lesions frequently in
      WKY (ulcer indices : 52 +/- 7mm2) but less frequently in SHR (ulcer indices : 3
      +/- 1mm2). Although NE content decreased in both SHR and WKY as a result of water
      immersion restraint, it remained higher in SHR than in WKY. ACh content decreased
      by the procedure in WKY but not in SHR. DA content was increased by the procedure
      in all gastric regions of SHR. The gastric lesions induced in SHR were aggravated
      by pretreatment with 6-hydroxydopamine, an agent for chemical sympathectomy,
      following decreases of NE and DA contents. These results indicate that the
      relative sympathetic hyperfunction, parasympathetic hypofunction and dopaminergic
      mechanism in the stomach contribute to the prevention of gastric lesion formation
      in SHR.

PMID- 1749313
TI  - Inhibition of proliferation of fibroblasts by lazaroids (21-aminosteroids).
AB  - Lazaroids (21-aminosteroids) are a novel group of compounds that inhibit lipid
      peroxidation in biological systems and protect cells from oxidative damage during
      tissue injury. In vivo efficacy of lazaroids has been demonstrated in a variety
      of animal models of traumatic or ischemic injury of central nervous system (1-6).
      However, very little is known about the affects of lazaroids on cellular
      responses associated with tissue repair and remodeling eg cell proliferation and
      synthesis of extracellular matrix. In the present study, we show that lazaroids
      and certain related compounds inhibit cell proliferation in vitro. Light
      microscopic examination and determination of release of intracellular enzyme,
      lactate dehydrogenase suggested that cell growth inhibition by lazaroids was not
      due to cell death resulting from cytotoxic effects. Examination of several
      lazaroid related antioxidants and other known antioxidants eg vitamin E and
      Probucol showed that compounds with similar antioxidant potential did not exhibit
      identical antiproliferative activity, suggesting that cell growth inhibition by
      lazaroids may be unrelated to their antioxidant action. These results may have
      implication in the therapeutic actions of lazaroids.

PMID- 1749314
TI  - Forging connections: the consumer connection.

PMID- 1749316
TI  - Restructured workplace could result in chaos.

PMID- 1749315
TI  - Parental assistance important in pain control for children.

PMID- 1749317
TI  - Sorting the complexities of respiratory distress syndrome.

PMID- 1749318
TI  - Giving infants and children drugs: precision + caution = safety.

PMID- 1749319
TI  - A crossword quiz: labor and delivery medications.

PMID- 1749320
TI  - Standards for testing and test users.

PMID- 1749321
TI  - "Rust v. Sullivan".

PMID- 1749322
TI  - Needle recapping: do we practice what we preach?

PMID- 1749323
TI  - Investigating "greedy.".

PMID- 1749324
TI  - [The capillary blood flow in the lungs of patients with chronic laryngeal and
      tracheal stenosis].
AB  - Altogether 19 patients with chronic laryngo- and tracheostenosis of different
      etiology were investigated. All the patients were broken into 3 groups (1--less
      than 1 year, 2-1-3 years, 3--over 3 years) with regard to the time of canulla
      bearing. The patients were examined with 99mTc-human serum albumin particles.
      Major disorders in the capillary blood supply of both lungs were detected. These
      changes were focal-diffuse. Abnormalities were mainly observed in the apical area
      of both lungs and in the mediastinal zone. Redistribution of the pulmonary blood
      supply in the direction of the upper parts of the lungs was revealed. Lung
      abnormalities increased depending on the time of canulla bearing.

PMID- 1749325
TI  - [The ultrasonic diagnosis of changes in the hepatobiliary system in the practice
      of mass medical examinations].
AB  - Investigation of 1258 servicemen during the first year of their service using
      ultrasound scanning of the hepatobiliary system has shown signs of chronic
      cholecystitis in 170, chronic hepatitis in 70, pyelonephritis and renal calculi
      in 120; 25 servicemen were recommended for further medical examination. It has
      been concluded that ultrasound scanning must become part of obligatory
      investigations of conscripts.

PMID- 1749326
TI  - [A case of the ultrasonic detection of familial autoimmune thyroiditis].
AB  - During mass screening of 22,053 persons a case of familial autoimmune thyroiditis
      was detected by ultrasound investigation. Diagnosis was based on characteristic
      ultrasound signs of thyroiditis and was reaffirmed by cytological and
      immunological methods of investigation.

PMID- 1749327
TI  - [The radiation therapy of bladder cancer in a regimen of nontraditional
      fractionation with local radiomodification by metronidazole].
AB  - The authors presented short-term and immediate results of radiation therapy of
      bladder cancer by a conventional method and optimized program, combining
      accelerated hyperfractionation and local radiomodification with metronidazole. A
      variant, proposed by the authors, included the use of a single focal dose of 1.4
      Gy twice a day with a 4-hour interruption up to a total dose of 39.2 Gy. It was
      followed by a dose of 6 Gy once a week with preliminary administration of 2 g of
      metronidazole in 30-40 ml of 50 per cent dimexide solution in the bladder. A
      total of 2 large fractions of irradiation combined with metronidazole were used.
      This method was used for the treatment of 89 cancer patients. Better local
      control and survival in anemic patients with poorly differentiated cancer were
      observed.

PMID- 1749328
TI  - [The surgical treatment of radiation damage to the rectum].
AB  - Radiation therapy of cervical cancer causes late radiation lesions of the rectum
      in a majority of patients. Surgery is a method of choice of the treatment of
      postradiation corrosive strictures and fistulas. Modern diagnosis of
      complications permits adequate surgical rehabilitation.

PMID- 1749330
TI  - [The structure of radiation therapy and of the guarantee of its quality].

PMID- 1749329
TI  - [Physicotechnical and dosimetric support of human whole-body irradiation in a
      standard medical source of photon radiation].
AB  - The paper is concerned with physicotechnical and dosimetric support of technology
      of therapeutic whole-body irradiation on a serial gamma apparatus ROKUS, with
      which a majority of radiological institutions in the USSR are fit out. Technology
      consists of the following procedures: patient positioning with relation to a
      source with a horizontal axis of radiation. Correction of dose distribution by
      means of a three-element compensator taking into account patient's constitutional
      peculiarities and preradiation preparation data; double irradiation in the
      bilateral regimen in the supine position.

PMID- 1749331
TI  - [Postmanipulation hemostasis in angiography from different approaches].
AB  - The paper is concerned with some data on the quality of hemostasis after various
      types of angiography in 629 patients: manual hemostasis in transfemoral
      catheterization was used in 130 patients, mechanical fixing rubber pellets were
      used in 108 patients. Postmanipulation tamponade in the area of catheterization
      was used in 163 of 321 patients after catheterization translumbar angiography. In
      mechanical hemostasis, hematomas were found in 1.8%, in manual hemostasis--in
      4.6%; CT and USI findings showed no hematomas after catheterizations translumbar
      angiography, in PTLA hematomas over 200 ml were found in 3.7%.

PMID- 1749332
TI  - [The characteristics of managing cancer patients during gamma teletherapy].
AB  - Gamma-beam therapy of cancer patients is accompanied by general and local
      radiation reactions, their degree depending on numerous factors (a tumor site, an
      area of irradiated tissues and a value of a total absorbed dose). Preventive and
      therapeutic measures during radiotherapy allow the reduction of severity of a
      course of general and local radiation reactions.

PMID- 1749333
TI  - [The chronicle of Russian roentgenology: the first pages (1896)].

PMID- 1749334
TI  - [The ultrasonic study of the liver, its large vessels and the spleen in chronic
      diffuse liver diseases].
AB  - The paper is concerned with some methodological aspects of ultrasound
      investigation of the liver, portal veins and the spleen, the importance of this
      investigation for the detection, differential diagnosis and follow-up of patients
      with various chronic liver diseases.

PMID- 1749335
TI  - [The current achievements in radiopharmaceutical dosimetry].

PMID- 1749336
TI  - Enemy radar, theoretical physics, and computer-assisted diagnosis.

PMID- 1749337
TI  - Analysis of complex data, image reconstruction, and Joshua Willard Gibbs.

PMID- 1749338
TI  - The HELP system: a review of clinical applications in infectious diseases and
      antibiotic use.
AB  - The HELP hospital information system, now under development for more than 20
      years, has become an essential part of the daily operation of LDS Hospital, a 500
      bed tertiary-care facility in Salt Lake City, Utah. The overall goal of the
      system is to provide decision-making capabilities for medical personnel and thus
      improve patient care. Since 1983, clinical applications have been available to
      improve the use of antibiotics and increase infection control. This article
      describes these applications and the essential features of the HELP system.

PMID- 1749339
TI  - A computer-based outpatient medical record for a teaching hospital.
AB  - We developed a computer-based outpatient medical record system to facilitate
      direct physician interaction with the clinical computing system at the Beth
      Israel Hospital in Boston. During the 2 years since the medical record system was
      installed, 20 staff physicians, 5 fellows, 64 residents, and 11 nurse
      practitioners have entered 15,121 active problems and 1996 inactive problems for
      3524 patients, as well as 12,651 active medications and 1894 discontinued
      medications for 3430 patients. Another 20,321 items were entered on health
      promotion and disease-prevention screening sheets, and with the help of automatic
      updating by the computer, an additional 21,897 entries on screening sheets were
      made for 8686 patients. Clinicians wrote 10.9 +/- 12.8 (mean +/- SD) words per
      problem when they were working at the computer, as compared with 4.3 +/- 2.5
      words per problem when they were writing in the paper medical record. We conclude
      that physicians will readily enter data directly into a computing system when
      they are given appropriate tools, and that they consider the computer-based
      problem list to be a valuable improvement over its paper counterpart. Use of a
      computer-based medical record system has obvious benefits for data management and
      patient care.

PMID- 1749340
TI  - Reasoning foundations of medical diagnosis.

PMID- 1749342
TI  - Getting to know your operating system.

PMID- 1749341
TI  - Obligations of the expert system builder: meeting the needs of the user.
AB  - Builders of expert systems have generally accepted the principle that computer
      software should not be subject to government regulation if health care
      practitioners can be expected to interpret and apply the systems intelligently.
      The purpose of this paper is to identify the information that builders must make
      available to permit health care practitioners to exercise their clinical judgment
      in interpreting and applying the output of computing systems.

PMID- 1749343
TI  - Medical hardware and software. Buyers guide.

PMID- 1749344
TI  - How to produce instructional text for a medical audience.
AB  - Instructional text continues to play a major role in medical education.
      Production of this type of learning resource requires an understanding of the
      objectives of the learner and the characteristics of text which facilitate
      student learning. Success in producing effective readable text requires attention
      to the content as well as to the way it is presented. This review outlines the
      factors which have a major impact on those two elements.

PMID- 1749345
TI  - Can medical education be researched?
AB  - Many medical educators are tempted or encouraged to conduct research into
      teaching techniques, methods of evaluation, and curricular change. These
      educators are generally career physicians who become distressed by their
      inability to apply the social science model of research to their project with
      impunity. This paper addresses the issues involved in conducting educational
      research and provides some suggestions for methodology that can be used.

PMID- 1749347
TI  - Teaching medical decision making and students' clinical problem solving skills.
AB  - Medical students need to be taught explicitly about decision making to be
      prepared for the changing health care environment. Medical decision making
      curricula have received favourable responses from students and have influenced
      some aspects of student performance. Questions remain about the impact of the
      teaching on students' general problem solving skills. A 15 hour course covering
      decision making topics was presented during a preclinical elective preceptorship
      for 5 years. Problem solving ratings made by clinical supervisors for the third
      year psychiatry and internal medicine clerkships were not better for the students
      who had the instruction and clinical experience than for the students in the
      comparison group. The results suggest that this approach to teaching decision
      making requires further development and testing.

PMID- 1749346
TI  - Alternative medical school curriculum design: the independent study program.
AB  - The University of Wisconsin Medical School established an alternative Independent
      Study Program (ISP) in the basic medical sciences in 1972. This program enabled
      class size to be increased without increasing laboratory teaching space, provided
      better education for students with diverse educational backgrounds, permitted
      individual progress, and promoted independent study. When compared to the most
      receptive oriented regular curriculum students (RCR) and those most discovery
      oriented (RCD), the preferred learning style of self-selected ISP students was
      more discovery or self-directed. They retained that style after graduation, while
      RCD students frequently became less discovery oriented. The ISP group was older,
      had more females, and had more advanced degrees. Although they had lower
      undergraduate grade point averages, they did well on the Verbal, General
      Information, Problem-Solving, and Quantitative sections of the MCAT. They also
      did well scholastically in Medical School, scored well on the National Boards
      Medical Examination, had the same distribution of residencies, and obtained the
      same quality of residency placement for medicine, surgery, and pediatrics. They
      have been very supportive of the program and feel that it was valuable in
      developing their abilities for continued self education.

PMID- 1749348
TI  - The way we train the clinical eye through slides.
AB  - Inspection is an important clinical skill. It is remarkable that in basic medical
      education this skill is not specially trained. To remedy this, we have developed
      a method of instruction at Groningen University Hospital to train inspection. We
      give an outline of the method and provide examples of dialogue.

PMID- 1749349
TI  - When babies die: death and the education of obstetrical residents.
AB  - This paper, based on 4 years in a Department of Obstetrics and Gynecology in
      which the author was both a resident physician and anthropologist participant
      observer, explores how obstetrical residents are taught to deal with the birth of
      anomalous and/or dead or dying babies. Not only is formal training lacking in
      this area, but residents may be strongly sanctioned for any emotional response in
      such situations. This paper argues that unless, and until, residents are taught
      to recognize and deal with, rather than repress, their responses, these
      physicians-in-training will not be equipped to help grieving parents deal with
      these situations.

PMID- 1749350
TI  - Medical education and the GCSE generation--a transferable activity-skills
      programme in medical sociology.
AB  - The first major intake of medical students who studied the new GCSE occurred in
      Autumn 1990. These students have experienced a range of student-centred
      educational approaches to learning, but medical education in the UK remains
      committed to teacher-centred approaches. This mismatch of expectations is
      discussed. An innovative course in medical sociology at the University of
      Sheffield is reported, which illustrates student-centred learning approaches
      including transferable activity-skills development and self-assessment profiling.
      An innovative approach to course evaluation is discussed.

PMID- 1749351
TI  - [The dual condemnation of Gramsci. A tentative biographical interpretation].
AB  - This study proposes a "biographical" approach using a particular heuristic
      method. The structure of an important and significant letter written by Gramsci
      while in prison is analysed in this light. This interpretation leads us to the
      conclusion that, at the time of writing, Gramsci was in full possession of all
      his mental faculties, although worried by his long imprisonment and smitten by a
      profound disillusion as a result of the deformation of the "socialist" system.
      The victim of a "dual seclusion", he was not only able to make an exhaustive
      analysis of the situation, but in a certain sense he also succeeded in predicting
      the tragic events which were taking shape on the historical-political horizon of
      the world to which he belonged.

PMID- 1749352
TI  - [Clinical investigation on depression on a randomized and stratified sample in an
      elderly population].
AB  - The prevalence of depression in the elderly was investigated in a random
      stratified sample of 100 subjects from the general population of Appignano
      (Macerata, Regione Marche, Italy). After sampling with the simple random method,
      each subject underwent a diagnostic work-up including: a) three psychodiagnostic
      tests (Short Scale for the Assessment of Mental Health--SSAMH, Geriatric
      Depression Scale--GDS, and Scale for the Self-evaluation of Depression from the
      Psychogeriatric Interview--PGI) and b) psychiatric evaluation (according to DSM
      III-R diagnostic criteria). Results were as follows: a) all the 3 tests (SSAMH,
      GDS, PGI) were suitable for the goals of this research, with a sensibility of
      95.4%, 90.9%, and 95.4%, and a specificity of 90.4%, 88.9%, and 90.5%,
      respectively; b) the prevalence of depression in the sample was 25.9% (26.1% in
      females and 25.6% in males); c) the most common disorder was dysthymia, with
      higher percentage in females than in males (75% and 50% of all the depressive
      syndromes, respectively); d) the prevalence of depression was higher in females
      60-69 years old and in males 70-79 years old.

PMID- 1749353
TI  - [Psychopathological heterogeneity in opium drug addicts].
AB  - The aim of the study was to assess the presence and nature of psychiatric
      disorders in opium drug addicts. One hundred and six subjects receiving treatment
      at the CMAS in Cagliari were included in the study. Hathawai and McKinley's MMPI
      test was preventively carried out on all subjects; each drug addict was then
      interviewed three times in the space of three weeks in order to formulate a
      diagnosis in line with DSM III R criteria. The results obtained show a high
      incidence of psychopathological disorders which are not included among those
      caused by drug abuse, and a high degree of diagnostic heterogeneity on both axis
      I and axis II. The comparative assessment of three subsamples undergoing
      different phases of treatment reveals both qualitative and quantitative
      differences.

PMID- 1749354
TI  - [Custodianship or abandonment in psychiatry? The neo-contractual hypothesis].
AB  - In this report role, possibilities and limits of psychiatry have been taken into
      account. Starting from a historical analysis, the Authors advance some
      hypotheses. Psychiatry could possible play a mediation role between sociology and
      biology, providing every patients with a specific therapy.

PMID- 1749355
TI  - [Dynamic psychopathology for a unified approach to psychogenic eating disorders].
AB  - The paper focuses on psychopathological problems relating to psychogenic dietary
      disorders. Using a psychodynamic approach, the Authors hypothesise the existence
      of a structural "continuum" which links these diseases to the contexts of either
      exaggerated food consumption or reduced or insufficient food intake. The
      discussion in centered on the dynamic-genetic aspect, also taking into account
      intermediate psychopathological morphologies, which underlies this branch of
      clinical psychiatry. The failure to overcome "infantile dependence" is identified
      as the most important genetic factor. The type and efficacy of strategy used to
      neutralise the persistent anxiety caused by this unresolved
      "separation/identification" of the Ego shape the individual symptomatology of
      each dietary disorder described in the study.

PMID- 1749356
TI  - [Time in depression].
AB  - Subjective estimation of time varies according to age, to physical state and to
      the activity we are occupied with. The relationship between time and major
      depression can be considered from two different point of view. From a clinical
      psychological point of view normal subjects with major depression estimate time
      intervals differently. Future, past and present change their meaning in major
      depression. These alterations cause important consequences in the cognitive
      structure of subjects with major depression and therefore influence depressive
      symptoms. On the other hand also the "biological time" is altered in major
      depression. Subjects with major depression suffer from many chronobiological
      alterations. The relationship between these two aspects are considered in the
      present report.

PMID- 1749357
TI  - [Acting out and schizoid personality].
AB  - The Authors examine the crime-symptoms, sole index of an asymptomatic clinic
      history, and make some remarks on the indexes of social dangerousness. By this
      point of view, the structural traits of pre and post-critic personality seem to
      be a first predictory index. In relation to this question the Authors make
      mention to schizoidia.

PMID- 1749358
TI  - [Graphology in intuition, science and conscience. Cognitive possibility and
      ethical behavior of the graphologist].

PMID- 1749359
TI  - Mental health and the community.

PMID- 1749360
TI  - Libel and medicine.

PMID- 1749361
TI  - The medical and legal trauma of disasters.

PMID- 1749362
TI  - Medical negligence: disclosure of risk and causation (Singapore).

PMID- 1749363
TI  - Drugs for sexually transmitted diseases.

PMID- 1749364
TI  - Rapid metabolic failure in spontaneously hypertensive rats after middle cerebral
      artery ligation.
AB  - The metabolic characteristics of the penumbral region were examined in
      spontaneously hypertensive rats one hour after permanent middle cerebral artery
      occlusion. The effect of hyperglycemia on this region was examined by providing a
      glucose load prior to occlusion. The depressed concentrations of adenosine
      triphosphate and elevated levels of lactate in the penumbral region were similar
      to those found in the ischemic focus. The purported neuroprotective effect of
      hyperglycemia in the penumbral region was not reflected in an increased high
      energy phosphate level in the penumbral region. The rapid deterioration of the
      metabolic status of this region in this strain of rat suggests that the increased
      consistency of infarction may come at the expense of the penumbral region, and
      thus this model may not be well suited for the study of metabolic changes and
      perhaps even therapeutic intervention.

PMID- 1749365
TI  - Cerebrospinal fluid amino acids in relation to neurological status in
      experimental portal-systemic encephalopathy.
AB  - Using an indwelling cisterna magna catheter technique, serial CSF samples were
      analyzed for amino acid content in rats at various stages of portal-systemic
      encephalopathy resulting from ammonium acetate administration following
      portacaval anastomosis. Anastomosis alone resulted in increased CSF
      concentrations of glutamine, tyrosine, phenylalanine, glutamate and alanine. GABA
      levels, on the other hand were not significantly changed. Onset of severe
      neurological symptoms following ammonium acetate administration resulted in
      selectively increased CSF alanine. Other amino acids were not further increased
      at severe stages of encephalopathy. Increased CSF alanine probably results from
      increased glutamine transamination in the brains of portacaval shunted rats.

PMID- 1749366
TI  - Transient changes in energy metabolites and intracellular pH during spreading
      depression in the chick retina.
AB  - The in vitro preparation of the chick retina can be used to show the occurrence
      of transient changes in the intracellular pH and of energy metabolites which
      occurs during spreading depression (SD). There is an initial increase in
      intracellular pH associated with elevated values for ADP, P-Creatine, lactate and
      pyruvate, an intermediary acid shift with increases in ATP values and decreases
      in ADP, and a late alkaline rebound where P-Creatine levels are reduced and the
      content of ADP and lactate are elevated. These transient changes in intracellular
      pH observed during SD, when correlated to the levels of energy metabolites,
      supports the hypothesis that the intracellular pH can be used by the tissue as a
      mechanism to rapidly modify the metabolic activities of neurons and glial cells.
      We suggest that the first alkaline shift is caused by glial cells and the
      intermediary acid shift by neurons. However, a specific cell could not be pointed
      out as responsible for the late alkaline shift but it could explain the
      refractoriness of the neurons during the phenomenon.

PMID- 1749367
TI  - Energy metabolism in rat hippocampus during and following seizure activity.
AB  - The hippocampus exhibits a post-ictal phenomenon in which it is unresponsive to
      further stimulation. It has been suggested that this loss of excitability is the
      basis of post-seizure amnesia. The biochemical events associated with this
      phenomenon are unclear. In the present study, energy metabolites were measured in
      the stratum oriens, stratum pyramidale and stratum radiatum in rat hippocampus,
      and correlated with field potential recordings. Wistar rats were anesthetized and
      the calvarium removed. Following removal of the cortex by aspiration, the
      hippocampus was covered with oil, and stimulating and recording electrodes were
      placed. Stimulation consisted of a train of stimuli at 100 Hz (10-20 m Amps).
      This stimulation was found to be effective in evoking self-sustaining after
      discharges and post-ictal depression. Tissues for metabolite analysis were taken
      from a series of controls, from animals during active self-sustaining seizures,
      and from animals which were totally unresponsive to further electrical
      stimulation. Hippocampal tissue for metabolite analysis was obtained by pouring
      liquid N2 on the exposed tissue, then removing the frozen tissue. Glucose, ATP,
      and phosphocreatine were measured in hippocampal layers of CA1 using fluorescence
      techniques and enzymatic cycling. Results showed that during seizure activity,
      glucose, ATP, and phosphocreatine were all decreased from 40-80% in the three
      layers of the hippocampus, whereas from 60 seconds after the onset of hippocampal
      shutdown, energy metabolites had returned toward normal. Thus, at a time when the
      hippocampus was unresponsive, energy metabolites were at control levels. These
      data suggest that the shutdown phenomenon occurs in the presence of adequate
      energy stores.

PMID- 1749369
TI  - Characteristics and risk behaviors of homeless black men seeking services from
      the Community Homeless Assistance Plan--Dade County, Florida, August 1991.
AB  - The number of homeless persons in the United States has been estimated to range
      from 600,000 to 3 million (Dr. Barbara Cohen, The Urban Institute, personal
      communication, 1991), with higher concentrations of these persons in several
      large urban centers. Because of the circumstances of homelessness, neither the
      health status nor the public health needs of these persons are well defined. In
      Dade County (which includes incorporated Miami), Florida (1990 population: 1.9
      million), the average daily number of persons who are homeless is estimated to be
      6000; during a 1-year period, approximately 10,000 persons are homeless at some
      time (Dr. Andrew Cherry, Barry University, Miami, personal communication, 1991).
      This report presents findings from a survey conducted in August 1991 to assess
      the health risks of homeless persons in Dade County seeking services from the
      Community Homeless Assistance Plan (CHAP), a pilot case-management project that
      places homeless persons into housing, jobs, and appropriate social services.

PMID- 1749368
TI  - Synergistic effect of bile acid, endotoxin, and ammonia on brain edema.
AB  - The effects of cytotoxic substances such as ammonia, bile acids and endotoxin,
      all of which increase in the circulating blood during fulminant hepatic failure
      (FHF), on the blood-brain barrier (BBB) permeability and development of brain
      edema were examined in the rats. Direct intracarotid injection of various bile
      acids resulted in the staining of the cerebral hemisphere with Evans blue as well
      as the increase of brain water contents. Elevation of ammonia was also observed
      in the cerebral hemisphere where the reversible opening of the BBB was induced by
      deoxycholate under hyperammonemic conditions. To see the synergistic significance
      of cytotoxic substances (ammonia, bile acid and endotoxin) under the more
      physiological condition as FHF, they were simultaneously injected into a
      peripheral vein. Brain uptake index of 14C-inulin and brain water content
      increased, and electron micrographs showed the swollen astrocytic foot processes
      surrounded brain capillary, but not opening of tight junction, the same as an
      animal model of fulminant hepatic failure. The results suggest that ammonia, bile
      acids and endotoxin might have a possible synergistic role in the pathogenesis of
      the brain edema, mainly cytotoxic, and vasogenic due to acceleration of vesicular
      transport, in FHF.

PMID- 1749370
TI  - Tuberculosis among residents of shelters for the homeless--Ohio, 1990.
AB  - During 1990, 17 cases of clinically active pulmonary tuberculosis (TB) occurred
      among residents of homeless shelters in three Ohio cities (Cincinnati, Columbus,
      and Toledo). This report summarizes the results of investigations of these cases
      by the Ohio Department of Health.

PMID- 1749371
TI  - Deaths among homeless persons--San Francisco, 1985-1990.
AB  - In San Francisco (1990 population: 723,959), an estimated 6000-18,000 persons are
      homeless. To characterize the causes of death among homeless persons in San
      Francisco during 1985-1990, the Health Care for the Homeless Program, San
      Francisco Department of Public Health, reviewed records of homeless decedents
      from the city medical examiner's (ME's) office. This report summarizes the
      results of that study.

PMID- 1749372
TI  - Federal regulatory action against sporicidin cold sterilizing solution.

PMID- 1749373
TI  - Food and Drug Administration approval of use of diphtheria and tetanus toxoids
      and acellular pertussis vaccine.

PMID- 1749375
TI  - Analysis of the structural relationships between the DNA-binding phosphoproteins
      pp42, pp43 and pp44 by in situ peptide mapping.
AB  - A structural homology is established between three DNA-binding phosphoproteins
      located in the 42 to 44 kDa range, referred to as pp42, pp43 and pp44, from
      Chironomus tentans salivary gland cells by in situ peptide mapping. The staining
      patterns of pp42, pp43 and pp44 which resulted from digestion with Staphylococcus
      aureus V8, trypsin or papain proteases show the presence of 8 to 15 spots
      majority of which have identical mobility. In the patterns of the digests
      generated by treatments with trypsin about 10 spots appear in common between any
      pair of the protein substrates. In addition, each pattern includes two to three
      peptides of mobility not present in the other. Thus the peptide mapping of pp42,
      pp43 and pp44 based on the staining patterns of proteolytic digests suggest the
      existence of structural homology between the three unlabelled substrates. The
      proteolytic peptides carrying the rapidly turning over phosphate groups form
      markedly different electrophoretic patterns than the unlabelled peptides
      visualized by staining. Treatment of 32P-labelled pp42, pp43 and pp44 with V8
      generates only one labelled fragment in the 30 kD range. The cleavage patterns of
      pp44 produced by chymotrypsin or papain contain seven to ten labelled fragments
      while those of pp42 and pp43 contain only two. The 32P-labelled tryptic peptides
      of pp42, pp43 and pp44 exhibit a ladder pattern for each substrate which probably
      arise by a consecutive removal of 25 to 35 amino acid residues from the primary
      digestion products pp29, pp29.5 and pp30 by cleavage of four to five putative
      interdomain regions. The possibility that these three structurally related
      phosphoproteins belong to the category of transcription factors is discussed.

PMID- 1749374
TI  - The role of glycation in aging and diabetes mellitus.
AB  - One of the hypotheses trying to explain the process of aging is the idea of
      glycation of proteins. This reaction, also called the Maillard or browning
      reaction, may explain age-related symptoms such as cataract, atherosclerosis and
      modification of collagen-containing tissues. Diabetics, which possess elevated
      blood sugar levels, show signs of accelerated aging exposing similar
      complications. The Maillard reaction, which occurs on a large scale in vivo, may
      play a key role in the initiation of these symptoms.

PMID- 1749376
TI  - Plasmodium falciparum: recombinant baculoviruses direct the expression of
      circumsporozoite proteins in Spodoptera frugiperda cell cultures.
AB  - The DNA coding for the circumsporozoite protein (CPS) of Plasmodium falciparum
      has been cloned into the baculovirus expression vector pAcYM1 and expressed in
      Spodoptera frugiperda (Sf9) insect cells. Three DNA constructs have been made:
      the first one directs the synthesis of the complete CSP (aa 1-412), the second
      leads to the production of a species devoid of the anchor domain (aa 1-391) and
      the third one to a molecule lacking both signal and membrane anchor sequences (aa
      18-391). All three recombinant CPS were produced at about 3 micrograms per 10(6)
      infected cells and were characterized in terms of immunoreactivity and apparent
      molecular weight. Analytical purification of the recombinant proteins was
      achieved by a combination of heat treatment, acidification, isoelectric focusing
      and ion exchange chromatography. The purified material, when injected into mice,
      generated only modest antibody responses, although antisera from immunized mice
      reacted with control CSP antigens carrying or not the major immunodominant repeat
      region.

PMID- 1749377
TI  - DNA-protein cross-linking in L1210 cells sensitive and resistant to cis
      diamminedichloroplatinum (II).
AB  - The role of restricted cellular accumulation of cis-diamminedichloroplatinum(II)
      (cis-DDP) and altered repair of DNA-Pt-protein cross-links in the mechanism of
      L1210 murine leukemia cell resistance was examined. An immunochemical method was
      used to analyze the formation and removal of DNA-Pt-protein complexes in L1210
      cells sensitive and resistant to cis-DDP. The accumulation of Pt into the cells
      and the binding of Pt to the DNA was measured by atomic absorption spectroscopy.
      The results demonstrated that both decreased accumulation of the drug and the
      rate of DNA-Pt protein cross-link removal may be important factors in L1210 cell
      resistance to cis-DDP.

PMID- 1749378
TI  - Sequence analysis of the first intron of the bovine gamma s-crystallin gene.

PMID- 1749379
TI  - Commemorative issue for the 100th anniversary of the discovery of antibodies
      (1890-1990).

PMID- 1749380
TI  - [The mechanism of diphtheria immunity and tetanus immunity in animals. 1890].

PMID- 1749381
TI  - Discovery of antitoxins and development of antibody preparations for clinical
      uses from 1890 to 1990.

PMID- 1749382
TI  - IgG galactosylation--its biological significance and pathology.

PMID- 1749383
TI  - Structure of antibodies and their complexes with antigens.

PMID- 1749384
TI  - Dynamic aspects of antibody structure.

PMID- 1749385
TI  - Engineering monoclonal antibodies to determine the structural requirements for
      complement activation and complement mediated lysis.

PMID- 1749386
TI  - Diversification of the IgG molecule by oligosaccharides.

PMID- 1749387
TI  - The minimal antigen-binding fragment of antibodies--Fv fragment.

PMID- 1749388
TI  - Autoantibodies and autoantigens: a conserved system that may shape a primary
      immunoglobulin gene pool.
AB  - Formation of certain autoantibodies is associated with a variety of autoimmune
      diseases, but the production of small amounts of autoantibodies also occurs in
      the normal immune system. Germline-encoded IgM antibodies that are autoreactive
      and bind to diverse antigen structures with low affinity are prominent in the
      primary antibody repertoire. Many IgG disease-related autoantibodies differ in
      structure and binding properties from these normally occurring IgM
      autoantibodies. The two sets may arise independently, but some properties, such
      as shared idiotypes, link some members of the two populations. Many autoantigen
      targets of both sets of autoantibodies are structurally conserved among species,
      as are certain features of the autoantibodies themselves. These elements,
      interacting before exposure of the system to foreign antigens, may constitute a
      conserved system that contributes to shaping and maintaining a primary
      immunoglobulin gene pool.

PMID- 1749389
TI  - Ultrastructure of asteroid bodies in sporotrichosis.
AB  - Ultrathin sections were prepared from a paraffin-embedded tissue specimen which
      had been obtained from a sporotrichosis patient and in which large numbers of
      asteroid bodies had been observed. Electronmicroscopic examination of the
      ultrastructure of the asteroid bodies revealed a central fungal cell with
      peripheral rays. These cells were almost structurally identical with fungal
      elements found elsewhere than in asteroid bodies; and in the rays, electron-dense
      granular substance was arranged in layers marked by fissures and material
      resembling remnants of destroyed host cells. The outermost layer was formed of a
      granular substance of rather low electron density, surrounded by adherent cell
      membrane fragments. These findings suggest that an asteroid body might be
      composed of crystalline products of disintegrated host cells deposited around a
      fungal cell.

PMID- 1749390
TI  - A rapid Candida albicans hyphal-form growth inhibition assay: determination of
      myelomonocytic-mediated antifungal activity.
AB  - An in vitro microassay for the measurement of Candida albicans hyphal-form growth
      inhibition by myelomonocytic cells is described. The assay is rapid, easy-to
      perform and objective. A Candida strain capable of in vitro dimorphic transition
      from yeast to hyphal form has been employed. The assay is based on the
      incorporation of 3H-glucose by the fungus, the effect being dependent upon the
      time of pulse, size of the inoculum and concentration of radiolabelled
      metabolite. In particular, C. albicans hyphal form, obtained by a 3 h incubation
      in vitro in the presence of 10% fetal calf serum, is co-incubated with the
      effector cells. A pulse with 3H-glucose in water is then performed and the
      radioactivity incorporated by the residual Candida is taken as an indication of
      hyphal growth. We found that polymorphonuclear cells, peritoneal macrophages and
      the cloned GG2EE macrophage cell line significantly inhibited hyphal growth, the
      effects being time and effector-to-target cell ratio dependent.

PMID- 1749391
TI  - Penetrating gastric ulcer as a cause of mixed bacterial and fungal pericarditis.
AB  - We describe a case of pneumopyopericarditis caused by a mixture of fungal and
      bacterial pathogens. This originated from a gastric ulcer (within a hiatus
      hernia) which had eroded into the pericardial sac. Further complications included
      the late discovery of the ulcer and asplenism. Similar cases have been reported,
      but to the best of the authors' knowledge, none with an actual mixture of the two
      pathogens.

PMID- 1749392
TI  - Efficiency of crude and purified fungal antigens in serodiagnosis to discriminate
      mycotic from other respiratory diseases.
AB  - Mycotic immunodiagnosis was performed in 186 hospitalized patients with different
      respiratory diseases, mostly considered as tuberculosis and others with a
      doubtful diagnosis. Crude histoplasmin, coccidioidin, paracoccidioidin,
      blastomycin, candidin, aspergillin, and sporotrichin, as well as purified
      polysaccharide-protein complexes (PPC) of Histoplasma capsulatum, Coccidioides
      immitis, and Paracoccidioides brasiliensis were used as antigens. Immune tests
      used included skin test (ST), gel immunodiffusion (ID),
      counterimmunoelectrophoresis (CIE), complement fixation (CF), and ELISA. A
      possible association with candidosis was observed in 17% of patients with
      tuberculosis and diabetes; one presumptive paracoccidioidomycosis, one confirmed
      aspergillosis, and six cases of active histoplasmosis were determined. Candidin
      ST showed 29% of positive reactions with an increased frequency in patients
      between 31 and 55 years of age. CF test showed the highest positivity percentages
      with crude antigens, specially for Candida antigen (26.3%) and histoplasmin
      (18.2%). Cross reactions were evident with crude antigens but decreased when
      PPC's were used in ELISA.

PMID- 1749393
TI  - Opsonizing activity of C-reactive protein in phagocytosis of Aspergillus
      fumigatus conidia by human neutrophils.
AB  - In complement-free neutrophil monolayer assays pathological levels of C-reactive
      protein (CRP) were found to promote greater phagocytosis of metabolically-active
      conidia of Aspergillus fumigatus than dormant spores. This suggests that
      metabolically-active conidia bind CRP which facilitates in vitro phagocytosis by
      human neutrophils.

PMID- 1749394
TI  - Study of the invasion of human hair in vitro by Aphanoascus spp.
AB  - The course of the destruction of human hair in vitro by three species of the
      genus Aphanoascus (A. keratinophilus, A. fulvescens and A. verrucosus) was
      studied with light microscopy, and transmission and scanning electron microscopy.
      The results obtained show that all the three species develop keratinolytic
      activity. A. fulvescens and A. verrucosus have similar sequences of degradation,
      invading the hair through the cuticula, but without the presence of specialized
      erosive organs. A. keratinophilus, however, shows a different way of invasion,
      and the keratinolytic activity was mainly located in the cortex and from that
      point on expanded to the cuticula.

PMID- 1749395
TI  - Ultrastructural aspects of the demolition of human hair in vitro by Chrysosporium
      tropicum Carmichael.
AB  - The pattern of invasion of human hair in vitro by a non-dermatophytic fungus,
      Chrysosporium tropicum, was studied by transmission and scanning electron
      microscopy. The components of the hair were attacked in sequence, depending on
      their level of keratinization, i.e. their content of cystine. In the cuticle, the
      sequence of digestion was as follows: intercellular material, cytoplasmic
      membrane, endocuticle, exocuticle, layer A, and a thinner layer below the inner
      cytoplasmic membrane of the cuticle cells. In the cortex, the order was:
      cementing material, plasmalemma, intermacrofibrillar material, microfibrils and
      matrix of the microfibrils. At the same time a different mode of attack was
      radial penetration of the various layers without regard to degree of
      keratinization. This occurred by means of perforating hyphae originating in the
      cuticle from structures similar to appressoria. With both modes of attack, the
      process showed all the characteristics of enzymatic digestion rather than
      physical breakdown. Ch. tropicum thus demonstrated important physiological
      parallels with dermatophytes in its demolition of hair in vitro. This could be of
      interest in predicting its ability to infect in vivo.

PMID- 1749396
TI  - Kinetic study of antifungal activity of amphotericin B, 5-fluorocytosine and
      ketoconazole against clinical yeast isolates using liquid-phase turbidimetry.
AB  - The fungal growth of clinical yeast isolates and of VW32 clone of Candida
      albicans were measured in vitro using a liquid-phase turbidimetric system
      (Bioscreen from Labsystems, France) in defined conditions. Cultures were
      performed in Shadomy's liquid medium and the fungal growth automatically
      evaluated every 10 minutes for 24 hours using various concentrations of drugs.
      The system made it possible to test 200 culture samples in one experiment. Yeast
      sensitivity to drugs was also measured by using our routine semi-automatic
      turbidimetric system. We observed that kinetic patterns of activity of each
      antifungal agent were typical. The in vitro tests showed that of 927 clinical
      yeast isolates 99.2% were sensitive to amphotericin B, 94.4% to 5-fluorocytosine
      and 69.7% to ketoconazole.

PMID- 1749397
TI  - The preservation of fungal cultures by lyophilization.
AB  - A method for the preservation of fungal strains is presented. The cultures are
      grown on Sabouraud glucose agar in glass ampoules and lyophilized without further
      processing. By this method the macroscopical morphology of the cultures is
      preserved, so that these can be used immediately without recultivation as
      reference cultures. All tested mould and yeast strains remained viable over the
      six months duration of the experiment, whereas the dermatophyte strains could
      only partially be recultivated.

PMID- 1749398
TI  - Modification of responses of Candida albicans to cisplatin by membrane damaging
      antimycotic agents.
AB  - The genotoxic, antineoplastic platinum coordination complex, cisplatin (cis
      diamminedichloroplatinum (II], exists as a positively charged aquated complex in
      water solution and as a neutral, nonaquated complex in saline solution. Candida
      albicans exhibited greater susceptibilities to cellular inactivation and
      induction of mitotic recombination when treated with the aquated rather than the
      nonaquated drug. The differential in responses was expressed by cells grown after
      treatment at 37 degrees C or at 25 degrees C, a temperature which promotes
      recovery from DNA damages by the yeast generally. Studies with protoplasts
      established that cell wall components do not influence cellular reactions to
      either form of the drug. However, membrane damaging antimycotic agents markedly
      affected responses. Pretreatments with fungistatic ketoconazole or with
      miconazole, under fungistatic or fungicidal conditions, enhanced cellular
      resistance to inactivation by aquated cisplatin: the effect was more pronounced
      with post-cisplatin growth at 25 degrees C than 37 degrees C. Fungicidal
      pretreatments with amphotericin B or miconazole greatly increased
      susceptibilities of surviving cells to the lethal and recombinagenic effects of
      nonaquated cisplatin with post-cisplatin recovery at 25 degrees C or 37 degrees
      C. Possible mechanisms underlying these responses and their implications for
      stability of C. albicans populations in cancer patients undergoing therapy with
      cisplatin are discussed.

PMID- 1749399
TI  - Dermatophytoses in Cusco (Peru).
AB  - A total of 90 cases of suspected dermatophytoses was observed over a period of 9
      months in the city of Cusco (Peru) and in its environs. The age groups most
      commonly infected were 1-10 and 11-20 year old. The most common tineae diagnosed
      were tinea capitis (13.3%) and tinea unguium (11.1%). Only four species of
      dermatophytes were isolated: Microsporum canis (52.4%), Trichophyton
      mentagrophytes (35.7%), Tr. rubrum (9.5%) and Epidermophyton floccosum (2.4%).
      Dry weather, low temperature and high altitude do not seem to affect
      proliferation and infections by dermatophytes.

PMID- 1749400
TI  - Effect of the incubation conditions on the production of patulin by Penicillium
      griseofulvum isolated from wheat.
AB  - Sixty-four wheat samples from Spanish flour factories were screened for patulin
      and patulin-producing moulds. None of them was found to contain any patulin,
      whereas samples experimentally contaminated with this toxin proved it to be
      highly unstable. On the other hand, Penicillium griseofulvum was the only in
      vitro patulin-producing species found (19 samples). Mould growth in the samples
      was investigated by using yeast-sucrose medium (YES) and high-performance liquid
      chromatography (HPLC) to measure the amounts of toxin produced during 40 day's
      incubation at 20 and 28 degrees C. The highest yield rate of patulin was obtained
      between the 20th and 30th day of incubation; such a rate, however, was very low
      throughout the vigorous growth phase, during the first 20 days of incubation. The
      more appropriate temperature for incubation and patulin production was 28 degrees
      C. We also investigated the influence of other incubation conditions in the yield
      and found stationary dark cultures to be more efficient that shaken or
      fermentation cultures in YES medium. The best patulin yield achieved was 11.9 mg
      in the culture broth and 6.3 mg in the mycelium from 100 ml of medium.

PMID- 1749401
TI  - Isolation of beauvericin as an insect toxin from Fusarium semitectum and Fusarium
      moniliforme var. subglutinans.
AB  - Nonpolar methylene chloride-soluble extracts from the mycelia of Fusarium
      semitectum and Fusarium moniliforme var. subglutinans were toxic to Colorado
      potato beetles. The major toxic metabolite was isolated and found to be the
      cyclodepsipeptide, beauvericin. This is the first report of the isolation of
      beauvericin from the genus Fusarium.

PMID- 1749402
TI  - Allergic contact dermatitis caused by mushrooms. A case report and literature
      review.
AB  - The first author is allergic to skin contact with mushrooms of Suillus
      americanus, S. granulatus, S. grevillei, S. luteus, or S. neoalbidipes. Symptoms
      develop between one and two days after contact and last for approximately a week,
      disappearing completely without treatment. Symptoms consist of reddening,
      swelling, and itching, at the sites of contact with pileus cuticle mucilage of
      all five species. Pore layer tissues (tested for S. americanus and S. luteus)
      also produced strong reactions, as did pileus trama (tested for S. luteus).
      Spores from spore prints (tested for S. americanus and S. luteus) produced no
      reaction. The reaction can be avoided by wearing gloves when handling allergic
      species and by washing hands promptly after working with these species. Similar
      cases, reported from North America, Europe, and Russia, involve Agaricus,
      Boletus, Lactarius, Paxillus, Ramaria, and Suillus species. Several cases involve
      allergy to multiple species or genera. Symptom severity varies, presumably with
      intensity of exposure. In one case, symptoms were renewed following ingestion.
      Most cases demonstrate delayed allergic contact sensitivity.

PMID- 1749403
TI  - Adhesion of Candida albicans to epithelial cells effect of polyoxin D.
AB  - Data from our previous studies suggested that the fungal cell wall component,
      chitin, is involved in the adhesion of Candida albicans to mucosal surfaces. In
      the present study, we investigated the effect of polyoxin D, an inhibitor of
      chitin synthase, on the interaction of the fungus with epithelial cells. The
      effect of polyoxin D on Candida was evaluated in in vitro assays for its capacity
      to adhere to buccal epithelial cells (BEC), and by fluorescent-microscopy
      photometry and flow cytometry using cells stained with cellufluor (CF), a
      fluorochrome with affinity for chitin. C. albicans grown with and without
      polyoxin D was stained with CF and examined in a fluorescent microscope equipped
      with a photometer. Measurements of fluorescence revealed a wide range of
      intensity among C. albicans cells and a decreased intensity in polyoxin D treated
      cultures. Flow cytometry analyses of yeasts revealed 2 peaks of fluorescence
      intensity, and pointed to differences between polyoxin D treated and non-treated
      microorganisms. C. albicans stained with CF were separated into 2 subpopulations
      by flow cytometry according to fluorescence intensity. In vitro adhesion of each
      subpopulation to BEC was similar. Polyoxin D treated fungi showed significantly
      reduced adherence to BEC, as evaluated by a radioactivity assay with
      radiolabelled yeasts and by microscopic readings. The reduction in adhesion was
      Polyoxin D concentration dependent. These observations support our previous
      findings suggesting involvement of chitin in the attachment process of C.
      albicans (CBS562) to epithelial cells.

PMID- 1749404
TI  - Cardiovascular toxicity of cocaine: underlying mechanisms.

PMID- 1749405
TI  - Cocaine-induced myocardial depression.

PMID- 1749406
TI  - Prevalence of myocardial ischemia in cocaine addicts.
AB  - The finding that most young cocaine addict patients had a negative exercise
      treadmill test suggests that they did not have preexisting obstructive coronary
      artery disease. Noninvasive testing did show, however, that these patients
      frequently had a high incidence of ST elevation episodes during the first 2 weeks
      of withdrawal. The pathophysiological mechanism of cocaine-induced cardiovascular
      disease is not yet clearly understood, but it is probably more complex than the
      drug's acute direct effects on the cardiovascular system. It may be complicated
      by fluctuations in catecholamine homeostasis and further temporally complicated
      by cycles of cocaine use and withdrawal. Research on how cocaine use alters
      catecholamine homeostasis will increase the understanding of the pathophysiology
      of cocaine and assist in developing effective pharmacologic and prophylactic
      treatment for its abuse.

PMID- 1749407
TI  - Cocaine-induced myocardial infarction: clinical observations and pathogenetic
      considerations.
AB  - Clinical and experimental data published to date suggest several possible
      mechanisms by which cocaine may result in acute myocardial infarction. In
      individuals with preexisting, high-grade coronary arterial narrowing, acute
      myocardial infarction may result from an increase in myocardial oxygen demand
      associated with cocaine-induced increase in rate-pressure product. In other
      individuals with no underlying atherosclerotic obstruction, coronary occlusion
      may be due to spasm, thrombus, or both. With regard to spasm, the clinical
      findings are largely circumstantial, and the locus of cocaine-induced
      vasoconstriction remains speculative. Although certain clinical and experimental
      findings support the hypothesis that spasm involves the epicardial, medium-size
      vessels, other data suggest intramural vasoconstriction. Diffuse intramural
      vasoconstriction is not consistent with reports of segmental, discrete
      infarction. Whereas certain in vivo data suggest that these effects are alpha
      mediated, other in vitro data suggest the opposite. The finding of cocaine
      induced vasoconstriction in segments of (noninnervated) human umbilical artery
      suggests that the presence or absence of intact innervation is not sufficient to
      explain the discrepant data involving the possibility of alpha-mediated effects.
      Finally, the contribution of a primary, thrombotic effect of cocaine has not been
      excluded.

PMID- 1749408
TI  - Cardiac electrophysiological effects of cocaine in animal models.

PMID- 1749409
TI  - Effects of cocaine on intracellular calcium handling in cardiac and vascular
      smooth muscle.
AB  - The inotropic and lusitropic (i.e., relaxant) actions of cocaine on the heart
      appear to be caused primarily by changes in intracellular calcium handling. The
      positive inotropic and lusitropic effects of low and moderate concentrations
      (i.e., less than or equal to 10(-5)M) are mediated by catecholamines; the
      negative inotropic effects of higher concentrations appear to be due to the
      direct local anesthetic effects of cocaine on excitation-contraction coupling
      mechanisms. The relevance of these findings to humans is suggested by the fact
      that blood levels of cocaine in excess of 10(-5) M have been described in
      patients abusing this drug (Van Dyke et al. 1976; Paly et al. 1982). Blood
      vessels from certain vascular beds, including the epicardial coronary arteries of
      humans and swine, show little or no constrictor response to low concentrations of
      cocaine and relax at higher concentrations. In contrast to the effects on the
      heart, the relaxant effects of cocaine on vascular smooth muscle appear to be
      related to marked changes in myofilament calcium responsiveness, which may be
      mediated by the protein kinase-C system. These results at least indicate that the
      depressant effects of cocaine on cardiac vs. vascular smooth muscle occur by
      different mechanisms and suggest the need for specific therapeutic approaches to
      managing cardiac depression vs. vasodilatation when they occur in cocaine
      intoxicated individuals. Moreover, these data provide evidence supporting the
      hypothesis that the net effects of cocaine in the intact organism are highly
      dependent on the underlying level of sympathetic adrenergic activity.

PMID- 1749410
TI  - Cocaine-induced changes in the biochemistry and morphology of rabbit aorta.

PMID- 1749411
TI  - Effects of cocaine on the physiology of exercise.

PMID- 1749412
TI  - Effect of acute cocaine administration on cardiac and respiratory patterning in
      the freely moving cat.

PMID- 1749413
TI  - Direct and indirect morphological markers of cocaine toxicity in the human heart.

PMID- 1749414
TI  - Cocaine-associated cardiovascular disease: clinical and pathological aspects.
AB  - With regard to cardiac findings in cocaine abuse, at autopsy the vast majority of
      patients dying with cocaine toxicity have either no pathologic change in the
      heart or only minimal changes that could not account for the patient's death. The
      second most frequent finding is underlying, mild-to-moderate coronary
      atherosclerosis, with or without coronary thrombosis. There may be acute or
      healed myocardial infarction or a sudden cardiac death without myocardial changes
      of ischemia. A high incidence of contraction band necrosis has been reported in
      the absence of coronary artery disease and may cause a sudden arrhythmic death.
      Myocarditis also has been described in a few cases as either lymphocytic or
      lymphocytic and eosinophilic infiltrate in the presence of myocyte necrosis.
      Usually, the foci are sparse and not always associated with contraction band
      necrosis. The underlying mechanisms are thought to be either direct effects of
      norepinephrine on myocytes or through vasospasm of resistance vessels and
      secondary myocardial ischemia. Cocaine rarely has been associated with aortic
      dissection, which is probably a result of cocaine's hypertensive effects.

PMID- 1749415
TI  - Pharmacokinetics and time-action profile of cocaine in dogs.

PMID- 1749416
TI  - Acute tolerance to the chronotropic effect of cocaine in humans.

PMID- 1749417
TI  - Mechanisms of cardiac and vascular responses to cocaine.

PMID- 1749418
TI  - Maternal-fetal cardiovascular system: a target of cocaine.

PMID- 1749419
TI  - Cardiovascular effects of cocaine in squirrel monkeys.

PMID- 1749420
TI  - Role of the sympathetic nervous system in the cardiovascular effects of cocaine.

PMID- 1749421
TI  - FDA vs. free speech over drug promotions.

PMID- 1749422
TI  - US plans frontiers support.

PMID- 1749423
TI  - HIV infection. France will compensate.

PMID- 1749424
TI  - Human genome dispute.

PMID- 1749425
TI  - Tissue shortage.

PMID- 1749426
TI  - Gene therapy on the move.

PMID- 1749427
TI  - A three-base-pair deletion in the peripherin-RDS gene in one form of retinitis
      pigmentosa.
AB  - The group of retinopathies termed retinitis pigmentosa (RP) greatly contribute to
      visual dysfunction in man with a frequency of roughly 1 in 4,000. We mapped the
      first autosomal dominant RP (adRP) gene to chromosome 3q, close to the gene
      encoding rhodopsin, a rod photoreceptor pigment protein. Subsequently, mutations
      in this gene have been implicated as responsible for some forms of adRP. Another
      adRP gene has been mapped to chromosome 8p. A third adRP gene in a large Irish
      pedigree has been mapped to chromosome 6p, showing tight linkage with the gene
      for peripherin, a photoreceptor cell-specific glycoprotein, which is thus a
      strong candidate for the defective gene. We have now identified a three-base-pair
      deletion which results in the loss of one of a pair of highly conserved cysteine
      residues in the predicted third transmembrane domain of peripherin. This deletion
      segregates with the disease phenotype but is not present in unaffected controls,
      and suggests that mutant peripherin gives rise to retinitis pigmentosa.

PMID- 1749428
TI  - A candidate spermatogenesis gene on the mouse Y chromosome is homologous to
      ubiquitin-activating enzyme E1.
AB  - The human X-linked gene A1S9 complements a temperature-sensitive cell-cycle
      mutation in mouse L cells, and encodes the ubiquitin-activating enzyme E1. The
      gene has been reported to escape X-chromosome inactivation, but there is some
      conflicting evidence. We have isolated part of the mouse A1s9 gene, mapped it to
      the proximal portion of the X chromosome and shown that it undergoes normal X
      inactivation. We also detected two copies of the gene on the short arm of the
      mouse Y chromosome (A1s9Y-1 and A1s9Y-2). The functional A1s9Y gene (A1s9Y-1) is
      expressed in testis and is lost in the deletion mutant Sxrb. Therefore A1s9Y-1 is
      a candidate for the spermatogenesis gene, Spy, which maps to this region. A1s9X
      is similar to the Zfx gene in undergoing X-inactivation, yet having homologous
      sequences on the short arm of the Y chromosome, which are expressed in the
      testis. These Y-linked genes may form part of a coregulated group of genes which
      function during spermatogenesis.

PMID- 1749429
TI  - Oncogenic and transcriptional cooperation with Ha-Ras requires phosphorylation of
      c-Jun on serines 63 and 73.
AB  - Recent advances indicate a link between tumour promoters, transformation, and AP
      1 activity. Protein kinase C activation increases AP-1 DNA-binding activity
      independently of new protein synthesis. AP-1 is also stimulated by transforming
      oncoproteins and growth factors. These proteins are thought to participate in a
      signalling cascade affecting the nuclear AP-1 complex composed of the Jun and Fos
      proteins. Because c-Jun is the most potent transactivator in the AP-1 complex and
      is elevated in Ha-ras-transformed cells, in which c-Fos is downregulated, we
      focused on it as a potential target. c-Jun could convert input from an oncogenic
      signalling cascade into changes in gene expression. Indeed, transformation of rat
      embryo fibroblasts by c-Jun requires an intact transcriptional activation domain
      and cooperation with oncogenic Ha-ras. Expression of oncogenic Ha-ras augments
      transactivation by c-Jun and stimulates its phosphorylation. Here we describe the
      mapping of the Ha-ras-responsive phosphorylation sites to serines 63 and 73 of c
      Jun. Site-directed mutagenesis indicates that phosphorylation of these serines is
      essential for stimulation of c-Jun activity and for cooperation with Ha-ras in
      ocogenic transformation.

PMID- 1749430
TI  - [Paralysis of the recurrent nerve and a normal thorax picture: idiopathic?].

PMID- 1749431
TI  - [Transient ischemic attacks, non-invalidating brain infarcts and the prevention
      of worse: current findings on its treatment].

PMID- 1749432
TI  - [Serological diagnosis in rheumatoid arthritis].

PMID- 1749433
TI  - [The surgical treatment of rheumatoid arthritis].

PMID- 1749434
TI  - [Consensus cerebrovascular accident].
AB  - A consensus conference on stroke was held on March 22, 1991. Subjects on which
      consensus was reached were: There are different kinds of cerebral haemorrhage and
      infarction, which can be differentiated by computerized tomography, and this can
      have practical consequences. At clinical examination special attention should be
      paid to cognitive impairment. Angiography is indicated only if carotid surgery or
      unusual causes are considered. CSF examination and EEG are performed only on
      special indications. Cardiological consultation is necessary in young patients,
      or if clinical signs of cardiogenic embolism are present. Coumarin derivatives
      are prescribed in some of these cardiac causes of stroke, to prevent recurrence.
      There is as yet no effective medical treatment for cerebral infarction. In lobar
      and cerebellar haemorrhage surgical treatment may be indicated. In the acute
      phase of stroke it is always important to prevent aspiration pneumonia, pulmonary
      embolism and decubitus, and to care for muscles and joints. Advantages and
      disadvantages of gastric tube and indwelling catheter should be weighed.
      Treatment of hypertension after the acute phase is indicated to prevent recurrent
      stroke. After TIA and minor stroke, aspirin is prescribed, which reduces the risk
      of cerebral and myocardial infarction by 30%. Carotid endarterectomy in
      symptomatic patients with carotid stenosis of 70% or more, reduces the number of
      fatal or disabling strokes by 50%, if perioperative complications are less than
      4%. Rehabilitation after stroke reduces disability and improves the adaptation of
      both the patient and his environment. The patient should be stimulated and
      supported; good information, including the family, is essential. Supplying aids
      and taking special measures should be done on individual basis, after a period of
      training.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1749435
TI  - [Prevalence of Lyme borreliosis in The Netherlands].
AB  - In the autumn of 1989 a seroepidemiological study was carried out among 440
      owners of hunting dogs and 1052 blood donors from different regions in the
      Netherlands. To detect IgG antibodies to Borrelia burgdorferi an enzyme-linked
      immunosorbent assay was performed. The prevalence of antibodies to B. burgdorferi
      in owners of hunting dogs was 15%, which was significantly higher than in blood
      donors (9%). In both groups the prevalence of seropositivity increased with age.
      There was no difference between men and women. The prevalence of antibodies to B.
      burgdorferi in blood donors from different regions varied significantly, ranging
      from 2% to 17%. Only 3% of the owners of hunting dogs could recall having had
      symptoms most likely to be due to Lyme borreliosis. Of the 68 seropositive
      hunters 64 (94%) were asymptomatic. The results of this study indicate that in
      the Netherlands asymptomatic infections with B. burgdorferi are common in
      individuals highly exposed to ticks and that there is considerable variation in
      the prevalence of seropositivity in the general population. Hence caution is
      called for in the clinical interpretation of IgG test results.

PMID- 1749436
TI  - [Exercise-dependent anaphylaxis].
AB  - The clinical features of exercise-induced anaphylaxis in 5 patients are
      described, with an accurate history, skin tests, IgE determinations and exercise
      tests. In these 5 patients we were able to distinguish three different forms of
      exercise-induced disease: exercise-induced anaphylaxis based upon an IgE-mediated
      allergy to foods, exercise-induced anaphylaxis without food allergy and
      cholinergic urticaria.

PMID- 1749437
TI  - [How toxic is dioxin for humans?].

PMID- 1749438
TI  - [Pancreatitis in children].

PMID- 1749440
TI  - [Cell biology from a medical perspective. VIII. The cytoskeleton, cell movement].

PMID- 1749439
TI  - [Identical breathing sounds].

PMID- 1749441
TI  - [Hormonal aspects and hormone therapy of cancer].

PMID- 1749443
TI  - [Report by the Commission Nomenclature Lung Sounds].

PMID- 1749442
TI  - [Nephrotic syndrome: therapeutic possibilities].

PMID- 1749444
TI  - [Comparison of iodine scintigraphy and computerized tomography in the
      localization of pheochromocytoma].
AB  - A comparison is made of the results of CT scanning and MIBG scintigraphy in the
      localization of phaeochromocytoma. In 21 out of 24 patients with clinically
      diagnosed phaeochromocytoma in the University Medical Hospital, Groningen in 1983
      1990, MIBG scintigraphy provided accurate localization, while in 16 out of 18
      patients with phaeochromocytoma who underwent CT scanning a correct localization
      was obtained. False negative results were mainly present when lesions were
      smaller than 2 cm. There were no false positive results. It is concluded that the
      sensitivity of the two methods in the localization of phaeochromocytoma is about
      equal. The use of one of the methods rather than of both is advised.

PMID- 1749445
TI  - [Regulation of diabetes and late complications in the ambulatory treatment of
      patients with Type II diabetes mellitus].
AB  - In order to obtain more information on the quality of metabolic control and
      presence of secondary complications in type 2 diabetic patients treated in a
      hospital outpatient-clinic, we studied 124 of our diabetic patients (56 males, 68
      females, age 65 (SD 11) years, duration of diabetes 9, range 1-32 years). HbA1c
      levels were 7.9% in patients on oral hypoglycaemic agents (n = 56), and 8.2% in
      insulin-treated patients (n = 59). Cholesterol and triglyceride levels tended to
      be lower in the insulin-treated patients. The prevalence of vascular
      abnormalities was high: in comparison with a population of general practice
      patients more patients had hypertension (56% vs 38%), coronary artery disease
      (48% vs 40%), and cerebrovascular disease (15% vs 6%). In addition, 35% of our
      diabetics had signs of peripheral artery disease. Retinopathy was present in 35
      patients, microalbuminuria was found in 31 patients, proteinuria in 18 patients.
      The presence of microalbuminuria and proteinuria was a strong indicator for
      cardiovascular disease, polyneuropathy and retinopathy. The use of cardiovascular
      medication was high: 57 patients used antihypertensive therapy, 37 used
      diuretics, and 26 long-acting nitrates. Only 25 patients took no medication apart
      from to their diabetes therapy.

PMID- 1749446
TI  - [Hemorrhagic fever caused by dengue in 2 tourists].
AB  - Dengue haemorrhagic fever in two female tourists to Thailand (1990) and Indonesia
      (1989) respectively, is reported for the first time in the Netherlands. The main
      symptoms directly after return were high fever, haemorrhagic exanthema,
      thrombocytopenia and in one patient signs of haemoconcentration. Initially both
      patients were treated with antibiotics. They recovered after intravenous fluid
      therapy; one of them received a thrombocyte transfusion. Increasing travel to
      Asia and South America will result in more tourists returning with this
      potentially serious arboviral disease (dengue haemorrhagic shock).

PMID- 1749447
TI  - [Medical activities under adverse conditions. The Royal Institute for the
      Tropics].

PMID- 1749448
TI  - [Are there still indications for plasma transfusions?].

PMID- 1749449
TI  - [Cell biology from a medical perspective. IV. Cell nucleus and the action of the
      genome].

PMID- 1749450
TI  - [Neurogenetics--the challenge for neurology. Part 1. Gene mapping and gene
      diagnostics].
AB  - Recent advances in gene mapping have provided distinct chromosomal locations for
      a number of neurological disease genes. Mapping strategies include the
      identification of chromosomal aberrations associated with disorders and the
      candidate gene approach which requires correct assumptions about the primary
      biochemical defect. The most successful strategy, linkage analysis, relies on
      family studies and allows the mapping of genes without knowledge of the molecular
      cause of a disorder. Once the chromosomal position for a disease gene is known,
      indirect DNA diagnosis becomes available, providing risk estimates for
      individuals in affected families. Identification of the disease gene itself
      allows the characterization of the protein involved and direct diagnosis at DNA
      and protein level, thus leading to a greater understanding of the molecular
      pathology of neurogenetic disorders.

PMID- 1749451
TI  - [Neurogenetics--the challenge for neurology. 1. Neurogenetic diseases].
AB  - Progress in molecular genetics has provided insight into a number of neurogenetic
      disorders. The chromosomal location of the genes for Huntington's disease,
      Wilson's disease, myotonic dystrophy and Friedreich's ataxia are now known. In
      families affected by these illnesses, linkage analysis can now be employed for
      presymptomatic or prenatal diagnosis. The genes for Duchenne and Becker muscular
      dystrophy and neurofibromatosis I have been cloned and sequenced, allowing the
      direct analysis of the genetic defect in many cases, and thereby providing
      further insight into the pathophysiology. In addition, the classification of
      several neurogenetic diseases, such as the hereditary motor and sensory
      neuropathies or the spinal muscular atrophies can now be based on the chromosomal
      location of the affected gene(s).

PMID- 1749452
TI  - [Anticerebellar antibodies--anti-Hu and anti-Yo--in the diagnosis of
      paraneoplastic neurologic syndromes].
AB  - The detection of antineuronal antibodies against cytoplasm and nuclei of Purkinje
      cells is considered to be an essential factor in the diagnosis of neurologic
      paraneoplastic syndromes. Published data rely on different immunological methods
      and relatively small numbers of patients. The clinical relevance of this
      phenomenon is not clear from the literature. A positive correlation between
      antibody detection and the appearance of neurologic paraneoplastic syndromes has
      been reported, but this finding has been questioned in critical reviews.

PMID- 1749453
TI  - [Corpus callosum agenesis. Interhemispheric integration of semantic information].

PMID- 1749454
TI  - [Speech apraxia in dialysis-associated aluminum encephalopathy].
AB  - A 57-year-old man on long-term renal dialysis presented with speech dyspraxia, a
      symptom characteristic of early aluminium encephalopathy. Once fully developed,
      this condition has a poor prognosis despite deferoxamine (DFO) treatment.

PMID- 1749455
TI  - [Presenile dementia in xeroderma pigmentosum].
AB  - Neurological manifestations of xeroderma pigmentosum, a rare autosomal recessive
      neurocutaneous syndrome, are variable. The association with progressive mental
      retardation, usually with onset in childhood, is well known. We present a case of
      x.p. with progressive presenile dementia. This combination has, to our knowledge,
      not yet been reported in the literature. Although no hints on another aetiology
      have been found, the coincidental combination of x.p. with M. Alzheimer has to be
      taken into consideration. CT scan and MRI showed a marked cerebral atrophy.

PMID- 1749456
TI  - [Clinical aspects and electrophysiologic findings in an unusual course of central
      pontine myelinolysis].

PMID- 1749458
TI  - Effect of medial zona incerta lesions on the ovulatory surge of gonadotrophins
      and prolactin in the rat.
AB  - Bilateral electrolytic lesions of the incertohypothalamic A13 dopamine (DA)
      system were made on the morning of proestrus in female rats with regular estrous
      cycles under ether anesthesia. Hourly blood samples were withdrawn, via a jugular
      catheter from conscious, freely moving rats, between 14.00 h and 18.00 h on the
      afternoon of proestrus. Plasma LH, FSH and prolactin levels were determined by
      RIA. The preovulatory surges of LH and prolactin were blocked in animals in which
      the A13 DA nucleus was destroyed by more than 70%. Levels of FSH were not
      significantly different from those of control of sham-lesioned groups. Lesions
      that were dorsal, ventral or caudal to the A13 DA systems did not affect the
      preovulatory surges of LH and prolactin whereas anterior lesions caused variable
      changes in the level of all three hormones. These data suggest that the A13 DA
      region may have a role in the control of the preovulatory surges of LH and
      prolactin.

PMID- 1749457
TI  - Regulation of hypothalamic gonadotropin-releasing hormone and neuropeptide Y
      concentrations by progesterone and corticosteroids in immature rats: correlation
      with luteinizing hormone and follicle-stimulating hormone release.
AB  - In a previous study, we demonstrated that progesterone (P4) and the synthetic
      glucocorticoid triamcinolone acetonide (TA), but not cortisol, could induce LH
      and FSH release in estrogen-primed ovariectomized immature rats. Therefore, the
      purpose of this study was to determine if the stimulatory effect of P4 and TA on
      LH and FSH release were associated with changes in GnRH or NPY concentrations in
      the medial basal hypothalamus (MBH) or preoptic area (POA). Ovariectomized
      immature rats primed with estradiol at 27 and 28 days received either vehicle,
      P4, TA or cortisol (1 mg/kg BW) at 9.00 h on day 29. Animals were killed at 9.30,
      10.00, 12.00 and 13.00 h on day 29 for serum LH and FSH measurements, and the MBH
      and POA were dissected and analyzed for GnRH and NPY concentrations via RIAs. P4-
      and TA-treated animals showed significantly elevated serum LH and FSH levels from
      13.00 h to 15.00 h. Cortisol was without effect. P4 significantly increased MBH
      GnRH and NPY concentrations at 12.00 h followed by a significant fall at 13.00 h.
      P4 modulated POA GnRH and NPY concentrations in a fashion similar to that seen in
      the MBH, except POA NPY concentrations did not fall at 13.00 h after the
      elevation at 12.00 h. TA had no significant effect on MBH GnRH and NPY levels at
      12.00 h compared to the values at 9.30 h and 10.00 h but, as with P4, there was a
      significant fall in MBH GnRH and NPY levels at 13.00 h. TA had no significant
      effect on POA GnRH and NPY concentrations at any time point studied.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1749459
TI  - Naltrexone does not reverse the inhibitory effect of chronic restraint on
      gonadotropin secretion in the intact male rat.
AB  - There is considerable evidence suggesting that endogenous opioids may play an
      important role in acute stress-induced decreases in luteinizing hormone (LH)
      release. Studies were undertaken to analyze the role of endogenous opioids in
      chronic stress-induced decrease in circulating LH and follicle-stimulating
      hormone (FSH). Chronic restraint (6 h daily over 4 days) evoked a decrease in
      circulating LH and FSH. Naltrexone treatment, (2 mg/kg three times daily) during
      the 4 days of restraint, caused an increase in plasma concentrations of LH and
      FSH, and antagonized the LH suppressory effect of morphine (10 mg/kg)
      administration. Despite this, naltrexone treatment was ineffective in preventing
      the inhibitory effect of chronic restraint stress on circulating LH and FSH.
      Chronic restraint also induced a decrease in hypothalamic LH-releasing hormone
      (LHRH) content in saline-treated rats. On the contrary, in naltrexone-treated
      rats, chronic restraint evoked an increase in hypothalamic LHRH content. Thus
      endogenous opioids and chronic stress seem to act by different mechanisms on the
      hypothalamic LHRH neuron. In unstressed orchidectomized rats, naltrexone
      administration did not modify circulating LH, but increased plasma concentrations
      of LH in acutely restrained rats. These data suggest that endogenous opioids may
      mediate gonadotropin secretion during acute stress, but not during chronic
      stress.

PMID- 1749460
TI  - Autoradiographic analyses of the effects of restraint-induced stress on 5-HT1A, 5
      HT1C and 5-HT2 receptors in the dorsal hippocampus of male and female rats.
AB  - Quantitative autoradiography was used to evaluate the effects of sex and either 1
      or 5 daily 2-hour sessions of restraint stress on binding at 5-HT1A, 5-HT1C and 5
      HT2 receptors in the rat dorsal hippocampus. Neither sex nor restraint stress
      were found to have effects on binding at 5-HT1C or 5-HT2 receptors. However,
      restraint stress increased binding of [3H]8-hydroxy-2-(di-n-propylamino)tetralin
      at 5-HT1A receptors in the CA4 region and in the infrapyramidal dentate gyrus. In
      addition, levels of binding at 5-HT1A receptors in the oriens and lacunosum
      moleculare layers of the CA1 region were significantly higher in female rats.
      Neither estradiol benzoate nor estradiol benzoate plus progesterone had effects
      on binding at hippocampal 5-HT1A receptors in ovariectomized rats, making it
      unlikely that the sex differences were related to stages of the estrous cycle.
      Stress-induced levels of corticosterone (CORT) were higher in females. Although
      CORT levels in blood obtained during restraint decreased from session 1 to
      session 5 in both male and female rats, the decrease became significant in
      females only. Female rats also displayed higher levels of activity in the open
      field. Although activity in the open field was reduced in male and female rats
      after restraint, these decreases were not significant. Results are discussed in
      relation to anxiety and depression.

PMID- 1749461
TI  - Influence of human corticotropin-releasing hormone and adrenocorticotropin upon
      spontaneous growth hormone secretion.
AB  - Hormones of the hypothalamo-pituitary-adrenocortical (HPA-) axis are considered
      to be of physiological and clinical relevance in regulating spontaneous growth
      hormone (GH) secretion. To further investigate interdependencies between both
      systems, we studied the effects of adrenocorticotropin [ACTH(1-24)] and human
      corticotropin-releasing hormone (h-CRH) upon spontaneous GH secretion in 10 male
      volunteers. Administration of 1 microgram ACTH (1-24), 10 micrograms h-CRH or
      saline (control: CTL) every hour from 9.00 to 6.00 p.m. resulted in significant
      differences of cortisol secretion during the entire observation period (8.00 a.m.
      3.00 a.m.) between the three groups (p less than 0.001, Friedman two-way ANOVA).
      Mean area under the time course curve (AUC) values (+/- SEM) for cortisol
      expressed as ng x 1,000 x min/ml showed also significant differences between the
      three treatments from 8.00 a.m. to 3.00 a.m.: CTL 64.0 +/- 6.4, ACTH(1-24) 178.5
      +/- 9.4 (p less than 0.01, Wilcoxon test), h-CRH 88.5 +/- 5.6 (p less than 0.01).
      The main portion of cortisol was released during daytime from 8.00 a.m. to 11.00
      p.m., where the most significant differences in the AUC values emerged: CTL 59.6
      +/- 5.8, ACTH(1-24) 171.5 +/- 8.8 (p less than 0.01, Wilcoxon test), h-CRH 80.2
      +/- 5.1 (p less than 0.01). With regard to GH secretion, significant differences
      became obvious between the three treatments during daytime from 8.00 a.m. to
      11.00 p.m. and the sleep-related period from 11.00 p.m. to 3.00 a.m. (p less than
      0.01 and p less than 0.02, Friedman two-way ANOVA).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1749462
TI  - Effect of cold exposure on the hypothalamic release of thyrotropin-releasing
      hormone and catecholamines.
AB  - The effects of cold exposure on the release of thyrotropin-releasing hormone
      (TRH) and catecholamines as estimated by push-pull perfusion of the mediobasal
      hypothalamus were studied. Before cold exposure, the male rats had been kept at
      room temperature or at 30 degrees C for 3 weeks. Transfer to 4 degrees C
      increased plasma levels of thyroid-stimulating hormone (TSH), but this cold
      induced TSH response was more pronounced in animals which had been acclimatized
      to 30 degrees C. Exposure to 4 degrees C also increased plasma thyroid hormone
      levels, but had no effect on plasma prolactin. The hypothalamic content of TRH
      and dopamine remained similar after transfer to 4 degrees C, but after 6 h of
      cold, the content of noradrenaline and adrenaline had increased 1.6-fold and 3
      fold, respectively. In vivo hypothalamic release of TRH, adrenaline and dopamine
      remained similar during a 2-hour period in control rats kept at room temperature
      or 30 degrees C. The hypothalamic release of TRH, dopamine and adrenaline did not
      change in rats transferred from room temperature to 4 degrees C. The amount of
      dopamine and adrenaline in push-pull perfusate also remained similar in rats
      acclimatized to 30 degrees C after transfer to low temperatures. However, in
      these rats kept at 30 degrees C for 3 weeks, exposure to 4 degrees C increased
      TRH release in perfusate from the mediobasal hypothalamus in the first 15 min of
      cold exposure (2-fold increase). Thus, exposure to cold stimulates the
      hypothalamo-pituitary-thyroid axis and increases the hypothalamic release of TRH
      in rats which had been acclimatized to 30 degrees C.

PMID- 1749463
TI  - Influence of pentobarbital and urethane on release from magnocellular neurons.
AB  - We examined the responses of vasopressin-neurons (VP-neurons) and oxytocin
      neurons (OT-neurons) to acute salt-loading in a group of conscious rats (CON, n =
      8) and rats under sodium pentobarbital (NEM, 50 mg/kg, i.p., n = 8) or urethane
      (URE, 1.6 g/kg, i.p. n = 8) anesthesia. Fifteen minutes following the induction
      of anesthesia, sodium pentobarbital produced an increase in basal plasma
      osmolality (Posm, 290 +/- 2 to 296 +/- 3 mosm/kg H2O, p less than 0.007) while
      urethane did not change basal Posm (287 +/- 2 to 289 +/- 2 mosm/kg H2O). Neither
      anesthetic agent resulted in any significant changes in basal plasma levels of
      vasopressin-associated neurophysin (VP-RNP) and oxytocin-associated neurophysin
      (OT-RNP). In response to intravenous infusion of 18% saline, all three groups of
      rats had similar rises in Posm. The slopes of the relationship between the rise
      in plasma VP-RNP and the rise in Posm were markedly reduced in both groups of
      anesthetized animals compared to that observed for conscious animals (CON = 2.54
      +/- 0.5; NEM = 1.22 +/- 0.18; URE = 1.17 +/- 0.24 fmol.ml-1.mosm-1.kg H2O-1 p
      less than 0.0126). The slopes of the relationship between the rise in plasma OT
      RNP and the rise in Posm were not significantly (p less than 0.4478) different
      between the CON group and the NEM group, while the slope for the URE group was
      significantly (p less than 0.05) smaller than that for the CON group (CON = 10.9
      +/- 1.5; NEM = 9.3 +/- 1.5; URE = 6.3 +/- 0.7 fmol.ml-1.mosm-1.kg H2O
      1).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1749464
TI  - Electrophysiological actions of oxytocin on hypothalamic neurons in vitro:
      neuropharmacological characterization and effects of ovarian steroids.
AB  - Oxytocin (OT) neurotransmission in the brain has a facilitatory effect on sexual
      receptivity in rats. This effect of OT is dependent on priming by ovarian
      steroids, estrogen and progesterone. These steroids modulate OT binding in
      specific brain nuclei, including the ventrolateral portion of the ventromedial
      hypothalamic nucleus (vlVMN). In the present study, single-unit activity was
      recorded from the vlVMN in hypothalamic slices to characterize the
      electrophysiological actions of OT. To examine the effects of ovarian steroids on
      OT actions, we used brain slices prepared from ovariectomized rats either treated
      with estrogen or not, and some slices were treated with progesterone in vitro. OT
      had little modulatory action on neuronal responses to other agents, but affected
      the activity of large numbers of vlVMN units. Of those neurons affected, 94%
      responded with excitation. This predominant stimulatory action of OT is
      consistent with its lordosis-facilitating effect, because increases in the
      activity of VMN neurons are generally associated with the facilitation of
      lordosis. Pharmacological analyses with selective OT agonists and antagonists as
      well as structurally related peptides showed that the excitatory action of OT is
      mediated by OT receptors. Estradiol modulated several aspects of OT transmission.
      First, it increased neuronal responsiveness to OT, especially at the lowest
      concentration used (0.2 nM). In addition, it caused neuronal responses to OT to
      correlate significantly with responses to acetylcholine and norepinephrine, which
      also can act on the ventromedial hypothalamus to facilitate lordosis. Finally,
      estradiol enhanced the excitability of laterally projecting neurons, which have
      been implicated in lordosis. In estrogen-pretreated slices, addition of
      progesterone in vitro caused little further effect on responses of individual
      neurons to exogenous OT. Altogether, the present electrophysiological findings
      are consistent with the hypothesis that estrogen potentiates OT action by
      increasing functional OT receptors preferentially in lordosis-relevant neurons,
      thereby enabling OT to efficiently facilitate female reproductive behavior.

PMID- 1749465
TI  - The role of imaging in the management of cerebral and ocular ischaemia.
AB  - The last decade has seen several major technological advances in vascular
      neuroradiology, the most clinically significant of which have been the facility
      to image the brain and the extracranial carotid bifurcation noninvasively with
      accuracy and safety. Another major advance has been unequivocal evidence from
      formal statistical overviews that antiplatelet therapy, particularly aspirin,
      reduces the risk of serious vascular events by about 25%. These advances have
      changed clinical practice such that most patients presenting with symptoms
      suggestive of cerebral ischaemia should now have cranial CT to exclude
      intracerebral hemorrhage, not only because the causes and prognosis of cerebral
      ischaemia differ from those of intracerebral hemorrhage, but because many
      patients with cerebral ischaemia should be considered for antiplatelet therapy.
      Besides the use of long term antiplatelet therapy and control of vascular risk
      factors, other acute treatment options are limited with the possible exception of
      anticoagulation, thrombolysis, cytoprotective agents and carotid endarterectomy.
      If, as seems likely, the current clinical trials show that carotid endarterectomy
      plus medical therapy improve upon the stroke-free survival of patients treated
      medically, at least in symptomatic patients with severe stenosis, the number of
      carotid endarterectomies performed will increase considerably because carotid
      bifurcation disease is the most common cause of cerebral and ocular ischemic
      events. It will then be even more important to be able to obtain accurate
      anatomical and physiological information about the extracranial and intracranial
      circulations with utmost safety. Duplex ultrasound is currently the noninvasive
      screening method of choice for carotid bifurcation disease because it is
      available, relatively cheap, and reasonably accurate. It not only images the
      vessel lumen and degree of stenosis, but also the morphology of the vessel wall
      and associated plaque, the relevance of which is still uncertain in the
      pathogenesis of cerebral and ocular ischaemia. A major limitation of duplex
      sonography is that it cannot reliably distinguish tight stenosis from occlusion
      and it does not image the proximal or distal carotid circulation. The aim of
      newer techniques will be to distinguish tight extracranial carotid stenosis from
      occlusion and to provide anatomical, physiological and pathological information
      about the intracranial circulation and ischemic lesions (in view of potential for
      thrombolytic therapy of major intracranial vessel occlusion) with safety and
      reproducible accuracy.

PMID- 1749466
TI  - MR imaging of the brainstem: normal postnatal development.
AB  - Magnetic resonance imaging (MRI) of the mesencephalon during the first four years
      of life allowed normal maturational processes of the various midbrain structures
      in vivo to be followed. Using T2-weighted SE sequences, we found 5 characteristic
      age dependent patterns on axial tomograms taken at the level of the superior
      colliculi, that let us derive a grading system for normal development of the
      quadrigeminal plate, the cerebral peduncles, the reticular substantia nigra and
      the red nuclei. A subsequent statistical analysis of these age dependent changing
      patterns on T2-weighted MRI of 60 neonates, infants and small children yielded
      normal age ranges for each of the 5 maturational stages of the midbrain. Grading
      the changing pattern of midbrain structures during early postnatal life into 5
      distinct maturational stages allowed not only monitoring of normal
      differentiation, e.g. myelination of the brainstem in vivo, but may also help to
      distinguish between normal, delayed and abnormal development of the mesencephalon
      on routine MRI.

PMID- 1749467
TI  - MRI: a method to detect minor brain damage following coronary bypass surgery?
AB  - In order to assess the occurrence of minor focal brain lesions after coronary
      bypass surgery, magnetic resonance imaging (MRI) was used. Nine male patients
      (age 42-63) with angina pectoris were investigated at 0.5 Tesla. The
      investigation was performed one to seven weeks prior to the operation and one
      month after the operation. Before surgery, the images demonstrated more than five
      high intensity spots in the white matter of the brain in all but two patients. No
      additional spots were found after operation. This pilot study indicates that it
      might be difficult to use MRI to detect minor parenchymal lesions after
      cardiopulmonary bypass surgery.

PMID- 1749468
TI  - Granular cell tumour of the orbit: radiological findings.
AB  - Radiological findings in four cases of intraorbital granular cell tumour are
      presented, and compared with those previously reported. These rare lesions often
      appear to involve an extraocular muscle, and are seen on CT as an enhancing mass,
      usually well defined, and frequently lying anteriorly. Plain films are
      characteristically normal; angiographic findings range from normality to a dense
      tumour blush.

PMID- 1749469
TI  - Low-dose CT and inflammatory disease of the paranasal sinuses.
AB  - Computed tomography (CT) is the gold standard for exact delineation of
      inflammatory sinus disease, especially before endoscopic surgical treatment, and
      in cases of postoperative recurrences. In routine CT studies, the radiation dose
      to the patient is not negligible. Therefore, the authors evaluated prospectively
      the CT scans of 44 patients with inflammatory disease of the paranasal sinuses,
      to define the imaging ability of low-dose CT (i.e. 60 mA-3 s, 30 mA-3 s, and 30
      mA-2 s), comparatively with the standard mAs settings (130 mA-3 s). In all cases,
      the exact extent of the disease was correctly assessed on each of the low-dose
      settings, with no false negative study. The increasing graininess of low mAs
      sections did not induce errors of interpretation, despite a less pleasant
      appearance to the eyes. In cases of extensive sinus disease, the thickness and
      integrity of the ethmoid septa were sometimes more difficult to evaluate on low
      dose CT sections. The authors recommend the use of low mAs settings in the
      evaluation of inflammatory disease of the sinuses, complemented, if necessary, in
      cases of extensive abnormalities, by one or two sections obtained with standard
      mAs settings, focused on questionably abnormal bone septa.

PMID- 1749470
TI  - Lumbar percutaneous discectomy. Initial experience in 28 cases.
AB  - Since November 1988, 28 patients with lumbar L5 radiculopathy refractory to
      conservative care and with a radiologically verified central or mediolateral disc
      herniation at the level of L4/L5 had had a percutaneous discectomy. Radiological
      verification consisted of spinal CT +/- myelography, +/- myelo-CT, +/- MRI. A
      short-term follow-up analysis of at least 2 months taking the clinical and
      functional status as well as the professional reintegration into account revealed
      a 64.3% (18/28 patients) satisfactory outcome and a 32.1% (10/28 patients)
      failure rate. Of the latter 28.6% (8/28 patients) required further open surgery.
      One patient whose pain had only partially in regressed was shown at open
      operation to have a sequestered cranial prolapse as revealed by spinal CT after
      the percutaneous procedure. There were no major complications. One patient
      developed a sequestered extraforaminal herniation through the nucleotomy canal
      three weeks after the procedure. One patient bled for 2 minutes. There were no
      major vessel injuries. One patient reported local muscular pain, and enhanced
      nerve root pain after introduction of the trocar sleeve.

PMID- 1749471
TI  - Theory and practice: how much contrast for myelography?
AB  - A questionnaire sent to members of the British Society of Neuroradiologists
      revealed that the majority of practitioners will, when necessary, inject more
      than 3 g of iodine during myelography with iohexol or iopamidol. The 3 g limit
      recommended by the contrast medium manufacturers is not based upon scientific
      studies involving these media, and it is the experience of British
      neuroradiologists that larger amounts of modern contrast agents can be used
      without an increase in post myelography complications. There is, therefore, a
      need for a controlled trial to assess the question of the most appropriate dose
      of contrast medium in myelography.

PMID- 1749472
TI  - CT of adult lumbar disc herniations mimicking posterior apophyseal ring
      fractures.
AB  - This report concerns 35 adult patients with lumbar or sciatic pain and axial CT
      findings reportedly associated with posterior apophyseal ring fractures. Review
      of the CT images suggested two pathophysiologic categories. (1) Posterior Schmorl
      -A posterior intravertebral disc herniation with posterior displacement of a
      fractured or remodelled vertebral margin. (2) Calcified subligamentous--Reactive
      annular and or posterior longitudinal ligament calcification at the periphery of
      a herniated disc with or without remodelling and anterior displacement of the
      posterior vertebral margin.

PMID- 1749473
TI  - Combined use of spin-echo and gradient-echo MR-imaging in cervical disk disease.
      Comparison with myelography and intraoperative findings.
AB  - In a prospective study we compared the diagnostic value of combined gradient-echo
      (GE) and spin-echo (SE) MR imaging with cervical myelography in 30 patients with
      clinical signs and symptoms of cervical radiculopathy and/or myelopathy due to
      disk disease. Only patients who subsequently underwent surgery (anterior
      interbody approach) were included. By means of MRI the clinically relevant
      segment was identified in all cases, by means of myelography in all but two
      patients. Using both spin-echo (SE) and gradient-echo (GE) techniques it was
      possible to differentiate between bone tissue and disk material by MR in all but
      one. It is concluded that MRI-especially gradient-echo imaging is a viable
      alternative to cervical myelography and can be considered as an initial
      diagnostic procedure for suspected cervical disk disease.

PMID- 1749474
TI  - Long term follow-up of diffuse idiopathic skeletal hyperostosis in the cervical
      spine. Analysis of progression of ossification.
AB  - In eleven patients with diffuse idiopathic skeletal hyperostosis who presented
      with extensive ossification in the cervical spine, progression or regression of
      ossification during the follow-up period were measured in extent and thickness
      radiographically. Intervertebral range of motion was also measured and the
      relation between changes of ossification and intervertebral mobility was
      analyzed. The range of motion at the segments at which ossification progressed
      was statistically quite different from those at which no progression was
      observed. It was found that ossification grew in thickness at mobile segments and
      no growth of ossification was present at immobile segments. Dysphagia caused by
      massive ossification was cured by surgical removal in two cases. Recurrent
      ossifications were detected in them some years after surgery, and one of them
      complained of dysphagia again. To prevent recurrent ossification and dysphagia,
      it was considered that immobilization of the concerned segment was necessary by
      bone grafting or preservation of the continuity of ossification.

PMID- 1749475
TI  - Visual toxicity following intra-arterial chemotherapy with hydroxyethyl-CNU in
      patients with malignant gliomas. A prospective study with statistical analysis.
AB  - We studied the effects of intra-arterial chemotherapy (IAC) with a new
      nitrosourea (hydroxyethyl-chloroethyl nitrosourea: HeCNU) on the visual system of
      68 patients with malignant gliomas. The intra-arterial chemotherapy was given as
      a complementary treatment of glioma after surgery (19 patients), after tumor
      recurrence (28 patients) and as the preliminary treatment before radiotherapy (21
      patients). Eleven patients (16%) suffered a visual complication after two or more
      courses of chemotherapy. The main visual symptoms included mild to major decrease
      of visual acuity and in some cases ocular pain, palpebral edema and conjunctival
      injection. The delay in onset of ocular symptoms from the last course of IAC
      varied from 1 week to 9 months. From ophthalmoscopic findings, visual field
      testing and fluorescein angiography, the visual symptoms presented by our
      patients could be related to ischemic optic neuropathy or retinal vasculopathy.
      None of the patients had hypertension, diabetes, cardiopathy or hematological
      disease. Statistical analysis failed to demonstrate a relationship between the
      occurrence of visual toxicity and patient age, number of courses of HeCNU, the
      vascular axis treated, total systemic dose or dose by carotid artery, suggesting
      a possible specific sensitivity of some patients to chemotherapy. The
      pathophysiology and the therapeutic implications of this visual toxicity are
      discussed.

PMID- 1749476
TI  - Computed tomography in Alexander's disease. An atypical case with extensive low
      density in both frontal lobes.

PMID- 1749477
TI  - Hajdu-Cheney syndrome: MR imaging.
AB  - Hajdu-Cheney syndrome is a rare congenital disease with acro-osteolysis,
      osteoporotic changes of the spine and long bones of extremities and marked
      basilar invagination with an unusually deformed skull. Magnetic resonance imaging
      of a 32-year-old male revealed the deformed skull and almost horizontal basal
      angle and the elongated and upwardly shifted brain stem caused by the tip of the
      odontoid process of the second cervical vertebra invaginating the base of the
      skull. In addition there were atrophic pituitary gland, widely open sella turcica
      and symmetrical fluid collections along the optic nerve sheath.

PMID- 1749478
TI  - Gd-DTPA-enhanced MR imaging of cryptococcal meningoencephalitis.
AB  - This report describes magnetic resonance (MR) imaging of biopsy-proved
      cryptococcal central nervous system (CNS) infection in a 31-year-old HIV negative
      man. Initial MR imaging revealed multi-focal Gd-DTPA enhancement and showed more
      lesions than contrast enhanced CT. The lesions regressed after antifungal
      therapy. MR imaging aids in diagnosis as well as helps to monitor the response to
      the pharmacological therapy of cryptococcal meningoencephalitis and possibly
      provides valuable insights into the pathophysiology of this condition.

PMID- 1749479
TI  - Medulloblastoma with extensive calcification.
AB  - Calcification in cases of medulloblastoma has been described with varying
      frequency (10%-15.4%) on computed tomographic (CT) scan. Usually these
      calcifications are small in size and speckled. The authors report a case of
      medulloblastoma with extensive calcification in the lateral hemisphere of the
      cerebellum in an 18-year-old boy.

PMID- 1749480
TI  - Massive ischemic cerebellar infarction due to cocaine use.
AB  - This young female suffered massive unilateral infarction of the cerebellum due to
      cocaine use. While cocaine-associated small, asymptomatic cerebellar infarcts
      have been reported in the literature, massive, symptomatic cerebellar infarction
      attending the use of cocaine has not been previously reported.

PMID- 1749481
TI  - Aneurysm of the lingual artery. Endovascular treatment.

PMID- 1749482
TI  - Bony exostosis of the atlas with resultant cranial nerve palsy.
AB  - A case of tenth and twelfth nerve compression secondary to a bony exostosis of
      the first cervical vertebra is described. This uncommon phenomenon serves to
      outline the importance of imaging the course of a cranial nerve when no
      intracranial abnormality is demonstrable on CT or MRI. The radiologic features of
      spinal osteochondromas are reviewed.

PMID- 1749483
TI  - MRI diagnosis of thoracic ossification of posterior longitudinal ligament with
      concomitant disc herniation.
AB  - Ossification of the posterior longitudinal ligament is a potentially curable
      cause of thoracic myelopathy. As this case illustrates, MRI can confirm the
      diagnosis, demonstrate other concomitant pathology such as disc herniation, and
      help assess the clinical significance of OPLL by showing spinal word compression.

PMID- 1749484
TI  - Capillary hemangioma in the cauda equina: neuroradiological findings.
AB  - A case of capillary hemangioma of the cauda equina is reported. Myelography with
      water-soluble contrast material showed a complete obstruction of the contrast
      column at the L1-L2 level. Neither plain nor intravenously enhanced CT revealed
      the tumor. Spinal angiography showed a feeding vessel to the tumor and a faint
      tumor stain. Magnetic resonance imaging (MRI) showed a mass lesion of slightly
      higher than cauda equina intensity, which was clearly enhanced with Gd-DTPA. MRI,
      especially Gd-DTPA-enhanced study, plays the most important role in the diagnosis
      of a spinal capillary hemangioma. Spinal angiography was interesting in showing a
      tumour with a capillary blush.

PMID- 1749485
TI  - Spinal epidural cavernous angioma. MRI finding.

PMID- 1749486
TI  - Posterior dislocation of the neural arch of L5 due to spondylolysis.

PMID- 1749487
TI  - Agenesis of a lumbar pedicle: MR demonstration.

PMID- 1749488
TI  - CT and MR of the sellar spine.

PMID- 1749489
TI  - Cerebral berry aneurysms and systemic lupus erythematosus.

PMID- 1749490
TI  - Snakebite management.

PMID- 1749491
TI  - Ballistics accuracy.

PMID- 1749492
TI  - Physical training.

PMID- 1749493
TI  - A philosophy of limb salvage in war: use of the fixateur externe.
AB  - Over the period 1973-1983, we treated by external fixation 110 severe grade three
      open or complicated fractures caused in war (minimum follow-up, 7 years). We
      present our data analyzed according to method, location, and type of fracture.
      The methods we have evolved over the years are described in detail: primary wound
      stabilization by fixateur externe; primary radical wound excision, repeated every
      48 hours as required, including excision of dead bone; delayed primary vascular
      soft tissue cover; delayed primary or secondary skeletal and soft tissue
      reconstruction as dictated by local wound conditions; prophylactic antibiotics
      and intensive physiotherapy to the joints and muscles of the injured limb and as
      rapid an ambulation of the patient as possible. The advantages and limitations of
      external fixation are enumerated. It is possible to avoid the complications of
      pin tract infection and ring necroses, but care is required to avoid refracture
      after removal of the apparatus, since the quality of bone healing is not always
      good with the use of external fixation. External fixation has greatly facilitated
      the various methods for achieving delayed primary vascular soft tissue cover over
      severe open fractures, bringing about an improved prognosis; micro-vascular
      techniques hold great promise for wound cover and skeletal reconstruction.
      Similarly, the Ilizarov method of bone osteotaxis has opened up new vistas in the
      treatment of bone mass loss. The latter requires a sophisticated set-up which
      will not be available in most war zones. In spite of the advances in treatment
      and in the improved results achieved by modern techniques of wound stabilization,
      wound soft tissue cover, and bone and soft tissue reconstructions, the temptation
      to try to salvage useless limbs must be resisted. Amputation, judiciously
      adjudged and correctly timed, remains one of the most successful forms of
      treatment in these severe injuries, saving the casualty from a physical and
      spiritual via dolorosa. Enthusiasm for surgical endeavor must be well tempered
      with mature judgment and realistic clinical acumen.

PMID- 1749494
TI  - Risk factors for infection in fracture war wounds (1973 and 1982 wars, Israel)
AB  - The development of post-surgical wound infection was compared in two groups of
      soldiers who sustained fractures or amputations on the battlefield during the
      first month of the 1982 and 1973 wars. Risk factors for the development of post
      surgical wound infection were sought. In the 1982 group, numbering 184, the four
      variables independently associated with infection were multiple operations during
      the follow-up period; drains inserted in the first operation; extensive tissue
      loss; and blood transfusion during the first operation. For the 1973 group,
      numbering 130, the significant variables were multiple operations; amputations
      (highly correlated with extensive tissue loss); injury involving other body
      systems in addition to the fracture; and open drains. The high risk associated
      with open drains in both wars raises doubt about their usefulness. The main
      distinction between injuries of the two wars was the high prevalence (72.3%) of
      multi-system injuries in 1973 versus low prevalence (29.2%) in 1982. Overall
      infection rates were similar (30.5% and 31.5%), but infections at the site of the
      fracture were twice as high in 1982. Pseudomonas was the most common single
      species of bacteria isolated from infected wounds (26% in 1982, 33.6% in 1973).
      It appeared in the wounds relatively late, 10-14 days after admission.

PMID- 1749495
TI  - Risk factors for stress fractures among Israeli infantry recruits.
AB  - In order to answer the question of why the stress fracture morbidity rates among
      Israeli infantry recruits are so high, we prospectively evaluated 392 infantry
      recruits for risk factors for stress fractures. Prior to training, each recruit
      underwent a detailed evaluation. Using multivariate analysis, five risk factors
      for tibial fractures were identified: shorter tibial length (p less than 0.0001);
      relatively greater valgus knee alignment (p less than 0.002); right leg dominance
      (p less than 0.02); external rotation of the hip greater than 65 degrees (p less
      than 0.02); and training in specific subunits (p less than 0.0002., 0.03). No
      risk factors for femoral stress fracture were found by multivariate analysis.

PMID- 1749496
TI  - Medical support of the Sinai Multinational Force and Observers: an update, 1990.
AB  - The Multinational Force and Observers in an 11-nation peacekeeping force
      established to monitor the 1979 Egyptian-Israeli Treaty of Peace. Provision of
      medical support for this force was the first employment of the U.S. Army Medical
      Department in an effort of this kind. This article is an update to "Medical
      Support of the Sinai Multinational Force and Observers, 1982," published in
      Military Medicine in October 1983. We compare the execution of medical support in
      1982 with that of 1990 and describe medical conditions and problems encountered
      during our tour.

PMID- 1749497
TI  - Field assessment of wet bulb globe temperature: present and future.

PMID- 1749498
TI  - An overview of physical fitness of female cadets at the military academies.

PMID- 1749499
TI  - Preventative mental health in disaster situations: "terror on the autobahn".
AB  - As part of Return of Forces to Germany 1990, a number of Second Armored Division
      soldiers participated in the heroic rescue of German and American civilians
      injured in a 32-vehicle crash on an autobahn in West Germany. Six people were
      killed and 18 others were seriously injured at the accident site. This paper (1)
      briefly reviews acute and chronic stress reactions; (2) describes the accident
      and rescue; (3) emphasizes specific risk factors for the rescuers; and (4)
      reviews specific preventative actions that were taken to minimize the risk of
      future psychologic morbidity in these individuals.

PMID- 1749500
TI  - A new look at disaster medical assistance teams.

PMID- 1749501
TI  - Total quality management and the Army health care system.
AB  - Total quality management (TQM) is the newest in a long line of magic formulas
      which have been touted as saviors for American industry and medicine. The author
      discusses the basic concepts of TQM and notes that much of it resembles
      philosophical beliefs long held by the medical community. TQM does offer many
      opportunities to refine old concepts and further those goals of quality care to
      which health care providers have always aspired. If, however, it becomes simply
      another codified bureaucracy, then a great deal of time and money will be
      invested for very little gain.

PMID- 1749502
TI  - Hodgkin's disease at William Beaumont Army Medical Center: survey of practice
      from 1985 to 1988.
AB  - We reviewed the records of all patients with a diagnosis of Hodgkin's disease
      from 1985 to 1988 at William Beaumont Army Medical Center. The clinical
      presentation, staging, time efficiency to diagnosis and treatment, and survival
      were analyzed.

PMID- 1749503
TI  - Surgical management of anorectal infection in the leukemic patient.
AB  - Anorectal infections are a common complication in immunocompromised patients.
      Such infections are multifactorial in etiology, often promoted by breaks in the
      anorectal mucosa and depressed leukocyte counts, both secondary to chemotherapy.
      Because of altered immune response to infection, diagnosis of anorectal
      infections in leukemic patients is often delayed, with a resultant mortality of
      up to 78%. Management is typically supportive for fears of extension of infection
      or non-healing of wounds with surgical intervention. We recently encountered a 17
      year-old woman who presented with an anorectal infection heralding the onset of
      acute nonlymphocytic leukemia. Because of her unusual presentation,
      chemotherapeutic induction occurred subsequent to surgical drainage of an
      anorectal abscess. She demonstrated adequate healing of her wounds in the early
      post-operative, post-induction period. Her case and a review of the current
      management of anorectal infections in patients with leukemia are presented.

PMID- 1749504
TI  - Effort thrombosis: recognition and management while underway.
AB  - Effort thrombosis of the axillary and subclavian veins is an uncommon cause of
      upper extremity swelling. Prompt recognition and treatment of this disorder is
      important in order to minimize the complications of pulmonary embolism and
      postphlebitic syndrome that can occur with this condition. This can be very
      challenging while underway or in the field. A sailor who developed effort vein
      thrombosis while underway on board the aircraft carrier USS Abraham Lincoln is
      presented to review the presentation and management of this disorder,
      particularly as it applies to active duty military personnel.

PMID- 1749505
TI  - Charcot foot osteoarthropathy in diabetes mellitus.
AB  - Charcot joint, a destructive bone and joint disorder of the foot, is becoming
      more common in long-term diabetic patients. The combination of diabetic
      neuropathy and painless trauma causes dislocation and collapse of the tarsal
      joints. The resulting soft tissue and osseous pathology easily mimics an
      infective episode. This report presents a review of the clinical identification,
      diagnosis, and treatment of this unusual diabetic complication, plus a review of
      three cases. Also, the pathogenesis of Charcot joint is explained in describing
      why surgery can be a viable treatment alternative in these patients, after
      careful evaluation. It is also necessary that physicians inspect the feet of
      their diabetic patients to rule out quiescent beginnings of Charcot joints.
      Referral to a podiatrist is recommended for long-term management of the Charcot
      foot.

PMID- 1749506
TI  - Casualty radiology with lightweight X-ray machine.
AB  - A small lightweight X-ray machine is needed for use in military medicine for
      humanitarian service missions, training exercises, and even tactical situations.
      In such circumstances, the large size and great weight of conventional X-ray
      equipment limit its use and make this diagnostic modality unsuitable. I have used
      a small lightweight X-ray machine and obtained adequate X-ray exams in a high
      percentage of patients.

PMID- 1749507
TI  - Simulator sickness provoked by a human centrifuge.
AB  - Simulator sickness is now a well-recognized entity. It is recognized as a form of
      motion sickness, having a higher incidence in the more sophisticated simulators.
      Human centrifuges (dynamic simulators) are the newest innovation in aircrew
      training devices. Simulator sickness has never been reported in human
      centrifuges. We are reporting on a case of delayed simulator sickness in a pilot
      subject after a centrifuge experience. A review of the "psycho-physiological"
      problems routinely experienced by subjects on human centrifuges indicates such
      problems are due to simulator sickness, although they are not reported as such.
      In this paper, we give a brief overview of simulator sickness and briefly discuss
      simulator sickness, as related to the human centrifuge experience.

PMID- 1749508
TI  - Immunomodulators: a key to controlling infections in military personnel?

PMID- 1749509
TI  - Sulfated glycoprotein-2 (SGP-2) mRNA is expressed in rat striatal astrocytes
      following ibotenic acid lesions.
AB  - A combination of in situ hybridization and immunocytochemistry (ICC) was used to
      identify the cells that contained mRNA for sulfated glycoprotein-2 (SGP-2) in
      adult male rats after striatal ibotenic acid (IA) lesioning. Astrocytic responses
      were monitored by ICC for glial fibrillary acidic protein (GFAP). IA lesioning
      that caused death of striatal neurons also stimulated astrocytic responses as
      monitored by GFAP and SGP-2. The SGP-2 immunoreactivity showed punctate deposits
      in the lesioned striatum without any apparent cellular localization. By in situ
      hybridization combined with ICC, SGP-2 mRNA was localized in astrocytes that were
      GFAP-immunopositive. These data suggest that reactive astrocytes may express SGP
      2 which may be eventually secreted.

PMID- 1749510
TI  - A fractal analysis of pyramidal neurons in mammalian motor cortex.
AB  - Pyramidal neurons in the mammalian cerebral cortex can be described by a fractal
      dimension (Mandelbrot, 1982), which is an objective, quantitative measure of the
      complexity of their soma/dendritic borders. In the cat, the fractal dimensions of
      lamina V cells, which include pyramidal tract neurons (PTN), indicate that these
      cells are more complex than other pyramidal neurons (PN) in the same region of
      motor cortex. The lamina V cells of the cat are also more complex than those in
      motor cortex of the monkey. Moreover, lamina III neurons in the monkey are more
      complex than monkey lamina V neurons. The fractal dimension of the intracortical
      axon collateral arborizations of the same pyramidal neurons indicated, in all
      cases, that the branching of these terminals is less complex than the branching
      of the dendrites of the same cells. In line with the observation that the fractal
      dimensions of some homologous cellular populations are different in different
      species, it is suggested that the fractal dimension and the degree of
      morphological complexity may relate to the requirement for the number of
      separable functions to be accommodated within one neuron. For example, as the
      size of the cortex and the number of neurons in a region increase, the
      opportunity exists within a given cortical zone, for individual functions to be
      segregated and for functional specialization to be accommodated with less
      morphological complexity of the individual neurons performing each of these
      functions.

PMID- 1749512
TI  - Membrane bilayer instability and the pathogenesis of disorders of myelin.
AB  - We have previously shown that total lipid extracts from normal nervous tissues
      spontaneously form a structure in vitro resembling the cell membrane bilayer, but
      only at a critical temperature, T*, equal to the 'physiological' temperature of
      the original tissues. In the present study, we found T* for normal human myelin
      lipids was 37 degrees C, in agreement with the concept that lipid metabolic pools
      maintain a critical composition in vivo which permits spontaneous formation of
      the (myelin) membrane bilayer at normal body temperature. But T* for myelin
      lipids from a patient with metachromatic leukodystrophy was less than 30 degrees
      C. Thus, myelin lipid composition was inappropriate for normal bilayer stability
      at this patient's core temperature, suggesting a mechanism whereby defective
      lipid metabolism in this disease could produce pathological myelin. The shift in
      T* in this patient was unlikely to be simply secondary to myelin destruction, as
      myelin lipids from a patient with advanced multiple sclerosis yielded a normal
      value for T* of 37 degrees C, even when extracted from areas of extensive
      demyelination.

PMID- 1749511
TI  - NGF restores decrease in catalase and increases glutathione peroxidase activity
      in the brain of aged rats.
AB  - The effects of subchronic administration of nerve growth factor (NGF) into the
      lateral ventricle on catalase and selenium-dependent glutathione-peroxidase (GSH
      Px) activity in several areas of the brain in 3-, 12- and 24-month-old rats were
      studied. NGF given daily (1 microgram for 28 consecutive days) produced in all
      brain areas studied a significant increase in catalase activity in 12- and 24
      month-old rats. The most important finding was a complete restoration in 12- and
      24-month-old rats of catalase activity to levels similar to those occurring in
      young (3-month-old) rats. In addition, NGF produced in comparison to 3-month-old
      rats and to same age vehicle-treated rats a significant increase in selenium
      dependent GSH-Px in all the brain areas studied in 12- and 24-month-old animals,
      whereas selenium-independent GSH-Px was unaffected. In conclusion, the present
      results show that long-term administration of NGF into the lateral ventricle
      significantly increases in old animals the activity of key enzymes involved in
      the metabolic degradation of hydrogen peroxide.

PMID- 1749513
TI  - Activation of spinal neurons by afferent fibers in the ventral roots of rats.
AB  - The present investigation was aimed to search for spinal neurons which are
      activated by afferent fibers in the ventral roots, and once found, to study their
      receptive field and rostral projection. After dorsal roots L1-S4 on the left side
      were cut, ventral roots were stimulated to record extracellular responses of the
      neurons using glass microelectrodes filled with Fast green FCF. Thirty-nine
      neurons were activated by stimulating ventral roots at 2.5-26.7 x threshold (T)
      of the lowest threshold fibers of the ventral root. Six neurons were classified
      as wide dynamic range neurons and 16 high threshold neurons according to their
      response patterns to the periphery. Seventeen neurons were unresponsive to
      cutaneous stimulation, suggesting they had innervated visceral organs. Most of
      the neurons (71%) were located in layer V and VI. In 7 neurons (18%), rostral
      projection was confirmed by collision block method and ability to respond to high
      frequency stimuli with constant latency.

PMID- 1749514
TI  - Influence of oxygen availability on the neurotoxic effect of 6-hydroxydopamine on
      nigro-striatal dopaminergic neurons.
AB  - The neurotoxin 6-hydroxydopamine (6-OHDA) was intracerebroventricularly injected
      (50 micrograms per mouse) in mice submitted to various oxygenation conditions and
      the striatal levels of dopamine (DA) and its metabolites were determined by HPLC
      7 days later. In normoxic conditions the striatal depletion in DA reached 50%.
      This effect was not modified by a normobaric hypoxia (10% O2) applied 30 min
      before and 30 min after the 6-OHDA injection. On the contrary, the neurotoxic
      effect was reduced when the hypoxia was prolonged up to 11 h after the drug
      administration. When a normobaric hyperoxia (60% O2) was applied 30 min before
      and 11 h after the 6-OHDA injection, the neurotoxic effects of the latter were
      not modified. These data, as well as other results obtained from ex vivo
      experiments showing that normobaric hypoxia or hyperoxia did not modify the
      striatal synaptosomal [3H]DA uptake, indicate that oxygen availability does not
      exert a critical influence on the efficiency of the neuronal dopamine uptake
      complex.

PMID- 1749515
TI  - Carbachol microinjections in the mediodorsal pontine tegmentum are unable to
      induce paradoxical sleep after caudal pontine and prebulbar transections in the
      cat.
AB  - In 7 cats, total transections of the brainstem at the caudal pontine or the
      prebulbar level led to preparations which presented neither behavioral nor
      electrophysiological signs of paradoxical sleep (PS) throughout their survival
      periods (17-30 days). Carbachol microinjections in the mediodorsal pontine
      tegmentum (MDPT), which induced PS in the intact cat, were no longer able to
      induce it in the transected animals. Rapid eye movement (REM) and pontogeniculo
      occipital (PGO)-like bursts were evoked by carbachol microinjections in the
      pontine magnocellular tegmental field (FTM) of cats transected at the prebulbar
      level, as in the intact cat. Only REM bursts were obtained by the same injections
      in caudal pontine transected cats. It is concluded that (1) the pons is
      insufficient to generate PS; (2) complex reciprocal interactions with the medulla
      are necessary for the generation of this state of sleep; and (3) the production
      of long REM and PGO bursts is controlled by the caudal pontine tegmentum.

PMID- 1749516
TI  - Effect of ketone body (D-3-hydroxybutyrate) on neural activity and energy
      metabolism in hippocampal slices of the adult guinea pig.
AB  - The role of ketone body on neural activity and energy metabolism in the brain was
      investigated. Guinea pig hippocampal slices were prepared, and postsynaptic field
      potentials (PSPs) were recorded in the granular cell layer of the dentate gyrus.
      ATP and phosphocreatine (CrP) in the tissue slice were measured after 60 and 120
      min incubation in standard medium (1) with 10 mM glucose, (2) with 10 mM glucose
      plus 20 mM D,L-3-hydroxybutyrate (3-OHBA), (3) without glucose, (4) with 20 mM 3
      OHBA instead of 10 mM glucose. In (3), both ATP and CrP in the slice decreased to
      40-45% of the original level after 120 min. On the other hand, the ATP level was
      well maintained even 120 min after incubation in (1), (2) and (4), whereas the
      CrP level decreased to 62% in (4). Further, slices were incubated in (3) and (4)
      for 30, 60, and 120 min, and the presence of PSP was tested. In (3), the number
      of slices from which PSPs could be recorded decreased, and after 120 min PSPs
      were hardly observed. In (4), that number decreased gradually, and only 45% of
      the slices showed PSPs after 120 min. These results indicate that 3-OHBA can be a
      substrate to produce high-energy phosphate but cannot maintain the neural
      activity as glucose does.

PMID- 1749517
TI  - Alteration of second messenger systems after transient cerebral ischemia in
      gerbils: protective effect of pentobarbital and an autoradiographic analysis.
AB  - The postischemic alteration of second messenger systems in the gerbil brain was
      analyzed by receptor autoradiography using [3H]phorbol 12,13-dibutyrate (PDBu)
      and [3H]inositol 1,4,5-trisphosphate (IP3). The alteration of the [3H]PDBu
      binding in striatum and hippocampus was milder than that of the [3H]IP3 binding 5
      h and 7 days after 10-min ischemia. The administration of pentobarbital prevented
      a decrease in the [3H]IP3 binding sites in all areas 5 h and 7 days after
      ischemia. These results suggest that the disruption of intracellular calcium
      homeostasis may play an important factor in ischemic brain damage.

PMID- 1749518
TI  - Phosphorylation of pyruvate dehydrogenase in the hippocampal slice: time course
      of response to cellular depolarization.
AB  - In the rat hippocampal slice, we evaluated the effects of potassium
      depolarization on phosphorylation of the alpha subunit of the pyruvate
      dehydrogenase complex (E1 alpha, mol. wt. approximately 41 kDa) using an in vitro
      back-titration assay. The in vitro back-titration phosphorylation of El alpha was
      maximal following 30 s of depolarization and remained elevated for up to 3 min
      following termination of the depolarizing pulse. Possible significance of and
      mechanisms for the depolarization-induced changes in E1 alpha phosphorylation are
      discussed.

PMID- 1749519
TI  - Reversible decrease of fluoride resistant acid phosphatase-positive neurons after
      herpes simplex virus infection.
AB  - Herpes simplex virus (HSV) frequently infects human sensory ganglion neurons, and
      similar infections have been reported in experimental animals. Reported here is
      an investigation of in vivo neuronal function after HSV infection. It was
      observed that the proportion of fluoride resistant acid phosphatase (FRAP)
      positive trigeminal ganglion neurons was decreased for several months after
      experimental infection of mice, and it is suggested that other neuronal functions
      may also be altered by HSV.

PMID- 1749520
TI  - Short biotinylated oligonucleotides bind non-specifically to senile plaques of
      Alzheimer's disease.
AB  - We have used in situ hybridization with biotinylated oligonucleotide (antisense)
      probes and streptavidin-biotinylated alkaline phosphatase method to detect the
      amount of amyloid beta-protein mRNA in the paraffin-embedded and formalin-fixed
      brain samples of patients affected by Alzheimer's disease and those of non
      affected controls. Instead of the expected specific binding to neuronal
      cytoplasm, the probes did constantly bind to neuritic senile plaques, the
      strongest binding being found in the hippocampus and the cerebral cortex. We have
      been able to constantly repeat this peculiar phenomenon with other (30-mer)
      oligonucleotide probes, e.g. the sense probes for beta-amyloid protein and those
      specific for human papillomavirus (HPV) 18- and c-erb B-2 mRNAs. Replacing the
      probe with water as a negative control lead to abolishment of the colour
      reaction, thus excluding the possibility of the non-specific staining being due
      to the detection system. This confirms that the oligonucleotide probe is
      essential for this binding phenomenon.

PMID- 1749521
TI  - Is balance or posture at the end of a voluntary movement programmed?
AB  - Two leg movements, differing only by the final balance conditions, were analysed
      to determine whether the final body posture or the equilibrium were taken into
      account by the motor programming. The test movement was a flexion-extension of a
      lower limb executed at maximal velocity. The initial body posture was bipedal,
      while the final one was either bipedal or unipedal. The biomechanical and
      electromyographic data showed significant differences between parameters of the
      two movements. The results indicate that the final body equilibrium is the major
      parameter controlled.

PMID- 1749523
TI  - License suspension.

PMID- 1749522
TI  - Retinal lesion by bright artificial light increases vasoactive intestinal
      polypeptide in the rat ventral tegmental area/substantia nigra.
AB  - Sprague-Dawley rats were treated with bright light to induce retinal lesions and
      vasoactive intestinal polypeptide in the ventral tegmental area/substantia nigra
      was measured by radioimmunoassay. In Sprague-Dawley rats, but not in Brown Norway
      rats where light did not induce retinal lesions, significantly increased
      concentrations of vasoactive intestinal polypeptide were found 21 days after
      exposure with bright light. This increase declined to control values 60 days
      after the treatment. Our studies indicate that vasoactive intestinal polypeptide
      may be involved in visual neurotransmission and that the ventral tegmental
      area/substantia nigra may be connected to retinal input.

PMID- 1749524
TI  - The study of cancer in minorities.
AB  - Data inventories provide a concise reference base for researchers. The authors
      created a set of reference volumes listing databases used for studying cancer in
      New Jersey minorities. The process followed can be adapted for other disease
      outcomes or other regions.

PMID- 1749525
TI  - Tonsillar polypoid lymphangioma in a small child.
AB  - The authors report a case of an unusual tonsillar polypoid lymphangioma in a
      three-year-old child. A discussion of the possible mechanisms of its pathogenesis
      is included, as well as a review of the literature of benign lymphangiomatous
      tonsillar lesions.

PMID- 1749526
TI  - Prostatic cancer: the case for conservatism.
AB  - Carcinoma of the prostate is the most common malignancy in men. It is the second
      leading cause of cancer deaths in men, with a five-year survival rate of 72
      percent. One asks, "Is the cure necessary in those in whom it may be possible? Is
      cure possible in those whom it may be necessary?"

PMID- 1749527
TI  - Diet, nutrition and the prevention of chronic diseases. A report of the WHO Study
      Group on Diet, Nutrition and Prevention of Noncommunicable Diseases.

PMID- 1749528
TI  - The osteocalcin gene promoter: stimulated by vitamins A and D, inhibited by cell
      growth factors Jun-Fos.
AB  - The gene of the bone protein osteocalcin has a promoter region recognized by the
      receptors for 1,25-dihydroxyvitamin D3 and retinoic acid, both of which stimulate
      transcription. Unexpectedly, this same gene element interacts with the cell
      proliferation factors Jun-Fos, which inhibit osteocalcin gene transcription.

PMID- 1749529
TI  - Iatrogenic liver disease from vitamin A.
AB  - In a retrospective case series, 41 patients developed severe liver disease after
      prolonged administration of vitamin A originally recommended for the treatment of
      medically benign conditions, mostly dermatologic. Six patients died of liver
      failure during follow-up.

PMID- 1749530
TI  - Behavioral consequences of pyridoxine deficiency in mothers and infants.
AB  - Maternal vitamin B6 status correlates birth weight with infant behavior and
      maternal infant interactions.

PMID- 1749531
TI  - Folate deficiency and pregnancy outcome.
AB  - The degree of folate deficiency can be manipulated in rats by the extent of
      exposure to a deficient diet. In turn, this can affect pregnancy outcome and
      neonatal health.

PMID- 1749532
TI  - Lowering cholesterol with diet and lovastatin.
AB  - The addition of lovastatin to a high- and a low-fat diet produces a comparable
      percentage improvement in plasma lipoprotein profiles. However, lower absolute
      lipid and lipoprotein levels are achieved by adherence to a low-fat diet.

PMID- 1749533
TI  - A short course of intravenous nutrition in inflammatory bowel disease improves
      respiratory and skeletal muscle function.
AB  - In malnourished patients hospitalized because of acute exacerbations of
      inflammatory bowel disease, a brief course of intravenous nutrition can restore
      skeletal and respiratory muscle function even before body protein has been
      repleted.

PMID- 1749534
TI  - New insights on prolactin function.
AB  - A new rat model for the study of hyperprolactinemia has been developed by
      subcutaneous injection of a prolactin-secreting pituitary tumor cell line.
      Hyperprolactinemia caused excess urinary calcium. Bone loss in this animal model
      may be associated with suppressed calcium levels or an effect of prolactin on
      renal calcium reabsorption.

PMID- 1749535
TI  - Nutritional resilience in a hostile environment: positive deviance in child
      nutrition.
AB  - The term "positive deviance" applies to the study of children who demonstrate
      above-average growth in impoverished environments. Favorable values on known
      malnutrition correlates and attentive child care characterize positive deviants.
      Best-growing children do not necessarily mirror the malnourished; for example,
      best- and worst-nourished infants may both get more breast-milk substitutes than
      middle growers. Positive deviants receive more high-quality foods, physical
      interaction, affection and praise, and verbal and environmental stimulation.
      Factors that influence child growth through care quality also predict cognitive
      development, health, and social adjustment. They include: the type of society;
      parental education, mental health, initiative, and work burden; family and
      community structure; and the value of children to parents. Feeding practices
      related to growth include: permitting the child to control the length of feeding,
      encouraging eating while avoiding a power struggle, actively spoon- or hand
      feeding, not displacing appetite by giving frequent sweets, and timely
      introduction of appropriate foods.

PMID- 1749536
TI  - The American Journal of Clinical Nutrition, Volume 25, 1972: Influence of
      recurrent infections on nutrition and growth of children in Guatemala.

PMID- 1749537
TI  - United States Nutrition Labeling and Education Act of 1990.

PMID- 1749538
TI  - Different effects of dietary saturated fatty acids on cholesterol metabolism in
      nonhuman primates.
AB  - Dietary saturated fatty acids did not act alike in their effect on plasma
      cholesterol concentrations in non-human primates. Palmitic acid was less
      hypercholesterolemic than lauric plus myristic acids. Myristic appeared to be a
      greater offender than lauric.

PMID- 1749539
TI  - Energy intake restriction and oxidant defense.
AB  - Caloric restriction alters the expression of genes in rat liver that code for
      oxidant defense enzymes. Dietary restriction also reduces ethane production, an
      index of in vivo lipid peroxidation.

PMID- 1749540
TI  - All-trans and 13-cis-retinoic acids are normal constituents of human blood formed
      from all-trans-retinyl palmitate.
AB  - All-trans and 13-cis-retinoic acids are normal constituents of human blood. Blood
      levels of both compounds increase upon oral ingestion of all-trans-retinyl
      palmitate, to a greater extent with higher amounts of ingested retinyl palmitate.
      These data suggest a mechanism whereby levels of dietary vitamin A could
      influence blood levels of the known cancer chemopreventive retinoic acids.

PMID- 1749541
TI  - Folate deficiency, parenteral caffeine, and cytogenetic damage in mice.
AB  - Chromosomal damage can be detected in bone marrow or peripheral red blood cells
      in the form of micronuclei. In mice, folate deficiency increased the frequency of
      micronuclei in erythrocytes. Intraperitoneal caffeine administration, in the
      setting of folate deficiency, increased the risk of cytogenetic damage in
      rodents.

PMID- 1749542
TI  - The influence of tea on iron and aluminum bioavailability in the rat.
AB  - The aluminum from tea or tea leaves was very poorly absorbed by young, growing
      rats. Tea had a decidedly adverse effect on the animals' iron status.

PMID- 1749543
TI  - Keep potassium chloride off your unit.

PMID- 1749544
TI  - My most treasured Christmas gift.

PMID- 1749545
TI  - H.I.V.-positive nurse tells her story.

PMID- 1749546
TI  - Obstructed airway with wired jaws.

PMID- 1749547
TI  - Protecting yourself from allegations of nursing negligence.

PMID- 1749548
TI  - Pain control a top priority.

PMID- 1749549
TI  - The doctor was wrong.

PMID- 1749550
TI  - How much do you know about laboratory studies?

PMID- 1749551
TI  - Sandra was a rebellious teenager in a wheelchair.

PMID- 1749552
TI  - New drugs.

PMID- 1749553
TI  - Hypomagnesemia correction.

PMID- 1749554
TI  - Nurs/patient ratio too high.

PMID- 1749555
TI  - Shedding light on i.v. therapy.

PMID- 1749556
TI  - Keeping hope alive.

PMID- 1749557
TI  - Dealing with a hidden hazard: M.R.S.A.--methicillin-resistant Staphylococcus
      aureus.

PMID- 1749558
TI  - Using an aquathermia pad safely.

PMID- 1749559
TI  - My applesauce lady.

PMID- 1749561
TI  - Are you a good follower?

PMID- 1749560
TI  - Managing the patient with diabetes.

PMID- 1749562
TI  - Breathe new life into your career.

PMID- 1749563
TI  - Abstracts of the fifteenth annual meeting of the Japan Neuroscience Society,
      Tokyo, Japan, December 17-19, 1991.

PMID- 1749564
TI  - AIDS and the ADA.

PMID- 1749565
TI  - The changing face of dental students.
AB  - Today's dental students are more diverse than typical. What they have in common,
      however, is a desire for independence and stability in an increasingly more
      complex profession.

PMID- 1749566
TI  - Papillon-Lefevre syndrome.
AB  - Papillon-Lefevre syndrome is a particularly devastating disease that eludes all
      forms of therapy. It challenges researchers to find a connection between the
      dermatologic aspects of the disease and the severe periodontosis resulting in an
      edentulous patient in just a few years.

PMID- 1749567
TI  - Dentistry is making a career comeback.
AB  - Technology took some of the bloom off dentistry as a career choice. Ironically,
      it's the same force that has given new status to the profession and made
      dentistry the career of the future.

PMID- 1749568
TI  - The dental assistant. The case for recognition.

PMID- 1749569
TI  - Restorative needs and pathological findings in northern Manhattan dentate
      community.
AB  - When determining the dental health of the population, radiographic findings
      cannot be omitted. Nor should large groups of people be left out as this affects
      the results significantly.

PMID- 1749570
TI  - Dentists and pharmacy law.

PMID- 1749571
TI  - New health department policy supports DSSNY position.

PMID- 1749573
TI  - Medicaid Search Committee formed.

PMID- 1749572
TI  - First district office is target of takeover.

PMID- 1749574
TI  - The future of science and medicine.

PMID- 1749575
TI  - U.S. Senate adds AIDS amendments.

PMID- 1749576
TI  - 10 years of AIDS in Ohio.

PMID- 1749577
TI  - Physician responsibilities under new living will law.

PMID- 1749578
TI  - Tissot's twist in taste.

PMID- 1749579
TI  - Clinical results with the pineal hormone melatonin in advanced cancer resistant
      to standard antitumor therapies.
AB  - The pineal hormone melatonin (MLT) is able to exert an oncostatic action. Its
      possible use in the treatment of human tumors, however, has not yet been
      investigated. The present study was carried out to evaluate the effects of MLT in
      patients with metastatic solid tumors resistant to conventional therapies. The
      study included 54 patients, most of them were affected by lung cancer or
      colorectal carcinoma. MLT was given intramuscularly at a daily dose of 20 mg at
      3.00 p.m. for 2 months; this induction phase was followed by a maintenance period
      at a dose of 10 mg orally in responder patients or in those with an improvement
      in performance status (PS). The clinical response was as follows: 1 partial
      response (cancer of pancreas), 2 minor responses (colon cancer and
      hepatocarcinoma) and 21 with stable disease. The remaining 30 patients rapidly
      progressed within the first 2 months of therapy. An evident improvement in PS was
      achieved in 18 of 54 (33%) cases. These results, by showing an apparent control
      of the neoplastic growth and an improvement in the quality of life in a
      reasonable number of cancer patients for whom no other standard therapy is
      available, would justify further clinical trials to better define the impact of
      MLT therapy on the survival and quality of life of untreatable advanced cancer
      patients.

PMID- 1749580
TI  - Treatment of myelodysplastic syndromes with orally administered 1-beta-D
      arabinofuranosylcytosine-5'-stearylphosphate.
AB  - 1-beta-D-Arabinofuranosylcytosine-5'-stearylphosphate (fosteabine) was
      administered orally to patients with myelodysplastic syndromes (MDS); refractory
      anemia with excess of blasts (RAEB), RAEB in transformation, acute leukemia
      derived from RAEB and chronic myelomonocytic leukemia, in an early phase II study
      in a multi-institutional study. Among 62 evaluable patients, 2 patients achieved
      a complete remission, 6 a good response and 8 partial response by daily oral
      administration of 100-200 mg of fosteabine. The overall response rate was 25.8%.
      The response rates were almost the same among the four subtypes of MDS. Responses
      were reached 2-23 weeks (median, 8 weeks) after the start of therapy and
      continued for 3-50 weeks (median, 10 weeks). Major side effects were
      myelosuppression and gastrointestinal toxicities. In spite of the disadvantages,
      such as unpredictable absorption, this newly developed orally administrable
      cytarabine analogue will be a useful drug in the treatment of MDS.

PMID- 1749581
TI  - Treatment of resistant Hodgkin's disease with CCNU, etoposide and prednimustine
      (CEP).
AB  - Starting in January 1984, 63 patients with resistant Hodgkin's disease received
      CEP as salvage-usually third-line-chemotherapy. Complete response (CR) was
      achieved in 3%, partial response (PR) in 51%. The median duration of remission
      (CR + PR) was greater than 15 months. Treatment was generally well tolerated. Our
      results confirm that CEP is an effective therapeutic regimen in resistant
      Hodgkin's disease.

PMID- 1749582
TI  - Ifosfamide, methotrexate and 5-fluorouracil for pretreated advanced breast
      cancer.
AB  - A total of 51 fully evaluable patients with advanced and intensively pretreated
      breast cancer were treated with a combination chemotherapy of ifosfamide plus
      mesna, methotrexate and 5-fluorouracil. All patients had received at least one
      series of combined chemotherapy, 30 patients had received more than one
      combination and 41 patients had had anthracyclines before. Metastatic lesions in
      more than one site were found in 42 patients, and 24 patients had metastatic
      liver lesions. Partial remission was achieved in 10 patients (20%) and no change
      in 16 patients (31%). Survival was almost identical in both groups of responding
      patients and significantly shorter in treatment failures. Response was favorable
      in patients without pretreatment with anthracyclines. Two patients who received
      this protocol directly after progression with cyclophosphamide, methotrexate and
      5-fluorouracil (CMF protocol) responded with a partial remission. Median time to
      progression was 7 months for partial responders and 4.5 months for patients
      achieving a no-change status. Median survival was 8 months for all patients.
      Toxicity was tolerable. Leukocytopenia and thrombocytopenia were treatment
      limiting parameters. Overall, this protocol is well tolerable and effective in
      breast cancer patients with advanced disease and in intensively pretreated
      patients.

PMID- 1749583
TI  - Immunologic changes in renal cell carcinoma patients receiving gamma interferon.
AB  - Immunologic changes were monitored in 5 patients with metastatic renal cell
      carcinoma participating in a phase II trial of recombinant interferon gamma (rIFN
      gamma). Treatment consisted of a 4-week period of intravenous infusion of either
      0.1 mg/m2 given over 4 h on alternate days (3 times/week) or 2 mg/m2 given over 1
      h for 5 days every other week. One minor response was seen at the higher dose
      level and toxicity was minimal (grades I-II). Absolute leukocyte counts and
      lymphocyte subpopulations did not change significantly. Both natural killer
      cytolytic activity and spontaneous monocyte-mediated tumoricidal activity
      increased. Prostaglandin E2 synthesis of patient leukocytes was abnormally high
      and pretreatment levels dropped during treatment. Data suggest that rIFN gamma
      may be potentially useful for enhancing immunologic function in renal cell
      carcinoma.

PMID- 1749584
TI  - Modulation of methotrexate cytotoxicity with natural interferon upon human
      leukemia cell line HL-60.
AB  - The effect of alpha- and gamma-interferon on methotrexate cytotoxicity against
      human promyelocytic cell line HL-60 has been evaluated. Synergistic inhibition of
      proliferation is observed with the combination of methotrexate and gamma
      interferon. Enhanced cytotoxic effect of methotrexate with alpha- or gamma
      interferon is removed by adding thymidine to the growth medium. The depletion of
      folate pools caused by methotrexate is enhanced in presence of interferons, this
      depletion is also removed by adding thymidine to the growth media.
      Synchronization of HL-60 cells in 'S' phase of cell cycle caused by methotrexate
      is enhanced in the presence of interferons. These results suggest that specially
      gamma-interferon changes the cellular environment of HL-60 cells in such a way as
      to make methotrexate more potent cytotoxic agent to HL-60 cells causing cell
      death. This study also clearly indicates the biochemical role of thymidine in
      modulating the activity of methotrexate in combination with interferons.

PMID- 1749585
TI  - Protective effect of elastase on cis-platinum-induced renal toxicity.
AB  - The protective effects of elastase (Ela) and fosfomycin against renal toxicity of
      cis-diamminedichloroplatinum (II) (CDDP) were evaluated in an experimental study
      using rats. When Ela was used concomitantly with CDDP, the elevation of urinary N
      acetyl-beta-D-glucosaminidase levels in the early phase and the sharp fall in
      these levels in the latter phase were prevented. It was also found that the blood
      urea nitrogen levels and serum creatinine levels were significantly lowered.
      Histologically, atrophic and necrotic changes in the tubular epithelium were
      prevented. The total serum platinum levels showed no change with the addition of
      Ela; however, the platinum levels in the renal tissues were significantly
      reduced. These results suggested that Ela is effective against platinum deposits
      in the renal tissues, particularly in the tubular epithelium, thus protecting the
      kidneys. On the other hand, fosfomycin demonstrated no such positive results
      suggestive of a protective effect on the renal function parameters or during
      histological observation.

PMID- 1749586
TI  - Nasopharyngeal carcinoma: role of marrow biopsy at diagnosis.
AB  - Twenty-seven new patients with advanced nasopharyngeal carcinoma were evaluated
      by marrow biopsy at diagnosis. The marrow trephines and blood clots were
      evaluated by morphology and immunohistochemical studies for cytokeratin and found
      negative in all cases. The median follow-up of this group of 27 patients was 22
      months, and 7 of them had relapsed in the skeletal system. We conclude, in view
      of its poor sensitivity, that routine use of marrow biopsy for the staging of
      nasopharyngeal carcinoma is not recommended.

PMID- 1749587
TI  - Follicular cancer of the thyroid gland.
AB  - Between 1965 and 1987 the authors studied the survival of 169 patients (130
      females, 39 males) suffering from follicular thyroid cancer. It is established
      that the factors favorably influencing the course of the disease are as follows:
      age below 40 years, female sex, tumor location inside the thyroid capsule.
      Radical surgery does not affect the survival, though it prolongs the time to the
      onset of metastases. In women below 40 years of age, iodine treatment performed
      within 1.5 months following surgery does not increase the effectiveness;
      therefore, its routine application is not recommended. In case of local
      metastases associated with hindered swallowing or respiration, external beam
      radiotherapy is indicated. Hormone substitution ensuring TSH restriction results
      in improved prognosis.

PMID- 1749588
TI  - Diet and urine estrogens among postmenopausal women.
AB  - Creatinine-adjusted levels of estrone, estradiol and estriol were determined in
      overnight urine specimens from 88 postmenopausal women from Athens, Greece, and
      were correlated with daily nutrient intakes estimated through a semiquantitative
      food frequency questionnaire. Although obesity was positively and significantly
      related to all three urinary estrogens and their total, none of the investigated
      macro- or micronutrients was significantly or suggestively associated to any of
      these urinary estrogens, after controlling for energy intake, reproductive and
      biosocial variables. These results suggest that quantitative rather than
      qualitative aspects of nutrition affect the levels of postmenopausal estrogens,
      although endogenous factors could also be responsible for the association of
      these estrogens with obesity. Alcohol intake was also positively associated with
      urinary estrogens (mainly estrone and estradiol), after controlling for energy
      intake, obesity and the other indicated variables.

PMID- 1749589
TI  - Reticulum cell sarcoma: two complete 'spontaneous' regressions, in response to
      high-dose ascorbic acid therapy. A report on subsequent progress.
AB  - In 1975, we reported the remarkable case of a 42-year-old man with histologically
      proven widely disseminated reticulum cell sarcoma who, in a remarkably short
      time, appeared to enjoy not one, but two, complete spontaneous regressions of his
      fatal illness. Both these regressions coincided exactly in time with intravenous
      high-dose ascorbate administration, and it seemed reasonable to conclude that
      this unconventional therapy must have been responsible for his excellent
      responses. For those interested in spontaneous regressions of cancer and the
      possible mechanisms, we now report his subsequent progress some 17 years later.

PMID- 1749590
TI  - Effects of combined therapies with protein-bound polysaccharide (PSK, Krestin)
      and fluorinated pyrimidine derivatives on experimental liver metastases and on
      the immunologic capacities of the hosts.
AB  - An experimental model is introduced for the study of liver metastases using
      intrasplenically injected EL-4 and Lewis lung tumor cells. Fluorinated pyrimidine
      derivatives, 1-(2-tetrahydrofuryl)-5-fluorouracil and 5-fluorouracil, showed
      inhibitory effects on the frequencies of liver metastases. Immunosuppressive
      effects of these drugs were compared at the doses capable of showing 50%
      inhibition of the development of metastatic nodules. These derivatives strongly
      suppressed the phagocytic activity and the number of Kupffer cells of the liver
      and then the humoral response against sheep red blood cells, the delayed
      hypersensitivity against picryl chloride. On the contrary, combined
      administration of protein-bound polysaccharide (PSK) and 1-(2-tetrahydrofuryl)-5
      fluorouracil showed no inhibitory effect on these activities.

PMID- 1749591
TI  - Effects of retinoid glucuronides on mammary gland development in organ culture.
AB  - Retinoyl beta-glucuronide (RAG) and retinyl beta-glucuronide (ROG) inhibit
      prolactin-induced morphological developments in cultured mouse mammary gland, and
      are equally effective in depressing prolactin and steroid hormone-induced DNA
      synthesis in the same tissue. Retinol is essentially inactive by both assay
      methods. Although RAG and ROG show little or no toxicity in several cell and
      animal models, some possibly toxic manifestations were seen at higher
      concentrations in cultured mammary tissue. Nonetheless, because of the strong
      correlation between the actions of chemopreventive agents in culture mouse
      mammary glands and their effectiveness in vivo, the retinoid glucuronides may
      well prove to be useful cancer chemopreventive agents.

PMID- 1749592
TI  - Fractional incorporation of radionucleotides, a marker of in vitro tumor cell
      chemosensitivity in colorectal cancer.
AB  - Working with the antimetabolic chemopredictivity assay on short term cultures we
      evidenced a correlation between in vitro chemosensitivity of colorectal cancer
      and fractional incorporation of radionucleotides. Four different drugs (5-FU,
      mitomycin C, 4'-iododeoxydoxorubicin and ruboxyl, a nitroxyl derivative of
      daunorubicin) were tested on 102 tumor cultures. The extent of 3H-TdR and 3H-UdR
      incorporation into DNA and RNA in the related control cultures was in
      relationship with the chemosensitivity of the tumor. Along with the labeling
      index this simple metabolic-kinetic trait may gain a role for the screening of
      tumor phenotypes sensitive to chemotherapy.

PMID- 1749593
TI  - Glenn A. Fry Award Lecture 1990: three perspectives on low vision reading.

PMID- 1749594
TI  - Computerized contact lens fitting.
AB  - A keratometer with a standard and a large mire was used to estimate the corneal
      apical radius and p value. A computer program used this information to determine
      an optimum fitting contact lens. A fitting set was used independently to
      determine the optimum contact lens by conventional clinical assessment. The two
      approaches were in broad agreement, but the computerized approach was quicker.
      However, calculations revealed that in this group of subjects standard
      keratometry provides a good estimate of the equivalent sphere which is used to
      determine the optimum back optic zone radius in the computerized approach.

PMID- 1749595
TI  - Quantity of protein deposited on hydrogel contact lenses and its relation to
      visible protein deposits.
AB  - The purposes of this study were to determine if the quantity of protein deposited
      (QPD) upon hydrogel lenses was affected by enzymatic cleaning and to test the
      potential relation between QPD and visible protein deposition (VPD) and change.
      Seventy-four contact lens patients classified as "heavy depositors" wore new
      lenses for an average of 80 (SD = 32) days. Cleaning and disinfection solutions
      varied. One lens was cleaned weekly by a papain enzymatic treatment. The
      distribution of QPD measurements was bimodal and was related to the FDA material
      for nonionic, low water content lenses (FDA Materials Group no. 1). The mean
      deposition was 45 micrograms/cm2 (N = 112) compared with that of ionic, high
      water content lenses (FDA Materials Group no. 4), which was 1010 micrograms/cm2
      (N = 30). VPD distributions were the same for the FDA Group no. 1 and no. 4
      lenses. Enzymatic treatment did not significantly reduce QPD; however, enzymatic
      treatment did reduce VPD. Thus QPD and VPD are independent phenomena and possible
      reasons for this are given.

PMID- 1749596
TI  - Hydrogel lens water content and the stability of the prelens tear film.
AB  - Using a noninvasive method, the stability of the tear film over a hydrogel lens
      appears to be related to its water content. The clinical and practical relevance
      of the findings are discussed.

PMID- 1749597
TI  - Aging-related foveal flicker sensitivity losses in normal observers.
AB  - Photopic flicker sensitivity for healthy subjects over 60 years of age was
      compared with that of subjects in their 20s and 30s. The stimulus was achromatic
      and viewed foveally through a 2.0-mm artificial pupil which assured a constant
      pupil size in all subjects. As a group, older subjects had lower flicker
      sensitivity than younger subjects. This was found even when the retinal
      illuminance difference between age groups that arises from increased lens
      absorption in older adults was taken into account. The results indicate that a
      reduction in retinal illuminance with age cannot account for all the flicker
      sensitivity losses in older adults.

PMID- 1749598
TI  - Spatial contrast sensitivity in Alzheimer's disease: a comparison of two methods.
AB  - The present study was designed to compare the contrast sensitivity functions
      (CSF) obtained with the Nicolet CS2000 and the Vistech VCTS6500 for a sample (N =
      25) of patients diagnosed with probable Alzheimer's disease (AD) and a sample (N
      = 25) of healthy elderly adults. With the Nicolet, CSF were determined for
      gratings presented under static and rapidly counterphased (7.5 Hz) conditions.
      All research participants were able to complete the Vistech test. However, 13.7
      and 7.4% of the original samples of Alzheimer patients and healthy adults,
      respectively, did not yield usable data. Both test instruments showed uniformly
      low contrast sensitivities for the AD group. The results support the proposition
      that AD involves a primary visual disturbance and suggest that the Vistech chart
      can be used with a broader range of patients for initial screening.

PMID- 1749599
TI  - Reading speed through different equivalent power low vision devices with
      identical field of view.
AB  - Adequate reading speed is one of the criteria low vision patients may use to
      assist them when they are comparing and selecting equivalent power low vision
      devices. Inherently, various optical devices of equivalent power will produce
      different fields of view. We compared the reading speed of 32 trained, normal
      observers with 4 commonly prescribed types of low vision devices of +12 D
      equivalent power (spectacles, hand magnifier, stand magnifier, and
      telemicroscope) which were modified to provide nearly identical fields of view.
      Our results show that only the reading speed obtained with the telemicroscope was
      significantly different from those of the other systems (p less than 0.01).
      Implications are that the field of view provided by a low vision device is the
      primary parameter limiting reading speed of equivalent power devices.

PMID- 1749600
TI  - Tear characteristics of the VDU operator.
AB  - The volume and stability of the tear film was measured in a small group of Visual
      Display Unit (VDU) operators and a non-VDU operating group. Using noninvasive
      methods of tear measurement, we found no difference in precorneal tear film
      stability between the two groups; however, the tear volume of the VDU users was
      greater than in the non-VDU operating group. No relation was found to exist
      between precorneal tear film stability and tear volume.

PMID- 1749601
TI  - Binocular interaction with neutral density filters as measured by the visual
      evoked response.
AB  - The influence of neutral density (ND) filters on the pattern visually evoked
      response (VER) was investigated as a function of check size. Monocular and
      binocular transient pattern reversal VER's were recorded through three ND filters
      (0.6, 1.0, and 2.6 log units) before 1 eye on 55 adult subjects using 5.5 min arc
      and 50 min arc check sizes. The 5.5 min arc check produced responses which
      suggest that partial binocular summation is present in the absence of ND filters
      but disappears as the filter density increases. In the case of the 50 min arc
      check size the presence of binocular summation is less certain and a 1.0 log unit
      ND filter produces binocular inhibition which may be due to latency differences
      between the two eyes. Eye dominancy appears to have no effect on these results.

PMID- 1749602
TI  - Anomalous kinetic visual fields found in family members of patients with a
      confirmed diagnosis of Gilles de la Tourette syndrome.
AB  - Three visual manifestations of Gilles de la Tourette syndrome (TS), a
      neuropsychiatric disorder, have been previously reported. In this paper we report
      anomalies in the measured kinetic paracentral visual field of TS patients and
      their family members. We found that 96% of TS patients exhibited paracentral
      kinetic visual field defects (nasal and temporal steps, enlargement, "ringing,"
      and/or baring of the blind spot). Ninety-three percent of fathers of TS children
      and, surprisingly, about 80% of mothers exhibit these characteristic visual field
      anomalies. Sample data and examples of family studies are reported.

PMID- 1749603
TI  - Changes in ocular astigmatism over the whole range of accommodation.
AB  - The refraction of 20 subjects was measured over the whole range of accommodation
      using an objective automated refractometer in order to investigate the astigmatic
      change whose origin is presumed to be at the lens. For this purpose, the corneal
      vertex was used as the plane of reference to avoid changes in the optical
      effectively of a cylindrical lens at near. The change in the astigmatism with
      accommodation was observed in each subject. Subjects were then divided into three
      groups: (1) seven subjects showed an increase in astigmatism with accommodation;
      (2) eight subjects showed constant astigmatism up to the accommodative nearpoint;
      and (3) five subjects showed other types of change, such as reduced astigmatism
      in the intermediate accommodative state. These variations suggest that
      accommodative astigmatism is affected by many elements such as lens, zonule, and
      muscle. Two of 20 subjects could see the vertical line of the visual target
      composed of many directional lines clearer than the horizontal line at distance.
      Conversely, they could see the horizontal line clearer than the vertical line at
      near. We also studied the correspondence between the dark focus of accommodation
      and the dioptric distance where astigmatism is at a minimum, as suggested
      previously. The results showed that no such direct relation existed.

PMID- 1749605
TI  - Lens power matrices and the sum of equivalent spheres.

PMID- 1749604
TI  - Inhibition of binocular contrast sensitivity in hypermetropic anisometropia.
AB  - Binocular contrast inhibition can occur when the monocular contrast sensitivities
      are not equal. It has been reported in cases of monocular cataracts. Our case is
      an 18-year-old female with 3.50 D of hypermetropic anisometropia. She was not
      amblyopic but showed a typical binocular contrast inhibition.

PMID- 1749606
TI  - Clinical experience in halting myopia.

PMID- 1749607
TI  - [The computer and the orthodontist].

PMID- 1749608
TI  - [Esthetics of the face and teeth].

PMID- 1749609
TI  - [Esthetics and orthodontics].

PMID- 1749610
TI  - [Functional hierarchy and mandibular esthetics].
AB  - The purpose of the present study based on the comparison of two populations
      showing a different average of age, was to see the possible action of the tongue
      on the mandibular morphology. This study included the examination of norma
      lateralis teleradiographs, while both facial and lingual musculatures were in
      rest position. If it appears that older subjects show a close correlation between
      mandibular divergence and lingual height, this relation doesn't take place in
      younger subjects although they present an earlier mandibular hyperdivergence. May
      breathing, a function hierarchically of the highest importance be more
      determinant in lower face organisation than deglutition and lingual equilibrium?

PMID- 1749611
TI  - [Prognostic factors of treatment results through diagnostic and therapeutic
      elements].
AB  - A file including 559 treated patients, from whom the result of treatment is know,
      is analysed. It concerns 52 diagnostic and 7 therapeutic variables. The statistic
      analysis is executed in particular by scoring method. It allows to identify the 8
      most discriminating variables relating to orthodontic prognosis. The ANGLE Class
      presents an essential weight. The other 7 variables differently interfer
      according to ANGLE Classes.

PMID- 1749612
TI  - [Morphogenetic normalization, the contribution of orthodontics].

PMID- 1749613
TI  - [A comparative study of cephalometric evaluation criteria of the cutaneous
      profile].
AB  - The objectives of this study is to challenge the soft tissue profile standards of
      esthetics and to compare them with the feeling and the sense of beauty of the
      large public. The facial profile of one hundred fifty-two cinema stars and top
      models (seventy-one men and eighty-one women) were analysed. Twenty three
      measurements were taken among the most used and widely accepted. These references
      come from the works of very reknown orthodontists and researchers: BURSTONE,
      HOLDAWAY, MERRIFIELD, PECK and PECK, RICKETTS, STEINER, WORMS (as described by
      MOSHIRI). The results demonstrate, after statistical analysis that: some values
      are very different compared with the references; those discrepancies neither
      concern the same values nor for the same amount, or to the same direction for the
      male or the female samples. The mean male soft tissue profile is more concave,
      prognathic type with more retruded upper and lower lips and more reduced lower
      face height than the standards described by the authors. The mean women soft
      tissue profile tends to be more convex with a relatively more protruded upper lip
      and a more retrognathic mandible than the "standards". The whole face height is
      significantly reduced with a more marked discrepancy for the nasal height and the
      lower lip length. The nasal prominence is also reduced compared with the norms.
      It appears then that we cannot trust anymore references that do not take into
      account differences between men and women ideal facial profiles for the analysis
      of soft tissue profile in orthodontics and maxillo-facial surgery. The values
      described by the authors, which are our daily standards, do not seem to match the
      large public sense of esthetics and therefore our patients feeling of beauty.

PMID- 1749614
TI  - [The therapeutic smile: orthodontics, surgery and mental attitude].

PMID- 1749615
TI  - [Esthetics and bioprogressive therapy].

PMID- 1749616
TI  - [Labial incompetence. Therapeutic considerations of esthetic and functional
      deficits].
AB  - The lips constitute an anatomic, physiologic and aesthetic specific entity which
      is integrated between nasal and chin areas. Inocclusion of the lips at rest forms
      an anomaly which affects mandibular growth, lip function and facial morphology.
      This vertical labial dysharmony implies on one hand an architectural skeletal
      unbalance at inferior third of the face, mostly associated with dento-alveolo
      maxillary disturbance, on the other hand a disorder of oro-facial muscular
      behaviour. The treatment's aim is the restoration of a spontaneous lip seal at
      rest. It will be institute as early as growth-hood using functional orthopaedic
      devices. In adolescent and adult, the correction of existing dento-alveolar
      dysharmonies by orthodontic means will be completed, if necessary, by surgical
      procedures either orthognathic correcting retrognathism or maxillary anterior
      alveolar hyperplasia with dental extrusion, or morphologic to achieve elongation
      of congenital upper short lip or elevating of lower lip attracted towards the
      chin. Orthopaedic and morphologic analyses are necessary to locate the site of
      the responsible anomalies and indicate particular surgical technics relative to
      the magnitude of functional and aesthetic repercussion.

PMID- 1749617
TI  - [The Tip Edge technic. Is it an advance in orthodontic concepts?].
AB  - The originality of Tip Edge technique is due to the possibilities to take benefit
      both of the advantages of BEGG technique and Edgewise technique. With the
      differential anchorages, bite opening is more rapid and the correction of all the
      occlusal abnormalities is easy during stage I. During stage III the bracket Tip
      Edge with its original design permit a progressive torque, roots uprighting and
      an Edgewise finish.

PMID- 1749618
TI  - [Aging of the facial profile in the adult resting and balanced occlusion].

PMID- 1749619
TI  - [Control of treatment and facial balance].
AB  - Cephalometric analysis (made from the tracings of lateral head X-rays)
      participates to the orthodontic diagnosis. As it is done for each patient before
      and after treatment, the analysis allows for precision of the goals and for the
      control of their obtainance. Because therapeutic means have grown more and more
      precise, progress tracings during the active treatment are now considered very
      precious. They display teeth (and bones) good and bad displacement. They allow
      for mechanical activations, therapeutic decisions, and help for a better
      precision of the patient's cooperation. As the stability of the treated occlusion
      is the main goal, may be the post-treatment records (taken immediately after
      debanding) could be delayed for some months or even some years.

PMID- 1749620
TI  - ["Special" orthodontics to serve esthetics and function].
AB  - Classical orthodontic approaches to bicuspid extractions in closed bite cases do
      not always reach the esthetic goal. To avoid worsening the profile concavity and
      undesired alterations in the nasolabial angle, incisor retraction must be
      discussed individually. We report third molar extraction cases with optimized
      changes in facial profiles.

PMID- 1749621
TI  - [Our testament in neuro-occlusal rehabilitation].

PMID- 1749622
TI  - [High vaccination rates--only a question of information?].

PMID- 1749623
TI  - [Therapeutic drugs, illicit poisons and environmental chemicals in breast milk-
      assessing the risk].
AB  - Our knowledge about the transfer of drugs and environmental chemicals into breast
      milk has increased in the last years. This review is mainly based on recently
      published literature and focuses on all drugs and environmental substances with
      documented effects on lactation and the nursing infant. Our aim is to provide
      brief information for physicians who are counseling breastfeeding mothers.

PMID- 1749624
TI  - [Comparison of the classical Gibson-Cooke methods and the chloride-sensitive
      electrode in sweat testing for diagnosis of cystic fibrosis].
AB  - In 43 children and adolescents (30 healthy and 13 CF patients) the Quantitative
      Pilocarpine Iontophoresis Test (QPIT) was compared with the ion-specific
      electrode. We found an excellent correlation between these two methods (r = 0.93)
      and no false positive or false negative results. With both procedures the total
      chloride-ion-concentration in sweat of healthy subjects and patients with CF
      differed significantly (p less than 0.001). Both, the original Gibson and Cooke
      sweat-test (QPIT) and the assessment of chloride with the sensitive electrode are
      highly reliable procedures for confirming the diagnosis of CF.

PMID- 1749625
TI  - [Delayed evaluation of test strips for blood glucose determination in small
      reflectometers].
AB  - The precision and accuracy of reacted reagent strips (Haemoglucotest 20-800 R,
      Reflocheck) stored in an envelope and analysed 24 and 48 hours later, by means of
      glucose reflectance meters (Reflolux II, Reflocheck) was studied. A good
      correlation of the values estimated after 24 and 48 hours to the value analysed
      immediately after sampling was found for both systems (Reflolux II 24 hours
      later, r = 0.9713, y = 24.16 + 0.7369. x, and 48 hours later, r = 0.9388, y =
      44.21 + 0.5234. x; Reflocheck 24 hours later, r = 0.977, y = 9.72 + 0.9525. x,
      and 48 hours later, r = 0.9433, y = 45.97 + 0.4802. x). Our data show, that the
      initial value can be calculated using the 24 and 48 hour values by means of
      linear regression. Therefore the analysis of reacted reagent strips for blood
      glucose determination is beneficial in the management of Typ-I-Diabetics.

PMID- 1749626
TI  - [Prenatal diagnosis and postnatal management of urologic abnormalities. Review
      and personal experiences].
AB  - The possibilities and the difficulties of prenatal ultrasonography in detecting
      fetal renal abnormalities are discussed in this review article. The consequences
      of prenatally diagnosed uropathies are: intrauterine surgery, termination of
      pregnancy, induction of premature labour and an optimal preparation for the
      immediate postnatal diagnosis and management.

PMID- 1749627
TI  - [Polyvalent immunoglobulins in prevention of viral infections in children with
      neoplastic diseases treated with immunosuppressive therapy].
AB  - 31 children with leukemias, lymphomas and solid tumors treated by
      polychemotherapy received prophylactic i.v. polyvalent immunoglobulins during 48
      hours after exposion with varicella-zoster-virus, rubella-virus or mumps-virus.
      None of the 23 children with immunity against the exposed virus developed the
      infection. 8 children had no antibodies against the exposed virus. The
      prophylaxis with the polyvalent immunoglobulin protected them against chickenpox
      (6 children) and rubella (2 children). All children showed an elevation of the
      IgG level in plasma and the antibody titers against measles-, mumps-, rubella-
      and varicella-zoster-virus after application of the immunoglobulin. A study with
      a larger number of patients is necessary to confirm our results, that polyvalent
      immunoglobulins with high titers against exposed viruses are effective in
      prevention of this diseases in immunocompromised children.

PMID- 1749628
TI  - McKusick-Kaufman syndrome: report of the 66th case complicated by a staphyloma of
      the left eye.
AB  - Sixty-five cases of the Kaufman-McKusick syndrome, an autosomal recessive
      disorder, have been thus far reported in the literature. In the female,
      hydrometrocolpos and postaxial polydactyly are the prominent features of the
      disorder, and together with congenital heart disease form the distinctive triad
      of symptoms characterizing this entity. Since the initial reports, multiple other
      anomalies have been reported in the affected patients. Hydrometrocolpos,
      especially if unrecognized, may be a life-threatening condition in the newborn
      girl. We present a child with the features of the syndrome, and a staphyloma of
      the left eye, which necessitated its enucleation.

PMID- 1749629
TI  - [You make the diagnosis. Marshall syndrome].

PMID- 1749630
TI  - [Rare indications for iron chelation therapy with desferrioxamine].
AB  - In beta thalassaemia patients the subcutaneous desferrioxamine chelation therapy
      is performed routinely. Rare indications are hypoplastic anaemia, congenital
      dyserythropoetic anaemia and Fanconi anaemia. We initiated the chelation agent in
      three patients with the above mentioned diagnoses. The beginning of treatment in
      hypoplastic anaemia depends upon the quantity of red cell transfusions, whereas
      in dysterythropoetic anaemia the increased intestinal iron absorption has to be
      taken into consideration. Aim of the therapy is a negative iron balance. The
      evaluation of the iron balance is relatively simple. The girl with hypoplastic
      anaemia has been treated for 1.5 years. Within this time she received 11,680 mg
      iron by blood transfusions. The urinary iron output was 7112 mg. Depending on the
      analyzing method, the mean fecal iron excretion amounts 36.5% or 61% of the
      global excretion. Laboratory findings and clinical course are in favour to the
      aimed negative iron balance in two patients.

PMID- 1749631
TI  - [Vaccination against Haemophilus influenzae].

PMID- 1749632
TI  - [The Austrian Scientific Prize for Pediatrics and Adolescent Medicine. An
      alternative method of financing research in pediatrics].

PMID- 1749633
TI  - [Publications from Austrian pediatric institutions--analysis of the year 1989].

PMID- 1749634
TI  - Is there such a thing as geriatric pain?

PMID- 1749635
TI  - Getting away from simple muscle contraction as a mechanism of tension-type
      headache.

PMID- 1749636
TI  - Clinical and pathophysiological observations in migraine and tension-type
      headache explained by integration of vascular, supraspinal and myofascial inputs.
AB  - A vascular-supraspinal-myogenic (VSM) model for pain in migraine based on our
      previous clinical and pathophysiological observations is proposed. According to
      the model, perceived pain (headache) intensity is determined by the sum of
      nociception from cephalic arteries and pericranial myofascial tissues converging
      upon the same neurons and integrated with supraspinal effects (usually
      facilitating). Vascular input predominates over myofascial input in migraine,
      whereas significance of supraspinal facilitation is difficult to estimate. The
      importance of these 3 effects may vary between patients and in the same
      individual with time. The model is in accordance with recent experimental studies
      showing convergence of somatovisceral afferents upon n. caudalis neurons. Also,
      long term potentiation due to nociceptive activation and sensitization of neurons
      to input from wider areas and non-nociceptive stimuli are relevant to our model.
      In tension-type headache, nociception is primarily myofascial, but vascular input
      cannot be disregarded. Supraspinal facilitation probably plays a large, sometimes
      dominant role (the MSV model). The model explains much of the complexity of the
      clinical picture of these disorders as well as their tendency to overlap and to
      change into one another. Also, a number of pathophysiological observations such
      as why muscles are tender during migraine, why trigger-point injection may cure
      migraine attacks and why chronic tension-type headache is often associated with
      episodes of pulsating pain, can be explained. The model gives a rational
      explanation of empirically developed, internationally accepted, multimodal
      treatment strategies for migraine and tension-type headache. It may thus serve a
      useful purpose in explaining the disorder to patients. Finally, the model points
      to several avenues of future research in animals and man.

PMID- 1749637
TI  - Differential effect of glucocorticoids on abdominal pain induced by morphine.
AB  - In patients with unexplained pain after cholecystectomy, morphine often induces
      pain and may increase plasma aspartate aminotransferase (AST) activity because of
      exaggerated or prolonged rises in pressure within the biliary system. These
      anomalous effects of morphine may be mediated by activation of autonomic or
      related afferent nuclei. In this study, 16 patients with pain and increases in
      AST after morphine were further studied after pre-treatment with dexamethasone
      and hydrocortisone. Pre-treatment with dexamethasone decreased scores for pain
      and nausea and prevented or attenuated increases in plasma AST and glucose; these
      effects were not observed after pre-treatment with hydrocortisone. Serial changes
      in plasma concentrations of catecholamines were determined in 8 patients and
      showed that pre-treatment with dexamethasone, but not hydrocortisone, was
      associated with lower concentrations of norepinephrine and epinephrine with
      overall reductions of 53% and 67%, respectively. These observations are
      consistent with a role for sympatho-adrenomedullary activation in abdominal pain
      induced by morphine. The different effects of dexamethasone and hydrocortisone
      raise the possibility that sympatho-adrenomedullary activation after morphine is
      influenced by the interaction of cortisol with type I glucocorticoid receptors
      which have a low affinity for dexamethasone and a high affinity for cortisol.

PMID- 1749638
TI  - Analyzing pain in rheumatoid arthritis patients. Pain coping strategies in
      patients who have had knee replacement surgery.
AB  - This study used the Coping Strategies Questionnaire (CSQ) to investigate pain
      coping strategies in 52 rheumatoid arthritis patients who reported having knee
      pain 1 year or more following knee replacement surgery. Data analysis revealed
      that, as a group, these patients were active copers in that they reported
      frequent use of a variety of pain coping strategies. Pain coping strategies were
      found to be related to measures of pain and adjustment. Patients who rated their
      ability to control and decrease pain high and who rarely engaged in
      catastrophizing (i.e., who scored high on the Pain Control and Rational Thinking
      factor of the CSQ) had much lower levels of pain and psychological disability
      than patients who did not. Coping strategies were not found to relate to age,
      gender, obesity status or disability/compensation status. Taken together, these
      results suggest that an analysis of pain coping strategies may be helpful in
      understanding pain in arthritis patients who have pain following joint
      replacement surgery.

PMID- 1749639
TI  - Does the sympathetic block outlast sensory block: a thermographic evaluation.
AB  - A study to evaluate the duration of sympathetic and sensory block in the L2 and
      L5 dermatome distributions using thermography and pinprick was conducted. Twenty
      patients received epidural block using 2% lidocaine with epinephrine. Onset and
      duration of the sensory and sympathetic blocks were determined and compared
      statistically. There was no difference between the duration of sensory and
      sympathetic block over the L2 dermatome, but sympathetic block was significantly
      longer than sensory block in the L5 dermatome. This study demonstrates that the
      duration of sympathetic block can be either longer or shorter than sensory block
      in L2 and L5 dermatomes. This has important implications for interpretation of
      results of differential epidural studies in that one cannot predict the duration
      of sympathetic block based on duration of sensory block.

PMID- 1749640
TI  - Depression and the chronic pain experience.
AB  - The present study examined the relationship between depression and a
      constellation of pain-related variables that describe the experience of chronic
      pain patients. Thirty-seven depressed and 32 non-depressed heterogeneous chronic
      pain patients were identified through structured interviews, use of standardized
      criteria and scores on the Beck Depression Inventory (BDI). The 2 groups were
      compared on demographic variables and scores on the Marlowe-Crowne Social
      Desirability scale (MC), as well as measures of disability and medication use,
      pain severity, interference due to pain and reported pain behaviors. The
      depressed group was found to be younger and to score lower on the MC than the non
      depressed group. Multivariate analyses of covariance (MANCOVA), using age and MC
      as covariates, revealed that depressed chronic pain patients, relative to their
      non-depressed counterparts, reported greater pain intensity, greater interference
      due to pain and more pain behaviors. There were no group differences on the
      measures of disability and use of medications. The results provide further
      support for the importance of incorporating depression into clinical and
      theoretical formulations of chronic pain. Future use of structured interviews and
      standardized criteria for diagnosing depression may clarify some of the
      inconsistencies found in the literature.

PMID- 1749641
TI  - Pain beliefs and the use of cognitive-behavioral coping strategies.
AB  - Patients' beliefs about chronic pain, such as how long it will last and whether
      it is a mysterious experience, have been shown to be related to compliance with
      treatment programs. The present study examined whether these pain beliefs related
      to a specific component of pain management, namely the frequency of use and the
      perceived effectiveness of cognitive and behavioral coping strategies. One
      hundred twenty chronic pain patients were administered the Pain Beliefs and
      Perceptions inventory (PBAPI) and the Coping Strategies questionnaire (CSQ). A
      cluster analysis of 2 pain beliefs (that pain is enduring and that pain is
      mysterious) was conducted revealing 3 distinct subgroups of patients based upon
      these 2 beliefs. Multivariate analysis of variance was used to detect whether the
      use of cognitive-behavioral pain coping strategies differed in patients in the 3
      pain beliefs subgroups. The results indicated that patients belonging to the
      group characterized by the belief that pain was enduring and mysterious were less
      likely to use cognitive coping strategies (e.g., reinterpretation of pain
      sensation), more likely to catastrophize, and less likely to rate their coping
      strategies as effective in controlling and decreasing pain than patients
      believing their pain to be understandable and of short duration. The implications
      of these results for understanding the patient's choice of and compliance with
      treatment and coping efforts is discussed.

PMID- 1749642
TI  - A possible indicator of functional pain: poor pain scale correlation.
AB  - We studied correlations of pain measures in patients with either inflammatory
      bowel disease (IBD), a disease with a clear organic cause, or irritable bowel
      syndrome (IBS), a functional pain syndrome in which there is little demonstrable
      pathology. Correlations were determined between measures on the visual analogue
      scale (VAS) and on the McGill Pain Questionnaire (MPQ). The VAS score and present
      pain intensity scale (PPI) of the MPQ correlated well in the organic IBD but
      correlated poorly in the functional IBS. Differences in correlation between the
      VAS and PPI scores in functional versus organic disease did not appear to be due
      to altered sensory and affective pain components. This finding is similar to what
      we observed in our previous study of organic and functional pain syndromes in the
      musculoskeletal system. Correlations between the other measures are also
      discussed.

PMID- 1749643
TI  - The prognosis with postherpetic neuralgia.
AB  - One hundred and fifty-six patients with moderate to severe postherpetic neuralgia
      (PHN) were followed for up to 11 years. Nearly half of all patients were doing
      well at the final assessment (median 2 years) and more than half of these were on
      no therapy at this time. The most commonly used agents associated with a good
      outcome were antidepressants, topical capsaicin and analgesics of various kinds.
      Longer duration PHN appeared to have a worse prognosis. More of these patients
      were noted to be using some form of treatment at follow up. A group of patients
      seemed to follow a progressive course and were refractory to all treatments used
      in this study.

PMID- 1749644
TI  - Discharge behaviour of feline gamma-motoneurones following induction of an
      artificial myositis.
AB  - The study was undertaken to test the widely held hypothesis that a painful lesion
      of the skeleto-motor system leads to an increase in the neuromuscular component
      of muscle tone by activating gamma-motoneurones in the affected region. In
      chloralose-anaesthetized cats, artificial myositis was induced in the lateral
      gastrocnemius-soleus (LGS) muscle and several hours later the impulse activity
      was recorded from single gamma-motoaxons supplying the medial gastrocnemius (MG)
      muscle. Under the conditions of the study, the majority of the fusimotor neurones
      had a resting activity and could be readily excited by natural stimuli. In
      contrast to the assumptions of the working hypothesis, the gamma-motoneurones in
      the myositis animals were not activated but showed a strong inhibition; both
      resting activity and excitability by electrical and natural stimuli were
      decreased. Additional recordings from fusimotor neurones of a flexor muscle
      (tibialis anterior, TA) demonstrated that in the preparation used, the behaviour
      of the flexor gamma-motoneurones was different from extensor ones in that the
      former usually had no resting activity and did not respond to natural stimuli.
      The only discernible effect of a myositis of the LGS muscle on the TA gamma
      motoneurones was a decrease in their electrical reflex threshold. The results of
      the study do not support the assumption that a painful muscle lesion is followed
      by an activation of the gamma-loop that leads to an increase in muscle tone.
      Instead, the data may offer an explanation for the weakness and--in chronic cases
      -the reflex atrophy of lesioned muscles.

PMID- 1749645
TI  - The threshold for the depressive effect of intrathecal morphine on the spinal
      nociceptive flexor reflex is increased during autotomy after sciatic nerve
      section in rats.
AB  - The effect of intrathecal (i.t.) morphine on the spinal nociceptive flexor reflex
      in doses ranging between 10 ng and 10 micrograms was studied in decerebrate,
      spinalized, unanesthetized rats with intact sciatic nerves or in rats in which
      the sciatic nerve had been unilaterally sectioned. In rats with intact nerves the
      initial effect of i.t. morphine on the flexor reflex was a brief facilitation
      followed by depression. The threshold dose of morphine for reflex depression was
      100 ng. In animals which did not develop autotomy after nerve section or in which
      autotomy had ceased for several days prior to the acute experiments, i.t.
      morphine had a similar depressive effect on the flexor reflex as in animals with
      intact nerves. However, in rats which were autotomizing at the time of the acute
      experiment, the threshold dose of the depressive effect of morphine was increased
      3-5 fold. With higher doses of morphine (1-3 micrograms), similar depression of
      the reflex was found in all groups. The present results revealed a decreased
      sensitivity of spinal reflex mechanisms to low, but not high, doses of morphine
      after sciatic nerve section accompanied by autotomy. Nerve section per se did not
      alter opioid sensitivity. Thus, decreased effectiveness of morphine in this model
      for neuropathic pain may be partially due to a desensitization to the analgesic
      action of opioids in the spinal cord. Since after sciatic nerve section there is
      a differential sensitivity to the antinociceptive effect of i.t. morphine between
      autotomizing and non-autotomizing rats, it is further suggested that autotomy
      after peripheral nerve section in rats is a useful model for the study of
      neuropathic pain.

PMID- 1749646
TI  - Pain in chronic pancreatitis.

PMID- 1749647
TI  - On "The effect of intravenous lidocaine on nociceptive processing in diabetic
      neuropathy" by Bach et al. in Pain, 40 (1990) 29-34.

PMID- 1749648
TI  - An additional perspective on the Fordyce/Schmidt controversy.

PMID- 1749649
TI  - On 'Spinal cord stimulation for chronic, intractable pain: superiority of 'multi
      channel' devices' by North et al., in Pain (1991) 119-130.

PMID- 1749650
TI  - Stable and unstable fractures of the femoral shaft.
AB  - A retrospective review of 99 cases of stable and unstable femoral shaft fractures
      treated with Grosse-Kempf intramedullary fixation is presented. Despite minor
      complications and technical problems, the procedures resulted in union with
      acceptable alignment in 98% of cases. Details of the complications and technical
      problems are reviewed. There was no incidence of deep infection despite 16 open
      fractures. The two cases of nonunion were salvaged with revision internal
      fixation and bone grafting. Grosse-Kempf interlocking intramedullary fixation is
      a technically demanding procedure, but offers excellent results in the management
      of stable and unstable, open and closed fractures of the femoral shaft.

PMID- 1749651
TI  - Traumatic axial-ulnar disruption of the carpus.
AB  - Six men and two women (aged 37 to 50) with traumatic axial-ulnar disruption of
      the carpus were evaluated at an average of 34 months following treatment. The
      injuries were caused by a broad, anteroposterior crushing force to the hand and
      wrist resulting from, in most cases, an industrial accident. Our treatment began
      2 weeks postinjury in five patients and more than 1 month postinjury in three
      patients. Treatment techniques included closed or open reduction and plaster
      immobilization, primary or delayed skin grafting, immediate revascularization,
      and secondary techniques. Cooney's criteria rated treatment results as excellent
      in one patient, good in two, fair in two, and poor in three. Although four
      variations of this injury were identified, the pattern of disruption appeared to
      have no influence on the results. An early surgical procedure seems to be most
      effective.

PMID- 1749652
TI  - Reflex sympathetic dystrophy of the patellofemoral joint.
AB  - Eighteen patients with a diagnosis of reflex sympathetic dystrophy (RSD)
      affecting the knee were reviewed. Minor isolated injuries and operations about
      the knee triggered the original episode. The symptoms, regardless of location and
      mechanism of injury, occurred in the patellofemoral joint. Roentgenographic
      features of patchy demineralization and abnormal uptake on a 99mTc scan were
      typically located in the patella and corresponding femoral articular surface. At
      the initial stage of the syndrome, pain, hypersensitivity to touch, and
      inhibition of the quadriceps muscle were the most prominent features. In the
      later stages of the syndrome, functional instability due to quadriceps weakness
      created dependence on a knee brace or crutch support. Six patients whose RSD was
      initially misdiagnosed underwent numerous unsuccessful surgical procedures. In
      three of these patients, the knee was ultimately fused. All patients had an
      initial isolated knee injury (usually after minor trauma), and prolonged periods
      of immobilization and a cast, and 12 of the 18 patients were involved with
      workers' compensation. Early diagnosis and prompt treatment with an epidural
      block, followed by intensive physiotherapy, are recommended. A personal
      doctor/patient relationship that offers guidance and encouragement is key to
      successful management of this syndrome.

PMID- 1749653
TI  - Intraosseous ganglia of the carpal bones.
AB  - Intraosseous ganglia are benign, cystic lesions of bone that are most commonly
      found in the subchondral region of long bones of the lower extremity. Reports of
      isolated carpal involvement are rare; however, it has been well documented that
      these lesions may produce chronic wrist pain. Various theories of pathogenesis
      have been advanced, including synovial herniation, mucoid degeneration, primary
      cellular metaplasia, and chronic repetitive trauma. In our study, 11 patients
      (seven female, four male) with 12 lesions were treated for chronic wrist pain
      associated with intraosseous carpal ganglia. All patients had similar complaints
      preoperatively and were unable to obtain relief with rest, immobilization, or
      nonsteroidal medication. Aside from local tenderness over the involved bone, the
      physical examination was unremarkable. Acute trauma was not found to be a factor
      in any of these patients' histories. Eleven lesions in 10 patients were grafted
      with bone from the distal radius. A complete resolution of symptoms was seen at a
      20-month follow-up examination.

PMID- 1749654
TI  - Arthroscopic treatment of septic arthritic knees in children and adolescents.
AB  - Septic arthritis of the hip and knee is very common in children and adolescents.
      Sixteen consecutive patients were treated for septic arthritis of the kee with
      arthroscopic lavage and debridement. Ten of the 16 knees were culture positive on
      preoperative aspiration. The average duration of antibiotic treatment was 19
      days. The mean immobilization period was 1 1/2 days and the time to full and
      painless range of motion averaged 2.8 weeks. All patients resumed normal
      activities by 3 weeks, no infections recurred, and postoperative morbidity was
      minimal.

PMID- 1749655
TI  - Works in progress #7. Clinical experience with the Accu-Path threaded acetabular
      cup. A preliminary report.
AB  - Clinical experience with the Accu-Path threaded titanium hemispheric cup is
      presented. A series of 62 cases was followed for an average of 28.1 months
      (range, 6 to 48). Primary surgery was performed in 50 cases and revision surgery
      in 12. The surgical technique is described in detail. Preoperative Harris scores
      improved from 28 to 93 in primary cases and from 24 to 84 in revision cases.
      Complications included 3.2% dislocation, 3.2% loss of cup position, and 1.6%
      recurrent subluxation. The overall reoperation rate was 8% (8% in primary surgery
      and 8.3% in revision surgery). Roentgenographic analysis is discussed. The
      importance of preservation of the subchondral plate and a rim fit in the use of
      this implant is stressed. It is not indicated in those with loss of the plate due
      either to prior surgery (as in revision) or in aggressive over-reaming in primary
      cases. Although the overall results were encouraging, caution was recommended-
      especially in revision surgery or in the patient with severe osteopenia.

PMID- 1749656
TI  - Tips of the trade #40. Removal of a fractured intramedullary nail.

PMID- 1749657
TI  - Growing pains.

PMID- 1749658
TI  - Imaging rounds #109. Intraosseous ganglia of the scaphoid.
AB  - An intraosseous ganglion is a relatively uncommon, benign, cyst-like lesion that
      occurs in middle-aged adults, and has a predilection for the tibia.
      Roentgenographically, it commonly appears as well a well-defined osteolytic
      lesion with a surrounding area of sclerosis.

PMID- 1749659
TI  - Tips of the trade #41. Modified coaptation splint for humeral shaft fractures.
AB  - A technique for applying a modified coaptation splint for humeral shaft fractures
      is presented. Using this method, the splint extends from the base of the neck,
      passes over the shoulder and along the front and back of the arm, and returns
      toward the axillary fold. To prevent slippage, the proximal end of the splint is
      secured to the chest with a strap.

PMID- 1749660
TI  - Recurrent dislocation of the proximal tibiofibular joint.
AB  - Recurrent dislocation of the proximal tibiofibular joint is a rare injury. This
      report presents a case of bilateral recurrent dislocations of the proximal
      tibiofibular joint in a jet skier that responded to physical therapy and activity
      modification. A review of the literature is provided, with attention to the
      mechanism of injury and other treatment options--including arthrodesis and
      resection of the proximal fibula. This diagnosis should be considered in jet
      skiers with lateral-sided knee pain.

PMID- 1749661
TI  - Operative management of distal femoral fractures.
AB  - Fractures of the distal femur can be managed successfully with surgery. A good
      result depends on identification of all fragments, adequate repair of soft
      tissue, appropriate bone grafting, meticulous intrafragmentary compression, and
      complete reduction of the joint space. Instrumentation may include condylar blade
      plates, condylar screws, or locked intramedullary rods. Anatomic reconstruction
      with stable fixation permits early rehabilitation and recovery of full function
      after fracture.

PMID- 1749662
TI  - Isolated dislocation of the radial head.
AB  - Fifty-four patients (12 bilateral) with isolated dislocations of the radial head
      were encountered over a 20-year period. The congenital varieties (26 patients)
      included isolated unilateral, familial, synostosis-related, and syndrome-related.
      The acquired types (28 patients) involved trauma, neuromuscular impairment, or
      adaptive dislodgments. Acute, traumatic dislocation (17 patients) was the most
      common presentation. Others were diagnosed incidentally, or associated with
      discomfort, dysfunction, or deformity. Closed reduction of an acute traumatic
      dislocation was generally successful (16 of 17 patients). Realignment attempts
      (three cases) on late diagnosed traumatic cases and isolated congenital types
      were invariably unsuccessful, eventually requiring radial head excision. Four
      patients underwent excision of the head of the radius as primary treatment.

PMID- 1749663
TI  - Hematoma block of distal forearm fractures. Is it safe?
AB  - Fractures of the distal radius and ulna are common, and methods of obtaining pain
      relief prior to their reduction include general anesthesia, intravenous regional
      anesthesia, and local infiltration of the fracture hematoma (hematoma block). A
      prospective study of 132 distal forearm fractures treated with hematoma block was
      undertaken. This group was compared with a control group of 100 patients who had
      had either general anesthesia or intravenous regional anesthesia. Results
      revealed no incidence of infection in either group. If appropriate precautions
      are taken, hematoma block does not increase the risk of infection.

PMID- 1749664
TI  - Survey of health care available to child athletes.
AB  - Surveys were sent to 84 children's hospitals and 397 sportsmedicine clinics to
      characterize the care available for the child athlete (aged 4 to 12 years); they
      were completed by 209 facilities (43% response rate). Fourteen of the facilities
      had a sportsmedicine clinic specifically for children; care was available for the
      child athlete in an additional 46 facilities, but less than 10% of the clinic
      visits were made by athletes aged 4 to 12 years. All responding clinics were
      further characterized by location, length of operation, composition, referral
      base, profitability and funding, etc. Although there are few sportsmedicine
      clinics specifically for children, many facilities provide experienced personnel
      in existing clinics to care for young athletes.

PMID- 1749665
TI  - Low-velocity knee dislocation.
AB  - Complete knee dislocation is an uncommon but potentially devastating injury with
      a reported high rate of neurovascular injury. Treatment of this ligamentous
      injury is controversial. The operative (repair of all ligaments) and nonoperative
      management of ligament injuries appears to result in a stiff knee (decreased
      range of motion [ROM]), and/or a significant incidence of clinical instability
      and pain. We report our data on low-velocity knee dislocations and present a
      treatment plan of noninvasive assessment of the vascular status, a stabilizing
      procedure centered on posterior cruciate ligament reconstruction (PCL) and an
      aggressive rehabilitation program that can result in improved ROM, acceptable
      stability, and a more optimal functional outcome.

PMID- 1749666
TI  - Imaging considerations of central nervous system manifestations in pediatric
      patients with neurofibromatosis type 1.
AB  - CT and MRI were used in a prospective study of the central nervous system (CNS)
      manifestations in 41 consecutive children with neurofibromatosis type 1 (NF-1).
      Gadolinium-DTPA was used in 15 patients. MRI was more effective than CT in
      delimiting the extension of the optic pathway glioma and in evaluating associated
      cerebral malformations. MRI visualized lesions generally undetected by CT, in the
      form of iso- or hyperintense foci with respect to the cerebral cortex in T2
      weighted sequences. Well-delimited lesions of high signal intensity were observed
      in the globus pallidus (22 cases), the internal capsule (6 cases), corpus
      callosum (2 cases), anterior commissure (1 case) and semioval center (2 cases).
      Poorly defined hyper- or isointense areas were also observed affecting the
      cerebellar white matter (21 cases) and brain stem (17 cases). None of these
      lesions showed Gadolinium-DTPA enhancement, and were of no clinical significance.
      MRI has displaced CT in the initial diagnosis of patients with NF-1. Periodic
      annual MRI controls are only justified in patients with MRI changes to evaluate
      the progression or stabilization of the lesions.

PMID- 1749667
TI  - Cerebral-blood-flow-velocity measurements in neonates: technique and
      interobserver reliability.
AB  - The interobserver reliability for absolute cerebral-blood-flow-velocity
      measurements by colour and duplex Doppler sonography was tested in 32 neonates
      with a mean birth weight of 1489 (SD 644) g, and a gestational age of 29.9 (SD
      3.5) weeks. Using standardized technique, two observers recorded on videotape,
      the Doppler spectrum of the anterior cerebral artery, the intracranial internal
      carotid artery and the middle cerebral artery. Peak systolic flow, end diastolic
      flow, mean flow velocity, resistive index and pulsatility index were computed
      from 3 consecutive waveforms by each observer. The estimates of interobserver
      reliability using the intraclass correlation coefficient of the examiners varied
      from 0.95 to 1.00. Therefore, cerebral blood flow velocity can be reliably
      measured in premature infants.

PMID- 1749668
TI  - Neurosonographic abnormalities in chromosomal disorders.
AB  - A retrospective study of cranial sonograms in infants with autosomal trisomies
      excluding Down's syndrome was performed. A range of abnormalities was found
      including structural anomalies, vascular changes and hydrocephalus. Although
      nonspecific, many of these abnormalities can suggest a specific chromosomal
      abnormality in the appropriate clinical setting.

PMID- 1749669
TI  - Cervical lymphadenitis complicated by mycotic carotid artery aneurysm.
AB  - A case of mycotic carotid artery aneurysm due to cervical lymphadenitis in a four
      year old child is presented. Sonography and computed tomography (CT) demonstrated
      an irregular fluid-containing neck mass, similar in appearance to an
      uncomplicated abscess. Continuity with the carotid artery was suggested on
      sonography, and CT demonstrated intense contrast enhancement of the liquid
      portion of the mass. Mycotic carotid artery aneurysm is a rare, but potentially
      fatal, complication of cervical lymphadenitis that is detectable with noninvasive
      diagnostic imaging studies.

PMID- 1749670
TI  - Pulmonary changes in congenital syphilis.
AB  - Three of seven infants afflicted with congenital syphilis at our institution in
      the past five years showed diffuse pulmonary infiltrates. These persisted long
      after adequate antibiotic treatment of the primary infection. Review of
      pathologic literature suggests these infiltrates represent pulmonary immaturity,
      extramedullary hematopoiesis, and interstitial scarring.

PMID- 1749671
TI  - Esophageal foreign bodies in children with vascular ring or aberrant right
      subclavian artery: coincidence or causation?
AB  - This is the report of 4 children, 2 with a vascular ring and 2 with an aberrant
      right subclavian artery, who presented with an esophageal foreign body in the
      proximal esophagus above the level of the vascular anomaly. A deep erosion of the
      esophagus at the site of the foreign body was demonstrated in 2 patients.

PMID- 1749672
TI  - Esophageal diverticula in childhood associated with strictures from unsuspected
      foreign bodies of the esophagus.
AB  - Two pediatric patients are presented with progressive dysphagia due to esophageal
      strictures secondary to unrecognized foreign bodies. Diverticula were present
      above the strictures.

PMID- 1749673
TI  - Salt losing nephropathy simulating congenital adrenal hyperplasia in infants with
      obstructive uropathy and/or vesicoureteral reflux--value of ultrasonography in
      diagnosis.
AB  - Salt losing nephropathy, occurring predominantly in male infants, has been
      reported in association with a spectrum of urologic diseases including
      obstructive uropathy and massive, infected vesicoureteral reflux (VUR). This has
      been called pseudo-hypoaldosteronism (PHA) or alternatively, pseudo salt-losing
      congenital adrenal hyperplasia (CAH), and is thought to reflect a tubular
      unresponsiveness to aldosterone. We report our experience with six cases, discuss
      one case in detail and review the 39 cases previously reported. A one month old
      male infant presented with a left upper quadrant mass. Signs and symptoms
      included vomiting, dehydration, hyponatremia and hyperkalemia. This suggested the
      diagnosis of CAH for which therapy was instituted. Ultrasonographic examination
      subsequently revealed the mass to be a urinoma in an infant with posterior
      urethral valve (PUV) and obstructive hydronephrosis.

PMID- 1749674
TI  - RARE-MR-urography in the diagnosis of upper urinary tract abnormalities in
      children.
AB  - RARE-MR-urography (Rapid Acquisition with Relaxation Enhancement) is a fast MR
      imaging technique (6.4 s/acquisition) that selectively depicts fluid by heavy T2
      weighting. From 9/1989 to 11/1990, RARE-MR urograms were prospectively evaluated
      in the diagnosis of upper urinary tract abnormalities in 55 children. The method
      is performed in several planes and combined with a coronal, T1-weighted spin-echo
      sequence. Forty out of 42 kidneys with dilated renal pelvis, and 21 out of 24
      dilated ureters were identified, only the mildly dilated ones were missed. Even
      in non-functioning kidneys the urinary tract was clearly depicted by RARE-MR
      urography. However, no differentiation could be made with this technique between
      vesicoureteral reflux and non-refluxing dilatation of ureter and/or renal pelvis.
      All 19 pelviureteric obstructions and all eight renal duplications with a dilated
      segment were identified. RARE-MR-urography is a new tool for diagnosing urinary
      tract abnormalities in children without having to employ ionizing radiation,
      contrast media, or general anesthesia. A dilated urinary tract can be shown in
      one image displaying the entire urinary system, similar to excretory urography.
      The technique is presently not able to provide the information of voiding
      cystourethrography or renal scintigraphy, nor is it as easy to perform as
      ultrasound. However, in certain cases it may replace excretory urography.

PMID- 1749675
TI  - Perinatal lethal hypophosphatasia; clinical, radiologic and morphologic findings.
AB  - Clinical, radiographic and morphologic analysis of nineteen cases of perinatal
      (lethal) hypophosphatasia was performed. Three families each had two affected
      offspring. All of the patients had lethal short limb dwarfism with very soft
      calvaria. Other clinical findings included polyhydramnios, blue sclerae and spurs
      in the mid-portion of the forearms and lower legs. Considerable variability was
      found in the skeletal radiographs. In addition to the well known radiographic
      features such as generalized decrease in the size of ossified bones with some
      bones not ossified at all, other changes observed included: 1) marked variability
      in the amount of bone ossification; 2) variability between patients as to which
      bones were most severely affected; 3) unusually dense, round, flattened,
      butterfly shaped; and sagittally clefted vertebral bodies; 4) variability in
      femoral shape including "chromosome" like, "campomelic" like, and shortening with
      or without metaphyseal cupping or irregularities; 5) osteochondral projections
      (Bowdler spurs) of the midshaft of the fibula and ulna. Recognition of the marked
      clinical and radiographic variability in this autosomal recessive lethal skeletal
      dysplasia is important for accurate genetic counseling and prenatal diagnosis.

PMID- 1749676
TI  - Kabuki make-up (Niikawa-Kuroki) syndrome: clinical and radiological observations
      in two Sicilian children.
AB  - The Authors describe two patients aged 5 and 8, a female and a male, affected by
      a condition of polymalformations known as Kabuki make-up or Niikawa-Kuroki
      syndrome, having a neonatal incidence of 1:32,000 in Japan. There are two
      hypothesis about the apparent rarity of the syndrome in the rest of the world,
      including the Asian Continent: the first is that it exists, but is infrequently
      recognized outside Japan and the second is that it is really more frequent in
      those parts of the world, where ethnic exchanges are uncommon, as it happens in
      Japan.

PMID- 1749677
TI  - Tuberous sclerosis complex: oligosymptomatic variant associated with subependymal
      giant-cell astrocytoma.

PMID- 1749678
TI  - Rectal diverticulum in an infant.
AB  - The occurrence of rectal diverticula are rare. They are invariably accompanied by
      colonic diverticulosis, especially the sigmoid segment. To our knowledge, this
      condition has not been previously detected during childhood, and the youngest
      patient reported was 18 years old. In this report we present a solitary rectal
      diverticulum in a 25-day-old infant without accompanying colonic diverticula. The
      existence of rectal diverticulum in this infant convincingly suggests a
      congenital etiology.

PMID- 1749679
TI  - Primary lymphoma of brain in childhood.
AB  - Primary brain lymphoma is exceedingly rare during the first decade of life. We
      report an unusual case, not only being one of the youngest presented, but also
      because of the unusual CT features exhibited.

PMID- 1749680
TI  - Normal size left ventricle on antenatal scan in lethal hypoplastic left heart
      syndrome.
AB  - We present a case of lethal hypoplastic left heart syndrome missed at routine 20
      week antenatal ultrasound examination because the left ventricle was of normal
      size on the standard four-chamber cardiac view. Hypoplastic left heart syndrome
      includes a spectrum of cardiac malformations. This case illustrates the
      difficulty in excluding the diagnosis of hypoplastic left heart syndrome on a
      single view from one antenatal second-trimester ultrasound examination.

PMID- 1749681
TI  - Infected teratoma of lower posterior mediastinum in a six-year-old boy.
AB  - A six-year old boy presented with prolonged unexplained fever caused by an
      infected teratoma of the lower posterior mediastinum. Modern imaging, combining
      ultrasonography with computed tomography, enabled the correct diagnosis of
      topography, extension and nature of this rare lesion to be made and explained the
      clinical features. Follow-up CT showed regression of the abscess after
      antibiotics thus permitting elective surgery.

PMID- 1749682
TI  - Left-sided posterior mediastinal thymus--MRI findings.
AB  - Anomalous descent of the thymus may result in ectopic thymic tissue in the neck
      and/or the mediastinum and can mimic an abnormal mediastinal mass. We present one
      case of a "posterior mediastinal mass" that was diagnosed as a posterior
      mediastinal thymus utilizing CT plus MRI.

PMID- 1749683
TI  - Torsion of a wandering spleen in a one month old, with a confusing ultrasound
      examination.
AB  - Torsion of a wandering spleen is an uncommon diagnosis and rare in children. The
      entity is commonly misdiagnosed. In our case, a one month old infant presented
      with an abdominal mass. Ultrasound identified a large heterogeneous mass but also
      revealed what appeared to be normal splenic tissue below the left hemidiaphragm.
      The ultrasound findings steered us away from the diagnosis of wandering spleen or
      splenic infarction. Differential diagnosis of the mass included twisted
      hemorrhagic ovarian cyst, neoplastic mass, or inflammatory abscess. Postoperative
      histologic analysis demonstrated splenic infarction.

PMID- 1749684
TI  - Plasma cell granuloma presenting as an iliopsoas mass--mimicking a
      rhabdomyosarcoma.
AB  - Plasma cell granuloma is a rare benign tumour that can affect people of all ages.
      These are most commonly found in the lung but have been reported in numerous
      extrapulmonary sites. By gross and radiographic appearance they can mimic
      malignancies. We report a case of a plasma cell granuloma arising in the right
      pelvis contiguous with the iliopsoas mimicking a sarcoma.

PMID- 1749685
TI  - Chondroosseous dysplasia in severe combined immunodeficiency due to adenosine
      deaminase deficiency (chondroosseous dysplasia in ADA deficiency SCID).
AB  - Adenosine deaminase (ADA) deficiency may manifest as severe combined
      immunodeficiency (SCID) in early infancy. Some of these children develop
      radiologic changes which may be in part related to effects of this enzyme
      deficiency on the bony epiphysis. We describe the radiologic changes in a neonate
      with ADA deficiency and their resolution with polyethylene glycol conjugated
      adenosine deaminase (PEG-ADA, ADAGEN: Enzon, Inc., South Plainfield, NJ) enzyme
      replacement therapy.

PMID- 1749686
TI  - Congenital ossifying fibroma (osteofibrous dysplasia) of the tibia--a case
      report.
AB  - Ossifying fibromas of the long bones of the leg are benign lesions occurring in
      the pediatric age group identical in histological appearance to the similarly
      named tumor of the jaw in adults. Most frequently presentation occurs after minor
      trauma with symptoms of a swelling of the tibia or fibula which may be painful.
      Pathological fracture or limp are also occasional presentations. Congenital cases
      are extremely rare. We describe an otherwise normal male neonate who presented at
      birth with a bowed right lower leg. The limb was 1 cm shorter than the other
      side, with tibia vara and a firm mass situated anteriorly. X-ray showed a mixed
      lytic and sclerotic lesion in the proximal metaphysis of the tibia. Biopsy showed
      collagenous stroma containing spindle cells and irregular trabeculae of woven
      bone rimmed by plump osteoblasts. As the appearances were typical of an ossifying
      fibroma (osteofibrous dysplasia) no surgical treatment was given. The patient was
      well with no growth of the tumor and with radiological evidence of healing at 1
      year follow up. This case is presented to draw attention to the
      clinicopathological features of this unusual lesion which must be considered in
      the differential diagnosis of congenital lesions of the tibia.

PMID- 1749687
TI  - Simultaneous (synchronous) occurrence of Ewing sarcoma.
AB  - A case of Ewing sarcoma in a girl 13 year-old with multiple bone and soft tissue
      lesions at the time of diagnosis is presented. The lungs were free from the
      disease. This patient represents most likely a simultaneous (synchronous) Ewing
      sarcoma.

PMID- 1749688
TI  - Multifocal chronic osteomyelitis with exuberant periosteal formation.
AB  - A very protracted unusual course of multifocal osteomyelitis in a young child is
      presented. Initial radiolucencies were followed by a marked periosteal
      overgrowth, which resulted in severe bone deformities. A viral etiology is
      suggested.

PMID- 1749689
TI  - Maple tree knee: a unique foreign body--value of ultrasound and CT examination.
AB  - This report describes an intraosseous maple branch fragment which presented on
      initial radiographs as a benign appearing lytic bone lesion. Sonography and CT
      confirmed the presence of intraosseous and intra-articular foreign body and
      chronic foreign body reaction.

PMID- 1749690
TI  - Management of the febrile child: a survey of pediatric and emergency medicine
      residency directors.
AB  - We conducted a survey to determine whether there is uniformity in the training of
      residents regarding the management of febrile children. One hundred forty-three
      (62%) of 231 pediatric and 39 (53%) of the 73 emergency medicine residency
      directors responded. There was no uniformity in the definition of a fever. Ninety
      nine percent of the pediatric and 82% of the emergency medicine residency
      directors teach that all febrile infants less than 4 weeks of age should be
      hospitalized (P less than 0.0001). Forty-six percent of residency directors teach
      that a lumbar puncture should be performed for all children less than 12 months
      of age with their first febrile convulsion. Thirty percent of pediatric and 62%
      of emergency medicine residency directors teach that a blood culture should be
      obtained from a child with fever without source who is younger than 24 months of
      age (P less than 0.0005). Nonspecific tests are taught to be used to determine
      which febrile child should have a blood culture as follows: white blood cell
      count, 50%; differential, 20%; erythrocyte sedimentation rate, 13%; and C
      reactive protein, 2%. There was little uniformity of teaching regarding the
      approach to the febrile child and there were significant differences in training
      by specialty.

PMID- 1749691
TI  - The changing spectrum of group B streptococcal disease in infants: an eleven-year
      experience in a tertiary care hospital.
AB  - Risk factors, clinical syndromes and the case-fatality rates associated with
      Group B Streptococcus (GBS) infections in infants managed at the University of
      Rochester Medical Center during 1979 to 1989 were reviewed. Overall 92 episodes
      of early onset disease (EOD) and 54 of late onset disease (LOD) were diagnosed in
      143 infants (3 infants with EOD presented later with LOD). About one-third of
      patients with EOD and controls were non-white compared with two-thirds of
      patients with LOD that occurred in racial minority groups. Prematurity and low
      birth weight were significantly more common in patients with invasive GBS disease
      than in controls. Eighty-three of 92 (90%) cases of EOD were detected during the
      first day of life and 10 of 54 (19%) cases of LOD occurred in infants older than
      3 months of age. At the time of diagnosis 4% of infants with EOD were
      asymptomatic, 54% had respiratory disease, 27% had sepsis without a focus, 15%
      had meningitis and 1% had urinary tract infection or omphalitis. Among infants
      with LOD 46% had sepsis, 37% meningitis, 7% urinary tract infection, 6%
      osteomyelitis and/or septic arthritis and 4% cellulitis or pneumonia. Leukopenia
      and shift to the left were observed in 43 and 61% of episodes of EOD and in 28
      and 57% of episodes of LOD, respectively. All infants were promptly treated with
      antibiotics and vigorous supportive therapy. The case-fatality rate was 13% in
      EOD and 0 in LOD.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1749692
TI  - Characteristics and outcome of acute infection with hepatitis B virus in children
      with cancer.
AB  - After an outbreak of hepatitis B virus (HBV) infection in a unit of pediatric
      oncology, the clinical outcome and HBV markers were followed in 1 child with
      chronic and 10 children with acute HBV infection for 12 months. Four children had
      acute hepatitis with jaundice whereas 7 of the infections were subclinical. Ten
      children had antecedent malignancies and 1 had aplastic anemia. Four patients
      died of causes unrelated to the hepatitis after periods of 2, 4, 8 and 10 months.
      All 3 children who were not immunosuppressed at the time of contracting the HBV
      infection quickly turned negative for hepatitis B surface antigen (HBsAg),
      whereas only 2 of 8 patients who were immunosuppressed by chemotherapy eventually
      became HBsAg-negative. The latter 8 patients were also hepatitis B e antigen
      (HBeAg)-positive. Two of them quickly cleared HBeAg, but 6 remained HBeAg
      positive throughout the follow-up. In 6 of 9 patients HBsAg was also detected in
      saliva. These results suggest that children who are receiving anticancer
      chemotherapy have an increased risk of remaining HBeAg-positive and secreting
      HBsAg and possibly HBV in their saliva, which makes them particularly infective.

PMID- 1749693
TI  - Immunologic study of the asplenia syndrome.
AB  - Asplenia syndrome is usually associated with complex congenital cardiovascular
      defects. These patients often succumb to overwhelming infections. A complete
      immunological evaluation was therefore conducted on 13 consecutive patients with
      asplenia syndrome and 12 age-matched patients with congenital heart disease but
      without evident splenic problems. IgG, IgA, IgM and C3 and C4 values were normal
      for age in all subjects studied. T cell subsets, including the percentage of CD3,
      and CD4 cells and the CD4/CD8 ratio were significantly different in patients and
      controls (P less than 0.01, respectively). Lymphoproliferative responses to
      mitogens (ConA, concanavalin A, phytohemagglutinin and pokeweed mitogen) were
      also decreased in patients. Fc-mediated clearance of sensitized autologous
      erythrocytes was significantly impaired in patients (n = 13) when compared with
      age-matched controls (n = 5) (clearance t1/2 59.0 +/- 9.6 minutes vs. 12.5 +/-
      1.6 minutes, P less than 0.001). Thus profoundly impaired reticuloendothelial
      clearance and decreased T cell function might account for the life-threatening
      infections frequently seen in patients with congenital asplenia syndrome.

PMID- 1749694
TI  - Ureaplasma urealyticum demonstrated by open lung biopsy in newborns with chronic
      lung disease.
AB  - Lung biopsy tissue from eight infants with chronic lung disease was evaluated for
      the presence of Ureaplasma urealyticum. Specimens from four infants grew the
      organism. Pleural fluid cultures matched lung tissue but tracheal cultures were
      negative in two babies with positive lung tissue. There were no distinguishing
      pathologic findings in the four culture-positive infants which could be used to
      identify them vs. the culture-negative infants. Three culture-positive infants
      improved clinically after therapy directed at Ureaplasma even though two remained
      culture-positive. Ureaplasma grows in lung tissue of infants with chronic lung
      disease, it does not demonstrate any specific standard pathologic findings and
      tissue cultures do not match endotracheal cultures.

PMID- 1749695
TI  - Stability of isoniazid, rifampin and pyrazinamide in suspensions used for the
      treatment of tuberculosis in children.
AB  - The stability of monosuspensions, cosuspensions and multisuspensions of isoniazid
      (INH), pyrazinamide (PZA) and rifampin (RIF) has been evaluated by high pressure
      liquid chromatography over a period of 28 days both with and without the addition
      of vitamin C (20 micrograms/ml) and at ambient temperatures of 4 degrees C, 24
      degrees C and 40 degrees C. At the end of 28 days greater than 90% of initial
      concentrations of INH, PZA and RIF in monosuspensions remained unchanged
      irrespective of ambient temperature as was the case with INH and PZA in
      cosuspension. The addition of RIF to either INH or PZA in cosuspension or
      together in multisuspension led to a marked fall in the concentration of one or
      more of the agents, an effect that was accentuated by the addition of vitamin C.
      In the case of a multisuspension of INH + RIF + PZA with vitamin C added, 41.7%
      (4 degrees C), 24.1% (24 degrees C) and 20.3% (40 degrees C) of initial INH
      concentrations and 1.9% (4 degrees C), 1.3% (24 degrees C) and 0.0% (40 degrees
      C) of initial RIF concentrations remained detectable after 28 days. The addition
      of vitamin C to monosuspensions of INH and PZA led to a marked decline in the
      amount of drug detectable and only in the case of RIF was greater than 90% of
      initial concentrations of the drug detectable after 28 days. The dispensing of
      cosuspensions or multisuspensions of antituberculosis agents containing RIF is
      inadvisable as is the addition of vitamin C in any form.

PMID- 1749697
TI  - Pityriasis rosea.

PMID- 1749696
TI  - Miliary tuberculosis in children: a review of 94 cases.
AB  - This is a retrospective review of the clinical, radiologic and laboratory
      features of 94 cases of childhood miliary tuberculosis seen during a 5-year
      period, 1985 to 1989. A history of Bacillus Calmette-Guerin vaccination was
      documented in 88% of children. The median age at presentation was 10.5 months,
      52% of cases occurring in those younger than 1 year. The presenting symptoms were
      nonspecific: cough (72%); fever (61%); loss of appetite and weight (40%); and
      diarrhea and vomiting (33%). The main presenting signs were hepatomegaly (82%),
      splenomegaly (54%), lymphadenopathy (46%) and pyrexia (39%). Most of the patients
      were malnourished and anergic. Meningitis occurred in 19% of patients and this
      was the only significant risk factor identified for mortality, the overall case
      fatality rate being 14%. The diagnosis in the vast majority was made on the
      clinical presentation supported by a classic miliary pattern on chest
      roentgenogram (91% of cases). Mycobacterium tuberculosis was cultured in 33% of
      cases. In addition a review of hospital admissions from 1981 to 1989 revealed
      that annually miliary tuberculosis in children and adults accounted for 8.3 and
      1.3%, respectively, of all tuberculosis admissions. This study confirms that
      miliary tuberculosis is a relatively common complication of tuberculosis in young
      children.

PMID- 1749698
TI  - Spinal epidural abscess in infancy: successful percutaneous drainage in a nine
      month-old and review of the literature.

PMID- 1749699
TI  - The effects of maternal antibodies on neonatal rotavirus infection.

PMID- 1749700
TI  - Fatal intrauterine meningococcal infection.

PMID- 1749701
TI  - Peritonitis with Paecilomyces complicating peritoneal dialysis.

PMID- 1749702
TI  - Ceftriaxone failure in meningitis caused by Streptococcus pneumoniae with reduced
      susceptibility to beta-lactam antibiotics.

PMID- 1749703
TI  - Trimethoprim/sulfamethoxazole-resistant nontypable Haemophilus influenzae.

PMID- 1749704
TI  - Growth retardation, congenital heart disease and thrombocytopenia in a newborn
      infant.

PMID- 1749705
TI  - Zidovudine therapy in thrombocytopenic human immunodeficiency virus-infected
      children.

PMID- 1749706
TI  - Management of asymptomatic bacteriuria.

PMID- 1749707
TI  - Controlling cancer chemotherapy-induced emesis. An update.
AB  - Cytotoxic chemotherapy can induce acute, delayed and anticipatory nausea and
      vomiting. The efficacy and toxicity data of the available anti-emetics and their
      role in chemotherapy-induced emesis are reviewed. Moreover, some pitfalls in the
      methodology of anti-emetic trials as well as factors known to affect the
      individual sensitivity of patients for the emetic challenge are illustrated. So
      far, high-dose metoclopramide (3-6 mg.kg-1.d-1) was the most effective single
      agent in the control of acute emesis. However, extrapyramidal reactions caused by
      its dopamine antagonism remained a major drawback. The addition of dexamethasone
      and/or lorazepam decreases the incidence of extrapyramidal reactions, and further
      improves anti-emetic control. In animals, serotonin type 3 receptor antagonists
      have demonstrated promising anti-emetic results against chemotherapy-induced and
      radiotherapy-induced emesis; the results of clinical studies are awaited. Delayed
      nausea and vomiting have not been studied as extensively. At present, the
      combination of metoclopramide and dexamethasone offers an optimal protection in
      approximately 50% of patients on cisplatin chemotherapy. Anticipatory nausea and
      emesis remain major problems, and an effective pharmacological treatment is
      lacking. Attempts to control this type of emesis focus on drugs with amnesic
      properties and on behaviour therapy.

PMID- 1749708
TI  - Pharmacokinetics, N1-glucuronidation and N4-acetylation of sulfamethomidine in
      humans.
AB  - Sulfamethomidine metabolism was studied in 6 volunteers. In humans, only N1
      glucuronidation and N4-acetylation take place, leading to the final double
      conjugate N4-acetylsulfamethomidine N1-glucuronide. The N1-glucuronides were
      directly measured by high pressure liquid chromatography. Fast and slow
      acetylators show a similar half-life for sulfamethomidine (26 +/- 6 h) and its
      conjugates sulfamethomidine (26 +/- 6 h) and N4-acetylsulfamethomidine (36 +/- 16
      h). Approximately 50-60% of the oral dose of sulfamethomidine is excreted in the
      urine, leaving 40-50% for excretion into bile and faeces. The main metabolite of
      sulfamethomidine is its N1-glucuronide, which accounts for 36 +/- 7% of the dose,
      followed by N4-acetylsulfamethomidine (16 +/- 8%). N1-glucuronidation results in
      a 75% decrease in protein binding of sulfamethomidine. N4-acetylsulfamethomidine
      and its N1-glucuronide showed the same high protein binding of 99%. The renal
      clearance of N4-acetylsulfamethomidine is 7.9 +/- 2.2 ml/min and approximately 20
      times as high as that of the parent drug (0.46 +/- 0.16 ml/min). Total body
      clearance of sulfamethomidine is 4.5 +/- 0.9 ml/min and the volume of
      distribution in steady state 10.6 +/- 1.7 1. No measurable plasma concentrations
      of the N1-glucuronides from sulfamethomidine are found in plasma. This may be
      explained by renal glucuronidation after active tubular reabsorption.

PMID- 1749709
TI  - Ofloxacin intravenous. Compatibility with other antibacterial agents.
AB  - The physical and chemical compatibility of ofloxacin (infusion solution 100 ml =
      200 mg) with amoxicillin, amoxicillin + clavulanic acid, flucloxacillin,
      tobramycin, gentamicin, clindamycin, vancomycin, ceftazidime and piperacillin was
      investigated. Upon admixture with flucloxacillin a precipitate formed between 7
      and 24 hours. No other physical or chemical incompatibilities were observed with
      any of the other combinations. Ofloxacin may be safely combined with the tested
      antimicrobial drugs, except for flucloxacillin.

PMID- 1749710
TI  - In vitro and in vivo comparison of creams containing dithranol 0.5%.
AB  - In an in vitro model, the release and penetration through a silicon membrane of
      different cream formulations and ointments containing 0.5% dithranol were
      studied. The results indicated that the method is not suitable for predicting in
      vivo release and penetration. Experiments with rabbits showed that the degree of
      skin irritation produced by a hospital-prepared product containing 0.5% dithranol
      was comparable to that of of a commercial product. Clinical efficacy and side
      effects of these two products were investigated in a double-blind left-right
      comparative study in 35 patients with chronic plaque psoriasis. The two creams
      proved to be equally effective and showed the same incidence of side-effects.

PMID- 1749711
TI  - Omeprazole. A pharmaco-epidemiological study of its use in a university hospital.
AB  - A pharmaco-epidemiologic study in hospitalized patients was carried out in order
      to establish the place and use of omeprazole (Losec), a new and promising drug in
      the treatment of acid-related diseases. A comparison is made with cimetidine and
      ranitidine use. It appeared that prescribed omeprazole doses were high in
      relation to the established defined daily doses and that substitution of H2
      receptor antagonists by omeprazole led to tremendously increased drug costs. From
      the clinical indication data it could be established that the drug was prescribed
      appropriately.

PMID- 1749713
TI  - Abstracts of papers. Clinical pharmacological meeting. Utrecht (The Netherlands),
      4 October 1991.

PMID- 1749712
TI  - Abstracts of posters. Drug utilization research and pharmacoepidemiology meeting.
      Leiden (The Netherlands), 13 December 1991.

PMID- 1749714
TI  - Abstracts of papers. Biopharmaceutical meeting. Leiden (The Netherlands), 13
      October 1991.

PMID- 1749715
TI  - Morning sickness.

PMID- 1749716
TI  - Anaemia.

PMID- 1749717
TI  - Status regarding development of infrastructural facilities in India: the primary
      health care approach.

PMID- 1749718
TI  - Noise-induced hearing impairment and health problems of the industrial workers.

PMID- 1749719
TI  - Self retaining catheter: a brief manual.

PMID- 1749720
TI  - About nurses and nursing.

PMID- 1749722
TI  - Maintaining professional ethics and discipline in nursing.

PMID- 1749721
TI  - Nurses in psychiatric rehabilitation.

PMID- 1749723
TI  - Module on weaning and supplementary feeding.

PMID- 1749724
TI  - A study of complications of intravenous therapy in children.

PMID- 1749725
TI  - You and your child: the need for love and security.

PMID- 1749726
TI  - Attitude of unmarried girls towards family planning: a study in an Orissa City.

PMID- 1749727
TI  - European multicenter prospective follow-up study of 1,002 implants of a single
      lead VDD pacing system. The European Multicenter Study Group.

PMID- 1749728
TI  - Blood transfusion reactions. Which are life-threatening and which are not?
AB  - Adverse reactions occur acutely or some time after the fact in 20% of all blood
      transfusions. Since reactions are so common, it is important to recognize quickly
      whether the reaction is easily correctable or serious enough to force
      discontinuation or modification of treatment. The authors present a practical
      discussion of the topic, classifying reactions in terms of clinical presentation
      rather than pathophysiologic description.

PMID- 1749729
TI  - Hypothyroidism in the elderly. When symptoms are not a 'normal' part of aging.
AB  - Clinical findings alone may not lead to prompt diagnosis of hypothyroidism in
      elderly patients. Therefore, routine thyroid function tests may be warranted in
      older patients, especially women. Serum thyrotropin (TSH) is the most sensitive
      marker for hypothyroidism, although the test is more costly than that for serum
      thyroxine (T4). Patients with overt hypothyroidism who have elevated TSH and low
      T4 levels require replacement therapy. In addition, patients who have a TSH level
      higher than 20 microU/mL or who have a mildly elevated TSH level and high titers
      of antithyroid antibodies may benefit from prophylactic treatment. The usual
      recommended replacement dose is 0.05 to 0.1 mg/day of levothyroxine sodium
      (Levothroid, Synthroid).

PMID- 1749730
TI  - Understanding serum electrolytes. How to avoid mistakes.
AB  - Serum electrolyte levels by themselves may be difficult to interpret. For
      example, an abnormal serum potassium concentration cannot be understood without
      taking into account the patient's history, other serum electrolyte values, and
      possibly results of other laboratory tests. Knowledge of the principles of serum
      electrolyte concentrations, therefore, is an important adjuvant to understanding
      their implications.

PMID- 1749731
TI  - Adult respiratory distress syndrome. Strategies to provide support and enhance
      oxygen delivery.
AB  - Respiratory failure itself is rarely the cause of death in patients with adult
      respiratory distress syndrome (ARDS). The multiple-organ failure that often
      accompanies the syndrome or the underlying disease or trauma that leads to ARDS
      is more frequently the cause. Thus, care of these patients consists of providing
      life-sustaining support until they respond to therapy. The authors explain what
      happens in respiratory failure and how gas exchange can be enhanced in these
      critically ill patients.

PMID- 1749732
TI  - Corticosteroid therapy for rheumatoid arthritis. Benefits and limitations.
AB  - Oral corticosteroids, despite their potential side effects, have a select role in
      the treatment of rheumatoid arthritis. For articular disease, these drugs must be
      targeted to short-term goals, such as symptom relief. Close attention to the
      indications and potential hazards of steroid therapy may ensure optimal benefit
      and reduced risk. Intra-articular steroid injections can provide local
      symptomatic relief when only one or a few joints are swollen. Septic arthritis is
      most important to exclude before injection of a joint. Complications of intra
      articular injection are few, and relief may be long-lasting.

PMID- 1749733
TI  - Social phobia. Helping patients who are disabled by fear.
AB  - Persistent fear of embarrassment or humiliation in social situations can paralyze
      a person's educational and career advancement and lead to loneliness and
      isolation. What are the clinical signs of social phobia? How does it lead to
      disability and impairment? Dr Marshall answers these questions and discusses
      differential diagnosis and management.

PMID- 1749734
TI  - Hepatitis C update. New answers, new questions.
AB  - Currently available tests for infection with the hepatitis C virus detect the
      presence of antibodies against the virus. The value of these tests is limited,
      however, because the appearance of antibodies may be delayed and because there is
      a significant rate of false-positive results. Supplementary tests now being
      developed should greatly facilitate diagnosis of hepatitis C. Patients with
      chronic liver disease due to the hepatitis C virus can be treated with interferon
      alfa-2b (Intron A). This treatment should also be considered for patients with
      markedly elevated transaminase levels, evidence of significant histologic injury,
      or symptoms referable to the liver.

PMID- 1749735
TI  - A bright spot in winter.

PMID- 1749736
TI  - Leishmaniasis. Another threat to Persian Gulf veterans.
AB  - Leishmaniasis, a protozoal infection transmitted by sand flies, is one of the
      most common parasitic diseases worldwide. As US military troops return from
      endemic areas, it is likely that physicians will encounter cases of this
      previously seldom seen disease. The incubation period is long, and initial
      infection is often insidious and difficult to diagnose. To prevent the high
      mortality of untreated visceral forms and the potentially disfiguring scarring of
      the cutaneous form, primary care physicians (especially those caring for Persian
      Gulf veterans) should be aware of the disease and familiar with its treatment.

PMID- 1749737
TI  - Delayed weakness following a gunshot wound.
AB  - Injury to the vascular system in the cervical mediastinal area can cause delayed
      neurologic symptoms. In this article, the authors describe a patient in whom
      pseudoaneurysm formation after a gunshot wound eventually led to weakness in the
      shoulder and arm.

PMID- 1749738
TI  - Triglycerides and serum cholesterol.

PMID- 1749739
TI  - Ischemic stroke. How to keep the first one from happening.
AB  - The prevention of stroke has undenied merit. Recognition of stroke-inducing
      conditions (eg, cardiac diseases associated with embolism, polycythemia) provides
      opportunities for specific prevention strategies. For a larger number of
      patients, however, risk factors for degenerative vascular disease should be
      addressed. The evidence for efficacy is strongest for treatment of hypertension,
      and smoking cessation also reduces the risk of stroke. The value of treatment of
      hyperlipidemia in reducing the incidence of a first stroke remains to be
      demonstrated. Optimal management of carotid bruit and asymptomatic stenosis will
      be clarified by results of ongoing clinical trials. On the basis of available
      data, use of aspirin by healthy persons without risk factors cannot be
      recommended as a method for preventing a first ischemic stroke.

PMID- 1749740
TI  - Cardioembolic stroke. Primary and secondary prevention.
AB  - Modern prospective trials have recently shown that warfarin prescribed to produce
      less anticoagulant effect than was customary in the past reduces cardioembolic
      stroke by up to 80% in patients with nonvalvular atrial fibrillation. These
      results represent a major advance in stroke prevention. The effectiveness of
      antithrombotic treatment in other settings in which there is risk of
      cardioembolism is less well established but likely to be substantial.

PMID- 1749741
TI  - Prevention of recurrent ischemic stroke.
AB  - Treatment after an ischemic stroke or transient ischemic attack (TIA) should
      target the presumed cause of the initial episode to facilitate focused
      prophylaxis. In the majority of ischemic strokes, degenerative large- and small
      vessel disease is the cause. In these patients, attention to modifiable risk
      factors is an important priority. However, uncertainty and controversy remain
      regarding therapy, although issues are gradually being settled. There are now
      strong scientific data to support the use of carotid endarterectomy in patients
      with 70% to 99% stenosis and an ipsilateral TIA or nondisabling stroke. Aspirin
      is accepted as standard preventive therapy and should be used in all patients
      with a TIA or stroke, including those who undergo endarterectomy. Although the
      dose most commonly used in clinical trials is 1,300 mg/day, a daily dose of 325
      mg is probably equally effective with less gastrotoxicity. Given present
      evidence, use of dipyridamole (Persantine) is not warranted. The role of
      ticlopidine hydrochloride (Ticlid) in stroke prophylaxis is not well defined. Its
      superiority over aspirin demonstrated in one study may make it the drug of first
      choice despite its expense and side effects. The efficacy of warfarin sodium
      (Coumadin, Panwarfin, Sofarin) or heparin in ischemic stroke caused by
      degenerative cerebrovascular disease is not supported by scientific data, but no
      prospective controlled studies have demonstrated that these agents are
      ineffective. Therefore, it seems prudent to reserve anticoagulant therapy for
      situations in which an ongoing thrombotic process is likely (eg, progressing
      stroke). Heparin therapy in the immediate post-TIA period is not warranted on the
      basis of current scientific evidence.

PMID- 1749742
TI  - Antiarrhythmic drug therapy in congestive heart failure. Indications and
      complications.
AB  - High-grade ventricular arrhythmias are common in congestive heart failure (CHF).
      However, antiarrhythmic drug therapy is indicated only for patients with
      symptomatic or hemodynamically significant sustained arrhythmias. Before such
      therapy is initiated, reversible causes of arrhythmias (eg, electrolyte
      imbalance, drug interactions and toxicity, decompensation of CHF, ongoing
      ischemia) should be sought out and corrected. Patients with poor ventricular
      function or a history of CHF should be hospitalized and monitored continuously
      during initiation and evaluation of antiarrhythmic therapy so that early
      detection of proarrhythmic response is possible. Therapy should be initiated with
      the smallest effective dose, which then is increased slowly to minimize the risk
      of side effects. Drug selection should be guided electrophysiologically or
      noninvasively, and empirical antiarrhythmic drug therapy must be avoided.

PMID- 1749743
TI  - Tumour necrosis factor in inflammation: relation to other mediators and to
      macrophage antitumour defence.

PMID- 1749744
TI  - Molecular action of class I antiarrhythmic drugs and clinical implications.
AB  - This report briefly reviews the advance in our knowledge of cellular
      electrophysiological effects of membrane stabilizer antiarrhythmic drugs (sodium
      channel blockers) including some new ones. The class I drugs block cardiac sodium
      channels and differ in the kinetics of the interaction with sodium channels and
      in the actions on the repolarization phase. The class I drugs can be subdivided
      into subclasses (I a,b,c). This review focuses on the interaction of these drug
      with sodium channels and the molecular models of their action. The interaction of
      class I drugs with the sodium channel receptor is influenced by the state of the
      myocardium (pH, ischaemia) and by other drugs as well. The clinical implications
      of different actions of sodium channel blockers, alone and in combination, and
      their proarrhythmic effects are summarized.

PMID- 1749745
TI  - The in vitro effects of lipid peroxidation on the content of individual forms of
      cytochrome P-450 in liver microsomes of guinea-pigs.
AB  - The effect of lipid peroxidation in vitro on the amounts of several forms of
      cytochrome P-450 in liver microsomes from guinea-pigs was investigated. Lipid
      peroxide formation in liver microsomes from ascorbic acid (VC)-deficient animals
      was much higher than that observed in control animals. The antibodies to rat P
      450IA2 (P-448-H), P-450IIB1 (P-450b) and human P-450IIIA4 (P-450NF) recognized
      one or two forms of cytochrome P-450 in liver microsomes of guinea-pigs. Neither
      cytochrome P-450 cross-reactive with anti-P-450IIB1 antibodies nor cytochrome P
      450 cross-reactive with antibodies to P-450IIIA4 was virtually affected by
      microsomal lipid peroxidation induced by NADPH in vitro. In contrast, the forms
      of cytochrome P-450 immunochemically related to P-450IA2 were decreased with the
      increased level of lipid peroxide formation. The form-specific degradation of
      cytochrome P-450 due to lipid peroxidation was in agreement with our previous
      observation that the amounts of cytochrome P-450 cross-reactive with antibodies
      to P-450IA2 but not with antibodies to P-450IIIA (P-450PB-1) were predominantly
      decreased in VC-deficient guinea-pigs compared to control animals in vitro.

PMID- 1749746
TI  - Different effects of captopril and other angiotensin converting enzyme inhibitors
      on cardiovascular preparations.
AB  - The effects of captopril and of other angiotensin-converting enzyme inhibitors
      (zofenopril, fosenopril and enalaprilic acid) were tested on the isolated rabbit
      heart and aorta. Captopril elicited an erratic negative inotropic effect and a
      reduction in basal coronary perfusion pressure (10(-5)-10(-4) M). The increase of
      coronary perfusion pressure induced by vasopressin, methoxamine, angiotensin II
      and Bay K 8644 was partially antagonized by captopril (10(-7)-10(-4) M) in a non
      specific manner. These actions were not modified by saralasin or indomethacin and
      by ex vivo pretreatment with captopril itself. On the aortic strips, the
      contraction plateau induced by KCl and angiotensin II was partially inhibited
      (10(-6)-10(-4) M), while no effect was observed on those induced by
      noradrenaline, serotonin and PGF2 alpha. The Ca2+ concentration-response curve
      appeared shifted to the right in a non-competitive manner. The other angiotensin
      converting enzyme inhibitors showed no effect up to 10(-4) M on isolated heart or
      aorta. Results obtained with captopril were consistent with vasorelaxant activity
      independent of the tissue renin-angiotensin system. Modulatory activity on the
      intracellular calcium movement may be involved.

PMID- 1749747
TI  - Effects of different drugs on the cystometrogram in conscious rats.
AB  - The effects on urodynamic parameters of i.v. administration of different drugs
      utilized in the therapy of detrusor instability, have been studied in conscious
      catheterized rats. Emepronium bromide, oxybutynin and nifedipine affected in a
      dose-dependent way the micturition pressure (MP), with sporadic changes in
      bladder volume capacity (BVC). Terodiline induced significant increases in BVC
      values in a wide range of doses. These changes, however, were always not dose
      dependent. The drug significantly reduced MP only at the higher administered dose
      (10 mg/kg). Flavoxate induced increases of bladder capacity (BVC) not dependent
      on the administered doses, with no changes in micturition pressure (MP).
      Indomethacin significantly increased BVC and weakly reduced MP, but the effects
      were not dose-related. The effects of drugs on BVC were unrelated with the basal
      value of this parameter, whereas the decrease of MP seems to be related to high
      basal values before treatment. From a quantitative point of view,
      cystometrographic recordings in conscious normal rats can provide comparative
      data among drugs acting on bladder contractility (MP) such as anticholinergics
      and strong calcium antagonists.

PMID- 1749748
TI  - Clonidine differentially modulates the release of endogenous GABA in various rat
      brain areas.
AB  - The effects of clonidine on the release of endogenous gamma-aminobutyric acid
      (GABA) have been studied in superfused synaptosomes prepared from rat
      hypothalamus, nucleus tractus solitarii (NTS) and cerebellum. Clonidine enhanced
      in a concentration-dependent manner the basal release of GABA from hypothalamus
      and NTS synaptosomes. In contrast, the imidazoline did not affect the release of
      the amino acid from the cerebellar preparation. The alpha 2-adrenoceptor
      antagonist yohimbine prevented the releasing effect of clonidine, while the alpha
      1-adrenoceptor antagonist prazosin was ineffective. The results show that the
      release of GABA from hypothalamus or NTS nerve endings can be enhanced by
      clonidine through the activation of adrenoceptors of the alpha 2 subtype. The
      GABAergic nerve terminals of cerebellum do not seem to possess presynaptic
      adrenoceptors by which clonidine can regulate the basal outflow of the amino
      acid. The results suggest that some of the clonidine effects may occur through
      activation of the GABA system.

PMID- 1749749
TI  - The role of the adrenergic system in the heart: regulation of contractility by
      cardiac adrenoceptors.

PMID- 1749750
TI  - Spectral analysis of cardiovascular variabilities in the assessment of
      sympathetic cardiac regulation in heart failure.

PMID- 1749751
TI  - [Tuberculin diagnosis and its significance in massive BCG re-vaccination].
AB  - The diagnosis of primary tuberculosis contamination becomes difficult and the
      effectiveness of tuberculin diagnosis drastically declines under conditions of
      mass vaccination and threefold revaccination of children. Study of the influence
      of different intervals between BCG revaccination on the nature of tuberculin
      sensitivity was carried out in order to improve the preventive measures in
      children and adolescents. An increase in revaccination intervals was found to
      contribute to a more precise detection of primary tuberculosis contamination and
      larger (more than four times) BCG coverage of adolescents.

PMID- 1749752
TI  - [BCG vaccination of children with differing perinatal pathology].
AB  - Information on 586 newborns with perinatal abnormalities who were not given BCG
      vaccination in the maternity homes of Novosibirsk is analysed. The most common
      causes of BCG vaccination refusal were intrauterine hypotrophy (35%), CNS
      affection (29.2%) and prematurity (22.7%). A follow-up of 693 children with
      perinatal abnormalities who received BCG vaccination in polyclinics has shown
      that this vaccination is sufficiently effective and the course of the vaccination
      reaction does not differ from that in children who were vaccinated in the
      maternity homes. It has been concluded that BCG vaccination can be given to the
      majority of children with perinatal abnormalities within the first 2 months of
      life provided their condition is satisfactory.

PMID- 1749753
TI  - [The differential diagnosis of sarcoidosis of the respiratory organs using
      mathematical methods and computers].
AB  - A system for detecting sarcoidosis has been proposed on the basis of the results
      of a primary examination, which comprises a combination of programs for
      determining whether sarcoidosis may occur in various X-ray syndromes (enlarged
      intrathoracic lymph nodes, disseminated process, infiltrative or pneumonia-like
      shadow and cavity formation). The system has been developed with the help of a
      program-algorithm complex which enables one to make the dialogue system of the
      decision-make support on the basis of statistical methods of "image recognition"
      containing basic structural elements of the expert systems. Program development
      proceeds from the findings obtained in 406 patients with sarcoidosis of
      respiratory organs and 723 patients having similar clinical and X-ray picture of
      the disease. The diagnostic efficiency of the system was 89% in disseminated
      processes, 90% in enlarged intrathoracic lymph nodes and cavitary changes, and
      96.2% in infiltrative changes.

PMID- 1749754
TI  - [The incretory function of the pancreas in patients with pulmonary tuberculosis
      and diabetes mellitus].
AB  - Serum C-peptide levels were studied in 88 patients with pulmonary tuberculosis
      concurrent with diabetes mellitus. The pancreatic incretory function in combined
      pathology was found to be related both to the type and severity of diabetes
      mellitus and the severity of tuberculosis. Specific and medicamental intoxication
      negatively affects residual insulin secretion and the body's insulin-sensitivity.
      High functional capacity of B-cells of the pancreas and insulin resistance in
      noninsulin dependent diabetes, on the one hand, and rapid depletion of the
      insular apparatus in serious chronic tuberculosis, on the other, made it possible
      to recommend combined hypoglycemic therapy with insulin and oral sugar-lowering
      drugs to patients with a prolonged severe course of each of the diseases
      (pulmonary tuberculosis and Type II diabetes) in their combination.

PMID- 1749755
TI  - [Tarivid in the combination therapy of patients with pulmonary tuberculosis].
AB  - The effectiveness of tarivid, a new drug having a broad spectrum of antimicrobial
      action and antituberculous effect, was studied. The drug was given to 29 patients
      with newly detected destructive pulmonary tuberculosis and bacillary excretion.
      Eight patients had microbacterial resistance to streptomycin, rifampicin and
      isoniazid, 12 had tolerance to them, in 9 patients tuberculosis was complicated
      by a nonspecific inflammatory process. The course of treatment ranged from 3
      weeks to 3 months. The drug was well tolerated. Its effect was manifested by
      reduction of intoxication, resolution of the inflammatory and pericavitary
      pulmonary lesions and bacilli absence. Tarivid can be considered an efficacious
      drug in the multimodality therapy of tuberculosis patients.

PMID- 1749756
TI  - [The use of bio-controlled electrostimulation of the respiration in the combined
      modality treatment of patients with pulmonary tuberculosis].
AB  - Electric respiration stimulation (ERS) synchronized with the onset of spontaneous
      breathing is more effective than induced one. Introduction of the biocontrolled
      ERS into the treatment and prevention of respiratory complications in the
      postoperative period improved the effectiveness of surgical treatment of
      phthisiopulmonologic patients. The biocontrolled ESR is known to provide
      favourable results in the multimodality treatment of patients with pneumonia,
      chronic bronchitis and bronchial asthma.

PMID- 1749757
TI  - [Diagnosis of ocular tuberculosis].
AB  - Ways for enhancing the diagnostic accuracy for tuberculous diseases of the eyes
      and shortening the terms of examination of patients are shown on the basis of
      research and the elaboration of new early diagnostic methods. It is only further
      work in this direction that will promote the improvement and accuracy of the
      diagnosis of tuberculous uveitis.

PMID- 1749758
TI  - [The surgical treatment of disseminated forms of tubercular spondylitis using
      Byzov's apparatus].
AB  - Analysis of treatment of 123 patients with disseminated forms of tuberculous
      spondylitis is presented. Among the patients 67 (54.4%) subjects were over 55
      years of age. The main cause of disseminated spondylitis forms was ungroundlessly
      prolonged conservative treatment under bed regime. As a result, symptoms of low
      cardiac activity were seen in 79 (64.2%), lymphovenous stasis in 22 (17.8%) and
      osteoporotic signs in 38 (30.8%) patients. Complications and concurrent diseases
      in 41 (33.3%) of the cases prompted surgery from the posterior approach, in 82
      (66.7%)--from the anterior approach with replacement of the defect by an
      autograft or biocompatible implant with extrafocal posterior fixation of the
      operated segments by Byzov's apparatus. The patients became active beginning on
      days 7-12 of postoperation, which promoted reparative process normalization in
      the operative area. The late therapeutic results were studied in 117 patients.
      Support capacity recovered in 99 patients and improved in 18. The method used is
      functionally justified, well tolerated by patients and highly effective in
      treating the abnormality.

PMID- 1749759
TI  - [Characteristics of primary tuberculosis from the morphologic point of view
      (lecture)].

PMID- 1749760
TI  - [The method of endobronchial thermometry in the evaluation of the activity of
      tuberculosis of the respiratory organs].
AB  - Local temperature reactions were studied in 72 patients with intrathoracic
      tuberculosis (64 of them had active tuberculosis and 8 residual pulmonary changes
      after prior tuberculosis). Endobronchial thermometry in the dynamics of a
      specific process was conducted in 7 patients with pulmonary tuberculosis.
      Bronchial temperature was measured during fibrobronchoscopy under local
      anesthesia by a device of an original design. Marked thermoregulatory
      disturbances were found in the bronchi which were caused by a specific active
      process in the lungs and were manifested in a significant decline of
      endobronchial temperature as compared to normal values. Clinical recovery of
      pulmonary tuberculosis with the development of posttuberculous fibrous changes
      does not cause any disturbances in local temperature reactions. The temperature
      level in the bronchi is significantly affected by the nature and degree of the
      inflammatory process in the bronchi.

PMID- 1749761
TI  - [AIDS and lung diseases].

PMID- 1749762
TI  - [The NBT test of alveolar macrophages in patients with infiltrative pulmonary
      tuberculosis].

PMID- 1749763
TI  - [Hemofiltration in the treatment of patients with renal tuberculosis and
      tuberculosis of other organs, complicated by chronic renal insufficiency].

PMID- 1749764
TI  - [The voluntary limitation of lung ventilation and suppression of expiration in
      the treatment of bronchial asthma].

PMID- 1749765
TI  - [The use of highly dispersed iron particles for increasing the sensitivity of the
      luminescent microscopic method of determining Mycobacterium tuberculosis].
AB  - A highly dispersed ferromagnetic powder obtained by a plasmochemical method
      (particle size was 100-500 A) was treated by means of an ultrasonic disperser:
      suspension was added to the trisodium phosphate homogenized and neutralized
      sputum (0.3 mg of the initial powder per 1 ml of sputum) of patients with various
      forms of pulmonary tuberculosis. The sputum was then incubated at slight stirring
      for 40 min and centrifuged; the precipitate was used to prepare smears which were
      stained with auramine; mycobacteria were detected by luminescence microscopy. The
      ferromagnetic suspension was found to increase luminescence microscopy
      sensitivity to 85.4%. The efficacy of the method was 30.8% more than that in the
      cultivation of infectious material in solid nutrient media.

PMID- 1749766
TI  - [Dynamics of the indices of the immune system as affected by endobronchial laser
      therapy in patients with complicated tuberculosis of the lungs].
AB  - The results of study of the local and humoral immune defense during endobronchial
      laser therapy of nonspecific endobronchitis in patients with newly diagnosed
      pulmonary tuberculosis are presented. Laser therapy proved to have no negative
      action on the humoral immunity in pulmonary tuberculosis patients during
      treatment of catarrhal and purulent endobronchitis, while a marked increase in
      IgM levels, thus rapidly reacting and well opsonizing antibodies can be regarded
      as a positive or stimulating the impact on the whole immune system. Endobronchial
      laser therapy for catarrhal and especially purulent inflammatory bronchial
      process in the multimodality treatment of patients with newly diagnosed pulmonary
      tuberculosis normalized parameters of the local immune system, especially that of
      locally secreted immunoglobulins, i.e. helium-neon laser radiation has a
      favourable influence on local immune defense, which is essential in increasing
      the efficacy of therapy of this category of patients.

PMID- 1749767
TI  - [Potentialities and perspectives for the use of thermographic methods in
      phthisiology and pulmonology].

PMID- 1749768
TI  - [The 70th anniversary of the Chair of Phthisiopulmonology of the I.M. Sechenov
      Moscow Medical Academy].

PMID- 1749769
TI  - [Apropos of V.M. Kolomiits's article "Administrator-phthisiologist in current
      conditions"].
AB  - The editorial board of the journal presented for discussion the paper by V. M.
      Kolomiyits "A phthisiological curator under the present-day conditions". Four
      review papers have been received which are concerned with pro and contra of the
      activity of a phthisiological curator. All the participants of the discussion
      supported the idea of remaining curator's activities in either form.

PMID- 1749770
TI  - An autoantibody to single-stranded DNA: comparison of the three-dimensional
      structures of the unliganded Fab and a deoxynucleotide-Fab complex.
AB  - Crystal structures of the Fabs from an autoantibody (BV04-01) with specificity
      for single-stranded DNA have been determined in the presence and absence of a
      trinucleotide of deoxythymidylic acid, d(pT)3. Formation of the ligand-protein
      complex was accompanied by small adjustments in the orientations of the variable
      (VL and VH) domains. In addition, there were local conformational changes in the
      first hypervariable loop of the light chain and the third hypervariable loop of
      the heavy chain, which together with the domain shifts led to an improvement in
      the complementarity of nucleotide and Fab. The sugar-phosphate chain adopted an
      extended and "open" conformation, with the base, sugar, and phosphate components
      available for interactions with the protein. Nucleotide 1 (5'-end) was associated
      exclusively with the heavy chain, nucleotide 2 was shared by both heavy and light
      chains, and nucleotide 3 was bound by the light chain. The orientation of
      phosphate 1 was stabilized by hydrogen bonds with serine H52a and asparagine H53.
      Phosphate 2 formed an ion pair with arginine H52, but no other charge-charge
      interactions were observed. Insertion of the side chain of histidine L27d between
      nucleotides 2 and 3 resulted in a bend in the sugar-phosphate chain. The most
      dominant contacts with the protein involved the central thymine base, which was
      immobilized by cooperative stacking and hydrogen bonding interactions. This base
      was intercalated between a tryptophan ring (no. H100a) from the heavy chain and a
      tyrosine ring (no. L32) from the light chain. The resulting orientation of
      thymine was favorable for the simultaneous formation of two hydrogen bonds with
      the backbone carbonyl oxygen and the side chain hydroxyl group of serine L91 (the
      thymine atoms were the hydrogen on nitrogen 3 and keto oxygen 4).

PMID- 1749771
TI  - Thiol proteases and aldehyde dehydrogenases: evolution from a common
      thiolesterase precursor?
AB  - The C-terminal 222 residues of human liver aldehyde dehydrogenase can be aligned
      with the C-terminal 226 residues of a thiol protease from Dictyostelium
      discoideum to yield 47 residue identities, including matching active site
      cysteine residues. A multiple alignment with three more aldehyde dehydrogenases
      and three more thiol proteases yields three regions with clustered residue
      similarities. In the tertiary structure of papain, these three regions are in
      close proximity although widely separated in primary structure, and many
      conserved residues are located in the active site groove. The three-dimensional
      relationships, the common thiol ester mechanisms of the enzymes, the locations of
      exon boundaries in the dehydrogenase and protease genes, and the conservation of
      internal salt-bridging and disulfide-paired residues in papain, all appear
      compatible with the hypothesis of an ancestral relationship between thiol
      proteases and aldehyde dehydrogenases.

PMID- 1749772
TI  - A 175-psec molecular dynamics simulation of camphor-bound cytochrome P-450cam.
AB  - The structure and internal motions of cytochrome P-450cam, a monooxygenase heme
      enzyme with 414 amino acid residues, with camphor bound at the active site have
      been evaluated on the basis of a 175-psec molecular dynamics simulation carried
      out at 300 K. All hydrogen atoms were explicitly modeled, and 204
      crystallographic waters were included in the simulation. Based on an analysis of
      the time course of the trajectory versus potential energy, root mean square
      deviation, radius of gyration, and hydrogen bonding, the simulation was judged to
      be stable and representative of the average experimental structure. The averaged
      structural properties of the enzyme were evaluated from the final 135 psec of the
      simulation. The average atomic displacement from the X-ray structure was 1.39 A
      for all heavy atoms and 1.17 A for just C-alpha atoms. The average root-mean
      square (rms) fluctuations of all heavy atoms and backbone atoms were 0.42 and
      0.37 A, respectively. The computed rms fluctuations were in reasonable agreement
      with the experimentally determined temperature factors. All 13 segments of alpha
      helix and 5 segments of beta-sheet were well preserved with the exception of the
      N-terminal half of helix F which alternated between an alpha-helix and a 310
      helix. In addition there were in general only small variations in the relative
      orientation of adjacent alpha-helices. The rms fluctuations of the backbone
      dihedral angles in the secondary structure elements were almost uniformly
      smaller, with the fluctuation in alpha-helices and beta-sheets, 31 and 10% less,
      respectively, than those in nonsecondary structure regions. The reported crystal
      structure contains kinks in both helices C and I. In the simulation, both of
      these regions showed high mobility and large deviations from their starting
      positions. Since the kink in the I helix is at the oxygen binding site, these
      motions may have mechanistic implications.

PMID- 1749773
TI  - Collective motions in proteins: a covariance analysis of atomic fluctuations in
      molecular dynamics and normal mode simulations.
AB  - A method is described for identifying collective motions in proteins from
      molecular dynamics trajectories or normal mode simulations. The method makes use
      of the covariances of atomic positional fluctuations. It is illustrated by an
      analysis of the bovine pancreatic trypsin inhibitor. Comparison of the covariance
      and cross-correlation matrices shows that the relative motions have many similar
      features in the different simulations. Many regions of the protein, especially
      regions of secondary structure, move in a correlated manner. Anharmonic effects,
      which are included in the molecular dynamics simulations but not in the normal
      analysis, are of some importance in determining the larger scale collective
      motions, but not the more local fluctuations. Comparisons of molecular dynamics
      simulations in the present and absence of solvent indicate that the environment
      is of significance for the long-range motions.

PMID- 1749774
TI  - Crystal parameters and molecular replacement of an anticholera toxin peptide
      complex.
AB  - TE33 is an Fab fragment of a monoclonal antibody raised against a 15-residue long
      peptide (CTP3), corresponding in sequence to residues 50-64 of the cholera toxin
      B subunit. Crystals of the complex between TE33 and CTP3 have been grown from 20%
      (w/v) polyethylene glycol-8000 at pH 4.0. The crystals are orthorhombic, space
      group P2(1)2(1)2, with unit cell dimensions a = 104.15, b = 110.61, and c = 40.68
      A. X-Ray data have been collected to a resolution of 2.3 A. The asymmetric unit
      contains one molecule of Fab and one molecule of CTP3. The presence of CTP3 has
      been demonstrated by fluorescence quenching of the dissolved crystal after X-ray
      data collection. A molecular replacement solution was found based on the
      coordinates of DB3, an antiprogesterone Fab fragment.

PMID- 1749775
TI  - Analysis of the steric strain in the polypeptide backbone of protein molecules.
AB  - The extent to which local strain is present in the polypeptide backbone of folded
      protein molecules has been examined. The occurrence of steric strain associated
      with nonproline cis peptide bonds and energetically unfavorable main chain
      dihedral angles can be identified reliably from the well ordered parts of high
      resolution, refined crystal structures. The analysis reveals that there are
      relatively few sterically strained features. Those that do occur are located
      overwhelmingly in regions concerned with function. We attribute this to the
      greater precision necessary for ligand binding and catalysis, compared with the
      requirements of satisfactory folding.

PMID- 1749776
TI  - Crystallization and preliminary X-ray diffraction studies of human salivary alpha
      amylase.
AB  - Nonglycosylated alpha-amylase, a major component of human parotid saliva, has
      been crystallized by the vapor diffusion technique using 2-methyl-2,4-pentanediol
      as the precipitant in the presence of CaCl2 at pH 9.0. The crystals are
      orthorhombic, space group P2(1)2(1)2(1) with unit cell dimensions of a = 53.3, b
      = 75.8, and c = 138.1 A. The asymmetric unit contains one amylase molecule. The
      solvent content is 54%. The crystals are stable to X-rays and diffract up to 2.8
      A and appear to be suitable for X-ray diffraction studies.

PMID- 1749777
TI  - Crystallization and preliminary X-ray investigation of a recombinant form of rat
      catechol O-methyltransferase.
AB  - Rat catechol O-methyltransferase cDNA was introduced into an E. coli expression
      vector pKEX14, which utilizes the inducible T7 promoter. Active and soluble
      recombinant catechol O-methyltransferase was produced in bacteria and purified to
      electrophoretic homogeneity by chromatographic procedures. The purified enzyme
      has been crystallized by the method of vapor diffusion using polyethylene glycol
      as precipitant. The space group is P3(1)21 or P3(2)21 with a = b = 51.3 A and c =
      168.5 A and one molecule in the asymmetric unit. The crystals diffract beyond 3.2
      A and are suitable for three-dimensional X-ray structure determination.

PMID- 1749778
TI  - Asymmetry of mandibular dimensions in European skulls.
AB  - Eighteen mandibular dimensions (mm) in sex-determined, 10th-12th-century European
      skulls from burial sites in South-Eastern Hungary were examined to discover
      whether differences exist between the right and left sides. There was a
      statistically significant difference in only one dimension, the smallest sagittal
      diameter of the mandibular neck, in both males and females. The frequencies with
      which the various 18 dimensions were identical between right and left sides
      ranged from 39.9% to 82.0% in males, and from 45.9% to 83.2% in females. The
      examined individual dimensions appeared to be smaller on the right side in 7.0%
      to 33.7% (mean 19.1%) of the male cases, and in 7.1% to 29.9% (mean 17.9%) of the
      females, while the right side was larger in 7.7% to 50.9% (mean 22.3%) of the
      males and in 7.9% to 54.3% (mean 22.5%) of the females. In conclusion, asymmetry
      of the left and right sides was found between the measured individual mandibular
      dimensions on average in 41.4% of the males and 40.4% of the females.

PMID- 1749779
TI  - A new method for studying the effect of glass ionomer on plaque in vivo.
AB  - In order to study the amount of fluoride originating from glass ionomer, a test
      appliance was constructed and set on upper molars of sixteen volunteers using
      glass ionomer. The control appliance was set on the contralateral tooth using
      composite. Six weeks after the setting of appliances, plaque samples were taken
      and analysed. Mean amounts of protein corresponding to the amounts of plaque were
      equal in the test and the control groups. The mean fluoride/protein ratio in
      plaque was 80 times higher in the glass ionomer group than in the composite
      group. With this sampling method it is possible to collect sufficient amounts of
      plaque for quantification of plaque fluoride.

PMID- 1749780
TI  - Plaque accumulation on glass ionomer filling materials.
AB  - It has been suggested that fluoride released by glass ionomers inhibits the
      growth of plaque. The aim of this study was to compare plaque accumulation on
      glass ionomers and composite. The materials tested were (1) freshly mixed glass
      ionomer (Ketac-Fil), (2) artificially aged glass ionomer (Ketac-Fil), (3) freshly
      mixed silver glass ionomer (Ketac-Silver) and (4) light-cured hybrid composite
      (Valux). Ten volunteers wore an acrylic appliance for three periods of 18 hours,
      one for each glass ionomer. A glass ionomer disk was inserted on one randomly
      chosen side of the appliance and the composite disk on the other. The volunteers
      rinsed once an hour with a 15% sucrose solution. The amount of pellicle and
      plaque on the disk was estimated by analysing its protein content. During each
      cycle, more plaque accumulated on the glass ionomers than on the composite (fresh
      Ketac-Fil/Valux p less than 0.05, aged Ketac-Fil/Valux p less than 0.01, Ketac
      Silver/Valux NS). On examination using a scanning electron microscope the
      surfaces of the glass ionomers were found to be markedly more porous, and to
      contain more microbes, than the composite surface. The presence of silver in the
      silver glass ionomers may have affected the initial adherence of bacteria.

PMID- 1749781
TI  - Safety of dental restorative materials: a survey of dentists' attitudes.
AB  - In order to obtain information from practising dentists in Finland about their
      experiences of and attitudes to dental restorative materials, a cross-sectional
      survey was conducted in spring 1990 using a postal questionnaire. The response
      rate was 73% (454 replies). Virtually all (99%) respondents had faced questions
      about the safety of dental materials in 1989 and 93% of all questions concerned
      amalgam. Most respondents assessed their theoretical knowledge and practical
      experience of amalgam, composite and glass ionomer as good, whereas gold and
      ceramics as filling materials were less familiar. However, the three latter
      materials were regarded as safe by most respondents. Composite was believed to
      pose the highest risk of side-effects. Although few dentists regarded amalgam as
      hazardous, it was estimated that the use of this material will decrease over the
      next five years in favour of glass ionomer, ceramic materials and composite.
      Changing dental fillings at the patient's request without odontological
      indications was opposed by about 80% of the dentists, even if patients were to
      bear the total cost themselves. Only 7% of the dentists claimed to be worried
      about the possible risks to themselves of handling amalgam at work, and 97%
      reported having amalgam fillings personally.

PMID- 1749782
TI  - Dental erosion and associated factors among factory workers exposed to inorganic
      acid fumes.
AB  - The occurrence of dental erosion and the relative importance of some related
      factors were explored in a cross-sectional study, using blind dental
      examinations. A sample of 186 workers from four factories was drawn. Among the
      157 dentate participants 76 were working in departments containing acid fumes and
      81 controls had never worked under such conditions. Out of the dentate
      participants, 20 (12.7% had erosion). Anterior teeth were affected more often
      than posterior ones. Exposure to acid fumes, increasing age and frequency of
      intake of fruits increased the probability of dental erosion. It can be concluded
      that exposure to acid fumes in the work environment is associated with dental
      erosion especially on anterior teeth.

PMID- 1749783
TI  - The Finnish family competence study: dental oral self-care behaviour and
      awareness of gingivitis/calculus in fathers of young families.
AB  - The purpose of this study was to examine oral self-care behaviour and the
      prevalence of gingivitis and dental calculus in fathers of young families using a
      questionnaire. The participation rate at 18 months after the birth of the first
      child was 73.1%. The mean age of the respondents (n = 917) was 28.1 years (range
      17-49; SD 4.6). Dental health and dental care were assessed by asking about the
      existence of gingivitis and dental calculus. Oral hygiene habits were analysed by
      asking about the use of toothpicks and dental floss and the regularity of
      toothbrushing. Gingivitis and dental calculus were found to be related to age and
      to educational and occupational status. The older respondents used dental floss
      and toothpicks more often and brushed their teeth more regularly than those in
      the younger age group. When the wife's knowledge was poor, the respondent's oral
      hygiene habits were also poor. If the wife's knowledge level was good, the young
      father's oral hygiene was good, too. Parents transfer their own oral health care
      habits to their children. Respondents whose parents had a high socio-economic
      status exhibited good oral hygiene habits. The Maternity Health Care Clinic and
      Well-Baby Clinic network can also influence oral health care habits. The relevant
      parts of general prophylactic guidance given at these clinics should be included
      in dental health programmes.

PMID- 1749784
TI  - The frequency of mother-infant salivary close contacts and maternal caries
      activity affect caries occurrence in 4-year-old children.
AB  - Dental caries was investigated in 248 4-year-old children in the Lohja District
      Health Centre, Finland in relation to the postpartum caries incidence rate in
      their mothers and the frequency of salivary close contacts between mothers and
      babies when the latter were 7 months old. Dental caries occurred in 32% of the
      children. Frequent maternal consumption of sugar-containing foods and drinks was
      significantly associated with a high maternal caries incidence rate. The mothers
      who had frequent close contacts with their babies gave them significantly more
      sweet comforters than the mothers who did not have close contacts frequently.
      However, only 25% of the children (n = 44) who had frequent maternal close
      contacts and whose mothers had a high caries incidence rate had caries, although
      levels of risk factors (bottle feeding with juices, frequent consumption of
      refined foodstuffs, added sugar and sweets, infrequent toothbrushing) were
      highest for these children. Dental caries was significantly more frequent in
      children in whom maternal caries incidence was low and close contacts were
      frequent (n = 35, 40%) and in those in whom maternal caries incidence was high
      and close contacts were rare (n = 55, 45%) than in those in whom maternal caries
      incidence was low and close contacts rare (n = 68, 18%). The results of the study
      support the theory that maternal caries incidence and salivary contacts with a
      child are connected with caries infection and immunity. Variations in bacterial
      challenge via such factors before and during the eruption of teeth may modify
      caries development in the primary dentition.

PMID- 1749785
TI  - Nutritional and hormonal regulation of genes for lipogenic enzymes.

PMID- 1749786
TI  - Trace element-gene interactions with particular reference to zinc.

PMID- 1749787
TI  - Genetics of obesity and human energy metabolism.

PMID- 1749788
TI  - Digestion of non-starch polysaccharides by non-ruminant omnivores.

PMID- 1749790
TI  - Organ-specific measurements of protein turnover in man.
AB  - Methods that were originally developed for animal studies have now been modified
      for measuring tissue protein turnover in man with stable isotopes. Of the three
      techniques which have been discussed, only the arterio-venous difference method
      has the capacity to measure both the synthesis and degradation. This technique
      is, however, difficult to perform and has a number of potential sources of error,
      one of the most important being the assessment of precursor labelling. Constant
      infusion of a labelled amino acid with measurement of the incorporation into
      protein of a biopsy is a simpler and more precise technique for measuring
      synthesis in patients as well as volunteers, but the most appropriate means of
      assessing the precursor labelling still remains to be worked out. The flooding
      dose procedure aims to minimize the difficulty of assessing precursor labelling
      and there is no evidence that the unphysiological dose of labelled amino acid
      given influences the synthesis rate which is measured. It is rapid to perform and
      is very well suited to measurements in patients, in whom a wide range of tissues
      can be studied. These advances in techniques have been facilitated particularly
      by improvements in mass spectrometry, which have allowed the use of stable in
      place of radioactive isotopes, and have enabled measurements of isotopic
      enrichments to be made in small samples of tissue. These techniques for assessing
      the dynamics of protein metabolism in individual tissues are now being used to
      answer nutritionally and clinically important questions in human volunteers and
      patients.

PMID- 1749789
TI  - Whole-body protein and amino acid turnover in man: what can we measure with
      confidence?

PMID- 1749791
TI  - Measurement of energy expenditure: the doubly-labelled-water method in clinical
      practice.

PMID- 1749792
TI  - Indirect calorimetry in critical care.

PMID- 1749793
TI  - Vitamin E and the immune response.

PMID- 1749794
TI  - Vitamin A and immune function.

PMID- 1749795
TI  - Selenium and the immune response.

PMID- 1749796
TI  - Atopy, allergy and the alimentary canal.

PMID- 1749797
TI  - Fructose intolerance: diet and inheritance.

PMID- 1749798
TI  - Current perspectives on placental development and its integration with fetal
      growth.

PMID- 1749799
TI  - Energy and substrate requirements of the placenta and fetus.

PMID- 1749800
TI  - Placental transport studied by means of isolated plasma membrane vesicles.

PMID- 1749801
TI  - Perfusion of isolated human placenta.

PMID- 1749802
TI  - Human placental trophoblast culture: one-sided and two-sided models.

PMID- 1749804
TI  - Placental corticotrophin-releasing hormone: activator of the pituitary-adrenal
      axis in human pregnancy?

PMID- 1749803
TI  - In vivo measurements of placental transport and metabolism.

PMID- 1749805
TI  - Determinants of energy density with conventional foods and artificial feeds.

PMID- 1749806
TI  - Dietary energy density on using sugar alcohols as replacements for sugars.

PMID- 1749807
TI  - Changes in dietary energy with novel proteins and fats.

PMID- 1749808
TI  - 'Slimming.'.

PMID- 1749809
TI  - Obesity and health: why slim?

PMID- 1749810
TI  - A diet for slimming?

PMID- 1749811
TI  - Physiological responses to slimming.

PMID- 1749812
TI  - Exercise for slimming.

PMID- 1749814
TI  - The media and slimming.

PMID- 1749813
TI  - The association of slimming with eating disorders.

PMID- 1749815
TI  - The safety of dieting.

PMID- 1749816
TI  - The Sir David Cuthbertson Medal Lecture 1990. The effects of injury and joint
      disease on muscle mass and protein turnover.

PMID- 1749817
TI  - A chlamydial plasmid is differentially transcribed during the life cycle of
      Chlamydia trachomatis.
AB  - A 7.5-kb cryptic plasmid is found in all serotypes of the obligate intracellular
      parasite, Chlamydia trachomatis. Although at least nine open reading frames are
      apparent from sequence analysis of plasmid DNA, only a small region of
      approximately 500 bp has been consistently shown to be transcriptionally active
      by Northern blot analysis. In this study, transcription was analyzed using a host
      free system in which RNA synthesized by chlamydiae isolated from host cells was
      hybridized to different regions of the plasmid. The results suggest that
      fragments corresponding to all open reading frames are transcribed, but at varied
      relative levels depending upon the stage of the life cycle. The hybridization
      patterns also suggested a net chemical degradation of plasmid-specified RNA in a
      3' to 5' direction.

PMID- 1749818
TI  - Nucleotide sequence analysis of the unusually long terminal inverted repeats of a
      giant linear plasmid, SCP1.
AB  - SCP1 is a giant linear plasmid of 350 kb coding for the methylenomycin
      biosynthetic genes in Streptomyces coelicolor. The unusually long terminal
      inverted repeats present on both ends of SCP1 were analyzed on the nucleotide
      sequence level. Analysis of six clones containing the terminal 0.35-kb XbaI
      fragment revealed a slight heterogeneity in the nucleotide sequences of the SCP1
      ends. Moreover, it was indicated that this fragment contained seven palindromic
      inverted repeats and a GT-rich region in the 5'-end strand. The size of the
      terminal inverted repeats was determined to be 81 kb by the cloning and
      sequencing of their end-points. An insertion sequence, IS466 was shown to be
      present just at the end of the right terminal inverted repeat.

PMID- 1749819
TI  - Low cost device for electrotransformation and its application to the highly
      efficient transformation of Escherichia coli and Enterococcus faecalis.
AB  - A simple, low cost device for electrotransformation has been designed and
      constructed. The cost of the circuit was only $150. Maximum field strength of
      12,000 V/cm with an actual time constant up to 11 msec was obtained with a newly
      designed circuitry and a 0.1-cm electrode gap cuvette. Eschericia coli strains
      DH1, DH5 alpha, and LE392 were transformed at an efficiency of 10(9)/micrograms
      DNA with plasmids pUC18 and pBR322. E. faecalis strain OG1X was transformed at an
      efficiency of 0.9 x 10(5)/micrograms DNA without treatment with glycine.

PMID- 1749820
TI  - Bacteriophages for incompatibility group H plasmids: morphological and growth
      characteristics.
AB  - Two independently isolated temperature-sensitive bacteriophage that are specific
      for enterobacterial hosts harboring HI and HII plasmids were characterized to
      determine if any identifiable differences existed between them. The traits
      examined included adsorption pattern of phage to H pili, bacteriophage size,
      sensitivity to chloroform, RNA strandedness, reaction with F-specific antiphage
      serum, virion protein pattern, temperature range of lytic ability, and plaque
      morphology. No differences between the phages were observed for any of the
      features analyzed. Ecological questions on the origin and maintenance of
      temperature-sensitive phages are discussed.

PMID- 1749821
TI  - A fully modular vector system for the optimization of gene expression in
      Escherichia coli.
AB  - The new expression vector system CYTEXP is designed to facilitate the
      optimization of both transcription and translation in Escherichia coli, while at
      the same time allowing the exchange of its major components using unique
      restriction sites. In vitro mutagenesis can be performed in situ using single
      stranded DNA generated from the bacteriophage f1 ORI sequence. The basic vector
      pCYTEXP1 bears a synthetic copy of the intercistronic sequence that enhances the
      translation of the E. coli atpE gene. Reading frames can be inserted directly
      downstream of this sequence. The bacteriophage lambda promoters, the atpE
      sequence, the bacteriophage fd transcriptional terminator, the f1 ORI, and the
      amp antibiotic resistance gene are all borne on exchangeable "modules." Thus,
      both the efficiency and the conditions of expression of cloned genes can be
      readily optimized.

PMID- 1749822
TI  - Identification and mapping of loci involved in motility, adsorption to wheat
      roots, colony morphology, and growth in minimal medium on the Azospirillum
      brasilense Sp7 90-MDa plasmid.
AB  - We have constructed a cosmid library of the Azospirillum brasilense Sp7 90-MDa
      plasmid (p90) and established the EcoRI restriction map of this plasmid. The
      central regions of cloned p90 DNA fragments from several recombinant cosmids were
      deleted by restriction endonuclease digestion and replaced by a DNA cassette
      encoding kanamycin resistance. Using these in vitro constructed deletions for
      marker exchange in Sp7, we made six different p90 deletion derivatives spanning
      all together 50% of the total length of p90. Comparison of the deletion
      derivatives with Sp7 for several properties revealed p90 loci involved in colony
      morphology, growth on minimal medium, motility, and adsorption to wheat roots. In
      analogy with the rhizobial symbiotic plasmids (pSym), we propose to denote the
      p90 plasmid as a rhizocoenotic plasmid (pRhico), carrying several genes involved
      in the A. brasilense-plant root interaction.

PMID- 1749823
TI  - Protein dynamics: comparison of simulations with inelastic neutron scattering
      experiments.

PMID- 1749824
TI  - Physical properties of the fluid lipid-bilayer component of cell membranes: a
      perspective.

PMID- 1749825
TI  - Development of an "early" detection battery for dementia of the Alzheimer type.
AB  - 1. To develop a diagnostic battery sensitive to and specific for the early
      detection of Alzheimer disease (AD) dementia, the authors reviewed over 400
      journal articles dealing with the diagnosis of A.D. or senile dementia and
      cognitive assessment in organic brain dysfunction and closed head injury. 2. We
      culled those studies that met our criteria for solid, reliable and statistically
      significant results and recommend the testing paradigms that most often produced
      good discrimination of mild AD dementia from normal senescence. 3. These include
      tests of language, verbal and non-verbal memory, perception, praxis, attention
      and reasoning. 4. The battery we assembled takes less than 1 hour to administer,
      requires no special equipment, and was designed as an early screen for use by
      psychologists, psychiatrists and other trained health care professionals; it is
      not intended for repeated administration, as in pharmacological or longitudinal
      studies.

PMID- 1749826
TI  - Cytokines in Alzheimer's disease.
AB  - 1. Human astrocytoma cells produced biologically active interleukin-6 when
      treated with a variety of agents including bacterial lipopolysaccharides,
      viruses, and interleukin-1. 2. Both human recombinant IL-6 and IL-6 produced by
      stimulated astrocytes promoted differentiation of cultured neuronal cells and
      reduced survival time in culture. 3. Interleukin-6 and interleukin-1 stimulated
      the synthesis of the Alzheimer's disease beta-amyloid precursor protein. 4.
      Cytokines may be involved in stimulation of dystrophic neuritic sprouting,
      neuronal death, and amyloid deposition noted in the brains of Alzheimer's disease
      patients.

PMID- 1749827
TI  - Clonidine and scopolamine: differences and similarities in how they change human
      information processing.
AB  - 1. Humans have been tested on a choice reaction time task designed to disclose
      interactions between stimulus complexity and drug effect. 2. Tests were carried
      out using oral scopolamine (1.2 mg) and clonidine (0.2 mg). 3. Reaction times and
      event related potentials were measured. 4. Both drugs slowed reaction time and
      the N1 component of the ERP. 5. SCOP slows RTs to easy-to-discriminate stimuli
      more than RTs to harder stimuli. Its effect on P3 is the same for both types of
      stimuli. 6. CLON tends to slow P3 latencies to easy stimuli more than P3
      latencies to harder stimuli, while the RT slowing is almost identical for both
      types of stimuli.

PMID- 1749828
TI  - Abuse of "BRON": a Japanese OTC cough suppressant solution containing
      methylephedrine, codeine, caffeine and chlorpheniramine.
AB  - 1. The paper describes the mental disturbances of 44 abusive cases of "BRON," an
      over-the-counter (OTC) cough suppressant solution containing methylephedrine,
      codeine, caffeine, and chlorpheniramine. 2. Major psychiatric symptoms observed
      included hallucinatory-paranoid state and affective disorder. There also were
      groups which exhibited a combination of the two states and abuse only. 3. The
      hallucinatory-paranoid state group had a relatively small BRON usage amount,
      short usage term and few withdrawal symptoms. The affective disorder group, in
      contrast, had large usage amount, longer usage term, and showed significant
      autonomic nerve disorders during withdrawal. These tendencies were seen more
      clearly in the mixed state group. 4. The hallucinatory-paranoid state group
      showed little or no physical dependence, while that of the affective disorder
      group was thought to be firmly established. Thus, in the former group,
      methylephedrine was considered the major behavior modifying drug, while in the
      latter, it was thought to be codeine.

PMID- 1749829
TI  - Buprenorphine responders: a diagnostic subgroup of heroin addicts?
AB  - 1. A 26-32 month follow-up of 16 heroin-dependent subjects who entered a pilot
      trial of treatment with buprenorphine (a mixed agonist/antagonist) suggests that
      positive response to treatment may identify a subgroup of untreated addicts whose
      levels of psychosocial functioning are intermediate between those for whom
      methadone (a pure agonist) or naltrexone (a pure antagonist) would be indicated.
      2. Buprenorphine's pharmacologic profile provides a missing link in available
      modalities for opiate dependence treatment, making it acceptable for many addicts
      who will not accept methadone maintenance treatment, join a residential
      therapeutic community, or be successful on naltrexone treatment. 3. Eight of the
      16 ss were abstinent from heroin while receiving 0.6-3.9 mg/day buprenorphine and
      counseling. Responders (mean age 34 yrs) had been heroin dependent for a mean of
      9.5 years (range 6-17 yrs), all were self-supporting, 4 lived with a non-addicted
      spouse, 5 had no prior treatment for addiction and 3 had prior naltrexone
      treatment, but had discontinued it and relapsed. Non-responders (mean age 30 yrs)
      had been heroin dependent for a mean of 7.4 yrs (range 2-19 yrs), 7 had no
      regular employment, all were single and 7 had no prior treatment for addiction.
      4. Levels of psychosocial functioning (work, home, leisure) and global
      assessments of functioning were significantly higher for buprenorphine responders
      than non-responders (p less than .001 and p less than .01 respectively). 5. A new
      formulation of buprenorphine needs to be developed for addiction treatment,
      ideally consisting of 0.5 mg and 2.0 mg sublingual tablets.

PMID- 1749830
TI  - A nicotinic receptor antagonist enhances the hypothermic response to a muscarinic
      agonist.
AB  - 1. Chronic treatment with amitriptyline produces supersensitivity to the
      hypothermic effects of the muscarinic agonist oxotremorine. 2. Chronic treatment
      with amitriptyline also produces supersensitivity to the hypothermic effects of
      nicotine. 3. Oxotremorine and other naturally occurring muscarinic agonists are
      also nicotinic agonists. 4. Chronic treatment with amitriptyline produces time
      dependent and reversible supersensitivity to the hypothermic effects of nicotine.
      5. The authors assessed the possibility that the development of supersensitivity
      to oxotremorine following chronic treatment with amitriptyline is related to an
      effect of this antidepressant on a nicotinic mechanism. 6. A nicotinic receptor
      antagonist would blunt (though not necessarily eliminate) enhanced sensitivity to
      the thermic effects of oxotremorine if the nicotinic effects of the latter are
      significant. 7. The simultaneous administration of mecamylamine (a peripherally
      and centrally active nicotinic receptor antagonist) greatly augments (rather than
      blunts) the hypothermic response to oxotremorine. 8. The data suggest that the
      oxotremorine may activate a nicotinic mechanism counterbalancing its effect on a
      muscarinic mechanism. 9. This is consistent with previously published reports
      that the activation of nicotinic and muscarinic mechanisms can exert opposite
      effects.

PMID- 1749831
TI  - Interleukin-1 potentiation of beta-endorphin secretion and the dynamics of
      interleukin-1 internalization in pituitary cells.
AB  - 1. This study demonstrates that human recombinant interleukin-1 (IL-1) stimulates
      beta-endorphin release and potentiates the secretion of beta-endorphin in both a
      mouse anterior pituitary cell line AtT-20 and rat pituitary cell cultures. 2. In
      pituitary cell cultures, prolonged treatment with phorbol ester had no effect on
      IL-1-induced beta-endorphin release, but abolished the potentiating effects of IL
      1 on vasopressin-induced beta-endorphin secretion. 3. The enhancement of CRF
      stimulated beta-endorphin release by IL-1 was also reduced in normal pituitary
      cell cultures following depletion of protein kinase C. 4. The late IL-1-induced
      secretion of beta-endorphin does not require the continuous presence of the
      cytokine. 5. Incubation of monolayers with 125I-IL-1 alpha (10(-9) M) at 8
      degrees C and then at 37 degrees C for various times revealed that IL-1 alpha was
      internalized. There was a progressive increase in the ratio of cytoplasmic to
      cell-surface-associated 125I-IL-1 alpha. 6. These results indicate that the IL-1
      induced beta-endorphin release and its potentiation of beta-endorphin secretion
      involves internalization of this cytokine, perhaps via cell surface IL-1
      receptors.

PMID- 1749832
TI  - Effect of ageing on melatonin synthesis induced by 5-hydroxytryptophan and
      constant light in rats.
AB  - 1. This paper describes the effect of the serotonin precursor 5-hydroxytryptophan
      (5-HTP) on pineal melatonin synthesis young and old rats. 2. 5-HTP itself
      increased pineal melatonin levels in old rats but did not change melatonin
      concentrations in young rats kept under 12 hr/12 hr light/dark conditions. 3.
      After continuous exposure to light for 72 hrs, 5-HTP induced a significant
      increase in melatonin levels in young rats but did not change the 5-HTP effect on
      melatonin in old animals. 4. These results are discussed in consideration of
      previous reports of altered beta-receptor up-regulation by light in old animals,
      and suggest that the age-related decrease in melatonin synthesis is not entirely
      related to changes of the enzymatic machine for melatonin synthesis.

PMID- 1749833
TI  - Naloxone effects on the visual evoked potentials recorded from the main and
      accessory visual pathways of the cat.
AB  - 1. The effects produced by repetitive i.v. administration of naloxone (1, 2 or 4
      mg/kg) on the visual evoked potentials (VEPs) recorded along the main and
      accessory visual pathways were investigated in a modified "encephale isole" cat
      preparation. 2. Naloxone provoked a progressive amplitude enhancement and latency
      reduction of some components, depending on the structure analyzed, the dose used
      and the number of administrations applied. Electroretinogram (ERG) and N1-P1 VEP
      components of optic chiasm (OCh), lateral geniculate body (LGB) and visual cortex
      (VC) did not present significant changes. 3. Late-latency components (more than
      200 msec) appeared in the VEPs of LGB and VC, mainly when 4 mg/kg were used. 4.
      Our results suggest that endogenous opioids have a modulatory role in the
      processing of sensory information at different levels of the visual system.

PMID- 1749834
TI  - Caring for depression in America: lessons learned from early findings of the
      medical outcomes study.
AB  - Research has documented that depressive disorders are a highly prevalent
      condition among adults in general population and patient samples and that these
      disorders are strongly associated with functional limitations. But data have not
      been available to compare the societal importance of depression to other major
      health conditions. In addition, although about one-half of persons with
      psychiatric disorders are believed to have their only contact with health care
      providers in the primary care sector, research findings suggest that depression
      often remains undetected and untreated in this secto; and there have been few
      data on how appropriateness of care for depression differs for patients in
      different health care delivery systems, or whose care is financed by prepayment
      or fee-for-service arrangements. As a result, it is not clear which health care
      systems should be promoted as providing appropriate care for this important
      psychiatric disorder. Data from the Medical Outcomes Study corroborate and
      strengthen the conclusion that depression is of considerable clinical and social
      importance in both outpatient medical and mental health specialty care sectors.
      Specifically, we have learned that depression is associated with as much
      limitation in multiple aspects of daily functioning and well-being as are most
      common chronic medical conditions. In addition, we have found that rates of
      detection of depressive disorder in the primary care sector are low and
      influenced by nonclinical factors such as type of payment for services. These
      findings increase the urgency of improving care for depression in the primary
      care sector, and of carefully evaluating how changes in the financing and
      organization of health care delivery systems affect the clinical care of
      psychiatric disorders.

PMID- 1749835
TI  - Research advances in consultation-liaison psychiatry.

PMID- 1749836
TI  - Uses of hypnosis in managing medical symptoms.

PMID- 1749837
TI  - The medical-psychiatric unit as a site for outcome research in
      dementia/depression syndromes.
AB  - The era of cross-sectional "snapshot" clinical epidemiology studies in
      consultation-liaison psychiatry, while still important, do not in themselves
      yield the critical outcome information needed to document both the clinical
      efficacy and cost-efficacy of timely psychiatric treatment of patients with
      concurrent medical-psychiatric illness. As consultation-liaison psychiatry has
      been plagued by problems regarding reimbursement for clinical services rendered
      and has only a few systematic outcome studies as yet documenting the
      effectiveness of treatment interventions, more prospective studies are
      desperately needed to confirm the value of our efforts. The era of proselytizing
      the virtues of consultation-liaison psychiatry is over, and as with every other
      area of psychiatric therapy, governmental policy makers and third party payors
      are appropriately demanding to see "proof" that our treatments are both
      clinically- and cost-effective. As may be seen from this brief overview of our
      research demonstrating the potential reversibility of disabling cognitive
      dysfunction in depressed medical-psychiatric patients and the efficacy of
      labetalol in decreasing cardiovascular complications from ECT in high risk
      medical patients, positive reports from clinical investigations that are
      strategically planned and implemented on specific populations form strong
      arguments for the clinical and probable cost efficacy of both consultation
      liaison psychiatry and medical-psychiatric units.

PMID- 1749838
TI  - Effectiveness of treatment for somatoform disorder patients.

PMID- 1749839
TI  - Research applications of a consultation-liaison psychiatry data base.

PMID- 1749840
TI  - The development of a randomized trial of consultation-liaison psychiatry trial in
      distressed high utilizers of primary care.

PMID- 1749841
TI  - Experimental study of psychiatric consultation for unrecognized psychopathology
      in general medical inpatients.

PMID- 1749842
TI  - The shift from outcome studies to epidemiological studies of specific medical
      illnesses in consultation-liaison psychiatry.

PMID- 1749843
TI  - Psychiatric aspects of renal dialysis and organ transplantation.

PMID- 1749844
TI  - Challenges, problems, and opportunities in consultation-liaison psychiatry
      research.
AB  - While consultation-liaison (C-L) psychiatry has blossomed as a psychiatric sub
      specialty, C-L research remains relatively underdeveloped. Individual case
      reports or else small series studies predominate. In contrast, relatively few
      studies are hypothesis-driven, experimental, or include design features such as
      blinding or randomization. Now that the field has matured, it is ready for such
      studies. Aside from the fact that developing fields require time to develop a
      research infrastructure, another reason for the lag in consultation-liaison
      research is the distraction with other issues such as the continuing debate
      between advocates of consultation vs liaison, competition with behavioral
      medicine practitioners, and the quest for formal sub-specialization status.
      Unless the development of a firm research base is equally emphasized, one worries
      about the longterm intellectual development of this important area.

PMID- 1749845
TI  - Value of MR imaging in evaluating focal fatty infiltration of the liver:
      preliminary study.
AB  - Focal fatty infiltration of the liver is a well-known entity that occasionally
      mimics metastatic disease on ultrasonographic (US) and computed tomographic (CT)
      scans and requires biopsy for diagnosis. To determine if high-field-strength
      magnetic resonance (MR) imaging might be useful in the differential diagnosis of
      the lesions, the authors compared US, CT, and MR findings in three patients with
      biopsy-proved fatty hepatic lesions. Areas of focal fatty infiltration were
      hyperechoic on US scans and had low attenuation on CT scans. No mass effect of
      the lesions on vascular structures or liver contours was observed, particularly
      on contrast material-enhanced CT scans. For all three patients, MR findings
      suggested the correct diagnosis by demonstrating focal high signal intensity on
      spin-echo T1- and T2-weighted images. On the basis of these preliminary findings,
      it appears that focal fatty infiltration of the liver may be differentiated from
      metastatic disease by means of high-field-strength MR imaging.

PMID- 1749846
TI  - State-of-the-art digital radiography.
AB  - Technologic advances in digital radiography have improved the ways in which
      radiographic images are acquired, displayed, transmitted, recorded, and archived.
      With computed radiography, performed with storage phosphor plates and interactive
      high-resolution workstations, radiation dose is reduced and repeat exposures
      necessitated due to technical errors are eliminated. Digital fluorography allows
      reductions in dose, procedure time, and film costs. These digital imaging
      modalities have been well accepted clinically and are equal in diagnostic
      accuracy to conventional methods. Teleradiology has advanced with the development
      of laser film digitization, fiberoptic networks, and dial-up circuit switching
      technology. Laser film printers yield improved hard copies of transmitted images,
      but further work is needed to faithfully reproduce the images displayed on high
      resolution work-stations. Although the capacity for archiving digital image data
      has increased (260,000 examinations or 23,500 Gbytes can be stored in a six-unit
      optical disc library), higher capacity storage media are needed. Further
      technologic advances in the speed of image transmission and storage capacity are
      anticipated.

PMID- 1749847
TI  - Radiology and computer science?

PMID- 1749848
TI  - Role of angiography in limb-tumor surgery.
AB  - Routine preoperative angiograms obtained in 97 consecutive patients with bone and
      soft-tissue tumors of the extremities were retrospectively reviewed to determine
      the role of angiography in surgical planning. Some degree of major vessel
      displacement was demonstrated in 51 patients. Encasement of major vessels, which
      precluded limb-salvage surgery, was seen in five of 76 bone tumors and in three
      of 21 soft-tissue tumors. All five patients with osteochondromas had associated
      vessel occlusion or compromise. For surgical planning, the demonstration of
      adequate anastomoses in the arches of the hands and feet is important, as
      branches of brachial and popliteal arteries may have to be sacrificed during limb
      tumor surgery. Angiographic findings indicated or supported the need for a
      vascular surgeon in five cases in this series. Preoperative angiography provides
      important information with regard to the status of the vasculature and therefore
      is essential in the management of bone and soft-tissue tumors of the extremities.

PMID- 1749849
TI  - CT of posterior mediastinal masses.
AB  - This article presents an algorithmic approach to the evaluation of posterior
      mediastinal masses seen with computed tomography (CT). CT remains the study of
      choice, since it not only can be used to help confirm the presence of these
      masses, but it also helps define the (a) location and extent of the lesion, (b)
      adjacent organ involvement, or (c) vascular involvement. Causes of posterior
      mediastinal masses include esophageal lesions, congenital or acquired vascular
      lesions, foregut cysts, intrathoracic goiters, mediastinal pseudocysts, fat
      containing tumors, adenopathy, neurogenic tumors, infectious spondylitis, and
      vertebral tumors. From the CT appearance of the lesion, one can often distinguish
      among the various masses and identify their origin and cause. This information
      enables patient triage and therapy to be expedited and, in most cases of
      posterior mediastinal masses, allows a correct diagnosis to be made solely on the
      basis of the CT examination.

PMID- 1749850
TI  - Developmental lymphatic disorders of the thorax.
AB  - Developmental disorders that involve the lymphatic channels of the thorax,
      although rare, are important and must be distinguished from the more common
      causes of chest masses or diffuse lung disease. There are four major types of
      developmental lymphatic disorders that affect the thorax: lymphangiectasis,
      characterized by congenital anomalous dilatation of pulmonary lymph vessels;
      localized lymphangioma, a rare and benign, usually cystic, lesion characterized
      by masslike proliferation of lymph vessels; diffuse lymphangioma, a proliferation
      of vascular, mainly lymphatic, spaces in which visceral and skeletal involvement
      are common; and lymphangioleiomyoma, which involves a haphazard proliferation of
      smooth muscle in the lungs and dilatation of lymphatic spaces. These
      characteristic findings can be seen with radiographic studies as well as with
      histologic evaluation. The discovery of one of these lymphatic disorders may
      prompt an investigation for associated congenital anomalies, including Noonan
      syndrome, asplenia, Gorham syndrome, and tuberous sclerosis.

PMID- 1749851
TI  - Typical, atypical, and misleading features in meningioma.
AB  - Meningiomas are the most common nonglial primary tumors of the central nervous
      system and the most common extraaxial neoplasms, accounting for approximately 15%
      of all intracranial tumors. They are usually benign neoplasms, with
      characteristic pathologic and imaging features. However, there are several
      important histologic variants of meningioma, and even a histologically typical
      meningioma can have unusual or misleading radiologic features that may not be
      suggestive of meningioma. The typical meningioma is a homogeneous, hemispheric,
      markedly enhancing extraaxial mass located over the cerebral convexity, in the
      parasagittal region, or arising from the sphenoid wing. Meningiomas may originate
      in unexpected locations such as the orbit, paranasal sinus, or ventricles or be
      entirely intraosseous (within the calvaria). Unusual imaging features such as
      large meningeal cysts, ring enhancement, and various metaplastic changes
      (including fatty transformation) can be particularly misleading. Because
      meningiomas are so common, the radiologist must be aware of their less frequent
      and uncharacteristic imaging features in order to suggest the correct diagnosis
      in cases that are atypical.

PMID- 1749852
TI  - Personal and public perceptions of radiation risks.
AB  - Risks often are accompanied by benefits, which are not attainable without
      incurring the risks. When a person voluntarily decides to take a risk, he or she
      assumes responsibility for the outcome, whether beneficial or adverse. The
      converse concerning involuntary risks is also true, with the result that many
      people oppose involuntary risks with their threat of adverse outcomes. Medical
      exposure to radiation can be perceived as both an involuntary and voluntary risk.
      In American culture, the entertainment and news media have contributed greatly to
      the public's abhorrence of radiation, radioactivity, and nuclear energy. Because
      people respond emotionally rather than intellectually to risk information, the
      risks of radiation exposure are best communicated by someone who is
      knowledgeable, is recognized as a health expert, is trustworthy, and has no
      conflict of interest but a stake in the community, such as a community physician.
      Such a spokesperson must respond first to perceptions of risks and underlying
      emotions, since use of only facts often fails to counteract fears. With trust
      established, a rational discussion of risks and benefits can begin.

PMID- 1749854
TI  - Career choices in radiology.

PMID- 1749853
TI  - Wrong turns on radiology's road of progress.

PMID- 1749855
TI  - Ultrasound case of the day. Cystic adenomatoid malformations of the lung, type
      II.

PMID- 1749856
TI  - General case of the day. Congenital bronchial atresia.

PMID- 1749857
TI  - Pediatric case of the day. Cystic lymphangioma (omental cyst).

PMID- 1749858
TI  - Color Doppler US of the scrotum.
AB  - Color Doppler ultrasonography (US) is an increasingly important tool in the
      evaluation of the scrotum, especially in acute scrotal disorders. With this
      modality, arterial flow is readily detected in the normal spermatic cord and
      testis but is not seen in the epididymis; venous flow is not seen anywhere in the
      normal scrotum. Scrotal inflammatory lesions appear as hypervascularity of the
      epididymis or testis, even though gray-scale findings may be normal or
      nonspecific. Testicular torsion is demonstrated by an absence or marked decrease
      in the number of visible vessels. Small tumors (less than 1.5 cm) are
      hypovascular, and larger tumors (greater than 1.5 cm) are hypervascular. The
      modality also demonstrates Valsalva maneuver-induced venous flow augmentation in
      varicoceles and altered flow in testicular tumors. Color Doppler US allows for
      evaluation of morphologic findings and perfusion and enables accurate diagnosis
      of most scrotal disorders.

PMID- 1749859
TI  - Imaging of intra- and extraabdominal desmoid tumors.
AB  - Desmoid tumors are characterized by proliferation of fibroblastic cells that
      arise from the fascia or aponeurosis of muscle. They are most commonly found in
      the abdomen of adults, arising from the anterior abdominal wall, mesentery, or
      retroperitoneum. At sonography, desmoids have variable echogenicity, with smooth,
      well-defined margins. On contrast-enhanced computed tomographic scans, the tumors
      are generally high attenuation (relative to muscle) and have either ill- or well
      defined margins. At magnetic resonance imaging, desmoids have low signal
      intensity relative to muscle on T1-weighted images and variable signal intensity
      on T2-weighted images. There are no specific imaging features to distinguish
      desmoid tumors from other solid masses. The diagnosis of desmoid tumor should be
      considered in patients with an abdominal mass, a history of abdominal surgery or
      injury, or Gardner syndrome.

PMID- 1749860
TI  - Diagnostic pitfalls in abdominal CT.
AB  - Many factors result in suboptimal performance of abdominal computed tomography
      (CT) or inaccurate interpretation of the images. Improper technique, observers'
      errors, and lack of clinical information are major contributors to misdiagnoses.
      Because of inadequate oral administration of contrast material, normal structures
      (eg, bowel) may remain unopacified and simulate tumors. Repeat scanning with
      additional contrast material and sodium bicarbonate, at selected levels, and
      perhaps with changes in patient position often reveals the true nature of
      pseudotumors in the gastrointestinal tract. Dynamic CT of the liver, performed
      during contrast material injection, yields the best results. Occasionally,
      reconstruction of axial images in coronal or sagittal planes helps delineate
      normal sectional anatomic variations of the diaphragm and liver and avoid
      misdiagnosis of pseudomasses. Volume averaging can cause problems when the
      section thicknesses are larger than the lesions (eg, small hepatic cysts) or
      structures are very close (eg, kidney and spleen); repeat CT with thinner
      sections is needed to obtain accurate attenuation values or delineate normal
      anatomic relationships. The gallbladder, spleen, and pancreas can change position
      due to prior surgery and raise suspicion of a mass unless clinical history is
      known. Familiarity with these and other pitfalls described herein should lead to
      accurate interpretation of CT scans.

PMID- 1749861
TI  - [Inflammatory aspects in bronchial asthma].

PMID- 1749862
TI  - [New insights on and diversity of causative allergens for bronchial asthma].

PMID- 1749863
TI  - [Epidemiology and natural history of bronchial asthma--prognosis of child-onset
      asthma in adulthood].

PMID- 1749864
TI  - [Clinical role of antiallergic drugs in the treatment for bronchial asthma].

PMID- 1749865
TI  - [Mortality from asthma].

PMID- 1749866
TI  - [Software contest: aims, procedures and results].

PMID- 1749867
TI  - [Electrophysiological effect of verapamil on human atrium].
AB  - To investigate the effect of verapamil on atrial vulnerability, the following
      measurements were performed before and after the intravenous administration of
      verapamil (0.15 mg/kg) in 10 subjects with paroxysmal atrial fibrillation (Paf),
      and 10 subjects without Paf (non-Paf). During the sinus rhythm, 1) intra
      /interatrial conduction time (Intra-/Inter- ACT); the initial deflection of high
      right atrium (HRA) to that of His bundel/coronary sinus were measured. After 8
      consecutive HRA stimuli (A1), premature stimulus (A2) was introduced by
      shortening the coupling interval (A1A2) and we measured 2) conduction delay zone
      (CDZ); the zone of A1A2 with the prolongation of Inter-ACT, 3) % maximum atrial
      fragmentation (%MAF); % maximum value of the ratio of HRA activity width at A2
      (Awt) against that at A1 (Awc), 4) fragmented atrial activity zone (FAZ); the
      zone of A1A2 with % value of Awt/Awc more than 150%,5) repetitive atrial response
      (RAR); more than 2 atrial activities which occur in response to A2. (6) right
      atrial effective refractory period (RAERP). Verapamil significantly shortened CDZ
      and %MFA, slightly lengthened RAERP, and had RAR disappear in Paf, while it did
      not effect any indices significantly in non-Paf. We concluded that verapamil
      could reduce atrial vulnerability in Paf due to blocking of atrial conduction
      delay mediated by slow response fibers.

PMID- 1749868
TI  - [Impairment of left ventricular diastolic function during the asymptomatic period
      in vasospastic angina patients without significant coronary stenosis].
AB  - We examined whether recurrent transient ischemia may effect left ventricular
      systolic and diastolic function or not. Left ventricular systolic and diastolic
      function during the asymptomatic period was studied by gated radionuclide
      ventriculography (RNV) in 25 patients with vasospastic angina (VA) who had no
      significant coronary stenosis, in 25 patients with effort angina (EA), and in 20
      controls (C). There was no significant difference among patients in all three
      groups in regards to systolic indices (Ejection Fraction, Peak Ejection Rate).
      But diastolic indices (Peak Filling Rate, Time to Peak Filling Rate, 1/3 Mean
      Filling Rate, 1/3 Filling Fraction) were impaired not only in patients with EA
      but also in patients with VA. The treatment with nitrates and/or Ca antagonist
      for 6-24 months did not bring about any changes in these data concerning systolic
      and diastolic function in patients with VA. Thus, it is suggested that the
      diastolic function is impaired in patients with VA even during the asymptomatic
      period, though systolic function remains normal. Recurrent transient ischemia may
      cause irreversible myocardial injury.

PMID- 1749869
TI  - [Mitral flow dynamics in patients with hemodialysis: assessment with pulsed
      Doppler echocardiography].
AB  - We investigated transmitral flow dynamics before (B) and after (A) hemodialysis
      (HD). Pulsed Doppler echocardiography was performed in 15 patients (10 males and
      6 females, with a mean age of 51) with neither valvular disease nor heart
      failure. After HD, systolic and diastolic pressure declined significantly to [156
      +/- 27----135 +/- 24mmHg (p less than 0.01) and 84 +/- 16----75 +/- 15mmHg (p
      less than 0.02)] respectively. However, heart rate did not change. Doppler
      derived indexes were peak early filling velocity (E), peak filling during atrial
      contribution (A), early filling time velocity integral (IE), atrial time velocity
      integral (IA), and percent atrial contribution [IA/(IE + IA) x 100] (%A) There
      was a positive correlation between E and peak systolic stress (r = 0.437, p less
      than 0.05). Conclusion; In HD, early diastolic filling is dependent on preload.
      It is necessary to consider preload when diastolic function is assessed.

PMID- 1749870
TI  - [Coronary flow reserve and stenosis as the determinant of exercise capacity in
      patients with stable effort angina].
AB  - The coronary flow reserve was evaluated in 33 patients with stable effort angina
      and single vessel disease of the left anterior descending artery. We used a
      catheter-tip Doppler flow probe with injection of contrast media to the vessel in
      order to induce so-called reactive hyperemia. The reactive change was used as an
      index of the flow reserve of the coronary artery. In 15 patients out of 33, PTCA
      was performed and the change in the coronary flow reserve was evaluated. There
      was a good correlation between the coronary flow reserve and the exercise
      capacity in the treadmill ECG exercise test. As theoretically expected, the
      exercise capacity was determined by the coronary flow reserve. There was a poor
      correlation between the degree of stenosis shown in coronary arteriography and
      the coronary flow reserve. The degree of stenosis did not relate with the
      exercise capacity. The coronary flow reserve was increased with the procedure of
      PTCA. Though the patho-anatomic findings in coronary angiography give us
      important information to evaluate patients with ischemic heart disease, we
      concluded that these findings were still insufficient to allow us to estimate the
      flow reserve in the coronary artery. The exercise capacity did not relate well
      with the degree of stenosis.

PMID- 1749871
TI  - [Tolerance to a sustained release form of isosorbide dinitrate: comparison
      between 20 mg four times and 40 mg twice-daily administrations].
AB  - Attenuation of antianginal effects of oral isosorbide dinitrate in a sustained
      release from (ISDN-SR) were studied using the treadmill exercise test in eleven
      patients with stable exertional angina and a positive exercise test. We compared
      the four-time-daily administration of 20 mg with a twice-daily regimen of 40 mg
      for 10 days using the double-blind, crossover method. On the 1st day of the
      administration, with both regimens, the treadmill walking time, the time to 1mm
      and 2mm ST depression, and several hemodynamic parameters increased
      significantly. These improvements were reduced gradually on day 5 and day 10
      after the administration. In the comparison between the four-time-daily and two
      time-daily regimens, the former application showed clearer antianginal and
      hemodynamic effects than the latter regimen, but these effects were attenuated
      more markedly in the four-time daily administration. With both dosage regimens,
      the plasma ISDN concentrations increased gradually. With the long-term four-time
      daily regimen, the time-to-time changes of the ISDN concentration were smaller
      each day. These data suggest that tolerance to oral ISDN-SR exists even if it is
      applied only two time daily, but its degree is less than when a four-time-daily
      dose in administered.

PMID- 1749872
TI  - [Two cases of atrial septal defect diagnosed by two-dimensional Doppler
      echocardiography: comparison with other methods for detecting atrial septal
      defect].
AB  - We describe two cases of atrial septal defect(ASD) diagnosed by chance with two
      dimensional Doppler echocardiography(2DD) which was carried out for another
      purpose. There were no findings characteristic of ASD such as systolic murmurs in
      the pulmonary area, incomplete right bundle branch block pattern on
      electrocardiograms, increased hilar shadow on chest films or increased right
      ventricular chamber diameter in two-dimensional echocardiography. However, the
      2DD showed blood flow crossing through the atrial septum. Cardiac catheterization
      confirmed the presence of a small ASD. ASD diagnosed by 2DD alone without other
      classical characteristic signs of ASD indicates that the ASD is small and
      clinically insignificant as it is with Doppler valvular heart disease.

PMID- 1749873
TI  - [A case of Behcet's disease complicated with acute myocardial infarction].
AB  - A 23-year-old-man was admitted to our department complaining of chest oppression.
      He had had a diagnosis of intestinal-Behcet because of a 7-year history of
      recurrent oral and genital ulcers, arthritis, cutaneous folliculitis and ulcer in
      the ileocecal region. Cardiac catheterization revealed total occlusion at the
      proximal portion of the left anterior descending artery (LAD) without aneurysm
      formation at other coronary trees. During medical follow-up, this case showed
      vasospastic angina probably associated with active coronary vasculitis. The
      incidence of vascular involvement in the total number of cases of Behcet's
      disease reported in the literature is 3.6-7.7%. Overall, thrombophlebitis and
      arterial aneurysm formation is relatively common and frequently reported in cases
      of vasculo-Behcet. Our case demonstrated the following uncommon pattern as
      vasculo-Behcet; 1) initial clinicopathologic manifestation at the coronary artery
      without any other vascular lesion, 2) abrupt total occlusion (clear cut lesion)
      at LAD, 3) complication of vasospastic angina, which has not yet been reported in
      medical literature.

PMID- 1749874
TI  - [A case of adult type of anomalous origin of left coronary artery from pulmonary
      artery--with a referential consideration to the disease in Japan].
AB  - A case of a 33-year-old man with anomalous origin of the left coronary artery
      from the pulmonary artery (ALCP) was reported with a referential consideration to
      the adult type of ALCP previously reported in Japan. The patient visited our
      hospital for further examination of cardiac murmur detected on a mass physical
      checkup. He was found to have a continuous murmur, the loudest in the left
      sternal border of 3rd intercostal space, and developed evidence of ischemia
      during the exercise stress test in the ECG leads of L2, L3, aVF, and V2 through
      V6. In addition, studies using echocardiography and color Doppler
      echocardiography detected a hypertrophied intraventricular septum and a pattern
      of turbulent blood flow in the proximal pulmonary artery. Cardiac catheterization
      and aortography proved the existence of ALCP with a markedly developed collateral
      circulation from the right coronary artery to the left coronary artery. After
      surgical restoration by ligating the anomalous opening of the left coronary
      artery, and by bypass grafting to the left coronary artery, it was clear that
      dilation and kinking of the right coronary artery was lessened and hypoperfusion
      in the anterior left ventricular wall was improved. As far as we know, this case
      is the 35th of adult type ALCP reported in our country. Results from this case
      and others suggest that early detection and therapy for adult type ALCP is
      important from the point of view preventing ischemic progression, and indicate
      that restoration by ligation and bypass grafting may be one of the effective
      surgical procedures for ALCP.

PMID- 1749875
TI  - [What is your diagnosis? Tension headache - basilar migraine?].

PMID- 1749876
TI  - [Substitution therapy in alpha 1-protease inhibitor deficiency (alpha 1
      antitrypsin deficiency)].
AB  - Deficiency of alpha 1-protease inhibitor is a dominant autosomally inherited
      error of metabolism leading to destruction of alveolar septa by proteolytic
      enzymes mainly released by neutrophils often before the fifth decade. Diagnosis
      and determination of phenotype are achieved by serologic tests. Affected
      individuals have to be informed about the accelerated evolution of the lung
      disease by smoking and the possibility of therapy by substitution. The latter
      aims at maintenance of anti-proteolytic serum levels compatible with arrest of
      emphysema by weekly to monthly injections of human alpha 1-protease inhibitor as
      we illustrate with a case-report. In the future antiprotease produced by gene
      technology, the application via aerosols or an infection of endothelial cells
      with viruses transferring genes for antiprotease may be possible.

PMID- 1749877
TI  - [New viewpoints on old cases: pneumonia. 1841].
AB  - In this third presentation of reviewed old case histories a lecture by the famous
      clinician Schoenlein held in 1841 at the Charite on a patient with pneumonia is
      commented on. This case is in many ways instructive and interesting. The lecture
      at first reveals the numerous diagnostic difficulties in medicine 150 years ago
      and then demonstrates the great innovation brought to physical examination by
      ausculatation introduced to the clinic by Schoenlein against great opposition.
      For the first time the clinical diagnosis of pulmonary lesions had become
      possible whereby the diagnostic criteria for pneumonia obtained by auscultation
      and percussion were already precisely established. Furthermore the utilized
      therapeutic measures are in part still applicable. This impressive didactic
      demonstration reveals why Schoenlein was regarded as the most important clinical
      teacher of his time introducing modern scientific medicine.

PMID- 1749878
TI  - [Maculopapular rash, pruritus, upper abdominal pain, attacks of dizziness].
AB  - A 48 year old male patient presented with maculopapular rash, pruritus, peptic
      ulcer disease and attacks of headache and vertigo. Rubbing of the cutaneous
      lesions led to urticarial whealing which is indicative of abnormal mast cell
      proliferation in the cutis. Histologic evidence of abnormal mast cell
      proliferation in biopsy specimens of skin and bone marrow led to the diagnosis of
      systemic mastocytosis. Treatment with H1 and H2 receptor antagonists was started.

PMID- 1749879
TI  - [A case from practice (231). Erythema nodosum of unclear origin].

PMID- 1749880
TI  - [What is your diagnosis? Multiple sclerosis].

PMID- 1749881
TI  - [Gastrospirillum hominis--a new bacterium in chronic gastritis].

PMID- 1749882
TI  - [Primary volvulus of the small intestines in adults].
AB  - In our area, small bowel volvulus is a sporadic form of mechanical intestinal
      obstruction. Diagnostic problems may occur. The clinical presentation is that of
      an acute abdomen. The cause of symptoms may be due to narrowing of the bowel
      itself, or strangulation of the blood supply, or both. The types (primary and
      secondary) and incidence of small bowel volvulus are age-related and demonstrate
      astonishing geographical differences. Goals for treatment of small bowel volvulus
      should include physician awareness and accurate workup of this uncommon
      diagnosis.

PMID- 1749883
TI  - [Experiencing and coping with the diagnosis and therapy of a malignant bone tumor
      and the survival time afterwards].
AB  - Six patients who had been treated for osteosarcoma of the lower extremity report
      their experience and how they mastered diagnosis and therapy as well as the time
      thereafter. They give information regarding especially the following points:
      psychological stress during different phases of their disease, aspects of the
      information they received during treatment, how they felt during therapy and how
      and where they have received support, wishes, etc. RESULTS: In order to master
      the disease as well as the sequelae they need sufficient time and opportunities
      to express their feelings to others and sufficient understandable informations
      about examinations, therapy and prognosis. There are large variations in how the
      individual patient responds to the threat by the disease. The whole period of
      time with repeated hospitalizations that extends over about one year in
      retrospect has been judged to be very burdening. Most of the patients feel to be
      strongly challenged during chemotherapy; physically, they are reduced, are
      oversensitive and need sensitivity and support by the persons taking care of
      them. The informations given by the patients allow us to improve treatment and
      support of patients in the future.

PMID- 1749884
TI  - [A case from practice (233). Eosinophilic myalgia syndrome].

PMID- 1749885
TI  - [Phlebo-varicography in chronic venous insufficiency of the lower limbs].

PMID- 1749886
TI  - [Chronic venous insufficiency: clinical functional tests and non-invasive
      paraclinical studies].

PMID- 1749887
TI  - [Superficial thrombophlebitis].

PMID- 1749888
TI  - [Nutritional support of the patient with AIDS].

PMID- 1749889
TI  - [12 theses on drug abuse].

PMID- 1749890
TI  - [Accident insurance, CNA and medical corps].

PMID- 1749891
TI  - [Role of the medical consultant in Sick Fund cases].

PMID- 1749892
TI  - [Medical secrecy].

PMID- 1749893
TI  - [Intercantonal Office for Drug Control. Its history, activities, current
      problems].

PMID- 1749894
TI  - [Tasks of the Federal Office of Social Security in the field of health].

PMID- 1749895
TI  - [The Swiss health system. Potentials, problems and perspectives].

PMID- 1749896
TI  - [Venous insufficiency: review of anatomy, physiopathology and epidemiology.
      Definition of varices].

PMID- 1749897
TI  - [Clinical and cutaneous aspects of chronic venous insufficiency].

PMID- 1749898
TI  - [Ambulatory treatment of chronic venous insufficiency].

PMID- 1749899
TI  - [Diagnosis of deep venous thrombosis of the lower limbs: the role of clinical and
      paraclinical methods].

PMID- 1749900
TI  - [Phlebography in deep venous thrombosis of the lower limbs].

PMID- 1749901
TI  - This nurse recalls a leeching case long ago.

PMID- 1749902
TI  - A plea to remember the constant need for organ donations.

PMID- 1749903
TI  - FDA makes AIDS drug available before tests are complete.

PMID- 1749905
TI  - Do nurses know the fact about AIDS?

PMID- 1749904
TI  - Voice your opinions about the mandatory AIDS testing bills.

PMID- 1749906
TI  - New estimates on the cost of treating HIV.

PMID- 1749907
TI  - When your supervisor hands you the reins.

PMID- 1749908
TI  - The best fetal monitor? Maybe it's you.

PMID- 1749909
TI  - Cardiac assessment.

PMID- 1749910
TI  - RN pins down nursing history.

PMID- 1749911
TI  - Pediatric i.v. therapy: soothing the patient.

PMID- 1749912
TI  - Pediatric i.v. therapy: starting the line.

PMID- 1749913
TI  - A simple way to treat simple pneumothorax.

PMID- 1749914
TI  - One way up. In tandem with a doctor.

PMID- 1749915
TI  - Pressure ulcer update.

PMID- 1749916
TI  - If you're asked to be an expert witness.

PMID- 1749917
TI  - Vitamins, minerals, and the common cold.

PMID- 1749918
TI  - Oxygen therapy helps when treating reimplanted limbs.

PMID- 1749919
TI  - Dietary antigen handling by mother and offspring.
AB  - Sows were fed ovalbumin (OvA) as a novel protein antigen either throughout
      gestation and lactation (G + L) or during lactation only (L). This resulted in a
      significant uptake of OvA into blood, colostrum and milk along with a specific
      IgG response. In piglets from the G + L group, OvA and antibodies to OvA were
      detected in serum after ingestion of colostrum. In a large proportion of these
      piglets OvA was still detected at 3 weeks of age. In the L group a significant
      proportion of the piglets responded to OvA whilst still suckling their mother. At
      3 weeks of age all piglets were weaned onto an egg-based diet. A similar uptake
      of OvA was seen in all piglets but there was no response to OvA in the G + L
      piglets. In piglets from sows fed only during lactation, however, a rapid IgG
      anti-OvA response and signs of diarrhoea were seen. The results suggest that
      factors of immunological importance are passed over from mother to offspring and
      it is proposed that immunological experience of dietary antigens by the mother is
      important for a 'safe' tolerance induction in her offspring.

PMID- 1749920
TI  - Separation of leucocytes: improved cell purity by fine adjustments of gradient
      medium density and osmolality.
AB  - This paper briefly reviews commonly used procedures for separation of mononuclear
      cells (MNC) and granulocytes from human blood with X-ray contrast media as
      gradient material, and also presents new and modified procedures for leucocyte
      preparation. Standard techniques for human blood do not always yield satisfactory
      results with blood from other species. In general pure MNC are easily obtained
      (top fraction), but often the granulocyte fraction has a low purity, due to
      contamination with MNC that move to the bottom during centrifugation and
      contaminate the granulocyte suspension. Obviously the density distribution of MNC
      differs between species. However, the separation can be improved by fine
      adjustment of gradient medium osmolality. For this purpose we have used Nycodenz,
      a non-ionic X-ray contrast medium. A favourable property of Nycodenz solutions is
      that the osmolality and density can easily be varied over a broad range. The
      cells react promptly to a change of medium osmolality. In hypertonic medium the
      cells expel water, shrink, their density increases and they sediment faster, in
      spite of a smaller radius. Further, the cells may pass what was initially a
      density barrier. A hypotonic environment has the opposite effect. In the present
      work we were able to show that a slight change of medium osmolality clearly
      improved different techniques for separation of leucocyte subgroups. For
      instance, the Isopaque-Ficoll (IF) technique consistently yielded MNC and
      granulocytes of high purity with human blood. However, with blood from rabbits,
      rats and mice the granulocyte suspensions were contaminated by 40-60% MNC. By
      utilizing Nycodenz, and lowering the osmolality by 10-12 per cent (at constant
      density--1.077 g/ml) we obtained satisfactory separation of MNC as well as
      granulocytes with blood from these species. A problem in the routine separation
      of granulocytes (IF) is a high contamination of erythrocytes (2-5 per cell) in
      the granulocyte suspension. With a two-layer technique with Nycodenz solutions of
      different densities it was possible to separate granulocytes almost devoid of
      erythrocytes, after proper adjustment of osmolality. By appropriate combination
      of density and osmolality, Nycodenz was a suitable gradient material in other
      separation procedures as well, e.g. the separation of monocytes and mast cells.
      To facilitate the use of Nycodenz as a versatile gradient material, a computer
      program providing recipes for various Nycodenz solutions is included as an
      appendix.

PMID- 1749921
TI  - Enhancement of IgE synthesis in the human myeloma cell line U-266 with an IgE
      binding factor from a human T-cell line.
AB  - An IgE-binding factor(s) (IgE-BF(s] was partially purified from the supernatant
      of human HTLV-II carrying T-cell line MO. This IgE-BF(s) was shown to increase
      the IgE synthesis in the human myeloma cell line U-266, but did not affect its
      viability or growth. The effect of the IgE-BF(s) was dose-dependent and selective
      for IgE protein synthesis as beta 2-microglobulin synthesis in the U-266 and the
      immunoglobulin production in the U-1958 IgG-secreting human myeloma cell line
      were unaffected. The IgE-BF(s) increased the production of the epsilon heavy
      chain but not the lambda light chain production. The IgE-BF(s) was distinct from
      IL-1 beta, IL-3, IL-4, IL-5, IL-6, TNF-alpha, IFN-alpha, -beta, -gamma, M-CSF,
      and fragments of CD23.

PMID- 1749922
TI  - Spectral analysis of the renal sympathetic neurogram during left ventricular
      assistance.
AB  - To assess the effect of left ventricular assistance on cardiac-related
      sympathetic nerve activity, renal sympathetic nerve activity was analysed using
      power spectrum and coherence function. Our TH-7B pneumatically driven sac type
      Ventricular Assist Device (VAD) was used in the acute experiment of 7 adult
      mongrel dogs. VAD were inserted between the left atrium and the descending aorta
      as left heart bypass. RSNA was detected by use of the bipolar electrodes attached
      to the left renal sympathetic nerve. Values of squared coherence between the
      arterial pulse wave and RSNA were measured at the cardiac rhythm and VAD pumping
      rhythm. Before the left ventricular assistance, coherence at the cardiac rhythm
      and the pumping rhythm were 0.62 +/- 0.15, 0.23 +/- 0.18 (mean +/- SD),
      respectively. With the VAD pumping, these values became 0.09 +/- 0.05, 0.53 +/-
      0.20, respectively. These results indicate that arterial pressure wave which was
      created by the VAD assistance contributed to the post ganglionic sympathetic
      activity.

PMID- 1749923
TI  - Development and evaluation of the vibrating electromagnetically-driven artificial
      heart.
AB  - An vibrating electromagnetically driven univalved artificial heart was newly
      developed in our team. The fluid mechanical, hematological, and hemodynamical
      properties of this pump was evaluated in the moc circulation and animal
      experiments using adult goats. This vibrating electromagnetic (VEM) pump could
      generate more than 101/min with 10 Hz vibration, and could obtain the 2 kinds of
      flow and pressure patterns, such as constant peak and periodical peak patterns.
      The values of free Hb showed within acceptable values. We concluded that this
      pump is useful for totally implantable artificial heart.

PMID- 1749924
TI  - TH-7B pneumatically driven sac-type ventricular assist device and drive system.
AB  - TH-7B pneumatically driven sac-type ventricular assist device and drive system
      including automatic control system were developed and evaluated in the chronic
      animal experiments. The blood-contacting surfaces of the blood pump are coated
      with either Cardiothane or Cardiomat. In the chronic experiments using adult
      goats, only one of fifteen goats showed sudden thrombus formation after 34
      pumping days. No gross findings of thrombus formation were observed in any of the
      cases, except for a thin circular thrombus at the junction of the connectors and
      the sac of the blood pump. These results suggest that antithrombogenicity of this
      system was satisfactory for clinical use.

PMID- 1749925
TI  - Development of the total artificial heart control system.
AB  - Sympathetic neurogram is potentially useful for the real time total artificial
      heart (TAH) control system. In this study, we used sympathetic tone and
      hemodynamic derivatives to prospect the following cardiac output in acute animal
      experiments using adult mongrel dogs. Moving averages of the mean left atrial
      pressure and mean aortic pressure were used as the parameters of the preload and
      afterload, respectively. Renal sympathetic nerve activity (RSNA) was also
      utilized as the parameter of the sympathetic tone. Equation which prospect the
      following cardiac output was calculated using the multiple linear regression
      analysis of the time series data in adult mongrel dogs. A significant correlation
      was observed between the prospective and following measured cardiac output. These
      results suggest the potential usefulness of the sympathetic neurogram for the
      real time TAH automatic control system.

PMID- 1749926
TI  - Coherence function between sympathetic neurogram and arterial pulse wave in
      animal with total artificial heart.
AB  - To assess the influence of the total artificial heart replacement on autonomic
      nervous system, sympathetic neurogram was analyzed by power spectrum and
      coherence function. Two pneumatically driven sac-type ventricular assist devices
      were implanted as biventricular bypass (BVB) in adult mongrel dogs. After the BVB
      pumping, natural heart was electrically fibrillated to constitute the BVB type
      TAH model. Renal sympathetic nerve activity (RSNA) was recorded using the bipolar
      electrode attached to the left renal sympathetic nerve. RSNA was amplified and
      integrated by the use of R-C integrator. Power spectra of the RSNA and the values
      of squared coherence between the arterial pressure waveform and the RSNA were
      calculated by the computer system. In animal with TAH, coherence at the cardiac
      rhythm frequency was decreased, and coherence at the TAH pumping rhythm frequency
      was increased. These results indicate that the arterial pulse wave which was
      observed in TAH animal contributed to sympathetic neurogram.

PMID- 1749927
TI  - Clinical application of the ventricular assist devices in Japan.
AB  - From 1980 to March in 1989, there were 177 clinical application of ventricular
      assist device in Japan. Original diseases were 50% ischemic heart disease and 37%
      valvular disease. Duration of assistance ranged from one hour to 70 days. Thirty
      one cases weaned from ventricular assistance and 11 cases became long-time
      survivors.

PMID- 1749928
TI  - Importing biological materials.

PMID- 1749929
TI  - Negative reinforcement.

PMID- 1749930
TI  - David Baltimore's final days.

PMID- 1749931
TI  - Hepatitis A vaccine shows promise.

PMID- 1749932
TI  - MRC denies blocking access to genome data.

PMID- 1749933
TI  - The energy landscapes and motions of proteins.
AB  - Recent experiments, advances in theory, and analogies to other complex systems
      such as glasses and spin glasses yield insight into protein dynamics. The basis
      of the understanding is the observation that the energy landscape is complex:
      Proteins can assume a large number of nearly isoenergetic conformations
      (conformational substates). The concepts that emerge from studies of the
      conformational substates and the motions between them permit a quantitative
      discussion of one simple reaction, the binding of small ligands such as carbon
      monoxide to myoglobin.

PMID- 1749934
TI  - Heterogeneous amino acids in Ras and Rap1A specifying sensitivity to GAP
      proteins.
AB  - Guanosine triphosphatase (GTPase) activity of Ras is increased by interaction
      with Ras-GAP (GTPase-activating protein) or with the GAP-related domain of the
      type 1 neurofibromatosis protein (NF1-GRD), but Ras is not affected by
      interaction with cytoplasmic and membrane forms of Rap-GAP; Rap1A, whose effector
      function can suppress transformation by Ras, is sensitive to both forms of Rap
      GAP and resistant to Ras-GAP and NF1-GRD. A series of chimeric proteins composed
      of portions of Ras and Rap were constructed; some were sensitive to Ras-GAP but
      resistant to NF1-GRD, and others were sensitive to cytoplasmic Rap-GAP but
      resistant to membrane Rap-GAP. Sensitivity of chimeras to Ras-GAP and cytoplasmic
      Rap-GAP was mediated by amino acids that are carboxyl-terminal to the effector
      region. Residues 61 to 65 of Ras conferred Ras-GAP sensitivity, but a larger
      number of Rap1A residues were required for sensitivity to cytoplasmic Rap-GAP.
      Chimeras carrying the Ras effector region that were sensitive only to Ras-GAP or
      only to cytoplasmic Rap-GAP transformed NIH 3T3 cells poorly. Thus, distinct
      amino acids of Ras and Rap1A mediate sensitivity to each of the proteins with GAP
      activity, and transforming potential of Ras and sensitivity of Ras to Ras-GAP are
      at least partially independent properties.

PMID- 1749935
TI  - Cloning and expression of the cDNA for human gamma-glutamyl carboxylase.
AB  - The cDNA for human gamma-glutamyl carboxylase, which accomplishes the post
      translational modification required for the activity of all of the vitamin K
      dependent proteins, was cloned. The enzyme is a 758-residue integral membrane
      protein and appears to have three transmembrane domains near its amino terminus.
      The hydrophilic COOH-terminal half of the carboxylase has 19.3 percent identity
      with soybean seed lipoxygenase. Expression of the cloned cDNA resulted in an
      increase in carboxylase activity in microsomes of transfected cells compared to
      mock-transfected cells.

PMID- 1749936
TI  - Dopaminergic and ligand-independent activation of steroid hormone receptors.
AB  - The current view of how steroid hormone receptors affect gene transcription is
      that these receptors, on binding ligand, change to a state in which they can
      interact with chromatin and regulate transcription of target genes. Receptor
      activation is believed to be dependent only on this ligand-binding event.
      Selected steroid hormone receptors can be activated in a ligand-independent
      manner by a membrane receptor agonist, the neurotransmitter dopamine. In vitro,
      dopamine faithfully mimicked the effect of progesterone by causing a
      translocation of chicken progesterone receptor (cPR) from cytoplasm to nucleus.
      Dual activation by progesterone and dopamine was dissociable, and a serine
      residue in the cPR was identified that is not necessary for progesterone
      dependent activation of cPR, but is essential for dopamine activation of this
      receptor.

PMID- 1749938
TI  - Schonlein-Henoch syndrome in adults and children.
AB  - Sixty-one patients (15 adults and 46 children) with Schonlein-Henoch syndrome
      (SHS) were seen at the Hadassah University Hospital over the last 20 years. The
      presentation, clinical course, and prognosis of these patients were studied. The
      disease course was generally similar in children and adults, except for the
      epidemiological background and the pattern of skin and joint involvement. In
      these nonselected patients, the disease was self-limited, and progressive renal
      failure was not found. The long-term prognosis was excellent for both adults and
      children.

PMID- 1749937
TI  - Intracellular signaling by 14-hydroxy-4,14-retro-retinol.
AB  - In mammals, retinol is the precursor for retinoids, which affect various aspects
      of morphogenesis and development. However, B lymphocytes, although retinol
      dependent, do not use retinoic acid as mediator. Retinol is metabolized by B
      lymphocytes and other cell lines to optically active 14-hydroxy-4,14-retro
      retinol; it is this compound that mediates the growth control. Thus another
      second messenger molecule, in addition to retinoic acid and retinal, is derived
      from retinol.

PMID- 1749939
TI  - Treatment of the eosinophilia-myalgia syndrome.
AB  - The eosinophilia-myalgia syndrome (EMS) is a unique entity associated with
      products that contain L-tryptophan (L-trp). Studies of the underlying
      etiopathogenic processes are underway. EMS is a distinct syndrome, but shares
      features with eosinophilic fasciitis and other variants of systemic sclerosis. A
      wide spectrum of clinical manifestations has been described, but there is no
      consensus regarding treatment. We report the clinical and laboratory features of
      12 patients. All were treated with nonsteroidal antiinflammatory drugs (NSAIDs)
      and analgesics with transient or minimal effect. Two received D-penicillamine
      (DP) and colchicine, with minimal improvement; one had no response to
      azathioprine (AZA). Eleven received corticosteroids and had improvement of
      general symptoms, arthralgias, arthritis, myalgias, skin changes, eosinophilia,
      and leukocytosis. Nevertheless, all but the latter two findings recurred when
      corticosteroids were tapered. Seven patients who were unresponsive to the former
      treatments received low-dose pulse oral methotrexate. Six exhibited continued
      improvement after a mean follow-up of 4.5 months, with good drug tolerance.
      Corticosteroids were tapered and, in some instances, discontinued without relapse
      or complications. One patient improved but later died of aspiration pneumonia. We
      conclude that methotrexate (MTX) is a therapeutic alternative for patients with
      severe or refractory EMS.

PMID- 1749940
TI  - The rheumatoid hand: orthotics as preventative.
AB  - The treatment of hand disease in patients with rheumatoid arthritis (RA), with
      focus on rehabilitation and splinting, is discussed. A review of the data on
      splinting of hands in RA is included, as is a review of methods for evaluating
      hand function and staging RA. Recommendations are made for splinting early in the
      disease course and prior to surgery, rather than late in the course of RA, in an
      effort to minimize contractures.

PMID- 1749941
TI  - Variables associated with decreased survival in systemic lupus erythematosus.
AB  - Fifty-one deaths occurred among 310 patients with systemic lupus erythematosus
      (SLE) observed for 1,234 patient-years. Twenty-one of 97 entry variables at first
      clinic visit were associated with an increased risk of mortality. When corrected
      for multiple comparisons, the only risk factor that retained statistical
      significance was systolic blood pressure. Each millimeter unit increase in
      systolic blood pressure corresponded to a 2% increase in mortality risk. Stepwise
      covariance and recursive partitioning analyses tended to identify nonspecific
      prognostic variables, rather than the classic serological and diagnostic features
      of SLE. These data suggest that hypertension is a more significant risk factor
      for mortality in SLE than the more specific measures of disease severity.

PMID- 1749942
TI  - Septic arthritis in heroin addicts.
AB  - Over a 6-year period (1982 to 1988), 36 episodes of septic arthritis were
      diagnosed in 35 heroin addicts from Barcelona, Spain. Thirty (86%) were men and
      five (14%) were women, with a mean age of 24 years (range, 14 to 39). Twenty-nine
      episodes (80%) were monoarticular and seven (20%) were oligoarticular. The
      sacroiliac (16 cases), sternoclavicular (8), hip (5), and shoulder (4) joints
      were most frequently infected. Staphylococcus aureus and Pseudomonas aeruginosa
      were the etiological agents in 75% and 11% of episodes, respectively. Response to
      antibiotic treatment was good in 32 cases (90%), eight patients needed surgical
      drainage, and none died. We conclude that septic arthritis in heroin addicts
      localizes predominantly in axial joints. In our geographic area, infection with S
      aureus is more frequent than with gram-negative rods such as P aeruginosa or
      Serratia marcescens, which are most frequently found in reports from the United
      States.

PMID- 1749943
TI  - Chiral stereoisomeric molecules in the treatment of arthritis.
AB  - Pharmacokinetic and pharmacodynamic properties of drugs and their ultimate
      therapeutic effects are often significantly influenced by interactions between
      the geometry of host receptors, host enzymes, and the three-dimensional structure
      of drugs. Drug molecules that are mirror images of each other are chiral
      stereoisomers, and such chiral isomer compounds are commonly used as therapeutic
      agents by rheumatologists either as racemates (mixtures of chiral isomers) or as
      pure stereoisomers. Understanding and using such stereoisomeric drugs may lead to
      lower risks of drug toxicity, better therapeutic indices, and newer approaches
      for the treatment of articular disorders. A review of the properties of these
      special isomers is presented, and their therapeutic advantages are discussed.

PMID- 1749944
TI  - The place of methotrexate in the treatment of rheumatoid arthritis. Introduction.

PMID- 1749945
TI  - A double-blind comparison of parenteral methotrexate and parenteral gold in the
      treatment of early erosive rheumatoid arthritis: an interim report on 102
      patients after 12 months.
AB  - One hundred two patients with active erosive rheumatoid arthritis (RA) without
      malalignment or deformities (median disease duration, 14 months) entered a double
      blind, randomized study to compare the effects of 50 mg gold sodium thiomalate
      (GST) with 15 mg methotrexate (MTX) administered intramuscularly for 12 months.
      Roentgenograms of hands, wrists, and forefeet were taken at baseline and after 6
      and 12 months, and 32 joints were evaluated according to Larsen. Sixteen of 50
      patients in the MTX group were withdrawn; one patient in the MTX group died of
      cerebral bleeding that was not related to treatment. Thirty-four GST patients and
      44 MTX patients were evaluated for efficacy. Thirty-eight joints were counted.
      The number oftender and swollen joints, the Lansbury articular index, morning
      stiffness, activities of daily living (ADL) score, and erythrocyte sedimentation
      rate improved significantly in both groups without statistical intergroup
      differences. After 12 months, there was a significant deterioration of the mean
      Larsen index and the number of joints with erosions without intergroup
      difference. However, the radiological progression was retarded significantly
      during the second 6-month period in the gold group, whereas this effect was less
      pronounced in the MTX group. At 12 months, the progression rate was the same in
      both groups.

PMID- 1749946
TI  - Therapy for rheumatoid arthritis: combinations of disease-modifying drugs and new
      paradigms of treatment.
AB  - The last 10 years have witnessed a change in the way rheumatologists view
      rheumatoid arthritis (RA). It is no longer considered a slowly progressive
      disease limited to the joints, but rather an aggressive systemic disease that
      results in clinically significant morbidity early in its course and can
      contribute to excess mortality. Heightened awareness of the health impact of RA
      has spurred a search for effective therapy to be applied early in the course of
      disease for patients with moderate to severe RA. Combinations of disease
      modifying antirheumatic drugs (DMARD) have become an increasingly popular
      alternative to sequential monotherapy. In this report, we review published series
      of patients with RA who have been treated with combinations of DMARDs, sometimes
      including chemotherapeutic agents, with some critical comment. Published
      paradigms of treatment are also reviewed and a new strategy is presented. The
      "step-down bridge" strategy allows early treatment with at least four DMARDs, but
      may place some patients with mild disease at an inappropriately high risk of
      adverse effects. The "sawtooth" strategy gives little guidance as to which
      DMARD(s) should be chosen for initial treatment. We describe a "graduated-step"
      strategy that provides numerical grading to match disease severity and disease
      activity with appropriate initial therapy and that facilitates therapeutic
      decisions throughout the course of treatment.

PMID- 1749947
TI  - Pathogenesis of rheumatoid arthritis: basis for future therapies.
AB  - Despite an increase in the number of rheumatologists in clinical practice over
      the past 15 years, the outcome for patients with rheumatoid arthritis (RA)
      remains relatively poor. The poor prognosis for patients with this disease is due
      to a lack of effective therapies. Better therapies will be developed only after
      the cause and pathogenesis of RA are better understood. Although the precise
      cause is unknown, a variety of evidence indicates that RA results from the
      presentation of a relevant antigen to an immunogenetically susceptible host. This
      report reviews recognized potential antigens and known genetic variables
      affecting the immune response, as well as the various cellular and humoral immune
      responses that result from the antigen-host interaction. More successful therapy
      for RA will most certainly result from a better understanding of the pathobiology
      of the disease.

PMID- 1749948
TI  - Prognostic staging for therapy of rheumatoid arthritis.
AB  - An attempt should be made to predict the most likely course of individual disease
      when a patient is first diagnosed as having rheumatoid arthritis (RA). Such a
      prediction can be called prognostic staging for therapy. While no specific marker
      will accomplish this accurately, the summation of demographic, genetic,
      historical, physical, laboratory, radiologic, and scanning data may be used to
      make a reasonable estimation of outcome. The use of immunogenetic typing is the
      newest technique that can help identify patients likely to develop more serious
      disease. Once patients are identified as having probable aggressive disease, that
      is, beyond stage I, combination therapy should be initiated. Goals of therapy
      should include the prevention and/or interference of progression of radiologic
      erosions, as well as functional improvement as measured by life-style and
      productivity.

PMID- 1749949
TI  - [Organ donation. How to proceed with organ donation].

PMID- 1749950
TI  - [Portuguese legislation on the utilization of organs and tissues].

PMID- 1749951
TI  - [Joao Cidade, nurse of God].

PMID- 1749952
TI  - [The psychotic patient].

PMID- 1749953
TI  - [The role of nurses in promoting family life (the contribution of the Comitee
      International Catholique des Infirmieres et Assitantes Medico-Social for the WHO
      strategies for "Health for All in the Year 2000" and for the preparation and
      execution of the International Year of the Family in 1994)].

PMID- 1749954
TI  - [A prayer from the sick person].

PMID- 1749955
TI  - [The humanization of care. The paper crane].

PMID- 1749956
TI  - [Ethical conflicts. The relation between parents and minor children and between
      guardians and the mentally retarded and the eventual conflict with the
      responsibility of the health team].

PMID- 1749957
TI  - [The myths--and facts--about postoperative discomfit].

PMID- 1749958
TI  - Demographic characteristics of cigarette smokers in the United States.
AB  - This research uses a multivariate log-linear examination of a national data set
      to analyze the combined influences of ethnicity, age, and sex on cigarette
      smoking status, not only for smokers but for former smokers and current
      nonsmokers as well. In general, we find that demographic differences in smoking
      vary across several dimensions. For instance, compared to females, males are more
      likely to smoke and to smoke heavily. The differences between male and female
      cessation rates vary with ethnicity; also, males and females tend to have
      different ratios of former smokers to light, moderate, and heavy smokers. Mexican
      Americans who smoke generally smoke small quantities of cigarettes. And Blacks
      are as likely as other groups not to smoke at all, and less likely than Anglos to
      smoke heavily. This article discusses potential future mortality effects,
      intervention strategies, and directions for future research.

PMID- 1749959
TI  - Seasonality of vital events in a Pacific Island population.
AB  - Analyses of vital data derived from a family record register for the native
      population of Guam reveal significant variations in births, deaths, and marriages
      over the period 1901-41. Although lacking marked photoperiod or temperature
      changes of temperate zones, the tropical island is subject to marked seasonal
      differences in rainfall characteristic of western Pacific islands. Marital
      patterns exhibit troughs associated respectively with the Lenten period and with
      Christmas celebrations. Infant and childhood deaths show close correspondence
      with rainfall patterns, consistently exceeding expected values during the rainy
      season (July-November) when conditions are optimal for the spread of communicable
      and gastrointestinal diseases. Births attain a peak in November, or at the
      beginning of the more advantageous season for infant health and survival.
      Seasonality in vital events, reported for many Euroamerican and some African and
      Asian populations of modern and historical periods, has rarely been documented
      for native populations of the tropical Pacific. Comparisons of differences in
      these patterns among different populations in varied environments provide unique
      opportunities to evaluate causal models of interactions among biological,
      sociocultural, and physioenvironmental factors.

PMID- 1749960
TI  - Effect of infertility on the population structure of the Herero and Mbanderu of
      southern Africa.
AB  - Analysis of the fertility of Herero and Mbanderu pastoralists of the northern
      Kalahari Desert of Botswana indicates that they have suffered from infertility.
      The smoothed population pyramid constructed from a recent census shows waves of
      births occurring about every 22 years. Since generation times in human
      populations are typically longer, we suggest that infertility is responsible for
      prematurely terminating the reproductive spans of women, resulting in a reduced
      generation time. The eigenvalues of a series of Leslie matrices indicate that the
      periods of oscillation in the population have increased from 22 to 29 years
      following the recovery from infertility. Increases in fertility since the 1950's
      have also transformed the Herero from a slowly declining population to one
      growing at a rate of nearly 3.5 per cent per year.

PMID- 1749961
TI  - Race of parents and infant birthweight in the United States.
AB  - Detailed 1977 national natality data are used to investigate social, demographic,
      and genetic effects on birthweight differentials. Analysis of birthweight
      differences among infants with white, black, and mixed black-white parents
      indicates that a portion of the observed weight differentials appear to be due to
      biologic factors. Infants with a black mother and father have the lowest mean
      birthweights, while infants with two white parents have the highest weights.
      Newborns with mixed-race parents have intermediate birthweight distributions.
      Multivariate analysis suggests that the effects of parental race on birthweight
      are not the result of maternal/obstetric differences among parents of the same or
      mixed race.

PMID- 1749962
TI  - Note on the reliability and validity of mothers' retrospective reports of their
      children's birthweights.
AB  - Using data from the 1973, 1976, and 1982 National Survey of Family Growth
      Studies, mothers' retrospective reports of their children's birthweights are
      compared across surveys and with vital registration data. Comparisons focus on
      estimated levels for blacks and whites, and on the effects of possible
      determinants. Despite the fact that nonresponse is more common for blacks,
      especially for births occurring at dates more distant from the surveys, results
      show that retrospective reports of low birthweight (less than 5.5 pounds) provide
      valid and reliable estimates of trends and differentials.

PMID- 1749964
TI  - Mean age and life expectancy at birth in stationary populations: comment.

PMID- 1749963
TI  - Births and cohort size.
AB  - Ahlburg (1983, 1986) tested a simple version of Easterlin's relative-cohort-size
      model of fertility on the basis of U.S. and Canadian post-war data. His
      conclusion was that the Easterlin model fits the data very well and can therefore
      be used for calculating forecasts. However, the model he estimated is
      oversimplified. In this paper an alternative specification is presented. The
      model is applied to Dutch fertility data. The Easterlin effect is found to affect
      the movement of births in the Netherlands during the period 1950-85, but a
      declining long-term trend in average family size proves far more important in
      explaining post-war births. The model forecasts a rise of births until 2000.

PMID- 1749965
TI  - Comment on "Sudden Infant Death Syndrome as a socially determined cause of
      death".

PMID- 1749966
TI  - Japanese migration in contemporary Japan: economic segmentation and
      interprefectural migration.
AB  - This paper examines the economic segmentation model in explaining 1985-86
      Japanese interregional migration. The analysis takes advantage of statistical
      graphic techniques to illustrate the following substantive issues of
      interregional migration: (1) to examine whether economic segmentation
      significantly influences Japanese regional migration and (2) to explain
      socioeconomic characteristics of prefectures for both in- and out-migration.
      Analytic techniques include a latent structural equation (LISREL) methodology and
      statistical residual mapping. The residual dispersion patterns, for instance,
      suggest the extent to which socioeconomic and geopolitical variables explain
      migration differences by showing unique clusters of unexplained residuals. The
      analysis further points out that extraneous factors such as high residential land
      values, significant commuting populations, and regional-specific cultures and
      traditions need to be incorporated in the economic segmentation model in order to
      assess the extent of the model's reliability in explaining the pattern of
      interprefectural migration.

PMID- 1749967
TI  - Seasonality of births in human populations.
AB  - Seasonal fluctuations in births have been observed in virtually all human
      populations. In this paper we re-examine the seasonality of births with two main
      objectives in mind. The first is to provide an overview of the basic facts about
      the seasonality of births, presenting new estimates of the seasonal patterns.
      Seasonality is an important if not dominant source of nontrend variation in
      births in virtually all populations, but there are dramatic and puzzling
      differences across countries and time periods in the pattern of seasonal
      variation observed in particular populations. The second purpose of the paper is
      to survey the leading hypotheses about birth seasonality that have appeared in
      the literature and to discuss the consistency of these hypotheses with observed
      seasonal patterns. Using our estimates of seasonal patterns along with other
      evidence in the literature, we conclude that no single explanation receives
      strong, consistent support from the data.

PMID- 1749968
TI  - Voluntary childlessness among American men and women in the late 1980's.
AB  - Most studies of childlessness in the United States have relied on
      unrepresentative, opportunistic samples collected in a variety of ways. Thus, the
      relationship of various correlates to childlessness is not well known. Some
      studies have focused on demographic variables, but have not examined attitudinal
      factors associated with childlessness--something the opportunistic samples have
      been able to do. In this paper we examine both attitudinal and demographic
      factors associated with childlessness in the United States. The data used in this
      paper are from the National Survey of Families and Households collected in 1987
      and 1988. The data set includes both demographic data, perceived advantages and
      disadvantages of having children, and attitudinal data about related social
      issues. Overall, the rate of voluntary childlessness was not high. Only 3.5 per
      cent of the men and 2.8 per cent of the women reported that they were childless
      and did not expect to have children. Only one category of people (unmarried men
      and women over the age of 35) had rates that exceeded ten per cent. A combined
      variable of age and marital status was the best predictor of childlessness. A
      scale of reasons or justifications for having children was the next best
      predictor. In addition, attendance at religious services, number of hours the
      respondents desired to work and education (for women only) were related to
      childlessness. Those who scored highly on measures of support for traditional
      families and support of extended families also tended to have lower rates of
      childlessness. Occupational status, religious denomination, and race, on the
      other hand, were not significantly related to childlessness. Measures of gender
      equality, religious fundamentalism, and support for mothers working were also not
      related to childlessness.

PMID- 1749969
TI  - Anticipated child loss to migration and sustained high fertility in an east
      Caribbean population.
AB  - Development today is commonly accompanied by rapid urbanization and, where
      possible, high rates of migration to industrialized countries. At the same time,
      the expected demographic transition has often not materialized despite decreases
      in death rates. Child-to-woman ratios in St. Vincent and the Grenadines are
      related to the educational attainment of women in a census district, the
      percentage of men engaged in agriculture, whether the district has direct access
      to the outside world through a port or airport, and, when the other variables are
      controlled, the stability of a district's population. Those districts with the
      greatest stability of population had the lowest child-to-woman ratios, suggesting
      that the anticipated loss of children to migration may be an important factor in
      maintaining high reproductive rates.

PMID- 1749970
TI  - Chaplains and the health care team.

PMID- 1749971
TI  - What to say to persons with HIV disease.
AB  - I believe that the circumstances in which one learns of being infected with human
      immunodeficiency virus (HIV) can form a pattern that may either hasten or
      postpone the physical and psychologic progress of HIV to full-blown AIDS. The
      experience of learning about one's seropositivity from one's physician sets the
      stage for the patient to determine who else needs to be told. This paper
      discusses the steps in communicating the diagnosis of seropositivity.

PMID- 1749972
TI  - Endovascular infections caused by enterococci highly resistant to ampicillin.
AB  - Enterococci frequently cause endocarditis and are the most common gram-positive
      isolates in polymicrobial bacteremia. We report three cases of polymicrobial
      endovascular infections at a single institution during a 12-month period; the
      enterococcal isolates were highly resistant to penicillins. These cases comprised
      18% of all enterococcal endovascular isolates during the same 12-month period.
      Previous use of antibiotics, presence of endovascular catheters, and nosocomial
      acquisition of the organism occurred in all three cases. Clinicians should be
      aware of enterococcal resistance to penicillins and should exercise care in
      designing appropriate regimens for serious enterococcal infections.

PMID- 1749973
TI  - Emphysematous pyelitis and emphysematous pyelonephritis characterized by
      computerized tomography.
AB  - We report three cases of emphysematous pyelonephritis, all of them associated
      with perinephric emphysema, and one case of emphysematous pyelitis to demonstrate
      the value of computerized tomography (CT) in both diagnosis and patient
      management. The differentiation between air in the collecting system
      (emphysematous pyelitis), air within the parenchyma (emphysematous
      pyelonephritis), and air in the perinephric space (perinephric emphysema) may
      have significant prognostic (survival) and therapeutic (medical vs surgical)
      implications. Computerized tomography is currently the best method for
      demonstrating intrarenal air and for characterizing the location of that air
      (intracalyceal, intraparenchymal, perinephric, or pararenal).

PMID- 1749974
TI  - Cutaneous aging: effect of intrinsic changes on surgical considerations.
AB  - Intrinsic age-related structural and functional changes in the skin, independent
      of sun-induced damage, directly affect wound healing in the elderly. These
      alterations, as well as concomitant medical illness, pharmaceutical intake, and
      dietary changes, result in delayed wound healing, decreased ultimate tensile
      strength, and increased rates of wound dehiscence, ecchymosis, tape-strip
      injuries, infection, and persistent contact dermatitis.

PMID- 1749975
TI  - Evaluation of surgical services in a large university-affiliated VA hospital: use
      of an in-house-generated quality assurance data base.
AB  - In this era of occurrence screening, increased documentation of surgical resident
      supervision, and overall efforts to alter quality of patient care through
      increased documentation, an in-house quality assurance data base can greatly
      facilitate these activities. To establish a data base, 6241 operative procedures
      over a 15-month interval were logged into a StatView II Database using the
      patient's name and record number, diagnosis, and operative information available
      from the standard operation report worksheet. Additional information, including
      the name of the supervising staff and level of supervision, had also been
      recorded concurrently on this form. Each month, after this demographic
      information has been entered into the data base for each surgical service, it is
      reviewed, ensuring 100% surveillance of all cases. The subsequent morbidity and
      mortality (M & M) information is then added to the data base. Using the
      contingency table option of the StatView II Database, quarterly and annual
      reviews have been done to study individual services, types of cases, staff
      attending, individual supervision, levels of staff involvement, and incidence of
      complications. Our Surgical Service has reported an overall morbidity of 306
      cases (4.9%) and mortality of 71 (1.14%). Average numerically coded levels of
      resident supervision have been compiled with regard to individual services and
      staff surgeons. This data base has proved helpful in the recredentialling process
      of our surgical staff, resident logs, identification of necessary reviews of
      certain case types, and formation of a computerized operative log.

PMID- 1749976
TI  - Flow cytometry of needle aspirates from bone and soft tissue tumors.
AB  - Fine needle aspiration specimens from 29 patients with bone and soft tissue
      neoplasms were analyzed by flow cytometry for DNA index and cell cycle analysis
      to determine whether such studies were helpful in cytologic diagnosis. Of 15
      cases initially cytologically diagnosed as benign, 14 had a DNA index of 1.0,
      indicating a diploid population. The remaining case diagnosed as cytologically
      benign had a DNA index of 1.3. Further tissue from this tumor revealed an
      osteogenic sarcoma. Of the 14 cases initially diagnosed as malignant, 12 were
      hyperdiploid. Cell cycle analysis showed that malignant tumors had a higher
      proportion of cells in S phase (15.2% +/- 8.7%) than benign tumors (6.9% +/-
      1.6%). Furthermore, high-grade malignancies had a significantly greater number of
      cells in S phase (18.5% +/- 1.5%) than low-grade tumors (9.9% +/- 6.3%).

PMID- 1749977
TI  - Awareness of substance abuse in orthopedic patients: a survey of orthopedic
      surgeons.
AB  - We surveyed 178 orthopedic physicians in the Washington, DC, area to ascertain
      the effect on patient care of previous education in the area of drug and alcohol
      issues. The return rate was 75%. Of the respondents, 99% were male, average age
      was 46.7 years (+/- 9.3), and average number of years in practice was 15.2 (+/-
      9.6). A majority of respondents indicated that they did not have training in the
      abuse potential of analgesics (92 [69%]), characteristics of benzodiazepine abuse
      (77 [58%]), or when to seek the assistance of an addiction medicine specialist
      for patients with chronic pain (106 [80%]). Only 41 (31%) of the orthopedists
      indicated that they inquire about alcohol and drug use before prescribing opiates
      for more than a week. We offer suggestions for self-education for interested
      physicians.

PMID- 1749978
TI  - Analgesia after thoracotomy in children: a comparison of interpleural, epidural,
      and intravenous analgesia.
AB  - The cohort for this study included 39 patients, between the ages of 8 and 20
      years, who had had thoracotomy. Postoperative analgesia was provided by one of
      three techniques: intravenous narcotics (20 patients), thoracic epidural catheter
      (10 patients), or interpleural analgesia (IPA) (nine patients). Both IPA and
      epidural analgesia were administered according to a specific protocol. The
      efficacy of the three methods was evaluated using two indicators: the total
      intravenous narcotic requirements for the initial 72 hours and the number of
      times a dose of intravenous narcotic or supplemental epidural fentanyl was
      administered to each patient. Patients in the IPA group required significantly
      less intravenous narcotics (P less than .05) during the first three postoperative
      days (2.2 +/- 0.4, 1.9 +/- 0.6, and 1.4 +/- 0.5 mg of meperidine/kg/day) than
      patients in the intravenous narcotic group (8.1 +/- 1.2, 7.2 +/- 0.9, and 5.6 +/-
      1.2 mg of meperidine/kg/day). When comparing epidural analgesia and IPA, the
      number of interventions in the patients receiving epidural analgesia was
      significantly less (P less than .05) than in the group receiving IPA. Four of 10
      patients in the epidural group and two of nine in the IPA group required no
      interventions during the initial 72-hour postoperative course. In the epidural
      analgesia group, there were 19 days (of a total of 30 days) during which patients
      required no interventions. This percentage was significantly greater (P less than
      .05) than that of the IPA group, in which there were 9 days (of a total of 27
      days), during which no interventions were required.

PMID- 1749979
TI  - Inpatient cardiopulmonary resuscitation: is survival prediction possible?
AB  - We retrospectively reviewed 443 patients who had cardiopulmonary resuscitation
      (CPR). The focus of the study was to discover what preexisting factors should be
      assessed to determine the probability of survival. There were 88 successes out of
      340 cases (25.9%). The absence of a previous myocardial infarction (MI), shock,
      partial pressure of oxygen (PaO2) less than 60 mm Hg, blood urea nitrogen (BUN)
      level greater than 20 mg/dL, pneumonia, pulmonary edema, and oliguria were found
      to predict a successful outcome. Logistic regression was used to predict
      percentage of successes in the various groups of patients with various clinical
      characteristics. The observed and predicted numbers of successes were in close
      agreement in most cases. We also constructed a classification function to predict
      whether an individual subject would survive the event for which CPR was required.
      Sixty-seven of the 88 observed successes would have been predicted, for an
      estimated sensitivity of 76%, and 164 of the 252 failures would have been
      predicted, for an estimated specificity of 65%. A large percentage (24%) of cases
      in which the patient actually survived CPR would have been predicted to be
      failures. We conclude that preexisting factors before a cardiopulmonary arrest do
      not accurately predict survival after CPR.

PMID- 1749980
TI  - Ectopic pregnancy in an urban teaching hospital: can tubal rupture be predicted?
AB  - We evaluated the medical history, physical examination, and laboratory tests done
      on 245 patients with laparoscopically proven ectopic pregnancies. The absence of
      abdominal pain was the only clinically useful negative predictive value (91%)
      regarding tubal rupture. Although mean levels of serum human chorionic
      gonadotropin (hCG-beta subunit) were significantly higher in patients with
      ruptured versus unruptured ectopic pregnancies (16,612 mIU/mL vs 6406 mIU/mL), no
      breakpoint excluded the possibility of tubal rupture. In fact, one third of
      ectopic pregnancies in patients with a serum beta-hCG level below 100 mIU/mL were
      ruptured. We conclude that clinical symptoms and signs are poor predictors of
      tubal rupture. In addition, absolute values of serum beta-hCG are not helpful in
      excluding the possibility of rupture.

PMID- 1749981
TI  - Diet, behavior modification, and exercise: a review of obesity treatments from a
      long-term perspective.
AB  - Reviewed herein are the long-term weight loss outcomes of three fairly recent
      major modifications of standard dietary therapy for obesity. Appraised separately
      and in combination, these therapeutic approaches are very low calorie diets
      (VLCD), behavior modification, and exercise. The weight loss results from VLCD
      are impressive for only the first 6 to 10 months. Adding behavioral procedures to
      VLCD increases the weight loss for the first year or two, but not in 3 to 5
      years. Adding exercise further increases the weight loss at 1 to 2 years, and
      those who continue regular exercise achieve the best weight loss results 1 to 6
      years later.

PMID- 1749982
TI  - Myths about vitamin B12 deficiency.
AB  - Neurologic manifestations of vitamin B12 deficiency are protean, including
      neuropathy, depression, and dementia. We present evidence to dispel confounding
      myths about vitamin B12 deficiency. Hematologic indices are normal in up to 30%
      of patients with vitamin B12 deficiency, and results of the Schilling test may be
      normal in patients with symptoms of deficiency. Isolated neuropathy or myelopathy
      may occur independently, but often appear concurrently. The neuropathy is
      primarily axonal and predominantly sensory. Myelopathy is caused by demyelinated
      areas in posterior and lateral columns. After therapy, recovery from neuropathy
      is incomplete or may extend for several years. Vitamin B12 replacement should not
      be withheld from patients with borderline vitamin B12 levels, since the
      consequences of allowing myelopathy, neuropathy, dementia, and mental disorders
      to worsen clearly outweigh any disadvantage of therapy.

PMID- 1749983
TI  - Use of the chaplaincy in the neonatal intensive care unit.
AB  - The hospital chaplain is a relatively new member of the health care team, and
      there is little objective information on the chaplaincy's role in the hospital.
      To evaluate the chaplain's role, I collected information from the chaplain's
      daily logs and from a medical staff/parent questionnaire on the use of the
      chaplaincy in the neonatal intensive care unit (NICU). Both the medical/nursing
      staff and the chaplains viewed the chaplain's role as encompassing both
      traditional (religious functionary) and nontraditional functions. However, the
      medical/nursing staff consulted chaplains only for traditional roles. The
      discrepancy in chaplain use suggests a need for objective study about the
      chaplain's role. I offer hypotheses for testing the role of the chaplaincy in the
      NICU.

PMID- 1749984
TI  - Horace Smithy: pioneer heart surgeon.

PMID- 1749985
TI  - William Harvey and the circulation of the blood.

PMID- 1749986
TI  - Plato's cavagram: shadows on the wall of the reading room.

PMID- 1749987
TI  - Incisional hernias: factors influencing development.
AB  - We have presented a study of 125 patients treated for incisional hernia. This
      complication occurred more frequently in women (81%), and gynecologic and
      obstetric procedures were responsible for 58%. The method of surgical repair in
      all cases was peritoneal-aponeurotic transposition. The 5-year recurrence rate
      was less than 3%.

PMID- 1749989
TI  - Comparing ECGs.

PMID- 1749988
TI  - Mycobacterium kansasii infection in a patient with AIDS.
AB  - We have presented the case of a 45-year-old HIV-positive man who had a 2-week
      history of shortness of breath and fever and who was found to have pneumonia due
      to an acid-fast bacillus. Despite treatment with isoniazid, rifampin, ethambutol,
      and clofazimine, he died of the infection. Culture results obtained after his
      death showed the organism to be Mycobacterium kansasii. Mycobacterial infections
      are common in patients with AIDS, but are usually due to M tuberculosis or M
      avium complex. Of the 35 patients with AIDS and M kansasii infection mentioned in
      the literature, only eight of these were described; and of the four patients
      (including our patient) who received therapy considered appropriate for this
      infection, only two survived.

PMID- 1749991
TI  - Hodgkin's disease in epitrochlear lymph node only.

PMID- 1749990
TI  - Imipramine-induced syndrome of inappropriate antidiuretic hormone secretion.

PMID- 1749992
TI  - Aspartame.

PMID- 1749993
TI  - Hyperpyrexia as the sole symptom of thyrotoxicosis.

PMID- 1749994
TI  - Periactin for headache.

PMID- 1749995
TI  - Genetic study of ossification of the posterior longitudinal ligament in the
      cervical spine with human leukocyte antigen haplotype.
AB  - To evaluate the genetic background of ossification of the posterior longitudinal
      ligament, the relationship between the presence of absence of ossification and
      human leukocyte antigen haplotypes was studied in 33 families of patients with
      ossification of the posterior longitudinal ligament. The study revealed that
      human leukocyte antigen haplotypes formed certain types of clusters, and that
      some human leukocyte antigen haplotypes were very rare in the Japanese
      population, suggesting the involvement of human leukocyte antigen-linked factors
      in the pathogenesis of ossification of the posterior longitudinal ligament of the
      cervical spine. In the families of these patients, ossification of the posterior
      longitudinal ligament was demonstrated by radiography in 56% (10/18) of the
      siblings. Each of these siblings shared both human leukocyte antigen haplotypes
      with the patient. None of those who shared only one human leukocyte antigen
      haplotype with the patient had developed ossification of the posterior
      longitudinal ligament. From these findings, the presence of both pathogenic human
      leukocyte antigen haplotypes is considered to be necessary for the development of
      ossification of the posterior longitudinal ligament, and this genetic
      predisposition may be activated by multiple factors, including regressive
      degeneration due to aging and the environment.

PMID- 1749996
TI  - Comparative study between magnetic resonance imaging and histopathologic findings
      in ossification or calcification of ligaments.
AB  - Magnetic resonance imaging findings were compared with histopathologic specimens
      of ossified or calcified ligaments, including the surrounding tissue, to evaluate
      the usefulness of magnetic resonance imaging as a means to predict the
      progression of ossification. In addition, factors influencing signal intensity
      were evaluated by histochemical and immunohistochemical analyses. The area of low
      signal intensity corresponded to the hyperplastic ligament around the
      ossification, and to the transitional area between the ligament and the
      ossification. A mineralization front and chondrocyte proliferation with strong
      metachromasia were recognized in these areas. The presence of a low-intensity
      signal area suggested the progression of ossification. The isointensity signal
      corresponded to proliferation of small vessels in the hyperplastic ligament,
      presumably representing the initiation of ossification. Histochemically, the
      metachromasia was intense at the transitional area between the ligament and the
      ossification, and the main constituent in these areas was chondroitin sulfate.
      Immunohistochemically, S-100 protein, transforming growth factor-beta 1, and Type
      II collagen showed an intense immunoreactivity in the chondrocytes, indicating
      increased production of the extracellular matrix. We postulate that the
      activation of chondrocytes and the alteration of the extracellular matrix may
      have affected the signal intensity.

PMID- 1749997
TI  - Magnetic resonance imaging and histologic study of hypertrophic cervical
      posterior longitudinal ligament. A case report.
AB  - Magnetic resonance imaging and histologic features of hypertrophic cervical
      posterior longitudinal ligament were determined in a cervical myelopathy patient.
      On T1-weighted images, the thickened ligament and the prolapsed nucleus pulposus
      showed isointensity shadows, making it impossible to differentiate these tissues.
      On T2-weighted images, the thickened ligament and prolapsed nucleus pulposus were
      visualized at high and low intensity, respectively. Sagittal T1-weighted images
      after gadolinium-diethylene triamine pentaacetic acid injection showed obvious
      enhancement of the thickened ligament.

PMID- 1749998
TI  - A simple technique for cervical myelography.
AB  - A new method has been devised for obtaining high-quality cervical myelograms
      safely and easily through lumbar injection. This method uses simple radiographic
      equipment, and does not require a tiltable table or fluoroscopy. Fifty-seven
      patients with cervical disorders were examined by this method using 9.5 ml of
      iohexol (300 mg l/ml), and successful myelograms were obtained in all patients.
      No serious complications were encountered.

PMID- 1749999
TI  - Bilateral open laminoplasty using ceramic laminas for cervical myelopathy.
AB  - Evaluation was done of 65 patients with cervical myelopathy treated by bilateral
      open laminoplasty using artificial laminas, between 1984 and 1988, who had been
      followed for more than 2 years. The mean recovery rate on the Japanese
      Orthopaedic Association scoring system was 65% in all cases, and 72% in the cases
      with no other complications. The artificial laminas appeared well adapted to the
      laminas in computed tomography and dynamic radiographic examinations, and there
      were no cases of reduction of the enlarged canal. Postoperative restriction of
      the range of motion of the cervical spine was lessened by the positioning of
      lateral grooves, more appropriate external fixation, and posterior flexion
      exercise after operation. This procedure is not technically complicated, it does
      not involve appreciable blood loss during operation, it prevents grafted free fat
      from migrating into the spinal canal, and is advantageous for posterolateral bone
      chip grafting.

PMID- 1750000
TI  - Neurologic complications of surgery for cervical compression myelopathy.
AB  - Neurologic complications resulting from surgery for 384 cases of cervical
      myelopathy (cervical soft disc herniation, spondylosis, ossification of the
      posterior longitudinal ligament) were reviewed. Surgical procedures performed
      included 134 anterior interbody fusions (Cloward or Robinson-Smith technique), 70
      subtotal corpectomies with strut bone graft, 85 laminectomies, and 95
      laminoplasties. Twenty-one patients (5.5%) sustained neurologic deterioration
      related to surgery. The deterioration was classified into two types on the basis
      of the neurologic signs observed: deterioration of spinal cord function or of
      nerve root function. Manifestations of the former varied from weakness of the
      hand to tetraparesis. Paralysis of the deltoid and biceps brachii muscles was an
      exclusive feature of deterioration in the nerve root group. Causes of this
      paralysis included malalignment of the spine related to graft complications, and
      a tethering effect on the nerve root following major shifting of the spinal cord
      after decompression. The causes of deterioration of the cord function included
      spinal cord injury during surgery, malalignment of the spine associated with
      graft complication, and epidural hematoma.

PMID- 1750001
TI  - Changes in the evoked spinal cord potentials associated with chronic experimental
      cord compression.
AB  - To determine the functional changes occurring in the early period after the
      development of chronic cord compression, an ossification of the ligamentum flavum
      model, which is a model of chronic cord compression, was created in domestic
      rabbits using bone morphogenetic protein, and monitored evoked spinal cord
      potentials. Sixty-seven rabbits were used for these experiments. Myelography,
      evoked spinal cord potential measurements, and histologic examinations were
      performed in 16 of the ossification of the ligamentum flavum rabbits and six of
      the healthy control rabbits. Our results show that 1) mild degrees of cord
      compression produce greater evoked spinal cord potential alterations in chronic
      than in acute compression, as reported in the literature; 2) chronic compression
      from the dorsal side produces injury in the superficial layer of the dorsal
      column and dorsolateral column; and 3) changes in evoked spinal cord potentials
      precede the development of paralysis and histologic changes.

PMID- 1750002
TI  - Intraoperative monitoring for tethered spinal cord syndrome.
AB  - Functions of the lower extremities and bowel and bladder must be monitored during
      releasing surgery for tethered spinal cord syndrome, because neural elements are
      embedded in lipoma or anomalous tissues. Evoked muscle action potentials of the
      external anal sphincter muscle, external urethral sphincter muscle, and lower
      extremity muscles can indicate promptly whether or not neural elements are
      involved before the surgeon releases or cuts the tissue for cord release. It is
      also important to monitor vesical pressure because of different types of
      innervation from the external urethral and anal sphincters, in spite of slow
      reaction times of vesical pressure elevation. Evoked muscle action potentials
      indicate only motor function; therefore, it is more appropriate to record evoked
      spinal cord potentials from the spinal cord above a lumbosacral operative field,
      because sensory function can also be monitored. Evoked muscle action potentials
      are an easy and extremely sensitive monitoring system; nevertheless, monitoring
      of vesical pressure and evoked spinal cord potentials should also be done to
      achieve optimum monitoring. For the past 5 years, 10 patients have undergone cord
      release surgery with such a monitoring system, and the results indicate no
      exacerbating case.

PMID- 1750003
TI  - Spinal dysraphism. A study of patients over the age of 10 years.
AB  - Thirty patients over the age of 10 years, exhibiting cutaneous manifestations on
      the back suspected to be due to spinal dysraphism, and neurologic deficits, were
      studied to analyze neurologic appearance. Neurologic deficits appeared by age 5
      in 26 patients. No patient complained of low-back pain or sciatica. Paralytic
      deformities of the lower extremities were divided into four grades for
      evaluation: A = no deformity, with only urinary disturbance (four cases); B = toe
      limited deformity (two cases); C = toe and foot-limited deformity (six cases); D
      = toe, foot, ankle, and lower limb deformity (18 cases). Patients with slight
      neurologic disturbance, either Grade A or without urinary disturbance, were seen
      among the patients who had undergone a release operation by age 2, although
      neurologic appearance in patients in severe grades was not related to the age at
      release operation. Also, the release operation was thought to be effective in
      preventing low-back pain or sciatica.

PMID- 1750004
TI  - Cotrel-Dubousset pedicle screw system for various spinal disorders. Merits and
      problems.
AB  - Eighty-five consecutive patients with various spinal disorders who underwent
      surgery using the Cotrel-Dubousset pedicle screw system at Kantoh Rosai Hospital
      between August 1986 and November 1989 were studied. The group included 52 men and
      33 women, ranging in age from 19 to 76 years, with an average age of 53 years.
      The postoperative follow-up period was from 15 to 54 months, with an average of
      33 months. The diagnoses were lumbar degenerative disorders in 69 cases
      (spondylolisthesis in 32, lumbar degenerative spinal canal stenosis without
      spondylolisthesis in 21, and "unstable lumbar spine" in 16), spinal trauma in 9,
      spinal deformities in 5 (scoliosis in 3 and kyphosis in 2), and tumor in 2 (1
      spinal cord tumor and 1 vertebral tumor). The Cotrel-Dubousset pedicle screw
      system proved not only to be useful in fixing an unstable spine from the lower
      thoracic vertebra to the sacrum, as is the case with the other pedicle screw
      systems, but also to have great advantages for use in various spinal disorders,
      including reduction of slipped vertebra, correction of spinal deformity combined
      with a hook system, and for anterior spinal instrumentation. Postoperative
      clinical results were good in most of the cases, but pseudarthrosis considerably
      affected the results in a few cases. Therefore, great care must be taken, both
      strategically and technically, to prevent pseudarthrosis.

PMID- 1750005
TI  - A biomechanical analysis of Zielke, Kaneda, and Cotrel-Dubousset instrumentations
      in thoracolumbar scoliosis. A calf spine model.
AB  - A biomechanical study was performed in order to evaluate the initial stability of
      three spinal instrumentation systems, applied to a scoliosis model. Five calf
      spines (T11-L2) were destabilized anteriorly, and, by inserting a wedge-shaped
      resin disc within each destabilized intervertebral space, a thoracolumbar
      scoliosis was created. Three spinal instrumentation systems (Zielke anterior
      instrumentation, Kaneda anterior multisegmental fixation device, and Cotrel
      Dubousset posterior instrumentation) were applied to correct the simulated
      scoliotic condition. Mechanical nondestructive cyclical testing in axial
      compression, rotation, flexion, and extension was performed on each spinal
      construct. The Kaneda device was the most stable instrumentation in all four
      loading conditions. Zielke instrumentation failed to restore the stability to the
      level of the intact spine in rotation, and was the least rigid instrumentation in
      flexion and extension. The Cotrel-Dubousset instrumentation demonstrated
      favorable stability in flexion and extension, but became the least rigid
      instrumentation in axial compression and rotation. This study suggests that a one
      stage procedure with Zielke instrumentation and a two-stage procedure (anterior
      release with bone graft and posterior stabilization) with Cotrel-Dubousset
      instrumentation applied for the correction of scoliosis, should be supplemented
      with additional external or internal supports. The Kaneda device may offer enough
      stability with an anterior procedure alone in the correction of scoliosis.

PMID- 1750006
TI  - Diagnosis and operative treatment of intraforaminal and extraforaminal nerve root
      compression.
AB  - The clinical, radiologic, and operative findings, and clinical results in 26
      cases of foraminal nerve root involvement, each treated by variable operative
      procedures for an existing pathologic condition, were studied. These 26 cases
      consisted of 8 intraforaminal or extraforaminal lumbar disc herniations and 18
      foraminal nerve root entrapments. The cases with an extreme lateral lumbar disc
      herniation underwent lateral fenestration or osteoplastic hemilaminectomy without
      concomitant spinal fusion, and showed excellent operative results. A sufficient
      selective decompression was achieved with a good clinical result in the cases of
      lumbar spondylosis without preoperative spinal instability, by lateral
      fenestration or osteoplastic hemilaminectomy. This result suggests that the
      selective decompression procedure is recommended for cases with reliable
      preoperative diagnoses. When an intraspinal lesion makes it difficult to diagnose
      coexisting foraminal nerve root involvement, decompression of the nerve root
      canal, approaching from medial to lateral, is recommended. The fusion operation
      should be performed in cases undergoing even a unilateral total facetectomy,
      regardless of the patient's old age. A correct preoperative diagnosis is crucial
      in order to obtain satisfactory operative results.

PMID- 1750007
TI  - A quantitative evaluation of sensory dysfunction in lumbosacral radiculopathy.
AB  - A quantitative evaluation of sensory disturbance of the foot was attempted in 94
      cases of lumbosacral radiculopathy using the biothesiometer, the Semmes-Weinstein
      esthesiometer, light touch, tuning fork, and dermatomal somatosensory evoked
      potentials. Dermatomal somatosensory evoked potentials was the most sensitive of
      these tests, and reflected the duration of the lumbosacral radiculopathy better
      than the biothesiometer and the Semmes-Weinstein esthesiometer. The
      biothesiometer and Semmes-Weinstein esthesiometer reflected the clinical severity
      of sensory dysfunctions, the extent of numbness, and the immediate change in
      sensory function better than the dermatomal somatosensory evoked potentials. It
      is important to understand the characteristics of each test and to choose
      informative tests for clinical use. Grades of sensory disturbance in patients
      with lumbosacral radiculopathy were classified into three categories in
      combination with the findings of dermatomal somatosensory evoked potentials and
      the values recorded with the biothesiometer and Semmes-Weinstein esthesiometer.

PMID- 1750008
TI  - The Steffee variable screw placement system using different methods of bone
      grafting.
AB  - Two groups of patients with diseased lumbar spines treated by the Steffee
      variable screw placement system were studied, in order to compare concomitant
      posterolateral fusion and posterior lumbar interbody fusion. The use of
      posterolateral fusion resulted in less invasiveness than posterior lumbar
      interbody fusion, with regard to operating time and blood loss. With the
      posterolateral fusion method, correction of olisthesis or kyphotic deformity, if
      attained at all, was difficult to maintain. Posterior lumbar interbody fusion
      produced better correction and maintenance, even in osteoporotic cases. Bone
      union was achieved at an average of 11 months in only 60% of the posterolateral
      fusion group, whereas it was complete within a significantly shorter period
      (average; 6 months) in 91% of the posterior lumbar interbody fusion group.
      Breakage or loosening of screws occurred in 14% of the posterolateral fusion
      group. Deep wound infection and adhesive arachnoiditis, which were never seen in
      the posterolateral fusion group, developed in 3% of the posterior lumbar
      interbody fusion group. Posterior lumbar interbody fusion is considered to be a
      better method of bone grafting than posterolateral fusion, when used with the
      Steffee variable screw placement system.

PMID- 1750009
TI  - An experimental study on transpedicular screw fixation in relation to
      osteoporosis of the lumbar spine.
AB  - In order to elucidate the relationship between the severity of osteoporosis and
      the fixation strength of a pedicle screw, screw pull-out tests were performed
      using cadaveric lumbar vertebrae. The severity of osteoporosis was evaluated by
      the Jikei osteoporosis grading scale (Jikei method), bone mineral density, and
      microdensitometry. When a 7.0-mm screw was used, the pull-out force of the screw
      was 1,056.4 N in the normal group (as determined by the Jikei method), while it
      was 495.6 N in the Grade I osteoporosis and 269.5 N in the Grade II osteoporosis
      groups, respectively. There were also positive correlations between the pull-out
      force and bone mineral density and each parameter of the microdensitometry
      method. When bone cement was used in an osteoporotic vertebra, twofold stronger
      pull-out force was obtained in comparison to that obtained without bone cement.

PMID- 1750010
TI  - Cervical myelopathy with Prader-Willi syndrome in a 13-year-old boy. A case
      report.

PMID- 1750011
TI  - Spinal metastasis of sweat gland carcinoma. A case report.

PMID- 1750012
TI  - Conjoined nerve roots associated with lumbosacral spine anomalies. A case report.

PMID- 1750013
TI  - Tuberculosis in the Third World.

PMID- 1750014
TI  - Extracorporeal membrane oxygenation: a breath of fresh air or yesterday's
      treatment?

PMID- 1750015
TI  - Body composition and exercise performance in patients with chronic obstructive
      pulmonary disease.
AB  - To investigate whether a compromised nutritional state may limit exercise
      performance in patients with chronic obstructive pulmonary disease we studied 54
      such patients (FEV1 less than 50% and arterial oxygen tension (PaO2) greater than
      7.3 kPa) whose clinical condition was stable and who were admitted to a pulmonary
      rehabilitation centre. Fat free mass was assessed anthropometrically (from
      skinfold measurements at four sites) and by bioelectrical impedance; creatinine
      height index and arm muscle circumference were also assessed. The mean (SD)
      distance walked in 12 minutes was 845 (178) m. No association was established
      between the distance walked and spirometric measures. A good correlation was
      found between the distance walked and fat free mass in the whole group (r = 0.73
      for impedance measurements and 0.65 for skinfold thickness) and in a subgroup of
      23 lean patients (body weight less than 90% of ideal weight; r = 0.66 for
      impedance measurements and 0.46 for skinfold thickness). Body weight correlated
      with the distance walked only in the whole group (r = 0.61). On stepwise
      regression analysis fat free mass measured by bioelectrical impedance, maximal
      inspiratory mouth pressure, and PaO2 accounted for 60% of the variation in the
      distance walked in 12 minutes. We conclude that fat free mass, independently of
      airflow obstruction, is an important determinant of exercise performance in
      patients with severe chronic obstructive pulmonary disease.

PMID- 1750016
TI  - Prophylactic intranasal alpha 2 interferon and viral exacerbations of chronic
      respiratory disease.
AB  - BACKGROUND As respiratory virus infections often lead to exacerbations of chronic
      bronchitis and asthma an effective antiviral drug may be helpful in such
      patients. Alpha 2 interferon has been shown to give protection against rhinovirus
      infections in field studies. METHODS Patients with chronic respiratory disease
      exposed to close contacts with symptoms of upper respiratory tract infection were
      randomly allocated to receive nasal sprays of recombinant alpha 2 interferon (3 x
      10(6) IU) or placebo twice daily for five days. Of the 123 patients recruited
      into the study, 69 took 117 courses of medication; 11 courses were excluded from
      analysis. RESULTS No important side effects were recorded and the incidence of
      possible adverse effects was similar in the two groups. Interferon treatment did
      not reduce the number or severity of symptomatic episodes; 11 of 48 patients
      given interferon and 16 of 58 given placebo developed lower respiratory symptoms.
      There were no differences in mean symptom scores (51 interferon and 52 placebo),
      number of symptomatic days (3.3 interferon and 5.0 placebo), peak flow values,
      number of general practitioner consultations, or use of antibiotics. CONCLUSION
      Alpha 2 interferon 3 x 10(6) IU taken twice daily for five days does not protect
      patients with chronic respiratory disease from exacerbations after they have been
      in contact with an upper respiratory tract infection.

PMID- 1750017
TI  - Improvement of drug delivery with a breath actuated pressurised aerosol for
      patients with poor inhaler technique.
AB  - BACKGROUND The metered dose inhaler is difficult to use correctly, synchronising
      actuation with inhalation being the most important problem. A breath actuated
      pressurised inhaler, designed to help patients with poor inhaler technique, was
      compared with a conventional metered dose inhaler in terms of aerosol deposition
      and bronchodilator response. METHODS Radioaerosol deposition and bronchodilator
      response to 100 micrograms salbutamol were measured in 18 asthmatic patients, who
      inhaled from a conventional metered dose inhaler by their own chosen metered dose
      inhaler technique, from a conventional metered dose inhaler by a taught metered
      dose inhaler technique, and from a breath actuated pressured inhaler (Autohaler).
      RESULTS In the 10 patients who could coordinate actuation and inhalation of the
      inhaler on their own deposition of aerosol in the lungs and bronchodilator
      response were equivalent on the three study days. By contrast, in the eight
      patients who could not coordinate the mean (SEM) percentage of the dose deposited
      in the lungs with their own inhaler technique (7.2% (3.4%] was substantial lower
      than those attained by the taught metered dose inhaler technique (22.8% (2.5%]
      and by Autohaler (20.8% (1.7%]. CONCLUSION Although of little additional benefit
      to asthmatic patients with good coordination, the Autohaler is potentially a
      valuable aid to those with poor coordination, and should be considered in
      preference to a conventional metered dose inhaler in any patient whose inhaler
      technique is not known to be satisfactory.

PMID- 1750018
TI  - Pulmonary deposition of nebulised amiloride in cystic fibrosis: comparison of two
      nebulisers.
AB  - BACKGROUND Preliminary evidence suggests that regular inhalation of nebulised
      amiloride reduces sputum viscoelasticity, increases the clearance of sputum by
      mucociliary mechanisms and by coughing and reduces the rate of deterioration in
      lung function in patients with cystic fibrosis. These effects depend on adequate
      delivery of amiloride to the airways. This study was performed to quantify and
      compare pulmonary deposition of amiloride produced by two different nebuliser
      systems. METHODS The pulmonary deposition of nebulised amiloride (1 mg in 3 ml
      saline) was measured in eight patients with cystic fibrosis when given via a jet
      (System 22 with CR 60 compressor) and an ultrasonic (Fisoneb) nebuliser. Human
      serum albumin labelled with technectium-99m was used as an indirect marker for
      amiloride and its deposition in the lung was detected with a gamma camera.
      RESULTS Amiloride inhalation caused no side effects or changes in spirometric
      indices. The mean (SD) total pulmonary amiloride deposition was 57 (24)
      micrograms with the System 22 and 103 (53) micrograms with the Fisoneb nebuliser.
      Pulmonary deposition was completed more rapidly with the Fisoneb (4-5 minutes)
      than with the System 22 nebuliser (7-8 minutes) and the Fisoneb was preferred by
      the patients. CONCLUSIONS Both nebulisers appeared to deliver adequate amounts of
      amiloride to the lungs, but treatment with the Fisoneb nebuliser was quicker,
      more efficient, and more acceptable to the patients. Of the two nebulisers
      assessed, the Fisoneb would be preferred for clinical trials.

PMID- 1750019
TI  - Diagnostic value of lung clearance of 99mTc DTPA compared with other non-invasive
      investigations in Pneumocystis carinii pneumonia in AIDS.
AB  - Various non-invasive investigations were carried out in patients infected with
      HIV who had respiratory symptoms with and without pneumocystis pneumonia (with
      pneumonia, n = 13 (five smokers); without pneumonia, n = 22 (13 smokers]. These
      included chest radiography; lung function tests (forced expiratory volume in one
      second, forced vital capacity; transfer factor and coefficient for carbon
      monoxide); arterial blood gas tensions; arterial oxygen saturation at rest and on
      exercise; and lung clearance of diethylenetriaminepenta-acetic acid labelled with
      technetium-99m (99mTc DTPA). The effect of scan time (seven v 45 minutes from
      peak counts) and subtraction of background counts were examined. There were no
      significant differences between the two groups in lung function tests or arterial
      blood gas tensions at rest. The median clearance half time of inhaled 99mTc DTPA
      for the first seven minutes from peak counts was 7.2 minutes for patients with
      pneumocystis pneumonia and 22 minutes for those without. The median arterial
      oxygen desaturation on exercise was 5% in patients with pneumocystis pneumonia
      and 2% in those without. 99mTc DTPA lung clearance was better than the other non
      invasive tests in discriminating pneumocystis pneumonia from other pulmonary
      disorders in patients positive for HIV. A short scan time of seven minutes was as
      sensitive and specific as the longer scan time of 45 minutes, and this allows the
      clearance of 99mTc DTPA to become a rapid screening test.

PMID- 1750020
TI  - Results of thoracotomy in osteogenic sarcoma with pulmonary metastases.
AB  - BACKGROUND Resection of pulmonary metastases may be followed by long term
      survival and now that it is an accepted method of treatment for patients with
      osteogenic sarcoma indicators of favourable prognosis are needed to aid the
      assessment of suitability for resection. This study compares the survival rates
      of patients who did and did not undergo resection of their pulmonary metastases
      and relates them to prognostic indicators. METHODS The study population was the
      43 patients with osteosarcoma who developed pulmonary metastases out of the 111
      patients with osteosarcoma treated by the Birmingham bone tumour treatment
      service during 1977-83. All patients who developed metastases confined to the
      lungs were considered for resection, thoracotomy being advised for all patients
      (provided that they were fit enough) who had metastases thought to be resectable
      even if they were multiple. RESULTS Of the 18 patients who did not have a
      thoracotomy, 15 died of disseminated disease after a mean interval of eight
      months; one patient died of cardiomyopathy and two are alive after 26 and eight
      months. Of the 25 patients who underwent thoracotomy in an attempt to resect
      metastases, three were found to have inoperable disease and died after a mean
      interval of 5.4 months from thoracotomy. Overall, after thoracotomy (repeated if
      necessary) there was a 20% survival at five years from the first thoracotomy.
      When survival was assessed with respect to the disease free interval and the
      number and bilaterality of the metastases no significant relationships were
      found. There was, however, a significant relation between survival and the
      position of metastases, patients with metastases confined to one lobe of the lung
      having a mean survival of 29.5 months, compared with 13.7 months in patients with
      disease in more than one lobe. CONCLUSION Thus patients who had a thoracotomy
      survived longer from the time of diagnosis of pulmonary metastasis than those not
      undergoing thoracotomy; metastases confined to one lobe predicted a better
      prognosis.

PMID- 1750021
TI  - Measurement of tracheobronchial clearance after sauna in subjects with chronic
      bronchitis.
AB  - The effect of sauna on tracheobronchial clearance was studied in five male
      patients with chronic bronchitis by a radioaerosol technique. No enhancement of
      tracheobronchial clearance could be detected.

PMID- 1750022
TI  - What makes granulomas tick?

PMID- 1750023
TI  - Mycobacterium fortuitum lung abscess treated with ciprofloxacin.
AB  - Mycobacterium fortuitum rarely causes lung disease. Although treatment in the
      past has included intravenous antibiotics, this is the first report of a
      Mycobacterium fortuitum lung abscess that resolved with a prolonged course of
      oral ciprofloxacin alone. There is no evidence of recurrence 14 months after the
      end of treatment.

PMID- 1750024
TI  - Computed tomography and magnetic resonance findings in lipoid pneumonia.
AB  - A case of exogenous lipoid pneumonia was documented by computed tomography and
      magnetic resonance imaging. Although strongly suggesting the presence of fat on
      T1 weighted images, magnetic resonance does not produce images specific for this
      condition. Computed tomography is the best imaging modality for its diagnosis.

PMID- 1750025
TI  - Percutaneous biopsy of mediastinal tumours under sonographic guidance.

PMID- 1750026
TI  - The laryngeal mask airway and flexible bronchoscopy.

PMID- 1750027
TI  - [A non-specific veterinarian].
AB  - John Akkermans, who became 65 on july 4th, 1991, started his veterinary career on
      december 1st, 1952. He contributed in many ways to veterinary science. In the
      Netherlands many diseases were diagnosed by him for the first time. He had the
      ability to arouse the interest of many for his findings by writing papers as the
      sole author. But by stimulating his co-workers even more papers were published of
      which he was co-author and not always the first one. He was obviously able to
      follow the developments in veterinary science and animal husbandry without any
      problems and to create openings when the profession was confronted by problems.
      He was often involved in diseases of pigs but also in furred animals and
      ruminants. He was not a specialist in a single species of animal or in a single
      professional area, but in several fields. Not a specialist, but a more specific
      veterinarian in the sense that he is unique.

PMID- 1750028
TI  - [Changed health problems in a changing pig-farming concern in The Netherlands
      until 1980].
AB  - In 1905 Poels published 'Disease of swine in the Netherlands'. This book dealt
      predominantly with swine fever, erysipelas, tuberculosis and 'pneumonia'. Between
      1920 and 1940 others reported on streptococci, lobular haemmorrhagic pneumonia,
      bordetellosis, Aujeszky's disease and postweaning diarrhoea. After the second
      world war, particularly after 1960, the Dutch pig-farming industry developed at a
      tremendous rate. As a consequence, the health problems changed. Certain diseases
      became less important: tuberculosis, erysipelas, Leptospira tarrasovi,
      enteroviruses. Yet other diseases including postweaning diarrhoea, atrophic
      rhinitis and Aujeszky's disease became problems of increasing importance. At the
      end of the seventies the knowledge of E. coli toxin types was substantial. On the
      other hand, information concerning the pathogenesis and pathophysiology was very
      limited. Bordetella bronchiseptica was still considered to be the most important
      agent in AR, zootechnical factors being predisposing. However, one was aware of
      missing links. Aujeszky's disease was obscure until the late fifties. Until 1972
      only occasional reports were made. In that year, an epidemic occurred in the
      Gelderse Vallei. Another epidemic occurred in 1974 in the provinces of Brabant
      and Limburg. By 1980 proper vaccines were available and Aujeszky's disease was
      not yet a political problem.

PMID- 1750029
TI  - [The Veterinary Service Board, EEC-guidelines for the protection of the welfare
      of domestic animals].

PMID- 1750030
TI  - [Atrophic rhinitis A.D. 1991].
AB  - In the Netherlands the Central Veterinary Institute (CVI) and the Animal Health
      Services carried out investigations on aetiology, pathogenesis, therapy and
      prevention of Atrophic Rhinitis (AR) since 1970. Since the discovery of AR toxin
      in AR pathogenic P. multocida in SPF piglets, quicker and cheaper tests were
      developed e.g. the mouse test and guinea pig skin test. Today ELISA-tests with
      poly- and monoclonals are also available. The CVI carried out DNA probes and is
      developing a PCR-test. Tests to detect a natural infection were difficult to
      develop. The SN test by Bechmann, the skin test by Schimmelpfenning and the ELISA
      test by Foged give some perspectives. From investigations with B. bronchiseptica
      in piglets, it appears that the role of this germ is overestimated in the
      development of AR. On 16-week-old pigs an infection with AR toxigenic P.
      multocida caused conchae atrophy and septum deviation within 4 weeks. This fact
      has to be taken into account concerning the preventive medications in piglets.
      Only high maternal antibody titres against the AR toxin are able to protect the
      piglets for a sufficiently long period. Conchae atrophy and brachygnathia
      superior are indicators for suspicion of AR but do not prove the diagnosis of AR.
      By means of selective agars the isolation of P. multocida from nose, tonsils and
      lungs could be improved. The incubation period of clinical AR may last longer
      than two years. The AR pathogenic P. multocida is predominantly transmitted by
      pigs, incidentally also by rabbits, cattle, sheep, goat, poultry, dogs and cats.
      Humans can get infected and diseased. The AR pathogenic P. multocida has to be
      classified as a zoonosis. By way of stamping out and air filtering the
      transmission can be prevented. Vaccination cannot avoid an infection with the AR
      pathogenic P. multocida. The Animal Health Services developed a program to
      certify breeding herds 'free of AR pathogenic P. multocida'.

PMID- 1750031
TI  - [Towards a better health status in pig farming].
AB  - The Dutch pig-farming industry is on the verge of sweeping changes due to
      national and European legislation and changes towards a buyers market. An
      improved health-status is a necessity. Such improvements must fall in line with
      changes in the industry. This paper presents the characteristics of primary,
      secondary and tertiary infectious disease, and methods by which improvements can
      be achieved. These are: stamping out; systematic vaccinations; systematic pre
      medications; improved husbandry; in-line production; breeding for improved
      disease-resistance; the SPF system; and Early Medicated Weaning. In the Dutch pig
      farming industry the number of farms will decrease to approx. 10,000. These farms
      will be organised in vertically integrated production systems. IN CONCLUSION:
      improvement of the national pig-health status is acquired through vertically
      integrated production systems under improved husbandry conditions. Particular
      infectious microorganisms will be banned through EEC regulations; other diseases
      will be minimised by vaccination. Selection for disease-resistance will
      contribute to some extent to an improved health-status in the future.

PMID- 1750032
TI  - [Coprophagia in dogs].

PMID- 1750033
TI  - [A belly full of lucky breaks].

PMID- 1750034
TI  - [The Veterinary Service Board. Legislation for the practice of veterinary
      medicine].

PMID- 1750035
TI  - Regional blood flow in skeletal muscle measured by the heated thermocouple method
      during electrical nerve stimulation of the canine gracilis muscle.
AB  - Skeletal muscle blood flow (MBF) and intramuscular pressure (IMP) were measured
      using a heated thermocouple (HTC) and a solid-state catheter-tip transducer
      during electrical nerve stimulation in the gracilis muscle of anesthetized dogs.
      MBF values obtained simultaneously by the HTC method and the inhalated hydrogen
      gas (H2) clearance method showed an excellent linear regression with a
      correlation coefficient of 0.93. Electrical nerve stimulation at frequencies of 5
      and 100 Hz increased total MBF, determined by an electromagnetic flowmeter, over
      control values 6.57 +/- 0.82 and 6.32 +/- 0.93 ml/min/100 g, respectively.
      Regional MBF at 5 Hz stimulation determined with HTC increased in the same
      magnitude both at the midpoint and the distal portion of the gracilis muscle.
      However, following 100 Hz stimulation, MBF at the midpoint was decreased from
      8.15 +/- 1.55 to 4.09 +/- 1.54 ml/min/100 g, whereas at the distal portion flow
      was increased from 6.39 +/- 1.71 to 21.2 +/- 5.29 ml/min/100 g. IMP in both
      regions was low and approximately 2.0 mmHg at rest. IMP was remarkably increased
      to 27.9 +/- 8.43 mmHg at the midpoint but not in the distal portion during 100 Hz
      tetanic contraction, but showed no significant change in either region following
      5 Hz stimulation. These data suggest that HTC can serve to measure MBF, and that
      following 100 Hz tetanic contraction, increased IMP may be associated with
      decreased regional MBF, irrespective of a total increase in flow in the gracilis
      muscle.

PMID- 1750036
TI  - Effects of elastic loading and exercise on pulmonary gas exchange in dogs.
AB  - We assessed the effects of negative intrathoracic pressure induced by inspiratory
      elastic loading on pulmonary, gas exchange with and without electrically induced
      hindlimb exercise in 8 normal, anesthetized dogs. Two elastic loads (EL) were
      used; one of 81 and one of 140 cmH2O/liter. These are equivalent to doubling and
      tripling the normal elastance of the dog's respiratory system, respectively.
      Elastic loading decreased ventilation and caused hypoxemia and hypercapnia, but
      it did not affect systemic arterial pressure or heart rate. During exercise,
      increase in ventilation was limited, whereas increase in cardiac output was not
      affected by elastic loading. Alveolar-arterial O2 tension difference (A-aDO2) was
      not changed significantly by exercise alone. However, elastic loading accompanied
      by exercise increased A-aDO2. Although comparable end-inspiratory pleural
      pressure was achieved with large EL (-29 +/- 2 cmH2O, mean +/- SE) and small EL
      with exercise (-30 +/- 2 cmH2O), the latter increased A-aDO2 whereas the former
      did not. Large negative intrapleural pressure combined with increased cardiac
      output may have caused transient interstitial edema.

PMID- 1750037
TI  - Establishment of an estrogen receptor-positive cell line (HMA-1) derived from
      human breast carcinoma.
AB  - We have established a novel human breast carcinoma cell line, HMA-1, derived from
      ascites of a female breast cancer patient. HMA-1 was shown to be an epithelial
      cell line with intracytoplasmic duct-like vacuoles, microvilli, desmosomes and
      tonofibrils in accordance with human breast cancer. The cell line demonstrated a
      good cell growth ability in monolayer fashion with a doubling time of 46 hr.
      Based on a whole cell binding assay the cell line contained estrogen receptor
      (1.45 x 10(-4) sites/cell). Tamoxifen, an anti-estrogen agent induced a dose
      dependent decrease in the cell growth rate, but estradiol stimulated the cell
      growth. HMA-1 could be transplanted subcutaneously into BALB/c nude mice, and was
      able to cause tumors approximately two months after heteroinoculation. These
      results indicate that HMA-1 cell line may serve as a new human breast carcinoma
      cell line which could be utilized in the breast cancer research.

PMID- 1750038
TI  - Association between renal tubular dysfunction and mortality among residents in a
      cadmium-polluted area, Nagasaki, Japan.
AB  - A retrospective cohort study was carried out to clarify the effect of exposure to
      environmental cadmium (Cd) on mortality. A total of 256 residents aged 50 years
      or older, living in Sasu, a Cd-polluted area in Tsushima Island in Nagasaki
      Prefecture, Japan, were followed from July 1979 to February 1989. The expected
      number of deaths calculated was based on the sex- and age- specific mortality
      rate in Tsushima Island in 1985. In Sasu residents of both sexes with urinary
      beta 2-microglobulin (beta 2-m) concentration greater than 1,000 microgram/g
      creatinine in 1979, observed deaths were greater than expected. However, the p
      value of the difference was less than 0.05 only in men. The relationships of age,
      mean blood pressure, urinary beta 2-m and urinary Cd concentration to mortality
      were examined using Cox's proportional hazards model. Urinary beta 2-m was
      independently and significantly related to mortality in men but not in women. The
      results suggest an association between Cd-induced renal tubular dysfunction and
      mortality.

PMID- 1750039
TI  - Environmental pollutants and diseases. A cell biological approach using chronic
      cadmium exposure in the animal model as a paradigm case.

PMID- 1750040
TI  - A critical appraisal of stroke evaluation and rating scales.
AB  - BACKGROUND: To judge the efficacy of new, putative stroke therapies, we need a
      method to measure neurological deficit accurately in groups of patients before
      and after treatment. No single measurement technique has yet proven to be
      universally acceptable, but one approach is the use of rating instruments that
      summarize the neurological deficit found on clinical examination. Currently,
      stroke assessment scales may be based on the examination of physical deficits, an
      inventory of activities of daily living, or a global evaluation of functional
      outcome. SUMMARY OF REVIEW: Scientific methods for authenticating stroke scales
      are available in the psychometric and statistical literature. We review currently
      available stroke scales for their validity and reliability and propose
      investigations needed to refine further the standardized measurement of
      neurological deficit following stroke. CONCLUSIONS: We suggest that clinical
      stroke trials include a physical deficit scale and a global rating during the
      acute phase and that an activities of daily living scale be added at later points
      in recovery.

PMID- 1750041
TI  - Selection process for surgeons in the Asymptomatic Carotid Atherosclerosis Study.
AB  - BACKGROUND AND PURPOSE: The Asymptomatic Carotid Atherosclerosis Study is a
      prospective, multicenter, randomized clinical trial of carotid endarterectomy for
      the treatment of asymptomatic hemodynamically significant stenosis. This report
      describes the selection process for participating surgeons in the trial. METHODS:
      The Surgical Management Committee established guidelines for minimal annual
      experience and maximum neurological morbidity and mortality for surgeons to
      qualify to participate in the study. For approval, a surgeon must perform at
      least 12 carotid endarterectomies per year. Based on a review of the surgeon's
      last 50 consecutive endarterectomies, the combined neurological morbidity and
      mortality rate must be no greater than 5% for all indications and no greater than
      3% for endarterectomies performed on asymptomatic patients. RESULTS: One hundred
      sixty-four surgeons from 48 centers applied for approval: 117 were approved, 17
      were rejected, and 30 were not reviewed. The 117 approved surgeons submitted a
      total of 5,641 endarterectomies with a combined mortality and neurological
      morbidity rate of 2.3% for the variety of indications for operation. CONCLUSIONS:
      This overall experience with carotid endarterectomy is one of the largest series
      reported to date. The data from approved surgeons are well within the range of
      acceptable neurological morbidity and mortality rates recommended by the Stroke
      Council of the American Heart Association, which attests to the overall quality
      of the surgeons participating in the study.

PMID- 1750042
TI  - Systemic vascular changes in spontaneous occlusion of the circle of Willis.
AB  - BACKGROUND AND PURPOSE: We examined the presence of systemic etiologic factors
      causing vascular changes in so-called "spontaneous occlusion of the circle of
      Willis" (cerebrovascular moyamoya disease) to determine whether extracranial, as
      well as intracranial, vessels are involved in this disease. METHODS:
      Histopathologic examination and morphometric analysis of the extracranial vessels
      were performed in 13 patients with this disease. RESULTS: The histopathologic
      findings of the extracranial vessels were as follows: 1) advanced intimal fibrous
      thickening similar to that of the intracranial vessels; and 2) characteristic
      intimal fibrous nodular thickening, which may indicate organization of mural
      thrombi, at the proximal portions of the pulmonary arteries in three of 13
      patients. Morphometric analysis revealed significant intimal thickening of the
      pulmonary arteries (p less than 0.05), renal arteries (p less than 0.05), and
      pancreatic arteries (p less than 0.01) in patients with this disease as compared
      with age- and sex-matched control patients. CONCLUSIONS: On the basis of these
      findings, it is highly likely that this disease has systemic etiologic factors,
      as well as focal etiologic factors, that work to create vascular change in both
      the intracranial and extracranial vessels.

PMID- 1750043
TI  - Cerebrovascular effects of angiotensin converting enzyme inhibition involve large
      artery dilatation in rats.
AB  - BACKGROUND AND PURPOSE: The aim of the study was to selectively examine the
      effects of converting enzyme inhibition on the large brain arteries by using
      concomitant inhibition of carbonic anhydrase to cause severe dilatation of mainly
      parenchymal resistance vessels. METHODS: Cerebral blood flow was measured using
      the xenon-133 injection technique in three groups of Wistar rats either during
      carbonic anhydrase inhibition with acetazolamide (treatment A, n = 8), during
      carbonic anhydrase inhibition followed by converting enzyme inhibition with
      captopril 40 minutes later (treatment B, n = 10), or during carbonic anhydrase
      inhibition preceded by converting enzyme inhibition 20 minutes earlier (treatment
      C, n = 7). RESULTS: After treatment A, cerebral blood flow rose rapidly and
      stabilized within 20 minutes at an average of 220 ml/100 g.min; flow remained
      stable until at least 60 minutes. After treatment B, cerebral blood flow
      increased by a further 17.4%, from an average of 219 ml/100 g.min to an average
      of 257 ml/100 g.min (p less than 0.01). After treatment C, cerebral blood flow
      stabilized at an average of 238 ml/100 g.min, with flow from 20 to 60 minutes
      always being higher (from 5% to 17%) than during carbonic anhydrase inhibition
      alone (p less than 0.02). Thus the additional inhibition of converting enzyme
      resulted in higher cerebral blood flow than during inhibition of carbonic
      anhydrase alone. CONCLUSIONS: These results suggest that converting enzyme
      inhibition reduced resistance of large brain arteries and support the hypothesis
      that there is some angiotensin II-induced tone in large cerebral arteries.

PMID- 1750044
TI  - Lacunar infarcts. Pathogenesis and validity of the clinical syndromes.
AB  - BACKGROUND AND PURPOSE: In this study, we investigated the lacunar hypothesis to
      answer three questions: 1) Is the lacunar syndrome valid for diagnosing lacunar
      infarction? 2) What is the frequency of potential cardiac versus carotid sources
      of embolism in patients with lacunar versus cortical infarct? 3) What is the
      frequency of vascular risk factors in these two groups of patients? METHODS: The
      study was performed in a well-defined prospective series of 103 patients with a
      first-ever lacunar infarct and 144 other patients with a first-ever infarct
      involving the cortex. RESULTS: Sensitivity and specificity of the lacunar
      syndromes in diagnosing lacunar infarction were 95% and 93%, respectively.
      Positive and negative predictive values of diagnosing lacunar infarction in
      patients with lacunar syndromes were 90% and 97%, respectively. Risk factor
      analysis showed no differences for either group of cerebral infarction. A cardiac
      source of embolism was significantly less frequent in patients with lacunar
      infarction (odds ratio = 0.32, 95% confidence interval = 0.17-0.61, p less than
      0.001). Significant carotid stenosis (diameter reduction greater than or equal to
      50%) was also less frequent in patients with lacunar infarction (odds ratio =
      0.35, 95% confidence interval = 0.16-0.76, p less than 0.001). CONCLUSIONS: These
      findings show that the lacunar syndrome is an excellent clinical test for
      diagnosing lacunar infarction and that cardiac and carotid embolism are unlikely
      causes of lacunar infarction, supporting the hypothesis that lacunar infarcts are
      usually caused by small vessel disease.

PMID- 1750045
TI  - Incidence of silent lacunar lesion in normal adults and its relation to cerebral
      blood flow and risk factors.
AB  - BACKGROUND AND PURPOSE: There are few reports comparing incidence of silent
      lacunar lesions detected by magnetic resonance imaging and cerebral blood flow in
      neurologically normal adults. METHODS: We studied the incidence of such lesions
      and its relation to cerebral blood flow and risk factors in 246 neurologically
      normal adults (145 men, mean age 62 years; 101 women, mean age 60 years) who
      received health screening examinations of the brain. RESULTS: Thirty-two subjects
      (13%) had possible silent lacunar lesions (66% of these were recognized by both
      T1- and T2-weighted image). The regional cerebral blood flow measured by the
      xenon-133 inhalation method was significantly lower in subjects with silent
      lacunes than in those without (p less than 0.02). Cerebral blood flow was mildly
      but significantly decreased in those with silent lacunes (p less than 0.05).
      Periventricular hyperintensity was closely related to silent lacune (p less than
      0.01). However, there was no significant difference in cerebral blood flow
      between subjects with and without apparent periventricular hyperintensity.
      CONCLUSIONS: Silent lacunar lesion was closely related to decrease of cerebral
      circulation and may be an important risk factor for symptomatic cerebrovascular
      disease.

PMID- 1750046
TI  - Cerebral blood flow and neuropsychological asymmetries in unilateral stroke.
AB  - BACKGROUND AND PURPOSE: This study sought to determine the degree of agreement
      between asymmetries of neuropsychological functioning and nine methods of
      quantifying asymmetries of regional cerebral blood flow. METHODS: The regional
      cerebral blood flow methods combined three markers of cerebral blood flow
      asymmetry (percent hemispheric difference, maximum percent probe-pair asymmetry,
      and number of probe-pair asymmetries) with three indexes of regional cerebral
      blood flow (fast compartment flow, initial slope index, and initial slope).
      Eleven patients with left hemispheric ischemic strokes and 13 with right
      hemispheric ischemic strokes were studied with the xenon-133 inhalation technique
      and neuropsychological tests. RESULTS: Blind clinical judgments of
      neuropsychological asymmetry significantly correlated with all nine methods of
      cerebral blood flow asymmetry determination; correlations ranged from -0.42 to 
      0.77. Clinical judgment of asymmetry of neuropsychological functioning accurately
      predicted the hemisphere of lower flow in 71-92% of cases, depending on the
      method of cerebral blood flow asymmetry determination. Agreement between cerebral
      blood flow and neurobehavioral signs of asymmetry was greater for initial slope
      and initial slope index than for the fast flow index. The initial slope and
      initial slope index showed equally good agreement. The use of the number of
      asymmetrical probe pairs to detect cerebral blood flow asymmetries agreed less
      well with neurobehavioral asymmetry than did the other two markers studied.
      CONCLUSIONS: Both the initial slope index and the initial slope measures of
      cerebral blood flow are useful in predicting neuropsychological asymmetries,
      especially when the magnitude of the asymmetry is taken into account.

PMID- 1750047
TI  - 14,15-Epoxyeicosatrienoic acid inhibits platelet aggregation in mouse cerebral
      arterioles.
AB  - BACKGROUND AND PURPOSE: Epoxygenase metabolites of arachidonic acid are produced
      by several tissues and have been shown to inhibit in vitro platelet aggregation.
      The purpose of the present investigation was to determine whether 14,15- or 8,9
      epoxyeicosatrienoic acid, epoxygenase derivatives of arachidonic acid, affect the
      speed of platelet aggregation in in vivo mouse cerebral arterioles. METHODS: We
      performed a craniectomy in 116 anesthetized male mice and observed the pial
      arterioles by microscopy. We induced in situ platelet aggregation using a mercury
      light and intravascularly injected fluorescein dye. RESULTS: Indomethacin (0.5
      mg/kg i.p.), a known cyclooxygenase inhibitor, and 14,15-epoxyeicosatrienoic acid
      (0.3 mg/kg i.v.) increased the time necessary for the light plus dye to induce
      the first arterial platelet aggregate by 35% and 26%, respectively, whereas 8,9
      epoxyeicosatrienoic acid (0.3 mg/kg i.v.) had no effect. Analysis of mouse serum
      by radioimmunoassay showed that the degree of inhibition of platelet aggregation
      by indomethacin and epoxyeicosatrienoic acids correlated with the degree of
      inhibition of thromboxane production. CONCLUSIONS: We conclude that 14,15
      epoxyeicosatrienoic acid is a potent inhibitor of in vivo platelet aggregation
      but cannot conclusively confirm that its effect on aggregation occurs via its
      reduction of platelet thromboxane A2. Because epoxyeicosatrienoic acids are
      produced by several tissues, including brain and vascular tissue, they may be
      important in vivo modulators of platelet aggregation and hemostasis.

PMID- 1750048
TI  - Dietary treatment of atherosclerosis abolishes hyperresponsiveness of retinal
      blood vessels to serotonin in monkeys.
AB  - BACKGROUND AND PURPOSE: Atherosclerosis alters vascular responses of the eye to
      serotonin. Augmented vasoconstrictor responses in the retina to serotonin are
      associated with functional impairment and may contribute to amaurosis fugax. The
      goal of this study was to test the hypothesis that dietary treatment of
      atherosclerosis restores vascular responses of the eye toward normal. METHODS: We
      measured blood flow to the retina using microspheres in six normal monkeys, five
      atherosclerotic monkeys, and five atherosclerotic monkeys that were fed a normal
      (regression) diet for 18 months. RESULTS: Infusion of 8 and 40 micrograms.min
      1.kg-1 serotonin into the left atrium had little effect on blood flow to the
      retina in normal monkeys. In contrast, the high dose of serotonin reduced blood
      flow to the retina by a mean +/- SEM of 81 +/- 9% (p less than 0.05) in
      atherosclerotic monkeys. In monkeys that were fed the regression diet, serotonin
      had no effect on blood flow to the retina. CONCLUSIONS: Regression of
      atherosclerosis abolishes augmented responses of the retinal circulation to
      serotonin.

PMID- 1750049
TI  - Clentiazem protects against chronic cerebral vasospasm in rabbit basilar artery.
AB  - BACKGROUND AND PURPOSE: Experiments were carried out in rabbits to determine
      whether clentiazem (8-chlorodiltiazem), a cerebrovascular-selective calcium
      channel blocker, administered 24 hours before subarachnoid hemorrhage influenced
      the subsequent cerebral vasospasm. METHODS: Subarachnoid hemorrhage was induced
      by multiple injections of blood into the prepontine cisterns of 35 male New
      Zealand White rabbits, and clentiazem (5 mg/kg) was administered 4 times daily
      until sacrifice. Cerebral artery diameter was assessed in vivo by angiography.
      Functional features of basilar arteries were measured using conventional in vitro
      methodology. RESULTS: Clentiazem reduced the angiographic narrowing seen on days
      2 and 5 from 35% and 34%, respectively (sham control, 1.42 +/- 0.31 mm [n = 22]),
      to 8% and 11%, respectively, and prevented the narrowing (32%) that occurred on
      day 9. Narrowing in the untreated rabbits was only partly reversed by papaverine;
      all narrowing in clentiazem-treated animals was papaverine sensitive. Clentiazem
      prevented or reduced many of the changes in the basilar artery caused by the
      subarachnoid hemorrhage. Of particular relevance to arterial narrowing were the
      increased wall stiffness, the transient spontaneous changes in wall force, and
      the reduction in relaxation to acetylcholine. Reduction of the changes in wall
      force induced by agonists and by stimulation of intramural sympathetic nerves was
      observed. CONCLUSIONS: The vascular damage associated with chronic cerebral
      vasospasm is related to calcium entry into the smooth muscle and endothelial
      cells, and possibly sympathetic nerve terminals, through calcium channels
      sensitive to clentiazem, which suggests that clentiazem may be of value in the
      management of chronic cerebral vasospasm.

PMID- 1750050
TI  - Age-related vulnerability to cerebral ischemia in spontaneously hypertensive
      rats.
AB  - BACKGROUND AND PURPOSE: We sought to determine the effects of aging on regional
      cerebral blood flow and ischemic brain damage in transient cerebral ischemia in
      rats. METHODS: Five adult (5-6 months) and five aged (18-22 months) female
      spontaneously hypertensive rats were subjected to 20 minutes of bilateral carotid
      occlusion and 60 minutes of recirculation under amobarbital anesthesia (100 mg/kg
      i.p.). Regional cerebral blood flow in the hippocampus and striatum was measured
      using the hydrogen clearance method. Nine adult and 14 aged rats were subjected
      to 20 minutes of bilateral carotid occlusion or were sham-operated under ether
      anesthesia. Seven days after 20 minutes of cerebral ischemia, the rats' brains
      were perfusion fixed. Ischemic damage in the hippocampus and striatum was graded
      (0 [normal] to 3 [majority of neurons damaged]). RESULTS: After 20 minutes of
      bilateral carotid occlusion, striatal cerebral blood flow decreased to 9.1 +/-
      1.5 and 3.9 +/- 2.0 ml/100 g/min in aged and adult rats, respectively, and
      hippocampal cerebral blood flow decreased to 8.6 +/- 2.4 and 5.7 +/- 2.4 in aged
      and adult rats, respectively. Although these ischemic cerebral blood flow values
      were not significantly different between the two age groups, scores for ischemic
      damage in the hippocampus CA-1 subfield and striatum were significantly higher in
      aged than in adult rats (p less than 0.05, Kruskal-Wallis' h test with Bonferroni
      correction). CONCLUSIONS: We conclude that aging may be a primary factor in the
      development of greater ischemic neuronal damage observed in aged hypertensive
      rats.

PMID- 1750051
TI  - Does vasospasm occur in small pial arteries and arterioles of rabbits?
AB  - BACKGROUND: Vasospasm is a serious complication associated with subarachnoid
      hemorrhage. Successful management of vasospasm will ultimately depend on a clear
      understanding of the scope of this phenomenon, including whether arterial
      elements of different calibers are equally affected. We therefore examined the
      responses to subarachnoid hemorrhage in rabbit basilar arteries, small pial
      arteries, and arterioles. SUMMARY OF REPORT: We compared the brain stem pial
      arteries of 10 perfusion-fixed male New Zealand White rabbits after experimental
      subarachnoid hemorrhage to those of five control rabbits using morphological
      analysis of cross-sections of plastic-embedded vessels. After subarachnoid
      hemorrhage, the internal elastic lamina was highly corrugated in all basilar
      arteries (mean diameter 319 +/- 51 microns). These arteries were severely
      constricted in comparison with the control group, in which the mean diameter was
      691 +/- 17 microns, and corrugation of the internal elastic lamina was not
      present. In contrast, small pial arteries and arterioles very rarely demonstrated
      a vasoconstrictive configuration after subarachnoid hemorrhage. The contractility
      of the smaller vessels was confirmed by injecting 2 mg/kg BaCl2 intracisternally.
      Following BaCl2 injection, corrugation of the internal elastic lamina was
      detected in the small arteries and arterioles as well as the basilar arteries.
      CONCLUSIONS: We conclude that experimental chronic vasospasm after subarachnoid
      hemorrhage in rabbits tends to occur in large conducting arteries rather than in
      smaller pial arteries and arterioles.

PMID- 1750052
TI  - Familial association of intracranial aneurysms and cervical artery dissections.
AB  - BACKGROUND AND PURPOSE: The familial occurrence of intracranial aneurysms and
      cervical artery dissections has been described in different families and supports
      the hypothesis that a primary arteriopathy may play a role in the pathogenesis of
      these disorders. Although the basis for this arteriopathy is generally not
      believed to be similar among cases of intracranial aneurysms and cervical artery
      dissections, several similarities exist in the epidemiology of these disorders
      and a common underlying arterial abnormality may be suspected. SUMMARY OF
      REPORTS: The medical records of all 175 patients with spontaneous dissections of
      the cervical arteries who were seen at the Mayo Clinic between 1970 and 1989 were
      reviewed to identify families in which intracranial aneurysms and cervical
      dissections coexisted. Three families were identified in which intracranial
      aneurysms and cervical artery dissections were observed among siblings. These
      families are described in detail. CONCLUSIONS: The familial occurrence of
      intracranial aneurysms and cervical artery dissections within the same families
      provides support to the importance of a common underlying arteriopathy in the
      pathogenesis of both these disorders. The underlying vascular defect may, at
      least in some cases, be inherited.

PMID- 1750053
TI  - Deriving clinical prediction rules from stroke outcome research.
AB  - BACKGROUND AND PURPOSE: Our purpose was to determine whether clinical prediction
      rules could be derived from current stroke outcome research. SUMMARY OF REPORT:
      We reviewed 92 articles on stroke outcome research to determine their suitability
      for implementation as a clinical prediction rule. Methodological problems in many
      of these studies made implementation of their results as a clinical prediction
      rule difficult. CONCLUSIONS: Implementation of stroke outcome research as
      clinical prediction rules would be facilitated by description of patient
      population demographics; precise definitions of predictor and outcome measures;
      stratification of patients by stroke mechanism; use of adequate patient sample
      sizes; and description of the mathematical methods used, including coding
      schemes, cutpoints, beta coefficients, constant terms, and a priori
      probabilities.

PMID- 1750054
TI  - Cerebral vasculitis associated with cocaine abuse.
AB  - BACKGROUND: Earlier reports of cocaine-associated cerebral vasculitis have been
      based primarily on angiographic findings without pathological verification. CASE
      DESCRIPTION: We present a case of acute encephalopathy following intravenous and
      intranasal administration of cocaine. Brain biopsy revealed vascular changes
      involving primarily small arteries. Findings included lymphocytic infiltration,
      endothelial thickening, and deposition of proteinaceous amorphous material within
      and around vessel walls. CONCLUSIONS: These abnormalities are consistent with
      pathological features of arteritis previously reported in association with
      amphetamine and multiple-drug abuse. Vasospasm-induced changes are an alternative
      explanation for the vascular picture seen in this case. The patient made modest
      improvement with high-dose intravenous steroids.

PMID- 1750055
TI  - Lacunar infarctions due to cholesterol emboli.
AB  - BACKGROUND AND PURPOSE: Hypertension is commonly considered the major cause of
      lacunar infarctions. However, in some cases, it has been suggested that lacunes
      could be caused by cerebral emboli from cardiac or carotid sources. Cholesterol
      cerebral emboli have been rarely reported as a cause of lacunes. CASE
      DESCRIPTION: We describe a 79-year-old patient with a progressive multi-infarct
      dementia who developed transient motor aphasia and paresis of the right arm.
      Computed tomography showed lacunar infarcts in the right caudate nucleus, left
      thalamus, and left putamen, as well as an old right frontal infarction.
      Neuropathological examination demonstrated no prominent vascular hyalinosis, but
      did show multiple cholesterol emboli occluding small arteries around lacunar
      infarcts and leptomeningeal arteries near cortical infarcts. The cholesterol
      material presumably originated in the extended atheromatous changes along the
      aortic arch. CONCLUSIONS: Our report confirms that lacunes can be caused by
      cholesterol emboli in some patients. Small cerebral emboli should not be
      overlooked as a cause of lacunes.

PMID- 1750056
TI  - Evidence of somatotopic organization of the sensory thalamus based on infarction
      in the nucleus ventralis posterior.
AB  - BACKGROUND: This is to describe a restricted sensory syndrome of unique
      distribution due to thalamic infarct. CASE DESCRIPTION: We report a case of pure
      sensory disturbance involving the left intraoral and perioral regions and the
      tips of the thumb and forefinger of the left hand. Magnetic resonance imaging
      revealed a small infarct in the contralateral thalamus, presumably affecting the
      nucleus ventralis posterior. CONCLUSIONS: This patient provides an excellent
      correlation between clinical findings and thalamic representation of body surface
      as established during stereotactic procedures.

PMID- 1750057
TI  - Central nervous system complications of infective endocarditis.

PMID- 1750058
TI  - South Australian stroke rehabilitation outcome study.

PMID- 1750059
TI  - Responses of rat basilar artery to acetylcholine and platelet products in vivo.

PMID- 1750060
TI  - Effect of elevated norepinephrine levels on electrocardiographic changes in
      subarachnoid hemorrhage.

PMID- 1750061
TI  - Improvement in experimental cardiac preservation based on metabolic
      considerations.
AB  - Viability of rat hearts preserved in the standard Euro-Collins and a modified
      preservation medium utilizing the Euro-Collins medium as the base were assessed.
      The additions for the modified medium were chosen in order to attenuate the
      various forms of damage that may occur to an organ during cold ischemia. The
      viability of the hearts was assessed biochemically via 31P nuclear magnetic
      resonance spectroscopy and functionally during reperfusion in an isolated
      Langendorff preparation. It was noted that a modified medium containing
      magnesium, adenosine, allopurinol, glutathione, and polyethylene glycol provided
      superior protection of the cold ischemic myocardium as compared with the standard
      Euro-Collins medium in the isolated heart perfusion apparatus. Both physiologic
      function (dp/dt) and metabolic status (Pi/PCr ratio) were superior with the
      modified compared with the control medium (325 +/- 83 vs. 90 +/- 35 mmHg/sec and
      0.42 +/- .09 vs. 0.68 +/- .05, respectively, both P less than 0.05). Moreover,
      this modified solution resulted in more rapid development of contractions, as
      well as improved Pi/PCr ratio (0.71 +/- .32 vs. 2.02 +/- .59, P less than 0.05)
      in the in vivo heterotopic transplant model. It seems likely that a combination
      of pharmacologic additives may be developed that synergistically attenuate damage
      to the preserved myocardium.

PMID- 1750062
TI  - The quality of initial function following renal transplantation determined by
      creatinine elimination kinetics. Comparison of Minnesota antilymphocyte globulin
      and cyclosporine induction immunosuppression.
AB  - To compare the effect of type of induction immunosuppression on the quality of
      initial renal allograft function, we identified 35 cadaver donor kidney pairs in
      which one recipient of a kidney from a given pair received induction
      immunosuppression with Minnesota antilymphocyte globulin (MALG group) while the
      recipient of the contra-lateral kidney received cyclosporine from day zero (CsA
      group). In the absence of an existing quantitative measure to assess and compare
      the status of those grafts that function primarily, we defined the half-life of
      creatinine elimination (t1/2SCr) as such an outcome measure based on a review of
      creatinine elimination kinetics. All organs were procured with in-situ perfusion
      and en-bloc removal. Total cold storage times, rewarm times, and perioperative
      management were comparable for the two groups. In the MALG group, the mean
      t1/2SCr) was not different from that in the CsA group (1.38 +/- 0.96 days vs 1.35
      +/- 1.2 days P = NS). Multiple regression analysis performed on the differences
      in recipient age, number of DR-B locus matches, total cold ischemia time, rewarm
      time, and central venous pressure at reperfusion of a given donor pair
      demonstrated no significant impact of any of these differences on the difference
      in t1/2SCr for the same pair set in this sample. The nadir of serum creatinine
      achieved in the first five days posttransplant was somewhat higher in the CsA
      group (234 +/- 131 mumol/L) as compared with the MALG group (200 +/- 132 mumol/L)
      but the difference was not significant. A similar nonsignificant trend was
      observed in the comparison of mean serum creatinine values at 30 days
      posttransplant (MALG group: 158 +/- 62 mumol/L vs. CsA group: 200 +/- 141
      mumol/L). Only one of seventy recipients (CsA group) was dialyzed within the
      first 5 days posttransplant for an overall incidence of ATN of less than 2%.
      Fourteen of 35 (40%) recipients in both groups received treatment for acute
      rejection. The mean time to first treatment for acute rejection episode was
      shorter in the CsA group than the MALG group (10 +/- 8 days vs 23 +/- 24 days, P
      = 0.055). Graft survival at one year was not different for the two groups (92%
      vs. 87% for the MALG and CsA groups respectively, P = NS).(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1750063
TI  - Hepatic dysfunction following T-cell-depleted allogeneic bone marrow
      transplantation.
AB  - We reviewed the medical records of 97 patients undergoing T cell-depleted
      allogeneic bone marrow transplantation at our institution from 1984 to 1990 to
      determine the incidence of hepatic dysfunction, including venoocclusive disease
      of the liver following BMT. All patients received allogeneic marrow that had been
      purged with monoclonal antibody to the CD6 surface antigen (T12) and rabbit
      complement as the sole method of graft-versus-host disease prophylaxis. No
      additional immunosuppressive agents were routinely administered to these
      patients. Overall, 55% of patients in our series developed two-fold elevations in
      serum bilirubin, SGOT, or alkaline phosphatase within the first 30 days following
      BMT. A five-fold elevation in any liver function test was noted in only 19% of
      patients. Logistic regression analysis revealed that the presence of GVHD, female
      sex, and administration of amphotericin B all were independently associated with
      laboratory evidence of hepatic dysfunction. While LFT abnormalities were common
      in our series, they were generally mild, and the development of VOD was rare.
      Only three patients (3.1%) fulfilled clinical criteria sufficient to establish a
      diagnosis of VOD. Among the 86 patients whose ablative regimen consisted of
      cyclophosphamide (60 mg/kg x2) and total-body irradiation (1200-1400 cGy in 200
      cGy fractions), only 1 patient (1.2%) developed VOD. Our experience suggests that
      patients undergoing allogeneic BMT are at low risk for VOD and other serious
      hepatic complications when they receive high-dose cyclophosphamide, fractionated
      TBI, and T cell-depleted marrow without hepatotoxic medications for GVHD
      prophylaxis.

PMID- 1750064
TI  - Biliary secretion of bile acids, lipids, and bilirubin by the transplanted liver.
      A quantitative study in patients on cyclosporine.
AB  - To investigate biliary secretion in liver-transplanted patients on cyclosporine
      treatment we used duodenal perfusion with a nonabsorbable marker. After an
      overnight fast, 4 women and 5 men were studied for 6 hr at least 6 weeks after
      orthotopic liver transplantation. The data were compared with those obtained in 6
      healthy controls. All transplanted patients received immunosuppressive therapy
      (corticosteroids, azathioprine, and cyclosporine). Biliary secretion rates of
      healthy controls were: bile acids 1.58 +/- 0.67 mmol/hr, phospholipids 0.27 +/-
      0.11 mmol/hr, cholesterol 0.11 +/- 0.01 mmol/hr, and bilirubin 18 +/- 0.7
      mumol/hr (mean +/- SEM). Liver-transplanted patients excreted 2.60 +/- 0.4
      mmol/hr bile acids, 0.56 +/- 0.08 mmol/hr phospholipids, 0.18 +/- 0.04 mmol/hr
      cholesterol, and 22.0 +/- 4.5 mumol/hr bilirubin. Analysis of individual bile
      acids revealed that in the bile of liver transplant patients the percentage of
      cholic acid was elevated, whereas that of deoxycholic acid was reduced as
      compared with controls. These findings indicate that in the transplanted liver
      under immunosuppressive therapy with cyclosporine biliary secretion of bile
      acids, lipids, and bilirubin is not reduced.

PMID- 1750065
TI  - bcr/abl mRNA detection following bone marrow transplantation for chronic
      myelogenous leukemia.
AB  - We have utilized the polymerase chain reaction (PCR) to sensitively detect
      persistence of the chronic myelogenous leukemia (CML) malignant clone and to
      study bcr/abl mRNA splicing patterns following bone marrow transplantation.
      Thirteen of sixteen patients displayed persistent malignant cells during post-BMT
      clinical remission. In two patients bcr/abl mRNA was detected 4 and 9 months
      prior to clinical relapse. In eleven of fourteen patients in continued clinical
      remission malignant cells were detected post-BMT. Ten of these eleven patients
      were also cytogenetically normal. Seven patients have lost all evidence of
      bcr/abl transcript, but only at 1-2 years posttransplant, while four have shown
      persistence of the bcr/abl transcript from 28 days to 3 years post-BMT and one
      has converted from an initially negative result at 1 year post-BMT to detectable
      levels of chimeric mRNA at 2 years. Thus, 8/9 patients tested at or before 6
      months, 7/12 at 1 year, and 3/10 at 2 years showed persistent detectable CML
      cells. Intriguingly, mRNA splicing patterns changed in 5 patients following BMT,
      with complete loss of mRNA containing bcr exon 3 (n = 2) or new appearance of
      mRNA not containing bcr exon 3 (n = 2). A single patient transiently lost
      evidence of bcr exon 3 expression while persistently expressing the bcr exon
      2/abl exon 2 splice. Our data suggest that the majority of patients harbor small
      numbers of malignant cells following transplantation, and that such persistence
      may not inevitably predict clinical relapse. Complete elimination of the
      malignant CML clone post-BMT may rely on immunological mechanisms (e.g., graft-vs
      leukemia).

PMID- 1750066
TI  - The role of natural antibodies in the activation of xenogenic endothelial cells.
AB  - Hyperacute rejection of organ xenografts is thought to be mediated by the
      reaction of naturally occurring antibodies and complement of the recipient with
      blood vessels in the donor organ. We have suggested previously that the
      pathogenesis of hyperacute rejection might involve the activation of endothelial
      cells in the graft. To evaluate the potential role of natural antibodies and
      complement in hyperacute xenograft rejection, sixteen human sera were tested for
      variation in the ability to activate porcine endothelial cells as manifested by
      the release of biosynthetically labeled heparan sulfate from the cells. It was
      then asked to which extent such variation might reflect differences in natural
      antibody titer and/or complement activity. The sera mediated release of 3.6-57%
      of endothelial cell-associated heparan sulfate. Heparan sulfate release
      correlated significantly with the titer, in the sera, of IgM antibodies that
      bound to cultured endothelial cells (P = 0.0008) or to a triad of glycoproteins
      believed to represent the major targets of natural antibodies in porcine to
      primate xenografts (P = 0.001); correlation was also observed with the total
      concentration of IgM (P = 0.0046). The release of heparan sulfate did not
      correlate with corresponding properties of serum IgG, with anti-swine
      hemagglutination or with isohemagglutination titers. Heparan sulfate release
      correlated with deposition on endothelial cells of iC3b (P = 0.0095), but not
      with serum complement activity. Our findings indicate that in the reaction
      between human serum and xenogeneic endothelial cells, it is the concentration of
      xenoreactive IgM and not differences in complement activity that limits the
      ensuing pathophysiologic events.

PMID- 1750067
TI  - The failure of skin grafting to break tolerance to class I-disparate renal
      allografts in miniature swine despite inducing marked antidonor cellular
      immunity.
AB  - Long-term specific tolerance to one haplotype class I plus minor antigen
      disparate renal allografts develops without exogenous immunosuppression in
      approximately 35% of miniature swine (n = 128). Previous studies have suggested
      that this phenomenon is related to limited class I-specific helper T cell
      activity as evidenced by the failure of antibody class switching in vivo and the
      ability of exogenous interleukin 2 to elicit antidonor responses in vitro. To
      determine whether tolerance could be broken by inducing antidonor reactivity with
      donor antigen and a source of T cell help, multiple skin grafts bearing donor
      class I plus third-party class II antigens were placed on tolerant animals. Skin
      grafts were placed at least 3 months after the kidney transplant, at which time
      all recipients had normal renal function as measured by blood urea nitrogen and
      serum creatinine. First-set rejection of skin grafts by SLAad and SLAdd hosts
      occurred in 11.8 +/- 1.1 days (mean +/- SEM, n = 6) and in 9.3 +/- 0.9 days (n =
      4), respectively. Coincident with skin rejection, most animals developed a
      transient rise in BUN to 62 +/- 11 mg/dl (n = 10) and a similar rise in Cr to 4.9
      +/- 1.2 mg/dl (n = 10), with normal levels returning in all animals within two
      weeks. Subsequent skin grafts with the same disparity did not undergo second-set
      rejection and did not induce BUN or Cr elevations. Prior to skin grafting,
      animals showed no antidonor activity in mixed lymphocyte reaction or cell
      mediated lymphocytotoxicity assays. After two skin grafts, all animals developed
      donor-specific CML and secondary MLR responses, and additional skin grafts
      amplified this cellular immunity. Development of marked antidonor immunity
      without a break in tolerance suggested that either graft adaptation or local
      suppression might be involved in maintaining tolerance to class I MHC antigens.
      In preliminary studies, an immunized SLAad animal and an immunized SLAdd animal
      were retransplanted with kidneys MHC matched to their first allografts. In both
      cases, the second graft was accepted permanently without immunosuppression,
      suggesting that graft adaptation is not necessary for the maintenance of
      tolerance to renal allografts in miniature swine.

PMID- 1750068
TI  - The immunosuppressive properties of enisoprost and a 5-lipoxygenase inhibitor (SC
      45662).
AB  - Metabolic derivatives of arachidonic acid such as prostaglandins and leukotrienes
      may alter immune responses. Enisoprost (ENO), a synthetic prostaglandin E analog,
      inhibited the response of human peripheral blood mononuclear cells to
      phytohemagglutinin in a concentration-dependent fashion: .1, 1.0, and 10
      micrograms/ml yielding 4.0, 21.7, and 74.3% inhibition, respectively. ENO also
      potently inhibited both IL-2 production (measured by ELISA) and IL-2
      responsiveness (measured by CTLL-2 response to IL-2) in a concentration-dependent
      manner, yet did not inhibit acquisition of IL-2 receptors. ENO similarly
      diminished efferent immune function in a concentration-dependent fashion, as
      measured by inhibition of cytotoxic T cell and natural killer effector function.
      A 5-lipoxygenase inhibitor (5-LO), SC-45662, also inhibited mononuclear cell
      response to PHA in a concentration-dependent manner: 0.1, 1.0, and 10
      micrograms/ml yielding 5.0, 9.7, and 79.7% inhibition, respectively. Although 5
      LO potently inhibited IL-2 production, it had no effect on IL-2 responsiveness or
      IL-2 receptor acquisition. Like ENO, 5-LO impaired CTL and NK effector function
      yet was not as potent in inhibiting CTL effector function. In summary, ENO and 5
      LO inhibit afferent and efferent immune function. The inhibitory effects of these
      drugs are not related to cytotoxicity as cell viability is maintained for 72 hr
      in the presence of these drugs, and the inhibitory effect is reversible when the
      drugs are removed. The 5-LO does not inhibit mononuclear cell responses simply by
      shunting the formation of arachidonic acid precursors to form inhibitory
      prostaglandins, since it does not impair IL-2 responsiveness in a manner similar
      to ENO. These two compounds may prove to have clinical utility in organ
      transplantation if safely achieved serum concentrations of these drugs yield in
      vivo immunosuppression parallel to our in vitro results.

PMID- 1750069
TI  - Detection of pancreatic islet tissue following islet allotransplantation in man.

PMID- 1750070
TI  - Renal transplant patients with steroid withdrawal evaluated longitudinally for
      their donor--specific cytotoxic T cell reactivity.

PMID- 1750071
TI  - The effect of meal composition on cyclosporine absorption.

PMID- 1750072
TI  - The renal artery resistive index and serum creatinine changes during the
      treatment of renal allograft rejection with the monoclonal antibody OKT3.

PMID- 1750073
TI  - Soluble interleukin 2 receptor and neopterin serum levels after lung/heart-lung
      transplantations--absence of predictive value for late allograft rejection.

PMID- 1750074
TI  - Production of marked prolongation of survival of canine islet xenografts in mice
      by antilymphocyte sera and L3T4 antibody.

PMID- 1750075
TI  - A technique of cervical heterotopic heart transplantation in mice.

PMID- 1750076
TI  - Transplantation in the mouse model--the use of a Y-chromosome-specific DNA clone
      to identify donor cells in situ.

PMID- 1750077
TI  - Problems with therapeutic monitoring of cyclosporine using silicone central
      venous line samples.

PMID- 1750078
TI  - Essential fatty acid deficiency and cardiac allograft survival in
      histoincompatible rats.

PMID- 1750079
TI  - The barrier to xenotransplantation.

PMID- 1750080
TI  - Prevention of graft-versus-host disease following small bowel transplantation
      with polyclonal and monoclonal antilymphocyte serum. The effect of timing and
      route of administration.
AB  - Graft-versus-host disease is a potential problem following small bowel
      transplantation. We have previously shown that a two-day intraperitoneal course
      of polyclonal antilymphocyte serum completely prevents GVHD without impairing
      allograft function in a unidirectional rat small bowel transplant model. In the
      present study we sought to determine the optimum route and timing of ALS
      administration and whether donor pretreatment with the anti-T cell receptor
      monoclonal antibody R73 would be similarly effective in preventing GVHD. Both
      intravenous and intraperitoneal injection of ALS effectively prevent GVHD in this
      model. ALS must be given to donors at least 48 hr prior to graft procurement for
      maximum effectiveness. Prevention of GVHD correlates with lymphocyte depletion in
      mesenteric lymph nodes, as opposed to peripheral blood or small bowel lamina
      propria. Donor pretreatment with the monoclonal antibody R73 significantly delays
      the onset of GVHD in this small bowel transplant model but appears less effective
      than polyclonal ALS.

PMID- 1750081
TI  - The combi-effect--reduced rejection of the heart by combined transplantation with
      the lung or spleen.
AB  - The term combi-effect was introduced to describe the phenomenon of a reduction in
      rejection of heart grafts after combined transplantation with the lung. In this
      study in rats we investigated whether the combi-effect was an immunological
      process and whether it could also be induced by combined transplantation of the
      heart with the spleen or with a lymphocyte-depleted spleen. Heart and spleen
      grafts were transplanted into the abdomen; left lungs were transplanted into the
      thorax of recipient rats. To deplete spleens of their lymphocytes, prospective
      donor rats were irradiated. Cyclosporine was injected once, on day 2 after
      transplantation. All heart allografts transplanted alone and treated with
      cyclosporine were rejected acutely (median survival time [MST] of 14.5 days). In
      contrast, after combined transplantation of a donor lung or spleen with the
      heart, almost all heart grafts survived indefinitely. Transplantation of a
      syngeneic lung or third-party spleen had little effect on heart graft survival
      (MST of 22.5 days and 26.5 days, respectively). Without cyclosporine treatment,
      combined transplantation with a donor lung or spleen hardly prolonged heart graft
      survival. Transplantation of a lymphocyte-depleted spleen with the heart induced
      a combi-effect in cyclosporine-treated rats that was somewhat weaker: only two of
      six hearts survived indefinitely. We conclude that in the combi-effect an
      immunological mechanism reduces rejection of the heart. This mechanism is
      probably generated by the lymphoid tissue (bronchus-associated lymphoid tissue in
      lung and white pulp in spleen) in the combined transplant.

PMID- 1750082
TI  - Inhibition of myointimal hyperplasia and macrophage infiltration by estradiol in
      aorta allografts.
AB  - A major cause of organ graft loss after heart transplantation is accelerated
      atherosclerosis. In this study we used aorta allografts and investigated the
      effect of estradiol-17 beta treatment on both the degree of myointimal
      hyperplasia and morphological changes evaluated by light and electron microscopy.
      Outbred New Zealand white male rabbits (2.7-3.5 kg) were fed cholesterol (0.5%)
      from one week prior to transplantation, and until sacrifice three weeks later.
      The donor abdominal aorta was transplanted end-to-end to the right carotid artery
      of the recipient animals. Immediately following surgery, cyclosporine (10 mg/kg/d
      s.c.) was administered to prevent graft rejection. The allograft recipients were
      randomly assigned to one of five groups and treated with cottonseed oil (placebo)
      or estradiol cypionate at 1, 10, 100, or 1000 micrograms/kg/d i.m. for 3 weeks.
      The aorta grafts were harvested and fixed for transmission electron microscopy
      and morphometry. The area of myointimal thickening was calculated as a percent of
      total vessel area (mean +/- SEM); the control group was 6.6 +/- 0.5% (n = 5).
      Estradiol treatment significantly inhibited (P less than 0.05) myointimal
      hyperplasia at all doses. The values were 3.9 +/- 0.6% (n = 6) for 1
      microgram/kg/day; 4.4 +/- 0.7% (n = 5) for 10 micrograms/kg/day; 3.5 +/- 0.4% (n
      = 6) for 100 micrograms/kg/day; and 2.9 +/- 0.1% (n = 3) for 1000
      micrograms/kg/day. Electron microscopic evaluation revealed that the four doses
      of estradiol protected the endothelium from the degenerative changes seen in all
      aorta allografts from the animals in the control group. Furthermore 10, 100, and
      1000 micrograms/kg/day of estradiol prevented the appearance of vacuolized
      macrophages (foam cells) and also the vacuolization of smooth muscle cells that
      was observed in the aorta allografts from the control group and the group treated
      with 1 microgram/kg/day of estradiol. We conclude that the inhibitory effect of
      estradiol on the development of graft atherosclerosis may be due to inhibition of
      smooth muscle cell proliferation and preservation of ultrastructurally normal
      endothelial cells. The inhibitory effect on foam cell production and a
      concomitant vacuolization of smooth muscle cells may play a lesser role. We
      suggest that estrogen replacement therapy may be beneficial in postmenopausal
      women with organ allografts.

PMID- 1750083
TI  - Hepatic and splanchnic metabolism of plasma proteolytic enzymes before, during,
      and after clamping of the hepatic artery and portal vein.
AB  - Parameters of the kallikrein-kinin, fibrinolytic, and coagulation systems before
      (control), during, and after occlusion of the hepatic artery and the portal vein
      were studied in anesthetized pigs. Hepatic synthesis was observed for kallikrein,
      plasmin, and plasminogen. The other factors, prekallikrein, kallikrein inhibitor,
      alpha 2-antiplasmin, prothrombin, and antithrombin-III were all released by the
      liver and underwent partial hepatic inactivation. The splanchnic area showed a
      significant synthesis of antithrombin-III. After 90 min of hepatic arterial
      occlusion, the hepatic release of all factors declined, and synthesis of
      kallikrein, plasmin, and plasminogen fell an average of 54%. The inactivation of
      prekallikrein and alpha 2-antiplasmin was increased and the splanchnic synthesis
      of antithrombin-III fell. Portal vein blood flow fell by 38%. After 15 min of
      portal vein occlusion (combined occlusion of the hepatic artery and portal vein)
      the splanchnic area started to synthetize kallikrein and the hepatic inflow of
      kallikrein increased by more than 50%. Splanchnic metabolism of other factors was
      also altered, but after revascularization of the hepatic artery changes were
      mostly insignificant. Hepatic synthesis of kallikrein and plasmin remained
      depressed after reperfusion, and that of plasminogen fell to zero. After this
      short period of occlusion of the hepatic artery and portal vein, plasma
      concentrations of prekallikrein, plasmin, and alpha 2-antiplasmin were decreased,
      causing a state of fibrinolysis. A role for kallikrein/bradykinin in hepatic
      blood flow regulation is proposed and implications of these observations for
      liver transplantation are discussed.

PMID- 1750084
TI  - The beneficial effect of a prostaglandin I2 analog on ischemic rat liver.
AB  - This study was undertaken to determine whether or not prostaglandin I2 (PGI2)
      analog pretreatment could successfully preserve organ viability after warm
      hepatic ischemia in rats. Although 120-min ischemia of the liver did not permit
      survival in rats administered normal saline solution (NS group) before warm
      ischemia, the survival rate of PGI2 analogue (500 ng/kg/min)-treated rats (PG
      group) significantly improved to 57% (P less than 0.05). Recirculation following
      120-min hepatic ischemia in the NS group resulted in no improvement of B
      phosphorus of the ATP (B-ATP)/inorganic phosphate (Pi) ratio measured by 31P
      nuclear magnetic resonance, a marked increase in the serum aspartate
      aminotransferase (SAST) level, and an increase in the malondialdehyde (MDA) level
      in liver tissue. In the PG group, the B-ATP/Pi ratio was significantly improved
      (P less than 0.05), the elevation in SAST was also markedly suppressed (P less
      than 0.05), and the MDA level of the liver was lowered more than that in the NS
      group. Severe congestion and extensive vacuolization of hepatocytes from the
      peripheral to the midzonal areas were histologically exhibited with single-cell
      necrosis in the NS group. There were fewer histological alterations of the liver
      and these coincided with the changes in other parameters in the PG group. Our
      results indicate that PGI2 analog reduces warm ischemic injury of the liver and
      provides greater protection for organs to be transplanted.

PMID- 1750085
TI  - Correlation between high adenosine triphosphate tissue concentration and good
      posttransplant outcome for the canine pancreas graft after preservation by the
      two-layer cold storage method.
AB  - Assessment of viability of a pancreas graft during preservation is very important
      to avoid transplantation of a nonfunctioning allograft. In the present report the
      correlation between adenosine triphosphate tissue concentration at the end of
      cold preservation by the two-layer method and viability a of canine pancreas
      graft following transplantation was studied. After preservation by an original
      two-layer (Euro-Collins' solution/perfluorochemical) method (group 1) and a
      modified two-layer (University of Wisconsin solution/PFC) method (group 2) for
      24, 48, 72, 96, and 120 hr (subgroups A, B, C, D, and E), the tissue
      concentration of ATP was determined using high-performance liquid chromatography,
      and the viability of the pancreas graft was tested in the canine model of
      segmental pancreas autotransplantation. Maintenance of normoglycemia for at least
      five days after transplantation was considered to indicate a viable pancreas
      graft. In group 1, functional success rates were A: 5/5, (100%), B: 4/4 (100%),
      C: 4/4, (100%), and D: 0/4 (0%), respectively. The ATP tissue concentrations were
      7.47 +/- 0.47 (n = 5), 7.91 +/- 1.21 (n = 4), 8.29 +/- 0.21 (n = 4), and 4.94 +/-
      1.11 (n = 4) mumol/g dry weight in groups 1A, 1B, 1C, and 1D, respectively. There
      was a statistically significant difference between viable groups (groups 1A, 1B,
      and 1C, 7.86 +/- 0.77 mumol/g dry weight [n = 13]) and the nonviable group (group
      D, 4.94 +/- 1.11 mumol/g dry weight (n = 4) (P less than 0.01). On the other
      hand, the functional success rates were 3/3 (100%), 3/3 (100%), 3/3 (100%), 5/7
      (71%), and 0/3 (0%) in groups 2A, 2B, 2C, 2D, and 2E, respectively. Two of seven
      dogs died of causes related to the grafts (pancreatitis and thrombosis). The ATP
      tissue concentrations were 8.53 +/- 1.45 (n = 3), 9.64 +/- 1.77 (n = 3), 13.81 +/
      2.09 (n = 3), and 12.49 +/- 2.52 (n = 5) mumol/g dry weight in groups 2A, 2B,
      and 2C and in viable grafts in group 2D, respectively, but the ATP tissue
      concentration of nonviable grafts in group 2D and group E were 3.51 +/- 0.81 (n =
      2) and 3.98 +/- 1.34 (n = 3) mumol/g dry weight, respectively. There was a
      statistically significant difference between viable groups (groups 2A, 2B, 2C and
      viable grafts in group 2D, 11.03 +/- 2.72 mumol/g dry weight [n = 14]) and
      nonviable groups (group E and nonviable grafts in group 2D, 3.79 +/- 1.06 mumol/g
      dry weight [n = 5]) (P less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1750086
TI  - Evidence that adenosine is a key component in Carolina rinse responsible for
      reducing graft failure after orthotopic liver transplantation in the rat.
AB  - Recently, a rinse solution, Carolina rinse, designed to minimize reperfusion
      injury following liver transplantation in the rat has been developed. When used
      to rinse cold-stored grafts prior to completion of implantation surgery, Carolina
      rinse improved postoperative survival dramatically. Here we report the results of
      studies designed to determine the key components of Carolina rinse. Livers were
      explanted, stored for 12 hr in cold UW solution (0-4 degrees C), and rinsed with
      15 ml of Ringer's solution immediately prior to completion of implantation
      surgery. In this group, 12/13 rats died within 2 days (nonsurvival conditions).
      In a second group, explants stored under identical conditions were rinsed with 15
      ml of Carolina rinse. Carolina rinse increased average 30-day survival time
      significantly to over 75%. Furthermore, when grafts were rinsed with Carolina
      rinse lacking nicardipine or with the pH increased to 7.4, long-term survival of
      recipient rats was also about 75% (i.e., the modifications did not affect
      survival). However, Carolina rinse lost its efficacy (12% survival) when
      adenosine was omitted. In addition, when donor livers were rinsed with Ringer's
      solution containing adenosine (0.1 mM), average survival time was increased from
      8% to 63%. Rinsing with Ringer's solution containing higher concentrations of
      adenosine (5 mM), however, did not improve survival significantly. Survival was
      also not improved by rinsing with Ringer's containing 0.1 mM ribose and 0.1 mM
      adenine, substrates for ATP synthesis that are not vasoactive. SGOT values were
      around 3000 U/L 1-3 days postoperatively in the nonsurviving group rinsed with
      Ringer's solution alone. Values were decreased over 6-fold by Carolina rinse but
      were not reduced significantly by Ringer's solution containing adenosine. Thus,
      adenosine improves survival following liver transplantation without preventing
      parenchymal cell injury, indicating that adenosine may work via nonhepatic
      mechanisms. Liver injury was also assessed by electron microscopy. After either
      adenosine or Ringer's rinse, sinusoidal thrombi and polymorphonuclear margination
      were observed together with a pattern of pericentral hepatocellular vacuolization
      and disruption of the sinusoidal lining characteristic of changes observed
      following hypoxia. With Ringer's rinse, Kupffer cells exhibited surface
      irregularity in pericentral regions indicative of activation. Following adenosine
      rinse, however, Kupffer cells appeared more flattened with less ruffling and
      reduced surface debris (i.e., they were less activated). Carbon uptake by Kupffer
      cells was also decreased significantly by Ringer's rinse when adenosine was
      present. Furthermore, adenosine lowered intracellular free calcium concentration
      in cultured Kupffer cells and improved hepatic microcirculation postoperatively.
      Adenosine rinse also affected extrahepatic systems: it reduced postoperative
      clotting time and diminished lung injury significantly.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1750087
TI  - Functional analysis of graft lamina propria associated lymphocytes from a
      recipient of a human cadaveric small bowel allograft primarily immunosuppressed
      with FK 506.

PMID- 1750088
TI  - FK 506 used as rescue therapy for human liver allograft recipients.

PMID- 1750089
TI  - A tuberculosis outbreak in a renal transplant program.

PMID- 1750090
TI  - Effect of FK 506 on islet allograft rejection in mice and pigs.

PMID- 1750091
TI  - Rapamycin and cyclosporine synergistically prolong heart and kidney allograft
      survival.

PMID- 1750092
TI  - Xenotransplantation in newborn goats with FK 506.

PMID- 1750093
TI  - The new era of immunosuppressive therapy in autoimmune diseases.

PMID- 1750094
TI  - The effect of FK 506 on cyclophosphamide-induced diabetes in the NOD mouse model.

PMID- 1750095
TI  - Prevalence of malaria in native and transmigrant populations. Effects of age and
      history of exposure.
AB  - A malaria prevalence study was performed in a village in Irian Jaya, Indonesia,
      that contains a population of people who have been exposed lifelong to
      hyperendemic malaria and another population of people who had arrived 18 months
      previously from areas of very low endemicity. Mean spleen sizes correlated
      positively with prevalence of malaria, not resistance to it. Prevalence of sexual
      and asexual blood stage parasites was higher in transmigrants than in the
      natives. The data also show that clinical resistance to malaria in this part of
      the world includes resistance to Plasmodium falciparum gametocytemia and that
      this is not the passive byproduct of a reduction in asexual parasites. This
      indicates that the introduction of native people into a populated malarious area
      will increase the percent of gametocyte carriers and may, thereby, increase the
      entomologic inoculation rate.

PMID- 1750096
TI  - Diabetes mellitus and Klebsiella pneumoniae liver abscess in adults.
AB  - Klebsiella pneumoniae hepatic abscess in five diabetic patients is reported. The
      recognition of a possible association between diabetes mellitus and pyogenic
      hepatic abscess, especially solitary ones, is highlighted. The clinical
      presentation including metastatic complications and the need for early diagnosis
      and institution of therapy are emphasized. Needle aspiration under
      ultrasonography is advocated and culture for anaerobes is stressed.

PMID- 1750097
TI  - Multiple faecal and urinary fistulae as a complication of native treatment of
      inguinal hernia.
AB  - A case is described of a patient who developed multiple faecal and urinary
      fistulae after repeated treatment for right-sided scrotal hernia by a native
      doctor. The patient recovered after resection of an incarcerated loop of sigmoid
      colon which showed fistulae with the inguinal skin and with the bladder. The
      bladder defect was closed. This kind of complication may be more frequent than
      reported.

PMID- 1750098
TI  - Evaluation of antibody response in meningococcal patients, contacts and vaccinees
      in north India.
AB  - Serological response was studied in a high risk age 16-30 years group, during the
      period December 1986-April 1988, following vaccination with a meningococcal
      vaccine (Biomerieux, France). A total of 200 serum samples were collected from 50
      individuals before vaccination and at 1, 3 and 6 months post-vaccination
      respectively. Antibody response was measured by Enzyme Linked Immuno-Sorbent
      Assay (ELISA) and indirect haemagglutination assay (IHA). In the vaccinees
      antibody response by IHA test showed 56%, positivity in the pre-vaccination
      samples and 82%, 78% and 74% positivity 1 month, 3 months and 6 months in the
      post-vaccination samples. By ELISA 2%, 80%, 74% and 66% of the above groups
      showed serological response. Difference in the pre-vaccination and titres/O.D. of
      various post-vaccination groups was found to be statistically significant (p =
      0.001). There was, however, no significant difference (p = 0.05) amongst the
      titres/O.D. of three post-vaccination groups. Similarly, acute and convalescent
      blood samples of 25 patients one sample each of 31 contacts was studied for
      antibody response. In general, higher antibody titres are produced with systemic
      infection than with local nasopharyngeal infection or following vaccination.

PMID- 1750099
TI  - Adenomyosis uteri in Ile-Ife, Nigeria. A prospective clinicopathologic study.
AB  - A 12-month prospective study of 120 consecutive hysterectomy and 12 myomectomy
      specimens received at the histopathology laboratory of the Obafemi Awolowo
      University Teaching Hospitals was undertaken to determine the occurrence of
      adenomyosis. The observed incidence was 9.8%. Adenomyosis was commonest in
      multiparous women in the fifth decade of life. The principal presenting complaint
      was abnormal uterine bleeding. The average dimension of a typical affected uterus
      was 10 x 7 x 6 cm weighing an average of 175 g. Diagnosis was mostly post
      operative. This study shows that adenomyosis uteri is not uncommon in Nigerians.

PMID- 1750100
TI  - A hospital outbreak of cholera in Dhaka, Bangladesh.

PMID- 1750101
TI  - Serum ferritin and cholera. A prospective study.
AB  - An association has been shown between iron deficiency and a low gastric acidity
      while the latter is known to increase susceptibility to cholera. This study was
      undertaken to ascertain whether iron deficiency is a risk factor for contracting
      cholera. The subjects were 60 adult males-30 with cholera admitted to ICDDR,B and
      30 controls matched for age, sex and socio-economic status from the same
      household or immediate neighbourhood of the index case. Fingerstick blood was
      taken from all subjects to estimate the haematocrit, and serum ferritin
      concentration by an ELISA. The mean ferritin level of the study group was 38.7
      ng/100 ml, in the controls. There was a significant difference in the serum
      ferritin level between the groups (P less than 0.005), Wilcoxon Sign Rank test
      for matched pairs suggesting that cholera patients tend to have lower serum
      ferritin concentration. Further prospective studies are required to define the
      possible association between iron deficiency and cholera more accurately.

PMID- 1750102
TI  - Chloroquine therapy still useful in the management of malaria during pregnancy in
      Muheza, Tanzania.
AB  - In searching for effective malaria chemosuppressives during pregnancy in Muheza
      District--Tanzania, pregnant women are randomly given either 300 mg base
      chloroquine once weekly or 200 mg daily proguanil. Breakthroughs presenting with
      clinical malaria are treated with 25 mg base chloroquine/kg (25 CQ) over three
      days. Due to loss of malaria immunity during pregnancy and Muheza moderate levels
      and degrees of chloroquine resistance, the in vivo response to 25 CQ was
      monitored. Between March and May 1989, 49 women were treated resulting into 32
      (65%) parasitological clearances and 17 (35%) failures within 7 days. Two of 17
      failures (12%) exhibited RIII response and the remaining 15 (88%) had a
      favourable clinical response. Only 6 (19%) of 32 cleared patients either
      recrudesced or got reinfected during the three weeks follow up period. In
      addition to its safety and affordability, the observed drug efficacy during peak
      malaria transmission and inspite of prevailing resistance makes 25 CQ an ideal
      first line drug for the management of malaria during pregnancy.

PMID- 1750103
TI  - Parasitic infections in young Jamaicans in different ecological zones of the
      island.
AB  - Data are presented for the first country wide prospective study on
      gastrointestinal tract parasitic infections done in Jamaica. Samples from 2,947
      young Jamaicans drawn from all ecological zones and from all parochial divisions
      of the island were analyzed. Pica was practised by 8.6%. Generally, prevalence of
      organisms was as follows: Trichuris trichiura (12.3%), Ascaris lumbricoides
      (9.5%), hookworm (2.2%), Strongyloides stercoralis (0.3%), Giardia lamblia (6.3%)
      and Entamoeba coli (7.7%). Several other spp. of protozoans were recorded.
      Prevalence of A. lumbricoides, T. trichiura and Necator americanus was
      significantly greater in upland than in lowland (both urban and rural), while the
      situation was reversed for G. lamblia-infections. Greatest variations were age
      related. A. lumbricoides and T. trichiura reached peak prevalence of 15.3 and
      20.5% respectively in 5-9-year-olds, while hookworm peaked later at 15-19 years
      of age. Suggestions are made for a national and even regional antihelminthic
      program for the mass treatment of pre- and primary school age children.

PMID- 1750104
TI  - Studies on a focus of yaws in the Santiago Basin, province of Esmeraldas,
      Ecuador.
AB  - A clinical and serological epidemiological study done on a yaws focus in the
      Santiago Basin area, province of Esmeraldas, showed a prevalence of 11.3% for
      active clinical lesions and a seropositivity of 94.9%. The Rio Santiago was
      hyperendemic for yaws (prevalence, 17.9%; seropositivity, 98.0%) while Rio
      Zapallito was found to be mesoendemic and the Rio Cayapas and Rio Onzoles
      hypoendemic. Active and latent evidence of yaws was found only in the black race.
      Children, ages 5-12 year, were found to have the highest incidence (55.8%) of
      clinical lesions, with the majority found on the legs (64.2%). Papilloma was the
      most prevalent lesion (55.4%). Mass treatment of the basin using benzathine
      penicillin G was done according to WHO recommendation.

PMID- 1750105
TI  - Epidemiology of common transmissible skin diseases among primary school children
      in north-west Ethiopia.
AB  - A total of 1842 school children were examined for the occurrence of common
      transmissible skin infections in a rural area in North-West Ethiopia. The result
      showed a prevalence rate of 49.2%. Tinea capitis, impetigo, infected wounds and
      verrucae vulgaris were common. In addition the overall prevalence rate of lice
      infestation was 55.4%. The findings indicated the need to develop appropriate
      intervention programmes both at school and community levels.

PMID- 1750106
TI  - Hepatic dysfunction in undernourished patients receiving isoniazid and
      rifampicin.
AB  - Adult undernourished tuberculous patients receiving isoniazid, rifampicin and
      ethambutol were evaluated clinically and biochemically for hepatic dysfunction.
      The nutritional status was assessed by body-mass index, serum albumin and
      haemoglobin. While only 11% of the patients developed jaundice, the majority of
      the patients had a significant elevation of the serum hepatic enzymes suggesting
      subclinical hepatotoxicity. A significant downward trend during the 3-6 months
      period was seen in patients with multiple estimations of SGOT and SGPT indicating
      a self-limiting toxic process. However, the continued elevation of GGT suggests
      enzyme induction by rifampicin. Undernutrition contributes to drug toxicity by
      various mechanisms. Therefore, it is important to evaluate the nutritional status
      of the tuberculous patients receiving drugs, which are potentially hepatotoxic.

PMID- 1750107
TI  - A study of group B streptococcal carrier state during late pregnancy.
AB  - The carriage of Group B Streptococcus was investigated in 500 females in the
      third trimester of their pregnancy by culturing vaginal and rectal swabs and
      urine collected from each patient. A high rate of colonization was noted since
      152 cases (30.4%) were found to harbor the organism, and 219 specimens (48%) from
      a total of 456 collected from these 152 cases were positive for Streptococcus
      agalactiae. Of the 219 positive specimens, 94 (42.9%) were vaginal swabs, 90
      (41.1%) were rectal swabs and the remaining 35 (16%) were urine specimens. It is
      recommended that vaginal and rectal swab culture be used to detect carriers of
      group B streptococci, since using such a combination in this study revealed 91.4%
      of all positive cases.

PMID- 1750108
TI  - Lack of relationship between sorghum consumption, mycotoxin contamination and
      pellagra in a traditionally sorghum eating population.
AB  - Traditionally, the disease pellagra has been associated with corn consumption and
      niacin deficiency, and has presently been recognised as a multiple factor
      nutritional syndrome. In the recent past, it has been suggested that consumption
      of mycotoxin contaminated sorghum/corn may be involved in the development of
      pellagra in a sorghum/corn eating population. The present study relates to the
      assessment of levels of mycotoxins (aflatoxin B1 and T-2 toxin) in sorghum
      collected from a traditionally sorghum eating population. Despite 25% fungal
      contamination in the sorghum samples collected, the levels of mycotoxins were
      minimal (1.4%) and there was no incidence of pellagra in the survey area. The
      absence of pellagra in the survey areas may be attributed to the changing dietary
      pattern.

PMID- 1750109
TI  - Surveillance of patients attending a rural diarrhoea treatment centre in
      Bangladesh.
AB  - In May 1983, a surveillance system was set up at a rural diarrhoea treatment
      centre of the International Centre for Diarrhoeal Disease Research, Bangladesh
      (ICDDR,B) to study a 20% systematic sample of all admissions. Between May 1983
      and April 1984, 2,635 patients were studied. A recognized enteric pathogen was
      detected in 69% of the patients screened, 15% of whom had a mixed infection.
      Vibrio cholerae 0: 1 was the most common enteropathogen detected (39%), followed
      by enterotoxigenic Escherichia coli (ETEC) (14%), Shigella spp. (11%), and
      Campylobacter jejuni (11%). Detection of C. jejuni was highest in infants,
      Shigella spp. in children between 1-4 years and V. cholerae 0:1 in children
      between 3-9 years of age. 75% of patients presented with watery diarrhoea, a
      presentation that was significantly more common in patients infected with V.
      cholerae 0:1 (94%) and ETEC (88%). Bloody diarrhoea was the presenting complaint
      in 18% of all patients, but in 65% of patients in whom Shigella spp. was
      isolated. Although 91% of patients reported that they had prior experience of use
      of oral rehydration therapy (ORT), 54% of the patients came to the treatment
      centre with no or mild dehydration and more than half of them did not use ORT
      before coming to the treatment centre. Most of these patients could have been
      safely treated at home if ORT could be made available and acceptable.

PMID- 1750110
TI  - Haematologic indices in African children.
AB  - A full blood count was performed on 380 children (186 preschool and 194 school
      children). It was found that the school children had significantly higher
      haemoglobin, haematocrit, neutrophil and platelet counts than the preschool
      children. The preschool children had higher total leucocyte and lymphocyte
      counts.

PMID- 1750111
TI  - Glucose-6-phosphate dehydrogenase variants and sickle cell genes in Al-Qunfuda,
      Saudi Arabia.
AB  - This study was conducted on 823 male and female subjects to determine the
      frequency of glucose-6-phosphate dehydrogenase (G-6-PD) deficiency and sickle
      cell gene in Al-Qunfuda, a densely populated and malaria endemic region in
      western Saudi Arabia. The results show the presence of both sickle cell and G-6
      PD deficiency genes in this population. The prevalence of Hb S heterozygotes in
      the total population was 18.93% and that of homozygotes was 2.02%. The gene
      frequency of sickle cell gene was 0.121. G-6-PD-B+ was the normal enzyme and
      occurred at a frequency of 83.60% and 78.46% in the male and female population,
      respectively. G-6-PD variants identified included G-6-PD Mediterranean, G-6-PD
      A+, G-6-PD-A- and G-6-PD-Mediterranean-like. The frequency of each variant in the
      male and female population was 10.65% and 9.74% for G-6-PD-Mediterranean, 2.30%
      and 1.53% for G-6-PD-A+, 0.46% and 0.51% for G-6-PD-A- and 3.0% and 9.74% for the
      G-6-PD-Mediterranean-like variants, respectively. No significant interaction
      between sickle cell and G-6-PD genes could be demonstrated.

PMID- 1750112
TI  - Inpatient or outpatient initiation of insulin therapy. Experience and cost
      effective analysis in a suboptimal clinical setting.
AB  - In diabetic day-care centres insulin therapy is started on an outpatient basis.
      However, in areas where such centres are non-existent, diabetics are admitted to
      hospital for initiation of insulin therapy. As an alternative to this practice,
      insulin was initiated in 53 outpatients in a suboptimal clinical setting to find
      out if it is safe, feasible, acceptable and cost-effective. Fifty-one diabetics,
      admitted for initiation of insulin, served as controls. No significant difference
      was found in the mean blood glucose before and after treatment, insulin
      requirement and response to treatment in both groups. Cost analysis showed that
      outpatient treatment was cheaper than inpatient treatment at third class and
      indicated a saving of US $273.00 per patient; these costs were much higher for
      those admitted to expensive classes. None of the outpatients had hypoglycaemia or
      ketoacidosis during the study period. Thus, outpatient insulin therapy is safe,
      feasible, acceptable and cost effective; it could be adopted even in places with
      suboptimal clinical setting.

PMID- 1750113
TI  - Extraction of an hyperglycaemic principle from the annatto (Bixa orellana), a
      medicinal plant in the West Indies.
AB  - The red powdery extract from the seeds of the annatto, Bixa orellana, is a well
      known food colouring. In an oil suspension it is used as a folk remedy (bush tea)
      in the West Indies, for diabetes mellitus. Detailed investigations on this
      extract, yielded a methyl ester, trans-bixin, molecular weight 394 and molecular
      formula C24H30O4. This purified substance was demonstrated, in anaesthetised
      mongrel dogs, to cause hyperglycaemia. Concomitant electron microscopy of tissue
      biopsies, revealed damage to mitochondria and endoplasmic reticulum mainly in
      liver and pancreas. When dogs were fed on a diet fortified with riboflavin, there
      was neither demonstrable tissue damage nor associated hyperglycaemia. These
      findings point to: (i) the potential dangers of informal medications such as
      'bush teas'; (ii) the possible role of plant extracts/food additives in the
      development of diabetes mellitus especially in the undernourished state.

PMID- 1750114
TI  - The pattern of malignant disease in north east Nigeria.
AB  - This paper is a retrospective review of the 780 admissions with malignancy to the
      University of Maiduguri Teaching Hospital over a five year period, 1983-1987,
      carried out to determine the type of malignancies presenting and their relative
      frequencies and to compare this with the rest of West Africa. The commonest
      tumours were primary liver cell carcinoma with a proportional frequency of 17%,
      carcinoma of the breast (8%) and bladder (7%). There is a lower incidence of
      trophoblastic carcinoma (0.3%) than might be expected and a higher incidence of
      nasopharyngeal carcinoma (8% of male tumours). Carcinoma of the stomach and
      colorectum are uncommon. The possible reasons for this are discussed.

PMID- 1750115
TI  - Coronary heart disease and coronary risk profile in a primitive population.
AB  - A study of coronary heart disease and risk factors was conducted in a total Sri
      Lankan aboriginal population who face imminent extinction due to developmental
      programmes in the vicinity of their jungle homelands. Coronary heart disease was
      not detected among the aborigines. Hypertension was present in 5.7% of males and
      1.9% of females. 39% of males smoked. Serum cholesterol, triglyceride and high
      density lipoprotein cholesterol levels were 5.25 mmol/l (SD 0.45), 1.99 mmol/l
      (SD 0.92) and 1.2 mmol/l (SD 0.2) respectively. Obesity was not seen and the
      level of physical activity was high. The rarity of coronary heart disease could
      be attributed to this favourable coronary risk profile.

PMID- 1750116
TI  - Pattern of upper gastrointestinal disease in the eastern province of Saudi
      Arabia. Endoscopic evaluation of 2,982 patients.
AB  - The records of 2,982 patients who were subjected to upper gastrointestinal (UGI)
      endoscopy were retrospectively analyzed. All patients were seen at King Fahd
      Hospital of the University, Al-Khobar during the period 1982-1986. All were adult
      patients with a mean age of 46 years, of whom two thousand nine (67.4%) were
      males. The commonest endoscopic diagnosis was chronic gastritis (21.4%) followed
      by duodenal ulcer (17%) and chronic oesophagitis (11.7%). Of 1,256 biopsied
      patients a 'histologically normal' diagnosis was obtained in 565 (45%) from all
      sites. However, chronic non-specific superficial gastritis (22.6%) followed by
      chronic duodenitis (17.5%) constituted the two commonest histological diagnoses.
      Helicobacter pylori was identified histologically on the gastric mucosa of 72% of
      patients with superficial chronic active gastritis, with or without associated
      peptic ulcer disease. Duodenal ulcers followed by oesophageal varices were the
      two commonest diagnoses encountered in 200 patients presenting with UGI bleeding.
      These results are discussed and compared to those of other studies.

PMID- 1750117
TI  - The prevalence of symptoms of dyspepsia in north eastern Nigeria. A random
      community based survey.
AB  - In a randomised household survey of 620 people in rural north eastern Nigeria
      there was a 26% six month prevalence of dyspepsia in adults and a 6% prevalence
      amongst teenagers. Dyspepsia was associated with the intake of alcohol (p less
      than 0.0054) and Cola nut (p less than 0.00013). The prevalence increased with
      age; the mean length of history was nearly four years and over half of the
      subjects with dyspepsia had sought medical advice, mainly from traditional
      healers. 12% of a similar group of hospital patients with dyspepsia were
      previously found to have peptic ulceration, suggesting that the community
      prevalence for peptic ulceration is 18/1000. This is lower than found in the
      'West'.

PMID- 1750118
TI  - Poliomyelitis control by annual immunization campaigns with oral polio-virus
      vaccine in a rural area of India.
AB  - The effectiveness of Oral Polio Vaccine (OPV) delivered in annual immunization
      campaigns in reducing the prevalence of poliomyelitis was evaluated in January
      1989 by conducting a sample survey in 66 villages in Northern India with a
      population of 42,000. The prevalence of residual paralytic poliomyelitis was 13.4
      per 1,000 children born during 1974-1978; this is 2.7 times higher than the rate
      of 5.0 per 1,000 born in 1979-1983 and 9.6 times higher than the rate of 1.4 per
      1,000 born during 1984-1988. The marked decline in disease prevalence in recent
      years may be related to the rise in OPV immunization. The vaccination rate was
      less than 26% before 1978, 38-75% during 1979-1983 and 77-89% during 1984-1987.
      The annual immunization strategy can be used to control poliomyelitis in
      developing countries where the health care infrastructure is not well developed.

PMID- 1750119
TI  - Reactivation of Chagas' myocarditis during therapy of Hodgkin's disease.
AB  - A 46-year-old female patient with chronic Chagas' myocarditis without heart
      failure was submitted to chemotherapy because of Hodgkin's disease. During
      treatment the frequency of polymorphic ventricular extrasystoles raised and the
      patient died by a sudden cardiac arrest. Autopsy revealed chronic Chagas
      myocarditis with an acute exacerbation. Nests of amastygotes with a density of up
      to 14 pseudocysts/cm2 were found in the myocardium, although restricted to the
      septum and left ventricular posterolateral wall. Extensive histologic examination
      did not reveal parasites in other locations. This favors the concept of a
      localized exacerbation of Chagas' disease due to immunosuppression developing
      from a persistent parasitic focus in the heart. Although this reactivation during
      chemotherapy of malignant disease is rarely reported in literature, a careful
      monitoring of patients with positive Chagas' serology during chemotherapy is
      recommended.

PMID- 1750120
TI  - Rice-ORS shortens the duration of watery diarrhoeas. Observation from rural
      Bangladesh.
AB  - In rural Bangladesh, standard glucose based oral rehydration salt (glucose-ORS)
      and rice based oral rehydration salt (rice-ORS) were compared as domiciliary
      treatment for watery diarrhoea. Using identical supply systems, packaged glucose
      ORS was provided in one area and packets of rice-ORS in another. Mothers of under
      five children in each area were trained in the preparation and use of the
      respective ORS. A third area, where no ORS was provided from the study source,
      served as comparison. In two years of surveillance and follow-up about 10,000
      diarrhoeal episodes were detected in each area, approximately one-third of which
      were watery diarrhoea. Rice-ORS alone was used to treat 74% of these episodes and
      glucose-ORS alone for 65% of the episodes in the respective areas. Drugs were the
      main treatment regimen used in the comparison area. Results of the study showed
      that rice-ORS treated episodes of watery diarrhoea ended with shorter duration
      (median duration 2 days vs. 4 days) and fewer hospitalisation (0.1% vs. 0.5%)
      compared to those treated with glucose-ORS. These differences were statistically
      significant. But, diarrhoeal mortality was unaffected by the use of either ORS
      under the study situation.

PMID- 1750121
TI  - Severe clinical nutritional neurological damage in a young Nigerian detainee.
AB  - The case of a 22-year-old Nigerian detainee with features of severe clinical
      malnutrition, is reported. Within 2 years of prison confinement and
      undernutrition, he developed features of severe malnutrition, with severe sensory
      and motor neuropathy of the lower limbs, and pulmonary tuberculosis. Despite
      intensive nutritional rehabilitation, patient did not regain the use of his lower
      limbs. The initial economic constraint in the management is highlighted.

PMID- 1750122
TI  - Adenosquamous carcinoma of the stomach. With a note on pathogenesis.
AB  - A case of the rare adenosquamous carcinoma of the stomach is presented. This
      unusual type of stomach tumour is the first such case to be reported in Jamaica
      and in the Commonwealth Caribbean. We provide evidence in support of the
      metaplastic derivation of the squamous component from an existing adenocarcinoma.

PMID- 1750123
TI  - Felty's syndrome in a Nigerian.
AB  - The first case of Felty's syndrome to be reported in a Nigerian, a fifty five
      year-old woman who developed splenomegaly and leukopenia during the course of
      strongly seropositive rheumatoid arthritis of ten years duration is presented.
      her arthritis had lasted for about ten years, but she did not have the severe
      deforming disease known to be associated with Felty's syndrome. Radiologically
      there were no erosions and subcutaneous nodules were absent. She had a positive
      granulocyte specific anti-nuclear factor, cryoglobulins containing IgA and IgM
      and her polymorph-nuclear granulocytes showed evidence of impaired killing of
      staphylococci.

PMID- 1750124
TI  - Default and non-compliance among adult epileptics in Zaria, Nigeria. The need to
      restructure continued care.
AB  - Forty five epileptics were observed for non-compliance or default over 2 1/2
      years. There were 39 episodes of non-compliance among 19 patients. Six patients
      had 3 or 4 episodes of non-compliance. Thirteen patients gave their reasons as
      non-availability of drugs or excessive cost of drugs. Drowsiness or confusion
      over drug dosages was the reason given by 3 others. Three other patients
      unilaterally suspended medication. Eighteen patients had defaulted. Twelve of
      them were males. Three had defaulted after only a single clinic attendance.
      Seizures in 9 patients were in temporary control immediately prior to default. It
      is suggested that otherwise well epileptics should be managed in their local
      community. As a matter of urgency governments need to provide drugs at subsidised
      rates and provide a mechanism for distributing them efficiently.

PMID- 1750125
TI  - Immunological response to Helicobacter pylori among Nigerians.
AB  - Among 420 Nigerians examined, 39% had antibodies to Helicobacter pylori. The
      prevalence was significantly higher in males (55%) than in females (29%). The
      prevalence tended to rise with age in both sexes and was significantly higher in
      the 30-34 years age group. Socio-economic class and rural dwellage did not affect
      the prevalence. The study may indicate that H. pylori is endemic in Nigeria. It
      also shows that the detection of antibodies to H. pylori may be a rapid and cheap
      method for diagnosing H. pylori infection in developing countries where
      sophisticated equipment for detecting this organism is not available.

PMID- 1750126
TI  - Urinalysis and electrolyte profiles in patients with acquired immunodeficiency
      syndrome.
AB  - One hundred and twenty six patients diagnosed as having AIDS had their urinalysis
      and electrolyte profiles studied. The commonest electrolyte abnormalities were a
      low serum bicarbonate in 56% of the patients and hyponatraemia in 48%. Possible
      aetiological factors are discussed. Significant pyuria was found in 10% of the
      patients and significant bacteriuria in 13%. Escherichia coli was the commonest
      isolated organism (56% of all the culture positive cases). Proteinuria above the
      upper limit of normal was detectable in 13% of the patients; of these, 25% had
      proteinuria in the nephrotic range. Of the patients 3% had clinical and
      biochemical evidence of renal insufficiency. It is concluded that significant
      bacteriuria occurs commonly in AIDS and that renal insufficiency and nephrotic
      syndrome may be associated with the disease. It is also noted that other
      electrolyte and acid-base abnormalities, in particular hyponatraemia and low
      bicarbonate levels may contribute to the morbidity and mortality in patients
      suffering from AIDS.

PMID- 1750127
TI  - Human immunodeficiency virus type 1 infection in a community of southern
      Mozambique.
AB  - We report the results of a study held between 1986 and 1988 on a population
      constituted by 493 subjects (425 of Mozambican nationality) all living in the
      camp organized for the building of the dam in Corumana (Sabie district, Maputo).
      We found five subjects, all of them from Mozambique, seropositive for HIV-1
      antibodies (ELISA and WB) with a prevalence of 1.2%. Four of the positive samples
      came from female subjects (1.7% of 239 females tested); one positive sample came
      from a male subject (0.5% of 186 tested).

PMID- 1750128
TI  - Food intake and socioeconomic status in children in northeast Thailand.
AB  - To assess the food intake and to evaluate the relationship between socioeconomic
      status (SES) and food consumption of northeastern Thai children a dietary survey
      was carried out among 108 urban and rural 3-8-year-olds in Sakon Nakhon province.
      Energy and nutrient intakes were assessed by the 24 hour recall method and
      calculated with local food consumption tables. Urban children consumed
      significantly more eggs and products containing animal proteins than rural
      children. In urban areas the percentage of users of meat, eggs, and fruit was
      significantly higher than in rural areas; fish was consumed more frequently in
      rural areas. As compared with the FAO/WHO RDA (Recommended Daily Allowances) all
      children showed a very inadequate supply of energy, calcium, iron (except urban
      children), vitamin A, thiamin, riboflavin, and niacin. The mean daily protein
      intake was almost equal to or higher than the calculated requirements. Children
      of lower socioeconomic background showed a lower fat intake, a lower contribution
      of fat to the energy intake, and a higher contribution of carbohydrates to the
      energy intake than children from families with a higher SES. This study shows
      that nutrient intakes far below recommended intakes are common among the examined
      northeastern Thai children and of a serious nature, and that much more emphasis
      needs to be given to increase the energy or food intake rather than the protein
      content of their grossly inadequate diets.

PMID- 1750129
TI  - The use of plasma fructosamine in the assessment of diabetic control.
AB  - Plasma fructosamine and glycosylated haemoglobin were measured in insulin
      dependent (n = 30) and in non-insulin-dependent diabetics (n = 90) and in healthy
      controls (n = 45). Fructosamine correlated significantly with glycosylated
      haemoglobin in the non-insulin dependent (r = 0.5, P less than 0.001) better than
      in the insulin-dependent group (r = 0.39, P less than 0.05). No correlation was
      found between plasma fructosamine and albumin or total protein concentrations
      when the concentrations of albumin and protein are within normal reference range.
      The fructosamine test has got many desirable characteristics, which will give it
      a role in the assessment of diabetic control.

PMID- 1750130
TI  - Plasma lipids and lipoproteins in type II diabetic Nigerians with retinopathy.
AB  - Derangements in plasma lipids and lipoproteins have been observed in Caucasian
      diabetics with retinopathy, a major microvascular complication of diabetes
      mellitus. The role of plasma lipids and lipoprotein in the development of
      diabetic retinopathy is not clear and its alteration in black Africans has not
      been investigated. Fasting plasma cholesterol, triglyceride and HDL-cholesterol
      concentrations were estimated in 27 Type II (non insulin-dependent) Nigerian
      diabetics with retinopathy and 37 without retinopathy and 63 healthy subjects.
      Both diabetic subgroups were comparable regarding their blood glucose control,
      body mass index and duration of diabetes. Plasma lipid and lipoprotein
      concentrations were similar in each group of patients, with no significant
      differences in diabetics with and without retinopathy. Plasma lipids and
      lipoproteins were not affected by the duration of the diabetic state. These
      results suggest that diabetic retinopathy in Nigerians is not associated with
      significant alteration in the concentration of plasma lipids and lipoproteins.

PMID- 1750131
TI  - Nasopharyngeal carcinoma. A comparative study.
AB  - A comparative study of Ghanaian and Saudi hospital cases of nasopharyngeal
      carcinoma (NPC) shows a higher occurrence among younger subjects in the Ghanaian
      group, with the peak age incidence in the Saudi group being similar to those
      reported from other parts of the world. In view of the known high prevalence of
      Burkitt's lymphoma among Ghanaian children, it is suggested that the much higher
      proportion of younger Ghanaian subjects with NPC may be related to early exposure
      to the Epstein-Barr virus which is known to be associated with both malignancies.

PMID- 1750132
TI  - Histiocytic necrotising lymphadenitis (Kikuchi-Fujimoto disease) in Saudi Arabia.
AB  - Five cases of histiocytic necrotising lymphadenitis (Kikuchi-Fujimoto disease)
      are described. As the condition appears to be poorly recognised in Saudi Arabia,
      an extensive review of the histological features is presented, in order to
      improve pathologists' awareness and to minimise the risk of diagnosing
      prognostically less favourable conditions such as malignant lymphoma. Etiologic
      and pathogenetic features of the disease are also discussed.

PMID- 1750133
TI  - An effective and safe surgical method for the treatment of hydatid cysts of the
      liver in children.
AB  - Between June 1986 and May 1989 35 children (18 boys and 17 girls) below the age
      of 12 years were surgically treated for hydatid cysts of the liver. Of the
      children 24 (68.5%) had a single cyst situated in either of the lobes of the
      liver, while the remaining 11 (31.5%) harboured more than one cyst. A uniform
      method of enucleation, partial cystectomy and external tube drainage was used in
      all of them. Small residual cavities were not drained but were kept open on to
      the surface of liver. Results showed that six patients (17.1%) had transient
      biliary discharge which resolved within 3-6 days, whereas in two children (5.7%)
      biliary drainage persisted for four, respectively six weeks following surgery.
      This also stopped spontaneously. The method we used in our patients was safe and
      effective.

PMID- 1750134
TI  - Attitudes and behaviour of physicians towards smoking in Riyadh city, Saudi
      Arabia.
AB  - In Riyadh city 698 physicians were studied for their smoking habits, attitudes
      and behaviour; 48% were smokers and 34% are currently smoking. Males smoked
      significantly more than females currently and in the past. Smoking prevalence and
      intensity tended to decrease with age and quitting periods were longer. More than
      60% of the physicians agreed that smoking is a major contributing factor in the
      causation of coronary artery disease, lung cancer and chronic bronchitis; less
      than 20% said the same for bladder cancer and neonatal death. Setting a good
      example for children was the most important reason for not smoking.

PMID- 1750135
TI  - The problem of trauma in Nigeria. Pattern as seen in a multicentre study.
AB  - Between 1982 and 1984 a multicentre study of trauma was conducted at the
      University of Ilorin Teaching Hospital (UITH) and eight other hospitals receiving
      patients from four states adjoining Kwara State of Nigeria. Average trauma
      admissions ranged between 4.3 and 20.6% of total admissions while 2.4% of dam
      construction workers sustained injuries. Peak trauma incidence and operations
      occurred in the third decade of life, followed road traffic accidents (RTA's) and
      involved males. Most outpatient trauma activity occurred on Saturdays while
      trauma admissions were highest on Mondays and Wednesdays. Trauma mortalities in
      the hospitals appeared to reflect severity of trauma encountered.

PMID- 1750136
TI  - Jimson weed food poisoning. An epidemic at Usangi rural government hospital.
AB  - Ten agitated and psychotic patients were admitted to Usangi hospital after having
      eaten stiff-porridge (Ugali) made from millet (Serena). This had been bought from
      the local regional branch of the National Milling Corporation (NMC). The patients
      had cardinal signs of atropine poisoning, viz., psychosis with hallucinations,
      tachycardia, fixed dilated pupils and a dry mouth. Toxicological analysis of the
      food samples revealed contamination with Jimson weed (Datura stramonium) seeds
      which contained an atropine-like alkaloid. On studying the records of the chief
      government chemist, it was found that a similar type of food poisoning had
      occurred in at least eight other regions. The clinical picture and management of
      this entirely preventable type of agricultural food poisoning are discussed.

PMID- 1750137
TI  - Two cases of ocular leishmaniasis.
AB  - Two cases of cutaneous leishmaniasis with ocular involvement are presented. The
      diagnostic difficulty, the possible complications and the importance of a correct
      diagnosis of such cases is discussed in the light of the cases presented and of
      previous similar case reports.

PMID- 1750138
TI  - Sickle cell-thalassemia in a Jordanian family.
AB  - A family case report of sickle cell-thalassemia syndrome shows three problems
      concerning this disease. Firstly, the problem of differentiating sickle cell
      thalassemia from the sickle cell disease; secondly, the wide range varieties in
      clinical picture; thirdly and finally contradiction in the criteria of prognosis.
      In this report sickle cell-thalassemia case was confirmed by constructing a
      hemoglobin electrophoresis pedigree for the patient. Clinical varieties and
      prognosis of sickle cell-thalassemia in this family are discussed.

PMID- 1750139
TI  - [Rheumatic manifestations in human immunodeficiency virus (HIV) infection].

PMID- 1750140
TI  - [Caries prophylaxis by fluoride, is it necessary in Tunisia?].

PMID- 1750141
TI  - [Biochemical approaches in states of urinary proteins].

PMID- 1750142
TI  - [The role of echography in the diagnosis of extra-uterine pregnancy].

PMID- 1750143
TI  - [Digestive hemorrhages in the cirrhotic patient].

PMID- 1750144
TI  - [Resuscitation of drowning patients].

PMID- 1750145
TI  - [AIDS and tuberculosis in central Tunisia].

PMID- 1750146
TI  - [Role of ultrasensitive detection of TSH and free thyroxine in the surveillance
      of primary treated hypothyroidism (79 cases)].

PMID- 1750147
TI  - [The contribution of tomodensitometry in the evaluation of hypopharyngeal
      esophageal cancer metastasis].

PMID- 1750148
TI  - [Current role of anterior sero-myotomy associated with posterior vagotomy (Taylor
      operation) in the treatment of chronic duodenal ulcer].

PMID- 1750149
TI  - Energy-loss near-edge fine structure and compositional profiles of cryomilled
      oxide-dispersion-strengthened aluminum.
AB  - Spatially resolved electron energy-loss spectroscopy (SREELS) makes possible the
      identification of small second-phase particles in an oxide-dispersion
      strengthened aluminum alloy produced by mechanical alloying in a liquid-nitrogen
      slurry. Near-edge fine structure profiles based on aluminum L23 features that are
      characteristic of Al-Al or Al-O bonding yield the metal/oxide fraction as a
      function of probe position. Profiles of nitrogen fraction are derived from linear
      sequences of spectra so that detection limits can be analyzed at each point in a
      scan. Quantitative analysis of these linear profiles shows that particles with
      diameters in the range 10 to 30 nm are rich in nitrogen. A combination of
      statistical analysis of background removal results with visual inspection of
      derivative spectra is used to estimate detection limits.

PMID- 1750150
TI  - Algorithms for Bayesian background-subtracted Fourier darkfield imaging.
AB  - Formal consideration of prior information on the Fourier amplitude of background
      contrast in an image, using the same Bayesian principles of statistical inference
      which underlie thermodynamics, allows one to subtract background without favoring
      only selected parts of frequency space. Without the bias in frequency space which
      causes periodicity bleeding and mars literal interpretation of Fourier-filtered
      images, the shape transform of aperiodic objects can be left intact. Algorithms
      for Bayesian background subtraction from one- and two-dimensional images are
      presented which further consider, in ad hoc fashion, one's uncertainty about
      background amplitude. The results help explain the reported success of Fourier
      truncation, and indicate that Bayesian background-subtracted images can minimize
      root-mean-square image error, as well as periodicity bleeding, in comparison to
      Fourier-filtered and Fourier-truncated alternatives.

PMID- 1750151
TI  - [Nursing insurance. Insurance responsibility or responsibility insurance?].

PMID- 1750152
TI  - [Meaning of the "scientific validity clause" of private hospital insurance
      (section 5/1 f MB/KK 76). With reference to recent verdicts].
AB  - As per Section 5/1 f of the classic conditions 1976 of the "Association of
      private health insurance carriers" (Verband der privaten Krankenversicherung),
      benefits won't be paid for methods of examination or treatment and remedies which
      are from the scientific point of view generally not recognized. Basic reflections
      have led to the fact that today the term "scientifically recognized methods" and
      the term "traditional medicine" will be treated as equivalent. Contrary verdicts,
      according to which treatments on the basis of anthroposophic medicine or by means
      of electro-acupuncture by Voll would be considered as generally recognized
      medicine from the scientific point of view and would have to be paid by the
      private health insurance carriers, are consequently not comprehensible. Supposing
      that the trend continues that private health insurers have to pay more and more
      expenses incurred for all kind of outsider-methods, this would lead not only to a
      great drain on the purse of the private health insurance carriers, but have also
      unpleasant consequences for the whole medicine, because the uniformity of the
      medicine is endangered. To take steps against has not only to be the task of the
      private health insurance carriers, but it is also in the interest of the
      physicians and, at last, of the patients, too.

PMID- 1750153
TI  - [Alternative therapy. Chances in Bechterew disease?].
AB  - The Bechterew disease is inherited but the illness is triggered by outer
      influences. We are therefore not able to do causal treatment. In consequence a
      lot of alternative remedies like the extract of Thymus and Vitamin E have been
      tried. If the Bechterew disease shows more or less an ossifying progress they do
      not show any effect. If the issue is inflammatory Vitamin E could act as
      radicalintercepter. The extract of Thymus is only a placebo.

PMID- 1750154
TI  - [Risks of electromagnetic fields for humans].
AB  - Different kinds of electromagnetic fields are treated regarding their possible
      effects on the human organism. Only scientific findings are taken as a basis for
      these considerations. According to the latest state of research only strong
      magnetic fields of low frequency and strong electromagnetic fields of high
      frequency can be critical for humans if exposed for a prolonged period. Possible
      causes for this threat are either the incidence of heart fibrillation or grave
      burnings of the body. Fields with such a strong intensity, however, are found
      only in few specific technical environments where they usually can be avoided by
      the specialists there. An impairment of well-being may also occur in connection
      with almost all other kinds of fields due to direct or indirect influence when
      the strength of the field becomes very high. An exception to that is only the
      static magnetic field where there are different findings from in-vivo- as well as
      in-vitro-experiments which, however, do not fit into these categories. Since the
      mechanisms of these effects are not understood yet, it is impossible to make
      statements about the medical relevance of the observed effects. Considering the
      variability and the partial inconsistency of the results found in magnetic fields
      it must be concluded that additional studies are necessary to validate these
      findings statistically. Last not least this also applies to the presumed and in
      public controversially discussed connection between the promotion of cancer and
      relatively weak time-varying magnetic fields, which in these low intensities
      occur not only in households, cars and trains, but also in almost all working
      environments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750155
TI  - [Heart damage after electric injury].
AB  - Death from electrical accident due to low voltage (220 Volt/380 Volt) is usually
      caused by ventricular fibrillation. In humans who sustain non fatal electrical
      injury abnormal ECG findings due to myocardial damage are rare. 243 (76%) of 320
      ECGs of survivors of an electrical accident were diagnosed as normal. In 42
      patients (13%) unspecific electrographic changes were seen and in 35 (11%)
      abnormal ECGs were found. In comparison to findings in normal populations no
      significant accumulation of ECG changes was observed. A causal relationship
      between abnormal ECG findings and electrical accident is only then probable if
      ECG abnormalities are documented immediately after injury and serial ECG controls
      demonstrate significant changes in comparison to the initial abnormality.

PMID- 1750156
TI  - [Arteriosclerotic plaque rupture. Its significance for myocardial infarct, sudden
      heart death and unstable angina].
AB  - In coronary heart disease ruptures of atherosclerotic plaques have a key
      position. As a rule plaque fissuring develops in the fibrous cap of a complex
      atherosclerotic plaque with necrotic core. In myocardial infarction in nearly all
      cases mural or occlusive thrombi develop as a consequence of plaque ruptures. In
      instable angina, too, plaques with ruptured surfaces are very numerous but often
      thrombi are smaller than in patients dying from myocardial infarction. Also in
      cases of sudden death plaque fissurings are frequently observed. Dynamic thrombi
      covering plaque ruptures may be sources of microemboli in the myocardium.

PMID- 1750157
TI  - [Intermittent claudication].
AB  - The symptom of intermittent claudication indicates a generalised
      arteriosclerosis. The high mortality of these patients is due to myocardial
      infarction, cerebrovascular events and rupture of aortic aneurysms. Prognostic
      factors for the progression of peripheral occlusive arterial disease to rest pain
      and trophical lesions are persistent nicotine consumption, arterial occlusions on
      more than one extremity, brachiopedal pressure quotient less than 0.5 and
      diabetes mellitus. Therapy of choice in most cases is the walking exercise. When
      the claudication distance remains very short or decompensation of peripheral
      circulation is imminent, reopening procedures like percutaneous transluminal
      angioplasty should be performed. If they are successless a prostanoid therapy is
      able to relief the complaints.

PMID- 1750158
TI  - [Diagnosis and prognosis of carotid artery stenosis].
AB  - The diagnosis of a carotid stenosis inevitably includes a neurological
      examination as well as CCT or MRI of the brain. Typical neurological and
      neuropsychological symptoms and signs as well as syndromes are described
      according to the vascular supply areas of the brain. CCT as well as MRI may
      identify cerebral infarction or other diseases and additionally give some
      information with regard to the underlying etiology or pathogenesis of an infarct.
      Satisfactory non-invasive demonstration of the carotid and vertebral arteries
      including their intracranial branches can be achieved by the use of sonographic
      methods (Dopplersonography, B-mode imaging, Duplex and colour-coded systems).
      Additionally, transcranial Dopplersonography is mandatory in most instances.
      Cerebral angiography is only justified preoperatively or for a disease which
      cannot be diagnosed reliably by other means, eg. cerebral venous thrombosis. The
      prognosis of a carotid stenosis depends not only on the degree of luminal
      narrowing and the shape of the stenosis but also on the clinical status of the
      patient (asymptomatic or symptomatic carotid stenosis, accompanying coronary
      artery disease etc.). Prophylactic treatment implies therapy of risk factors as
      well as antiaggregation, anticoagulation and carotid endarterectomy in selected
      cases.

PMID- 1750159
TI  - Neutrophil function in dogs with congenital ciliary dyskinesia.
AB  - In vitro neutrophil function was assessed in two English Springer Spaniel dogs,
      two Bichon Frise dogs, and one Chow Chow dog with congenital ciliary dyskinesia;
      three clinically normal English Springer Spaniel dogs that were presumed
      heterozygous for congenital ciliary dyskinesia; and five control dogs. Chemotaxis
      and random migration in affected and heterozygous dogs were found to be
      comparable to those of control dogs. Increased (P less than or equal to 0.05)
      neutrophil adhesion, antibody dependent cell-mediated cytotoxicity, iodination of
      proteins, and oxygen radical production in neutrophils from affected dogs were
      probably the result of chronic bacterial infection in vivo. Bacterial ingestion
      by neutrophils from the three heterozygous English Springer Spaniel dogs was
      significantly increased compared to control dogs but was not different from
      affected English Springer Spaniel dogs, suggesting a breed-related phenomenon.
      Significant decreases in neutrophil function were not seen in any of the dogs
      with congenital ciliary dyskinesia, indicating that a defective microtubular
      system is not shared by respiratory cilia and neutrophils and that defective
      neutrophil function does not contribute to respiratory infection.

PMID- 1750160
TI  - Ganglioneuromas of the thyroid gland in a colony of Sprague-Dawley rats.
AB  - Ganglioneuromas of the thyroid gland of Sprague-Dawley rats were found in 7.2% of
      698 rats used in two, 2-year oncogenicity bioassays. The incidence of the tumor
      was unrelated to treatment or sex. Of the 52 ganglioneuromas of the thyroid gland
      identified in 50 animals, 40 (80%) had coincident C cell proliferations in the
      same or contralateral lobe. Ganglioneuromas were contiguous or commingled with C
      cell proliferations in 63.5% of the cases. The ganglioneuromas consisted of large
      ganglion cells and, in a few cases, cells thought to be less differentiated
      neuronal precursors, in a matrix of neurites and Schwann cells. They grew,
      infiltrating and expanding in the thyroid parenchyma, and did not metastasize.
      Immunohistochemical staining for calcitonin, S-100 protein, and neurofilaments,
      as well as electron microscopy, were used to further characterize the tumors. The
      close association of ganglioneuromas with C cell tumors supports the theory of
      neural crest origin of C cells and provides a parallel to the association of
      ganglioneuromas and pheochromocytomas in the adrenal medulla. This is the first
      report of ganglioneuromas occurring in the thyroid gland or occurring as a common
      entity in any species.

PMID- 1750161
TI  - Congenital and acquired melanocytomas (benign melanomas) in eighteen young
      horses.
AB  - In a retrospective study, cutaneous melanocytic tumors from 18 horses, less than
      2 years old, were examined histopathologically and clinical follow-up requested.
      Melanocytomas (benign melanomas) occurred in a variety of breeds and in horses of
      varied coat color. The age of the horses at the time of biopsy ranged from 3
      weeks old to 2 years old. Four melanocytomas were congenital, 11 melanocytomas
      were acquired by 1 year of age, and three were acquired prior to 2 years of age.
      Of the 18 horses, five were male, and 13 were female. All tumors were solitary
      and located on the legs or trunk; none were in the perineal region. Ulceration of
      the overlying epidermis was common. Tumors were generally localized and were not
      encapsulated. The tumors had a variety of cell patterns ranging from sheets, to
      streams, or nests of melanocytes. Cellular morphologic findings also ranged from
      epithelioid, to a mixture of epithelioid and spindle cells or to a spindle
      pattern. The nuclei were large and euchromatic, especially in the epithelioid
      cells. Several tumors had moderate cellular pleomorphism and binucleate cells.
      Mitotic activity was generally low (less than 1/high-powered field), but was
      readily detected (1-2/high-powered field) in bleached sections of four cases.
      Melanin pigmentation varied from mild to heavy. Melanophages were admixed with
      the tumor cells or in the adjacent tissue. Follow-up information was obtained on
      15/18 horses and revealed that 14/15 horses were free of recurrence following
      excision. One neoplasm, that was poorly demarcated and had a spindle cell
      pattern, was not completely resected and continued to grow. These melanocytic
      tumors in young horses are distinct from melanomas in aged horses in their
      location, epithelial involvement, and age of horses affected. The majority of
      these tumors appear to be benign and share features of melanocytic nevi of human
      beings.

PMID- 1750162
TI  - Immunocytochemistry of canine thyroid tumors.
AB  - Immunocytochemical studies using the peroxidase-antiperoxidase method with
      commercial antibodies against thyroglobulin, calcitonin, calcitonin gene-related
      peptide (CGRP), neuron specific enolase (NSE), somatostatin, and neurotensin were
      performed on 38 Bouin-fixed, paraffin-embedded canine thyroid tumors obtained
      from necropsy and surgical files from 2 Ecoles Nationales Veterinaires (Alfort
      and Nantes, France) and from the Laboratoire d'Histo-Cytopathologie Veterinaire,
      Maisons-Alfort (France). The tumors consisted of two follicular adenomas, nine
      follicular carcinomas, nine solid carcinomas, 12 follicular-compact-cellular
      carcinomas, and six C-cell carcinomas. All 32 follicular-cell tumors were stained
      positively for thyroglobulin, half of them had weak to moderate positive
      immunoreactivity for NSE, and all histologic patterns were represented. They had
      no immunoreactivity for somatostatin or neurotensin. Four C-cell carcinomas had a
      solid alveolar pattern, while two had a pseudo follicular pattern characterized
      by uneven, often coalescent, pseudo-follicular formations with a multilayered
      epithelium surrounding a cavity that often contained red blood cells. Four C-cell
      carcinomas had uneven immunoreactivity for calcitonin, while all six were
      positive for CGRP or NSE. Immunoreactivity for CGRP was stronger or more
      widespread than positivity for calcitonin when both occurred in the same tumor.
      Some cells of three C-cell carcinomas had positive immunoreactivity for
      somatostatin. No immunoreactivity for neurotensin was detected. Seven tumors of
      follicular cell origin contained a few cells positive for calcitonin or CGRP,
      while three C-cell carcinomas had a few cells positive for thyroglobulin. These
      tumors were considered to contain entrapped remnants of normal thyroid tissue
      rather than being dual hormone producing tumors.

PMID- 1750163
TI  - Spontaneous fibro-osseous proliferative lesions in the sternums and femurs of
      B6C3F1 mice.
AB  - Bone morphology associated with fibro-osseous proliferation in the femurs and
      sternums of 98 female B6C3F1 mice were compared morphologically and
      quantitatively to femurs and sternums from 100 male B6C3F1 and 79 CF1 mice (48
      female and 31 male). In addition, sternal samples from five B6C3F1 mice per sex
      were collected and processed for electron microscopy. Fibro-osseous proliferation
      was present in female B6C3F1 mice, but not male B6C3F1 or female CF1 mice. In
      female B6C3F1 mice at 32 weeks of age, the marrow spaces in the region of the
      proximal and distal epiphyseal plate were lined by large osteoblasts and had
      large vascularized centers. At 58 weeks, metaphyseal fibrovascular proliferative
      areas containing multinucleated cells and new cancellous bone delineating the
      lesion were seen. At 84 weeks, fibro-osseous tissue occupied the outer third of
      the sternal marrow cavity and by 110 weeks, more than two thirds of the marrow
      cavity. Fibro-osseous proliferation was present in 100 and 94% of the examined
      sternums and femurs, respectively, of female B6C3F1 mice at 110 weeks of age, but
      not in male B6C3F1 or female CF1 mice. Ultrastructural examination of the sternal
      changes at 110 weeks showed numerous osteoblasts, irregular bony spicules, and
      fibrocyte-like cells. By morphometry, the normal marrow cavity in B6C3F1 females
      occupied 35% of a longitudinal section of the whole sternebra compared with 70%
      and 75% of the whole sternebra in B6C3F1 males and CF1 female,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750164
TI  - Cutaneous neoplasia in 340 cats.
AB  - A total of 340 cases of cutaneous neoplasia were diagnosed in 340 of 3,564 cats
      that were examined by biopsy or necropsy during a 41-month period from January 1,
      1986 through May 31, 1989. Eighteen types of tumor occurred, but four types
      comprised 77% of the cases. These were basal cell tumor, 89 cases (26%, mean age
      10.3); mast cell tumor, 72 cases (21%, mean age 8.6); squamous cell carcinoma, 52
      cases (15%, mean age 11.6); and fibrosarcoma, 50 cases (15%, mean age 10.2). For
      each of these four types of tumors, peak number of cases occurred in cats older
      than 10 years. Mast cell tumor was the only tumor diagnosed in cats younger than
      1 year. The head was the most common site for basal cell tumors, mast cell
      tumors, and squamous cell carcinomas. The legs were the most common location of
      fibrosarcomas. Siamese cats had approximately three times as many mast cell
      tumors as statistically expected, but only one-fourth as many squamous cell
      carcinomas. Breed predilection for other skin tumors was not apparent. Sex
      predilection was not detected for any skin tumor.

PMID- 1750165
TI  - Distinctive unclassified mesenchymal tumor of the digit of dogs.
AB  - Four examples of a mesenchymal tumor of undetermined histogenesis occurred in
      three mixed-breed dogs and one Yorkshire terrier. All tumors occurred as
      solitary, soft to firm, solid, tan, and ulcerated masses in the digits of dogs
      aged 11 to 15 years. The compact cellular tumor had cells with anisokaryotic
      round, oval, or irregular nuclei, some of which were multinucleated. The
      neoplastic cells appeared to arise in the tissue near the third phalanx in the
      area of dense collagenous trabeculae located proximal to the fat pad and sweat
      glands. The unclassifiable cells had some features of histiocytes by transmission
      electron microscopy, but failed to stain for lysozyme and alpha-1
      antichymotrypsin, markers for monocyte-macrophage derived cells.
      Immunohistochemically, the cells stained for vimentin but not for cytokeratins,
      desmin, S-100 protein, epithelial membrane antigen, alpha-lactalbumin, lysozyme,
      alpha-1-antichymotrypsin, alpha-lactalbumin, casein, and heavy and light chain
      immunoglobulins. The combined findings of light and transmission electron
      microscopy and immunohistochemistry exclude tumor histogenesis from an epithelial
      cell, melanocyte, mast cell, plasma cell, Schwann cells, and Merkel cell.

PMID- 1750166
TI  - Spontaneous amelanotic melanomas of the uveal tract in F344 rats.
AB  - Five intraocular amelanotic melanomas were identified in the National Toxicology
      Program's database consisting of records from more than 60,000 female and 60,000
      male F344 rats, which were used as control and treated animals in 2-year
      carcinogenicity studies. The five spontaneous melanomas were grossly observed as
      white or yellow, unilateral nodules, which originated in the region of the iris
      and ciliary body, often also involving the choroid. These amelanotic melanomas
      were composed predominantly of spindle cells arranged in a whorled pattern often
      with perivascular orientation. Mitotic figures were common in five tumors. The
      spindle cells had a positive immunoreactivity for S-100 protein but were negative
      for desmin. Electron microscopic studies provided clear evidence that these
      tumors originated from the uveal melanocytes. Ultrastructurally, the spindle
      cells contained numerous cytoplasmic premelanosomes (stage II melanosomes) that
      were not associated with melanin. Special histochemical studies showed that the
      spindle cells had a negative reaction for melanin. Although electron microscopic
      features are critical in the diagnosis of amelanotic melanomas of the uveal
      tract, the whorled pattern of spindle cells is a useful histologic criterion in
      differential diagnosis of this tumor in F344 rats.

PMID- 1750167
TI  - Pathogenesis of Venezuelan equine encephalitis virus infection in mice and
      hamsters.
AB  - The pathogenesis of Venezuelan equine encephalitis (VEE) virus infection was
      compared in intraperitoneally inoculated mice (n = 24, 6 to 8 weeks old) and
      hamsters (n = 9, 90-110 g) using histopathology and immunohistochemical
      localization of VEE virus antigen. Infected mice developed paralysis, and the
      majority died by 9 days after inoculation. In contrast, hamsters did not survive
      beyond 3 days after inoculation, and they did not develop any neurologic signs.
      VEE virus antigen, demonstrated by immunoperoxidase staining, and pathologic
      changes were present in extraneural organs of both mice and hamsters. There was
      more severe involvement in hamsters, particularly in Peyer's patches of the
      distal small intestine. There was a severe encephalomyelitis in mice, but
      pathologic changes were not well established in the brains of hamsters before
      death. VEE virus antigen was widespread in the central nervous system of both
      mice and hamsters. VEE virus was found to be highly neurotropic in hamsters and
      had a similar distribution in the brain as in mice, but hamsters died from their
      extraneural disease before major central nervous system disease developed.

PMID- 1750168
TI  - Heterophil function in healthy chickens and in chickens with experimentally
      induced staphylococcal tenosynovitis.
AB  - Heterophil function was evaluated in 16 healthy chickens and in 46 chickens with
      experimentally induced staphylococcal tenosynovitis. In paired blood samples,
      heterophils from chickens with tenosynovitis had a significant increase in
      adherence, chemotaxis, phagocytosis, and bacterial killing of Staphylococcus
      aureus compared to heterophils from healthy chickens. The percent adherence of
      heterophils to nylon fiber columns increased significantly from a 78.4% mean +/-
      6.6% standard deviation to 87.6% +/- 3.2% after induction of staphylococcal
      tenosynovitis. Heterophil movement following in vitro exposure to saline or
      endotoxin was increased in chickens with tenosynovitis; 3 +/- 1 heterophils/0.25
      mm2 to 10 +/- 6 heterophils/0.25 mm2 and 136 +/- 29 heterophils/0.25 mm2 to 340
      +/- 74 heterophils/0.25 mm2, respectively. Endotoxin-activated serum was
      chemoattractive for heterophils from all chickens. Flow cytometry was used to
      define the heterophil population on light scatter histograms, evaluate individual
      cell phagocytosis of latex beads, and quantitate the number of beads phagocytosed
      per heterophil. When incubated with increased numbers of beads, only heterophils
      from chickens with tenosynovitis phagocytosed higher numbers of beads. At
      heterophil to bead ratios of 1:10, the percentage of heterophils that
      phagocytosed beads increased from baseline values of 37.8% +/- 9.0% to post
      infection values of 67.3% +/- 7.5%. Using 1:20 heterophil to bead ratios,
      heterophil phagocytosis increased from 38.7% +/- 9.9% to post-infection values of
      79.8% +/- 7.3%. Heterophils from all chickens were able to phagocytose and kill
      log phase staphylococcal bacteria. After phagocytosis, the heterophils from
      chickens with staphylococcal tenosynovitis rapidly decreased the number of viable
      bacterial colony forming-units per milliliter by approximately one log.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1750169
TI  - Bovine undifferentiated alveolar rhabdomyosarcoma and its differentiation in
      xenotransplanted tumors.
AB  - At necropsy, a 7-year-old Holstein cow, clinically diagnosed via rectal palpation
      as having malignant abdominal neoplasia was found to have many metastatic tumors
      of various sizes in the abdominal and thoracic cavities and in the liver, lung,
      kidney, adrenal, uterus, and lymph nodes. These tumors were examined by
      histologic and immunohistochemical methods using anti-human myoglobin, anti
      bovine myoglobin, and anti-desmin sera. Tumors were diagnosed as undifferentiated
      alveolar rhabdomyosarcomas. The tumors in the abdominal and thoracic cavities
      differed histologically from the metastases in organs. The former tumors
      consisted of only undifferentiated cells, most of which did not stain positively
      for desmin or myoglobin. The metastatic tumors contained a few rhabdomyoblastic
      cells that stained positively for desmin and myoglobin. Tumors tissues from the
      cow were transplanted and propagated through six passages in athymic nude mice.
      After one passage, the transplanted tumor histologically resembled those from the
      abdominal serosa and consisted of cells with scanty cytoplasm with an alveolar
      arrangement. Cells from this tumor stained positively for desmin and negatively
      for myoglobin. After two passages through nude mice, tumor cells were of two
      distinct histologic types: those cells with scanty cytoplasm and elongated cells
      with plentiful eosinophilic cytoplasm. Both of these cells stained positively for
      both desmin and myoglobin. After six passages, cross striations were detected in
      neoplastic cells by electron microscopy. These findings illustrate that a highly
      undifferentiated bovine rhabdomyosarcoma, in which most of the cells in the
      original tumor lacked desmin and myoglobin, became better differentiated and
      stained positively for desmin and myoglobin after serial transplantation in nude
      mice.

PMID- 1750170
TI  - Intradermal neutrophil mobilization induced by complement fragments and endotoxin
      is more effective in neonatal than in adult cattle.

PMID- 1750171
TI  - Prevalence and location of mast cell tumors in slaughter cattle.

PMID- 1750172
TI  - Dentigerous cysts in sheep.

PMID- 1750173
TI  - Transmission of salmonellae among calves penned individually.
AB  - An analysis of the spatial and temporal patterns of excretion of salmonellae by
      calves penned individually showed that non-contagious routes were more important
      than contagious routes in disease spread. The avoidance of aerosol production,
      and the effective cleaning and disinfection of utensils between feeds and of
      buildings between batches, are likely to be more important than pen design in the
      control and prevention of calf salmonellosis.

PMID- 1750174
TI  - Physiological responses of sheep to two hours anaesthesia with diazepam-ketamine.
AB  - The cardiopulmonary effects of repeated intravenous injections of a combination
      of diazepam and ketamine for anaesthesia were evaluated in six domestic sheep.
      Induction doses of 0.375 mg/kg and 7.5 mg/kg were followed by maintenance doses
      of 0.188 mg/kg and 3.75 mg/kg every 15 minutes for 105 minutes. Although this
      dosing regimen produced the desired anaesthetic effects, it caused untoward
      cardiopulmonary effects. Salient features of multiple dosing with diazepam and
      ketamine were hypoventilation, respiratory acidosis and an increase in both
      systemic and pulmonary vascular resistance.

PMID- 1750175
TI  - Immobilisation of southern elephant seals and leopard seals with cyclohexamine
      anaesthetics and xylazine.
AB  - Ketamine and xylazine were given to 55 southern elephant seals (Mirounga leonina)
      for stomach lavaging, and to three leopard seals (Hydrurga leptonyx). The
      elephant seals showed prolonged apnoea and two of them died owing to aspiration
      of stomach contents. Two of the leopard seals died from unknown causes.
      Tiletamine and zolazepam were given to five elephant seals and one leopard seal.
      Two of the elephant seals and the leopard seal died from unknown causes. Xylazine
      alone was administered to 34 leopard seals. Sedation was poor at low dose rates
      (less than 1.7 mg/kg) but four of the seals given higher dose rates died owing to
      the aspiration of stomach contents.

PMID- 1750176
TI  - Cryptosporidiosis in game birds.

PMID- 1750177
TI  - Patent urachus with a perforated urethra in a Nigerian Balami lamb.

PMID- 1750178
TI  - Use of transtracheal aspiration to identify pathogens in pneumonic calves.

PMID- 1750179
TI  - Anticoccidial efficacy of diclazuril in partridges.

PMID- 1750180
TI  - Homeopathic remedies.

PMID- 1750181
TI  - Homeopathic treatment of a dog.

PMID- 1750182
TI  - Systolic cardiac murmurs in boxers.

PMID- 1750183
TI  - Enterotoxaemia in cats.

PMID- 1750184
TI  - Practice in Bulgaria.

PMID- 1750185
TI  - Pathology of septum formation in primary biliary cirrhosis: a histological study
      in the non-cirrhotic stage.
AB  - Bridging or incomplete septum formation, an important step leading to cirrhosis
      in various chronic progressive liver diseases, was examined in 231 liver biopsy
      specimens of primary biliary cirrhosis (non-cirrhotic stage. Incomplete septa
      from the enlarged portal tracts and portal to portal bridges were frequent and
      appeared first, while portal to central ones appeared subsequently and became
      frequent in the liver specimens with changes resembling cirrhosis. These septa
      were divided into four types histologically: ductular, lymphocytic, loose
      connective tissue and fibrous type. More than one type was usually found in the
      same specimen. The pathology of the first three types was similar to and
      frequently continuous with that of neighbouring periportal regions, suggesting
      that most of these septa were formed by the extension of periportal destructive
      processes. The fibrous type might be an advanced form of the other three types.
      Incomplete septa seemed to pinch off part of the hepatic parenchyma in a hepatic
      lobule; this was followed by an unusual enlargement of the portal tracts and an
      approximation of portal tracts and central veins. There were perivenular
      hepatocellular necroses on occasion. Progression of periportal hepatocellular
      damage may lead to septum formation and finally progress to cirrhosis, in primary
      biliary cirrhosis. The significance of perivenular necroses remains speculative.

PMID- 1750186
TI  - Purkinje cell toxicity of beta-aminopropionitrile in the rat.
AB  - Compounds causing neurolathyrism are putative aetiological agents in
      neurodegenerative disorders including amyotrophic lateral sclerosis. beta
      Aminopropionitrile (BAPN) is one such compound. We have administered this
      lathyrogenic agent at a dose of 1 g/kg by the intraperitoneal route in
      experiments in adult Sprague-Dawley rats during a period of 10 weeks. The rats
      developed marked kyphoscoliosis, ataxia with paralysis and muscle wasting of the
      hind limbs. Vacuolation and loss of Purkinje cells developed, but no anterior
      horn cell degeneration was noted. Immunohistochemical studies of phosphorylated
      neurofilaments and the 72 kDa heat shock protein were normal and no intraneuronal
      ubiquitinated inclusions were seen. High-dose intraperitoneal BAPN in the rat
      causes Purkinje cell changes, but no other central nervous system abnormalities.

PMID- 1750187
TI  - The histopathology of the liver in older patients with hepatitis B virus surface
      antigenaemia.
AB  - The histopathology of the liver and the detectability of intrahepatic hepatitis B
      virus (HBV) markers were studied in 34 autopsy cases in elderly patients (mean
      age 73.9 years, range 60-91 years) who had had a history of positive HBV surface
      antigenaemia prior to death. Seven of 14 persistent HBV carrier cases (group A)
      in which long-lasting HBV surface antigen (HBsAg) carriage in the sera had been
      confirmed by sequential assays, and 5 out of 15 HBV-infected people (group C,
      single assay) showed significant primary liver damages including chronic
      hepatitis, toxic hepatitis, liver cirrhosis and hepatocellular carcinoma. In 5
      cases (group B), one of which was type B liver cirrhosis, HBsAg became negative
      and HBsAb appeared during the follow-up period (up to 33 months). Among confirmed
      HBV carriers, HBsAg and HBV core antigen were most frequently found in the liver
      of cirrhotic cases with and without hepatocellular carcinoma (5 of 6), whereas
      these were rarely detected in those with non-specific changes or slight hepatitic
      activity (1 of 7). All 5 cases in group B were negative for histological HBV
      related antigens and the findings in group C were variously interpreted. Post
      mortem cases of the aged HBV carriers who survived their mean life expectancy
      represent an important population in which to study the natural history of HBV
      carriers.

PMID- 1750188
TI  - Endosteal surfaces in hyperparathyroidism: an enzyme cytochemical study on low
      temperature-processed, glycol-methacrylate-embedded bone biopsies.
AB  - Alkaline phosphatase (AlP) and tartrate-resistant acid phosphatase (TRAP)
      activities have been studied comparatively in needle biopsies of the iliac crest
      of four cases of secondary hyperparathyroidism (renal osteodystrophy). AlP
      activity was associated with the plasma membrane of osteoblasts and their
      processes, of reticular cells of bone marrow and of young osteocytes of osteoid
      borders and woven bone. Moreover, it was detected in the fibroblast-like cells of
      the endosteal "fibrosis". These cells were orderly in arrangement and were
      parallel to the endosteal surfaces near zones of bone formation. They were
      disorderly near zones of bone resorption. A strong TRAP-positive reaction was
      present in osteoclasts and mononuclear cells of endosteal "fibrosis" and in
      osteocytes located near active osteoclasts and in woven bone. These results
      suggest that the so-called fibrosis of hyperparathyroidism, rather than
      representing reparative, inert tissue, consists of osteoblast-like cells,
      probably precursors of osteoblasts derived by parathormone-stimulated
      proliferation of AlP-positive stromal cells of bone marrow, and of TRAP-positive,
      mononuclear cells, probably preosteoclasts. Moreover, they show that TRAP
      activity can be present in osteocytes, probably under stimulation by the same
      factors which stimulate osteoclast activity. The histochemical demonstration of
      AlP and TRAP facilitates the morphological diagnosis of metabolic bone disease
      and may improve knowledge of bone physiopathology.

PMID- 1750189
TI  - Morphological and cytogenetic studies of angiosarcoma in Stewart-Treves syndrome.
AB  - A morphological and cytogenetic analysis of a multifocal angiosarcoma in a
      typical case of Stewart-Treves syndrome is reported. The morphological analysis
      indicated differentiation along both blood and lymph vessel endothelium lines. By
      light and electron microscopy there were areas with well-developed erythrocyte
      containing, capillary-like vessels and poorly differentiated areas with abortive
      vascular formations. In these the endothelium revealed immunoreactivity to factor
      VIII RAg, binding of Ulex europaeus I and Psophocarpus tetragonolobus agglutinin
      lectins, Weibel-Palade bodies ultrastructurally and presented a continuous
      enclosing external lamina and immunoreactivity for laminin and collagen IV, all
      features of blood-vessel differentiation. There were also lymphangioma-like areas
      as well as poorly differentiated areas where the immunohistochemical, lectin
      binding and ultrastructural features were compatible with a lymph vessel
      differentiation. Cytogenetic analysis of cultured tumour cells revealed
      chromosome counts in the diploid region. About 40% of the cells analysed had a
      normal diploid karyotype. The remaining cells showed a multitude of mainly
      nonclonal structural alterations; 17 unique marker types resulting from different
      translocations and deletions were observed. There were also a few cells with
      clonal numerical deviations showing monosomy 22, monosomy X and trisomy 2
      respectively. It is of interest that the losses of chromosome 22 and the X
      chromosome also have been observed in Kaposi's sarcoma and that the PD-ECGF gene,
      a novel angiogenetic factor, has been mapped to chromosome 22.

PMID- 1750190
TI  - Leu-M 1 immunoreactivity in papillary carcinomas of the thyroid gland;
      microcarcinoma, encapsulated, conventional and diffuse sclerosing subtypes.

PMID- 1750191
TI  - A study of malignant lymphomas in Iran, based on the updated Kiel classification.
AB  - One hundred and sixty-two consecutive cases of malignant lymphomas were collected
      from two diagnostic centres in north and south Iran. Tissue samples were examined
      by immunohistological methods, and the non-Hodgkin's lymphomas were classified
      according to the updated Kiel classification. The distribution of the different
      types of malignant lymphoma in this study is compared with the situation in
      Western countries.

PMID- 1750192
TI  - Paragangliomas: neuroendocrine features and cytometric DNA distribution patterns.
      A clinico-pathological study of 22 cases.
AB  - Paragangliomas from 22 patients with extraadrenal tumours of this type were
      studied. Neuroendocrine features were examined using immunohistochemical
      techniques. Twenty-two antisera raised against neuroendocrine "markers",
      regulatory peptides, serotonin and intermediate filament proteins were studied in
      this group and cytometric DNA assessments were made by means of image cytometry.
      One normal and 5 hyperplastic carotid bodies were used as controls in the DNA
      cytometric investigations. Clinical and/or histopathological evidence of
      "malignancy" was present in 5 cases. The tumour cells showed heterogeneity with
      regard to their expression of different peptides, and the immunohistochemical
      analyses did not permit differentiation between benign and malignant
      paragangliomas. An euploid nuclear DNA distribution pattern was found in all
      controls and in 17 of the tumours; all except 1 were clinico-pathologically
      benign. An aneuploid DNA pattern was observed in 5 of the cases and some
      malignant features were present in 4 of these cases. DNA data may give further
      information apart from that obtained from the histopathological findings which
      may be of value in predicting the biological behaviour of this tumour type.

PMID- 1750193
TI  - Nuclear DNA content in 27 pancreatic endocrine tumours: correlation with
      malignancy, survival and expression of glycoprotein hormone alpha chain.
AB  - Paraffin-embedded tissue from resection specimens of 14 functioning and 13
      nonfunctioning pancreatic endocrine tumours (PET) was analysed for nuclear DNA
      content by image cytometry. Data on follow-up (mean 5.5 years) were available in
      all patients. DNA histograms with a diploid pattern were found in 13 (48%)
      tumours, while an aneuploid pattern was seen in the remaining 14 tumours (52%).
      Six (40%) of the diploid tumours and 9 (60%) of the aneuploid tumours were
      malignant. Survival was shorter in patients with malignant and aneuploid PET
      (mean 3.5 years, range 0.5-7) than in those with malignant and diploid PET (mean
      5.7 years, range 3-8). Human chorionic gonadotropin-alpha was expressed in 3 of
      12 benign PET, with 1 being aneuploid, and 6 of 15 malignant PET, with 4 being
      aneuploid. We conclude from these results that the ploidy pattern of PET allows
      no discrimination between benign and malignant tumours but may provide prognostic
      information on the aggressiveness of malignant PET.

PMID- 1750194
TI  - Is the grading of breast carcinomas affected by a delay in fixation?
AB  - The effect of delay in fixation on the modified Bloom and Richardson grade of
      eight breast carcinomas was investigated. Topologically shuffled samples of each
      tumour were immersed in fixative at times of 0.5, 2, 4, 6, 18 and 24 h after
      surgical removal. The grade of each tumour was assessed at delays of 0.5 and 6 h.
      The tubule formation and nuclear pleomorphism components of the grade showed no
      change with a delay in fixation of 6 h. The number of mitotic figures declined by
      a mean of 53% over the same period and this resulted in a decrease in the
      histological grade of one of the tumours. The implications of these findings for
      the handling of breast specimens in a diagnostic histopathological laboratory are
      discussed.

PMID- 1750195
TI  - Mucin-histochemical and immunohistochemical profiles of epithelial cells of
      several types of hepatic cysts.
AB  - Epithelial cells of several types of hepatic cysts were examined by mucin
      histochemistry and immunohistochemically. There were some differences in mucus
      and antigenic expression among the hepatic cysts examined. Epithelial cells of
      non-parasitic simple cysts and adult-type polycystic liver showed similar mucin
      histochemical and immunohistochemical features, and were characterized by little
      mucin and weak immunoreactivities to several antibodies examined. Epithelial
      cells of hepatic hilar cysts were characterized by much mucin and moderate
      immunoreactivities to carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic
      antigen (CEA) and epithelial membrane antigen (EMA). Epithelial cells of ciliated
      hepatic foregut cysts were characterized by much mucin and immunoreactivities to
      actin and tubulin which were positive in cilia. Epithelial cells of biliary
      cystadenoma were characterized by much mucin and moderate to strong
      immunoreactivities to cytokeratins CAM5.2 and AE1 and 3 as well as to CA 19-9,
      CEA, EMA and DU-PAN-2. Epithelial cells of biliary cyst-adenocarcinoma were
      characterized by much mucin and moderate to strong immunoreactivities to
      cytokeratins CAM5.2 and AE1 and 3 as well as to CA 19-9, CEA, EMA and DU-PAN-2.
      These differences in epithelial mucus and antigenic expression among several
      types of hepatic cysts may reflect differences in their origin and biological
      characteristics. These differences may be helpful in the differential diagnosis
      of hepatic cysts in small biopsy specimens.

PMID- 1750196
TI  - Quantitative analysis of nucleolar margination in diagnostic cytopathology.
AB  - The diagnostic value of nucleolar margination, defined as the percentage of
      nucleoli touching the nuclear membrane, was investigated in 359 cytological
      preparations of benign and malignant lesions of the thyroid, breast, prostate and
      central nervous system. Premalignant lesions of the uterine cervix and non
      invasive papillary carcinomas of the bladder were also examined. It was observed
      that the percentages in benign lesions were, in general, lower than in the
      malignant and that the values increased progressively with increasing grade in
      the cervix and bladder. When the overlap index was calculated, this gave exact
      information on the usefulness of nucleolar margination in distinguishing benign
      from malignant lesions, particularly in the prostate and thyroid and, to a lesser
      extent, in the breast and central nervous system. As for lesions of different
      grades, the calculation of the index allowed the identification of two subgroups,
      one corresponding to low grades (mild cervical dysplasia or urothelial papillary
      carcinoma of grade 1), the other subgroup to high grades (severe cervical
      dysplasia and carcinoma in situ, or papillary carcinoma of grade 3). Moderate
      dysplasia cases and grade 2 papillary carcinomas do not appear as separate
      intermediate categories but rather show values falling into the range of either
      the higher or lower grades. The margination values obtained from the cytological
      preparations corresponded well to those in the histological slides obtained from
      the resected specimens. In conclusion, nucleolar margination appears to be a
      feature which is easy to evaluate in a reproducible way and useful in cytological
      diagnosis.

PMID- 1750197
TI  - Very large peroxisomes in distinct peroxisomal disorders (rhizomelic
      chondrodysplasia punctata and acyl-CoA oxidase deficiency): novel data.
AB  - We report very large hepatic peroxisomes (d-circle greater than 1 micron) in a
      patient with rhizomelic chondrodysplasia punctata and a patient with acyl-CoA
      oxidase deficiency. The effects of peroxisomal enlargement on the enzymatic
      activity are discussed. As increase in peroxisomal size is also reported in at
      least 12 other patients with peroxisomal disorders, we propose a relationship
      between the enlargement of the organelles and their functional deficiency.

PMID- 1750198
TI  - [Kidney sorbitol dehydrogenase: kinetic mechanism].
AB  - Properties of sorbitol dehydrogenase isolated from rat kidney were studied.
      Sorbitol dehydrogenase reactions followed the consecutive irregular order as
      shown in studies of kinetic patterns, inhibition by end products and
      thermoinactivation of the enzyme in the presence of substrates.

PMID- 1750199
TI  - [Protein metabolism in patients with atherosclerosis using a 15(N) isotope].
AB  - Incorporation of 15N into blood plasma proteins and blood cells was studied in 11
      patients with ischemic heart disease and peripheric atherosclerosis and in 7
      healthy volunteers after oral administration of 15NH4Cl (95 atm%/15N) at a dose
      of 3 g per 70 kg of body mass. Metabolism of fibrinogen was stimulated, while
      incorporation of 15N into thrombocyte proteins was decreased in the patients with
      atherosclerosis as compared with healthy persons. Possible reasons of these
      alterations are discussed.

PMID- 1750200
TI  - [Various features of the formation and secretion of bile acids in spontaneous
      atherosclerosis].
AB  - Main pathways of cholesterol catabolism were found to be dissimilar in patients
      with spontaneous coronary atherosclerosis accompanied by hyperlipoproteinemia as
      compared with healthy persons of the same age. In the patients, independently of
      the hyperlipoproteinemia type, a longer pathway prevailed which terminated at the
      step of cholic acid formation, while in healthy persons the shorter pathway was
      found to be discontinuous after chenodeoxycholic acid production. The specific
      property of cholesterol catabolism in healthy persons appears to be due to a
      decrease in activity of V12 alpha-hydroxylase thus protecting against development
      of spontaneous atherosclerosis.

PMID- 1750201
TI  - [Stability of serum immunoglobulin conformation in various tumors].
AB  - As shown by means of temperature-perturbation differential spectrophotometry
      blood serum immunoglobulins G from patients with gastric cancer and with some
      other tumors were more resistant to 2 M urea as compared with the immunoglobulins
      from healthy volunteers and patients with gastric ulcerous disease. The
      resistance of IgG conformation was altered in the course of gastric cancer
      treatment.

PMID- 1750202
TI  - [Characteristics of the structure and biological role of lysophospholipids].

PMID- 1750203
TI  - [Proteolytic lysosomal enzymes in ovarian cancer].
AB  - Activity of lysosomal proteinases cathepsins B and D was studied in normal
      tissues, malignant and benign ovary tumors, in blood sera and ascites fluid of
      patients with primary ovary cancer. The cathepsin B activity was 12-fold higher
      in tissues of ovary malignant tumors as compared with that of normal ovary and 6
      fold higher -- as compared with tissues of benign tumors. Activation of the
      enzyme depended directly on the mass of malignant tumors and on the intensity of
      their penetration into surrounding tissues (uterus, urinary bladder, small pelvic
      fat) and spreading over peritoneum. Activity of cathepsin D was 2- and 2.6-fold
      higher in malignant ovary tumors as compared with normal tissue and benign
      tumors, respectively. The data obtained suggest that estimation of cathepsins B
      and D activities in bioptic material from ovary tumors might be useful for
      diagnosis of the disease.

PMID- 1750204
TI  - [Comparative characteristics of membrane bound and cytoplasmic monoamine oxidases
      in human placenta].
AB  - Catalytic and physico-chemical properties of human placental monoamine oxidases
      (MAO) were studied. Both forms of the enzyme, membrane-bound and soluble,
      exhibited similar properties: optimal activity at pH8.3, equal rate of inhibition
      with selective MAO inhibitors, identical substrate specificity (the best
      substrate--serotonin). Some specific differences were found only for cytoplasmic
      (soluble) MAO: lower affinity for substrates as compared with membrane-bound
      enzymes, reversible interaction with an inhibitor Lilly 51641 even after long
      term preincubation, whereas the mitochondrial MAO bound Lilly 51641 irreversibly.
      The property of cytoplasmic MAO to form aggregates during storage and/or in gel
      filtration and concentration did not affect the main catalytic properties of
      soluble enzyme. Analysis of isoenzyme spectra of membrane-bound and cytoplasmic
      MAO by means of selective inhibitors and electrophoresis showed that MAO of the
      two types--A and B were detected in all the subcellular fractions studied.
      Subunits of MAO of the A type had molecular masses 62, 61 and 61 kDa and of MAO
      of the B type--51, 55 and 55 kDa in mitochondria, microsomes and cytosol,
      respectively.

PMID- 1750205
TI  - [Brain monoamine oxidase during aging].
AB  - MAO activities were studied in 4 months old and 19 months old Wistar rats. MAO-B
      activity was higher in brain stem and hemispheres of old rats as compared with
      that of young animals. MAO-A activity was lowered only in the stem and was not
      changed in the hemispheres of old rats. Actinomycin D increased MAO-A activity in
      the brain stem of young rats and lowered MAO-B activity in the hemispheres of old
      rats. Emotional stress increased MAO-A activity in the stem and hemispheres of
      both young and old animals. Actinomycin D abolished the stress effect on these
      two forms of MAO both young and old rats. Delta-sleep including peptide at the
      dose of 120 micrograms/100 g increased MAO-A activity and lowered MAO-B activity
      in young animals but did not affect the MAO-A activity in old rats.

PMID- 1750206
TI  - [Regulation of the activity of brain cytoplasmic creatine kinase by pyridine
      nucleotides].
AB  - Effect of oxidized and reduced forms of pyridine nucleotides on activity of
      creatine kinase BB was studied in rat brain. NAD did not affect the enzymatic
      activity at concentrations of 1.0-4.0 mM, while in presence of NADH activity of
      creatine kinase BB was gradually decreased as the coenzyme concentration
      increased. The plot of 1/V against 1/S at various NADH concentrations produced a
      series of lines intersecting at one point (-1/Km), thus indicating the
      noncompetitive type of brain cytoplasmic creatine kinase inhibition by reduced
      pyridine nucleotides. Apparent Ki value for NADH was about 1.5 mM which was lower
      than the known parameter for cytoplasmic creatine kinase isozymes from skeletal
      and heart muscles. Dependence of brain creatine kinase BB on the rate of pyridine
      nucleotide reduction suggested a possible mechanism for the enzyme regulation
      under hypoxic conditions.

PMID- 1750207
TI  - [The effect of early visual deprivation on the level of N-acetyl-1-asparaginic
      acid and the activity of phosphate-activated glutaminase in visual analyzer
      structures and various regions of the dog cerebral cortex and cerebellum].
AB  - Under conditions of 45-days visual deprivation content of N-acetyl-L-aspartic
      acid was considerably increased in visual cortex (field 17) tissues and decreased
      in the superior colliculus and exterior geniculate body. At the same time,
      content of N-acetyl-L-aspartic acid was not altered in the visual cortex
      mitochondrial fraction; in the outer structures studied level of this amino acid
      was distinctly decreased both in tissues and mitochondrial fractions. After
      prolongation of the visual deprivation up to 90 days content of N-acetyl-L
      aspartic acid was sharply decreased in tissues and mitochondrial fractions of all
      the formations studied of dog brain visual analyzer. The maximal 4.5-fold
      decrease was found in mitochondrial fractions of the visual analyzer (field 17),
      in the exterior geniculate body and superior colliculus content of the amino acid
      was decreased 2.4-3.9-fold as compared with controls. In 90 days-long visual
      deprivation total activity of phosphate-dependent glutaminase was considerably
      increased (1.18-3.71-fold as compared with controls) in myelinic (A), membraneous
      (B), light (C), and heavy synaptosomal and synaptic mitochondrial (E)
      subfractions of the visual cortex (field 17). The rate of the enzyme activation
      was distinctly higher in these subfractions as compared with that of the motor
      and parietal cortical subfractions. After 90 days-long visual deprivation the
      similar alterations were found in A, B, D and E cerebellum subfractions but these
      alterations were less distinct as compared with the visual, motor and parietal
      subfractions.

PMID- 1750208
TI  - [Stable reduction of endogenous insulin production in the body in experimental
      insulin-dependent diabetes].
AB  - Implantation of beta-cells allogenic culture into animals with alloxan diabetes
      did not produce persistent positive effect. The implanted beta-cells lost their
      viability as a result of toxic effect of natural diabetogenic factor occurring in
      blood plasma during insulin-dependent diabetes. Long-term administration of
      heparin into these animals within first 90 days of the experiment enabled to
      avoid the negative phenomenon and to neutralize the diabetogenic factor activity.
      Under these conditions the implanted beta-cells effectively produced endogenous
      insulin and the symptoms of diabetes disappeared within 14 months.

PMID- 1750209
TI  - [Pancreatic glycosaminoglycans in acute pancreatitis].
AB  - Content of glycosaminoglycans was increased in pancreas of rats with acute
      pancreatitis. With development of the disease not only content of
      glycosaminoglycans but heterogeneity of their molecules were increased. This
      suggests that carbohydrate chains of glycosaminoglycans were degraded; the rate
      of degradation correlated with severity of pancreatitis.

PMID- 1750210
TI  - [Age-dependent status of the antioxidant system of rat tissues under the effect
      of short-term vibration].
AB  - Oxidation of low molecular thiols and ascorbic acid, alterations in superoxide
      dismutase, catalase, glutathione reductase and glucose-6-phosphate dehydrogenase
      activities were observed in erythrocytes and tissues of rats after short-term
      total vertical vibration. The rate of alterations found depended on the initial
      state of the antioxidative system components as well as on the vibration
      duration. The most pronounced impairments of the antioxidative system were
      detected in blood and nervous system of old animals in which the initial level of
      the antioxidative system functional activity was minimal.

PMID- 1750211
TI  - [Regulation of by arginine of cytochrome p-450 activity and lipid peroxidation in
      rat liver and testicular tissue during hypoxia].
AB  - Arginine, preadministered intraperitoneally at a dose of 120 mg per 100 g of body
      mass before hypoxia, decreased content of diene conjugates by 42-64% and Schiff
      bases by 7-15% in rat liver and testicular microsomal membranes as compared with
      control rats nontreated with arginine. Under these conditions cytochrome P-450
      catalytic activity with aniline as a substrate was increased by 65-152% and with
      amidopyrine as a substrate--by 72-148%, respectively. Exogenous arginine
      inhibited an increase in membranes microviscosity, specific for hypoxic state;
      relative microviscosity of lipid bilayer was decreased by 36% and of the protein
      lipid contact zones--by 84% as compared with control hypoxic animals.

PMID- 1750212
TI  - [Efficacy of various antioxidants in experimental ischemia and myocardial infarct
      in the rat].
AB  - Complex of vitamins E and C showed the most effective antinecrotic action in rats
      with simulated myocardial infarction in series of antioxidants studied:
      ascorbate, alpha-tocopherol, quercetine, derivatives of o-benzoquinone OBQ2 and
      OBQ3. Stabilization of lipid peroxidation in cardiomyocytes, increase in
      biomembranes stability and absence of distinct alterations in the antioxidative
      enzymatic system were found in rats with ischemia and myocardial infarction after
      treatment with the complex. Protective effect of the vitamins E and C complex was
      realised via antiradical mechanism.

PMID- 1750213
TI  - [Effect of the functional state of the central nervous system on brain lipid
      peroxidation processes in experimental cranial-brain trauma].
AB  - Interrelationship between the functional state of central nervous system and
      brain metabolism was studied in animals with craniocerebral trauma. Stimulation
      of nervous activity was shown to prevent an increase in lipid peroxidation in
      brain of the experimental animals. A distinct decrease of the brain antioxidative
      activity was also noted. Lipid peroxidation and antioxidative activity were
      markedly impaired in the animals with craniocerebral trauma either after
      depression of central nervous system or without any additional treatment.

PMID- 1750214
TI  - [Metabolism of thiamine and its di- and triphosphorus esters in the blood of
      patients with neurological symptoms of osteochondrosis].
AB  - Concentrations of phosphate esters in blood of patients with vertebral
      osteochondrosis and activities of enzymes involved in thiamine metabolism have
      been investigated. The pathological processes were characterized by a decrease in
      content of thiamine triphosphate while concentration of coenzyme, thiamine
      diphosphate, was relatively constant. The enzymes involved in the initial and
      final steps of biosynthesis and degradation of thiamine phosphorylated
      derivatives play the main role in maintaining vitamin B1 metabolic homeostasis.

PMID- 1750215
TI  - [Metabolic function of isolated liver mitochondria during various conditions of
      vitamin D and K supply and administration of pelentane].
AB  - Alimentary deficiency of vitamin K caused a decrease in the rate of respiration
      in presence of ADP and in the rate of oxidative phosphorylation in the presence
      of succinate. Administration of the antivitamin K pelentane, excess of vikasol
      and deficiency of vitamin D did not affect these parameters. As distinct from
      controls and rats treated with pelentane, transport of calcium was decreased in
      presence of all the substrates studied in mitochondria isolated from liver tissue
      of animals deprived of vitamins K and D as well as of animals treated with
      vikasol excess. At the same time, accumulation of calcium led to time-dependent
      inhibition of respiratory chain if NAD-dependent substrates were used. Possible
      reasons of dissimilarity observed are discussed; the phenomenon found may occur
      due to exhaustion of the mitochondrial pyridine nucleotides pool. The data
      obtained suggest that antivitamins K altered only some parameters of body status
      (prothrombin time) similarly to the alterations observed in alimentary deficiency
      of vitamin K.

PMID- 1750216
TI  - [Level and ratio of prostaglandins group E and F2(alpha) in bronchoalveolar
      washes in pulmonary tuberculosis patients].
AB  - Content of prostaglandins PGE and PGF2 alpha was studied by means of
      radioimmunoassay; their ratio was calculated in bronchoalveolar lavages obtained
      from impaired lung and from contralateral, intact lung of 86 patients with
      various forms of pulmonary tuberculosis. Concentration of prostaglandins was
      calculated per 1 mg of protein in lavage to standardize the data obtained. In the
      patients with tuberculosis production of PGE was increased in both lungs.
      However, the prostaglandin content was distinctly higher in the impaired lung but
      approximately similar in various forms of the disease. Hyperproduction of PGF2
      alpha occurred in the impaired lung and depended on the type of the process.
      Content of PGF2 alpha was maximal in complicated destructive forms of
      tuberculosis. Bronchial muscle tension depended on the ratio of both groups of
      prostaglandins in bronchoalveolar space. Bronchial obstruction was accompanied by
      a decrease of PGE content in intact lung and by high concentration of PGF2 alpha
      near the tuberculosis focus.

PMID- 1750217
TI  - [Physico-chemical properties of alveolar surfactant in intermediate type
      allergy].
AB  - Development of sensitization involved accumulation of protein, lipoproteins and
      neutral triglycerides in lung surfactant, which inactivated surface active
      phospholipids and decreased the surface activity of surfactant. In anaphylactic
      shock a decrease in content of phospholipids and alteration of their fatty acid
      spectrum occurred as a result of which the moistening capacity of the covering
      complex was lowered and expiration of the bronchoalveolar secretion was
      restricted thus contributing to formation of asphyxia.

PMID- 1750218
TI  - [Use of reagents from various firms in the "Spectrum" biochemical analyzer made
      by Abbott Laboratories].

PMID- 1750219
TI  - [Enzymatic methods for quantitative determination of total cholesterol in blood
      serum].
AB  - Advantages and disadvantages of enzymatic assays of total cholesterol content in
      human blood serum are reviewed. Factors, affecting these assays are discussed:
      specificity of the enzymes used (cholesterol esterase and cholesterol oxidase),
      conditions of analysis and composition of the reaction mixture, interference with
      components of blood serum. Adaptation of the enzymatic assays of total
      cholesterol estimation for various types of biochemical analyzers, including
      systems containing immobilized enzymes, is considered.

PMID- 1750220
TI  - [Spectrophotometric determination of lipid peroxidation end products].
AB  - Spectrophotometric assay of the final lipoperoxidation products based upon light
      absorption at 400 nm was developed. Relative content of these products in
      different phases of lipid extract was calculated as E400/E220 ratio. Data
      obtained by the technique developed were consistent with those of histochemical
      results. Appreciable correlation between the relative lipoperoxidation products
      content and age was demonstrated.

PMID- 1750221
TI  - The present status of eicosanoids and related substances in the control of the
      cardiovascular system.

PMID- 1750222
TI  - [Metabolism of intravenously administered prostaglandin E1 in patients with
      peripheral arterial occlusive disease].
AB  - Using high performance liquid chromatography and radioimmunoassay we have
      investigated the stability of prostaglandin (PG) E1 and its metabolite 13,14
      dihydro-PGE1 in human plasma as well as the initial metabolism of PGE1 infused
      intravenously (80 micrograms/patient/hour) in patients with peripheral arterial
      occlusive disease. 13,14-dihydro-PGE1 degraded like PGE1 in human plasma at 37
      degrees C with a half-life of several hours. During infusion of PGE1 higher
      plasma concentrations of the major metabolite 15-keto-13,14-dihydro-PGE1 and
      lower plasma levels of PGE1 and 13,14-dihydro-PGE1 were observed. The metabolite
      13,14-dihydro-PGE1 is of interest, since in contrast to 15-keto-13,14-dihydro
      PGE1 it is biologically active. The biosynthesis of 13,14-dihydro-PGE1 could
      contribute to the therapeutic efficacy of PGE1 administered intravenously in
      patients with peripheral arterial occlusive disease.

PMID- 1750223
TI  - [Prostaglandin E1 in therapy of peripheral arterial occlusive disease].
AB  - The intraarterial and intravenous infusion of prostaglandin E1 (PGE1) today is
      well established in the therapy of peripheral arterial occlusive disease. This
      review summarizes the results of pharmacological-clinical studies and the
      influence of PGE1 on the pathomechanism of ischaemia due to its antithrombotic,
      leukocyte and endothelial stabilizing properties. Clinical data available on
      continuous and intermittent infusion for both modes of administration are
      critically appraised, taking into account more recent data on active metabolites.

PMID- 1750224
TI  - [Risk factors of atherosclerosis: results of screening in Southern Austria].
AB  - In the western industrialized countries atherosclerosis is the leading cause of
      death. In this investigation serum cholesterol and blood pressure were measured
      in 4321 (60.9% females) inhabitants of Lower Austria. In addition, a short
      cardiovascular history was taken and age, sex, body weight, height and smoking
      habits were recorded. In the various villages the mean serum cholesterol differed
      considerably (194 +/- 52-244 +/- 49 mg/dl). Overall, women had a slightly, but
      non-significantly, higher serum cholesterol (224.0 +/- 53.5 mg/dl) than men
      (218.6 +/- 58.4 mg/dl). Although 2/3 of the participants showed an elevated serum
      cholesterol, only 6% were taking lipid lowering drugs. An age-dependent increase
      in cholesterol was found in women, whereas this correlation was present in men
      only until the age of 40. Approximately 30% of the participants reported a
      positive family history. A comparison with the mortality register showed a
      correlation between smoking and bronchogenic cancer. No correlation, however, was
      demonstrable between smoking and cardiovascular mortality--perhaps due to
      methodological difficulties. Regional analysis of the results indicates the
      importance of the role of local general practitioners in the prevention of
      atherosclerosis.

PMID- 1750225
TI  - Cocaine alters heart rate dynamics in conscious ferrets.
AB  - This study was designed to test the hypothesis that cocaine intoxication induces
      distinctive alterations in sinus rhythm heart rate dynamics. Time-series and
      spectral analysis techniques were used to examine the effects of lethal doses of
      cocaine on heart rate variability in conscious, restrained ferrets. In all
      animals (n = 5), cocaine administration resulted in a marked decrease in sinus
      rhythm heart rate variability prior to sudden death. Heart rate variability
      (coefficient of variation of heart rate) just prior to death (0.018 +/- 0.005)
      was significantly (p less than 0.02) decreased compared to that at baseline prior
      to cocaine administration (0.061 +/- 0.022). There was also a significant (p less
      than 0.02) decrease in total spectral power prior to death compared to baseline.
      Transient low-frequency (0.04-0.10 Hz) oscillations in heart rate were also noted
      in three of the five animals following cocaine administration. There were,
      however, no significant changes in mean heart rate in response to cocaine.
      Alterations in heart rate dynamics were not seen in three saline-treated
      controls. Lethal effects of cocaine included ventricular arrhythmias (n = 2) and
      seizures (n = 3). One animal developed transient ST segment elevations that were
      consistent with coronary vasospasm. In conclusion, lethal doses of cocaine in the
      conscious ferret induce characteristic alterations in heart rate dynamics. These
      abnormalities (loss of heart rate variability and the appearance of low-frequency
      heart rate oscillations) are similar to those reported previously in certain
      patients at high risk of sudden cardiac death due to organic heart disease.

PMID- 1750226
TI  - Roentgen therapy for infections: an historical review.
AB  - Radiation was used extensively for the treatment of all types of infections
      before the advent of antibiotics. Although this mode of therapy is now in
      disrepute, radiation therapists of that era were firm believers in the ability of
      radiation to cure infections. A review of the literature suggests, but certainly
      does not prove, that low-dose local radiation, in the range of 75 to 300
      roentgens, is an effective treatment modality for a wide variety of infections.
      Two then-prevailing rationales held that the effect was due either to radiation
      damage to the immune cells, causing stimulation of the immune response, or to the
      increase in local inflammation with resultant increased blood flow. Modern
      research has been limited but provides support for both arguments. Although there
      are no present indications for using radiation as therapy for infectious disease,
      a reasonable argument can be made from the available data that radiation is
      effective for the treatment of localized infections. The mechanisms of low-dose
      radiation as a treatment for infections remain unclear. The known and probable
      long-term sequelae of low-dose local irradiation preclude its common use for this
      condition. Nevertheless, it is hoped that this review will stimulate
      investigations into this relatively unexplored area of radiobiology.

PMID- 1750227
TI  - Ozone, air pollution, and respiratory health.
AB  - Of the outdoor air pollutants regulated by the Clean Air Act of 1970 (and
      recently revised in 1990), ozone has been the one pollutant most difficult to
      control within the federal standards. The known human health effects are all on
      the respiratory system. At concentrations of ozone which occur during summer air
      pollution episodes in many urban metropolitan areas of the United States, a
      portion of the healthy population is likely to experience symptoms and reversible
      effects on lung function, particularly if exercising heavily outdoors. More
      prolonged increase in airway responsiveness and the presence of inflammatory
      cells and mediators in the airway lining fluid may also result from these
      naturally occurring exposures. Serial exposures to peak levels of ozone on
      several consecutive days are more characteristic of pollution episodes in the
      Northeast United States and may be associated with recurrent symptoms. No "high
      risk" or more sensitive group has been found, in contrast to the case of sulfur
      dioxide, to which asthmatics are more susceptible than normals. The occurrence of
      multiple exposure episodes within a single year over many years in some areas of
      California has led to studies looking for chronic effects of ozone exposure on
      the lung. To date, no conclusive studies have been reported, although further
      work is under way. Much of what we know about the effects of this gas on the lung
      are based on controlled exposures to pure gas within an environmental exposure
      laboratory. Interactions between substances which commonly co-occur in air
      pollution episodes are also under investigation.

PMID- 1750229
TI  - [Percutaneous balloon valvuloplasty of pulmonary stenosis in childhood: early
      hemodynamic results and long-term Doppler echocardiography results].
AB  - Pulmonary balloon valvuloplasty was performed in 35 children aged 3 days to 18
      years (mean 4.5 years). Balloon/annulus ratio was 1.21 +/- 0.12. There were 6
      infants less than 1 year of age (including 1 newborn), 4 with dysplastic valves
      and 4 with postoperative restenosis. Systolic transvalvular gradient showed a
      decrease of 69 +/- 14% from 68 +/- 15 mm Hg before to 21 +/- 11 mm Hg after
      dilatation (p less than 0.0001), and right ventricular pressure/systemic pressure
      ratio decreased from 0.8 +/- 0.29 to 0.4 +/- 0.15 (p less than 0.0001). Follow-up
      studies were performed in all patients up to 5 years (2.5 +/- 1.3 years) after
      dilatation. In 63% (22/35) follow-up period was more than 2 years (3.5 +/- 0.95
      years). Doppler derived gradient had further decreased to 16 +/- 11 mm Hg (n.s.).
      Results in the 6 infants showed an immediate gradient relief of 71 +/- 11% from
      85 +/- 4 mm Hg to 25 +/- 10 mm Hg (p less than 0.0001) with a further decrease to
      20 +/- 10 mm Hg at follow-up. There were two early complications which had to be
      treated (tachycardia in WPW-syndrome, femoral vein dissection), no late
      complications were seen. The good immediate results and high persistent long-term
      success rate confirm balloon pulmonary valvuloplasty being the treatment of first
      choice for all patients in childhood.

PMID- 1750228
TI  - Effects of calcium channel blockers on potassium homeostasis.
AB  - The known effects of calcium channel blockers on various aspects of potassium
      homeostasis are reviewed. Regulation of potassium homeostasis requires both renal
      and external handling mechanisms. Signaling by calcium appears to mediate both of
      these. Calcium channels have been identified in adrenal glomerulosa cells, and
      cellular calcium entry has been demonstrated in vitro to be necessary for the
      synthesis and secretion of aldosterone. Calcium channel antagonists such as
      verapamil and nifedipine, at pharmacologic doses, can block aldosterone
      production. In vivo, however, only chronic administration of verapamil appears to
      attenuate aldosterone responsiveness to angiotensin II. Chronic administration of
      nifedipine does not have a dramatic effect on aldosterone production following
      potassium loading. Other studies have demonstrated improved extrarenal potassium
      disposal following treatment with calcium channel blocking agents. Clinically,
      there are no reports of either hyperkalemia or hypokalemia with the routine
      therapeutic use of these agents given alone. This review was prompted by the
      development of hyperkalemia in a patient with chronic renal failure following the
      initiation of therapy with the calcium channel blocker diltiazem: however,
      numerous other etiologies may also have contributed to the development of
      hyperkalemia in this case. Review of the data indicates that current evidence
      implicating this class of drugs in the pathogenesis of disordered potassium
      regulation remains equivocal.

PMID- 1750230
TI  - [Experiences with the Rashkind duct occluder].
AB  - In five patients, aged from 34 to 64 years, a persistent ductus arteriosus was
      occluded transvenously with a Rashkind umbrella occluder. The diameter of the
      ductus ranged from 3.6 to 9 mm, the pulmonary artery pressure ranged from 20/4 to
      55/25 mm Hg. Four patients had calcifications of the ductus wall. In one patient
      with a very large ductus a first occluder embolized into the pulmonary artery and
      was removed together with the introducer sheath. The ductus was occluded with a
      second umbrella. However, there was a residual shunt in this patient. In all
      other patients the procedure was successful without residual shunt.

PMID- 1750231
TI  - [Diagnosis by endomyocardial biopsy: angina pectoris as a manifestation of lupus
      erythematosus].
AB  - A 64-year-old female patient with a prosthetic mitral valve suffered from
      recurrent typical angina and dyspnea. Left heart catheterization excluded a
      dysfunction of the prosthesis and coronary artery disease (CAD). A stress
      thallium scan demonstrated an ischemic reaction. An antimyosin scintigram was
      positive, indicating myocytal membrane disruption. Serological tests were
      suspicious for systemic lupus erythematosus (SLE). Therefore, an endomyocardial
      biopsy (EMB) was performed and a severe alteration of an intramyocardial artery,
      comparable with chronic SLE, was diagnosed. EMB is a useful diagnostic tool in
      patients with typical chest pain, positive thallium and anti-myosin scintigrams,
      however exclusion of CAD.

PMID- 1750232
TI  - [Diagnosis and classification of tricuspid valve insufficiency with dynamic
      magnetic resonance tomography: comparison with right ventricular angiography].
AB  - To evaluate the diagnostic potential of magnetic resonance imaging (MRI) to
      diagnose and evaluate tricuspid incompetence (TI), right ventricular angiography
      (RVA) and MRI were compared in 51 patients. For angiographic semi-quantification
      a 4-grade modified Sellers classification was used. Several MRI-parameters (jet
      volume, jet area, number of slices with visible jet, duration of the
      regurgitation and volume of the right atrium) were examined concerning their
      validity to evaluate TI and compared to the angiographic data. Limits for MRI jet
      areas and volumes for each angiographic group were defined to obtain the best
      agreement with angiographic results. Thirty of 34 patients with angiographically
      visible TI (sensitivity = 88%) were diagnosed correctly with MRI. The 4 remaining
      patients also showed a small regurgitant jet which was, however, interpreted as
      physiologic. One of the 17 patients without angiographic TI was diagnosed as mild
      TI by MRI (specificity = 94%). MRI classification using jet volume (46/51 = 90%
      correct classifications) was not significantly better than the easier and faster
      MRI classification using jet area (43/51 = 84%). The other parameters (number of
      slices, duration of regurgitation and volume of the right atrium) showed
      considerable overlap between angiographic groups and did therefore not allow a
      classification into 4 grades. However, simple classification into hemodynamic
      relevant and irrelevant TI was possible. Thus MRI is able to diagnose TI with
      good sensitivity and specificity. Classifications based on jet volume and jet
      area showed good agreement with angiographic results. However, both parameters
      depend on the magnet and the pulse sequence used and must therefore be
      specifically determined for each imaging routine.

PMID- 1750233
TI  - [Diagnosis of arrhythmogenic right ventricular disease using magnetic resonance
      tomography].
AB  - In our study, 12 patients with ventricular arrhythmias, but without any
      documented cardiac disease, and 10 healthy volunteers were investigated by spin
      echo magnetic resonance tomography (MRT) using a 0.5 Tesla magnet. Axial T1
      weighted spin-echo sequences, as well as double angulated, multislice-multiphase
      sequences were acquired. Left- and right-ventricular volumes were then evaluated
      by outlining the endocardium in an end-systolic and an end-diastolic frame. The
      right-ventricular free wall and the right-ventricular outflow tract were
      investigated for myocardial thickness and intramural fat.

PMID- 1750234
TI  - [Principles, epidemiology and pharmacotherapeutic interventions in
      atherosclerosis].

PMID- 1750235
TI  - [Apotheosis and tragedy of S. S. Iudin].

PMID- 1750236
TI  - [Biomedical aspects of the use of cadaver blood].
AB  - The author analyzes historical periods during which Academician S. S. Yudin
      developed the theory of cadaveric blood and pioneered its practical
      implementation, storage and the clinical use. Demonstrates the efficacy of the
      new transfusion medium in the management of patients with emergency conditions.
      Reviews 3 trends in the investigations carried out in this area: in morbid
      anatomy and forensic medicine, in experimental and clinical transfusiology, and
      in biomedical studies. Provides evidence for the fact that blood plasma of sudden
      death victims and perfusate of the vessels are specific raw materials for
      obtaining plasmakinase, a fibrinolytic agent, and fibrinogen degradation products
      as well as another source for obtaining preparations with a directed action.
      Based on a large factual material, the author shows the possibility, importance,
      prospects and efficiency of the use of components, preparations and biologically
      active substances from cadaveric blood plasma.

PMID- 1750237
TI  - [A goal-oriented local approach to the prevention of postoperative suppurative
      complications].
AB  - A goal-oriented local approach to the prevention of postoperative purulent
      complications includes the use of compression suture devices to establish
      intestinal anastomoses and a complex of measures aimed at preventing surgical
      wound suppurations. To form compression anastomoses, use was made of the original
      AKA-2, AKA-4, IZhKA and SPTU devices fitted with compression clamps and of magnet
      facilities. The complex of measures to prevent postoperative wound suppurations
      includes optimal methods of laparotomy wound suture and the use of antibacterial
      suture materials, bathing of the wound by pulsed douche under pressure, local
      antibacterial prophylaxis by new dosage forms, preventive aspiration lavage and
      drainage of the wounds. Comparative clinical investigations carried out in more
      than 3,000 patients have demonstrated the effectiveness of the preventive methods
      under consideration and a decrease of the rate of postoperative wound
      suppurations from 11.7 to 2.3%. The rate of anastomosis failure amounted to 2.7%.

PMID- 1750238
TI  - [Use of fibrinolysis blood in patients with acute surgical diseases and
      injuries].
AB  - S. S. Yudin paid much attention to the use of cadaveric blood in urgent medicine.
      While transfusing large amounts of blood (2-3 1) for pre- and intraoperative
      correction of hypovolemia, the danger of isoimmune reaction is reduced. Blood
      circulation measurement fluctuations while using both cadaveric and donor's blood
      are similar. However, the use of cadaveric blood helps correct hypercoagulation
      caused by some anesthetics. Cadaveric blood can be substituted for donor's blood.
      Besides, large amounts of cadaveric blood can be used from the same donor, which
      provides economic effectiveness.

PMID- 1750239
TI  - [Realization of the decisions of the 61st session of the General Meeting of the
      USSR Academy of Medical Sciences and further goals of the Academy].

PMID- 1750240
TI  - [Plastic surgery of the pharyngo-esophageal junction as a new method of the
      surgical treatment of achalasia of the upper esophageal sphincter].
AB  - Dramatic disorders of swallowing function of the central genesis (mostly because
      of cerebral circulatory disturbances) can be eliminated by surgery. Based on the
      first experience gained in this country with aphagia correction the author
      devised and employed a new method of surgical treatment--plasty of the
      pharyngoesophageal transition, providing beneficial short- and long-term results.

PMID- 1750241
TI  - [Surgical tactics in patients with postburn cicatricial esophageal stenosis].
AB  - Surgical policy during the first years after burn was aimed at the recovery of
      natural nutrition. To achieve that, esophageal bougienage (503 cases) or total
      retrosternal esophagoplasty from the large intestine (192 cases) were performed.
      The authors hold that in order to attain complete medical rehabilitation for the
      patients, it is necessary to remove all the cicatricially changed tissues.
      Esophageal resection was performed in 78 patients, including 27 with preservation
      of the n. vagus. In the long-term postburn period, a problem arises as to the
      surgical correction of functional and morphological alterations associated with
      the establishment of artificial esophagus (80 cases including 35 patients who
      were operated on by S. S. Yudin). While choosing surgical policy it is necessary
      to take into account both the technical skills of a surgeon and the whole complex
      of changes in the patient's body, which have already developed and are going to
      develop in the future.

PMID- 1750242
TI  - [Effectiveness of the treatment of chemical burns of the esophagus by local
      endoscopic laser therapy].
AB  - Overall 240 patients with chemical burns of the esophagus were examined. Local
      endoscopic treatment with the aid of lasers was applied in 180 victims. The
      efficacy of different types of laser radiation was compared in terms of the times
      of the healing of the esophageal wall. It is concluded that further studies
      should be carried out in the given area.

PMID- 1750243
TI  - [Pathogenetic bases of the use alpha-tocopherol and emoxypin in acute
      hemorrhage].
AB  - The accumulation of lipid peroxidation (LP) products and decrease of alpha
      tocopherol (TP) content were demonstrable in the heart, lungs, kidneys and liver
      after acute blood loss. Injection of TP acetate inhibited LP and raised the
      content of endogenous TP in the heart, lungs and liver. The antioxidant emoxypin
      increased the reduced oxygen tension in the liver and kidneys after blood loss.
      The drug prevented the reduction of the glucocorticoid type II receptor level and
      increased the content of the type III receptors in liver cytosol of hemorrhagic
      animals.

PMID- 1750244
TI  - [Mechanisms of enteral correction of posthemorrhagic hypovolemia].
AB  - It has been demonstrated in chronic experiments that after hemorrhage liquid
      absorption from the small intestine does not interfere with the process of its
      supply from the interstice. Totally both these processes considerably enhance the
      degree of autohemodilution. Infusion of the electrolyte monomer solution to the
      duodenum of the dogs which suffered hemorrhage (20-50 ml/kg bw) ensure, during
      the preserving of absorption function, a rapid and stable growth of the
      circulating plasma volume, proteins, sodium and potassium, being an effective
      means of steady replenishment of posthemorrhagic hypovolemia. Reduction of water
      retaining plasma components discovered in the experiments attests to the
      participation of the digestive organs in formation of the basic volemia substrate
      water-protein-electrolyte in volemic homeostasis maintenance.

PMID- 1750245
TI  - [Anthropogenic low-intensity environmental factors and life expectancy: new
      aspects of the problem].
AB  - Based on their own universal concept of the causal relationship between chemical
      environmental agents and the human body, confirmed by numerous experimental data,
      the authors suggest that the biological process of aging may be accelerated or
      inhibited under exposure to chemical low-intensity environmental factors due to
      changes in the nonspecific resistance of the body.

PMID- 1750246
TI  - [Diabetes mellitus: facts and hypotheses].
AB  - The paper summarizes the experience gained in examining diabetes mellitus and its
      complications in the experimental and clinical settings for many years. It
      forwards the basic aspects in the major problems of diabetology: etiology,
      pathogenesis, prevention, and therapy. The paper analyses the fate of some
      hypotheses advanced in different years and emphasizes new advances made in theory
      and practice of medicine.

PMID- 1750247
TI  - [Lung cancer and age factor].
AB  - The authors provide the results of examination and treatment of 920 young
      patients under 45 (group I) and 462 elderly patients aged 60-74 years (group II).
      It has been revealed that in the young patients, primarily affected were the
      distal, proximal, intermediate and main bronchi. In group I patients, the tumor
      was localized in the intermediate or in the main (extrapulmonary) bronchus (in
      6.9 and 9.8% of cases, respectively). In the elderly patients, the analogous data
      accounted for 2.7 and 1%, respectively. The segmental bronchi were more often
      involved in the patients of group II (11.3%) than in those of group I (5.3% of
      the cases examined). Analysis of the forms of lung carcinoma shows that in group
      I patients, the tumor was more often located near the root. Thus, in the young
      patients, the nodular peribronchial and peripheral (connected with the bronchus
      gap) forms of growth have been recorded in 34.1 and 25% of the cases examined
      whereas in the elderly patients, only in 14 and 13.1% of the cases. It has been
      noted that group I patients mostly demonstrated poorly differentiated carcinoma
      (47.6%) rather than high-differentiated epidermoid cancer (35.8%). Meanwhile high
      differentiated adenocarcinoma was seen only in 16.4% of the cases analyzed. In
      the elderly patients, the estimates were respectively 29.6, 59.0 and 11.2%. It
      should be emphasized that in young male patients, poorly differentiated carcinoma
      occurred 1.7 times more often that in group II patients (48.8 and 28.3%,
      respectively).

PMID- 1750248
TI  - [Structural bases of the barrier-protective function of the stomach and small
      intestine].
AB  - The gastrointestinal tract acts as a barrier-protective tool in addition to its
      digestive and transport functions. The structural bases of the barrier protective
      function of the stomach and small intestine were shown in health, duodenal ulcer
      (DU), experimental gastroduodenal ulcers (GDU), vagotomy, and peritonitis in case
      of the interaction of these structures with parietal microflora (PM) which may be
      a valid criteria for assessing the barrier-protective function. PM increases in
      number in DU, GDU, vagotomy, and peritonitis. Various modifying interventions can
      normalize this parameter. Identifying the components of protective levels makes
      it possible to differentiate the affect of protective levels and makes it
      possible to differentiate affect some links of the barrier-protective function in
      order to restore it or prevent its disturbance.

PMID- 1750249
TI  - [Resolutions of the 62d session of the General Meeting of the USSR Academy of
      Medical Sciences].

PMID- 1750250
TI  - Gestational diabetes in Papua New Guinea.
AB  - Pacific populations have some of the highest prevalences for diabetes in the
      world. Whilst universal screening for diabetes in pregnancy does yield the best
      pick-up rate it is not economically feasible in developing countries. Traditional
      risk factors have increasingly been shown to miss most gestational diabetes,
      particularly in populations for whom family history is unknown and obstetrical
      history not recorded. This study shows genetic origin to be a potent marker for
      gestational diabetes in a Pacific Island population. It is recommended that in
      Port Moresby 'at-risk ethnicity' (urban Motuan or Marshall Lagoon origin) be
      added to the list of indications for antenatal glucose tolerance testing in Papua
      New Guinean women.

PMID- 1750251
TI  - Motor development and nutritional status of young children in Madang, Papua New
      Guinea.
AB  - The relationship between nutritional status and motor development was
      investigated in a cross-sectional study of 457 0-2 year old children in Madang,
      Papua New Guinea. The median ages at which the major motor developmental
      milestones are attained are almost comparable to western populations up to 6
      months of age. However, crawling and independent walking are slower to develop.
      At any given age children of higher nutritional status by weight for age (W/A),
      length for age (L/A) or weight for length (W/L) are more likely to have attained
      a given developmental stage than children of lower nutritional status.

PMID- 1750252
TI  - Betel-nut chewing may aggravate asthma.
AB  - A questionnaire survey on the relationship between chewing betel nut and asthma
      was carried out in 61 asthmatic patients who regularly attend a follow-up clinic
      at Port Moresby General Hospital. 54 of these had once chewed or were still
      chewing betel nut; 20 patients had already given it up, while 34 were still
      regular or occasional chewers. 7 patients had never chewed. 11 of the 20 patients
      who used to chew but had given up reported having stopped because of aggravation
      of their asthma. 22 of the 34 patients who still chewed also reported aggravation
      of their asthma by betel nut. Anecdotal reports were given directly linking
      specified methods of chewing the nut with asthma aggravation, in some cases
      indicating dose-response (toxicity) relationships. While more elaborate and
      objective studies are being undertaken, it is hereby suggested that patients with
      asthma be cautioned against chewing betel nut.

PMID- 1750253
TI  - Management of common potentially serious paediatric illnesses by aid post
      orderlies at Tari, Southern Highlands Province.
AB  - Systematic observations were made of a small number of aid post orderlies (APOs)
      managing children with the common but potentially serious symptoms of cough,
      fever and diarrhoea. On-site performance was evaluated against recommended
      management guidelines set out in Dr Keith Edwards' Diagnosis and Treatment of
      Common Childhood Illnesses for APOs. History taking at the aid post was brief and
      usually non-exploratory; examination of patients was often neglected. Drug
      prescription was generally appropriate for the diagnosis made, but drug dosages
      were often incorrect and treatment principles were rarely explained to guardians.
      Preventive health issues were rarely tackled. Our study reaffirms the need for on
      site assessment of the performance of paramedical workers, sets priority demands
      for continuing education of health workers, and provides a framework for
      competency-based problem-solving activities within this context.

PMID- 1750254
TI  - A survey of Papua New Guinea's health sector financing and expenditure.
AB  - As a result of increasing economic constraints in the health sector of Papua New
      Guinea, the Department of Health embarked upon a major financial policy review
      program in 1986, which incorporated several studies in key areas. This paper
      presents the results of one component of the review, a health sector financing
      and expenditure study, which was undertaken for the 1986 financial year. The
      study found that: 1) 88% of health sector expenditure was provided by the public
      sector; 2) over 95% of expenditure was used for recurrent costs and there was
      poor utilization of overseas aid for capital projects; 3) the balance of
      expenditure between primary and secondary health was appropriate; 4) there were
      regional inequities in expenditure; and 5) a disproportionate amount of recurrent
      expenditure was consumed by personnel costs. The need to increase nongovernment
      expenditure on health was identified and further investigation of alternative
      sources of financing the health sector is required.

PMID- 1750255
TI  - Supervision of rural health centres in Papua New Guinea: consolidation of the
      delivery of health services.
AB  - Aid posts and health centres remain the health facilities in most direct contact
      with the community in Papua New Guinea. The planners of health services have well
      accepted the difficulties of adverse geography and sectoral differences, and
      adapted a method of delivery which is efficient and appropriate for all levels of
      health personnel. Those peripheral staff, however, have been left to their own
      devices. It should be considered that the continued success and achievement of
      the milestones of health care in Papua New Guinea require close surveillance and
      support at the basic level. Intensive supervision is essential to the
      consolidation and progress of existing health services.

PMID- 1750256
TI  - The diagnosis and management of common forms of arthritis in adults in Papua New
      Guinea.
AB  - Reactive arthritis is the leading cause of arthritis in Papua New Guinea,
      followed probably by gonococcal arthritis. Indomethacin and local hydrocortisone
      acetate are useful in the treatment of reactive arthritis. Refractory cases of
      reactive arthritis may be helped by weekly low-dose oral methotrexate or by long
      courses of doxycycline. When Neisseria gonorrhoeae is thought to be involved
      treatment should cover penicillinase-producing strains. Infective arthritis due
      to Staphylococcus aureus and Mycobacterium tuberculosis is less common but should
      be considered in all patients because prompt and specific treatment is required
      to avoid permanent damage.

PMID- 1750257
TI  - Making family planning more effective--Papua New Guinean style.

PMID- 1750258
TI  - Primary amoebic meningoencephalitis in the Western Province.
AB  - Six cases of primary amoebic meningoencephalitis were diagnosed and treated at
      the Balimo Health Centre between December 1986 and September 1988. This disease
      has not previously been reported in Papua New Guinea although from information
      derived from other studies it should be occurring in the lowlands of Papua New
      Guinea from time to time. Although less than optimum treatment was given to the
      early cases the case fatality rate in the series was only 66%. This compares very
      favorably with a case fatality rate of nearly 100% from other studies. Early
      diagnosis and prompt treatment should help to reduce mortality.

PMID- 1750259
TI  - Impaired cell-mediated immunity in Papua New Guinean infants.
AB  - Immune function was studied in Papua New Guinea highland infants with pneumonia,
      healthy highland controls and expatriate controls under the age of 15 months.
      Delayed-type hypersensitivity to tuberculin was depressed in highland pneumonia
      patients and highland controls as were CD4/CD8 T-lymphocyte ratios. The
      differences between highland and expatriate infants were more pronounced after 6
      months of age, suggesting an environmental effect. Serum immunoglobulin and
      complement concentrations were higher in highland infants than in expatriate
      controls. Indices of nutritional status were similar in highland and expatriate
      infants but iron deficiency was more common in the highland infants in the study.

PMID- 1750260
TI  - The aetiology, management and prevention of acute respiratory infections.

PMID- 1750261
TI  - Control of acute respiratory infections in children in Papua New Guinea.

PMID- 1750262
TI  - Mortality and morbidity from acute lower respiratory tract infections in Tari,
      Southern Highlands Province 1977-1983.
AB  - Monthly demographic surveillance by village reporters has been ongoing in the
      Tari Basin since 1970. Cause of death is ascertained by verbal autopsy. 20% of
      deaths between 1977 and 1983 were from acute lower respiratory tract infection
      (ALRI). ALRI mortality rates were highest in the very young and the elderly and
      have risen since the early 1970s but declined in the 1981-1983 period when
      pneumococcal vaccine was being tested in Tari. 44% of ALRI deaths in children
      under 5 years of age occurred before the age of 6 months but ALRI mortality
      remained high during the second year of life. Utilization of health services
      before death was highly age-dependent, with the vast majority of young children
      but few elderly people receiving some form of medical attention. However, less
      than half the children who died of ALRI received inpatient care. Fortnightly
      morbidity surveillance of children between 1981 and 1983 showed that ALRI was the
      commonest cause of severe morbidity; children suffered 2-3 episodes of ALRI in
      the first year of life, 20% of which were moderate or severe disease. Improved
      case management, nutritional status and hygiene in addition to good coverage with
      pertussis and measles vaccines and immunization with efficacious pneumococcal and
      H. influenzae vaccines are required to reduce mortality and morbidity from ALRI.

PMID- 1750263
TI  - The bacteriology of acute pneumonia and meningitis in children in Papua New
      Guinea: assumptions, facts and technical strategies.
AB  - Acute respiratory infections in children aged less than 5 years in the Eastern
      Highlands of Papua New Guinea were investigated bacteriologically for 10 years
      from November 1978. Haemophilus influenzae and Streptococcus pneumoniae were
      responsible for 73% of all bacteria cultured from lung aspirate (83 samples),
      85.5% from blood (1024 samples) and 92% from cerebrospinal fluid (155 samples).
      Nonencapsulated H. influenzae was carried by up to 90% of children and was the
      predominant haemophilus type cultured from lung tissue. Mixed infections of the
      lung with two types of H. influenzae (8 cases) and both H. influenzae and S.
      pneumoniae (18 cases), commonly together with other organisms of questionable
      pathogenicity, reflected the proximity of this organ to the upper respiratory
      tract. Serotype b accounted for 62% and 82% of H. influenzae isolated from
      bacteraemic pneumonia and meningitis cases, respectively. Polymicrobic
      bacteraemic pneumonia occurred in 16 children. Both H. influenzae and S.
      pneumoniae establish dense, unregulated long-term colonization in the nasopharynx
      during the neonatal period. Each inhibit autochthonous microflora by mechanisms
      that are currently unclear. Infections with two or more types occur in 30% (S.
      pneumoniae) and 60% (H. influenzae) of carriage-positive children. 70-75% of H.
      influenzae and S. pneumoniae isolates from blood concomitantly colonize the upper
      respiratory tract. Intense exposure of Papua New Guinean children to penicillin
      at all levels of health care since the 1940s has resulted in widespread relative
      resistance among pneumococci to this antibiotic. Resistant strains are now found
      in 32 serotypes, and in children penicillin resistance is present in 75% of all
      carriage strains and 52% and 22% of blood and cerebrospinal fluid isolates,
      respectively. Penicillin-susceptible and resistant pneumococcal serotypes
      commonly coexist in multiply populated carriage sites. Resistance to betalactam
      antibiotics is rare among H. influenzae strains and resistance has not been
      detected in either H. influenzae or S. pneumoniae to chloramphenicol,
      erythromycin, tetracycline or cotrimoxazole. It should not be assumed that the
      technology of respiratory bacteriology as it is practised in developed countries
      can be transferred to the third world for utilization in paediatric aetiology and
      carriage studies. Respiratory bacteriology strategies as they evolved in Goroka
      were subject to diverse influences. The type distribution of the major causative
      agents defied fashionable beliefs, generated the need for more precise
      epidemiological differentiation and, by virtue of their carriage density,
      cultural properties and response to commonly used antibiotics, required the
      introduction or development of compatible diagnostic procedures.

PMID- 1750264
TI  - Influenza virus activity in Papua New Guinea.
AB  - Influenza viruses remain a major cause of respiratory disease in both developed
      and developing countries. A great deal of information concerning the structure,
      pathology and modes of transmission of these viruses has been accumulated, but no
      means of successfully combating them have, as yet, been devised. The most
      appropriate strategy for limiting the effects of influenza is to monitor the
      emergence and spread of new strains carefully and warn the public and at-risk
      groups of impending epidemics. In Papua New Guinea, as in most other developing
      countries, the major at-risk groups are the very young and the elderly. In the
      past, influenza epidemics were rare and affected the whole community, but with
      modern development and increased mobility the transmission dynamics of influenza
      have changed. The only influenza surveillance centre in Papua New Guinea is at
      the Papua New Guinea Institute of Medical Research in Goroka, and the
      surveillance activities of this centre are limited to the immediately surrounding
      areas. There is a need to establish a national influenza surveillance network, to
      provide nation-wide monitoring of influenza activity, and to provide a central
      repository of current information on influenza infections in the country.

PMID- 1750265
TI  - Acute respiratory infections in Australian Aboriginal children: current knowledge
      and future requirements.
AB  - Although inadequately documented, it is clear that acute respiratory infection
      (ARI) is a major cause of morbidity and hospitalization in Australian Aboriginal
      children. ARIs continue to cause substantial mortality in Aboriginal children,
      and they are likely to cause a variety of potentially serious sequelae. The
      literature emphasizes the importance of pneumonia as a cause of hospitalization
      of Aboriginal children. There is good evidence that Streptococcus pneumoniae and
      Haemophilus influenzae are predominant causes of severe pneumonia, but little is
      known about the importance of other respiratory pathogens, such as respiratory
      syncytial virus, as causes of ARI in Aboriginal children. Poor living conditions,
      low birthweight and malnutrition are likely to be important risk factors for ARI
      in some groups of Aboriginal children. Although broad-ranging economic and
      environmental changes will be required to bring about a sustained reduction in
      ARI in Aboriginal children, there should be an emphasis upon correct case
      management of ARI at the primary care level so as to reduce the need for
      hospitalization. Some research priorities are discussed.

PMID- 1750266
TI  - Immune function risk factors for acute lower respiratory tract infections.
AB  - The immune response of pneumonia patients and controls to Streptococcus
      pneumoniae was investigated by enzyme-linked immunosorbent assay (ELISA).
      Patients less than 6 months of age had significantly lower levels of anti
      pneumococcal polysaccharide antibodies than their age-matched controls. Patients
      and controls 6-14 months of age had lower antibody levels than the children 0-5
      months of age. Adult patients and controls did not differ in their antibody
      status. However, patients and Papua New Guinean controls had depressed cell
      mediated immunity and low T-cell numbers. Low levels of antibodies to
      pneumococcal polysaccharides in children less than 6 months of age appear to be
      an important risk factor for acute lower respiratory tract infections but other
      factors may be important in older infants and adults.

PMID- 1750267
TI  - Health systems research and acute respiratory infections: essential focus on the
      health system.
AB  - Health systems research is receiving increasing prominence in the developing
      world as an aid to decision-making. In acute respiratory infection (ARI), health
      systems research has focused on alternative means of educating mothers to
      recognize pneumonia and seek treatment and on improving the case management
      practices of health workers. While these interventions have demonstrated their
      effectiveness in reducing ARI mortality in the research setting, on a wider scale
      the management and control of ARI will depend on a well-functioning health
      system, with skilled workers, essential drugs and equipment, an operating
      referral system, adequate supervision and an active monitoring system. The
      essential focus for health systems research in the reduction of the impact of ARI
      on public health in Papua New Guinea should be on improving the effectiveness of
      the health care delivery system. Some potential areas for health systems research
      are outlined.

PMID- 1750268
TI  - Clinical management of acute respiratory infections and measles in Papua New
      Guinea.

PMID- 1750269
TI  - [Low dose ionising radiation and cancer: findings and methods. Report of a
      meeting and consequences for Switzerland].
AB  - Today's society is concerned about the dangers of ionising radiation, especially
      in the aftermath of Chernobyl. On the other hand, there exists a widespread lack
      of understanding radiation biology and radioepidemiology--the very sciences which
      provide the data from which today's risk estimates have been derived. The papers
      in this issue of the Journal were presented at a workshop on "Low level radiation
      and cancer: data and methods" held on 10th-11th December in Feuisberg, near
      Zurich. The meeting was organised by the Institute of Social and Preventive
      Medicine of the University of Zurich under the auspices of the Swiss Federal
      Office of Public Health. Its aims were threefold. First, to give an introduction
      to some basic facts and methodological issues in radiation physics, biology and
      epidemiology. Secondly, to give an overview of the availability of data for
      radioepidemiological research in Switzerland and, thirdly, to evaluate possible
      research strategies in this country. A list of some notions and units commonly
      used in the radiation sciences serves an an introduction to the field (G. Schuler
      et al.). In using units and notions it is important to distinguish the
      description of biological experiments and epidemiological observations from
      definitions and risk projections proposed by international reports and consensus
      bodies for radioprotection purposes. The next papers deal more specifically with
      selected aspects of the basic sciences. Dosimetry means quantifying the physical
      effects of ionizing radiation in human tissue; this is not a straight-forward
      procedure (I. Cordt). The foundations of general radiation biology are succinctly
      summarised by C. Michel. An account of our present knowledge and theories of
      radiation carcinogenesis is provided by W. Burkart. W Lutz compares dose-response
      models of chemical carcinogenesis with those used in radiation carcinogenesis.
      During the last decade the epidemiological foundations of radioprotection have
      changed considerably. Longer follow-up studies have become available from the
      atomic bomb survivors and fro other cohorts. A new dosimetry system (DS 86) has
      been introduced for Hiroshima and Nagasaki. Exposure to domestic radon has become
      a major focus of interest. Not only the data, but also the methods of analysis
      and modeling of risks have evolved, as shown by the recent reports of national
      and international scientific committees.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750270
TI  - Some notions and units in radioepidemiology and radiation protection. A
      structured list for the epidemiologist.
AB  - An annotated list of some notions and units used in radioepidemiology is
      presented, with special emphasis on differentiating between the realms of
      radiation physics, radiation biology, radioepidemiology and radiation protection.

PMID- 1750271
TI  - Comments on radiation dosimetry and linear energy transfer.
AB  - The quantification of the physical effects of ionizing radiation in human tissue
      is the basis of risk assessment. This quantification results from determination
      of kerma or absorbed dose. The procedure for the absolute determination of
      absorbed dose with an ionization chamber is discussed. The biological effects of
      ionizing radiation are dependent, not only on the absorbed dose but also on a
      second physical parameter, the linear energy transfer.

PMID- 1750272
TI  - Radiobiological fundamentals in radioepidemiology and radiation protection.
AB  - Radiation is a convenient tool to study fundamental processes of life. Biological
      effects of irradiation may result from indirect actions which are mediated by
      free radicals (e.g. OH-radicals) or from direct actions which involve ionizations
      in the DNA and other biomolecules. Damage to the DNA is the principal, but not
      exclusive target for cell death, loss of reproductive integrity, mutation,
      cancer, developmental anomalies and other radiobiological effects. Repair of
      damaged DNA and cellular recovery processes play an essential role in affecting
      the survival of cells. Dose, dose rate, radiation quality, biological and
      chemical modifiers also have a pronounced effect upon the extent of radiation
      responses. The biological effects of ionizing radiation are somatic or hereditary
      and can further be classified into stochastic and deterministic effects. For
      radiation epidemiology and protection the stochastic action is more relevant
      because the probability of an effect is a function of dose, without a threshold.
      Induction of cancer, hereditary diseases and probably also mental retardation are
      regarded as stochastic effects.

PMID- 1750273
TI  - From energy deposition to cancer.
AB  - Recent progress in molecular biology, genetics and microdosimetry has
      considerably increased our knowledge of the mechanisms of radiation-induced
      carcinogenesis. However, as a result of the complexities involved in the many
      genetic and epigenetic changes in cells leading to the expression of malignancy
      only years or even decades after radiation exposure, risk coefficients for the
      quantification of health detriment still have to be derived largely from
      epidemiological data and animal studies. On the other hand, improved
      understanding of molecular and cellular mechanisms is increasingly important in
      testing and refuting hypotheses about the relative carcinogenic potential of
      different radiation qualities and dose rates, and of low-level exposures.

PMID- 1750274
TI  - Dose-response relationship for chemical carcinogenesis by genotoxic agents.
AB  - Formation and repair of DNA adducts from genotoxic carcinogens is expected to be
      proportional to dose as long as the rates of the enzymatic and non-enzymatic
      activation and inactivation reactions are all proportional to the substrate
      concentration. Deviations from linearity are expected in situations of induced
      and saturated kinetics. A sublinear shape of the dose-response curve is always
      expected at toxic dose levels when regenerative hyperplasia accelerates the
      fixation and accumulation of mutations resulting from the DNA adducts. In a
      heterogeneous population, however, a nonlinear dose-response curve is linearized
      when genetic and life-style factors result in individual variability in the rates
      of the activation and inactivation pathways. Finally, in the light of the
      endogenous and therefore partly unavoidable nature of genetic damage, it is
      proposed that the cancer risk from exposure to an exogenous carcinogen should be
      expressed as a reduction of tumor-free life span rather than in absolute terms of
      additional cases.

PMID- 1750275
TI  - Projecting radiation-induced cancer risks across time and populations.
AB  - Various methods can be used to project the risks of radiation-induced cancer
      estimated in cohort studies beyond the period of follow-up and to other
      populations. The epidemiological evidence for the choice of risk projection model
      is reviewed based on data from studies such as those of the Japanese atomic bomb
      survivors and UK ankylosing spondylitis patients given x-ray therapy. The results
      of risk projections based on various approaches are presented, including those
      suggested by UNSCEAR and by the BEIR V Committee. It is emphasised that the
      continued follow-up of populations such as the Japanese atomic bomb survivors is
      of great importance in estimating lifetime risks, and that further parallel
      analyses are required to examine how risks vary across populations.

PMID- 1750276
TI  - Lung cancer and alpha radiation.
AB  - The considerable radiosensitivity of the human lung together with the highly
      localized alpha-doses in the bronchial and pulmonary regions from naturally
      occurring and man-enhanced radon decay products make the respiratory tract the
      most critical organ for cancer from exposure to ionizing radiation in our
      environment. From indoor radon, the tracheobronchial region of the lung generally
      receives radiation doses which are at least an order of magnitude above the total
      dose to any other organ. Excess lung cancer deaths found in epidemiological
      studies on heavily exposed populations of miners can be fitted reasonably well to
      a relative risk model, when declines in relative risk with both age at risk
      evaluation, and time since exposure, are incorporated. Smoking seems to act
      synergistically. A comparison of the major radon risk projections shows
      considerable discrepancies in the best estimates of risk, indicating that the
      uncertainties remain large.

PMID- 1750277
TI  - Radiation-induced thyroid neoplasia.
AB  - Thyroid cancer is a well documented late effect of exposure to ionizing
      radiation. The excess risk begins 5-10 years after exposure and continues until
      at least 40 years after exposure. Females are roughly three times more
      susceptible to both radiogenic thyroid cancer and to thyroid cancer of other
      origins than are males. Therefore, relative risk estimates for radiogenic thyroid
      cancer do not necessarily differ by sex. The excess risk is higher among children
      exposed prior to five years of age than in those exposed later. The risk for
      radiogenic cancer following exposure to 131I appears to be lower than that
      following exposure to high dose-rate external irradiation, and in the Swedish
      diagnostic study 131I was nearly one fourth as efficient as external X-rays in
      inducing thyroid cancer. The Swedish data suggest that 131I is substantially less
      efficient in inducing thyroid cancer than high dose-rate exposures. In that
      study, however, 95% of the exposed individuals were 20 years or older (mean age
      45 years).

PMID- 1750278
TI  - Approaches to investigating clusters: by example, childhood leukaemia near
      Sellafield.
AB  - There is occasionally concern about suspected clusters of disease in
      geographically localised areas among members of the general public or other
      groups. These occurrences need a systematic approach to their investigation. Such
      an approach needs to consider the definition and characteristics of the cluster
      and of the putative environmental cause for concern. Depending on the outcome of
      these considerations there will be different actions, possibly involving
      epidemiological studies. The necessary components of the approach and resulting
      actions are outlined in this paper, and illustrated by the example of childhood
      leukaemia rates around the Sellafield nuclear plant.

PMID- 1750279
TI  - Epidemiological designs in radioepidemiological research.
AB  - Most of the information currently available on radiation effects comes from the
      observation of individuals who received high doses, either from one acute
      exposure or a series of exposures. Because of the uncertainties in extrapolating
      risks from these studies to the exposure circumstances of most cancers today (in
      particular, low-level environmental exposure), direct epidemiologic studies of
      populations receiving low doses chronically are needed. The effects which we want
      to quantify are likely to be small, however, and extreme care must therefore be
      put into the design of such studies if they are to be informative for risk
      assessment purposes. The areas of particular importance in designing risk
      assessment studies are reviewed. The advantages and limitations of various
      epidemiological study designs, and the problems and importance of dosimetry are
      discussed. Examples from the recent epidemiological literature are presented to
      illustrate the discussion.

PMID- 1750280
TI  - Components of total irradiation dose in Switzerland and their ranges.
AB  - The present knowledge about dose components in Switzerland and their ranges is
      reviewed. Considerable ranges are found for doses induced by radon decay-products
      and by cosmic and terrestrial radiation. Yearly doses from radon decay-products
      show average values between about 1 and 20 mSv in different communities and
      individual values up to about 150 mSv. The reliability of these average values
      is, however, limited, because radon concentrations have been measured up to now
      only in a small number of houses, and because corrections of the raw data are
      necessary, increasing the uncertainty of the results. Doses from terrestrial and
      cosmic radiation show locally variable values between about 0.5 and 1.5 mSv per
      year. These doses are mainly derived from outdoor measurements. Therefore, these
      results also are only of limited use in possible epidemiological applications.

PMID- 1750281
TI  - Dosimetric data on radiation workers in Switzerland: availability and limitations
      for epidemiological research.
AB  - In 1990 the Swiss National Dose Registry started a test phase of data collection
      and processing. The question has been raised whether this new, centralised
      database with its computerized, easily obtainable data on occupational radiation
      exposure in Switzerland can be used for radioepidemiological studies. This paper
      sketches the organisation of personal dosimetry in Switzerland, describes the
      dose registry and other dosimetric data sources and discusses their suitability
      and limitations for radio-epidemiological studies.

PMID- 1750282
TI  - Medical prophylaxis for Swiss nuclear workers.
AB  - Medical prophylaxis for Swiss nuclear workers is prescribed by law, as for all
      other persons occupationally exposed to radiation. Medical examinations including
      questions about the personal history, a physical examination and blood counts
      take place on entering the job and each year thereafter. Follow-up after leaving
      the job is not done. With the coming new legislation, medical prophylaxis will be
      better adjusted to the latest requirements.

PMID- 1750283
TI  - The "post-Chernobyl" childhood leukemia study (ECLIS Study).
AB  - Numerous European cancer registries are working together to evaluate the current
      trends in the incidence of childhood leukemias after the Chernobyl accident. The
      study is coordinated by the International Agency for Research on Cancer. The
      primary objective is to establish whether the accident has resulted in an
      increase in the number of cases. The results will also allow an evaluation of the
      clusters which could be reported. According to the provisional estimations, the
      accident could lead to an increase of an average of 0.8% of the frequency of new
      cases in the European regions covered by the study. For the whole of Switzerland,
      this increase would correspond to 0.5 supplementary cases per year.

PMID- 1750284
TI  - [Diagnosis and therapy of malignant thyroid diseases].
AB  - The clinically important malignancies are characterized on the basis of 257
      primary surgical procedures performed between 1973 and 1990 (9.1% of all thyroid
      operations during this period). Our own proceeding is characterized both in
      diagnostics and surgical technique in primary and recidive operations under
      special regard of a modified lymph node dissection. Obligatory and facultative
      adjuvant therapies are described. The follow-up schedule, which has found to be
      essential for the individual prognosis, should be discussed.

PMID- 1750285
TI  - [Spinal metastases of differentiated thyroid cancers. Disease picture, diagnosis,
      therapy].
AB  - Thyroid malignancy should be ruled out, whenever an osteolytic lesion in the
      spine is detected. In the presence of a single bone lesion, surgical procedure
      should be the treatment of choice. Even if these patients will not be "tumour
      free" after the orthopedic correction they can live without pain and no mobility
      problem.

PMID- 1750286
TI  - [Diagnosis and interdisciplinary therapy of spinal cord compression caused by
      spinal metastases].
AB  - Metastatic tumours of the bone system occur up to 60% in the spinal cord. The
      epidural spinal cord compression is also found by metastatic tumour, so patients
      with metastatic disease in this localisation carry a poor prognosis. From 1986 to
      1988 35 patients with symptomatic spine metastasis are operated upon. 43% of
      these patients recover their capability of walking. 90% from the operated
      collective show a reduction of pain. The primary tumour is first found from
      cancer of the lung and second from the kidneys. The most common localisation of
      metastatic tumour is the thoracic spine. The ratio from male to female is 2:1. If
      the risk of operation and differential therapy is discussed, the decompression
      and tumour resection will be the first. The concept for postoperative
      mobilisation and therapy concludes the stabilisation of spinal cord with internal
      fixation. Treatment of metastatic tumours takes aim at the improvement of life
      quality.

PMID- 1750287
TI  - [Evaluation of thyroid gland scintigraphy and thyroid gland ultrasonography from
      the surgical viewpoint].
AB  - The results of thyroid ultrasound and scanning on 251 patients have been reviewed
      in regard of the postoperative histological findings. Both procedures (thyroid
      ultrasound and scanning) cannot predict the histology. But with ultrasound
      adenomas of the thyroid for example could be localized in 93%, with isotope
      scanning only in 74%. Merely 2% of cold nodules with decreased or mixed
      sonographic pattern have been malignant. Ultrasonography is extremely helpful for
      the surgeon in his operative planning.

PMID- 1750288
TI  - [Atypical thyroid gland adenoma. Experiences during 12 years struma surgery].
AB  - In a period of 12 years atypical adenomas were found in 82 cases and thyroid
      carcinomas were diagnosed in 93 patients in the main group of 2176 patients
      undergoing a thyroid resection. Mean age was 46.5 years for atypical adenomas and
      48 years for carcinomas. In 76.8% of the cases with atypical adenomas the
      postoperative course and long term results were followed up. None of these
      patients developed a recurrence or malignancy. 93.3% of the patients were treated
      with Levothyroxin for prevention. Hyperthyroidism did not occur pre- or
      postoperatively.

PMID- 1750289
TI  - [Reoperations in primary hyperparathyroidism].
AB  - We report on 14 patients suffering from persistent (n = 13) and truly recurrent
      (n = 1) primary hyperparathyroidism. Reoperations were successful in 13 cases.
      Cervical reexploration was only required for 5 patients who had previous
      operations by unexperienced surgeons in other clinics. In 5 out of 7 patients
      operated by us, the causes of the persistent primary hyperparathyroidism were 4
      adenomas and one hyperplastic gland in the mediastinum found by median
      sternotomy. The remaining cases were a rare ectopic location of the inferior
      glands and an inadequate resection in four-gland-hyperplasia. Preoperative
      localization procedures were carried out for most patients. 201-Tl/99m-Tc
      subtraction scintigraphy has proved for localization in both the cervical region
      and the mediastinum to be a highly sensitive method. Reoperative parathyroid
      surgery can be reduced with thorough initial cervical exploration by experienced
      surgeons in specialized clinics.

PMID- 1750290
TI  - [Improved survival rate of postoperative renal failure caused by high volume
      hemofiltration].
AB  - Continuous arteriovenous hemofiltration is the treatment of choice for
      postoperative acute renal failure (ARF). The clinical value of two different
      treatment modalities (spontaneous vs. pump-driven hemofiltration PDHF) were
      compared in two groups of patients with postoperative ARF. There were no
      differences in both groups regarding age, duration of treatment, severity of
      illness or cause of renal failure. The survival rate of patients treated with
      PDHF was significantly higher (29.4 vs. 12.5%). PDHF also led to a significantly
      larger daily ultrafiltrate volume (15.6 +/- 1.9 vs. 7.0 +/- 0.4 l/d, p less than
      0.05). The accelerated elimination of toxic mediators through the filtration
      membrane in high-volume filtration using a pump system (PDHF) may have been
      responsible for the improved survival rate.

PMID- 1750291
TI  - [Animal experiment studies of the distribution and elimination of radioactively
      marked endotoxin].
AB  - We were able reproduce typical morphological and laboratory changes of
      endotoxinemia in dogs and small experimental animals by administration of E. coli
      = 111 K58 endotoxin labelled with 99m Tc. Contrary to the literature our
      distribution studies in rats showed a high concentration of endotoxin in the
      kidney. An effective endotoxin elimination was possible by extracorporal
      hemoperfusion in vitro and vivo. Optimal results were achieved using
      immunoabsorption in combination with plasmapheresis. However, further
      experimental studies are necessary to clarify the problem fully.

PMID- 1750292
TI  - [The colloid osmotic pressure of blood. Physiology, measuring technique and pre
      analytic factors of influence].
AB  - Since the fundamental work of Starling the central of colloid osmotic pressure
      for maintaining volume homoeostasis and for transcapillary fluid exchange has
      been well known. To treat an intravasal volume deficit colloidal plasma
      substitution solutions are able to secure a sufficient colloid osmotic pressure.
      The last one can be measured by oncometry. Therefore an individual therapy is
      possible. This review describes the physiologic function, measurement techniques
      and important influencing parameters and disturbing factors which may be taken
      into consideration when colloid osmotic pressure is determined.

PMID- 1750293
TI  - [Experiences with synthetic laparotomy frames].
AB  - Report about good experiences with frames for laparotomy made with synthetic
      material. They reduce bruise of abdominal wall and pressure lesions of femoral
      nerve.

PMID- 1750294
TI  - [Report on the 6th International Congress on infections in gynecology and
      obstetrics, 13-16 February 1991 in Munich].

PMID- 1750295
TI  - [Chronic recurrent vaginal candidosis].

PMID- 1750296
TI  - [The cardiovascular system in pre-eclampsia. Pathophysiology and sequelae to be
      treated].
AB  - Physiologic alterations of the cardiovascular system during normal pregnancy are
      the basis of all discussions about the problem of preeclampsia and treatment. The
      main point has to be the sufficient blood supply to the fetus. In this review
      cardiovascular alterations in high and low pressure system have been reported.
      High arterial blood pressure, elevated total peripheral resistance, reduced
      plasma volume, hemoconcentration, reduced suspension stability and hyperviscosity
      are symptoms which can be treated. Clinical experiences with a hemodynamic
      adjusted treatment, giving firstly infusionary therapy for correcting hypovolemia
      with the aim of an improvement within the low pressure system which cause an
      increase of cardiac output and then secondly the use of only such
      antihypertensive drugs having favourable effects on the uteroplacental blood flow
      are good and confirm theoretical considerations.

PMID- 1750297
TI  - [Therapeutic aspects of trichomonas infection of the female genitals].
AB  - Infection with trichomonas is a common event in patients in gynecologic practice.
      In patients in an outpatient department the incidence of trichomonas infection
      was 7%, in cases with other genital infections 16%. Especially in alcalic vaginal
      milieu and in Gardnerella infections higher rates of trichomonas could be
      observed. The recurrence rate after monotherapy was 8%.

PMID- 1750298
TI  - Serum concentration of secretory IgA during pregnancy and in gynaecological
      diseases affecting glands and mucosas.
AB  - Secretory IgA (S-IgA) was measured in serum samples from pregnant women by means
      of radial immunodiffusion according to Mancini with an antiserum against the
      secretory component and an S-IgA standard. The results neglect the
      differentiation in SC, S-IgA, and S-IgM. The study includes S-IgA serum levels
      during pregnancy and post partum as well as in patients with cervical carcinoma
      and inflammation of the genital tract. The S-IgA serum levels of pregnant women
      (2nd and 3rd trimester) and after delivery were increased significantly in
      comparison to nonpregnant women (p less than 0.01). The S-IgA levels in genital
      inflammation diseases and cervical carcinoma were only sometimes elevated.
      Pregnant women, 1st trimester: means = 40.0 mg/l (s = 12.2); pregnant women, 2nd
      trimester: means = 60.13 mg/l (s = 18.9); pregnant women, 3 rd trimester: means =
      73.5 mg/l (s = 17.4); post partum: means = 77.5 mg/l (s = 29.52); cervical
      carcinoma: means = 41.9 mg/l (s = 17.3); adnexitis: means = 46.46 mg/l (s =
      16.8); controls: means = 38.61 mg/l (s = 10.5). In a second part S-IgA could be
      estimated in serum samples of pregnant women by means of an enzyme-linked
      immunosorbent assay (ELISA). The levels ranged from 7.1 mg/l to 19.3 mg/l in the
      1st trimenon and from 16.8 mg/l to 82 mg/l in the 3rd trimenon (means = 11.72
      mg/l; s = 4.419; n = 21 and means = 40.01 mg/l; s = 15.117; n = 60). This
      increasing was significant too (p less than 0.01).

PMID- 1750299
TI  - [Morphologic studies of endometrial cancer for biological assessment of nuclear
      grading].
AB  - Three hundred and eighty-three cases of endometrial carcinoma stage pT1NxM0 had
      been reviewed retrospectively by making use of histo- and cytomorphological
      studies. The carcinomas were re-classified and histological and cytological
      gradings, independent from each other, have been carried out. Typical tumor
      characteristic of the nucleus (nuclear grading) and their biological importance
      have been described compared with morphological factors of prognosis (typing,
      histological grading, depth of myometrial invasion, lymph- and blood vessel
      invasion). Interrelations and discrepancies between histological and nuclear
      grading will also be described.

PMID- 1750300
TI  - Long term care inservice resource centres.

PMID- 1750301
TI  - 1991--75th Anniversary AARN. Our history--a proud heritage 1980-1991.

PMID- 1750303
TI  - Writing a research grant for AFNR: talk to someone first.

PMID- 1750302
TI  - Graduate education: the first step.

PMID- 1750304
TI  - A Christmas gift: valuing nursing.

PMID- 1750305
TI  - Barer-Stoddart Report: toward integrated medical resource policies for Canada.

PMID- 1750306
TI  - Scheduling satisfaction: a job enhancement project Medicine Hat Regional
      Hospital.

PMID- 1750307
TI  - Beneficial effect of sodium sucrose-sulfate on the ocular surface of patients
      with severe KCS in primary Sjogren's syndrome.
AB  - Sucralfate (aluminium sucrose-sulfate), a well known gastric mucosal protectant,
      has been tested topically on 22 patients (20 females and 2 males) suffering from
      primary Sjogren's syndrome. Median treatment period was 6 months (range 1-19
      months). Statistically significant improvement in the ocular surface condition
      was found judged from the reduction in Rose-Bengal score (P less than or equal to
      0.00005). The beneficial effect appeared within the first 1-4 months of
      treatment. No adverse side effects were encountered.

PMID- 1750308
TI  - Correlation of conjunctival impression cytology results with lacrimal function
      and age.
AB  - Impression specimens were obtained from the bulbar conjunctiva of 146 eyes of 73
      healthy volunteers (mean age, 52 years). Goblet cell densities and nuclear
      cytoplasmic (N/C) ratio were determined. Break-up time (BUT), Schirmer-I test (S
      I), Rose Bengal scores (RBs) were also recorded. Using a simple linear regression
      analysis, no correlation between the number of Goblet cells and age, BUT and S-I
      was found. Negative correlation with RBs (P = 0.05) was found. The N/C ratio has
      a negative correlation (P less than 0.01) with age and RBs and a positive
      correlation with BUT (P less than 0.01) and S-I (P = 0.03).

PMID- 1750309
TI  - Plasminogen activator inhibitors in human tears.
AB  - Plasminogen activator inhibitor activity was demonstrated in tears of patients
      suffering from various corneal and conjunctival diseases. Active plasminogen
      activator inhibitor was also detected by reverse fibrin zymography in tears of a
      patient suffering from Sjogren's syndrome and in those who underwent eye surgery.
      Immunoblotting revealed that both type 1 and type 2 plasminogen activator
      inhibitors may be present in human tears when the epithelial cells of the cornea
      and conjunctiva are affected and/or the permeability of the conjunctival blood
      vessels is increased. The molecular weight of inhibitors suggested the
      simultaneous presence of both free and activator-complexed inhibitors. However,
      no plasminogen activator inhibitor was detectable in normal human tears,
      suggesting that the presence of plasminogen activator inhibitors in tears may be
      associated with the pathological events at the ocular surface.

PMID- 1750310
TI  - A comparison of the precorneal residence of an artificial tear preparation in
      patients with keratoconjunctivitis sicca and normal volunteer subjects using
      gamma scintigraphy.
AB  - The precorneal residence of an artificial tear preparation has been compared in
      twelve patients with keratoconjunctivitis sicca (KCS) and twelve normal healthy
      volunteers. The artificial tear solution was radiolabelled by the inclusion of 1
      MBq technetium-99m diethylenetriaminepentaacetic acid (99Tcm-DTPA), and 25
      microliters was instilled into one eye only. Deposition of the preparation was
      followed by gamma scintigraphy. Precorneal clearance of the solution was found to
      follow bi-exponential kinetics in all subjects with no significant differences in
      clearance rates between the two study populations. There was also no significant
      difference in the area under the time-activity profile for the two study groups.
      This suggests that the reduced reflex tearing and basal lacrimation in KCS
      patients, indicated by the Schirmer's test, are not important in the clearance of
      isotonic solutions from the eye surface.

PMID- 1750311
TI  - Long-term prognosis of pigmentary glaucoma.
AB  - Outcome, prognosis and course of pigmentary glaucoma were studied in 38 patients
      (75 eyes). The mean age of the subjects at the time of diagnosis was 34.0 years
      and at the time of the study 44.1 years. The follow-up time ranged from 2 to 30
      years with a mean follow-up time of 10.1 years. At the time of the study eighty
      nine percent of the eyes had normal vision (0.7 or better), 3% slight impairment
      of vision (0.6-0.3), 5% low vision (0.2-0.05) and 3% were blind. Visual field
      defects were mild in 78%, moderate in 13% and severe in 8% of the eyes. One eye
      (1%) had normal fields. In 8 patients the stage of the field defects was
      asymmetrical between the two eyes. All were able to read at least monocularly
      with glasses. No one was blind, retired early or professionally limited because
      of pigmentary glaucoma. Thirty-nine eyes were on topical treatment. Fifteen eyes
      had additionally been treated with laser trabeculoplasty when the glaucoma could
      not be stabilized with topical treatment combined with systemic acetazolamide.
      Further twenty eyes had undergone trabeculectomy, 18 of them when medical
      treatment had failed and 2 following LTP. The non-involved eye of a patient
      suffering from a monocular disease was without treatment. The mean intraocular
      pressure at the time of the diagnosis was 33.5 mmHg (SD 10.4 mmHg) and at the
      final visit 17.5 mmHg (SD 3.4 mmHg). Four eyes were operated for cataracts and
      one for retinal detachment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750312
TI  - Computerized patient record system for the glaucoma ward.
AB  - A system for computerized glaucoma patient record, developed from a data base
      called 'Advanced Revelation', is described. The record is made up from free text
      as well as from choices among listed alternatives. All data are stored on
      magnetic media and also printed out on paper in a well disposed and easily
      surveyable form. Apart from saving personnel and time in the clinical routine,
      the main advantages of the system is a powerful tool for clinical research. Data
      retrieval occurs on 'list', 'count', or 'sort' orders, facilitating retrospective
      studies. The system has been used for over a year at a glaucoma ward (Lund) to
      increasing satisfaction.

PMID- 1750313
TI  - Trabeculectomies. A long-term study.
AB  - This study comprises 277 primary open-angle glaucomas in 239 patients followed up
      to 10 years after trabeculectomy. Sixty-four per cent had capsular glaucoma and
      36% simple glaucoma. The number of cases showing no progression of glaucoma
      damage and not needing additional medical therapy decreased slowly with time.
      Seventy-five per cent showed no progress after one year, 70% after 2 years, 57%
      after 5 years and 42% after 10 years. There was a significant trend that fewer
      capsular glaucomas progressed than simple glaucomas. High pressure levels before
      trabeculectomy did not indicate a bad prognosis. Cases with advanced or moderate
      glaucomatous damage seemed to have the same prognosis. Cataract was a common
      complication; a 50% reduction of preoperative visual acuity was found in 37% of
      eyes after 5 years of follow-up.

PMID- 1750314
TI  - Trabeculectomy with 5-fluorouracil.
AB  - The effect of subconjunctival injection of 5-fluorouracil (5-FU) after
      trabeculectomy was studied retrospectively in 205 eyes of 168 patients. A life
      table analysis of the surgical outcome was based on the type of glaucoma and age
      related differences, and a comparison was made with patients who had
      trabeculectomy without subconjunctival 5-FU. The success rate at 30 months after
      trabeculectomy with 5-FU therapy was considerably higher in primary open-angle
      glaucoma at 93.6% (72.7%), secondary glaucoma at 88.9% (72.4%), and refractory
      glaucoma at 72.2% (32.5%) with (or without) the use of ocular hypotensive drops
      when compared with historical control groups treated without 5-FU (60.0% (41.7%),
      35.5% (24.0%), and 18.0% (8.0%), respectively). In patients aged over 70 years,
      no statistically significant improvement could be demonstrated with the use of 5
      FU after trabeculectomy in primary open-angle glaucoma. Our study may provide
      data on the appropriate dosage and indications for the use of this drug after
      glaucoma surgery.

PMID- 1750315
TI  - Prevention of the rise in intraocular pressure following neodymium-YAG posterior
      capsulotomy using topical clonidine.
AB  - We studied the ability of topical clonidine, an alpha-agonist, to suppress the
      acute rise in intraocular pressure (IOP) following neodymium-YAG posterior
      capsulotomy (YPC). In a randomized controlled trial 63 eyes were pretreated with
      one drop of either 0.25% clonidine or saline 1 h before performing YPC and
      immediately following the procedure. The greatest IOP rise in the saline treated
      eyes occurred in the second hour after YPC, when the mean (+/- SD) IOP rose from
      a baseline pressure of 12.7 +/- 3.2 to 18.7 +/- 10.7 mmHg. In clonidine treated
      eyes, the IOP fell from a mean of 11.9 +/- 3.4 to 9 +/- 3.3 mmHg 2 h
      postoperatively. In the saline treated group 9 eyes (27%) developed an IOP rise
      greater than 10 mmHg. Clonidine proved to be highly effective in preventing the
      rise in IOP following YPC.

PMID- 1750316
TI  - Iris vasculopathy in exfoliation syndrome. An immunocytochemical study.
AB  - Samples of control iris tissue obtained from seven enucleated eyes and nine
      exfoliative iridectomy specimens were prepared for an immunocytochemical study of
      the matrix in the walls of iris vessels. The distribution of collagen types I, IV
      and laminin was studied in normal and exfoliative vessels. Laminin was an
      integral component of exfoliation material and was present mainly in the matrix
      of the outer surface of normal vascular cohort cells. The laminin content in the
      latter location was reduced in vessels in which exfoliation aggregates were not
      visible. Collagen type IV was absent from exfoliation material. While type I was
      present in the deposits, it was considered to represent a residue of native
      normal tissue. Exfoliation deposits appeared to stimulate the synthesis of
      collagen types I and IV at an early stage of the disease.

PMID- 1750317
TI  - Primary success with low vision aids in age-related macular degeneration.
AB  - The benefit obtained from various low vision aids (LVAs) was studied in 65
      consecutive patients with atrophic (70.3%) or disciform (29.7%) age-related
      macular degeneration (ARMD). 13.8% were able to read newsprint with age-related
      reading correction under proper lighting conditions. The primary success achieved
      with LVAs was good, 91.4% of patients being able to read newsprint. In most cases
      a simple magnifier (52.3%), high-powered reading glasses (10.8%) or Fonda's
      glasses (12.8%) were sufficient. The magnification preferred was 5x or less in
      25.6% and greater than 5x to 9x in 48.8%. Patients with disciform degeneration
      required higher magnification than those with atrophic degeneration. It is
      concluded that most patients with ARMD found low vision aids useful for reading
      purposes and that a simple optical device was sufficient to achieve reading
      vision.

PMID- 1750318
TI  - pH homeostasis in the frog retina: the role of Na+:HCO3- co-transport in the
      retinal pigment epithelium.
AB  - Transport of acid/base equivalents across the isolated frog retinal pigment
      epithelium (RPE) was studied by means of pH selective microelectrodes. Abrupt
      changes in retinal extracellular pH, from 7.40 to values between 6.66 and 7.66,
      were found to cause rapid changes in both intracellular pH and choroidal
      extracellular pH. The initial rates of these changes were reduced by more than
      60%, when the cellular Na+:HCO3- co-transport system was inhibited by Na+
      removal, or by administration of 1 mM SITS. It is concluded that RPE
      transcellular HCO3- transport changed in response to changes in retinal
      extracellular pH. If present in vivo these changes in RPE HCO3- transport would
      tend to stabilize retinal extracellular pH. It is suggested that cellular
      Na+:HCO3- cotransport plays a significant role for the retinal pH homeostasis.

PMID- 1750319
TI  - The postnatal development of the oscillatory potentials of the electroretinogram.
      III. Scotopic characteristics.
AB  - The postnatal development of the oscillatory potentials (OPs) of the rat
      electroretinogram (ERG) was studied during more extreme scotopic conditions.
      Enhancement of scotopic conditions did not facilitate any earlier appearance of
      the OPs, including the later ones, compared to previously studied less scotopic
      conditions. The oscillatory activity appeared at Days 12 to 15, and increased
      rapidly up to Day 17, which coincided with the major period of development of the
      photoreceptors. After the physiological opening of the eyelids there was a
      decline of the OPs. We propose that the decline of the oscillatory activity
      induced during more extreme scotopic conditions is related to early cell death in
      the distal retina and/or to developmental neuronal plasticity in the proximal
      retina.

PMID- 1750320
TI  - High-pass resolution perimetry and age-related loss of visual pathway neurons.
AB  - The normal, age-related decline of results of high-pass resolution perimetry
      (HRP) predicts a loss of approximately 9,000 retino-cortical neural channels per
      year of age, or about 1 channel each hour. Previously published counts of numbers
      of neurons in the optic nerve indicate a loss of approximately 5,000 neurons per
      year. The HRP results can be accounted for by postulating that neurons are lost
      at the same rate also in the geniculo-striate visual pathway.

PMID- 1750321
TI  - High-pass resolution perimetry in uncomplicated myopia.
AB  - Fifteen subjects (28 eyes) with uncomplicated myopia (3-9 D) were examined using
      high-pass resolution and Goldmann perimetry. In the central 30 degree field a
      slight increase was observed in mean resolution threshold significantly
      correlated to the degree of myopia. In the Goldmann visual fields threshold
      increase was observed in the area around the blind spot in eight subjects (10
      eyes). In the resolution fields only one subject (one eye) showed a corresponding
      abnormality.

PMID- 1750322
TI  - Loss of visual function associated with microalbuminuria in diabetes mellitus: a
      pilot study.
AB  - Visual function loss has been documented in diabetes mellitus in relation to
      flicker and contrast. However, no direct correlation between the degree of loss
      in sensitivity and the level of retinopathy has been established. It has been
      suggested that such non-invasive psychophysical procedures actually reflect
      metabolic disturbances within the diabetic retina. This study investigates the
      possibility of whether early nephropathy demonstrated by microalbuminuria, is an
      indicator of microangiopathy which may be a cause of retinal disturbance leading
      to a loss of visual function. The visual function of a group of diabetics showing
      microalbuminuria was studied. Contrast and flicker threshold were measured and
      the results compared with those obtained with an age-matched control diabetic
      group. The procedures used effectively separated the two groups and raises the
      issue of incorporating psychophysics in retinal screening programmes.

PMID- 1750323
TI  - Does the lymph drainage from the head influence aqueous humour outflow and visual
      functions?
AB  - Effect of lymphoedema of the head on the central nervous system is known.
      Possible changes in intraocular pressure, tonogram, electroretinogram, visual
      functions and ophthalmologic state was studied in animal experiments and in
      patients following serious surgical impairment of the cervical lymph drainage.
      Lymph drainage from the orbit to the deep cervical lymphatics was established,
      while no ophthalmologic alteration was detected after surgery.

PMID- 1750324
TI  - Tear lysozyme levels in bacterial, fungal and viral corneal ulcers.
AB  - Low levels of tear lysozyme were observed in patients with infective corneal
      ulcers, when compared with controls. Lowest levels were seen in patients with
      bacterial corneal ulcers. The levels of tear lysozyme showed a corresponding
      decrease with the increase in Schirmer test values; meaning thereby, that in
      ocular conditions associated with increased rate of tear flow, the lysozyme
      content in tears tends to be low.

PMID- 1750325
TI  - A model for testing the mutagenicity of excimer laser radiation in ophthalmology.
AB  - Because excimer laser radiation is applied more and more in therapeutic and
      refractive corneal surgery, the possibility of mutagenic side effects of this
      treatment should be considered. A mutagenicity model is presented approximating
      closely the ophthalmological conditions when mutagenic effects are studied:
      Heparinized human blood is filled into the anterior chamber of an enucleated cow
      eye. After irradiation of the cornea with the excimer laser, the blood is removed
      and whole blood cultures are set up. Lymphocytes are stimulated, fixed during
      metaphase, and scored for chromatid and chromosome aberrations. First results
      obtained with this model after 248 nm laser irradiation (500 J, 277 mJ/cm2, 10 or
      20 Hz) revealed no mutagenic effects. However, when the blood was exposed under
      the same physical conditions in a quartz chamber (positive control),
      statistically highly significant increases of the yields of chromatid aberrations
      were observed.

PMID- 1750326
TI  - Image analysis of conjunctival hyperemia. A personal computer based system.
AB  - An image analysis system that estimates conjunctival hyperemia is described. The
      system gives a good estimate of minor to moderate hyperemia in the conjunctiva,
      and is easy and fast to operate.

PMID- 1750327
TI  - Increased magnesium in aqueous humour from patients with senile cataract.
AB  - A previous observation of increased aqueous magnesium in eyes with senile
      cataract has been re-examined in a totally different material. The serum and
      aqueous level of calcium and magnesium from 34 patients with senile cataract were
      tested against comparable values from 4 patients with choroidal melanoma. In
      contrast to calcium, the magnesium aqueous/serum ratio was significantly higher
      in the cataract group. Possible explanations are suggested.

PMID- 1750328
TI  - Occult haemolacria in females.
AB  - A series of 125 healthy subjects were examined by the stix method (chemical
      response) for occult occurrence of blood in tears. Blood was found in 18% of
      fertile women, definitely most often in the menstrual phase (in 39% of 51 samples
      within the first week, reckoned from the first day of menstruation). The
      incidence was independent of use of the contraceptive pill. On the other hand,
      occult haemolacria was observed in no more than 7% (= 30) of pregnant women and
      in none at the menopause (N = 7). Among males the phenomenon was noticed in 8% (N
      = 24). Occult haemolacria in fertile women thus seems to be induced by hormones,
      whereas haemolacria most often is provoked by local factors (bacterial
      conjunctivitis, environmental damage, injuries).

PMID- 1750329
TI  - Visual acuity and refraction in type I diabetic patients aged 25-34 years.
AB  - Of the total population of 270 25- to 34-year-old insulin dependent diabetic
      patients with onset less than or equal to 30 years in the county of Fyn, Denmark,
      a sample of 138 was drawn for examination. Of the 138 examined patients, 4 (2.9%)
      were legally blind and 119 (86.2%) had good vision in both eyes. The cause of
      reduced vision was proliferative retinopathy in the majority of eyes. Refraction,
      measured objectively with a refractometer in cycloplegia and transformed to
      spherical equivalents, was -0.25 D or more myopic in approx. 50% of eyes.
      Correlation analyses did not demonstrate significant association between
      refraction, and duration of diabetes or Hb-A1c.

PMID- 1750330
TI  - Recurrent corneal epithelial erosions in Alport's syndrome.
AB  - Alport's syndrome is a heritable disorder of uncertain aetiology characterized by
      nephritis, sensorineural deafness and ocular abnormalities. Bilateral corneal
      epithelial erosions are a previously unreported finding which support the
      hypothesis that Alport's syndrome is a disorder of selected basement membranes.

PMID- 1750331
TI  - Acute glaucoma in the presence of a patent neodymium: YAG laser iridotomy.

PMID- 1750332
TI  - Plasma dopamine, norepinephrine, epinephrine and DOPAC levels in preterm infants
      prior to and immediately after a sleep ventilation hypercarbia test.
AB  - The postnatal maturation and the adaptational ability of the sympathoadrenal
      system has been investigated in preterm neonates (n = 8), and in sick preterm
      neonates with respiratory disorders (n = 10). Plasma levels of dopamine (DA),
      norepinephrine (NE), epinephrine (E) and 3-4 dihydroxyphenylacetic acid (DOPAC)
      were evaluated at rest during the first month of life, and following an
      inhalation of a 5% carbon dioxide-21% oxygen mixture for 10 min. During the first
      month of life the sick preterm neonates exhibited similar NE, E, and DOPAC plasma
      levels but higher DA amounts than healthy infants. Plasma DA levels were
      inversely correlated with the transcutaneous oxygen tension (r = -0.636)
      indicating that hypoxemia was able to enhance the release of DA. Immediately
      following the hypercarbia test, there were no significant changes of plasma
      catecholamine levels in the sick preterms, but there was a significant increase
      of E plasma levels (+140%, p less than 0.05) and a moderate elevation of NE and
      DA amounts in the healthy preterms. It is concluded that preterm neonates who
      have had respiratory disorders did not exhibit an immaturity of the
      sympathoadrenal system at rest, but had a defect in the release of E following
      hypercarbia exposure, which may be secondary to an alteration in chemoreceptor
      function and/or reduced catecholamine stores.

PMID- 1750333
TI  - Neonatal macrosomia and hypoglycaemia in children of mothers with insulin-treated
      gestational diabetes mellitus.
AB  - All newborn children to mothers with gestational diabetes mellitus (GDM) in the
      county of Orebro were investigated during a one year prospective study. Neonatal
      macrosomia (birthweight greater than 3 SD) was observed in 27% of children of
      mothers with GDM and was significantly correlated to the cord C-peptide
      concentration. Hypoglycaemia (B-glucose less than 1.5 mmol/l) was observed in 38%
      of the children, most frequently two hours after delivery. Hypoglycaemia was not
      more common in macrosomic children and could not be predicted by the blood
      glucose concentration of the mother at delivery or by the cord C-peptide level.
      It is concluded that mothers with GDM must be intensively treated in order to
      avoid the occurrence of macrosomia in their infants and that the newborn child
      must be carefully observed and treated in order to avoid neonatal hypoglycaemia.

PMID- 1750334
TI  - Studies on adherence and outer membrane protein of enteropathogenic Escherichia
      coli 0127: H6 and their related plasmids.
AB  - The following characteristics were found in 20 epidemic strains of
      enteropathogenic Escherichia coli (EPEC) 0127: H6 isolated from an outbreak of
      neonatal diarrhea: 1) Absent Vero toxin production; 2) No potential for
      invasiveness; 3) Possession of 1.5 and 60 Md plasmid identical restriction digest
      and outer membrane protein (OMP) patterns; 4) Ability of localized adherence to
      HEp-2, HeLa and FL cells; 5) Capability to cause diarrhea in rabbits with
      destruction of the ileal microvilli at the areas of bacterial adherence. After
      elimination of the 60 Md plasmid from EPEC 0127: H6 the 45 and 82 Kd OMPs of the
      parent strain were lost. These plasmid-cured strains became non-adherent to HEp
      2, HeLa and FL cells, and unable to cause diarrhea in rabbits. These results
      suggest that the pathogenic mechanism of EPEC 0127: H6 induced diarrhea may be
      related to the genes on a 60 Md plasmid expressed as 45 and 82 Kd OMPs which
      cause localized adherence to epithelial cells and destruction of ileal
      microvilli. This damage leads to a marked reduction in absorptive surface area,
      resulting in diarrhea.

PMID- 1750335
TI  - The treatment of persistent diarrhoea and malnutrition: long-term effects of in
      patient rehabilitation.
AB  - This study aimed to characterise the clinical condition of Gambian children
      presenting with persistent diarrhoea and severe protein energy malnutrition and
      to evaluate the effects of short term in-patient treatment in terms of long-term
      outcome. Twenty-two children (aged 6 to 36 months) with persistent diarrhoea
      (greater than or equal to four loose stools/day for more than two weeks) and
      severe malnutrition (weight-for-height less than 75% of the National Center for
      Health Statistics median value) were assessed prior to in-patient treatment for
      three weeks with antibiotics and high nutrient-density milk. Initial assessment
      included biochemical and immunological status together with stool microbiology.
      Criteria for discharge--cessation of diarrhoea for five consecutive days and
      steady weight gain--were met in all subjects within four weeks. Progress was
      assessed clinically and anthropometrically at weekly intervals and 6 and 12
      months following discharge. Results showed a steady improvement in growth during
      the period of in-patient treatment. Continuing improvement in weight-for-age and
      mid-upper arm circumference was observed after 6 and 12 months and weight-for
      height continued to improve up to 6 months but fell back by 12 months. This study
      has demonstrated that, in the treatment of persistent diarrhoea in the tropics,
      relatively short periods of in-patient rehabilitation, whilst leading to a
      resolution of diarrhoeal symptoms and weight gain in the short term, do not lead
      to complete recovery. Persistent diarrhoea and malnutrition are likely to recur
      when the child returns to his village.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750336
TI  - Types of fluid disorder in children with bacterial meningitis.
AB  - As part of a prospective study of children with bacterial meningitis we analyzed
      in 36 patients of our hospital the fluid balance on admission and during the
      first three days of treatment. On admission 10 of them (28%) had inappropriate
      antidiuretic hormone secretion SIADH, 10 (28%) hypo-osmolal and 10 (28%) iso
      osmolal contraction. Six patients (17%) had no clear fluid disorder. The patients
      with SIADH had significantly lower mean serum NA+ (127 vs. 132 mEq/l, p less than
      0.01) and higher mean urine Na+ (111 vs. 26 mEq/l, p less than 0.01)
      concentration as well as higher mean urinary Na+/K+ ratio (2.23 vs. 0.365, p less
      than 0.005) than the patients with hypo-osmolal contraction. They also tended to
      be younger and have a shorter history of fever. The patients with SIADH had a
      less strict fluid restriction than the patients with hypo-osmolal contraction,
      and their fluid balance normalized more slowly. Our findings support initial
      water restriction for all children with bacterial meningitis.

PMID- 1750337
TI  - Immunoglobulin and complement studies in children with Schonlein-Henoch Syndrome
      and other vasculitic diseases.
AB  - In 35 children with Schonlein-Henoch Syndrome (SHS) serum IgG, IgM, and IgA
      concentrations were increased in 15%, 21%, and 44% of cases, respectively. Seven
      children with other vasculitic syndromes (VS) had normal serum Ig concentrations.
      Serum concentration of IgG subclass IgG1 was increased in 72% of children with
      SHS and 57% with VS. In SHS this was related to the presence of arthritis, but
      inversely related to nephritic symptoms. Only a few children had IgG subclasses
      IgG2, IgG3, or IgG4 concentrations outside the normal ranges. Platelet associated
      Ig (PAIg) was found in 75% of children with SHS or VS. In SHS the identification
      of increased amounts of PAIgG was related to the presence of nephritis. The serum
      concentration of properdin, a component of the alternative complement system, was
      reduced in 21% of children with SHS. This was related to the presence of
      abdominal symptoms or nephritis. No cases of retinal vasculitis was observed, but
      4 of 22 children with SHS had punctuate retinal haemorrhages. SHS and VS may be
      clinical variations of the same syndrome. The immunological aspects indicate a
      close relationship with autoimmune diseases.

PMID- 1750338
TI  - The natural history of screening detected IgA glomerulonephritis in children.
AB  - The clinical course of 43 children with IgA glomerulonephritis detected by mass
      urine screening was followed for a mean period of 8.1 years. Histological
      findings were graded according to the severity of glomerular and
      tubulointerstitial lesions. There was no correlation in the severity of
      histological grade and clinical outcome between subjects with microscopic
      hematuria and those with microscopic hematuria and proteinuria nor between those
      with and without one or more episodes of macroscopic hematuria during the follow
      up period. None of the 35 children with proteinuria less than or equal to 1
      g/m2/day had severe histological findings or developed renal impairment. In
      contrast, the 8 children with proteinuria greater than 1 g/m2/day had moderate
      and severe histological findings. Four of these 8 children developed hypertension
      or renal insufficiency during the follow-up period. Our study indicates that the
      outcome of screening detected IgA glomerulonephritis in children correlates with
      the level of proteinuria and the severity of renal pathology.

PMID- 1750339
TI  - Psychological and respiratory physiological effects of a physical exercise
      programme on boys with severe asthma.
AB  - Ten boys 9-12 years of age with severe perennial asthma participated in a
      physical exercise programme lasting 8 months. Pulmonary function and
      psychological tests were performed before training, immediately after, and one
      year after the end of the exercise programme. Static lung volumes, flow-volume
      variables and histamine tolerance were used as indicators of pulmonary function.
      Ego structure, body image, social development and concentration capacity were
      used as indicators of personality development. Before the study, the group had
      high FRC (p less than 0.05) and RV (p less than 0.001), low FEV1, MEF50 and MEF25
      (all p less than 0.001) and low histamine tolerance. They showed marked
      disturbances in their personality development with low scores in psychological
      variables. During the training period, MEF50 and MEF25 increased slightly (p less
      than 0.01). Marked improvement was observed in all psychological variables (p
      less than 0.001). The positive effects remained during the following year. The
      marked and lasting improvement in personality development was regarded as an
      essential factor behind the more modest positive clinical and pulmonary function
      changes. The results emphasize the importance of including exercise programmes in
      the treatment of children with asthma.

PMID- 1750340
TI  - Epidemiology of absence epilepsy. III. Clinical aspects.
AB  - Absence epilepsy was studied in a Swedish population, aged 0-15 years, in 1978
      1982. Cases were selected by electroencephalographic criteria. In the 134
      children with 3 Hz spike-and-wave discharges, 97 (72.4%) had absences alone or in
      combination with generalized tonic-clonic seizures (grand mal): 56 had absences
      alone, 31 absences followed by grand mal, and 10 started with initial grand mal.
      Two distinct groups could be discerned: 1) childhood absence epilepsy: onset
      before the age of 12, with a quick response to therapy, little or no risk of
      grand mal, and a high remission rate; 2) juvenile absence epilepsy: onset at the
      age of 12 or later, a very high risk of grand mal, and usually a good response to
      therapy, but a high risk of relapses at withdrawal. This classification of
      absence epilepsy into subgroups may be useful for prognostic guidelines.

PMID- 1750341
TI  - Nose tapping test inducing a generalized flexor spasm: a hallmark of
      hyperexplexia.
AB  - The present report describes a benign disorder of neonates or young infants
      presenting with generalized hypertonicity accompanied by brisk muscle stretch
      reflexes, intermittent clonus, and exaggerated startle response. This condition
      is termed hyperexplexia, and may be either familial or sporadic. Two affected
      families are reported: Two sisters and their mother are involved in the first
      family; in the second family, where the parents are asymptomatic first degree
      cousins, all three siblings suffer from hyperexplexia of various severity. Nose
      tapping in infants of affected families induced a uniform reaction of facial
      twitching accompanied by head extension, and a generalized flexor spasm, all of
      which may be a hallmark of hyperexplexia. Severely hypertonic infants were
      treated with small doses of benzodiazepines and improved markedly, all becoming
      asymptomatic by two years of age. Unnecessary investigation and treatment may be
      avoided by sufficient awareness of possible hyperexplexia.

PMID- 1750342
TI  - School readiness and CNS maturity: relation to psychophysical and psychosocial
      development and to early school achievement.
AB  - In randomly selected schools 113 girls and 102 boys were subjected to a School
      Readiness (SR) test and to a Complex Reaction Time (CRT) measurement at the age
      of 7. Their psychophysical development, social adjustment and school achievement
      were assessed by teachers and by means of self-ratings during the first 3 school
      years. The developmental outcome of the children seemed principally related to
      CNS-maturity as measured by CRT, and not to the SR test scores. A CNS
      dysfunction, indicated by slow CRT, seemed to be an essential handicap during the
      early school years, impairing particularly the boys' language and motor
      development and their school achievement and causing feelings of inferiority.
      This handicap, which is mainly a developmental delay, should thus be taken into
      consideration when assessing school maturity. Early detection of this handicap
      might enable us to take preventive measures with regard to these children.

PMID- 1750343
TI  - Product-related home accidents in children. A survey of 1590 accidents.
AB  - In a well defined geographical area a total of 1590 accidents related to home
      products in children 0-15 years of age were prospectively registered. The
      incidence of product-related accidents was 279 per 10,000 children per year. A
      higher incidence in boys and a decreasing incidence of accidents with age was
      found. The most common localization of lesions was upper extremities 41% and face
      and skull 30%. In children 0-4 years of age household and child furniture,
      constructional features of the house and corrosives, hot liquids and heating
      equipment were the most common products causing accidents, whereas in children 5
      15 years of age playthings and sports equipment as well as constructional
      features of the house were involved in a higher percentage of accidents.

PMID- 1750344
TI  - Is cow's milk protein sensitive enteropathy a cell mediated immunological
      phenomenon?

PMID- 1750345
TI  - Defective regulation of electrolyte and protein secretion in submandibular saliva
      of cystic fibrosis patients.

PMID- 1750346
TI  - Osteocalcin cord plasma levels: influence of perinatal factors.

PMID- 1750347
TI  - The responses of plasma ionised calcium and intact parathyrin to calcium
      supplementation in preterm infants.

PMID- 1750348
TI  - Frequent past exposure to adenovirus 12 in coeliac disease.

PMID- 1750349
TI  - Brain abscess in glycogen storage disease type Ib.
AB  - Neutropenia, neutrophil dysfunction, and recurrent infections are important
      manifestations of glycogen storage disease type Ib. We report here a child who
      has had adequate metabolic control, but developed brain abscess, an infection not
      previously described in this disease. This case provides further evidence that
      the neutrophil anomaly is related to the basic enzyme defect, not secondary to
      the metabolic derangement.

PMID- 1750350
TI  - Faecal incontinence due to perianal cellulitis.
AB  - A 4-year-old boy presented with a 6-week history of painful defaecation and
      faecal incontinence due to streptococcal perianal cellulitis. After treatment
      with a 10-day course of oral penicillin his symptoms had fully resolved. Early
      diagnosis and treatment of this under-recognised condition is essential.

PMID- 1750351
TI  - Imerslund-Grasbeck syndrome in a Saudi family.
AB  - Imerslund-Grasbeck syndrome, an autosomal recessive trait of defective uptake of
      intrinsic factor-vitamin B12 complex by terminal ileum, is described in a Saudi
      family (two siblings and their first cousin). This rare disease has previously
      been reported only in Northern Europe and North African Jewish ethnic groups.

PMID- 1750352
TI  - Atypical allergic colitis in preterm infants.
AB  - Two atypical cases of colitis due to cow's milk protein intolerance (CMPI) are
      reported, affecting preterm infants. One developed a toxic dilatation of the
      colon and responded well to a casein hydrolysate based feed. The second presented
      insidiously and failed to tolerate a casein hydrolysate, but responded well to a
      chicken-based modular feed.

PMID- 1750353
TI  - Design and performance of blanket heat shields for neonates.
AB  - BACKGROUND: Several designs of plastic blanket heat shields are in use. This
      study was done to compare different designs for their efficiency in reducing heat
      loss. METHODS: Four heat shield designs were tested by sequentially covering each
      of 14 infants (wt. 640-2,030 g) cared for under radiant warmers. The power
      consumption of the radiant warmers was measured as a surrogate for heat loss. All
      designs were tested for a total of 20 min on all infants. Results were calculated
      as percent change in power consumption from shield to shield. The most efficient
      design was further modified and evaluated in another group of 14 infants (wt. 700
      1,180 g). RESULTS: The relative reductions in power consumption were: no shield
      (control) -0%, a plastic foil over the side rails: -17%, a single layer close to
      the infant but excluding the head: -34%, the same as double layer -37% and the
      most efficient one, a single layer covering the whole infant -42%. A modification
      of this design, tested in the second group of infants, reduced power consumption
      by 13% (95% CI -5.9/-19.7), (p less than 0.004) when compared to the single layer
      covering the whole infant. It was tucked under the connecting tubes to the
      ventilator. It also reduced the risk for displacement and allowed for the
      endotracheal tube to be suctioned without removing the blanket. CONCLUSION:
      Modifications of the design of heat shield blankets for infants resulted in
      significant increases in efficiency.

PMID- 1750354
TI  - Periodic variations in skin perfusion in full-term and preterm neonates using
      laser Doppler technique.
AB  - In 37 full-term and preterm infants periodic oscillations of skin blood flux were
      studied by means of laser Doppler technique during the first week of life. The
      development of rhythmic oscillations of skin blood flux was similar in all
      infants. On the first postnatal day rhythmic oscillations were present in the
      heel skin of all full-term and preterm infants, but were rarely observed in the
      back and thigh skin. These flux motion patterns were not influenced by small
      changes in skin temperature. On day 4 rhythmic oscillations became predominant in
      all body regions. The oscillation frequencies of blood flux in the back, thigh
      and heel skin of full-term neonates reached the lower range of adult values at
      the end of the first postnatal week, whereas the oscillation frequencies in the
      preterm infants were still below the range of full-term neonates.

PMID- 1750355
TI  - Glutathione peroxidase and glutathione S-transferase, class alpha, in rat
      intestine. Immunohistochemical and immunoblotting studies on changes in
      expression of these antilipoperoxidative enzymes during normal development.
AB  - Glutathione peroxidase (GSH-PO) and glutathione S-transferase (GST), class alpha,
      showing GSH-PO-like enzymatic activity, were localized immunohistochemically in
      frozen sections of rat intestine in order to elucidate changes in the expression
      of these antilipoperoxidative enzymes during normal development. The direct
      immunoperoxidase method was performed using specific rabbit antibodies (Fab
      fragments) against the enzymes purified from rat liver. Immunoreactive GSH-PO and
      GST-alpha were demonstrated in the intestinal villous epithelial cells. In the
      duodenum, GSH-PO was positive during the period from 19 days of gestation to 1
      week after birth, while GST-alpha was negative during this period. Two weeks
      after birth, positivity for GST-alpha appeared, and GSH-PO became undetectable.
      In the ileum, both of the enzymes were observed until 2 weeks of age, but after
      weaning their expression disappeared. These immunohistochemical findings were
      confirmed by immunoblot analysis using intestinal tissue extracts. To evaluate
      environmental effects on the expression of these enzymes, germ-free animals,
      common bile duct-ligated rats, and Hank's solution-fed infant rats were prepared.
      No remarkable alterations in the immunohistochemical localization pattern were
      observed. Since the switching of enzyme expression around the time of weaning was
      not influenced by these experimentally induced environmental conditions, it
      appears that these enzymatic changes are genetically predetermined.

PMID- 1750356
TI  - Immunohistochemical observation of recovery of the periarteriolar lymphoid
      sheath, lymph follicle and marginal zone in the 60Co-irradiated spleen of rats.
AB  - After 60Co irradiation of rat spleen, the most severe damage was found initially
      in the lymph follicles (LFs); lymphocytes were decreased in number in the
      periarteriolar lymphoid sheath (PALS), and almost completely depleted in the
      marginal zone (MZ). Recovery was observed first in the PALS, followed by the LFs,
      and finally the MZ. From the results of immunohistochemistry, the process of
      recovery was assumed to involve migration of T and B lymphocytes along the
      arterioles from the area surrounding the terminal arteriole at the end of the
      PALS into the central part of the PALS and into the LF. Peripheral blood IgM+,
      IgD- B lymphocytes, known to be MZ precursor cells, flowed from the follicular
      artery to settle in the MZ. Furthermore, recovery of the PALS prior to the LFs
      was suggested to be essential for lymphocyte migration to the LFs.

PMID- 1750357
TI  - Quantitative study of neurofibrillary tangles in subdivisions of the hippocampus.
      CA2 as a special area in normal aging and senile dementia of the Alzheimer type.
AB  - The frequency of neurofibrillary tangles (NFTs) in relation to aging was examined
      in five regions of the hippocampus of 139 normal controls (60 to 106 years) and
      14 patients with senile dementia of the Alzheimer type (SDAT). The regions were
      CA4, CA3, CA2 and CA1, the latter being subdivided into CA1a (the region near
      CA2) and CA1b (the region near the subiculum). Only CA2 showed no correlation of
      NFTs with normal aging. CA2 in SDAT was the site most vulnerable to NFT
      formation. Therefore, it is considered that CA2 is a special region in both
      normal aging and SDAT. CA1 was characterized by the early appearance of large
      amounts of NFT, and was the most reliable marker of senile change related to
      aging. Like CA1, both CA3 and CA4 showed an increase of NFTs with normal aging,
      but their aging process was far less marked. In addition, statistical analysis
      based on a "normal" distribution was considered to be unsuitable for quantitative
      study of senile change, because no histogram of NFTs in any subdivisions for any
      age showed such a distribution.

PMID- 1750358
TI  - Granulomatous arteritis with massive eosinophilic leukocyte infiltration and
      transient peripheral eosinophilia subsequent to transarterial embolization
      therapy with a gelatin sponge.
AB  - A 38-year-old man presented with a cavernous hemangioma in the liver.
      Transarterial embolization (TAE) using a gelatin sponge was carried out 14 days
      prior to surgical resection of the tumor. Granulomatous arteritis with massive
      infiltration by eosinophilic leukocytes and histiocytes was present at the
      periphery of the hemangioma, and transient eosinophilia in the peripheral blood
      occurred six days after resection. Granulomatous arteritis was evident in medium
      sized arteries and there was narrowing or occlusion of the vascular lumen. In the
      granulomatous cellular infiltrates in the arteries, giant cells of the foreign
      body type were numerous. An eosinophilic substance differing from fibrin was
      present in some of the vascular lumina. As this showed staining for collagen, it
      was considered likely to be fragments of the gelatin sponge. The patient had no
      symptoms of fever, chills or general fatigue. The clinical course and pathologic
      findings suggest a causative role of the gelatin sponge in this case of
      granulomatous arteritis. Vascular change, a rare complication of TAE therapy, may
      be induced by a hypersensitivity reaction against the intra-arterial gelatin
      sponge.

PMID- 1750359
TI  - Primary malignant lymphoma of the rectum with diagnostic problems. Report of two
      cases with an analysis of gene rearrangement.
AB  - We present two similar cases of rectal B-cell lymphoma with diagnostic problems.
      Grossly, both tumors appeared as a well demarcated polypoid mass with eroded
      mucosa. In spite of their histologic resemblance to reactive lymphoid
      hyperplasia, including the presence of lymph follicles, fibrosis and polyclonal
      plasma cells, both cases were diagnosed as malignant lymphoma of low-grade
      malignancy because of the full-thickness involvement of the rectum with diffusely
      infiltrated small or medium-sized lymphoid cells showing rare mitoses. In one
      case, clonal proliferation of differentiated B cells was demonstrated by analysis
      of gene rearrangement. Therapeutic problems related to low-grade malignant
      lymphoma in the rectum are also discussed.

PMID- 1750360
TI  - Abortion of a sow caused by Pasteurella aerogenes.
AB  - Three strains of the Pasteurella aerogenes complex were isolated as sole
      pathogens from aborted fetuses of a sow aborted at the 12th week of gestation on
      a farm of 600 sows. Gross pathology showed no characteristic lesions. The
      isolates were biochemically identical and resembled P. pneumotropica on the basis
      of their strong indole and urease positivity but they produced gas, were
      ornithine decarboxylase negative and fermented mannitol but not trehalose. Only a
      few differences were apparent in biochemical characteristics between the isolated
      strains and P. aerogenes. They differed from the type strain of P. aerogenes in
      ornithine decarboxylase activity, indole production and lactose and mannitol
      fermentation; however, such strains do occur within this heterogeneous species.
      At the time of abortion the antibody titre of the aborted sow was 1 in 16 when
      examined with live bacterial suspension and 1 in 128 if boiled antigen was used.
      Similar strains could not be isolated from the vaginas of aborted sows or
      pregnant and newly farrowed sows in the same group. The bacteriological,
      serological and histological findings support the opinion of other workers on the
      occasional pathogenic nature of P. aerogenes.

PMID- 1750361
TI  - Suitability of lactate dehydrogenase activity and somatic cell counts of milk for
      detection of subclinical mastitis in Merino ewes (short communication).
AB  - The relationship between somatic cell counts (SCC) and LDH activity in milk was
      examined in Turkey to find out the suitability of these variables for early
      detection of subclinical mastitis in Merino ewes. A significant positive
      correlation was found between LDH activity and SCC in ewes' milk. LDH activity in
      milk samples appeared to be a sensitive and specific indicator of subclinical
      mastitis in ewes: it was significantly higher in milk from inflamed (mastitic)
      udders than in normal milk.

PMID- 1750362
TI  - Goat serum, a substitute of bovine serum in cultivation of Babesia bovis.
AB  - Babesia bovis (a Mexican isolate) was cultivated in MASP culture system using
      goat serum in various concentrations as substitute of bovine serum. It was
      observed that 20% goat serum + 20% bovine serum + 60% Parker's medium 199
      supported the growth of the parasite, which was maintained in this medium through
      8 subcultures. The soluble exoantigen (vaccine) present in the culture
      supernatant is to be quantified and tested in vitro. Goat serum from
      slaughterhouses may be utilized for in vitro cultivation of the parasite and,
      expectedly, production of vaccine. This study may prove to be useful in reducing
      the cost of vaccine at least in tropical countries.

PMID- 1750363
TI  - Changes induced in newborn piglets by the trichothecene toxin T-2.
AB  - Three pregnant sows, being in the last quarter of gestation, were used in an
      experiment to study the changes induced in newborn piglets by T-2 toxin. One sow
      was used as control (C). The other two received 24 mg (sow A) and 6 mg (sow B) T
      2 toxin, respectively, mixed in the feed, daily, up to the time of farrowing. The
      piglets of sow A became ill by 48-72 h after birth, while the litters of sow B
      and C remained healthy. The clinical symptoms included faintness, diarrhoea,
      decreased blood glucose level, and collapse followed by death. The milk and urine
      of sow A and the stomach contents of affected and dead piglets contained T-2
      toxin and its metabolites. Pathological changes seen at necropsy included acute
      enteritis, degeneration of the liver and kidneys, and oedema of the mesentery.
      The stomach was filled with clotted milk. Histopathological and electron
      microscopic findings consisted of reduced glycogen content and pathological
      simple fatty infiltration of the liver cells, lymphocyte depletion and necrosis
      in the lymphoid follicles of the intestinal mucosa, atrophy of the thymic cortex,
      and hyperfunction of the adrenal and thyroid glands compared to the control.

PMID- 1750364
TI  - Effect of treatment with Prolan or with a GnRH superactive analog on the sexual
      function of sows after weaning.
AB  - On a large, closed pig farm using artificial insemination (AI), 29 sows were
      treated with Prolan S-ol injection (Bayer, FRG) and 31 sows with a GnRH
      superactive analog (Ovurelin, D-Phe6-GnRH-EA, Reanal, Hungary) 48 h after
      weaning. The effect of treatment on the sows' sexual function was monitored by
      serum progesterone radioimmunoassay (RIA). The conception rate in the control
      group (36 sows) was 69.4%. In the groups treated with Prolan and Ovurelin it was
      79.3 and 71%, respectively. The use of Prolan S-ol injection markedly reduced the
      number of acyclic sows and of those having an irregular oestrous cycle. Treatment
      with the GnRH analog inhibited the manifestation of weaning-induced heat;
      subsequently, however, it induced a regular cycle in 30 out of the 31 sows
      treated.

PMID- 1750365
TI  - Effect of volatile fatty acid infusion on blood plasma free amino acid profiles
      in growing lambs.
AB  - Five ram lambs (average body mass: 25 kg) were given, through a catheter inserted
      into the left ruminal vein, a total of 28.8 mM sodium acetate, 14.4 mM sodium
      propionate and 4.8 mM sodium butyrate per kg body mass as a 2-hour infusion.
      During and at 0, 1, 2, 4, 6, 10 and 24 h after the infusion blood samples were
      taken from the jugular vein and the blood plasma was assayed for free amino acid
      (FAA) and immunoreactive insulin (IRI) concentrations. Volatile fatty acid (VFA)
      infusion significantly decreased the blood plasma concentrations of all FAA but
      cystine. The lowest FAA concentrations were measured in plasma samples taken at
      the end of the 2-h infusion. Subsequently the level of all amino acids rose and
      by 24 h after the infusion the blood plasma concentration of all FAA came close
      to the preinfusion value. The largest differences were observed in the
      concentration of glutamate, glycine, leucine and isoleucine. In contrast to FAA,
      IRI concentration was increased significantly (almost fivefold) by VFA infusion.
      By 10 h after the infusion IRI concentration returned to the initial level. The
      results reported here indicate that energy supply given in the form of VFA
      infusion significantly affects blood plasma FAA profiles, supposedly as a result
      of changes induced in protein synthesis in tissues. Insulin presumably plays a
      role in the regulation of these changes.

PMID- 1750366
TI  - Blood pH, plasma carotene, vitamin A, albumin and globulin concentrations in
      newborn calves and in dams during the first three days of the postnatal period.
AB  - Blood pH, total plasma carotene, plasma vitamin A fractions and some plasma
      proteins were determined in newborn calves (n = 38) and their dams. Calves were
      assigned to one of two groups according to their blood pH immediately after
      birth: group 1 (normal) with pH above 7.2 (n = 27) and group 2 (slightly
      acidotic) with pH 7.0 to 7.2 (n = 11). The difference between the neonatal blood
      pH values of the two groups immediately post partum disappeared 24 h after birth.
      The blood pH of the dams was normal. The extremely low plasma carotene
      concentration (group 1: 32.7 micrograms/l; group 2:20.5 micrograms/l) and the low
      plasma globulin fractions (group 1:19.6 g/l; group 2:19.2 g/l) immediately after
      birth were elevated by the intake of colostrum. There was no significant change
      in plasma vitamin A fractions (retinol, retinyl ester) during the early postnatal
      period (3 days post partum) in newborn calves. The acid-base balance of newborn
      calves does not have any influence on the physiological alterations of plasma
      vitamin A, carotene and some plasma proteins during the first three days of life.

PMID- 1750367
TI  - Lipid composition of pulmonary surfactant in breeding foxes with cardiopulmonary
      insufficiency.
AB  - The lipid composition of the pulmonary surfactant of breeding foxes was examined.
      The surfactant isolated from healthy polar and common foxes did not show
      significant strain differences in lipid composition. On the other hand, in the
      surfactant isolated from the lung of common foxes that died with the symptoms of
      cardiopulmonary insufficiency the quantity of phosphatidylcholine and
      phosphatidylglycerol was lower and that of sphingomyelin and
      lysophosphoglycerides was higher than in the surfactants prepared from healthy
      animals. Moreover, in the phosphatidylcholine and phosphatidylglycerol fractions
      of the surfactant isolated from the diseased animals the level of palmitic acid
      was significantly lower.

PMID- 1750368
TI  - Effect of some electrolytes on in vitro rumen microbial protein synthesis in
      buffaloes.
AB  - In vitro studies were carried out to examine the effect of MnCl2, MgCl2, CoCl2
      and CaCl2 on protein synthesis by rumen microorganisms obtained from fistulated
      buffalo calves (Bubalus bubalis). The concentration of the electrolytes in
      stained rumen fluid (SRF) ranged from 1 to 20, 1 to 20, 0.25 to 5 and 1 to 20 mM,
      respectively. MnCl2 (15 mM), MgCl2 (10 mM), CoCl2 (2.5 mM) and CaCl2 (20 mM)
      increased the protein content in the incubation mixture (IM) by 501, 230.8, 537.6
      and 84% and the per cent incorporation of 35S from (NH4)2 35SO4 into microbial
      protein by 125.6, 108.5, 113.4 and 40.3, respectively, over the control values,
      when the incubation lasted 8 h. The NH3-N content in IM decreased by 8, 14, 43
      and 16% when 10 mM MnCl2, 20 mM MgCl2, 1 mM CoCl2 and 1 mM CaCl2, respectively,
      was added and the incubation lasted 6 h. The reasons for increased protein
      biosynthesis by rumen microorganisms in the presence of the above electrolytes
      are discussed.

PMID- 1750369
TI  - The school placement revolution.

PMID- 1750370
TI  - Teacher competency exams.

PMID- 1750371
TI  - Conservation and metaphor acquisition in hearing-impaired children. Some
      relationships with communication mode, hearing acuity, schooling, and age.
AB  - This study focused on conservation and metaphor acquisition in 35 hearing
      impaired children who used different modes of communication and who spanned a
      wide age range. Children who used either cued speech or oral-aural communication
      modes were tested at two different school sites. Relationships were determined
      between the dependent variables, conservation and metaphor, and the independent
      variables of age, degree of hearing loss, years of schooling, and mode of
      communication. Findings revealed a significant positive relationship between
      conservation and metaphor in both communication modes. Significant relationships
      between age and metaphor and between age and conservation were also found,
      suggesting that experience plays an important role in understanding both of them.
      Neither conservation nor metaphor was significantly related to either degree of
      hearing loss or communication mode. The conservation order of acquisition was
      number (91%), weight (60%), volume (50%), and liquid (46%). Suggestions for
      teachers based on the findings are presented.

PMID- 1750372
TI  - ASL and the family system.
AB  - This paper examines some of the sociological implications of poor interaction on
      families in which one of the members is deaf. When a family systems perspective
      is used, once a child is diagnosed as deaf the family is no longer considered
      "hearing"; the parents may be hearing, the other children may be, but the family
      system becomes "hearing and deaf." By viewing this as a hearing/deaf problem, it
      becomes clear that no adequate solution can be found without the participation of
      deaf adults and the benefit of their perspectives and insights. We suggest that
      attention be directed toward neutralizing the effects of the stigma associated
      with deafness so that American Sign Language can become a pivotal tool for
      facilitating functional symbolic interaction in hearing/deaf families.

PMID- 1750373
TI  - Improving the career decisions of deaf seniors in residential and day high
      schools.
AB  - Career development interventions can have positive effects on the career
      decisions that deaf seniors make before graduating from high school. Interviews
      with 189 seniors from 16 residential and day high schools revealed their career
      decisions and their experiences with career development activities. School staff
      evaluated the seniors' career decisions, career decision-making skills, and
      probable post-high school placements. The results indicated that seniors who had
      vocational training were more knowledgeable about their vocational aptitudes than
      were seniors who had no vocational training. Seniors with vocational training
      were also more likely to have considered other careers prior to making career
      decisions. Seniors who had received career counseling were more knowledgeable
      than those who had not about the skills needed to enter their chosen careers and
      were more interested in their career choices. More importantly, the amount of
      interest in one's career choice was determined to be related to ratings of
      motivation, readiness, and prospects for completing the postsecondary placement.
      The implications of these results are discussed below for professionals in
      education and rehabilitation.

PMID- 1750374
TI  - A national profile of school-based transition programs for deaf adolescents.
AB  - In this study, the transition programs of 326 secondary educational programs for
      deaf and severely hearing-impaired adolescents were surveyed. Three types of
      programs were surveyed: residential, mainstream, and "other" (a combination of
      the first two programs). Sixty-four items depicting desirable transition
      characteristics were included in the survey, and each item was rated by the
      programs on a value scale and an implementation scale. Analyses of variance were
      calculated to determine if there were statistically significant differences among
      the three program types for each individual survey item on the two rating scales.
      Based on the data, it appears that the residential schools had higher
      implementation rates than the mainstream and other programs. All three respondent
      groups valued the transition items more than they had implemented them (i.e., the
      value scores were higher than the implementation scores). The data point out the
      need for researchers and educators to develop and implement more effective
      transition programs for deaf and severely hearing-impaired students.

PMID- 1750375
TI  - When the same is different. A comparison of the information processing strategies
      of deaf and hearing people.
AB  - In this study, the information processing strategies of Gallaudet University
      students who are profoundly and prelingually deaf were evaluated. The subjects
      demonstrated the highest levels of recognition to the left and right of the
      fixation point, often referred to as a reading strategy when found in hearing
      people. Additionally, they demonstrated higher levels of recognition at positions
      in the top right quadrant of the display, a pattern not found in hearing people.
      A main effect was found: subjects whose primary and secondary school backgrounds
      were oral and manual combined had significantly higher levels of recognition
      overall than did subjects from oral-only educational backgrounds. Differences in
      background did not interact with strategy use in this study. These findings lead
      to the conclusion that the information processing strategies of deaf people need
      to be evaluated closely before general conclusions can be made. Alternative means
      for evaluating these types of findings are suggested.

PMID- 1750376
TI  - Self-concept in hearing and prelingual, profoundly deaf students. A comparison of
      teachers' perceptions.
AB  - A self-concept measure was administered to a group of 68 deaf students aged 8-19
      years and a comparison group of 68 hearing students. Teachers for both of the
      groups completed observer reports of self-concept. Although tentative, the
      findings indicate that hearing teachers' perceptions of students' self-concepts
      are in closer agreement for hearing students than they are for deaf students. At
      the same time, the results show that deaf students do not appear markedly
      different from hearing students in their own reports of self-concept.

PMID- 1750377
TI  - Family-centered early intervention. The perceptions of professionals.
AB  - This paper, based on a nationwide survey, examines the attitudes and opinions of
      professionals regarding parent-professional involvement in the planning and
      implementation of goals and services for hearing-impaired infants and toddlers
      and their families. The implications of the findings are discussed as they
      pertain to PL 99-457, the new federal mandate for services to young children with
      special needs and their families.

PMID- 1750378
TI  - New aspects of the morphology and function of the human hip joint ligaments.
AB  - The capsular ligaments of the human hip joint were submitted to exact
      morphological analysis, and they proved to be multiple and numerous. We have
      described various ligamentous systems and their interconnections, and have
      suggested new terminologies and systematics. The ligaments were subjected to
      functional analysis by means of measuring strips to determine the positions in
      which the ligaments are taut. The ligament systems were all found to serve a
      restrictive function, and various parts of the apparatus restricted all possible
      movements in the hip joint. Extension is restricted by the medial iliofemoral
      complex, abduction by the pubofemoral ligament, and adduction by the posterior
      coxal ligaments and by the superior ischiofemoral ligament. Flexion is restricted
      by the inferior ischiofemoral ligaments, inward rotation by the superior
      ischiofemoral ligament, and outward rotation by the lateral iliofemoral complex.
      Only the ligament of the femoral head is unable to exert a restricting function,
      despite reaching a state of tension in extreme adduction.

PMID- 1750379
TI  - Generation of color composites for enhanced tissue differentiation in magnetic
      resonance imaging of the brain.
AB  - Currently, the diagnostic interpretation of magnetic resonance (MR) images
      requires that radiologists integrate specific tissue contrast information from
      several different images obtained at the same anatomic slice position. Each of
      these images has its own unique tissue contrast patterns which are based on the
      image acquisition parameters (pulse sequence) selected. The complex contrast
      patterns observable in these images reflect the inherent biophysical
      characteristics of the tissues and fluids present in the imaged section. In an
      effort to increase the diagnostic accuracy and efficiency of MR image
      interpretation, we have generated color composite images from quantitatively
      analyzed achromatic MR images of the brain, obtained while utilizing different
      pulse sequences. By using a DEC MicroVAX II computer with Interactive Digital
      Language (IDL), this color display method has been applied to images obtained
      from General Electric Signa and Siemens Magnatom imagers. For this study, our
      image sets included T1-weighted, T2-weighted, and proton density spin echo
      sequences as well as both high and low flip angle gradient echo sequences.
      Advantages of our color composite methods, in contrast to many other image
      processing techniques that have been described, are that minimal information is
      lost, computer misclassification of tissues is avoided, and the conspicuity of
      specific tissues is enhanced. Furthermore, with this method it is possible to
      produce composite images whose color renditions approach a natural anatomic
      tissue appearance. Availability of these color composites to radiologists may
      improve the efficiency and accuracy of the diagnostic interpretation of MR
      images.

PMID- 1750380
TI  - Electron microscopic and histochemical studies of the mononuclear osteoclast of
      the mouse.
AB  - Osteoclasts collected from the long bones of mice were cultured on dentin slices.
      To identify osteoclasts, the tartrate-resistant acid phosphatase (TRACPase)
      activity of cultured cells was histochemically examined by the azo dye method.
      The TRACPase-positive cells could be distinguished from other cells by light
      microscopy. The cells were sectioned by alternating semithin and ultrathin
      sections to observe their ultrastructure and three-dimensional structure.
      TRACPase activity was detected both in multi-nucleated osteoclasts and in
      mononuclear cells. Most of the mononuclear TRACPase-positive cells had features
      similar to preosteoclasts. A mononuclear TRACPase-positive cell was a ruffled
      border and clear zone was reconstructed three-dimensionally by NIKON COSMOZONE
      2SA. The reconstruction showed that this cell possessed a large clear zone and
      small ruffled border. Under the ruffled border, no lacuna was apparent; but there
      was disruption of the dentin surface. The results suggest that this cell was a
      mononuclear osteoclast and that it might have been in the process of making a new
      lacuna.

PMID- 1750381
TI  - Morphological and histochemical comparison of the cells elicited by ectopic bone
      implants and tibial osteoclasts.
AB  - Pellets of mineralized and demineralized bone and a composite mixture of
      mineralized and demineralized, devitalized bone particles were implanted
      subcutaneously on the dorsal body wall of young adult rats. Two weeks post
      implantation, the pellets were removed and processed for histochemical and
      morphological analyses. Rat proximal tibia was also processed for evaluation. The
      levels of tartrate-resistant acid phosphatase (TRAP) activity in the
      multinucleated giant cells (MNGCs) from each of the three implants and from
      osteoclasts were assessed using an image analyzer. The osteoclasts from the
      proximal tibia and the majority of MNGCs from the demineralized implants
      demonstrated high levels of TRAP activity. MNGCs from the mineralized implants
      showed either a low level or absence of TRAP activity. Most MNGCs from the
      composite implants exhibited a low level of TRAP activity; however, there was a
      population of cells that demonstrated a high level of reaction product, similar
      to that seen in the tibia and demineralized implant. Morphologically, osteoclasts
      from the proximal tibia and from the osteogenic demineralized implant exhibited
      ruffled borders. A small population of MNGCs from the composite implant also
      revealed osteoclastic features. In summary, MNGCs from the mineralized implant
      did not exhibit a level of TRAP reaction product or morphology similar to
      osteoclasts, while the majority of cells from the demineralized implant and a
      subpopulation of the MNGCs elicited by the composite implant did demonstrate TRAP
      expression and morphology similar to osteoclasts. The expression of osteoclastic
      characteristics in cells at an ectopic site may be dependent on accessory signals
      from the skeletal microenvironment; such signals appear to be absent from or
      incomplete in the mineralized implants but appear to be present when
      demineralized bone particles are implanted.

PMID- 1750382
TI  - Ultrastructure of palatal taste buds in the perihatching chick.
AB  - Palatal taste buds of perihatching chicks were examined by electron microscopy.
      Four intragemmal cell types were characterized. 1) Light: with voluminous,
      electron-lucent cytoplasm containing scattered free ribosomes, rough and smooth
      endoplasmic reticulum, plump mitochondria, sparse perinuclear filaments,
      occasional Golgi bodies, and numerous clear and dense-cored vesicles. Clear
      vesicles sometimes aggregate in a presynaptic-like configuration apposed to an
      axonal profile. These cells contained large, spherical, uniformly granular nuclei
      with one nucleolus. 2) Dark: with dense cytoplasm containing filamentous bundles
      surrounding the nucleus, occasional clear vesicles, centrioles, rough endoplasmic
      reticulum, and compact mitochrondria. The apical cytoplasm noticeably lacks dense
      secretory granules. Irregular to lobulated nuclei are densely granular, and
      contain scattered clumps of chromatin, adhering especially to the inner leaflet
      of the nuclear membrane, and at least one nucleolus. Cytoplasmic extensions of
      dark cells envelop other intragemmal cell types and nerve fibers. Light and dark
      cells project microvilli into the taste pore. 3) Intermediate: contain gradations
      of features of light and dark cells. 4) Basal: darker than the other intragemmal
      cell types and confined to the ventral bud region. Putative afferent synapses in
      relation to light cells, and axo-axonal contacts are described. While the
      appearance of axo-axonal contacts may be a transient developmental event, other
      bud features are consonant with observations in adult chickens and suggest that
      the peripheral gustatory apparatus is mature at hatching in this precocial avian
      species.

PMID- 1750383
TI  - Temporospatial study of the migration and distribution of cardiac neural crest in
      quail-chick chimeras.
AB  - It has been demonstrated that the septation of the outflow tract of the heart is
      formed by the cardiac neural crest. Ablation of this region of the neural crest
      prior to its migration from the neural fold results in anomalies of the outflow
      and inflow tracts of the heart and the aortic arch arteries. The objective of
      this study was to examine the migration and distribution of these neural crest
      cells from the pharyngeal arches into the outflow region of the heart during
      avian embryonic development. Chimeras were constructed in which each region of
      the premigratory cardiac neural crest from quail embryos was implanted into the
      corresponding area in chick embryos. The transplantations were done unilaterally
      on each side and bilaterally. The quail-chick chimeras were sacrificed between
      Hamburger-Hamilton stages 18 and 25, and the pharyngeal region and outflow tract
      were examined in serial paraffin sections to determine the distribution pattern
      of quail cells at each stage. The neural crest cells derived from the presumptive
      arch 3 and 4 regions of the neuraxis occupied mainly pharyngeal arches 3 and 4
      respectively, although minor populations could be seen in pharyngeal arches 2 and
      6. The neural crest cells migrating from the presumptive arch 6 region were seen
      mainly in pharyngeal arch 6, but they also populated pharyngeal arches 3 and 4.
      Clusters of quail neural crest cells were found in the distal outflow tract at
      stage 23.

PMID- 1750384
TI  - Pigment cell localizations in anuran ventral skin at climactic metamorphosis.
AB  - In anuran amphibians, the specific color pattern of the skin is expressed after
      metamorphosis, and its formation involves pigment cell migrations. Pigment cells
      are differently distributed in the tadpole, larval, and froglet skin. To learn
      more about their fate during metamorphic climax and in the young froglet, we
      focused our attention on the different localizations of larval melanophores and
      iridophores in the ventral skin of Rana esculenta before and during skin homing.
      Localizations of melanophores and iridophores can be elucidated at the
      developmental stages suggested by Taylor and Kollros (TK stages). At TK stage II
      (during early premetamorphosis), large melanophores beneath the larval skin are
      detected. At TK stage X, dispersed melanophores lie under bundles of muscular
      striated fibrils near the larval skin; they are also observed at the vascular
      level. At TK stage XVII (prometamorphosis), melanophores are extended on the
      inner side of the basement lamellar collagen. At the end of prometamorphosis,
      iridophores are located with melanophores in the separating space between
      attached basement collagen and derived basement collagen. At TK stage XX (earlier
      climax), melanophores and iridophores are detected inside the upper extremities
      of fractures opened in the derived basement collagen. At TK stage XXIV (later
      climax), both types of larval pigment cells are observed in the inner extremities
      of breaks derived from the fractures. During climax, these pigment cells occupy
      the well-formed breaks. At TK stage XXV in young froglet, the pigment cells
      remain alone in the breaks formed in the derived basement collagen. Briefly,
      breaks in the basement lamellar collagen are opened by invading cell processes of
      mesenchymal cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750385
TI  - Police brutality. The role of clinical forensic medicine.

PMID- 1750386
TI  - Unusual cases from Dubai, United Arab Emirates.
AB  - Dubai is one of the small countries of the United Arab Emirates located on the
      shores of the Persian Gulf in the Middle East. This report deals with two deaths:
      one an unusual method of suicide by hanging and the other, a death under
      investigation into whether it was accidental or suicidal.

PMID- 1750387
TI  - An analysis of the medicolegal autopsies performed in Adana, Turkey, in 1983
      1988.
AB  - Data on 1,000 medicolegal autopsies have been compiled by the Morgue Department
      of the Adana branch of the Council of Forensic Medicine of Turkey, and have been
      reviewed to determine the local differences in causes of death, as well as age
      and sex distributions of decedents, in medicolegal deaths in this region. This is
      the first report on this subject in this region of Turkey. Unusual categories of
      death and incidences of death are also discussed. The results of this study show
      that the number of medicolegal autopsies and the rate of natural death in Adana
      are quite close to those of some other cities of Turkey and some foreign
      countries. Contrary findings are revealed in the frequencies of the causes of
      death.

PMID- 1750388
TI  - Medicoritual trephinations in modern Israel.
AB  - Two recent cases of ritual trephinations that were revealed during regular
      autopsies are described. The osteologic findings are discussed in relation to
      hospital craniotomy and ancient trephination, and the forensic practitioner is
      offered a set of criteria to differentiate properly between trephination and
      craniotomy.

PMID- 1750389
TI  - Human immunodeficiency virus infection in cases presenting to the Philadelphia
      Medical Examiner's Office.
AB  - Serum samples were available from 492 of 1,058 cadavers seen at the Philadelphia
      Medical Examiner's Office between August 4 and December 15, 1989. These sera were
      tested for the presence of antibodies to human immunodeficiency virus (HIV) by
      enzyme-linked immunosorbent assay (ELISA) and Western blot. The overall
      prevalence of HIV in the autopsy population was 2.24%. The following populations
      showed increased prevalence as compared to the total sampled population: blacks
      (3.60%, p less than 0.01), males (2.51%, n.s.), and homicide victims (3.74%,
      n.s.). Seroprevalence data from this study are compared with those from earlier
      studies of other related populations, with regard to overall prevalence and risk
      factor analysis.

PMID- 1750390
TI  - Gunshot residue, ten years later.
AB  - Gunshot residues may be central to a competent reconstruction of a shooting
      incident. When a young boy was shot in the neck by a playmate using a .22-caliber
      single-action revolver, permanent paralysis from mid-thorax downward ensued. Ten
      years later the victim sued the importer, the vendor, the German manufacturer,
      and the shooter's family. Investigative reports indicated "horseplay" and
      questionable emergency medical team care. Depositions were contradictory. The
      entry wound, removed at surgery, was fixed and processed for slides. The
      histopathologist referred to "black pigment granules" in the wound track. The 10
      year-old slides and block were retrieved. The coverslip was removed from a
      representative slide that was examined under the scanning, x-ray dispersive
      microscope. The black granules contained amounts of lead, barium, and antimony
      far beyond any normal range. The firing range had to have been no greater than 6
      12 in (15.24-30.48 cm). The case was promptly settled out of court.

PMID- 1750391
TI  - An unusual entrance wound associated with rimfire rifles.
AB  - In many cases of self-inflicted contact wounds of the head with rimfire rifles,
      we have noted that the entrance wound appears unusual: in 50% of cases studied, a
      pencil-like extension or zone of blackened and seared skin extends downward from
      the entrance. The most probable cause for the appearance of this wound is a
      momentary break in contact between the muzzle and skin as the victim reaches for
      the trigger with resultant escape of a jet of hot sooty gas. Whereas not unique
      for rimfire rifles, such a wound from a handgun is uncommon.

PMID- 1750392
TI  - Qualitative diatom analysis as a tool to diagnose drowning.
AB  - Since the 1950s, quantitative diatom analysis has been used successfully at the
      Department of Forensic Medicine at the University of Helsinki as a supportive
      method for diagnosing deaths by drowning. The reliability of the method was
      firmly established in 1986 by a study involving 107 probable cases of drowning.
      Since 1982, the quantitative analysis has been complemented with qualitative
      diatom analysis. This report presents potential applications of the latter method
      by describing its use in six cases of drowning.

PMID- 1750393
TI  - Death during immersion in water in childhood.
AB  - Drowning is a relatively common cause of accidental death in children. Autopsy
      records at the Adelaide Children's Hospital over a 27-year period from 1964 to
      1990 were examined, and 58 cases were found where the cause of death was listed
      as drowning. In six cases, however, careful examination of the history and
      postmortem findings provided important additional information that suggested a
      more complex antemortem sequence of events. Specifically, four patients aged
      between 6 years, 10 months and 11 years were known to have had epilepsy. A
      further patient, an 8-year-old boy, died from a subarachnoid hemorrhage due to a
      bleeding cerebral arteriovenous malformation while swimming. The final patient,
      an 11-year-old boy who collapsed in a public swimming pool, was found at autopsy
      to have marked hypoplasia of the right coronary artery. In this series, six of 58
      (10.3%) of the pediatric cases had additional underlying medical problems that
      could either have initiated the drowning episode or caused death due to alternate
      mechanisms. We present the clinicopathological findings in detail to demonstrate
      that a high index of suspicion must be maintained in all cases of pediatric
      drowning, not only for unnatural causes of death but also for additional natural
      disease processes that may have contributed significantly to the fatal episode.
      These findings may have particular relevance in jurisdictions where full
      postmortem examination is not always required by law.

PMID- 1750394
TI  - Diagnosis of electrical skin injuries. A review and a description of a case.
AB  - This paper presents a brief review of the results of research in the area of
      electrical skin injuries. It also includes a case report of a 5-year-old girl
      noted on her admission to the hospital to have injuries to the skin of her chest
      and left arm. Histological examinations demonstrated that the skin lesions were
      segmental and showed necrosis and inflammation. Deposits of calcium salts
      distinctly located to collagen fibers were observed below the regenerated
      epidermis at the periphery of two skin lesions of the chest wall, in the lower
      part of dermis at the periphery of a skin lesion of the left arm, and within
      connective tissue adjacent to elastic arteries and peripheral nerves from the
      thoracic cavity. The pattern of calcification localized to collagen fibers and
      situated both superficially and deeply in the skin in a zone of viable tissue
      close to necrotic tissue is characteristic of electrically induced lesions.
      Although there have been reports of deposition of calcium salts on collagen
      fibers after application of calcium salts in high concentration at the skin
      surface, the collagen calcification in the pattern observed in this patient is
      probably diagnostic of electrical injury.

PMID- 1750395
TI  - A 28-year (1963-90) study of homicide in Marion County, Oregon.
AB  - We describe 240 consecutive homicidal deaths that occurred in Marion County,
      Oregon, over a 28-year period (1963-90). An epidemiological assessment of the
      homicides yielded the following information: More than 91% of these deaths were
      primary homicides. In primary homicide, 63% of the victims and 88% of the
      offenders were male. In secondary homicide, 76% of the victims and all of the
      offenders were male. A high percentage of victims (83%) and offenders (84%) in
      primary homicide were Caucasian, as were 100% of victims and offenders in
      secondary homicide. About 12% of victims and 10% of offenders in primary homicide
      were Hispanic. Fifty-nine percent of primary homicides were intrasexual, as
      compared to 87% of secondary homicides. An intraracial pattern was found in 90%
      of primary homicides and in 100% of secondary homicides. The most frequent means
      of death in both primary and secondary homicides were firearms, physical beating,
      and stabbing. Strangers committed 80% of secondary homicides. This was in marked
      contrast to the victim-offender relationship found in primary homicides, where
      strangers were responsible for approximately 16% of the total, acquaintances for
      approximately 36%, and family members for approximately 48%. The overall
      clearance rate (i.e., the identification and charging of a suspect for the death)
      was 88%.

PMID- 1750396
TI  - Effect of carcass size on rate of decomposition and arthropod succession
      patterns.
AB  - Decomposition studies were conducted using two carcasses of domestic pigs, Sus
      scrofa L., 8.4 kg and 15.1 kg in weight, to determine the effects of carcass size
      on the rate of decomposition, composition of the arthropod fauna, and succession
      patterns. A total of 46 arthropod taxa were recovered during this study. No size
      related differences were observed between carcasses with respect to composition
      of the arthropod fauna or patterns of succession. A greater number of arthropods
      were observed attracted to the 15.1-kg carcass, and the rate of decomposition
      observed was more rapid for the 15.1-kg carcass than for the 8.4-kg carcass.
      Internal temperatures of the 8.4-kg carcass were more directly related to
      external ambient temperatures during the fresh and bloated stages of
      decomposition. During the decay stage, both carcasses generated internal
      temperatures significantly above ambient temperatures. Following this stage,
      internal temperatures fell to approximate ambient temperatures during the
      postdecay and remains stages.

PMID- 1750397
TI  - Cyanide ingestion. Case studies of four suicides.
AB  - Deliberate ingestion of cyanides is relatively rare, as reflected in the
      Registrar General's figures. There are no pathognomonic specific autopsy findings
      and even the distinctive smell may be missed by some individuals. We present four
      cases of cyanide ingestion, one of which appears to be the first reported case of
      magnesium cyanide poisoning in humans. The problems involved in investigating
      deaths from cyanide ingestion are discussed.

PMID- 1750398
TI  - The unusual accidental death of a pregnant woman by sexual foreplay.
AB  - This is the case of a young pregnant black woman who died during foreplay when
      her male partner with his hands accidentally forced air from her vaginal cavity
      into her uterine cavity, causing air embolization in the veins on the surface of
      her heart and her brain. Her premature infant was removed by cesarean section by
      emergency-room personnel after she died. The infant survived for 12 days before
      being declared brain dead.

PMID- 1750399
TI  - Demonstration of a fatal hemolytic transfusion reaction using immunoperoxidase
      techniques.
AB  - An immunoperoxidase technique coupled with monoclonal antibodies to the ABO blood
      group antigens was used to document a fatal ABO hemolytic transfusion reaction in
      a medical examiner's case. A case report with explanation of the technique is
      presented.

PMID- 1750400
TI  - The man in the scarlet cloak. The mysterious death of Peter Anthony Motteux.
AB  - Peter Anthony Motteux (1663-1718), a Huguenot refugee in London, established a
      literary reputation by completing Sir Thomas Urquhart's translation of Rabelais'
      Gargantua and Pantagruel, then Cervantes' Don Quixote. He later became an import
      export merchant. On his 55th birthday he donned his scarlet cloak and went out on
      the town. He picked up a prostitute and after some dalliance returned to her
      bordello. Shortly thereafter he was found dead, although the evidence is that he
      was in good health when he arrived. Literary evidence is that he died from
      assisted erotic asphyxia, a variant of autoerotic asphyxia, cf. the case of
      Frantisek Koczwara (Am J Forensic Med Pathol 5:145-149, 1984.)

PMID- 1750401
TI  - A simple dictation device.
AB  - A simple device for autopsy and scene dictation uses a small cassette recorder
      with a built-in microphone attached to a remote push-button switch worn on the
      belt or waistband. The recorder is carried in a shirt or scrub suit pocket and is
      functional under a protective apron or gown. The components, construction,
      advantages, and disadvantages of the device are presented.

PMID- 1750402
TI  - Sudden death of an elderly man with multiple malignant neoplasms.
AB  - With the lengthening of the human life span, cancer has become an increasingly
      important medical problem for the aged. It is not uncommon to find multiple
      primary neoplasms in elderly individuals. We recently investigated the death of
      an elderly man who had died suddenly and had three incidental malignant
      neoplasms, including a pleural mesothelioma, first diagnosed at autopsy. The
      importance of performing a complete medicolegal autopsy for epidemiological and
      statistical purposes is emphasized.

PMID- 1750403
TI  - Medicolegal problems in the health care field.

PMID- 1750405
TI  - Peer review for medical examiners.

PMID- 1750404
TI  - Nail gun suicides.

PMID- 1750406
TI  - Religious objections to autopsy.

PMID- 1750407
TI  - Rhabdomyolysis and heroin abuse.

PMID- 1750408
TI  - Proceedings of a symposium. Consensus Development Conference on Osteoporosis.
      October 19-20, 1990, Copenhagen, Denmark.

PMID- 1750409
TI  - Estrogens, bone mass, and osteoporotic fracture.

PMID- 1750410
TI  - Evaluating the benefits and risks of postmenopausal hormone therapy.
AB  - The evidence that estrogen protects against coronary heart disease is
      biologically plausible, consistent, and strong. These benefits have not been
      established by a randomized trial, however, so that the degree of protection
      against heart disease might have been overestimated because estrogen users tend
      to be healthier than nonusers. A randomized trial to determine whether estrogen
      alone or in combination with progestin protects against coronary heart disease
      should be given a high priority. Progestins generally attenuate the effects of
      estrogen on the concentrations of HDLC. It is not known whether this effect also
      limits the beneficial effects of estrogen on the risk of coronary heart disease.
      Recent studies suggest that estrogen may protect against coronary heart disease
      in other ways besides favorably altering serum concentrations of lipoproteins and
      that progestins might not have adverse effects on the risk of heart disease.
      Currently, theoretical concerns that progestins might be harmful seem outweighed
      by the evidence that they protect against endometrial cancer in women who have a
      uterus. For these women, some may find the side effects of progestins to be so
      bothersome that they prefer to take estrogen alone. This approach is reasonable
      so long as the patient has periodic endometrial biopsies for early detection of
      pre-malignant or malignant endometrial changes. Women without a uterus should
      take estrogen alone. Women who take long-term estrogen therapy appear to have
      about a 30% greater chance of developing breast cancer. On the other hand, breast
      cancer that develops while taking estrogen therapy might have a slightly better
      prognosis. Quantitative comparisons of fatal conditions suggest that the benefits
      of long-term therapy outweigh the risks. But these comparisons assume that all
      causes of deaths are equally important and do not adequately take account of
      other psychologic and physical effects of hormone therapy.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1750411
TI  - Effect of calcitonin on bone mass and fracture rates.

PMID- 1750412
TI  - Theoretical overview: bone development, peak bone mass, bone loss, and fracture
      risk.

PMID- 1750413
TI  - Effect of calcium on skeletal development, bone loss, and risk of fractures.
AB  - In assessing the role of calcium, it must be stressed that calcium is not the
      cause of bone health but simply a necessary condition for it. It is mechanical
      usage that is of primary importance for bone. In just the same way iron is
      essential for hemoglobin synthesis and protein is essential for muscle mass, but
      neither is sufficient by itself. What, then, ought we to expect from a high
      calcium intake? Can we prevent estrogen-withdrawal bone loss? No. Calcium is not
      a substitute for estrogen, anymore than it is a substitute for exercise. Will
      calcium slow the remodeling loss that occurs with aging? Yes, to some extent; as
      calcium slows remodeling, it will inevitably slow remodeling-related loss. But
      most importantly, a high calcium intake will prevent calcium-deficiency bone
      loss. The only question, therefore, is the extent to which calcium deficiency
      loss may contribute significantly to bone fragility in various populations. The
      bone loss and fracture data reviewed briefly here indicate that an important
      portion of the osteoporotic fracture burden is calcium-related. What that portion
      is will be a function of the fraction of the population with inadequate intakes
      in any given country. Better than half of all adult American women have calcium
      intakes less than 500 mg/day, whereas only a small fraction of Dutch or Danish
      women, for example, would be under that level. Hence, a population-wide program
      to increase calcium intake in the United States would be likely to yield a
      greater benefit than in either the Netherlands or Denmark. That does not mean, of
      course, that there could not be substantial benefit to individuals with low
      intakes in all countries. Calcium intakes of greater than or equal to 1,500 mg
      are both safe and natural. While not all bone loss and low trauma fractures are
      due to low calcium intake, some almost certainly are. Adaptation to low intakes
      does occur, but it is seldom sufficient to compensate for the low intake. We
      cannot easily distinguish those who need more calcium from those who need less,
      and for that reason it makes good sense to ensure an adequate calcium intake for
      the entire adult population. What should that intake be? During adolescence,
      1,500 mg will come close to ensuring the achievement of genetically programmed
      levels of peak bone mass.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750414
TI  - The restoration of skeletal mass: a theoretic overview.

PMID- 1750415
TI  - Treatment of osteoporosis with sodium fluoride or parathyroid hormone.

PMID- 1750416
TI  - Use of bisphosphonates in the prevention of bone loss and fractures.

PMID- 1750417
TI  - Risk prediction in osteoporosis: a theoretic overview.

PMID- 1750418
TI  - Measurement of bone mineral density: current status.

PMID- 1750419
TI  - Exercise and its interaction with genetic influences in the determination of bone
      mineral density.

PMID- 1750420
TI  - Bone mass measurements in diagnosis and assessment of therapy.

PMID- 1750421
TI  - Biochemical markers of bone turnover: methodology and clinical use in
      osteoporosis.

PMID- 1750422
TI  - Biochemical markers of bone turnover in diagnosis and assessment of therapy.

PMID- 1750423
TI  - Helicobacter pylori and the etiology of duodenal ulcer: necessary but not
      sufficient.

PMID- 1750424
TI  - Is Helicobacter pylori a cause of duodenal ulcer? A methodologic critique of
      current evidence.
AB  - INTRODUCTION: Helicobacter pylori (HP) in the gastric antrum has been strongly
      associated with both duodenal ulcer (DU) and chronic active gastritis (CAG). The
      relationship between HP and DU has been interpreted as causal by many observers.
      An alternate hypothesis is that HP coincidently colonizes CAG, which is
      independently associated with DU by some yet-unknown mechanism. PURPOSE: To
      assess the extent to which a causal relationship between HP and DU has been
      demonstrated, we performed a methodologic critique of published clinical studies.
      We carried out a literature search to identify clinical studies that included at
      least 25 subjects. Of the eight studies we identified, six used a cross-sectional
      design and two used a prospective cohort design. We applied methodologic criteria
      to assess causation: strength of association, biologic gradient, temporality, and
      experiment. METHODS: A strong association between HP and DU was demonstrated in
      all eight studies. Biologic gradient and temporality were not assessed in any
      study. In the two experimental studies of therapy, loss of antral HP was
      associated with a decreased rate of DU relapse; however, we did not interpret
      this as sufficient to support causality because the effect may have been due to a
      direct mucosal action rather than eradication of HP. CONCLUSION: We conclude that
      published evidence does not establish HP as a cause of DU. One approach to
      address causality would be an observational cohort study of ulcer relapse to
      assess the temporal relationships between HP, CAG, and DU.

PMID- 1750425
TI  - The baseline electrocardiogram.

PMID- 1750426
TI  - Resting electrocardiograms as baseline tests: impact on the management of elderly
      patients.
AB  - PURPOSE: We evaluated management decisions of house staff in a university
      hospital emergency department (ED) to determine the impact of baseline
      electrocardiogram (ECG) results on the care of elderly patients. SUBJECTS AND
      METHODS: The study employed a prospective before-after research design. The
      subjects included internal medicine house staff assigned to the ED and the 47
      elderly patients treated by them during 58 ED visits. The measures of impact on
      patient care included how often and in what ways comparison of baseline and ED
      ECG results changed the house staff's diagnostic impressions and treatment plans.
      To determine changes, we asked house staff to indicate their impressions and
      management plans before and after comparing baseline and ED ECG results. In
      addition, a panel of faculty members used a modification of the nominal group
      process to determine treatment changes and to estimate benefit to patients from
      the changes. RESULTS: House staff indicated that baseline ECG results led them to
      change diagnostic impressions during 13 (22%) and treatment plans during eight
      (14%) of the 58 visits. Six of the patients benefited from the treatment changes.
      The faculty judges indicated that baseline ECG findings would have altered their
      diagnostic impressions in eight (14%) and treatment decisions in three (5%) of
      the 58 cases, one of which would have benefited from the change. All patients for
      whom there were changes of impression or plan had prior histories of
      cardiovascular disease. CONCLUSION: We conclude that baseline ECGs provide ED
      house staff with diagnostic information that often leads to changes in management
      of elderly patients with prior histories of cardiovascular disease. Future
      studies should evaluate the efficacy of baseline ECGs in patients without such
      histories.

PMID- 1750427
TI  - Improving influenza vaccination rates for high-risk inpatients.
AB  - PURPOSE: In 1987, the Minneapolis Veterans Affairs Medical Center implemented an
      ongoing, multifaceted influenza vaccination program that targeted all high-risk
      outpatients followed at the medical center. While the program achieved and
      sustained vaccination rates of 60% or more for high-risk outpatients, vaccination
      rates for high-risk inpatients continued to be 25% or less. Beginning with the
      1989-1990 immunization season, the "flu shot" program was extended to include all
      high-risk inpatients. Both the outpatient and inpatient components of the
      Minneapolis Flu Shot Program emphasized administrative and organizational
      elements. The program's goal was to achieve vaccination rates of at least 60% for
      both high-risk outpatients and inpatients. This study assesses the effectiveness
      of the inpatient program among elderly patients hospitalized on the medical
      service during the immunization season. PATIENTS AND METHODS: To estimate patient
      risk characteristics and vaccination rates, 50% of elderly patients who were
      discharged from the medical service during the immunization season were surveyed
      using a validated postcard questionnaire. Their responses were compared with the
      responses of elderly patients to the annual outpatient survey conducted to assess
      the "flu shot" program. RESULTS: Overall, 78.6% of elderly respondents discharged
      from the medical service during the immunization season were vaccinated.
      Vaccination rates within various high-risk subgroups all exceeded 70%. None of
      these vaccination rates for inpatient groups differed significantly from the
      rates for corresponding outpatients. CONCLUSION: An outpatient "flu shot" program
      that emphasizes administrative and organizational elements can be successfully
      expanded to high-risk inpatients. The vaccination rates attained with such a
      program may not only achieve but exceed the national health objective for
      influenza vaccination.

PMID- 1750428
TI  - Altered insulin sensitivity, hyperinsulinemia, and dyslipidemia in individuals
      with a hypertensive parent.
AB  - PURPOSE: Essential hypertension is, in some patients, complicated by impairment
      of insulin-mediated glucose disposal and hyperinsulinemia. Whether this metabolic
      disturbance is a consequence of the hypertensive process or whether it may
      precede, and thus possibly promote, the development of hypertension has been
      unknown. SUBJECTS AND METHODS: Searching for hereditary or familial defects in
      hypertension-prone humans, we prospectively investigated insulin sensitivity,
      plasma insulin and glucose, and serum lipoproteins in normotensive offspring of
      essential hypertensive as compared with age- and body habitus-matched offspring
      of normotensive families. RESULTS: Compared with 78 control subjects, 70
      offspring of essential hypertensive parents had similar age (mean +/- SEM: 24 +/-
      1 versus 24 +/- 1 years, respectively) and body mass index (22.3 +/- 0.2 versus
      22.4 +/- 0.2 kg/m2), a blood pressure of 127/77 +/- 1/1 versus 123/76 +/- 1/1 mm
      Hg (p less than 0.05 for systolic), and significantly elevated (p less than 0.01
      to 0.001) fasting plasma insulin levels (9.9 +/- 0.3 versus 8.6 +/- 0.3
      microU/mL), serum total triglycerides (1.03 +/- 0.06 versus 0.83 +/- 0.03
      mmol/L), total cholesterol (4.37 +/- 0.08 versus 3.93 +/- 0.07 mmol/L), low
      density lipoprotein cholesterol (2.45 +/- 0.08 versus 2.14 +/- 0.07 mmol/L), and
      total/high-density lipoprotein cholesterol ratio (4.3 +/- 0.1 versus 3.7 +/-
      0.1). Insulin sensitivity was lower (9.4 +/- 0.7 versus 13.2 +/- 1.1 x 10(-4) x
      minute-1/microU/mL, p less than 0.001), while post-glucose-load plasma insulin
      levels were higher (p less than 0.05) in the 41 offspring of essential
      hypertensive parents than in the 38 offspring of normotensive parents so
      investigated. CONCLUSION: These findings demonstrate that young normotensive
      humans in apparently excellent health but with one essential hypertensive parent
      tend to have an impairment of insulin-mediated glucose disposal,
      hyperinsulinemia, and dyslipidemia. It follows that a familial trait for
      essential hypertension seems to coexist commonly with defects in carbohydrate and
      lipoprotein metabolism that can be detected before or at least at a very early
      stage of the development of high blood pressure as judged by resting blood
      pressure measurements.

PMID- 1750430
TI  - Autologous bone marrow transplantation for patients with relapsed Hodgkin's
      disease.
AB  - PURPOSE: High-dose therapy and autologous bone marrow transplantation (ABMT) are
      being increasingly utilized for the management of patients with relapsed
      Hodgkin's disease. Because patients with relapsed Hodgkin's disease often
      initially respond to salvage chemotherapy regimens, ABMT is frequently delayed
      until late in the course of the disease. The optimal timing for ABMT has not been
      identified. The purpose of this study was to determine the value of ABMT earlier
      in the course of Hodgkin's disease. PATIENTS AND METHODS: We treated 70 patients
      between October 1984 and October 1988 with high-dose cyclophosphamide,
      carmustine, and etoposide, followed by infusion of previously cryopreserved
      autologous bone marrow, and analyzed the results to determine the impact of
      timing of ABMT on treatment outcome. One (17 patients), two (24 patients), or
      three or more (29 patients) chemotherapy regimens had failed in patients before
      ABMT. RESULTS: The results for all 70 patients included a complete remission rate
      of 59%, an early death rate of 11%, a 4-year survival of 47%, and 27% of all
      treated patients alive and in complete remission at 4 years. The median follow-up
      for patients remaining in complete remission is 56 months (range 26 to 73
      months). The frequency of achieving a complete remission was higher in patients
      in whom fewer regimens had failed before ABMT (i.e., 82% versus 58% versus 45%, p
      = 0.02), as was the 4-year disease-free survival (i.e., 44% versus 33% versus
      21%, p = 0.04). CONCLUSION: ABMT is a more effective therapy when used early for
      patients with relapsed Hodgkin's disease.

PMID- 1750429
TI  - The hypocholesterolemic effect of an antacid containing aluminum hydroxide.
AB  - STUDY OBJECTIVE: To evaluate the efficacy, safety, and hypocholesterolemic effect
      of an aluminum hydroxide-containing antacid in hypercholesterolemic individuals.
      DESIGN: A prospective, randomized, double-masked, placebo-controlled phase of 2
      months' duration, followed by an open-design treatment phase of 2 months'
      duration and a washout phase of 2 months' duration. SETTING: Family practice
      clinics of two rural communities (kibbutzim) in Israel. PATIENTS: Fifty-six men
      and women with hypercholesterolemia (type IIa or IIb). Fifty individuals
      completed the study. INTERVENTION: After 2 months of dietary modification (low
      fat, low-cholesterol diet), the participants were randomized into two matched
      groups. Group 1 (28 participants) was treated for 2 months with a chewable
      antacid tablet containing simethicone, magnesium hydroxide, and 113 mg of
      aluminum hydroxide per tablet, at a dose of two tablets four times daily. Group 2
      (22 participants) was given a similar number of placebo tablets for 2 months.
      During the following 2 months, both groups received the antacid at the above
      dose. MEASUREMENTS AND MAIN RESULTS: Lipoprotein levels were evaluated at
      baseline and every 2 months thereafter for 6 months. Compared with pretreatment
      levels, Group 1 experienced a decrease in low-density lipoprotein cholesterol
      (LDL-C) of 9.8% after 2 months (p less than 0.001) and 18.5% after 4 months (p
      less than 0.001). Compared with Group 2, the decrease in LDL-C in Group 1 was
      6.2% at the end of the 2-month double-masked, placebo phase. Although the high
      density lipoprotein cholesterol (HDL-C) was also reduced in Group 1 at the end of
      4 months of therapy (10.2%), the HDL-C/LDL-C ratio increased by 13% during the
      same interval (p less than 0.05). The treatment was well tolerated, with minimal
      side effects. CONCLUSIONS: An aluminum hydroxide-containing antacid reduces LDL-C
      in hypercholesterolemic individuals. Although HDL-C was also reduced to a lesser
      extent, the overall atherogenic index was improved. Further studies should be
      conducted to evaluate the long-term safety and efficacy of antacids containing
      aluminum hydroxide in hypercholesterolemic patients.

PMID- 1750431
TI  - Hematologic manifestations of systemic mast cell disease: a prospective study of
      laboratory and morphologic features and their relation to prognosis.
AB  - PURPOSE: Systemic mast cell disease (SMCD) follows an indolent course in most
      patients, but a significant number of patients die of neoplastic hematologic
      disorders. Reviews of the literature and retrospective studies in a single
      institution have defined features that may be associated with a poor prognosis,
      but prospective studies have been lacking. Therefore, we prospectively analyzed
      the relationship between clinical, laboratory, and hematopathologic findings and
      clinical outcome in a series of 46 patients with mast cell disease. This analysis
      was employed to both define clinically useful prognostic variables and describe
      the histologic evolution of bone marrow mast cell infiltration and its
      relationship to hematologic neoplasia. PATIENTS AND METHODS: Forty-six adult
      patients were referred to the National Institutes of Health (NIH) with clinical
      and/or pathologic evidence of mast cell proliferation. All patients had bone
      marrow examinations, and 10 patients underwent serial bone marrow biopsies. The
      diagnosis of SMCD required pathologic documentation of bone marrow mast cell
      infiltrates. The patients were followed for up to 13 years at the NIH (up to 30
      years after the initial pathologic diagnosis of mast cell disease). Statistical
      analysis defined the correlation between variables and the presence of diagnostic
      bone marrow lesions. The Kaplan-Meier method was used to construct survival
      curves, and the effects of various variables on the survival time were examined.
      RESULTS: Thirty-two of 46 patients (74%) had a bone marrow biopsy diagnostic for
      SMCD. The remaining 14 patients were considered to have cutaneous mast cell
      disease (CMCD). Univariate analysis showed that hepatosplenomegaly, alkaline
      phosphatase level, absolute lymphocyte count, and age at onset of symptoms were
      positively correlated with SMCD, whereas hemoglobin level was negatively
      associated with diagnostic bone marrow lesions. With multivariate analysis, only
      hemoglobin and absolute lymphocyte count remained as significant independent
      predictors of bone marrow findings. No CMCD patient died or had significant
      clinical deterioration in the 1- to 30-year period of follow-up (median = 8.5
      years), whereas 10 of 32 SMCD patients (31%) died from 1 to 22 years after
      diagnosis (median = 2.5 years) (p less than 0.0001). Univariate analysis revealed
      the following variables as significantly increasing the risk of death in patients
      with SMCD: later onset of symptoms, absence of cutaneous mastocytosis,
      thrombocytopenia, elevated lactate dehydrogenase (LDH) level, anemia, bone marrow
      hypercellularity, qualitative peripheral blood smear abnormalities, elevated
      alkaline phosphatase level, and hepatosplenomegaly. Multivariate analysis showed
      that only the age at onset of symptoms and LDH levels were significant
      independent predictors of survival. Eight of the 10 SMCD patients who died had
      myeloproliferative or myelodysplastic syndromes or acute nonlymphocytic leukemia.
      CONCLUSION: Our prospective study has defined a number of important variables in
      patients with clinical evidence of mast cell proliferation that can predict both
      the presence of SMCD and the likelihood of fatal disease. Since recent evidence
      suggests that mast cells derive from a bone marrow hematopoietic progenitor, SMCD
      may represent a myeloproliferative condition with the propensity to evolve into a
      neoplastic granulocytic disorder in a significant minority of patients.

PMID- 1750432
TI  - Frequent occurrence of asplenism and cholelithiasis in patients with autoimmune
      polyglandular disease type I.
AB  - PURPOSE: This study assesses the occurrence of asplenism and gallstones in
      patients with autoimmune polyglandular disease type I (APG I). PATIENTS AND
      METHODS: Nine patients with APG I (ages 14 to 48) were studied at the National
      Institutes of Health. Each patient received endocrine testing, a careful
      examination of his or her peripheral blood smear, lymphocyte immunophenotyping, a
      liver-spleen scan, and either an upper abdominal ultrasound or a computer
      assisted tomogram to evaluate the spleen and gallbladder. RESULTS: We documented
      asplenism in four patients and cholelithiasis in four patients, with two patients
      having both conditions. The patients with asplenism had Howell-Jolly bodies on
      peripheral blood smears, lack of splenic uptake by liver-spleen scan, and absent
      spleens by abdominal computed tomographic scan or ultrasound evaluation. The
      clinical presentation of the patients with cholelithiasis ranged from acute
      symptoms requiring surgery to asymptomatic gallstones. Lymphocyte
      immunophenotyping did not reveal consistent changes in either B- or T-cell
      subpopulations in the patients studied. CONCLUSION: Asplenism and gallstones
      occur frequently in patients with APG I. In addition to careful examination of
      the peripheral blood smear for Howell-Jolly bodies to screen for asplenism, we
      recommend an abdominal ultrasound to detect asplenism and/or gallstones in all
      patients with APG I. Appropriate immunizations and antibiotic coverage may be
      helpful in those patients with absent spleens.

PMID- 1750433
TI  - Familial occurrence of hypersensitivity to phenytoin.
AB  - PURPOSE: Therapy with anticonvulsants such as phenytoin, phenobarbital, and
      carbamazepine can be complicated by severe hypersensitivity reactions. Previous
      work has suggested that the predisposition to such reactions is based on an
      inherited abnormality in the detoxification of reactive metabolites of the drugs.
      However, there are no reports of familial occurrence of the reactions in the
      literature. In the current study, we examined a family in which three siblings
      developed hypersensitivity reactions to phenytoin, confirming the inheritance of
      a predisposition to the reactions. Detoxification of reactive metabolites of the
      anticonvulsants was studied in cells from the patients and their siblings.
      PATIENTS AND METHODS: Three siblings from a family of 12 siblings developed
      hypersensitivity reactions to phenytoin characterized by fever, rash,
      lymphadenopathy, and anicteric hepatitis. All recovered completely after
      discontinuation of treatment. One sibling tolerated phenobarbital without toxic
      sequelae. Peripheral blood mononuclear cells from the three patients and five
      additional siblings who had never taken anticonvulsants were exposed to oxidative
      metabolites of phenytoin, phenobarbital, and carbamazepine generated by a hepatic
      microsomal drug-metabolizing system in vitro. The toxicity of metabolites in the
      cells from the siblings was compared with that in cells from control subjects.
      RESULTS: Cells from each of the patients who had experienced a hypersensitivity
      reaction exhibited increased toxicity from metabolites of phenytoin and
      carbamazepine, while the cellular response to metabolites of phenobarbital was
      within normal limits. Cells from four of the other siblings showed an abnormal
      response to phenytoin metabolites, while cells from the final sibling detoxified
      phenytoin metabolites normally. CONCLUSION: Our observations on the patients
      confirm the inherited nature of phenytoin hypersensitivity reactions in vivo. In
      vitro studies demonstrated abnormal metabolite detoxification in the patients and
      several of their siblings. The detoxification defect included metabolites of
      phenytoin and carbamazepine but not of phenobarbital. A family history of a drug
      hypersensitivity reaction should alert physicians to the probability of a
      markedly increased risk of an adverse reaction in family members. In vitro assays
      to confirm adverse reaction risks may ultimately be able to provide
      individualized risk assessment for patients who must take anticonvulsants.

PMID- 1750434
TI  - National High Blood Pressure Education Program (NHBPEP) review paper on
      complications of shock wave lithotripsy for urinary calculi.
AB  - This decade has witnessed dramatic advances in the surgical management of urinary
      calculi. Today, most stones can be removed by minimally invasive means. In fact,
      the treatment of choice in 60% to 90% of patients with renal and ureteral calculi
      that need to be surgically removed is extracorporeal shock wave lithotripsy
      (ESWL). This article reviews indications for ESWL and discusses deleterious
      effects of ESWL.

PMID- 1750435
TI  - Psychologic effects of the diagnosis and treatment of hypercholesterolemia:
      lessons from case studies.
AB  - Some patients exhibit adverse psychologic responses to the diagnosis and
      treatment of hypercholesterolemia. These responses are, in part, a function of
      the patient's perception of the distinction between disease and illness and the
      patient's understanding of the probabilistic relationship between risk factors
      and associated diseases. Moreover, failure to acknowledge some of the specific
      complexities of hypercholesterolemia (e.g., natural fluctuations in serum
      cholesterol levels, variability of response to diet, etc.) may result in
      considerable anxiety. Clinicians should recognize and address these potential
      sources of dysfunctional psychologic reactions when they counsel
      hypercholesterolemic patients.

PMID- 1750436
TI  - Refractory hypoxemia in right ventricular infarction from right-to-left shunting
      via a patent foramen ovale: efficacy of contrast transesophageal
      echocardiography.

PMID- 1750437
TI  - Cocaine-associated thrombocytopenia.
AB  - In this retrospective report, four male intravenous cocaine users are described
      with thrombocytopenia temporally related to the use of the drug. Mucosal bleeding
      and megakaryocytic hyperplasia occurred in all patients. The cocaine
      thrombocytopenia relationship was especially apparent in one individual who
      developed thrombocytopenia on two separate occasions after intravenous cocaine
      use. Three patients were treated successfully with high doses of intravenous
      gamma globulin and steroids, while one patient required splenectomy. Along with
      the widespread use of cocaine in our society has come the recognition of a number
      of adverse effects of the drug. Thrombocytopenia may be added to a list that
      includes myocardial infarction and central nervous system complications.

PMID- 1750438
TI  - The rashes of dermatomyositis in a black patient.

PMID- 1750439
TI  - Pericarditis: an unusual manifestation of giant cell arteritis.

PMID- 1750440
TI  - Interleukin-4 levels in the eosinophilia-myalgia syndrome.

PMID- 1750441
TI  - Academic medicine: no longer an individual sport.

PMID- 1750442
TI  - "Transfer" and "turning" fractures in nursing home patients.

PMID- 1750443
TI  - Upright tilt-table testing in patients with syncope.

PMID- 1750444
TI  - RNA-directed molecular hybridization screening: evidence for inapparent
      chlamydial infection.
AB  - Both clinical and epidemiological data suggest that inapparent infection by
      Chlamydia trachomatis occurs in humans. To confirm and study such infections, we
      developed a hybridization screening system directed toward chlamydial ribosomal
      RNA (rRNA). Six restriction endonuclease fragments derived from the cloned rrnA
      operon of chlamydial serovar L2(434) were tested as hybridization screening
      probes, but only one fragment encoding the 5' portion of the 16s rRNA gene plus
      some upstream flanking sequence was both sensitive and highly specific in such
      experiments. In Northern slot blot assays, hybridization analyses with this
      fragment as probe routinely detected one picogram or less of chlamydial RNA when
      that RNA was bound to membranes alone or as part of a mixture with a vast excess
      of mammalian RNA. The probe did not hybridize to RNA from mammalian and relevant
      bacterial sources but did hybridize to rRNA from B (ocular) and E (genital)
      serovars of C. trachomatis. Experiments using RNA from conjunctival biopsies and
      standard conjunctival swab samples from cynomolgus monkeys showed that the probe
      reliably distinguishes between known chlamydia-infected and uninfected samples.
      This suggests that it may be useful for clinical screening. Characterization
      assays for the RNA-directed probe screening system in this monkey model of
      trachoma provide initial molecular evidence that ocular chlamydial infection may
      persist longer than previously thought, based solely on direct fluorescence
      antibody assay (DFA) and culture analyses.

PMID- 1750445
TI  - Evaluation and management of patients with chronic fatigue.
AB  - Chronic fatigue is a common and disabling problem in primary care practice. The
      differential diagnosis of chronic fatigue is extensive and includes medical
      disorders, altered physiologic states (eg, pregnancy, exertion), psychiatric
      disorders, lifestyle derangements, drugs, and controversial entities (eg, chronic
      candidiasis, food allergies, environmental illness, and chronic fatigue
      syndrome). The most common diagnoses are psychiatric disorders, including mood,
      anxiety, and somatoform disorders. A comprehensive approach to diagnosis and
      management is necessary, including structured psychiatric interviewing,
      functional assessment, and elicitation of the patient's diagnostic beliefs.
      Patients often believe they are suffering from an organic medical disorder (eg,
      viral or immunologic) and resist psychiatric labelling of their symptoms and
      referral to mental health practitioners. Establishing and maintaining rapport,
      having a flexible approach, and demonstrating a personal concern for the patient
      is essential. Drug therapy for specific psychiatric and medical illnesses and
      cognitive-behavioral approaches for enhancing coping mechanisms are effective.

PMID- 1750446
TI  - Computer imaging analysis of the correlation between intensities of glomerular
      immune-deposits and histopathology in patients with IgA nephropathy.
AB  - The relationship between the intensities of IgA, C3c, and C9 deposition in renal
      glomeruli and the severity of histopathologic injuries in patients with IgA
      nephropathy was examined using Microscope-Photometer 01K and a computer.
      Percentages of glomerular adhesion to Bowman's capsules, crescent formation, and
      glomerular sclerosis were calculated in the renal specimens. There was a
      significant correlation between the intensity of each C3c and C9 deposition in
      glomeruli and the degree of glomerular adhesion to Bowman's capsules and crescent
      formation in patients with IgA nephropathy. There was no significant correlation
      between the intensity of C3c or C9 deposition in glomeruli and the degree of
      glomerular sclerosis. No relationship was found between the intensity of IgA
      deposition in glomeruli and the degree of histopathologic injuries. The patients
      with negative or trace amounts of glomerular C3c deposits showed less severe
      glomerular injuries. Thus, the intensity of C3c and C9 deposition in glomeruli
      appears to be one of the critical factors responsible for the active progression
      of glomerular inflammatory process in patients with IgA nephropathy.

PMID- 1750447
TI  - Gastric mucosal cytoprotection in the rat by scavenging oxygen-derived free
      radicals.
AB  - Oxygen-derived free radicals are cytotoxic and promote tissue damage. Dimethyl
      sulfoxide (DMSO) and allopurinol scavenge hydroxyl radicals, and the latter agent
      also inhibits the enzyme xanthine oxidase, which is responsible for the formation
      of superoxide anions. These agents were given daily by gavage (1 ml/d). After 2
      days of administration as 1, 2, or 5% solutions, the H+ output of the rat with or
      without pyloric ligation was not significantly affected. After six hours
      reserpine (5 mg/kg i.p.) or serotonin (50 mg/kg i.p.) produced ischemic mucosal
      injury in all stomachs (39 +/- 5.2 mm2 and 25.9 +/- 2.8 mm2, mean +/- standard
      error of the mean [SEM], n = 10). Pretreatment for 2 days with 1 ml/d of 1%
      allopurinol or DMSO significantly (p less than 0.001) protected the rat against
      the reserpine (23 +/- 2.1 mm2 and 24 +/- 1.9 mm2, respectively, vs 39 +/- 5.2
      mm2, n = 10) and serotonin injury (10 +/- 1.5 mm2 and 11 +/- 1.8 mm2,
      respectively, vs 25.9 +/- 2.8 mm2, n = 10). However, 2 days pretreatment with 1
      ml/d of 2% allopurinol or DMSO was more effective (p less than 0.001) in this
      respect, and injury only developed in 40% of the rats given reserpine (8 +/- 1.2
      mm2 and 9 +/- 1.6 mm2) and in 20% of those given serotonin (2.4 +/- 0.4 mm2 and
      1.9 +/- 0.5 mm2). Similar pretreatment with 5% solutions completely protected the
      rat stomach against the reserpine and serotonin injuries without significantly
      influencing the H+ output.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750448
TI  - Case report: extensive brain calcification in hypoparathyroidism.
AB  - It is well known that most patients with hypoparathyroidism have radiologically
      detectable basal ganglia calcification. Not as well known is that the brain
      calcinosis may be more extensive. We describe a 55-year-old woman with a 44-year
      history of symptomatic idiopathic hypoparathyroidism who has extensive
      calcification of her cerebrum and cerebellum as well as her basal ganglia,
      evident on computed tomography of the head. When first evaluated here 32 years
      ago, plain radiography of the skull demonstrated calcification of both caudate
      and lentiform nuclei (basal ganglia). Despite fair control of her serum calcium
      level, she has developed focal seizures, possibly related to the calcinosis of
      her brain.

PMID- 1750449
TI  - Case report: salmonellosis complicated by leukocytoclastic vasculitis.
AB  - We report the case of a healthy young Hispanic man with Salmonella typhimurium
      bacteremia and leukocytoclastic vasculitis. Leukocytoclastic vasculitis has not
      been previously reported as a complication of salmonella gastroenteritis and
      bacteremia. Salmonella gastroenteritis is rarely associated with bacteremia in
      healthy young adults.

PMID- 1750450
TI  - Prospects of gene therapy for hemoglobinopathies.
AB  - Gene therapy offers the promise of a definitive cure of the hemoglobinopathies
      and thalassemias. The background of gene therapy for these disorders is discussed
      along with the obstacles that must be overcome before this promise becomes
      reality.

PMID- 1750451
TI  - Community responsive medicine: defining an academic discipline.
AB  - Academic medicine is entering a period of introspection created by changing
      patterns of health and disease and changing patterns in reimbursement and health
      policy. To respond to existing health challenges, innovative strategies for
      health care delivery and education must be devised. The migration of medical
      education and health care delivery into centralized and frequently difficult-to
      access campuses is being reviewed by payors, policy analysts, and purchasers of
      care. One proposed solution to this problem responds to the identified
      shortcomings in medical education and some of the failures of our health care
      delivery system. Community Oriented Primary Care (COPC) and the related
      discipline of Community Responsive Medicine define health-oriented strategies
      that blend traditional primary care and public health. The classroom in Community
      Responsive Medicine is the community. The curriculum is defined by the elements
      and skills necessary to improve the health status of the target community. The
      model allows the student and resident to appreciate and experience the entire
      spectrum of health and disease and to understand the sequence of events that may
      lead to illness. Tertiary care is a critical curriculum component, but in
      Community Responsive Medicine the curriculum is balanced between the ambulatory
      and tertiary care settings. Community Responsive Medicine defines a role for new
      leadership that can create responsive educational and health care delivery
      systems accountable to the communities they serve.

PMID- 1750452
TI  - The endothelium--a key regulator of vascular tone.
AB  - Emerging evidence suggests the endothelium produces several substances capable of
      locally regulating organ blood flow. Vasoactive prostaglandins, endothelium
      derived relaxing factor, and endothelin are examples of these vasoactive
      substances. Abnormalities of endothelial function may contribute to the
      pathogenesis of disease in several circumstances, including hypertension,
      diabetes, and septicemia. Evidence for the endothelium as a regulator of regional
      perfusion and several of the endothelium-derived substances and their potential
      role in disease are reviewed.

PMID- 1750453
TI  - Elevated fetal plasma lactate produces polyhydramnios in the sheep.
AB  - In human fetuses with hemolytic diseases such as erythroblastosis fetalis,
      hydrops fetalis or polyhydramnios often develops. The mechanism(s) that produces
      these fluid imbalances is unknown, although lactate concentrations have been
      reported to be elevated in hydropic human fetuses with erythroblastosis. In this
      study we explored the role of lactate in producing fetal fluid imbalances. In
      seven near-term fetal sheep, we infused 5 mol/L sodium lactate at a rate of 10
      mmol/hr for 3 days. Fetal plasma lactate rose by 6.0 +/- 1.0 (mean +/- SE) mmol/L
      above control. Fetal plasma osmolality and Na+ increased slightly, Cl- decreased,
      and bicarbonate rose in proportion to the Cl- decrease. Fetal renal lactate
      excretion was 1.1 +/- 0.3 mmol/hr while Na+ excretion was 10.6 +/- 1.9 mEq/hr.
      Fetal urine flow increased by 1.9 +/- 0.4 L/day and the urine remained hypotonic
      relative to fetal plasma throughout the infusion. Amniotic fluid lactate and Na+
      rose during the infusion period and remained elevated during a 24-hour recovery
      period. Amniotic plus allantoic fluid volume at autopsy was 5.3 +/- 0.8 L
      compared with a normal of 0.5 to 1.0 L. There was little evidence of fetal edema.
      In summary, a moderate sustained elevation in fetal plasma lactate concentration
      appears to be a powerful osmotic agent for fetal accumulation of fluid from the
      maternal compartment over a period of days. This may be the primary mechanism
      whereby hydrops fetalis or polyhydramnios develops in severely anemic human
      fetuses.

PMID- 1750454
TI  - Oral-nasal membranes are not the major route for fetal absorption of amniotic
      fluid arginine vasopressin.
AB  - Intraamniotically injected substances such as arginine vasopressin and digoxin
      have been found to rapidly appear in the ovine fetal circulation, irrespective of
      whether the fetal esophagus has been ligated or occluded. To determine if the
      ovine fetal oral-nasal membrane plays a significant role in this fetal absorption
      of amniotic substances, we used two groups of chronically catheterized fetal
      sheep with a surgical glove sewed over the fetal head to prevent access of the
      head to amniotic fluid. In the first group 22.5 micrograms of arginine
      vasopressin was injected into the amniotic cavity; in the second group 22.5
      micrograms was injected into the glove over the fetal head. We found that, after
      injection into the amniotic cavity, there were rapid and highly significant
      increases in amniotic fluid arginine vasopressin concentrations, from 6.1 +/- 1.3
      to 51,249 +/- 18,182 pg/ml (mean +/- SE) (p less than 0.00001). Concurrently
      there was a rapid increase in fetal plasma arginine vasopressin concentrations
      from 4.5 +/- 1.3 to 93.8 +/- 18.9 pg/ml (p less than 0.00001). The increase was
      significant within 15 minutes and reached a maximum at 60 minutes after the
      injection. Fetal arterial pressure increased by 10 +/- 2 mm Hg, whereas heart
      rate decreased by 30 +/- 5 beats/min (p less than 0.00001). In contrast, after
      the injection into the glove covering the fetal head, there were no significant
      changes in any of the measured parameters. This suggests that the ovine fetal
      oral-nasal membrane is not a significant route of absorption of amniotic fluid
      arginine vasopressin and that the most likely route of absorption is the
      vascularized fetal surface of the placenta and vascularized fetal membranes,
      i.e., the intramembranous pathway.

PMID- 1750455
TI  - Amniotic fluid volume response to esophageal occlusion in fetal sheep.
AB  - Although ovine and human fetuses swallow considerable volumes of fluid, the
      impact of absence of fetal swallowing on amniotic fluid volume regulation is
      unclear. To study the role of fetal swallowing on urine production and amniotic
      fluid, seven ovine fetuses (126 +/- 1 days) were chronically prepared with fetal
      bladder and vascular catheters, an esophageal flow probe, an inflatable
      esophageal cuff, and amniotic fluid catheters. In the five fetuses that underwent
      esophageal ligation after the control period, fetal swallowing averaged 0.27
      ml/min before occlusion. In response to esophageal occlusion, significant
      increases were noted in fetal plasma arginine vasopressin (6.9 +/- 2.6 to 16.6 +/
      4.4 pg/ml) and urine osmolality (159 +/- 1 to 324 +/- 30 mOsm/kg), whereas urine
      volume (0.25 ml/min) did not change. Amniotic fluid volume increased nearly
      threefold after 3 days of esophageal occlusion (582 +/- 180 to 1530 +/- 271 ml).
      Amniotic fluid volume remained normal (334 to 419 ml) in the one fetus in which
      the occluder did not inflate. In the one fetus in which the esophagus was
      occluded at surgery, amniotic fluid volume was increased after the surgical
      recovery period (1489 ml). These data indicate an important role of fetal
      swallowing in amniotic fluid homeostasis and the potential interaction of
      swallowing with fetal urine production.

PMID- 1750456
TI  - Angiotensin II vascular smooth-muscle receptors are not down-regulated in near
      term pregnant sheep.
AB  - Normal human and ovine pregnancies are associated with elevated plasma
      angiotensin II levels and refractoriness to the vasoconstrictor effects of
      infused angiotensin II, which is greater in the ovine uteroplacental vascular bed
      than in the systemic vasculature. It remains unclear whether this refractoriness
      reflects alterations in angiotensin II vascular smooth-muscle receptor density or
      affinity. We examined the angiotensin II vascular smooth-muscle receptor in
      nonpregnant (n = 12) and near-term pregnant (130 +/- 3 days [mean +/- SD], n =
      10) sheep, comparing binding characteristics on plasma membranes prepared from
      the medial layer of aorta, mesenteric artery, and uterine artery. Plasma
      angiotensin II levels were increased threefold to fourfold (p less than 0.001) in
      pregnant ewes. A single class of high-affinity angiotensin II vascular smooth
      muscle receptor was identified in each type of artery. Receptor density was
      similar in nonpregnant and pregnant mesenteric artery (92 +/- 21 vs 103 +/- 40
      fmol/mg protein, respectively), aorta (186 +/- 29 vs 220 +/- 46 fmol/mg protein),
      and uterine artery (59 +/- 20 vs 77 +/- 20 fmol/mg protein) tissue. Receptor
      affinity also was unchanged during pregnancy. Because changes in the density and
      affinity of the angiotensin II vascular smooth-muscle receptor were not observed
      in near-term pregnant ewes, the attenuated vasoconstrictor responses seen during
      pregnancy do not reflect receptor down-regulation or decreased affinity.

PMID- 1750457
TI  - Effects of hyperglycemia on mitochondrial morphology in the region of the
      anterior neuropore in the explanted rat embryo model: evidence for a modified
      Reid hypothesis as a mechanism for diabetic teratogenesis.
AB  - Congenital malformations are the leading cause of the increased perinatal
      mortality in the infants of insulin-dependent diabetic mothers. The mechanisms(s)
      of diabetic teratologic development has yet to be defined. Hyperglycemia is known
      to depress aerobic metabolism in many organisms and cell lines. Reid hypothesized
      that exposure to hyperglycemia could result in decreased mitochondrial biogenesis
      in embryonic cells. Should these cells suddenly be changed to an environment of
      lower glucose concentration, decreased energy capabilities would exist until
      sufficient numbers of mitochondria could be regenerated. Such cells may not be
      capable of meeting temporal-spatial requirements, thereby resulting in structural
      abnormalities. In our study the explanted rat embryo model demonstrated that in
      the head-fold region hyperglycemia produced morphologic alterations of
      mitochondria but no difference in the number of mitochondria per cell.
      Specifically, embryos cultured in euglycemia demonstrated orthodox mitochondrial
      configuration, whereas those cultured in hyperglycemia had mitochondria in a
      condensed configuration. These findings were reversible. A modification of Reid's
      original hypothesis may provide an explanation for the mechanism of diabetic
      teratologic development.

PMID- 1750458
TI  - Longitudinal changes in insulin release and insulin resistance in nonobese
      pregnant women.
AB  - To assess the longitudinal changes in insulin release and insulin sensitivity in
      nonobese normal women during gestation, six women were evaluated with oral
      glucose tolerance testing, body composition analysis, intravenous glucose
      tolerance tests, and the hyperinsulinemic-euglycemic clamp before conception, at
      12 to 14 weeks, and at 34 to 36 weeks' gestation. There was a significant
      increase in the insulin/glucose ratio (p = 0.028) during the oral glucose
      tolerance test during gestation. There was also a significant 3.0- to 3.5-fold
      increase throughout gestation in first-phase (p = 0.001) and second-phase (p =
      0.0001) insulin release during the intravenous glucose tolerance test. Peripheral
      insulin sensitivity was estimated as the glucose infusion rate (in milligrams per
      kilogram fat-free mass per minute) during the hyperinsulinemic-euglycemic clamp.
      There was a significant (p = 0.0003) 56% decrease in insulin sensitivity through
      36 weeks' gestation. These results are the first to prospectively evaluate the
      longitudinal changes in maternal carbohydrate metabolism from the time before
      conception through late gestation with newer methods such as the hyperinsulinemic
      euglycemic clamp.

PMID- 1750459
TI  - The changing glycemic response to exercise during pregnancy.
AB  - This study was designed to test the hypothesis that pregnancy reverses the
      nonpregnant hyperglycemic response to sustained exercise. Serial data were
      obtained from 75 exercising women. Before pregnancy, exercise produced an
      intensity-dependent increase in blood glucose that averaged 1.5 mmol/L at high
      intensities. By the eighth week this response was blunted and blood glucose
      increased only when exercise intensity exceeded 80% of maximum. At 15 weeks this
      progressed and was not associated with a change in either the insulin or
      catecholamine response. By the twenty-third week exercise produced a decrease in
      blood glucose that was no longer related to exercise intensity. We conclude that
      the hypothesis is correct and speculate that the early change in the response is
      related to decreased hepatic glucose release coupled with increased glucose
      oxidation. In late pregnancy this is probably accentuated by fetoplacental
      demands.

PMID- 1750460
TI  - The changing thermal response to endurance exercise during pregnancy.
AB  - This study was designed to test the hypothesis that the thermal response to
      endurance exercise is altered by the thermal adaptations to pregnancy.
      Accordingly, rectal temperature was monitored in 18 recreational athletes before,
      during, and after 20 minutes of continuous exercise before conception and every 6
      to 8 weeks during pregnancy. Mean exercise intensity was 64% of VO2 max before
      conception and did not change during pregnancy. However, the peak rectal
      temperature reached during exercise decreased by 0.3 degrees C at 8 weeks and
      then fell at a rate of 0.1 degrees C per lunar month through the thirty-seventh
      week. This appeared to be related to changes in resting temperature, thermal
      mass, sweating threshold, and venous capacitance that began early in pregnancy.
      These data suggest that the magnitude of any exercise-associated thermal stress
      for the embryo and fetus is markedly reduced by the maternal physiologic
      adaptations to pregnancy.

PMID- 1750461
TI  - Maternal levels of prostacyclin, thromboxane, vitamin E, and lipid peroxides
      throughout normal pregnancy.
AB  - In normal pregnancy the vasodilating actions of prostacyclin and the antioxidant
      activity of vitamin E are important for normal physiologic function. Thromboxane
      and lipid peroxides oppose these actions by promoting vasoconstriction and
      peroxidation reactions, respectively. An imbalance between thromboxane and
      prostacyclin and between lipid peroxides and antioxidant activity is implicated
      in pathologic states such as preeclampsia. We hypothesized that in normal
      pregnancy there would be a balance in the ratios of prostacyclin to thromboxane
      and of vitamin E to lipid peroxides that would favor prostacyclin and vitamin E.
      Blood samples were collected from normally pregnant women throughout gestation
      and analyzed for prostacyclin, thromboxane, vitamin E, and lipid peroxides. Serum
      levels of lipid peroxides remained relatively stable throughout gestation, but
      the levels of vitamin E progressively increased. Plasma levels of prostacyclin
      progressively increased with advancing gestation, whereas levels of thromboxane
      progressively decreased. Therefore the ratios of both prostacyclin/thromboxane,
      and vitamin E/lipid peroxides progressively increased during pregnancy. The
      increase in the ratios was highly correlated, r = 0.94. We conclude that the
      changes in the maternal concentrations of these compounds and the progressive
      increase in the ratios of prostacyclin/thromboxane and vitamin E/lipid peroxides
      suggest that the vasodilating actions of prostacyclin and the antioxidant
      activity of vitamin E are progressively favored with advancing gestation in
      normally pregnant women.

PMID- 1750462
TI  - The imbalance between thromboxane and prostacyclin in preeclampsia is associated
      with an imbalance between lipid peroxides and vitamin E in maternal blood.
AB  - Preeclampsia is associated with an imbalance between thromboxane and
      prostacyclin. The cause of the imbalance is unknown. Preeclampsia sera contain
      cytotoxic factors that can damage endothelial cells. Lipid peroxides can damage
      cell membranes, so elevated levels in the mother's blood could be related to
      endothelial cell injury and decreased prostacyclin in preeclampsia. This study
      determined maternal plasma levels of thromboxane and prostacyclin and serum
      levels of lipid peroxides and vitamin E in women with normal pregnancy (n = 12),
      mild preeclampsia (n = 16), and severe preeclampsia (n = 19) between 36 and 40
      weeks' gestation. In normal pregnancy the ratio of thromboxane to prostacyclin
      (0.63) favored prostacyclin, and the ratio of lipid peroxides to vitamin E (0.43)
      favored vitamin E. Prostacyclin was significantly decreased in both mild and
      severe preeclampsia. Thromboxane was not increased in mild preeclampsia but was
      significantly increased in severe preeclampsia. The ratio of thromboxane to
      prostacyclin was increased in mild preeclampsia (0.77) and greatly increased in
      severe preeclampsia (1.94). Lipid peroxides were significantly increased in mild
      preeclampsia and increased further in severe preelcampsia. Vitamin E levels were
      unaltered in mild preeclampsia but significantly decreased in severe
      preeclampsia. The ratio of lipid peroxides to vitamin E was increased in mild
      (0.52) and greatly increased in severe (1.09) preeclampsia. We concluded the
      following: (1) Maternal plasma prostacyclin is decreased in both mild and severe
      preeclampsia, but thromboxane is increased only in severe cases. (2) Lipid
      peroxides are significantly increased in both mild and severe preeclampsia and
      vitamin E is significantly decreased in severe preeclampsia. We speculate that
      this imbalance could result in endothelial and platelet cell damage and in
      decreased prostacyclin and increased thromboxane synthesis. (3) Preeclampsia is
      associated with an imbalance not only between thromboxane and prostacyclin but
      also between lipid peroxides and vitamin E in maternal blood. The imbalances
      progressively favor thromboxane and lipid peroxides with the increasing severity
      of preeclampsia, which is consistent with the clinical symptoms of this disorder.

PMID- 1750463
TI  - Antioxidant systems in normal pregnancy and in pregnancy-induced hypertension.
AB  - Increased free radical activity has been implicated in the pathogenesis of
      pregnancy-induced hypertension. This article investigates whether changes in
      antioxidant systems contribute to this condition. Two extracellular (plasma
      thiols and ceruloplasmin) and two intracellular (red blood cell lysate thiols and
      red blood cell superoxide dismutase) antioxidant markers were assayed in 25
      nonpregnant women, 16 pregnant women with normal blood pressure, 19 women with
      pregnancy-induced hypertension, and 13 women with proteinuric pregnancy-induced
      hypertension. In the normotensive pregnant group (in comparison with the
      nonpregnant group) the plasma thiol level was reduced (p less than 0.001) and the
      ceruloplasmin level raised (p less than 0.005), suggesting increased free radical
      activity. The lysate thiol level increased (p less than 0.005), which may reflect
      a compensatory protective response. In the hypertensive pregnant groups the
      lysate thiol rise was not present. These red blood cells may be more prone to
      oxidative stress. Whether this situation is a cause or an effect of oxidative
      stress in pregnancy-induced hypertension has yet to be elucidated.

PMID- 1750464
TI  - Selective effects of preeclamptic sera on human endothelial cell procoagulant
      protein expression.
AB  - Current concepts of preeclampsia suggest that dysfunction of maternal vascular
      endothelium in vivo is a central pathogenetic feature of this syndrome. This
      hypothesis is suggested by the activation of the coagulation cascade associated
      with preeclampsia and evidence for a role of endothelium in maintaining
      thromboresistance. Previous in vitro studies with monolayers of human umbilical
      vein endothelial cells demonstrated direct cytotoxic effects of sera from
      preeclamptic parturients. In the current studies, we have examined the in vitro
      expression of three procoagulant protein activities regulated by endothelial
      cells: cellular fibronectin, an important mediator of platelet aggregation known
      to be elevated in preeclamptic women in vivo; tissue factor, the most potent
      endogenous procoagulant activity; and von Willebrand factor, a major component of
      coagulation factor VIII. Monolayer cultures of human umbilical vein endothelial
      cells were incubated with pregnancy sera for 24 hours before these proteins and
      activities were quantified. Exposure of identical endothelial cell cultures to
      predelivery preeclamptic sera caused significantly greater release of cellular
      fibronectin than postdelivery preeclamptic or predelivery or postdelivery normal
      pregnancy sera (p less than 0.05). However, neither tissue factor activity nor
      von Willebrand factor expression appeared to be increased preferentially by
      preeclamptic sera. The data indicate that sera from women with preeclampsia
      induce a selective, but not a generalized, activation of endothelial cell
      procoagulant protein production.

PMID- 1750465
TI  - Potential role of endothelin-1 in normal and hypertensive pregnancies.
AB  - Endothelins are the most potent naturally occurring vasoconstrictors yet
      discovered. Both normal and abnormal pregnancies are associated with significant
      changes in vascular smooth muscle; therefore the potential role of endothelin in
      pregnancy was investigated. Plasma immunoreactive endothelin-1 concentration was
      measured by radioimmunoassay in blood from women with normal pregnancy and
      preeclampsia and in cord blood from normal pregnancies. Endothelin-1 levels were
      elevated in pregnant women during labor when compared with levels in nonpregnant
      women and patients with normal pregnancies before labor. Preeclampsia in
      nonlaboring women before treatment was associated with higher endothelin values
      when compared with values in normal nonlaboring patients and women with
      preeclampsia after magnesium sulfate infusion. The umbilical venous concentration
      of endothelin was 10 times higher than normal pregnant levels and four times
      higher than levels in laboring patients.

PMID- 1750466
TI  - Endothelin-1-induced vasoconstriction is not mediated by thromboxane release and
      action in the human fetal-placental circulation.
AB  - The vasoconstrictor peptide endothelin-1 (8 x 10(-10) to 1 x 10(-8) mol/L)
      significantly increased fetal-placental perfusion pressure in vitro in a
      cumulative manner from 30 +/- 2 to 123 +/- 25 mm Hg (mean +/- SEM, n = 5, p less
      than 0.0005, analysis of variance). Accompanying this vasoconstriction was a
      corresponding reduction in fetal-placental perfusate flow rate. Measurement of
      thromboxane B2 and 6-keto-prostaglandin F1 alpha in the fetal-placental perfusate
      revealed a significant reduction in their release (p less than 0.0096 and p less
      than 0.0004, analysis of variance, respectively) when corrected for flow rate.
      Neither the thromboxane synthesis inhibitor dazoxiben (10(-6) mol/L) nor the
      thromboxane receptor antagonist SQ29548 (10(-6) mol/L) was able to block the
      vasoconstrictor actions of endothelin-1. Therefore endothelin-1-induced
      vasoconstriction in the human fetal-placental circulation does not appear to be
      mediated by thromboxane release or action. The stimulus to eicosanoid release in
      the fetal-placental circulation may be hydrodynamic, i.e., flow or shear stress.

PMID- 1750467
TI  - An endothelial cell model for the investigation of the molecular regulation of
      fetal vascular tone.
AB  - Human umbilical vessels are not innervated, and hence regulation of tone in these
      vessels must come from locally derived vasoactive substances such as
      prostacyclin. To evaluate the regulation of prostacyclin production by human
      umbilical vein endothelial cells, we incubated confluent cultures of these cells
      with various concentrations of inflammatory mediators (endotoxin, interleukin-1
      beta, and tumor necrosis factor), protein kinase C agonists (phorbol 12-myristate
      13-acetate, phorbol 12,13-dibutyrate), and calcium ionophores (A-23187 and
      ionomycin). Human umbilical vein endothelial cells were prepared from term
      pregnancies, and confluent cultures were incubated with test substances for 16
      hours. Prostacyclin was measured as its metabolite 6-keto-prostaglandin F1 alpha
      by radioimmunoassay. Concentration-related increases in 6-keto-prostaglandin F1
      alpha production were observed in response to endotoxin, cytokines, phorbol
      esters, and calcium ionophores. We conclude that human umbilical vein endothelial
      cell prostacyclin production is influenced by several intracellular messengers
      and that human umbilical vein endothelial cells may provide a useful in vitro
      model for investigating the physiology and pathophysiology of umbilical vessel
      vascular tone.

PMID- 1750468
TI  - Prenatal diagnosis with fetal cells isolated from maternal blood by
      multiparameter flow cytometry.
AB  - A long-sought goal of medical genetics has been development of prenatal
      diagnostic procedures that do not endanger the conceptus. Reliable and universal
      screening for cytogenetic disorders would require analysis of fetal cells
      isolated from the maternal circulation. This would be applicable to all pregnant
      women, irrespective of their ages or histories. In the current study fetal
      nucleated erythrocytes were flow sorted on the basis of four parameters: cell
      size, cell granularity, transferrin receptor, and glycophorin-A cell surface
      molecule. By polymerase chain reaction with oligonucleotide primers flanking
      single-copy Y-specific deoxyribonucleic acid sequences, male fetuses were
      correctly identified among flow-sorted samples in 12 of 12 (100%) pregnancies;
      female fetuses were correctly identified in 5 of 6 (83%) pregnancies. We also
      achieved the prenatal diagnosis of fetal aneuploidies by use of flow-sorted
      nucleated fetal erythrocytes and in situ hybridization with chromosome-specific
      deoxyribonucleic acid probes: one case of trisomy 21 that was detected in
      maternal blood taken 1 week after chorionic villus sampling and one case of
      trisomy 18 that was detected in maternal blood taken immediately before chorionic
      villus sampling. Although our results are promising, additional data on the
      background sensitivity and specificity of in situ hybridization in flow-sorted
      fetal cells will be necessary to minimize subjective interpretation and permit
      clinical application.

PMID- 1750469
TI  - Absence of hyperinsulinemia in isoimmunized fetuses treated with intravascular
      transfusion.
AB  - We serially sampled blood from fetuses of five severely isoimmunized pregnancies
      at the time of each intrauterine intravascular transfusion and at birth. We were
      unable to demonstrate either an elevation in the plasma insulin/glucose ratio or
      a relationship between the insulin/glucose ratio and hemoglobin concentration at
      any time period. Plasma total glutathione concentration, however, decreased
      dramatically from the initial to the second transfusion (323 +/- 114 to 43 +/- 9
      ng/ml; t = -5.06, p less than 0.01). We speculate that intrauterine transfusion
      may modify or prevent the previously reported fetal pancreatic beta-cell
      hyperplasia and hyperinsulinemia associated with isoimmunization by decreasing
      red blood cell hemolysis and thereby circulating glutathione.

PMID- 1750470
TI  - Does the brachial artery Doppler flow velocity waveform reflect changes in
      downstream impedance?
AB  - Brachial artery Doppler flow velocity waveforms were recorded from 10 nonpregnant
      women and 19 women with uncomplicated pregnancies. The pregnant group showed
      higher peak systolic frequencies (3.24 compared with 2.26, p = 0.01), higher
      maximum end-diastolic frequencies (0.62 compared with 0.25, p = 0.01), and lower
      pulsatility indices (2.57 compared with 3.95, p = 0.06) when compared with the
      nonpregnant group. These Doppler changes could reflect the increase in maternal
      cardiac output and decline in systemic vascular resistance that occur in normal
      pregnancy. The effect on brachial artery Doppler of acutely increasing downstream
      impedance by hand immersion in ice-cold water was studied in nine women with
      uncomplicated pregnancies at 32 to 38 weeks' gestation. Immersion for 15 seconds
      was associated with a significant reduction in peak systolic frequencies (from
      3.06 to 1.97, p less than or equal to 0.005) and maximum end-diastolic
      frequencies (from 0.82 to 0.03, p less than or equal to 0.005) and a significant
      increase in the pulsatility index (from 1.87 to 5.62, p less than or equal to
      0.005). These changes persisted for the duration of immersion (60 seconds). After
      immersion, the brachial artery flow velocity waveform returned to its
      preimmersion pattern by 60 seconds. We conclude that in normal pregnancy, the
      maternal brachial artery Doppler flow velocity waveform reflects acute and
      chronic changes in downstream impedance.

PMID- 1750471
TI  - Effect of pregnancy on the accuracy of light-reflection rheography.
AB  - Light-reflection rheography is a noninvasive method to detect venous obstruction
      by indirectly measuring venous emptying time. In nonpregnant women it has greater
      than 90% sensitivity when compared with venography but has not been tested during
      gestation. To determine if the nonthrombotic occlusion of venous outflow by the
      pregnant uterus might alter the performance of light-reflection rheography, we
      examined 17 normal patients with a vascular Accuscan (Hemodynamics, Inc., Boca
      Raton, Fla.) in the third trimester of pregnancy and 11 patients during the early
      second trimester. These results were compared with the defined normal
      (nonpregnant) rate of venous emptying (slope 0.54 +/- 0.06). The mean (+/- SD)
      for the entire sample was 0.58 +/- 0.23 mm/sec in the right leg and 0.52 +/- 0.19
      mm/sec in the left leg measured in the standard sitting position (p = 0.21). The
      results did not vary with gestational age. A subset of patients in late pregnancy
      were used to compare the effect of various positions (supine, lateral decubitus,
      and sitting) on test performance. Positions other than sitting provided results
      that were inconsistent. It appears that the large pregnant uterus does not
      significantly obstruct venous outflow from the lower extremities in the standard
      sitting position; thus the results of light-reflection rheography are not
      affected. Comparison of light-reflection rheography versus venography in pregnant
      patients with suspected venous thrombosis is being investigated.

PMID- 1750472
TI  - Anticardiolipin antibody-positive serum enhances endothelial cell platelet
      activating factor production.
AB  - Circulating antiphospholipids have been linked to recurrent pregnancy loss by a
      mechanism involving placental and decidual thrombosis. We hypothesized that
      platelet-activating factor, an autacoid synthesized by vascular endothelium,
      might mediate this phenomenon through its ability to promote platelet aggregation
      and fibrin deposition. Alternatively, antiphospholipid antibodies might exert a
      procoagulant effect by inhibiting the synthesis of prostacyclin. To evaluate
      these theories, endothelial cells (harvested from human umbilical veins) were
      grown to confluence and incubated for 48 hours with 20% concentrations of
      anticardiolipin antibody-positive and -negative human sera as well as fetal
      bovine serum. After incubation culture wells were stimulated with 10 mumol/ml
      calcium ionophore A23187 (an agonist of platelet-activating factor and
      prostacyclin synthesis). Intracellular platelet-activating factor was measured by
      tritiated acetate incorporation, phospholipid extraction, thin-layer
      chromatography, and scintillation spectrophotometry. Enhanced platelet-activating
      factor synthesis was identified in cultures incubated with anticardiolipin
      antibody-positive serum (25,544 +/- 2604 disintegrations per minute, mean +/- SD)
      when compared with anticardiolipin antibody-negative serum (18,600 +/- 3316 dpm)
      or fetal bovine serum (19,014 +/- 4233 dpm; analysis of variance, p = 0.033). In
      similar experiments, prostacyclin synthesis was determined by measuring its
      primary metabolite, 6-keto-prostaglandin F1 alpha, in culture supernatants. No
      differences between anticardiolipin antibody-positive and control cultures were
      observed (analysis of variance, p = 0.90). We conclude that in this endothelial
      cell model, anticardiolipin antibody-positive serum enhances ionophore-mediated
      platelet-activating factor synthesis but has no apparent effect on the production
      of prostacyclin. These findings suggest a potential role for platelet-activating
      factor in anticardiolipin antibody-mediated vascular thrombosis.

PMID- 1750473
TI  - Combination antibiotics and indomethacin in idiopathic preterm labor: a
      randomized double-blind clinical trial.
AB  - Subclinical infection may play a role in the failure of magnesium sulfate
      tocolysis. Using a double-blind randomized study design, we administered a
      combination of ampicillin-sulbactam and indomethacin or corresponding placebos to
      patients in preterm labor who were receiving intravenous magnesium sulfate
      tocolysis. The mean gestational age at enrollment was 30.1 weeks, and mean
      cervical dilatation was 2.15 cm. No differences were noted between placebo (n =
      43) and study patients (n = 43) in gestational age at delivery, term deliveries,
      days gained, or neonatal outcome. Preterm delivery (less than 36 weeks) occurred
      in 61% of the total population. The likelihood of a beta error was 0.07 to 0.23
      on the basis of outcome analysis. In our population adjunctive ampicillin
      sulbactam with indomethacin did not improve the success of magnesium sulfate
      tocolysis.

PMID- 1750474
TI  - Dose-related action of gonadotropin-releasing hormone on basal prostanoid
      production from the human term placenta.
AB  - The dose-related effect of gonadotropin-releasing hormone on placental
      prostanoids was studied with a perifusion system. Villous tissues were perifused
      with medium 199 (1 ml/hr) and at the beginning of the fifth hour, either 0, 10(
      10), 10(-9), 10(-8), 10(-7), or 10(-6) mol/L gonadotropin-releasing hormone was
      added to the medium of triplicate chambers. The concentration of prostaglandin E,
      prostaglandin F, 13,14-dihydro-15-keto-prostaglandin F2 alpha, 6-keto
      prostaglandin F1 alpha, and thromboxane B2 in the effluent medium, collected
      every hour, was determined by specific radioimmunoassay. The cumulative release
      after gonadotropin-releasing hormone treatment for each chamber was calculated,
      and replicate chambers were averaged. Linear regression analysis of the average
      for each dose from three different placentas was used to determine the dose
      response relationship. Gonadotropin-releasing hormone significantly inhibited the
      release of placental prostaglandin E, prostaglandin F, and thromboxane B2 in a
      dose-dependent fashion. Gonadotropin-releasing hormone had no significant effect
      on 13,14-dihydro-15-keto-prostaglandin F2 alpha and 6-keto-prostaglandin F1
      alpha, although there was an apparent increase in 13,14-dihydro-15-keto
      prostaglandin F2 alpha. These data support the hypothesis that chorionic
      gonadotropin-releasing hormone inhibits prostanoid production from the placenta,
      which in turn may regulate various functions of prostanoids during pregnancy.

PMID- 1750475
TI  - Circadian myometrial and endocrine rhythms in the pregnant rhesus macaque:
      effects of constant light and timed melatonin infusion.
AB  - Six chronically catheterized rhesus macaques maintained on a 12-hour-light/dark
      cycle (lights on from 7 AM to 7 PM) showed a nocturnal uterine activity rhythm
      with peak contractile events between 9 and 11 PM (p less than 0.05). In blood
      samples collected at 3-hour intervals over a 24-hour period, we determined that
      plasma melatonin and progesterone concentrations were elevated at night whereas
      estradiol, estrone, and cortisol reached peak concentrations in the early morning
      (p less than 0.05). Lights were then left on for the remainder of the study.
      After 12 days in constant light, daily rhythms in uterine activity and plasma
      steroid levels were relatively unchanged, whereas melatonin concentrations were
      suppressed. Animals then received a timed infusion of melatonin (0.2 mg/kg/hr
      each day from 7 PM to 6 AM daily until delivery). The nocturnal uterine activity
      rhythm and the rhythms in plasma steroid concentrations were maintained. We
      conclude that the 24-hour patterns in maternal uterine activity and plasma
      steroid hormone levels are circadian rhythms generated by an endogenous biologic
      clock and do not appear to be driven by the pattern of melatonin in circulation.

PMID- 1750476
TI  - Effects of intravenous cocaine on reproductive function in the mated rabbit.
AB  - A dramatic increase in the use of crack cocaine by young women has resulted in
      the exposure of a substantial number of fetuses to the drug in utero. The goal of
      these experiments was to investigate the effects of intravenous cocaine (a model
      for crack) on reproductive function in the female rabbit. We used two protocols:
      (1) single daily injections over the course of pregnancy ("single daily"
      protocol), with animals examined on day 1, 8, 15, 22, or 29, and (2) six hourly
      injections on the day of mating ("binge" protocol). The maximum tolerated dose of
      cocaine, 4 mg/kg, was administered at 0.5 ml/min. The single daily protocol
      increased ovulation but had no effect on fetal and placental weights or preterm
      delivery. The binge protocol significantly reduced in vitro development of
      retrieved embryos but did not affect implantation assessed on day 8 of pregnancy.

PMID- 1750477
TI  - Expression of extracellular matrix-degrading metalloproteinases by cultured human
      cytotrophoblast cells: effects of cell adhesion and immunopurification.
AB  - In vitro, invasion of basement membrane by human trophoblast can be blocked by
      metalloproteinase inhibitors. The purpose of our study was to characterize these
      enzymes by zymography, to define their cellular origin. First-trimester
      cytotrophoblast cells were prepared according to the method of Kliman et al. Half
      of the cell suspension was further purified with an antibody to leukocyte common
      antigen (CD45). Cytotrophoblast cells (immunopurified or not) were incubated in
      Dulbecco's modified Eagle's medium on different matrices. Progesterone, total
      human chorionic gonadotropin, and free beta-human chorionic gonadotropin were
      measured in the supernatant by radioimmunoassay or enzyme immunoassays. Secreted
      (in the medium) and cell-bound proteases were characterized by zymography on
      sodium dodecyl sulfate-polyacrylamide gels containing gelatin. Cytotrophoblast
      cell preparations contained 12% to 34% leukocyte common antigen-positive cells
      before and 0% after immunopurification. Large zones of digested matrices were
      observed after 48 hours of culture on Matrigel or rat tail collagen but not on
      agarose. Cells secreted progesterone, human chorionic gonadotropin, and free beta
      human chorionic gonadotropin in vitro, but no difference was observed among cells
      grown on different matrices or between immunopurified and nonimmunopurified
      cells. By zymography, seven gelatin-degrading enzymes were seen in culture
      supernatants and five of them were present in cell lysates. The molecular weights
      of these proteases ranged from 59 to 230 kd. Immunopurification eliminated three
      of these enzymes, so they were clearly produced by bone marrow-derived cells
      (leukocyte common antigen positive) contaminating the cytotrophoblast cell
      preparation. Cells grown on Matrigel express a unique 59 kd gelatinase that was
      not seen in the supernatants of cells grown on other matrices. Zymography in the
      presence of inhibitors showed that these enzymes were neutral metalloproteinases,
      which might be responsible for the observed extracellular matrix degradation.

PMID- 1750478
TI  - Improvement of in vitro fertilization and early embryo development in mice by
      coculture with human fallopian tube epithelium.
AB  - Coculturing one- and two-cell embryos with various cell lines has been shown to
      overcome species-specific developmental blocks and to improve blastocyst
      transformation rates. The objective of this study was to assess whether human
      fallopian tube epithelium organ explants influence in vitro fertilization and
      subsequent early embryo development in a murine model. Fertilization, blastocyst
      transformation, and blastocyst expansion and hatching rates were significantly
      higher in the coculture group when compared with rates for culture in standard
      media or media conditioned by human tubal explant cultures. The results from
      conditioned and unconditioned media were not significantly different.

PMID- 1750479
TI  - Comparison of intermittent and continuous use of a gonadotropin-releasing hormone
      antagonist (Nal-Glu) in in vitro fertilization cycles: a preliminary report.
AB  - The agonistic effect of the gonadotropin-releasing hormone agonist often
      necessitates an extended period of treatment, resulting in a longer treatment
      cycle and increased cost. We have evaluated the intermittent use of a
      gonadotropin-releasing hormone antagonist, Nal-Glu, and have designed a new,
      simplified protocol for its use in in vitro fertilization. Seven women who had
      previously undergone treatment with leuprolide acetate and human menopausal
      gonadotropins were treated with Nal-Glu. Leuprolide acetate, 1 mg/day
      subcutaneously, was administered in the midluteal phase until down regulation was
      achieved (estradiol less than 30 pg/ml). Human menopausal gonadotropins, three to
      four ampules per day intramuscularly, was administered in conjunction with 500
      micrograms subcutaneous leuprolide acetate. In the treatment cycles Nal-Glu (50
      micrograms/kg/day) was administered intramuscularly on cycle day 1 or 2 for 3
      days to achieve down regulation. Human menopausal gonadotropins, three to four
      ampules intramuscularly, was then administered daily without the antagonist. Nal
      Glu was resumed when the follicles reached 14 to 16 mm and was continued until
      the day of human chorionic gonadotropin administration. Compared with leuprolide
      acetate-human menopausal gonadotropins cycles, the days required for down
      regulation with Nal-Glu were significantly shortened (20.6 +/- 4.1 vs 1.6 +/- 0.3
      days, p less than 0.001), as was total cycle length (31.3 +/- 5.8 vs 11.0 +/- 1.0
      days, p less than 0.01). The mean number of days of treatment with human
      menopausal gonadotropins, the mean number of ampules of human menopausal
      gonadotropins, peak estradiol levels, the number of oocytes, and the percent of
      oocytes fertilized were not statistically different. No luteinizing hormone
      surges were detected with Nal-Glu in serum or urine. Nal-Glu was well tolerated,
      and five pregnancies have resulted. We conclude that intermittent administration
      of Nal-Glu is highly effective in achieving down-regulation and blocking
      spontaneous luteinizing hormone surges. Compared with leuprolide acetate-human
      menopausal gonadotropins cycles, an equally high oocyte and embryo yield may be
      anticipated. This new protocol substantially decreases cycle length and increases
      patient convenience.

PMID- 1750480
TI  - The gonadotropin-releasing hormone antagonist (Nal-Glu) acutely blocks the
      luteinizing hormone surge but allows for resumption of folliculogenesis in normal
      women.
AB  - The gonadotropin-releasing hormone antagonist offers several advantages over the
      use of the agonist and allows several physiologic questions to be addressed. In
      this study, we evaluated the ability of Nal-Glu to acutely inhibit the
      luteinizing hormone surge and prevent ovulation. We also assessed whether
      recovery of the follicle would be possible after several days of gonadotropin
      deprivation and estradiol decrement. Eight normal ovulatory women were randomized
      to control or Nal-Glu-treated cycles (50 micrograms/kg intramuscularly) for 3 to
      4 days. Monitoring was carried out with daily vaginal ultrasonographic scans and
      serum estradiol levels and twice-daily serum luteinizing and follicle-stimulating
      hormone levels. Nal-Glu acutely inhibited the luteinizing hormone surge and
      ovulation, even when administered as late as the onset of the luteinizing hormone
      surge. Evidence was provided that spontaneous follicular rescue recurred in eight
      of 10 cycles after 3 to 4 days of Nal-Glu administration. Although an estradiol
      to follicular size dissociation occurred with Nal-Glu, subsequent ovulation
      occurred in 5.1 +/- 0.6 days after the last Nal-Glu dose. The decrement in
      estradiol after Nal-Glu administration correlated negatively with the days
      required for subsequent ovulation to occur (r = 0.77, p less than 0.05). The
      subsequent luteal phase also was normal in terms of length and progesterone
      levels. These data confirm the potency and efficacy of Nal-Glu in acutely
      inhibiting gonadotropins and extends our knowledge on the physiologic
      characteristics of the dominant follicle.

PMID- 1750481
TI  - The effect of the menstrual cycle and of decompression stress on arachidonic acid
      induced platelet aggregation and on intrinsic platelet thromboxane production in
      women compared with men.
AB  - Menstrual cycle variations in platelet aggregation and thromboxane production in
      association with sex steroids have been reported. External stimuli such as
      decompression sickness have been associated with clotting activity changes,
      specifically, increased platelet aggregation. Differences in response of
      platelets from women and men, when subjected to such a stress, have been
      observed. This study evaluated the ability of washed platelets from women in the
      proliferative and secretory phases of the menstrual cycle to aggregate in
      response to arachidonic acid and the aggregation difference between washed
      platelets from women and men in response to decompression stress and arachidonic
      acid. Additionally, platelet thromboxane production differences between the
      assessed platelet populations were compared. Our results indicate no difference
      in platelet aggregability between phases of the menstrual cycle. A significant
      aggregation difference between platelets from women and men was noted. Platelets
      from women were more sensitive to arachidonic acid aggregation. These differences
      were not affected by decompression stress. No difference in thromboxane B2
      production was noted between the platelet populations evaluated.

PMID- 1750482
TI  - Tryptophan and neutral amino acids in premenstrual syndrome.
AB  - An abnormality of the serotonin system may play a role in the genesis of the
      symptoms of premenstrual syndrome, especially those related to mood and appetite.
      Whole blood and platelet uptake of serotonin are decreased during the luteal
      phase in women with premenstrual syndrome. The ratio of L-tryptophan (the amino
      acid precursor of serotonin) to the sum of the other neutral amino acids that
      compete for the same protein carrier cerebral uptake mechanism has been suggested
      to reflect central L-tryptophan levels and resultant serotonin levels in the
      brain. We evaluated the ratio of plasma L-tryptophan to the sum of five competing
      neutral amino acids in women with premenstrual syndrome and in controls. There
      were no significant differences between groups or across time, suggesting that it
      is unlikely that the aberrations of the serotonergic system in women with
      premenstrual syndrome are due to saturation of the tryptophan-carrying protein.

PMID- 1750483
TI  - The role of prostaglandins in detrusor instability.
AB  - To study the role of prostaglandin production by detrusor muscle in women with
      idiopathic primary detrusor instability, biopsies of detrusor muscle were
      obtained from 20 women. Nine women had detrusor instability, and 11 women had
      stable bladders. Prostaglandin F2 alpha and the stable metabolites of
      prostacyclin and thromboxane A2, namely, 6-keto-prostaglandin F1 alpha and
      thromboxane B2, respectively, were measured after in vitro incubations of
      detrusor muscle for 3 hours. A significant reduction in the production of 6-keto
      prostaglandin1 alpha in women with detrusor instability was noted. There were no
      differences in the production of prostaglandin F2 alpha and thromboxane B2,
      between women with stable and unstable bladders. These results suggest for the
      first time that women with idiopathic primary detrusor instability may have a
      deficient production of prostacyclin.

PMID- 1750484
TI  - Effects of peritoneal macrophages from patients with endometriosis on the
      proliferation of endometrial carcinoma cell line ECC-1.
AB  - Endometriosis has been shown to be associated with increased number and activity
      of peritoneal macrophages. The peritoneal macrophage-conditioned media from 33
      women with or without endometriosis were studied for their effects on an
      endometrial carcinoma cell line, ECC-1. The media from six of six stage III/IV
      cases demonstrated a mitogenic effect, which was blocked by an antibody to
      epidermal growth factor receptor. However, the conditioned media from seven of
      nine stage I/II cases and 14 of 18 normal women did not show a mitogenic effect.
      The difference between stage III/IV and the other two groups was significant (p
      less than 0.01). The incorporation of tritium-thymidine was three times higher
      with the media from stage III/IV cases, as compared with that of controls. When
      purified cytokines were tested in the tritium-thymidine uptake assay, only
      epidermal growth factor-transforming growth factor-alpha was mitogenic on ECC-1,
      whereas tumor necrosis factor, interleukin-1, and platelet-derived growth factor
      had no effect. Thus peritoneal macrophages in patients with endometriosis may
      play an important role in the progression of endometriosis, and the noted effects
      could be mediated by epidermal growth factor or a related growth factor.

PMID- 1750485
TI  - Prolonged clearance of intraperitoneal 16 alpha-[125I]iodo-17 beta-estradiol in
      presence of ascites.
AB  - Radioestrogens have potential as adjunct therapeutic agents against ovarian
      carcinoma, because selected radionuclides can deposit lethal doses of radiation
      to tumor cells and many ovarian carcinomas and their metastases express estrogen
      receptors. Because intraperitoneal administration is a possible approach, we
      investigated absorption from the peritoneal cavity of a radioiodoestradiol after
      intraperitoneal application in rats with and without ovarian tumors and ascites
      and compared the distribution of the radioactivity with that obtained after
      intravenous injection. In the absence of ascites, 70% of the intraperitoneal dose
      was cleared into the intestine within 2 hours after injection, indicating fast
      absorption from the peritoneal cavity. In the presence of ascites, clearance of
      intraperitoneal radioiodoestradiol was considerably slower; at 2 hours after
      injection, 50% of the injected dose remained in the ascites, mostly as
      radioiodoestradiol. Uptake of radioactivity in estrogen receptor-rich tissues,
      e.g., uterus, after intraperitoneal injection was high (about 20:1 over blood),
      regardless of the presence of ascites, but moderately lower than that observed
      after intravenous injection of radioiodoestradiol.

PMID- 1750486
TI  - Increased progesterone concentrations are necessary to suppress interleukin-2
      activated human mononuclear cell cytotoxicity.
AB  - Fetal trophoblast is generally resistant to lysis by cytotoxic cells. Trophoblast
      progesterone and estrogens may act at the choriodecidual interface, where they
      are present in high concentrations to provide a local, paracrine
      immunosuppressive effect on cellular cytotoxicity. However, interleukin
      activation of these cytotoxic lymphocytes enhances their ability to lyse
      trophoblast. Recent evidence suggests that immunoactivation occurs in certain
      aberrant pregnancy conditions, including preeclampsia. Preeclamptic placentas
      produce more progesterone in vitro than do normal placentas. To study the
      potential association between progesterone production and immunoactivation, we
      evaluated the immunomodulatory effect of progesterone on cellular cytotoxicity.
      Comparisons were made with the use of both normal and interleukin-2-stimulated
      peripheral blood mononuclear cells as effector cells in a cytotoxicity assay.
      Progesterone suppressed cytotoxicity in a dose-dependent manner. Interleukin-2
      augmented cellular cytotoxicity, and higher concentrations of progesterone were
      required to attenuate this response. An additive suppression of cytotoxicity was
      also observed when estrone, estradiol, estriol, and progesterone were combined.
      We speculate that the higher placental production of progesterone seen in
      preeclampsia may be a trophoblast compensatory response to immunoactivated
      maternal effector cells.

PMID- 1750487
TI  - Sister chromatid exchange frequency in directly prepared cytotrophoblasts:
      demonstration of in vivo deoxyribonucleic acid damage in pregnant women who smoke
      cigarettes.
AB  - Assessing frequency of sister chromatid exchange is a sensitive method of
      monitoring exposure to clastogens, mutagens, and other substances that induce
      deoxyribonucleic acid damage. Aware that cigarette smoke is associated with
      increased sister chromatid exchange in many cell types, we sought to determine
      whether an in vivo effect of cigarette smoke could be demonstrated by study of
      sister chromatid exchange in chorionic villus cells. Directly prepared
      cytotrophoblasts and cultured mesenchymal core cells were analyzed. Mean sister
      chromatid exchange frequency in cytotrophoblasts from smoking subjects (8.87
      sister chromatid exchanges per cell) was significantly greater than in nonsmoking
      subjects (5.81 sister chromatid exchanges per cell; p less than 0.001); however,
      no significant difference in cultured mesenchymal core cells was found. Our
      results demonstrate that maternal exposure to cigarette smoke results in direct
      placental deoxyribonucleic damage, which in turn could explain deleterious
      effects of smoking on pregnancy. Increased sister chromatid exchange frequency
      was observed only in directly prepared cytotrophoblasts, showing the necessity of
      using this cell type to evaluate the effects of clastogens on placentas.

PMID- 1750488
TI  - Cellular localization of mullerian inhibiting substance messenger ribonucleic
      acid during human ovarian follicular development.
AB  - Mullerian inhibiting substance is expressed in the human reproductive system and
      has been associated with oocyte meiotic arrest. In situ hybridization was used to
      selectively localize ovarian cells containing high levels of mullerian inhibiting
      substance messenger ribonucleic acid, a mullerian inhibiting substance precursor,
      during different stages of human follicular development. Mullerian inhibiting
      substance transcript was noted in the granulosa cells of primordial, primary, and
      antral follicles. Surprisingly, transcript was also identified within the
      cytoplasm of oocytes and throughout the ovarian stroma. Controls included sense
      oligoprobe, positive and negative tissue controls, and treatments minus the
      detection antibody. Localization of transcript within the cytoplasm demonstrates
      that active transcription of mullerian inhibiting substance messenger ribonucleic
      acid occurs within both fetal and adult human female gonads. The presence of
      mullerian inhibiting substance messenger ribonucleic acid within oocyte cytoplasm
      could implicate an autocrine role for mullerian inhibiting substance-derived
      peptides in the establishment of oocyte competence.

PMID- 1750489
TI  - The presence of the testicular determining sequence, SRY, in 46,XY females with
      gonadal dysgenesis (Swyer syndrome).
AB  - Subjects with 46,XY gonadal dysgenesis (Swyer syndrome) have a distinctive
      phenotype. They are normal or tall in stature, lack somatic anomalies, and
      possess bilateral rudimentary gonads. Critical Yp deletions have been described
      in some cases, but in the majority no defects at the molecular level have been
      reported. To verify the presence or absence of SRY, the putative testicular
      determining factor gene, specific primers were designed to amplify the conserved
      region of the SRY gene. Deoxyribonucleic acid from control males (n = 10) and sex
      reversed females with the Swyer syndrome phenotype (n = 5) generated the
      anticipated 310 bp band. This Y-specific band was absent in the deoxyribonucleic
      acid from control females (n = 9). To search for possible point mutations, the
      amplified products of all study subjects and one control male were sequenced in
      both orientations. The base pair sequences were all identical and similar to the
      previously published report.

PMID- 1750490
TI  - Evidence for a partial deletion in the androgen receptor gene in a phenotypic
      male with azoospermia.
AB  - Androgen resistance is thought to vary phenotypically from a normal female to an
      infertile male. Previous evaluation of infertile males has been limited to
      androgen receptor-binding affinity. The androgen receptor gene has been isolated,
      cloned, and studied extensively in patients with complete androgen insensitivity
      syndrome, but no comparative data are available on infertile males. To address
      this matter, the androgen receptor gene was studied in seven azoospermic males by
      use of the polymerase chain reaction and Southern blot hybridization. A partial
      gene deletion was found in one patient. This study provides the first molecular
      evidence of an abnormality in the androgen receptor gene in a phenotypic male
      with azoospermia.

PMID- 1750491
TI  - Giacomello's observation and nuchal cords.

PMID- 1750492
TI  - Ethics in medical studies with human subjects.

PMID- 1750493
TI  - Factors affecting embryo implantation after human in vitro fertilization.

PMID- 1750494
TI  - The origin of brain lesions in survivors of twin gestations complicated by fetal
      death.

PMID- 1750495
TI  - First report: prenatal diagnosis of a true knot.

PMID- 1750496
TI  - The effect of amnioinfusion on uterine pressure and activity.

PMID- 1750497
TI  - Alternative estimates of ectopic pregnancy risks during contraception.

PMID- 1750498
TI  - First report: prenatal diagnosis of long cord.

PMID- 1750499
TI  - Transforming growth factors beta 1 and beta 2 are differentially expressed in
      fibrotic liver disease.
AB  - Transforming growth factor (TGF) beta 1 has been implicated in the control of
      hepatocyte growth and stimulation of extracellular matrix synthesis in acute and
      chronic liver disease. The cellular localization of transforming growth factor
      (TGF) beta 1 and beta 2 RNA transcripts was determined in normal and fibrotic
      liver by in situ hybridization with [35S]-labeled RNA probes in combination with
      immunostaining for cell type characteristic markers. Fibrotic specimens were from
      patients with hepatitis B virus infection or alcohol abuse and rats with fibrosis
      secondary to bile duct ligation and scission. In normal liver, low levels of TGF
      beta 1 transcripts were found in some portal tract stromal cells, and TGF beta 2
      RNA was not detectable. In fibrotic liver, high TGF beta 1 RNA levels were
      present in most mesenchymal liver cells, in most inflammatory cells, and in few
      bile duct epithelial cells. Hepatocytes did not express this cytokine with the
      exception of few limiting plate hepatocytes in cases of human cirrhosis with high
      activity. TGF beta 2 transcripts were detected at high levels in proliferating
      bile ducts of fibrotic livers, but were absent in all other cell types. TGF beta
      1 expression in the liver is thus a function predominantly of mononuclear and
      mesenchymal cells as well as of some hepatocytes, whereas TGF beta 2 expression
      is a specific property of bile duct epithelial cells that may be related to the
      formation of specialized periductular connective tissue during bile duct
      proliferation.

PMID- 1750500
TI  - Absence of t(14;18) major and minor breakpoints and of Bcl-2 protein
      overproduction in Reed-Sternberg cells of Hodgkin's disease.
AB  - The t(14;18) translocation, found in most human follicular non-Hodgkin's
      lymphomas (NHLs), juxtaposes the Bcl-2 oncogene at 18q21 with the immunoglobulin
      heavy chain locus at 14q32. As a result, the Bcl-2 protein is markedly
      overproduced. Most of the breakpoints on chromosome 18 cluster at one of two
      sites, the major breakpoint region (mbr) and the minor cluster region (mcr).
      Recently, others used the polymerase chain reaction (PCR) to detect the t(14;18)
      mbr in 32% of specimens diagnosed as Hodgkin's disease (HD). In an attempt to
      confirm and extend those observations the authors used PCR to assay for both the
      mbr and mcr in HD specimens diagnosed at their institution and examined the
      specimens for Bcl-2 overproduction. The authors subjected the DNAs from 28 well
      characterized HD tumors of 26 patients to PCR analyses using primers specific for
      the t(14;18) mbr and mcr breakpoints. Based on various PCR controls, the authors
      ascertained that 26 of the 28 specimens contained amplifiable template DNA.
      Southern blotting of the amplification products showed that none of the 26 HD
      DNAs had detectable t(14;18) mbr or mcr breakpoints. By admixing small amounts of
      t(14;18)-bearing NHL DNA with HD DNA samples, the authors directly demonstrated
      that the sensitivity of the PCR assays was adequate for the molecular detection
      of t(14;18)-bearing cells at a frequency comparable to that of Reed-Sternberg
      cells and their variants in HD. Immunohistochemical studies employing a highly
      specific anti-Bcl-2 antiserum under conditions optimized to detect t(14;18)
      mediated overexpression of the Bcl-2 gene showed that the Reed-Sternberg cells
      and variants in all 19 HD tumors examined were negative for Bcl-2 immunostaining.
      In conclusion, the PCR and immunohistochemical data provided evidence that the
      t(14;18) translocation was not involved in the pathogenesis of the HD cases.

PMID- 1750501
TI  - AIDS-associated Kaposi's sarcoma-derived cells in long-term culture express and
      synthesize smooth muscle alpha-actin.
AB  - Spindle-shaped cells from Kaposi's sarcoma lesions (AIDS-KS cells) were cultured
      for long periods in the presence of conditioned medium from activated CD4
      positive T cells (HTLV-II infected transformed nonvirus producer) and
      characterized under in vitro conditions. To investigate a possible vascular
      origin, AIDS-KS cells were analyzed for the presence of smooth muscle alpha
      actin, a differentiation marker for vascular smooth muscle cells.
      Immunofluorescence studies using a monoclonal antibody for smooth muscle alpha
      actin demonstrated positive staining of the AIDS-KS cells (KS-3 and KS-4) but not
      by endothelial cells or fibroblasts. Northern blot analysis using an
      oligonucleotide probe unique for human smooth muscle alpha-actin indicated the
      expression of this gene by AIDS-KS cells. Similar analysis of biopsies from the
      KS lesion showed that in addition to the staining of smooth muscle cells
      associated with the blood vessels, the tumor-related spindle cells also stained
      positively. These cells were also analyzed for the expression of different growth
      factor genes. The platelet-derived growth factor (PDGF) A-chain gene was
      expressed at a moderate level. The insulin-like growth factor-1 (IGF-1) and
      insulin-like growth factor-2 (IGF-2) genes were not overexpressed in relation to
      control cells. These data suggest that the analyzed AIDS-KS cells may be smooth
      muscle-like cells and therefore of vascular origin. Based on these results as
      well as previous reports, we speculate that cells of the immune system may
      regulate growth of cells in the vascular wall by a novel pathway.

PMID- 1750502
TI  - Myositis in mice inoculated with Borrelia burgdorferi.
AB  - The authors describe the appearance of myositis in immunocompetent and
      immunodeficient mice after subcutaneous inoculation with Borrelia burgdorferi by
      histology and immunohistology. Experimental infection of mice 1) causes
      inflammation of striated but not smooth muscles, 2) affects the entire
      musculoskeletal system, and 3) is characterized by perivascular and
      interfacicular infiltration of mononuclear leukocytes in the striated muscle
      leading to necrosis as well as disruption of muscle fibers. The lesions found in
      striated muscle specimens were most pronounced in immunodeficient (SCID), less
      severe in T-cell-deficient nu/nu (BALB/c, C57BL/6) and marginal to moderate or
      almost not present in immunocompetent AKR/N and C.B-17 mice, respectively.

PMID- 1750503
TI  - Early viral replication in the brain of SIV-infected rhesus monkeys.
AB  - To investigate the mechanism of simian immunodeficiency virus (SIV) entry into
      the central nervous system (CNS) and the initial events leading to
      neuropathogenesis, SIV replication was studied by in situ hybridization in the
      CNS of 5 Rhesus macaques at 7 days, 1, 2, and 3 months after SIV intravenous
      inoculation. CNS infection was found to be a frequent and early event, as SIV was
      detected in the CNS of all the animals studied and as early as 7 days
      postinoculation. At the earliest stage, the infection localized mainly to
      perivascular cells. Using combined immunohistochemistry and in situ
      hybridization, infected cells were shown to express the CD68 marker, suggesting
      that infected mononuclear phagocytes crossing the blood-brain barrier represent
      the main source of virus in the CNS. Early viral replication coincided with
      neuropathologic changes, consisting in gliosis, perivascular infiltrates and rare
      glial nodules. Immunophenotyping of brain tissue showed that increased macrophage
      infiltration, microglial reactivity and MHC class II induction occurred within
      the first week of infection, indicating a possible immunopathologic mechanism in
      early CNS pathogenesis.

PMID- 1750504
TI  - Angiotensin-converting enzyme inhibitor versus angiotensin II, AT1 receptor
      antagonist. Effects on smooth muscle cell migration and proliferation after
      balloon catheter injury.
AB  - The angiotensin-converting enzyme (ACE) inhibitor, benazeprilat and the
      angiotensin II (Ang II), AT1-specific receptor antagonist, DuP753, were compared
      for their effects on intimal lesion formation as well as smooth muscle cell (SMC)
      proliferation and migration in Sprague Dawley rats after carotid balloon injury.
      Both the ACE inhibitor (benazeprilat, 3 mg/kg/day) and the AT1 antagonist (DuP
      753, 10 mg/kg/day) significantly reduced intimal lesion formation after balloon
      injury (by 35% and 49%, respectively). Medial SMC proliferation after injury was
      reduced 53% by the AT1 antagonist; however, the ACE inhibitor had no effect on
      SMC proliferation. SMC migration was reduced 94% by the AT1 antagonist and 68% by
      the ACE inhibitor. These data demonstrate the importance of Ang II in SMC
      proliferation and migration after balloon injury. They also demonstrate that in
      the balloon injury model, the ACE inhibitor reduced intimal lesion size by
      inhibiting SMC migration alone without affecting SMC proliferation. A more
      pronounced reduction in lesion size was obtained after AT1 antagonism, however,
      when both SMC migration and proliferation were inhibited.

PMID- 1750505
TI  - HML-1 antigen on mucosa-associated T cells, activated cells, and hairy leukemic
      cells is a new integrin containing the beta 7 subunit.
AB  - The monoclonal antibodies HML-1, B-ly7 and Ber-ACT8 recognize intramucosal gut T
      lymphocytes, activated cells, and hairy cell leukemia. The antigen on hairy cells
      consists of three glycoproteins (160 kappa D, 130 kappa D and 105 kappa D
      unreduced; 145 kappa D and 120 kappa D reduced). These peptides have biochemical
      features reminiscent of integrins but we have shown by immunoprecipitation that
      they are not known integrin subunits. We have used a newly produced antibody
      (BP6) to purify this molecule and shown by N-terminal sequence analysis that the
      smallest subunit is the product of integrin beta 7 cDNA. This molecule is thus a
      new member of the integrin family of leucocyte adhesion proteins.
      Immunoprecipitation experiments indicate that the two larger subunits are
      recognized by HML-1, B-ly7 and Ber-ACT8.

PMID- 1750506
TI  - Human lung-derived mature mast cells cultured alone or with mouse 3T3 fibroblasts
      maintain an ultrastructural phenotype different from that of human mast cells
      that develop from human cord blood cells cultured with 3T3 fibroblasts.
AB  - Culture systems designed to maintain or develop human mast cells have proved
      difficult, yet these systems would provide valuable resources for future
      investigations of human mast cell biology. Cocultures of either isolated mature
      human lung mast cells (Levi-Schaffer et al., J Immunol 1987, 139:494-500) or
      human cord blood mononuclear cells (Furitsu, Proc Natl Acad Sci USA 1989,
      86:10039-10043) with 3T3 embryonic mouse skin fibroblasts have implicated
      fibroblasts as an important factor in the successful maintenance and development
      of human mast cells in vitro. The authors cultured isolated, mature human lung
      mast cells either with or without 3T3 cells for 1 month and examined their
      ultrastructural phenotype. Mast cell viability in each circumstance was
      equivalent, but mast cell yield was improved in the presence of 3T3 cells. The
      ultrastructural phenotype was identical in both culture systems. Mast cells were
      shown to maintain the phenotype of their in vivo lung counterparts (ie, scroll
      granules predominanted, and numerous lipid bodies were present). This
      ultrastructural phenotype differs from that of mast cells that develop in
      cocultures of human cord blood cells and 3T3 cells, where developing mast cells
      with crystalline granules and few lipid bodies prevail, a phenotype much like
      that of human skin mast cells in vivo (Furitsu, Proc Natl Acad Sci USA 1989,
      86:10039-10043).

PMID- 1750507
TI  - Immunohistochemical localization of syndecan in mouse skin tumors induced by UV
      irradiation. Loss of expression associated with malignant transformation.
AB  - Immunoreactivity for syndecan, a cell surface proteoglycan, which binds
      extracellular matrix molecules and growth factors, was studied in hairless
      (hr/hr) mice exposed to UV-A and UV-B irradiation. Positive staining was observed
      at the surface of normal epidermal cells as well as in the dermal abortive hair
      follicle cysts characteristic to this mouse strain. Early reaction to UV
      irradiation showing hyperplastic epidermis with slight cellular atypia showed
      also positive, although reduced, staining of epidermal cell surfaces. Specimens
      with severe dysplasia showed weak staining in the granular cell layer, whereas
      the basal cell layer was negative. In papillomas and keratoacanthomas,
      immunoreactivity for syndecan was observed in the benign hyperplastic epidermal
      cells as well as in the proliferating epidermal cells of the horn cysts.
      Malignant transformation of epithelium, expressed as the formation of early
      invasive and anaplastic squamous cell carcinomas, was uniformly associated with
      loss of syndecan staining. These results are consistent with the previous
      findings of reduced expression of syndecan associated with malignant
      transformation of cultured epithelial cells, but also suggest an important role
      for syndecan in the maintenance of normal tissue architecture and differentiation
      pattern of the skin.

PMID- 1750508
TI  - Characterizations of and interactions between bile ductule cells and hepatocytes
      in early stages of rat hepatocarcinogenesis induced by ethionine.
AB  - Numerous hepatic cell lineage pathways have been proposed for the development of
      hepatocarcinogensis induced by chemical carcinogens in rats. The roles of bile
      ductule cells and hepatocytes in the development of carcinogenesis were
      investigated using light and electron microscopic procedures to detect
      differences in morphology and in the phenotypic expression of antigens that are
      associated with each cell type. In early stages of hepatocarcinogenesis (4-10
      weeks after initiation of feeding of a choline-deficient ethionine containing
      diet), both bile ductulelike (BDL) cells and hepatocytes were seen in mitosis. At
      the light microscope level, BDL cells showed intense cytoplasmic pyronin (RNA)
      staining and were positive for the antigens defined by monoclonal antibody 270.38
      (bile ductule cells and "oval" cell marker) and glutathione-S-transferase (Yp
      isoform), whereas hepatocytes were positive for the antigens defined by
      monoclonal antibodies 270.26 and 258.26 (liver parenchymal cell markers),
      catalase activity (peroxisome marker) and adenosine triphospatase activity (bile
      canalicular marker). The authors frequently encountered BDL cells and hepatocytes
      in close proximity. Ultrastructural examination showed extensive plasma membrane
      appositions between a subset of BDL cells and hepatocytes. Desmosome structures,
      tight junctions, microvilli interdigitations and ATPase-positive bile
      canalicularlike structures were present along the contiguous plasma membrane
      domains of BDL cells and hepatocytes. Many of the BDL cells attached to
      hepatocytes were also attached to other BDL cells that had retained a basal
      lamina. In many cases, BDL cells connected to both hepatocytes and other BDL
      cells were no longer completely surrounded by basal lamina and had acquired a
      dual polarity as a consequence of their sharing apical and lateral membrane
      domains with both BDL cells and hepatocytes. BDL cells showed increased numbers
      of microperoxisomes (catalase positive organelles) and numerous free ribosomes.
      Hepatocytes showed a prominent development of the smooth endoplasmic reticulum, a
      feature prominent in hepatocytes within hyperplastic nodules. Since BDL cells and
      hepatocytes proliferate and BDL cells and hepatocytes develop intercellular
      junction sites, the authors propose that both cell types in early stages of
      carcinogenesis have the capacity to enter the cell lineage pathway leading to the
      development of hepatocarcinoma. Furthermore, the finding that BDL cells and
      hepatocytes form multiple attachment sites at the level of the plasma membrane,
      suggests the possibility that at some stage convergence of separate hepatic cell
      pathways may occur.

PMID- 1750509
TI  - Differential expression of basement membrane collagen in membranous nephropathy.
AB  - Membranous nephropathy (MN) is characterized by subepithelial immune complex
      formation and progressive thickening of the glomerular basement membrane (GBM).
      Kidney tissues from 21 patients stratified according to morphology (stage I: 5
      patients; stage II: 5 patients, stage III: 11 patients) were studied by
      immunohistochemical techniques using antibody probes to matrix components of
      recently described (novel) chains of type IV collagen [alpha 3(IV)NC, alpha
      4(IV)NC, Alport antigen] and of traditional type IV collagen [alpha 1(IV)NC,
      alpha 2(IV)NC, 7S(IV), triple helix]; as well as laminin B2, nidogen and
      fibronectin. In Stage I, there were no detectable changes when compared with
      normal tissue. In Stage II and early Stage III, the subepithelial projections of
      GBM (spikes) and the thickened GBM consisted predominantly of the novel type IV
      collagen chains as well as laminin B2 and nidogen, with no detectable changes in
      traditional type IV collagen. In late Stage III, an increase in the latter was
      observed in the subendothelial region of the thickened GBM with narrowing of the
      capillary lumen. At this stage, there was close apposition of novel and
      traditional type IV collagen molecules. The expression of these two groups of
      molecules is spatially and temporally distinct during the evolution of MN. It is
      hypothesized that immune complex formation in the subepithelial region of the GBM
      leads to increased formation of the novel type IV collagen network by visceral
      epithelial cells resulting in the formation of spikes and thickening of GBM
      between and surrounding immune deposits. These changes precede and are distinct
      from detectable alterations in traditional type IV collagen. With progression and
      time, the deposits become embedded in the novel collagen network and increased
      subendothelial formation of traditional type IV collagen molecules occurs with
      narrowing of the capillary lumen.

PMID- 1750510
TI  - Central nervous system endothelial cell-polymorphonuclear cell interactions
      during autoimmune demyelination.
AB  - The homing and adhesion of circulating cells to target tissue vasculature
      precedes their subsequent invasion of inflamed tissue. Polymorphonuclear cells
      (PMNs), key players in most inflammatory events, are among the first cells to
      arrive. The present work, performed on CNS lesions from mice with experimental
      autoimmune encephalomyelitis, provides morphologic evidence for interactions
      between PMNs and unique, frondlike extensions from endothelial cells (EC) during
      early attachment. Platelets also were seen attached to these endothelial fronds.
      The structures projected into vessel lumina from the vicinity of tight junctions
      and were often branched and complex, the latter characteristics suggesting a
      possible role in cellular 'trapping'. Polymorphonuclear cells appeared to
      traverse the CNS vasculature between EC where the blood-brain barrier was
      severely compromised with junctional complexes reduced to simple contact points.
      The cells from which the fronds derived were often plump and possessed cytoplasm
      rich in organelles, perhaps indicative of activation. The present report
      contrasts with previous observations on lymphocytes in the same system where
      lymphocytic pseudopodia formed intimate contacts before their burrowing directly
      through the endothelium and where EC fronds were not involved.

PMID- 1750511
TI  - Tissue distribution, intracellular localization, and in vitro expression of
      bovine macrophage scavenger receptors.
AB  - Macrophage scavenger receptors are trimeric membrane proteins implicated in the
      pathologic deposition of cholesterol in atherogenesis. The authors have studied
      the tissue distribution and intracellular localization of bovine scavenger
      receptors using monoclonal antibovine receptor antibody IgG-D2. The receptor
      proteins were detectable in macrophages of various organs and tissues,
      particularly Kupffer cells, alveolar macrophages, and macrophages in the spleen
      and lymph nodes. In the brain, perivascular macrophages were immunoreactive with
      IgG-D2. Fibroblasts, endothelial cells, smooth muscle cells, and dendritic cells
      such as epidermal Langerhans cells, interdigitating cells, or follicular
      dendritic cells, however, showed no immunoreactivity to IgG-D2. Immunoelectron
      microscopy showed localization of reaction products for these receptors on the
      cell surface, vesicles, and endosomes of macrophages. Transient expression of
      bovine scavenger receptors on cultured cells shows that scavenger receptors are
      mainly expressed in the endoplasmic reticulum, nuclear envelope, and Golgi
      apparatus of nonmacrophage cells and moved to the cell surface and endosomes of
      macrophagelike cells. These results indicate that efficient intracellular
      transport of scavenger receptors in macrophages is mediated by a macrophage
      specific transport system.

PMID- 1750512
TI  - Iron translocation by free fatty acids.
AB  - Organic extracts of cigarette smoke and uncombusted tobacco contain substances
      capable of translocating iron from aqueous solutions into immiscible organic
      solvents. Such extracts will also effect the organic solvation of iron present in
      ferruginous forms of asbestos such as amosite and crocidolite (Qian and Eaton,
      Arch Biochem Biophys 1989, 275:280). These substances, previously detected by
      their iron-translocating properties, have now been purified and identified by
      mass spectroscopy as saturated fatty acids, predominantly stearic and palmitic
      acids. Organic extracts of tobacco smoke, as well as the pure fatty acids, also
      transfer ferrous iron into both isolated red cell membranes and intact human
      erythrocytes. The increased membrane iron may enhance cellular susceptibility to
      exogenous oxidants; erythrocyte membranes subject to fatty acid-mediated iron
      accumulation show elevated peroxidation of endogenous polyunsaturated fatty
      acids. These observations may help explain the phlogistic effects of tobacco use
      and suggest, in a broader context, that free fatty acids may act as physiologic
      and pathologic mediators of metal translocation.

PMID- 1750513
TI  - Heterogeneous distribution of Weibel-Palade bodies and von Willebrand factor
      along the porcine vascular tree.
AB  - Vessels obtained from different levels of pig vascular tree were examined by
      transmission electron microscope, with the aim of determining whether or not
      their endothelial cells contain Weibel-Palade bodies (WPB). As these organelles
      are known to store the von Willebrand factor (vWF), a two-step immunogold
      labeling of this protein also was performed. Our results showed for the first
      time a heterogeneous distribution of WPB along the vascular tree of the normal
      pig: These structures were absent from the thoracic aorta, rare in the abdominal
      aorta, present in myocardial capillaries, and numerous in the inferior vena cava
      and pulmonary artery. Atypical WPB devoid of tubules were seen in all endothelial
      cells. The ultrastructural labeling of vWF demonstrated its presence only in the
      WPB, being absent in the subendothelium, and showed the same variation in its
      distribution along the vascular tree as for its storage organelle. Pigs
      homozygous for the von Willebrand disease were found to have only the atypical
      WPB, and do not express the vWF.

PMID- 1750514
TI  - Repeated exposures to enzyme-generated oxidants cause alveolitis, epithelial
      hyperplasia, and fibrosis in hamsters.
AB  - Oxidant-mediated epithelial injury and repair processes may promote the
      development of pulmonary fibrosis. The authors examined this hypothesis by
      inducing oxidant injury in hamsters with intratracheally instilled mixtures of
      glucose, glucose oxidase (GO) and lactoperoxidase at weekly intervals. Solutions
      containing denatured GO (DE) served as a control treatment. One and six days
      after each treatment, anesthetized animals were sacrificed and lavaged, and their
      lungs and plasma were preserved for further study. Although DE-treatment
      consistently evoked a transient, neutrophil-rich inflammatory response, no
      significant biochemical or morphologic changes were detected at the ensuing 6-day
      time points. In contrast, repeated GO treatments prolonged inflammation and
      injured the alveolar epithelium, evidenced by significantly greater levels of
      neutrophils and macrophages in bronchoalveolar lavage fluid (BALF) and increased
      BALF levels of protein, beta-glucuronidase and lactic dehydrogenase activities.
      Active GO also altered BALF lymphocytes and monocytes, but no discernable pattern
      emerged. Fibrotic, consolidated parenchyma appeared after the second and third GO
      exposures, coinciding with increased levels of total collagen, prolyl hydroxylase
      activity, and anti-oxidant enzyme activities. Although alveolitis and type II
      cell hyperplasia were observed after the initial treatment, polyplike nodules
      covered by hyperplastic, undifferentiated epithelium were evident after the third
      treatment. After each exposure, GO-treated animals had larger volumes of
      parenchymal lesion than DE-treated hamsters. These data indicate that normal
      alveolar epithelial repair processes were greatly disrupted by repeated oxidant
      injury and suggest that repeated and/or continued epithelial injury may
      contribute to the development of pulmonary fibrosis.

PMID- 1750515
TI  - Antiproliferative effects of novel, nonanticoagulant heparin derivatives on
      vascular smooth muscle cells in vitro and in vivo.
AB  - The proliferation of vascular smooth muscle cells (VSMC) is strongly inhibited by
      whole heparin both in vitro and in vivo. To identify and characterize
      antiproliferative, but nonanticoagulant heparin derivatives, heparin fragments
      made by periodate treatment were produced and acylated with 2-, 4-, or 6-carbon
      chain lengths. In culture, the 4- and 6-carbon acylated compounds were more
      effective than whole heparin in inhibiting serum stimulated VSMC growth at equal
      mass or approximately equal mean molar concentrations. Further testing was
      performed in the rat carotid balloon injury model. Myointimal VSMC proliferation
      produced by balloon catheterization of rat carotid arteries was inhibited by the
      4-carbon acylated compound as effectively as heparin at the same mass dose.
      Importantly, unlike heparin, the 4-carbon acylated compound had no anticoagulant
      effect in vivo. These experiments suggest nonanticoagulant, acylated heparin
      derivatives may have a pharmacologic role in preventing myointimal proliferative
      lesions that are responsible for failures of vascular surgeries and
      angioplasties.

PMID- 1750516
TI  - Ovine GM-1 gangliosidosis.

PMID- 1750517
TI  - Effects of NG-nitro-L-arginine methyl ester on renal function and blood pressure.
AB  - The dose-dependent effects of intravenous infusions of nitric oxide (NO)
      synthesis inhibitor, NG-nitro-L-arginine methyl ester (L-NAME; 0.1, 1, 10, and 50
      micrograms.kg-1.min-1), were studied in anesthetized rats to determine whether
      the inhibitory actions of L-NAME are manifested primarily in alterations of renal
      function or whether they are the consequences of the increase in systemic blood
      pressure. Mean arterial pressure (MAP) was not altered by the intravenous L-NAME
      infusions of 0.1 and 1.0 microgram.kg-1.min-1. However, 0.1 microgram.kg-1.min-1
      L-NAME induced a 30% decrease in urine flow rate (UV). The administration of 1.0
      microgram.kg-1.min-1 L-NAME, in addition to decreasing UV, also decreased urinary
      sodium excretion (UNaV) and renal plasma flow (RPF). The intravenous L-NAME
      infusions of 10.0 and 50.0 microgram.kg-1.min-1 intravenous L-NAME infusions of
      10.0 and 50.0 microgram.kg-1.min-1 produced significant increases in MAP that
      reversed the initial fall in UV and UNaV, despite decreasing RPF and glomerular
      filtration rate (GFR). The administration of L-arginine alone (10 micrograms.kg
      1.min-1) did not modify any of the parameters measured, but it effectively
      prevented all the hemodynamic and renal changes induced by the infusion of 50
      micrograms.kg-1.min-1 L-NAME. These results suggest that the decrease in nitric
      oxide production induced by the intravenous infusion of L-NAME affects renal
      excretion of sodium and water in the absence of any significant change in blood
      pressure. At larger doses, L-NAME also produces hypertension that overrides the
      initial antinatriuretic effect.

PMID- 1750518
TI  - Coupled water transport by rat proximal tubule.
AB  - Simultaneous microperfusion of proximal tubules and peritubular capillaries in
      kidneys of rats anesthetized with Inactin was used to examine water reabsorption
      by this epithelium. Osmolality of the luminal solution was varied with changes in
      NaCl concentration and by the addition of raffinose. Capillary perfusates
      contained either low (2 g/dl) or high (16 g/dl) concentrations of albumin. We
      used low-bicarbonate perfusates for both lumen and capillary so that we might
      apply the nonequilibrium thermodynamic model of transport for a single solute
      (NaCl) to interpret our observations. Linear regression with the volume flux
      equation Jv = -Lp delta II - Lp sigma delta C + Jav (where Jv is volume flux, Lp
      is hydraulic conductance, delta II is oncotic force, sigma is osmotic reflection
      coefficient, delta C is salt concentration difference, and Jav is the component
      of Jv not attributed to transepithelial hydrostatic or osmotic forces) revealed a
      tubule water permeability (Pf = 0.11 +/- 0.01 cm/s) and a sigma (0.74 +/- 0.08)
      in agreement with previous determinations. These transport parameters were
      unaffected by changes in peritubular protein. We also found that Jav was
      substantial, approximately three-fourths of the rate of isotonic transport under
      these perfusion conditions. Further, this component of water transport nearly
      doubled with the transition from low- to high-protein peritubular capillary
      perfusion. When expressed as a capacity for water reabsorption against an osmotic
      gradient, the salt concentration differences required to null volume flux were
      13.2 +/- 2.4 and 29.4 +/- 4.0 mosmol/kgH2O under low and high peritubular
      protein. Our data suggest that this protein effect is, most likely, an increase
      in solute transport by the tubule epithelial cells.

PMID- 1750519
TI  - Localization of ral, a small Mr GTP-binding protein, to collecting duct cells in
      bovine and rat kidney.
AB  - Plasma membranes from bovine kidney cortex were separated by sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and transferred to
      nitrocellulose membranes. Blotting with [alpha-32P]GTP and [35S]GTP gamma S
      demonstrated specific binding to three and six distinct protein bands,
      respectively, in the 20,000- to 29,000-Mr range. This indicated the presence of
      small Mr GTP binding proteins (smg) in bovine kidney cortex. Only one smg with
      28,000 Mr was labeled with hydrolysis-resistant GTP photoaffinity probe p3-(4
      azidoanilido)-p1-5GTP (AAGTP). The major smg in platelet membranes that binds GTP
      on nitrocellulose blots has been identified as ral-Mr 29,000. With the use of an
      antiserum against the ral A gene product, one of the smg with Mr of 29,000
      present in bovine renal cortical plasma membranes was identified as ral. Ral was
      absent from glomerular homogenate, suggesting that it is localized to the tubular
      segments of the nephron. Ral was detected only in the particulate fraction and
      not the cytosol. Further subcellular localization of ral was investigated by
      immunohistochemical staining. Anti-ral antibody immunostained the apical and
      basolateral membranes of cells in the cortical and medullary collecting ducts in
      a speckled pattern in the bovine kidney. In the rat kidney, however, uniform
      linear staining of cortical and medullary collecting ducts predominantly
      localized to the apical membrane was observed. To date, no function has been
      assigned to ral. Localization of the ral gene product to the collecting duct
      suggests a specific functional role for this GTP-binding protein.

PMID- 1750520
TI  - Expression of cytokine-like genes JE and KC is increased during renal ischemia.
AB  - Both mitogenic and inflammatory phenomena accompany the renal response to
      ischemic injury. Previous studies have shown that several nuclear-binding members
      of the immediate early genes are prominently expressed after renal ischemia and
      may underlie the mitogenic response to such injury. We now report on the
      expression of JE and KC, other growth-factor-responsive genes that code for small
      secreted glycoproteins with cytokine-like properties, which may play a role in
      inflammation. The expression of the immediate early genes JE and KC was
      determined in rat kidney tissue at varying time points after release of a 50-min
      period of bilateral renal hilar clamping. Relative levels of mRNA for JE and KC
      were analyzed by Northern blot analysis of cortical and outer stripe mRNA. KC
      mRNA rose rapidly to peak values at 1 h and returned toward low baseline levels
      by 24 h after release of the hilar clamp. By contrast, JE mRNA reached peak
      levels later and remained elevated for at least 96 h after ischemia. JE antigen
      was localized immunocytochemically to the apical regions of the cortical and
      medullary thick ascending limbs as well as in the lumen of the distal nephron in
      ischemic kidneys. Cells of the glomerulus and proximal tubules were negative for
      JE antigen. In contrast to the increase in JE and KC mRNA, steady-state levels of
      uromodulin (Tamm Horsfall) mRNA, a cytokine binding protein also made by the
      thick ascending limb, declined to virtually undetectable levels by 24 h after
      ischemia. Thus the increases in JE and KC are not generalized phenomena.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1750521
TI  - Osmotically regulated taurine content in rat renal inner medulla.
AB  - During antidiuresis renal medullary cells were previously found to accumulate
      large amounts of organic osmolytes, namely sorbitol, myo-inositol,
      glycerophosphorylcholine (GPC), and betaine. Large quantities of amino acids are
      also present in the renal medulla, but it has been questionable whether the
      levels of medullary amino acids are osmotically regulated. Therefore we directly
      measured 26 different amino acids, as well as sorbitol, myo-inositol, GPC, and
      betaine alone the corticomedullary axis of rats that were either salt loaded,
      after infusion of hypertonic NaCl solution, or were hydrated, after infusion of
      hypotonic NaCl solution. The amounts of sorbitol, myo-inositol, GPC, and betaine
      are greater in the inner medullas of salt-loaded rats compared with hydrated
      rats. In addition, the amount of taurine is much greater in the inner medullas of
      salt-loaded rats. Aspartic acid also increases in salt-loaded rats but to a
      lesser extent. There are substantial gradients of taurine, aspartic acid, and
      some of 24 other measured amino acids along the corticomedullary axis. However,
      taurine and aspartic acid are the only measured amino acids that increase
      significantly during salt loading.

PMID- 1750522
TI  - Differing renal effects of activated and nonactivated isoelectric peaks of human
      prorenin in rats.
AB  - Isoelectric species of renin are physically heterogeneous. Recent evidence
      suggests that they may differ functionally, with some species producing
      natriuresis and diuresis, whereas others have no effect. A physiological function
      of secreted prorenin has not been documented in any species. The present study
      was designed to confirm and describe for the first time the renal effects of
      certain isoelectric species of prorenin. Anesthetized Sprague-Dawley rats were
      injected (0.1 ml) with trypsin-activated or nonactivated prorenin obtained from
      human ovarian follicular fluid. The dose chosen was calculated as sufficient to
      produce 2,300 ng angiotensin I.h-1.100 g rat body wt-1 in the presence of excess
      sheep substrate. Blood pressure, creatinine clearance, urine flow rate, and urine
      sodium, potassium, and osmolar excretion were measured. Activated prorenin from
      isoelectric peaks at isoelectric points (pI) 5.1, 5.2, 5.4, and 5.6 produced
      marked increases in urine volume (sixfold) and sodium excretion (7- to 10-fold)
      compared with the group receiving the vehicle (1% albumin in 0.9% saline).
      Activated prorenin from peaks at pI 4.9 and 5.8 produced no significant increase
      over the vehicle-only experiments. Captopril pretreatment (1 mg/kg iv) completely
      blocked the effects of peaks at pI 5.4 and 5.6. Interestingly, injection of
      nonactivated prorenin from peaks at pI 5.4 and 5.6 produced effects similar to
      the injection of activated prorenin from these peaks. Similarly, this effect was
      blocked by pretreatment with captopril. In summary, only certain isoelectric
      peaks of human prorenin whether activated, to active renin, or nonactivated
      produced a marked natriuresis and diuresis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750523
TI  - Effect of inhibitors of oxidative phosphorylation on erythropoietin mRNA in
      isolated perfused rat kidneys.
AB  - We have used RNase protection to measure oxygen-dependent changes in
      erythropoietin (EPO) mRNA in isolated perfused kidneys and to compare the effect
      of hypoxia with the response to inhibitors of oxidative phosphorylation. In well
      oxygenated kidneys perfused for 2 h at 12 ml/min, with hematocrit of 0.09 +/-
      0.005 and PO2 of 443 +/- 67 mmHg, EPO mRNA levels were similar to the baseline
      levels measured in nonperfused contralateral kidneys from the same animals. When
      perfusions were performed under identical conditions but at a PO2 of 32 +/- 4
      mmHg, EPO mRNA increased approximately 16-fold. In contrast, graded
      concentrations of cyanide (10, 100, and 300 microM and 1 mM), antimycin (0.01,
      0.1, 0.5, and 1 microM), and oligomycin (0.01, 0.1, and 1 microM) did not alter
      EPO mRNA in well-oxygenated perfused kidneys. However, in kidneys perfused at low
      PO2 with a high concentration of each inhibitor, EPO mRNA levels were increased,
      demonstrating that the ability to respond to hypoxia was retained. Thus
      inhibitors of oxidative phosphorylation did not mimic the effects of hypoxia,
      indicating that oxygen-dependent expression of the EPO gene in the kidney is not
      effected through hypoxic compromise of oxidative phosphorylation.

PMID- 1750524
TI  - Kinetic analysis of clearance of epidermal growth factor in isolated perfused rat
      kidney.
AB  - Our previous in vivo studies identified the saturable uptake of epidermal growth
      factor (EGF) by rat kidney (D.C. Kim, Y. Sugiyama, H. Sato, T. Fuwa, T. Iga, and
      M. Hanano, J. Pharm. Sci. 77: 200-207, 1988). In the present study, renal
      handling of EGF in filtering and nonfiltering isolated perfused rat kidneys was
      investigated. At designated times after the recirculatory perfusion of 125I-EGF
      in the nonfiltering kidney, the surface-bound and internalized EGF were
      separately determined by an acid-washing technique. Time profiles of cell-surface
      bound and internalized EGF obtained at the perfusion of a tracer 125I-EGF were
      fitted to the pharmacokinetic model, and kinetic parameters obtained were as
      follows: konRs = 0.49 ml.min-1.g-1, koff = 0.87 min-1, kint = 0.20 min-1 where
      konRs is the binding clearance of EGF with its receptor and koff and kint
      represent the dissociation and internalization rate constants of the EGF-receptor
      complex, respectively. The Scatchard analysis of the concentration-dependent EGF
      binding in the nonfiltering kidney suggests the presence of two binding
      components, one with high affinity [the apparent dissociation constant (Kd1 = 0.1
      nM) and the other with low affinity (Kd2 = 30 nM]. By comparing the
      internalization clearance (CLi) with filtering and nonfiltering kidneys, we
      concluded that the renal uptake of EGF occurs mainly from the antiluminal side
      via receptor-mediated endocytosis in a saturable manner and that the nonsaturable
      reabsorption of EGF from the luminal membrane after glomerular filtration is
      relatively small. The contribution of reabsorption, however, becomes larger with
      the increase in EGF concentration.

PMID- 1750525
TI  - Adenosine triphosphate-sensitive potassium channels in the cardiovascular system.
AB  - ATP is normally available in cells at millimolar concentrations and is "buffered"
      by intracellular pools of other high-energy phosphates, such as creatine
      phosphate. Thus intracellular [ATP] [( ATP]i) may seem an unlikely candidate for
      a regulatory signal inside cells. Recent evidence suggests, however, that [ATP]i
      regulates the behavior of a class of potassium (KATP) channels that are found
      throughout the cardiovascular system. KATP channels are present in cardiac,
      skeletal, and vascular smooth muscle. The channels are inhibited by micromolar
      [ATP]i, and this inhibition is relieved by micromolar [ADP]i. We present evidence
      in support of the idea that variations of [ATP]i and [ADP]i, even within normal
      concentration ranges, may influence cellular function in the heart and vascular
      system via a direct action on the KATP channel. Furthermore, very specific
      modulators of KATP channel activity are available. We discuss the mechanism of
      action of these agents and their interaction with endogenous modulators and
      consider their potential roles in cardiovascular therapy.

PMID- 1750526
TI  - Areas of rostral medulla providing tonic control of renal and splenic nerves.
AB  - The objective of this study was to determine whether nonuniform control of tonic
      discharge of renal and splenic nerves by the rostral ventrolateral medulla (RVLM)
      is dependent on viscerotopic representation of the kidney and the spleen in this
      region. Small (15 nl, 13 pmol) injections of the potent tau-aminobutyric acid
      agonist muscimol were used to map the RVLM of anesthetized rats, searching for
      areas that selectively provided tonic excitation of renal or splenic nerves. Most
      of the muscimol microinjections produced depressor responses and inhibition of
      sympathetic nerve activity. Activity of renal nerves was inhibited significantly
      more than that of splenic nerves, but we found no evidence for topographical
      organization of RVLM influences on tonic activity of these two nerves. However,
      this investigation did yield an important new observation, since approximately
      10% of the injections caused pressor responses and increases in sympathetic
      discharge. The unexpected increases must have been caused by blockade of small
      groups of tonically active sympathoinhibitory neurons located throughout the
      RVLM. This disinhibition was not evoked from any specific region of the RVLM. In
      conclusion, the RVLM neurons and putative interneurons that tonically control the
      discharge of postganglionic renal and splenic neurons appear to be distributed
      homogeneously throughout this area. Neither excitatory nor inhibitory elements
      were organized topographically to specifically influence the renal or the splenic
      nerve. The neural organization responsible for the preferential effect on renal
      nerves may exist in the local microcircuitry within the RVLM and will be revealed
      only by an even more discrete analysis of these circuits.

PMID- 1750527
TI  - Experimental instrumentation and left ventricular pressure-strain relationship.
AB  - Pericardial pressure measurement with a balloon transducer requires opening and
      reapproximating the pericardium. If this instrumentation significantly
      compromises pericardial volume, the heart may be constrained, exaggerating the
      magnitude of pericardial pressure and thus altering the left ventricular end
      diastolic pressure-volume relationship. In open-chest dogs, we studied the
      effects of opening the pericardium, inserting a pericardial balloon transducer
      and myocardial sonomicrometer crystals, and reapproximating the pericardium on
      the left ventricular end-diastolic pressure-strain relationship (LVEDPSR). After
      a thoracotomy, sonomicrometer crystals were inserted through small holes (less
      than 3 mm) in the pericardium to measure LV segment length. A micromanometer with
      a reference lumen was used to measure LV pressure. LVEDPSRs were recorded in the
      following situations: 1) before the pericardium was opened (but after the
      crystals were inserted); 2) after the pericardium was opened, the heart was
      instrumented (4 pairs of crystals and 1 balloon), and the pericardium was
      reapproximated with interrupted sutures; and 3) after the pericardium was
      removed. For each dog, a cubic regression equation was fitted to the data
      obtained before opening the pericardium, and the 95% confidence intervals for the
      individual data points were determined. In each case, the LVEDPSR obtained after
      instrumentation was similar to the LVEDPSR described before opening the
      pericardium. Furthermore, data obtained after instrumentation were uniformly
      located within the confidence intervals of the LVEDPSR obtained before opening
      the pericardium and instrumenting the heart.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750528
TI  - Glycolysis is predominant source of myocardial ATP production immediately after
      birth.
AB  - Glycolytic flux, as well as glucose, fatty acid, and lactate oxidation, was
      determined in isolated working hearts obtained from 1- and 7-day-old rabbits. One
      day-old rabbit hearts were perfused via the inferior cava against a constant
      aortic and pulmonary arterial afterload, whereas hearts from 7-day-old rabbits
      were perfused via the left atria against a constant aortic afterload. Hearts were
      perfused with buffer containing 100 microU/ml insulin and either 1) 11 mM [U
      14C/2-3H]glucose, 0.4 mM palmitate, 2 mM lactate; 2) 11 mM glucose, 0.4 mM [1
      14C]palmitate, 2 mM lactate; or 3) 11 mM glucose, 0.4 mM palmitate, 2 mM [U
      14C]lactate. Glycolytic rates (measured as 3H2O production) were high in 1-day
      old hearts but decreased by 7 days (from 2,730 +/- 280 to 580 +/- 80 nmol.min-1.g
      dry wt-1). Rates of glucose oxidation (measured as 14CO2 production) were lower
      in both 1- and 7-day-old hearts (59 +/- 4.4 and 23 +/- 2 nmol.min-1.g dry wt-1).
      Palmitate oxidation rates were low in 1-day-old hearts but dramatically increased
      by 7 days (22.6 +/- 5.6 and 305 +/- 33 nmol oxidized.min-1.g dry wt-1,
      respectively). In contrast, lactate was readily oxidized by both 1- and 7-day-old
      hearts (169 +/- 14 and 456 +/- 52 nmol.min-1.g dry wt-1, respectively). In 1-day
      old hearts, 44% of steady-state ATP production from exogenous sources were
      derived from glycolysis, whereas 18, 13, and 25% were derived from glucose,
      palmitate, and lactate oxidation, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750529
TI  - Interaction of pressure- and flow-induced responses in porcine coronary
      resistance vessels.
AB  - Pressure-induced myogenic responses and flow-induced vasodilatory responses have
      been documented in coronary resistance arterioles, but the interaction of these
      two mechanisms and the nature of the flow-mediated response are not well
      understood. Experiments were designed to quantitatively study the interaction of
      pressure- and flow-induced responses and to characterize the nature of the
      substance responsible for flow-mediated dilation in isolated coronary arterioles.
      Subepicardial arterioles (40-80 microns) were isolated from pigs and cannulated
      with two glass micropipettes and then pressurized via independent reservoir
      systems. Flow was initiated by simultaneously moving the reservoirs in equal and
      opposite directions thus generating a pressure gradient (delta P) without
      changing the mean intraluminal pressure (IP). IP was changed by moving both
      reservoirs in the same direction to alter myogenic tone in the absence of flow
      (delta P = 0). Flow-mediated dilation competed with myogenic constriction when
      flow and pressure were elevated. Also, flow potentiated myogenic dilation when IP
      was decreased. The magnitude of flow-induced dilation was greatest at an
      intermediate level of vascular tone (IP = 60 cmH2O) but was attenuated at higher
      and lower levels of tone. In the presence of flow (delta P = 4 cmH2O), pressure
      diameter relationships were shifted upward, and the magnitude of myogenic
      responsiveness was attenuated. Double-vessel bioassay studies indicated that a
      transferable substance was released from intact endothelium in response to flow.
      Flow-induced dilation was not affected by indomethacin but was abolished by NG
      monomethyl-L-arginine or by mechanical removal of endothelium.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1750530
TI  - Reciprocal regulation by putatively nitroxidergic and adrenergic nerves of monkey
      and dog temporal arterial tone.
AB  - In monkey and dog superficial temporal artery strips denuded of the endothelium,
      transmural electrical stimulation and nicotine produced a contraction that was
      abolished by phentolamine and potentiated by NG-nitro-L-arginine (L-NNA), a
      nitric oxide (NO) synthesis inhibitor. The potentiation was reversed by L
      arginine but not by its D-enantiomer. The arteries treated with phentolamine and
      contracted with prostaglandin F2 alpha responded to the electrical stimulation
      and nicotine with relaxations that were abolished by tetrodotoxin and
      hexamethonium, respectively, and were markedly inhibited by L-NNA but not by D
      NNA, atropine, and timolol. The L-NNA-induced inhibition was reversed by L
      arginine. Nicotine increased the level of guanosine 3',5'-cyclic monophosphate in
      the monkey arteries; the increment was prevented by L-NNA. It is concluded that
      the monkey and dog temporal arterial tone appears to be reciprocally regulated by
      adrenergic vasoconstrictor and nonadrenergic noncholinergic vasodilator nerves.
      The neurogenic relaxation would be mediated by NO that is possibly released from
      the vasodilator nerve and transmits information to smooth muscle; therefore the
      nerve may be called "nitroxidergic."

PMID- 1750531
TI  - Abnormal Cai2+ handling is the primary cause of mechanical alternans: study in
      ferret ventricular muscles.
AB  - We tested the hypothesis that mechanical alternans of the heart is due to
      alternations in intracellular calcium (Cai2+) levels. Eight papillary muscles
      were isolated from the right ventricles of male ferrets and were chemically
      loaded with aequorin to record cytoplasmic Cai2+. To produce a steady-state
      mechanical alternans, the preparations were perfused with a physiological salt
      solution containing a low calcium concentration (0.25 mM), at 22 degrees C, and
      stimulated at 0.5-1.0 Hz in the presence of carbachol and propranolol. The
      aequorin signal (Cai2+) and isometric contraction were simultaneously recorded.
      In each muscle, the strong beats (beats with higher peak tension) were associated
      with larger Ca2+ transients than the weak beats. The relationships between peak
      Cai2+ and peak tension, both during strong and weak beats, were similarly
      modified by short-term frequency responses. On the other hand, the time courses
      of the isometric contractions and Ca2+ transients during strong beats and weak
      beats were superimposable. These data indicate that mechanical alternans is
      caused by an alternate change of Cai2+ available for activation of the
      myofilaments. Prolongation of the time for recycling Ca2+ by the sarcoplasmic
      reticulum, i.e., a depressed uptake function of the Ca2+ pump with concomitant
      slow transportation of Ca2+ from the uptake compartment to the release
      compartment in the sarcoplasmic reticulum, is suggested as a cause of the
      abnormal Cai2+ handling during mechanical alternans.

PMID- 1750532
TI  - Pyruvate carboxylation prevents the decline in contractile function of rat hearts
      oxidizing acetoacetate.
AB  - Acetoacetate, when present as the only fuel for respiration in rat hearts, causes
      an impairment in contractile function that is reversible with the addition of
      substrates that can contribute to anaplerosis. To determine the importance of
      pyruvate carboxylation via NADP(+)-dependent malic enzyme on metabolism and
      function in hearts oxidizing acetoacetate, isolated working rat hearts were
      perfused with [1-14C]pyruvate and acetoacetate. While the cardiac power output
      after 60 min of perfusion in hearts utilizing acetoacetate alone had fallen to
      44% of the initial value, the addition of pyruvate resulted in a stable
      performance with no fall in the work output. When hydroxymalonate, an inhibitor
      of NADP(+)-dependent malic enzyme and malate dehydrogenase, was added to the two
      substrates, function at 60 min was similar to the value for hearts oxidizing
      acetoacetate alone. Measurements of the specific activities of malate, aspartate,
      and citrate confirm inhibition of both pyruvate carboxylation and malate
      oxidation. The findings are consistent with a mechanism in which the enrichment
      of malate by pyruvate improves function by increasing the production of reducing
      equivalents by the malate dehydrogenase and the isocitrate dehydrogenase
      reactions increase flux through the span of the tricarboxylic acid cycle from
      malate to 2-oxoglutarate. The present study demonstrates the physiological
      importance of anaplerotic pathways in maintaining contractile function in the
      heart.

PMID- 1750533
TI  - Blood volume changes in liver and spleen during cardiogenic shock in dogs.
AB  - Changes in vascular capacitance of the liver and spleen were studied in seven
      anesthetized dogs during cardiogenic shock induced by coronary microembolization.
      Left ventricular end-diastolic pressure increased from 2 +/- 2 to 28 +/- 4 mmHg
      (P less than 0.001), and mean aortic pressure decreased from 111 +/- 7 to 56 +/-
      9 mmHg (P less than 0.001). Hepatic venous pressure increased from 1.8 +/- 0.6 to
      5.0 +/- 1.0 mmHg (P less than 0.05). Portal venous pressure did not change. Blood
      volume changes were assessed from sonomicrometric measurements of organ
      diameters. Hepatic diameter increased after embolization, corresponding to an
      estimated 54 +/- 14 ml increase of hepatic blood volume (P less than 0.01).
      Splenic diameter gradually decreased during shock until an estimated 33 +/- 12 ml
      of blood had been released (P less than 0.05). Occlusion of hepatic venous
      outflow by a balloon catheter was used to cause ramp changes in hepatic volume
      and hepatic venous pressure so that a pressure-volume curve could be estimated.
      Analysis of the hepatic curves showed an increase in unstressed volume with no
      change in vascular compliance during shock. The blood volume increase could in
      part be attributed to increased outflow pressure, but active dilation of hepatic
      capacitance vessels probably contributed. Splenic curves were shifted downward,
      suggesting expulsion of blood by active contraction.

PMID- 1750534
TI  - External mechanical work during relaxation period does not affect myocardial
      oxygen consumption.
AB  - We assessed the effect of external mechanical work (EW) during the relaxation
      period (RP) on myocardial oxygen consumption (VO2) and clarified the energetic
      significance of the potential energy (PE) portion of the pressure-volume area
      (PVA) in the cross-circulated dog left ventricle. We changed the course of the
      relaxation segment of the pressure-volume (P-V) trajectory by increasing or
      decreasing EW within a given PVA without changing the end-diastolic volume (EDV)
      and the systolic segment of the P-V trajectory while measuring VO2. Thus the
      ventricle underwent ejection or filling during RP. Although the percent fraction
      of EW in PVA (%EW/PVA) was markedly increased from 32 +/- 12 (SD) to 93 +/- 3% in
      ejecting contractions (8 hearts) and from 0 to 93 +/- 5% in isovolumic
      contractions (3 hearts), these marked changes in %EW/PVA did not significantly
      affect VO2. Moreover, the VO2-PVA data during these procedures fell on the
      reference VO2-PVA relation line obtained by changing EDV and PVA of isovolumic
      contractions. We conclude that EW during RP at a constant PVA does not affect VO2
      and part of PE can be converted into EW in an energetically equivalent manner.

PMID- 1750535
TI  - Endothelium-dependent vasodilation of canine coronary collateral vessels.
AB  - The objective of this study was to determine whether endothelium-mediated
      relaxation occurs in canine coronary collateral vessels. Responses to endothelium
      dependent vasodilators in coronary collateral vessels (250-350 microns) were
      compared with those obtained in normal native coronary arteries of similar size.
      Rings of small arteries and collateral vessels were suspended in baths, and
      tension was recorded. All rings were constricted with prostaglandin F2 alpha (3
      microM) and subsequently exposed to cumulative concentrations of acetylcholine or
      bradykinin. In separate experiments, the procedure was repeated in the presence
      of 300 microM NG-monomethyl-L-arginine (L-NMMA) to inhibit endothelium-mediated
      vasodilation. Endothelium-dependent relaxation was further studied in the
      presence of indomethacin, and endothelium-independent relaxation was examined
      with sodium nitroprusside. Acetylcholine and bradykinin relaxed both normal
      native and collateral rings. In preconstricted small arteries and collateral
      vessels the concentration at 50% of maximal response of acetylcholine was 85.5 +/
      19.5 and 61.0 +/- 14.0 microns, and bradykinin was 11.9 +/- 7.4 and 10.7 +/- 2.1
      microns, respectively. L-NMMA attenuated the response to acetylcholine and
      bradykinin in both groups. The results indicate that endothelium is present and
      functional in canine coronary collateral vessels. Both small coronary arteries
      and collateral vessels are equally responsive to endothelium-dependent
      vasodilators and inhibition of endothelium-dependent relaxing factor.

PMID- 1750536
TI  - Coronary artery narrowing in rats: mechanical alterations of left and right
      myocardium.
AB  - To determine the effects of chronic coronary artery narrowing on myocardial
      contractile performance, nonocclusive constriction of the left coronary artery
      near its origin was surgically induced in rats and global cardiac hemodynamics,
      left and right myocardial mechanics, and the magnitude and distribution of tissue
      damage and interstitial fibrosis in the left ventricular wall were analyzed 1 mo
      later. Reductions in coronary artery luminal diameter of 55% resulted in left
      ventricular failure as characterized by decreases in systemic arterial pressures,
      systolic ventricular pressure, rise and decay in first derivative of left
      ventricular pressure (+/- dP/dt), and an increase in left ventricular end
      diastolic pressure. Right side dysfunction was also present as documented by an
      elevation in right ventricular end-diastolic pressure and a reduction in -dP/dt.
      In vitro measurements of papillary muscle mechanics revealed a biventricular
      reduction in isometric developed tension and peak rates of tension rise and
      decay. Moreover, the kinetic parameters of isometric contraction duration, time
      to peak tension and time to one-half relaxation, were significantly shorter in
      left muscles from coronary artery-narrowed animals. Isotonically, peak muscle
      shortening was reduced in the left muscle, whereas time to peak shortening was
      prolonged in the right myocardium. In addition, the velocities of muscle
      shortening and relengthening were decreased in both ventricles. Foci of
      replacement fibrosis and diffuse interstitial fibrosis were found in the
      epimyocardium, midmyocardium, and endomyocardium, demonstrating that a
      significant amount of myocyte loss occurred throughout the left ventricular
      wall.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750537
TI  - Role of sinoaortic afferents in modulating BP and pulse-interval spectral
      characteristics in unanesthetized cats.
AB  - Sinoaortic denervation (SAD) is accompanied by an increase in blood pressure (BP)
      and a reduction in pulse-interval (PI) variance. Little is known, however, about
      the effect of SAD on the complex BP and PI variability pattern, which is
      identified by spectral analysis. In nine unanesthetized cats in which intra
      arterial BP was monitored before and 7-10 days after SAD, spectral powers
      (estimated by fast Fourier transform) were calculated for the low frequency (LF,
      0.025-0.07 Hz), midfrequency (MF, 0.07-0.14 Hz), and high frequency (HF, 0.14
      0.60 Hz) band. The very low frequency (VLF) BP and PI components (VLF less than
      0.025 Hz) were also estimated. SAD increased systolic BP variance and decreased
      PI variance. The reduction of PI variance was paralleled by significant and
      marked reductions in all PI powers including the VLF components. In contrast, the
      increase in systolic BP variance was accompanied by a marked increase in LF
      power, a decrease in MF power, and no change in HF power. The VLF BP components
      increased after SAD for frequencies between 0.025 and 0.0012 Hz, whereas a sudden
      marked reduction was observed below 0.0012 Hz. Similar results were obtained for
      diastolic BP powers. Thus the reduction in PI variance induced by SAD is
      paralleled by a reduction in all PI fluctuations identified by spectral analysis.
      This is not the case for the SAD-related increase in BP variance, which is
      accompanied by an increase, no change, or even a reduction in the different BP
      spectral components.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750538
TI  - Regional circulatory contributions to increased systemic vascular conductance of
      pregnancy.
AB  - In pregnancy, maternal systemic vascular conductance increases, a new vascular
      circuit grows, and the maternal systemic circulation develops a diminished
      pressor response to angiotensin II (ANG II). However, the quantitative
      contributions of the latter two circulatory changes to the increased systemic
      vascular conductance of pregnancy have not been explored. In this experiment, we
      examined regional circulatory contributions to the increased systemic vascular
      conductance in conscious, late-gestation guinea pigs. Systemic arterial pressure,
      cardiac output (dye dilution), and regional blood flows (radiolabeled
      microspheres) were measured during baseline conditions and progressive ANG II
      infusion. Systemic and regional conductances were calculated from arterial
      pressure and cardiac output or regional blood flows. In pregnancy, maternal
      systemic vascular conductance increased from 3.2 to 5.0 ml.min-1.mmHg-1 (P less
      than 0.001); increased nonuteroplacental conductance contributed 71% to the
      increase in whole body conductance. Pregnancy tended to decrease the
      nonuteroplacental conductance response (P = 0.072), but did not change the
      uteroplacental conductance response (P greater than or equal to 0.29), to ANG II.
      The increased uteroplacental blood flow of pregnancy was preserved during ANG II
      induced vasoconstriction. We conclude that maternal systemic vascular conductance
      increased primarily because nonuteroplacental vascular conductance
      increased.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750539
TI  - Protein kinase C and phospholipase C in adenosine receptor-mediated relaxation in
      coronary artery.
AB  - The effect of adenosine, 2-chloroadenosine (CAD), and 5'-(N-ethylcarboxamido)
      adenosine (NECA) on the contraction produced by phorbol 12,13-dibutyrate (PDB)
      was investigated in porcine coronary artery in vitro to determine whether
      adenosine receptor-mediated relaxation was linked to protein kinase C. Also, the
      coronary relaxation produced by adenosine and NECA in KCl-contracted coronary
      rings was investigated before and after treatment with the phospholipase C
      inhibitor neomycin to examine a possible link between phospholipase C and
      adenosine receptor-mediated relaxation. Ring segments of coronary artery were
      suspended in organ baths for measurement of isometric force. PDB (10 nM-1 microM)
      caused concentration-dependent contraction, and this response was significantly
      attenuated by pretreatment with the protein kinase C inhibitor staurosporine (200
      nM) but not 1-(5-isoquinolinylsulfonyl)-2-methyl-piperazine (10 microM).
      Treatment of rings with either adenosine, CAD, or NECA (100 microM) significantly
      attenuated the PDB-induced contraction, whereas treatment with either sodium
      nitroprusside (SNP; 1 microM) or isoproterenol (Isop; 1 microM) did not affect
      the contraction produced by PDB. The attenuation of the PDB-induced contraction
      by adenosine and its analogues was blocked by prior treatment of the coronary
      rings with 8-phenyltheophylline (10 microM). In a separate series of experiments,
      pretreatment of rings with the phospholipase C inhibitor neomycin (1 mM) resulted
      in a significant attenuation of the relaxing response to both adenosine and NECA
      while having no significant effect on the relaxation-response to SNP or Isop.
      These results provide indirect evidence that adenosine receptor-mediated
      relaxation in porcine coronary artery may be linked to modulation of protein
      kinase C and phospholipase C.

PMID- 1750540
TI  - Myocardial mechanics predict hemodynamic performance during normal function and
      alcohol-induced dysfunction in rats.
AB  - To determine whether mechanical evaluation of muscle tissue removed from the
      myocardium can be employed as a direct indicator of cardiac contractile
      performance in situ, isometric and isotonic parameters of muscle mechanics in
      vitro were correlated with in vivo global functional characteristics of the same
      heart. Twelve-month-old animals maintained on standard food and water were
      employed as representative of normal cardiac function. Animals of identical age
      with left ventricular (LV) dysfunction induced by oral alcohol (30%) ingestion
      from 4 to 12 mo were utilized to represent depressed cardiac performance.
      Accordingly, 24 h after the establishment of the hemodynamic profile for a
      control or experimental heart, the LV posterior papillary muscle was removed from
      the same heart and examined isometrically and isotonically. Least squares
      regression analysis was employed to establish a correlation coefficient and P
      values between various in vitro and in vivo parameters. Hemodynamic measurements
      were performed under chloral hydrate anesthesia and LV pump performance was
      evaluated with respect to aortic and ventricular pressures and the rates of rise
      and decay of the LV pressure trace. Papillary muscles were evaluated with respect
      to timing parameters of the isometric and isotonic twitch, the first derivative
      of isometric tension development, and the speed of muscle shortening at
      increasing physiologic loads. LV peak rate of pressure rise and decay were then
      correlated with the various isometric and isotonic properties. Myocardial
      mechanics and hemodynamics revealed depressed function in the papillary muscles
      and hearts from alcoholic rats. Moreover, significant correlations were found
      between the LV rate of pressure change (peak +dP/dt and -dP/dt) and both
      isometric and isotonic twitch measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750541
TI  - Responses of atrium and ventricle to sustained sympathetic nerve stimulation.
AB  - To determine whether chronotropic and atrial inotropic responses to sympathetic
      nerve stimulation are maintained longer than ventricular inotropic response, the
      present study was performed with control and acute reserpinized dogs. We
      stimulated the right stellate ganglion of both groups supramaximally for 60 min
      and compared right atrial responses (chronotropism and inotropism) with left
      ventricular (LV) dP/dtmax. In the control group, heart rate (HR) immediately
      increased and was only slightly attenuated with 60 min of stimulation, and right
      atrial (RA) inotropic response was less attenuated than was LV response (7% in
      HR, 33% in RA dP/dtmax, 50% in LV dP/dtmax, P less than 0.01, from the peak value
      of each response). RA and LV norepinephrine (NE) content was decreased by the
      stimulation but remained higher than the LV control value. In the reserpinized
      group, NE content in the RA was low before the stimulation and was further
      decreased by the stimulation. In this group, HR response was attenuated (27% in
      HR, P less than 0.01) as was LV dP/dtmax, and the difference in contractile
      responsiveness between atrium and ventricle disappeared (58% in RA dP/dtmax vs.
      61% in LV dP/dtmax, NS). The results indicate that the chronotropic response was
      only slightly attenuated and that the atrial contractile response was attenuated
      less than the ventricular response, with sustained sympathetic nerve stimulation
      in the normal heart. This can be ascribed to the much higher NE content in the RA
      than that in the LV.

PMID- 1750542
TI  - Immunoglobulin and renal abnormalities in Dahl genetically hypertensive rat.
AB  - The Dahl salt-sensitive rat (DS) is a model of genetically determined arterial
      hypertension exacerbated by dietary salt. We report two additional abnormalities
      of DS rats, which are both genetically determined and enhanced by salt: 1)
      immunoglobulin disorders and 2) renal dysfunctions. These abnormalities precede
      and are not the result of the arterial hypertension. In young, prehypertensive DS
      rats the plasma and tissue concentrations of immunoglobulin (Ig) G, but not of
      IgM or IgA, are decreased compared with those of the salt-resistant strain (DR).
      A high-salt diet (8.0% NaCl) decreases the plasma and tissue IgG levels of DS but
      not of DR rats. Reduction of IgG in the DS strain results from both decreased
      synthesis and increased urinary excretion. Renal dysfunction in young,
      prehypertensive DS animals is manifested by increased excretion of high molecular
      weight proteins, including albumin, IgG, IgA, and IgM. The high-salt diet
      increases the urinary excretion of these proteins within 1-2 days, and the effect
      is much greater in DS compared with DR rats. The urinary excretion of IgG is
      selectively increased relative to immunoglobulin light chains, IgA and IgM in DS
      compared with DR animals. The present studies provide new markers characteristic
      of the DS phenotype and pose the issue of possible genetic or functional
      interrelationships among the salt-sensitive hypertension, immunoglobulin
      disorders, and renal dysfunctions.

PMID- 1750543
TI  - Carotid baroreceptor control of right atrial mechanics in dogs.
AB  - To investigate the influence of the carotid arterial baroreceptors on right
      atrial mechanics, the carotid sinus region was isolated surgically in eight dogs
      prepared acutely under pentobarbital. Right atrial pressure and conductance
      volume were measured with a strain-gauge tip catheter and a conductance catheter,
      respectively. Reduction of carotid sinus pressure from 225 to 50 mmHg elicited
      significant increases in the a wave in right atrial pressure, in atrial stroke
      volume, in atrial stroke work (2.5-fold), and in atrial stroke power (4-fold).
      Mean central venous pressure and atrial volume at the onset of each beat did not
      change. These responses were unchanged after bilateral cervical vagotomy. Head-up
      tilt was applied at carotid sinus pressures less than or equal to 150 mmHg in
      four dogs to oppose any contribution of decreased systemic venous capacity to the
      responses through increased atrial filling. Tilt did not change atrial stroke
      work or atrial filling during late ventricular systole before vagotomy but
      inhibited these variables significantly after vagotomy. The slope of the
      relationship between right atrial stroke work and atrial volume at the onset of
      contraction increased significantly with reduction of carotid sinus pressure.
      This response was unaffected by either vagotomy or tilt. Carotid arterial
      hypotension appears to augment right atrial stroke work and stroke volume through
      an increase in atrial contractility. A decrease in venous capacity may contribute
      to this response especially after vagotomy.

PMID- 1750544
TI  - Cigarette smoke extract attenuates endothelium-dependent arteriolar dilatation in
      vivo.
AB  - The purpose of this study was to examine the effects of cigarette smoke extract
      on endothelium-dependent and endothelium-independent dilatation of arterioles in
      vivo. Using intravital microscopy, we measured diameter of arterioles contained
      within the microcirculation of the hamster cheek pouch during suffusion with
      acetylcholine and nitroglycerin, before and after treatment with cigarette smoke
      extract. Under control conditions, acetylcholine and nitroglycerin produced dose
      related dilatation of cheek pouch arterioles. Superfusion of cigarette smoke
      extract (1.0%) did not alter baseline diameter of arterioles or vasodilatation in
      response to nitroglycerin but impaired dilatation of arterioles in response to
      acetylcholine. Next, we examined the possibility that impaired dilatation of
      cheek pouch arterioles in response to acetylcholine after exposure to cigarette
      smoke extract may be related to the release of substances produced via the
      cyclooxygenase pathway. In indomethacin-pretreated hamsters, acetylcholine
      produced similar vasodilatation before and after exposure to cigarette smoke
      extract. Thus these findings suggest that cigarette smoke extract impairs
      endothelium-dependent responses of cheek pouch arterioles. The mechanism of
      impaired responses of cheek pouch arterioles after exposure to cigarette smoke
      extract appears to be related to the release of substances produced via the
      cyclooxygenase pathway.

PMID- 1750545
TI  - Relationships between lymphatic pump flow and total lymph flow in the small
      intestine.
AB  - Response of collecting lymphatics to acute elevations in lymph formation was
      studied in vivo. Mesentery of 33 rats was prepared for intravital microscopic
      study, and indexes of lymph propulsion (contraction frequency, stroke volume, and
      ejection fraction) were monitored. In 14 rats, total lymph flow was measured by
      cannulating the main intestinal lymph trunk. After a control period, lymph flow
      was increased by hemodilution with isotonic saline. Right atrial pressure did not
      significantly increase during the hemodilution period. Total lymph flow increased
      to approximately 25 times control. Lymph propulsion (the product of stroke volume
      and contraction frequency) decreased in five lymphangions (group I). In 22
      lymphangions, lymph propulsion increased one to five times control (group II).
      The remaining six lymphangions increased lymph propulsion by greater than five
      times control (group III). Group I possessed the largest end-diastolic diameter,
      highest baseline contraction frequency, and did not dilate as lymphatic filling
      increased. Group III possessed the smallest initial end-diastolic diameter and
      lowest baseline contraction frequency, and end-diastolic diameter doubled as
      lymphatic filling increased. The characteristics of group II were between those
      of groups I and III. Total lymph flow and lymph propulsion by group III
      lymphangions tended to agree when lymph flow was less than five times control. In
      more edematous conditions, total lymph flow exceeded lymphatic pump flow. The
      characteristics of group II were between those of groups I and III. Analysis of
      the location of various sized lymphangions within the lymphatic network indicated
      that the smaller group III lymphangions were located nearer the intestinal wall,
      and the larger group I lymphangions were nearer the outflow from the
      mesentery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750546
TI  - Synergistic nonuniform shortening of atrial refractory period induced by
      autonomic stimulation.
AB  - We investigated the nonuniform effects of autonomic nerve stimulation of the
      effective refractory period (ERP) of the right atrium in the anesthetized dog.
      Stimulation of the discrete intracardiac sympathetic nerves to the sinoatrial
      (SA) nodal region uniformly shortened ERPs at three sites in the right atrium
      after administration of atropine. Right ansa subclavia (RS) stimulation similarly
      shortened ERPs in the absence of atropine. Stimulation of the discrete
      intracardiac parasympathetic nerves to the SA nodal region (SAP stimulation)
      shortened ERPs of the right atrium in a nonuniform manner. Simultaneous RS and
      SAP stimulation additively shortened ERPs at each site and decreased sinus rate
      much more than SAP stimulation alone. Shortening of ERP induced by SAP
      stimulation was greater than that induced by RS stimulation at similar absolute
      changes in heart rate. These results suggest that simultaneous activation of
      sympathetic and parasympathetic nerves nonuniformly shortens the ERP in the right
      atrium as the algebraic sum of the individual responses to each stimulation.
      However, parasympathetics exert the principal neural control over atrial ERP.

PMID- 1750547
TI  - Regulation of glycolytic flux by coronary flow in guinea pig heart. Role of
      vascular endothelial cell glycocalyx.
AB  - Hemodynamic forces continuously act on endothelial cell lining of blood vessels.
      Blood flow, perfusing pressure, and shear stress are known to induce the release
      of bioactive substances from the endothelium. Furthermore, coronary flow (CF) is
      a well-known stimulant of myocardial contraction. Our concern was whether other
      Ca(2+)-dependent responses like glycolytic flux (Gf) were also CF dependent. For
      this purpose, isolated guinea pig hearts were perfused with a medium containing 5
      mM 3-[3H]glucose, and the 3H2O released during perfusion was measured as an index
      of Gf. Changes in CF within the 3- to 25-ml/min range resulted in linear increase
      of Gf. This stimulatory effect of CF was also observed in K(+)-arrested hearts.
      In addition, increasing shear stress on addition of dextran to the perfusing
      solution (5% and 10% wt/vol), while keeping CF constant, also stimulated Gf. We
      hypothesized that endothelial cell membrane glycocalyx may act as sensor to this
      stimuli. Thus one would expect that substances acting on these structures
      (enzymes heparinase, hyaluronidase, or chondroitinase or the lectin concanavalin
      A) when added to the perfusate might inhibit the CF-induced Gf. The results
      showed that concanavalin A and heparinase inhibited the Gf-CF-induced response,
      whereas chondroitinase and hyaluronidase had no effect. These findings suggest
      that there may be a selective effect of these agents affecting the Gf response to
      CF. Our data suggest that CF stimulates Gf through shearing forces acting on
      specific endothelial glycocalyx component(s). Therefore, deformation of these
      components could result in the transduction of physical signals into release of
      chemical messengers that act on the biochemical machinery of underlining
      parenchymal cells.

PMID- 1750548
TI  - Effect of an arginine analogue on acetylcholine-induced coronary microvascular
      dilatation in dogs.
AB  - The purpose of this study was to elucidate the contribution of endothelium
      derived relaxing factor (EDRF) derived from arginine to acetylcholine (ACh)
      induced coronary arteriolar vasodilatation in vivo. Experiments were performed in
      62 open-chest anesthetized dogs. Internal diameters of small arterioles (less
      than 120 microns) and large arterioles (greater than 120 microns) were measured
      using an intravital microscope and stroboscopic epiillumination synchronized to
      the cardiac cycle. Topically administered NG-monomethyl-L-arginine (L-NMMA, 3 x
      10(-4) M) constricted small arterioles (-10.7 +/- 3.1% from control diameter, P
      less than 0.05), but L-NMMA did not produce vasoconstriction in large arterioles.
      ACh, in the absence of L-NMMA, caused a dose-dependent vasodilatation in both
      small and large arterioles. In large arterioles, L-NMMA completely abolished the
      ACh-induced vasodilatation (10(-5) M topical ACh: from 13.3 +/- 3.0 to -2.0 +/-
      1.5%, P less than 0.05; 10(-4) M ACh: from 20.9 +/- 3.9 to -3.0 +/- 1.9%, P less
      than 0.01). In small arterioles, L-NMMA only partially inhibited the
      vasodilatation (10(-5) M ACh: from 35.4 +/- 4.0 to 19.0 +/- 2.7%, P less than
      0.05; 10(-4) M ACh: from 42.5 +/- 4.8 to 22.6 +/- 3.1%, P less than 0.05). L
      Arginine (10(-3) M topically) reversed L-NMMA inhibition of ACh-induced
      vasodilatation. Persistent dilatation of small arterioles also occurred when NG
      nitro-L-arginine rather than L-NMMA was administered.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1750549
TI  - Arteriovenous oxygen diffusion shunt is negligible in resting and working
      gracilis muscles.
AB  - Distribution of O2 within and among arterioles and venules was determined in dog
      and rat gracilis muscles with a cryospectrophotometric method. Saturation in 40
      microns arterioles was not demonstrably different from saturation in the aorta
      even when flow was abnormally low. Arterioles greater than 40 microns ran
      parallel to venules. Measurements and a mathematical model indicate that
      diffusive shunting is negligible for typical separation distances between
      arterioles and venules. Most separation distances were greater than 30 microns.
      In some venule segments less than 15 microns from an arteriole, saturation within
      10 microns of the wall facing the arteriole was higher than at other locations
      within the venule. However, saturation in the population of venules did not
      increase with venule diameter, and mean venular saturation was not different from
      saturation in effluent blood. We make the following conclusions: 1) a small
      arteriovenous diffusive O2 flux exists in postural muscles; 2) contribution of
      this flux to O2 mass balance is negligible; 3) O2 diffusivity of the arteriolar
      wall and surrounding tissue in vivo cannot be much higher than O2 diffusivity
      determined in vitro; and 4) effluent PO2 closely approximates mean end-capillary
      PO2.

PMID- 1750550
TI  - Pulse-chase study on lipoprotein lipase in perfused guinea pig heart.
AB  - Lipoprotein lipase (LPL) in guinea pig hearts was labeled by perfusion for 15 min
      with [35S] methionine, followed by chase perfusion with unlabeled medium for less
      than or equal to 90 min. Suitable conditions for pulse and chase and for
      immunoprecipitation of LPL were worked out. Differences in labeling between
      individual hearts were found to be substantial. A technique to take serial
      biopsies (approximately 20 mg) from the heart ventricle was therefore worked out
      and validated. Regional differences of LPL labeling within the ventricle were
      small. There was no evidence for enhanced release of LPL caused by biopsy. When
      heparin was present throughout the chase, labeled LPL began to appear in the
      medium after 30 min. Thus LPL can move rapidly from synthesis in parenchymal
      cells to the endothelial surface and into the medium. After 90 min chase with
      heparin, approximately equal amounts of LPL (approximately 32%) had been released
      to the medium, remained in the heart, or had been degraded, respectively. In
      contrast, no detectable amount of labeled LPL appeared in the medium during 90
      min chase without heparin, and a heparin flush at this time brought out only
      approximately 9% of the pulse-labeled LPL.

PMID- 1750551
TI  - Role of xanthine dehydrogenase and oxidase in focal cerebral ischemic injury to
      rat.
AB  - The role of xanthine dehydrogenase and oxidase as a source of free radicals
      contributing to focal cerebral ischemic injury was evaluated in Long-Evans rats
      after the middle cerebral artery was permanently occluded and both carotid
      arteries were clamped for 90 min. The fraction of xanthine dehydrogenase present
      as the free radical producing oxidase increased slightly from 22% in control
      cortex to 30% in the ischemic right cortex during the first 3 h of reperfusion
      and then remained relatively unchanged over the next 24 h. This increase may in
      part be due to entrapped plasma, which contained 4.5 +/- 0.8 nmol.min-1.ml-1
      xanthine oxidase entirely in the free radical-producing form. Infarct volume was
      unaffected by pretreatment with 50 mg allopurinol/kg per day over 3 days before
      surgery but was decreased by 8% with 100 mg/kg and 24% with 150 mg/kg of
      allopurinol (P less than 0.05). However, inhibition of xanthine oxidase by
      dietary depletion of the essential molybdenum cofactor increased infarct volume
      by 19%, suggesting that protection by allopurinol at higher dosages was
      independent of xanthine oxidase inhibition. Neither xanthine oxidase present in
      rat brain nor circulating in plasma appears to be the primary source of oxygen
      radicals that contributes to infarction in focal cerebral ischemia.

PMID- 1750552
TI  - Measurement of regional glucose metabolic rates in reperfused myocardium.
AB  - Regional myocardial glucose utilization was measured with [18F]fluorodeoxyglucose
      (FDG) and positron emission tomography in normal and postischemic tissue after 3
      h of intracoronary balloon occlusion in closed-chest chronically instrumented
      anesthetized dogs. Estimates of glucose metabolic rates were made using the
      Sokoloff model, assuming the lumped constant to be unchanged in reperfused
      tissue. Myocardial sectors were classified as normal, reversibly injured, or
      infarct containing based on occlusion blood flow images and postmortem histology.
      Occlusion flow, measured by microspheres, was reduced by 38% in reversibly
      injured and 74% in infarct-containing sectors, recovering to 91 and 66%,
      respectively, 1 h postreperfusion. One month postreperfusion, flow was normal in
      reversibly injured sectors but remained depressed at 60% in infarct-containing
      sectors. Glucose utilization at baseline was homogeneous, averaging 0.8 mumol.g
      1.min-1. After 3 h of reperfusion following occlusion of the left anterior
      descending coronary artery, regional glucose metabolic rate was increased 60%
      relative to baseline in normal myocardium but not in postischemic sectors,
      leading to an enhancement of FDG uptake in normal relative to postischemic
      myocardium. At 24 h postreperfusion, the glucose metabolic rate decreased in
      normal remote tissue to 46% of baseline levels, probably reflecting increased
      plasma free fatty acid levels, but was not significantly altered in reversibly
      injured myocardium, leading to enhanced FDG uptake in reversibly injured relative
      to normal myocardium. Subsequently, glucose metabolism in normal and postischemic
      sectors was not significantly different. Prolonged relative enhancement of
      glucose metabolic rate in postischemic tissue was found when the glucose
      metabolic rate in normal myocardium was low. Myocardial glucose utilization
      correlated with hg, the rate constant for FDG phosphorylation under all
      conditions (r = 0.88).

PMID- 1750553
TI  - Ischemically sensitive abdominal visceral afferents: response to cyclooxygenase
      blockade.
AB  - Ischemically sensitive abdominal visceral afferents are known to reflexly
      stimulate the cardiovascular system. These nerve endings respond to severe
      hypoxia as well as to exogenously administered bradykinin and prostaglandins such
      as PGI2, PGE, and PGF2 alpha. We have shown previously that these prostaglandins
      can sensitize some previously unresponsive afferents to respond to ischemia. To
      determine if endogenously produced prostaglandins contribute to the observed
      increase in activity during ischemia, we recorded activity of 6 A delta- and 23 C
      fiber sympathetic afferents in anesthetized cats during 5 min of ischemia before
      and 15-30 min after intravenous administration of either indomethacin (5 mg/kg)
      or aspirin (50 mg/kg). Before cyclooxygenase inhibition, we noted repeatable
      increases of 1.44 +/- 0.22 and 1.44 +/- 0.36 impulses/s in the A delta- and C
      fibers, respectively, in response to ischemia. After indomethacin or aspirin,
      these increases were significantly reduced (P less than 0.05) in both thinly
      myelinated and unmyelinated afferents (0.69 +/- 0.36 and 0.46 +/- 0.21
      impulses/s, respectively). In a second protocol, we observed that the activity of
      six A delta- and seven C-fibers was significantly reduced by aspirin or
      indomethacin when a single period of ischemia preceded cyclooxygenase blockade.
      These data, in conjunction with our previous observations, indicate that
      prostaglandins significantly contribute to the increased afferent discharge
      activity associated with ischemia of the abdominal visceral region.

PMID- 1750554
TI  - Independent dual perfusion of left and right coronary arteries in isolated rat
      hearts.
AB  - A novel dual lumen aortic cannula was designed and constructed to permit
      independent perfusion of left and right coronary beds in isolated rat hearts
      without necessitating the cannulation of individual arteries. Stability of the
      dual-perfusion preparation was shown to be similar to that of the conventional
      Langendorff preparation, in terms of coronary flow, heart rate, and high-energy
      phosphate content. The independence of left and right perfusion beds was
      confirmed by unilateral infusion of disulfine blue dye and spectrophotometric
      detection of the dye in ventricular homogenates. Transient cessation of flow to
      the left coronary bed resulted in severe ventricular arrhythmias upon
      reperfusion, as in conventional models of regional ischemia and reperfusion. The
      dual-perfusion model is technically undemanding, reproducible, inexpensive, and
      can be used in several species. It enables studies with 1) regional low flow
      ischemia, 2) regional zero-flow ischemia without coronary ligation (with
      attendant damage to vasculature), 3) selective application of drugs or
      interventions to the ischemic-reperfused zone, and 4) selective application of
      components of ischemia and reperfusion to a site anatomically relevant to
      ischemic heart disease.

PMID- 1750555
TI  - 1H-nuclear magnetic resonance deoxymyoglobin signal as indicator of intracellular
      oxygenation in myocardium.
AB  - We report in this study that the intracellular oxygenation state is measurable
      with the 1H nuclear magnetic resonance signal of the proximal histidine N delta H
      proton of deoxymyoglobin. The signal appears in a clear spectral region of the 1H
      spectrum and is sensitive to various hypoxic and ischemic conditions. In perfused
      heart, the deoxymyoglobin's response to tissue oxygenation precedes the one
      reflected in the 31P phosphocreatine or ATP signals, suggesting that oxidative
      energy metabolism is still sufficient even when the myoglobin is partially
      saturated with oxygen. Our method offers then a unique way to observe tissue
      oxygenation and its interaction in localized tissue region in vivo.

PMID- 1750556
TI  - Lipid-soluble cardiodepressant factor vs. water-soluble myocardial depressant
      factor-like substances in shock.

PMID- 1750557
TI  - Comparative insights into the mechanisms of renal organic anion and cation
      secretion.
AB  - Comparative models have played a major role in defining the mechanisms that
      enable vertebrate proximal tubules to transport organic anions and cations from
      the peritubular interstitium to the urine. The unique advantages of these models
      and their contributions to our understanding of organic anion and cation
      transport mechanisms are summarized here. Recent studies of the organic anion
      transport system suggest that transport is coupled to metabolic energy via
      indirect coupling to the sodium gradient. Organic anions enter the cell across
      the basolateral membrane in exchange for alpha-ketoglutarate (alpha-KG), and the
      alpha-KG is returned to the interior via Na-alpha-KG cotransport. Indirect
      coupling to Na has been demonstrated in both isolated membranes and intact renal
      epithelial cells of species ranging from marine crustaceans to mammals. This
      mechanism was shown to drive not only cellular accumulation but also secretory
      transepithelial fluxes of organic anions. Luminal exit of secreted organic anions
      appears to be carrier mediated but is, at present, poorly understood, with
      mediated potential-driven efflux and anion exchange-driven efflux implicated in
      some species. As for organic anions, the renal clearance of some organic cations
      approaches the renal plasma flow. Although there is considerable variation in the
      handling of specific substrates between species, the basic properties of organic
      cation transport include carrier-mediated potential-driven uptake at the
      basolateral membrane, intracellular sequestration that reduces the free
      concentration of the cation, and luminal exit by organic cation-proton exchange.
      Reabsorptive transport is also observed for some organic cations, but its
      mechanisms and driving forces are not well understood.

PMID- 1750558
TI  - Freeze-thaw injury in erythrocytes of the freeze-tolerant wood frog, Rana
      sylvatica.
AB  - Erythrocytes from the freeze-tolerant wood frog (Rana sylvatica) were subjected
      to in vitro tests of freeze tolerance, cryoprotection, and osmotic fragility. The
      responses of cells from frogs acclimated to 4 or 15 degrees C were similar.
      Erythrocytes that were frozen in saline hemolyzed at -4 degrees C or lower. The
      addition of high concentrations (150 and 1,500 mM) of glucose or glycerol,
      cryoprotectants produced naturally by freeze-tolerant frogs, significantly
      reduced cell injury at -8 degrees C, but concentrations of 1.5 or 15 mM were
      ineffective. Hemolysis was reduced by 94% with 1,500 mM glycerol and by 84% with
      1,500 mM glucose; thus glycerol was the more effective cryoprotectant. Mean
      fragility values for frog erythrocytes incubated in hypertonic and hypotonic
      saline were 1,938 and 49 mosM, respectively. Survival in freeze tolerance and
      cryoprotection experiments was comparable for erythrocytes from frogs and humans,
      suggesting that these cells may respond similarly to freezing-related stresses.
      However, the breadth of osmotic tolerance, standardized for differences in
      isotonicity, was greater for frog erythrocytes than for human erythrocytes. Our
      data suggest that erythrocytes from R. sylvatica are adequately protected by
      glucose under natural conditions of freezing and thawing.

PMID- 1750559
TI  - Glucose increases rat plasma norepinephrine levels by direct action on the brain.
AB  - The hypothesis that glucose can selectively activate the sympathetic nervous
      system (SNS) by direct action on the brain was tested using plasma norepinephrine
      (NE) and epinephrine (Epi) responses to intracarotid and intravenous glucose
      injections as indexes of SNS and adrenal medullary responses, respectively.
      Intracarotid glucose bolus injections (0.1 g/kg) transiently raised plasma
      glucose (22%) and insulin (98%) levels at 2 min and increased plasma NE, but not
      Epi, levels from 2 to 60 min. Areas under the NE curve were 700% higher than
      equiosmolar doses of mannitol. An intravenous glucose bolus (1 g/kg) gave
      quantitatively similar but delayed (30 min) NE responses to the 0.1 g/kg
      intracarotid dose but raised plasma glucose 500% and insulin 1,700% above
      baseline at 2 min postinjection. Slow intracarotid glucose infusions for 60 min
      at 4 mg.kg-1.min-1 raised plasma NE levels from 30 to 60 min with 250% higher
      areas under the NE curve than the intracarotid and intravenous bolus doses but
      without a change in plasma glucose, insulin, or Epi levels. Infusions at 6 mg.kg
      1.min-1 transiently raised plasma NE levels at 30 min without altering glucose,
      insulin, or Epi levels. These results suggest that glucose alone can produce a
      selective, delayed SNS activation by a direct action on the brain.

PMID- 1750560
TI  - Role of gram-negative and gram-positive gastrointestinal flora in temperature
      regulation of mice.
AB  - An earlier study showed that the presence of gut flora elevates body temperature
      of mice and rats. In these experiments, we questioned whether the signal coming
      from the gut was endotoxin from gram-negative (Gm-) bacteria or some signal
      derived from gram-positive (Gm+) microorganisms. To test the idea that endotoxin
      is responsible for the effects of flora, we compared the temperature of the
      endotoxin-resistant mouse (C3H/HeJ) with that of endotoxin-sensitive strains of
      mice (C3H/SnJ and C3H/HeN). Temperature of C3H/HeJ was not different from that of
      C3H/SnJ or C3H/HeN during the light period but was significantly lower during the
      later hours of the dark period. We speculated that, if endotoxin leaking across
      the gut wall were responsible for elevating temperature, then reduction of gut
      flora with nonabsorbable antibiotics would depress the temperature of the
      endotoxin-sensitive mice more than that of the endotoxin-resistant mice. Because
      antibiotics lowered the temperature of both strains of mice to the same extent,
      the signal coming from the gut is unlikely to be endotoxin. To test whether Gm+
      flora can be responsible for elevating temperature, we inoculated one group of
      germfree mice with Gm+ organisms. Their mean temperature was significantly higher
      than that of mice that remained germfree. Cecectomy had no effect on temperature,
      indicating that the special properties of the germfree cecum were not involved in
      lowering the temperature of germfree mice. These data support the hypotheses that
      Gm+ organisms are a major source of the stimulatory effect of flora on normal
      body temperature and that the presence of Gm- organisms is unnecessary.

PMID- 1750561
TI  - Role of adrenal catecholamines during forced submergence in ducks.
AB  - Maximum underwater tolerance (UTmax) of chronically adrenalectomized ducks (ADX,
      5.3 +/- 0.3 min) and chronically adrenal-denervated ducks (DNX, 7.2 +/- 0.2 min)
      was significantly lower than sham-operated controls (SH-ADX, 10 +/- 0.8 min; SH
      DNX, 12.2 +/- 0.5 min). After 4 min forced submergence, heart rates of ADX (62 +/
      16 beats/min) and DNX (31 +/- 2 beats/min) ducks were significantly higher than
      in their respective sham-operated controls (23 +/- 3 and 17 +/- 2 beats/min),
      although their blood pressure was significantly lower. Arterial partial pressure
      of O2, arterial O2 content, arterial pH, and lactate levels in DNX ducks (42 +/-
      2 mmHg, 4.5 +/- 0.8 ml O2/100 ml blood, 7.233 +/- 0.016, 3.1 +/- 0.3 mM,
      respectively) were significantly lower than in SH-DNX ducks after 5 min forced
      submergence (53 +/- 1 mmHg, 6.8 +/- 0.4 ml O2/100 ml blood, 7.301 +/- 0.007, 4.8
      +/- 0.4 mM, respectively). Venous infusion of catecholamines in ADX and DNX ducks
      during forced submergence significantly increased UTmax. It is suggested that
      adrenal catecholamines increase tolerance to underwater submersion by enhancing
      peripheral vasoconstriction, thus preserving the O2 stores for the heart and
      brain. Other adrenal products could also be involved.

PMID- 1750562
TI  - Intraruminal rehydration of ovine fetuses.
AB  - During oral rehydration of adult mammals, oropharyngeal stimulation, the act of
      swallowing, and/or gastric factors contribute to a rapid decrease in plasma
      arginine vasopressin (AVP) that precedes plasma osmolality changes. To determine
      whether similar mechanisms are present in the developing fetus, six chronically
      prepared ovine fetuses were rehydrated with intraruminal (IR) distilled water
      infusions (1 ml.kg-1.min-1 for 60 min) after 43 +/- 3 h of maternal water
      deprivation. In response to maternal dehydration, significant increases were
      noted in maternal and fetal mean plasma osmolalities, sodium and AVP
      concentrations, and fetal urine osmolality. As estimated by hematocrit, fetal
      intravascular volume decreased by 11%. Fetal rehydration via IR distilled water
      infusion evoked a significant decrease in fetal plasma osmolality but no change
      in urine osmolality. Unexpectedly, fetal arterial blood pressure increased and
      arterial PO2 decreased while fetal hematocrit indicated a further 7% decrease in
      intravascular volume after the IR infusion. There was a nonsignificant trend
      toward increased fetal glomerular filtration rate, urine volume, and plasma AVP
      concentrations. Identical IR water infusions to five euhydrated fetuses resulted
      in significant decreases in fetal plasma osmolality and increases in glomerular
      filtration rate, urine flow, and osmolar excretion. The euhydrated fetuses also
      exhibited significant increases in mean arterial blood pressure and hematocrit
      and decreased fetal arterial PO2. These results indicate that IR water does not
      suppress AVP secretion in the dehydrated ovine fetus. Rather, both euhydrated and
      dehydrated fetuses exhibit an idiosyncratic vasoconstrictive response to IR
      water.

PMID- 1750563
TI  - Regulation of food intake and body weight in rats by the synthetic heme analogue
      cobalt protoporphyrin.
AB  - Cobalt protoporphyrin (CoPP) in single subcutaneous doses produces prolonged
      weight loss in adult and aged male rats. The altered body weight level in treated
      animals is actively defended against starvation or overfeeding over prolonged
      time periods (greater than 50-100 days). The actions of CoPP on appetite and body
      weight regulation are biphasic, comprising an initial period of hypophagia,
      probably mediated centrally, until a particular body weight level is attained.
      Resumption of normal calorie intake follows, although lowered body weight levels
      are sustained, suggesting an additional action of the compound on peripheral
      substrate metabolism. Controlled decrements in body weight can be produced by
      repetitive low-dose CoPP treatment (e.g., 1 mumol/kg body wt weekly); low-dose
      regimens do not elicit altered hormonal homeostasis or aberrations in
      heme/cytochrome P-450 regulation that have been observed following larger doses
      (25-50 mumol/kg body wt) of the compound. CoPP may be a valuable probe with which
      to explore the role of heme-related molecules in the regulation of appetite and
      body weight.

PMID- 1750564
TI  - Intracerebroventricular administration of cobalt protoporphyrin elicits prolonged
      weight reduction in rats.
AB  - Intracerebroventricular administration of the synthetic heme analogue cobalt
      protoporphyrin (CoPP) results in a dose-dependent decrease in body weight in
      rats. Among several other metalloporphyrins tested, this effect was found to be
      specific to cobalt chelated in native or minimally modified protoporphyrin rings.
      Metabolic balance studies showed that the initial effect of
      intracerebroventricular treatment with CoPP (0.4 mumol/kg body wt) was a
      transient reduction in food intake. However, following resumption of normal food
      intake and growth rate, absolute body weights remained reduced for prolonged
      periods of time (200-300 days) in both male and female rats. Heme oxygenase
      activity was induced and cytochrome P-450 activities were reduced in both brain
      and hypothalamus following intracerebroventricular administration of CoPP. The
      proximate mechanism of action of this synthetic heme analogue is not known at
      present, but it appears to act in the central nervous system, probably in the
      vicinity of the hypothalamus, to reduce the body weight set point of treated
      animals.

PMID- 1750565
TI  - Elevations of plasma glucose do not support taste-to-postingestive consequence
      learning.
AB  - We examined whether elevations in plasma glucose are a sufficient postingestive
      consequence to support taste-to-postingestive consequence learning. Because real,
      but not sham, feeding supports taste-to-postingestive consequence learning, we
      recorded changes in plasma glucose during sham and real feeding. For the 1st 15
      min of the meal, both sham and real feeding produced similar elevations in plasma
      glucose. Thereafter, real feeding produced sustained elevations in plasma
      glucose, whereas sham feeding did not. However, mimicking the plasma glucose
      profile of real feeding in the sham feeding rat by infusing glucose intravenously
      did not produce taste-to-postingestive consequence learning. Using radiolabeled
      sucrose, we determined that the rise in plasma glucose during sham feeding
      results from absorption of nutrient. We conclude that elevations in plasma
      glucose in isolation are not a sufficient consequence to support taste-to
      postingestive consequence learning.

PMID- 1750566
TI  - Heart rate variability as a measure of autonomic function during weight change in
      humans.
AB  - Changes in autonomic function were studied during experimentally induced weight
      changes in seven subjects. A spectral analysis of heart rate variability (HRV)
      was used to evaluate autonomic activity during weight change. With a 10% increase
      in body weight above the usual or starting weight, there was a decline in
      parasympathetic power accompanied by a rise in mean heart rate. Heart rate
      declined during weight reduction, but the power of HRV did not change
      significantly. Because heart rate power at the frequency of respiratory rate can
      be affected by respiratory rate, three additional subjects were tested at a
      constant respiratory rate. Weight increases in this group also led to a decline
      in the power of HRV at a frequency attributable to the parasympathetic nervous
      system. Such a parasympathetic effect of weight increase may be one mechanism for
      the arrhythmias and other cardiac alterations that accompany obesity.

PMID- 1750567
TI  - Low salt mimics effects of dark pulses on circadian pacemaker in cultured chick
      pineal cells.
AB  - Chick pineal cells in static culture display a persistent photosensitive
      circadian rhythm of melatonin production and release. Pulses of white light or
      darkness, in otherwise constant red light, induce phase shifts in subsequent
      cycles whose magnitude and direction depend on the phase at which the pulse is
      given. Such "phase-dependent phase shifts" are mediated by effects on the
      underlying pacemaker. We reported previously that inhibiting the Na-K-ATPase with
      ouabain or salt solutions lacking potassium evokes phase shifts with the same
      phase dependence as those induced by pulses of darkness. One of the consequences
      of inhibiting the sodium pump is cell swelling. To test the relevance of this
      effect, we exposed chick pineal cells to pulses of medium containing reduced
      concentrations of NaCl, which should cause cell swelling. These hypotonic
      solutions induced phase shifts in the melatonin rhythm with the same phase
      dependence as those caused by pulses of ouabain or darkness. The size of the
      phase shifts varied with degree of dilution, and phase shifting was prevented by
      replacement of NaCl. In view of previous results showing that hypertonic media
      mimicked the phase-shifting effects of light, these results suggest that cell
      swelling may mediate the darklike effects of ouabain on the circadian pacemaker
      in chick pineal cells.

PMID- 1750568
TI  - Mechanisms involved in the rapid dissipation of plasma epinephrine response to
      bacterial endotoxin in conscious rats.
AB  - Conscious rats treated with bolus endotoxin (ET; 4.0 mg/kg) increased plasma
      epinephrine (Epi) 48-fold (from 134 +/- 5 to 6,545 +/- 1,607 pg/ml) at 30 min,
      but by 6 h this elevation was less than 9-fold above control (1,174 +/- 166
      pg/ml). In contrast, plasma norepinephrine (NE) elevation (6.5-fold above
      control) was maintained during the protocol. The present study was designed to
      test the hypothesis that the decreased Epi response following ET was due to 1)
      depletion of adrenal Epi content such that adrenomedullary stimulation would not
      release Epi, 2) decreased Epi release with direct stimulation, i.e.,
      desensitization of release, or 3) decreased afferent signals generated by ET
      itself. In these experiments an initial low ET dose (0.5 mg/kg) was followed 3 h
      later by a second dose of either the same (0.5 mg/kg) or greater (4.0 mg/kg)
      magnitude. Plasma Epi was elevated following the initial (low) dose but not
      following the same second (0.5 mg/kg) dose, whereas the second higher dose (4.0
      mg/kg) resulted in elevated plasma Epi. This response to high dose was 60% less
      than that observed with 4.0 mg/kg as an initial dose. Just before the second ET
      bolus, there was no depletion of adrenal Epi content (P greater than 0.05 saline
      vs. ET treated), and direct nerve stimulation demonstrated enhanced rather than
      attenuated Epi release from the adrenal medulla (P less than 0.05 saline vs. ET
      treated). These results suggest that the decline in Epi following the ET-induced
      elevation may be mediated by a decrease in the afferent signal that initiates Epi
      release.

PMID- 1750569
TI  - Development of passive permeability characteristics of rat placenta during the
      last third of gestation.
AB  - To investigate how the passive permeability of the rat placenta changes during
      the last third of gestation we measured the unidirectional maternofetal clearance
      (Kmf) of three polar nonelectrolytes. We found that Kmf (microliters.min-1.g
      placenta-1) for all three tracers increased between days 15 and 22 (term is 23
      days). The increase was less for the largest tracer, [14C]inulin (3.5-fold
      increase from 0.5 +/- 0.1 to 1.6 +/- 0.1 microliters.min-1.g placenta-1), than
      for the smaller tracers, [14C]mannitol (7-fold increase from 1.6 +/- 0.1 to 10.9
      +/- 0.4 microliters.min-1.g placenta-1) and 51Cr-labeled EDTA (9.5-fold increase
      from 0.8 +/- 0.04 to 7.6 +/- 0.7 microliters.min-1.g placenta-1). These data
      suggest that whilst the overall permeability of the rat placenta increases during
      this period of pregnancy, restriction to the diffusion of large (greater than or
      equal to 1.5 nm molecular radius) polar nonelectrolytes also increases.

PMID- 1750570
TI  - Compartmental analysis and glomerular filtration in chick embryos.
AB  - We have developed microtechniques that allow the determination of compartmental
      fluid distribution and glomerular filtration rate in chick embryos during three
      significant developmental periods: phase 1, the developmental period when the
      mesonephros alone is functioning; phase 2, periods of simultaneous
      meso/metanephric kidney function; and phase 3, the period during late development
      when the metanephros completely replaces the degenerated mesonephros. Water
      content of tissues is greater in younger embryos (89.4 +/- 0.2%, day 10) compared
      with older animals (78.3 +/- 0.5%, day 18). Although all major tissue components
      show an absolute increase in mass during this period, the embryo proper increases
      at five times the rate of the extraembryonic tissues. Glomerular filtration rate
      increases during development from 0.61 +/- 0.08 ml/h at day 10 to 2.31 +/- 0.11
      ml/h at day 18. Glomerular filtration rate scales to body mass with an allometric
      exponent identical to adult birds only if total tissue mass (embryo + membranes)
      is considered. Our data suggest that significant errors in allometry will be
      encountered when scaling measurements are made on embryonic or fetal amniotes
      without taking into consideration the extraembryonic tissues.

PMID- 1750571
TI  - Effect of desipramine on norepinephrine metabolism in humans: interaction with
      aging.
AB  - To determine whether differences in neuronal reuptake contribute to age-related
      changes of sympathetic nervous system activity, we compared norepinephrine (NE)
      release and metabolism during [3H]NE infusion and decay in six young (age 19-26
      yr) and seven older (age 61-73 yr) healthy nonobese subjects. Subjects were
      studied on a control day and on a separate day after desipramine (DMI; 125 mg
      orally), a neuronal reuptake blocker. Compartmental analysis of plasma NE
      specific activity was used to determine several NE kinetic parameters. Plasma NE
      levels and NE spillover rates were higher in the elderly. Although plasma NE was
      unaffected by DMI in both age groups, both the metabolic clearance rate of NE
      from plasma and the rate of NE spillover into plasma fell in young and older
      groups during DMI. Furthermore, DMI dramatically lowered the mass of NE in the
      extravascular compartment and the rate of NE entry into the extravascular
      compartment. Thus neuronal uptake blockade has major effects on NE release as
      well as NE metabolism in humans. However, age-related differences in NE kinetics
      cannot be explained by differences in neuronal uptake.

PMID- 1750572
TI  - Intracellular pH rises and astrocytes swell after portacaval anastomosis in rats.
AB  - The basis for astrocytic swelling after the early period after portacaval
      anastomosis (PCA) is poorly defined. In other eukaryotic cells intracellular pH
      (pHi) and volume are determined, in part, by the same general mechanisms, yet how
      astrocytic pHi varies with enlargement of these cells after PCA is unknown.
      Therefore, direct measurements of pHi in astrocytes were made and compared with
      pericapillary astrocytic area as determined from electron micrographs in rats 5-8
      days after PCA. Astrocytic area (n = 14 measurements for each group) was found to
      be significantly (P less than 0.0009) greater in PCA animals (n = 3) than in sham
      operated control animals. (n = 3). Double-barrel pH-sensitive microelectrodes
      were used to measure pHi in neocortical cells defined by electrophysiological
      criteria to be astrocytic. Astrocytes (n = 25) from PCA animals (n = 5) had a
      resting membrane potential of 72 +/- 5 mV (mean +/- SD) and an pHi of 7.11 +/-
      0.11 while comparable cells (n = 12) from sham-operated controls (n = 2) had a
      membrane potential of 81 +/- 6 mV and an pHi of 7.00 +/- 0.10. Astrocytes from
      PCA animals were significantly more depolarized (P less than 0.001) and alkaline
      (P less than 0.009), at a time when they were also significantly larger than
      those from sham-operated controls. Astrocytes are known to become more alkaline
      when they are activated by brief depolarizing stimuli. However, this is the first
      demonstration that such an interrelationship can also exist for steady-state
      conditions of these cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750573
TI  - Role of angiotensin in ameliorating the renal actions of norepinephrine.
AB  - To determine the importance of the arterial pressure effects of angiotensin II
      (ANG II) on renal function during acute renal adrenergic stimulation, we examined
      the effects of a 2-h intrarenal arterial infusion of norepinephrine (NE) at 0.1
      and 0.25 micrograms.kg-1.min-1 on renal function in five conscious dogs during 1)
      control conditions, 2) servo-control of renal arterial pressure (RAP) at control
      levels, and 3) chronic captopril administration. The low rate of NE infusion
      produced an approximately 20% decrease in glomerular filtration rate (GFR) and
      renal plasma flow (RPF) and an approximately 8-mmHg increase in RAP in
      association with an approximately 2.5-fold rise in plasma renin activity (PRA).
      The high rate of NE infusion produced greater increments in both PRA and RAP and
      an approximately 50% reduction in GFR and RPF. Neither servo-control of RAP nor
      captopril administration significantly affected the above renal responses to the
      low rate of NE infusion. In marked contrast, when increases in RAP (approximately
      20 mmHg) were prevented at the high rate of NE infusion by servo-control of RAP,
      both the PRA and renal responses were enhanced. Furthermore, when RAP was reduced
      (approximately 25 mmHg) as a result of chronically blocking the renin-angiotensin
      system with captopril, the renal responses to the high rate of NE infusion were
      exaggerated even further; in four of five dogs, total renal ischemia occurred in
      response to NE. These results indicate that ANG II indirectly ameliorates the
      renal actions of renal adrenergic stimulation by increasing RAP.

PMID- 1750574
TI  - Increase in hepatic blood flow during early sepsis is due to increased portal
      blood flow.
AB  - Although hepatic blood flow increases significantly during early sepsis [as
      produced by cecal ligation and puncture (CLP)], it is not known whether this is
      due to the increase in portal or hepatic arterial blood flows. To study this,
      rats were subjected to CLP, after which they and sham-operated rats received
      either 3 or 6 ml normal saline/100 g body wt subcutaneously (i.e., all rats
      received crystalloid therapy). Blood flow in various organs was determined by
      using a radioactive microsphere technique at 5 and 20 h after CLP or sham
      operation. Portal blood flow was calculated as the sum of blood flows to the
      spleen, pancreas, gastrointestinal tract, and mesentery. Total hepatic blood flow
      was the sum of portal blood flow and hepatic arterial blood flow. A significant
      increase in portal blood flow and in total hepatic blood flow was observed at 5 h
      after CLP (i.e., early sepsis), and this was not altered by doubling the volume
      of crystalloid resuscitation after the induction of sepsis. In contrast, hepatic
      arterial blood flow during early sepsis was found to be similar to control;
      however, it was significantly reduced in late sepsis (i.e., 20 h after CLP).
      Cardiac output was significantly higher than the control in early sepsis.
      However, even in late sepsis, cardiac output and total hepatic blood flow were
      not significantly different from controls. These results indicate that the
      increased total hepatic blood flow during early hyperdynamic sepsis is solely due
      to the increased portal blood flow.

PMID- 1750575
TI  - Inhibitory renorenal reflexes: a role for renal prostaglandins in activation of
      renal sensory receptors.
AB  - In anesthetized rats, activation of renal sensory receptors with a mechanical
      stimulus (increased ureteral pressure) and a chemical stimulus (renal pelvic
      perfusion with 0.9 M NaCl) results in an increase in ipsilateral afferent renal
      nerve activity and a reflex increase in contralateral urine flow rate and urinary
      sodium excretion, i.e., a contralateral inhibitory renorenal reflex. Because both
      interventions are known to increase renal prostaglandin (PG) synthesis, we
      examined whether renal PGs were involved in the renorenal reflex response to
      renal sensory receptor stimulation. In the first part, mechanical and chemical
      activation of renal sensory receptors was performed in the absence and presence
      of renal pelvic perfusion with indomethacin or meclofenamate (0.2
      micrograms/min). Indomethacin inhibited the ipsilateral afferent renal nerve
      activity response to increased ureteral pressure (7 +/- 2 vs. 38 +/- 10%, P less
      than 0.01) and renal pelvic perfusion with 0.9 M NaCl (3 +/- 3 vs. 28 +/- 5%, P
      less than 0.01) and the contralateral diuretic and natriuretic responses in the
      absence of any renal hemodynamic changes. Similar effects were produced by
      meclofenamate. In the second part, mechanical and chemical activation of renal
      sensory receptors was performed in the presence of renal pelvic perfusion with
      vehicle, indomethacin, and indomethacin plus PGE2 (20 micrograms/min). Addition
      of PGE2 to the renal pelvic perfusate in indomethacin-treated kidneys restored
      the responses to mechanical and chemical activation of renal sensory receptors to
      levels not different from their pre-indomethacin control values. We conclude that
      PGs in the renal pelvic area are involved in inhibitory renorenal reflex
      responses to mechanical and chemical activation of renal sensory receptors.

PMID- 1750576
TI  - Inhibition of gluconeogenesis by extracellular ATP in isolated rat hepatocytes.
AB  - The aim of this study was to determine the effect of externally added ATP on
      gluconeogenesis by isolated hepatocytes from starved rats. High concentrations of
      extracellular ATP inhibited gluconeogenesis from lactate and pyruvate but not
      from glycerol or fructose. This inhibition was associated with an increase in
      intracellular adenosine contents. ADP, AMP, or adenosine but not guanosine
      5'triphosphate, inosine 5' triphosphate, or adenine also inhibited
      gluconeogenesis. alpha, beta-Methylene-ATP, a nonmetabolizable structural
      analogue of ATP, did not affect the rate of gluconeogenesis. Intracellular ATP
      levels were increased by externally added ATP or adenosine, but ATP-to-ADP ratios
      in the cytosolic and mitochondrial compartments were diminished. Malate and
      phosphoenolpyruvate contents were decreased by extracellular ATP or adenosine.
      Our results show that inhibition of gluconeogenesis by high levels of
      extracellular ATP may be mediated by adenosine derived from ATP catabolism at the
      plasma membrane.

PMID- 1750577
TI  - Hemodynamics and organ blood flow in fetal sheep subjected to chronic anemia.
AB  - To investigate cardiovascular adaptation to chronic anemia we studied eight ovine
      fetuses made anemic by serial isovolemic hemorrhage and seven nonanemic controls.
      After 1 wk carotid arterial oxygen content was reduced to 1.6 +/- 0.2 ml/dl and
      hematocrit to 13.3 +/- 1.6% in anemic fetuses compared with 6.9 +/- 1.2 ml/dl and
      32.4 +/- 3.9% in controls. Cardiac output was higher in the anemic group (753 +/-
      102 vs. 490 +/- 66 ml.min-1.kg fetus-1) as stroke volume and heart rate both
      increased. Blood flow to the carcass, skin, kidneys, intestines, brain, and heart
      was increased. Vascular resistance fell in all tissues except the placenta.
      Central venous pressure, arterial pH, plasma total protein, and blood volume were
      not different although extravascular fluid accumulated in six of the anemic
      fetuses. The estimated capillary hydrostatic pressure was greater in anemic (7.6
      +/- 1.8 mmHg) than control fetuses (5.0 +/- 1.5 mmHg) and the ratio of
      precapillary to postcapillary resistance was less. We conclude that reduction in
      the ratio of precapillary to postcapillary resistance in chronic fetal anemia
      increases blood flow, oxygen delivery, and capillary hydrostatic pressure.

PMID- 1750578
TI  - Glucose loading prevents freezing injury in rapidly cooled wood frogs.
AB  - The wood frog (Rana sylvatica) is the most commonly studied of ten species of
      freeze-tolerant vertebrates. Under natural (i.e., slow) rates of cooling,
      freezing initiates the production of the cryoprotectant glucose, which is
      mobilized from the liver and distributed to tissues throughout the body. Rapid
      cooling during freezing is injurious to wood frogs, probably because
      cryoprotectant production and mobilization are inhibited. To test this
      hypothesis, we investigated whether rapid-cooling injury is reduced if exogenous
      glucose is experimentally introduced to tissues before freezing. Glucose-loaded
      and control (saline-injected) wood frogs were rapidly cooled during freezing to 
      2.5 degrees C and subsequently assayed for injury at both cellular (erythrocyte)
      and neuromuscular (behavioral reflex) levels. Rapid cooling produced substantial
      hemolysis in control frogs, but erythrocyte injury was significantly reduced in
      glucose-loaded frogs. Similarly neuromuscular injury was significantly higher in
      control frogs than in glucose-loaded frogs. These findings suggest that rapid
      cooling injury results from an inadequate production and distribution of
      endogenous glucose during freezing. Furthermore, the inverse relationship between
      the degree of freezing injury and the quantity of exogenous glucose present
      strongly implicates glucose as a cryoprotectant in R. sylvatica.

PMID- 1750579
TI  - Dietary fat, hypothalamic glutamate decarboxylase, and food intake of
      streptozotocin-diabetic rats.
AB  - The association among changes in glucose status, glutamate decarboxylase (GAD)
      activity, and food intake was evaluated in several hypothalamic areas of
      streptozotocin-diabetic rats fed a low- (12% of calories as fat) or high-fat diet
      (59% of calories as fat). Control rats consumed approximately 90 kcal/24 h of
      either diet, whereas diabetic rats consumed approximately 150 kcal/24 h of the
      low-fat diet and approximately 100 kcal/24 h of the high-fat diet. At the end of
      the study, diabetic rats fed the high-fat diet weighed more and had higher
      retroperitoneal fat depot weights (P less than 0.05) than diabetic rats fed the
      low-fat diet. In diabetic rats, GAD activity was 15-20% higher in the
      ventromedial nucleus (P less than 0.01) but similar to controls in the lateral
      hypothalamus, paraventricular nucleus, and area postrema. Diet did not affect GAD
      activity in the brain areas studied. The increase in ventromedial nucleus GAD
      activity was not associated with the level of food intake and was the likely
      result of altered glucose homeostasis in diabetic rats.

PMID- 1750580
TI  - alpha-Chloralose alters autonomic reflex function of the lower urinary tract.
AB  - The effects of alpha-chloralose on the micturition reflex were evaluated using an
      efficiently voiding decerebrate cat model. At laparotomy cannulas were introduced
      into the urethra and/or bladder for measurement of urethral perfusion pressure
      and/or bladder pressure during bladder filling and voiding. After establishment
      of efficient voiding in the anesthetic-free decerebrate cat, chloralose, 50 mg/kg
      iv, was administered. Parameters assessed before and after anesthetic included
      bladder pressure at peak of contraction (voiding pressure), intravesical pressure
      at onset of bladder contraction (threshold pressure), contraction amplitude,
      duration of bladder contraction, bladder volume at onset of bladder contraction
      (volume threshold), and residual bladder volume after voiding (postvoid
      residual). In addition to these parameters, preparations with intact bladder
      urethra and with divided bladder-urethra were used to assess effects of
      chloralose on voiding efficiency and coordination between bladder and urethra,
      respectively. Chloralose significantly reduced voiding pressure, contraction
      amplitude, and voiding efficiency. Neither vehicle for the chloralose nor
      sympathetic denervation of the lower urinary tract affected these reductions.
      Chloralose had no effect on direct contraction of the bladder and urethra
      produced by intra-arterial acetylcholine (25-100 micrograms). Chloralose
      converted the synergic bladder and urethral responses during voiding to
      dyssynergic responses. Neuromuscular blockade with gallamine, 10 mg/kg iv,
      improved voiding efficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750581
TI  - Dietary modulation of intestinal nutrient transport in the teleost fish tilapia.
AB  - Tilapia (Oreochromis mossambicus) were fed a diet with either 60% carbohydrate
      (70% grain-4% fish meal) or 17% carbohydrate (11% grain-65% fish meal) for
      greater than or equal to 4 wk. Intestinal uptake of radiolabeled acetate, D
      glucose, and L-proline was measured in brush-border membrane vesicles. As
      expected, fish fed high carbohydrate had significantly higher D-glucose uptake
      than those fed low carbohydrate [maximal uptake rate (Vmax), respectively, 84.2
      +/- 18.2 vs. 37.4 +/- 10.9 pmol.mg protein-1.s-1; n = 4 batches of vesicles in
      each case; t test, P less than 0.025]. The change in glucose transport was
      specific, because in the same batches of vesicles there was no significant diet
      effect on carrier-mediated uptake of L-proline or acetate. Also as expected,
      dietary modulation of carrier-mediated transport was effected primarily by
      alterations in Vmax and not apparent Michaelis constant (Km); Km was not
      significantly altered by diet for either D-glucose (high carbohydrate vs. low
      carbohydrate, respectively, 0.34 +/- 0.17 vs. 0.12 +/- 0.03 mM; P greater than
      0.2), L-proline (respectively, 0.10 +/- 0.03 vs. mM 0.13 +/- 0.05), or acetate
      (respectively, 4.8 +/- 1.4 vs. mM 6.5 +/- 2.2).

PMID- 1750582
TI  - Neural and humoral effects on hindlimb vascular resistance of ducks during forced
      submergence.
AB  - Circulating catecholamines increase by three orders of magnitude in forced
      submerged ducks; their role in promoting vascular resistance was studied using
      vascular perfusion of hindlimbs. Perfusion pressure and blood flow were recorded
      simultaneously in hindlimbs of ducks during forced submergence. One leg was
      perfused with blood mixtures devoid of catecholamines (test leg) and compared
      with the other autoperfused leg. Perfusion pressures in test legs perfused with
      hyperoxic and hypocapnic blood or with hypoxic and hypocapnic blood were not
      significantly different from those in the matching autoperfused legs. However,
      when test legs were perfused with hypercapnic blood, regardless of whether blood
      was hypoxic or hyperoxic, perfusion pressures were significantly lower than in
      autoperfused legs. Adding catecholamines to test legs perfused with hypoxic and
      hypercapnic blood, after 3 min submergence, significantly enhanced
      vasoconstriction. Hypercapnia acts directly on the peripheral vascular beds and
      impairs the neurally mediated vasoconstriction during submergence, while
      circulating catecholamines restore peripheral vasoconstriction. Thus circulating
      catecholamines are needed to compensate for the depressant action of hypercapnia
      on neurally mediated vasoconstriction.

PMID- 1750583
TI  - Isoflurane field anaesthesia at extreme temperatures.

PMID- 1750584
TI  - The potential hazards of using iodine as an antiseptic solution.

PMID- 1750585
TI  - Supplementary oxygen--potential for disaster.

PMID- 1750586
TI  - Dose-response relationship and time course of action of Org 9426. A new muscle
      relaxant of intermediate duration evaluated under various anaesthetic techniques.
AB  - The dose-response relationship of Org 9426, its time course of action and the
      reversibility of the residual block by neostigmine have been investigated in 100
      patients undergoing various anaesthetic techniques. The dose-response was
      measured immediately following induction of anaesthesia. Doses of Org 9426,
      required for 50% and 90% depression of the twitch height, were 202 and 328
      micrograms.kg-1, respectively. The clinical duration of the maintenance doses,
      150 micrograms.kg-1, ranged from 9.5 to 13.4 min and from 12.8 to 18.9 min for
      the first and fifth maintenance doses, respectively. Spontaneous recovery indices
      (25%-75%) were between 9.5 and 16.7 min; neostigmine methylsulphate administered
      at 25% recovery of the twitch height promptly reversed the residual block. No
      side effects were observed. The extent of the influence of the anaesthetic on the
      time course of Org 9426 appears to be fractional considering the variation of the
      time course within the separate groups.

PMID- 1750587
TI  - Effects of epidural diamorphine on the somatosensory evoked potential to
      posterior tibial nerve stimulation.
AB  - We have studied the effects of the epidural administration of diamorphine 0.1
      mg/kg at the L3-4 interspace on somatosensory evoked potentials in the cervical
      epidural space before corrective surgery for idiopathic adolescent scoliosis. A
      further eight patients in whom anaesthesia was maintained with a propofol
      infusion acted as a control group. Epidural diamorphine had no effect on the
      latency or amplitude of the evoked potentials. We conclude that epidural
      diamorphine is a suitable technique to use in scoliosis surgery because of its
      lack of effect on neurophysiological variables, although the potential
      respiratory problems need investigation.

PMID- 1750588
TI  - Analgesic efficacy of controlled-release dihydrocodeine. A comparison of 60, 90
      and 120 mg tablets in cold-induced pain.
AB  - A prospective, double-blind, single-dose placebo-controlled four-part crossover
      study of 12 healthy volunteers was carried out to compare the analgesic efficacy
      of controlled-release dihydrocodeine tablets 60, 90 and 120 mg (DHC Continus
      tablets, Napp Laboratories) in cold-induced pain. Subjects received each of the
      four treatments in a random order using a latin square design. On each of the
      four study days, the volunteers performed cold pressor tests, before dose and
      again at 4, 8 and 12 hours after dose. Subjects rated their pain continuously
      over a 120-second period using a visual analogue scale. At 4 hours there was a
      significant reduction in pain in subjects who received 120 mg or 90 mg tablets
      compared with placebo, and in subjects who received 120 mg tablets compared with
      those who received 60 mg tablets. At 8 hours, 120 mg and 90 mg dihydrocodeine
      were still better than placebo. There was no significant difference in side
      effects between treatments.

PMID- 1750589
TI  - Pain following thoracotomy. A randomised, double-blind comparison of lumbar
      versus thoracic epidural fentanyl.
AB  - Fifty-eight patients scheduled for elective thoracotomy were randomly allocated
      to receive fentanyl by either the thoracic or the lumbar epidural route for
      postoperative analgesia. The infusion rate was adjusted to optimise analgesia.
      Dose adjustment, pain assessment and the incidence of side effects were monitored
      by a blinded observer at set times over the 24 hour study period. Similar pain
      scores were obtained in both groups at all assessment times. In addition, there
      was no significant difference in dose requirements or incidence of side effects
      between the two groups. There appears little justification for the use of the
      generally less familiar, and potentially more dangerous, thoracic approach when
      fentanyl alone is infused into the epidural space following thoracotomy.

PMID- 1750590
TI  - Intra-ocular pressure changes using the laryngeal mask airway and tracheal tube.
AB  - Intra-ocular pressure was measured before and throughout airway establishment
      with either the laryngeal mask airway or tracheal tube. Similar measurements were
      made on removal of either airway and the amount of coughing noted in the first
      minute after removal. There was a significantly smaller increase in intra-ocular
      pressure (p less than 0.001) using the laryngeal mask airway, both on placement
      and removal, than with the tracheal tube. Postoperative coughing was
      significantly reduced using the laryngeal mask airway (p less than 0.001). There
      was a significantly greater rise in heart rate using the tracheal tube (p less
      than 0.01) probably related to an increased cardiovascular response. The
      laryngeal mask airway is recommended as an alternative to tracheal intubation in
      routine and emergency intra-ocular surgery.

PMID- 1750591
TI  - Protamine--the need to determine the dose. Comparison of a simple protamine
      titration method with an empirical dose regimen for reversal of heparinisation
      following cardiopulmonary bypass.
AB  - A simple method of protamine titration using the Hemochron system was compared
      with an empirical dose protocol for reversal of heparinisation following
      cardiopulmonary bypass in 40 patients undergoing elective myocardial
      revascularisation. Protamine titration revealed a wide range for protamine
      requirement and resulted in a significant reduction in protamine dose compared
      with the empirical dose protocol (p less than 0.01). Heparin reversal was
      assessed as adequate in all patients. The titration technique was easy and
      straightforward to use in the operating theatre.

PMID- 1750592
TI  - Acute tolerance from benzodiazepine night sedation.
AB  - The hypothesis that benzodiazepine night sedation causes acute tolerance to
      benzodiazepine sedation given the following morning was examined in six
      volunteers in a double blind, randomised, crossover study. Before each of three
      study days, subjects received midazolam 15 mg or flunitrazepam 2 mg or placebo as
      oral night sedation. They were then given intravenous midazolam 5 mg the
      following morning and the resulting sedative effects examined, using an observers
      sedation scale and a psychomotor test battery (critical flicker fusion frequency,
      digit-symbol substitution, reflex time, tapping test and a visual analogue
      sedation scale). Although a consistent pattern emerged with the greatest degree
      of sedation following the placebo night sedation and the least degree of sedation
      following the midazolam, with flunitrazepam intermediate, no statistically
      significant differences were present between the three treatment groups. The
      results indicate that single use of benzodiazepine night sedation is not an
      important influence on benzodiazepine requirements for intravenous sedation.

PMID- 1750593
TI  - Hysteria. A cause of failure to recover after anaesthesia.
AB  - Hysteria as a cause of failure to recover consciousness following general
      anaesthesia is a rare event. This case report describes such an instance in a
      young, healthy 22-year-old female suffering severe dental phobia who was
      undergoing dental conservation. The literature is reviewed and a summary of the
      possible physiological mechanisms involved is given.

PMID- 1750594
TI  - Double-blind testing fails to confirm analgesic response to extradural morphine.
AB  - We report two patients with chronic non-malignant pain in whom morphine given
      intravenously via a patient-controlled analgesia system produced partial pain
      relief but was accompanied by severe side effects. Open administration of
      epidural morphine resulted in complete pain relief with minimal side effects and
      the patients were considered as candidates for implanted opioid delivery systems.
      However, when the epidural morphine was given in a double-blind and placebo
      controlled manner, morphine did not produce greater analgesia than placebo and no
      dose-response relationship was seen. These cases show that careful investigation
      is necessary before proceeding to implanted systems and that changing the route
      did not improve the analgesia:side effect balance for morphine in these patients.

PMID- 1750595
TI  - Reversible renal failure following opioid administration.
AB  - A patient who received intravenous papaveretum during and after operation
      developed anuria and biochemical evidence of impaired renal function in the first
      6 hours after surgery. Administration of naloxone 0.4 mg was associated with a
      sustained improvement in urine output. Mean arterial pressure did not change
      significantly. The impairment of renal function may have been related to high
      plasma concentrations of codeine, one of the constituents of papaveretum.

PMID- 1750596
TI  - A case of malignant hyperthermia?
AB  - An acute episode of a malignant hyperthermia-like syndrome is described which
      occurred after suxamethonium and isoflurane anaesthesia in a 41-year-old healthy
      male patient undergoing a minor elective hand operation. Dantrolene therapy
      rapidly reversed the life-threatening signs. Laboratory results appeared to
      confirm the suspicion of malignant hyperthermia. However, the in vitro
      contracture test, which was carried out according to the standards of the
      European Malignant Hyperthermia Group, was equivocal.

PMID- 1750597
TI  - Extradural analgesia and previous spinal surgery. A radiological appraisal.
AB  - Extradural block was performed in a nulliparous patient with previous spinal
      surgery. Epidurographic evidence explains the rapid onset and extensive sensory
      block obtained.

PMID- 1750598
TI  - A low-flow to-and-fro system. Laboratory study of mixing of anaesthetic and
      driving gases during mechanical ventilation.
AB  - The insertion of a long deadspace tube between an anaesthetic breathing system
      and a ventilator produces only imperfect separation of the breathing system gas
      from the driving gas. This laboratory study has investigated different connecting
      tubes to establish the maximum tidal volume possible before ventilator gas
      contaminates the gas in a low-flow to-and-fro system (fresh gas flow 1
      litre/minute). A larger volume tube enables the use of larger tidal volumes, and
      plastic corrugated tubes are slightly better than black rubber corrugated tubes
      in this respect. The maximum tidal volume possible without contamination
      decreases as ventilatory rate increases, but the maximum minute volume is
      increased. A 22 mm plastic corrugated tube of internal volume 1.5 litres should
      be adequate for clinical use with the to-and-fro system described in this study
      at a fresh gas flow of 1 litre/minute.

PMID- 1750599
TI  - Evaluation of a small soda lime canister in a to-and-fro system.
AB  - The main disadvantages of the to-and-fro system (the bulky canister and the
      progressive increase in apparatus deadspace) may be overcome by the use of a
      smaller canister. In this laboratory study, we have evaluated a 160 g canister in
      a low-flow to-and-fro system (fresh gas flow 1 litre/minute). Two carbon dioxide
      productions of 150 and 200 ml/minute were simulated. The mean times to
      exhaustion, defined here as a 0.5 kPa rise in end-tidal PCO2, were 112 and 79
      minutes in the 150 and 200 ml/minute carbon dioxide groups respectively.
      Ventilation to normacapnia or hypocapnia did not affect the times to exhaustion.
      The soda lime absorbed 16 litres of carbon dioxide before exhaustion, and this
      was not affected by minute volume or carbon dioxide production. A small soda lime
      canister is suitable for carbon dioxide absorption in a low-flow to-and-fro
      system for ventilated adults.

PMID- 1750600
TI  - Environmental contamination during tracheal suction. A comparison of disposable
      conventional catheters with a multiple-use closed system device.
AB  - The extent of airborne environmental bacterial contamination which occurs
      following tracheal suction has been investigated in patients undergoing
      intermittent positive pressure ventilation in the intensive therapy unit. Two
      methods of performing suction, one using a conventional open technique and one
      using a closed system (Stericath), have been compared. Significantly lower levels
      of environmental contamination were observed when the closed system was used.

PMID- 1750601
TI  - Mortality associated with anaesthesia. A case review study.
AB  - The review is based on an analysis of anonymous case record material at the
      Medical Protection Society's London Office for the 5-year period 1982-1986, in
      which death was associated with anaesthetic procedures. A total of 25 cases were
      analysed. The principal events which resulted in death were failed intubation,
      drug-related problems and problems with equipment. The principal contributory
      factors were inadequate supervision, inadequate pre-operative assessment and
      failure of communication. The present review suggests that supervision and
      training of junior staff, decision-making by senior staff and patterns of
      communication both within and between specialties are areas which should be
      selected for further research.

PMID- 1750602
TI  - Acid aspiration prophylaxis in morbidly obese patients: famotidine vs.
      ranitidine.
AB  - Famotidine and ranitidine were compared as agents for the prevention of acid
      aspiration syndrome in 32 morbidly obese patients undergoing vertical banded
      gastroplasty. Single-dose oral famotidine or double-dose oral ranitidine were
      administered on a random basis before surgery. Gastric contents were aspirated
      through a gastric tube, manually aided by the surgeon with the abdomen open. Mean
      (SD) gastric volumes were 13.8 ml (6.7) and 12.1 ml (13.0) for the famotidine and
      ranitidine groups, respectively. Mean (SD) gastric pH values were 6.2 (1.5) and
      6.8 (1.5), respectively. There were no significant differences between the groups
      and no patient was considered 'at risk' (pH less than 2.5 and gastric volume
      greater than 25 ml). We conclude that single-dose oral famotidine and double-dose
      oral ranitidine are equally effective for preventing acid aspiration syndrome in
      morbidly obese patients.

PMID- 1750603
TI  - Diamorphine analgesia after caesarean section. Comparison of intramuscular and
      epidural administration of four dose regimens.
AB  - In a randomised double-blind study, the efficacy, duration of action and side
      effects of five diamorphine analgesia regimens following Caesarean section are
      described. The time to next analgesia was shorter in the 5 mg intramuscular group
      (3.53 hours) than in any of the four epidural groups: 5 mg (5.7 hours, p =
      0.007), 2.5 mg (4.76 hours, p = 0.103), 5 mg with adrenaline 1/200,000 (7.2
      hours, p = 0.001) and 2.5 mg with adrenaline 1/200,000 (6.05 hours, p = 0.007).
      Multiple regression analysis showed that the addition of adrenaline significantly
      increased the duration of action of epidural diamorphine (p less than 0.05). The
      5 mg dose with adrenaline showed no advantage when compared with 2.5 mg with
      adrenaline (p = 0.16). No serious side effects were reported in any group.

PMID- 1750604
TI  - Inhaled nebulised fentanyl for postoperative analgesia.
AB  - The effects of three concentrations of inhaled nebulised fentanyl citrate
      solution given for postoperative pain relief were studied. Each of 30 patients
      inhaled one dose of 3 ml of solution nebulised over 9 min. A combined analysis of
      pain relief, time to further analgesia and effect on respiratory frequency showed
      the highest concentration (318 micrograms/ml fentanyl base) to be more effective
      (p less than 0.01) than the two lower concentrations (159 micrograms/ml and 64
      micrograms/ml) which were indistinguishable from each other. There were no major
      side effects. This study provides evidence for the efficacy and safety of inhaled
      fentanyl for postoperative analgesia. Estimation of the delivered doses did not
      support the hypothesis that fentanyl is more effective by this route compared
      with other parenteral routes. Further studies are required to improve the method
      of delivery and investigate the pharmacodynamic features of this technique.

PMID- 1750605
TI  - Parents in the anaesthetic room. A questionnaire survey of parents' reactions.
AB  - One hundred and forty-one parents were asked to complete a questionnaire about
      their reactions after accompanying their child during induction of anaesthesia.
      Of 139 respondents, 99% believed that their presence was of benefit to their
      child, and 95% believed that they helped the anaesthetist. The degree of anxiety
      experienced by the parent did not significantly affect this view, nor was the
      degree of anxiety affected by the method of induction chosen by the anaesthetist.

PMID- 1750606
TI  - Intubation through the laryngeal mask.

PMID- 1750607
TI  - Cricoid pressure and the laryngeal mask airway.

PMID- 1750608
TI  - Facilitation of the insertion of the laryngeal mask.

PMID- 1750609
TI  - Use of the laryngeal mask in a patient with an unstable fracture of the cervical
      spine.

PMID- 1750610
TI  - Cardiovascular effects of epidural local anaesthetics.

PMID- 1750611
TI  - Cost of intensive care.

PMID- 1750612
TI  - Pulse oximetry in pulseless patients.

PMID- 1750613
TI  - A false compatibility.

PMID- 1750614
TI  - Glycopyrronium and reflex bradycardia on elevation of zygoma.

PMID- 1750615
TI  - Pre-operative removal of dentures.

PMID- 1750616
TI  - Parents do not always want to be present at induction of anaesthesia of their
      children.

PMID- 1750617
TI  - Chickenpox pneumonia: NAB before IPPV?

PMID- 1750618
TI  - Higher pressure ventilation and the Bain coaxial breathing system.

PMID- 1750619
TI  - Penlon Nuffield Anaesthesia Ventilator Series 200. The case for vigilance?

PMID- 1750620
TI  - Atrial fibrillation after electroconvulsive therapy.

PMID- 1750621
TI  - Temperature and drug potency.

PMID- 1750622
TI  - Block of epidural needle by blood clots.

PMID- 1750623
TI  - Anaesthesia for laparoscopic cholecystectomy.

PMID- 1750624
TI  - Dangerous repairs.

PMID- 1750625
TI  - Sensitivity to papaveretum in Gilbert's disease.

PMID- 1750626
TI  - Wound infiltration and caesarean section.

PMID- 1750627
TI  - It would have been the anaesthetist's fault.

PMID- 1750628
TI  - Kuhn's endotracheal tube.

PMID- 1750629
TI  - Carbon monoxide poisoning.
AB  - Carbon monoxide is a common domestic and industrial poison which may be lethal.
      Survivors can develop permanent neuropsychiatric disability. The mechanisms of
      toxicity are poorly understood and the traditional criteria used to determine the
      severity of the poisoning have low predictability. Oxygen is the recommended
      antidote to carbon monoxide, but it appears that oxygen under hyperbaric
      conditions repeated either daily or as indicated by the patient's condition may
      be required to provide an effective dose. A reliable marker of the severity of
      carbon monoxide poisoning is urgently needed so that trials of alternative
      regimens can proceed.

PMID- 1750630
TI  - Granulocyte transfusions--a review for the intensive care physician.
AB  - In order to achieve the maximum therapeutic benefit in the treatment of
      malignancies, doses of chemotherapeutic agents are pushed to the point of severe
      marrow toxicity. This aggressive therapy can lead to iatrogenic complications
      including haemorrhage and sepsis due to the depletion of platelets and
      granulocytes. Prior to the advent of platelet transfusions, haemorrhage was the
      leading cause of death in these patients. Advances in blood banking and the
      availability of platelet transfusions have markedly decreased the incidence of
      fatal haemorrhage. As a result, infection has become the leading cause of death
      in patients with marrow failure. Although the risk of infection in patients with
      neutropenia has been well documented, the role of granulocyte transfusions in the
      treatment and prevention of these infections remains controversial. This paper
      will attempt to review the currently available literature regarding granulocyte
      procurement techniques and the efficacy of granulocyte transfusions.

PMID- 1750631
TI  - Gastric emptying in the postpartum period.
AB  - We measured gastric emptying, using the technique of paracetamol absorption, in
      eight women on their first and third postpartum day. Gastric emptying was rapid
      and there was no difference between the first and third day in the time to peak
      plasma concentration of paracetamol. Six women returned after six weeks for a
      further study. Gastric emptying was still rapid but the metabolism of paracetamol
      appeared to be slower than that found during the immediate postpartum period.
      These findings suggest that fluid fasting guidelines in patients more than one
      day postpartum need not be different from those in non-pregnant patients.

PMID- 1750632
TI  - Single versus double occlusive dressing technique to minimize infusion
      thrombophlebitis: Vialon and Teflon cannulae reassessed.
AB  - Infusion thrombophlebitis is the commonest complication of intravenous
      cannulation. This study was undertaken to prospectively evaluate a double
      occlusive dressing technique and a new cannula, bismuth oxide-Teflon (Critikon
      Inc., Aust.), comparing it to Vialon (Deseret Medical Inc., Utah, USA). The study
      group of two hundred patients had a 16 gauge intravenous cannula inserted in
      theatre using a standard technique. The incidence of thrombophlebitis was
      determined on a daily basis. Cannula tips were sent for culture on removal.
      Vialon was found to be superior to Teflon after day 1. Although a double
      occlusive dressing technique increased the duration of cannulation (50.9 vs. 41.9
      hours, P less than 0.05), there was no difference in the incidence of
      thrombophlebitis. Neither cannula material nor dressing technique had an
      influence on the results of cannula tip culture (6% incidence). There was no
      evidence of bacteraemia in any case.

PMID- 1750633
TI  - The efficacy of antivenom in prevention of cardiovascular depression and
      coagulopathy induced by brown snake (Pseudonaja) species venom.
AB  - The efficacy of antivenom in prevention of cardiovascular depression and
      coagulopathy induced by Brown Snake species (Pseudonaja textilis, Pseudonaja
      affinis) was investigated in anaesthetised mechanically ventilated dogs. Venom
      and antivenom in variable amounts were incubated together at 37 degrees C for 30
      minutes prior to intravenous injection. The dose of antivenom required to prevent
      severe cardiovascular depression and coagulopathy induced by Pseudonaja textilis
      venom was 25 times the current recommended dose for clinical use. A tenfold dose
      of antivenom was required to neutralise similar effects induced by Pseudonaja
      affinis venom. Large amounts of antivenom may be required in clinical use if
      coagulopathy or cardiovascular depression are present after envenomation by
      species of the Brown Snake genus.

PMID- 1750634
TI  - Diclofenac in combination with opiate infusion after joint replacement surgery.
AB  - The effect of intramuscular diclofenac or placebo on analgesia obtained and on
      opiate and antiemetic requirements was observed in a randomised double-blind
      study of sixty patients receiving continuous intravenous papaveretum. Those
      patients receiving diclofenac required less papaveretum (P = 0.001) than those
      receiving placebo. They also had lower visual analogue pain scores (VAS) at four
      hours (P less than 0.05) and decreased requirement for antiemetics (P less than
      0.02). No gastrointestinal complications were observed in either group and blood
      loss did not differ significantly between the two.

PMID- 1750635
TI  - Interpleural bupivacaine infusion compared with intravenous pethidine infusion
      after cholecystectomy.
AB  - Twenty-six cholecystectomy patients received either an interpleural infusion of
      bupivacaine (Group B, n = 12) or an intravenous infusion of pethidine (Group P, n
      = 14) for management of postoperative pain over a three-day period. Patients in
      Group P experienced a significantly (P less than 0.05) greater incidence of total
      side-effects (146) than patients in Group B (66). Pain scores (VAS) and responses
      to a pain questionnaire were similar for both groups; however, within Group B
      improvement in mean VAS scores at rest with time were more sustained. Similar
      reductions in FEV1 and FVC from preoperative values occurred for both groups,
      while for Group P there were significant (P less than 0.05) changes in arterial
      blood gases (increase in PCO2, decrease in PO2) over two days postoperatively.
      Patients in Group P recorded longer times to passing flatus and unaided
      mobilisation (P less than 0.05), and required a significantly greater number of
      additional medications (anti-emetics and analgesics) over the postoperative
      period (41 vs 29, P less than 0.05).

PMID- 1750636
TI  - Use of the cell saver during elective abdominal aortic aneurysm surgery-
      influence on transfusion with bank blood. A retrospective survey.
AB  - One hundred and two patients undergoing elective abdominal aortic aneurysm repair
      and admitted to ICU at RPAH in 1989/90 were studied. In forty patients a cell
      saver was used during the operative procedure (Group CS) while in the remaining
      sixty-two patients intraoperative blood loss was drained and discarded
      conventionally (Group NCS). Preoperative ASA grade and postoperative APACHE score
      were similar in these two groups. The amount of bank blood transfused
      intraoperatively was less in Group CS than in Group NCS (0.6 +/- 0.2 vs 3.3 +/-
      0.3 units) (mean +/- SEM) (P less than 0.0001). The total amount of bank blood
      transfused during hospital admission was also less in Group CS (1.5 +/- 0.4 vs
      4.8 +/- 0.4 units, P less than 0.0001). Of Group CS, 22 patients (55%) received
      no bank blood compared to two patients (3%) in Group NCS. There was no difference
      between the groups with respect to postoperative haemoglobin and creatinine
      levels. ICU stay was similar in both groups. We conclude that use of the cell
      saver reduces perioperative bank blood transfusion in elective abdominal aortic
      surgery.

PMID- 1750637
TI  - Caudal blockade for postoperative analgesia: a useful adjunct to intramuscular
      opiates following emergency lower leg orthopaedic surgery.
AB  - The efficacy of a single caudal epidural injection of bupivacaine 20 ml 0.5%
      following emergency orthopaedic surgery to the lower leg and ankle was
      investigated. Forty adult patients were studied, randomised to either the caudal
      or control group. The mean 24 hour postoperative papaveretum consumption was
      significantly reduced in the caudal group. Analogue pain scores as assessed in a
      double-blind manner were also significantly reduced in this group. The duration
      of analgesia after caudal blockade was approximately eight hours as estimated by
      the average time to the first dose of papaveretum. Our study demonstrates that
      caudal blockade represents an effective adjunct to intramuscular opiates
      following this type of surgery.

PMID- 1750638
TI  - Variation in the blood concentration/analgesic response relationship during
      patient-controlled analgesia with alfentanil.
AB  - The effect of supplementing postoperative patient-controlled analgesia (PCA) with
      a mandatory fixed-rate infusion was studied using alfentanil. Patients were
      assigned by lottery to receive alfentanil PCA with a bolus of 200 or 300 mcg or
      alfentanil PCA with a bolus of 100 or 200 mcg plus an infusion of 900 mcg/hr,
      such that ten patients received each treatment. Seven patients receiving PCA
      only, compared to two in the groups receiving infusion, were withdrawn due to
      inadequate pain relief (0.1 greater than P greater than 0.05). One patient
      receiving PCA only was withdrawn because of a low respiratory rate, whereas three
      patients receiving PCA plus infusion developed respiratory depression. Patients
      prescribed PCA plus infusion received significantly more alfentanil but did not
      describe less pain than patients prescribed PCA only. The blood alfentanil
      concentration immediately prior to demands was significantly higher in the PCA
      plus infusion groups. These results suggest that during PCA therapy the drug
      prescription influences the blood concentration associated with satisfactory
      analgesia.

PMID- 1750639
TI  - CPAP, effective respiratory support in patients with AIDS-related Pneumocystis
      carinii pneumonia.
AB  - Human Immunodeficiency Virus (HIV) related Pneumocystis carinii pneumonia (PCP)
      associated with severe respiratory failure is an increasingly common problem in
      major centres and is associated with a high mortality in previous and recent
      studies. Early in the epidemic, alternatives to invasive intensive care treatment
      were utilized in our institution and found to be successful. When respiratory
      failure developed, mask CPAP was used instead of intubation and ventilation. A
      retrospective review of 175 cases of HIV infected patients with confirmed first
      presentation PCP was undertaken. Treatment with our protocol resulted in an
      overall hospital mortality of 9%. Those patients who did not require supplemental
      oxygen or respiratory support had no in-hospital mortality. The group who
      required supplemental oxygen had a mortality of 10%. If respiratory failure
      supervened (severe respiratory distress, PaO2 less than 50 mmHg, SaO2 less than
      90% on mask oxygen), CPAP was introduced. The mortality in this group was 22%.
      Only two patients were admitted to the intensive care unit for respiratory
      support after failure of CPAP. Both patients were intubated and received
      intermittent positive pressure ventilation (IPPV). Both patients died.

PMID- 1750640
TI  - Shoulder manipulation to facilitate central vein catheterization from the
      external jugular vein.
AB  - Manipulation of the shoulder to facilitate passage of J-wires past the clavicle
      during external jugular vein catheterization was tested prospectively in 111
      adult patients undergoing cardiac surgery. On 10 of 25 occasions when the wire
      would not pass into the thorax, manipulation of the shoulder then allowed the
      wire to pass.

PMID- 1750641
TI  - Epidural abscess associated with postoperative epidural analgesia.

PMID- 1750642
TI  - Propofol and convulsions--the evidence mounts.

PMID- 1750643
TI  - Interpleural anaesthesia in the management of upper limb ischaemia. A report of
      three cases.

PMID- 1750644
TI  - Two cases of naloxone-induced pulmonary oedema--the possible use of phentolamine
      in management.

PMID- 1750645
TI  - Acute anaemia to a haemoglobin of 14 g.l-1 with survival.

PMID- 1750646
TI  - Development of a high block in an infant during an epidural bupivacaine infusion.

PMID- 1750647
TI  - Urgent airway access--an indication for percutaneous tracheostomy?

PMID- 1750649
TI  - Diaphragmatic pacing: an alternative to long-term mechanical ventilation.
AB  - Electrical percutaneous stimulation of the phrenic nerves was first employed in
      1948 by Sarnoff to provide temporary artificial ventilation in patients with
      respiratory failure. However, the technique was limited by development of
      infection around the electrode. Short-term radiofrequency stimulation of the
      phrenic nerves was first utilised by Glenn in 1964 and adapted to long-term use
      in patients with central hypoventilation in 1968 and with traumatic quadriplegia
      in 1972. The technique employed alternate pacing of each hemidiaphragm with high
      frequency stimulation (25-30 Hz) with a respiratory rate of 12 to 17 per minute
      which, in a series of 17 quadriplegic adults, although initially successful, was
      self-limiting because of eventual damage to the nerves and diaphragms. More
      recently, continuous bilateral simultaneous low frequency (up to 8 Hz)
      stimulation with a respiratory rate of 5 to 9 per minute has not induced
      myopathic changes. This phenomenon has been attributed to: 1. the conversion of
      the mixture of slow and fast twitch fibres in the diaphragm to a uniform
      population of fatigue resistant fibres induced by low frequency stimulation, and
      2. the reduction in the total current necessary to achieve adequate gas exchange
      when both diaphragms contract simultaneously with the less frequent stimulation
      at lower energy. Diaphragmatic pacing has been applied to infants and children
      with emphasis on the selection of patients and optimum setting of stimulus
      parameters. This communication presents a case report of diaphragmatic pacing in
      a child with a review of the principles of application. The advantages and
      disadvantages compared to mechanical ventilation are also discussed.

PMID- 1750648
TI  - A comparison of five devices for the bedside monitoring of heparin therapy.
AB  - Five instruments were tested for their capacity to monitor heparin therapy on
      whole blood at the bedside. The instruments were 512 Coagulation Monitor (Ciba
      Corning), Thrombotrack (Nycomed), Automated Coagulation Timer (Hemotec),
      Hemochron-ACT and Hemochron-APTT (International Technidyne Corporation). Fifty
      subjects with various levels of heparinisation were tested on each instrument and
      were also assayed for antithrombin III, fibrinogen, haematocrit, platelet count
      and plasma heparin level. The results were compared with a reference APTT
      performed on the Automated Coagulation Laboratory 300R (Instrumentation
      Laboratories). The Hemochron-ACT correlated least well. The Hemotec and
      Thrombotrack were unsuitable in a clinical setting because of pipetting
      requirements, although the Thrombotrack did correlate well with the reference
      parameters. The 512 Coagulation Monitor was the simplest to use, but its maximum
      response corresponded to the midpoint of the reference APTT therapeutic range.
      The Hemochron-APTT was simple to use, had an adequate response range and
      correlated well with reference parameters.

PMID- 1750650
TI  - The second Geoffrey Kaye oration.

PMID- 1750651
TI  - Modified intravent LMA.

PMID- 1750652
TI  - Using a peripheral nerve stimulator as a nerve locator.

PMID- 1750653
TI  - Vomiting after strabismus surgery.

PMID- 1750654
TI  - Awareness.

PMID- 1750655
TI  - Ulco carbon dioxide absorber.

PMID- 1750656
TI  - Epidural LA/opioid.

PMID- 1750657
TI  - Complications of epidural analgesia.

PMID- 1750658
TI  - Tubeless anaesthesia for microlaryngeal surgery?

PMID- 1750659
TI  - A 'too close to the door' knob.

PMID- 1750660
TI  - Pulse oximetry or pulse photometry.

PMID- 1750661
TI  - Inserting the laryngeal mask.

PMID- 1750662
TI  - Scavenging hazard.

PMID- 1750663
TI  - A spuriously low end-tidal carbon dioxide.

PMID- 1750664
TI  - Anabolic steroids and anaesthesia.

PMID- 1750665
TI  - Anaesthesia system errors.

PMID- 1750666
TI  - Chemical procedures for C-terminal sequencing of peptides and proteins.

PMID- 1750667
TI  - Lysis and fractionation of Mycobacterium paratuberculosis and Escherichia coli by
      matrix solid-phase dispersion.
AB  - A novel method for the lysis and subsequent fractionation of bacterial
      constituents from Mycobacterium paratuberculosis strain 19698 (M.
      paratuberculosis) and Escherichia coli strain DH5 alpha utilizing the technique
      of matrix solid-phase dispersion (MSPD) is described. Bacteria were blended with
      octadecylsilyl (C18) derivatized silica to obtain cellular lysis. The blended
      material was used to prepare a column which was sequentially eluted with solvents
      of increasing polarity. Fractionation of cellular components was confirmed by
      analysis of the solvent extracts. The possible applicability of the MSPD
      technique as a general method for the lysis and fractionation of bacterial
      components is proposed.

PMID- 1750668
TI  - Preparative in vitro mRNA synthesis using SP6 and T7 RNA polymerases.
AB  - A method for preparative in vitro mRNA synthesis is presented. The method makes
      it possible to generate several hundred RNA copies per molecule of linearized DNA
      template. The protocol is applicable to the synthesis of RNAs of differing
      lengths (from 200 to 3000 bases), and both SP6 and T7 RNA polymerases can be
      used. The transcription can be scaled up to at least 6-12 ml, yielding 4.5-18 mg
      of homogeneous biologically active mRNA.

PMID- 1750669
TI  - Biotinylated basic fibroblast growth factor is biologically active.
AB  - Basic fibroblast growth factor (bFGF) was modified by biotinylation via amino
      group substitution, using biotin-N-hydroxysuccinimide ester at molar reaction
      ratios of 20, 200, and 2000 per bFGF molecule (respectively named bio-bFGF.20,
      bio-bFGF.200, and bio-bFGF.2000). The biotinylated bFGF derivatives, bio-bFGF.20
      and bio-bFGF.200, conserved the same affinity for heparin as native bFGF, in
      contrast to bio-FGF.2000 which lost this property. Bio-bFGF.20 and bio-bFGF.200
      were as effective as native bFGF in their capacity to compete with 125I-bFGF for
      binding to bFGF receptor on bovine brain membranes. The biological activity of
      these bFGF derivatives was tested on CCL39 cells; bio-bFGF.20 and bio-bFGF.200
      were as able as native bFGF to promote growth of CCL39.

PMID- 1750670
TI  - Single-sweep polarographic investigation of concanavalin A and its interaction
      with polysaccharide.
AB  - A simple, rapid, and sensitive single-sweep polarographic method has been
      developed for investigation of concanavalin A (con A) and its interaction with
      selected polysaccharides. In a solution containing 0.001 M 2,2'-bipyridine, 0.015
      M hexamethylenetetramine, and 0.1 M sodium chloride, con A exhibits a single
      sweep polarographic wave, and the cathodic peak potential is -1.50 V (vs SCE).
      The peak current varies linearly with con A concentration over a range of 1.0 x
      10(-8) to 1.2 x 10(-7) M by derivative single sweep polarography. A preliminary
      discussion on properties of the con A polarographic wave has been made. In
      addition, it has been demonstrated that single sweep polarography can be a useful
      method for studies on interactions of con A with its complementary
      polysaccharides in solution.

PMID- 1750671
TI  - Detection of poly(ADP ribose) polymerase in crude extracts by activity-blot.
AB  - We have recently devised an activity-blot procedure permitting the detection, on
      the same nitrocellulose sheet, of the functional poly(ADP ribose) polymerase
      (PARP) activity as well as the immunostained active peptide(s) after renaturation
      of the transferred protein(s). Using this technique we have analyzed the PARP
      activity in higher and lower eukaryotes directly on crude extracts from cell
      cultures. This procedure has been extended also to in situ screening of bacterial
      colonies expressing the PARP enzymatic activity.

PMID- 1750672
TI  - Enzymatic determination of total CO2 in freeze-clamped animal tissues and plasma.
AB  - An enzymatic method for measuring total carbon dioxide content in freeze-clamped
      animal tissues is described. Total carbon dioxide content [TCO2] was defined as
      the sum of the dissolved CO2, the bicarbonate concentration, and the carbonate
      concentration. Tissue was extracted in 80% methanol, 20 mM 2-amino-2-methyl-1
      propanol, pH 9.5 at 25 degrees C and homogenized in a 1.5-ml Sardstat screw-top
      test tube containing 0.5-mm glass beads and a minibead beater. Total CO2 was
      determined as bicarbonate/carbonate by monitoring the oxidation of NADH at 340 nm
      using the coupled assay of phosphoenolpyruvate carboxylase (EC 4.1.1.31) and
      malate dehydrogenase (EC 1.1.1.37). In the coupled assay system, 1 mumol of
      bicarbonate/carbonate consumed is equivalent to the oxidation of 1 mumol NADH at
      340 nm. The assay medium comprised 50 mM 2-amino-2-methyl-1-propanol, pH 9.0 at
      25 degrees C, 5 mM phosphoenolpyruvate (PEP), 0.25 mM NADH, 5 mM MgCl2, 5 mM
      mercaptoethanol, 0.02% bovine serum albumin, 10 mM oxamate, PEP carboxylase (0.5
      units/ml), and malate dehydrogenase (0.5 units/ml). The total CO2 content
      measured in freeze-clamped rat heart, liver, brain, and skeletal muscle was 20.53
      +/- 0.64, 17.34 +/- 0.67, 17.00 +/- 0.48, 16.06 +/- 0.53 mumol/g wet wt tissue,
      respectively (n = 5). The total CO2 in the crusher muscle of the lobster was
      found to be 5.0 +/- 0.33 mumol/g wet wt. Total CO2 was also enzymatically
      measured in arterial plasma from four chronically cannulated male wistar rats and
      was 24.65 +/- 1.81 mumol/ml plasma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750673
TI  - Optimization of an alcian blue dot-blot assay for the detection of
      glycosaminoglycans and proteoglycans.
AB  - A modification of a method for the detection of proteoglycans on positively
      charged nylon was adapted for use in a dot-blot assay and improved. Different dot
      blot membranes were tested and variations in the Alcian blue staining solution
      (including pH, critical electrolyte concentration, and ionic strength) were
      explored. With modifications, we were able to eliminate interferences by other
      polyanions such as DNA or proteins. We were able to detect glycosaminoglycans and
      proteoglycans down to the 10 ng range. Furthermore, our assay is compatible with
      high concentration of urea (up to 7 M) used in classic proteoglycans extraction
      methods and is a useful tool to monitor the isolation of proteoglycans by anion
      exchange and gel filtration chromatography. It is technically easier, faster,
      more sensitive, and more specific than previously published methods and can be
      adaptated as a quantitative assay using a scanning densitometer with a linear
      range of detection from 10 to 100 ng of glycosaminoglycans.

PMID- 1750674
TI  - Correction for incomplete labeling in the measurement of distance distributions
      by frequency-domain fluorometry.
AB  - Measurements of time-resolved fluorescence are now being used to recover
      conformational distributions of biological macromolecules. The fluorescence data
      of the donor are easily corrupted by incomplete labeling of the macromolecules by
      the acceptor. In the present paper we describe a general procedure to correct for
      incomplete acceptor labeling in the determination of distance distributions from
      frequency-domain measurements of the donor fluorescence decay kinetics. The
      method can also be used to determine the extent of acceptor labeling. Simulated
      data were used to determine the effect of incomplete labeling on resolution of
      the distance distribution and the effect on the recovered distributions if one
      fails to account for incomplete labeling by the acceptor. The expressions and
      implemented algorithm were verified using known mixtures of donor-control and
      donor-acceptor pair molecules, which simulated the presence of a donor population
      lacking the acceptor. Finally, we present data on the distance distributions
      between two labeled sites in myosin S1 (Cys-697 to Cys-707) where it was not
      possible to obtain complete labeling of the acceptor site.

PMID- 1750675
TI  - Analysis of glutathione S-transferase from human liver by isoelectric focusing in
      a urea minigel system.
AB  - A method for the rapid analysis of isozyme subunits of glutathione transferase
      (GST) from human liver is described. Following purification of enzyme protein to
      electrophoretic homogeneity on columns of GSH-agarose, pooled transferase
      fractions were concentrated by ultrafiltration and subjected to further
      fractionation and analysis by urea-isoelectric focusing in minigels using a
      Hoefer Mighty Small II electrophoresis system. These methods combined with
      immunoblotting techniques permitted the resolution, detection, and eventual
      analysis of up to six different subunits of the alpha isozyme of human GST and at
      least three to four different forms of the pi isozyme of the transferase
      rapidity, accuracy, and sensitivity of the methodology may prove useful to the
      analysis and quantification of GST subunits in biopsies of malignant human tissue
      and to the development of effective chemotherapeutic regimens.

PMID- 1750676
TI  - Bulk purification of isochorismic acid by low-pressure octadecyl (C18) reverse
      phase liquid chromatography.
AB  - Partially purified isochorismate synthase (EC 5.4.99.6) from Klebsiella
      pneumoniae 62-1 was used to produce bulk quantities (3.4-6.8 mg) of isochorismate
      from chorismate. A new, preparative, low-pressure liquid chromatographic method
      for the purification of isochorismate was used; a (1.0 X 13.0 cm) octadecyl (C18)
      reverse-phase column with a discontinuous, stepped methanol gradient as eluent.
      The recovery of isochorismate was quantitative and its purity was verified by
      HPLC using a butyl (C4) reverse-phase column. This chromatographic method is
      superior to those previously described.

PMID- 1750677
TI  - Se-(8-azidoadenosyl)[75Se]selenomethionine as a photoaffinity label for S
      adenosylmethionine binding proteins.
AB  - A method is described for the synthesis and purification of the photoaffinity
      label Se-(8-azidoadenosyl)[75Se]selenomethionine. This photoaffinity label can be
      used to specifically and covalently label the S-adenosylmethionine binding site
      of proteins that use this cofactor, as exemplified by labeling of thioether
      methyltransferase. By utilizing the gamma-emitting isotope of selenium, Se-(8
      azidoadenosyl)[75Se]selenomethionine eliminates the need for the impregnation of
      acrylamide gels with fluorographic enhancers and dilution of liquid samples into
      scintillation cocktails, as is required with the commonly used methyl-3H-labeled
      and 35S-labeled S-(8-azidoadenosyl)methionine.

PMID- 1750678
TI  - Application of a new slot comb to electrophoretic analysis.
AB  - In the present experiment, a new slot comb was designed in order to form a wide
      and sloped sample well on the stacking gel of electrophoresis. Using this slot
      comb, a gradient of the reagent layer of interest can be easily formed
      transversely on the gel that is perpendicular to the direction of
      electrophoresis. Thus, the protein sample overlaid on the agent migrates across
      the gradient layer during electrophoresis to produce a continuous electrophoretic
      band reflecting the interaction between the protein and reagent. This new slot
      comb (tentatively called slope comb) was applied to the following two
      experiments. In the first experiment, in combination with this comb and a
      reducing agent, 2-mercaptoethanol, the reducing steps of cross-linked axonemal
      proteins with o-iodosobenzoic acid (OIBA) were analyzed electrophoretically,
      enabling visualization of the reducing pattern of each axonemal protein in a
      single experiment. The results obtained indicate that alpha and beta tubulins are
      cross-linked differently by OIBA. In the second experiment, the formation of the
      Ca2+ gradient layer using this slope comb could electrophoretically differentiate
      the Ca2+ sensitivity of three Ca(2+)-binding proteins.

PMID- 1750679
TI  - Synthesis, chromatographic purification, and analysis of isomers of biliverdin IX
      and bilirubin IX.
AB  - Neutral solvent systems were developed to isolate the alpha, beta, gamma, and
      delta isomers of biliverdin IX dimethyl ester by TLC. The individual free acids
      of biliverdin IX were obtained by saponification of the corresponding dimethyl
      esters. The bilirubin IX isomers were prepared by reducing the corresponding
      biliverdin IX isomers with NaBH3CN. Starting from a pure biliverdin IX dimethyl
      ester, the corresponding free acid of biliverdin IX or bilirubin IX was available
      within 3-4 h. Preparation of spectrally pure bile pigment required final TLC on
      acid-cleaned neutral TLC plates. The absorption spectra of the free acids and
      dimethyl esters of biliverdin IX in methanol showed a broad band at about 650 nm
      and a sharp band at about 375 nm. The long-wave-length band was extremely
      sensitive to the presence of strong acid. A 10-fold molar excess of HCl caused a
      35- to 50-nm shift of the absorption maximum to longer wavelengths and near
      doubling of the maximum absorption. The molar absorption coefficients of
      biliverdins were identical for each free acid and dimethyl ester pair. In each
      case, Beer's law was followed in both methanol and acidified methanol. Methanol
      also proved to be a suitable solvent for spectroscopic determination of the non
      alpha isomers of bilirubin IX. The wavelength of maximum absorption and molar
      absorption coefficient of each dipyrrolic ethyl anthranilate azo pigment derived
      from the various bilirubin IX isomers are also reported.

PMID- 1750680
TI  - Photoduplication and fluorescence measurement in polyacrylamide gel
      electrophoresis.
AB  - A simple method of photoduplication of gel electrophoresis, visualized with
      fluorescent reagents, is described. The procedure is convenient and rapid and
      requires no camera or expensive equipment. Using electrophoresis duplicating
      paper (Kodak), positive prints suitable for documentation or publication may be
      obtained. With usual photographic paper, negative prints may be obtained,
      allowing reliable measurement by scanning. The technique may be applied to
      protein or nucleic acid electrophoresis.

PMID- 1750681
TI  - Europium(III) cryptate: a fluorescent label for the detection of DNA hybrids on
      solid support.
AB  - We report here a new detection method for DNA hybrids on dot blots. The process
      utilizes DNA or oligonucleotide probes labeled with biotin, followed by
      recognition with a conjugate of streptavidin and europium cryptate, a time
      resolved fluorescent label. Unlike the other lanthanide chelates, this label is
      an organic molecule embedding a europium ion into an intramolecular cavity. This
      structure has a better stability in diluted assay media, a good sensitivity even
      on solid support, and an elevated fluorescence lifetime which allows elimination
      of most of the background generated by other species present in the assay medium.
      This procedure is quantitative and detects down to 2 amol of a model DNA, which
      is similar to other nonisotopic (especially colorimetric) methods. The main
      advantages of this method are easy automation, quantitation, and rapidity of
      measurements.

PMID- 1750682
TI  - Analysis of cardiolipin molecular species by high-performance liquid
      chromatography of its derivative 1,3-bisphosphatidyl-2-benzoyl-sn-glycerol
      dimethyl ester.
AB  - Cardiolipin (CL, 1,3-bisphosphatidyl-sn-glycerol) is a four-acyl-chain
      phospholipid whose molecular species composition cannot be analyzed by standard
      procedures. Here we report a method to resolve the molecular species of CL by
      high-performance liquid chromatography of its derivative 1,3-bisphosphatidyl-2
      benzoyl-sn-glycerol dimethyl ester. The CL derivative was characterized by 1H
      nuclear magnetic resonance spectroscopy, ultraviolet (uv) spectroscopy, thin
      layer chromatography, and fatty acid analysis. The derivatization procedure did
      not change the fatty acid profile and provided a virtually complete conversion to
      the highly apolar, uv-visible product. In HPLC separations, recorded by 228 nm
      absorbance, a linear correlation was found between the area of individual peaks
      and their amount of lipid phosphorus. Bovine heart CL was resolved into 11
      molecular species of which 6 (together accounting for 97 mol%) could be
      identified. The molecular species of bovine heart CL feature a linear
      relationship between their logarithmic retention time and their double bond
      number.

PMID- 1750683
TI  - Stepped potential microcoulometry of ferritin.
AB  - A coulometric method for measuring the redox potentials of ferritins and the
      rates of reduction of the iron core is reported. The half-reduction potential,
      Eo', of the protein is determined from the coulomb-applied potential curve. This
      curve is obtained from the difference between the curves for the mediator plus
      protein and the mediator alone. The coulomb-applied potential curves are
      generated by stepping the potential in increments over the region of interest and
      measuring the charged passed following each step. The method is reasonably fast,
      enabling the redox potential to be determined in 1 day, and gives Eo', values for
      mediators and the protein that are in good agreement with literature values.

PMID- 1750684
TI  - Homogeneous enzyme immunoassay for lipoic acid based on the pyruvate
      dehydrogenase complex: a model for an assay using a conjugate with one ligand per
      subunit.
AB  - A homogeneous enzyme immunoassay for lipoic acid was developed by using an enzyme
      ligand conjugate containing only one ligand per enzyme subunit. Theoretical
      studies have shown that the traditional use of multisubstituted enzyme-ligand
      conjugates has limited the detection limits and sensitivity obtainable with these
      assays. The use of conjugates with a smaller number of ligands should allow for
      improved assays. The pyruvate dehydrogenase complex was chosen for this study
      because each polypeptide chain of dihydrolipoyl transacetylase contains one
      lipoic acid as a covalently attached prosthetic group. Thus, the naturally
      occurring enzyme can be considered as an enzyme-lipoic acid conjugate. Anti
      lipoic acid antibodies were developed in New Zealand White rabbits to be used as
      the analyte-specific binders. Association and binder dilution curves were
      prepared in order to optimize the reagent concentrations and the analytical
      conditions. Unexpected inhibition by free lipoic acid resulted in a biphasic dose
      response curve with a detection limit of 5 x 10(-6) M lipoic acid. This technique
      has several advantages over previous electrochemical and chromatographic
      techniques for lipoic acid determination.

PMID- 1750685
TI  - Spectrophotometric method for the determination of microquantities of lactic acid
      in biological material.
AB  - A simple spectrophotometric method for the determination of microquantities of
      lactic acid is described. Lactic acid was quantitatively oxidized to acetaldehyde
      by cerium(IV) under prescribed conditions. Oxidation was terminated by reducing
      cerium(IV) to cerium(III) with nitrite. The acetaldehyde was reacted with copper
      ions and oxalydihydrazide under alkaline conditions to form an intense blue
      complex which is measured spectrophotometrically. The developed citrate-phosphate
      borate-sodium hydroxide alkalizing reagent enhanced color stability by removing
      cerium from solution and also ensured extremely low blank values. Beer's law was
      followed over the range 0 to 150 micrograms of lactate. The method was
      successfully applied to the routine determination of lactate in silage and blood.

PMID- 1750686
TI  - Assay of myosin light chain kinase activity by high-performance liquid
      chromatography using a synthetic peptide as substrate.
AB  - The most popular method to determine the activity of myosin light chain kinase is
      to measure the radioactivity incorporated from [gamma-32P]ATP into phosphoryl
      accepting substrates. In this paper, we report a new method for determination of
      myosin light chain kinase activity without using radioisotopes. Synthetic
      peptides and nonradiolabeled ATP were used as substrate, and the peptide
      substrate was phosphorylated by myosin light chain kinase purified from chicken
      gizzard. After terminating the reaction, the reaction mixture was directly
      injected into a reversed-phase HPLC column without pretreatment, separated with
      the isocratic solvent system of acetonitrile-H2O-trifluoroacetic acid, and
      monitored at 220 nm uv absorbance. The reaction rate was determined from the peak
      areas of phosphorylated and unphosphorylated peptides. One chromatographic
      separation was achieved within 9 min, and the analysis could be repeated
      successively more than 100 times without washing the column. Using this method,
      we measured the differential inhibition of myosin light chain kinase by various
      inhibitors. With the aid of an automatic injector, the HPLC method with synthetic
      peptide enables us to handle many samples quickly and is useful for screening new
      myosin light chain kinase inhibitors.

PMID- 1750687
TI  - Affinity electrophoresis used for determination of binding constants for antibody
      antigen reactions.
AB  - The use of affinity electrophoresis in agarose gels for determination of binding
      constants for the interaction of antigens with monoclonal antibodies is
      exemplified for monoclonal anti-human serum albumin and anti-alpha 1-fetoprotein
      antibodies. The calculated binding constants are verified by independent binding
      assays. The electrophoretic separation of antigen-antibody complexes of different
      stoichiometry is also demonstrated. Thus, affinity electrophoresis represents an
      alternative method for both qualitative and quantitative assessment of antigen
      antibody interactions.

PMID- 1750688
TI  - Measurement and analysis of triplet-state lifetimes by multifrequency cross
      correlation phase and modulation phosphorimetry.
AB  - In this paper we describe a novel approach to study the triplet-state lifetimes
      by a conventional multifrequency cross-correlation phase and modulation
      apparatus. The analysis of phase and modulation data of eosin-labeled band 3
      erythrocyte ghosts revealed the existence of two phosphorescence lifetime values
      of 2700 and 750 microseconds, with a fractional contribution of 78 and 22%,
      respectively, which are in good agreement with those reported in the literature.
      Differential polarization phase analysis, which facilitates the study of the
      rotational properties of band 3, provided data in good agreement with those
      reported in the literature. The method proposed in this paper to study the
      radiative emission from the triplet state may represent a convenient alternative
      to the pulse laser flash technique.

PMID- 1750689
TI  - Quantitation of time- and frequency-resolved optical spectra for the
      determination of tissue oxygenation.
AB  - The recent development of near-infrared time- and frequency-resolved tissue
      spectroscopy techniques to probe tissue oxygenation and tissue oxygenation
      kinetics has led to the need for further quantitation of spectroscopic signals.
      In this paper, we briefly review the theory of light transport in strongly
      scattering media as monitored in the time and frequency domains, and use this
      theory to develop algorithms for quantitation of hemoglobin saturation from the
      photon decay rate (delta log R/delta t) obtained using time-resolved
      spectroscopy, and from the phase-shift (theta) obtained from frequency-resolved,
      phase-modulated spectroscopy. To test the relationship of these optical
      parameters, we studied the behavior of delta log R/delta t and theta as a
      function of oxygenation in model systems which mimicked the optical properties of
      tissue. Our results show that deoxygenation at varying hemoglobin concentrations
      can be monitored with the change in the photon decay kinetics, delta delta log
      R/delta t in the time-resolved measurements, and with the change in phase-shift,
      delta theta, in the frequency-resolved technique. Optical spectra of the adult
      human brain obtained with these two techniques show similar characteristics
      identified from the model systems.

PMID- 1750690
TI  - Sequence-specific DNA affinity chromatography: application to the purification of
      EcoRI and SphI.
AB  - Several rapid and effective methods have been described to obtain restriction
      endonucleases suitable for commercial exploitation. However, lengthy and
      laborious protocols have been necessary to obtain homogeneous enzymes. We now
      report the use of sequence-specific DNA affinity chromatography to purify
      restriction endonucleases to near homogeneity. Restriction endonucleases EcoRI
      and SphI from the microorganisms Escherichia coli RY 13 and Streptomyces
      phaeochromogenes, respectively, were purified to near homogeneity employing a two
      step procedure which involves DNA-cellulose chromatography and oligonucleotide
      ligand affinity chromatography.

PMID- 1750691
TI  - Rotating disc electrode characterization of immobilized glucose oxidase.
AB  - The kinetic properties of glucose oxidase (EC 1.1.3.4) which has been covalently
      immobilized to a rotating glassy carbon electrode surface have been investigated.
      Analysis of the rotation rate dependence of the hydrogen peroxide-derived current
      suggests that oxygen mass transport to the enzyme-electrode surface is rate
      controlling at low rotation rates. Only as the diffusion layer approaches zero
      thickness (i.e., infinitely fast rotation rate) does mass transport become
      unimportant. A diffusion-free glucose Km for air-saturated buffer is found to be
      66 mM using this methodology. The importance of mass transport restrictions in
      two-substrate enzymes such as glucose oxidase is discussed in the context of
      biosensor design.

PMID- 1750692
TI  - A two-cycle immunoprecipitation procedure for reducing nonspecific protein
      contamination.
AB  - A two-cycle immunoprecipitation procedure is described that markedly reduces
      nonspecific protein contamination occurring during the precipitation of hepatic
      lipase from rat H4 hepatoma cells. In this method, the precipitation of immune
      complexes during both cycles is achieved by utilizing a sodium dodecyl sulfate
      (SDS)-washed preparation of lyophilized Staphylococcus aureus cells (Staph A);
      this washed preparation effectively removes Staph A contaminants without
      compromising the ability to bind immune complexes. Following initial
      immunoprecipitation of the antigen, the Staph A/IgG/antigen complex containing
      coprecipitated nonspecific proteins was dissociated with SDS. Triton X-100 was
      added to the dissociated immunoprecipitate at a concentration (by weight) of at
      least 5 parts Triton X-100 to 1 part SDS. A second cycle of immunoprecipitation
      was then initiated by addition of fresh antibody, followed by Staph A
      precipitation of immune complexes and analysis by SDS-polyacrylamide gel
      electrophoresis. The two-cycle procedure is shown to be reproducible and suitable
      for the quantitative determination of relative amounts of hepatic lipase. The
      procedure described here is generally applicable to the immunoprecipitation of
      other antigens.

PMID- 1750693
TI  - A continuous spectrophotometric method for the determination of diphenolase
      activity of tyrosinase using 3,4-dihydroxymandelic acid.
AB  - A continuous spectrophotometric method for the rapid determination of diphenolase
      activity of tyrosinase is described. It uses 3,4-dihydroxymandelic acid (DOMA) as
      the substrate of tyrosinase and measures the final product, 3,4
      dihydroxybenzaldehyde (DOBA). The spectrum of this product shows a bathochromic
      displacement of its absorbance maximum when the pH increases. The optimization of
      the method is described by using tyrosinase from several biological sources,
      whose enzymatic activities show different optimal pH. Thus, the enzymatic
      activity of mushroom tyrosinase was assayed at pH 7.5 and monitored at 350 nm
      (epsilon 350 pH 7.5 (DOBA) = 15,200 M-1 cm-1), whereas the spectrophotometric
      experiments with grape tyrosinase were carried out at pH 3.0 and monitored at 310
      nm (epsilon 310 pH 3.0 (DOBA) = 9200 M-1 cm-1). The method for mushroom
      tyrosinase was found to be 50-fold more sensitive than the commonly used
      dopachrome assay, whereas for grape tyrosinase the method was found to be
      threefold more sensitive than the commonly used o-quinone production assay. The
      great solubility and stability of the chromophoric product, DOBA, as well as its
      high molar absorptivities at any pH, enable the method to be employed to
      determine the diphenolase activity of tyrosinase from different biological
      sources.

PMID- 1750694
TI  - Quantitation of uracil in rodent diet.
AB  - Feeding of high levels of uracil to laboratory rodents results in the formation
      of calculi in the lumen of the urinary bladder. This urolithiasis stimulates
      cellular proliferation in the bladder and has been used in studies of two-stage
      carcinogenesis. Quantitation of uracil in rodent diet was achieved by extraction
      from the diet with ammonium hydroxide. The extract was applied to a strong anion
      exchange solid-phase extraction column. Uracil is not retained on this matrix
      which adsorbs the majority of contaminants in the extract. The uracil was
      quantitated by HPLC on an ODS microbore column (100 x 2 mm internal diameter)
      eluted at 0.5 ml/min with 200 mM KH2PO4, pH 3.5, at 30 degrees C. Three
      structurally related pyrimidine bases, cytosine, uracil, and thymine, showed
      increasing retention on this column/solvent combination, thereby demonstrating
      selectivity of the analysis. Recovery of uracil was 76-90% with lower values
      observed when dietary levels of uracil were in excess of 4.5%.

PMID- 1750695
TI  - Operation of ion-selective electrode detectors in the sub-Nernstian/linear
      response range: application to flow-injection/enzymatic determination of L
      glutamine in bioreactor media.
AB  - A novel approach for eliminating positive errors from endogenous ionic
      interferences when using ion-selective electrodes as detectors in flow-injection
      enzyme-based blosensing configurations is described. The method involves using a
      high background level of interfering ions in the sample diluent/carrier stream to
      convert the normally logarithmic potentiometric sensor into a linear detector
      over a given concentration range of primary ions. A split-stream single-detector
      arrangement provides a convenient means to compensate for varying levels of
      background interferent ions in the injected samples. One portion of the split
      stream passes directly to the ion-electrode detector, yielding a signal linearly
      related to the concentration of endogenous primary ions in the sample. The second
      portion of the split sample is delayed while passing through an immobilized
      enzyme that generates electrode detectable primary ions in proportion to the
      concentration of the substrate analyte in the sample. Two linear equations with
      two unknowns describe the twin potentiometric responses observed. The concept is
      demonstrated by the accurate determination of L-glutamine in hybridoma bioreactor
      media via the use of an ammonium-ion-selective membrane electrode detector and
      immobilized glutaminase enzyme.

PMID- 1750696
TI  - Increased analytical precision in the hollow cathode discharge emission source by
      improved discharge current control.
AB  - A significant improvement in the precision of the hollow cathode as an emission
      source is reported. Precision of 1% or less has been observed several times over
      periods of several hours. An average long-term stability of 4.3% for Ll and 6.0%
      for Na in the emission signal from microsamples (less than 50 nL) deposited in
      the hollow cathode discharge source is reported. The improved precision is
      attributed primarily to the introduction of electronics that hold the discharge
      current more nearly constant and to the shielding of all wiring to the source
      from the power supply. A current-controlled switch that is capable of driving a
      hollow cathode discharge in either dc or pulsed mode is described. This switch is
      capable of generating current pulses as short as 2 microseconds through a
      resistive load and greatly improves the discharge stability and repeatability at
      turn-on in both the dc and pulsed modes. The characteristics of pulses produced
      by this switch are presented; however, analytical performance is reported only
      for the dc mode. Temporal current plots are presented for the new instrumentation
      and compared to plots taken with commonly used current-controlled power supplies.
      Instrumentation, operation, and sample preparation procedures are described.
      Typical temporal profiles of the emission signal from microsamples deposited in
      AI and stainless steel hollow cathodes are given.

PMID- 1750697
TI  - Trace-concentration detection of cobalt in a liquid flow cell by degenerate four
      wave mixing using low-power off-resonant laser excitation.
AB  - Optical phase conjugation by degenerate four-wave mixing (D4WM) in an absorbing
      metal-ion solution using a low-power argon-ion laser as the excitation source is
      demonstrated. This nonlinear laser technique can be used as a sensitive
      analytical spectroscopic method for trace-concentration measurement of metal ions
      in a small-volume continuously flowing analyte cell. Several important
      characteristics are discussed, including the effects of solvent properties,
      excitation wave-length, laser intensity, and analyte absorptivity on signal
      intensity. Detection of 0.26 ng (4.4 pmol) of cobalt inside the laser probe
      volume of 0.14 microL is reported using an excitation wavelength that is 136 nm
      away from the maximum absorption wavelength of the analyte solution. The minimum
      absorbance measured in our D4WM experiment is 2.0 X 10(-5) without complex
      formation for cobalt. The D4WM detection sensitivity, in terms of the
      concentration-absorptivity product, is 4.05 X 10(-4) cm-1 for cobalt(II) in
      ethanol. Our preliminary detection sensitivity compares favorably with other
      laser-based spectrometric methods. This nonlinear laser technique is applicable
      to both fluorescing and nonfluorescing analytes.

PMID- 1750698
TI  - Detection of biomolecules on surfaces using ion-beam-induced desorption and
      multiphoton resonance ionization.
AB  - Multiphoton resonance ionization (MPRI) has been combined with ion-beam-induced
      desorption to examine a set of thermally labile biological molecules present on
      surfaces. Specifically, we have examined films of adenine and beta-estradiol,
      molecules with a rigid skeletal backbone. In both of these cases, molecular ions
      could be produced efficiently without cooling the neutral molecules into their
      ground vibrational state. We have also studied other more fragile molecules such
      as tryptamine, tryptophan, phenylalanine, and serotonin. The base peak in the
      mass spectra of these molecules is fragment ions formed by losses of the amine
      side chains. Even with this fragmentation, however, it is possible to achieve
      sensitivity limits that are many orders of magnitude greater than for secondary
      ion mass spectrometry, without preparing the samples in special matrices. For
      serotonin, detection limits of 40 fmol on the surface of a silicon target are
      achievable. The results also yield a linear relation between the serotonin base
      fragment ion intensity and the known surface concentration.

PMID- 1750699
TI  - Optimization of the fragmentation in a frit-fast atom bombardment ion source for
      the sequencing of peptides at the picomole level.
AB  - Peptides derived from enzymatic digestions (cathepsin D and trypsin) were
      characterized and amino acid sequences determined by using their LC/MS spectra. A
      Frit-FAB interface that produces extensive peptide fragmentation and permits
      amino acid sequencing at the low picomole level is described for a model antigen,
      Staphylococcus aureus nuclease (Nase), and an enzyme of unknown structure, yeast
      aminopeptidase B. The amino acid sequences of peptides derived from digestion of
      Nase with cathepsin D (a relatively nonspecific endoprotease) were readily
      deduced and have provided insights into the nature of antigen processing. Frit
      FAB LC/MS spectra of the Nase peptides contained a sufficient number of fragment
      ions to conclusively identify peptides with a mass below 2000 Da. Capillary LC/MS
      provided a means for the separation and identification of these enzymatically
      derived peptides in a fraction of the time that would have been required by gas
      phase Edman sequence analysis. The optimized Frit-FAB experiment was consequently
      evaluated for the partial characterization of aminopeptidase B recently purified
      to homogeneity from Saccharomyces cerevisiae. Sequence-specific ions observed in
      the Frit-FAB mass spectra of these tryptic peptides were identical with those
      commonly observed in high-energy collision-induced dissociation (CID) spectra and
      included side-chain fragment ions that differentiated leucine from isoleucine.
      These fragment ions were used to deduce entire amino acid sequences for several
      of the tryptic peptides.

PMID- 1750700
TI  - Determination of dissolved selenium species in environmental water samples using
      isotope dilution mass spectrometry.
AB  - In order to clarify the species composition of selenium in environmental water
      samples, analytical methods have been developed for the selective determination
      of different chemical forms of this element (selenite, selenate, and organic
      species including trimethylselenonium) using isotope dilution mass spectrometry
      (IDMS). The species analysis was made possible by means of chromatographic
      separation procedures and an 82Se-enriched selenate, selenite, and
      trimethylselenonium spike for the isotope dilution process. The total selenium
      concentration was determined after decomposition of organic compounds with a
      HNO3/HCIO4 mixture. Selenium was measured in the mass spectrometer by producing
      negative Se- thermal ions for detection. Precise determination at the parts-per
      trillion level was achieved. This new methodology was applied to different types
      of natural water samples (groundwater, pond water, river water, moorland lake
      water) with total selenium concentrations in the range of 200 pg/g to 15 ng/g.
      Selenite and selenate have been the only detected species in most of the
      investigated samples, with selenate dominating all except one. In samples with
      high contents of dissolved organic carbon, however, different organoselenium
      compounds including trimethylselenonium ions were additionally quantified in the
      range of 10-95 pg/g. In these cases, the sum of all selenium species agreed well
      with the independently determined total element concentration.

PMID- 1750701
TI  - Determination of ethylenethiourea in crops using particle beam liquid
      chromatography/mass spectrometry.
AB  - Several food crops were analyzed for residues of ethylenethiourea (ETU), a
      suspect thyroid and liver carcinogen present in EBDC fungicides, using a
      commercial particle beam (PB) LC/MS method. The PB/LC/MS detection limits for ETU
      in crops (5 ppb, 1.25 ng) are comparable to those obtained by LC with
      electrochemical detection. Spectra obtained from crop samples containing as
      little as 5 ng of ETU were matched with the NBS library reference EI spectrum.
      Isotopically labeled ETU was used as an internal standard for quantitation and
      determination of recoveries. No enhancement of molecular ion signal intensity
      from unlabeled ETU was observed upon coelution with the isotopically labeled
      variant. This MS method permits detection of ETU with increased selectivity
      without compromising sensitivity.

PMID- 1750702
TI  - Liposome flow injection immunoassay: model calculations of competitive
      immunoreactions involving univalent and multivalent ligands.
AB  - The use of liposomes as detectable reagents in solid-phase immunoassays has been
      explored in a flow injection immunoanalysis (FIIA) system. Model calculations are
      presented for FIIA based on the competitive binding of univalent analyte and
      multivalent liposomes to immobilized antibodies. Parameters such as binding
      constants, concentrations of liposomes and antibody, and steric hindrance are
      considered for their relative effects on detectable liposome signal response to
      analyte concentrations. Qualitative comparisons of the model with the
      experimental data are made.

PMID- 1750703
TI  - Prediction of gas chromatographic relative retention times of anabolic steroids.
AB  - The prediction of gas chromatographic relative retention times (RRTs) of anabolic
      steroids, used in the doping control of athletes, was performed by a quantitative
      structure-retention relationship (QSRR) and multiple linear regression analysis
      study. A nine-variable model was generated with a multiple correlation
      coefficient R = 0.991 and relative standard error of less than 3%. Preliminary
      results indicated that the application of the model, especially in the prediction
      of RRTs of metabolites of the anabolic steroids, will be helpful.

PMID- 1750704
TI  - Capillary gel affinity electrophoresis of DNA fragments.
AB  - The incorporation of an affinity ligand within a polyacrylamide gel provides a
      general means of manipulating the selectivity of capillary gel electrophoresis
      separations. As an example of this approach, high resolution of DNA restriction
      fragments by capillary gel affinity electrophoresis has been achieved by adding a
      soluble intercalating agent, ethidium bromide, to the gel-buffer system. A
      migration model has been developed that can be used for selectivity optimization.
      Various parameters, such as ligand concentration and applied electric field, have
      been examined in terms of their influence on retention and selectivity of
      different-size DNA molecules. From this study, high-resolution separations have
      been developed with efficiencies as high as 10(7) theoretical plates per meter.

PMID- 1750705
TI  - Determination of halocarbons in drinking water by direct aqueous injection gas
      chromatography.

PMID- 1750706
TI  - Immunocytochemical localization of follicle regulatory-protein (FRP) in testis.
AB  - Follicle regulatory protein (FRP) can exert paracrine control over follicular
      development. It is synthesized by the granulosa cells of the developing follicles
      and was localized in the cytoplasm of the mural cells by immunocytochemistry.
      When administered to male dogs and rats, FRP causes impairment of
      spermatogenesis. In the intact male rat, it has been postulated that FRP
      manifests its effects at a stage prior to the conversion of testosterone to
      dihydrotestosterone. Sertoli cells of the seminiferous tubules are implicated in
      testosterone metabolism. Furthermore, Sertoli cells in male gonads are regarded
      as the counterpart of granulosa cells in ovaries. The exact source of FRP in the
      male is not known. Therefore, it was of interest to study the localization of FRP
      in the male gonads. Testicular sections of the pig, dog, cat, rat, mouse, monkey,
      and man were immunocytochemically stained with monoclonal antibody to porcine FRP
      of ovarian origin. Sections of pig ovaries were used as controls throughout the
      study. Specificity of immunocytochemical localization was established by
      preabsorption. FRP antibody predominantly localized to the interstitial
      compartment of the pig testis. In the seminiferous tubules, FRP localization was
      limited to basal spermatogonia and Sertoli cells of tubules at few specific
      stages of spermatogenesis. The study also showed that the monoclonal antibody
      against porcine FRP is species-specific. Antibody binding was found only in pig
      testis, whereas tissues from the cat, dog, mouse, rat, monkey, and man did not
      display any immunocytochemical reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750707
TI  - FSH in testes of marmosets during development: immunocytochemical localization
      and de novo biosynthesis.
AB  - Immunocytochemical localization of FSH was carried out in various cell types of
      marmoset testes during development using antisera generated against intact as
      well as beta-subunit of human FSH. Significant differences in the intensity as
      well as distribution of FSH in various cell types were observed in neonatal,
      pubertal, and adult marmosets. Intensity of staining in Leydig cells was maximum
      at day 1 and in adults (1-3 years), whereas it was minimum at 3 months. In
      seminiferous tubules (Sertoli cells), FSH was present in trace amount until
      puberty and subsequently increased at maturity. Further studies demonstrate de
      novo biosynthesis of FSH-like moiety in vitro by testicular tissue, which was age
      dependent.

PMID- 1750708
TI  - Experimental analysis of blood vessel development in the avian wing bud.
AB  - Shortly after its appearance, the avian limb bud becomes populated by a rich
      plexus of vascular channels. Formation of this plexus occurs by angiogenesis,
      specifically the ingrowth of branches from the dorsal aorta or cardinal veins,
      and by differentiation of endogenous angioblasts within limb mesoderm. However,
      mesenchyme located immediately beneath the surface ectoderm of the limb is devoid
      of patent blood vessels. The objective of this research is to ascertain whether
      peripheral limb mesoderm lacks angioblasts at all stages or becomes avascular
      secondarily during limb development. Grafts of core or peripheral wing mesoderm,
      identified by the presence or absence of patent channels following systemic
      infusion with ink, were grafted from quail embryos at stages 16-26 into the head
      region of chick embryos at stages 9-10. Hosts were fixed 3-5 days later and
      sections treated with antibodies that recognize quail endothelial cells and their
      precursors. Labeled endothelial cells were found intercalated into normal
      craniofacial blood vessels both nearby and distant from the site of implantation
      following grafting of limb core mesoderm from any stage. Identical results were
      obtained following grafting of limb peripheral mesoderm at stages 16-21. However,
      peripheral mesoderm from donors older than stage 22 did not contain endothelial
      precursors. Thus at the onset of appendicular development angioblasts are present
      throughout the mesoderm of the limb bud. During the fourth day of incubation,
      these cells are lost from peripheral mesoderm, either through emigration or
      degeneration.

PMID- 1750709
TI  - Occurrence of epidermal growth factor-binding sites during differentiation of
      cementoblasts and periodontal ligament fibroblasts of the young rat: a light and
      electron microscopic radioautographic study.
AB  - Occurrence of epidermal growth factor (EGF)-binding sites during differentiation
      of cementoblasts and periodontal ligament (PDL) fibroblasts was investigated
      using radioautography after I. V. injection of 125I-EGF to 14-day-old rats.
      During differentiation of cementoblasts, a very low level of EGF-binding sites
      was present on the mesenchymal cells in dental follicle proper, precementoblasts,
      and cementoblasts. On the other hand, during differentiation of PDL fibroblasts,
      numerous EGF-binding sites were observed on the undifferentiated paravascular
      cells and on the perifollicular mesenchymes representing the major source of PDL
      fibroblast precursor cells. Also heavy labeling was observed throughout their
      differentiation to PDL fibroblasts, as well as during full synthetic activity as
      mature cells. Quantitative analysis of the light microscopic radioautographs
      revealed that these cells demonstrated approximately 4 grains per 100 microns 2
      of cell area. These results suggest that EGF plays an important role in
      differentiation of PDL fibroblasts, but not in that of cementoblasts.
      Furthermore, the well-known in vivo effect of EGF in producing precocious
      eruption of teeth may be a consequence of a more extensive effect of EGF
      throughout differentiation of PDL fibroblasts as well as during full synthetic
      activity as mature cells.

PMID- 1750710
TI  - Anionic site and immunogold quantitation of heparan sulfate proteoglycans in
      glomerular basement membranes of puromycin aminonucleoside nephrotic rats.
AB  - Renal glomerular basement membranes (GBMs) exhibit a charge-selective barrier,
      consisting of heparan sulfate proteoglycan (HSPG) that restricts the passage of
      anionic molecules into the urine. Previous efforts to localize the HSPG core
      protein within various layers of the GBM have been contradictory. Furthermore,
      attempts to correlate proteinuria in several disease states with a decrease in
      anionic sites of HSPG core protein have yielded conflicting results. When
      antibodies to HSPG from the EHS tumor matrix [anti-(EHS) HSPG] and GBMs [anti
      (GBM) HSPG] were used together with immunogold to label renal tissues from
      puromycin aminonucleoside nephrotic (PAN) rats, immunolabeling results indicated
      that a portion of the protein core recognized by anti-(EHS) HSPG was
      significantly reduced, while immunolabeling with anti-(GBM) HSPG was only
      slightly reduced in early PAN. Anionic sites (stained with the cationic probe,
      polyethyleneimine) within the lamina rara externa of the GBM remained unaltered
      throughout the course of PAN.

PMID- 1750711
TI  - The kidney of tapirs: a macroscopical study.
AB  - The renal cortex of tapirs, water-loving primordial ungulates, was continuous,
      nonlobed, and about 80% of renal mass in adult and 71% in term-neonate. In the
      neonates even the peripheral glomeruli were moderately mature. Tapirus bairdi had
      about 4 million glomeruli per kidney and T. pinchaque about 3 million smaller
      glomeruli. Number of glomeruli per gm of cortex was 12,444 in T. bairdi and
      13,400 in T. pinchaque. Cortical loops were common in the medullary rays. The
      medulla was the simple crest-type. The terminal collecting ducts (T.C.D.) opened
      separately at the crest and not into a tubus maximus. The "outer stripe" of the
      outer medulla apparently was telescoped into the deep cortex. The medullary loops
      turned at a thick portion and at nearly all levels of the medulla. The medullary
      crest was lined by urothelium which extended into the ends of the T.C.D.
      Otherwise the T.C.D. were made of columnar epithelium. The pelvic urothelium was
      continuous with that of the medullary crest at the dorsal and ventral fornices.
      The fornices were well within the inner medulla. Hence only inner medulla could
      be exposed to pelvic urine. The hilar arteries, unlike the other two
      perissodactyl families (rhinoceri and equids), passed through the cortico
      medullary (C-M) border and some large arteries and veins passed through the outer
      medulla to and from the C-M border without branches or tributaries. Unlike
      kidneys with a medullary crest in diverse eutherian mammals, tapirs lacked pelvic
      extensions along the major intrarenal blood vessels and thus lacked pelvic
      intervascular eminences.

PMID- 1750712
TI  - Distribution of actin isoforms within cells of the seminiferous epithelium of the
      rat testis: evidence for a muscle form of actin in spermatids.
AB  - Recently, a cDNA that coded for an enteric smooth muscle gamma-actin (SMGA) that
      was expressed in post-meiotic mouse testicular cells was identified. To determine
      the cellular location(s) of the protein encoded by this cDNA, this SMGA was
      probed for by immunocytochemistry in the cells of the seminiferous epithelium
      with two different monoclonal antibodies (Mabs), B4 and HUC 1-1, known to be
      muscle actin selective. As a control, we also examined the immunoreactivity of a
      third Mab, C4, that reacts with all non-muscle and muscle vertebrate isoactins.
      Using light and electron microscopy, a progressive increase in immunolabeling was
      observed with the muscle selective HUC 1-1 Mab over a loose actin filamentous
      network distributed throughout the cytoplasm of steps 4-16 spermatids.
      Thereafter, the labeling decreased such that at step 17 spermatids, only
      cytoplasmic labeling in the tail of the spermatids was observed. No labeling of
      this network was noted with the C4 or B4 Mabs. However, myoid cells enveloping
      seminiferous tubules and smooth muscle cells of interstitial blood vessels
      demonstrated comparable intense labeling with each of the three Mabs. The C4 Mab
      intensely labeled actin filaments of the Sertoli-Sertoli and Sertoli-spermatid
      ectoplasmic specializations. Also well labeled were numerous actin filaments
      found in the apical Sertoli cell processes encapsulating the heads of late step
      19 spermatids at stage VII of the cycle of the seminiferous epithelium. In
      addition, actin filamentous bundles enveloping tubulobulbar complexes of the late
      spermatids within the Sertoli cell apical processes were intensely labeled. The
      actin filaments in the Sertoli apical processes and surrounding the tubulobulbar
      complexes were also strongly immunolabeled with the HUC 1-1 Mab. The C4 Mab but
      not the B4 or HUC 1-1 Mabs, recognized actin in the subacrosomal space of steps 4
      18 spermatids. This study suggests that there are muscle isoforms of actin within
      the cytoplasm of developing spermatids and within apical processes of Sertoli
      cells.

PMID- 1750713
TI  - Cervical lymph nodes and mast cells in the marsupial Sminthopsis crassicaudata.
AB  - A study of the cervical lymph nodes from the fat-tailed dunnart, Smithopsis
      crassicaudata, revealed the nodes were pigmented with lipofuscin and contained
      many large cells which were identified as mast cells from their ultrastructure
      and histochemical staining properties. It is believed that the very high density
      of mast cells in the cervical lymph nodes contributed to an increase in size of
      these organs compared to other animals. Very high levels of histamine (90
      micrograms/g) were found in the nodes. Cervical lymph nodes with these unusual
      features were found not only in healthy, umprimed laboratory bred adults, but
      also in pouch young, wild caught animals, and adults of the closely related
      species, Sminthopsis macroura. A comparison of the histochemical and
      ultrastructural characteristics of mast cells from various organs of adult S.
      crassicaudata was also made. Mast cells from lymph node, skin, tongue, salivary
      glands, intestinal mucosa, and spleen showed slight variations in staining and
      structure.

PMID- 1750714
TI  - Evidence that vinculin is co-distributed with actin bundles in ectoplasmic
      ("junctional") specializations of mammalian Sertoli cells.
AB  - Ectoplasmic specializations of Sertoli cells are actin containing structures
      found at sites of attachment to spermatids and to neighboring Sertoli cells. We
      suspect that these cytoskeletal structures are a form of actin-associated
      adhesion junction. If this is true, then molecular components, such as vinculin,
      that characterize actin-associated adhesion junctions in general should be
      present in ectoplasmic specializations. In this paper we have used two approaches
      to verify the prediction that vinculin is a component of ectoplasmic
      specializations. First, we have used fluorescence microscopy to probe
      immunologically for vinculin in ectoplasmic specializations associated with
      spermatids of the ground squirrel. Second, we have used immunogold techniques to
      probe for vinculin in ectoplasmic specializations of rat testis. Our results
      indicate that the immunological probe for vinculin was reactive with ectoplasmic
      specializations. In single label fluorescence experiments, linear patterns
      obtained with the vinculin probe were similar to those obtained with probes for
      filamentous actin. In double label experiments, the vinculin probe was co
      distributed with the actin probes. In immunogold studies, specific labelling with
      the probe for vinculin occurred in ectoplasmic specializations both at sites of
      attachment to spermatids and adjacent to basal Sertoli cell junctions. Moreover,
      gold particles were concentrated adjacent to filament bundles within each
      ectoplasmic specialization. Our results support the conclusion that vinculin is
      present in ectoplasmic specializations. Further, they indicate that vinculin is
      co-distributed with actin bundles within each ectoplasmic specialization.

PMID- 1750715
TI  - Patch tests: will they die a bureaucratic death?

PMID- 1750716
TI  - Licensing of allergen patch tests.

PMID- 1750717
TI  - Recent advances in contact dermatitis.

PMID- 1750718
TI  - Skin test reactivity to whole body and fecal extracts of American (Periplaneta
      americana) and German (Blatella germanica) cockroaches in atopic asthmatics.
AB  - Forty-six atopic asthmatic subjects aged 3 to 58 years attending the allergy
      clinic of a university hospital were evaluated for prick skin test reactivity
      with commercially available extracts of cockroach (CCE) and house dust (HD).
      Additionally, skin testing was performed with American cockroach whole body
      (AWBE) and fecal extracts (AFE) as well as German cockroach whole body (GWBE) and
      fecal extracts (GFE) prepared in our laboratory. Commercial cockroach extract was
      prepared from American, German, and Oriental cockroach whole bodies. Skin test
      reactivity to the different extracts were as follows: 83% to HD, 70% to CCE, 70%
      to AWBE and/or GWBE, 63% to AWBE, 57% to GWBE, 63% to AFE and/or GFE, 52% to AFE,
      50% to GFE, 48% to both AWBE and GWBE, and 39% to both AFE and GFE. The subjects
      with positive skin tests to AWBE and/or GWBE (70%) were the same individuals who
      showed skin test reactivity to CCE (70%). Subjects from lower income families
      (less than $10,000) had a significantly higher skin test reactivity to cockroach
      allergens than those from families with an annual income of $11,000 to $24,000 (P
      = .04). These results demonstrate the significance of cockroach sensitization in
      atopic asthmatics, suggest the importance of fecal cockroach allergens, and
      support earlier observations of shared interspecies allergens between American
      and German cockroach whole bodies.

PMID- 1750719
TI  - Outcome of habit cough in children treated with a brief session of suggestion
      therapy.
AB  - Nine patients with habit cough, initially misdiagnosed as asthma, were treated
      during a period of sustained repetitive symptoms with a brief session of
      suggestion therapy. Symptoms had previously been present for up to 2 years
      (median = 2 months). Five had been hospitalized for the cough. Evaluation
      revealed no physiologic or radiologic abnormality. All patients became symptom
      free during a 15-minute session of suggestion therapy. During the subsequent
      week, one remained completely asymptomatic and 8 had transient minor relapses
      that were readily self-controlled. Seven of the 9 could be contacted for
      determination of long-term outcome at periods up to 9 years (median 2.2 years)
      after the session. Six were totally asymptomatic; one had occasional minor self
      controlled symptoms. A standardized questionnaire assessing psychologic symptoms
      at the time of follow-up revealed no somatization nor emotional distress. In
      contrast to this apparent cure, others have reported extended periods of
      continued symptoms in the absence of a uniform treatment plan for suggestion
      therapy even though the correct diagnosis was made. We conclude that the
      classical habit cough syndrome is amenable to immediate relief and long-term cure
      in most cases with a single session of appropriate suggestion therapy.

PMID- 1750720
TI  - Repeated dosing of Uniphyl tablets under fed and fasting conditions: comparison
      of serum theophylline levels, pulmonary function, and asthma symptoms.
AB  - In order to determine the effects of repeated administration under fed and
      fasting conditions on the bioavailability and clinical efficacy of Uniphyl
      tablets, 22 adult asthmatics took the drug immediately following their evening
      meal for seven consecutive days and under fasting conditions for an additional
      seven consecutive days. For each patient, the daily theophylline dose remained
      constant throughout the study. Peak and trough serum theophylline concentrations
      (STC), spirometry, asthma symptoms, side effects and use of beta-agonist inhalers
      were recorded daily at 0730 and 1900 hours. The mean daily theophylline dose was
      818.2 +/- 213.0 mg. The mean peak STC when Uniphyl was taken with food was 14.4
      +/- 4.5 mg/L and was 13.1 +/- 3.6 mg/L when taken under fasting conditions (P
      less than .05). The trough STC was 7.4 +/- 2.8 mg/L with food and 6.9 +/- 2.1
      mg/L while fasting (NS). There were no significant differences between the two
      dosing conditions in terms of spirometry, asthma symptom scores, side effects or
      use of beta-agonist inhalers. There was no significant difference between the
      patients' morning and evening FEV1 under either dosing condition. Since the
      differences in STC between fed and fasting conditions were not clinically
      significant, we conclude that there is no need to restrict patients to a rigid
      relationship between Uniphyl dosing and meal conditions. On the basis of patient
      preference and compatibility with a normal lifestyle, we recommend that patients
      should generally be instructed to take the drug with or shortly following their
      evening meal.

PMID- 1750721
TI  - Intranasal treatment with lysine acetylsalicylate in patients with nasal
      polyposis.
AB  - Forty-three patients suffering from nasal polyposis underwent intranasal
      treatment with increasing doses of lysine acetylsalicylate (LAS) corresponding to
      20, 200, and 2000 micrograms of aspirin (ASA), until a maximal dose of 2000
      micrograms weekly was reached. The patients were divided in two groups: a group
      of 28 patients with ASA intolerance, including 20 with ASA triad, and a group of
      15 patients without ASA intolerance. The local treatment was usually started 1
      month after polypectomy and was well tolerated without side effects. A control
      group included 191 subjects with nasal polyposis, 130 of whom had ASA
      intolerance. After polypectomy the controls received no further medical
      treatment. Patients were examined every 3 months and radiographs of the paranasal
      sinuses were obtained every 6 months. After 24 months 34 of 43 patients (79.1%)
      treated with topical LAS had suffered no relapse of polyposis. Only 45 of 191
      control patients (23.6%) failed to relapse after 24 months (P less than .0001).
      Nine of 28 (32.1%) ASA-intolerant patients treated with LAS and 105 of the 130
      (80.77%) control subjects relapsed (P less than .0001). None of the 15 ASA
      tolerant patients treated with LAS relapsed, but 41 of the 61 (67.21%) nontreated
      control subjects relapsed (P less than .00001). These data indicate topical LAS
      is effective in preventing recurrence of nasal polyps after polypectomy.

PMID- 1750722
TI  - Evaluation of oral terfenadine for treatment of the common cold.
AB  - This study was a single center trial comparing the effects of the nonsedating
      antihistamine terfenadine, at a dose of 120 mg twice a day, with placebo in the
      treatment of rhinitis symptoms associated with the common cold. Forty-nine
      subjects were treated with terfenadine, 120 mg twice each day, and 48 subjects
      were treated with placebo twice each day for four or five days. Evaluations by
      both subjects and physicians suggest that terfenadine at 120 mg given twice daily
      marginally improved sneezing and total symptom scores at day 4. When comparing
      terfenadine to placebo, neither the symptoms nor signs of the common cold
      improved in a clinically or statistically significant manner. Terfenadine was
      well tolerated and had a low incidence of side effects. Terfenadine was found to
      be ineffective in the treatment of the signs and symptoms of the common cold.

PMID- 1750723
TI  - Etiologic significance of mosquito (Anopheles stephensi) in respiratory allergy
      in India.
AB  - The etiologic significance of Anopheles stephensi, a common mosquito species in
      Delhi, in respiratory allergic disorders was investigated. Intradermal (ID) tests
      with the mosquito whole body extract (WBE) were performed on 247 patients with
      bronchial asthma and/or rhinitis and 50 healthy nonallergic volunteers. Of these
      247 patients, 118 (47.8%) had positive (1+ to 4+) reactions including 72 (29.1%)
      with markedly positive (2+ to 4+) ID reactions. We did not observe any 2+ to 4+
      skin reactions in normal healthy volunteers, giving evidence for the specificity
      of markedly positive ID response. The skin test positivity was not influenced by
      various clinical characteristics (age at onset, duration and type of disease, and
      family history) of patients included in the study. The specificity of positive ID
      response was further supported by the results of mosquito RAST with the sera of
      14 patients. Ten of the 12 sera (83%) from patients with positive ID response to
      mosquito WBE were RAST positive. Sera from two patients with negative ID
      reactions were RAST negative. The bronchial provocation tests (BPTs) were
      uniformly negative in all five healthy volunteers and two patients showing
      negative ID responses to mosquito WBE, while the three patients showing 2+ to 4+
      responses gave positive BPTs. Our results suggest that mosquito-derived particles
      are important inhalant allergens in the etiology of IgE-mediated respiratory
      allergic disorders in India.

PMID- 1750724
TI  - Consistency of evaluators assessing inhaler technique.
AB  - Since correct inhaler technique is vital for maximum efficacy, the evaluation of
      technique in patients or health care professionals involved in education programs
      or research projects is essential. Inconsistency could lead to confused patients
      and inaccurate research findings. This study is the first to determine interrater
      consistency with assessing recitation and demonstration of inhaler technique and,
      if needed, was designed to improve consistency until 95% agreement was achieved.
      A checklist for correct inhaler technique was constructed by consolidating
      information from the literature and package inserts. Initially three evaluators
      were used, however, a fourth evaluator was added for the last two trials to
      create teams to improve consistency. Percent agreement, probability and kappa
      scores were calculated. Six trials evaluating inhaler technique of 56 health care
      professionals at five different sites, revisions of the checklist, and evaluator
      teams were required to increase overall percent agreement from 81% to 98%.
      Agreement increased substantially on the verbal component because of specific
      changes made in the checklist and the objective nature. Demonstration steps
      consistently had lower agreement than verbal steps. Agreement on the
      demonstration component was more difficult because of subjectivity involved in
      observing a subject actuate the inhaler at the correct time, inhale or exhale
      slowly, and hold one's breath. The relative rankings of percent agreement and
      kappa scores were the same, however, kappa scores allowed differentiation of
      agreement due to chance and ability. To achieve interrater consistency, training
      and practice are required. Interrater consistency should be achieved to ensure
      accurate reporting of research results on inhaler technique and education of
      patients.

PMID- 1750725
TI  - Association of cigarette smoking with elevated serum IgE levels in Hispanic
      Puerto Rican men.
AB  - Unexplained elevation of serum IgE concentrations occurs in cigarette-smoking
      Caucasian males from temperate zones. To determine whether race or geography
      might be factors, we measured serum IgE concentrations in 94 Puerto Rican
      Hispanic patients, including smokers and nonsmokers. Mean serum IgE levels were
      elevated in our total patient population compared with Caucasian Americans.
      Geometric mean IgE was significantly increased in total smokers (157 IU/mL)
      compared with nonsmokers (78 IU/mL) and in male smokers greater than age 55 years
      (335 IU/mL) compared with male nonsmokers (41 IU/mL). Serum IgE was not
      significantly increased in female smokers. Among patients older than 55 years,
      persistent elevation of serum IgE occurred in male smokers. Our findings in a
      Puerto Rican Hispanic population are similar to those in studies of Caucasian
      smokers in temperate zones.

PMID- 1750726
TI  - Interleukin 4-mediated induction of CD4+/CD8+ T cells during infancy.
AB  - Neonatal human CD4+ T cells will co-express CD8 on their surface following short
      term culture with interleukin 4 (IL-4). Adult T cells do not respond in this
      manner. In this study we examine this phenomenon as a function of age and
      determine that IL-4 responsiveness decreases with time to approach adult levels
      at about 2 years. This phenomenon may be relevant to the documented ability of
      neonatal CD4+ T cells to function as suppressors.

PMID- 1750727
TI  - Effect of terfenadine on nasal, eustachian tube, and pulmonary function after
      provocative intranasal histamine challenge.
AB  - Previous studies have documented that intranasal histamine challenge results in
      nasal and eustachian tube obstruction (ETO) in human volunteers. The purpose of
      the present study was to assess the effect of pretreatment with terfenadine, a
      nonsedating antihistamine on the pathophysiologic consequences of intranasal
      histamine challenge. Fifteen subjects with allergic rhinitis were challenged
      intranasally with saline and increasing histamine doses (0.01, 0.1, 0.5, 1.0,
      5.0, and 10.0 mg) before pretreatment (baseline) and after 1 week of pretreatment
      with terfenadine, 60 mg b.i.d., terfenadine, 120 mg b.i.d., and placebo. Nasal
      conductance as measured by posterior rhinomanometry showed a dose-dependent,
      monotonic decrease following sequential administration of the histamine
      solutions, but there were no apparent differences in the average responses among
      the four challenge sessions. The frequency of ETO after histamine challenge was
      decreased by pretreatment with both doses of terfenadine, although this was not
      significant. Histamine-induced sneezing and rhinorrhea, but not congestion, were
      significantly reduced by terfenadine pretreatment. There was no evidence of
      extension of the histamine effects to the lower airway. The results of the
      present study suggest that terfenadine, a nonsedating antihistamine, had a
      favorable effect on sneezing and rhinorrhea after provocative intranasal
      histamine challenge, but did not significantly attenuate the subjective or
      objective nasal and ET obstructive responses.

PMID- 1750728
TI  - Scale model studies of the transport of airborne pollutants on coalfaces.
AB  - Studies have been carried out to investigate airflows in coalmine models, with
      special regard to the transport of airborne pollutants, and to examine how they
      relate to what happens at full-scale in an actual underground mine. If such
      models can be shown to provide data representative of actual mine ventilation
      engineering, then they can provide cost-effective alternatives to full-scale
      investigations. The work set out in the first instance to identify the properties
      of: (a) the bulk airflow and associated transport of airborne pollutants along a
      longwall coalface; and (b) the transport of material out of regions that were
      partially enclosed or poorly ventilated (e.g. in the cutting zone, in headings).
      For the former, an appropriate quantity is the dispersivity of the coalface
      airflow, for the latter the mean retention time. Both quantities may be rendered
      non-dimensional with respect to dimensions characteristic of the system and to
      velocities of the airflow. Their behaviour in relation to a third dimensionless
      quantity, the flow Reynolds' number is also important. Experiments were
      performed, using smoke or dust tracers, to investigate how these properties are
      interrelated and how they scale between small-scale and full-scale systems. They
      were carried out in a 1/10-scale laboratory model, in a full-scale surface model,
      and underground in an actual coalmine. The basis of most of the experiments was
      the 'tracer decay' method, in which the transport properties of the aerodynamic
      system under investigation were determined from observations of the changes in
      tracer concentration with time immediately following the removal of the tracer
      source. During these experiments, the feasibility of using small-scale models to
      investigate ventilation problems was clearly indicated and preliminary scaling
      relationships which may be used as an initial basis for predicting the transport
      and local build-up of pollutants in mines were developed. It is expected that
      applications of the ideas and methodology described will be relevant to other
      industries.

PMID- 1750729
TI  - Inhalation anaesthetics--exposure and control during veterinary surgery.
AB  - Results are reported for air sampling surveys carried out by the Health and
      Safety Executive (HSE) in 14 veterinary surgeries. For all personnel the
      geometric mean (GM) time-weighted average (TWA) exposures to halothane and
      nitrous oxide over the working period were 2.6 ppm (range: less than 0.5 119 ppm)
      and 100 ppm (range: 14-1700 ppm), respectively. Since surgery rarely lasted for
      more than 4 h the corresponding GMs for 8-h TWAs were lower, being 1.3 ppm
      (range: less than 0.5-34 ppm) for halothane and 34 ppm (range: 5-530 ppm) for
      nitrous oxide. The GM exposures of veterinarians and nurses were very similar.
      The size of the practice and the use of scavenging were significant factors in
      determining personal exposures to inhalation anaesthetics: by comparison general
      ventilation had little effect. The results are compared with earlier data from
      human surgery, and previous studies of exposure to inhalation anaesthetics during
      veterinary surgery are briefly reviewed.

PMID- 1750730
TI  - Inflammatory response to particles in the rat lung: secretion of acid and neutral
      proteinases by bronchoalveolar leucocytes.
AB  - Leucocyte proteinases are considered to be central to the tissue damage that is
      associated with chronic inflammatory lung disease. Both acid and neutral
      proteinases have the ability to degrade connective tissue molecules and both may
      therefore play a part in tissue proteolysis in inflamed lungs. In this study we
      have used a rat model of lung inflammation to investigate levels of acid and
      neutral proteinase activity in the bronchoalveolar region of control and inflamed
      lungs. We assessed the ability of proteinases, secreted by resident and
      inflammatory bronchoalveolar leucocytes, to damage the connective tissue molecule
      fibronectin. Inflammatory bronchoalveolar leucocytes had greater ability to
      mediate connective tissue damage than had resident alveolar macrophages and the
      tissue proteolysis was mediated, in the main, by proteinases active at neutral
      rather than at acid pH. The increased secretion of proteinase by inflammatory
      leucocytes was dependent on in vivo stimulation: exposing resident or
      inflammatory bronchoalveolar leucocytes in vitro to particulate or soluble
      stimuli had no effect in increasing their ability to degrade fibronectin or
      secrete the inflammogenic proteinase, plasminogen activator. Thus, neutrophils in
      the bronchoalveolar region of the rat lung have proteolytic activity which is
      mediated largely by neutral proteinases.

PMID- 1750731
TI  - Levels of exposure to wood dust.
AB  - Surveys of exposure to inhalable dust have been carried out in two woodworking
      machine shops and five other woodworking shops where both manual and machine tool
      work is carried out. The Occupational Exposure Limits for wood dust were found to
      be frequently exceeded in some workshops. It is possible that the fraction of
      dust projected from woodworking machines towards the operator may have
      contributed both to measured dust concentrations and to exposure. Dust exposure
      may be reduced by careful attention to enclosure and ventilation, possibly using
      total enclosure at some machines. Emission of dust from portable orbital type
      sanding machines was considerably reduced by the use of low-volume high-velocity
      type extraction. It is suggested that suppliers of woodworking machines should
      provide data on dust emission to assist the user to manage better the
      introduction of new machines.

PMID- 1750732
TI  - An estimate of the rate at which crocidolite asbestos fibres are cleared from the
      lung.
AB  - The cumulative fibre exposure of 36 deceased persons who had been employed on
      crocidolite asbestos mines of the NW Cape was compared with their lung burden
      determined by fibre count by optical microscope. Allowance for the period which
      lapsed between date of last exposure and death revealed a lung clearance rate
      amounting to a half-life of about 6 years.

PMID- 1750733
TI  - Ocular findings associated with congenital X-linked ichthyosis.
AB  - Ichthyosis is frequently associated with ocular and extraocular signs. We present
      a case of X-linked ichthyosis associated with alterations of the anterior and
      posterior segments. A penetrating keratoplasty was done, and because of the
      patient's corneal alterations, we did a histopathologic study of the button by
      light and transmission electron microscopy.

PMID- 1750734
TI  - Severe allergic keratoconjunctivitis and erythema multiforme after a routine eye
      examination: discerning the cause.
AB  - Acute allergic dermatitis of the eyelids with keratoconjunctivitis is associated
      with a specific triggering factor. Therapy for the acute inflammation can
      complicate the search for such a factor if the process worsens. We report a case
      of acute contact dermatitis and keratoconjunctivitis after a routine eye
      examination to demonstrate the difficulty in evaluating such patients and the
      role of skin patch testing in determining the cause.

PMID- 1750735
TI  - Pigmented paravenous retinochoroidal atrophy in a 68-year-old man.
AB  - A 68-year-old man with patchy paravenous zones of retinal degeneration with bone
      spicule pigmentation OU was diagnosed as having pigmented paravenous
      retinochoroidal atrophy. We reviewed the literature and found 71 previously
      reported cases of this condition. Most of the affected individuals were young
      adults. By comparison, our patient was afflicted at a considerably older age.

PMID- 1750736
TI  - Ocular findings in cutaneous T-cell lymphoma.
AB  - Seventeen patients with cutaneous T-cell lymphoma undergoing an investigative
      treatment regimen using extracorporeal photochemotherapy underwent ophthalmologic
      examinations to investigate the ocular findings in this disease. The most
      frequent finding was seborrheic blepharoconjunctivitis, which was noted in 13 of
      17 patients. Other common lid findings included cicatricial ectropion,
      meibomianitis, chalazia, and madarosis. Corneal and conjunctival disease was also
      increased in this group of patients. The syndrome of cutaneous T-cell lymphoma
      has recently been redefined, and a discussion of the revised concept of this
      disease is included. Previous studies used the old definition of this disease and
      were limited to the subgroups of mycosis fungoides and Sezary syndrome, which
      comprise only one third of the cutaneous T-cell lymphoma population.

PMID- 1750737
TI  - Treatment for herpes zoster ophthalmicus: stellate ganglion block as a treatment
      for acute pain and prevention of postherpetic neuralgia.

PMID- 1750738
TI  - Tear lysozyme levels in contact lens wearers.
AB  - Tear lysozyme levels in various types of asymptomatic contact lens wearers were
      compared with those in age- and sex-matched healthy control subjects. We used a
      radial immunodiffusion technique, and the lysozyme levels were in the normal
      range in controls and contact lens wearers. A comparison of the tear lysozyme
      levels of 27 contact lens wearers (mean, 1.05 +/- 0.45 g/L) with 22 control
      subjects (mean, 0.84 +/- 0.39 g/L) was statistically significant (P less than
      .05). The mean tear lysozyme levels of rigid (1.12 +/- 0.54 g/L, P less than .05)
      and high water-content (1.20 +/- 0.43 g/L, P less than .03) contact lens wearers
      were increased in comparison with the control group. The tear lysozyme difference
      was significant (P less than .03) between high and low water-content (0.82 +/-
      0.20 g/L) contact lens users. Our study revealed that, although most of the
      contact lens wearers were asymptomatic and there was no pathologic sign of
      external ocular inflammation, a change in tear lysozymes was observed. Contact
      lens wear is irritating to the cornea and conjunctiva, and tear lysozyme
      physiology is disturbed most by high water-content contact lenses.

PMID- 1750739
TI  - Antibiotic responsive exophthalmos and lateral rectus paralysis.
AB  - Sinusitis is an unusual cause of exophthalmos in adults since the advent of
      antibiotics. Many periorbital complications of sinusitis have been described;
      however exophthalmos associated with apparent sixth cranial nerve palsy in the
      absence of ipsilateral sphenoidal sinusitis is a rare and, to our knowledge,
      unreported complication of sinusitis. We report such a case that was treated with
      oral antibiotics. We believe that sinusitis must always be considered in adults
      as a treatable cause of exophthalmos and various orbital complications from
      isolated lateral rectus paralysis to acute-onset, acquired Brown's syndrome.

PMID- 1750740
TI  - [The perinatal transmission of the hepatitis B virus in the Paris area].
AB  - HBsAg was detected in 152 pregnant women among 6,605 (2.3%) screened in the
      prenatal clinics of four hospitals representative of the Paris metropolitan area.
      In 98% of cases, HBsAg positivity indicated chronic HBV carrier status. Among
      patients born out of continental France (47% of screened women, 79% of positive
      women) relative risk of chronic infection was 6 in Asians, 5.5 in Africans, and 4
      in French women born in non-continental France. No significant difference in
      medical history was seen between HBsAg-positive and HBsAg-negative patients, in
      any of the birthplace groups. In women born out of continental France, number of
      children and crowding in the home were correlated with HBsAg-positivity; these
      correlations were not found in French women born in continental France. In non
      African, non-Asian women, screening on the basis of medical, social and familial
      criteria (simulated in this study) would not be effective. Routine screening for
      HBsAg in pregnancy is advocated. The cost of the prevention of each case of
      perinatally acquired chronic HBV infection by routine screening followed by
      prophylactic treatment of a risk neonates was estimated at 180,000 French Francs
      (35,000 dollars). This approach is the only means of preventing the long-term
      life-threatening complications of chronic HBV infection in the 600 neonates born
      each year in France to HBsAg-positive mothers.

PMID- 1750741
TI  - [Post-vaccinal hemi-convulsion hemiplegia syndrome].
AB  - An 18-month-old infant developed hemiseizure-hemiplegia syndrome following a
      booster dose of vaccine against diphtheria, pertussis, tetanus, and
      poliomyelitis. Clinical, CT scan, and electroencephalographic findings during the
      two-and-a-half-year follow-up are described. The timing of events and data from
      the literature suggest that hemiseizure-hemiplegia syndrome is related to post
      immunization hyperthermia rather than to direct neurologic toxicity of the
      vaccine.

PMID- 1750742
TI  - [Cerebral artery ischemia and neonatal convulsions].
AB  - A new case of neonatal seizures due to arterial ischemia is reported and the
      symptoms and prognosis of this condition are discussed. Arterial ischemia should
      be routinely considered in neonates who develop seizures a few days after an
      uneventful birth. Seizure recurrences exhibit unchanging features, in particular
      consistent focalization. The value of cerebral CT scan studies is underlined.
      Transfontanellar ultrasonography is not helpful in this condition. MRI may be
      especially informative for monitoring anatomical lesions over time and Doppler
      studies may be of value when performed at a very early stage. The outcome in the
      case reported herein and in previous reports is fairly favorable.

PMID- 1750743
TI  - [Cardiac involvement in mucopolysaccharidosis. Apropos of an echocardiographic
      study in 8 cases].
AB  - Of all the storage diseases, mucopolysaccharidosis is the one whose cardiac
      manifestations are probably the least well known. Clinical and above all
      echocardiographic findings of heart involvement were studied in 8 patients with
      mucopolysaccharidosis, including four with Hunter disease. The paucity of
      clinical manifestations was in sharp contrast with the highly informative
      echocardiographic results. Valvular dystrophy, usually of the left side of the
      heart, was the most common anomaly, with five patients affected. Whereas some
      valvular lesions had no consequences, others led to stenosis or incompetence.
      Asymmetrical hypertrophy of the septum was found in one patient. No patient had
      evidence suggestive of vascular involvement, in particular of the coronary
      arteries.

PMID- 1750744
TI  - [Examination of the prepuce in 511 nursery school children. The role of
      retraction technics].
AB  - The foreskin of 511 nursery school children was examined. Among the 500
      unoperated children, 69.4% had a freely retractable foreskin. Adhesions were
      found in 28% of children and phimosis in 2.6% (total proportion of children with
      phimosis including the operated cases was 4.5%). A negative history for forcible
      retraction was found in 63.6% of children; among these subjects, 64% had a freely
      retractile foreskin and 31.1% had adhesions, which were usually extensive. Among
      children who had undergone forcible retraction, 77.5% had a freely retractile
      foreskin and 22% had adhesions, which were minor in most instances (p less than
      0.001). The person who performed forcible retraction (the family physician in 54%
      of cases) and the age of the child at the time of forcible retraction were
      recorded. This retrospective study in a pediatric population of mean age 3 years
      7 months provides data on the outcome after forcible retraction. Mean age at
      forcible retraction was 13 months in 36.4% of patients. Among the 500 unoperated
      children, 204 (40.8%) were spontaneously free of foreskin adhesions.

PMID- 1750745
TI  - [An analytic study of cases of childhood diabetes in a pediatric department in
      Tunis].
AB  - Insulin-dependent diabetes mellitus is common in Tunisia. Eighty-six pediatric
      cases managed at the diabetes clinic of a department of pediatrics in Tunis from
      1979 through 1989 were studied. Relevant clinical and biological findings were
      abstracted from case-records. Admissions of patients with diabetes mellitus
      accounted for approximately 0.44% of admissions to the pediatric ward during the
      study period. Mean age of patients was 7 years. Sex ratio was 0.89. Polyuria with
      polydipsia and ketoacidosis were the two most common presenting manifestations.
      Mean blood glucose level at diagnosis was 22.44 mmol/l. Rate of consanguinity was
      48%. HLA typing studies demonstrated a high prevalence of DR3 and DR4 alleles and
      especially of simultaneous expression of both these alleles. Several factors are
      incriminated in the development of childhood insulin-dependent diabetes mellitus.

PMID- 1750746
TI  - [Value and limits of research on Mycoplasma hominis and Ureaplasma urealyticum in
      the gastric fluid of newborn infants].
AB  - Mycoplasma hominis and Ureaplasma urealyticum were cultured and counted in the
      gastric fluid of 153 neonates divided into three groups: 28 preterm neonates
      managed in an intensive care unit (Group I); 83 full term neonates with suspected
      infection (Group II); and 42 full term neonates with no evidence of infection
      (Group III). The colonization rate (17.85%) in the intensive care unit group was
      not significantly different from the rates seen in the two other groups. These
      results do not militate against the pathogenic role of the two organisms studied
      but rather suggest a contributory role of other factors.

PMID- 1750747
TI  - [The efficacy of smectite in acute infantile diarrhea, compared to a placebo and
      loperamide].
AB  - Fifty-six infants (aged 2 months to two years) with moderate to severe diarrhea
      were entered in a comparative therapeutic trial of smectite versus placebo or
      loperamide. Results showed that diarrhea resolved faster under smectite than
      under placebo and at least as fast under smectite as under loperamide. Tolerance
      of smectite is excellent as a result of the lack of any effect on intestinal
      motility.

PMID- 1750748
TI  - [Prevention of neonatal conjunctivitis. A comparative clinical and bacteriologic
      study of 2 eyedrops: silver nitrate and oxytetracycline chlorhydrate].
AB  - This study carried out at the Saint-Germain-en-Laye Hospital maternity ward
      included all the neonates delivered between February and September 1989 who
      exhibited no abnormal manifestations during their stay in the ward, except for
      ocular symptoms in some subjects. Nine hundred neonates were enrolled. Each day,
      one of two eyedrop preparations for the prevention of neonatal ocular infections
      was selected at random. Investigators were blinded to the preparation used. Study
      subjects were evaluated twice, between D1 and D7 (900 infants) and between D15
      and D30 (407 infants). Ocular findings were classified as follows: normal,
      minimally abnormal (isolated swelling of the eyelids, clear discharge), or
      frankly abnormal (conjunctivitis, purulent discharge). A bacteriologic study was
      performed in all patients with minimally abnormal or abnormal findings. Between
      D1 and D7, ocular symptoms were significantly (p less than 0.05) more prevalent
      in neonates treated with silver nitrate than in neonates treated with
      oxytetracycline hydrochloride. This difference was no longer present between D15
      and D30. Bacteriologic studies recovered no gonococci. One enfant in the
      oxytetracycline group had bacteriologically confirmed Chlamydia trachomatis
      ocular infection. The other organisms recovered were mainly Staphylococcus aureus
      and non-hemolytic streptococci. In inclusion, no currently available eyedrop
      preparation offers complete protection against C. trachomatis but tolerance is
      considerably better with oxytetracycline hydrochlorate than with silver nitrate.

PMID- 1750749
TI  - [Post-vaccinal hemi-convulsion hemiplegia syndrome].

PMID- 1750750
TI  - Measurement of growth variability and environmental quality in Guatemalan
      children.
AB  - The measurement of within-population growth variability may be a sensitive
      indicator of environmental quality. Specifically, it is hypothesized that within
      population variability will increase in adverse environments. To evaluate this
      hypothesis the variability in stature growth of three samples of Guatemala school
      children (5-10 years old) is assessed. These samples include high socioeconomic
      status (SES) ladinos (84 boys and 98 girls) and low SES ladinos (136 boys and 101
      girls) living in Guatemala City and very low SES Mayan Indians (139 boys and 73
      girls) living in a rural town near the city. SES is used as a proxy for
      environmental quality. The coefficient of variation (CV) for distance achieved at
      each age, or for the increment of growth from age to age, is used as the measure
      of variability. The three samples differ significantly for variability in stature
      growth, both for the distance and the increments of growth. Low SES urban ladinos
      have the largest variability. Very low SES Mayan children have coefficients of
      variation that are sometimes equal to, and sometimes either larger or smaller
      than, CVs for the high SES ladinos. The results show that degree of environmental
      adversity does not correlate uniformly with growth variability. Factors such as
      rates of infant and early childhood mortality and the greater heterogeneity of
      the low SES urban environment, compared with the high SES urban or low SES rural
      environments, may account for differences in the CV in these three samples.

PMID- 1750751
TI  - Population genetics of abnormal haemoglobins in Burkina Faso, west Africa.
AB  - The gene frequencies of haemoglobin A (HbA), HbS and HbC were studied in Burkina
      Faso (BF) and in a neighbouring region of Niger, Ayorou. The frequency of HbS was
      higher in the Sahel region, (northern part of BF and Ayorou) than in the Savanna
      region. The reverse was true for the HbC gene. The major findings of this study
      are: (a) confirmation of a peak of HbC gene frequency in the central region of BF
      (Mossi plateau); (b) a possible negative correlation between the frequencies of
      HbS and HbC-Cavalli-Sforza and Bodmer have observed that this correlation is at a
      significantly different level from that expected because of the allelic
      relationship between HbS and HbC; (c) comparison with the data collected by
      Livingstone shows a modification in the fitness of the different genotypes in the
      last thirty years: AS individuals have a lower and AA and SS a higher fitness.
      Our data favour a partial selection relaxation in this region.

PMID- 1750752
TI  - Tempo-unconditional 1-year bone score velocities in well-off north-west Indian
      children.
AB  - Tempo-unconditional 1-year bone maturity score velocities in well-off 6-16 year
      old North-west Indian children from Chandigarh (245 boys and 238 girls) are
      presented for the first time using the TW2 system. Rater's
      replicability/comparability was high. The peak RUS bone maturity score velocity
      is reached at 13 years in girls and at 15 years in boys, maintaining a standard 2
      year difference. Velocities of the three bone maturity scores are relatively
      larger, but their respective standard deviations are smaller than those reported
      for American whites and blacks. North-west Indian children seem to be maturing
      faster than the British standards.

PMID- 1750753
TI  - Longitudinal analysis of incomplete adolescent data.
AB  - An approach is illustrated for the analysis of longitudinal variables collected
      during adolescence. Since the method requires complete data, three techniques are
      compared for application when some individuals have missing values. These methods
      are implemented in a study of systolic blood pressures and dietary fat intakes
      collected longitudinally in adolescent girls. The value of adolescent systolic
      and fat variables in predicting systolic pressure in adult women is investigated.

PMID- 1750754
TI  - Anthropometric-hormonal correlation patterns in San and Kavango males from
      Namibia.
AB  - Correlations between sex hormone levels and body dimensions--so far investigated
      only in Caucasian populations--were analysed using data from 114 !Kung San hunter
      gatherers and 137 urban and rural Kavango men from Namibia. The androgens
      testosterone (Tser) and 5 alpha-dihydrotestosterone (DHT) in the serum and free
      testosterone in the saliva (Tsal) as well as oestradiol (E2) in the serum were
      determined by the radioimmunoassay method. The body dimensions were described by
      50 anthropometric features which were additionally subjected to factor analysis
      yielding seven factors. Most of the individual measurements as well as the
      resulting factor scores correlated significantly with the sex hormone variables
      and the hormone ratios Tser/DHT, Tsal/Tser, and Tser/E2 in the !Kung San and the
      two Kavango samples. For an extended comparison pertinent data from a German
      sample were included in the analysis. This made it possible to test the stability
      of metric hormonal correlations in different populations living under various
      ecological and economical conditions. While the breadth measurements in all
      samples show relatively consistent correlations to both absolute hormones and
      hormone ratios, the correlations to the other body measurements and individual
      factor scores turn out to be less stable. Here, the effect of sex hormones on
      physical growth, which is experimentally well documented, is obviously
      differentially covered by genetic and environmental factors specific for the
      groups in question.

PMID- 1750755
TI  - Physical growth of children treated for phenylketonuria.
AB  - The growth of 133 children participating in the Collaborative Study of Children
      Treated for Phenylketonuria (PKU) was compared to growth data from the National
      Center for Health Statistics (NCHS) to determine whether the growth patterns of
      the children with PKU were the same as those of unaffected children. Height and
      weight by age, and weight by height, were analysed for ages 2-10 years. Head
      circumference by age was analysed for ages 2-7 years. Median height by age of the
      PKU children was consistently near the 50th percentile of the NCHS growth curves
      for males and females. However, for both sexes, median weight by height and by
      age was between the 50th and 75th percentiles for children over 3 years old. Two
      sample t-tests showed mean weight was significantly different (p less than 0.05)
      between the PKU and NCHS groups at most ages for both sexes. Median head
      circumference for the PKU children tended to be smaller than NCHS standards;
      however, the maximum difference at any age was less than 0.5 cm. Polynomial
      growth curves fitted to the PKU and NCHS growth data showed that, on average, the
      PKU males and females weighed more than their unaffected counterparts, while
      height and head circumference for both groups were very close. Including median
      serum phenylalanine (phe) level (mg/dl) in the growth curves suggested that the
      weight differences between the PKU and NCHS groups are related to degree of diet
      adherence. Higher phe levels in the PKU group were associated with higher weight
      levels, more so for girls (p less than 0.001) than for boys (p = 0.08). No
      relationship was found between phe level and height or head circumference. We
      conclude that growth in children treated for PKU differs from national standards
      for weight by age and weight by height, but not for height by age. We speculate
      that diet adherence may be an important factor in determining which children have
      a tendency to become overweight.

PMID- 1750756
TI  - Cerebral blood flow velocity changes after rapid administration of surfactant.
AB  - A computer linked Doppler system was used to make continuous measurements of
      cerebral blood flow velocity (CBFV) from the middle cerebral artery, mean
      arterial blood pressure (MAP) from the umbilical artery, and heart rate before,
      during, and for 20 minutes after the endotracheal administration of 200 mg/kg of
      porcine surfactant in 10 preterm infants with respiratory distress syndrome.
      Within two minutes of surfactant administration, there was a median fall of 6 mm
      Hg (15%) fall in MAP and 36% in CBFV. There was a change in the Doppler spectra
      with almost complete loss of diastolic velocities. A rapid reduction in pulmonary
      vascular resistance with consequent left to right ductal shunting is one possible
      cause. These acute changes in MAP and CBFV after bolus surfactant administration
      may increase the risk of intraventricular haemorrhage.

PMID- 1750757
TI  - Hypocapnia and cerebral ischaemia in hypotensive newborn piglets.
AB  - This study tested the hypothesis that hypocapnia superimposed upon hypotension
      produces a further reduction in cerebral blood flow velocity (CBFV). In 12
      newborn piglets, CBFV was measured continuously by Doppler ultrasound through an
      artificial fontanelle. Hypotension was induced by removing 30 ml/kg of blood.
      Increasing the ventilator rate reduced the average arterial carbon dioxide
      tension from 5.5 to 2.0 kPa. When mean arterial pressure (MAP) was held steady at
      45 mm Hg or above, hypocapnia produced a substantial drop in CBFV but, in all the
      piglets with MAP below 38 mm Hg, hypocapnia failed to change CBFV by 10%.
      Hypocapnia produced an increase in lactate in sagittal sinus blood but cerebral
      venous hypoxanthine concentrations were not affected by hypocapnia.
      Hyperventilation (without haemorrhage) produced a significant drop in MAP,
      preventable by infusing colloid. Hypocapnia itself does not further reduce CBFV
      in the hypotensive piglet. However, the pressure effect of hyperventilation may
      significantly impair the cerebral circulation.

PMID- 1750758
TI  - Effects of intrauterine growth retardation on postnatal visceral and cerebral
      blood flow velocity.
AB  - Blood flow velocity and pulsatility index were measured with Doppler ultrasound
      in the superior mesenteric artery, coeliac axis, and anterior cerebral artery in
      18 very low birth weight, small for gestational age infants, and compared with
      findings from 18 weight matched, and 18 gestation matched, appropriate for
      gestational age controls. Mean velocity in the superior mesenteric artery was
      lower in the small for gestational age infants (15 cm/s) than in the gestation
      matched control group (20.4 cm/s). In those small for gestational age infants who
      had evidence of fetal hypoxia the mean velocity in the superior mesenteric artery
      was even lower (11.5 cm/s). There were no differences in velocity in the cerebral
      artery among the groups. Infants who were small for gestational age still had
      significantly lower superior mesenteric artery velocity than gestation matched
      controls at 1 week of age. The results suggest a specific reduction in visceral
      perfusion in infants who are small for gestational age and who have experienced
      fetal hypoxia, and this could predispose these infants to necrotising
      enterocolitis.

PMID- 1750759
TI  - Global and depth resolved phosphorus magnetic resonance spectroscopy to predict
      outcome after birth asphyxia.
AB  - Twelve normal and 32 asphyxiated neonates were studied using global and depth
      resolved phosphorus magnetic resonance spectroscopy (31PMRS). Eight of the
      asphyxiated group died or survived with major neurodevelopmental abnormalities. A
      global phosphocreatinine/inorganic phosphate (PCr/Pi) ratio below the range of
      values from normal infants predicted adverse outcome after asphyxia with a
      positive predictive value of 64%, sensitivity 88%, and specificity 83%.
      Corresponding values for global inorganic orthophosphate/adenosine triphosphate
      (Pi/ATP) ratios were positive predictive value 88%, sensitivity 96%, and
      specificity 88%. Spatially localised MRS data, obtained using phase modulated
      rotating frame imaging, showed cerebral energy metabolism to be more abnormal in
      deep than superficial regions after birth asphyxia. However, in this population
      of full term infants none of the regional metabolite concentrations were superior
      to global data for prediction of outcome.

PMID- 1750760
TI  - Otoacoustic emissions and auditory brainstem responses in the newborn.
AB  - The auditory function of 370 infants, drawn from both low and high risk groups,
      was tested before postnatal discharge using three tests: standard auditory brain
      stem responses (ABR), automated analysis of ABR, and automated analysis of evoked
      otoacoustic emissions (OAE). All infants failing any neonatal test had further
      audiological evaluation. Follow up information was also available on those who
      passed neonatal tests. Automated OAE testing of both ears was quickest (median
      12.5 minutes) and least invasive (no scalp electrodes). Bilateral failure rates
      (and upper 95% confidence limits) with a stimulus 35-36 dB above normal hearing
      threshold level (nHL) were 3.0% (4.6) with automated OAE, 3.2% (5.1) with ABR,
      and 2.7% (4.4) with automated ABR. Automated OAE was the test most sensitive for
      subsequently confirmed hearing impairment. Sequential testing with automated OAE
      followed, in those failing this test, by automated ABR would have provided a
      screening test for substantial hearing impairment with a specificity greater than
      99% in this population. Possible application as a universal screen is discussed.

PMID- 1750761
TI  - Neonatal at risk screening and the identification of deafness.
AB  - From a cohort of 10,686 live births, 322 (3%) were identified as being at risk of
      a hearing impairment defined as moderate, or worse. These neonates were screened
      by measurement of auditory brainstem responses. The neonatal at risk screening
      programme was effective in terms of both yield and cost. The mean age at which
      hearing aids were fitted was 6 months in the children identified by the neonatal
      screen. Such a programme is both practicable and useful in a district general
      hospital. The yield from the neonatal programme was, however, only 43% of the
      total number of deaf children eventually identified from the cohort. The need to
      identify more deaf children by a sensitive infant distraction test screening
      programme remains.

PMID- 1750762
TI  - Impact of sleep and movement on gastro-oesophageal reflux in healthy, newborn
      infants.
AB  - Seventy four normal, healthy newborn babies were studied to examine the
      relationship between gastro-oesophageal reflux, sleep state, and movement.
      Multichannel pen recordings were made to determine sleep state, movement,
      breathing, and reflux. The mean number of reflux episodes per hour was highest in
      wakefulness, followed by active and indeterminate sleep. In quiet sleep reflux
      rarely occurred. The mean duration of reflux episodes per hour was longest in
      active sleep followed by wakefulness, indeterminate and quiet sleep. There was a
      strong positive correlation between duration of reflux and movement time for
      wakefulness, active and indeterminate sleep. Movement preceded 88% of all reflux
      episodes. Physiological reflux occurs in most newborn infants but is clinically
      inapparent. The results suggest that state and movement are related to the
      incidence and duration of reflux. Sleep state is therefore an important variable
      in determining normal values for reflux in infancy since developmentally the
      amount of sleep time lessens but quiet sleep proportionally increases.

PMID- 1750763
TI  - Patient triggered ventilation using a flow triggered system.
AB  - The role of patient triggered ventilation (PTV) for the newborn was assessed
      using a new patient triggered ventilator, the Draeger Bablylog 8000, which
      incorporates significant improvements in both ventilator performance and the
      triggering system. Thirty three infants, median gestational age 30 weeks and
      postnatal age 2.5 days, were entered into the study to compare blood gases
      obtained during conventional and patient triggered ventilation. Oxygenation did
      not improve with PTV in the group overall but increased significantly (median
      change 7%) in infants greater than 28 weeks' gestation. Arterial carbon dioxide
      tension (PaCO2) decreased during PTV in the majority of infants (median reduction
      7%), this was not related to the gestational or postnatal age, but was greatest
      in infants previously on a low conventional ventilation rate. Blood gases (both
      PaO2 and PaCO2) deteriorated in infants requiring the highest inspired oxygen
      concentration. We conclude that patient triggered ventilation is most useful in
      infants with mild respiratory distress.

PMID- 1750764
TI  - Cardiac anomalies complicating congenital contractural arachnodactyly.
AB  - A newborn boy with congenital contractural arachnodactyly (CCA) was found to have
      an atrial septal defect, ventricular septal defect, patent ductus arteriosus, and
      aortic arch anomalies. These resulted in congestive failure but subsequent
      progressive dilatation of both great arteries and development of aortic
      regurgitation were associated with eventual cardiorespiratory failure and death
      at 11.5 months. Others have noted that cardiac anomalies in CCA may be comparable
      with those of infantile Marfan's syndrome. Our case further extends the spectrum
      of cardiac abnormalities in CCA and substantiates that there is overlap with
      infantile Marfan's syndrome. This fact and our literature review suggest that
      early and complete cardiac assessment is necessary for appropriate management and
      evaluation of prognosis in any newborn infant with findings suggestive of either
      condition.

PMID- 1750765
TI  - Amniotic fluid N-acetyl-beta-D-glucosaminidase activity and renal abnormalities.
AB  - Amniotic fluid N-acetyl-beta-D-glucosaminidase (NAG) activity was measured in 21
      normal pregnancies to determine reference values, and in 10 pregnancies with
      fetuses who had prenatally recognised renal and urinary tract malformations. The
      normal values obtained at 17-19 and 28-31 gestational weeks did not differ, and
      an activity of 105 units NAG/mmol creatinine was the upper limit of the normal
      range. Raised NAG activities were found in four fetuses with oligohydramnios and
      severe bilateral renal disease, and also in two infants with a normal amount of
      amniotic fluid, only unilateral renal lesions, and a normal renal function after
      birth. Three of four cases with normal NAG activities had malformations without
      kidney damage, but one baby with prune belly syndrome was subsequently found to
      have dysplastic kidneys and renal failure. Our preliminary results suggest that a
      high level of NAG activity in the amniotic fluid indicates unilateral or
      bilateral kidney damage but is not proof of intrauterine renal failure.

PMID- 1750766
TI  - Factors influencing plasma renin and renin substrate in premature infants.
AB  - Concentrations of plasma renin (PRC) and plasma renin substrate (PRS) were
      measured during the first week of life in 52 infants born at less than 37 weeks'
      gestation (mean (SEM) gestation 30 (0.4) weeks, mean (SEM) birth weight 1.35
      (0.08) kg). Both PRC (median 35, interquartiles 16.3, 94.5 ng/ml/hour) and PRS
      (median 2.3, interquartiles 1.3, 5.0 micrograms/ml) were raised compared with
      adults. The proportional rise in PRC was much greater than that in PRS,
      suggesting that PRS may be rate limiting in the generation of angiotensin I.
      Log10 PRC was inversely proportional to gestational age and a high urinary sodium
      loss was associated with a significantly raised log10 PRC. In hypoxaemic infants,
      there was a strong correlation between log10 PRS and haemoglobin concentration;
      this is a new observation in human infants but consistent with data available
      from other species.

PMID- 1750767
TI  - Diamorphine infusion in the preterm neonate.
AB  - The effects of diamorphine were studied in 34 premature neonates who were given a
      loading dose of 50 micrograms/kg of diamorphine followed by a constant rate
      intravenous infusion of 15 micrograms/kg/hour. Small but significant falls were
      noted in blood pressure (at 30 minutes) and heart rate (at 30 minutes, six hours,
      and 12 hours) after administration of diamorphine, but these did not appear to
      cause any clinical deterioration and were thought to be related to the sedative
      effect of the drug. A significant fall in respiration rate at 30 and 60 minutes
      reflected the desired intention to encourage synchronisation of the infants'
      breathing with the ventilator. The mean (SD) plasma concentration of morphine
      measured during the infusion at steady state was 62.5 (22.8) ng/ml (range 20 to
      98 ng/ml). The data suggest that this dosage regimen of diamorphine is safe. It
      results in plasma concentrations of morphine in the premature neonate which are
      comparable with those that are known to provide effective analgesia in the child
      and adult.

PMID- 1750768
TI  - Imaging of neonatal arterial thrombosis.
AB  - The case of a neonate who presented with symptoms of upper limb ischemia related
      to spontaneous multiple arterial and venous thromboses that were demonstrated by
      colour Doppler sonography and digital subtracted angiography is reported. The
      presentation of limb ischaemia at birth may be the warning sign of simultaneous
      cerebral infarction.

PMID- 1750769
TI  - Intermittent fetal tachycardia and fetal hydrops.
AB  - A case is reported where fetal hydrops was noted 10 days after an initial
      observation of intermittent fetal tachycardia at 31 weeks. A diagnosis of
      supraventricular tachycardia was made and a successful conversion to sinus rhythm
      was achieved with maternally administered flecainide, with subsequent resolution
      of the hydrops. The fetus required no further treatment in pregnancy or at follow
      up. The mother suffered no side effects of the treatment.

PMID- 1750770
TI  - Family implications of neonatal Gorlin's syndrome.
AB  - Two very preterm infants (born at 29 and 25 weeks, respectively) were found to
      have abnormal ribs. Though this was thought unimportant at the time, it was
      subsequently shown to indicate that some members of their families had a
      dominantly inherited risk of developing skin cancer and other serious problems.

PMID- 1750771
TI  - Gastroduodenal perforation in preterm babies treated with dexamethasone for
      bronchopulmonary dysplasia.
AB  - Three cases of gastroduodenal perforation and one case of ulceration and extreme
      thinning of the gastric wall occurred in preterm babies treated with
      dexamethasone for bronchopulmonary dysplasia. This complication of treatment with
      steroids has not to our knowledge previously been described in preterm infants.
      Urgent abdominal paracentesis was an essential part of the resuscitation in these
      cases, and this potentially serious side effect should be considered in all
      babies treated with steroids.

PMID- 1750772
TI  - Premature labour.

PMID- 1750773
TI  - Dr Nils Rosen (1706-1773): the father of paediatrics in Sweden.

PMID- 1750774
TI  - Beyond the walls.

PMID- 1750775
TI  - Psychobiology and psychiatric nursing: a philosophical matrix.
AB  - Over the past several years, conceptualizations of the mind have been challenged
      by a knowledge explosion in the psychobiological sciences. Such new knowledge
      continues to fuel a paradigm shift in psychiatry away from traditional
      psychodynamic models of the mind and toward ones balanced with a psychobiological
      dimension. The combination of psychodynamic and psychobiological fields of
      knowledge offers an opportunity for a holistic perspective on the human
      experience. Psychiatric nursing faces the challenge of integrating this new
      knowledge for the enrichment of its practice. To accomplish this complex task,
      issues need to be addressed in many areas critical to psychiatric nursing. Three
      areas are discussed in this article and include philosophy, communication of
      philosophy, and testing of philosophy. This article concludes with a discussion
      of some potential mechanisms to deal with the tensions generated by a paradigm
      shift in psychiatric nursing.

PMID- 1750776
TI  - A model of clinical judgment processes in psychiatric nursing.
AB  - This study addressed judgment processes in psychiatric nursing by analyzing
      reported use of clinical cues cited as being relevant in the process of making a
      nursing judgment. Using an exploratory, qualitative approach, data were collected
      by interviewing 15 subjects who provided 36 in-depth interviews upon completion
      of an intake interview. Comparative content analysis was used to determine the
      underlying structure in subject reports. A model depicting judgment processes is
      presented and discussed. Results suggest that although judgments were highly
      context-dependent, all subjects assessed data labeled as universals in the
      psychiatric nursing assessment: suicidality, depression, drug and alcohol use,
      and patient functional abilities. Similarities among subjects were noted in that
      presenting behaviors were most salient, a categorization process occurs within
      the judgment process, and patients are included in the judgment process. Finally,
      nursing judgments uncovered an action orientation rather than a labeling
      function.

PMID- 1750777
TI  - Adolescents' attitudes toward mental illness and perceived sources of their
      attitudes: an examination of pilot data.
AB  - This exploratory descriptive pilot study examined the attitudes of 89 Floridian
      adolescents toward mental illness and found significant differences according to
      gender and education about mental illness. Responses to social distance items
      showed that adolescents tended to be less accepting as they were proposed
      relationships that suggested greater intimacy with the mentally ill. The mass
      media, personal experience with someone who had a mental illness, and parents
      were perceived by the adolescents as the most important sources of their
      attitudes. The major implications for nursing practice with adolescents, and
      particularly in the school system, are discussed with suggested interventions.

PMID- 1750778
TI  - Correlates of disruptive behavior in cognitively impaired elderly nursing home
      residents.
AB  - Disruptive behavior, resulting in negative consequences for both residents and
      caregivers, occurs in a large proportion of the nursing home population. This
      review of literature surveys studies that describe disruptive behavior and the
      correlates of this behavior in the cognitively impaired elderly. In the studies
      reviewed, the average prevalence of reported disruptive behavior among a total of
      5,650 subjects was 42.8%. Correlates most frequently linked with disruptive
      behavior include cognitive status, functional ability, age, and premorbid
      personality. Suggestions for future research are discussed.

PMID- 1750779
TI  - The effects of reminiscence on psychological measures of ego integrity in elderly
      nursing home residents.
AB  - The purpose of this study was to investigate the efficacy of a reminiscence group
      to increase ego integrity in elderly nursing home residents. Erickson's
      developmental theory and Butler's theory of reminiscence provided the theoretical
      framework for the study. It was hypothesized that reminiscing would increase life
      satisfaction, self-esteem, and decrease depression. Fifty-four nursing home
      residents were randomly assigned to a reminiscence group or a control group. No
      statistically significant relationship was found between reminiscing and life
      satisfaction, depression, or self-esteem; however, results indicated there was a
      positive socializing effect for those who participated in the group process.

PMID- 1750780
TI  - Current treatment approaches to obsessive-compulsive disorder.
AB  - The two most useful treatments in obsessive-compulsive disorder are
      pharmacotherapy with potent serotonin reuptake-blocking agents and behavioral
      techniques, such as exposure and response prevention. Based on the authors'
      cumulative clinical experience, it is suggested that patient education, cognitive
      therapy, and psychodynamic psychotherapy are helpful adjuncts during various
      treatment stages of obsessive-compulsive disorder. The patient's strengths and
      knowledge of the illness can be used by the nurse-therapist to determine the
      implementation and timing of these therapeutic measures. Specific behavioral and
      cognitive techniques that may be useful in treating specific symptoms of
      obsessive-compulsive disorder are highlighted. Suggestions for future nursing
      research are outlined.

PMID- 1750781
TI  - Lance: a gay recovering alcoholic misdiagnosed as HIV-positive.
AB  - Lance is a 29-year-old gay alcoholic who was misdiagnosed as human
      immunodeficiency virus (HIV)-positive. In reaction to the diagnosis, Lance
      subsequently engaged in a series of destructive behaviors towards himself and
      others. When he was told that his diagnosis was in error, Lance was able to break
      out of his self-destructive cycle. This article explores the symbolic
      interactionist concepts of definition of the situation and of stigma and provides
      nursing implications for caring for people with HIV infection and the acquired
      immune deficiency syndrome.

PMID- 1750782
TI  - Literature: a vehicle for emotional connection between clinician and client.
AB  - Nurses have used literature in a variety of ways to increase understanding of the
      problems and dilemmas of their patients. Literature can be used in psychotherapy
      when a patient either selects a literary work to discuss or writes his or her own
      work. Incorporation of literature into psychotherapy offers opportunities for
      discussion that yield important information about the patient as he or she
      explores conscious and unconscious issues.

PMID- 1750783
TI  - The future of our profession from the eyes of today.

PMID- 1750784
TI  - Vascular access thrombosis in epoetin alfa therapy.

PMID- 1750785
TI  - The development of the nephrology nursing certification program.
AB  - The certification examination for nephrology nurses was developed by the
      Nephrology Nursing Certification Board (NNCB) and the ANNA Certification Ad Hoc
      Committee with guidance from the National League for Nursing (NLN) Test Services.
      The development of a written examination is the continuing responsibility of the
      NNCB. This article provides a summary of the 3 years experience with the
      examination and focuses on the process of actual test construction: the
      organization, development, evaluation, and quality of test items.

PMID- 1750786
TI  - Self-administration of epoetin beta by peritoneal dialysis patients.
AB  - Recombinant human erythropoietin (epoetin) reverses the anemia of end stage renal
      disease. Benefits have been evaluated primarily in hemodialysis patients because
      of the ease of administration via existing intravenous access. Studies are under
      way to evaluate the feasibility of subcutaneous self-administration of epoetin in
      continuous ambulatory peritoneal dialysis (CAPD) patients. Preliminary study
      results, using the maintenance of target hemoglobin levels to measure success and
      a case study demonstrate the practicality of subcutaneous self-administration of
      epoetin in CAPD patients.

PMID- 1750787
TI  - "If I only knew:" a patient education program on advance directives.
AB  - This article describes a unique renal patient education program on advance
      directives. It explains why the program was developed, the components of the
      program and their use, and the effects of the program. It is argued that programs
      like this one are needed to provide patients with reliable information about
      advance directives in a sensitive, time efficient manner.

PMID- 1750788
TI  - The synthetic axillofemoral graft for hemodialysis access.
AB  - Patients who have exhausted all options for conventional dialysis access due to
      lack of available vessels may be candidates for placement of a synthetic
      axillofemoral vascular graft. The axillofemoral access is surgically constructed
      under general anesthesia. The synthetic graft is anastomosed, end to side, to the
      axillary artery, proximally, and distally to the common femoral vein. Surgical
      complications have been negligible and intravascular blood flow rates support
      efficient dialysis. A review of two cases demonstrates the positive outcomes and
      acceptability of this nonconventional approach for blood access in hemodialysis
      patients.

PMID- 1750789
TI  - A care plan for self-administration of epoetin alfa.
AB  - A care plan was developed to assist nephrology nurses managing the care of
      patients self-administering epoetin alfa. This is a generic care plan intended to
      serve as a basis for communication and should be adapted for appropriateness to
      individual facilities.

PMID- 1750790
TI  - Documentation related to Epogen administration.

PMID- 1750791
TI  - Case study: end stage liver failure patient managed with CAVH pretransplant.
AB  - The patient met 4 of the 5 expected outcomes. Effective therapy with CAVH was
      maintained in the ICU setting and in the operating room. The catheters functioned
      throughout the entire treatment without signs or symptoms of infection, bleeding,
      or thrombosis. She received hyperalimentation, filtration replacement fluid, and
      adequate fluid boluses to maintain volume status, nutritional requirements and
      vital signs. Cardiac vasopressor medications were required for a short period.
      The one problem that did occur was related to the anticoagulation therapy. The
      PTT was checked every 4 hours and the heparin drip was titrated to keep the PTT
      at 50 to 60 seconds. At one point, the PTT was 92 seconds but immediate measures
      were undertaken to reverse the condition. In the situation where a patient has an
      underlying coagulopathy and a potential source of bleeding, the nursing
      recommendation is that hourly bedside ACTs with every 4 hour PTTs should be
      performed as a routine part of the care. CRRT has been used successfully in
      critically ill unstable patients with multiorgan involvement. These therapies
      provide an avenue for collaboration between nursing professionals in nephrology
      and critical care. The focus of CRRT can now progress from the technical aspects
      of the procedures to patient centered nursing issues.

PMID- 1750792
TI  - Medication review: fluconazole.
AB  - Fluconazole is an antifungal agent available for the treatment of oropharyngeal
      and esophageal candida and cryptococcal meningitis. It has been found to be equal
      to or more efficacious than amphotericin B in treating oral and esophageal
      candidiasis and in providing maintenance therapy for cryptococcal meningitis. It
      still remains to be seen if it can be equally effective in treating acute
      cryptococcal infections and systemic candidiasis. In these fungal infections,
      amphotericin B remains the clinically proven drug of choice. To its advantage, it
      does not cause acute renal failure, bone marrow depression, or suppress
      corticosteroid production which are significant drawbacks to other available
      agents. It is a drug with great promise for its specific indications, but more
      studies in renal failure and organ transplant patients are needed to firmly
      establish its efficacy in these populations.

PMID- 1750793
TI  - Case management of the anemic patient. Epoetin alfa: focus on dialysis
      efficiency.
AB  - Dialysis efficiency has traditionally been measured using kinetic modeling
      (KT/Vurea). However, once anemia is corrected with Epoetin alfa, using urea as
      the only measure of dialysis effectiveness may not be adequate. Two case studies
      describe the use of the urea kinetic model and other means of assessing dialysis
      efficiency in nonanemic patients.

PMID- 1750794
TI  - Systemic sclerosis (scleroderma). Introduction.

PMID- 1750795
TI  - Raynaud's phenomenon: its relevance to scleroderma.

PMID- 1750796
TI  - Epidemiology of scleroderma.

PMID- 1750797
TI  - Clinical aspects of systemic sclerosis (scleroderma).

PMID- 1750798
TI  - Major histocompatibility complex class II genes and systemic sclerosis.
AB  - 1. In no ethnic group is the overall association between systemic sclerosis and
      the MHC strong enough for direct clinical use. MHC associations do support the
      classification of the disease into limited cutaneous systemic sclerosis and
      diffuse cutaneous systemic sclerosis. 2. Indications are that associations
      between specific subsets of patients with systemic sclerosis and genetic markers
      will assume greater importance both diagnostically and prognostically. The group
      with lung fibrosis look prime candidates, for example. 3. Genetic markers are
      useful means of relating chemically induced systemic sclerosis like disorders
      with the classical disease. Vinyl chloride disease provides an example. 4.
      Evidence is emerging of strong associations between certain genetic markers and
      autoantibody production; a similar story has emerged in systemic lupus
      erythematosus. We believe that, eventually, genetic tests will be used to
      influence treatment in at least a subset of patients with systemic sclerosis but
      that a dramatic breakthrough will not be made until we know how the genetics of
      the disease relate to the primary biochemical disease characteristic--that is,
      the overproduction of collagen. In this respect it has been suggested that the 5'
      flanking DNA of dermal collagen genes is particularly susceptible to the action
      of Scl-70 (topoisomerase I). A problem is how to tie this and the other
      observations discussed above together. The association of autoantibodies with
      topoisomerase I provides a tentative link between the MHC and collagen gene
      expression. Although the role and reason for anti-Scl-70 in systemic sclerosis is
      unknown, humoral autoimmunity, at least in systemic lupus erythematosus, seems to
      be strongly dependent on specific HLA genes. With an understanding of the
      function of MHC products at the molecular level, HLA and disease associations can
      now be analysed on a mechanistic level. For insulin dependent diabetes mellitus
      it has been shown that the MHC determined susceptibility to the disease is
      conferred by neutral residues (Val, Ser, Ala), at position 57 of the DQ beta
      chain, while Asp at this position correlates with resistance. A similar
      phenomenon has been described in rheumatoid arthritis. Although DR4 in general is
      associated with rheumatoid arthritis, it is heterogeneous, but a subtype of DR4
      which is characterised by positively charged residues at positions 70 and 71 of
      the beta chains is not found in patients with rheumatoid arthritis (Wordsworth B
      P et al, unpublished data). A similar approach applied to the study of systemic
      sclerosis is likely to be similarly rewarding. The precise subtyping of the class
      II genes and the characterisation of their associated haplotypes is therefore
      required for a complete understanding of the contribution of the MHC to the
      disease. Additional genes linked to the MHC must not be overlooked, and are
      relevant to associations of haplotypes with the disease. Of particular interest
      are the recent reports of a new class of proteins, which are determined by genes
      in the MHC and which are considered to play a part in the assembly of the antigen
      peptide/MHC molecule complex.

PMID- 1750799
TI  - The endothelium: its role in scleroderma.

PMID- 1750800
TI  - Transcriptional control mechanisms for the expression of type I collagen genes.

PMID- 1750801
TI  - Treatment of systemic sclerosis.
AB  - Proper classification of patients into diffuse cutaneous and limited cutaneous
      subsets and the anticipation of complications are the keys to the management of
      subjects with systemic sclerosis (scleroderma). Patients with early diffuse
      disease and rapidly progressive skin thickening are at highest risk of developing
      serious disease of the internal organs (intestine, lung, heart, kidney) and
      should be considered for disease modifying treatment. The targets of the disease
      and sites of possible intervention are vascular endothelium (vasoprotective
      agents), mononuclear cell subsets (immunosuppressive agents), and fibroblasts
      (colchicine, D-penicillamine). A number of new agents with sound scientific
      rationale are currently undergoing therapeutic trials. Much can be done to
      improve the lifestyle of those with scleroderma. The most dramatic recent
      development is the ability to reverse kidney disease by the prompt use of
      angiotensin converting enzyme inhibitors and modern methods of renal dialysis and
      transplantation. Scleroderma is not a hopeless disease.

PMID- 1750802
TI  - The hyperlipidemic hamster as an atherosclerosis model.
AB  - The descending thoracic and abdominal aortas of normal and hypercholesterolemic
      Golden Syrian hamsters were examined with transmission electron microscopy and
      immunofluorescence microscopy. Serum cholesterol distribution in lipoproteins was
      determined by gradient ultracentrifugation. Luminal surfaces appeared free of
      lesions and no intimal thickening or foam cells were seen. The main rise of
      cholesterol during the hypercholesterolemic diet was in the VLDL + IDL fraction.
      These findings suggest differences in the localization of atherosclerotic lesions
      and lipoprotein cholesterol distribution between humans and hamsters, which
      hamper the use of this species as a model for human atherosclerosis.

PMID- 1750803
TI  - Effects of long term 2% fish oil supplements on tissue fatty acids,
      phospholipids, cholesterol, and arterial histology in Japanese quail (Coturnix
      coturnix japonica).
AB  - The effects of 2% olive oil (OO) or fish oil (FO) (Super epa500) dietary
      supplementation (9 months) on Japanese "SEA" quail was investigated. The animals
      were examined for tissue biochemical changes and possible blood vessel fatty
      deposition. The fatty acids of blood and tissue extracts from heart, liver and
      fat were analyzed by gas-chromatography/mass spectrometry. The ratio of
      arachidonic acid to eicosapentaenoic or docosahexaenoic acid was markedly
      decreased in FO treated animals compared to OO or control diet treated animals.
      Tissue cholesterol and total phospholipids were present in elevated amounts in
      the heart and liver of FO treated animals. After the 9-month regimen many animals
      had residual atherosclerotic lesions but the FO treated birds had considerably
      more fatty streaks and fatty deposition in their large vessels compared to
      control or OO treated animals. Although the lipid composition of tissues of FO
      treated animals would indicate that the purported cardioprotective omega-3 fatty
      acids are enriched in the various tissues examined compared to olive oil and
      control diet treated animals, the possible detrimental effect of saturated fat,
      cholesterol, or some other component of the fish oil preparations is suggested
      from the histological appearance of fatty deposition in the blood vessels
      (aortae) of these inbred animals. These results in quail are strikingly similar
      to that seen in the omega-3 FA treated WHHL rabbit (15).

PMID- 1750804
TI  - The effect of apolipoprotein E isoform difference on postprandial lipoprotein in
      patients matched for triglycerides, LDL-cholesterol, and HDL-cholesterol.
AB  - The postprandial response to three test meals provided during a single day was
      investigated in subjects with either the apo E3/3 phenotype (n = 8), or the apo
      E4/3 phenotype (n = 4), who had LDL-C greater than 160 mg/dl. Vitamin A (60,000
      U/m2) was ingested with the first meal and retinyl palmitate determined four
      hours later. Triglyceride and total cholesterol concentration were determined on
      whole plasma and total cholesterol and free cholesterol determined following
      single spin ultracentrifugation (d less than 1.006 g/ml) and dextran
      precipitation of the d greater than 1.006 fraction to separate apoprotein-B
      containing lipoproteins. Fasting values revealed significantly lower HDL
      cholesterol ester (p less than 0.03) and HDL3-cholesterol ester (p less than
      0.03) and significantly greater HDL-free cholesterol (p less than 0.03) and HDL3
      free cholesterol (p less than 0.02) in subjects with the E4/3 phenotype. Four
      hour postprandial HDL and HDL3 cholesterol ester increased significantly more (p
      less than 0.05) in E4/3 patients and HDL and HDL3 free cholesterol decreased
      significantly more (p less than 0.05) in E4/3 subjects. Eight-hour postprandial
      change values maintained the significant HDL3-cholesterol ester and free
      cholesterol difference, and, revealed a significantly greater triglyceride rich
      lipoprotein cholesterol ester reduction (p less than 0.01) in the E4/3 group.
      Individuals with the apolipoprotein E4/3 phenotype reveal significant differences
      in postprandial lipemia compared to individuals with the E3/3 phenotype, and,
      postprandial lipemia following multiple meals reveals differences not apparent
      from responses to a single meal.

PMID- 1750805
TI  - Lecithin:cholesterol acyltransferase activity in patients with acute myocardial
      infarction and coronary heart disease.
AB  - Literature data suggest that identification of the conditions preventing
      lecithin:cholesterol acyltransferase (LCAT) to produce normal cholesterol
      esterification might be of utmost importance in the follow-up of atherosclerosis.
      Interrelationship between LCAT activity, and total cholesterol (TC), unesterified
      cholesterol (UC), esterified cholesterol (EC), low and high density lipoprotein
      cholesterol (LDL-C, HDL-C), triglycerides (TG), phospholipids (PL), free fatty
      acids (FFA), l-lactate (LAC), and electrolytes, i.e. zinc (Zn), calcium (Ca) and
      magnesium (Mg), was investigated in 60 patients with acute myocardial infarction
      (AMI), 30 patients with coronary heart disease (CHD) and 30 healthy control
      subjects. Results of the study revealed LCAT activity to be significantly
      decreased in atherosclerotic patients, with a significantly increased ratio of
      unesterified-esterified cholesterol (UC/EC), as compared to the control group of
      normal subjects. A decreased LCAT activity was accompanied by elevated values of
      phospholipids and LDL-C, a moderate increase in triglycerides, and a decreased
      quotient of HDL3/HDL2 cholesterol. Accordingly, a decreased activity of LCAT
      could with great certainty be considered a high-risk biochemical factor for
      atherosclerosis.

PMID- 1750806
TI  - Guidelines for the nursing management of alcohol related withdrawal symptoms in
      the home.

PMID- 1750807
TI  - Recreation in a nursing home: a nursing success.

PMID- 1750808
TI  - Postnatal depression: increasing professional and community awareness.

PMID- 1750809
TI  - ANF, HIV/AIDS train the trainer project year one completed.

PMID- 1750810
TI  - Cisapride.

PMID- 1750811
TI  - Nurse and the law. In the best interests of the child.

PMID- 1750812
TI  - Aussie DRGs: development of the Australian Inpatient Casemix Classification.

PMID- 1750813
TI  - Surgery for asymptomatic primary hyperparathyroidism.

PMID- 1750814
TI  - Advanced trauma life support in the 1980s: a decade of improvement in trauma
      care.

PMID- 1750815
TI  - Ectopia and agenesis of the gall-bladder: a report of two sets of twins and
      review of the literature.
AB  - We report two sets of twins with agenesis and ectopia of the gall-bladder. It is
      important to be aware of this condition, as many of these patients present with
      biliary-type pain and have unnecessary laparotomies. The literature on this
      condition is reviewed.

PMID- 1750816
TI  - Ulcerative colitis in the anal canal of patients undergoing restorative
      proctocolectomy.
AB  - The development of stapling instruments has obviated the need to perform anal
      mucosectomy for ulcerative colitis, but the potential exists for continued
      inflammation and, perhaps, malignant change. We reviewed the pathology specimens
      of patients who had had restorative proctocolectomy, to determine the incidence
      and severity of inflammation in the anal mucosa.

PMID- 1750817
TI  - Anorectal physiology and pathology.

PMID- 1750818
TI  - Traumatic rupture of the thoracic aorta: ten-year experience with follow up.
AB  - In the past 10 years, 13 cases of acute traumatic rupture of the thoracic aorta
      were treated at the Dunedin Hospital. Ages ranged from 16 to 77 years, with a
      mean of 27 years. Twelve of the patients were involved in high speed motor
      vehicle accidents and one sustained a fall. The diagnosis was suspected in all 13
      cases by a widened mediastinum on plain chest X-ray and confirmed by aortography
      in all cases. Associated injuries were common. The time interval from injury to
      surgery ranged from 5 h to 16 days, with a mean of 3 days. A Gott Shunt was used
      in five patients, seven had partial bypass and one had simple aortic cross
      clamping. Mean aortic cross-clamp time was 62 min. Mortality was 15%, both deaths
      occurring in the bypass group. There were two cases of paraplegia, one occurring
      in the bypass group and the other in the patient having simple cross-clamping of
      the aorta. Follow up was possible in 8 of 13 patients and ranged from 3 months to
      10 years, with a mean of 39 months. Delayed death due to heart failure occurred
      after discharge in a 77 year old man 40 days after operation. The long-term
      results were satisfactory in all survivors, apart from one poorly rehabilitated
      paraplegic.

PMID- 1750819
TI  - Measurement of the healing of venous ulcers.
AB  - The surface area of 99 leg ulcers was measured from a scaled photograph using a
      computerized ultrasonic digitizer. This was compared with the area obtained by
      multiplying the two maximal perpendicular diameters of each ulcer. There was an
      extremely good correlation between these two methods (r = 0.951). Seventy-four
      patients were followed up as part of a placebo-controlled double-blind study. In
      this study, treatment was assessed by the time taken for the ulcerated limb to
      heal completely. The initial ulcer size was found to be a weak predictor of
      subsequent ulcer healing (r = 0.49). The healing rates of individual ulcers
      calculated over 1 month intervals from presentation proved to be a poor predictor
      of the time required for complete ulcer healing (Spearman rank correlation
      coefficients ranged from 0.15 to 0.61). The healing curves of individual ulcers
      showed considerable fluctuations during the process of healing. The product of
      the maximal dimensions of an ulcer provides an easy and accurate method of
      monitoring treatment. The reduction in ulcer size within a set time interval,
      used in many ulcer studies, is a poor predictor of eventual ulcer healing. The
      percentage of ulcers completely healed within a pre-determined time interval is a
      better method of assessing new treatments.

PMID- 1750820
TI  - Inhibition of human endothelial prostacyclin synthesis by different aspirin
      formulations.
AB  - The availability of different formulations of low-dose aspirin for use as anti
      thrombotic agents merits a comparison of their effects on vessel wall
      biochemistry. We compared the effect of ingestion of an enteric-coated slow
      release aspirin (Astrix) with that of soluble aspirin (Cardiprin) on human
      endothelial prostacyclin synthesis. Patients undergoing varicose vein surgery (10
      per group) ingested 100 mg aspirin per day as Astrix or Cardiprin for 7 days
      prior to surgery. A control group ingested no aspirin. Prostacyclin synthesis by
      the endothelial surface of the great saphenous vein was determined in vitro. Both
      aspirin formulations caused significant inhibition of endothelial prostacyclin
      synthesis compared with the control group. Using the median values, the enteric
      coated slow-release aspirin caused 76% inhibition, whereas the soluble
      formulation caused significantly greater inhibition (95%). If differential
      inhibition of platelet thromboxane synthesis with 'sparing' of endothelial
      prostacyclin synthesis is necessary for an optimum anti-thrombotic effect of
      aspirin, the results suggest that a lower dose of soluble aspirin than enteric
      coated slow-release aspirin may be preferred.

PMID- 1750821
TI  - Leiomyosarcoma of the superficial femoral artery presenting as a ruptured
      aneurysm.

PMID- 1750822
TI  - Pyogenic psoas abscess.
AB  - In a 12-month period, five cases of pyogenic psoas abscess presented to the
      Townsville General Hospital. These cases are presented, together with a review of
      the literature to illustrate the clinical features of this condition and the
      therapeutic challenge it may pose.

PMID- 1750823
TI  - Caecal volvulus in a child: an unusual postoperative complication.
AB  - A 2.5 year old dysmorphic child with severe gastro-oesophageal reflux was
      admitted for elective fundoplication. Three days postoperatively, she developed
      progressive signs of intestinal obstruction. The diagnosis of caecal volvulus was
      suggested on the plain radiographic appearance, confirmed at laparotomy and
      treated by right hemicolectomy. The predisposing factors, diagnosis and approach
      to surgical management are discussed.

PMID- 1750824
TI  - Rapidly growing twelfth rib osteoid osteoma.

PMID- 1750825
TI  - Adenocarcinoma in a female urethral diverticulum.
AB  - Carcinoma occurring within a diverticulum of the female urethra is an exceedingly
      rare disease for which the treatment is ill-defined. We present here the first
      reported case of this condition from Australasia and review some of the
      recommendations for treatment.

PMID- 1750826
TI  - Electromagnetic pulsed-wave radiation in spherical models of dispersive
      biological substances.
AB  - In analytical studies, we investigated induced-field patterns and SAR
      distributions in a lossy, dispersive, homogeneous, dielectric sphere typical of
      muscle tissue as irradiated by a plane-wave pulse train consisting of a pulse
      modulated sinusoidal carrier wave. Calculations were made for carrier frequencies
      of 1, 3, and 15 GHz, pulse widths of 0.333, 2.0 and 4 ns, and pulse repetition
      rates of 1.11 x 10(6), 100 x 10(6), and 181.18 x 10(6) pps. The classical Mie
      solution was modified for a train of incident pulses that was represented by a
      Fourier series, and the fast-Fourier transform was used to sum the series.
      Computationally, the technique proved to be feasible and less expensive than we
      expected. The calculated field patterns show that the sphere's physical
      dimensions and the internal wavelength of the carrier greatly influence the
      nature of pulse-train propagation in the sphere. Harmonics having internal
      wavelengths nearly equal to the radius of the sphere produce most of the
      absorption; other harmonics produce little absorption. An intense hot spot is
      observed in spheres with radii that match the carriers' wavelengths.

PMID- 1750827
TI  - Japanese encephalitis virus (JEV): potentiation of lethality in mice by microwave
      radiation.
AB  - The expression of Japanese Encephalitis Virus (JEV) lethality in mice requires
      entry of the virus into the central nervous system. This entry is presumably
      through the capillary endothelial cells (CEC), because entry between CECs is
      inhibited by bands of circumferential tight-junctions. A viremic stage occurs
      during the first 4 to 5 days after JEV administration in mice, and both microwave
      radiation (2.45-GHz, continuous wave, 10-min exposure) and hypercarbia were
      employed to increase CEC permeability to JEV. Exposure to microwaves at power
      densities of 10-50 mW/cm2 resulted in a dose-dependent increase in JEV-induced
      lethality. Mice did not become tolerant or sensitized to microwave potentiation
      of JEV-induced mortality because 4 daily exposures at 10 or 50 mW/cm2 (SARS,
      approximately 24-98 W/kg) did not alter the lethality pattern to subsequent
      microwave radiation of JEV-exposed animals. Similarly, hypercarbia (5, 10, and
      20% CO2) was observed to produce a dose-dependent increase in JEV-induced
      lethality. Both microwave radiation and hypercarbia are thought to promote
      pinocytosis in CNS capillary endothelial cells. This may be one mechanism by
      which they enhance JEV-induced lethality in adult Swiss-Cox mice.

PMID- 1750828
TI  - Electric fields induced in chicken eggs by 60-Hz magnetic fields and the
      dosimetric importance of biological membranes.
AB  - Chicken eggs are convenient models for observing the effects of inhomogeneities
      and variations, such as those found in biological membranes and in cellular
      conductivities, on the distribution of internal electric fields as induced by
      exposure to magnetic fields. The vitelline membrane separates the yolk, which has
      a conductivity of 0.26 S/m, from the white, which has a conductivity of 0.85 S/m.
      A miniaturized probe with 2.4-mm resolution was used to measure induced fields in
      eggs placed in a uniform, 1-mT magnetic field at 60 Hz. The E fields induced in
      eggs with homogenized contents agreed with expectations based on simple theory.
      Results were similar to intact eggs unless the probe moved the yolk off-center,
      which greatly perturbed the induced fields. A more reproducible arrangement,
      which consisted of saline-agar filled dishes with a hole cut for test samples,
      was developed to enhance definition of electrical parameters. With this test
      system, the vitelline membrane was found to be responsible for most of the
      perturbation of the induced field, because it electrically isolates the yolk from
      the surrounding white. From a theoretical viewpoint, this dosimetry for the
      macroscopic egg yolk is analogous to the interaction of fields with microscopic
      cells. These findings may have important implications for research on biological
      effects of ELF electromagnetic fields, especially for studies of avian embryonic
      development.

PMID- 1750829
TI  - Effects of exposure to a 60-kV/m, 60-Hz electric field on the social behavior of
      baboons.
AB  - We found in a previously reported study that exposure to a 30-kV/m, 60-Hz
      electric field had significant effects on the social behavior of baboons.
      However, it was not established whether or not the effects were related
      specifically to the 30-kV/m intensity of the field. A new experiment was
      conducted to determine whether or not exposure to a 60-Hz electric field at 60
      kV/m would produce like changes in the baboons' social behavior. We exposed one
      group of eight male baboons to an electric field 12 hours a day, 7 days a week,
      for 6 weeks. A second group of eight animals was maintained under sham-exposure
      (control) conditions. Rates of performing on each of six categories of social
      behavior and on four categories of nonsocial behavior were used as criteria for
      comparing exposed with unexposed subjects and for within-group comparisons during
      three six-week experimental periods: Pre-Exposure, Exposure, and Post-Exposure.
      The results indicate that (1) during the exposure period, exposed animals
      exhibited statistically significant differences from controls in means of
      performance rates based on several behavioral categories; (2) across all three
      periods, within-group comparisons revealed that behaviors of exposed baboons were
      significantly affected by exposure to the electric field; (3) changes in
      performance levels probably reflect a stress response to the electric field; and
      (4) the means of response rates of animals exposed at 60 kV/m were higher, but
      not double, those of animals exposed at 30 kV/m. As in the 30-kV/m experiment,
      animals exposed at 60 kV/m exhibited significant differences in performances of
      Passive Affinity, Tension, and Stereotypy. Mean rates of performing these
      categories were 122% (Passive Affinity), 48% (Tension), and 40% (Stereotypy)
      higher in the exposed group than in the control group during exposure to the 60
      kV/m field.

PMID- 1750830
TI  - In vitro exposure parameters with linearly and circularly polarized ELF magnetic
      fields.

PMID- 1750831
TI  - [Electron microscopy of alpha-latrotoxin from the venom of the black widow spider
      Latrodectus mactans tredecimguttatus].
AB  - Two-dimensional crystals of alpha-latrotoxin from the venom of black widow spider
      (Latrodectus mactans tredecimguttatus) were studied by the negative staining
      electron microscopy. Two-dimensional crystals were obtained by adsorption of the
      protein solution with a high Mg2+ concentration on carbon-coated electron
      microscopy grids. The crystals were about 0.4 mkm in size, had the unit cell
      parameters: a = b = 15.55 nm, gamma = 90 degrees, p4 plane group symmetry. The
      contour map of a stain-excluding region of such crystals was calculated by the
      Fourier-filtering procedure at about 4 nm resolution. The calculation of
      molecular weight of the unit cell, with the symmetry p4 taken into account,
      showed that alpha-latrotoxin particles, revealed by negative staining, consisted
      of 4 or 8 protomers.

PMID- 1750832
TI  - [Tyrosyl-tRNA-synthetase from bovine liver. Functional role of histidine
      residues].
AB  - A specific chemical modification of histidyl residues in tyrosyl-tRNA synthetase
      by diethyl pyrocarbonate was performed. It is shown that five of sixteen histidyl
      residues can react with diethyl pyrocarbonate in the native conditions.
      Modification of two histidyl residues per dimer results in the inactivation of
      tyrosyl-tRNA synthetase in both steps of the tRNATyr aminoacylation. All
      substrates protect tyrosyl-tRNA synthetase against inactivation with diethyl
      pyrocarbonate, the most effective protector being combination of ATP and
      tyrosine. Histidyl residues of tyrosyl-tRNA synthetase are suggested to be
      involved in the catalytic mechanism of aminoacylation of tRNATyr.

PMID- 1750833
TI  - [Anomalous behavior of certain proteins having an isoelectric point near 4.5
      during their precipitation from aqueous solutions from organic solvents].

PMID- 1750834
TI  - [Ligation of DNA containing a 5'-terminal thiophosphate group, with T4-DNA
      ligase].

PMID- 1750835
TI  - [Enzymatic synthesis of acyl peptides containing p-nitroanilides of basic amino
      acids].
AB  - A method is suggested for synthesis of acylpeptides, containing arginine or
      lysine p-nitroanilides at the C-terminus, via the acyl transfer reaction
      catalyzed by the Bacillus subtilis serine proteinase. Acyl-di- and acyltripeptide
      ethers with L- and D-amino acids were used as the carboxyl component taken in a
      twofold excess. When the concentration of dimethylformamide increases, the
      hydrolysis of the initial ether and the reaction product diminishes. Because of
      the enzyme inactivation by dimethylformamide the latter's optimal concentration
      is 70-80%.

PMID- 1750836
TI  - [Synthesis of the tripeptide glycyl-L-leucyl-L-phenylalanine and its analogs].
AB  - Peptide Gly-L-Leu-L-Phe and its derivatives were synthesized by the C-end
      elongation utilizing DCC/HOBT technique and by enzymatic route with the help of
      papain using esters of N-benzyloxycarbonyl-glycine and -L-leucine as acyl donors
      have been suggested. The chemical, similarly to the enzymatic, synthesis was not
      accompanied by racemization. Conditions for HPLC separation and preparative
      isolation of the enzymatic reaction products were developed.

PMID- 1750837
TI  - [Synthesis, conversion and biological activity of 5-substituted 2'-deoxyuridines
      modified by carbohydrates].
AB  - 5-Benzyloxymethyl(Bom)-2'-deoxyuridine and its alpha-anomer were used as the key
      compounds for syntheses of thymidine analogues or 3'-derivatives. Anomeric 5-Bom
      2'-deoxyuridines were synthesized from 5-Bom-uracil and 2-deoxy-3,5-di-O-p-toluyl
      alpha-D-ribo-furanosyl chloride by means of the silyl method. 5-Bom-2'
      deoxyuridine was transformed successively to 3',5'-di-O-mesyl derivative, 2,3'
      anhydro-1-(2-deoxy-5-O-p-toluyl-beta-D-xylofuranosyl)-5-Bom-uracil and 3'-azido
      2',3'-dideoxy-5-Bom-uridine. Treatment of the last with SnCl4 in methylene
      dichloride--methanol led to 3'-azido-2',3'-dideoxy-5-methoxymethyluridine. Under
      the same conditions the 5-methoxymethyl derivative was obtained from 3',5'-di-O-p
      toluyl-5-Bom-2'-deoxyuridine. Interaction of 1-(2-deoxy-alpha-D-ribofuranosyl)-4
      Bom-uracil with SnCl4 in methylene dichloride as well as the hydrogen transfer
      hydrogenolysis in the presence of cyclohexene and Pd(OH)2/C in ethanol led to 1
      (2-deoxy-alpha-D-ribofuranosyl)-5-hydroxymethyluracil. Only 3'-azido-2',3'
      dideoxy-5-Bom-uridine showed a cytotoxic activity against CaOv cells in vitro: in
      10(-5)-10(-4) M concentrations it inhibits the thymidine incorporation into DNA
      by 78.8-95.1%. Elucidation of antitumor activity in vivo showed that this
      nucleoside inhibits growth of solid tumours, Ca755 and LLC, by 79 and 79-83%,
      respectively, but has no therapeutic effect against lympholeukemia P388.

PMID- 1750838
TI  - [Antigenic properties of synthetic peptides of hexon proteins human adenovirus
      type 2 fiber].

PMID- 1750839
TI  - [A rapid method of complete deblocking of synthetic oligonucleotides].

PMID- 1750840
TI  - Professional practices perspective on clinical outcomes.

PMID- 1750841
TI  - A new institute. A promising future of research.

PMID- 1750842
TI  - Responsible conduct of research.

PMID- 1750843
TI  - Managing heritable hearing loss: the audiologist's role.

PMID- 1750845
TI  - Beyond tradition.

PMID- 1750844
TI  - A research mentoring process.

PMID- 1750846
TI  - Oversight noted.

PMID- 1750847
TI  - Scholarly publications alive and well in ASHA.

PMID- 1750848
TI  - Historically black and majority-white universities.
AB  - This paper details a cooperative sisterhood minority recruitment and retention
      agreement that was established between a predominantly White university and a
      historically Black university for the purpose of increasing the numbers of
      minority personnel in speech-language pathology and audiology. This paper also
      provides some suggestions for universities that may wish to implement a similar
      model. The program is still in its infancy. It is too early to determine how well
      a sisterhood agreement is able to provide a bridge of financial, academic, and
      emotional support to enable minority students to be successful. With continued
      experience with our new sisterhood relationship, we will be able to evaluate the
      program, make changes to improve it, and eventually determine whether or not the
      program is meeting the purpose for which it was designed. Faculty from both
      universities also look forward to collaborating on research projects and other
      scholarly activities. In the meantime, however, given the shortage of minority
      personnel in our profession, it seemed appropriate to offer the sisterhood
      concept as one means by which universities can help alleviate this critical
      problem.

PMID- 1750849
TI  - The professional doctorate: opinions of members with doctorates and of directors
      of doctoral programs.

PMID- 1750851
TI  - International Association of Laryngectomees.

PMID- 1750850
TI  - Medicare speech-language pathology medical review edits.

PMID- 1750852
TI  - Meniere's disease.

PMID- 1750853
TI  - "Thunderous" motor sports.

PMID- 1750854
TI  - Animal research.

PMID- 1750855
TI  - Museum proposed.

PMID- 1750856
TI  - Alternative testing proposed.

PMID- 1750857
TI  - Cultural diversity in the elderly population.

PMID- 1750858
TI  - Universal health care: the time has come.

PMID- 1750859
TI  - Dr Jack Kevorkian and medically assisted suicide. A patient's right to a good
      death.

PMID- 1750860
TI  - Transplantation of purified autologous fat: a 3-year follow-up is disappointing.
AB  - The idea of autologous fat microtransplants has recently resurfaced because of
      interest by the press. Past experiments have shown that small amounts of fat may
      be transplanted with an expected survival rate between 10 and 50 percent without
      ectodermis. A great fund of knowledge exists showing that skin grafts will
      survive quite dependably if their thickness is up to about 0.0020 inch. For the
      first week or so, they live by diffusion and inosculation, and then
      neovascularization enables them to continue viability. I have developed a
      technique whereby fat is harvested through a blunt cannula with minimal vacuum to
      prevent explosion of the cellular fat globules. Fibrin and cellular debris are
      removed, and the fat globules are separated from the free fat, blood, and other
      constituents of the aspirate. Individual, free-floating 1- to 3-mm adipose
      fragments are then suspended in nutrient solution and injected through an 18
      gauge needle. Multiple radial pathways, with each fat segment being separated
      from the other by host tissue, maximizes the host-prosthesis interface and the
      possibility for exchange of nutrients. I have attempted this procedure in more
      than 100 patients with widely varying results. In acne pits of the face, no
      significant improvement could be noted 6 weeks after injection. For the first few
      weeks, a near-perfect result was obtained, but none of these transplants in
      scarred areas of this kind have been of benefit. Injection of 10 to 50 cc in
      other areas has resulted in some cells (perhaps 10 percent) surviving over 2
      years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1750861
TI  - Smoking and older chest physicians.

PMID- 1750862
TI  - The changing face of asthma.

PMID- 1750863
TI  - Endothelin. Key to coronary vasospasm?

PMID- 1750864
TI  - Bioavailable testosterone in salivary glands.

PMID- 1750865
TI  - Iodine deficiency disorders and infertility.

PMID- 1750866
TI  - Vulval reconstruction by free tissue transfer. Case report.

PMID- 1750867
TI  - Setting up and using a cardiac monitor.

PMID- 1750868
TI  - Dynamic urethral pressure profilometry pressure transmission ratio: what do the
      numbers really mean?
AB  - Sixty-three women with genuine stress urinary incontinence were evaluated
      urodynamically both before and after modified Burch colposuspension to determine
      the association between pressure transmission ratio and leakage of urine during
      dynamic urethral pressure profile and the effect of surgery on pressure
      transmission ratio. Preoperatively, there was no difference in pressure
      transmission ratios between urethral pressure profiles associated with leakage of
      urine and those without urine leakage. Postoperatively, there were differences in
      pressure transmission ratios between leak and nonleak profiles in the sitting
      full and supine positions (P less than .001). We could not determine a threshold
      pressure transmission ratio that was more characteristically associated with
      leakage of urine. Finally, preoperative pressure transmission ratios were not
      associated with surgical success, but the higher the postoperative pressure
      transmission ratio, the more likely the surgery was to be successful (P = .023).
      In addition, the greater the difference between preoperative and postoperative
      pressure transmission ratios, the more likely was a cure (P = .011). The pressure
      transmission ratio may not be helpful in discriminating leak from nonleak dynamic
      urethral pressure profiles, and there may not be a threshold pressure
      transmission ratio below which patients characteristically leak urine. However,
      comparison of preoperative and postoperative pressure transmission ratios is
      helpful in determining the adequacy of surgical correction of the anatomical
      defect associated with genuine stress incontinence.

PMID- 1750869
TI  - Standardized percentile curves of body-mass index for children and adolescents.
AB  - Weight-for-height indexes are often used in the clinical assessment of obesity in
      children and adolescents. The direct measurement of adiposity, using hydrostatic
      weighing and other techniques, is not feasible in studies involving young
      children or with large numbers of older subjects. Ratios of weight relative to
      height, such as the body-mass index (weight/height), may be used as indirect
      measures of obesity and correlate with more direct measures of adiposity. Using
      data from the First National Health and Nutrition Examination Study, 1971 to
      1974, standardized percentile curves of body-mass index for white children and
      adolescents were developed. These curves may be used to monitor the body-mass
      index of white children and adolescents longitudinally and for comparing an
      individual with others of the same sex and age.

PMID- 1750870
TI  - Training for the new contract.

PMID- 1750871
TI  - Effectiveness of ward based opportunistic immunisation policy.

PMID- 1750872
TI  - Effects of dietary supplementation on work performance in Gambian laborers.
AB  - The effect of food supplementation on productivity of Gambian subsistence farmers
      was studied during a natural food shortage induced by the annual hungry season.
      Sixteen men in two groups matched for weight, height, hemoglobin, and physical
      work capacity followed a crossover protocol with 6-wk supplementation and control
      periods. Productivity was assessed over the final 3 wk of each period by
      quantifying piece-rate-paid road building. Supplementation comprised an ad
      libitum supply of highly palatable energy-dense food provided three times daily.
      Outcome variables were total loads transported, loads per working hour, time per
      load, total energy expenditure assessed by doubly labeled water and heart-rate
      monitoring, postwork activity, and anthropometry. Body weight decreased during
      control periods, indicating a real energy deficit, and increased during
      supplementation in both groups. Supplementation had no significant impact on
      productivity variables. Energy-deficient men can maintain maximal productivity
      over short periods if sufficiently motivated but at the expense of body weight.

PMID- 1750873
TI  - Sociocultural correlates of eating disorders among Asian schoolgirls in Bradford.
AB  - A survey of 204 south-Asian and 355 Caucasian schoolgirls was conducted in
      Bradford using the EAT-26 and the BSQ. At interview, seven Asian girls and two
      Caucasian girls met DSM-III-R criteria for bulimia nervosa, yielding a prevalence
      of 3.4% and 0.6% respectively. One Asian girl met DSM-III-R criteria for anorexia
      nervosa. Factor analyses of the EAT and BSQ supported their cross-cultural
      conceptual equivalence in this south-Asian population. Among the Asians, high EAT
      and BSQ scores were associated with a more traditional cultural orientation and
      not with greater Westernisation. It is probable that these findings reflect the
      cultural and familial difficulties faced by these Asian girls growing up in
      Britain.

PMID- 1750874
TI  - Let's provide primary care to all uninsured Americans--now!
AB  - Gridlock in the political process makes comprehensive health insurance for the
      uninsured an unlikely prospect in the near future. While the debate continues, we
      should provide basic primary care services to all uninsured Americans. Primary
      care is the most economical safety net we can offer our citizens. By prepaying
      participating physicians, we could provide this needed care at a cost the nation
      could afford and with excellent prospects for controlling expenditures over time.

PMID- 1750875
TI  - Absence of siblings--a risk factor for hypertension?

PMID- 1750876
TI  - The A9 antigen associated with aggressive human squamous carcinoma is
      structurally and functionally similar to the newly defined integrin alpha 6 beta
      4.
AB  - We previously reported that altered expression of the A9 antigen (defined by
      monoclonal antibody UM-A9) is a predictive marker of early recurrence and
      progression of squamous cell carcinoma (SCC). In normal squamous cells A9
      expression is limited to the site of contact with the basement membrane in vivo
      and the culture surface in vitro, whereas aggressive SCCs exhibit loss of
      polarity and increased intensity of A9 expression. The potential relationship of
      the A9 antigen to structures known to be involved in cell adhesion was analyzed
      by immunobiochemical and cell adhesion assays. UM-A9 precipitates a complex of
      protein chains reminiscent of the alpha and beta heterodimer glycoproteins that
      characterize the integrin family of extracellular matrix receptors. Proteins were
      isolated from A9-positive cells using UM-A9 and well-defined antibodies specific
      for integrin alpha and beta chains. UM-A9, anti-alpha 6, and anti-beta 4
      monoclonal antibodies (mAbs) all precipitated proteins with comparable
      electrophoretic mobilities. Furthermore, UM-A9 mAb precleared the SCC alpha 6
      beta 4 integrin complex isolated with anti-alpha 6 or anti-beta 4 mAbs but not
      that isolated by anti-beta 1 mAb. The isoelectric points of the A9 complex chains
      were consistent with those reported for alpha 6 and beta 4. Three of the
      polypeptide chains (140, 175, and 205 kDa) precipitated by UM-A9 showed peptide
      homology to one another and to the beta 4 chain precipitated by mAb 439-9B. The
      A9/alpha 6 subunit is composed of 125- and 30-kDa chains and was distinguished
      from beta 4 and beta 1 chains by its peptide map and isoelectric point. UM-A9
      binds to an epitope common to the beta 4 subunits since in pulse-chase analysis
      the beta 4 species are precipitated at an early time point, whereas detection of
      alpha-subunit synthesis is detected during assembly of the mature complex.
      Immunoprecipitation and preclearing experiments demonstrated that in SCC the
      alpha 6 subunit is associated primarily with the beta 4 species and not with the
      130-kDa beta 1 subunit. In cell adhesion assays on extracellular matrix proteins,
      the alpha 6-specific GoH3 mAb inhibited binding of SCC to laminin, suggesting
      that alpha 6 beta 4 may function as a laminin receptor in SCC. These data and our
      prior observations showing an association between altered A9 expression and early
      recurrence in SCC provide the first evidence that altered expression of alpha 6
      beta 4 integrin is associated with the clinical behavior of human squamous cell
      carcinomas.

PMID- 1750877
TI  - Potential health effects of greenhouse effect and ozone layer depletion in
      Australia.
AB  - OBJECTIVE: To identify potential health effects of the greenhouse effect and
      ozone layer depletion in Australia. DATA SOURCES: Data were derived from a number
      of sources: (i) published articles accessed from relevant databases in the
      disciplines of health, public health and climatology over the past 20 years; (ii)
      published conference proceedings, review monographs and government reports
      covering the topic; (iii) a survey of experts in public health and
      climatology/geography (150 individuals were surveyed in the first phase with a
      63% response rate); and (iv) a consensus conference in which 22 invited experts
      reviewed the results of the literature review and survey and a second conference
      in which 18 senior members of the health bureaucracy and public health profession
      considered the implications of the findings. STUDY SELECTION: Over 200 published
      articles or monographs were reviewed. Criteria for selection were whether the
      papers contributed information to the objectives of the review. DATA EXTRACTION:
      Because of the nature of the problem under investigation, predictions based on
      reasonable scientific assumptions were the major content of the review rather
      than conclusions based on scientific research. DATA SYNTHESIS: The major
      predicted health effects of long-term climatic change in Australia are skin and
      eye damage from increased ultraviolet radiation exposure, increased incidence of
      some respiratory diseases, vector-borne and water-borne diseases, and the social
      and physical effects of natural hazards and social and economic restructuring.
      The most vulnerable groups include the aged, the very young, the chronically ill,
      those living in poorly designed neighbourhoods and those working in outdoor
      occupations or heavy industry. CONCLUSIONS: The potential effects on health of
      long-term climatic change cover the broad spectrum of public health concerns.
      Detailed predictions of likely problems in specific geographic areas are not yet
      possible, but progressive development of such predictive capability is a high
      priority. Doctors will have an increasingly important role in monitoring local
      health status and participating in disease prevention and surveillance
      programmes.

PMID- 1750878
TI  - Controlling adverse effects of chemotherapy.

PMID- 1750879
TI  - Continuing education of general dental practitioners.

PMID- 1750880
TI  - A dual approach to the AIDS epidemic.

PMID- 1750881
TI  - Surgical treatment of obstructive sleep apnea syndrome (OSAS)
AB  - Obstructive sleep apnea syndrome patients usually present with multiple areas of
      anatomic disproportions. The site or sites of obstruction must be accurately
      diagnosed preoperatively by a systematic means of examining the patient. This
      includes nasopharyngoscopy with Muller maneuver and sometimes cephalometrics. The
      surgical treatment is individualized to the site or sites of obstruction and can
      include tracheostomy, septoplasty, UPPP, geniohyoid advancement and suspension of
      the hyoid. For extreme cases advancement of the maxilla, mandible and hyoid bone
      are sometimes necessary.

PMID- 1750882
TI  - Ultraviolet A radiation: staying within the pale.

PMID- 1750883
TI  - Is bioethics really a "new" medical specialty?

PMID- 1750884
TI  - Maternity services: the shaping of things to come.

PMID- 1750885
TI  - Junior doctors, nurses, and drips.

PMID- 1750886
TI  - How Europe regulates its genes.

PMID- 1750887
TI  - A user's guide to the T-test.

PMID- 1750888
TI  - Misuse of streptokinase in dissecting aortic aneurysm.

PMID- 1750889
TI  - Sternal-clavicular plasmacytomas with atypical morphology.

PMID- 1750890
TI  - Deafness in children.

PMID- 1750891
TI  - Appraising journals' reviewing procedures.

PMID- 1750892
TI  - Late bleeding after endoscopic sphincterotomy for bile duct calculi.

PMID- 1750893
TI  - Identification of the interpleural space.

PMID- 1750894
TI  - Unrecognised HIV related deaths.

PMID- 1750895
TI  - Skewed distributions and parametric tests.

PMID- 1750896
TI  - Present day anatomy.

PMID- 1750897
TI  - Cooling jacket modifications.

PMID- 1750898
TI  - Rifampicin in rheumatoid arthritis.

PMID- 1750899
TI  - Occupational health research needs in developing countries.

PMID- 1750900
TI  - Silicone intraocular lens implant discoloration in humans.

PMID- 1750901
TI  - Vitrectomy for prevention of macular hole study.

PMID- 1750902
TI  - A new Igk-V gene family in the mouse.

PMID- 1750903
TI  - Response to article by Foote et al.

PMID- 1750904
TI  - Topical (bathwater) PUVA therapy.

PMID- 1750905
TI  - "Eliminating" hyperthyroidism.

PMID- 1750906
TI  - Let's provide primary care to all uninsured Americans--now.

PMID- 1750907
TI  - The Marlboro Grand Prix.

PMID- 1750908
TI  - Transoral approach for removal of intradural lesions at the craniocervical
      junction.

PMID- 1750909
TI  - Localization of transected wire.

PMID- 1750910
TI  - Managing hypertension.

PMID- 1750911
TI  - Uric acid in pregnancy and preeclampsia: an alternative hypothesis.

PMID- 1750912
TI  - A morphological and immunological study of human placental bed biopsies in
      miscarriage.

PMID- 1750913
TI  - Selection of controls.

PMID- 1750914
TI  - Standardized care plans.

PMID- 1750915
TI  - Beta-carotene didn't prevent cancer: what's up doc?

PMID- 1750916
TI  - The impact of volume on outcome in seriously injured trauma patients: two years'
      experience of the Chicago trauma system.

PMID- 1750917
TI  - Management of prenatally diagnosed fetal abnormality.

PMID- 1750918
TI  - Acute asthma in children.

PMID- 1750919
TI  - Clinical disagreement.

PMID- 1750920
TI  - Relation of blood pressure to number of siblings.

PMID- 1750921
TI  - Surgical treatment of obstructive sleep apnea.

PMID- 1750922
TI  - [Infection of knee endoprosthesis].
AB  - In knee arthroplasties, infection was and still is the most decisive factor with
      respect to the end result. Control of infection without removal of the
      endoprosthesis can be achieved only when an early revision is performed in the
      first 6 weeks after the arthroplasty. Half-hearted antibiotic medication alone is
      an unsuitable remedy. Therefore, an infection must be diagnosed without delay and
      followed up by decisive management. Clinical and laboratory data must be
      considered together and must supplement each other. Late infections need
      temporary or permanent removal of the endoprosthesis as a prerequisite for
      getting rid of the infection. Reimplantation and arthrodesis should be done in a
      two-stage procedure after the infection is healed. Reimplantation should be
      restricted to cases in which the infection is definitely under control and in
      which there is a good bone stock. Arthrodesis is still the treatment of choice,
      especially in patients with bony defects in the metaphysis of the femur and
      tibia. Arthrodesis also needs good soft tissue cover, and to prevent a
      reinfection in this dangerous area we suggest the use of antibiotic-releasing
      bone plates for stabilisation. External fixation has a high percentage of
      pintrack infections and often cannot be applied long enough; thus non-unions are
      the logical consequence.

PMID- 1750923
TI  - Academic boycott.

PMID- 1750924
TI  - Effects of fish-oil ingestion on cardiovascular risk factors.

PMID- 1750925
TI  - Genital self-amputation and the Klingsor syndrome.

PMID- 1750926
TI  - Further functions of IL-6.

PMID- 1750927
TI  - Ancient technique of olive detection.

PMID- 1750928
TI  - Manometry vs. pH step-up.

PMID- 1750929
TI  - The CS5 peptide is a second site in the IIICS region of fibronectin recognized by
      the integrin alpha 4 beta 1. Inhibition of alpha 4 beta 1 function by RGD peptide
      homologues.
AB  - The alternatively spliced type III connecting segment (IIICS) region of
      fibronectin contains two distinct sites that support the adhesion of melanoma
      cells. These sites are contained within the synthetic peptides CS1 and CS5
      (residues 1-25 and 90-109 of the IIICS, respectively). Recently, the cellular
      receptor for the CS1 site has been identified as the integrin heterodimer alpha 4
      beta 1. In this report, we have investigated the role of the CS5 sequence in
      melanoma cell adhesion and the identity of its receptor. Adhesion to CS5, when
      presented to cells as an immobilized IgG conjugate, was blocked by antifunctional
      monoclonal antibodies directed against either the alpha 4 or beta 1 integrin
      subunits, but not by antibodies against other subunits, implying that alpha 4
      beta 1 is also the receptor for CS5. In peptide inhibition experiments, CS5 was
      inhibitory for melanoma cell spreading on both CS5-IgG and CS1-IgG conjugates;
      conversely, CS1 inhibited spreading on both CS1-IgG and CS5-IgG. In both cases,
      peptide inhibition could be outcompeted by increasing the concentration of
      substrate-bound conjugate. These results suggest that CS1 and CS5 are recognized
      by the same or overlapping sites on alpha 4 beta 1. The minimal active sequence
      within CS5, the tetrapeptide Arg-Glu-Asp-Val (REDV), is somewhat related to the
      Arg-Gly-Asp-Ser (RGDS) sequence that represents a major active site in the
      central cell-binding domain (CCBD) of fibronectin. When RGDS peptide homologues
      were tested for their ability to inhibit spreading of melanoma cells on CS1- and
      CS5-IgG conjugates, GRGDS, GRGES, and REDV were found to be inhibitory, while
      GRDGS had no effect. In contrast, spreading on a fibronectin fragment containing
      the CCBD was inhibited by GRGDS only. GRGDS was also able to elute alpha 4 beta 1
      specifically from a CS1 affinity column, confirming directly that alpha 4 beta 1
      IIICS interactions are sensitive to peptides containing this recognition motif.
      Because the minimal active sequence within CS1 is the tripeptide Leu-Asp-Val
      (LDV; Komoriya et al., manuscript submitted for publication), these findings
      together define a new adhesive recognition sequence, X-Asp-Y, used by alpha 4
      beta 1 for binding to fibronectin. The central aspartate residue in this
      tripeptide is almost always essential, but some flexibility in the amino acid
      residues at X (glycine, leucine, or glutamic acid) and Y (serine or valine) is
      tolerated. Potential models for the interaction of the IIICS region with alpha 4
      beta 1 are discussed.

PMID- 1750930
TI  - Restoration by a 35K membrane protein of peroxisome assembly in a peroxisome
      deficient mammalian cell mutant.
AB  - Peroxisomes are among the intracellular organelles of eukaryotic cells that
      contain specialized sets of enzymes with specific functions. Little is known of
      membranous components involved in assembly of the intracellular compartments. We
      isolated two peroxisome-deficient and mutually complementary, Chinese hamster
      ovary cell mutants, Z65 and Z24, which closely resembled fibroblasts from
      patients with autosomal recessive, peroxisome-defective disorders such as
      Zellweger syndrome. These patients show characteristic dysmorphism, severe
      hypotonia, psychomotor retardation, and peroxisomal dysfunctions and rarely
      survive early childhood. Here we report what seems to be the first direct cloning
      and characterization of a complementary DNA encoding a peroxisomal membrane
      protein of relative molecular mass 35,000 (Mr35K) that restores the biogenesis of
      peroxisomes and complements the defect of peroxisomal functions in the mutant
      Z65.

PMID- 1750931
TI  - Purpactins, new inhibitors of acyl-CoA:cholesterol acyltransferase produced by
      Penicillium purpurogenum. I. Production, isolation and physico-chemical and
      biological properties.
AB  - Penicillium purpurogenum FO-608, a soil isolate, was found to produce a series of
      new inhibitors of acyl-CoA:cholesterol acyltransferase (ACAT). Three active
      compounds, designated purpactins, A, B and C, were isolated from the fermentation
      broth of the producing strain by solvent extraction, silica gel column
      chromatography and HPLC. Purpactins inhibit ACAT activity in an enzyme assay
      system using rat liver microsomes with IC50 values of 121 approximately 126
      microM. Purpactin A also inhibited cholesterol ester formation in J 774
      macrophages, indicating the inhibition of ACAT activity in the living cells by
      purpactin A.

PMID- 1750932
TI  - The effects of graft tensioning on the laxity and kinematics of the anterior
      cruciate ligament reconstructed knee.
AB  - An in vitro study of eight cadaveric knees was conducted to investigate the
      effect of initial graft tension on the laxity and full three-dimensional
      kinematics of the anterior cruciate ligament reconstructed knee. A parallel
      strand, prototype, expanded polytetrafluoroethylene graft (W. L. Gore and
      Associates, Flagstaff, AZ, U.S.A.) was used. The graft was placed in the over-the
      top position with initial tensions of 18, 36, 54, 72, and 90 N applied with the
      knee in full extension or at 30 degrees of flexion. The motion of the tibia
      relative to the femur was measured by a 6 degrees-of-freedom spatial linkage, and
      the applied forces and moments, the quadriceps force, and the graft tension were
      measured by load cells. Near normal anterior laxity in the Lachman test was
      restored with all the tested initial graft tensions. However, over constraint,
      posterior, lateral, and external tibial subluxation, and abnormalities in joint
      stiffness developed as the initial graft tension increased. Graft tension-related
      posterior tibial subluxation resulted in an increase in quadriceps force needed
      to achieve full extension.

PMID- 1750933
TI  - Double-layered lateral meniscus: a newly found anomaly.
AB  - We report two cases of a double lateral meniscus, with one meniscus overlying
      another. It was characteristic that the upper accessory meniscus was connected at
      the posterior horn and middle segments of the lower meniscus. Symptoms in both
      cases disappeared after resecting the upper meniscus arthroscopically. There was
      no evidence of tear or other pathologic finding in the meniscus, which showed no
      disturbance of the fiber arrangement.

PMID- 1750934
TI  - Contaminated patellar tendon grafts: incidence of positive cultures and efficacy
      of an antibiotic solution soak--an in vitro study.
AB  - The incidence of positive cultures after contamination of sterile patellar tendon
      grafts in an operating room environment was studied in 10 specimens. The grafts
      were dropped on the floor for 3 min and then cultured. Six of the 10 grafts (60%)
      had a positive culture at 10 days. To test the efficacy of an antibiotic solution
      on cleansing contaminated grafts, 10 additional grafts were dropped on the floor
      for 3 min. Before the grafts were cultured they were soaked in a sterile saline
      solution containing bacitracin (33.33 U/ml) and polymyxin B (333.33 U/ml) for 15
      min. Thirty percent of these grafts (3 of 10) cultured positive at 10 days. In
      each case the bacterial contaminant was found to be sensitive to one of the
      antibiotic agents used in the cleansing solution. The results of this study
      suggest that although soaking contaminated grafts in this antibiotic solution for
      15 min may reduce the incidence of positive cultures, it still results in a 30%
      incidence of nonsterile grafts.

PMID- 1750935
TI  - Assessing arthroscopic notchplasty.
AB  - To evaluate the ability to perform a widening arthroscopic intercondylar
      notchplasty as part of an anterior cruciate ligament reconstruction, 20 patients
      had notch-width index measurements compared with either preoperative or normal
      side values. The notch-width index increased an average of 0.062, correlating
      with absolute notch widening of 4-6 mm. This study provides in vivo evidence that
      notchplasty widening can be reproducibly performed arthroscopically. The optimal
      notch width for reconstructive anterior cruciate ligament surgery has yet to be
      determined.

PMID- 1750936
TI  - The effect of tourniquet use and hemovac drainage on postoperative hemarthrosis.
AB  - Postoperative hemarthrosis is the most common reported complication after
      arthroscopic knee surgery. The purpose of this study was to determine the effects
      of hemovac drainage and tourniquet use on the incidence of postoperative
      hemarthrosis. Sixty patients who had undergone arthroscopic knee surgery were
      divided into groups based on tourniquet use and whether a drain was used
      postoperatively. At follow-up, patients had range of motion recorded, and
      clinical assessment of their hemarthrosis (Grades 0 through 4). Patients who had
      a hemovac drain used postoperatively, and those patients who did not have a
      tourniquet used, had fewer hemarthroses and a greater range of motion at all
      periods of follow-up. We conclude that use of a drain can decrease the incidence
      of hemarthrosis and allow patients to regain an active range of motion sooner.
      Also, the routine use of a tourniquet should be avoided because of its
      correlation with hemarthrosis.

PMID- 1750937
TI  - Lateral retinacular release for patellofemoral pain in the older patient.
AB  - Lateral release for patellofemoral pain was performed on 39 knees in 34 patients
      aged greater than or equal to 30 years. At a mean follow-up of 6 years, there
      were 56% good or excellent results. Only 20% of patients did not achieve any
      benefit from the procedure. Although these results may not be as good as in the
      younger patient, this low morbidity procedure is nevertheless useful in the
      management of the older patient with patellofemoral malalignment.

PMID- 1750938
TI  - Risks of neurovascular injury in elbow arthroscopy: starting anteromedially or
      anterolaterally?
AB  - A cadaver dissection study was performed to study the risks of neurovascular
      damage in elbow arthroscopy. The risk of injury to the radial nerve in the
      anterolateral approach was higher than the risk of damaging the median nerve in
      the anteromedial approach. In addition, starting medially may contribute to
      accurate placement of the anterolateral portal and may further help to decrease
      the risk of injuring the radial nerve. Therefore, starting with an anteromedial
      approach has several advantages above starting anterolaterally.

PMID- 1750939
TI  - Arthroscopic subacromial decompression: results in advanced impingement syndrome.
AB  - A study group composed of 25 shoulders in 24 patients underwent arthroscopic
      subacromial decompression for advanced impingement syndrome. There were no full
      thickness rotator cuff tears, biceps tendon ruptures, significant
      acromioclavicular arthrosis, or evidence of glenohumeral instability. Twenty men
      and four women ranging in age from 18 to 63 years (mean age 37) with dominant arm
      involvement in 17/24 were evaluated for an average follow-up of 20.3 months
      (range 14-32) postoperatively. Operative results were based on the UCLA shoulder
      rating scale. Eighty-eight percent of the cases (22/25) had good or excellent
      results. Twelve percent had fair results (3/25). There were no poor results. The
      average UCLA pain score improved from 2.6 preoperative (constant pain) to 7.8
      postoperative (occasional pain). Ninety-two percent of the patients were
      satisfied, said they were better, and that they would have the surgery again.
      Arthroscopic subacromial decompression is recommended as an alternative to open
      anterior acromioplasty in advanced impingement syndrome.

PMID- 1750940
TI  - Extrusion of the medial meniscus.
AB  - Disruption of the anchoring points of the menisci of the knee has been
      hypothesized to result in subluxation of the affected meniscus from the articular
      surface. A case report of such an extrusion of the medial meniscus is presented.
      Medial subluxation of the meniscus from the tibiofemoral articulation occurred as
      a result of avulsion of the posterior horn with concomitant medial collateral and
      posterior cruciate ligament injuries.

PMID- 1750941
TI  - Precision acromioplasty in arthroscopic subacromial decompression of the
      shoulder.
AB  - Arthroscopic techniques for subacromial decompression have been criticized for
      lack of precision in resecting the anterior acromial undersurface and evaluating
      the amount of bone resected. The goal of subacromial decompression is production
      of a flat undersurface for the acromion and acromioclavicular joint, thus
      enlarging the supraspinatus outlet and deterring impingement. Achieving this goal
      using the arthroscope requires preoperative evaluation of the acromial
      morphology, planning of the dimensions of bony resection, a reproducible
      acromioplasty method with intraoperative evaluation of the adequacy of resection,
      and postoperative confirmation of the resulting acromial shape. A precise
      technique for arthroscopic acromioplasty has been developed in the course of
      performing over 200 shoulder arthroscopies. This method adheres to conventional
      open surgical goals for bony resection and allows for reliable intraoperative
      evaluation of the result. Using this technique, over 90% good and excellent
      results may be achieved in treatment of stage II subacromial impingement
      syndrome.

PMID- 1750942
TI  - An arthroscopic technique of demonstrating the pathomechanics of the
      suprapatellar plica.
AB  - The suprapatellar plica or incomplete suprapatellar septum of the knee is a
      recognized cause of knee pain in some patients and appears to exist in others
      without causing any symptoms. To date no clear method of demonstrating the
      pathomechanics of the suprapatellar plica by arthroscopic means has been
      described. This article describes a new technique of visualizing this structure
      arthroscopically and demonstrating the mechanism of its morbidity. By the use of
      a proximal viewpoint via the lateral suprapatellar portal, we have shown that the
      suprapatellar plica impinges on the medial femoral condyle and is trapped between
      the quadriceps mechanism and the femoral trochlea when the knee is flexed beyond
      70 degrees. We conclude that our arthroscopic method may show the mechanism of
      production of symptoms of the pathological suprapatellar plica.

PMID- 1750943
TI  - Cost-effectiveness study of magnetic resonance (MR) scanning of the acutely
      injured knee.

PMID- 1750944
TI  - Sequence analysis of the D1 and D2 reaction center proteins of photosystem II.
AB  - A compilation of 38 sequences for the D1 and 15 sequences for the D2 reaction
      center proteins of photosystem II is presented. The sequences have been compared
      and a similarity index that takes into account the degree of conservation and the
      quality of the changes in each position has been calculated. The similarity index
      is used to identify and describe functionally important domains in the D1/D2
      heterodimer. Comparative hydropathy plot are presented for the aminoacid
      sidechains that constitute the binding domain of the tyrosine radicals, TyrZ and
      TyrD, in photosystem II. The structure around TyrZ is more hydrophilic than the
      structure around TyrD. The hydrophilic residues are clustered in the part of the
      binding pocket for TyrZ that is turned towards the lumenal side of the thylakoid
      membrane. Most prominent is the presence of two conserved carboxylic aminoacids,
      D1-Asp 170 and D1-Glu 189. Their respective carboxyl-groups come close in space
      and are proposed to constitute a metal binding site together with D1-Gln 165. The
      distance between the proposed metal binding site and the center of the ring of
      TyrZ is approximately 7 A. The cavity that constitutes the binding site for TyrD
      is composed of residues from the D2 protein. Its character is more hydrophobic
      than the TyrZ site and the environment around TyrD lacks the cluster of putative
      metal binding side-chains.

PMID- 1750945
TI  - The end of mandatory retirement and its implications for academic medicine.
AB  - The prohibition against age-based mandatory retirement, codified in amendments to
      the Age Discrimination in Employment Act (ADEA) in 1986, remains a concern in the
      academic medical community. A seven-year exemption covering tenured faculty
      expires at the end of 1993. The author reviews the legislative history of the
      ADEA and explores in detail the planning and management issues--and the available
      projections of likely faculty behavior in the future--concerning the banning of
      age-based mandatory retirement of higher education faculty, with special
      reference to the academic medical community. Although the major studies
      concerning the probable course of events after the seven-year exemption expires
      indicate that there will not be a cataclysmic effect on institutions of higher
      education, it is still not certain how tenured faculty will behave and how that
      will affect medical schools. The author cautions that the management acumen of
      institutional leaders will be taxed, and that medical school deans should realize
      this and begin the transition into the new era by improving systems for faculty
      evaluation and development, clarifying the financial guarantees of tenure,
      implementing space utilization reviews, and developing programs to make
      retirement attractive.

PMID- 1750946
TI  - Forty years of litigation involving residents and their training: II. Malpractice
      issues.
AB  - The authors reviewed 136 cases of malpractice litigation involving residents or
      programs of graduate medical education that were reported from 1950 through 1989.
      Before 1970 malpractice constituted the only area of reported litigation for
      residents. The number of malpractice cases involving residents increased
      substantially after 1975, paralleling the growth of malpractice cases nationally.
      The regional pattern of reported cases involving residents also corresponded with
      previous findings. Questions of vicarious liability, the applicable standard of
      care, and residents' supervision were at issue in the great majority of cases.
      Questions related to judicial procedure, immunity from liability, breach or
      causation, and informed consent were also litigated. Residents were on the side
      of the prevailing party in 44% of the cases. Malpractice continues to be the key
      legal issue facing programs of residency training.

PMID- 1750947
TI  - Medical students' professional ethics: defining the problems and developing
      resources.
AB  - An AAMC working group concluded that medical educators have paid insufficient
      attention to students' development of professional standards and to the immediate
      ethical dilemmas that students face as students. Its discussion of the primary
      determinants of medical students' ethical development focused on improving: (1)
      the evaluation of candidates for admission; (2) the medical school learning
      climate, including recognition of the challenges inherent in the increasing
      cultural diversity among students and patients; and (3) communication to students
      of expectations of professional behaviors and standards. An AAMC initiative is
      outlined that includes preparation of a resource book featuring cases
      illustrating common ethical dilemmas that medical students face, descriptions of
      effective honor systems, suggestions for faculty development, and an annotated
      bibliography.

PMID- 1750948
TI  - A humanities and medicine program for faculty.

PMID- 1750949
TI  - The contribution of medical missions: the intercultural transfer of standards and
      values.

PMID- 1750950
TI  - The Department of Veterans Affairs health care system and national health care.

PMID- 1750951
TI  - Broadening the focus of medical education reform.

PMID- 1750952
TI  - Medical students' perceptions of the practice of internal medicine.

PMID- 1750953
TI  - Teaching both the management and the molecular biology of sickle cell disease.

PMID- 1750954
TI  - Overview of recent literature on undergraduate ambulatory care education and a
      framework for future planning.
AB  - This study provides an interpretive overview of ambulatory care undergraduate
      education from 1979 to 1991 and identifies two major problems for medical
      education: (1) the difficulties inherent in the transfer of educational
      techniques from the hospital to the ambulatory care setting; and (2) the misuse
      of and lack of agreement on definitions of ambulatory care, primary care, and
      community-oriented primary care. The authors distinguish various types of
      ambulatory care and examine factors that differentiate ambulatory care and
      hospital sites for educating medical students, including the setting, program
      management, curriculum issues, evaluation, cost, faculty time, and space. Based
      on concepts and issues identified in the study, the authors propose a framework
      for planning future ambulatory care education and research.

PMID- 1750955
TI  - Stability of medical specialty selection at the University of Kentucky.
AB  - In the fall of 1989, all graduates of a 30-year-old medical college were surveyed
      by questionnaire concerning their motivations for their original selections of
      specialties, motivations for changing their specialties when such changes had
      occurred, and factors involved in their current choices of specialties. The 723
      respondents were grouped by specialty response into one of three groups (primary
      care plus medicine and pediatrics subspecialties; surgery; or controllable
      lifestyle), and responses were statistically analyzed. The most important factors
      influencing initial specialty selection were perceived match of personality and
      specialty; technology and methodology characteristic of the specialty; and time
      for family activities, in that order. The ratings of the 175 respondents who
      stated that they had changed specialties indicated that time for avocational
      pursuits and time for family activities were the most important reasons for
      change. The reasons for selecting a different specialty varied. This study's
      findings suggest that a student's likelihood of making an inappropriate specialty
      choice may be reduced by a broad undergraduate medical education with realistic
      experiences in clinical activity. Students' lack of awareness of the lifestyle of
      a particular specialty may be a significant factor in the flow of physicians from
      noncontrollable lifestyle specialty areas. Those who counsel medical students
      need to be aware of the increasing importance of controllable lifestyle features,
      changing attitudes, faculty role-modeling, and mentors as strong influences on
      students' choices of specialties.

PMID- 1750956
TI  - A review of the validity and accuracy of self-assessments in health professions
      training.
AB  - Valid self-assessment is fundamental to continuing professional competence but is
      seldom explicitly taught in health professions training. This review analyzed 18
      scholarly articles published between January 1970 and February 1990 (14 articles
      regarding health professions trainees, and four concerning college students or
      graduate trainees) in which it was possible to compare performance as self
      assessed by trainees with performance as assessed by experts or objective tests.
      The validity of self-assessed performance was found to be low to moderate and did
      not improve with time in conventional health professions training programs. Self
      assessed performance seemed closely related to generalized self-attributions and
      was minimally influenced by external feedback in the form of test scores, grades,
      or faculty assessments. In five programs emphasizing explicit self-assessment
      goals and training strategies, moderate-to-high validity outcomes or improvements
      over time were demonstrated. Much of what passes for self-assessment in training
      seems the exercise of an underdeveloped skill, but effective training to improve
      validity and accuracy is available and feasible.

PMID- 1750957
TI  - Attitudes and factors affecting the decisions of men and women pediatrics
      residents toward having children during their residencies.
AB  - This study examines attitudes and factors affecting the decisions of pediatrics
      residents of both sexes toward having children during their residencies. In 1987,
      the authors surveyed by mail all 742 pediatricians who had trained at eight
      university-based residencies from 1981 to 1987; 417 responded. Of these, the men
      were significantly more likely than the women to have had children during their
      residencies (p less than .001). At the time of their residencies, 265 of these
      pediatricians were married. Of those who were married but did not have children
      during their residencies (175), the women were significantly more likely than the
      men to believe that having a child during residency would have had a negative
      influence on their careers (p less than .001) and would have been associated with
      difficulties in arranging child care (p less than .001). By contrast, among those
      pediatricians who were married and did have children during their residencies
      (90), their perceptions concerning the impacts on their careers of having
      children and the difficulty in arranging child care did not differ significantly
      by gender. The authors suggest that programs might explore the possibilities of
      greater flexibility in scheduling and of making child care more available so that
      residents could more easily combine their careers with having children.

PMID- 1750958
TI  - The student-initiated, faculty-assisted system of evaluation of clinical teaching
      at the University of Virginia.
AB  - The University of Virginia School of Medicine has developed a student-initiated,
      faculty-assisted system to evaluate the faculty who teach the third-year clinical
      clerkships. All students complete an evaluation at the end of each clerkship, and
      the fourth-year class and student government compile the results and publish a
      detailed annual report of the data, offering constructive criticism and
      recommendations for change. Teaching faculty then review the report and respond
      to the student government, the faculty clerkship committee, and the student
      curriculum committee, addressing the contents of the report and initiating
      proposals to correct deficiencies and improve teaching. The experience of the
      first two administrations of this system (1988-1990) has been encouraging, and
      the authors suggest that the system will be applicable to the evaluation of
      clinical teaching on a universal basis.

PMID- 1750959
TI  - A collaborative approach to a primary care preclinical preceptorship for
      underserved settings.
AB  - This study describes the first few years of a collaborative effort undertaken by
      the University of Washington School of Medicine (UWSM), the Washington-Alaska
      Montana-Idaho (WAMI) Area Health Education Center program, the Washington Academy
      of Family Practice, and the Family Health Foundation of Washington to provide
      students with an early introduction to primary care practice in rural and urban
      underserved settings. Starting in 1988, these collaborators organized a summer
      preceptorship that offered placements in the WAMI region to 23 student volunteers
      who were between their first and second years at the UWSM in 1989 and to 51 such
      students in 1990. A preliminary evaluation of the program indicated that the
      students (73 of whom participated in the evaluation) were extremely satisfied
      with the program's ability to provide them with firsthand exposure to community
      medicine. In conclusion, the authors discuss the advantages of collaboration and
      make suggestions for identifying potential educational partners.

PMID- 1750960
TI  - Retraining faculty for the problem-based curriculum at the University of Hawaii,
      1989-1991.
AB  - The problem-based learning (PBL) curriculum, adopted by an increasing number of
      medical schools, requires retraining faculty for new roles as tutors with small
      groups of medical students. This study describes the procedures and results of
      four PBL training workshops (1989-1991) given at the University of Hawaii John A.
      Burns School of Medicine. Eighty-eight faculty volunteers each answered a 20-item
      multiple-choice questionnaire testing their knowledge of PBL both before and
      after they participated in a workshop. The posttest results were used to identify
      deficiencies in the tutors' knowledge and practice of both their role and their
      function. The authors conclude that these deficiencies, now identified, will be
      addressed in a systematic fashion in subsequent workshops.

PMID- 1750961
TI  - Behavior-change strategies used by a sample of physicians for patients at risk of
      coronary problems.

PMID- 1750962
TI  - Practitioners' ability to predict the educational value of their patients.

PMID- 1750963
TI  - [Croup and air pollutants: results of a two-year prospective longitudinal study].
AB  - The Reutlingen/Tubingen/Rottenburg region in Baden-Wurttemberg is characterized
      by medium and small sized towns and rural areas. In 1986/87 875 cases of croup
      were registered there by the treating physicians during a 24-months period. In
      consideration of meteorological and virological "disturbing variables" the
      influence of the measured air pollution by SO2, NO, NO2, CO, ozone and dust on
      croup frequency was computed by means of statistical regression methods. For the
      months September till March, the main manifestation period of croup, weak but
      statistically significant influences of the daily means of NO and NO2 were found,
      for the whole year influences of NO, NO2, and CO. During the winter months
      temperature correlates positively and velocity of wind negatively, both
      statistically with significance, to croup frequency. The essential conditions of
      croup are individual and familiar disposition on the one hand, virus infections
      on the other. Air pollution of a concentration like given in the investigated
      region was found to be a weak additional factor that favours the manifestation of
      croup.

PMID- 1750964
TI  - A note on the comparative efficacy of three selective media for isolation of
      Campylobacter species from environmental samples.
AB  - The efficacy of three selective broths and agars, i.e. Preston-, mCCD- and CAR
      medium, were compared to each other in various combinations. Twelve Campylobacter
      coli and 9 Campylobacter jejuni strains that had been isolated from sewage were
      used as test strains. To evaluate the applicability for highly contaminated
      environmental samples 15 sewage samples were examined, subsequently. Significant
      differences between the media could not be ascertained. The application of
      Preston broth/agar or CAR broth/Preston agar, however, is strongly recommended
      for investigation of highly contaminated environmental samples, as bacterial
      overgrowth (CAR agar) and difficult retrievability from agar surfaces (mCCD agar)
      were observed. A necessity of blood-supplementation is assumed.

PMID- 1750965
TI  - [Detection methods and occurrence of Cryptosporidium sp. in selected surface
      waters].
AB  - Cryptosporidium, a small coccidian parasite, is accepted as an important cause of
      severe diarrheal illness in man and animals; in immunocompromised persons illness
      may be life-threatening. Cryptosporidium is transmitted by oocysts, passed in the
      faeces. These oocysts are remarkable resistant to common disinfectants and they
      can survive for several months. Person-to-person, animal-to-person and faecal
      contaminations of the environment are proven routes of transmission. Also
      waterborne disease outbreaks caused by Cryptosporidium are well documented. This
      paper represents a modification of a method for the detection of Cryptosporidium
      in water, developed by Musial et al. and Rose et al. The method includes steps
      for filtration, elution, centrifugation, flotation and microscopic detection of
      Cryptosporidium oocysts in sediments using an indirect immunofluorescence
      technique and a native contrast-technique. With this modified method efficiency
      of recovery ranged from 8.1% to 27.1%. In addition, selected surface waters in
      Northrhine-Westphalia were examined. The finding of Cryptosporidium oocysts in 7
      of 9 water samples (78%) demonstrates the occurrence of Cryptosporidium oocysts
      in surface waters in Western-Germany. These results suggest that more detailed
      studies are needed to assess the risk of this new pathogen in water, especially
      in removal and disinfection in water treatment plants.

PMID- 1750966
TI  - Evaluation of an enzymatic method for fast identification of Listeria spp. in
      cheese and meat products.
AB  - Listeria-Tek ELISA was compared with conventional cultural procedure of FIL/IDF
      (Federation International de Laiterie/International Dairy Federation) modified by
      us. The ELISA assay is able to detect Listeria innocua, Listeria monocytogenes,
      Listeria murrayi and Listeria welshimeri, after 48 h in artificially contaminated
      cheeses. No specific reactions, no false positive or negative were detected and
      the assay has a high correlation with the conventional method used in this
      research. We also analyzed meat products and cheeses and identified Listeria spp.
      and Listeria monocytogenes serotypes. In 313 food samples examined there were
      only 3 false positives. With ELISA Kit we obtained 0.9% more than with the
      cultural method and the percentage of false positives is 1.6%. So in commercial
      products the total absence of false negatives demonstrates the great sensitivity
      of the method in respect to investigated microorganisms. As determined by
      cultures 218 samples contained 47 Listeriae monocytogenes, 67 Listeriae innocua,
      21 Listeriae welshimeri, 7 Listeriae ivanovii, 3 Listeriae murrayi and 3
      Listeriae denitrificans. Listeria monocytogenens includes serotypes 1 (13) and
      serotypes 4 (14). 20 Listeriae monocytogenes were serotyped by polyantisera Difco
      (Detroit, Michigan).

PMID- 1750967
TI  - [Laboratory studies of Salmonella decontamination in bone meal using propionic
      acid].
AB  - Laboratory investigations centered on determining the concentration and time of
      influence of propionic acid to decontaminate salmonella in bone meal as well as
      on the inhibitory effect of reanimation and recontamination. Tests have been
      conducted by means of contaminated bone meal charges either naturally or
      artificially stressed. Findings revealed, that freedom of salmonella could be
      achieved ranging between one hour and 21 days when adding 3% of propionic acid to
      the bone meal dependent on the stress of salmonella. Evidence could be proved to
      the inhibitory effect of reanimation of propionic acid at least one week after
      the entry of action. Protection of the bone meal treated with 3% of propionic
      acid against new contamination of salmonella has proved to be independent of the
      rate of recontamination. Freedom of salmonella lasting for two or three weeks
      could be stated after a holding time of one day.

PMID- 1750968
TI  - Occurrence of mycobacteria in drinking water samples.
AB  - 33 ground water samples from three drinking water treatment plants and 72 samples
      from domestic drinking water distribution systems were studied for the occurrence
      of mycobacteria. 86 out of these samples tested positive for mycobacteria with
      concentrations generally ranging between 10(2) and 10(3) cfu/l. In one
      distribution system up to 4.5 x 10(5) cfu/l were found. Species identified by
      biochemical reactions and by thin layer chromatography of mycolic acids included:
      Mycobacterium gordonae (most water samples), M. flavescens, M. kansasii, M.
      chelonae (domestic water systems) and M. fortuitum (drinking water treatment
      plant). Most isolates did not show patterns of biochemical reactivity
      attributable to any known mycobacterial species.

PMID- 1750969
TI  - Microorganisms in water, soil and air. Abstracts of papers presented at the
      Workshop of the Deutsche Gesellschaft fur Hygiene and Mikrobiologie, Section
      Hygiene and Public Health, Berlin, 14.-15.3. 1991.

PMID- 1750971
TI  - Use of a nutrition information system.

PMID- 1750970
TI  - [Guidelines for the testing and evaluation of skin disinfectants].

PMID- 1750972
TI  - Use and misuse of dietary recommendations to evaluate food intake.

PMID- 1750973
TI  - Analysis of the sugar flow in Norway.

PMID- 1750974
TI  - Proposed system for food and nutrition surveillance in Norway.

PMID- 1750976
TI  - Grouping foods: uses of FAO food balance sheet database.

PMID- 1750975
TI  - Nutrition information systems and data quality requirements.

PMID- 1750977
TI  - A review of household budget surveys in 17 countries.

PMID- 1750978
TI  - Health impact monitoring.

PMID- 1750979
TI  - Food balance sheets.

PMID- 1750980
TI  - Household budget surveys.

PMID- 1750981
TI  - Dietary surveys and the use of the results.

PMID- 1750982
TI  - Problems and pitfalls of foot-to-nutrient conversion.

PMID- 1750983
TI  - Database requirements for calculations from food balance sheet data and household
      budget surveys.

PMID- 1750984
TI  - Comparison of dietary data from different sources: some examples.

PMID- 1750985
TI  - [Profession and market].

PMID- 1750986
TI  - [Indications for home care--hot potato or logical development?].

PMID- 1750987
TI  - [Indications for home care--it works this way!].

PMID- 1750988
TI  - [The Free University Hospital in Amsterdam--looks to the future].

PMID- 1750989
TI  - [Quality of the intake interview in district nursing].

PMID- 1750990
TI  - [Nutrition of the bedridden patient. Care to measure and care for well-being].

PMID- 1750991
TI  - [How competent do nurses want to be? The Law BIG/art. 55a (Professions in
      Individual Health Care)].

PMID- 1750992
TI  - [Certification of competence].

PMID- 1750994
TI  - [Nursing science and nursing care. The other side of one's own right].

PMID- 1750993
TI  - [Land of courses].

PMID- 1750995
TI  - [Exploring in the land of research. Experiences of the district nurse].

PMID- 1750996
TI  - [Provincial Hospital Santpoort--from the dunes to the city].

PMID- 1750997
TI  - [Developments in the labor market (1). Demand and supply till the year 2000].

PMID- 1750998
TI  - [Nutrition in chronic loss of kidney function. Never able to just eat something
      that's nice...].

PMID- 1750999
TI  - [Demonstration Nursing 1992 shaping up].

PMID- 1751000
TI  - [Part-time education nursing science--1987 to the present].

PMID- 1751001
TI  - [Training first-grade instructors in nursing. A new course].

PMID- 1751002
TI  - The human cerebro-cerebellar system: its computing, cognitive, and language
      skills.
AB  - In this review of the human cerebro-cerebellar system, the focus is on the
      possible contributions of the cerebellum to cognitive and language functions. The
      role of the cerebellum in these human functions has tended to be obscured by the
      traditional preoccupation with the motor functions of the cerebellum, which have
      been widely observed in other vertebrates as well. In the human brain, some
      phylogenetically new parts evolved and enlarged in the cerebellum, concomitantly
      with the enlargement of association areas in the cerebral cortex. Anatomical
      evidence and behavioral evidence combine to suggest that this enlarged cerebellum
      contributes not only to motor function but also to some sensory, cognitive,
      linguistic, and emotional aspects of behavior. The anatomical evidence derives
      from the modularity of the cerebellum, whose cortical nerve cells are organized
      into longitudinal micro-modules, which are arrayed perpendicular to the cortical
      surface and parallel to each other. The number of these micro-modules increased
      when the cerebellum enlarged, which enlarged the computing capabilities of the
      network. (From principles underlying the processing of information, it is known
      that when modules with modest processing capabilities are assembled in large
      numbers in parallel, the resulting network can achieve remarkably powerful
      computing capabilities.) Such cerebellar computing capabilities can be utilized
      in the different areas of the cerebral cortex to which the cerebellum sends
      signals. The cerebellar output connections convey signals through the thalamus to
      the cerebral cortex in segregated channels of communication, which preserve the
      modularity of the cerebellum. Through these channels, modules in the lateral
      cerebellum can send signals to new cognitive and language areas of the cerebral
      cortex, such as Broca's area in the prefrontal cortex. The anatomy of the human
      cerebro-cerebellar system therefore suggests that the cerebellum can contribute
      to the learning not only of motor skills but also of some cognitive and language
      skills. Supporting this anatomical evidence is the mounting behavioral evidence,
      obtained both in normal brains and in clinical studies, which indicates that the
      lateral cerebellum is indeed involved in some cognitive and language functions.

PMID- 1751003
TI  - Effects of monocular deprivation on the visual fields of squirrel monkeys.
AB  - Five squirrel monkeys were monocularly deprived at birth for 3 years. Visual
      field testing for the deprived eye revealed no responses to visual stimuli at any
      position, including the monocular segment. These results are similar to those
      obtained in macaque monkeys after long-term neonatal monocular deprivation and
      indicate that lack of patterned visual input to an eye during development in
      primates can produce functional blindness throughout the visual field. Because
      the monocular segment of the visual field was not spared, binocular competition
      cannot be the only mechanism underlying this loss. Instead, lack of patterned
      visual input probably causes improper neuronal connections during development in
      all segments of the visual cortex resulting in complete loss of form vision.

PMID- 1751004
TI  - Differential involvement of anterior and posterior cingulate cortices in spatial
      discriminative learning in a T-maze in mice.
AB  - The contribution of the anterior and posterior cingulate cortical areas to
      spatial learning and memory was examined in mice using a behavioral paradigm
      based on a spatial discrimination task in a T-maze. Multiple injections of small
      amounts of ibotenic acid were used to produce fiber-sparing lesions of either the
      anterior (ACC) or the posterior (PCC) cingulate area. Mice with ACC lesions,
      though learning the initial acquisition and first reversal of the discrimination
      at about the normal rate, were impaired during the subsequent four reversal
      sessions. In contrast to control mice, they failed to improve their performance
      from the first to the last session. Nevertheless, when later required to
      repeatedly learn the same discrimination over several days (repetitive testing),
      animals with ACC lesions no longer exhibited any learning deficit. The converse
      pattern of results was found in mice with PCC lesions. These animals performed
      much more poorly than control animals during the acquisition and first reversal
      of the discrimination, but displayed remarkable improvement over the subsequent
      four reversal sessions, gradually overcoming their initial impairment. However,
      when later submitted to repetitive testing, these animals again showed a
      substantial learning deficit. Neither ACC nor PCC cingulate lesions significantly
      affected the animals' retention capacities as measured by single test-trials over
      a 24-h interval. Yet, mice with PCC lesions were retarded in reversal learning
      after a long intersession interval (10 days), indicating that PCC, but not ACC,
      lesions did interfere with some long-term retention processes. These results
      imply that the ACC, as a part of the medial frontal cortex, may play a crucial
      role in temporally ordering a series of spatial responses, whereas the PCC seems
      to contribute to the formation and retention of each individual spatial response,
      probably by transmitting information from limbic structures such as the anterior
      thalamus and hippocampal formation to posterior neocortical association areas.

PMID- 1751005
TI  - Zona incerta lesions: effects on copulation, partner-preference and other socio
      sexual behaviors.
AB  - Sexually active males prefer a sexually receptive female to a non-receptive
      female, and partner-preference tests provide one way of studying the effect of
      brain damage on sexual motivation. Male rats with bilateral electrolytic lesions
      of the caudal zona incerta do not mate, and we studied the effects of zona
      incerta destruction on copulation and partner-preference. Lesioned males did not
      mate but were not indifferent to sexually receptive females. They continued to
      show a strong preference for a sexually receptive female over a non-receptive
      female. In addition, lesioned males showed many incomplete mounts i.e. mounts not
      accompanied by the pelvic thrusting necessary for intromission and ejaculation.
      Anogenital investigation of the receptive female was common. Taken together,
      these facts suggest that zona incerta destruction eliminates copulation without
      affecting sexual motivation, and that the failure to mate after lesioning
      probably reflects an inability to properly engage the locomotor responses of
      copulation.

PMID- 1751006
TI  - Both fornix and anterior thalamic, but not mammillary, lesions disrupt delayed
      non-matching-to-position memory in rats.
AB  - Rats with radiofrequency lesions of the fimbria/fornix, or neurotoxic lesions of
      the mammillary bodies or the anterior thalamic nuclei were tested on their
      ability to perform a delayed non-matching-to-position task that had been learnt
      before surgery. In this task rats had to respond to a sample lever in an operant
      chamber and, after a variable delay (during which they were required to respond
      at the magazine tray), press the other lever when both were presented. Extensive
      mammillary body lesions had no effect on performance. In contrast, lesions in
      either the anterior thalamic nuclei or the fimbria/fornix produced marked
      deficits, the pattern of these deficits being consistent with a mnemonic
      impairment. It is argued that the anterior thalamic nuclei represent an important
      hippocampal output for spatial problems, but that the mammillary bodies are only
      necessary for certain types of mnemonic task.

PMID- 1751007
TI  - The effects of posterior cortical lesions on responses to visual threats in the
      Mongolian gerbil (Meriones unguiculatus).
AB  - Mongolian gerbils received aspiration lesions of either primary visual cortex
      (PVC), medial extrastriate visual cortex, retrosplenial cortex (RSC), or sham
      operations. The responses of gerbils to the presentation of an overhead visual
      stimulus were recorded in an open field. In all groups, presentation of the
      stimulus produced an increase in rearing. This suggests that the stimulus was
      detected by all animals. Gerbils with RSC or PVC lesions showed reduced levels of
      response to the stimulus. We suggest that some of the observed deficits can be
      explained as failures to produce responses to threat that are appropriate to the
      context in which the the threat was presented.

PMID- 1751008
TI  - Interactions between amygdaloid and hypothalamic self-stimulation: a re
      examination.
AB  - The function relating bar-pressing rate to the frequency of cathodal pulses was
      obtained in rats self-stimulating with amygdaloid (AMY) and lateral hypothalamic
      (LH) electrodes. The maximum self-stimulation (SS) rates in the AMY was found to
      be very low, compared to the LH. Concurrent stimulation with pairs of AMY-LH
      pulses did not shift the rate-frequency functional laterally, indicating the
      absence of summation of the two rewarding effects. In a second experiment,
      concurrent AMY-LH stimulation (using sub-threshold intensity LH pulses)
      facilitated bar-pressing for AMY stimulation (it increased the slope of the AMY
      rate-frequency function) without shifting this function laterally. In a third
      experiment, subjects were given a choice between a pulse frequency yielding
      maximal AMY rate and a series of higher pulse frequencies. Subjects consistently
      preferred the higher frequency values, attesting that the maximum AMY rates were
      not constrained by a saturating reinforcing effect. In a fourth experiment,
      subjects were given a choice between AMY stimulation and concurrent AMY-LH
      stimulation, using low intensity LH pulses. Subjects showed no preference for
      either stimulation condition, although rates were higher for the latter
      condition. These findings suggest that the maximum rate for AMY stimulation was
      constrained by factors interfering with bar-pressing and that the effect of these
      factors was attenuated by co-activation of the LH. In a fifth experiment, pre
      treatment with phenobarbital mimicked the rate-enhancing effect of concurrent AMY
      LH stimulation for 2 of the 4 subjects tested. This finding suggests that the LH
      pulses contributed to attenuate seizure activity accompanying AMY SS. In a final
      experiment, AMY SS rates were also increased by co-activation of rewarding sites
      in the rostral MFB but not the dorsal raphe, suggesting an anatomical specificity
      of this effect.

PMID- 1751009
TI  - Motor effects of globus pallidus stimulation in the rat: lesions to corticofugal
      fibers block the motor effects.
AB  - Unilateral electrical stimulation of the globus pallidus (GP) in anesthetized
      male rats was used to determine the nature of the activity driven in muscles of
      the neck and shoulder by GP output. In 6 groups of animals stimulation was
      coupled with lesions to sites that interrupted corticofugal fibers or GP output.
      Interruption of corticofugal fibers blocked the driven activity while lesions
      that compromised GP output left the activity unaffected.

PMID- 1751010
TI  - Activity of spinal trigeminal pars oralis and adjacent reticular formation units
      during differential conditioning of the rabbit nictitating membrane response.
AB  - Spinal trigeminal nucleus pars oralis (SpoV) is anatomically linked to brain
      circuitry thought to subserve unconditioned and conditioned nictitating membrane
      responses in rabbit. Single-unit recording from SpoV and adjacent reticular
      formation obtained during conditioning from awake, behaving animals revealed
      modulation of unit firing related to CS, US, and CR occurrence. SpoV participates
      directly in the unconditioned response and probably relays US information to
      other brain areas subserving conditioning. The presence of CR-related activity
      suggests that SpoV may participate in the CR motor output pathway, and may also
      provide CR-related information to cerebellum. Sensory convergence and CR-related
      activity in reticular formation mark this structure as a candidate locus of
      primary neuronal plasticity in this example of conditioning.

PMID- 1751011
TI  - Control of food delivery in food-deprived rats mediates analgesia.
AB  - An experiment was carried out to investigate the effects of control of food
      delivery, in food-deprived rats, on analgesia. Tail flick latency was used as an
      index of pain sensitivity and naloxone reversibility of analgesia was used as the
      criterion for opioid involvement. Food-deprived rats were submitted to one of two
      schedules of food delivery. The 'contingent' group could control the delivery of
      food by lever-pressing. The 'non-contingent' group received the same number of
      food pellets but delivery of food was independent of lever-pressing behaviour.
      Animals in the 'control' group were placed in the test chamber but did not
      receive any pellets. Subjects were tested on 6 consecutive days, each test
      session being of 10 min duration. Half of the animals in each group received an
      intraperitoneal injection of saline (0.5 ml) prior to each test session, the
      other half received an intraperitoneal injection of naloxone (5 mg/kg in 0.5 ml
      saline) prior to each session. Both contingent and non-contingent food delivery
      resulted in a significant post-test analgesia. The analgesia was noticeably
      greater when food delivery was non-contingent and this analgesia was reversible
      by naloxone. The findings suggest that non-contingent food delivery, in food
      deprived rats, elicits an opioid analgesia, whilst contingent food delivery
      elicits a non-opioid analgesia.

PMID- 1751012
TI  - Inhibitory effects of powerline-frequency (60-Hz) magnetic fields on
      pentylenetetrazol-induced seizures and mortality in rats.
AB  - The possibility that exposure to powerline frequency (60-Hz) magnetic fields
      might affect the form or intensity of epileptic seizures, induced by
      administration of pentylenetetrazol (PTZ) in rats, was examined. Male adult rats
      were exposed to either 60-Hz magnetic fields with intensities of up to 1.85 gauss
      (185 microT) or to a sham field condition, for 1 h prior to injections of PTZ (45
      75 mg/kg). The subsequent seizures were monitored and recorded on videotape and
      any subsequent mortalities were noted. Exposure to 60-Hz magnetic fields prior to
      administration of PTZ was found to significantly (P less than 0.005) reduce the
      lethality of the drug-induced seizures. The LD50 for the sham-exposed group was
      65.88 mg/kg, whereas for the 60-Hz magnetic field-exposed rats, the LD50 was
      85.33 mg/kg. In some experiments exposure to the 1.0 and 1.5 gauss magnetic
      fields also produced significant (P less than 0.05) reductions in seizure
      durations. These findings suggest that acute exposure to low intensity 60-Hz
      magnetic fields has an inhibitory effect on the lethality and expression of PTZ
      induced seizures in rats. Some possible mechanisms, which could account for these
      observed effects of magnetic field exposure on seizures, are discussed.

PMID- 1751013
TI  - Anti-muscarinic drug effects in a swim-to-platform test: dose-response relations.
AB  - Rats were given subcutaneous or intraperitoneal injections of scopolamine,
      intraperitoneal injections of atropine, or control injections, and trained on a
      simple swim-to-platform task. Errors were proportional to dose for both drugs
      over a wide range. No difference was found in the effects of intraperitoneal or
      subcutaneous scopolamine but scopolamine was 25 times more potent than atropine.
      The potency of both drugs in impairing swim-to-platform behavior was similar to
      their potency in abolishing the cholinergic component of neocortical low voltage
      fast activity. The electrocortical effect of anticholinergic drugs may be a major
      factor in the behavioral impairment they produce.

PMID- 1751014
TI  - Brightness-discrimination learning in cats is influenced by early visual
      deprivation.
AB  - A two-choice apparatus for food reward was used. Normal and visually deprived
      cats were trained to discriminate white and black cards. After the animals had
      reached criterion, the contrast difference between the cards was diminished in
      steps. When the brightness ratio had been reduced to 1.8, discrimination was
      impaired in the deprived cats and not in the normally raised cats.

PMID- 1751015
TI  - Clinical course of spontaneous gangliothalamic hemorrhage in the acute period-
      who requires surgical removal?
AB  - We analyzed the clinical courses of 93 consecutive patients with gangliothalmic
      hemorrhage for the first three weeks after the ictus and investigated the factors
      affecting the clinical course and the final outcome. The clinical status was
      assessed daily using the Glasgow Coma Score (GCS) and patients were divided into
      two groups according to the clinical course; Group I included those who improved
      and Group II consisted of patients who deteriorated. There were 44 patients
      (47.3%) in Group I and 49 patients (52.7%) in group II. Each group was subdivided
      into the conservative group and the surgical group. In Group I only eight
      patients (18.2%) received surgery while twenty-five patients (51.0%) received
      surgery in Group II. Clinical features and computed tomography characteristics of
      these four groups were compared. Our results suggested that the surgery is rarely
      required for patients 1) whose GCS values are 12 or more without deterioration;
      2) with hematomas smaller than 3 cm in diameter or 20 ml in volume; 3) with
      midline shifts of less than 3 mm, and 4) whose subtypes of the hematomas are P1,
      P2a, T1, T2a, and T2b. For proper comparison of the results of medical and
      surgical treatment, the patient population should include the patients 1) who
      became deteriorated progressively regardless of initial GCS values; 2) whose GCS
      values are below 12; 3) with hematomas larger than at least 3cm in diameter or
      20ml in volume; 4) with midline shift of more than 3mm, and 5) whose subtypes of
      the hematoma are P2b or GT.

PMID- 1751016
TI  - Sodium salicylate sensitivity in an asthmatic patient with aspirin sensitivity.
AB  - Non-acetylated salicylates have been recommended for use as alternatives to
      nonsteroidal anti-inflammatory drugs (NSAIDs) in aspirin and/or tartrazine
      sensitive patients. We experienced a case of an aspirin-sensitive asthmatic
      patient who developed a broncho-obstructive reaction after taking 100 mg of
      sodium salicylate. The result of this study suggests that sodium salicylate may
      cross-react with aspirin in aspirin-and tartrazine-sensitive patients.

PMID- 1751017
TI  - Surgical treatment of giant cavernous hemangiomas of the liver--analysis of 7
      patients.
AB  - Seven patients with giant cavernous hemangioma of the liver were treated
      surgically with success at Pusan Gospel Hospital, Kosin Medical College, Pusan,
      from 1980 through 1989. They were 3 males and 4 females, and their ages ranged
      from 6 to 59 years. The tumors were located on the right lobe of the liver in 5
      patients and on the left lobe in 2. The lesions were solitary in all patients,
      and their sizes varied from 4cm to 15cm in diameter. All patients underwent
      hepatic resection: 1 right hepatic lobectomy and 4 partial resections for tumors
      on the right lobe, and 1 left lobectomy and 1 left lateral segmentectomy for
      tumors on the left lobe. There was no surgical death, but 1 patient had a
      postoperative complication: multiple stress ulcers on the stomach and ileum. The
      pathologic diagnosis was cavernous hemangioma in all cases. In the long-term
      follow-up, there was no recurrence of preoperative symptoms in any patient.

PMID- 1751018
TI  - A survival study of surgically treated lung cancer in Korea. Lung Cancer Surgical
      Study Group.
AB  - Survival rate over a 5-year period were studied in a series of 658 proven primary
      lung cancer patients treated by thoracic surgeons at 8 institutes during the
      period from 1976 to 1987 in Korea. The study was designed as a multi-center
      cooperative work for the statistical analysis of the followup result. Clinical
      data of age, sex, morbidity, and staging of the tumor were assessed in 540
      patients to evaluate their 5-year survival rates. Eventually, 405 resectable
      patients were analyzed by stage, cell type, surgical procedure, and TNM status.
      The 5-year actuarial survival rates by stage in the resectable group were: stage
      I 39.7%, II 30.6% III A 16.3%, III B 6.7%, and IV 0%. The 5-year survival rates
      by cell type were: squamous cell 31.9%, adenocarcinoma 21.2%, large cell 11%, and
      small cell 6%. The survival rates by surgical procedures were: lobectomy 30.7%
      and pneumonectomy 25.7%. The survival rates by TNM status in the operable group
      were: T1 34.7%, T2 26.8%, T3 7.5%, T4 5%; N1 23%, N2 10%, N3 3%; MO 21%, and M1
      0%, respectively. The overall actuarial 5-year survival rate in the group of 405
      resectable patients was 25.9%.

PMID- 1751019
TI  - Effect of ursodeoxycholic acid on experimental hepatic porphyria induced by
      griseofulvin.
AB  - Griseofulvin(GF) has become the drug of choice as an antifungal agent for
      patients who suffer from many kinds of fungal infection. In order to clarify
      hepatic injury by griseofulvin(GF) overload and the effect of UDCA on GF-induced
      hepatic injury, the authors carried out biochemical, histologic, and
      ultrastructural studies of liver following treatment with griseofulvin and
      ursodeoxycholic acid(UDCA) in mice. Urine porphobilinogen excretion in the group
      treated with GF alone was significantly increased and reached the highest level
      in the 4th week and declined thereafter. Biochemical studies of the liver
      function showed no remarkable changes of serum bilirubin levels throughout the
      experimental period in all groups, except for SGPT and alkaline phosphatase
      activities which were significantly elevated and reached the highest level in the
      second week. Then they slightly decreased in GF treated groups(GF alone and GF
      plus UDCA) in comparison with the control group. Pathologic findings in the group
      treated with GF alone include focal liver cell necrosis(esp, zone 3), Mallory
      bodies in hepatocytes(esp, zone 1), Kupffer cell activation, and brown
      protoporphyrin pigments in the hepatocytes, bile canaliculi and interlobular bile
      ducts with a marked inflammatory cell infiltration in the portal tracts. Under
      the polarizing light microscope, bile ductular and canalicular thrombi showed a
      "Maltese cross" birefringence in mice treated with GF alone. There is no definite
      finding of fatty change in hepatocyte. Under the microscope, the liver appeared
      normal with an intact lobular architecture in the GF plus UDCA treated group.
      Electron microscopically, GF-induced changes include swelling of mitochondria,
      globular protoporphyrin crystals in the hepatocyte cytoplasm, markedly dilated
      bile cannaliculi and bile ducts and the formation of a Mallory hyaline bodies in
      the hepatocytes. There were no noticeable structural changes in the GF plus UDCA
      treated group. Therefore the results suggest that GF causes hepatic injury,
      namely porphyria and cholestasis, and the treatment of UDCA may have
      cytoprotective and choleretic effects on GF-induced hepatic injuries.

PMID- 1751020
TI  - Solitary myeloma with massive extracellular crystalline structures--a case
      report.
AB  - We describe a case of solitary myeloma showing cystic change filled with massive
      crystalline structures in a 54-year-old woman. A bone X-ray showed a solitary
      cystic osteolytic lesion in the right iliac bone. Serum and urine protein
      electrophoresis showed no demonstrable M-protein, and bone-marrow aspirates did
      not show any myeloma cells. Histologic examination of the tumor revealed
      aggregation of plasma cells with massive extracellular infiltration of the
      rhomboid-shaped crystalline structures. In immunoperoxidase staining, both these
      crystalline structures and the cytoplasms of the myeloma cells demonstrated a
      positive reaction for lambda light chain. By electron microscope, the large
      extracellular crystalline structures were observed, and we found unique rhomboid
      or rectangular-shaped crystalline structures in the cytoplasms of the myeloma
      cells.

PMID- 1751021
TI  - Body stalk anomaly--a case report.
AB  - A case is presented of an amnionic rupture sequence which led to massive fetal
      ventral herniation and lordoscoliosis. Characteristic ultrasonographic findings
      of an omphalocele, fetal attachment to the placenta, and the absence of free
      floating umbilical cord were observed.

PMID- 1751022
TI  - High jejunal obstruction as a sequela of necrotizing enterocolitis.
AB  - A case of high jejunal obstruction due to stricture is reported. It is a rare
      form of late sequelae of neonatal necrotizing enterocolitis(NEC). Barium contrast
      study of the small bowel is recommended for earlier diagnosis and treatment
      before discharge from the hospital, even is an asympto-matic patient.

PMID- 1751023
TI  - Arteriovenous malformation of the uterus--a cause of massive operative bleeding.
AB  - Arteriovenous malformations of the uterus are extremely rare and they occur
      either in congenital or acquired forms. The most common clinical presentation is
      abnormal uterine bleeding, which may be aggravated by therapeutic curettage.
      Because of their rare incidence and clinical importance in management of
      patients, we report a case of arteriovenous malformation causing serious bleeding
      during a hysterectomy for uterine leiomyoma. The patient was a 47-year-old
      multiparous woman who had a history of chronic vaginal bleeding for one year.
      Numerous anomalous blood vessels draining into the right and left uterine
      arteries were found on the anterior wall of the uterus and parametrium.

PMID- 1751024
TI  - Alternating dissociated nystagmus with palatal myoclonus--a case report.
AB  - An extraordinary eye movement was seen in a vegetative patient. His eyeballs were
      exotropic in the primary position and showed dissociated nystagmus which appeared
      alternately in each eye every few seconds. He also had palatal myoclonus quite
      asynchronous with the nystagmus. To our knowledge, there has been no such
      nystagmus documented in the literature. We report the new nystagmus with his EOG
      and brain MRI.

PMID- 1751025
TI  - A 23187-stimulated calcium uptake and GABA release by cerebrocortical
      synaptosomes: effects of high pressure.
AB  - Guinea pig cerebrocortical synaptosome preparations were used to study the effect
      of compression to 62 ATA on 45Ca2+ uptake and [3H]GABA release using a calcium
      ionophore A 23187, which bypasses the voltage-sensitive calcium channel. Pressure
      was found to exert a suppressive effect on the A 23187-induced release of
      [3H]GABA, while having no significant effect on A 23187-stimulated 45Ca2+ uptake.
      On the other hand, both depolarization-induced 45Ca2+ uptake and [3H]GABA release
      were inhibited by pressure exposure. These results suggest that pressure may
      suppress GABA release by affecting pre-synaptic events subsequent to calcium
      influx.

PMID- 1751026
TI  - The effect of (+)- and (-)-oxaprotiline administered repeatedly on the dopamine
      system.
AB  - The behavioural and biochemical effects of repeated (14 and 28 days) treatment
      with (+)-oxaprotiline (a noradrenaline uptake inhibitor) and (-)-oxaprotiline
      (levoprotiline, without influence on noradrenaline uptake; the clinically active
      antidepressant) were studied in rats. Both those enantiomers given repeatedly
      increased the locomotor and exploratory activity and reduced the immobility time
      in Porsolt's test. The D-amphetamine-induced locomotor hyperactivity, as well as
      the stereotypies induced by D-amphetamine and apomorphine, were increased by the
      oxaprotilines. Single-dose treatment with both the oxaprotilines was not
      effective in the tests mentioned above. Repeated (+)-oxaprotiline administration
      reduced the binding (Bmax but not KD) to dopamine D-1 receptors in the striatum
      and limbic system; levoprotiline was inactive. The binding to dopamine D-2
      receptors was not changed by either drug. Both the enantiomers showed only low
      affinity for brain dopamine D-1 and D-2 receptors in vitro. The obtained results
      indicate that chronic treatment with (+)- and (-)-oxaprotiline increases
      behavioural responsiveness of the dopamine mesolimbic and striatal systems.

PMID- 1751027
TI  - Brain kinetics of L-[beta-11C]dopa in humans studied by positron emission
      tomography.
AB  - The in vivo dopamine precursor L-3,4-dihydroxyphenylalanine (L-DOPA) labelled
      with 11C in the beta position has been used for positron emission tomography
      studies of L-DOPA utilization in the brain. The brain uptake and kinetics of L
      [11C]DOPA-derived radioactivity were studied in healthy male volunteers, and the
      specific utilization, i.e. decarboxylation rate of L-[11C]DOPA in different brain
      areas, was quantified using a brain region devoid of specific L-[11C]DOPA
      utilization as reference. Total uptake of L-[11C]DOPA-derived radioactivity
      measured in the brain varied two- to three-fold between subjects, with highest
      radioactivity in the striatal region. Specific utilization of L-[11C]DOPA
      radioactivity in the striatal region and in the prefrontal cortex varied twofold
      between subjects. No specific utilization was observed in other regions of the
      brain. The uptake of radioactivity in the brain increased dose-dependently with
      the simultaneous administration of unlabelled L-DOPA up to 10 mg. On the other
      hand, a decrease in brain radioactivity uptake was measured after pretreatment
      with 1 mg/kg oral L-DOPA, indicating competition for transport across the blood
      brain barrier. Benserazide 0.5 mg/kg orally increased somewhat the radioactivity
      uptake to the brain. None of these pharmacological perturbations demonstrated any
      clearcut effect on specific utilization of L-[11C]DOPA. Thus, 11C-labelled L-DOPA
      is introduced as an alternative to the well-established L-6-[18F]fluoro-DOPA
      methodology in clinical studies on brain L-DOPA uptake and dopamine synthesis.

PMID- 1751028
TI  - The presence of glutathione in primary neuronal and astroglial cultures from rat
      cerebral cortex and brain stem.
AB  - The concentration of the tripeptide glutathione (GSH) was measured in primary
      cultures of neurons and astroglial cells from rat cerebral cortex and brain stem.
      The concentration of GSH was found to be approximately 20 nmol/mg protein in the
      neuronal culture from the cerebral cortex and ca. 40 nmol/mg protein in the
      neuronal brain stem cultures. A GSH concentration of approximately 20 nmol/mg was
      observed in the astrocyte cultures from both brain regions. The possibility to
      increase the GSH concentration was tested by incubating the cultures in the
      presence of the GSH precursor gamma-glutamylcysteine (gamma-GC). In the cultured
      astrocytes gamma-GC produced a dose-dependent increase in GSH. A similar increase
      was observed in the neuronal cultures, but this effect failed to reach
      statistical significance.

PMID- 1751029
TI  - Facilitating effect of amphetamine on the response of rabbit aortic strips to
      adrenaline, dopamine and serotonin.
AB  - Amphetamine increased the response of rabbit aortic strips to adrenaline,
      dopamine and serotonin at consistently lower doses than those exerting a direct
      contracting effect. The amphetamine-facilitated contraction had the same shape as
      that produced by biogenic amines alone, whereas the contraction produced by
      amphetamine alone was more delayed and flatter. Serotonin and dopamine
      facilitated each other, but less markedly and with a narrower interval between
      facilitating and contracting doses than amphetamine. Pargyline exerted no
      facilitating effect on biogenic amines. Phentolamine and prazosin inhibited the
      direct response to adrenaline, dopamine and amphetamine, and the amphetamine
      facilitated response to adrenaline and dopamine; they were inactive against
      serotonin alone and combined with a facilitating dose of amphetamine or dopamine.
      Cyproheptadine inhibited the direct response to serotonin and amphetamine, and
      the amphetamine-facilitated response to serotonin; it was inactive against
      dopamine and adrenaline both alone and combined with a facilitating dose of
      amphetamine or serotonin.

PMID- 1751030
TI  - Buspirone does not produce a 5-HT1A-mediated decrease in temperature in man.
AB  - Buspirone, a putative serotonin (5-HT)1A partial agonist, did not produce
      hypothermia in 17 normal volunteers in a placebo controlled, single blind study.
      Thus, buspirone may be a weaker agonist at those 5-HT1A receptors which mediate
      hypothermia compared to ipsapirone or gepirone, two other 5-HT1A partial agonists
      which have been reported to produce hypothermia by a 5-HT1A-mediated mechanism.

PMID- 1751031
TI  - (-)-Deprenyl can induce soluble superoxide dismutase in rat striata.
AB  - (-)-Deprenyl (0.25 or 2 mg/kg) or saline was injected daily into male Wistar rats
      for 3 weeks. The striata were dissected out and soluble and particulate
      superoxide dismutase activity measured. (-)-Deprenyl at 2 mg/kg induced a
      significant increase in the soluble but not the particulate form of the enzyme.
      The possibility that this action contributes to the ability of (-)-deprenyl to
      retard nigral degeneration in man and prolong life in rats is discussed.

PMID- 1751032
TI  - Developmental expression of cathepsin L and c-rasHa in the mouse placenta.
AB  - An investigation is described of the expression of the cysteine proteinase
      cathepsin L during placental development. In addition, whether cathepsin L
      expression is linked to c-rasHa expression in development, as it is in metastatic
      cells, is examined. Large amounts of cathepsin L and its transcript are present
      in the mouse placenta, more than six times more than in adult kidney and liver.
      Throughout gestation, cathepsin L and its transcript are located in the giant
      cells and spongiotrophoblasts of the placenta. Several forms of different
      mobility on denaturing gels are found in the placenta. Their apparent molecular
      weights, as determined from the gels, are 43,000, 39,000, 29,000, and 20,000. The
      39-kDa form is procathepsin L. The 29-kDa and 20-kDa forms are lysosomal
      cathepsin Ls. The 39-kDa procathepsin L and the 20-kDa mature cathepsin L are the
      most abundant species in the placenta and are present in about equal amounts
      throughout gestation. At any time during gestation, placental minces synthesize
      and secrete only procathepsin L. The amniotic fluid of the fetus contains the 43
      kDa form of cathepsin L and procathepsin L, but no detectable amounts of mature
      cathepsin L. By contrast, serum from nonpregnant or pregnant mice contains three
      forms of cathepsin L (i.e., the 43-kDa form, procathepsin L, and mature cathepsin
      L). Cathepsin L and the rasHa oncogene are expressed in two coincident waves
      corresponding to periods during which the placenta is invasive and just before
      parturition. The presence of large amounts of cathepsin L in the placenta
      suggests that the proteinase has a significant function there. Expression of
      cathepsin L in the placenta is potentially under the control of the ras gene
      product p21; both are under developmental control.

PMID- 1751033
TI  - Sequence requirements for embryonic transcriptional activation of a gastrula
      specific actin gene in Xenopus laevis.
AB  - Cytoskeletal actin genes undergo developmentally timed transcriptional activation
      at the gastrula stage of embryonic development in the amphibian Xenopus laevis.
      To study the regulation of this process, a molecularly marked cloned actin gene
      has been introduced into living embryos by microinjection, and levels of its
      transcripts (which are distinct from endogenous actin message) have been measured
      by RNase protection. In vitro mutagenesis of the marked gene, followed by
      microinjection and transcriptional analysis of various mutants, has been used to
      search for gene sequences that participate in accurate transcriptional initiation
      and developmental control. Deletion mutants containing only 90 nucleotides of
      upstream sequence undergo correct developmental regulation, while deletion to -33
      prevents normal activation of the gene. In the presence of sufficient upstream
      sequence, an actin-globin fusion gene, containing only 564 nucleotides downstream
      of the actin gene transcription startsite, is correctly activated. Taken
      together, these results imply that all sequences necessary for correct temporal
      regulation reside between -90 and +564 nucleotides, with respect to the
      transcriptional start site of the actin gene. They further suggest that
      developmental activation of actin gene transcription may involve either (1)
      interaction of non-DNA binding proteins with basal transcription factors, or (2)
      the concerted action of ubiquitous promoter-binding factors and factors that
      interact with downstream regulatory regions.

PMID- 1751034
TI  - Efficient transfection of chicken cells by lipofection, and introduction of
      transfected blastodermal cells into the embryo.
AB  - Chicken blastodermal cells (CBCs) and primary chicken fibroblasts (PCFs) have
      been lipofected with a variety of lacZ constructs encoding Escherichia coli beta
      galactosidase (beta-gal). A reporter construct (phspPTlacZpA) containing a mouse
      heat-shock protein 68 gene (hsp 68) promoter was used to establish conditions for
      efficient lipofection. The construct, in circular or linear plasmid form or as
      reporter sequences alone, was transferred efficiently by incubating the cells for
      3.5 h in a mixture of 6.2 micrograms Lipofectin (a cationic liposome preparation
      from Bethesda Research Laboratories) and 1.55-3.1 micrograms DNA per mL DMEM.
      These lipofection conditions were used to transfer a reporter construct
      (pCBcMtlacZ) containing a Zn(2+)-inducible chicken metallothionein (cMt)
      promoter, and constructs showing constitutive expression due to Rous sarcoma
      virus plus chicken beta-actin (pmiwZ) or cytomegalovirus (pMaori3) promoters.
      Endogenous chicken beta-gal and transferred bacterial beta-gal activity could be
      distinguished clearly by incubating the cells with the substrate, Xgal, at pH 4.3
      or 7.4, respectively. Expression of phspPTlacZpA in chicken cells did not appear
      to require specific induction of the mouse hsp68 promoter, whereas expression of
      pCBcMtlacZ required treatment of the cells for 6-12 h with 150 microM ZnCl2.
      Bacterial beta-gal activity was observed following lipofection of CBCs that were
      cultured in suspension or plated. The efficiency of lipofection was at least 1 in
      25 for CBCs, judging by the proportion of cells shown to have beta-gal activity
      16-24 h after lipofection treatment began; these events could represent transient
      or stable incorporation of the construct.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751035
TI  - Production of transgenic mice from cryopreserved fertilized ova.
AB  - Cryopreserved fertilized mouse ova were used to generate transgenic mice via
      micromanipulation. Five-DNA constructions were injected into a total of 1,052
      cryopreserved ova, of which 683 (65%) survived the injection and were transferred
      into recipients. Of 35 recipients, 66% became pregnant and littered a total of 88
      pups. As controls, these DNA constructions were also injected into 1,123 fresh
      ova, of which 744 (66%) survived and were transferred. Of 42 recipients, 79%
      became pregnant and littered a total of 167 pups. That is, 22% of fresh ova that
      were transferred developed into live pups, whereas only 13% of cryopreserved ova
      did so. Of the pups born, 42 of the 167 (25%) produced from fresh ova were
      transgenic, and 28 of the 88 (32%) produced from cryopreserved ova were
      transgenic. In terms of the injected ova that had been transferred, 5.6% of the
      744 fresh and 4.1% of the 683 frozen ova developed into transgenic mice. These
      data indicate that the efficiency of production of transgenic mice from
      cryopreserved ova is close to that from fresh ova. That observation and the fact
      that cryopreserved ova allow more efficient utilization of animals suggest that
      cryopreserved ova can be used instead of fresh ova to produce transgenic mice.

PMID- 1751036
TI  - Growth and DNA replication in rabbit blastocysts.
AB  - DNA content and DNA polymerase activity were measured on rabbit blastocysts
      removed from the uterus at 24-hr intervals over the period of days 4-7 postcoitum
      (pc). Median DNA content increased 53 times over the 72-hr period, from 25.3 ng
      on day 4 to 1,360 ng on day 7. Median DNA polymerase activity (fmole of
      radiolabeled nucleotide incorporated in 30 min at 37 degrees C) increased 393
      fold from day 4 to day 7: 32.8 to 12,900. These embryos also increased in surface
      area and volume by 334-fold and 6,078-fold, respectively. Litters containing
      individuals with high DNA content also tended to have similar individuals with
      high DNA polymerase activity. Therefore, DNA polymerase activity may be a useful
      measure of the potential for the next cell division. A large amount of variation
      existed between blastocysts in all parameters measured. An analysis of variance,
      conducted to partition variation between litters and within litters, determined
      that within-litter variation was actually greater than that between litters,
      resulting in intraclass correlation coefficients less than 0.5. There was also a
      positive regression of DNA content and DNA polymerase activity on surface area in
      6- and 7-day-old blastocysts after eliminating variation attributable to litters.
      The developmental pattern of DNA polymerase activity in the rabbit may be
      quantitatively different from that described in the mouse. The pattern in mammals
      is very different from that described in several nonmammalian species.

PMID- 1751037
TI  - Effects of maturation and co-culture treatments on the developmental capacity of
      early bovine embryos.
AB  - A total of 901 cumulus-oocyte complexes (COCs) were collected from bovine ovaries
      obtained at a local abattoir. COCs randomly assigned to Treatment I (n = 451),
      were cultured in TCM-199 + 10% fetal bovine serum (FBS) and hormones, while
      oocytes in Treatment II (n = 450) were cultured in TCM-199 + 20% estrous cow
      serum (ECS). Assessment of maturation revealed that 91.3% (42/46) of oocytes in
      Treatment I had reached metaphase II of meiosis, which was greater (P less than
      0.05) than the 73.3% (33/45) in Treatment II. Following in vitro fertilization,
      203 oocytes from Treatment I were co-cultured on bovine granulosa cells
      (Treatment IA) while the remaining 202 oocytes were co-cultured on bovine
      oviductal cells (Treatment IB). Similarly, 203 oocytes from Treatment II were co
      cultured on granulosa cells (Treatment IIA) or oviductal cells (Treatment IIB, n
      = 202). Co-culture was maintained for 8 days. The proportion of cleaved zygotes
      was higher (P less than 0.05) in Treatment IB (86.6%) compared to Treatments IA
      (78.8%), IIA (58.1%), and IIB (64.8%). The proportion of cleaved zygotes that
      progressed beyond the 16-cell stage was also greater (P less than 0.001) in
      Treatment IB (71.4%) compared to Treatments IA (50.0%), IIA (35.4%) and IIB
      (55.8%). Treatment IB also produced the highest proportion of blastocysts (P less
      than 0.0001) (41.1%) versus 24.6% (IA), 11.3% (IIA) and 18.3% (IIB). The
      proportion of day 6 morulae that progressed to form day 8 blastocysts was similar
      for both co-culture treatments (IA, 70.1%; IB 70.2%; IIA, 51.5%; IIB 50.8%) and
      varied only between in vitro maturation groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751038
TI  - Enhancement of acrosome reaction and subzonal insemination of a single
      spermatozoon in mouse eggs.
AB  - The acrosome reaction in mouse spermatozoa was induced by various means. These
      were 1) varying incubation time in T6 medium, 2) incubation in T6 medium with
      added A23187, 3) incubation in T6 medium with added dbcGMP and imidazole, 4)
      exposure to an electric field, and 5) a combination of incubation in a medium
      with dbcGMP and imidazole and electroporation. The mean percentages of acrosome
      free spermatozoa obtained by these various methods and assessed on the basis of
      both Bryan's stain and immunolocalization by FITC-labeled monoclonal antibodies
      increased by steps from 36% to 67%, 73%, 86%, and 92%. Individual spermatozoa
      from the various treatments were afterwards microinjected under the zona
      pellucida of a mouse oocyte. The fertilization rate for eggs microinjected with a
      spermatozoon treated with A23187, dbcGMP, and imidazole, by electroporation and
      by a combination of the last two methods also increased by steps from 17% to 34%,
      36%, and 70%, respectively. Ninety-five percent of the fertilized oocytes reached
      the early blastocyst stage, thirty-eight percent of these blastocysts implanted
      in pseudopregnant mice, and twenty-eight percent developed to term. These results
      indicated the varying degrees of success of different ways of inducing acrosomal
      loss in spermatozoa and their subsequent success rates in fertilization and
      further in vitro and in vivo development.

PMID- 1751039
TI  - Sperm selection capacity of the human zona pellucida.
AB  - Previous hemizona assay (HZA) results have illustrated a positive and significant
      correlation between the percentage of morphologically normal spermatozoa in the
      semen and the number of spermatozoa tightly bound to the zona pellucida. The
      present study was designed to evaluate the morphologic features using strict
      criteria of spermatozoa tightly bound to the zona pellucida. Semen samples of 4
      normozoospermic and 11 teratozoospermic men were used to compare the percentage
      of normal spermatozoa in the semen with that found 1) after swim-up separation
      and 2) bound to the zona under HZA conditions. The mean (+/- SEM) % normal forms
      for normozoospermic men in semen, after swim-up and zona-bound spermatozoa were
      21.5 +/- 1.6, 27.5 +/- 2.9, and 44.8 +/- 3.4, respectively. A significantly
      higher % of normal forms were found among zona-bound sperm compared to swim-up
      forms (p = 0.02) and seminal sperm (p = 0.02). The mean % of normal sperm forms
      present in semen, after swim-up and zona pellucida-binding for teratozoospermic
      men, were 3.7 +/- 0.9, 5.8 +/- 1.6 and 15.6 +/- 3.1, respectively. Significant
      differences existed between the % of normal sperm forms found in the swim-up and
      zona-bound spermatozoa (P = less than 0.01 and P = less than 0.0003,
      respectively) compared to the original ejaculates. Results indicate that a
      selective process against abnormal spermatozoa occurs at the site of the zona
      pellucida.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751040
TI  - Cytochemical evidence of an organized microtubular cytoskeleton in Xenopus laevis
      oocytes: involvement in the segregation of mitochondrial populations.
AB  - An organized microtubular cytoskeleton was discovered in the cytoplasm of Xenopus
      laevis oocytes. The microtubules were observed in 10- to 30-micron cryostat
      sections by indirect immunoperoxidase labeling using an antibody to tubulin. A
      gradual extraction of cells with a nonionic detergent was essential for good
      penetration of the antibody into the cells. In the cytoplasm of all
      previtellogenic oocytes, a dense network of criss-crossed long microtubules was
      associated in a basket-like structure surrounding the mitochondrial mass. At the
      beginning of vitellogenesis, the network meshes enlarged, while clusters of
      mitochondria migrated, in close association with microtubule bundles. At the
      beginning of vitellogenesis, the reorganization of the microtubular network,
      mostly in the vegetal hemisphere, occurred during the segregation of the
      mitochondrial populations. Reorganization is characterized by (1) a temporary
      enlargement of the network and close association of mitochondrial clusters with
      microtubular bundles, and (2) a progressive organization of a ring-shaped
      microtubular structure in the crown elaboration area. It is hypothesized that
      these modifications of the microtubular cytoskeleton contribute to the
      maintenance of cell shape and the polarized organization of the cell.

PMID- 1751041
TI  - Equine oocyte in vitro maturation: influences of sera, time, and hormones.
AB  - Objectives of the present research were to determine the influences of types of
      media, sera, time and hormones on equine oocyte in vitro maturation (IVM). The
      following types of media and sera were evaluated: Menezo's B2 medium (B2),
      modified Tissue Culture Medium 199 (TCM), Defined Medium (DM), fetal calf serum
      (FCS), mare serum collected on the first day of estrus (MS), and mare serum
      collected on the day of ovulation (MSO). Resultant oocyte maturation was compared
      with the control: DM with bovine serum albumin (BSA). Effect of culture time (0,
      15, and 32 hr) and the following hormones on oocyte IVM were evaluated: none,
      bovine luteinizing hormone (bLH; 1, 10, 100 micrograms/ml), equine luteinizing
      hormone (eLH; 100 micrograms/ml), bovine follicle-stimulating hormone (FSH; 5
      micrograms/ml), and equine chorionic gonadotropin (eCG; 1 and 100 IU/ml). Cumulus
      expansion in the media and sera experiments was 50% (DM with BSA), 80% (TCM, B2,
      and DM with MS or MSO), and 100% (FCS with any medium). The proportion of
      metaphase II (MII) oocytes was significantly (P less than 0.05) increased the
      percentage of MII oocytes as compared with 0 hr of culture. Cumulus expansion in
      the hormone experiments was 80% (none, bLH, and eLH), and 100% (eCG and FSH).
      Freshly prepared bLH significantly (P less than 0.05) inhibited nuclear
      maturation of equine oocytes. In summary, 15 hr of culture was sufficient time
      for equine oocyte IVM and all combinations of medium, serum, and hormone addition
      were equally effective in achieving IVM except fresh bLH and DM with BSA.

PMID- 1751042
TI  - Distribution of filamentous actin in and around spermatids and in spermatozoa of
      Australian conilurine rodents.
AB  - The distribution of filamentous actin around the maturing sperm head and in
      spermatozoa of four species of Australian conilurine rodents was investigated at
      the light and electron microscopic levels. Similar results were obtained for all
      the species studied. Mechanically isolated spermatids had NBD-phallacidin
      positive longitudinal bands of fluorescence over the dorsolateral surface and, in
      late spermatids, bands of bright fluorescence passed perpendicularly from the
      dorsal convex to ventral concave surface. TEM observations indicated that these
      regions corresponded to filaments of ectoplasmic specializations and granular
      filamentous material around the tubulobulbar complexes, respectively. In
      testicular and cauda spermatozoa NBD-phallacidin fluorescent material was present
      in the two ventral processes that extended from the upper concave surface of the
      sperm head; also fainter material occurred along the concave border and as a
      dorsocaudal spur. Its distribution was identical for testicular and cauda
      spermatozoa. TEM of late spermatids showed that in the ventral process closest to
      the apical hook there were between 170 and 245 filaments, which attached to the
      inner surface of the postacrosomal dense lamina; in the more caudal ventral
      process about 70 filaments occurred. No filaments were, however, visible in the
      mature spermatozoon but, after immunocytochemical labelling for actin, deposition
      of gold particles was evident over ventral processes of both late spermatids and
      cauda spermatozoa. Within the female tract these ventral processes made contact
      with the zona matrix and were taken into the egg cytoplasm unchanged in
      morphology. The possible functional significance of the filamentous actin in
      these structures is discussed.

PMID- 1751043
TI  - Improvement of fertilizing performance by normal and abnormal mouse semen after
      zona opening of mature oocytes.
AB  - The usefulness of opening the zona pellucida by partial zona dissection (PZD) to
      enhance fertilization of mature mouse oocytes was studied after insemination with
      three types of semen: normal and diluted semen and semen from long-term
      vasectomized males. Zona opening did not by itself induce parthenogenetic
      cleavage of mature oocytes and did not significantly increase mono- and
      polyspermic fertilization of oocytes inseminated with normal semen. While a
      fertilization rate of 62% was obtained among intact oocytes, of which 4.5% were
      polyspermic, a 66.8% fertilization rate was observed among PZD oocytes, 6.3% of
      which were polyspermic. However, after using diluted semen, only 54 of 193 intact
      oocytes were fertilized (28%), and PZD improved the fertilization rate to 65.4%.
      Cleavage rate of nonmanipulated oocytes inseminated with abnormal semen from
      vasectomized males was dramatically decreased in comparison with those
      inseminated with normal semen (7.6% vs. 65%). PZD induced a moderate but
      significant improvement of fertilization performance when using this abnormal
      semen (19.6%).

PMID- 1751044
TI  - Time course and pattern of cortical granule breakdown in hamster eggs after sperm
      fusion.
AB  - We have determined the temporal relationship between sperm fusion and cortical
      granule breakdown in the hamster egg. Sperm fusion was determined by the Hoechst
      transfer method (Stewart-Savage and Bavister: Dev Biol 128:150-157, 1988), and
      cortical granules were visualized with fluorescein isothiocynate-conjugated Lens
      culinaris agglutinin (Cherr et al. J Exp Zool 246:81-93, 1988). By 55 min after
      insemination, there was an 85% reduction in the density of cortical granules
      (fewer than four granules/100 microns2). Taking this value as the completion of
      the cortical reaction, analysis of the data indicate that the cortical reaction
      was completed 9 min after sperm fusion and 3 min after the formation of the zona
      and cell surface blocks to polyspermy. There was no obvious spatial pattern of
      granule loss in eggs that had a Hoechst-positive sperm but had not completed the
      cortical reaction.

PMID- 1751045
TI  - Detection of a soluble acrosome reaction-inducing factor, different from serum
      albumin, associated with the ovulated egg-cumulus complex.
AB  - Soluble extracts of the ovulated hamster egg-cumulus complex (ECC) were tested on
      capacitated sperm for activity in inducing the physiological acrosome reaction
      (AR). Evidence for occurrence of the physiological AR included enhanced sperm
      penetration of intact homologous zonae pellucidae as well as induction of AR in
      nonattached and in zona-bound sperm following a brief coincubation with test
      compound. Since hamster serum albumin, a major protein of hamster body fluids,
      also induces spontaneous ARs under certain conditions, it was used as one of the
      comparators for the acrosome reaction inducing factor (ARIF; Westrick et al.,
      Biol Reprod 32 [Suppl 1]. 213, 1985) activity in the ECC. Sperm exposure to
      concentrations of the soluble ECC extract ranging from 0.04 to 0.2 mg protein/ml
      significantly increased penetration of salt-stored zonae by 36%, mean numbers of
      penetrating sperm by 90%, ARs in nonattached sperm by 65%, and ARs in zona-bound
      sperm by 102%. Hamster serum albumin added after completion of capacitation had
      no significant effect on these parameters. We conclude that 1) the ovulated ECC
      contains a soluble ARIF that augments zona-induced ARs and sperm penetration and
      2) the ARIF is not serum albumin.

PMID- 1751046
TI  - [Retrograde cardioplegia and reperfusion in patients with multiple lesions of the
      coronary arteries].

PMID- 1751047
TI  - [Surgical tactics in occlusive lesions of the brachiocephalic and coronary
      arteries].
AB  - Surgical management of combined arterial occlusions is a difficult problem.
      Combined lesions of the coronary arteries and brachiocephalic trunk are marked by
      significant mutual aggravation. The authors examined 48 patients with this
      pathological condition in the last 4 years, 32 of them underwent restorative
      surgical interventions. The direct effect was positive in 87% of patients. Four
      patients died after the operation. Comparative evaluation of the late-term
      results was carried out by the actuarial method. The authors believe a stage-by
      stage character of the intervention to be expedient, except for cases of one
      stage critical ischemia carried out simultaneously in two arterial channels and
      the possibility of simultaneous reconstruction of the sternotomy approach.

PMID- 1751048
TI  - [Plastic correction of aortic stenosis in two- and three heart valve diseases].
AB  - Plastic correction of aortic stenosis with simultaneous intervention on the
      mitral and, in some cases, on the tricuspid valve was performed on 50 patients
      whose ages ranged from 25 to 53 years (average age 43.2 years); 15 were in NYHA
      functional class III and 35 in class IV. There were 38 females and 12 males.
      Correction of the aortic stenosis was achieved by open valvulotomy and additional
      plane resection of the cusps, suture plastic was conducted whenever necessary. In
      6 cases calcinates were removed form the cusps simultaneously. Mitral valve
      prosthetics was undertaken in 42 patients, and open mitral commissurotomy in 8
      patients. In 17 patients aortic and mitral stenoses were attended by defect of
      the tricuspid valve which called for plastic correction. Among the 50 patients
      who underwent operation 8 (16.0%) died. there were no fatal outcomes among
      patients related to the NYHA functional class III. In 41 cases the result of
      aortic stenosis correction was satisfactory, which was confirmed by clinical and
      echocardiographic data. After the operation, opening of the aortic valve cusps
      during echocardiography in the M-regimen increased, on average, from 12 +/- 2.0
      to 18 +/- 2.6 mm. According to doppler-echocardiogram, the gradient on the aortic
      valve reduced, on average, from 45 +/- 5.0 to 26.5 +/- 4.0 mm. Only in one female
      patient aortic incompetence started progressing after the operation and called
      for prosthetics 6 months later.

PMID- 1751049
TI  - [Inter-arterial anastomosis in dextral position of the aortic arch in patients
      with tetralogy of Fallot].
AB  - The article discusses the results of formation of inter-arterial anastomoses in
      58 (12.7%) patients with a severe form of Fallot's tetralogy in dextra-position
      of the arch of the aorta. The specific features of the course and diagnosis of
      dextra-position of the aortic arch in Fallot's tetralogy are analysed, and the
      significance of radiologic and echocardiographic examination in the choice of the
      position and type of interarterial anastomoses is determined. It is proved that
      Blalock-Taussig's anastomoses must be formed on the side opposite to the aortic
      arch, while shunting operations must be carried out on the side on which the arch
      of the aorta is located.

PMID- 1751050
TI  - [A physiological method of annuloplasty of the mitral valve].
AB  - The work deals with an anatomo-functional substantiation of plastic repair of the
      mitral valve. Isolated annuloplasty was carried out in 20 patients with mitral
      incompetence, annuloplasty with aortic prosthetics was conducted in 13 patients.
      The method allows a prosthesis with a larger diameter to be used in the last
      named group of patients. A fatal outcome which was not connected with the
      operative method was encountered in 2 cases. The clinical and hemodynamic effect
      was good in all patients.

PMID- 1751051
TI  - [Various aspects of surgical treatment of vasorenal hypertension].
AB  - The results of examination and treatment by surgery of 103 patients with
      vasorenal hypertension are analysed. Retromboses and restenoses of the
      reconstructed renal arteries and grafts and uncorrected hyperaldosteronism were
      the most frequent causes of the poor results. Adequate reconstruction of the
      renal arteries leads to correction of hyperaldosteronism in patients with normal
      or high activity of plasma renin. Low-renin secondary hyperaldosteronism in
      patients with vasorenal hypertension is an indication for simultaneous
      correction.

PMID- 1751052
TI  - [Late results of mitral valve replacement with ball-type and low-profile
      prostheses].
AB  - The discussion covers long-term results of mitral valve replacement with Soviet
      made prostheses. Two hundred and sixty-three patients have been under
      observation, the follow-up periods lasting from six months to five years. A ball
      valve prosthesis (MK4-25) was implanted to 125 patients; 138 patients received a
      low-profile (,) prosthesis. Functional parameters were improved in 86 (69.9
      percent) patients with ball-valve implants and in 118 (89 percent) patients with
      low-profile implants. Ten ball valve implanted patients (8 percent) and 6 (4.3
      percent) patients with low-profile prostheses died in the long-term period. The
      five-year survival of rotation-disc artificial valve recipients was 90 percent,
      and that of the ball valve-implanted patients, 83 percent.

PMID- 1751053
TI  - [Criteria of the operability of patients with a common arterial trunk based on
      hemodynamic data].
AB  - Criteria of operability of patients with a common arterial trunk were evaluated
      from a complex of hemodynamic, clinical, and morphological data. The patients
      were divided into 2 main groups according to the value of the pulmonary blood
      flow (PBF): group 1 with the pulmonary to systemic blood flow ratio (PBF/SBF)
      greater than 1; group 2 with PBF/SBF less than 1. The indications for operation
      in group 1 depended on the degree of PBF increase. For instance, an operation was
      indicated for patients with marked increase of PBF (PBF/SBF greater than 2); in
      cases with moderate PBF growth [formula: see text] the indications for operation
      were determined only after additional lung biopsy. The operation was not
      indicated for group 2 patients (PBF/SBF less than 1.0) because of the severity of
      their condition due to obstructive pulmonary vascular disease.

PMID- 1751054
TI  - [Detection of cardiac insufficiency by computer-assisted monitoring of the
      response of intra-cardiac hemodynamics to exercise test in patients with ischemic
      heart disease with similar lesions of the coronary arteries (patient selection
      for the aortocoronary bypass)].
AB  - Preoperative identification of cardiac insufficiency in patients with ischemic
      heart disease (IHD) has proved essential for the success of surgery on the
      coronary arteries. To provide for an objective assessment of the contractile
      function of the myocardium in selecting candidates for surgery among IHD patients
      with over 70-percent narrowing of one, two, and three coronary arteries, use was
      made of the central hemodynamics indices in response to the loading test during
      right heart catheterization with computer-assisted monitoring and mathematical
      analysis. Two patient groups were distinguished during the hemodynamic loading
      test: group I showing a high and effective chronotropic reserve (+X) and group II
      presenting a negative chronotropic reserve (-X). It was established that with
      equal numbers of narrowed coronary arteries and similar clinical manifestations,
      the estimates of myocardial contraction may differ which determines indications
      for surgery and preoperative care.

PMID- 1751055
TI  - [Morphological changes in patent ductus arteriosus after endovascular occlusion
      (clinico-experimental study)].
AB  - The work is based on a comparison of data gained in experiments with the results
      of clinical examination of a large group of patients in the late-term period
      after endovascular occlusion of a patent ductus arteriosus (PDA). The regular
      features of the course of the morphological process in the zone of the PDA after
      implantation of a botallo-occluder into it were studied. Clinico-morphological
      parallels were made. The high efficacy and reliability of the new method of
      endovascular treatment of PDA, developed at the Moscow Second Medical institute,
      was substantiated morphologically and confirmed clinically.

PMID- 1751056
TI  - [Diagnosis and treatment of expiratory stenosis of the trachea and main bronchi
      in children].
AB  - The results of examination and the course of expiratory stenosis were studied in
      15 children, 3 of them suffered from bronchomalacia of the left main bronchus.
      Bronchoscopy and poly-positional radioscopy with contrast study of the trachea
      and the large bronchi are the principal diagnostic methods in this disease.
      Sclerosing therapy was carried out in III degree expiratory stenosis. Two
      patients with bronchomalacia of the main bronchus and cystic lung hypoplasia
      underwent pulmonectomy with treatment of the main bronchus at the site of its
      branching off from the tracheal bifurcation. The results of sclerosing therapy
      and operations were good.

PMID- 1751057
TI  - [Pulmonary hypertension and the possibilities of its radiographically guided
      endovascular correction in chronic nonspecific lung diseases].
AB  - Bronchial arteriography and catheterization of the pulmonary artery (PA) were
      applied in the examination of 120 patients with chronic nonspecific diseases of
      the lungs. The specific features of bronchopulmonary blood circulation in various
      pathological processes were revealed. Pulmonary hypertension (PH) was encountered
      in 71.5% of cases, and pressure in the PA was significantly higher in the group
      of patients with massive bronchopulmonary blood shunting (chronic pulmonary
      suppurations) than in the group of patients with minimal blood shunting
      (nonsuppurative processes). Radiologically-guided endovascular correction of the
      disorders of the bronchopulmonary blood flow was conducted in 85 patients by
      occlusion of the bronchial arteries (BA). Pressure in the PA significantly
      reduced after the correction due to diminished left-to-right blood shunting.
      Thus, besides the generally known mechanisms, bronchopulmonary shunting of blood
      plays a certain role in the pathogenesis of PH in chronic suppurative processes.
      Endovascular BA occlusion for correction of PH in patients with bilateral lesions
      is expedient.

PMID- 1751058
TI  - [Surgical tactics in complicated pulmonary echinococcosis].
AB  - The authors analyse treatment of 326 patients with hydatid disease of the lungs.
      Complications were found in 112 (34.3%) of them. Broncho-fibroscopy was included
      in the complex of therapeutic measures in rupture of the cyst into the bronchus,
      and pleural puncture, therapeutico-diagnostic thoracoscopy and drainage of the
      pleural cavity in rupture into the pleural cavity. Temporary occlusion of the
      draining bronchus with Fogarty's catheter was conducted to prevent intraoperative
      aspiration complications. If organ-preserving operations are indicated,
      preference is given to A. A. Vishnevsky's echinococcectomy with a laser scalpel
      since the Delbet's method is fraught with the danger of cutting of the sutures
      due to acute inflammatory changes of the wall with the formation of a residual
      cavity or an abscess of the lung. A differentiated approach to preoperative
      management and the choice of the operative techniques reduced the incidence of
      postoperative complications and reduced mortality in complicated hydatid disease
      of the lungs to 0.9%.

PMID- 1751059
TI  - [Repeated anti-reflux operations].
AB  - The authors had under observation 73 patients who underwent various antireflux
      operations with poor results, 68 of them were subjected to repeated
      interventions, fundoplication in most cases. The causes of failure of primary and
      repeated antireflux operations are analysed, the indications for and the
      techniques of reconstructive interventions are discussed. It is emphasized that
      patients with hiatal hernia and reflux esophagitis must be concentrated in
      specialized medical institutions.

PMID- 1751060
TI  - [Non-pharmacological treatment of arrhythmia using the method of trans-catheter
      ablation].
AB  - Trans-catheteral ablation is an important therapeutic method for
      nonpharmacological management of various types of cardiac arrhythmias. Since its
      introduction into clinical practice in 1982, it has proved its efficacy in
      disturbance or change of the type of atrioventricular conduction and conduction
      along accessory abnormal atrioventricular conduction pathways. Positive results
      have also been attained in the treatment of some patients with ventricular
      tachycardia. The energy sources used for ablation include direct current pulses
      possessing large energy, high-frequency currents, and laser energy. Ablation with
      direct current and high-frequency current is already used successfully in
      patients, while the use of laser energy for ablation of myocardial arrhythmogenic
      tissue is limited mainly to operations on the open heart. The use of alternating
      high-frequency current has attracted particular attention in the last years.
      Trans-coronary chemical ablation is another recently introduced method which is
      not connected with the use of electric current. Only experimental and a small
      clinical experience with this new method has been gained to date. This survey
      systemasizes the current knowledge of the biophysical bases of the various method
      of ablation from the standpoint of the mechanisms of treatment, the methodology
      and the main types of tissue response. Clinical experience with trans-catheteral
      treatment of cardiac arrhythmias is analysed.

PMID- 1751061
TI  - [Calcinosis of the pulmonary valve in trilogy of Fallot].

PMID- 1751062
TI  - [Recurrence factors in benign gastric ulcer].
AB  - Among 7015 upper gastrointestinal endoscopies done during five consecutive years
      (1984-1988) 642 patients were diagnosed as having benign gastric ulcer. Of this
      group, 213 patients have been followed-up during an adequate period of time. A
      recurrence was diagnosed endoscopically in 43 (20.18%). The authors analyze the
      influence on recurrences of general factors (age, sex, alcohol, tobacco and
      drugs), family history and local factors (site and size of the ulcer,
      histological lesions, concomitant duodenal ulcer or single or multiple ulcers).
      The conclusions are that in females and in males over 60 years of age, NSAIDS are
      the factors which greatly influence recurrences, while in males under 60 years of
      age, excessive smoking and alcohol. Chronic gastritis and intestinal metaplasia
      are common in recurrent ulcers. Multiple ulcers as well as those associated with
      duodenal ulcers have a greater tendency to recur. Recurring ulcers are more
      common at the incisura angularis. Recurrences are usually located at the site of
      a previous ulcer.

PMID- 1751063
TI  - [The extraintestinal manifestations of Crohn's disease: our experience].
AB  - During a period of sixteen years we have treated 120 patients with Crohn's
      disease, 41 of them with extraintestinal lesions besides of it's main intestinal
      pathology. These patients represented the 34.1% of all attended in this service.
      We describe the clinical and epidemiological aspects and the incidence of
      extraintestinal manifestations of the disease. Joint manifestations were
      prominent (90.2%), followed by cutaneous-mucosal lesions (47.8%) and
      cholelithiasis (24.3%). Urinary symptoms secondary to fistula or invasion from
      the adjoining inflammatory process came in fourth place. Other rare localizations
      are described. The literature is reviewed.

PMID- 1751064
TI  - [Experimental acute pancreatitis in the rat. The quantification of pancreatic
      necrosis after the retrograde ductal injection of sodium taurocholate].
AB  - Acute haemorrhagic pancreatitis was induced in rats by injecting 5% sodium
      taurocholate into the common biliopancreatic duct. The condition was associated
      with an increase in the serum amylase levels as well as progressive pancreatic
      necrosis resulting in 100% mortality before 36 hours. This experimental model was
      documented by quantifying nine different parameters of pancreatic necrosis and
      giving more information about the induced lesion. The extent of pancreatic
      necrosis was evaluated at different intervals, 5.77% at 12 hours, 14.9% at 24
      hours, and the rats died before 36 hours of pancreatitis induction with an
      average percentual necrosis of 29.9%. This model seems suitable for more
      pathogenic as well as therapeutic studies on acute pancreatitis in the rat.

PMID- 1751065
TI  - [Klatskin's tumor. The current status 25 years later].

PMID- 1751066
TI  - [Sarcoidosis of the tongue. Apropos a case].
AB  - Here we present the case of a patient with lesion on the tongue, during more than
      6 months, which in its self required different therapeutic measures and because
      of a benign evolution is remitted to this center for study, which concluded with
      an histological diagnosis of sarcoidosis, a granulomatous disease systemic in
      character which in this patient only affect the tongue which reminds us daily the
      necessity to remember this entity by internist, gastroenterologists and dentists.

PMID- 1751067
TI  - [Acute abdomen due to eosinophilic gastroenteritis. A study of 2 cases].
AB  - Report of two cases of eosinophilic gastroenteritis. In both cases the
      presentation was an acute abdomen syndrome. The etiological diagnosis was
      postoperative, because in the preoperative period there were no data
      characteristic of this entity. Probably this disease is more frequent than
      reported and although the treatment is medical, there are some cases in which
      surgery is justified.

PMID- 1751068
TI  - [Portal hypertension secondary to an arterioportal fistula. Treatment by
      embolization].
AB  - We report a case of arterioportal fistula which was probably the result of
      percutaneous liver biopsy. Portal hypertension with hemorrhage by esophageal
      varices was the clinical presentation. We describe the features of the
      ultrasound, selective arteriography and Doppler ultrasound examination. The
      fistula was catheterized superselectively and successfully embolized with steel
      coils.

PMID- 1751069
TI  - [Acute pancreatitis associated with primary hyperparathyroidism].
AB  - A case of acute pancreatitis associated with primary hyperparathyroidism is
      reported. There was none of usual causes of pancreatitis, which did not recur
      following the removal of a parathyroid adenoma. There are over one hundred of
      cases of acute or chronic pancreatitis associated with hyperparathyroidism in the
      literature, suggesting a causal relationship between the two entities. The
      pancreatic disease has been attributed either to the hypercalcemia or to the
      excess of circulating parathyroid hormone. However, some authors have recently
      questioned any link between these two diseases.

PMID- 1751070
TI  - [Gastric leiomyosarcoma. Apropos a case].

PMID- 1751071
TI  - [Endoscopy units].

PMID- 1751072
TI  - [The usefulness of a difference in the transmucosal potential in the functional
      evaluation of ileoanal reservoirs].

PMID- 1751073
TI  - [A giant retroperitoneal cystic lymphangioma].

PMID- 1751074
TI  - [Crohn's disease in Spain. Don Carlos Marina Fiol, 30 years ago].

PMID- 1751075
TI  - ASAIO presidential address.
AB  - ASAIO has a proud heritage and a list of many accomplishments. It has given birth
      to many highly specialized societies and meetings. These changes and new
      developments in other fields have diverted it from being mainly a kidney society
      to being more multidisciplinary than ever before. Although meeting attendance
      declined for a number of years, the productivity of the society did not. Now
      attendance is increasing, and the number of submitted abstracts has exceeded all
      past records. Increasing activity in ASAIO may reflect the awareness of the need
      for a multidisciplinary meeting in this explosive era of artificial organ
      development. ASAIO can and should play a major role in fostering artificial organ
      research and development in the years to come. I am confident that it has the
      strengths to accomplish many important goals. I am very proud to have served as
      President of this society with a marvelous past and a promising future.

PMID- 1751076
TI  - Thrombin generation in cardiac device recipients.
AB  - Thrombin generation measured after LVAS (4 patients) and TAH (1 patient)
      implantation was found to be elevated (3 times normal) in the first postoperative
      week and declined to normal levels when anticoagulation was begun. Thrombin
      generation was not elevated at the times of thromboembolic events (TIAs; N = 4
      episodes).

PMID- 1751077
TI  - Preliminary in vitro evaluation of the first neonatal total artificial heart.
AB  - A neonatal total artificial heart (TAH), used as a bridging device, can offer
      circulatory support for patients suffering from otherwise insupportable and
      inoperable congenital cardiac defects. The choice of the 7.0 ml stroke volume
      (SV) was based on reported studies on cardiac output (CO) requirements and
      maximum dimensions of a neonate size TAH. This SV will allow a bridging period of
      up to 10 weeks in the growing neonate. For in vitro testing purposes, "high
      profile" ball valves of in-house design (10-13 mm ID) were used. Redesign of the
      existing in vitro testing systems, including mock circulation and high-flow blood
      reservoirs, was required for the smaller device. Mock circulation studies (rates
      90-160 BPM, full-fill and ejection modes) showed adequate device performance,
      with CO values well above the reported marginal output value of 139 ml/kg/min.

PMID- 1751078
TI  - K & T covariate with V in hemodialysis. As K increases and T decreases, V also
      decreases.
AB  - The authors varied urea clearance (K), dialysis time (T), and ultrafiltration
      (UF) in 294 hemodialyses on 23 patients and studied changes in urea space (V),
      determined by total dialysate urea removal. As K increased and UF and T
      decreased, V also decreased. K, T, and V, thus, covariate and dialysis adequacy,
      as studied by KT/V is not a simple function of three independent variables.
      Patients dialyzed quickly with little UF will need a higher KT/V than those
      dialyzed slowly with much UF.

PMID- 1751079
TI  - Kt/V: patients do not get what the physician prescribes.
AB  - Monthly urea kinetic modeling is performed [service Kt/V (urea)] to ensure that
      dialysis prescriptions provide patients a Kt/V greater than or equal to 1 and
      yield a protein catabolic rate (PCR) greater than or equal to 0.8. The frequency
      with which the dialysis prescription (physician's order +/- 5%, p +/- 5%) was
      achieved was calculated by three methods: 1) CompuMod (3 ureas; computer
      derived), 2) Jindal-Goldstein, and 3) Daugirdas, (2 and 3% reduction of urea).
      Ten patients were followed serially over 1 month for a total of 120 dialyses.
      Mean Kt/V values for each method were: prescription, 1.54 +/- 0.36; service, 1.40
      +/- t0.63; CompuMod, 1.33 +/- 0.27; Jindal-Goldstein, 1.55 +/- 0.24; and
      Daugirdas, 1.33 +/- 0.23. The percentages of dialyses within the p +/- 5% were
      12.4%, CompuMod; 12.8%, Jindal-Goldstein and 14.3%, Daugirdas. The percentages
      above p +/- 5% were 20.4%, CompuMod; 47%, Jindal-Goldstein; and 21.4%, Daugirdas.
      The percentages below p +/- 5% were 67.3%, CompuMod; 40.2%, Jindal-Goldstein; and
      64.3%, Daugirdas. The CompuMod and Daugirdas methods of assessment of Kt/V were
      significantly lower (p less than 0.001) than the prescribed Kt/V, whereas the
      Jindal-Goldstein estimate was not. The authors conclude that dialysis patients
      rarely achieve their prescribed Kt/V. The service Kt/V, therefore, is not a
      useful parameter for prescribing dialysis therapy. The CompuMod and Daugirdas
      methods are the best estimates of the Kt/V, while the Jindal-Goldstein equation
      overestimates the Kt/V. The need for frequent urea kinetic modelling is stressed.
      An online urea monitor for each dialysis would be the ideal solution.

PMID- 1751080
TI  - The influence of dialysis membrane upon protein catabolic rate.
AB  - It has been hypothesized that the protein catabolic rate (PCR) is dependent upon
      the amount [Kt/V (urea)] and the type of dialysis (synthetic vs. cellulosic
      membrane). In an ongoing multicenter study comparing short hour-high flux with
      conventional cellulosic dialysis, 49 patients have completed 6 months and serial
      urea kinetic data has been obtained. Of the 49, 28 were on AN69S membrane
      dialyzers, and 21 on cellulosic. The patients on AN69S received significantly
      less Kt/V than those on cellulosic dialyzers (0.97 +/- 0.3 vs. 1.20 +/- 0.2; p =
      0.0016), yet attained similar PCRs (1.07 +/- 0.2 vs. 1.02 +/- 0.1, NS).
      Significant (p = 0.002) linear relationships between PCR and Kt/V (urea) were
      found, yet the line slopes were higher for AN69S (average 0.46) than cellulose
      (average 0.25). Patients on AN69S achieve the same PCR for less Kt/V than
      patients on cellulosic dialyzers, supporting the hypothesis.

PMID- 1751081
TI  - Is Na+ modeling necessary in high flux dialysis?
AB  - One important pathogenic factor in dialysis hypotension is the drop in plasma
      osmolality. Increasing the dialysate Na+ concentration decreases hypotensive
      episodes. The authors studied 39 patients being treated with high flux dialysis.
      During a 9 week period, the patients were on a standard Na+ dialysate (Na+ = 140
      meq/L) basal period (B); 9% (Na+ = 149 meq/L) linear (L); step drop (S); and
      exponential drop (E). The Na+ program was changed weekly at random. The results
      obtained with the three Na+ modeling programs were similar. We compared the
      periods with and without Na+ modeling: no differences were found in weight gained
      interdialysis, mean blood pressure predialysis and postdialysis, and
      hemoconcentration. Serum Na+ levels were significantly higher predialysis and
      postdialysis for those patients on Na+ modeling. Hypotensive episodes and cramps
      decreased 50% with Na+ modeling. The amount of hypertonic and normal saline given
      during dialysis was markedly reduced. Na+ modeling should always be used in
      patients being maintained on high flux dialysis.

PMID- 1751082
TI  - Comparison of conductivity measured hematocrit to microhematocrit.
AB  - Two electrical conductivity methods of hematocrit (H) measurement, Coulter
      Counter (CCH) and lonometer (IH), were compared to the microhematocrit (MH) with
      two different anticoagulants, Li Heparin (Li) and EDTA. The results showed MH-Li
      is higher than MH-EDTA (mean difference 1.7 vol%). The IH-Li is 1.8 vol% higher
      than CC H-EDTA. These differences are attributed to osmotic shrinking of red
      cells by EDTA. The MH-Li and IH-Li correlate very closely (r = .992), and are
      considered to provide the truest hematocrit values.

PMID- 1751083
TI  - Less symptomatic hypotension using blood volume controlled ultrafiltration.
AB  - Symptomatic hypotension due to ultrafiltration (UF) is one of the most frequent
      unwanted side effects of dialysis therapy. Using hemoglobinometry for continuous
      monitoring of blood volume (BV), ultrafiltration rate (UFR) can be adapted to
      actual changes in BV. A control system is shown in which UFR is set according to
      a predefined profile of BV. The conditions of control are: relative BV shall
      decrease steadily; BV shall decrease rapidly during the first 60 min of dialysis,
      thereafter decrease in BV should be less; UFR shall be as high as possible; and
      dry weight should be obtained within a given time. Application of this controlled
      UF method in 10 dialysis patients shows significantly fewer hypotensive periods
      and muscle cramps compared to conventionally constant UFR. It is concluded that
      BV controlled UF is an important step toward optimizing dialysis therapy.

PMID- 1751084
TI  - High venous urea concentrations in the opposite arm. A consequence of
      hemodialysis-induced compartment disequilibrium.
AB  - Resistance to urea diffusion among body fluid compartments diminishes the
      therapeutic effectiveness of hemodialysis. Cell membrane or capillary wall
      resistance is thought to be responsible for hemodialysis-induced urea
      disequilibrium. The authors examined the possibility that reduced blood flow
      might contribute to urea disequilibrium in the arm opposite the blood access
      site. Blood samples were taken simultaneously from a vein in the arm opposite the
      access site and from the arterial port after occluding the access graft between
      the needle sites for 1 min. Venous urea nitrogen levels from the opposite arm
      averaged 10% higher after 5 min, 26% higher after 60 min, and 36% higher after
      120 min of dialysis. A three-compartment model of urea kinetics that includes a
      blood flow term accurately predicted all measured urea nitrogen concentrations in
      both arms. These data suggest that the opposite arm often behaves as a
      compartment with high resistance to urea diffusion. Slow diffusion from this
      compartment is partially due to reduced blood flow/compartment volume, and
      results in a delayed fall in venous blood urea nitrogen (BUN).

PMID- 1751085
TI  - The effect of surface hydrophilicity on biomaterial-leukocyte interactions.
AB  - Leukocyte adhesion onto a series of polyetherurethanes containing various ratios
      of polyethylene oxide (PEO) to polytetramethylene oxide (PTMO) in the soft
      segment was evaluated using an in vitro series shunt. The deposition of
      polymorphonuclear (PMN) and mononuclear (MN) leukocytes was measured
      quantitatively using labelling techniques. Results showed that H/H-1, the most
      hydrophobic surface, adsorbed higher amounts of PMN leukocytes. It was also
      observed that for most materials the number of PMN and MN leukocytes deposited
      reached a plateau within 15 minutes. Unlike MN adherence, the presence of plasma
      proteins increased the number of PMN leukocytes deposited on the materials.

PMID- 1751086
TI  - SPUU-PEO-heparin graft copolymer surfaces. Patency and platelet deposition in
      canine small diameter arterial grafts.
AB  - The influence of an SPUU-PEO-Heparin (B-PEO-HEP) copolymer coated blood
      contacting surface on patency and platelet deposition in small diameter (4 mm
      i.d.) Biomer grafts was investigated using a canine model. Grafts were implanted
      in the bilateral carotid and femoral arteries. B-PEO-HEP coated grafts still
      showed patency after 3 days. Control Biomer grafts occluded before 24 hr.
      (postoperatively). SEM of the luminal surfaces of the Biomer grafts demonstrated
      large amounts of adherent platelets with distorted morphologies, while B-PEO-HEP
      grafts did not. In platelet studies, B-PEO-HEP grafts showed significantly less
      platelet adhesion than Biomer grafts. The improved blood compatibility of B-PEO
      HEP graft co-polymer coatings attests to their usefulness for coating or casting.

PMID- 1751087
TI  - A physical model for the titanium-tissue interface.
AB  - X-ray photoelectron spectroscopy (XPS) was used to determine changes in titanium
      oxide composition, oxide stoichiometry, and adsorbed surface species as a
      function of exposure to model physiologic environments. The oxide on titanium
      became heterogeneous and polarized as a function of exposure. Changes included an
      increase in surface hydroxyl groups, and adsorption of H2PO4- and HPO4(2-). The
      heterogeneous nature of the surface led to preferential adsorption of
      lipoproteins, glycolipids, or both from serum.

PMID- 1751088
TI  - In vivo results of hydrogel composite pericardial substitutes.
AB  - In this study, two improved pericardial patches were developed and evaluated for
      their efficacy as pericardial substitutes. The patches are composites consisting
      of a hydrogel (PHEMA) that coats an underlying mesh (either ETFE or PET). Studies
      were conducted using subcutaneous implants in rats and pericardial patch implants
      in greyhound dogs. Adhesions between the substitute and pericardium and the
      epicardium were minimal. The ETFE composite patch caused an unacceptable
      epicardial reaction. The PET patch results were encouraging; the epicardium was
      largely unaffected by the patch.

PMID- 1751089
TI  - Measurement of peritoneal dialysate volume by CT.
AB  - Three-dimensional (3-D) graphic reconstruction of serial image data of x-ray CT
      on three dialysis patients was studied to measure peritoneal dialysate (PD)
      volume. Volume estimation with a surface reconstructed model provided a 16%
      error; a 35% error was found with a voxel model, although the total time required
      by the voxel model was 15 times less.

PMID- 1751090
TI  - Staphylococcus epidermidis biofilms: unexpected outcome of double and triple
      antibiotic combinations with rifampin.
AB  - Staphylococcus epidermidis, in contact with artificial surfaces, may produce a
      protective glue-like matrix or biofilm. The authors demonstrated that rifampin
      alone among 35 antibiotics penetrated the biofilm within a 24 hr exposure
      producing a major but incomplete killing. Antibiotics of the cell-wall active
      class (including vancomycin) were synergistic with rifampin, completing the
      bactericidal action. The addition of these antibiotics to a rifampin-vancomycin
      combination did not alter the synergy. Other antibiotics (including
      aminoglycosides) antagonized rifampin activity. This antagonism of rifampin was
      maintained when the antibiotics were added to the rifampin-vancomycin synergistic
      combination. These results may have implications for the choice of optimal
      therapeutic regimens in the management of implant-associated infection.

PMID- 1751091
TI  - Comparative rates of antibiotic action against Staphylococcus epidermidis
      biofilms.
AB  - The relative resistance of S. epidermidis implant-associated infections to
      antibiotic therapy has been ascribed to a protective function of the gluelike
      biofilm matrix produced by strains of S. epidermidis in contact with artificial
      surfaces. Using a standardized S. epidermidis biofilm assay we determined the
      periods of exposure required by various antibiotics to produce cessation of
      biofilm metabolic activity. Rifampin has the superior rate of action, producing
      substantial disruption of biofilm activity by 7 hr of exposure, but leading to
      replacement of the susceptible bacterial cells by rifampin-resistant mutant
      survivors. Other antibiotics required longer periods of exposure, in excess of 48
      hr, but produced a bactericidal outcome. Combinations of antibiotics with
      rifampin produced strikingly divergent results. Cefazolin and vancomycin (cell
      wall active antibiotics) produced a bactericidal outcome at 16 hr of exposure,
      whereas gentamicin (aminoglycoside) neutralized the rapid action of rifampin with
      metabolic activity maintained at 48 hr. We confirmed the selectively protective
      function of the S. epidermidis biofilm with regard to antibiotic action. In vitro
      biofilm assays may be of value in guiding antibiotic therapy in S. epidermidis
      implant-associated infection.

PMID- 1751092
TI  - Optimization of pacing parameters for conditioned latissimus dorsi muscle in
      cardiomyoplasty.
AB  - Synchronous paced contractions of latissimus dorsi muscle pedicle (LDM) around
      the heart improve ventricular function in dynamic cardiomyoplasty. To optimize
      assistance and prolong pacemaker battery life, the LDM should be stimulated with
      the lowest energy pacing parameters (PP) that will produce maximal muscle
      contraction. Muscle fractional shortening (FS) and duration of contraction (CT)
      were studied in conditioned, fatigue-resistant LDM of six goats. Fractional
      shortening and CT were determined at increasing amplitude, (A, 1-6v); pulse
      width, (PW, 60-450 musec); and frequency, (F, 5-130 Hz). Maximal rate of
      contraction was determined by pacing at higher rates. Maximal FS plateaued after
      V, 2.4 +/- .6v; PW, 125 +/- 47 musec; and F, 36 +/- 9 Hz. Mean CT for all PP was
      significantly longer (p less than or equal to 0.001) than the burst length (185
      msec). Increasing F resulted in CT, which peaked at 460 +/- 59 msec. Increasing
      rate of contraction demonstrated that over 87 beats per minute the muscle fails
      to achieve complete relaxation, and, therefore, maximal FS.

PMID- 1751093
TI  - Perineural leads and burst stimulation optimize contraction of skeletal muscle.
AB  - Electrode position and stimulation mode were hypothesized to be independent
      variables for the contractile response of skeletal muscle. Perineural and
      intramuscular electrodes were tested with single and burst pulse generators.
      Voltage requirements and muscle force generation were measured. Perineural leads
      improved the efficiency of stimulation for muscle contraction and yielded reduced
      threshold and plateau voltages compared to intramuscular leads. There were no
      differences between the different types of perineural leads. Burst stimulation
      had a wider range of voltage for muscle fiber recruitment and was confirmed to
      elicit greater maximal force than single stimulation.

PMID- 1751094
TI  - First significant animal survival with a Wankel-type left ventricular assist
      device.
AB  - The authors' laboratory is developing a device for heterotopic left ventricular
      assistance. It consists of a titanium Wankel-type rotary pump, driven by an
      hermetically sealed electric motor. In our animal experiments, the motor-pump
      unit was implanted in the thoracic wall. The pump was connected to the left heart
      chambers by left atrial cannulation, and to the descending aorta. The motor was
      connected to the power and control unit by an electric wire through the skin. In
      this report, the authors describe the first significant animal survival with this
      system. Laboratory results were encouraging for hemolysis. The pump failed at 13
      days due to a deposit of fibrin and blood cells in the gear housing. This problem
      was not surprising since similar events have been encountered with centrifugal
      devices. However, further design improvements should allow longer animal survival
      and clinical application.

PMID- 1751095
TI  - Transesophageal echocardiography for the evaluation of mitral valve prostheses in
      the weanling sheep.
AB  - The sheep model has been widely accepted for evaluating the in vivo performance
      of artificial valves. Introduction of transthoracic echocardiography
      revolutionized the evaluation of human cardiac valves, but in many cases,
      resolution of transthoracic studies in sheep is inadequate. The authors used
      transesophageal echocardiography to follow the performance of chronically
      implanted mitral prostheses. The technique has proven feasible and safe,
      requiring sedation only and being done in the spontaneously breathing animal
      without endotracheal intubation in the left lateral position. The HP 77020A,
      equipped with a standard HP 5 mHz transesophageal transducer probe, is used. The
      authors have had to modify the probe to allow for automatic cooling. Standard
      insertion techniques are used and the probe is positioned in the stomach, close
      to the gastroesophageal junction. They were able to assess leaflet motion,
      vegetations, and calcification and use color flow doppler to evaluate stenosis
      and regurgitation. The technique is convenient and permits a complete assessment
      of valve function in 10 minutes. Reproducibility has been confirmed. Validation
      of quantitative data will require further study.

PMID- 1751096
TI  - Long-term anticalcification effect of Fe3+ in rat subdermal implants of
      glutaraldehyde preserved bovine pericardium.
AB  - Fe3+ preincubation has been shown to inhibit pathologic calcification of
      glutaraldehyde preserved bovine pericardium (GPBP) in the short-term rat
      subdermal model (21 days). This study was designed to test the long-term
      anticalcification efficacy of Fe3+ in the same model. Glutaraldehyde preserved
      bovine pericardium was preincubated (1 hr, 25 degrees C) in 0.1M FeCl3, 0.01M
      FeCl3, or 0.05M HEPES, then implanted subdermally in weanling male rats (40-60
      gm) for 21, 60, 90, and 120 days. At explant, Fe3+ and Ca2+ levels were measured
      by atomic absorption spectroscopy. Fe3+ effectively inhibited calcification in
      both experimental groups compared to control through the longest implant (Ca2+
      levels, 120 day implant: 0.1M FeCl3 = 46.85 +/- 17.45 micrograms/mg; 0.01M FeCl3
      = 17.31 +/- 7.38 micrograms/mg; control = 258.04 +/- 15.71). Measurement of
      explanted GPBP Fe3+ levels showed that tissue Fe3+ levels of at least 7.28 +/-
      0.70 micrograms/mg were required to effectively inhibit calcification after a 120
      day implant. There was no evidence of Fe3+ impairment of rat growth. In
      conclusion, Fe3+ pretreatment of GPBP significantly inhibited calcification after
      long-term (120 day) rat subdermal implant.

PMID- 1751097
TI  - In vitro evaluation of a stentless porcine aortic bioprosthesis. A preliminary
      study.
AB  - Currently available aortic bioprosthetic heart valves are all relatively
      suboptimal due to the constraints placed on leaflets by stenting. The constraints
      on the stenting mechanism may directly or indirectly cause turbulence in the
      orifice neighborhood, be nidi of tissue calcification, and impart transleaflet
      stress differentials. To address all these deficiencies, we undertook the
      development of a stentless porcine aortic bioprosthesis (SPAB). This study
      evaluates the hemodynamic performance and durability of this design in special
      chambers with near physiologic compliance. The results are compared to those
      shown by a stented porcine aortic bioprosthesis. The pressure measurements under
      steady flow conditions showed that the hemodynamic performance (including
      pressure gradient and effective orifice area) of SPAB is superior to that of its
      stented counterpart, especially in the smaller sizes. In addition, it is expected
      that this stentless design should minimize the mechanical stress to which the
      leaflets are subjected throughout the cardiac cycle, thus enhancing the
      durability of the bioprosthesis. In our accelerated durability study for up to 2
      equivalent years, no valve failure has been observed. More in vitro studies under
      pulsatile flow conditions, including color Doppler flow visualization, are
      currently being conducted.

PMID- 1751098
TI  - Improved biocompatibility of bovine pericardium using a new method of cross
      linking.
AB  - The authors used glycerol (Gly) as a cross linking agent to treat bovine
      pericardium (BP) and compared it mechanically (tensile test) and biologically
      (subcutaneous implantation in rats) with glutaraldehyde (Glu) fixed lonescu
      Shiley BP (ISBP). Maximum tensile stress (Stmax) was the same in both groups (n =
      12 each), while maximum strain (Snmax) was larger in Gly BP. Calcium content (Ca)
      was lower and water content of tissue (WC) was higher in implants of Gly BP
      versus ISBP (n = 9 each). Gly BP appeared more hydrated than ISBP in specimens
      studied by scanning electron microscopy (SEM). In addition, SEM of three Gly BP
      mitral valves in sheep showed good growth of endothelial (En) cells. These
      biomechanical advantages of Gly BP over ISBP suggest that Gly may be a useful
      substitute for Glu in cross linking bovine pericardial valves.

PMID- 1751099
TI  - A newly designed anticancer tumor immunity drug delivery system.
AB  - The authors used a fibrin clot (FC) as a carrier of an anti-cancer drug (AD) to
      achieve sustained release of the drug. Adriamycin (ADM) and cis-platinum (CDDP)
      were individually encapsulated into an FC, and the profile of release of each AD
      from the FC-AD was examined in vitro. The FC-AD was placed intra-abdominally in
      ascites hepatoma AH130-bearing rats, and ADM or CDDP solution was
      intraperitoneally injected (IP) into other cancer bearing rats. The survival time
      was recorded, and related oncolytic mechanisms were investigated. The release of
      AD from the FC continued for over 15 days. Sixty-eight percent of the rats
      treated with FC-AD survived for more than 200 days and evidence of malignancy
      disappeared. Almost all of the IP rats and non-treated rats died within 20 days;
      these animals had massive ascites and extensive metastases. Immunologic studies
      confirmed that various tumor immunoresponses were induced in the rats treated
      with FC-AD. The FC-AD system warrants further study for possible antineoplastic
      activities in vivo.

PMID- 1751100
TI  - Application of finite element analysis for assessing biocompatibility of intra
      arterial catheters and probes.
AB  - A commercial finite element modeling program (FIDAP) was adapted to compute the
      fluid dynamics of laminar blood flow around an intra-arterial catheter and/or
      sensor probe. The model provided an accurate transient solution to the Navier
      Stokes equations under pulsatile blood flow conditions. To simulate the
      compliance in the catheter tubing set, a second order convolution integral was
      incorporated into the boundary conditions. The saline drip rate and catheter
      compliance could be specified, and the bulk blood flow, blood pressure, and heart
      rate were varied to simulate specific patient conditions. Analysis of the
      transient solution was used to assess probable sites for thrombus activation and
      deposition. The transient velocity and pressure fields identified regions of
      separated flow and recirculation. The computed shear rates and stresses were used
      to predict hemolysis, platelet activation, and thrombus formation. Analysis of
      particle paths provided an estimate of residence times and thrombus deposition
      sites.

PMID- 1751101
TI  - Effects of dialysis factors and route of administration on response of
      hemodialysis patients to recombinant human erythropoietin.
AB  - Data on the use of recombinant human erythropoietin (rHuEPO) were obtained from
      25 hemodialysis centers to determine whether route of administration (intravenous
      [i.v.] vs. subcutaneous [s.c.]) or various dialysis factors influenced the
      response to rHuEPO; 844 of 958 patients had sufficient data for evaluation.
      Hematocrit (HCT) increased from 23.8 to 29.1% after a mean rHuEPO treatment
      period of 202 days; 48.4% of all patients did not reach a HCT greater than or
      equal to 29%. The s.c. route increased HCT more than the i.v. route. Multivariate
      analysis of the response (i.e., increase in HCT from baseline) showed a positive
      correlation with more rapid dialysis but a negative correlation with reuse,
      baseline HCT, transfusion dependence, and frequency of administration. The
      effects of dialysis and reuse were not present when the response was normalized
      by weekly dose. It was concluded that one half of all patients treated did not
      attain the recommended target HCT, perhaps due to economic constraints or
      resetting of goals. The s.c. route may be preferable to optimize response.

PMID- 1751102
TI  - Is hematologic response to iron and erythropoietin in hemodialysis patients
      affected by other factors?
AB  - Multiple factors have been implicated in the hematologic response to
      erythropoietin (EPO). The authors studied 54 hemodialysis patients; 44 received
      1.5 g of iron intravenously, 16 received oral iron for 12 weeks, and 24 were
      treated with EPO. Some patients received these treatments in sequence. The
      factors evaluated were serum albumin, protein catabolic rate, serologic evidence
      of hepatitis B or C, parathormone (PTH), and aluminum levels. Red cell production
      was expressed as milliliters of red blood cell increase per day per kilogram of
      body weight. For patients receiving EPO, hematologic response was normalized to
      50 U/kg/dialysis. Of the patients on oral iron, 31% had a good response
      (hematocrit greater than or equal to 30%). Of the patients who received iron
      intravenously, 50% had a good response (hematocrit greater than or equal to 30%).
      All patients treated with EPO responded well, except for one patient who did not
      respond to doses of EPO up to 200 U/kg/dialysis. The response to intravenous iron
      dextran was more rapid than the response to oral iron or EPO. Nutritional factors
      (serum albumin and protein catabolic rate), serologic evidence of hepatitis,
      elevated PTH levels, or elevated aluminum levels did not significantly affect the
      response to iron supplementation or EPO treatment.

PMID- 1751103
TI  - Determinants of dialyzer reuseability.
AB  - The authors observed a wide variability in the number of uses per dialyzer in
      their hemodialysis patients. In 54 patients who reused their dialyzers, heparin
      dose (U/kg/min) related directly and white blood cell count related inversely to
      reuseability. Average reuse was 5.1 +/- 2.9 (SD) in diabetics (n = 13) and 7.8 +/
      3.8 (SD) in non-diabetics (n = 41; p = 0.007). Of the diabetics, 77% achieved
      six or less reuses, and 59% of non-diabetics achieved six or more reuses (chi
      square = 4.96; p less than 0.05). In non-diabetics, heparin dose was the most
      significant determinant of reuse, and in diabetics the major determinant was
      white blood cell count. Hematocrit levels, platelet count, erythropoietin use, or
      type of membrane (polysulfone/cellulose acetate) did not correlate with
      reuseability. It was concluded that reuseability of dialyzers is less in diabetic
      patients, patients on lower heparin doses (U/kg/min), and patients with higher
      white blood cell counts. Determinants of dialyzer reuseability warrant further
      study.

PMID- 1751104
TI  - Effect of erythropoietin on neutrophil chemiluminescence in hemodialyzed
      patients.
AB  - Erythropoietin (EPO) has been used widely for correcting anemia in hemodialyzed
      (HD) patients. Enhancement of phagocytic function during EPO treatment of HD
      patients has been studied, but no data have been available on the effect of EPO
      on neutrophil chemiluminescence (CL) after challenge with phorbol myristate
      acetate (PMA). CL was measured in prehemodialysis whole blood samples from 15
      stabilized patients and 15 normal healthy control subjects (C) after challenge
      with PMA. Before EPO treatment, CL was noted to be significantly higher in HD
      patients than in C, which changed significantly after 5 weeks of treatment (Rx)
      and continued for 13 weeks of Rx. There was a significant increase in hematocrit
      in these HD patients after 5 weeks that persisted until the 13th week. It was
      concluded that there is a significant decrease in whole blood CL in response to
      challenge with PMA during correction of anemia in HD patients treated with EPO.
      This study demonstrated that EPO could decrease enhanced PMA-activated reactive
      oxygen metabolite production and suggested that this decrease may protect against
      tissue damage, including red blood cell hemolysis in the uremic milieu.

PMID- 1751105
TI  - Performance evaluation of hydroxylated and acylated silicone rubber coatings.
AB  - Hydroxylated and C16 acylated silicone rubber films were prepared with enhanced
      albumin binding. Lee-White clotting times were significantly increased for both
      treatments. Hydroxylation significantly reduced C5a production. Hydroxylated
      silicone rubber femoral vein catheters in canines reduced 111In-labeled platelet
      activity, compared with bilateral silicone rubber catheter controls. The results
      suggest hydroxylated silicone rubber films have enhanced biocompatibility.

PMID- 1751106
TI  - Nafamostat mesilate administration during cardiopulmonary bypass decreases
      postoperative bleeding after cardiac surgery.
AB  - The hemostatic effect of nafamostat mesilate (FUT-175) was evaluated in patients
      undergoing cardiopulmonary bypass (CPB) surgery. Thirty patients undergoing
      aortocoronary bypass grafting were divided into two groups. In the control group,
      anticoagulation was achieved with an initial dose of heparin (3 mg/kg). In the
      FUT-175-treated group, in addition to the ordinary treatment with heparin, FUT
      175 was infused continuously into the circuit throughout the procedure at a rate
      of 100 mg/hr. Thrombin-antithrombin III complex (TAT), fibrinopeptide A (FPA),
      and fibrin degradation products (FDP-D) dimer increased in both groups as CPB
      proceeded. In the FUT-175-treated group, these parameters remained lower and
      decreased more rapidly after the end of CPB. Alpha 2 plasmin inhibitor/plasmin
      complex (PIC) increased progressively during CPB in the control group; no such
      significant increases were seen in the FUT-175-treated group. Postoperative blood
      loss was significantly lower in the FUT-175-treated group than in the control
      group. It was concluded that FUT-175 reduces postoperative blood loss by
      inhibiting both coagulation and fibrinolysis during CPB.

PMID- 1751107
TI  - Development of thermosensitive peptidyl cell substrate synthesis and artificial
      fibrin glue.
AB  - A totally synthetic fibrin glue was developed. The molecular structure is a co
      polymer of N-isopropyl acrylamide (NIAM) and vinyl monomer units with a cell
      adhesion peptidyl moiety (Arg-Gyl-Asp). The buffer solution is a viscous liquid
      at room temperature, but spontaneous precipitation occurs due to thermoresponsive
      phase transition derived from poly-NIAM. The peptidyl moieties bind to platelet
      receptors. When applied to tissues, spontaneous precipitation and subsequent
      platelet aggregation occurred, indicating that the synthetic bioactive polymer
      effectively functions like fibrin glue.

PMID- 1751108
TI  - Fibronectin surface density affects endothelial cell function and growth on
      hydrophilic polymer.
AB  - Adhesive biomolecules have been used to promote endothelial cell adherence to
      polymer surfaces. The authors varied the surface density of one such biomolecule
      (fibronectin) applied to a hydrophilic polymer in an in vitro model system and
      then measured the amount of prostaglandin E2 (PGE2) produced by endothelial cells
      grown on these modified polymers. Endothelial cells grown on polymers with
      fibronectin applied at a surface density of 10 and 35% produced significantly
      more PGE2 (25.7 +/- 2.1 and 26.8 +/- 0.9 pg, respectively) than cells grown on
      polymer with no fibronectin (7.3 +/- 1.0 pg) and with complete saturation of the
      polymer surface with fibronectin (13.1 +/- 5.3 pg), with a p less than 0.005 for
      the comparison. The surface density of biomolecules on an artificial substrate is
      an important determinant of endothelial cell function.

PMID- 1751109
TI  - Development of a new scrim cardiac wall substitute.
AB  - A cardiac wall substitute made of non-woven ultrafine fibers was developed. It
      consists of a basal knitted scrim with strongly entangled ultrafine polyester
      fibers, lined with a fine velour of entangled ultrafine fibers that provide high
      ravel and tear resistance, a perfect matrix for preclotting, and an anchor for
      cell adhesion. Six of the new patches and all control patches (a
      polytetrafluorethylene patch, woven Dacron patch, and glutaraldehyde-treated
      equine pericardium) were implanted in the right ventricular outflow tracts in 24
      dogs. Animal experiments showed that the new patch was easy to handle and suture
      without fraying or tearing through the edge.

PMID- 1751110
TI  - Experimental evaluation of a new type of heparin-bonded polyurethane.
AB  - A new type of heparin bonding method using polyurethane (H-PU) in an ionically
      equivalent manner was examined experimentally. In vitro testing of
      polyvinylchloride tubes with this coating showed that the behavior of the heparin
      was attributed to the activation of retained heparin on the surface. After 4 hrs
      of heparinless arterio-arterial bypass in a canine model with a central shear
      rate of 25 sec-1 (inner diameter, 0.8 x 80 cm), macroscopic and scanning electron
      microscopic examinations showed that the H-PU coated tube had better
      antithrombogenicity than that of a conventional PU coated tube (Pellethane).
      These results suggest that this heparin bonding method with PU appears to have
      good antithrombogenicity with possible long durability.

PMID- 1751111
TI  - Electric power induction through an isolated intestinal pouch.
AB  - A new transintegumental power transformer uses the walls of an isolated
      intestinal pouch to separate primary and secondary coils. It may surpass
      transcutaneous devices in heat dissipation potential and in comfort. It was
      acutely tested in 13 dogs. Corrections in geometry and insulation were suggested
      by the nine initial trials. In the remaining four animals, up to 14.1 W were
      delivered, incrementing over 90 to 395 min. Three pouch and two remote
      thermistors recorded temperature (T) at 10 min intervals. Thirty sets of data
      were taken at 4 W or less (Group A), 31 at 4-8 W (Group B), and 16 at more than 8
      W (Group C). T elevations above reference drift were 0.096 + 0.062 degrees C,
      0.468 + 0.234 degrees C, and 0.876 + 0.156 degrees C for groups A, B, and C,
      respectively. These were significant by t-tests (p less than 0.001 for Group A
      vs. B; p less than 0.05 for Group B vs. C). The concept appears to be feasible,
      and longer term implantation trials seem justified.

PMID- 1751112
TI  - A servomatic pneumatic driver system for left ventricular assist devices.
AB  - A new ventricular assist device (VAD) pneumatic driver with a servomatic left
      atrial pressure (LAP) control mechanism was developed for easy and safe control
      of left ventricular assist devices. The negative driving pressure (NP) can be
      automatically varied to control the assisted circulatory flow (AF), comparing the
      patient's LAP with prescheduled LAP (s-LAP). Animal experiments revealed this
      servomatic control system to be useful.

PMID- 1751113
TI  - Electrohydraulic ventricular assist device development.
AB  - A 64 ml (effective stroke volume) in vitro electrohydraulic ventricular assist
      device (VAD) prototype has been built. The energy converter is an axial flow pump
      driven by a brushless direct current (DC) motor. Systole begins as silicone oil
      is pumped from the volume displacement chamber (VDC) into the ventricle,
      displacing the flexing diaphragm separating the oil and the blood. In diastole,
      the motor reverses, providing active filling by pumping oil from the ventricle
      into the VDC. The surface mount electronic internal controller provides motor
      commutator, energy management, telemetry, and physiologic control functions.
      Energy is supplied externally by either a 12 V DC power supply or a 12 V DC
      rechargeable battery and is transmitted through the skin by a transcutaneous
      energy transformer (TET). Energy can also be supplied by a 12 V DC rechargeable
      internal battery. Bidirectional infrared telemetry is used to transmit
      information between the internal and external controllers.

PMID- 1751114
TI  - Control of pulsatile rotary pumps without pressure sensors.
AB  - When ventricular assistance is achieved with a volumetric pump driven by an
      electric actuator, overpumping can cause venous collapse. To prevent this
      problem, pump speed must be monitored and controlled. The authors developed a
      regulatory system based on the current intensity signal from the electric motor.
      This signal is processed and compared with predicted values calculated according
      to a mathematical model at the beginning of each ejection phase. If a difference
      is detected, pump speed is adequately adjusted. The great advantage of this
      system is elimination of the need for an implantable pressure sensor. It requires
      a simple and ubiquitous electronic component, i.e., a resistor, that can be
      easily integrated into the motor control circuit and does not require
      calibration.

PMID- 1751115
TI  - A sophisticated electromechanical ventricular simulator for ventricular assist
      system testing.
AB  - With the advent of chronically implanted left ventricular assist systems, new
      adaptive control algorithms are being developed to allow automatic device control
      under a variety of hemodynamic conditions. An electromechanical pump is described
      that accurately mimics ventricular function. A pusher-plate sac pump with tri
      leaflet valves is coupled to a high-speed linear motor. Pump chamber volume and
      pressure are constrained to follow the time-varying elastance model of
      ventricular function by use of a microprocessor feedback loop.

PMID- 1751116
TI  - A model of right ventricular failure after global myocardial ischemia and
      mechanical left ventricular support.
AB  - Postcardiotomy right ventricular (RV) failure after institution of mechanical
      left ventricular (LV) support is poorly understood. Using a canine model
      supported by cardiopulmonary bypass (CPB), the animals underwent 30 min of aortic
      clamping or no ischemia and were weaned to an LV assist device (LVAD).
      Echocardiographic measurements of LV and RV cavity size off support allowed
      calculation of percentage change in cavity area (fractional shortening). There
      were no differences at baseline. After 2 hrs on LVAD, there were significant
      differences between ischemic and control groups in both LV (38 +/- 12 vs. 61 +/-
      6) and RV (15 +/- 3 vs. 55 +/- 12). The ischemic RV also had significantly
      decreased function compared with the LV (38 +/- 12 vs. 15 +/- 3). The control
      group demonstrated no differences in ventricular function. The authors concluded
      that global ischemia diminishes LV and RV function, and this effect is
      accentuated in the RV after LVAD support. In controls, RV function is not
      affected by LVAD support, but after ischemia, LVAD support alone often will be
      inadequate.

PMID- 1751117
TI  - Reconstructed image of the human heart based on magnetic resonance images for
      total artificial heart implantation.
AB  - Parameters used to develop a three-dimensional reconstructed image of the
      remaining heart after total artificial heart implantation (i.e., for the mitral
      and tricuspid annuli, ascending aorta (AO), and pulmonary artery [PA]) were
      calculated based on reconstructed images from data obtained from four magnetic
      resonance (MR) image views: 1) transverse, 2) coronal, 3) left ventricular long
      axis (LAX), and 4) four chamber view (FCV). The values obtained were compared
      with those obtained from silicone models of the same hearts. It was found that,
      of the four MR image views, LAX and FCV provided the greatest numbers of points
      reflecting annular contour that were useful in reconstruction of the
      atrioventricular (AV) annuli, and the highest percentages of segmented outline
      connecting points less than 1 cm apart for the total outline. The AV annuli were
      sliced in the least slice time using FCV imaging. The authors applied FCV MR
      imaging to a beating heart to reconstruct the AV annuli and obtained accurate
      results. To quantify more accurately the data for the axis directions of AO and
      PA, research to establish a new orientation on the thorax is in progress.

PMID- 1751118
TI  - Anatomic study for in vivo evaluation of a total artificial heart in calves.
AB  - A poor fit will negate any physiologic evaluation of an implantable total
      artificial heart (TAH). Fifteen Holstein calves (weight, 65-111 kg) were used to
      measure intrathoracic dimensions for TAH design, to find correlations between
      intrathoracic and external parameters for preoperative animal selection, and to
      suggest minor modifications for fitting a TAH in calf chests. The following
      dimensions were found to be critical to avoid compromising venous return: 1)
      mitral annulus center (MVC)-sternum, 10.4 +/- 1.0 cm; 2) tricuspid annulus center
      (TVC)-sternum, 9.8 +/- 1.6 cm; 3) MVC-TVC, 5.5 +/- 0.4 cm; 4) MVC-diaphragm, 3.4
      +/- 0.8 cm; 5) MVC-left chest wall, 4.5 +/- 0.9 cm; and 6) TVC-right chest wall,
      4.5 +/- 1.0 cm. These dimensions had no statistically significant correlation
      with body weight, but three of them did with the following external parameters:
      1) bronchial carina-sternum on chest radiograph, p less than 0.05; 2)
      dorsoventral dimension at xiphoid, p less than 0.05; and 3) circumference at the
      caudal end of the scapula, p less than 0.05. Based on these results, the port
      orientation of the left housing of this electrohydraulic TAH designed for humans
      was modified for in vivo evaluation in calves. No other pump features required
      change. These data should prove useful to others involved in TAH development.

PMID- 1751119
TI  - Blood compatibility of the jellyfish valve without anticoagulant.
AB  - The blood compatibility of the jellyfish valve was studied. Artificial heart (AH)
      blood pumps incorporating jellyfish valves were connected to 18 goats as total
      artificial hearts (TAHs) and pumped for 1 to 125 days without anticoagulant or
      antiplatelet drugs. No thrombus was formed on the valve membrane or around the
      valve seat. Scanning electron microscopy showed almost no platelet deposition or
      microfibrin clot formation on the valve membrane, including its central region;
      the spokes of the valve seat were also free from platelet and microfibrin clots.
      No calcification was observed during these tests, and plasma free hemoglobin was
      between 2 and 7 mg/dl. The jellyfish valve revealed good blood compatibility,
      even without anticoagulant use.

PMID- 1751120
TI  - Liquid nitrogen snap frozen saphenous vein for vascular access in dialysis.
AB  - In the authors' centers, fresh saphenous veins (FSV) procured from routine
      saphenectomies have been preferred to synthetic prostheses in cases of difficult
      vascular accesses (VA) for dialysis. The need for veins of different lengths and
      diameters prompted them to preserve SV by instantaneous freezing in liquid
      nitrogen since November 1987. Until now, 59 patients have received 35 FSV and 32
      cryopreserved SV (CSV). Actuarial patency rates after 1 year are 82% and 72%,
      respectively. The 6-keto prostaglandin F1 alpha measured on punches of both veins
      showed residual production of prostacyclin even in CSV, but this was unresponsive
      to stimulation by arachidonic acid and bradykinin, or to inhibition by aspirin.
      In the authors' opinion, despite marked endothelial damage, satisfactory clinical
      results can be obtained by this very simple and cheap method of storing biologic
      prostheses for dialysis VA.

PMID- 1751121
TI  - Antidiuretic hormone regulation in hemodialysis.
AB  - The relative influence of stimulation and suppression of osmoreceptors and low
      and high pressure baroreceptors was studied in 12 patients on hemodialysis. The
      stimuli were separated by ultrafiltration and dialysis. When high and low
      baroreceptors were deloaded by volume contraction during ultrafiltration, but
      there was no change in osmolality, the antidiuretic hormone (ADH) level rose
      steeply. When osmoreceptors were suppressed, but there was no influence on
      baroreceptors during dialysis, ADH level declined by the same amount it had
      increased during ultrafiltration. When osmoreceptors were stimulated by an
      increase in osmolality in the phase between dialyses, but baroreceptors were
      loaded by an increase in volume, ADH levels did not change. Others showed that
      when baroreceptors are stimulated and osmoreceptors suppressed during
      simultaneous ultrafiltration and dialysis, there is also no change in ADH levels.
      These results indicate that the hierarchy of receptors regulating ADH is
      osmoreceptors followed by high and low baroreceptors. Simultaneous stimulation or
      suppression of both baroreceptors appears equal to the influence by
      osmoreceptors.

PMID- 1751122
TI  - Protamine-coated Cuprophan. A potential nonthrombogenic hemodialysis membrane
      with improved blood compatibility.
AB  - A protamine-coated Cuprophan hemodialysis membrane possessing improved blood
      compatibility was developed. Protamine was covalently immobilized onto the inner
      walls of the Cuprophan hollow fibers, using the cyanogen bromide (CNBr)
      activation method. Studies conducted with aqueous solutions indicated that the
      immobilization process did not introduce deterioration of the membrane mechanical
      and mass transfer properties; the permeability of several compounds through the
      protamine-coated membrane was unchanged. The modified membrane was rendered
      nonthrombogenic by the adsorption of heparin to the protamine-bound surfaces.
      Heparin adsorbed on the immobilized protamine retained about 20% of its initial
      anticoagulant activity. Preliminary studies using the hemolytic complement assay
      indicated that complement activation by the protamine-coated membrane was
      statistically far less than that by the untreated membrane.

PMID- 1751123
TI  - Continuous measurement of pressure in internal arteriovenous fistulae and
      prevention of symptomatic hypotension during hemodialysis.
AB  - To continuously monitor the blood pressure (BP) in an internal arteriovenous
      fistula, the blood tubing wall was punctured with a long, fine needle (25 gauge),
      and the needle tip was advanced into the fistula vein through the lumen of the
      outflow blood access puncture needle. It was found that the intrafistula BP thus
      measured varied in parallel with the systemic arterial BP during hemodialysis
      (HD). When the intrafistula BP fell to 60% of the level at the start of HD, 50 ml
      of saline was administered. As a result, hypotension was prevented completely in
      60 HD in five patients who often showed symptomatic hypotension during HD.

PMID- 1751124
TI  - The use of the Gianturco intravascular stent in stenotic hemodialysis fistulas.
AB  - This study was initiated to investigate the use of the Gianturco intravascular
      stent in prolonging dialysis access graft patency after angioplasty. Stents were
      placed in 25 patients with follow-up to date of 0.5-8 months. The stent used was
      1.5 x 3 cm and consisted of two units connected by a single strut. In Phase 1,
      the strut was rigid, and the stent had no barbs. The rigidity of the stent and
      stent migration caused problems. In Phase 2, an articulated strut design was
      used, and in Phase 3, barbs were added. These modifications solved the previously
      noted problems. No anticoagulation was used, and clotting was not a significant
      problem. The duration of patency for the total group was not significantly better
      than for control groups. However, there were no losses with the modified stent
      design used in Phases 2 and 3 with follow-up to date of 0.5-5.5 months. Further
      study of this treatment modality appears warranted.

PMID- 1751125
TI  - Glomerulopressin in end-stage renal disease. Effect of hemodialysis.
AB  - Plasma and hemofiltrate activities and hemodialysis (HD) clearance of
      glomerulopressin (GP) were measured in eight end-stage renal disease (ESRD)
      patients. Four normal volunteers served as controls. Plasma GP was elevated
      significantly in the ESRD group and fell with HD. Significant amounts of GP were
      found in the hemofiltrate. Single passage through the dialyzer resulted in a
      24.7% fall in plasma GP activity. Dialyzer clearance of GP averaged 144 ml/min
      (75.4% of urea clearance). In conclusion, plasma GP was elevated in ESRD and
      readily removed by HD.

PMID- 1751126
TI  - A completely implantable total artificial heart system.
AB  - The authors developed, built, and tested in vivo a completely implanted total
      artificial heart (TAH) system. The system used a reduced size version of a roller
      screw energy converter and mating sac blood pumps. The motor drive, pumps, and a
      compliance chamber were implanted intrathoracically. A canister containing
      controlling electronics and an emergency battery was implanted in the abdomen.
      The secondary coil of an inductive energy transmission and telemetry system was
      placed over the ribs. The system was implanted in three calves, that survived 0.5
      13 days with the system. The system maintained safe left atrial pressures and
      adequate cardiac outputs during each animal's entire course.

PMID- 1751127
TI  - A unique, efficient, implantable, electromechanical, total artificial heart.
AB  - A completely implantable, one piece electromechanical total artificial heart
      (TAH) intended for permanent human use was developed. It consisted of left and
      right conically shaped pusher-plate blood pumps sandwiching a thin centerpiece
      with a compact, efficient electromechanical actuator. The actuator consisted of a
      direct current brushless motor; a planetary roller screw fit the space between
      the two conically shaped pusher-plates. The rotational motion of the motor was
      converted to the rectilinear motion of the rollerscrew to displace the left and
      right pusher-plates in the left master alternate mode. The diameter of the
      assembled TAH was 97 mm, with a central thickness of 82 mm. The overall weight
      was 620 g, with a displaced volume of 510 ml. The pump provided flows of 3-8
      L/min with a preload of 1-15 mmHg against an afterload of 100 mmHg. The net
      efficiency ranged from 15% to 18%. This model showed good fit in the pericardial
      space of heart transplant recipients (body weight, 77 kg).

PMID- 1751128
TI  - The newly designed univalved artificial heart.
AB  - A univalved artificial heart (AH) powered electromagnetically in the frequency
      range of 1-30 Hz was developed to obtain a totally implantable AH. This small
      sized AH consisted of a vibrating tube, coils, magnets, and a jellyfish valve as
      an outlet AH valve. The fluid mechanical, hemodynamic, and hematologic properties
      were evaluated in a mock circulation and 10 animal experiments using adult goats.
      This vibrating electromagnetic AH could generate more than 10 L/min as an output
      volume, with 10 Hz vibration using 20 volts supplied voltage. It could also
      provide two kinds of flow and pressure patterns, in constant-peak and periodic
      peak patterns. The values of free hemoglobin remained within acceptable limits.
      The authors concluded that this new type of pump was useful as a totally
      implantable AH, ventricular assist, or organ assist system.

PMID- 1751129
TI  - A new pulsatile total artificial heart using a single centrifugal pump.
AB  - A new pulsatile total artificial heart (TAH) system, combining a single
      centrifugal pump (CFP) with two three-way valves, was developed. One port of each
      three-way valve was connected to the inlet and outlet of a CFP, respectively. The
      other two ports of each valve ware connected to the right and left atrium,
      pulmonary artery, and aorta. The CFP can perfuse the pulmonary and systemic
      circulation alternately with pulsatile flow. A prototype system composed of a
      Sarns' CFP and solenoid valves was connected to a mock circulatory system
      resulting in 1) a pulsatile TAH that could be produced with a single CFP, 2) 5
      L/min of pulsatile output with a normal flow wave form that can be obtained
      alternately on the right and left side by switching the solenoid valves, and 3)
      flow balance between the left and the right that could be controlled easily by
      the length of switching duration. This new system could be miniaturized and is
      feasible for a totally implantable TAH.

PMID- 1751130
TI  - Chronic evaluation of a compact nonseal magnet pump as a nonpulsatile pump for
      long-term use.
AB  - Use of a nonpulsatile pump is one of the most interesting approaches in the
      development of artificial hearts. A centrifugal pump without a seal around the
      rotating part was evaluated in five goats. The size of the pump is 8.4 cm x phi
      7.0 cm, including an electric motor. A polypropylene impeller with four fins on
      the top of a column in which a magnetic ring is embedded spins by coupling with a
      rotating magnet outside the housing. In the goats, the pump was placed
      paracorporeally to provide total left heart bypass at a flow rate of 4.6-7.6
      L/min, and activated clotting time was controlled at 200-300 sec by continuous
      heparin infusion. Although the first three goats died within 3 days due to
      bleeding, embolism, and a jammed impeller, respectively, a pump could be driven
      for 14 days in the fourth goat, and another pump with a rotational control
      feedback system ran for 32 days in the fifth goat. Plasma free hemoglobin levels
      were 13.8 +/- 4.3 mg/dl and 9.5 +/- 2.5 mg/dl, and platelet counts were 53.8 +/-
      24.7 x 10(4)/mm3 and 62.0 +/- 22.0 x 10(4)/mm3 after 12 hours and 7 days pumping,
      respectively. No thrombus was observed in the blood chamber in the last two
      cases. In conclusion, this pump has possibilities as a nonpulsatile pump for long
      term use.

PMID- 1751131
TI  - Spherical rotary piston machine as an artificial heart.
AB  - A positive displacement pump with six rotary pistons was proposed as an
      artificial heart. The pump's design was characterized by high symmetry and
      compactness. Thus, a spherical volume of 4 1/4 inch diameter sufficed for a pump
      delivering 10 L/min at 120 pulses/min with the pistons turning at 30 rpm. The
      pistons and four connecting gears were the only moving parts. The pump functions
      in two separate halves as left and right ventricles, with two of the six pistons
      each having inlet and outlet passages, and one of them replacing mitral and
      pulmonary valves with the other, tricuspid and aortic valves. The function of the
      intraventricular septum was provided by the other four pistons whose interiors
      also accommodated driving motors each capable of 0.4 Nm torque for a combined
      power of 5 watts. There were no stagnant regions in the pumping volume, and at
      all internal surfaces in contact with blood, there was periodic shear stress not
      exceeding approximately 300 Pa.

PMID- 1751132
TI  - Atrial compliance changes in animal total artificial heart recipients.
AB  - Right atrial compliance of chronically implanted total artificial heart animals
      was calculated from the pressure-volume relationships acquired at autopsy and
      compared with those of a control animal. The chronically implanted animals showed
      right atrial dilatation and low compliance. Even though atrial dilatation and
      decreased compliance have an opposite direct effect on atrial pressures, these
      changes may, in turn, disturb stretch-dependent volume regulatory processes,
      resulting in high atrial pressure.

PMID- 1751133
TI  - A biolized, compact, low noise, high performance implantable electromechanical
      ventricular assist system.
AB  - An implantable electromechanical ventricular assist system (VAS) intended for
      permanent human use was developed. It consisted of a conically shaped pumping
      chamber, a polyolefin (Hexsyn) rubber diaphragm attached to a pusher-plate, and a
      compact actuator with a direct current brushless motor and a planetary
      rollerscrew. The outer diameter was 97 mm, and the total thickness was 70 mm.
      This design was chosen to give a stroke volume of 63 ml. The device weighs 620 g,
      with a total volume of 360 ml. The pump can provide 8 L/min flow against 120 mmHg
      afterload with a preload of 10 mmHg. The inner surface of the device, including
      the pumping chamber and diaphragm, was made biocompatible with a dry gelatin
      coating. To date, two subacute (2 and 6 day) calf studies have been conducted.
      The pump showed reasonable anatomic fit inside the left thorax, and the entire
      system functioned satisfactorily in both the fill-empty mode using the Hall
      effect sensor signals and the conventional fixed rate mode. There were no
      thromboembolic complications despite no anticoagulation therapy. The system now
      is being endurance tested greater than 10 weeks (9 million cycles). This VAS is
      compact, low noise, easy to control, and has excellent biocompatibility.

PMID- 1751134
TI  - Determination of critical pericardial dimensions in patients with dilated
      cardiomyopathy.
AB  - The development of orthotopically positioned cardiac replacement devices requires
      a knowledge of the space available to guide the design of the blood pumping
      system. Pericardial dimensions from in vivo and cadaver studies of normal
      subjects have been reported, but little information is available on in vivo
      pericardial dimensions in patients with dilated cardiomyopathies. The critical
      pericardial dimensions were determined in 13 men who were cardiac transplant
      recipients (age, 42 +/- 13 years; body mass, 72 +/- 11 kg; three with ischemic
      and 10 with idiopathic cardiomyopathy) by comparison of corresponding pericardial
      axes on chest radiographs to measurements obtained during orthotopic cardiac
      transplant in the context of a total artificial heart fit trial. The main
      pericardial dimensions measured intraoperatively were found to be the T10 midline
      anteroposterior (AP) axis (12.3 +/- 1.4 cm), the aortic root to diaphragm length
      (9.7 +/- 1.5 cm), the T10 total cardiac lateral axis (18.1 +/- 2.3 cm), and the
      tricuspid annulus to left ventricular apex (12.1 +/- 1.7 cm). All patients had
      cardiomegaly as indicated by a greater than normal cardiothoracic ratio. These
      data described the limited dimensions of the pericardial space available for
      orthotopic cardiac replacement devices. Chest film dimensions can be corrected
      using 0.92 and 0.88 as reduction factors for the (AP) and lateral axis
      dimensions, respectively. In this patient sample, there was little or no
      correlation between pericardial dimension and patient body mass or
      diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751135
TI  - Anatomic fit study for development of a one piece total artificial heart.
AB  - A fit study was conducted to define anatomic constraints to total artificial
      heart (TAH) insertion in 26 human orthotopic cardiac transplant recipients, and
      the parameters necessary for designing a totally implantable TAH were obtained
      from the excised heart. A multiadjustable fitting device was made (height, 118
      mm; width, 81 mm; diameter, 97 mm), and with this model, 15 fitting and measuring
      studies were conducted to validate the design and demonstrate anatomic
      compatibility. Satisfactory fit of the contour model was observed in all cases.
      The model was placed through a sternotomy wound in the pericardial space. In
      addition to this mock-up fit study, the anatomic dimensions of the connection
      points to the TAH and the excised hearts also were measured. With the prototype
      model based on these data, a fit verification study was done in 11 recipients.
      Satisfactory fit in the pericardial space without compression of adjacent
      structures was observed in seven of 11 patients. This study suggests that the
      newly designed model of an anatomically and surgically practical configuration
      could be implanted in most patients in this population as a completely
      implantable cardiac prosthesis.

PMID- 1751136
TI  - Microbially infected thrombus in animals with total artificial hearts.
AB  - In a retrospective study of 330 animals with total artificial hearts (TAH), 103
      (31%) had microbially infected thrombi (MIT). The incidence of MIT approximated
      75% in the animals surviving more than 100 days. The most common pathogen
      isolated from animals with MIT was Pseudomonas. Most thrombi appeared to have
      originated from valve junctions and connectors. Methods to prevent MIT should be
      aimed at eliminating thrombus formation by improved design and materials and
      controlling the route of bacterial colonization. These findings suggest that
      bacterial interaction with the thrombus, device-related bacterial colonization,
      host immunomodulation, and gut barrier function after TAH implantation need
      further study.

PMID- 1751137
TI  - Device related infections in patients supported with mechanical circulatory
      support devices for greater than 30 days.
AB  - Mechanical circulatory support with systems that require transcutaneous cannulas
      or drive lines are associated with a high incidence of device related infections.
      The development of infection often is related to the duration of support. Data
      were reviewed on 10 patients (nine men and one woman) supported with assist
      devices (Thoratec-five, Nova-cor-three, Sarns-one, Jarvik-one) for longer than 30
      days (range, 31-440; mean, 137 days). Seven patients had device related
      infections. Five also had positive blood cultures with the same organisms
      responsible for the device related infection. Two had mediastinitis from an
      ascending infection (one cannula and one drive line). Eight patients were
      transplanted, with seven survivors. One patient was weaned and survived, and one
      died during support. These data show that device related infections are common
      and severe, but they do not preclude successful transplantation, weaning, or
      survival.

PMID- 1751138
TI  - Platelet deposition on polyethylene. Dependence of second layer platelet
      attachment on von Willebrand's disease plasma.
AB  - The role of von Willebrand's factor (VWF) was examined in platelet deposition on
      polyethylene by exposing 3/16 inch diameter discs of polyethylene to 111In
      labeled platelets re-suspended in citrated blood from normal and severe von
      Willebrand's disease donors. Discs were oscillated for 30 and 60 min, washed,
      fixed, counted for 111In, and examined by scanning electron microscopy (SEM).
      Total platelet deposition in the 0% VWF group was significantly greater than
      control discs at 30 min (7.0 x 10(6) +/- 0.5 compared with 3.29 x 10(6) +/- 0.6
      platelets/cm2). The SEM examination revealed patches of spread platelets, with
      platelets adhering to platelets in controls. A dense, uniform monolayer of
      platelets was found on the 0% VWF discs. At 60 min, control discs had significant
      increases in the platelet deposition with SEM examination revealing uniform
      coverage of the disc with additional platelets.

PMID- 1751139
TI  - The three-dimensional relationships between mitral and tricuspid valvular annuli
      for total artificial heart implantation.
AB  - The three-dimensional relationship between the mitral valvular annulus (MVA) and
      tricuspid valvular annulus (TVA) was studied in 32 cadaver hearts. It was found
      that when the distance from the center of the MVA and TVA (D-G) were standardized
      and when MVA and TVA were overlapped by matching their centers, MVA was located
      in the fan shaped region in the lateral view of the TVA and pointed toward the
      orifice of the coronary sinus. D-G was correlated with the volume of the space
      occupied by both ventricles. When the value of D-G was standardized, TVA remains
      free to change its shape and orientation toward either the cranial or caudal
      direction.

PMID- 1751140
TI  - Determination of atrial shunt size needed to balance an electrohydraulic total
      artificial heart.
AB  - An interatrial shunt (IAS) was developed and tested to balance a volumetrically
      coupled electrohydraulic total artificial heart (EHTAH). The IAS diameter was
      determined theoretically with the equation: [formula: see text] where D = orifice
      diameter, delta P = pressure drop across the orifice, rho = fluid density, Q =
      volume flow through the orifice, and C = empiric constant. The calculated orifice
      diameter was 2.9-5.3 mm to keep a 3-5 mmHg pressure difference between left and
      right atria, with 0.42-1.05 L/min of expected flow through the IAS. Three
      different sizes (3.4, 5.4, and 5.5 mm) of IAS were implanted and tested in four
      calves. The in vivo left-right pressure difference ranged from 3 to 8 mmHg, with
      0.57-1.38 L/min of theoretically calculated flow through the IAS. At autopsy,
      none of the IAS showed macroscopic thrombus formation.

PMID- 1751141
TI  - In vitro testing of venous valves.
AB  - The need to test prosthetic venous valves led to the design of a hydraulic mock
      circuit that reliably mimics natural venous flow. Components of this system
      simulate calf muscle pump and thoracoabdominal suction pump action. Flow and
      pressures are serially measured along the circuit. Valve function can be observed
      and videotaped. Evaluation of biologic venous valves provides visual and
      quantitative assessment of venous valve function with respect to tissue
      processing, valve design, and implantation technique. Further improvement in this
      system in terms of more compliance and less rigidity of components is being
      pursued.

PMID- 1751142
TI  - Laser welding and irradiation in alcohol preserved homografts.
AB  - This experiment examined the effect of laser welding and irradiation on the
      patency rate of microvascular anastomoses done with alcohol preserved homografts.
      The carotid arteries from Sprague-Dawley rats were freshly harvested and
      preserved in 70% ethyl alcohol for at least 3 weeks. The homografts were
      interposed into the carotid arteries with one of the following techniques: Group
      I, grafts were anastomosed with three stay sutures and laser welding (carbon
      dioxide laser, 90 mW); Group II, anastomoses were completed with eight to nine
      interrupted sutures (10-0 nylon); or Group III, the same technique used in Group
      II, but followed by laser irradiation (90 mW for 1 min) of the grafts. These
      results showed that patency at 2 weeks was 73% in Group I, 71% in Group II, and
      82% in Group III, respectively. The patency at 12 weeks was 67% in Group I and
      unchanged in Groups II and III. In conclusion, laser irradiation and laser
      welding did not increase the patency rate of microvascular anastomoses done with
      alcohol preserved homografts. Thrombotic occlusion in microvascular homografts
      usually occurs before the second week postoperatively.

PMID- 1751143
TI  - Determinants of measured dialysis venous pressure and its relationship to true
      intra-access venous pressure.
AB  - Venous pressure measured at the venous bubble trap (VPdm) is a complex function
      of true intra-access pressure (VP0), hematocrit, needle gauge, and blood flow. In
      a patient free circuit, needle gauge, hematocrit, and blood flow influenced the
      pressure drop through the venous return needle. Measured intra-access pressure
      (VPm) and VPdm also were determined 149 times in 83 subjects. The increase in
      VPdm above VP0 under conditions of flow through 16 gauge needles was affected by
      blood flow rate, hematocrit, and VP0 with coefficients similar to those found in
      vitro. Calculation of VP0 from VPdm produced an absolute difference greater than
      20 mmHg in 35-40% of cases. Mean VP0 was significantly lower in subjects with
      native compared with expanded polytetrafluorethylene accesses. It was concluded
      that VP0 is influenced by access type and can be estimated but that direct
      measurement is preferred. Direct measurement of VP0 may be a sensitive test to
      screen for venous outlet stenosis because it should vary with access flow and
      outlet geometry.

PMID- 1751144
TI  - Transcatheter placement of an intraluminal prosthesis for the thoracic aorta. A
      new approach to aortic dissections.
AB  - A new aortic prosthesis (SAP, shape memory aortic prosthesis) was developed with
      its transfemoral placement system to treat aortic dissection with minimal
      invasion. The SAP consists of a Nitinol stent and polyurethane tube, and it is
      designed in such a configuration that it can be compressed inside a 14 Fr
      catheter when cold. It regains its original shape when warmed to 30 degrees C.
      From the results of intra-aortic sutureless placement of SAP in 10 mongrel dogs,
      we concluded that a SAP of proper diameter could be implanted safely for more
      than 3 months. The transfemoral placement system is composed of a delivery
      catheter, pushing rod, catching catheter, and pulling wire. Using these devices,
      transfemoral placement of SAP was demonstrated successfully in three dogs and one
      sheep. The original SAP and delivery system can be used as an emergency procedure
      for aortic dissections, such as Stanford type B. The advantages of the procedure
      are minimal invasion of acutely ill patients and prompt application in the
      catheter laboratory.

PMID- 1751145
TI  - Experimental studies on improved polyester-polyurethane vascular grafts for
      hemodialysis.
AB  - A new poly(ether-urethane) graft (PEUG) was developed. Although this graft had
      several advantages, it became clear that it also had disadvantages, such as the
      formation of pseudoaneurysms by repeated puncture. To overcome these problems,
      the PEUG was modified to add mechanical strength by incorporating knitted
      polyester fibers. Physical strength tests were done, and it was concluded that
      the graft was more durable than either PEUG or expanded polytetrafluorethylene.
      Additional experiments showed that gelatin coated PEUG implanted in dogs
      facilitated endothelialization of the internal surface and improved its patency,
      although these observations were too short to draw any definitive conclusions.

PMID- 1751146
TI  - Effect of recombinant human erythropoietin on vascular access.
AB  - The use of recombinant human erythropoietin (r-HuEPO) corrects the anemia of
      chronic hemodialysis (HD) patients and improves their quality of life. The role
      of r-HuEPO in the genesis of graft thrombosis is controversial. A retrospective
      study was conducted of 46 stable chronic HD patients receiving r-HuEPO. It showed
      an increase in graft thrombosis in those who received the drug.

PMID- 1751147
TI  - A survey of permanent double lumen catheters in hemodialysis patients.
AB  - The use of permanent double lumen hemodialysis catheters (PermCath, Quinton,
      Seattle, WA) was surveyed in 17 dialysis units with a total of 1,372 patients.
      During the period of study, 210 patients received or already had such catheters.
      Their use varied widely, being highest in units dialyzing many older patients
      with associated diseases and difficulties with vascular access. Flow problems
      occurred in 46% and clotting in 24%; 27% required urokinase (at least once), and
      10% received some form of anticoagulation. Local infections occurred in 15% and
      septicemia (at least once) in 15%. Some older patients elected to continue with
      this form of "painless" dialysis.

PMID- 1751148
TI  - Ventricular assist with heparin surface coated devices.
AB  - Heparin surface coated ventricular assist devices (VADs) were evaluated without
      systemic heparinization and compared with uncoated control VADs with systemic
      heparinization (bovine experiments, n = 8; bodyweight, 75 +/- 6 kg). No heparin
      was given in the study group, whereas heparin (300 IU/kg) was given before
      cannulation in the control group. Mean activated clotting time (ACT) was 127 +/-
      12 sec before and 122 +/- 17 sec after 6 hours of left ventricular assist for
      coated (NS) versus 184 +/- 114 sec before and 650 +/- 240 sec after for uncoated
      (p less than 0.05) VADs. No difference was observed in platelet depletion, plasma
      hemoglobin, lactic dehydrogenase (LDH) production, mixed venous oxygen
      saturation, and VAD clot score. No VAD occlusions occurred. Ventricular assist
      can be achieved without systemic heparinization if VADs are improved.

PMID- 1751149
TI  - Easy access for a left ventricular assist system without thoracotomy.
AB  - In a previous article, a left ventricular assist system (LVAS) with a
      percutaneous transseptal cannulation technique for easy application was
      described. This system was safe and efficient (maximum output greater than 3
      L/min) and fitted between the intraaortic balloon pumping and LVAS with
      thoracotomy. But technical skill for placement was slightly complicated. The
      cannulation system has been improved. In the new system, the inlet cannula is
      initially used as a sheath introducer and is quickly inserted into the left
      atrium after transseptal puncture. The new inlet cannula is made of polyvinyl
      chloride (TM100, Toyobo, Co., Ltd., Osaka, Japan), which has excellent
      antithrombogenicity and low friction using a polyester plasticizer. The distal
      part is designed to be flexible with a spiral wire for easy manipulation. A
      sealing hub was installed to prevent bleeding at the proximal The simplicity and
      safety of the new system were examined in chronic animal experiments. The inlet
      cannula was placed into the left atrium within a few seconds after transseptal
      puncture. During 20 days of activation, there were no episodes of systemic or
      pulmonary embolism, although no anticoagulant was used. Under fluoroscopy, there
      was no thrombus formation around the cannula at removal. On the 14th day after
      removal, the puncture site of the septum had healed. This system is ready for
      clinical use and shows promise of satisfactory safety and manageability.

PMID- 1751150
TI  - Percutaneous cardiopulmonary support in cardiac arrest.
AB  - Of 11 patients who underwent emergency resuscitation from cardiac arrest using a
      system of percutaneous cardiopulmonary support (CPS), two (18%) were long-term
      survivors. Percutaneous cardiopulmonary support was instituted without
      complication in all patients, with flows ranging from 1.8 to 5.5 L/min; the
      average duration of support was 304.3 min. All four patients who underwent
      emergency surgery (two coronary revascularization, one mitral valve
      revascularization, one mitral valve replacement with coronary revascularization,
      and one primary left ventricular assist device insertion) died. One patient died
      while on CPS secondary to irreversible ventricular arrhythmias after a successful
      percutaneous transluminal coronary angioplasty (PTCA). Six patients were weaned
      from the support system, three of whom had undergone PTCA while on CPS. The two
      survivors were the youngest patients (33 and 24 years). One of them had severe
      hypothyroidism as the cause of cardiac arrest, and the second was a hypothermia
      patient who was in ventricular fibrillation for 2 hr before establishing CPS. In
      comparing survivors (two) to nonsurvivors (nine), a significant difference (p =
      0.034) in age was found, with survivors being younger. There was also a
      difference in incidence of atherosclerotic cardiovascular disease (p = 0.018),
      with survivors having none. There was no difference in the time to CPS (p =
      0.905) or time on CPS (p = 0.156). Cardiopulmonary support can be instituted,
      resulting in excellent stabilization in patients with cardiac arrest. Survivors
      tended to be young and not have atherosclerotic cardiovascular disease (ASCVD) as
      their primary diagnosis. Neither length of cardiac arrest before CPS nor time on
      support correlated with a poor outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751151
TI  - Frequency and significance of infections in patients receiving prolonged LVAD
      support.
AB  - Infections in patients undergoing mechanical circulatory support as a bridge to
      transplant are associated with significant mortality and morbidity. To determine
      the frequency and effects of infection during such procedures, a retrospective
      analysis was done of 14 patients who received prolonged (greater than 14 days)
      support with the Heartmate left ventricular assist device (LVAD) (Thermo
      Cardiosystems, Inc., Woburn, MA). All patients were men (mean age, 44.3 years),
      and duration of LVAD support ranged from 19 to 233 days (mean, 98.1 days). During
      LVAD support, five patients had no infections, and, in the remaining nine
      patients, infections were most common in the respiratory tract, catheter tips,
      and urine. Four device related infections occurred in three patients, all of
      which were resolved with antibiotic therapy. All 14 patients underwent
      transplantations, and none of the operations was delayed because of infection.
      Eleven of the patients are long-term survivors (range of time after transplant,
      7.5-37 months). Infections were not associated with mortality or significant
      morbidity in this group of patients.

PMID- 1751152
TI  - The consequence of ventricular assist on acute profound biventricular failure
      with induced severe myocardial injury.
AB  - The effect of ventricular assist on acute profound biventricular failure (BVF)
      was examined in chronic animal experiments using 10 adult goats. Induction of BVF
      was achieved by normothermic anoxic arrest for 30-60 min during the use of a left
      ventricular assist system (LVAS, eight goats), or biventricular assist system
      (BVAS, two goats). The LVAS could maintain near normal circulation with volume
      loading in six goats, and three of eight goats were weaned from LVAS after 13-18
      days. In the early stages, left atrial pressure was significantly higher, and
      right atrial pressure was significantly lower, compared with measurements in
      nonweaned goats. During BVAS, circulation was well maintained without volume
      loading, but neither of the two goats could be weaned from VAS. Myocardial
      fibrosis in goats without myocardial recovery was significantly more severe. Left
      ventricular wall thickness was thinner in nonweaned goats and there was a
      significant inverse correlation between the thickness of the left ventricular
      free wall and the assist duration in nonweaned goats. Based on these data, it was
      concluded that myocardial damage was severe in nonweaned cases, and the potential
      for healing is affected by the severity of myocardial damage before VAS
      application. Prolonged unloading with VAS of these severely damaged hearts caused
      loss of left ventricular wall thickness.

PMID- 1751153
TI  - Univentricular support results in reduction of pulmonary resistance and improved
      right ventricular function.
AB  - A retrospective analysis was performed to assess the effects of univentricular
      support on the transpulmonary gradient (TPG), pulmonary vascular resistance
      (PVR), total pulmonary resistance (TPR), and right ventricular ejection fraction
      (RVEF) in 16 patients who spent from 2 to 144 days (mean, 61) on the Novacor left
      ventricular assist system ([LVAS] Novacor Corp., Baxter Healthcare, Oakland, CA)
      as a bridge to cardiac transplantation. Results revealed a significant reduction
      in the TPR, and improvement in RVEF while patients were on the LVAS. After
      orthotopic heart transplantation (OHTx), TPG and PVR were significantly lower
      than when calculated before support. It was concluded, therefore, that the
      reduction in the TPR and the improvement in the RVEF, seen in patients who were
      provided univentricular support with the Novacor LVAS, are associated with a
      significant reduction in the TPG and the PVR, which are persistent after OHTx.
      Four patients who otherwise would have been considered at higher risk for OHTx
      because of elevated pulmonary resistance before veniventricular support underwent
      successful OHTx after LVAS support.

PMID- 1751154
TI  - A theoretical study of new types of valve shunts for cerebrospinal fluid.
AB  - Two new solutions for cerebrospinal fluid (CSF) valve shunts are described. The
      first is based on the principle of multihole flow, and the second, which is less
      complex mechanically, is based on the action of elastic elements on a ball-cone
      valve.

PMID- 1751155
TI  - Catheter with an anchoring tip for chronic joint capsule perfusion.
AB  - An orthopedic catheter for long-term access to the synovial joint is anchored by
      a hollow threaded tap that penetrates the capsule through a hole drilled in the
      surrounding bone. The proximal end of the catheter is connected to either an
      implantable drug infusion pump or an implantable access port for continuous or
      intermittent perfusion or sampling. Four catheters were evaluated in dogs. Three
      were attached to ports, the fourth to a pump. Water (one trial, 22 weeks) and
      hyaluronic acid (HA) (5 mg/ml; two trials of 8 weeks each) were administered
      through ports twice weekly in 1.5 ml boluses; 5 mg/ml HA was delivered by pump (1
      trial of 33 weeks) at 0.31 ml/day.

PMID- 1751156
TI  - A protamine-mediated heparin sensing device.
AB  - A convenient, protamine mediated strip assay for heparin was developed. The assay
      is established on the specific interaction between heparin and protamine, and the
      metachromatic color change of methylene blue dye from blue to purple in the
      presence of heparin. The device consists of a fibrin cup fabricated with a
      cellulose paper strip containing immobilized protamine. To analyze plasma heparin
      levels, a fixed volume of the test sample is placed in the fibrin cup and allowed
      to migrate through the strip in a descending manner until exhaustion. The region
      to which heparin binds is then visualized as purple in color by spraying
      methylene blue dye onto the strip. The heparin level in the sample is estimated
      from the length of the purple region using a preconstructed standard curve. This
      device proved to be capable of detecting and differentiating heparin in
      clinically relevant concentrations.

PMID- 1751157
TI  - Development of an implantable drug delivery catheter.
AB  - A microtextured, pillared drug delivery system has been designed and tested in
      rabbits. This model has allowed for the calculation of the mass transport rate
      indicating after a 4 week time period a pillar device's mass transport rate K1
      [min-1] is K1p 1.54 x 10(-2) in contrast to the smooth control which is K1C .043
      x 10(-2) and K1im IM which is 0.136 x 10(-2). As a result of these experiments,
      it is apparent a micropillared drug delivery system is an order magnitude faster
      than an intramuscular injection and is 30 times faster than the smooth control
      device. The etiology for this difference is related to close blood vessel
      proximity and minimal to no fibrous capsule formation with the micropillared
      implant. Finally, even after a 6-month implantation time, the pillared device has
      greater reproducibility regarding curve profile and there is no loss in magnitude
      or rate of mass transport, in contrast the smooth control devices in many
      instances resulted in complete occlusion with total loss of mass transport
      capabilities.

PMID- 1751158
TI  - Prostatic titanium urethral stents. A new treatment option for obstructive
      uropathy: early clinical results and indications.
AB  - An expandable titanium stent was used as an alternative to standard treatment for
      urinary obstruction in 20 men. Six patients had recurrent urethral strictures.
      Fourteen patients had obstruction secondary to benign prostatic hyperplasia (BPH)
      and were considered high risk surgical candidates. Complete results with a mean
      follow-up of 12 months are available for 11 patients. Four of the six stricture
      patients are currently unobstructed. All seven of the available men with BPH are
      voiding well. No side effects have been related to the stents, and no
      encrustations or calculi have formed.

PMID- 1751159
TI  - In vitro and in vivo evaluation in dogs of a miniaturized glucose sensor.
AB  - A miniaturized glucose sensor was developed, consisting of a platinum wire
      entirely coated with teflon, except for a 1 mm section near its extremity where
      glucose oxidase is immobilized. The in vitro sensitivity to glucose of the
      sensors was 2.3 +/- 0.4 nA/mM, mean +/- SEM (n = 23). These sensors were
      implanted in the subcutaneous tissue of normal beagles. Two consecutive glucose
      infusions (15-30 mg/kg/min) were performed. The current generated by the sensor
      was used for calculation of the sensitivity coefficient (SC) (nA/mM), and the
      background current in the absence of glucose (lo) (nA). These parameters were
      used for determination of the apparent subcutaneous glucose concentration. The in
      vivo sensitivity was less than the in vitro sensitivity (0.5 +/- 0.1 vs. 2.2 +/-
      0.2; n = 12 comparisons; p less than 0.01). Stability of sensor function was
      demonstrated by the absence in variation of SC and lo, calculated from the
      different plateaus obtained during the glucose infusions. This study provides a
      simple method for evaluating in vivo the function of a miniaturized sensor
      implanted in subcutaneous tissue.

PMID- 1751160
TI  - An integrated artificial heart-lung device.
AB  - An integrated artificial heart-lung device (IAHLD) is being developed as a novel
      system for simultaneous long-term support of heart and lung. The IAHLD consists
      of an artificial lung component (LC) and two blood pumps. The LC is made with a
      special composite hollow fiber membrane that prevents serum leakage. The fibers
      are arranged as piled-up lattices and potted in a cylindrical housing made of
      polyurethane. The blood pump with a single port is of a pneumatic pusher-plate
      type, and a Bjork-Shiley valve is mounted in the port. The LC is sandwiched
      between the inlet and outlet pumps, and all components are integrated. This
      special structure provides high gas exchange efficiency, prevention of flow
      channeling and stagnation, and reduction of blood contacting surfaces. The
      prototype IAHLD had exchange rates of up to 170 ml/min of O2 and CO2 and up to
      5.5 L/min of pump output. A flow visualization analysis with cineroentgenography
      revealed that the flow distribution within the IAHLD was uniform, without any
      stasis. It was concluded that the IAHLD is a promising system for long-term heart
      and lung support, and can be used without systemic heparinization given
      thromboresistant surface treatment as the next step of development.

PMID- 1751161
TI  - Racial differences in renal transplant outcome of insulin-dependent diabetic
      recipients in the cyclosporine era.
AB  - In an attempt to analyze the influence of race on renal allograft outcome among
      insulin-dependent diabetic uremics, all 109 cyclosporine treated transplants were
      studied. Black recipients were noted to have inferior 1 year survival for both
      living related and cadaver donor grafts when compared with both whites and
      Hispanics (67% and 43% vs. 92% and 84%, 100% and 80%, respectively, p less than
      0.01). Nonimmunologic causes accounted for 69% of graft losses among blacks,
      compared with 39% and 33% in whites and Hispanics, respectively. Among long-term
      survivors, however, renal function remained relatively stable among all racial
      groups. This differing trend among black diabetic recipients suggests the need
      for aggressive cardiac workups before transplantation, and judicious
      immunosuppression in the posttransplant period.

PMID- 1751162
TI  - Neoendothelial healing of modified EPTFE grafts.
AB  - Expanded polytetrafluoroethylene (EPTFE) grafts have poor neoendothelial healing
      characteristics and low patency rates after long-term implantation. The authors
      have shown that this is due to the low porosity of currently used EPTFE grafts
      (20-30 microns fibril length). The inner surface coated grafts made of long
      antithrombogenic material fibrils (40-60 microns) are desirable, especially for
      small diameter grafts. The authors have implanted these surface modified grafts
      (coated grafts) and noncoated grafts into abdominal arteries of rats and observed
      good patency rates, and the effects of surface modification of the grafts on
      stable endothelial tissue growth. The authors used four different kinds of grafts
      (fibril length, 20, 40, 60, and 90 microns, respectively) to investigate the
      effect of porosity. High porosity (long fibril length) grafts induce good
      neoendothelial healing and collagen production.

PMID- 1751164
TI  - Serum silicon levels in recipients of an electrohydraulic ventricular assist
      system.
AB  - This study was designed to determine the permeation rate of silicon oil from the
      authors' electrohydraulic ventricular assist system (EHVAS), and to evaluate
      influences on organ function. The permeation rate through the diaphragm of the
      EHVAS was determined by in vitro experiments. Influences on organ function were
      evaluated in three goats with EHVAS by monitoring blood chemical parameters and
      serum silicon levels (S-Si). The permeation rate from the EHVAS was about 0.2
      ml/month, calculated from the data obtained in the in vitro experiments. S-Si
      levels did not increase during chronic animal implantation, and renal and hepatic
      function were not affected. The permeation rate through the diaphragm must,
      however, be taken into consideration.

PMID- 1751163
TI  - Hemostatic evaluation of Sarns/3M-VAD implantation in calves.
AB  - The authors evaluated the potential for thrombotic complications arising from
      implantation of a ventricular assist device (Sarns/3M-VAD) in four calves.
      Coagulation screening tests (prothrombin time [PT], partial thromboplastin time
      [PTT], thrombin time [TT]), fibrinogen levels, and antithrombin III functional
      activity were found to be of little value as predictors of the degree of
      activation of the hemostatic system. However, platelet counts, adenosine
      diphosphate (ADP)- and collagen-induced platelet aggregation, and thromboxane
      (TXB2) levels were good indicators of changes in platelet reactivity. Platelet
      counts (initial value 6 x 10(5) rose, and were associated with increased rate and
      extent of ADP- and collagen-induced platelet aggregation, which remained elevated
      during the entire 25 day postimplantation period. The first 5 days
      postimplantation revealed a typical acute inflammatory response, with increased
      platelet levels, but with TXB2 levels significantly decreased during this period.
      A monoclonal antibody based bovine D-dimer assay and Western blot studies
      indicated a small but significant increase in circulating bovine D-dimer,
      indicating localized fibrin formation and its dissolution.

PMID- 1751165
TI  - Effects of long-term Novacor artificial heart support on blood rheology.
AB  - This study presents characteristics of hemorheology for six patients during long
      term support (85-144 days) on a Novacor left ventricular assist device (LVAD) as
      a bridge-to-cardiac transplantation. Results indicate that a certain "baseline"
      rheology can be identified in patients whose support was uneventful. However, in
      the patients who had one or more neurologic episodes during support, these events
      were associated with altered hemorheology, including increases in plasma and
      relative blood viscosity, and red cell rigidity.

PMID- 1751166
TI  - Bovine pericardial valves. Nine-year clinical experience with the Novacor left
      ventricular assist system.
AB  - The Novacor electrically powered left ventricular assist system (LVAS), currently
      used in a bridge-to-transplant (BTT) clinical trial, incorporates bovine
      pericardial (BP) valves (Edwards CVS Division, Baxter Healthcare Corporation). In
      preclinical evaluation in the adult sheep, BP valves exhibited severe calcific
      stenosis as early as 8 weeks postimplant (longest implant 158 days, elective
      termination for calcific deposit). The clinical experience, however, has been in
      sharp contrast. Eighty-one patients have been supported for a cumulative duration
      of 9.1 years (two currently on LVAS). Thirty-five (43%) patients were supported
      for longer than 30 days, and of these, 29 (85%) were transplanted. The longest
      implant duration was 370 days (alive, 8 months posttransplant). There was no
      evidence of calcific degeneration of these valves for durations to 370 days.
      These results are encouraging for ultimate chronic clinical application.

PMID- 1751167
TI  - Pulsatile flow and EC morphology in a VAD-like chamber.

PMID- 1751168
TI  - Novel airway stent using a thermal shape-memory Ti-Ni alloy.
AB  - An attempt was made to develop a tracheal or bronchial stent for nonsurgical
      implantation using a bronchoscope. Titanium-nickel alloy composed of 50% by
      weight of each metal has unique thermal shape-memory properties, with a
      transition temperature of 20 degrees C. Each stent consists of one wire with a
      diameter of 0.9 mm. It is 30 mm long with a cross-sectional profile resembling a
      horseshoe. The stent is designed to sustain the airway only at the cartilage
      rings. Tracheal cartilages of dogs were broken to make a tracheomalasia model,
      and 10 stents were implanted in 10 animals. The stents were made straight by
      cooling in liquid nitrogen and then inserted into the region of tracheomalasia.
      Once in place, they were warmed and recovered their initial shape. The animals
      were killed between 1 week and 6 months after implantation, and then examined.
      Nine of the ten stents were located in the implanted area. In one dog, the stent
      had been displaced into the bifurcation. Microscopic observation showed that the
      wires were gradually covered with epithelium. At 6 months, 58% were covered with
      epithelium.

PMID- 1751169
TI  - Tumor necrosis factor clearances during veno-venous hemodiafiltration in the
      critically ill.
AB  - Tumor necrosis factor alpha (TNF) is a mediator of injury in the critically ill.
      Its small molecular size (17 kd) should allow its clearance during continuous
      hemodiafiltration (CHD). The authors studied TNF extraction in 12 critically ill
      patients (APACHE II score 26.3 mean; range, 19-34) receiving CHD. Tumor necrosis
      factor levels were measured in prefiltered and filtered blood and
      ultradiafiltrate at 0.4 and 24 hours of therapy. Before CHD, mean plasma TNF
      levels were 261 pg/ml (95% confidence interval [CI]: 184-578) and 291 pg/ml (95%
      CI: 0-589) after 24 hours. There were no statistically significant differences
      between prefilter and postfilter TNF levels. Most ultradiafiltrate samples (74%)
      contained demonstrable TNF (mean, 314 pg/ml; 95% CI: 67-561). Daily TNF excretion
      was a mean of 15.9 micrograms (+5.6 standard error [SE]), with a mean daily
      clearance of 27.5 L (95% CI: 2.5-52.5). The authors conclude that significant
      amounts of TNF are excreted in the ultradiafiltrate during CHD. This observation
      may provide a rationale for use of similar therapies in critically ill patients
      in the absence of conventional indications for dialytic support.

PMID- 1751170
TI  - In vivo catecholamine extraction during continuous hemodiafiltration in inotrope
      dependent patients.
AB  - Many critically ill patients require inotropic or vasopressor support to maintain
      adequate oxygen delivery. Removal of catecholamines by continuous
      hemodiafiltration (CHD) could alter exogenous catecholamine requirements. The
      authors have studied hemodynamic state, catecholamine clearances, and
      catecholamine requirements in 12 critically ill patients (mean APACHE II score,
      24.5) receiving CHD. Hemodynamic parameters were assessed before CHD initiation,
      and at 4 and 24 hours of therapy. Simultaneous determinations of serum and
      ultradiafiltrate dopamine (D), norepinephrine (NE), and epinephrine (E)
      concentrations were obtained. There were no significant changes in any of many
      hemodynamic parameters measured during CHD. Mean catecholamine requirements were
      not altered by CHD. Plasma catecholamine levels were not significantly affected
      by CHD (mean values at 0, 4, and 24 hours: D: 10,801, 12,056, and 8,797 pg/ml;
      NE: 1124, 566, and 926 pg/ml; E: 1,420, 1,383, and 843 pg/ml). Catecholamine
      clearances from CHD (D:43.7 ml/min; NE: 43.5 ml/min; and E: 46.6 ml/min) resulted
      in daily excretion of only 379 micrograms D, 32.9 micrograms NE, and 37.2
      micrograms E. Clearances of catecholamines by CHD represented a daily loss of
      less than 0.1% of the administered load. In conclusion, although CHD can remove
      circulating catecholamines, cumulative daily catecholamine extraction is minimal
      in pharmacologic terms, and has no impact on hemodynamic status.

PMID- 1751171
TI  - A new treatment strategy using both intermittent short dialysis and continuous
      ambulatory hemofiltration.
AB  - The authors devised a new treatment strategy using continuous ambulatory
      hemofiltration (CAHF) in between short hemodialyses (short HD). For CAHF, a small
      wearable hemofilter (0.1 m2) was developed using a membrane permeable to low
      molecular weight proteins. During short HD, no body water was removed, but
      saline, equivalent to 3% body weight, was administered at a constant rate. During
      CAHF, 1 L of replacement fluid was administered intravenously after every meal to
      increase the replacement volume. Switch from the conventional to new strategy
      resulted in far more stable blood pressure during short HD, a decrease in time
      averaged body weight, and a decrease in a decrease in time averaged blood urea
      nitrogen and plasma beta 2-m levels.

PMID- 1751172
TI  - Microencapsulated hepatocytes. Prospects for extracorporeal liver support.
AB  - To assess the potential for encapsulated hepatocytes as a bioartificial liver
      support system, rabbit hepatocytes were encapsulated within multicomponent
      capsules using a complex coacervation technique, and cultured both on plates and
      in a perfusion reactor. The urea synthesis rate and antipyrine and diazepam
      degradation rates were evaluated in each system over a 10 day period, and
      compared with standard plate-cultured hepatocyte efficacy. Urea synthesis rates
      were significantly higher in the perfusion cultures than in either of the plate
      culture environments, whereas drug degradation rates were not significantly
      different in any of the systems.

PMID- 1751173
TI  - Blood purification for postoperative liver failure with special reference to
      chronic hepatic support for those awaiting liver transplantation.
AB  - Blood purification, mainly plasma exchange (PE), was carried out for 13 cases of
      acute, and two cases of chronic postoperative liver failure. Four of thirteen
      acute cases (31%) survived. Although only one of eight with chronic liver disease
      survived, three of five without chronic liver disease survived. In most of those
      who lived, other organ failure occurred less often; total bilirubin and blood
      ammonia were less than 15 mg/dl and 200 micrograms/dl, respectively, before PE:
      and total bilirubin, blood ammonia, and branched chain amino acid/aromatic amino
      acid (BCAA/AAA) ratios recovered after five or fewer sessions of PE. Two chronic
      cases, treated for 1 and 4 years, respectively, were good candidates for liver or
      multiple organ transplantation. Although both died, PE was effective in reducing
      jaundice and in improving consciousness and general condition. Plasma exchange
      should be introduced early after assessing the changes in total bilirubin, blood
      ammonia, and coma grade in patients with acute postoperative liver failure.
      Plasma exchange could be useful as a chronic hepatic support system for those
      awaiting liver transplantation.

PMID- 1751174
TI  - Neurologic improvement of patients with hepatic failure and coma during sorbent
      suspension dialysis.
AB  - Fifteen patients with acute deterioration of liver function, high serum ammonia,
      and an average coma level of 3.9 (of 4) were treated for 8-12 hrs daily with a
      system that uses the membranes of a cellulosic plate dialyzer to pump blood
      through a single access at 200-225 ml/min, and includes a sorbent suspension as
      dialysate. Neurologic status of the patients was declining before treatment, but
      significantly improved during each treatment and over the course of 1-12
      (average, 4) treatments. Diastolic blood pressure and pulse rate normalized. For
      half the patients, treatment with the BioLogic-DT system served as a bridge to
      liver transplant or liver recovery.

PMID- 1751175
TI  - A hybrid artificial liver system. Function of cultured monolayer pig hepatocytes
      in plasma from hepatic failure patients.
AB  - To produce a new hybrid artificial liver system, cultured pig hepatocytes were
      used in this study. Hepatocytes from normal healthy pigs were cultured in
      multiwell dishes. From the third day of cultivation, hepatocytes were divided
      into three groups according to the media used (Group 1, L-15; Group 2, normal
      human plasma; Group 3, plasma from hepatic failure [HF] patients). Measurements
      of cellular function of the cultured pig hepatocytes included metabolic activity
      (gluconeogenesis and ureogenesis), DNA content, and amino acid changes in the
      plasma. The ability to provide gluconeogenesis and ureogenesis by the cultured
      hepatocytes in HF plasma was maintained for 3 days, equal to that observed in
      Groups 1 and 2. DNA content was no different in the three groups. Elevated amino
      acid levels in the HF plasma, Phe, Met, Lys, and Gly, were significantly reduced
      by the cultured hepatocytes. The results indicate that the use of primary
      cultured pig hepatocytes is a step toward a hybrid artificial liver system, and a
      promising candidate as a bioreactor.

PMID- 1751176
TI  - Management of postoperative biventricular failure by means of a right ventricular
      assist device and an intraaortic balloon pump.
AB  - Right dominant biventricular failure often accompanies the end-stage of combined
      rheumatic valvular disease and some kinds of congenital heart disease. The
      management of right ventricular failure with conventional medical treatment,
      however, has encountered many difficulties. Mechanical support of the right
      ventricle with an RVAD (right ventricular assist device) has proved useful and
      effective. Seven patients who could not be weaned from cardiopulmonary bypass
      were subsequently transferred to an intraaortic balloon pump (IABP) and RVAD.
      Among these, five had severe combined rheumatic valvular disease, one had
      congenital heart disease and was advanced in age, and the other had a left atrial
      myxoma with tricuspid regurgitation. Preoperatively, all of these patients had
      had biventricular failure. All seven cases were successfully weaned from RVAD,
      and later from IABP. Five patients were discharged from the hospital and returned
      to normal daily life. Two patients died during their postoperative course. Long
      term survival rate was 71%. Mechanical assist with RVAD and IABP seemed to be
      effective in the management of right dominant biventricular failure, such as that
      seen in combined valvular disease and some kinds of congenital heart disease.

PMID- 1751177
TI  - Experience and directions using cardiopulmonary support in fifty-three
      consecutive cases.
AB  - Emergency cardiopulmonary support (CPS) was instituted in 53 consecutive patients
      for acute life threatening pathologies. Indications for CPS deployment were:
      cardiac arrest, 60% (n = 32); cardiogenic shock, 20.4% (n = 11), supported
      angioplasty, 13% (n = 7); and adult respiratory distress syndrome, 5.6% (n = 3).
      Cardiopulmonary support was successfully deployed in 51 of the 53 patients (96%),
      resulting in a mean blood pressure greater than or equal to 60 mmHg, CO greater
      than or equal to 3-5 L/min, and partial pressure of oxygen greater than or equal
      to 100 mmHg, with venous oxygen saturation greater than or equal to 60%. The
      average time from arrest to CPS deployment was 40 minutes. Seventy-nine major
      cardiovascular procedures were done in these 51 patients (average, 1.5/patient).
      The duration of support ranged from 1 to 75 hrs (mean, 16.1 hrs). Twenty-seven
      patients (53%) were weaned, 13 successfully (32%), with 11 (85%) surviving
      greater than 24 hrs, and six (46%), greater than 30 days. The other 24 patients
      (47%) were transferred to other treatment modalities, including cardiac surgery
      and bridge-to-transplant ventricular assist devices. Four of these patients died
      (17%), whereas 20 (83%) survived. Of these survivors, 19 (95%) survived greater
      than 24 hrs, whereas 11 (55%) survived greater than 30 days. The overall survival
      using the CPS system is 59% short-term (greater than 24 hrs.), and 33% long-term
      (greater than 30 days). In conclusion, the CPS system is a potent and effective
      resuscitative tool. It requires transfer to other treatment modalities for
      survival in most cases.

PMID- 1751178
TI  - Comparison of an extraaortic counterpulsation device versus intraaortic balloon
      pumping in severe cardiac failure.
AB  - A valveless, single orifice polyurethane ventricle was implanted on the
      brachiocephalic artery in sheep (n = 14) to provide extraaortic counterpulsation.
      In parallel, an intraaortic balloon was placed in the descending thoracic aorta.
      Both devices were pneumatically driven by a standard intraaortic balloon pump
      (IABP) console at a preload of 40 cc. Severe cardiac failure was induced with
      high dosages of esmolol. Measured parameters were aortic pressure (PA) and flow
      (QA), coronary flow (QC), and left ventricular pressure (PLV). Tension time index
      (TTI), total QA and QC, and end-diastolic aortic pressure (EDP) were computed to
      compare the efficacy of counterpulsation between assisted and unassisted
      conditions. Three conditions of inflation/deflation timing were examined: Normal
      timing (NT), early inflation (EI), and late deflation (LD). Results indicated
      that extraaortic counterpulsation device actuation yielded statistically
      significant increases in QC, and significant decreases in EDP and TTI for all
      timing conditions examined, when compared with unassisted conditions. Flow was
      significantly increased only for EI and NT timing conditions. Counterpulsation
      delivered with IABP yielded statistically significant increases in EDP for LD
      timing, and significant decreases in TTI for NT only. These results indicate that
      EACD is much less dependent on inflation/deflation timing when compared with
      IABP. The extraaortic counterpulsation device consistently increases QC and
      decreases TTI, which enhances the oxygen supply/consumption ratio (S/C) of the
      left ventricle. The intraaortic balloon pump does not significantly increase S/C
      in severe cardiac failure, and will increase afterload if deflation timing is not
      properly set.

PMID- 1751179
TI  - Recovery of end-stage organ dysfunction by circulatory assist.
AB  - To clarify the effectiveness of left ventricular assist on recovery of critical
      organ dysfunction, 18 patients with ventricular septal rupture or free wall
      rupture after acute myocardial infarction were retrospectively studied. Fifteen
      patients were managed with an intraaortic balloon pump (IABP group), and three
      with a left ventricular assist device (LVAD group) after surgery. In the IABP
      group, nine patients survived and six died. There were no significant differences
      between survivors and nonsurvivors with respect to age, cardiopulmonary bypass
      time, or preoperative renal function. In addition, there were no significant
      differences in the early postoperative changes in cardiac index. Larger doses of
      catecholamines were required in nonsurvivors than in survivors, however; blood
      urea nitrogen and creatinine levels were significantly higher in nonsurvivors
      than in survivors, and the nonsurvivors' creatinine clearance values stayed under
      20 ml/min during the postoperative course, so that all nonsurvivors required
      renal assist. All in the LVAD group were weaned. Two patients were lost, however,
      because of cardiac arrythmia and massive gas embolism. Cardiac index in the LVAD
      was maintained at over 2.1 L/min/m2 with a minimum dose of catecholamines,
      regardless of poor left ventricular function, and creatinine clearance recovered
      to over 20 ml/min during circulatory assist. From these data, high doses of
      catecholamines depressed renal function after surgery. Therefore, it has been
      concluded that the major role of circulatory assist is to maintain more of the
      physiologic circulation with minimum doses of drugs.

PMID- 1751180
TI  - Mean velocities and Reynolds stresses within regurgitant jets produced by tilting
      disc valves.
AB  - Fluid velocities were measured with a two-component laser Doppler anemometry
      system in the regurgitant jet regions of Bjork-Shiley Delrin monostrut tilting
      disc valves mounted within a Plexiglas model of the 70 cm3 Penn State electric
      left ventricular assist device. At each measurement location, 250 instantaneous
      velocity realizations were collected at times when regurgitation through the
      valves occurred. The maximum Reynolds shear and normal stresses were calculated
      after filtering the data. Results show that Reynolds shear and normal stresses
      proximal to the mitral valve were elevated to magnitudes of 9,000 dynes/cm2 and
      20,000 dynes/cm2, respectively. The peak Reynolds stresses near the mitral valve
      occurred during early systole, when regurgitant jet velocities reached magnitudes
      as high as 440 cm/sec. The Reynolds shear and normal stresses proximal to the
      aortic valve reached magnitudes of 9,900 dynes/cm2 and 20,500 dynes/cm2,
      respectively. The peak Reynolds stresses near the aortic valve occurred during
      early diastole, when regurgitant jet velocities were as high as 280 cm/sec. These
      high Reynolds stresses created by turbulent regurgitant flow have the potential
      to cause significant blood damage.

PMID- 1751181
TI  - Two-dimensional mechanical and ultrastructural correlates of bovine pericardium
      for prosthetic valves.
AB  - Scanning electron microscopy of bovine pericardium (BP) shows anisotropic
      collagen fiber orientation (CFO). We studied the effect of CFO on the breaking
      strength of longitudinal (L) and transverse (T) strips cut from six pieces of
      fresh (Fr), glutaraldehyde (Glu)-, or formaldehyde (For)-fixed BP loaded at
      constant rate until rupture. Maximum tensile stress (Stmax) and strain (Snmax)
      were measured. The Stmax of L strips were larger than T ones in all groups, and
      Snmax was the same. Similar results were also observed in 10 pieces of Glu fixed
      normal canine mitral valves (MV). Maximum tensile stress is obtained when the
      load is parallel to CFO in both canine MV and BP.

PMID- 1751182
TI  - Real-time in vitro observation of cavitation in a prosthetic heart valve.
AB  - A technique for real-time in vitro observation of cavitation on a prosthetic
      heart valve operating in a ventricular assist device under normal physiologic
      conditions has been developed. Considering the documented observation of
      cavitation erosion in heart valve components from human explants, and the
      potential risk of blood damage that cavitation presents, the technique developed
      in this study may prove useful in the design of prosthetic heart valves and
      ventricular assist devices. Cavitation of a glycerol blood analog fluid has been
      documented for a Medtronic/Hall prosthetic heart valve operating in a Penn State
      Electric Ventricular Assist Device. The ventricular assist device was operated in
      a mock circulatory system under normal physiologic conditions. The valve was
      located in the mitral position, with the cavitation occurring on the inlet side
      after valve closure. Bubble cavitation was seen on the valve occluder face, and
      vortex cavitation was observed at two locations in the vicinity of the valve
      occluder and housing. The cavity growth and collapse cycle for these forms of
      vaporous cavitation was less than 1 msec. Stroboscopic photography and
      stroboscopic videography with frame grabbing were used to document the cavity
      life cycle. With beat rate held constant, the cavity duration time was found to
      decrease with increasing mean venous return pressure.

PMID- 1751183
TI  - Evaluation of a stented polyurethane mitral valve prosthesis.
AB  - In the search for the perfect valve prosthesis, polyurethane has been used for
      its excellent physical properties, but thrombosis and embolism have been real
      problems. The authors investigated the performance and durability of a 23 mm
      vacuum formed polyurethane Tricuspid Semilunar Valve, in the mitral position. The
      valve was implanted in eight sheep using standard cardiopulmonary bypass and
      intermittent aortic cross clamping. Two early failures were due to valve tears.
      After modification of the manufacturing process, six further valves were
      implanted in six sheep. All were anticoagulated with warfarin. The valves were
      calcified on echocardiography and had increasing transvalvular gradients
      beginning 3 months postoperatively. All six survived and were killed 1-2.5 years
      after implantation. Despite gross calcification of the leaflets, medium-term
      function was good. Careful serial sections of brain showed no evidence of
      thromboembolism. Both kidneys contained small calcium emboli, but no evidence of
      infarction. Despite calcification, with good medium-term function and no cerebral
      emboli, this valve may find application in temporary cardiac assist devices.

PMID- 1751184
TI  - The correlation between improved cellular viability and clinical performance in
      5,000 cryopreserved human heart valves.
AB  - This study analyzes the 5 year, clinical performance of 5,000 recorded implants
      of cryopreserved human heart valves. Successive changes in the processing methods
      have increased cell viability to 88% of control data. Data show that increased
      cell viability correlates with improved clinical performance. The 79 reported
      removals at 5 years gave an actuarial survival estimate for all reoperations and
      complications of 97%.

PMID- 1751185
TI  - Venturi pressure cannot cause cavitation in mechanical heart valve prostheses.
AB  - Surface pitting of certain mechanical heart valve (MHV) explants has prompted
      investigation into possible causes of cavitation during MHV operation. Leaflets
      of a 29 mm MHV were glued shut with B-datum (BD) gaps fixed at 0.0089, 0.0174,
      and 0.0219 cm. Each BD gap setting was tested in a steady flow chamber, with
      leakage flow established at transvalvular pressures (delta P) of 20 to 200 mmHg.
      Laser Doppler velocimeter (LDV) velocity measurements were recorded 220 microns
      distal to the BD, along with leakage flowrates. Maximum LDV velocities were
      compared with those calculated using the mass conservation equation. At identical
      P, the LDV flow velocities for the three BD settings were found to be
      approximately equal. This indicates a geometric independence of the leakage flow
      velocity. At atmospheric pressure, the local velocity necessary to cavitate blood
      as a liquid is approximately 13 m/sec. These results demonstrate that the leakage
      velocity is insufficient to cause cavitation. A simplified theoretical model is
      proposed to illustrate the necessary delta P to produce Venturi related
      cavitation.

PMID- 1751186
TI  - Real time sound spectral analysis for early detection of thrombosed Bjork-Shiley
      standard disc valves.
AB  - Clinical usefulness of sound spectral analysis (SSA) in early detection of
      thrombosed Bjork-Shiley standard tilting disc prostheses (B-SP) was evaluated.
      Among a total of 365 B-SP, nine valves developed thrombosis. These included seven
      MVR and two AVR, and replacement of the affected valves was performed in all
      cases. Thrombus formation was localized at the minor strut in two cases in which
      the SSA demonstrated preoperative abnormalities of only opening clicks. In four
      cases, thrombus formation was noted at both minor and major struts, and the SSA
      showed abnormalities both on opening and closing clicks. In two cases with pannus
      formation, no abnormalities were found by SSA. As the thrombi were seen on the
      minor strut during surgery in all cases with thrombosed valves, the minor strut
      is considered as the preferred, and probably initial area of thrombus formation,
      and the diagnosis therefore could be made by abnormal findings on opening clicks.
      In conclusion, the SSA was found to be a useful diagnostic tool for early
      detection of thrombosis of B-SP, because the opening clicks of the tilting disc
      valves were often too low in amplitude for abnormalities to be detected by
      auscultation.

PMID- 1751187
TI  - Effects of Hemopump support on left ventricular unloading and coronary blood
      flow.
AB  - The effects of the Hemopump (HP) on left ventricular (LV) and coronary
      hemodynamics, with and without myocardial ischemia, were studied in an acute,
      anesthetized, open-chest dog preparation (n = 6). Coronary blood flow velocity in
      the left circumflex was assessed with an intracoronary Doppler catheter.
      Measurements were made at two pump speeds (minimal = HP1 and maximal = HP7)
      before coronary ligation (control), after ligation of the LAD (ischemia), and
      after induction of cardiac failure by multiple ligations of the diagonal branches
      (failure). Changing from HP1 to HP7 resulted in 1) Increased total cardiac output
      in ischemia and failure; 2) Increased mean aortic pressure and systemic vascular
      resistance in control, ischemia, and failure; 3) Decreased LV external work (LV
      systolic pressure X stroke volume) in control, ischemia, and failure; 4)
      Decreased LV end diastolic pressure in ischemia; 5) Decreased LV systolic
      pressure and pressure-rate product in failure; and 6) Increased coronary blood
      flow/O2 demand ratio in failure. Hemopump support reduced O2 demand by LV
      decompression, and improved blood flow/O2 demand ratio in the nonoccluded
      coronaries of ischemic, failing hearts.

PMID- 1751188
TI  - Effect of synchronous and asynchronous pulsatile flow during left, right, and
      biventricular bypass.
AB  - Ventricular assist devices augment aortic or pulmonary flow while the patient's
      heart recovers from surgery or infarction. Most are used in the asynchronous full
      to-empty mode, but they also may be used in a synchronous counter-pulsation mode.
      This study examines which assist mode optimally reduces myocardial oxygen
      consumption (MVO2). Eighteen pigs were instrumented with pulmonary artery,
      carotid artery, and coronary sinus catheters for determination of MVO2. Pierce
      Donachy Ventricular Assist Devices (VAD) were used in left, right, or
      biventricular assist mode. Fifteen minute periods each of control, synchronous,
      and asynchronous bypass were randomly instituted. The mid-left anterior
      descending coronary artery was then ligated, and the sequence repeated. At the
      end of each period, MVO2 was determined. In comparison with controls, MVO2 was
      statistically significant in the BIVAD asynchronous mode only. Synchronized
      counterpulsation did not decrease MVO2. When ventricular assist devices are used
      to aid in cardiac recovery postoperatively or postmyocardial infarction,
      biventricular assist should be used.

PMID- 1751189
TI  - Peripheral circulation during nonpulsatile systemic perfusion in chronic awake
      animals.
AB  - Peripheral circulation (PC) during nonpulsatile (NP) perfusion is not
      satisfactorily understood, although it is known that animals can survive with
      chronic NP flow. In awake goats, PC was analyzed by hemodynamic and hormonal
      parameters, tissue blood flow of the ear measured by a noninvasive laser Doppler
      flowmeter, and distribution of the body surface temperature monitored by
      thermography. An NP systemic circulation was established in five 40-64 kg goats
      with a centrifugal pump (MD-10, Iwaki Pump, Japan) that replaced a pulsatile
      ventricular assist device 2 weeks postoperatively; this was done without
      anesthesia. Nonpulsatile total left heart bypass was obtained, with flow rates of
      78-165 ml/kg/min. Systemic vascular resistance and blood adrenalin and
      noradrenalin levels were not affected by the depulsation. Tissue blood flow
      during NP perfusion was well maintained and showed comparable values to those
      during pulsatile systemic circulation. Vasomotion of 10-20 cycles/min was obvious
      in the tissue blood flow pattern, indicating adequate PC at each sampling point.
      Thermography before and after depulsation indicated no change of temperature
      distribution, and displayed warm peripheral areas. In conclusion, PC of animals
      on chronic NP systemic perfusion is adequately maintained.

PMID- 1751190
TI  - Percutaneous transluminal coronary angioplasty with hemoperfusion.
AB  - Balloon inflation time during percutaneous transluminal coronary angioplasty
      (PTCA) is limited by the patient's tolerance to ischemia. A nonpulsatile,
      variable flow rate syringe pump that develops pressures up to 200 psi has been
      developed, along with PTCA catheters capable of delivering 0-70 cc/min of blood
      across a lesion at these pressures. Using this system, 110 patients have been
      treated with active hemoperfusion during routine PTCA. In eight cases, no
      preperfusion tolerated inflation time was obtained. In 96 of 102 cases, the
      tolerated inflation time was increased by at least 50%, for a success rate of
      94%. This study demonstrated that active hemoperfusion during PTCA prolongs
      tolerated inflation time. The catheters and pump are capable of performing
      routine PTCA, supported when necessary by active hemoperfusion.

PMID- 1751191
TI  - Outcome of cardiopulmonary resuscitation in patients on chronic dialysis.
AB  - The authors analyzed the outcome of 56 episodes of cardiopulmonary resuscitation
      (CPR) in dialysis patients. Eleven patients (20%) left the hospital alive.
      Univariate analysis showed that a functional cause of cardiac arrest, absence of
      rib fractures, and the occurrence of cardiac arrest in the dialysis or intensive
      care units were associated with a favorable outcome. Logistic regression showed
      that the outcome of CPR was related to the presence of rib fractures, cause of
      arrest, degree of preexisting heart disease, and patient age. Despite the high
      incidence of rib fractures (77%), the outcome of CPR in dialysis patients is
      similar to its outcome in the general population.

PMID- 1751192
TI  - Sensory perception in uremic patients.
AB  - Peripheral (PNS) and central (CNS) sensory nervous system function was
      quantitatively assessed using neuroselective transcutaneous electrical nerve
      stimulation (TENS) in a population of 19 chronic hemodialysis patients (ages 17
      77, median 47 years; duration 1-14, median 3 years). Cutaneous current perception
      threshold (CPT) provided an index of PNS integrity, and a new technique involving
      cranial TENS to characterize cephalic evoked noncutaneous sensations (CENS) was
      used to assess CNS sensory function. Patients showed both CPT (32%) and CENS
      (89%) abnormalities as compared with previously tested healthy subjects. No
      significant correlation was observed between age, duration of dialysis, PNS, and
      CNS abnormalities. The CPT examination provides a sensitive and easy to
      administer test of PNS sensory function for the purpose of assessing the adequacy
      of dialysis in chronic hemodialysis patients; the CENS examination also may prove
      useful in this regard.

PMID- 1751193
TI  - Optimal dialysate bicarbonate during hemodialysis.
AB  - Eleven stable hemodialysis patients were treated with acetate dialysate, then
      changed to bicarbonate dialysate at three different concentrations. Blood was
      drawn from the arterial limb of the arteriovenous fistula before and after
      dialysis for pH, partial pressure of carbon dioxide, bicarbonate radical, and
      partial pressure of oxygen. Both acetate (35 mEq/L) and the lowest bicarbonate
      concentration (25 mEq/L) resulted in inadequate control of acid-base balance.
      Using a bicarbonate concentration of 30 mEq/L, mild predialysis acidosis was
      still present; this could be abolished using 35 mEq/L, but only at the cost of
      postdialysis alkalosis and mild hypoxemia.

PMID- 1751194
TI  - Intradialytic parenteral nutrition in chronic hemodialysis patients.
AB  - The effects of intradialytic parenteral nutrition (IDPN) were studied in chronic
      hemodialysis (CHD) patients who had a normalized protein catabolic rate (PCRN) of
      less than or equal to 0.8 g/kg/day, and KT/V = 0.94 +/- 0.04. Intradialytic
      parenteral nutrition was administered during thrice weekly CHD for 3-6 months,
      and consisted of essential and nonessential amino acids (42.5 g), glucose (125
      g), and lipid emulsion (50 g). Blood urea nitrogen, creatinine, total protein,
      albumin, transferrin, pre-albumin, total lymphocyte count, anthropometrics,
      protein catabolic rate, 3 day historic dietary protein intake, and dietary energy
      intake (DEI) were measured at baseline, before IDPN, during IDPN, and at
      completion of IDPN. Six of nine enrolled patients completed the study. Reasons
      for withdrawal included nausea and hyperglycemia or hypoglycemia. DPI normalized
      for body weight (DPIN) increased significantly from 0.75 +/- 0.1 to 1.02 +/- 0.18
      (p = 0.02). Increases in PCRN (0.57 +/- 0.18 to 0.78 +/- 0.2) and DEI (1495 +/-
      266 to 1681 +/- 358) did not reach statistical significance. More aggressive IDPN
      or a longer study period may be necessary to assess this form of nutritional
      intervention.

PMID- 1751195
TI  - The effect of ultrafiltration on dialysance. Mathematical theory and experimental
      verification.
AB  - It is known that convective transport (ultrafiltration, QF) augments diffusive
      transport. This augmentation achieves great importance as solute molecular weight
      increases. Previous mathematical treatments of dialysance (D) have provided the
      relationship between D and blood flow rate (QB), dialysate flow rate (QD), and
      dialyzer membrane surface area permeability product (KoA), in the limit of QF =
      0. The authors derived the relationship between D (defined as D') and QB, QD, and
      KoA for the general case of QF greater than or equal to 0: D' = X-Y/In X/Y . [(1
      o) QF + KoA] for X = X(D', QF, QD) = 1 - [D'/QD + QF] Y = Y(D', QF, QB) = D'
      QB/QF-QB o = the Staverman reflection coefficient. This equation demonstrates an
      approximate linear increase in D' as QF increases. Experimental verification is
      provided by in vivo studies of dialysis patients in which the dialysance of
      vancomycin doubles as QF is increased from 0 to 50. Because D' varies linearly
      with QF, this allows for the determination of KoA and o. Using the Cobe 500HG
      Hemophan membrane, KoA for vancomycin was determined to be 6.54 and o = 0.88.

PMID- 1751196
TI  - Behavioral and biochemical indices of compliance in hemodialysis patients.
AB  - Noncompliance has been implicated in modifying morbidity and mortality in end
      stage renal disease patients; however, the data are conflicting, and measurement
      of compliance has been difficult. Traditional measurements of compliance include
      serum potassium (K) and phosphorus (P) concentrations, and interdialytic
      fluctuations in weight gain (IWG). This study correlated three indices: 1)
      Adequacy of dialysis (Kt/V); 2) protein ingestion (PCR); and 3) the percentage of
      time dialyzed compared with the total dialysis time prescribed (% Time) with the
      traditional measurements of compliance. Correlations were calculated among pre-
      and post-BUN (blood urea nitrogen), Kt/V, K and P, PCR, IWG, and % Time. As
      expected, BUN levels correlated with Kt/V, K, P, PCR, IWG, and % Time. Protein
      ingestion correlated with K and IWG, but not with % Time. Adequacy of dialysis
      correlated with P levels, but not with PCR, WG, or % Time. Phosphorus correlated
      with pre- and post-BUN, Kt/V, and % Time, but not with K. Potassium, P, and IWG
      did not correlate internally. The authors conclude that standard biochemical
      measures of compliance reflect different compliance behaviors (dietary selection
      and restriction, restriction of fluid and salt intake, and adherence to
      medication regimens). Percent time may be a powerful, independent measure of
      patient compliance with the dialysis regimen.

PMID- 1751197
TI  - Clinical effects of recombinant human erythropoietin in hemodialysis patients.
      Results of the "Abruzzo" Multicenter Trial.
AB  - Anemia in regular dialysis treatment (RDT) patients is primarily due to a
      deficiency in renal-derived recombinant human erythropoietin (EPO). The aim of
      this study was to evaluate the results of a multicenter trial in 81 end-stage
      renal disease (ESRD) patients on RDT. An "open" study was conducted over 2 years;
      starting dose of r-HuEPO was 50 IU/kg/three times weekly i.v. and eventually was
      increased in steps of 25 Ul/kg/dialysis until 300 Ul/kg/week. Mean weekly dose
      per patient was 15 Ul/kg, with mean Hb increase of 27.5%. Mean hematocrit (Hct)
      levels increased in these patients from 22.9 +/- 2.5 to 31.7 +/- 2.8 (p less than
      0.001) after 2 years of therapy. Both spontaneous and evoked potentials improved.
      The response to r-HuEPO is dose dependent; hypertension and hyperkalemia are the
      most common side effects, but they are easily controlled. Central nervous system
      function before and after treatment is improved, and seems consistent with an
      enhancement of patients' quality of life.

PMID- 1751198
TI  - Component selection to optimize blood flow for continuous arteriovenous
      hemofiltration and dialysis.
AB  - Blood flow with an arteriovenous access is limited by the resistance of the
      catheters and hemofilters or dialyzers in the extracorporeal system. Resistance
      data from manufacturers are varied as to the test conditions used, however,
      making it difficult to select optimum components. Furthermore, the same size
      catheters may have varying inner diameters, resulting in large differences in
      flow resistance. The pressure at various flow rates was determined using a water
      manometer. The pressure/flow relationship for catheters gave a curve, whereas the
      logarithmic function resulted in a straight line with a slope of 1.48. The
      pressure/flow relationship for hemofilters and dialyzers was a straight line with
      an intercept close to the origin. The data in the tables for flow resistance at
      50 and 100 ml/min can be used to compare the various components, and to estimate
      flow in a given extracorporeal system.

PMID- 1751199
TI  - Endothelin and platelet activating factor. Possible indices for biocompatibility
      of hemodialysis.
AB  - To clarify the roles of endothelin (ET: vasoconstrictor) and platelet activating
      factor (PAF: vasodilator) in hemodialysis (HD), intradialytic changes in those
      substances were compared by a crossover study between HD with regenerated
      cellulose (RC) and polymethylmethacrylate (PMMA) membranes using currently
      developed radioimmunoassay methods. Hemodialysis patients demonstrated higher
      plasma ET values than normal controls, and hypertensive HD cases showed the
      highest levels. Although ET decreased significantly during the initial stage of
      HD with both membranes, the decreasing rates were greater in the group with
      intradialytic hypotension than those in the normotensive group. Plasma PAF did
      not differ among normal controls, hypertensive HD, and normotensive HD patients.
      Platelet activating factor tended to increase during HD in both hypotensive and
      normotensive groups; however, the increasing rates were greater in HD with RC
      than those with PMMA. These results indicate that the decrease in ET may
      partially contribute to the initiation of HD induced hypotension. Because PAF is
      an intracellular mediator, and there is an intradialytic increase in PAF with RC
      membrane, PAF should be regarded as one of the indices of membrane
      biocompatibility.

PMID- 1751200
TI  - Evidence of mononuclear cell activation by hemodialysis.
AB  - The acute effects of hemodialysis (HD) on activation and function of mononuclear
      cells (MC) were studied in a model of in vitro HD. During the HD session, both
      cuprophan (CU) and polysulfone (PS) induced transcription of interleukin-2
      receptor (IL-2R) mRNA. Expression of IL-2R on the cytoplasmic membrane, and
      release of soluble IL-2R (sIL-2R), however, did not change during HD, nor did
      responsiveness to IL-2. Polysulfone caused a slight reduction of the
      proliferative response to phypohemagglutinin, and of the release of sIL-2R.
      Hemodialysis did not induce IL-2 production, but induced IL-1 synthesis.

PMID- 1751201
TI  - Zinc-mediated lymphocyte energy charge modification in dialysis patients.
AB  - The authors studied the effects of 6 months of zinc therapy on cell-mediated
      immunity in regular dialysis therapy patients. Serum zinc was significantly
      enhanced (p less than 0.01) at 2 months. While cells, OKT3, and OKT4 did not show
      significant variation, but after 6 months of therapy a significant (p less than
      0.02) decrease of OKT8 cells, with enhancement of the OKT4/OKT8 ratio, and a
      significant (p less than 0.01) increase in the Multitest Composite score were
      found. At the same time, a significant elevation (p less than 0.001) of adenosine
      triphosphate (ATP), and a reduction (p less than 0.01) of lymphocyte adenosine
      monophosphate was seen; consequently, energy charge levels increased. Zinc
      induced improvement of uremic lymphocyte function is likely mediated by an
      increase in intracellular ATP.

PMID- 1751202
TI  - Cytokine levels during hemodialysis.
AB  - The authors measured plasma IL-1 (interleukin-1), IL-2, IL-2 receptor (IL-2R), IL
      4, IL-6, tumor necrosis factor (TNF), and granulocyte macrophage colony
      stimulating factor (GMCSF) in 10 stable patients during hemodialysis (HD) using
      new or reused polyacrylonitrile (PAN) or cuprophan (CU) dialyzers. Five HD
      patients with wasting syndrome, and 16 normal controls, were included.
      Hemodialysis patients showed a marked elevation of IL-2R. No IL-4, IL-6, or GMCSF
      were detected in any group. Tumor necrosis factor and IL-2 in the HD group were
      comparable with control values. No difference was found in the TNF levels in HD
      patients with and without wasting syndrome. Cytokine levels were unaffected by
      either new or used PAN or CU dialyzers.

PMID- 1751203
TI  - Interleukin-1 kinetics in hemodialysis.
AB  - Interleukin-1 (IL-1) was measured in the plasma and in mononuclear cell (MC)
      lysates from patients on maintenance hemodialysis (HD) using either cuprophan
      (CU) or polysulfone (PS) membranes. Basal plasma levels of IL-1 in HD patients
      were significantly higher than those of uremic patients on conservative treatment
      or of healthy subjects. In 10 patients on conservative treatment, plasma levels
      of IL-1 increased significantly after 3 and 6 months of HD. During a single HD
      session, plasma IL-1 fell to 21% (CU) and 22% (PS) of pre-HD levels. Hemodialysis
      patients had a significantly higher intracellular IL-1 content than normal
      controls. During HD, a further increase was seen regardless of the membrane
      employed. A parallel in vitro study showed that IL-1 produced during HD requires
      at least 24 hours to be released, and that both CU and PS are able to bind and
      clear IL-1.

PMID- 1751204
TI  - A simple and practical method for assessing the adequacy of hemodialysis.
AB  - The authors plotted the values of the postdialysis/predialysis blood urea
      nitrogen ratio, R, of 104 functionally anephric maintenance hemodialysis patients
      against the Kt/V values that had been derived from a single-pool, variable
      volume, urea kinetic modeling method. When the R value was less than or equal to
      0.4, the Kt/V value was consistently greater than or equal to 1.0. Maintaining an
      R value below 0.4 would ensure that Kt/V would never be less than 1.0. When a
      Kt/V value of greater than 1 is desired, an R value of less than 0.4 should be
      the goal.

PMID- 1751205
TI  - Response of continuous peritoneal dialysis patients to subcutaneous recombinant
      human erythropoietin differs from that of hemodialysis patients.
AB  - The hematologic response of 65 continuous ambulatory peritoneal dialysis (CAPD)
      patients to subcutaneous recombinant human erythropoietin (rHuEPO) was compared
      with that of 369 hemodialysis patients (HD). Pretherapy transfusions were more
      common in HD than CAPD. The response was measured as the change in hematocrit
      after 70 or more days of therapy (or as the hematocrit change normalized by a
      weekly dose) in CAPD patients. The weekly rHuEPO dose did not differ, but the
      dosing frequency was less in CAPD than in HD patients. Hematologic response
      parameters were greater in CAPD. Multivariate analysis showed that the response
      in both groups varied inversely with the frequency of dosing and with pretherapy
      baseline hematocrit. In HD subjects, the response also varied inversely with
      previous transfusion history. The authors concluded that CAPD patients responded
      better to rHuEPO than HD patients. This may be a result, in part, of lower
      ongoing blood losses. Patients with more severe anemias responded less well,
      whereas more sensitive patients were dosed less frequently.

PMID- 1751206
TI  - Uremic myopathy and calcitriol therapy in CAPD patients.
AB  - During 7 months of calcitriol treatment in eight CAPD patients, significant
      increases in serum creatinine and daily excretion of this substance in dialysis
      fluid were observed, but there was a significant decrease in creatinine in the
      urinary daily output. When therapy was stopped, creatinine levels fell to
      baseline in serum and peritoneal fluid, and urine values continued to decrease as
      previously observed. Dynamometric performance showed a significant increase
      during treatment, which remained after drug withdrawal. These findings suggest
      that the transient increase of serum creatinine during calcitriol treatment may
      be a result of an increased production and release of this metabolite from
      muscle.

PMID- 1751207
TI  - Tidal peritoneal dialysis. Urea and total nitrogen losses.
AB  - Tidal dialysis urea [NU] and total nitrogen [NT] clearances were obtained from
      nine patients, weighing 15-79 kg. Clearances normalized to a 70 kg body weight
      [nClr in ml/min/70 kg] increased with dialysate flow normalized to body weight
      [nFlow in ml/hr/kg]. The nClr [NU] = 6.862 + 0.352 x nFlow (r = 0.641, p less
      than or equal to 0.01). The nClr [NT] = 15.815 + 0.431 x nFlow (r = 0.460, p less
      than or equal to 0.01). Dialysate non-urea nitrogen [NT - NU] losses were 44.63
      +/- 2.79 mg/kg daily, and these were altered minimally by the dialysate flow
      rate.

PMID- 1751208
TI  - Protein catabolic rate calculations in CAPD patients.
AB  - Four different approaches to calculating the protein catabolic rate (PCR, in
      g/kg/day) were investigated in 28 stable continuous ambulatory peritoneal
      dialysis (CAPD) patients and compared to the dietary protein intake (DPI) from a
      3 day diet history. The modified Borah technique is based on the hemodialysis
      correlation, with the addition of measured effluent protein losses. The Randerson
      technique is a correlation similar to the Borah hemodialysis correlation, but it
      was established in a CAPD population. The Teehan technique estimates total
      nitrogen loss by adding the measured urea nitrogen loss to average values from
      the literature for protein, amino acid, and non-urea nitrogen losses. The
      Kjeldahl technique measures total nitrogen loss. All four techniques yielded
      similar PCR values (0.85-0.92 g/kg/day), none of which was significantly
      different from the DPI (0.89 g/kg/day). Based on the simplicity of the
      measurements and calculations, the Randerson technique is recommended for routine
      monitoring of PCR in CAPD patients.

PMID- 1751209
TI  - Plasma water filtration and lymphatic uptake during peritoneal dialysis.
AB  - To clarify further the extent, pathways, and significance of convective transport
      during peritoneal dialysis, acute transport studies were conducted in which five
      continuous ambulatory peritoneal dialysis (CAPD) patients underwent 6 hr dialyses
      (2 L infusate with 2.25% dextrose) on 2 successive days, with multiple sampling
      of both blood and peritoneal dialysate. Concentrations of permeants (urea,
      creatinine, uric acid, beta 2 microglobulin, and apolipoprotein A) and a
      radiolabeled marker (125I-polyvinyl pyrollidone [PVP]) were determined at 20-30
      min intervals in dialysate and every 90 min in plasma. Intraperitoneal volumes
      and lymphatic flows were calculated from rates of dilution and disappearance of
      125I-PVP. Intratreatment lymphatic flow rate averaged 76 +/- 15 ml/hr. Although
      lower than observed in small animal models and reported by some clinical groups,
      this level of lymphatic drainage was still sufficient to decrease net patient
      weight loss by approximately 50% and to resorb approximately 15% of metabolites
      in the peritoneal cavity, independent of molecular weight. Transcapillary
      ultrafiltration ranged from 7.4 +/- 1.5 ml/min at 10 min into the exchange to 1.3
      +/- 1.5 ml/min at 345 min. Reverse ultrafiltration, from the peritoneal cavity
      back through capillary vasculature to the patient, was not observed in any
      patient in this study.

PMID- 1751210
TI  - Clinical application of low calcium peritoneal dialysate.
AB  - Low calcium dialysate (LCa) with calcium levels of 2.3 mEq/L was prepared for
      peritoneal dialysis, and its equilibration was compared with those of
      conventional dialysates with calcium contents of 3.5 mEq/L and 4.0 mEq/L. The
      variation in dialysate to plasma concentration ratios of total calcium of
      conventional dialysates was positive; that of LCa was negative. Mass transfer of
      calcium per day was positive and normal for calciums of 4.0 mEq/L (31 +/- 51
      mg/day) and 3.5 mEq/L (-37 +/- 40 mg/day), compared with a negative balance for
      LCa (-157 +/- 26 mg/day). The LCa was used in six patients over 6 months. The
      doses of calcium carbonate and vitamin D also were increased from 1.2 +/- 1.5 to
      5.4 +/- 3.3 g/day (p less than 0.05) and from 0.17 +/- 0.2 to 0.38 +/- 0.47
      micrograms/day, respectively. Aluminum gel was discontinued. Low calcium
      dialysate may become the standard dialysate for stable continuous ambulatory
      peritoneal dialysis patients.

PMID- 1751211
TI  - Miniature membrane oxygenator for use in neonatal ECMO.
AB  - A new miniature membrane oxygenator (Kuraray KMO, size, 0.3 m2, with a priming
      volume of 47 ml, compliance of less than 0.1 ml/100 mmHg, and pressure loss of 45
      mmHg) with improved gas transfer and mechanical durability was developed and
      tested. The membrane material is a hollow fiber double layer polyolefin. The
      testing procedures determined by the AAMI were followed, and the results showed
      improved O2 and CO2 transfer (70 ml/min and 55 ml/min, respectively). Hemolysis
      was within acceptable limits, and plasma leakage was undetectable after 7 days of
      perfusion. Clinical study demonstrated satisfactory performance.

PMID- 1751212
TI  - Hybrid respiratory support system with extracorporeal placental oxygenation.
AB  - The authors developed a novel hybrid system for long-term respiratory support
      with extracorporeal placental oxygenation. In this system, the patient's blood is
      oxygenated with O2 saturated artificial blood across the villous membrane during
      passage through the fetal circuit of the placenta, which is placed in a specially
      constructed artificial uterus. Human term placentas were obtained immediately
      after vaginal delivery and used for the experiments. The gas transfer performance
      of the current apparatus was 60 ml/min for O2 and 40 ml/min for CO2 at a blood
      flow rate of 1.0 L/min. From these results (and the assured blood compatibility
      of the placenta), the authors conclude that this system will become one of the
      most promising modalities for prolonged extracorporeal oxygenation.

PMID- 1751213
TI  - Use of an intravascular oxygenator/carbon dioxide removal device in an ovine
      smoke inhalation injury model.
AB  - The intravascular oxygenator/carbon dioxide removal device (IVOX) is a hollow
      fiber, implantable membrane oxygenator that lies in the vena cavae and is
      designed to augment gas exchange during acute respiratory failure. An ovine model
      of smoke inhalation injury (lethal dose for 50% of animals at 48 hr) was used in
      eight ewes to test the safety and efficacy of this device. The IVOX was placed in
      the vena cavae through a right internal jugular vein cut-down. A vacuum pump
      withdrew O2 through the hollow fiber membrane, and IVOX gas flow was measured
      with a flow meter. Outlet gas was analyzed for CO2 concentration. Changes in O2
      exchange were calculated as changes in mixed venous O2 content with the IVOX on
      compared with the IVOX off, multiplied by the cardiac output. The IVOX did not
      significantly change cardiac output, mean arterial pressure, pulmonary artery
      pressure, or hemoglobin concentration measured every 6 hr for 48 hr. The maximum
      CO2 exchange averaged 40.2 +/- 10.5 ml CO2/min. The average change in oxygen
      exchange was 98.4 +/- 76.0 ml O2/min. Iliac vein injury from attempted IVOX
      placement without fluoroscopic guidance resulted in one death. The authors
      concluded that the IVOX was safe when properly inserted and provided
      approximately 25-30% of the gas exchange requirements in this model.

PMID- 1751214
TI  - Quantitative gas transfer into and out of circulating venous blood by means of an
      intravenacaval oxygenator.
AB  - The volume of O2 and CO2 transferred into/out circulating venous blood by various
      sized IVOX devices has been assessed by ex vivo and in vivo animal experiments
      and by reviewing the gas transfer data collected from the first 20 human ARDS
      patients studied during Phase I of the IVOX clinical trials. Data from these
      assessments indicate that oxygen transfer through the size 5 IVOX ranges from
      15.4 to 18.0 cc/min; through the size 6 IVOX ranges from 22.8 to 35.5 cc/min;
      through the size 7 IVOX ranges from 28.5 to 66.7 cc/min; through the size 8 IVOX
      ranges from 34.9 to 66.3 cc/min; through the size 9 IVOX ranges from 45.9 to
      115.7 cc/min; through the size 10 IVOX ranges from 52.9 to 133 cc/min.
      Quantitative carbon dioxide transfer through the various size IVOX devices
      closely follows the quantitative oxygen transfer achieved by IVOX. These
      quantitative data provide valuable information to clinicians considering using
      IVOX to augment the inadequate gas transfer existing in patients with acute,
      potentially reversible respiratory failure. They indicate IVOX transfers
      clinically significant quantities of O2 into and CO2 out of circulating venous
      blood in an intact subject without involving the subjects natural lungs.

PMID- 1751215
TI  - Prophylactic administration of tranexamic acid preserves platelet numbers during
      extracorporeal circulation in rabbits.
AB  - Neonatal extracorporeal life support is associated with platelet consumption and
      hemostatic disorders. This study in rabbits was undertaken to evaluate the effect
      of heparin coating and of the plasminogen and plasmin inhibitor, tranexamic acid
      on platelet consumption during extracorporeal circulation. Fibrinogen consumption
      was prevented by heparin coating, but platelet consumption was only prevented
      after the prophylactic administration of tranexamic acid. The authors concluded
      that inhibition of the fibrinolytic system had a specific effect on preserving
      platelet numbers, rather than improving the thromboresistance of the artificial
      surface. The main advantage of a heparin coating is the anticoagulant activity of
      the surface. Thus systemic heparinization can be reduced or omitted.

PMID- 1751216
TI  - Vascular access for extracorporeal circulation. Resistance in double lumen
      cannulas.
AB  - Double lumen catheters (DLCs) currently are being used for vascular access with
      extracorporeal circulation. Blood flow studies were done on various DLCs
      connected to a circuit made of polyvinyl chloride tubing. Sheep's blood was used
      with all catheters at flows of 200 and 400 ml/min. The inlet and outlet pressures
      were measured and resistances calculated. Modified versions of the Shiley and
      Kendall catheters, also were tested. In both catheters, resistance was reduced
      with the use of perfusion adaptors. Flow through catheters, with a diameter that
      exceeded the Luer fitting dimension, was compromised. The modified Shiley and
      unmodified Kendall catheters had the lowest resistance to flow, and they thus are
      best suited for extracorporeal circulation.

PMID- 1751217
TI  - Practical assessment of natural heart function using echocardiography in
      mechanically assisted patients.
AB  - Left ventricular assist systems (LVAS) can maintain the systemic circulation of
      patients with acute, profound heart failure. The assessment of natural heart (NH)
      function, however, is difficult in the clinical setting. The authors introduced a
      new index, heart rate-corrected ejection time/left atrial pressure (ETc/LAP)
      using echocardiography to evaluate NH function in 15 adult patients on the
      original LVAS for greater than 2 days. Bypass flow (BF) was gradually decreased
      according to the recovery of NH. Five patients were weaned from LVAS within 15
      days, and LV function was well maintained (Group 1). Another six patients were
      weaned from LVAS within 21 days but died within 2 weeks (Group 2). The other four
      patients died on LVAS without recovery of NH (Group 3). In Group 1 patients,
      ejection time/pre-ejection period (ET/PEP) with LVAS assist increased
      continuously. In Groups 2 and 3, ET/PEP increased slowly and reached a plateau at
      approximately 10 days or remained low. Group 1 patients reached an ETc/LAP of 35
      +/- 10 on LVAS within 7 days. Group 2 and Group 3 patient values were 18 +/- 2 (p
      less than 0.05) and 9 +/- 6 (p less than 0.01), respectively, on the seventh day.
      Based on these data, this new index provides an estimate of global NH function
      and a prediction of the probability of NH recovery.

PMID- 1751218
TI  - Quality of life in long-term survivors of the Hemopump left ventricular assist
      device.
AB  - The courses of 10 patients (nine men and one woman; mean age, 54 years) were
      reviewed to determine the long-term results of treatment with the Hemopump
      (Nimbus Medical, Inc., Rancho Cordova, CA) left ventricular assist device.
      Indications for treatment were postcardiotomy cardiogenic shock (n = 8) and acute
      cardiac allograft rejection (n = 2). Two of the patients with postcardiotomy
      shock required a bridge to transplantation. At follow-up (mean, 21 months), eight
      patients were alive: four were in New York Heart Association Functional Class I
      and four were in Class II. None had long-term adverse effects that were
      attributable to the site of insertion (e.g., limb ischemia or infected groin
      wounds). All the patients considered themselves independent in their daily
      activities, and most of the patients were able to exercise and pursue hobbies.
      The Hemopump appears to offer long-term survival with an acceptable quality of
      life to a population of patients whose survival would have been highly unlikely
      otherwise.

PMID- 1751219
TI  - Clinical evaluation of the Novacor totally implantable ventricular assist system.
      Current status.
AB  - The totally implantable Novacor left ventricular assist system (LVAS) is
      currently approaching clinical evaluation. In vivo testing and production are
      underway with National Institutes of Health (NIH) support. Activity over the past
      year has focused on manufacturing engineering, preproduction quality assurance,
      and in vivo experiment completion. Subsequent to successful completion of the NIH
      sponsored, 2-year preclinical device readiness test (DRT), a number of
      refinements were identified and approved by the NIH technical/data review board.
      Most of these were necessitated by obsolescence or unavailability of electronic
      components and the decision to use only high reliability military (MIL) qualified
      electronic components and processes. A few additional refinements were identified
      to increase design margins, all of which were qualified by accelerated testing.
      The development of production processes, automated test programs, and MIL
      compliant environmental stress screening procedures was completed. Production of
      LVAS subsystems, including core electronic components (hybrids, application
      specific integrated circuits, and surface mount boards), was initiated. Animal
      studies are underway. The clinical trial, at Presbyterian-University Hospital of
      Pittsburgh and St. Louis University Medical Center, awaits completion of in vivo
      experiments, protocol development, and Food and Drug Administration approval.

PMID- 1751220
TI  - Extended support with a left ventricular assist device as a bridge to heart
      transplantation.
AB  - The Heartmate-1000IP, an intracorporeal, pneumatically activated, pulsatile left
      ventricular assist device (LVAD) with textured blood-contacting surfaces, is
      undergoing clinical evaluation as a bridge to heart transplantation (HTx). During
      a 3 year period (January 1988 to April 1991), the authors evaluated 12 patients
      who required extended LVAD support (greater than 30 days) while awaiting HTx.
      Duration of support ranged from 31 to 233 days (mean, 117 days). LVAD performance
      was excellent, with average pump flow indices of 2.5-3.5 L/min/m2. Long-term
      antithrombotic therapy consisted of dipyridamole and aspirin in all except one
      patient who received only low-molecular-weight dextran. After the initial
      recovery period, prothrombin and partial thromboplastin times returned to
      baseline levels. Plasma-free hemoglobin levels averaged less than 10 mg/dl. One
      patient is currently receiving support (91+ days); the 11 other patients
      underwent successful HTx, with follow-up ranging from 7 to 36 months. The
      authors' cumulative experience with this LVAD totals more than 1,506 days of
      support (greater than 4 years) without evidence of any thromboembolic episodes.
      These results suggest that this LVAD provides an effective bridge to HTx for
      extended periods.

PMID- 1751221
TI  - Importance of ventricular arrhythmias in bridge patients with ventricular assist
      devices.
AB  - To evaluate whether bridge to transplant patients with ventricular arrhythmias
      (VA; fibrillation or tachycardia) are at risk of death before or during
      ventricular assist device (VAD) support, the records of 28 patients who were
      supported with VADs for periods of 0.1 to 370 days (mean, 35.3 days) were
      retrospectively reviewed. VADs were effective in reducing the incidence of VA by
      36%; however, patients with ischemic heart disease had a high incidence of VA
      (44%) during VAD. Only one patient with non-ischemic heart disease (8%) had VA
      during VAD. All five patients supported with left ventricular assist devices who
      had VA during support survived. Overall, the occurrence of VA during VAD was not
      a mortality risk. Since VAs are not predictors of survival, the presence of VA
      should not influence patient selection. While biventricular assist devices may be
      necessary in patients with the most severe VA, an LVAD provides excellent support
      in many patients.

PMID- 1751222
TI  - Continuous monitoring of artificial heart pump performance.
AB  - Continuous monitoring of pump performance is essential and effective for optimal
      driving of a pulsatile blood pump. The authors contrived a practical method for
      continuous estimation of blood volume in a pump by measurement of electrical
      impedance (Z). This method was evaluated with the air-driven, diaphragm type
      pump. The pump was made from polyurethane and had two metal connectors at the
      inlet and the outlet ports. Z was measured by charging the alternating current
      (50 kHz, 0.4 mA) between two connectors as electrodes. In in vitro tests, Z
      reached maximum value during full-empty and minimum value at full-fill. The blood
      volume calculated by an empirical equation of Z was linearly related to the real
      blood volume (r = 0.99). In in vivo tests with goats, pump output estimated by
      this method was linearly related to pump output measured with an electromagnetic
      flowmeter and effectively evaluated pump performance. For calibration, this
      method needed only to measure Z at full-fill. This method was useful as a
      controller of a full-fill to full-empty drive. It was concluded that this method
      is a practical estimate of pump performance, even if implantable diaphragm type
      pumps are used, and easily applicable to any kind of pulsatile pump.

PMID- 1751223
TI  - Do humoral factors removed by plasmapheresis suppress the cellular immune system
      in cryoglobulinemia?
AB  - The efficacy of plasmapheresis (PP) is believed to be primarily related to the
      removal of plasma humoral factors. Little is known, however, about the effect of
      solute removal on cellular systems. The effect of the presence of
      cryoprecipitable proteins (CPPT) on mononuclear blastogenesis (MNB) and
      polymorphonuclear cell phagocytosis (PMN-P) was studied. MNB stimulated by
      concanavalin A (Con A), phytohemagglutinin (PHA), and pokeweed mitogen (PWM) was
      significantly inhibited in cryoglobulinemic (CG) patients to 70, 75, and 60% that
      of normal controls, respectively. PMN-P were significantly suppressed to 30% that
      of normals. CPPT purified from cryoglobulinemic plasmas, type I and type III CG,
      exhibited higher suppressive effects (and in a concentration dependent manner) on
      normal MNB and PMN-P than albumin used as a control. The studies indicate that
      patients with CG have defective leukocyte function and that CPPT have suppressive
      effects on normal leukocyte function in vitro. Removal of plasma CPPT may improve
      the immunologic status of CG patients.

PMID- 1751224
TI  - Prolongation of cardiac xenograft function after reduction of natural antibodies
      using double filtration plasmapheresis.
AB  - A double filtration plasmapheresis (DFPP) technique was applied to selectively
      remove the natural antibodies in discordant xenotransplantation. A swine heart
      was heterotopically transplanted in a canine neck after two DFPP procedures
      during which 200 to 500 ml of plasma were replaced with the same amount of
      Hartman's solution containing 7% human albumin. Mean removal rate of IgC and IgM
      by DFPP ranged from 74.2 +/- 0.5 to 95.9 +/- 2.8%. The anti-swine lymphocytotoxic
      reaction of canine serum was decreased after DFPP but still remained in low
      titers. Mean graft survival time in the group treated by DFPP in which 1000 ml of
      plasma was totally replaced was prolonged to 107 +/- 47 min, while it was 9 +/- 5
      min in the group without any treatment (p less than 0.01). Deposits of canine IgM
      and C3 on the vascular endothelium of the graft were observed on
      immunofluorescence, while there were no deposits of IgG. In conclusion, DFPP
      effectively removed the natural antibodies, resulting in prolongation of
      xenograft survival time. Immunofluorescence study suggested that natural IgM
      antibodies played an important role in this xeno-hyperacute rejection.

PMID- 1751225
TI  - Combined LDL apheresis and hemodialysis in a patient with end-stage renal disease
      and accelerated coronary atherosclerosis.
AB  - The first long-term experience with lipid apheresis in a hemodialysis patient
      with refractory combined hyperlipidemia and coronary heart disease is described.
      Simultaneous treatment was performed once a week using two separate machines
      connected by parallel flow. Correction of hyperlipidemia was achieved,
      accompanied by inhibition of progressive coronary heart disease, enabling kidney
      transplantation.

PMID- 1751226
TI  - Development of a 3-D artificial extracellular matrix. Design concept and
      artificial vascular media.
AB  - A photodimerizable monomer was synthesized and subsequently co-polymerized with a
      hydrophilic monomer to obtain a photocrosslinkable, water soluble polymer. This
      polymer attained a highly hydrated, gel-like phase on irradiation with
      ultraviolet (UV) light. Furthermore, incorporation of the well known cell
      adhesive ligand Arg-Gly-Asp-Ser (RGDS) peptidyl moiety into the above co-polymer
      resulted, on UV light irradiation, in a three-dimensional hydrophilic gel matrix
      containing cell adhesive ligands. The UV irradiation on a mixture of
      photocrosslinkable and cell adhesive polymer and smooth muscle cells in a medium
      trapped the cells throughout the gel matrix, indicating that the cell-entrapped
      gel and the designed synthetic polymer biomimic the media of the vascular wall
      and extracellular matrix, respectively.

PMID- 1751227
TI  - Bioartificial thyroid. The in vitro culture of microencapsulated rabbit thyroid
      tissue.
AB  - A new technique of encapsulating thyroid tissue with an artificial membrane for
      protection against immune attack is reported. The membrane was made of calcium
      alginate and a poly-L-lysin coating. The membrane prevents the diffusion of large
      molecules such as hemoglobin but freely permits the passage of smaller molecules
      such as T4 and culture medium 1640. Because larger molecules are barred, the
      contents of the microcapsules are safe from immune system rejection. In vitro
      cultured, microencapsulated rabbit thyroid tissue secreted T3 and T4, achieving a
      concentration of 8.68 +/- 2.93 nmol/L and 245.23 +/- 124.87 nmol/L, after 3 days;
      this level remained steady for 6 to 9 days of incubation. These microcapsules
      show promise as a treatment modality and as a possible solution to the problem of
      immuno-isolation.

PMID- 1751228
TI  - Control of cellular orientation in two-dimensional tissue formation. Surface
      topologic effect of collagen fibers on endothelialization.
AB  - The authors studied the effect of polymorphous states of collagen on in vitro
      cellular orientation of bovine aortic endothelial cells (ECs). Little orientation
      of adherent ECs was observed on a nonoriented collagen coated surface,
      irrespective of culture period. Only ECs that adhered to fiber bundles 10 microns
      in diameter exhibited cellular elongation or alignment. The collagen membrane
      with highly oriented fine fibers provided no cellular alignment for ECs in sparse
      culture. Resultant confluent monolayers, however, were characterized by cellular
      orientation, suggesting that surface microtopology of collagen induces cellular
      orientation on incubation. Control of cellular orientation would be an elementary
      requirement for cell seeding technology leading to hybrid artificial organs.

PMID- 1751229
TI  - Liposome-embedded-heme as a totally artificial oxygen carrier.
AB  - To produce a totally artificial oxygen carrying substance, a synthetic iron
      porphyrin (heme) complex that is analogous to the oxygen binding site (protoheme)
      of hemoglobin was embedded in the phospholipid bilayer of a liposome. The O2
      carrying capacity of this liposome-embedded-heme (L/H) was examined by exchange
      transfusions in beagles. Six beagles were divided into two groups. In Group I, 15
      ml/kg of blood was removed, and the same amount of L/H solution was injected
      intravenously. In Group II, 30 ml/kg of blood was withdrawn, and the same amount
      of the L/H solution was injected intravenously. The mean L/H concentration in the
      blood was 0.9 mM in Group I and 1.5 mM in Group II. The oxygen volume transported
      by 1 mM of the L/H at 1 L/min of cardiac output in Groups I and II were 15 and 17
      ml/mM.L.min, respectively. The oxygen volume consumed from 1 mM of the L/H at 1
      L/min of cardiac output in Groups I and II were 7.7 and 8.3 ml/mM.L.min,
      respectively. O2 volume transported by the L/H in Groups I and II were 8 and 15%,
      respectively. O2 volume consumed from the L/H in Groups I and II were 12 and 24%,
      respectively. Thus, this liposome-embedded-heme has the ability to combine with
      oxygen, to transport it to the tissue, and to release it in the tissue. The
      oxygen volumes transported by and consumed from the L/H were proportional to the
      L/H concentration in the blood.

PMID- 1751230
TI  - Placement of aortic valve bioprostheses in sheep via a left thoracotomy.
      Implantation of stentless porcine heterografts.
AB  - Juvenile sheep provide a good model for assessing the efficacy of
      antimineralization techniques because of their rapid calcification of
      bioprosthetic valves. Stentless bioprosthetic valves are under evaluation for
      possible improved durability as aortic valve replacements. A left thoracotomy
      approach for aortic valve implantation, which facilitates intraoperative and
      postoperative hemodynamic data collection, has been developed and refined in 13
      sheep. A critical feature of this technique is a partial rib resection that
      creates a soft tissue acoustic window to improve postoperative transthoracic
      echocardiographic examination. This allows both quantification of valvular
      gradients and qualitative assessment of valve leaflet motion and calcification.
      Excellent correlation was observed between the intraoperative invasive valvular
      gradients and the postoperative echocardiographic gradients available in four
      animals (mean gradient r = 0.96, p = 0.003; peak gradient r = 0.98, p = 0.0004).
      This is an excellent technique for serial postoperative noninvasive evaluation of
      valve prostheses implanted in the aortic position.

PMID- 1751231
TI  - Nondestructive analysis of mitral valve collagen fiber orientation.
AB  - Collagen is the most abundant and highest modulus component in mitral valve (MV)
      tissue. MV leaflet and chordal collagen ultrastructure were analyzed by small
      angle light scattering (SALS) and polarized light microscopy (PLM) to provide
      collagen fiber architecture mapping. It was hypothesized that structural
      arrangement strongly influences MV tissue mechanical properties and thus
      physiologic function.

PMID- 1751232
TI  - In vitro continuous wave Doppler gradients of mechanical valves in less than
      optimal orientations.
AB  - Continuous wave Doppler ultrasound is a noninvasive method of determining
      transvalvular gradients that may overestimate the gradients of prosthetic valves.
      It is theorized that a valve rotated or tilted in its annulus will create
      abnormally high velocities that calculate into derived gradients that are greater
      than those actually present. An in vitro apparatus was constructed to analyze the
      velocities and the actual and derived gradients of prosthetic valves in less than
      optimal orientations. Continuous flow studies of a 27 mm Omniscience prosthesis
      indicated good agreement between the actual and derived gradients with the
      valve's major orifice oriented toward the aorta's larger radius. These values
      increase as the valve is tilted to decrease its net opening angle. When the valve
      is rotated 180 degrees, the Doppler gradients tend to overestimate the actual
      pressure drops. These data indicate that certain valve misorientations create
      velocities that overestimate the transvalvular gradients.

PMID- 1751233
TI  - Advances in design principle and fluid dynamics of a flexible polymeric heart
      valve.
AB  - The three leaflet J-3 valve is manufactured in a medium open position with almost
      flat leaflets, whereby the stent is expanded by a cone shaped mold. After
      manufacturing, the dipcoated leaflets have stable closed and open positions. The
      transition succeeds with very low membrane stresses. Due to this design, the J-3
      polymer valve showed superior hydrodynamic performance compared with commercial
      valves. In durability tests, prototypes have reached lifetimes up to 17 years.
      While animal tests are encouraging, they also reveal needed manufacturing
      improvements.

PMID- 1751234
TI  - In vitro quantification of regurgitant jet flow by color Doppler ultrasound and
      conservation of momentum.
AB  - Prosthetic valve regurgitant jets can be imaged with color Doppler ultrasound
      (CDU), but clinical quantitation remains elusive. An equation based on an
      integrated conservation of momentum analysis was implemented for CDU quantitation
      of regurgitation. This was compared with a simple, non-CDU momentum balance
      analysis recently reported that requires only a pulsed Doppler ultrasound (PDU)
      reading within the jet and a continuous wave Doppler (CWD) reading of the orifice
      velocity. For in vitro steady flows, the simple, non-CDU method was accurate only
      with PDU readings taken 5 cm from the orifice; flows were underestimated when
      readings 1 and 3 cm from the orifice were used. The CDU method was accurate, even
      when flows calculated from readings between 0.5 and 6.0 cm from the orifice were
      averaged together.

PMID- 1751235
TI  - Characterizing sleep disorders in chronic hemodialysis patients.
AB  - Forty-eight chronic hemodialysis (HD) patients (pts) completed questionnaires
      that used linear analogue scales (LAS), yes/no responses, and demographic data
      collection to characterize sleep disorders. Twenty-five pts (52%) reported
      problems sleeping. These pts graded sleep problems significantly higher than
      those without sleep problems (6.5 +/- 3 vs. 1.8 +/- 2, p less than 0.001 by LAS).
      Those with sleep disorders were more likely to smoke cigarettes (13/25 vs. 6/23,
      p less than 0.05) and have bone pain (14/25 vs. 6/23, p less than 0.05). No
      differences among pts with and without sleep problems were seen in age, gender,
      time on dialysis, caffeine intake, pruritus, feelings of sadness, worry, or
      anxiety, or Kt/V values (1.5 +/- 0.2 vs. 1.4 +/- 0.2, p less than 0.13). Restless
      legs (84%), onset insomnia (76%), and nighttime (76%) and early A.M. waking (72%)
      characterized the sleep disorders; symptoms suggesting nocturnal myoclonus were
      less common (20%). We conclude that sleep disorders are common in HD pts and may
      be exacerbated by tobacco use, bone pain, and restless legs. Kt/V does not
      correlate with sleep disorders. Further examination of this problem, including
      formal sleep studies, is needed.

PMID- 1751236
TI  - Mathematical modeling of erythropoietin therapy.
AB  - A simple mathematical model to describe hemoglobin (Hb) concentration response to
      recombinant human erythropoietin (EPO) therapy is proposed. The model is based on
      the assumption that Hb production increases linearly with EPO dose level. The
      resulting equation contains two patient parameters: 1) S, the proportionality
      constant between g Hb generated/L blood/wk and IU EPO administered/kg body
      weight/wk; and 2) tau, the patient erythrocyte lifetime in weeks. The model was
      applied retrospectively to 67 patients from the Canadian Erythropoietin Study,
      yielding an average error of 5.5 g/L between 27 measured and predicted Hb value
      pairs over the 27 week study. The model parameters, S (mean +/- SD = 0.015 +/-
      0.005) and tau (14.0 +/- 4.1), varied over an order of magnitude. The model was
      also used to predict the EPO dose required to reach a target Hb of 110 g/L; the
      EPO requirements varied from 55 to 742 IU EPO/kg/wk (mean +/- SD = 225 +/- 124).
      It is recommended, based upon the model results, that EPO therapy be initiated at
      3 IU EPO/kg/wk for each g/L difference between target and baseline Hb, with
      subsequent EPO dose adjustment guided by patient modeling.

PMID- 1751237
TI  - Red blood cell membrane permeability of uremic and normal cells.
AB  - Although there is extensive evidence that uremic red cells are more fragile and
      less deformable than normal cells, there are essentially no data on red cell
      membrane permeability in uremia. We have obtained data for creatinine and uric
      acid permeability of red cells from normal and uremic individuals (dialysis
      patients on EPO). The creatinine permeability of uremic cells was significantly
      less than that of normal cells (p less than 0.02), while the uric acid
      permeability was significantly greater than that of normal cells (p less than
      0.01). Experiments with uremic and normal cells suspended in phosphate buffered
      saline, and with normal cells suspended in uremic plasma, indicated that uremia
      alters both the red cell membrane and the plasma, with an unknown plasma
      constituent affecting the permeability.

PMID- 1751238
TI  - Phosphate removal during hemodialysis, hemodiafiltration, and hemofiltration. A
      reappraisal.
AB  - Kinetics of phosphate removal, based on hourly collection of used dialysate or
      filtrate and hourly changes of phosphate plasma concentration, were studied in
      hemodialysis (QB 300; QD 500 ml/min), hemodiafiltration (QB 300; QD 500; QSF 25
      ml/min), and hemofiltration (QB 250; QSF 70 ml/min) for six 5-hour sessions in
      each mode of therapy. Whatever the pretreatment phosphate concentration (1.5-2.0
      mmol/L range), and whatever the treatment modality used, final plasma phosphate
      concentration was in the narrow range of 0.8-0.9 mmol/L, and about 50% of the
      total mass transfer occurred during the first 2 hours. At the third hour, a
      steady state is reached, suggesting that removal of phosphate is limited by the
      rate of phosphate transfer from body compartments to extracellular fluid, which
      was on the average about 362 mumol/kg.hr. Consequently, total phosphate mass
      transfer accounts only for 20 to 28 mmol per session. Control of pretreatment
      phosphatemia in the range of 1.5 to 2.0 mmol/L depends on daily phosphate binder
      prescription, calcitriol supplementation, and control of metabolic acidosis; one
      cannot rely on intermittent phosphate removal during the dialysis session.

PMID- 1751239
TI  - A multicenter study of short hour dialysis using AN69S. Preliminary results.
AB  - A multicenter prospective study of short hour (SH, less than or equal to 3 hr)
      dialysis using a high flux membrane (AN69S) plus volumetric control (VC), versus
      conventional (greater than or equal to 4 hr) (CNV) cellulosic non-VC dialysis, is
      ongoing. The study hypothesizes that SH treatment over 1 year will provide
      adequate dialysis, will not increase morbidity, and may improve quality of life.
      To date, 112 patients have been entered, and 54 have completed 6 months, 30 by
      SH. There were no differences in biophysiologic parameters at 6 months. Mean
      hospitalization was 5.24 days per patient. The SH group had a higher (p = 0.0374)
      hospitalization rate because of two patients. Quality of life was similar in SH
      and CNV groups. The study indicates that SH dialysis is feasible, safe, and as
      comfortable as CNV.

PMID- 1751240
TI  - Experimental study on limitations of anastomotic endothelialization of vascular
      prostheses.
AB  - We studied the effect of endothelial cell (EC) senescence on proliferation,
      migration, and endothelialization in vitro using a culture model. Two generations
      of cultured bovine aortic ECs were used. The results showed that 1) the senescent
      ECs had much reduced rates of proliferation, migration, and endothelialization in
      vitro, and 2) that the young ECs at the leading edge gradually developed
      morphology similar to that of the senescent ECs as endothelialization proceeded.
      Computerized videomicroscopic observation revealed that the ECs at the leading
      edge had higher motile activity than the ECs at the back. This suggests that the
      ECs at the leading edge, and circumvented from contact inhibition, may
      proliferate much more frequently than the ECs at the back. Localized cellular
      aging may result in decelerated or incomplete endothelialization, as found
      clinically.

PMID- 1751241
TI  - Dynamic internal compliance of a vascular prosthesis.
AB  - A new technique was used to measure dynamic internal compliance of a blood vessel
      or vascular graft subjected to dynamic internal pressure. The internal compliance
      can be broken into three categories: the volumetric compliance (CV), defined as
      (dV/V)/dP; the longitudinal compliance (CL), defined as (dL/L)/dP; and radial
      compliance (CR), defined as (dR/R)/dP. It can be shown mathematically that CV = 2
      CR + CL. Thus, measuring any two of the three entities will also give the value
      for the third. A Dynatek DCT1 dynamic compliance tester was used for measuring
      the compliance of DenaflexTM biologic grafts and fresh bovine internal thoracic
      arteries, from which the Denaflex grafts were obtained by fixation. Volumetric
      compliance was obtained with the test sample mounted in a loose loop that allowed
      the sample to move both radially and longitudinally. By mounting the sample in a
      straight fashion that limited longitudinal movement, the radial compliance was
      determined. The longitudinal compliance was then calculated from the above
      relationship. Test results show that the fresh bovine artery had an average
      volumetric compliance of 26.1%/100 mmHg, radial compliance of 9.5%/100 mmHg, and
      longitudinal compliance of 7.2%/100 mmHg. The Denaflex vascular graft showed a
      reduction in longitudinal and radial compliance, compared to the fresh raw
      artery, as a result of extensive fixation.

PMID- 1751242
TI  - Facilitation of endothelial cell growth on hydroxylated ePTFE vascular grafts.
AB  - The authors have modified ePTFE by hydroxylating the surface using aluminum
      deposition and removal with sodium hydroxide. This process has no effect on the
      microfibrillar structure, but reduces the hydrophobicity of ePTFE. There were
      significantly greater numbers of rat aortic endothelial cells on the surface of
      modified as compared to control ePTFE after 14 days (469 +/- 44 vs. 4 +/- 3
      cells/mm2, p less than 0.01, paired t-test). This simple chemical modification
      facilitates endothelialization, without using thrombogenic cell adhesives.

PMID- 1751243
TI  - Healing process of vascular prostheses seeded with venous tissue fragments.
AB  - Rapid neointima formation in fabric vascular prostheses seeded with autologous
      venous tissue fragments was examined. A piece of peripheral vein was minced into
      small fragments and stirred into 20 ml of saline. This tissue suspension was
      sieved through the wall of Dacron prostheses. The prostheses implanted in the
      descending aortae of dogs showed extremely rapid healing of the neointima.
      Endothelial cells lined the entire luminal surface within 14 days. There was no
      difference in the healing process between the area near anastomotic sites and the
      center.

PMID- 1751244
TI  - In vivo evaluation of porous versus skinned polyurethane-polydimethylsiloxane
      small diameter vascular grafts.
AB  - Two types of spongy polyurethane-polydimethylsiloxane (PU-PDMS) vascular grafts
      (1.5 mm ID, 450 microns wall thickness) were fabricated with either a skinned
      (SG) or a porous (PG) luminal surface and an open mesh filamentous external
      surface by a spraying, phase-inversion technique. Tubular membranes, 15-20 mm in
      length, were all implanted by the same surgeon as infrarenal aorta replacements
      in male Sprague-Dawley rats weighing 250-350 g (SG: n = 12, PG: n = 23). The
      patency rates at 2 weeks and 3 months were 0% (0/7) and 0% (0/1) for SG, 72%
      (8/11) and 8% (1/12) for PG. Because the wall structure of these grafts was
      relatively compact and did not provide enough communicating voids, another series
      of 15 highly porous luminal surface grafts was fabricated with a higher void to
      material ratio. These grafts (HPG) exhibited a 73% patency at 3 months, with a
      fully endothelialized surface. The authors conclude that a very open luminal
      surface structure, and a high wall porosity, are significant factors of graft
      patency in small diameter vascular prostheses made of a porous material.

PMID- 1751246
TI  - Effect of pulsatile reperfusion on myocardial high energy phosphates following
      global ischemia.
AB  - To evaluate the effects of pulsatile reperfusion (PR) on the postischemic
      myocardial phosphometabolites, 17 sheep were put on cardiopulmonary bypass (CPB)
      and randomly divided into a pulsatile group (P group) and nonpulsatile group (NP
      group). The heart was arrested by global ischemia for 45 minutes, then
      defibrillated and reperfused for 2 hours while the circulation was supported by
      CPB. Myocardial needle biopsies were obtained, and ATP, ADP, and AMP were
      measured with high performance liquid chromatography. There were no significant
      differences between the two groups in myocardial ADP and AMP. However, after 120
      minutes of reperfusion, the myocardial ATP was restored in the P group, but
      continued to decrease further in the NP group. Experimental results imply that PR
      might reduce reperfusion injury and promote recovery of the ischemic myocardium.

PMID- 1751245
TI  - The development of a clinically relevant canine model of postperfusion syndrome.
AB  - Investigation into the complex etiology of the postperfusion syndrome (PPS) has
      been limited by access to only retrospective human case studies, and performance
      of animal studies that examine biochemical predictors of injury rather than the
      PPS itself. To determine whether a reproducible canine model of the clinical
      syndrome was possible, seven dogs underwent cardiopulmonary bypass (CPB) with a
      bubble oxygenator for 0 (n = 1, sham), 2 (n = 1), 4 (n = 1), and 6 (n = 4) hours.
      Arterial oxygenation, chest radiographs, serum creatinine, and total leukocyte
      and platelet counts continued to change through the second postoperative day,
      illustrating the need for prolonged follow-up (48 hours) to accurately detect
      postperfusion organ dysfunction. The dogs that did not undergo CPB for 6 hours (n
      = 3) did not develop important pulmonary dysfunction postoperatively, but three
      of the four dogs undergoing 6 hours of CPB developed profound, persistent,
      arterial hypoxemia associated with radiographic, histologic, and hemodynamic
      evidence of severe PPS. Early evidence of renal dysfunction was also apparent
      within 84 hours of 6 hour CPB. It is concluded that the canine long duration (6
      hour) CPB model, with prolonged (48 hour) postoperative monitoring, generates a
      reproducible, clinically relevant model of human PPS.

PMID- 1751247
TI  - Membrane pore size and filtration selectivity in cryoglobulinemic plasma
      fractionation.
AB  - Efficiency of albumin (Alb) and immunoglobulin G (IgG) separation from
      cryoprecipitable proteins (CPP) and IgM was compared between a membrane plasma
      fractionator with a mean pore diameter (MPD) of 0.1 micron, surface area of 0.65
      m2, and a new large pore diameter filter with a MPD of 4.3 microns, and surface
      area of 0.14 m2. In five in vitro tests at 4 degrees C using polyclonal
      cryoglobulinemic (CG) plasma from a patient treated by plasma exchange (PE), the
      large pore filter retained only 22% of the mass of Alb, and a comparable amount
      of CPP and IgM, as compared to the plasma fractionator, at a fraction of its
      total retention capacity. The new filter can replace PE in treatment of
      polyclonal CG.

PMID- 1751248
TI  - LDL cholesterol apheresis by dextran sulfate cellulose adsorption. Long-term
      experience in patients with familial hypercholesterolemia.
AB  - Five patients with diet and drug resistant familial hypercholesterolemia (FH)
      (low density lipoprotein [LDL] cholesterol, LDL greater than 230 mg/dl) were
      treated by LDL apheresis, using dextran sulfate cellulose adsorption (DSC), to
      prevent coronary heart disease (CHD). After membrane plasma separation, two 150
      ml columns of DSC alternately adsorbed LDL, and were regenerated by 4.1% saline.
      Five patients received 230 treatments with 7 to 14 days intervals over 6 to 30
      months. The treated plasma volume per session was 3.8 +/- 0.6 L. Post-apheresis
      values in percent of pre-apheresis were: total cholesterol, 42%; LDL, 27%; VLDL,
      62%; HDL, 96%; triglycerides, 70%; WBC, 115%; platelets, 88%; C3 complement, 78%;
      fibrinogen, 67%; albumin, 94% (p less than or equal to 0.005 for all values).
      Safety parameters showed only slight changes. The initial LDL of 436 +/- 172
      mg/dl decreased to nonatherogenic levels of between 150 and 100 mg/dl, whereas
      high density lipoprotein remained unchanged. Adverse events (hypotension, angina
      pectoris, technical problems) occurred in six treatments. Long-term treatment of
      patients with therapy resistant FH by extracorporeal DSC adsorption is effective
      and safe.

PMID- 1751249
TI  - Simultaneous heparin extracorporeal LDL precipitation and hemodialysis. First
      clinical experience.
AB  - Simultaneous heparin extracorporeal LDL precipitation (HELP)-dialysis was carried
      out at weekly intervals in six patients with end-stage renal failure, associated
      hyperlipidemia, and a high risk of premature atherosclerosis. Evaluating 135
      single treatments, a mean acute total cholesterol/LDL reduction of 31% and 39%,
      respectively, was found, while clearance of urinary substances was comparable to
      that in regular hemodialysis treatment. Treatment tolerance was excellent and no
      derangements in albumin, hemodialysis parameters, or blood coagulation were
      detected.

PMID- 1751250
TI  - Immunoadsorption of anti-A or anti-B antibody for successful kidney
      transplantation between ABO incompatible pairs and its limitation. Japanese
      Biosynsorb Research Group.
AB  - Kidney transplantation between ABO incompatible pairs, contraindicated because of
      a high incidence of hyperacute rejection episodes, has become feasible after
      provisional removal of anti-A or anti-B antibody from recipient canidates.
      Initially, a total of 54 patients were scheduled to be transplanted with ABO
      incompatible kidneys after removal of anti-A or anti-B antibody by
      immunoadsorption, using A or B antigen expressing trisaccharide immobilized on
      silica beads. Levels of anti-A and/or anti-B antibody (-ies) were negative (below
      less than X8 dilution) after three to four immunoadsorption treatments, and,
      thereafter, kidneys were successfully transplanted in 47 patients
      (incompatibility in A:21, B:25, AB:1). However, in four patients, anaphylactoid
      reaction occurred immediately after initiation of immunoadsorption, and double
      filtration plasmapheresis (DFPP) took place. Kidney transplantation was cancelled
      in three patients because of rebound to high level of anti-A or anti-B antibody,
      or appearance of T cell antibody after immunoadsorption.

PMID- 1751251
TI  - Safe and effective plasma exchange to remove antibodies prior to xenogeneic heart
      transplantation in small primates.
AB  - The ability of an on-line, rapid plasma exchange (PE) system to remove
      circulating antibodies in preparation for xenogeneic heart transplantation was
      studied. Plasma exchanges were performed 27 times on 13 rhesus monkeys weighing
      from 6.5 to 12.0 kg, using systemic heparinization, without untoward effects.
      Blood flow rates of 22-72 ml/min resulted in plasma collection rates of 7-22.5
      ml/min. Serum immunoglobulin levels were decreased by more than 90%, and specific
      antiendothelial xenoreactive IgM was completely removed after two plasma
      exchanges. Transferrin levels were decreased 85-95%, and complement levels fell
      by greater than 80%. Platelets were partially conserved, with removal rates of 18
      60%. All factors returned to normal ranges within 48 hours and no bleeding
      complications were encountered. When antiendothelial antibodies were removed in
      this manner, survival of a pig heart transplanted into a rhesus monkey was
      extended to 12 hours, from a baseline of 2 hours, without treatment.

PMID- 1751252
TI  - Development of an automatic control algorithm for the electrohydraulic total
      artificial heart without transducers.
AB  - To achieve a reliable and simple implantable total artificial heart, the number
      of implanted transducers providing the physiologic information required for
      automatic control should be minimized. To address this need, a new automatic
      control algorithm, based on a transducerless electrohydraulic total artificial
      heart (EHTAH) system, is proposed. The current EHTAH physiologic control
      algorithm relies on two implanted pressure transducers. Without these
      transducers, the information required for automatic control must be extracted
      from the running motor's parameters. These parameters correlated with the
      differential pressure across the axial flow pump used to actuate the EHTAH.
      Changes in this differential were chosen as a cue for cardiac output control.
      This algorithm can be viewed as depending upon systemic vascular resistance
      determined by subtracting mean right atrial pressure (RAP) from mean aortic
      pressure (AoP) and dividing the result by total cardiac output (CO). The
      difference between mean AoP and mean RAP was confirmed to correlate with the
      differential hydraulic pressure across the energy converter during the left
      systolic phase. As an interim configuration, a single differential pressure
      transducer measuring the differential hydraulic pressure across the energy
      converter was tested on a Donovan mock circulation system. The resultant CO
      response shows good sensitivity according to changes in both preload and
      afterload.

PMID- 1751253
TI  - Application of a new nuclear scintigraphy camera to evaluate flow and mechanical
      pumping of artificial hearts.
AB  - To assist in the development of an artificial blood pump, The Milwaukee Heart (MH
      1), a new nuclear scintigraphy camera was used to study the wash-in and wash-out
      patterns of the MH-1. These studies indicate the MH-1 has an ejection fraction of
      59.3%, with a stroke volume of 72 +/- 3 ml, and an afterload of 130 mmHg. Flow
      through the device is highly uniform, with no areas of stagnation. Regional
      ejection fraction images demonstrate homogeneous ejection from apex to base. The
      ability to scan through the first pass images allows study of wash-in, mixing,
      and wash-out of the tracer. In conclusion, this technique may provide a new
      approach to evaluating artificial heart pumps.

PMID- 1751254
TI  - Development of a totally implantable total artificial heart controller.
AB  - Using a one chip microcontroller, 87C196 (One chip EPROM), and an erasable and
      programmable logic device (EPLD), an implantable control system to drive a
      pendulum type electromechanical total artificial heart was developed. This
      control system consists of four parts: a main management system, a motor driver
      with power regulator, a state monitoring system, and a communication portion. The
      main system has a speed detector, proportional and integral (PI) control, pulse
      width modulation (PWM) generation, serial communication, and an analog data
      processor. Two kinds of power system are used, separated by eight photocoupler
      arrays to improve system stability. When the performance of each compartment was
      compared with that of the previously used Z80 microprocessor based control
      system, good correspondence was shown. Logic power consumption was reduced to one
      third that of the previous controller. Using mock circulation tests, the overall
      performance of the control system was evaluated.

PMID- 1751255
TI  - Comparison of microsphere and intraoperative quantitation of bronchial blood
      flow.
AB  - Although significant variation in bronchial blood flow (BBF) has been reported,
      precise quantitation is difficult because of the small sized vessels and variable
      anatomy. Ventricular balance is critical to the function of the total artificial
      heart (TAH), and variation in BBF can alter this balance in the bovine model.
      Bronchial blood flow was measured in 12 calves by two methods: six by the
      radioactive labeled microsphere technique (MBBF), and six intraoperatively (IBBF)
      during cardiopulmonary bypass (CPB). In the MBBF group, BBF ranged from 1.9 ml/kg
      to 16.0 ml/kg, whereas IBBF varied from 2.6 ml/kg to 10 ml/kg (NS). Cardiac
      output (CO) was significantly higher (p less than 0.0005) in the MBBF group.
      Bronchial blood flow in both groups was highly variable. The higher flow in the
      MBBF group may be attributed to the arteriovenous shunting of microspheres,
      whereas lower flow in the IBBF group may be secondary to physiologic changes
      during CPB. This technique, described to measure IBBF, can estimate large
      variations in the natural right to left shunt that contributes to imbalance in
      the TAH.

PMID- 1751256
TI  - Using magnostrictive metal as a pump for biomedical application.
AB  - A new theory of pumping fluids, including blood, has been developed using
      magnetostrictive technology. This new pump uses the magnetostrictive material
      known as Terfenol-DTM. A magnetic field is imposed on the Terfenol in periodic
      pulses causing it to expand and then relax to its original state. The expansion
      and relaxation of the terfenol cause a smooth, continuous flow of fluid. This
      pump is currently being built and will be tested as a left ventricular assist
      device, totally implantable artificial heart, or both.

PMID- 1751257
TI  - The valvo-pump. An axial, nonpulsatile blood pump.
AB  - The valvo-pump, an axial, nonpulsatile blood pump implanted at the heart valve
      position while preserving diseased heart muscle, has several advantages over an
      artificial heart replacement, including 1) a good anatomic fit to the natural
      heart, 2) less blood contacting surface, and 3) ease of implantation. The housing
      for the pump is a tube, 37 mm in diameter (maximum) and 33 mm in length. Within
      the housing there is an impeller with either 10 vanes (33 mm in diameter) or 5
      vanes (22 mm in diameter). The impeller is connected to a samarium-cobalt-rare
      earth magnet direct current (DC) brushless motor measuring 23.8 mm in diameter
      and 30.2 mm in length. Sealing is achieved by means of a magnetic fluid seal. A
      guiding wheel with 4 vanes is located behind the impeller. The pump was studied
      on a hydraulic mock circulatory system to evaluate its performance
      characteristics. A pump flow of 6.9 L/min was obtained at a pump differential
      pressure of 48 mmHg, and flow of 3.1 L/min was obtained at 58 mmHg. The valvo
      pump can be made feasible by developing a small, high-output, power motor and an
      endurable seal, as well as by optimizing the impeller design.

PMID- 1751258
TI  - Ischemic heart disease, serum cholesterol, and apolipoproteins in CAPD.
AB  - Thirty-one patients, mean age 54 years, had been on chronic ambulatory peritoneal
      dialysis (CAPD) for an average of 38 months. Mean values (mg/dl) for
      triglycerides (567), total-C (267), LDL-C (133), and Apo-B (154) were elevated,
      and HDL-C (30) were low. The low values for total-C/Apo-B and LDL-C/Apo-B suggest
      an increase in the number of low density lipoprotein (LDL) particles, rather than
      in the amount of cholesterol per LDL particle. Without knowledge of lipids,
      ischemic heart disease for the 31 patients was categorized into five grades in
      the following manner. All patients were graded based on history (angina,
      myocardial infarction, and bypass surgery), electrocardiogram (EKG), and
      echocardiography. In addition, five patients underwent coronary angiography, the
      results of which were considered in their grading. The five grades were assigned
      as follows: Grade I, no evidence (n = 15); Grade II, angina with EKG ischemia (n
      = 4); Grade III, myocardial infarction (MI) (n = 1); Grade IV, MI with dyskinesia
      akinesia on echo (n = 4); Grade V, severe three vessel disease on angiography, or
      multiple infarcts, or Grade IV with heart failure (n = 7). Only Apo-B (r = 0.56)
      and total-C/HDL-C (r = 0.57) correlated with severity of grade, with p less than
      0.001. When patients with and without detectable ischemic heart disease were
      compared by stepwise logistic regression, Apo-B was the only variable that
      independently predicted heart disease (p = 0.001). However, contribution of the
      lipid changes induced by CAPD has not been established.

PMID- 1751259
TI  - Decreased technique-related morbidity for continuous ambulatory peritoneal
      dialysis.
AB  - Patients who began continuous ambulatory peritoneal dialysis (CAPD) at the Mayo
      Clinic from 1979 to 1982 were hospitalized during that period 7.8 days per
      patient year (PPY) for access-related causes, whereas home hemodialysis (HHD)
      patients were hospitalized 1.6 days PPY. As the incidence of peritonitis
      decreased, it was found that patients who began CAPD and HHD from 1985 to 1988
      were hospitalized during that period for access-related causes for similar
      amounts of time (1.8 vs. 1.2 days PPY, respectively). For CAPD patients, more
      than one half of the hospitalization time was for reasons other than peritonitis.

PMID- 1751260
TI  - Importance of ventricular arrhythmias in recovery patients with ventricular
      assist devices.
AB  - The effect of ventricular arrhythmias (VA) on survival was retrospectively
      reviewed in 41 patients (33 men, 8 women) who were supported with Thoratec
      ventricular assist devices (VAD [Thoratec Medical Inc., Berkeley, CA]) (17 left,
      9 right, and 15 biventricular). Ages ranged from 15 to 71 years (mean, 56 years),
      and duration of support was 0.1-17 days (mean, 4.7 days). There was no
      significant difference in age, gender, or type of support between survivors and
      nonsurvivors, and no correlation between the type of support and incidence of VA.
      Only two patients (both on left ventricular assist devices [LVAD]) died as a
      direct result of VA. There was no significant difference in the occurrence of VA
      before or during VAD support between survivors and nonsurvivors. These data show
      that evidence of VA is not a predictor of survival in patients in whom myocardial
      recovery is expected.

PMID- 1751261
TI  - Myocardial tolerance to ischemia after resuscitation. Direct mechanical
      ventricular actuation versus cardiopulmonary bypass.
AB  - This study assessed myocardial ischemia after resuscitation from cardiac arrest
      using direct mechanical ventricular actuation (DMVA) or cardiopulmonary bypass
      (CPB). Myocardial ischemic tolerance was better after DMVA resuscitation.
      Resuscitation using DMVA, when compared with CPB, may improve outcome when
      subsequent coronary artery bypass grafting (CABG) is required.

PMID- 1751262
TI  - Jaw stiffness--an ill understood condition.

PMID- 1751263
TI  - Airway obstruction associated with the use of the Guedel airway.
AB  - Soft tissue lateral neck radiography was used in 22 male patients older than 60
      yr, to determine the cause of pharyngeal airway obstruction during anaesthesia,
      before and after insertion of a Guedel airway. In six of the patients, the airway
      was radiologically and clinically clear with the head in the neutral position.
      Nine patients showed obstruction of the airway by a "shelf" of tongue, but seven
      were cleared clinically by dorsiflexion at the atlanto-occipital joint, and the
      remaining two by the Esmarch-Heiberg manoeuvre. In four of the 22 patients, the
      Guedel airway was lodged in the vallecula in the neutral position. This was
      cleared clinically by dorsiflexion at the atlanto-occipital joint in all these
      patients. In three patients the Guedel airway was obstructed by the epiglottis,
      but this was cleared by dorsiflexion at the atlanto-occipital joint in two; in
      the third patient, the Guedel airway slipped into the vallecula after
      dorsiflexion at the atlanto-occipital joint and remained there despite the
      Esmarch-Heiberg manoeuvre. There was only one instance in 66 trials of a
      clinically obstructed airway without an apparent radiological cause. However,
      there were 10 instances in 66 trials of a clinically clear airway with an
      apparent radiological cause for obstruction.

PMID- 1751264
TI  - Changes in amplitude and latency of the P300 component of the auditory evoked
      potential with sedative and anaesthetic concentrations of nitrous oxide.
AB  - The P300 component of the auditory evoked response was recorded from six subjects
      whilst they listened via headphones to a series of clicks which were interrupted
      unpredictably by a tone burst. They were instructed to press a button as quickly
      as possible after hearing the tone whilst breathing first air and then a series
      of increasing concentrations of nitrous oxide. Both the amplitude and the latency
      of the P300 changed in a dose-dependent manner with nitrous oxide, as did minimum
      reaction time. At nitrous oxide concentrations which prevented recall of any
      events that occurred whilst breathing the gas, four subjects continued to respond
      to the tone by pressing the button. In three subjects, the P300 wave was still
      detectable with a nitrous oxide concentration at which the task was no longer
      performed. These results show that there is retention of the ability to perform a
      reaction time task when there is a complete loss of recall of the task. There may
      be some recognition of an auditory stimulus, as manifest by a P300 wave, albeit
      reduced greatly in amplitude, in the absence of a motor response to it. The P300,
      therefore, merits investigation as a tool for studying conscious awareness under
      anaesthesia.

PMID- 1751265
TI  - Effects of i.v. lignocaine on psychological performance and subjective state in
      healthy volunteers.
AB  - In order to assess the effects of different doses of lignocaine on performance,
      nine healthy volunteers aged 21-34 yr received i.v. infusions of saline, low and
      high dose lignocaine (mean plasma concentrations 0.92 and 1.78 micrograms ml-1,
      respectively) in a double-blind randomized order. The Digit-Symbol Substitution
      Test (DSST) and Visual Analogue Scales (VAS) were performed repeatedly and a
      battery of performance tests once. The median (lower, upper quartile) number of
      correct responses for the DSST during the infusion period was: placebo 69 (67,
      77); low 74 (71, 80); high 66 (61, 75) (P less than 0.001, General Linear Models;
      all pairwise comparisons P less than 0.05). None of the measures in the full
      battery showed any significant changes. VAS showed that subjects felt more
      interested (P less than 0.05), drowsy (P less than 0.01), dizzy, tense, abnormal,
      drunk and muzzy (P less than 0.001) with lignocaine than with placebo. These
      results confirm that lignocaine can produce acute performance effects (both
      improvements and impairments). Subjects were clearly aware of the presence of
      lignocaine, suggesting that subjective reports may be a useful indicator of its
      CNS effects.

PMID- 1751266
TI  - Propofol and midazolam act synergistically in combination.
AB  - We have studied interactions between i.v. propofol and midazolam for induction of
      anaesthesia in 200 unpremedicated female patients undergoing elective
      gynaecological surgery. Using end-points of "hypnosis" (loss of response to
      verbal command) and "anaesthesia" (loss of response to a 5-s transcutaneous
      tetanic stimulus), we determined dose-response curves for propofol and midazolam
      alone and in combination. For hypnosis, synergistic interaction was found (P less
      than 0.01), the combination having 1.44 times the potency of the individual
      agents. Although midazolam failed to produce anaesthesia in the dose range used,
      the dose of propofol required to produce anaesthesia was reduced by 52% in the
      presence of midazolam (P less than 0.01). The reduction in arterial pressure at
      induction was the same for the combination as for the individual agents. The
      cause of the synergism was not clear, but may have been interaction at CNS GABAA
      receptors.

PMID- 1751267
TI  - Intra-arterial thiopentone is directly toxic to vascular endothelium.
AB  - Ear artery segments removed from urethane-anaesthetized rabbits were mounted,
      perfused with Krebs solution, and pressurized before constriction with
      extraluminal noradrenaline. Vessel diameter was measured using a diode array
      mounted above the artery. After the degree of dilatation in response to
      intraluminal acetylcholine and glyceryl trinitrate was measured, vessels were
      perfused for 120 s with solutions of either 2.5-10% thiopentone or isotonic
      sodium carbonate in saline of matched pH. Administration of thiopentone solutions
      in all concentrations resulted in destruction of endothelial cells. The
      dilatation of vessels to glyceryl trinitrate and their myogenic reactivity was
      unaltered. Isotonic solutions of sodium carbonate (pH 10.6) had no effect on
      either endothelial cell function or direct vasodilatation. These data show that
      administration of thiopentone removes arterial endothelial cells, while vascular
      smooth muscle function is essentially unaltered.

PMID- 1751268
TI  - Jugular bulb cannulation: description of a cannulation technique and validation
      of a new continuous monitor.
AB  - We have compared in vivo oxygen saturation recordings obtained from the Oximetrix
      3 with in vitro measurements using the Instrumentation Laboratories 282 Co
      Oximeter. The small mean difference (0.85%) and close limits of agreement (-4% to
      6%) are close enough for clinical purposes, provided in vivo calibration is
      performed after insertion of the fibreoptic catheter and repeated at least every
      12 h. Continuous monitoring of jugular bulb oxygen saturation during intensive
      care of brain injured patients is now possible using fibreoptic technology. This
      technique may be of value in detecting global ischaemia, and as a predictor and
      monitor of cerebral perfusion pressure therapy.

PMID- 1751269
TI  - Ketamine for caudal analgesia in children: comparison with caudal bupivacaine.
AB  - Fifty children undergoing inguinal herniotomy were allocated randomly to three
      groups to receive a caudal injection of either 0.25% bupivacaine 1 ml kg-1 with
      or without ketamine 0.5 mg kg-1 or ketamine 0.5 mg kg-1 with normal saline 1 ml
      kg-1. There was no significant difference in quality of pain relief,
      postoperative behaviour or analgesic requirements between the ketamine group and
      the two other groups. The bupivacaine-ketamine mixture provided better analgesia
      than the bupivacaine solution alone. Side effects such as motor weakness or
      urinary retention were not observed in the ketamine group.

PMID- 1751270
TI  - Maternal temperature regulation during extradural analgesia for labour.
AB  - We have studied the effect of analgesia on maternal temperature (oral and
      tympanic membrane) progression in 53 women during normal spontaneous labour.
      Three groups were studied: two received extradural analgesia with a continuous
      infusion of 0.25% bupivacaine with or without the addition of fentanyl; the third
      group received only parenteral opioid analgesia. All patients were afebrile and
      without clinical evidence of infection at the beginning of the study. Both groups
      of patients receiving extradural analgesia had a consistent and significant
      increase in temperature after approximately 5 h of analgesia; no such trend was
      observed in the parenteral opioid group. Alterations in mechanisms of heat
      dissipation may explain these findings.

PMID- 1751271
TI  - Clearance of atracurium and laudanosine in the urine and by continuous venovenous
      haemofiltration.
AB  - We have measured the steady state urinary clearances of atracurium, given by
      constant infusion, and laudanosine in eight patients undergoing artificial
      ventilation; all had normal renal function (mean creatinine clearance 81 ml min
      1). Mean (SD) urinary clearance of atracurium was 0.55 (0.5) ml kg-1 min-1; that
      of laudanosine was 0.33 (0.2) ml kg-1 min-1. Simultaneous plasma clearances were
      7.1 (1.4) ml kg-1 min-1 and 3.8 (1.5) ml kg-1 min-1, respectively. Notional
      haemofiltration clearances of the two substances were measured also in seven
      critically ill patients with renal and respiratory failure undergoing continuous
      venovenous haemofiltration. Mean (SD) clearances of atracurium and laudanosine in
      the haemofiltrate fluid were 0.11 (0.06) ml kg-1 min-1 and 0.09 (0.02) ml kg-1
      min-1, respectively whilst plasma clearances were atracurium 6.7 (1.8) ml kg-1
      min-1 and laudanosine 4.5 (1.8) ml kg-1 min-1. There were no significant
      differences between the plasma clearances of the drugs in the two groups, despite
      the difference in severity of sickness. Urinary clearance rates of atracurium and
      laudanosine were approximately 8 and 9% of that in the plasma, but the
      haemofiltration clearance of both substances was only 2%.

PMID- 1751272
TI  - Alcohol after sedation with i.v. midazolam-fentanyl: effects on psychomotor
      functioning.
AB  - Patients who arrive home several hours after outpatient surgery may drink
      alcohol. The extent to which residual drugs used in outpatient surgery interact
      with alcohol is not known. The purpose of this study was to determine if two i.v.
      drugs commonly used together in outpatient surgery, midazolam and fentanyl, have
      residual effects which would interact with alcohol drunk 4 h after injection.
      Twelve healthy male volunteers participated in a double-blind, randomized,
      placebo-controlled and cross-over study. Subjects were studied four times
      successively with a period of 1 week between trials. On each day of testing, the
      subjects received randomly, by slow i.v. injection (30 s), either saline followed
      immediately by saline, or midazolam 0.1 mg kg-1 followed immediately by fentanyl
      2 micrograms kg-1. Four hours after the injection, the subjects consumed a
      beverage which either did or did not contain alcohol 0.7 g kg-1. Before and 1, 3,
      5 and 7 h after injection (and before and 1 and 3 h after consumption of
      beverage), psychomotor performance and mood were assessed. While both the
      combination midazolam-fentanyl and alcohol had independent effects on the
      dependent measures in this study, there was no interaction between midazolam
      fentanyl and alcohol (no potentiating of effects of alcohol by i.v. sedation). We
      conclude that the effects of benzodiazepines and opioids that are short-acting
      and used in outpatient surgery have probably dissipated by the time a patient
      arrives home, and that effects from alcohol ingested at home will probably not be
      affected by recent administration of these drugs.

PMID- 1751273
TI  - Clinical and haemodynamic effects of milrinone in the treatment of low cardiac
      output after cardiac surgery.
AB  - We have studied the haemodynamic effects of i.v. milrinone, a new
      phosphodiesterase inhibitor, in patients with low cardiac output after cardiac
      surgery. Thirty-five patients with a cardiac index (Cl) less than 2.5 litre min-1
      m-2 and a pulmonary capillary wedge pressure (PCWP) greater than 8 mm Hg were
      given a loading dose of milrinone 50 micrograms kg-1 followed by an infusion at
      one of three rates: 0.375 micrograms kg-1 min-1, 0.5 micrograms kg-1 min-1 or
      0.75 micrograms kg-1 min-1 for 12 h. After 1 h there were increases in Cl (35%)
      (P less than 0.001), heart rate (13%) (P less than 0.01) and stroke volume index
      (19%) (P less than 0.005). There were decreases in mean arterial pressure (12%)
      (P less than 0.01), systemic vascular resistance (35%) (P less than 0.001) and
      PCWP (24%) (P less than 0.05). Pulmonary vascular resistance was unchanged or
      reduced and left ventricular stroke work index was unchanged or increased. The
      haemodynamic improvements were sustained throughout the infusion period.
      Milrinone was tolerated well: three patients developed tachycardia greater than
      125 beat min-1, one patient developed atrial fibrillation and one patient had a
      short run of atrial bigemini. We conclude that milrinone is a useful agent in the
      treatment of patients with a reduced cardiac output after cardiac surgery.

PMID- 1751274
TI  - Renal function after cardiopulmonary bypass in children: comparison of dopamine
      with dobutamine.
AB  - We have compared low dose dopamine with dobutamine in conserving renal function
      in 142 children younger than 10 yr undergoing cardiopulmonary bypass (CPB).
      Patients were allocated randomly to receive a continuous infusion of either
      dopamine 2.5 micrograms kg-1 min-1 (group 1) or dobutamine 2.5 micrograms kg-1
      min-1 (group 2) from the time of induction of anaesthesia. Administration of
      inotropes and diuretics was controlled strictly to agreed regimens. There was no
      clinical or statistically significant difference between the two groups in
      postoperative urine output, serum concentration of creatinine, fractional sodium
      excretion or need for diuretic therapy. This was true also of the subgroup of
      patients who received no other inotropic support. However, the subgroup of
      patients in group 1 who underwent periods of CPB in excess of 2 h (n = 17) had
      persistently greater postoperative serum concentrations of creatinine. Low dose
      dopamine did not appear to be superior to dobutamine for protection of renal
      function in these patients.

PMID- 1751275
TI  - Modification by drugs used in anaesthesia of CNS stimulation induced in mice by
      laudanosine and strychnine.
AB  - We have investigated in mice the effects of several drugs which may be
      administered as part of an anaesthetic technique on the convulsive threshold to
      laudanosine and to strychnine, which is reported to have a similar mechanism of
      action. I.v. administered propofol, thiopentone and midazolam increased the dose
      of convulsant necessary to produce seizure when administered 2 min before the
      convulsive stimulus. In contrast, methohexitone and etomidate exhibited a
      proconvulsant effect, although with the latter this was significant only in
      laudanosine-treated mice. Pethidine was proconvulsant in both laudanosine- and
      strychnine-treated mice, but morphine was proconvulsant only in strychnine
      treated mice. The effects of morphine, but not pethidine, were antagonized by
      naloxone 1 mg kg-1. Laudanosine, but not strychnine caused arousal from
      anaesthesia in subconvulsive doses. This and other evidence suggests that the
      mechanism of the CNS excitation produced by strychnine and laudanosine are not
      the same.

PMID- 1751276
TI  - Determination of contamination of a chemical warfare-proof operating theatre with
      volatile anaesthetic agents and assessment of anaesthetic gas scavenging systems.
AB  - Three types of anaesthetic waste scavenging systems (active antipollution system,
      Papworth Block passive system and activated charcoal absorber system) were
      compared with a non-scavenging control to assess their effectiveness in reducing
      waste halothane concentrations in a chemical warfare-proof operating theatre. All
      three systems were found to reduce the level of pollution significantly.

PMID- 1751277
TI  - Haemodynamic effects of propofol: induction with 2.5 mg kg-1.
AB  - Serial measurements of haemodynamic variables were performed at 1-min intervals
      in nine ASA I, unpremedicated patients before and for 5 min after induction of
      anaesthesia with propofol 2.5 mg kg-1. End-tidal carbon dioxide concentration was
      maintained within the normal range. Stroke volume and left ventricular function
      were measured by Doppler and cross-sectional echocardiography at the aortic
      valve. Systemic arterial pressure was measured by automated oscillotonometry and
      heart rate by electrocardiograph. Stroke volume, cardiac output, systemic
      vascular resistance, left ventricular stroke work and rate-pressure product were
      calculated. There was a decrease at all time points in systolic, mean and
      diastolic arterial pressure. There was an initial increase in heart rate and
      cardiac output, with a subsequent decrease to less than baseline. There was an
      initial decrease in systemic vascular resistance followed by partial recovery,
      and a delayed decrease in left ventricular function as measured by peak aortic
      blood flow velocity and acceleration.

PMID- 1751278
TI  - Inverse correlation between the peak venous serum concentration of bupivacaine
      and the weight of the patient during interscalene brachial plexus block.
AB  - Thirty-five adult patients with rheumatoid arthritis received for 36 interscalene
      brachial plexus blocks a standard dose of bupivacaine 200 mg, regardless of the
      weight (range 39.2-102.5 kg) of the patient. The peak venous serum concentrations
      (Cmax) of bupivacaine, measured by HPLC, were in the range 0.82-4.30 mg litre-1;
      there were no signs of toxicity. There was a very significant inverse correlation
      between the Cmax of bupivacaine and the weight of the patient (r = -0.5922; t = 
      4.285; P = 0.0001, Pearson's test). In spite of the correlation, only 35.1% of
      the total variance could be explained by regression. Thus weight had little
      influence on Cmax under interscalene brachial plexus block.

PMID- 1751279
TI  - Postoperative myocardial ischaemia: temporal association with nocturnal
      hypoxaemia.
AB  - Three patients presenting for elective aortic surgery were studied before
      operation and for up to 3 days after operation with ambulatory
      electrocardiographic monitoring and nocturnal pulse oximetry. Supplementary
      oxygen was administered for the first 2 days after operation and withdrawn on the
      3rd morning after operation. Heart rate remained increased for the first 3 days
      after operation. Two patients developed episodes of myocardial ischaemia during
      the first 48 h after operation while their arterial oxygen saturation remained
      greater than 90%. On the third day, and during the third night after operation,
      both the severity and duration of myocardial ischaemia increased markedly,
      associated with arterial hypoxaemia. A temporal relationship between decreases in
      oxygen saturation and fluctuations in ST segment level were observed in the three
      patients.

PMID- 1751280
TI  - Unusual presentation of acute upper airway obstruction caused by an anterior
      mediastinal mass.
AB  - We report an unusual case of acute upper airway obstruction. Inhalation of a
      foreign body caused choking in a 5-yr-old child, but subsequent investigations
      revealed a large anterior mediastinal tumour, externally compressing the trachea
      and the main bronchi. Such a presentation may be deceptive and is important, as
      general anaesthesia may result in complete airway obstruction with fatal
      consequences.

PMID- 1751281
TI  - Transient ischaemic attack after spinal anaesthesia.
AB  - A case of transient ischaemic attack lasting 6 h occurred after spinal
      anaesthesia with bupivacaine. The level of sensory block was satisfactory and
      there was no significant hypotension. We discuss the possible cause of this
      previously undescribed complication.

PMID- 1751282
TI  - Temperature dependence of led and its theoretical effect on pulse oximetry.
AB  - Ambient temperature is known to affect the emission spectrum of a light-emitting
      diode (LED). This study has investigated the effect of changes in ambient
      temperature on the emission spectra of two LED with peak emission wavelengths
      similar to those used in pulse oximetry. There was a 5.5-nm increase in the peak
      wavelength for a 660-nm LED, and a 7.8-nm increase in the peak wavelength for a
      950-nm LED as temperature increased from 0 to 50 degrees C. Using a simple
      theoretical model based on the Beer-Lambert law, the effect of these shifts in
      wavelength on pulse oximeter accuracy was examined and found to be negligible
      over the temperature range studied.

PMID- 1751283
TI  - Fresh gas requirement of the Bain system.

PMID- 1751284
TI  - Anaesthesia and bone marrow aplasia.

PMID- 1751285
TI  - Speed of onset of analgesia of diamorphine or morphine.

PMID- 1751286
TI  - Isoprenoid modification and plasma membrane association: critical factors for ras
      oncogenicity.
AB  - Association of ras protein with the plasma membrane is critical for its
      transforming activity. This association is promoted by a series of post
      translational modifications that are signaled by the consensus C-terminal CAAX
      motif present in all ras proteins. The recent discovery that a 15-carbon
      isoprenoid (farnesyl) group, derived from an essential intermediate in
      cholesterol biosynthesis, is attached covalently to ras proteins has stimulated
      considerable interest and has suggested several important new directions for ras
      studies. In particular, one promising pharmacologic approach for antagonizing
      oncogenic ras activity in human malignancies would be to design specific
      inhibitors of the enzymes that catalyze ras processing and thereby interfere with
      ras protein association with the plasma membrane.

PMID- 1751287
TI  - The DNA-activated protein kinase, DNA-PK: a potential coordinator of nuclear
      events.
AB  - DNA-PK is a moderately abundant serine/threonine protein kinase found in the
      nucleus of a wide range of eukaryotic cells. It is one of the few known cellular
      enzymes whose activity is regulated directly by DNA. Many DNA binding proteins,
      including a number of transcription factors, are substrates for DNA-PK in vitro.
      We suggest that this kinase may coordinate signal transduction pathways and
      nuclear events, including transcription, in response to changes in DNA or
      chromatin state.

PMID- 1751288
TI  - Maud Slye.

PMID- 1751289
TI  - Skeletal imaging in metastatic disease.
AB  - Radionuclide bone scanning is a well-established technique for the investigation
      of suspected metastatic disease to bone. Most commonly, primary cancers of
      breast, prostate, and lung tend to metastasize to the skeleton. Current topics on
      the role of bone scanning in patients with these conditions are reviewed. Despite
      the now known sensitivity of MR imaging for the detection of bone marrow
      involvement, bone scanning continues to be the methodology of choice in view of
      its simplicity, low cost, and ability to screen the whole body. Tumor markers
      such as prostate-specific antigens have a new role in the investigation of
      metastasis arising from prostate carcinoma; this area is also reviewed. Although
      bone-seeking radionuclide tracers have, on the whole, remained unchanged from a
      diagnostic point of view, new bone-seeking tracers have been developed for the
      treatment of unremitting pain in patients with multiple secondary tumors to the
      skeleton. This new area appears particularly promising and will widen the scope
      of the radionuclide tracer method as a therapeutic modality. Single-photon
      emission CT is helpful in improving the more exact localization of areas of
      increased tracer uptake in the skeleton and is therefore more often used as an
      imaging methodology.

PMID- 1751290
TI  - 201Tl myocardial perfusion imaging.
AB  - Despite predictions that 201Tl imaging would be completely supplanted by the new
      99mTc perfusion agents, thallium perfusion imaging is alive and well. In fact, in
      the past year, important new information on thallium imaging continued to emerge.
      Among the new data, the reinjection of a "booster" dose of 201Tl after the
      redistribution images has been heralded as a breakthrough that would equal
      positron-emission tomography in the prediction of myocardial viability.
      Pharmacologic coronary vasodilation has been increasingly popular, especially
      since the approval of intravenous dipyridamole by the Food and Drug
      Administration and in view of recent studies showing that adenosine is a very
      attractive alternative to dipyridamole in patients who cannot exercise. Beyond
      the undisputed diagnostic value of dipyridamole-thallium imaging, data on risk
      stratification continue to accumulate for patients receiving peripheral vascular
      surgeries as well as for those recovering from a myocardial infarction. The
      advent of single-photon emission CT in combination with 201Tl imaging allows
      improved quantification of jeopardized myocardium. This technique has now been
      used increasingly to complement the information obtained from coronary
      angiography by the determination of the functional significance of known coronary
      stenoses. Recent studies have shown marked heterogeneity in the extent of
      jeopardized myocardium in patients with coronary artery disease. Equally
      important have been recent reports on the high prevalence of silent ischemia in
      patients undergoing 201Tl exercise scintigraphy. Technical progress has also
      enhanced the diagnostic capability of 201Tl imaging, allowing sharper
      identification of perfusion defects and quantification of reversible myocardial
      ischemia precipitated by exertion. Finally, one of the most exciting areas of
      research in thallium scintigraphy is its established prognostic value in patients
      with stable angina or those recovering from a myocardial infarction. Recently,
      these prognostic data have also been extended to patients with unstable angina or
      those receiving thrombolytic therapy.

PMID- 1751291
TI  - 99mTc myocardial perfusion imaging.
AB  - For more than 15 years, 201Tl has been used for measuring myocardial perfusion
      and viability although its physical characteristics, which include a photon
      energy of 68 to 80 keV and a physical half-life of 73 hours, are far from ideal.
      In early 1991, 99mTc tracers from the group of compounds known as isonitriles and
      boronic acid adducts of technetium dioximes (BATO) compounds were made available
      for general use in the United States, with approval by the Food and Drug
      Administration in late 1990. The uptake of these agents in the myocardium is
      proportional to regional blood flow. Because these tracers have 99mTc as the
      radiolabel, they have better physical characteristics--a gamma photon energy of
      140 keV and a half-life of 6 hours--than 201Tl. The isonitrile with the best
      properties for myocardial imaging is 99mTc-hexakis-2-methoxyisobutyl isonitrile
      (MIBI) (Cardiolite, DuPont, Wilmington, DE). It has transient hepatic uptake and
      little or no myocardial redistribution, making it an ideal single-photon emission
      CT tracer. The commercially developed agent of the BATO group is 99mTc-teboroxime
      (Cardiotec, Squibb, Princeton, NJ). Its extraction fraction by the myocardium is
      higher than that of 201Tl and 99mTc-MIBI but its washout is very rapid and flow
      related. Because of the lack of redistribution with 99mTc-MIBI and the rapid
      washout with 99mTc-teboroxime, two separate injections are necessary for these
      new tracers to enable them to distinguish ischemia from scar tissue. It is
      recommended to perform the rest study first, and then to do the exercise study if
      a 1-day protocol is being used.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751292
TI  - Cardiac applications of positron-emission tomography.
AB  - Positron-emission tomography is an advanced imaging technology that can be used
      for the noninvasive evaluation of myocardial blood flow, determination of
      myocardial metabolism, and the assessment of myocardial tissue viability. 82Rb
      and 13N-ammonia represent the most commonly used tracers for qualitative
      evaluation of regional myocardial perfusion. In combination with pharmacologic
      vasodilation, these agents provide accurate detection of coronary artery disease.
      Comparative studies using single-photon emission CT with 201Tl have shown 82Rb
      positron-emission tomography to be superior in terms of diagnostic accuracy. The
      use of tracer kinetic modeling with the radiopharmaceuticals 15O-water or 13N
      ammonia has allowed accurate quantification of myocardial blood flow and
      determination of regional coronary flow reserve using dynamic positron-emission
      tomography imaging. The labeling of metabolic substrates such as 11C-palmitate,
      11C-acetate, and 18F-fluorodeoxyglucose has proven to be useful in evaluating
      cardiac metabolism. The use of fluorodeoxyglucose uptake as a marker of exogenous
      myocardial glucose utilization allows the differentiation of ischemic but viable
      tissue from myocardial scar. The relationship of 11C-acetate turnover to
      oxidative metabolism and myocardial oxygen consumption may have important future
      applications for evaluating the efficiency of energy conversion of the heart into
      external work. Such a parameter could be used to evaluate the condition of
      patients with impaired left ventricular performance and to assess their response
      to therapy. Positron-emission tomography offers a useful research and clinical
      tool for the noninvasive evaluation of many aspects of cardiac disease. With the
      development of quantitative techniques, the clinical importance of positron
      emission tomography is expected to further increase in the future.

PMID- 1751293
TI  - Nuclear medicine detection of inflammation and infection.
AB  - The diagnosis and localization of inflammation and infection by nuclear medicine
      techniques continue to improve. The past year has seen a number of innovations
      and improvements in both commonly used radiopharmaceuticals and those still in
      the research phase. A good, in-depth knowledge of the many pathophysiologic
      changes that can occur at various sites and with different etiologies remains
      important in understanding and choosing which tests are most likely to provide
      useful clinical information. A number of important publications over the past
      year are reviewed.

PMID- 1751294
TI  - Hepatobiliary imaging.
AB  - Recent publications continue to refine the technique and interpretation of
      hepatobiliary scanning. Studies related to the evaluation of suspected acute
      cholecystitis have shown that morphine-augmented hepatobiliary imaging may not
      overcome the problem of false-positive study results in severely ill patients and
      the criterion for a normal study should be gallbladder visualization within 30
      rather than 60 minutes. In patients with suspected acute cholecystitis,
      nonvisualized extrahepatic activity despite good hepatic uptake is highly
      predictive of acute cholecystitis, usually with biliary obstruction. The
      limitations of cholecystokinin-hepatobiliary imaging studies in patients with
      abdominal pain syndromes were defined and its use in evaluating common bile duct
      dynamics, and duodenogastric reflux was explored. Unusual findings and less
      common uses of hepatobiliary scanning were reported, including assessment of
      conjoined twins, liver transplantation, primary biliary cirrhosis, gallbladder
      perforation, and persistent splenic visualization.

PMID- 1751295
TI  - Pulmonary nuclear medicine.
AB  - The major nuclear medicine contribution to the pulmonary imaging literature for
      the past year was the inaugural report from the Prospective Investigation of
      Pulmonary Embolism Diagnosis study. Investigations focusing on the role of
      thrombolytic agents for the management of pulmonary thrombosis have advanced to
      the stage in which different therapeutic regimens are being tested along with new
      agents that continue to emerge. Ongoing research and clinical trials are
      evaluating newer radiolabeled aerosols in patients with airways and interstitial
      lung disease using imaging and clearance measurements. Positron-emission
      tomography continues to be utilized in a few research centers for tumor
      localization and characterization.

PMID- 1751296
TI  - Nuclear oncology.
AB  - Nuclear scintigraphy in the evaluation of patients with cancer is a significant
      part of the practice of clinical nuclear medicine. The oncologic applications in
      nuclear medicine are dynamic in that traditional techniques are undergoing change
      due to the development of new pharmaceutical agents and instrumentation. New
      scintigraphic applications in oncologic diagnosis, staging, and monitoring of
      therapy are emerging. The impact of these tests on the clinical management of
      cancer is significant.

PMID- 1751297
TI  - Neuronuclear medicine.
AB  - The importance of the development of the medical neurosciences is evidenced by
      the fact that the President of the United States and Congress have declared the
      1990s the "decade of the brain." Special emphasis will be placed on managing and
      treating brain disease and, in particular, salvaging damaged brain from cerebral
      artery disease, trauma, tumor, and so forth. The advent of brain or cerebral care
      units in hospitals can be anticipated, analogous to the commonly available
      coronary care unit that resulted from recent concerted efforts to "conquer" heart
      disease. This effort will probably lead to a markedly expanded purview for
      clinical research in central nervous system disease. During the past year, a
      virtual explosion of publications in the mainstream medical literature on the
      basic and clinical utilization of nuclear medicine in the neurosciences has
      occurred. More than 400 substantive papers were published and the majority dealt
      with some aspect of positron-emission tomography. The more clinically pertinent
      of these papers are reviewed.

PMID- 1751298
TI  - Imaging of the skeleton and soft tissue in children.
AB  - Normal metaphyses in infants contain a step-off not to be confused with child
      abuse. Extension of physeal lucency into the metaphyses can be a sign of healing
      child-abuse fracture of experimental physeal fracture, as well as deferoxamine
      overdose. Sonography can reveal costochondral dislocation, the pattern of healing
      fracture callus, the patellar tendon in jumper's knee, synovium of rheumatoid
      arthritis, sequestrum in advanced osteomyelitis, the unossified dislocated
      patella, and, even after 2 years of age, the dislocated femoral head. Further
      developments concern bone scanning, MR imaging, CT, and plain films of specific
      trauma, tumor, and infectious, metabolic, and orthopaedic conditions. Ultrasound
      has been proven useful for radiologist removal of soft tissue foreign bodies,
      whereas CT can be helpful for osteoid osteoma nidus removal under imaging
      control.

PMID- 1751299
TI  - Imaging of the brain in children.
AB  - As proclaimed by the National Institutes of Health, the 1990s have been
      designated the "decade of the brain." Within this decade, we can expect to see an
      emergence of functional imaging in addition to the traditional role of anatomic
      neuroimaging to separate normal from pathologic anatomy. Technical advances
      continue to redefine the upper limits of resolution for both anatomic and
      functional imaging and provide us with a greater understanding of how disease
      processes affect normal brain growth and development. For example, whereas
      improvements in anatomic resolution will provide greater insight into
      understanding congenital malformations of the brain, through functional imaging,
      we will better understand the effect of disease on normal brain growth and
      development.

PMID- 1751300
TI  - Imaging modalities for the pediatric spine.
AB  - The role of MR imaging is emphasized in the evaluation of paraspinal and
      intraspinal soft tissue abnormalities. The technical aspects in performing a high
      resolution MR image of the pediatric spine in reference to imaging parameters,
      sedation protocol, and the use of intravenous gadolinium are detailed. The
      changes in the normal pediatric spine on MR imaging are demonstrated. The
      diagnosis and evaluation of specific intraspinal and paraspinal neoplastic
      disorders in infants and children are outlined in terms of their clinical
      presentation and MR characteristics.

PMID- 1751301
TI  - Pediatric chest imaging.
AB  - Several new therapies have resulted in marked improvement in morbidity and
      mortality rates for neonates with respiratory distress syndrome and related
      disorders. These therapies include the use of exogenous surfactant to treat
      existing surfactant deficiency in babies with respiratory distress syndrome.
      Follow-up of patients previously treated with extracorporeal membrane oxygenation
      for diaphragmatic hernia has shown continued pulmonary function abnormalities
      despite this therapy. Follow-up studies have also shown significant neurologic
      abnormalities. New uses of ultrasonography include scanning of the larynx and
      airway for evaluating retropharyngeal and parapharyngeal infections and
      evaluating perithyroidal inflammation secondary to congenital fistulas in this
      region.

PMID- 1751302
TI  - Imaging of the pediatric cardiovascular system.
AB  - Magnetic resonance imaging has become increasingly useful in the assessment of
      pediatric congenital heart disease. Spin-echo, gradient-echo, and cine techniques
      allow for both anatomic and functional cardiac assessment. MR imaging has proven
      most valuable in assessing complex heart disease and in visualizing areas that
      are sometimes poorly seen on echocardiographic studies. In particular, the
      anatomy of the aorta, central pulmonary arteries, and veins are usually well
      defined on MR imaging. Duplex and color Doppler sonography have become
      indispensable for evaluating the major vessels of the abdomen. The presence of
      clot, and quantity and quality of vascular flow as well as changes over time and
      response to therapy are readily assessed. Pulmonary sequestration is just one
      example of the burgeoning utility of duplex and color Doppler sonography in
      evaluating abdominal, mediastinal, and juxta-diaphragmatic masses. Sonography
      shows promise as a simple and accurate method for rapidly identifying the
      aberrant systemic blood supply in suspected cases of sequestered lung.

PMID- 1751303
TI  - Pediatric interventional radiology.
AB  - Hydrostatic reduction of intussusception has, until recently, been accomplished
      using barium sulfate or meglumine sodium diatrizoate, and has resulted in
      successful reduction in up to 80% of cases. Pneumatic reduction is an old
      technique but is new to North America. In a short time, air reduction has been
      widely accepted. It is easy to perform and success is achieved in over 80% of
      cases. The advantages of pneumatic reduction include a lower cost, shorter
      procedure time, and if perforation occurs, there is a lower likelihood of fecal
      contamination of the peritoneum. The vein of Galen malformation was initially
      described in 1895. The age at which symptoms occur and the severity of the
      clinical syndrome depend on the magnitude of arteriovenous shunting. Cross
      sectional imaging techniques are helpful for diagnosis and management planning.
      In infants with high-output congestive heart failure, neurointervention is now
      the treatment of choice.

PMID- 1751304
TI  - Pediatric genitourinary imaging.
AB  - The reviewed articles herein deal with morphologic as well as functional aspects
      of the pediatric genitourinary tract. Structural considerations, pathogenesis,
      and differential diagnostic criteria are the main focus in tumorous and
      nontumorous parenchymal and vascular diseases of the kidney and in malformations
      of the postrenal urinary and genital tracts including cloacal abnormalities. A
      number of case reports are included because they contain unusual yet important
      conditions and concepts of which the pediatric radiologist should be aware. Size,
      structure, and metabolic aspects of the adrenals and testes in congenital adrenal
      hyperplasia have been reported. Color Doppler ultrasonography in the context of
      acute scrotal disease was emphasized. Further diagnostic and therapeutic
      management of newborns and infants with prenatally diagnosed hydronephrosis
      underline the importance and consequence of fetal ultrasonography. Interventional
      procedures are somewhat limited in children, but the development of the biopsy
      gun that is now used in renal biopsies is a major improvement with regard to
      time, effectiveness, and safety of the procedure. Studies on measurement and
      variations conclude this review.

PMID- 1751305
TI  - Nuclear medicine.

PMID- 1751306
TI  - Pediatrics.

PMID- 1751307
TI  - The molecular genetics of systemic lupus erythematosus and Sjogren's syndrome.
AB  - With recent advances in understanding of the organization, complexity, and
      function of the major histocompatibility complex and other genes involved in the
      immune response, a rational approach to interpreting associations of systemic
      lupus erythematosus and Sjogren's syndrome with these genes is now possible. For
      example, both systemic lupus erythematosus and Sjogren's syndrome appear to be
      heterogeneous syndromes comprised of different major histocompatibility complex
      mediated (and perhaps T-cell receptor-and immunoglobulin genes-mediated)
      autoantibody responses. Moreover, HLA class II associations with systemic lupus
      erythematosus- and Sjogren's syndrome-linked autoantibody responses seem to be
      better explained by specific amino acid residues or epitopes on these class II
      heterodimers, residues or epitopes putatively involved in the binding and
      presentation of processed antigen to the T-cell receptor that can be shared by
      different class II alleles. These basic themes underlie this review of recent
      work in the immunogenetics of these autoimmune diseases.

PMID- 1751308
TI  - Autoantibodies and their idiotypes.
AB  - Idiotypes are serologically defined markers in the variable region of an antibody
      molecule. In the study of autoimmunity, these markers have been valuable probes
      in defining patterns of autoantibody variable region gene utilization, mechanisms
      of immune dysregulation, and the operation of the network in the generation of
      abnormal responses. Recent advances in the molecular analysis of immunoglobulin
      genes have provided insights into the structural basis of autoantibody idiotypes
      and the manner in which sequence homologies between idiotype-bearing antibodies
      and autoantigens can lead to autoreactivity. Immune manipulation using these
      sequences could lead to novel models of disease as well as prospects for
      immunotherapy.

PMID- 1751309
TI  - Murine models for systemic lupus erythematosus and Sjogren's syndrome.
AB  - Of the types of defects that have been observed in autoimmune mice, two are
      common to most strains and appear to be of critical importance in the development
      of autoimmune disease. The first of these is a deficiency in the maintenance of
      self-tolerance by B or T lymphocytes. This is an intrinsic defect due to genetic
      abnormalities that presumably affect an early developmental signaling mechanism.
      The disruption of early B- and T-cell development leads to the appearance of
      lymphocytes that are predisposed to loss of tolerance. In certain strains of
      autoimmune mice, it also leads to overproduction of Ly1+ (CD5+) B cells or CD4
      CD8-B220+ T cells, which apparently do not contribute to autoimmunity. The second
      type of defect is a strain-specific, antigen-driven autoimmune disease syndrome.
      This defect is limited by the affinities of the available T-cell receptor and
      immunoglobulin variable regions and the efficiency of antigen presentation.
      Current evidence suggests that the major histocompatibility complex molecules
      play the most important role in determining which autoantigens lead to a
      pathogenic antigen-driven immune response. For example, the type and magnitude of
      the autoimmune response may be directed by the production of specific cytokines.
      The type of antigen and the context of its presentation can bias the production
      of cytokines that favor the production of the Th2 subset of CD4+ T helper cells.
      These cells secrete predominantly interleukin-4, interleukin-5, and interleukin
      10, and may contribute to a chronic response and autoimmune disease.

PMID- 1751310
TI  - Clinical manifestations of disease activity, its measurement, and associated
      morbidity in systemic lupus erythematosus.
AB  - Although nephritis remains a very important clinical disease manifestation of
      systemic lupus erythematosus (SLE), the focus has shifted from issues of
      mortality to morbidity. An improved method for measuring renal function is
      presented, and the value of renal biopsy, specifically the chronicity index, is
      confirmed as a predictor of end-stage renal disease. Several studies detailing
      the generally favorable course in SLE patients with renal failure who have
      eventually required chronic dialysis or renal transplantation are discussed. A
      high frequency of cardiovascular manifestations, often subclinical, is
      documented, including abnormalities of ventricular and valvular function. The
      clinical course and response to treatment of SLE patients with diffuse
      interstitial lung disease and pulmonary hypertension are outlined. Cases of the
      unusual gastrointestinal presentation of protein-losing enteropathy in SLE have
      been described by several authors. The clinical correlates and significance of
      persistent rheumatoid-like arthritis and radiologic erosive and cystic bony
      lesions in SLE are discussed. Serologic markers of specific SLE disease
      manifestations and general predictors of disease activity are evaluated.
      Complications related to infection, malignancy, and pregnancy are described.

PMID- 1751311
TI  - Prognosis of systemic lupus erythematosus and the factors that affect it.
AB  - The prognosis of systemic lupus erythematosus has improved over the past four
      decades. Articles published in the past year continue to demonstrate this
      improved survival, both overall and in patients with renal disease. Several
      factors may be associated with improved survival, including earlier diagnosis,
      better treatment for systemic lupus erythematosus, and improved medical therapy
      in general. Hydroxychloroquine has now clearly been shown to prevent flares, and
      ancrod has been shown to improve renal disease in patients with glomerular
      thrombosis. Treatment with dialysis and transplantation resulted not only in
      improved survival but also in improved renal status, and reduction in overall
      disease activity. Specific organ damage continues to be an issue, primarily with
      regard to kidney disease and neurocognitive impairment. The inclusion of health
      status assessment in the evaluation of patients with lupus, and as an outcome
      measure, is discussed.

PMID- 1751312
TI  - Treatment of systemic lupus erythematosus.
AB  - Reports on a variety of therapies for systemic lupus erythematosus have been
      published over the past year. Most of these are single case reports or open
      studies. As reported last year in this journal, the potential uses of intravenous
      gamma globulin and plasmapheresis continue to be explored. The use of
      cyclophosphamide for nonrenal manifestations follows studies last year of its use
      for lupus nephritis. No major double-blind studies of therapy for lupus nephritis
      were published; however, the course of lupus patients receiving dialysis or
      grafts was the subject of three interesting studies. An interesting study on the
      ability of hydroxychloroquine to prevent disease exacerbations was also
      published. In summary, the reports of therapy over the past year represent
      variations on themes. The use of new agents will most likely be based on
      improvements in our understanding of the pathogenesis of systemic lupus
      erythematosus.

PMID- 1751313
TI  - Drug-related lupus.
AB  - All physicians should be alerted to the many drugs and other agents that are
      associated with drug-related lupus, as there is an increasing number of such
      drugs. A wide range of immune responses and antibodies are being reported with
      this syndrome. A new concern is the perceived ability of new biologic treatments
      to induce these autoimmune phenomena. More in-depth studies of various
      environmental factors are providing new insights into possible mechanisms. These
      include the immune responses to the drugs, their metabolites, and drug-altered
      conjugates; bioactivation mechanisms of drug protein conjugation; the role of
      macrophages in antigen recognition and processing; and lastly, the important role
      of the acetylation of various drugs and the relationship to immunogenetic
      factors. Continued study of this human experimental model of lupus will help to
      clarify the etiology and mechanisms of systemic lupus erythematosus itself.

PMID- 1751314
TI  - New developments in Sjogren's syndrome.
AB  - Over the past months, noteworthy contributions to our understanding of the
      clinical manifestations of Sjogren's syndrome have been made. Scintigraphic and
      echographic techniques have been refined to document xerostomia. Various systemic
      complications, such as nervous system involvement, pulmonary lesions, gastric and
      pancreatic dysfunction, and Raynaud's phenomenon have been further described.
      Mast cells have been shown to participate in the salivary gland infiltration,
      together with T lymphocytes, of which the majority are of the memory
      helper/inducer phenotype. Antinuclear antibodies are directed to SS-A/Ro and SS
      B/La particles. Two studies have been devoted to the cloning of the DNA encoding
      the 52-kD component of the former, and a series of SS-B/La DNA fragments have
      been generated to analyze the peptides of the latter. Virologic data have been
      provided, particularly the detection of anti-human immunodeficiency virus type 1
      p24 protein in a number of Sjogren's syndrome patients, and the discovery of a
      human intracisternal A-type retroviral particle in lymphoblastoid cells exposed
      to homogenates of salivary tissue from patients with Sjogren's syndrome.

PMID- 1751315
TI  - Rheumatic fever, reactive arthritis, and musculoskeletal infections in children.
AB  - Infections may cause musculoskeletal symptoms either by inducing reactive disease
      or by directly infecting bone, joints, or muscle. Differentiation of reactive
      disease from direct infections of the musculoskeletal system is an important
      clinical problem. Both reactive disease and direct infections result from
      interactions of the host, the environment, and the infecting agent. This review
      provides an update of the recent literature on rheumatic fever, the classic
      example in rheumatology of reactive disease, and direct musculoskeletal
      infections.

PMID- 1751316
TI  - Genetic disorders of connective tissues.
AB  - Due to the growing knowledge of structure and function of extracellular matrix
      proteins, congenital abnormalities of connective tissues are identified or
      suspected in an increasing number of clinical disorders. In osteogenesis
      imperfecta and two subtypes of Ehlers-Danlos syndrome, the affected matrix
      proteins were identified and mutations in the corresponding genes (procollagen
      type I and type III, respectively) could be demonstrated. Some forms of
      chondrodysplasia were shown to be associated with mutations in the gene encoding
      for the cartilage-specific collagen (type II). In part, the clinical phenotype is
      determined by the tissue-specific distribution of these collagens. However, the
      correlation of location and character of the mutation to the phenotype is only
      just emerging and remains unpredictable in most cases. Recent findings suggest
      the mutations in matrix genes may be causative not only for rare pediatric
      diseases but also for more common disorders such as osteoarthritis or aortic
      aneurysms.

PMID- 1751317
TI  - Juvenile chronic arthritis and juvenile spondyloarthropathy.
AB  - Clinically recognized subgroups of juvenile chronic arthritis and the juvenile
      spondyloarthropathies are gradually being shown to be immunogenetically distinct;
      greater subdivision may ultimately be required. Mechanisms by which the
      association of certain genes work await further elucidation. Meanwhile, therapy
      such as intravenous gamma globulin may be most effective in systemic disease.
      Sulfasalazine is recommended for patients with later-onset pauciarticular
      disease, particularly HLA-B27 patients. Methotrexate should probably be reserved
      for severe unresponsive disease, particularly polyarthritis, until side effect
      profiles are better evaluated.

PMID- 1751318
TI  - Systemic lupus erythematosus, dermatomyositis, scleroderma, vasculopathies, and
      other connective tissue disorders in children.
AB  - The diverse disorders discussed in this review share the underlying features of
      multisystem involvement and vasculitis as a part of their pathophysiology. A
      review of morbidity seen in childhood-onset systemic lupus erythematosus reveals
      the need for careful monitoring for complications secondary to treatment and
      infections. Current understanding of the pathophysiology and risks of developing
      the neonatal lupus syndrome are reviewed, with the important recognition of the
      association of specific maternal autoantibodies with affected offspring. A review
      of current management issues in the treatment of juvenile dermatomyositis is
      discussed. Kawasaki disease, one of the most common childhood vasculitides,
      continues to provoke interest in the areas of accurate diagnosis, potential
      etiologic role of common viruses, management, and late morbidity. Interesting
      case reports of children with unusual features of the more rarely described
      disorders of Sjogren's syndrome, scleroderma, and Behcet's syndrome are
      discussed.

PMID- 1751319
TI  - Advances in pediatric orthopaedics.
AB  - New technology is fueling advances in pediatric orthopaedics. Ultrasonography
      represents a safe and highly accurate method of screening for hip dislocation and
      dysplasia that is superior to the clinical examination. Image intensification now
      provides a safe and more anatomically accurate method for the operative treatment
      of slipped capital femoral epiphysis. Magnetic resonance imaging allows for
      greater accuracy in the diagnosis of subtle neural abnormalities associated with
      congenital spinal deformities. Adjuvant chemotherapy and the treatment of
      osteogenic sarcoma have greatly improved the survival rate and permitted the use
      of limb-sparing procedures in children.

PMID- 1751320
TI  - Systemic lupus erythematosus and Sjogren's syndrome.

PMID- 1751321
TI  - Pediatric and heritable disorders.

PMID- 1751322
TI  - [The principles of radical surgery for colorectal cancer].

PMID- 1751323
TI  - [The evolution of immunosuppression in clinical kidney transplantation: the
      experience of 700 cases].
AB  - Kidney transplantation was first introduced in Italy in 1966 by the II Surgical
      Pathology of the University of Rome giving a great contribution to the
      development of the transplant surgery in this country. The authors report their
      25-year experience analyzing the results obtained in more than 700 kidney
      allografts. A progressive refinement in the surgical transplant technique both
      from cadaver and live as well as clinical trials on new immunosuppressive
      protocols characterized their work.

PMID- 1751324
TI  - Photodynamic therapy in general surgery.
AB  - Authors' experience in detecting neoplasms by a computerized telethermographic
      system in animal models is reported. The new technique seems to have a great
      potential as a photo-diagnostic method particularly when followed by the surgical
      treatment or the photodynamic therapy (PDT) of the neoplastic lesions. Literature
      reports on the PDT of tumors are reviewed.

PMID- 1751325
TI  - [The surgical therapy of morbid obesity: our experience].
AB  - The authors report their experience of two years in the surgical management of
      morbid obesity. The efficacy of the biliopancreatic diversion, method created by
      Nicola Scopinaro, is underlined. Sixteen patients affected by morbid obesity were
      treated with this method. Results obtained are comparable to those reported in
      literature; therefore the authors have been induced to continue in this
      direction.

PMID- 1751326
TI  - [Primary intrahepatic calculosis: hepatic lithotomy or hepatectomy?].
AB  - The authors discuss about the different surgical approaches in the management of
      primary intrahepatic stones, conforming their experience to literature reports.
      In the future they hope for a more conservative treatment on the basis of the
      good results obtained with percutaneous transhepatic fiber cholangioscopy
      (P.T.C.S.) and ultrasonographic extra-body lithotripsy recently adopted in the
      clinical practice.

PMID- 1751327
TI  - [Postoperative esophageal-visceral fistulae: their prevention and treatment].
AB  - A series of 12 cases of esophageal anastomotic leakage following esophageal
      surgery observed from 1969 to 1989 is retrospectively analyzed. In the period
      1969-1975 6 patients were treated in emergency and the mortality rate was 66.6%,
      while the remaining 6 patients observed from 1975 to 1989 were treated
      conservatively with total parenteral nutrition (sometimes associating adequate
      surgical drainage): the mortality rate was 16.6%. In conclusion, not only in the
      treatment of anastomotic leakage, but also in its prevention, artificial
      nutrition has a crucial role. The outcome of thoracic and abdominal fistulas
      depends mainly on adequate drainage, not necessarily surgical. Cervical fistulas
      heal in 2-4 weeks, but strictures arise frequently and respond to endoscopic
      dilatation.

PMID- 1751329
TI  - [The use of a new prosthesis for ureterocutaneostomy].

PMID- 1751328
TI  - [Infectious chemoprophylaxis in colorectal surgery. A multicenter study of
      imipenem-cilastatin vs. cefuroxime and metronidazole or cefotetan].
AB  - The authors report the results of a multicentric clinical study on prevention of
      surgical infections in colorectal surgery by chemo-antibiotic prophylaxis. This
      trial was carried on to evaluate the effect of imipenem-cilastatin (1 g i.v. just
      before operation and 1 g i.v. 3 hours from surgical procedure) vs. cefuroxime +
      metronidazole (1.5 g + 0.25 g i.v.) or cefotetan (1 g i.v.) given with the same
      modalities. In 48 patients undergoing colorectal resection (47 with malignant
      neoplastic disease) 24 were treated with imipenem, 18 with cefuroxime and 6 with
      cefotetan. In group A (imipenem-cilastatin) the infection rate was 4.2% (1/24
      cases), in group B (cefuroxime + metronidazole or cefotetan) postoperative
      infections were registered in 4 out of 24 cases (16.6%). This study documented
      the good results of systemic chemoprophylaxis and the great efficacy of imipenem
      cilastatin in colorectal surgery.

PMID- 1751330
TI  - [The use of human fibrin glue in fistulous pathology of the lung].
AB  - Currently, bronchopleural fistulas present a decreasing complication rate in
      thoracic surgery, especially since surgical management of tubercular infections
      is no longer needed. The introduction of non-reacting suture materials and the
      technological advances have also lowered the incidence of such complication.
      Although fistulas tend to be chronic, their treatment is possible. Today, in
      fact, the use of human fibrin glue gives positive results which depend on the
      extent of the fistula as well as the adherence of the glue to the bronchial wall.
      The authors report their experience in two cases treated with human fibrin glue.

PMID- 1751331
TI  - [Observations in sclerosing cholangitis].
AB  - Sclerosing cholangitis is a rare liver disease of unknown etiology with a slow
      but progressive course. The authors report their experience and illustrate some
      surgical procedures to preserve bile duct patency in view of a liver
      transplantation program.

PMID- 1751332
TI  - [A commendation of Prof. C. W. Lillehei on the occasion of the conferring of an
      honorary degree].

PMID- 1751333
TI  - [Anatomicosurgical study of the superior mesenteric vein].
AB  - Results of an autoptic study of the superior mesenteric vein in thirty cadavers
      are reported. The anatomo-surgical patterns of the venous axis are emphasized. In
      fact, a better knowledge of this vessel allows an easier and safer surgical
      approach during pancreatic resections.

PMID- 1751334
TI  - [Intensive therapy in general surgery].
AB  - A good diagnostic protocol as well as a proper preparation to surgery and a
      careful intensive observation (associated if necessary with an intensive therapy)
      can lead to a better prognosis in major surgical procedures or routine surgery in
      poor risk patients. Candidates to ICU are divided in three classes: type A is a
      stable patient requiring constant monitoring for high probability of
      complications, type B is still a stable patient who needs an intensive nursing;
      finally type C is an instable patient who requires a true intensive care. In the
      surgical department of USL 20/B Figline Valdarno (FI) a postoperative Intensive
      Care Unit (ICU) has been established in the last three years: a three-bed section
      with its own staff is located in the surgical department itself. In 37 months 467
      operated patients requiring intensive observation or intensive therapy have been
      admitted.

PMID- 1751335
TI  - [Nonepithelial nonlymphomatous tumors of the stomach].

PMID- 1751336
TI  - [A subclavian vein lesion due to the positioning of a chest tube via
      thoracostomy].
AB  - The authors describe an unusual complication of chest tube placement: subclavian
      vein lesion. After a literature review concerning complications of chest tube
      placement, the authors conclude that associated risks may be best minimized with
      a strict adherence to standardized technique and management protocol.

PMID- 1751338
TI  - [A case of ganglioneurofibroma of the lung].
AB  - A case of ganglioneurofibroma of the lung surgically managed is reported.
      Symptoms were those of an enlarging mass in the thorax. The essential clinical
      features of the condition are briefly discussed.

PMID- 1751337
TI  - [Respiratory complications in compressive goiters].
AB  - Authors' experience in respiratory complications of compressive goiter is
      reviewed. Three cases with typical symptoms, relative therapy and outcome are
      reported. Appearance of respiratory distress should urge to avoid delay in
      elective surgery performing. In case of acute respiratory failure, immediate
      emergency tracheostomy is mandatory, subsequently followed by elective
      intervention. In case of malignancy, if radical surgery is not possible,
      tracheostomy is the short and medium-term palliative surgical treatment of
      choice.

PMID- 1751339
TI  - [Acute appendicitis secondary to carcinoma of the right colon].
AB  - In a series of 954 laparotomies performed for suspected acute appendicitis 5
      (0.5%) cecal carcinomas were encountered. When considering patients over 50 years
      of age only, the incidence of right sided colon carcinomas raised to 5%. The
      authors review the therapeutic options in order to optimize patients' survival.

PMID- 1751340
TI  - [Morgagni-Larrey hernia: 2 clinical cases].
AB  - The authors report two cases of hernia of Morgagni, respectively observed in a 42
      year-old man and in a 16-year-old boy. In the first case the diagnosis was
      previous (20 yrs.) to surgical treatment. On the contrary, in the second case the
      diagnosis was not possible before surgery because of the patient's young age and
      mild symptoms. Surgical treatment, through thoracotomy in the first case and
      laparotomy in the second one, was able to repair the diaphragmatic gap.

PMID- 1751341
TI  - [Angiolymphoid hyperplasia with eosinophilia (Kimura's disease): an unusual
      pathology].
AB  - The authors report a case of Kimura's disease recently observed. Diagnostic
      problems related to this rare pathologic condition as well as current and most
      reliable etiopathogenetic hypothesis are emphasized. Histopathological and
      clinical features are described in detail.

PMID- 1751342
TI  - [Ketoprofen in the prevention of postoperative pain in abdominal surgery. A
      multicenter study].
AB  - Two-hundred-forty-eight patients undergoing abdominal surgery were admitted to a
      multicentric clinical trial. The patients were randomly assigned to a single i.v.
      dose of ketoprofen or acetylsalicylic acid, 15 minutes after the end of
      operation. Ketoprofen showed a better analgesic activity with a statistically
      significant difference at 2 and 4 hours after administration. Two patients
      treated with ketoprofen reported vomiting and skin rash respectively. The results
      of this study confirm the efficacy of ketoprofen for the prophylaxis of
      postoperative pain in abdominal surgery.

PMID- 1751343
TI  - [Esophagogastric devascularization in bleeding esophageal varices due to portal
      hypertension: median-term results].
AB  - The authors report their personal experience in the treatment of bleeding
      gastroesophageal varices related to portal hypertension. The excellent results of
      the esophagogastric devascularization observed in the middle-term follow-up (5
      years) reinforced authors' opinion on this surgical procedure as the most valid
      alternative to derivative surgery. Furthermore, they emphasize esophagogastric
      devascularization can often replace, on principle, derivative surgery.

PMID- 1751344
TI  - [Infections in surgery].
AB  - In this paper the authors review current concepts on surgical infections. Topics
      covered are: hospital-acquired surgical infections, prognostic indexes,
      antibiotic prophylaxis, surveillance and control measures.

PMID- 1751345
TI  - A comprehensive approach to the analysis and interpretation of the resonances of
      spins 3/2 from living systems.
AB  - An extensive protocol for the study of tissue resonances of spin 3/2 nuclei is
      described. The roles of the most relevant multiple pulse experiments are
      indicated. Their theory is organized in terms of irreducible tensor operators and
      the pulse and quadrupolar relaxation transfer functions which relate them for a
      type c spectrum. A systematic approach to the interpretation of the temperature
      and/or magnetic field dependences of all six of the relaxation rate constants of
      the resonance of a single population of isolated spins in fast exchange, and
      giving rise to a type c spectrum, is presented. An experimental calibration and
      an application of this protocol are presented in an accompanying paper. The
      comprehensive method we describe has a number of practical benefits in the
      interpretation of the physiological spectra obtained from conventional one pulse
      experiments. A consideration of the appropriate transverse relaxation transfer
      function leads to an analytical expression for the heretofore empirical NMR
      visibility factor. This includes factors which account for relaxation during the
      receiver 'dead' time and relaxation during the pulse itself. Also, consideration
      of realistic transverse relaxation times likely to be observed in tissue leads to
      a reasonable strategy for the quantitative resolution and integration of in vivo
      spectra obtained in the presence of hyperfine shift reagents.

PMID- 1751346
TI  - The molecular environment of intracellular sodium: 23Na NMR relaxation.
AB  - The comprehensive approach described in the accompanying paper is illustrated
      here with the 23Na signal of a concentrated solution of bovine serum albumin
      (BSA) in saline and the intracellular (Nai) 23Na resonance of a dense suspension
      of Na(+)-loaded yeast cells. We use frequency shift reagents to discriminate the
      latter from the extracellular resonance. We find that the Nai signal corresponds
      to that of an effective single population of Na+ ions exhibiting a single type c
      spectrum. This is true despite the fact that the yeast protoplasm is too large
      and too compartmentalized for a given Na+ ion to sample its entirety on the
      relevant NMR timescale. Our results show clearly that, in addition to the decay
      of transverse magnetization, the recovery of longitudinal magnetization is
      biexponential. This is required for a type c spectrum but has not often been
      detected. The temperature dependence of the relaxation rate constants of the Nai
      resonance is not consistent with either a simple Debye process or a discrete
      exchange mechanism connecting two sites in the fast limit. We have fitted the
      data using an asymmetric continuous distribution of correlation times for the
      fluctuations of electric field gradients sensed by the Nai nuclei. The analogous
      distribution function for the Na+ in a 44% (w/w) BSA solution is quite similar to
      that of the Nai at the same temperature. This suggests that while the
      macromolecular environment of the Nai ions is quite congested, it is also
      isotropic on quite a small spatial scale. Also, one can use the correlation time
      distribution function, obtained from fitting the relaxation data, to calculate a
      relaxometry curve. This is useful because experimental 23Na relaxometry is
      difficult. The calculated curve may be a reasonable model for the mostly
      extracellular 23Na resonance encountered in vivo.

PMID- 1751347
TI  - Characterization of a microcarrier cell culture system for 23Na MR spectroscopy
      studies.
AB  - A MR spectroscopy method is described for the simultaneous discrimination and
      observation of sodium from the three compartments created by an intact cell
      monolayer. Results are reported for Madin Darby Canine Kidney (MDCK) cells, an
      epithelial-like continuous cell line, cultured on Cytodex 1 microcarrier beads
      and perfused with medium containing 6 mM dysprosium (III) tripolyphosphate
      [Dy(TPP)2(7-)] as shift reagent. The sodium spectrum shows three resonances which
      are assigned to the shifted intrabead (basolateral) and extrabead (apical) pools
      and the unshifted intracellular pool. Ouabain inhibition of the Na(+)-K(+)-ATPase
      cellular pump mechanism was used to demonstrate the sensitivity of the method for
      monitoring intracellular sodium. The supported MDCK cells in this system remained
      viable after exposure for 5 h to medium containing Dy(TPP)2(7-) at a
      concentration of 6 mM, as determined by trypan blue dye exclusion and by
      comparison of the log growth rate and ability to form domes in subsequent
      generations of exposed cells vs unexposed controls.

PMID- 1751348
TI  - Cell adhesion in Hailey-Hailey disease and Darier's disease: immunocytological
      and explant-tissue-culture studies.
AB  - The pathogenesis of Hailey-Hailey disease and Darier's disease was investigated
      using immunocytological and explant-tissue-culture techniques. There was
      breakdown of the intercellular adhesions between keratinocytes in explants from
      clinically uninvolved skin of patients with Hailey-Hailey disease or Darier's
      disease. The major desmosomal components were present in the cultures and were
      expressed in a punctate peripheral pattern at cell-cell contact sites, but there
      was diffuse staining of acantholytic cells. Plasminogen, which is expressed by
      basal keratinocytes in normal skin, was detected in association with suprabasal
      acantholytic cells in skin biopsies from these diseases. Plasminogen was
      reversibly displaced from the cells by 6-aminohexanoic acid, suggesting that
      binding is mediated by a reaction with the lysine receptor on the plasminogen
      molecule. Plasminogen was also detected in separating cells in explant cultures
      and there was cytoplasmic expression of the plasminogen activator urokinase by
      these cells. These abnormalities are not unique to either disease and do not
      account for the phenotypic differences between Darier's disease and Hailey-Hailey
      disease, but plasmin generation may have a role in perpetuating cell separation.

PMID- 1751349
TI  - Diurnal variations in lower leg subcutaneous blood flow rate in patients with
      chronic venous leg ulcers.
AB  - The blood flow rate in subcutaneous adipose tissue was measured on the lower legs
      of 11 patients with chronic lower-leg venous insufficiency and ulceration and in
      eight age-matched control subjects for 12-20 h, under ambulatory conditions,
      using the 133Xe wash-out technique with portable Cadmium telluride (CdTe(Cl))
      detectors. In both groups, the change from an upright to a supine position at the
      beginning of the night period elicited an instantaneous increment in the blood
      flow rate of 30-40% with a decrease in the central and local postural sympathetic
      vasoconstrictor activity. After approximately 1 h of sleep, a considerable
      increase in blood flow rate was seen in both patient and control groups which
      persisted for nearly 100 min. In the patient group, the mean increase was 137%
      compared to a mean increase of 68% in the control group (P less than 0.01). The
      blood flow then returned to the same level as at the beginning of the night and
      remained stable until the subjects woke in the morning. The differences between
      this nocturnal hyperaemic phase and the adjacent phases were highly significant
      in both groups (P less than 0.0001 and P less than 0.005, respectively). The
      blood flow levels measured on the second day were of the same magnitude as those
      registered on the first day. The mean values of the wash-out rate constants (k)
      of the two groups were of the same magnitude in all phases of subcutaneous blood
      flow level, except in the hyperaemic phase, where it was significantly higher in
      the patient group (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751350
TI  - The prevalence of antinuclear antibodies in patients with apparent polymorphic
      light eruption.
AB  - Polymorphic light eruption (PLE) is a very common photosensitive disorder, the
      most important differential diagnosis of which is lupus erythematosus (LE). One
      hundred and forty-two patients with PLE were screened for circulating antinuclear
      (ANA), Ro and La antibodies over a 2-year period. Results were negative in 66
      patients. Sixty-two patients had low-titre ANA of various patterns, ranging from
      trace to 1/80 without evidence of LE although one later developed subacute
      cutaneous LE. Fourteen had more significant findings, six with ANA ranging from
      1/160 to 1/1280 but no anti-Ro antibodies, four with ANA ranging from 1/160 to
      1/1280 and also with anti-Ro antibodies and four patients with anti-Ro antibodies
      but low-titre ANA, one of whom later developed discoid LE. Three of these 14
      patients fulfilled the American Rheumatism Association criteria for the diagnosis
      of systemic LE, but it was not certain in any of the patients whether the PLE
      like rash represented cutaneous LE or coincidental PLE. However the overall 10%
      incidence of definite or possible LE in patients with suspected PLE suggests that
      all PLE patients should be screened for LE.

PMID- 1751351
TI  - Taking the 'sting' out of local anaesthetics.
AB  - In order to investigate factors influencing the discomfort caused by the
      injection of different lignocaine preparations, a randomized, double-blind
      comparison of paired injections was performed in 32 patients. In all subjects 2%
      plain lignocaine was found to be more painful than 0.5% plain lignocaine.
      Lignocaine with adrenaline 1:200,000 was found to be significantly more painful
      than plain lignocaine. The presence of sodium metabisulphite (the antioxidant in
      commercial adrenalized lignocaine) significantly increased the discomfort.
      Neutralization of acidic 0.5% lignocaine (pH 4.7) reduced the discomfort caused
      in 44% of patients, but this was not statistically significant.

PMID- 1751352
TI  - The treatment of 45 patients with cutaneous T-cell lymphoma with low doses of
      interferon-alpha 2a and etretinate.
AB  - Forty-five patients with cutaneous T-cell lymphomas (CTCL), 32 with mycosis
      fungoides (MF) and 13 with Sezary syndrome (SS), were treated with interferon
      alpha 2a (IFN-alpha 2a) (6-9 x 10(6) IU daily) for 3 months. Those responding to
      treatment were then treated with interferon-alpha alone (6-9 x 10(6) IU three
      times weekly), and non-responders received a combination of etretinate (0.5
      mg/kg/day) and IFN-alpha 2a in similar concentrations. After 12 months of
      treatment, 28/45 patients (62.2%) were in complete or partial (greater than 50%)
      remission. Of these, 17 (60.7%) were receiving IFN-alpha alone and 11 the
      combined interferon-retinoid therapy. Of the patients with MF stage I and II,
      20/25 were responders (12 receiving IFN-alpha alone and eight on combined
      therapy), whereas only 8/20 with stage IV or SS responded to treatment (five
      receiving IFN-alpha 2a alone and three combined therapy). These results suggest
      that the association of etretinate with low-dose recombinant IFN-alpha 2a is an
      effective means of treating epidermotropic CTCL, particularly in the early
      stages.

PMID- 1751353
TI  - Necrolytic migratory erythema without glucagonoma: the role of dietary essential
      fatty acids.

PMID- 1751354
TI  - Psoriasis induced by interferon-alpha.
AB  - Recombinant human interferon-alpha has been used in the treatment of several
      cancers, but there have been several reports that it may exacerbate psoriasis or
      trigger off its onset. We report four patients, three of whom first developed
      psoriasis and one who had an aggravation of the condition during treatment with
      interferon-alpha. Three of the patients had the carcinoid syndrome and one a
      renal carcinoma, and all were treated with interferon-alpha 2b or 2a (IFN-alpha
      2b, 2a) with doses ranging from 1.5 x 10(6) U daily to 18 x 10(6) U three times
      weekly. In two of the patients there appeared to be a correlation between the
      severity of the psoriasis and the dosage of interferon.

PMID- 1751355
TI  - Neurilemmomatosis.

PMID- 1751356
TI  - Pulmonary capillary leak syndrome complicating generalized pustular psoriasis:
      possible role of cytokines.
AB  - Two cases are reported of generalized pustular psoriasis complicated by profound
      alterations in pulmonary capillary permeability. Several features suggest the
      involvement of cytokines in the pathogenesis of this condition.

PMID- 1751357
TI  - Eruptive vellus hair cysts with sebaceous glands.
AB  - A patient is described who had eruptive vellus hair cysts with and without
      sebaceous glands in the cyst walls. An association is suggested between eruptive
      vellus hair cysts and the condition of steatocystoma multiplex.

PMID- 1751358
TI  - Hereditary epidermolytic palmoplantar keratoderma with knuckle pad-like lesions
      over the finger joints.

PMID- 1751359
TI  - Generalized hair follicle hamartoma with a positive anti-acetylcholine receptor
      antibody.

PMID- 1751360
TI  - Chronic cutaneous graft-versus-host disease: successful treatment with UVB.

PMID- 1751361
TI  - Clearing of pyoderma gangrenosum by intralesional cyclosporin A.

PMID- 1751362
TI  - Placental lactogen is a haemopoietic hormone.
AB  - The anaemia and thrombocytopenia of hypophysectomized (Hypox) rats could be
      corrected readily by daily treatment with human placental lactogen. Spontaneous
      DNA synthesis in the bone marrow of Hypox rats was grossly impaired, which was
      also normalized by placental lactogen. Human placental lactogen exerted a direct
      mitogenic effect on rat bone marrow cells in vitro. These results indicate that
      placental lactogen is a potent haemopoietic hormone.

PMID- 1751363
TI  - Recipient origin of bone marrow-derived fibroblastic stromal cells during all
      periods following bone marrow transplantation in humans.
AB  - The bone marrow microenvironment, which is composed of fibroblasts, endothelial
      cells, adipocytes and macrophages, plays an important role in the haematopoiesis
      and lymphopoiesis by producing various cytokines. Therefore, investigation of the
      origin of these cells following allogeneic bone marrow transplantation (BMT) is
      very significant, in terms of the haematological and immunological reconstitution
      after BMT. We have investigated the origin of fibroblastic stromal cells in long
      term cultures in seven of the sex-mismatched cases. This was carried out by in
      situ hybridization using a Y-chromosome specific cDNA probe (PHY10), conserving
      the morphology of the cells. In situ hybridization analysis showed that bone
      marrow fibroblasts (BMF) in long-term cultures in all the sex-mismatched cases
      originated from the recipients. We have also performed Southern blot analysis
      using a PHY10 probe in the sex-mismatched cases and using a variable number of
      tandem repeats (VNTR) probe, which can detect DNA polymorphisms, in two fo the
      sex-matched cases. In addition, we have employed polymerase chain reaction (PCR)
      using the VNTR marker (MCT118). Although all the patients showed haemopoietic
      engraftment with donor cells, their BMF were found, by Southern blot analysis and
      PCR method, to be of the recipient origin. These data indicate that bone marrow
      derived fibroblastic stromal cells which proliferate in long-term cultures are
      not transplantable in the conditioning regimens used for allogeneic BMT in
      humans.

PMID- 1751364
TI  - Drug-induced agranulocytosis: prognostic factors in a series of 168 episodes.
AB  - The prognostic value of 36 clinical and analytical parameters at diagnosis in
      patients with drug-induced agranulocytosis was analysed in an adult population.
      This multicentre, retrospective study examined possible prognostic factors by
      multiple logistic regression analysis in a series of 168 clinical episodes. The
      overall mortality was 16%. Renal insufficiency at diagnosis and the development
      of bacteraemia were associated with a poor prognosis. Advanced age, decreased
      leucocyte count, lymphocytopenia, bone marrow myeloid hypoplasia, increased
      percentage of bone marrow plasma cells and shock were found to be associated with
      a poor prognosis only in the univariate analysis. An independent analysis of the
      myeloid cellularity at diagnosis showed an inverse correlation with the time to
      recovery of the granulocyte counts (r = -0.43; P = 0.001). Our data indicate that
      despite some important clinical differences (higher incidence of infections of
      the oropharynx, shorter period of neutropenia and almost exclusive presence of
      gram-negative organisms), the infections complicating the treatment of cancer
      patients have the same prognostic features than those seen in patients with acute
      agranulocytosis. Therefore the established therapeutic guidelines for neutropenia
      after cancer chemotherapeutic agents are applicable to patients with acute
      agranulocytosis.

PMID- 1751365
TI  - IL-2 abolishes fibroblast proliferation in long-term bone marrow culture by
      inhibition of an accessory cell.
AB  - Addition of interleukin-2 (IL-2 (greater than 250 U/ml) during the first 3 d of
      long-term bone marrow culture (LTBMC) permanently abolished the fibroblast
      component of the stromal layer, even when IL-2 was removed after the 3 d culture
      period. When IL-2 was added at more than 72 h after initiation of culture, no
      effect was observed. Stromal growth in IL-2-treated culture was restored by
      addition of irradiated bone marrow, indicating that the IL-2 inhibited an
      accessory cell rather than the fibroblast directly. Accessory cells were shown to
      be necessary for fibroblast proliferation at low cell densities and were also
      inhibited by IL-2. The accessory cell effect could not be replaced by LTBMC
      supernatants or extracellular matrix. It is suggested that these observations are
      relevant to the suppression of haemopoiesis observed in patients receiving IL-2.

PMID- 1751366
TI  - The treatment of patients with newly diagnosed poor prognosis acute myelogenous
      leukaemia: response to treatment and treatment failure.
AB  - The failure of poor prognosis patients with newly diagnosed AML to enter
      remission is usually due to two phenomena: a high mortality rate and resistance
      of the leukaemia to chemotherapy. We conducted a pilot study of a regimen
      designed to overcome these two types of treatment failure. Patients were
      carefully selected for therapy on the basis of their likelihood of surviving.
      Chemotherapy consisted of high dose cytosine arabinoside (HDaraC) with the doses
      modified on the basis of patient age so as to reduce the risk of toxicity.
      Finally, daunorubicin was administered only to those patients for whom HDaraC was
      not likely to produce sufficient antileukaemia effects to produce a remission.
      The median patient age was 67 years and 69/88 (78%) patients had a history of
      preleukaemia and/or toxic exposure. Only 11/84 (13%) patients died during
      remission induction therapy and 40/84 (48%) entered CR. Patients with only one
      risk factor had a higher CR rate than those with more than one risk factor (56%
      v. 30%, P = 0.02) and also had longer durations (222 d v. 113.5 d, P = 0.035).
      Two types of resistance to chemotherapy were observed: 'classical resistance'
      (the failure of chemotherapy to produce substantial killing of leukaemia cells)
      and the rapid regrowth of leukaemia cells subsequent to a level of cytoreduction
      which otherwise would have been sufficient to produce a CR.

PMID- 1751367
TI  - Prognostic importance of Sudan Black positivity: a study of bone marrow slides
      from 1,386 patients with de novo acute myeloid leukaemia.
AB  - Analysis of bone marrow slides from 1,386 patients entered into the Medical
      Research Council's 8th and 9th trials in Acute Myeloid Leukaemia confirmed that
      features associated with differentiation in blast cells, in particular increasing
      Sudan Black (SB) positivity, were the most important morphological features for
      predicting remission achievement (P = 0.002) and hence survival (P less than
      0.0001). SB positivity was also weakly predictive of remission duration (P =
      0.05). A low complement of maturing granulocytes was associated with early
      induction death and a high percentage of blasts with shorter remissions. The few
      patients with acute promyelocytic leukaemia (FAB M3) had a high haemorrhagic
      death rate during induction and a low relapse rate. Apart from this, lineage
      involvement was not predictive of outcome. Multiple lineage leukaemias, in
      particular those with megakaryocytic and/or erythroid involvement, which had been
      reported previously to have a poor prognosis, did not have any worse remission
      rates in this series. When more than one cell line was involved, no combination
      with particularly good or poor prognosis could be identified. Multivariate
      analysis suggested that percentage SB positivity was adequate on its own to
      divide granulocytic leukaemias into poorly differentiated (less than 50% SB +ve)
      and well-differentiated groups (50% or more SB +ve) without the need for further
      measurements. This simple and reproducible test was strongly predictive of
      resistant disease but not of induction deaths. It was of considerably greater
      prognostic value--and was less open to inter-observer disagreement--than the FAB
      criteria which are usually used to classify granulocytic lineage leukaemias into
      the M1 and M2 subgroups. It is proposed that greater than or equal to 50% of
      blasts with SB positivity should replace blasts greater than 10% of maturing
      myeloid cells for this sub-categorization between M1 and M2.

PMID- 1751368
TI  - Immunophenotypic, genomic and clinical characteristics of blast crisis of chronic
      myelogenous leukaemia.
AB  - We have studied phenotypic and clinical features in a consecutive series of 45
      patients with chronic myelogenous leukaemia (CML) in blast crisis (BC). In
      addition, in 22 of these patients we have analysed the genotypic characteristics
      including immunoglobulin, T-cell receptor (TCR) and major breakpoint cluster
      region (M-bcr) gene organization. The granulomonocytic and megakaryoblastic
      lineages are the most commonly involved in these BC of CML (33% and 33% of cases,
      respectively); only 18% of our cases displayed a lymphoid phenotype. Moreover,
      both morphological and immunophenotypic studies revealed the frequent coexistence
      of two or three cell populations, especially when the megakaryoblast component is
      involved. The lymphoid BC displayed the highest incidence of complete remissions
      although this was not associated with a longer survival. Only minor differences
      between the different myeloid subgroups were observed. Immunoglobulin heavy chain
      (IgH) gene rearrangement was found in five of the six lymphoid BC and in one
      myeloid BC. Only one case showed k light chain gene rearrangement. In all but one
      myeloid BC the TCR-beta gene was in germline configuration. The TCR-gamma gene
      was rearranged in all lymphoid and one myeloid BC, while TCR-delta gene
      rearrangement was detected in 67% and 16% of the lymphoid and myeloid BC,
      respectively. Most of the lymphoid BC (4/5) had the M-bcr breakpoint in subregion
      3, while the myeloid BC had the breakpoint either in subregion 2 or 3. No
      differences between the different myeloid phenotypic subgroups were observed in
      relation to breakpoint.

PMID- 1751369
TI  - Mitozantrone and cytosine arabinoside as first-line therapy in elderly patients
      with acute myeloid leukaemia.
AB  - We have prospectively evaluated a regimen of mitozantrone and cytosine
      arabinoside (Ara-C) as first-line therapy in elderly patients with acute myeloid
      leukaemia (AML). One hundred and four patients with a median age of 68 (range 60
      81) were studied, in whom 86 had de-novo AML, and 18 had preceding myelodysplasia
      or secondary AML. Complete remission was achieved in 64% of de-novo cases, in 28%
      of MDS/secondary cases, and in 58% overall. The incidence of early death within
      28 d of chemotherapy was 11%. The median disease-free survival (DFS) was 11
      months with an actuarial DFS of 15% at 43 months. The median overall survival was
      9 months with an actuarial survival of 10% at 44 months. The incidence of non
      haematological toxicity was acceptably low, and usually of mild to moderate
      severity. Quality of life was improved, or unchanged, in 90% of responders. We
      conclude that mitozantrone and ara-C is an effective and well-tolerated regimen
      which produces high remission rates in elderly patients with AML.

PMID- 1751370
TI  - Diagnostic criteria and classification of clinical subtypes of adult T-cell
      leukaemia-lymphoma. A report from the Lymphoma Study Group (1984-87).
AB  - The following diagnostic criteria are proposed to classify four clinical subtypes
      of HTLV-1 associated adult T-cell leukaemia-lymphoma (ATL): (1) Smouldering type,
      5% or more abnormal lymphocytes of T-cell nature in PB, normal lymphocyte level
      (less than 4 x 10(9)/l), no hypercalcaemia (corrected calcium level less than
      2.74 mmol/l), lactate dehydrogenase (LDH) value of up to 1.5 x the normal upper
      limit, no lymphadenopathy, no involvement of liver, spleen, central nervous
      system (CNS), bone and gastrointestinal tract, and neither ascites nor pleural
      effusion. Skin and pulmonary lesion(s) may be present. In case of less than 5%
      abnormal T-lymphocytes in PB, at least one of histologically-proven skin and
      pulmonary lesions should be present. (2) Chronic type, absolute lymphocytosis (4
      x 10(9)/l or more) with T-lymphocytosis more than 3.5 x 10(9)/l, LDH value up to
      twice the normal upper limit, no hypercalcaemia, no involvement of CNS, bone and
      gastrointestinal tract, and neither ascites nor pleural effusion. Lymphadenopathy
      and involvement of liver, spleen, skin, and lung may be present, and 5% or more
      abnormal T-lymphocytes are seen in PB in most cases . (3) Lymphoma type, no
      lymphocytosis, 1% or less abnormal T-lymphocytes, and histologically-proven
      lymphadenopathy with or without extranodal lesions. (4) Acute type, remaining ATL
      patients who have usually leukaemic manifestation and tumour lesions, but are not
      classified as any of the three other types. A total of 818 ATL patients with a
      mean age of 57 years, newly diagnosed from 1983 to 1987, were analysed by this
      criteria. There were 448 males and 370 females, and 253 were still alive with a
      median follow-up time of 13.3 months from diagnosis, while 565 were dead with a
      median survival time (MST) of 5.4 months. MST was 6.2 months for acute type, 10.2
      months for lymphoma type, 24.3 months for chronic type, and not yet reached for
      smouldering type. Projected 2- and 4-year survival rates were 16.7% and 5.0% for
      acute type, 21.3% and 5.7% for lymphoma type, 52.4% and 26.9% for chronic type,
      77.7% and 62.8% for smouldering type, respectively. Distinct clinical features
      and laboratory findings of each clinical subtype are described.

PMID- 1751371
TI  - Detection of soluble IL-2 receptor in the serum of patients with myelodysplastic
      syndromes: induction under therapy with GM-CSF.
AB  - Sera of 15 healthy controls and 33 patients suffering from myelodysplastic
      syndromes (MDS) were investigated for soluble interleukin-2 receptor (sIL-2R)
      expression with a cell-free enzyme-linked immunosorbent assay (ELISA) system (T
      Cell Sciences; Cambridge, U.S.A.). The upper limit of the assay is indicated with
      477 U/ml. According to the FAB classification eight refractory anaemia (RA), 15
      refractory anaemia with excess of blasts (RAEB), five refractory anaemia with
      excess blasts in transformation (RAEBt) and five chronic myelomonocytic leukaemia
      (CMML) were examined. None of the patients had reported infectious episodes or
      been under treatment with cytotoxic agents and/or cytokines within the previous 3
      months. Significant differences in sIL-2R levels between RA (median 368 U/ml).
      RAEB (median 675 U/ml) and RAEBt (median 971 U/ml) and between RA and CMML
      (median 723 U/ml) were detected. Six patients, who had been under treatment with
      rhGM-CSF for at least 2 weeks, demonstrated a three- to sevenfold increase of sIL
      2R expression compared to pretreatment levels. In kinetic evaluation of serum
      samples for 24 h, the increase of sIL-2R expression begins within 4 h after
      subcutaneous application of GM-CSF and reaches its maximum after 12 h. Our data
      cannot suggest whether increased sIL-2R expression is a primary event due to
      involvement of lymphocytes in the malignant clone or whether it results from
      secondary alteration of the cytokine network. Application of GM-CSF in MDS may
      result in improvement of altered lymphocyte function. As GM-CSF induces sIL-2R
      expression, a down regulation of the immune response caused by neutralization of
      free IL-2 cannot be excluded.

PMID- 1751372
TI  - Thrombocytopenia in acute leukaemia patients treated with IL2: cytolytic effect
      of LAK cells on megakaryocytic progenitors.
AB  - In vivo administration of recombinant interleukin 2 (IL2) has been associated, in
      acute leukaemia as well as in other tumours, with a variable degree of
      thrombocytopenia. In two patients with acute myeloid leukaemia who showed a
      progressive and severe fall in platelet count during daily continuous i.v.
      infusion of IL2, we assessed whether peripheral blood IL2-generated lymphokine
      activated killer (LAK) lymphocytes could affect growth of the autologous bone
      marrow megakaryocytic progenitor cell compartment (CFU-MK) in vitro. Following
      overnight pre-incubation in liquid culture of the marrow cells with autologous
      LAK effectors, there was an almost complete abrogation of the CFU-MK colony
      growth (97% and 89% inhibition). Pre-incubation in the presence of a monoclonal
      antibody to tumour necrosis factor alpha (TNF) completely reversed the inhibitory
      effect. The role played by TNF was confirmed by the finding that recombinant TNF
      caused a dose-dependent inhibition of the growth of CFU-MK. IL2 alone was
      ineffective. These results suggest that the often severe thrombocytopenia
      observed in patients with acute leukaemia treated with IL2 is at least partly due
      to autologous LAK cells activated in vivo following the administration of IL2.

PMID- 1751373
TI  - Consistently normal CD4+, CD8+ levels in haemophilic boys only treated with a
      virally safe factor VIII concentrate (BPL 8Y)
AB  - Prospective biochemical, virological and selected immunological follow up has
      been done for up to 32 months on 15 previously untreated haemophilic boys
      following treatment with an intermediate purity dry heated factor VIII
      concentrate (BPL 8Y). Tests for liver function and antibodies to blood-borne
      viruses have been assessed monthly for the first year after starting treatment
      and thereafter every 2 months. All patients were immunized against hepatitis B
      and have not developed hepatitis B core antibodies and no boy has shown any rise
      in alanine transaminase level nor has anyone developed antibodies to hepatitis C
      (HCV). All patients have remained anti-HIV seronegative. T lymphocyte subsets
      have been measured approximately every 4 months and in no patient has there been
      a significant rise in CD8+ cells; one patient showed a significant decrease in
      CD4+ cells but these and all CD4+ values for the other boys remained within
      normal age related limits. Changes in CD4+ levels in this one boy were not
      related to the total amount of treatment received. This group of patients who
      appear not to have contracted HIV, hepatitis B or non A non B hepatitis following
      treatment with this intermediate purity factor VIII concentrate have also not
      shown any consistent changes in CD4+ or CD8+ cells, which have been recorded
      previously in frequently treated haemophiliacs.

PMID- 1751374
TI  - An alloimmunized, thrombocytopenic patient successfully transfused with acid
      treated, random-donor platelets.
AB  - Alloimmunized, thrombocytopenic patients, refractory to random-donor platelet
      transfusion, often respond to HLA-identical single-donor platelets. HLA
      compatible platelets are expensive, take time to prepare, and donors are
      sometimes not to be found. We have used random-donor platelets and 'peeled' the
      HLA-antigen off the platelets, using a modified laboratory method (incubation of
      platelets with citric acid solution at 0 degrees C). Platelet recovery in two
      healthy subjects was 72.0% for acid-treated platelets, and 73.5% for untreated
      control platelets, using 111In-labelled autologous platelets. Survival time
      (multiple hit) was 6.25 and 7.95 d, respectively. Random-donor platelets that
      were strongly positive in the crossmatch with serum from a patient became
      negative after treatment with the acid solution. Furthermore, transfusion of
      these platelets gave a post-transfusion, platelet-count increment comparable with
      transfusion of HLA-compatible single-donor platelets.

PMID- 1751375
TI  - A cathepsin-like cysteine proteinase proaggregating activity in thrombotic
      thrombocytopenic purpura.
AB  - The platelet aggregating activity (PAA) of serum and plasma from thrombotic
      thrombocytopenic purpura (TTP, eight patients) and haemolytic uraemic syndrome
      (HUS, three patients) was investigated. Sample-induced aggregation of washed
      platelets and the parallel 3H-serotonin release were studied both in the presence
      and the absence of purified von Willebrand factor (vWF) or defibrinated
      cryoprecipitate, according to Kelton et al (1987). All the samples but two were
      positive in the test, vWF being indispensable for aggregation in all but two of
      the active cases. Samples from five patients during remission were ineffective
      under the same conditions, as were 14 controls from healthy donors. An inhibition
      study using four cysteine proteinase inhibitors (1 mM iodoacetamide, 0.5 mM E-64,
      0.1 mM antipain and 0.1 mM leupeptin) and two serine proteinase inhibitors (200
      U/ml aprotinin and 0.2 U/ml hirudin) confirmed that TTP/HUS's PAA behaved
      enzymatically as a cysteine proteinase, as described (Murphy et al, 1987a). These
      results were confirmed on a protein preparation obtained from pooled plasmas
      after Al(OH)3 adsorption, ammonium sulphate precipitation, binding to and elution
      from a p-(chloromercuri)benzoate (PCMB) affinity resin. To further characterize
      this activity we investigated whether it was a calcium-dependent neutral protease
      or a lysosomal cathepsin by testing the sensitivity to a series of peptidyl
      diazomethyl ketones, synthetic inhibitors specifically designed for cysteine
      proteinases. We confirm here the presence of a circulating platelet aggregating
      cysteine proteinase in TTP/HUS and provide evidence for the first time that this
      activity behaves like a lysosomal cathepsin.

PMID- 1751376
TI  - Abnormal low and high density lipoproteins in homozygous beta-thalassaemia.
AB  - The levels, structure and composition of plasma lipoproteins were determined in
      67 patients with homozygous beta-thalassaemia and compared to healthy or
      heterozygous members of the same families and to patients with either sickle cell
      or iron deficiency anaemia. Plasma total and LDL and HDL cholesterol levels were
      low in patients with homozygous beta-thalassaemia and with sickle cell anaemia.
      Plasma triglycerides did not differ between subjects. The low plasma and
      lipoprotein cholesterol was independent of age, transfusion requirements and
      splenectomy. Abnormal structure and composition of lipoproteins was found in
      homozygous beta-thalassaemia. The LDL was of higher density and was triglyceride
      rich and cholesterol ester-poor. HDL separated to three populations. HDL2 was
      prominent (in spite of low plasma HDL cholesterol). HDL3 was of normal density
      and an intermediate HDL population, not found in normal subjects, was identified
      and designated HDL2-3. All three HDL populations were enriched with triglycerides
      and poor in cholesterol ester content. The modified LDL and HDL particles may
      then be possibly cleared rapidly from the plasma by activated monocytes and
      macrophages.

PMID- 1751377
TI  - Diagnosis of paroxysmal nocturnal haemoglobinuria using immunophenotyping of
      peripheral blood cells.
AB  - Paroxysmal nocturnal haemoglobinuria (PNH) is now generally accepted as a disease
      in which bone marrow derived cells are deficient in phosphatidylinositolglycan
      (PIG)-anchored surface molecules. A series of new monoclonal antibodies detecting
      PIG-anchored surface structures on human leucocytes (CD48, CD55, CD59) has
      recently been described. In the present study 12 patients with the diagnosis PNH
      and a positive Ham test were examined for PIG-anchored surface antigen expression
      on various cell lineages using immunofluorescence. In all patients deficient
      cells were detected in erythrocyte, granulocyte and monocyte analysis. A
      deficient lymphocyte subset was also observed in all but one of these patients.
      Using two-colour analysis, all lymphocyte subpopulations such as T, B and NK
      cells were found to be affected. In addition, peripheral blood cells of 22
      patients with severe aplastic anaemia (SAA) were tested for the PIG-anchoring
      defect. In five of these patients the defect was detected, and in four of the
      five the lack of PIG-anchored molecules was confined to the granulocyte and
      monocyte lineages apparently without affecting the erythrocytes. The results of
      these studies demonstrate that cytofluorographic testing of peripheral blood
      cells provides a simple and reliable method for establishing the diagnosis of
      PNH. Furthermore, especially in the case of aplastic anaemia patients, the
      sensitivity of immunophenotyping might be superior to conventional laboratory
      tests.

PMID- 1751378
TI  - Lewis antigen expression in benign and malignant tissues from RBC Le(a-b-) cancer
      patients.
AB  - Eight red blood cell (RBC) Le(a-b-) individuals were selected from a series of
      patients with bladder or colon cancer. Defined by the presence or absence of
      alpha 1-4-L-fucosyltransferase activity in saliva, four of these patients were
      characterized as non-genuine Lewis negative [RBC Le(a-b-) with alpha 1-4-L
      fucosyltransferase activity in saliva], and four as genuine Lewis negative [RBC
      Le(a-b-) with no alpha 1-4-L-fucosyltransferase activity in saliva]. Stainings of
      paraffin embedded formalin fixed tissue sections for Lea and Leb antigens were
      performed by means of an indirect immunohistochemical method on all malignant and
      benign tissue previously removed from these eight patients. Leb antigens were
      always expressed independently of both the Lewis and the secretor status of the
      individual. Lea antigens, on the other hand, showed a different staining pattern.
      Although primarily expressed in non-genuine Le(a-b-) individuals, Lea antigens
      were expressed in genuine Le(a-b-) individuals as well--to a limited extent, but
      still detectable. Thus, these findings seem to show that the Lewis antigen
      expression is tissue dependent, and it is not possible to predict tissue Lewis
      antigen expression by merely examining erythrocytes or saliva.

PMID- 1751379
TI  - Haemorheological changes in the very short term after abstention from tobacco by
      cigarette smokers.
AB  - A study was made of the haemorheological changes that took place in the days
      immediately following tobacco withdrawal from cigarette smokers. In both males
      and females substantial and persistent reductions in blood viscosity occurred
      within 2 d, the fall at high shear rate corresponding to about 8% while at low
      shear rate it was approximately twice as much. These changes were due partly to a
      fall in packed cell volume (PCV), but also to reductions in total plasma protein
      and fibrinogen concentrations which led to reductions in plasma viscosity and
      rouleaux formation. These plasma protein-related changes were less pronounced in
      the female group. The results indicate that, even in the very short-term,
      abstention from cigarettes leads to substantial improvements in the
      haemorheological profile of heavy smokers.

PMID- 1751380
TI  - Comparisons of human, rat and mouse erythropoietins by isoelectric focusing:
      differences between serum and urinary erythropoietins.
AB  - Isoelectric focusing (IEF) in the pH range 2.5-5.0 has been used to compare the
      immunoreactive (ir) erythropoietin (Epo) in paired samples of serum and urine
      from three patients, two with idiopathic aplastic anaemia and one with paroxysmal
      nocturnal haemoglobinuria and also from three anaemic rats. Serum samples only
      were also examined from two further patients with aplastic anaemia and from three
      mice, made anaemic (like the rats) by irradiation and phenylhydrazine treatment.
      Most of the ir-Epo recovered after IEF was found in the pH range 2.5-3.9. For the
      sera, the proportion of more acidic ir-Epo with pI less than 3.0 recovered after
      IEF increased from human to rat to mouse. Human sera contained a greater
      proportion of ir-Epo with pI greater than 3.4 than rat or mouse sera. For the
      urines, the distribution of ir-Epo by IEF was similar between human and rat. For
      both species, the proportion of ir-Epo with pI less than 3.0 recovered after IEF
      was greater in urine than in the paired serum samples. The Second International
      Reference Preparation of Human Urinary Epo differed from the Epo in unextracted
      human urine in that there was a lower proportion of ir-Epo with pI less than 3.0.
      The differences observed between serum and urinary Epo are of particular interest
      because only the urinary form of native human Epo has ever been purified, and
      because this was used to compare native with rDNA-derived Epo.

PMID- 1751381
TI  - Dramatic improvement of pure red cell aplasia refractory to combined cyclosporine
      and prednisolone therapy induced by prednisolone dose escalation.

PMID- 1751382
TI  - Development of aggressive plasma cell leukaemia under interferon-alpha therapy.

PMID- 1751383
TI  - Systemic release of neutrophil elastase and tumour necrosis factor alpha
      following ABO incompatible blood transfusion.

PMID- 1751384
TI  - Haemopoiesis: a lottery or genomic determinism?

PMID- 1751385
TI  - Plasma erythropoietin levels in patients with acquired renal cystic disease.

PMID- 1751386
TI  - Malignant mastocytosis and myelodysplastic syndrome.

PMID- 1751387
TI  - Marrow stem cell and stroma cell function in aplastic anaemia.

PMID- 1751388
TI  - Differentiation of mesenchymal tissues during phallic morphogenesis with emphasis
      on the os penis: roles of androgens and other regulatory agents.
AB  - This article reviews various aspects of differentiation and growth of phallic
      mesodermal tissues with special reference to the os penis. In many species of
      certain mammalian orders the penile interior contains an os penis or baculum with
      bona fide bone. Mechanisms of phenotypic sex differentiation and the androgenic
      regulation of morphogenesis of genitourinary tracts of both sexes are first
      overviewed. Thereafter the various mesodermal tissues in fully developed penes
      and clitorides are discussed. The developmental fate of mesenchymal cells in the
      fetal genital tubercles is then considered in detail, including considerations of
      epithelial-mesenchymal interactions. The review concludes with a discussion of
      the possible roles of certain polypeptide growth factors acting in concert with
      androgenic steroids. Special emphasis is placed on the potential role of bone
      morphogenetic proteins in formation of the os penis in a restricted number of
      eutherian mammalian taxa.

PMID- 1751389
TI  - Extraadrenal expression of steroid 21-hydroxylase and 11 beta-hydroxylase by a
      benign testicular Leydig cell tumor.
AB  - We present an unusual case with bilateral testicular Leydig cell tumors
      displaying extraadrenal expression of steroid 21-hydroxylase and 11 beta
      hydroxylase. Histological examination of a 38-yr-old man infertile due to
      azoospermia showed him to have bilateral testicular Leydig cell tumors. The in
      vitro steroidogenic potential of the tumors and their adjacent testicular tissue
      was evaluated using organ culture. Tumor tissue was found to secrete
      deoxycorticosterone (DOC), corticosterone (B) and cortisol, which are not
      produced in normal adult testis, into the medium, while testicular tissue
      adjacent to the tumors secreted a small amount of DOC and B. Northern blot
      analysis with cytochrome P-450C21 complementary DNA (cDNA) and P-45011 beta cDNA
      as probes revealed that the tumor contained a considerable amount of mRNA for P
      450C21 and P-45011 beta, while the MRNAs were not detected in the testicular
      tissues adjacent to the tumors. It is suggested that the high local levels of
      estrogen and/or progesterone within the Leydig cell tumors and their adjacent
      testicular tissues induced extraadrenal expression of steroid 21-hydroxylase and
      11 beta-hydroxylase by the tumors and their adjacent testicular tissues.

PMID- 1751390
TI  - Bovine adrenal cytochrome P-450(11 beta)-mediated conversion of 11-deoxycortisol
      to 18- and 19-hydroxy derivatives; structural analysis by 1H-NMR.
AB  - Incubation of 11-deoxycortisol with a cytochrome P-450(11 beta)-reconstituted
      system yielded, in addition to cortisol, several new steroid products. In this
      study, structures of the three steroid products were elucidated. Retention time
      of the first product (Peak 2 substance) coincided with that of authentic 18
      hydroxycortisol on reverse phase HPLC. To further confirm the chemical identity
      of this product, the purified sample was subjected to 1H-NMR analysis. The
      spectrum was essentially identical to that of 18-hydroxycortisol. The retention
      time of the second product (Peak 3 substance) did not coincide with those of
      commonly occurring steroids. The one- and two-dimension 1H-NMR spectra provided
      strong evidence for its structure of 19-hydroxy-11-deoxycortisol. The retention
      time of the third product (Peak 4 substance) did not coincide with those of
      commonly occurring steroids. The 1H-NMR spectrum showed the presence of signals
      of 19-CH3 and 18-CH2 protons. There was also evidence that this product is not
      hydroxylated at the 11-position. Further analysis of the COSY spectra identified
      its structure as 18-hydroxy-11-deoxycortisol. From these results, we conclude
      that bovine P-450(11 beta) can catalyze the hydroxylation of 11-deoxycortisol at
      11 beta-, 18- and 19-positions and produce cortisol, 18-hydroxy-11-deoxycortisol,
      18-hydroxycortisol and 19-hydroxy-11-deoxycortisol.

PMID- 1751391
TI  - Steroidogenic enzyme activity in the hypogonadal (hpg) mouse testis and effect of
      treatment with luteinizing hormone.
AB  - The hypogonadal (hpg) mouse, which lacks circulating gonadotrophins during
      development, has been used (a) to determine whether initial expression of
      steroidogenic enzyme activity is dependent upon gonadotrophins and (b) to examine
      the responsiveness of these enzymes to luteinizing hormone (LH) stimulation.
      Activities of 17 alpha-hydroxylase, 17-ketosteroid reductase and 5 alpha
      reductase were very low but detectable in the hpg testis while cholesterol side
      chain cleavage (CSCC) activity was undetectable. In contrast, 3 beta
      hydroxysteroid dehydrogenase (3 beta HSD) activity was high (11% of normal
      testis). Treatment with LH increased CSCC and 17 alpha-hydroxylase activity more
      than 11-fold within 24 h. 5 alpha-Reductase activity was increased 3-fold after 3
      days treatment while 17-ketosteroid reductase and 3 beta HSD activities did not
      respond until after 10 days of treatment. The overall increases in 5 alpha
      reductase (4-fold) and 3 beta HSD (6-fold) activities were low while changes in
      17-ketosteroid reductase (20-fold) and, particularly, CSCC (greater than 130
      fold) and 17 alpha-hydroxylase (153-fold) were more marked. Results show (1) that
      expression of 3 beta HSD activity may be independent of gonadotrophins, (2) that
      activity of 17 alpha-hydroxylase, 17-ketosteroid reductase and 5 alpha-reductase
      is expressed, though at low levels, in the absence of gonadotrophins and (3) that
      prior exposure to gonadotrophins is not required for a rapid response to LH
      stimulation, particularly with respect to the cytochrome P-450 enzymes.

PMID- 1751392
TI  - The antiglucocorticoid RU486 downregulates the expression of interleukin-2
      receptors in normal human lymphocytes.
AB  - The effects of the antiglucocorticoid RU486 on the expression of low and high
      affinity interleukin-2 receptors (IL-2R) in phytohaemagglutinin (PHA)-activated
      human peripheral blood lymphocytes were investigated. We demonstrated that RU486
      inhibits in a dose-dependent way the expression of both classes of IL-2R, thereby
      mimicking the effects of the glucocorticoid agonist dexamethasone. The maximal
      effect on the low affinity binding sites was observed at 10 microM (28 +/- 2% of
      control, P less than 0.001) and on the high affinity IL-2R at 1 microM (from 2938
      +/- 74 to 437 +/- 108 binding sites per cell, P less than 0.001). This inhibition
      of IL-2R expression occurs at a pretranslational level since RU486 decreased the
      accumulation of beta-chain IL-2R mRNA transcripts. Our data support the concept
      that the antiglucocorticoid RU486 at pharmacological concentrations can exert
      agonistic-immunosuppressive effects.

PMID- 1751393
TI  - 19-nor-DOC biosynthesis in the isolated perfused rat kidney.
AB  - 19-nor-deoxycorticosterone (19-nor-DOC) is a potent salt retaining and
      hypertensinogenic mineralocorticoid that is excreted in the urine. While the
      precursor of 19-nor-DOC, 19-oxo-DOC, is produced by the adrenal cortex,
      conversion to 19-nor-DOC does not occur in the adrenal gland. We have examined
      the hypothesis that 19-nor-DOC is synthesized from precursors in the kidney. 19
      oxo-DOC was added to the perfusate of isolated rat kidney preparations (n = 5) at
      a concentration of 10 microM. During 1 h of perfusion following addition of 19
      oxo-DOC, 71 +/- 6% of the precursor was converted to 19-oic-DOC, an immediate
      precursor of 19-nor-DOC, and 8.3 +/- 1.8% was converted to 19-nor-DOC. This
      represents the first definitive evidence that 19-nor-DOC is produced in the
      kidney from adrenal precursors.

PMID- 1751394
TI  - Quantitation of glucocorticoid receptors in bovine skeletal muscle: topographical
      distribution, sex effect and breed comparisons.
AB  - The concentration of the cytosolic glucocorticoid receptor (GR) was determined in
      skeletal muscles of calves in order to study possible differences in individual
      muscles from different parts of the body as well as the influence of sex and
      breed. In male and female Simmental calves the topographical distribution of GR
      was similar: the lowest concentrations were seen in abdominal muscle, whereas in
      neck, shoulder and hindleg the GR concentrations were higher; this difference was
      more pronounced in male than in female calves. In general, female calves had
      about 2-fold higher GR concentrations than males. The cytosolic cortisol
      concentrations were differing neither between individual muscles nor between
      sexes. The cortisol secretion during a 24-h sampling period 1 week prior to
      slaughter showed no sex difference. GR concentrations in neck muscle of female
      calves of four different German cattle breeds (Holstein Friesian, Brown Swiss,
      Simmental and German Gelbvieh) were rather similar; however, when Brown Swiss
      with the highest GR levels were compared to Holstein Friesian calves with the
      lowest concentrations, a significant difference was evident (P less than 0.05).

PMID- 1751395
TI  - Suppression of 5 alpha-androstane-3 beta,17 beta-diol hydroxylase activity in rat
      pituitary by cobalt protoporphyrin: implications for testosterone homeostasis.
AB  - Cobalt protoporphyrin (CoPP) administered subcutaneously to adult male rats
      caused a marked reduction in the conversion of 5 alpha-androstane-3 beta-17 beta
      diol (3 beta-adiol) to its main triol derivative (6 alpha-atriol) by homogenates
      of the pituitary but not of the prostate or brain (ventromedial hypothalamus and
      cortex). No effect in the brain was observed when this heme analogue was infused
      intracerebroventricularly. 3 beta-adiol hydroxylase, the enzyme responsible for
      the reaction and whose main function is thought to be the elimination of
      dihydrotestosterone and its metabolites from target tissues, was also inhibited
      by CoPP and SKF-525A added in vitro. The reaction was microsomal and dependent on
      NADPH. It is proposed that the lack of reciprocal elevation of luteinizing
      hormone in the face of the low testosterone levels observed following treatment
      with CoPP may be due, in part, to increased levels of androstanediols. These
      metabolites accumulate because of increased production from testosterone and
      decreased conversion to their triol derivatives in the pituitary.

PMID- 1751396
TI  - A time-dependent inactivation of aromatase by 19-oxygenated androst-4-ene-3,6,17
      triones.
AB  - 19-Hydroxyandrost-4-ene-3,6,17-trione (19-OHAT), its 19-oxo derivative (19-oxo
      AT) and 4 beta, 5 beta-epoxyandrostane-3,6,17-trione (5) were synthesized as
      possible intermediates involved in a mechanism-based inactivation of aromatase
      caused by androst-4-ene-3,6,17-trione (AT). These compounds, inhibited the enzyme
      in a competitive manner with Ki's of 0.61, 7.5 and 5.1 microM for 19-OHAT, 19-oxo
      AT, and compound 5. The two 19-oxygenated steroids showed a time-dependent,
      pseudo-first order rate of inactivation of aromatase with kinact's of 0.222 and
      0.076 min-1 for 19-OHAT and 19-oxo AT, respectively, while compound 5 did not.
      NADPH and oxygen were required for the inactivation. Androstenedione blocked the
      inactivation, while L-cysteine partially prevented that of 19-OHAT and almost
      completely that of 19-oxo AT. When the 19-oxygenated steroids were separately
      subjected to reaction with N-acetyl-L-cysteine, these rapidly disappeared from
      the reaction mixture with t1/2 of 25 min (19-OHAT) and 20 s (19-oxo AT). This
      finding indicates that L-cysteine prevents inactivation by a chemical dependent
      elimination of the inhibitors from the incubate. These results suggest that the
      19-oxygenation rather than the 4,5-epoxidation may be involved in the time
      dependent inactivation by AT.

PMID- 1751397
TI  - In vitro effect of synthetic progestogens on estrone sulfatase activity in human
      breast carcinoma.
AB  - The effect of progesterone and nine synthetic progestogens on the activity rate
      of microsome estrone sulfatase obtained from human breast carcinoma tissues was
      studied. The progestogens were classified into three groups: group I with a
      strict inhibitor effect: demegestone and chlormadinone acetate; group II with a
      strict activator effect: medroxyprogesterone acetate, quingestanol acetate,
      lynestrenol and progesterone and group III with a nonsignificant effect:
      dydrogesterone, promegestone, norgestrel and danazol. Demegestone was the most
      potent inhibitor and medroxyprogesterone acetate and quingestanol acetate had the
      highest activator effect. The effect of Triton X-100, a nonionic detergent, was
      also tested. This detergent consistently increased the microsome estrone
      sulfatase activity. A comparison was made between the effects of demegestone,
      medroxyprogesterone acetate and danazol on estrone sulfatase activity measured
      with or without Triton X-100 in the incubation medium. The presence of the
      detergent modified the progestogen action. Our results suggest that synthetic
      progestogens can influence the estrone sulfatase activity measured in human
      breast carcinoma tissues. However, the effect of progestogens was dependent on
      experimental conditions. Progestogens such as demegestone and chlormadinone
      acetate which inhibited estrone sulfatase activity in intact preparations, can
      reduce the intracellular production of biological active estrogen via the
      sulfatase pathway.

PMID- 1751398
TI  - In vivo and in vitro studies on sex steroid binding protein (SBP) regulation in
      rainbow trout (Oncorhynchus mykiss): influence of sex steroid hormones and of
      factors linked to growth and metabolism.
AB  - The respective roles of sex steroids and hormones related to growth and
      metabolism, on SBP regulation have been studied in rainbow trout. In vivo,
      oestradiol (E2) supplementation induces a slow but significant increase of plasma
      SBP concentration. Testosterone or cortisol injections have no effect. In vitro,
      the steroid binding protein that accumulates in incubation medium of hepatic cell
      primary cultures has been characterized and found to be similar to blood SBP. Its
      production is increased by addition of E2 (maximum: +300%). This effect develops
      slowly over several days of culture and is dose dependent; as little as 1-10 nM
      E2 is effective. Recombinant rainbow trout GH (rtGH)--0.01 to 1 microgram/ml-
      also increases SBP accumulation as compared to control cells and seems to
      maintain SBP production over culture duration. In preliminary experiments, (1)
      insulin-like growth factor (IGF) and SBP concentrations were found to change
      inversely after a 4 days stimulation with increasing concentrations of GH; (2)
      recombinant human IGF1 (250 ng/ml) tended to be inhibitory when SBP production
      was expressed per mg of total cellular protein, and a micromolar concentration of
      bovine insulin was clearly inhibitory. Other hormones tested in vitro:
      triiodothyronine (10-1000 nM), thyroxine (100 nM), 17 alpha, 20 beta
      dihydroprogesterone (10-2000 nM), and testosterone (1-1000 nM) did not influence
      SBP concentration in hepatic cells culture media.

PMID- 1751399
TI  - DNA ploidy pattern of parathyroid parenchymal cells in renal secondary
      hyperparathyroidism with relapse.
AB  - The nuclei of parathyroid parenchymal cells, analyzed using image cytometry
      (ICM), in relapsing and non-relapsing secondary hyperparathyroidism due to
      uremia, showed a DNA-distribution pattern of diploid type. Nevertheless, some
      differences were observed within the groups, as regards the concept of 'scattered
      cells' in ICM DNA histograms. The relative incidence of 'scattered cells' was
      particularly high in the histograms from parathyroid glands with nodular
      hyperplasia and in those from parathyroid parenchyma grafted into the skeletal
      musculature. In these two kinds of parathyroid specimens, the 'scattered cells'
      were both of chief-cell and oxyphil-cell types. In contrast, 'scattered cells'
      were not so conspicuous when parenchymal cells of glands with diffuse hyperplasia
      were analyzed. As there is some clinical and histopathological evidence that the
      cells in both nodular-hyperplastic and autografted parathyroid parenchyma have
      increased growth potential, it is hypothesized that the relative incidence of the
      'scattered cells' in the ICM DNA histograms indicates an increased proliferative
      activity.

PMID- 1751400
TI  - Stage related morphometry of sarcoid granulomas and inflammatory cell types in
      broncho-alveolar lavage.
AB  - The epithelioid granulomas, interstitial and intra-alveolar mononuclear
      inflammatory infiltrates and the cellular compartments obtained by broncho
      alveolar lavage (BAL) were measured in 40 patients with pulmonary involvement of
      sarcoidosis. The granulomas were divided into a central (epithelioid-cellular)
      zone and into a peripheral (lymphocytic-fibrotic) zone, and the density of
      various inflammatory cells was measured in both compartments. The cases were
      grouped and analyzed according to the radiological and clinical stages. The
      results are as follows: neutrophilic granulocytes seen in the BAL probably
      originate from the sarcoid granulomas in patients with stage 1 of the disease and
      may derive from other compartments of the lung parenchyma in patients with stage
      2 or stage 3. Lymphocytes seen in the BAL of patients with stage 1 or stage 2 of
      the disease probably derive from intra-alveolar lymphocytic agglutinations. They
      originate from the sarcoid granulomas only in patients with stage 3. Macrophages
      seen in the BAL probably derive from the sarcoid granulomas independent from the
      stage of sarcoidosis. No relationship was found between the morphometric
      parameters and the clinical outcome of the disease.

PMID- 1751401
TI  - Tissue status of epidermal growth factor and its receptor as an indicator of poor
      prognosis in patients with gastric cancer.
AB  - An immunohistological study of epidermal growth factor (EGF) and epidermal growth
      factor receptor (EGFR) was made with 157 specimens of stomach cancer. EGF stained
      positively in 70 specimens (45%), and EGFR in 53 specimens (34%). The cancers
      were classified into three groups; Group 1 with neither EGF nor EGFR staining
      positively (67 tumors); Group 2 with either EGF or EGFR staining positively (57
      tumors); and Group 3 with both EGF and EGFR staining positively (33 tumors). The
      incidence rates of tumors of macroscopically infiltrative, poorly differentiated,
      deep invading and node-positive types were significantly higher for Group 3 than
      for Groups 1 and 2. The bromodeoxyuridine labeling indices (BrdU LIs) were
      significantly higher for Group 3 (median: 15.1%) than for Group 1 (median: 10.7%)
      or Group 2 (median: 11.4%). Patients with synchronous expression of EGF and EGFR
      (Group 3) had the poorest prognosis. From the results, it may be concluded that
      tumors with synchronous expression of EGF and EGFR have the highest malignant
      potentials and this phenomenon may cause autocrine secretion for self
      replication.

PMID- 1751402
TI  - Use of nuclear image cytometry, histopathological grading and DNA cytometry to
      make breast cancer prognosis more objective.
AB  - Feulgen-stained tissue sections of 187 invasive ductal carcinomas (94 with lymph
      node metastases; mean follow-up: 44 months) were studied using computer assisted
      image cytometry. Based on survival time, the prognostic significance of nuclear
      image analysis was compared with the results using conventional histopathological
      grading according to Bloom and Richardson, as well as with image cytometric DNA
      measurements. The histopathological grading has the disadvantage of poor
      interobserver reproducibility (71.1%). Despite statistically significant
      differences between the actuarial survival curves of grade 1 and grade 3
      patients, the prognostic significance of the conventional grading method for
      individual patients seems to be low and the number of grade 2 cases (42.8%) is
      large. The quantitative morphological method for analyzing nuclear images gives
      more reproducible results. Compared to histopathological grading, the predictive
      values for good or poor prognosis are clearly higher and the number of cases with
      uncertain prognosis is significantly smaller (20.9%). DNA ploidy measurements
      also make it possible to distinguish statistically significant differences
      between favorable and unfavorable prognoses with respect to over-all survival
      time. However, the classification accuracy based on the best single parameter
      (DNA-histogram type according to Auer) is 70.2% compared with 78.9% for nuclear
      image analysis.

PMID- 1751403
TI  - Selected bibliography.

PMID- 1751404
TI  - The role of jun and fos gene family members in 12-O-tetradecanoylphorbol-13
      acetate induced hemopoietic differentiation.
AB  - Terminal differentiation of the leukemic cell lines U-937 and HL-60 by 12-O
      tetradecanoylphorbol-13-acetate is accompanied by marked changes in gene
      expression. In this study, we demonstrate that the expression of jun and fos gene
      family members is induced with variable kinetics during 12-O-tetradecanoylphorbol
      13-acetate induced differentiation, with c-jun expression best paralleling
      differentiation. The generation of AP-1 complexes, as measured by DNA binding
      activity, closely parallels morphological differentiation. Furthermore, the
      ability of these complexes to regulate gene expression is demonstrated by
      increased transcription from an AP-1 driven reporter construct and marked
      increases in the expression of endogenous AP-1 regulated genes. Differentiation
      assays using water soluble phorbol esters reveal that differentiation becomes
      irreversible soon after AP-1 appears. This tight correlation between c-jun
      expression, the generation of AP-1 activity, and differentiation suggests a
      critical role for this gene and transcriptional complex during this process.

PMID- 1751405
TI  - Retinoic acid negatively regulates p34cdc2 expression during human neuroblastoma
      differentiation.
AB  - p34cdc2 is a protein kinase that has an important role in controlling cell cycle
      progression and may regulate tumor suppressor gene activity. In this work, we
      show that the arrest of cell growth and induction of differentiation in a
      tumorigenic neuroblastoma cell line by retinoic acid (RA) is associated with a 75
      fold decrease in the level of p34cdc2 protein. The RA induced decrease in p34cdc2
      levels does not simply reflect the arrest of cell growth, because p34cdc2 levels
      are not reduced when neuroblastoma cells are growth arrested by nutrient
      deprivation. Furthermore, dephosphorylation of the tumor suppressor gene product
      RB, a substrate for the p34cdc2 kinase activity, is observed only when p34cdc2
      levels are decreased in RA treated cells. These studies link regulation of cdc2
      level, RB phosphorylation state, and induction of differentiation by RA and
      suggest that alterations in the cdc2 gene or in genes controlling its regulation
      contribute to tumorigenesis.

PMID- 1751406
TI  - Decrease of proliferation rate and induction of differentiation by a MYCN
      antisense DNA oligomer in a human neuroblastoma cell line.
AB  - The effects of an antisense oligodeoxynucleotide to codons 2-7 of the oncogene
      MYCN on the human neuroblastoma cell line LAN-5 were studied. Treated cells
      showed a decreased MYCN protein expression and synthesis by immunoperoxidase
      staining and immunoprecipitation. At the same time, the replication rate was
      inhibited, and the phenotype was modified toward a more differentiated type. Our
      data suggest the involvement of oncogene MYCN in both proliferative and
      differentiative processes.

PMID- 1751407
TI  - A melanoma octamer binding protein is responsive to differentiating agents.
AB  - Analysis of human melanocytes and melanoma cell lines for proteins interacting
      with the octamer control sequence (ATGCAAAT) has revealed two distinct melanoma
      octamer binding proteins, Oct-M1 and Oct-M2. The latter was restricted to cell
      lines derived from tumor metastases. The level of Oct-M1 activity in a pigmented
      melanoma line was enhanced in comparison to the general octamer binding protein
      Oct-1 when cells were cultured in the presence of the depigmenting agent
      dithiothreitol and conversely was reduced by the differentiating and pigment
      inducing agents butyric acid and dimethyl sulfoxide.

PMID- 1751408
TI  - Joints in the regulatory lattice: composite regulation by steroid receptor-AP1
      complexes.

PMID- 1751409
TI  - The network of hemopoietic regulatory proteins in myeloid cell differentiation.
AB  - There are clones of myeloid leukemic cells that can be induced to undergo
      terminal cell differentiation to macrophages by normal hemopoietic regulatory
      proteins. Induction of differentiation in two different clones of myeloid
      leukemic cells with interleukin 6 (IL-6) or granulocyte-macrophage colony
      stimulating factor (GM-CSF) resulted in induction of mRNA for the hemopoietic
      regulatory proteins IL-6, GM-CSF, interleukin 1 alpha and interleukin 1 beta,
      tumor necrosis factor, and transforming growth factor beta 1. In one of these
      clones, induction of differentiation with GM-CSF was also associated with
      induction of mRNA for macrophage colony-stimulating factor (M-CSF) but not for
      the receptor for M-CSF (c-fms), whereas in the other clone, induction of
      differentiation with IL-6 was associated with induction of mRNA for both c-fms
      and M-CSF. The clones also differed in their responsiveness to these regulators.
      There was no induction of mRNA for granulocyte colony-stimulating factor or
      interleukin 3 during differentiation of either clone. The results indicate that
      the genes for a nearly normal network of positive and negative hemopoietic
      regulatory proteins are induced during differentiation of these myeloid leukemic
      cells and that there are leukemic clones with specific defects in this network.

PMID- 1751410
TI  - Overexpression of the retinoblastoma gene in a familial adrenocortical carcinoma.
AB  - Tumors derived from a Li-Fraumeni syndrome cancer-susceptible family were
      examined for expression of the retinoblastoma susceptibility gene (RB). Whereas
      RB expression was normal in a primary breast carcinoma and its metastases from
      one member of this family, overexpression of RB was found in an adrenocortical
      carcinoma from another family member. This was in contrast to normal RB
      expression in normal tissue of this patient, the adrenocortical adenocarcinoma
      cell line SW-13, and the fibroblast cell line MRC-5, and low level RB expression
      in normal adrenal tissue. The overexpression in the adrenocortical carcinoma
      resulted in increased synthesis of the RB-encoded protein and did not appear to
      be associated with RB amplification or rearrangement. This result is novel as it
      is usually the loss of expression or production of an altered RB transcript
      exhibiting deletions that is associated with carcinogenesis. In light of the
      recent discovery of p53 point mutations in the affected Li-Fraumeni syndrome
      family members tested, RB overexpression may constitute a secondary event in Li
      Fraumeni syndrome tumorigenesis.

PMID- 1751411
TI  - Cloning, sequencing, and expression of two Xenopus laevis c-ets-2 protooncogenes.
AB  - In a general approach to identify genes important in the control of genetic
      expression during development of Xenopus laevis, two complementary DNAs
      corresponding to two different c-ets-2 genes were cloned and sequenced. One of
      these complementary DNAs appears to be almost full length. The two variant genes
      differ in their overlapping sequences by 87 nucleotide substitutions, leading to
      17 amino acid modifications in the proteins, 8 of them being conservative. All
      but one of these changes map outside of the 142 COOH-terminal residues, a region
      critical for nuclear localization and DNA binding in the ets proteins. Features
      potentially important for the biological activity of the gene products are
      conserved. Two transcripts (3.2 and 1.7 kilobases) with maternal characteristics
      are detected at a constant level from stages II/III of oogenesis to stage 10 of
      embryogenesis. They later decline to hardly detectable levels at stages 30-40.
      Variable amounts of the same transcripts are observed in many adult tissues. All
      of these characteristics support the idea that the ets-2 gene products play an
      important role during embryogenesis, as well as in adult life. Indeed, they act
      as ubiquitous transcriptional activators, as recently demonstrated by several
      investigators (C. V. Gunther, J. A. Nye, R. S. Bryner, and B. J. Graves, Genes &
      Dev., 4: 667-679, 1990; R. Bosselut, J.F. Duvall, A. Gegonne, M. Bailly, A.
      Hemar, J. Brady, and J. Ghysdael, EMBO J., 9: 3137-3144, 1990; R. Wasylyk, C.
      Wasylyk, P. Flores, A. Begue, D. Leprince, and D. Stehelin, Nature (Lond.), 346:
      191-193, 1990).

PMID- 1751412
TI  - Immunohistochemical localization of retinal serotonin cells in the lamprey
      (Lampetra fluviatilis).
AB  - Light-microscopic immunocytochemistry was used to study serotonin (5HT)
      containing retinal cells in the lamprey (Lampetra fluviatilis). Observations of
      sections and flatmounted retinas enabled us to distinguish four principal types
      of 5HT-immunoreactive neurons, on the basis of the localization of their somata
      and the arrangement of their processes in the inner plexiform layer, (IPL). Type
      1 cell bodies (9 micron mean diameter) were numerous and were found in the
      innermost row of the inner nuclear layer (INL). They sent their processes into a
      dense plexus in sublamina a of the IPL. Type 2 cell bodies (12 micron mean
      diameter) were observed near the inner limiting membrane, their processes forming
      a plexus in sublamina b of the IPL. Most of the type 3 cells were bistratified,
      their cell bodies (similar in dimension to type 1) were located in the INL and
      their dendrites projected to both plexuses. Type 4 cell bodies (15 micron mean
      diameter) were observed in the middle of the IPL and could be compared with the
      interstitial described elsewhere. Their processes probably ended in the 5HT
      plexus of sublamina b but because of their sinuous course in the IPL, we could
      not affirm this fact. Most of 5HT immunoreactive cells were thought to be
      amacrine cells, but the presence of some thin processes emerging either from the
      soma or the primary dendrite, principally in type 1 and 2 cells, raises the
      possibility that some ganglion cells could be 5HT immunoreactive. The
      organization of the 5HT processes into two plexuses located in sublaminae a and b
      of the IPL resemble the functional ON and OFF pathway seen in the other
      vertebrates.

PMID- 1751413
TI  - Visual performance of horseshoe crabs day and night.
AB  - A circadian clock modulates the structure and function of the lateral eyes of
      Limulus polyphemus, greatly increasing their sensitivity at night. During the
      mating season, male Limulus are visually attracted both day and night to females
      and objects that resemble females. This paper asks how well Limulus can see day
      and night, and whether the circadian changes in retinal sensitivity might
      influence the ability of these animals to find mates. We recorded the visual
      behavior of male and female horseshoe crabs in the vicinity of an object--a
      cement hemisphere (29.5 cm diameter) similar in size and shape to a female
      horseshoe crab--placed in a mating area near Mashnee Dike, Bourne, Massachusetts.
      Males oriented toward this target from an average distance of 0.94 m during the
      day and 0.88 m at night; and females appeared to avoid the target. We conclude
      that males can see potential mates at night almost as well as they can during the
      day. Apparently the circadian changes in the retina help compensate for the daily
      changes in illumination in the animal's normal environment. This study provides
      the first evidence for a role of visual circadian rhythms in an animal's natural
      behavior.

PMID- 1751414
TI  - Lagged Y cells in the cat lateral geniculate nucleus.
AB  - We report on the existence of lagged Y (YL) cells in the A laminae of the cat
      lateral geniculate nucleus (LGN) and on criteria for identifying them using
      visual and electrical stimulation. Like the lagged X (XL) cells described
      previously (Mastronarde, 1987a; Humphrey & Weller, 1988a), YL cells responded to
      a spot stimulus with an initial dip in firing and a delayed latency to discharge
      after spot onset, and an anomalously prolonged firing after spot offset. However,
      the cells received excitatory input from retinal Y rather than X afferents, and
      showed nonlinear spatial summation and other Y-like receptive-field properties.
      Three YL cells tested for antidromic activation from visual cortex were found to
      be relay cells, with long conduction latencies similar to those of XL cells.
      Simultaneous recordings of a YL cell and its retinal Y afferents show striking
      parallels between lagged X and Y cells in retinogeniculate functional
      connectivity, and suggest that the YL-cell response profile reflects inhibitory
      processes occurring within the LGN. The YL cells comprised approximately 5% of Y
      cells and approximately 1% of all cells in the A laminae. Although infrequently
      encountered in the LGN, they may be roughly as numerous as Y cells in the retina,
      and hence could fulfill an important role in vision.

PMID- 1751415
TI  - Localization of retinal photoisomerase in the compound eye of the honeybee.
AB  - The distribution of honeybee retinal photoisomerase, a soluble light-requiring
      enzyme that stereospecifically forms 11-cis retinal, was investigated by
      immunoelectron microscopy and by HPLC. Immunolocalization with polyclonal
      antibodies shows that the highest concentration of retinal photoisomerase is
      located in the proximal portion of the primary pigment cells in large aggregates
      (approximately 2 microns diameter). Photoisomerase is also located in the
      peripheral portion of the photoreceptor cells, laterally displaced from the
      rhabdom, but in much lower concentration. Because of the larger volume of the
      photoreceptor cells, about half of the total immunoreactivity is associated with
      the primary pigment cells. Dissection of the eye with the subsequent use of HPLC
      to assay for photoisomerase activity showed that most of the photoisomerase
      activity is associated with tissues near the cornea. The same tissue also
      supports the reduction of 11-cis retinal to 11-cis retinol. These biochemical
      findings are consistent with the immunolocalization of retinal photoisomerase to
      the high-concentration aggregates in the primary pigment cells that surround the
      crystalline cones. The major synthesis of 11-cis retinol therefore takes place in
      the primary pigment cells, and the retinoid must be moved into the photoreceptor
      cells to be available to newly synthesized opsin. The immunoreactivity of the
      photoreceptor cells appears to reflect the presence of some isomerase without an
      attached retinoid chromophore.

PMID- 1751416
TI  - Mechanism of anomalous retinal correspondence: maintenance of binocularity with
      alteration of receptive-field position in the lateral suprasylvian (LS) visual
      area of strabismic cats.
AB  - We have examined the effects of rearing kittens with a unilateral convergent
      strabismus, induced surgically at 3 weeks of age, on the binocularity (ocular
      dominance) and receptive-field position of neurons in the motion-sensitive
      lateral suprasylvian (LS) area of cat extrastriate cortex. Data were compared to
      those obtained from area 17 in the same animals, and from the two areas of cortex
      in normal adult cats. Interocular alignment of the operated cats was assessed in
      alert adults using corneal reflex photography and during recording from the
      positions of retinal landmarks under paralysis. The strabismus magnitude in each
      operated cat was calculated by comparison with equivalent data from the normal
      animals. Strabismus always caused a major loss of binocularity in area 17. The
      remaining binocular neurons had receptive-field (RF) pairs arising from positions
      of normal correspondence in the two retinae and would thus have been responsive
      to different regions of visual space through the misaligned eyes in the alert
      animal. In area LS, the effects were dependent on the strabismus magnitude. In
      the group of four cats with pronounced strabismus (18-30 deg crossed), a loss of
      binocularity occurred in area LS equivalent in severity to that in area 17. The
      majority of the remaining binocular LS neurons possessed RF pairs in normal
      retinal correspondence and would thus, in the alert animal, have received
      spatially disparate visual input through the two eyes. This also occurred in
      three other cats with more moderate strabismus (11-15 deg crossed), although only
      a small breakdown in the binocularity of area LS was apparent. The group of cats
      with mild strabismus (less than or equal to 10 deg crossed) had normal
      proportions of binocular neurons in area LS. In three of these cats, the
      maintenance of binocularity was accompanied by shifts in RF position, with visual
      inputs arising from anomalous retinal locations. These shifts compensated, in
      part, for the strabismus angle present in each cat, so that most of the binocular
      LS neurons would have received inputs from regions of visual correspondence
      through the misaligned eyes when the animal was alert. Similar mechanisms could
      afford a basis for the binocular visual compensations that occur in humans with
      small-angle strabismus of early onset. If so, anomalous retinal correspondence in
      such individuals would have as a locus areas of extrastriate cortex with a role
      in motion perception, and would involve alterations to the neural substrate
      underlying normal binocular vision.

PMID- 1751417
TI  - A molecular basis for Weber's law.
AB  - A mathematical model is presented that obeys a strong form of Weber's law--over a
      range of adapting and stimulus intensities, equal contrast stimuli evoke
      identical responses. To account for the strong Weber's law, the adaptive stage in
      the proposed model employs a "delayed" reverse reaction along with a power-law
      input. It is suggested that this Weber's law mechanism is responsible for a slow,
      voltage-uncorrelated component of adaptation in the vertebrate photoreceptor. A
      plausible biochemical mechanism is the G-protein cycle with phosphorylation of
      photoactivated photopigment (and binding of arrestin to the phosphorylated
      photopigment) as the adaptive process. In an Appendix, features of the general
      model and implications of a specific biochemical model are examined by computer
      simulation.

PMID- 1751418
TI  - Development of visual inhibitory interactions in kittens.
AB  - This study was designed to monitor the development of inhibitory interactions
      elicited in the cat visual system by oriented visual stimuli. Steady-state visual
      evoked potentials (VEPs) were recorded from the scalp of 11 behaving and alert
      kittens while they viewed contrast-reversed sinusoidal gratings. In adult cats,
      the form of VEP contrast-response curves (the amplitude of second harmonic
      modulation as a function of stimulus contrast) was modified by superimposing a
      mask grating on the test. Parallel masks displaced the curves to a higher
      contrast region (probably via contrast gain-control mechanisms), increasing
      contrast threshold without affecting the slope of the curve. Orthogonal gratings,
      on the other hand, decrease the slope of the curve without affecting threshold
      (so called cross-orientation inhibition: Morrone et al., 1981). These effects are
      similar to those previously reported in human VEPs (Morrone & Burr, 1986; Burr &
      Morrone, 1987) and single cortical cat cells (Morrone et al., 1982). For young
      kittens of 20 days, the orthogonal mask had no effect whatsoever on the response
      curves, and the effect of the parallel mask was much less than for adult cats. At
      about 40 days, the orthogonal mask began to attenuate responses multiplicatively,
      and by 50 days the amount of multiplicative attenuation had reached adult levels.
      The effect of the parallel mask (as indicated by the increase in threshold
      elevation) increased gradually from 20-50 days. The results are consistent with
      the existence of at least two types of inhibition in cat visual neurones that
      develop at different rates.

PMID- 1751419
TI  - Effects of monocular deprivation on the development of visual inhibitory
      interactions in kittens.
AB  - A visual-evoked-potential (VEP) masking technique was used to assess the effects
      of short- and long-term monocular deprivation on the development of visual
      inhibitory interactions in kittens. VEP contrast-response curves were recorded in
      response to contrast-reversed sinusoidal gratings, both with and without
      superimposed high-contrast masks. The contrast-response curves measured from the
      nondeprived eye were similar to those of normal cats: with no mask VEP amplitudes
      increase with contrast up to saturation at about 10% contrast; parallel masks
      shift the curves to the right, decreasing thresholds; and orthogonal masks
      decrease the slope of the contrast-response curves without affecting thresholds.
      After monocular deprivation (either brief or extensive), the contrast-response
      curves without mask did not show the typical response saturation, and neither
      parallel nor orthogonal mask had any effect on the contrast-response curves. The
      masking effects did not return after 100 days of normal vision, although contrast
      sensitivity and acuity recovered to about half of the normal levels during that
      period. The results indicate that the inhibitory intracortical circuitry that
      mediates the orientation-dependent masking effects are highly vulnerable to
      visual experience.

PMID- 1751420
TI  - Mechanisms of early visual processing in the medulla of the locust optic lobe:
      how self-inhibition, spatial-pooling, and signal rectification contribute to the
      properties of transient cells.
AB  - In the arthropod medulla, which is the second ganglion on the afferent visual
      pathway, a column of about 40 cells represents each point in space (i.e. compound
      eye facet). Some stages of visual processing underlying the responses of one
      class of cells in the locust medulla have been identified. These transient cells
      give very similar responses to intensity increments and decrements, and also to
      pulses and steps; there is no spontaneous activity and a stimulus causes one or
      two spikes to fire at fixed latencies. Movement, however, produces a prolonged
      spike discharge by successive excitation of subunits within the receptive field.
      One of the main features of the transient cells' responses is a self-inhibition
      which attenuates responses to successive stimuli at one point. This inhibition is
      restricted to the outputs of single receptor (rhabdom), it decays after about 100
      ms, and is polarity sensitive so that stimuli of one polarity (e.g. dimming) do
      not inhibit responses to stimuli of the opposite polarity (e.g. brightening). The
      inhibition effectively alters the contrast threshold of the cells, because after
      adaptation with stimuli of one contrast, a modest (less than 20%) increase in
      contrast is sufficient to elicit an unadapted response. Transient cells are not
      directionally selective and there are no local spatio-temporal interactions of
      the kind necessary for directional selectivity. But, by analogy with the
      directional veto in directionally selective cells in the rabbit retina (Barlow &
      Levick, 1965), self-inhibition is suggested as a mechanism of non-directional
      motion detection. After the inhibition, there is some spatial pooling of signals
      which is followed by rectification. The transient cells' spiking outputs could
      abstract a refined subset of visual information which may encode the presence,
      but not the direction, amplitude, or polarity of moving object borders.

PMID- 1751421
TI  - Habituation-like decrease in the responses of neurons in inferior temporal cortex
      of the macaque.
AB  - In both anesthetized and behaving macaques, we examined the responses of neurons
      in the inferior temporal cortex (IT) to repeated presentation of a visual
      stimulus. In anesthetized animals, the responsiveness of IT neurons decreased
      with repeated stimulus presentation at interstimulus intervals (ISIs) of 2-12 s
      but not at 20 s. Responsiveness recovered after a 5-min period of no stimulus
      presentation. The response decrement was similar in anesthetized and awake
      animals at a 2-s ISI, but at a 6-s ISI, response decrement in the awake animal
      was much less.

PMID- 1751422
TI  - Physiological and morphological properties of off- and on-center bipolar cells in
      the Xenopus retina: effects of glycine and GABA.
AB  - We studied the morphology and center-surround organization of Lucifer Yellow
      injected OFF- and ON-center bipolar cells in the light-adapted Xenopus retina and
      the effects of glycine and GABA on their cone-mediated light responses. In both
      classes of cell, prominent antagonistic surround responses up to 20 mV in
      amplitude could be evoked without first suppressing the center responses with
      steady illumination. An additional feature of the light-evoked bipolar cell
      response was a pronounced (up to -24 mV) delayed hyperpolarizing after potential
      (DHAP) which followed the depolarizing responses of both classes of bipolar cell.
      The morphological features of dye-injected bipolar cells conformed to the general
      idea of segregation of ON and OFF pathways in the inner and outer interplexiform
      layer, however, the morphology of axonal arborizations was different for both
      classes. OFF-center cells ramified symmetrically around the primary branchpoint,
      whereas ON-center cells had a strongly asymmetrical arrangement of their axonal
      tree. The center and surround responses were differentially sensitive to glycine
      and GABA. Glycine eliminated the antagonistic surround responses in both OFF and
      ON cells; the center responses were reduced to some extent but were not
      eliminated. In contrast, GABA affected the hyperpolarizing responses much more
      strongly than the depolarizing response components. That is, the amplitude of the
      center response in the OFF cell and the surround response in the ON cell was
      reduced 80-90% during exposure to GABA, whereas the surround and center
      depolarizations of OFF and ON cells, respectively, were reduced only 0-10%. Our
      findings implicate a role for GABAergic and glycinergic pathways in the center
      surround organization of bipolar cells in Xenopus retina. In addition, the
      results suggest that the pathways mediating center-surround antagonism may be
      different in OFF-bipolar cells vs. ON-bipolar cells.

PMID- 1751423
TI  - Antibodies to human leucocyte antigens indicate subpopulations of microglia in
      human retina.
AB  - Monoclonal antibodies to human leucocyte antigens, including anti-CD45 and anti
      CD68, have been used to describe microglia in flatmounts of normal adult human
      retina for the first time. Anti-CD45 (the leucocyte common antigen) intensely
      labeled large numbers of cells in a regular distribution across the retina; anti
      CD68 and anti-macrophage antibodies labeled fewer cells with distinctive
      morphologies, suggesting the presence of subpopulations of microglia in the human
      retina expressing leucocyte antigens.

PMID- 1751424
TI  - Visual input to commissural neurons of the cat's superior colliculus.
AB  - Cells projecting into the commissure of the cat's superior colliculus were
      identified during extracellular recording by antidromic activation. Electrical
      stimulation of the ipsilateral optic tract evoked action potentials in the
      majority of commissural neurons. Response latencies of 1.4 +/- .5 ms (mean +/-
      S.D.) in a few cells indicated that some commissural neurons receive direct input
      from the axons of retinal Y-cells. Most commissural cells responded 5.9 +/- 1.9
      ms (mean +/- S.D.) following optic tract shock, implying that the responsible
      pathway was composed of more slowly conducting axons or did not proceed directly
      to the colliculus. Results of previous studies of retinal inputs to cells in the
      deep tectal layers suggest that the later responses were mediated by an indirect
      Y pathway through the visual cortex.

PMID- 1751425
TI  - Directional performances with moving plaids: component-related and plaid-related
      processing modes coexist.
AB  - A moving grating oriented +/- 45 degrees to the vertical can be perceived at
      choice as drifting along a left-right or up-down directional axis. When the
      drifting stimulus is presented alone, direction discrimination thresholds are
      independent of the specified response-axis. However, they strongly depend on it
      when the moving stimulus is superimposed on a vertical or horizontal stationary
      grating. Facilitation is always obtained when the drift direction of the
      intersections of the two gratings ('blobs') is collinear with the response-axis
      (i.e. when the orientations of the stationary grating and of the response-axis
      coincide), while inhibition is observed in the 'noncollinear' cases (i.e. when
      the orientations of the stationary grating and of the response-axis are
      orthogonal). These results are generalized in a series of reaction time (RT)
      experiments where the stimulus configuration described above was set at
      suprathreshold contrasts and where the orientation/direction of the drifting
      grating was variable. RT increased when the angle between the response-axis and
      the direction of the drifting grating increased (uncertainty effect), whether the
      test stimulus was presented alone, or superimposed on the stationary grating. The
      uncertainty effect was, however, significantly decreased under 'collinearity'
      conditions. The attenuation of the uncertainty effect was proportional with the
      velocity of the blobs and about equal in amount to the RT decrease obtained
      through the manipulation of the velocity of the drifting grating when presented
      alone (velocity effect). This observation strongly suggests that both component-
      and blob/plaid-related information contribute to the directional perception of a
      compound stimulus and that they sum algebraically.

PMID- 1751426
TI  - Edge extraction by active defocusing.
AB  - A novel edge extraction method that employs an active defocusing technique is
      presented. The method is based on the principle that a Laplacian-of-Gaussian
      (LOG) operation can be approximated by a Difference-of-Gaussian (DOG) operation.
      While such an operation is usually done in digital image processing, it can also
      be very effective conducted in a combination of optical techniques and digital
      processing. In this edge extraction method, a focused image of an object in a
      scene is first acquired. The image of the scene is then slightly defocused by
      changing the focal length of the camera. A real time subtraction operation is
      applied to subtract the defocused image from the previously acquired image. It
      produces a residual image that emphasizes abrupt intensity variations. An
      objective evaluation, called an edge index, is performed on the resulting image.
      The amount of defocusing is carefully adjusted according to this measurement so
      that a desired edge image is generated. Boundaries of objects can then be
      obtained by further enhancement of the edge image. Since this edge detection
      method is an optical-based process aided by digital processing, it is fast and
      relatively inexpensive.

PMID- 1751427
TI  - The search operating characteristic as a tool for analyzing performance in
      dynamic visual search tasks.
AB  - A standard data plot for the analysis of eye movement behavior in visual search
      and related tasks, a Search Operating Characteristic (SOC), is proposed. The SOC
      plots mean fixation duration (in ms) vs. search span (in items/fixation) for
      different difficulty levels. It is well specified by a reciprocal power function
      and this function can be explained with the help of Pieron's law.

PMID- 1751428
TI  - Effects of adaptation to apparent movement on recovery of structure from motion.
AB  - Past work on the recovery of three-dimensional structure from dynamic two
      dimensional images has led to inconsistent conclusions regarding the
      contributions of the short-range and long-range motion processes. In the present
      experiments, subjects adapted to displays (either four lines or 50 randomly
      positioned pixels) whose spatiotemporal parameters were chosen to favor either
      the short-range or long-range process. Adaptation periods were followed by test
      displays that simulated the rotation of a four-pixel random object about the
      vertical gamma-axis. The dependent measure was the angle of rotation between
      successive frames of the rotation display at which percepts of three-dimensional
      structure broke down. Both the original data and derived measures based on best
      fitting polynomials showed small but consistent effects: Compared to control
      conditions, adaptation to short-range motion reduced the angle at which percepts
      of structure broke down; adaptation to long-range motion increased them. It is
      suggested that both low-level (i.e. short-range) and high-level (long-range)
      processes contribute to the recovery of structure from motion.

PMID- 1751429
TI  - Comments on Cavanagh and Mather (1989): coming up short (and long)
AB  - Cavanagh and Mather (1989) reviewed literature concerning the possible
      distinction between short- and long-range processes in motion perception and
      concluded that the distinction cannot be supported. Instead, they proposed that
      motion perception be considered on the basis of detectors for first-order
      (luminance, color) and second-order (first-order motion, texture, stereo)
      stimulus attributes. They supported their position with studies of motion based
      on second-order stimuli. The present paper contends that when experiments
      permitting the investigation of both processes in the same display are included
      and when criteria are examined in their totality rather than one-by-one, the
      original short-range/long-range distinction can be retained. Furthermore, it is
      argued that the first-order/second-order distinction does not represent a
      theoretical advancement and that studies of second-order motion can be
      interpreted in terms of the older distinction. It is concluded that the short
      range/long-range distinction is useful and should not be abandoned.

PMID- 1751430
TI  - Short-range vs long-range motion: not a valid distinction.

PMID- 1751431
TI  - Randomized controlled trial of antenatal social support to prevent preterm birth.
AB  - OBJECTIVE: To test the effect of a programme of additional antenatal social
      support on the occurrence of preterm birth (a birth from 20 to 36 weeks
      gestation) in women at risk of preterm birth. DESIGN: A prospective randomized
      controlled trial. The design was one of randomization before consent for a new
      treatment. SETTING: Three public hospital antenatal clinics in Perth and the
      offices of 87 obstetricians and general practitioners in Western Australia.
      SUBJECTS: 1970 pregnant women with poor obstetric histories entered the trial;
      983 of these were randomly allocated to the programme group and 987 to the
      control group. INTERVENTIONS: Normal antenatal care was provided for both groups.
      In addition, members of the programme group were offered an intervention aimed at
      providing expressive (emotional) social support, consisting of antenatal home
      visits and telephone calls by midwives. Of the women allocated to the programme
      group, 24 refused consent and 69 were not traced before completion of their
      pregnancies, the remaining 890 women (90.5%) agreed to enter the programme, and
      each received at least one intervention. MAIN OUTCOME MEASURES: Gestational age
      at completion of the pregnancy. A pregnancy ending before 20 weeks was labelled a
      miscarriage. RESULTS: There were 126/981 (12.8%) preterm births in the programme
      group and 147/986 (14.9%) in the control group. The outcome data for two women in
      the programme group and one in the control group could not be found. The
      unadjusted odds ratio for preterm birth in the programme was 0.84 (95% CI 0.65
      1.09). The observed relative reduction in preterm births associated with the
      programme was 13.8% (95% CI -8.2% to +31.5%) and the trial had a 60% power to
      exclude a true relative reduction of 25%. CONCLUSIONS: The results of this trial
      and those of other controlled clinical trials provide little evidence for the
      effectiveness of social support interventions in the prevention of preterm birth
      in women with poor obstetric histories.

PMID- 1751432
TI  - Pre-eclampsia and offspring's blood pressure, cognitive ability and physical
      development at 17-years-of-age.
AB  - OBJECTIVE: To investigate the influence of maternal pre-eclampsia on the blood
      pressure, physique and intelligence of the offspring at the age of 17 years.
      DESIGN: Data obtained at the age of 17 during assessment for drafting to the
      Israel Defence Forces and from the records of the mothers' pregnancies from the
      Jerusalem Perinatal Study. SUBJECTS: Study subjects were 145 girls and 283 boys
      whose mothers had had pre-eclampsia and controls were 12,701 girls and 20,416
      boys whose mothers did not have pre-eclampsia. MAIN OUTCOME MEASURES: Systolic
      and diastolic blood pressure, weight, height and intelligence scores at the age
      of 17 were related to birthweight and the occurrence of pre-eclampsia during
      their mothers' pregnancies. RESULTS: Systolic blood pressure was greater than 140
      mmHg in 6.9 and 11.0% of the study girls and boys, compared with 2.9 and 9.9% of
      the control girls and boys. The study boys but not the girls had a higher mean
      body mass index than the controls (P less than 0.001). There were no differences
      in the intelligence scores. Using multiple logistic regression to allow for the
      confounding effects of body mass index, weight and birthweight, the odds ratio
      for the risk of a systolic pressure greater than 140 mmHg was 2.30 (95% CI 1.80
      4.46) for the study girls but was not significantly increased for the study boys.
      CONCLUSION: Maternal pre-eclampsia does not impair growth and cognitive
      performance in the children who reach late adolescence but may be associated with
      hypertension.

PMID- 1751433
TI  - The effect of induced abortion on subsequent pregnancy outcome.
AB  - OBJECTIVE: To investigate the effect of induced abortion on the outcome of the
      next pregnancy. DESIGN: Long-term prospective controlled cohort study. SETTING:
      Joint Royal College of General Practitioners/Royal College of Obstetricians and
      Gynaecologists study based in general practice in England, Scotland and Wales.
      SUBJECTS: 1311 women whose recruitment pregnancy had ended in induced abortion
      (the abortion group) and 2131 women whose recruitment pregnancy had a natural
      conclusion (the non-abortion group). MAIN OUTCOME MEASURES: Non-viable outcome
      (spontaneous or missed miscarriage, ectopic pregnancy or stillbirth),
      birthweight, length of gestation. RESULTS: Induced abortion was not materially
      associated with any of the three measures of adverse outcome. Compared with the
      non-abortion group the relative risk of a non-viable outcome in the abortion
      group was 1.01 (95% CI 0.81 to 1.27). In the abortion group birthweight was an
      average 23 g lighter (95% CI -76 g to + 30 g) and length of gestation an average
      0.9 days shorter (95% CI -2.2 days to + 0.4 days) than in the non-abortion group.
      Women who had their abortions in NHS premises had an increased risk of a non
      viable outcome (RR 2.55, 95% CI 1.31 to 4.94) and had babies with significantly
      lower mean birthweight (-119 g, 95% CI -233 g to +5 g) compared with those who
      obtained their operations in the private sector. Women whose abortion had been
      carried out by a consultant had the lowest risk of non-viable outcome. Although
      these differences remained after adjustment for a number of important variables,
      it is possible that factors not measured in the present study, such as economic
      status and occupation, played a contributory role. CONCLUSION: Overall, induced
      abortion was not associated with any important effect on the three measures of
      adverse outcome in the subsequent pregnancy.

PMID- 1751434
TI  - Pre-operative cervical preparation before first trimester vacuum aspiration: a
      randomized controlled comparison between gemeprost and mifepristone (RU 486).
AB  - OBJECTIVE: To compare the effectiveness of 200 mg mifepristone with 1 mg
      gemeprost vaginal pessary in achieving cervical dilatation and softening
      ('priming') before late first trimester pregnancy vacuum aspiration. DESIGN: A
      randomized, operator blind, placebo controlled trial. SETTING: UK teaching
      hospital. SUBJECTS: 90 primigravid women with 63-91 days amenorrhoea and
      ultrasonically confirmed single living fetus of correct size for gestational age.
      INTERVENTIONS: The women were allocated to receive 200 mg mifepristone orally or
      an identical oral placebo 36 h before operation or 1 mg gemeprost vaginal pessary
      3-4 h preoperatively. MAIN OUTCOME MEASURES: Onset of new symptoms following drug
      administration, a proven objective measure of the force required to dilate the
      cervix, and estimated intraoperative blood loss. RESULTS: There were no
      significant differences in the baseline cervical dilatation, the force required
      to dilate the cervix or the volume of intraoperative blood loss between the
      active treatment groups. Both drugs were significantly more effective than
      placebo. Significantly fewer women in the mifepristone group had adverse side
      effects than in the gemeprost group. CONCLUSIONS: Mifepristone is a highly
      effective cervical priming agent, and has the advantages of being an oral
      preparation associated with few side effects.

PMID- 1751435
TI  - A clinical comparison of sonographic hydrotubation and hysterosalpingography.
AB  - OBJECTIVE: To assess the value of vaginal sonographic hydrotubation as a
      preliminary test of uterine configuration and tubal patency in infertility
      investigation, and to compare this new test with hysterosalpingography. DESIGN: A
      prospective blind comparison of the two tests in an unselected group of infertile
      women. SETTING: Hillbrow Hospital, Johannesburg, South Africa. SUBJECTS: Sixty
      women undergoing routine infertility investigations agreed to participate in the
      study. There were no refusals. INTERVENTIONS: Within 4 weeks before or after
      hysterosalpingography sonographic hydrotubation was performed as follows: The
      uterus and tubes were identified using a 5 MHz vaginal ultrasound probe and
      between 10 and 20 ml of normal saline were injected into the uterine cavity
      through an endocervical catheter. MAIN OUTCOME MEASURES: The shape of the uterus
      and its cavity, the flow of saline through the tubes, the presence of
      hydrosalpinges before and after injection of saline and the presence of free
      fluid in the pouch of Douglas. RESULTS: The sonographic and
      hysterosalpingographic findings were similar in 82% of the women with respect to
      uterine assessment and in 72% with respect of tubal findings. In seven women
      (12%) found to have bipolar tubal disease on sonography and cornual block on
      hysterosalpingography, the sonographic diagnosis was confirmed at laparoscopy.
      Septate uterus in three women was diagnosed with greater certainty with
      sonographic hydrotubation. CONCLUSIONS: Sonographic hydrotubation is a simple
      office procedure which should be used in the preliminary assessment of the
      uterine cavity and fallopian tubes. Its use will reduce the need for
      hysterosalpingography and in some cases laparoscopy.

PMID- 1751436
TI  - A new treatment for endometrial cancer with gonadotrophin releasing-hormone
      analogue.
AB  - OBJECTIVE: To test the antitumour effect of gonadotrophin releasing-hormone
      (GnRH) analogues in women with recurrent endometrial cancer. DESIGN: An open
      phase II observational trial of GnRH analogues. Serial measurements of
      gonadotrophins, sex hormones and tumour dimensions were made together with repeat
      biopsy when possible to assess the response to treatment. SETTING: The outpatient
      clinics of the Department of Medical Oncology at The Royal London, Royal Marsden
      and St Bartholomew's hospitals. SUBJECTS: 17 patients with endometrial cancer
      which had recurred after surgery, radiotherapy and progesterone treatment and was
      symptomatic, progressive and assessable for response. INTERVENTION: Monthly
      subcutaneous injection of GnRH analogue. MAIN OUTCOME MEASURES: Reduction in
      serum gonadotrophins and reduction in tumour dimensions. RESULTS: Six out of 17
      patients (35%, 95% CI 12.6-58%) achieved a complete or partial remission which
      continues for a median of 20 months with no adverse effects. CONCLUSION: GnRH
      analogues have a significant antitumour effect in recurrent endometrial cancer
      which warrants further examination in comparison with progestogens.

PMID- 1751437
TI  - Postpartum eclampsia and acute renal failure; treatment with prostacyclin. Case
      report.

PMID- 1751438
TI  - Repeated measurement of maternal weight during pregnancy. Is this a useful
      practice? Patterns of maternal weight gain in pregnancy.

PMID- 1751439
TI  - Comparison of the T/QRS ratio of the fetal electrocardiogram and the fetal heart
      rate during labour and the relation of these variables to condition at delivery.

PMID- 1751440
TI  - A randomized controlled trial of early amniotomy.

PMID- 1751441
TI  - What is birth asphyxia?

PMID- 1751442
TI  - Doppler flow velocity waveform analysis in high risk pregnancies: a randomized
      controlled trial.
AB  - OBJECTIVE: To test whether the introduction of Doppler waveform analysis into the
      ultrasound department of a tertiary level hospital reduces neonatal morbidity and
      improves obstetric management. DESIGN: A randomized controlled trial. SETTING:
      Department of Ultrasound, King Edward Memorial Hospital, Perth, Western
      Australia. SUBJECTS: 505 women with pregnancy abnormalities referred to an
      ultrasound department for fetal investigation during the third trimester.
      INTERVENTION: Continuous wave Doppler studies of umbilical and uteroplacental
      arterial circulations. Results were revealed to patients and clinicians. MAIN
      OUTCOME MEASURES: Principal end point was the duration of neonatal stay in
      hospital; other end points included the number and type of fetal heart rate
      monitoring studies, obstetric interventions, frequency of fetal distress,
      birthweight, Apgar scores and need for neonatal intensive care. RESULTS: There
      was no effect on the duration of neonatal stay in hospital. Small trends in
      obstetric management were observed with study group patients having fewer
      contraction stress tests, less likelihood of antepartum fetal distress, and more
      likelihood of fetal distress after induction of labour leading to emergency
      caesarean section. Depressed Apgar scores were more frequent in the study group.
      CONCLUSION: Introduction of Doppler waveform studies did not result in reduced
      neonatal morbidity but did have a small effect on obstetric management. For each
      institution the role of Doppler studies in late pregnancy will be influenced by
      the usage of other tests of fetal welfare already entrenched in clinical
      practice.

PMID- 1751443
TI  - Trophoblast deportation in pre-eclamptic pregnancy.
AB  - OBJECTIVES: To examine the deportation of trophoblast cells into the maternal
      blood in pre-eclamptic (gestational proteinuric hypertension) and normal
      pregnancy. DESIGN: The monoclonal anti-cytokeratin antibody JMB2 was used in the
      APAAP technique to label trophoblast cells in cell smears of uterine vein blood
      obtained at caesarean section. SUBJECTS: 10 women with proteinuric pre-eclampsia
      requiring caesarean section, 10 pregnant women requiring elective caesarean
      section for reasons other than pre-eclampsia and five control women who had never
      been pregnant. RESULTS: Three populations of trophoblast cells were identified;
      two mononuclear cytotrophoblast types with diameters varying from 11-14 microns
      and 19-25 microns respectively, and multinucleated syncytiotrophoblast cells
      varying in size from 23-88 microns. Women with pre-eclampsia had more trophoblast
      cells in uterine vein blood than were found in pregnant women without pre
      eclampsia. There was no correlation between the numbers of trophoblast cells and
      the stage of gestation or severity of the pre-eclampsia, although an acute
      maternal or fetal event necessitating delivery was associated with increased
      deportation of trophoblast. Mononuclear cytotrophoblast cells were detected in
      the peripheral blood of only 1 of 5 pre-eclamptic patients, despite their
      presence in the uterine vein blood of all 5 women. CONCLUSIONS: Trophoblast
      deportation is increased in pre-eclamptic pregnancy, with both cytotrophoblast
      and syncytiotrophoblast present in the uterine vein blood, but there is no
      correlation with the severity of the disease. In some cases cytotrophoblast may
      also enter the peripheral circulation.

PMID- 1751444
TI  - (Patho)physiological implications of chronic dietary sodium restriction during
      pregnancy; a longitudinal prospective randomized study.
AB  - OBJECTIVE: To study the possible pathophysiological implications of long
      continued dietary sodium restriction in pregnancy. DESIGN: Longitudinal
      prospective randomized study of the effects of a low sodium diet compared with
      unrestricted sodium intake in pregnancy. SETTING: Academic Department of
      Obstetrics and Gynaecology at Sint Radboud Hospital, Nijmegen, The Netherlands.
      SUBJECTS: 42 healthy nulliparous women. INTERVENTION: A low sodium diet (20 mmol
      sodium daily) started in the 14th week of pregnancy and stopped after delivery.
      MAIN OUTCOME MEASURES: Maternal weight gain, food intake, blood pressure, cardiac
      output, systemic vascular resistance, haematocrit and birthweight. RESULTS: Total
      maternal weight gain and dietary energy intake during pregnancy and weight at 1
      and 6 weeks postpartum were significantly lower in the low sodium group. Blood
      pressure during pregnancy did not show major differences. Stroke volume and
      cardiac output during pregnancy were significantly lower in the low sodium group
      whereas systemic vascular resistance was significantly higher. Haematocrit values
      in the low sodium group tended to be lower during pregnancy, but were
      significantly lower at 1 and 6 weeks postpartum than in the unrestricted group.
      Placental and birthweights were not significantly different between the two
      groups. CONCLUSIONS: Chronic dietary sodium restriction during pregnancy is
      characterized by a diminished body fat accumulation and a reduction in
      circulating volume, due to a decrease in both plasma and red cell volume, in
      combination with a high systemic vascular resistance without major effects on
      blood pressure and birthweight.

PMID- 1751445
TI  - Bilateral oophorectomy and hysterectomy in the treatment of intractable pelvic
      pain associated with pelvic congestion.
AB  - OBJECTIVE: To determine whether bilateral oophorectomy combined with hysterectomy
      is an effective treatment for chronic pelvic pain due to congestion. DESIGN:
      Prospective non-randomized single centre study. SETTING: Tertiary referral centre
      to a specialist pelvic pain clinic in a teaching hospital. SUBJECTS: 36 women, 33
      of whom had failed to obtain long term relief of pain on medical therapy. MAIN
      OUTCOME MEASURES: Relief of pain, coital frequency, and effect on daily life.
      Histology of uterus and ovaries. RESULTS: Median pain score on visual analogue
      scale fell from a pre-operative value of 10 to 0 at one year. Twelve of the 36
      women had some residual pain at one year postoperatively, but in only one woman
      was the pain affecting her daily life. Thirty women were noted to have pelvic
      tenderness pre-operatively, at one year, 26 had no tenderness and four minimal
      tenderness on pelvic examination. The median frequency of sexual intercourse
      increased from once per month preoperatively to eight times per month one year
      postoperatively. The uterus was histologically normal in 25 women, adenomyosis
      was present in eight of whom two had ovarian endometriosis. Fibroids were present
      in three and endometriosis was found confined to the ovaries in one woman.
      Multiple peripheral cysts were present in the ovaries of 25 women. CONCLUSION:
      Bilateral oophorectomy combined with hysterectomy and hormone replacement therapy
      is an effective treatment for chronic pelvic pain due to venous congestion, which
      has failed to respond to medical treatment and leads to restoration of normal
      coital function and daily life.

PMID- 1751446
TI  - Cancer of the cervix in women under 40 years of age, a regional survey, 1975
      1984.
AB  - OBJECTIVE: To review the method and results of treatment of carcinoma of the
      cervix in women less than 40 years old. DESIGN: Retrospective review of all
      available case records. SETTING: Yorkshire Regional Health Authority. SUBJECTS:
      428 women less than 40 years old treated for stage IB-IV carcinoma of the cervix
      between 1975 and 1984 inclusive. MAIN OUTCOME MEASURES: Overall survival by
      stage, effect of age, identifiable factors of prognostic significance, survival,
      grade 3 morbidity and pattern of recurrence in relation to treatment. RESULTS:
      The 5-year actuarial percentage survival by stage was 78.4 (IB), 54.4 (II), 18.4
      (III) and 0 (IV). Identifiable factors of prognostic importance were stage, nodal
      metastases (P less than 0.001) and tumour grade (P less than 0.01). CONCLUSION:
      Primary surgical treatment for young women with early disease allows ovarian
      conservation and the avoidance of radiotherapy in 80% of them. Such treatment
      results in less local recurrence, particularly evident in patients with moderate
      or poorly differentiated tumours and a lower incidence of serious morbidity.

PMID- 1751447
TI  - Going public.

PMID- 1751448
TI  - Heat shock and thermotolerance in plant and animal embryogenesis.
AB  - Although the strategies of early embryogenesis differ greatly among multicellular
      eukaryotes, there are certain parallels in structure, form, and function that
      cross even kingdom lines: the extreme heat sensitivity of zygotes and very early
      embryos, followed by the acquisition of thermotolerance during subsequent
      development, is one such parallel. The heat sensitivity may be so extreme that
      even moderate increases in temperature result in lethality (generally associated
      with the earliest phases of embryogenesis), or the effects may be less severe,
      resulting in defects in development but not in lethality. Mechanistically, and
      molecularly, these two forms of thermosensitivity appear to have different
      origins. On the one hand, outright lethality appears to result from an inability
      to induce heat shock genes and proteins; on the other hand, heat-induced
      developmental defects appear to result from an alteration in expression of non
      heat shock genes and from a delay in the overall developmental program that
      generally accompanies the cell's response to heat shock. This review is focused
      on the developmental regulation of the heat shock response during early
      embryogenesis and on the impact of this regulation on the development of both
      animal and plant embryos. The two basic issues that we address here are (i) the
      expression of heat shock genes in the absence of heat shock during embryogenesis
      and (ii) the expression (or lack of expression) of heat shock genes after
      deliberate exposure of the embryos to heat shock and the consequences of this
      expression on its subsequent survival and development.

PMID- 1751449
TI  - Multiple regions of v-Fos protein involved in the activation of AP1-dependent
      transcription: is trans-activation crucial for transformation?
AB  - We show that trans-activation by v-Fos requires several functionally separable
      regions, including the leucine repeat, the basic DNA-binding region, a directly
      adjacent acidic cluster, and additional flanking sequences. Structural
      alterations in the flanking regions are in part responsible for the greater trans
      activating potential of the fos gene product of the Finkel-Biskis-Reilly mouse
      osteosarcoma virus, FBR-MuSV. A point mutation in the acidic cluster, which is
      known to activate the immortalizing potential of Fos, leads to a significant
      increase in trans-activation. However, comparison of the trans-activating and
      transforming properties of mutant Fos proteins suggests that functions other than
      trans-activation are involved in the induction of transformation.

PMID- 1751450
TI  - Soluble HTLV-I Tax1 protein stimulates proliferation of human peripheral blood
      lymphocytes.
AB  - Human T-cell leukemia virus type I (HTLV-I) is associated with two human
      diseases, adult T-cell leukemia (ATL) and tropical spastic paraparesis/HTLV-I
      associated myelopathy (TSP/HAM). Lymphocytes from patients with ATL or TSP/HAM
      display abnormal proliferation properties in culture. Here we report that
      purified, soluble Tax1 protein can be taken up by, and stimulate proliferation
      of, uninfected human peripheral blood lymphocytes (PBLs) that have been
      stimulated with phytohemagglutinin (PHA). Tax1 was 40 to 70% as active as
      interleukin-2 (IL-2) in stimulating proliferation of PBLs. Heat inactivation,
      chloroform extraction, and immunoprecipitation with antisera specific for Tax1
      each abolished the ability of the protein to stimulate lymphocyte proliferation.
      Tax1 failed to stimulate PBL proliferation in the absence of PHA. After an
      initial round of cell division, Tax1-treated PBLs exhibited prolonged sensitivity
      to IL-2-induced proliferation. These results indicate that Tax1 can stimulate
      lymphocyte proliferation in culture and imply that extracellular Tax1 may be
      involved in the spontaneous proliferation of TSP/HAM lymphocytes and the IL-2
      dependent proliferation of ATL lymphocytes.

PMID- 1751451
TI  - A cluster of genes that affects nucleoid segregation in Salmonella typhimurium.
AB  - Thirteen conditional lethal mutations in genes of Salmonella typhimurium map at
      the clmF locus and affect both viability and the faithful partitioning of
      daughter nucleoids. These mutations have now been divided into three
      complementation groups by using cloned fragments of S. typhimurium DNA and
      renamed parC, parE, and parF. The proteins produced from the cloned fragments
      predict that ParC is an 85-kD protein, ParE is 75 kD in size, and ParF, 27 kD.
      The parE gene is about 5 kb upstream of the parC gene, and parC is just upstream
      of parF. Genes situated between parC and parE produce at least two proteins of
      unknown function. The DNA sequence of the S. typhimurium parC gene was determined
      and has 56% homology with the first 1400 base pairs of the Escherichia coli gryA
      gene, which encodes the A subunit of DNA gyrase, and 85% homology with the E.
      coli parC gene. Despite the strong homology between gryA and parC, these two
      genes cannot substitute for one another. The DNA sequence of the S. typhimurium
      parF gene was determined and predicts a protein with a hydrophobic N terminus.
      The ParF protein may interact with ParC and ParE to anchor these proteins to the
      membrane. These results raise questions about the relative roles of gyrase and
      ParCEF in nucleoid decatenation. In addition, the parC and gyrA genes provide an
      example of the evolution of essential functions by gene duplication.

PMID- 1751452
TI  - Selective elimination of recombinant genes in vivo with a suicide retroviral
      vector.
AB  - The ability to express recombinant genes in vivo offers potential new treatments
      for human disease if questions of safety and toxicity can be addressed.
      Complications of gene transfer could include, for example, overexpression of
      introduced genes for growth or angiogenic factors or insertional mutagenesis,
      both of which could cause uncontrolled cell growth. We report the development of
      a suicide retroviral vector that provides a method to eliminate cells undergoing
      rapid growth in vivo. A murine amphotropic retroviral vector was constructed in
      which the gene for herpesvirus thymidine kinase was included to render
      proliferating cells sensitive to ganciclovir, and the Escherichia coli beta
      galactosidase gene served as a reporter. This vector's efficacy was first
      assessed in vitro, and beta-galactosidase activity was abolished in several cell
      lines after treatment with ganciclovir. In vivo, a transplantable murine CT26
      adenocarcinoma whose cells were transduced with this vector regressed completely
      after administration of ganciclovir. In contrast, expression in nondividing cells
      within rabbit arteries transduced by retroviral infection in vivo was unaffected.
      This suicide vector therefore eliminates transformed cells but allows survival of
      normal nondividing cells that express its specific recombinant genes in vivo, and
      may thus improve the safety and efficacy of gene transfer into living organisms.

PMID- 1751453
TI  - Generation of synaptic noise: selective involvement of neuronal subsets.
AB  - All central neurons are subjected to continuous and random variations of their
      membrane potential because of "spontaneous" activity in their presynaptic
      afferents. This activity, which is called synaptic noise, is presumed to be
      responsible for the uncertainty of the input-output relation in these cells. In
      the Mauthner cell of teleosts, noise is mainly inhibitory, and is generated by
      the release of neurotransmitter in a probabilistic manner. This inhibitory
      activity has been studied in detail previously. Taking advantage of this
      understanding, we have constructed a model of the inhibitory networks and their
      target in order to determine the conditions required to reproduce the main
      stochastic aspects of synaptic noise. We have used a combination of computer
      simulations and simple semianalytical arguments. We conclude that, surprisingly,
      cells in the presynaptic networks do not contribute equally to these background
      fluctuations. Rather, noise is generated primarily by the operation of subsets of
      afferent cells: the spectrum is either dominated by signals originating from
      interneurons which make few terminals on the Mauthner cell, or by the output of
      "burster" cells firing spike trains rather than single spikes. Both possibilities
      lead to specific predictions, one of which has already been verified.

PMID- 1751454
TI  - Molecular biology and the new paradigm.

PMID- 1751455
TI  - Pressure and posture.

PMID- 1751456
TI  - Randomised double-blind trial of bromovinyldeoxyuridine (BVDU) and
      trifluorothymidine (TFT) in dendritic corneal ulceration.
AB  - The results of a randomised double-blind clinical trial of 0.1%
      bromovinyldeoxyuridine (BVDU) and 1% trifluorothymidine (TFT) in 60 patients with
      corneal dendritic ulceration are presented. There was no significant difference
      between BVDU and TFT in terms of numbers of ulcers healed (p = 0.61), mean
      healing time (p = 0.065), and cumulative healing rate (p = 0.058). No serious
      side effects were observed, though transient stinging was recorded in five
      patients receiving TFT and in three patients receiving BVDU. One patient in the
      group treated with TFT developed a punctate epitheliopathy.

PMID- 1751457
TI  - Postural change of intraocular and blood pressures in ocular hypertension and low
      tension glaucoma.
AB  - The effect of body position on the intraocular and blood pressures of normal
      volunteers and of patients with ocular hypertension and low tension glaucoma was
      studied. Changing from the sitting to the supine position increased the
      intraocular pressure by an average of 4.4 (SD 2.0) mm Hg in the control group,
      4.0 (SD 2.0) mm Hg in the ocular hypertension group, and 4.1 (SD 1.8 mm Hg) in
      the low-tension glaucoma group. After 30 minutes in the supine position the
      intraocular pressure in normal volunteers and patients with low tension glaucoma
      remained stable. In contrast patients with ocular hypertension showed a further
      significant increase in intraocular pressure of 1.6 (SD 2.8) mm Hg (p = 0.004).
      This was accompanied by an equally significant decrease in blood pressure (p less
      than 0.001). We believe that these are manifestations of different mechanism of
      intraocular pressure regulation between these groups.

PMID- 1751458
TI  - Plasma viscosity or erythrocyte sedimentation rate in the diagnosis of giant cell
      arteritis?
AB  - Plasma viscosity (PV) has replaced the erythrocyte sedimentation rate (ESR) as a
      routine laboratory test in many hospitals. The finding of a normal PV but raised
      ESR in a case of biopsy proved giant cell arteritis (GCA) cast doubt on this
      substitution in cases of suspected GCA. To assess the equivalence of PV and ESR
      in the diagnosis of this disease 40 suspected cases were prospectively
      investigated with both tests. The correlation between the two tests was good (r =
      0.742, p less than 0.0001). The substitution of one test for the other would
      appear to be justified in most cases of suspected GCA. In the presence of biopsy
      proved disease, however, the PV and ESR each produced 13.3% false negatives.
      These occurred both in combination with and independently of the other test
      showing that, when in error, the two tests may not be equivalent. In cases of
      doubt the performing of both PV and ESR tests together improves but does not
      achieve complete diagnostic accuracy. Clinical judgment based on careful
      assessment of all available symptoms and signs must remain the foundation of
      diagnosis.

PMID- 1751459
TI  - Postoperative conjunctival chemosis in cataract surgery caused by subconjunctival
      gentamicin injection.
AB  - A prospective study of 75 patients undergoing cataract surgery was conducted to
      identify the cause of postoperative conjunctival chemosis seen in patients with
      cataracts in this department. The patients were split in three groups of 25 each.
      Group G patients were given a subconjunctival injection of gentamicin at the end
      of the cataract procedure; group W patients did not receive subconjunctival
      gentamicin, but a cellulose wick drain was used during the procedure; and Group
      GW patients received a subconjunctival injection of gentamicin and a wick drain
      was also used. The incidence, severity, and the duration of chemosis were
      observed in the three groups. Chemosis was seen only in groups G and GW, and the
      difference between the number of patients who received gentamicin and those who
      did not receive gentamicin was significant (p less than 0.001).

PMID- 1751460
TI  - Should nylon corneal sutures be routinely removed?
AB  - Three groups of patients who had undergone cataract extraction through a corneal
      incision closed with 10/0 nylon sutures one, two, and three years previously were
      recalled to determine the incidence of suture related complications. Broken
      corneal sutures were found in 87.5% of patients after two years and 90% after
      three years and were causing symptoms in over half the patients. It is
      recommended that 10/0 nylon corneal sutures be routinely removed no later than
      one year after surgery.

PMID- 1751461
TI  - Optic foraminal radiography--a redundant investigation?
AB  - A retrospective study of all plain radiographs taken of optic foramina during the
      six years 1984-9 inclusive, comprising a total of 318 examinations, was carried
      out in order to determine the role of this investigation in patients with
      ophthalmic disorders. All but one of the radiographs were reported as showing no
      abnormality. However, for this exception, review of the radiographs showed that
      the optic foramina were asymmetrical but fell within the normal range. This study
      indicates that plain radiographs of the optic foramina have little or no useful
      function. Abandoning the use of these views as a routine will result both in a
      reduction in radiation hazard and in considerable financial saving.

PMID- 1751462
TI  - Prosthesis motility with and without intraorbital implants in the anophthalmic
      socket.
AB  - Ocular prosthesis motility was measured and compared in 15 patients with a
      primary baseball implant after enucleation of an eye, in 11 patients with a
      secondary baseball implant, in 12 patients with an Allen implant, and in 11
      patients without any intraorbital implant. In all patients a noticeable lag of
      movement of the prosthetic eye was measured: in the extreme directions of gaze
      the excursions of the prosthesis were far less in comparison with the
      contralateral normal eye. For normal eye movement round the primary position of
      gaze, however, the prosthesis motility in the primary baseball and Allen implant
      group appeared to be sufficient to give a lifelike appearance. The average
      motility of the prostheses in these two groups did not differ. The motility in
      the secondary baseball group and in the group without an implant was evidently
      worse. In the last group the prosthesis motility was most impaired. We conclude
      that the insertion of an implant, even when inserted some time after the
      enucleation (a secondary implant), improves the motility of the prosthesis
      markedly. We recommend the primary baseball implant as the correction of choice
      after enucleation.

PMID- 1751463
TI  - Postinflammatory cataracts in the mouse: induction by human mycoplasma-like
      organisms.
AB  - Cataracts often occur in humans secondary to uveitis. Uveitis may be caused by
      various infectious agents, but rarely is the agent detected in the cataract.
      Mycoplasma-like organisms (MLO) were recently reported to cause human uveitis and
      retinitis. Cataracts were often present in those inflamed eyes. MLO are
      intracellular cell wall deficient pathogenic bacteria. They are pleomorphic
      tubulospherical and filamentous organisms with a characteristic ultrastructural
      appearance. No MLO culture system has been found despite 20 years of effort. The
      diagnosis of MLO disease rests on detection of the organisms in parasitised cells
      by a transmission electron microscope and response to antibiotics. In human
      intraocular inflammatory disease MLO are detectable in parasitised leucocytes and
      retinal pigment epithelial cells at the disease sites. Inoculation of MLO from a
      human source into mouse eyelids produced intraocular, chronic, progressive,
      inflammatory disease, with intraocular leucocytes parasitised by MLO in 15 of 100
      mice versus 0 in 200 controls (p less than 0.05). This report describes the
      cataracts with MLO-parasitised intralenticular leucocytes in the inflamed eyes of
      14 of those 15 mice versus 0 in 200 control mice (p less than 0.05). The results
      indicate that MLO penetrated the lens capsules to produce the cataracts, and they
      suggest that MLO could cause human cataracts. Alternative methods for detection
      of MLO and rifampin treatment of MLO intraocular disease are discussed.

PMID- 1751464
TI  - Ofloxacin compared with chloramphenicol in the management of external ocular
      infection.
AB  - The safety and efficacy of 0.3% ofloxacin in treating bacterial ocular infections
      was compared with that of 0.5% chloramphenicol in a parallel-group, randomised
      clinical trial at five sites. Clinical and microbiological improvement rates were
      studied in 84 culture-positive patients. Patients with suspected bacterial ocular
      infections were evaluated for clinical improvement and were included in drug
      safety and comfort analyses. Clinical improvement did not differ significantly
      between drug treatments. All patients completing the study (79 assigned
      ofloxacin, and 74 chloramphenicol) showed clinical improvement. Clinical
      improvement in the culture-positive groups was 100% (41/41) after ofloxacin
      treatment, and 95% (41/43) after chloramphenicol treatment. Microbiological
      improvement rates were similar for the two drugs: 85% (33/39) improved with
      ofloxacin, and 88% (38/43) improved with chloramphenicol. Both drugs were well
      tolerated. Adverse reactions possibly due to the study medication occurred in 1%
      (1/89) of those who received ofloxacin, and in 4% (4/93) of those who received
      chloramphenicol.

PMID- 1751465
TI  - Orbital xanthogranuloma in adults.
AB  - The onset of periorbital xanthogranuloma in adults is rare and may be accompanied
      by haematological abnormalities and malignancy. The appearance of the eyelid
      lesions is virtually diagnostic, producing readily recognisable diffuse, yellow
      plaques, and affected patients should be investigated and reviewed regularly for
      systemic disease. Three cases are described, in which periorbital cutaneous
      plaques were associated with abnormal tissues in the superior part of the orbit;
      these abnormal tissues caused displacement or restricted movement of the globe or
      upper eyelid. The possibility that two cases represent a necrobiotic type of
      xanthogranuloma is presented. Nine years after the onset of xanthogranuloma one
      patient developed non-Hodgkin's lymphoma. A multiple-drug regimen of systemic
      chemotherapy, given for lymphoma, caused a marked clinical reduction in the
      periorbital xanthogranuloma.

PMID- 1751467
TI  - Inadvertent application of silicone foam elastomer catalyst to the eye.
AB  - Silicone foam elastomer is used extensively to treat granulating wounds. A case
      is presented in which the catalyst to the polymer was inadvertently applied to
      the eye. This produced conjunctival and corneal injury, which was slow to heal
      and resistant to conventional treatment. This form of injury has not previously
      been described.

PMID- 1751466
TI  - Choroidal involvement in lymphomatoid granulomatosis.
AB  - A 13-year-old boy with evidence of pulmonary lymphomatoid granulomatosis
      developed monocular diplopia. Fluorescein angiography revealed bilateral
      choroidal involvement. Following treatment with vincristine, cyclophosphamide,
      and prednisone his diplopia resolved and the angiographic appearances returned to
      normal.

PMID- 1751468
TI  - Cleft anterior segment with maternal hypervitaminosis A.
AB  - We report a case of an 'hourglass' cornea and iris with reduplicated lens in the
      left eye of an infant girl. An excess of vitamin A products had been taken by the
      mother during pregnancy. Mechanisms by which vitamin A excess could have caused
      this are discussed.

PMID- 1751469
TI  - Acquired pigmentation simulating Peutz-Jeghers syndrome: initial manifestation of
      diffuse uveal melanocytic proliferation.
AB  - A 74-year-old man with an occult carcinoma of the colon developed pigmentation of
      the mouth and penis typical of the Peutz-Jeghers syndrome as the first
      manifestation of bilateral diffuse uveal melanocytic proliferation. The
      simultaneous appearance of extraocular pigmented lesion and those in the uveal
      tract of both eyes of this patient provides further evidence that bilateral
      diffuse uveal melanocytic proliferation may be caused by activation of occult
      melanocytic naevus cells in response to either a hormone-producing carcinoma or
      to some other common oncogenic stimulus.

PMID- 1751470
TI  - Ocular myositis as first presenting symptom of human immunodeficiency virus (HIV
      1) infection and its response to high-dose cortisone treatment.
AB  - A 30-year-old male presented with signs of ocular inflammation and motility
      disturbances in an early stage of HIV infection. The provisional diagnosis of an
      ocular myositis was confirmed by orbital echograms. A general check up revealed
      positive anti-smooth-muscle antibodies and antinuclear antibodies as well as a
      raised erythrocyte sedimentation rate. Oral steroid treatment in addition to
      steroid eyedrops achieved complete resolution of clinical and sonographic
      symptoms within 15 weeks. Autoimmune phenomena are well known presentations of
      HIV infection. In this case oral cortisone proved to be an effective therapy even
      in the setting of an HIV infection.

PMID- 1751471
TI  - Intraocular involvement with subretinal pigment epithelium infiltrates by mycosis
      fungoides.
AB  - We report a case of intraocular mycosis fungoides in a 48-year-old man. The
      patient presented with decreased visual acuity, white subretinal lesions, and
      vitritis. Post-mortem histopathology revealed malignant T cell infiltrates
      consistent with mycosis fungoides in the retina, vitreous, and between the
      retinal pigment epithelium (RPE) and Bruch's membrane Focal atrophy of the RPE,
      along with the sub-RPE infiltrates, correlated with the clinically visible fundus
      lesions.

PMID- 1751472
TI  - Oestrus ovis ophthalmomyiasis acquired in the UK: case report and scanning
      electron microscopic study.
AB  - A case of external ophthalmomyiasis acquired in the UK is reported. Oestrus ovis
      infestation of the external conjunctiva is described and a scanning electron
      microscopic study made of the first stage larvae. To our knowledge this
      represents only the third case reported of UK acquisition of ophthalmomyiasis.

PMID- 1751473
TI  - Herpes simplex keratitis in renal transplant patients.

PMID- 1751474
TI  - Fixed breathing frequency decreases end-tidal PCO2 in humans.
AB  - We tested the effect of a fixed breathing frequency on the partial pressure of
      CO2 in the end-tidal air (PETCO2) in resting healthy subjects. In the first
      experiment, three different rates of breathing were dictated: the same frequency
      of breathing as the subject's control one (1f), a double frequency (2f), and half
      of the control frequency (0.5f). 10 min dictate of 1f and 2f induced a decrease
      of PETCO2. The dictate of 0.5f had no significant effect on PETCO2. In the second
      experiment, 1f was dictated for 30 min, inducing a decrease of PETCO2 throughout
      the duration of the dictate. These results demonstrate that fixing the breathing
      frequency by the dictate affects the chemostatic control of ventilation.

PMID- 1751475
TI  - Cellular sodium and calcium in experimental hypertension.

PMID- 1751476
TI  - Interaction of the neuromuscular blocking drug atracurium with muscarinic
      acetylcholine receptors.
AB  - On isolated rat heart atria, atracurium competitively antagonized the negative
      chronotropic effect of methylfurmethide, shifting the concentration-response
      curve to the right without diminishing the agonist's maximal effect; Kd
      calculated from dose ratios was 3.0 mumol/l. On the longitudinal muscle of rat
      ileum, atracurium antagonized the effect of methylfurmethide in a non-competitive
      manner; at 50 mumol/l atracurium, the maximum response to methylfurmethide was
      diminished by about 50%. Atracurium antagonized the binding of (3H)quinuclidinyl
      benzilate [3H)QNB) to muscarinic binding sites in the atria, ileal longitudinal
      muscle and cerebellum with IC50 values of 5-8 mumol/l, and in brain cortex of 25
      mumol/l. Atracurium was little efficient, however, in antagonizing the binding of
      N-(3H-methyl) scopolamine [3H)NMS) to muscarinic binding sites. Complete blockade
      was not achieved at concentrations up to 1 mmol/l. Concentrations required to
      diminish the binding by 50% were 10 - 1000 times higher for (3H)NMS than for
      (3H)QNB. Atracurium brought about the dissociation of (3H)QNB-receptor complexes,
      but its effect was considerably stronger at a concentration of 30 mumol/l than at
      1 mmol/l. Atracurium slowed down the dissociation of (3H)QNB-receptor complexes
      observed after the addition of atropine. The effects of atracurium on the
      dissociation of (3H)NMS-receptor complexes were similar to those on (3H)QNB
      receptor complexes, but a high concentration of atracurium (1 mmol/l) produced a
      transient increase in (3H)NMS binding preceding its subsequent dissociation.
      Although the observations of the antagonism by atracurium of the effect of
      methylfurmethide on the heart atria, and of the inhibition of the specific
      binding of (3H)QNB to the atria, ileal smooth muscle, cerebellum and brain cortex
      are compatible with the assumption of a competitive interaction, the discrepancy
      between the effects of atracurium on the binding of (3H)QNB and (3H)NMS indicates
      that atracurium does not bind to the same binding site as (3H)QNB and (3H)NMS. It
      appears that most effects of atracurium on muscarinic receptors are allosteric
      and that both negative and positive cooperatives play a role in interactions
      between atracurium and muscarinic ligands.

PMID- 1751477
TI  - Influence of light regimen and the time of year on circadian oscillations of
      thyroid hormones in rats.
AB  - Male SPF rats (Wistar strain) were adapted in the course of the year to natural
      light (N) and to a 12:12 h (light:dark) artificial light (A) regimen. At
      approximately the spring and autumn equinox and the summer and winter solstice,
      rats were killed at 3-h intervals over a 24 h period and their serum thyroxine
      (T4), triiodothyronine (T3) and reverse T3 levels were determined. The light
      regimen and time of year significantly influenced the basic characteristics of
      the oscillations of the hormones. In the N regimen, T4 levels (T3 levels less)
      culminated in all seasons in correlation to sunrise. In the A regimen they
      culminated irregularly after daybreak. In animals with the N regimen, the
      oscillations of the hormones were rhythmic in all seasons, but in the A regimen
      in only some seasons. In the N regimen, the mean daily T4 concentration value
      (the mesor) was the highest in the spring and the lowest in the autumn; in the A
      regimen the mesors were the same, except for a low mesor in the autumn. In both
      light regimens, the T3 mesors were the highest in the autumn and low in the
      winter; the rT3 mesors were a mirror image of the T3 mesors. The annual mean of
      serum T4 concentrations was lower in the N group than in the A group.

PMID- 1751478
TI  - Observations on the biological activity of epitestosterone.
AB  - Epitestosterone, a 17 alpha-epimer of testosterone is a normal constituent of
      body fluids in many species including man. It has long been believed that it is
      devoid of any biological significance. However, it is now demonstrated that in in
      vivo experiments on castrated male mice it counteracts the action of testosterone
      on androgen-dependent organs. In vitro experiments show that on the overall
      antiandrogenicity of epitestosterone participate true antiandrogenic action due
      to the binding to androgen receptors, strong 5 alpha-reductase inhibiting
      activity as well as a weak antigonadotropic activity. Epitestosterone is devoid
      of any embryotoxicity as checked by chick embryo-toxicity screening test.

PMID- 1751479
TI  - Effect of oyster fungus (Pleurotus ostreatus) on serum and liver lipids of Syrian
      hamsters with a chronic alcohol intake.
AB  - The authors studied the effect of oyster fungus (Pleurotus ostreatus) (2% dried
      fruiting bodies in a standard diet) on the serum and liver lipids of growing male
      Syrian hamsters with a chronic alcohol intake (a 15% aqueous solution). After
      eight weeks' alcohol intake there was an increase in their serum cholesterol,
      triacylglycerol (TG) and phospholipid (PL) concentration, 40 - 60% of which was
      accounted for by an increase in the very low density lipoprotein (VLDL)
      concentration. The proportion of VLDL in the lipoprotein pool rose by almost 15%,
      whereas the proportion of high density lipoproteins (HDL) fell. The simultaneous
      administration of the fungus in the diet reduced the cholesterol level below the
      value in the control animals not given any alcohol. Both the serum TG and the
      VLDL concentration fell by 30%, but neither the chemical composition and
      concentration of the HDL nor the cholesterol concentration were affected. The
      addition of the fungus to the diet completely abolished the increase induced in
      the liver cholesterol and TG concentration by the chronic intake of alcohol.

PMID- 1751480
TI  - Influence of hypergravity on the pH profile and proteolytic activity of the avian
      gastrointestinal tract.
AB  - The present study deals with the effect of hypergravity (2xg) on the pH and on
      the proteolytic activity in the digesta of the gastrointestinal tract of Japanese
      quails during intense growth. The birds were raised on a semisynthetic diet
      containing free amino acids (A) and a commercial diet (B). During days 35 till 40
      post-hatching the quails were exposed to hypergravity (2xg) using a specially
      designed centrifuge. On days 40 (experimental group, 2xg) and 41 (control group,
      1xg) the animals were sacrificed. The pH of the digesta in various segments of
      the gastrointestinal tract was measured by means of a semi-microelectrode. Total
      proteolytic activity was determined by means of azo-dye-modified proteins serving
      as general proteolytic substrates. Hypergravity leads in general to an
      alkalization of digesta in various parts of the gastrointestinal tract. In case
      of the gizzard and duodenum (diet A) and also in the distal jejunum (diet B) the
      differences are significant. With both diets, hypergravity leads to a
      considerable decrease in the total proteolytic activity. The reduction is most
      expressed in the duodenum and jejunum. Changes in the pH of digesta compensate
      for the decrease in the proteolytic activity. This may explain why hypergravity
      per se does not seem to impair growth of the Japanese quails.

PMID- 1751481
TI  - P-aminohippurate accumulation in kidney cortex slices: stimulation by
      dicarboxylates, amino acids and their oxoanalogues.
AB  - The effect of various amino acids and oxoacids on the accumulation of PAH in rat
      kidney cortex slices was determined. The following compounds were found to
      increase the PAH tissue to medium ratio (T/MPAH): a) dicarboxylic acids:
      glutarate, 2-oxoglutarate and oxaloacetate, b) amino acids: glutamate,
      isoleucine, leucine, valine, methionine, tryptophane, histidine, threonine and
      glycine, c) monocarboxylates: hydroxymethionine, oxovaline, oxoisoleucine and
      oxoleucine. There were no marked concentration/effect differences to glycine,
      glutamate, glutarate and oxovaline. Ouabain inhibited T/MPAH only slightly, but
      abolished its increase by pyruvate, 2-oxoglutarate and histidine. Oxygen
      hyposaturation abolished the T/MPAH increase caused by 2-oxoglutarate, pyruvate,
      glutamate and histidine. It is concluded that various substrates stimulating the
      organic anion transport system (OATS) do so namely by improving the energy
      supply, although the direct participation of dicarboxylates in OATS could be of
      relevance namely in short-lasting variations.

PMID- 1751482
TI  - Observations on respiratory and cardiovascular rhythmicities during yogic high
      frequency respiration.
AB  - Yogic high-frequency respiration--kapalabhati (KB)--was studied in 24 subjects
      from a point of rhythmicity. Respiratory movements, blood pressure and R-R
      intervals of ECG were recorded in parallel and evaluated by spectral analysis of
      time series. Respiratory signals during KB were modulated by 0.1 Hz rhythm in 82%
      of experiments. This component was also present in R-R intervals and blood
      pressure during KB. Frequency (0.2-0.3 Hz) was observed in 67% of respiratory
      records. The presence of the component 0.2-0.3 Hz in respiration was dependent on
      resting respiratory frequency. This frequency component was reduced in R-R
      intervals but increased in blood pressure during kapalabhati as compared to that
      at rest. The occurrence of both frequency components in respiration during KB
      supports the hypothesis about the integrative role of cardiovascular and
      respiratory rhythms in physiological states characterized by altered respiratory
      frequency.

PMID- 1751483
TI  - Effect of indomethacin on selected immune parameters in different age groups of
      mice.
AB  - The authors studied the effect of indomethacin on the phagocytic activity of
      polymorphonuclear leucocytes (PMNL) and on haemolytic antibody formation
      (plaques) by lymphoid cells of the spleen in 3-, 6- and 12-month-old mice. In 3-
      and 12-month-old animals the phagocytic activity of the PMNL was significantly
      inhibited. Plaque formation was likewise significantly inhibited in 3-month-old
      mice, but it was significantly raised in 6- and 12-month-old animals.

PMID- 1751484
TI  - Reconstitution of a heat shock effect in vitro: influence of GroE on the thermal
      aggregation of alpha-glucosidase from yeast.
AB  - alpha-Glucosidase from yeast is inactivated rapidly at temperatures above 42
      degrees C. The thermal inactivation is accompanied by aggregation. The molecular
      chaperone GroEL suppresses the formation of aggregates by binding the thermally
      inactivated alpha-glucosidase. Spectroscopic studies suggest that GroEL binds
      alpha-glucosidase in an intermediately folded state. The complex between alpha
      glucosidase and GroEL can be dissolved by MgATP. GroES accelerates the MgATP
      dependent dissociation of the alpha-glucosidase-GroEL complex. At elevated
      temperatures this release leads to the formation of aggregates, while at lower
      temperatures native, enzymatically active molecules are formed.

PMID- 1751485
TI  - 1H NMR studies of DNA recognition by the glucocorticoid receptor: complex of the
      DNA binding domain with a half-site response element.
AB  - The complex of the rat glucocorticoid receptor (GR) DNA binding domain (DBD) and
      half-site sequence of the consensus glucocorticoid response element (GRE) has
      been studied by two-dimensional 1H NMR spectroscopy. The DNA fragment is a 10
      base-pair oligonucleotide, 5'd(GCTGTTCTGC)3'.5'd-(GCAGAACAGC)3', containing the
      stronger binding GRE half-site hexamer, with GC base pairs at each end. The 93
      residue GR-DBD contains an 86-residue segment corresponding to residues 440-525
      of the rat GR. Eleven NOE cross peaks between the protein and DNA have been
      identified, and changes in the chemical shift of the DNA protons upon complex
      formation have been analyzed. Using these protein-DNA contact points, it can be
      concluded that (i) the "recognition helix" formed by residues C460-E469 lies in
      the major groove of the DNA; (ii) the GR-DBD is oriented on the GRE half-site
      such that residues A477-D481, forming the so-called D-loop, are available for
      protein-protein interaction in the GR-DBD dimer on the intact consensus GRE; and
      (iii) the 5-methyl of the second thymine in the half-site and valine 462
      interact, confirming indirect evidence [Truss et al. (1990) Proc. Natl. Acad.
      Sci. U.S.A. 87, 7180-7184; Mader et al. (1989) Nature 338, 271-274] that both
      play an important role in GR-DBD DNA binding. These findings are consistent with
      the model proposed by Hard et al. [(1990) Science 249, 157-160] and the X-ray
      crystallographic complex structure determined by Luisi et al. [(1991) Nature 352,
      497-505].

PMID- 1751486
TI  - Calorimetric studies of the binding of ferric ions to ovotransferrin and
      interactions between binding sites.
AB  - Transferrins are two-domain proteins with a very strong site for iron binding
      located in each domain. Using ultrasensitive titration calorimetry, the binding
      of ferric ion (chelated with a 2-fold molar excess of nitrilotriacetate) to the
      two sites of ovotransferrin was studied in detail as well as the binding to the
      single site in the N- and C-terminal half-molecules. In the presence of excess
      bicarbonate ion, the binding occurs in two kinetic steps. The fast process of
      contact binding is instantaneous with respect to instrument response time, is
      strongly exothermic for the N site and less so for the C site, and corresponds to
      binding of the chelated ferric ion. The slower process of bicarbonate insertion
      with concomitant release of nitrilotriacetate occurs on a time scale of 2-20 min
      over the temperature range 7-37 degrees C and is endothermic for the N site and
      exothermic for the C site, with rates being significantly slower for insertion at
      the C site. The delta H of binding is strongly temperature-dependent for both
      sites, arising from a large negative delta Cp of binding which probably indicates
      removal of hydrophobic groups from contact with water. When bicarbonate ion is
      absent, only the fast process of contact binding is seen. Each site within a half
      molecule is qualitatively similar to the same site in intact ovotransferrin,
      although quantitative differences were detected. It was shown that contact
      binding to ovotransferrin occurs reversibly with free exchange of Fe+3 between N
      and C sites, while the attachment to either site becomes essentially irreversible
      after bicarbonate insertion. The strong preference for the first ferric ion to
      bind to the N site is shown to be due to its larger contact binding constant and
      the faster rate of bicarbonate insertion, relative to the C site, and is not due
      to stronger thermodynamic binding after bicarbonate insertion. True equilibrium
      is achieved only over much longer periods of time. In another series of
      experiments, direct binding studies were carried out between the two half
      molecules under different states of ligation with Fe+3 in the presence of
      bicarbonate. The results indicate that the two binding sites in ovotransferrin,
      separated by ca. 40 A, are not independent of one another but communicate as a
      result of ligand-dependent changes in the heats and free energies of domain
      domain interactions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1751487
TI  - Amino acid sequence and location of the disulfide bonds in bovine beta 2
      glycoprotein I: the presence of five Sushi domains.
AB  - beta 2 glycoprotein I is a plasma protein with the ability to bind with various
      kinds of negatively charged substances. The complete amino acid sequence and the
      location of all the disulfide bonds of bovine beta 2 glycoprotein I were
      determined. Bovine beta 2 glycoprotein I consists of 326 amino acid residues with
      five asparagine-linked carbohydrate chains. Homology with the human protein was
      calculated to be 83%. Eleven disulfide bonds in bovine beta 2 glycoprotein I
      constitute four characteristic domains, Sushi domains, and one modified form of a
      Sushi domain.

PMID- 1751488
TI  - Reconstitution of catalytically competent human zeta-thrombin by combination of
      zeta-thrombin residues A1-36 and B1-148 and an Escherichia coli expressed
      polypeptide corresponding to zeta-thrombin residues B149-259.
AB  - Human zeta-thrombin, a catalytically competent serine proteinase, arises from a
      single chymotryptic cleavage at Trp-148 in alpha-thrombin to generate two
      nonconvalently associated polypeptide segments designated zeta 1-thrombin (the 36
      residue A-chain disulfide linked to B-chain residues B1-148) and zeta 2-thrombin
      (B149-259). We report here the expression of recombinant zeta 2-thrombin in
      Escherichia coli and the reconstitution of catalytically competent zeta-thrombin
      by combination of zeta 1-thrombin with recombinant zeta 2-thrombin. A DNA
      fragment encoding zeta 2-thrombin was cloned into a pATH2 expression vector as a
      trpE-zeta 2 fusion gene, in which a factor Xa cleavage site was inserted between
      the trpE and the zeta 2-thrombin gene. High-level expression of this fusion
      protein was achieved under the control of the E. coli trp promoter. The expressed
      zeta 2-thrombin was liberated from the fusion protein by factor Xa cleavage,
      reduced with DTT, and purified to homogeneity by reverse-phase HPLC. Oxidation of
      the reduced zeta 2-thrombin in the presence of 80 microM CuSO4 and 6 M urea at pH
      8.15 yielded material that was indistinguishable on HPLC from zeta 2-thrombin
      isolated by resolution of human zeta-thrombin. Catalytically active zeta-thrombin
      was generated by combination of recombinant zeta 2-thrombin with zeta 1-thrombin
      that was isolated by resolution of human zeta-thrombin. Recombinant zeta-thrombin
      displayed catalytic activities, toward a small chromogenic substrate and
      fibrinogen, that were similar to those of alpha-thrombin prepared from human
      blood plasma and zeta-thrombin obtained by treatment of alpha-thrombin with
      chymotrypsin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751489
TI  - A sectored colony assay for monitoring mutagenesis by specific carcinogen-DNA
      adducts in Escherichia coli.
AB  - To study the mutagenicity of various carcinogen-DNA adducts in Escherichia coli,
      a cassette plasmid was developed that permits positioning of specific carcinogen
      modified bases within the ATG initiation codon of the lacZ' alpha-complementation
      gene. Adduct-induced mutations inactivate the gene and lead to formation of blue
      and white sectored colonies when transformants from an alpha-complementing
      version of E. coli strain AB1157 are grown on media containing 5-bromo-4-chloro-3
      indolyl beta-D-galactoside. In the absence of mutation, blue colonies are
      produced. This system has been used to measure the mutagenicity of O6-methyl-, O6
      ethyl-, and O6-benzyl-2'-deoxyguanosine residues incorporated in place of the
      normal 2'-deoxyguanosine of the ATG initiation codon. Although a low percentage
      of sectored colonies was produced in this repair-proficient strain, pretreatment
      of the bacteria with N-methyl-N'-nitro-N-nitrosoguanidine to disable DNA repair
      led to a dose-dependent increase in the percentage of sectored colonies. This
      percentage increased as a function of modified guanine in the order O6-benzyl-
      less than O6-methyl- less than O6-ethyl-2'-deoxy-guanosine. The only mutations
      detected at the site of incorporation of these O6-substituted guanines were G-to
      A transitions. This sectored colony assay system permits convenient screening of
      large numbers of colonies and simplifies quantification of modified-base-induced
      mutations whether they be single-base changes, frameshifts, insertions, or
      deletions.

PMID- 1751490
TI  - DNA cross-linking and sequence selectivity of aziridinylbenzoquinones: a unique
      reaction at 5'-GC-3' sequences with 2,5-diaziridinyl-1,4-benzoquinone upon
      reduction.
AB  - Several bifunctional alkylating agents of the aziridinylbenzoquinone class have
      been evaluated as potential antitumor agents. 3,6-Bis[(2-hydroxyethyl)amino]-2,5-
      diaziridinyl-1,4-benzoquinone (BZQ), 2,5-diaziridinyl-1,4-benzoquinone (DZQ), 3,6
      bis(carboxyamino)-2,5-diaziridinyl- 1,4-benzoquinone (AZQ), and six analogues of
      AZQ have been studied for their ability to induce DNA interstrand cross-linking,
      as measured by an agarose gel technique, and to determine whether they react with
      DNA in a sequence-selective manner, as determined by a modified DNA sequencing
      technique. At an equimolar concentration (10 microM), only DZQ and BZQ showed any
      detectable cross-linking at pH 7 without reduction. Cross-linking was enhanced in
      both cases at low pH (4). Reduction by ascorbic acid at both pH's increased the
      cross-linking, which was particularly striking in the case of DZQ. In contrast,
      AZQ and its analogues only produced a significant level of cross-linking under
      both low-pH and reducing conditions, the extent of cross-linking decreasing as
      the size of the alkyl end group increased. The compounds reacted with all guanine
      N7 positions in DNA with a sequence selectivity similar to other chemotherapeutic
      alkylating agents, such as the nitrogen mustards, although some small differences
      were observed with BZQ. Nonreduced DZQ showed a qualitatively similar pattern of
      reactivity to the other compounds, but on reduction (at pH 4 or 7) was found to
      react almost exclusively with 5'-GC-3' sequences, and in particular, at 5'-TGC-3'
      sites. A model to explain this unique reaction is proposed.

PMID- 1751491
TI  - Nitrosamine-induced cancer: O4-alkylthymine produces sites of DNA
      hyperflexibility.
AB  - The carcinogenic properties of N-nitroso compounds are associated with their
      ability to alkylate DNA, in particular to form O6-alkylguanine and O4
      alkylthymine. DNA duplexes containing either O6-alkylguanine or O4-alkylthymine
      were synthesized, and each duplex was ligated to form a set of DNAs of increasing
      length with the alkylated base out of phase (16 base-pairs apart) or in phase (21
      base-pairs apart) with the helical repeat of the DNA. The DNA contained the
      sequence 5' CAA 3', which is the 61st codon of the K-ras gene, because this codon
      is a preferred site of mutation for a number of carcinogens including the
      methylating carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1- butanone (NNK). O4
      Methylthymine or O4-ethylthymine replaced thymine in either of the two A.T base
      pairs of this codon (normally CAA), and O6-methylguanine replaced the guanine in
      the G.C pair. All the sequences containing O4-alkylthymine exhibited anomalous,
      slow, gel migration and ligated to form circles of unusually small diameter. In
      general, the effect was seen when the alkylated base-pair was out of phase with
      the helical repeat as well as when it was in phase, suggesting that the alkylated
      base-pair confers flexibility which is largely isotropic, i.e., has no preferred
      direction, rather than anisotropic flexibility or bending. However, at pH 8.3 the
      21-base-pair set containing O4-alkylT.A had significantly greater anomalous
      migration than the 16-base-pair set, suggesting that the flexibility produced by
      this base-pair has a significant anisotropic component and thus resembles true
      bending.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751492
TI  - Fidelity of mammalian DNA replication and replicative DNA polymerases.
AB  - Current models suggest that two or more DNA polymerases may be required for high
      fidelity semiconservative DNA replication in eukaryotic cells. In the present
      study, we directly compare the fidelity of SV40 origin-dependent DNA replication
      in human cell extracts to the fidelity of mammalian DNA polymerases alpha, delta,
      and epsilon using lacZ alpha of M13mp2 as a reporter gene. Their fidelity, in
      decreasing order, is replication greater than or equal to pol epsilon greater
      than pol delta greater than pol alpha. DNA sequence analysis of mutants derived
      from extract reactions suggests that replication is accurate when considering
      single-base substitutions, single-base frameshifts, and larger deletions. The
      exonuclease-containing calf thymus DNA polymerase epsilon is also highly
      accurate. When high concentrations of deoxynucleoside triphosphates and
      deoxyguanosine monophosphate are included in the pol epsilon reaction, both base
      substitution and frameshift error rates increase. This response suggests that
      exonucleolytic proofreading contributes to the high base substitution and
      frameshift fidelity. Exonuclease-containing calf thymus DNA polymerase delta,
      which requires proliferating cell nuclear antigen for efficient synthesis, is
      significantly less accurate than pol epsilon. In contrast to pol epsilon, pol
      delta generates errors during synthesis at a relatively modest concentration of
      deoxynucleoside triphosphates (100 microM), and the error rate did not increase
      upon addition of adenosine monophosphate. Thus, we are as yet unable to
      demonstrate that exonucleolytic proofreading contributes to accuracy during
      synthesis by DNA polymerase delta. The four-subunit DNA polymerase alpha-primase
      complex from both HeLa cells and calf thymus is the least accurate replicative
      polymerase. Fidelity is similar whether the enzyme is assayed immediately after
      purification or after being stored frozen.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751493
TI  - Arginine-395 is required for efficient in vivo and in vitro aminoacylation of
      tRNAs by Escherichia coli methionyl-tRNA synthetase.
AB  - We have previously shown that the anticodon of methionine tRNAs contains the
      major recognition site required for aminoacylation of tRNAs by Escherichia coli
      methionyl-tRNA synthetase (MetRS) and have located part of the anticodon binding
      domain on the enzyme at a site close to Trp461 [Schulman, L. H., & Pelka, H.
      (1988) Science 242, 765-768; Ghosh, G., Pelka, H., & Schulman, L.H. (1990)
      Biochemistry 29, 2220-2225]. In order to gain information about other possible
      sites of contact between MetRS and its tRNA substrates, we have examined the
      effects of mutations at a series of positively charged residues on the surface of
      the C-terminal domain of the enzyme. Conversion of Arg356, Arg366, Arg380, or
      Arg453 to Gln had little or no effect on enzyme activity. Similarly, conversion
      of Lys402 or Lys439 to Asn failed to significantly alter aminoacylation activity.
      Conversion of Arg380 to Ala or Arg442 to Gln produced a 5-fold reduction in
      kcat/Km for aminoacylation of tRNAfMet, with no effect on methionine activation,
      indicating a possible minor role for these residues in interaction of the enzyme
      with the tRNA substrate. In contrast, mutation of a phylogenetically conserved
      residue, Arg395, to Gln increased the Km for aminoacylation of tRNAfMet about 30
      fold and reduced kcat/Km by 25,000-fold. The mutant enzyme was also shown to be
      highly defective by its inability to complement a strain of E. coli having an
      altered chromosomal MetRS gene.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751494
TI  - Use of site-directed mutagenesis to define the limits of sequence variation
      tolerated for processing of the M13 procoat protein by the Escherichia coli
      leader peptidase.
AB  - Leader peptidase cleaves the leader sequence from the amino terminus of newly
      made membrane and secreted proteins after they have translocated across the
      membrane. Analysis of a large number of leader sequences has shown that there is
      a characteristic pattern of small apolar residues at -1 and -3 (with respect to
      the cleavage site) and a helix-breaking residue adjacent to the central apolar
      core in the region -4 to -6. The conserved sequence pattern of small amino acids
      at -1 and -3 around the cleavage site most likely represents the substrate
      specificity of leader peptidase. We have tested this by generating 60 different
      mutations in the +1 to -6 domain of the M13 procoat protein. These mutants were
      analyzed for in vivo and in vitro processing, as well as for protein insertion
      into the cytoplasmic membrane. We find that in vivo leader peptidase was able to
      process procoat with an alanine, a serine, a glycine, or a proline residue at -1
      and with a serine, a glycine, a threonine, a valine, or a leucine residue at -3.
      All other alterations at these sites were not processed, in accordance with
      predictions based on the conserved features of leader peptides. Except for
      proline and threonine at +1, all other residues at this position were processed
      by leader peptidase. None of the mutations at -2, -4, or -5 of procoat (apart
      from proline at -4) completely abolished leader peptidase cleavage in vivo
      although there were large effects on the kinetics of processing.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1751495
TI  - Determination of peptide regions on the surface of the eubacterial and
      archaebacterial ribosome by limited proteolytic digestion.
AB  - Limited proteolysis was used in combination with two-dimensional gel
      electrophoresis, blotting, and amino acid sequence analysis to investigate the
      surface of intact ribosomal subunits at the peptide and amino acid level. Surface
      sites of 14 ribosomal proteins from Escherichia coli 50S subunits were determined
      using proteases with different specificities. To assess the evolutionary
      conservation of ribosomal topography among eubacteria, large subunits from
      Bacillus stearothermophilus were also subjected to limited proteolysis. The
      results obtained indicate a conservation of the three-dimensional ribosomal
      structure at the peptide level. The data for the eubacterial ribosomes are in
      full agreement with the model of the 50S protein topography derived from
      immunological data. Furthermore, peptide surface regions of archaebacterial
      ribosomes have been investigated. The results presented in this work prove that
      limited proteolysis can successfully be applied to halophilic and thermophilic
      ribosomes from archaebacteria.

PMID- 1751496
TI  - Properties of lipoamide dehydrogenase altered by site-directed mutagenesis at a
      key residue (I184Y) in the pyridine nucleotide binding domain.
AB  - The binding of pyridine nucleotide to human erythrocyte glutathione reductase, an
      enzyme of known three-dimensional structure, requires some movement of the side
      chain of Tyr197. Moreover, this side chain lies very close to the isoalloxazine
      ring of the FAD cofactor. The analogous residue, Ile184, in the homologous enzyme
      Escherichia coli lipoamide dehydrogenase has been altered by site-directed
      mutagenesis to a tyrosine residue (I184Y) [Russell, G. C., Allison, N., Williams,
      C. H., Jr., & Guest, J.R. (1989) Ann. N.Y. Acad. Sci. 573, 429-431].
      Characterization of the altered enzyme shows that the rate of the pyridine
      nucleotide half-reaction has been markedly reduced and that the spectral
      properties have been changed to mimic those of glutathione reductase. Therefore,
      Ile184 is shown to be an important residue in modulating the properties of the
      flavin in lipoamide dehydrogenase. Turnover in the dihydrolipoamide/NAD+ reaction
      is decreased by 10-fold and in the NADH/lipoamide reaction by 2-fold in I184Y
      lipoamide dehydrogenase. The oxidized form of I184Y shows remarkable changes in
      the fine structure of the visible absorption and circular dichroism spectra and
      also shows nearly complete quenching of FAD fluorescence. The spectral properties
      of the altered enzyme are thus similar to those of glutathione reductase and very
      different from those of wild-type lipoamide dehydrogenase. On the other hand,
      spectral evidence does not reveal any change in the amount of charge-transfer
      stabilization at the EH2 level. Stopped-flow data indicate that, in the reduction
      of I184Y by NADH, the first step, reduction of the flavin, is only slightly
      slowed but the subsequent two-electron transfer to the disulfide is markedly
      inhibited.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751498
TI  - Fluorescence assay for phospholipid membrane asymmetry.
AB  - Highly fluorescent 7-nitro-2,1,3-benzoxadiazol-4-yl-lipid (NBD-lipid) analogues
      are widely used to examine lipid transport and membrane structure. We have
      developed a method for chemically modifying NBD-labeled lipids in both artificial
      and biological membranes. This was achieved by treating fluorescently labeled
      membranes with dithionite (S2O4(-2)). When small unilamellar vesicles containing
      NBD-labeled phospholipids were reacted with dithionite, only the fluorescent
      lipid located on the outer leaflet of the vesicles' bilayer was reduced. Seven
      different NBD-lipid analogues, including a fluorescent sterol, were reduced by
      treatment with dithionite to nonfluorescent 7-amino-2,1,3-benzoxadiazol-4-yl
      lipid derivatives. To assess the feasibility of using this reagent in biological
      systems, N-(7-nitro-2,1,3-benzoxadiazol-4-yl)dioleoylphosphatidylethanol ami ne
      was inserted into the outer leaflet of the plasma membrane of CHO-K1 cells.
      Subsequent incubation of these cells with a nontoxic concentration of dithionite
      resulted in the complete loss of fluorescence from the plasma membrane. In
      contrast, when cells were permitted to endocytose some of their fluorescently
      labeled plasma membrane and then treated with dithionite, fluorescence at the
      plasma membrane was eliminated, while intracellular labeling was not affected.
      These data suggest that dithionite reacts with NBD-labeled lipids in the outer
      leaflet of membrane bilayers, producing nonfluorescent derivatives. We
      demonstrate how reduction of NBD-lipids with dithionite can be used to prepare
      asymmetrically labeled liposomes and to measure transverse-membrane asymmetry in
      vesicles. This method should be useful in many biochemical investigations,
      including the measurement of phospholipid translocase activity.

PMID- 1751497
TI  - Phospholipase A2 engineering. X-ray structural and functional evidence for the
      interaction of lysine-56 with substrates.
AB  - Site-directed mutagenesis studies of bovine pancreatic phospholipase A2 (PLA2,
      overproduced in Escherichia coli) showed that replacement of surface residue Lys
      56 by a neutral or hydrophobic amino acid residue resulted in an unexpected and
      significant change in the function of the enzyme. The kcat for
      phosphatidylcholine micelles increases 3-4-fold for K56M, K56I, and K56F and ca.
      2-fold for K56N and K56T but does not change for K56R. These results suggest that
      the side chain of residue 56 has significant influence on the activity of PLA2.
      In order to probe the structural basis for the enhanced activity, the crystal
      structures of wild-type and K56M PLA2 were determined by X-ray crystallography to
      a resolution of 1.8 A. The results suggest that the mutation has not only
      perturbed the conformation of the side chain of Met-56 locally but also caused
      conformational changes in the neighboring loop (residues 60-70), resulting in the
      formation of a hydrophobic pocket by residues Met-56, Tyr-52, and Tyr-69. Docking
      of a phosphatidylcholine inhibitor analogue into the active site of K56M,
      according to the structure of the complex of cobra venom PLA2
      phosphatidylethanolamine inhibitor analogue [White, S.P., Scott, D. L.,
      Otwinowski, Z., Gleb, M. H., & Sigler, P. (1990) Science 250, 1560-1563], showed
      that the choline moiety [N(CH3)3]+ is readily accommodated into the newly formed
      hydrophobic pocket with a high degree of surface complementarity. This suggests a
      possible interaction between residue 56 and the head group of the phospholipid,
      explaining the enhanced activities observed when the positively charged Lys-56 is
      substituted by apolar residues, viz., K56M, K56I, and K56F. Further support for
      this interpretation comes from the 5-fold enhancement in kcat for the mutant K56E
      with a negatively charged side chain, where there would be an attractive
      electrostatic interaction between the side chain of Glu-56 and the positively
      charged choline moiety. Our results also refute a recent report [Tomasselli, A.
      G., Hui, J., Fisher, J., Zurcher-Neely, H., Reardon, I.M., Oriaku, E., Kezdy,
      F.J., & Heinrikson, R.L. (1989) J. Biol. Chem. 264, 10041-10047] that substrate
      level acylation of Lys-56 is an obligatory step in the catalysis by PLA2.

PMID- 1751499
TI  - Lipid asymmetry in rabbit small intestinal brush border membrane as probed by an
      intrinsic phospholipid exchange protein.
AB  - All classes of phospholipids present in brush border membrane are exchanged in a
      1:1 ratio for egg phosphatidylcholine when brush border membrane vesicles from
      rabbit small intestine are incubated with small unilamellar vesicles of egg
      phosphatidylcholine. The exchange reaction exhibits biphasic kinetics similar to
      those of the hydrolysis of brush border membrane phospholipids by phospholipase
      A2 and sphingomyelinase C. In both reactions there is an initial fast phase
      followed by a markedly slower one. The phospholipid exchange appears to be
      catalyzed by intrinsic brush border membrane protein(s), while the digestion by
      phospholipases is mediated by externally added enzymes. From a comparison of the
      kinetics of phospholipid exchange and phospholipid hydrolysis, the following
      conclusions can be drawn: Both sets of experiments indicate the presence of two
      phospholipid pools differing in the rate of phospholipid exchange and hydrolysis.
      Except for sphingomyelin, the size of the two phospholipid pools derived from
      phospholipid exchange is in good agreement with that derived from phospholipid
      hydrolysis. This is the main finding of this work, and on the basis of this
      result the two lipid pools are tentatively assigned to phospholipid molecules
      located on the outer and inner layer of the brush border membrane. The slow rate
      of phospholipid exchange reflects the rate of transverse or flip-flop movement of
      phospholipids. The half-time of this motion is approximately 8 h for isoelectric
      (neutral) phospholipids such as phosphatidylethanolamine and approximately 80 h
      for negatively charged phosphatidylserine and phosphatidylinositol. Isoelectric
      phospholipids (phosphatidylcholine, phosphatidylethanolamine) are preferentially
      located on the inner (cytoplasmic) side (to about 70%) while the negatively
      charged phospholipids are more evenly distributed: 55-60% are located on the
      inner side.

PMID- 1751500
TI  - Picosecond rotation of small polar fluorophores in the cytosol of sea urchin
      eggs.
AB  - A new fluorescence method to measure viscosity in cell cytosol [Fushimi, K., &
      Verkman, A. S. (1991) J. Cell Biol. 112, 719-725] has been applied to determine
      fluid-phase viscosity in sea urchin eggs. Freshly harvested eggs from Lytechinus
      pictus were loaded with the dyes 2,7-bis(2-carboxyethyl)-5-(and-6
      )carboxyfluorescein (BCECF), 6-carboxyfluorescein (6CF), fluorescein, or calcein.
      Fluorescence lifetimes and anisotropy decay were measured in single eggs by
      multiharmonic, frequency-domain microfluorometry using a 1-2-micron focused laser
      spot and 25x air objective. In calibration solutions consisting of glycerol in pH
      8 buffered sea water, probe lifetime was single exponential and probe rotation
      was isotropic with a single correlation time which increased linearly with
      viscosity in the range 1-3.6 cP. In eggs at 22 degrees C, there were single
      lifetimes (in nanoseconds) of 3.6 (BCECF), 3.4 (6CF), 3.2 (fluorescein), and 3.3
      (calcein). Probe rotation in eggs had two components, a fast component (in
      picoseconds, mean +/- SE, 10-18 eggs) of 568 +/- 39 (BCECF), 311 +/- 21 (6CF),
      313 +/- 15 (fluorescein), and 516 +/- 44 (calcein) and a slow component of 10-40
      ns. The fractional amplitude of the fast component, corresponding to unbound dye,
      was 0.72-0.81. Apparent viscosities of fluid-phase cytoplasm (centipoises) given
      by the four different probes were in good agreement: 2.3 +/- 0.2 (BCECF), 2.1 +/-
      0.1 (6CF), 2.5 +/- 0.1 (fluorescein), and 2.3 +/- 0.2 (calcein). The viscosity in
      cytosol of sea urchin eggs (2.1-2.5 cP) is thus relatively low, yet significantly
      greater than that of water (1 cP) or cytosol in cultured fibroblasts (1.2-1.4
      cP).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751501
TI  - Reexamination of the secondary and tertiary structure of histidine-containing
      protein from Escherichia coli by homonuclear and heteronuclear NMR spectroscopy.
AB  - Analysis of the histidine-containing protein (HPr) from Escherichia coli by two
      dimensional homonuclear and heteronuclear nuclear magnetic resonance techniques
      has been performed, extending the work originally reported [Klevit, R. E.,
      Drobny, G. D., & Waygood, E. B. (1986) Biochemistry 25, 7760-7769; Klevit, R. E.,
      & Drobny, G. P. (1986) Biochemistry 25, 7770-7773; Klevit, R. E., & Waygood, E.
      B. (1986) Biochemistry 25, 7774-7781]. Two-dimensional homonuclear total
      coherence spectroscopy (TOCSY) allowed for more complete assignments of the side
      chain spin systems than had been possible in the original studies. As well, two
      dimensional 15N-1H heteronuclear spectroscopy was used to resolve a number of
      ambiguities present in the homonuclear spectra due to resonance redundancies.
      These analyses led to the correction of a number of resonance assignments that
      were made with the spectra that could be collected with the technology that
      existed 6 years ago. In addition, amide exchange rates and 3JNH coupling
      constants have been measured, extending the original analysis and yielding new
      structural information. All these data have been used to reexamine the folding
      topology of E. coli HPr. Structure calculations showed that the topology derived
      from the earlier NMR data, i.e., a four-stranded beta-sheet with three alpha
      helices running along one side of the sheet, was essentially unchanged, although
      at the present level of analysis, a well-defined "helix B" could not be
      established with high confidence. In addition, the data reported here revealed
      the existence of two slowly-exchanging side-chain hydroxyl protons belonging to
      Ser31 and Thr59. Their behavior strongly suggests that these side chains are
      involved in hydrogen bonds.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751503
TI  - Preliminary results suggesting exaggerated ovarian androgen production early in
      the course of polycystic ovary syndrome.

PMID- 1751502
TI  - Double standard, double jeopardy: research on health problems of adolescent
      women.

PMID- 1751504
TI  - Fat and protein composition of mature milk in adolescents.
AB  - The levels of certain components, notably total protein, total fat, energy, and
      fatty acids, of mature milk from 48 adolescent and 44 adult mothers was studied.
      These two groups were subdivided into high and low socioeconomic level (SEL). All
      mothers were primiparous, eutrophic, and with term pregnancy; and their newborns
      weighted over 2500 g at birth. The age factor appeared to have significant
      influence on the concentration of total protein, with higher levels in the group
      of adolescent mothers possibly as a compensatory mechanism to maintain the
      caloric value of the milk. The fatty acid content was altered significantly by
      the SEL probably due to the direct effect of maternal diet. The milk in
      adolescent mothers of low SEL demonstrated higher concentration of lauric and
      myristic acids, while the milk in low SEL adults contained higher proportions of
      linoleic and linolenic acids. The milk in adult mothers of high SEL demonstrated
      higher concentrations of palmitic, palmitoleic, and oleic acids. The different
      feeding habits of two socioeconomic groups may explain these results. The regular
      intake of soya oil, corn oil, and margarine by the urban population in general
      resulted in higher levels of linoleic acid in the milk of all groups studied.

PMID- 1751505
TI  - Use of the pen delivery system for intensive insulin therapy in college-age
      students with type I diabetes.
AB  - The present report describes our experience with 16 adolescents and young adults
      with insulin-dependent diabetes mellitus (IDDM; Type I) who switched from two
      injections of insulin per day to the NovolinPen and four insulin injections a
      day. Their mean age at the initiation of therapy was 19.2 years with a duration
      of diabetes of 8.9 years. Sixteen random computer-matched (for age, sex, and
      duration of diabetes) controls who remained on two insulin injections a day were
      evaluated for comparison. Most subjects were preparing to leave home for college.
      After a minimum of 1 year of using the pen, the mean weight gain of the test
      subjects was significantly greater (P less than .05) than for the computer
      matched controls. Glycemic control, as monitored by mean HbA1c values, were
      similar for the NovolinPen and the control groups (10.8 versus 10.9,
      respectively) after almost 2 years. The main advantage to the pen expressed by
      the users was a sense of freedom of lifestyle.

PMID- 1751506
TI  - Eating attitudes, health-risk behaviors, self-esteem, and anxiety among
      adolescent females in a suburban high school.
AB  - In order to determine whether adolescent females with abnormal eating attitudes
      display lower levels of self-esteem and higher levels of anxiety than their
      peers, and whether these adolescents participate in health-risk behaviors to a
      greater or lesser degree than their peers, we administered a series of
      questionnaires to the females attending a suburban high school in New York State.
      The questionnaires, completed by 268 students (mean age, 16.2 years), included
      data on health-risk behaviors and weight attitudes, an Eating Attitudes Test, a
      self-esteem scale, and an anxiety inventory. Results indicated that almost two
      thirds of the students described themselves as overweight, almost three-quarters
      felt they were above the healthiest weight for their age and height, and almost
      four-fifths were above the weight at which they would be most happy; 18% of the
      students scored 30 or more on the Eating Attitudes Test, a score suggestive of an
      eating disorder. Use of Spearman-rank correlation coefficients and multiple
      linear regression analysis revealed that those with more unhappiness with their
      weight and higher scores on the eating attitudes test were more likely to have
      lower self-esteem and higher anxiety and to participate more in health-risk
      behaviors, including cigarette smoking, alcohol use, drug use, and sexual
      activity with more total partners. The data from this study further corroborate
      the growing belief that health-risk behaviors tend to cluster together in
      vulnerable adolescents and demonstrate that abnormal eating attitudes and
      behaviors may be part of this cluster, especially in females with low self-esteem
      and high levels of anxiety.

PMID- 1751507
TI  - Predictors of HIV-preventive sexual behavior in a high-risk adolescent
      population: the influence of perceived peer norms and sexual communication on
      incarcerated adolescents' consistent use of condoms.
AB  - Data were collected from 112 sexually active adolescents incarcerated in a
      juvenile detention facility to identify predictors of consistent use of condoms
      during sexual intercourse. Adolescents completed an anonymous epidemiologic
      survey instrument developed by the Centers for Disease Control. The self-report
      survey assessed demographic, psychosocial, and behavioral factors. Three factors
      were identified as associated with consistent condom use. These significant
      bivariate factors were entered into a multivariate logistic regression model to
      identify the independent contribution of each factor. Non-Black adolescents,
      adolescents who communicate with their sex partners about AIDS, and those who
      perceive peer norms as supporting condom use were significantly more likely to be
      consistent condom users. The findings suggest that Human Immunodeficiency Virus
      (HIV) prevention programs for incarcerated adolescents that emphasize training in
      communication skills and modifying perceptions of peer normative behavior may be
      more effective in increasing the adoption and maintenance of condom use.

PMID- 1751508
TI  - Self-reported health concerns and sexual behaviors in adolescents with cervical
      dysplasia. A pilot study.
AB  - A group of 46 women attending an adolescent dysplasia clinic were surveyed
      regarding the reported impact of cervical dysplasia on sexual beliefs and
      behaviors. The adolescents reported being concerned about their future health and
      having changed their sexual practices. There were no clear relationships between
      demographic variables or sexual attitudes and changes. The adolescents' self
      reports of their behavior were not consistent; those adolescents who reported
      safer sex practices did not have lower rates of sexually transmitted diseases
      postbiopsy. The results of this study indicate the important but complex impact
      of sexually transmitted disease on adolescents and suggests that this impact on
      adolescents may be different from that on adults.

PMID- 1751509
TI  - Chronic fibrosing pancreatitis in a 12-year-old female.
AB  - Recurrent abdominal pain in an adolescent population is a frequent complaint.
      However, diseases of the pancreas, and especially chronic pancreatitis, in this
      age group are extremely uncommon. One type of pancreatitis, fibrosing
      pancreatitis, has been reported in only 14 previous pediatric patients, five of
      whom were over 12 years of age. We report an additional 12-year-old female with
      this condition. This case serves to remind us that fibrosing pancreatitis needs
      to be considered in any adolescent patient with chronic abdominal pain, recurrent
      vomiting, weight loss, steatorrhea, and painless obstructive jaundice.

PMID- 1751510
TI  - Cerebral infarct associated with lupus anticoagulant in an adolescent girl: a
      case report with review of the literature.
AB  - A 15-year-old girl with right-sided cerebral infarct in association with lupus
      anticoagulant is described. The literature on the primary antiphospholipid
      syndrome and its neurological complications is reviewed.

PMID- 1751511
TI  - Exacerbation of fibrous dysplasia associated with an adolescent pregnancy.
AB  - Fibrous dysplasia is a metabolic skeletal disorder in which the medullary spaces
      of affected bones are replaced by fibro-osseous tissue. Patients with fibrous
      dysplasia usually become symptomatic during childhood; the adolescent patient we
      describe is unusual because she was not known to suffer from fibrous dysplasia
      until she became pregnant and experienced a dramatic reactivation of the
      symptoms. The therapeutic implication of this case and reproductive counselling
      for young women with fibrous dysplasia are discussed.

PMID- 1751512
TI  - Synaptin/synaptophysin, p65 and SV2: their presence in adrenal chromaffin
      granules and sympathetic large dense core vesicles.
AB  - The subcellular distribution of three proteins of synaptic vesicles
      (synaptin/synaptophysin, p65 and SV2) was determined in bovine adrenal medulla
      and sympathetic nerve axons. In adrenals most p65 and SV2 is confined to
      chromaffin granules. Part of synaptin/synaptophysin is apparently also present in
      these organelles, but a considerable portion is found in a light vesicle which
      does not contain significant concentrations of typical markers of chromaffin
      granules (cytochrome b-561, dopamine beta-hydroxylase or the amine carrier). An
      analogous finding was obtained for sympathetic axons. The large dense core
      vesicles contain most p65 and also SV2 but only a smaller portion of
      synaptin/synaptophysin. A lighter vesicle containing this latter antigen and some
      SV2 has also been found. These results establish that in adrenal medulla and
      sympathetic axons three typical antigens of synaptic vesicles are not restricted
      to light vesicles. Apparently, a varying part of these antigens is found in
      chromaffin granules and large dense core vesicles. On the other hand, the light
      vesicles do not contain significant concentrations of functional antigens of
      chromaffin granules. Thus, the biogenesis of small presynaptic vesicles which
      contain all three antigens as well as functional components like the amine
      carrier is likely to involve considerable membrane sorting.

PMID- 1751513
TI  - Distribution of control of oxidative phosphorylation in mitochondria oxidizing
      NAD-linked substrates.
AB  - The flux control distribution of the net rate of state 3 respiration was
      determined in heart and kidney mitochondria incubated with low concentrations of
      pyruvate (0.5 mM) or 2-oxoglutarate (1 mM), and in conditions that led to
      activation of NAD-linked dehydrogenases, i.e., high substrate or Ca2+
      concentrations. Control of flux was exerted by the ATP/ADP carrier (flux control
      coefficient, ci = 0.37) and Site 1 of the respiratory chain (ci = 0.28) when
      dehydrogenase activity was low. Control of the process shifted to the ATP
      synthase (ci = 0.32) and the Pi carrier (Ci = 0.27) when dehydrogenases were
      activated by high pyruvate and high Ca2+. The changes in the control exerted by
      the ATP/ADP carrier and the ATP synthase were not due to changes in the
      transmembrane potential, nor to a modification of intramitochondrial ATP/ADP
      ratios. Applying the summation theorem of the control analysis, it was found that
      at low Ca2+ and pyruvate concentrations the dehydrogenases shared the control of
      state 3 respiration with other steps. The NAD-linked dehydrogenases did not exert
      any significant control at high Ca2+ or high pyruvate concentrations.

PMID- 1751514
TI  - Respiration in non-phosphorylating yeast mitochondria. Roles of non-ohmic proton
      conductance and intrinsic uncoupling.
AB  - Respiratory rate, protonmotive force and charge/O ratio were measured under two
      different kinds of steady state in non-phosphorylating yeast mitochondria: (i)
      when the electron flux was modulated by a variable limitation in electron supply
      or (ii) when oxygen consumption was decreased by respiratory chain inhibitor
      titration. We showed that the relationships between either delta p or charge/O
      ratio and respiratory rate are different under the two kinds of steady state,
      indicating different degrees of intrinsic uncoupling in respiratory chain.
      Moreover, we observed a non-ohmic dependence between H(+)-conductance and delta
      p. We concluded that the high rate of static-head respiration in yeast
      mitochondria was determined both by the non-ohmic proton conductance of the inner
      membrane and the saturation of the redox proton pump slipping.

PMID- 1751515
TI  - Hexose uptake in primary cultures of bovine brain microvessel endothelial cells.
      I. Basic characteristics and effects of D-glucose and insulin.
AB  - The basic characteristics of hexose uptake and regulation of the glucose
      transporter (GLUT1) by D-glucose and insulin were studied in primary cultures of
      bovine brain microvessel endothelial cells (BMECs). A non-metabolizable glucose
      analog, 3-O-[3H]methyl-D-glucose [( 3H]3MG), was used as a model substrate, and
      the uptake was studied using BMECs grown in tissue culture plates. Uptake of
      [3H]3MG was equilibrative, temperature-dependent, and independent of sodium. The
      uptake also decreased gradually with culture age from 7 to 13 days. Saturation
      kinetics were observed for [3H]3MG uptake and the apparent Km and Vmax values
      were determined to be 13.2 mM and 169 nmol/mg per min, respectively. Pre
      incubation with high concentrations of D-glucose and 3MG accelerated [3H]3MG
      uptake by BMECs by a counter-transport mechanism. D-Glucose, 2-deoxy-D-glucose, D
      mannose, D-xylose, D-galactose and D-ribose showed significant competitive
      inhibition with [3H]3MG, whereas L-glucose, D-fructose, and sucrose did not
      affect [3H]3MG uptake by BMECs. [3H]3MG uptake was inhibited significantly by
      cytochalasin B and phloretin but not by phlorizin, 2,4-dinitrophenol, or ouabain.
      D-Glucose starvation of BMECs by incubation with D-glucose-free media for 24 h
      resulted in a significant increase (40-70%) in uptake of [3H]3MG compared with
      control conditions (7.3 mM D-glucose). Low D-glucose treatments (2.43 and 1.83
      mM) for 7 days induced a slight but significant increase (20%) in [3H]3MG uptake,
      while long-term high glucose treatments (25 mM) showed no significant effect on
      [3H]3MG uptake irrespective of exposure time. The increase in [3H]3MG
      accumulation following D-glucose starvation was dependent upon starvation time
      (12 to 48 hr) and protein synthesis. Refeeding of D-glucose (7.3 mM) to D-glucose
      starved BMECs resulted in a return of [3H]3MG uptake to control levels in 48 h.
      The D-glucose-starvation-induced increase in [3H]3MG uptake was shown to result
      from an increase in Vmax; the Km remained constant. In addition, D-glucose
      starved BMECs were shown to have an increased level of GLUT1 using an antibody
      against human GLUT1 and an enzyme-linked immunosorbent assay (ELISA). The
      increased uptake following D-glucose starvation was not significantly affected by
      the presence of L-glucose, was partially impaired by the presence of D-galactose,
      D-fructose, and D-xylose, and was completely inhibited by the presence of D
      mannose and 3MG. Furthermore, preincubation of BMECs with insulin (10
      micrograms/ml) for 20 min did not affect the uptake of [3H]3MG or 2-deoxy-D
      [3H]glucose ([3H]2DG).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1751516
TI  - Hexose uptake in primary cultures of bovine brain microvessel endothelial cells.
      II. Effects of conditioned media from astroglial and glioma cells.
AB  - Regulation of glucose uptake by an astroglial cell secreted factor(s) was studied
      in primary cultures of brain microvessel endothelial cells (BMECs). Uptake of a
      non-metabolizable glucose analog, 3-O-[3H]methyl-D-glucose ([3H]3MG), was
      measured after the BMECs were treated with media conditioned by primary cultures
      of rat astrocytes (Astrocyte Conditioned Media: ACM) or rat C6 glioma cells
      (Glioma Cell Conditioned Media: GCM). Uptake of [3H]3MG was significantly
      increased by ACM (30-50%) and GCM (60-200%) treatments, whereas conditioned
      medium from 3T3 fibroblasts (3T3) caused no significant effect. The elevation in
      [3H]3MG uptake increased with increasing time of exposure of BMECs to these
      conditioned media (CM), and the effect was shown to be reversible. Glucose
      depletion of CM was shown not to be a factor. The presence of cycloheximide, a
      protein synthesis inhibitor, during treatment of the BMECs with ACM and GCM
      blocked the increase in [3H]3MG uptake by the cells. These results suggested that
      ACM or GCM treatment elevated de novo synthesis of brain-type glucose transporter
      (GLUT1). Indeed, enhanced GLUT1 expression by these treatments in BMECs was
      demonstrated directly by enzyme-linked immunosorbent assay (ELISA) using
      antibodies against human GLUT1. After trypsinization of ACM and GCM, both
      conditioned media still induced significant stimulation of [3H]3MG uptake by
      BMECs. A significant increase in [3H]3MG uptake was also observed when ACM or GCM
      was exposed to BMECs through a dialysis membrane with a molecular weight cutoff
      of 1000. To examine whether the effects were specific to brain endothelial cells,
      [3H]3MG uptake experiments were performed employing aortic endothelial cells
      (AECs), pulmonary microvessel endothelial cells (PMECs), and 3T3 cells. ACM
      treatment did not alter 3MG uptake by these cells, suggesting that the ACM effect
      was specific to BMECs. On the other hand, [3H]3MG uptake by AECs and PMECs
      treated with GCM was significantly enhanced. The present study demonstrated that
      some factor(s) of relatively small molecular weight, which was released from
      astrocytes or glioma cells, stimulated glucose uptake by enhancing GLUT1
      synthesis in BMECs.

PMID- 1751517
TI  - Cation and harmaline interactions with Na(+)-independent dibasic amino acid
      transport system y+ in human erythrocytes and in erythrocytes from a primitive
      vertebrate the pacific hagfish (Eptatretus stouti).
AB  - Transport systems y+, asc and ASC exhibit dual interactions with dibasic and
      neutral amino acids. For conventional Na(+)-dependent neutral amino acid system
      ASC, side chain amino and guanido groups bind to the Na+ site on the transporter.
      The topographically equivalent recognition site on related system asc binds
      harmaline (a Na(+)-site inhibitor) with the same affinity as asc (apparent Ki
      range 1-4 mM), but exhibits no detectable affinity for Ha. Although also
      classified as Na(+)-independent, dibasic amino acid transport system y+ accepts
      neutral amino acids when Na+ or another acceptable cation is also present. This
      latter observation implies that the y+ translocation site binds Na+ and suggests
      possible functional and structural similarities with ASC/asc. In the present
      series of experiments with human erythrocytes, system y(+)-mediated lysine uptake
      (5 microM, 20 degrees C) was found to be 3-fold higher in isotonic sucrose medium
      than in normal 150 mM NaCl medium. This difference was not a secondary
      consequence of changes in membrane potential, but resulted from Na+ functioning
      as a competitive inhibitor of transport. Apparent Km and Vmax values for lysine
      transport at 20 degrees C were 15.2 microM and 183 mumol/l cells per h,
      respectively, in sucrose medium and 59.4 microM and 228 mumol/l cells per h in
      Na+ medium. Similar results were obtained with y+ in erythrocytes of a primitive
      vertebrate, the Pacific hagfish (Eptatretus stouti), indicating that Na(+)
      inhibition is a general property of this class of amino acid transporter. At a
      permeant concentration of 5 microM, the IC50 value for Na(+)-inhibition of lysine
      uptake by human erythrocytes was 27 mM. Other inorganic and organic cations,
      including K+ and guanidinium+, also inhibited transport. In parallel with its
      actions on ASC/asc harmaline competitively inhibited lysine uptake by human cells
      in sucrose medium. As predicted from mutually competitive binding to the y+
      translocation site, the presence of 150 mM Na+ increased the harmaline inhibition
      constant (Ki) from 0.23 mM in sucrose medium to 0.75 mM in NaCl medium. We
      interpret these observations as further evidence that y+, asc and ASC represent a
      family of closely related transporters with a common evolutionary origin.

PMID- 1751518
TI  - Phospholipid acylation by mouse sciatic nerve microsomes.
AB  - The partition of 0.3 nmol of [1-14C]oleoyl-CoA in the microsomes (10 micrograms
      proteins) from mouse sciatic nerves is unaffected by the presence of
      lysophospholipids and is about 45% of the total oleoyl-CoA (77% of the
      acylglycerophosphocholine partition in the membrane). The concentration of both
      oleoyl-CoA and acylglycerophosphocholine is over 1 mM in the membrane. There is a
      selective acyl transfer from acyl-CoA to lysolipid acceptors (oleoyl greater than
      myristoyl, palmitoyl, stearoyl much greater than eicosanoyl greater than
      docosanoyl, tetracosanoyl). The exogenous acyl acceptors are
      acylglycerophosphocholine and acylglycerophosphoinositol and to a lesser extent
      acylglycerophosphoethanolamine, but not acylglycerophosphoserine. A PC formation
      from acylGPC in the absence of exogenous acyl donors or from oleoyl-CoA in the
      absence of exogenous acyl acceptor was also observed.

PMID- 1751519
TI  - Monensin blocks the transfer of very long chain fatty acid containing lipids to
      the plasma membrane of leek seedlings. Evidence for lipid sorting based on fatty
      acyl chain length.
AB  - Delivery of newly synthesized fatty acids and lipids to the plasma membrane in
      leek seedlings via the endoplasmic reticulum (ER)-Golgi apparatus pathway is
      primarily by bulk transport (without sorting). However, pulse-chase experiments
      revealed kinetics of transport of lipids with VLCFA (very long chain fatty acids
      having more than 18 carbon atoms) in favor of a preferential transfer of these
      molecules to the plasma membrane. Use of monensin showed the accumulation of
      lipids in the Golgi apparatus and a related decrease of the amount of lipids
      transported to the plasma membrane. Lipid and fatty acid analyses revealed that
      transport of VLCFA-containing phospholipids was most strongly inhibited by the
      monensin block. These results taken together with an inability of the plasma
      membrane to synthesize VLCFA support a role for the Golgi apparatus in VLCFA
      delivery to the plasma membrane and leads to the hypothesis of a sorting function
      as well, based on fatty acyl chain length.

PMID- 1751520
TI  - Influx and incorporation into protein of L-phenylalanine in the perfused rat
      pancreas: effects of amino acid deprivation and carbachol.
AB  - The rate of protein synthesis in the isolated perfused rat pancreas was measured
      from the rate of incorporation of L-[3H]phenylalanine into total protein, and was
      compared with the transport of this amino acid into the epithelium.
      Unidirectional (15 s) and net (15-30 min) uptake of L-[3H]phenylalanine was
      measured relative to D-[14C]mannitol (extracellular marker) using a cell loading
      technique. The fractional rate of protein synthesis in the pancreas was also
      measured in vivo using a flooding dose technique and found to be 118 +/- 10% day
      1 (corresponding to an absolute rate of incorporation of L-Phe into protein of
      36.1 +/- 3 nmol min-1 g-1) in overnight fasted rats. Compared with the in vivo
      rate, the perfused pancreas exhibited a markedly lower rate of protein synthesis
      which increased significantly when amino acids were added to the perfusate (15.6
      +/- 1.9 vs. 22.5 +/- 0.9% day-1 or 4.7 +/- 0.6 vs. 6.9 +/- 0.3 nmol L-Phe min-1 g
      1). Carbachol (3 x 10(-7) M) stimulated protein synthesis provided amino acids
      were also supplied in the perfusate. Protein synthesis rates measured under all
      conditions in vivo and in vitro were at least an order of magnitude lower than
      the unidirectional influx (121 +/- 14 nmol min-1 g-1) of L-phenylalanine into the
      pancreatic epithelium. These results demonstrate that amino acid transport across
      the basolateral membrane of the epithelium is not rate-limiting for pancreatic
      protein synthesis.

PMID- 1751521
TI  - A neutron diffraction study of the influence of ions on phospholipid membrane
      interactions.
AB  - Neutron diffraction is used to examine the effects of Ca2+ and ClO4- ions on
      interactions and some structural features of dipalmitoylphosphatidylcholine
      membranes in both solid and fluid lamellar phases. The results are described
      within the framework of Derjaguin-Landau-Verwey-Overbeek (DLVO) theory with
      reference to electrostatic, van der Waals, and hydration components of disjoining
      pressure. The Hamaker constants are evaluated under equilibrium conditions.
      Addition of 100 mM CaCl2 to the aqueous phase substantially increases the
      lamellar repeat spacing (d), which is interpreted in terms of adsorption of Ca2+
      ions to bilayers followed by electrostatic repulsion between membranes. The rise
      of NaClO4 concentration in the presence of 100 mM CaCl2 leads to gradual decrease
      in d, evidently resulted from the diminution of Ca(2+)-induced positive surface
      potential by both electrostatic screening and binding of ClO4- ions. In the
      absence of CaCl2, elevation of NaClO4 concentration to 100-300 mM drastically
      enhances the repeat spacing and then dramatically decreases d at about 1 M
      NaClO4. Estimation of the hydration coefficients showed that the pronounced
      decrease of the repeat spacing at high NaClO4 concentrations was resulted mainly
      from the (partial) disruption of the structure of intermembrane bound water by
      chaotropic ClO4- ions and subsequent decrease in hydration repulsive pressure.
      Moreover, in the case of solid membranes (20 degrees C) high concentrations of
      ClO4- induced formation of interdigitated phase paralleled with marked reduction
      in bilayer thickness and corresponding increase in the effective cross-sectional
      area per lipid molecule.

PMID- 1751522
TI  - Adenine and hypoxanthine transport in human erythrocytes: distinct substrate
      effects on carrier mobility.
AB  - Transport of adenine and hypoxanthine in human erythrocytes proceeds via two
      mechanisms: (1) a common carrier for both nucleobases and (2) unsaturable
      permeation 4-5-fold faster for adenine for hypoxanthine. The latter process was
      resistant to inactivation by diazotized sulfanilic acid. Carrier mediated
      transport of both substrates was investigated using zero-trans and equilibrium
      exchange protocols. Adenine displayed a much higher affinity for the carrier (Km
      approximately 5-8 microM) than hypoxanthine (Km approximately 90-120 microM) but
      maximum fluxes at 25 degrees C were generally 5-10-fold lower for adenine (Vmax
      approximately 0.6-1.4 pmol/microliters per s) than for hypoxanthine (Vmax
      approximately 9-11 pmol/microliters per s). The carrier behaved symmetrically
      with respect to influx and efflux for both substrates. Adenine, but not
      hypoxanthine reduced carrier mobility more than 10-fold. The mobility of the
      unloaded carrier, calculated from the kinetic data of either hypoxanthine or
      adenine transport, was the same thus providing further evidence that these
      substrates share a common transporter and that their membrane transport is
      adequately described by the alternating conformation model of carrier-mediated
      transport.

PMID- 1751523
TI  - Interaction of positively-charged liposomes with blood: implications for their
      application in vivo.
AB  - Liposomes with positively-charged lipid components have previously demonstrated
      efficacy in animal models for human diseases, and are currently being evaluated
      in human clinical studies. Cationic lipids can improve entrapment efficiency of
      drugs and other substances which are negatively charged, and facilitate
      penetration of biological membranes in vitro, e.g. in transfection. However,
      toxic effects have also been reported for positively-charged liposomes containing
      stearylamine. In this report we have examined gross interactions between plasma
      components or erythrocytes with cholesterol-rich SUV composed of PC or DPPC and
      having 0-50 mol% of phospholipid replaced with positively-charged stearylamine,
      DOTMA, or BisHOP. Plasma interactions observed included increased turbidity of
      the usually clear stroma and/or formation of a clot-like mass. At plasma
      concentrations of 0.25 mumol/ml or more, the extent of plasma interactions
      depended upon the concentration of positive charge, the charge density of
      cationic lipid initially present in the liposomes, and to a lesser degree, the
      nature of the lipid providing the positive charge. At liposomal positive charge
      concentrations of greater than 0.5 mumol/ml plasma, stearylamine provoked a
      strong increase in plasma turbidity, whereas liposomes incorporating DOTMA or
      BisHOP provoked a strong clotting response. Some hemolysis of erythrocytes in
      vitro occurred on interaction with cationic liposomes where positive charge was
      contributed by DOTMA or stearylamine, but not BisHOP. Implications for the
      clinical use of liposomes containing cationic lipids, is discussed.

PMID- 1751524
TI  - The influence of hypothyroidism on the transport of phosphate and on the lipid
      composition in rat-liver mitochondria.
AB  - The influence of hypothyroidism on the transport of phosphate and on the lipid
      composition in rat-liver mitochondria was examined. It was found that the rate of
      phosphate transport is reduced (around 40%) in mitochondria from hypothyroid rats
      compared to that obtained in mitochondria from normal rats. Treatment of
      hypothyroid rats with thyroid hormone reverses this effect completely. Kinetic
      analysis of the phosphate transport indicates that only the Vmax of this process
      is affected, while there is no change in the Km values. The lower rate of
      phosphate transport in mitochondria from hypothyroid rats is also demonstrated by
      swelling experiments. There is no significant difference either in the
      respiratory control ratios or in the ADP/O ratios between these two types of
      mitochondria. The hepatic mitochondrial lipid composition is altered
      significantly in hypothyroid rats. The total cholesterol increases, the
      phospholipids decrease and the cholesterol/phospholipid molar ratio increases
      (around 40%). Among the phospholipids, cardiolipin shows the greatest alteration
      (30% decrease in the hypothyroid rats). The
      phosphatidylethanolamine/phosphatidylcholine ratio also decreases. Alterations
      were also found in the pattern of fatty acids. These changes in lipid composition
      may be responsible, at least in part, for the depression of the phosphate carrier
      activity in mitochondria from hypothyroid rats.

PMID- 1751525
TI  - Sterically stabilized liposomes: a hypothesis on the molecular origin of the
      extended circulation times.
AB  - Therapeutic applications of intravenously injected liposomes have been limited by
      their rapid clearance from the bloodstream and their uptake by the macrophage
      cells of the liver and spleen (RES). Recently, however, liposomes which
      substantially evade the rapid uptake by the RES have been introduced. Since these
      liposomes exhibit dramatically different pharmacokinetics and biodistribution,
      new therapeutic opportunities have appeared. These include enhanced efficacy of
      antineoplastic agents against tumors, sites of inflammation, and targeting ligand
      coupled liposomes to extravascular targets. Despite extensive experimental work,
      the mechanism underlying the ability of liposomes to avoid the rapid uptake by
      the RES is still not fully understood. Our approach is an alternative to seeking
      the answers in complex differential interactions of liposomes with various
      components of blood. We believe that the effect can be easily explained, at least
      in qualitative terms, by the fundamental principles of colloid stability. In this
      communication, we propose that steric stabilization of liposomes is responsible
      for their prolonged circulation times. We propose that stabilization results from
      local surface concentration of highly hydrated groups that sterically inhibit
      both electrostatic and hydrophobic interactions of a variety of blood components
      at the liposome surface.

PMID- 1751526
TI  - Goat sperm membrane: lectin-binding sites of sperm surface and lectin affinity
      chromatography of the mature sperm membrane antigens.
AB  - The cell surface glycoproteins of goat epididymal maturing spermatozoa have been
      investigated using lectins as surface probes that interact with specific sugars
      with high affinity. Concanavalin A (ConA) and wheat-germ agglutinin (WGA) showed
      high affinity for mature cauda epididymal sperm agglutination, whereas RCA2,
      kidney beans lectin and peanut agglutinin caused much lower or little
      agglutination of the cells. The mature sperm exhibited markedly higher efficacy
      than the immature caput epididymal sperm for binding both ConA and WGA, as
      evidenced by sperm agglutination and the binding of the fluorescence
      isothiocyanate (FITC)-labelled lectins. FITC-ConA binds uniformly to the entire
      mature sperm surface whereas FITC-WGA binds to the acrosomal cap region of the
      head. The FITC-RCA2 mainly labelled the posterior head of mature cauda sperm.
      However, no WGA-specific glycoprotein receptors could be detected in sperm plasma
      membrane (PM) by WGA-Sepharose affinity chromatography. The data implied that the
      epididymal sperm maturation is associated with a marked increase in the ConA/WGA
      receptors and that WGA receptors may be glycolipids rather than glycoproteins.
      Analysis of the ConA receptors of cauda sperm PM identified by ConA-Sepharose
      affinity chromatography and subsequent resolution in SDS-PAGE demonstrated the
      presence of five glycopolypeptides of different concentrations (98, 96, 43, 27
      and 17 kDa) of goat sperm membrane. The immunoblot of these ConA-specific
      glycopeptides with anti-sperm membrane antiserum showed that 98- and 96-kDa
      receptors are immunoresponsive.

PMID- 1751527
TI  - Platelet glycoprotein IIb-IIIa is associated with 21-kDa GTP-binding protein.
AB  - Platelet membrane glycoprotein IIb-IIIa has been widely studied in the last years
      because of its role as an activation-dependent, adhesive protein receptor.
      Recently we demonstrated that occupancy of glycoprotein IIb-IIIa-receptor sites
      by specific ligands exerts an inhibitory effect on platelet responses induced by
      mild stimulation, leading us to suppose that this event may interact with
      activation pathways. Although the mechanisms of signal transduction in human
      platelets are not completely elucidated, the hypothesis that GTP-binding proteins
      are involved is generally accepted. Our results demonstrate that platelet ConA
      receptors, known to be located mainly on GP IIb-IIIa, are able to bind [35S]GTP
      gamma S; the GTP-binding activity is specific and is due to the association with
      the receptors of two G-proteins, with apparent molecular masses of 25 and 21 kDa,
      respectively. After the purification of GP IIb-IIIa, a glycoprotein complex
      electrophoretically pure was obtained that was still associated with a GTP
      binding activity, migrating in SDS-polyacrylamide gel electrophoresis as a narrow
      band of about 21 kDa.

PMID- 1751528
TI  - Caco-2 cell line: a system for studying intestinal iron transport across
      epithelial cell monolayers.
AB  - Iron transport across polarized intestinal epithelium was studied by using Caco-2
      cells grown in bicameral chambers. When cells were grown under conditions of low,
      normal, or high iron concentration not only was the iron content of the cells
      markedly altered but the low iron cells exhibited a nearly 2-fold increase in
      transepithelial electrical resistance (TEER). 59Fe uptake from the apical surface
      into cells and transport into the basal chamber was affected both by the valency
      of the iron and the iron status of the cells. Uptake from 59Fe(II)-ascorbate was
      about 600 pmol 59Fe/h per mg protein, increased about 2-fold in low iron cells,
      and was about 13-200-fold greater than uptakes from 59Fe(III) chelated to
      nitrilotriacetic acid, BSA, or citrate. Transport into the basal chamber from
      59Fe(II)-ascorbate was 3.7 +/- 1.7 pmol/h per cm2 for Fe-deficient cells vs. 0.72
      +/- 0.1 pmol/h per cm2 for normal-Fe cells and from 59Fe(III)-BSA 1.1 +/- 0.2
      pmol/h per cm2 vs. 0.3 +/- 0.03 pmol/h per cm2 for deficient vs. normal iron
      cells, respectively. The greater transport of iron both from Fe(II) and in iron
      deficient cells supports the use of the Caco-2 cells as a model for iron
      transport.

PMID- 1751529
TI  - Separation of large unilamellar liposomes from blood components by a spin column
      procedure: towards identifying plasma proteins which mediate liposome clearance
      in vivo.
AB  - In order to facilitate the isolation of liposomes from blood components, we have
      developed a simple and rapid procedure combining chromatographic and centrifugal
      methods. This 'spin column' procedure was used to isolate liposomes from
      incubation mixtures with human serum or from the blood of CD1 mice after
      intravenous administration of liposomes. An advantage of this procedure is that
      processing times are fast (typically minutes) such that the isolation procedure
      can be done in the absence of chelators or other coagulation inhibitors which may
      affect protein/liposome interactions. Furthermore, several samples can be
      analyzed together and small sample volumes can be processed. In addition, we show
      that this spin column procedure can be employed to isolate large unilamellar
      vesicles averaging 100 nm in diameter from lipoproteins and plasma proteins. The
      applicability of this spin column procedure in studying protein/liposome
      interactions is demonstrated by quantitating the amount of human complement
      component C3 bound per liposome using a C3 competitive ELISA assay after
      incubation with human serum. The proteins associated with the recovered liposomes
      were further analyzed by conventional SDS-polyacrylamide gel electrophoresis. We
      show that egg phosphatidylcholine/cholesterol (55:45, mol/mol) or egg
      phosphatidylcholine/cholesterol/dioleoylphosphatidylserine (35:45:20, mol/mol)
      liposomes isolated from the circulation of CD1 mice within minutes of
      administration have distinct, complex profiles of associated proteins. By
      isolating circulating large unilamellar liposomes using the spin column method
      and characterizing the proteins associated with their membranes, this protein
      fingerprinting approach will expedite identifying protein interactions which
      affect liposome stability and clearance in vivo.

PMID- 1751530
TI  - Investigation of a possible correlation between rates of secretion and microsomal
      membrane association of plasma proteins synthesized by rat liver.
AB  - The rates of secretion of complement C3, haptoglobin and plasminogen have been
      determined after pulse labelling with [3H]leucine, and compared to the secretion
      of prothrombin, albumin and transferrin investigated previously (Kvalvaag, A.H.,
      Tollersrud, O.K. and Helgeland, L. (1988) Biochim. Biophys. Acta 937, 319-327).
      To study membrane association, rough microsomes were treated with increasing
      concentrations of saponin, sodium deoxycholate or Triton X-100. All six proteins
      were quantitated in the soluble and membrane fraction by enzyme immunoassays. At
      concentrations of saponin from 0.08% to 0.32%, each secretory protein showed a
      characteristic distribution, almost identical to that obtained with 0.05% sodium
      deoxycholate or 0.08% Triton X-100. Albumin and transferrin with half-times for
      secretion (t1/2) 30 and 75 min, respectively, are both almost exclusively found
      in the luminal fraction (greater than 95%). Prothrombin and plasminogen, which
      both show an intermediate t1/2 (approx. 55 min), are partially associated with
      the membranes, as only about 60% was released. Haptoglobin and complement C3 also
      show some association with the membranes (80-85% released). C3 is secreted at the
      same rate as prothrombin and plasminogen (t1/2 = 55 min), whereas haptoglobin is
      secreted more rapidly (t1/2 = 40 min). Accordingly, no correlation between
      kinetics of secretion and membrane association was demonstrated.

PMID- 1751531
TI  - Lipid and membrane fluidity abnormalities in platelets and megakaryocytes of the
      hereditary macrothrombocytopenic Wistar Furth rat.
AB  - Biochemical and functional abnormalities of megakaryocytes and platelets were
      studied in Wistar Furth (WF) rats which have genetically determined
      macrothrombocytopenia and megakaryocytopenia, and were compared with their
      counterparts in Sprague-Dawley (SD) rats. Both megakaryocytes and platelets
      synthesized phospholipids from [14C]acetate. WF and SD megakaryocytes
      incorporated 0.27 and 0.29 nmol acetate per 10(6) cells, respectively.
      Phosphatidylcholine (PC) accounted for 64% and 58% of the PL radioactive label in
      megakaryocytes of SD and WF rats, respectively, (P less than 0.05), while 69% of
      labeled activity was associated with PC of SD platelets compared to 60% found in
      PC of WF platelets (P less than 0.01). In WF platelets a significant increase in
      the levels of lysophosphatidylcholine (6.1% vs. 3.0%) was observed. WF platelets
      had substantially higher levels of esterified cholesterol, triglycerides,
      ceramides and a 3-fold increase in the total protein per platelet compared to SD
      platelets. The fatty acid composition of WF platelet PC showed quantitative
      abnormalities. Plasma lecithin-cholesterol acyl transferase activity and platelet
      function monitored by the uptake and release of [14C] serotonin showed
      nonsignificant variations between SD and WF rats. Compared with the control,
      platelet membrane fluidity, measured by fluorescence polarization using platelets
      labeled with 1,6-diphenyl-1,3,5-hexatriene, was significantly decreased in the WF
      rats.

PMID- 1751532
TI  - Interactions of an antimicrobial peptide, tachyplesin I, with lipid membranes.
AB  - Tachyplesin I, isolated from the acid extracts of hemocytes of Tachypleus
      tridentatus, is a cyclic broad-spectrum antimicrobial peptide forming a rigid,
      antiparallel beta-sheet because of two intramolecular S-S linkages. The strong
      binding of the peptide to lipopolysaccharides cannot explain the susceptibilities
      of gram positive bacteria and fungi to the peptide. We found that tachyplesin I
      caused a rapid K+ efflux from Escherichia coli cells, concomitant with a reduced
      cell viability. This result suggests that the peptide-induced permeability
      enhancement of the bacterial membranes may be a plausible action mechanism. Thus,
      we studied the interactions of tachyplesin I with various large unilamellar
      vesicles (LUVs) to reveal the molecular machinery of the antimicrobial activity.
      Tachyplesin I induced the leakage of calcein, a trapped fluorescent marker, from
      LUVs of acidic phospholipids, especially phosphatidylglycerol (PG), but not from
      phosphatidylcholine LUVs. A detailed analysis found that the affinity of the
      peptide to the PG membranes is very strong and that the binding of one peptide
      molecule to approx. 200 lipid molecules leads to a significant leakage. The
      location of tachyplesin I in membranes was estimated by use of the Trp-2
      fluorescence of the peptide. The presence of PG LUVs caused a blue shift of the
      maximum wavelength, an increase in the quantum yield, and a complete protection
      from fluorescence quenching by an aqueous quencher, acrylamide. Moreover, the
      degree of fluorescence quenching of the Trp residue by n-doxylstearates was in
      the order n = 5 greater than 7 greater than 12 approximately equal to 16. These
      results show that the Trp residue of tachyplesin I seems to locate in a
      hydrophobic environment near the surface of the PG bilayers.

PMID- 1751533
TI  - The cesium-induced delay in myoblast membrane fusion is accompanied by changes in
      cellular subfraction lipid composition.
AB  - We have recently demonstrated that the delay in myoblast membrane fusion induced
      by cesium is accompanied by changes in isolated membrane lipids (Santini, M.T.,
      Indovina, P.L., Cantafora, A. and Blotta, I. (1990) Biochim. Biophys. Acta 1023,
      298-304). In the present study, we have investigated changes in the lipid profile
      of total cell homogenates and microsomal membrane fractions during myoblast
      membrane fusion as well as the effects that addition of cesium may have on these
      lipid variations in order to try to understand the production and translocation
      of lipids during this myogenic process. The data presented here indicate that the
      lipid composition of cell homogenates and microsomes varies in a different manner
      from isolated plasma membranes during myogenic fusion. In addition, cesium
      affects, in a different manner, the normally-occurring lipid production and
      distribution which takes place in each subcellular fraction.

PMID- 1751534
TI  - Accumulation of polyunsaturated free fatty acids coincident with the fusion of
      rough endoplasmic reticulum membranes.
AB  - The accumulation of polyunsaturated free fatty acids (PUFAs) was observed
      coincident with GTP-dependent fusion of liver rough microsomes. Whereas 0.5 mM
      NADPH led to a parallel reduction (greater than 50%) in membrane fusion and PUFA
      accumulation, indomethacin (50 microM) either had little effect or slightly
      augmented both processes. CTP was observed to stimulate accumulation of PUFAs and
      diacylglycerol (DAG). Therefore PUFAs may be relevant for GTP-dependent membrane
      fusion and together with DAG may play a role in fusion stimulated in the presence
      of CTP.

PMID- 1751535
TI  - Measurements of local pH changes near bilayer lipid membrane by means of a pH
      microelectrode and a protonophore-dependent membrane potential. Comparison of the
      methods.
AB  - Shifts of pH near the bilayer lipid membrane (BLM) were measured in the absence
      of pH difference between bulk solutions by two methods, i.e. pH microelectrode
      and membrane potential recordings in the presence of a protonophore. A
      quantitative agreement of the results of both methods was obtained. The kinetics
      of the generation of potential induced by the addition of ammonium chloride was
      accounted for by the time of the diffusion through the unstirred layers. The
      thickness of the unstirred BLM layers was determined in the experiment.

PMID- 1751536
TI  - The effect of monoacylglycerol on the phase behavior of egg phosphatidylcholine.
AB  - Phosphatidylcholine bilayers can accommodate large quantities of
      monoacylglycerol. Incorporating up to 40% monoacylglycerol has little effect on
      the orientation and motion of the phosphatidylcholine polar group. Briefly
      heating mixed dispersions of 1-monooleoylglycerol/egg phosphatidylcholine (1:1,
      weight ratio; 2.1:1, mole ratio) to 50-60 degrees C induced spontaneous
      vesiculation: unilamellar and some oligolamellar vesicles bud off the large
      multilamellar particles. The size of the resulting vesicles ranges from 100 to
      1000 nm, with the bulk of the vesicles having diameters between 100 and 500 nm.
      The spontaneous vesiculation process is reflected in the visual clearance of the
      mixed lipid dispersion and in the collapse of the 31P powder NMR spectrum to a
      sharp, asymmetric peak. The narrowing of the 31P-NMR spectrum is explained in
      terms of additional molecular and/or segmental motion of the lipid polar groups.
      In mixed dispersions of 1-monooleoylglycerol/egg phosphatidylcholine containing
      an excess of 1-monooleoylglycerol (greater than or equal to 50%) domain formation
      takes place, i.e., the formation of local clusters enriched in either of the two
      lipids. As a result the mechanical properties of these mixed lipid bilayers seem
      to be quite different from those of pure egg phosphatidylcholine.

PMID- 1751537
TI  - Capsaicin effects on non-neuronal plasma membranes.
AB  - Capsaicin has been touted as a pharmacological tool specific for sensory afferent
      neurons and is widely used in neurophysiological studies. However, we have
      recently demonstrated that in concentrations commonly employed within the
      gastrointestinal tract, capsaicin inhibits platelet aggregation to at least three
      different stimuli. Since this was observed in a nerve free system it raised the
      question of how specific capsaicin is. In this communication we report that
      capsaicin has profound effects on physical properties of non-neuronal cell plasma
      membranes. These effects were observed while measuring the effect of capsaicin
      upon the fluidity of both intact cell membranes and a variety of purified
      membrane preparations. Membrane fluidity was assessed with the fluorescent probes
      diphenylhexatriene (DPH) and its trimethylamino derivative TMA-DPH and
      demonstrated concentration-dependent capsaicin effects. Furthermore, the effects
      were cell specific and for full expression required both intact cells and a non
      lipid extractable component of the plasma membrane. These non-neuronal effects
      must be carefully considered when contemplating the explanation for capsaicin
      induced effects.

PMID- 1751538
TI  - Anomalous mixing of zwitterionic and anionic phospholipids with double-chain
      cationic amphiphiles in lipid bilayers.
AB  - High-sensitivity scanning calorimetry has been used to examine the thermotropic
      behavior of mixtures combining dipalmitoylphosphatidylcholine (DPPC),
      phosphatidylethanolamine (DPPE) and O-methylphosphatidic acid (DPPA-OMe) with the
      double-chain cationic amphiphiles N,N-dihexadecyl-N,N- dimethylammonium chloride
      (DHDAC), 1,2-dipalmitoyloxy-3-(trimethylammonio)propane (DPTAP) and the
      corresponding monomethylated tertiary amino compounds (DHMMA-H+ and DPDAP-H+). At
      physiological ionic strength, mixtures of these cationic amphiphiles with the
      anionic phospholipid DPPA-OMe can show gel-to-liquid-crystalline phase
      transitions at considerably higher temperatures than do either of the pure
      components. Surprisingly, binary mixtures of DPPC and these cationic amphiphiles
      also show strongly nonideal mixing, with phase diagrams exhibiting pronounced
      maxima in their solidus and liquidus curves. Similar behavior is not observed for
      mixtures of DPPC with DPPA-OMe, which closely resembles DPTAP and DPDAP-H+ in
      backbone configuration and polar headgroup size. The present results suggest that
      perturbation of the orientation of the phosphatidylcholine headgroup by cationic
      amphiphiles, as demonstrated previously by Seelig and co-workers (Biochemistry 28
      [1989], 7720-7728), can significantly affect the thermotropic behavior of
      phospholipids such as DPPC. Such effects may exert a generally important (though
      not always easily recognizable) influence on the organization and thermotropic
      behavior of systems where zwitterionic phospholipids are combined with charged
      bilayer-associated molecules.

PMID- 1751539
TI  - Plasma membrane depolarization and calcium influx during cell injury by
      photodynamic action.
AB  - The plasma membrane has been implicated as one of the critical targets of
      photodynamic action. We observed that plasma membrane depolarization is an early
      event in the photodynamic action of zinc phthalocyanine disulfonate in mouse
      myeloma cells, showing both photosensitizer concentration and light dose
      dependence. The depolarization was observed immediately upon exposure to light,
      while membrane integrity was retained and showed a strong correlation with cell
      killing. In this study the use of channel blockers and alteration of ion
      concentration was employed to determine the factors involved in the membrane
      depolarization process. A general rise in cation permeability is associated with
      the depolarization. Loss of intracellular potassium was detected and an increase
      in intracellular free calcium was also observed. Sodium was found to strongly
      influence the photosensitized depolarization.

PMID- 1751540
TI  - Inhibition of L-lactate transport and band 3-mediated anion transport in
      erythrocytes by the novel stilbenedisulphonate N,N,N',N'-tetrabenzyl-4,4'
      diaminostilbene-2,2'-disulpho nat e (TBenzDS).
AB  - (1) The synthesis of the novel stilbenedisulphonate N,N,N',N'-tetrabenzyl- 4,4'
      diaminostilbene-2,2'-disulphonate (TBenzDS) is described, and its interaction
      with the lactate transporter and band 3 protein of erythrocytes investigated. At
      10% haematocrit the IC50 (concn. required for 50% inhibition) for inhibition of
      transport of 0.5 mM L-lactate into rat erythrocytes at 7 degrees C was approx.
      1.6 microM, as low as any other inhibitor of the transporter. In human
      erythrocytes at 10% haematocrit the IC50 value was increased from approx. 3
      microM to 9 microM upon raising the temperature from 7 degrees C to 25 degrees C.
      (2) TBenzDS inhibited transport of L-lactate into rat erythrocytes in a manner
      that was competitive with the substrate, as is the case for some other stilbene
      disulphonate derivatives (Poole, R.C. and Halestrap, A.P. (1991) Biochem. J. 275,
      307-312). (3) Increasing the haematocrit from 5 to 20% caused a 3-fold increase
      in the IC50 value for inhibition of L-lactate transport in rat erythrocytes. (4)
      TBenzDS was found to bind to erythrocyte membranes, with a partition coefficient
      (Pm) of 6000-7000 under all conditions tested. (5) TBenzDS also inhibited band 3
      mediated sulphate transport in rat erythrocytes; 50% inhibition required approx.
      2.5 microM TBenzDS for cells at 10% haematocrit. (6) TBenzDS is fluorescent, and
      an enhancement of this fluorescence occurs upon addition of BSA or erythrocyte
      membranes. The fluorescence enhancement caused by erythrocyte membranes is due to
      binding of the inhibitor to the band 3 protein at the same site as the
      stilbenedisulphonate 4,4'-diisothiocyanodihydrostilbene-2,2'-disulphonate
      (H2DIDS).

PMID- 1751541
TI  - The transport systems of mammalian lysosomes.

PMID- 1751542
TI  - Techniques and concepts in exocytosis: focus on mast cells.

PMID- 1751543
TI  - c-myc oncoprotein function.
AB  - Genetic alterations of the c-myc locus in various malignancies and the ability of
      c-myc to transform cultured cells and induce tumors in transgenic animals attest
      to its central role in many neoplasms. By dissecting the c-Myc protein, a number
      of critical functional domains of c-Myc have been identified and characterized;
      these findings suggest a model for c-Myc function and intracellular activity
      (Fig. 4). c-Myc is synthesized in the cytoplasm and undergoes oligomerization
      another protein such as Max. Its nuclear localization signal allows c-Myc to be
      targeted to and retained in the nucleus, where the protein seeks out and binds to
      specific DNA sites, perhaps facilitated by c-Myc's ability to bind non
      specifically to DNA. Once bound to specific DNA sequences, c-Myc then activates
      or inhibits transcription of a number of target genes, with consequent
      alterations in cell growth and differentiation. Continued studies of c-Myc and
      its partner Max should further elucidate the mechanisms by which c-Myc can
      contribute both to the regulation of normal cell growth and the alteration in
      that regulation in neoplasia.

PMID- 1751544
TI  - The trk family of tyrosine protein kinase receptors.

PMID- 1751545
TI  - The role of Jun, Fos and the AP-1 complex in cell-proliferation and
      transformation.

PMID- 1751546
TI  - Molecular mechanisms in lung pathogenesis.

PMID- 1751547
TI  - Antigen receptor genes in hemopoietic malignancies.

PMID- 1751548
TI  - Ras p21: effects and regulation.

PMID- 1751549
TI  - Protection of cellular and mitochondrial functions against anoxic damage by
      fructose in perfused liver.
AB  - In anoxic perfused liver, conversion of fructose to lactate was greatly increased
      to about 3 mumol/min per g liver. This increase in lactate implied that the same
      amount of ATP was also produced. The rate of metabolism of glucose was less than
      10% of that of fructose, as judged by rate of production of lactate. In anoxic
      liver perfused with fructose, the ATP levels of both the tissue and mitochondria
      remained high, despite lack of oxygen, thus preventing enzyme leakage and
      preserving processes requiring ATP, such as bile excretion and urea formation.
      The mitochondrial oxidative phosphorylation capacity of anoxic liver perfused
      with fructose was also unimpaired. Spectral analysis of light transmitted through
      the liver revealed that the mitochondrial electron transfer system was in the
      completely reduced state during anoxia, indicating that the mitochondria were
      incapable of synthesizing ATP. These results suggest that fructose metabolism
      during anoxia resulted in sufficient production of ATP for maintaining the
      physiological functions of the cells and the oxidative phosphorylation capacity
      of their mitochondria.

PMID- 1751550
TI  - On the thyroid hormone-induced increase in respiratory capacity of isolated rat
      hepatocytes.
AB  - The respiratory capacities of hepatocytes, derived from hypothyroid, euthyroid
      and hyperthyroid rats, have been compared by measuring rates of oxygen uptake and
      by titrating components of the respiratory chain with specific inhibitors.
      Thyroid hormone increased the maximal rate of substrate-stimulated respiration
      and also increased the degree of ionophore-stimulated oxygen uptake. In titration
      experiments, similar concentrations of oligomycin or antimycin were required for
      maximal inhibition of respiration regardless of thyroid state, suggesting that
      the changes in respiratory capacity were not the result of variation in the
      amounts of ATP synthase or cytochrome b. However, less rotenone was required for
      maximal inhibition of respiration in the hypothyroid state than in cells from
      euthyroid or hyperthyroid rats, implying that hepatocytes from hypothyroid
      animals contain less NADH dehydrogenase. The concentration of
      carboxyatractyloside necessary for maximal inhibition of respiration was 100
      microM in hepatocytes from hypothyroid rats, but 200 microM and 300 microM in
      hepatocytes from euthyroid and hyperthyroid rats, respectively, indicating a
      possible correlation between levels of thyroid hormone and the amount or activity
      of adenine nucleotide translocase. The increased capacity for coupled respiration
      in response to thyroid hormone is not associated with an increase in the
      components of the electron transport chain or ATP synthase, but correlates with
      an increased activity of adenine nucleotide translocase.

PMID- 1751551
TI  - Adaptation of Bacillus FTU and Escherichia coli to alkaline conditions: the Na(+)
      motive respiration.
AB  - Mechanisms of Na+ transport into the inside-out subcellular vesicles of alkalo-
      and halotolerant Bacillus FTU and of Escherichia coli grown at different pH have
      been studied. Both microorganisms growing at pH 7.5 are shown to possess a system
      of the respiration-dependent Na+ transport which (i) is inhibited by
      protonophorous uncoupler, by delta pH-discharging agent diethylammonium (DEA)
      acetate, by micromolar cyanide arresting the H(+)-motive respiratory chain, and
      by amiloride, and (ii) is resistant to the Na+/H+ antiporter monensin and to Ag+,
      inhibitor of the Na(+)-motive respiratory chain. Growth at pH 8.6 strongly
      changes the activator and inhibitor pattern. Now (1) protonophore stimulates the
      Na+ transport, (2) DEA acetate is without effect in the absence of protonophore
      and is stimulating in its presence, (3) amiloride and low cyanide are
      ineffective, (4) monensin and Ag+ completely arrest the Na+ accumulation in the
      vesicles. Independent of pH of the growth medium, (a) valinomycin is stimulatory
      for the Na+ transport, (b) Na+ ionophore ETH 157 is inhibitory and, (c) Na+
      transport can be supported by NADH----fumarate as well as by ascorbate (TMPD)---
      O2 electron transfers. Growth at alkaline pH results in the appearance of
      ascorbate (TMPD) oxidation resistant to low and sensitive to high cyanide
      concentrations. These relationships are in agreement with the concept (Skulachev,
      V.P. (1984) Trends Biochem. Sci. 9, 483-485) that adaptation to alkaline
      conditions in bacteria growing in the high [Na+] media causes substitution of Na+
      for H+ as a coupling ion. The obtained data indicate that under alkaline
      conditions, Na+ can be pumped from the cell by the Na(+)-motive respiratory chain
      with neither H(+)-motive respiration nor the Na+/H+ antiporter involved. In the
      Na(+)-motive respiratory chain of Bac. FTU or E. coli, two Na+ pumps are
      localized, one in its initial and the other in its terminal spans.

PMID- 1751552
TI  - Molecular mechanisms for the control of enzymic activity by protein
      phosphorylation.

PMID- 1751553
TI  - The administration of triiodothyronine to rats results in a lowering of the
      mitochondrial membrane potential in isolated hepatocytes.
AB  - Although thyroid status has been shown to influence the magnitude of the membrane
      potential in isolated rat-liver mitochondria, there is variation in the reported
      size and direction of the thyroid hormone-induced change relative to the normal
      state. Measurement of the mitochondrial membrane potential in intact hepatocytes
      isolated from hyperthyroid and euthyroid rats reveals that hyperthyroidism
      results in a decrease of approximately 30 mV in the magnitude of this potential
      relative to that in the euthyroid state. As well, the magnitude of the plasma
      membrane potential of hepatocytes from hyperthyroid rats is reduced by 6 mV
      compared with that in cells from euthyroid rats. The thyroid hormone-induced
      decrease in these potentials may reflect reported changes in the lipid
      composition of the membranes.

PMID- 1751554
TI  - Secretion of chondroitin 6-sulfotransferase and chondroitin 4-sulfotransferase
      from cultured chick embryo chondrocytes.
AB  - We found that chondroitin 6-sulfotransferase and chondroitin 4-sulfotransferase
      were released into the culture medium from the cultured chick embryo
      chondrocytes. Since the release of the sulfotransferases was observed not only in
      serum-supplemented medium but also in serum-free medium, the released
      sulfotransferases were unlikely to be derived from serum. Addition of ascorbate
      to the serum-free medium supported the continuous release of the
      sulfotransferases. Monensin, which is known to cause dilatation of the Golgi
      apparatus and to inhibit sulfation of proteoglycan, was found to affect the
      release of the sulfotransferases. In the presence of 10(-6) M monensin,
      chondroitin 6-sulfotransferase activity in the cell layer was decreased to less
      than one tenth of the control, and the rate of the release of the activity became
      much smaller than the control after the initial rapid release. The activity of
      chondroitin 4-sulfotransferase was also affected by monensin, but the reduction
      of the chondroitin 4-sulfotransferase activity in the cell layer was not so great
      as the reduction of chondroitin 6-sulfotransferase activity. Unlike to the
      microsomal sulfotransferases, both chondroitin 6-sulfotransferase and chondroitin
      4-sulfotransferase released into the culture medium were retained in the soluble
      fraction after centrifugation at 100,000 x g for 60 min, and were not activated
      by detergent. pH optimum and requirements for sulfhydryl compounds of the
      released sulfotransferases were similar to those observed previously in the
      chondroitin sulfotransferases from chick embryo cartilage and from cultured chick
      embryo chondrocytes. These results suggest that chondroitin sulfotransferases,
      which are localized in the Golgi apparatus, may be secreted to the extracellular
      space in a soluble form under the culture conditions.

PMID- 1751555
TI  - [Radiologic diagnosis in hyperparathyroidism].
AB  - The most important radiologically detectable effects of the primary and secondary
      hyperparathyroidism of the skeletal system and the periarticular soft tissue
      structures are presented. In the following sensitivity and specificity of
      radiological imaging--sonography, scintigraphy, computed tomography, magnetic
      resonance imaging, arteriography and selective venous sampling--in the
      preoperative diagnostic of the parathyroid adenomas are discussed. Therefore,
      radiological imaging can be omitted before primary surgery. It was only in
      secondary surgery that radiological process proved useful and a guide during
      surgical intervention.

PMID- 1751556
TI  - [Quality control of film viewing boxes].
AB  - Film inspection boxes have been examined in order to find out whether the
      introduction of the Roentgen regulation has led to positive results with regard
      to amount, illuminating density and homogeneity. In comparison to former results
      which have been published, it seems that the illuminating density is still too
      low. On the average, we found a value of 1.700 cd/m2.

PMID- 1751557
TI  - [Introductory remarks of the Editor to the comments on the paper "The visual
      method for constancy testing of film processing" by H. Eder].

PMID- 1751558
TI  - [Color-coded Doppler sonography of chronic venous insufficiency].
AB  - 20 patients (i.e. 40 lower extremities) with chronic venous insufficiency were
      examined by means of colour-coded Doppler sonography (CCDS). This method enables
      the simultaneous visualisation of the anatomy and haemodynamics of the examined
      vessels. All cases of varicosis of the stem of the vena saphena magna (VSM) (n =
      21) and of the vena saphena parva (VSP) (n = 13) were correctly diagnosed by
      CCDS. However, an incomplete varicosis of the stem was identified in only 3 of 5
      cases. Insufficiency of the V. perforantes was identified by CCDS with a high
      rate of accuracy in diagnosing the insufficiency of the cross of the VSM and VSP.
      Although assessment of the V. perforantes and diagnosis of incomplete stem
      varicoses or varicoses of lateral branches is possible, as a rule, it does take
      up much time and requires a great deal of experience on the part of the
      investigator.

PMID- 1751559
TI  - [The value of plain x-ray diagnosis and phlebography in the thoracic outlet
      syndrome].
AB  - The compression of the neurovascular bundle of the upper limb (thoracic outlet
      syndrome, TOS) can be caused by osseous, muscular, fibrous, tumourous and
      habitual abnormalities of the cervicothoracic junction. Osseous causes can be
      shown in a conventional x-ray of the cervicothoracic junction. In about 40% of
      the cases there is a venous stenosis which can be proved by means of phlebography
      in a special patient position (provocation position). The type of stenosis and
      location provides information on the cause of it. We examined 34 patients.

PMID- 1751560
TI  - [Complications of pulmonary involvement in Bechterew's disease].
AB  - Fibrocystic changes in the upper lung lobes are a rare visceral manifestation of
      ankylosing spondylitis. The impaired bronchopulmonary clearance in bronchial,
      pulmonary or pleural cavities predisposes to secondary microbial colonisation.
      Two cases are reported--one patient proved to have non-tuberculous mycobacterial
      disease caused by M. kansasii, the other developed an aspergilloma.

PMID- 1751561
TI  - [The application of digital subtraction angiography in patients with peripheral
      arterial insufficiency and suspicion of stenosis/occlusion of the superficial
      femoral artery: intravenous or intra-arterial?].
AB  - 36 patients with clinical signs of lower limb ischaemia and suspected
      stenosis/occlusion of the superficial femoral artery were investigated
      prospectively and randomly by either intravenous (i.v.) or intraarterial (i.a.)
      digital subtraction angiography (DSA) to evaluate which of the two modalities
      might be chosen as a routine examination. In 4 patients from the i.v. group a
      supplementary i.a. examination had to be performed due to insufficient
      visualisation of the crural arteries, caused by long occlusions of the
      femoropopliteal segment.

PMID- 1751562
TI  - [Iotrolan-300 versus Iopamidol-300 in hysterosalpingography].
AB  - From 9.1988 to 7.1989 we carried out on 50 patients at the Department of
      Gynaecology of the University of Freiburg a randomized double-blind study to
      compare the first dimeric, nonionic, hexaiodinated, water-soluble contrast agent
      (Iotrolan-300 corresponding to Isovist-300) with a nonionic, monomeric
      preparation (Iopamidol-300 corresponding to Solutrast-300) using the
      concentration of 300 mg I/ml. Both medicaments show a high contrast quality in
      the X-rays. Complications like hypersensitivity reactions resp. actual local
      irritations were not recorded. Iotrolan-300 was found to be the best tolerated of
      the two contrast media in respect of mildest intensity of pain.

PMID- 1751563
TI  - [A rare constellation of findings: bile duct cancer, ulcerative colitis, deep
      venous thrombosis of the leg].
AB  - A case of a 28-year-old patient with long-standing chronic ulcerative colitis is
      presented, in whom cholangiocarcinoma was diagnosed by CT and ultrasound guided
      liver biopsy. This association is well known, because the incidence of bile duct
      carcinoma in patients with chronic ulcerative colitis is increased. A possible
      precursor of the disease is thought to be primary sclerosing cholangitis which
      also more frequently occurs in patients with ulcerative colitis. Our patient was
      initially hospitalized for deep venous thrombosis, which in retrospect had to be
      interpreted as a paraneoplastic syndrome.

PMID- 1751564
TI  - [Empyema necessitatis--a differential diagnostic problem in ventilated patients
      in intensive care].
AB  - Development of an empyema necessitatis under mechanical artificial respiration
      with high peak pressures is described on the basis of a case report on a patient
      in whom the phenomenon was the sequel of pneumonia with abscess formation.
      Conventional x-ray diagnosis can merely yield pointers towards possible
      differential diagnoses, whereas CT supplies an unequivocal diagnosis. X-ray image
      and differential diagnosis are discussed.

PMID- 1751565
TI  - [Traumatic apophyseolysis of the ischiadic tuber].
AB  - Traumatic apophyseolysis of the os ischii is a rare injury occurring during
      sports activities. It mostly affects young men between 14 and 25 years of age.
      Conservative treatment is often sufficient unless there is a mechanical
      obstruction or an irritation of the conditioned rupture of the os ischii with
      subsequent load-dependent complaints.

PMID- 1751566
TI  - [Aneurysmal bone cyst of the thoracic spine].
AB  - A case of aneurysmal bone cyst of the thoracic spine is described. The value of
      the various imaging procedures in diagnosis of this benign bone lesion and its
      pathogenesis are discussed.

PMID- 1751567
TI  - [Global cost analysis of radiological procedures].
AB  - In the Federal Republic of Germany, the amount spent on investments in
      electromedical equipment and systems has remained constant at 0.7% of total
      health expenditure over the last 15 years. One-fifth of this sum is used for
      large medico-technical systems such as CT scanners, cardioangiography systems or
      shock-wave lithotriptors. Expenditure on this category of equipment, including
      investments and total application costs, amounts to 2 billion DM. This sum also
      amounts to 0.7% of total health expenditure, or 1.5% of the volume of the
      statutory health insurance schemes. This paper contains evaluation from various
      countries showing that the correct implementation of such high-performance units
      in diagnosis and therapy results in considerable savings. The cost-reducing
      effects can nevertheless be over-compensated by additional applications carried
      out due to the specific advantages of these technologies. However, the growing
      utilisation indicates improved and more economic medical care of the population.

PMID- 1751568
TI  - [Magnetic resonance tomography. Strong praise for a weak field].

PMID- 1751569
TI  - Nurse anesthesia: the practice of nursing, medicine, or something else?

PMID- 1751570
TI  - Point: MSN is the appropriate academic credential for nurse anesthetists.

PMID- 1751571
TI  - Counterpoint: MSN is the appropriate academic credential for nurse anesthetists.

PMID- 1751572
TI  - The morbidity and mortality conference: a prolegomenon on its role as an
      anesthesia risk-management tool.
AB  - Although the morbidity and mortality conference (MMC) is an essential component
      of any anesthesia risk-management program, it has not undergone systematic
      analysis. All MMC narratives detailing the proceedings at two university centers
      from June 1988 to June 1990 were examined by content analysis and the unique
      perspectives of MMC participants were captured. The majority of MMC events were
      of an educational or informational nature; 32% dealt with patient complications,
      and 14% involved incidents that could have led to detrimental outcomes.
      Participant beliefs were ultimately organized into categories describing "the
      lived experience" of the MMC. These included (1) disclosure of knowledge, (2)
      correspondence of relationship, (3) teaching conformity to rule, (4) developing a
      sense of aplomb, (5) preparation for litigation, (6) the ceremony, (7) a quality
      assurance mechanism, (8) a personal lambaste function, and (9) an instrument of
      punitive retribution. The MMC appeared improperly named; "case conference" or
      "clinical teaching conference" may serve as a more accurate rubric. The MMC
      played a variety of cognitive and affective roles. Recognition of the nature of
      the teaching and learning associated with the MMC will allow risk managers to
      utilize it optimally in achieving envisioned objectives that enhance patient
      outcomes.

PMID- 1751573
TI  - Comparison of two instructional methods on the levels of physiologic and
      psychologic stress as measured by blood cortisol and the State-Trait Anxiety
      Inventory.
AB  - This study was designed to determine whether a systematic or nonsystematic
      instructional strategy affected the levels of physiologic and psychologic stress
      as measured by blood cortisol levels and the State-Trait Anxiety Inventory (STAI)
      in students in the postsecondary educational setting. A convenience sample
      consisting of 43 subjects was randomly assigned to either a systematic or
      nonsystematic teaching group. The blood cortisol and STAI were measured 1 and 2
      weeks before the treatment and following the treatment on the day of the study.
      Results of the study demonstrated that there were differential posttreatment
      increases in the amount of physiologic stress, as measured by blood cortisol
      levels produced by either instructional method. However, between the control
      measurement 1 week before the treatment and the posttreatment measurement, there
      were no effects observed for the psychologic STAI measures for either group.
      Accounting for the circadian rhythm effect of cortisol, there was a significant
      "buffering effect" in stress experienced by the subjects in the systematic
      teaching group. More specifically, the nonsystematic teaching group experienced a
      55.42% rate increase in cortisol compared to a 10.74% rate increase for the
      systematic teaching group which was statistically significant. The systematic
      teaching method may be more effective in preventing physiologic stress in the
      educational setting and possibly in the clinical practice of anesthesia nursing.
      Additionally, the results suggested that the STAI may be inappropriate when used
      as an index of stress in certain educational settings.

PMID- 1751575
TI  - Writing a case report for the literature.

PMID- 1751574
TI  - Impact of whole blood usage in massive transfusion.
AB  - A retrospective survey comparing blood and component usage during
      thoracoabdominal aortic reconstruction between patients receiving whole blood vs
      packed red cells was conducted. Volume of salvaged blood, usage of homologous
      blood components, and total homologous exposures were compared between eight
      patients who received only packed red blood cells and four patients who received
      whole blood for replacement of surgical losses, using a chi-square test for
      comparison. All variables demonstrated a decline among patients who received
      whole blood. The declines in homologous blood and plasma usage were statistically
      significant (P less than .05). The decline in platelet usage did not reach
      statistical significance. The decline in total homologous exposures approached
      statistical significance (P less than .1). The data suggest that use of whole
      blood for expected massive transfusion may reduce total blood-component
      requirements and total homologous exposures.

PMID- 1751576
TI  - Newsletters respond to AIDS and cancer information overload.

PMID- 1751577
TI  - Treatment of non-Hodgkin's lymphoma.
AB  - Many of the advances in the management of non-Hodgkin's lymphomas have been based
      on more precise understanding of the various cell types that constitute these
      disorders. During the past year, we have seen some dramatic changes in the
      therapeutic approach to low-grade lymphomas. Until recently, the usual approach
      to these disorders was a purely palliative one, but a number of publications from
      the past year describe a more intensive approach with the goal of developing a
      curative modality. The use of combination chemotherapy in addition to radiation
      therapy for the early Ann Arbor stages as well as the use of high-dose
      chemotherapy with bone marrow transplantation in patients with high-risk factors
      has been reported recently. In the area of intermediate-grade lymphomas, most of
      the recent publications have described prognostic factors associated with various
      chemotherapy protocols. One of the most interesting recent developments is
      related to the dose-intensity issue. A consensus appears to be developing in
      regard to the correlation of dose intensity with clinical outcome. Despite the
      fact that new third-generation regimens have been associated with cures in 50% to
      66% of the patients, a significant fraction of patients require salvage
      chemotherapy. Some of the new salvage regimens are discussed, as is the use of
      calcium channel blockers to reverse multiple-drug resistance. Finally, management
      of the high-grade lymphomas, specifically the small noncleaved cell type, has
      been associated with a cure rate in the range of 50% in two recently published
      studies. Patients who are human immunodeficiency virus-positive with small
      noncleaved cell lymphoma can be cured of their underlying malignancy, but many of
      them later develop complications of acquired immunodeficiency syndrome, to which
      they usually succumb.

PMID- 1751578
TI  - Prognostic factors in Hodgkin's and non-Hodgkin's lymphomas.
AB  - A review of prognostic factors described recently in Hodgkin's and non-Hodgkin's
      lymphomas is presented with some comments on their interest and value for
      treatment choice and comprehension of the disease. The most important parameters
      are divided into three categories: 1) age; 2) extent of the tumor, ie, number of
      nodal or extranodal sites, bulkiness, stage, lactate dehydrogenase level or beta
      2-microglobulin level; and 3) host-tumor interaction, ie, performance status,
      serum albumin level, and erythrocyte sedimentation rate. These initial parameters
      permit the stratification of lymphoma patients into subgroups with different
      outcomes in which different therapeutic modalities are tested.

PMID- 1751579
TI  - Treatment-related morbidity in patients with lymphoma.
AB  - The evolution of effective therapies for lymphoma has led to cures for many
      patients. In addition to the acute morbidity associated with cytotoxic therapy,
      significant delayed treatment-related effects have been identified. Complications
      include immunologic, cardiovascular, pulmonary, thyroid, and gonadal dysfunction
      as well as the development of second neoplasms. These complications results from
      tissue injury caused by the administration of radiation or chemotherapy,
      persistent immunologic deficits related to the underlying malignancy or its
      therapy, and complications of surgical staging and splenectomy. Disease or
      treatment-related immunosuppression and the mutagenic effects of therapy appear
      to predispose these patients to an increased risk of second cancers. This article
      reviews data from the recently published literature on these issues.

PMID- 1751580
TI  - Pathogenesis of HIV-related malignancies.
AB  - Human immunodeficiency virus (HIV)-1 infection is associated with increased
      frequency of Kaposi's sarcoma and high-grade B-cell lymphoma. Several other
      cancers in HIV-1-infected individuals have been reported, although without
      statistically significant increase in their respective occurrences. Although HIV
      1 does not infect either Kaposi's sarcoma-derived spindle cells or B lymphocytes
      in vivo, viral proteins in vitro have been shown to be mitogenic to both Kaposi's
      sarcoma-derived spindle cells and B lymphocytes. Furthermore, several cytokines
      influence directly and indirectly the proliferative differentiation capacity of
      these cells. These cytokines include interleukin-1, interleukin-4, interleukin-6,
      and tumor necrosis factor. Many of these cytokines also are regulated by HIV-1
      infection of T lymphocytes and monocyte/macrophage. Furthermore, elevated levels
      of interleukin-1, interleukin-6 and tumor necrosis factor have been observed in
      patients with HIV-1 infection, particularly in advanced stages, when these tumors
      often manifest. Thus, it appears that although HIV-1 does not directly transform
      cells permissive to its infection, viral proteins directly and through regulation
      of cellular genes exert activities that may lead to the development of Kaposi's
      sarcoma and B-cell lymphoma.

PMID- 1751581
TI  - Biologic therapy and immunotherapy for ovarian cancer.
AB  - Ovarian cancer remains an attractive model for evaluation of biologic and
      immunologic therapies due to the availability of multiple reagents, the
      development of preclinical murine models, and the intraperitoneal pattern of
      clinical disease. Recent studies have focused on conjugated monoclonal
      antibodies, including radioconjugates, immunotoxins, and bispecific antibodies.
      Other preclinical and clinical studies have been conducted with recombinant
      cytokines and adoptive cellular immunotherapy for small-volume residual disease.
      Dose-limiting clinical toxicities have emerged with many of these approaches in
      the absence of frequent antitumor responses, and new strategies will be required
      to develop effective therapies in the future.

PMID- 1751582
TI  - Epidemiology, etiology, screening, prevention, and diagnosis in female genital
      cancer.
AB  - Cancers of the endometrium, ovary, and cervix share certain characteristics.
      Etiologic factors are generally environmental. Prevention of the three cancers
      requires further improvement in the efficiency of the available screening
      methods. Trials to improve survival require more accurate staging and diagnosis,
      in addition to the identification of more significant prognostic factors that
      could allow recognition of low- and high-risk groups of patients.

PMID- 1751583
TI  - Issues in gynecologic radiation oncology.
AB  - Radiation therapy has a number of established roles in the curative, adjuvant,
      and palliative management of gynecologic malignancies. Specific indications for
      use of radiation therapy, concepts of integration of radiation therapy with other
      modalities, and techniques of radiation therapy, however, continue to evolve.
      Rather than discuss the use of radiation therapy in specific diseases, this paper
      reviews recent studies dealing with current issues in gynecologic radiation
      oncology.

PMID- 1751585
TI  - Lymphoma.

PMID- 1751586
TI  - Cancer in AIDS.

PMID- 1751584
TI  - Chemotherapy and complications in gynecologic cancer.
AB  - Amelioration of toxicity is of major concern to every physician treating patients
      suffering from gynecologic cancer. If dose escalation in treatment of ovarian
      cancer is to be considered, the highest priority should be trying to overcome the
      toxicities of cisplatin, the cornerstone of chemotherapy. So far, dose limiting
      side-effects are nephro-, neuro-, and ototoxicity. These toxicities may play an
      even more important role when doses, higher than conventionally given, are to be
      considered. At higher doses other toxicities such as myelosuppression may become
      dose limiting. However, nausea and vomiting, which up until now have been
      intractable, are the most outspoken acute adverse events suffered by the
      patients. Development of new antiemetic treatment modalities is therefore
      noteworthy.

PMID- 1751587
TI  - Gynecologic cancer.

PMID- 1751588
TI  - Reflections: of hope and of concern.

PMID- 1751589
TI  - Positive selectable markers for use with mammalian cells in culture.
AB  - As more complicated gene expression studies are necessary, the need for multiple
      positive selection schemes becomes critical. Numerous selectable markers have
      been described over the last 25 years. A hallmark of the most generally useful
      markers is easy selection in a wide number of cell types. This paper briefly
      reviews the spectrum of available selectable markers and describes some of the
      applications that have been found for these genes, particularly with respect to
      retrovirus-mediated gene transfer.

PMID- 1751590
TI  - Gene transfer of adenosine deaminase into primitive human hematopoietic
      progenitor cells.
AB  - The inherited deficiency in adenosine deaminase (ADA), which results in severe
      combined immunodeficiency, is generally regarded as an optimal model for the
      development of human somatic gene therapy. The ideal target for the correction of
      ADA deficiency and other lympho-hematopoietic disorders would be the
      hematopoietic stem cell. We have used a combination of recombinant human
      interleukins-3 and -6 to stimulate the proliferation of primitive human
      hematopoietic progenitor cells during a period of co-cultivation with irradiated
      cells producing high titers of an ADA-transducing retroviral vector packaged in
      amphotropic particles. In a series of nine experiments, an average of 83% of the
      clonogenic progenitors (CFU-E and CFU-GM) were found to have acquired the
      transferred sequence as determined by polymerase chain reaction analysis. In
      addition, in two experiments, 24-44% of the clonogenic progenitors derived from
      long-term myeloid cultures 9 weeks post-transduction were found to contain vector
      sequence. The latter cells are derived from so-called "long-term culture
      initiating cells" (LTC-IC), which are primitive cells probably related to
      hematopoietic stem cells. Moreover, the transduced ADA enzyme was found to be
      expressed in both normal and ADA-deficient erythroid colonies, and in the
      nonadherent cells of long-term bone marrow culture for at least 2 weeks at levels
      that approximate the endogenous ADA levels of normal erythroid cells. These
      results indicate that the ADA coding sequence can efficiently be introduced by
      retroviral gene transfer into both committed and primitive human hematopoietic
      progenitor cells, and that this will result in adequate expression of the
      transduced enzyme in the progeny of committed hematopoietic progenitors.

PMID- 1751591
TI  - Liability considerations presented by human gene therapy.
AB  - Through the use of a hypothetical scenario, this article examines the legal
      liability associated with gene therapy. Basic negligence principles are applied
      to the factual context of a human gene therapy experiment gone awry, including
      its prior governmental review and its potential effect on future generations. The
      federal requirements, while not preempting state law damages claims, do provide a
      mechanism for achieving some protection from liability. The effect on future
      generations raises questions about the limits of liability.

PMID- 1751592
TI  - Regulatory concerns in human gene therapy.
AB  - Gene therapy in humans is now being undertaken in an investigational setting.
      Such therapy involves the administration of biological products to human
      patients. A document entitled, "Points to Consider in Human Somatic Cell Therapy
      and Gene Therapy" has been prepared by the Center for Biologics Evaluation and
      Research (CBER) of the Food and Drug Administration (FDA) and is published
      elsewhere in this issue. This paper provides explanatory material about the CBER
      regulatory process and the scientific and regulatory basis for the requests for
      data in that document.

PMID- 1751593
TI  - Points to consider in human somatic cell therapy and gene therapy (1991).

PMID- 1751594
TI  - Problems in comparisons of clearances prescriptions in hemodialysis and
      continuous ambulatory peritoneal dialysis.

PMID- 1751595
TI  - Which statistical method to use when analyzing the incidence of peritoneal
      dialysis related infections?

PMID- 1751596
TI  - Multiple-dose-kinetics of ofloxacin after intraperitoneal application in CAPD
      patients.
AB  - Pharmacokinetics of ofloxacin in plasma and peritoneal fluid were studied in 11
      patients on continuous ambulatory peritoneal dialysis (CAPD). Seven patients
      without peritonitis received 20 mg ofloxacin added to 2L dialysate i.p. every 6 h
      for one day only, while 4 patients with acute peritonitis were treated with this
      same dosage every 4 h for 3 days, then every 6 h for the next 7 days. Ofloxacin
      concentrations in plasma and dialysate were determined by HPLC. After i.p. drug
      application there was a rapid elimination of ofloxacin from dialysate, this being
      significantly faster in patients with peritonitis as compared to those without.
      Likewise, the total amount lost from the first bag after a 3 h dwell was higher
      in the peritonitis group (84.7 +/- 1.5%; mean +/- SEM) than in the non
      peritonitis group (75.6 +/- 2.1%). Twenty-four h after start of ofloxacin
      treatment, the mean peritoneal fluid concentrations at the end of each exchange
      studied were all above 3 mg/L. In patients with peritonitis, plasma
      concentrations of ofloxacin rose to 0.94 +/- 0.05 mg/L after 24 h reaching a Cmax
      of 1.8 +/- 0.2 mg/L after a tmax of 84 +/- 23 h. Intraperitoneal administration
      of ofloxacin was well tolerated, and no local or systemic adverse events were
      observed. Peritonitis episodes that were caused by Staphylococcus epidermidis (3)
      and by E. coli (1) were cured in all patients.

PMID- 1751597
TI  - Peritoneal transport kinetics of glucose, urea, and creatinine during infancy and
      childhood.
AB  - Peritoneal handling of glucose and metabolites is reported to be higher in young
      children treated with CAPD than in older children. Reference curves for the
      standardized peritoneal equilibration test (PET) are not available for younger
      ages. The present study describes the results of the PET in 19 children (mean age
      5.0 years, ranging from 0.3-15) during the first month of CAPD treatment. No age
      dependency for the handling of glucose, urea, and creatinine could be established
      when the group was subdivided into 1. children below the age of 3 years, and 2.
      children above that age. There was, however, a significant correlation between
      equilibration of creatinine and age, indicating more rapid equilibration at
      younger ages.

PMID- 1751598
TI  - Short-term effects of low-calcium dialysis solutions on calcium mass transfer,
      ionized calcium, and parathyroid hormone in CAPD patients.
AB  - Patients on CAPD using calcium carbonate (CaCO3) as phosphate binder might
      benefit from low-calcium (Ca) concentration dialysis solutions; however, no data
      are available for the effects of this regimen on Ca metabolism. We studied 10
      patients on stable CAPD regimens with standard dialysis solutions (Ca 7 mg/dL)
      who were taking CaCO3 to control hyperphosphatemia (mean daily doses 4.5 +/- 2.4
      g). Hypercalcemic episodes had been recorded in 6 patients. Standard dialysis
      solutions were replaced with solutions containing 5 mg/dL of Ca. Calcium and
      phosphate peritoneal mass transfer (MT), serum concentrations of total Ca,
      ionized Ca (Ca++), phosphate, intact PTH, and mid-molecular PTH, were evaluated
      before and 48 hours after change of dialysate. The switch to low-Ca solutions was
      accompanied by significant changes in calcium mass transfer (Ca MT) (+9.84 +/-
      48.22 versus -96.74 +/- 48.32 mg/day, p less than .001). Ca MT was significantly
      (p less than .05) correlated with the serum/dialysate Ca gradient. There was no
      difference in phosphate MT. Serum Ca++ significantly (p less than .05) decreased
      from 5.20 +/- 0.32 to 4.88 +/- 0.36 mg/dL, and intact PTH significantly increased
      (81.5 +/- 139 versus 112.4 +/- 168 pg/mL, p less than .05). It is concluded that
      dialysis solutions with Ca 5 mg/dL result in a negative peritoneal Ca MT and can
      be useful to prevent and treat hypercalcemia in CAPD patients taking CaCO3 as
      phosphate binder. A careful monitoring of ionized calcium, PTH, and phosphate is
      suggested when an extensive and long-term use of this solution is considered.

PMID- 1751599
TI  - The role of omentectomy in continuous ambulatory peritoneal dialysis.
AB  - Long-term survival of the peritoneal catheter is essential for successful CAPD.
      In our unit, all CAPD catheters are now placed by an open surgical technique,
      which in some cases has included performing a partial omentectomy. The aim of
      this study was to assess the influence of omentectomy on CAPD catheter survival.
      Three hundred consecutive CAPD catheters inserted over a 5-year period were
      analyzed. Omentectomy was performed in 113 cases (38%). Data relating to a number
      of potentially significant risk/benefit factors were analyzed using multiple
      regression analysis (proportional hazards method of Cox). Performing a partial
      omentectomy at the time of catheter insertion was found to significantly improve
      CAPD catheter survival (p = 0.0002).

PMID- 1751600
TI  - Exit-site infection in continuous ambulatory peritoneal dialysis: a review.
AB  - Although the ability of CAPD to successfully treat end-stage renal disease is now
      well established, exit-site infection (ESI) remains a serious cause of morbidity.
      The objective of this article is to review recent advancements relating to ESI
      pathogenesis and its reduction. Current definitions of ESI are reviewed, as are
      comparative studies of etiology. Emphasis is placed on the literature identifying
      Staphylococcus aureus as the primary cause of ESI in CAPD. The article reviews
      reported rates of ESI and discusses reasons for variations of this complication's
      reported frequency. The selection of catheters available in CAPD are discussed,
      as are studies demonstrating the threat of S. aureus to catheter survival. The
      pathogenesis of exit-site infection related to S. aureus nasal carriage in CAPD
      is reviewed in light of recent findings indicating the pre-CAPD nasal carrier as
      the patient at risk for subsequent ESI. Postoperative and long-term care of the
      catheter patient are reviewed for various literature protocols. Treatment
      recommendations for choice of agents are discussed. Future research should
      include a better understanding of the morphology of the CAPD catheter exit-site
      in humans and the healing process. ESI epidemiological studies should be
      encouraged in tandem with well-designed, controlled studies on the value of
      prophylactic treatment.

PMID- 1751601
TI  - Quality of life of patients on in-center hemodialysis versus continuous
      ambulatory peritoneal dialysis.
AB  - This study compared chronic hemodialysis and CAPD patients on several quality of
      life variables: dietary adherence, self-esteem, hope, wellbeing, marital
      happiness, perceived control over life, marital status, number of emotional
      support persons, and participation in social, recreational, and work activities.
      Statistically significant differences in the quality of life variables due to
      treatment modality or demographic variables were not found. However, CAPD
      patients did engage in significantly more social and recreational activity,
      though not more work activity, than did hemodialysis patients. It is noted that
      73% of the CAPD patients were Caucasian and that 72% of the hemodialysis patients
      were of black origin. Similarly skewed racial compositions in preceding research
      comparing patients on CAPD and hemodialysis suggest that 1. choice of treatment
      is occurring on the basis of some set of patient characteristics, or 2.
      systematic assignment is occurring on the basis of race, sex, and/or education.
      However, given no significant race/demography differences for variables used in
      this research, it appears that quality of life across racially different groups
      of hemodialysis and CAPD patients is comparable.

PMID- 1751602
TI  - Catheter infections in insulin-dependent diabetics on continuous ambulatory
      peritoneal dialysis.
AB  - We compared a group of 60 insulin-dependent diabetics maintained on CAPD with 60
      nondiabetic matched controls to determine if the diabetic patients were at
      increased risk for catheter-related infections. Although catheter infection rates
      were 17% higher in the diabetics (1.4/year versus 1.2/year in nondiabetics), time
      to first catheter infection was not different between the groups (p = 0.6). Rates
      of peritonitis, peritonitis associated with catheter infection, multiple catheter
      infection, and catheter removal were also similar among the diabetics and
      controls. S. aureus caused 52% (42/81) of the catheter infections in the
      diabetics and 60% (35/58) in the controls. More catheter infections in the
      nondiabetics versus the diabetics lacked drainage or resulted in sterile cultures
      (17/75 versus 7/88 respectively, p less than or equal to 0.01), but the
      significance of this finding is uncertain. In conclusion, we did not find insulin
      dependent diabetes mellitus to be a statistically significant risk factor for
      catheter-related infections.

PMID- 1751603
TI  - Effects of chondroitin sulphate on fluid and solute transport during peritoneal
      dialysis in rats.
AB  - The effect of chondroitin sulphate (CS) on peritoneal fluid and solute transport
      was studied in rats undergoing peritoneal dialysis. In the presence of CS, net
      ultrafiltration increased, while absorption of glucose and horseradish peroxidase
      from the peritoneal cavity decreased. Albumin, used instead of CS, did not modify
      either fluid or solute transport. In in vitro experiments on isolated rabbit
      mesentery, CS decreased transmembrane water flow induced by hydrostatic pressure,
      and its effect was not fully reversed 60 minutes after "wash-out" of this
      glycosaminoglycan. We postulate that the polyanionic CS molecules are trapped in
      the peritoneal interstitium, thus decreasing its hydraulic conductivity and
      permeability, which in turn increases net fluid removal during peritoneal
      dialysis because of its slower absorption from the peritoneal cavity.

PMID- 1751604
TI  - Can intracatheter retention of antifungal agents cure fungal peritonitis? Two
      cases successfully treated without catheter removal.

PMID- 1751605
TI  - CAPD in patients unable to do their own bag change.

PMID- 1751606
TI  - Intraluminal lithiasis of a peritoneal catheter.

PMID- 1751607
TI  - Recovery of S. epidermidis and E. coli from effluent peritoneal dialysate.

PMID- 1751608
TI  - Intraperitoneal phosphate for severe hypophosphatemia.

PMID- 1751609
TI  - An "organizer" for a safe bag exchange.

PMID- 1751610
TI  - Prazosin induced priapism in a patient on continuous ambulatory peritoneal
      dialysis (CAPD)

PMID- 1751611
TI  - Literature. October-December 1991.

PMID- 1751612
TI  - [The effect of the acidity of the medium on the magnitude of the light-dependent
      antibacterial activity of chlorophyllides].
AB  - The influence of medium acidity on the intensity of light-dependent antibacterial
      activity of chlorophyllides isolated from biomass of microscopic green alga
      Westella botryoides has been studied. This light-dependent antibacterial activity
      has been shown to be maximum at low pH values. The ability to suppress the
      bacterial growth under the action of light decreases in neutral and alkaline
      media. It has been concluded that the reason of increase of light-dependent
      antibacterial activity of chlorophyllides at low pH values is formation of
      pheophorbides out of them

PMID- 1751613
TI  - [Microorganisms synthesizing enzymes with thrombolytic action].
AB  - The literary and experimental data obtained by the authors concerning the ability
      of various microorganisms to synthesize exoproteases lysing the thrombi of human
      blood are presented in the article. Various methods of enhancing the thrombolytic
      activity of microorganisms cultures, the properties of some isolated and purified
      preparations, methods of enlarging the specificity of the enzymes to fibrin and
      of reduction of their toxicity are considered.

PMID- 1751614
TI  - [The characteristics of the effect of dipalmitoylphosphatidylcholine and its
      structural fragments on the lipid peroxidation of biological membranes].
AB  - The effect of dipalmitoyl phosphatidylcholine (DPPC) and its structural fragments
      -phosphatidic acid (PA) and choline chloride--on the ascorbate-dependent mice
      liver microsomal lipid peroxidation (LP) has been studied at the different LP
      rate. At DPPC, PA and choline chloride introduction into the incubation medium
      before the onset of peroxidation induction DPPC causes the more considerable
      inhibition of LP than PA each separate fragment. The inhibition effect of DPPC is
      lower than PA or choline chloride when DPPC, PA and choline chloride added on the
      background of developing process of peroxidation (e.i. after LP induction). A
      specific regulatory role of PC in the normal cell membrane LP process and during
      pathologic development is under discussion.

PMID- 1751615
TI  - [The effect of arginine on cytochrome P-450 activity and the structural state of
      the microsomal membranes of the rat liver and testes].
AB  - A single intraperitoneal arginine injection increases the amidopyrin
      demethylation on 230% and aniline hydroxylation on 74% in rat liver microsomes.
      For all this the rate of lipid peroxidation estimated by the number of dienic
      conjugates and Schiff bases does not change. At the same time the exogenous
      arginine decreases the lipid bilayer microviscosity on 35% and increases the
      degree of protein submersion into lipid matrix on 54%. The experiments in vitro
      confirm the fact of activation in cytochrome P-450 isoform by arginine. A
      possible arginine effect on microsome membrane is under discussion.

PMID- 1751616
TI  - [The modifying effect of novocaine on the clinical manifestations of the
      intestinal form of radiation sickness].
AB  - On rats and dogs exposed to absolute lethal doses of X-irradiation (rats--10, 12
      Gy; dogs--15 Gy sublethally) it has been shown that novocaini injection to
      animals immediately after radiation exposure reduces the primary radiation
      reaction and at the same time shifts the changes in morphofunctional state of
      peripheric blood on 24 hours, reduces the symptoms of acute radiation sickness,
      increases the average life length of the animals on 1,5 days. A conclusion
      concerning the expressed therapeutic influence of intraperitoneal novocaini
      injection immediately after radiation has been drawn.

PMID- 1751617
TI  - [The effect of the acute and chronic administration of dalargin to mongrel rats
      on cardiac chronotropism at rest and under physical loading].
AB  - In chronic experiments on untrained awakening males of white rats it has been
      shown that the prolonged intraperitoneal injection of the opiate receptor agonist
      delargin (during 4, 5 days; 10 mkg/kg; twice a day) leads the chronotropic heart
      response to the maximum level of exercises and simultaneous decrease of heart
      rate variability. All this is accompanied by animals' undue fatiguability. It has
      been concluded that the chronic injection of opioid agonist receptors causes the
      decrease of sensitivity of these receptors to the action of endogenic opioids and
      as a consequence--the increase of sympathetic regulatory action on the heart rate
      at physical exercises and growth of fatiguability.

PMID- 1751618
TI  - Chronic fatigue syndrome: the need for an integrative approach.

PMID- 1751619
TI  - Magnetic resonance imaging in schizophrenia: altered brain morphology associated
      with P300 abnormalities and eye tracking dysfunction.
AB  - This study was designed to investigate whether auditory P300 event-related
      potential and smooth pursuit eye-movement abnormalities in schizophrenia are
      associated with brain structural changes measured using magnetic resonance
      imaging (MRI). Serial coronal MRI scans obtained from 31 schizophrenic subjects
      and 33 volunteer controls were analysed by a rater who had no knowledge of the
      subjects' diagnoses. The brain areas measured bilaterally were the temporal lobe,
      hippocampus, amygdala, parahippocampal gyrus, head of caudate, cingulate cortex,
      frontal cortex, and the lateral ventricles. The area of the third ventricle, the
      thickness of the corpus callosum, and the intracranial area were also measured.
      Auditory P300 and eye tracking performance were recorded on all subjects. There
      was a significant increase in the latency and a reduction in amplitude of the
      P300 in the schizophrenic group. Only in the schizophrenic group was P300 latency
      correlated negatively with the area of the right and left cingulate cortex and
      positively with the difference in size between the right and left amygdala. In
      the subgroup of schizophrenic subjects whose P300 latency was greater than 2
      standard deviations above the control mean, the area of the left cingulate cortex
      was significantly smaller than in controls, and the absolute right-left
      difference in the area of the amygdala was significantly increased. Eye tracking
      dysfunction in schizophrenia was not related to changes in the amygdala or
      cingulate cortex but was significantly correlated with enlargement of the lateral
      ventricles. Schizophrenic subjects with poor eye tracking had significantly
      larger lateral ventricles than controls. Eye tracking dysfunction, but not P300
      abnormality, was correlated with the severity of both positive and negative
      symptom of schizophrenia. These findings demonstrate that psychophysiological
      abnormalities are associated with altered brain structure in schizophrenia.

PMID- 1751620
TI  - The MCPP challenge test in schizophrenia: hormonal and behavioral responses.
AB  - In a neuroendocrine challenge paradigm, the present study investigated responses
      of schizophrenic patients to m-chlorophenylpiperazine (MCPP), a serotonin (5
      hydroxytryptamine, 5HT) agonist. In an oral dose of 0.25 mg/kg, MCPP was
      administered in a placebo-controlled double-blind design to male schizophrenic
      patients (n = 7) and normal male controls (n = 8). Behavioral (Positive and
      Negative Syndrome Scale; PANSS) and hormonal (cortisol, prolactin) variables were
      measured over the subsequent 210 min. The schizophrenic patients experienced an
      overall exacerbation of psychopathology on MCPP as compared with placebo (p less
      than 0.05), with specific worsening of PANSS-positive symptoms (p less than
      0.025) and PANSS activation (p less than 0.001). In addition, the schizophrenic
      patients showed significantly lower cortisol (p less than 0.05) and prolactin (p
      less than 0.05) responses than the normal subjects. The schizophrenic patients
      had lower peak MCPP blood levels than the normal subjects, although this
      difference was not statistically significant. The findings are discussed in terms
      of 5HT receptor(s) sensitivity and the pharmacokinetics of MCPP in schizophrenia.

PMID- 1751621
TI  - Maladaptive anticipatory saccades in schizophrenia.
AB  - We compared the saccades made by 8 neuroleptic-treated and 7 drug-free
      schizophrenic inpatients with those made by 11 normal controls during two eye
      movement tasks. The first task was designed to elicit visually guided but not
      internally guided saccades. The second task was designed so that optimal
      performance required saccades be guided on the basis of an internal
      representation of target behavior. During the first task, schizophrenics made
      visually guided saccades that were as accurate as those made by control, but both
      drug-free and neuroleptic-treated schizophrenics made intrusive saccades at a
      significantly higher rate than control subjects. Most of these maladaptive
      saccades appeared to be premature attempts to anticipate target jump. During the
      second eye movement task, which for optimal performance required use of an
      internal representation to guide eye movements, most patients learned to
      anticipate target jump as well as controls. However, neuroleptic-treated patients
      made significantly smaller adaptive anticipatory saccades than either drug-free
      schizophrenic patients or normal subjects. These finding are discussed as they
      relate to the prefrontal cortex-basal ganglia circuits involved in the regulation
      of behavior by representational knowledge and the idea that the abnormal
      anticipatory saccades we observed represent a failure in the sensorimotor gating
      of information derived from internal representations.

PMID- 1751622
TI  - Fatty acid levels in the brains of schizophrenics and normal controls.
AB  - Essential fatty acids are important constituents of the brain. There is evidence
      that levels in blood of certain essential fatty acids and their eicosanoid
      derivatives may be abnormal. We now report that in the frontal cortex of
      schizophrenic patients there are significant differences from normal in the fatty
      acid composition of phosphatidylethanolamine. These differences from normal were
      not found in the cerebellar cortex.

PMID- 1751623
TI  - Neurological "hard" signs and family history of psychosis in schizophrenia.
AB  - Previous research found schizophrenics to have significantly more neurological
      signs than normal controls, even when signs were screened to exclude possible
      artifacts, and limited to "hard" signs of localizing significance. Schizophrenics
      with a family history of psychosis also tended to have more neurological signs
      than those without such a history. The present study examined whether these
      findings could be confirmed in new samples of schizophrenics and controls, using
      interview-based DSM-III and DSM-III-R diagnoses. Schizophrenics had significantly
      more hard signs than controls, and schizophrenics with a family history for
      psychosis again had more signs than those without this history. When present
      study data were analyzed alone, as well as when pooled with data from previous
      research using similar methods, hard signs were significantly greater in both (a)
      schizophrenics versus controls and (b) schizophrenics with versus without a
      family history of psychosis, supporting the hypothesis that neurological signs
      reflect a significant etiologic factor in schizophrenia.

PMID- 1751624
TI  - Effects of partial sleep deprivation on the diurnal variation of mood and motor
      activity in major depression.
AB  - Partial sleep deprivation (PSD), keeping a subject awake from 2 AM to 9 PM
      produces an acute mood improvement in 60% of patients with major depression. We
      sought to characterize the timing, subcomponent mood, and motor activity changes
      of this response. Thirty-seven subjects with major depression were rated with the
      6-item Hamilton Depression Scale (HAM-6) at 1 PM and completed the Profile of
      Mood States (POMS) every 2 hr on the day before and day of PSD. Locomotor
      activity was monitored continuously during the trial with an automated device.
      Bipolar I patients responded more frequently than other groups. Positive mood
      responders had greater improvement than nonresponders in POMS subscales of
      depression, tension, confusion, and anger. The mood improvement increased
      steadily during the day, peaked in late afternoon, and declined thereafter.
      Responders showed significantly higher levels of locomotor activity on the
      baseline pre-PSD day than did nonresponders. All subjects increased motor
      activity following sleep deprivation, however.

PMID- 1751625
TI  - HLA DR2 in narcolepsy with sleep-onset REM periods but not cataplexy.
AB  - To determine the association of HLA DR2 in patients with narcolepsy without
      cataplexy, a case-control study was performed. Patients receiving the diagnosis
      of narcolepsy without cataplexy had excessive daytime sleepiness (EDS) and
      polysomnographic findings consistent with narcolepsy but no clinical evidence of
      cataplexy. Of 28 patients identified, 12 agreed to return for HLA typing.
      Respondents did not differ from nonrespondents in demographic, clinical, or sleep
      laboratory data. The comparison group was 503 individuals, those 30 years and
      older, on the Michigan Kidney Transplant Registry. The odds ratio obtained from
      logistic regression indicated a strong association between narcolepsy without
      cataplexy and HLA DR2. To control for potential confounding variables,
      multivariate models were constructed to explore the joint effects of HLA DR2 and
      each one of the covariates (age, sex, and race), their possible combinations, and
      the effect of all three covariates. The odds ratios decreased minimally and the
      association between the disease and HLA DR2 remained significant.

PMID- 1751626
TI  - Increased platelet membrane lysophosphatidylcholine in schizophrenia.

PMID- 1751627
TI  - Prostaglandin E2 secretion by oviductal transport-stage equine embryos.
AB  - This study was conducted to identify embryonic products whose secretion was
      temporally associated with the oviductal transport period of the mare. Chemicals
      secreted by oviductal-transport-stage equine embryos were identified by
      incubating Day 6 or Day 7 early uterine embryos with 35S-methionine/cysteine, 3H
      progesterone, or 3H-arachidonic acid for 24 h, and subsequently identifying
      radioactively labeled proteins (SDS-PAGE; n = 3 embryos), steroids (HPLC; n = 3
      embryos), or prostaglandins (HPLC; n = 3 embryos) in the culture medium. Early
      uterine embryos secreted 116.1 +/- 45.5 pg of prostaglandin (PG) E2/embryo, 1.0
      +/- 0.2 pg of 17 alpha-hydroxy progesterone/embryo, 4.8 +/- 0.6 pg of
      androstenedione/embryo, and 11.5 +/- 4.5 pg of PGF2 alpha/embryo. They did not
      secrete detectable quantities of protein, testosterone, or estradiol-17 beta. A
      second experiment was conducted to measure temporal changes in embryonic PGE2
      secretion during the oviductal and early uterine period. Day 3, Day 4, Day 5, and
      Day 6 embryos (n = 8 embryos/day) were incubated with 3H-arachidonic acid for 24
      h, and the concentration of 3H-PGE2 in the culture medium was subsequently
      measured by HPLC. Embryos did not secrete detectable amounts of PGE2 prior to the
      expected time of oviductal transport (Day 3 and Day 4). They secreted 5.7 +/- 1.0
      pg of PGE2/embryo immediately before and during the expected time of oviductal
      transport (Day 5), and they secreted significantly of PGE2/embryo immediately
      before and during the expected time of oviductal transport (Day 5), and they
      secreted significantly (p less than 0.01) higher amounts (42.0 +/- 11.5 pg) of
      PGE2/embryo immediately after uterine entry (Day 6).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1751628
TI  - Prostaglandin E2 hastens oviductal transport of equine embryos.
AB  - The hypothesis that treatment of pregnant mares with prostaglandin E2 (PGE2)
      hastens the oviductal transport of equine embryos was tested by treating bred
      mares with PGE2 on Day 3 after ovulation and subsequently measuring the rate of
      hastened oviductal transport (estimated by the uterine embryo recovery rate on
      Day 4 after ovulation). In a preliminary, noncontrolled experiment, oviductal
      transport was apparently not hastened after intramuscular, intrauterine, or
      intraperitoneal PGE2 administration to bred mares (0/6, 0/3, and 0/3 mares,
      respectively). Oviductal transport appeared to be hastened in 1/13 mares after a
      single intraoviductal administration of PGE2, and in 2/2 mares after continuous
      intraoviductal administration of PGE2. In a subsequent, controlled experiment,
      treatment with a continuous intraoviductal infusion of PGE2 hastened oviductal
      transport in significantly more (p less than 0.01) mares versus a continuous
      intraoviductal infusion of vehicle or no treatment (6/11 vs. 0/11 or 0/11 mares,
      respectively). Unfertilized oocytes and oviductal masses were also recovered from
      mare uteri after continuous intraoviductal PGE2 administration, but were not
      recovered after vehicle administration or no treatment. These results support the
      hypothesis that PGE2 treatment hastens the oviductal transport of equine embryos,
      and suggest a role for embryonic PGE2 in the initiation of selective oviductal
      transport in the mare.

PMID- 1751629
TI  - The effect of ovarian follicle size on pituitary and ovarian responses to
      copulation in domesticated South American camelids.
AB  - The relation of ovarian follicle size to pituitary and ovarian responses to
      copulation was studied in domesticated South American camelids (llamas and
      alpacas). Females from each species were divided into four groups according to
      follicle size: small (4-5 mm), growing (6-7 mm), mature (8-12 mm), and regressing
      (10-7 mm). The pituitary response to copulation was determined by analysis of LH
      and FSH concentrations in plasma. The ovarian response to copulation was
      determined by ultrasonography and by analysis of estrone sulfate (follicular
      status) and pregnanediol glucuronide (luteal status) concentrations in urine.
      Females with small follicles (4-5 mm) released less LH after copulation than did
      those with larger follicles, and ovulation was not induced. Females with growing
      and mature follicles (7-12 mm) released LH in response to copulation that was
      adequate to induce ovulation and to initiate normal luteal activity. While
      copulation-induced LH release in females with regressing follicles was similar to
      that released in animals with growing and mature follicles, regressing follicles
      were luteinized instead of being ovulated. The luteal structure formed as a
      result of luteinization of follicles had a short life span, i.e., 5.1 days.
      Copulation-induced LH release was significantly higher in llamas vs. alpacas in
      animals with mature or regressing follicles, but not in those with small or
      growing follicles. Urinary estrone sulfate and pregnanediol glucuronide
      concentrations correlated positively with the presence of follicles and corpora
      lutea, respectively.

PMID- 1751630
TI  - Cell-specific expression of guanine nucleotide-binding proteins in rat testicular
      cells.
AB  - Guanine nucleotide-binding proteins (G proteins) are key components in membrane
      signal transduction that may play an important role in testis function. The
      present study is the first description of cell-specific differences in the
      contents of G protein alpha-subunits and their mRNAs in isolated rat testicular
      cells (pachytene spermatocytes, round spermatids, Sertoli cells, peritubular
      cells). By using Western blot techniques G1-3 alpha was shown to be the only
      pertussis toxin (PTX) substrate present in all the testicular cells examined.
      Surprisingly, we observed a lack of immunoreactive Gi-1 alpha/Gi-2 alpha protein
      in pachytene spermatocytes and round spermatids in spite of significant levels of
      the corresponding mRNAs as revealed by Northern analysis. No immunoreactive Gs
      alpha was detected in germ cells, in agreement with previous findings that the
      hormone-sensitive adenylyl cyclase is absent in these cell types. Peritubular
      cells and Sertoli cells contained no Go alpha, whereas high levels of both
      immunoreactive protein and mRNA were found in pachytene spermatocytes. This
      indicates that the Go protein may play a role at this stage of spermatogenesis.
      The stimulation of phospholipase C (PLC) in germ cell membranes by 5'-guanylyl
      imidophosphate indicates that PTX-sensitive PLC activation may be mediated by Go
      alpha or Gi-3 alpha.

PMID- 1751631
TI  - The influence of extracellular matrix components on the proliferation and
      migration of inner cell mass-derived parietal endodermal cells.
AB  - Reichert's membrane is a basement membrane deposited on the inner surfaces of rat
      and mouse trophectodermal (TE) cells beginning at the blastocyst stage of
      embryonic development that may play a role in the migration of the parietal
      endodermal (PE) cells to form an inner lining to the TE. The abilities of various
      glycoproteins present in Reichert's membrane to support PE cell migration and
      replication in vitro were examined by isolating inner cell masses (ICMs) from Day
      5 rat blastocysts (Day 1 = day of vaginal plug) and culturing them (24-72 h)
      either on surfaces that had been precoated with collagen IV, fibronectin, or
      laminin or on thin (1-2-mm) gels of Matrigel (a tumor cell-derived basement
      membrane preparation) or type I collagen. Time-dependent changes in the area
      occupied by each ICM on the culture surface and the number of migrating cells per
      ICM were quantified by morphometric analysis. Type IV collagen, the basement
      membrane-specific collagen, supported ICM attachment and the outward migration
      (overall increase of approx. 60-fold in mean ICM area occupied on the culture
      surface) and proliferation (cell doublings following every 24 h of culture) of
      laminin-containing PE-like cells. These effects were not altered by the inclusion
      of exogenous fibronectin or laminin in the culture medium. Collagen IV coating
      concentrations as low as 0.16 micrograms/ml supported PE cell attachment and
      migration, and maximal responses were seen with a coating concentration of 0.63
      micrograms/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751632
TI  - Ovarian steroid production in vitro during gonadal regression in the turkey. I.
      Changes associated with incubation behavior.
AB  - The mechanism regulating ovarian regression during incubation behavior in the
      domestic turkey has not been elucidated. This study was designed to determine
      whether ovarian steroidogenic potential is depressed during gonadal regression
      associated with the onset of incubation behavior. Hens were housed in floor pens
      equipped with trap nests that were checked 7 times per day. Hens were grouped,
      according to nesting frequency and egg production, into the following
      classifications: laying (laid an egg every day and trapped in the nest only
      once/day); transitional (laid an egg every day but trapped in the nest 4 or more
      times/day); and Day 1, Day 3, and Day 5 incubating (no egg for 2, 4, or 6 days,
      respectively, while trapped in the nest at least 4 times/day). Follicular atresia
      was evident in the largest preovulatory follicle (F1) in transitional hens,
      extensive in F1 through the third largest follicle (F3) in Day 1 incubating hens,
      and extensive in F1 through F7in Day 3 incubating hens. Levels of circulating LH,
      progesterone (P), androgen (A), and estradiol (E) decreased in transitional hens
      relative to concentrations in laying hens and remained low thereafter. In
      contrast, levels of prolactin were greater in Day 3 and Day 5 incubating hens
      than in laying, transitional, or Day 1 incubating hens. Basal production of P by
      F1 granulosa cells was lower from Day 1 incubating hens than from the other
      groups. Production of P in response to porcine-luteinizing hormone (pLH) was
      greater by cells from transitional and Day 1 incubating hens than from those of
      laying hens.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751633
TI  - Ovarian steroid production in vitro during gonadal regression in the turkey. II.
      Changes induced by forced molting.
AB  - In the turkey, the onset of incubation behavior is associated with altered
      ovarian steroidogenesis, ovarian regression, decreased, LH secretion, and
      increased serum prolactin (Prl) levels. To clarify the relative contribution of
      circulating LH and Prl to the initiation of ovarian regression, laying hens were
      exposed for 0, 3, 7, or 14 days to a forced molting procedure (exposure to
      reduced day length of 6L:18D and removal of feed and water for the initial 3
      days) that induces ovarian regression and decreased LH levels but does not
      increase Prl levels. On each of these days, hens were killed and granulosa and
      theca interna cells from the largest (F1) and fifth largest (F5) preovulatory
      follicles and total cells from the small white follicles (SWF) were incubated for
      5 h in the presence or absence of ovine LH (oLH; 0-1,000 ng/ml). Force-molted
      hens exhibited diminished levels of circulating LH, Prl, progesterone (P),
      androgen (A), and estradiol (E) by Day 3 of treatment. Ovarian atresia began in
      F1 by the third day of treatment, and included F1 and F5 by the seventh day. No
      preovulatory follicles were present on the fourteenth day. With both F1 and F5
      granulosa cells, production of P in the presence of oLH was initially enhanced
      (Day 3) and later absent (Day 7). In contrast, production of A by F5 theca
      interna cells in the presence of oLH was initially suppressed (Day 3) and then
      returned to pretreatment levels (Day 7).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751634
TI  - Effects of carbohydrates on the pharmacokinetics and biological activity of
      equine chorionic gonadotropin in vivo.
AB  - The sialylation of eCG was examined to determine its influence on the in vivo
      metabolism and biological activity of the molecule. Sialic acid was decrementally
      removed from eCG by incubation with agarose-linked neuraminidase for varying time
      periods. Pharmacokinetic parameters for the disappearance of 4,000 IU (267
      micrograms) of three desialylated eCG preparations (20%, 53%, and 80% sialic acid
      removed) and control eCG were determined in sheep. The clearance rate of eCG
      increased (p less than 0.05) with each decrement of sialic acid. The removal of
      53% sialic acid enhanced the distribution of eCG into the tissues, compared to
      control and 20% desialylated eCG (p less than 0.05), presumably because of
      increased lipid solubility and decreased molecular size. Desialylation to 53% did
      not alter the elimination half-life of eCG. The removal of 80% sialic acid
      resulted in the disappearance of eCG from the serum within 1 h, whereas control
      eCG was still present at 120 h. In vivo trials in rats disclosed that the control
      eCG preparation increased ovulatory rate at doses of 10-100 IU and ovarian weight
      at doses of 10-300 IU relative to saline-treated rats (p less than 0.01). The 20%
      desialylated eCG induced superovulatory and ovarian weight responses, but 100-500
      IU were required to achieve the same result as that produced by control eCG. The
      53% and 80% desialylated eCG preparations induced a mild superovulatory response
      (p less than 0.01) but no ovarian weight response. It was concluded that sialic
      acid was significant to the distribution and disappearance of eCG. The effects of
      carbohydrate removal on biological activity (e.g., superovulation) are primarily
      a function of clearance rate rather than tissue-specific phenomena.

PMID- 1751635
TI  - Further characterization of the electromyographic activity of the myometrium and
      mesometrium in nonpregnant sheep under estrogen supplementation.
AB  - The effects of estrogen administration on uterine contractility varies with
      animal species. In nonpregnant ovariectomized sheep, estrogen administration has
      been reported either to inhibit, inhibit then stimulate, or only stimulate
      uterine contractility. The aim of the present study was to determine the effects
      of prolonged estrogen administration in the electromyographic (EMG) activity
      recorded from the myometrium and mesometrium in nonpregnant ovariectomized sheep
      after estrous synchronization by inserting vaginal progesterone sponges 14 days
      before surgery. Surgery was performed on four ewes under halothane anesthesia.
      Bilateral oophorectomy was performed, and stainless steel EMG electrodes were
      sewn to the mesometrium and myometrium in both left and right horns of the
      uterus. Blood samples were taken at 1000 h from the uterine vein for 13,14
      dihydro-15-keto-prostaglandin F2 alpha determination, and from the femoral artery
      for estradiol determination. Starting on Day 7 after surgery, estradiol 17 beta
      (50 micrograms/24 h) was infused continuously into the jugular vein. Estrogen
      administration had a different effect on the EMG activity recorded from
      myometrium and mesometrium. The myometrial response to estrogen was an increase
      in the frequency of short EMG events from 19.0 +/- 8.7 to 57.0 +/- 5.0 (p less
      than 0.05) for events less than 60 sec, and from 2.70 +/- 0.83 to 10.30 +/- 1.36
      (p less than 0.05) for events lasting greater than 60 sec but less than less than
      180 sec. In contrast, there was no stimulatory effect of estrogen on mesometrial
      EMG for both types of short events less than 60 sec, and greater than 60 but less
      than less than 180 sec.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751636
TI  - Activation of reproduction in nulliparous and primiparous voles is blocked by
      vomeronasal organ removal.
AB  - Chemical cues from male voles activate reproduction in female prairie voles
      (Microtus ochrogaster). Twelve hours of contact with a male, followed by exposure
      to his soiled bedding for 2 days, is sufficient to initiate follicular maturation
      and induce uterine hypertrophy. Our recent work indicates that the chemosensory
      vomeronasal organ (VNO) can mediate this response. Here, we examined whether
      other sensory systems can acquire the ability to activate female reproduction as
      a result of learning or experience. To explore this issue, the VNO was removed
      (VNX) from nulliparous and primiparous females who were then exposed to cues from
      males. In Experiment 1, we found that nulliparous VNX females had lower uterine
      and ovarian weights than did sham-operated females. In Experiment 2, we
      determined that sexual experience did not ameliorate the reproductive deficits
      normally induced by VNX. The present results contrast with those of previous
      studies suggesting that males of some rodent species, when allowed reproductive
      experience prior to VNX, can utilize other sensory systems to mediate subsequent
      reproductive responses. We conclude that the role of the VNO in transducing
      chemosensory information is crucial for coordinating the reproductive efforts of
      male and female prairie voles.

PMID- 1751637
TI  - Temporal structuring of delivery in the absence of a photoperiod: preparturient
      myometrial activity of the rhesus monkey is related to maternal body temperature
      and depends on the maternal circadian system.
AB  - No convincing evidence exists that the shift from myometrial contractures to
      contractions, which determines the synchronized 24-h rhythm in the dynamics of
      the primate uterus, may be attributed to an endogenous circadian rhythm. We
      therefore wished to ascertain whether a 24-h periodic shift would also occur in
      the myometrial activity of animals kept under constant conditions. We studied
      five pregnant rhesus monkeys, kept in continuous darkness from 56-77 days
      gestational age until delivery at 117-167 days gestational age. During the last
      week before delivery we determined the individual phase, level, and amplitude of
      circadian changes in maternal body temperature and 24-h myometrial activity
      patterns in the form of contractions. In all five monkeys, a rhythm with a period
      of 24-h characterized the temporal incidence of preparturient contraction
      activity. A consistent phase lag of 6-7 h from the temperature crest was observed
      in four out of the five animals. The circadian phase of all individual rhythms
      was idiosyncratic among animals. We conclude that endogenous rhythms in body
      temperature and preparturient myometrial activity are truly circadian. In
      addition, these rhythms are either interdependent or subject to the same maternal
      timekeeping mechanism, supporting the hypothesis that the exact time of the day
      at which birth occurs in the rhesus monkey depends on the maternal circadian
      system.

PMID- 1751638
TI  - The critical period for mullerian duct regression in the dog embryo.
AB  - The embryonic period during which Mullerian duct regression and Mullerian
      Inhibiting Substance (MIS) secretion occur was determined in canine embryos
      removed from timed pregnancies (32, 36, 37, 39, 42, and 46 days gestation). Sex
      chromosomes of each embryo were identified in metaphase spreads prepared from
      fibroblast cultures. Testicular differentiation, defined by seminiferous tubule
      formation and the presence of Sertoli cells and Leydig cells, and the degree of
      Mullerian duct regression were determined by careful morphologic analysis of
      histologic sections of canine embryonic gonads (n = 20) and Mullerian ducts (n =
      20). MIS was detected immunohistochemically in embryonic testes using avidin
      biotin complex enhancement of a specific rabbit polyclonal anti-MIS antibody.
      Testicular differentiation was observed at 36 days gestation. The earliest
      evidence of Mullerian duct regression in male embryos was observed at 36 days
      gestation, and regression was completed by 46 days gestation. Positive staining
      for MIS was present in testes from 36 to 46 days (n = 9). Staining was absent in
      the undifferentiated testis (n = 1) at 32 days gestation and in ovaries at all
      ages tested (n = 10). Thus, MIS is normally present throughout the critical
      period for Mullerian duct regression in the embryonic male dog.

PMID- 1751639
TI  - Regulation of androgen receptor mRNA in rat Sertoli and peritubular cells.
AB  - Regulation of 9.5-kb androgen receptor mRNA concentrations in Sertoli and
      peritubular cells from 20-day-old rats was studied by Northern blot analysis.
      Treatment of cells in vitro for 1-7 days with 300 ng/ml FSH increased androgen
      receptor mRNA up to 4-fold in Sertoli cells but not in peritubular cells.
      Testosterone (100 ng/ml) had no effect or slightly decreased androgen receptor
      mRNA in Sertoli and peritubular cells. Androgen receptor mRNA concentrations in
      Sertoli and peritubular cells from rats killed 15 days after hypophysectomy were
      elevated 4-5-fold over those in cells from intact rats. The androgen receptor
      mRNA concentration was decreased in both Sertoli and peritubular cells isolated
      from hypophysectomized animals treated with 500 micrograms/day testosterone
      propionate in vivo and subsequently with 100 ng/ml testosterone in vitro. FSH
      treatment (100 micrograms/day in vivo, followed by 300 ng/ml in vitro) did not
      increase androgen receptor mRNA over that in cells from hypophysectomized
      controls but rather decreased its concentration to varying degrees in Sertoli and
      peritubular cells. The rise in androgen receptor mRNA in both Sertoli and
      peritubular cells isolated from hypophysectomized animals is attributable, at
      least in part, to the absence of the inhibitory influence of testosterone. Other
      data in the literature suggest positive regulation of Sertoli cell androgen
      receptor protein by FSH and androgens. Consequently, complex mechanisms involving
      transcriptional, translational, and post-translational regulation probably
      control androgen receptor concentrations in the cells of the rat seminiferous
      tubule.

PMID- 1751640
TI  - Cardiomyopathies in children with neuromuscular disorders.
AB  - In this paper eight patients with myogenic or neurogenic muscle disorders are
      presented, in whom cardiomiopathy was also found. Six patients developed a
      dilated cardiomiopathy associated with neurogenic atrophies or progressive
      muscular dystrophy. In patients with Mb. Friedreich and HSNM type II together
      with the total dilatation of the septum hypertrophy was observed and in patients
      with spinal muscular amyotrophy of scapuloperoneal type atriomyopathy dominated.
      In two patients with mitochondrial disorders a hypertrophic cardiomyopathy was
      found. One of them had mitochondrial encephalomyoneuropathy and the other
      mitochondrial encephalopathy with myoclonic epilepsy. In none of them a
      restrictive cardiomyopathy was found. From the presentation could be concluded
      that in neurogenic muscle diseases and progressive muscular dystrophy
      respectively most frequently dilated cardiomyopathies have been developed.
      Hypertrophic cardiomyopathies are usually found in children with mitochondrial
      disorders.

PMID- 1751641
TI  - Diagnostic possibilities of closed head injuries of acceleration type using
      computed tomography.
AB  - A group of 42 patients with closed head injuries of acceleration type is
      reported. All of them were treated at various departments of the General Hospital
      in Maribor. The aim of investigation was to find out the diagnostic possibilities
      of head and brain damages in closed head injuries of acceleration type by the
      method of computed tomography (CT) and making comparison with the clinical
      picture of each individual patient. The patients were not investigated at random
      but were grouped in accordance with the direction of traumatic force action. The
      CT analyses were performed according to characteristic patterns of traumatic
      brain disease. The circumstances of head injury were reliable guidelines for
      devoting more attention to some brain areas. The density of each lesion was
      examined, too. The investigation has shown that lesions of "inner cerebral
      trauma" pattern (ICT-Grcevic 1965) are visible on CT at least as often as coup
      contrecoup lesions or even more. Only in cases with latero-lateral direction of
      traumatizing force (control group) coup-contrecoup lesions were found more
      frequently. Deep cerebral lesions of the latero-lateral type of acceleration head
      trauma were never or seldom encountered.

PMID- 1751642
TI  - Cerebrospinal fluid CK enzyme and CK isoenzymes in the outcome prognosis of
      cerebrovascular disease.
AB  - The article presents the results of the analysis of total CK enzyme activity and
      CK isoenzymes in the cerebrospinal fluid of 148 patients with acute stroke,
      treated at the Intensive Care Unit of the Department of Neurology and Department
      of Neuropathology of the Clinical Hospital Center Rebro. The aim of the study was
      to determine the reliability of the applied methods in the prognosis of the
      outcome of cerebrovascular diseases. Greatly increased total CK enzyme activity
      is more frequently encountered in patients with ICH than in those with ISI. Great
      elevation of total CK activity can be considered a bad prognostic sign in
      patients with ICH, while in those with ISI only moderately increased total CK
      enzyme activity can be regarded as a bad prognostic sign. The greatest incidence
      of pathological CK isoenzyme profile, that is the presence of both MM and BB
      fractions together, was found in the group of patients who died with ICH, while
      the greatest frequency of BB fraction alone was observed in the group of patients
      who survived with ISI. In the group of the deceased with ISI the greatest
      frequency was that of MM and BB fractions together. Therefore, the occurrence of
      BB fraction alone can be considered a good prognostic sign, while the occurrence
      of MM and BB fractions together a bad one. The presence of MM and BB fraction
      together, as well as the simultaneous presence of all three fractions of
      isoenzymes, are most frequently associated with elevated total CK enzyme
      activity. The occurrence of BB isoenzyme fraction alone is most frequently
      accompanied by normal value of total CK activity, rarely with slightly to
      moderately, and very rarely with greatly increased total CK enzyme activity. The
      determination of total CK activity and of CK isoenzyme profile is performed by
      means of two complementary investigations which should be performed
      simultaneously.

PMID- 1751643
TI  - Transcranial Doppler diagnostic criteria in the evaluations of arteriovenous
      malformations.
AB  - In order to get a better insight in hemodynamic occurrence of intracranial
      arteriovenous malformations (AVM), 31 patients with AVM, documented by CT and
      angiography, were investigated by Transcranial Doppler (TDC). Although the
      angiography provides definite diagnosis of AVM, its size, position, type feeders
      and involvement of various vascular segments, TCD provides more information about
      collateral circulation, intracerebral shunts or functional stenosis due to high
      blood velocities within the blood vessels involved by AVM. The parameters
      obtained by TCD: mean cerebral blood flow velocities (MCBFV) in middle and
      internal carotid artery (MCA, ICA), pulsatility index (PI), MCA/ICA ratio and (S
      D)/S ratio were introduced. Results have shown that TCD findings in non-feeding
      arteries were normal in all patients. TCD finding of MCBFV in MCA and ICA, PI and
      MCA/ICA ratio in feeding arteries has shown a significant difference from normal
      arteries (p less than 0.01). These parameters are shown to be AVM size dependent.
      MCBFV in MCA on the feeder side was statistically significant higher in those
      patients with large AVM (greater than 4 cm) size (p less than 0.01). For
      assessment of AVM and its improved and advanced analysis the potential advantages
      of parameters: (S-D)/S ratio and 3D hemodynamic mapping has been emphasised.

PMID- 1751644
TI  - Regional distribution of brain gangliosides in Alzheimer's disease.
AB  - In this study, brain gangliosides of patients with Alzheimer's disease (AD, N =
      5) were analyzed and compared with control human brains (C, N = 3). Gangliosides
      were analyzed in seven brain regions: cerebral cortex (frontal, parietal,
      temporal and occipital), hippocampus, basal telencephalon and frontal white
      matter. The results demonstrated gangliosides to be decreased in the majority of
      regions analyzed, however, a significant decrease in gangliosides (nmol LBSA/mg
      proteins or g fresh weight) in frontal cortex and white matter (P less than 0.05)
      was recorded. When gangliosides were expressed in nmol LBSA/mg DNA
      (deoxyribonucleic acid), their basal telencephalon, suggesting that high
      astroglial proliferation might have concealed the real neuronal degeneration. In
      the ganglioside composition, all human brain regions contained moderately
      decreased ganglio-series gangliosides (GT1b, GD1b, GD1a, GM1) but a statistically
      significant decrease was detected in frontal cortex, and white matter (nmol
      LBSA/g fresh weight) or frontal cortex, temporal cortex and basal telencephalon
      (nmol LBSA/mg DNA). In addition, frontal and parietal cortex also showed elevated
      concentration (nmol LBSA/g fresh weight) of simple gangliosides (GM2, GM3, GM4,
      GD3). A decreased concentration of ganglio-series gangliosides in Alzheimer's
      disease correlates with degeneration of cortical neurons. However, elevation of
      simple gangliosides in frontal and parietal cortex may correlate with: (a) an
      accelerated lysosomal degradation of gangliosides occurring during neuronal death
      (GM2); (b) astrogliosis (GM3 and GD3); and (c) activation of oligodendrocytes
      (GM4). The fact that gangliosides are altered in Alzheimer's disease might be
      important for better understanding of the pathogenesis of the disease.

PMID- 1751645
TI  - Development of carotid stenosis.
AB  - A group of 29 patients with carotid artery stenosis was analyzed with the purpose
      of following-up the development of stenosis, and performing duplex scanner of
      carotid arteries. The follow-up was performed on the very first day of the study
      and six months later. There were 49 stenoses of internal carotid arteries in 29
      patients. Carotid stenoses were classified into six categories. Most carotid
      stenoses were unchanged during the six month period (57.2%), or progressed
      (36.7%), but spontaneous regression was found in 6.1%. The ultrasonic
      characterization of carotid plaques was made in four types. Regression was
      noticed mainly in ulcerative plaques, while hard and fibrous plaques remained
      unchanged or progressed. Soft plaques progressed in all cases. Intraplaque
      hemorrhage was found in 2 patients. The most common risk factors for carotid
      atherosclerosis were hypertension, hyperlipidemia and cigarette smoking.

PMID- 1751646
TI  - Sleep-waking cycle disturbance in patients with obstructive sleep apnea syndrome.
AB  - Eighteen (18) obese patients with clinically confirmed obstructive sleep apnea
      syndrome (OSAS) and five (5) obese persons with no apnea crises noticed during
      sleep apart from occassional loud snoring, have been polysomnographically
      assessed. The obtained results show that the patients with apnea syndrome sleep
      very badly, and consequently, shortened sleep latency and frequent body
      movements, along with apneas, are regarded as the leading polysomnographic
      symptoms. Vigilance profile during sleep, that is, interchange and frequency of
      each of sleep stages (I, II, III, IV, REM) are similar in both tested groups. The
      suppression of restitutive stages of sleep (III, IV, REM) is considered to be a
      dominant characteristic of vigilance during sleep in obese persons and obese
      persons with manifest apnea syndrome. Relatively prolonged sleep latency in obese
      persons without manifest apnea syndrome indicates, however, restitutively higher
      quality of their nocturnal sleep. Contrary to the patients with apnea syndrome,
      they do not suffer from excessive evening somnolence, so that their daily
      alertness and sleep vigilance during night are of a better quality, although the
      lack of deep and REM sleep is observed in them as well.

PMID- 1751647
TI  - The clinical picture of rabies in a child.
AB  - An eight-year-old boy developed rabies 31 days after having been scratched by a
      dog and died 9 day later. Intensive supportive medical treatment was complicated
      by apnea, cardiac arrest, hypotension, increased secretion of antidiuretic
      hormone and severe hypoproteinemia. The treatment with intramuscular human
      antirabies immunoglobulin (HRIG) 2400 I.U. and intrathecal 1200 I.U. in
      combination with intramuscular interferon alpha 4 million I.U. was given every
      second day. The diagnosis of rabies was confirmed before death, on the third day
      of the disease, by direct fluorescent antibody staining of the saliva and
      cerebrospinal fluid for viral antigen. At the autopsy, the brain tissue specimens
      were tested for the presence of the virus by inoculation into the suckling mice
      brain and for the viral antigen by direct fluorescent antibody method. The brain
      tissue specimens collected at autopsy were also tested for virus by direct
      fluorescent antibody method.

PMID- 1751648
TI  - Dumbbell meningioma of the cervico-clavicular region.
AB  - The authors are reporting on a case of a 55-year-old man with an epidural
      meningioma in the region from the C VII. to the Th I. segment. The tumor
      encircled this region, and to the front and right involved the channels through
      which pass the C VI, C VII. and C VIII. roots. Subdurally, no tumoral mass was
      found. Another part of this tumor, of the same histological architecture as the
      epidural cervicospinal part was found in the supraclavicular region to the right,
      closely connected to the arteries and nerves of this region. The authors discuss
      the possibility of the tumoral occurrence at this site, primarily taking into
      account the origin of this tumor from the cells of the outer surface of the
      arachnoidea, i.e. cap cells which can invade the dura, with later separation from
      the main arachnoidal layer. The other possibility of such dumbbell meningioma
      occurring at the outgoing openings of the neural paths from the spinal channel
      should be looked for in the remnants of the arachnoidal cells in the region of
      the outgoing openings. In the paper are also discussed and correlated clinico
      pathological, CT and angiographic findings.

PMID- 1751649
TI  - [Stress and anesthesia].

PMID- 1751650
TI  - [The endocrine stress reaction in anesthesia and surgery--origin and
      significance].
AB  - Stress can be defined as a "reaction by living beings to any relevant
      impairment". The effect of anaesthesia on endocrine function is closely related
      to the actual stress concept based on the works by Cannon and Selye. Cannon
      described the role of catecholamines in stress and characterised the fight-flight
      reaction. Selye emphasised the role of the adrenocortical reaction defining the
      "general adaptation syndrome", which evolves in three stages ("alarm reaction",
      "stage of resistance", "stage of exhaustion"). Later, Henry postulated the dual
      stress concept. The sympathetic-adrenomedullary system is activated during the
      fight-flight reaction, thus representing an active role of the organism. The
      pituitary-adrenocortical system is activated during loss of control, submission
      and depression, especially in a social context. Main valid parameters of this
      endocrine stress response are adrenaline, noradrenaline, ADH, ACTH and cortisol.
      In the perioperative period, both pathways are "stressed". The most important
      factors are patient, operation, and anaesthesia. Anaesthesia can influence the
      stress response by afferent blockade (local anaesthesia), central modulation
      (general anaesthesia) or peripheral interactions with the endocrine system
      (etomidate). Up to now, a total peripheral blockade of the nociceptive system is
      impossible, due to surgical technique (destruction of nerve fibres) and release
      of mediator substances. With regard to reduction of endocrine stress response,
      inhalation anaesthesia with volatile anaesthetics and nitrous oxide may be less
      effective than neuroleptic, spinal or epidural anaesthesia. Immediately after
      extubation, rapid increases of endocrine parameters are observed. In addition to
      central modulation of pain and stress, both halothane and enflurane inhibit
      catecholamine release from the adrenal medulla. Neuroleptic anaesthesia and total
      intravenous anaesthesia are very potent and sufficient to control the increases
      in endocrine parameters even during major surgery, due to their central effects.
      Spinal and epidural anaesthesia alone as well as in combination with general
      anaesthesia can reduce the endocrine stress response more than necessary. This is
      due to the sympathetic blockade, combined with an afferent blockade of central
      cord fibers which modulate the pituitary-adrenocortical system. Only few data are
      available concerning the stress response during infiltration anaesthesia or nerve
      block, but additional sedation seems to be beneficial. Peripheral interactions
      with the endocrine system like blockade of the adrenal cortex by etomidate is
      dangerous and has caused a high mortality in intensive-care patients if the
      substance was admitted for a longer period. Assessment of endocrine stress
      response in anaesthesia and surgery is controversial.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1751651
TI  - [Optimized analgesic sedation techniques for ESWL].
AB  - Analgo-sedation for ESWL treatment has been associated with a variety of
      problems. Minimal invasiveness of this technique should combine with haemodynamic
      stability as well as with adequate oxygenation. Patient acceptance has to be
      considered as another important aspect. Our study demonstrates the effectiveness
      of an analgosedative regimen with regard to these aspects. 50 ASA I-III patients
      scheduled for ESWL treatment were randomly allocated to receive either no
      premedication (n = 25) or chlorazepam as oral premedication (n = 25). The
      analgosedative technique was identical in both groups, consisting of atropine
      0.25 mg, droperidol 5 mg (2.5 mg, if body weight less than 60 kg), and alfentanil
      10 micrograms/kg intravenously. If necessary, repeated boluses of alfentanil 5
      micrograms/kg were administered up to a maximum of 2 mg. Heart rates, arterial
      blood pressures, and peripheral oxygen saturation were measured during treatment.
      Post-treatment, patients were interviewed to assess the quality of analgesia. The
      results showed that our analgo-sedative regimen is suitable for ASA I-III
      patients. Stable heamodynamic conditions and adequate oxygenation were achieved
      in all patients. Patient acceptance was good. Patients with anxiolytic
      premedication benefited in terms of reduction in blood pressure and heart rate.
      The study also showed that anaesthesiologists may underestimate the pain
      intensity experienced and assessed by the patient.

PMID- 1751652
TI  - [Muscle relaxation using atracurium in porphyria variegata--case notes].
AB  - A case is presented involving the use of atracurium (120 mg) as a muscle relaxant
      in a patient with known variegate porphyria. The concentrations of urinary
      porphyrins and porphyrin precursors did not increase after this anaesthetic, and
      no exacerbation of the disease was noted. This single case suggests that
      atracurium can be used safely in patients with porphyria.

PMID- 1751653
TI  - [In vitro drug interactions and their importance in anesthesiologic practice].
AB  - The potential for in vitro drug interactions is great in anaesthesiology because
      of routine intravenous comedication. When the drug is applied directly into (via)
      the injection port of the cannula most of these interactions are overlooked,
      whereas others show no visible signs. Chemical interactions depend on pH changes,
      formation of insoluble salts, oxidation and reduction, complex formation, or
      hydrolysis. Physical interactions are caused by changing of solvent system
      polarity, salting out, emulsion cracking or sorption. Solving the problem
      requires information (1) and precautions in respect of the mode of application
      (2). (1) Anaesthesiologists should know the most frequent mechanisms. Glucose
      infusions cannot be considered as safe carrier solutions for admixtures.
      Pharmacological databases should offer as much information as possible on
      incompatibility. (2) Injections into a separate line or lumen with a sodium
      chloride infusion are safe. Admixture is recommended only if compatibility is
      known.

PMID- 1751654
TI  - [Mini-Symposium. Intensive medicine 1991. Introduction].

PMID- 1751655
TI  - [New aspects of enteral nutrition].

PMID- 1751656
TI  - [The effect of nutrition on the work of breathing].

PMID- 1751657
TI  - [Nutrition in acute kidney failure].

PMID- 1751658
TI  - [Endocrine dysfunction in critically ill patients].

PMID- 1751659
TI  - [New ventilatory techniques].

PMID- 1751660
TI  - [Intensive medicine aspects of pre-eclampsia--eclampsia].

PMID- 1751661
TI  - [Compartment syndrome of the forearm due to infusion and transfusion using a
      pressure pump].
AB  - Two cases are reported in whom infusions and transfusions by means of pressure
      pumps caused a compartment syndrome of the forearm. Subfascial tissue pressure
      measurement is a decisive device under general anaesthesia to confirm the
      diagnosis. The development of a compartment syndrome caused by extracorporal
      fluids, be it an arthroscopy or a transfusion, as well as the indication for a
      conservative or an invasive procedure are discussed.

PMID- 1751662
TI  - Overview: techniques and indications of LDL-apheresis.
AB  - In recent years, LDL-apheresis has emerged to be an efficient treatment of
      hyperlipidemia in patients who do not respond sufficiently to diet and lipid
      lowering drugs. A survey of LDL lowering extracorporeal procedures is presented.
      Among them, to date 5 procedures have been used clinically on a routine basis:
      unselective plasma exchange, semi-selective double filtration (including its
      modifications like thermofiltration and predilution/backflush) and three highly
      selective LDL-apheresis systems: LDL-adsorption on dextran sulfate coated
      cellulose beads or anti-apoprotein B-linked sepharose and heparin induced
      extracorporeal LDL and fibrinogen precipitation (the so-called HELP system).
      Advantages, limitations and special indications of these commercially available
      systems are discussed. If atherosclerosis can really be made regress by drastic
      reduction of elevated serum cholesterol levels as indicated by recent
      publications, lipid apheresis will no doubt play a major role in attaining this
      goal.

PMID- 1751663
TI  - Basic studies of local adsorption in burn treatment.
AB  - The model of a full-thickness thermal burn in rats was used to demonstrate that
      the application of adsorptive dressings made of a fibrous activated carbon
      material (ACFM) after early excision of a burn crust exerts a considerable
      influence on the development of both local and general symptoms of burn disease.
      Three days after the excision a water content in underlying tissues falls from
      84.81 +/- 0.62% to 54.47 +/- 4.2%, the wound surface area decreases by 10%, while
      this surface area under gauze bandages increases by 6.3%. The local adsorption
      results in lower activity of proteolytic serum enzymes and toxicity of blood
      serum in burned animals as well as in the positive dynamics of changes in
      functional activity of the immune system. By the 14th day the T-cell activity in
      animals with adsorptive carbon dressings was by 3.2 times higher than that in the
      animals with gauze bandages. The level of B-cell response if ACFM is applied
      exceeds normal values to a great extent, starting from the first days after the
      excision of a burn crust.

PMID- 1751664
TI  - Application sorption: experience in clinical use and prospects of development.
AB  - The analysis of experimental - clinical results obtained during the last decade
      in the field of application of adsorptive carbon dressings in wound and burn
      therapy is given. Possible mechanisms of the therapeutic effect of this material
      are discussed, the feasibility of their application during different phases of
      wound process and burn disease treatment is demonstrated. The local absorption
      may be independent efficient method of treatment in the case of surface burns and
      wound with a small area of injury and provide a pronounced detoxifying effect in
      the case of suppurative-septic complication of a mechanical trauma and burns.

PMID- 1751665
TI  - A study of oral adsorbent in chronic renal failure.
AB  - In order to examine the effect on the progression of chronic renal failure (CRF),
      we have applied an oral adsorbent (AST-120) composed of spherical porous carbon
      particles to patients with chronic renal failure undergoing conservative therapy.
      Its effect was observed in improvement of uremic symptoms, improvement of slope
      in linear regression of reciprocal of serum creatinine vs. time plots and delayed
      initiation of hemodialysis, compared to control patients, together with reduced
      uremic peak 2a in HPLC analysis of serum and lower levels of beta 2 microglobulin
      in AST-120 group than in control. The improvements of uremic symptoms, creatinine
      and 2a levels were confirmed in double blind study where background of patients
      were evenly randomized between AST-120 and placebo groups and no improvement was
      observed in placebo group. The result leads us to conclude that the oral
      adsorbent therapy is expected as an useful therapy for retardation of progression
      of CRF.

PMID- 1751666
TI  - Enterosorption in oncotherapy.
AB  - Patients with lymphogranulomatosis undergoing radiotherapy according to the
      radical scheme were treated with fibrous carbon enterosorbent VESTA in tablets
      for 14 days (group I, 23 patients) from the moment of leukopenia development
      (lower then 2.2 x 10(9)/l) or were traditionally treated using parenteral
      administration of hemostimulants, hemosubstitutes and detoxicants (group II, 23
      patients). After 14 days leukopenia was cured in 18 patients of group I (78%) and
      in 11 patients of group II (48%), with an average number of leukocytes in the
      patients of groups I and II growing by 2 and 1.6 times, respectively. The
      administration of enterosorbents enabled interruptions in radiotherapy caused by
      the development of leukopenia and the deterioration of health status to be
      greatly shortened and the requirements in expensive transfusion media to be
      sharply reduced.

PMID- 1751667
TI  - Treatment of neuroleptic malignant syndrome with direct hemoperfusion.
AB  - Neuroleptic malignant syndrome (NMS) is an uncommon but serious and fatal
      idiosyncratic reaction to neuroleptics. It is difficult to correct this
      abnormalities successfully. There has been several reports on the treatment of
      NMS with dantrolene and/or bromocriptine. But these therapy are not effective in
      every cases. We have experienced ten cases of NMS. Six of them were presented
      with respiratory distress. Seven patients were treated with direct hemoperfusion
      and the remainder were managed by dantrolene, bromocriptine and other drugs.
      Patients treated with direct hemoperfusion two to four times could got a good
      improvement within several days and recovered. As to the patients treated by
      drugs. One of them who was not serious recovered with bromocriptine after twenty
      days. Two patients needed hemodialysis. NMS is occur not only by the use of
      neuroleptics but also by the break of them. So, this syndrome is do not develop
      by the high concentration of neuroleptics merely. NMS differed from ordinary drug
      intoxication. The etiology of NMS has unknown. But two major theories are
      present. One is dopaminergic blockade theory the other is direct toxic effect on
      skeltal muscles. We speculate that direct hemoperfusion remove metabolites of
      neuroleptics or normalize the alteration in the central nervous system.

PMID- 1751668
TI  - Anticoagulant therapy in a congenital antithrombin III (ATIII)-deficient patient
      with chronic renal failure undergoing regular hemodialysis.
AB  - We describe a 43-year-old male patient with congenital antithrombin III
      deficiency requiring hemodialysis due to extension of venous thrombus from
      recurrent deep vein thrombosis. During dialysis with adequate heparinization, the
      patient often revealed clot formation in the extracorporeal circuit resulting in
      unexpected discontinuation of dialysis. When either a combination of antithrombin
      III concentrate + heparin or the newly developed synthetic antithrombin
      preparation, MD805, was administered during dialysis, he could be uneventfully
      dialyzed with either of the two regimens.

PMID- 1751669
TI  - Long term effect of LDL apheresis in Japan. LDL Apheresis Study Group.
AB  - LDL-apheresis is introduced in many cases all over Japan. Among them, evaluation
      of long-term effect on ischemic heart disease (IHD) has made on 10 cases with
      homozygous familial hypercholesterolemia (FH) and 49 cases with heterozygous FH.
      As to homozygous FH, 3 patients had angina pectoris. Mean duration of treatment
      was 26 months (52 treatments). The changes in total cholesterol (TC) in each
      treatment was from 426 mg/dl to 151 mg/dl. Improvement in IHD was observed in 5
      out of 10 cases. As to heterozygous FH, 17 cases had history of myocardial
      infarction and 12 had angina pectoris. Mean duration of treatment was 13 months
      (19 treatments). Mean TC was decreased from 271 mg/dl to 126 mg/dl by each
      treatment. Regression in Achilles tendon thickenting or skin and palpebral
      xanthomas was observed. Frequency of anginal attacks decreased in 8 out of 17
      cases. Ischemic change in ECG were improved in 3 out of 26 cases. Coronary
      angiography performed with 2 to 3 years of interval in some cases revealed
      regression or no progression in coronary stenosis. As a whole, IHD improved in 15
      cases and exacerbated in 2 cases. Main side effect was hypotension attack.
      Bradycardia and anginal attack during treatment were observed in some cases. LDL
      apheresis was judged as effective in 25 out of 44 patients with IHD or xanthoma.

PMID- 1751670
TI  - Application of plasma perfusion in hepatic failure.
AB  - To evaluate the efficacy of plasma perfusion as a liver-assistance system, 17
      patients with hepatic failure were treated with a total 37 sessions of plasma
      perfusion and 43 sessions of plasma exchange. For plasma perfusion, Plasma-flo AP
      08-H was used as a plasma separator, and the separated plasma was passed through
      an adsorber, Bespore UPC-III (Jap.Med.Suppl., Hiroshima) or BR 350 (Asahi Med.
      Co., Tokyo). The mean treated plasma volume was 5.0 liters. The mean proportion
      of bilirubin removed by routine plasma exchange was 29% with a mean of plasma
      exchange volume of 2.1 L. In the plasma perfusion with Bespore and BR, the
      removal rates were 37% and 42%, respectively. The plasma ammonia level decreased
      by 16% (from 121 to 97 mumol/L) with plasma exchange. Likewise, plasma perfusion
      decreased the plasma ammonia level from 75 to 56 mumol/L with an average
      decrement rate of 23%. The capacity for removal of amino acids was analyzed in
      terms of the change in the Fisher score ([Val+Leu+Ileu]/[Tyr+Phe]). The Fisher
      score was improved by plasma perfusion from 1.8 to 2.4. Thus, we concluded that
      in terms of removal of bilirubin, ammonia and amino acids, plasma perfusion was
      as efficient a therapy as plasma exchange. However, further clinical evaluation
      will be required before this procedure can be applied for the treatment of
      hepatic failure.

PMID- 1751671
TI  - Efficacy and limitations of plasma exchange in patients with acute hepatic
      failure; comparing with hemoadsorption, and with impaired regeneration syndrome.

PMID- 1751672
TI  - Assortment of posthepatectomy hyperbilirubinemia by the occurring time with
      reference to indication of plasma exchange.
AB  - This study was undertaken to assort the group of posthepatectomy
      hyperbilirubinemia by occurring time for helping elucidate its indication of
      plasma exchange (PE). PE was carried out for 14 cases among 198 hepatectomized
      patients. The 14 cases were classified for 3 groups due to the period between
      operation and PE. 1: Early type (less than 2 weeks), 2:Intermediate type (2 less
      than-less than 8 weeks), 3: Late type (greater than 8 weeks). The results were as
      follows. Number (liver cirrhosis (LC)) [table: see text]. The effect was expected
      for the early groups since PE would remove overload against the regenerating
      residual liver. However, there were no survival cases among the early group or LC
      group. These results suggest that PE may be effective for the slowly increasing
      hyperbilirubinemia in not cirrhotic patients and that the state of
      hyperbilirubinemia is the terminal stage for LC patients even under the
      particular situation such as posthepatectomy.

PMID- 1751673
TI  - Self-regulated delivery of insulin from microcapsules.
AB  - We previously developed self-regulating insulin delivery systems using
      concanavalin A (Con A)-bound succinyl-amidophenyl-glucopyranoside insulin (SAPG
      insulin) in pouch membrane which exhibited long lag times for exchange diffusion
      in response to glucose changes. We report here the preparation of a new system
      with a short exchange diffusion onset composed of hydrophilic nylon microcapsules
      containing Con A and SAPG-insulin in vitro. It is considered that this SAPG
      insulin system can quickly respond to glucose changes when it is composed of at
      least two layers which include active Con A and where unbound SAPG-insulin
      permeation is the rate limiting step.

PMID- 1751674
TI  - Polystyrene latex particles: preparation and properties.

PMID- 1751675
TI  - Myasthenia gravis (MG) treatment with immunoadsorbent columns.
AB  - We performed ten plasma perfusion (PP) treatments on eight patients affected by
      Myasthenia Gravis (MG) with high serum levels of autoantibodies against
      acetylcholine receptors (anti AChR-AB), and one PP treatment on a patient with MG
      of probable genetic origin and without specific antibodies. All patients
      (Osserman group III-IV) had undergone thymectomy and immunosuppressive therapy.
      Each patient received a treatment cycle of six PP sessions. Clinical conditions
      were assessed before and after the treatment with evaluation of muscular
      strength, ventilatory function, and electromyographic testing. Immunologic
      markers were tested before and after each PP. The patient without specific
      antibodies showed no improvement with PP and was excluded from our study. All the
      other patients showed continued improvement, with increased muscle strength and
      improved respiratory function. Four patients (follow-up 16-24 months) still
      maintain the clinical improvement; two, unexpectedly relapsed 11-12 months after
      PP, received a new treatment successfully (follow-up 9-10 month).

PMID- 1751676
TI  - Immunoadsorption with PH-350: as a beneficial therapy for acute Guillain-Barre
      syndrome.
AB  - The subjects here were patients (two males and a female) with the severe acute
      Guillain-Barre Syndrome admitted to our hospital between September 1987 and
      December 1988. One case was treated with a double filtration plasmapheresis and
      two cases were with a immunoadsorption. Of the two extracorponeal thrapeutical
      methods, the clinical efficacies seemed not to be different however biochemical
      and serological laboratory data showed prominent differences. For instance the
      large molecular substances in blood; immunoglobulins, coagulating factors and
      albumin were reduced in plasma levels by the double filtration plasmapheresis,
      but not or less by the immunoadsorption. Considering the expectable side effects
      of the two methods, it may say that the immunoadsorption should be applied as a
      beneficial extracorponeal method for the acute Guillain-Barre Syndrome.

PMID- 1751677
TI  - Clinical experience of double filtration plasmapheresis for drug refractory
      neurological diseases.
AB  - The effect of therapeutic double filtration plasmapheresis (DFPP) was clinically
      investigated for drug refractory neurological disorders. DFPP therapy was
      performed 181 times for 10 patients who were treated with medical therapy of
      steroid or immunosuppressive drugs without any improvement of their symptoms.
      After the induction of DFPP therapy the neuromuscular disturbances were soon
      ameliorated in 9 cases of them. After DFPP, serum levels of IgG, IgA or IgM were
      decreased as follows: IgG 0.53 +/- 0.16; IgA 0.60 +/- 0.11; IgM 0.59 +/- 0.09 (M
      +/- SD). After the DFPP therapy there was no relapse in improved 9 cases. But we
      could not regard the immunologic markers as the index of efficacy of DFPP.
      Because serum levels of IgG, IgA or IgM showed a tendency to decrease by using
      drugs, when we didn't observe any improvement of symptoms. These results suggest
      that DFPP is a beneficial therapy for neurological diseases who had no effect
      with drug therapy, however, serum concentrations of the immunologic markers were
      not necessarily correlated to the severity.

PMID- 1751678
TI  - Immunoadsorption and plasma exchange in multiple sclerosis: complement and plasma
      protein behaviour.
AB  - Three groups of patients suffering from acute attacks or progressive multiple
      sclerosis (MS) are under investigation. First results revealed remarkable
      clinical improvements of patients with acute attacks in the groups treated by
      therapeutic plasma exchange (TPE) and immunoadsorption (IA). Only slight or no
      improvements were seen in the patients of the control group treated only with
      steroids. Plasma protein levels (IgG, IgM, IgA, fibrinogen) were considerably
      reduced in patients of the TPE group after each treatment procedure as expected.
      The same holds true concerning the total hemolytic capacities (THC) of the
      complement of the classic (CP) and the alternative (AP) pathway. On the other
      hand in the IA group only slight decreases of plasma proteins (about 20%) were
      observed, but the behaviour of THC's were quite similar than those seen in the
      patients of the TPE group. The THC decreases in both groups can be explained by
      removal of all complement factors (TPE group) or by the adsorption of single
      factors (IA group) of both complement pathways according to earlier in vitro
      investigations. The THC decreases in patients of both groups suffering from acute
      MS attacks could mean an "antiinflammatory" effect and could--at least partially-
      contribute to the clinical improvements of these patients.

PMID- 1751679
TI  - LDL-apheresis and improvement in the coronary atherosclerosis of familial
      hypercholesterolemia--correlation of computerized quantitative coronary
      angiography with autopsy findings.
AB  - We have evaluated the effects of LDL-aphereses performed over 15 to 62 months,
      involving both Double Filtration Plasmapheresis (DFPP) and LDL Adsorbent
      Plasmapheresis (LAPP), for 5 patients with familial hypercholesterolemia (FH) (1;
      homozygous, and 4; heterozygous) using computer image analysis by coronary
      angiography, (CAG). Results by CAG showed that in homozygous FH, 9 (75%) of 12
      segments demonstrated no progression, 2 (16.7%) segments showed regression, and
      only 1 (8.3%) segment showed progression. In heterozygous FH, 27 (81.8%) of 33
      segments showed progression, and 6 (18.2%) segments showed regression. Aorto
      coronary bypass was beneficial with obtained patency in 13 (93%) of the 14
      grafts. We also performed an autopsy on one patient, with heterozygous FH who
      died suddenly probably due to fibrillation. The patient had received long-term
      LDL apheresis for 6 years and 7 months and had shown angiographic regression. The
      pathological findings showed no typical or new atheroma, significant
      cicatrization in the thickened intima and an eccentric thickened wall lesion. The
      serial angiographic findings together with the pathological findings very clearly
      support the use of LDL-apheresis for producing "true" regression in coronary
      atherosclerosis in FH.

PMID- 1751680
TI  - Treatment of severe hypercholesterolaemia by LDL-apheresis.
AB  - The most severe forms of hypercholesterolaemia scarcely respond to diet and
      conventional drugs administration and need, therefore, alternative treatments.
      Terapeutic Plasma Exchange demonstrated an improved survival of subjects with
      Familial Hypercholesterolaemia (FH) in spite of its limitations. Semi-selective
      and selective techniques have been developed in order to remove LDL cholesterol
      alone. We studied the efficiency in LDL removal both of membrane filtration as of
      dextrane sulphate adsorption on 14 FH patients, performing 302 procedures.
      Cholesterol extraction with the different methods was in the range of 40-65%.
      Mean cholesterol level was reduced from 7% to 64% depending on the protocol used.
      The procedures were all performed on an outpatient basis. Side effects occurred
      rarely and were always of not serious degree. The short and the middle term
      clinical effects of LDL-Apheresis are then evaluated.

PMID- 1751681
TI  - An experimental study on selective elimination of beta 2-microglobulin using
      immunoadsorption method in patients with chronic renal failure.
AB  - We studied selective elimination of beta 2-microglobulin (beta 2-m) from plasma
      of patients with chronic renal failure (CRF) by using immunoadsorption method.
      Anti-human beta 2-m antibody of rabbit IgG was coated with cellulose beads, which
      were filled into a small-column. One gm of cellulose beads contains 5.0 mg of the
      protein of antibody. Five to 7 ml of plasma samples with 40 to 70 mg/l of beta 2
      m were passed through the column at 1.0 ml/10 min and each effluent was then
      collected by 1.0 ml consecutively. Before and after passing through the column,
      beta 2-m and other plasma proteins were measured. Plasma beta 2-m concentrations
      in all the effluent fractions after passing through the column were greatly
      reduced to 1/100. But no other plasma protein components than beta 2-m varied in
      concentration. Neither Immune complex (IC) nor rabbit IgG was detected in any
      effluent fraction. These results indicate that selective and effective
      elimination of beta 2-m from plasma in patients with CRF was possible by using
      our method. In addition, since neither IC nor rabbit IgG was detected in the
      effluent, this method was considered to be clinically applicable.

PMID- 1751682
TI  - Sterile and endotoxin free dialysis fluid for hemodialysis.
AB  - As the quality of water in dialysis fluid varies considerably, and, in view of
      the fact that endotoxin or active derivates can cause acute and chronic side
      effects in patients under hemodialysis treatment, the dialysis fluid must be
      sterile and endotoxin-free. The predialyzer fluid in 20 hemodialysis patients was
      investigated. The bacterial loading was between 5/ml and 12,000/ml, the endotoxin
      concentration was high and extremely variable. Therefore we introduced the
      ultrafiltration of the dialysis fluid by a polyamide hollow fiber membrane before
      entering the dialyzer. All samples were free of bacteria, and the concentration
      of endotoxin was lower than the detectable limit. With this procedure we can
      obtain sterile dialysis fluid, which is endotoxin free. Our preliminary results
      showed that Interleukin-1 in the patients was significantly (p less than 0.005)
      lower under ultrafiltration of the dialysis fluid than without ultrafiltration.

PMID- 1751684
TI  - [Acute pancreatitis: a disease with 2 faces].

PMID- 1751683
TI  - Increased concentrations of free light chain lambda in sera from chronic
      hemodialysis patients.
AB  - Serum levels of FLc were determined in 5 pre-HD CRF patients, 63 CRF patients
      receiving HD therapy, 15 CAPD and 40 healthy volunteers. The highest serum FLc
      concentration was observed in patients receiving HD. Concentrations of kappa- and
      lambda FLc were higher than normal in patients with CRF, and were about 4-fold
      and 1.8 fold greater than control values in HD patients, with a predominance of
      lambda chains. This HD-associated elevation of serum FLc strongly suggests a role
      for FLc in the etiology of light chain deposit disease and AL-amyloidosis. Lambda
      FLc and beta 2-m exhibited similar patterns of change in the serum during the
      course of HD therapy. Further studies may reveal other pathological conditions
      other than CRF in which these polypeptides may play a role.

PMID- 1751685
TI  - [The parenteral drug addict in the emergency service].
AB  - Clinical and epidemiological features of intravenous drug addicts (IVDA), who
      attended the emergency department between 1984 and 1988, were studied. The number
      of cases treated over these 4 years had increased three-fold (256 vs 724). The
      median age had increased by 3 years (p less than 0.01). The sex ratio had not
      changed. A third of the cases knew that they were HIV-seropositive in 1988. The
      main reason for consultation in 1984 was overdosage and in 1988 it was fever. The
      rate of admission was similar in both years (around 21%). There was a significant
      increase in admissions caused by respiratory diseases in 1988 (p less than
      0.0001) and a significant decrease of admissions caused by overdosage (p less
      than 0.001).

PMID- 1751686
TI  - [The bone manifestations in 94 cases of sarcoidosis].
AB  - 94 patients diagnosed as having sarcoidosis were studied in Galicia in order to
      evaluate the frequency of bone manifestations, as well as to analyse the clinical
      and radiological features. Bone lesions were found in 10 patients (10.6%) with a
      median age of 47.4 years, the predominant sex being female in this group (70%).
      The lesions were of two types: a) osteolytic on metacarpal (4 cases), nasal bones
      (1 case), sacrum (1 case), femur (1 case); b) osteosclerosis on femur and fibula
      (1 case), acrosclerosis (3 cases), metacarpal (1 case). The first lesions were
      associated to chronic types of sarcoidosis with skin and lung involvements. The
      second lesions were associated to a sub-acute type of Lofgren. We highlight the
      behaviour of both types of bone lesions and comment on the physiopathology of the
      sclerotic lesions.

PMID- 1751687
TI  - [A mortality study in the Internal Medicine Emergency Service of October 12
      Hospital during 1989].
AB  - 152,902 patients were attended at the Emergency Department of "12 de Octubre"
      Hospital during 1989; 48,701 of them were seen in the Internal Medicine area. 196
      dead, 164 case histories were selected in order to fulfil the protocol. Several
      variants were analysed, such as age, sex, diagnosis, time spent at the hospital,
      quality of life, date, etc. 53.6% were male; the median age was 73 years and the
      overall median age of all patients seen was 55.9 years. Median Karnovsky was
      52.50% of the patients died during their first 5 hours at the Emergency
      Department. The most frequent diagnoses for the area were neurological, followed
      by cardiovascular, oncological, digestive, etc. The most frequent diseases
      observed were cerebrovascular accident, cardiac insufficiency and acute
      infarction, oncological cases and death on arrival. Mortality was higher in
      winter. On the whole, mortality was higher in oncology patients followed way
      behind by neurology digestive and cardiovascular patients.

PMID- 1751688
TI  - [Insulin-dependent diabetes mellitus and arterial hypertension].
AB  - Blood pressure variations of 30 insulin-dependent diabetic patients free of
      complications, and aged between 14-35 years have been studies, comparing their
      results to those from a control group formed by healthy person of the same age
      and physical features. Median systolic pressure of diabetic population was 120 +/
      11.07, compared to 112.90 +/- 11.31 from control group. The median diastolic
      pressure of diabetic population was 76.76 +/- 10.12 and 67.40 +/- 7.94 of the
      control group. A significant difference on systolic (p less than 0.05) and
      diastolic (p less than 0.001) pressures were observed in insulin-dependent
      diabetic patient comparing their results to those from the control group.

PMID- 1751689
TI  - [Splenic artery aneurysm. Apropos 3 cases].
AB  - 3 cases of aneurysm of the splenic artery are presented. The incidence of this
      disease in the general population is not particularly low, however, it is not
      often diagnosed as it is not symptomatic. 2 of our patients were admitted because
      of abdominal pain, one of them with acute abdomen and shock and the other had two
      periods of symptoms with a nonsymptomatic interval between them; both patients
      had aneurysm resection and splenectomy. The third patient was non-symptomatic and
      the aneurysm was discovered due to a ring-like calcification. We highlight the
      value of a contrast CT scan in order to diagnose splenic artery aneurysms.

PMID- 1751690
TI  - [Necrotizing myelopathy associated with neoplasia. A clinico-pathological study
      of 2 cases and a review of the literature].
AB  - Two cases of necrotic myelopathy are presented. This is a very rare paraneoplasic
      syndrome. One patient had clear cell renal carcinoma and other had lymphatic
      metastasis of malignant melanoma without filiation of the primary tumor. The
      complete spinal study (MNR, CT, myelography) proved normal. Diagnosis is possible
      when all other causes of spinal disease have been discarded. Nowadays, it is
      possible to diagnose this disease premortem. The international literature
      reviewed showed 31 cases published since 1903, associated mainly to malignant
      diseases such as lymphomas, lung cancer, renal carcinoma, breast cancer,
      leukemias, etc. The differential diagnosis appears in the comments, as well as
      the presentation and evolution of the cases described up until now.

PMID- 1751691
TI  - [Lupus myopathy refractory to steroid treatment].
AB  - A 58-year-old patient with lupus erythematosus (LE) who needed treatment with
      azathioprine, due to resistant myopathy to steroids, is presented. Clinical and
      histological features, as well as therapy, are discussed.

PMID- 1751692
TI  - [Plasmacytoma of the thyroid. A review apropos a case].
AB  - Isolated presentation of outer bone marrow plasmatic cell neoplasia are non
      frequent (less than 10% of all plasmacytomas). Thyroid gland involvement is
      rarely described. A case where immunohistochemistry confirmed the monoclonal type
      of proliferative cell is presented. Clinical, pathological and diagnosis
      criteria, as well as response to treatment, are reviewed.

PMID- 1751693
TI  - [Substances harmful for the gastric mucosa].
AB  - Gastroduodenal mucosa has a self-defense capacity against a wide range of
      potentially harmful exogenous and endogenous agents. It has been proven that
      certain diet compounds damage gastric mucosa, which explains--at lest partially-
      the regional variations in the incidence of peptic ulcer. Ethanol blocks the
      defense mechanisms of gastric mucosa and induces the onset of acute lesions, but
      there is no definite proof to show that ethanol ingestion helps produce the onset
      of peptic ulcer. It has been confirmed that tobacco negatively affects the
      healing and relapse of ulcers. From an epidemiological point of view, the
      controversy of the relationship between tobacco abuse and peptic ulcer genesis is
      still ongoing. Non-steroid anti-inflammatory non-acid soluble produces lesions
      acute and chronic) in gastroduodenal mucosa. They can reactivate old lesions and
      increased the risk of complications. Aspirin is the most harmful compound in this
      pharmacologic group. Paracetamol is the compound which has the safest spectrum.
      The harmfulness of steroids is still being discussed, however, it is accepted
      that they have a rapid effect on gastric mucosa in relation to dosage and
      duration of treatment.

PMID- 1751694
TI  - [An update on the management of Raynaud's phenomenon].
AB  - Basic knowledge of clinical management of Raynaud's phenomenon was established
      and reviewed. Body protection against cold weather and the avoiding of all
      activities which cause the setting off of the ischemic episodic trigger are the
      first step in the therapy for this type of patient. Medical treatment includes
      vasoactive drugs and other drugs which act against the different factors such as
      plasmapheresis, sympathectomy and electric neurostimulation must be reserved for
      patients with severe vascular symptoms.

PMID- 1751695
TI  - [Acute kidney failure (AKF) and hemolysis secondary to accidental discontinuous
      treatment with rifampicin].

PMID- 1751696
TI  - [The incorrect use of inhalers].

PMID- 1751697
TI  - [The indication for treatment with home oxygen therapy after the hospital
      discharge].

PMID- 1751698
TI  - [Solitary bone metastases of unknown origin. Apropos 15 cases].

PMID- 1751699
TI  - [Rhabdomyolysis, Salmonella enteritidis infection and the bibliography].

PMID- 1751700
TI  - [Chickenpox and acute pericarditis in a patient with HIV infection].

PMID- 1751701
TI  - [Still's disease in the adult: suspect it from the analysis and minor symptoms].

PMID- 1751702
TI  - [Pneumonia caused by Bordetella bronchiseptica in a patient with Crohn's
      disease].

PMID- 1751703
TI  - [Chronic massive idiopathic pericardial effusion].

PMID- 1751704
TI  - [The ethical aspects of clinical trials in primary care].

PMID- 1751705
TI  - [Consensus conferences in Spain and their practical application].

PMID- 1751706
TI  - [Consensus for the Control of Arterial Hypertension in Spain. Madrid, 1989].

PMID- 1751707
TI  - [The satisfaction of the primary care consumer: a comparison between distinct
      models of care].
AB  - The results of a questionnaire about satisfaction in the users of an urban health
      area of the city of Alicante, where the traditional model of primary care (the
      clinic, C), the new model (the health center, HC) and private practice (P)
      coexist are reported. The questionnaires were administered by staff unrelated
      with the health center. In general, satisfaction was significantly greater (p =
      0.001) in users of HC and P than in C users. no significant difference was found
      between HC and P. The specific satisfaction was also greater (p less than 0.05)
      for all services in HC than in C: General practice (GP), nursing care (N),
      pediatrics (PED), and administration-information (ADMON). The general
      satisfaction did not correlate with sociodemographic variables; it was weakly
      correlated with the service use variables, and was clearly correlated (p less
      than 0.001) with the specific satisfaction with the use of services such as GP (r
      = 0.57), PED (r = 0.49), ADMON (r = 0.56), and N (r = 0.58).

PMID- 1751708
TI  - [Community-acquired urinary infection: the in vitro activity of trimethoprim and
      cotrimoxazole].
AB  - To evaluate the in vitro sensitivities of trimetoprim (TMP) in our area and to
      compare them with those to co-trimoxazole (CMX) a prospective study was carried
      out in females with uncomplicated lower urinary tract infection (UCLUTI), as a
      preliminary step for the possible use of a monodose of TMP in these patients.
      Fifty-five cases of UCLUTI were included. Escherichia coli was the predominating
      organism (70.9%). The general sensitivity to CMX was 80% and that to TMP 76.4%.
      The E. coli sensitivity to CMX was 79.5%, and 76.9% to TMP. The difference in the
      sensitivities to both antimicrobials was not statistically significant (p = 0.5).
      The routine introduction of TMP in the antibiogram would permit to evaluate the
      resistance to this antimicrobial in each area and, on the basis of the results,
      to assess the effectiveness of TMP in the treatment of UCLUTI.

PMID- 1751709
TI  - [The effect of family factors on school retardation in the Cartuja quarter of
      Granada].
AB  - The possible influence of the family on school retardation was evaluated in the
      Cartuja quarter in Granada for the academic term 1988-89. The study was performed
      on 258 schoolchildren of the 7th and 8th primary courses in the four public
      schools from the quarter. Data were collected with a questionnaire including the
      following variables: school retardation, sex, number of siblings, ordinal number
      among siblings, educational level of the parents, and work of the mother outside
      the household. To evaluate family function the APGAR questionnaire was used. A
      remarkably high (45.7%) school retardation was found, higher than that in the
      rest of Spain. School retardation cannot be related with the family dysfunction
      detected by the familial APGAR. It was related, rather, with the child's sex, the
      educational level of the mother, the number of siblings and the ordinal place of
      the child among them.

PMID- 1751710
TI  - [The results of the introduction of a protocol of preventive activities in a
      primary care center].
AB  - A sample of 360 people was analyzed. They had received the protocol of preventive
      activities of the "Unitat Docent de Medicina Familiar i Comunitaria de Barcelona"
      during 1989. The results of those activities directed to the prevention of
      cardiovascular risk and to the detection of excessive alcohol intake are
      reported, as they are those with the easiest and widest implementation. Overall
      results include hypercholesterolemia in 43.9%, abnormal blood pressure in 10.5%,
      a rate of smokers of 31.7%, 7.7% with an excessive alcohol intake, and 51.9% of
      obese individuals. The results are also shown by age and sex groups. In the
      discussion, the results are compared with those expected for our population. It
      is concluded that preventive measures should be encouraged by primary health are
      teams.

PMID- 1751711
TI  - [The incidence and clinical presentation of tuberculosis in HIV-positive
      patients].
AB  - To evaluate the features of tuberculous infection in HIV+ patients from our area
      we reviewed the 50 cases of seropositive patients admitted to a provincial
      hospital from 1985 to June 1989. TB was diagnosed in 18 of the 50 patients; mean
      patient age was 27 years, with a male predominance. PDA was the major risk
      practice. The most common localization were lymph nodes; 95% had fever and weight
      loss and 39% had nightly perspiration and cough; cervical lymphadenopathy and
      hepatosplenomegaly were found in more than 50%. Tuberculin skin test was negative
      in 75% of cases. The diagnosis of TB represented the diagnosis of AIDS for 66% of
      patients. 25 of the 50 seropositive patients met the criteria for AIDS, and 68%
      of these had TB. TB is a common infection in HIV+ patients from our area, and it
      is the first cause of the diagnosis of AIDS. The index of suspicion of TB in
      these patients should be high, as clinical features are often nonspecific.
      However, it is preventable and curable superinfection.

PMID- 1751712
TI  - [The Melkersson-Rosenthal syndrome. Apropos 2 cases].
AB  - Melkersson-Rosenthal syndrome is classically defined as facial palsy, oedema
      facial and plication of the tongue, constituting one rare cause of facial palsy.
      The primary care physician must include this syndrome in the differential
      diagnosis of Bell's palsy. We report two cases of this syndrome, one in a young
      man, another in a 56 aged woman, and also a succinct literature review.

PMID- 1751713
TI  - [Reflections on the somatization concept].

PMID- 1751714
TI  - [Radiology of the colon].

PMID- 1751715
TI  - [The medical consultation and health promotion].

PMID- 1751716
TI  - [The immune status vis-a-vis Toxoplasma of the pregnant population of
      Valladolid].

PMID- 1751717
TI  - [The suitability of the use of injectable antibiotics in primary care].

PMID- 1751718
TI  - [Epidemiological survey: apropos a case of trichinosis].

PMID- 1751719
TI  - [Atopy and IgA deficiency].

PMID- 1751720
TI  - [Vaccination and hepatitis B: only for groups at risk?].

PMID- 1751722
TI  - [Temporal arteritis].

PMID- 1751721
TI  - [Enalapril-induced cough].

PMID- 1751723
TI  - [The Family Medicine Program and AIDS].

PMID- 1751724
TI  - [The terminal patient in primary care].

PMID- 1751725
TI  - [Health for all and research on primary care].

PMID- 1751726
TI  - [The epidemiology of breast feeding: its prevalence and duration].

PMID- 1751727
TI  - [A prospective study of programmed nursing consultation in an urban health
      center].
AB  - A study of the programmed nurse clinic in a health center was carried out to
      evaluate its different health care activities, the time consumed in them, the
      type of patients cared for, and the mechanism of organization of the clinic. A
      remarkable finding was a high number of daily appointments (11.8 persons), with
      an excellent rate of compliance with the appointment (89.3%). It was found that
      most of the diseases cared for in the nurse clinic were those most commonly
      managed with a protocol design in primary care: hypertension (34.1%), diabetes
      (6.9%), hyperlipoproteinemia (9%) and obesity (12.8%). Other parameters were
      evaluated, such as mean time per visit, which was predominantly between five and
      ten minutes, or activities during the visits, with a clear predominance of the
      clinical protocols. There was a remarkably high efficiency of the nursing staff,
      with a low rate of referral to the medical clinic (6.9%). We conclude that nurse
      clinics play an important role in the health centers, as the only possible
      mechanism to guarantee the correct fulfillment of the different programs. This
      requires a definite constant physical space for a given minimal period of time of
      about 2 hours per day.

PMID- 1751728
TI  - [The diagnosis of diabetes mellitus in epidemiological studies].
AB  - The aim of the present study was to evaluate the relative usefulness of some of
      the diagnostic methods used to estimate the prevalence of diabetes mellitus in
      epidemiological studies. A cross-sectional descriptive study with multistage
      stratified sampling was designed. A personal interview, a capillary baseline
      glycemia and a OGTT were carried out. The medical records and the use of
      antidiabetic drugs and self-control products were also evaluated. The prevalences
      obtained with these methods were: Medical records = 1.31%, personal interview =
      7.91%, use of drugs = 1.93%, self-control products = 1.05%, capillary baseline
      glycemia greater than or equal to 120 mg/dl = 4.04%, OGTT with WHO criteria =
      5.62%. Using OGTT as a reference, the diagnostic test with the greatest overall
      value was capillary baseline glycemia equal to or higher than 120 mg/dl. We think
      that, as a whole, the election of one method or another will depend on both the
      precise aim of the study and the type of design and the cost that can be
      sustained.

PMID- 1751729
TI  - [An analysis of the referrals to specialist consultations made in a health
      center].
AB  - The study of referrals from primary care areas permits the evaluation of health
      care in this level and reveals the educational requirements of the specialists in
      family medicine. Between January and April 1988 a prospective study was carried
      out to evaluate the referrals to the second level of care in the health center V
      Centenario. In 27,657 visits 1,906 referrals to the different specialties were
      ordered, which represents a rate of 6.89%. The most commonly consulted
      specialties were gynecology (18.94% of the overall referrals), ophthalmology
      (18.04%) and traumatology (16.10%). Psychiatry (1.41%), neurology (1.31%) and
      endocrinology (1.41%) were the specialties with the lowest referral rates. We
      compared our results with those from other authors and we have calculated what
      influence would be exerted on the second level of care if all primary care
      physicians had similar referral rates to those obtained in our center.

PMID- 1751730
TI  - [Cardiovascular risk factors in the working population of Alicante].
AB  - The aim of the present study was to evaluate the prevalence of certain
      cardiovascular risk factors in the population of Asepeyo-Elche. The study sample
      was a working population of 697 persons (71.8% males and 28.2% females) with ages
      ranging from 15 to 65 years (mean age 34.7 +/- 13.2 years), seen during the first
      6 months of 1990 in the health care center of Asepeyo-Elche. The evaluated
      cardiovascular risk factors and their prevalence rates were: hypertension
      (14.2%), hypercholesterolemia (18.5%), smoking (52.5%), hyperglycemia (3.5%),
      obesity (28.2%) and sedentariness (80.3%). We conclude that in our working
      population the prevalence rates of some cardiovascular risk factors are high and
      that intervention programs to modify the diet and lifestyle are mandatory to
      prevent the pathogenetic consequences of these factors.

PMID- 1751731
TI  - [The current concepts of drugs, drug dependencies and the drug-dependent].

PMID- 1751732
TI  - [Intravenous urography].

PMID- 1751733
TI  - [The efficacy of systematic vaccinations in Spain].

PMID- 1751734
TI  - [Captopril and the liver].

PMID- 1751735
TI  - [Another case of diabetes insipidus diagnosed in primary care].

PMID- 1751736
TI  - [Inaccuracies in bibliographic citations: an obstacle for the quality of our
      scientific publications].

PMID- 1751737
TI  - [Nitrendipine and nycturia].

PMID- 1751738
TI  - [The attitudes on the part of specialists in family and community medicine
      respecting their specialty. A failure of the educational system?].

PMID- 1751739
TI  - [The recording of mental pathology in the clinical history at a rural health
      center].

PMID- 1751740
TI  - [Urinary infections at a health center: the microorganisms and antibiotic
      resistance].

PMID- 1751741
TI  - [Imported diseases and immigration medicine].

PMID- 1751742
TI  - [The legal possibilities for action in the health inspection of public eating
      establishments].
AB  - This study, based upon the Spanish legal framework and upon the experience of the
      authors, is intended to establish the legal procedures for action when a sanitary
      inspector finds himself in the situation where he observes that a public
      establishment is infringing some hygiene or sanitary regulation which may carry a
      health risk of varying seriousness. Possibilities for action are outlined,
      depending on the urgency and seriousness of the situation, as well as indicating
      who is responsible for the application of the law in each case. The legal
      possibilities for action are: the closure of the establishment, a warning, and
      institution of penal proceedings. Finally some suggestions are made as to the
      method of carrying out such inspections.

PMID- 1751743
TI  - [The evaluation of noncompliance in an anti-influenza vaccination program].
AB  - The article presents an evaluation of an anti-influenza vaccination programme in
      a population at risk, with a special study of the general characteristics of the
      group of non-complying patients, and the possible relation of these
      characteristics with their conduct. Moreover, a study was made of the possible
      motives for not complying with the vaccination programme by means of a survey
      carried out by post and telephone in a representative sample of 108 individuals.
      A 34.77% of the registered population did not receive the anti-influenza vaccine,
      corresponding largely with the youngest age group (15 to 44 years) and there were
      no significant differences determined by sex or risk factor or doctor. A positive
      response was received from 75% of those surveyed, and the basic conclusions drawn
      were a low proportion of information error attributable to the programme (2.94%),
      and patient refusal as the principal cause of non-compliance (54.41%), followed
      by "other reasons" (hospitalisation, absence from home, etc.) (32.35%). The
      strategies that may be followed in the face of this problem require definition of
      the group of non-compliers, further understanding of the motives for their
      conduct, and educational measures to change their attitude. 95.9%). Incidence of
      hypertension and hyperlipemia was 56.2% and 47.3%. Late vascular events varied
      between 2.6% (nephropathy) and 19.5% (retinopathy). A total of 101 patients
      (44.6%) were unaware of the existence of diabetic health education programmes.
      Moreover, 68 (30.3%) declared that they had never received any previous
      information about their diabetes. Practical skills were evaluated on an
      individual basis.

PMID- 1751744
TI  - [Mental malaise in health professionals: an approach to its study].
AB  - A study was made of the incidence of psychiatric malaise among health workers in
      the health area of La Axarquia, in the province of Malaga. Goldberg's General
      Health Questionnaire (GHQ, 28 items) was applied to the sample population (n =
      137), and the differences obtained are discussed in relation to social and job
      related variables. The occurrence of psychiatric malaise among the whole sample
      was 29.85%, with significant differences among those above the cutoff and place
      of work (hospital), sex (women), tobacco habit (smokers), and pleasantness of
      work situation (not pleasant). There were no significant differences among those
      above the cutoff and profession (although higher scores were recorded among
      administrative personnel), nor according to contractual situation (although
      higher scores were recorded among contracted staff). The study concludes with a
      series of measures aimed at early prevention and detection of symptoms of
      psychiatric maladjustment within the working environment.

PMID- 1751745
TI  - [The management of minor burns in primary care].

PMID- 1751746
TI  - [Retrograde cystourethrography].

PMID- 1751747
TI  - [Semiexperimental and experimental design and evaluative research].

PMID- 1751748
TI  - [Resources for exploring autonomic neuropathy in diabetes].

PMID- 1751749
TI  - [Dextrocardia with complete situs inversus].

PMID- 1751750
TI  - [The detection of cardiovascular risk factors via a program of preventive
      activities].

PMID- 1751751
TI  - [An evaluation of the structural characteristics of local consultation offices in
      a rural health area].

PMID- 1751752
TI  - [Severe hyponatremia: an infrequent but serious complication of thiazide
      diuretics].

PMID- 1751753
TI  - [Castleman's disease].

PMID- 1751754
TI  - Priming of phagocytes by cytokines and water-soluble products of lipid
      peroxidation.
AB  - It is well known that during certain pathological processes phagocytes acquire
      the ability to generate activated oxygen species during phagocytosis. The priming
      of phagocytes by cytokines and water-soluble products of lipid peroxidation (LPO)
      is described. Preincubation of human polymorphonuclear leukocytes (PMNL) with the
      water-soluble products of LPO or oxidised liposomes for 15-20 min at 37 degrees C
      enhanced their functional activity when they were stimulated by opsonised zymosan
      or latex particles. There was a 2-3-fold increase in luminol-dependent
      chemiluminescence response of cells stimulated in this way, and an increase in Fc
      receptor expression on the PMNL surface. An endogenous cytokine alone did not
      activate the phagocytes for an oxidative burst response, but preincubation of
      murine peritoneal macrophages (MP) and human PMNL with cytokines (molecular mass
      20-30 kDa) for 3-48 h at 37 degrees C enhanced the cell chemiluminescence
      response to opsonised zymosan by a factor of 5-9 for MP and a factor of 2-3 for
      PMNL. Treatment of phagocytes with the cytokine complex also increased other
      effector functions of the phagocytes such as tumouricidal activity, phagocytosis,
      secretion of interleukin-1, and antiparasitic activity. The protein synthesis
      inhibitor cycloheximide abolished cytokine-induced priming of MP (but not of
      PMNL). The mechanisms of short-term and prolonged priming of the two types of
      phagocytes (MP and PMNL) are discussed.

PMID- 1751755
TI  - The effect of tryptophan on the phenobarbital-mediated induction of cytochrome P
      450 in rat liver. The role of tryptophan 2,3-dioxygenase.
AB  - The effect of intraperitoneal administration of phenobarbital (80 mg kg-1 body
      weight) and tryptophan (200 mg kg-1 body weight), separately or in combination,
      on the microsomal content of cytochrome P-450 and the activity of tryptophan 2,3
      dioxygenase (EC 1.13.11.11) in Wistar rat liver was determined at different time
      intervals after injection. There was an increase in the amount of cytochrome P
      450 within 12 h of administration of a single dose of phenobarbital which was
      maintained over the next 12 h. Tryptophan had no effect on the amount of
      cytochrome P-450, but administration of tryptophan in combination with
      phenobarbital blocked the increase that was found after administration of
      phenobarbital alone. Both phenobarbital and tryptophan increased tryptophan 2,3
      dioxygenase activity (total enzyme and holoenzyme) but had different effects on
      the rate of activation and the degree of saturation of the enzyme with haem.
      Administration of tryptophan and phenobarbital in combination invoked the same
      effect as tryptophan alone. Significant activation of the holoenzyme was found,
      when tryptophan was administered 2 h after phenobarbital administration. It is
      proposed that combined administration of phenobarbital and tryptophan leads to
      substrate stabilisation of tryptophan 2,3-dioxygenase, and that this is
      accompanied by the binding of the newly synthesised haem, thus making haem
      unavailable for formation of cytochrome P-450.

PMID- 1751756
TI  - Intracellular factors determining the deposition of glycogen. The role of
      gluconeogenesis.
AB  - The interrelationship between glycogen biosynthesis and do novo glucose formation
      in rats was studied by determining the oxaloacetic acid, ATP, and glycogen levels
      in the tissues of healthy starved rats and during the growth of transplantable
      hepatomas with different rates of growth. From the results obtained it was
      proposed that glycogen biosynthesis and de novo glucose formation are mutually
      enhanced and coupled processes. The validity of this conclusion was confirmed by
      in vitro model experiments involving the use of isolated-liver perfusion. Results
      of a multiple regression analysis indicated that the efficiency of
      gluconeogenesis and glycogen deposition is determined by the supply of oxygen to
      the liver, by the oxaloacetic acid content of this organ, and also by the degree
      of reduction of the glucose precursor. It was also shown that the ability of
      glucocorticoids and glucagon to enhance gluconeogenesis is dependent on the
      supply of oxygen to the liver. From the results of this in vivo and in vitro
      comparative study it is concluded that deposition of glycogen in the liver and
      possibly also in the brain is determined by the efficiency of gluconeogenesis.

PMID- 1751757
TI  - The study of fibrin polymerization with monoclonal antibodies.
AB  - Three kinds of monoclonal antibody (Mab) of different specificity have been
      obtained against the N-terminal disulphide knots of fibrinogen and fibrin. Their
      effects on different phases of fibrin polymerization have been studied. These
      antibodies were shown to be directed against different epitopes of the B beta(1
      53) fragment of the fibrinogen molecule. The different Mab had different effects
      both on the rate of protofibril lateral aggregation and on the final turbidity of
      fibrin clots. The Mab were of three specificities: (1) those from clone 2d-2a
      inhibited the rate of lateral aggregation of protofibrils and decreased the
      turbidity of the final clot; (2) those from clone B-4C accelerated the
      polymerization step but did not affect clot turbidity: and (3) those from clone D
      IB did not have any effect on either fibrin polymerization or final clot
      turbidity. The localization of the epitopes recognized by all three kinds of Mab
      and analysis of our own data and those of others allow us to conclude that one of
      the active loci involved in protofibril lateral association is situated in the B
      beta(15-53) fragment of the fibrinogen molecule. Fibrinopeptide B does not need
      to be split off for this site to function. Fibrin polymerization can occur when
      one of the two sites of protofibril lateral aggregation in dimeric fibrin
      molecules is blocked by Mab, and the final clot turbidity is then reduced. The
      splitting off of one of the two fibrinopeptides B in fibrinogen molecules by
      thrombin can take place even when the second B beta(Arg14-Gly15) bond is blocked
      by an antibody molecule.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751758
TI  - The effect of the structure of the terminal regions of the hepatitis B virus gene
      C polypeptide on the formation of core antigen (HBcAg) particles.
AB  - A series of plasmids encoding native and modified sequences of the hepatitis B
      virus core antigen (HBcAg) was created. Analysis of the products generated by
      expression of the plasmid genomes in Escherichia coli showed that a polypeptide
      with primary structure identical to that deduced for native HBcAg forms particles
      in the bacterial cells which are indistinguishable from the native nucleocapsids
      in morphological and antigenic properties. Removal of the thirty-nine C-terminal
      amino acids which form a protamine-like domain caused insignificant impairment of
      the particle-forming process. Modification of the N-terminal region of the
      polypeptide showed that at least part of the structural determinant governing
      particle formation is localised between amino acid residues 3 and 11. When the
      plasmid genes were expressed in an E. coli cell-free transcription - translation
      system, polypeptides devoid of ten to twenty N-terminal amino acids were formed
      in addition to the full-length products. From the results obtained it is proposed
      that a protease digestion site situated within the region containing amino acid
      residues 10 - 20 plays a role in the formation of the HBe antigen.

PMID- 1751759
TI  - Interhemispheric asymmetry of EEG coherence as a reflection of different
      functional states of the human brain.
AB  - EEG coherence analysis was used to study aspects of the synchronisation of
      electrical processes in the left and right cerebral hemispheres of right-handed
      and left-handed healthy subjects in a state of calm wakefulness. Right-handed
      subjects showed a greater coherence in the left hemisphere and left-handed
      subjects in the right hemisphere. There were also differences between right
      handed and left-handed subjects in the regional profiles of interhemispheric
      asymmetry and in the interhemispheric asymmetry of individual spectral bands.
      These differences may reflect variations in the involvement of cortical and
      subcortical cerebral structures in the formation of the hemispheric specificity.
      Changes in interhemispheric coherence with the onset of drowsiness were also
      observed. This suggests that changes in the interconnections of neural networks
      are also involved in changes in arousal. Certain characteristic regional
      interhemispheric asymmetry patterns and asymmetries in the spectral bands appear
      to be necessary for normal human brain function.

PMID- 1751760
TI  - Analysis of the fine structure of the antigenic determinants of the transmembrane
      protein in the HIV coat with chemically modified synthetic peptides.
AB  - The amino acids involved in IgG reactivity to four HIV-1 gp41 overlapping
      synthetic peptides from the sequence 584-624 have been determined by a method
      based on the chemical modification of trifunctional amino acids, especially the
      acetylation of the amino groups of the lysine residues at pH 8-9. The
      reactivities of the sera from HIV-infected individuals and gp41-specific human
      Mab were studied with the overlapping peptides and their modified forms in
      indirect and competitive ELISA. Peptides 584-602 and 609-624 (CN-185) reacted
      with 88% of HIV-positive sera; the highest diagnostic significance (100%) was
      found with peptides 584-611 (AS-551) and 603-624 (CN-191). Acetylation resulted
      in a 10%-15% decrease in peptide reactivity. Moreover the concentration at which
      50% inhibition occurred was 1.5 x 10(-6) M for unmodified AS-551 compared with
      1.5 x 10(-5) M for the modified peptide. Circular dichroism spectra showed that
      acetylation did not alter the conformation of these peptides. Coupling of peptide
      AS-551 to a protein carrier at pH 6.5-7.0 did not affect the immunoreactivity of
      this peptide. Mab against human gp41 reacted with peptide 603-624 (CN-191). The
      concentration of this peptide necessary for 50% inhibition of Mab binding was 5.2
      x 10(-6) M. It is concluded from the epitope mapping of the Mab that the
      antigenic determinant lies within the 603-609 fragment. Lys-608 appears to play a
      crucial role in the interaction with human HIVc-Mab.

PMID- 1751761
TI  - HIV-1 gag proteins in virions and in infected cell fractions.
AB  - The relation of the initial products of the HIV-1 gag gene to the final products
      was determined in virus samples and cell fractions of infected H9 and Jurkat-tat
      cell cultures. The proteins were identified by immunoblotting with pooled sera
      from AIDS patients or monoclonal antibodies. The proportion in the virions of gag
      precursor proteins and the products of their proteolytic cleavage varied
      according to the maturity of the virus particles as determined by electron
      microscopy. The distribution of viral gag proteins in the cell fractions was
      determined 2, 4, and 24 h after infection. Treatment of cells with cycloheximide
      to block de novo protein synthesis did not significantly affect the results. Gag
      proteins containing the N terminus of the precursor p55 (including p55, the
      intermediate precursors p41(45) and p39, and mature protein p17) were found in
      the cell nuclei up to 24 h after infection. The major core protein p24 was
      located in the cytoplasmic fraction. These data strongly suggest that gag
      precursors from the p55 N terminus and the matrix protein p17 enter the infected
      cell separately from the major core protein p24, or become separated from it in
      the cytoplasm.

PMID- 1751762
TI  - Diet-induced hypercholesterolaemia in the rabbit.
AB  - Intraspecies variation in diet-induced hypercholesterolaemia in rabbits,
      simulating atherosclerosis, was studied. The chinchilla rabbit population
      examined contained several subpopulations, as indicated by polymodal forms of
      histograms of plasma cholesterol levels. This finding indicates that the
      inclusion of subpopulations in an investigation can lead to erroneous
      conclusions, and that subpopulations should be identified before such work is
      undertaken. The relationship between the molar cholesterol/phospholipid ratio in
      rabbit erythrocyte membranes and the plasma cholesterol level in experimental
      atherosclerosis was also studied. A correlation was evident only over the range
      of 1-5 g cholesterol per litre of plasma.

PMID- 1751763
TI  - Karyological approach to the identification of true cell lines susceptible to the
      human immunodeficiency virus (HIV).
AB  - A karyological analysis of twenty-two variants of eight cell lines, which
      differed in their susceptibility to the human immunodeficiency virus (HIV) and
      which had been obtained from different sources, was carried out by means of
      differential chromosome staining for G and C bands. The karyotypes of eight T
      lymphoblastoid cell lines were identified, including five (MT-4, Molt-3, CEM, H
      9, and Hut-78) not previously studied by cytogenetic methods. Karyotyping
      confirmed the identity of seventeen variants of the eight cell lines, and five
      variants of four lines were found to be misidentified. Comparative analysis of
      the cytogenetic characteristics of the three CEM-line variants demonstrates the
      need for karyotype evaluation in the course of in vitro cell cultivation.
      Fourteen identical marker chromosomes were revealed in H-9 and Hut-78 cell
      karyotypes, confirming the common origin of these two lines. It was found that
      the cells of the HIV-susceptible lines had a tendency to undergo polyploidisation
      both during the initial stages after isolation and in the course of cultivation.

PMID- 1751764
TI  - Region of hepatitis B virus DNA with a homology to the yeast ARS replication
      enhancer.
AB  - A computer analysis of the primary sequence of hepatitis B virus (HBV) subtype
      ayw DNA, cloned within the pVG2 recombinant plasmid, which raises its stability
      in Saccharomyces cerevisiae transformants, was performed. This revealed that the
      structure of the HBV DNA has: two bends in the termination regions of the HBs and
      HBc genes, and multiple sequences with a high degree of homology to the ARS
      (autonomously replicating sequence) core consensus in this region of the HBs
      gene. DNA fragments from the HBs region (330 bp) and from the HBc region (378 bp)
      have an abnormal electrophoretic mobility in 8% polyacrylamide gels. The
      similarity of the structural motifs in the stop-region of HBs gene with the B
      domain of the S. cerevisiae ARS element is discussed.

PMID- 1751765
TI  - Neural correlate of mental error detection in the human brain cortex.
AB  - The use of long-term intracerebral electrodes combined with advances in
      stereotaxic neurosurgery and a complex multimethodological approach to brain
      research has made possible a study of the neurophysiological mechanisms of higher
      mental functions in the course of diagnosis and/or treatment of some chronic
      cerebral diseases. Investigations in which both local oxygen tension and neuronal
      impulse activity were recorded while the patients were performing psychological
      tasks have revealed selective responses in some neuronal populations of the
      thalamus and of the striopallidal complex, which occur only during erroneous task
      performance. So-called 'error detector' neurons were also found in the
      perirolandic and parietotemporal regions of the human brain cortex.

PMID- 1751766
TI  - Influence of native and modified exogenous alcohol dehydrogenase on alcohol
      consumption in rats.
AB  - The effect of native alcohol dehydrogenase (ADH) and ADH modified by polyethylene
      glycol on alcohol consumption and certain other behavioural parameters in rats
      were studied. Intravenous injection of native heterologous ADH significantly
      suppressed alcohol consumption between the 10th and 15th days after injection
      with a duration of the effect of 40 days or more. During this period, a low but
      reliable production of anti-ADH antibodies occurred. ADH modified by covalent
      attachment of polyethylene glycol did not give these results. Native ADH and ADH
      modified by polyethylene glycol caused enhanced nociception and active avoidance
      formation.

PMID- 1751767
TI  - Individual-specific patterns of human variable genomic regions detected by a DNA
      probe from the HIV-1 env gene.
AB  - It was postulated that similar genetic elements that are 'hot spots' for genetic
      variation might exist in both the HIV-1 and the human genome. To test this
      possibility a short repeated sequence from a region of variability in the HIV-1
      glycoprotein (env) gene was amplified and used as a probe for blot hybridization
      with human genome DNA. Human genomic regions were hybridized and characterized by
      a set of polymorphic restriction DNA fragments. The pattern of the restriction
      fragments was individual specific. Thus a DNA probe from the HIV-1 env gene can
      serve as a genetic marker for hybridization with human genome regions and for the
      identification of individuals.

PMID- 1751768
TI  - A scheme for the testing and quality control of medicinal immunobiological
      preparations in the USSR.

PMID- 1751769
TI  - International symposium on 'Regulation and clinical importance of immunoglobulin
      E'.

PMID- 1751770
TI  - Michel Mandel 65.

PMID- 1751771
TI  - Molecular characterisation of kappa- and lambda-carrageenan by gel permeation
      chromatography, light scattering, sedimentation analysis and osmometry.
AB  - Gel permeation chromatography, in conjunction with a double detection system
      involving a low angle laser light scattering apparatus (LALLS) and a refractive
      index monitoring device (RI), has been used to obtain both the molecular weight
      and the molecular weight distribution of sodium salts of kappa-carrageenan and
      lambda-carrageenan in saline solutions. The results, Mw and Mn, are in excellent
      agreement with independent determinations of molar mass based on static light
      scattering experiments, sedimentation-diffusion analysis and osmometry. The
      relevance of the data is discussed with respect to current problems in
      carrageenan research.

PMID- 1751772
TI  - Solution and gelling properties of polysaccharide polyelectrolytes.
AB  - Attention is focussed on the special class of polysaccharide polyelectrolytes
      belonging to the family of the microbial polysaccharides. But a few exceptions,
      these are high molecular weight water- soluble polycarboxylates with complex,
      regular structures. Complexity and regularity in primary structure--two features
      normally not shared by other polysaccharides of either vegetal or animal origin-
      quite naturally entail unique conformational propensities, special physico
      chemical properties in bulk and in solution and, as a consequence, make these
      biopolymers of particular interest from both a basic research and an industrial
      standpoint. What is outlined in this presentation should demonstrate that for
      many exocellular microbial polycarboxylates the solution properties are, as
      expected, dictated by the conformation assumed by the polyelectrolytic chains
      which, in turn, are governed by several free energy terms in particular stemming
      from specific solvent-chain interactions, among which the coulombic contribution
      may play a minor role.

PMID- 1751773
TI  - Polyelectrolytes at the endothelial cell surface.
AB  - It is recalled that the tension in a stretched polyelectrolyte chain mechanically
      compensates both the coulomb interaction and the hydrostatic pressure increase
      around the chain in a compromise which minimises the free energy and keeps water
      chemical potential constant throughout. Stretching strongly favors parallel
      cylinder nematic order in polyelectrolyte brushes on a surface or in the slit
      between two surfaces when the polyelectrolyte chains function as bridges. Strong,
      stiffly stretched chains result when the molarity of the fixed charge
      distribution is larger than the molarity of the neutral salt solution with which
      the brushes are in equilibrium. The relevance of these two systems to the
      endothelial cells which cover the walls of blood vessels is discussed.

PMID- 1751774
TI  - Tumor necrosis factor-alpha, interleukin 1, and phorbol myristate acetate are
      independent activators of NF-kappa B which differentially activate T cells.
AB  - Gene expression in eukaryotic cells can be altered in different ways by
      extracellular agents, including mitogens and cytokines. Such differential gene
      expression is mediated in part through the effects of these stimuli on distinct
      sets of cellular transcription factors. In this report, the effects of phorbol
      myristate acetate, tumor necrosis factor-alpha (TNF-alpha), and interleukin 1 (IL
      1) on differential gene expression in the LBRM mouse T-lymphoma cell line are
      examined. Although these three different stimuli produce similar levels of
      induction of the NF-kappa B transcription factor, it is reported that they cause
      differential expression of other cellular activation genes, including c-fos and
      IL-2. The roles of IL-1 and TNF-alpha were also analyzed in EL-4 cells in the
      presence of a second activator, ionomycin. IL-1, but not TNF-alpha, was found to
      stimulate the IL-2 enhancer in the presence of this costimulator. These findings
      suggest that one transcription factor can be the target of cellular activators
      that exert otherwise different effects on gene expression. Cellular activation
      pathways can therefore be defined by the set of transcription factors stimulated
      within a cell. This approach may allow a more precise definition of the
      requirements for differential gene activation in different cell types and thereby
      provide a basis for the selective manipulation of gene expression in cytokine
      responsive cells.

PMID- 1751775
TI  - Constitutive and NF-kappa B-like proteins in the regulation of the serum amyloid
      A gene by interleukin 1.
AB  - Serum amyloid A (SAA) is a major acute-phase protein whose chronic production by
      the liver can lead to the fatal disorder of secondary amyloidosis. Control of SAA
      is mediated by several inflammatory cytokines, including interleukin 1 (IL-1). To
      study the cis-acting regulatory elements responsible for constitutive and IL-1
      induced expression, DNA constructs containing varying lengths of the promoter
      region from the human SAA2 beta gene 5' to the bacterial reporter gene,
      chloramphenicol acetyltransferase (CAT), were generated and transfected into
      human hepatoma cells, HepG2. Both positive and negative regulatory elements were
      found in the 5' flanking region of the human SAA2 beta gene. The more proximal
      region contains an IL-1 enhancer sequence GGGACTTTCC (SAA kappa B1; between -82
      and -91), the binding site for the ubiquitous transcription factor NF-kappa B. IL
      1 induction of the binding of nuclear factor to this sequence is maximal between
      5 min and 30 min after incubation with IL-1 and negative in cells incubated for
      60 min or longer. Mutation of the SAA kappa B1 sequence to a nonbinding form of
      NF-kappa B (CTCACTTTCC) abolishes the IL-1 effect. The SAA 5' region also
      contained an upstream repressor element, shown by transfection experiments.
      Within this element, a second NF-kappa B binding site (SAA kappa B2; -626 to 
      635) was found, and mutation of SAA kappa B2 to a non-NF-kappa B-binding form
      results in an increase in both constitutive + IL-1 stimulated SAA
      transcription.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751776
TI  - Temperature is a powerful promoter of interleukin 2 transcription.
AB  - Elevated temperature has profound effects on the immune system, particularly by
      increasing T-cell proliferation rates, interleukin 1 (IL-1)-driven secretion of
      IL-2, and primary antibody responses to T-dependent antigens. Therefore, this
      study shows, in detail, the effects of incubation temperature (29 degrees C to 41
      degrees C) on proliferation, IL-2 secretion, and IL-2 mRNA expression in both a
      murine thymoma cell line (EL4-6.1) and in nontransformed murine splenocytes.
      Temperature was found to be a positive regulator of IL-2 secretion whether or not
      IL-1 was part of the activation signal. Parallel effects were observed at the
      level of IL-2 gene expression. Messenger RNA was quantitated with a novel system,
      using solution hybridization followed by detection of RNA-DNA complexes by enzyme
      immunoassay. The time to onset of IL-2 mRNA expression was inversely related to
      temperature, and mRNA levels increased 20- to 50-fold with increases in average
      incubation temperature from 29 degrees C to 39 degrees C. This effect was
      observed whether cells were incubated at constant temperature or exposed
      intermittently to elevated temperature. Over the same intervals of time and
      temperature, mRNA levels for tau-actin and beta-tubulin remained relatively
      constant. Taken together, these findings suggest that temperature-mediated
      augmentation of IL-2 secretion does not require the presence of IL-1, and that
      the effect occurs at a pretranslational level.

PMID- 1751777
TI  - Rapid acquisition of an enhanced capacity to produce tumor necrosis factor,
      alpha/beta interferon, and interleukin 6 after implantation of tumor cells.
AB  - This study shows that the ability of mice to produce tumor necrosis factor (TNF),
      alpha/beta interferon (IFN-alpha/beta), and interleukin 6 (IL-6), but not
      interleukin 1 (IL-1), in response to endotoxin was dramatically augmented within
      24 h of intradermal implantation of 10(6) tumor cells. Tumor cell implantation
      also caused endotoxin-independent appearance of IFN-alpha/beta and IL-6 in serum
      within 24 h. Priming for endotoxin-induced TNF production was not evident during
      the first 12 h of tumor cell implantation and it had decreased by 72 h. However,
      this decrease was followed by a second peak of priming on day 6 of tumor growth.
      Priming for endotoxin-induced TNF production was not induced by injection of dead
      tumor cells, the products of live tumor cells, or syngeneic or allogeneic
      splenocytes. Priming for TNF production was associated with an increased
      susceptibility of mice to endotoxin toxicity. These data suggest the existence of
      a cytokine-dependent host defense mechanism that is rapidly elicited in response
      to tumor cell implantation.

PMID- 1751778
TI  - Antibodies to interleukin 3 as probes for the interaction of interleukin 3 with
      its receptor.
AB  - A series of antibodies, directed against murine interleukin-3 (IL-3) or synthetic
      peptides corresponding to portions of the IL-3 sequence, has been used to detect
      receptor-bound IL-3 on the surface of cells. An assay was developed in which the
      bound primary antibody was detected using a biotinylated secondary antibody and
      fluorescein isothiocyanate-labeled streptavidin, followed by analysis on a
      fluorescence-activated cell sorter. The fluorescence signal was shown to be
      specific for cells known to express IL-3 receptors and was dependent on the
      preincubation of cells with IL-3 under conditions that did not allow
      internalization of receptors. Antisera raised against full-length synthetic IL-3
      or to the N-terminal 29 residues were found to give equivalent signals. On the
      other hand, antibodies to residues 91-118 showed no signal in this assay, despite
      being able to bind to IL-3 in solution and neutralize IL-3 bioactivity. When
      peptides corresponding to residues 30-43 and 123-140 were incubated with the anti
      IL-3 antiserum, the majority of the fluorescence signal was abolished, indicating
      that these two peptides contained the primary epitopes being recognized by the
      antiserum in this assay. This antiserum also bound to the 91-118 peptide, but the
      corresponding peptide was not able to reduce the fluorescence signal in a similar
      competition assay. These results suggest that the 91-118 region is not accessible
      to antibody when IL-3 is bound to its receptor, whereas at least portions of
      epitopes 1-29, 30-43, and 123-140 remain accessible to antibody.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1751779
TI  - Differential activity of granulocyte-macrophage and macrophage colony stimulating
      factors on bone resorption in fetal rat long bone organ cultures.
AB  - In this study, the ability of recombinant human macrophage (M) and murine
      granulocyte-macrophage (GM) colony stimulating factor (CSF) to affect both basal
      and stimulated bone resorption in fetal rat long-bone organ cultures was
      assessed. It was found that M-CSF does not affect basal bone resorption or bone
      resorption stimulated by parathyroid hormone, recombinant human interleukin 1
      beta, prostaglandin E2 (PGE2), and 1,25 dihydroxy vitamin D3. Specifically, M-CSF
      at concentrations as high as 30 nM (1 microgram/mL) did not modulate 45Ca release
      from fetal rat long bones stimulated by these agents. The addition of recombinant
      murine GM-CSF (at equal molar concentration to M-CSF) also did not affect bone
      resorption stimulated by parathyroid hormone and interleukin 1 beta. On the other
      hand, GM-CSF stimulated basal bone resorption over a 120-h period and augmented
      the resorption mediated by exogenous PGE2 over a 48-h incubation. In addition, GM
      CSF was shown to stimulate production of endogenous PGE2 in cultures of bone
      rudiments. These effects on bone resorption were blocked by the addition of
      prostaglandin synthesis inhibitors and specific antibodies to murine GM-CSF.
      These data indicate that M-CSF does not act as a regulator of bone turnover, but
      GM-CSF may cause bone resorption by stimulating the synthesis of PGE2 in bone.

PMID- 1751780
TI  - Regulation of the interleukin 2 receptor complex tyrosine kinase activity in
      vitro.
AB  - Interleukin 2 (IL-2) has been shown to stimulate tyrosine phosphorylation of a
      number of proteins requiring only the p75 beta chain of the IL-2 receptor. Unlike
      the receptors for epidermal growth factor, insulin, and other growth factors, the
      p55-alpha and p75-beta chains of the IL-2 receptor have no tyrosine protein
      kinase domain suggesting that the IL-2 receptor complex activates protein kinases
      by a unique mechanism. The activation of tyrosine kinases by IL-2 in situ was
      studied and using a novel methodology has shown tyrosine kinase activity
      associated with the purified IL-2R complex in vitro. IL-2 stimulated the in situ
      tyrosine phosphorylation of 97 kDa and 58 kDa proteins which bound to
      poly(Glu,Tyr)4:1, a substrate for tyrosine protein kinases, suggesting these
      proteins had characteristics found in almost all tyrosine kinases. IL-2 was found
      to stimulate tyrosine protein kinase activity in receptor extracts partially
      purified from human T lymphocytes and the YT cell line. Biotinylated IL-2 was
      used to precipitate the high-affinity-receptor complex and phosphoproteins
      associated with it. The data indicated that the 97-kDa and 58-kDa phosphotyrosyl
      proteins were tightly associated with the IL-2 receptor complex. These proteins
      were phosphorylated on tyrosine residues by IL-2 stimulation of intact cells and
      ligand treatment of in vitro receptor extracts. Furthermore, the 97-kDa and 58
      kDa proteins were found in streptavidin-agarose/biotinylated IL-2 purified
      receptor preparations and showed high affinity for tyrosine kinase substrate
      support matrixes. The experiments suggest that these two proteins are potential
      candidates for tyrosine kinases involved in the IL-2R complex signal transduction
      process.

PMID- 1751781
TI  - Recombinant antibodies.
AB  - Many fundamental advances in our understanding of the structure and function of
      eukaryotic genes were derived from the study of antibody genes. Examples include
      mRNA splicing and rearrangement to generate antibody diversity. The capacity to
      immortalize an individual B cell using cell fusion permitted the generation of
      monoclonal antibodies. Monoclonal antibodies have had wide application in many
      fields of the life sciences and beyond. Recent advances permitting manipulation
      of antibody genes using recombinant DNA techniques offer many advantages over
      conventional somatic cell hybridization techniques. Rodent monoclonals can be
      "humanized" and antibody isotype readily changed. Grafting of the complementarity
      determining regions from rodent to human framework regions demonstrated the
      importance of these hypervariable portions of the immunoglobulin to the integrity
      of the antibody combining site. Recombinant monoclonal antibodies (rMAb) or
      fragments thereof have been successfully produced in both prokaryotic and
      eukaryotic hosts at levels equal to those produced by hybridomas. Successful
      efforts to express rMAbs in plants and other large capacity systems suggest that
      rMAbs can be produced inexpensively. Use of antibody catalysis and antibodies
      mimicking various receptors or ligands have numerous applications. Technology
      developed to immortalize the heavy and light chain repertoire permits the
      generation in vitro of recombinatorial libraries of antibodies. The capacity to
      artificially generate high-affinity antibodies in vitro using the methods of
      recombinant DNA technology has enormous pharmaceutical and industrial potential.

PMID- 1751782
TI  - Use of severe combined immunodeficient (SCID) mice to produce human hybridoma
      ascites.
AB  - The use of the severe combined immunodeficient mouse (SCID), CB-17/Icr//Imd-SCID,
      was investigated for the production of human hybridoma ascites containing human
      antibody. Human-human hybridomas, generated from the fusion of lymphocytes
      isolated from regional draining lymph nodes of cancer patients with the SHFP-1
      fusion partner, were injected i.p. at various cell concentrations into pristane
      primed SCID mice. Ascites growth was typically observed at 7-14 days
      postinoculation. No significant differences in ascites yield or production were
      observed between IgG- and IgM-secreting hybridomas. Yields of immunoreactive
      human immunoglobulin ranged from approximately 0.5 to 3 mg/ml of harvested
      ascites. The ease and relatively low cost suggest that the use of SCID mice is
      preferred over conventional and costly large-scale industrial procedures.

PMID- 1751783
TI  - Human monoclonal antibody JDB1 reacts with cytoplasmic and membrane bound
      antigens present on a variety of human breast tumor cell lines.
AB  - The human monoclonal antibody JDB1 was examined for reactivity to five breast
      cancer cell lines as well as normal fibroblasts. The JDB1 clone secretes both
      IgG3 and IgM antibody. In these studies both the total antibody (containing IgG3
      and IgM) as well as the purified IgG3 and IgM fractions were examined for tumor
      cell binding reactivity. Peroxidase staining was observed in the breast cancer
      lines SW527, MCF-7, T47D, SKBR3, and MDAMB231, while GM179 and GM5758 fibroblast
      lines were negative for antibody binding. Tumor cells were examined using two
      techniques: a drop cell technique in which cells were fixed onto slides and also
      a cover slip assay in which cells were grown onto sterile cover slips and
      subsequently stained with the human monoclonal antibody using a peroxidase
      technique. Both cytoplasmic and membrane staining were observed for all of the
      breast tumor cells tested using both assays. In addition, a cellular ELISA was
      developed and used to quantitate the binding of these antibodies to tumor cells.

PMID- 1751784
TI  - Antigens recognized by two human monoclonal IgM anticolon cancer antibodies,
      16.88 and C-OU1 (B9165).
AB  - We have compared by SDS-PAGE Western blotting the molecules detected by two human
      monoclonal antibodies, C-OU1 and 16.88. The antibodies have previously been shown
      to detect a cytoplasmatic antigen with an Mr of 43 kD present in colon
      adenocarcinoma cell lines and in colon cancer tissues. We now demonstrate that
      these antibodies differ significantly in their fine specificity, resulting in a
      quite dissimilar tumor selectivity. The antibody 16.88, in addition to reactivity
      with the 43-kD molecule, also recognizes a 190-kD molecule present both in
      melanoma cells and in cells previously reported as 16.88 antigen positive. The
      16.88 antibody does not detect a 43-kD molecule in extracts of melanoma cells.
      The 190-kD component was not detectable in hepatoma or mamma carcinoma cells,
      both of which showed presence of the 43-kD molecule. The C-OU1 antibody shows no
      reactivity with the 190-kD molecule in any of the cells tested or with other
      proteins in melanoma cells. Radiolabeled 16.88 antibody shows better localization
      to melanoma cancer than to colon cancer xenograft transplanted onto nude mice.
      These findings indicate the presence of a tumor-associated antigen not previously
      described and have obvious implications for potential clinical uses of the
      antibodies.

PMID- 1751785
TI  - Dietary protein restriction in chronic renal failure: nutritional efficacy,
      compliance, and progression of renal insufficiency.
AB  - Two findings prompted investigators to examine the effects of dietary
      manipulation on progression of chronic renal failure: dietary protein restriction
      is an effective method of ameliorating uremic symptoms and the course of renal
      insufficiency in an individual patient is predictable. Results from studies of
      patients and animals with chronic renal failure suggested that a low-protein,
      phosphorus-restricted diet could slow the rate of loss of renal function. In
      evaluating these studies, three questions should be considered. First, is the
      diet nutritionally adequate? Second, has dietary compliance been monitored and
      achieved? Third, is there evidence that restricting the diet will change the rate
      of loss of renal function? The scientific basis for each of these questions is
      addressed in this review.

PMID- 1751786
TI  - Is there a "point of no return" in progressive renal disease?
AB  - The pathogenesis of progressive renal damage is most probably multifactorial.
      Whatever the mechanisms involved in renal disease progression, the existence of a
      "point of no return" has been hypothesized, that is, a stage of structural and
      functional damage beyond which progression of renal disease occurs independently
      of dietary measures and/or pharmacological treatment. In experimental animals,
      dietary protein and phosphate restriction is not fully successful in ameliorating
      the progression of functional deterioration if administered when renal injury is
      severe and long standing. Similarly, late treatment with various pharmacological
      agents (mainly antihypertensive drugs) is less effective than early
      administration of the same substances. A serum creatinine of 176 mumol/L seems a
      critical point discriminating the results of either dietary protein and phosphate
      restriction or antihypertensive treatment in patients with chronic renal disease.
      The protective effects of both dietary and nondietary intervention seem to be
      most effective when at least 50% of the residual renal mass is still functioning.
      The extent to which glomerular sclerosis, vascular hyalinosis, and interstitial
      fibrosis have already developed can probably blunt or avert the expected results
      of treatment. Some clinical tests may identify those patients who would benefit
      from measures such as the reduction in glomerular hemodynamic stress, the long
      term inhibition of the renin-angiotensin system, and the aggressive treatment of
      systemic hypertension. The continuous search for a rational preventive treatment
      before the disease process has reached the "point of no return" will undoubtedly
      constitute a formidable task for the modern nephrologist.

PMID- 1751787
TI  - Adjunctive therapy with intravenous human immunoglobulin G improves survival of
      patients with acute renal failure.
AB  - The objective of this prospective, randomized, double-blind, placebo-controlled
      clinical trial was to evaluate the efficacy of adjunctive therapy with iv human
      immunoglobulin G in reducing the morbidity and mortality associated with acute
      renal failure. Forty patients greater than or equal to 18 yr of age who were
      identified within 48 h of the onset of acute renal failure and who met the
      enrollment criteria were enrolled in the study. Thirty-five patients were
      considered evaluable. Patients were grouped according to the admitting service
      (medical or surgical/trauma) and were randomized to receive either immunoglobulin
      G (400 mg/kg body wt) or placebo (normal saline; 8 mL/kg body wt) at study entry
      and then weekly thereafter for a maximum of 4 doses. The groups were well
      balanced with respect to demographics, clinical presentation, and severity of
      illness (APACHE II scores). A significant reduction in mortality at 42 days after
      study entry was observed. Two of 17 (12%) patients in the immunoglobulin G
      treated group compared with 8 of 18 (44%) patients in the placebo-treated group
      died (P = 0.025). No differences were observed in the frequency of major
      complications that occurred in association with acute renal failure. However, in
      patients who manifested infection, greater survival was observed in the
      immunoglobulin G treatment group. The results suggest that immunoglobulin G
      administered at the onset of acute renal failure reduced mortality possibly by
      decreasing the severity of infectious complications associated with the
      occurrence of of acute renal failure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751788
TI  - The influence of mannitol on myoglobinuric acute renal failure: functional,
      biochemical, and morphological assessments.
AB  - This study was undertaken to explore the protective influence of mannitol against
      the glycerol model of myohemoglobinuric acute renal failure. Three hypotheses
      were tested: (1) mannitol confers cytoprotection by acutely blunting renal
      hypoperfusion, thereby improving tubular cell energetics; (2) as an hydroxyl
      radical (OH.) scavenger, mannitol mitigates Fe-driven lipid peroxidation and,
      hence, decreases tubular cell necrosis; and (3) mannitol prevents intrarenal heme
      pigment trapping, decreasing cast formation. Rats were injected with 50% glycerol
      (10 mL/kg im), followed immediately by an iv mannitol (1.25 mL/100 g over 1 h) or
      sham infusion. Mannitol induced a brisk diuresis (approximately 5.7 mL/2 h;
      approximately 35 mg of heme protein excreted), whereas glycerol controls were
      anuric. Mannitol did not significantly increase postglycerol RBF (2.8 mL/min),
      and it paradoxically worsened cellular energetics, halving cortical ATP
      concentrations at 1 h. However, this adverse effect on ATP was transient,
      correlating with active diuresis. Glycerol did not induce convincing in vivo
      lipid peroxidation (malondialdehyde; conjugated diene assay), and mannitol did
      not block Fe-driven in vitro lipid peroxidation of isolated brush border membrane
      vesicles. Na benzoate, an OH. scavenger, conferred no in vivo or in vitro
      protection. However, Na2SO4, not an OH. scavenger, reproduced the diuretic and in
      vivo protective effects of mannitol. Purified myoglobin infusion (35 mg) largely
      negated the beneficial action of mannitol. It was concluded that mannitol confers
      functional but not cytoprotection against the glycerol acute renal failure model,
      it acutely worsens renal bioenergetics, and its protective influence is probably
      due to a diuretic, not an antioxidant, effect.

PMID- 1751789
TI  - Effect of diet on creatinine clearance and excretion in young and elderly healthy
      subjects and in patients with renal disease.
AB  - Thirty-seven young healthy subjects with normal renal function were studied to
      assess the quantitative effect of protein intake on creatinine clearance. A
      standard 24-h urine collection and blood sample at the end of the collection were
      obtained for creatinine and urea concentrations. Correlations between creatinine
      clearance and urinary urea nitrogen excretion (r = 0.8; P less than 0.0001) and
      calculated protein intake (r = 0.8; P less than 0.0001) were observed. A
      significant relationship between creatinine clearance and urea nitrogen excretion
      was also demonstrated in 28 elderly healthy subjects and 33 patients with renal
      disease. To demonstrate a cause and effect between urea nitrogen excretion and
      creatinine clearance in healthy subjects, 18 of the 37 healthy subjects repeated
      the 24-h urine collection and blood sample after ingesting 5 g of urea in
      addition to their usual diet. Mean urinary urea nitrogen excretion increased from
      a mean value of 9.8 +/- 4.0 to 11.8 +/- 4.0 g/day. There was a strong correlation
      between the changes in urea nitrogen excretion and the changes in creatinine
      clearance. In acute studies with oral protein loading, there was a significant
      correlation between creatinine clearance and urinary urea nitrogen excretion. It
      was concluded that protein intake has a direct and quantitative effect on
      creatinine clearance in healthy subjects. In normal humans, it is likely that GFR
      is not a fixed function. Thus, a low creatinine clearance is not a categorical
      sign of renal disease. A low creatinine clearance adjusted for urea nitrogen
      excretion may be a useful clinical tool to assess renal function.

PMID- 1751790
TI  - Factors affecting inorganic mercury transport and toxicity in the isolated
      perfused proximal tubule.
AB  - The effects of cysteine (80 microM), glutathione (80 microM), rabbit albumin (100
      microM), and an ultrafiltrate of rabbit plasma on the toxicity and transport of
      inorganic mercury (Hg2+; 18.4 microM) in isolated perfused S1, S2, and S3
      segments of the renal proximal tubule from the rabbit were studied. Cellular and
      tubular injuries were assessed qualitatively by light microscopy observations and
      quantitatively by the tubular leak of the volume marker 3H-glucose. The lumen-to
      bath transport of inorganic mercury was assessed by measuring both the rate of
      disappearance of inorganic mercury from the luminal fluid and the rate of
      appearance of inorganic mercury in the bath. When glutathione was added to the
      perfusate containing the inorganic mercury, no signs of epithelial cell necrosis
      or injury were detected in any of the three segments of the proximal tubule.
      There was also an absence of or a decrease in cellular injury in the epithelium
      of the same tubular segments when either cysteine or the ultrafiltrate was
      present in the perfusate. However, when rabbit albumin and inorganic mercury were
      present in the perfusate, severe degenerative and necrotic changes occurred very
      rapidly in the epithelium of all three segments of the proximal tubule. In almost
      every instance where glutathione, cysteine, or the plasma ultrafiltrate were
      present in the perfusate, the disappearance flux of inorganic mercury from the
      tubular lumen into the tubular epithelium was lowered. It was concluded that
      glutathione, cysteine, and the ultrafiltrate of rabbit plasma provide isolated
      perfused S1, S2, and S3 segments of the proximal tubule varying degrees of
      protection from the toxic effects of inorganic mercury. This protection appears
      to be related to a decrease in the movement of inorganic mercury across the
      luminal membrane of the tubular epithelial cells.

PMID- 1751791
TI  - Osmoregulatory betaine uptake by rat renal medullary slices.
AB  - Betaine is an osmolyte present in high concentrations in renal medullary cells.
      Betaine and other organic osmolytes, such as glycerophosphorylcholine, myo
      inositol, and sorbitol, have been shown to increase in concentration during
      antidiuresis when the inner medullary extracellular osmolality rises. Its
      concentration may increase in renal cells either by betaine uptake or by choline
      metabolism to betaine. These studies measured the uptake of (14C)betaine into
      cortical, outer medullary and inner medullary slices from rat kidney. The tissue
      to-medium ratio of (14C) betaine increased with increasing osmolality up to 450
      mosmol/kg in outer medullary and inner medullary slices, but not in cortical
      slices. Betaine uptake increased when the osmolality was raised with NaCl or
      mannitol, but not with urea. When LiCl was substituted for NaCl in a medium of
      300 mosmol/kg, there was significant inhibition of betaine uptake, although the
      tissue-to-medium ratios remained greater then unity. Thus, increases in
      osmolality stimulate betaine uptake in rat renal medullary slices and this uptake
      occurs by both sodium-dependent and sodium-independent betaine transport.

PMID- 1751792
TI  - Chloride and membrane potential dependence of sodium ion-proline symport.
AB  - Proline accumulation by renal proximal tubule brush border membrane vesicles is
      Na+ dependent, but little is known about the role of anions or membrane potential
      on proline uptake. Recent studies in a variety of transport systems, including
      rat renal brush border membrane vesicles, indicate that halide anions chloride
      (Cl-) and bromide (Br-) are essential for glycine, beta-alanine, gamma
      aminobutyric acid, and taurine uptake, so the possibility that Na(+)-proline
      symport is Cl- dependent was explored. Also, the role of membrane potential on
      transport was assessed by determining the effect of external anions with
      different membrane permeabilities. The ratio of initial rate Cl- stimulated to
      thiocyanate (SCN)(-)-stimulated uptake values serves to measure Cl- dependence.
      The initial rate of proline uptake to equilibrium value was 3.11 +/- 0.5 (SE) in
      the presence of Cl- versus SCN-. The ratio for D-glucose, whose uptake is
      governed only by electrogenic status of the membrane, was 0.61 +/- 0.47 (P less
      than 0.001 versus proline). In another series of experiments, uptake values for
      various anions as a percent of equilibrium (I/E x 100) were: SCN-, 84.9 +/- 10.9;
      NO3, 49.9 +/- 11.0; SO4(2-), 27.3 +/- 4.4; F-, 68.5 +/- 18.3; Cl-, 164.1 +/-
      44.6; Br-, 150.6 +/- 30.2; I-, 56.7 +/- 13.5. The stoichiometry of uptake by Hill
      plot analysis of proline uptake in the presence of varying concentrations of Na+
      (0 to 100 mM) and Cl- (0 to 100 mM) was 2Na+:1Cl-:1 proline.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1751793
TI  - Intradialytic modulation of granulocyte C5a receptors.
AB  - Hemodialysis with new cellulosic membranes is associated with profound
      granulocytopenia, with a nadir 15 min after initiation, followed by a rebound
      leukocytosis seen 1 h after initiation and persisting up to the termination of
      dialysis. The rapid reversal of granulocytopenia during hemodialysis has
      previously been ascribed to down-regulation of granulocyte C5a receptors. In this
      report, a method of characterizing C5a receptors by using a novel probe
      consisting of C5a attached to biotin via a six-carbon spacer chain is described.
      Cellulose acetate electrophoresis and cation exchange HPLC demonstrated a biotin
      to-C5a ratio of 1:1. Analysis of granulocyte cell surface C5a receptors were
      performed with the probe with a fluorescein-avidin conjugate and by using
      fluorescence flow cytometry. The maximum decrease in C5a receptors was measured
      at the 15-min sampling time, when the number of C5a receptor decreased from
      189,240 +/- 24,500 predialysis to 160,740 +/- 19,380 receptors (P was not
      significant) at the nadir of granulocytopenia. However, during recovery from
      neutropenia, granulocyte cell surface C5a receptors increased to 172,140 +/-
      19,380 at 30 min and 193,800 +/- 24,510 at the end of dialysis. Concentrations of
      C3a and C5a peaked at 15 min and declined rapidly thereafter, but both remained
      significantly above baseline at all times. These studies suggest that down
      regulation of C5a receptors, which is seen maximally at 15 min after initiation
      of dialysis, does not sufficiently account for the reversal of granulocytopenia
      during hemodialysis.

PMID- 1751794
TI  - Blood pressure in hemodialysis patients during amelioration of anemia with
      erythropoietin.
AB  - This study analyzed blood pressure in hemodialysis patients treated with epoetin
      beta in multicenter trials. Antihypertensive drugs were prescribed as usual.
      Placebo-controlled trials compared epoetin (100 to 150 U/kg; N = 151) with
      placebo (N = 78) for 82 days. Hemoglobin (108 +/- 18 versus 75 +/- 14 g/L) (mean
      +/- SD) and diastolic blood pressure (84 +/- 14 versus 78 +/- 15 mm Hg) were
      greater (P less than 0.05) after epoetin. Clinically important increases in blood
      pressure (increases in diastolic blood pressure greater than or equal to 10 mm Hg
      and/or drug therapy) were more frequent with epoetin (58 versus 37%; P = 0.005).
      A dose-response trial compared epoetin, 25 U/kg (N = 42), 100 U/kg (N = 40), and
      200 U/kg (N = 39) for 138 days. Increases in hemoglobin were dose dependent, but
      clinically important increases in blood pressure were not. In analyses of all
      patients treated with epoetin (N = 272), no baseline or final level of
      hemoglobin, or rate of hemoglobin rise, was a threshold for a rise in blood
      pressure. Patients requiring antihypertensive drugs or having uncontrolled
      hypertension (diastolic blood pressure greater than 90 mm Hg) at baseline had
      decreases in blood pressure (P less than 0.05) with antihypertensive therapy.
      Thus, compared with placebo, 21% of patients had clinically important increases
      in blood pressure during amelioration of anemia. The baseline or final levels of
      hemoglobin, the extent or rate of hemoglobin rise, or uncontrolled hypertension
      or antihypertensive drug use at baseline were not confirmed as risks.
      Antihypertensive drug therapy was important for blood pressure control.

PMID- 1751796
TI  - Treatment of viral hepatitis. International Association for the Study of the
      Liver. Satellite meeting. Gold Coast, Australia, 3-5 September 1990.

PMID- 1751795
TI  - Improved method for the isolation of mouse glomeruli.

PMID- 1751797
TI  - Alpha-interferon combined with immunomodulation in the treatment of chronic
      hepatitis B.
AB  - Interferon has profound anti-viral, anti-proliferative and immunomodulatory
      effects. Future studies should be directed at observing how the immunomodulatory
      effects predict a response in certain groups of patients. Interferon is very
      useful in chronic hepatitis B but may require the addition of a steroid pulse.
      Individuals with low serum ALT appear to benefit most from a steroid pulse.
      Therapy should be given with a great deal of caution in patients with
      decompensated liver disease, as one may precipitate the untimely demise of the
      patient even though viral replication is decreased. One of the patients in the
      IFN study in fact did have decompensation after prednisone therapy, which
      subsequently led, a couple of months later, to a variceal haemorrhage. In
      summary, in treating hepatitis B viral infection, no single agent is totally
      effective and perhaps the combination of suppressing viral replication and
      augmenting the immune system is the optimal way to eradicate the virus. At
      present, an adequate response is found in only about 30-40% of patients even with
      'optimal' therapy.

PMID- 1751798
TI  - Alpha-interferon therapy for chronic hepatitis B virus infection in children and
      Oriental patients.
AB  - In summary, these four studies showed that alpha-IFN therapy alone produced
      sustained inhibition of HBV replication in a minority of Chinese adults with
      chronic HBV infection. The response was not improved by instituting treatment at
      an earlier age. The major reason for the poor response in Chinese patients is
      probably immune tolerance as a result of early exposure to HBV. The response in
      Chinese patients with elevated pre-treatment serum ALT levels, who presumably had
      ongoing endogenous immune lysis of infected hepatocytes, was significantly better
      than and comparable with that reported in Caucasian patients. Prednisone priming
      did not provide any additional advantage over therapy with IFN alone in patients
      with normal pre-treatment serum ALT levels, but appeared to have additional
      benefit in patients with elevated ALT levels.

PMID- 1751799
TI  - Design of new anti-viral agents for chronic hepatitis B virus infection.
AB  - The effectiveness of therapies for chronic hepatitis B will depend on their
      ability to inhibit all HBV replicative intermediates including viral SC DNA as
      well as stimulating the host's immune system to clear virus and produce sustained
      immunity. Future therapies will require the use of combined treatments in
      'cocktail-type arrangements' as outlined in this paper, linked with careful
      staging of the hepatitis B carrier state.

PMID- 1751800
TI  - Management of hepatitis D virus infection.

PMID- 1751801
TI  - Treatment of chronic hepatitis C with alpha-interferon.

PMID- 1751802
TI  - Alpha-interferon treatment of chronic hepatitis B infection: predictors of
      responsiveness.

PMID- 1751803
TI  - Dedifferentiation phenomena after denervation of mammalian adult vestibular
      receptors.
AB  - The effect of transecting the vestibular nerve on the vestibular sensory
      epithelium was studied in adult guinea-pigs. When denervation was complete, after
      fifteen days, the vestibular hair cells began to show morphological features of
      immaturity. After two months, the majority of hair cells showed a supporting cell
      phenotype. By four months, both hair cells and supporting cells had become
      morphologically similar to the epithelial cells which line the vestibular
      cavities. When denervation was incomplete, hair cells and supporting cells
      retained their normal phenotype. This, plus the dedifferentiation after complete
      denervation, indicates that the phenotypes of the hair cells and supporting cells
      are innervation-dependent.

PMID- 1751804
TI  - Embryonic mouse spinal cord motor neuron hybrid cells.
AB  - Studies of motor neurons are difficult because of limitations in their isolation
      and culture. One solution is to produce clonal neural hybrid cells that can
      express motor neuron characteristics; we fused an aminopterin-sensitive and
      neomycin-resistant mouse neuroblastoma cell line to isolated embryonic mouse
      spinal cord motor neurons. Several hybrid neuron cell lines expressing high
      levels of choline acetyltransferase (CHAT) enzyme activity were found. These were
      cloned and clones with high CHAT activity isolated. The hybrid nature of cloned
      cells was confirmed by karyotyping and determining glucose phosphate isomerase
      allozymes. The availability of these embryonic clonal hybrid cells will enable
      molecular, physiological, and biochemical studies to define motor neuron-specific
      properties.

PMID- 1751805
TI  - Back-firing of ventromedial medulla neurons from the spinal cord in awake, freely
      moving rats.
AB  - In the awake, freely moving rat we showed, by means of single-unit recordings and
      antidromic spinal cord activation, that at the ventromedial medulla level, in
      these particular experimental conditions, the 'multimodal, multireceptive' units
      excited by auditory, cutaneous non-noxious and noxious stimuli are possibly
      involved in a spinal descending control system. These neurons were back-fired
      from the medial part of the lateral funiculus, hence they probably projected to
      the dorsal and intermediate horn of the cord, and not to the ventral horn, which
      emphasizes a role in the control of nociception. Due to their convergent
      properties, these units are probably involved in nonspecific aspects of
      nociception such as alertness or stress.

PMID- 1751806
TI  - Nuclear membrane antigen specific to nerve and muscle tissues.
AB  - A monoclonal antibody, 2F7, raised against a nuclear protein subfraction
      recognized the nuclear membrane of nervous and muscular tissues of guinea pig,
      rat and rabbit, but no other tissue was stained. In the nervous system, both
      neurons and glial cells were labelled. An electron microscopic
      immunohistochemical study demonstrated that 2F7 antibody labelled the inner
      surface of the nuclear membrane. Western blot analysis on the nuclear envelope
      fraction containing nuclear lamina revealed that this antibody reacted to two
      minor component proteins of 80 and 82KDa. These 2F7 antigens expressed
      preferentially in the nervous and muscular tissues were distinct from the major
      nuclear envelope proteins reported so far and might be related to neuronal or
      muscular tissue-specific functions.

PMID- 1751807
TI  - Hepatocytes enhance neurite regeneration and survival from transected nerve
      terminals.
AB  - The culture of hepatocytes dissociated from adult mice by the collagenase
      perfusion method enables neurons or neuronal tissues to be cultured with
      hepatocytes or in hepatocyte-conditioned media. Co-culture with hepatocytes or
      hepatocyte-conditioned media enhances neurite regeneration and their survival
      from nerve-transected terminals of dorsal root ganglia with nerve fibers
      dissected from adult and aged mice. Hepatocytes secrete a factor which enhances
      not only neurite regeneration but also neurite survival. Activities of other
      known neurotrophic factors were not as crucial as those of the hepatocyte
      conditioned medium, suggesting that this factor may differ from other trophic
      ones.

PMID- 1751808
TI  - Intraretinal grafting restores visual function in light-blinded rats.
AB  - In seeing rats light flashes inhibit acoustic startle reflexes at short lead
      times. In contrast, visually impaired (light-blinded) rats show an early phase of
      exaggerated reflex expression, revealing the presence of pathological visual
      processing, and then an aberrant late phase of delayed inhibition. Grafting fetal
      retinal cells into the damaged retina entirely removed reflex facilitation and
      restored a modest degree of properly timed and statistically significant reflex
      inhibition. This restoration of visually-mediated behaviour, observed in two
      independent groups, reveals that intraretinal grafts provide useful information
      to blinded hosts.

PMID- 1751809
TI  - Nerve fibres in the uterine artery increase in number in pregnant guinea-pigs.
AB  - Perivascular nerves of the uterine artery were studied in four-month-old pregnant
      and non-pregnant guinea-pigs. In pregnancy, the uterine artery hypertrophies
      (more than two-fold growth in diameter and length and 50% increase in wall
      thickness), but its density of innervation remains high, because of the growth of
      many new axons. The axons in a complete transverse section of the vessel increase
      by 40%. The nerve bundles grow by 100%. Small nerve bundles increase more than
      large bundles: nearly 70% of the nerve bundles contain 10 or fewer axons in
      pregnant guinea-pigs (37% in non-pregnant animals). The increase in axon number
      is accompanied by formation of new varicosities, hence presumably of new
      neuromuscular junctions.

PMID- 1751810
TI  - Vitamin E supplements fail to protect mice from acute MPTP neurotoxicity.
AB  - The effect of chronic treatment with vitamin E (VE) on acute 1-methyl-4-phenyl
      1,2,3,6-tetrahydropyridine (MPTP)-induced neurotoxicity, as assessed by striatal
      dopamine (DA) depletion, was studied. Male C57B1/6J mice were fed VE (48 mg kg-1
      per day, intragastric) for 4, 8, or 12 weeks prior to administration of MPTP (20
      mg kg-1, i.p. x 3, 2 h intervals) or its diluent. Brain VE concentration was
      increased by exogenous supplements for 12 weeks. Striatal DA content was reduced
      by 85% to 90% after MPTP in control and VE-treated mice. Mice with elevated
      cerebral VE were not protected from MPTP toxicity, with DA content as an
      indicator. In conclusion, these findings indicate that moderate elevation of
      brain VE is not adequate for protecting DA-containing neurons against the toxic
      actions of a high dose of MPTP.

PMID- 1751811
TI  - Rifaximin versus neomycin on hyperammoniemia in chronic portal systemic
      encephalopathy of cirrhotics. A double-blind, randomized trial.
AB  - Preliminary data suggest that rifaximin a new non-absorbable rifamycin-derivate,
      has beneficial effects on chronic portal systemic encephalopathy (PSE). To
      compare the efficacy and safety of rifaximin vs neomycin in the treatment of the
      hyperammoniemic state of PSE, 30 cirrhotic patients with grade I to III of PSE
      were randomly allocated to one of two groups: group A (15 patients) receiving
      rifaximin (400 mg/8h) and group B (15 patients) neomycin (1gr/8h). The duration
      of treatment was 21 consecutive days. Age, sex, hepatic and renal function, level
      of PSE, EEG and number connection test were similar in both groups. A significant
      decrease in blood ammonia levels was observed at the end of the treatment period
      in both groups; moreover rifaximin produced an earlier reduction of blood ammonia
      levels. The neuropsychic syndrome related to the PSE improved in both groups
      without significant difference. No side effects attributable to therapy were
      observed in the rifaximin group. These results indicate that, rifaximin is at
      least as effective as neomycin in the achievement and maintenance of low blood
      ammonia levels in cirrhotics with chronic PSE.

PMID- 1751812
TI  - Insufficiency of local approach regarding treatment of early gastric cancer.
AB  - Out of 1041 patients who underwent surgery for gastric cancer between 1968 and
      1987, 120 patients suffered from early gastric cancer (11.5%). Until 1976, early
      gastric cancer was treated along the lines of surgical treatment of benign ulcer
      disease, i.e. by partial 2/3-gastric resection without lymphadenectomy, even
      though malignancy had been confirmed preoperatively in all cases. Since 1979
      oncological criterias (subtotal or total gastrectomy with lymphadenectomy) have
      gained importance in treating early gastric carcinoma. In the case of mucosal
      carcinoma, the extent of surgical intervention does not have any influence on the
      10-year survival rate. In treating submucosal carcinoma 10-year survival rates of
      72.9 (+/- 7.2%) can only be achieved by performing total gastrectomy and
      lymphadenectomy whereas the 10-year survival rate after performing partial 2/3
      gastric resection alone (p = 0.01) is only 17.6 (+/- 9.2%). Since mucosal and
      submucosal carcinoma cannot accurately be differentiated preoperatively, surgical
      intervention must be carried out in an oncological sense. The fact that 2/3
      partial gastric resection does not generally ensure adequate therapy implies that
      local procedures are even less sufficient. Even in cases of mucosal infiltration
      only, local procedures such as laser therapy and local excision of the tumour
      cannot be considered being a curative approach, since hereby the probability of
      lymph node metastases (4%) is not taken into account.

PMID- 1751813
TI  - Pepsinogen A/pepsinogen C or pepsinogen A multiplied by gastrin in the diagnosis
      of gastric cancer?
AB  - Being pepsinogen A (PGA) levels generally reduced and pepsinogen C (PGC)
      increased in gastric cancer patients, PGA/PGC ratio has been proposed as a useful
      marker of the tumour. We tested PGA, PGC and Gastrin (G) levels in patients with
      gastric cancer (39) and, as a control, in patients with epithelial dysplasia
      (21), chronic atrophic gastritis (57), gastric ulcer (11) or subjects lacking
      major or minor endoscopic and microscopic changes at gastroscopy (48). PGA and
      PGA/PGC levels were significantly reduced in gastric cancer patients (p less than
      0.005 and p less than 0.0001 respectively with analysis of variance). Gastrin
      levels were also reduced in the same patients (p less than 0.005). We therefore
      adopted an index number (PGA x Gastrin) which was also dramatically reduced in
      gastric cancer (p less than 0.005); using an arbitrarily chosen cut-off, the
      "marker" showed very high sensitivity (76%), specificity (96%) and overall
      accuracy (74%, by Youden J test). We therefore suggest the use of the index
      number PGA x G in the diagnosis of gastric cancer, as the most useful gastrin
      presently available, to our knowledge.

PMID- 1751814
TI  - A nine year retrospective analysis of resectable pancreatic cancer at the
      National Cancer Center Hospital in Tokyo: clues to diagnosis and diagnostic
      assessment.
AB  - A nine year retrospective survey was carried out at the National Cancer Center
      Hospital in order to define the diagnostic clues and most suitable diagnostic
      assessment in resectable pancreatic cancer patients. Forty six cases were
      detected (27 pancreatic head cancers, 19 pancreatic body and tail cancers). There
      were 8, 26, 3 and 9 cases of t1, t2, t3 and t4 tumour size cancers, respectively.
      Abdominal pain and/or discomfort and back pain were the most common initial
      symptoms and chief complaints. Jaundice was present only in pancreatic head
      cancer cases. Abnormal GTT and CA 19-9 were the biochemical tests most commonly
      found abnormal, irrespective of tumour size. ERCP followed by US and CT were the
      most accurate technical tests. The best care toward the awareness of the initial
      symptoms needs to be followed, as a first choice, by a proper biochemical (CA 19
      9, GTT) and technical (US, ERCP, CT) assessment in the hope of identifying those
      patients whose prognosis might be improved by an early operation.

PMID- 1751815
TI  - Modifications of the trophism of intestinal mucosa after intestinal and bilio
      pancreatic diversion in the rat.
AB  - Morphofunctional alterations to the intestinal mucosa are influenced by three
      main factors: food, bilio-pancreatic secretions, intestinal hormones. In order to
      assess the importance of each one, histological and histochemical tests were
      performed on different segments of intestine taken from rats which were
      sacrificed one month after the following procedure: gastrojejunal anastomosis on
      a Roux loop (Model I); same procedure plus biliopancreatic bypass into the
      jejunum (Model II). When compared to the controls, Model I duodenum samples
      revealed hypertrophy of the entire wall with "bundles" of villi, while Model II
      samples showed a clear hypotrophy and reduction in the number of duodenal villi.
      To such modifications of the duodenum correspond longer, thinner villi in the
      other bowel segments, particularly in the jejunum and distal ileum. These results
      suggest that the predominant trophic effect derives from contact with
      biliopancreatic secretions at a proximal level. The modifications of the duodenal
      mucosa appear to regulate the trophism of the distal segments probably by the
      secretion of distant acting enterohormones.

PMID- 1751816
TI  - Ultrasonographic study of the Wirsung duct caliber after meal.
AB  - The pancreatic duct or at least parts of this structure can be demonstrated today
      by sonography in 50-82% according to various authors. We have measured the
      caliber of the sonographically visualized pancreatic duct in 20 normal subjects
      after physiological stimulation with meal. The mean caliber of the duct markedly
      increased after meal. During dilatation a longer segment of duct is more clearly
      visualized. It is possible to document an increase of caliber of Wirsung duct "in
      vivo" as an evident sign of pancreatic secretion.

PMID- 1751817
TI  - Stroke-cirrhosis relationship: an autopsy study in a heavy drinking population.
AB  - A positive association between alcohol consumption and stroke incidence has been
      clearly established. The present study evaluated the frequency of stroke in a
      sample of 500 autopsied patients affected by liver cirrhosis mainly due to
      chronic alcohol abuse as confirmed by the histologic pattern mostly of mixed and
      micronodular types. Frequency of stroke was compared to that of 4,741 non
      cirrhotic patients autopsied in the same period. Our findings demonstrate that
      stroke frequency, especially when due to thromboembolism, decreased significantly
      in cirrhotics. Therefore, hepatopathy is a crucial event in alcoholic patients.
      Nevertheless the concomitant presence of liver cirrhosis, in studies dealing with
      this subject, is not being currently evaluated.

PMID- 1751818
TI  - Prevalence of Helicobacter pylori in military barracks.

PMID- 1751819
TI  - Cirrhosis associated with homozygous alpha-1 antitrypsin deficiency in the adult:
      a case report.
AB  - A 34 year old woman admitted to the department of Gastroenterology of Florence
      hospital was diagnosed as suffering from liver cirrhosis with an alpha-1
      antitrypsin deficiency (PiZZ phenotype). Liver biopsy showed the presence of
      intra-hepatocyte PAS-positive inclusions and the presence of alpha-1 antitrypsin
      was confirmed using the immunoperoxidase technique. No other organ appeared to be
      affected and respiratory function tests were within normal limits. The
      quantitative assay of alpha-1 antitrypsin was higher than values reported in the
      literature for PiZZ homozygotes. The authors report the case and discuss some
      aspects of this disease.

PMID- 1751820
TI  - A case of portal thrombosis arisen after treatment with dihydroergotamine.
AB  - We describe the case of a 42 year old woman with abdominal pain, ascites, and
      splenomegaly after having taken dihydroergotamine continuously for three months
      due to frequent hemicranic episodes. The celiac-mesenteric angiography
      demonstrated diffuse thrombosis of splenic, superior mesenteric and portal veins.
      No surgical intervention was possible. We believe that it is possible that
      dihydroerogotamine, a hydrogenated derivative of ergotamine, inasmuch as it is
      capable of causing peripheral vasoconstriction, intimal lesions, arterial and
      venous thrombi, was also the cause of our patient's portal thrombosis. We
      therefore suggest the minimum effective amount of the drug be utilized to achieve
      the relief of cephalalgia.

PMID- 1751821
TI  - Prognosis in primary biliary cirrhosis. A review.
AB  - Recent progress has been made in estimating prognosis in primary biliary
      cirrhosis using Cox models. These models have also demonstrated the therapeutic
      value of liver transplantation by comparing the observed survival for a group
      after transplantation with the expected survival without transplantation
      calculated from the Cox prognostic model. However, good risk patients and those
      not transplanted principally for hepatocellular failure may not have a survival
      advantage for many years. Cox models have several limitations: the selection
      criteria for the patient populations used to derive the models, the selection of
      the time at which the patients are evaluated, the poor prognostic accuracy for
      individual patients rather than patient groups and lastly the fact that they use
      variables derived at only one time point-time independent Cox models. Thus new
      statistical tools must be used to improve prediction of survival in individual
      patients with PBC in order to optimize timing of liver transplantation. In
      addition a more precise definition of the natural history of both symptomatic and
      asymptomatic forms of this disease is needed to evaluate the efficacy of
      therapeutic agents in randomized clinical trials. However, although use and
      timing of therapeutic intervention, including liver transplantation, still
      requires good clinical experience and judgement, statistical modelling does give
      some objective measurement of prognosis, which is useful for the clinician
      treating patients with PBC. At the same time that new treatments are being
      evaluated, there is an obvious need to improve prognostic tools for application
      to individual patients with PBC. This may be achieved by using serial data in a
      different form of modelling-time dependent Cox models.

PMID- 1751822
TI  - Ambulatory 24-hour oesophageal pH monitoring in normal subjects: a multicentre
      study in Italy. G.I.S.M.A.D. GOR Study Group.
AB  - A multicentre study was performed in Italy in order to establish normal values
      for acid gastro-oesophageal reflux. In 73 healthy subjects 24-hour oesophageal pH
      measurements were carried out under standardized conditions. The hourly number of
      reflux episodes and oesophageal acid exposure was assessed and analyzed by means
      of a computerized system. The distribution frequency of both parameters was
      skewed to the left, thus exhibiting a non-normal pattern. Acid reflux was lowest
      during the night and highest after meals. The oesophageal acid exposure and the
      number of reflux episodes were correlated both over 24 hours and in the subsets
      studied. A good agreement was found with data from previous reports. Our findings
      should be helpful in establishing a data base for physiological gastro
      oesophageal reflux.

PMID- 1751823
TI  - Sulphydryl mediation in the protection of gastric mucosal cells in tissue culture
      by acetaminophen.
AB  - Acetaminophen protects gastric mucosa in vivo against acute drug-induced damage
      and has also been shown to protect gastric epithelial cells in vitro. Protection
      afforded by acetaminophen in vitro is not associated with increased prostaglandin
      output. The present study evaluated whether protection of gastric epithelial
      cells by acetaminophen in vitro may be mediated by endogenous sulphydryls.
      Monolayers from a well-differentiated human gastric epithelial cell line were
      studied. Sodium taurocholate was used as a damaging agent and cell damage was
      assessed by the 51Cr release assay. Acetaminophen dose-dependently protected
      gastric cell monolayers against damage induced by sodium taurocholate. The
      sulphydryl blocker iodoacetamide dose-dependently decreased the concentration of
      nonprotein glutathione and cysteine and counteracted the protection afforded by
      acetaminophen. This suggests that sulphydryl compounds may mediate the protection
      of gastric epithelial cells by acetaminophen in vitro.

PMID- 1751824
TI  - Measuring gastric PGE2 release in healthy and alcoholic subjects after ethanol
      stimulation.
AB  - The aim of this work was to study the effect of 20% and 40% ethanol, administered
      acutely, on gastric PGE2 release in normal subjects and alcoholics. Ethanol 20%
      did not modify the release of PGE2 into the gastric juice, whereas 40% ethanol
      increased PGE2 release only in healthy subjects. The basal PGE2 levels were
      higher in alcoholic patients.

PMID- 1751825
TI  - Animal models of hepatocellular carcinoma: hepadnavirus-induced liver cancer in
      woodchucks.
AB  - Woodchuck hepatitis virus (WHV), a member of the Hepadnaviridae, is closely
      related to hepatitis-B virus (HBV) in its virus structure, genetic organization,
      and mechanism of replication. As with HBV in man, persistent WHV infection is
      common in natural woodchuck populations and is associated with chronic hepatitis
      and hepatocellular carcinoma (HCC). Experimental studies have established that
      WHV causes HCC in woodchucks. Chronic WHV carriage as an outcome of experimental
      infection is a function of animal age at time of exposure, virus dose, and,
      possibly, virus strain. Almost all (97%) chronic carriers developed
      histologically confirmed HCC within 3 years while no HCC developed in uninfected
      animals held concurrently in the same laboratory setting. The model has
      application in the study of underlying mechanisms of hepadnavirus-induced
      hepatocarcinogenesis and to the development of prophylactic and therapeutic
      strategies of disease control.

PMID- 1751826
TI  - Endoscopy: simply a technical tool or an integral part of clinical diagnosis?

PMID- 1751827
TI  - Mirizzi's syndrome: a contraindication to coelioscopic cholecystectomy.
AB  - An impacted gallstone in the cystic duct with subsequent inflammation and edema
      resulting in extrinsic compression of the common bile or common hepatic duct with
      obstructive jaundice is known as Mirizzi's syndrome. An uncommon complication of
      cholelithiasis, Mirizzi's syndrome should be included in the differential
      diagnosis of any patient who has extrahepatic biliary obstruction. We present a
      case of a patient who underwent open rather than coelioscopic cholecystectomy
      based upon the preoperative diagnosis of Mirizzi's syndrome. A multidisciplinary
      approach to such patients facilitates the decision between open and endoscopic
      cholecystectomy. Mirizzi's syndrome may represent a contraindication to
      endoscopic cholecystectomy.

PMID- 1751828
TI  - [Focus on stromelysine-3].

PMID- 1751829
TI  - [Analytical limits in clinical pharmacokinetics: example of vinca-alkaloids].
AB  - The radioimmunoassays commonly used to quantify plasmatic levels of vinca
      alkaloids (VA) have a specificity primarily directed towards the catharantine
      moiety of the molecules. They do not authorize a specific quantitation of parent
      drug with regard to the degradation or metabolism products issuing from vindoline
      substitutions especially those at positions 2, 3 or 4. However, they do allow
      quantitation of levels as low as 0.05 ng/ml from a 100-microliters sample volume.
      On the other hand, the HPLC methods which permit the separation of the
      deacetylated metabolites DVLB and DNVB cannot be used below 1 or 0.5 ng/ml of VA
      and require a 1-ml sample volume. These HPLC assays whose sensitivity is limited
      are less suitable for clinical VA pharmacokinetics than RIA but are essential for
      investigation of metabolism of these drugs both in animals, cellular and
      subcellular models. The quantitation of circulating VA levels during the apparent
      terminal elimination phase, which is essential for calculating the elimination
      half-life and clearance is still not fully accurate. This is because at these low
      levels estimated largely by RIA, cross-reactivity with a metabolite cannot be
      excluded.

PMID- 1751830
TI  - [Gangliosides and cancer].
AB  - Gangliosides are glycosphingolipids which contain neuraminic acid. Although they
      are present in the plasma membranes of all cells, gangliosides are expressed
      differently, both quantitatively and qualitatively, in certain types of cancer.
      Modifications in ganglioside composition may account for some of the abnormal
      interactions between these tumor cells and their environment. Furthermore, some
      of the gangliosides are shed by tumor cells and may modify host immunity, thus
      contributing to the development of tumors. In cases of melanoma and
      neuroblastoma, the modifications in ganglioside expression are such that
      gangliosides may be used both as tumor markers and as targets for immunotherapy.

PMID- 1751831
TI  - [Prolymphocytic leukemia].
AB  - Prolymphocytic leukemia is an entity characterized by morphologic, immunologic,
      clinical and behavioral features which allows its keeping apart from chronic
      lymphoid leukemia. Careful analysis of blood smear is the main step for its
      diagnosis. Our purpose is to remind this particular chronic lymphoproliferative
      syndrome which requires energetic initial treatment. Prolymphocytic leukemia de
      novo as well as a possible transformation of chronic lymphoid leukemia to
      prolymphocytic leukemia are discussed.

PMID- 1751832
TI  - [Suramin inhibits the proliferation and stimulates the differentiation of tumoral
      cell lines HT29-D4 and C6].
AB  - Suramin is an anti-helminthic drug that has been shown to antagonize the effects
      of a variety of growth factors including EGF, PDGF and TGF beta. When added to
      the culture medium, suramin inhibited the proliferation of both human colonic
      adenocarcinoma cells HT29-D4 and rat glioma cells C6. Suramin also induced the
      differentiation of both cell lines: appearance of cellular extensions for C6
      cells, enterocyte-like epithelial differentiation for HT29-D4-cells. In the
      latter case, suramin probably acts at the level of glucose metabolism, which is
      likely to be modulated by autocrine growth factors. The permanent secretion of
      such factors probably stimulates HT29-D4 proliferation and simultaneously
      inhibits their differentiation. It is hypothesized that interfering with this
      autocrine loop, suramin allows HT29-D4 cells to differentiate.

PMID- 1751833
TI  - [Prognosis of operable breast cancers in women aged under forty years].
AB  - The present study is based on the data of a homogeneous series of 736 women with
      stage I and II operable breast cancer. The same methodology was used for
      treatment and follow-up. Eighty-seven patients were under 40 and 649 between 40
      and 70 years ols. No statistical difference was noted between the distribution in
      these 2 groups regarding tumor size, the axillary or internal mammary nodal
      status or hormonal receptor levels. Small tumors were noted more frequently in
      the under 40 yr group. Overall survival was the same in both groups,
      independently of tumor size, axillary nodal status or hormonal receptors. Disease
      free survival differed between the 2 groups: local relapse risk was 1.6 times
      higher for women under 40 yr, in relation to a higher frequency of conservative
      treatment in this group. No difference was noted for DFS in relation a tumor
      size, axillary nodal status of hormonal receptors.

PMID- 1751834
TI  - [Chemotherapy with cisplatin and 5-fluorouracil in inoperable brain metastases of
      bronchopulmonary cancers].
AB  - Chemotherapy is not a common treatment for cerebral metastases. The authors
      report results of combination chemotherapy with cisplatin (CDDP) and fluorouracil
      (5-FU). Sixteen men (age range 31-73 years) with brain metastases were treated
      with CDDP 20 mg/m2/day in continuous infusion for 5 days (d 1-5) and 5-FU 1
      g/m2/day in continuous infusion for 4 days (d 1-4), and the treatment schedule
      repeated every 3 weeks. A brain computerized tomography after 2, 4 and 6 cycles
      was performed to assess efficacy. It was considered that complete response was
      achieved if no lesion was found on the CT scan, and partial response if at least
      half of the total volume had decreased. After 2 cycles, the response rate was
      therefore 8/16 (50%). Treatment toxicity was very mild with only 1 case of severe
      but reversible myelotoxicity (grade III). It is concluded that chemotherapy
      combination with CDDP and 5-FU is a useful treatment for brain metastasis of lung
      carcinoma.

PMID- 1751835
TI  - [Cisplatin, adriamycin and mitomycin-C in advanced stomach cancer].
AB  - Eighteen patients with advanced gastric cancer were treated with cisplatin 80
      mg/m2 d 1, doxorubicin 30 mg/m2 d 3 and mitomycin-C 12 mg/m2 d 3. One complete
      and 6 partial responses were observed in 17 evaluable patients (41%, confidence
      interval 17-65%). Median duration of response was 7 months; median survival was 8
      months. One death due to toxicity was observed. This combination of 3 active
      drugs should not be recommended in cases of gastric cancers.

PMID- 1751836
TI  - [Untested treatments in "Cancer ward" by A. Solzhenitsin].

PMID- 1751837
TI  - Measurement of interleukin 1 alpha and 1 beta (IL-1 alpha and IL-1 beta) in human
      cystic lesions of the jaw. Implications for the pathogenesis of radicular cysts.
AB  - Human radicular cystic tissue of jaws was found to contain between 0.823 pg/mg to
      18.026 pg/mg interleukin 1 beta and from 0.34 pg/mg to 0.708 pg/mg interleukin 1
      alpha. No IL-1 beta and alpha could be found in specimens from healthy patients.
      A finding which may be extremely relevant in cystic growth and episodes of
      alveolar bone resorption around the cystic lesion.

PMID- 1751838
TI  - Analysis of pH variation of various calcium hydroxide compounds in vitro.
AB  - Among the reasons for the use of calcium hydroxide products, there is their
      alkalinity. Variations in the alkalinity of six commonly used calcium hydroxide
      compounds were studied in vitro at different time intervals. All these compounds
      rendered the saline solution strongly alkaline. Dycal, Life, Nucap and Reocap,
      had a weaker effect as compared with Contrasil and to Pulpdent paste. Such
      differences in the pH values were accompanied by differences in calcium loss, as
      revealed by scanning electron microscopy. Differences in the alkaline pH values
      and calcium losses among these calcium hydroxide compounds may account for their
      different clinical effectiveness in vivo.

PMID- 1751839
TI  - Lectin histochemistry in the developing oto-maxillo-facial primordia of the mouse
      embryo.
AB  - The binding sites of several lectins (Con-A, SBA, WGA, PNA, RCA-I, UEA-I, DBA)
      were studied in the different tissues involved in mouse visceral cephalogenesis.
      As compared to various other lectins which have only a weak affinity for
      precartilaginous rudiments, PNA preceded by neuraminidase treatment shows a very
      strong fixation in the precartilaginous blastemata and their immediate
      environment. PNA receptors exist also on the enamel epithelium and mesenchymal
      sac. RCA affinity for blood vessels has also enabled detailed observations on the
      vascularization of the palatal shelves, particularly in area 3. Various other
      localizations have been described and correlated with other histochemical data.

PMID- 1751840
TI  - [The relations of the mandibular canal with the outer surfaces of the body of the
      mandible and the risks which arise from its injury].
AB  - The investigations of relations and position of the mandibular canal (CM) were
      carried out on 80 mandibles (33 dentulous, 27 partly edentulous and 20 completely
      edentulous). The studies of relations of CM to the sides of mandibular body were
      accomplished by morphometric analysis of CM on consecutive transversal sections
      of mandibular body (54 preparations). The relation of the CM to be buccal or to
      the lingual side is expressed as the distance from the surface of the
      correspondent side of the mandibular body, which is shown in Table 1. According
      to these data, the position of the canal is at first proximate to the lingual
      side, and from the first molar tooth (M1) it approaches the buccal surface of the
      mandibular body. The position of the entire CM was determined by analysis of
      mandibular preparations (26) after removing the buccal osseous lamina. These
      investigations revealed that the position of the CM is predominantly buccal.
      Reconstruction of relations of the CM to the sides of mandibular body, according
      to the data obtained from transversal sections, and the real position of the CM
      are presented in Scheme I. The difference in direction lines of relations and of
      predominant position of the CM is a consequence of morphological characteristics
      of mandibular body.

PMID- 1751841
TI  - Crystal growth on enamel in relation to acid etching.
AB  - Crystal formation may occur during etching of enamel surfaces with phosphoric
      acid. In this in vitro study we observed, from a morphological standpoint, some
      crystals left after etching, on the surfaces, using the scanning electron
      microscope. More often, after water-spraying, a thin generalized precipitate
      remains on the surface. This precipitate may be harmful for the retention of
      composite resins. On few specimens we obtained needle-shaped or petal-like
      crystals. Crystal deposits were spread evenly, on the surface, or nucleated from
      different points. We tempted to identify these crystal formations by X-ray
      diffraction and microprobe analysis. Chemical identification seems very important
      because calcium phosphates solubility varies. Crystal dissolution in saliva can
      lead to marginal leakage and impairs the quality of esthetic restorations. On the
      contrary insoluble crystals may ensure microscopic retentions and crystal growth
      is now considered as an alternative for enamel pretreatment in bracket bonding.
      Crystal formation, in these first experiments, is too scarce to be used for
      crystal bonding. But it appears that two factors may enhance the crystal number:
      a preliminary topical application of fluoride and adsorption of an acidic
      protein, on the surface, before etching. However, further investigations are
      still necessary.

PMID- 1751842
TI  - Meta-analysis in aid of alcohol studies.

PMID- 1751843
TI  - Tobacco and the European common agricultural policy.
AB  - The common agricultural policy of the European Community subsidizes tobacco
      production to the tune of 1,300 million ecu a year (US$ 1,500 million, UK pounds
      900 million). This amounts to 2,500 ecu ($3,100, pounds 1,700) per minute, and is
      more in one year than the total amount spent on tobacco subsidies by the US in
      the last 50 years. The purpose of this policy was to maintain farmers' incomes
      and adapt community production to demand. Demand for the dark tobaccos which
      dominate EC production has fallen, while demand for light flue cured tobacco like
      Virginia has risen. A complex system of production subsidies and quotas was
      intended to discourage production of the dark tobaccos, for which there is
      virtually no market, and lead to more Virginia production. The policy has failed.
      Expenditure has spiralled out of control, production of unmarketable tobacco
      varieties has risen enormously, and the EC is the world's largest importer of raw
      tobacco. As a result tobacco is being bought by the community for intervention
      storage and surpluses of the dark high tar varieties are being 'exported' to
      eastern Europe and north Africa at giveaway prices. There has been no effective
      monitoring or control of this policy. This paper explains how this has happened
      and argues that, in view of the health risks attached to tobacco, these subsidies
      should be abolished.

PMID- 1751844
TI  - An integrated approach to meta-analysis in alcohol studies.
AB  - The research design and methods utilized by the Collaborative Alcohol-Related
      Longitudinal Project are described. The project design addresses the critical
      need to develop procedures to assess the replicability of research results in
      alcohol studies. Key features of the research plan include: re-analysis of
      original data from multiple longitudinal studies of drinking behavior in the
      general population; centralization of all data analyses, developed and
      implemented by an interdisciplinary core staff; development of the research plan
      and interpretation of results in co-operation with original investigators of
      studies included in the project; and use of modeling procedures from meta
      analysis to quantify the relative contribution of factors influencing the
      distribution of effect estimates across studies, including both methodological
      differences and aggregate level variables. The final section describes
      statistical methods for meta-analysis used by the project, including procedures
      for the calculation and combination of estimates of effect magnitude, categorical
      and continuous modeling procedures for use with effect sizes, and random effects
      models.

PMID- 1751845
TI  - Coherence of the dependence syndrome in cocaine users.
AB  - The method of diagnosing drug dependence introduced in DSM-III-R is largely
      untested for drugs other than alcohol. Cocaine, unlike alcohol, lacks clearly
      identifiable withdrawal symptoms, yet is also considered highly addictive. Can
      criteria derived from the dependence syndrome concept be generally applied to
      treatment seeking cocaine users? To evaluate the coherence of the dependence
      syndrome elements for cocaine, factor analysis models are applied to the nine
      dichotomous DSM-III-R drug-dependence criteria derived from structured clinical
      interviews with 399 cocaine users. A single factor model, in which both the
      centrality and severity of each criteria were assessed, adequately describes the
      criteria and supports the coherence of the dependence syndrome concept for
      cocaine. Pre-occupation was the most central criterion in defining cocaine
      dependence. However, avoiding withdrawal through the use of other drugs measured
      the most severe level of drug dependence. Inability to stop using the tolerance
      were only minimally related to the measurement of cocaine dependence.

PMID- 1751846
TI  - Estimating drug consumption in opioid users: reliability and validity of a
      'recent use' episodes method.
AB  - The efficient and accurate measurement of recent drug use is an essential
      component of treatment and research among opioid users. Urinalysis results alone
      will not give sufficient information to either the clinician or researcher, due
      to limitations in detection and an inability to distinguish extent of use. The
      present paper describes a 'recent use episodes method', adapted from the
      measurement of alcohol consumption, for obtaining self-reported drug use in
      eleven different drug categories. Reliability and validity data indicate that the
      method provides a quick means by which accurate information may be obtained on
      the overall recent drug use of opioid users.

PMID- 1751847
TI  - A scale for estimating the health status of opioid users.
AB  - The health status of injecting drug users has both clinical and research
      relevance. In order to evaluate the impact of treatments for opiate dependence on
      drug users' health status we need valid and reliable instruments which are short
      and easily administered by non-medical personnel. This paper describes the
      construction of a brief interviewer administered scale for assessing the current
      health status of injecting drug users. Data evaluating its reliability and
      validity are presented which indicate that the scale has excellent psychometric
      properties.

PMID- 1751848
TI  - Public support for warning labels on alcoholic beverage containers.
AB  - Warning labels are now required on alcohol beverage containers in the United
      States. Prior to the enactment of the warning label law, a random sample of
      adults in the general population of the United States were interviewed by
      telephone to assess baseline knowledge and support for the warning labels (n =
      2006). This paper proceeds on the assumption that public support is crucial for
      sustained success of alcohol control policies such as the warning label mandate.
      We found that a vast majority (87%) of the respondents felt that alcoholic
      beverages should have warning labels about possible health hazards, with
      abstention as the most significant predictor of support. A majority of the
      respondents also felt that alcohol education, server intervention, treatment and
      counter-advertisement programs should be increased. A large minority felt that
      alcohol taxes should be increased store hours should be decreased, and the legal
      drinking age should be increased. Most respondents agreed that warning labels
      would not have much effect on heavy drinkers. When compared to responses to
      similar questions about alcohol control policies over the past 20 years, evidence
      supporting a conservative trend towards alcohol in the United States was found.

PMID- 1751849
TI  - Problem drinking and family history.
AB  - Data on SADQ, GHQ, disciplinary, financial and relationship problems were
      collected from 103 problem drinkers and 96 controls. Problem drinkers were
      significantly more severely affected than controls on all measures except
      financial problems. Of the problem drinkers, 55% had a positive family history,
      and this group were more severely affected on SADQ, GHQ and financial problem
      measures than family history negative subjects. The most severely affected group
      were those with a positive family history who also reported significant childhood
      problems, and the least affected were those without a family history who did not
      report significant childhood problems.

PMID- 1751850
TI  - Tobacco advertising restrictions, price, income and tobacco consumption in OECD
      countries, 1960-1986.
AB  - Factors affecting tobacco consumption per adult in 22 countries of the OECD
      between 1960 and 1986, were studied using pooled cross-section time-series
      analysis. The resulting log-linear model was estimated using Generalized Least
      Squares. The severity of tobacco advertising restrictions in each country and
      year was scored from published legislation and information from health agencies.
      Tobacco advertising restrictions have since 1973 increasingly been associated
      with lower tobacco consumption. Lower consumption levels were also associated
      with higher real tobacco prices, and with increased female labour force
      participation. Higher levels of consumption were associated with higher per
      capita real income and with a larger fraction of tobacco consumed as manufactured
      cigarettes. The model explains 99.5% of the variance in the average annual level
      of tobacco consumption across these countries. Ten-fold differences in purchasing
      power for tobacco products were found across the countries and years studied. In
      all countries tobacco products became more affordable between 1960 and 1986. In
      1986 either a 36% inflation-indexed increase in real tobacco prices, or
      legislation to end tobacco promotion in those countries without a total ban,
      would have lowered average consumption by 6.8% and both together, by 13.5%.
      Across the OECD, if in 1986 all governments had raised tobacco product prices
      relative to income to Irish levels, and had banned all tobacco promotion, tobacco
      products consumption per adult would have fallen by 40% in that year.

PMID- 1751851
TI  - HIV and human rights.

PMID- 1751852
TI  - HIV infection in London.

PMID- 1751853
TI  - Personality disorder in perspective.
AB  - Personality disorders have for many years been on the fringe of psychiatry, with
      considerable doubts expressed about the usefulness, implications and validity of
      the concept. It is argued here that developments in the past few years have
      brought personality disorders into the mainstream of psychiatric practice. In
      particular, the recognition that personality function can be separated usefully
      from clinical symptoms, and that both mental state and personality can be
      disordered simultaneously, has led to better assessment and understanding.
      Advances in the classification, epidemiology, treatment and prognosis of
      personality disorders show that these conditions are common, extensive in their
      pathology, and cause much suffering. They cannot be ignored or dismissed as
      peripheral to psychiatry for they are an essential part of good psychiatric
      practice.

PMID- 1751854
TI  - Delusional memories: first-rank symptoms?

PMID- 1751855
TI  - Some aspects of family interventions in schizophrenia. I: Adherence to
      intervention programmes.
AB  - Although family intervention programmes to instruct relatives in management and
      coping skills are often effective in reducing schizophrenic relapse, many
      families either fail to be engaged or withdraw from treatment at an early stage.
      Some possible reasons for this are described and some suggestions for increasing
      adherence are made. Adherence with interventions may be viewed as a complex
      behaviour pattern, and factors increasing or decreasing the probability of such
      behaviour occurring and being maintained can and should be investigated to
      maximise the clinical potential of family intervention programmes.

PMID- 1751856
TI  - Some aspects of family interventions in schizophrenia. II: Financial
      considerations.
AB  - The direct costs to the mental health services for patients who participated in a
      trial of a behavioural family intervention to reduce schizophrenic relapse were
      estimated. Comparisons were made between two patient groups from households of
      high expressed emotion (HEE): one group received a nine-month family intervention
      (HEE Intervention) and the other group routine treatment (HEE Control). A third
      group consisted of patients from low-EE households (LEE Control). The significant
      decrease in relapse rates in the HEE Intervention group compared with the HEE
      Control group has previously been reported; the analysis of costs indicates that
      any increase in costs due to the family intervention is outweighed by a decrease
      in usage of the established mental health services. The intervention resulted in
      a decrease of 27% in mean cost per patient.

PMID- 1751857
TI  - Schizophrenia, bipolar disorder and depression. A discriminant analysis, using
      'lifetime' psychopathology ratings.
AB  - Discriminant and canonical variate analyses were performed using 302 patients, on
      whom ratings of lifetime psychopathology and course of illness has been made. DSM
      III diagnoses were used to form the criterion groups. Bipolar disorder emerged as
      a distinct grouping, but there are reasons for dissatisfaction with its
      definition. The remaining patients formed a 'schizodepressive continuum', but
      this also had a tendency to bimodality. It is possible that the distinction
      between schizophrenia and depression was obscured by inadequacies in the data and
      the inclusion of excessive numbers of patients with schizoaffective depression in
      this study.

PMID- 1751858
TI  - Negative symptoms in chronic schizophrenia. Relationship to duration of illness.
AB  - The frequency and distribution of negative symptoms in a sample of 40 patients
      admitted to hospital with RDC-definite schizophrenia were examined. There was a
      highly significant positive correlation between negative symptom scores obtained
      using three different rating scales, but the presence of negative symptoms was
      not significantly related to duration of illness or number of episodes of
      illness. These findings do not support a model of negative symptoms being the
      consequence of schizophrenic relapse, but are in favour of their being an
      integral component of the schizophrenic syndrome, as salient in the first as in
      later episodes.

PMID- 1751859
TI  - Douglas House. Seven years' experience of a community hostel ward.
AB  - Of 24 residents of a ten-bed, community-based hostel ward suffering chronic
      psychiatric illness, nine have been resettled in the community, with four more
      expected to follow them. Five residents have made Douglas House their home but
      another six have manifested behavioural disturbance necessitating return to
      hospital wards. We found community discharge to be associated with illnesses
      having good prognostic features, while organic illness militated against such
      placement. Indicators of a prior history of behavioural disturbance seem to
      predict difficulties in managing a patient in this environment.

PMID- 1751860
TI  - Sleep electroencephalography in depressive illness. A collaborative study by the
      World Health Organization.
AB  - Eight WHO research centres from Europe, North America and Asia took part in a WHO
      study aimed at assessing the reliability and consistency of sleep-EEG
      abnormalities in major depression. Each centre was asked to include in the study
      ten depressed patients aged 20-65 years meeting the Research Diagnostic Criteria
      for a major depressive disorder, and to match them by age and gender with ten
      controls. There were 67 patients and 66 controls included in the study. Compared
      with controls, depressed patients showed sleep-continuity disturbances such as
      increase in sleep-onset latency, and decrease in total sleep time and in sleep
      efficiency. Stages 2 and 3, as percentages of total sleep time, were reduced in
      depressed patients, REM latency was shortened and REM density increased. These
      findings confirm the presence of specific sleep-EEG abnormalities in major
      depression.

PMID- 1751861
TI  - Suicide among adolescents in Greece.
AB  - The mean suicide rate among 10-19-year-olds in Greece from 1980 to 1987 was
      0.98/100,000 per year (male 1.07, female 0.89). Girls and boys demonstrated the
      greatest suicide rate at 16 and 19 years, respectively. The combined suicide rate
      was significantly higher in the rural areas (1.48) than in Athens (0.48) and the
      other urban areas (0.98). Boys committed suicide more frequently than girls in
      Athens and other urban areas, whereas girls did so in the rural areas. The
      suicide rate declined during the last three years of the study. Differences in
      the methods used and the reported reasons for suicide were observed among the
      adolescents in Athens, other urban areas, and the rural areas. Greek adolescents
      appear to be relatively protected from suicide, particularly those who live in
      the urban areas.

PMID- 1751862
TI  - Psychiatric manifestation of systemic lupus erythematosus in Singapore. A cross
      cultural comparison.
AB  - In a case-control, cross-cultural study of the psychiatric morbidity of systemic
      lupus erythematosus in an Oriental population, 30 patients suffering from SLE and
      29 controls with rheumatoid arthritis were interviewed. The SLE patients in
      Singapore exhibited greater psychiatric morbidity than their Western
      counterparts. Significant correlation was observed between psychiatric morbidity
      and the clinical disease activity. The patient's perception of the severity of
      arthritis, myalgia and dermatological lesions was an important aetiological
      factor. Culturally determined, disease-related psychological stresses also
      contributed to the psychopathology.

PMID- 1751863
TI  - A family with multiple instances of definite, probable and possible early-onset
      Alzheimer's disease.
AB  - A family with a multigenerational history of proven or suspected early-onset
      Alzheimer's disease (AD) consistent with autosomal-dominant inheritance is
      described. To date, the pedigree comprises five generations in which there are 13
      known affected individuals. The mean age of onset of cognitive deficits in those
      for whom data are available (n = 11) is 47.6 (s.d. 3.0) years and the mean age of
      death (n = 10) is 58.8 (s.d. 4.0) years. The variability in the extent and
      quality of available data illustrates the diagnostic difficulties encountered in
      ascertaining such an extended pedigree, and the need for caution in interpreting
      the evidence.

PMID- 1751864
TI  - Phobic disorders in the elderly.
AB  - Sixty confirmed cases of phobic disorder identified in an urban elderly community
      sample were compared with 60 controls matched pairwise for age and sex. Cases
      reported higher rates of specific and non-specific neurotic symptoms, and all
      were assigned to a diagnostic CATEGO class, compared with seven of the controls.
      A past history of chronic psychiatric disorder other than phobia was commoner in
      the cases. Most cases had more than one fear; agoraphobic main fears were
      predominantly of late onset and associated with moderate to severe social
      impairment, whereas specific main fears were associated with early onset and
      minimal social impairment. The onset of agoraphobic fears in old age was
      attributed by most cases to an episode of physical illness or other traumatic
      event. Increased rates of palpitations, dyspnoea, giddiness and tinnitus not
      attributable to anxiety were identified in the cases. Cases did not differ from
      the controls in socio-economic status, or in the number or quality of current
      intimate confiding relationships, but they reported higher rates than controls of
      parental loss before the age of 18 years. Cases reported higher rates of contact
      with general practitioners, but only one was in contact with psychiatric services
      at the time of interview. Cases also reported receiving more help in personal
      care from family members.

PMID- 1751865
TI  - Causal attributions and psychiatric symptoms in survivors of the Herald of Free
      Enterprise disaster.
AB  - The aim of the present study was to explore the relationship between causal
      attributions and psychiatric symptoms in those who survived the capsizing of the
      Herald of Free Enterprise ferry, two years following the disaster. Internal and
      controllable attributions for disaster-related experience are strongly related to
      poorer psychological outcome.

PMID- 1751866
TI  - Reactions of police officers to body-handling after a major disaster. A before
      and-after comparison.
AB  - This study reports the results of an unusual opportunity to follow up a group of
      police officers who were involved in body-handling duties following the Piper
      Alpha disaster, and for whom there were available data from pre-disaster
      assessments. In addition, after these duties, the officers were compared with a
      matched control group of officers who had not been involved in such work. The
      comparisons failed to demonstrate high levels of post-traumatic distress or
      psychiatric morbidity. The results are interpreted in terms of issues such as the
      officers' own coping strategies, and major organisational and managerial factors.

PMID- 1751867
TI  - The 1978 Italian mental health law--a personal evaluation: a review.
AB  - "The author discusses the sociopsychiatric consequences of the 1978 Italian
      mental health law. He also reviews the international scientific ideas that led up
      to it. The sociopolitical psychiatric views of the late Franco Basaglia, pioneer
      of the change in the mental health system of the Italian Republic, are described.
      Statistical reports and critical analyses are reported. Objective data, based on
      the author's personal experience as a practising psychiatrist in Rome, Italy,
      from 1969 to 1987, are given."

PMID- 1751868
TI  - The prevalence of eating disorders in recently admitted psychiatric in-patients.
AB  - Of 107 recently admitted psychiatric patients screened for eating-disorder
      symptoms by questionnaire, 17% met DSM-III-R criteria for eating disorders. Eight
      patients (one male) had bulimia nervosa. Ten patients had eating disorder not
      otherwise specified: seven (three male) bulimic type, and three (one male)
      anorexia nervosa type. The most common concurrent diagnoses were mood and
      personality disorders. As eating-disorder symptoms are relevant to the diagnosis
      and management of other psychiatric disorders they should be assessed routinely
      in all psychiatric patients.

PMID- 1751869
TI  - Effect of caffeine intake on psychotic in-patients.
AB  - Psychotic in-patients who consume caffeine may present complications in the
      course of their illness. Two cases are described which illustrate the clinical
      profile of such patients, whose caffeine-associated complications are often
      misdiagnosed.

PMID- 1751870
TI  - Recurrence of puerperal psychosis during late pregnancy.
AB  - Two cases of pre-partum psychosis are described. Both patients had previous
      episodes of puerperal psychosis but no non-puerperal illnesses. The possible
      relationship of pre-partum and post-partum psychosis is discussed.

PMID- 1751871
TI  - Psychotropic drug use in medical and surgical wards of a teaching hospital in
      northern Nigeria.
AB  - The overall prescription rate of psychotropic drugs in a Nigerian teaching
      hospital was 33.1%. This was slightly higher among surgical than medical
      patients. It is suggested that more attention needs to be paid to psychotropic
      drug education in developing countries in order to ensure a more rational use of
      these drugs.

PMID- 1751872
TI  - Neuroleptic malignant syndrome secondary to loxapine.
AB  - Loxapine was introduced to the British market two years ago although it has been
      used in North America for eight years. We report the first probable case of
      neuroleptic malignant syndrome (NMS) secondary to loxapine in Britain. Two
      previous cases have been reported in North America (manufacturer's data).

PMID- 1751873
TI  - Suspicion of somatoform disorder in undiagnosed tabes dorsalis.
AB  - We present a case of tabes dorsalis, which consisted of intermittent, sharp pains
      and diffuse neurological abnormalities, and was initially considered to be a
      somatoform disorder. The unusual behavioural presentations of neurosyphilis may
      lead to premature psychiatric diagnoses. It is thus important that psychiatric
      consultants be aware of the myriad manifestations of the disease.

PMID- 1751874
TI  - Sleep-loss as a possible mediator of diverse causes of mania.
AB  - When sleep duration and mood were monitored longitudinally in a 59-year-old woman
      with bipolar illness, sleep loss appeared to mediate the triggering of mania by
      psychosocial and pharmacological precipitating factors. This interpretation was
      supported by observations that mania could repeatedly be induced experimentally
      by depriving her of sleep for one night. The patient's data illustrate how sleep
      loss might be a preventable cause of mania in a variety of situations.

PMID- 1751875
TI  - Money hidden and rediscovered in subsequent manic phases. A case of action
      dependent on mood state?
AB  - A manic-depressive patient hid 3000 pounds during one manic phase and
      subsequently, when his mood stabilised, could not remember where he had hidden
      it. He found the money during a subsequent manic phase a few months later. We
      suggest that this is not a clear case of state-dependent memory, since the
      patient at no point explicitly recollected where he had hidden the money. Instead
      we suggest that this represents state-dependent action. The links between this
      case and previous research on state-dependent memory are outlined.

PMID- 1751876
TI  - Withdrawal from heroin and methadone.

PMID- 1751877
TI  - Psychogenic amnesia?

PMID- 1751878
TI  - Portrayal of women in advertisements.

PMID- 1751879
TI  - Winnicott's contribution.

PMID- 1751880
TI  - Incidence rates of schizophrenia.

PMID- 1751881
TI  - Ethnic nomenclature.

PMID- 1751882
TI  - Pathological jealousy defined.

PMID- 1751883
TI  - Access to health records.

PMID- 1751884
TI  - Anorexia nervosa in Asian children.

PMID- 1751885
TI  - The clinical application of restricted environmental stimulation therapy (REST):
      observations of a psychiatrist.

PMID- 1751886
TI  - Is oncogene activity involved in the alcohol withdrawal syndrome?

PMID- 1751887
TI  - Politically motivated suicides.

PMID- 1751888
TI  - NMS and genetic drug oxidation.

PMID- 1751889
TI  - Reading about ... sex therapy.

PMID- 1751890
TI  - Underwater medicine: a neglected area in Accident and Emergency specialist
      training.
AB  - We have evaluated the available medical care to sports divers by a postal
      questionnaire sent to consultants and senior registrars in Accident and Emergency
      medicine in the UK, assessing their training in underwater medicine. Replies were
      received from 60 of 96 consultants (63%) and 32 of 58 (55%) senior registrars.
      Thirty-two per cent of consultants and 50% of senior registrars had previous
      personal experience in managing an underwater diving accident. Thirty per cent of
      consultants and only 19% of senior registrars had prior formal postgraduate
      training in underwater medicine. Twenty-seven per cent of consultants and 13% of
      senior registrars replying did not know the pattern of referral for specialist
      advice nor where the nearest recompression chamber was to be found. We believe
      that more formal postgraduate training in underwater medicine is needed by A and
      E medical staff. Furthermore, clear guidelines about emergency management and
      patterns of referral for diving accidents should be displayed prominently in all
      A and E departments.

PMID- 1751891
TI  - Hazards of horse-riding as a popular sport.
AB  - The increasing incidence of horse-riding accidents, which are often severe in
      nature, prompted a pilot study of a questionnaire designed to elucidate the cause
      of such accidents. It was hoped that, on a larger scale, the information gleaned
      would highlight possible preventative measures which might improve the safety of
      an important recreational pursuit enjoyed by young and old from many walks of
      life. A retrospective study of riders sustaining serious spinal injuries admitted
      to Stoke Mandeville Hospital was compared with riders sustaining minor but
      significant injuries as the accidents came to the attention of the authors. The
      detailed analysis paid particular attention to the setting and to the experience
      and task of horse and rider. It was found that 70% of the 20 accidents could be
      thought attributable to the behaviour of the horse at the time, and seven of
      these were in the spinal injuries group. Rider error was a significant
      contribution in seven cases, and in two instances the rider was under instruction
      at the time. There was also inadequate experience of the rider in seven cases, of
      which five were thought to show inadequate supervision. The limited number of
      cases studied precludes significant observations, but, as the majority of
      accidents seemed preventable, a larger study has been initiated in collaboration
      with the British Horse Society.

PMID- 1751892
TI  - Sports clinics and hospital trusts.

PMID- 1751893
TI  - Human chorionic gonadotrophin and sport.
AB  - Human chorionic gonadotrophin (hCG) is a glycoprotein hormone which is produced
      in large amounts during pregnancy and also by certain types of tumour. The
      biological action of hCG is identical to that of luteinizing hormone, although
      the former has a much longer plasma half-life. Some male athletes use
      pharmaceutical preparations of hCG to stimulate testosterone production before
      competition and/or to prevent testicular shutdown and atrophy during and after
      prolonged courses of androgen administration. Testosterone administration can be
      detected by measuring the ratio of concentrations of testosterone to
      epitestosterone (T/E). An athlete is often considered to have failed a drug test
      if the urinary T/E ratio is greater than 6. In contrast, hCG administration
      stimulates the endogenous production of both testosterone and epitestosterone
      without increasing the urinary T/E ratio above normal values. Although the
      administration of hCG was banned by the International Olympic Committee (IOC) in
      1987, no definitive test for hCG has been approved by the IOC. Currently, the
      only way of measuring small concentrations of hCG is by immunoassay, and this
      does not have a discriminating power as great as gas-liquid chromatography with
      mass-spectrometry which is necessary to satisfy IOC requirements. Extraction
      procedures and chromatographic steps could be introduced before using a selected
      immunoassay for hCG to meet these requirements.

PMID- 1751894
TI  - Protecting the sportsman's brain (concussion in sport). Annual guest lecture
      1990, London Sports Medicine Institute.

PMID- 1751895
TI  - Ice hockey injuries: incidence, nature and causes.
AB  - In this prospective study, we have investigated incidence of injuries of
      different severity, types of injury, and mechanisms of injury during ice hockey
      games. All twelve Swedish elite hockey teams were observed during the season 1988
      1989 when a total number of 664 games were played. There was a total number of
      285 injuries, of which the majority were minor (61%) and only 9% were classified
      as major. Seventy-four per cent of the injuries occurred during games and 26%
      during practice. The overall incidence of injury was 53.0 per 1000 player-game
      hours. Eighty-five per cent of injuries were caused by trauma and 15% by over
      use. Injuries were most often localized to the head/face (39%) or the lower limb
      (32%). Most injuries resulted from stick contact or player contact including
      checking. A reduction of minor and moderate injuries should be possible by
      stricter enforcement of the hockey rules, and more widespread use of visors.

PMID- 1751896
TI  - Factors affecting adherence of end-stage renal disease patients to an exercise
      programme.
AB  - Recently it has been shown that regular exercise is both physiologically and
      psychologically beneficial to patients with end-stage renal disease (ESRD).
      However, ESRD patients traditionally have a high non-adherence level to their
      self-care and medical regimens. To date, their adherence to exercise programmes
      has not been studied. Background information about employment, medical history,
      previous exercise habits and locus of control was obtained from 40 volunteer ESRD
      patients who started exercise at home. Twenty-eight participants maintained the
      exercise programme, consisting of aerobic activity lasting an average of 25 min,
      four times per week, for 12 weeks. The adherent patients were found to have
      encouraging support groups (75 versus 25%), to be between 41 and 60 years of age
      (64 versus 33%), to have been on dialysis for between 2 and 5 years, and to have
      loci of control (feeling of control over life events) classed as 'internal' (68
      versus 25%). Factors such as sex, race, employment status and depression were
      found to have little influence on adherence. The major finding of this study was
      that patients adherent to exercise could be distinguished by unique psychological
      and psychosocial factors, and that adherence in this population was higher (70
      compared with 50%) than some estimates for the general population.

PMID- 1751897
TI  - Meniscotibial ligament strains: a prospective survey.
AB  - Medial knee pain is an increasingly common presentation in sports medicine
      practice. A prospective review was undertaken of 72 patients, mean age 48 years,
      seen in 1986-1987. The physical findings which were most diagnostic were a loss
      of some degrees of flexion which was painful medially when forced, and tenderness
      over the posteromedial joint line. Treatment was either injection of local
      steroid, or physiotherapy, together with emphasis on quadriceps exercise. Five
      patients failed to respond and were referred for arthroscopy. Nine patients
      relapsed once but no subsequent episode has occurred. Meniscotibial ligament
      strain is a common cause of knee pain in middle-aged sports people.

PMID- 1751898
TI  - Comparison of clinical tests and the KT1000 in the diagnosis of anterior cruciate
      ligament rupture.
AB  - A prospective study was undertaken to compare the accuracy of the Lachman test,
      anterior drawer test and jerk test with the KT1000 knee arthrometer in patients
      with proven anterior cruciate ligament deficiency. The Lachman and anterior
      drawer tests were found to be the most accurate indicators of anterior cruciate
      ligament deficiency. The KT1000 knee arthrometer was found to be totally
      inaccurate, which precludes its use as an objective measure of anteroposterior
      laxity of the knee.

PMID- 1751899
TI  - Paragliding injuries.
AB  - Regulations controlling the sport of paragliding were issued in April 1987 by the
      German Department of Transportation. The growing popularity of this sport has led
      to a steady increase in the number of associated injuries. This study presents
      the incidence, localization and degree of injuries associated with paragliding
      documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218
      paragliders were documented in the period 1987-1989: 181 occurred during landing,
      28 during starting procedures and nine during flight. The mean patient age was
      29.6 years. There were 34.9% spinal injuries, 13.4% upper extremity injuries and
      41.3% lower limb injuries. Over half of these injuries were treated surgically
      and in 54 instances permanent disability remained. In paragliding the lower
      extremities are at greatest risk of injury during landing. Proper equipment,
      especially sturdy footwear, exact training in landing techniques as well as
      improved instruction in procedures during aborted or crash landings is required
      to reduce the frequency of these injuries.

PMID- 1751900
TI  - [Transcranial Doppler ultrasound].
AB  - Over the last decade, transcranial Doppler examination of the cerebral vessels
      has been made possible by the development of a high-intensity, low-frequency (2
      MHz) pulse probe. The middle, the anterior and the posterior cerebral arteries,
      the cavernous portion of the carotid artery and the basilar artery can thus be
      easily studied transtemporally or transorbitally or from below the foramen
      magnum. The transcranial Doppler examination is already used clinically to study
      arteriosclerosis and in the diagnosis and follow-up of vasospasm and
      arteriovenous malformations. This review describes the examination procedure and
      summarizes and illustrates its major indications.

PMID- 1751901
TI  - Computed tomography of the knee.
AB  - Although magnetic resonance imaging (MRI) has become the imaging technique of
      choice in Canada and elsewhere in the evaluation of knee disorders, magnetic
      resonance units are frequently unavailable, or access to them is greatly
      restricted. The authors have found that computed tomography (CT) can sometimes be
      successfully substituted for MRI as a noninvasive method for imaging a wide
      variety of knee disorders. This article reviews the CT appearance of normal knee
      anatomy and illustrates a wide variety of pathological conditions that can be
      successfully evaluated.

PMID- 1751902
TI  - Physician payment reform: issues for Canadian radiologists.
AB  - Policy decisions taken by the US Congress in the 1980s to restrain health care
      costs included the designation of diagnostic-related groups, the creation of
      scales of relative value and legislation to introduce free-for-service payment to
      physicians in 1992; discrepancies in the system are to be corrected by 1996.
      Under federal contract a system of resource-based relative-value scales was
      created for all medical disciplines except radiology, which by special
      legislation prepared its own experience-based relative-value scale. The scales
      are based on magnitude estimation of the work of physicians and analyses of
      actual costs. Codes for medical services have been published, which include a
      weighting for each service in relation to all others. Multiplication by a
      conversion factor establishes the fee to be paid by the carriers acting for the
      Health Care Financing Administration. The relative values will be updated every 5
      years. Publication of this information for US Medicare patients (the disabled,
      the elderly and those with end-stage renal disease) will likely have a profound
      effect on the physician payment system in Canada. Under the reformed system the
      lifetime earnings of all physicians will become more similar. Four problem areas
      are discussed in the paper: self-referral, administrative complexity, malpractice
      and the plight of those without medical coverage. Resolution of these problems is
      being actively sought.

PMID- 1751903
TI  - Panic disorder: vascular evaluation with transcranial Doppler ultrasonography.
AB  - Several recent studies have shown neurophysiologic and neuroanatomic
      abnormalities in panic disorder. This study aimed to assess by transcranial
      Doppler (TCD) ultrasonography the magnitude of the changes in blood flow during
      panic attacks induced by intravenous sodium lactate infusion. The subjects
      consisted of 30 patients with panic disorder (DSM-III-R) and 25 controls; all
      were between the ages of 18 and 40 years and were right-handed. The flow in the
      middle cerebral artery was recorded bilaterally before the infusion began (to
      provide baseline readings) and at 3-minute intervals during the infusion. The
      patients showed a more rapid acceleration of flow (p less than 0.05) than the
      controls. Higher maximal velocity and higher variations in velocity (p less than
      0.05) were observed in the patients sensitive to lactate but only in the right
      middle cerebral artery. These results suggest that abnormalities of local
      cerebrovascular autoregulation occurred in the patients with panic disorder
      during attacks induced by sodium lactate.

PMID- 1751904
TI  - Portable scanning slit device for obese patients.
AB  - A portable apparatus with rotating scanning slits has been designed to reduce
      scatter in the radiographs of obese patients. Rotating scanning slit radiography
      reduces scatter efficiently, but previous instruments with linear or curved slits
      have been too heavy to be portable. The author's "dart-board" pattern of multiple
      sector-shaped holes is theoretically efficient at reducing scatter, compensates
      for potential ring artifacts by overlapping the holes and expands the holes in
      the lower plate to account for penumbra. Computer simulation with Monte Carlo
      techniques shows that the new design is free of concentric ring artifacts. This
      design should improve the quality of radiographs of very obese patients.

PMID- 1751905
TI  - Optimization of prostatic magnetic resonance imaging technique.
AB  - With a 1.5-T magnetic resonance imager the authors systematically varied a large
      number of technical factors to obtain an optimum balance between high image
      quality and reasonable imaging time for the prostate gland. Each parameter was
      adjusted relative to benchmark images of very high quality to achieve a
      reasonable acquisition time with as little loss of the signal-to-noise ratio
      (SNR) as possible. Image quality was judged subjectively by magnetic resonance
      radiologists and objectively by measurements of SNR for the prostate. The authors
      recommend multislice, multiecho spin-echo pulse sequences with dual surface
      coils, fat suppression, reduced bandwidth, a repetition time of 1500 ms, echo
      times of 30 and 60 ms, a flip angle of 60 degrees, two excitations, a slice
      thickness of 5 mm with a 1.5-mm gap and 192 phase-encoding steps. The acquisition
      time for one such series was 9.6 minutes.

PMID- 1751906
TI  - Isolated colonic hemangioma in a child.
AB  - Hemangiomas of the large bowel are very rare and usually occur in the
      rectosigmoid. A large cavernous hemangioma of the colon was demonstrated in a 9
      month-old child who presented with recurrent lower gastrointestinal tract
      bleeding. Barium examination demonstrated an annular lesion of the hepatic
      flexure. Computed tomography demonstrated the extent of the lesion, and contrast
      enhancement suggested the vascular nature of the tumour before a laparotomy was
      performed to remove the tumour.

PMID- 1751907
TI  - Lingular opacity with an endobronchial mass.

PMID- 1751908
TI  - Restoration of the threadless Cope-Cook catheter.

PMID- 1751909
TI  - Dual technique for preoperative localization of nonpalpable breast lesions.
AB  - The combination of guide wire and dye techniques for preoperative localization of
      nonpalpable breast lesions is superior to either technique alone. The dye acts as
      a backup in the event of migration, transection or removal of the wire, which has
      occurred in 2 (1.3%) of 154 localizations of breast lesions at the author's
      institution.

PMID- 1751910
TI  - Residents' corner. Answer to case of the month #10. Malrotation of the small
      bowel with intermittent herniation and volvulus.

PMID- 1751911
TI  - Lacrimal canaliculoscopy: development of the instrument.
AB  - We have developed an endoscopic device for use in the lacrimal drainage system.
      The device employs a flexible, small-calibre fibreoptic cable that can easily
      negotiate the canalicular system. The device can be used in conjunction with a
      video camera and monitor for simultaneous viewing. The endoscope can be used
      alone for the diagnosis of lacrimal disorders. Possible future applications
      include laser treatment of lacrimal disorders.

PMID- 1751912
TI  - Retinal dialysis: lack of evidence for a genetic cause.
AB  - The author reviewed 150 cases of retinal detachment secondary to retinal
      dialysis. In 95 cases (63%) a definite history of ocular trauma was obtained. In
      91% of the 45 cases with superonasal, superotemporal or inferonasal involvement
      there was a history or evidence of blunt injury, compared with 63% of the 105
      cases with inferotemporal involvement. Review of the family history, eye
      examinations of close relatives and ophthalmoscopic follow-up of the fellow eye
      in the 35 cases of inferotemporal dialysis with no history or evidence of trauma
      ruled out a genetic basis for the dialysis. Forgotten or denied trauma or a
      nongenetic developmental anomaly were felt to be the cause of the dialysis in
      these cases.

PMID- 1751913
TI  - Cryopexy in pars planitis.
AB  - Cryotherapy has been reported to be of benefit in pars planitis. We studied 16
      eyes with classic pars planitis unresponsive to corticosteroid therapy. Eight
      eyes continued with systemic and periocular steroid therapy, and in the remaining
      eight eyes transconjunctival cryopexy of the peripheral retina and vitreous base
      was done as an additional procedure. At 6 months four of the eyes that received
      cryopexy showed an improvement in Snellen visual acuity, and in the other four
      the acuity was unchanged; none of the eyes showed any vitreous base
      neovascularization. Among the eyes that received steroid therapy only, the acuity
      was unchanged in five, improved in one and reduced in two.

PMID- 1751914
TI  - Ocular motor apraxia following cardiac surgery.
AB  - Ocular motor apraxia is characterized by a deficiency in the generation of
      voluntary saccadic eye movements despite the presence of spontaneous saccades. We
      report two cases of isolated ocular motor apraxia, both in children, that
      developed following cardiac surgery. Electro-oculography was done in one case and
      showed slow saccades and decreased pursuit gain. The authors review the
      neuroanatomic and neurophysiologic features relevant to supranuclear gaze
      mechanisms.

PMID- 1751915
TI  - Metastatic choroidal choriocarcinoma: a clinicopathological study.
AB  - A previously healthy 33-year-old woman presented with decreased vision and pain
      in her left eye. Funduscopic examination revealed a mass in the posterior pole of
      the eye, and chest radiography showed a lesion in the lower lobe of her left
      lung. The eye became painful and blind over 12 days and was enucleated. The
      tumour had the typical histopathological and immunohistochemical features of
      choriocarcinoma: sheets of cytotrophoblasts with pleomorphic nuclei and lacy
      cytoplasm intermingled with multinucleated syncytiotrophoblasts. The neoplastic
      cells stained positively for cytokeratin and the beta subunit of human chorionic
      gonadotropin (beta-HCG). The serum beta-HCG level was markedly elevated, at
      82,000 (normally less than 5) IU/L. The patient was treated with combination
      chemotherapy, and normal serum beta-HCG levels were obtained. Thirty months after
      presentation the serum beta-HCG level was normal and there had been no clinical
      evidence of recurrence. To our knowledge this is the second case of metastatic
      choriocarcinoma in the eye in which the ocular tumour caused the presenting
      symptom.

PMID- 1751916
TI  - Gastric linitis plastica metastatic to the uvea.
AB  - A 59-year-old man underwent total gastrectomy for diffuse, poorly differentiated
      gastric adenocarcinoma diagnosed as linitis plastica. Loss of vision in the right
      eye 5 months later due to extensive choroidal tumours was the first indication of
      metastatic disease. Radiologic studies showed multiple bony metastases. The
      blind, painful eye was enucleated. Pathological examination of the globe showed
      massive metastatic mucus-secreting adenocarcinoma of the choroid, with positive
      immunohistochemical staining for carcinoembryonic antigen (CEA) of the foci of
      the more highly differentiated neoplastic cells. The plasma CEA level had been
      normal. The patient died 3 months after enucleation from metastatic disease.

PMID- 1751917
TI  - Adenoma of the nonpigmented epithelium of the ciliary body.
AB  - A 56-year-old man presented with a left ciliary body mass, anterior vitreous
      hemorrhage and a subluxed, cataractous lens. The clinical course included rapid
      enlargement of the mass, anterior uveitis, cataract progression and secondary
      glaucoma. Investigation included fluorescein angiography, ultrasonography and
      computed tomography. The eye was enucleated because of progressive enlargement
      with poor vision and uncontrolled secondary glaucoma. Histopathological
      examination showed an adenoma of the nonpigmented ciliary epithelium with cystic
      areas of hyaluronidase-sensitive acid mucopolysaccharide. The mass distorted the
      iris, occluded the angle structures and produced a complete cataract. The
      basement membrane of the adjacent ciliary processes was extensively thickened.
      The authors discuss the clinical association with vitreous hemorrhage and the
      local damage caused by this benign tumour.

PMID- 1751918
TI  - Dog and human bites of the eyelid repaired with retrieved autogenous tissue.
AB  - Two cases of traumatic avulsion of the upper eyelid were surgically repaired with
      retrieved autogenous tissue. Both injuries were caused by bites, canine in one
      case and human in the other. Surgical repair consisted of debridement of the
      retrieved tissue and layered closure of the wound 17 and 40 hours after the
      injury occurred. Good functional results were obtained in both cases. In both
      patients mild lid retraction and loss of cilia were noted. One of the patients
      underwent a secondary lid-lengthening procedure with scleral grafting for optimal
      cosmesis.

PMID- 1751919
TI  - Malpractice crisis is easing, if only slightly.

PMID- 1751920
TI  - A need for evaluation.

PMID- 1751921
TI  - Women and academic medicine.

PMID- 1751922
TI  - Medical training in the United States.

PMID- 1751923
TI  - Nutrients as modulators of immune function.

PMID- 1751924
TI  - Generic drug companies are the winners.

PMID- 1751925
TI  - Stress and the ethical physician.

PMID- 1751926
TI  - Psychiatrists confront an image problem.

PMID- 1751927
TI  - Recruiting ambulance volunteers: rural physicians can help.

PMID- 1751928
TI  - Periodic health examination, 1991 update: 6. Acetylsalicylic acid and the primary
      prevention of cardiovascular disease. Canadian Task Force on the Periodic Health
      Examination.

PMID- 1751929
TI  - Snowboarding injuries: an analysis and comparison with alpine skiing injuries.
AB  - OBJECTIVE: To analyse the types and causes of injuries associated with
      recreational snowboarding and to compare these with the injuries seen in alpine
      skiing. DESIGN: Prospective case series. SETTING: Rural hospital near three large
      ski resorts. PATIENTS: All people presenting to the Emergency Department with an
      injury caused by snowboarding during two ski seasons (1988-90). Of the 115
      injured snowboarders identified, 73 (63%) completed the questionnaire.
      Information on the other patients was obtained from the hospital emergency
      records. Information was also obtained on seven alpine skiers who collided with
      snowboarders. RESULTS: Of the snowboarders 87 (76%) were male, and the mean age
      was 20.3 years. A total of 132 injuries were documented. Of the respondents to
      the questionnaire 83% reported that their fitness level was excellent or above
      average, 36% had never been on a snowboard previously, 25% were in their first
      year of snowboarding, 39% reported excellent snow conditions, 59% reported light
      traffic on the hill, and 7% had consumed alcohol before their accident. Injuries
      were equally divided between the upper body and the legs, 75% of the lower-limb
      injuries involving the left (lead) leg. Significant differences were noted
      between the patterns of injuries in snowboarding and alpine skiing: snowboarders
      were less likely to have lacerations (0% v. 8% respectively), boot-top contusions
      (0% v. 4%), thumb injuries (1% v. 10%) and knee sprains (14% v. 27%) and more
      likely to have spinal injuries (12% v. 4%), foot or ankle injuries (28% v. 5%)
      and distal radius fractures (10% v. 1%). CONCLUSIONS: Snowboarding is associated
      with a unique pattern of injuries, the knowledge of which could influence
      snowboarder education, accident prevention and equipment design. Additional
      research is needed to understand better the types, causes and rates of injury
      associated with snowboarding.

PMID- 1751930
TI  - Use of acetylsalicylic acid by physicians and in the community.
AB  - OBJECTIVE: To determine physicians' attitudes toward prescribing acetylsalicylic
      acid (ASA), physicians' own use of ASA and the prevalence of ASA use in the
      community following the trials of ASA for primary prevention of coronary heart
      disease. DESIGN: Random sample surveys of physicians and the general public by
      mail and telephone respectively and a mail survey of a selected panel of expert
      cardiologists and neurologists. SETTING: London, Ont., and surrounding Middlesex
      County. PARTICIPANTS: A total of 210 physicians (77% of eligible subjects),
      including family practitioners and most types of specialists, with an active
      medical licence and 666 English-speaking people (75% of eligible subjects) aged
      18 years or more living in a household with active, listed telephone service.
      MAIN OUTCOME MEASURE: Long-term ASA use (at least 80 mg on alternate days for 4
      or more consecutive weeks) for the treatment of atherosclerosis. MAIN RESULTS:
      Sampled physicians and experts agreed that long-term ASA therapy was indicated in
      patients with unstable angina, a transient ischemic episode or recent myocardial
      infarction but not for primary prevention in healthy middle-aged men and women at
      low risk for ischemic vascular disease. Both groups were uncertain about the role
      of ASA in primary prevention in asymptomatic people with risk factors for
      atherosclerosis. Nine (16%) of the 55 male physicians aged 50 years or more took
      ASA routinely for primary prevention. In the community survey almost all those
      who used ASA routinely were 50 years or older. The proportions of men and women
      in this age group who used ASA routinely for any reason were 19% (95% confidence
      limits [CLs] 11 and 28) and 14% (95% CLs 8 and 19) respectively; the proportions
      of men and women who used ASA routinely and apparently for primary prevention
      were 8% and 1% respectively. A total of 43% (95% CLs 30 and 57) of those with
      apparent ischemic vascular disease took ASA routinely. Medically unsupervised
      long-term ASA use for primary or secondary prevention of ischemic vascular
      disease was uncommon (reported by 2% of those who used the drug routinely).
      CONCLUSIONS: Physicians generally agree on a role for long-term ASA therapy in
      the secondary prevention of ischemic vascular disease. However, the prevalence of
      long-term ASA use in people with overt atherosclerosis in the community may be
      less than optimal. The role of the drug in the primary prevention of ischemic
      vascular disease is less accepted. Long-term ASA use in the community for primary
      prevention is uncommon but detectable.

PMID- 1751931
TI  - Moth-associated dermatitis in Canadian travellers returning from Mexico.

PMID- 1751932
TI  - Nutritional management of chronic renal disease.

PMID- 1751933
TI  - The work of a stationary hospital in the field. 1919.

PMID- 1751934
TI  - Safety of polyurethane-covered breast implants. Expert Panel on the Safety of
      Polyurethane-covered Breast Implants.

PMID- 1751935
TI  - Major Mustard and me.

PMID- 1751936
TI  - More Canadian MDs showing interest in US practice, but entry isn't quick or easy.

PMID- 1751937
TI  - Crossing the border to practise is no guarantee of happiness or success.

PMID- 1751938
TI  - In a greying Canada, hospice care is the wave of the future.

PMID- 1751939
TI  - The Civil War comes to Queen's.

PMID- 1751940
TI  - Side effects during long-term treatment with depot antipsychotic medication.
AB  - During long-term treatment of schizophrenia with antipsychotic medication, side
      effects such as weight gain and tardive dyskinesia may develop, while other
      extrapyramidal side effects may continue. A large multicenter, double-blind,
      comparative trial of haloperidol decanoate and fluphenazine decanoate has been
      completed, in which 181 patients took part. The study lasted for 1 year and
      patients were assessed using the Krawiecka scale, the Montgomery-Asberg scales
      for schizophrenia and depression, the Simpson-Angus scale for parkinsonism, the
      AIMS for tardive dyskinesia, and a scale for akathisia. Patients were also
      weighed at each assessment. The results provide further evidence about the
      occurrence of weight changes, extrapyramidal side effects, and depression during
      long-term treatment and about the relative benefits of the two treatments.

PMID- 1751941
TI  - Reproducibility of an oral cancer and precancer detection program using a primary
      health care model in Sri Lanka.
AB  - A pilot feasibility study utilizing primary health care workers (PHCW) in the
      early detection of oral cancer and precancer was reported in 1984. The present
      study was to assess the reproducibility of this model in a different geographic
      area using existing Government Health Services. In order to improve the
      compliance of individual referrals following detection (54% in the previous
      study) a simultaneous health education program was mounted. Of 72,867 villagers
      aged 20 years and over who were allocated for screening, 57,124 (78%) were
      examined during 1 year by 36 PHCWs. Oral lesions were detected in 3559 (6.2%). Of
      these, 2193 (62%) complied by presenting for a reexamination at the hospital.
      Twenty new cancers and 1716 subjects with oral precancerous lesions were
      confirmed. While the population screening coverage achieved was higher than in
      the feasibility study, compliance was marginally improved. Noteworthy, however,
      was the detection of 20 new cancers as compared to 4 in the feasibility study.
      This primary health care model for cancer detection appears to be
      organizationally feasible for a developing country.

PMID- 1751942
TI  - Management of oral mucosal dysplasia with beta-carotene retinoic acid: a pilot
      cross-over study.
AB  - Mucosal dysplasia in the head and neck region is recognized to be a precancerous
      lesion. Between January 1983 and December 1987, a pilot study was conducted at
      the Manitoba Cancer Treatment and Research Foundation to determine the effects of
      beta-carotene and cis-retinoic acid on mucosal dysplasias. Eighteen patients were
      treated with a "cross-over" regimen. The overall response to treatment was 61%,
      with 33.3% complete responses. Patients who smoked had a significantly better
      response than nonsmokers. The response rate for 9 of 11 smokers was 81.2%, and 2
      of 7 nonsmokers or 28.6% responded to this protocol. The beneficial effect of
      these drugs should be established by prospective, randomized trial in high risk
      populations.

PMID- 1751943
TI  - Retinol and retinol-binding protein in lung cancer screening.
AB  - Human epidemiology studies demonstrate an inverse correlation between serum
      levels of vitamin A and the incidence of lung cancer. While such studies suggest
      that vitamin A may have a role in cancer prevention, the intent of this study was
      to investigate the use of vitamin A status parameters as markers for detection of
      occult lung cancer. In the first of two phases of this study, we established
      criteria for a prospective screening study. Serum levels of retinol-binding
      protein (RBP), zinc, retinol, and beta-carotene in lung cancer patients were
      compared to levels in controls. For the second phase, a prospective screening
      study, 100 ambulatory male cigarette smokers over the age of 45 were enrolled.
      Subjects were excluded if they had a known diagnosis of cancer, recent weight
      loss, or serum albumin less than 3.5 g/dl. Subjects with RBP less than 4.2 mg/dl
      and retinol less than 42 micrograms/dl were classified as high-risk; those
      remaining were classified as controls. A chest X-ray (CXR) was obtained on all 17
      high-risk subjects and on 26 of the 83 controls. CXR was read and follow-up was
      performed by physicians without knowledge of this study. Lung cancer was detected
      in 24% (4/17) of the high-risk subset, and 4% (1/26) of the controls. These data
      suggest that retinol and RBP may be useful in lung cancer screening for selecting
      a high-risk population that warrants further examination.

PMID- 1751944
TI  - Smoking and other risk factors associated with the stage and age of diagnosis of
      colon and rectum cancers.
AB  - The present study analyzes data on colon and rectum cancer cases from a
      population-based cancer registry to determine the effect of smoking, alcohol
      drinking, and family history of cancer on disease characteristics. A total of 771
      cases of primary invasive cancer of the colon and 304 cancers of the rectum
      constitute the study sample. More advanced colon cancer was present in female
      smokers than in female nonsmokers, while in males there was no smoking effect on
      stage at diagnosis of colon cancer. For cancer of the rectum, male smokers had a
      higher frequency of advanced disease than did nonsmokers. Smoking men and women
      were found to have lower mean ages at diagnosis of both colon and rectum cancer
      than did nonsmokers (p less than 0.001 and p less than 0.004, respectively).
      Alcohol drinking remained consistently associated with lower age at diagnosis in
      both sexes for both colon and rectum cancer (p less than 0.001 and p less than
      0.001, respectively). Those cases of rectum cancer having positive family history
      for colorectal cancer in their first degree relatives had younger age at
      diagnosis than those having negative family history (p less than 0.005). The age
      at diagnosis was progressively younger as the number of risk factors increased (p
      less than 0.001 for colon cancer and p less than 0.003 for cancer of the rectum).
      Our findings indicate an interaction between exposures to risk factors that are
      potentially carcinogenic or cocarcinogenic and manifestations of cancer of the
      colon and rectum.

PMID- 1751945
TI  - Mass screening for colorectal cancer in Japan.
AB  - A mass screening program for colorectal cancer has been conducted in Japan for
      several years, and the nationwide statistics showed a total of 416,382
      participants in 1988. This paper describes the present status of mass screening
      program for colorectal cancer in Japan and related issues as follows: annual
      trend of the number of examinees, age distribution of examinees, screening
      methods, diagnostic methods, evaluation of screening accuracy for fecal occult
      blood tests, and screening interval.

PMID- 1751946
TI  - International comparisons of nutrition and mortality from pancreatic cancer.
AB  - Average per capita consumption of eggs, milk, and meat; total caloric intake; and
      protein and fat consumption in 29 countries from 1964 through 1966 was related to
      the average age-adjusted mortality rates from cancer of the pancreas in these
      same countries for the period 1978 through 1979. A direct and significant
      correlation between mortality rates from cancer of the pancreas and per capita
      consumption of eggs, milk (p less than 0.001), and meat (p less than 0.01 for
      males and p less than 0.05 for females) was found. The total caloric intake was
      directly correlated with mortality rates from pancreatic cancer (p less than
      0.01). This correlation was stronger for calories derived from animal sources of
      food (p less than 0.001) for both sexes, while consumption of vegetable calories
      correlated with decreased rates of mortality from pancreatic cancer. The average
      per capita intake of both total and animal fat was also directly correlated with
      mortality from cancer of the pancreas (p less than 0.001). This suggests that
      animal sources of calories, protein, and fat may play an important role in the
      etiology of pancreatic cancer.

PMID- 1751947
TI  - Reproductive factors and cancers of the breast and genital organs--are the
      different cancer sites similarly affected?
AB  - Relationships between reproductive factors and cancer of the breast and genital
      organs were investigated in a prospective study of 63,090 Norwegian women. During
      followup from 1961 through 1980 1565 cases of breast cancer, 422 cases of cancer
      of the corpus uteri, and 471 cases of ovarian cancer were diagnosed. High parity
      was associated with low risk of cancer of the breast, corpus uteri, and ovary in
      analyses with adjustment for age at first birth. Age at first birth and age at
      last birth were positively associated with risk of breast cancer and inversely
      associated with endometrial cancer, whereas no clear associations were observed
      with ovarian cancer. Results suggest that the effect of a pregnancy on cancer
      risk is mediated, at least in part, by different mechanisms for these three
      sites. Age at menarche was inversely and age at menopause positively related to
      risk of breast and endometrial cancer, whereas no association was observed for
      ovarian cancer. In analyses of squamous cell carcinoma of the cervix uteri, an
      association with reproductive factors was expected from the known relationships
      with sexual habits. However, this cannot account for the high risk observed in
      this study in women with early age at first birth.

PMID- 1751948
TI  - First degree relatives of breast cancer patients: screening practices and
      provision of risk information.
AB  - Little is known about breast cancer screening knowledge and behaviors among women
      with a family history of breast cancer. Data gathered from 125 first-degree
      relatives of breast cancer patients indicated that only 63.3% of women over age
      35 "ever" had a mammogram, 53% of women 40 or older reported a mammogram in the
      last year, and only 36.8% of all participants reported monthly breast self-exam
      (BSE). Self-reported BSE competence was generally poor. One hundred five (105)
      (84%) reported a clinical breast exam over the previous year. Only 71 (56.8%) of
      the women indicated that they had been asked about their family history of breast
      cancer by their physician, and minimal information about risk related to family
      history was provided. Worry about developing breast cancer was positively related
      to mammography use and BSE competence. Confidence in performing BSE and learning
      BSE from a physician/nurse were both positively related to competence. Women who
      believed they had control over finding breast cancer in its early stages reported
      more frequent BSE. Poor compliance of women with a family history of breast
      cancer in the practice of BSE and utilization of mammography, and lack of risk
      information provided by physicians mandate a search for effective intervention.

PMID- 1751949
TI  - Tumor necrosis factor-alpha and B-cell growth factor induce leukemic hairy cells
      to proliferate in vitro.
AB  - To clarify the mechanisms accounting for the hairy cell proliferation, in five
      patients with hairy cell leukemia (HCL), we evaluated the ability of neoplastic
      cells to proliferate in vitro in response to tumor necrosis factor-alpha (TNF
      alpha), B-cell growth factor (BCGF), and interleukin 4 (IL-4). In addition,
      supernatants recovered from cultures of unstimulated hairy cells were tested for
      the capability to induce the proliferation of allogeneic hairy cells. We
      demonstrated that TNF-alpha and BCGF were able to induce the in vitro growth of
      hairy cells (stimulation index (SI) ranging, at different concentrations, from
      1.6 to 10.7 and from 1.6 to 25.1 for TNF-alpha and BCGF, respectively). IL-4 did
      not show any proliferative effect on hairy cells. When unstimulated hairy cell
      supernatants were tested for the proliferative activity on allogeneic hairy
      cells, we demonstrated a low proliferative effect that was not inhibited by an
      anti-TNF-alpha antibody. Our findings demonstrate that unstimulated hairy cells
      proliferate in vitro in response to TNF-alpha and BCGF, thus suggesting that
      these cytokines could be involved in an autocrine model of cell proliferation.

PMID- 1751950
TI  - Cell proliferation of human leukemia and solid tumors studied with in vivo
      bromodeoxyuridine and flow cytometry.
AB  - Bromodeoxyuridine (BUDR) is a thymidine analog that is incorporated into the DNA
      of proliferating cells. Because the dose of BUDR that is needed to label cells is
      not toxic, cell labeling can be accomplished in vivo by infusing the substance
      into patients. A monoclonal antibody against BUDR is then used to identify BUDR
      labeled cells. The same cell population can also be stained for DNA content with
      propidium iodide (PI). Using bivariate flow cytometry (FCM) for measurements,
      both the percentage of BUDR-labeled cells and their total DNA content can be
      evaluated. This technique allows one to obtain the labeling index (LI) and the
      DNA synthesis time (TS). The potential doubling time (Tpot) and the fractional
      turnover rate (FTR) can be mathematically derived. During a 15-month period, in
      vivo BUDR infusion to study cell kinetics was used in 112 consecutive patients
      with various types of malignant tumors: acute leukemia (50), gastric cancer (42),
      and brain gliomas (20). The procedure took 6 to 9 h to complete and there was no
      immediate toxicity from BUDR administration. Successful LI and TS determinations
      were obtained in 89 (80%) and in 80 (72%) of the 112 patients, respectively.
      Proliferative activity in 34 patients with acute nonlymphoblastic leukemias who
      were uniformly treated for remission induction and maintenance was measured from
      Tpot and FTR. It was greater in responsive than in nonresponsive patients, and in
      those who experienced remission for over 8 months than in those who had a shorter
      remission. Proliferative activity was also greater in patients with advanced
      gastric cancers than in those with more limited disease.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1751951
TI  - A proportionate mortality study on risk of bladder cancer among rubber workers.
AB  - A proportionate mortality study was based on a sample of 6208 workers who were
      employed for at least 4 months during the period from 1917 to 1983 in a rubber
      tire manufacturing plant in Ontario, Canada. Identifying information of the
      workers was extracted from company records and linked to the Ontario Cancer
      Registry 1964-1983 death files. Among the cohort, 153 cancer deaths (146 male, 7
      female), which included 6 bladder cancer deaths (all male), were found. For the
      six bladder cancer deaths, average age at time of first employment was 33.5
      years, and average time from first employment to time of death was 31.8 years
      (with a range from 25.3 to 38.3 years). Proportionate mortality ratio (PMR) and
      mortality odds ratio (MOR), and their standardized forms (SPMR and SMOR), were
      calculated using the general population in Ontario for comparison. PMR and MOR
      were found to be 1.44 and 1.45, respectively. When the Ontario proportionate
      cancer mortality was applied to the cohort, adjusted for age and sex, 4.69
      bladder cancer deaths were expected. The six bladder cancer deaths among the
      rubber workers therefore represented a 1.28-fold increase in standardized
      proportionate bladder cancer mortality when compared to the general population.
      Age and sex adjusted SMOR was found to be 1.29.

PMID- 1751952
TI  - Large-scale production of human tumorcytotoxic macrophages grown from blood
      monocytes of cancer patients.
AB  - For adoptive immunotherapy protocols using cells of the macrophage (M phi)
      system, well differentiated and functionally competent effector cells are
      required. In this presentation the generation of a large number of M phi grown in
      vitro from blood monocytes (mo) is reported. Mononuclear cells (MNC) were
      collected by cytapheresis and subsequent Ficoll centrifugation. Mean yield was
      6.9 x 10(9) MNC (range from 3 x 10(9) to 1.2 x 10(10), n = 18) with a mean mo
      count of 22 +/- 14%. MNC were cultured at 5 x 10(6)/ml in suspension on
      hydrophobic Teflon foils with 2% autologous serum for 7 days with recombinant
      human interferon-gamma (rhIFN-gamma) being present for the last 18 h of culture.
      Cells were harvested and activated mo-derived M phi separated from lymphocytes by
      counter-current centrifugal elutriation. On average, 42% of mo cultured could be
      recovered as M phi, the maximal number of M phi generated being 1.7 x 10(9) with
      a purity of up to 96%. Mo-derived M phi appeared to be mature by their expression
      of maturation-associated antigens and proved to be cytotoxic to allogeneic tumor
      targets in vitro. They secreted large quantities of tumor necrosis factor alpha
      (TNF-alpha), interleukin-6 (IL-6), and granulocyte-macrophage colony stimulating
      factor (GM-CSF) upon stimulation with endotoxin. Using the technology described,
      this study revealed that large amounts of tumorcytotoxic M phi can be generated
      from the peripheral blood of cancer patients to be used in adoptive immunotherapy
      trials.

PMID- 1751953
TI  - A new approach to adoptive immunotherapy of cancer using tumorcytotoxic
      macrophages grown from peripheral blood monocytes.
AB  - Clinical trials to evaluate the potential of adoptive immunotherapy in cancer
      patients have been restricted to the use of lymphoid effector cells. Of the other
      probably even more important host defense system against tumor growth, the mono
      nuclear phagocyte system, only monocytes (mo) have been reinfused which, however,
      represent immature precursor cells and acquire full functional competence only
      upon further maturation. This is a report on 7 patients who received autologous
      macrophages (MO) grown in vitro from blood mo and activated by interferon-gamma
      (IFN gamma). Mononuclear cells were isolated from whole blood by cytapheresis and
      cultured for 7 days with 2% autologous serum on hydrophobic Teflon foils.
      Eighteen house before cell harvest, recombinant human IFN gamma was added at 200
      IU/ml. Mo-derived MO were purified by counter-current elutriation. Starting with
      10(8) MO cells, therapy was escalated up to the maximal number of MO obtainable
      from one single preparation cycle. Currently, 26 therapies have been performed
      with the maximal dose being 1.7 x 10(9) MO per infusion. Except for low grade
      fever (less than 38 degrees C), MO autografts were well tolerated, with no side
      effects observed. Biological response was followed by analyzing the serum levels
      of beta 2-microglobulin, neopterin, interleukin-6, tumor necrosis factor, and
      lysozyme. While in 3 out of 7 patients serum neopterin increased in response to
      MO therapy, other biological response parameters remained at pretreatment levels.
      Radiolabeled MO were shown to first accumulate in the lungs, then to pool into
      liver and spleen.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1751954
TI  - [The noninvasive estimation of right atrial pressure improves the Doppler
      evaluation of the pulmonary systolic pressure].
AB  - The right ventricular systolic pressure can be evaluated with the Doppler method
      through the right ventricular-atrial gradient (RV-RA gradient) and the right
      atrial pressure. The former is expressed by the transtricuspid velocity of flow,
      the latter is generally assumed. In 50 patients with elevated pulmonary pressure
      we tested whether ultrasounds may be utilized for the evaluation of the right
      atrial pressure, and whether the derived values contribute to improve the
      accuracy of the method. We estimated the right ventricular systolic pressure with
      method A: RV-RA gradient + 10; and method B: RV-RA gradient x 1.1 + 14, where 10
      and 14 are the assumed right atrial pressure (mmHg). Through the collapsibility
      index of the inferior vena cava, taken as an ultrasound-derived index of right
      atrial pressure, we were able to identify 3 groups of patients with normal (Group
      1, 14 cases), elevated (Group 2, 21 cases) and moderately elevated (Group 3, 15
      cases) right atrial pressure, respectively. In them the right ventricular
      systolic pressures obtained with both method A and method B were compared to
      those derived with catheter. In Group 1 the non-invasive values were
      significantly closer to the invasive ones when calculated with method A; the same
      was true of method B in Group 2. In Group 3 the accuracy of the 2 methods was
      similar. We conclude that ultrasound assists in the non-invasive approximation of
      the right atrial pressure as well as in the choice of the appropriate formula, so
      that Doppler estimation of the right ventricular systolic pressure is improved.

PMID- 1751955
TI  - [Is lipid peroxidation responsible for the damage caused by postischemic
      reperfusion?].
AB  - Peroxidation of membrane phospholipid polyunsaturated fatty acids is considered a
      major mechanism of the damage occurring during post-ischemic reperfusion. The
      evidences in support for this mechanism of damage are based on tissue
      malondialdehyde (MDA) quantitation by the thiobarbituric acid test (TBA-test). In
      an attempt to verify this topic we have subjected isolated and Langendorff
      perfused rabbit hearts to a period of 60 min of severe ischemia plus 30 min of
      reperfusion. At appropriate time points MDA was determined in the tissue by means
      of TBA-test and directly by reversed phase, high pressure, liquid chromatography
      (HPLC). We have found no correlation between the 2 compared assays. During
      reperfusion, there was the formation of non-lipid related, MDA like, TBA-reactive
      substance which leads to overestimation of the extent of lipid peroxidation. On
      the contrary, by direct HPLC quantitation, there was a decrease of tissue MDA
      during ischemia and during the early phases of reperfusion. Our results
      demonstrate that TBA-test is not a reliable index of lipid peroxidation in organ
      systems and that MDA accumulation does not precede the evidence of the functional
      alterations occurring on reperfusion of the previously ischemic myocardium. These
      results are of relevance in the understanding of the exact mechanism of
      reperfusion damage as, in the same experimental model, oxy radicals have been
      shown to be generated and antioxidants are protective.

PMID- 1751956
TI  - [Is coronary angioplasty less costly than aortocoronary bypass?].
AB  - We retrospectively compared the cost-benefit ratio of coronary bypass grafting
      (CABG) and percutaneous coronary angioplasty (PTCA). Data were obtained on 40
      CABG's and 40 PTCA's patients treated from 15/2/86 to 15/9/86. All patients had
      at last 1-year follow-up. PTCA and CABG groups had similar baseline clinical and
      angiographic criteria. We analyzed the following cost components: real estate,
      biomedical products, drugs, hospital charges, medical fees, cardiac and non
      cardiac tests. Total cost of CABG exceeds that of PTCA by a factor of 1.64:
      15,095,000 vs 9,201,346 Italian liras (ILit). Taking into account early and late
      medical and surgical complications, the factor decreases to 1.39: 15,746,500 vs
      11,323,000 ILit. After 1 year of follow-up the factor decreases to 1.18:
      16,613,500 vs 14,027,500 ILit. Our data show that the initial savings were
      reduced when complications and follow-up are considered, but PTCA's patients had
      shorter hospitalization, earlier return to work, lower psychosocial stress.

PMID- 1751957
TI  - Anomalous coronary arteries: a report of 2 cases of single coronary artery.
AB  - One patient with chronic exertional angina, not significant electrocardiographic
      signs of myocardial ischemia at exercise stress test and recent onset of angina
      at rest underwent coronary arteriography. A second one with known severe aortic
      stenosis underwent cardiac catheterization and coronary arteriography because of
      effort chest pain and syncope. A single coronary artery originating respectively
      from the right and from the left sinus of Valsalva but without significant
      coronary stenosis was detected in both patients. This entity is a quite uncommon
      finding of relevant interest if surgical treatment is required and good prognosis
      if not associated with additional cardiac anomalies.

PMID- 1751958
TI  - [The diagnosis by a Doppler color echocardiographic method of an aortocaval
      fistula following the rupture of an aortic aneurysm into the inferior vena cava].
AB  - We describe a clinical case presenting 2 rare features. The first was a
      spontaneous aortocaval fistula which had developed from rupture of an
      atherosclerotic aortic aneurysm into the inferior vena cava. The second
      infrequent feature depended on the unusual method by which the diagnosis was
      performed. In fact, using an echo-color Doppler flow imaging (HP 77020A
      ultrasound system) with a 2.5 MHz echocardiographic probe abdominal examination
      showed an aneurysm of the descending aorta that communicated to a dilated
      inferior vena cava. Furthermore, flow study with color Doppler showed a
      continuous turbulent, mixed (arterial and venous) blood flow into the inferior
      vena cava.

PMID- 1751959
TI  - [The physiopathological mechanisms of transient regional myocardial ischemia and
      the approach to therapy].

PMID- 1751960
TI  - [The intravascular imaging technic with ultrasound].

PMID- 1751961
TI  - [The value of a tradition in the history of the Societa Italiana di Cardiologia].

PMID- 1751962
TI  - Calcium-binding proteins in Aplysia neurons.
AB  - 1. Calcium (Ca)-binding proteins of neuronal ganglia and of single, identified
      neurons of the marine mollusk, Aplysia californica, were investigated. Using
      transblot/45Ca overlays two proteins, at Mr 45,000 and Mr 23,000, with a high Ca
      binding ability were found. 2. Western blot analysis revealed that the protein at
      Mr 45,000 could be separated by 2D-PAGE into proteins with Mr 40,000 and Mr
      43,000. The protein at Mr 40,000 immunocross-reacted with antisera directed
      against parvalbumin and rat calbindin D-28K, indicating a novel Ca-binding
      protein sharing common antigenic determinants for both proteins. 3. The protein
      at Mr 23,000 could be separated into a group of proteins with Mr 13,000-20,000
      which showed a high degree of similarity to sarcoplasmatic calcium-binding
      proteins (SCP). 4. We further investigated the protein pattern of single,
      identified neurons of different electrical activity (bursting, beating, and
      silent) by 2D-PAGE. Major differences were found in the range of low Mr and low
      pI, where Ca-binding proteins are generally located. A protein at high
      concentrations characteristic for silent cells migrated at a position similar to
      crayfish SCP. 5. The results show that various Ca-binding proteins are
      characteristic for neurons in the Aplysia nervous system and support the idea
      that they may effect the electrical behavior of nerve cells.

PMID- 1751963
TI  - Gamma-interferon, retinoic acid, and cytosine arabinoside induce neuroblastoma
      differentiation by different mechanisms.
AB  - 1. The effects of gamma-interferon (gamma-IFN), retinoic acid (RA), and cytosine
      arabinoside (ARA-C) on the growth, morphology, and phenotype of the human
      neuroblastoma (NB) cell lines, LAN-1 and GI-ME-N, have been extensively tested.
      2. RA, gamma-IFN, and ARA-C induced a dose-dependent morphological
      differentiation and growth inhibition, without affecting cell viability. Cells
      exposed to 10(-6) M RA or 1000 U/ml gamma-IFN significantly decreased their
      growth rate within the first 24 and 48 hr of culture, respectively. Cells became
      smaller and polygonal and sprouted long cellular processes with varicosities
      along their courses. In contrast, ARA-C-differentiated cells were larger and
      flattened, with few elongated dendritic processes. 3. Analysis of membrane and
      cytoskeletal markers by immunofluorescence and Western blot showed several
      changes in NB-specific antigen expression after 5 days of treatment with all
      inducing agents. Analysis of labeled phosphatidylinositol metabolites from
      prelabeled cells showed, within 1 min of treatment with RA, a rapid decrease in
      inositol 1,4,5-trisphosphate and of 1,2-diacylglycerol levels. No changes in
      inositol phospholipid metabolism were observed in gamma-IFN- or ARA-C-treated
      cells. 4. We conclude that RA-induced decrease in phosphatidylinositol (PI)
      hydrolysis is not likely to be a consequence of the acquisition of a different
      phenotype, as its changes precede the acquisition of neuronal markers. In
      addition, gamma-IFN and ARA-C, both inducing a mature phenotype, did not affect
      PI hydrolysis. 5. Decreased PI hydrolysis seems to be sufficient, although not
      necessary, to commit NB cells to neuronal differentiation. Analysis of molecular
      mechanisms associated with NB cell differentiation may be helpful to clarify the
      potential of various biological agents in affecting the development of the neural
      cell.

PMID- 1751964
TI  - Relationship among methylation, isoprenylation, and GTP binding in 21- to 23-kDa
      proteins of neuroblastoma.
AB  - 1. Dimethylsulfoxide-induced differentiated neuroblastoma express high levels of
      membrane 21 to 23-kDa carboxyl methylated proteins. Relationships among
      methylation, isoprenylation, and GTP binding in these proteins were investigated.
      Protein carboxyl methylation, protein isoprenylation, and [alpha-32P]GTP binding
      were determined in the electrophoretically separated proteins of cells labeled
      with the methylation precursor [methyl-3H]methionine or with an isoprenoid
      precursor [3H]mevalonate. 2. A broad band of GTP-binding proteins, which overlaps
      with the methylated 21 to 23-kDa proteins, was detected in [alpha-32P]GTP blot
      overlay assays. This band of proteins was separated in two-dimensional gels into
      nine methylated proteins, of which four bound GTP. 3. The carboxyl-methylated 21
      to 23-kDa proteins incorporated [3H]mevalonate metabolites with characteristics
      of protein isoprenylation. The label was not removed by organic solvents or
      destroyed by hydroxylamine. Incorporation of radioactivity from [3H]mevalonate
      was enhanced when endogenous levels of mevalonate were reduced by lovastatin, an
      inhibitor of mevalonate synthesis. Lovastatin blocked methylation of the 21 to 23
      kDa proteins as well (greater than 70%). 4. Methylthioadenosine, a methylation
      inhibitor, inhibited methylation of these proteins (greater than 80%) but did not
      affect their labeling by [3H]mevalonate. The results suggest that methylation of
      the 21 to 23-kDa proteins depends on, and is subsequent to, isoprenylation. The
      sequence of events may be similar to that known in ras proteins, i.e., carboxyl
      methylation of a C-terminal cysteine that is isoprenylated. 5. Lovastatin reduced
      the level of small GTP-binding proteins in the membranes and increased GTP
      binding in the cytosol. Methylthioadensoine blocked methylation without affecting
      GTP binding. 6. Thus, isoprenylation appears to precede methylation and to be
      important for membrane association, while methylation is not required for GTP
      binding or membrane association. The role of methylation remains to be determined
      but might be related to specific interactions of the small GTP-binding proteins
      with other proteins.

PMID- 1751965
TI  - Inhibition of intracellular granule movement by microinjection of monoclonal
      antibodies against caldesmon.
AB  - Monoclonal antibodies, C2, C9, C18, and C21, against chicken gizzard caldesmon
      (called high molecular weight isoform) were shown to crossreact with a low
      molecular weight isoform of caldesmon in chicken embryo fibroblasts (CEF). These
      antibodies were used in a microinjection study to investigate the in vivo
      function of caldesmon in nonmuscle cell motility. Injected cells did not appear
      to change their morphology significantly; the cells displayed a flat appearance
      and were able to ruffle and locomote normally. However, in the C21 injected
      cells, saltatory movements of granules and organelles appeared to be greatly
      inhibited. This inhibition of granule movement was reversible, so that by 3 hr
      after injection, granules in injected cells had already recovered to normal
      speed. The inhibition of granule movement in cells injected with C2, C9, or C18
      antibody, or with C21 antibody preabsorbed with caldesmon, were not significantly
      different from that in uninjected cells. In a previous epitope study, we
      demonstrated that, of the antibodies used in this study, only C21 antibody was
      able to compete with the binding of caldesmon to Ca++/calmodulin and to F-actin,
      although both C21 and C2 antibodies recognized the same carboxyl-terminal 10K
      fragment of gizzard caldesmon [Lin et al., 1991: Cell Motil. Cytoskeleton 20:95
      108]. The caldesmon distribution in C21 injected cells changed from stress-fiber
      localization to a more diffuse appearance, when the injection was performed at 10
      30 mg/ml of C21 antibody. We have previously shown that a monoclonal anti
      tropomyosin antibody exhibited motility-dependent recognition of an epitope, and
      that microinjection of this antibody specifically inhibited intracellular granule
      movements of CEF cells [Hegmann et al., 1989: J. Cell Biol. 109:1141-1152].
      Therefore, it is likely that tropomyosin and caldesmon may both function in
      intracellular granule movement by regulating the contractile system in response
      to [Ca++] change inside nonmuscle cells.

PMID- 1751966
TI  - The identification of mammalian centrosomal antigens using human autoimmune
      anticentrosome antisera.
AB  - Human autoimmune sera were screened for the presence of anticentrosome
      autoantibodies. Two high titer sera were identified that reacted with HeLa, CHO,
      and PtK2 centrosomes by immunofluorescence, although the fluorescent patterns
      that were obtained using the two antisera were separate and distinct. Serum
      obtained from patient IJ contained antibodies that reacted with epitopes present
      only in mitotic centrosomes; staining of interphase centrosomes was never
      detected uing IJ antiserum. Immunoblot analysis demonstrated that antibodies
      present in IJ antiserum reacted with a 190 kD spindle pole antigen.
      Immunofluorescent staining of cultured mammalian cells demonstrated that
      antibodies present in serum obtained from patient SPJ reacted with both
      interphase and mitotic centrosomes. Characterization of SPJ antiserum by
      immunoblotting demonstrated that antibodies present in the SPJ serum recognized
      proteins of Mrs of 39, 185, and 220 kD, although the possibility that the 185 kD
      polypeptide was a proteolytic breakdown product of the 220 kD protein has not
      been eliminated. Neither antiserum was able to inhibit microtubule nucleation
      from centrosomes in a lysed cell system in which pure 6S tubulin was added to
      permeabilized cells following pretreatment of the cells with either SPJ or IJ
      antiserum. These antisera should be useful probes for studying the biochemistry
      of the mammalian centrosome.

PMID- 1751967
TI  - Analysis of inducible contractile rings suggests a role for protein kinase C in
      embryonic cytokinesis and wound healing.
AB  - A semi-in vitro system derived from Xenopus oocytes which allows induction of
      contractile ring (CR) formation and closure is described and exploited to
      elucidate regulatory and structural features of cytokinesis. The inducible CRs
      (ICRs) are composed of actin filaments and closure is actin filament-dependent as
      is cytokinesis in vivo. ICR closure in this system is calcium-dependent and pH
      sensitive, as is cytokinesis in permeabilized cells (Cande: Journal of Cell
      Biology 87:326, 1980). Closure of ICRs proceeds at a rate and with a kinetic
      pattern similar to embryonic cytokinesis. Collectively, these data demonstrate
      that this system is a faithful mimic of cytokinesis in vivo. ICR formation and
      closure is protein kinase C (PKC)-dependent and neomycin-sensitive, indicating
      that the PKC branch of the polyphosphoinositide pathway regulates formation of
      the actomyosin ring which is the effector of cytokinesis. Kinetic measurements
      show that the rate of ICR closure reaches a peak of 4-8 microns/sec. Since the
      maximum measured velocity of actin filament translocation by vertebrate, non
      muscle myosins is 0.04 micron/sec, the later observations support a model in
      which the CR is segmented, containing multiple sites where filaments overlap in a
      "sliding filament" fashion. Because the rate decreases after reaching a peak, the
      results also suggest that the number of overlap sites decrease with time.

PMID- 1751968
TI  - Post-translational incorporation of actin into myofibrils in vitro: evidence for
      isoform specificity.
AB  - The incorporation of actin into myofibrils has been examined in a cell-free
      system [Bouche et al.: Journal of Cell Biology 107:587-596, 1988; Goldfine et
      al.: Cellular and Molecular Biology of Muscle Development, 1989]. Actin was
      translated in a reticulocyte lysate in the presence of 35S-methionine (35S-actin)
      or purified from muscle and labeled with fluorescein-5-isothiocyanate (FITC
      actin). Myofibrils were incubated with either 35S-actin or FITC-actin and then
      analyzed by gel electrophoresis or fluorescence microscopy. When myofibrils were
      incubated with FITC-actin monomer in the reticulocyte lysate buffer, strong
      fluorescent labeling was observed in Z-band regions and less so in I-bands. No
      fluorescence was detected in non-overlap regions of A-bands. Confocal microscopic
      analysis of these myofibrils indicated that FITC-actin was distributed evenly
      across the diameter of the myofibrils. These observations suggest that actin
      incorporation in the reticulocyte lysate buffer occurred at sites in the
      sarcomere which contain actin. In contrast, FITC-actin showed a variety of non
      physiological incorporation patterns when incubated with myofibrils in the
      presence of an isotonic buffer (I-buffer). However, when ATP was added to I
      buffer, FITC-actin showed a pattern of incorporation into myofibrils similar to
      that seen in the reticulocyte lysate buffer. Immunoblots indicated that actin of
      native size was released from myofibrils during incubation in the reticulocyte
      lysate buffer. No actin release was detected when the myofibrils were incubated
      in I-buffer lacking ATP. We used this system to compare the incorporation of
      actin isoforms into myofibrils. Both alpha- and beta-actins exhibited
      incorporation into the myofibrils but there was a three-fold greater
      incorporation of the alpha isoform. We propose that the differential affinities
      of actin isoforms for myofibrils and other cytoskeletal structures could provide
      a mechanism for actin isoform targeting within the cytoplasm.

PMID- 1751969
TI  - Analysis of cDNA clones for Acanthamoeba profilin-I and profilin-II shows end to
      end homology with vertebrate profilins and a small family of profilin genes.
AB  - We have cloned and sequenced full length cDNAs for Acanthamoeba profilin-I and
      profilin-II. The genes and the encoded proteins are nearly identical except for
      the region between bp 121 and 210 where 35% of the nucleotides and 47% of amino
      acids differ. Most of these substitutions are conservative, although three of
      them are responsible for the differences in the isoelectric points of the
      isoforms [Kaiser et al., Cell Biol., 102:221-226, 1986]. The DNA sequence
      revealed six corrections in the previously published protein sequence of profilin
      I [Ampe et al., J. Biol. Chem. 260:834-840, 1985] and for the first time resolved
      the ambiguities at the five positions where profilin-IA and -IB differ. The DNA
      sequence of profilin-II also allowed us to make two corrections in the protein
      sequence [Ampe et al., FEBS Lett. 228:17-21, 1988a]. Probes prepared from the
      cDNAs revealed 1 profilin-IA gene, one strongly cross-hybridizing profilin-I gene
      and one strongly reacting profilin-II gene on Southern blots of Acanthamoeba DNA.
      Weaker reactions with other genomic DNA fragments leave open the possibility of
      one additional gene each for profilin-I and profilin-II. Four different profilin
      RNAs were resolved on Northern blots. It possible to align the sequences of the
      three Acanthamoeba profilins with the sequences of nine other profilins from five
      different phyla. There are only two invariant residues in these profilin
      sequences, but many pairwise identities and conservative substitutions that
      indicate considerable divergence of this family of proteins from its ancestral
      precursor.

PMID- 1751970
TI  - Dictyostelium discoideum essential myosin light chain: gene structure and
      characterization.
AB  - We have used a Dictyostelium essential myosin light chain (EMLC) cDNA clone to
      isolate additional cDNA clones which supply a different 3' sequence from that
      previously described. The revised cDNA sequence encodes a polypeptide of 150
      amino acids. Amino acid residues 147-167 of the previously reported sequence are
      replaced by new residues 147 to 150. The new cDNA encodes a polypeptide with 66%
      amino acid sequence identity with the Physarum polycephalum EMLC, and
      approximately 30% identity with mammalian EMLC sequences. These new cDNA clones
      were used to isolate two genomic DNA fragments which contain the entire EMLC
      gene. The Dictyostelium EMLC gene contains a single intron located immediately 3'
      of the translation initiation codon and encodes a product most similar to MLC3
      isoform of vertebrates. Primer extension analysis places the transcription
      initiation site approximately 90 nucleotides upstream of the translation
      initiation site. A DNA fragment containing 350 bases of sequence upstream of the
      putative transcription initiation site is sufficient to drive expression of a
      reporter gene upon reintroduction into growing Dictyostelium cells. In addition,
      the CAT reporter mRNA produced by this construct showed a pattern of
      developmental regulation similar to that previously reported for the endogenous
      EMLC mRNA. Based on comparison with published EMLC sequences from a variety of
      sources, the Dictyostelium EMLC shows slightly higher similarity to vertebrate
      EMLCs from striated muscle sources than nonmuscle sources. While Dictyostelium
      and human nonmuscle sequences display only 28% identity over their entire
      sequence, the region from residue 88 to 108 shows much higher identity (67%). The
      high evolutionary conservation of this region of the EMLC suggests it may play an
      important role in EMLC function, and as such, represents a good target for future
      mutagenesis studies.

PMID- 1751971
TI  - [Stiff man syndrome--an autoimmune disease].

PMID- 1751972
TI  - [Initial clinical experience with the use of 31P MR spectroscopy in the
      examination of children with neuromuscular diseases].
AB  - 31P MR spectroscopy (MRS) was used to investigate neuromuscular diseases of
      different origin in 35 patients, mostly children. After elaboration of the
      procedure of MR examination and evaluation of results the method of pattern
      recognition analysis was used. According to the results of 31P MR spectroscopy
      patients can be divided into three groups. Group A comprises patients with severe
      muscular lesions such as Duchenne dystrophy. The second group B is characterized
      by milder atrophic changes of muscle fibres. The third group comprises obscure
      cases. The 31P MRS method was also used for investigating the development of the
      disease in time--a drop of parameter PCR/Pi corresponds to a deterioration of the
      clinical condition of patients from group one. Maintenance of approximately the
      same values was observed in group B. An increase of PCR/Pi was also observed
      during administration of Prednisone in patients with child polymyositis.

PMID- 1751973
TI  - [Cystic meningiomas].
AB  - The author gives an account of three cases of cystic meningioma in a group
      comprising 184 operated meningiomas (1.63%). He reviews views on the aetiology of
      the cystic peri- and intra-tumoural formation. Neuroradiological findings
      resembling glial and metastatic tumours with cystic or necrotic changes
      frequently lead to an incorrect preoperative diagnosis in this potentially
      curable lesion. For prevention of relapses of cystic meningioma it is essential
      to remove not only the solid tumourous node but the entire wall of the cyst,
      which may be difficult from the technical aspect.

PMID- 1751974
TI  - [Epilepsy and rehabilitation using psychological methods (psychotherapy)].
AB  - 41 subjects (39 patients and two mothers) participated in 1983-1988 in group
      psychotherapy for ambulatory adult patients focused on psychosocial problems and
      questions of the therapeutic regime. According to the independent evaluation by
      the attending physician the individually outlined goal was achieved in 38% of the
      patients. 31% of the patients left without a special effect, however,
      participation in the group meant probably a certain enrichment of their life.
      Another 31% of the patients had a negative attitude to participation in the
      group. Successful patients attended much longer, had a significantly higher
      verbal IQ and all responded reliably in Washington's psychosocial seizure
      inventory--WPSI. Conversely, 27% of the other patients gave invalid responses to
      WPSI. Psychological procedures should be part of a wider scale of rehabilitation
      approaches to epilepsy, including occupational rehabilitation and club
      activities.

PMID- 1751975
TI  - [West's syndrome--infantile myoclonic spasms].
AB  - The article is a review of contemporary knowledge of the so-called West syndrome.
      It deals with the definition, aetiology, clinical aspects, therapy and prognosis
      of this disease. In addition to the clinical picture of West's syndrome the
      author describes also recently described units which may fuse with this syndrome
      or mutually. The author deals on purpose in more detail with treatment of West's
      syndrome, in particular steroid administration (specially ACTH and its synthetic
      derivatives) as among our neurologists there are still very controversial views
      as regards indication and control of steroid treatment, sometimes associated with
      certain not always rational prejudices.

PMID- 1751976
TI  - [Present trends and use of ultrasonic diagnosis in neuroangiology and
      cerebrovascular diseases].

PMID- 1751977
TI  - [International classification of headache (shortened form)].

PMID- 1751978
TI  - HIV-1 infection among incarcerated men--Quebec.

PMID- 1751979
TI  - Tropical health and quarantine notes.

PMID- 1751980
TI  - [Power and helplessness in therapeutic care of children].
AB  - The child is exposed to force, starting at birth, and force accompanies him
      through later life. Absence of force should thus start by gentle delivery in an
      operation theatre and be associated with the subsequent upbringing of the child.
      Trauma of separation in hospital is one of his most painful experiences. This led
      in the sixties to basic psychohygienic reforms in paediatric clinics, with
      unrestricted visiting times and admission of mothers to the department with the
      child. Force determines our lifestyle and penetrates via the mass media
      continuously into our families. Parents are therefore requested to alter their
      style of upbringing psychotherapists are requested to avoid any force used in
      aversive therapy by behavioural therapists or so-called "Festhaltetherapie" of
      autistic children. The number of disrupted families, demonstrated on the example
      of children of divorced parents indicates the tasks of "doctors as educators of
      children" (see Czerny). In an environment of soulles medicine based on
      apparatuses steady control of his activities are needed. The remedial teacher is
      an important assistant in paediatric hospitals. Psychological knowledge and
      experience can protect the doctor against abuse of force in therapy.

PMID- 1751981
TI  - [Current problems in pediatric ophthalmologic oncology].
AB  - The authors give an account of contemporary problems of child ophthalmological
      oncology from the paediatrician's aspect. The most serious intraocular tumors are
      retinoblastomas, in the orbitopalpebral area rhabdomyosarcomas. The authors draw
      attention to the five main alarming symptoms typical for tumorous processes at
      these sites: red painful eye, leukokoria, acute visual failure, acute strabism
      and various rapidly developing protrusions of the bulbus. Subsequently they
      inform on possible ophthalmological complications of comprehensive oncological
      treatment.

PMID- 1751982
TI  - [Characteristics of E. coli strains isolated in infantile diarrhea].
AB  - In a group of 50 strains of E. coli isolated from infants hospitalized on account
      of diarrhoea the authors investigated, based on the phenotypic manifestation and
      in a selected number of strains also genotypic factors of virulence: fimbrial
      adhesins, aerobactin, haemolysins, colicins, toxic and lethal action in mice,
      seroresistence and resistance against tetracycline, streptomycin,
      chloramphenicol, kanamycin, ampicillin and sulfamethoxidine. All strains had one
      to eight factors of virulence. The presence of plasmid DNA was confirmed in 14 of
      16 tested strains. From this the authors conclude that the investigated virulence
      factors were in the majority coded plasmids.

PMID- 1751983
TI  - [What should the pediatrician know about retinopathy of prematurity?].
AB  - The paper is concerned with the practical aspect of the problem of retinopathies
      of premature babies (ROP) from the aspect of collaboration of the child
      ophthalmologist and paediatrician. The paper provides basic information
      pertaining to contemporary possibilities of prevention and treatment of ROP, some
      late sequelae and their possible correction. The conclusions which ensure are the
      result of a confrontation of the author's experience and data in the literature.

PMID- 1751984
TI  - [Intermittent transcutaneous monitoring of acid-base equilibrium in neonates].
AB  - The authors discuss intermittent transcutaneous monitoring of the acid base
      balance in blood where the feedback model: lungs-milieou interieur is used as
      part of a new theory, i.e. the concept of "electronic blood" (Kovac A.) which
      implies simulation of the internal environment by a computer. Part of the model,
      evidence of the existing relationship of the external and internal environment
      are the following parameters: a shift in the Haldane effect and the constant in
      Haldane's effect. The authors compare the values of the acid-base balance
      obtained by surgical means and by means of a computer.

PMID- 1751985
TI  - [Urethral dilation in the treatment of urinary tract infections in girls].
AB  - In the presented retrospective study the authors evaluate the effect of
      dilatation of the urethra in the treatment of relapsing infections of the urinary
      pathways in girls. In 1982-1987 at the Clinic of Paediatric Surgery in Brno 387
      girls with infections of the urinary pathways were examined, in 112 stenosis of
      the distal urethra was found, in 24 moreover vesicoureteral reflux and 40
      suffered from enuresis. After dilatation of the urethra, the technique of which
      is described in detail the urinary findings were normal in 83% of the girls and
      in more than half significant or complete regression of the vesicoureteral reflux
      was noted, in more than two thirds enuresis was eliminated. The authors therefore
      recommend the method and also calibration of the urethra during examination of
      the patients.

PMID- 1751986
TI  - [Diaphragmatic hernia in the pediatric population in the Roznava District].

PMID- 1751987
TI  - [Results of new research in the physiology of vision and its reflection in the
      care of younger patients with ophthalmic diseases].

PMID- 1751988
TI  - [Report on the results of the SPTR P 12-335-802 DU 17 research tasks in the field
      of pediatrics].

PMID- 1751989
TI  - [Infant mortality in Slovakia 1990--analysis and perspectives].

PMID- 1751990
TI  - [Changes in children with mental retardation in a long-term study].

PMID- 1751991
TI  - [Short report on mortality in children with a low birth weight].

PMID- 1751992
TI  - [Pre-existing knowledge and knowledge gained from the print media about adoption
      and foster care by adoption seekers during the 2-3 year waiting period].

PMID- 1751993
TI  - [Alkaline phosphatase activity in neutrophils in children with type I diabetes
      mellitus].

PMID- 1751994
TI  - [Hemangiomatosis of the liver in a 3-month-old infant].

PMID- 1751995
TI  - [Detection of T-lymphocytes using the E. coli strain ATCC 11303].

PMID- 1751996
TI  - Postoperative myocardial damage in patients with coronary artery disease
      undergoing major non cardiac surgery.
AB  - A prospective study was carried out in a group of 50 patients with coronary
      artery disease, presenting for major non-cardiac surgery, to investigate the
      timing and incidence of further perioperative myocardial damage. A standardised
      anaesthetic was used. A standard 12-lead ECG was taken immediately before surgery
      and at 24, 48, and 72 hr after the start of anaesthesia. Blood samples were taken
      immediately preoperatively and at 6, 24, 48, and 72 hr after anaesthesia for
      total CK and CK-MB assay. Thirty-three patients (66%) showed ECG evidence
      suggestive of further infarction, and of these, two (4%) died in the immediate
      perioperative period. The first ECG change occurred in 27/31 (87%) by 24 hr, in
      3/31 (10%) by 48 hr, and 1/31 (3%) by 72 hr. Twenty-nine patients (58%) including
      the two deaths showed CK-MB enzyme changes. The first elevation in CK-MB was nil
      at 6 hr and 72 hr, with 23/27 (85%) at 24 hr, and 4/27 (15%) at 48 hr. In 22/50
      (44%) ECG and enzymes were correlative. Goldman and Cooperman risk indices were
      calculated for each patient. The Cooperman risk index was superior to the Goldman
      scale in the correlation of observed with predicted myocardial morbidity.
      Patients with ECG changes only before surgery were just as liable to further
      myocardial damage as those patients with ECG changes and a documented history of
      a previous infarct and/or symptoms. Myocardial damage is maximal in the first 24
      hr after surgery, and may not be adequately predicted by current risk indices.

PMID- 1751997
TI  - Early postoperative myocardial morbidity in patients with coronary artery disease
      undergoing major non-cardiac surgery: correlation with perioperative ischaemia.
AB  - As a part of a study assessing early postoperative myocardial morbidity in 50
      patients with active coronary artery disease undergoing major non-cardiac
      surgery, the ECG was monitored continuously for 24 hr after the onset of
      anaesthesia, using a frequency modulated (FM) Holter monitor. Concurrent
      automated blood pressure and pulse were measured non-invasively at three-minute
      intervals during anaesthesia and subsequently at five-minute intervals. Thirty
      patients were monitored with two-site ECG recordings, from modified V1 and V5
      (Group A). Twenty patients had seventeen-site ECG monitoring, multiplexing a four
      by four array of precordial electrodes onto one channel of the frequency
      modulated recorder (Group B). Tapes were analyzed for noise, supraventricular and
      ventricular dysrythmias, runs of tachy- and bradycardia, and ST segment changes.
      These data were correlated with serial standard 12-lead ECGs and CK-MB assay in
      the 72 hr after surgery. Seven tapes from Group A could not be analyzed. Change
      (greater than 1 mm) on ST monitoring from both Groups A (14/23), B (14/20),
      correlated with serial 12-lead ECG and/or CK-MB changes. The majority of first ST
      change 19/28 (70%) occurred after anaesthesia. In 14/28 (50%) ST change occurred
      during episodes of tachycardia and elevated blood pressure (greater than 20%
      above baseline). Nine patients (9/23) in Group A had no ST change; however, six
      had serial 12-lead ECG and/or CK-MB changes. Six patients (6/20) in Group B had
      no ST changes, and none of these patients had any change of serial 12-lead ECGs
      or CK-MB assay. No patient complained of chest pain during the Holter monitoring
      period. Continual monitoring of heart rate and blood pressure and accurate ST
      monitoring are essential to detect and treat perioperative myocardial ischemia. A
      multiple-lead precordial system is substantially more sensitive than traditional
      two-lead ECG holter monitoring in detecting myocardial ischaemia.

PMID- 1751998
TI  - Metoclopramide does not decrease the incidence of nausea and vomiting after
      alfentanil for outpatient anaesthesia.
AB  - Sixty patients were studied in a randomized, double-blind manner to determine
      whether metoclopramide added to droperidol decreased further the incidence of
      emetic symptoms (nausea, retching, vomiting) in outpatients receiving alfentanil
      anaesthesia for nasal surgery. Group 1 (n = 30) received metoclopramide 0.15
      mg.kg-1 and Group 2 (n = 30) received placebo. In addition, both groups received
      droperidol 0.02 mg.kg-1 immediately before anaesthesia which was supplemented by
      alfentanil 20 micrograms.kg-1 at induction followed by an infusion of 0.25-1
      micrograms.kg-1.min-1. Emetic symptoms were assessed 0-3 hr, 3-6 hr and 6-24 hr
      after surgery. Both groups received similar doses of alfentanil (mean +/- SD;
      Group 1 4641 +/- 1894 micrograms, Group 2 4714 +/- 1640 micrograms). The
      percentage of patients who had either nausea or vomiting at 0-3, 3-6 or 6-24 hr
      was 23%, 14% and 13% in Group 1; and 20%, 17% and 10% in Group 2. The overall
      incidence for each group was 8/30 (27%). There was no difference in the incidence
      of emetic symptoms between the groups at any time interval or throughout the
      study. Metoclopramide did not improve upon the antiemesis of droperidol during
      alfentanil anaesthesia for outpatient nasal surgery.

PMID- 1752000
TI  - On-site risk management.

PMID- 1751999
TI  - Critical incidents in anaesthesia: medico-legal and other aspects.

PMID- 1752001
TI  - Why accidents happen.

PMID- 1752002
TI  - How to measure what happens.

PMID- 1752003
TI  - A systematic method for the investigation of anaesthetic incidents.

PMID- 1752004
TI  - Medico-legal consequences.

PMID- 1752005
TI  - Epinephrine-aminophylline-induced arrhythmias after midazolam or thiopentone in
      halothane-anaesthetized dogs.
AB  - The purpose of this study was to evaluate epinephrine-aminophylline-induced
      arrhythmias during halothane anaesthesia after induction with thiopentone or
      midazolam. Ten mongrel dogs were studied during 1 MAC halothane and 50% N2O:O2
      anaesthesia while maintaining constant acid-base status. The minimal
      arrhythmogenic infusion rate of epinephrine (MAIRE) and the corresponding plasma
      concentration of epinephrine (MAPC) required to produce ventricular arrhythmias
      before and after aminophylline were higher following induction of anaesthesia
      with midazolam than with thiopentone (P less than 0.05); the MAIREs decreased
      stepwise with aminophylline (P less than 0.05). The correlation coefficient
      between individual MAIREs and MAPCs was 0.93 (P less than 0.001). Epinephrine
      alone and in combination with aminophylline was less arrhythmogenic after
      induction with midazolam than with thiopentone.

PMID- 1752006
TI  - Anaesthesia for Treacher Collins syndrome using a laryngeal mask airway.
AB  - Patients with Treacher Collins syndrome pose a serious problem to anaesthetists
      in maintaining their airway because of retrognathia. Two patients with Treacher
      Collins syndrome undergoing tympanoplasty are reported in whom a laryngeal mask
      was used in place of an endotracheal tube for airway maintenance.

PMID- 1752007
TI  - Anaesthetic management of Miller's syndrome.
AB  - Miller's syndrome is a rare congenital disorder with facial features similar to
      that of Treacher-Collins syndrome. This report details the anaesthetic management
      of an infant during multiple surgical procedures, beginning with pylormyotomy at
      one month of age. Airway management was difficult because of severe micrognathia
      and was accomplished using an awake intubation with a conventional straight blade
      modified for continuous administration of oxygen ("oxyscope"). Due to recurrent
      upper airway obstruction and the anticipated need for multiple surgical
      procedures in the first years of life, a tracheostomy was placed. Because of the
      multiple airway, orthopaedic, and nutritional difficulties, it is important that
      a prospective, multidisciplinary approach be used in these patients' care.
      Consideration should be given to early tracheostomy for airway maintenance.

PMID- 1752008
TI  - Role of two-dimensional transoesophageal echocardiography in the management of a
      right ventricular tumour.
AB  - Right ventricular outflow tract tumours are rarely reported. The perioperative
      management of a patient presenting for excision of an obstructing right
      ventricular outflow tract myxoma is described. Two-dimensional transoesophageal
      echocardiography was performed intraoperatively and was found to be of
      considerable value in understanding the pathophysiology of the tumour. Following
      excision of the tumour, right ventricular function improved and tricuspid
      regurgitation resolved.

PMID- 1752009
TI  - Clinical application of cardiac risk indices: how to avoid misleading numbers.
AB  - Perioperative cardiac complications are associated with a high mortality rate.
      During the preoperative assessment the anaesthetist must determine if the patient
      is at risk so that appropriate interventions can be made to ensure the best
      possible outcome. Over the past three decades several indices have been proposed
      to identify the surgical patient at risk of cardiac morbidity or mortality. These
      indices can be thought of as diagnostic tests which determine the likelihood of
      perioperative cardiac complication. In this article the authors review the
      epidemiological basis of diagnostic tests and apply this theory to three
      currently available indices of perioperative risk: the American Society of
      Anesthesiologists physical status classification, the Goldman multifactorial
      cardiac risk index and a modified version devised by Detsky. A case history
      describing a surgical patient with unstable angina is first presented to show how
      different indices can lead to different predictions. These indices are then
      analysed as if they were diagnostic tests to predict cardiac complications after
      surgery. The characteristics of diagnostic tests such as sensitivity,
      specificity, positive and negative predictive values, and receiver operating
      characteristic curves are described and applied to the indices. Basic principles
      such as odds ratio, likelihood ratio and their relation to prevalence and post
      test probability are also presented. This overview will help the anaesthetist to
      understand the limitations of risk indices as predictors of adverse cardiac
      outcome and to apply these scales more effectively to individual patients at
      different institutions.

PMID- 1752010
TI  - Successful use of a Fortec II vaporizer in the MRI suite: a case report with
      observations regarding magnetic field-induced vaporizer aberrancy.
AB  - Conducting a general anaesthetic within a magnetic resonance imaging (MRI) suite
      poses many problems for the anaesthetist. Ferromagnetic substances are contained
      in most anaesthetic and monitoring equipment. Their presence within the magnetic
      field may cause hazards and artifacts during imaging. This report describes the
      testing and use of a free-standing Fortec II vaporizer within an MRI suite. The
      Fortec II vaporizer's function was altered depending upon its distance from and
      orientation to the magnetic field. The MRI images were not affected by this
      vaporizer's presence within the MRI suite. We conclude that an inhalational
      anaesthetic can be administered, using a pretested free-standing anaesthetic
      vaporizer and a Bain circuit, within the magnetic field of a magnetic resonance
      imager.

PMID- 1752011
TI  - Flexible cystofibrescope for difficult intubation.

PMID- 1752012
TI  - Pharyngeal foreign body.

PMID- 1752013
TI  - Relationship between PaCO2-PETCO2 gradient and physiological dead space.

PMID- 1752014
TI  - Alarms in the operating room.

PMID- 1752015
TI  - Desflurane: the dawn of a new era?

PMID- 1752016
TI  - Perceived urgency and the anaesthetist: responses to common operating room
      monitor alarms.
AB  - Increasing numbers and varieties of electronic monitors are used in hospital
      operating rooms. Many of these are equipped with auditory alarms which are loud,
      insistent, or irritating, and thus are frequently disabled by the anaesthetist.
      This study was planned to evaluate two components of auditory alarm design which
      may influence the usefulness of the alarm: the perceived urgency of the auditory
      signal and its correlation with the urgency of the corresponding clinical
      situation. We also assessed the ability of practising anaesthetists to identify
      the monitor or condition responsible for the alarm. Sixty-four anaesthetists
      attending a national conference assessed ten common operating room alarm sounds
      for perceived urgency. Results were compared with the urgency of the
      corresponding clinical situation as determined by 12 senior anaesthetists.
      Discrepancies between the clinical and perceived urgencies of several monitor
      alarms were found, and there was no correlation between the two measures. The
      subjects were also tested for their ability to identify the alarm sounds
      correctly. The overall correct identification rate was 33%, and only two monitors
      were correctly identified by more than 50% of the subjects. The results of this
      study have implications for design and use of auditory alarms in hospitals and
      suggest the need for further research.

PMID- 1752017
TI  - Metabolism of desflurane and isoflurane to fluoride ion in surgical patients.
AB  - The metabolism of isoflurane and the investigational volatile anaesthetic
      desflurane to fluoride ion was examined in 25 surgical patients. The patients
      were randomly assigned to four groups, to receive isoflurane or desflurane at
      either 0.65 MAC or 1.25 MAC. Anaesthesia was induced in all patients with
      thiopentone and midazolam and included nitrous oxide 60% in addition to the
      volatile agent. Blood was drawn before induction and at the end of the operation
      for determination of serum fluoride ion concentration. Plasma fluoride ion
      concentrations increased (+ 1.36 +/- 0.93 microM, P less than 0.01) in patients
      receiving isoflurane but were unchanged (-0.13 +/- 0.50 microM) in patients
      receiving desflurane. Metabolic release of fluoride ion is less with desflurane
      than with isoflurane during administration of the anaesthetics to surgical
      patients, and is unlikely to be of clinical significance.

PMID- 1752018
TI  - Metabolic and endocrine responses to surgery during caudal analgesia in children.
AB  - Plasma concentrations of glucose, lactate, epinephrine, norepinephrine, insulin,
      cortisol and growth hormone were measured in 28 healthy children, three to six
      years of age, before, during, and after lower abdominal surgery. The children
      received premedication with secobarbital, 6 mg.kg-1, pentazocine, 0.5 mg.kg-1,
      and atropine, 0.01 mg.kg-1 im. Fourteen children received general anaesthesia
      with nitrous oxide and halothane, and 14 others received caudal analgesia with
      1.5% mepivacaine. Plasma glucose, epinephrine and norepinephrine concentrations
      remained unchanged in the general anaesthesia group, but decreased during and
      after surgery in the caudal analgesia group (P less than 0.05). During surgery,
      these concentrations were different between the two groups (P less than 0.05).
      Plasma insulin and cortisol concentrations increased after surgery (P less than
      0.05), and growth hormone concentration increased during and after surgery in the
      general anaesthesia group (P less than 0.05), but the concentrations of these
      hormones remained unchanged during and after surgery in the caudal analgesia
      group. Plasma lactate concentrations were unchanged in both groups. These results
      indicate that caudal analgesia suppresses the metabolic and endocrine responses
      to stress associated with lower abdominal surgery in children.

PMID- 1752019
TI  - Transcranial Doppler sonography: nitrous oxide and cerebral blood flow velocity
      in children.
AB  - To determine the effect of nitrous oxide (N2O) on cerebral blood flow velocity
      (CBFV) and cerebrovascular resistance index (RI+) in children, ten ASA physical
      status I or II patients aged one to eight years old, scheduled for urological
      procedures, were studied. Anaesthesia was induced with thiopentone 2 mg.kg-1,
      fentanyl 5 micrograms.kg-1 and diazepam 0.3 mg.kg-1. Muscular relaxation was
      ensured by using vecuronium 0.1 mg.kg-1. After tracheal intubation, anaesthesia
      was randomly assigned to either a mixture of air in oxygen (N2/O2) or 70% N2O in
      oxygen (N2O/O2) producing an FIO2 of 30%. Three sets of measurements of CBFV and
      RI+ were made with both gas mixtures. The CBFV and RI+ were measured in the
      middle cerebral artery (MCA) with a transcranial Doppler monitor. Measurements
      were made while using the initial gas mixture, then the second gas mixture was
      administered, and finally, the patient again was given the initial gas mixture. A
      continuous caudal epidural or lumbar epidural block was performed before skin
      incision. Neuromuscular blockade was maintained with vecuronium 0.05 mg.kg-1.
      Temperature, heart rate, end-tidal CO2, arterial oxygen saturation, haematocrit
      and arterial blood pressure were maintained constant. Ventilation was adjusted to
      achieve normocapnia. The CBFV increased when 70% N2/O2 was replaced by 70% N2O/O2
      (P less than 0.05) while the CBFV decreased when 70% N2/O2 was readministered (P
      less than 0.05). Likewise, the CBFV decreased when 70% N2O/O2 was replaced by 70%
      N2/O2 (P less than 0.05) while the CBFV increased when 70% N2O/O2 was
      readministered (P less than 0.05).

PMID- 1752020
TI  - Alfentanil infusion for sedation in infants and small children during cardiac
      catheterization.
AB  - We have analyzed several sedation techniques for paediatric cardiac
      catheterization which offer stable conditions for a few hours investigation, and
      maintain spontaneous breathing. In the present study, after premedication with
      oral flunitrazepam 0.1 mg.kg-1, 14 children aged 1-17 mo were sedated with an
      individually titrated alfentanil infusion. Every patient was sedated to a level
      which produced no reaction to pain or any discomfort. The induction dose and the
      maintenance requirement of alfentanil were 24 +/- 8 micrograms.kg-1 and 32 +/- 8
      micrograms.kg-1.hr-1 (mean +/- SD), respectively. These doses were less in
      cyanotic than in acyanotic patients: 21 +/- 6 vs 28 +/- 8 micrograms.kg-1 and 29
      +/- 10 vs 34 +/- 3 micrograms.kg-1.hr-1, respectively (P less than 0.05). The
      mean plasma concentration of alfentanil during maintenance of sedation was 79 +/-
      23 ng.ml-1. Ventilation of two children was assisted for a short time after an
      incremental bolus of alfentanil. It is concluded that an alfentanil infusion
      technique with close monitoring of breathing is a practical sedation method for
      paediatric cardiac catheterization.

PMID- 1752021
TI  - Evaluation of oxygen saturation monitoring by pulse oximetry in neonates in the
      delivery system.
AB  - The pulse oximeter was evaluated for use in neonates in the delivery room. One
      hundred neonates, delivered vaginally or by Caesarean section with general or
      epidural anaesthesia, were studied. After delivery, pulse oximetry probes were
      placed simultaneously on the ulnar side of the right hand and on the right
      Achilles tendon to determine whether there was a difference in arterial
      oxygenation (SpO2). Measurements of SpO2 were taken at 1, 5, 10 min, and 24 hr
      after delivery. At one and five minutes, SpO2 recorded from the right hand was
      higher than that recorded from the lower extremities (71.9% +/- 6.5% vs 63.4% +/-
      4.3% and 83.3% +/- 4.2% vs 76% +/- 4.1%, mean +/- SD, respectively). At ten
      minutes these differences diminished, and had almost completely disappeared after
      24 hr. These results can be explained by the presence of R-L shunting at the
      ductus arteriosus level, producing reduced SaO2 in the lower extremities. Oxygen
      saturation did not differ between neonates delivered vaginally or by Caesarean
      section, regardless of the presence or type of anaesthesia. We concluded that
      neonates remain relatively desaturated in the immediate postpartum period and
      that the SpO2 obtained from the right hand is a better index of neonatal
      oxygenation than that obtained from the heel.

PMID- 1752022
TI  - Large tidal volume ventilation improves pulmonary gas exchange during lower
      abdominal surgery in Trendelenburg's position.
AB  - Impaired pulmonary gas exchange is a common complication of general anaesthesia.
      Periodic hyperinflation of the lungs and large tidal volume ventilation were the
      first preventive measures to be widely embraced, but their effectiveness in
      clinical practice has never been clearly established by controlled clinical
      studies. To assess their effects in high-risk patients we studied 24 adults
      having lower abdominal gynaecological surgery in the Trendelenburg (head down)
      position. Pulmonary oxygen exchange was determined during four steady-states:
      awake control (AC), after 30 min of conventional tidal volume (CVT, 7.5 ml.kg-1)
      or high tidal volume (HVT, 12.7 ml.kg-1) ventilation, introduced in random order,
      and five minutes after manual hyperinflations (HI) of the lungs. The patients'
      lungs were ventilated with air/O2 by an Ohmeda volume-controlled ventilator via a
      circle system. The FIO2 was controlled at 0.5, and FETCO2 was controlled by
      adding dead space during HVT. Arterial blood gas analysis was used to calculate
      the oxygen tension-based indices of gas exchange. There was significant
      deterioration of (A-a)DO2 at 30 min in Group A, whose lungs were first ventilated
      with CVT (81.6 +/- 7.2 to 166.8 +/- 13.7 mmHg, P less than 0.001); but not in
      Group B, whose lungs were first ventilated with HVT (77.0 +/- 9.9 to 104.4 +/-
      16.8 mmHg). When Group A and B data were pooled there was no difference between
      randomized CVT and HVT, but improvement occurred after HI. In this model of
      compromised O2 exchange large inflation volumes (HVT and HI) were of considerable
      clinical benefit, HVT prevented and HI reversed the gas exchange disorder.

PMID- 1752023
TI  - Effects of rGM-CSF on leukemia cell proliferation and on the incorporation of
      cytosine arabinoside into DNA.
AB  - In vitro studies of the effects of recombinant granulocyte macrophage-colony
      stimulating factor (rGM-CSF) on freshly obtained human leukemia cells were
      conducted to determine if there is a relationship between the effects of this
      growth factor on the proliferative characteristics of leukemia cells and on their
      incorporation of cytosine arabinoside (araC) into DNA. While rGM-CSF was found to
      be able to stimulate both leukemia cell proliferation and araC incorporation, for
      individual leukemia specimens there was no consistent relationship among these
      effects. In some specimens proliferation was stimulated without an increase in
      araC incorporation. The reverse was also observed. These studies demonstrate the
      difficulty in identifying assays capable of predicting the clinical effects of
      growth factors on leukemia cells in patients since the effect in vitro vary with
      the assay.

PMID- 1752024
TI  - Mitochondrial nucleotide translocase from skeletal muscle of halothane sensitive
      pigs: an electrophoretic study.
AB  - ATP translocation into mitochondria isolated from halothane-sensitive pig (HP)
      muscle was dramatically reduced compared with normal pigs (NP). To determine if
      this was due to a decreased amount of ATP translocase in the mitochondrial
      membranes, or a structural modification of this protein, an electrophoretic study
      was undertaken. Total proteins and purified translocase preparations from (NP)
      and (HP) mitochondria were analyzed by SDS gel electrophoresis. In the two types
      of mitochondria no significant differences were observed either in the amount of
      ATP translocase or in the molecular weight. Also, neither nonequilibrium pH
      gradient gel electrophoresis nor the analysis of peptides produced by limited
      proteolysis revealed any structural difference between the two types of protein.
      On the basis of these results, the depressed translocase activity observed in
      (HP) mitochondria cannot be explained by a reduced amount of the nucleotide
      translocase, nor a structural alteration of this protein. Possible inhibition of
      (HP) translocase activity by Ca2+ accumulation or by other mechanisms is
      discussed.

PMID- 1752025
TI  - A comparative study of the effects of the diamine oxidase inhibitor
      aminoguanidine, with or without dietary restriction, on the nucleic acid and
      protein composition of cardiac and type I and type II skeletal muscles of the
      rat.
AB  - It has been proposed that the diamine oxidase inhibitor aminoguanidine may be a
      potential therapeutically important anabolic agent. An investigation was
      therefore made into the effects of aminoguanidine treatment with or without
      nutritional restriction, on cardiac and skeletal muscles containing mainly of
      either Type I (i.e. soleus) or Type II fibres (i.e. plantaris) or a mixture of
      Type I and II fibres (i.e. gastrocnemius). After 3 weeks, dietary restrictions
      reduced cardiac weight, protein, RNA and DNA contents by between 31 per cent and
      36 per cent. Similar, but smaller, reductions were observed in the soleus (18-31
      per cent), plantaris (22-34 per cent) and gastrocnemius (22-34 per cent).
      Aminoguanidine had no effect on the heart of the rats fed ad libitum, nor did it
      alter the response to dietary restriction. Treatment with aminoguanidine had no
      overt anabolic effect on skeletal muscle, but a reduction in DNA content was
      observed. It was concluded that cardiac protein and nucleic acid contents are
      more sensitive to dietary deprivation than either anaerobic or aerobic skeletal
      muscles. Furthermore, aminoguanidine does not appear to promote growth or reduce
      catabolism as previous studies have suggested.

PMID- 1752026
TI  - Variation in the isoenzymes of N-acetyl-beta-D-glucosaminidase and protein
      excretion in aminoglycoside nephrotoxicity in the rat.
AB  - Three aminoglycosidic antibiotics: tobramycin, amikacin and sisomicin were
      administered to rats. There was an increase in the activity of N-acetyl-beta-D
      glucosaminidase (NAG) excreted in the urine and this was characterized by a
      change in the isoenzyme profiles eluted from DEAE--cellulose. The largest
      increase in NAG activity was observed following sisomicin administration due
      mainly to an increase in the B-form of NAG with a concomitant fall in the
      intermediate (I-form). Separation of urinary proteins by SDS-polyacrylamide gel
      electrophoresis demonstrated a mixed tubular and glomerular proteinuria following
      administration of sisomicin. It is concluded that the separation of NAG
      isoenzymes and urinary proteins provides valuable additional information on the
      nature and severity of antibiotic nephrotoxicity.

PMID- 1752027
TI  - Managing three common oncologic emergencies.

PMID- 1752028
TI  - Lytic lesion of the knee in a 27-year-old man.

PMID- 1752029
TI  - Pulmonary hypertension secondary to fibrosing mediastinitis.

PMID- 1752030
TI  - Severity of illness: APACHE II analysis of an ICU population.
AB  - We reviewed the population of a surgical intensive care unit from July 1, 1987 to
      June 30, 1988, adjusting for severity of illness using the APACHE II system.
      Nineteen different departments admitted a total of 613 patients to the surgical
      intensive care unit. Predicted mortality was 22.9%; actual mortality was 15.7%.
      APACHE II generated reports which included analysis by age, mortality risk,
      department, primary physician, and diagnosis. We recommend reporting intensive
      care unit outcome by APACHE criteria to allow more meaningful comparisons of data
      and standardization of quality assurance programs. Finally, we present a critical
      review of the current APACHE II system and describe developments to be included
      in APACHE III.

PMID- 1752031
TI  - Demographics of long-term ventilator-dependent patients outside the intensive
      care unit.
AB  - Continued management of clinically stable ventilator-dependent patients in the
      intensive care unit is controversial, given the expense and limitations of
      intensive care resources. A proposed alternative, which could reduce the cost of
      care, has been "noninvasive respiratory units." We review the management of 99
      ventilator-dependent patients on routine nursing floors to define our case mix
      and the outcome of long-term care.

PMID- 1752032
TI  - Signal-averaged electrocardiography for detection of ventricular tachycardia
      using fast Fourier transform filtering on a standard ECG cart.
AB  - Signal-averaged electrocardiography has been advocated as a technique to predict
      the occurrence of ventricular tachycardia, especially in patients with ischemic
      heart disease. We studied a heterogeneous population of 77 patients referred for
      electrophysiologic testing using a recently developed fast Fourier transform
      filtering system available as part of a standard electrocardiography cart. The
      sensitivity, specificity, and positive predictive accuracy of this system were
      consistent with those previously determined using bidirectional Butterworth
      filters or finite impulse response filtering techniques. This new filtering
      approach in generation of signal-averaged ECG data for detection of ventricular
      tachycardia has promise but will require use in larger groups to establish its
      true clinical value.

PMID- 1752033
TI  - Perioperative blood transfusion and survival of breast cancer patients after
      modified radical mastectomy.
AB  - To investigate the effect of perioperative blood transfusion on the survival of
      patients with breast cancer, the authors reviewed the clinical records of 455
      patients who underwent modified radical mastectomy between 1960 and 1979. Thirty
      eight patients (8.4%) received blood transfusions. For stage I patients who
      received perioperative transfusions, 5- and 10-year survival rates were 53% and
      47%; for the no-transfusion group, the rates were 93% and 85%. There was also a
      significant difference in disease-free survival for stage I patients: for the
      transfusion group, 5- and 10-year survival rates were 47%; for the group not
      receiving a transfusion, the rates were 89% and 84%. For stage II patients, there
      was no difference in total or disease-free survival between those who received
      transfusions and those who did not, and both groups had comparable distribution
      of nodes.

PMID- 1752034
TI  - Experimental limbic epilepsy: models, pathophysiologic concepts, and clinical
      relevance.
AB  - Complex partial seizures originating in the temporal lobe are one of the most
      common types of seizures in patients with epilepsy. They are frequently
      intractable to medical treatment and are increasingly considered for surgical
      therapy. These seizures are often associated with focal epileptogenicity in
      limbic structures (amygdala and hippocampus) or with rapid spread of seizure
      activity to these areas. Much research is being undertaken to better understand
      this disorder and to develop more effective approaches to diagnosis and
      treatment. Experimental work in animals has contributed to the understanding of
      epileptogenesis, the interictal state, and the homeostatic mechanisms that limit
      seizure activity.

PMID- 1752035
TI  - Orf: case report and literature review.
AB  - Ecthyma contagiosum, or orf, is an uncommon dermatosis resulting from cutaneous
      infection with sheep pox virus. It is generally a benign and self-limited
      condition. Early clinical recognition is paramount to avoid unnecessary surgical
      intervention or extensive diagnostic workup. Diagnosis is usually based on a
      clinically typical skin lesion, characteristic histology, and a history of sheep
      exposure. We report the case of an infected sheep farmer and review the
      literature.

PMID- 1752036
TI  - Benefits and risks of blood transfusion.

PMID- 1752037
TI  - Caring for the hospitalized ventilator-dependent patient outside the ICU: united
      and stand, or divided and fall?

PMID- 1752038
TI  - Cryopreservation and transplantation of immature rat retina into adult rat
      retina.
AB  - A bank of freeze-stored donor retinas would free transplantation research from
      dependence on availability of fresh donor tissue. Donor retinas from E13, E16,
      E19 and E22 (P1) rat embryos were cryoprotected and stored in liquid nitrogen for
      up to 8 months. Cryopreserved and fresh donor retinas were grafted to adult rat
      retina. After 4 weeks survival, transplants were evaluated according to a scoring
      protocol for the criteria of size, viability, lamination and integration. All
      donor ages of fresh and cryopreserved retina resulted in successful transplants,
      with the exception of cryopreserved E13. Cryopreserved grafts were significantly
      less laminated than grafts of fresh tissue. The best lamination scores of
      cryopreserved transplants were achieved with donor age E16. Surviving transplants
      were found in the epiretinal and/or subretinal space. Subretinal transplants had
      higher viability scores than did epiretinal grafts; the difference was more
      pronounced with transplants of cryopreserved than with fresh tissue. Fresh
      subretinal transplants were also significantly better laminated than fresh
      epiretinal transplants. This study shows that (1) cryopreserved retinal donor
      tissue can successfully be transplanted to rat retina; and (2) the subretinal
      space appears to be more favorable than the epiretinal space for retinal
      transplants.

PMID- 1752039
TI  - Muscle-derived factors reverse the cholinotoxic effects of ethanol during early
      neuroembryogenesis in the chick embryo.
AB  - The interaction between muscle-derived factors and ethanol on cholinergic
      neuronal expression was studied in the chick embryo during early
      neuroembryogenesis using choline acetyltransferase (ChAT) as cholinergic neuronal
      marker. Ethanol (10 mg/50 microliters) and limb muscle extract (130 micrograms
      protein/50 microliters) (LME) were administered in ovo either alone or
      concomitantly at embryonic days 1-3 (E1-E3); or ethanol was given E1-E3 and
      followed by LME at E4-E7. All groups were sacrificed at embryonic day 8 (E8) and
      ChAT activity was assayed in homogenates of whole brain and of spinal cord. As
      previously reported, ethanol at E1-3 produced a 30% decrease in brain ChAT
      activity and 35% in spinal cord. Concomitant administration of ethanol and LME at
      embryonic days E1-E3 eliminated the decrease in choline acetyltransferase
      activity produced by ethanol in the brain, but not in the spinal cord. On the
      other hand, administration of LME at embryonic days E4-E7 to embryos pretreated
      with ethanol at embryonic days E1-E3, raised ChAT activity to control level in
      the spinal cord, but only partially restored ChAT activity in the brain. In view
      of the alleged neurotrophic effects of muscle-derived factors on neuronal
      survival and neuronal growth, we interpret these findings to suggest that LME in
      addition to its ability to decrease natural neuronal death, may prevent death
      resulting from neurotoxicity.

PMID- 1752040
TI  - Stereological analysis of the hypothalamic ventromedial nucleus. II. Hormone
      induced changes in the synaptogenic pattern.
AB  - Stereological electron microscopic analysis of the rat hypothalamic ventromedial
      nucleus (VMN) throughout postnatal development revealed that synaptogenesis takes
      place up to day 45. Our results disclosed a sexual dimorphism in the synaptic
      organization of the neuropil of the ventrolateral (VL) subdivision of the VMN.
      The numerical densities of spine and shaft synapses in the adult male were higher
      than in the female. A dimorphic pattern in the numerical density of spine
      synapses occurred as early as day 5, and was present throughout postnatal life,
      even though in the adult rats both spine and shaft synapses were sexually
      dimorphic. Neonatal treatment of female rats with testosterone increased the
      numerical density of axodendritic synapses, inducing a pattern similar to the
      adult male. On the other hand, administration of tamoxifen to newborn male rats
      significantly reduced the numerical density of spine synapses to levels
      comparable to normal female rats.

PMID- 1752041
TI  - Development of rostrocaudal dendritic bundles in rat thoracic spinal cord:
      analysis of cholinergic sympathetic preganglionic neurons.
AB  - Using monoclonal antibodies to choline acetyltransferase (ChAT) and glial
      fibrillary acidic protein (GFAP), we have analyzed the development of the
      dendritic bundles formed by cholinergic sympathetic preganglionic neurons (SPNs)
      in relationship to changes in the organization of glial fibers. In adult rat
      thoracic spinal cord, SPNs in the intermediolateral (IML) and central autonomic
      (CA) regions extend dendrites in both the mediolateral and rostrocaudal
      directions, forming a ladder-like pattern in horizontal sections of thoracic
      spinal cord. We report that, while the mediolateral dendrites form prenatally,
      the rostrocaudal dendritic bundles are not detected until at least a week later,
      during early postnatal life. The rostrocaudal dendrites develop rapidly during
      the first postnatal week, and achieve an adult-like pattern by postnatal day 14.
      The observed ontogenetic arrangements of dendritic bundles were correlated with
      the developing organization of astroglial processes with which they are
      intimately associated. While the appearance of mediolateral dendrites is
      consistent with the radial organization of glial in the embryonic spinal cord,
      the developmental time course of the rostrocaudal dendritic bundles coincides
      with the transformation of glial cells from this predominantly radial or
      transverse orientation to the randomly-oriented, stellate pattern of mature
      astrocytes. This temporal association suggests that ontogenetic changes in the
      organization of glial cells may contribute to the differential development of
      mediolateral and rostrocaudal dendritic patterns in the spinal cord.

PMID- 1752042
TI  - Maturational and aging effects on guanine nucleotide binding protein
      immunoreactivity in human brain.
AB  - Age-related changes in transmembrane signal transduction have been reported for a
      number of hormonal receptors in human tissues. Guanine nucleotide binding
      proteins (G-proteins) are major regulatory components in the signal transduction
      processes for numerous receptors. Developmental changes in the abundance of
      specific G-protein alpha subunits, especially for Go, have already been shown in
      rat brain and in neuronal cell lines. In this study, immunoblotting analyses were
      performed with specific rabbit polyclonal antisera to Gs alpha, Gi alpha, Go
      alpha, and G beta subunits to estimate semi-quantitatively these G-protein
      subunits in samples of parietal cortex obtained postmortem from 18 subjects free
      of neurologic or psychiatric disease whose ages ranged from 3 days to 92 years.
      The Gs and Gi alpha subunit immunoreactivities were correlated significantly and
      inversely with age. The Gi alpha immunoreactivity declined markedly (46%) after
      the age of 40. As other G-protein subunit concentrations showed no age-dependent
      changes, the observed relationship between Gs and Gi alpha subunits and age is
      not likely due to cell loss occurring with advancing age. Of particular interest,
      the ratio of 52 to 45 kDa Gs alpha subunit immunoreactivities was significantly
      higher in infants than that found for adult parietal cortex. Given that changes
      in G-protein subunit abundance directly affect receptor-G-protein-effector
      functionality and response, these age-related alterations may be of importance in
      cerebral dysfunction and the development of neuropsychiatric disease in the later
      years of life.

PMID- 1752043
TI  - The histopathological, behavioral and neurochemical effects of intraventricular
      injection of ethylcholine mustard aziridinium (AF64A) in the neonatal rat.
AB  - This study investigated the histopathological, behavioral and neurochemical
      effects of bilateral injection of 2.0, 0.5 and 0.1 nmol/ventricle ethylcholine
      aziridinium (AF64A) on postnatal day (PND) 2. The rats showed a significant, but
      non-dose-related reduction of choline acetyltransferase (ChAT) in the hippocampus
      but not the cerebral cortex or the caudate nucleus when sacrificed on PND 16. No
      effect on ChAT was found in any region at PND 58. The group given 2
      nmol/ventricle were hyperactive and showed a deficit in spatial learning when
      tested on the Morris water maze at PND 38-43. No such differences were observed
      for the rats injected with 0.1 or 0.5 nmol/ventricle AF64A. This spatial learning
      impairment in the 2 nmol group was associated with non-specific tissue damage
      seen only in animals from this group that were sacrificed at PND 40. This tissue
      damage was most evident in the left medial frontal cortex, the caudate nuclei and
      the anterior dorsal hippocampus.

PMID- 1752044
TI  - Molecules secreted from target and non-target tissues promote and repel
      sympathetic fiber distribution in vitro.
AB  - By using an in vitro assay system detecting the ability of nerve terminals to
      recognize the test molecules, I found that sympathetic fibers distributed densely
      on substrates coated with the particulate (adheron) fractions of growth
      conditioned medium from expansor secundariorum (target tissue), but did not on
      substrates coated with those from skeletal muscle (non-target). This result
      suggests that adheron particles are involved in the haptotactic process of
      specific sympathetic innervation on the target tissue.

PMID- 1752045
TI  - Role of fibronectin in the inhibitory effect of TGF-beta on choline
      acetyltransferase activity in co-cultures of spinal cord neurons and myotubes.
AB  - We have recently shown that the enhanced expression of choline acetyltransferase
      (ChAT) activity in co-cultures of spinal cord motoneurons and muscle cells was
      blocked by transforming growth factor-beta (TGF-beta) (Dev. Brain Res., 57, 129
      137, 1990). This study was performed to investigate the role of fibronectin in
      this effect. TGF-beta increased fibronectin level about 2-fold in extracellular
      matrix of spinal cord cells and skeletal myotubes in culture. Addition of a
      synthetic polypeptide that competitively inhibits fibronectin binding to its cell
      surface receptor recovered the TGF-beta-induced suppression of ChAT activity in
      co-cultures. The polypeptide did not affect ChAT activity in cultures of spinal
      cord cells alone or in co-cultures without TGF-beta. These results indicate that
      TGF-beta inhibits the stimulation of ChAT activity in spinal cord neurons in co
      culture through a change in the composition and/or amount of fibronectin in the
      extracellular matrix at neuromuscular contacts.

PMID- 1752047
TI  - Distribution of immunoreactive relaxin in the genital tract and in the mammary
      gland of non-pregnant women.
AB  - Relaxin was determined in healthy and pathological tissue samples from mammary
      gland, ovary, myometrium and cervix uteri of non-pregnant women. Relaxin could be
      detected in all groups of tissues examined. The highest values were found in
      healthy ovary, the lowest concentrations in the cervix, which is known as a
      target organ for relaxin activity during pregnancy. Mammary parenchyma showed the
      highest specific activity of all healthy tissues examined. The relaxin
      concentration in myoma tissue is significantly higher than in healthy myometrium.

PMID- 1752046
TI  - Effects of early in ovo administration of ethanol on expression of the GABAergic
      neuronal phenotype in the chick embryo.
AB  - In order to study the influence of ethanol on GABAergic neuronal expression in
      the chick embryonic brain, activity of glutamate decarboxylase (GAD; a GABAergic
      neuronal marker) was examined in whole brain derived from embryonic chick
      following the in ovo administration of ethanol. GAD activity was already
      detectable by 3 days of embryogenesis and exhibited a logarithmic increase up to
      embryonic day 16 (E16). By E18, GAD activity began to plateau. Administration of
      ethanol (10 mg/50 microliters/day) to embryos in ovo on days E1-E3, resulted in
      increased GAD activity in whole brain when embryos were sacrificed at E8.
      However, when embryos were administered ethanol on days E4-E7, activity of GAD
      was unchanged as compared with controls. Similarly, when embryos were
      administered ethanol chronically from E1-E7 no significant effect was observed in
      GAD activity. The increase observed in GAD activity after exposure to ethanol
      during a period of active neuronal proliferation (E1-E3) supports our view that
      E1-E3 is the critical period of sensitivity to ethanol with respect to the
      development of neuronal phenotypes during embryogenesis. Furthermore, the absence
      of any significant effect of ethanol administered from E1 to E7 on GAD activity
      suggests the existence of a compensatory response to ethanol insult.

PMID- 1752048
TI  - Intra-uterine foetal death: an avoidable diagnostic pitfall.
AB  - A case is presented where maternal tachycardia was misinterpreted as foetal heart
      activity on cardiography in a case of IUFD. Diagnostic implications and the use
      of real line ultrasound scanning are discussed.

PMID- 1752049
TI  - Psychological aspects of therapeutic abortion after early prenatal diagnosis.
AB  - The early discovery of a fetal pathology creates a "crisis" situation fraught
      with psychic problems for the couple who must live through it. The Authors
      observed a group of patients in the second trimester of pregnancy. They had all
      requested therapeutic abortion since serious malformation of the fetus had been
      confirmed. By means of a questionnaire constructed for the purpose, certain
      characteristics of fetal malformation and of pregnancy were evidenced, as well as
      the way these were experienced by the patients. The immediate and delayed
      reactions to the diagnosis of malformation were also studied, as was the
      experience lived when faced with the choice of abortion.

PMID- 1752050
TI  - Peritoneal fluid volume parameters in infertile patients.
AB  - The peritoneal fluid volume (PFV) and its cellular and acellular components have
      been repeatedly associated with infertility. The PFV from 88 infertile women was
      analyzed in relation to endometriosis, pelvic adhesions, tubal patency,
      luteinization, endometrial cells and macrophages. The independent existence of
      parameters such as the onset of luteinization, the increased population of
      macrophages and the presence of endometriosis increase statistically
      significantly the PFV. In the presence of peritoneal adhesions or/and obstructed
      tubes the PFV was significantly decreased.

PMID- 1752051
TI  - Evaluation by means of radius bone densitometry of the fracture risk due to
      osteoporosis in post-menopause.
AB  - The aim of this work is to establish the predictive value of radius bone density
      with reference to the risk of fracture in postmenopausal women. Our data confirm
      a significant predictability of the radius for limb and rib fractures, but not
      for vertebral bones.

PMID- 1752052
TI  - Telephonic transmission of cardiotocographic recordings from a remote facility to
      an obstetric unit.
AB  - The Authors describe their experience in telephonic transmission of
      cardiotocographic recordings. With a Corometrics 116 and 410 unit installed in a
      remote facility, 61 CTG recordings were tele-transmitted and received by a
      Toshiba personal computer. The concordance between original and transmitted CTG
      record was excellent and a very low percentage of signal loss during transmission
      (3.2%) was found. The advantages of telephone transmission of CTG in peripheral
      areas are stressed.

PMID- 1752053
TI  - Induction of labour in the presence of ruptured membranes with prostaglandin E2
      gel.
AB  - The study shows the safety and the efficacy of labour induction with
      prostaglandin E2 gel. By combining an initially conservative approach with later
      induction by PGE2 a vaginal delivery rate of 96.8% was achieved.

PMID- 1752054
TI  - Maternal serum cortisol and prolactin variations during labor.
AB  - Maternal serum cortisol (F) and prolactin (PRL) levels were measured during labor
      in 20 uncomplicated pregnancies. Four pregnant women were admitted with ruptured
      membranes (RM group) and 16 were admitted with intact membranes (IM group), ten
      with spontaneous onset of labor (SL group) and 10 with induced labor (IL group),
      five with a prolonged for duration labor (PL group) and 15 with a normal for
      duration labor (NL group). Before the inset of labor F levels were statistically
      higher (p less than 0.05) in the RM group (x = 975 ng/ml), than in the IM group
      (x = 664 ng/ml), and also in the SL group (x = 783 ng/ml), than in the IL group
      (x = 679 ng/ml). During labor, in all twenty pregnant women a marked rise of F
      (from x = 726 ng/ml before the onset of labor, to x = 911 ng/ml) and a marked
      fall of PRL (from x = 161 ng/ml to x = 122 ng/ml) were observed (p less than
      0.05). In the PL group the F elevation and the PRL drop were more pronounced (p
      less than 0.001). After placental separation, PRL levels increased slightly while
      F values remained unchanged. These changes in hormone levels before and during
      labor could be attributed to the emotional and physical stress of labor.

PMID- 1752055
TI  - Quality of life in gynaecological oncology.
AB  - In the last twenty years a new philosophy in the management of gynaecological
      cancer has begun: the goal of the therapy is now not only to save the life but
      also the patient's quality of life. To this end, on the basis of a century's
      experience and of progress in the oncologic field, therapies have been
      progressively personalized and modulated, considering both the surgical
      pathological staging and the effective possibilities in terms of survival and
      quality of life, in order to avoid over or undertreatments. Moreover, in the last
      few years also the patients submitted to surgery for gynaecological malignancies
      are beginning to ask gynaecologists for access to hormonal replacement therapy in
      order to prevent the symptoms typical of menopause, and physicians have to decide
      when that is possible. Consequently gynaecologist oncologists have to bear in
      mind the therapy's real cost/benefit balance for the patients, also from a
      psychological point of view, and in any case, treatments must be performed only
      if they are unquestionably useful and if they involve the patient's consciousness
      in choices and decisions.

PMID- 1752056
TI  - Growth hormone-binding proteins.

PMID- 1752057
TI  - Effects of sex and age on serum GH binding protein levels in normal adults.
AB  - OBJECTIVE: The effects of sex and age on serum growth hormone binding protein
      (GHBP) levels during adulthood were investigated. DESIGN: The levels of GHBP,
      insulin-like growth factor-I (IGF-I), and growth hormone (GH) were determined and
      analysed as a function of sex and age. PATIENTS: We studied 101 normal adults (45
      men, aged 20-77 years; 56 women, aged 20-80 years). MEASUREMENTS: GHBP levels
      were determined using an Ultrogel AcA 44 minicolumn. RESULTS: During the second
      and third decade, GHBP levels were not different between men (22.8 +/- 1.1%)
      (mean +/- SE) and women (23.2 +/- 0.8%). After the age of 40 years, however, GHBP
      levels in men were significantly decreased (19.1 +/- 0.7%), and were lower than
      those in women (22.7 +/- 0.9%). IGF-I levels correlated positively with GHBP
      levels in men (r = 0.51, P less than 0.01) but not in women (r = 0.16, NS).
      CONCLUSIONS: These results indicate that both sex and age may have some effects
      on the GH-GH receptor-IGF-I axis.

PMID- 1752058
TI  - Antisperm antibodies in the polyglandular autoimmune (PGA) syndrome type I:
      response to cyclical steroid therapy.
AB  - OBJECTIVE: To determine if cyclical intermediate dose steroid therapy could
      improve semen parameters in an infertile man with sperm autoimmunity associated
      with the polyglandular autoimmune (PGA) syndrome. DESIGN: Sperm agglutination
      studies performed before, during and after three courses of cyclical intermediate
      dose prednisolone therapy. PATIENT: A twenty-six-year old man with polyglandular
      autoimmune syndrome, consisting of Addison's disease, hypoparathyroidism, chronic
      mucocutaneous candidiasis and alopecia totalis, presented with infertility. He
      had normal endocrine testicular function but severe exocrine failure evidenced by
      a low sperm count (4.5 x 10(6)/ml), zero motility and universal sperm
      agglutination. MEASUREMENTS: Sperm agglutination tests. RESULTS: At presentation
      the gelatin agglutination test (GAT) was strongly positive in serum (1/1204) and
      seminal plasma (1/64) as was the tray agglutination test (TAT) (1/32). The
      patient's wife had a regular menstrual cycle with normal luteal phase
      progesterone levels. Following three courses of cyclical prednisolone (20 mg
      twice daily on days 1-10 of wife's cycle, and 5 mg on days 11 and 12), sperm
      quantity and motility improved considerably (12 x 10(6)/ml, 40% respectively) and
      sperm agglutination tests became negative. After a fourth course of therapy the
      patient's wife became pregnant. Three months post-treatment sperm motility was
      very low again and agglutinating activity in serum and seminal plasma increased.
      CONCLUSIONS: This is the first case of male infertility due to sperm autoimmunity
      in association with the PGA syndrome type 1. The immunosuppressive action of
      cyclical intermediate dose steroid therapy led to a significant quantitative and
      qualitative improvement in semen parameters.

PMID- 1752059
TI  - The secretory granule peptides 7B2 and CCB are sensitive biochemical markers of
      neuro-endocrine bronchial tumours in man.
AB  - OBJECTIVE: Bronchial tumours are the most frequent cause of the ectopic ACTH
      syndrome. Two types of tumours are classically responsible: the relatively benign
      carcinoids and the highly aggressive small cell carcinomas. Both have neuro
      endocrine features and are thought to originate from the endocrine component of
      the bronchial tree. Our objective was to assess the sensitivity of 7B2 and
      secretogranin 1 as new biochemical markers of neuro-endocrine differentiation in
      these tumours in comparison with gastrin releasing peptide. METHODS: Tissue
      concentration of 7B2, secretogranin 1 fragments (GAWK and CCB), gastrin releasing
      peptide and beta-endorphin were measured in normal human lung (n = 4), bronchial
      carcinoid tumours with (n = 5) and without (n = 15) the ectopic ACTH syndrome,
      small cell carcinomas (n = 2), squamous cell carcinomas (n = 11) and
      adenocarcinomas (n = 6). Molecular weight forms of immunoreactive--ACTH, -GAWK, 
      gastrin releasing peptide, and -7B2 were also examined using gel exclusion
      chromatography and Western blot analysis. RESULTS: We detected 7B2
      immunoreactivity in 19 of 22 neuro-endocrine lung tumours (with values ranging
      from less than 5 to 555 fmol/mg wet weight tissue), CCB immunoreactivity in 20 of
      22 tumours with neuro-endocrine features (with values ranging from less than 5 to
      19,875 fmol mg wet weight tissue) and gastrin releasing peptide immunoreactivity
      in 10 of 22 neuro-endocrine lung tumors (with values ranging from less than 5 to
      11,132 fmol/mg wet weight tissue). Immunoreactive 7B2 and CCB were detected
      neither in tumours with non-endocrine features, nor in the four normal lung
      specimens. Differing molecular weight forms of immunoreactive 7B2 in two
      bronchial carcinoids associated with the ectopic ACTH syndrome showed a
      predominant signal corresponding to a molecular weight of 22 kDa; in addition, a
      second signal of 19 kDa was also present. The differing molecular weight forms of
      immunoreactive ACTH related peptides in the five tumours responsible for the
      ectopic ACTH syndrome showed, in addition to ACTH1-39, the constant presence in
      variable proportions of corticotrophin-like intermediary lobe peptide (or ACTH18
      39). The differing molecular weight forms of immunoreactive GAWK showed
      heterogeneous results with materials eluting at Kav of 0, 0.3 and 0.4
      respectively. In the three bronchial carcinoids studied, two immunoreactive
      gastrin releasing peptide molecular weight forms were always found at Kav of 0.5
      and 0.85 corresponding to gastrin releasing peptide and its fragment 14-27
      respectively. CONCLUSION: Our results show that 7B2 and the two fragments of
      secretogranin 1 (GAWK and CCB) are the best biochemical markers of neuro
      endocrine differentiation in human lung tumours.

PMID- 1752060
TI  - Serum and follicular fluid insulin like growth factors I and II during growth
      hormone co-treatment for in-vitro fertilization and embryo transfer.
AB  - OBJECTIVE: We wished to assess the changes in serum IGF-I and IGF-II
      concentrations during gonadotrophin treatment alone or with additional GH
      treatment and to compare follicular fluid IGF-I and IGF-II concentrations in the
      two treatment groups. DESIGN: We performed an open study of co-treatment with GH
      and subsequently a randomized double blind comparison of addition of placebo or
      GH to clomiphene citrate and gonadotrophins. PATIENTS: We studied previously poor
      responders to superovulation regimens for in-vitro fertilization and embryo
      transfer, six women in an open study, four of whom had ultrasound diagnosed
      polycystic ovaries, and 17 women in a double blind study, 12 of whom had
      polycystic ovaries. MEASUREMENTS: We measured serum IGF-I and IGF-II
      concentrations throughout treatment cycles. Follicular fluid concentrations were
      measured at the time of oocyte recovery. RESULTS: Neither serum IGF-I nor IGF-II
      concentrations were altered by gonadotrophin treatment alone. However, co
      treatment with GH led to a significant rise in serum IGF-I concentrations in
      women with ultrasound diagnosed polycystic ovaries. Concentrations of IGF-I and
      IGF-II in follicular fluid were lower than in serum, although follicular fluid
      IGF-I concentrations were higher in women receiving GH than in those receiving
      placebo. CONCLUSIONS: Poor responders to superovulation regimens may have an
      abnormality of growth factor response. GH co-treatment leads to an increase in
      circulating IGF-I concentrations in women with polycystic ovaries but our results
      do not support the hypothesis that GH stimulates IGF-I production in the human
      ovary.

PMID- 1752061
TI  - Treatment with biosynthetic growth hormone of short thalassaemic patients with
      impaired growth hormone secretion.
AB  - OBJECTIVE: Impairment of linear growth is a common clinical feature in patients
      with beta-thalassaemia major. Although growth hormone secretion appears to be
      normal in many short thalassaemic patients, it proves to be deficient in some of
      them. In these cases, administration of biosynthetic growth hormone seems
      justified. The aim of this study was to evaluate the effect of such treatment in
      a group of patients with beta-thalassaemia major presenting with growth failure
      and impairment of growth hormone secretion. DESIGN: Recombinant human growth
      hormone, 0.6 U/kg body weight per week, given subcutaneously in three divided
      doses, was administered for 12 months. PATIENTS: Eight prepubertal patients with
      beta-thalassaemia major, presenting with severe growth retardation and impaired
      growth hormone secretion in response to provocative stimuli (insulin-induced
      hypoglycaemia, L-dopa and growth hormone-releasing hormone), were investigated.
      MEASUREMENTS: Height and pubertal stage of the patients, as well as plasma levels
      of insulin-like growth factor I, were determined before, during and after
      biosynthetic growth hormone treatment. RESULTS: During the first 6 months of
      therapy, a significant increase of growth velocity was observed, from a mean
      pretreatment value of 2.1 +/- 0.45 cm/year to a value of 4.8 +/- 0.66 cm/year (P
      less than 0.002). Mean growth rate at 12 months (4.1 +/- 0.50 cm/year), though
      slightly decreased in comparison to that recorded at 6 months, was still
      significantly higher than basal (P less than 0.001). A significant increase in
      plasma levels of insulin-like growth factor I was recorded during treatment (2.82
      +/- 0.47 vs 0.96 +/- 0.22 U/ml, P less than 0.005). No side-effects, adverse
      reactions or alterations in routine laboratory examinations ensued during or
      after therapy. CONCLUSIONS: It appears from these data that biosynthetic growth
      hormone administration is worth serious consideration in patients with beta
      thalassaemia major presenting growth retardation and impaired growth hormone
      secretion.

PMID- 1752062
TI  - Inhibin and age in men.
AB  - OBJECTIVE: Normal elderly men are reported to have decreased testicular function
      despite elevated gonadotrophin levels. We wished therefore to determine if
      changes in testicular function occur over the age range 19-60 years. DESIGN:
      Single fasting blood samples were obtained between 0800 and 0900 h. PATIENTS:
      Working men in a large industrial company between the ages of 19 and 60 years
      participated in the study. MEASUREMENTS: FSH, serum immunoreactive inhibin and
      total testosterone were measured, the latter two as measurements of Sertoli and
      Leydig cell function respectively. RESULTS: The mean baseline serum
      immunoreactive inhibin level was significantly lower in men from the older age
      groups, 31-40 years (479 U/l), 41-50 years (439 U/l) and 51-60 years (415 U/l)
      than in men from the youngest age group, 21-30 years (613 U/l) while serum FSH
      was higher in men from the older age groups, 41-50 years (3.7 IU/l) and 51-60
      years (6.1 IU/l) than in men from the youngest age group, 21-30 years (2.6 IU/l).
      There appears to be a change in both FSH and inhibin production, consistent with
      a primary decline in testicular function. There was no significant difference in
      testosterone levels between the older age group, age 51-60 years and the younger
      age group, age 21-30 years. However, testosterone levels were significantly lower
      in the 41-50 year age group, when compared with the 21-30 year, this significance
      levelling out at about age 45 years. CONCLUSION: The data are consistent with the
      hypothesis that immunoreactive inhibin reflects inhibin bioactivity, and that
      inhibin plays a role in the feedback control of FSH secretion in men.

PMID- 1752063
TI  - Ketoconazole treatment in Cushing's syndrome: experience in 34 patients.
AB  - OBJECTIVE: Ketoconazole treatment of Cushing's syndrome has been reported in
      single cases and a few small groups of 5-8 patients. We report our experience in
      34 patients. DESIGN: Clinical study, with pretreatment and post-treatment
      evaluations. PATIENTS: Out of 67 patients with Cushing's syndrome admitted during
      the last 6 years, 34 (28 females/six males; age range 14-67 years) received
      ketoconazole as a palliative treatment due to severe clinical conditions or
      management of the disease while awaiting results of definitive therapy.
      MEASUREMENTS: Urinary cortisol, plasma cortisol and ACTH, and routine chemistry
      were measured every week for 4 weeks, and then once a month. RESULTS: Comparing
      the last values (mean +/- SEM) during treatment with baseline, urinary cortisol
      decreased from 1296 +/- 176 to 270 +/- 69 nmol/d (n = 34; P less than 0.001);
      plasma cortisol decreased from 672 +/- 31 to 549 +/- 35 nmol/l (n = 34; P less
      than 0.001). For patients with pituitary-dependent Cushing's syndrome, urinary
      cortisol decreased from 1073 +/- 126 to 200 +/- 21 nmol/d (n = 28; P less than
      0.001) while plasma ACTH changed from 12.5 +/- 1.3 to 11.3 +/- 0.8 pmol/l (n =
      26; not significant). Twelve patients were treated for more than 6 months, and
      those with pituitary-dependent disease all received pituitary radiation therapy,
      except the two who eventually escaped pharmacological control. One additional
      patient with adrenal carcinoma and one with ectopic ACTH syndrome showed lack of
      control of urinary cortisol levels. Ketoconazole was withdrawn within the first
      week in two patients for allergic reaction and acute liver toxicity. Other side
      effects included: asymptomatic liver function abnormalities in three patients;
      gastrointestinal symptoms in four; worsening of gynaecomastia in one. Rapid
      clinical improvement was observed together with the normalization of urinary
      cortisol levels, with regression of symptoms such as diabetes mellitus,
      hypertension, hypokalaemia, and restoration of well being. CONCLUSIONS: These
      data confirm that ketoconazole is valuable in the management of hypercortisolism,
      provided that patients are closely watched to exclude those who may develop liver
      toxicity and to prevent the occurrence of adrenal insufficiency.

PMID- 1752064
TI  - beta-Endorphin and adrenocortical function in obesity.
AB  - OBJECTIVE: To test the hypothesis that the hyperendorphinaemia in obesity
      originates from outside the pituitary. DESIGN: Intravenous administration of
      corticotrophin-releasing hormone (CRH) after overnight suppression with 2 mg of
      dexamethasone in normal-weight controls and in obese subjects before and after
      weight reduction. PATIENTS: Eleven obese females, age (mean +/- SEM) 30 +/- 2.1
      years, body mass index (BMI) 41.2 +/- 1.9 kg/m2. Eight normal-weight females
      served as controls, age 26 +/- 2.1 years, BMI 21.4 +/- 0.5 kg/m2. Five obese
      subjects were also studied after weight loss of 18.4 +/- 1.0% of original weight.
      MEASUREMENTS: Plasma beta-endorphin, ACTH and cortisol. Cortisol production rate
      in 24-hour urine. Basal (without dexamethasone suppression) plasma beta-endorphin
      levels. RESULTS: Basal (without dexamethasone suppression) beta-endorphin levels
      were 7.7 +/- 0.8 pmol/l in the obese and 3.8 +/- 0.5 pmol/l in the control
      subjects (P less than 0.005). The degree of suppression of beta-endorphin after
      dexamethasone was similar in the obese (23.2 +/- 3.7%) and in the control
      subjects (28.2 +/- 0.12%). Administration of CRH following dexamethasone
      suppression resulted in a small but significant increase of plasma beta-endorphin
      in both obese (from 1.55 +/- 0.12 to 2.32 +/- 0.28 pmol/l) and control subjects
      (from 0.98 +/- 0.24 to 1.69 +/- 0.33 pmol/l). The groups did not differ regarding
      this response, nor regarding the release of ACTH and cortisol after CRH. Cortisol
      production rate was higher (P less than 0.001) in the obese (68.7 +/- 3.3
      mumol/24 h) than in the controls (40.0 +/- 3.0 mumol/24 h). No correlation
      between cortisol production rate and basal beta-endorphin levels was found.
      Weight loss appeared to have no influence on cortisol production rate, basal beta
      endorphin levels, or on the responses to dexamethasone or CRH. CONCLUSIONS:
      Plasma beta-endorphin in obese subjects can be affected by manipulations of the
      hypothalamic-pituitary-adrenocortical axis; the hypothesis that the
      hyperendorphinaemia of obesity originates from outside the pituitary cannot be
      confirmed.

PMID- 1752065
TI  - Regulation of hunger and satiety in man.
AB  - From the perspective presented in this minireview, it is clear that a variety of
      psychological and physiological factors interact to regulate feeding behavior.
      The hunger-satiety cycle involves preabsorptive and postabsorptive humoral and
      neuronal mechanisms. Psychological, social and environmental factors, nutrients
      and metabolical processes and gastric contractions originate hunger signals.
      Eating, in turn, activates inhibitory signals to produce satiety. Because of the
      delay between the swallowing of food and the digestion of food, the satiety
      mechanism requires a short-term signal to prevent over-eating. This short-term
      satiety signal is activated by psychological factors (such as sensory-specific
      satiety), chemical senses (taste and smell) and mechanical factors related to the
      process of swallowing and gastric distension. The long-term satiety is then
      activated by the chemoreception of nutrients and peptides by the gastrointestinal
      system (including the liver), the CNS and by intrinsic CNS mechanisms. The fine
      regulation of feeding behavior through these mechanisms will ensure the
      maintenance of normal energy metabolism. It is important to note, however, that
      despite all the efforts that have gone into the study of peripheral and central
      mechanisms of ingestive behavior--expressed in thousands of publications related
      to the anatomy, chemistry and metabolism, physiology and behavioral aspects of
      feeding--we will lack an understanding of the interactions among signals within a
      system or among different systems.

PMID- 1752066
TI  - Abdominal tuberculosis: a critical review.

PMID- 1752067
TI  - Etiology, pathogenesis and therapy of pigment gallstones.

PMID- 1752068
TI  - Portal hypertensive gastropathy.

PMID- 1752069
TI  - Hepatic fibrosis and its serum markers: a review.
AB  - Hepatic fibrosis is characterized by a progressive increase in extracellular
      matrix in the liver, formed by collagens, proteoglycans and glycoproteins,
      qualitatively similar but quantitatively different from that in normal liver. A
      great number of matrix-related substances have been investigated in serum in
      order to identify reliable serum markers of liver fibroplasia. Among the various
      cleavage products of collagen precursor, the NPIIIP collagen is at present
      considered the most reliable serum marker of active fibrogenesis in liver, useful
      in monitoring the progression of fibrosis and in assessing the therapeutic
      efficacy of antifibrotic drugs. Lam-P1 and type IV collagen are now regarded as
      putative markers of basement membrane formation and sinusoids capillarization, an
      important pathological process in fibrosing disease, related to the impairment of
      hepatic circulation. Other serum-measured matrix-related substances, e.g. enzymes
      involved in collagen metabolism, fibronectin and proteoglycans, have not proved
      to reflect liver fibroplasia reliably. In spite of the availability of useful
      serum markers, the assessment of hepatic fibrosis is still based on liver biopsy.

PMID- 1752070
TI  - Morphologic findings in "zero-hour" biopsies of renal transplants.
AB  - The extreme lack of renal grafts for transplantation stimulated us to analyze how
      strict the selection criteria of kidney donors must be. We investigated therefore
      if preexisting lesions in renal grafts influence initial and late renal function.
      147 zero-hour biopsies of 101 donors (mean age 33, from 6-64 years) were
      examined. By ligh microscopy 38% of biopsies showed no, 44% showed nonspecific
      and 18% specific lesions. Nonspecific lesions comprised intimal fibrosis of small
      arteries in 44%, interstitial fibrosis in 8% and an arteriolar hyalinosis in 29%.
      Out of 102 immunohistologically examined biopsies 74.5% showed nonspecific IgM/C3
      deposits in glomeruli and/or arterioles. An age dependent decrease of normal
      renal biopsies was found which was most evident in donors older than 40 years.
      Specific findings consisted of glomerulosclerosis (n = 4), glomerulonephritis (n
      = 11), intravascular coagulation (n = 10) and eclamptic kidney (n = 1). In case
      of nonspecific immunohistologic findings and in glomerulonephritis rebiopsies
      showed that antigen deposits usually disappeared within 4 months. Independent of
      morphologic findings 82% of transplant recipients had a good initial and late
      renal function. Since donor age, glomerulosclerosis, glomerulonephritis,
      intravascular coagulation or eclamptic changes seem not to compromise renal
      function after transplantation a more liberal choice of donors should be
      considered.

PMID- 1752071
TI  - A membranous nephropathy associated with adult polycystic kidney disease.
AB  - A 53-year-old woman with adult polycystic kidney disease (PKD) developed a
      nephrotic syndrome. Evaluation of the renal biopsy specimens showed typical
      findings of membranous nephropathy (MN). There are few reports of nephrotic
      syndrome associated with PKD and only one proved to be MN. The possible mechanism
      of the association of PKD with MN was evaluated. Autoantibodies against the brush
      border were not detected in this patient's serum by indirect immunofluorescence.
      Three monoclonal antibodies against the tubular brush border and epithelial cell
      of distal tubulus did not react with subepithelial deposits in the biopsy
      specimen. Therefore tubular brush border antigen which was reported to induce
      membranous nephropathy was not detected in the immune complexes deposited in the
      glomeruli. So we could not determine any direct relationship between PKD and MN.
      The reaction of antibodies against basement membrane components (type IV
      collagen, laminin, fibronectin, heparansulfate proteoglycan) with the basement
      membranes of the cysts was evaluated by indirect immunofluorescence. The reaction
      with anti-heparansulfate proteoglycan antibody was decreased compared with normal
      tubular basement membrane. The reactivity to anti-fibronectin antibody was
      remarkably increased in the cystic walls, tubules, and interstitium. Changes of
      tubular basement membrane antigens was observed in PKD.

PMID- 1752072
TI  - Urine kallikrein excretion in relation to renal sodium handling in minimal change
      nephrotic syndrome.
AB  - Twenty-four-hour urine kallikrein excretion (Uka), urine protein excretion, renal
      sodium handling, and the activity of the renin-angiotensin-aldosterone system
      were serially studied in 11 children at three different stages of the minimal
      change nephrotic syndrome (MCNS)-edema forming state, proteinuric steady state in
      which a relapse of the disease was just starting but no edema as yet and
      remission. The value for Uka was significantly increased in the edema forming
      state in contrast to the normal values of proteinuric steady state and remission.
      Serum sodium concentration was only decreased in the edema forming state and the
      degree of hypoalbuminemia and proteinuria did not differ between the edema
      forming and proteinuric steady states. Urine volume, absolute and fractional
      sodium excretion were significantly decreased in the edema forming and
      proteinuric steady states as compared with those in remission, suggesting that
      sodium retention was present in both states of the disease although the change in
      these parameters was more profound in the edema forming state than in the
      proteinuric steady state. Creatinine clearance did not differ among each stage of
      the disease. Plasma renin activity and plasma aldosterone concentration were
      significantly increased in the edema forming state as compared with those in the
      proteinuric steady state and remission. Plasma renin activity and plasma
      aldosterone concentration were significantly correlated directly with Uka and
      plasma aldosterone concentration was correlated inversely with urine sodium
      excretion. No relation was noted between Uka and other variables.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1752073
TI  - Repeated albumin infusions do not lower blood pressure in preeclampsia.
AB  - Since intravascular volume contraction is regarded as an important pathological
      feature in preeclampsia, it has been proposed that plasma volume expansion could
      be a therapeutic manoeuver that interrupts the pathogenetic chain of hypovolemia
      inducing increased vascular resistance. Furthermore, tissue perfusion should be
      improved and, if albumin is used as plasma expander agent, interstitial edema
      should also be reduced. We report the results observed in an open pilot study in
      ten preeclamptic patients treated with daily albumin infusions (0.4 to 1 g/kg)
      from 7 to 36 days. No acute effects were shown on blood pressure, and the need
      for antihypertensive therapies did not decrease in the following days. Serial
      evaluation after at least five or ten days of repeated albumin infusions did not
      show stable changes in electrolytes excretion, renal clearances, serum protein
      concentration and hematocrit value, nor in aldosterone, renin and atrial
      natriuretic peptide basal levels, while proteinuria tended to increase.
      Uteroplacental and fetoplacental blood flow acutely ameliorated in 3 cases only
      after albumin 1 g/Kg, but reached basal values again on the next day. The
      clinical implications are that daily albumin infusions with this schedule dosage
      do not lower blood pressure and that they are unable to induce stable changes in
      renal function, uteroplacental and fetoplacental resistance. No maternal
      complications were observed during the conservative management, but fetal
      mortality was high (6/10). Given the uncontrolled study, we cannot know whether
      similar results had been achieved by conventional therapy only.

PMID- 1752074
TI  - Renal failure and cholesterol crystal embolization: a report of 4 surviving cases
      and a review of the literature.
AB  - Four patients with end-stage renal failure (suspected to be) caused by
      cholesterol crystal emboli are described. Although cholesterol crystal
      embolization is generally considered to be fatal specifically when it is
      associated with renal failure, all four patients survived and in three renal
      function improved after periods of 3 weeks to 14 months of hemo- or peritoneal
      dialysis. The literature on cholesterol crystal embolization is reviewed and
      possible mechanisms of (partial) recovery of renal function are discussed.

PMID- 1752075
TI  - Once weekly versus twice weekly subcutaneous administration of recombinant human
      erythropoietin in patients on continuous ambulatory peritoneal dialysis.
AB  - Twice weekly subcutaneous (s.c.) administration of recombinant human
      erythropoietin (rHuEPO) is effective in reversing renal anemia in CAPD patients.
      However the optimal frequency of administration has not been established. It
      would be more convenient to give rHuEPO by once weekly rather than twice weekly
      injection. We have therefore compared the effect of twice weekly versus once
      weekly s.c. administration of rHuEPO. Two groups of 10 CAPD patients were given
      the same starting dose of s.c. rHuEPO (100 U/kg body wt/week) either as a single
      weekly dose or twice weekly in divided doses. The rHuEPO dosage was then adjusted
      according to the hematologic response. The aim was to increase hemoglobin levels
      by about 1 g/dl per month. The target hemoglobin was 10 g/dl. After 16 weeks of
      treatment with rHuEPO, the hemoglobin levels rose from 6.6 +/- 1.2 (mean +/- SD)
      to 10.1 +/- 1.1 g/dl in the once weekly group and from 6.4 +/- 0.8 to 10.2 +/-
      1.1 g/dl in the twice weekly group. The average doses of rHuEPO used during the
      study were 84 +/- 16 and 88 +/- 15 U/kg body wt/wk for the once weekly and twice
      weekly groups respectively. Subcutaneous administration of low dose rHuEPO is
      effective in reversing renal anemia. Similar responses were obtained with once
      weekly and twice weekly regimens. It is therefore acceptable and convenient for
      patients to receive one weekly s.c. injection of rHuEPO for the treatment of
      renal anemia.

PMID- 1752076
TI  - Effect of recombinant human erythropoietin (rHuEpo) on the hemostatic system in
      chronic hemodialysis patients.
AB  - Hemostatic measurements were undertaken in eight chronic hemodialysis uremic
      patients on recombinant human erythropoietin (rHuEpo). Same measurements were
      repeated in another seven patients in whom anemia was corrected by the
      transfusion of red blood cells. The correction of the anemia by rHuEpo therapy
      was accompanied by 1. correction of the prolonged Simplate Bleeding Time (BT) to
      normal less than 10.0, minutes after 16 weeks of rHuEpo treatment; 2. significant
      increases in the levels of fibrinogen, clotting FVIII:C, vWF:antigen,
      vWF:ristocetin cofactor and platelet count; 3. enhanced aggregation responses to
      ADP, adrenaline, arachidonic acid, collagen and ristocetin. There was no
      significant fluctuation in other coagulation parameters PT, APTT, TT, reptilase
      time and antithrombin III and plasma fibrinogen. In patients who were treated
      with RBC transfusion and despite the correction of the anemia, the bleeding time
      shortened significantly but not corrected, mean BT before and after RBC
      transfusion was 17.1 +/- 1.4 and 11.6 +/- 1.9 minutes respectively. Besides there
      was significant elevation of vWF:Ricofactor levels but not FVIII:C, vWF:Ag or
      platelet count. Platelet aggregation responses to ADP remained unchanged. It is
      concluded that significant elevations of FVIII:related activities, plasma
      fibrinogen, improved platelet aggregability and correction of the BT are salient
      hemostatic changes that follow rHuEpo therapy in uremic patients.

PMID- 1752077
TI  - Iatrogenic hypercalcemia in hemodialysis patients.
AB  - Calcium carbonate is frequently used in large doses as a phosphorus binder in
      hemodialysis patients, which often results in hypercalcemia. In most studies in
      which calcium carbonate is prescribed to control serum phosphorus levels the
      patients are not given calcitriol. However, calcitriol may be necessary for
      suppression of parathyroid hormone. The risk of hypercalcemia when calcium
      supplements are used in conjunction with calcitriol has not previously been
      examined in detail. We reviewed the charts of 74 hemodialysis patients (119
      patient dialysis years) to determine the relationship of serum calcium to
      calcitriol, calcium therapy, and PTH levels. Twenty-eight patients (38%) were
      hypercalcemic at some point. Calcitriol therapy significantly increased the risk
      of hypercalcemia, independently of calcium therapy (p = 0.032). However, patients
      on a low dose of calcitriol were more than twice as likely to be hypercalcemic
      than patients on higher doses. Mean PTH levels were lower in the patients on the
      lower doses of calcitriol, indicating less severe hyperparathyroid disease. We
      conclude that hypercalcemia is a common complication in hemodialysis patients on
      calcitriol and calcium carbonate. Whether lowering the dialysate calcium, as
      suggested by other investigators, will successfully decrease the risk of
      hypercalcemia without worsening hyperparathyroidism remains to be determined.

PMID- 1752078
TI  - Myoglobinuria after KENDOU training.

PMID- 1752079
TI  - Predicting outcome after childhood hemolytic uremic syndrome.

PMID- 1752080
TI  - Anaphylactoid reactions in patients on hemodiafiltration with AN69 membranes
      whilst receiving ACE inhibitors.

PMID- 1752081
TI  - Mixed inocula of mouse mammary tumour cell subpopulations result in changes of
      organ-specific metastasis.
AB  - Tumour and metastatic phenotypes, the pattern of mouse mammary tumour virus
      (MMTV) integration and expression, and the expression of a metastasis associated
      gene, nm23, were examined in three mammary tumour cell subpopulations, 66, 168
      and 4526. Tumour growth, host survival, metastatic aggressiveness, and the
      distribution of different cell types in metastasis resulting from mixed cell
      inocula were also analysed. The results of these studies indicated that the cell
      lines were distinguishable from each other both phenotypically and genotypically.
      However, a rearrangement of the mammary tumour specific protooncogene, int-1,
      caused by MMTV was found to be a unique characteristic of the cell line 4526.
      Therefore, int-1 was used as a stable marker to examine the genotype of the
      metastatic colonies that developed in mice bearing tumours of mixed cell inocula.
      Highly metastatic 4526 cells influenced the metastatic range of poorly metastatic
      66 cells. Line 66 cells that normally colonize only to lungs were also found to
      colonize liver when inoculated together with the liver-metastasizing 4526 cells.
      This acquired metastatic phenotype of 66 cells was transient. On the contrary,
      mixed cell inocula of 4526 and non-metastatic 168 cells did not produce any
      colony of 168 cells. The metastatic aggressiveness of 4526 cells was inhibited by
      both 66 and 168 cells. Furthermore, the metastatic behaviour of mixed inocula
      differed depending on the relative abundance of the component populations in the
      mixtures. These findings suggest that interaction between cells of different
      metastatic phenotypes may result in changes of their metastatic behaviour.

PMID- 1752082
TI  - The spread of human lung cancer cells on collagens and its inhibition by type III
      collagen.
AB  - The cell spreading ability of human lung cancer cells on collagen substrata was
      examined in comparison with normal human tracheal epithelial cells. Plastic
      dishes or multiwells were coated with type I, III or IV collagen gel at a
      concentrate of 200 micrograms/cm2. Ninety per cent of the normal cells were round
      on all collagens. Adenocarcinoma RERF-LC-MS and VMRC-LCD cell lines and squamous
      cell carcinoma VMRC-LCP cell line, which metastasize weakly after intrasplenic
      transplantation in nude mice, spread relatively poorly. Adenocarcinoma, A549 and
      SK-LU-1 and squamous cell carcinoma Calu-1 cell lines, which were highly
      metastatic to liver, spread well. Adenocarcinoma ABC-1 cell line, which is
      moderately metastatic to liver in nude mice, spread moderately. On type III
      collagen, three adenocarcinoma cell lines (A549, ABC-1 and VMRC-LCD) gradually
      started to contract after initial spreading and became round at 24 h. These
      results suggest that there may be a correlation between the degree of malignancy
      of human lung cancer cells and their spreading ability on collagen substrata, and
      that the cell spreading ability may be regulated by type III collagen in some
      lung cancer cells.

PMID- 1752083
TI  - Active components of intestinal bacteria for abdominal irradiation-induced
      inhibition of lung metastases.
AB  - We have previously reported that abdominal irradiation of mice inhibited lung
      metastases of a weakly immunogenic fibrosarcoma, and that transmigration after
      the irradiation of Enterobacter cloacae into mesenteric lymph nodes coincided
      with this phenomenon. In this paper, we show that Escherichia coli as well as E.
      cloacae reduce the number of metastatic lung colonies when these bacteria were
      intravenously injected into mice prior to the tumour cell challenge. The
      inhibition was caused not only by the administration of living bacteria but also
      by that of killed bacteria. Bacterial lipopolysaccharide (LPS), a component of
      membrane, replaced at least in part the effect of whole bacteria. Transfer of
      spleen cells from LPS-treated mice into intact recipients prominently inhibited
      metastatic development in the recipient mice. 'Cross transfer' between LPS high
      responders and LPS low responders suggested an indirect activity of transferred
      spleen cells. The antimetastatic activity of LPS depended on the tumour cell
      type; metastasis of fibrosarcomas was extensively inhibited by LPS irrespective
      of tumour immunogenicity while that of adenocarcinomas was only slightly
      inhibited. These results suggest that non-immunological mechanisms are involved
      in the antimetastatic activity of LPS.

PMID- 1752084
TI  - Effects of rotational stress on the effectiveness of cyclophosphamide and
      razoxane in mice bearing Lewis lung carcinoma.
AB  - The effects of conventional vs protected housing, and those caused by the
      periodic application of a psychological stressor (rotational stress, spatial
      disorientation) on mice kept in a protected housing, with spontaneous tumor
      metastasis have been determined in mice implanted with Lewis lung carcinoma as a
      function of tumor inoculum size and response to treatment with cyclophosphamide
      and razoxane. With a reduced inoculum size, tumor takes do not occur in mice kept
      in the protected housing, but do occur with spatial disorientation. With a larger
      inoculum size, tumor takes occur in all untreated mice, and the weight of
      spontaneous lung metastasis is significantly increased by spatial disorientation.
      For mice in protected housing, cyclophosphamide results in the absence of
      macroscopically detectable tumors in all of the treated mice, whereas the use of
      spatial disorientation abolishes this therapeutic action. The antimetastatic
      effects of razoxane are also reduced by rotational stress. These results indicate
      that housing conditions and a psychological stressor can control tumor takes and
      metastasis formation. They also indicate that host's antitumor resistance
      effectors, which are susceptible to neuroendocrine modulation by environmental
      and psychological stressors, participate to determine the effectiveness of the
      treatment with a cytotoxic (cyclophosphamide) and antimetastatic (razoxane)
      antitumor drug.

PMID- 1752087
TI  - Flare response in Ewing's sarcoma.
AB  - A 3 1/2-year-old boy had thigh pain and a leg mass. Bone scanning demonstrated
      intense uptake within the involved femur, but no uptake within the soft tissues
      or evidence of metastatic spread. Radiographs and CT scanning showed a large soft
      tissue mass and periosteal reaction suggestive of Ewing's sarcoma. Following
      chemotherapy, the patient had an apparently good clinical response. However, bone
      scanning showed uptake that was more intense and extensive than it was before
      therapy. Plain films and CT showed that the uptake was evidence of soft tissue
      calcification and that the mass had shrunk. This is an unusual example of the
      flare response to therapy because the apparent progression of the disease on bone
      scanning was caused by extraskeletal uptake.

PMID- 1752086
TI  - Role of the host tissue in the anti-invasive activity of the
      alkyllysophospholipid, ET-18-OCH3, in vitro.
AB  - The alkyllysophospholipid, racemic-l-O-octadecyl-2-O-methylglycero-3-
      phosphocholine (ET-18-OCH3) was previously shown to inhibit invasion of malignant
      cells into precultured heart fragments (PHF) in vitro. In particular,
      pretreatment of PHF with 10 micrograms ET-18-OCH3 for 48 h was sufficient to
      induce in the host tissue resistance towards invasion by mouse MO4 cells.
      Resistance was obvious when MO4 cells were confronted either immediately (the
      pretreatment experiment) or after withdrawal of the drug 7 days prior to
      confrontation (the reversibility experiment). In the present study, the survival
      of PHF cells in the pretreatment and reversibility experiments was similar to
      that of untreated PHF cells as determined by the 3-(4,5-dimethyl-2-thiazolyl)-2,5
      diphenyltetrazolium bromide (MTT) test and by the PHF explantation test. The
      effective anti-invasive concentration was 6 micrograms/ml in the pretreatment
      experiment while 3 micrograms/ml was sufficient to inhibit invasion in the
      reversibility experiment. Induction of resistance towards invasion in pretreated
      PHF was shown to occur not only with MO4 cells but also with mouse LLC-H61 Lewis
      lung carcinoma and mouse BW-O-Li1 T-lymphoma cells. The increase in molecular
      weight of N-linked cell surface glycosylpeptides (N-GP) of PHF was apparent in
      the pretreatment experiment and was enhanced in the reversibility experiment.
      This effect was completely abolished in cells obtained from pretreated PHF which
      were converted into a cell suspension and further cultured as a monolayer on
      tissue culture plastic without drug for 7 days. The results reported here provide
      additional evidence for the causal involvement of N-GP of the PHF host tissue in
      the anti-invasive activity of ET-18-OCH3 in vitro.

PMID- 1752085
TI  - Characterization of the invasive and metastatic phenotype in human renal cell
      carcinoma.
AB  - The purpose of these studies was to identify some characteristics of metastatic
      cells and deficiencies of non-metastatic cells in the heterogeneous SN12 human
      renal cell carcinoma. The SN12 parental line and several isolated variants with
      different metastatic potential were studied both in vivo and in vitro. We
      compared the ability of metastatic and non-metastatic cells to adhere to
      components of the extracellular matrix or to endothelial cells, to migrate and
      invade, to form multicell aggregates, to survive in the circulation, and to
      produce experimental and spontaneous lung metastases. In general, highly
      metastatic SN12 cells capable of producing spontaneous lung metastases
      demonstrated invasion through reconstituted basement membrane-coated filters; the
      cells also released diffusible collagenolytic activity into the culture medium
      that could enhance invasion by otherwise non-invasive and non-metastatic SN12
      cells. In addition to enhanced invasion, metastatic cells produced more homotypic
      aggregation then non-metastatic cells and survived to produce experimental
      metastasis. Collectively, these data confirm that metastatic cells must complete
      all steps of the process; in this process, failure to produce metastasis is
      probably due to one or more deficiencies.

PMID- 1752088
TI  - Porous-coated acetabular component. Quantitative assessment of normal
      radiophosphate uptake as a function of implant age.
AB  - A computer-assisted quantitative analysis was undertaken of normal radiophosphate
      bone uptake adjacent to the porous-coated acetabular component in asymptomatic
      patients. Implants ranged from 1.6 to 49 months of age. In 62 hips, it was found
      that implants newer than 12 months of age had uptakes that were significantly
      greater than those 12 months or older. Between 12 and 49 months, there was no
      correlation with age, indicating a stabilization of the remodeling process.

PMID- 1752089
TI  - Visualization of suppressed thyroid tissue by Tc-99m MIBI.
AB  - The authors describe a case of suppressed normal thyroid tissue in a patient with
      autonomous toxic nodule, which was visualized by a Tc-99m MIBI thyroid scan
      without thyrotropin (TSH) stimulation. The findings suggest that Tc-99m MIBI can
      be a substitute for conventional thyroid imaging using I-131 to visualize
      suppressed normal thyroid tissue without TSH stimulation and its side effects.

PMID- 1752090
TI  - False-positive radionuclide arthroscintigraphy with a porous-coated total hip
      prosthesis.
AB  - The evaluation of a painful hip prosthesis for suspected loosening frequently
      requires a multi-modality approach. Radionuclide arthroscintigraphy is a valuable
      adjunct to contrast arthrography, demonstrating greater sensitivity than contrast
      arthrography in detecting loosening of the femoral component of the prosthesis.
      Despite its reliability in the evaluation of cemented hip prostheses, the value
      of arthroscintigraphy in patients with uncemented or porous-coated prostheses is
      undetermined. The case of a false-positive radionuclide arthroscintigram in a
      patient with an uncemented prosthesis is reported. The literature is briefly
      examined, and the potential implications regarding interpretation of
      arthroscintigraphy in patients with porous-coated prostheses are discussed.

PMID- 1752091
TI  - Tc-99m MIBI SPECT in the assessment of myocardial reperfusion after percutaneous
      transluminal coronary angioplasty.
AB  - Tc-99m MIBI SPECT was used to assess the early benefits of successful
      percutaneous transluminal coronary angioplasty (PTCA) in nine consecutive
      patients. SPECT stress studies were done by artificial cardiac pacing just prior
      to PTCA and 16-20 hours later, with perfusion images obtained 2-3 hours after
      pacing stress and Tc-99m MIBI injection. Angiographic restenosis was demonstrated
      in three patients at a later date, and all of these showed no significant
      improvement on the perfusion study after PTCA. All four patients asymptomatic at
      7 months following PTCA had an average 15% improvement in segmental perfusion
      after the procedure. In two patients symptomatic after PTCA, one showed
      angiographic patency and had greater than 15% improvement in perfusion, while the
      second showed no scintigraphic improvement (no angiographic data obtained). This
      preliminary study suggests that Tc-99m MIBI is an important adjunct to
      angiography in estimating the amount of myocardium "at risk" before and after
      PTCA.

PMID- 1752092
TI  - Impact of early post-exercise myocardial redistribution of TI-201 on SPECT
      imaging. Preliminary observations.
AB  - In a series of 62 male patients undergoing exercise TI-201 SPECT myocardial
      scintigraphy, planar 45 degrees LAO images were acquired before (2-5 minutes
      postinjection, P1) and after (35 minutes postinjection, P2) the initial SPECT
      study in order to identify those patients with redistribution during the first 30
      minutes after exercise. Consensus interpretation by four readers identified early
      redistribution (between P1 and P2) in 11 patients (18%), rated major (change of
      greater than 1.5 scoring unit) in five and minor (change of 1-1.5 scoring unit)
      in six. Only one patient (2%) showed major early redistribution that could not be
      appreciated on corresponding SPECT images. In this preliminary investigation,
      early thallium redistribution sufficient to affect identification of significant
      exercise-induced ischemia on SPECT imaging was infrequent and of limited clinical
      importance.

PMID- 1752093
TI  - Scintigraphic manifestation of iliotibial band injury in an endurance athlete.
AB  - The scintigraphic appearance of an overuse injury at the insertion of the
      iliotibial band is described. This injury was depicted on three-phase bone
      scintigraphy as focally increased radionuclide concentration in the anterolateral
      tibial condyle (lateral tibial tubercle) where the iliotibial band inserts.
      Overuse injuries involving the insertion of the iliotibial band are uncommon and
      are not to be confused with a stress fracture or other bony lesion involving the
      lateral tibial condyle.

PMID- 1752094
TI  - Early and delayed I-123 IMP SPECT in epileptic patients with partial seizures and
      normal CT.
AB  - Forty-six epileptic patients with partial seizures and normal CT underwent 48
      examinations of early and delayed SPECT using I-123 IMP in the interictal phase.
      One of them underwent a follow-up SPECT in a more stable state compared to the
      first SPECT. Another patient, with informed consent, underwent a follow-up SPECT
      in combination with pharmacologic activation with bemegride. Early SPECT was
      performed 30 minutes after an IMP injection and delayed SPECT 4 to 4 1/2 hours
      later. Temporal changes in uptake pattern were visually classified into six types
      and compared with known patterns of SPECT uptake in relation to ischemic,
      hyperemic, and other changes. These were also correlated with the amount of
      epileptic activity seen on the EEG.

PMID- 1752095
TI  - Demonstration of increased bone metabolism in melorheostosis by multiphase bone
      scanning.
AB  - The multiphase bone scan features of melorheostosis are presented. Early
      increased tracer delivery demonstrated by blood pool imaging supports the concept
      of ongoing accelerated bony metabolism as a cause of tracer uptake within the
      osteosclerotic lesions of melorheostosis. There is excellent correlation between
      the scintigraphic and radiographic distribution of these lesions.

PMID- 1752096
TI  - SPECT anti-CEA monoclonal antibody detection of occult colorectal carcinoma
      metastases.
AB  - Radioimmunodetection (RAID) using Tc-99m labeled Fab' fragments of the anti-CEA
      monoclonal antibody IMMU-4 was performed in a 68-year-old man for preoperative
      evaluation of colonic metastases. Planar images at 3 and 18 hours showed uptake
      within known metastases in the left lobe of the liver that had been observed with
      CT and at surgery during the preceding month. SPECT images at 3 hours
      demonstrated two additional unsuspected lesions. All sites were surgically
      confirmed the following day using intraoperative sonographic guidance, with the
      smallest occult lesion measuring only 6 x 9 mm. This case illustrates the
      limitations of CT and surgery, the potential of RAID for the detection of occult
      metastases, the increased sensitivity of SPECT over planar images for detecting
      lesions less than 1 cm in diameter, and the value of intraoperative guidance for
      small nonpalpable lesions.

PMID- 1752097
TI  - Hepatodiaphragmatic colonic interposition (Chilaiditi's syndrome) demonstrated on
      Tc-99m DISIDA scan.

PMID- 1752098
TI  - Tuberculous lymphadenitis In-111 leukocyte and Ga-67 imaging.

PMID- 1752099
TI  - Abscess mimicking normal spleen on In-111 WBC scan.

PMID- 1752100
TI  - Aneurysmal dilatation of portal vein demonstrated on radionuclide hepatic
      scintiangiogram.

PMID- 1752101
TI  - Ga-67 citrate and Tc-99m HMPAO leukocyte scanning in extrapulmonary tuberculosis.

PMID- 1752102
TI  - Spontaneous calcaneal fracture in osteoporosis without fluoride therapy.

PMID- 1752103
TI  - Radiographic and scintigraphic demonstration of mono-ostotic fibrous dysplasia of
      the skull. Advantage of SPECT imaging.

PMID- 1752104
TI  - Tc-99m labeled RBC scan in Maffucci's syndrome.

PMID- 1752105
TI  - Complementary imaging modalities in the diagnosis of a mycotic aneurysm.

PMID- 1752106
TI  - Bridging the gender gap in research.

PMID- 1752107
TI  - Sports pharmacology.

PMID- 1752108
TI  - Individual variability in concentrations of urinary sulindac sulfide.
AB  - Among 70 patients with arthritis who were receiving satisfactory maintenance
      therapy with sulindac (300 to 400 mg daily), 64% had no detectable sulindac
      sulfide (active metabolite) in one to four random urine specimens. However, 36%
      had 1.0 to 7.8 (mean, 2.2 +/- 1.4) micrograms/ml sulindac sulfide in urine,
      similar to the therapeutically effective concentrations found in 24 concurrent
      plasma specimens (1.4 to 9.0 micrograms/ml). Ten patients had sulindac sulfide in
      only one or two of two to four urine specimens. Thus, 36% of the patients had
      pharmacodynamically significant concentrations of sulindac sulfide in urine,
      presumably capable of suppressing the cyclooxygenase pathway responsible for
      prostaglandin synthesis in the kidney and elsewhere. The findings suggest
      individual variability in the capacity for renal oxidation of sulindac sulfide to
      inactive metabolites, perhaps related to genetic or environmental factors or
      both. These findings may help to explain conflicting reports on the effects of
      sulindac on urinary prostaglandins and renal function.

PMID- 1752109
TI  - Pharmacokinetic and dynamic correlates of intravenous alprazolam challenge.
AB  - The concentration-effect relationship of alprazolam plasma concentration and
      growth hormone changes was studied in six healthy volunteers by use of three
      different intravenous bolus doses of alprazolam (0.003, 0.007, and 0.02 mg/kg) in
      a random blind order. There was a linear increase in peak concentration (Cmax)
      and area under the curve (AUC) of alprazolam with increasing dose (r = 0.96).
      There was no significant correlation between alprazolam Cmax and effect on growth
      hormone measured as either maximum increase or maximum percentage change from
      baseline. There was, however, an overall positive correlation (r = 0.58) between
      the AUC values of alprazolam and growth hormone from 0 to 120 minutes, although
      the relative degree of increased AUC of growth hormone with increasing AUC of
      alprazolam varied greatly across individuals. The difficulties of interpreting
      the mechanisms underlying differential growth hormone responses even when
      concentration of stimulus is controlled are discussed.

PMID- 1752110
TI  - Human liver xanthine oxidase: nature and extent of individual variation.
AB  - Xanthine oxidase catalyzes the biotransformation of many drugs, including the
      thiopurines and methyl-xanthines. We used a sensitive radiochemical assay to
      determine optimal conditions for the assay of human liver xanthine oxidase
      activity. We then used those assay conditions to study the nature and extent of
      individual variation of xanthine oxidase activity in 189 samples of hepatic
      tissue from patients undergoing clinically indicated partial hepatectomy or open
      liver biopsy. The average hepatic xanthine oxidase activity was 21% higher in
      samples from male patients than in those from female patients (1.27 +/- 0.43
      [mean +/- SD, n = 92] versus 1.05 +/- 0.38 U/gm tissue [n = 97, p less than
      0.0001], respectively). Seventy-nine of these tissue samples had been obtained
      from patients with normal liver function studies and normal serum creatinine
      values. Average xanthine oxidase activity in these 79 samples remained
      approximately 20% higher for men than for women (1.35 +/- 0.38 versus 1.12 +/-
      0.33 U/gm tissue, respectively). Probit analysis of the data for samples from
      patients with normal liver function studies and normal creatinine values
      suggested the presence of a subgroup of samples with relatively low xanthine
      oxidase activity in 21% (9 of 42) of male patients and 27% (10 of 37) of female
      patients. These observations may have implications with regard to individual
      variation in the biotransformation of drugs metabolized by xanthine oxidase.

PMID- 1752111
TI  - Pharmacokinetics and pharmacodynamics of cisapride in patients undergoing
      hemodialysis.
AB  - Twenty-two patients who were receiving hemodialysis were studied in three groups
      of eight subjects each to assess the pharmacokinetics during the dialysis-free
      interval and during hemodialysis treatment and to assess the pharmacodynamics of
      cisapride. Cisapride and its metabolite norcisapride were measured by use of HPLC
      and gas chromatography, respectively. The pharmacodynamic effect of cisapride was
      measured by means of radionuclide gastric emptying. After a single oral dose of
      20 mg the terminal half-life of cisapride was 9.6 +/- 3.3 hours, the volume of
      distribution was 4.8 +/- 3.3 L/kg, the total oral plasma clearance was 380 +/-
      161 ml/min, the area under the curve was 1024 +/- 447 ng.hr/ml (mean +/- SD).
      Norcisapride only could be detected in the dialysate (0.36 +/- 0.067 mg) and was
      eliminated by a hemodialysis clearance of 34.7 +/- 7.9 ml/min. Cisapride reduced
      gastric retention from 77.6% +/- 21.1% to 43.7% +/- 18.2% of maximum filling (40
      minutes after meals) and normalized the abnormal gastric emptying time in
      patients receiving dialysis. Cisapride dosage adjustment or substitution after
      hemodialysis is not necessary.

PMID- 1752112
TI  - Influence of rifampin on the pharmacokinetics of pefloxacin.
AB  - Pefloxacin and rifampin are frequently associated in the antibiotic therapy of
      deep-seated, and especially bone-located, infections. The influence of rifampin,
      a potent drug metabolism enzyme inducer, on the pharmacokinetics of pefloxacin
      was studied in a randomized crossover trial involving eight young healthy male
      volunteers. Every volunteer received either pefloxacin alone (period A) or
      pefloxacin after a 10-day induction by rifampin (period B) given as a 900 mg
      daily oral dose, and both periods were separated by a 3-week washout period.
      During both periods, pefloxacin was given during 3 days as a 400 mg b.i.d. oral
      dose (six doses) followed by a 400 mg intravenous dose on the fourth day. The
      kinetics of pefloxacin are significantly influenced by rifampin: The minimum (12
      hour) plasma concentration, area under the concentration-time curve, and
      elimination half-life decreased respectively from 4.26 +/- 1.57 to 2.70 +/- 1.00
      mg/L, 78.91 +/- 22.82 to 57.81 +/- 16.69 mg.hr/L, 14.46 +/- 3.46 to 10.08 +/-
      2.44 hours (p less than 0.05). The renal clearance of pefloxacin was unchanged,
      but the plasma clearance increased from 94.04 +/- 39.04 to 126.82 +/- 47.36
      ml/min (p less than 0.05). The plasma clearance of N-demethyl and N-oxide
      metabolites were similar for both periods, but the cumulative renal excretion (0
      to 96 hours) decreased significantly (p less than 0.01) for period B versus
      period A. This definite but moderate inductive effect of rifampin on the
      pharmacokinetics of pefloxacin does not suggest a dose modification of pefloxacin
      in therapeutic association with rifampin, but pefloxacin assay in plasma seems to
      be advisable.

PMID- 1752113
TI  - Vancomycin pharmacokinetics in acute renal failure: preservation of nonrenal
      clearance.
AB  - INTRODUCTION: The normal nonrenal clearance of vancomycin is reduced in patients
      with chronic renal failure (40 versus 6 ml/min). The nonrenal clearance of
      vancomycin in patients with acute renal failure has not been characterized
      extensively. PURPOSE: To prospectively determine the pharmacokinetic profile of
      vancomycin in anuric patients with acute renal failure who are receiving
      continuous venovenous hemofiltration. METHODS: Vancomycin serum samples were
      obtained in 10 patients immediately before and 1 and 12 hours after a 1-hour
      infusion. Thirteen sets of data were obtained. Vancomycin concentration data were
      incorporated into a first-order, single-compartment model. Determinations for the
      area under the serum concentration-time curve were made by the trapezoidal rule.
      RESULTS: Total vancomycin clearance was 28.5 +/- 6.4 ml/min (range, 17.1 to 36.6
      ml/min. Hemofilter clearance was either 6.7 or 13.3 ml/min, depending on
      ultrafiltrate production rate (assuming a sieving coefficient of 0.8). Nonrenal
      clearance, calculated as total clearance minus hemofilter clearance was 16.2 +/-
      7.0 ml/min (range, 3.8 to 23.3 ml/min). Total clearance did not correlate with
      hemofilter clearance (r = 0.1; p greater than 0.25) but correlated strongly with
      nonrenal clearance (r = 0.94; p less than 0.0005). Nonrenal clearance decreased
      significantly as the days on continuous venovenous hemofiltration increased
      (range, 2 to 14 days; r = 0.68; p less than 0.025). CONCLUSION: Early in the
      course of acute renal failure there is a substantial preservation of the normal
      nonrenal clearance of vancomycin. This nonrenal clearance appears to decrease
      with the duration of renal failure, eventually approaching the clearance observed
      in patients with chronic failure.

PMID- 1752114
TI  - Disposition of drugs in cystic fibrosis. III. Acetaminophen.
AB  - The disposition of acetaminophen after oral administration was investigated in
      adults with cystic fibrosis (n = 5) and in age-matched healthy control subjects
      (n = 5). The total plasma clearance of acetaminophen was found to be greater (p
      less than 0.025) in subjects with cystic fibrosis (0.362 +/- 0.081 L/hr/kg) than
      in control subjects (0.247 +/- 0.022 L/hr/kg). This difference in clearance was
      found to be primarily attributable to a greater metabolic clearance of
      acetaminophen to acetaminophen sulfate (0.080 +/- 0.023 L/hr/kg for subjects with
      cystic fibrosis and 0.045 +/- 0.008 L/hr/kg for control subjects; p less than
      0.05) and to a greater metabolic clearance of acetaminophen to acetaminophen
      glucuronide (0.189 +/- 0.051 L/hr/kg for subjects with cystic fibrosis and 0.114
      +/- 0.017 L/hr/kg for control subjects; p less than 0.05) in persons with cystic
      fibrosis. Of the mechanisms that may be responsible for these differences, the
      most likely is enhanced activity (in subjects with cystic fibrosis) of the
      transferases that mediate the metabolism of acetaminophen to acetaminophen
      sulfate and acetaminophen glucuronide, respectively.

PMID- 1752115
TI  - Comparative pharmacokinetics and pharmacodynamics of epoetin alfa and epoetin
      beta.
AB  - Different recombinant human erythropoietin products have been developed. Although
      they appear to have similar pharmacokinetics and function, these have not been
      directly compared. This randomized, double-blind, four-period crossover study
      compared the pharmacokinetics and pharmacodynamics of intravenous and
      subcutaneous epoetin alfa and epoetin beta in 18 normal male volunteers. As a
      control, three subjects received placebo treatment. After intravenous
      administration, the steady-state volume of distribution and beta-phase volume of
      distribution of epoetin beta were 7.7% and 16.9% larger than for epoetin alfa (p
      less than 0.05). The terminal elimination half-life after intravenous
      administration of epoetin beta was 20% longer than the terminal elimination half
      life of epoetin alfa. After subcutaneous administration there was a delayed drug
      absorption with epoetin beta compared with epoetin alfa (p less than 0.05). There
      was a small but significantly greater absolute reticulocyte response after
      subcutaneous epoetin beta compared with subcutaneous epoetin alfa. The findings
      support differences in the pharmacokinetics and function of epoetin alfa and beta
      that are possibly caused by differences in their glycosylation.

PMID- 1752116
TI  - Pharmacokinetics of recombinant human superoxide dismutase in healthy volunteers.
AB  - We studied the pharmacokinetics and effects of recombinant human superoxide
      dismutase (rhSOD) in 32 normal human volunteers after intravenous bolus doses
      from 1 mg/kg to 45 mg/kg in a single-blind, placebo-controlled, crossover design.
      The drug was well tolerated. Neither cardiovascular nor renal function, such as
      the echocardiographically determined cardiac index, insulin or para
      aminohippurate clearance, or the urinary excretion of beta 2-microglobulin or N
      acetylglucosaminidase, was affected. Pharmacokinetic analysis by use of
      noncompartmental methods showed an overall half-life of rhSOD to be about 4 hours
      for doses from 3 mg/kg to 45 mg/kg. The peak concentrations ranged from 24 to 837
      mg/L, and urinary excretion increased from 3% to 57% of total dose after single
      intravenous bolus administrations of the drug from 1 mg/kg to 45 mg/kg. The mean
      renal clearance of rhSOD initially increased with dose then plateaued at the
      highest dose, whereas the nonrenal clearance decreased with dose to a plateau;
      total clearance remained essentially constant. The progressive increase in renal
      clearance may be explained by saturation of the tubular reabsorption and
      degradation of the protein, a mechanism previously described in animal models.

PMID- 1752117
TI  - Pain and hyperalgesia after intradermal injection of bradykinin in humans.
AB  - Pain and hyperalgesia, the perceptual campanions of tissue injury and
      inflammation, are thought to be in part attributable to the sensitization of
      primary afferent nociceptors by endogenously released chemicals, such as
      bradykinin. Bradykinin (0.1 to 10 nmol in 10 microliters) evoked a dose-dependent
      pain, hyperalgesia to heat stimuli, and wheal and flare when injected in a double
      blind manner into the volar forearm intradermally. Though hyperalgesia to
      mechanical stimuli is a conspicuous feature of inflammatory pain, none was
      measurable for any of the bradykinin doses in response to graded nylon
      monofilament probes. A second injection of bradykinin (5- or 30-minute intervals)
      at the same site produced markedly less pain and hyperalgesia to heat stimuli,
      indicating that the algesic and hyperalgesic effects of bradykinin undergo
      tachyphylaxis. These findings suggest that bradykinin alone cannot account for
      all aspects of the hyperalgesia that occurs after inflammation.

PMID- 1752118
TI  - Effects of lovastatin and pravastatin on sleep efficiency and sleep stages.
AB  - The effects on sleep of two 3-hydroxy-3-methylglutaryl coenzyme A reductase
      inhibitors (40 mg lovastatin and 40 mg pravastatin) were evaluated in 12 normal
      subjects in a double-blind placebo-controlled sleep laboratory study. Subjects
      were randomly assigned to each of two parallel groups (lovastatin and
      pravastatin). Each parallel-group protocol consisted of 22 consecutive nights
      including 4 placebo-baseline nights, 2 weeks of drug administration, and 4
      placebo-withdrawal nights. Lovastatin did not disturb sleep initially (nights 5
      through 7) but, with continued administration (nights 16 through 18), it
      significantly and markedly increased wake time after sleep onset and stage 1
      sleep compared with baseline. By contrast, pravastatin was not associated with
      sleep disturbance either initially or with continued use. Neither drug caused any
      sleep disturbance after withdrawal. Lovastatin's sleep disturbing effects with
      continued administration are attributed to its high degree of lipophilicity in
      contrast with the hydrophilicity of pravastatin.

PMID- 1752119
TI  - A problem decomposition method for efficient diagnosis and interpretation of
      multiple disorders.
AB  - Diagnosis of multiple disorders can be made more efficient by reasoning
      explicitly about problem decompositions. A diagnostic problem can be decomposed
      by hypothesizing about common and disjoint cause relationships among the given
      symptoms. The resulting structure exploits computational principles of causal
      intersection, subproblem independence, and minimal factorability to increase
      efficiency. By assigning structure to a problem, the symptom decomposition
      approach offers a new type of decision-support task called symptom
      interpretation. Experimental results indicate that symptom decomposition yields
      substantial increases in performance compared to existing methods for
      multidisorder diagnosis.

PMID- 1752120
TI  - Thomas: building Bayesian statistical expert systems to aid in clinical decision
      making.
AB  - Knowledge-based system for classical statistical analysis must separate the task
      of analyzing data from that of using the results of the analysis. In contrast, a
      Bayesian framework for building biostatistical expert system allows for the
      integration of the data-analytic and decision-making tasks. The architecture of
      such a framework entails enabling the system (1) to make its recommendations on
      decision-analytic grounds; (2) to construct statistical models dynamically; (3)
      to update a statistical model based on the user's prior beliefs and on data from,
      the methodological concerns evinced by, the study. This architecture permits the
      knowledge engineer to represent a variety of types of statistical and domain
      knowledge. Construction of such systems requires that the knowledge engineer
      reinterpret traditional statistical concerns, such as by replacing the notion of
      statistical significance with that of a pragmatic clinical threshold. The
      clinical user of such a system can interact with the system at a semantic level
      appropriate to her fund of methodological knowledge, rather than at the level of
      statistical details. We demonstrate these issues with a prototype system called
      THOMAS which helps a physician decision maker interpret the results of a
      published randomized clinical trial.

PMID- 1752121
TI  - An approach to evaluating the accuracy of DXplain.
AB  - DXplain is a computer-based decision support system which generates a
      differential diagnosis (ddx) from a given list of clinical manifestations
      (Barnett et al., J. Am. Med. Assoc. 258 (1987) 67-74). An approach was developed
      to evaluate the accuracy of the ddx's produced by DXplain. The first step
      involves the collection of 65 benchmark cases drawn from a variety of sources and
      authors. Despite their diverse origins, the cases share in common that they are
      all clinical cases upon which a consulting physician might be asked to produce a
      differential. This helps to ensure that the evaluation of the system will be done
      in an environment similar to that in which the system is actually used. In the
      second step, all cases are reviewed by five board-certified physicians (experts)
      as well as DXplain. For each case, the evaluators (experts and DXplain) produce a
      rank-ordered ddx list along with an indication of how strongly each disease was
      felt to be supported by the case findings. A scoring technique was devised which
      rewards concordance with the gold standard: a consensus of the evaluators' ddx
      lists. Each evaluator receives a score which is proportional to the degree of
      agreement achieved with the consensus on the ddx submitted. Preliminary results
      on a trial evaluation of 46 cases indicate that DXplain, on average, did well in
      agreeing with the consensus. Agreement was achieved both in regard to the
      specific diagnoses listed in the ddx and the degree to which the diseases were
      felt to be supported by the case findings. A discussion of some important issues
      in the evaluation of knowledge-based systems is undertaken.

PMID- 1752122
TI  - Weaning patients from mechanical ventilation. A knowledge-based system approach.
AB  - The WEANing PROtocol (WEANPRO) knowledge-based system assists respiratory
      therapists and nurses in weaning post-operative cardiovascular patients from
      mechanical ventilation in the intensive care unit. The knowledge contained in
      WEANPRO is represented by rules and is implemented in M.1 by Teknowledge, Inc.
      WEANPRO will run on any IBM-compatible microcomputer. WEANPRO's performance in
      weaning patients in the intensive care unit was evaluated three ways: (1) a
      statistical comparison between the mean number of arterial blood gases required
      to wean patients to a T-piece with and without the use of WEANPRO, (2) a critique
      of the suggestions offered by the system by clinicians not involved in the system
      development, and (3) an inspection of the users acceptance of WEANPRO in the
      intensive care unit. The results of the evaluations revealed that using WEANPRO
      significantly decreases the number of arterial blood gas analyses needed to wean
      patients from total dependance on mechanical ventilation to independent breathing
      using a T-piece. In doing so, WEANPRO's suggestions are accurate and its use is
      accepted by the clinicians. Currently, WEANPRO is being used in the intensive
      care unit at the East Unit of Baptist Memorial Hospital in Memphis, Tennessee.

PMID- 1752123
TI  - A computer planning model for blood platelet production and distribution.
AB  - We consider a class of policies for stocking hospital blood banks with units of
      random donor platelet concentrate ('Platelets') based upon scheduled daily
      deliveries from a regional blood center to replenish the platelet inventory to a
      fixed 'base stock' level. The measures of interest are the 'shortage rate' (the
      proportion of days for which the on-hand inventory at the hospital blood bank is
      insufficient to meet the demand) and the 'outdate rate' (the proportion of total
      units shipped which are not transfused within the usable life span of 5 days).
      Our principal results give a predictive model which relates the base stock level
      to the shortage rate and outdate rate. Our model uses only the mean daily demand
      as a parameter. It provides a basis to unify the results from other studies which
      have demonstrated improvements in platelet inventory management in particular
      hospitals and blood centers.

PMID- 1752124
TI  - Interactive Query Workstation: standardizing access to computer-based medical
      resources.
AB  - Methods of using multiple computer-based medical resources efficiently have
      previously required either the user to manage the choice of resource and terms,
      or specialized programming. Standardized descriptions of what resources can do
      and how they may be accessed would allow the creation of an interface for
      multiple resources. This interface would assist a user in formulating queries,
      accessing the resources and managing the results. This paper describes a working
      prototype, the Interactive Query Workstation (IQW). The IQW allows users to query
      multiple resources: a medical knowledge base (DXplain), a clinical database
      (COSTAR/MQL), a bibliographic database (MEDLINE), a cancer database (PDQ), and a
      drug interaction database (PDR). Descriptions of each resource were developed to
      allow IQW to access these resources. The descriptions are composed of information
      on how data are sent and received from a resource, information on types of query
      to which a resource can respond, and information on what types of information are
      needed to execute a query. These components form the basis of a standard
      description of resources.

PMID- 1752125
TI  - Distinguishing drug toxicity syndromes from medical diseases: a QMR computer
      based approach.
AB  - Drug effects can mimic a wide variety of diseases. Experts note that adverse drug
      reactions (ADRs) have become the 'greatest imitator' of disease in clinical
      medicine. Quick Medical Reference (QMR) is a decision support system providing
      diagnostic data about more than 600 medical diseases. Currently, QMR contains
      only limited drug information. Just as physicians have difficulty diagnosing
      ADRs, QMR has similar problems in differentiating natural disease manifestations
      from drug toxicity syndromes. To remedy this problem, two prototype Drug
      Syndromes (DS), Carbamazepine Toxicity and Penicillin Toxicity, were incorporated
      into the QMR Knowledge Base (KB). Using detailed case reports, we demonstrated
      that a DS-augmented version of QMR was successful in discriminating these DS from
      the other diseases in QMR's KB. The addition of DS significantly improves QMR's
      diagnostic performance in cases in which some of the pathologic features are the
      consequence of drugs.

PMID- 1752126
TI  - Contextual pathognomony: a computationally useful extension of pathognomony.
AB  - Lack of adequate focus in problem-solving is a common problem in abductive expert
      systems. Pathognomonic findings could theoretically provide such focus, but their
      rarity in most domains makes the concept computationally useless. Pople's concept
      of constrictor is a useful extension of the concept of pathognomony. By relaxing
      the focus from a disease to a class of disease, constrictors have less
      theoretical power than pathognomonic symptoms, but they are more ubiquitous, thus
      more computationally useful. Similarly, this paper introduces the concept of
      contextual pathognomony. Contextual pathognomony is an extension of pathognomony
      that takes into account the current diagnostic context. Like constrictors,
      contextual pathognomony is more ubiquitous, thus more computationally useful,
      than pathognomony. Following the description of this new concept, this paper
      reports and analyses an experiment showing the existence and utility of
      contextual pathognomony in providing focus to abductive reasoning in the domain
      of alloantibody identification.

PMID- 1752127
TI  - Modeling all dialogue system participants to generate empathetic responses.
AB  - A dialogue system between an expert system and its users is described which
      combines two recent hypotheses. First, that the dialogue system should explicitly
      model both the person directly interacting with the dialogue system (the agent)
      and the person reasoned about by the expert system (the patient) in order to
      communicate meaningfully with both people. Second, that a dialogue system can
      model the domain-related beliefs, preferences and concerns of both its users and
      generate responses empathetic to both. This dialogue system is called SERUM,
      standing for 'System for Empathetic Responses with User Models.' SERUM generates
      natural-language responses about attribute values of domain objects, via three
      transformations. First, the system converts properties of the agent and patient,
      and domain knowledge, into a pragmatic objective like empathy. Second, SERUM
      converts the pragmatic objectives into surface structure cues like object
      emphasis and level of technicality. Finally, SERUM converts the surface structure
      cues to realize text that is natural, appropriately technical and emotionally
      empathetic. SERUM is demonstrated in describing tests and treatments for lung
      disease in AIDS patients, a sensitive domain where empathetic responses may be
      needed.

PMID- 1752128
TI  - Effects of four cryoprotectants in combination with two vehicle solutions on
      cultured vascular endothelial cells.
AB  - The necessary first step in successful organ cryopreservation will be the
      maintenance of endothelial cell integrity during perfusion of high concentrations
      of cryoprotective agents (CPAs). In this report we compare the effects of
      incubation on cultured porcine endothelial cells at 10 degrees C for 1 h with the
      CPAs glycerol, dimethyl sulfoxide (Me2SO), ethanediol (EG), and propane-1,2-diol
      (PG) in the vehicle solutions RPS-2 (high potassium, high glucose) and HP-5NP
      (low potassium, high sodium), both with and without added colloids. Tritiated
      adenine uptake and acid phosphatase estimation of cell number were used as
      indicators of cell viability. HP-5NP was superior to RPS-2 except with Me2SO when
      the differences in viability were not significant. Adding Haemaccel to HP-5NP
      improved the results, but adding albumin to RPS-2 was of no significant benefit.
      Osmotic stress appeared to be the major problem with glycerols use. Beyond 3.0 M
      the toxicity of Me2SO increased dramatically but it could not be determined if
      this was osmotic or chemical toxicity. PG was remarkably well tolerated to 3.0 M
      but a sharp decrease in cell viability beyond this concentration suggests that PG
      may be most useful with mixtures of other CPAs. Overall, EG appeared to be the
      least toxic CPA and in the context of vascular preservation warrants further
      investigation.

PMID- 1752129
TI  - Chlorpromazine, quinacrine, and verapamil as donor pretreatment in liver
      preservation, tested in the isolated perfused rat liver.
AB  - Rats were pretreated with a single iv dose of chlorpromazine (CPZ) 3 mg/kg,
      verapamil 1 mg/kg, or quinacrine 2 mg/kg. Livers were taken out and perfused with
      University of Wisconsin (UW) preservation solution and stored on ice for 48 h in
      the UW solution before reperfusion with erythrocyte-free and colloid-free Krebs
      Hanseleit buffer at 38 degrees C in a nonrecirculating perfusion system for 2 h.
      CPZ- and quinacrine-pretreated livers produced significantly more bile than
      control livers and also released significantly less alanine aminotransferase into
      the perfusate at 30, 60, and 120 min of reperfusion. Aspartate aminotransferase
      levels were lower at 30 and 60 min of reperfusion for CPZ-pretreated livers but
      not at 120 min. The only difference between groups concerning lactate
      dehydrogenase (LDH) release into the perfusate was that CPZ decreased the amount
      of LDH released at 60 min. Total tissue water or tissue electrolyte content of
      the liver tissue at the end of the reperfusion did not differ between groups. In
      conclusion, verapamil was ineffective when given as single dose iv pretreatment
      to the liver donor but pretreatment with CPZ or quinacrine appeared to improve
      the function of the preserved liver.

PMID- 1752130
TI  - Effect of sugars in the preservation solution on liver storage in rats.
AB  - We have performed 128 rat liver transplants in order to examine the effect of
      sugars in preservation solutions on cold storage of rat livers. Glucose (Mw.
      180), sucrose (Mw. 348), and raffinose (Mw. 594) were tested. Rat livers were
      preserved at 4 degrees C for 12, 16, 18, and 24 h in standard Eurocollins
      solution (EC solution) (solution A) or in one of three modified EC solutions in
      which 194 mM/liter glucose in standard EC solution was replaced by 140 mM/liter
      of glucose (solution B), sucrose (solution C), or raffinose (solution D). The
      osmolarity of the modified solutions (solution B-D) was 320 mOsm/liter. Using
      standard EC solution (solution A), the 1-week survival rate of rats receiving
      livers preserved for 12, 16, 18, or 24 h was 6/8, 4/8, 1/8, and 0/4,
      respectively. With solution B, in which 194 mM/liter glucose was replaced by 140
      mM/liter glucose, 1 week survivors following transplantation of livers preserved
      for 12, 16, 18 or 24 h were 4/8, 3/8, 2/8 and 0/4, respectively. Solution C,
      which was identical to solution A except for the replacement of 194 mM/liter
      glucose by 140 mM/liter sucrose, gave the following 1-week survival rates: 5/8
      for 12 h, 5/8 for 16 h, 2/8 for 18 h, and 0/4 for 24 hours preservation,
      respectively. Using solution D, which differed from A in the replacement of
      glucose by 140 mM/liter raffinose, the 1-week survival rates of rats grafted with
      livers preserved for 12, 16, 18, and 24 h were 6/8, 5/8, 3/8 and 0/4,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1752131
TI  - Cryopreservation of isolated hepatocytes: intracellular ice formation under
      various chemical and physical conditions.
AB  - Kinetics of intracellular ice formation (IIF) for isolated rat hepatocytes was
      studied using a cryomicroscopy system. The effect of the cooling rate on IIF was
      investigated between 20 and 400 degrees C/min in isotonic solution. At 50 degrees
      C/min and below, none of the hepatocytes underwent IIF; whereas at 150 degrees
      C/min and above, IIF was observed throughout the entire hepatocyte population.
      The temperature at which 50% of hepatocytes showed IIF (50TIIF) was almost
      constant with an average value of -7.7 degrees C. Different behavior was seen in
      isothermal subzero holding temperatures in the presence of extracellular ice.
      50TIIF from isothermal temperature experiments was approximately -5 degrees C as
      opposed to -7.7 degrees C for constant cooling rate experiments. These
      experiments clearly demonstrated both the time and temperature dependence of IIF.
      On the other hand, in cooling experiments in the absence of extracellular ice,
      IIF was not observed until approximately -20 degrees C (at which temperature the
      whole suspension was frozen spontaneously) suggesting the involvement of the
      external ice in the initiation of IIF. The effect of dimethyl sulfoxide (Me2SO)
      on IIF was also quantified. 50TIIF decreased from -7.7 degrees C in the absence
      of Me2SO to -16.8 degrees C in 2.0 M Me2SO for a cooling rate of 400 degrees
      C/min. However, the cooling rate (between 75 and 400 degrees C/min) did not
      significantly affect 50TIIF (-8.7 degrees C) in 0.5 M Me2SO. These results
      suggest that multistep protocols will be required for the cryopreservation of
      hepatocytes.

PMID- 1752132
TI  - The effects of cryopreservation on protein synthesis and membrane transport in
      isolated rat liver mitochondria.
AB  - Protein synthesizing activity and membrane transport were examined in fresh and
      cryopreserved isolated rat liver mitochondria. In the presence of 0.6, 1.2, and
      1.8 M final concentrations of dimethyl sulfoxide (Me2SO), both metabolic
      parameters were considerably inhibited in the fresh samples and even more
      inhibited in the cryopreserved specimens. However, simple exposure to this
      penetrating cryoprotectant, followed by its subsequent removal by washing, did
      not seem to affect significantly the examined functions. When different freeze
      thaw regimes were investigated, it was observed that optimal recovery of protein
      synthesis and membrane transport functions were obtained when fast freezing took
      place in the absence of Me2SO.

PMID- 1752133
TI  - New thermal stress test to assess the viability of cryopreserved boar sperm.
AB  - A new, rapid, thermal stress test for assessing the viability of boar semen,
      requiring only 45 min of incubation at 42.5 degrees C, was developed and compared
      with a widely used stress test of 180 min incubation at 37 degrees C. The shorter
      procedure was found to have the same discriminatory ability as the standard test
      in assessing the effects of freezing conditions on the percentage of spermatozoa
      remaining motile. Neither test was able to show differences in the kinetic rating
      of motile sperm after freezing in relation to the glycerol concentration present
      during freezing. However, the new test had a greater ability to distinguish the
      effects of different concentrations of glycerol, over the range of 0 to 6%, and
      to reveal different degrees of acrosomal damage sustained during freezing. The
      longer procedure was unable to distinguish among glycerol concentrations from 0
      to 4% with respect to acrosomal damage and produced an overall lower proportion
      of sperm having a normal apical ridge. The new thermal stress test thus has the
      advantages of greater sensitivity and more rapid execution over the test hitherto
      in widespread use.

PMID- 1752134
TI  - Insights into the cryoprotective mechanism of dimethyl sulfoxide for phospholipid
      bilayers.
AB  - Dimethyl sulfoxide (Me2SO) is a widely used cryoprotectant for biological
      structures such as membranes. Despite hundreds of studies on the effects of this
      molecule, surprisingly little is known about its cryoprotective mechanism. This
      study investigates the ability of various Me2SO analogs to serve as
      cryoprotectants for liposomes. The data show that an increase in hydrophobicity
      progressively reduces the cryoprotective effect of sulfoxides. Additional
      experiments using phospholipid vesicles of varying composition demonstrate the
      Me2SO is markedly less effective on liposomes carrying a net negative charge. In
      fact, cryoprotection by Me2SO was virtually eliminated in vesicles composed of
      30% phosphatidylserine (a negatively charged lipid). Based on these results, we
      suggest that the polar sulfoxide moiety of Me2SO interacts electrostatically with
      phospholipid membranes and that this interaction is critical for Me2SO's
      cryoprotective effect for membranes.

PMID- 1752135
TI  - Enhanced survival of yeast expressing an antifreeze gene analogue after freezing.
AB  - Yeast, like most organisms, survives poorly under freezing conditions. It has
      been proposed that after rapid cooling yeast suffers a loss in viability from the
      recrystallization of intracellular ice. Antifreeze proteins found in the blood of
      certain polar fishes have been shown to be potent inhibitors of ice
      recrystallization at very low concentrations. We have examined the feasibility of
      protecting rapidly cooled yeast cells from freezing damage by inhibiting the
      recrystallization of intracellular ice through in vivo expression of an
      antifreeze analogue gene. A chemically synthesized gene encoding a protein
      similar to but differing from the antifreeze proteins of the fish
      Pseudopleuronectes americanus (winter flounder) was genetically fused to the 3'
      end of a truncated staphylococcal Protein A gene. When the fused gene was
      expressed in the budding yeast Saccharomyces cerevisiae, its cells were shown to
      produce a new chimeric protein that inhibited the recrystallization of ice in
      vitro. Yeast cells expressing the chimeric antifreeze protein showed a twofold
      increase in survival after rapid freezing (95 degrees C/min to -196 degrees C)
      and moderate rates of warming (26 to 64 degrees C/min) compared to cells lacking
      the chimeric protein.

PMID- 1752136
TI  - Intrinsic alteration of the reactive properties of arteries during hypothermia.
AB  - This study compares the reactive and contractile properties of helical strips of
      femoral arteries taken from normothermic rabbits and rabbits that were
      anesthetized with pentobarbital and cooled to 25 degrees C. The purpose of this
      comparison was to see if previous exposure to whole body hypothermia would alter
      vascular muscle responsiveness to norepinephrine. We found that, after 2 h of in
      vivo hypothermia, the hypothermic-derived vascular strips contracted more slowly,
      but required from 10 to 100 times less norepinephrine to have a detectable
      contractile response. This continued while the tissue was in vitro for at least
      12 h. Although the maximal tension developed by the strips was equivalent, the
      ED50 values for the hypothermic-derived arteries were lower than those of the
      normothermic tissue. This study has identified prolonged alterations in in vitro
      vascular responsiveness attributable to previous exposure to whole body
      hypothermia, which may help to explain the disruptions of blood pressure during
      and following exposure of the whole body to cold.

PMID- 1752137
TI  - Some seasonal changes in the thecal gland in the ovaries of hibernators (Citellus
      citellus L.).
AB  - The ovaries of 36 ground squirrels were studied in March, April, July, and
      December. Morphological and functional seasonal characteristics of theca interna
      were studied by histological methods, electron microscopy, and quantitative
      methods for determinating the volume density and histoenzyme activity of NADH2
      tetrazolium reductase, glucose-6-phosphate dehydrogenase, and delta 5-3 beta
      hydroxysteroid dehydrogenase. Maximal activity of theca interna as a steroid
      producing structure was observed during spring awakening. A significant increase
      in the histoenzyme activity of delta 5-3 beta-hydroxysteroid dehydrogenase in
      December, versus two other enzymes studied, indicated steroid synthesis in theca
      terna.

PMID- 1752138
TI  - AIDS prevention and control in China.

PMID- 1752139
TI  - Basic and clinical researches in microsurgery.

PMID- 1752140
TI  - Immunologic investigation of Chinese hemophiliacs with and without human
      immunodeficiency virus infection.
AB  - Cellular and humoral immune functions in Chinese hemophiliacs with and without
      human immunodeficiency virus (HIV) infection were compared with those of healthy
      controls. There was a significant increase in peripheral T8 cells and a
      significant decrease of peripheral T4 cells as well as the T4/T8 ratio in 3
      hemophiliacs with HIV infection when compared with 26 hemophiliacs without HIV
      infection and 18 healthy controls (P less than 0.005, P less than 0.05 and P less
      than 0.002, respectively). In contrast, there were no statistical differences in
      the above mentioned parameters between hemophiliacs without HIV infection and
      healthy controls. All the three HIV seropositive hemophiliacs had anergy for
      1:2000 OT test whereas among the 15 HIV seronegative hemophiliacs, only two had
      anergy for 1:2000 OT test. These results demonstrate that the immunological
      abnormalities of the 3 HIV seropositive hemophiliacs were attributed to HIV
      infection, and that even though hemophiliacs without HIV infection had been
      treated with blood products, their immune functions are generally normal. These
      findings are somewhat different from those reported abroad. This difference may
      be due to the fact that Chinese hemophiliacs are often treated with much smaller
      dose of blood products as a part of the treatment of their coagulative defects.

PMID- 1752141
TI  - Myocardial protective effect of captopril cardioplegia on ischemia and
      reperfusion injury in the isolated rabbit heart.
AB  - The myocardial protective effect of captopril cardioplegia was investigated
      through the recovery of cardiac functions, biochemical changes and
      ultrastructural assays in the isolated working rabbit heart after hypothermic
      ischemic arrest for 3 hours. Hearts were randomly divided into 3 groups with 8 in
      each. Another 3 groups of hearts (8 in each) were arranged for studying the
      biochemical changes and ultrastructure during the ischemic period. In the control
      group (I), the hearts were protected by the modified St. Thomas' cardioplegic
      solution No. I, while in Group II and III the cardioplegic solutions contained
      2.3 mumol/L and 23 mumol/L captopril respectively. The results showed that the
      percent recoveries of cardiac function in the 23 mumol/L captopril group compared
      with the control group were 97.9 +/- 9.8% vs 84.9 +/- 7.3% in left ventricular
      peak systolic pressure (P less than 0.01), 118 +/- 33% vs 79 +/- 20% in +dp/dt
      max (P less than 0.01), 111 +/- 22% vs 75 +/- 18% in -dp/dt max (P less than
      0.01), 145.6 +/- 44.8% vs 76.7 +/- 18% in coronary flow (P less than 0.01), 120.2
      +/- 45.7% vs 36.4 +/- 22.2% in aortic flow (P less than 0.01), 127.4 +/- 27.3% vs
      56.1 +/- 14% in cardiac output (P less than 0.01), and 118.2 +/- 33.5% vs 52.5 +/
      19.9% in stroke volume (P less than 0.01) respectively.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1752142
TI  - Changes of plasma immuno-reactive beta-endorphin content in patients with
      congestive heart failure and their clinical significance.
AB  - Immunoreactive beta-endorphin (ir-beta-EP) content in plasma was measured by
      radioimmunoassay in 101 cardiac patients and 30 normal subjects. The results
      showed that plasma ir-beta-EP levels in patients of Class II (New York Heart
      Association Classification), Class III and Class IV were significantly higher
      than those in the normal group and those in patients of Class I (43.14 +/- 2.80,
      54.25 +/- 4.47, 79.28 +/- 8.96 ng/L vs 24.23 +/- 2.13, and 24.98 +/- 3.35 ng/L,
      respectively, P less than 0.01). Plasma concentration of ir-beta-EP in patients
      complicated with atrial fibrillation was significantly higher than that in
      patients without atrial fibrillation (56.27 +/- 4.13 vs 44.66 +/- 3.41 ng/L, P
      less than 0.05). Ir-beta-EP contents in plasma were correlated positively to the
      cardiothoracic ratios (r = 0.63, P less than 0.001) and PEP/LVET ratios (r =
      0.33, P less than 0.01), and were correlated negatively to the left ventricular
      ejection fraction and axis shortening (r = -0.41 and r = -0.39, P less than
      0.001). These results indicated that plasma ir-beta-EP content may serve as a
      parameter in evaluating cardiac dysfunction.

PMID- 1752143
TI  - Pathological study on cerebral amyloid angiopathy.
AB  - The cerebral amyloid angiopathy (CAA) was pathologically confirmed in 26 cases in
      which there were 20 cerebral hemorrhages, 2 subarachnoid hemorrhages, 3 cerebral
      infarctions, and 1 subdural hematoma. The CAA mainly involved the media and
      extima of small and medium-sized arteries as well as the capillaries of the brain
      tissue. Half of all cases in our series had the CAA associated vasculopathies
      (CAA-AV), including microaneurysms, "double barreling", onion skin-like intima,
      fibrinoid necrosis, clusters of arterioles and perivascular lymphocytic
      infiltrations. The CAA was often accompanied with the senile plaques and
      neurofibrillary tangles.

PMID- 1752144
TI  - Localization of functional projections from corpus callosum to cerebral cortex.
AB  - In 30 patients with intractable generalized epilepsy treated with cerebral
      commissurotomy, the corpus callosum was stimulated intraoperatively at a 1 cm
      interval with electric current, and evoked potentials (EPs) were recorded from
      different areas of the brain for determining the distribution patterns of
      functional projections from the corpus callosum to the cerebral cortex. The
      surface of the corpus callosum in man was 12 cm long and it was divided into 12
      segments (1 cm each). Stimulation of the first segment resulted in EPs only in
      the frontal lobe. Stimulation of segments 2-4 produced EPs mainly in the
      anterior, middle and posterior frontal lobe, anterior and central temporal lobe,
      rarely in parietal and occipital lobes. Stimulation of segments 5-8 induced EPs
      mainly in the frontal and temporal lobes, but rarely in the parietal and
      occipital regions; on stimulation of segments 9-11, EPs occurred only in the
      parietal and occipital regions. These results were confirmed
      electrophysiologically in 5 cats and anatomically in 8 cats. These data provide
      an anatomical basis for selective cerebral commissurotomy in the treatment of
      intractable epilepsy. Hence in patients with a concentration of epileptic
      discharges in the frontal lobe, the 4 anterior segments of the corpus callosum
      should be incised. Epileptic discharges in the frontotemporal region indicates
      that the middle segments should be incised and epileptic activities originating
      from the parieto-occipital regions can be treated effectively by selective
      section of the posterior corpus callosum (segments 9-12).

PMID- 1752145
TI  - Plasma shock wave lithotripsy of gallstones in vitro. Animal experiments and
      clinical application.
AB  - It is sometimes very difficult to extract a huge impacted stone through the T
      tube fistulous tract by conventional techniques with choledochoscope. To simplify
      the procedure, a lithotriptor PSW-G type using plasma shock wave to disintegrate
      the stone was designed. The efficacy to fragmentate stone was investigated both
      in vitro and in vivo. Stones can be shattered into pieces less than 3 mm in
      diameter in about 30 times of spark with lower energy ranging from 1.7-3.4 kV and
      1-3 J. Animal experiments were carried out to prove the safety of the
      lithotriptor. There was neither interference with the cardiovascular and
      respiratory systems nor obvious damage to the adjacent tissue where plasma shock
      wave applied to break stones. Six patients with retained calculi impacted both in
      extra- and intra-hepatic duct were successfully treated by plasma shock wave
      lithotripsy. It appears very useful in dealing with a huge impacted stone in the
      biliary tract.

PMID- 1752146
TI  - Partial purification and osteoinductive activity of swine bone morphogenetic
      protein.
AB  - Bone morphogenetic protein (BMP) was isolated from the bone matrix of swine and
      partially purified by means of differential precipitation and molecular sieve
      chromatography. The molecular weight of BMP estimated by SDS-gel electrophoresis
      was 19,000 dalton. Bioassay by implanting two milligrams of BMP fraction into
      thigh muscles of mice resulted in bone formation in 100% of the experimental
      animals.

PMID- 1752147
TI  - Histopathological and ultrastructural changes of lichen sclerosus et atrophicus
      on the vulva.
AB  - Studies of 82 skin specimens from 81 cases of lichen sclerosus et atrophicus
      (LSA) are reported. Typical LSA pathological changes showed atrophy of the
      epidermis, hydropic degeneration at the basal layer, and homogenization of the
      collagen fibers in the superficial dermis with inflammatory cell infiltration
      underneath. Ultrastructural changes showed intercellular spaces enlarged,
      particularly near basal cells. Some mitochondria were swollen and rough
      endoplasmic reticula were enlarged. Some basement membranes were thinner,
      collagen fibers of varying diameters were arranged in irregular shapes and the
      fine structures had become unclear and had sometimes even disappeared.

PMID- 1752148
TI  - Can magnetic stimulation induce secondary cerebral hemorrhage?

PMID- 1752149
TI  - [Association of HLA antigens with thyrotoxic periodic paralysis].
AB  - Periodic paralysis is a rare and peculiar complication of thyrotoxicosis,
      especially in Chinese and Japanese patients. The susceptibility to autoimmune
      thyroid disease has recently been reported to be strongly linked with certain
      immunogenetic factors. The objective of this study was to seek a genetic marker
      by HLA typing in Chinese patients with thyrotoxic periodic paralysis (TPP). The
      distribution of HLA-A, B, C, DR and DQ antigens in 20 thyrotoxic patients with
      periodic paralysis and 51 thyrotoxic patients without periodic paralysis was
      compared with that in 100 controls. The results showed that among the patients
      with TPP, these was a highly significantly increase of HLA-B51 frequency and B51
      appeared to be linked with Cw3 in a state of dysequilibrium.

PMID- 1752150
TI  - [Delayed gastric emptying in diabetes mellitus].
AB  - Function of gastric motility was studied in thirty one diabetes mellitus patients
      by testing gastric emptying time (GET). The test was performed by giving patients
      food labelled with 99mTc. The results showed that GET in patients with diabetes
      mellitus was significantly delayed as compared with that in the controls (P less
      than 0.001). 15 among the 31 diabetic patients had delayed GET, accounting for
      48.4%. There was no difference in age, duration of the disease, treatment regimen
      and microvascular complications between patients with delayed GET and those with
      normal GET. The only difference was the obviously increased incidence of
      autonomic nerve dysfunction in the former group of patients (P less than 0.05).
      We concluded that the incidence of delayed gastric emptying time was higher in
      diabetic patients with autonomic neuropathy.

PMID- 1752151
TI  - [Relationship between free radicals and diabetic microangiopathy].
AB  - Lipid peroxide (LPO) values in blood plasma, along with the glutathione
      peroxidase (GSH-PX) activity in whole blood and superoxide dismutase (SOD)
      activity in erythrocytes were determined in 50 patients with non-insulin
      dependent diabetes mellitus (NIDDM) and in 33 control subjects. The mean LPO
      value, SOD activity, LPO/GSH-PX and LPO/SOD ratios in the diabetic patients were
      significantly higher than those in the control subjects. The increases of LPO
      value, LPO/GSH-PX and LPO/SOD ratios were more pronounced in diabetics with
      microangiopathy than in those without microangiopathy. Our results suggest that
      free radicals may be implicated in the pathogenesis of diabetic microangiopathy.

PMID- 1752152
TI  - [Prospective study of functional changes in the gallbladder and formation of
      gallstones induced by long-term treatment of somatostatin analogue SMS201-995 in
      patients of active acromegaly].
AB  - We reports the result about the changes of function of gallbladder in 17
      acromegalic patients after treatment with long-acting somatostatin analogue
      SMS201-995 for 3-36 months by ultrasonogram. The number of cases developed bile
      sludges, gallstones, chronic and acute cholecystitis was 14, 8, 10 and 1
      respectively during therapy. The contractibility of gallbladder after fatty meal
      was inhibited in all of the patients during the course of therapy. A bolus
      injection of SMS201-995 with a dosage of 100 micrograms for acromegalic patients
      resulted in marked suppression of the contractibility of the gallbladder. Our
      result indicates that the decreased contractibility of the gallbladder leads to
      the formation of gallstones during the long-term therapy of SMS201-995.
      Therefore, it is important to follow the gallbladder carefully in the course of
      the therapy of SMS201-995.

PMID- 1752153
TI  - [Influences of open thoracoscopy on human body: experience in 65 cases].
AB  - The influence of open thoracoscopy with fiber-bronchoscope on human body was
      studied in 65 patients with pleural disease. The items observed included blood
      pressure, Pulse rate, respiration rate, blood gas analysis and clinical
      manifestations. It was found that open thoracoscopy has little influence on human
      body and the patients tolerated it well. No severe complication was found and
      operative procedures might be avoided popularization of this technique is
      therefore suggested.

PMID- 1752154
TI  - [Sodium nitroprusside in treating acute high-altitude pulmonary edema].
AB  - Sodium nitroprusside (NP) alone Was given to the 39 cases with acute high
      altitude pulmonary edema (AHPE). 33 of them (84.6%) fully recovered and 6
      (15.38%) obviously improved in 72 hours. The total efficacy was 100%. There was
      obvious improvement in the cardiac pumping and contractile function as well as
      total peripheral resistance. The mean pulmonary artery pressure (MPAP) decreased
      from 52.22 +/- 7.51mmHg to 25.13 +/- 10.36mmHg in 3 to 5 hours after the first
      dose. Strophanthin K was given to another 11 cases with AHPE, But none fully
      recovered or obviously improved. During the 72 hours of treatment, 4 improved
      slightly, 4 showed no therapeutic effect and 3 became worse. The heart rate was
      reduced obviously and cardiac contractile function strengthened while the cardiac
      pumping function and total peripheral resistance had no change. Vasodilator
      therapy is a new method for AHPE treatment and this study shows that the NP is an
      ideal drug in treating AHPE and that dilation of the small pulmonary arteries by
      NP may explain its efficacy.

PMID- 1752155
TI  - [An analysis of ST segment shift in procordial leads in patients with acute
      inferior myocardiac infarction with and without right ventricular infarction].
AB  - ST segment change in procordial leads was analysed in 58 patients with acute
      inferior myocardial infarction (IMI). ST segment depression in V2 lead was
      negatively correlated with ST segment elevation in a VF lead in patients with
      IMI. ST segment depression in V2 lead was not observed when IMI was accompanied
      by right ventricular infarction. It indicates that ST segment depression in
      procordial leads was the reciprocal change of ST segment elevation in inferior
      leads. The direction and amplitude of ST segment shift in procordial leads may be
      affected by the presence of right ventricular infarction (RVI). The ratio of ST
      V2/ST aVF less than 0.5 may suggest a diagnosis of IMI with accompanying RVI.

PMID- 1752156
TI  - [The difference of erythropoietin concentration in various disease].
AB  - The serum concentration of erythropoietin in 79 cases with various blood
      diseases, uremia, chronic obstructive pulmonary disease etc was determined. At
      comparable degrees of anemia, patients with myelodysplastic syndrome and aplastic
      anemia had the highest levels of erythropoietin in our study. The high level of
      erythropoietin titer in patients with aplastic anemia should be taken as the nom
      for renal synthesis and release of this hormone. The erythropoietin level in
      patients with uremic anemia was lower than the level in patients with anemia of
      other causes but still higher than that of the normal controls. Patients
      suffering from polycystic kidney disease with or without uremia had a high level
      of erythropoietin due to local hypoxia of remnant kidney tissue resulting from
      the pressure of cystic formation. Different methods are used to determine the
      erythropoietin level, which varies with the stage and etiology of the diseases.
      There are other stimulating or inhibitory factors of erythropoiesis when the
      assay is processed. Transfusion and administration of certain drugs also
      influence the growth of erythroid cells, thus the serum titers of erythropoietin
      differed markedly between patients at comparable hemoglobin concentration.

PMID- 1752157
TI  - [A study of Kirby-Bauer method of antimicrobial sensitivity test and resistant
      plasmid assay with 486 strains of Shigella isolated clinically].
AB  - 486 cases of bacillary dysentery admitted to an army hospital during the peak
      season (July to September) from 1986 to 1988 were studied. The pathogens in 452
      cases were tested for antimicrobial sensitivity with 14 kinds of antibiotics by
      using Kirby-Bauer method recommended by WHO. The results showed that the number
      of antibiotics to which the dysentery bacteria became resistant had increased. In
      1986 the number was 9, while in 1987 and 1988 it increased to 12 and 13
      respectively. Among the resistant strains of bacteria, 331 had been assayed for
      resistant plasmids. 88.8% was positive with more than three resistant plasmids.
      The result of antimicrobial sensitivity test coincided well with that of
      resistant plasmid assay.

PMID- 1752158
TI  - [Determination of neuropeptide Y concentration in the cerebrospinal fluid in
      patients with cerebrovascular diseases and its significance].
AB  - Concentration of neuropeptide Y (NPY) in the cerebrospinal fluid (CSF) of
      patients with cerebrovascular diseases was measured by using radioimmunoassay.
      The results showed that NPY concentration in CSF in patients with hemorrhagic
      cerebrovascular diseases (HCVD) was 4148 +/- 397.2 pg/ml, being significantly
      higher than the control level of 1083.7 +/- 245.8 pg/ml. While the NPY
      concentration in CSF of patients with ischemic cerebrovascular diseases (ICVD)
      was 2214 +/- 289.2 pg/ml, being not significantly different from the level in the
      control group. The effect of NPY in vasospasm after HCVD was preliminarily
      discussed.

PMID- 1752159
TI  - Hair cell regeneration: the identities of progenitor cells, potential triggers
      and instructive cues.
AB  - Hair cells are produced and accumulate in the ears of fish and amphibians as they
      grow during postembryonic life; hair cell regeneration occurs in lateral line
      organs in those groups and in the cochlea in birds. Continuous time-lapse
      microscopy has directly demonstrated that supporting cells divide to give rise to
      hair cells during regeneration in lateral line neuromasts. Supporting cells also
      appear to give rise to hair cells during regeneration in the avian ear, but
      additional cell types have been proposed as hair cell progenitors. Alternative
      interpretations of current evidence are discussed in relation to the possibility
      that supporting cells may be the common progenitor in all cases of hair cell
      regeneration. The regenerative proliferation of hair cells in birds occurs in
      populations of cells that are mitotically quiescent in undamaged ears. Evidence
      suggests that the extrusion of damaged hair cells and the breaking of
      intercellular junctional adhesions may be a trigger for regenerative
      proliferation. The potential triggering influence of phagocytes is also
      discussed. The differentiation of replacement cells during regeneration in the
      cochlea may be regulated by surface interactions between cells. A model that
      could account for the reconstitution of the mosaic pattern of hair cells and
      supporting cells is proposed.

PMID- 1752160
TI  - Structural reorganization of hair cells and supporting cells during noise damage,
      recovery and regeneration in the chick cochlea.
AB  - Exposure of the chick cochlea to intense acoustic overstimulation leads to rapid
      changes in the structural organization of hair cells and supporting cells. During
      the noise exposure the surface areas of the hair cells are reduced and,
      concomitantly, the adjacent supporting cells expand. If the exposure continues
      long enough hair cells bleb out apically and are ejected from the sensory
      epithelium. Surviving hair cells begin to expand their surface areas again within
      24 hours after the termination of noise exposure. By 48 hours of recovery most of
      the hair cells that have died are ejected from the epithelium and new,
      regenerating hair cells begin to sprout immature stereociliary bundles. The
      regenerating stereociliary bundles undergo steps in their maturation that are
      equivalent to those seen during the normal embryonic development of hair cells.
      The extent and timing of recovery in the chick cochlea correlates with the length
      of the noise exposure. Shorter exposures (approximately 12 hours) result in only
      a few regenerating hair cells but the basilar papilla recovers almost completely
      within 14 days. Longer exposures (approximately 24 hours) lead to the production
      of more new hair cells but the recovery of the basilar papilla is incomplete,
      even after 28 days of recovery.

PMID- 1752161
TI  - Regeneration of lateral line and inner ear vestibular cells.
AB  - Labelling experiments with [3H]thymidine demonstrate a continuous production of
      cells in the mechanoreceptive lateral line organs of the eel (Anguilla anguilla)
      and butterfly fish (Pantodon buchholzi) as well as in the electroreceptive
      ampullary organ of the transparent catfish (Kryptopterus bicirrhus). Shortly
      after [3H]thymidine injection many cells are labelled in the middle and basal
      parts of the sensory organ and after a few days' survival sensory cells are also
      labelled. The vestibular sensory organs of selected species of fishes,
      amphibians, reptiles and birds also show a continuous production of cells. In the
      budgerigar (Melopsittacus undulatus) labelled cells are found in the basal and
      middle layer of the sensory epithelium a few hours after injection with
      [3H]thymidine. A few days after the injection labelled cells are found in non
      calyceal hair cells. After one month the calyceal cells are also labelled.
      Similar experiments with the bat Pipistrellus nathusii and with normal and
      gentamicin-treated mice (Mus musculus) show no labelled cells in the inner ear
      sensory epithelia. The lateral line organs and vestibular epithelia of non
      mammalian vertebrates all contain a small number of dark cells with the
      characteristics of apoptotic cells. Macrophages and inclusions in some cells,
      thought to be remnants of apoptotic cells, are occasionally seen. Fixation at
      different osmolarities has little effect on the number of dark cells. It is
      suggested that the continually produced cells replace apoptotic dying cells.

PMID- 1752162
TI  - Retinal regeneration in teleost fish.
AB  - The neural retina in teleost fish can regenerate after surgical or neurotoxic
      destruction. Whereas in amphibians the retina regenerates by transdifferentiation
      of pigmented retinal epithelial cells, in goldfish (Carassius auratus) the source
      of regenerated retinal cells is a population of scattered proliferating cells
      located in the outer nuclear layer within the differentiated retina. These
      proliferating cells are modified neuroepithelial cells termed 'rod precursors'
      because in the intact retina they produce only rod photoreceptor cells and do so
      continuously, inserting new rods into the growing adult retina. Although rod
      precursors normally exhibit a restricted developmental fate they appear not to be
      committed to the rod lineage. When retinal neurons are destroyed, rod precursors
      cease producing rods and give rise to clusters of primitive neuroepithelial cells
      which divide vigorously and reconstitute the retina in an orderly temporal
      pattern that mimics the process of normal development. Only after production of
      cones and other retinal neurons has ceased do rod precursors again appear and
      resume the generation of rods. We conclude that rod precursors respond to local
      cues in their environment that regulate the differentiation and choice of cell
      fate by their progeny.

PMID- 1752163
TI  - Common mechanisms of retinal regeneration in the larval frog and embryonic chick.
AB  - Amphibians and embryonic chicks possess the ability to regenerate retinal neurons
      by the transdifferentiation of pigment epithelium into neuronal progenitors.
      Recent studies have begun to identify the molecular factors involved in this
      process. Laminin (a component of the extracellular matrix) has been shown to be
      important in the process of retinal regeneration in the larval frog both in vitro
      and in vivo and basic fibroblast growth factor (bFGF) stimulates the same process
      in chicks in vivo. To determine the mechanisms by which these factors induce
      retinal regeneration we studied their effects on cultured chick pigment
      epithelium cells. bFGF was added to enzymically dissociated chick embryo pigment
      epithelial cells plated at several different densities on various substrates
      including laminin. We found that bFGF stimulated proliferation but although the
      cells lost pigmentation and demonstrated distinct morphological changes, no
      definitive transdifferentiation could be demonstrated using several neuron
      specific antibodies as markers. When the pigment epithelium was cultured as
      aggregates on a shaker device which prevented flattening and spreading on the
      substrate a large number of retinal progenitor cells were generated from the
      pigment epithelium treated with bFGF. The ability of chick pigment epithelium to
      undergo transdifferentiation thus appears to be dependent on the physical
      configuration of the cells.

PMID- 1752164
TI  - Regenerative capacity of retinal cells and the maintenance of their
      differentiation.
AB  - Mechanisms underlying cell type stability and the capacity of retinal cells for
      transdifferentiation are discussed. It is shown that cells of amphibian pigmented
      epithelium can be transformed into retina or lens cells depending on the inducing
      cell type: the influence of retina enables them to be transformed into retina,
      the influence of lens epithelium, to lens cells (lentoids or lenses). This led to
      an attempt to discover the molecular character of cell action by means of
      transfilter induction in early gastrula ectoderm of Xenopus laevis. The results
      show that the induced cell types correspond to the main inducing cell type,
      around which a range of neighbouring cell types is produced; this has been shown
      for five different cell types. The inducing factors involved seem to show
      qualitative differences. It is probable that they play a stabilizing role in the
      maintenance of the differentiated state of tissues, since temporary dissociation
      into cells leads eye tissues to transdifferentiate into other types. Such
      molecular factors can play a significant role in the maintenance of the type of
      differentiation and also in conversion into other cell types. These mechanisms of
      maintenance are not restricted to interactions between molecules and cells, since
      membranes on the surface of the retina and pigmented epithelium contribute to
      their shaping and consequently to the stability of the cell type.

PMID- 1752165
TI  - Regeneration of olfactory receptor cells.
AB  - The vertebrate olfactory system has become an important model for the study of
      neural regeneration. The most remarkable feature of this system is its unique
      capacity for neurogenesis and replacement of degenerating receptor neurons. This
      replacement is made possible by a persistent neurogenesis among basal cells.
      Basal cells differentiate, develop into sensory neurons and grow axon processes.
      Receptor cell axons project back to the olfactory bulb where they reestablish
      connections with the central nervous system. When mature receptors reach a
      critical age, are damaged by nerve injury, or are exposed to environmental agents
      that enter the nasal cavity, they degenerate and are subsequently replaced by
      newly regenerated receptor cells. Recent experiments demonstrate that olfactory
      neurogenesis is not simply an extension of growth and development but is a unique
      capacity for cell replacement that persists beyond maturity and well into old
      age. Even more remarkable is the finding that replacement receptor cells re
      establish connections with the CNS and restore sensory function. It is expected
      that further studies of olfactory neurogenesis using cell and tissue culture
      methods will provide important advances for the field of neural regeneration.

PMID- 1752166
TI  - Regulation of neurogenesis and neuronal differentiation in primary and
      immortalized cells from mouse olfactory epithelium.
AB  - We have developed an in vitro system for studying molecular events regulating
      neurogenesis in the mouse olfactory epithelium (OE). Our observations suggest
      that two types of neuronal precursor may be involved: (1) a transiently existing,
      immediate neuronal precursor (INP), which generates two postmitotic daughter
      neurons; and (2) a neuroepithelial stem cell, which may be the basal cell (or
      some subclass of basal cell) of the OE, and is presumed to be the progenitor of
      the INP. Using antibody markers that distinguish basal cells and postmitotic
      receptor neurons in vitro and in vivo, we have shown that neurogenesis occurs
      early on in OE cultures, but then ceases because INPs divide only once to
      generate postmitotic neurons and no new INPs are produced by basal cells. To
      determine whether the basal cell-to-INP transition, or proliferation and neuronal
      differentiation of the INP, are regulated by crucial growth factors or cellular
      interactions, we are testing various polypeptide growth factors and extracellular
      matrix proteins for their effects on OE neurogenesis in vitro. We have also
      generated immortalized OE cell lines by using retroviruses to transduce oncogenes
      into cultured OE cells. One such cell line (derived from a primary OE basal cell
      culture) develops branching processes when transplanted into neonatal mouse brain
      -a condition in which cells from freshly isolated OE can undergo apparent
      morphological differentiation into neurons.

PMID- 1752167
TI  - Rules for the production of sensory cells.
AB  - During development and regeneration, cells divide, move, change their internal
      state, respond to environmental signals and die according to rules specified by
      their genome. These rules of cell behaviour are fundamental to any explanation of
      how sensory tissues are generated or repaired. An attempt is made to summarize
      and compare the rules underlying the development of four different sensory
      tissues: mammalian retina, avian auditory epithelium, mechanosensory bristle
      fields in Drosophila and, very briefly, Drosophila retina. There are parallels in
      cell lineage, in the timing of developmental decisions, in the postponement of
      the choice of differentiated state until the final cell division cycle, in the
      role of short-range lateral inhibition, and in the involvement of genes such as
      Notch and achaete/scute. These similarities may reflect the conservation of some
      basic mechanisms of sensory development that originated early in the evolution of
      multicellular animals. If so, studies in Drosophila, with its advantages for
      molecular genetics, may give important clues to the mechanisms of sensory
      development and regeneration in vertebrates.

PMID- 1752168
TI  - Neuronal-epithelial interactions in mammalian gustatory epithelium.
AB  - There are two neurally controlled morphogenetic programmes in the fungiform
      papillae of the rodent tongue. When gustatory axons are present they not only
      promote the expression of taste receptor cells but also simultaneously suppress
      the outgrowth of an ectopic filiform spine. Innervation during development is
      essential for the initial formation of taste buds. Consequently, denervation
      during development irreversibly prevents the establishment of a permanent line of
      stem cells for taste buds, in contrast to the reliable re-emergence of taste buds
      after the reinnervation of denervated adult gustatory epithelium. Monoclonal
      antibodies to keratins selectively recognize cells in particular differentiated
      states and may contribute to an understanding of the cell lineages and cell-cell
      interactions that lead to taste buds and filiform spines. Regeneration may
      recapitulate the late steps in taste development but not the early steps, which
      are slower and subject to irreversible alteration with denervation. Arguments are
      set forth that the nerve dependence of taste buds and some other cutaneous
      receptor cells provides an important selective advantage. Nerve dependence
      ensures that a more protective integumental covering will replace any
      superficial, secondary sensory cells rendered useless by denervation.

PMID- 1752169
TI  - Regeneration of electroreceptors in weakly electric fish.
AB  - Weakly electric teleost fish possess two classes of electroreceptors: tuberous
      and ampullary organs. Ampullary organs are used for detecting prey, while
      tuberous organs detect the fish's own electric organ discharges (EODs) and those
      of conspecifics. EOD frequency varies among individuals within a species and a
      fish's tuberous receptors are sharply tuned to its own EOD frequency. In young,
      small fish both tuberous and ampullary afferents innervate only single organs. As
      fish grow new receptor cells are added to each organ and it divides into two
      daughter organs. This process continues resulting in numerous organs in a
      cluster; the afferent nerve innervates all the organs in a cluster. When a patch
      of skin is removed new skin grows back complete with new receptor organs of both
      classes. From our studies we have shown that: (1) new organs are found only in
      the presence of nerve fibres; (2) their morphological development during
      regeneration is similar to their normal development; (3) organs divide rapidly
      giving rise to daughter organs until each afferent fibre innervates the correct
      number of organs for a fish of its size; (4) receptor cells are broadly tuned
      below the EOD frequency of a given fish and they gradually increase their tuned
      frequency and sharpness of tuning until they become correctly tuned to that EOD
      frequency; (5) the correct matching of receptor tuning to EOD frequency occurs in
      fish in which the spinal cord has been severed or with lesions of the medullary
      pacemaker nucleus, thereby eliminating the EOD and any possible 'calibration'
      signal; and (6) basal and capsule cells of receptor organs in the intact skin
      around the wound divide after skin damage and are a possible source of precursor
      cells for new receptor organs.

PMID- 1752170
TI  - The general architecture of sensory neuroepithelia.
AB  - All neuroepithelia are sheets of cells lining an internal or external surface of
      the body and resting on a basement membrane. They consist of at least two kinds
      of cell, receptor cells and sustentacular (supporting) cells. Some contain
      undifferentiated precursor cells and senescent or degenerating cells. The
      potential for plasticity and regeneration in different sensory neuroepithelia
      varies widely according to their origins and structure in any individual animal
      and according to the species in which they occur. Four sensory neuroepithelia are
      described as examples of the range of construction, complexity, and life history.

PMID- 1752171
TI  - Regeneration in epithelial proliferative units as exemplified by small intestinal
      crypts.
AB  - Surface epithelia are subdivided structurally into a series of partially
      autonomous proliferative units. Within each unit the proliferative cells are
      organized into a lineage or hierarchy each with relatively few ancestral (stem)
      cells. This structural organization is strikingly illustrated by the
      gastrointestinal mucosa where the proliferative cells are packaged into crypts.
      In the mouse small intestine there are 250 cells in total per crypt of which
      about 150-160 are proliferative. The latter cells are arranged as a series of
      about 10 rings each of about 16 cells, starting at about the 4th position from
      the bottom of the crypt and running up to the 13th-14th cell position. The stem
      cells are believed to be located in the lowermost ring. We have been studying the
      regenerative process in mouse small intestinal crypts after various levels of
      injury. Exposure to small doses of cytotoxic agents (e.g. gamma-radiation)
      reveals that some cells in the stem cell zone are very sensitive but that
      apparently unaffected cells in the zone are easily disturbed in their cell cycle
      characteristics by this minor damage. Such observations suggest that some of the
      controls on stem cell proliferation are extremely local in their action. The stem
      cells can detect the death of one of their members and the remainder respond
      accordingly. After more severe injury (drugs or higher doses of radiation) the
      first detectable changes also appear in the stem cell zone. It is concluded that
      the crucial cells in the regeneration process in epithelia are the stem cells.
      The cell kinetic properties during regeneration have been studied experimentally
      and modelled mathematically.

PMID- 1752172
TI  - Hair cell regeneration in the avian inner ear.
AB  - The postembryonic production of hair cells in fish and reptiles has been known
      for several decades. Until recently it was assumed that this capacity was absent
      in the more highly specialized inner ears of birds and mammals. Recent research
      has shown, however, that birds have the capacity to rebuild a damaged inner ear.
      Summarized here are studies conducted in our laboratory which address the
      following questions: (1) Which are the precursors of the regenerated hair cells?
      (2) Are the new hair cells functional? (3) What are the ultrastructural
      properties of regenerated hair cells? and (4) Can the level of proliferation be
      regulated? Both the auditory and the vestibular systems of the avian inner ear
      were studied. Our results provide some answers to these questions. The
      implications of the results are discussed.

PMID- 1752173
TI  - [Assessment of Hasegawa's dementia scale for screening and diagnosis of dementia
      in the elderly].
AB  - A sample of 2573 older inhabitants living in Shanghai was investigated on the
      spot for screening dementia by HDS. Their scale scores on HDS ranged from 3 to
      32.5, and the mean score 25.4; according to the 4-grad classification on HDS,
      35.3% were classified as normal, 46.3% as borderline, 16.1% as predementia, and
      2.3% as definitive of dementia. The assessment by HDS corresponded well with
      clinical diagnosis of dementia according to DSM-III based on clinical symptoms in
      96.3% of 2573 aged. Assessment by HDS was applied to 100 older patients with
      clinical diagnosis of psychiatric disorders. The scale scores in 76 cases with
      functional psychiatric disorders and in 24 cases with organic psychosis ranged
      from 16 to 32.5 and 1 to 28, respectively, and the mean scale score 28.1 and
      17.2, respectively. The mean scale score of those with schizophrenia was 29.9,
      neurosis 30, depression 28.3, SDAT 9.1, MID 15.1, and other dementia 23.6. These
      results demonstrate that HDS is a practical and valuable tool of assessment for
      epidemiological, clinical diagnosis and research work to evaluable dementing
      states of Chinese elderly.

PMID- 1752174
TI  - [Relation between psychoactive drugs and body weight among inpatients].
AB  - A self-control study was conducted among 92 inpatients for the purpose of the
      establishment of the relationship between psychoactive and body weight, with the
      latter measured once a week, stepwise regression (alpha = 0.3) revealed: increase
      or decrease of body weight was associated not only with the kinds of medicines
      administered, but also with the types of the diseases, living standard, and
      therapeutic effects. The mechanism of body weight increase was explored and some
      suggestions were also given with regard to the prevention of the increase of body
      weight.

PMID- 1752175
TI  - [A randomized controlled trail of maprotiline treatment of depressive disorder].
AB  - In order to evaluate the clinical effects of maprotiline (home made), the authors
      made a clinical comparison with Ludimil (Cida-Geigy) 96 cases (66 endogenous
      depression and 30 neurotic depression) meet the CMA diagnostic criteria (1984)
      were analysed. The patients' symptoms were assessed with HAMD, side effects with
      TESS. The study group included 72 patients treated with chinese product, the rest
      cases as control group treated with Ludimil. No significant differences of
      efficacy in terms of age, sex and duration of symptoms were found in both groups.
      After the six-week course of Maprotiline treatment, the authors found the dosage,
      therapeutic effect and adverse reaction in both groups are very similar. It is
      concluded that the chinese product is safe and effective.

PMID- 1752176
TI  - [Developments observation of serum thyrohormone level in schizophrenics].
AB  - Measure of serum T3, T4, RUR, FT4I was made at admission, sixth weeks after
      admission and discharged from hospital for 42 cases schizophrenic. T4, FT4I value
      of sixteen patients was higher than in normal controlled group, but there was no
      difference between other 26 cases schizophrenic and controlled group. The authors
      reported that abnormal levels of T4, FT4I in 16 cases patients relate to disease
      course and severe symptoms and suggested that the change of serum T4, FT4I in
      some cases was related to the disease in itself.

PMID- 1752177
TI  - [Serum prolactin response to electroconvulsive therapy in patients with major
      depression].
AB  - Serum prolactin (PRL) levels were determined at 30 min before and 5, 15, 30 and
      60 min after the first and sixth electroconvulsive therapy (ECT-1 and ECT-6) in
      12 female patients with major depression. There was a significant increase in
      serum PRL after ECT-1. The mean maximum PRL level was obtained at 30 min after
      ECT-1 and was 3.18 times of baseline level. The rate between mean maximum PRL
      level after and baseline before ECT-6 was 1.89 and was significantly lower than
      that during ECT-1. ECT-6 caused a significantly lower PRL release than did ECT-1
      too. The possible mechanisms of produced these results were discussed.

PMID- 1752178
TI  - [Quantitative EEG analysis and the value for differential diagnosis on
      depression: I. Spectral power and coherence analysis].
AB  - Spectral power and coherence analysis were taken on 47 depressive patients and 43
      normal controls. Depressive patients showed abnormal brain activity mostly in
      frontal-central regions. The endogenous and manic-depressive groups mainly
      presented higher power of slow activity and predominant in right hemisphere,
      while the non-endogenous and other groups presented higher power mainly in the
      fast bands. Coherence analysis showed that the coherence of EEG between
      homogenous points of two hemispheres was decreased in depressed patients.

PMID- 1752179
TI  - [Quantitative EEG analysis and the value for differential diagnosis on
      depression: II. Multivariate regression and discriminate analysis].
AB  - Multivariate regression and discriminate analyses were carried out based on the
      EEG power variables and some related clinical materials from 47 depressed
      patients and 43 normal controls. The results of regression analysis showed that
      the severity and duration of depression were associated with EEG slow activity,
      while the age of first episode and age of the patients were associated with EEG
      fast activity. Discriminate analysis clearly demonstrates the possible utility of
      EEG data in the differential diagnosis of depression.

PMID- 1752180
TI  - [Psychologic correlates in peptic ulcer].
AB  - Psychological correlates of peptic ulcer were assessed in a group of volunteer
      patients whose ulcers were identified by endoscopy. Logistic regression analysis
      and "t" test indicates that the peptic ulcer patients studied had higher
      "neuroticism" scores on EPQ, more life events experienced in the year previous to
      the investigation (on the revised Holmes' Social Readjustment Rating Scale), more
      severe symptoms on SCL-90, and lower social support scores on the Social Support
      Rating Scale than matched controls. The most frequently reported SCL-90 symptoms
      were anxiety, depression, somatization and obsession. The relationship between
      the occurrence of peptic ulcer and the characteristics of personality, life
      events, social support and psychological health level is discussed.

PMID- 1752181
TI  - [Changes of monoamines in the ischemic rat brains with a modified technique of
      fluorescent histochemistry induced by glyoxylic acid].
AB  - A modified technique of fluorescent histochemistry induced by glyoxylic acid was
      used to study the changes of catecholamine (CA) and 5-hydroxytryptamine (5-HT) in
      the brains, walls of the brain vessels and the dura mater of the rats at regular
      intervals after ligation of bilateral common carotid arteries (BCCA). At the same
      time the effect of chinese herbs, Radix Salviae Miltorrhixae, red flower and
      Motherwort on CA and 5-HT of these rats was also observed. In the normal rats,
      yellow fluorescent granules that indicated the presence of 5-HT were found in the
      walls of the cerebrum, brainstem, cerebellum and dura mater vessels. Green
      fluorescent fibers that indicated the presence of CA were clearly revealed to
      follow the walls of vessels of the dura mater, but not those of the brain
      vessels. After ligation of BCCA, the 5-HT granules of the walls of the brain
      vessels and the CA fibers of dura mater vessels decreased, but CA fibers occurred
      in the walls of the brain arteries. The above mentioned changes became more
      marked following prolonged of ischemia of the brain 24 hours after ligation of
      BCCA, very few 5-HT granules and CA fibers were found in the walls of the brain
      and dura mater vessels. It was interesting to see that the increase of CA fibers
      occurred in the whole muscle layer of the brain arteries. The changes of the
      monoamines were not so evident in those rats treated with Radix Salviae
      Miltorrhixae, red flower and motherwort even though they had also ligation of
      BCCA.

PMID- 1752182
TI  - [Pathological and clinical features of primary ventricular hemorrhage due to
      moyamoya disease].
AB  - The clinical and pathological features of 20 cases of moyamoya disease
      complicated with primary intraventricular hemorrhage (PIVH) and verified by CT
      scanning, cerebral angiography and autopsy were reported. It seemed to the author
      that moyamoya disease appeared to be prone to cause PIVH, this hemorrhage being
      likely due to ischemic malacia in the ventricular wall. The tortuous, abnormal
      network vessels ruptured and bled as a result of infarction and damage of the
      walls of the miliary aneurysms. PIVH might be divided into two types: the
      panventricular hemorrhage and partial ventricular hemorrhage, according to the
      amount of blood that filled into the ventricles. 6 cases of the panventricular
      type were fatal. The symptoms were in conformity with the traditional concept of
      the most critical, intraventricular hemorrhage. The external ventricular drainage
      in combination with lumber puncture drainage would be the better way of treatment
      for these patients. 14 cases of the partial ventricular hemorrhage type showed
      the clinical features of acute subarachnoid hemorrhage (SAH). The treatment was
      similar to SAH too, and the prognosis was much better. It would be worth noting
      that moyamoya disease should be a factor not to be neglected in causing PIVH.

PMID- 1752183
TI  - [Continuous observation of the electrocardiogram following experimental cerebral
      hemorrhage].
AB  - An intracranial injection of 5 ml of heparinized autoblood was made into 14
      healthy domestic dogs. Model of experimental cerebral hemorrhage was made. 7 dogs
      of a control group were not injected with the blood. Electrocardiograms (ECG)
      were recorded before operation, 6 hours after operation and once a day from the
      first to the seventh day after operation in order to observe the changes of ECG
      after cerebral hemorrhage. The result indicated that 11 dogs (78.57%) among the
      dogs of the hemorrhage group had abnormal ECG after operation, but only 2
      (28.57%) of the 7 dogs of the control group were so. Comparison between the two
      groups showed significant difference, P less than 0.01. Abnormal ECG displayed
      the earliest during the postoperation 6 hours. These abnormal phenomena, mainly
      obvious in T wave changes and prolongation of the Q-T interval, were transient
      and began to disappear on the third day.

PMID- 1752184
TI  - [Electromyographic studies on myotonic dystrophy].
AB  - EMG studies were made on 12 cases of myotonic dystrophy (MyD). The EMG of the
      distal and proximal muscles of the limbs showed no marked difference (P greater
      than 0.05). The myotonic potentials, pathologic spontaneous potentials and
      incomplete interference patterns had more marked differences respectively as the
      durations of the disease were prolonged.

PMID- 1752185
TI  - [A twin study on the heredity of electroencephalogram].
AB  - A human twin study was undertaken to research the heredity of the EEG. The
      accuracy of the twins zygosity diagnosis was more than 98 per cent. Thirteen
      pairs of monozygotic twin had an intraclass correlation of 0.43 in alpha
      frequency and 0.65 in alpha sequence time per minute, and twelve pairs of
      dizygotic twins had an intraclass correlation of 0.20 and 0.34. Their
      hereditability was estimated by three methods as 29-58 per cent and 47-66 per
      cent, respectively.

PMID- 1752186
TI  - [An analysis of findings EEG and brain CT scans in patients with primary
      hypoparathyroidism].
AB  - 10 cases of primary hypoparathyroidism showed abnormal findings on EEG. Among
      them 9 cases were also verified by CT scans. It was considered that the severity
      of abnormalities in primary hypoparathyroidism was not only influenced by the
      serum concentration of calcium, but also related with the severity and extent of
      calcification in the brain. These findings would be of significance with regard
      to the diagnosis, treatment and prognostic evaluation of primary
      hypoparathyroidism.

PMID- 1752187
TI  - [A brief account of event-related potentials].

PMID- 1752188
TI  - Kinematics of epithelial wound closure in the rabbit cornea.
AB  - The kinematics of wound closure in the healing rabbit corneal epithelium are
      modelled. The analysis is able to model the movement of the wound edge on the
      corneal surface. A unified formalism is described which embeds the surface
      velocity of the wound margin within the computational algorithm to enable
      calculation of the surface velocity of the wound margin from the time course of
      (1) planar wound area, or (2) wound diameter. The procedure can be implemented
      with the standard least-squares estimation procedure. A polynomial velocity
      function is discussed, but the model allows for any appropriate velocity function
      to be used to suit particular conditions of wound closure. Corneal curvature
      effects are incorporated to avoid the errors associated with a planar
      representation of wound closure on a curved corneal surface. The approach offers
      greater flexibility by avoiding the theoretical flaws of previous models which
      are often limited in scope and nonbiological in nature.

PMID- 1752189
TI  - The subretinal fluid in retinal detachment. A cytologic study.
AB  - Following retinal detachment, subretinal fluid (SRF) fills the neoformed space.
      Subsequently subretinal and preretinal strands of proliferative tissue begin to
      form. We have collected the subretinal fluid withdrawn during retinal detachment
      surgery. We have studied subretinal fluid cytologically to evaluate the number
      and the type of cells present in the fluid, and by means of transmission electron
      microscopy. The first cell type to be present in the fluid represented
      degenerated aspects of pigmented epithelial cells (PECs). Successively, other
      cell types appeared in the fluid as nerve cells (rods, cones and glial cells),
      macrophages and well preserved pigmented epithelial cells.

PMID- 1752190
TI  - Reduced severity of oxygen-induced retinopathy in the newborn rat after topical
      administration of timolol maleate. A preliminary study.
AB  - The effects of timolol maleate on intraocular pressure (IOP) and the severity of
      retinopathy induced by exposure to 80% oxygen were studied in newborn Wistar
      rats. One drop of timolol maleate (0.25%) instilled in each eye twice a day for
      the first ten days of life substantially reduced intraocular pressure without
      significantly modifying arterial pressure. Forty percent of the ratlings treated
      in this way failed to develop oxygen-induced retinopathy (OIR) after exposure to
      80% oxygen for the first five days of life; in the other 60% OIR was less severe
      than that seen in an identically oxygenated group that did not receive timolol.
      The authors hypothesize that the pharmacologically induced reduction in IOP may
      have attenuated the effects of the high concentrations of oxygen on the immature
      retinal vessels by improving the ocular perfusion pressure. The possibility that
      timolol maleate also exerts a direct action on the caliber of these vessels
      cannot be excluded.

PMID- 1752191
TI  - A new diffuse loss index for estimating general glaucomatous visual field
      depression.
AB  - Experience with a number of visual fields has shown that the algorithm used
      earlier for estimating general depression in glaucomatous visual fields was too
      conservative. A new, more sophisticated algorithm for calculating diffuse loss
      has been devised and the results obtained in the evaluation of 20 glaucomatous
      visual fields were compared with those obtained manually. The new algorithm is
      less restrictive, yet produces values for diffuse loss which agree well with the
      empirical estimates (R = 0.97, N = 14). The new diffuse loss index is also
      compared with the mean defect index (R = 0.77, N = 159), the 18th Bebie curve
      ranked value (R = 0.87, N = 159), and the previous diffuse loss index (R = 0.98,
      N = 105). A general discussion of various aspects of diffuse loss is included.

PMID- 1752192
TI  - Carcinoma arising in an odontogenic keratocyst with orbital invasion.
AB  - A 54-year-old black female presented with proptosis and reduced visual acuity of
      the left eye. Computerized tomography (CT) revealed tumor involvement of the left
      cavernous sinus and posterior orbit. The patient had a nineteen year history of a
      left-sided jaw tumor which recurred despite surgical and radiation therapy.
      Biopsy demonstrated a parakeratinized odontogenic keratocyst with areas of
      transformation into an invasive squamous cell carcinoma. Although a
      parakeratinized odontogenic keratocyst may be locally invasive, to our knowledge,
      no case of a parakeratinized odontogenic keratocyst involving the orbit or
      cavernous sinus previously has been reported.

PMID- 1752193
TI  - Effects of ultraviolet radiation and visible light on hamster pupil.
AB  - Light does not cause a miotic response in mammals after a topical application of
      atropine. However, such common sense is based on the pupillary response to
      visible light. We found ultraviolet (UV) caused slight but evident miosis, even
      when the patient did not perceive visible light. In order to understand this
      mechanism further, we conducted in vitro experiments using hamsters. The in vitro
      hamster iris contracted even when the retina was withdrawn in an incubation
      solution. The contraction of the hamster pupil caused by visible light was
      inhibited by procaine, quinacrine, and by the withdrawal of divalent cations, but
      not by indomethacin, AA861, FPL55712 or autonomic blocking agents. UV-induced
      miosis was very delayed, continuing after cessation of UV stimuli.
      Nordihydroguaiaretic acid did not inhibit the miosis induced by UV and/or visible
      light. The UV-induced miosis was not significantly affected by allopurinol or
      verapamil, suggesting mechanisms other than neuronal mediation and oxidative
      stress. This study shows that the isolated hamster iris can react to UV and
      visible rays. UV-induced miosis is different from the miosis caused by light
      reflex. To our knowledge, UV-induced miosis has not yet been reported.

PMID- 1752194
TI  - [Ultrastructural features of a neurotransplant, functionally integrated with the
      recipient's brain].

PMID- 1752195
TI  - [Progesterone concentration in mice at early stages of homo- and heterogeneous
      pregnancy].

PMID- 1752196
TI  - [General and peculiar traits of colchicine and platinum (II) complexes binding
      with tubulin].

PMID- 1752197
TI  - [Peripheral localization of enkephalin-immunoreactive neurons in pteropod
      molluscs].

PMID- 1752198
TI  - Prevalence of substance abuse in a psychiatric evaluation unit.
AB  - The prevalence of substance abuse and psychiatric illness was studied in a
      Psychiatric Evaluations Unit. Twenty-six percent of the subjects received a
      psychiatric diagnosis only with no concomitant substance use disorder. Thirty
      four percent were diagnosed with a substance use disorder but with no other
      psychiatric disorders. Thirty-nine percent of the subjects had a history of both
      psychiatric and substance use disorder; 62% of these substance abusers with a
      psychiatric illness reported using drugs (including alcohol) the week before the
      interview; 56% used illicit drugs while 44% used alcohol only. Differences among
      substance abusers with a psychiatric illness, those with a substance abuse
      diagnosis alone, and those with a psychiatric diagnosis alone are presented.

PMID- 1752199
TI  - Evaluation of nefazodone self-administration in rhesus monkeys.
AB  - Intravenous self-administration of nefazodone, a potential new antidepressant
      medication, was evaluated using a substitution procedure in rhesus monkeys.
      Subjects had established stable rates of responding for cocaine (0.033 mg/kg per
      infusion) under a fixed-ratio 10 schedule during 60-min sessions each day.
      Various does of nefazodone hydrochloride (0.03-0.3 mg/kg per infusion) were
      substituted for cocaine for four consecutive daily self-administration sessions.
      Compared to rates of responding obtained during saline substitutions, nefazodone
      failed to function as a reinforcer when substituted for cocaine. In only one
      monkey, at one dose, did the rate of responding exceed the range of saline
      responding; an effect not observed in two subsequent replications in that
      subject. In all three monkeys, the total number of infusions tended to decrease
      during the 4-day nefazodone substitution and the majority of nefazodone infusions
      occurred during the first quarter of each session, with few infusions occurring
      in the latter three-quarters. Overall intake of nefazodone increased as a
      function of dose per infusion. Such a result is expected when response rates do
      not vary with dose, which is more likely to occur when a test drug is not a
      reinforcer. In summary, the present results provide no evidence of reinforcing
      effects with nefazodone and suggest that it would possess little or no abuse
      liability.

PMID- 1752200
TI  - Comparison between observer assessment and self rating of withdrawal distress
      during opiate detoxification.
AB  - The Subjective Opiate Withdrawal Questionnaire (SOWQ) and the Objective Opiate
      Withdrawal Scale (OOWS) were administered to detect withdrawal distress during a
      rapid opiate detoxification. No correlations could be observed between the
      clinical assessments and self ratings of the 20 patients participating in this
      study. The observers' ratings of withdrawal reached pre-treatment levels within 3
      days. In subjective rating, withdrawal distress returned to normal levels 120 h
      after detoxification. We conclude, that self reports are as important as observer
      ratings in assessing treatment efficacy. The use of both scales might prevent
      early relapse after detoxification.

PMID- 1752201
TI  - Scottish cocaine users: wealthy snorters or delinquent smokers?
AB  - Ninety-two cocaine users were interviewed in Scotland. Most were middle-class
      nasal users, also used other drugs and generally gave cocaine a positive rating.
      One half of them had at some time used cocaine more than once a week. For some,
      this period lasted some months, when as much as 30 'lines' of cocaine were used
      per day of cocaine use. More of these heavy users reported adverse effects of
      cocaine than was the case for light users. Nonetheless, most heavy users had
      reduced their use by themselves to the point that their current cocaine use was
      no different from that of light users. Possible explanations for this apparently
      spontaneous reduction are discussed.

PMID- 1752202
TI  - Effects of ethanol on phospholipid acylation in rat erythrocytes: a model for a
      biochemical approach to membrane adaptation.
AB  - Challenging intact erythrocytes from naive rats with ethanol resulted in dose
      dependent decreases in rates of acylation of phosphatidylcholine and
      phosphatidylethanolamine. In erythrocytes from ethanol-treated animals, the
      responses were of lesser magnitude, indicating a lower sensitivity to ethanol.
      This relative resistance, typical of the state of tolerance, was not associated
      with increased baseline rates of acylation of PC and PE, nor with changes in
      fatty acid specificity of acylation reactions. Taken together, the data suggest
      that (1) intact rat erythrocytes represent a reliable and easily reproducible
      model for studying biochemical correlates of the adaptive response to ethanol;
      (2) phospholipid acylation reactions are implicated in the initial sensitivity
      and subsequent acquisition of tolerance to ethanol in membrane erythrocytes; (3)
      on the basis of the measured acylation reactions, rat erythrocytes appear to
      develop tolerance, but not dependence, to ethanol.

PMID- 1752203
TI  - The decrease of superoxide dismutase activity and depletion of sulfhydryl
      compounds in ethanol-induced liver injury.
AB  - There appears to be increasing evidence that ethanol toxicity may be associated
      with an increased production of reactive oxygen intermediates. In rats we studied
      the effect of 4 weeks of ethanol ingestion on the liver cytosolic defense system
      against active oxygen species. Compared with the control rats, the ethanol-fed
      animals had a significantly higher liver malondialdehyde content and
      significantly lower reduced glutathione level. Moreover, ethanol feeding resulted
      in a decrease of superoxide dismutase and catalase activities while glutathione
      peroxidase activity was only slightly diminished. Thus, prolonged ethanol
      administration profoundly modified the hepatic status of the enzymatic defense
      system leading to lipid peroxidation that may disrupt vital functions of liver
      cells.

PMID- 1752204
TI  - [Computer-assisted determination of the pharmacokinetic parameters of Solupront
      after intrauterine administration in cattle].
AB  - The drug "Solupront" a sulfonamide was clinical tested in healthy heifers and
      cows with endometritis, retentio secundinarum etc. The test-results were
      evaluated with the computer-program "Phakimo". The pharmacokinetic parameters
      show that there are similar relationships between the extravasal and the
      intravasal application of this osmochemotherapeutic. A retard of absorption is
      shown in dioestrus and in prooestrus. If there are pathological signs in uterus,
      the rate of absorption of the drug is higher and the excretion via urine is more
      quickly, too. The effect of the sulfonamide in the drug "Solupront" is impaired
      after application in the uterus in order of the quick absorption, of distribution
      and excretion and also in order of dilution by lochia and by interaction with p
      aminobenzoic acid.

PMID- 1752205
TI  - [Preliminary studies of the content of lead, cadmium and arsenic in feed, cattle
      and food of animal origin from different production regions of Saxony].
AB  - The modern industrial and agricultural production provides many contact points
      for the food animals with several toxic substances. After their ingestion by the
      way of feed or water they may endanger the human health as residues or
      environmental contaminants in food of animal origin. Currently meat, milk and
      eggs produced on farms in the new federal states of Germany are considered to be
      dangerous with respect to their xenobiotic burden by numerous consumers. The own
      trials have been made to give first information about lead, cadmium and arsenic
      concentrations in feedstuffs, meat and milk from different dairy farms in
      Saxonia. No serious problems could be detected referring to the metal contents in
      roughage, grain and crops. Only a few feed samples reached eg. exceeded the
      permissible upper limits for arsenic and cadmium. But none of the examined
      feedstuffs contained inadmissible lead concentration. Milk and muscle produced in
      a metal polluted and not polluted areas were very low in cadmium, lead and
      arsenic. Total different is the situation in the cases of liver and kidney. Both
      organs of cows held on farms near a smelter were rich in cadmium and lead. The
      cadmium concentration in liver and kidney often and the lead concentration
      sometimes exceeded the permissible upper limits for food. In this context cadmium
      in kidney of older cows seems to be a problem in general. The results of the own
      examinations give no information about differences in the mean metal burden of
      feed and food between new and old federal states of Germany.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1752206
TI  - [Interrelationships between methylmercury exposure and selenium supplementation
      in cockerels using selected laboratory diagnostic parameters and toxicological
      parameters of residues].
AB  - A feed loading experiment was applied in 2 phases to 45 young cocks over 12
      weeks, using 1,2-N,N-bis(methylmercury)-p-toluolsulphamide-dressed wheat (50% of
      base ration). Investigations were conducted to study the effects of selenium
      supplementation (0,2 mg Se as sodium selenite/l drinking water) on biochemical
      and hematological parameters (calcium, phosphorus, total protein, albumin,
      creatinine, urea, activity of alkaline phosphatase, hematocrit, hemoglobin,
      leucocyte count) as well as on parameters relating to toxicological residues
      (selenium and mercury levels in liver, musculature and kidneys). Statistically
      secured differences were found to exist between the experimental groups with
      regard to selenium and mercury in the liver and mercury concentrations in
      kidneys. Possible interrelationships were discussed.

PMID- 1752207
TI  - [Circadian rhythm of the toxicokinetics and toxicodynamics of the plant
      protection substance dinitro-ortho-cresol in rabbits].
AB  - Results from chronotoxicological investigations with the plant protection
      chemical DNOC has been described and judged. It has been studied hyperthermia
      caused by i.v. application of 7.5 mg/kg body weight on rabbits to 6 different
      times, starting at 4 a.m. with 4-hours-intervals as well as the dose-effect
      relation in each case with 3 doses to the time of application at 12 a.m., 6 p.m.,
      12 p.m. and 6 a.m. and the renal DNOC excretion after a dose of 10 mg/kg body
      weight. There was found a time dependent rhythm in all experiments. Acrophase of
      hyperthermia is placed in the middle of the phase of activity of the animals at
      12 p.m., however it depends on the dose. The results are showing, that the
      position of acrophase by constant environmental factor is neither a substance
      specific nor an animal specific constant.

PMID- 1752208
TI  - [The occurrence and metabolism of physiologically normal-appearing hydrocarbons
      in agricultural animals].
AB  - Carbohydrates are determined in food from animals as result of contamination.
      Therefore they are a risk for the consumer and may impair the quality of the
      products. There are differences in the pattern of residues between the groups of
      carbohydrates. Especially the saturated carbohydrates indicate heavy differences.
      Aromatic carbohydrates have an equalized level. These relationships are examined
      by tests with n-alkane-yeasts-feeding of pigs.

PMID- 1752209
TI  - Prophylactic and therapeutic application of Propionibacterium avidum KP-40 in
      swine and calves with acute enzootic bronchopneumonia.
AB  - The usefulness of the prophylactic or therapeutic application of
      Propionibacterium avidum KP-40, a potent stimulator of the monocyte-macrophage
      system, was demonstrated in piglets and calves. After a 3-month-period of
      observation PA-treated piglets showed a significantly improved development
      (decreased number of infections, gain of body weight). In piglets and calves the
      therapeutic use of PA together with oxytetracycline proved to be superior in the
      treatment of acute endemic enzootic bronchopneumonia (AEB) as compared to groups
      of animals receiving PA or oxytetracycline alone.

PMID- 1752210
TI  - [Review article: factors influencing the estrogen and progesterone concentration
      in the blood of cows in late pregnancy].
AB  - This review describes the factors influencing the estrogen und progesterone
      levels in late pregnant cows. The various endogenous and exogenous factors
      (breed, calf birth weight, sex of calf, number of fetuses, season, nutrition and
      stressors) influence particularly significant estrogen and progesterone
      concentrations in peripheral blood and may lead to high variations of hormone
      values between cows. The possible mechanisms of influence on the estrogen und
      progesterone levels are discussed.

PMID- 1752211
TI  - [The concentration of ascorbic acid in different tissues of calf fetuses in 3
      different development stages].
AB  - The concentration of ascorbic acid in the cerebrum and in the brain stem of
      bovine fetuses decreased with increasing body weight; in the cerebellum there was
      no change. The decrease of the concentration in the lungs, in the heart, in the
      kidneys, in the M. longissimus and in the M. semimembranosus in the course of the
      fetal growth was different. In the liver and in the adrenals the concentration in
      the 3 groups of fetuses with a body weight of 4.18 +/- 2.01, of 9.72 +/- 0.97 and
      of 17.12 +/- 2.61 kg was similar. The highest concentrations were found in the
      adrenals, in the testes and in the cerebrum. The functional significance of the
      changes in the concentration in the tissues of the bovine fetuses is discussed
      and compared with the results in human fetuses and in adult cattle.

PMID- 1752212
TI  - [A method for the treatment of oviduct obstruction in cattle using CO2
      insufflation into the uterus].
AB  - The investigations were carried out on 59 cows from Holstein half-breed,
      establishing that 8 cows suffered salpinx obstruction (5 cases with unilateral
      obstruction and 3 cases with bilateral obstruction). The authors are using an
      apparatus made by themselves, for insufflation of air in the obstructed uterus,
      and which is useful in desobstruction treatment, too. For diagnosis, CO2 was
      introduced inside of uterus. The authors used for treatment PBS (saline phosphate
      buffer) in addition with penicillin G, hydrocortisone and trypsin. Before air
      insufflation in uterus there will be infused 10-20 ml 2% Lidocaton. The cows must
      be examined in oestrus period, or 2 days after PGF2 alfa administration. The gas
      must be introduced under rectal palpation, and pressure must not be higher than
      500 mm H2O column. If there is a permeable oviduct, after 15-20 sec. from gas
      introduction, ist is possible to palpate the filled oviduct. From ovary we can
      perceive a rustle produced by gas crossing in abdominal cavity. In case of
      salpinx obstruction, the treatment must be start as soon as possible. The
      utilized liquid for treatment will be introduce by gas pressure, inside of uterus
      and oviducts. Using this method, it managed the repermeability of oviducts at 3
      from 8 treated cows. In each case, there were used 3 treatments at 48 h interval.
      After the second insemination (I.A.) 2 cows remained pregnant.

PMID- 1752213
TI  - The influence of colostral leukocytes on the immune system of the neonatal calf.
      IV. Effects on bactericidity, complement and interferon; synopsis.
AB  - The influence of colostral leukocytes on the bactericidity of whole blood of
      calves against a strain of E. coli and on the activities of haemolytic complement
      and interferon-alpha (the antiviral activity of sera resisting an acidic
      treatment at pH 2 for 6 h) in the serum was investigated during a period of 4
      weeks using 4 experimental groups. The calves received either complete colostrum
      (COL+, n = 16), cell-depleted colostrum (COL-, n = 16), cell-supplemented milk
      substitute (MS+, n = 7) or pure milk substitute (MS-, n = 6) during their first
      three days of life. The bactericidity of whole blood of the COL+ group was
      significantly higher on the second and third days of life while the activity of
      haemolytic complement was lower after the first week as compared to the COL-
      group. No interferon-alpha was detectable in the sera of both COL groups. The
      bactericidity of the MS groups was significantly lower than that of the COL
      groups after the first day of life. It was significantly lower in the MS+ group
      after one week of life while the activity of haemolytic complement was higher
      than that of the MS- group. Three out of 5 MS- and only one out of 7 MS+ calves
      had low titres of interferon-alpha in their sera on the third day. Three out of 6
      MS- calves died and 5 out of 7 MS+ animals. The mean day of death was 4.0 in the
      MS- and 8.4 in the MS+ group. Based on the in vitro results of this and the
      previous three communications it can be concluded that leukocytes which are an
      integral part of normal bovine colostrum, influence immunological reactions of
      the calf and that they may enhance its defence against infection. Colostral
      leukocytes in the absence of humoral components of the colostrum are not able to
      prevent fatal losses in the calves due to natural infection, although their
      influence on immune responses of the calves was detectable in vitro.

PMID- 1752214
TI  - The female brindled mouse as a model of Menkes' disease: the relationship of fur
      pattern to behavioral and neurochemical abnormalities.
AB  - The brindled mottled mutant mouse, a model of Menkes' disease, has alterations in
      copper homeostasis which cause, among other sequelae, neuronal degeneration in
      selected areas of brain. This work examined the neurochemical changes at
      postnatal days (PND) 15, 30 and 60 in females heterozygous for the sex-linked
      brindled mutation. These data were compared to behavioral alterations and to fur
      coat color at these same time points. The brindled heterozygotic females had
      lower concentrations of norepinephrine (NE) in the cingulate cortex, and higher
      levels of dopamine or dopamine metabolites in the cingulate cortex, thalamus and
      hypothalamus across all ages, although the difference was greatest at PND 15. The
      brindled females were much less active than their normal littermates at PND 15,
      but the differences were no longer evident at PND 30 and 60. Mottling of the fur
      is believed to result from low tyrosinase activity caused by abnormalities in
      copper metabolism. The fur pattern and behavior of the brindled mice were highly
      correlated with NE levels in the cingulate cortex and thalamus. These data show
      that female brindled mice have neurochemical abnormalities similar to (if less
      severe than) the male hemizygotes, that these abnormalities are regionally
      specific, are most apparent prior to 30 days of age, and are linked to behavioral
      deficits. These data also show that the extent of such deficits can be predicted
      by a quantitative analysis of the fur pattern of these females.

PMID- 1752215
TI  - Effects of interleukin-1 and tumor necrosis factor-alpha on astrocytes,
      microglia, oligodendrocytes, and glial precursors in vitro.
AB  - Microglia and astrocytes undergo proliferative and differentiative changes in
      vivo after trauma or diseases such as multiple sclerosis (MS). Oligodendrocytes
      are destroyed in lesions in MS. Interleukin-1 (IL1) and tumor necrosis factor
      alpha (TNF alpha) are involved in inflammation of the central nervous system and
      are elevated in MS. We have investigated the changes in cell morphology and cell
      number induced by IL1 and TNF alpha in purified and mixed populations of primary
      rat brain microglia, astrocytes, oligodendrocytes, and glial precursors.
      Depending on the target population, proliferation, differentiation, or inhibition
      of cultured cells was observed. The data also suggest that interactions among
      cell populations occur and support the hypothesis that IL1 and TNF alpha effects
      may be indirect, possibly through induction of other factors.

PMID- 1752216
TI  - Neuronal lysosome accumulation in degrading synapses of sensory-motor and limbic
      subsystems in the duck Anas platyrhynchos: indication of rearrangements during
      avian brain development?
AB  - Brains of developing duck embryos and ducklings were analysed daily by light
      microscopy after complete serial brain sectioning and lysosome staining (Gallyas
      technique), providing insight into synaptic degradation and degeneration during
      short periods of synaptogenesis. Both regional and temporal shifting pattern of
      lysosome accumulation (LA) in degraded synapses were detected in sensory-motor
      pathways during the course of development. LA occurred in sensory projections of
      embryos, and proceeded from forebrain sensory fields toward limbic regions and
      finally motor projections. LA disappeared from these structures at the age of 4-6
      weeks. LA was analysed ultrastructurally in selected sensory, limbic and motor
      regions indicating that lysosomes selectively accumulated in transient synapses,
      leaving parts of either pre- or postsynaptic elements untouched. In no case did
      denervated neurons exhibit any signs of cell death. Apparently, the LA phenomenon
      seems critical in terms of both irreversible elimination and remodelling of
      persisting synapses. Thus, neuronal rearrangement mediated by lysosomal
      degradation, i.e. degeneration of synaptic components, is supposed to be an
      integral constituent of synaptogenesis during adaptive processes in sensory-motor
      systems. These results are discussed with regard to developing brain functions
      during behavioural adaptation of this precocious bird.

PMID- 1752217
TI  - Cosmetics and their adverse effects.

PMID- 1752218
TI  - Acute poisoning from hair dye.
AB  - A series of 18 cases of acute hair dye (paraphenylenediamine) poisoning were
      reported. The characteristic features of swollen face and the chocolate brown
      colour of the urine were diagnostic. Asphyxia was found to be the major early
      challenge of life. Tracheostomy and intensive medical treatment with
      hydrocortisone and chlorpheniramine maleate (antihistaminic drug) and penicillin
      cover were life saving in all serious cases. The mild cases were successfully
      treated with hydrocortisone and chlorpheniramine maleate and penicillin without
      tracheostomy. The dye was detected in the urine by thin layer chromatography on
      silica gel and proved to be paraphenylenediamine. Early prompt diagnosis and
      clinical management proved to be life saving in both serious or mild hair dye
      poisoning.

PMID- 1752219
TI  - Haematocrit levels and anaemia in Ethiopian children.
AB  - The paucity of data on the haematological profile of Ethiopian children prompted
      this survey. In October and November, 1987, a survey of haematocrit levels
      utilizing capillary blood and morphological studies on blood films by means of
      the Wright stain was conducted in the peri-urban community of Koladiba in
      Northwestern Ethiopia. All but 21 children (0.5-6 years) in the community
      participated. The mean and median haematocrit levels in children 0.5-6 years was
      38% each with a range of 26-52%. Lowest haematocrit was found between 1-2 years
      of age. The 3rd and 97th percentile values were 31-45% and identical with the
      mean +/- 2 S.D. values. On a third of the children (251), blood film studies were
      done and 20% had microcytic hypochromic red blood cells. When an altitude
      corrected cut-off point of 38% was employed to define anaemia, the prevalence
      rate was 47.2%, the highest rate (60%) in children 1-2 years. However, use of a
      cut-off point based on the third percentile or +/- 2 SD (31%), resulted in an
      underestimation of anaemia rates by 40%. The findings of this study are
      consistent with previous reports on anaemia rates and haematocrit levels in
      Ethiopian children residing in a similar environment. Although the iron content
      of the Ethiopian diet is one of the highest in the world, nutritional anaemia is
      a public health problem. Intervention measures using iron supplementation and
      nutrition education through existing primary health care network are recommended.

PMID- 1752220
TI  - Effect on sodium sulphate on the adsorption of chloroquine and mefloquine to
      activated charcoal.
AB  - The effect of an added saline cathartic (Sodium sulphate) on the in vitro
      adsorption of chloroquine and mefloquine by activated charcoal were determined.
      Chloroquine phosphate at 125, 250 and 500 micrograms/ml had 10.0, 23.0 and 38.4
      percent adsorption to 50 mg charcoal. When the concentration of activated
      charcoal was increased from 50 to 200 mg, there was no significant difference in
      the amount of chloroquine adsorbed. The amount of mefloquine (400-1000 ng/ml)
      adsorbed ranged from 60.62 to 95.8 percent. The common saline purgatives sodium
      sulphate at 7.5 mg/ml increased the B-50 for chloroquine slightly from 376 to 444
      mg whereas it has little or no effect on the adsorption of mefloquine to
      activated charcoal.

PMID- 1752221
TI  - Long distance truck-drivers: 1. Prevalence of sexually transmitted diseases
      (STDs).
AB  - A cross section study was conducted among long distance truck drivers to
      determine the prevalence of sexually transmitted diseases (STDs) and antibodies
      to human immunodeficiency virus (HIV). A total of 8 drivers and their assistants
      en route from port of Mombasa to countries in East and Central Africa were
      enrolled into the study. Blood was taken for HIV and syphilis serology.
      Discharges from urethra and genital ulcer disease (GUD) were cultured.
      Seroprevalence for HIV was 18% and 4.6% for syphilis. Fifty percent of Neisseria
      Gonorrhea cultured were penicillinase producers. Most of the men with urethral
      discharge and all the GUD were culture negative, probably due to prior treatment.
      Lack of circumcision, past history of GUD and urethritis were significantly
      associated with HIV seroconversion.

PMID- 1752222
TI  - Rupture of the gravid uterus: a review.
AB  - A total of 105 patients were treated for ruptured gravid uteri at the Kenyatta
      National Hospital, Nairobi, Kenya, over a five year period, January, 1984 to
      December, 1988. During the same period, there were 44,156 deliveries, giving an
      incidence of uterine rupture of 1:425 deliveries. Of these, records for 95
      patients were traced and analysed, and the results are presented here. Majority
      (61.0%) of these patients were aged less than 30 years, and 62.1% were gravida 5
      or less. 54 (56.8%) of them had rupture of scarred uteri, 33 (34.7%) had
      spontaneous rupture, while 8 (8.4%) had traumatic rupture. 56 (59.0%) ruptured
      while at the Kenyatta National Hospital. Repair of the uterus without tubal
      ligation was the treatment offered to most of them, while total abdominal
      hysterectomy was rarely done. The perinatal case fatality rate was 60% and there
      were two maternal deaths giving a maternal case fatality rate of 2.1%. Factors
      associated with uterine rupture at the Kenyatta National Hospital are discussed,
      and possible ways of reducing the incidence suggested.

PMID- 1752223
TI  - Vascular access for haemodialysis.
AB  - In a fifteen month period (August 1987 to November 1988) forty patients requiring
      haemodialysis had 83 angioaccess procedures performed. Arteriovenous (AV) shunts
      and arteriovenous fistulae were the commonest procedures, comprising 56 (67%) and
      20 (24%) of the patients respectively. Subclavian catheters and artificial grafts
      were used less frequently. Nephrologists and senior house officers attached to
      the Renal Unit were responsible for fashioning A-V shunts and inserting
      subclavian catheters while the A-V fistulae were fashioned by the urologists and
      vascular surgeons. The commonest complication of A-V shunts were clotting,
      occurring in 31 (55.4%) followed by bleeding in 14 (25%). Eight (32%) of the A-V
      fistulae never functioned from the beginning. It is noted that we are still very
      dependent on A-V shunts for vascular access in end stage renal disease (ESRF)
      patients and this is associated with an unacceptable level of complications. This
      dependency on A-V shunts in ESRD patients should be stopped or phased out. A-V
      fistulae should be used more frequently. Their constructions should be well
      thought out, executed and supervised by the few surgeons who are versed in them
      together with their follow-ups.

PMID- 1752224
TI  - Screening for dementia in elderly Nigerians: results of the pilot test of a new
      instrument.
AB  - We developed a new instrument for the assessment of cognitive functions in
      elderly Nigerians as a preliminary step towards the determination of the burden
      of dementia in Nigerian Communities. The instrument was pilot tested on 250
      cognitively-normal Nigerians and their scores compared with those of 15 subjects
      with clinically-diagnosed dementia. The cognitively normal subjects had a mean
      score of 24 (SD 2.3) while the cognitively-impaired subjects had a mean of 35 (SD
      3.0) and p less than 0.01). Of those with normal cognition, subjects with at
      least 6 years of education had significantly lower mean scores than illiterates
      (p less than 0.005). The instrument was completed in 4 minutes in normal subjects
      as against 7 minutes in those with cognitive impairment. The 19 item instrument
      had a sensitivity of 80% and a specificity of 72% at a cut-off value of 27. With
      the elimination of 3 items related to information, the sensitivity and
      specificity increased to 93% and 83% respectively. We conclude that the 16 item
      version is adequate for a 2 stage study of dementia in this environment, its main
      role being that of screening in the first stage.

PMID- 1752225
TI  - Vaginal and cervical abnormalities associated with trichomonal infection.
AB  - Cytological changes were studied among 393 women, reporting to Samir Health
      Centre, Khartoum (Sudan), using Papanicolaou staining. Vaginal trichomoniasis was
      confirmed by wet-mounts and cultural methods. Non-specific inflammatory changes
      were prominent (17.4%). In 33.5% of parasitised patients, the cervix was found
      healthy. Cancer of the cervix was not detected in patients investigated.

PMID- 1752226
TI  - Urinary stone disease in Dar es Salaam.
AB  - Forty four adult patients, 34 males and 10 females, with urinary stones were seen
      over a six-month-period at Muhimbili Medical Centre, Dar es Salaam. Most patients
      were peasants and semiskilled workers. 8 of the patients were Arabs, which
      suggests a high predisposition for this race. 12 of the patients had a history of
      having suffered from bilharzia. There was a high proportion of bladder (and
      urethral) stones (30%) but upper urinary tract stones were still predominant
      (70%). Of 20 patients whose stones were available for analysis, 8 were composed
      of calcium oxalate, 7 of calcium phosphate and 5 of mixed composition. The ratio
      of stone patients to all hospital admissions of 243 per 100,000 suggests the
      prevalence of urinary stone disease is comparable to that found in Western
      countries.

PMID- 1752227
TI  - Carotid angiography in Nigeria: a review.
AB  - Five hundred and seventy-five patients subjected to carotid cerebral angiography
      at the University of Nigeria Teaching Hospital, Enugu, over a period of five
      years are presented. The commonest indication for the study consisted of clinical
      suspicions of tumour, trauma and vascular problems. In cases of subacute or late
      sequelae of head trauma, cerebral angiography prove to be an important neuro
      investigative tool especially in institutions where CT scan is not available.
      Despite the invasive nature of cerebral angiography, the low incidence of side
      effects encountered in this procedure, the ease of the technique and the general
      non-availability of the more advanced non-invasive neuro-diagnostic aids and the
      relative low cost implications are strong enough factors and reasons which have
      encouraged us to advocate the use of the technique in developing countries.
      Nevertheless, because the reported complications are mostly related to the
      expertise of the investigator the occasional investigator must be discouraged.

PMID- 1752228
TI  - Outcome of pregnancy in nephrotic syndrome: a report on five cases.
AB  - In a 6 year period (1984-1989) we have had the opportunity to take care of five
      patients who had nephrotic syndrome and became pregnant. Four of them had
      mesangial proliferative glomerulonephritis while one had focal segmental
      glomerulosclerosis. Four of the pregnancies went to term while one was terminated
      at 34 weeks gestation because of deteriorating renal function in the mother. All
      the pregnancies ended in delivery of normal babies. However, two patients have
      since died of end stage renal disease, while the remaining three continue to be
      nephrotic with reduced levels of renal function following the deliveries.

PMID- 1752229
TI  - Depressed erythropoietic activity of Nigerian pregnant women.
AB  - Reticulocytes production index was determined in 63 pregnant women and in 96
      patients. The results show that 86% of the pregnant women, who were registering
      their pregnancy for the first time, were anaemic. There was significant
      reticulocytopenia in all the anaemic pregnant women and in the patients.
      Erythropoiesis was found to be depressed in all subjects patients by two to seven
      times those expected in normal responsive bone marrows. There was no correlation
      of the bone marrow impairment with parity of the pregnancy. The bone marrow
      impairment was more pronounced during the 16th week of gestation and less so in
      older pregnancies. Malnutrition and infection (especially malaria) are suggested
      as the aetiological factors of the bone marrow depression of erythropoiesis.

PMID- 1752230
TI  - Timing of surgery in acute cholecystitis.
AB  - Eighty-one cases of cholecystectomy performed over a period of 12 months were
      reviewed. Those operated upon acutely, those operated upon electively, and those
      initially treated in the hospital before surgery was performed were compared with
      regards to the length of hospital stay, injury to the common bile duct, wound
      infection and mortality rate. There is no significant difference in the mortality
      rate, but the rate of wound infection 23%, and injury to the common bile duct
      (17.95%) are highest in those operated upon acutely. It would seem as if the
      "delayed" surgery, that is, conservative treatment for about a week to two in the
      hospital before surgery, is preferred if common bile duct exploration or a
      choledocho-enterostomy is anticipated.

PMID- 1752231
TI  - Formation of 6 beta-hydroxydexamethasone from dexamethasone by A6 cells.
AB  - A6 cells, a continuous cell line derived from kidney of Xenopus laevis, were
      incubated with [3H]-dexamethasone for 24 h. When radioactive compounds in media
      were separated by reversed phase high pressure liquid chromatography, two
      radioactive fractions were found. The less polar fraction which contained 91-93%
      of total radioactivity cochromatographed with dexamethasone, whereas the polar
      fraction contained 5% of total radioactivity in media. In order to rigorously
      identify the polar metabolite, large scale cultures were carried out and the
      polar compound was separated and purified by reversed phase high pressure liquid
      chromatography. The purified material was analyzed by secondary ion mass
      spectrometry and nuclear magnetic resonance spectroscopy. By these procedures,
      this material was identified as 6 beta-hydroxydexamethasone. To our knowledge
      these are the first data indicating that dexamethasone can be metabolized by
      transporting epithelia such as A6 cells.

PMID- 1752232
TI  - Effect of dietary calcium on serum BGP (osteocalcin).
AB  - The present study was designed to clarify the effects of dietary calcium (Ca)
      intake on serum BGP (osteocalcin) levels. Twelve women with a mean age of 21.2
      years participated in the study. After one week of normal Ca intake (mean +/- SE,
      535 +/- 2 mg/day), a low-Ca diet (163 +/- 1 mg/day) was given for one further
      week. Additional asparagine Ca (3 g as Ca/day) was also given to half of the
      subjects. Serum total and ionized Ca concentrations as well as BGP, PTH and
      1,25(OH)2D3 were measured at the end of each period. Amounts of Ca and
      hydroxyproline excreted in urine were also determined. The plasma level of
      ionized Ca was significantly increased without any change in total Ca in either
      group. Low and high Ca intake decreased and increased urinary Ca excretion by 28%
      and 56%, respectively. Serum levels of BGP and 1,25(OH)2D3 were significantly
      augmented along with a transient increase in urinary hydroxyproline excretion
      after Ca deprivation. These results suggest that serum BGP is increased after one
      week of Ca restriction in healthy subjects.

PMID- 1752233
TI  - Maturation of the pituitary-thyroid axis during the perinatal period.
AB  - To clarify the maturation process of the pituitary-thyroid axis during the
      perinatal period, thyrotropin (TSH) response to thyrotropin releasing hormone
      (TRH) and serum thyroid hormone levels were examined in 26 healthy infants of 30
      to 40 weeks gestation. A TRH stimulation test was performed on 10 to 20 postnatal
      days. Basal concentrations of serum thyroxine (T4), free thyroxine (free T4) and
      triiodothyronine (T3) were positively correlated to gestational age and birth
      weight (p less than 0.001-0.01). Seven infants of 30 to 35 gestational weeks
      demonstrated an exaggerated TSH response to TRH (49.7 +/- 6.7 microU/ml versus
      22.1 +/- 4.8 microU/ml, p less than 0.001), which was gradually reduced with
      gestational age and normalized after 37 weeks gestation. A similar decrease in
      TSH responsiveness to TRH was also observed longitudinally in all of 5 high
      responders repeatedly examined. There was a negative correlation between basal or
      peak TSH concentrations and postconceptional age in high responders (r = -0.59 p
      less than 0.05, r = -0.66 p less than 0.01), whereas in the normal responders TSH
      response, remained at a constant level during 31 to 43 postconceptional weeks. On
      the other hand, there was no correlation between basal or peak TSH levels and
      serum thyroid hormones. These results indicate that (1) maturation of the
      pituitary-thyroid axis is intrinsically controlled by gestational age rather than
      by serum thyroid hormone levels, (2) hypersecretion of TSH in preterm infants
      induces a progressive increase in serum thyroid hormones, and (3) although there
      is individual variation in the maturation process, the feedback regulation of the
      pituitary-thyroid axis matures by approximately the 37th gestational week.

PMID- 1752234
TI  - Suckling stimulates the expression of vasoactive intestinal polypeptide gene in
      rats.
AB  - The effect of suckling on vasoactive intestinal polypeptide (VIP) gene expression
      in the hypothalami was studied during the postpartum period in rats. Female rats
      were divided into two groups immediately after delivery. In one group, a mother
      was housed with 8 pups, and in the other, without any pups. The former group was
      named S(+) and the latter S(-). On days 0, 3, 6, 9 and 12 after delivery, the
      mothers were killed by decapitation. Hypothalamic VIP mRNA was measured by RNA
      dot hybridization. Although the VIP mRNA level showed no significant change after
      delivery in the S(-) group, VIP mRNA in the S(+) group on days 6, 9 and 12
      increased to 1.6, 3.5 and 2.1 times higher than the level observed on day 0,
      respectively. These results suggest that suckling induces the synthesis of VIP
      after 6 postpartum days.

PMID- 1752235
TI  - Effect of oral administration of glycyrrhizin on the pharmacokinetics of
      prednisolone.
AB  - The pharmacokinetics of total and free prednisolone (PSL) in six healthy men,
      with or without pretreatment with oral glycyrrhizin (GL), was investigated to
      confirm whether oral administration of GL influences the metabolism of PSL in
      man. Each subject received an intravenous administration of 0.096 mg/kg of
      prednisolone hemisuccinate (PSL-HS) with or without pretreatment with 50 mg of
      oral GL four times. Blood samples were taken from a peripheral vein at 5, 10, 15,
      30, 45 min and 1, 1.5, 2, 3, 4, 6, 8, 10, 12 and 24 h after the start of PSL-HS
      infusion. The concentrations of total PSL in plasma were analyzed by high
      performance liquid chromatography, and the free PSL was measured by an
      isocolloidosmolar equilibrium dialysis method. The pharmacokinetic parameters of
      PSL were determined by non-compartment analysis. Oral administration of GL was
      found to significantly increase the concentrations of total PSL at 6, 8 h, and of
      free PSL at 4, 6 and 8 h after PSL-HS infusion. Moreover, oral administration of
      GL was also found to modify the pharmacokinetics of both total and free PSL.
      After oral administration of GL, the area under the curve (AUC) was significantly
      increased, the total plasma clearance (CL) was significantly decreased, and the
      mean residence time (MRT) was significantly prolonged. However, the volume of
      distribution (Vdss) showed no evident change. This suggests that oral
      administration of GL increases the plasma PSL concentrations and influences its
      pharmacokinetics by inhibiting its metabolism, but not by affecting its
      distribution.

PMID- 1752236
TI  - Adenosine 3',5'-cyclic monophosphate-dependent protein kinase (A kinase)
      regulation of insulin receptor function: phosphorylation of insulin receptor with
      A kinase decreases the insulin binding activity.
AB  - The effect of phosphorylation of insulin receptor with adenosine 3',5'-cyclic
      monophosphate-dependent protein kinase (A kinase) on its insulin binding activity
      was investigated by using insulin receptors prepared from rat liver in vitro. A
      95 KDa protein was phosphorylated by stimulation of insulin receptor kinase. This
      protein was also phosphorylated by A kinase. Analysis of phosphoamino acid showed
      that tyrosine residue(s) was phosphorylated by activation of insulin receptor
      kinase, whereas phosphoserine and phosphothreonine were dominantly generated by
      activation of A kinase. [125I] Iodoinsulin binding activity was decreased by
      prior phosphorylation of the receptor with A kinase. Scatchard analysis showed
      that the affinity for insulin was decreased by the phosphorylation with A kinase.
      Although the maximal activity of insulin receptor kinase was not affected by
      phosphorylation with A kinase, the insulin concentration which induced half
      maximal activity (ED50) of the receptor kinase was increased by the
      phosphorylation with A kinase. These results suggested that counter regulatory
      hormones whose actions are mediated by the generation of adenosine 3',5'-cyclic
      monophosphate regulate the insulin binding to the alpha subunit through
      phosphorylation of the beta subunit of insulin receptor.

PMID- 1752237
TI  - Paradoxical prolactin response to growth hormone-releasing hormone in a patient
      with hyperprolactinemia and empty sella.
AB  - In a 30-year-old woman with amenorrhea due to hyperprolactinemia, serum PRL
      increased to twice the basal amount in response to growth hormone-releasing
      hormone (GHRH). Roentgenological studies revealed no pituitary adenoma but empty
      sella. Bromocriptine therapy normalized serum PRL and made the paradoxical
      response to GHRH disappear. The paradoxical response did not occur in any of
      eight other patients with hyperprolactinemia due to prolactinoma. Although this
      case is rare, GHRH stimulates PRL as well as GH release remarkably in some cases
      with hyperprolactinemia without a GH-producing tumor.

PMID- 1752238
TI  - Silent thyroiditis in an eleven-year-old girl, associated with transient increase
      in serum IgM and thyroid hormone.
AB  - An 11-year-old-girl with silent thyroiditis associated with a transient increase
      in serum IgM and thyroid hormone is described. The levels of serum IgM decreased
      from 4.38 g/L to 3.35 g/L after 1.5 months at the same time as thyroid hormones
      returned to normal. An unidentified antecedent infection or exposure to antigen
      causing the increase in serum IgM might have triggered the occurrence of silent
      thyroiditis in this patient, although a search for viral antibodies revealed no
      significant titer changes during the course of the disease.

PMID- 1752239
TI  - The electrophoretic properties of a DNA cube and its substructure catenanes.
AB  - Electrophoretic properties have been measured for a DNA molecule whose helix axes
      have the connectivity of a cube. This molecule is a topologically bonded complex
      of six cyclic 80-mer molecules, in which each cycle corresponds to a face of the
      cube. Each cyclic molecule is doubly catenated to each of its four neighbors.
      Substructures of this molecule include a 5-cycle structure lacking one strand,
      two topoisomers of 4-cycle structures and two topoisomers of 3-cycle structures.
      One 4-cycle structure is a cyclic belt around the cube, lacking a top and a
      bottom, whereas the other lacks two catenated strands, such as the top and the
      front. One 3-cycle structure is a linear belt of three cycles, and the other
      corresponds to the three cycles that surround a corner. Each of these molecules
      is separable from the others under appropriate gel conditions. We have measured
      mobilities and calculated Ferguson plots for each of these molecules on
      polyacrylamide gels under both native and denaturing conditions. The measurements
      have been made with 1.25, 2.5, and 5% crosslinking of the gels. The data show
      that the higher-symmetry 3-cycle and 4-cycle structures migrate more slowly than
      their lower-symmetry isomers, under conditions where their Ferguson plots are
      parallel.

PMID- 1752240
TI  - Estimation of polyacrylamide gel pore size from Ferguson plots of linear DNA
      fragments. II. Comparison of gels with different crosslinker concentrations,
      added agarose and added linear polyacrylamide.
AB  - The mobilities of various DNA fragments in two normally migrating molecular
      weight ladders were studied in polyacrylamide gels containing different
      concentrations of the crosslinker N,N'-methylenebisacrylamide (Bis). The
      acrylamide concentration ranged from 2.5-10.5%T (w/v); the Bis concentration
      ranged from 0.5-10%C (w/w), with respect to total acrylamide. Ferguson plots were
      constructed for each of the DNA fragments in gels of each composition. The
      Ferguson plots of the different multimers in each molecular weight ladder were
      nearly parallel in gels containing 0.5-3%C, converged close to a common intercept
      at zero gel concentration in gels containing 4%C, and crossed at approximately
      1.5%T in gels containing 5 and 10%C. If the mobilities observed for the different
      DNA fragments at zero gel concentration were also extrapolated to zero DNA
      molecular weight, a common limiting mobility was observed in gels of all
      crosslinker concentrations. This limiting mobility was approximately equal to the
      free solution mobility of DNA. The effective pore radius of each gel was
      estimated from Ferguson plots based on relative mobilities, using the mobility of
      the smallest DNA fragment in each molecular weight ladder as the reference
      mobility. The calculated gel pore radii ranged from 142 nm to 19 nm,
      respectively, for gels containing 4.6%T, 1.5%C, and 10.5%T, 5 or 10%C. These pore
      radii are an order of magnitude larger than previously accepted values, but are
      consistent with scanning electron microscope measurements (Ruchel, R., et al., J.
      Chromatogr. 1978, 42, 77-90).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1752241
TI  - Electrophoretic size separations in liquified agarose of polystyrene particles
      and circular DNA.
AB  - Polystyrene sulfate particles of 0.37 to 1.78 mu in diameter are retarded in
      their electrophoretic migration in proportion to the concentration of agarose
      liquified above its gelling temperature. In the concentration range of 0.02 to
      0.2% liquified agarose, the degree of this retardation in electrophoresis at 40
      degrees C is inversely related to particle size. By contrast, mitochondrial DNA
      (16 kb), plasmid pBR322 DNA (4 kb) and plasmid PSA509 DNA (3 kb) exhibit under
      the same conditions a degree of retardation which is proportional to their size.
      This confirms the existence of two divergent mechanisms of size separation
      similarly observed in other liquid polymer media, i.e. one based on collisions
      with the gel fiber (molecular sieving) and one based on exclusion from the fiber
      network (the electrophoretic equivalent of gel permeation).

PMID- 1752242
TI  - Analysis of limiting factors of DNA band separation by a DNA sequencer using
      fluorescence detection.
AB  - The factors affecting the electrophoretic separation of DNA bands in DNA base
      sequencing using fluorescence detection are analyzed. All the factors
      contributing to DNA band spacing and band width are evaluated; DNA diffusion and
      thermal effects on gels are the main considerations. The dependence of the gel's
      electrical resistivity on gel temperature and the variation of temperature over
      gel thickness are associated with a broadening of DNA band width. As a result of
      the analyses the maximum separable base number is represented as a function of
      various electrophoretic variables. The best separations are possible with an
      electric field strength corresponding to gel thickness. The maximum separable
      base number increases as the gel thickness decreases. It also increases as the
      migration distance increases, but it becomes saturated and has an upper limit
      when the migration distance is long. This upper limit increases as gel thickness
      decreases. DNA fragments with 600 and 601 bases can be completely separated from
      each other under optimum conditions for a 0.2 mm thick gel plate. Furthermore,
      using the band spacing information, under the same conditions, 750 bases could be
      assigned separately.

PMID- 1752243
TI  - Isoelectric membrane simulator: a computational approach for isoelectric
      immobiline membranes.
AB  - Isoelectric membrane simulator (IMS) is a computer program meant for computation
      of pH, buffering power (beta), ionic strength (I) and dissociation degree (a) of
      a mixture of up to 3 buffering and 1 titrant Immobilines, for generating in a
      reproducible manner isoelectric membranes. Such membranes, of precise isoelectric
      point, are then used for large-scale protein purification by isoelectric focusing
      in multicompartment electrolyzers. IMS can be used, in a more general
      application, for titrating mixtures of buffers to a desired pH value. This
      versatile program is written in M.Q.BASIC rel. 2.5 and it runs on any IBM
      hardware or compatible machine supported by MS-DOS. An example of purification of
      superoxide dismutase in a multicompartment electrolyzer with a set of fixed pI
      membranes of widely differing composition is shown.

PMID- 1752244
TI  - Electrophoresis with intermittent scanning of the migration path: detection of
      resolution within shortened time.
AB  - Intermittent optical scanning (by detection of optical density or fluorescence)
      of the electrophoretic migration path was applied to the resolution of two dyes
      under an arbitrary set of conditions. Scanning at 5-min intervals allows for
      detection of resolution between the two zones at least 3 times faster than
      conventional automatic zone detection employing a detector at the end of the
      migration path. This result promises that replacing stationary by mobile
      detectors in general would result in a substantial time saving for automated
      detection of electrophoretic zones.

PMID- 1752245
TI  - Use of a fast protein electrophoretic purification procedure for N-terminal
      sequence analysis to identify S-locus related proteins in stigmas of Brassica
      oleracea.
AB  - In the cruciferous plant Brassica oleracea L. (cabbage), the S-locus specific
      glycoproteins (SLSGs) isolated only in stigmas are considered to play an
      important role in the normal prevention of self-fertilization. Recent molecular
      data have shown that the gene encoding these glycoproteins (the SLG gene)
      belonged to a multigenic family consisting of about 10 homologous copies among
      which another member is expressed, the S-locus related gene (SLR1gene). Our aim
      was to determine whether the SLR1-gene proteins were expressed in the stigmatic
      tissues. We first identified the putative SLSGs or SLR1-proteins by Con A
      peroxidase detection of glycoproteins separated after isoelectric focusing in
      polyacrylamide gels. We describe a fast purification procedure for the
      glycoproteins of interest, based on analytical isoelectric focusing,
      electrophoresis, and electroblotting of proteins onto polyvinylidene difluoride
      membranes. Blotted proteins were sequenced for N-terminal amino acid
      determination. By comparison of the N-terminal sequences of the purified proteins
      with the peptide sequence predicted from the SLR1-cDNA, we demonstrate the
      expression of SLR1-like proteins in stigmas of B. oleracea.

PMID- 1752246
TI  - Temperature-dependent spot positional variability in two-dimensional polypeptide
      patterns.
AB  - The effect of temperature, at which isoelectric focusing with immobilized pH
      gradients is performed, on spot positions and pattern quality in two-dimensional
      (2-D) electrophoresis was examined. Increased temperatures revealed improved 2-D
      patterns with respect to sample entry, resolution, and background staining.
      Focusing at 20 degrees C was superior to focusing at 10 and 15 degrees C. Even at
      30 degrees C, a pattern of well-resolved polypeptide spots with a minimum amount
      of horizontal streaking at the basic end was observed. A computer-based analysis
      showed that a substantial proportion of polypeptides assumed altered positions in
      the 2-D pattern in relation to temperature. Mobility shifts of polypeptides were
      more variable on the neutral part than on the acidic or basic end. The mobility
      shifts were not restricted to one direction for all the spots whose migration was
      altered. However, for any given spot, the direction was the same with subsequent
      increments of temperature. The results clearly demonstrate that a defined
      temperature for first-dimensional isoelectric focusing is a requirement for the
      reproducibility of 2-D electrophoresis. After elimination of the cathodic drift,
      a major source of variability in 2-D patterns, associated with carrier
      ampholytes, temperature control becomes a critical parameter.

PMID- 1752247
TI  - Comparison of 14C-amino acid mixture and [35S]methionine labeling of cellular
      proteins from mouse fibroblast C3H10T1/2 cells by two-dimensional gel
      electrophoresis.
AB  - Total cellular proteins from mouse C3H10T1/2 fibroblasts were compared by two
      dimensional (2-D) gel electrophoresis after radiolabeling with [35S]methionine
      (35S-Met) or 14C-amino acids (14C-AA). 35S-Met labeling of protein was three to
      four times greater than 14C-AA incorporation over a 24 h period. Automated
      comparative analysis of replicate fluorographs after 6, 12, and 24 h of labeling
      showed considerable homology between radiolabeling methods. More than 88% percent
      of 35S-Met and 14C-AA-labeled proteins were common at each time point. However,
      the total number of 35S-Met-labeled proteins dropped from 6 to 24 h while the
      number of 14C-AA-labeled proteins increased. Additionally, twenty-one proteins
      were uniquely labeled by 14C-AA that were not detectable by 35S-Met over the
      labeling period. Densitometric analysis showed that several 35S-Met and 14C-AA
      labeled proteins exhibited time-related differences in radiolabel incorporation
      while most proteins remained relatively constant. Protein patterns of silver
      stained gels from 6 to 24 h were highly registered and showed few qualitative
      differences. Proteins detected in radiolabeled gels were generally, but not
      always, found in silver-stained gels. Thus, 35S-Met appears better suited for
      short-term radiolabeling of cellular protein while more comprehensive labeling of
      protein occurs with 14C-AA during prolonged incubation of cell cultures under
      present experimental conditions.

PMID- 1752248
TI  - Genetic polymorphisms of the A and B subunits of human coagulation factor XIII in
      mainland Italy and Sardinia: description of a new FXIIIA variant allele.
AB  - The distribution of the two alleles of FXIIIA and the three alleles of FXIIIB
      were studied in populations from mainland Italy and from Sardinia. The
      frequencies of the FXIIIA*2 allele were 0.266 and 0.265. The frequencies of
      FXIIIB*1 were 0.787 and 0.765; of B*2, 0.070 and 0.094; of B*3, 0.143 and 0.141.
      A new cathodal FXIIIA allele (A*7) was described in the Rome sample. No
      significant difference in the distribution of allele frequencies for either
      system was found between the two populations studied. For typing both markers,
      good results were also obtained by using whole blood instead of plasma.

PMID- 1752249
TI  - The characterization and use of different antibodies against the hsp70 major heat
      shock protein family for the development of an immunoassay.
AB  - The hsp70 family of major stress proteins is composed of several different
      members exhibiting similar structural and functional properties. In order to
      obtain an antiserum with wide epitope reactivity, rabbits were immunized with a
      mixture of native and denatured hsp70 purified from bovine muscle by ATP-affinity
      chromatography. Screening for antibody specificity was performed by a "sandwich"
      enzyme linked immunosorbent assay (ELISA). Immunoprecipitation and immunoblotting
      analyses demonstrated that the polyclonal antiserum obtained by us and a
      monoclonal antibody raised against a different preparation of antigen recognized
      the same determinant on the native hsp70 molecule (inducible form). With a
      different specificity the polyclonal antiserum recognized only the denatured
      monomers of the other members of the hsp70 family. These results are discussed in
      relation to the immunological features of the hsp70 molecule and to the
      development of an immunoassay for the detection of hsp70 in cell and tissue
      extracts.

PMID- 1752250
TI  - A modified method of genomic DNA preparation in agarose inserts for pulse field
      gel electrophoresis.
AB  - According to standard protocol, DNA in agarose inserts is prepared by first
      embedding the cell in agarose. This is then incubated in the required enzyme
      (lysozyme, lysostaphin, or zymolase) depending on the cell type (bacterial or
      plants), for spheroplast formation. Subsequent treatment of the spheroplast with
      proteinase K allows the isolation of large genomic DNA in agarose suitable for
      pulse field gel electrophoresis. An efficient and rapid method of preparation of
      spheroplast is described. In this method a low concentration of enzyme required
      for spheroplast formation was added before embedding the cell in agarose, which
      facilitated the digestion of cell wall by the enzyme and allowed use of a low
      amount of enzyme. Digestion of DNA in agarose inserts prepared by this method,
      with rare cutting restriction enzyme and pulse field gel electrophoresis, showed
      that the quality of DNA was as good as obtained by the standard method.

PMID- 1752251
TI  - High resolution scanning of DNA autoradiographs.
AB  - The sizes of DNA fragments (alleles) on autoradiographs are measured by means of
      a computerised video scanner developed in this laboratory. This report
      investigates the advantages of using higher resolution equipment for this
      purpose. High resolution is simulated by using existing equipment and moving the
      video camera closer to the autoradiograph. Test autoradiographs, used to validate
      the original scanner, have been rescanned to determine the degree of improvement
      that could be obtained using expensive high resolution equipment.

PMID- 1752252
TI  - Improved method for identification of proteins using two-dimensional
      electrophoresis with immobilized pH gradient isoelectric focusing.
AB  - Recent advances in protein sequence analysis now permit the determination of
      partial N-terminal and internal primary structure from low picomole quantities of
      protein. The major remaining hurdles to sequence analysis of small amounts of
      protein are the identification, isolation, and handling of microgram and
      submicrogram quantities of protein. The technique of two-dimensional
      electrophoresis using immobilized pH gradient isoelectric focusing circumvents
      many of these problems. However, poor correlation between the first and second
      dimension have prevented use of this technique for the identification of some
      proteins which can only be assayed prior to the denaturing conditions used in the
      second dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis
      procedure. An improved method is presented which allows correlation of the native
      biological activity (first dimension) to a silver stained protein (second
      dimension) with a high degree of confidence.

PMID- 1752253
TI  - A simplified method of protein electroblotting after isoelectric focusing on an
      ultrathin polyacrylamide gel layer fixed on a cellophane support.
AB  - A method is described for isoelectric focusing of proteins, using an ultrathin
      layer polyacrylamide gel on cellophane, followed by electrophoretic transfer of
      separated proteins onto a nitrocellulose membrane. The polyacrylamide gel is
      firmly attached to the cellophane and thus protected from mechanical damage; such
      gels are easily manipulated. Cellophane is permeable to ions and application of
      this gel support overcomes difficulties resulting from the removal of ultrathin
      gels from a plastic support on electroblotting. Proteins separated under
      nondenaturing conditions were transferred onto a nitrocellulose membrane and
      detected by the concanavalin A-peroxidase technique. The proposed approach makes
      it possible to analyze the variability of nondenatured proteins and glycoproteins
      of different origin.

PMID- 1752254
TI  - Detection of proteins after immunoblotting on nitrocellulose using fluorescent
      antibodies.
AB  - A Western blot method is described utilizing 5-dimethylaminonaphthalene-1
      sulfonyl (dansyl chloride)-conjugated antibodies to detect proteins transferred
      onto nitrocellulose. Four proteins of different molecular weight, including human
      albumin, gamma heavy chain, kappa and lambda light chains of immunoglobulins,
      were tested. Labeling with the fluorochrome was compared with the method of
      enzyme-conjugated antibodies and was found to have similar sensitivity,
      specificity, and safety. Moreover, this method is less expensive, and the labeled
      antibodies can be prepared fresh in a short time and are free from the
      disadvantages of enzyme label whose activity is affected by the presence of
      activators or inhibitors in the tested specimens.

PMID- 1752255
TI  - Increased selectivity in the detection of glycoproteins on nitrocellulose
      membranes by washing with sodium hydroxide solution.
AB  - We increased selectivity in the detection of glycoproteins on nitrocellulose
      membranes by introducing a washing step using sodium hydroxide solution.
      Glycoproteins on the nitrocellulose membrane were first oxidized by sodium
      periodate; biotin hydrazide was then coupled to the aldehyde groups generated in
      the sugar moiety of the glycoproteins. The membrane was washed twice using sodium
      hydroxide solution, and avidin-horseradish peroxidase was then coupled to the
      remaining biotin. This system allows the detection of nanograms of glycoproteins
      on nitrocellulose membranes, and its specificity allows the clear distinction of
      glycoproteins from the nonglycosylated protein of bovine serum albumin.

PMID- 1752256
TI  - Dodecyl maltoside detergent improves resolution of hepatic membrane proteins in
      two-dimensional gels.
AB  - This report describes the incorporation of an alkyl maltoside detergent in two
      dimensional polyacrylamide gel electrophoresis (2-D PAGE) sample lysis buffer in
      order to improve resolution of protein patterns separated by nonequilibrium pH
      gradient electrophoresis. Membrane-associated proteins with alkaline isoelectric
      points form horizontal streaks on two-dimensional electrophoretograms when
      solubilized with conventional nonionic detergent. Dodecyl maltoside enhances
      protein delipidation during solubilization and improves pattern resolution and
      protein mobility.

PMID- 1752257
TI  - Estimating imprecision of radioassays and related procedures: some
      considerations.

PMID- 1752258
TI  - Gallium scintigraphy in Hansen's disease.
AB  - Gallium 67 imaging was used in 12 patients with documented Hansen's disease
      undergoing treatment or not, in an attempt to determine the pattern of the
      disease. Diagnosis was confirmed by histopathology in all patients. The Mitsuda
      reaction was seen in all patients. Specific nuclear studies were performed when
      needed to evaluate particular organs better. Gallium 67 images show homogeneous,
      diffuse and moderate accumulation over the entire skin surface (except for the
      face) of untreated patients with multibacillary disease. The facial skin in these
      cases presented homogeneous, diffuse but very marked uptake of gallium. Internal
      organ involvement was variable. There was a very good correlation among clinical,
      scintigraphic, immunological and histopathological data. The pattern of the body
      skin ("skin outlining") and facial skin ("beard distribution") may be distinct
      for untreated patients with multibacillary leprosy.

PMID- 1752259
TI  - Evaluation of cellular viability by quantitative autoradiographic study of
      myocardial uptake of a fatty acid analogue in isoproterenol-induced focal rat
      heart necrosis.
AB  - Previous studies led us to hypothesize that a fatty acid analogue, 15-p
      iodophenyl-beta-methyl pentadecanoic acid (IMPPA or BMIPP), which is taken up but
      not quickly metabolized by heart cells, would be a more suitable tracer of
      cellular viability than thallium-201. Biodistribution studies of 1-14C-IMPPA in
      conscious, freely moving rats showed that the concentration ratio of
      radioactivity in the heart with respect to the blood was about 8 for at least 60
      min after intravenous administration, permitting its use as a putative tracer in
      these conscious, freely moving rats. Thereafter, the myocardial uptake of 14C
      IMPPA was studied in isoproterenol-treated rats (daily treatment for 10 days in
      order to induce cardiac hypertrophy and necrotic foci) with respect to control
      ones. Comparison of myocardial localizations by quantitative autoradiography of
      the uptake of 201Tl and 14C-IMPPA with that of triphenyltetrazolium chloride
      (TTC) staining enabled comparative evaluation of nutritional blood flow,
      localization and uptake of 14C-IMPPA and necrotic foci size. Distributions of 14C
      IMPPA and 201Tl in control rats' hearts were homogeneous, like TTC staining. In
      infarcted hearts, areas of decreased 14C-IMPPA uptake were nearly the same (100%
      +/- 5%) as those unstained by TTC. These areas were larger than those showing a
      decrease in thallium uptake (about 70% +/- 5% of the total scar size). Therefore,
      IMPPA seems to be a more accurate and sensitive indicator of necrosis
      localization compared with thallium. It may be a useful agent for assessment of
      myocardial viability by single photon emission tomography (SPET) imaging.

PMID- 1752260
TI  - Ventricular function during the acute rejection of heterotopic transplanted
      heart: gated blood-pool studies.
AB  - Twenty patients who had undergone a heterotopic heart transplant were studied
      prospectively to determine the relationship between rejection and ventricular
      dysfunction assessed from gated blood-pool studies. A fully automated method for
      detecting ventricular edges was implemented; its success rate for the grafted
      left and right ventricles was 94% and 77%, respectively. The parameters, peak
      ejection and filling rates, were calculated pixel per pixel using a two-harmonic
      Fourier algorithm and then averaged over the ventricular region of interest. Peak
      filling and ejection rates were closely related with the severity of the
      rejection, while the left ventricular ejection fraction was not. Peak filling
      rates of both ventricles were the indices closely related to the presence of
      moderate rejection. Despite the low number of patients, these data suggested that
      gated blood-pool-derived indices of ventricular function are associated with
      ventricular dysfunction resulting from myocarditis rejection. Radionuclide
      ventriculography provides parametric data which are accurate and reliable for the
      diagnosis of rejection.

PMID- 1752261
TI  - Measurement of blood flow from first-pass radionuclide angiography: influence of
      bolus volume.
AB  - Fractionation of cardiac output on first-pass radionuclide angiography is a
      recently described technique for measuring blood flow. In order to determine the
      influence of bolus volume, splenic blood flow (SBF) and renal blood flow (RBF)
      were measured from widely differing bolus volumes given in sequence over a period
      of a few minutes in patients undergoing routine bone scintigraphy with technetium
      99m methylene diphosphonate. A bolus volume of 0.5 ml, followed by 20 ml of
      rapidly delivered saline "chaser", was regarded as a "gold standard" bolus. A 50
      ml bolus, but not a 20 ml bolus, resulted in a significant underestimation of
      both SBF and RBF. Thus, using a left ventricular region of interest to generate
      an arterial first-pass time-activity curve, RBF from a 50 ml bolus was 58% (SEM
      4%) that given by a 0.5 ml bolus, while RBF for a 20 ml bolus was 98% (8%).
      Corresponding values for SBF were 52% (10%) and 102% (12%). A quality control
      adjustment did not correct the underestimation given by the 50 ml bolus. Bolus
      volumes greater than 20 ml give unreliable estimates of organ blood flow by this
      technique.

PMID- 1752262
TI  - Clinical role of indium-111 antimyosin imaging.
AB  - Myocyte necrosis occurs in ischaemic, inflammatory and toxic heart diseases and
      can be detected by indium-111 antimyosin imaging. This allows a non-invasive
      evaluation of the site, extent and quantitation of the severity of myocardial
      necrosis. Simultaneous imaging of perfusion in patients with myocardial
      infarction allows the differentiation of necrosed and perfused areas and the
      varying degrees of mismatch and overlap, which has prognostic significance. 111In
      antimyosin imaging is useful in the assessment of patients with unstable angina
      and in those for whom the diagnosis of infarction or unstable angina is not
      clear. In suspected myocarditis, a positive scan indicates the necessity for
      endomyocardial biopsy to confirm inflammation, whereas a negative scan makes the
      diagnosis of myocarditis unlikely. Antimyosin imaging is not useful as a marker
      of rejection in the 1 year post-transplant, but uptake after this period is
      associated with an increased rejection rate and is therefore an important tool in
      planning management strategies. Most patients on anthracycline treatment have
      demonstrable uptake, which is related to the cumulative dose and to the ejection
      fraction. Its role in this situation is as yet unclear. The use of new ligands
      and radioisotopes (99mTc) is likely to allow earlier imaging and produce improved
      quality.

PMID- 1752263
TI  - Positive gallium-67 citrate scintigraphy in Wiskott-Aldrich syndrome with
      malignant lymphoma.
AB  - This case describes the first detection of solid lymphoma lesions by gallium-67
      scintigraphy in a 12-year-old patient with Wiskott-Aldrich syndrome. Gallium 67
      uptake was found in multiple sites in the patient who had developed an
      undifferentiated small, non-cleaved cell lymphoma. Response to chemotherapeutic
      treatment is correlated with findings on the gallium scintigraphy follow-up.

PMID- 1752264
TI  - Effect of implanted epidural stimulator on lower urinary tract function in spinal
      cord-injured patients.
AB  - A spinal cord stimulator was implanted in the epidural space in 33 spinal-cord
      injured patients for the treatment of severe extremity spasticity. We
      prospectively evaluated the effect of the stimulator on the lower urinary tract
      in these patients. Urodynamic evaluation was performed preoperatively, and in 23
      patients 3 months to 1 year after implantation. Postoperative changes in the
      lower urinary tract function were noted in 6 patients. One patient converted from
      detrusor areflexia to detrusor hyperreflexia, and 1 patient converted from
      detrusor hyperreflexia to detrusor areflexia. Four patients demonstrated changes
      in the duration of detrusor contraction and external sphincter dyssynergia. In 2
      of these 4 patients, the changes in the duration of detrusor contraction and
      external sphincter dyssynergia were related to the activation and deactivation of
      the stimulator. Urodynamic parameters did not change significantly following
      implantation in the remaining 17 patients. We conclude that epidural stimulator
      implanted for the treatment of spasticity may alter the lower urinary tract
      function. Patients with postoperative changes in the lower tract function should
      be evaluated with the stimulator activated and deactivated.

PMID- 1752265
TI  - Modified surgical technique to correct congenital and acquired penile curvature.
AB  - We treated 37 patients with severe congenital or acquired penile curvature with a
      modified Essed-Schroeder corporoplasty without excision of the tunica albuginea.
      After penile straightening, 34 of the 37 patients (91.9%) were able to resume
      normal coitus and 29 (78.4%) had excellent results, cosmetic and sexual.
      Postoperative progression of Peyronie's disease and shortening of the erect penis
      were rare. In 4 patients, partial necrosis of penile shaft skin or of the prepuce
      complicated the postoperative course, but there were no long-term sequelae in any
      case. In patients with concomitant preoperative erectile dysfunction, the
      dysfunction did not improve after corporoplasty; such patients should be treated
      primarily with a penile implant. We recommend the modified Essed-Schroeder
      corporoplasty as a safe and simple method to correct penile curvature.

PMID- 1752266
TI  - Localized amyloidosis of the urinary bladder.
AB  - Localized amyloidosis of the urinary bladder is a rare condition. Five patients,
      1 with localized secondary amyloidosis, are described. The symptoms, macroscopic
      hematuria and tumor-like appearance in cystoscopy, may mimic bladder cancer.
      Diagnosis is based on histopathological examinations with Congo red staining. In
      most instances, the treatment of choice is transurethral resection and
      electrocoagulation. Because of the risk of recurrences, a close follow-up is
      recommended.

PMID- 1752267
TI  - Efficacy and safety of clean intermittent catheterization in adults.
AB  - A prospective study was carried out on the efficacy and safety of clean
      intermittent catheterization (CIC). The series included 41 adults (15 females, 26
      males), the mean follow-up time being 40 months. Most patients were suffering
      from neurogenic bladder disorders. All of them used a self-lubricating
      hydrophilic catheter. Thirty-one patients (76%) continued to undergo CIC, but 9
      discontinued. Thirty patients (73%) experienced bacteriuria during the procedure.
      Three males had epididymitis. Contrary to many earlier reports, urinary tract
      infections seem to increase after CIC, raising the question of whether
      prophylactic antibiotic therapy should be used more often in these cases. There
      were no urethral complications suggesting that the self-lubricating hydrophilic
      catheters may be less traumatic than those used previously.

PMID- 1752268
TI  - ESWL as the treatment for lithiasis in horseshoe kidney.
AB  - Thirteen patients with lithiasis and horseshoe kidney were evaluated (4 cases
      with bilateral stones). Fifteen kidney units were treated with extracorporeal
      shock wave lithotripsy (ESWL), and in 2 cases, percutaneous nephrolithotomy (PCN)
      was used. The excellent results achieved with ESWL (80%) and the low incidence of
      complications (2 cases of nephritic colics and 1 case of acute pyelonephritis),
      lead us to propose ESWL as the therapy of choice for lithiasis in patients with
      horseshoe kidneys. PCN alone or in association with ESWL would be used in cases
      with large lithiasic masses. Conventional surgery would only be indicated in
      those cases which due to their high degree of complexity or difficult
      endourological access prevent the use of the above-mentioned techniques.

PMID- 1752269
TI  - Agenesis of seminal vesicles in infertile males: ultrasonic diagnosis.
AB  - We present the incidence of seminal vesicle agenesis and its association with
      deferens ductus agenesis in 141 males presenting with infertility. Transrectal
      ultrasonography was performed in every patient. Ten presented seminal vesicle
      agenesis (8 unilateral and 2 bilateral). Three had absence of the vas deferens on
      physical examination (3 of 7 with unilateral seminal vesicle agenesis and 1 of 2
      with bilateral). Computed tomography confirmed the ultrasound findings. We
      emphasize the importance of the anomalies as a cause of infertility and the
      association with other genitourinary anomalies. Moreover, we state the necessity
      of transrectal ultrasound in the diagnosis.

PMID- 1752270
TI  - Vesical tumors in patients under 25 years of age.
AB  - Behavior of transitional cell carcinoma of the bladder during the third decade of
      life remains a controversial subject. During the period 1980-1988, we treated 7
      patients (4 male and 3 female), 25 years of age or less (mean age 19.3, range 14
      25), with transitional cell carcinoma of the bladder. Until now, all patients are
      alive and without disease during 12-50 months after surgery. In 6 of the 7
      patients, endoscopic resection was the choice treatment for superficial stage
      A/O. The seventh patient underwent a partial cystectomy for a B1 Jewet stage cell
      carcinoma. We conclude that transitional cell carcinoma of the bladder in
      patients under 25 years of age has a less aggressive biological behavior.
      Therefore, ultrasonographic examinations and serial urine cytology represent the
      elective test for follow-up. Cystoscopy would only be performed in doubtful
      cases.

PMID- 1752271
TI  - Recurrence of bladder tumors following surgery for transitional cell carcinoma of
      the upper urinary tract.
AB  - A retrospective analysis of 53 patients with an upper urinary tract (UUT)
      transitional cell carcinoma, which was treated surgically, was performed in
      relation to the development of a subsequent bladder tumor. In 19 of the 53
      patients (35.8%) bladder tumors developed following surgery of a UUT tumor. The
      simultaneous occurrence of a bladder tumor and more than two tumors in the UUT
      had a significant influence on the rate of bladder tumor recurrence. On the other
      hand, location, mode of growth, grade, stage and vascular invasion of the UUT
      tumor, and history of bladder tumors did not seem to be related to the frequency
      of subsequent bladder tumors. These findings suggest that the diversity of UUT
      tumors at the time of diagnosis is an important factor in bladder tumor
      recurrence. Therefore, clinical and pathological examinations should be carefully
      performed in patients with UUT tumors.

PMID- 1752272
TI  - Early diagnosis and treatment of spinal dysraphism to prevent urinary
      incontinence.
AB  - Spinal dysraphism represents a very rare congenital anomaly of the spinal cord
      and cauda equina, often associated with cutaneous sacral lesions. This condition
      results in distorsion of neural tissue, possibly leading to vesical dysfunction
      and urinary incontinence. A series of 12 children with spinal dysraphism (4
      lipomeningoceles with tethered cord, 3 tight filum terminale, 2 dermal sinuses, 2
      arachnoid cysts, 1 anterior meningocele) observed during the last 6 years is
      presented. The patients are divided into two groups: group A includes 5 infants
      (age range 4 months-2 years) and group B 7 older children (4-12 years). All 7
      patients of group B were referred for urinary incontinence as their chief
      complaint; only 1 had evidence of a skin lesion while 3 had a club foot. In group
      A, 4 had skin lesions (2 asymptomatic and 2 dermal sinuses referred after several
      episodes of meningitis) and the 5th child had a club foot. The diagnosis was made
      by myelo-CT scan in the earlier 4 and by magnetic resonance imaging in the more
      recent 8 cases. All 12 children were operated. In group B, the patients' urinary
      incontinence persisted but did not worsen (3 were stable and 4 had slightly
      improved); in group A, 2 were dry (follow-up greater than 2 years), 1 could not
      be accurately evaluated because he was less than 2 years of age, and the 2 who
      suffered from meningitis were incontinent. Early diagnosis and neurosurgical
      treatment of spinal dysraphism may prevent urinary incontinence. Accurate
      urodynamic, neurophysiologic, and neuroradiologic evaluation of children with
      severe voiding anomalies or club foot is recommended even if no lumbosacral
      cutaneous lesions are present.

PMID- 1752273
TI  - Pericavernous prosthetic band for erectile dysfunction in venogenic impotence. A
      new surgical technique.
AB  - A series of 35 patients who were treated surgically by pericavernoplasty using a
      prosthetic band is presented. At the 1-year follow-up visit, 57% still had
      improved erectile capability. At the present time, it is difficult to determine
      whether or not surgical treatment will result in failure. However, according to
      recent histological studies, prognostic insight in the future might be provided
      through the analysis of erectile tissue, but for the present moderation must be
      used in deciding upon surgical treatment since there is a lack of precise
      physiopathologic understanding of erectile dysfunction.

PMID- 1752274
TI  - Stone fragility--measurement of stone mineral content by dual photon
      absorptiometry.
AB  - We measured the mineral content of urinary tract stones by dual photon
      absorptiometry, which is widely used for the analysis of bone mineral content,
      and compared the values of the stones by dual photon absorptiometry (DPA values)
      with the results of an in vitro fracture study as well as those of an in vivo
      extracorporeal shock wave lithotripsy treatment study. The results of a
      preliminary experiment showed that the DPA values of 20 urinary tract stones
      reflected actual stone mineral content. As a result of the in vitro fracture
      study, the DPA value calculated by volume of a struvite stone, which was the most
      easily disintegrated, was the lowest (0.53 g/cm3). The DPA values of calcium
      oxalate monohydrate and apatite stones, which poorly disintegrated, were the
      highest (0.98, 1.01 g/cm3). The DPA value of calcium oxalate dihydrate, which
      moderately disintegrated, was 0.86 g/cm3. By the in vivo extracorporeal shock
      wave lithotripsy treatment study, the total DPA values of stones measured before
      extracorporeal shock wave lithotripsy treatment in 12 patients were 0.73 +/- 0.34
      g in successful cases and 1.92 +/- 0.43 g in unsuccessful cases with a
      significant difference between the two (p less than 0.05). These results showed
      that the measurement of stone mineral content by dual photon absorptiometry was
      useful in predicting the fragility of stones against shock waves before
      performing extracorporeal shock wave lithotripsy treatment for patients with
      urinary tract stones.

PMID- 1752275
TI  - Anatomy of the venous drainage of the human testis: testicular vein cast,
      microdissection and radiographic demonstration. A new anatomical concept.
AB  - The venous drainage of the testis was identified and described in an autopsy,
      radiographic and operative series of 30, 28 and 7 adult males, respectively.
      Testicular vein cast--right and left--was prepared in autopsy specimens to
      identify the course, tributaries and communications of the testicular vein.
      Intraoperative spermatic venography was done in 17 men with and in 11 men without
      varicocele. The retrograde spermatic venography showed the precise anatomy of the
      pampiniform plexus. Antegrade spermatic venography was done to identify the
      valves. During cystectomy in 7 adult men, the whole tree of the spermatic vein
      was taken and microdissected. Our findings show that the venous drainage of the
      testis cannot be looked upon as it is in the standard anatomy; on the contrary,
      it deviates from the description in the text. We demonstrated that the venous
      drainage of the testis is via the pampiniform plexus, which is primarily drained
      by the testicular and external pudendal veins. The testicular vein--midway
      between the internal inguinal ring and the lower pole of the kidney--divides into
      the medial and lateral branch to form a delta. The medial branch communicates
      with the ureteral and contralateral veins; there, it terminates in the left renal
      vein or inferior vena cava on the right side. The lateral branch communicates
      with colonic and renal capsular veins and terminates in the perinephric space.
      There is no cross-communication between the left and right testicular venous
      systems in the scrotal, retropubic or pelvic areas. The only cross-communication
      is in the abdomen, and is seen in only 50% of men. The testicular vein has no
      valves.

PMID- 1752276
TI  - Angiosarcoma of the bladder: a case report with regard to histologic and
      immunohistochemical findings.
AB  - Bladder angiosarcoma is an extremely rare neoplasia whose aggressive biological
      behavior follows that of other angiosarcomas. The second case of primary
      angiosarcoma of the bladder is reported pointing out the immunohistochemical
      characteristics of these neoplasias. Using immunoperoxidase staining techniques,
      Ulex lectin has proved to be a more sensitive marker for endothelial cells than
      factor VIII-related antigen, and it should be used as an additional marker for
      endothelial cell-derived tumors.

PMID- 1752277
TI  - Bilateral seminal vesicle abscesses.
AB  - We report a case of a seminal vesicle abscess successfully treated by
      percutaneous perineal drainage. Magnetic resonance imaging was helpful in
      clarifying the differential diagnosis. Seminal vesicle abscess is a rare
      pathological entity; since 1958, only 7 cases have been reported in the
      literature. Because of its nonspecific clinical symptoms, clinical diagnosis is
      often ambiguous. An overview of the literature, as well as a discussion of the
      diagnosis and the treatment of the seminal vesicle abscess will be presented.

PMID- 1752278
TI  - Renal cell carcinoma: late recurrence in 2 cases.
AB  - We present 2 patients with late recurrence 16 and 11 years after nephrectomy for
      renal cell carcinoma. Metastases were solitary and their location very uncommon
      (vastus externo muscle and colon). In the reviewed series of 5,758 patients with
      renal cell carcinoma only a temporal muscle metastasis and another in the colon
      were observed but none of them was solitary.

PMID- 1752279
TI  - Treatment of carcinoma in situ of the urethra with intraurethral instillations of
      bacillus Calmette-Guerin. Case report and review of literature.
AB  - We present the case of a 60-year-old man with carcinoma in situ of the urethra
      after previous successful radiotherapy of an invasive bladder tumor.
      Intraurethral instillations with bacillus Calmette-Guerin were given. In spite of
      initial success, recurrences developed after two courses of 12 intraurethral
      instillations, and radical surgery was performed. The use of bacillus Calmette
      Guerin is reviewed with regard to the locations of superficial transitional cell
      carcinoma outside the bladder cavity.

PMID- 1752280
TI  - Methotrexate, vinblastine, adriamycin and cisplatin versus methotrexate and
      cisplatin in advanced urothelial cancer. A randomized study.
AB  - From September 1984 to December 1988, 28 consecutive patients with metastatic
      urothelial cancer entered a randomized study to compare 4 courses of modified
      methotrexate, vinblastine, adriamycin and cisplatin (M-VAC) to 4 courses of
      methotrexate followed by folinic acid rescue and cisplatin (MP). Non-responders
      or relapsing patients were to be crossed to the other therapy. Hematological
      toxicity was more frequent (85%), but less severe, in patients treated with M-VAC
      than in patients treated with MP (21%, with 1 septic death). Complete plus
      partial remissions were achieved in 10 (71.4%) of 14 patients treated with M-VAC
      and in 6 (50%) of the 12 evaluable patients treated with MP. The 20% difference
      lay only on complete remissions, which were 8.3% in the MP versus 28.5% in the M
      VAC group. At cross-over, however, only 1 of 5 patients resistant to MP responded
      to M-VAC, while 3 of 5 patients resistant to M-VAC responded to MP. It seems that
      M-VAC should be considered as the first-line therapy of choice in metastatic
      urothelial cancer, while MP, or high-dose methotrexate, could be considered for
      salvage.

PMID- 1752281
TI  - Value of bladder wash cytology in the follow-up of patients with bladder
      carcinoma receiving intravesical chemoprophylaxis with mitomycin C.
AB  - 511 bladder wash cytologic findings in 121 patients receiving intravesical
      chemoprophylaxis with mitomycin C after transurethral resection of stage pTa to
      stage pT2 bladder carcinoma were retrospectively analyzed. In 42 recurrent
      tumors, sensitivity of detection by cytology amounted to 67% in GIII tumors, 56%
      in GII tumors, and 20% in GI tumors. 16% of G0 tumors were cytologically
      positive. 33% of a total of 30 endoscopically detected recurrent GI-GIII tumors
      yielded negative results at bladder wash cytology, the findings were suspicious
      in 27%, while only 40% of all recurrences had a positive bladder wash cytology.
      Positive cytologic findings combined with normal endoscopic results were obtained
      in 24 patients. 15 of these (62%) developed recurrences after a mean interval of
      15 months (3-60 months) during or after metaphylaxis. When suspicious findings
      were included, 20 of 30 carcinomas were detected, while 7 of 12 G0 tumors were
      overgraded. Bladder wash cytology has its merits for early detection of
      recurrences, since almost two thirds of the patients with positive cytologic
      findings and negative endoscopy developed a recurrent tumor at a later date.
      Whether or not positive cytology combined with negative endoscopic results should
      lead to therapeutic consequences remains to be discussed.

PMID- 1752282
TI  - Ultrasonography of urinary tract and micturition as an alternative to radiologic
      investigations in the spinal-cord-injured patient.
AB  - Over a period of 1.5 years (July 1989-Jan. 1991), a total of 504 patients, 442 of
      them suffering from spinal cord injuries with subsequent voiding disorders, were
      investigated by ultrasonography of the genitourinary tract. Ultrasonography of
      the upper urinary tract as well as the bladder and prostate provided and accurate
      image of the pathomorphological changes which go along with this kind of
      malfunction of the lower urinary tract in this group of patients. The application
      of rectal ultrasonography using a linear array rectal transducer was able to
      provide equal or even better images of the micturition process than micturition
      cystourethrography (MCU). An adequate and accurate real time image of the
      bladderneck, the prostatic urethra and the external rhabdosphincter could be
      obtained in all instances. Combined micturition cytourethrosonography (MCUS) with
      urodynamic evaluation has also been performed, which made the observation and
      judgement of the bladder outlet as well as the position of the catheter possible
      throughout the procedure without the interference of X-rays.

PMID- 1752283
TI  - Current concepts in cholesterol gallstone pathogenesis.

PMID- 1752284
TI  - Cyclosporin-A-induced lipid peroxidation in human liver microsomes and its
      influence on cytochrome P-450.
AB  - The present in vitro study using human liver tissue was performed to investigate
      the effect of cyclosporin A on lipid peroxidation and cytochrome P-450
      concentration in isolated liver microsomes. Incubations were either carried out
      with cyclosporin A concentrations of 10, 30, 100 and 300 micrograms ml-1 for 1 h
      or for different time periods (15, 30, 60 and 90 min) with cyclosporin A 300
      micrograms ml-1. Lipid peroxidation was monitored measuring the amount of
      malondialdehyde. In additional experiments the effect of reduced and oxidized
      glutathione (1 mM) on cyclosporin-A-induced lipid peroxidation in human liver
      microsomes was studied. Cyclosporin A caused a significant dose and time
      dependent increase of the lipid peroxidation product malondialdehyde. At the
      highest cyclosporin A concentration (300 micrograms ml-1) malondialdehyde
      production increased 5-fold in comparison to corresponding control values.
      Incubations for different time periods resulted in a 5-fold net increase of
      malondialdehyde formation after 90 min. In the presence of reduced glutathione,
      cyclosporin-A-induced lipid peroxidation was significantly inhibited.
      Furthermore, cyclosporin-A-induced microsomal lipid peroxidation was accompanied
      by a significant dose-dependent decline of the microsomal cytochrome P-450
      content. At a cyclosporin A concentration of 300 micrograms ml-1, cytochrome P
      450 content was decreased to 49% in comparison to control values. In the presence
      of reduced glutathione, cyclosporin A decreased the cytochrome P-450
      concentration only to 79% (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1752285
TI  - Copper metallothionein in patients with hepatic copper overload.
AB  - We studied the Cu-MT present in the hepatic cytosol obtained from 7 patients
      suffering from conditions associated with hepatic Cu overload (Wilson's disease,
      biliary atresia, familial cholestatic cirrhosis). Since chromatographic methods
      appropriate for the isolation of Zn- and Cd-MT were unsuitable for Cu-MT, we
      developed an indirect procedure for the estimation and resolution of the latter.
      This procedure involved the preparation of apo-MT and its reconstitution to holo
      MT with Zn or Cd. Three predominant isoforms of MT were present in all specimens.
      Our results indicate that at most 36 +/- 5% of the Cu present in the 10 kDa
      fraction of cytosol is bound to MT in the liver of patients with hepatic copper
      overload.

PMID- 1752286
TI  - Relationships between local inflammation, interleukin-6 concentration and the
      acute phase protein response in arthritis patients.
AB  - Interleukin-6 (IL-6) concentrations in knee joint synovial fluids and paired
      plasma samples of arthritis patients were examined with respect to each other and
      parameters of the inflammatory response. Synovial fluid and plasma IL-6
      concentrations were significantly higher in patients with inflammatory arthritis
      than those detected in patients with osteoarthritis (P less than 0.001). The IL-6
      concentrations in synovial fluids were considerably higher than, but
      significantly correlated with (r = 0.65; P less than 0.001), those of plasma.
      Furthermore, synovial fluid IL-6 concentrations in bilaterally inflamed knees
      were significantly correlated (r = 0.79; P less than 0.001) and there was a
      significant correlation with the extent of inflammatory cell infiltrate (r =
      0.75; P less than 0.001). In unselected rheumatoid arthritis patients there was
      only a weak correlation between IL-6 and plasma C-reactive protein (CRP)
      concentration, and no correlation between IL-6 and erythrocyte sedimentation rate
      (ESR). However, both ESR and CRP concentration were highly correlated with plasma
      IL-6 concentration in patients with other inflammatory arthritides, particularly
      psoriatic and HLA B27 positive spondyloarthritis (r = 0.72-0.94; P less than
      0.005). These relationships suggest that IL-6 production in inflammed knee joints
      can be a significant determinant of acute phase protein responses in arthritis
      patients, although the situation in patients with rheumatoid arthritis is more
      complex and may be influenced by other disease-related factors.

PMID- 1752287
TI  - Alveolar macrophage chemotaxis in fire victims with smoke inhalation and burns
      injury.
AB  - In vitro migration of alveolar macrophages was studied in 24 fire victims and 19
      controls; all subjects were cigarette smokers. Unstimulated (P = 0.01) and
      stimulated migration towards casein-(P = 0.01) and zymosan-activated serum (P =
      0.002) of macrophages from smoke inhalation patients (SI) (n = 19) was increased
      when compared to control subjects (CS). Migration of alveolar macrophages from
      patients with burns without smoke inhalation (burns only, BO) was not increased.
      Patients with smoke inhalation and no burns (smoke only, SO) (n = 9) had
      increased migration when compared to controls but this was not statistically
      significant. Patients with smoke inhalation and burns (SB) (n = 10) had increased
      unstimulated migration (P = 0.01) and increased migration towards casein (P less
      than 0.005), ZAS (P less than 0.002) and F-met-leu-phe (P less than 0.05) when
      compared to controls (CS). Lavage fluid from the fire victims displayed
      chemotactic activity towards normal human neutrophils and its analysis for the
      components of the complement cascade proved positive (Clq, Clr, Factor B and C3).
      These data suggest that activation of alveolar macrophages may contribute to the
      development of pathophysiological changes in patients with smoke inhalation (SI)
      and particularly those with smoke inhalation and burns (SB).

PMID- 1752288
TI  - Platelet response to the aggregatory effect of platelet activating factor (PAF)
      ex vivo in patients with acute myocardial infarction.
AB  - Platelets from patients with acute myocardial infarction exhibit an increased
      sensitivity to the aggregatory effect of PAF, in vitro, the first 48 h after the
      onset of the symptoms. This sensitivity, expressed as PAF EC50 values, seems to
      be transient after the 2 day period. Also, a remarkable decreased sensitivity to
      the inhibitory effect of PGI2 against the aggregation induced by PAF appears to
      the platelets of those patients the first hours after the onset of the symptoms,
      and persists for at least 14 days. Treatment of patients by drugs with a known
      inhibitory effect on platelet aggregation in vivo and in vitro (aspirin,
      nifedipine, indomethacin), does not influence the increase in platelet
      sensitivity to PAF, but inhibits the secondary aggregation induced by the
      released aggregating factors from the PAF activated platelets. The increase in
      platelet sensitivity to PAF is not unique to the AMI since it is also observed in
      patients with acute bacterial pneumonia. However, we cannot support the theory
      that it is a general phenomenon of acute tissue injury since it is general
      phenomenon of acute tissue injury since it is not observed in patients with acute
      muscular injury.

PMID- 1752289
TI  - Serum neurone specific enolase (NSE) levels as an indicator of neuronal damage in
      patients with cerebral infarction.
AB  - A radioimmunoassay has been developed and used to measure serum neurone specific
      enolase (NSE) concentrations in 24 patients, following cerebral infarction. A
      significant correlation between cerebral infarct volume and maximum serum NSE
      concentration was observed (P = 0.047). Serum NSE was also assayed at times 24,
      48, 72 and 96 h post ictus. At 72 h a significant correlation existed between
      serum NSE levels and infarct volume (P = 0.012), and levels appeared to be
      approaching statistical significance at 48 h (P = 0.067). No correlation existed
      at 24 and 96 h. In addition serum concentrations of NSE were compared to clinical
      outcome as determined by the Glasgow Outcome Score. Using the Mann-Whitney U
      test, there was no significant difference in maximum NSE level between patients
      graded 1-3 on the Glasgow Outcome Score and those graded 4 and 5. However,
      further studies are required on a larger population to more completely assess
      this. NSE may prove to be a useful marker of neuronal damage in the study of
      stroke, with particular application in the assessment of treatment.

PMID- 1752290
TI  - Cholecystokinin receptor antagonist loxiglumide modulates plasma levels of gastro
      entero-pancreatic hormones in man. Feedback control of cholecystokinin and
      gastrin secretion.
AB  - The effect of the potent specific cholecystokinin (CCK) receptor antagonist
      loxiglumide on meal-stimulated plasma concentrations of CCK, gastrin, pancreatic
      polypeptide (PP), neurotensin, glucose-dependent insulinotropic polypeptide
      (GIP), insulin and C peptide was investigated in a placebo-controlled study in 10
      healthy male volunteers. Intravenous infusion of loxiglumide (10 mg kg-1 h-1)
      significantly augmented integrated incremental IR-CCK levels 7.3-fold after
      stimulation by a standard breakfast (504 +/- 54 vs 3.665 +/- 365 pmol-1 135 min
      1, P less than 0.001), as measured by a specific CCK radioimmunoassay. Basal IR
      CCK concentrations were not affected by administration of loxiglumide. Oral
      treatment with bile acids (2 g ursodeoxycholic acid plus 2 g chenodeoxycholic
      acid) together with the meal abolished this augmentation, whereas high-dose
      substitution with pancreatic enzymes (4.2 g pancreatin) reduced elevated IR-CCK
      levels by only 38%. CCK-like bioactivity, determined by a bioassay using rat
      pancreatic acini, was not detectable in all samples that contained loxiglumide at
      plasma concentrations of 100-250 micrograms ml-1. Plasma gastrin concentrations
      in response to the breakfast were elevated 3.2-fold during loxiglumide infusion
      and not influenced by substitution with bile acids or pancreatic enzymes. Meal
      stimulated integrated incremental plasma PP concentrations were significantly
      suppressed (55-65% inhibition, P less than 0.01) by loxiglumide. Infusion of the
      CCK receptor antagonist only slightly increased postprandial peak plasma glucose,
      insulin and C-peptide levels, whereas GIP and neurotensin levels were not
      significantly influenced. These findings suggest: (i) CCK secretion is under
      feedback control by intraduodenal bile acids and to a lesser extent by pancreatic
      enzymes; (ii) simultaneous extraction of CCK and loxiglumide results in
      circulating plasma CCK-like bioactivity of zero; (iii) gastrin secretion is
      feedback controlled via an indirect mechanism probably involving CCK-induced
      somatostatin secretion; (iv) release of PP is under inhibitory control of CCK;
      (v) CCK does not play a major role as insulinotropic hormone in the entero
      insular axis in humans.

PMID- 1752291
TI  - The effect of angiotensin-I converting enzyme inhibition on insulin action in
      healthy volunteers.
AB  - Acute hyperinsulinaemia, achieving insulin levels within the physiological range,
      induces sodium retention. At the same time an activation of the renin-angiotensin
      system occurs, with a rise in plasma renin activity (PRA) and angiotensin-II
      level but no change in plasma aldosterone. After administration of higher,
      pharmacological doses of insulin an increase in systolic blood pressure and heart
      rate can also be observed, while further increases in PRA and angiotensin-II are
      noted. To determine whether angiotensin-II is involved in observed insulin
      actions, we studied the renal and cardiovascular effects of three dosages of
      insulin (50 (Ins I), 300 (Ins II) and 500 (Ins III) mU kg-1 h-1) in healthy
      subjects after one week of treatment with the angiotensin-I converting enzyme
      inhibitor enalapril (10 mg twice a day), using the euglycaemic clamp technique.
      Control data were obtained from two previously conducted experiments in the same
      subjects, one with infusion of insulin and one with the insulin solvent only. The
      effect of insulin on fractional sodium excretion, blood pressure and heart rate
      was unaffected by enalapril, which precludes any involvement of the renin
      angiotensin system with regard to these aspects of insulin action. Insulin
      sensitivity increased significantly during treatment with enalapril (with
      enalapril: Ins I: 11.3 +/- 3.0, Ins II: 20.0 +/- 3.4 and Ins III: 20.6 +/- 3.9 mg
      kg-1 min-1 glucose (mean +/- SD); without enalapril: Ins I: 8.7 +/- 2.3, Ins II:
      13.7 +/- 3.0 and Ins III: 15.5 +/- 3.1 mg kg-1 min-1 glucose; P less than
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1752292
TI  - Adrenergic regulation of lipolysis in human fat cells during exercise.
AB  - The adrenergic regulation of lipolysis was studied, before and after 30 min of
      submaximal exercise, in isolated adipocytes removed from the abdominal and
      gluteal regions of healthy non-obese men and women. Noradrenaline-induced
      lipolysis was significantly enhanced in gluteal adipocytes from men but not in
      women after exercise. However, the pure beta-adrenergic responsiveness was
      equally increased in gluteal adipocytes of both sexes after exercise, as judged
      by the effect of isoprenaline. Furthermore, the alpha 2-adrenergic anti-lipolytic
      responsiveness was more apparent after exercise in females than in males thereby
      counter-balancing the increase in the beta-adrenergic effect in the gluteal
      region in the former. The increased beta-adrenergic responsiveness induced by
      exercise in gluteal adipocytes of males could be mimicked by agents acting at the
      levels of adenylate cyclase, coupling proteins, phosphodiesterase, and protein
      kinase and seems to be due to an adaptive enhancement at the hormone-sensitive
      lipase level. There was no change in the stoichiometric properties of beta
      adrenoceptors of gluteal adipocytes after exercise. Abdominal adipocytes of both
      sexes were four to five times more responsive to noradrenaline than gluteal ones.
      However, exercise induced no further enhancement of the catecholamine-stimulated
      lipolysis rate in fat cells from this site. Thus, the influence of exercise on
      catecholamine-stimulated lipolysis is regional and sex dependent. Men, but not
      women, have a greater ability to adapt lipolysis to increasing energy demands
      during exercise that are due to an acute increase in the effectiveness of the
      hormone-sensitive lipase complex.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1752293
TI  - Response of sympathetic nervous system activity to exercise in patients with
      congestive heart failure.
AB  - To investigate the serial sympathetic nervous system response to exercise, plasma
      norepinephrine (NE) and epinephrine (E) concentrations were measured at rest,
      during each stage of treadmill exercise, and immediately and 5 minutes after
      exercise in 68 congestive heart failure (CHF) patients (NYHA functional class I
      24, II 25, III 19) and 30 normal subjects. Circulatory responses of NYHA class II
      patients increased at early stages of exercise. Systolic blood pressure and
      double product at peak exercise were significantly lower in NYHA class III
      patients. Plasma NE response of NYHA class I patients was similar to that of
      normal subjects. However, plasma NE at rest, and during and after exercise were
      significantly higher in NYHA classes II and III patients than in normal subjects
      and NYHA class I patients (peak NE (pg ml-1); Normals: 547 +/- 37, I: 535 +/- 53,
      II: 867 +/- 87, III: 1033 +/- 157). There was no significant difference in plasma
      E levels among the four groups. NE response to exercise was augmented according
      to the severity of heart failure, which suggested compensatory activation of
      sympathetic nervous system activity. Circulatory responses were reduced in NYHA
      class III patients despite the exaggerated compensatory activation of the
      sympathetic nervous system. Blunted circulatory responses to increased NE
      concentration in NYHA class III patients might relate to a decreased cardiac
      responsiveness to sympathetic activity in severe CHF patients.

PMID- 1752294
TI  - Liquid crystal thermography as a screening test for deep vein thrombosis in
      patients with cerebral infarction.
AB  - Pulmonary embolism secondary to deep vein thrombosis is a frequent cause of death
      in stroke patients. In a multicentre study of deep vein thrombosis prophylaxis,
      112 patients with cerebral infarction and leg paresis were given aspirin 300 mg
      three times a day (t.d.s.) alone or with dipyridamole 100 mg t.d.s. To screen for
      deep vein thrombosis liquid crystal thermography of the legs was performed daily
      for 15 days on all patients. Those patients with positive thermography underwent
      immediate X-ray venography of the appropriate limb as the definitive
      investigation for venous thrombosis. Twenty-two patients had positive
      thermograms, of whom 16 had confirmed deep vein thrombosis as demonstrated by X
      ray venography. Only 8 of the 22 had clinical signs of deep vein thrombosis and 2
      of those had a negative venogram. Of the 14 patients with positive thermography
      but negative clinical signs 10 had positive venograms. Difference in the
      incidence of deep vein thrombosis in the two treatment groups was not
      demonstrated. It is concluded that occult deep venous thrombosis is common after
      ischaemic stroke and it can occur without clinical signs. Liquid crystal
      thermography is a simple, rapid and cheap screening test that will allow the
      detection of clinically unrecognized thrombosis.

PMID- 1752295
TI  - In vitro inhibition of Helicobacter pylori urease: biochemical and
      ultrastructural analysis.
AB  - Inhibition of H. pylori urease was studied by means of electron-microscopy and
      electrophoretic methods using different urease inhibitors, such as
      acetohydroxamic-acid (AHA), L-ascorbic acid (AsA), copper ions, a combination of
      L-ascorbic acid with copper ions and UV light. AHA in two different
      concentrations and AsA at a concentration of 0.1 mg ml-1 showed incomplete
      inhibition of H. pylori urease activity in our electrophoretic experiments. Only
      membrane-bound activity was inhibited with AHA but not the activity localized
      within the cytoplasma as demonstrated by electron-microscopy. AsA at a
      concentration of 0.5 mg ml-1 and the combination of copper ions (1 microgram ml
      1) with AsA completely inhibited the urease activity as demonstrated by electron
      microscopy and electrophoretic experiments. Cu2+ ions in high concentrations (100
      micrograms ml-1) and UV light exposure for more than 4 h induced a complete
      disintegration of H. pylori. Electrophoresis showed no active protein after UV
      light exposure of 2 h. Different urease inhibitors tested in this study showed
      dose-dependent inhibitory effects on H. pylori urease in vitro.

PMID- 1752296
TI  - Statistical methods applied in microbiology and epidemiology.

PMID- 1752297
TI  - Bacteriological quality of potable water sources supplying Morogoro municipality
      and its outskirts: a case study in Tanzania.
AB  - Bacteriological quality of potable water supplying Morogoro municipality and its
      outskirts (population 135,000 people) was assessed by the determination of the
      most probable number (MPN) of faecal coliforms, Escherichia coli, faecal
      streptococci and Clostridium perfringens for a period of 6 months. River water
      and chlorinated pipeborne water were found contaminated with microorganisms in
      the order of 3.8 x 10(1) to 4.95 x 10(3); 3.2 x 10(1) to 4.5 x 10(3); 10(1) to
      6.4 x 10(1) and 1.2 x 10(1) to 2.5 x 10(2)/100 ml of water respectively. Injured
      coliforms in treated water averaged 87%. Pollution of river water by organic
      matter was much above acceptable standard. These findings indicate that there is
      a need for further treatment of water before consumption in order to avoid
      potential health hazards.

PMID- 1752298
TI  - An outbreak of waterborne cryptosporidiosis in Swindon and Oxfordshire.
AB  - An outbreak of cryptosporidiosis resulted in 516 cases in Wiltshire and
      Oxfordshire. The outbreak caused widespread interest and led to an official
      inquiry. The majority of cases were in children; 8% of cases were admitted to
      hospital and the median duration of illness was 3 weeks. The geographical
      distribution of cases matched the distribution of water supplies from three
      treatment works and cryptosporidium oocysts were found at these works and in the
      treated water. Attack rates in electoral wards supplied by the three treatment
      works were significantly higher than in other wards. The cause of the outbreak
      appeared to be the failure of normal treatment to remove oocysts. Measures at the
      treatment works reduced the number of oocysts detected in treated water, after
      which the outbreak came to an end. The conclusion of the investigations was that
      cryptosporidiosis is a risk of conventionally treated public water supplies.

PMID- 1752299
TI  - An outbreak of cryptosporidiosis associated with a swimming pool.
AB  - In August 1988 an increase was noted in the number of cases of cryptosporidiosis
      identified by the microbiology laboratory at Doncaster Royal Infirmary. By 31
      October, 67 cases had been reported. Preliminary investigations implicated the
      use of one of two swimming pools at a local sports centre and oocysts were
      identified in the pool water. Inspection of the pool revealed significant
      plumbing defects which had allowed ingress of sewage from the main sewer into the
      circulating pool water. Epidemiological investigation confirmed an association
      between head immersion and illness. The pools were closed when oocysts were
      identified in the water and extensive cleaning and repair work was undertaken.
      The pool water was retested for cryptosporidial oocysts and found to be negative
      before the pool reopened.

PMID- 1752300
TI  - Cryptosporidiosis in the Isle of Thanet; an outbreak associated with local
      drinking water.
AB  - An outbreak of cryptosporidiosis occurred in the Isle of Thanet during December
      1990 and January 1991. A total of 47 cases ranging in age from 2 months to 85
      years were identified in residents from the Margate, Broadstairs and Ramsgate
      areas, with dates of onset of illness from 3 December to 14 January. A case
      control study demonstrated a strong statistical association between illness and
      the consumption of unboiled tap water from a particular source, with evidence of
      a dose-response relationship. Although no cryptosporidial oocysts were identified
      in samples of untreated or treated water taken during the investigation, the
      results were consistent with the view that the source of infection was treated
      river water which was used to supplement borehole water.

PMID- 1752301
TI  - The epidemiology of Salmonella in calves: the role of markets and vehicles.
AB  - Environmental contamination has been shown to be an important aspect of the
      epidemiology of salmonellosis in calves. Markets and transport vehicles are
      important links in the calf marketing chain and these were investigated to
      determine the level of salmonella contamination. Salmonellas were isolated from 7
      of the 14 markets surveyed, with 31 of 838 samples (3.7%) being positive. Nine
      different salmonella serotypes, of which the commonest was Salmonella
      typhimurium, were isolated. Four different phage types of S. typhimurium were
      detected, the commonest being DT204C. Salmonellas were isolated from 22 of the
      107 vehicles (20.6%) examined before washing and from 4 of the 62 vehicles (6.5%)
      examined after cleaning. Twelve different salmonella serotypes were isolated, of
      which the most frequent was S. typhimurium. The commonest of the six different S.
      typhimurium phage types was DT204C. These results indicate that improved cleaning
      and disinfection routines both for vehicles and markets are necessary to control
      salmonellosis in calves.

PMID- 1752302
TI  - Evaluating the sensitivity and predictive value of tests of recent infection:
      toxoplasmosis in pregnancy.
AB  - The diagnosis of maternal infection in early pregnancy depends on tests which are
      sensitive to recent infection, such as specific IgM. Two types of test are
      considered: those where the response persists for a period following infection
      and then declines, such as IgM, and those whose response increases with time
      since infection, such as IgG-avidity. However, individuals vary in their response
      to infection, and it may not always be possible to determine whether an infection
      occurred during pregnancy or before it. Mathematical methods are developed to
      evaluate the performance of these tests, and are applied to the diagnosis of
      toxoplasmosis in pregnancy. It is shown that, based on existing information,
      tests of recent infection are unlikely to be both sensitive and predictive. More
      data on these tests are required, before they can be reliably used to determine
      whether infection has occurred during pregnancy or before it.

PMID- 1752303
TI  - The population structure and transmission of Escherichia coli in an isolated
      human community; studies on an Antarctic base.
AB  - The population structure and transmission of Escherichia coli in a small group of
      individuals isolated for 26 weeks on an Antarctic base were studied by multilocus
      electrophoresis of eight enzymes and plasmid analysis. Two hundred and sixty-nine
      strains were isolated. They were grouped into 60 allozyme types (ETs). Half of
      these ETs were only isolated once; others were repeatedly isolated from single
      subjects. Eleven were found in more than one subject and the pattern of the
      occurrence of some of them was considered to provide evidence of their spread
      from subject to subject.

PMID- 1752304
TI  - Genotypic and phenotypic analysis of Streptococcus uberis isolated from bovine
      mammary secretions.
AB  - Genotypic and phenotypic analysis of 42 strains of Streptococcus uberis isolated
      from mammary secretions of 17 cows collected at different periods of the
      lactation cycle and from episodes of clinical mastitis were performed. Seventeen
      restriction endonuclease fingerprint (REF) patterns and 12 bacteriocin-like
      inhibitory substance (BLIS) fingerprints were observed. REF identified and
      differentiated closely related strains of S. uberis isolated from mammary
      secretions collected from the same cow at different periods of the lactation
      cycle and from episodes of clinical mastitis. BLIS fingerprinting of S. uberis
      complemented REF results. REF and BLIS fingerprinting provided evidence
      concerning persistence of infection in the same quarter or different quarters of
      the mammary gland over different periods of the lactation cycle, and occurrence
      of infection with similar and dissimilar strains of S. uberis. Biochemical
      profiles could not identify closely related strains nor did they complement REF
      results. Antibiotic resistance patterns alone were of little value in
      differentiating closely related strains, but were identical with isolates having
      same REF pattern. None of the S. uberis strains was found to carry plasmids. REF
      and BLIS fingerprinting can be utilized effectively to differentiate closely
      related and unrelated strains of S. uberis isolated from bovine mammary
      secretions.

PMID- 1752305
TI  - Phage typing of Staphylococcus saprophyticus.
AB  - This study included 502 staphylococcus strains; Staphylococcus saprophyticus (297
      strains) S. cohnii (47), S. xylosus (10), S. epidermidis (67) and S. aureus (81).
      Mitomycin C induction was performed on 100 isolates of S. saprophyticus and all
      induced strains were reacted with each other. Twenty-six strains proved to be
      lysogenic. Phages were propagated and titrated. With 12 of the phages there were
      three frequent associations, named lytic groups A, B and C, which included 75% of
      all typable strains. Typability of the system was 45% and reproducibility was
      between 94.2% and 100%. Phages did not lyse S. aureus and S. epidermidis strains,
      but they lysed S. saprophyticus and only rare strains of other novobiocin
      resistant species. Effective S. saprophyticus typing serves ecological purposes
      and tracing the origin of urinary strains from the skin or mucous membranes.
      Phage typing in association with plasmid profiling previously described, are
      anticipated as complementary methods with strong discriminatory power for
      differentiating among S. saprophyticus strains.

PMID- 1752306
TI  - rDNA fingerprinting as a tool in epidemiological analysis of Salmonella typhi
      infections.
AB  - Characterization of 169 strains of Salmonella typhi of phage types C1, C4, D1 and
      D9 isolated in 1975-88 was carried out by rDNA gene restriction pattern analysis.
      Twenty-four isolates had been recovered during four large waterbone outbreaks in
      the last 20 years in Sicily; 145 strains, isolated from apparently sporadic cases
      of infection in Southern Italy in the same period of time, were also examined.
      Application of rRNA-DNA hybridization technique after digestion of chromosomal
      DNA with Cla I showed the identity of patterns of the epidemic strains of phage
      types C1 and D1, confirming attribution of the outbreaks to single bacterial
      clones. Patterns of the two available strains of lysotype D9 were slightly
      different, whilst the 12 epidemic strains of phage type C4 could be assigned to
      two distinct patterns scarcely related to each other and, consequently, to two
      different clones. A considerable heterogeneity was detected among all apparently
      sporadic isolates of the four phage types under study. This fingerprinting method
      appears a reliable tool to complement phage typing in characterizing isolates of
      S. typhi. In particular, epidemiological features of spread of this salmonella
      serovar in areas, where simultaneous circulation of indigenous and imported
      strains occurs, can be elucidated.

PMID- 1752307
TI  - Changing trends of gonococcal infection in homosexual men in Edinburgh.
AB  - In an attempt to explain the recent resurgence of homosexually-acquired
      gonorrhoea in the Lothian region of Scotland the number of infections and pattern
      of infection (urethral, rectal and pharyngeal) of all gonococcal isolates from
      homosexual men attending the Department of Genitourinary Medicine at Edinburgh
      Royal Infirmary between 1985 and 1990 were analysed. Serovar typing data were
      available from infections acquired between January 1986 and December 1990. A
      correlation between one serovar, Bacejk/Brpyust, and the overall pattern of
      gonorrhoea was observed. The number of infections caused by minor serovars also
      correlated with rates of gonococcal infection. The number of minor serovars
      isolated, which may represent strains from other geographical locations, is
      related to the total incidence of gonorrhoea. It is possible that the incidence
      of Bacejk/Brpyust may be determined by the size of the infected pool of
      gonorrhoea. The most likely explanation for the recent increase in gonorrhoea is
      a change in sexual behaviour and/or an influx of strains from other geographical
      areas.

PMID- 1752308
TI  - Control of endemic nosocomial legionnaires' disease by using sterile potable
      water for high risk patients.
AB  - In a setting where potable water is contaminated with Legionella pneumophila
      serogroup 1, we performed two case control studies. The first case control study
      consisted of 17 cases of nosocomial Legionnaires' disease (LD) and 33 control
      (the patients who were admitted to the ward where the case was admitted
      immediately before and after the case) subjects. Cases had a higher mortality
      rate 65% vs 12% (P less than 0.004); were more likely to have received assisted
      ventilation (P less than 0.00001); to have nasogastric tubes (P less than 0.0004)
      and to be receiving corticosteroids or other immunosuppressive therapy (P less
      than 0.0001). Based on the results of this study, sterile water was used to flush
      nasogastric tubes and to dilute nasogastric feeds. Only 3 cases of nosocomial LD
      occurred during the next year compared with 12 the previous year (P less than
      0.0001). Nine cases subsequently occurred and formed the basis for the second
      case-control study. Eighteen control subjects were those patients admitted to the
      same unit where the case developed LD, immediately before and after the case. The
      mortality rate for the cases was 89% vs 6% for controls (P less than 0.00003).
      The only other significant difference was that cases were more likely to be
      receiving corticosteroids or other immunosuppressive therapy 89% vs 39% (less
      than 0.01). We hypothesized that microaspiration of contaminated potable water by
      immunocompromised patients was a risk factor for nosocomial Legionnaires'
      disease. From 17 March 1989 onwards such patients were given only sterile potable
      water. Only two cases of nosocomial LD occurred from June 1989 to September 1990
      and both occurred on units where the sterile water policy was not in effect. We
      conclude that aspiration of contaminated potable water is a possible route for
      acquisition of nosocomial LD in our hospital and that provision of sterile
      potable water to high risk patients (those who are receiving corticosteroids or
      other immunosuppressive drugs; organ transplant recipients or hospitalized in an
      intensive care unit) should be mandatory.

PMID- 1752309
TI  - Differentiation of strains of Helicobacter pylori by numerical analysis of 1-D
      SDS-PAGE protein patterns: evidence for post-treatment recrudescence.
AB  - Twenty-three pre- and post-treatment isolates of Helicobacter pylori from the
      antral mucosa of eight patients with dyspepsia and gastritis were compared using
      1-D SDS PAGE of proteins. The protein patterns were highly reproducible and were
      used as the basis for two numerical analyses. The first, based on the total
      protein patterns, showed that a number of the strains did not cluster with their
      respective patient set. This was thought to be due to differences in both
      mobility and intensity of proteins in the major band region. The second analysis,
      based on partial patterns, excluding the major band region (51-68 kDa), divided
      the clinical isolates into clearly defined groups corresponding to the patient
      sets. Although there was a degree of heterogeneity with respect to protein
      pattern between the pre- and post-treatment isolates of some patients, there was
      nonetheless clear evidence that each patient was harbouring strains of only a
      single type. These results suggested that patients were not being reinfected with
      a different strain but that there was recrudescence of the pre-treatment strain.
      Protein 'fingerprints' provided a precise and reproducible means of strain
      differentiation, and revealed that in each patient the same strain persisted
      after drug therapy even though there was marked patient-to-patient strain
      variation.

PMID- 1752310
TI  - Study of colonization resistance for Enterobacteriaceae in man by experimental
      contamination and biotyping as well as the possible role of antibodies in the
      clearance of these bacteria from the intestines.
AB  - The colonization resistance (CR) of the digestive tract was determined in 10
      healthy volunteers by oral contamination with a neomycin resistant Escherichia
      coli (NR-E. coli) strain and measurement of the faecal concentration of this
      strain during 14 days after the contamination. This 'gold standard' was compared
      with another parameter of CR; the determination of the mean number of different
      biotypes of Enterobacteriaceae isolated from four faecal samples per volunteer.
      Both measures are significantly correlated (P less than 0.01). The NR-E. coli
      strain could be cultured from faecal samples of 4/10 volunteers as long as 300
      days after contamination. Serum antibody titres against endogenous E. coli
      strains and the NR-E. coli strain used for experimental oral contamination were
      measured by an indirect immunofluorescence (IIF) assay. The assay was read by a
      video camera connected to an image processing system. The 95% confidence limits
      of antibody titres (log2) against endogenous E. coli strains ranged between less
      than 3 and 7.1 for IgA, between less than 3 and 8.7 for IgG and between less than
      3 and 7.4 for IgM. Antibody titres against the NR-E. coli4 strain were within
      this (normal) range. The serum antibody titres against the NR-E. coli strain
      increased slowly after oral contamination, especially IgG and IgM. Little
      increase in IgA titres could be observed. An increase of serum antibody titres
      did not correlate with the elimination of the oral contaminant from the
      intestines. Therefore, we conclude that the CR is not IgG nor IgM antibody
      mediated.

PMID- 1752311
TI  - Relapse versus reinfection with Clostridium difficile.
AB  - Relapse of Clostridium difficile-associated diarrhoea occurs in 15-20% of
      patients; however, whether relapse is due to an endogenous source of the organism
      or reinfection from the environment remains unclear. Restriction enzyme analysis
      (REA) of chromosomal DNA was used to type multiple isolates from ten patients who
      had experienced apparent relapses. More than half the relapses were due to
      infection with a new strain of C. difficile. The remaining patients were infected
      with the same strain, but whether this strain was acquired from the environment
      or from endogenous sources could not be determined. Relapses with a different
      strain of C. difficile could occur if an individual harboured more than one
      strain in their gastrointestinal tract. To investigate this possibility ten other
      patients were assessed for carriage of multiple strains. Ten colonies from a
      primary culture plate from each patient were typed by REA and tested for their
      ability to produce cytotoxin. All isolates from the same patient were identical
      by both methods, indicating that multiple carriage of strains may be a rare
      event.

PMID- 1752312
TI  - Characterization of a protective protein antigen of Erysipelothrix rhusiopathiae.
AB  - Although vaccination is widely practiced against infection by Erysipelothrix
      rhusiopathiae in pigs and turkeys, the protective antigen(s) involved have not
      been fully characterized or purified to homogeneity. Antigens of E. rhusiopathiae
      strain T28, serotype 2b, and of FRANKFURT XI, serotype N, in culture supernatant
      and in extracts made with hot acid, 10 mM NaOH, ultrasound or EDTA were compared
      by SDS-PAGE and immunoblotting and in a mouse protection test. EDTA and 10 mM
      NaOH yielded highly protective extracts; culture supernatant was less protective
      and ultrasonic or hot acid extracts stimulated little or no protection in mice.
      Protective antisera from swine, horses and mice recognized prominent bands of
      molecular mass (m.m.) of 66-64 and 40-39 kDa in EDTA and 10 mM NaOH extracts.
      Mice immunized with preparations of the 66-64 kDa band purified by preparative
      electrophoresis were protected. Both antigens were trypsin sensitive, contained
      no detectable polysaccharide, and showed a marked tendency to aggregate in the
      absence of SDS.

PMID- 1752313
TI  - Gastrointestinal carriage of Clostridium difficile in cats and dogs attending
      veterinary clinics.
AB  - Cats and dogs being treated at two veterinary clinics were investigated for
      gastrointestinal carriage of Clostridium difficile using selective solid and
      enrichment media. Thirty-two (39.5%) of 81 stool samples yielded C. difficile.
      There were significant differences in isolation rates between clinics, 61.0% of
      animals being positive at one clinic compared to 17.5% at the other (Chi-square,
      P less than 0.005). Of 29 animals receiving antibiotics, 15 (52.0%) harboured C.
      difficile while 11 (23.9%) of 46 animals not receiving antibiotics were positive
      (Chi-square, P less than 0.01). There was no difference in carriage rate between
      cats (38.1%) and dogs (40.0%). The environment at both veterinary clinics was
      surveyed for the presence of C. difficile. Fifteen of 20 sites at one clinic were
      positive compared to 6 of 14 sites at the other clinic. Both cytotoxigenic and
      noncytotoxigenic isolates of C. difficile were recovered from animals and
      environmental sites. These findings suggest that household pets may be a
      potentially significant reservoir of infection with C. difficile.

PMID- 1752314
TI  - Evaluation of enzyme immunoassay (EIA) as a screening method for hepatitis B
      markers in an open population.
AB  - Commercially available kits for detection of hepatitis B surface antigen (HBsAg)
      and hepatitis B surface antibody (anti-HBs) by enzyme immunoassay (EIA) were
      evaluated in American Samoa during a public health programme to eliminate the
      transmission of hepatitis B. The first 19,184 serum specimens obtained,
      representing 68% of the total cooperating population, were initially tested for
      anti-HBs, and those without detectable antibody were tested for HBsAg. All the
      antigen-positive serum samples, and a selection of the antigen- and antibody
      negative specimens were tested by radioimmunoassay (RIA) for detection of both
      markers. Compared with the standard tests, the EIA kits for anti-HBs and HBsAg
      performed well; sensitivity and specificity were 90.3 and 96.0%, respectively,
      for antibody, and 97.8 and 97.9% respectively for antigen. Substantial
      disagreement between the EIA and RIA tests for HBsAg was found only for specimens
      considered weakly reactive by EIA. Few differences were found between three EIA
      method options for follow-up HBsAg testing of weakly reactive serum specimens;
      each option contributed about equally to improved test specificity for these
      'borderline' specimens. Based on their demonstrated equivalence to the standard
      RIA tests, we conclude that the EIA kits for anti-HBs and HBsAg detection are
      suitable for use in hepatitis B control programmes in open populations.

PMID- 1752315
TI  - Reticulo-fibroblastoid stromal cell progenitors (CFU-RF) in murine bone marrow.
AB  - The hemopoietic inductive microenvironment (HIM) of the bone marrow is
      responsible for secretion of growth factors that regulate hemopoiesis. It is
      composed of an extracellular matrix and a complex variety of cell types with a
      range of functions related to blood cell development. In order to understand how
      such a complex system operates, it will first be necessary to determine the
      role(s) of the integral parts. Several of the stromal cell types have been
      identified morphologically in various culture systems, and some of their
      functions have been elucidated. We have identified a new stromal cell type in
      mouse bone marrow that appears similar if not identical to its human counterpart.
      When bone marrow cells are placed in methylcellulose/plasma clot culture with
      phytohemagglutinin-stimulated human leukocyte-conditioned medium in the presence
      of bovine calf serum (BCS), mercaptoethanol, and hydrocortisone, extensive
      branching colonies develop within 14 days. These "reticulo-fibroblastoid" (RF)
      colonies arise from a putative reticulo-fibroblastoid colony-forming unit (CFU
      RF) stem cell, and many become adipocytic by day 14; the addition of fresh
      medium, methylcellulose, and BCS on day 7 inhibits this change. The batch of
      human citrated plasma used in the culture system and the type and source of
      stimulating factor all influence the number of RF colonies that develop as well
      as the percent of colonies that become adipocytic. Whether this adipogenesis
      represents functional maturity or terminal differentiation is not yet known.
      Information gained on the role of these RF cells in normal and impaired
      hemopoiesis should contribute to the elucidation of the complicated interactive
      role of the microenvironment in the support and modulation of hemopoiesis.

PMID- 1752316
TI  - Megakaryocyte maturation in long-term marrow culture.
AB  - Evidence has been sought for megakaryocyte maturation in long-term cultures of
      mouse bone marrow. Cultures up to 14 weeks of age were examined for the presence
      of megakaryocytes with processes, that is, resembling the morphological
      appearance seen in vivo prior to platelet liberation. Such cells were found
      floating just above the adherent stromal layer using low magnification phase
      contrast microscopy. It was rare to observe as many as 20 of these cells per 25
      cm2 flask. At higher magnification, processes were seen to be attenuated with
      constrictions at intervals along their length. Time-lapse photography was used to
      follow the development and behavior of the processes. Direct evidence of rupture
      was very rare; generally the megakaryocytes retracted their processes within 48
      h. Careful searching of cultures occasionally revealed the presence of several
      process fragments, and sometimes individual platelets were found.
      Ultrastructurally, the processes were seen to contain organelles that are usually
      associated with platelets. The observations applied to both Dexter and Whitlock
      Witte cultures. It is concluded that maturation of megakaryocytes occurs in long
      term marrow culture to the point where platelet release appears imminent. Final
      rupture is rare and may require shearing forces, which in vivo would be provided
      by blood flow.

PMID- 1752317
TI  - Responsiveness of highly enriched CFU-GM subpopulations from bone marrow,
      peripheral blood, and cord blood to hemopoietic growth inhibitors.
AB  - Human early and late granulocyte-monocyte progenitors (granulocyte-macrophage
      colony-forming units, CFU-GM), depleted of accessory cells, were physically
      separated using an antimyeloid monoclonal antibody (DS1.1). They were separately
      cultured at optimal growth conditions and tested for responsiveness to
      prostaglandin E2 (PGE2), recombinant tumor necrosis factor alpha (TNF alpha), and
      transforming growth factor beta-1 (TGF beta 1). Late (DS1.1+) CFU-GM displayed
      the highest sensitivity to PGE2 and TNF alpha, the first significant inhibition
      being evident at 10(-9)M PGE2 and 1 U/ml TNF alpha. Conversely, their growth was
      stimulated (211%-217%) by 0.25-2.5 ng/ml TGF beta 1. Early (DS1.1-) marrow CFU-GM
      evidenced a lower sensitivity to PGE2 and TNF alpha. Their growth, however, was
      inhibited by 0.25-2.5 ng/ml TGF beta 1. Early CFU-GM constitute the totality of
      peripheral blood myeloid progenitors. Cord blood CFU-GM were also demonstrated
      here to be entirely DS1.1-. Both adult and cord blood CFU-GM displayed the
      highest resistance to PGE2 and TNF alpha. By contrast, they showed the maximum
      sensitivity to growth inhibition by TGF beta 1, active at 0.025-0.25 ng/ml. For
      the first time, therefore, highly purified subsets of human CFU-GM were separated
      that displayed a different responsiveness to well-defined growth-regulatory
      molecules. Our results indicate that TGF beta 1 has a dual activity; it is
      inhibitory on early and stimulatory on late CFU-GM, whereas PGE2 and TNF alpha
      preferentially inhibit late CFU-GM growth.

PMID- 1752318
TI  - Effects of erythroid differentiation factor (EDF) on proliferation and
      differentiation of human hematopoietic progenitors.
AB  - The effects of erythroid differentiation factor (EDF) on normal human
      hematopoietic progenitor cells were examined by bone marrow colony assay.
      Addition of EDF to the erythroid colony assay system enhanced erythroid burst
      forming unit (BFU-E)-derived colony formation, and this effect disappeared on
      removal of adherent cells. Conditioned medium of EDF-treated monocytes also
      enhanced BFU-E colony formation, whereas conditioned medium of EDF-treated T
      cells did not. In contrast, EDF inhibited erythroid colony-forming unit (CFU-E)
      colony formation dose-dependently, although it had no effect on colony formation
      by myeloid cells. These data show that EDF has a specific effect on human
      hematopoietic progenitors of the erythroid lineage. The results also indicate
      that EDF enhanced BFU-E colony formation by stimulating adherent cells to produce
      factors with burst-promoting activity (BPA), but suppressed CFU-E colony
      formation by promoting differentiation of these cells.

PMID- 1752319
TI  - The thermal response and development of thermotolerance of the bone marrow
      stromal progenitor CFU-F.
AB  - The effect of hyperthermia on the murine bone marrow stromal progenitor
      (fibroblast colony-forming unit, CFU-F) was evaluated and its ability to develop
      thermotolerance demonstrated. CFU-F were obtained from nucleated marrow of Balb/c
      mice and heated in vitro in alpha minimum essential medium plus 15% fetal bovine
      serum. Thermotolerance development was tested two ways. 1) The development of
      thermotolerance during prolonged hyperthermia was observed with a "step-up"
      heating protocol (i.e., cells were incubated at 41 degrees C and at regular
      intervals challenged with 15 min at 44 degrees C). 2) The development of
      thermotolerance at 37 degrees C after a short exposure to a high temperature
      (greater than or equal to 43 degrees C) was observed with a split treatment
      protocol that consisted of two 15-min treatments of 44 degrees C separated with
      time at 37 degrees C. The inverse of the slopes of the hyperthermia dose-response
      relationships (Do +/- SE) for CFU-F were 118 +/- 14, 53 +/- 7, 23 +/- 0.6, 11 +/-
      0.3, 7 +/- 0.3, and 5 +/- 0.5 min for exposures of 41.5 degrees, 42 degrees, 42.5
      degrees, 43 degrees, 43.5 degrees, and 44 degrees C, respectively. The plot of
      the slopes of the heat "dose-response" relationships versus the inverse of the
      absolute temperature (Arrhenius plot) yields a change in slope at approximately
      43 degrees C, and the inactivation enthalpies (slopes above and below the
      inflection point at 43 degrees C) were 606 +/- 100 kJ/mol (145 +/- 24 kcal/mol)
      and 1372 +/- 29 kJ/mol (328 +/- 7 kcal/mol) above and below 43 degrees C,
      respectively. The maximum thermotolerance ratio (TTR, surviving fraction after
      maximum thermotolerance development to surviving fraction of normotolerant CFU-F)
      at 37 degrees C after an acute thermal exposure to 15 min at 44 degrees C
      occurred after 12 h, with a half time of 60 min and a TTR of 41. The maximum TTR
      during prolonged hyperthermia at 41 degrees C was 2.4 by approximately 50 min.
      These results show that CFU-F are as sensitive as committed hematopoietic
      precursors (e.g., granulocyte-macrophage colony-forming units, CFU-GM) to
      hyperthermia over a wide range of thermal exposures and are capable of
      thermotolerance development during prolonged hyperthermic exposures and at 37
      degrees C after short exposures. We conclude that at least one of the stromal
      elements of normal marrow may be compromised during whole-body or regional
      clinical hyperthermia protocols.

PMID- 1752320
TI  - Toxic effects on the hematopoietic microenvironment.

PMID- 1752321
TI  - The International Society for Experimental Hematology meeting.

PMID- 1752322
TI  - Manual of food quality control. 6. Food for export.

PMID- 1752323
TI  - [The current principles of managing delivery].

PMID- 1752324
TI  - [Abscess of the greater vestibular gland of the vagina].

PMID- 1752325
TI  - [The follow-up of the psychomotor development of infants in the 1st year of life
      in a pediatric polyclinic].

PMID- 1752326
TI  - [The characteristics of hematopoiesis and the composition of the blood in
      children].

PMID- 1752327
TI  - [Osteogenic sarcoma and Ewing's sarcoma in children].

PMID- 1752328
TI  - [First aid in anaphylactic shock].

PMID- 1752329
TI  - [The problems of the sexual adaptation of young newlyweds].

PMID- 1752330
TI  - [Viral hepatitis and pregnancy].

PMID- 1752331
TI  - [Faucial diphtheria].

PMID- 1752332
TI  - [Myocardial infarct and cardiogenic shock].

PMID- 1752333
TI  - [Chronic endometritis].

PMID- 1752334
TI  - [New organizational forms of delivering medical care abroad].

PMID- 1752335
TI  - [Ecology and health].

PMID- 1752336
TI  - [A study of anti-pituitary-antibodies in patients with hypopituitarism and their
      hereditary background].
AB  - Recently several types of anti-pituitary-antibodies (APA) have been found in
      patients with pituitary disorders including hypopituitarism and diabetes
      insipidus, and in postpartum women. However, the pathophysiological role(s) of
      APA still remains unknown. In order to elucidate the clinical significance of
      APA, longitudinal follow-up and family study of APA in patients with
      hypopituitarism were performed. APA in serum was examined in a total of 11
      patients with various types of hypopituitarism (7 of isolated ACTH deficiency, 1
      of partial hypopituitarism, 3 of Sheehan's syndrome, 6 males and 5 females).
      Chronic thyroiditis was associated in 3 out of 7 patients with isolated ACTH
      deficiency, and empty sella was found in each one patient with isolated ACTH
      deficiency and partial hypopituitarism, and in 3 patients with Sheehan's
      syndrome. APA was examined on 2 or 3 occasions at more than a 6 month interval
      (longitudinal study). In 5 patients, their 16 family members were examined for
      the presence of APA, and pituitary functions were evaluated in 3 out of 7 family
      members with positive APA (family study). For pituitary function tests, arginine
      infusion test, TRH, LH-RH or CRH test and insulin tolerance test were performed.
      APA reacting to rat pituitary cytoplasmic antigens (pituitary cell antibodies:
      PCA) and APA reacting to rat GH3 cells and/or mouse AtT20 cells surface antigens
      (pituitary cell surface antibodies: PCSA) were assayed with indirect
      immunofluorescence method. At the initial examination, 6 out of 11 patients (55%)
      showed positive APA. The patients were divided into 3 subgroups according to the
      longitudinal study: the group with disappearance of initially positive APA (3
      patients), the group with altered titers or types of initially positive APA (3
      patients), and the group with sustained initially negative APA (4 patients). No
      effects of replacement therapy on the alterations of APA were observed. In 16
      family members of 5 patients (each 1 with partial hypopituitarism and isolated
      ACTH deficiency syndrome, and 3 with Sheehan's syndrome), APA in their sera were
      investigated. Seven out of 16 members (44%) showed positive APA. Among 6 first
      degree relatives of 16 family members, both or either one of APA and PCSA were
      positive in 4 (67%). Out of 10 of their second- or third-degree relatives, 3
      (30%) were positive for PCA or PCSA. All of 3 relatives with positive APA studied
      showed mild pituitary hypofunction without any clinical manifestations.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1752337
TI  - [Effect of growth hormone on immune function in normal and hypophysectomised
      rats].
AB  - The effect of growth hormone (GH) on immune function was studied using normal and
      hypophysectomised male Wistar rats. Hypophysectomy was performed by the auditory
      approach at 4 weeks of age. Normal and hypophysectomised rats were treated with
      saline or 0.4IU/body GH daily during 7 to 11 weeks of age. Histological features
      of the thymus and spleen and immunological parameters including blood cell
      counts, lymphocyte subsets, serum immunoglobulin levels, splenic natural killer
      activity, and mitogen-induced splenic lymphocyte proliferation were examined in
      the rats at 11 weeks of age. In hypophysectomised rats, the counts of peripheral
      white blood cells (5,513 +/- 813/microliters), lymphocytes (4,838 +/-
      737/microliters), Th/i cells (2,237 +/- 329/microliters), and B cells (1,400 +/-
      509/microliters), Th/i/Ts/c ratio (1.78 +/- 0.27), splenic T cell subsets (pan T:
      51.0 +/- 4.3%, Th/i: 31.6 +/- 3.0%, Ts/c: 23.9 +/- 2.7%), and serum IgG level
      (2,148 +/- 470mg/l) were significantly decreased as compared with normal rats.
      Natural killer activity (17.8 +/- 4.6%) and mitogen-induced proliferation of T
      cells (Con A: 47.1 +/- 15.7, PHA: 51.6 +/- 12.5) were also suppressed. Hypoplasia
      of the thymus and spleen was observed in parallel to retarded growth of the rats.
      In contrast, GH supplement to the hypophysectomised rats resulted in increases in
      growth and lymphoid tissue, and the restoration of the counts of peripheral white
      blood cells (6,850 +/- 840/microliters), lymphocytes (6,211 +/- 731/microliters),
      Th/i cells (2,909 +/- 304/microliters), and B cells (1,947 +/- 402/microliters),
      Th/i/Ts/c ratio (2.04 +/- 0.34), serum IgG level (3,414 +/- 1,326mg/l), and
      natural killer activity (25.7 +/- 4.7%). However, splenic lymphocyte subsets and
      mitogen-induced proliferation of T cells were not recovered by GH treatment for 4
      weeks. GH administered to normal rats increased serum IgG level (4,982 +/-
      1,496mg/l) but did not affect other immunological parameters. These results
      indicate that humoral and cell-mediated immune function are impaired in
      hypophysectomised rats, but GH supplement administered to them restored most of
      the impaired immune function, suggesting that GH plays an important role in the
      development of immune function.

PMID- 1752338
TI  - [Studies on the iodide metabolism and the expression of thyroglobulin and thyroid
      peroxidase mRNA in the thyroid of BB/W rats].
AB  - BioBreeding/Worcester (BB/W) rats develop insulin dependent diabetes mellitus
      (IDDM) and lymphocytic thyroiditis (LT) spontaneously. Our previous studies have
      shown that BB/W (Saitama-Tokyo colony) rats develop LT at about 10 weeks of age.
      Their serum TSH values increase as LT extends, although their serum thyroid
      hormone levels remain normal. This indicates that BB/W rats suffer from
      subclinical hypothyroidism. To investigate whether BB/W rats have a defect in
      iodide metabolism, the thyroidal radioactive iodine uptake (RAIU) in BB/W rats
      was examined. Thyroidal RAIU at 3hr in both 8 and 16 week-old BB/W rats was
      significantly higher than that in age-matched normal Wistar rats. On the other
      hand, BB/W rats had significantly lower 48hr thyroidal RAIU than normal Wistar
      rats. This suggests that BB/W rats appear to have some defects in iodide
      metabolism, especially in iodide organification even before the development of
      LT. The expression of thyroid peroxidase (TPO) and thyroglobulin (Tg) mRNA in
      BB/W and Wistar rats was then examined using the Northern blot analysis. The
      expression of both TPO and Tg mRNA was greatly decreased in BB/W rats compared
      with that in Wistar rats despite the high serum TSH levels in BB/W rats. This
      indicates that BB/W rats may have pretranslational defects in TPO and Tg
      synthesis, resulting in the impaired thyroid hormone synthesis. In the present
      study, it has been demonstrated that BB/W rats appear to have a defect(s) in
      iodide metabolism possibly due to some abnormalities in TPO and Tg synthesis.

PMID- 1752339
TI  - [Enzymatic iodination of thyroglobulins obtained from patients with thyroid
      disease].
AB  - Iodination of the isolated thyroglobulin (Tg) by peroxidase was compared with
      various Tg preparations obtained from patients with thyroid diseases. For the
      purpose, the iodination process was observed in the incubation medium containing
      Tg, iodide, H2O2-generating system, and thyroid peroxidase (TPO) or
      lactoperoxidase (LPO). During the incubation, iodination of Tg preparations
      increased gradually and reached a plateau after 90 min., and 5 min. incubation
      with 3mIU or 14mIU of TPO, respectively. The degree of iodination level at the
      plateau region was different in each Tg preparation, depending on the iodine
      content of the original starting (native) preparation before incubation. The
      iodination level of cancer Tg with a very low iodine content (less than 0.1%) was
      low compared with the normal Tg level (obtained from normal thyroid tissue which
      contained about 0.4% iodine). The above findings suggest the possible existence
      of some structural differences of Tg in terms of the susceptibility to the
      iodination between the preparations of normal and diseased Tgs. As far as the
      immunological aspect concerned, there was no significant difference in the
      affinity (avidity) of Tg with polyclonal anti-Tg antibody between the native Tg
      and the enzymatically iodinated one. These results suggest that the changes of
      iodine and thyroid hormone contents of Tg by in vitro iodination, has no
      significant effect on the immunological property of Tg molecule.

PMID- 1752340
TI  - [Study of the predictive factors of postoperative blood pressure in cases with
      primary aldosteronism].
AB  - Some patients develop hypertension after adrenalectomy for primary aldosteronism.
      We treated 60 cases with primary aldosteronism, and the percentages of cases
      manifesting hypertensive blood pressures after operation were as follows: 40.0%
      at the first month, 24.2% at the second year, 30.4% at the 5th year after
      operation. What are the most important clinical factors relating to postoperative
      blood pressure? Knowledge of those factors would help in predicting the
      postoperative blood pressure in cases with primary aldosteronism. The
      relationships between the postoperative blood pressure and several clinical
      factors were evaluated for a certain postoperative period using multiple
      regression analyses. The results were as follows: 1. The duration of preoperative
      hypertension is the major determinant at the second month after operation. 2. The
      histological findings for the kidney are the major determinant at the 6th month
      and the first year after operation. 3. At the second year postoperation, the
      histological findings for the kidney and the familial history of hypertension are
      the major determinant respectively. 4. The familial history of hypertension is
      the most determinant at the 5th year after operation. It is concluded that the
      preoperative duration of hypertension and the histological findings for the
      kidney are helpful in predicting blood pressure during the first 2 years after
      operation, while the familial history of hypertension influences the
      postoperative blood pressure thereafter.

PMID- 1752342
TI  - [The 64th Fall Meeting of the Japan Endocrine Society, Maebashi, November 14-15,
      1991 and 18th Meeting of the Neuroendocrinology Subsection of the Society, Tokyo,
      November 17, 1991. Abstracts].

PMID- 1752341
TI  - [A case of dwarfism with severely reduced activity of growth hormone-binding
      protein].
AB  - We presented a 16-year-old boy with severe growth retardation and markedly
      decreased levels of growth hormone-binding protein (GHBP) in plasma, which was
      shown to correspond to the extracellular composition of hepatic GH receptor and
      suggested to reflect tissue concentration of the receptor. His height was 92.5 cm
      (-13.5 SD), the weight 9.6kg (-5.8 SD) and Tanner stage was I. His bone age was
      3.5 years old at 16 years of age. Karyotype was 46,XY and thyroid function was
      normal. SM-C levels, determined by Nichols RIA using unextracted plasma, were
      within the low normal range, 0.67/0.68U/ml. In contrast, using a method of acid
      ethanol extraction, IGF-I and IGF-II levels were definitely low, 29ng/ml (normal
      88-240) and 165ng/ml (374-804) respectively. GH responses in various provocation
      tests, including insulin, arginine and GRF, were within normal. Basal GH levels
      were 20 +/- 12ng/ml and urinary GH excretion rates 217 +/- 85pg/mg. Cr, which
      were elevated compared to age-matched control. Molecular size of his circulating
      GH was similar to control subjects. The biological activities of GH, evaluated by
      radioreceptor assay and Nb2 cell bioassay, were proportional to the
      immunoactivities of GH. SM bioactivities, which were determined by the
      stimulatory effects on DNA synthesis of rabbit costal chondrocytes and human
      fibroblasts, were apparently reduced. Electrophoretic patterns of IGF-binding
      protein was similar to those of GH deficient cases. Daily administration of hGH
      (4U/day) for 5 days resulted in a poor response of SM-C production (before 0.68,
      after 0.77U/ml). GHBP activities were definitely low by gel-filtration,
      immunoprecipitation and charcoal methods, as seen in Laron dwarfism which is
      defined as a syndrome of congenital GH receptor defects. These results indicate
      that the tissue content of GH receptor in this case was quantitatively reduced
      and as a result, he showed a resistance to endogenous and exogenous GH. It
      remains to be elucidated whether the GH receptor defect in our case is derived
      from a genetic origin or an acquired condition.

PMID- 1752343
TI  - The insulin-like properties of vanadium: a curiosity or a perspective for the
      treatment of diabetes?
AB  - Vanadium is a trace metal that has raised increasing interest in diabetology
      since the discovery of its insulin-like properties in vitro and in vivo. This
      brief article is a review of the most recent data concerning the cellular
      mechanisms by which vanadium salts stimulate glucose metabolism. The beneficial
      effects of vanadium on glucose homeostasis of animal models of insulinopenic or
      insulin-resistant diabetes are discussed. The perspectives that the use of
      vanadium opens for the treatment of diabetes are also considered, in the light of
      the potential toxicity of the element.

PMID- 1752344
TI  - Restoration of sensitivity to sulfonylurea after strict glycaemic control with
      insulin in non-obese type 2 diabetic subjects.
AB  - Ten non-obese type 2 diabetic patients with secondary failure to sulfonylureas
      received an intensive insulin therapy (four doses schedule) for 90 days. The
      glycaemic control was poor at entry (HbA1c = 11.7 +/- 1.2%) and ameliorated
      significantly after insulin (HbA1c = 7.1 +/- 0.7%, p less than 0.01). The
      reintroduction of the sulfonylurea after insulin withdrawal resulted in a
      persistent satisfactory long-term control (300 days) in all, but two diabetics
      responded no more after about 3 and 4 months of clinical remission (good control
      on sulfonylurea). Both basal and stimulated (iv glucagon and mixed meal) beta
      cell secretory activity increased significantly at 3 months and declined
      thereafter without falling below baseline values. Three months of strict
      metabolic control seem to restore the sensitivity to sulfonylurea by enhancing
      beta-cell secretory activity in non-obese type 2 diabetic patients.

PMID- 1752345
TI  - [Psychological aspects of remission induced by intensive insulin therapy in type
      I diabetes. A retrospective study of 44 patients].
AB  - The psychological consequences of induced remission of type 1 diabetes, have not
      yet been investigated thoroughly. We studied the psychological status of 44
      patients (16 women, 28 men), age 21 years +/- 8 months (mean +/- SD), whose
      remission lasted 12 +/- 9 months. Patients' psychological reactions were analyzed
      retrospectively, using a 20 items standardized questionnaire, investigating 3
      successive periods: 1) initial intensive insulin therapy; 2) remission; 3)
      permanent insulin therapy. 8% of the subjects only considered the remission phase
      useless, whereas 49% expressed a positive appraisal. Hope was predominant
      feeling, 25% of the patients believing in a completed recovery of diabetes.
      Perceived therapeutic constraints were, in decreasing order: regimen, way of
      life's regularity, self monitoring of blood glucose. When starting permanent
      insulin therapy, opposite answers were given: 49% negative feelings, 33% positive
      feelings and 18% ambivalent feelings. During this period, insulin injections
      represented the major therapeutic constraint, followed by self monitoring of
      blood glucose. To summarize, induced remission does not appear to be
      psychologically harmful and is considered useful by a large majority of patients.
      Effective psychological support has to be offered to help those patients to cope
      with their irrational hopes of healing and to dampen their deception at the end
      of the remission period.

PMID- 1752346
TI  - Variation of insulin absorption during subcutaneous and peritoneal infusion in
      insulin-dependent diabetic patients with unsatisfactory long-term glycaemic
      response to continuous subcutaneous insulin infusion.
AB  - The aim of present study was to analyse the reproducibility of plasma-free
      insulin profiles of subcutaneously (CSII) and intraperitoneally (CIPII)
      administered insulin in 6 C-peptide-negative, type 1, diabetic patients. The
      patients were selected for CIPII because of unsatisfactory, long-term, metabolic
      response to CSII. Plasma-free insulin was measured repeatedly, twice during
      subcutaneous infusion and twice during intraperitoneal infusion, for 4 hours,
      following a standard breakfast. In the CSII experiment, insulin was given as a
      meal-dose of 0.1 U per kg body weight, and in the CIPII experiment the meal-dose
      was 0.05 U per kg body weight. The dose-induced peak occurred earlier after the
      CIPII than with the CSII (60.0 +/- 8.0 vs 133.6 +/- 16.3 min). In conclusion, the
      intra-patient coefficient of variation (C.V.) of plasma-free-insulin profiles at
      0-60 min and 0.240 min, as well as the peak time, were markedly lower for CIPII
      insulin than for CSII, indicating a more reproducible way of insulin
      administration with CIPII in this selected group of patients.

PMID- 1752347
TI  - Age, sex and ICA influence on beta-cell secretion during the first year after the
      diagnosis of type 1 diabetes mellitus.
AB  - We studied the independent influence of sex, age and islet-cell antibodies (ICA)
      on residual beta-cell secretion and metabolic control during the first year after
      the diagnosis of type 1 diabetes mellitus in 40 consecutive newly diagnosed
      patients. Glucagon-stimulated C-peptide secretion was measured after 5-10 days
      and 3, 6 and 12 months of diagnosis. ICA (JDF units) and complement-fixing ICA
      (CF-ICA) were determined at diagnosis and after 12 months. The influence of sex,
      age and ICA was analyzed in a multivariate analysis of variance of 3 factors
      (age, sex and ICA) for repeated measures over time. ICA and CF-ICA were positive
      in 75.0% and 35.0% of patients at diagnosis and in 48.7% and 20.5% of patients
      one year later. Persistence of ICA positivity was higher in females (p. less than
      0.001) and in CF-ICA+ patients (p less than 0.01), but did not involve a
      different evolution of C-peptide secretion. Males had a lower C-peptide secretion
      than females (p = 0.023) during the first year after the diagnosis of type 1
      diabetes, independently of the age and ICA status of the patients. Adult patients
      (greater than or equal to 18 years-old) had lower HbA1 values than younger
      patients (p = 0.006) and ICA+ patients with a moderate or high value (greater
      than 10 JDF units) had a lower C-peptide secretion over time (p = 0.031 at 6
      months, p = 0.067 at 12 months) and higher HbA1 values (p = 0.056) than younger
      patients. HbA1 was significantly explained by ICA and C-peptide values in a
      stepwise multiple regression analysis (p = 0.005).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1752348
TI  - [Microalbuminuria in a population of 653 patients with type 1 and 2 diabetes].
AB  - The aim of this retrospective study was to evaluate the prevalence of
      microalbuminuria in type 1 and 2 diabetic patients with or without high blood
      pressure levels. 653 patients were involved in the study [type 1: n = 413
      (normotensive: n = 298; hypertensive: n = 115); type 2: n = 240 (normotensive: n
      = 93; hypertensive: n = 147)]. In type 1 diabetic patients, the prevalence of
      microalbuminuria was of 21 per cent. Microalbuminuria was also found in 28 per
      cent of type 2 diabetic subjects (p less than 0.10 vs type 1). The prevalence of
      microalbuminuria was significantly higher in hypertensive than in normotensive
      diabetic subjects (28 vs 20 per cent; p less than 0.05). Blood pressure in type 1
      and 2 normotensive patients was significantly higher in subjects with than
      without microalbuminuria. We also observed higher HbA1 levels in microalbuminuric
      type 1 diabetic patients. Finally, we also assessed that the prevalence of
      diabetic chronic complications was higher in type 1 patients with than without
      microalbuminuria (p less than 0.05). This relationship was not evidenced in type
      2 diabetic patients. In conclusion, the prevalence of microalbuminuria in a
      population of type 1 and 2 diabetic patients is high. We confirm in this study
      the relationship between microalbuminuria, blood pressure, and HbA1.

PMID- 1752349
TI  - Accuracy of blood glucose self monitoring in elderly insulin treated diabetic
      patients.
AB  - We investigated the accuracy of blood glucose self monitoring in 131 patients
      (mean +/- SD age 65 +/- 7 years, duration of diabetes 11 +/- 6 years) who
      participated in a 5-day inpatient group treatment and teaching programme
      especially designed for elderly insulin-treated patients. Patients' estimations
      and laboratory blood glucose measurements were compared on day 1 (after
      theoretical and practical introduction into blood glucose self monitoring) and on
      day 4 of the programme. Patients were trained in the visual reading of
      Haemoglukotest 20-800R; blood glucose meters were recommended only exceptionally.
      Error grid analysis showed a high accuracy of visually assessed blood glucose
      values, both on day 1 (94% of measurements in zone A, 5% in zone B) and on day 4
      (95% in zone A, 4% in zone B). Patients with no prior experience in blood glucose
      self monitoring (n = 67) showed a significant improvement (p less than 0.02) in
      accuracy from day 1 to day 4. Values determined by blood glucose meters were less
      accurate, although this trend did not reach statistical significance. A second
      group of 94 consecutive patients was reexamined 5 years after participation in
      the treatment and teaching programme. 55 patients were still alive and 42 could
      be evaluated. Accuracy of blood glucose estimations was assessed in all 26
      patients practising blood glucose self monitoring (age 69 +/- 5 years, diabetes
      duration 18 +/- 8 years), either at their homes (n = 23) or at our diabetes
      outpatient clinic (n = 3). Error grid analysis showed a high accuracy by visual
      reading (n = 21, 95% zone A, 5% zone B).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1752350
TI  - Effects of metformin on glucose, insulin and lipid metabolism in patients with
      mild hypertriglyceridaemia and non-insulin dependent diabetes by glucose
      tolerance test criteria.
AB  - The effect of metformin treatment was studied in nine patients with mild (fasting
      plasma glucose concentration less than 7.5 mmol.l-1) non-insulin-dependent
      diabetes mellitus (NIDDM) and fasting plasma triglyceride (TG) concentration
      greater than 2.0 mmol.l-1. Individuals were studied before and three months after
      receiving 2.5 g/day of metformin. Mean hourly plasma glucose concentration from 8
      AM to 4 PM (7.5 +/- 0.5 vs 6.5 +/- 0.4 mmol.l-1, p less than 0.001), as well as
      glycosylated hemoglobin levels (7.0 +/- 0.5 vs 6.2 +/- 0.2%, p less than 0.02)
      were significantly lower following metformin treatment. The improvement in
      glycaemic control was not associated with an improvement in insulin stimulated
      glucose disposal as measured by the glucose clamp technique. Mean hourly day-long
      concentrations of plasma insulin (519 +/- 81 vs 364 +/- 64 pmol.l-1, p less than
      0.001), FFA (502 +/- 45 vs 460 +/- 35 mu mol.l-1, p less than 0.01), and
      triglyceride (3.60 +/- 0.33 vs 3.02 +/- 0.31 mmol.l-1, p less than 0.001)
      concentrations were significantly lower following three months of metformin
      treatment. Finally, fasting plasma TG concentration, very low density lipoprotein
      (VLDL)-TG, and VLDL-cholesterol concentrations were significantly decreased,
      while high density lipoprotein (HDL)-cholesterol concentration was significantly
      increased following metformin therapy. Thus, metformin administration to
      individuals with NIDDM, who did not have significant fasting hyperglycaemia, led
      to a decrease in plasma glucose, insulin, FFA, and TG concentration, and an
      increase in plasma HDL-cholesterol concentration.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1752351
TI  - [Non-pharmacological interventions in the treatment of arterial hypertension
      associated with diabetes].

PMID- 1752352
TI  - Age-related differences in sensory conditioning in rats.
AB  - Four experiments tested rats 8, 12, or 21 days postnatal for sensory conditioning
      in terms of the association acquired between two odors presented simultaneously
      or sequentially. The sensory conditioning of 8- and 12-day-old rats exceeded that
      of rats 21 days of age when the odors were presented simultaneously. When one
      odor was presented immediately followed by another, however, 21-day-old rats
      conditioned as effectively as the younger animals, and with a sufficiently long
      interval between odors (20 min), the sensory conditioning of the 21-day-old rats
      surpassed that of the rats 12 days of age. Although consistent across a variety
      of procedures, in previous experiments and within the present study, the age
      related differences in sensory conditioning after simultaneous presentation of
      two odors are difficult to understand. Increasing knowledge of the ontogeny of
      orienting may lead to an explanation in terms of Thompson's (1972) theory linking
      sensory conditioning with orienting and sensitization.

PMID- 1752353
TI  - A refractory period for the heart rate response in infant visual attention.
AB  - A refractory period for the heart rate (HR) response of 14-, 20-, and 26-week-old
      infants to second stimulus onset and primary stimulus offset during termination
      of visual attention was investigated. A stimulus that elicited a significant HR
      deceleration was presented. Following the return of HR to prestimulus level, a
      second stimulus occurred or the first stimulus ended at time delays of 0, 3, 6,
      and 9 s. If the second stimulus occurred at 0 or 3 s after HR returned to its
      prestimulus level, the HR response was smaller than the initial HR orienting
      response (OR). A usual HR OR resulted by waiting 6-9 s after the return of HR to
      prestimulus level. A significant offset response occurred only for the 6-sec
      delay. Active inhibition of vagal cardiac activity during attention termination
      may cause the observed refractory period in the HR response, which appears to
      last from 3-6 s following sustained attention.

PMID- 1752354
TI  - Prenatal stress effects on exploratory activity and stress-induced analgesia in
      rats.
AB  - Pregnant rats were exposed three times daily to immobilization stress during
      gestational Days 15-19. The behavior of their offspring was compared with the
      behavior of offspring from unstressed control mothers. Although the stress
      procedure decreased the weight gain of mothers during pregnancy, it slightly but
      significantly increased the weight of their offspring at birth and at weaning. On
      postnatal Day 10, prenatally stressed pups returned to their home cage more
      quickly than did prenatally unstressed control pups during a nest odor
      discrimination task, but no differences between groups in the number of correct
      responses were found. On postnatal Days 70-72, prenatally stressed offspring
      showed increased exploratory activity in a complex tunnel maze compared with
      control offspring. On postnatal Day 80, analgesia induced by stress (swimming for
      3 min in cold water) was determined (tail flick latency). The degree of stress
      induced analgesia was smaller in prenatally stressed rats than in control rats.
      These data suggest that the effects of prenatal stress on behavior are most
      clearly discernable when such animals are confronted with a novel or stressful
      situation.

PMID- 1752355
TI  - The human genome initiative.

PMID- 1752356
TI  - Mozart, Alexander the Great, and the animal rights/liberation philosophy.

PMID- 1752357
TI  - Cellular desiccation and hydration: developmentally regulated proteins, and the
      maturation and germination of seed embryos.
AB  - Little more than a decade ago, 2-dimensional mapping of proteins and biochemical
      study of their allied coding elements (mRNA and DNA) were first used to probe
      possible changes in the embryo during seed germination. Because specification was
      of primary importance, our attention was initially directed toward the
      characterization of individual proteins and coding elements which, in preliminary
      surveys of the germinating wheat embryo, were found to be conspicuously subject
      to developmental regulation. Three of the proteins have become subjects of
      comprehensive investigations in this and other laboratories: the Em protein, the
      Ec protein, and germin. The Em and Ec proteins are encoded by the conserved mRNA
      'stored' in the mature embryos of dry, field-ripened seeds but germin is encoded
      by the nascent mRNA formed after mature embryos are germinated in water. The Ec
      protein is the only bona fide Zn metallothionein yet found in higher plants.
      Studies of their biology and molecular biology suggest that the Em protein has a
      role in hormone-mediated (abscisic acid) cellular desiccation and that germin has
      a role in hormone-mediated (auxin) cellular hydration. It is projected that
      further studies of the Em protein may help elucidate the molecular basis for a
      loss of dessication tolerance during germination, and that further studies of
      germin may help elucidate the molecular basis of plant cell enlargement.

PMID- 1752358
TI  - Enzymatic control of pigmentation in mammals.
AB  - Visible pigmentation in mammals results from the synthesis and distribution of
      melanin in the skin, hair bulbs, and eyes. The melanins are produced in
      melanocytes and can be of two basic types: eumelanins, which are brown or black,
      and phaseomelanins, which are red or yellow. In mammals typically there are
      mixtures of both types. The most essential enzyme in this melanin biosynthetic
      pathway is tyrosinase and it is the only enzyme absolutely required for melanin
      production. However, recent studies have shown that mammalian melanogenesis is
      not regulated solely by tyrosinase at the enzymatic level, and have identified
      additional melanogenic factors that can modulate pigmentation in either a
      positive or negative fashion. In addition, other pigment-specific genes that are
      related to tyrosinase have been cloned which encode proteins that apparently work
      together at the catalytic level to specify the quantity and quality of the
      melanins synthesized. Future research should provide a greater understanding of
      the enzymatic interactions, processing, and tissue specificity that are important
      to pigmentation in mammals.

PMID- 1752359
TI  - Androgen resistance caused by mutations in the androgen receptor gene.
AB  - Defects in the human androgen receptor cause a spectrum of defects in male
      phenotypic sexual development associated with abnormalities in the receptor
      protein assayed in cultured fibroblasts and in broken cell assays. In some
      patients these abnormalities are associated with absent ligand binding, in other
      qualitative or quantitative abnormalities of ligand binding are present, and in
      some no abnormality of ligand binding is detected. Analysis of the androgen gene
      structure in such patients has permitted identification of the causative mutation
      in many families. Although results of these studies often reinforce concepts
      established by in vitro mutagenesis studies of other steroid receptors, some
      mutations have provided unusual insight into the structural organization of the
      androgen receptor molecule.

PMID- 1752360
TI  - Site-specific recombination in the immune system.
AB  - Site-specific DNA recombination has been identified in a wide variety of
      biological systems. In vertebrates, however, the only identified use of this
      genetic device is in the immune system. Here it plays a critical role in
      generating a diverse repertoire of surface receptors to intercept invading
      microbes and parasites. The mechanism and orchestration of this reaction are
      intriguing and are relevant to a broad array of related biological and biomedical
      issues.

PMID- 1752361
TI  - Regulation of enzyme activity in the cell: effect of enzyme concentration.
AB  - The rapid development in our understanding of the regulation of enzyme activity
      makes it a high priority to ascertain whether the behavior of purified enzymes
      reflects their functional characteristics in vivo. Enzyme concentration is
      usually the most significant difference between routine in vitro assays and in
      vivo conditions, as it is well known that many intracellular enzymes are present
      in vivo at much higher concentrations than used in vitro. Various procedures are
      suitable for kinetic analysis at physiological concentrations of enzyme. Those
      more frequently used have been cell permeabilization, the utilization of purified
      enzymes at concentrations close to the in vivo range, and the addition of
      polyethylene glycol to increase the local protein concentration. In this review
      we briefly summarize observations on enzymes reported to exhibit concentration
      dependent activity. The effect of enzyme concentration has been most thoroughly
      investigated in the case of phosphofructokinase. These studies may provide
      insight into the regulation of this important enzyme in the cell. The
      implications of both homologous and heterologous protein-protein interactions for
      the effect of enzyme concentration and their roles in the control of enzyme
      activity in vivo are also discussed.

PMID- 1752362
TI  - Signal transduction in erythropoiesis.
AB  - The polypeptide hormone erythropoietin (Ep) is a growth factor whose actions on
      the erythroid progenitor cell induce proliferation and differentiation. The
      signal transduction system activated by Ep to mediate these cellular processes
      remains largely uncharacterized despite many years of research devoted to its
      elucidation. It is clear that an Ep receptor-mediated activation of adenylate
      cyclase or guanylate cyclase does not occur, although cAMP and cGMP may play
      modulatory roles. The role of calcium in the action of Ep is less clear. Although
      the presence of extracellular calcium seems to be an absolute requirement for Ep
      induced proliferation, the positive changes induced by Ep in intracellular
      calcium occur with a time course suggestive of influx through ion channels
      opening within the cell membrane rather than release of intracellular stores by
      inositol trisphosphate. There is good evidence for the involvement of
      phospholipases A2 and C in the actions of Ep, including an early rise in
      lipoxygenase metabolites of arachidonic acid. Activation of phospholipase C can
      also result in the activation of protein kinase C in response to Ep. We present a
      model for the signal transduction pathway of Ep that is consistent with current
      knowledge and provides a framework for the coordinate actions of several
      intracellular mechanisms in the mediation of Ep-induced proliferation.

PMID- 1752363
TI  - Vomeromodulin, a putative pheromone transporter: cloning, characterization, and
      cellular localization of a novel glycoprotein of lateral nasal gland.
AB  - Vomeromodulin, a novel glycoprotein of lateral nasal gland, has been cloned by
      differential hybridization from nasal/olfactory tissue. The 2.2-kb mRNA directs
      the in vitro synthesis of a 60-kDa primary translation product in reticulocyte
      lysates. Differential sensitivity to endoglycosidases indicates that
      vomeromodulin is posttranslationally modified in vivo by N-glycosylation to form
      a 70-kDa glycoprotein of the complex type. Immunocytochemical localization with
      two different antipeptide antisera demonstrates that vomeromodulin is abundant in
      the lateral nasal glands and is also present in the posterior septal and
      vomeronasal glands. Most striking is the observation that it is highly
      concentrated in the mucus of the vomeronasal organ of Jacobson but is not
      detectable in the mucus of the main olfactory neuroepithelium. Evaluation of mRNA
      and protein distribution by Northern and Western analyses, respectively,
      indicates that vomeromodulin is absent from 15 other tissues. The glandular and
      mucosal distribution of this glycoprotein implies a transport function that may
      be related to the mechanisms by which pheromones of low volatility gain access to
      their receptors in the vomeronasal organ. These observations support our
      hypothesis that vomeromodulin participates in perireceptor events that facilitate
      the process of pheromone access and detection.

PMID- 1752364
TI  - Transgenic animals in biomedical research.
AB  - The advent of transgenic technology, in which foreign genetic information is
      stably introduced into the mammalian germ line, has dramatically enhanced our
      basic knowledge of physiologic and pathologic processes. Transgenic animals
      created by these genetic manipulations are being used to provide insights into
      gene regulation, development, pathogenesis, and the treatment of disease.
      Furthermore, transgenic biotechnology holds great promise for the creation of
      genetically superior livestock and the industrial production of precious
      pharmaceuticals. It is evident now that the study and use of transgenic animals
      will significantly improve the human condition.

PMID- 1752365
TI  - Early choline research and the aftermath.

PMID- 1752366
TI  - Relationship between interferon-gamma, indoleamine-2,3-dioxygenase and
      tryptophan.

PMID- 1752367
TI  - Regulating body mass.

PMID- 1752368
TI  - [Lactase deficiency and lactose intolerance-related symptoms in adult healthy
      subjects from western France].
AB  - The prevalence of lactase deficiency (LD) and lactose intolerance is not well
      known in France. Using breath hydrogen and methane analysis after 50 g oral
      lactose load, we investigated the prevalences of LD, lactose intolerance, and
      methane producer status in 102 healthy adults born in western France, and we
      examined the relationships between these parameters and the daily milk
      consumption. In 10 subjects with LD and lactose intolerance, we studied the
      reproducibility of the lactose hydrogen breath test results for the diagnosis of
      LD and lactose intolerance and estimated the quantity of lactose malabsorbed in
      comparison with the lactulose hydrogen breath test. The prevalence of LD was 23.4
      percent and symptoms of lactose intolerance were observed in 50 percent of the 24
      subjects with LD. The daily milk consumption was not significantly different in
      the 24 subjects with LD and in the 78 subjects without LD (281 +/- 197 vs 303 +/-
      217 ml/24 h). The prevalence of methane producer status was 42.1 percent. The
      symptomatic group of lactose malabsorbers (n = 12) was characterized by a shorter
      lactose mouth to caecum transit time (39 +/- 20 vs 88 +/- 48 min; P less than
      0.05), and more marked hydrogen production (6.1 +/- 2.3 vs 3.4 +/- 2.4 10(3)
      ppm.min; P less than 0.04). In the 10 subjects with LD and lactose intolerance,
      the hydrogen breath test was reproducible for diagnosis of LD and lactose
      intolerance, and for hydrogen production. The quantity of lactose malabsorbed was
      60 percent. In France, symptoms of lactose intolerance are not severe and do not
      affect the daily consumption of milk and dairy products.

PMID- 1752369
TI  - [Appendectomy, cholecystectomy, cholelithiasis and colorectal cancer. A
      retrospective case control study at the Cote-d'Or].
AB  - Several studies have shown that there might be a relationship between previous
      history of appendectomy or cholecystectomy and the subsequent risk of colorectal
      cancer. In order to investigate these hypotheses, a case-control study was set up
      to compare the history of appendectomy and cholecystectomy as well as the
      presence of cholelithiasis in patients with colorectal carcinoma vs patients with
      gastric carcinoma. The study was performed in the 727 patients included in the
      Registry of Digestive Cancers of the Cote d'Or and treated at the Dijon
      University Hospital during the period 1981-1987. These patients were well matched
      to those of the whole registry population for sex, age, stage, and residence
      distributions. In females, in comparison to the gastric cancer patients, a
      personal history of appendectomy was more commonly observed in case of right
      colonic cancer (odds ratio: 3.5; P less than 0.01) and a personal history of
      cholecystectomy in case of left colonic cancer, in particular when considering
      only those earlier than 10 years (odds ratio: 3.2; P less than 0.05). In
      contrast, the risk of rectal cancer was lower in case of a cholecystectomy
      performed more than 10 years earlier (odds ratio: 0.2; NS) and in case of
      cholelithiasis (odds ratio: 0.4; P less than 0.05). In males, there was no
      difference between cases and controls as for the proportion of appendectomies,
      cholecystectomies or cholelithiasis. These observations are consistent with the
      hypothesis that the appendix as a lymphoid organ plays a protective role in colon
      carcinogenesis, in particular in women.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1752370
TI  - [Does chronic pancreatitis promote duodenal ulcer in men?].
AB  - The aims of this study were to assess the prevalence of duodenal ulcer during
      chronic pancreatitis and the relationship between the occurrence of duodenal
      ulcer and the course of chronic pancreatitis. The population consisted of 264 men
      with chronic pancreatitis, 94 percent of which were of alcoholic origin. Duodenal
      ulcer occurred in 37 patients (14 percent). Fifteen patients with gastric or
      anastomotic ulcer were excluded. The 37 patients with duodenal ulcer were
      compared with 212 patients without ulcer. There was no significant difference
      between the two groups as regards the course of chronic pancreatitis except for
      insulin-dependent diabetes mellitus which was significantly more frequent in
      patients without duodenal ulcer (P less than 0.05). Eight patients with duodenal
      ulcer died but the cause of death was not related to their ulcer. All patients
      with duodenal ulcer and 92 percent of those without were smokers (not
      significant). Duodenal ulcer occurred in 25/37 patients (68 percent) before the
      clinical onset of chronic pancreatitis. The risk of duodenal ulcer occurrence was
      constant in 17-65 year old patients and independent of the time of chronic
      pancreatitis onset. We concluded that in men with chronic pancreatitis: a)
      prevalence of duodenal ulcer is 14 percent; b) duodenal ulcer occurred most often
      before clinical onset of chronic pancreatitis; c) duodenal ulcer occurs
      independently of the course of pancreatitis which cannot account for its high
      prevalence. Smoking may be a promoting factor.

PMID- 1752371
TI  - [Antibiotic-induced gastrointestinal side effects].

PMID- 1752372
TI  - [Treatment of chronic hepatitis C with interferon alpha].

PMID- 1752373
TI  - Efficacy of long term recombinant interferon-alfa in patients with chronic
      hepatitis C. A clinical, biological, histological and immunohistological study.
AB  - A prospective, non randomized trial was conducted in 22 patients with chronic
      hepatitis C treated for 6 months with interferon-alfa at the dose of 3 million
      units three times a week followed by decreasing doses for the following 6 months.
      Transaminase activity measurements were taken at 2, 6, 12, 18, and 24 months and
      a liver biopsy was performed at zero and 6 months to assess efficacy.
      Immunohistochemical study of HLA class I and lymphocyte subsets was performed on
      the biopsy specimen before and after 6 months of treatment. A complete biological
      response was observed in 82, 82, 60, 64 and 70 percent of patients at 2, 6, 12,
      24 and 36 months, respectively. Four patients relapsed including 2 patients who
      suddenly stopped taking interferon-alfa. An improvement of histological features
      was observed in 90 percent of patients for necrosis and in 80 percent of patients
      for inflammation, with an overall improvement in Knodell's score reaching 85
      percent. Immunohistochemical studies showed CD8+ cell infiltration already
      present in the area of necrosis before treatment. These tests also showed that
      HLA class I expression by the hepatocyte membranes was increased at 6 months and
      was identical in patients with or without histological improvement.

PMID- 1752374
TI  - [Rejection in liver transplantation].

PMID- 1752375
TI  - [Polypoid pseudosarcomatous carcinoma of the esophagus. Report of two cases with
      favorable outcome after medical treatment].
AB  - The authors report two cases of esophageal polypoid pseudosarcoma with favorable
      outcome after endoscopic and medical treatment. Neither of the two patients could
      undergo general anesthesia. Endoscopic resection or monopolar electrocoagulation
      of the tumor was associated with chemotherapy and radiation therapy. A complete
      response of the tumor was observed in both cases. The two patients were alive and
      well with no evidence of recurrence or metastasis 3 and 5 years after diagnosis.
      Immunohistochemical study of those two tumors with monoclonal antibodies to
      intermediate filaments (keratin and vimentin) suggests duality in the spindle
      cell component. It may explain the biological behaviour of these particular
      cancers that have a better prognosis than other types of squamous cell carcinomas
      of the esophagus.

PMID- 1752376
TI  - [Analysis of the activities (1985-1991) of the doctoral thesis "Cellular and
      Functional Biology of Digestion"].

PMID- 1752377
TI  - [Successful treatment of fulminant Crohn's colitis with azathioprine].

PMID- 1752378
TI  - Pitfalls in graphical display of 24-hour pH measurement.

PMID- 1752379
TI  - [Efficacy of ursodeoxycholic acid in the treatment of duodenogastric reflux in
      the antrectomized patients].

PMID- 1752380
TI  - [Efficacy of high level cholestyramine therapy in radiation-induced hemorrhagic
      proctitis].

PMID- 1752381
TI  - [Acute hemorrhagic colitis related to oral administration of cephalosporin].

PMID- 1752382
TI  - [Fulminant hepatitis probably induced by medifoxamine (Cledial)].

PMID- 1752383
TI  - [Ascariasis: an unusual cause of cholangitis in our climate].

PMID- 1752384
TI  - [Granulomatous hepatitis following intravesical BCG immunotherapy for cancer of
      the bladder].

PMID- 1752385
TI  - [Surgical treatment of Barrett esophagus].

PMID- 1752386
TI  - [Adjuvant treatment of resected colon cancers using a 5-fluorouracil-levamisole
      combination].

PMID- 1752387
TI  - [Prevention of post-transfusion hepatitis non-A, non-B. Report established by the
      National Agency for the Development of Medical Evaluation on demand of the
      General Health Direction].

PMID- 1752388
TI  - Manometric evaluation of esophageal function in progressive systemic sclerosis
      with special regard to the disease severity.
AB  - A study was conducted to elucidate the relation between the severity of
      progressive systemic sclerosis (PSS) and the grade of esophageal function
      disorder, the extent of which was estimated using esophageal manometry. Fifty two
      patients with PSS were divided into the mild, moderate and severe groups
      according to the severity score established by the PSS Research Group supported
      by The Ministry of Health and Welfare of Japan. Primary peristaltic pressure in
      the esophageal body at 25 to 35cm from the incisors as well as lower esophageal
      sphincter pressure (LESP), which represents the function of the smooth muscle of
      the esophagus, were significantly decreased in parallel with the increasing
      severity of PSS. In contrast, there was no significant difference in upper
      esophageal sphincter pressure (UESP) or in primary peristaltic pressure at 20cm
      from the incisors, indicating that the function of striated muscle of the
      esophagus was not impaired. In addition, even in the mild PSS group without
      dysphagia (19 cases), primary peristaltic pressure in the esophageal body at 25
      to 35cm from incisors was found to be significantly decreased in comparison with
      the control. Hence, esophageal manometry was useful for early detection of the
      pathophysiological state of the esophageal function in PSS.

PMID- 1752389
TI  - A new method of separation and quantitation of mucus glycoprotein in rat gastric
      mucus gel layer and its application to mucus secretion induced by 16,16-dimethyl
      PGE2.
AB  - A method was established for recovering the mucus gel layer of rat gastric mucosa
      without damage to underlying surface epithelium. The mucus gel was solubilized by
      stirring the gastric mucosa in a solution of N-acetylcysteine (NAC), a mucolytic
      agent. Optimal mucus gel solubilization was possible by treatment with 2% NAC for
      5 minutes at room temperature. Mucus glycoprotein was quantitatively extracted
      and measured from the mucus gel sample obtained by the NAC treatment. This
      treatment caused no damage to surface epithelial cells, as observed by a light
      microscope. Besides NAC, pronase solution was also adequate for solubilizing the
      mucus gel layer without any damage to the surface epithelium. However, extraction
      and measurement of mucus glycoprotein from the pronase-treated mucus gel sample
      was not possible due to contamination by high molecular hexose-containing
      substances which were eluted along with the mucus glycoprotein from the column of
      Bio-Gel A-1.5m. This NAC method was used to examine changes in mucus glycoprotein
      content in the mucus gel at one hour following the oral administration of 16,16
      dimethyl prostaglandin E2. A significant increase in mucus glycoprotein of the
      gel was brought about by the prostaglandin treatment. Thus, the present method
      was suitable for estimating the amount of mucus secreted in to the mucus gel
      layer.

PMID- 1752390
TI  - Advanced gastric cancer of the antrum: anatomic-functional correlation between
      chief cell mass and serum pepsinogen I.
AB  - Chief cell mass and type I serum pepsinogen (PGI) were calculated in 19 advanced
      antral gastric cancer of intestinal type. Comparisons were also made with
      parietal cell mass and acid secretion. In gastric cancer of the antrum there is a
      significant decrease of the chief cell mass and of serum pepsinogen I. The
      patients were subdivided according to the histological findings of the fundic
      mucosa. In cases of antral gastric cancer with superficial fundic gastritis there
      is normozymogenism with hyperpepsinogenemy; with preatrophic fundic gastritis
      there is hypozymogenism with normopepsinogenemy; with atrophic fundic gastritis
      there is hypozymogenism with hypopepsinogenemy. Similar behavior of the chief
      cell mass between antral gastric cancer and fundic atrophic gastritis without
      cancer has become recognized and while the validity of PGI as a marker of fundic
      atrophic gastritis has emerged it does not allow discrimination between atrophic
      fundic gastritis and atrophic fundic gastritis associated with gastric cancer of
      the antrum.

PMID- 1752391
TI  - 2',5' Oligoadenylate synthetase activity in peripheral blood mononuclear cells
      and serum during interferon treatment of chronic non-A, non-B hepatitis.
AB  - The 2'-5' oligoadenylate synthetase (2-5 AS) activity of peripheral blood
      mononuclear cells and serum was measured in 23 patients with chronic non-A, non-B
      hepatitis during interferon therapy, 16 of whom were found to have antibody to
      hepatitis C virus (anti-HCV). Patients received a daily dose of either 1 million,
      3 million or 6 million units of human interferon-alpha or -beta for 4 to 6 weeks.
      Before treatment, the 2-5 AS activity was not significantly different from that
      in normal control subjects or patients with chronic hepatitis B. However, during
      treatment the 2-5 AS activity increased 2- to 41-fold from the initial level.
      Alanine aminotransferase (ALT) levels normalized promptly after the start of
      treatment in 15 (65.2%) of the 23 patients, but remained elevated in the
      remaining 8 (34.8%). Six (40%) of the 15 patients showed consistently normal ALT
      levels for 6 to 30 months after the end of treatment. There was no significant
      difference between the responders and non-responders in the pattern of change of
      2-5 AS activity, but pretreatment activity levels in peripheral blood mononuclear
      cells were significantly higher (P less than 0.001) in the patients whose ALT
      levels did not normalize during treatment. The frequency of patients with a
      positive anti-HCV was significantly higher (P less than 0.05) in the group in
      which ALT levels normalized. Therefore, these findings suggest that the
      pretreatment 2-5 AS activity and the detection of anti-HCV may be useful
      parameters for predicting the response to interferon therapy.

PMID- 1752392
TI  - Beneficial effects of fructose-1,6-diphosphate infusion on liver regeneration
      after ischemic liver injury.
AB  - The effect of fructose-1,6-diphosphate (FDP) on cellular viability after partial
      hepatectomy in partial ischemic liver was investigated in rats. The
      administration of FDP did not increase blood flow in the hepatic tissue; however,
      it significantly suppressed the elevation of serum liver functions for 24 hours
      after partial hepatectomy. Levels of DNA synthesis, protein synthesis, and
      labeling index were significantly higher in the groups administered divided doses
      of FDP before and after partial hepatic ischemia than in the control group (P
      less than 0.01). Thus, these findings indicate that FDP has cytoprotective and
      hepatotrophic effects on liver with ischemic injury and that divided dose
      administration of FDP is more effective than bolus doses in decreasing damage
      following ischemic and reperfusion injury.

PMID- 1752393
TI  - Photodynamic therapy using pheophorbide-a and Q-switched Nd:YAG laser on
      implanted human hepatocellular carcinoma.
AB  - To evaluate whether administration of pheophorbide-a, a new photosensitizer,
      followed by use of Q-switched Nd:YAG laser produces a photodynamic reaction, we
      administered pheophorbide-a to female nude mice (BALB/c-nu) that had been
      implanted with human hepatocellular carcinoma. Intra-tumoral concentrations of
      pheophorbide-a were measured by high-performance liquid chromatography. 3 hours
      after peroral administration of 1 mg/kg body weight, the intra-tumoral
      concentration was too low to reveal photodynamic effects. Peroral administration
      of 250 mg/kg body weight, intra-peritoneal administration of 5 mg/kg body weight,
      and intra-tumoral injection of 200 micrograms yielded 0.24 micrograms/g, 0.83
      micrograms/g and 3.68-108 micrograms/g tumor concentrations, respectively. All
      tumors were irradiated interstitially using a Q-switched Nd:YAG laser at 1064 nm.
      Only tumors that had been intra-tumorally injected had areas of necrosis larger
      than those in control tumors. The results suggest that the injection of
      pheophorbide-a followed by interstitial irradiation using a Q-switched Nd:YAG
      laser does not induce sufficient photodynamic reaction if the intra-tumoral
      pheophorbide-a concentration is less than 0.83 micrograms/g tumor tissue, and
      that photodynamic therapy may be useful if the pheophorbide-a tumor concentration
      is within the range of 0.83-108 micrograms/g.

PMID- 1752394
TI  - Novel high-performance liquid chromatography for determination of membrane
      phospholipid composition of rat hepatocytes.
AB  - We have developed a new, quick and efficient method of high-performance liquid
      chromatography (HPLC) for the isolation and quantitative determination of
      phospholipids in hepatocyte membranes. A silica gel column was used for the
      isolation and determination, and an isocratic mixture of acetonitrile, methanol
      and 85% phosphoric acid (130:5:1.7, v/v/v) was used as a mobile phase. Six kinds
      of phospholipids, i.e. phosphatidylinositol (PI), phosphatidylserine (PS),
      phosphatidylethanolamine (PE), phosphatidylcholine (PC), lysophosphatidylcholine
      (LPC) and sphinogomyelin (SPH), in this order, were completely isolated within 45
      min. The phospholipid composition of sinusoidal membrane vesicles (SMV) and
      canalicular membrane vesicles (CMV) obtained from rat liver, as well as of human
      erythrocyte ghosts were determined by this HPLC method. The level of SPH in CMV
      was significantly higher than that in SMV, and the level of PC in CMV was
      significantly lower than that in SMV. These results were considered attributable
      to the low fluidity of CMV. The phospholipid composition of human erythrocyte
      membrane was different from that of rat SMV and CMV. The present technique is
      suitable for quantitative determination of phospholipids in cell membranes.

PMID- 1752395
TI  - Experimental study on the pathogenesis of acute acalculous cholecystitis, with
      special reference to the roles of microcirculatory disturbances, free radicals
      and membrane-bound phospholipase A2.
AB  - To elucidate the pathogenesis of acute acalculous cholecystitis, the gallbladder
      was subjected to ischemia-reperfusion by simultaneously occluding the middle
      hepatic artery and the superior mesenteric vein in dogs, and the degree of
      inflammation and biochemical changes in the gallbladder mucosa were studied by
      varying the duration of ischemia or reperfusion. Ischemia alone did not induce
      cholecystitis either macroscopically and histologically, although it increased
      phospholipase A2 (PLA2) activity, content of lipid peroxide, and superoxide
      dismutase (SOD) activity in the mucosa with prolongation of the ischemic time.
      Cholecystitis was produced in all animals by 45-min ischemia followed by 90-min
      reperfusion as the shortest ischemia and reperfusion times. In this model,
      prolongation of the ischemic time increased the area of mucosal inflammation
      horizontally with increases of the PLA2 activity, content of lipid peroxide, and
      SOD activity, whereas by prolonging the reperfusion time the inflammation area
      spread deeper vertically toward the serosal side with significant increase in the
      mucosal PLA2 activity, content of lipid peroxide, and SOD activity. These results
      revealed that ischemia-reperfusion plays an important role in the pathogenesis of
      acute acalculous cholecystitis, causing the generation of free radicals and the
      activation of membrane-bound PLA2.

PMID- 1752396
TI  - Histological changes of the gallbladder and liver after extracorporeal shock wave
      lithotripsy for gallbladder.
AB  - The histological changes of the gallbladder and liver following extracorporeal
      shock wave lithotripsy (ESWL) were investigated in a canine model. After
      performing ESWL on human cholesterol stones placed in the gallbladder of 8 dogs,
      the gallbladder and livers were removed for pathological study. The mucosa of the
      gallbladder showed erosion and ulceration in three of the eight dogs. Edema and
      bleeding were found in the stroma of the gallbladder beds. Hemorrhagic necrosis
      and vacuolar degeneration occurred in liver parenchyma adjacent to the
      gallbladder bed, but the portal area was fairly well preserved. It can be said
      that ESWL caused damage to both the liver and the gallbladder, but its effects on
      the liver may be only slight because of the preservation of the portal area.

PMID- 1752397
TI  - Multiple diffuse hemangiomas of the large intestine.
AB  - A 54-year-old male case with multiple, diffuse hemangiomas of the large intestine
      is described. Large diffuse hemangiomas were located at the rectosigmoid and the
      ascending colon. Some polypoid lesions were located on the transverse colon. Tiny
      calcifications representing phleboliths were detected in those lesions. No skin
      hemangiomas were present. Although he did not manifest systemic bleeding
      tendency, blood examinations demonstrated the presence of mild consumption
      coagulopathy.

PMID- 1752398
TI  - A case of HBs antigen negative fulminant hepatitis with IgM antibody to hepatitis
      B core antigen persisting more than seven years.
AB  - A 33-year old dentist developed fulminant hepatitis. At admission, a test for IgM
      antibody to hepatitis B core antigen (IgM anti-HBc) was positive, while tests for
      HBsAg and HBeAg were negative. He was cured of the disease, but in follow-up
      examinations from 1983 to 1990 IgM anti-HBc was continuously detected with
      radioimmunoassay while HBsAg and HBV-DNA were absent in the serum. However, HBcAg
      was found in a biopsied liver specimen and a small quantity of HBV-DNA was
      detectable by polymerase chain reaction assay. These observation suggest that the
      continuous detection of IgM anti-HBc without HBsAg in serum is due to persistent
      HBV infection and HBV replication in the liver.

PMID- 1752399
TI  - Insemination of bile duct carcinoma to the liver after insertion of percutaneous
      biliary endoprosthesis.
AB  - Percutaneous transhepatic biliary drainage is widely used to relieve bile duct
      obstruction which can be caused by bile duct or pancreas carcinomas. Although the
      incidence is low, insemination of carcinoma along the transhepatic catheter tract
      is considered to be a serious complication of percutaneous transhepatic biliary
      drainage. The authors present a case of intrahepatic insemination of bile duct
      carcinoma along the catheter that subsequently underwent a curative resection
      consisting of pancreaticoduodenectomy and right hepatic lobectomy. It is
      suggested that a percutaneous biliary endoprosthesis through the tumor should be
      avoided in patients in whom a possible curative resection can be considered.
      External biliary drainage should only be performed in order to minimize the
      manipulation of the tumor in such patients.

PMID- 1752400
TI  - Expression of heat shock protein in human gastric mucosa.

PMID- 1752401
TI  - A solid-phase enzyme-linked immunospot (ELISPOT) assay for detection of
      Helicobacter pylori antibody-producing cells in gastric mucosa.

PMID- 1752402
TI  - Behcet's disease.

PMID- 1752403
TI  - [Study of the effectiveness of artificial oxygen carrier on the hemoglobin base
      in blood loss replacement in dogs].
AB  - The effectiveness of modified polyhemoglobin proposed as an artificial oxygen
      carrier (AOC) was evaluated in experiments on dogs with acute fatal hemorrhage.
      It was shown that total oxygen consumption, arterial blood pressure and
      circulating blood volume were maintained at the normal physiological levels
      during 4 h after infusion of 10% solution of polyhemoglobin. AOC infusion
      provided 100% survival of the animals. It has been concluded that hemoglobin
      polymer modified with pyridoxal-5'-phosphate can be used as the basis for the
      production of the medicinal form of AOC.

PMID- 1752404
TI  - [The oxygen system of an isolated heart during its perfusion with a suspension of
      human erythrocytes after different periods of their preservation in a solution
      containing adenine].
AB  - Seven series of experiments (68 tests) were conducted on an isolated rat heart
      with the functioning left ventricle during its coronary vessels perfusion with
      suspension of human erythrocytes of different storage terms preserved in the
      solution containing citroglucophosphate with adenine. The main parameters of
      hemodynamics and oxygen regimen were evaluated. The results of the study have
      shown that washed human donor erythrocytes preserved in the above solution after
      1, 7, 14, 21 and 28 days of storage present a highly efficient gas-carrying
      medium under conditions of acute anemic hypoxia.

PMID- 1752405
TI  - [Quantitative, functional and cytogenetic characteristics of lymphocytes and
      various indicators of immunity in persons participating in the decontamination
      work at the Chernobyl nuclear power plant].
AB  - Immunologic and cytogenetic investigations conducted in subjects, who had been
      engaged in liquidation of consequences of the Chernobyl NPS catastrophe, during
      the first months after their work was finished, showed decreased content of large
      granulo-containing lymphocytes and serum IgM in the blood, their levels were
      completely recovered 3 years later. A complex of unfavourable factors attending
      radiation (stress, changes in the way of life, chemical actions etc.) played an
      important role in the genesis of these changes.

PMID- 1752406
TI  - [Cell line regulation in hematopoiesis].

PMID- 1752407
TI  - [Plasma cell myeloma. I. A new concept of disease biology].

PMID- 1752408
TI  - [Cell number in the medullary substance of hair: a simple and sensitive indicator
      of exposure to radiation].
AB  - The medulla of the lower regions of a growing mouse hair contains a very
      regularly spaced column of cell nuclei. The total number of nuclei 3 days after
      irradiation in this column (from its lower recognition point to the point of
      terminal differentiation and nuclear degradation) proves to be a sensitive
      indicator of the level of radiation exposure.

PMID- 1752409
TI  - [Transduction of oncogene RAS into antibody-producing hybridoma].
AB  - The effect of introduction by means of electroporation of protogene ras into
      cells of antibody-producing hybridoma was studied. Doubling time (TD) of
      transduced subclones, in which H-ras gene was expressed, proved to be 1.8-fold
      shorter as compared to the parent line. Other characteristics of the hybridoma
      (cloning efficiency, antibody production in vitro, the time of ascitic fluid
      appearance in mice and antibody titer in vivo) were not changed. Addition of 12-0
      tetradecanoylphorbol acetate to the culture did not alter the growth parameters
      of H-ras transduced subclones.

PMID- 1752410
TI  - Qualitative and quantitative genetic studies of Arabidopsis thaliana.

PMID- 1752411
TI  - Pseudoreversion analysis indicates a direct role of cell division genes in polar
      morphogenesis and differentiation in Caulobacter crescentus.
AB  - A pseudoreversion analysis was used to examine the role of cell division genes in
      polar morphogenesis in Caulobacter crescentus. Extragenic suppressors of
      temperature sensitive mutations in pleC, a pleiotropic gene required for cell
      motility, formation of polar phi CbK bacteriophage receptors, and stalk
      formation, were isolated. These suppressors, which restored motility at 37
      degrees C, simultaneously conferred a cold sensitive cell division phenotype and
      they were mapped to the three new cell division genes divJ, divL and divK. The
      cold-sensitive mutations in divL, and to a lesser extent divJ, exhibited a
      relatively narrow range of suppression. The cold-sensitive cell division mutation
      in divK, by contrast, suppressed all pleC mutations examined and behaved as a
      classical bypass suppressor. The direct role of this cell division gene in the
      regulation of motility is suggested by the observation that divK341 mapped to the
      same locus as pleD301, a pleiotropic mutation that prevents loss of motility and
      stalk formation. These results provide strong evidence that the cell division and
      developmental pathways are interconnected and they support our earlier conclusion
      that cell division is required for the regulation of polar morphogenesis and
      differentiation in C. crescentus.

PMID- 1752412
TI  - Seven-base-pair inverted repeats in DNA form stable hairpins in vivo in
      Saccharomyces cerevisiae.
AB  - Palindromic sequences in single-stranded DNA and RNA have the potential for
      intrastrand base pairing, resulting in formation of "hairpin" structures. We
      previously reported a genetic method for detecting such structures in vivo in the
      yeast Saccharomyces cerevisiae. Below, we describe evidence indicating that a 14
      base-pair palindrome (7 bp per inverted repeat) is sufficient for formation of a
      hairpin in vivo.

PMID- 1752413
TI  - New SNF genes, GAL11 and GRR1 affect SUC2 expression in Saccharomyces cerevisiae.
AB  - To identify new genes required for depression of the SUC2 (invertase) gene in
      Saccharomyces cerevisiae, we have isolated mutants with defects in raffinose
      utilization. In addition to mutations in SUC2 and previously identified SNF
      genes, we recovered recessive mutations that define four new complementation
      groups, designated snf7 through snf10. These mutations cause defects in the
      derepression of SUC2 in response to glucose limitation. We also recovered five
      alleles of gal11 and showed that a gal11 null mutation decreases SUC2 expression
      to 30% of the wild-type level. Finally, one of the mutants carries a grr1 allele
      that converts SUC2 from a glucose-inducible gene.

PMID- 1752414
TI  - SUM1-1: a suppressor of silencing defects in Saccharomyces cerevisiae.
AB  - The repression of transcription of the silent mating-type locus HMRa in the yeast
      Saccharomyces cerevisiae requires the four SIR proteins, histone H4 and a
      flanking site designated HMR-E. The SUM1-1 mutation alleviated the need for many
      of these components in transcriptional repression. In the absence of each of the
      SIR proteins, SUM1-1 restored repression in MAT alpha strains; thus, SUM1-1
      appeared to bypass the need for the SIR genes in repression of HMRa. Repression
      was not specific to the genes normally present at HMR, since the TRP1 gene placed
      at HMR was repressed by SUM1-1 in a sir3 strain. Therefore, like the mechanisms
      of silencing normally used at HMR, silencing by SUM1-1 was gene-nonspecific. SUM1
      1 suppressed point mutations in histone H4, but failed to suppress strongly a
      deletion mutation in histone H4. Similarly, SUM1-1 suppressed mutations in the
      three known elements of HMR-E, but was unable to suppress a deletion of HMR-E.
      These epistasis analyses implied that the functions required for repression at
      HMR can be ordered, with the SIR genes and silencer elements acting upstream of
      SUM1-1. SUM1-1 itself may function at the level of chromatin in the assembly of
      inactive DNA at the silent mating-type loci.

PMID- 1752415
TI  - Deletion of SNF1 affects the nutrient response of yeast and resembles mutations
      which activate the adenylate cyclase pathway.
AB  - We have isolated a snf1/ccr1 mutant of Saccharomyces cerevisiae which loses
      viability upon starvation and fails to accumulate glycogen in response to abrupt
      depletion of phosphate or glucose. A snf1 null mutant is sensitive to heat stress
      and starvation and fails to accumulate glycogen during growth in rich medium. The
      phenotypes of the snf1 mutants are those commonly associated with an
      overactivation of the adenylate cyclase pathway. Mutations in adenylate cyclase
      or RAS2 which decrease the level of cAMP in the cell moderate the snf1 phenotype.
      In contrast, a mutation in RAS2 (RAS2val19) which increases the level of cAMP or
      a mutation in the regulatory subunit (BCY1) of cAMP-dependent protein kinase
      which results in unregulated cAMP-dependent protein kinase activity accentuates
      the snf1 phenotype. However, the action of SNF1 in the stress response appears at
      least partly independent of cAMP-dependent protein kinase because a snf1
      phenotype is observed in a strain that lacks all three of the genes that encode
      the catalytic subunits of cAMP-dependent protein kinase. SNF1 therefore acts at
      least in part through a cAMP-independent pathway.

PMID- 1752416
TI  - A mushroom-inducing DNA sequence isolated from the Basidiomycete, Schizophyllum
      commune.
AB  - A DNA sequence capable of inducing the de novo development of fruiting bodies
      (mushrooms) when integrated into the genome of unmated, nonfruiting strains of
      the Basidiomycete Schizophyllum commune has been isolated and partially
      characterized. This sequence, designated FRT1, overrides the normal requirement
      of a mating interaction for fruiting in this organism. It has been shown to
      integrate stably in different chromosome locations and appears to be trans
      acting. It also enhances the normal process of fruiting that occurs after mating.
      Additional DNA sequences with similarity to FRT1 were detected within the genome
      of the strain of origin by hybridization of labeled FRT1 DNA to blots of digested
      genomic DNAs. FRT1 and the genomic sequences similar to it were shown to be
      genetically linked. Southern hybridization experiments suggested sequence
      divergence at the FRT1 locus between different strains of S. commune. A testable
      model for how FRT1 may act as a key element in the pathway for the
      differentiation of fruiting bodies is presented as a working hypothesis for
      further investigation.

PMID- 1752417
TI  - Permanent rescue of a non-Mendelian mutation of Paramecium by microinjection of
      specific DNA sequences.
AB  - The mutant Paramecium tetraurelia cell line d48 is unable to express the serotype
      A protein on its surface. Although the A gene is intact in the micronuclei of
      d48, the A gene copies in the macronucleus contain a large deletion eliminating
      virtually the entire coding sequence. Previous studies showed that microinjection
      of a plasmid containing the entire A gene into the macronucleus of d48
      permanently restored A expression after autogamy. Together with other data, this
      result suggests that in wild type cells the A gene in the old macronucleus
      ensures the presence of a cytoplasmic factor that prevents A gene deletions at
      autogamy. In d48, where there are few, if any copies of the intact A gene in the
      old macronucleus, deletions occur during macronuclear formation. To elucidate the
      specific molecular mechanisms involved in this unusual phenomenon, we attempted
      to define the region(s) of the A gene necessary for rescuing d48. We show that
      microinjection of a 4.5-kb internal A gene fragment is sufficient for proper
      processing at autogamy and leads to permanent rescue of d48; i.e., the rescued
      strain is indistinguishable from wild type. Thus, rescue of d48 does not require
      upstream transcriptional control sequences, intact A mRNA or A serotype protein.
      We also show that various fragments of the A gene have the ability to rescue d48
      to different extents, some being more efficient than others. We find no evidence
      to suggest that the A gene gives rise to a small stable RNA that might act as or
      encode a cytoplasmic factor. Molecular mechanisms that may be involved in the
      rescue of d48 are discussed.

PMID- 1752418
TI  - Genetic analysis of a major segment [LGV(left)] of the genome of Caenorhabditis
      elegans.
AB  - From 10,900 F1 progeny of ethyl methanesulfonate (EMS)-mutagenized Caenorhabditis
      elegans nematodes, we isolated 194 lethal mutations on the left arm of LGV, a
      region balanced by the reciprocal translocation of eT1. The analysis of 166 of
      those mutations resulted in the identification of one deficiency and alleles of
      78 genes including 38 new genes, thus increasing the number of identified
      essential genes to 101. We estimate that there are a minimum of 120 essential
      genes in this region, which comprises approximately 7% of the recombinational
      distance, although only about 4.2% of the genes, in C. elegans. We calculate that
      there are a minimum of 2850 essential genes in the genome. The left arm of LGV
      has two recombinational gene clusters separated by a high-recombination and/or
      essential gene-sparse region. One gene in this region, let-330, is the largest
      EMS target on the left arm of LGV, with twice as many alleles (16) as the next
      most EMS-mutable genes, let-332 and rol-3. Another gene in the sparse region, lin
      40, and the region near lin-40 are major targets for Tc1 mobilization-induced
      mutagenesis. The analysis of essential genes in large regions should help to
      define C. elegans in terms of all its genes and aid in the understanding of the
      relationship of genome structure to genome function.

PMID- 1752420
TI  - Linkage disequilibrium analysis of chromosomal inversion polymorphisms of
      Drosophila.
AB  - The linkage disequilibrium pattern analysis is a method that allows one to detect
      present and past events of selection. We applied it to our data on the inversions
      of Drosophila mediopunctata and to published data of Drosophila subobscura, which
      are systems probably under complex modes of selection. The method gave meaningful
      results showing that it might be an excellent exploratory tool to identify
      problems worthy of further study. It is also suggested that it can be used as a
      criterion to determine the roots of inversion phylogenies.

PMID- 1752419
TI  - Analysis of sequences regulating larval expression of the Adh gene of Drosophila
      melanogaster.
AB  - The effects of a series of eight, 50 base pair internal deletions in the 5'
      region upstream of the proximal transcription start site of the Adh gene of
      Drosophila melanogaster were examined in a quantitative assay. Mixtures of two
      plasmids, one bearing a deleted gene, the other with an intact reference gene,
      were injected into alcohol dehydrogenase-negative embryos. Third instar larvae of
      the injected generation were assayed for relative alcohol dehydrogenase enzyme
      activity. Quantitative analysis of the eight deletions indicated that two regions
      were required for any detectable enzyme activity and one region was required for
      appropriate tissue specificity. The remaining five deletions significantly
      decreased, but did not eliminate activity. When the deleted genes were placed on
      a plasmid with an intact reference gene, activities of all but one deletion were
      restored to levels equivalent to that of the intact reference gene (regardless of
      orientation). This restoration of activity did not occur when the regulatory
      region of the intact gene was replaced with the Hsp70 heat shock promoter nor
      when the 50-base pair deletion encompassed the region that includes the TATA
      sequence. The fact that seven of the eight deleted genes express activity in the
      presence of a reference gene on the same plasmid suggests that the deleted gene
      is controlled by regulatory elements in the reference gene. Further, these
      regulatory elements exhibit no preference for their own, more proximate,
      promoter.

PMID- 1752421
TI  - The effect of DNA sequence polymorphisms on intragenic recombination in the rosy
      locus of Drosophila melanogaster.
AB  - The effect of simple DNA sequence polymorphisms on intragenic recombination in
      the rosy locus of Drosophila melanogaster was assayed. Two crosses were performed
      involving nearly identical molecular distances between selective ry null
      mutations (3778 nucleotides and 3972 nucleotides). In one heterozygote
      (ry606/ry531), in addition to the nucleotide substitution ry- mutations, there
      were 11 simple nucleotide polymorphisms between the selective markers as well as
      additional flanking simple nucleotide polymorphisms within the rosy locus. In the
      other heterozygote (ry606/ry609), there were no additional polymorphisms because
      the two rosy nucleotide substitution mutations were induced on the same rosy
      isoallele (ry+6). From ry606/ry531 heterozygous females, 27 intragenic crossovers
      and five marker conversions were seen among 4.53 x 10(5) progeny. From
      ry606/ry609 heterozygous females, 23 intragenic crossovers and eight marker
      conversions were seen among 4.18 x 10(5) progeny. The intragenic crossover
      frequencies per kilobase of DNA were very similar, 1.6 x 10(-5) for ry606/ry531
      and 1.4 x 10(-5) for ry606/ry609. Thus, simple DNA sequence polymorphisms neither
      inhibit nor promote intragenic recombination in D. melanogaster.

PMID- 1752422
TI  - Embryonic head involution and rotation of male terminalia require the Drosophila
      locus head involution defective.
AB  - We have characterized the head involution defective (hid) locus which is located
      within the chromosomal region 75B8-C1,2. During the morphogenetic reorganization
      of the embryonic head region, hid+ function is necessary for the movement of the
      dorsal fold across the procephalon and clypeolabrum, a process that forms the
      frontal sac. The absence of the frontal sac in the hid mutant embryos affects the
      formation of the dorsal bridge and disrupts the development of the larval
      cephalopharyngeal skeleton. In addition to its embryonic role, this same hid
      function is also required during pupal development for the 360 degrees rotation
      of the male terminalia about the anterior-posterior body axis, and for a late
      step of wing blade morphogenesis. Although the abnormal wing phenotype caused by
      the Wrinkled (W) mutation is quite different from the one resulting from the loss
      of-function hid mutations, the characterization of EMS-induced W revertants
      reveals that W is actually an antimorphic allele of hid.

PMID- 1752423
TI  - Two genetically and molecularly distinct functions involved in early neurogenesis
      reside within the Enhancer of split locus of Drosophila melanogaster.
AB  - Molecular correlation of the genetic aspects of the function of the neurogenic
      gene Enhancer of split [E(spl)] has previously been hampered by the densely
      transcribed nature of the chromosomal region within which it resides. We present
      data indicating that two distinct molecular species contribute to E(spl)
      function. Analysis of new E(spl) alleles has allowed us to define two
      complementing functions within the locus. Subsequent phenotypic analysis of
      different E(spl) deficiencies combined with P element-transformed constructs has
      demonstrated that these two functions correspond to: (1) a family of helix-loop
      helix (HLH) protein-encoding genes and (2) the single copy gene E(spl) m9/10,
      whose product shares homology with G-protein beta subunits. The zygotically
      active E(spl) HLH genes can, at least partially, substitute for one another's
      functions and their total copy number determines the activity of the locus.
      E(spl) m9/10 acts synergistically with the E(spl) HLH genes and other neurogenic
      genes in the process of neurogenesis. The maternal component of E(spl) m9/10 has
      the most pronounced effect in neurogenesis, while its zygotic component is
      predominantly required during postembryonic development. The lethality of trans
      heterozygotes of null E(spl) deficiency alleles with a strong Delta point
      mutation is a result of the concomitant reduction in activity of both E(spl) HLH
      and m9/10 functions. Immunocytochemical localization of the E(spl) m9/10 protein
      has revealed that it is a ubiquitously distributed nuclear component in
      embryonic, larval and imaginal tissues.

PMID- 1752424
TI  - Molecular basis for allelic polymorphism of the maize Globulin-1 gene.
AB  - An abundant protein in maize (Zea mays L.) embryos is a storage globulin encoded
      by the polymorphic Glb1 gene. Several Glb1 protein size alleles and a null allele
      have been described. Here we report the isolation and nucleotide sequence
      analysis of genomic clones corresponding to two Glb1 size alleles (Glb1-L and
      Glb1-S) and to the Glb1-0 null allele. The Glb1-L and Glb1-0 alleles differ from
      Glb1-S by the presence of small nucleotide insertions which are imperfect or
      perfect duplications, respectively, of adjacent sequences. In the case of Glb1-L,
      the insertion is in-frame and results in a protein larger than that encoded by
      Glb1-S, whereas in Glb1-0 the insertion causes a translational frameshift which
      introduces a premature termination codon. Although steady-state levels of Glb1-0
      transcripts are extremely low in Glb1-0/0 embryos, nuclear transcription assays
      indicate that the Glb1-0 gene is transcribed at a level comparable to that of
      Glb1-L. This suggests that the low amounts of Glb1-0 transcripts in the cytoplasm
      may be due to mRNA instability.

PMID- 1752425
TI  - Molecular analysis of the hot spot region related to length mutations in wheat
      chloroplast DNAs. I. Nucleotide divergence of genes and intergenic spacer regions
      located in the hot spot region.
AB  - The nucleotide divergence of chloroplast DNAs around the hot spot region related
      to length mutation in Triticum (wheat) and Aegilops was analyzed. DNA sequences
      (ca. 4.5 kbp) of three chloroplast genome types of wheat complex were compared
      with one another and with the corresponding region of other grasses. The
      sequences region contained rbcL and psaI, two open reading frames, and a
      pseudogene, rpl23' (pseudogene for ribosomal protein L23) disrupted by AT-rich
      intergic spacer regions. The evolution of these genes in the closely related
      wheat complex is characterized by nonbiased nucleotide substitutions in terms of
      being synonymous/nonsynonymous, having A-T pressure transitions over
      transversions, and frequent changes at the third codon position, in contrast with
      the gene evolution among more distant plant groups where biased nucleotide
      substitutions have frequently occurred. The sequences of these genes had diverged
      almost in proportion to taxonomic distance. The sequence of the pseudogene rpl23'
      changed approximately two times faster than that of the coding region. Sequence
      comparison between the pseudogene and its protein-coding counterpart revealed
      different degrees of nucleotide homology in wheat, rice and maize, suggesting
      that the transposition timing of the pseudogene differed and/or that different
      rates of gene conversion operated on the pseudogene in the cpDNA of the three
      plant groups in Gramineae. The intergenic spacer regions diverged approximately
      ten times faster than the genes. The divergence of wheat from barley, and that
      from rice are estimated based on the nucleotide similarity to be 1.5, 10 and 40
      million years, respectively.

PMID- 1752426
TI  - The selection-mutation-drift theory of synonymous codon usage.
AB  - It is argued that the bias in synonymous codon usage observed in unicellular
      organisms is due to a balance between the forces of selection and mutation in a
      finite population, with greater bias in highly expressed genes reflecting
      stronger selection for efficiency of translation. A population genetic model is
      developed taking into account population size and selective differences between
      synonymous codons. A biochemical model is then developed to predict the magnitude
      of selective differences between synonymous codons in unicellular organisms in
      which growth rate (or possibly growth yield) can be equated with fitness.
      Selection can arise from differences in either the speed or the accuracy of
      translation. A model for the effect of speed of translation on fitness is
      considered in detail, a similar model for accuracy more briefly. The model is
      successful in predicting a difference in the degree of bias at the beginning than
      in the rest of the gene under some circumstances, as observed in Escherichia
      coli, but grossly overestimates the amount of bias expected. Possible reasons for
      this discrepancy are discussed.

PMID- 1752427
TI  - Mutation-selection balance and metabolic control theory.
AB  - The evolution of metabolic control is examined with models that unify approaches
      of classical quantitative genetics and metabolic control theory. The quantitative
      traits considered are the activities of enzymes embedded within metabolic
      pathways. In the models, polygenic mutation alters the enzyme activities
      (Vmax/Km) according to prescribed distributions, and the population evolves
      following classical haploid viability selection. Stabilizing selection operates
      on global properties of the metabolic pathway, including either flux or
      metabolite pool concentration. Analytical results and numerical simulations
      demonstrate several important properties of these characters, including skewed,
      non-Gaussian equilibrium distributions, and an expected positive correlation
      between activities of enzymes flanking a substrate pool undergoing stabilizing
      selection. The house-of-cards approximation proved to be accurate in predicting
      the equilibrium distribution of allelic effects for a biologically reasonable
      segment of the parameter space. Further experimental and theoretical work is
      needed before a clear assessment can be made whether the observed variance in
      enzyme activities is explicable by a mutation-selection balance, and this system
      provides an excellent opportunity for such a test.

PMID- 1752428
TI  - Three-locus systems impose additional constraints on pairwise disequilibria.
AB  - Combinations of allele frequencies and pairwise linkage disequilibrium terms,
      each of which is permissible at the two-locus level, may not always be
      permissible at the three-locus level. These additional constraints on the
      possible maximum and minimum values for the pairwise disequilibrium terms are
      formally determined and numerically analyzed. In some cases, the three-locus
      constraints on a pairwise disequilibrium (D) may be equivalent to the usual two
      locus constraints, while in others, the positive or negative range may be
      restricted. This can result in situations where the allowable values of D are
      limited to only positive or only negative values up to the extreme case where
      there is only a single admissible value. No additional restrictions are placed on
      pairwise disequilibrium values when four loci are considered, other than those
      imposed by the three-way combinations containing the two loci of interest. A new
      measure of normalized pairwise linkage disequilibrium, allowing for the three
      locus constraints, is defined and illustrated by an application to data from the
      human histocompatibility antigen (HLA) system. An analogous normalized three-way
      disequilibrium measure is also formulated.

PMID- 1752429
TI  - Selection, hitchhiking and disequilibrium analysis at three linked loci with
      application to HLA data.
AB  - The HLA system has been extensively studied from an evolutionary perspective.
      Although it is clear that selection has acted on the genes in the HLA complex,
      the nature of this selection has yet to be fully clarified. A study of
      constrained disequilibrium values is presented that is applicable to HLA and
      other less polymorphic systems with three or more linked loci, with the purpose
      of identifying selection events. The method uses the fact that three locus
      systems impose additional constraints on the range of possible disequilibrium
      values for any pair of loci. We have thus examined the behavior of the normalized
      pairwise disequilibrium measures using two locus (D'), and also three locus (D"),
      constraints on pairwise disequilibria in a three locus system when one of the
      three loci is under positive selection. The difference between these measures,
      delta = magnitude of D' - magnitude of D", has a distribution for the two
      unselected loci differing from that for the selected locus with either of the
      unselected loci (the hallmark is a high positive value of delta for the two
      unselected loci). An examination of genetic drift indicates that positive delta
      values are unlikely to be found in human populations in the absence of selection
      when recombination is greater than about 0.1%. This measure can thus provide
      insight into which allele of several linked loci might have been subject to
      selection. Application of this method to HLA haplotypes from a large French
      population study (Provinces Francaise) identifies selected alleles on particular
      haplotypes. Application of a complementary method, disequilibrium pattern
      analysis also confirms the action of selection on these haplotypes.

PMID- 1752430
TI  - Age-dependent sexually asymmetric selection: the use of intrinsic values.
AB  - To study the evolutionary role played by differential male and female fertility
      (sexual asymmetry) both between individuals and over the life span within single
      individuals, the terms "intrinsic male fertility" and "intrinsic female
      fertility" are introduced. With the help of these terms, the concept of sexual
      asymmetry can be made precise and its effect on the establishment and maintenance
      of genetic polymorphisms can be analyzed. The main conclusions are: (1) any
      mutant causing a modification of the male fertility parameters which result in an
      increased intrinsic male fertility becomes established; (2) a corollary of this
      is that age-specific sexual asymmetry, as results from alternating degrees of
      female and male flowering in successive reproduction cycles, for example, has
      only secondary effects on the initial growth rate; (3) under the biologically
      reasonable premise that modifications of life histories result from reallocation
      of fixed net reproduction resources (defined as constant total female and male
      net reproduction output), a shift of net reproduction (whether female, male, or
      both in arbitrary proportions) to earlier ages is evolutionarily successful in
      growing but not in declining populations; shifts of net reproduction to later
      ages have opposite consequences.

PMID- 1752431
TI  - Transient mutators: a semiquantitative analysis of the influence of translation
      and transcription errors on mutation rates.
AB  - A population of bacteria growing in a nonlimiting medium includes mutator
      bacteria and transient mutators defined as wild-type bacteria which, due to
      occasional transcription or translation errors, display a mutator phenotype. A
      semiquantitative theoretical analysis of the steady-state composition of an
      Escherichia coli population suggests that true strong genotypic mutators produce
      about 3 x 10(-3) of the single mutations arising in the population, while
      transient mutators produce at least 10% of the single mutations and more than 95%
      of the simultaneous double mutations. Numbers of mismatch repair proteins
      inherited by the offspring, proportions of lethal mutations and mortality rates
      are among the main parameters that influence the steady-state composition of the
      population. These results have implications for the experimental manipulation of
      mutation rates and the evolutionary fixation of frequent but nearly neutral
      mutations (e.g., synonymous codon substitutions).

PMID- 1752432
TI  - Multistage selection for genetic gain by orthogonal transformation.
AB  - An exact transformed culling method for any number of traits or stages of
      selection with explicit solution for multistage selection is described in this
      paper. This procedure does not need numerical integration and is suitable for
      obtaining either desired genetic gains for a variable proportion selected or
      optimum aggregate breeding value for a fixed total proportion selected. The
      procedure has similar properties to multistage selection index and, as such,
      genetic gains from use of the procedure may exceed ordinary independent culling
      level selection. The relative efficiencies of transformed to conventional
      independent culling ranged from 87% to over 300%. These results suggest that for
      most situations one can chose a multistage selection scheme, either conventional
      or transformed culling, which will have an efficiency close to that of selection
      index. After considering cost savings associated with multistage selection, there
      are many situations in which economic returns from use of independent culling,
      either conventional or transformed, will exceed that of selection index.

PMID- 1752433
TI  - p53 alteration is a common event in the spontaneous immortalization of primary
      BALB/c murine embryo fibroblasts.
AB  - It has been shown previously that mutant p53 can act as an immortalizing gene
      when cotransfected into primary rat embryo fibroblasts along with a selectable
      marker. To determine whether a mutation at the p53 locus is a common event in the
      pathways leading to spontaneous cellular immortalization, 11 clonally derived
      BALB/c murine embryo fibroblast lines were established by passage on a 3T3
      schedule and examined for p53 alterations. By the following criteria, all 11
      independently established lines contain at least one mutant allele of p53. Seven
      of these lines have a PAb240-reactive p53 species and exhibit an extended p53
      half-life as determined by pulse-chase analysis. The p53 protein species in a
      subset of these lines is also capable of complex formation with the constitutive
      heat shock protein hsc70. p53 cytoplasmic DNAs (cDNAs) from several of these
      lines have been cloned by reverse transcription of cytoplasmic RNA followed by
      PCR amplification, and the mutations have been mapped by DNA sequence analysis.
      Point mutation in conserved domains of p53 appears to be a common alteration in
      these lines, although one established line carries a 24-bp in-frame deletion of
      p53. The remaining four cell lines do not express detectable p53 protein. For
      each line there is a different molecular event underlying the lack of p53
      expression: (1) deletion of at least the first 6 exons of both p53 alleles; (2)
      expression of a single p53 mRNA encoding a stop codon at amino acid position 173;
      (3) no detectable p53 mRNA; and (4) greatly diminished expression of p53 mRNA.
      These findings indicate that p53 alteration commonly occurs in spontaneously
      immortalized BALB/c mouse embryo fibroblasts passaged on a 3T3 schedule and,
      therefore, may be an important event for the immortalization process.

PMID- 1752434
TI  - Molecular cloning of a member of a new class of low-molecular-weight GTP-binding
      proteins.
AB  - We report the cloning of a low-molecular-weight GTP-binding protein that appears
      to be the first member of a new class of G proteins. This G protein was cloned
      from the HT4 neural cell line and has the closest homology to the rab, sec4, and
      ypt1 members of the low-molecular-weight (LMW) G-protein family. The amino acid
      sequence identity is only 30% with these other LMW G proteins, but in the four
      conserved GTP-binding domains, amino acid identity increases to 50-100%. A unique
      feature that distinguishes this G protein from other LMW G proteins is its
      carboxy-terminal amino acid sequence -Cys-Cys-Pro. In keeping with the current
      nomenclature for other members of the ras superfamily, we will designate this new
      class as rah (ras-related homolog). On the basis of sequence homology, rah may
      function in vesicular trafficking and possibly in neurotransmitter secretion.

PMID- 1752435
TI  - A meiosis-specific protein kinase homolog required for chromosome synapsis and
      recombination.
AB  - The mek1 (meiotic kinase) mutant of Saccharomyces cerevisiae was isolated in a
      screen for sporulation-proficient, meiotic-lethal mutants. Diploids homozygous
      for a mek1 null mutation produce only 13% viable spores. mek1 spore inviability
      is rescued by a spo13 mutation, which causes cells to bypass the meiosis I
      division. In a mek1 null mutant, meiotic recombination is reduced but not
      completely eliminated. Nuclear spreads of meiotic chromosomes from mek1 diploids
      reveal numerous stretches of synaptonemal complex (SC) that are shorter than wild
      type SCs. Analysis of a mek1::lacZ fusion gene and Northern blot hybridization
      demonstrate that the MEK1 transcript is present only in meiosis. The sequence of
      the MEK1 gene predicts a 56.8-kD protein with homology to serine-threonine
      protein kinases. The MEK1 gene maps to chromosome XV, 13 cM proximal to CDC64.
      Models for the function of the MEK1 gene product are proposed.

PMID- 1752436
TI  - A new role for MCM1 in yeast: cell cycle regulation of SW15 transcription.
AB  - In the yeast Saccharomyces cerevisiae cell cycle-regulated SW15 transcription is
      essential for ensuring that mother and not daughter cells switch mating type. We
      have identified a 55-bp promoter sequence that appears to be responsible for
      restricting transcription to the late S, G2, and M phases of the cell cycle. Two
      proteins, MCM1, a transcription factor described previously, and SFF (SWI five
      factor, a newly identified factor) bind this sequence in vitro. MCM1 binds the
      DNA tightly on its own, but SFF will only bind as part of a ternary complex with
      MCM1. We observe a strong correlation between the ability of mutated SWI5
      promoter sequences to form a ternary MCM1-SFF-containing complex in vitro and to
      activate transcription in vivo, which suggests that efficient transcription
      requires that both proteins bind DNA. Through its interactions with cell type
      specific coactivators and corepressors, MCM1 controls cell type-specific
      expression of pheromone and receptor genes. By analogy, we propose that SFF
      enables MCM1 to function as a part of a cell cycle-regulated transcription
      complex.

PMID- 1752437
TI  - RNA polymerase II carboxy-terminal domain contributes to the response to multiple
      acidic activators in vitro.
AB  - The largest subunit of RNA polymerase II contains a unique carboxy-terminal
      domain (CTD) that consists of repeats of the heptapeptide YSPTSPS. RNA polymerase
      II CTD truncation mutations affect the ability to induce transcription of a
      subset of yeast genes in vivo, and the lack of response to induction maps to the
      upstream activating sequences of these genes. Here, we report that progressive
      truncation of the yeast RNA polymerase II CTD causes progressive loss of trans
      activator-dependent transcription in nuclear extracts but has little effect on
      elongation or termination. Specific transcription, which is reduced by up to 50
      fold in these assays, can be restored in the defective nuclear extracts by adding
      purified wild-type RNA polymerase II. The defects in factor-dependent
      transcription are observed with templates that are assembled into nucleosomes as
      well as with templates that are not so assembled. Defects in factor-independent
      transcription are also observed, but these are not as profound as those observed
      in the presence of trans-activators. These results indicate that the RNA
      polymerase II CTD functions during transcription initiation and is required for
      normal levels of activated transcription in vitro.

PMID- 1752438
TI  - Protein encoded by the exuperantia gene is concentrated at sites of bicoid mRNA
      accumulation in Drosophila nurse cells but not in oocytes or embryos.
AB  - Formation of the anteroposterior gradient of the bicoid (bcd) protein morphogen
      in Drosophila occurs as a consequence of the prelocalization of bcd mRNA to the
      anterior pole of the oocyte. bcd mRNA localization requires at least three genes,
      with the exuperantia (exu) gene acting earliest in the pathway. We have cloned
      and characterized the exu gene. Notably, we find that exu protein is colocalized
      with bcd mRNA during the early phase of localization, when bcd mRNA is positioned
      at the apical regions of the nurse cells. However, there is no colocalization at
      the later stage when bcd mRNA is transferred from the nurse cells to the anterior
      pole of the oocyte. There is no detectable exu protein in embryos. Therefore, exu
      acts only in initiating bcd mRNA localization and does not play a persistent role
      in that process.

PMID- 1752439
TI  - Control of Drosophila wing and haltere development by the nuclear vestigial gene
      product.
AB  - The Dipteran flight appendages, the wings and halteres, develop from larval
      imaginal discs that also produce other sections of the second and third thoracic
      adult body segments. Loss of vestigial (vg) function in Drosophila selectively
      eliminates wing and haltere formation. Here, we show that vg expression is
      spatially restricted to the presumptive wing and haltere regions of these
      imaginal discs. An intronic regulatory element mediates this restriction and may
      elaborate upon cues that activate vg expression in the embryonic disc primordia.
      The nuclear vg protein lacks any recognized nucleic acid-binding motif but is
      comprised of two putative functional domains, one of which bears similarity to
      part of the Deformed homeotic protein and may mediate protein-protein
      interactions. These results suggest that vg is directly involved in determining
      which thoracic imaginal disc cells will form wings and halteres, perhaps by
      interacting with other nuclear regulatory proteins.

PMID- 1752440
TI  - The HIV-1 Tat protein activates transcription from an upstream DNA-binding site:
      implications for Tat function.
AB  - The Tat protein of human immunodeficiency virus type 1 (HIV-1) activates
      transcription following binding to nascent trans-activation response (TAR) RNA
      downstream of the transcription start site. Because Tat functions when bound to
      RNA, and in a position-dependent manner, it has been proposed that Tat works by a
      novel mechanism. Here, we perform a series of protein fusion experiments that
      reveal striking similarities between Tat and conventional cellular activators.
      Most significantly, we demonstrate that Tat can function when bound to upstream
      promoter DNA. This activity depends on a region within Tat that is also required
      for Tat to function when bound to TAR RNA. In contrast, the arginine-rich region
      of Tat, which is required for binding to TAR RNA, is dispensable for the function
      of DNA-bound Tat. When bound either to RNA or DNA Tat activity requires
      cooperation with promoter-bound cellular transcription factors. Finally, we show
      that Tat and a strong acidic activator stimulate transcription to comparable
      levels. On the basis of these and other results we suggest that Tat and acidic
      activators act on a similar step in the transcription process.

PMID- 1752441
TI  - Two distinct nuclear transcription factors recognize loop and bulge residues of
      the HIV-1 TAR RNA hairpin.
AB  - Transcriptional activation by the HIV-1 Tat protein requires specific residues in
      the hexanucleotide loop and trinucleotide bulge of the TAR RNA stem-loop
      structure found in the 5'-untranslated leader of all viral transcripts. Tat
      directly contacts residue U22 in the bulge and is thought to act in concert with
      cellular factors bound to the loop. We find that HeLa nuclear extracts contain
      two specific TAR RNA-binding proteins, designated TRP-1 and TRP-2, which compete
      for binding to the upper portion of the TAR hairpin. Analysis of point mutants in
      TAR RNA reveals that TRP-1 contacts residues in the loop that are important for
      trans-activation, whereas TRP-2 contacts the bulge, including the same residue
      (U22) that is required for the Tat-TAR interaction. Glycerol gradient
      sedimentation and UV cross-linking experiments indicate that TRP-1 is a large
      heteromeric complex containing a 185-kD RNA-binding protein, whereas TRP-2
      activity derives from a family of 110- to 70-kD proteins. Interestingly, both TRP
      1 and TRP-2 promote TAR-dependent transcription in vitro in the presence of Tat,
      although mixing experiments indicate that each of the three proteins must bind
      independently to TAR RNA. These findings suggest that the TAR element is
      recognized by two different nuclear RNA-binding proteins that affect
      transcriptional regulation by Tat.

PMID- 1752442
TI  - Efficient association of U2 snRNPs with pre-mRNA requires an essential U2 RNA
      structural element.
AB  - To understand the role of U2 RNA structure in pre-mRNA splicing we have
      characterized several cold-sensitive mutations in an essential stem-loop of yeast
      U2. Although mutant U2 is stable in vivo after a shift to restrictive
      temperature, splicing is rapidly inhibited, suggesting a direct effect on U2
      function rather than U2 synthesis or snRNP assembly. Splicing complexes form at
      23 degrees C in both mutant and wild-type extracts; however, stable association
      of mutant U2 snRNPs with pre-mRNA in vitro is inefficient at 15 degrees C, a
      temperature permissive for spliceosome assembly in wild-type extracts, indicating
      that the cold-sensitive defect is in U2 snRNP association with the assembling
      spliceosome. In vivo RNA structure probing reveals that the bulk of U2 RNA is
      misfolded in the mutants, even at permissive temperature. We propose that U2 stem
      loop IIa is recognized by an assembly factor that assists U2 snRNP binding to pre
      mRNA and that the cold sensitivity is due to a critical deficiency of correctly
      folded U2 for spliceosome assembly at low temperatures. Evolutionary conservation
      of the potential to form an interfering alternative RNA structure suggests the
      possibility that splicing could be regulated negatively at an early step by
      control of U2 snRNA conformation.

PMID- 1752443
TI  - Altered gene expression correlates with DNA structure.
AB  - We examined the participation of triplex DNA structure in gene regulation using a
      poly(dG)-poly(dC) sequence as a model. We show that a poly(dG)-poly(dC) sequence,
      which can adopt an intramolecular dG.dG.dC triplex under superhelical strain,
      strongly augments gene expression when placed 5' to a promoter. The activity of
      this sequence exhibits a striking length dependency: dG tracts of 27-30 bp
      augment the expression of a reporter gene to a level comparable to that observed
      with the polyoma enhancer in mouse LTK- cells, whereas tracts of 35 bp and longer
      have virtually no effect. A supercoiled plasmid containing a dG tract of 30 bp
      competes in vivo for a trans-acting factor as revealed by reduction in the
      reporter gene transcription driven by the (dG)29/promoter of the test plasmid,
      while dGs of 35 bp and longer in the competition plasmid failed to compete. In
      purified supercoiled plasmid DNA at a superhelical density of -0.05, dG tracts of
      32 bp and longer form a triplex, whereas those of 30 bp and shorter remain double
      stranded under a PBS solution. These results suggest that a localized
      superhelical strain can exist, at least transiently, in mouse LTK- cells, and
      before being relaxed by topoisomerases this rapidly induces dG tracts of 35 bp
      and longer to adopt a triplex preventing the factor from binding. Thus, these
      data suggest that a poly(dG)-poly(dC) sequence can function as a negative
      regulator by adopting an intramolecular triple helix structure in vivo.

PMID- 1752444
TI  - DNA-binding properties of the HMG domain of the lymphoid-specific transcriptional
      regulator LEF-1.
AB  - Lymphoid enhancer-binding factor 1 (LEF-1) is a pre-B and T lymphocyte-specific
      nuclear protein that participates in the regulation of the T-cell antigen
      receptor (TCR) alpha enhancer by binding to the nucleotide sequence 5'-CCTTTGAA.
      LEF-1 protein shares with the nonhistone high mobility group protein 1 (HMG-1)
      and several transcriptional regulators a single region of amino acid homology,
      termed the HMG box, which has been implicated in DNA binding. Here, we report the
      biochemical analysis of the interaction of this novel structural motif with DNA.
      First, amino- or carboxy-terminal truncations of the LEF-1 polypeptide delineated
      the HMG box as the DNA-binding domain. We purified to homogeneity a LEF-HMG
      domain peptide expressed in Escherichia coli and determined the equilibrium
      constant for specific binding to DNA as 1 x 10(-9) M. Second, cotranslation of
      wild-type and various truncated LEF-1 polypeptides did not generate any DNA
      binding heterodimers, suggesting that LEF-1 can bind DNA as a monomer. Third,
      methylation interference analysis indicated that the HMG domain specifically
      contacts DNA on one side of the double helix. Finally, changes of amino acids
      that are conserved among various members of the family of HMG-box proteins
      decreased the affinity of DNA binding by one to three orders of magnitude.
      Together, these data define the characteristics of specific DNA-binding by the
      HMG domain of LEF-1.

PMID- 1752445
TI  - [Pregnancy in adolescence. A review of 840 clinical cases].
AB  - Pregnancy during adolescence is a medical problem and a social phenomenon of
      increasing importance. Opportune medical care may resolve pregnancy risk, but the
      lacks of this stage of life, and the lack of resources of certain communities,
      may frustrate the mother's desires, in such a way, that pregnancy in adolescence,
      will mean more a social problem than a medical one.

PMID- 1752446
TI  - [Sexuality and reproduction. A questionnaire at the basic secondary educational
      level].
AB  - A 50 question survey was administered to 362 junior high school students in order
      to determine the level of sexual education. The objectives were to determine the
      themes of most interest to the students, to establish the precise participation
      of the school in sexual education, to define quality in teachers and to find
      possible differences in knowledge and attitudes according to school grade and
      sex. As expected, age but not sex, differed according to grades. Parents
      participated in the sexual education in their children in 50% of the sample; the
      high level of education of the majority of this group of parents will permit the
      development of additional programs for their participation in school related
      programs for sexual education. Sexual attitudes among students did not differ
      according to school grade. The percentage of responses about sexuality and
      reproduction that corresponded to materials in the curriculum was low; eighth
      grade students showed superior knowledge about theory, ninth grade students were
      superior in knowledge of more practical aspects. The principal sources of sexual
      education in this group were parents and teachers, 81% of the students reported
      having received some sexual education in the school, 51.4% as part of natural
      sciences course material and 12% as part of the eight grade course in social and
      human relations. We suggest a strategy of presenting progressively more complex
      materials of sexual education by grade in order to influence not only sexual
      attitudes but preventive sexual practices as well.

PMID- 1752447
TI  - [Nongynecological surgical procedures performed by an oncological gynecology
      service].
AB  - From March, 1987 to July 1990, 1,568 surgical procedures, were done at
      Oncological Gynecology Service; 206 of them (13.1%) were considered as "non
      gynecological" surgical procedures; 182 (88.3%) were secondary to a malignity
      diagnosis, being the most frequent one ovarian carcinoma (54.4%). As to benign
      lesions, 11.7% caused "non gynecological" surgery, most frequent were severe
      pelvic adhesions, 41.6%, and severe endometriosis, 25%. "Non-gynecological"
      surgical procedure carried out most frequently was pelvic lymphadenectomy.
      Morbidity was 3.8%, and mortality, 0.48% due to acute myocardial infarction. The
      acceptance for oncologic gynecologist is justified in this series, based on
      survival and morbi-mortality, which permits the participation in a
      multidisciplinary team.

PMID- 1752448
TI  - [Stress urinary incontinence. Its surgical management].
AB  - Ninety eight patients with stress urinary incontinence treated surgically at
      Central Military Hospital, were studied. We analyzed the risk factors as age,
      weight, height, parity, menopause age, and previous medical and surgical
      procedures. They were divided in two groups. The Group I, vaginal approach, with
      35 patients and Group II, retropubic surgery, with 63 patients. There were no
      differences both groups regarding age, weight, height, parity and menopausal age.
      The most frequent illness associated with stress urinary incontinence, was pelvic
      floor relaxation. The complications were 17.1% and 33.3%, respectively. The
      efficacy of Burch is procedure for the management of stress urinary incontinence,
      with a success rate of 84.1% versus 62.1% in the vaginal approach, was confirmed.

PMID- 1752449
TI  - [The role of hyperpolarization and depolarization of the membrane of the human
      spermatozoon].
AB  - The electric potential across the membrane (psi) is evaluated through the
      accumulation of the lipophilic, radiolabelled, triphenylmethylphosphonium (3H
      TPMP+), cation on membrane human sperm. The washed sperm cells, were incubated in
      presence of 3H-TPMP+ in low-K+ medium or high-K+ and allowed to take up the
      cation to steady-state (ie; 20 min at 37 degrees C). By using this differential,
      the value obtained was inserted in the Nernst equation, this value yielded a psi
      of -69 +/- 2 mV. The presence of divalent cations Zn++ and Mg++ in the incubation
      medium both induced a hyperpolarization of 10% and 8.6%, respectively. The
      addition of specific reagents such as p-chloromercuribenzene-sulfonate and
      ethylene-diamine-tetraacetic acid sodium salt both decreased the psi 35% and 58%
      respectively. The agents to act upon the components of the sperm cell membrane
      such as the dithiothreitol and progesterone induced hyperpolarization and
      depolarization of the membrane 16% and 40%, respectively. The presence of
      propranolol and L-alpha-lysophosphatidylcholine, which affect the ionic gradients
      present across the plasma membrane, both induced a depolarization from 43% and
      92% respectively. Finally, the addition of tetraphenylboron (TPB-) on the
      incubation medium, enhanced the value of the psi 75%. These studies are
      transcendent because with the utilization of agents depolarizing, or
      hyperpolarizing we obtain changes in the psi from -80 +/- 0.6 mV, until -6 +/-
      0.6 mV changes of 74 +/- 1.5 mV across of the sperm cell membrane.

PMID- 1752450
TI  - [Serum concentrations of estradiol and testosterone in patients with
      oligoasthenozoospermia and asthenozoospermia].
AB  - In order to study the possible influence of circulating concentrations of
      estradiol (E2) and testosterone (T) on the spermatogenesis, 43 subjects, 21 to 43
      years of age; 16 of them with oligoasthenozoospermia; 16 with "pure"
      asthenozoospermia, and 11 with normal semen study, were studied. This last group
      was taken as control for results evaluation and comparison. In all the cases, the
      presence of genitourinary infection, as well as testicular lesions and
      varicocele, was previously discarded. Serum concentrations of estradiol,
      testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH) and
      prolactin (PRL), were determined by radio-analysis, in fasting blood samples. The
      results are shown as average values +/- standard error (mean +/- SE). Statistical
      analysis of differences between the groups, was done by "t" Student test in
      paired samples. Patients with oligoasthenozoospermia showed a significant
      increase (56.9%) (less than 0.001) in estradiol circulating levels, while T, FSH,
      LH and PRL concentrations were below normal band, and there were not significant
      differences between the three groups. These results suggest that the excess of
      estradiol or of some of its metabolites could affect normal production of
      spermatozoa, maybe due to a direct effect on germinal epithelium of testicle.

PMID- 1752451
TI  - Neurochemistry of hepatic encephalopathy.

PMID- 1752452
TI  - Systematic comparison of conventional oesophageal manometry with oesophageal
      motility while eating bread.
AB  - Conventional oesophageal manometry is seldom accompanied by symptoms and may
      indeed be normal in patients with a history of dysphagia. We have recently shown
      that oesophageal manometry during eating may be helpful in the evaluation of
      patients with dysphagia but there has been little systematic comparison of fed
      oesophageal motor patterns with conventional clinical manometry. Oesophageal
      manometry in response to water swallows and during eating was therefore examined
      in 58 consecutive patients who had been referred for clinical oesophageal
      function studies. The patients were divided into three groups according to the
      percentage of peristaltic activity during conventional manometry: group 1 (n =
      21) had 100% peristalsis; group 2 (n = 29) had 1-99% peristalsis and group 3 (n =
      8) were aperistaltic. All the patients in group 3 had achalasia and remained
      aperistaltic during eating, however, was less than with water swallows in both
      group 1 (53% compared with 100%) and group 2 (49% compared with 82.3%) patients.
      Synchronous contractions and non-conducted swallows were correspondingly
      increased during eating. Although there was a significant correlation between the
      amplitude of peristaltic contractions with water and bread in groups 1 and 2,
      mean peristaltic amplitudes were less with bread than with water swallows. The
      data show that there are substantial differences in the distal oesophageal
      motility patterns produced by water swallows and by eating. Conventional
      manometry with water swallows does not allow prediction of the fed oesophageal
      motility pattern, except in patients with achalasia.

PMID- 1752453
TI  - Ambulatory 23 hour recording of intraoesophageal pressures in normal volunteers:
      a propagation analysis from one proximal and two distal recording sites.
AB  - pH data were obtained from one level and pressure data from three levels in the
      oesophagus over 23 hours in 24 healthy volunteers, followed by automatic
      propagation analysis of motility data and analysis of time with pH less than 4.
      Apart from periods of meal ingestion, isolated pressure complexes were found more
      frequently in the distal than in the proximal oesophagus. This was especially
      common in the recumbent position at night. Most contractions of the proximal
      oesophagus were propagating. In the distal oesophagus were propagating. In the
      distal oesophagus propagating pressure waves were more frequent during the day
      than during the night and most frequent during meals. The state of consciousness
      rather than body position per se is important in determining the frequency of
      simultaneous contractions in the distal oesophagus.

PMID- 1752454
TI  - Sleep and nocturnal acid reflux in normal subjects and patients with reflux
      oesophagitis.
AB  - Nocturnal gastro-oesophageal reflux may be important in the pathogenesis of
      reflux oesophagitis. This study aimed to determine whether: (1) gastro
      oesophageal reflux occurs during sleep in patients with reflux oesophagitis and,
      if so, to explore the mechanism, and (2) the sleep pattern of patients with
      oesophagitis is different from that of control subjects. After a standard evening
      meal, simultaneous manometric, oesophageal pH, and polysomnographic recordings
      were obtained in 11 patients with endoscopic oesophagitis and 11 control
      subjects. Patients with gastrooesophageal reflux disease had significantly more
      total reflux episodes throughout the nocturnal monitoring period than control
      subjects (105 v 6). Ninety two of 105 episodes of gastro-oesophageal reflux in
      patients occurred during the awake state and 10 during sleep stage II. A number
      of reflux episodes occurred during brief periods of arousal from the various
      sleep stages. Of the 105 reflux events recorded in patients, 42 were induced by
      transient lower oesophageal sphincter relaxation, 20 by stress reflux, 22 by free
      reflux mechanisms, and in 21 the mechanism was unclear. The sleep pattern and the
      time spent in each sleep stage was not different between the two groups. It is
      concluded that the awake state is crucial for the occurrence of nocturnal reflux
      episodes in normal subjects as well as in patients with reflux oesophagitis and
      that the difference between the frequency of gastro-oesophageal reflux between
      normal subjects and patients cannot be explained by different sleep patterns.

PMID- 1752455
TI  - Healing and prevention of relapse of reflux oesophagitis by cisapride.
AB  - Altogether, 138 patients were included in a study aimed at evaluating the effect
      of cisapride on healing and relapse of oesophagitis shown endoscopically. In the
      first phase of the study cisapride was given in an open fashion at 10 mg four
      times a day for 8 to 16 weeks, and healing was obtained in 69% of patients.
      Healing occurred later in patients with grades II to IV oesophagitis. The total
      score for reflux symptoms decreased by 67%. Eighty of the healed patients were
      included in the second phase. They were randomly assigned to double blind
      treatment with either cisapride 10 mg (n = 37) or placebo (n = 43) twice a day.
      Control endoscopy was performed when symptoms recurred or at the end of the six
      month trial. The cumulative percentage of patients in remission was higher (p =
      0.06, survival analysis) in the cisapride group than in the placebo group, the
      relapse rates being 20% and 39%. The duration of remission tended to be longer in
      patients with a lower initial degree of oesophagitis. Adverse effects were no
      more frequent with cisapride than with placebo. In conclusion, cisapride is
      efficacious in healing oesophagitis, and, unlike other gastrointestinal
      prokinetic drugs or low dose cimetidine (400-800 mg daily) or ranitidine (150 mg
      daily), it may prevent relapse of oesophagitis.

PMID- 1752456
TI  - Is Helicobacter pylori associated hypergastrinaemia due to the bacterium's urease
      activity or the antral gastritis?
AB  - Eradication of Helicobacter pylori is associated with a fall in serum gastrin but
      the way in which the infection raises the serum gastrin concentration is not
      clear. It may be related to the ammonia produced by the bacterium's urease
      stimulating gastrin release by the antral G cells. Alternatively, the antral
      gastritis induced by the infection may modify the regulation of gastrin release.
      We have examined serum gastrin in 10 patients before and 24 hours after starting
      triple anti-H pylori treatment consisting of tripotassium dicitrato bismuthate
      120 mg four times daily, metronidazole 400 mg three times daily, and amoxycillin
      500 mg three times daily. The urease activity, assessed by the 20 minute value of
      the 14C-urea breath test, fell from a median of 176 (range 116-504) kg% dose/mmol
      CO2 x 100 pretreatment to 5 (2-15) at 24 hours (p less than 0.005). The median
      antral gastritis score was 6 (4-6) pretreatment and fell to 3 (2-5) at 24 hours
      (p less than 0.02), and this was due to resolution of the polymorphonuclear
      component. Despite this complete suppression of bacterial urease activity and
      partial resolution of antral gastritis the median basal gastrin concentration
      remained unchanged, being 57 ng/l (45-77) pretreatment and 59 ng/l (45-80) at 24
      hours and the median integrated gastrin response to a standardised meal was also
      unaltered, being 4265 ng/l/min (range 1975-8350) and 4272 ng/l/min (range 2075
      6495) respectively. These findings do not support a causal association between H
      pylori urease activity and hypergastrinaemia and show rapid improvement of antral
      gastritis after starting anti-H pylori treatment.

PMID- 1752457
TI  - Long term serological surveillance after treatment of Helicobacter pylori
      infection.
AB  - Fifteen patients with type B gastritis caused by Helicobacter pylori infection
      were treated with 'triple' therapy consisting of colloidal bismuth subcitrate,
      amoxycillin, and metronidazole. All were followed up as outpatients every three
      months for at least one year. After 'triple' therapy a significant (p less than
      0.01) and persistent reduction in IgA and IgG antibody levels against H pylori
      was detected. In three patients recurrent active infection with H pylori at nine
      and 12 months was detected by a rise in IgA (three patients) and IgG (two
      patients) antibody levels against H pylori and worsening of symptoms, and was
      confirmed by culture and histology. In 11 patients, the absence of infection at
      12 months was confirmed by culture and histology. In a control group of 13
      patients with type B gastritis who received no antibacterial treatment, specific
      IgA and IgG antibody levels against H pylori remained unchanged during 12 months
      of follow up. Although specific IgG against H pylori is the most widely used
      serological test for screening, our data indicate that specific IgA is also
      valuable in monitoring treatment. These serological tests are easy to perform,
      relatively inexpensive, devoid of radioactivity and are very acceptable to
      patients. It is concluded that serological testing is the preferred method for
      follow up after treatment for H pylori infection and will probably replace
      endoscopy or the urea breath test.

PMID- 1752458
TI  - Influence of acid-pepsin secretion on gastric emptying of solids in humans:
      studies with cimetidine.
AB  - The commonly accepted model for gastric emptying suggests that the 'antral mill'
      is responsible for the triturition and subsequent emptying of solid food from the
      stomach. Little is known about the contribution to solid emptying made by other
      digestive mechanisms such as acid-pepsin secretion. We have investigated the
      effect of inhibiting gastic secretion on the rate at which a solid test meal
      emptied from the stomach. Using a radiolabelled beefburger, we performed paired
      gammacamera studies on consecutive days in 10 fasted, healthy volunteers to
      compare gastric emptying of the test meal with and without oral cimetidine (400
      mg 1 hour before the test, 800 mg at the start of the meal). Inhibition of acid
      pepsin secretion by cimetidine was associated with an appreciable delay in the
      rate of emptying of the burger from the stomach (T50 cimetidine 187 (16) min
      (mean (SEM); T50 no cimetidine 146 (15) min; p less than 0.01, paired t test).
      This delay was related to a change in the slope of the emptying profile and was
      not associated with a prolonged lag phase. These results may be explained by the
      relative achlorhydria and reduced pepsin activity induced by cimetidine impairing
      the breakdown of solid food into particles small enough to leave the stomach.

PMID- 1752459
TI  - Importance of the stomach in maintaining calcium homoeostasis in the rat.
AB  - The stomach helps to maintain calcium homoeostasis by making dietary calcium
      accessible for uptake in the intestines, although the effect of the stomach on
      calcium homoeostasis is poorly understood. We examined the effect on blood
      calcium of gastric surgery in the rat. Within three weeks gastrectomy and
      fundectomy (excision of the acid producing part of the stomach) induced a slight
      lowering of the blood calcium concentration. When parathyroidectomy was combined
      with either gastrectomy or fundectomy the blood calcium concentrations promptly
      dropped to values lower than after parathyroidectomy alone. The mortality was
      close to 100% during the first three weeks after combined parathyroidectomy and
      gastric surgery. It was nil in rats subjected to parathyroidectomy alone.
      Gastrectomised rats absorbed Ca2+ better than unoperated control rats, possibly
      reflecting the fact that the serum 1,25-dihydroxyvitamin D concentration was
      raised. Gastrectomised rats had a food intake that was about 70% of that in
      intact rats, and the amount of dietary calcium absorbed (net absorption per kg
      body weight) by the gastrectomised rats was approximately 65% of that in intact
      control rats. We conclude that the acid producing part of the stomach is
      important for calcium homoeostasis, since its removal induced lethal
      hypocalcaemia in parathyroidectomised rats. One possible explanation for the
      hypocalcaemia induced by gastrectomy is a progressive calcium deficit. In
      addition, the loss of calciotrophic hormones originating in the stomach may
      contribute.

PMID- 1752460
TI  - Osteopenia and osteomalacia after gastrectomy: interrelations between biochemical
      markers of bone remodelling, vitamin D metabolites, and bone histomorphometry.
AB  - The prevalence of metabolic disease in a population of 68 postgastrectomy
      patients was assessed using histomorphometric evaluation of transiliac bone
      biopsy specimens after tetracycline double labelling. Trabecular bone volume was
      significantly lower in the postgastrectomy group (p less than 0.01): 62% of the
      patients had increased osteoid surface, 56% increased osteoid thickness, and 24%
      increased mineralisation lag time. Only 18%, however, fulfilled the diagnostic
      criteria for osteomalacia--increased osteoid thickness and increased
      mineralisation lag time. Postgastrectomy patients had reduced serum
      concentrations of calcium (p less than 0.01), phosphate (p less than 0.01), and
      25-hydroxyvitamin D, while levels of alkaline phosphatase and 1,25
      dihydroxyvitamin D were high (p less than 0.01). The severity of the
      mineralisation defect as reflected by mineralisation lag time was positively
      correlated to serum 25-hydroxyvitamin D, but unrelated to serum 1,25
      dihydroxyvitamin D. Multiple linear regression analysis showed that serum 25
      hydroxyvitamin D, age, and the duration of postoperative follow up were
      significant determinants of the mineralisation defect in a given patient. The
      limited value of serum markers in the diagnosis of osteomalacia was emphasised by
      the fact that six of the eight patients with osteomalacia had normal serum levels
      of calcium and alkaline phosphatase, and five of the eight had values for 25
      hydroxyvitamin D in the normal range for healthy control subjects. The results
      clearly show the need for vitamin D supplementation and regular control after
      gastric resection.

PMID- 1752461
TI  - Calmodulin independence of human duodenal adenylate cyclase.
AB  - The calmodulin and calcium dependence of human adenylate cyclase from the second
      part of the duodenum was assessed in washed particulate preparations of biopsy
      specimens by investigating (a) the concentration dependent effects of free [Ca2+]
      on enzyme activity, (b) the effects of exogenous calmodulin on enzyme activity in
      ethylene glycol bis (b-aminoethyl ether)N,N'-tetra-acetic acid (EGTA) washed
      particulate preparations, and (c) the effects of calmodulin antagonists on enzyme
      activity. Both basal (IC50 = 193.75 (57.5) nmol/l (mean (SEM)) and NaF stimulated
      (IC50 = 188.0 (44.0) nmol/l) adenylate cyclase activity was strongly inhibited by
      free [Ca2+] greater than 90 nmol/l. Free [Ca2+] less than 90 nmol/l had no effect
      on adenylate cyclase activity. NaF stimulated adenylate cyclase activity was
      inhibited by 50% at 2.5 mmol/l EGTA. This inhibition could not be reversed by
      free Ca2+. The addition of exogenous calmodulin to EGTA (5 mmol/l) washed
      particulate preparations failed to stimulate adenylate cyclase activity.
      Trifluoperazine and N-(8-aminohexyl)-5-IODO-1-naphthalene-sulphonamide (IODO 8)
      did not significantly inhibit basal and NaF stimulated adenylate cyclase activity
      when measured at concentrations of up to 100 mumol/l. These results suggest that
      human duodenal adenylate cyclase activity is calmodulin independent but is
      affected by changes in free [Ca2+].

PMID- 1752462
TI  - Search for the ideal oral rehydration solution: studies in a model of secretory
      diarrhoea.
AB  - In situ perfusion of whole rat small intestine was used to compare the efficacy
      of five oral rehydration solutions in promoting water and sodium absorption in
      normal intestine and secreting intestine after exposure to cholera toxin.
      Solutions varied in their sodium (35-90 mmol/l) and glucose (111-200 mmol/l)
      concentrations, molar ratio of glucose:sodium (1.2-5.8), and osmolality (281-331
      mOsmol/kg), and contained either bicarbonate (18-30 mmol/l) or citrate (10
      mmol/l). In normal intestine all solutions promoted net water absorption. Cholera
      toxin induced reproducible water secretion but all solutions reversed this to
      absorption. Water absorption was greatest with solutions containing sodium 60
      mmol/l and glucose 111 or 140 mmol/l, and with a glucose:sodium ratio
      approximately 2, in both normal and secreting intestine. All solutions promoted
      net glucose absorption in both normal and secreting intestine. Net sodium
      absorption occurred with solutions containing greater than or equal to 60 mmol/l
      sodium in normal intestine but sodium secretion occurred from all solutions in
      secreting intestine. Sodium movement was directly related to the sodium
      concentration of the solution and sodium secretion occurred despite net water and
      glucose absorption. We consider that these studies may guide future development
      of oral rehydration solutions.

PMID- 1752463
TI  - Small intestinal length: a factor essential for gut adaptation.
AB  - Changes in small intestinal structure, cytokinetics, and function are dynamic
      ways in which the gut adapts to diet, disease, and damage. Adequate length
      provides a static 'reserve' permitting an immediate response to
      pathophysiological changes. The length of the small intestine from conception to
      adulthood using data taken from eight published reports of necropsy measurement
      of 1010 guts is described. Mean length at 20 weeks' gestation was 125 cm, at 30
      weeks' 200 cm, at term 275 cm, at 1 year 380 cm, at 5 years 450 cm, at 10 years
      500 cm, and at 20 years 575 cm. Prenatal small intestinal growth exceeded that of
      body length according to the law: small intestinal length alpha body length to
      the power 4/3. After birth there was a noticeable deceleration: small intestinal
      length alpha body length to the power 1/2. The coefficient of variation of small
      intestinal length postnatally was 24%, sixfold greater than for body length. The
      rapid prenatal small intestinal growth rate ensures that the mature newborn has
      adequate small intestine to meet postnatal nutritional demands, but handicaps the
      preterm infant who undergoes intestinal resection. The wide variation in lengths
      suggests a 'surplus' surface area that is immediately available to respond,
      independent of dynamic mucosal changes, to fluctuations in food availability,
      local intestinal disease, damage, rapid transit, and resection.

PMID- 1752464
TI  - Value of in vivo electrophysiological measurements to evaluate canine small bowel
      autotransplants.
AB  - This study aimed to develop a non-invasive method for in vivo measurement of the
      transepithelial potential difference in the canine small bowel and to evaluate
      this parameter in small bowel autotransplants. In group 0 (control group, n = 4),
      two intestinal loops were created without disturbing their vascular, neural, and
      lymphatic supplies. In group I (successful autotransplants, n = 11), two
      heterotopic small bowel loops were constructed. Long term functional sequelae of
      vascular, neural, and lymphatic division were studied. Group II (n = 6) consisted
      of dogs with unsuccessful autotransplants suffering thrombosis of the vascular
      anastomosis, which resulted in ischaemic small bowel autografts. In group I,
      values of spontaneous transepithelial potential difference, an index of base line
      active electrolyte transport, were significantly lower compared with group 0 (p
      less than 0.05), probably as a result of denervation of the autotransplants. Both
      theophylline and glucose stimulated potential difference responses, measuring
      cyclic adenosine monophosphate mediated chloride secretion and sodium coupled
      glucose absorption respectively, showed negative luminal values in group I at all
      time points after transplantation. These transepithelial potential difference
      responses diminished progressively with time. From day 21 onwards both
      theophylline and glucose stimulated potential difference responses were
      significantly less than the corresponding responses at day seven (p less than
      0.05). Morphometric analysis showed that the reduction of transepithelial
      potential difference responses preceded degenerative mucosal changes in the
      heterotopic small bowel autografts. In group II, potential difference responses
      to theophylline and glucose showed positive luminal values (p<0.01 v group I),
      probably as a result of passive potassium effusion from necrotic enterocytes.

PMID- 1752465
TI  - Body composition and calcium metabolism in adult treated coeliac disease.
AB  - Twenty two treated adult patients with coeliac disease (aged 20-70 years) were
      examined. Body composition was assessed from anthropometry and directly measured
      by dual photon absorptiometry. Bone mineral content was measured in the spine
      (dual photon absorptiometry) and at two forearm sites (single photon
      absorptiometry). Compared with age matched healthy subjects, treated coeliac
      patients had lower body mass index (-5%, p less than 0.05) and lower directly
      measured total body fat mass (-30%, p less than 0.001). They also had decreased
      bone mineral content (-9 to -13%, p less than 0.01) in the spine and in the
      forearms. The serum concentrations of albumin, D vitamin binding protein, and
      iron were reduced (-6 to -22%, p less than 0.01), but otherwise blood and urine
      analyses were normal. We conclude that this group of treated adult coeliac
      patients had a reduced fat mass and bone mineral content compared with the
      general population.

PMID- 1752466
TI  - Faecal bile acid excretion in children with inflammatory bowel disease.
AB  - Faecal bile acid excretion and intestinal transit time were studied in 18
      children with inflammatory bowel disease in clinical remission and with normal
      stools: 16 with ulcerative colitis, two with Crohn's colitis, mean age 14 years
      (range 10-17 years). Five healthy children, mean age 12.4 years (range 10-17
      years), were studied as control subjects. Most patients were taking
      sulphasalazine, but none were taking steroids. Transit time was determined by
      carmine and did not differ between groups. Faeces were collected for 72 hours,
      and faecal water was prepared by centrifugation of faeces at 15,000 x g for two
      hours. Bile acids in total faeces and faecal water were studied using capillary
      gas-liquid chromatography-mass spectrometry. Faecal excretion of total bile
      acids, unconjugated bile acids, and glycine and taurine conjugates were
      significantly increased in patients as was faecal water excretion of total bile
      acids, particularly the taurine conjugates and cholic and chenodeoxycholic acids.
      Total concentrations of bile acids in faeces and faecal water were two to five
      times higher in patients. The children with inflammatory bowel disease in
      clinical remission had high excretion and concentration rates of bile acids,
      especially taurine conjugates, in both total faeces and faecal water, a finding
      of considerable interest in the pathogenesis of malignancy in these diseases.

PMID- 1752467
TI  - Postprandial hypergastrinaemia in patients with colorectal cancer.
AB  - Gastrin is trophic to colon cancers that possess gastrin receptors. Whether
      fasting serum gastrin concentrations are high in patients with colon cancer is
      controversial. We therefore studied the effect of food on serum gastrin
      concentrations in patients with colon cancer and control subjects. Fasting serum
      gastrin was greater, though not significantly so, in patients with colon cancer
      before surgery (mean (SD) 17.4 (3.6) pmol/l, n = 16) compared with control
      subjects (12.6 (1.9) pmol/l, n = 14). Postprandial increases in serum gastrin
      were significantly and persistently higher than normal in the cancer patients.
      These increases were due to a subset of six patients with serum gastrin
      concentrations greater than the control mean + 2 SD at 20 and 40 minutes (62
      pmol/l-146 pmol/l). Four of the six patients had intra-abdominal metastases. The
      extent of the increase may well correlate with that of the disease. Surgical
      resection of the tumour resulted in a fall in serum gastrin values and probably
      reflects the cause of the hypergastrinaemia. Hypergastrinaemia may, therefore, be
      an important aetiological factor in colon carcinogenesis.

PMID- 1752468
TI  - Absorptive and motor components of the antidiarrhoeal action of loperamide: an in
      vivo study in pigs.
AB  - The effects of loperamide (0.1 mg/kg orally) on net colonic water absorption,
      orocolonic transit time, and intestinal motility were investigated in pigs
      chronically fitted either with two cannulas in the proximal colon and a catheter
      in the duodenum and the ileum or with intraparietal electrodes on the duodenum,
      jejunum, caecum, and proximal colon and a duodenal catheter. Loperamide, given 20
      minutes before a meal reduced significantly colonic net water absorption for 10
      hours after eating. It also reduced colonic flow rate, increased orocolonic
      transit time, modified the postprandial intestinal motility by inducing
      supplementary phase 3 motor complexes and did not affect caecocolonic motility.
      Intraduodenal infusion of a hypertonic solution of mannitol (900 mOsm/l; 0.6
      ml/minute) for the first postprandial hour strongly reduced or reversed net
      colonic water absorption, increased the colonic flow rate, accelerated the
      orocolonic transit, and induced profuse diarrhoea. After loperamide
      administration, all these effects were blocked and the relative colonic water
      absorption, expressed as the fraction of flow entering the colon, was strongly
      increased. Mannitol did not modify motility of the small and large intestine, and
      supplementary phase 3 motor complexes were observed when mannitol infusion was
      preceded by loperamide administration. It is concluded that in experimental
      osmotic diarrhoea loperamide causes a reduction in digesta flow entering into the
      colon, mediated by its action on small intestinal motility, and an increase in
      colonic water absorption.

PMID- 1752469
TI  - Intermittent rectal motor activity: a rectal motor complex?
AB  - Prolonged nocturnal recordings from multiple sites in the anorectum and duodenum
      were performed in 12 healthy volunteers to investigate the presence and determine
      the characteristics of nocturnal rectal motor activity and assess any
      synchronicity with phase III of the small intestinal migrating motor complex.
      Runs of phasic contractions of two contractile frequencies (3 or 6/minute),
      sustained for more than three minutes, and preceded and followed by motor
      quiescence were observed in 10 of the 12 subjects. This phenomenon is similar to
      that described by other investigators and termed the 'rectal motor complex'. The
      runs of contractions showed considerable inter- and intrasubject variation, with
      a duration of 3-30 minutes (median 9.0), amplitude of 10-55 mm Hg (median 20.0),
      and periods of 10-420 minutes (median 55.5) between contractile activity. There
      was no propagation through the rectum, the phasic motor activity rarely occurred
      simultaneously at more than one rectal recording site. No consistent relation
      with phase III of the small intestinal migrating motor complex was observed in
      any subject. In view of these findings, we question whether this intermittent
      motor activity merits the term 'rectal motor complex'.

PMID- 1752470
TI  - Improving biliary-enteric drainage in primary sclerosing cholangitis: experience
      with endoscopic methods.
AB  - Six jaundiced patients with primary sclerosing cholangitis and a dominant biliary
      stricture were managed by endoscopic placement of endoprostheses. Five showed
      considerable improvement within weeks of stenting: their serum bilirubin
      concentration fell from mean (range) 266 mumol/l (63-681) to 65 mumol/l (10-280)
      after one month. One patient required a liver transplant at five months because
      of continued deterioration in hepatic function. Follow up of 12-49 months in the
      remaining five patients shows sustained biochemical improvement, with repeat
      cholangiograms indicating doubling of the minimum calibre of the extrahepatic
      bile duct in four patients and considerable shortening of stricture length in
      three. Three patients developed sepsis at the time of the initial endoprosthesis
      insertion: surgical drainage was necessary in one. Endoscopic methods of
      improving biliary-enteric drainage in jaundiced patients with primary sclerosing
      cholangitis may be preferable to surgical and percutaneous methods, which may
      complicate subsequent liver transplantation.

PMID- 1752472
TI  - 'Solitary' necrotic nodules of the liver: an aetiology reaffirmed.
AB  - Morphological features of lesions conforming to the description of solitary
      necrotic nodules of the liver were compared with liver haemangiomata and necrotic
      tumour metastases in the liver. An origin in haemangiomata is confirmed for most
      of the lesions studied, although the necrotic nodule may represent the end stage
      of a variety of lesions. These lesions are usually benign, although necrotic
      nodules are often mistaken for liver metastases. A reticulin stain is useful in
      assessing the lesions.

PMID- 1752471
TI  - Effect of dietary calcium on the colonic luminal environment.
AB  - Dietary supplementation with calcium may prevent the development of colorectal
      cancer. This mechanism may be related to fatty acid and bile salt chelation in
      the small bowel forming non-toxic calcium-soap compounds. Calcium may also act
      locally or systemically on the colonic mucosa. Faecal concentrations of free
      fatty acids and free bile acids were measured in 17 Sprague-Dawley rats (weighing
      472 (39 g)) whose daily calcium intake had been trebled by enriching the chow and
      adding calcium lactate (24 g/l) to the drinking water. Mean (SEM) faecal
      concentrations of free bile acids were 33% less than in 19 controls (1.23 (0.15)
      v 1.82 (0.20) mg/g; p less than 0.001), whereas free fatty acid concentrations
      were 117% higher (14.68 (3.59) v 6.76 (2.41) mg/g; p less than 0.02). The
      'direct' effect of calcium was assessed by organ culture of rat colonic explants
      in three different concentrations of calcium. Crypt cell production rate
      (measured by a stathmokinetic technique), which was (mean (SEM)) 4.80 (0.23)
      cells/crypt/h in control medium (Ca2+ = 2.14 mmol/l), fell by 43% when calcium
      concentration was doubled (p less than 0.05) and by a further 43% when the
      concentration was trebled (p less than 0.02). Calcium binds free fatty acids but
      not free bile acids intraluminally. Calcium has a direct antitropic action on
      colonic crypts.

PMID- 1752473
TI  - Diclofenac hepatitis.
AB  - The characteristics of liver damage associated with the use of diclofenac, a
      popular nonsteroidal anti-inflammatory drug, were investigated by reviewing
      adverse drug reaction reports for Australia. Twenty six patients were reported
      for whom diclofenac was the sole suspected drug cause of their liver damage. The
      average age of the patients was 64 years (range 37-84 years); 19 (70%) were
      women. The most common clinical features were jaundice, hepatomegaly, anorexia,
      and nausea. Features of drug hypersensitivity were not reported. Duration of
      treatment with diclofenac before the onset of the illness ranged from 6-417 days
      (median 76 days). The most prominent biochemical abnormalities were raised serum
      aspartate transaminase and alanine transaminase activity of up to 30 to 40 times
      the upper limit of the normal range. Recovery generally started soon after
      withdrawal of diclofenac and the decrease in aspartate transaminase and alanine
      transaminase for the group was exponential, with half lives of around 13 days.
      The average total dose taken by 18 patients for whom accurate data were available
      was 8.7 g (range 1.4-63.5 g) and, unexpectedly, there was a significant relation
      between the logarithm of the dose of diclofenac and the logarithms of the peak
      and mean transaminase levels. Hepatocellular damage during treatment with
      diclofenac seems to be a rare event. From this analysis of Australian reports it
      seems that in a small subgroup of patients liver injury may be a direct toxic
      effect of diclofenac or a metabolite.

PMID- 1752474
TI  - Morphological and immunohistochemical analysis of the human liver in chronic
      pancreatitis.
AB  - Morphological and immunohistological appearances of liver biopsy specimens are
      described in a personal series of 52 patients undergoing operation for chronic
      pancreatitis. The findings are compared with those in a series of 10
      histologically normal liver biopsy specimens from patients without pancreatitis.
      Alcohol was the prime aetiological agent in 40 of the 52 patients (77%). No
      obvious damage to hepatic parenchymal cells or biliary structures was observed
      but minor morphological changes of alcohol associated liver disease were seen in
      42% of specimens. The most consistent finding, present in 48 specimens (92%), was
      a chronic inflammatory cell infiltration of portal tracts. In all but one case, T
      lymphocytes predominated, but a few B cells were present. In four biopsy
      specimens, T cells spilled over into adjacent hepatic parenchyma, but there was
      no evidence of T cell mediated cytotoxic damage to the parenchymal cells or
      biliary epithelium. It is suggested that these inflammatory cells are in transit
      from the pancreas through the liver via the portal circulation and may reflect
      the underlying pathogenesis of chronic pancreatitis rather than alcoholic liver
      disease.

PMID- 1752475
TI  - Is tobacco a risk factor for chronic pancreatitis and alcoholic cirrhosis?
AB  - In a case control study alcohol intake and tobacco use were assessed between 1975
      and 1987 in 103 male patients suffering from alcoholic cirrhosis of the liver, in
      145 patients with chronic pancreatitis, and in 264 control subjects. The patients
      with chronic pancreatitis were significantly younger than the patients with
      cirrhosis (mean (SD) age 41.92 (2.4) v 60.9 (11.6) years). Among the patients
      with chronic pancreatitis, 94% were both smokers and drinkers compared with 83%
      of patients with cirrhosis of the liver. The relative risks for each disease were
      calculated by conditional multiple logistic regression. Whereas daily intake of
      alcohol was a major risk factor for both cirrhosis of the liver and chronic
      pancreatitis, smoking was significantly related only to the risk of having
      chronic pancreatitis. Moreover, the mean age at onset of pancreatitis was lower
      among smokers.

PMID- 1752476
TI  - Gastric output of pancreatic secretory trypsin inhibitor is increased by
      misoprostol.
AB  - Pancreatic secretory trypsin inhibitor (PSTI) is a potent protease inhibitor that
      also has growth promoting activity. It has recently been identified in the
      foveolar cells of the stomach, which secrete mucus. We examined the effects of
      the prostaglandin E1 analogue misoprostol on gastric PSTI output. Seven normal
      volunteers took part. An initial period of gastric aspiration was followed by
      four 40 minute periods of gastric perfusion at 5 ml/minute of: 0.14 mol/l saline,
      0.17 mmol/l bicarbonate, bicarbonate with misoprostol 400 micrograms, and then
      bicarbonate again. All perfusates contained polyethylene glycol 4000 as a marker.
      Misoprostol increased median gastric secretion of PSTI from 11 to 33
      micrograms/hour (p less than 0.05), producing concentrations in gastric juice six
      times higher than those found in jejunal juice and about 1/30 of the values seen
      in pancreatic juice. Median mucus secretion increased to a lesser extent from 29
      to 38 mg/hour during misoprostol. There was no change in intragastric
      concentrations of protein or of epidermal growth factor during infusion of
      misoprostol. Infusion of pentagastrin (6 micrograms/kg/hour) had no effect on
      gastric secretion of mucus, PSTI, or protein. Human gastric mucus was degraded on
      incubation with trypsin in vitro and this was prevented by the addition of PSTI.
      These results suggest that gastric PSTI may protect the gastric mucus layer
      against refluxed pancreatic proteases. Increased output of PSTI during
      microprostol may contribute to the protective effect of this drug.

PMID- 1752477
TI  - National statistics for diet, alcohol consumption, and chronic pancreatitis in
      England and Wales, 1960-88.
AB  - This study compared national statistics for consumption of alcohol and dietary
      intake with the numbers of cases of chronic pancreatitis as recorded in a 10%
      sample of all hospital discharges (Hospital In-Patient Enquiry) and with the
      annual number of deaths. Hospital discharges for chronic pancreatitis became more
      common throughout the study period (7.0-11.1 discharges per million per year in
      1960-4; 26.8-32.4 discharges per million per year in 1980-4). The most rapid
      increase was from 1975-82. The rate increased fourfold in men, but only twofold
      in women, and the increase began earlier in men (1976) than in women (1980).
      Annual deaths from chronic pancreatitis also rose progressively (46-70 in 1960-4;
      64-91 in 1985-8). The annual per capita consumption of alcohol rose from 4.0-4.9
      litres in 1960-4 to a peak of 7.7 litres in 1979; it has been relatively stable
      (6.9-7.6 litres) in 1980-8. Total dietary energy intake assessed in the National
      Food Survey fell progressively, with a correspondingly greater fall in
      carbohydrate intake, so that the energy contributions of fat and protein rose
      slightly, although total fat and protein consumption fell from 1965-9 to 1980-4.
      These changes were small in relation to total dietary intake and seemed to be
      unrelated to the changes in the numbers of chronic pancreatitis discharges. There
      was a close correlation (r = 0.96) between per capita alcohol consumption and the
      numbers of discharges with chronic pancreatitis six years later. This suggests
      that epidemiological trends in chronic pancreatitis in the United Kingdom might
      be predictable from population based statistics of alcohol consumption.

PMID- 1752478
TI  - Gall bladder emptying patterns in response to a normal meal in healthy subjects
      and patients with gall stones: ultrasound study.
AB  - In this study gall bladder emptying patterns in response to a solid meal were
      studied using ultrasound. A similar triphasic pattern was seen in eight healthy
      control subjects and eight patients with gall stones, with 'early' and 'late' net
      emptying phases separated by a period of net refilling with peak postprandial
      gall bladder volumes occurring at (mean (SD)) 33.1 (17.9) minutes and 27.4 (18.8)
      minutes in control subjects and patients, respectively. A phase of slower net
      emptying followed, which was complete at 146 (33) minutes in control subjects and
      125 (33) minutes in the gall stone patients (not significant). Superimposed upon
      this overall triphasic pattern, postprandial gall bladder emptying was punctuated
      by repeated short lived episodes of filling and emptying. The mean (SD) estimated
      postprandial bile outputs were 0.83 (0.34) ml/min in four control subjects and
      1.2 (1.1) ml/min in seven patients with gall stones. We propose a 'washout' model
      to reconcile this large turnover of bile with the concentrating and storage
      functions of the gall bladder and predict that the extent rather than the rate of
      gall bladder emptying is important in determining stasis of bile in the gall
      bladder.

PMID- 1752479
TI  - Acute Helicobacter pylori infection: clinical features, local and systemic immune
      response, gastric mucosal histology, and gastric juice ascorbic acid
      concentrations.
AB  - The symptomatology of a case of acute infection with Helicobacter pylori is
      described, together with the accompanying changes in gastric mucosal histology,
      local and systemic humoral immune response, and gastric ascorbic acid
      concentration. The patient was an endoscopist, previously negative for the carbon
      14 urea breath test, who had a week of epigastric pain and then became
      asymptomatic. H pylori was detected by culture of antral biopsy specimens and was
      still present after 74 days. Five days after infection the histological findings
      showed acute neutrophilic gastritis; by day 74 changes of chronic gastritis were
      evident. The patient seroconverted by IgG enzyme linked immunosorbent assay by
      day 74, but a mucosal IgM and IgA response was evident as early as day 14.
      Infection was accompanied by a transient hypochlorhydria but a sustained fall in
      gastric juice ascorbic acid concentration.

PMID- 1752480
TI  - Response to autoimmune enteropathy to cyclosporin A therapy.
AB  - Small bowel enteropathies that are associated with an autoimmune process are
      often resistant to treatment. Two children with autoimmune enteropathy were
      treated with cyclosporin A for eight months. Both improved, as assessed by
      growth, small intestinal mucosal morphology, and carbohydrate absorption.
      Cyclosporin A is useful in the treatment of autoimmune enteropathy. This report
      also suggests that T cell activation (which is suppressed by cyclosporin A) is
      important in the pathogenesis of this condition.

PMID- 1752481
TI  - Angiodysplasia and ileal carcinoid.
AB  - A case of angiodysplasia, symptomatic for 18 years, is presented. This case
      highlights the difficulty of establishing a diagnosis. Associated findings
      included aortic stenosis and a carcinoid tumour of the ileum. Despite transfusion
      of a total of 1200 units of blood the liver was normal at necropsy.

PMID- 1752482
TI  - Postprandial mesenteric blood flow.

PMID- 1752483
TI  - Helicobacter pylori infection in healthy people.

PMID- 1752484
TI  - Medical treatment of bleeding peptic ulcer: old drugs, new regimens.

PMID- 1752485
TI  - Advances in the management of early stage ovarian cancer.

PMID- 1752486
TI  - Surgery without adjuvant chemotherapy for early epithelial ovarian carcinoma
      after comprehensive surgical staging.
AB  - From January 1981 to December 1987, 82 patients with carcinoma of the ovary,
      Stages 1A, 1B, and 1C (cytology negative) (FIGO 1988), were enrolled in this
      study following accurate surgical staging. No patient received adjunctive therapy
      and all were followed from 2 to 6 years with a mean duration of follow-up of 4
      years. Sixty-eight patients were eligible for review--thirty-nine Stage 1A, six
      Stage 1B, and twenty-three Stage 1C (twenty-one with tumor rupture, two with
      excrescences). The mean age was 48.8 years. Three patients had a recurrence of
      their disease (one death). Forty patients in this series were Stage 1A or 1B
      (well or moderately well differentiated, no excrescences, no rupture). Only 1
      patient in this group (with clear cell carcinoma) has recurred, suggesting that
      this patient population can be followed without adjunctive therapy. Adhesions or
      rupture in this series did not affect outcome. Clear cell tumors may have an
      ominous prognosis despite apparent local disease.

PMID- 1752487
TI  - Stage I ovarian epithelial carcinoma: survival analysis following definitive
      treatment.
AB  - Between 1977 and 1986, 55 patients with surgical stage I ovarian epithelial
      carcinoma were managed in a definitive fashion, which included surgical staging
      and adjuvant therapy in 51 of 55 patients (93%) and second-look laparotomy. The
      mean follow-up time from the data of reassessment surgery was 94 months, allowing
      sufficient time to facilitate the identification of one or more subgroups of
      patients at risk of having persistent disease or developing a recurrence.
      Treatment failures were detected at second-look laparotomy in 6 patients (11%),
      and an additional 5 patients (9%) subsequently had recurrences after being
      declared free of disease at second-look reassessment. Analysis of pathologic
      variables identified grade and substage as important prognostic factors, with 8
      of the 9 deaths (89%) being associated with Broders grade 3 or 4 and/or stage IC.
      Within the bivariate model consisting of patients harboring poorly differentiated
      (grade 3 or 4) stage IC lesions, 6 of 14 patients (43%) are dead from disease,
      yielding a long-term survival rate that at best approximates the survival rate
      associated with optimally reduced (microscopic residual) stage III patients
      subjected to contemporary adjuvant therapy and reassessment surgery. These data
      suggest that intensive therapy as utilized in advanced disease, including
      platinum-based chemotherapy, second-look laparotomy, and innovative salvage or
      investigational consolidation therapy, is equally applicable to this "high-risk"
      stage I group.

PMID- 1752488
TI  - A phase II trial of adjuvant cisplatin and doxorubicin in stage I epithelial
      ovarian cancer.
AB  - We have treated 26 patients with Stage I ovarian cancer with platinum-based
      chemotherapy. Patients received 50 mg/m2 cisplatin and 50 mg/m2 doxorubicin every
      21 days for six cycles. Eighteen patients had complete surgical staging defined
      as total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and
      aortic node sampling, omentectomy, and cytology. Eight patients had all of the
      above with the exception of node sampling. The overall median follow-up for the
      group is 43+ months. Three patients had grade 1 tumors with positive washings or
      capsule invasion and are disease free with a median follow-up of 53+ months. Of
      23 patients with grade 2-3 tumors, 22 are alive and free of disease with a median
      follow-up of 42+ months. There has been 1 recurrence, at 18 months, in a patient
      who had complete staging and a grade 2 tumor. The patient recurred with
      carcinomatosis, documented by laparoscopy. There was no significant hematologic,
      neurologic, or renal toxicity encountered in any patient. Adjuvant combination
      chemotherapy is beneficial for selected patients with early-stage ovarian cancer
      who are at high risk for failure after surgical treatment alone.

PMID- 1752489
TI  - Stage I endometrial carcinoma: treatment of nonoperable patients with
      intracavitary radiation therapy alone.
AB  - From 1976 to 1981, 171 patients with stage I endometrial adenocarcinoma (FIGO,
      1971) underwent intracavitary radiotherapy alone because of medical
      contraindications to surgery and external-beam irradiation. The mean age of
      patients was 71 years, with the majority of patients being in the age group of 70
      79 years. The intracavitary therapy consisted of intrauterine insertions of
      radium implants in three consecutive courses according to the packing method of
      Heyman. The estimated dose delivered to point A and to point B was 80 and 20 Gy
      (3500-7000 mg-hr; mean, 5500 mg-hr), respectively. The corrected 5-year survival
      rate for stage Ia was 76% and for stage Ib 72%. Grade had a profound effect on
      survival; corrected 5-year survival for G1 was 77%, for G2 68%, and for G3 53%,
      respectively. The total failure rate was 24% (40/171). Most of the recurrences
      occurred in the pelvis (35/171): uterus, 22; vagina, 9; rectum, 2; and bladder,
      1. One patient had both vaginal and uterine failure and five had distant
      metastases (four abdominal and one pulmonary). No difference was seen in the
      failure rates of stage Ia and stage Ib patients. No major complications
      (necessitating hospital care or delay of treatment) were seen. Our findings
      suggest that for patients with stage I endometrial cancer who are unfit for
      surgery, intracavitary low-dose-rate radiation therapy alone is an effective
      alternative treatment with a low risk of complications.

PMID- 1752490
TI  - Endometrial carcinoma: transvaginal ultrasonography prediction of depth of
      myometrial invasion.
AB  - Myometrial invasion greater than 33% negatively affects the prognosis of
      endometrial carcinoma. Since the endometrium is readily differentiated from
      myometrium via high-resolution transvaginal sonography (TVS), this prospective
      study was undertaken to evaluate the efficacy of TVS in determining the depth of
      myometrial invasion in women with endometrial adenocarcinoma. Eighteen subjects
      underwent TVS utilizing 5.0- and 7.5-MHz probes by a single examiner blinded to
      stage and grade of adenocarcinoma. Predicted TVS ratios were categorized as less
      than 33% or greater than or equal to 33% and compared to actual histologic
      invasion. Ultrasound predicted that TVS ratios greater than or equal to 33% are
      significantly associated with deep (greater than 33%) histologic invasion (P less
      than 0.01, Fisher's test). When histologic invasion was greater than or equal to
      33%, TVS was 100% accurate with no false negatives. The two cases in which TVS
      ratios erroneously indicated invasion greater than or equal to 33% contained
      adenomyosis and leiomyomas. TVS is a highly accurate and convenient method for
      preoperatively evaluating myometrial invasion. Potentially this evaluation could
      influence the selection of therapy for poor-surgical-risk candidates or direct
      appropriate referral of patients with deeper invasion to a gynecologic
      oncologist.

PMID- 1752491
TI  - Mitomycin-C/5-FU and radiation therapy for locally advanced uterine cervical
      cancer.
AB  - To assess the feasibility and effectiveness of combined therapy on locally
      advanced cervical cancer, we entered 38 patients into a study. The patients were
      treated with mitomycin-C (10 mg/m2) on Days 1 and 30 and 5-FU (1000 mg/m2) on
      Days 1 to 4 and Days 30 to 33. In 5 weeks 4500-5000 cGy was given concurrently,
      followed by radioactive implants. Twenty-six patients had an early-stage disease
      (IB-IIB) and twelve had a late-stage disease (IIIB-IVA). Eighty-seven percent
      (33/38) of the patients had a tumor measuring 5 cm or more. The other 5 patients
      with a tumor size under 5 cm had biopsy-proven positive pelvic nodes; 2 of these
      5 patients had a pretherapy hysterectomy. Tumor response, complete (CR) vs
      partial (PR), was assessed in 36 patients 3 months after completion of therapy. A
      CR was noted in 80% (29/36) of the patients. The PR status conferred a
      detrimental effect on the pelvic disease control (PDC), disease-free survival
      (DFS), and survival (S) while late stage correlated with the development of
      distant metastases (DM) and a poor DFS. PDC was obtained in 93% (27/29) of the
      patients who had a CR, as compared to only 43% (3/7) of those with a PR (P =
      0.0228). The DFS and S rates were 59 and 77% for patients with a CR and 21 and
      19% for those with a PR; respective P values were 0.0340 and 0.0002. Eleven
      percent (3/26) of the patients with an early stage developed DM, as compared to
      50% (6/12) of those with late stage, (P = 0.0016). The DFS rates were 80 and 37%
      for patients with an early and late stage, respectively (P = 0.0141). Four
      patients developed transient neutropenia and one had transient thrombocytopenia.
      The second dose of mitomycin-C was omitted in 4 patients due to persistent
      neutropenia in 3 and to transfusion-related hepatitis in 1. Two percent (5/21) of
      the patients who had a staging laparotomy developed wound dehiscence. Three
      patients developed non-cancer-related small bowel obstruction requiring surgery.
      We concluded that this combined regimen was well tolerated. Although it was
      effective in controlling the cancer in the pelvis, this regimen failed to control
      DM in late-stage patients.

PMID- 1752492
TI  - Flow cytometric DNA analysis versus cytology in the evaluation of peritoneal
      fluids.
AB  - The use of flow cytometric DNA analysis as an adjunct to cytology in peritoneal
      fluid evaluation was studied. One hundred ninety-five fluids from 193 gynecologic
      patients were subjected to both DNA analysis and cytologic examination. It was
      found that 117/195 (60%) had invasive malignancies (50 ovarian, 48 endometrial,
      17 cervical, and 2 miscellaneous); 34/117 (28%) patients with malignancies were
      positive by cytology, and 10/117 (8.5%) were positive (aneuploid) by DNA
      analysis. Of 34 cytologically positive cases, 7 (21%) were DNA positive, 25 (74%)
      were DNA negative, and in 2 (6%) insufficient cells were obtained. Only 3 fluids
      (3%) from malignancies were positive by flow cytometry and negative by cytology
      (1 stage I ovarian cancer, 1 stage I endometrial cancer, and 1 stage III ovarian
      cancer). No false-positive cytology and one probable false-positive flow result
      was obtained. If only those patients with histologically documented peritoneal
      involvement are considered, 29/43 (65%) had positive cytology and 8/43 (19%) had
      a positive flow result. We conclude that: (1) the high false-negative rate of
      flow cytometry (79%) versus cytology in this study may be related to a high
      percentage of diploid cancers, specimen preparation, or histogram interpretation,
      and (2) flow cytometry rarely adds to cytologic evaluation and is probably best
      reserved for use only in selected cases.

PMID- 1752493
TI  - Further experience with radiation therapy and concomitant intravenous
      chemotherapy in advanced carcinoma of the lower female genital tract.
AB  - Sixty-seven patients with advanced carcinoma of the lower female genital tract
      (cervix, vagina, and vulva) were treated with radiation and concomitant
      intravenous cisplatin and/or 5-fluorouracil. Fifty-seven patients (85%) responded
      completely clinically. Thirty-five (61%) complete responders recurred with a
      median time to recurrence of 6 months. Twenty-six of the thirty-five patients who
      recurred had some component of local failure. The 22 complete responders who have
      not recurred have been followed a median of 13 months. Acute toxicity was
      minimal, with only 6 patients requiring interruption of therapy. Nine (13%)
      patients developed severe late complications and eight required surgery. The
      actuarial 5-year survival is 22%. This treatment regimen is disappointing in
      terms of both survival and local control.

PMID- 1752494
TI  - Phase II trial of thio-TEPA in relapsed and refractory ovarian carcinoma.
AB  - On the basis of a Phase I reevaluation of thio-TEPA in which 3 of 9 patients with
      ovarian carcinoma responded, we instituted a Phase II study at high doses.
      Fourteen patients with a histologic diagnosis of epithelial carcinoma of the
      ovary, who had received at least one prior cisplatin-based regimen, were entered.
      Thio-TEPA was initially administered intravenously at a dose of 65 mg/m2 every 4
      weeks, but was reduced to 50 mg/m2 after severe myelotoxicity developed in the
      first 5 patients. In 4 patients stable disease lasted 3, 4, 5, and 9 months; 10
      patients progressed. There were no objective responses. At this dose and
      schedule, thio-TEPA has a response rate less than 20% in ovarian cancer patients
      previously treated with cisplatin.

PMID- 1752495
TI  - Specimen findings and survival after preoperative 252Cf neutron brachytherapy for
      stage II cervical carcinoma.
AB  - Twenty-seven patients with operable Stage II cervical cancer with a mean diameter
      tumor of 8.0 cm were studied in a feasibility study using preoperative 252Cf
      implants plus whole-pelvis radiation to 45 Gy followed by extrafascial total
      abdominal hysterectomy and bilateral salpingo-oophorectomy 4 to 6 weeks later.
      Hysterectomy specimens were studied by a set protocol. With the protocol used,
      13/27 (51%) specimens and abdominal stagings were negative for residual tumor.
      The survival rate for the patients with negative findings was 93% at 5 years. In
      14/27 (49%) patients the specimens were positive for residual tumor. In contrast,
      the 5-year survival rate for this group was 46% (P less than 0.001). In these
      patients several interrelated factors were determined to be of importance, i.e.,
      (1) tumor size greater than 8 cm in maximum diameter, (2) positive or negative
      residual tumor status, and (3) total dose of radiation given. Survival was lower
      for larger tumors and specimens were more likely to show residual tumor. A lower
      treatment dose led to more positive specimens, as well as to poorer survival.
      While the patients with Stage II disease fared very well when negative specimens
      were found, further prospective studies of the appropriate treatment for those
      with positive tumor specimens are needed.

PMID- 1752496
TI  - The effect of megestrol acetate on interleukin-1 activity.
AB  - The current study investigates the effect of megestrol acetate, a synthetic
      progestin, on the activity of interleukin-1. Murine thymocytes were suspended in
      vitro and stimulated with varying concentrations of interleukin-1. [3H]Thymidine
      uptake was observed as an index of thymocyte proliferation. A dose-dependent
      increase in [3H]thymidine uptake was observed with increasing concentrations of
      interleukin-1. When megestrol acetate was added to the solution, a marked
      suppressive effect was observed. Higher doses of megestrol acetate had a greater
      suppressive effect on thymocyte proliferation. Additional investigation is
      required to further delineate the potential systemic effects of megestrol
      acetate.

PMID- 1752497
TI  - Pretherapeutic scalene lymph node biopsy in ovarian cancer.
AB  - To study scalene lymph node involvement in ovarian cancer, 37 patients with this
      disease underwent pretherapeutic open sampling of the left scalene fat tissue.
      Only 1 patient had a palpable supraclavicular mass. Positive scalene nodes were
      found in 7 (22%) of 32 patients with stage III or IV disease. Three of four
      patients with positive scalene nodes also had both positive pelvic and positive
      paraaortic nodes; one patient with stage IV disease had negative pelvic and
      paraaortic nodes. Demonstration of scalene node involvement per se currently does
      not alter the management of patients with ovarian cancer, although patients with
      occult involvement of the scalene nodes could be considered ineligible for
      intraperitoneal chemotherapy.

PMID- 1752498
TI  - Concentrated albumin infusion as an aid to postoperative recovery after pelvic
      exenteration.
AB  - Twenty-eight patients underwent pelvic exenterations for gynecologic malignancies
      between June 1986 and June 1989. The postoperative fluid and electrolytes were
      managed by one of two regimens. One group of 10 patients was given concentrated
      25% albumin infusion for the first 16 hr after surgery in addition to maintenance
      intravenous crystalloid solution according to ideal body weight. The second group
      of 18 patients received only a standard crystalloid solution. The albumin
      infusion group was found to have a more stable postoperative course as evidenced
      by less fluid boluses (P less than 0.01), fewer electrolyte bolus requirements (P
      less than 0.01), and easier management of blood pressure and urine output. There
      was a 50% decrease in total fluid requirement, a higher mean right atrial
      pressure (P less than 0.05), and a lower maintenance intravenous fluid rate (P
      less than 0.01). As a consequence, central hyperalimentation was started earlier
      (P less than 0.01) and the albumin infusion group left the Intensive Care Unit
      sooner than the non-albumin infusion group. There was not a single instance of
      clinical fluid overload with this slow infusion technique. Thus, concentrated
      albumin infusion was beneficial in the acute fluid management of these difficult
      patients.

PMID- 1752499
TI  - The prognostic importance of site and type of radiation-induced bowel injury in
      patients requiring surgical management.
AB  - A multivariate analysis was performed to determine the outcome, and factors
      prognostic for outcome, in 57 patients requiring surgical intervention for
      radiation bowel injury. The actuarial 2- and 5-year cause-specific survival (CSS)
      was 76 and 74%, respectively, with a median follow-up of 62 months for the
      survivors. The median time from surgery to death from complications was 4 months.
      Identified sites of injury were both large and small bowel. The types of injury
      were defined as stricture, perforation, inflammation, and fistula. At surgery 9
      patients had more than one site, and 15 patients had more than one type of
      injury. Cox proportional hazards regression models relating survival to
      individual patient characteristics were constructed using surgical procedure,
      radiation-surgery interval, age, stage, radiotherapy technique and dose, and the
      individual sites and types of injuries. Only the site of injury was found to be
      of prognostic significance for CSS (P less than 0.03). However, when the site and
      type of injury were recoded as single or multiple, Cox regression analysis found
      both the site (P = 0.008) and the type (P = 0.02) of injury to be statistically
      significant for CSS (favoring single sites and types). Stepwise multivariate
      regression analysis found type of injury to be insignificant when site of injury
      was already in the model. Ileal damage was associated with the lowest CSS of any
      single site of injury (56%) and also appeared to be responsible for the poor CSS
      of those with multiple sites of injury (46%).

PMID- 1752500
TI  - Masculinizing sclerosing stromal tumor of the ovary during pregnancy.
AB  - Sclerosing stromal cell tumors of the ovary are an uncommon neoplasm that usually
      does not produce hormonal imbalances. Most patients showing a hormonal effect
      from this lesion have had menstrual cycle disturbances. Infertility and
      endometrial hyperplasia have also been described. One other reported case had
      masculinizing effects. Other authors have documented elevated levels of both
      estrogenic and androgenic hormones that corrected after surgery. A case of a
      pregnant 27-year-old Caucasian with hirsutism on her chin and neck and a male
      suprapubic hair pattern is presented. Elevated androstenedione,
      dehydroepiandrosterone, and free testosterone levels were present. A 3-cm left
      ovarian mass was excised and identified as a sclerosing stromal tumor. The
      histologic features included a pseudolobular pattern with focal areas of
      sclerosis and a two-cell population of spindled and polygonal cells.
      Immunohistochemical studies showed a positive vimentin reaction, weakly positive
      desmin and muscle-specific actin stains, and a negative cytokeratin stain.
      Following surgery the hormone levels returned to normal and the hirsutism
      resolved. A normal female infant without evidence of masculinization was
      delivered from the patient at term.

PMID- 1752501
TI  - Breast cancer and second primary ovarian cancer in dermatomyositis.
AB  - We report six female patients with breast cancer who developed dermatomyositis
      and compare our data with those from other reports. The development of
      dermatomyositis in two patients led to the discovery of a second primary ovarian
      carcinoma, whereas the development of dermatomyositis in another two patients led
      to the discovery of recurrent breast cancer. In three patients the diagnosis of
      dermatomyositis preceded the diagnosis of breast cancer, while the rest developed
      dermatomyositis after the diagnosis of breast cancer. A parallel clinical course
      of dermatomyositis and breast cancer was seen in only one patient. Coexisting
      dermatomyositis and breast cancer is a rare phenomenon, and dermatomyositis that
      develops during the course of breast cancer may indicate the occurrence of a
      second primary malignancy or recurrent breast cancer. The onset of
      dermatomyositis may precede, coincide with, or follow the diagnosis of breast
      cancer. The clinical course of dermatomyositis sometimes, but not always,
      parallels the course of breast cancer. There are no specific clinical or
      laboratory markers to distinguish patients with dermatomyositis who have
      malignancy from those without cancer.

PMID- 1752502
TI  - Cervical cancer metastatic to the breast: a rare presentation of tumor
      dissemination.
AB  - Metastatic disease presenting in the mammary gland from gynecologic malignancies
      is a rare occurrence. A case of metastatic adenosquamous carcinoma of the cervix
      presenting as an inflammatory breast lesion is reported. Metastases within the
      breast have distinct clinical, radiographic, and histologic features and should
      be suspected in a patient with a breast mass and a known extramammary primary. As
      with other distant metastases of cervical cancer, mammary gland involvement
      portends a poor prognosis.

PMID- 1752503
TI  - Radiation myelitis: a complication of concurrent cisplatin and 5-fluorouracil
      chemotherapy with extended field radiotherapy for carcinoma of the uterine
      cervix.
AB  - Radiation myelitis is a rare but serious complication of radiation therapy. The
      total dose of radiation to the spinal cord required to cause myelopathy is
      greater than 50 Gy when the treatment is administered in 25 or more fractions;
      however, recent evidence has suggested that the concurrent use of chemotherapy
      may decrease the tolerance of the spinal cord to radiation. This report describes
      a case of radiation myelitis in a patient after concomitant
      fluorouracil/cisplatin chemotherapy and extended field radiotherapy for stage IIA
      adenosquamous cell carcinoma of the uterine cervix metastatic to the para-aortic
      lymph nodes.

PMID- 1752504
TI  - Non-Hodgkin's lymphoma during pregnancy.
AB  - A rare case of non-Hodgkin's lymphoma stage IE complicating pregnancy is
      presented. The diagnosis was made by biopsy at 28 weeks gestation and treated
      with 2635 rad of external radiotherapy with abdominal and pelvic shielding
      beginning at 30 weeks gestation. Following delivery, the patient received
      combination chemotherapy and is disease-free 6 years later. The baby, weighing
      2015 g, was delivered by cesarean section at term. The effects of radiotherapy on
      a fetus are reviewed and the factors that were considered in the treatment of
      this patient are discussed. Radiotherapy with protective shielding can be an
      effective initial modality of treatment in this setting.

PMID- 1752505
TI  - Three cycles of chemotherapy followed by primary cytoreductive surgery for
      unresectable ovarian cancer.
AB  - Definitive primary cytoreductive surgery was achieved at second laparotomy after
      three cycles of combination chemotherapy (cisplatin and cyclophosphamide) in
      three patients who presented with unresectable disease at our Ovarian Tumor Unit.
      The ovarian cancer was inoperable at the first laparotomy and no surgical
      procedure was performed other than biopsy of malignant tumor to confirm the
      diagnosis. Following interventional surgical cytoreduction the patients were
      given a further six courses of combination chemotherapy and then maintained for a
      further six cycles on oral chlorambucil. Two patients are disease free at 17 and
      21 months, respectively, while the other patient has cytological evidence of
      malignancy but no other clinically detectable tumor deposits at 27 months.

PMID- 1752506
TI  - [Multiple myeloma. Mechanisms of proliferation and neoplastic progression and
      their clinical implications].

PMID- 1752507
TI  - [Nosographic profile of thrombocytopenia].

PMID- 1752508
TI  - [Platelet immunology: diagnostic aspects of thrombocytopenia].

PMID- 1752509
TI  - [Idiopathic thrombocytopenic purpura: therapeutic aspects in the adult].

PMID- 1752510
TI  - [Thrombocytopenia: therapeutic aspects in the child].

PMID- 1752511
TI  - [HIV-positive thrombocytopenia].

PMID- 1752512
TI  - [New anthracyclines and multidrug resistance].

PMID- 1752513
TI  - [The immunophenotype in leukemia].

PMID- 1752514
TI  - [Physiopathology of erythrocyte membrane transport].

PMID- 1752515
TI  - [Membrane processes in the aging of the human red cells].

PMID- 1752516
TI  - [Endogenous erythrocyte proteolysis: a new approach to the study of membrane
      physiopathology].

PMID- 1752517
TI  - [Epidemiology of the principal hematologic diseases and health needs].

PMID- 1752518
TI  - [Teaching hematology to medical students].

PMID- 1752519
TI  - [Teaching hematology in specialty schools].

PMID- 1752520
TI  - [Nuclear magnetic resonance in onco-hematology].

PMID- 1752521
TI  - [Cellular mechanisms in the pathogenesis of thrombosis].

PMID- 1752522
TI  - [New diagnostic methods for the pre-thrombotic state].

PMID- 1752523
TI  - [Thrombosis and anti-tumor chemotherapy].

PMID- 1752524
TI  - [Systemic effects of thrombolytic therapy].

PMID- 1752525
TI  - [The human hematopoietic stem cell, normal and leukemic].

PMID- 1752526
TI  - [Clinical use of hematopoietic growth factors].

PMID- 1752527
TI  - [Minimal residual disease].

PMID- 1752528
TI  - [Autotransplantation in acute nonlymphoid leukemia].

PMID- 1752529
TI  - [Bone marrow transplantation from non-consanguineous compatible donors: current
      state and prospects].

PMID- 1752530
TI  - [Thrombocythemia. General considerations].

PMID- 1752531
TI  - [Essential thrombocythemia: in vitro study of megakaryocytopoiesis].

PMID- 1752532
TI  - [Essential thrombocythemia: clinical aspects].

PMID- 1752533
TI  - [Essential thrombocythemia: pregnancy].

PMID- 1752534
TI  - [Essential thrombocythemia: conventional therapy].

PMID- 1752535
TI  - [Essential thrombocythemia: antiaggregants].

PMID- 1752536
TI  - [Essential thrombocythemia: therapy with alpha interferons].

PMID- 1752537
TI  - [Transfusion safety].

PMID- 1752538
TI  - [Autotransfusion: a critical review].

PMID- 1752539
TI  - [Chronic myeloid leukemia: progress and prospects].

PMID- 1752540
TI  - [Blood component therapy today].

PMID- 1752541
TI  - [Immunologic changes in polytransfused hemophiliacs].

PMID- 1752542
TI  - [Hematologic manifestations of HIV disease].

PMID- 1752543
TI  - [Bone marrow transplantation in thalassemia].

PMID- 1752544
TI  - [Therapy of adult acute lymphoblastic leukemia].

PMID- 1752545
TI  - [Myelodysplastic syndromes: mechanisms of transformation and neoplastic
      progression and their clinical implications].

PMID- 1752546
TI  - [Role of peptide regulatory factors in the proliferation of leukemic blasts].

PMID- 1752547
TI  - [Patient-controlled i.v. morphine for acute postoperative pain].
AB  - The use of patient-controlled i.v. analgesia for postoperative pain relief in 60
      cases is described. 0.1% morphine was given by Bard or Graseby microprocessor.
      After a loading dose of 2-6 mg, the pump delivered a bolus of 0.8-1.5 mg of
      morphine every 8-12 min. The dosages necessary to provide good analgesia varied
      from 30-85 mg (mean 48). Good pain scores of 0-2 (on a scale of 5) were obtained
      in 92%. The method was also found satisfactory by the families and health care
      providers, and is highly recommended for control of postoperative pain.

PMID- 1752548
TI  - [Osteoarticular tuberculosis in a general hospital].
AB  - The status of osteoarticular tuberculosis in recent years was studied. 82 cases
      diagnosed here between 1951-1985 were surveyed. The disease was more common among
      East European Jews (38%) and among young people: the mean age was 36 years and
      the highest incidence was in the third decade. A secular tendency to "aging" was
      noted, as in later years the mean age increased. However, there was also a
      secular decrease in incidence, explained by a progressive decrease in immigration
      to Israel. The disease affected most commonly the spinal vertebrae and the weight
      bearing joints. There was an average delay of 19 months between onset of symptoms
      and/or signs of the disease and its diagnosis.

PMID- 1752549
TI  - [Tuberculosis of the spine and ribs].
AB  - Tuberculosis of the spine or ribs is uncommon, occurring in less than 1% of
      patients with tuberculosis (TB). 2 women are presented who recently immigrated
      from Ethiopia and India, respectively. One, aged 55, presented with chest pain,
      fatigue and several masses under the skin of the scalp. Chest X-ray and CT scan
      suggested Pancoast tumor, and the lateral parts of the first 2 right ribs were
      absent. The origin of the patient, clinical findings and positive PPD suggested
      TB of the ribs and anti-TB therapy resulted in cure. The diagnosis was later
      confirmed by a positive culture. The other woman, aged 68, presented with
      fatigue, mild abdominal pain and axillary lymphadenopathy. The PPD was positive
      and X-ray showed widening of the mediastinum. A caseating granuloma with Langhans
      epithelioid cells was found in a lymph node. Flaccid paraparesis developed before
      therapy was started. CT scan showed a typical picture of TB affecting the T3-T6
      vertebrae. Drainage of a cold abscess of the spine via the anterior approach was
      followed by anti-TB therapy. Culture of a biopsied lymph node and of pus obtained
      at operation confirmed the diagnosis of TB. The patient died 2 months later from
      gastrointestinal bleeding. Awareness of the unusual presentations of various
      forms of TB is mandatory in countries with immigration from countries in which TB
      is still common.

PMID- 1752550
TI  - [Oral contraceptive lowers serum magnesium].
AB  - The effect of an oral contraceptive on serum magnesium was assessed in a group of
      32 women, mean age 24.2 years, attending a family planning clinic. The pill
      contained ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg. As in pregnancy
      and during estrogen replacement in postmenopausal women, the contraceptive pill
      lowered serum magnesium (from a mean of 0.82 mmol/l, to 0.61 mmol/l in 6 months).
      Larger studies may determine whether routine dietary magnesium supplementation is
      necessary in oral contraception.

PMID- 1752551
TI  - [Extracardiac malignancy presenting with cardiac tamponade].
AB  - We describe a 65-year-old man with cardiac tamponade as the first manifestation
      of malignancy. Biochemical, bacteriological and cytological examinations of the
      pericardial fluid were not diagnostic. Abdominal CT showed a mass in the right
      adrenal and fine needle aspiration revealed metastatic carcinoma. The patient
      died 4 months later with the clinical and roentgenological picture of
      bronchogenic carcinoma.

PMID- 1752552
TI  - [Evaluation of verapamil for hypertension by an isometric exercise test].
AB  - Since the resting blood pressure (BP) does not predict round-the-clock values, in
      order to evaluate the disease and its response to treatment BP should be measured
      during exertion. Verapamil, either 120 mg or 160 mg, twice daily, was given to 60
      hypertensives at rest and during isometric effort, according to our previously
      reported protocol. There was a significant response (p less than 0.005) to the
      treatments. Sustained release verapamil, 240 mg once a day, reduced systolic and
      diastolic BP significantly in 38 of 45 hypertensives at rest and during isometric
      effort. A simple, inexpensive, cost-effective, hand-grip method is strongly
      recommended as an integral part of treatment evaluation. The combination of
      highly effective drugs together with a simple method of BP evaluation may result
      in improved long-term treatment.

PMID- 1752553
TI  - [Complications of low-dose amiodarone].
AB  - Complications of low-dose amiodarone in 83 patients, in whom the drug was
      effective and who were followed for 1-13 years, are presented. Hypothyroidism was
      diagnosed in 11 (in 8 by the finding of elevated TSH). In 2 of the 3 in whom
      clinical signs of hypothyroidism were evident, amiodarone was continued, but
      thyroxine was also given. In 5 others thyrotoxicosis ensued. Propylthiouracil
      (PTU) was given and amiodarone was discontinued. PTU was then stopped within 4-8
      months, without recurrence of the hyperthyroidism. In 1 patient pneumonitis
      resolved spontaneously a few weeks after stopping amiodarone. Because of
      gastrointestinal distress amiodarone was stopped in 1 patient. In none were liver
      enzymes elevated, nor was the nervous system affected clinically.
      Photosensitivity in 6 patients and skin discoloration in 2 did not necessitate
      discontinuation of the drug. Blurred vision was reported by 4, but its connection
      with amiodarone was not proven. There was sinus bradycardia in 2. There was no
      arrhythmic effect of amiodarone seen on ECG nor on Holter monitoring, nor was
      there any mortality. We conclude that amiodarone in low doses causes many
      complications, most of them mild and transient. However, in only a few cases is
      discontinuation of the drug indicated.

PMID- 1752554
TI  - [Acute fulminant hepatic failure after short-term amiodarone].
AB  - Acute liver failure occurred in a 59-year-old man with congestive heart failure
      within 4 days of oral loading with amiodarone. Hepatic toxicity of amiodarone
      leads to 2 histologic pictures: pseudo-alcoholic hepatitis and phospholipoidosis.
      Immune mechanisms are possible in amiodarone hepatotoxicity.

PMID- 1752555
TI  - [Preajmaline-induced cholestatic hepatitis].
AB  - 2 cases of cholestatic hepatitis due to preajmaline recovered when the drug was
      stopped. One was a 40-year-old woman, and the other a 74-year-old man whose
      jaundice lasted for 8 months. Approximately 40 patients with preajmaline-induced
      hepatitis have been described in the literature. All recovered except 1, who
      developed biliary cirrhosis while using preajmaline in conjunction with other
      hepatotoxic drugs.

PMID- 1752556
TI  - [Sex determination--has the puzzle been solved?].

PMID- 1752557
TI  - [Recombinant erythropoietin--clinical use and future prospects].

PMID- 1752558
TI  - [Treatment of arrhythmias beyond CAST].

PMID- 1752559
TI  - [Intracavernous injections for the treatment of erectile dysfunction].

PMID- 1752560
TI  - [Malpositioning of central venous catheters].

PMID- 1752561
TI  - [CNS toxicity of antineoplastic drugs].

PMID- 1752562
TI  - [Popliteal artery entrapment syndrome].

PMID- 1752563
TI  - [History of anorexia nervosa and bulimia nervosa].

PMID- 1752564
TI  - [Recent aspects of post-operative pain control].

PMID- 1752565
TI  - [The streaming liver].

PMID- 1752566
TI  - [Parasites and autoimmunity].

PMID- 1752567
TI  - [Recent trends in the management of cancer of the vulva].

PMID- 1752568
TI  - [Immunological effects of vitamin A].

PMID- 1752569
TI  - [Pectus excavatum: only a cosmetic defect?].

PMID- 1752570
TI  - [Is there a linkage between mental illness and traffic accidents?].

PMID- 1752571
TI  - [New concepts in bronchial asthma].

PMID- 1752572
TI  - [Surgical treatment of urinary stress incontinence in females].

PMID- 1752573
TI  - [Suspected epilepsy: a dangerous diagnostic term].

PMID- 1752574
TI  - [Discovery of AIDS virus behind the scenes].

PMID- 1752575
TI  - [Shortness of breath, left hemiparesis and leukocytosis after coronary bypass].

PMID- 1752576
TI  - [Moh's micrographic surgery: first experience in Israel].
AB  - Moh's micrographic surgery is a method by which cancer of the skin may be excised
      under complete microscopic control. It consistently offers the highest cure rate
      in the treatment of malignancy of the skin, while the least amount of uninvolved
      tissue is sacrificed. This, the first center for Moh's micrographic surgery in
      Israel, started functioning in 1989. The first 50 patients included 33 women
      (average age 50.7 years) and 17 men (average age 60.6 years) suffering from basal
      cell carcinoma of the face. 56% of the patients were referred for Moh's surgery
      after failure of other primary treatments, and the rest were referred due to the
      problematic location of the lesion or its size. 13 patients (28%) were referred
      after previous treatment with solcoderm (Mardi's method). In these patients the
      lesions were especially deep and aggressive.

PMID- 1752577
TI  - [Surgical treatment of urinary stress incontinence in women].
AB  - 32 women with genuine stress urinary incontinence were operated on via the
      transvaginal approach during 1989-1990. They ranged in age from 27-72 years, with
      a mean of 55.7. In 26, in addition to the urine leakage, vaginal wall prolapse of
      various degrees was diagnosed. 6 underwent Raz modified Pereyra bladder neck
      suspension, 26 had Raz 4-corner bladder and bladder neck suspension, and in 17
      rectocele and perineal repair were also performed. 2 with uterine prolapse also
      underwent vaginal hysterectomy. At follow-up 2-12 months later 29 of the 32 were
      completely cured of stress incontinence (90.6%). In 7 urge incontinence persisted
      in various degrees, and 3 had developed urge incontinence de novo. All but 1 of
      them responded favorably to anticholinergic medication. There were postoperative
      complications in 5 (15.6%), including wound infection that required removal of
      Prolene sutures in 2, urethrovaginal fistula requiring reoperation in 1,
      perioperative myocardial infarction in 1, and in 1 voiding dysfunction initially
      treated with self-intermittent catheterization, but later cured by removal of a
      pair of Prolene sutures.

PMID- 1752578
TI  - [Fractures of the proximal femur].
AB  - 907 patients were operated on for fracture of the proximal femur in 1986-1987 and
      were then followed for an average of 7 months. There was a relatively high rate
      of complications in those over the age of 71, in whom mortality reached 15.5%,
      while the overall mortality was 6.8%. There was also a high rate of complications
      in those operated 3 or more days after the fracture had occurred. In those up to
      the age of 60, the ratio of males to females was almost 1 to 1, but in those over
      80 the ratio was 1 to 4. The mortality of males was higher (9.2%) than that of
      females (5.5%). In trochanteric fractures treated by various methods of rigid
      fixation there were no problems of union or delayed union. Early mobilization and
      early discharge from hospital reduced mortality and complications.

PMID- 1752579
TI  - [Morbidity in primary care clinics of 29 kibbutzim--prospective study].
AB  - All consultations and diagnoses in the clinics of 29 kibbutzim during the 12
      month period, March 1981-February 1982, were analyzed. In these clinics there is
      physician-nurse teamwork and the nurse handles independently certain types of
      consultations which in the regular Kupat Holim clinic would ordinarily be handled
      by a physician. The total study population was 15,605, and there were 62,950
      consultations during the observation period, giving an average annual rate of
      4.03 per person. More than 40% of the consultations were with nurses. The
      distribution of diseases by the 18 main diagnostic groups of the International
      Classification of Diseases was compared with that in 3 earlier primary care
      surveys in Israel and that in the large general practice survey in Britain for
      the years 1981 and 1982. There were no marked differences between the morbidity
      patterns of this survey and those of the others. The morbidity patterns were
      typical for those found nowadays at the primary care level in developed
      countries. With greater life expectancy in industrialized societies, chronic
      degenerative diseases and particularly cardiovascular diseases, have increased.
      This is reflected in more frequent visits to primary care clinics. The proportion
      of these visits is slightly lower in this survey than in the others due to the
      younger age profile of the kibbutz population.

PMID- 1752580
TI  - [Pulmonary edema complicating upper airway obstruction].
AB  - A 40-year-old man who developed acute pulmonary edema following relief of upper
      airway obstruction is presented. The mechanism of pulmonary edema associated with
      upper airway obstruction is complex and not fully understood. It is therefore
      difficult to predict which patients will develop pulmonary edema during or after
      the relief of obstruction.

PMID- 1752581
TI  - [Central retinal artery occlusion in a young man].
AB  - Central retinal artery occlusion (CRAO) is uncommon in those younger than 50. We
      present a 42-year-old man who complained of sudden loss of vision in the left
      eye. Fundus examination showed typical findings of CRAO. Extensive medical work
      up showed no evidence of diabetes or of cardiovascular, hematologic or collagen
      disease. However, a malignant tumor of the right testis was found, with
      metastases in the lung, retroperitoneal lymph nodes and brain. The right testis
      was resected and chemotherapy and brain irradiation resulted in remission during
      a follow-up of 2.5 years. The differential diagnosis of CRAO in younger patients
      is difficult. We believe that metastases from the primary tumor were the cause of
      CRAO in our patient. The possibility of malignancy with metastatic spread causing
      CRAO should be considered, particularly in relatively young patients with no
      other evidence of systemic disease.

PMID- 1752582
TI  - [Captopril-induced liver dysfunction].
AB  - Captopril is widely used for congestive heart failure and arterial hypertension.
      Its main side effects are cough, neutropenia, and renal injury. Liver dysfunction
      has rarely been described. We present a 71-year-old man with an acute myocardial
      infarction who developed high fever and progressive disturbance of liver function
      tests, hepatocellular and cholestatic, after beginning captopril. When other,
      more likely causes for his condition were ruled out, captopril was discontinued
      and the fever and liver dysfunction then quickly resolved. We recommend periodic
      laboratory follow-up in patients treated with angiotensin-converting enzyme
      inhibitors.

PMID- 1752583
TI  - [Management of attention deficit and hyperactivity disorder].

PMID- 1752584
TI  - [Medical malpractice in Israel court judgements and defensive medicine: is it
      possible to restore trust between patients and physicians? Part II. Defensive
      medicine].

PMID- 1752585
TI  - Semen finger print.
AB  - A correlation between testosterone (T) and dihydrotestosterone (DHT) exists in
      seminal plasma. These androgens play a role in sperm maturation. The T/DHT ratio
      is different from one person to the other, due to the heterogenicity of seminal
      plasma which stems for the most part from the male accessory sex glands, the
      prostate and seminal vesicles, and also from the 'epididymo-testicular unit'.
      This ratio is useful in identifying the person's semen. Consequently, the steroid
      values from assailant semen or accused persons and semen on the victim's clothes
      are of cardinal importance in matching. The results reported include data on the
      validation of this technique as a tool for semen identification. Coital and
      masturbated semen were correlated, and consecutive coital semen were also
      analysed. It may be concluded that the T/DHT value is specific for each person.

PMID- 1752586
TI  - Evaluation of a method for simultaneous quantification of codeine, ethylmorphine
      and morphine in blood.
AB  - Codeine, ethylmorphine and morphine are the most commonly detected opiates in
      forensic blood samples in Norway. A method for the simultaneous quantification of
      these opiates utilizing solid phase extraction and gas chromatography-mass
      spectrometry has been evaluated. The detection limits were 0.026 mumol/l for
      codeine, 0.025 mumol/l for ethylmorphine and 0.032 mumol/l for morphine
      (corresponding to 7.8, 7.8 and 9.1 micrograms/l, respectively). The analytical
      variations at concentrations of 1.0 mumol/l codeine, 1.0 mumol/l ethylmorphine
      and 0.5 mumol/l morphine were less than 5%.

PMID- 1752587
TI  - In vitro loss of potassium from erythrocytes during the 0-108 h postmortem period
      in rats: relationship between potassium loss and postmortem interval.
AB  - A simple technique was employed for measurement of potassium loss (K(los)s) from
      normal and from postmortem rat erythrocytes during controlled exposure to
      physiologically isosmotic NaCl solution. Potassium loss from the cells decreased
      in a (non-linear) time-related manner during the 0-108 h postmortem period;
      expression of the data in the form of a double logarithmic plot (log K(loss)
      versus log postmortem interval (PMI) linearized the relationship between 18 and
      108 h post mortem (r = -0.86; P less than 0.001 (n = 24)). Experimental data
      revealed that the observed postmortem changes in K(loss) were associated with and
      probably resulted from, the postmortem decrease in magnitude of the potassium
      concentration gradient across the erythrocyte membrane. Attention is drawn to the
      possibility of utilizing measurements of in vitro loss of potassium from
      erythrocytes as a means of estimating time elapsed since death.

PMID- 1752588
TI  - Gas chromatographic-mass spectrometric analysis of buflomedil hydrochloride in
      biological samples after acute intoxication.
AB  - Two cases of acute intoxication of buflomedil hydrochloride are reported. The
      analysis of this compound was performed by an Extrelut extraction followed by a
      gas chromatographic-mass spectrometric determination. Analytical parameters of
      linearity, reproducibility and specificity were satisfactory.

PMID- 1752589
TI  - Neurosurgical vascular complications associated with aneurysm clips evaluated by
      postmortem angiography.
AB  - Neurosurgical vascular complications were evaluated by postmortem angiography in
      a consecutive prospective series of 63 patients in Helsinki who suffered a fatal
      outcome following neurosurgery for ruptured intracranial aneurysm. Operative
      vascular complications were revealed in 28 (44%) of the cases. Massive
      intraoperative bleeding resulting from rupture of the aneurysm or adjacent major
      artery during dissection or clip application complicated the operation in 16
      (25%) patients. Clip-induced obstruction of cerebral arteries was detected by
      angiography in seven cases (11%). In six of the patients an adjacent cerebral
      vessel was accidentally clipped. In one case a kinking of the clip had caused
      obstruction of the right anterior cerebellar artery with resulting frontal
      infarct. A combination of rupture of the internal carotid artery and accidental
      ligation of the left posterior cerebellar artery occurring simultaneously during
      the clipping of a ruptured basilar aneurysm was detected in one patient (2%).
      Other types of complication were revealed in four cases (6%): detachment of clip
      with re-bleeding; clipping of an uninvolved aneurysm instead of the ruptured one;
      displacement of the clip beneath the ruptured aneurysm. Operations on ruptured
      basilar artery aneurysm were significantly (P less than 0.01) more prone to
      complications. The results indicate that operative vascular complications play a
      significant role in the mortality of aneurysm patients. Post-mortem angiographic
      technique with contrast medium that vulcanizes at room temperature is
      particularly suitable for demonstration of the haemodynamic significance of clip
      induced cerebrovascular accidental occlusions, and is the only method at autopsy
      to reveal an occlusion caused by a kinking of a properly placed aneurysm clip.

PMID- 1752590
TI  - The analysis of quaternary ammonium compounds in human urine by direct inlet
      electron impact ionization mass spectrometry.
AB  - An accurate and rapid screening test for nine quaternary ammonium compounds
      (suxamethonium chloride, pancuronium bromide, ambenonium chloride, benzethonium
      chloride, distigmine bromide, methylbenactyzium bromide, neostigmine bromide,
      propantheline bromide and pyridostigmine bromide) by direct inlet electron impact
      ionization mass spectrometry (DI/EI-MS) was investigated. Each compound was
      extracted from urine as an ion pair with KI3 into dichloromethane. The
      reliability of the identification of these compounds was verified by the mass
      chromatographic analysis of their characteristic fragment ions. The analysis of
      these drugs by DI/EI-MS could be performed within 5 min. The detection limits
      were between 20-150 ng/ml for the nine compounds. This method appears to be
      efficient, rapid and suitable as a screening procedure for the quaternary
      ammonium compounds found in urine.

PMID- 1752591
TI  - A new biochemical method for estimation of postmortem time.
AB  - Hypoxanthine (Hx) is formed by hypoxic degradation of adenosine monophosphate
      (AMP) and might be elevated due to antemortem hypoxia. However, it also increases
      after cessation of the life processes. Until now measurements of potassium in
      corpus vitreous humor have been used by forensic pathologists to determine
      postmortem time. In this study the influence of postmortem time and temperature
      on vitreous humor Hx and potassium levels were compared. Repeated sampling of
      vitreous humor was performed in 87 subjects with known time of death and
      diagnosis. The bodies were kept at either 5 degrees C, 10 degrees C, 15 degrees C
      or 23 degrees C. Hx was measured by means of HPLC and potassium by flame
      photometry. In 19 subjects from whom samples were obtained within 1.5 h after
      death, the normal level of Hx could be estimated to be 7.6 mumol/l and that of
      potassium to be 5.8 mmol/l. The spread of the potassium levels measured shortly
      after death was much greater than for the corresponding Hx levels. In the four
      temperature groups the Hx level increased 4.2, 5.1, 6.2 and 8.8 mumol/l per h,
      respectively, whereas the corresponding figures for potassium were 0.17, 0.20,
      0.25 and 0.30 mmol/l per h. The vitreous humor concentration of both Hx and
      potassium increases fairly linearly after death. The slopes are steeper with
      increasing temperature. Since the scatter of the levels is greater for potassium
      than for Hx, the latter parameter seems to be better suited for the determination
      of time of death in cases without antemortem hypoxia, especially during the first
      24 h.

PMID- 1752592
TI  - The polymerase chain reaction and post-mortem forensic identity testing:
      application of amplified D1S80 and HLA-DQ alpha loci to the identification of
      fire victims.
AB  - The application of DNA typing methods after amplification by the polymerase chain
      reaction (PCR) of DNA derived from body tissues from charred fire victims was
      investigated. A total of 26 different tissue specimens from ten extensively
      burned individuals were analyzed. The samples included femoral muscle, psoas
      muscle, bone marrow and blood. The post-mortem period varied from 38 to 183 h.
      After amplifying the DNA by PCR from the various tissues, the D1S80 locus was
      analyzed with a high resolution polyacrylamide gel electrophoresis technique
      followed by silver staining and the alleles of the HLA-DQ alpha locus were
      detected by using a reverse dot blot format. All samples could be typed for both
      loci and the genotypes were consistent in the various tissues from each
      individual. A parentage test was performed in two cases and Mendelian inheritance
      of the alleles for both loci was observed.

PMID- 1752593
TI  - Recent status of the medical examiner system in Japan: demographic variation of
      medicolegal deaths in Hyogo Prefecture and uncertainty in medicolegal
      investigations conducted by medical practitioners.
AB  - The medical examiner system has been steadily abolished in Japan. Instead,
      medicolegal investigations are entrusted by the police to medical practitioners,
      who are not permitted to perform autopsies. The necessity for the medical
      examiner system was assessed through inquest records in Hyogo, one of the three
      prefectures which still have medical examiner systems. Standardized mortality
      ratios (SMRs) for accidents and suicides were negatively associated with
      population density, being high in rural areas with a large proportion of elderly
      citizens, while the SMR for natural deaths was high in urbanized areas and
      associated with the proportion of inquests to total resident deaths. The high
      proportion of inquests, however, did not always mean that inquest records were of
      good quality. Significant differences in the quality of medicolegal
      investigations seemed to exist between medical examiners and medical
      practitioners. That is, in order to certify the cause-of-death, medical examiners
      performed autopsies in about half of their cases, while only 2% of medical
      practitioner cases were subjected to autopsies. Medical practitioners, who
      certified the cause-of-death as "heart failure" without advising an autopsy, were
      regularly entrusted with inquests. It is likely that the causes-of-death for
      medicolegal cases may be questionable since more than 85% of all medicolegal
      deaths were investigated by medical practitioners, which may cause inaccuracy in
      at least 3-7% of mortality statistics. It is necessary to educate medical
      practitioners concerning the importance of mortality statistics and ICD and on
      the validity of autopsies, in order to obtain accurate mortality statistics from
      medicolegal cases.

PMID- 1752594
TI  - Simultaneous observation of catecholamine, serotonin and their metabolites in
      incised skin wounds of guinea pig.
AB  - In order to examine the vital reaction in wounds, catecholamines, serotonin (5
      HT) and their metabolites in the incised skin wounds of guinea pigs were analyzed
      simultaneously by high-performance liquid chromatography (HPLC) using
      electrochemical detection (ECD). The principal changes in the levels of these
      compounds in vital wounds were as follows: a considerable decrease in
      norepinephrine (NE) content was observed 12-24 h after injury which persisted to
      at least 7 days. 3,4-Dihydroxyphenylacetic acid (DOPAC) decreased slightly for up
      to 30 min and then showed no significant difference compared with postmortem
      levels. Epinephrine and dopamine were barely detected by the HPLC-ECD method
      employed. 5-HT concentrations which showed an increase up to 24 h showed maximum
      levels 800 microns from the wound edge at 10 and 30 min after injury. 5
      Hydroxyindoleacetic acid (5-HIAA) was significantly higher than the postmortem
      level over almost the entire period of these experiments. A 5-HIAA content of at
      least twice the postmortem level was observed 800 microns from the wound edge of
      a 10-min-old vital wound. Therefore, 5-HIAA is a likely candidate as a new marker
      for evaluating the vital reaction in wounds. The vital characteristics of NE,
      DOPAC, 5-HIAA and 5-HT in 10-min-old wounds persisted for up to 12 h at room
      temperature after death. These results suggest that the HPLC-ECD method used here
      is very useful for simultaneous examination of the vital reaction in wounds from
      the earliest to the later stages of the wound-healing period.

PMID- 1752595
TI  - Ofloxacin in human hair determined by high performance liquid chromatography.
AB  - A procedure is presented for quantitating ofloxacin (OFLX) in human scalp hair by
      high performance liquid chromatography (HPLC) with a fluorescence detector. An
      octadecylsilane (ODS) column was used and the mobile phase was a mixture of
      potassium phosphate buffer (pH 2.6) and acetonitrile. The recovery of OFLX was
      90.9-93.8% and within- and between-run precisions were 0.35-1.41% and 1.41-5.49%
      as the coefficient of variation (CV), respectively, when 5-50 ng OFLX was added
      to 1 mg blank hair. The calibration curve was linear in the range of 0.5-50
      ng/tube (0.5 ml). Interference with other quinolone derivatives could be avoided
      according to the difference in their retention times or fluorescence spectra.
      Several pieces of hair were obtained from each of twelve healthy male volunteers,
      who had taken OFLX (100, 300 or 900 mg total dose) over a 1-3 day period 2 weeks
      before the hair sampling. In all hair samples except one obtained from a
      volunteer, who had taken the lowest dose, the 2-cm long segments nearest the
      scalp contained OFLX (5-45 ng/mg hair), while the upper segments did not. A
      highly significant positive correlation was observed between the total dose and
      the concentration of OFLX in the 2-cm long hair segments. Such a positive
      correlation was also revealed in rat hair sampled after repeated i.p.
      administration of OFLX over a 5-week period. These results suggest that the
      measurement of OFLX in hair by the present method would be useful for testing
      patient compliance in clinical pharmacology as well as for application to
      forensic science.

PMID- 1752596
TI  - Solid phase extraction method for rapid isolation and clean-up of some synthetic
      pyrethroid insecticides from human urine and plasma.
AB  - A simple and rapid method for the isolation of seven synthetic pyrethroid
      insecticides (methothrin, fenpropathrin, cyhalothrin, permethrin, cypermethrin,
      fenvalerate, deltamethrin) with a solid phase extraction (SPE), utilizing Sep-Pak
      C18 cartridges, from human urine and plasma is presented. The detection of the
      insecticides was performed using a wide bore capillary gas chromatograph (GC)
      with flame ionization detection (FID). The insecticide-containing samples mixed
      with 70% methanol were directly applied to the cartridges and eluted with 2 ml
      chloroform. The recoveries using the cartridges were between 90-102% for urine
      and 81-93% for plasma. Mixing samples with 70% methanol prior to extraction,
      seems very useful for the screening of synthetic pyrethroid insecticides.

PMID- 1752597
TI  - Event-related brain potentials as indicators of visual recognition and detection
      of criminals by their use.
AB  - An event-related potential (ERP) was recorded, using photographs as stimuli, in
      12 subjects for attended, 9 subjects for non-attended conditions and 14 subjects
      for a simulated criminal investigation. An ERP was detected only when a subject
      recognized a familiar image (target) mixed with other, unfamiliar images (non
      target), regardless of whether he was asked to attend to or neglect the target
      image. ERPs in the subject who watched each picture but tried to ignore the
      relevant picture (non-attended) were more activated at the parietal region than
      at the central region, in contrast with ERPs in the subjects who paid attention
      to each picture without trying to ignore the relevant picture (attended). In the
      simulated criminal investigation, only a simulated thief, but not a simulated
      innocent subject elicited ERP only after the picture of a criminal site or thing
      was intermingled with pictures bearing no relationship to the crime. These
      findings indicate that the ERP using photographs as stimuli is useful as an
      objective indicator of crime-relevance.

PMID- 1752598
TI  - New aspects of prolactin in human reproduction physiology. Tokyo, August 25,
      1990.

PMID- 1752599
TI  - Role of angiotensin on paracrine prolactin release in the pituitary gland and its
      possible effects on ovarian function.
AB  - The present study was undertaken to investigate the role of angiotensin II (AII)
      in GnRH-induced PRL release on the paracrine interaction among anterior pituitary
      cells of young male rats. A 20-min perifusion with 100 nM GnRH increased PRL
      release (p less than 0.01) from pituitary cell aggregates, and GnRH-stimulated
      release of PRL was significantly suppressed by saralasin, a specific AII
      antagonist. The release of AI from pituitary cell aggregates was significantly (p
      less than 0.01) increased by GnRH. These data demonstrate that GnRH is capable of
      stimulating PRL release through a mechanism that may involve the release of
      angiotensin. It was also speculated that some factors released from pituitary
      cells, such as angiotensin, might be involved in the control of ovarian
      functions. As an approach to investigate this possibility, porcine anterior
      pituitary cells and ovarian granulosa cells were co-cultured on type 1 collagen
      membrane which permits the exchange of the substance with molecular weights less
      than 9,000. The growth and progesterone production of the granulosa cells co
      cultured with pituitary cells were significantly (p less than 0.05) greater than
      those of the cells cultured in monolayer fashion. Thus, the results of the
      present study revealed the biological significances of the paracrine system
      involving angiotensin between gonadotroph and lactotroph in pituitary cells and
      the direct effect of the factors derived from pituitary cells on ovarian
      functions.

PMID- 1752600
TI  - Possible contribution of prolactin in the process of ovulation and oocyte
      maturation.
AB  - The present study was undertaken to evaluate the effects of PRL in the process of
      ovulation and oocyte maturation. In the first experiment, using an in vitro
      perfused rabbit ovary model, the addition of PRL to the perfusate inhibited hCG
      induced ovulation in a dose-related fashion, without any reduction in
      progesterone synthesis. In a subsequent experiment, PRL directly inhibited both
      the degeneration and decomposition of surface epithelial cells and the disruption
      of connective tissue at the apex of the follicle wall. Furthermore, PRL inhibited
      hCG-stimulated plasminogen activator (PA) activity in mature follicles in a dose
      related fashion. In the final experiment, we demonstrated conditions in which
      rabbit oocytes matured in vitro acquire competence for early embryonic
      development. PRL, as well as gonadotropins and estradiol, was an important
      constituent in the process of oocyte maturation, promoting embryonic development.
      These results suggest that the preovulatory environment of PRL within the
      follicle may influence the process of ovulation and oocyte maturation.

PMID- 1752601
TI  - New aspects of prolactin in human reproductive physiology. Overview.

PMID- 1752602
TI  - Effects of prolactin on fertilization and cleavage of human oocytes.
AB  - The effects of PRL on fertilization and cleavage of human oocytes and subsequent
      pregnancy were studied. Forty-five patients (47 cycles) with euprolactinemic
      normal menstrual cycles undergoing in vitro fertilization (IVF) for the treatment
      of tubal infertility were selected for this study. The patients were divided into
      three groups dependent upon their mean serum PRL concentrations for the 3 days
      prior to oocyte retrieval; hypoprolactinemic (less than 10 micrograms/l),
      euprolactinemic (10-30 micrograms/l) and hyperprolactinemic cycles (greater than
      or equal to 30 micrograms/l). Multiple follicular development was induced with
      hMG, and 10 patients were randomized to receive bromocriptine beginning with the
      previous menstrual cycle. In the hypoprolactinemic cycle group, the fertilization
      rate was significantly lower than in the hyperprolactinemic cycle group, and the
      cleavage rate was significantly lower than in the other groups. The fertilization
      rates and the cleavage rates in the hyperprolactinemic cycle group were higher
      than those in the euprolactinemic cycle group; however, these differences were
      not statistically significant. While the pregnancy rates in the euprolactinemic
      cycle group were higher than in the other two groups, the numbers were too small
      for meaningful statistical comparison. The present study demonstrates that below
      normal concentrations of PRL have deleterious effects on IVF outcome. These data
      suggest that PRL may play a beneficial stimulatory role in oocyte maturation and
      the acquisition of developmental capacity.

PMID- 1752603
TI  - Effects of clomiphene citrate on serum hormone levels and endometrial thickness
      in an in vitro fertilization and embryo transfer program.
AB  - Hormonal alterations and pregnancy rates were compared between the clomiphene
      citrate (CC)-hMG combination cycle and the hMG cycle alone in an in vitro
      fertilization and embryo transfer program. In the CC-hMG cycle, the numbers of
      follicles developed, oocytes recovered and embryos transferred were higher than
      those in the hMG cycle (p less than 0.01, p less than 0.01 and p less than 0.05,
      respectively). Pregnancy rates of the CC-hMG cycle (6.7%/operation, 7.1%/embryo
      transfer), however, were lower than those of the hMG cycle (25%/operation,
      31.6%/embryo transfer). PRL levels in the hMG cycle increased according to
      estradiol levels. In the CC-hMG cycle, CC might inhibit estradiol-induced
      hyperprolactinemia and the increase was lower even if the estradiol level was
      much higher than that of the hMG cycle until day 2. On day 4, the PRL level in
      the CC-hMG cycle further increased. The thickness of endometrium on day -2 in the
      hMG cycle alone was much thicker than that in the CC-hMG cycle (9.8 +/- 0.4 vs.
      6.8 +/- 0.4 mm, mean +/- SEM).

PMID- 1752604
TI  - Effect of prolactin in serum and follicular fluid on fertilization and cleavage
      of human oocyte.
AB  - To assess the effect of PRL on fertilization and cleavage of oocytes, PRL levels
      in serum and follicular fluid of normoprolactinemic women who had undergone in
      vitro fertilization and embryo transfer (IVF-ET) were determined, and the
      relationship between PRL levels and fertilization and cleavage rates was studied.
      A transient increase in serum PRL at the ovulatory phase was found in about half
      of the IVF-ET patients during clomiphene stimulation, and increased levels of PRL
      in serum and follicular fluid at the ovulatory phase may suppress the
      fertilization and cleavage of oocytes.

PMID- 1752605
TI  - Renin- and angiotensin-like immunoactivities in human ovarian follicular fluid in
      in vitro fertilization.

PMID- 1752606
TI  - Effect of prolactin on the secretion of hypothalamic GnRH and pituitary
      gonadotropins.
AB  - In order to clarify the mechanism by which excess PRL inhibits gonadotropin
      release, in vivo and in vitro studies were performed with adult female rats.
      First, we examined the effect of hyperprolactinemia, produced by implantation of
      anterior pituitary glands under the kidney capsule, on catecholamine turnover in
      the medial basal hypothalamus (MBH) and on GnRH concentrations in MBH and
      hypophyseal portal blood. Rats bearing pituitary transplants exhibited increased
      turnovers of dopamine (DA) in the MBH, decreased concentrations of GnRH in the
      MBH and in plasma of hypophyseal portal blood and impaired gonadotropin release
      from the pituitary gland. Second, we examined the effects of PRL on DA release
      and of DA on GnRH release from rat hypothalamic cells. We observed that PRL
      stimulated [3H] DA release, and DA inhibited ionophore-induced GnRH release from
      dispersed hypothalamic cells. Third, we examined the effect of PRL on estrogen
      induced LH release using the in vitro perfusion system. We found that
      administration of PRL suppressed estrogen-induced LH release by suppressing GnRH
      release from the hypothalamus. These findings suggest that chronic
      hyperprolactinemia may increase dopaminergic tone in the MBH that may inhibit
      GnRH secretion from the MBH and LH release from the pituitary and that these
      processes may be responsible for disturbances of cyclic hypothalamic pituitary
      ovarian activity.

PMID- 1752607
TI  - Effects of prolactin on cultured human endometrial cells.
AB  - We report the effects of PRL on cultured human endometrial cells (epithelial
      cells and stromal cells) and discuss the role of PRL in implantation. Essentially
      similar responses to PRL in cell attachment and growth were obtained both in
      epithelial and stromal cells: a low concentration of PRL (3-30 ng/ml of PRL)
      enhanced cell attachment and growth. In contrast, the presence of a high
      concentration of PRL (over 100 ng/ml) resulted in a decrease in cell attachment
      and growth in normal culture conditions. Morphological analysis of epithelial
      glandular reformation on basement membrane extracts indicated that PRL had dual
      effects on endometrial epithelial cells: as a stimulator in low concentrations
      and an inhibitor in high concentrations. These data suggest that PRL may
      influence the functions of human endometrial cells in a dual way depending on its
      level and plays an important role in the implantation process.

PMID- 1752608
TI  - Heterogeneity of serum and amniotic fluid prolactin in humans.
AB  - The molecular heterogeneity of PRL was studied in serum and amniotic fluid using
      immunoperoxidase electrophoresis. In the amniotic fluid, larger molecular
      variants (greater than 117 kD), small PRL (20 and 23 kD) and cleaved PRL were
      present in the nonreduced condition. Newly, three mercaptoethanol (MCE)-resistant
      forms (76, 64 and 53 kD), and 25- and 23-kD forms appeared after treatment with
      MCE. Two variants, 64 and 23 kD, did not bind to concanavalin A (Con A),
      indicating a simple peptide without sugars. Other glycosylated forms, 76, 53 and
      25 kD, bound to Con A. In maternal serum, the same components as those in the
      amniotic fluid were seen, except for a scanty amount of 23 kD and a newly
      appearing glycosylated variant of 28 kD in the reduced condition. This 23-kD form
      also appeared with the administration of TRH in women.

PMID- 1752609
TI  - Dimensions of potential arterial grafts for coronary artery bypass grafting in
      Indians--an autopsy evaluation study.
AB  - Total revascularization of the heart using as many arterial grafts as possible is
      the trend of the day. We have chosen two commonly used arterial grafts to
      evaluate their efficiency in myocardial revascularization in Indian subjects. An
      autopsy study was conducted in 25 cases. Both internal mammary arteries with
      their branches and the right gastroepiploic artery were harvested. These arteries
      were distended with heated Gelatin, deep frozen and their diameters were
      measured. In 56% of subjects diameter of internal mammary artery was 1.5 to 2.0
      mm (n = 14). However 36% of subjects had diameter above 2.0 mm (n = 9). Musculo
      phrenic and superior epigastric arteries had 1.85 and 1.65 mm internal diameters
      respectively. The mean internal diameter of right gastro-epiploic artery was 2.3
      mm. When these diameters were indexed to the body surface area, they were
      comparable with similar figures from western subjects.

PMID- 1752610
TI  - Effect of preload and heart rate manipulation on Doppler transmitral flow
      velocity pattern: search for load--independent parameters.
AB  - Pulsed Doppler transmitral flow-velocity provides a non-invasive method for
      serial evaluation of diastolic function. However confounding influence of loading
      conditions and heart rate on transmitral flow makes many conclusions suspect. To
      study the effect of preload, various parameters of Doppler mitral spectrum were
      studied in 11 patients with stable effort angina, angiographic coronary artery
      disease and intact global and segmental systolic function, before and after
      administration of sublingual isosorbide dinitrate (group 1). Following isosorbide
      dinitrate administration, there was a significant increase in heart rate (p less
      than 0.001), decrease in left ventricular end-diastolic volume (p less than
      0.01), no change in left ventricular ejection fraction and systolic blood
      pressure. Peak E velocity, E velocity-time integral, E/A velocity time integrals
      ratio, acceleration and deceleration rates and diastolic filling period were
      significantly reduced whereas peak A velocity, A velocity time integral,
      acceleration and deceleration times and atrial filling period were unchanged. In
      10 age-matched patients (group 2), atrial pacing performed to achieve similar
      degree of increase in heart rate as in group 1 (10 +/- 1 vs 12. +/- 4, p = NS),
      resulted in a decrease in E velocity time integral, E/A velocity time integrals
      ratio and diastolic filling period (p less than 0.01) without any significant
      change in any other parameter. Absolute A velocity time integral, acceleration
      and deceleration times are the only parameters of transmitral diastolic flow
      velocity profile which are relatively independent of preload and heart rate
      provided the change is small.

PMID- 1752611
TI  - Spectrum of tricuspid atresia--a study of 23 cases.
AB  - The present report describes the clinical and angio-cardiographic features of 23
      cases of tricuspid atresia. Nineteen patients had type I anatomy, 2 patients had
      type II anatomy and 2 patients had type III anatomy. In addition to the standard
      features, there were some uncommon associations observed. These included double
      outlet right ventricle, double outlet left ventricle, single coronary artery,
      complete heart block, right axis deviation, ostium primum atrial septal defect
      and coarctation of the aorta.

PMID- 1752612
TI  - A pitfall of selective coronary angiography--dual anterior descending arteries in
      tetralogy of Fallot.

PMID- 1752613
TI  - Balloon mitral valvotomy in a patient with Ebstein's anomaly of tricuspid valve
      and rheumatic mitral stenosis.
AB  - We report a young woman with Ebstein's anomaly of tricuspid valve and rheumatic
      mitral stenosis who successfully underwent mitral valvotomy using double balloon
      technique. The clinical and haemodynamic benefits are sustained at 1 year
      followup.

PMID- 1752614
TI  - ST segment alternans during percutaneous transluminal coronary angioplasty.

PMID- 1752615
TI  - Pathology of aortocoronary saphenous vein graft.

PMID- 1752616
TI  - Recurrent stenosis after coronary angioplasty--current concepts and future
      direction.

PMID- 1752617
TI  - Role of foetal echocardiography in predicting perinatal outcome.
AB  - To establish foetal cardiovascular parameters as predictors of perinatal outcome
      in pregnancy, M-Mode, 2-D echocardiography and pulse Doppler study was performed
      at 24-32 weeks of gestation in 65 pregnancies. These pregnancies were followed up
      for perinatal outcome. The studied population included 24 normal pregnancies, 21
      pregnant women with heart disease (14 rheumatic and 7 congenital heart disease)
      and 20 high risk pregnancies (bad obstetric history in 7, suspected intrauterine
      growth retardation in 4, hypertensive disease of pregnancy in 6 and diabetes
      mellitus in 3). There was no perinatal mortality. Two foetuses were born with
      complete heart block and one with a small ventricular septal defect; 6 neonates
      had intrauterine growth retardation and two of these had neonatal asphyxia with
      APGAR score less than 6 at one minute. Anatomically normal heart was correctly
      diagnosed in all 64 foetuses and ventricular septal defect was detected
      antenatally in one. Antenatal diagnosis of complete heart block was correctly
      made in two foetuses. One new born with complete heart block required a permanent
      pacemaker, which was implanted. The ratio of peak velocity across mitral valve
      during atrial systole (A) to peak velocity during early diastolic ventricular
      filling (E) was chosen to correlate with perinatal outcome. The ratio was less
      than 1.0 in 6 foetuses, all of whom were subsequently confirmed to have
      intrauterine growth retardation. In normal pregnancies A/E ratio was more than
      1.0. We conclude that foetal echocardiography is a useful tool for predicting
      perinatal outcome and may be helpful in screening patients who require specific
      perinatal management.

PMID- 1752618
TI  - Utility of foetal echocardiography in clinical practice.

PMID- 1752619
TI  - Electrocardiographic features of atrial depolarization during pacing of right
      atrial appendage.
AB  - Identification of atrial capture during pacing from right atrial appendage is
      frequently difficult. Electrocardiograms of forty five patients implanted with
      AAI/DDD pacemakers (thirty unipolar, fifteen bipolar) were analysed to
      characterize the specific morphology of paced P waves. Compared to sinus P waves,
      atrial pacing resulted in atrial depolarization of lower amplitude (0.16 +/- 0.05
      mv vs 0.11 +/- 0.032 mv, P less than 0.005) but increased duration (0.07 +/-
      0.009 sec vs 0.08 +/- 0.017 sec, P less than 0.005). P wave morphology was
      similar in unipolar and bipolar pacing units. It was positive in lead I (80%), II
      (71.11%), III (80%) and aVF (75.55%). In lead aVL, paced P waves were usually
      diphasic with an initial negative deflection (35.55%). Precordial leads showed
      paced atrial depolarization of small amplitude and did not help in identification
      of atrial capture. In unipolar pacing P waves were best seen in lead III because
      of small pacing spike in this lead. Lead II was suitable for identification of
      paced P waves in bipolar pacing. Thus careful examination of standard ECG leads
      for paced P waves of low amplitude, prolonged duration and specific morphology
      can help in confirming atrial capture following pacing stimulus from right atrial
      appendage.

PMID- 1752620
TI  - Percutaneous transluminal coronary angioplasty of distal lesions: comparison of
      results with proximal lesions.
AB  - The results of percutaneous transluminal coronary angioplasty (PTCA) of 57 distal
      lesions were compared with 55 proximal lesions in 42 patients, aged 31 to 66
      years (mean +/- SD: 51 +/- 9 yrs). Twenty nine (69%) had multivessel and 13 (31%)
      single vessel disease. The lesions classified as distal were located in left
      anterior descending (LAD) artery beyond the origin of second diagonal (D2), left
      circumflex (LCx) after the main obtuse marginal (OM) and right coronary artery
      (RCA) after the origin of acute marginal branch. Also included in this category
      were lesions in the second diagonal and obtuse marginal branches, two centimeters
      from their origin and stenosis in the posterior descending and posterolateral
      left ventricular branches of RCA. Out of 57 distal lesions 18 were 'complex'
      because of tandem location (5 patients), ulceration (6 lesions) and intraluminal
      thrombi (2 lesions). There was no significant difference in the mean luminal
      diameter stenosis between distal and proximal lesions, before and after PTCA. The
      primary success rate of angioplasty was 89.5% for the distal and 94.5% for the
      proximal lesions (P = NS). Inability to position the balloon across the lesion
      accounted for more failures in distal (3) compared to proximal (1) location.
      There were no major complications. Our results show that PTCA of distal lesions
      can be performed with a high rate of success, which is comparable to those with
      classical proximal lesions in the same patients.

PMID- 1752621
TI  - Safety and predictive value of exercise stress testing within three days after
      percutaneous transluminal coronary angioplasty.
AB  - The safety and efficacy of exercise stress testing within three days of
      successful coronary angioplasty was evaluated in 226 patients with coronary
      artery disease; 137 patients had single-vessel disease (SVD) and 89 had multi
      vessel disease (MVD). Comparisons were made between patients with SVD and MVD and
      between patients whose vessels restenosed and those whose vessels remained
      patent. The post-angioplasty exercise test was positive in 48% of SVD and 49% of
      MVD patients. However, a positive result did not predict future restenosis. There
      was a significantly [p = 0.004] higher proportion of patients in the MVD group,
      compared with the SVD group, who exhibited greater than or equal to 2mm ST
      depression, but again this was not indicative of restenosis. No complications as
      a direct result of having an early exercise test occurred. Exercise stress
      testing proved safe and was effective in demonstrating relief from angina in most
      patients early after coronary angioplasty. It did not, however, predict
      restenosis.

PMID- 1752622
TI  - Acute myocardial infarction in north Kerala--a 20 year hospital based study.
AB  - This is a retrospective study of patients with first attack of myocardial
      infarction admitted to Medical College Hospital, Calicut during the years 1969 to
      1988. The data analysed were compared to other hospital based studies in India
      and abroad. A striking increase in the percentage of acute myocardial infarction
      was observed. There was also an increase in the occurrence of myocardial
      infarction in the young. A properly designed population based study is warranted.

PMID- 1752623
TI  - Assessment of antianginal efficacy of long-acting sustained release isosorbide
      dinitrate in comparison with short-acting isosorbide dinitrate.
AB  - A quadruple blind randomized cross-over study evaluated the therapeutic efficacy
      of twice a day long acting sustained release isosorbide dinitrate (SRISDN) in
      comparison with 4 times daily of the short acting isosorbide dinitrate in 18
      patients with stable angina pectoris (NYHA class II-III) with a positive exercise
      treadmill test. The antianginal effect of sustained release isosorbide dinitrate
      (SRISDN) (exercise duration 472.61 +/- 112.49 sec and anginal episodes per week
      (1.33 +/- 1.18) was not significantly different (p less than 0.05) when compared
      to conventional isosorbide dinitrate (exercise duration 468.33 +/- 135.28 sec and
      anginal episodes per week 1.55 +/- 104). Twice a day long acting sustained
      release isosorbide dinitrate is as effective as four times a day conventional
      short acting isosorbide dinitrate. Such a regimen is likely to lead to a better
      patient compliance and ease of antianginal therapy.

PMID- 1752624
TI  - Polyene antibiotics in the membrane environment.
AB  - The cytotoxic activity of the polyene antibiotics mainly depends on the
      appearance of the drug species which arises from drug-sterol complexation. The
      unsaturation and intact macrolide ring of the polyenes are the requirements for
      the biological activity. All the polyene antibiotics can form the complex with
      the sterol having 3 beta-OH group, and planar ring and a hydrophobic side chain.
      Aromatic polyene antibiotics with positively charged head group have been
      considered as most potential antifungal agents.

PMID- 1752625
TI  - Cloned single copy DNA sequences of Mycobacterium tuberculosis as DNA probes.
AB  - A recombinant genomic clone was isolated from a lambda gt 11 library of M.
      tuberculosis on the basis of lack of hybridization with M. avium and M. kansasi.
      The specificity and sensitivity of M. tb DNA probes, 2.5 and 2.3 kb in size, were
      assessed by Southern blot and dot blot hybridization. These did not cross
      hybridize to DNA of mycobacteria other than members of M. tb complex, nor with
      DNA of non mycobacterial origin. Sensitivity was determined to be 200 pg which is
      equivalent to 10(4) bacilli. Genomic Southern hybridization indicated single copy
      nature of the probes.

PMID- 1752626
TI  - Binding of Cu(2+)-beta-cyclodextrin complex to calf thymus DNA.
AB  - Cu(2+)-beta-cyclodextrin (1:1) complex has been found by UV, fluorescence and CD
      spectroscopy, polarimetry and gel electrophoresis to bind reversibly to calf
      thymus DNA. Using UV the binding constant was found to be 45280 +/- 7100 M-1. The
      binding of the complex Cu(2+)-BCD with DNA was stronger than that of free Cu2+.
      However the ternary complex formed thus was destroyed by EDTA.

PMID- 1752627
TI  - Isolation and characterization of a naturally occurring inhibitor from mung bean
      (Vigna radiata) seedlings for serine hydroxymethyltransferase.
AB  - A naturally occurring inhibitor of serine hydroxymethyltransferase (EC 2.1.2.1)
      in mung bean seedlings extracts was purified by ammonium sulphate precipitation,
      phenyl-Sepharose chromatography followed by heating to release the inhibitor
      bound to the protein. The inhibitor had an absorption maximum at 200 nm, was not
      precipitated by trichloroacetic acid, was dialysable and resistant to
      inactivation by heating at 98 degrees C for 4 hr, protease and ribonuclease
      digestion; but was acid labile. The chromatographically pure preparation
      inhibited both mung bean and sheep liver SHMT. Qualitative and quantitative
      analyses indicated that it contained a carbohydrate moiety, an O-amino and
      vicinal diol groups. Paper electrophoresis at pH 4.3 suggested that the inhibitor
      was positively charged.

PMID- 1752628
TI  - Differential binding of NAD+ to acyl glyceraldehyde-3-phosphate dehydrogenase and
      its role in the acyl group transfer reaction.
AB  - Enzyme protein fluorescence of di-furylacryloyl-glyceraldehyde-3-phosphate
      dehydrogenase (di-FA-GPDH:lambda max.excitation 290 nm, lambda max.emission 338
      nm) is quenched about 28% on saturation with NAD+. Results of fluorometric
      titration of di-FA-GPDH with NAD+ suggest the presence of two tight and two loose
      coenzyme binding sites (Kdiss. 0.1 and 6.0 microM, respectively). Initial rates
      of the NAD(+)-dependent reaction of di-FA-GPDH with arsenate and phosphate and of
      mono-FA-GPDH with phosphate have been determined at varying coenzyme
      concentrations. The data suggest that binding of NAD+ at the tight sites does not
      activate the acyl group for its reaction with the acceptor (phosphate or
      arsenate). The group transfer reaction is dependent only on NAD+ binding to the
      loose sites, which carry the acyl group. The large difference in the NAD+ binding
      affinity to the two types of sites and their different effects on the group
      transfer reaction impart a sigmoidal shape to the rate versus [NAD+] plots. The
      sigmoidicity is abolished if the reactive SH groups at the unacylated sites are
      blocked by carboxymethylation.

PMID- 1752629
TI  - Protein adsorption at solid-liquid interfaces: Part IV--Effects of different
      solid-liquid systems and various neutral salts.
AB  - Adsorption isotherms of BSA at the solid-water interfaces have been studied as a
      function of protein concentration, ionic strength of the medium, pH and
      temperature using silica, barium sulphate, carbon, alumina, chromium, ion
      exchange resins and sephadex as solid interfaces. In most cases, isotherms for
      adsorption of BSA attained the state of adsorption saturation. In the presence of
      barium sulphate, carbon and alumina, two types in the isotherms are observed.
      Adsorption of BSA is affected by change in pH, ionic strength and temperature of
      the medium. In the presence of metallic chromium, adsorbed BSA molecules are
      either denatured or negatively adsorbed at the metallic interface. Due to the
      presence of pores in ion-exchange resins, adsorption of BSA is followed by
      preferential hydration on resin surfaces in some cases. Sometimes two steps of
      isotherms are also observed during adsorption of BSA on the solid resins in
      chloride form. Adsorption of BSA, beta-lactoglobulin, gelatin, myosin and
      lysozyme is negative on Sephadex surface due to the excess adsorption of water by
      Sephadex. The negative adsorption is significantly affected in the presence of
      CaCl2, KSCN, LiCl, Na2SO4, NaI, KCl and urea. The values of absolute amounts of
      water and protein, simultaneously adsorbed on the surface of different solids,
      have been evaluated in some cases on critical thermodynamic analysis. The
      standard free energies (delta G0) of excess positive and negative adsorption of
      the protein per square meter at the state of monolayer saturation have been
      calculated using proposed universal scale of thermodynamics. The free energy of
      adsorption with reference to this state is shown to be strictly comparable to
      each other. The magnitude of standard free energy of transfer (delta G0B) of one
      mole of protein or a protein mixture at any type of physiochemical condition and
      at any type of surface is observed to be 38.5 kJ/mole.

PMID- 1752630
TI  - Characterization of mitochondrial membrane fragments resulting from spontaneous
      swelling: novel stimulation of NADH-dependent respiration by carboxylic acids.
AB  - Metabolically induced high amplitude swelling of rat liver mitochondria has been
      found to result in the formation of a heterogeneous population of mitochondrial
      membranes consisting of right side-out particles with occluded fumarase activity
      and inside-out particles/fragments capable of NADH-dependent respiration. This
      rotenone-sensitive, uncoupler-insensitive, NADH-dependent respiration was
      specifically and instantaneously stimulated by several ligands such as glutamate
      and malate (which can be metabolized) and, interestingly, even lactate (which
      could not be metabolized by the swollen mitochondria). These observations suggest
      that high amplitude swelling results in a novel type of control of respiration in
      these fragments.

PMID- 1752631
TI  - NADH-dependent respiration in osmotically inactive swollen mitochondria: does
      transport replace phosphorylation in mediating respiratory control in swollen
      mitochondria?
AB  - Rotenone-sensitive, uncoupler-insensitive, NADH-dependent respiration was
      demonstrated in osmotically inactive fragments of the mitochondrial inner
      membrane obtained following high amplitude (spontaneous) swelling. This NADH
      dependent respiration as well as mitochondrial ATPase activity was stimulated by
      ligands which are known to be transported by specific transporters/mechanisms.
      The ligands capable of this anomalous respiratory control included several
      intermediates of the citric acid cycle, besides non-metabolizable ligands
      including lactate, cations such as K+ and Ca2+. The interaction between NADH
      dependent respiration and these ligands, as manifested by stimulation of
      respiration, was strongly ionic strength-dependent. The thermodynamic
      relationship between respiratory control and stimulation of transport ATPase by
      the relevant transportable ligands could also be demonstrated in the conventional
      (rat liver) microsomes. These experimental results offer a novel experimental
      base for search into an intra-membranous mechanism of energy transduction.

PMID- 1752632
TI  - Hepatic plasma membrane fluidity and dietary proteins.
AB  - Effect of protein deficient diet on hepatic plasma membrane fluidity has been
      studied in rats using (i) steady state fluorescence polarization and anisotropy,
      (ii) phospholipid and cholesterol contents, (iii) phospholipid fatty acid
      composition, (iv) turnover of phosphatidyl choline (PC), and (v) activities of
      membrane-bound enzymes as parameters and rats fed casein (20%) diet as standard
      group. A significant increase in steady state fluorescence and anisotropy values
      was registered in the deficient group, indicating increased resistance and hence
      decrease in fluidity of the plasma membrane. Supplementation of the diet with
      lysine and threonine improved these values, thereby suggesting the significance
      of diet for membrane fluidity. Simultaneous significant alterations in other
      parameters, viz. (i) decrease in PC, PE and free cholesterol and increase in
      esterified cholesterol contents, (ii) decrease in unsaturation of fatty acids of
      PC, (iii) decrease in incorporation of NaH2 32PO4, [CH3-14C]choline and [CH3
      14C]methionine into plasma membrane PC, and (iv) decrease in activities of plasma
      membrane 5'-nucleotidase and phosphodiesterase along with increase of (Na(+)
      K+)ATPase and adenyl cyclase, were observed in the deficient group which on
      supplementation with lysine and threonine showed improvement over alterations.

PMID- 1752633
TI  - Covalently bound fatty acids in the gastrointestinal epithelial cell membrane.
AB  - Myristic, palmitic, stearic, oleic and linoleic acids have been identified as the
      covalently bound fatty acids in the monkey gastrointestinal mucosal membrane
      proteins and among them palmitolation was predominant. Distribution studies in
      various regions of the gastrointestinal mucosa showed no significant difference
      in the content and composition of covalently bound fatty acids in these membrane
      and most of the fatty acids were found to be ester linked. Total membranes from
      isolated crypt and villus enterocytes and colonocytes had similar composition of
      these fatty acids. Covalently bound fatty acid levels were higher in the small
      intestinal brush border membrane. As suggested for the mucus glycoproteins,
      covalently bound fatty acids in the intestinal epithelial cell membrane may
      protect these membranes from proteolytic damage from the luminal proteases.

PMID- 1752634
TI  - Evaluation of media for primary isolation of Campylobacter jejuni from faecal
      samples from children and animals.
AB  - Different media were used for primary isolation of Campylobacter. Butzler &
      Preston medium was found to be more selective compared to Skirows & Blaserwang.

PMID- 1752635
TI  - Enzyme linked immunosorbent assay (ELISA) for detection of meningococcal
      antibodies in north India.
AB  - Serological response was studied in 16-30 years high risk age group, during the
      period December 1986-April, 1988, following meningococcal vaccine (Biomerieux,
      France). A total of 200 serum samples were collected from 50 individuals before
      vaccination and at 3 intervals of 1, 3 and 6 months post-vaccination
      respectively. Antibody response was measured by Enzyme Linked Immuno-Sorbent
      Assay (ELISA) and indirect haemagglutination assay (IHA). In the vaccinees
      antibody response by IHA test showed 56%, 82%, 78% and 74% positivity in the pre
      vaccination, 1 month, 3 months and 6 months post vaccination samples. By ELISA
      2%, 80%, 74% and 66% of the above groups showed serological response. Difference
      in the pre-vaccination and titres/O.D. of various post-vaccination groups was
      found to be statistically significant (p less than 0.001). There was, however, no
      significant difference (p greater than 0.05) amongst the titres/O.D. of three
      post-vaccination groups. Similarly acute and convalescent blood samples of 25
      patients and one sample each of 31 contacts was studied for antibody response. In
      general, higher antibody titres are produced with systemic infection than with
      local nasopharyngeal infection or following vaccination.

PMID- 1752636
TI  - The bicuspid aortic valve--an autopsy study.
AB  - Congenital Bicuspid Aortic Valve is a common congenital anomaly. We studied 48
      cases of bicuspid aortic valve seen over a period of 20 years. 18 cases were
      associated with other congenital anomalies, patent ductus arteriosus being the
      most frequent. 30 were isolated lesions. The morphology of the cusps and position
      of raphe were noted. Calcification and infective endocarditis were frequently
      noted in the isolated forms of Bicuspid Aortic Valve. Coronary arteries were
      dissected in 32 cases to determine the dominance.

PMID- 1752637
TI  - Actinomadura madurae causing mycetomas in Madras.
AB  - Two hundred and ten histologically diagnosed cases of mycetoma filed in the
      Departments of Pathology of four Medical Colleges in Tamil Nadu, India, between
      1964-1987 were subjected to detailed histopathological study; Actinomadura
      madurae, was found in 73 of them. In nine cases of mycetoma pedis, the organism
      A. madurae has been isolated in pure culture. In one case, the lesions were
      present in both the feet. The characteristic cream-coloured granules were seen in
      all. The lesions responded well to a combination of Streptomycin and dapsone.

PMID- 1752638
TI  - Diagnostic and prognostic significance of serum cholinesterase and lactate
      dehydrogenase in breast cancer.
AB  - Serum cholinesterase (ChE) and Lactate dehydrogenase (LDH) activities were
      estimated in 40 cases of carcinoma breast, 25 cases of benign tumours and
      compared with healthy controls (30 cases). Significant difference in enzyme
      activities were obtained between benign and malignant neoplasms of the breast
      when compared with each other as well as when compared with healthy controls.
      Also, there were significant enzyme changes between non-metastatic cases and
      those with metastasis and when Stage I and Stage II cancers were compared with
      those in Stage III and Stage IV. No difference in enzyme levels were recorded
      between pre and post-operative cases and in different types of breast cancers.
      While ChE was depressed in 80 per cent cases of malignancy breast, serum LDH was
      raised in 73.3 per cent cases.

PMID- 1752639
TI  - Determination of the probable date of delivery using vaginal cytology as an
      index.
AB  - 70 normal pregnant females were used for the study, 47 of whom had vaginal
      cytological follow-up from week 32 till the first stage of labour. 23 additional
      patients had vaginal smears made in the first stage of labour. The combined
      intermediate cell value was used as an index of impending labour with values at
      week 38 being 90.35 +/- 0.0863, week 39 being 89.41 +/- 0.1934, week 40 being
      81.25 +/- 0.0558 and at labour being 78.75 +/- 0.0995. The primigravidae showed a
      stepwise, gradual decrease in mean intermediate cell value from week 38 onwards,
      while the multigravidae showed a drop only at week 40. From this study, it has
      been shown, that it is possible to predict labour. It was also evident that there
      is a difference in reactivity of a primigravida versus multigravida to decreases
      in circulating progesterone as gauged by intermediate cell counts.

PMID- 1752640
TI  - Evaluation of cryostat frozen section in the diagnosis of surgical biopsies.
AB  - Cryostat frozen section technique was used on 1300 surgical biopsies. On final
      paraffin sections diagnosis there were 270 benign neoplasms, 200 malignant
      neoplasms and 830 inflammatory and non-neoplastic lesions. The overall accuracy
      using frozen section was 98.48 per cent with one false positive result (0.07 per
      cent), 17 false negative results (1.3 per cent) and 2 deferred diagnosis (0.15
      per cent).

PMID- 1752641
TI  - Perfusion nephropathy--a rare histological entity mimicking "hyperacute
      rejection".

PMID- 1752642
TI  - Malignant lymphoma scalp--a case report.

PMID- 1752643
TI  - Arcanobacterium haemolyticum brain abscess in a child (a case report).

PMID- 1752644
TI  - Histoplasmosis simulating cutaneous carcinoma.

PMID- 1752645
TI  - Autologous bone marrow transplantation.

PMID- 1752646
TI  - Bacteriology of diabetic foot ulcers.
AB  - Seventy five diabetic foot ulcers were cultured using optimal aerobic and
      anaerobic microbiologic techniques. There were a total of 223 isolates (162
      aerobes and 61 anaerobes) representing an average of 2.97 bacterial species per
      specimen. Mixed organisms were the most common isolates. Staphylococcus aureus
      was the commonest isolate being recovered in 60% of cases. Anaerobic organisms
      were isolated in 46 patients (61.33%) and the most frequent anaerobe isolated was
      Bacteroides fragilis. The other organisms predominantly isolated were Proteus,
      Klebsiella, Pseudomonas, Peptoccus and Clostridia. Antibiogram showed
      discouraging pattern with commonly used antibiotics. Metronidazole and gentamicin
      were the most effective antimicrobial agents against anaerobic and aerobic
      organisms respectively. Appreciation of the causative organisms in diabetic foot
      and their antibiotic sensitivity is essential for institution of appropriate
      antibiotic therapy.

PMID- 1752647
TI  - T and B lymphocytes in patients with enteric fever.
AB  - Estimation of T and B lymphocytes was done in 50 patients of enteric fever, 50
      duration matched non enteric fever patients and 50 normal healthy individuals.
      The difference in both early and late rosette forming T lymphocytes was found to
      be statistically significant in enteric versus non-enteric patients. Significant
      difference was also observed in enteric versus normal individuals in case of late
      rosette forming T lymphocytes.

PMID- 1752648
TI  - Circulating immune complexes and complement in bancroftian filariasis.
AB  - Sixty filarial cases, 30 endemic normal individuals and 10 non endemic subjects
      were investigated for the presence of Circulating Immune Complexes (CICs) and
      Complement Component C3. Using Polyethylene Glycol precipitation and Polyethylene
      Glycol precipitation-Complement Consumption methods, it was observed that CICs
      were raised significantly in chronic lymphatic filariasis and Tropical Pulmonary
      Eosinophilia (TPE) groups. The results observed by both the techniques for
      detection of CICs were comparable. Low levels of C3 were detected in chronic
      lymphatic filariasis cases by single radial immunodiffusion method, suggesting
      the utilization of complement by immune complexes.

PMID- 1752649
TI  - Cell marker studies in undifferentiated soft tissue sarcoma.
AB  - 100 cases of undifferentiated soft tissue sarcomas were studied using cell
      markers by immunoperoxidase technique with DAB as substrate. Vimentin, Desmin,
      Myoglobin, Actin, Keratin, Epithelial Membrane Antigen, S-100 protein, F VIII R
      Ag, A1 Antitrypsin, A1 Antichymotrypsin, Collagen-IV and UEA-1 lectin were used
      as markers. Fibrosarcoma was consistently positive for Vimentin and Collagen-IV.
      The undifferentiated Rhabdomyosarcoma showed strong and consistent positivity for
      Vimentin Actin and Myoglobin. Desmin positivity was the hallmark of
      leiomyosarcoma, whereas the malignant schwannomas were identified by their S-100
      positivity. This marker along with A1AT and A1ACT reactivity was of great use in
      the identification of malignant fibrous histiocytoma. Angiosarcoma/malignant
      haemangioendothelioma could be identified with great accuracy by their strong
      positivity for F VIII RAg and UEA-1 lectin. Other miscellaneous sarcomas also
      could be identified by their specific reactivity to the markers used. We consider
      immunohistochemistry to be an important and essential adjunct to routine stains
      in the diagnosis of undifferentiated soft tissue sarcomas.

PMID- 1752650
TI  - The challenge of multi-drug resistant typhoid fever.

PMID- 1752651
TI  - Current concepts of epidemiology, diagnosis and treatment of childhood
      tuberculosis in the United States.

PMID- 1752652
TI  - Multi drug resistant Salmonella typhi infection: clinical profile and therapy.
AB  - Multiple drug resistant Salmonella typhi infection was observed in thirty five
      recent cases among forty eight children with bacteriologically proven enteric
      fever. Incidence of complications such as shock, myocarditis, encephalopathy and
      paralytic ileus was higher among these. A combination of cephalexin and
      gentamicin was successfully used in the management of these children.

PMID- 1752653
TI  - Maternal fetal immunological relationship particularly mycobacterial immunity.
AB  - Thirty-nine paired maternal and cord blood from normal full term deliveries were
      tested for lymphocyte function by proliferative response to mitogens
      Phytohemagglutinin-P (PHA) and Poke week mitogens (PWM). Monocyte function was
      assessed by the ability of the monocytes to release hydrogen peroxide (H2O2) in
      response to standard stimulus (PMA). Mycobacterial immunity was assessed by
      lymphocyte proliferative response to purified proteins derivative (PPD) and IgM
      and IgG antibody response to H37Rv and 5 atypical mycobacteria. Lymphocyte
      functions were significantly lower in cord blood (PHA 20.6, PWM 21.2) as compared
      with maternal blood (PHA 65.8, PWM 37.8). The capacity of fetal monocytes to
      release H2O2 was comparable to maternal monocytes. The mean proliferative
      response of fetal lymphocytes to tubercular protein (PPD) was 0.67 as compared (P
      less than 0.01) to maternal lymphocytes (3.79). Nearly 86% of the cord blood did
      not show any response to PPD. None of the cord blood showed IgM antibody response
      to H37Rv nor to any of the range of 5 atypical mycobacteria though maternal IgM
      and IgG response was present. There was only passive transfer of IgG antibody
      from mother to fetus. Hence, though this is a highly endemic area for atypical
      mycobacteria and M. tuberculosis, there was apparently no transplacental transfer
      of antigen in normal sensitized mothers.

PMID- 1752654
TI  - Cerebrospinal dehydrogenases in central nervous system infections.
AB  - Cerebrospinal fluid (CSF) dehydrogenases were studied in 42 controls, 23 children
      with pyogenic meningitis, 22 with tuberculous meningitis and 19 with encephalitis
      to assess their usefulness in differentiating between the different central
      nervous system infections. CSF-LDH and ICD activity was increased in CNS
      infections (p less than 0.0001), LDH being significantly higher (p less than
      0.001) in pyogenic meningitis than in tuberculous meningitis or encephalitis.
      However, ICD activity was significantly different in each of these conditions (p
      less than 0.001). The dehydrogenase activity declined with subsequent clinical
      improvement, in all children with meningitis. A significant direct relationship
      was found between the enzyme activity and CSF protein content as well as total
      cell count. The 95% confidence interval confirms the utility of assaying CSF
      dehydrogenase activity to differentiate various CNS infections, thus improving
      the diagnostic ability.

PMID- 1752655
TI  - Enuresis: analysis of 100 cases.
AB  - One hundred children with enuresis were studied to find out various factors
      responsible for this condition. Enuresis was more frequent in first born, service
      class and bottle fed children. There was a significant role of stress factors in
      causation of enuresis. We found a higher frequency of behavioral symptoms among
      children with enuresis. There was no significant correlation between enuresis and
      sex, education of parents, social class, sleep patterns, age of mother at
      marriage and intellectual grades of the children. Worm infestations, giardiasis,
      amebiasis and urinary infection were seen in 70% of cases. General body weakness,
      cold and nervousness were the common causes of enuresis in the parents' opinion.
      The main reason for not seeking the treatment at an early stage in view of
      parents' was that they thought enuresis a normal variant.

PMID- 1752656
TI  - Diagnostic and therapeutic colonoscopy in children: experience from a pediatric
      gastroenterology centre in India.
AB  - Eighty colonoscopies were performed in 72 children suffering from various colonic
      disorders. The indications for colonoscopic examination were bleeding per rectum
      (83.3%), prolonged colitis (14.0%) and colonic obstruction (2.7%). Total bowel
      wash with normal saline was very good for colonic preparation in majority of the
      cases. Pediatric colonoscope (PCF-Olympus) was used and the procedure performed
      under sedation with intravenous diazepam and pentazocine. Juvenile polyps were
      the commonest lesions (69.4%). Diagnosis of idiopathic ulcerative colitis, acute
      colitis, tuberculous colitis, amebic colitis and allergic colitis was made in
      5.5, 4.2, 2.7, 1.3 and 1.3% cases, respectively. Tuberculous hypertrophic lesion
      and tuberculous stricture was seen in one case each. The commonest site of
      juvenile polyps was rectosigmoid region. Ninety per cent of them were single, 8%
      had polyps ranging from 2-4 in number and one (2%) child had juvenile polyposis
      coli. Successful colonoscopic removal of polyps with polypectomy snare was
      possible in 96% cases. No complications were observed. Colonoscopy is a safe and
      useful mode of investigation of colonic disorders in expert hands. It has a great
      therapeutic value in childhood.

PMID- 1752657
TI  - Calcium, magnesium and phosphorus concentrations in human milk and in sera of
      nursing mothers and their infants during 26 weeks of lactation.
AB  - Longitudinal calcium, magnesium and phosphorus concentrations were measured in
      milk and sera of 20 nursing mothers and their infants during a period of 26
      weeks. Within this period, progressive increase in serum calcium, magnesium and
      total protein concentrations were observed in breast-fed infants, in association
      with decreasing phosphorus content of breastmilk. Maternal serum calcium,
      magnesium and total protein concentrations also increased during this period. It
      is speculated that a decrease in serum phosphorus in breast-fed infants can cause
      rickets. It is also speculated that the physiological rise in serum calcium
      concentrations in maternal serum may be related to the physiological increase in
      serum total protein.

PMID- 1752658
TI  - Periventricular hemorrhage in term newborns originating from germinal matrix.
AB  - Six term newborns, presenting with seizures, in whom cranial sonogram showed
      isolated periventricular hemorrhage (SEH) are described. Age of onset of seizures
      ranged from day one of birth to day twenty-one. Seizures appeared spontaneously
      in previously healthy newborns in three cases. All but one survived, and three
      have near normal development. Isolation of hemorrhage to the periventricular area
      suggests germinal matrix to be the source of hemorrhage in these cases. These
      cases also emphasize the need to consider diagnosis of IVH in term-newborns
      presenting with seizures.

PMID- 1752659
TI  - Tuberculosis of petrous apex.

PMID- 1752660
TI  - Immunoglobulin profile in tuberculous and pyogenic meningitis.

PMID- 1752661
TI  - Hemoptysis in tetralogy of Fallot.

PMID- 1752662
TI  - Dental caries in children.

PMID- 1752663
TI  - Ciprofloxacin in the management of multiple drug resistant typhoid fever.

PMID- 1752664
TI  - Erythroleukemia.

PMID- 1752665
TI  - Hypokalemic paralysis.

PMID- 1752666
TI  - Chloramphenicol resistant typhoid fever.

PMID- 1752667
TI  - Treatment of enteric fever--what next?

PMID- 1752668
TI  - Non-nutritive sucking in pre-term infants on the full breast.

PMID- 1752669
TI  - Why dilute feeds?

PMID- 1752670
TI  - Rapid epidemiologic assessment.

PMID- 1752671
TI  - Quantitation of proteinuria using protein-creatinine ratio in random urine
      samples.
AB  - Estimation of proteinuria in children is cumbersome when a 24 h urine collection
      is needed. In the presence of a stable glomerular filtration rate, the ratio of
      urinary protein and creatinine should reflect the protein excretion. One hundred
      samples of urine (24 h and random samples) were collected from 50 children with
      nephrotic syndrome, 25 with nephrotic syndrome in remission and 25 normal
      children. The 24 h urine total protein and random urine protein-creatinine ratio
      were assessed on these samples. Linear regression analysis of the results showed
      excellent correlation between the values (r = 0.81, p less than 0.001). A random
      urine protein-creatinine ratio of greater than 3.5 correlated with massive
      proteinuria, while a ratio less than 0.2 was suggestive of physiological values.
      The sensitivity, specificity, positive and negative predictive values of the
      protein-creatinine ratio in massive proteinuria were very high. We conclude that
      the random urine protein-creatinine ratio can be used reliably to assess the
      degree of proteinuria in children.

PMID- 1752672
TI  - Evaluation of naked eye single tube red cell osmotic fragility test in detecting
      beta-thalassemia trait.
AB  - The Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) was applied
      to 4 groups of subjects: (i) Normal; (ii) Proven beta-thalassemia trait carriers;
      (iii) Iron deficiency anemia; and (iv) other hemoglobinopathies, to evaluate its
      effectiveness as a screening test for beta-thalassemia minor. The test was
      successful in detecting 105/110 subjects with beta-thalassemia trait. The
      sensitivity of the test was 95.5% and specificity was 87%. The predictive value
      of the positive test was 70.5% and that of the negative test was 98.3%. NESTROFT
      was also positive in 9/17 subjects with HbS trait, in 3/3 subjects with HbD trait
      and in 1/1 subjects with HbE trait. The test proved to be simple, cheap, easy to
      perform and adaptable for field surveys, coming close to an ideal screening test
      for beta-thalassemia minor.

PMID- 1752673
TI  - Icterometer: a useful screening tool for neonatal jaundice.
AB  - One hundred and sixty one jaundiced newborns were investigated for the usefulness
      of perspex icterometer as a screening tool for neonatal jaundice. Along with
      serum bilirubin estimation, icterometer score was simultaneously obtained in all
      the cases. The correlation between serum bilirubin and icterometer score was high
      (r = 0.99). The icterometer was useful in various subgroups. A high sensitivity,
      specificity, positive and negative predictive value was seen in all the groups. A
      possible role of icterometer in India for screening newborns with jaundice at
      peripheral level is highlighted.

PMID- 1752674
TI  - Reduction in parenteral nutrition related complications in the newborn.
AB  - A comparison of total parenteral nutrition (TPN) related complication in newborns
      was made between two study periods, namely, 1986 (Study A) and 1989-90 (Study B).
      A significant reduction was seen in all complications in Study B. Local
      complications (thrombophlebitis, gangrene, abscess) reduced from 80.0 to 29.4%,
      septicemia from 52.0 to 11.7% and metabolic complications from a computed mean of
      1.6 episode per baby to 0.88 episode per baby. The reduction in these
      complications has been attributed to the following additional inputs in the
      recent study (i) Additional staff (research officers, nurses, biochemist); (ii)
      Better training of resident staff; (iii) Use of a laminar flow system for mixing
      solutions; (iv) Specially designed locally manufactured intravenous sets and
      accessories; and (v) Use of well balanced nutrient solutions. Outstanding
      problems perceived are--high incidence of TPN-related cholestasis (14.7%),
      azotemia (26.4%), central catheter-related sepsis (75.0%) and the falling, but
      yet high cost of the technique (Rs. 650 per day).

PMID- 1752675
TI  - Clinical profile of severe birth asphyxia.
AB  - In this retrospective analysis, 56 babies with Apgar score 3 and less were
      studied. In 33, successful bag-mask ventilation was carried out. Seventeen babies
      received endotracheal IPPV. In 9 out of them bag-mask ventilation was never tried
      whereas in 8 bag-mask ventilation had failed. In 6 babies physical stimulation
      and blast of oxygen on the face was adequate. Following this experience, in the
      subsequent years, endotracheal intubation was required mainly in extremely low
      birth weight babies or babies with Apgar score 0 at birth. During the study
      period, drugs were used in about 50% babies. In subsequent years this figure has
      come down to 10%, that too in special situations. This study helped us to evolve
      a policy in resuscitations severely asphyxiated babies. Bag-mask ventilation is
      the first choice. Failure to achieve progressively improving Apgar score by 1
      minute, usually 4-5, is an indication for endotracheal intubation. Drugs are
      required in special situations only.

PMID- 1752676
TI  - Evaluation of ceruloplasmin in neonatal septicemia.
AB  - Serial serum ceruloplasmin (Cp) levels were estimated in healthy and septicemic
      neonates, using single radial immunodiffusion. In 25 healthy neonates mean Cp
      levels were 19.82 mg/dl at birth, 18.20 mg/dl at 12-24 hours, 17.26 mg/dl at 14
      +/- 4 days and 17.68 mg/dl at 28 +/- 4 days of life. For the entire neonatal
      period the mean Cp levels were computed to be 18.24 mg/dl. In 20 culture
      positive, septicemic neonates, mean Cp levels were 27 mg/dl at onset of disease,
      28.65 mg/dl 12-24 hours later and 36.2 mg/dl after 7 +/- 3 days of start of
      illness (p less than 0.001 for all sampling intervals as compared to healthy
      group values in first month of life). The mean Cp levels were unaffected by
      gestational age in both groups. In the septicemic neonates, the mean Cp levels in
      dying neonates did not differ significantly from recovering neonates for all
      sampling intervals. It is concluded that estimation of serum Cp levels may help
      in diagnosis of neonatal septicemia, but it is not useful as an early diagnostic
      aid or for prognostication.

PMID- 1752677
TI  - Congenital diaphragmatic hernia: a retrospective autopsy study.
AB  - Congenital diaphragmatic hernia is one of the acute pediatric surgical
      emergencies and an important cause of perinatal mortality. Its incidence varies
      from 1 in 2000 to 1 in 5000 live-births, with a greater incidence in stillbirths
      and abortions. Non-operative mortality is generally reported as 100% and early
      diagnosis is imperative. A retrospective study of all infant and neonatal
      autopsies done during last 30 years (1960 to 1989) was conducted. Ten cases of
      congenital diaphragmatic hernia were encountered among 588 autopsies and its
      incidence was 1.7% of all infant and neonatal autopsies, dying due to varying
      causes. The male:female ratio was 7:3, while maternal factors showed no
      consistent relationship. All cases had left-sided posterolateral diaphragmatic
      defects. Dyspnea, cyanosis and dextrocardia was the classical triad present in
      more than 50% cases. The commonest herniated contents were the small intestinal
      loops and the left lobe of liver. Associated congenital multiple anomalies
      related to neural axis, skull, vertebral column and cardiovascular system were
      noted in 30% cases and were major contributory factors for perinatal mortality.

PMID- 1752678
TI  - Urban parents' understanding of fever in children: its dangers, and treatment
      practices.
AB  - One hundred urban parents were interviewed for their knowledge, attitude and
      treatment practices towards fever in children. Only 55% parents were aware of the
      normal body temperature and 23% of the febrile temperature. A total of 58%
      considered fever as a disease, 91% felt that fever could go on rising if
      unchecked, and 60% believed that if it is brought down the child would be cured.
      As home treatment, paracetamol was used by 57% parents, and cold sponging by 29%.
      Sixty three per cent were of the opinion that a doctor must be consulted for any
      fever. The understanding of fever and home treatment practices were significantly
      better in highly educated parents. Above points must be considered while
      counselling parent of a febrile child, and for formulating health education
      package for the parents.

PMID- 1752679
TI  - Cerebrospinal fluid N-acetyl neuraminic acid estimation for early diagnosis and
      differentiation of bacterial meningitis.
AB  - Cerebrospinal fluid (CSF) analysis for free, bound and total N-Acetyl Neuraminic
      Acid (NANA) as well as serum NANA was done in 68 patients of bacterial
      meningitis, of which 37 cases were of pyrogenic meningitis and 31 of tuberculous
      meningitis. Ten patients were included in the control group. The free NANA levels
      were increased in only pyogenic meningitis, independent of protein levels but the
      bound form increased with the increase in CSF proteins. The increase of free NANA
      in CSF of pyogenic meningitis patients was not related to the cell count or sugar
      content in CSF or to the duration or severity of illness. This finding can be of
      great help in differentiating cases of pyogenic meningitis, particularly
      partially treated patients, who may have ambiguous pictures of CSF analysis, from
      the cases of tuberculous meningitis.

PMID- 1752680
TI  - Poisoning in children.
AB  - This study is a retrospective analysis of 670 cases of poisoning (including
      phenothiazine toxicity) admitted to this hospital in the past six years,
      accounting for 0.9% of all pediatric admissions. Nearly half (45%) of the cases
      were in the age group of 1-4 years. Medicines and chemicals were the commonest
      agents (53%), followed by pesticides (15%), kerosene (11.2%), plant poisons
      (9.4%), food poisoning (3.9%) and corrosives (1.9%). Accidental poisoning was the
      commonest (70%) followed by iatrogenic (29.6%) and suicidal (0.4%). Overall
      mortality was 1.8%. Stress is laid on judicious use of phenothiazines as
      antiemetics and replacing them with drugs of lesser toxicity.

PMID- 1752681
TI  - Drugs used in the treatment of childhood psychiatric disorders.

PMID- 1752682
TI  - Health education in school children.

PMID- 1752683
TI  - Jejunal diaphragm.

PMID- 1752684
TI  - Congenital cleft hand and cleft foot.

PMID- 1752685
TI  - Carbamylphosphate synthetase-I deficiency in a newborn: survival after early
      diagnosis and therapy.

PMID- 1752686
TI  - Transfusion associated malaria in endemic areas.

PMID- 1752687
TI  - Epidemic hysteria masquerading as food poisoning.

PMID- 1752688
TI  - Use of corticosteroids in bacterial meningitis.

PMID- 1752689
TI  - Do not clamp the umbilical cord too close.

PMID- 1752690
TI  - Pediatrician: the custodian of the child consumer.

PMID- 1752691
TI  - Nyctalopia.

PMID- 1752692
TI  - The relationship between development of lung inflammation and changes in bone
      marrow populations in guinea-pigs following inhaled antigen challenge.
AB  - Sensitised guinea-pigs were exposed to aerosolised antigen. The resultant
      cellular infiltration into the lung was assessed in lung tissue and
      bronchoalveolar lavage fluid 6, 24, 72 h and 7 days later. An early neutrophil
      infiltration peaking at 6 h was succeeded by eosinophil migration which persisted
      for 7 days, at which time some of the eosinophils appeared immature. The lung
      eosinophilia was accompanied by an initial fall in eosinophilic cells in the bone
      marrow, followed by an increase in this population. Treatment with dexamethasone
      (25 mg/kg i.p.) given daily for 7 days after antigen challenge reduced the lung
      eosinophilia and observed bone marrow changes.

PMID- 1752693
TI  - Purification and characterization of Par o I, major allergen of Parietaria
      officinalis pollen.
AB  - Par o I, a major allergen of Parietaria officinalis, was purified from the pollen
      extract. The purified allergen was obtained by ultrafiltration, Sephadex gel
      filtration and DE-52 ion exchange chromatography: the purified preparation yields
      a single band in polyacrylamide gel isoelectric focusing (PAG-IEF), sodium
      dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and
      immunoblotting, a single immunoprecipitation arc in crossed immunoelectrophoresis
      (CIE) and crossed radioimmunoelectrophoresis (CRIE) and a single peak in size
      exclusion high-performance liquid chromatography (HPLC). Par o I is a
      glycoprotein with a protein to carbohydrate ratio of 100:21. The molecular
      weight, determined by SDS-PAGE, Sephadex G-50 gel filtration and size exclusion
      HPLC, varied between 13.5 and 14.5 kDa according to the method employed. The
      isoelectric point was 4.6. The amino acid composition and the sequence of the
      first twelve N-terminal residues were determined. The allergenicity was assayed
      in vivo and in vitro. 29/29 Parietaria-allergic patients were skin positive to
      Par o I and possessed high level of specific serum IgE antibody as it determined
      by radioallergosorbent test (RAST). Par o I contained dominant epitopes for human
      IgE as inhibited to 85% the pollen extract RAST performed with a pool of sera of
      allergic patients. The RAST inhibitory activity was not abolished by
      deglycosylation.

PMID- 1752694
TI  - Role of interleukin-5 in local accumulation of eosinophils in mouse allergic
      peritonitis.
AB  - The injection of ragweed pollen extracts into the peritoneal cavity of actively
      immunized mice caused an accumulation of eosinophils in the cavity. We
      investigated the role of interleukin-5 (IL-5), one of the T-cell-derived factors,
      in this in vivo local accumulation. Ciclosporin, an immunosuppressant that mainly
      suppresses T cell functions, dose-dependently inhibited the in vivo local
      accumulation. Injections of the neutralizing antibody to IL-5 into the cavity
      decreased the number of the accumulating eosinophils. When the peritoneal cells
      of the immunized mice were cultured in the presence of the antigen in vitro, IL-5
      activity was detected in the culture supernatant. The results indicate that IL-5
      plays an important role in the in vivo local accumulation of eosinophils after an
      antigen challenge.

PMID- 1752695
TI  - Antiphospholipid antibodies reactive with bromelain-treated mouse erythrocytes in
      mice, rats and rabbits.
AB  - It has been reported that normal mice have a large number of B cells against
      bromelain-treated mouse erythrocytes (BrMRBC) and the anti-BrMRBC antibodies are
      reactive with liposomes of phosphatidylcholine and a phospholipid moiety of low
      density lipoproteins from chicken egg yolk (EyLDL). In this study, we detected
      anti-BrMRBC hemolytic antibodies in the normal sera of rats and rabbits as well
      as mice. The antibodies in all the three species of animals bound to the columns
      of EyLDL. The EyLDL-binding antibodies could react with both liposomes of
      phosphatidylcholine and BrMRBC. The immunization with EyLDL evoked a vast
      production of anti-BrMRBC antibodies in rats and rabbits as well as mice. The
      anti-BrMRBC antibodies in the immunized animals could also react with liposomes
      of phosphatidylcholine. These findings suggest that rats and rabbits have the
      equivalent of mouse anti-BrMRBC B cells.

PMID- 1752696
TI  - In vitro formation of complement activation products by lipopolysaccharide
      chemotypes of Salmonella minnesota.
AB  - We have applied immunoassays for complement activation products C4d, fragment Bb
      and the protein S-C5b-9 neoantigen (S-MAC) to assess activation of classical,
      alternative and terminal pathways, respectively, by lipopolysaccharides (LPS)
      from the smooth strain (SS) of Salmonella minnesota and the shallow rough (core)
      mutants R60, R345, R5 and R7. Incubations of sera (n = 6) with LPS generated
      small and insignificant quantities of Bb and S-MAC in the case of Rb, Rc and Rd
      chemotypes and slightly greater quantities with Ra. SS-LPS brought about
      significant (p = 0.01) increases in the formation of both Bb and S-MAC. No
      significant changes were observed in the concentration of C4d. Polymyxin B
      enhanced Bb and S-MAC production by SS-LPS, optimally at the lowest concentration
      of polymyxin B studied, 10 ng/ml. These data confirm and extend observations
      about complement activation by LPS and suggest that immunoassay may be useful in
      studying mechanisms of complement activation.

PMID- 1752697
TI  - Activation of human vascular endothelial cells by IFN-gamma: acquisition of HLA
      class II expression, TSST-1-binding activity and accessory activity in T cell
      activation by the toxin.
AB  - Human umbilical vascular endothelial cells (HUVEC) stimulated with recombinant
      human IFN-gamma were investigated for expression of HLA class II molecules, toxic
      shock syndrome toxin-1 (TSST-1)-binding activity and accessory cell (AC) activity
      in TSST-1-induced T cell activation. HUVEC stimulated with recombinant human IFN
      gamma ranging from 10 to 1,000 units/ml for 72 h express HLA class II molecules.
      Intensity of the expression was dependent on the concentration of IFN-gamma.
      HUVEC stimulated with 1,000 units/ml of IFN-gamma for 72 h exhibited 125I-TSST-1
      binding that was blocked by the unlabeled toxin and monoclonal antibodies (mAb)
      to DR/DP. The activity was not removed by paraformaldehyde fixation. The IFN
      gamma-stimulated HUVEC exhibited AC activity in TSST-1-induced IL-2 production by
      T cells from human peripheral blood mononuclear cells. The activity was blocked
      by mAb to DR. The above two activities were also observed in L cells transfected
      with DR2 genes but not in the unstimulated HUVEC and control L cells. In view of
      the fact that TSST-1 binds directly to HLA class II molecules and activates human
      T cells in association with HLA class II molecules on AC, it is likely that the
      acquisition of TSST-1-binding activity and AC activity in the toxin-induced T
      cell activation is mediated by the expression of HLA class II molecules. Vascular
      endothelial cells may play an important role in the development of pathological
      changes in TSS patients.

PMID- 1752698
TI  - Spontaneous monokine release by alveolar macrophages in chronic sarcoidosis.
AB  - In pulmonary sarcoidosis an activation of alveolar T lymphocytes and alveolar
      macrophages (AM) has been demonstrated. There is evidence that in contrast to
      acute disease a heightened T-cell response cannot be observed in the chronic
      phase of sarcoidosis. The role of AM in the inflammatory process of chronic
      sarcoidosis is not yet intensively evaluated. To address this question we
      measured the release of tumor necrosis factor alpha (TNF alpha) and interleukin-1
      (IL-1) by AM of 39 patients with chronic sarcoidosis (duration greater than 4
      years; 30 active, 9 inactive diseases) without therapy and correlated the
      monokine release with parameters of T-cell alveolitis and the course of the
      disease. The T4/T8 ratio was higher in the active than in the inactive group
      without reaching statistical significance. TNF alpha as well as IL-1 is
      spontaneously released by AM of the active group 2,099 +/- 518 pg/ml TNF
      alpha/10(6) cells/24 h and 8/13 (IL-1+/total) respectively. In the inactive group
      the AM release 375 +/- 246 pg/ml TNF alpha/10(6) cells/24 h which is in the range
      of the control and 1 out of 5 patients was IL-1-positive. There was no
      correlation between the monokine release and any parameter of T-cell alveolitis.
      These data support the hypothesis that the inflammatory process in chronic
      sarcoidosis is dominated by the activity of AM and that this activity determines
      the course of the disease.

PMID- 1752699
TI  - Tumor necrosis factor alters cytoskeletal organization and barrier function of
      endothelial cells.
AB  - Treatment of human umbilical cord vein endothelial cells with tumor necrosis
      factor results in marked changes in cell shape and cytoskeletal organization.
      After 4 h of treatment, these cells loose reciprocal contacts with the formation
      of intercellular gaps. This retraction reaches a maximum after 6 h when most
      stress fibers staining for F-actin disappear and vinculin becomes diffused in the
      cytoplasm. Such changes spontaneously reverse after 24 h in the presence of tumor
      necrosis factor or after 2 h of incubation in fresh medium. After treatment with
      tumor necrosis factor, endothelial monolayers become permeable to albumin because
      of gaps that form between cells. Normal human serum, plasma alpha 1-proteinase
      inhibitor and an anti-inflammatory peptide that decrease synthesis of platelet
      activating factor inhibit the changes induced by tumor necrosis factor.
      Furthermore, receptor antagonists of platelet-activating factor have the same
      effect. These findings suggest that platelet-activating factor is a secondary
      mediator responsible for the changes in cell shape and cytoskeletal organization,
      and for the leakiness of endothelial monolayers.

PMID- 1752700
TI  - Serum levels of interleukin 4, interleukin 6 and interferon-gamma following in
      vivo isotype-specific activation of IgE synthesis in humans.
AB  - It is now generally accepted that interleukin 4 (IL4), interleukin 6 (IL6) and
      interferon-gamma (IFN gamma) play main roles in the regulation of human IgE
      synthesis. This concept is based mainly on in vitro data. To obtain corresponding
      in vivo data, we determined IL4, IL6 and IFN gamma by immunoassays in sera
      collected from 4 atopic patients following a clinical trial of selective IgE
      apheresis (plasmaimmunoadsorption). This treatment removes several milligrams of
      IgE from patient's blood and is suggested to induce strong and isotype-specific
      activation of the IgE system. Serum IgE levels restored rapidly within 3-5 days
      after IgE apheresis. However, very low and constant levels of IL4 (from less than
      50 to 130 pg/ml) and IL6 (from less than 300 to 920 pg/ml) were detected in the
      sera of the treated patients. Serum IFN gamma was absent before treatment
      (concentrations less than 0.5 U/ml) and increased to low but detectable levels
      (0.90 and 8.05 U/ml) on the day following the last IgE apheresis in 2 of 4
      patients. In our opinion, the data presented argue against in vivo participation
      of IL4 and IL6 in the activation of the human IgE system, at least in atopic
      patients under constant allergen exposure.

PMID- 1752701
TI  - Strongyloidiasis influences the elevation of adult T-cell leukemia-associated
      antigen antibody titer.
AB  - We have carried out a seroepidemiological study on the infectious situation of
      adult T-cell leukemia and strongyloidiasis in Okinawa and in the south-western
      islands of Japan. The mean titer of adult T-cell leukemia virus-associated
      antigen (ATLA) antibody of human T-lymphotropic virus type-1 (HTLV-1) carriers
      with strongyloidiasis was significantly higher than that of HTLV-1 carriers
      without strongyloidiasis. This suggests the possibility that strongyloidiasis is
      also associated with an elevation of the ATLA antibody titer.

PMID- 1752702
TI  - Chemotactic cytokine gene expression and production induced in human monocytes by
      membrane proteoglycans from Klebsiella pneumoniae.
AB  - The present study was designed to investigate the effect of membrane
      proteoglycans (MPG) from Klebsiella pneumoniae on production of the chemotactic
      cytokine, IL-8, and monocyte chemotactic protein (MCP) by human peripheral blood
      monocytes. Exposure of human peripheral blood monocytes to MPG in vitro induced
      high levels of mRNA transcripts for IL-8 and MCP, as assessed by Northern blot
      analysis. Cytokine gene expression was associated with the production of
      chemotactic activity in the supernatants. The levels of IL-8 and MCP expression
      induced by MPG were comparable with those elicited by LPS. Induction of
      chemotactic cytokines in mononuclear phagocytes may play a role in the
      immunomodulatory activity of MPG.

PMID- 1752703
TI  - In vivo stimulation of thymocyte proliferation by thymocyte growth peptide (TGP).
AB  - Chromatographically pure thymocyte growth peptide (TGP) was injected into one of
      the two thymus lobes of guinea pigs. Pulse labelling of DNA-synthesizing cells
      was obtained by an intracardial injection of bromodeoxyuridine (BrdUrd). After 24
      and 48 h, the frequency of labelled cells was increased in the TGP-treated lobe
      in comparison with the control lobe. At 24 h, the increase was found in non
      rosetting, large, low-density cells, the population containing the highest
      frequency of DNA-synthesizing cells. At 48 h, labelled rosette-forming, small,
      high-density cells appeared in an increased frequency in the TGP-treated lobe.
      Serum thymic factor (FTS), which is structurally related to TGP, did not produce
      similar effects. The results show that TGP is active in vivo and stimulates
      proliferation of cycling thymic precursor cells which then are transformed into
      small thymocytes.

PMID- 1752704
TI  - Immunomodulatory action of levamisole--I. Structural analysis and
      immunomodulating activity of levamisole degradation products.
AB  - In our laboratory we observed that solutions of levamisole (LMS) stored at 4
      degrees C consistently enhanced the lymphocyte proliferation response to
      concanavalin A (Con A) more than freshly prepared solutions did. To determine if
      the increased immunopotentiation observed with the stored solutions of LMS was
      due to products formed from LMS, we assessed the stability of LMS when stored at
      4 or 37 degrees C at pH 6, 7, 7.5 and 8. Analysis of the various solutions by
      high pressure liquid chromatography demonstrated that LMS decomposes during
      storage in neutral and alkaline conditions to form three products. The formation
      of the products was accelerated by increasing the temperature from 4 to 37
      degrees C. The three degradation products were purified by preparative high
      pressure liquid chromatography and their structures determined by mass
      spectrometry, infrared spectrometry and homo- and heteronuclear two dimensional
      nuclear magnetic resonance spectroscopy. The degradation products, denoted as No.
      1, No. 2 and No. 3, based on their high pressure liquid chromatography retention
      times, were identified as: No. 1, 3-(2-mercaptoethyl)-5-phenylimidazolidine-2
      one; No. 2, 6-phenyl-2,3-dihydroimidazo (2,1-b) thiazole and No. 3, bis [3-(2-oxo
      5-phenylimidazolidin-1-yl) ethyl] disulfide. Product 2 significantly enhanced
      murine lymphocyte proliferation responses to concanavalin A (Con A) at
      concentrations between 0.5 and 10.0 micrograms/ml (whereas the optimum
      concentration of LMS is 10-100 fold higher (50-100 micrograms/ml)). Products 1, 2
      and 3 significantly inhibited the lymphocyte proliferative response at
      concentrations greater than 2.2, 10.0 and 10.0 micrograms/ml, respectively. These
      studies indicate that under relatively mild conditions, including physiological
      conditions, LMS may decompose to products which inhibit or enhance lymphocyte
      responses to Con A.

PMID- 1752705
TI  - Immunomodulatory action of levamisole--II. Enhancement of concanavalin A response
      by levamisole is associated with an oxidation degradation product of levamisole
      formed during lymphocyte culture.
AB  - Previously we determined that levamisole (LMS), when stored for a period of time,
      breaks down to three degradation products at neutral and alkaline pH. At low
      concentrations (10(-6) M), Product 1 inhibits the lymphocyte response to
      concanavalin A (Con A). Product 2 enhances the response and Product 3 has no
      effect. At higher concentrations (10(-5) M) all three products inhibit the
      response. To determine if these products are formed in culture media under
      culture conditions (e.g. in RPMI-1640 bicarbonate buffered medium, 37 degrees C,
      pH 7.0-7.5, during a 72 h culture period), we added freshly prepared LMS
      solutions to culture media with and without lymphocytes present and maintained
      the pH at 7.0, 7.25 or 7.5 by varying the amount of CO2 present. Periodically
      over a 72 h period, aliquots of the media were removed and analyzed for the
      presence of LMS and the three degradation products. Within 4 h, two of the
      degradation product began to form in culture media with or without lymphocytes
      present. Product No. 1, 3-(2-mercaptoethyl)-5-phenylimidazolidine-2-one or dl-2
      oxy-3-(2-mercaptoethyl)-5-phenylimidazolidine (OMPI), which inhibits the
      lymphocyte response to concanavalin A (Con A) at concentrations above 0.4
      micrograms/ml, was formed at pH 7.0, 7.25 and 7.5, but the compound did not reach
      inhibitory concentrations in the lymphocyte cultures during the 72 h culture
      period. Product No. 2, 6-phenyl-2,3-dihydroimidazo (2,1-b) thiazole, which
      enhances the Con A response between concentrations of 0.5 and 10 micrograms/ml,
      was detected at concentrations between 2.5 and 3.5 micrograms/ml at pH 7.25 and
      7.5. Product 2 was not detected in cultures at pH 7.0 and subsequently when we
      cultured lymphocytes with freshly prepared LMS and maintained the pH at 7.0, no
      significant enhancement of the Con A response was observed.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1752706
TI  - An enzyme-linked immunosorbent assay of anti-sheep red blood cell antibodies of
      the classes M, G, and A in the rat.
AB  - In order to investigate the immune system as a possible target for toxicity by
      chemicals, functional assays of the immune system are required. Sheep red blood
      cells (SRBC) are widely used as an antigen to study the immune competence of
      animals. Since routine toxicology includes data mainly provided with rat toxicity
      studies, there is a need for easy, specific, and reproducible assays of antibody
      responses to sheep erythrocytes in the rat. This report describes an enzyme
      linked immunosorbent assay (ELISA) of anti-SRBC antibodies of the classes M, G
      and A in the serum of rats. Antigen preparations, prepared from ghosts of sheep
      erythrocytes by extraction with KCl, were used to coat the bottom of wells in 96
      well microtiter plates. Serum samples from rats, that were immunized with sheep
      erythrocytes, were titrated on these plates, using specific polyclonal antibodies
      to rat immunoglobulins M and G, to which peroxidase was conjugated.
      Immunoglobulin A was assayed, using monoclonal anti-rat IgA antibodies, and
      polyclonal rat anti-mouse IgG that was conjugated with peroxidase. The results
      indicate that the ELISA of serum titers of IgM, G and A to sheep erythrocytes is
      an easy and reliable method, that can be used to detect the effects of chemicals
      on the immune system of the rat.

PMID- 1752707
TI  - Distinctive effects of three different modes of exercise on oxygen uptake, heart
      rate and blood lactate and pyruvate.
AB  - We intended to investigate the effects of different modes of exercise on oxygen
      uptake (VO2), the heart rate and the levels of lactate and pyruvate in venous
      blood. For this, untrained male subjects performed three modes of exercise with a
      treadmill (TR), a bicycle ergometer (UP) and a supine leg ergometer (SU). The
      percentage of maximal oxygen uptake (% VO2max) and VO2/weight for TR were
      significantly higher than those for UP or SU at lactate levels of 2, 3 and 4
      mmol/l. The heart rate was also higher for TR than for SU at these lactate
      levels. The correlations of blood lactate with % VO2max, VO2/weight and the heart
      rate were significant for TR and SU, but not for UP. Blood lactate levels were
      lower for TR than for SU or UP at 60, 70, 80% VO2max, whereas the values for UP
      were lower than those for SU only at 60% VO2max. Blood pyruvate levels were
      always lower for TR than for SU. The ratios of lactate/pyruvate differed for TR
      and SU only at 60% VO2max. For a given mode of exercise, blood lactate and the
      ratio of lactate/pyruvate increased with an increase in % VO2max, but those of
      pyruvate did not. These results reveal that the relationships between any two of
      lactate, pyruvate, VO2 and the heart rate are different at different modes of
      exercise, and that blood lactate depends on adaptation of muscles to a mode of
      exercise rather than on the quantity of muscles mobilized.

PMID- 1752708
TI  - Effects of caffeine ingestion on performance and anaerobic metabolism during the
      Wingate Test.
AB  - In order to determine the effects of caffeine ingestion on performance and
      metabolic responses during supramaximal exercise, six healthy volunteers
      performed the Wingate Anaerobic Test twice. Sixty min before each trial, while in
      a fasting state, they took capsules containing either caffeine (5 mg/kg) or a
      placebo, according to a single blind and randomized procedure. Caffeine
      administration did not significantly change either maximal anaerobic capacity
      (AC) or power (AP) and power decrease (PD). It did, however, induce significant
      (p less than 0.05) increases in both catecholamine and blood lactate levels as
      compared to values obtained after placebo administration. Moreover, maximal blood
      lactate occurred earlier (p less than 0.05), and lactate output seemed to be
      greater with caffeine (p less than 0.01). There was a strong correlation, both
      with and without caffeine, between epinephrine and lactate levels (r = 0.81) and
      between both AP and AC and lactate levels. These data suggest that caffeine,
      essentially via epinephrine, modifies glycolytic metabolism but fails to improve
      performance during the Wingate Anaerobic Test in nonspecifically trained
      subjects.

PMID- 1752709
TI  - Training-overtraining. A prospective, experimental study with experienced middle-
      and long-distance runners.
AB  - Overtraining may be one frequent cause of stagnation or decrease in performance
      capacity of athletes. Israel (19) differentiates between addisonoid
      (parasympathetic) and basedowoid (sympathetic) overtraining, characterized by
      inhibition or excitation. We tried to induce an overtraining syndrome in 8
      experienced middle- and long-distance runners, based on an increase in training
      volume from an average 85.9 km (week 1) to 115.1 km (week 2) and 143.1 km (week
      3) to 174.6 km per week (week 4). The influence of this training on
      cardiovascular, metabolic and hormonal parameters was examined with special
      respect to plasma and urinary catecholamines. Laboratory testing including graded
      treadmill running was performed on the days 0, 14 and 28. Training was held six
      days each week, with nearly 30 km per day in the fourth week. A stagnation in
      endurance performance capacity (running velocity at the aerobic-anaerobic
      transition range) and a decrease in maximum working capacity were observed in 6
      and a stagnation in 2 of the 8 sportsmen, indicated by a decrease in total
      running distance from 4719 + 912 m to 4361 + 788 m during incremental treadmill
      ergometry. The sportsmen could neither improve nor could they even approximately
      reach their personal records during the subsequent competitive season. Subjective
      complaints, classified on a four-point scale, increased from 1.2 (week 1) to 3.2
      in week 4. Glucose, lactate, ammonia, glycerol, free fatty acids, albumin, LDL,
      VLDL cholesterol, hemoglobin level (transient), leukocytes, and heart rate
      (before and during exercise) decreased significantly. Urea, creatinine, uric
      acid, GOT, GPT, gamma-GT, serum electrolytes (except phosphate and calcium)
      remained constant at the measuring times, CPK was elevated.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1752710
TI  - Hematological comparison of iron status in trained top-level soccer players and
      control subjects.
AB  - The aim of the present study was to compare the iron status of 19 top-level
      soccer players and 20 male control subjects. All players showed no impairment of
      physical performance and had a dietary iron intake adequate to cover the iron
      losses. Serum iron, TIBC, % transferrin saturation and serum ferritin were not
      significantly different in athletes and controls: serum haptoglobin was
      significantly lower in the former than in the latter, the result probably
      indicating an increase in resting intravascular hemolysis. Since the formed Hb-Hp
      complex is taken up and metabolized by hepatocytes, it has been suggested that in
      soccer players a redistribution of iron stores occurs among tissue compartments.
      A multiparametric hematological monitoring of iron metabolism, just as in
      runners, is therefore necessary in these athletes, too, in order to detect
      subjects at risk of real iron deficiency. The pharmacological iron
      supplementation should be limited to these subjects and only when clinical
      evidence of reduced tissue iron supply is present.

PMID- 1752711
TI  - Effects of maximal and submaximal exercise under normoxic and hypoxic conditions
      on serum erythropoietin level.
AB  - This study was carried out to investigate the influence of different exercise
      regimens on serum immunoreactive erythropoietin concentration (EPO). The same
      untrained male subjects performed bouts of maximal and submaximal exercise (60
      min at 60% of maximal performance) under normoxia (n = 10) and normobaric hypoxia
      (PIO2 92 mmHg, n = 9). Five of them were exposed to hypoxia for 90 min under
      resting conditions (RTH). [EPO] was unchanged up to five hours after maximal
      (MEN) and submaximal (SEN) exercise under normoxia. After RTH, [EPO] increased
      after 3 hours by 5.0 mU/ml (p less than 0.01). Submaximal exercise under hypoxia
      (SEH) led to a similar increase in [EPO] (after 3 hours: + 5.5 mU/ml), which
      remained elevated the following days (after 24 h: + 6.1 mU/ml, 48 h: + 5.3 mU/ml;
      ANOVA p less than 0.001). Maximal exercise under hypoxia (MEH) had no significant
      effect. The results indicate that exercise has no immediate effect on serum
      [EPO], whereas the higher EPO level one and two days after SEH could result from
      the occurring hemodilution as is indicated by a slight negative correlation
      between [EPO] and Hct (r = 0.59, p less than 0.001). The number of reticulocytes
      increased after all hypoxic experiments and after MEN without any correlation to
      [EPO].

PMID- 1752712
TI  - Iron supplementation and running performance in female cross-country runners.
AB  - The purpose of this study was to determine the effects of two weeks of high
      dosage iron supplementation on various blood iron indices and metabolic
      parameters in non-anemic, iron-depleted competitive female cross-country runners.
      The subjects were highly trained members of the Colorado State University cross
      country team and were completing 40 to 50 miles of training weekly. A pretest,
      post-test single-blind crossover design was employed. Upon collection of baseline
      exercise blood and metabolic data, five subjects were randomly assigned to iron
      supplementation (650 mg ferrous sulfate; 130 mg elemental iron) and five subjects
      to placebo treatment. At two weeks the treatments were reversed. Exercise blood
      and metabolic data were collected at two-week intervals. Dietary iron intake was
      assessed using a three-day dietary survey. Dietary analysis revealed deficiencies
      in vitamin B-6, iron, magnesium, and zinc according to USRDA standards. Baseline
      blood samples revealed no deficiencies in iron storage or transport proteins. Two
      weeks of iron supplementation resulted in no significant increases in blood iron
      indices. Metabolic parameters related to running performance were also unchanged
      after iron supplementation. High dosage, short-term iron supplementation appears
      to have no effect on blood or metabolic parameters in iron-depleted but non
      anemic female cross-country runners.

PMID- 1752713
TI  - Effects of technique and pole grip on physiological demands of roller skiing on
      level terrain.
AB  - This study evaluated the physiological responses to roller skiing with three
      different techniques, and compared the physiological responses during roller
      skiing with a standard pole grip and an innovative "anatomical" pole grip. Data
      were collected on ten experienced cross-country ski racers while roller skiing
      with the double pole, V1 skate, and kick double pole techniques on a flat track
      at mean (+/- SD) velocities of 14.6 +/- 0.2, 16.4 +/- 0.3, and 18.0 +/- 0.4 km.h
      1. The kick double pole technique induced the highest (p less than 0.05) oxygen
      uptakes, heart rates, and ventilations. The double pole technique elicited the
      lowest (p less than 0.05) oxygen uptakes, and the V1 skate technique elicited the
      lowest (p less than 0.05) perceived effort and respiratory exchange ratios.
      Comparison of the two pole grips showed no differences in the physiological
      responses and perceived effort. While the V1 skate technique is not the most
      economical roller skiing technique on flat ground, the lower associated perceived
      effort and respiratory exchange ratios may at least partially account for the
      general preference of cross-country ski racers to use the V1 skating technique
      rather than the double pole technique on flat terrain.

PMID- 1752714
TI  - Tennis: a physiological profile during match play.
AB  - Heart rate (HR), hematocrit, hemoglobin, blood glucose, and plasma concentrations
      of lactate, cortisol, and testosterone were monitored in 10 male subjects
      (Division I, 20.3 +/- 2.5 yrs, VO2max: 58.5 +/- 9.4 ml.kg-1.min-1) during singles
      tennis and a treadmill test. During the on-court session, HR was 144.6 +/- 13.2
      beats.min-1 for the 85 min of play. Plasma lactate rose 50% from a post-warmup
      value of 1.6 +/- 0.6 mmol.l-1 to 2.3 +/- 1.2 mmol.l-1 during play (p greater than
      0.05). Blood glucose slightly decreased (8%, p greater than 0.05) from a pre
      exercise value of 4.6 +/- 0.8 mmol.l-1 as a result of the 10-min warmup. This was
      followed by a 23% rise (p less than 0.05) from 4.2 +/- 1.0 mmol.l-1 to 5.2 +/-
      0.6 mmol.l-1, measured after the first 30 min of play. Blood glucose subsequently
      remained steady at slightly above the pre-exercise value. Plasma cortisol rose
      (9%, p greater than 0.05) during the warmup and subsequently decreased (p less
      than 0.05) from a post-warmup value of 558.2 +/- 285.2 nmol.l-1 to 337.1 +/-
      173.3 nmol.l-1 (a 40% decrease), and remained decreased during recovery. Plasma
      testosterone rose 22% (p less than 0.05) from pre-exercise to recovery (13.5 +/-
      3.8 nmol.l-1 and 16.5 +/- 2.6 nmol.l-1, respectively). Although tennis is
      characterized by periods of high-intensity exercise, the overall metabolic
      response resembles prolonged moderate-intensity exercise.

PMID- 1752715
TI  - The effect of warm-up on responses to intense exercise.
AB  - The purpose of this study was to determine if prior physical activity (warm-up)
      affected physiological responses to intense exercise. Eight highly trained
      collegiate swimmers performed a paced 365.8-m (440 yds) intense swim (mean +/-
      SE, 94.4 +/- 3.3% VO2max) 5 min after the following warm-up conditions: trial N,
      no warm-up; trial S, an intensity-specific interval set (4 x 45.7 m with one-min
      rest intervals at the intense swim pace); trial M, a mild-intensity, long
      duration swim (1371.6 m at 64.7 +/- 3.3% VO2max); and trial MS, a mild-intensity,
      long-duration swim (1188.7 m at the same pace as trial M) followed by the
      intensity-specific interval set (trial S). When comparing trial N with trials M
      and MS, stroke distance (m/stroke) was significantly (p less than 0.05) lower
      during the last 91.4 m of the intense, paced swim and 3-, 5-, 8- and 10-min
      recovery blood lactate levels and one-minute recovery heart rates were
      significantly elevated (p less than 0.05). There was no significant difference (p
      greater than 0.05) in stroke distance during the final 91.4 m of the intense swim
      between trials S and N. There were no significant differences for any variables
      between trials M and MS. These results suggest that a warm-up consisting of mild
      intensity, long-duration exercise was beneficial compared to no warm-up and that
      intensity-specific exercise was not a vital component of warm-up. Although
      performance was not directly measured, these data demonstrate the benefit of warm
      up.

PMID- 1752716
TI  - Effects of training and training cessation on insulin action.
AB  - Physical training has been shown to improve glucose tolerance and insulin action.
      In the present study, insulin action was determined using the euglycemic clamp
      technique in six trained male athletes compared with six untrained controls
      matched by age, sex, and weight at 14, 38, and 86 hours and at 6 days after
      cessation of exercise. The rate of insulin-mediated glucose uptake (glucose
      disposal) was 9.40 +/- 0.46 mg.kg-1.min-1 (mean +/- SEM) for the athletes at 14 h
      after the last exercise bout, compared with 6.80 +/- 0.86 mg.kg-1.min-1 obtained
      for the untrained controls (p less than 0.01). Glucose disposal was gradually
      decreased to 7.78 +/- 0.87 mg.kg-1.min-1 at 38 h, 6.82 +/- 0.49 mg.kg-1.min-1 at
      86 h and to 7.11 +/- 1.00 mg.kg-1.min-1 at 6 days after cessation of physical
      training. At 38 h, 86 h, and 6 days of detraining, glucose disposal exhibited by
      training athletes did not differ significantly from untrained controls. These
      results suggest that physical training increases insulin action, and that this
      effect could be reversed to the control levels within 38 h after detraining.

PMID- 1752717
TI  - Exercise changes in plasma tryptophan fractions and relationship with prolactin.
AB  - In the past the hypothesis was advanced that plasma tryptophan fractions mediate
      behavioural and neuroendocrine effects of exercise. To assess changes in free and
      total plasma tryptophan levels during and after exercise over a time period, and
      possible functional implications, 6 male volunteers were subjected to an
      endurance test of 1 hour duration on a bicycle ergometer at a work load below the
      4 mmol/l lactate threshold. Total and free plasma tryptophan were determined by
      high-performance liquid chromatography with electrochemical detection, prolactin
      by radioimmunoassay, glycerol and nonesterified fatty acids (NEFA) by enzymatic
      methods. No significant changes in total tryptophan were found. Free plasma
      tryptophan increased significantly (23%, p less than 0.01) from 40 to 60 minutes
      of exercise. Highest levels were observed after 10 minutes of recovery (50%
      against preexercise). Prolactin levels correlated with free plasma tryptophan
      throughout the test (r = 0.77, p less than 0.001, all measured values) and during
      recovery (10 minutes: r = 0.88, p less than 0.05; 20 minutes: r = 0.86, p less
      than 0.05). These findings may further support the hypothesis that changes in
      peripheral amino acid concentrations may influence physiological reaction of
      exercise mediated by brain systems.

PMID- 1752718
TI  - Serum and saliva cortisol responses and blood lactate accumulation during
      incremental exercise testing.
AB  - In six male physically active subjects the adrenocortical and metabolic changes
      in response to incremental exercise testing were investigated. Blood and saliva
      samples were taken at rest, at the end of every workload (duration 4 min with 50
      W increment), immediately and 10 min after 1 min all out spurt on the
      electrically braked cycle ergometer. Both saliva and serum cortisol were measured
      as well as blood lactate. The cortisol response in serum and in saliva showed
      similar dynamics (r = 0.86, p less than 0.001, n = 50) at submaximal work. At
      maximal work the serum cortisol concentration showed a transitory decrease, which
      was not manifested in saliva. It is hypothesized that a factor related to the
      metabolic acidosis masks the actual adrenocortical response in the serum but not
      in saliva. Correlation analysis revealed a positive relation between lactate and
      cortisol in serum (r = 0.56, p less than 0.01, n = 50) and saliva (r = 0.70, p
      less than 0.01, n = 50). Apparently, salivary cortisol closely reflects plasma
      free cortisol level, presenting advantage over total cortisol measurements.
      Moreover salivary measurement will permit studies in their authentic settings and
      should assist attempts to understand the nature of the adrenocortical function in
      exercise.

PMID- 1752719
TI  - Exercise-induced changes of endorphin contents in hypothalamus, hypophysis,
      adrenals and blood plasma.
AB  - Changes of alpha-, beta-, and gamma-endorphin contents were determined in
      hypothalamus, hypophysis, adrenals and blood plasma in Wistar rats. Four hours of
      swimming in water at 32 +/- 1 degrees C caused a decrease of the beta-endorphin
      content in hypophysis and hypothalamus. In adrenals, beta-endorphin did not
      change. Changes of alpha- and gamma-endorphins were not parallel to alterations
      of beta-endorphin. In blood plasma, levels of both alpha- and gamma-endorphins
      were elevated. After 7 days of swim training, 4 hours of swimming caused a slight
      increase of alpha-, beta- and gamma-endorphin levels in hypophysis as well as a
      pronounced increase of alpha- and beta-endorphins in adrenals. In hypothalamus,
      beta-endorphin content was decreased, but alpha-endorphin content was on the
      level of sedentary controls, gamma-endorphin content doubled. The levels of
      endorphins in blood were higher than after a single swimming bout. It was
      concluded that during acute exercise the activation of the opioid system is
      mainly based on the augmented release of beta-endorphin. In daily repeated
      exercise the production of beta-endorphin increases and exceeds the elevated
      release in hypophysis and adrenals.

PMID- 1752720
TI  - The effect of exercise at various temperatures on salivary levels of
      immunoglobulin A.
AB  - The purpose of this investigation was to determine the effect of ambient
      temperature on the salivary immunoglobulin A (s-IgA) response to submaximal
      exercise. Nine adult males (x age +/- SD = 22 +/- 2 yrs) volunteered to perform
      an incremental treadmill test to exhaustion for the determination of VO2max and
      three 30-minute treadmill runs at 80% VO2max in an environmental chamber at
      temperatures of approximately 6, 19 and 34 degrees C. Saliva samples were
      collected prior to each submaximal workbout as well as immediately and 1 hr post
      exercise. A 2 within subjects factors (temperature, sample time) repeated
      measures ANOVA indicated no significant interaction or main effects for sampling
      time or temperature. The results of this study indicated that 30 minutes of non
      competitive exercise at temperatures ranging from 6 to 34 degrees C had no effect
      on s-IgA. These findings suggest that moderate intensity exercises at a wide
      range of ambient temperatures does not increase the susceptibility to upper
      respiratory infection by decreasing s-IgA.

PMID- 1752721
TI  - The effect of increased functional load on the activation of satellite cells in
      the skeletal muscle of adult rats.
AB  - The comparison of the number of satellite cells in the fast oxidative glycolytic
      muscle fibers of m. quadriceps femoris in males of normal Wistar rats aged 16-17
      weeks (5 animals) and rats trained for endurance (5 animals) was made. After six
      weeks of treadmill running at a speed of 35 m/min in an increasing regimen, the
      number of satellite cells in trained animals (9.59 +/- 1.09%) increased over 2.5
      fold in comparison to controls (3.41 +/- 0.26%) within 24 hours. At the
      ultrastructural level complete and focal injuries of some muscle fibers and the
      partial denervation of individual muscle fibers were recorded in trained rats. It
      was proposed that the focal functional denervation of muscle fibers could be one
      of the factors for the activation of satellite cells in endurance exercise. Some
      trained rats demonstrated small groups of extra- and perisynaptic satellite cells
      under the basal membrane of muscle fibres, partial detachment of satellite cells
      from the surface of muscle fiber and presence in the interstitial space cell
      containing filaments.

PMID- 1752722
TI  - The effect of amenorrhea on calcaneal bone density and total bone turnover in
      runners.
AB  - To examine in athletes the effect of long-term amenorrhea on the skeleton,
      measurements of calcaneal density and whole body retention of 99mTc
      imidodiphosphate were made in 42 women who could be allocated to one of 3 groups
      defined by their level of physical activity and by menstrual status. There was no
      difference in bone density between eumenorrheic normoactive females and either
      eumenorrheic or amenorrheic athletes. However, calcaneal density was
      significantly greater for each group than for previously measured sedentary
      controls. Total body bone turnover was greater in both eumenorrheic and
      amenorrheic athletes than in eumenorrheic normoactive women. Sustained, intense
      physical activity does not significantly increase calcaneal bone density over and
      above the increase associated with normal levels of activity. This is despite a
      significant increase in the rate of total body bone mineral turnover.

PMID- 1752723
TI  - A time-series analysis of longitudinal weight changes in two adult women.
AB  - This study was conducted to examine individual longitudinal serial trends in body
      weight of two moderately obese adult women. Self-measured daily weights (over
      5000 data points for subject 1 and over 3500 for subject 2) were averaged for
      each month and analyzed using a time-series analysis approach. The best
      statistical model for both women indicated a significant upward trend (gain 30
      and 22 lb, respectively) interrupted by linear decreases (P less than 0.05)
      during weight loss programs over the 16- and 10-year observation periods,
      respectively. The women participated in six and eight weight control programs,
      respectively, and consistently lost weight, averaging 9.17 +/- 1.85 lb and 8.00
      +/- 3.57 lb. Both subjects regained weight after dieting, in a period
      approximately 2.25 times as long as the diet. Numerous weight fluctuations
      occurred and one subject lost and then regained 10 percent of her body weight
      during two 5-year periods. Results are examined in terms of a possible weight
      increase protection benefit, as well as the deleterious medical potential that
      may occur with numerous weight loss attempts. Suggestions for future research are
      provided regarding weight cycling, seasonal variations, set point theory, aging
      effects, and the use of self-directed weight loss initiatives in conjunction with
      formal weight reduction programs. This study may serve as a prototype for
      exploring weight fluctuation using time-series analyses and for further
      investigating the etiology and clinical management of obesity.

PMID- 1752724
TI  - Effect of obesity on circulating intermediary metabolite concentrations in the
      absence of impaired glucose tolerance.
AB  - The published literature on the influence of obesity on intermediary metabolite
      concentrations does not adequately address the potential confounding effects of
      the increased prevalence of impaired glucose tolerance in obese subjects. In
      order to remove this, we studied 109 subjects with proven normal glucose
      tolerance ranging from underweight to grossly obese (range 15.3-80.9 body mass
      index). All had blood intermediary metabolites, plasma insulin and C-peptide
      measured after an overnight fast. Thirty-six (18 from each end of the range of
      body mass index) received a 3-hour oral glucose tolerance test for metabolites
      and insulin. Fasting plasma insulin was highly significantly associated with body
      mass index (r = 0.72; P less than 0.001). Concentrations of lipid intermediaries
      were better associated with body mass index than with fasting plasma insulin: non
      esterified fatty acids (r = 0.36; P less than 0.001), glycerol (r = 0.47; P less
      than 0.001) and ketone bodies (r = 0.45; P less than 0.001). Fasting
      concentrations of carbohydrate intermediaries were, however, better correlated
      with fasting plasma insulin: lactate (r = 0.29; P less than 0.01), pyruvate (r =
      0.24; P less than 0.01) and alanine (r = 0.36; P less than 0.001). Glucose
      concentrations were associated with both to a similar degree (r = 0.33, r = 0.32,
      respectively; P less than 0.001). After oral glucose, exaggerated rises in plasma
      insulin and blood glucose were observed in obese subjects but a lesser rise was
      seen for lactate. Non-esterified fatty acids and ketones, although having higher
      fasting concentrations in obese subjects, fell to similar concentrations in the
      two groups after glucose whereas blood glycerol did not fall so far in the obese
      subjects. The results suggest, even if those subjects with impaired glucose
      tolerance are excluded, insensitivity to insulin in several aspects of
      intermediary metabolism in obesity the degree of which may vary in different
      metabolic pathways or tissues.

PMID- 1752725
TI  - Effects of gender and age on the heritability of body mass index.
AB  - We estimated genetic and environmental components of variance of body mass index
      (BMI) among 7245 same-sexed Finnish MZ and DZ twin pairs aged 18-54 years from
      the nationwide Finnish Twin Cohort. Age accounted for 20 per cent of variance
      among men and 26 per cent in women. The contributions of additive genetic
      effects, shared and non-shared environmental effects on BMI-variance were
      estimated by LISREL structural equation models. Genetic effects accounted for 72
      per cent and 68 per cent of total variance in men and non-pregnant women
      respectively, while 28 per cent of variance among men and 32 per cent among women
      was due to non-shared environmental effects. This gender difference was
      statistically significant. Models including shared environmental effects did not
      improve model fits. The magnitude of the genetic component of BMI was also
      analysed separately for each 10-year age group. Models with age-specific
      parameters for genetic and environmental effects fitted significantly better than
      models with effects constrained to be equal over age. Our results indicate a
      substantial genetic component in BMI. However, the magnitude of additive genetic
      effects decreases with age in both genders.

PMID- 1752726
TI  - Postural variation of the maximum inspiratory and expiratory pressures in obese
      patients.
AB  - Evaluating whether weight is a factor responsible for the decrease of muscle
      force in the supine position with respect to the upright and sitting positions,
      we measured maximum inspiratory and expiratory pressures (PImax and PEmax) in
      these postures in ten obese patients (age 38.7 +/- 9.1 years; height 168.7 +/-
      8.9 cm; and weight 139.3 +/- 28.4 kg) and ten normal control subjects (age 38.4
      +/- 8.2 years; height 169.3 +/- 7.9 cm and weight 66.9 +/- 11.9 kg.) In both
      study groups, PImax and PEmax values decreased in the supine posture with respect
      to upright and sitting positions. Differences between pressures in the various
      postures were similar for both groups with the exception of PEmax in obese
      females. The decrease in PEmax values from the sitting to supine positions was
      greater in obese than control females. Weight, sex and postural changes can
      influence the generation of maximal expiratory force.

PMID- 1752727
TI  - Multivitamin prophylaxis in prevention of post-gastric bypass vitamin and mineral
      deficiencies.
AB  - One hundred forty patients were followed for a mean 24.2 months after gastric
      bypass. Postop multivitamin (MV) prophylaxis was recommended for all patients and
      90 of 140 patients (64 percent) were regularly compliant. Deficiencies in iron,
      vitamin B-12 or folate were recognized in 88 of 140 patients (63 percent). Thirty
      of 45 patients (67 percent) with iron deficiency developed anemia. Forty-three of
      the 52 patients who did not have deficiencies were regularly taking MV vs 47 of
      88 patients who developed deficiencies (P less than 0.001). MV prophylaxis was
      successful in preventing folate (P less than or equal to 0.05) and vitamin B-12
      deficiencies (P less than or equal to 0.02) but did not prevent development of
      iron deficiency or subsequent anemia. There was no correlation between taking
      prescribed supplements and resolution of either iron deficiency of anemia. B-12
      and folate supplements corrected deficiencies in 73 percent of cases. We conclude
      that oral MV prophylaxis is useful in preventing folate and B-12 deficiency after
      gastric bypass. Additional prophylactic iron supplements should be provided for
      women to prevent iron deficiency and associated anemia.

PMID- 1752728
TI  - Relationship of fasting serum insulin concentrations with blood pressure in a
      representative sample of the adult population of the Seychelles.
AB  - Several studies have been performed to determine if plasma insulin concentration
      bears a relationship with blood pressure and may be a causative factor in the
      genesis of hypertension. The results reported were discrepant between studies:
      insulin was observed to be independently correlated with blood pressure in some
      studies, whereas no such relationship was observed in others. Serum insulin,
      whole blood glucose, weight, height, and diastolic and systolic blood pressure of
      839 fasting individuals, randomly selected from the adult population of Mahe
      Island, The Seychelles, were recorded; this population has a high hypertension
      prevalence rate. The proportion of hypertension was higher in subgroups of
      individuals with diabetes mellitus (52.4 percent) and with overweight (34.5
      percent) than in the general population. Subgroups of individuals with diabetes,
      excessive weight or high blood pressure had higher mean fasting plasma insulin
      (13.6 +/- (s.d.) 7.9, 14.0 +/- 8.0, 11.1 +/- 9.7 respectively) than individuals
      not affected with these conditions (8.1 +/- 4.6 microU/ml). Both systolic and
      diastolic blood pressure were positively correlated with age, body mass index and
      fasting blood glucose in a multivariate model. No correlation with insulin was
      observed. In contrast, in a subgroup of 223 overweight individuals, age, blood
      glucose and plasma insulin were each positively correlated with blood pressure.
      It is concluded that, in this cross-sectional study, insulin was not
      independently correlated with blood pressure except for overweight individuals.

PMID- 1752729
TI  - Contribution of glucose tolerance and plasma insulin levels to the relationships
      between body fat distribution and plasma lipoprotein levels in women.
AB  - Numerous interrelated metabolic and morphological variables such as plasma
      insulin levels, glucose tolerance and abdominal obesity are associated with
      changes in plasma lipoprotein levels. The present study was undertaken to
      differentiate, using a multivariate approach, the respective contributions of
      plasma glucose and insulin levels, obesity and regional adipose tissue
      distribution to the variance in plasma lipoproteins. The study group was composed
      of 69 healthy premenopausal women (age 35.4 +/- 5.0 years (mean +/- s.d.);
      percent body fat 40.7 +/- 10.1). Indices of carbohydrate metabolism showed
      significant univariate correlations with triglyceride (TG) and/or cholesterol
      (CHOL) content of plasma VLDL, LDL and HDL (P less than 0.05). Multivariate
      analyses indicated that the explained variance in plasma VLDL-TG (R2 x 100 = 44
      percent, P less than 0.05) and LDL-apoprotein (apo) B levels (R2 x 100 = 33.1
      percent, P less than 0.08) was entirely accounted for by indices of carbohydrate
      metabolism and body fat distribution, whereas total body fatness added no
      significant contribution to these models. Multivariate analyses also revealed
      that the best possible regression model to predict the variation in plasma HDL2
      CHOL levels only included computed tomography-derived deep abdominal adipose
      tissue area (P less than 0.0001). All other variables were unable to further
      improve the explained variance in plasma HDL2-CHOL levels. In partial correlation
      analyses, indices of carbohydrate metabolism and the waist-to-hip circumference
      ratio (WHR) remained significantly correlated with plasma VLDL-TG and LDL-apo B
      levels after adjustment of VLDL-TG and LDL-apo B for either insulin and glucose
      levels, or for the WHR (P less than 0.08). After correcting for deep abdominal
      fat accumulation, no significant correlation was observed between indices of
      carbohydrate metabolism and plasma HDL2-CHOL levels whereas deep abdominal fat
      showed significant correlations with HDL2-CHOL levels (P less than 0.05) after
      correction for indices of carbohydrate metabolism. These results suggest that
      both disturbances in glucose-insulin homeostasis and abdominal obesity are
      significantly associated with changes in plasma VLDL-TG and LDL-apo B levels and
      that these associations are partly independent from each other. These results
      also indicate that mechanisms other than disturbances in glucose homeostasis and
      hyperinsulinemia are responsible for the association between the level of deep
      abdominal fat and plasma HDL2-CHOL levels.

PMID- 1752730
TI  - Socioeconomic status differences in health behaviors related to obesity: the
      Healthy Worker Project.
AB  - Obesity and health behaviors that influence energy balance (diet, exercise, and
      dieting to lose weight) were examined in a population of 2108 and 2539 working
      men and women in relation to socioeconomic status (SES). The hypothesis
      investigated was that the inverse relationship between SES and obesity observed
      in a number of studies is due to the fact that the distribution of obesity
      relevant health behaviors differs by social class. Body mass index (BMI), as
      expected, was found to be inversely related to SES. Higher SES was also
      associated with several behaviors that contribute importantly to energy balance.
      High SES respondents reported a lower fat diet, more exercise, and a higher
      prevalence of dieting to control weight. However, lower smoking rates were
      observed in upper SES men and women and higher alcohol consumption was reported
      in upper SES women. Both of these associations appear to be inconsistent with the
      hypothesis that the inverse association between SES and obesity is caused by
      differences in health behaviors. In multiple regression analyses, SES remained a
      significant predictor of BMI after controlling for all measured health behaviors.
      Weaknesses in the methodologies for measuring health behaviors and possible
      effects of obesity itself on social mobility are suggested as possible
      explanations for the residual association between obesity and SES.

PMID- 1752731
TI  - Adrenalectomy in the Zucker fatty rat: effect on m-RNA for malic enzyme and
      glyceraldehyde 3-phosphate dehydrogenase.
AB  - The effects of adrenalectomy with or without replacement doses of corticosterone
      were examined on the levels of messenger RNA for malic enzyme (ME) and
      glyceraldehyde 3-phosphate dehydrogenase (GAPDH) in adipose tissue and liver from
      Zucker fatty (fa/fa) and littermate lean rats. The levels of both GAPDH and ME
      mRNAs were increased in the obese rats. Adrenalectomy markedly reduced the m-RNA
      for GAPDH and ME in Zucker fatty rats to the low levels observed in
      adrenalectomized lean rats. Corticosterone treatment induced a greater and
      earlier increase in mRNA levels in adrenalectomized obese rats than in
      adrenalectomized lean rats. Since the fatty rat represents an autosomal recessive
      trait, these results are consistent with the hypothesis that the genetic defect
      is a loss of a modulator of steroid action which normally restricts the response
      of genes to glucorticoid hormones.

PMID- 1752732
TI  - Late results after cholesteatoma surgery in early childhood.
AB  - The incidence of cholesteatoma in children living in an urban area of western
      Sweden has been studied. The total population of this area is 470,000 out of
      which 100,000 are children, 16 years or younger. The charts of all the children
      undergoing cholesteatoma surgery during the time period from 1977 to 1986 were
      collected and analyzed. Only those patients who had not been exposed to
      cholesteatoma surgery before were included. In a follow-up study the clinical
      situation and hearing level have been evaluated 4 years or more after surgery.
      Nineteen patients, that is an incidence of 0.4 children out of 100,000
      inhabitants each year, were found meeting these criteria with an irregular
      distribution over the 10 year period. During the first two years 11 cases were
      found, but in the following 8 years only 8 new cases were identified. Intact wall
      tympanoplasty was used in 10 cases and canal wall down operation in 9 cases.
      Residual cholesteatoma was detected in 6 cases and recurrent cholesteatoma in one
      case. Six of these had an intact wall tympanoplasty and all but one were later
      reoperated with a canal wall down approach. The study reveals a decrease in the
      incidence of cholesteatoma in children over a 10-year period. The more frequent
      use of tympanometry and otomicroscopy is a possible explanation.

PMID- 1752733
TI  - Does the epithelium play a central role in the immune function of rhinopharyngeal
      tonsils? An immunocytochemical and ultrastructural study.
AB  - Enlarged adenoids from 10 children with chronic rhinitis and otitis media with
      effusion have been studied immunocytochemically and ultrastructurally, to better
      define the possible role of the epithelium and the dendritic accessory cells in
      the immune activation of lymphoid cells, and provide further insight into the
      pathogenesis of the disease. The presence within the columnar epithelium of
      lymphocytes positive for CD8 antigen, and which electron microscopically have
      been found frequently apposed to degenerating epithelial cells suggests that the
      latter cells are targets for cytotoxic activity of intraepithelial lymphocytes,
      rather than being engaged in antigen presentation. Furthermore, the finding of
      typical dendritic accessory cells, recognized by their typical immunophenotypic
      and ultrastructural features, in the lamina propria, indicates that antigen
      presentation is more likely exerted by dendritic accessory cells. This is further
      supported by the fact that these cells express major histocompatibility (MHC)
      class II molecules, which are needed for antigen presentation, whereas epithelial
      cells do not. A possible relationship between epithelial damage and the
      pathogenesis of adenoidal enlargement is discussed.

PMID- 1752734
TI  - Paediatric tracheostomy: persistent tracheo-cutaneous fistula following
      decannulation.
AB  - A retrospective analysis of 101 children with tracheostomies, all performed for
      upper airway obstruction and who were decannulated in a single department, is
      reported. Persistent tracheo-cutaneous fistula occurred in 43% of patients and
      this was significantly related to age at tracheostomy and duration of
      tracheostomy. The operation of tracheo-cutaneous fistula closure is described.

PMID- 1752735
TI  - Assessment of cisplatin-induced ototoxicity using derived-band ABRs.
AB  - Ototoxicity is an adverse side effect of numerous therapeutic agents (amino
      glycoside antibiotics, blood chelating agents, diuretics and oncologic drugs)
      used in treatment of both adult and pediatric patients. Recently, there has been
      increasing interest in using the auditory brainstem response (ABR) to detect both
      short-term effects of ototoxicity in adults and long-term effects of drug
      administration on neonates and children. Since click ABRs have relatively poor
      frequency selectivity they best approximate the pure-tone hearing threshold in
      the 2000-4000 Hz frequency range. Hearing loss above or below that frequency
      range can be present without producing significant abnormalities in the ABR
      waveform parameters. Frequency-specific ABRs can be obtained using the derived
      response technique. The purpose of this study was to investigate early cisplatin
      ototoxicity using both the broadband click and derived ABR and to monitor
      progressive hearing loss with repeated drug trials in 18 patients studied over a
      2-year period. ABRs were obtained serially prior to and following intravenous
      administration of cisplatin. Derived ABRs were found to be more sensitive than
      broadband click ABR in detecting early high-frequency hearing loss. For click
      ABRs, the cumulative dosage of cisplatin at age of ABR examination was correlated
      with hearing loss in only those patients under 3 years of age. No significant
      correlation was found between cumulative cisplatin dosage when tested and degree
      of hearing loss in those patients over 3 years of age.

PMID- 1752736
TI  - Nasopharyngeal pH monitoring in infants and children with chronic
      rhinopharyngitis.
AB  - The etiology and mechanisms involved in determining and/or maintaining the
      inflammatory process along the airway mucosa remain partially obscure. The role
      of gastroesophageal reflux (GER) has been demonstrated in some cases of
      bronchitis and laryngitis especially in children. In adults, GER-related
      laryngitis has also been mentioned. In children, repeated rhinopharyngitis and
      otitis media due to GER remain a putative question. In this study, 31 infants and
      children underwent a day and night nasopharyngeal pH monitoring. Thirteen
      patients with known GER suffered from chronic or repeated rhinitis or
      rhinopharyngitis. Eighteen control subjects with or without GER were free of
      upper airway inflammatory process. In some pathological cases the pH dropped
      dramatically. The pH drops were more important in most of the GER/rhinitis cases
      than in controls. Of the reviewed criteria, the percentage of time spent below pH
      6 (or pharyngeal acidity index) is the most statistically significant (P less
      than 0.00005). Thus, the influence of a gastro-esophago-nasopharyngeal acid
      reflux is strongly suggested in this common pediatric pathology, among other
      causes. However, the technique used does not allow us to assess the true origin
      of these pH changes. Further investigation with two-site pH monitoring and larger
      series of patients are required in order to fully assess the influence of GER on
      pediatric nasopharyngeal inflammation.

PMID- 1752737
TI  - Temporal bone pathology of two infants with Larsen's syndrome.
AB  - Two infants who had multiple joint dislocations, unusual facies, and bony
      abnormalities, typical of the syndrome first reported by Larsen et al. (J.
      Pediatr., 37 (1950) 574-581) are described. This report expands Larsen's syndrome
      to include the following findings of temporal bone pathology. Case 1 (one year
      and 8 months old) showed dislocation of the malleus and incus, an abnormal foot
      plate, mesenchyme remaining in the attic and mesotympanum, poor development of
      the mastoid air cells, and poor development of the labyrinth. Case 2 (3 years and
      6 months old) showed dislocation of the malleus and incus, mesenchyme remaining
      in the attic and mesotympanum, and an abnormal stapes. These histological
      findings suggest that a maldevelopment similar to that which occurs in the
      skeletal system occurs in the temporal bones as well as in the face and
      extremities including many joints.

PMID- 1752738
TI  - Complement C4 types in coeliacs and controls.

PMID- 1752739
TI  - Screening for abnormal eating attitudes in an unselected population of 16 year
      old Dublin schoolgirls.

PMID- 1752740
TI  - Aminoglycoside induced ototoxicity in patients with cystic fibrosis.
AB  - The improved survival of cystic fibrosis (CF) patients is partly due to intensive
      treatment for their chronic infections. Treatment usually includes intravenous
      and nebulised aminoglycoside antibiotics and they receive a large cumulative dose
      of these antibiotics over their lifetime. There is little information in the
      literature on the prevalence of ototoxicity due to aminoglycoside in these
      patients. We performed pure tone audiometry on 43 CF patients aged 14-42 years.
      Seven (16%) had bilateral sensorineural hearing loss (SNHL) for high frequency
      sounds, consistent with aminoglycoside induced ototoxicity. However, only 2 of
      these patients had documented toxic serum levels in the past. The identification
      of bilateral SNHL in one in six adult CF patients is a cause for concern. It may
      be that the high cumulative dose of aminoglycosides received by these patients
      may be causing inner ear injury in the absence of specific episodes of toxic
      serum levels.

PMID- 1752741
TI  - Cerebral lymphoma and HIV encephalitis in a case of paediatric AIDS, with pre
      existing multicystic encephalomalacia.
AB  - A case of intracerebral malignant B cell lymphoma associated with encephalitis
      typical of Human Immunodeficiency Virus (HIV) infection is described in a 4 year
      old child, with post-transfusion Acquired Immune Deficiency Syndrome (AIDS) and
      severe pre-existing cystic encephalomalacia. This report further documents B cell
      lymphoma as the commonest cause of an intracerebral mass, and an important cause
      of death in paediatric AIDS. That more than one pathological process may be
      responsible for neurological symptoms in paediatric AIDS is also emphasised.

PMID- 1752742
TI  - Broad beam transmission properties of some common shielding materials for use in
      diagnostic radiology.
AB  - Broad beam geometry was used to measure the x-ray transmission properties of
      gypsum wallboard, steel, plate glass, and concrete for x-ray tube potentials of
      50-125 kVp using an x-ray generator having a three-phase, twelve-pulse waveform
      and total initial beam filtration sufficient to provide half-value layers
      representative of those found in common practice and required by regulatory
      agencies. Measurement results are presented graphically and as numerical fits to
      a mathematical model of broad beam transmission to permit their use in the design
      of protective barriers for medical diagnostic x-ray facilities.

PMID- 1752743
TI  - Measurement of photon-energy albedo from stratified shielding materials.
AB  - In the conventional method of measuring photon-energy albedo using a
      scintillation detector coupled with a multichannel analyzer, tedious efficiency
      correction by the inverse matrix method was needed. The indigenously designed
      proportional-response photon counter, with its detection efficiency proportional
      to energy of incident photons, was used in the present investigation. Use of the
      proportional-response photon counter makes the measurement straightforward and
      more accurate. Measurements of energy albedo from stratified layers of aluminum,
      iron, lead, and concrete using 662-keV and 1250-keV photon energies are reported.

PMID- 1752744
TI  - Naturally occurring 226Ra concentrations in bone at various ages and alpha doses
      in adults.
AB  - Radium-226 concentrations of bone from the fetus and stillborn and from subjects
      aged 0 to 87 y, especially those older than 15 y, were determined by alpha
      spectrometry after an ion exchange separation. The median and mean 226Ra
      concentrations in bone of the adults, 20 to 69 y, were 0.35 and 0.42 Bq (kg bone
      ash)-1, respectively, and those for ages 15 to 87 y were 0.35 and 0.41 Bq (kg
      bone ash)-1, respectively. For fetal bones, mean content was 0.29 Bq (kg bone
      ash)-1. Annual dose equivalents in cells near bone surfaces and active red bone
      marrow, received from alpha radiation emitted from 226Ra and its decay products
      in mineral bone, were estimated using the ICRP dosimetric model for bone and
      assuming masses of source and target tissues for a Japanese Reference Man.

PMID- 1752745
TI  - Biological dosimetry using the micronucleus assay for lymphocytes:
      interindividual differences in dose response.
AB  - The dose response of the number of micronuclei in cytokinesis-blocked lymphocytes
      after in-vitro irradiation of whole blood with x rays in the dose range 0-4 Gy
      was studied for a heterogeneous population of 10 donors. One thousand binucleated
      cells were systematically scored for micronuclei. A linear-quadratic dose
      dependency of the micronucleus yields was observed. The data were used to derive
      the accuracy of the dose assessment with the technique in case of a radiation
      accident. It was shown that for doses of 2 Gy and higher, the uncertainty of the
      dose was predominantly due to interindividual differences in the x-ray-induced
      micronucleus yields. At the 95% confidence level, doses lower than 0.3 Gy could
      not be unequivocally detected with the cytokinesis-blocked micronucleus assay due
      to the variability of the baseline micronucleus frequency within the donor
      population and the poor statistical accuracy when scoring 1,000 cells. The
      precision and sensitivity of the method in the low-dose range could be improved
      by the knowledge of individual pre-irradiation baseline values and an increase of
      the number of cells scored by automation of the technique.

PMID- 1752746
TI  - Evidence of a neutron RBE of 70 (+/- 50) for solid-tumor induction at Hiroshima
      and Nagasaki and its implications for assessing the effective neutron quality
      factor.
AB  - Carcinogenic and genetic effects in the cohort of A-bomb survivors are the main
      source of information on radiation effects on humans. A detailed analysis of the
      age-specific mortality rates for solid tumors as a group using the widely
      accepted linear-quadratic cum cell-killing dose-effect model reveals that the
      Hiroshima-Nagasaki data are statistically consistent with a limiting, low-dose
      neutron RBE of about 70. This value, although consistent with a wide range of
      neutron RBEs, is about 3.5 times higher than the current effective quality factor
      for neutrons. The data on leukemia mortality do not support the notion of a
      difference in effectiveness between neutron and gamma radiation; however, these
      two radiation sources appear to act synergistically. For both types of tumors,
      the commonly used concepts of constant, dose-independent RBE and "gamma effective
      dose" cannot be justified other than at very low neutron doses.

PMID- 1752747
TI  - Suitability of Chinese oil well loggers for an epidemiologic study of the
      carcinogenic effects of neutrons.
AB  - Neutron exposures to 191 well loggers at four oil fields in China were measured
      over a 3-mo period using CR-39 polycarbonate dosimeters. Doses (96% less than
      0.02 mGy) were slightly lower than literature values for well loggers in North
      America, possibly because of differences in drilling activity. Because doses are
      so low, an epidemiologic study of cancer among Chinese well loggers is unlikely
      to be informative about the carcinogenicity of neutrons relative to sparsely
      ionizing radiation.

PMID- 1752748
TI  - Effects of the tissue-air interface in calculations of beta-particle skin dose at
      a depth of 70 microns.
AB  - The effects that the tissue-air interface has on the basal-layer dose at a depth
      of 70 microns from beta emitters on the skin surface are studied using Monte
      Carlo calculations. The dose is decreased at small lateral distances from a point
      source but is increased at large distances.

PMID- 1752749
TI  - Measurements of radioactivity in Jamaican building materials and gamma dose
      equivalents in a prototype red mud house.
AB  - Concentrations of 226Ra, 232Th, and 40K measured in bauxite waste, local building
      materials, and soils are presented and used in model equations to estimate the
      effective gamma dose-equivalent increments over background in the center of a
      standard-sized room in a prototype house. Calculated and measured values compare
      reasonably well.

PMID- 1752750
TI  - Dose rates for several organs in a human from contaminated soil and hot particles
      using the QAD computer code.
AB  - Dose rates from contaminated soil and hot particles have been calculated for
      several organs of a reference human. The calculation was performed using the
      computer code QAD-CGGP, a point kernel code employing combinatorial geometry for
      the representation of the human phantom. QAD uses buildup factors based on the
      geometric progression form, a buildup factor representation adopted by the
      American Nuclear Standards Committee. The results indicate that QAD is a powerful
      and easy-to-run code that produces useful results for practicing health
      physicists.

PMID- 1752751
TI  - NTS fallout-induced multiple myeloma in Utah.

PMID- 1752752
TI  - Incorporating OMT in hospital training.

PMID- 1752753
TI  - Superlatives and concerns in osteopathic medical education.

PMID- 1752754
TI  - A genetically engineered protein may hold promise in the fight against the
      acquired immunodeficiency syndrome (AIDS)

PMID- 1752755
TI  - Congress has passed a compromise bill requiring healthcare workers who perform
      invasive procedures be tested regularly for the human immunodeficiency virus
      (HIV)

PMID- 1752756
TI  - Undergraduate osteopathic medical education.

PMID- 1752757
TI  - US osteopathic medical school finances.

PMID- 1752758
TI  - Osteopathic graduate medical education.
AB  - Osteopathic graduate medical education is still in transition. The AOA Department
      of Education will continue to monitor and report on the impact of these changes.

PMID- 1752759
TI  - AOA continuing medical education.

PMID- 1752760
TI  - Research programs of the AOA and their role in osteopathic medical education.

PMID- 1752761
TI  - Evaluating copper and zinc in dairy rations.

PMID- 1752762
TI  - Serologically atypical canine ehrlichiosis associated with Ehrlichia risticii
      "infection".

PMID- 1752763
TI  - Veterinary history.

PMID- 1752764
TI  - Preparing for disasters.

PMID- 1752766
TI  - Wills requiring the destruction of pets--the veterinarian's position.

PMID- 1752765
TI  - How to keep your sanity, self-respect, and dignity in a rural practice.

PMID- 1752767
TI  - Effect of storage on measurement of ionized calcium and acid-base variables in
      equine, bovine, ovine, and canine venous blood.
AB  - The stability of blood ionized calcium (Ca2+) and acid-base variables in equine,
      bovine, ovine, and canine venous blood samples (n = 15, in each group) stored at
      4 C for 3, 6, 9, 24, or 48 hours was studied. Variables included blood Ca2+ and
      standard ionized calcium (Ca2+ corrected to pH 7.4) concentrations, pH, blood
      carbon dioxide and oxygen tensions, base excess, bicarbonate concentration, and
      total carbon dioxide content. Results indicate that storage of blood samples at 4
      C for up to 48 hours, despite appreciable acid-base changes, is associated with
      less than 1.5% change in equine, bovine, and ovine blood Ca2+ concentrations.
      Similar changes were observed in canine blood during the first 9 hours' storage.
      After 24 and 48 hours' storage, clinically relevant decrease (10.5 and 15.5%) in
      canine blood Ca2+ concentration was measured. Therefore, Ca2+ concentration in
      equine, bovine, and ovine venous blood samples stored up to 48 hours, and in
      canine blood samples stored up to 9 hours at 4 C is of diagnostic use.

PMID- 1752768
TI  - Escherichia coli bacteremia associated with hypertrophic osteodystrophy in a dog.
AB  - Escherichia coli bacteremia was detected in a dog that had hypertrophic
      osteodystrophy. The dog improved after treatment with cephalothin sodium, iv
      fluid therapy, and cage rest. The cause of hypertrophic dystrophy has not been
      determined, although an infectious cause has been suggested. Dogs that are
      suspected of having hypertrophic osteodystrophy should be monitored closely for
      evidence of septicemia, and the administration of prophylactic antibiotics may be
      advisable.

PMID- 1752769
TI  - Bilateral wedge ostectomy on an 18-month-old llama with severe bilateral carpal
      valgus.
AB  - An 18-month-old llama was admitted with severe (45 degrees and 40 degrees)
      bilateral carpal valgus. The llama had grown normally until it was 6 months old,
      when the carpal deviations had commenced. Radiography revealed abnormalities at
      the distal ulnar physes. Premature closure of these physes or abnormal distal
      ulnar growth may have been the cause of the carpal valgus. The owners requested
      surgical correction of the condition. Medial wedge osteotomies of each radius
      were performed 3 weeks apart. Internal fixation of the osteotomized radial bones
      was accomplished with small right-angled T plates, and the limbs were placed in
      full-limb casts for 3 weeks and tube casts for 3 more weeks. Both limbs healed in
      straight alignment, and the llama was able to walk and run normally. Dorsal
      subluxation of the right radiocarpal joint was noticed after the operation. This
      was believed to be caused by the uncorrected dorsal bowing of the distal portion
      of the radius, which had occurred secondary to the severe carpal valgus.

PMID- 1752770
TI  - Lymphosarcoma with urinary bladder infiltration in a horse.
AB  - A 9-year-old Thoroughbred mare was examined because of pollakiuria, hematuria,
      and weight loss of 3 weeks' duration. Physical examination revealed a regular
      cardiac rhythm with occasional premature contractions, and a soft tissue mass in
      the pelvic canal palpable per rectum. Microscopic examination of urine sediment
      revealed numerous RBC and a large population of lymphocytes and lymphoblasts with
      characteristics of neoplasia. Similar cells were found in peritoneal fluid
      obtained by abdominocentesis. The horse was euthanatized without treatment.
      Necropsy revealed a soft tissue mass infiltrating the bladder, vagina, and
      uterus. Additional masses were found in the sublumbar muscles and myocardium. The
      histologic diagnosis was lymphosarcoma.

PMID- 1752771
TI  - Rostral mandibulectomy in five horses.
AB  - Rostral mandibulectomy with primary gingival closure was performed in 5 horses
      with rapidly growing or bleeding mandibular tumors. The technique involved
      preservation of the most caudal portion of the mandibular symphysis to maintain
      stability. There were no surgical complications or recurrences, and the cosmetic
      and functional results were good. The histopathologic diagnosis of all the tumors
      was ossifying fibroma. Rostral mandibulectomy affords a simple and effective
      technique of treating tumors of the rostral portion of the mandible in horses.

PMID- 1752772
TI  - Pharmacologic treatment of priapism in two horses.
AB  - Benztropine mesylate was used successfully to treat priapism that developed
      during anesthesia in 2 horses. After IV injection, there was a rapid resolution
      of signs in both horses, and no side effects were observed. The choice of an
      effective method to treat priapism is challenging because precise causes in most
      patients have not been well-defined. Benztropine mesylate is a synthetic compound
      resulting from the combination of the active portions of atropine and
      diphenhydramine, and is believed effective because of its central acetyl-choline
      antagonizing properties.

PMID- 1752773
TI  - Clinical management and surgical repair of atresia coli in calves: 66 cases (1977
      1988).
AB  - The medical records of 66 calves with atresia coli were reviewed; 64 calves were
      examined at the New York State College of Veterinary Medicine, and 2 calves were
      examined at the New Bolton Center. In each case, the site of the atresia was
      within the spiral loop of the ascending colon. In 1 of these calves, a segment of
      jejunum was also atretic. Absence of feces, progressive weakness, and abdominal
      distension were the most common clinical signs observed. Other congenital
      abnormalities were detected in 12 (18%) of 66 calves. Of the 66 calves examined,
      5 were euthanatized or died on admission, and 61 had an exploratory celiotomy
      performed. Eight calves were euthanatized or died during the surgery. In the
      remaining 53 calves, surgical treatment consisted of enterotomy followed by
      meconium evacuation, resection of the proximal blind end (in 30 calves), and
      restoration of intestinal continuity. Restoration of intestinal continuity was
      done either by side-to-side anastomosis of the proximal to distal blind ends (5
      calves), or by side-to-side or end-to-side anastomosis of the proximal blind end
      to the descending colon (48 calves). Of the 66 calves seen, 27 (41%) were
      discharged from the hospital, and 11 of these reached reproductive age (11 calves
      were lost to follow-up before they were 2 years old). From the 11 calves reaching
      reproductive age, 33 calves were born, one of which may have had atresia coli.
      The owners should anticipate that long-term survivors likely will have loose
      feces and normal offspring, but may not grow as well as otherwise expected.

PMID- 1752774
TI  - Clinical, clinicopathologic, and pathologic features of plague in cats: 119 cases
      (1977-1988).
AB  - The clinical, clinicopathologic, and pathologic features of 119 cases of plague
      in cats from 1977 to 1988 in New Mexico were reviewed. Fifty-three percent were
      bubonic, 10% were pneumonic, 8% were septicemic, and 29% with neither buboes nor
      pneumonia were unclassified (but presumed septicemic). Three quarters of the
      lymphadenopathy was submandibular, and almost half of this was bilateral. One
      third of all cats had the triad of lethargy, anorexia, and fever in addition to
      buboes; one quarter had this triad plus abscesses. The overall mortality rate was
      33%, with the greatest risk of death in pneumonic cases. For confirmatory
      diagnosis with a single laboratory test, fluorescent antibody was most frequently
      used (39% of cases). Cultures and passive hemagluttination titers were also used
      for confirmation. Gross and histologic findings depended on the type of plague,
      with Yersinia pestis organisms visualized in buboes of cats with bubonic plague
      and in the alveolar spaces and respiratory tubules of cats with pneumonic plague.

PMID- 1752775
TI  - What is your diagnosis? Mummified fetus in the middle portion of the abdomen.

PMID- 1752776
TI  - Transformation of CD8+ T-cells producing a strong cytopathic effect on CD4+ T
      cells through syncytium formation by HTLV-II.
AB  - Human T-cell leukemia virus type II (HTLV-II) is thought to play an important
      role in the development of CD8+ T-cell malignancies resembling hairy cell
      leukemia. In this study, dramatic cytopathic effects characterized by syncytium
      formation in various CD4+ T-cell lines were observed upon their cocultivation
      with HTLV-II infected T-cells. The HTLV-II infected T-cells, however, did not die
      as a result of syncytium formation. HTLV-II also transformed CD4+ T-cells and
      CD8+ T-cells at various coculture ratios. Furthermore, sera from anti-HTLV-II
      antibody-positive specific carriers inhibited syncytium formation in the CD4+ T
      cells. These results suggest that HTLV-II infection may contribute to the
      pathogenesis of associated CD8+ T-cell malignancies.

PMID- 1752777
TI  - Human granulocyte-macrophage colony-stimulating factor is a growth factor active
      on human ovarian cancer cells.
AB  - Human granulocyte-macrophage colony-stimulating factor (GM-CSF) is a regulatory
      glycoprotein that stimulates the production of granulocytes and macrophages from
      committed hematopoietic progenitor cells both in vitro and in vivo. In this
      report, we show that recombinant human GM-CSF enhances colony formation by
      nonhematopoietic human ovarian cancer cell lines, IGROV-1, A2774, ME-180, Pa-1
      and A2780. GM-CSF also enhanced the colony formation by cells obtained from fresh
      ascites of a patient with ovarian mucinous cystadenocarcinoma and a patient with
      serous papillary ovarian carcinoma. Our observations were made with GM-CSF
      concentrations between 0.1 to 1 ng/ml; these concentrations are equivalent to the
      dosages generally used for bone marrow recovery after chemotherapy.

PMID- 1752778
TI  - Effects of hormones on tumor growth and immunoreactive insulin-like growth factor
      1 of estrogen receptor-positive human breast cancer (MCF-7) transplanted in nude
      mice.
AB  - The effects of estrogens and tamoxifen were analyzed on estrogen receptor
      positive human breast cancer (MCF-7) transplanted into athymic nude mice. It was
      found that (1) the tumor growth and the proportion of 3H-thymidine-labeled cells
      were significantly increased in the 17 beta-estradiol dipropionate (E2) group,
      but significantly decreased in the tamoxifen (TAM) group with respect to the
      control group, and (2) the tumor content of insulin-like growth factor-1 (IGF-1)
      and the rate of IGF-1-positive cells were significantly lower in the E2 group,
      but significantly higher in the TAM group than in the control group. It was
      concluded that the tumor content of IGF-1 and the proportion of IGF-I-positive
      cells were inversely correlated to the tumor growth and the 3H-thymidine labeling
      index in vivo.

PMID- 1752779
TI  - Human tumor-infiltrating lymphocytes transfected with tumor necrosis factor gene
      could augment cytotoxicity to autologous tumor cells.
AB  - Human tumor-infiltrating lymphocytes (TILs) derived from pleural or ascitic fluid
      were incubated with recombinant interleukin 2 and transfected with human tumor
      necrosis factor (TNF) alpha gene by the lipofection procedure. The resulting TILs
      secreted significant amounts of TNF in the culture supernatant and exhibited
      cytotoxicity against established cell lines, such as K562 and Daudi, and
      autologous tumor cells. The TNF gene-transfected TILs exhibited an augmented
      killing of autologous tumor cells.

PMID- 1752780
TI  - Induction of renal cell tumors in rats and mice, and enhancement of
      hepatocellular tumor development in mice after long-term hydroquinone treatment.
AB  - Hydroquinone (HQ) was administered to F344 rats and B6C3F1 mice of both sexes at
      a level of 0.8% in the diet for two years. This treatment induced renal tubular
      hyperplasia as well as adenomas, predominantly in males of both species, and was
      associated with chronic nephropathy in rats. In addition, the occurrence of
      epithelial hyperplasia of the renal papilla was increased in male rats. Foci of
      cellular alteration of the liver were significantly reduced in number by HQ in
      rats, but in contrast, were increased in mice, where development of
      hepatocellular adenoma was also enhanced in males. The incidence of squamous cell
      hyperplasia of the forestomach epithelium was significantly higher in mice of
      both sexes given HQ than in the controls, but no corresponding increase in tumor
      development was observed. The present study strongly indicates potential renal
      carcinogenicity of HQ in male rats and hepatocarcinogenicity in male mice. Thus,
      it is possible that HQ, which is present in the human environment, may play a
      role in cancer development in man.

PMID- 1752781
TI  - Summation effects of uracil and other promoters on epithelial lesion development
      in the F344 rat urinary bladder initiated by N-butyl-N-(4
      hydroxybutyl)nitrosamine.
AB  - Five non-genotoxic chemicals previously demonstrated to be bladder cancer
      promoters in 36-week in vivo assays for carcinogenesis were reevaluated in a 20
      week experiment in order to assess the summation influence of dietary uracil, a
      component of RNA, on the development of (pre)neoplastic lesions. The test
      chemicals, sodium bicarbonate, sodium L-ascorbate, sodium citrate, butylated
      hydroxytoluene and ethoxyquin, were mixed into the diet at concentrations of 3%,
      5%, 5%, 1% and 0.8%, respectively, and administered to male F344 rats after
      initiation with 0.05% N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) in their
      drinking water for 4 weeks. The test chemicals were given from the 4th to the 8th
      and the 11th to 20th experimental weeks, uracil being administered at the level
      of 3% in the diet during the intervening period. Rats in the control group
      received only BBN and uracil. All animals were killed at week 20 and the bladders
      were evaluated for the occurrence of putative preneoplastic papillary or nodular
      (PN) hyperplasia and tumors. Significant increase in the occurrence of PN
      hyperplasia was observed in all groups initiated with BBN and fed uracil and test
      chemicals. Quantitative values for papillomas were also significantly increased
      except in the ethoxyquin-treated group. The results confirm that uracil given in
      the middle of the post-initiation stage enhances the promoting activity of
      chemicals and suggest that the use of this chemical might be useful to reduce the
      duration of current bioassays for bladder chemical carcinogens.

PMID- 1752782
TI  - Activation and suppression of a cryptic promoter in the intron of the human
      melanoma-associated ME491 antigen gene.
AB  - A deletion mutant of the human melanoma-associated ME491 antigen gene starting at
      the first intron (lambda R31) differentially mediates the antigen expression
      depending on the cell type. Cryptic promoter activity residing in a 270-base-pair
      (bp) fragment of the first intron was examined by primer extension analysis and
      recombinant chloramphenicol acetyltransferase (CAT) assay. The cryptic promoter,
      further localized within a 153-bp fragment (fr153BN), exerted its effect in Ltk-
      and H-ras-transformed NIH3T3 (3T3-Hras) but not in parental NIH3T3 cells. The
      results suggested that the cryptic promoter was associated with a novel ras
      responsive positive regulatory element, since fr153BN did not contain an AP-1
      binding sequence motif, known as the ras-responsive enhancer element. The cryptic
      promoter activity of fr153BN was suppressed by an upstream 121-bp fragment
      (fr121SB) which contained a consensus sequence motif for binding of a repressor
      protein, GC factor, and regions showing sequence similarity with putative cis
      acting repressor elements found in the vimentin gene. The degree of the
      suppression was greater in 3T3-Hras than in Ltk- cells. These positive and
      negative regulatory elements may be differentially involved in the regulation of
      ME491 antigen expression depending on the cell type.

PMID- 1752783
TI  - Assessment of new macroscopical classification of gastric malignant lymphoma.
AB  - We macroscopically classified gastric malignant lymphoma into ST type (submucosal
      tumor type), non-ST type (non-submucosal tumor type) and Combined type
      (combination of ST and non-ST type) and assessed this new classification by
      examining 60 surgically resected cases. Of these, 18 cases (21 lesions) were
      classified into ST type, 38 cases (54 lesions) into non-ST type and 4 cases (4
      lesions) into Combined type. All the large cell, immunoblastic type cases were of
      ST type and most of the diffuse, small cleaved cell type cases and all the
      plasmacytoma cases were of non-ST type. Diffuse, large cell type and diffuse,
      mixed type cases did not seem to be biased toward any of these three
      macroscopical types. The non-ST type cases frequently showed an infiltrative
      growth pattern and reactive lymphoid cell hyperplasia adjoining the lesions,
      while the ST type cases frequently showed an expansive growth pattern without
      reactive lymphoid cell hyperplasia. The Combined type cases showed both
      infiltrative and expansive growth patterns in the same lesion. The macroscopical
      classification defined in this study can be considered useful in determining a
      range for surgical resection of gastric malignant lymphoma.

PMID- 1752784
TI  - Prognostic significance of circulating immune complexes in cancer patients.
AB  - Circulating immune complexes (CIC) were estimated in 100 cancer patients and 25
      healthy control volunteers by means of the polyethylene glycol (PEG)
      precipitation test and latex agglutination inhibition (LAI) test. Pathological
      levels of CIC were found in 47% of the patients by PEG precipitation test and in
      59% of the patients by LAI test; both tests were positive in 33% of the patients.
      Consequently, the use of the two assays resulted in 73% seropositivity for CIC.
      The PEG precipitation test detects antigen-antibody complexes formed in the ratio
      of 2:1 (Ag2Ab), while the LAI test could detect immune complexes formed over an
      extended range of antigen-antibody ratio including complexes as small as 8S. CIC
      values were significantly higher by combined assays (P less than 0.001) as
      compared to individual assays (P less than 0.01) when compared with the control
      group. It was found that 75% of post-operative follow-up patients became
      seronegative for CIC in the combined assays, whereas the 25% of post-operative
      patients who remained seropositive for CIC showed recurrence within three months
      after surgery. Immune-complex deposition was demonstrated on malignant cells in
      vitro by direct immunofluorescence studies in 73.3% of patients, while 60% of
      patients revealed complement-fixing antigen-antibody complexes. It was found that
      20% of patients showing positive immunofluorescence with anti-C3-antisera had
      decreased levels of CIC. Complement-mediated cytotoxic injury results in
      reduction of tumor cell mass and subsequent decrease in CIC. Necrotizing and
      leucocytoclastic vasculitis in the tumor mass was initiated by raised CIC levels
      in vivo in 71% of patients. Necrosis of malignant tumors was seen in 58% of
      patients, and hemorrhage in 36% of patients. These changes were considered to be
      an aftermath of immuno-complex vasculitis initiated by CIC.

PMID- 1752785
TI  - Antitumor effector mechanism of interleukin-1 beta at a distant site in the
      double grafted tumor system.
AB  - Recombinant human interleukin-1 beta (IL-1 beta) inhibited the growth of not only
      the right, but also the left non-treated tumor in a double grafted tumor system.
      Since the antitumor activity of IL-1 beta against the right and left tumors was
      not seen in nude mice, lymphocytes have a key role in the antitumor effect of
      intratumoral administration of IL-1 beta. TIL (tumor-infiltrating leukocytes)
      obtained from left and right side tumors treated with IL-1 beta were examined by
      Winn assay for their antitumor activity against Meth-A sarcoma in BALB/c mice.
      TIL from the right side clearly inhibited the growth of admixed Meth-A cells, but
      control TIL did not. Spleen cells and right and left regional lymph node cells
      prepared from IL-1-treated mice were examined for Lyt-1, Lyt-2 and L3T4
      phenotypes. The number of Lyt-1-positive lymphocytes increased in the spleen and
      in the right regional lymph nodes after intratumoral administration of IL-1.
      Isolated tumor cells obtained from the right tumor treated with IL-1 beta and the
      left side tumor on day 6 were cultured in RPMI 1640 with 10% fetal calf serum for
      24 h. The culture supernatants were harvested and tested for the presence of
      chemotactic activity for neutrophils or macrophages. Significant neutrophil
      chemotactic factor and macrophage chemotactic factor activities were detected in
      the culture media from IL-1-treated tumor tissues cultured for 24 h. Neither
      significant neutrophil nor macrophage chemotactic activity was detected in the
      media from untreated tumor tissues. These results suggest that intratumoral
      administration of IL-1 first induces neutrophils and macrophages in the right
      tumor, then Lyt-1-positive cells in the right regional lymph nodes and in the
      spleen, and subsequently induces macrophages in the left, non-treated tumor.

PMID- 1752786
TI  - Murine tumor cells metastasizing selectively in the liver: ability to produce
      hepatocyte-activating cytokines interleukin-1 and/or -6.
AB  - Increasing evidence suggests that an intimate correlation may exist between the
      production of a cytokine, granulocyte-macrophage colony-stimulating factor (GM
      CSF) and the ability to metastasize spontaneously in the lungs in murine
      transplantable tumors. In the present study, we further examined the cytokine
      production by tumor cells with the ability to metastasize in the liver. Four out
      of 8 test tumors, which produced metastasis in the lungs but not in the liver,
      exhibited the ability to produce GM-CSF activity in culture. Three other tumors
      produced metastasis in the liver but not in the lungs. These tumor cells
      exhibited no ability to produce GM-CSF, but two of them expressed an interleukin
      6 (IL-6) mRNA and also produced IL-6 activity in the culture fluids. One of the
      two IL-6-producing tumors and the remaining liver metastatic tumor produced
      interleukin-1 (IL-1) as revealed by bioassay and neutralization test. In the
      tumor cells producing pulmonary metastasis, neither IL-6 gene expression nor IL-1
      production could be detected. The last test tumor, which produced no metastasis
      either in the lungs or liver, produced neither GM-CSF, IL-1 nor IL-6.
      Furthermore, injection of antisera reactive to recombinant murine IL-6 caused a
      marked decrease of the number of liver metastases of an IL-6-producing tumor, but
      not lung metastases of a GM-CSF-producing tumor, which could be markedly
      inhibited by injection of anti-recombinant murine GM-CSF sera. These results
      suggest the possibility that there may be a correlation between the cytokines
      produced by tumor cells and their organ specificity in spontaneous metastasis,
      and also indicate that these tumor models may provide a useful tool for studies
      on the role of cytokines in tumor metastasis.

PMID- 1752787
TI  - Fluctuations in tumor blood flow under normotension and the effect of angiotensin
      II-induced hypertension.
AB  - To elucidate the significance of angiotensin II (AII)-induced hypertension
      chemotherapy, changes of tissue blood flow both in normal subcutis and in tumors
      (AH109A, LY80) were measured with the hydrogen gas clearance method. A newly
      developed anesthetic machine was used to keep the animals' condition constant.
      Tissue blood flow in normal subcutis and tumors always fluctuated with time under
      normotension. The nature and the rate of fluctuation in tumor blood flow were
      almost identical in two different types of tumors. However, the fluctuation of
      blood flow in tumor and that in normal subcutis were almost always inversely
      related when blood flows in these different tissues were measured simultaneously,
      i.e., when tissue blood flow in normal subcutis decreased, tumor blood flow
      increased, and vice versa. The findings supported the idea that the connection
      mode between the tumor vascular bed and normal vascular bed is a parallel
      circuit. Vascular resistance in the normal vascular bed under AII-induced
      hypertension seemed to be greater than that under normotension, because the AII
      increased tumor blood flow always exceeded the maximum tumor blood flow under
      normotension. Due to the fluctuations of tumor blood flow, no-flow or low-flow
      areas, resistant to delivery of anti-cancer drugs, moved sporadically within the
      tumor under the normotensive condition. However, good conditions for drug
      delivery to tumor tissue were induced by AII-induced hypertension.

PMID- 1752788
TI  - Antitumor activity and metabolism of a new anthracycline-containing fluorine
      (ME2303) in Lewis lung carcinoma-bearing mice.
AB  - (7-O-(2,6-Dideoxy-2-fluoro-alpha-L-talopyranosyl)adriamycinone-14- hemipimerate
      (ME2303) showed a more marked growth inhibition of Lewis lung carcinoma than
      adriamycin (ADM). When administered to s.c. Lewis lung carcinoma-bearing mice,
      ME2303 in the plasma and liver was rapidly metabolized and disappeared. However,
      ME2303 was incorporated into the tumor at higher concentrations and remained in
      the tumor for a longer period than in the plasma and liver. ME2303 was
      metabolized to 7-O-(2,6-dideoxy-2-fluoro-alpha-L-talopyranosyl)adriamycinone
      (M1), the product of esterolysis, and its reduced derivative at the C-13 position
      (M2). Larger amounts of these metabolites were found in the analyzed tissues than
      in plasma. The maximum concentration of M1 in the tumor was observed at 2 h
      posttreatment, while the maxima in the plasma and liver were observed at 15 min.
      On the other hand, i.v. injection of M1 into mice showed a weaker antitumor
      effect than ME2303 injection, though M1 levels in the plasma and tumor were
      almost the same as those after administration of ME2303 at the maximum tolerated
      doses. Some metabolites of ME2303 were found in the tumor after administration of
      ME2303, but not after administration of M1. ADM remained in the analyzed tissues
      for a long period and ADM concentrations in the tumor were much higher than in
      the plasma but less than in the liver. M1 reached a concentration higher than
      that of ADM in the tumor, opposite to the pattern observed in the liver. The
      conversion process from ME2303 to M1, the metabolites and their locations in the
      tumor may be important for the marked antitumor effect of ME2303 in vivo.

PMID- 1752789
TI  - The influence of intra-arterial infusion of arginine vasopressin on cochlear
      blood flow in the rat.
AB  - Intra-arterially infused arginine vasopressin (AVP) elevated systemic blood
      pressure (BP) in the Sprague-Dawley rat according to a dose-response pattern
      while cochlear blood flow (CoBF), as measured by laser Doppler flowmetry, was
      elevated only at the highest dose. Skin blood flow (SBF) decreased significantly
      with AVP infusion. The local infusion of AVP into the anterior inferior
      cerebellar artery (AICA), which supplies the common cochlear artery, produced
      significant dose-dependent reductions in CoBF with no changes in systemic blood
      pressure. Pretreatment of the local cochlear supplying vessels with an AVP
      specific V1 receptor antagonist attenuated subsequent AVP-induced decreases in
      CoBF, thereby demonstrating specificity of the response. These results suggest
      that CoBF is reasonably stable in response to systemic AVP infusion until blood
      pressure exceeds an elevation from base level of approximately +60 mm Hg. One of
      the mechanisms responsible for this autoregulatory response may be
      vasoconstriction mediated by the interaction of vasoactive peptides such as AVP
      and its receptors located in the vasculature of the inner ear or in the more
      peripheral vessels directly supplying the cochlea.

PMID- 1752790
TI  - Objective auditory threshold estimation using sine-wave derived responses.
AB  - A derived response method of acquiring frequency specific auditory evoked
      potentials that utilizes a pure tone in combination with a toneburst is applied
      to the measurement of hearing sensitivity in guinea pigs, chinchillas and pocket
      gophers. Two experiments which demonstrate that thresholds acquired via tone
      derived responses are 10 to 15 dB more sensitive than thresholds to solitary
      tonebursts are described. The derived potentials approximate behaviorally
      acquired thresholds at frequencies of 0.5 kHz and above. This technique may
      provide a more rapid means of assessing hearing sensitivity in laboratory animals
      than by behavioral means.

PMID- 1752791
TI  - Shared-stimulus driving and connectivity in groups of neurons in the dorsal
      cochlear nucleus.
AB  - Extracellular spike discharges were recorded from ensembles of up to five neurons
      simultaneously in the DCN of guinea pig using solid-state, thin-film,
      multichannel electrodes having up to five recording sites spanning up to 600
      microns. Responses from 73 unit pairs were collected of which 54 had both units
      responding to pseudorandom wideband noise stimulation. Shared-stimulus driving
      was present in 78% (42/54) of the unit pairs and could be attributed to an
      overlap in their spectral sensitivities. Effective connectivity was indicated for
      87% (47/54) of the unit pairs. Wideband noise proved more useful than tonebursts
      for investigating shared-stimulus driving and connectivity because it evoked
      widespread, but not overly synchronous, responses in the ensembles.

PMID- 1752792
TI  - Coding of interaural time differences of transients in auditory cortex of Rattus
      norvegicus: implications for the evolution of mammalian sound localization.
AB  - We obtained quantitative evidence on the coding of interaural time differences
      (ITDs) of click stimuli by 40 single neurons in the auditory cortex of
      anesthetized albino rats. Most of the neurons (31/40) received an excitatory
      input from the contralateral ear, and an inhibitory input from the ipsilateral
      ear (EI cells). These neurons expressed their sensitivity to ITDs in a sigmoidal
      relation between spike count and ITD, with maximal responses associated with
      contralateral-leading ITDs. The mean ITD dynamic range was 590 microseconds. The
      dynamic ranges typically encompassed at least part of the behaviorally-relevant
      range (about +/- 130 microseconds). Variations in ITD from 130 microseconds
      favoring one ear to 130 microseconds favoring the other ear caused spike response
      rate changes, on average, of 29.5%. These data are similar to those previously
      presented for the central auditory systems of larger mammals, whose auditory
      localization acuity is significantly better than that of the rat. We argue,
      therefore, that the sound localization mechanisms based on transient ITDs have
      not evolved in a fashion that covaries with interaural distance, and that there
      exists a mismatch between the ITDs the rat will encounter in the free field, and
      the ITDs which are encoded by its nervous system. This may be one reason why
      sound localization acuity has a roughly inverse relation to interaural distance.

PMID- 1752793
TI  - Postnatal developmental changes in inner ear ornithine decarboxylase (ODC).
AB  - Ornithine decarboxylase (ODC), the rate-limiting enzyme in polyamine synthesis,
      is important in cellular growth, differentiation and development. Although ODC
      has been quantitated in cochlear tissues of the adult rat, it has not been
      assessed quantitatively in developing inner-ear tissues. The purpose of the
      present study was to quantitate ODC in cochlear tissues of the rat during the
      period of development of hearing. Cochlear ODC was significantly elevated
      throughout the period of cochlear maturation in that it increased rapidly during
      the first 10 days, peaked on day 10 and then declined thereafter. ODC in the
      lateral wall/organ of Corti tissues was significantly higher than in the cochlear
      nerve in developing, but not in adult rats. Further examination of separate
      cochlear tissues from 10-day old rats revealed that ODC activity was higher in
      the organ of Corti than in the lateral wall or cochlear nerve. Postnatal changes
      in ODC paralleled functional maturation of hearing and the hypersensitive period
      for aminoglycoside ototoxicity in the rat. Since aminoglycosides have been shown
      to inhibit ODC in vitro, aminoglycoside inhibition of polyamine synthesis may
      mediate the hypersensitivity of developing animals to the effects of these drugs.

PMID- 1752794
TI  - Rate-versus-level functions of primary auditory nerve fibres: evidence for square
      law behaviour of all fibre categories in the guinea pig.
AB  - Detailed measurements of rate-versus-level (RI) functions close to threshold were
      made from single primary auditory nerve fibres in the guinea pig cochlea. For all
      fibres, a simple square law provided the best statistical fit to the data near
      threshold, regardless of spontaneous fibrin rate of the fibre. In no case was a
      better fit obtained with an exponent greater than 2. We conclude that a simple
      square law is an accurate description of the underlying synaptic drive to all
      primary auditory nerve fibres. For fibres with very low spontaneous firing rates
      the best square law fit near threshold frequently led to the formal mathematical
      estimate of a negative firing rate as the asymptotic value of the spontaneous
      firing rate. The 'negative spontaneous rate' of low spontaneous rate fibres
      derived from curve fitting can be conceptualized by postulating that for sound
      pressures well below threshold in these fibres the underlying synaptic drive lies
      below a threshold value at a site determining action potential generation.

PMID- 1752795
TI  - Turn-specific and pigment-dependent differences in the stria vascularis of normal
      and gentamicin-treated albino and pigmented guinea pigs.
AB  - The aims of the present study were to determine which structures in the stria
      vascularis (SV) may depend upon the presence of pigmented melanocytes both for
      normal morphology and for the expression of gentamicin ototoxicity in the inner
      ear. These pigment-dependent influences were inferred through comparisons of the
      SV in pigmented guinea pigs and in albinos containing nonpigmented melanocytes.
      Results were obtained from 6 albino and 8 pigmented guinea pigs given gentamicin,
      and from 3 albino and 3 pigmented control animals not receiving the drug. One
      month old animals received gentamicin daily (100 mg/kg) for 14 days and recovered
      for an additional 14 days before being prepared for electron microscopy. The SV
      from each of the 4 cochlear turns was analyzed using stereological point counting
      procedures. In control animals, differences were found in the higher cochlear
      turns, where volume density for the marginal cells in albinos was abnormally
      large (turns 3 and 4), while the volume density for intermediate cells
      (melanocytes) was abnormally small (turn 3). Cell volume estimates for the
      intermediate cells were significantly smaller in the albino than pigmented
      control animals in the higher cochlear turns, indicating that functional
      abnormalities may be found in the albino cochlea. In animals exposed to
      gentamicin, marginal cell volume density was reduced significantly in turn 4 of
      albinos, but not in any region of the pigmented inner ears. Radial area of SV and
      estimates of the absolute volumes for marginal cells in albinos given gentamicin
      also were significantly reduced in turn 1 compared to their controls; such
      differences were not observed in the pigmented animals. The results indicate that
      marginal cell size is significantly reduced in albino but not pigmented animals
      14 days after gentamicin exposure, and further suggest a role of pigmented
      melanocytes in ameliorating gentamicin-induced cochlear damage.

PMID- 1752796
TI  - The development of frequency representation in the inferior colliculus of the
      kitten.
AB  - While morphologically the kitten's cochlea matures first at the basal or high
      frequency region, behavioural and physiological evidence suggests that it
      responds first to low-frequency sound. Explanations of this paradox include the
      suggestion that the spatial representation of frequency within the cochlea
      changes as a function of age. We have used the [14C]-2-deoxyglucose technique to
      study the development of frequency representation in the central auditory system
      of the kitten. We report here that while the locations within the inferior
      colliculus (IC) where high- and mid-frequency sounds are represented shift
      markedly between 10 and 35 days of age, the location where low-frequency sound is
      represented does not alter. The IC representation of low frequencies is adult
      like by 10 days of age but that of higher frequencies continues to mature until
      as many as 35 days. Despite its morphological immaturity with respect to other
      regions, the apex of the cochlea appears to be the first region to become tuned
      to those frequencies to which it is tuned in the adult. We found little labelling
      at 5 and 7 days of age to 75-80 dB stimuli, but it is quite possible that the
      high-frequency region might respond to very intense low frequencies before 10
      days of age. to very intense low frequencies before 10 days of age.

PMID- 1752797
TI  - Postnatal maturation of spiral ganglion neurons: a horseradish peroxidase study.
AB  - Using an in vitro cochlear preparation from postnatal hamsters, spiral ganglion
      cells (SGCs) were labeled retrogradely following extracellular injections of HRP
      into the cochlear nerve. In 24 cochleae from hamsters between postnatal days (P)
      0 and 10, the neuronal morphology of 201 SGCs and their peripheral axons were
      analyzed. From P 0 to 3, labeled SGCs had few distinguishable features. Although
      SGCs could be traced separately to inner hair cells (IHCs) and outer hair cells
      (OHCs), they all had roughly bipolar-shaped cell bodies. Approximately half of
      the labeled SGCs had peripheral axons that spiraled some distance before entering
      radial fiber bundles. From P 3 to 7, SGCs increased in size by nearly 30% and the
      number of SGCs with spiraling peripheral axons decreased to near zero. At P 10,
      the central axon diameter to peripheral axon diameter ratios distinguished two
      populations of SGCs. The hair-cell innervation patterns of SGCs also changed
      morphologically as a function of postnatal age. At P 0, radial fiber (RF)
      terminals of peripheral axons contacted as many as 8 IHCs; by P 3, RFs contacted
      typically one or two IHCs. The terminal portions of peripheral axons contacting
      OHCs did not show any appreciable spiral until P 2. By P 5, individual outer
      spiral fibers (OSFs) had greater spiral lengths underneath row-3 OHCs and the
      number of OHC contacts was also greatest for row-3 OSFs. These data suggest that
      SGCs undergo a systematic maturational process. Furthermore, the morphological
      differentiation of SGCs occurs after they have established separate inner and
      outer hair cell innervations.

PMID- 1752798
TI  - Effect of high-frequency hearing loss on compound action potentials recorded from
      the intracranial portion of the human eighth nerve.
AB  - Compound action potentials (CAP) were recorded from the exposed intracranial
      portion of the eighth nerve to stimulation with click sounds in patients with
      sensorineural high-frequency hearing loss who underwent microvascular
      decompression (MVD) operations to treat trigeminal neuralgia (TN). In patients
      with normal hearing the CAP recorded in that way is characterized by a negative
      peak, preceded by a small positivity and followed by a positivity and sometimes a
      second negative peak. In patients with high-frequency hearing loss the CAP also
      usually had an initial sharp negative peak in response to clicks of high
      intensity (105 to 110 dB Pe SPL), similar to findings in patients with normal
      hearing, but in patients with high-frequency hearing loss the initial negative
      peak was often followed by a slow negative deflection. The latency of the initial
      negative peak in the CAP in patients with high-frequency hearing loss was longer
      than the latency of this peak in patients with normal hearing, but the difference
      in latencies of this peak to condensation and rarefaction clicks was small. When
      the stimulus intensity was lowered the amplitude of the initial peak decreased,
      and the CAP became dominated by a broad negative peak with a latency of 6 to 8
      ms. In 11 of 15 patients with severe high-frequency hearing loss, a series of
      quasi-periodic waves was superimposed on the CAP. The frequency of these waves
      varied between 500 and 1200 Hz, and the waves could be detected between 6 and 16
      ms after presentation of the click stimulus. These waves were usually present in
      the response to stimuli in the intensity range from 75 to 110 dB Pe SPL. Only 4
      of 17 patients with normal hearing had similar waves.

PMID- 1752799
TI  - Hypoxia induced hearing loss in animal models of the fetus in-utero.
AB  - The human fetus in-utero has low arterial oxygen tension. It has, therefore, been
      suggested that at greater than 28 weeks gestational age, the fetus may have a
      sensori-neural hearing loss comparable to that seen in adult cats exposed to
      similar degrees of hypoxia. This is due to hypoxia induced depression of the
      endocochlear potential. However, fetal blood is provided with compensatory
      mechanisms (elevated hematocrit and hemoglobin and special fetal hemoglobin)
      which enable pick up and transport of more oxygen from the placenta than adult
      blood under the same physiological conditions. Therefore, the hypothesis of a
      fetal sensori-neural hearing loss due to oxygen lack was tested in the following
      animal models: a) Adult cats to which feline red blood cells were infused thus
      causing a polycythemia similar to fetal conditions; b) Adult rats acclimated to
      altitude in a hypobaric chamber, inducing erythropoiesis with elevated hematocrit
      and hemoglobin; c) Neonatal guinea pigs and goats studied when they were less
      than 12 hours old so that the fetal compensatory mechanisms were still present.
      In each model, hypoxia (PaO2 20-30 mmHg) induced an ABR threshold elevation
      resembling that obtained in the uncompensated adult animal. Thus these
      experiments seem to have confirmed the hypothesis of a fetal, hypoxic induced
      sensori-neural hearing loss even though such experiments have not been conducted
      directly on fetal animals.

PMID- 1752800
TI  - Course and distribution of efferent fibers in the cochlea of the mouse.
AB  - The course, distribution and termination of single efferent fibers to the cochlea
      has been described in only a few animals and relatively few fibers have been
      studied with knowledge of their ipsilateral or contralateral origin. In order to
      examine the efferent fibers in the mouse, the anterograde tracer Phaseolus
      vulgaris leucoagglutinin (PHA-L) was iontophoretically injected into one side of
      the brain stem near the location of known efferent nuclei. Examination of surface
      preparations of the cochlea revealed detailed information for both the lateral
      olivocochlear (LOC) and medial olivocochlear (MOC) systems. Many, but not all,
      fibers entered the cochlea within the intraganglionic spiral bundle (IGSB). The
      LOC fibers were restricted to the ipsilateral cochlea and rarely branched within
      the IGSB and osseous spiral lamina (OSL). In the organ of Corti, they traveled
      either basally or apically in the region of the inner hair cells (IHCs), spanning
      lengths up to 130 microns (basally) and 890 microns (apically). Terminal
      swellings of these fibers were ca 3.0 microns in diameter. Numerous en passant
      swellings were present where the fibers formed a plexus in the area of the IHCs.
      The MOC fibers followed a similar course in the IGSB and OSL, and within the OSL
      the fibers had few branches. Within the organ of Corti they traveled apically (up
      to 70 microns) in the nerve bundles located in the IHC area before they crossed
      the tunnel of Corti. In the region of the OHCs, 9% of the traceable fibers
      branched to innervate two to three OHCs while 91% appeared to innervate only one
      OHC. There was no discernible difference in the distribution of contralateral and
      ipsilateral MOC projections in terms of cochlear region or outer hair cell rows.

PMID- 1752801
TI  - The effect of estradiol, trenbolone acetate, or zeranol on growth rate, mammary
      development, carcass traits, and plasma estradiol concentrations of beef heifers.
AB  - The effect of a single implantation (on d 1) with one or two long-acting,
      biodegradable estradiol implants (1E or 2E) on plasma estradiol concentrations in
      beef heifers was determined. The growth rates of these (2E) heifers, and of
      heifers repeatedly implanted with trenbolone acetate (TBA) or zeranol (Z) on d 1,
      84, 168, and 252 of the trial, were compared to growth rates of controls.
      Trenbolone acetate alone was compared to TBA + 2E, and 2E was compared to 1E. At
      a mean age of 84 d (d 1 of experiment), 81 Hereford x Friesian heifers were
      allocated at random to the following treatments: Control (n = 15); TBA (n = 15);
      1E (n = 12); 2E (n = 15); Z (n = 13); or TBA + 2E (n = 11). Mean live weight (kg)
      prior to slaughter on d 368 and hot carcass weight (kg) for heifers assigned to
      treatment Groups 1 to 6, respectively, were 366 and 200, 391 and 212, 374 and
      201, 386 and 207, 387 and 210, and 391 and 208 (residual SD = 30.3 and 20.2).
      Heifers assigned to both the 2E and Z treatments were heavier on d 368 (P less
      than .05) and had longer teats on d 279 (P less than .05), less pelvic fat (P
      less than .05), and heavier kidneys (P less than .005) than control heifers.
      Heifers assigned to the TBA treatment had shorter teats on d 279 (P less than
      .001) but greater final live weight (P less than .05) and carcass weight than
      control heifers. Heifers given TBA alone had more pelvic fat (P less than .05)
      and lighter kidneys (P less than .05) than those given TBA + 2E. Mean estradiol
      concentrations in both the ipsilateral and contralateral jugular veins of heifers
      assigned to the 2E and TBA + 2E treatments, and in the ipsilateral jugular veins
      of heifers given 1E, were greater (P less than .05) than those in control
      heifers; concentrations did not decline during the experiment.

PMID- 1752802
TI  - Mastitis in beef cows and its effects on calf weight gain.
AB  - Quarter milk samples from 51 purebred (Angus, Polled Hereford, and Simmental) and
      69 crossbred (Angus x Simmental x Charolais three-way cross) beef cows were
      collected aseptically at three times during lactation to determine the prevalence
      of intramammary infection, milk somatic cell counts (SCC), and effects of
      infection on calf weight gain. Quarter infection prevalence was 13.1, 14.9, and
      27.5% in early, mid, and late lactation; corresponding cow infection prevalence
      was 25.8, 29.2, and 54.4%. Staphylococcus aureus was isolated from 2.9, 2.7, and
      3.2% of quarters in early, mid, and late lactation, respectively. Corynebacterium
      bovis, generally regarded as a minor pathogen, was isolated from 4.0, 7.6, and
      18.2% of quarters at the three respective times. Geometric SCC means (10(3)
      cells/ml) were 1,522, 344, and 509 for S. aureus-infected quarters; 344, 899, and
      221 for Staphylococcus hyicus-infected quarters; 65, 36, and 86 for C. bovis
      infected quarters; and 20, 17, and 18 for uninfected quarters in early, mid, and
      late lactation, respectively. Adjusted 205-d weight gain for calves with S.
      aureus-infected dams was 9.6 kg less (P less than .05) than for calves with
      uninfected dams. Adjusted 205-d weight gain for calves with dams infected with
      any mastitis pathogen did not differ significantly from that of calves with
      uninfected dams. At weaning half of the infected cows and half of the uninfected
      cows were given an intramammary infusion product containing 300 mg of cephapirin
      benzathine in each quarter; the remaining cows were untreated controls. Quarter
      samples were collected aseptically from all cows 14 to 28 d after subsequent
      calving. Quarter prevalence of infection after calving was lower (P less than
      .05) in treated (8.2%) than in control (22.4%) cows. Significantly more
      infections present at weaning were eliminated in treated than in control cows,
      but the new infection rate during the dry period and early lactation did not
      differ between the two groups.

PMID- 1752803
TI  - Effect of supplemental lysocellin and tetronasin on growth, ruminal and blood
      metabolites, and ruminal proteolytic activity in steers grazing ryegrass.
AB  - Forty-eight Angus and Brangus steers (249 kg initial BW) were used in a
      randomized complete block design. Steers grazed annual ryegrass (Lolium
      multiflorum [L.] Lam.) for 107 d and were sampled at 35 and 70 d. Treatments
      consisted of a corn supplement (C) or corn supplement plus either 80 mg.steer-1.d
      1 of lysocellin (L) or 60 mg.steer-1.d-1 of tetronasin (T). When compared with C,
      ADG of L- and T-fed steers was higher (P less than .05) for the complete 107-d
      study (1.15 vs 1.25 kg/d). At 35 d, ruminal acetate:propionate ratio tended (P =
      .07) to be higher for C than for L- and T-fed steers (4.6 vs 3.8). When compared
      with T, steers fed L tended (P = .11) to have higher acetate:propionate ratios.
      Ruminal concentrations of ammonia and free amino acids were not affected (P
      greater than .05) by treatment, but ruminal proteolytic activity tended (P = .13)
      to be lower for L- and T-fed than for C steers at 70 d. Ionophores did not alter
      (P greater than .05) ruminal mineral concentrations, but ruminal Mg concentration
      tended (P = .14) to be higher for T- than for L-fed steers at 70 d. When compared
      with L- and T-fed steers, C steers had lower (P less than .05) plasma
      concentrations of Mg (23.7 vs 21.9 mg/liter) and Ca (113.0 vs 104.2 mg/liter) at
      35 d. Plasma mineral concentrations were similar (P greater than .05) for L- and
      T-fed steers. Data are interpreted to indicate that L and T may improve ADG,
      decrease ruminal acetate:propionate ratio, and alter mineral metabolism.

PMID- 1752804
TI  - Production from first-calf beef heifers fed a maintenance or low level of
      prepartum nutrition and ruminally undegradable or degradable protein postpartum.
AB  - Two experiments were conducted in consecutive years to determine the effects of
      prepartum nutrient level and postpartum ruminally undegraded protein intake on
      nutrient status, milk production, subsequent calf production, and reproductive
      performance of 126 crossbred, primiparous beef heifers. Prepartum treatments were
      low nutrient intake (LN) (approximately 2.5 kg of TDN, .5 kg of CP animal-1.d-1
      and maintenance nutrient intake (MN) (5 kg of TDN, 1 kg of CP animal-1.d-1),
      which were fed for 75 d before parturition. Two postpartum protein supplements
      were formulated to provide 250 g/d of ruminally degradable protein (RD) and one
      to supply ruminally undegraded protein (UD) at 250 g/d of additional UD CP
      compared to the RD supplement. Cholesterol was lower (P less than .01) in heifers
      given UD than in heifers given RD. Blood urea nitrogen was higher (P less than
      .01) for UD-fed heifers than for RD-fed heifers and was higher in LN heifers (P
      less than .06) than in MN heifers. Milk production did not differ (P greater than
      .11) as a result of LN, MN, UD, or RD. Postpartum cow weight gain was greatest (P
      less than .01) for UD and LN heifers. The percentage of heifers bred during the
      first estrous cycle of the breeding season was greater (P less than .02) for UD
      than for RD. Overall, prepartum nutrition did not interact with postpartum
      protein supplement, nor did it have any effect on postpartum interval, whereas UD
      increased cow weight gain postpartum and reduced postpartum interval.

PMID- 1752805
TI  - The effects of recombinant porcine somatotropin on reproductive function in gilts
      treated during the finishing phase.
AB  - The objective of this study was to determine the effects of recombinant porcine
      somatotropin (rpST) treatment during the finishing phase on subsequent
      reproductive function in crossbred gilts. Forty gilts weighing 50 kg and housed
      in a swine finishing facility were randomly assigned to control or rpST
      treatment. Four control and four rpST-treated gilts were allotted per pen. Twenty
      rpST-treated gilts received 6 mg of rpST.gilt-1.d-1 in 1 ml of buffered carrier
      and 20 control gilts received 1 ml of buffered carrier.gilt-1.d-1. Injections
      were administered daily at 1400 in the extensor muscle of the neck. All gilts
      received an 18% CP diet containing 1.2% lysine. Treatment was terminated when the
      average weight in each pen reached 110 kg. Gilts treated with rpST gained more
      weight (P less than .05) than control gilts (59.8 +/- 1.0 vs 53.5 +/- 1.0 kg).
      Age at puberty was not different (rpST, 182.2 +/- 3.3; control 181.4 +/- 3.1 d).
      Prior treatment with rpST did not significantly affect length of estrus (rpST,
      1.9 +/- .1; control, 1.8 +/- .1 d) or estrous cycle length (rpST, 20.6 +/- .4;
      control, 20.4 +/- .4 d). Ovulation rates at second estrus were similar for rpST
      gilts (15.1 +/- .5) and control gilts (14.4 +/- .5). More embryos (P = .10) were
      recovered on d 9 to 12 of gestation from rpST-treated gilts than from control
      gilts (13.1 +/- .9 vs 10.7 +/- .9).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1752806
TI  - Effect of selection for litter size and body weight on hormone-induced ovulation
      rate in mice.
AB  - Genetic differences in natural vs hormone-induced ovulation rates were compared
      in immature female mice from five lines that had undergone long-term single-trait
      and antagonistic index selection for litter size and(or) 6-wk BW. Lines used were
      control (K); high litter size (L+); high BW (W+); low litter size and high BW (L
      W+); and high litter size and low BW (L+W-). Natural ovulation rate at a mean age
      of 34.3 d and hormone-induced (5 IU of pregnant mare's serum gonadotropin
      followed 2 d later by 5 IU of human chorionic gonadotropin) superovulation rate
      at a fixed age of 31 d were obtained. Total number of eggs ovulated was affected
      by line (P less than .001), treatment (P less than .001), and line x treatment
      interaction (P less than .001). Line differences were subsequently tested within
      treatment because of the significant line x treatment interaction. Line
      differences were important (P less than .001) for natural ovulation, hormone
      induced ovulation, and response to hormones. Mean natural ovulation rates for K,
      L+, W+, L-W+, and L+W- were 14.1, 19.8, 15.1, 13.6, and 16.4, respectively.
      Selection changed ovulation rate by 40, 16, 7, and -4% in the L+, L+W-, W+ and L
      W+ lines, respectively (P less than .01). Hormone-induced ovulation rates in K,
      L+, W+, L-W+, and L+W- were 32.3, 24.6, 19.6, 20.9, and 22.1, respectively.
      Exogenous hormones increased ovulation by 18.2, 4.8, 4.6, 7.3, and 5.7 ova for K,
      L+, W+, L-W+, and L+W-, respectively (P less than .001). Lines with lower natural
      ovulation rates had higher responses to superovulation. Increased ovulation rate
      due to treatment ranged from 24.3% in L+ to 129% in K. These results indicate
      significant differences among lines in ovarian response to exogenous hormones.

PMID- 1752807
TI  - A deterministic computer simulation model of life-cycle lamb and wool production.
AB  - A deterministic mathematical computer model was developed to simulate effects on
      life-cycle efficiency of lamb and wool production from genetic improvement of
      performance traits under alternative management systems. Genetic input parameters
      can be varied for age at puberty, length of anestrus, fertility, precocity of
      fertility, number born, milk yield, mortality, growth rate, body fat, and wool
      growth. Management options include mating systems, lambing intervals, feeding
      levels, creep feeding, weaning age, marketing age or weight, and culling policy.
      Simulated growth of animals is linear from birth to inflection point, then slows
      asymptotically to specified mature empty BW and fat content when nutrition is not
      limiting. The ME intake requirement to maintain normal condition is calculated
      daily or weekly for maintenance, protein and fat deposition, wool growth,
      gestation, and lactation. Simulated feed intake is the minimum of availability,
      DM physical limit, or ME physiological limit. Tissue catabolism occurs when
      intake is below the requirement for essential functions. Mortality increases when
      BW is depressed. Equations developed for calculations of biological functions
      were validated with published and unpublished experimental data. Lifetime totals
      are accumulated for TDN, DM, and protein intake and for market lamb equivalent
      output values of empty body or carcass lean and wool from both lambs and ewes.
      These measures of efficiency for combinations of genetic, management, and
      marketing variables can provide the relative economic weighting of traits needed
      to derive optimal criteria for genetic selection among and within breeds under
      defined industry production systems.

PMID- 1752808
TI  - Simulation of life-cycle efficiency of lamb and wool production for genetic
      levels of component traits and alternative management options.
AB  - A deterministic computer model was used to predict effects of genetic
      improvements in performance and of management options on life-cycle flock TDN
      input per unit of empty body weight (EBW) or carcass lean (CLN) equivalent value
      of market lamb, cull ewe, and wool output from a pure breeding system of sheep
      production for sheep fed to maintain normal weight. Relative values per kilogram
      for market lambs, cull ewes, and clean wool were 1 to .33 to 2.04 in lamb empty
      body equivalent, but 1 to .33 to 1 in lamb carcass lean equivalent. A 10%
      increase in lamb viability improved TDN/EBW or CLN by -15 to -20% for high to low
      lambing rates. Corresponding smaller gains were -7 to -11% for fertility, -3 to 
      13% for lambing rate, -1 to -3% for wool growth rate, -1 to -5% for milk
      production without creep feeding, -2 to -1% for mature size to about 70 kg, and 
      .6 to -.9% for precocity of fertility. Increasing leanness 10% improved TDN/CLN
      by -3 to -1% but increased TDN/EBW 3% because of higher maintenance requirements
      of leaner sheep. Higher protein requirements for increased lambing rate, milk
      production or leanness, or greater increases in non-feed than in feed costs,
      would mean only slightly less reduction of TDN/output than shown. Creep feeding
      was beneficial only for prolific, low-milking stock. Flushing reduced adverse
      effects of restricted feeding. Different values for wool vs meat or for costs of
      feed vs non-feed inputs would change results. These estimates for relative
      economic importance of traits apply to derivation of optimum criteria for
      selection among breeds or crosses, or within-breeds used in rotation
      crossbreeding, but would differ for specialized terminal-sire or maternal breed
      roles.

PMID- 1752809
TI  - Simulated effects of reproductive performance on life-cycle efficiency of lamb
      and wool production at three lambing intervals.
AB  - A deterministic computer model of a purebreeding sheep production system was used
      to simulate effects on life-cycle efficiency from genetic changes in lambing rate
      (LB), fertility (FERT), precocity of fertility (PREC), and estrus season length
      (ES) under annual (Y), 4-mo (A), and 73-d (S) breeding intervals. Ewes and lambs
      of a 1,000-ewe flock were fed to requirement through five yr, beginning with ewe
      lambs at the optimal breeding season and accumulating feed input (TDN) and market
      lamb equivalent weight of output (EBW), including cull ewes and wool. For annual
      lambing, improvement in cost (TDN/EBW equivalence) per 10% increase in genetic
      potential was -9.8, -8.2, -1.3, and -.8% for LB, FERT, PREC, and ES,
      respectively. For the A and S lambing intervals, corresponding gains in TDN
      efficiency were -19 for FERT and -9% for LB when ES was 72 d, but only -6 and -5%
      when ES was 192 d. Increasing PREC by 10% improved cost -3% under accelerated
      systems when ES was 72 d, but less than -1% when ES was 192 d. Cost reduction
      from 10% longer ES under A and S breeding intervals was greater when other
      reproductive performance was low (-11 and -17%) rather than high (-2 and -3%).
      Reduction in costs for A and S vs Y lambing intervals was greatest with long ES
      and was greater with low (-43 and -53%) than with high reproductive performance (
      20 and -24%). When ES was 72 d, A and S intervals would reduce costs for high (-9
      and -11%) but increase costs for low reproductive traits. Corresponding increases
      in CP/TDN required in diet would reduce gains in TDN/EBW only slightly. These
      results should aid in development of optimum selection criteria for stocks used
      for pure or rotation crossbreeding or as maternal parents of terminal crosses.

PMID- 1752810
TI  - Divergent selection for postweaning feed conversion in Angus beef cattle: I. Mean
      comparisons.
AB  - Each year from 1979 through 1983, 35 Angus bull calves were selected from a herd
      at the Eastern Ohio Resource Development Center to be individually fed in a 140-d
      postweaning performance test. From these 35 individually fed bulls, the three
      highest and three lowest for feed conversion (feed:gain) were selected and
      randomly mated to approximately 20 cows each. A different set of high vs low feed
      conversion sires was used each year. Four replicates (403 progeny) from high vs
      low sires were evaluated by sire groups for subsequent postweaning and carcass
      performance. Progeny were slaughtered when estimated by ultrasonic measurement to
      have 8.9 mm or more of subcutaneous fat at the conclusion of a 140-d postweaning
      performance test. Progeny with less than 8.9 mm of subcutaneous fat were fed for
      additional 28-d periods until they reached the required minimum. No differences
      were found between high and low feed conversion progeny for 140-d feed intake (P
      less than .30) although high feed conversion progeny gained .09 kg/d more weight
      (P less than .01) during the 140-d postweaning test. Differences tended to exist
      between high and low feed conversion progeny for unadjusted (P less than .15) and
      maintenance-adjusted (P less than .15) feed:gain ratios. Progeny of the high feed
      conversion group had greater subcutaneous fat (P less than .05) at the end of the
      140-d postweaning test and when slaughtered (P less than .05), indicating a
      genetic difference for composition of BW gain between high- and low-sired
      progeny. However, no significant differences existed for any other carcass traits
      evaluated. Bulls had more desirable unadjusted (P less than .001) and maintenance
      adjusted (P less than .001) feed:gain ratios than heifers with increased 140-d
      ADG (P less than .001) and pen feed intakes (P less than .001).

PMID- 1752811
TI  - Divergent selection for postweaning feed conversion in Angus beef cattle: II.
      Genetic and phenotypic correlations and realized heritability estimate.
AB  - A single generation divergent selection study, replicated four times (1983, 1984,
      1985, and 1986), was conducted to assess genetic differences between progeny of
      high and low feed conversion sires in Angus beef cattle and to determine
      correlated response for weight gain (ADG140), feed intake (AVFD140), and BW
      (OFFTSTWT) in a time- (140-d) and fat-constant (8.9 mm) period. Realized
      heritability estimates for unadjusted (feed/gain; FEFF140; .26) and adjusted feed
      conversion (adjusted as recommended by the BIF, 1986; ADJFDEFF; .46) were
      obtained. The difference in heritability estimates reflects variation accounted
      for by adjustment for BW differences, and thus maintenance requirements, of
      individual progeny. Phenotypic and "pseudo" realized genetic correlations of
      FEFF140 with ADG140, AVFD 140, and OFFTSTWT were -.33 and -.66, .49 and -.26, and
      .15 and -.41, respectively. Phenotypic and "pseudo" realized genetic correlations
      of ADJFDEFF with ADG140, AVFD140, OFFTSTWT, and FEFF140 were -.54 and -.59, .30
      and -.23, .27 and -.36, and .97 and .49, respectively. Subcutaneous fat (as
      estimated by ultrasonic measurement; BF140) had phenotypic and "pseudo" realized
      genetic correlations with FEFF140 of -.33 and .66, respectively, and with
      ADJFDEFF of -.44 and -.58, respectively.

PMID- 1752812
TI  - Maternal breed of sire effects on postweaning performance of first-cross heifers
      and production characteristics of 2-year-old heifers.
AB  - Postweaning growth rates from weaning to 18 mo, fall condition score, pregnancy
      rates, and production to 2 yr of age were evaluated in a study of Angus (A)-,
      Pinzgauer (P)-, Red Poll (R)-, Simmental (S)-, and Tarentaise (T)-sired females
      from Hereford dams. First-cross heifers from the different sire breeds did not
      differ (P greater than .10) in initial weight. During a 140-d feed test, S gained
      98.6 kg, exceeding (P less than .05) gains of P, 92.3; A, 91.4; and R, 87.3 kg
      but not T, 94.1 kg. Red Poll-sired heifers weighed less at the end of the 140-d
      test (P less than .05) than the other crosses, which did not significantly differ
      from each other. No breed of sire differences were found in gain from 140 d to
      fall weight. Simmental-sired heifers weighed more (P less than .05) than A- and R
      sired heifers at 18 mo. Breed of sire and year interacted to affect pregnancy
      rate of the yearling heifers when mated to Shorthorn sires for 45 d. Percentage
      of dystocia varied from a low of 26.3 and 28.9% for T- and A-sired heifers,
      respectively, to 54.4 and 60.8% for P- and S-sired heifers, respectively (P less
      than .05). Age of dam of heifers affected (P less than .05) weight at the
      different period end points but not gains after weaning. Age of dam also affected
      incidence of dystocia. Two-year-old heifers from young dams had more dystocia
      than heifers from older dams. Shorthorn-sired calves from 2-yr-old heifers with
      different sire breeds differed in birth weight (P less than .05) but not survival
      from birth to weaning, ADG from birth to weaning, weaning age, or weaning
      condition score. Average 200-d weight of calves from P-, S- and T-sired heifers
      exceeded those from A- and R-sired heifers by 10.7 kg, or 5.7%.

PMID- 1752813
TI  - Maternal breed of sire effects on postweaning performance of heifer and steer
      progeny: postweaning growth and carcass characteristics.
AB  - Heifer and steer progeny of 2-yr-old first-cross (F1) heifers and 3- to 6-yr-old
      F1 cows, from Hereford dams and five sire breeds, were evaluated for postweaning
      feedlot growth and carcass composition. Breeds of sire of dam were Angus (A), Red
      Poll (RP), Tarentaise (T), Simmental (Sm), and Pinzgauer (P). Calves from 2-yr
      old heifers were sired by Shorthorn, and calves from 3- to 6-yr-old dams were
      sired by Charolais. Breed of sire of dam was significant (P less than .05 to P
      less than .01) for total gain and final weight for female progeny from 2-yr-old
      dams. At all weights, Sm, P, and T ranked above A and RP. Progeny of A, P, Sm,
      and T F1 2-yr-old dams were not significantly different but were higher (P less
      than .05) than RP heifers in total feedlot gain. Breed of sire of dam was
      significant (P less than .05) for carcass weight and longissimus muscle area; T
      ranked highest and RP lowest. Breed was not significant for any growth traits of
      steer progeny of 2-yr-old dams. Breed was significant for marbling score; A
      ranked highest and exceeded (P less than .01) both RP and Sm steers. Breed was
      significant (P less than .05) for most growth traits in the heifer progeny of the
      3- to 6-yr-old dams bred to Charolais sires. Heifer calves of the Sm group were
      heavier (P less than .05) than all other groups for most weights and total gain.
      For total gain, P and T were intermediate and A and RP lowest. For heifer carcass
      traits from 3- to 6-yr-old dams, breed was significant (P less than .05 to P less
      than .01) for carcass weight, longissimus muscle area, percentage of cutability,
      and estimated kidney, heart, and pelvic fat. Heifers from Sm-sired dams were
      heavier (P less than .05) than those from all other groups but ranked second to
      heifers from P for percentage of cutability. Marbling scores of RP heifer
      carcasses ranked highest of all groups. Breed was not significant (P greater than
      .05) for any of the weights or gains in steer progeny of 3- to 6-yr-old dams;
      however, the Sm and P groups ranked above A and RP for all feedlot test
      weights.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1752814
TI  - Efficacy of alternative multivariate best linear unbiased prediction models for
      genetic evaluation of swine.
AB  - A comparison of the accuracy of alternative BLUP evaluations of swine performance
      data is reported. A simulated data set of performance for days to market,
      backfat, number born alive, number weaned, and litter weight in six herds was
      used for the evaluation. The data structure was derived by using the performance
      records of six herds sampled from the American Yorkshire Club's STAGES (Swine
      Testing and Genetic Evaluation System) database. For growth traits, 10,360 pig
      records from 129 sires and 897 dams were recorded. For maternal traits, records
      on 2,598 litters of 1,209 sows from 147 sires and 585 dams were included. The
      actual observed performance of each record was removed and replaced with
      simulated performance. These simulated data were analyzed by within- and across
      herd BLUP models using STAGES and Animal Model (AM) procedures. Results indicate
      that the alternative BLUP procedures produced similar estimates. Correlations
      between STAGES and AM EPD ranged from .84 to .95. Correlations between STAGES EPD
      and true genetic value (G) ranged from .41 to .74, and correlations between AM
      EPD and G ranged from .40 to .74. On average, AM EPD had a .04 larger correlation
      with G than did STAGES EPD, although the difference in the correlations was not
      significant (P greater than .05). Trends in EPD for sires, dams, and pigs or sows
      were the same. Likewise, standard errors of prediction for AM EPD averaged 4%
      smaller than those for STAGES EPD. Computationally, the AM procedures used 15 to
      20 times as much processing time as did STAGES procedures.

PMID- 1752815
TI  - Simulation of genetic and environmental interaction of three tropical hair sheep
      breeds.
AB  - The Texas A&M Sheep Simulation Model was used to examine genetic-environmental
      interactions (GEI) among Brazilian Somali, Morada Nova, and Santa Ines breeds and
      type and level of feed supplement in northeast Brazil. Two sets of simulations
      were conducted to examine effects of different supplement quality (napier grass
      vs cunha legume) and quantity (napier grass only). The analyses indicated the
      benefits from supplementing lambs at weaning during the dry season and from
      supplementing lactating ewes at the beginning of lambing season when forage is
      scarce. The cunha legume was an effective supplement, but choosing between cunha
      legume and napier grass is an economic consideration. Increasing the amount of
      napier grass supplement per ewe from 200 g/d to 400 g/d resulted in a significant
      GEI (i.e., different levels of response such as lamb mortality rate, lamb weaning
      weight, and lambing rate for different breeds). The Brazilian Somali was the
      least responsive, whereas the Santa Ines was the most responsive to
      supplementation. It was concluded that the level of supplement should be higher
      for the Santa Ines and Morada Nova than for the Somali. The amount of supplement
      should be regulated so that it neither substitutes for nor lowers the utilization
      of the native caatinga forage. None of the breeds was simulated to be superior in
      all environments. Thus, considering the wide range of resources of individual
      farmers, any one of these breeds may be the preferred choice, depending on the
      individual set of production resources.

PMID- 1752816
TI  - Body composition and fasting heat production from birth to 14 months of age for
      three biological types of beef heifers.
AB  - Thirty heifers were randomly sampled at five ages from each of the Hereford,
      Charolais, and Simmental herds at the U.S. Meat Animal Research Center to
      estimate association of fasting heat production (FHP) with body composition.
      Replicated measures of respiratory exchange were obtained for six heifers per
      breed at ages 2 d, 3 mo, 7 mo, 10 mo, and 14 mo using open-circuit calorimetry.
      Regression adjustment of FHP/live weight.75 to zero activity (AFHP) reduced the
      mean by 12% and variance among periods for the same animal by 42%. Daily AFHP
      (kcal/kg.75) was highest at 2 d (122), lowest at 10 mo (92) (P less than .01),
      and intermediate (103 to 106) at other ages and averaged 109, 106, and 102 for
      Charolais, Simmental and Hereford over all ages (P less than .05). Pooled within
      age correlations of AFHP were .77 with weight of carcass (CAR) nonfat or water
      and .75 with live and empty body weight (EBW) but were only .13 with fat weight.
      Prediction of AFHP within age groups was most accurate from multiple regression
      on the nonfat weight in visceral organs and blood (VOB), gastrointestinal tract
      (GIF), head, hide, and shanks (HHS), and CAR fractions (R2 = 61%, error SD =
      21.5), from regression on nonfat in CAR alone (60%, 21.6), or from regression on
      chemical components in each of the four fractions (59%, 22.0), relative to EBW
      (55%, 22.9) or its four chemical components (58%, 22.3). Partial regressions were
      largest for water or nonfat (P less than .01) and were negligible for fat.
      Importance in predicting AFHP was two to eight times greater for nonfat in CAR
      than in other fractions because CAR was 60 to 65% of EBW. Lean mass is clearly a
      major predictor of nutrient requirement that is useful to evaluate effects of
      body composition on the efficiency of beef production.

PMID- 1752817
TI  - Response to environmental temperatures in Brahman calves during the first
      compared to the second day after birth.
AB  - Brahman calves (n = 28) were used to evaluate the effect of environmental
      temperature during the 1st or 2nd d after birth. Calves were removed from their
      dams within 30 min of birth (newborn; D0) before suckling or at 20 h of age and
      fasted for 4 h before treatment (day-old; D1). Calves were placed in either a
      warm (W; 25 degrees C) or a cold (C; 5 degrees C) environment for 2 h and either
      maintained in or transferred to, respectively, W for 22 h. Blood samples were
      collected via jugular catheters at 15-min intervals beginning at initial
      placement in W or C through 3 h and at 4, 5, 6, 8, 10, 12, 14, 18, and 24 h.
      Rectal temperature (Tr) was recorded with each sample. Following the 60-min and
      12-h samples, each calf was administered 1 liter of colostrum from its dam. Serum
      or plasma was analyzed for glucose, lactate, plasma urea nitrogen, triglycerides,
      nonesterified fatty acids, insulin, cortisol, triiodothyronine (T3), and
      thyroxine (T4). Rectal temperature of D0C calves was lower (P less than .05) than
      that of other calves from 75 min through 3 h. Insulin, lactate, T3, and plasma
      urea nitrogen concentrations were not different among all calves. Higher (P less
      than .01) cortisol and T4 concentrations were observed in D0 than in D1 calves.
      Cortisol (P less than .008) and nonesterified fatty acid (P less than .05) levels
      were greater in C than in W calves. All D0 calves had lower (P less than .0001)
      glucose concentrations than D1 calves until the 12-h feeding.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1752818
TI  - Effect of feeding regimen on behavior of growing-finishing pigs supplemented or
      not supplemented with folic acid.
AB  - The effect of restricted feeding on the frequency of abnormal behaviors and
      gastric ulcers was investigated in 72 market pigs. Half of the pigs were fed
      restricted (R) amounts of feed twice a day (0800 and 1600) and received 90 to 95%
      of the intake recorded for the other half, which were allowed ad libitum (A)
      access to feed with addition of feed once a day at 0800. In each feeding group,
      24 pigs were supplemented with folic acid. The animals were housed in pairs and
      the behavior of each animal was recorded during 24 h at 18 and 20 wk of age. The
      results showed that the A group ate more frequently during light hours than the R
      group at 18 wk, but not at 20 wk. However, the frequency of eating behavior was
      higher in the R group than in the A group at 20 wk during the 2 h after feed
      distribution. Feeding regimen had an effect on the frequency of redirected
      behaviors during the 2 h preceding feed distribution. The percentage of time
      spent nibbling on the penmate was higher in R than in A pigs at 18 wk, whereas
      that of rooting on the penmate was higher at 20 wk. Moreover, the proportion of
      pigs performing redirected behaviors was higher in the R than in the A group at
      both ages. The overall frequency of gastric ulcers was similar in pigs given the
      two feeding treatments, but severe ulcers were more frequent in the R than in the
      A group. Some interactions were also found between feeding regimen and folic
      acid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1752819
TI  - Effects of synthetic hormone implants, singularly or in combinations, on
      performance, carcass traits, and longissimus muscle palatability of Holstein
      steers.
AB  - Seventy-two Holstein steers averaging 182 kg were assigned randomly to one of six
      treatment groups: 1) nonimplanted controls (C); 2) implanted with 36 mg of
      zeranol (Z); 3) implanted with 20 mg of estradiol benzoate and 200 mg of
      progesterone (EP); 4) implanted with 140 mg of trenbolone acetate (TBA); 5)
      implanted with 140 mg of trenbolone acetate plus 20 mg of estradiol benzoate and
      200 mg of progesterone (TBA + EP); and 6) implanted with 140 mg of trenbolone
      acetate plus 36 mg of zeranol (TBA + Z). Each treatment group consisted of three
      replications of four animals per pen, which were implanted on d 0, 56, 112, and
      168. Masculinity and muscling scores were assigned at 24 h preslaughter. Hide
      removal difficulty was scored by a plant supervisor. Quality and yield grade data
      were obtained at 24 h postmortem. Longissimus muscle (LM) steaks were removed and
      cooked for Warner-Bratzler shear (WBS) determinations and sensory panel (SP)
      evaluations. Over the entire feeding period (249 d), TBA + EP steers had higher
      (P less than .05) ADG than TBA + Z, TBA, and C steers. All treatments had higher
      (P less than .05) ADG than C, with the exception of TBA. The only feed efficiency
      differences were those following the 168-d implant time, when TBA steers were
      more (P less than .05) efficient than TBA + Z or C steers. The TBA + EP and TBA +
      Z steers were more (P less than .05) masculine and their hides were more (P less
      than .05) difficult to remove than those of EP and C steers. Carcass weights of
      TBA + EP steers were heavier (P less than .05) than those of TBA or C steers. The
      TBA + EP steers had larger (P less than .05) LM areas than Z, TBA, and C steers.
      Also, TBA + EP steers tended (P = .07) to have lower numerical yield grades than
      EP, Z, or C steers. Even though mean marbling scores and quality grades were
      similar (P greater than .05) among treatment groups, only 50% of TBA + EP
      carcasses graded low Choice or higher, compared with 100, 75, 82, 90, and 83% for
      C, TBA, Z, EP, and TBA + Z carcasses, respectively. The only meat palatability
      differences were that myofibrillar and overall tenderness scores tended to be
      lower (P = .07) for steaks from EP and TBA + Z than for steaks from Z and C
      groups.

PMID- 1752820
TI  - Degradation of myofibrillar proteins by extractable lysosomal enzymes and m
      calpain, and the effects of zinc chloride.
AB  - A study was conducted to examine the effects that physiological levels of m
      calpain (calpain requiring millimolar concentrations of Ca2+) extract and a
      lysosomal extract have on myofibrillar proteins in vitro, and the effects that
      zinc has on inhibiting proteolysis by these extracts. During a 22-h incubation
      period, the lysosomal extract degraded myosin heavy chain, alpha-actinin, desmin,
      troponin-I, and myosin light chains 1 and 2. The effectiveness of the lysosomal
      extract to degrade myofibrillar proteins was significantly affected by the
      presence or absence of EDTA. Zinc, which is a potent inhibitor of cysteine
      proteinases, prevented most, but not all, of the lysosomal extract-induced
      myofibrillar protein degradation. Incubation of myofibrils with m-calpain
      resulted in the hydrolysis of troponin-T, desmin, and a 58-kDa molecular weight
      protein, possibly vimentin, and 5 mM ZnCl2 completely blocked these changes.
      Results from this study indicate that the degradation by the lysosomal extract is
      far more extensive than the degradation that occurs with normal postmortem
      storage and that possibly a non-cysteine protease is present that is capable of
      hydrolyzing some myofibrillar proteins under this in vitro condition, because
      Zn2+ did not block all proteolysis. However, similar changes were induced by m
      calpain incubation and postmortem storage.

PMID- 1752821
TI  - Factors influencing intermuscular fat and other measures of beef chuck
      composition.
AB  - Carcasses from 59 steers produced from the mating of Braford, Simbrah, Senepol,
      and Simmental bulls to Brahman- and Romana Red-sired cows and Brahman bulls mated
      to Angus cows were used in this study. Effects of sire breed and feeding calves
      vs yearlings on fat depots in the chuck, when steers were fed to 1.0 cm external
      fat, were determined. Breed of sire and feeding calves vs yearlings had no effect
      (P greater than .05) on percentage of intermuscular fat. However, carcasses from
      Braford-sired steers had a higher (P less than .05) percentage of dissectable
      subcutaneous fat on the chuck than did those from other breed groups. Carcasses
      from Simmental-sired steers were superior (P less than .05) to those from Braford
      sired steers in USDA yield grade and had a higher average marbling score (P less
      than .05) than the Simbrah-sired group. Estimated kidney, pelvic, and heart (KPH)
      fat was higher (P less than .05) in carcasses from Brahman-, Simbrah-, and
      Senepol-sired steers than in Braford-sired steers. Steers fed as calves had
      higher percentages (P less than .05) of KPH fat and major chuck muscles than did
      those fed as yearlings. The best single predictor of percentage of intermuscular
      fat within the chuck was adjusted fat over the ribeye (R2 = .46).

PMID- 1752822
TI  - Using calcium chloride injection to improve tenderness of beef from mature cows.
AB  - The objective of this investigation was to determine the effect of calcium
      chloride (CaCl2) injection on Warner-Bratzler shear force (WBS), sensory panel
      ratings, and collagen traits of mature cow beef. Within 30 min of exsanguination,
      subprimals (top round, TR; top sirloin, TS; strip loin, SL) from alternate sides
      of the carcass were injected with a .3 M CaCl2 solution (10% of the subprimal
      weight) and aged for 1, 7, or 14 d. The corresponding cold-boned cuts of the
      other side served as a control. Injecting CaCl2 eliminated the requirement for
      extended postmortem storage, as indicated by d 1 WBS. During the 14-d aging
      period, WBS of noninjected cuts decreased by 2.59 kg, whereas WBS of CaCl2
      injected samples decreased by only .35 kg. Compared with control cuts, CaCl2
      injection improved (P less than .05) d-14 WBS of steaks from SL, TS, and TR by
      41.1, 40.1, and 15.3%, respectively. Additionally, CaCl2-injected subprimals
      exhibited higher (P less than .05) sensory panel tenderness ratings, lower (P
      less than .05) amounts of detectable connective tissue, and shorter (P less than
      .05) sarcomere lengths. No differences (P greater than .05) were observed in any
      quantitative collagen traits between CaCl2-injected and control cuts. These
      results indicate that CaCl2 injection improved ultimate tenderness and sensory
      ratings of meat from mature cow cuts.

PMID- 1752823
TI  - Effects of heating time and sodium metabisulfite on the nutritional value of full
      fat soybeans for chicks.
AB  - Two 21-d trials were conducted to evaluate the effect of heating time and sodium
      metabisulfite (SMBS) on the nutritional value of full-fat soybeans for chicks. In
      Trial 1, four pen-replicates of eight chicks each were fed corn-based diets (19%
      CP; 3,167 kcal of ME/kg) containing either 44% CP soybean meal or full-fat
      soybeans. The soybeans either were unheated or were autoclaved at 121 degrees C
      for 10, 20, 30, 40, 60, or 90 min. Soybean oil was added to the soybean meal diet
      to make it isoenergetic with the soybean diets. Trypsin inhibitor, urease
      activity, and the solubility of protein in the soybeans decreased as heating time
      increased. Weight gain increased and feed:gain and pancreas weights decreased
      quadratically (P less than .01) with heating time. Rate and efficiency of gain
      were maximized when the soybeans were heated for 40 min; further heating for 60
      or 90 min reduced performance. In Trial 2, SMBS was added at levels of 0, 1, or
      2% to full-fat, unheated soybeans or to soybeans before autoclaving at 121
      degrees C for 10, 20, or 40 min. Four pen-replicates of seven chicks each were
      fed corn-soybean diets (19% CP; 3,144 kcal of ME/kg) with 12 treatments in a
      factorial arrangement of heating times and SMBS levels. The rate and efficiency
      of chick weight gain improved linearly (P less than .01) and pancreas weights
      decreased linearly (P less than .01) as heating time increased. Less heating time
      was required to maximize performance and minimize pancreas weights when SMBS was
      added, resulting in a heating time x SMBS interaction (P less than .05). Under
      the conditions of this research, chicks fed full-fat soybeans achieved maximum
      performance when the soybeans were heated at 121 degrees C for 40 min, and SMBS
      decreased by one-half the heating time required to inactivate the trypsin
      inhibitors. Trypsin inhibitor activity in soybeans was more closely related to
      their nutritional value than was urease activity.

PMID- 1752824
TI  - Effects of dietary pH and phosphorus source on performance, gastrointestinal
      tract digesta, and bone measurements of weanling pigs.
AB  - Crossbred pigs (n = 144, average age and weight = 28 +/- 3 d, 7.5 kg) were used
      in two 6-wk trials to assess the effects of dietary pH and P source on growth
      performance, gastrointestinal digesta pH and chloride ion concentration (Cl-),
      and bone characteristics. Treatments were randomly allotted within blocks (based
      on weight within gender) to a 3 x 2 factorial arrangement with three dietary pH
      levels (5.4, 6.0, and 6.7) and two P sources: dicalcium phosphate (DCP) and
      defluorinated phosphate (DFP). Pigs fed the pH 6.7 diet had reduced ADG (P less
      than .01) and average daily feed intakes (ADFI; P less than .001) during wk 1 to
      3 and overall compared with pigs fed the pH 6.0 diet, but ADG and ADFI were not
      affected when the pH 5.4 diet was fed. There was a dietary pH x P source
      interaction (P less than .05) for ADFI. Pigs had decreased ADFI as dietary pH was
      increased from 6.0 to 6.7 for both DCP and DFP, but ADFI was similar for the pH
      6.0 and 5.4 diets with DFP, whereas ADFI was greater for the pH 5.4 diet with
      DCP. Dietary pH did not influence ADFI:ADG ratio (F:G; P greater than .05), and P
      source had no effect (P greater than .05) on either ADG, ADFI, or F:G.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1752825
TI  - Toxicity and tissue accumulation of copper in chicks fed casein and soy-based
      diets.
AB  - Experiments were conducted to study Cu toxicity in chicks fed casein or soy
      containing diets containing graded levels of excess CuSO4.5H2O. Differences
      between diets in measures of Cu toxicity were pronounced. Addition of 800 mg of
      Cu/kg to a casein-dextrose semipurified diet decreased weight gains by 63%, but
      the same addition of Cu to a corn-soybean meal complex diet decreased gains by
      only 8%. At all levels of Cu supplementation (100, 200, 400 or 800 mg/kg), Cu
      deposition in the liver was increased markedly in chicks fed casein diets
      compared with those fed the complex diet. Substituting soy-protein concentrate
      for casein in the semipurified diet resulted in a marked decrease in Cu toxicity
      as measured by weight gain reductions and tissue accumulation of Cu.

PMID- 1752826
TI  - Plasma levels of oxytetracycline, doxycycline, and minocycline in pigs after oral
      administration in feed.
AB  - Steady-state plasma levels were determined for oxytetracycline (OTC), doxycycline
      (DC), and minocycline (MC) after medication with different in-feed
      concentrations. Each concentration of the three tetracyclines was examined in six
      pigs. The animals were housed in individual pens and fed twice daily with an
      interval of 12 h. All pigs consumed their feed within 1 h after it was provided.
      Concentrations of 400, 800, 1,600, and 2,400 mg of OTC per kilogram of feed
      induced steady-state plasma levels ranging from .13 to .22, .19 to .50, .39 to
      1.43, and 1.41 to 2.14 micrograms/ml, respectively. On a feed intake basis, pigs
      received 13, 26, 54 to 81, and 108 mg of OTC per kilogram of BW per day,
      respectively. Steady-state plasma levels after medication with 200, 400, and 800
      mg of DC or MC per kilogram of feed ranged from .37 to .89, .71 to 1.14, and 1.62
      to 3.18 micrograms/ml for DC and from .21 to .60, .43 to 1.05, and 1.19 to 2.62
      micrograms/ml for MC. Pigs consumed 7, 13, and 26 mg of DC and 9, 18, and 36 mg
      of MC per kilogram of BW per day, respectively. For all three tetracyclines there
      was an increase in steady-state plasma levels when concentrations in feed or per
      kilogram of BW increased. Plasma levels were determined with both a HPLC method
      and a microbiological method. A good correlation existed between the results
      obtained by both methods. It was concluded that based on plasma levels and known
      in vitro activity DC and MC could be good alternatives for OTC to treat
      respiratory tract infections in pigs.

PMID- 1752827
TI  - Recombinant porcine somatotropin: an immunotoxicology study.
AB  - The present study was designed to determine the effect of recombinant porcine
      somatotropin (rpST; 5, 15, or 25 mg.pig-1.d-1 for 57 d) on a variety of immune
      function variables. We observed no significant effect of rpST treatment on the
      gross pathology of the pigs, histopathology of the immune system organs, total
      and differential white blood cell counts, lymphocyte blastogenic response to
      mitogens, or the neutrophil functions of chemotaxis, ingestion, reduction of
      cytochrome C, iodination, and antibody-dependent cell-mediated cytotoxicity.
      Those variables that were significantly affected by rpST treatment include a
      decreased hemoglobin and packed red blood cell volume (at some time points for
      all three rpST dosages), a decrease in plasma protein level at the 25-mg dose, a
      small increase in neutrophil random migration (at all three rpST dosages), and a
      decrease in IgG antibody response to tetanus toxoid at 15 d after immunization
      (but not at d 8, 22, or 29). Additionally, rpST treatment was associated with a
      decreased rate of BW gain (at 15-mg dose), increased liver and kidney weights (at
      all three dosage levels), and an increased incidence of renal tubular cytoplasmic
      vacuolation of minor severity. There were no observed differences in the overall
      health of the pigs due to rpST treatment, based on clinical observations as well
      as determination of antibody titer to, and isolation of, common swine pathogens.
      Therefore, there was no evidence that the observed influence of rpST treatment on
      immune function would be clinically relevant.

PMID- 1752828
TI  - The pharmacokinetics and residues of clenbuterol in veal calves.
AB  - Seven female Brown Swiss calves were used to study the pharmacokinetics of
      clenbuterol after an effective anabolic dosage of 5 micrograms/kg of BW was given
      twice daily for 3 wk. Analyses of clenbuterol concentrations in different tissues
      was done by enzyme immunoassay (EIA). Tissue samples were taken from three calves
      on the last day of administration and from two more after 3.5 or 14 d of
      clenbuterol withdrawal. The rate of clenbuterol elimination was dependent on time
      and tissue. Clenbuterol concentrations in the lung dropped from a mean of 76 ng/g
      to a level of less than .08 ng/g after 14 d, whereas in the liver the clenbuterol
      concentrations decreased from 46 ng/g to .6 ng/g within 14 d of withdrawal.
      Highest levels were always found in the eye: 118 ng/g, 57.5 ng/g, and 15.1 ng/g
      after 0, 3.5, and 14 d of withdrawal, respectively. These data reveal that
      different compartments contribute to the elimination of clenbuterol; therefore,
      concentrations in urine do not follow first order kinetics. An initial rapid
      decline in the concentration of clenbuterol in urine with a half-life of 10 h is
      followed by a slower elimination with a half-life of about 2.5 d. Treatments
      using the anabolic dose of 5 micrograms/kg of BW require longer withdrawal times
      than the therapeutic dose (.8 micrograms/kg BW).

PMID- 1752829
TI  - Exogenous opioids increase plasma prolactin in Holstein calves primarily via a
      dopaminergic mechanism.
AB  - A study was conducted to determine whether exogenous opioids increase prolactin
      (PRL) secretion in Holstein heifer calves via a dopaminergic mechanism. Twenty
      four Holstein heifer calves ranging in age from 5 to 7 mo were assigned to one of
      four treatment groups (six/treatment): 1) injection of saline (SAL); 2) injection
      of a synthetic enkephalin (D-Ala2, N-Me-Phe4, Met(O)5-ol enkephalin; DAMME); 3)
      injection of DAMME after pretreatment with the long-acting dopamine agonist 2
      bromo-alpha-ergocryptine; or 4) injection of thyrotropin-releasing hormone (TRH)
      after pretreatment with 2-bromo-alpha-ergocryptine. Calves were equipped with
      indwelling jugular cannulas on d 1, and baseline plasma PRL concentrations were
      established. Animals receiving 2-bromo-alpha-ergocryptine were injected s.c. 3 h
      after the last baseline sample was drawn on d 1. On d 2, calves assigned to
      receive SAL, DAMME, or TRH were injected 2 h after the start of sampling, and
      sampling was continued for an additional 4.5 h. Basal plasma PRL was lower (P
      less than .01) on d 2 in calves injected with 2-bromo-alpha-ergocryptine than
      baseline levels on d 1. Plasma PRL was higher (P less than .01) in calves not
      pretreated with 2-bromo-alpha-ergocryptine after DAMME injection on d 2 but was
      not different after DAMME injection in calves pretreated with 2-bromo-alpha
      ergocryptine. In contrast, plasma PRL increased (P less than .01) after TRH
      injection on d 2 in calves pretreated with 2-bromo-alpha-ergocryptine.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1752830
TI  - Suppression of sheep and goat lymphocyte proliferation by sheep, goat, and sheep
      x goat hybrid trophoblast tissue cultures.
AB  - Immunosuppressive activity of conditioned medium from cultured ovine, caprine,
      and hybrid trophoblast tissue was examined. Conceptuses were obtained from
      naturally mated donor ewes and does at d 20 of gestation and trophoblast tissue
      was cultured for 24 h in medium supplemented with 15% calf serum and 1%
      antibiotic/antimycotic. Conditioned medium was added to pokeweed mitogen
      stimulated sheep and goat lymphocyte cultures. Quantification of [3H]thymidine
      uptake by cells was used to measure lymphocyte proliferation. Ovine, caprine, and
      hybrid conditioned medium effectively suppressed sheep and goat lymphocyte
      proliferation (P less than .01). There were no differences (P greater than .05)
      between the immunosuppressive activity of the three tissue types on either sheep
      or goat lymphocytes. For all treatment groups, sheep lymphocytes were suppressed
      more than goat lymphocytes (P less than .05). These results indicate that, at d
      20 of gestation, sheep x goat hybrid trophoblast tissue is capable of suppressing
      pokeweed mitogen-stimulated lymphocyte proliferation.

PMID- 1752831
TI  - Comparison of urea treatment with established methods of sorghum grain
      preservation and processing on site and extent of starch digestion by cattle.
AB  - To determine the effect of dry (D); reconstituted and ensiled (R); reconstituted
      and acid-treated (A); and urea-treated, high-moisture (U) sorghum grain on starch
      digestibility, four Angus x Hereford steers (means BW = 350 kg) with duodenal and
      ileal cannulas were used in a 4 x 4 Latin square design. Diets consisting of 69%
      ground sorghum grain were fed every 2 h in equal portions (8.2 kg/d). Diets
      averaged 46.5% starch and 12% CP, except for U, which averaged 14% CP due to urea
      treatment. Ytterbium attached to sorghum was used as a particulate marker.
      Duodenal, ileal, and fecal samples were taken 1 h postfeeding after a 14-d
      adaption to diets. Whole samples were analyzed. Preduodenal starch digestion (%)
      was 89, 83, 76, and 70, and starch digestion over the total tract was 99, 97, 95
      and 91 for R, U, A, and D, respectively. Starch digestion proximal to each site
      (duodenum and ileum) was enhanced (P less than .05) by R and U compared with D.
      Within the small intestine, there was a linear relationship (P less than .003)
      between starch digestion and daily starch supply. However, digestibility of
      starch in the small intestine (mean = 45%) was not different among diets.
      Apparent digestibility of starch in the large intestine was not significantly
      different from digestibility in the small intestine. Urea-treated sorghum grain
      was equivalent to reconstituted, ensiled sorghum in digestion characteristics and
      was superior to dry sorghum.

PMID- 1752832
TI  - Effects of cold environment and intake level on the energetic efficiency of
      feedlot steers.
AB  - The effects of cold climatic conditions on energy partitioning were investigated
      with 49 Hereford-type steers fed an all-concentrate, barley-based diet in a 2 x 3
      factorial comparative slaughter trial. Steers (seven per treatment) were kept
      either indoors or outdoors (n = 2) and fed at 50, 65, or 80 g of DM/kg of BW.75
      (n = 3) for up to 106 d. Mean temperatures were 16.9 +/- 2.7 degrees C and -7.6
      +/- 6.8 degrees C in indoor and outdoor locations, respectively. Steers housed
      indoors grew 49% faster (P less than .001) and had 51% better gain: feed ratios
      (P less than .05) than those kept outdoors. Outdoor steers retained 65% less (P
      less than .001) energy. Estimated fasting heat production in the outdoor steers
      was 18% higher (P less than .01) and efficiency of ME use for maintenance 14%
      lower (P less than .01) than in the indoor steers, which resulted in an estimated
      increase of 41% in the ME requirements for maintenance in the outdoor steers. The
      NEg content of the diet was decreased from 1.29 Mcal/kg in the indoor steers to
      .76 Mcal/kg in the outdoor steers. Outdoor steers deposited 21% of their energy
      as protein, whereas indoor steers deposited only 14% of their energy as protein,
      which could explain the low NEg value of the diet in the cold environment. It was
      concluded that the main factors contributing to reduced energetic efficiency in
      the cold were an increased maintenance requirement and a greater proportion of
      the dietary energy retained as protein.

PMID- 1752833
TI  - Technical note: effectiveness of different methods of continuous marker
      administration for estimating fecal output.
AB  - Six ruminally fistulated crossbred steers (BW = 369 kg) were used in a randomized
      complete block experiment to test the efficacy of continuous-infusion pumps and
      controlled-release boluses for administering external markers to predict fecal
      output. Steers, limit-fed chopped alfalfa hay at 2% of BW daily, were fitted with
      continuous-infusion pumps that administered Co-EDTA and YbCl3 solutions
      intraruminally. In addition, a controlled-release bolus containing Cr2O3 was
      inserted into the rumen of each steer. Fecal grab samples were taken every 6 h
      for 7 d during initial marker equilibration; after this period, fecal grab
      samples were taken every 3 h for 48 h to evaluate diurnal variation patterns.
      Steers were subsequently fitted with fecal bags for 7 d to allow total fecal
      collection. Grab samples also were taken during the total fecal collection period
      at 0600 (AM) and 1400 (PM). The marker X time effect was nonsignificant.
      Similarly, time of grab sampling (AM or PM) did not affect estimates of fecal
      output (P greater than .10), but the Cr2O3 bolus overestimated fecal output (P
      less than .05). Fecal marker concentrations during the 48-h profile showed little
      diurnal variation regardless of marker used. All markers equilibrated in the
      feces at approximately 100 to 120 h after initiating infusions. The continuous
      infusion pumps evaluated were efficacious for administering markers for
      estimating total fecal output in limit-fed steers; however, the Cr2O3 boluses
      evaluated overestimated fecal output when the manufacturer's suggested release
      rate was used for fecal output calculations.

PMID- 1752834
TI  - Effect of a Saccharomyces cerevisiae culture on lactate utilization by the
      ruminal bacterium Selenomonas ruminantium.
AB  - The objective of this study was to examine the effects of a Saccharomyces
      cerevisiae culture (YEA-SACC) on lactate utilization by the predominant ruminal
      bacterium Selenomonas ruminantium. Lactate uptake was stimulated by YEA-SACC
      concentrations between 2.5 and 10 g/liter, and the 5-g/liter level increased
      uptake 3.8-fold. When YEA-SACC concentrations were increased above the 5-g/liter
      level lactate uptake was decreased, but 10 g/liter still stimulated uptake more
      than threefold. A filter-sterilized YEA-SACC filtrate also increased lactate
      uptake more than fourfold at all concentrations tested (10 to 100
      microliters/ml), and the 25-microliters/ml level increased uptake ninefold.
      Growth of S. ruminantium in medium that contained 2 g/liter of DL-lactate was
      stimulated more than twofold by either 2 or 5% (vol/vol) YEA-SACC filtrate after
      24 h. The YEA-SACC filtrate also increased the production of acetate, propionate,
      total VFA, and YLACTATE (grams of cells/mole of lactate) from lactate-grown
      cells. Because the increase in propionate production was greater relative to
      acetate, a decrease in the acetate:propionate ratio was observed. Growth on
      lactate and uptake of radiolabeled lactate by S. ruminantium was stimulated by a
      filter-sterilized YEA-SACC filtrate. The concentration of L-malic acid in the YEA
      SACC filtrate was 4.9 mM, and it seemed that L-malic acid played a role in the
      stimulation of growth on lactate as well as lactate uptake by S. ruminantium
      treated with YEA-SACC.

PMID- 1752835
TI  - Technological to a fault or faulty approach to technology development?

PMID- 1752836
TI  - From technical jargon to plain English for application.
AB  - These examples of translating technical jargon into plain English application
      words, acronyms, letter codes, and simple tests were necessary as we developed
      Precision Teaching. I hope our experience is useful to others facing the problems
      of applying technology in practical settings. At the least, our experience should
      give you an idea of the work and time involved in making your own translations.
      Above all, be patient. Accurate plain English translations do not come easily.
      They cannot be made at your desk. A search often takes years to produce one new
      accurate plain English translation. Rapid publication pressures, journal
      editorial policies, and investments in materials, books, and computer programs
      all combine to hamper these translations. It's possible that you will find some
      of our plain English equivalents useful in your own applied behavior analysis
      applications.

PMID- 1752837
TI  - Increasing habilitative services for persons with profound handicaps: an
      application of structural analysis to staff management.
AB  - We evaluated a structural analysis methodology for enhancing the utility of a
      staff management program. In Experiment 1, a structural analysis of direct-care
      staff behavior in a mental retardation facility revealed differences in work
      patterns over time. Specific times were identified when few basic care duties
      were necessary and staff engaged in nonwork activity. In Experiment 2, a
      management program was implemented to increase staff members' training activities
      during periods identified through the structural analysis. The program was
      accompanied by increases in training activities and decreases in nonwork
      behavior. The improvements were maintained during a 43-week period while the most
      labor-intensive component of the program was withdrawn. Staff acceptability
      measures indicated a positive response to the management intervention, although
      responses varied across components within the multifaceted program. The increased
      training was accompanied by beneficial changes among clients with profound
      handicaps. Results are discussed regarding practical considerations for improving
      staff performance and for adopting innovations resulting from applied research.

PMID- 1752838
TI  - Reactivity in self-recording: obtrusiveness of recording procedure and peer
      comments.
AB  - Reactivity refers to behavior change that occurs during self-recording without
      specific programming of consequences. We analyzed the effects of obtrusiveness of
      recording procedure and peer comments on reactivity to self-recording. Three
      first-grade students in Experiment 1 completed math questions during a 5-min work
      period. When we gave the children recording devices and told them to try to
      complete more questions than the highest number they had previously completed,
      math performance increased, as did the number of verbalizations about it. Two
      children showed more reactivity when they used the more obtrusive recording
      device. Because the increase in math performance corresponded closely to
      increases in peer comments, we manipulated peer comments directly in Experiment
      2. Four second-grade students completed a math task and an alphabet task. Three
      of the students showed increased math performance during periods when peer
      comments occurred compared to periods when peer comments did not occur. Although
      the data from the math task suggested that peer comments can enhance reactivity,
      we did not observe this relationship with the alphabet task. These results
      suggest that the conditions necessary to produce desirable results through self
      recording are complex and contextually specific.

PMID- 1752839
TI  - Effects of self-management training and reinforcement on the transfer of improved
      conduct in the absence of supervision.
AB  - The instruction, maintenance, and transfer of training of social skills of 3
      seriously emotionally disturbed adolescents were accomplished by a self
      management training and reinforcement package. During baseline sessions these
      students, who were covertly filmed in their classroom, averaged over 90% off-task
      or socially inappropriate behavior while their teacher was out of the room. They
      showed similar behaviors when walking between classes, unattended by their
      teacher. Treatment was introduced in the classroom and consisted of social skills
      and self-management training and reinforcement. Treatment procedures included
      instruction, modeling, and role playing of social skills, as well as self
      assessment, self-recording, and self-reinforcement for correct approximations of
      these skills. After 5 weeks of training, all subjects demonstrated substantial
      improvements in the classroom during the teacher's absence and when distracted by
      other students; however, transfer of social skills did not occur to the between
      class setting until students were given explicit instruction to initiate self
      managing procedures in this setting.

PMID- 1752840
TI  - A brief functional analysis of aggressive and alternative behavior in an
      outclinic setting.
AB  - We conducted a brief functional analysis to identify maintaining variable for
      aggressive behavior and an alternative replacement response during a 90-min
      outpatient evaluation of 3 individuals with severe handicaps. During the initial
      analogue assessment, which focused on identifying maintaining contingencies for
      aggressive behavior, each participant displayed a substantially greater frequency
      of aggressive behavior during one condition than during any other. The
      contingency that produced the highest percentage of aggressive behavior was then
      presented for the occurrence of a specific alternative behavior (a mand). During
      this contingency reversal phase, each participant displayed a substantial
      reduction in aggressive behavior and a substantial increase in alternative
      behavior, thus providing a direct analysis of the equivalency of the contingency
      for maintaining either behavior.

PMID- 1752841
TI  - The effects of severe behavior problems in children on the teaching behavior of
      adults.
AB  - Applied behavior analysts have focused on how adults can influence the problem
      behavior of children using a variety of behavior modification strategies. A
      related question, virtually unexplored, is how the behavior problems of children
      influence adults. This child-effects concept was explored empirically in a study
      involving 12 adults who were asked to teach four pairs of children in which one
      member of the pair exhibited problem behavior and the other typically did not.
      Results demonstrated that problem children displayed tantrums, aggression, and
      self-injury contingent on adult instructional attempts but not at other times,
      whereas nonproblem children showed little or no problem behavior at any time.
      Importantly, from a child-effects perspective, adults engaged in teaching
      activities with nonproblem children more often than with problem children. Also,
      when an adult worked with a problem child, the breadth of instruction was more
      limited and typically involved those tasks associated with lower rates of
      behavior problems. The implications of these results are discussed with respect
      to theories of escape behavior, current assessment practices, and intervention
      issues related to maintenance. The existence of child effects suggests that
      problem behavior may be better understood when it is conceptualized as involving
      a process of reciprocal influence between adult and child.

PMID- 1752842
TI  - Linking descriptive and experimental analyses in the treatment of bizarre speech.
AB  - Descriptive and experimental methods were used to analyze the environmental
      determinants of an adult's bizarre speech. A descriptive analysis of behavior
      under natural conditions indicated that bizarre vocalizations occurred most often
      in the presence of task-related demands and in the absence of adult attention.
      Further, bizarre speech occurring during tasks was followed frequently by the
      cessation of task demands by staff or the subject's voluntary disengagement from
      task-related activities; bizarre speech observed during noninteractional periods
      (i.e., in the absence of adult attention) was frequently followed by staff
      attention. The escape and attention hypotheses were tested under analogue
      conditions. Results of the experimental analysis supported only the attention
      hypothesis; that is, bizarre speech appeared to function as an attention
      producing behavior. The functional analysis data were used to select two
      different yet functionally equivalent treatments. The first treatment provided
      the subject with noncontingent scheduled attention. The second intervention
      taught the subject social language skills in the form of initiation and expansion
      statements. Both interventions were effective in suppressing maladapted speech.
      Advantages of linking descriptive and experimental analyses are discussed.

PMID- 1752843
TI  - Teaching self-administration of suctioning to children with tracheostomies.
AB  - We examined the effectiveness of using dolls to teach young children with
      tracheostomies to self-administer a suctioning procedure. Four children between
      the ages of 5 and 8 years, who had had tracheostomies for 6 months or longer,
      participated. After skills were taught via doll-centered simulations, in vivo
      skills were evaluated. All of the training and probe sessions were conducted in
      the participants' classrooms or homes. Results of a multiple baseline design
      across subjects and skill components indicated that the performance of all
      children improved as a function of training. Skill maintenance was demonstrated
      by all participants during follow-up assessments conducted 2 to 6 weeks
      posttraining. Results of a questionnaire completed by caregivers and interviews
      with the children revealed high levels of satisfaction with the training
      procedures and outcomes.

PMID- 1752844
TI  - Teaching adults with severe and profound retardation to exit their homes upon
      hearing the fire alarm.
AB  - Prompting, modeling, and differential reinforcement with client-chosen rewards
      were used to teach 3 nonverbal people with severe to profound mental retardation
      to exit their group homes at the sound of the house fire alarm, using a multiple
      baseline design. All 3 participants learned to exit independently in less than 2
      min in all experimenter-initiated surprise fire drills and in the majority of
      staff-initiated surprise fire drills. Each participant was also able to exit from
      five areas of the house from which teaching was not done.

PMID- 1752845
TI  - Assessing stimulus control in natural settings: an analysis of stimuli that
      acquire control during training.
AB  - When a learner is taught a new response, the stimuli that influence its display
      are often unknown. The presence or absence of these stimuli alters the
      probability of occurrence of the response. By identifying the stimuli influencing
      the probability of newly acquired responses, interventionists may program for
      their generalization more effectively and efficiently. This investigation
      describes the application of an operant methodology to assess functional
      relationships between responses and specific stimulus variables. Four young
      adults with moderate mental retardation were taught to include "please" as part
      of requests they made in school. Four environmental stimuli, present during
      training, were assessed for the controlling properties they acquired. Each of the
      four was assessed prior to and after training by presenting it in isolation
      (i.e., the other three were varied). If the presence of a single stimulus
      associated with training did not occasion "please," then pairs of stimuli were
      probed. The results revealed that single-stimulus probing occasioned responding
      by only 1 learner; paired-stimulus probing set the occasion for including
      "please" by 2 others. Control of the 4th learner's responding was lost before
      training was introduced, because he began including "please" in his requests
      during baseline. The implications of these results are discussed in terms of
      analyzing stimulus control and promoting stimulus generalization.

PMID- 1752846
TI  - Using time delay to promote spontaneous speech in an autistic child.
AB  - One of the frequently observed deficits in autistic children is their lack of
      spontaneous speech. We used a multiple baseline across behaviors to investigate
      the effectiveness of a time delay procedure for inducing spontaneous speech in a
      10-year-old male autistic child during play. We first taught the child to imitate
      the experimenter's verbal prompts that described the child's motor response. Once
      the child reached criteria on imitation, we implemented baseline wherein an
      immediate verbal prompt for speech was provided after each of the child's motor
      responses. Intervention consisted of a gradual delay in the presentation of the
      verbal prompts. The time delay effectively increased the child's spontaneous
      speech on trained items; some generalization to untrained items also occurred,
      but only within the same behavioral class of car play. Generalization was also
      observed across settings. Spontaneous speech remained at high levels during the 4
      month maintenance for the behavior of car play but decreased for a second
      behavior. Decreases in the child's response latencies suggest that spontaneous
      speech may be an anticipatory verbal response.

PMID- 1752847
TI  - Effects of caloric level on ruminating.
AB  - A series of recent studies has shown that a number of dietary variables affect
      ruminative behavior in institutionalized retarded persons. This experiment
      extends an earlier study that examined the influence of the caloric level of the
      diet on the frequency of ruminating. Subjects consumed regular portions of food
      that varied between phases from normal to high caloric levels. The data show a
      clear but modest inverse relation between the caloric value of the diet and the
      rates of postmeal ruminating.

PMID- 1752848
TI  - Reexposure to fluoxetine after serious suicide attempts by three patients: the
      role of akathisia.
AB  - Considerable controversy exists regarding the relationship between fluoxetine and
      the emergence of suicidal ideation. Three cases are presented of patients who
      were reexposed to fluoxetine after having previously made a serious suicide
      attempt during fluoxetine treatment. All three patients developed severe
      akathisia during retreatment with fluoxetine and stated that the development of
      the akathisia made them feel suicidal and that it had precipitated their prior
      suicide attempts. The akathisia and suicidal thinking abated upon the
      discontinuation of the fluoxetine or the addition of propranolol. The emergence
      of suicidal ideation during treatment with fluoxetine may be secondary to the
      development of akathisia. Gradual increments of fluoxetine dose and the prompt
      recognition and treatment of akathisia may reduce further the rare occurrence of
      suicidal ideation during fluoxetine treatment.

PMID- 1752849
TI  - Clozapine and jaw dyskinesia: a case report.
AB  - No convincing case of tardive dyskinesia has been associated with clozapine. We
      briefly discuss a case of clozapine-induced reversible initial dyskinesia
      described in the German literature, and we report a case of jaw dyskinesia in a
      49-year-old female schizophrenic. The dyskinesia appeared 2 weeks after the
      patient started clozapine treatment, did not respond to anticholinergic
      medication, and has continued for more than 1 year while the patient has remained
      on clozapine treatment. The patient had taken haloperidol (less than or equal to
      5 mg/day) for 5 weeks before starting clozapine treatment. These are the only two
      cases of dyskinesia associated with clozapine use that are known to us. They
      raise the possibility that clozapine can induce dyskinesia.

PMID- 1752850
TI  - Thrombocytopenia associated with carbamazepine: a case series.
AB  - Carbamazepine is increasingly being used in the acute and maintenance treatment
      of patients with bipolar disorder. Thrombocytopenia represents a serious adverse
      effect of carbamazepine with which clinicians need to be familiar. The authors
      describe the course of thrombocytopenia associated with carbamazepine in four
      patients with bipolar disorder. In all cases, thrombocytopenia appeared 14 to 16
      days after the initiation of carbamazepine; also in all cases the platelet count
      completely recovered within 7 days after the carbamazepine treatment was
      discontinued. Thrombocytopenia secondary to carbamazepine appears soon after the
      initiation of treatment and is rapidly followed by recovery after drug
      discontinuation.

PMID- 1752851
TI  - P.r.n. medications in child psychiatric patients: a pilot placebo-controlled
      study.
AB  - BACKGROUND: The administration p.r.n. (as needed) of sedative medications is a
      widespread practice in the management of acute dyscontrol of child psychiatric
      inpatients. Its efficacy, however, has never been tested in a controlled clinical
      trial. METHOD: Twenty-one male inpatients, aged 5-13 years, participated in a
      double-blind, placebo-controlled study of the p.r.n. use of diphenhydramine, a
      sedative antihistaminic often used in child psychiatry wards. The patients' DSM
      III-R diagnoses were conduct disorder, attention-deficit hyperactivity, and major
      depression. Each patient in acute dyscontrol blindly received either oral or
      intramuscular doses of diphenhydramine 25-50 mg (N = 9) or placebo (N = 12). The
      Conners Abbreviated 10-Item Teacher Rating Scale and the Clinical Global
      Impressions scale were completed before and 0.5, 1, and 2 hours after the dose.
      RESULTS: Repeated measures ANOVA showed significant time effects, but no
      difference due to drug. The intramuscular route tended to be more effective than
      the oral, regardless of whether active drug or placebo was given. CONCLUSION: The
      data indicate that if p.r.n. administrations are effective, this is a placebo
      effect. Likewise, intramuscular administrations are more effective because of a
      route effect ("the needle") and not because of a specific pharmacologic activity.

PMID- 1752852
TI  - An open label trial of alprazolam in comorbid irritable bowel syndrome and
      generalized anxiety disorder.
AB  - BACKGROUND: The irritable bowel syndrome (IBS) is very prevalent and psychiatric
      comorbidity runs high. A significant proportion of generalized anxiety disorder
      (GAD) patients manifest concurrent IBS. METHOD: We conducted a 14-week, open
      label trial of the triazolobenzodiazepine alprazolam in 32 patients with comorbid
      generalized anxiety and IBS. At the end of a 2-week placebo run-in, eligible
      subjects received 6 weeks of active drug therapy. RESULTS: Ninety-four percent of
      subjects (N = 25) had a full or partial anxiolytic response at the 6th treatment
      week (p less than .001). Eighty-nine percent (N = 24) experienced a concomitant
      reduction in IBS severity. For the majority, these dual benefits were still
      evident at the conclusion of a 4-week drug taper (p = .05) and achieved a trend
      (p = .07) at a 4-week postdrug discontinuation visit. CONCLUSION: Alprazolam was
      safe, effective, and well tolerated during the acute treatment of comorbid GAD
      and IBS; only a limited posttreatment rebound was observed.

PMID- 1752853
TI  - Cocaine-induced psychosis.
AB  - BACKGROUND: Chronic stimulant use can produce a paranoid psychosis that is
      similar to acute paranoid schizophrenia. While this phenomenon has been
      systematically explored in amphetamine abusers, it has been relatively unexplored
      in a systematic fashion in cocaine abusers. METHOD: The experience of cocaine
      induced psychosis was evaluated in 55 individuals consecutively admitted for
      treatment of DSM-III-R cocaine dependence. Each subject was interviewed about
      their experiences of psychosis while intoxicated by means of a standardized,
      semistructured interview. RESULTS: Fifty-three percent (29/55) of those
      interviewed reported experiencing transient cocaine-induced psychosis. There was
      no significant difference in lifetime amount of cocaine use or amount of cocaine
      use in the month before admission between those who experienced psychosis and
      those who did not. The psychosis-positive group used significantly more cocaine
      in the year prior to admission (p less than or equal to .02) and had a longer
      duration of use (p less than or equal to .01). Males were significantly (p less
      than or equal to .05) more likely than females to develop psychosis. Ninety
      percent (26/29) developed paranoid delusions directly related to drug use. Ninety
      six percent (28/29) of the subjects experienced hallucinations: 83% (24/29),
      auditory hallucinations; 38% (11/29), visual hallucinations; and 21% (6/29),
      tactile hallucinations. Twenty-seven percent (15/55) of subjects developed
      transient behavioral stereotypies. CONCLUSION: Cocaine-induced paranoia is a
      common experience among chronic users. Amount and duration of use are related to
      its development. Implications for a kindling model of cocaine-induced psychosis
      will be discussed.

PMID- 1752854
TI  - Susceptibility to spontaneous MAOI hypertensive episodes.

PMID- 1752855
TI  - Pimozide in clinical psychiatry.

PMID- 1752856
TI  - Serotonin and behavior: emphasis on motor control.
AB  - Electrophysiologic studies of brain serotonergic neurons in behaving animals
      indicate that their activity is closely related to the sleep-wake-arousal cycle
      and to certain specific types of repetitive motor activity. A variety of other
      environmental and physiologic manipulations are ineffective in altering the
      activity of this neurochemical system. An attempt is made to relate these results
      to well-known involvement of brain serotonin in human affective disorders.

PMID- 1752857
TI  - Hypothalamic serotonin in treatments for feeding disorders and depression as
      studied by brain microdialysis.
AB  - Microdialysis was used to measure changes in extracellular serotonin in the
      hypothalamus of rats while they engaged in feeding behavior or received drug
      treatments used to treat feeding disorders and affective disorders in humans.
      Hypothalamic serotonin increased significantly relative to controls in response
      to (1) intraperitoneal tryptophan after food deprivation, (2) the smell of food
      and eating a meal, (3) a conditioned taste aversion, (4) d-fenfluramine and
      fluoxetine, and (5) an amphetamine challenge test after chronic low doses of
      lithium. In some cases, increases correlated with nonspecific behavioral arousal
      were seen in the hippocampus. The results suggest that diet, drug, and behavioral
      therapies, alone or combined, can be used to preferentially modify hypothalamic
      serotonin in the control of behavioral, emotional, and endocrine problems.

PMID- 1752858
TI  - Awakening the sleeping giant: anatomy and plasticity of the brain serotonergic
      system.
AB  - The serotonergic neurons of the mammalian brain comprise one of the most
      expansive chemical systems known. The cell bodies are largely confined to the
      midline (raphe) region of the brain stem in two general clusters: a superior
      group that consists of the dorsal raphe nucleus (B-7 and B-6), median raphe
      nucleus (B-8 and B-5), caudal linear nucleus (rostral B-8), and supralemniscal
      nucleus (B-9), and an inferior group that consists of nucleus raphe obscurus (B
      2), nucleus raphe pallidus (B-1), nucleus raphe magnus (B-3), ventral lateral
      medulla (B-1/B-3), and the area postrema. The axons from these cells project
      throughout the neuroaxis from the spinal cord to the olfactory bulb and from the
      cerebral cortex to the hypothalamus. The development of this giant system begins
      very early in gestation and is influenced by a variety of growth regulatory
      factors, including the astroglial protein S-100 beta. Evidence will be presented
      that the serotonergic system plays a major role in the maturation of the brain by
      interacting with the 5-HT1A receptors which are most dense during these early
      developmental periods. The 5-HT1A receptor is located on both neurons and
      astrocytes, and in the latter cells may serve to stimulate release of S-100 beta.
      The developmental role of 5-HT appears to become dormant as the brain matures,
      and during aging and Alzheimer's disease, 5-HT receptors are significantly
      depressed. However, specific damage to 5-HT fibers in the adult brain by 5,7
      dihydroxytryptamine produces a sharp fall in the levels of 5-HT which seems to
      reactivate the developmental signals in the brain. Not only are the serotonergic
      fibers encouraged to sprout and expand their territory, but the stimulation of
      the astrocytic growth factor by a 5-HT1A agonist is reinstated. The ability to
      recall developmental processes in the adult brain by interrupting the 5-HT fibers
      may provide important tools for understanding and treating the aged brain.

PMID- 1752859
TI  - Serotonin activity in anorexia and bulimia nervosa: relationship to the
      modulation of feeding and mood.
AB  - Brain serotonin activity contributes to satiety. Theoretically, binging behavior
      is consistent with reduced serotonin function, whereas anorexia nervosa is
      consistent with increased serotonin activity. Brain serotonin abnormalities could
      also contribute to psychopathologic behaviors such as dysphoric mood, disturbance
      of impulse control, and obsessionality, as well as neuroendocrine disturbances.
      In fact, disturbances of serotonin have been found in acutely ill anorexia
      nervosa patients. Tryptophan, an essential amino acid found in the diet, is the
      precursor of serotonin. Thus serotonin disturbances could be secondary to dietary
      abnormalities. However, disturbances of serotonin activity appear to persist
      after long-term weight recovery from anorexia nervosa. While speculative, it is
      possible that increased serotonin activity could contribute to the pathogenesis
      of restricted eating and obsessional behaviors in this illness. Physiologic and
      pharmacologic evidence suggest that patients with normal weight bulimia have
      reduced serotonin activity when acutely ill. Such disturbances, even if secondary
      to dietary abnormalities, may still contribute to dysphoric mood and binging
      behavior.

PMID- 1752860
TI  - Opportunities for treatment of psychoactive substance use disorders with
      serotonergic medications.
AB  - The authors review both the preclinical and the clinical evidence for a role of
      serotonin (5-HT) systems in the regulation of drug-taking behavior. Animal
      studies show that pharmacologic treatments that enhance 5-HT function, notably
      selective reuptake inhibitors, reduce the self-administration of a variety of
      substances of abuse, including ethanol and cocaine. These treatments also tend to
      suppress consummatory behavior in general. In contrast to the broad spectrum of
      suppression following 5-HT enhancement, selective antagonists at the 5-HT3
      receptor subtype have been reported to reduce ethanol but not cocaine or food
      intake. Although essentially limited to alcohol abusers, clinical studies seem to
      support the preclinical findings that a number of 5-HT reuptake inhibitors
      decrease interest in and intake of alcohol in mild-moderate ethanol-dependent
      individuals. Furthermore, other serotonergic drugs may show utility in the
      treatment of alcohol abuse. Another way in which serotonergic medications can be
      used in treating substance abuse is by the treatment of comorbid psychoactive
      illness for which such drugs are already known to be effective, e.g., depression
      and anxiety disorders.

PMID- 1752861
TI  - Serotonin uptake inhibitors: effects on motivated consummatory behaviors.
AB  - Within the context of the role of serotonin (5-HT) in motivated behavior, the
      authors examine the effects of 5-HT uptake inhibitors on the regulation of
      motivated consummatory behavior. Emphasis in this field has for the most part
      focused on the consistent observation that treatment with these agents attenuates
      voluntary ethanol drinking behavior in both rats and humans. There has been
      extensive speculation that the underlying mechanism of the decrease in ethanol
      intake induced by 5-HT uptake inhibition may involve a modulation of ethanol's
      reinforcing properties. However, increasing evidence indicates that food
      consumption and fluid intake are also attenuated by these compounds. In addition,
      it has been shown that morphine, amphetamine, cocaine, and nicotine self
      administration, as well as intracranial self-stimulation, are all decreased
      following 5-HT uptake inhibition. These observations support strongly the notion
      that the effects of these agents are global in nature and not specific to any
      single consummatory behavior. They also suggest that 5-HT uptake inhibition may
      result in nonspecific modification of motivated behavior in general.

PMID- 1752862
TI  - A biomechanical model for the analysis of the cervical spine in static postures.
AB  - To gain a better understanding of the forces working on the cervical spine, a
      spatial biomechanical computer model was developed. The first part of our
      research was concerned with the development of a kinematic model to establish the
      axes of rotation and the mutual position of the head and vertebrae with regard to
      flexion, extension, lateroflexion and torsion. The next step was the introduction
      of lines of action of muscle forces and an external load, created by gravity and
      accelerations in different directions, working on the centre of gravity of the
      head and possibly a helmet. Although the results of our calculations should be
      interpreted cautiously in the present stage of our research, some conclusions can
      be drawn with respect to different head positions. During flexion muscle forces
      and joint reaction forces increase, except the force between the odontoid and the
      ligamentum transversum atlantis. This force shows a minimum during moderate
      flexion. The joint reaction forces on the levels C0-C1, C1-C2, and C7-T1 reach
      minimum values during extension, each in different stages of extension. Axial
      rotation less than 35 degrees does not need great muscle forces, axial rotation
      further than 35 degrees causes muscle forces and joint reaction forces to
      increase fast. While performing, lateral flexion muscle forces and joint reaction
      forces must increase rapidly to balance the head. We obtained some indications
      that the order of magnitude of the calculated forces is correct.

PMID- 1752863
TI  - A three-dimensional analysis of a bioprosthetic heart valve.
AB  - A three-dimensional finite element model of the leaflets of a bicuspid
      bioprosthetic heart valve is presented. The model is based on a non-linear
      elastic representation of the tissue behaviour which closely simulates that found
      in experiments. The geometry of the model is based on measurements from a real
      valve. Shell elements which permit bending have been used in the analysis. The
      results indicate that bending stresses in the leaflets make a significant
      contribution to their deformation. This confirms earlier two-dimensional work
      which had suggested that analyses, where only membrane stresses were modelled,
      were likely to produce significant errors in the stress states. The analysis also
      predicts peak stresses close to, but not at, the attachment of the leaflet to the
      stent post.

PMID- 1752864
TI  - Mechanical properties of trabecular bone. Dependency on strain rate.
AB  - The effect of strain rate (epsilon) and apparent density (rho) on stiffness (E),
      strength (sigma u), and ultimate strain (epsilon u) was studied in 60 human
      trabecular bone specimens from the proximal tibia. Testing was performed by
      uniaxial compression to 5% specimen strain. Six different strain rates were used:
      0.0001, 0.001, 0.01, 0.1, 1, and 10 s-1. Apparent density ranged between 0.23 and
      0.59 g cm-3. Linear and non-linear regression analyses using strength, stiffness
      and ultimate strain as dependent variables (Y) and strain rate and apparent
      density as independent variables were performed using the following models: Y = a
      rho b epsilon c, Y = rho b(a + c epsilon; Y = (a + b rho)epsilon c, Y = a rho 2
      epsilon c, E = a rho 3 epsilon c. The variations of strength and stiffness were
      explained equally well by the linear and the power function relationship to
      strain rate. The exponent was 0.07 in the power function relationship between
      strength and strain rate and 0.05 between stiffness and strain rate. The
      variation of ultimate strain was explained best using a power function
      relationship to strain rate (exponent = 0.03). The variation of strength and
      stiffness was explained equally well by the linear, power function and quadratic
      relationship to apparent density. The cubic relationship between stiffness and
      apparent density showed a less good fit. Ultimate strain varied independently of
      apparent density.

PMID- 1752865
TI  - The viscoelastic responses of the human cervical spine in torsion: experimental
      limitations of quasi-linear theory, and a method for reducing these effects.
AB  - The dynamic torsional viscoelastic responses of the human cadaver cervical spine
      were measured in vitro. The quasi-linear formulation of time dependent behavior
      was used to describe and predict the resultant torque as a function of applied
      angular deflection and time. The performance of the quasi-linear model was good,
      reaching correlation at the 99% confidence level; however, it tended to
      underestimate hysteresis energy (mean relative deviation = -19.1%) and observed
      stiffness. This was in part due to difficulties in establishing the physical
      constants of the quasi-linear model from finite rate relaxation testing. An
      extrapolation deconvolution technique to enhance the experimentally derived
      constants was developed, to reduce the detrimental effects of finite rate
      testing. The quasi-linear model based on this enhanced derivation showed improved
      predictive ability and hysteresis energy determination.

PMID- 1752866
TI  - Freezing for postmortal storage influences the biomechanical properties of linear
      skin wounds.
AB  - Specimens for biomechanical investigations are often stored frozen between
      sampling and testing. Several authors have analysed the effects of freezing on a
      variety of intact tissues; while some have found mostly minor changes, others
      have reported no adverse effects. Healing wounds contain more fragile tissue
      components than other tissues and are therefore more sensitive to possible
      adverse effects. This study on rat skin wounds (healed for 10 and 20 days)
      demonstrates that freezing has a significant adverse influence on the mechanical
      properties. It is concluded that fresh tissue should be used whenever possible.
      In case storage in a freezer is necessary great care should be taken when
      designing the experimental protocol.

PMID- 1752867
TI  - Application of homogenization theory to the study of trabecular bone mechanics.
AB  - It is generally accepted that the strength and stiffness of trabecular bone is
      strongly affected by trabecular microstructure. It has also been hypothesized
      that stress induced adaptation of trabecular bone is affected by trabecular
      tissue level stress and/or strain. At this time, however, there is no generally
      accepted (or easily accomplished) technique for predicting the effect of
      microstructure on trabecular bone apparent stiffness and strength or estimating
      tissue level stress or strain. In this paper, a recently developed mechanics
      theory specifically designed to analyze microstructured materials, called the
      homogenization theory, is presented and applied to analyze trabecular bone
      mechanics. Using the homogenization theory it is possible to perform
      microstructural and continuum analyses separately and then combine them in a
      systematic manner. Stiffness predictions from two different microstructural
      models of trabecular bone show reasonable agreement with experimental results,
      depending on metaphyseal region, (R2 greater than 0.5 for proximal humerus
      specimens, R2 less than 0.5 for distal femur and proximal tibia specimens).
      Estimates of both microstructural strain energy density (SED) and apparent SED
      show that there are large differences (up to 30 times) between apparent SED (as
      calculated by standard continuum finite element analyses) and the maximum
      microstructural or tissue SED. Furthermore, a strut and spherical void
      microstructure gave very different estimates of maximum tissue SED for the same
      bone volume fraction (BV/TV). The estimates from the spherical void
      microstructure are between 2 and 20 times greater than the strut microstructure
      at 10-20% BV/TV.

PMID- 1752868
TI  - The constitutive behaviour of passive heart muscle tissue: a quasi-linear
      viscoelastic formulation.
AB  - A quasi-linear viscoelastic law with a continuous relaxation spectrum describing
      triaxial constitutive behaviour of heart muscle tissue is presented. The elastic
      response of the viscoelastic law is anisotropic, while the relaxation behaviour
      is assumed isotropic. The law is designed for a biphasic description (fluid
      solid) of the myocardial tissue. Biaxial and uniaxial stress-strain curves from
      the literature are used to evaluate the parameters of the model. The non-linear
      elastic response, the difference between fibre and cross-fibre stiffness, the
      phenomenon of stress relaxation, the stiffening of the stress-strain relationship
      with increasing strain rate and the weak frequency dependency of the dissipated
      energy during cyclic loading are fairly well described by the proposed law.
      However, it is found that the model produces realistic values for the dissipated
      energy during cyclic loading only when relaxation parameter values are chosen
      which result in an overestimation of the stress relaxation data by more than
      100%. This finding may indicate non-quasi-linearity of viscoelasticity of passive
      heart muscle tissue.

PMID- 1752869
TI  - A conductive polymer sensor for measuring external finger forces.
AB  - This paper describes the construction and use of a durable and thin force sensor
      that can be attached to the palmar surface of the fingers and hands for studying
      the biomechanics of grasp and for use in hand injury rehabilitation. These force
      sensors were constructed using a modified commercially available conductive
      polymer pressure sensing element and installing an epoxy dome for directing
      applied forces through a 12 mm diameter active sensing area. The installation of
      an epoxy dome was effective for making the sensors insensitive to contact
      surfaces varying from 25 to 1100 mm2 and a 16 mm radius surface curved convex
      towards the finger. The completed sensors were only 1.8 mm thick and capable of
      being taped to the distal phalangeal finger pads. They were calibrated on the
      hand by pinching a strain gage dynamometer. The useful range was between 0 and 30
      N with an accuracy of 1 N for both static loading and normal dynamic grasp
      activities. The sensor time constant was 0.54 ms for a step force input. Because
      of varying offset voltages every time the sensors were attached, these sensors
      should be calibrated on the hand before each use. The sensors were used for
      measuring finger forces during controlled pinching and lifting tasks, and during
      ordinary grasping activities, such as picking up a book or a box, where the
      useful force range and response for these sensors were adequate.

PMID- 1752870
TI  - Non-interacting modes for stress, strain and energy in anisotropic hard tissue.
AB  - The six non-interacting modes for stress, strain and energy in an orthotropic
      elastic model of human femoral cortical bone tissue are discussed and
      illustrated. The stress and strain modes are illustrated using the representation
      of the stress and strain fields around a circular hole in a flat plate of
      cortical bone subjected to a uniaxial field of tension as the example. The six
      modes play a role in the stress analysis of orthotropic elastic materials similar
      to the roles played by the hydrostatic and deviatoric non-interacting stress,
      strain and energy modes in isotropic elasticity. The biomechanical significance
      of the six non-interacting modes for stress, strain and energy in hard tissue is
      both practical and suggestive. The modes suggest a practical scheme for the
      representation of stress and strain fields in hard tissue. The existence of the
      modes suggests physical insights, for example, possible failure mechanisms or
      adaptation strategies possessed by the hard tissues.

PMID- 1752871
TI  - Comments on 'The mechanical properties of the rabbit and human cornea'.

PMID- 1752872
TI  - Comments on 'Estimation of instantaneous moment arms of lower-leg muscles'.

PMID- 1752873
TI  - Etiology and control of postburn hypermetabolism: the 1991 presidential address
      to the American Burn Association.

PMID- 1752874
TI  - The burned patient's response to the environment: the 1991 Everett Idris Evans
      Memorial Lecture.
AB  - Homeostatic reflexes are believed to supply the means by which the body adapts to
      changes in the environment (posture, temperature, etc.) and, hence, it might be
      expected that their importance would increase when the body is disturbed by
      trauma. In fact, these reflexes are largely abandoned in the response to danger
      (the defense-arousal reaction), and it is only after simple fluid loss that a
      limited improvement is seen, that is, an increase in the sensitivity of the
      baroreflex. Whenever tissue damage generates nociceptive C fiber afferent
      impulses, there is serious and relatively long-lasting inhibition of the
      baroreflex and of all aspects of neural thermoregulation. Significant changes
      occur after quite moderate injuries and do not depend on any reduction in tissue
      oxygenation. In children with burns in whom early pyrexia is common, central
      thermoregulation may also be affected by cytokine pyrogens. These changes have
      implications for the management of patients with all types of injuries. However,
      further analysis is needed if we are to understand these responses and their role
      in the body's defense; without this knowledge, we shall not be able to modulate
      them effectively.

PMID- 1752875
TI  - Bactericidal and wound-healing properties of sodium hypochlorite solutions: the
      1991 Lindberg Award.
AB  - Toxic effects of sodium hypochlorite on wound healing elements have been confined
      to a restricted range of sodium hypochlorite concentrations. We investigated
      concentrations of sodium hypochlorite for antibacterial activity and tissue
      toxicity at varying time intervals. We attempted to find the efficacious
      therapeutic concentration that was both microbicidal and nontoxic. Gram-negative
      and gram-positive isolates (0.1/ml of 1 x 10(8)/ml) were introduced into various
      concentrations of buffered and unbuffered sodium hypochlorite solutions for
      determinations of bactericidal activity at 5-, 10-, 15-, and 30-minute intervals.
      Concentrations of sodium hypochlorite were 0.25%, 0.025%, and 0.0125%. In vitro
      assays with fibroblasts at the same concentrations were also performed to
      determine toxicity at the same time intervals. An in vivo incisional model was
      also used to determine the effects of sodium hypochlorite therapy on wound
      healing. Bactericidal effects were observed for concentrations as low as 0.025%.
      Tissue toxicity, both in vitro and in vivo, was observed at concentrations of
      0.25% but not at a concentration of 0.025%. Although concentrations below this
      level were nontoxic, they were not bactericidal. Therefore a modified "Dakin's"
      solution at a concentration of 0.025% is therapeutically efficacious as a fluid
      dressing, since it preserves bactericidal properties and eliminates the
      detrimental potential on wound healing.

PMID- 1752876
TI  - Effects of cimetidine on fluid requirement during resuscitation of third-degree
      burns.
AB  - Seventy percent body surface area third-degree burns were produced in four groups
      of six guinea pigs each, after which all were resuscitated with Ringer's lactate
      solution. Group 1 received 4 ml/kg/%burn. Group 2 received 1 ml/kg/%burn with
      cimetidine, which was begun at 0.5 hours after burn injury. Group 3 received 1
      ml/kg/%burn with cimetidine, which was begun at 1 hour after burn injury. Group 4
      received 1 ml/kg/%burn without cimetidine. There were no significant differences
      among any of the groups in blood pressures or heart rates during the study
      period. Group 4 showed significantly higher hematocrit values than group 2 at 4
      hours after burn injury and thereafter. The cardiac outputs of group 2 were the
      same statistically as those of group 1. The cardiac outputs of group 3 were
      significantly lower than those that received cimetidine early (group 2), though
      still higher than those of the 1 ml control group (group 4) at 4 hours after burn
      injury and thereafter. At 24 hours after burn injury, the water content of the
      burned skin of group 2 was significantly lower than that of the other groups. We
      conclude that in third-degree burns, cimetidine therapy can effectively reduce
      burn edema and the amount of required resuscitation fluid. Early administration
      is better than late administration of cimetidine.

PMID- 1752877
TI  - Reperfusion injury in burned rats after delayed fluid resuscitation.
AB  - Organ failure from ischemic injury is common in deaths that are due to burn when
      fluid resuscitation is not performed. Organ perfusion after a delay in
      resuscitation, however, may induce or even accelerate ischemic organ damage. To
      study this phenomenon, 40 rats were classified (n = 10) to serve as normal
      control, burn with no resuscitation, burn with early fluid resuscitation, and
      burn with delayed resuscitation groups. A modified Walker burn model was used to
      inflict 50% total body surface area scald burns on the rats. Cellular energy
      metabolism and tissue water content of several vital organs were measured at 8
      hours after burn injury. Adenosine triphosphate, total adenine nucleotides, and
      energy charge in liver, heart, and kidney tissues were significantly lower (p
      less than 0.05) with delayed fluid resuscitation compared with early
      resuscitation. Furthermore, in heart and kidney tissues adenosine triphosphate,
      total adenine nucleotides, and energy charge were significantly lower in the
      delayed resuscitation group compared with the group that received no fluid
      resuscitation. This indicates that heart and kidney tissue are more viable at 8
      hours after burn injury, with no fluid resuscitation compared with delayed
      resuscitation. Water content of lung and muscle tissue were significantly lower
      (p less than 0.05) in the burn group that received no fluid resuscitation
      compared with that in early and delayed resuscitation groups. Water content of
      muscle was significantly greater with delayed resuscitation compared with the
      early resuscitation group. Results indicate that delayed fluid resuscitation in
      cases of burn shock may disrupt the cellular energy metabolism in some vital
      organs and cause skeletal muscle edema.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1752878
TI  - Evaluation of erythropoietin levels in the anemia of thermal injury.
AB  - Thermal injury is associated with an anemia of multifactorial etiology.
      Erythropoietin is a hormone that increases red blood cell production in response
      to tissue hypoxia and is now being produced in a recombinant form for treatment
      of some anemias. How erythropoietin levels change in response to thermal injury
      has not been adequately investigated to date. We studied 27 patients with burns
      of 10% to 85% total body surface area by serially measuring hemoglobin,
      hematocrit, reticulocyte count, and erythropoietin levels. Erythropoietin levels
      were determined by radioimmunoassay. Measurements were taken at admission, before
      surgery, and after surgery, or at least weekly for a period of up to 4 weeks.
      Twenty-five of the patients had a reticulocytopenic anemia by the end of the
      first postburn week. Twenty-three patients remained anemic throughout the study
      period. Erythropoietin levels increased appropriately as the patients became
      anemic. Erythropoietin levels related to hemoglobin in a logarithmic fashion with
      a correlation of -0.869. No differences were found on the basis of burn size or
      age. This study indicates that the anemia of thermal injury is associated with
      reticulocytopenia and an elevation of endogenous erythropoietin.

PMID- 1752879
TI  - Microbial contamination in allografted wound beds in patients with burns.
AB  - Microbial wound contamination has been recognized as a cause of autograft skin
      graft failure. Human cadaver allograft is believed to decrease or control
      microbial wound contamination, and by its adherence to the wound bed, to indicate
      a sufficiently low microbial count to allow successful application of autograft.
      Suboptimal "take" of more fragile cultured skin grafts after removal of adherent
      allograft led us to reexamine the microbial population of these wound beds.
      Immediately before autografts were placed, wound beds beneath adherent allograft
      were biopsied for quantitative microbiologic analysis. Eighty tissue biopsy
      specimens from 21 patients were examined. No patients had signs of infection or
      sepsis at the time of biopsy. Fifty-seven percent of all patients had positive
      cultures beneath adherent allograft skin. Twenty-one percent of all cultures
      revealed "infected" wound beds (greater than 100,000 colonies per gram), and 30%
      of all wounds were "colonized" (less than 100,000 colonies per gram). These data
      suggest that take and vascularization of allograft does not guarantee that a
      wound bed is free of microbial contamination.

PMID- 1752880
TI  - The effect of ablation of the preoptic anterior hypothalamus on energy metabolism
      and plasma catecholamines after burn injury in the rat.
AB  - Rats with burn injuries demonstrate changes in thermoregulation including an
      upward shift of the set-point and reference temperatures with no change in
      sensitivity of the response in heat production to displacement of the temperature
      of the preoptic anterior hypothalamus. In the present studies, the response in
      plasma and urinary catecholamines to burn injury after destruction of the
      preoptic anterior hypothalamus was examined in the rat. Preoptic anterior
      hypothalamic lesioning impaired the hypermetabolic response to burn injury, and
      at 22 degrees C, burned lesioned rats were hypothermic. Furthermore, plasma
      levels and urinary excretion rates for catecholamines were not decreased in
      burned lesioned rats, but rather showed an inverse relationship with heat
      production. Burned lesioned rats were capable of maintaining body temperature at
      an ambient temperature of 28 degrees C. This suggests that a less precise
      thermoregulation is present in lesioned animals. Rats in which the preoptic
      anterior hypothalamus has been destroyed have reduced tolerance to burn injury.

PMID- 1752881
TI  - Ocular changes from electrical burn injuries. A literature review and report of
      cases.
AB  - One hundred fifty-nine consecutive patients with high-voltage burns were
      retrospectively reviewed to determine the ocular sequelae of these injuries. Five
      patients had ophthalmic changes (two had recurrent iritis, eight had cataracts,
      two had macular holes, and one had central retinal artery occlusion). All four
      patients with cataractous changes had characteristic anterior subcapsular
      opacifications, except for one patient who presented with a dense white opacified
      lens. All had bilateral lenticular changes in which the denser cataract developed
      earlier than the contact wound and ipsilateral to it. Central retinal artery
      occlusion has not been previously reported as a complication of electrical burns.
      Macular holes, formerly believed to be rare in these injuries, were found in two
      of the five patients. Ocular complications from electrical burn injuries are
      uncommon. Although a number of these ocular changes occur immediately after
      injury, many of the visually impairing changes develop days and even years after
      a severe electrical burn injury; thus, careful follow-up is mandated.

PMID- 1752882
TI  - Tumor necrosis factor mediates hypertriglyceridemia during thermal injury in mice
      genetically susceptible to lipopolysaccharides.
AB  - A rise in plasma triglycerides has been noted after thermal injury in a number of
      animal species including humans. In this study we identified a factor, tumor
      necrosis factor, which was responsible for increased plasma triglycerides during
      thermal injury that was induced by scalding. Two strains of mice that differed
      genetically in susceptibility to lipopolysaccharides were used. These were
      CH3HEB/HeJ (LPS-) and CH3HEB/FeJ (LPS+). A 15% total body surface area was
      burned; this resulted in an increase of plasma triglycerides of 126% of preburn
      levels in the LPS+ strain 24 hours after burn injury. No change in triglycerides
      was noted in the LPS- mice at any time after burn injury. Sera from LPS+ mice at
      1 to 2 hours after burn injury was injected into nonburned animals of the same
      strain; this caused a 62% +/- 5% increase in plasma triglycerides 24 hours after
      injection. When thermally injured LPS+ mice were injected with anti-tumor
      necrosis factor-alpha at 1 hour after injury, they did not show a rise in plasma
      triglycerides at any time between 24 to 72 hours after injury. Hepatic secretion
      of triglycerides was also measured 1 day after burn; the average secretion of
      triglycerides was significantly reduced (2.69 +/- 0.36 mg/kg/hr, compared with
      3.83 +/- 0.15 mg/kg/hr for the control). We conclude that tumor necrosis factor,
      a cytokine that inhibits lipoprotein lipase, causes hypertriglyceridemia during
      thermal injury in spite of a decreased secretion of triglycerides. This is the
      first report that demonstrates that hypertriglyceridemia that is secondary to
      thermal injury is induced by tumor necrosis factor.

PMID- 1752883
TI  - Treatment for depigmentation resulting from burn injuries.
AB  - A new surgical technique to "repigment" skin that has been depigmented by deep
      partial-thickness burn injuries has been developed and proven to be successful.
      Partial-thickness burn injuries frequently heal with pigmentary changes.
      Occasionally, permanent depigmentation is observed, especially in areas such as
      the hands and fingers. This article reports our surgical technique and our
      success in using it to treat depigmentation after burn injuries. This new
      technique consists of superficial dermabrasion of the depigmented region,
      followed by transplantation of melanocytes via epithelial grafts. With this
      technique, 15 separate surgical procedures have been performed on 11 patients.
      The follow-up period for these patients has ranged from 0.5 months to 94 months,
      with an average of 14 months. The skin-graft take has been excellent in all
      patients. The color match ranges from good to excellent. No complications have
      been observed, and this procedure has consistently and reliably improved the
      disfigurement from depigmentation after these burn injuries.

PMID- 1752884
TI  - Immunoglobulin synthesis by cultured lymphocytes from spleen and mesenteric lymph
      nodes after thermal injury.
AB  - A 30% burn injury has been previously reported to impair mitogenic response of
      splenocytes to a B-lymphocyte mitogen and to affect serum levels of serum class
      specific immunoglobulin. To further investigate the effect of burn injury on the
      function of B lymphocytes in gut-associated and systemic immune tissues, we
      studied class-specific immunoglobulin synthesis by cultured lymphocytes from
      spleen and mesenteric lymph nodes after burn injury in rats. Male Lewis rats
      received 30% full-thickness burn injuries, and 4 days later, the animals were
      killed to remove spleen and mesenteric lymph nodes. The cells from spleen and
      mesenteric lymph nodes were cultured for 5 days with 25 micrograms/ml of
      lipopolysaccharide. Concentrations of immunoglobulin G (IgG), IgM, and IgA in the
      supernatant of each well were then measured with enzyme-linked immunosorbent
      assay for class-specific immunoglobulin. Synthesis of IgG by lymphocytes from
      spleen was statistically significantly impaired by burn injury (p less than
      0.05), but synthesis of IgG by lymphocytes from mesenteric lymph nodes was not
      affected. There were no significant differences in IgM and IgA synthesis by
      lymphocytes from spleen between burned animals and controls. The immunoglobulin
      synthesis in mesenteric lymph nodes did not differ significantly in burned
      animals compared with controls. The impaired IgG synthesis by lymphocytes from
      spleen may contribute to increased risk of infection after burn injury.

PMID- 1752885
TI  - Conservative treatment of scald burns is superior to early excision.
AB  - Early excision of deep burns has been advocated; however, it is difficult to
      clinically determine the depth of scald burns during the early postburn period.
      This prospective, randomized study was designed to determine whether early
      excision was superior to conservative treatment of scald injuries. Patients with
      scald injuries (which were not caused by grease) of clinically indeterminant
      depth were randomized to early (n = 12) or late (n = 12) excision; all patients
      with obvious superficial and full-thickness injuries were excluded. In the early
      excision group, all deep wounds were tangentially excised and grafted within 72
      hours of admission, whereas in the late treatment group wounds were excised and
      grafted after 2 weeks had passed since injury. Area excised, postburn day of
      excision, percent graft take, operating-room time, blood replacement, incidence
      of infection, and length of hospital stay were compared. No patient experienced a
      significant wound infection or systemic sepsis. A significantly smaller area of
      excision was necessary for those patients who were treated with delayed surgery,
      and concomitant decreases in operating-room time and blood loss were observed.
      Notably, only one half of the patients who were randomized to the delayed
      excision group ultimately required surgical intervention to achieve wound
      closure. Graft take was comparable for both groups, as was length of hospital
      stay. Early clinical evaluation of scald injuries appears to be equivocal, and
      later evaluations reveal a less severe injury. Financial gains can be made when
      surgical excision of scald injuries is delayed until 2 weeks after injury because
      of a related reduction in hospital expenditures.

PMID- 1752886
TI  - Stroke prevention during carotid surgery in high risk patients (value of
      transcranial Doppler and local anesthesia).
AB  - In a series of 114 cases, carotid surgery was performed under local anesthesia by
      cervical block in order to assess cerebral status. Preoperative transcranial
      Doppler was used to select high risk patients for shunting. Intraoperatively
      brain function was checked by carotid arterial blood pressure monitoring and
      transcranial Doppler. No stroke occurred during the procedure. Postoperatively
      two deaths (1.8%) occurred, one due to intracerebral hemorrhage and one to a late
      myocardial infarct. The predictive value of both transcranial Doppler and stump
      pressure monitoring for shunting was 97% respectively. In combination, the two
      methods provided 100% protection. During the same period, 1406 patients underwent
      carotid surgery under general anesthesia. Carotid surgery stroke can be prevented
      either by using transcranial Doppler together with carotid stump pressure
      monitoring when the procedure is performed under general anesthesia or by
      operating under local anesthesia.

PMID- 1752887
TI  - Morbidity and mortality following carotid surgery.
AB  - The records of 920 patients who underwent carotid endarterectomy by the same
      surgeon (M. D'A) between 1976 and 1989 were reviewed. Particular attention was
      paid to both the neurological and general complications and to how and when the
      neurological symptoms appeared. Among these patients, a cumulative stroke plus
      death rate of 3.1% was observed. Complications were classified as clamping
      ischemia (2.2%), postoperative embolism (1.5%), postoperative thrombosis (2.4%),
      and cerebral haemorrhage (0.3%). Two patients (0.2%) died from myocardial
      infarction. In 3.5% of patients, neurological symptoms were transient. The
      incidence of clamping ischemia was higher when 40 mmHg was considered as the
      safety limit of the back-pressure; this incidence fell by raising this limit to
      50 mmHg, and introducing, in recent years, SEPs monitoring. Intraoperative
      monitoring of SEPs, in fact, reduced the neurological complications to 1.4%,
      while intraoperative angiography reduced the need for intraoperative reoperation
      from 10% to 2%. The use of antiplatelet drugs and an accurate surgical technique
      are useful steps in the prevention of postoperative embolism or thrombosis.

PMID- 1752888
TI  - Results of carotid endarterectomy in patients 75 years of age and older.
AB  - From April 1980 to September 1989, 69 patients over 75 years of age (mean 78
      years, range 75 to 86) underwent 81 carotid endarterectomies. Twenty three
      percent were asymptomatic, 56.5% had symptoms appropriate to lesion location and
      20.5% had a non hemispheric syndrome. Nine patients required an associated
      procedure (combined cardiac surgery 6 pts; vascular surgery 3 pts). Perioperative
      mortality was 3.7%. The combined early lethal and non lethal stroke rate was
      6.1%. Actuarial survival, at 10 years, was 58.4% +/- 10, and the incidence of
      freedom from stroke at 10 years was 86.2% +/- 5. Despite the fact that the
      hospital mortality of patients over 75 years undergoing carotid endarterectomy is
      more than three times that of patients operated on under 75 years of age (1.2%),
      the combined stroke and neurologic mortality rate is similar to that of patients
      under 75 years (5.3%). Carotid surgery in patients over 75 years of age does not
      increase life expectancy but does improve the quality of survival which depends
      mainly on cardiac events.

PMID- 1752889
TI  - Inflammatory abdominal aortic aneurysms: does an early stage exist?
AB  - Inflammatory aneurysms are characterised by a peculiar clinical (i.e. abdominal
      lumbar pain, weight loss and increased ESR) and morphological picture (whitish
      wall, adhesion to the surrounding organs and thickness greater than 0.5 cm). The
      lymphomonoplasmacellular infiltrate and the interstitial deposits of collagen
      define the histological picture of these lesions. The authors describe three
      abdominal aortic aneurysms macroscopically characterised by parietal edema,
      hyperemia and hypertrophy of the preaortic lymphnodes. Histological study
      revealed a conspicuous and widespread lymphomonoplasmacellular infiltrate and
      interstitial edema. The abdominal-lumbar pain, the increase in ESR and the
      reactive C protein defined the clinical and laboratory aspects. Serological tests
      for syphilis, rheumatoid arthritis and lupus erythematosis were negative. The
      question which arises from these observations is whether these forms represent
      separate entities or an early stage in the evolution of inflammatory abdominal
      aortic aneurysms with fibrosis.

PMID- 1752890
TI  - Randomized placebo-controlled, double-blind trial of ketanserin in treatment of
      intermittent claudication.
AB  - Ketanserin, a selective serotonin (5-HT) antagonist at 5-HT2 receptors, was
      investigated in a 12-month, double-blind placebo-controlled study in 35 patients
      with intermittent claudication. Benefit was assessed by repeated treadmill tests,
      recording claudication distance, and by measurement of Doppler ankle-brachial
      pressure indices (ABPI) and pulse volume recordings (PVR). Improvement in
      claudication distance of 42-44% was noted during the 12 months of the double
      blind study and this trend continued to 53-67% during an additional 3 month run
      out period on placebo. There were no significant differences between the group
      given Ketanserin and the placebo group. The hemodynamic measurements demonstrated
      no statistically significant change in either ABPI or PVR throughout the study
      period, and no significant differences between the two groups. The conclusion of
      the study indicates that Ketanserin is ineffective in the treatment of
      intermittent claudication.

PMID- 1752891
TI  - 99mTc-HSA lymphoscintigraphy and leg edema following arterial reconstruction.
AB  - Twelve patients with peripheral arterial occlusive disease were evaluated
      prospectively in an effort to further investigate the etiology of pedal and lower
      leg edema that occurs following revascularization (e.g., aorto-iliac or
      femoropopliteal bypass). Serum total protein, albumin, blood urea nitrogen, and
      creatinine levels were measured (in addition to peripheral venous pressure), and
      lymphoscintigraphy of the lower leg was performed. These parameters were assessed
      just prior to surgery, four weeks postoperatively, and again at follow-up. The
      serum levels obtained four weeks after surgery and on subsequent follow-ups were
      significantly higher than the preoperative values. Preoperative peripheral venous
      pressure was not significantly different from that obtained after surgery. There
      was no correlation between these pressure measurements and the degree of edema
      (Grades I to IV correspond to increasing degrees of severity). For both the
      supine and upright positions, lymphoscintigraphic counts in the inguinal region
      were significantly higher after surgery. However, the relative increase was
      dependent upon the severity of edema. The postoperative lymphoscintigraphic count
      in the upright position was 77 +/- 33 CPS in patients with Grades I and II edema
      (n = 6) and 20.6 +/- 16.2 CPS in patients with Grades III and IV edema (n = 10)
      (p less than 0.01). Thus, a lesser degree of postoperative pedal and lower leg
      edema was associated with higher lymphoscintigraphic counts. We conclude that
      major contributors to the development of lower extremity edema following arterial
      reconstruction are failed capillary hydrostatic pressure and interrupted
      lymphatic drainage.

PMID- 1752892
TI  - Intravenous digital subtraction angiography in the management of peripheral
      vascular disease.
AB  - All patients undergoing peripheral injection intravenous digital subtraction
      angiography (ivDSA) for peripheral vascular disease during 1987 have been
      reviewed (140 patients). The radiological distribution of disease was aorto-iliac
      occlusive (AI) 36 (23%), femoropopliteal (FP) 68 (44%), mixed AI/FP 36 (23%).
      Clinical diagnosis was correct for AI disease in 92%, for FP disease in 65% and
      for mixed AI/FP disease in 47%. ivDSA was the only investigation required for
      management in 111 of all 140 patients (79%), and in 33 of the 36 patients with AI
      disease (92%), but was less accurate in defining femoropopliteal disease, 22
      patients (32%) requiring additional arteriography. Conventional arteriography was
      performed in 200 patients in 1982 compared with 100 in 1987. ivDSA is
      particularly suitable for the investigation of AI disease, a condition which is
      accurately detected by clinical examination, with a reduction in morbidity and
      bed occupancy.

PMID- 1752893
TI  - Major stump trauma following below-knee amputation. Outcome and recommendations
      for therapy.
AB  - Injury to the stump of a below-knee amputation (BKA) may require revision to a
      higher level of amputation. We undertook a retrospective review of BKAs performed
      during a 14-year period. Twenty-three patients suffered trauma to their stumps.
      Most (80%) trauma resulted from a fall. The severity of the trauma was graded on
      a three-part scale. Operative reclosure was attempted in 8 cases with 2
      successes. Closure by secondary intent was successful in 7 of the 12 attempts. A
      total of 11 patients had revision to above-knee amputation (AKA) as the final
      outcome. The severity of trauma correlated inversely with the likelihood of
      eventual stump salvage. We conclude that primary reclosure or closure by
      secondary intent should be considered, since in 53% of attempts this results in
      knee preservation. Analysis of noninvasive vascular testing prior to the BKA was
      not helpful in predicting successful salvage of traumatized stumps.

PMID- 1752894
TI  - A self-retaining retractor for improved exposure of the infrarenal abdominal
      aorta.
AB  - A simple method of achieving better exposure of the infrarenal abdominal aorta
      during aortoiliac surgery is reported. Once the aorta is exposed, the peritoneum,
      retroperitoneal fat and the inferior vena cava are spread by an orthostatic
      retractor, of a Weilaner type, modified by the author, to meet this particular
      requirement.

PMID- 1752895
TI  - The retroperitoneal approach to aortic surgery associated with horseshoe kidney.
AB  - The horseshoe kidney is a rare anomaly that can significantly complicate aortic
      surgery. A bulky isthmus, abnormalities of renal anatomy, and a variable blood
      supply associated with a horseshoe kidney can pose technical difficulties in
      terms of aortic reconstruction. The left retroperitoneal approach affords an
      excellent exposure of the abdominal aorta in patients with a horseshoe kidney
      without dividing the renal isthmus and avoids the risk of injury to a ureter in
      an anomalous location. This is a case report of a patient with a horseshoe kidney
      who underwent a successful repair of an abdominal aortic aneurysm by a left
      retroperitoneal approach.

PMID- 1752896
TI  - Successful surgical treatment of aneurysm of the suprarenal abdominal aorta.
AB  - We report the successful surgical resection of a saccular aneurysm of the
      suprarenal abdominal aorta adjacent to the origin of the superior mesenteric
      artery. Reconstruction of the superior mesenteric artery with the splenic artery
      was a useful technique for salvaging the ischemic small intestine. However,
      successful surgical treatment of this type of aneurysm remains a great challenge.

PMID- 1752897
TI  - Abdominal aortic coarctation inducing aortic occlusion and renovascular
      hypertension.
AB  - Abdominal aortic coarctation is a rare, non-atherosclerotic disease. It is a
      functionally significant at an early age when associated with aortic branch
      stenosis and renovascular hypertension. The pathogenesis of aortic constrictive
      lesions remains unknown, but may be related to developmental error or aortic
      growth arrest and various hypotheses have been reported. When the renal arteries
      are involved by the coarctation, severe hypertension is common at an early age
      and in untreated patients, life-threatening complications commonly occur.
      Patients who reach the age of 40 years generally have the coarctation below the
      renal arteries but even when the renal arteries are not involved by the
      coarctation, renovascular disease may still occur due to secondary
      atherosclerosis. Aortic thrombosis secondary to abdominal aortic coarctation with
      renovascular disease and lower limb ischemia, occurring in a 63-year old woman,
      is reported.

PMID- 1752898
TI  - A case of congenital hypoplasia of the right external iliac artery.
AB  - A 18 years male had congenital hypoplasia of the right external iliac artery and
      thrombosis of its narrowest part. Congenital megacolon, anal atresia and
      hyposomical nanism were also present. Surgical intervention was indicated because
      he was developing arterial insufficiency and muscular hypotrophy of the right
      leg. A bypass was performed with a reversed autogenous vein between the common
      iliac artery and the common femoral artery.

PMID- 1752899
TI  - Giant retroperitoneal pelvic hemangiopericytoma.
AB  - Hemangiopericytoma is a rare soft tissue sarcoma, comprising less than one
      percent of all vascular neoplasms. This report describes a 75-year-old man with a
      very large malignant retroperitoneal hemangiopericytoma that was successfully
      excised. The tumor measured 23 cm in its greatest dimension and, as such, is the
      largest malignant hemangiopericytoma reported to date. The clinical and
      pathologic features of this lesion and a review of the literature are presented.

PMID- 1752900
TI  - Postlaminectomy arteriovenous fistula: the Brazilian experience.
AB  - Arteriovenous fistula is an infrequent complication of lumbar disc surgery. It is
      often not suspected, and the symptoms are diagnosed as deep venous thrombosis or
      heart failure. As a result of our review of the Brazilian literature and a survey
      of 3,500 Brazilian physicians, 5 cases of post-laminectomy arteriovenous fistula
      are added to the literature. A review of these cases shows that: (1) the right
      common iliac artery was injured in most cases, (2) the vena cava was frequently
      injured, and (3) direct repair was possible when the vena cava and the aorta were
      injured. A vascular prosthesis was necessary when the iliac arteries were
      damaged. The correct diagnosis is usually made by detection of an abdominal bruit
      in a patient with a history of lumbar disc surgery and is confirmed by
      arteriogram. Surgical treatment, either by suture or bypass, is the treatment of
      choice and results in cure.

PMID- 1752901
TI  - Combined surgical approach to coexistent carotid and coronary artery disease.
AB  - Combined coronary artery bypass and carotid endarterectomy were performed in 52
      patients (mean age 61 years) between 1981 and 1990. Of these, 36 (69%) had
      functional class III-IV angina pectoris, 33 (63%) had triple-vessel disease, 36
      (69%) had one, or more, previous myocardial infarctions, and 33 (63%) had an
      abnormal left ventricular function. In 4 cases, additional cardiac procedures
      were performed. Asymptomatic carotid stenosis was documented in 29 patients (56%)
      and the remaining 23 (44%) had experienced cerebrovascular symptoms. All patients
      had hemodynamically significant stenosis of at least one carotid artery, 17 (33%)
      had severe bilateral carotid artery stenosis, and 6 (11%) had an additional
      occlusion of the contralateral internal carotid artery. There were no early
      deaths. Perioperative morbidity included: myocardial infarction in 4 patients
      (7.7%) and neurological deficit in 3 (5.7%) but functional impairment was not
      permanent. Late results have been obtained for all 52 patients at a mean
      postoperative interval of 35 months. Four patients (7.7%) have died, and the 5
      year life-table survival rate was 83%. At five years, actuarial curves showed 67%
      of patients to be free of all serious events or death. Late mortality and
      morbidity were related above all to the progression of the coronary artery
      disease. We concluded that simultaneous endarterectomy of significant carotid
      artery stenosis in candidates for coronary bypass can be done safely and
      considered as more practical for the patient.

PMID- 1752902
TI  - Long term results of cardiac valve replacement in patients aged 75 years and
      older.
AB  - From June 1978 to December 1989, 158 patients over 75 years of age (mean: 78
      years; range 75 to 86 years) underwent 164 valve replacements: 134 in the aortic,
      18 in the mitral and 6 in double mitral and aortic positions. One hundred and
      seven of these valves (66%) were bioprostheses, 93 aortic and 14 mitral and 57
      valves (34%) were mechanical prostheses; 47 aortic and 10 mitral. Hospital
      mortality (less than or equal to 30 days) was 7% (11 patients, all in NYHA class
      III or IV) but was higher in patients who had undergone associated procedures
      (9.8%; 6/61 patients) or in patients who had mitral valve replacements (11%) and
      in double valve replacement (16.6%). Because of a minimal delay of one year, long
      term follow-up information (100%) was only obtained from the first 110 patients
      discharged from hospital. Late mortality has been 13.6% and actuarial survival at
      11 years was 71.5% +/- 5. Therefore, despite a hospital mortality of more than
      twice that of patients operated upon under 75 years of age (3.3%), an actuarial
      survival at 11 years, similar to that of patients under 75 years (77 +/- 5%) and
      the functional improvement obtained (95% of survivors are NYHA class I or II)
      certainly justify surgery in these patients. Because of the incidence of
      anticoagulant related hemorrhages in these patients (1.7% patient year) and
      since, structural deterioration of the bioprostheses was non existent in this
      series, a bioprosthesis appears to be the best valvular substitute in patients
      over 75 years of age.

PMID- 1752903
TI  - Bioprosthetic valve endocarditis: factors affecting bad outcome.
AB  - Prosthetic valve endocarditis (PVE) remains an uncommon but serious complication
      of cardiac valve replacement. We analysed several risk factors (active or healed,
      early or late endocarditis, congestive heart failure, arterial emboli etc.) in
      order to identify the factors which may predict bad outcome. The overall
      mortality rate was 46.8% (15/32 patients). There was a significantly higher
      mortality rate in patients with early endocarditis (80%) than in those with late
      endocarditis (38%) (p less than 0.01). In the group of patients who underwent
      reoperation, the mortality rate was higher in those with active endocarditis
      (70%) than in those with healed endocarditis (28.5%) (p less than 0.05). We
      believe that combined medical and surgical treatment is the best management for
      bioprosthetic valve endocarditis, with the institution of appropriate
      preoperative antibiotic therapy, to attempt to achieve sterilization.

PMID- 1752904
TI  - Clinical results with the Biocor porcine bioprosthesis.
AB  - In order to evaluate our clinical results with the use of the Biocor prosthesis,
      a total of 1,101 patients were studied. Follow-up was from 1 to 96 months (mean
      48); cumulative follow-up in the aortic group (385 patients) was 1,230 patient
      years and in the mitral group (716 patients) 3,018 patient years. Mitral patients
      had 102 late complications (14.24%), and aortic patients had 51 (13.2%). A total
      of 220 patients were under 20 years of age (176 mitral, 44 aortic). Intrinsic
      valve failure in this subgroup was found in 43% of mitral patients and 29% of
      aortic patients. Prosthetic endocarditis was more frequent in the aortic group
      (45%) than in the mitral group (29.9%). Sixty-two patients were reoperated, with
      a hospital mortality of 12.6%. Reoperation was more frequent in the mitral group
      and in patients under 20 years of age. The actuarial curve free mortality related
      to the bioprosthesis was 97.1% (32 patients). At the 8-year follow-up, 96.9% of
      the aortic versus 95.2% of the mitral group were free of valve dysfunction, and
      the majority were in Classes I or II of the New York Heart Association (NYHA)
      classification. The incidence of reoperation, although significant, is
      acceptable, especially since the bioprosthesis offers a safer alternative than
      mechanical prostheses followed for similar periods. Analysis of our results
      suggests the need for continued research for an ideal bioprosthesis.

PMID- 1752905
TI  - Epilepsy and cardiac surgery.
AB  - The complex and sometimes severe metabolic, haemodynamic or blood modifications
      induced by cardio-pulmonary bypass (CPB), can result in alteration of cerebral
      electrogenesis and even in epileptic paroxyms. Nineteen epileptics (EP) and 41
      risk patients (PR), 31 with a family history of epilepsy (FHE) and 10 prone to
      epilepsy (PPE) were operated upon under CPB; 6 of the EP and 2 of the PPE had
      abnormal but no paroxymal EEG features during operation. None of the other EP or
      PR showed any epileptic abnormalities. It seems that normothermia, light
      haemodilution and elimination of neuroleptic drugs for analgesia prevent per and
      post-operative epileptic paroxysms.

PMID- 1752906
TI  - Failure of cryopreserved saphenous vein allografts following coronary artery
      bypass surgery.
AB  - Internal mammary arteries and saphenous vein grafts are the most satisfactory
      conduits for coronary artery bypass. However, at times these conduits are not
      available, due to previous use or poor quality. This paper reports our experience
      with 6 patients who underwent coronary artery bypass operations using 10
      cryopreserved saphenous veins and internal mammary arteries. Postoperative graft
      patency was assessed with ultra fast computed tomography or cardiac
      catheterization. At operation, venous graft patency was 100% (10/10), at 1-8
      weeks was 60% (6/10), and at 6-30 months was 0% (0/9). Alternately, all seven
      internal mammary artery grafts were patent at 2 to 18 months following surgery.
      One patient died 6 months following operation. Poor graft patency may be related
      to destruction of the cellular components or fibrosis resulting from the
      cryopreservation process or from immunologic factors. Because of poor patency
      compared to autologous conduits, we conclude the use of cryopreserved saphenous
      veins for coronary artery bypass should be severely restricted.

PMID- 1752907
TI  - Cardiac myxomas: results of surgical treatment.
AB  - Nineteen patients with cardiac myxoma were seen at Allegheny General Hospital
      from November 1974 to December 1990. Eighteen underwent operative removal, 9
      females and 9 males; age range was 29-81 (mean 55). There were 18 operations for
      removal of a total of 24 myxomas. Fifteen patients had single myxomas and 3 had
      multiple myxomas. Of the 3 patients with multiple myxomas, 2 were familial. One
      patient had a metastatic recurrence intracranially. Perioperative mortality was 1
      of 18 (5.5%). Operative morbidity was 12 of 18 (66.6%). Three patients required
      permanent pacemakers postoperatively (16.6%). Follow-up is complete and 15 of 17
      patients (88%) are alive at a mean follow-up interval of 66.6 months (range 3-196
      months).

PMID- 1752908
TI  - Transesophageal echocardiography in the surgical management of renal cell
      carcinoma with intracardiac extension.
AB  - Renal cell carcinomas may extend into the vena cava and the tumor thrombus
      occasionally involves the right atrium. The operative approach depends upon
      precise preoperative and intraoperative staging and thrombus localization. We
      report a case of renal cell carcinoma with complete inferior vena caval and
      hepatic vein occlusion with tumor extension into the right atrium.
      Preoperatively, transesophageal echocardiography provided superior images of the
      tumor and its extension, and intraoperatively allowed continuous monitoring of
      cardiac function and the removal of tumor from the atrium and inferior vena cava.
      Its use obviated the need for more costly and invasive preoperative and
      intraoperative procedures.

PMID- 1752909
TI  - Mitral valve replacement in a patient with idiopathic thrombocytopenic purpura:
      preoperative treatment with danazol.
AB  - A 64-year-old woman with refractory idiopathic (autoimmune) thrombocytopenic
      purpura required urgent mitral valve replacement. Preoperative therapeutic
      interventions to raise dangerously low platelet counts were unsuccessful until
      danazol therapy was institued. Danazol therapy was associated with elevation of
      the platelet count to greater than 125 x 10(9)/L and allowed successful mitral
      valve replacement and left atrial thrombectomy to be performed. Postoperative
      bleeding was average and blood product replacement was not excessive. This case
      of mitral valve disease in a patient with idiopathic (autoimmune)
      thrombocytopenic purpura is unique, because perioperative hemostasis was
      accomplished using danazol and splenectomy was not required.

PMID- 1752910
TI  - Professional oaths--pharmacy can lead the way.

PMID- 1752911
TI  - Holism.

PMID- 1752912
TI  - The stability of four catecholamines in 5% glucose infusions.
AB  - The stability of adrenaline, noradrenaline, dopamine and dobutamine in 5% glucose
      infusion minibags stored at 5 degrees C was determined. Results indicated that
      noradrenaline (16 and 40 mg/l) and dobutamine (1 and 5 g/l) were relatively
      stable with t/95% values in excess of 30 days. Adrenaline and dopamine were less
      stable. The t/95% values were approximately 20 and 14 days respectively.

PMID- 1752913
TI  - Stability of cefuroxime axetil in suspensions.
AB  - Cefuroxime axetil is a mixture of two equally active isomers (50% each). A
      stability-indicating high-pressure liquid chromatography method for the
      quantification of cefuroxime axetil has been developed. The method is accurate,
      precise and reproducible. The percentage, relative standard deviation based on
      six injections was 1.2. Using the developed method, the chemical stability of
      cefuroxime axetil suspensions has been determined in three vehicles containing
      sugar and two without sugar. The results varied widely in the vehicles without
      sugar (up to +/- 31%). In the viscous vehicles containing sugar, the variations
      in the results were only up to +/- 6%. The cefuroxime axetil in these suspensions
      was stable up to 28 days when stored at 5 degrees C. In addition, pH values were
      stable and the physical appearances of the samples did not change.

PMID- 1752914
TI  - Comparative pharmacokinetics of temazepam Gelthix and liquid-filled soft gelatin
      capsules.
AB  - An open, randomized, cross-over study involving 24 healthy volunteers, shows that
      a novel formulation of temazepam (temazepam Gelthix, TG) in soft gelatin capsules
      designed to resist i.v. abuse has a similar pharmacokinetic (P-K) profile to that
      of a liquid-filled, reference formulation (TL) when administered as a single oral
      dose of 20 mg. The relative bioavailability of the two formulations assessed in
      terms of the area under the time versus plasma concentration profile (AUC),
      although statistically different (P less than 0.05), is well within the
      acceptable 80-120% limits for bioequivalence. Although the mean Cmax for TG
      (616.6 ng/ml) is lower than for TL (707.9 ng/ml) and the median time to reach
      Cmax (Tmax) is 40 min (TG) vs. 30 min (TL), there is no significant difference
      between TG and TL either in their absorption constant (Ka) (0.123 vs. 0.138 min-1
      respectively) or their distribution (a) (29.5 vs. 32.4 min) and elimination
      (beta) (6.3 vs. 6.6 h) half-lives (t1/2). Thus the essential P-K characteristics
      for the use of temazepam as a hypnotic and premedicant, specifically a rapid rise
      followed by a prompt fall in blood levels, are conserved by the Gelthix
      formulation.

PMID- 1752915
TI  - Captopril and hydrochlorthiazide--a safe antihypertensive for use in general
      practice?
AB  - The combination of captopril and hydrochlorthiazide was assessed in 15
      hypertensive patients in a general practice setting. The first aim was to
      determine whether the fall in blood pressure, noted after the first dose of an
      ACE inhibitor given alone, became unacceptable when the drug was given with a
      diuretic. The second aim was to assess the impact of the ACE inhibitor on the
      biochemical abnormalities associated with thiazide diuretic therapy. The drug
      combination markedly reduced blood pressure but not below 110 systolic after the
      first dose. In the long-term the treatment significantly lowered blood pressure
      but did not produce any significant or clinically relevant changes in serum
      chemistry.

PMID- 1752916
TI  - Liquid oxygen contaminants--increase in concentration during use of domiciliary
      liquid oxygen medical systems.
AB  - The quality of liquid oxygen in domiciliary medical systems used for oxygen
      therapy was investigated during the emptying cycle under simulated breathing
      conditions. The increase in the levels of contaminants during the use of these
      systems was evaluated by gas chromatography and two sampling methods. The quality
      of liquid oxygen from storage tanks located in hospitals and in the production or
      in distribution plants was also investigated.

PMID- 1752917
TI  - Comment on the statistical evaluation of data.
AB  - This paper represents a plea for a more professional approach to the statistical
      evaluation of data contained in biological research papers. On the one hand more
      attention needs to be given to ensuring that statistically rigorous methods are
      employed; the use of sophisticated methods is now a possibility due to the wide
      availability of statistical computer packages. Examples are presented of some
      interesting applications of the multivariate techniques Cluster Analysis and
      Principal Component Analysis, the data being drawn from early research work into
      in-vitro fertilization.

PMID- 1752918
TI  - Anisotropic crystalline microstructures in dendritic arborizations of dried mid
      cycle cervical mucus: surface morphology and crystallographic study.
AB  - Studies using scanning electron microscopic techniques permitted characterization
      of the nature and structure of the anisotropic elements present in dried
      preparations of mid-cycle cervical mucus. Sodium and potassium sulphates were
      located in the dehydrated matrix either isolated or bound to the dendrites.
      Depending on crystallization conditions, they appeared as well-formed individual
      crystals or as spherulites.

PMID- 1752919
TI  - Epidermal growth factor in human endometrium: proliferative effects in culture
      and immunocytochemical localization in normal and endometriotic tissues.
AB  - Endometrial proliferation is stimulated by oestradiol. The precise mechanism is
      poorly understood, but may be mediated by epidermal growth factor (EGF). The aim
      of the present study was to assess the effects of oestradiol and EGF on glandular
      and stromal proliferation in human endometrial cell cultures, and to determine
      the localization of EGF-like immunoreactivity (EGF-IR) using immunocytochemistry
      in normal and endometriotic tissue. Endometrium was obtained from women
      undergoing curettage or hysterectomy for benign disease, or laparoscopy for
      endometriosis. For tissue culture experiments, enriched glandular and stromal
      cells were prepared by digestion with collagenase and DNAase, and cultured for 4
      days with oestradiol or EGF, both alone and in combination. Immunocytochemical
      studies were performed using sheep primary antibody against EGF, with binding
      visualized using the unlabelled antibody--enzyme method. In combination,
      oestradiol and EGF increased mean cell counts from 1.15 +/- 0.06 and 1.36 +/-
      0.05 x 10(5)/ml to 1.68 +/- 0.1 (+46%) and 1.94 +/- 0.16 (+43%) x 10(5)/ml, in
      proliferative and secretory gland preparations respectively (n = 10, P less than
      0.01). No effect was seen in stromal cell preparations; however the stimulation
      in gland preparations was further augmented after the addition of stromal
      conditioned medium. EGF-IR was detected in endometrium from normal women, and in
      normal and ectopic endometrium from women with endometriosis. EGF-IR was seen in
      glands and stroma and was not related to the phase of the menstrual cycle. EGF
      may play a role in the oestrogen-stimulated proliferation of normal and
      endometriotic endometrium.

PMID- 1752920
TI  - Reevaluation of the roles of luteinizing hormone and follicle-stimulating hormone
      in the ovulatory process.
AB  - Circulating levels of luteinizing hormone (LH) are essential for the production
      of steroid hormones that regulate the timing of ovulation and target tissue
      responses, as well as maintenance of the corpus luteum and therefore early
      pregnancy. Clinical and basic science observations show that elevated levels of
      serum LH during the follicular phase of the menstrual cycle are not only
      unnecessary for follicular maturation but are deleterious to normal reproductive
      processes. These elevations may occur as a result of administration of exogenous
      LH or through an endogenous pathological process (i.e. polycystic ovarian
      disease, PCOD). Resting levels of LH, synergizing with locally produced IGFs,
      inhibin and perhaps other growth factors, are adequate for normal follicular
      growth and steroidogenesis. Elevations in serum LH above these resting levels may
      result in increased androgen production that diminishes follicular function and
      reduces early embryo viability. Elevated LH levels during the preovulatory period
      may also negatively influence post-ovulatory events such as conception and
      implantation. With these facts in mind, the best results for ovulation induction
      would be expected with purified follicle-stimulating hormone (FSH) administration
      to women following gonadotrophin releasing hormone (GnRH) down-regulation. It is
      hoped that this review provides the reader with an analysis of the complex series
      of events that regulate normal follicular maturation. The reevaluation of the two
      cell-two gonadotrophin theory suggests that during the preovulatory period,
      resting levels of LH are adequate for normal follicular maturation. Indeed,
      overstimulation of the ovary with excessive amounts of LH may diminish the
      ability of that target organ to produce fertile ova.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1752921
TI  - Salivary progesterone measurements reveal corpus luteum defects which respond
      poorly to hormonal treatments in operated mild and moderate endometriosis.
AB  - Thirty-five women who had been operated on for mild or moderate endometriosis
      were evaluated through 40 menstrual cycles by daily measurements of salivary
      progesterone concentrations. As controls, 17 women with normal ovulatory cycles
      and no endometriosis were studied. In the endometriosis group, 22 cycles were
      unstimulated, seven were stimulated by clomiphene citrate and 11 with clomiphene
      citrate, human menopausal gonadotrophin and human chorionic gonadotrophin. A
      variety of aberrations in profiles of salivary progesterone secretion was
      detected in all the groups of endometriosis patients and the frequency of normal
      cycles was significantly lower than in controls (14-18% versus 82%, P less than
      0.01). The response to the treatments varied greatly within the groups. In
      conclusion, the present data demonstrate that patients with endometriosis have a
      variety of defects in the menstrual pattern of salivary progesterone secretion
      and that their corpus luteum function responds poorly to stimulatory treatments.

PMID- 1752922
TI  - Clinical use of growth hormone-releasing factor for induction of superovulation.
AB  - A consistent body of in vivo and in vitro evidence suggests that insulin-like
      growth factor-I (IGF-I) and possibly growth hormone (GH) play a stimulatory role
      in the regulation of the ovarian follicular cycle. Administration of GH in
      protocols of induction of superovulation gave promising results. In the present
      study, 10 patients with a previously normal response to gonadotrophins were
      administered s.c. GH-releasing factor (GRF) combined with gonadotrophins for
      superovulation induction in an in-vitro fertilization/embryo transfer-gamete
      intra-Fallopian transfer (IVF/ET-GIFT) programme. Administration of GRF was
      followed by shortening of the stimulatory cycle and reduction of the total number
      of gonadotrophin ampoules utilized per patient relative to a previous stimulatory
      cycle with gonadotrophins alone. A significant increase of both follicular fluid
      IGF-I levels (compared to the previous cycle) and plasma GH levels immediately
      following GRF administration throughout the GRF cycle suggest that GRF supported
      the ovarian response to gonadotrophins through stimulation of the GH-IGF-I axis.
      A possible direct effect of GRF is discussed. Before employing GRF for
      superovulation in infertile patients, the pituitary GH response to provocative
      stimuli should be evaluated on an individual basis.

PMID- 1752923
TI  - Peritoneal fluid volume and levels of steroid hormones and gonadotrophins in
      peritoneal fluid of normal and norethisterone-treated women.
AB  - Peritoneal fluid and blood samples were collected at surgical sterilization from
      30 untreated women at various stages of the luteal phase and from 43 women
      treated with 300 micrograms norethisterone daily. Levels of oestradiol,
      progesterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH)
      were measured. The highest peritoneal fluid volume (mean, 23.1 ml) was found in
      the early luteal phase (LH 0 to + 3) and the lowest (mean, 5.9 ml) in the late
      luteal phase (LH + 12 to menses). The norethisterone treatment diminished the
      formation of peritoneal fluid and the degree of inhibition was dependent upon the
      type of ovarian reaction to norethisterone. Progesterone and oestradiol levels
      were higher in peritoneal fluid compared to plasma throughout the luteal phase
      and during norethisterone treatment. A comparison of the levels of these steroids
      between untreated controls (LH + 8 to + 11) and norethisterone-treated women
      demonstrated that the progesterone levels in peritoneal fluid were highly reduced
      by norethisterone treatment, while the oestradiol levels were not affected. The
      FSH and LH levels were, in contrast to the steroid hormones, significantly lower
      in peritoneal fluid than in plasma, both in the untreated and the treated women.
      No differences in the FSH or LH levels between the untreated and treated women
      were found. The results indicate that the peritoneal fluid volume and the steroid
      hormone levels in peritoneal fluid vary with the stages of the luteal phase.
      Norethisterone treatment significantly reduced the peritoneal fluid volume as
      well as its progesterone concentration, whereas the oestradiol and gonadotrophin
      levels remained unchanged.

PMID- 1752924
TI  - Preovulatory effects of the progesterone antagonist mifepristone (RU486) in mice.
AB  - The progesterone antagonist mifepristone (RU486), was given in mice once on
      different days of pregnant mare's serum gonadotrophin-human chorionic
      gonadotrophin (PMSG-HCG) treatment and its action upon the induction of ovulation
      studied. RU486 administered on the day after PMSG significantly reduced the
      ovulation rate. Ovulation was completely inhibited when the progesterone
      antagonist was given simultaneously with HCG, but RU486 administered 4 h after
      HCG treatment remained ineffective. The development of two-cell zygotes harvested
      on day 2 post-coitum from mice treated with RU486 on the day after the PMSG
      treatment was followed in vitro and showed a significant decrease in the number
      of embryos developing to blastocysts. These results favour the involvement of
      progesterone in the ovulation process, indicating a direct effect of this hormone
      at the ovarian level via a progesterone receptor-mediated action.

PMID- 1752925
TI  - Evaluation of intrauterine insemination with washed spermatozoa from the husband
      in the treatment of infertility.
AB  - In this study, we examined the efficacy of intrauterine insemination with washed
      spermatozoa from the husband (AIH/IUI) in the treatment of infertility. A total
      of 127 treatment cycles were completed (1.95 cycles per patient). The indications
      for AIH/IUI were male subfertility (group I: 53 couples), cervical factor (group
      II: four couples), male and cervical factor (group III: six couples) and
      unexplained infertility (group IV: two couples). Sperm washing caused a reduction
      of the sperm concentration from 52 x 10(6)/ml to 44 x 10(6)/ml (P less than 0.08)
      and motility from 49% to 45% (P less than 0.03). Twelve pregnancies were achieved
      (18.5% per couple and 9.5% per cycle): eight pregnancies in group I (15.1%), one
      in group II (25%) and three in group III (50%). Of the 12 pregnancies, eight
      occurred in the first insemination cycle, three in the second and one in the
      third (1.4 cycles/pregnancy). Sperm motility was significantly higher in the
      pregnant than in the non-pregnant group (65.5% versus 46.4%, respectively; P less
      than 0.004), whereas no significant difference was observed in the sperm
      concentration between these two groups (39 x 10(6)/ml and 54 x 10(6)/ml,
      respectively). In conclusion, AIH/IUI is a technically easy and non-invasive
      procedure which offers a satisfactory pregnancy rate in selected couples with
      male subfertility and/or cervical factor infertility.

PMID- 1752926
TI  - A controlled study of human chorionic gonadotrophin induced ovulation versus
      urinary luteinizing hormone surge for timing of intrauterine insemination.
AB  - Forty-eight patients in a programme of intrauterine insemination (IUI) were
      randomized in a cross-over study. All were stimulated with clomiphene citrate
      (CC) and inseminated either after follicular rupture induced by human chorionic
      gonadotrophin (HCG) or after a spontaneous urinary luteinizing hormone (LH)
      surge. The HCG was administered when follicles of 18-22 mm in diameter were
      observed on ultrasound and IUI was performed 37-40 h thereafter. The monitoring
      of a urinary LH peak was carried out using a rapid urinary LH test. IUI took
      place approximately 22 h after detection of the LH surge. Overall, the pregnancy
      rates were 9.3% (4/43) after HCG induced ovulation and 20.5% (9/44) after
      spontaneous ovulation (P = 0.12). Analysis of mid-cycle events showed that
      following sonographic criteria, the HCG injection was performed significantly
      earlier in the cycle compared with the spontaneous LH surge. In addition, the
      mean diameter of the preovulatory follicles was significantly smaller and
      insemination was substantially earlier in the HCG induced cycles. These findings
      suggest that a beneficial effect arises from allowing the natural process of
      final follicular maturation to occur.

PMID- 1752927
TI  - Differential distribution of aneuploidy in human gametes according to their sex.
AB  - The cytogenetic study of human gametes is a new and important source of
      information because most chromosomal abnormalities originate from meiotic
      disorders. The frequency and type of abnormalities were analysed in both
      spermatozoa and mature oocytes. A total of 13,975 human sperm chromosome
      complements and 1897 oocyte chromosome complements were analysed. In the present
      study, pooled cytogenetic data on human gametes have been examined to determine
      and compare the distribution of non-disjunctions in male and female gametes.
      Human spermatozoa are characterized by a significant excess of hypohaploidy and
      an equal distribution of aneuploidies among all chromosome groups, whereas mature
      oocytes display an equal ratio of hypohaploidy to hyperhaploidy and a high
      variability in the distribution of non-disjunction: in particular, there is a
      significant over-representation of aneuploidies in both D and G chromosome
      groups. This indicates that non-disjunction is not a random event in female
      meiosis and, consequently, that there are differences in the meiotic process
      between the sexes. Meiotic and environmental factors which could explain the non
      random malsegregation of chromosomes in female meiosis are discussed. The role of
      maternal age as a cause of aneuploidy is questioned.

PMID- 1752928
TI  - Perinatal outcome and congenital malformations in in-vitro fertilization babies
      from the Bourn-Hallam group.
AB  - The perinatal outcome and congenital malformations in children born between 1978
      and 1987 in Great Britain after in-vitro fertilization (IVF) at Bourn Hall Clinic
      and the Hallam Medical Centre are presented. The average maternal age was 34.2
      years. Multiple births were frequent, constituting 23% of all deliveries; 19%
      were twins and 4% triplets. There were no quadruplet or higher order multiple
      births during that period. Twenty-five per cent of all deliveries were preterm.
      The mean birth weight was 2793 g and was strongly related to multiplicity of
      pregnancy and gestational age. Overall, 32% of babies had a low birthweight (less
      than 2500 g) with 6% having a very low birthweight (less than 1500 g). The
      overall stillbirth and infant mortality rates were two to three times higher than
      those of infants born after natural conception in England and Wales; this is
      attributed to the high incidence of multiple births. The stillbirth rates were
      5.07, 20.8 and 24.7 per thousand total births in singletons, twins and triplets
      respectively. The corresponding figures for perinatal mortality were 13.5, 38.2
      and 37 per thousand. Overall, 2.5% of the babies had one or more major congenital
      malformations diagnosed within one week of life. This was within the range of
      expected values in the United Kingdom and there was no significant increase in
      any specific malformation.

PMID- 1752929
TI  - Human sperm capacitation and the acrosome reaction.
AB  - A model is presented that describes the mechanism of human sperm capacitation and
      the acrosome reaction. The processes of capacitation and the acrosome reaction
      are proposed to function in control of the activation/release of acrosomal
      enzyme(s) involved in sperm penetration through the zona pellucida. During
      capacitation, the sperm head membranes are biochemically modified, allowing the
      acrosome reaction to take place when the spermatozoon approaches or reaches the
      zona pellucida, resulting in the localized activation and release of the
      appropriate enzyme(s). Further, capacitation is presented as a continuing process
      that occurs during sperm transport through the female genital tract and is
      physiologically not completed until the spermatozoon reaches the oocyte (unless
      the spermatozoa are kept at a particular genital tract site for prolonged
      periods). The biochemical alterations that occur during capacitation are
      discussed. It is suggested that extensive modifications in the lipid bilayer
      structure, e.g. in the cholesterol or phospholipid content, are not part of
      capacitation because such changes would prematurely destabilize the membranes.
      Rather, such changes occur during the acrosome reaction. It is also proposed that
      the human sperm acrosome reaction has many similarities to the somatic cell
      exocytotic events which occur during the regulated pathway of secretion. One or
      more oocyte stimuli result in the activation of protein kinases, likely (but not
      necessarily) via activation of G-protein coupled receptors on the sperm plasma
      membrane and the formation of second messengers. The kinases phosphorylate and
      activate proteins, continuing the biochemical cascade that ultimately results in
      the acrosome reaction. The role of other enzyme systems such as those involved in
      ion transport, proteolysis, phospholipid metabolism (including that of
      arachidonic acid) and other metabolic events, is discussed. Calcium ion influx as
      initiator of the acrosome reaction is reconsidered. The proposed model also takes
      into consideration the structural events of membrane fusion.

PMID- 1752930
TI  - Sealed mini-chamber of variable depth for direct observation and extended
      evaluation of sperm motility under the influence of various gases.
AB  - A new chamber for microscopical observation of living cells, e.g. spermatozoa,
      under hermetically sealed conditions and over an extended period is described.
      Motile spermatozoa were serially observed for several hours and the effect of
      various gases on sperm motility has been studied. The chamber could also be used
      to study the effect of various toxic gases in the fields of microbiology and
      toxicology.

PMID- 1752931
TI  - Effects of cryopreservation on human sperm acrosomes.
AB  - Total acrosin activity and acrosomal status were determined before and after
      cryopreserving human spermatozoa. Three different cryopreservation protocols were
      used. Both acrosin activity and the incidence of intact acrosomes decreased
      during cryopreservation. The magnitudes of the decreases were weakly but
      significantly correlated (r = 0.29, P less than 0.05), suggesting that acrosomal
      loss contributed to the decrease in acrosin activity. The effects of the three
      cryopreservation protocols were not significantly different. Motility decreased
      more (average 43%) than did the percentage of spermatozoa with intact acrosomes
      (27%) and the total acrosin activity (24%). These measurements suggested that
      acrosomal damage may have been secondary to cell death. This hypothesis was
      tested by determining the acrosomal status of spermatozoa that survived
      cryopreservation. Spermatozoa that were motile after thawing averaged 96%
      acrosome-intact; their acrosin activity, however, was significantly less than
      that of motile, unfrozen spermatozoa. These observations support the idea that
      the acrosomal loss due to cryopreservation is associated with cell death but also
      demonstrate decreased total acrosin activity of the acrosome-intact spermatozoa
      that survive cryopreservation.

PMID- 1752932
TI  - Epididymal sperm aspiration in conjunction with in-vitro fertilization and embryo
      transfer in cases of obstructive azoospermia.
AB  - Epididymal sperm aspiration is a new treatment for vasal agenesis. In previous
      reports, epididymal spermatozoa resulted in pregnancy by utilizing in-vitro
      fertilization (IVF) or gamete intra-Fallopian transfer (GIFT). We sought to
      investigate the efficacy of epididymal sperm aspiration in conjunction with IVF
      in patients with congenital absence of the vas deferens or with secondary
      extended obstruction of spermatic ducts. Fifty-eight attempts were performed in
      23 patients (25-50 years). Eight patients (34.7%) had vasal agenesis and 14
      (60.8%) presented with vasal secondary extended obstruction. The sperm count was
      adequate (greater than or equal 20 x 10(6)/ml) in 13.8% of sperm retrievals and
      sperm motility of 20% was obtained in 15.5% of sperm retrievals. Fourteen
      attempts at IVF were performed with epididymal sperm counts of 2-44 x 10(6)/ml
      and motilities of 0-45%. A mean of six mature oocytes (0-13) were inseminated in
      each case. Five embryo transfers were performed in five patients' wives (35.7%)
      and two couples had an early pregnancy loss (14.2%). Epididymal sperm aspiration
      is an advance in treating such patients, as an adequate number of mature
      spermatozoa can be obtained and used for IVF. However, spermatozoa directly
      aspirated from the proximal epididymis and with fertilizing capacity in vitro,
      gave a high rate of embryo degeneration (greater than 50%) after embryo transfer.

PMID- 1752933
TI  - A comparison of the transient hyperprolactinaemic stress response obtained using
      two different methods of analgesia for ultrasound-guided transvaginal oocyte
      retrieval.
AB  - Transient hyperprolactinaemia has been shown to accompany the procedure of oocyte
      retrieval under laparoscopic control. This study was concerned with establishing
      whether transvaginal oocyte retrieval was also associated with
      hyperprolactinaemia and whether the hyperprolactinaemic response was dependent on
      the method of anaesthesia/analgesia employed. Two distinct patterns were
      recorded. Oocyte retrieval under general anaesthesia was accompanied by a rapid
      rise in prolactin levels, which peaked after 40 min. Oocyte retrieval under
      intravenous sedation was associated with a slow rise in circulating prolactin
      concentrations. Significant differences in the prolactin rise between the general
      anaesthesia and sedation groups appeared within 10 min of the start of the
      procedure. It is concluded that although the surgical stress of oocyte recovery
      is associated with mild transient hyperprolactinaemia, most of the
      hyperprolactinaemic response is due to the anaesthetic.

PMID- 1752934
TI  - Evaluation of the risk of pelvic infection following transvaginal oocyte
      recovery.
AB  - The risk of introducing infection into the peritoneal cavity at the time of
      transvaginal ultrasound-guided recovery of oocytes in assisted reproduction
      techniques was assessed by culturing peritoneal fluid samples from 25 women with
      unexplained infertility. The samples were collected laparoscopically at the time
      of zygote intra-Fallopian transfer (ZIFT), 24-48 h after oocyte collection. High
      vaginal and endocervical specimens from 25 women treated by in-vitro
      fertilization (IVF) and transcervical embryo transfer were cultured for
      comparison. The peritoneal cultures were negative in all but one patient. High
      vaginal swabs grew Candida albicans in three cases and endocervical specimens
      were all negative. Seven and three pregnancies occurred in the ZIFT and IVF
      groups respectively. No pelvic damage was noted at laparoscopy in those women who
      had had previous treatment cycles with transvaginal oocyte recovery. This method
      of oocyte recovery, using prophylactic metronidazole and chlorhexidine for
      preoperative vaginal preparation, appears to be safe for treatment of women with
      no previous pelvic damage.

PMID- 1752935
TI  - Protection from oxidative stress by thioredoxin and superoxide dismutase of mouse
      embryos fertilized in vitro.
AB  - A low oxygen tension and superoxide dismutase (SOD) have been demonstrated to
      promote development of embryos in vitro. In this study, we evaluated the effects
      of thioredoxin (TRX), a powerful protein disulphide reductase, on the development
      of mouse embryos fertilized in vitro. Moreover, to clarify the difference between
      the embryo-protecting mechanisms of TRX and SOD, as well as the critical periods
      of their actions, we carried out experiments in which we transferred embryos
      among three different media: basic, TRX- and SOD-supplemented. The rates of 4
      cell, blastocyst and expanded blastocyst formation in TRX- (53%, 40% and 34%
      respectively), or SOD- (59%, 29%, 22%) supplemented media were significantly
      higher than those (28%, 4%, 0%) in the basic medium. The results of the transfer
      of embryos using basic and TRX-supplemented media indicated an increase in the
      rate of expanded blastocysts when TRX was applied from 7 to 30 h, and especially
      from 18 to 24 h after insemination. In contrast, the results of the transfer of
      embryos using basic and SOD-supplemented media indicated that SOD, which was also
      most effective when applied from 7 to 30 h after insemination, had some effects
      after 30 h. These results indicate that TRX and SOD promote the in-vitro
      development of mouse embryos fertilized in vitro, which suggests that protection
      of embryos from oxidative stress is a prerequisite for their development in
      vitro. SOD and TRX provide protection from oxidative stress by different
      mechanisms.

PMID- 1752936
TI  - Human endometrial peptides: a review of their potential role in implantation and
      placentation.
AB  - This paper reviews human endometrial peptide synthesis and discusses the
      biological function of these peptides in relation to implantation and
      placentation. Despite the substantial literature on quantitative and qualitative
      peptide synthesis by the endometrium, it has not been possible to define the
      function of most of these substances. Various aspects of endometrial morphology,
      especially the endometrial leukocytes, are discussed in an attempt to relate
      cellular structure and function. A number of serum proteins are produced by the
      endometrial glandular epithelium and may play a role in early embryo development.
      Extracellular matrix proteins produced by stromal cells are important for
      endometrial structure and integrity but also provide a site for trophoblast
      attachment. Several hormones and binding proteins are also produced by stromal
      cells and probably influence endometrial metabolism. Complement factors and
      secretory component may have a role in maintaining a sterile intrauterine
      environment. Many other endometrial proteins have been less well characterized
      and their role in endometrial physiology at present remains uncertain. Perhaps
      the most exciting advance has been the realization that a number of peptide
      regulatory factors (cytokines and growth factors) are not only produced by the
      endometrium but play an integral part in the mediation of oestrogen-induced
      growth and differentiation of the endometrium and with the local metabolic and
      physiological processes.

PMID- 1752937
TI  - Risk factors for spontaneous abortion: a case-control study in France.
AB  - A case-control study was conducted in seven maternity hospitals in the Paris area
      in 1988 to evaluate the role of several risk factors in spontaneous abortion. A
      total of 279 cases and 279 controls were compared for socio-demographic
      characteristics, reproductive history and for conditions of conception. Prior
      fetal losses [odds ratio (OR) = 2.30 for n greater than or equal to 2; 95%
      confidence interval (CI) = 1.17-4.61] and maternal age at pregnancy (greater than
      30 years) appeared to be major and independent risk factors of spontaneous
      abortion. Other factors associated with an increased risk of fetal loss were:
      geographical or ethnic origin (OR = 2.85 for North African women; 95% CI = 1.58
      5.10); psychological problems at the time of conception, either related to the
      outcome of the pregnancy (OR = 3.08; 95% CI = 0.92-10.25) or unrelated to this
      outcome (OR = 3.35; 95% CI = 1.41-8.00). The following factors were not
      associated with spontaneous abortion: gravidity, parity, prior induced abortion,
      prior sexually transmitted diseases and Chlamydia trachomatis serology, menstrual
      cycle abnormalities, induced conception cycle and in-vitro fertilization,
      cigarette smoking, current or past use of combined oestrogen/progestagen pill or
      intrauterine device. These findings confirm the importance of two risk factors
      for fetal loss: maternal age and number of prior spontaneous abortions. Two risk
      factors, ethnic origin and psychological problems at the time of conception are
      also identified, which require further study.

PMID- 1752938
TI  - P29, an oestrogen receptor-associated protein, is down-regulated by mifepristone
      in first trimester human placenta and decidua.
AB  - P29 is an oestrogen receptor-associated protein which acts as a marker of
      oestrogen action in several systems. The concentration of P29 was measured in
      placenta and decidua from women following medical termination of pregnancy with
      the antiprogesterone steroid mifepristone (RU 38,486) and a prostaglandin E1
      analogue, and compared with the concentration of P29 found in matched controls
      undergoing surgical aspiration of pregnancy. Oestrogen receptors were also
      measured in the same samples. Placental and decidual P29 concentrations (IU/mg
      protein) in patients treated with mifepristone were 9.6 (4.6-54) and 4.8 (1.3
      13.3) (median and range), respectively. These values were significantly lower
      than the corresponding values, 39.5 (27-69) and 22.0 (2-107) in the surgical
      group. In contrast, the levels of oestrogen receptors did not change
      significantly in either decidua or placenta. These data show that mifepristone
      causes down-regulation of P29 in placenta and decidua, and therefore its action
      may disrupt oestrogen function in uterine tissues.

PMID- 1752939
TI  - Long-term use of copper-releasing intrauterine devices for contraception.

PMID- 1752940
TI  - Role of oxidized low density lipoprotein in atherogenesis.
AB  - Evidence to support an important role of oxidative modification in mediating the
      atherogenicity of LDL continues to grow. New hypotheses suggest mechanisms by
      which Ox-LDL or products of Ox-LDL can affect many components of the atherogenic
      process, including vasomotor properties and thrombosis, as well as lesion
      initiation and progression itself. These ideas suggest new approaches, that in
      combination with lowering of plasma cholesterol, could lead to the prevention of
      atherosclerosis and its complications.

PMID- 1752941
TI  - Detection of pre-C and core region mutants of hepatitis B virus in chronic
      hepatitis B virus carriers.
AB  - We analyzed the pre-C and core region of hepatitis B virus (HBV) DNA by a
      polymerase chain reaction in 22 chronic carriers. In 9 hepatitis B e antigen
      positive asymptomatic carriers, a single DNA band was detected at the expected
      size, whereas additional shorter DNA bands were observed in 7 out of 11 patients
      with chronic hepatitis. The smaller-sized DNAs from one chronic hepatitis patient
      had various lengths of deletions spanning from 105 to 183 bp in the middle of the
      core gene, and all deletions included common nucleotide sequences. All of the
      smaller-sized DNAs from the other patients proved to be variant core genes. They
      were deleted in similar regions by Southern analysis using oligonucleotide
      probes. A follow-up study revealed that four out of seven chronic hepatitis
      patients with a short core gene seroconverted to antibody to hepatitis B e
      antigen, but those with only a "wild type" did not. In another set of sequence
      studies, clones isolated from two chronic carriers displayed heterogeneity of the
      pre-C and core gene which was more often present in sera with normal alanine
      aminotransferase levels than with abnormal levels. These results suggest that
      mutant HBV alters the host immune response, and may modulate the clinical course
      of HBV infection. An alternative possibility is that chronic hepatitis selects
      for mutant forms.

PMID- 1752942
TI  - Increased expression of the interleukin-8 gene by alveolar macrophages in
      idiopathic pulmonary fibrosis. A potential mechanism for the recruitment and
      activation of neutrophils in lung fibrosis.
AB  - Neutrophil migration into the airspaces of the lung is thought to contribute to
      the alveolar damage and subsequent fibrosis in idiopathic pulmonary fibrosis
      (IPF). Interleukin 8 (IL-8), a monocyte- and macrophage-derived cytokine,
      displays potent chemotactic and activating properties towards neutrophils and
      thus may contribute to the pathogenesis of IPF. The objective of this
      investigation was to quantify the spontaneous expression of IL-8 transcripts by
      alveolar macrophages from normal healthy volunteers and individuals with IPF. A
      quantitative assay employing reverse transcription of mRNA and the polymerase
      chain reaction was utilized. The level of IL-8 mRNA in alveolar macrophages was
      found to be significantly elevated in individuals with lone IPF or with lung
      fibrosis associated with connective tissue disorders compared to normal healthy
      controls. Moreover, the level of IL-8 mRNA in the 23 individuals with IPF
      correlated with the number of neutrophils per milliliter in their bronchoalveolar
      lavage (BAL) and with the degree of disease severity. In addition, the level of
      IL-8 protein in BAL was found to reflect the pattern of IL-8 mRNA expression by
      alveolar macrophages. These data suggest that IL-8 derived from alveolar
      macrophages may significantly contribute to neutrophil involvement in the
      pathogenesis of IPF.

PMID- 1752943
TI  - An idiotypic marker associated with a germ-line encoded kappa light chain
      variable region that predominates the vaccine-induced human antibody response to
      the Haemophilus influenzae b polysaccharide.
AB  - Human antibodies specific for the Haemophilus influenzae b polysaccharide (Hib
      PS) frequently express a cross-reactive idiotype (CRI), and commonly utilize a VL
      region that is the product of the V kappa II gene A2. To examine further anti-Hib
      PS V region expression and to determine whether CRI expression is correlated with
      the V kappa IIA2 chain, we isolated a monoclonal antibody (MAb) reactive with an
      idiotypic determinant of anti-Hib PS antibodies. This MAb inhibited Hib PS
      binding but did not react with Ig isotypic determinants. The CRI recognized by
      this MAb, designated HibId-1, was associated with the Hib PS-combining site since
      the reactivity of the MAb with anti-Hib PS antibodies could be inhibited by Hib
      PS. HibId-1 was expressed by 17 of 17 clonally purified and sequence-defined anti
      Hib PS antibodies having V kappa IIA2 L chains. In contrast, 0 of 10 anti-Hib PS
      antibodies having either V lambda, V kappa I, or V kappa III chains expressed
      HibId-1. Western blot analysis showed that the MAb anti-CRI reacted with isolated
      anti-Hib PS V kappa IIA2 L chains but not with H chains or other L chains,
      indicating that the HibId-1 determinant is localized to the V kappa IIA2 chain,
      and does not require pairing with H chain for expression. Anti-Hib PS antibodies
      bearing HibId-1 were present in at least 85% of subjects immunized with either
      free Hib PS or Hib PS coupled to diphtheria toxoid (Hib PS-DT), and comprised on
      the average 60% of the total vaccine-induced serum anti-Hib PS. HibId-1
      expression was not related to age at vaccination inasmuch as infants, children,
      and adults had similar distributions of HibId-1-positive anti-Hib PS after
      vaccination with Hib PS-DT. HibId-1 was expressed at a lower frequency and
      comprised a smaller fraction of the total anti-Hib PS antibody in adult
      preimmunization sera as compared to post-Hib PS immunization sera, suggesting
      that immunization preferentially stimulates HibId-1-positive B cells. These data
      demonstrate that antibodies bearing HibId-1/V kappa IIA2 comprise a predominant
      component of the anti-Hib PS response induced by immunization, and that this
      pattern of VL expression is established early in ontogeny.

PMID- 1752944
TI  - The terminal complement proteins C5b-9 augment binding of high density
      lipoprotein and its apolipoproteins A-I and A-II to human endothelial cells.
AB  - Terminal complement protein complexes C5b-9 have been found in human
      atherosclerotic lesions. Insertion of C5b-9 in the endothelial cell membrane
      alters permeability, induces membrane vesiculation, and activates secretion. We
      hypothesized that complement might also alter interactions of the endothelial
      surface with lipoproteins, particularly high density lipoprotein (HDL), which is
      reported to inhibit C5b-9-induced hemolysis. We now demonstrate that exposure to
      C5b-9 increases (by 2- to 50-fold) specific binding of HDL and its
      apolipoproteins (apo) A-I and A-II to endothelial cells. Binding to cells exposed
      to antibody, C5b67, and C5b-8 was virtually unchanged. Enhanced binding was also
      dependent on the number of C5b-9 complexes deposited on the cells. Other agonists
      that activate endothelial secretion did not augment binding. Calcium was required
      for full exposure of new binding sites by C5b-9. The C5b-9-induced increase in
      binding was independent of the increase observed after cholesterol loading. In
      addition, apo A-I and A-II appear to compete for the same binding sites on
      untreated and C5b-9-treated cells. In contrast to the data reported for red
      cells, we were unable to detect significant inhibition of C5b-9-mediated
      endothelial membrane permeabilization by HDL (up to 1 mg/ml) or by apo A-I (up to
      100 micrograms/ml). These data demonstrate that the C5b-9 proteins enhance
      endothelial binding of HDL and its apoproteins, suggesting that intravascular
      complement activation may alter cholesterol homeostasis in the vessel wall.

PMID- 1752945
TI  - Abundant expression of parathyroid hormone-related protein in primary rat aortic
      smooth muscle cells accompanies serum-induced proliferation.
AB  - Parathyroid hormone-related protein (PTHrP), which is responsible for producing
      hypercalcemia in patients with humoral hypercalcemia of malignancy, has recently
      been identified in several normal tissues. Because PTHrP, like parathyroid
      hormone (PTH), is known to exhibit vasodilatory properties, we investigated the
      expression and regulation of PTHrP mRNA in cultured rat aortic smooth muscle
      cells (SMC). We report here that PTHrP mRNA is expressed in SMC and is markedly
      induced by serum in a time- and concentration-dependent fashion. Addition of 10%
      fetal calf serum to serum-deprived, confluent cells, resulted in a marked
      induction of PTHrP mRNA by 2 h with a peak at 4-6 h. PTHrP was detected in SMC by
      immunocytochemistry and radioimmunoassay of conditioned medium, and was shown to
      be up-regulated within 24 h after the addition of serum. The serum induction of
      PTHrP mRNA was blocked by actinomycin D and by cycloheximide indicating the need
      for protein synthesis to evoke the serum effect on PTHrP gene transcription. In
      addition, treatment with dexamethasone, which has been previously shown to reduce
      the constitutive expression of PTHrP in human cancer cells, also blunted the
      serum induction of PTHrP mRNA in SMC. Treatment of quiescent cells with the serum
      mitogens platelet-derived growth factor or insulin-like growth factor-I had no
      effect on PTHrP, whereas the vasoactive peptides endothelin, norepinephrine and
      thrombin stimulated PTHrP expression. Exogenous addition of recombinant PTHrP-(1
      141) had no significant effect on SMC DNA synthesis as measured by [3H]thymidine
      incorporation. In summary, the abundance of PTHrP mRNA and the characteristics of
      its regulation in SMC suggest a major role for PTHrP as a local modulator in
      vascular smooth muscle.

PMID- 1752946
TI  - Xanthine oxidase inhibits growth of Plasmodium falciparum in human erythrocytes
      in vitro.
AB  - Malaria parasites, unable to synthesize purine de novo, use host-derived
      hypoxanthine preferentially as purine source. In a previous study (1990. J. Biol.
      Chem. 265:6562-6568), we noted that xanthine oxidase rapidly and completely
      depleted hypoxanthine in human erythrocytes, not by crossing the erythrocyte
      membrane, but rather by creating a concentration gradient which facilitated
      hypoxanthine efflux. We therefore investigated the ability of xanthine oxidase to
      inhibit growth of FCR-3, a chloroquine-resistant strain of Plasmodium falciparum
      in human erythrocytes in vitro. Parasites were cultured in human group O+
      erythrocytes in medium supplemented, as required, with xanthine oxidase or
      chloroquine. Parasite viability was assessed by uptake of radiolabeled glycine
      and adenosine triphosphate-derived purine into protein and nucleic acid,
      respectively, by nucleic acid accumulation, by L-lactate production, and by
      microscopic appearance. On average, a 90% inhibition of growth was observed after
      72 h of incubation in 20 mU/ml xanthine oxidase. Inhibition was notably greater
      than that exerted by 10(-7) M chloroquine (less than 10%) over a comparable
      period. The IC50 for xanthine oxidase was estimated at 0.2 mU/ml, compared to 1.5
      x 10(-7) M for chloroquine. Inhibition was completely reversed by excess
      hypoxanthine, but was unaffected by oxygen radical scavengers, including
      superoxide dismutase and catalase. The data confirms that a supply of host
      derived hypoxanthine is critical for nucleic acid synthesis in P. falciparum, and
      that depletion of erythrocyte hypoxanthine pools of chloroquine-resistant malaria
      infection in humans. of chloroquine-resistant malaria infection in humans.

PMID- 1752947
TI  - Heterogeneous mutations in the human lipoprotein lipase gene in patients with
      familial lipoprotein lipase deficiency.
AB  - The DNA sequences were determined for the lipoprotein lipase (LPL) gene from five
      unrelated Japanese patients with familial LPL deficiency. The results
      demonstrated that all five patients are homozygotes for distinct point mutations
      dispersed throughout the LPL gene. Patient 1 has a G-to-A transition at the first
      nucleotide of intron 2, which abolishes normal splicing. Patient 2 has a nonsense
      mutation in exon 3 (Tyr61----Stop) and patient 3 in exon 8 (Trp382----Stop). The
      latter mutation emphasizes the importance of the carboxy-terminal portion of the
      enzyme in the expression of LPL activity. Missense mutations were identified in
      patient 4 (Asp204----Glu) and patient 5 (Arg243----His) in the strictly conserved
      amino acids. Expression study of both mutant genes in COS-1 cells produced
      inactive enzymes, establishing the functional significance of the two mis-sense
      mutations. In these patients, postheparin plasma LPL mass was either virtually
      absent (patients 1 and 2) or significantly decreased (patients 3-5). To detect
      these mutations more easily, we developed a rapid diagnostic test for each
      mutation. We also determined the DNA haplotypes for patients and confirmed the
      occurrence of multiple mutations on the chromosomes with an identical haplotype.
      These results demonstrate that familial LPL deficiency is a heterogeneous genetic
      disease caused by a wide variety of gene mutations.

PMID- 1752948
TI  - Induction of omega-oxidation of monocarboxylic acids in rats by acetylsalicylic
      acid.
AB  - The accumulation of dicarboxylic acids, particularly long chain, is a prominent
      feature of Reye's syndrome and diseases of peroxisomal metabolism. We assessed
      the omega-oxidation of a spectrum of fatty acids in rats and asked whether
      pretreatment of rats with aspirin, which is known to predispose children to
      Reye's syndrome, would affect omega-oxidation of long chain fatty acids. We found
      that aspirin increased liver free fatty acids and increased the capacity for
      omega-oxidation three- to sevenfold. Omega-oxidation of long chain substrate was
      stimulated to a greater degree than medium chain substrate and was apparent
      within one day of treatment, at serum aspirin concentrations below the
      therapeutic range in humans. The apparent Km for lauric acid was 0.9 microM and
      12 microM for palmitate. We also found a difference in the storage stability of
      activity toward medium and long chain substrate. Saturating concentrations of
      palmitate had no effect on the formation of dodecanedioic acid, whereas laurate
      decreased but never eliminated the omega-oxidation of palmitate. 97% of the total
      laurate omega-oxidative activity recovered was found in the microsomes, but 32%
      of palmitate omega-oxidative activity was present in the cytosol. These results
      demonstrate that aspirin is a potent stimulator of omega-oxidation and suggest
      that there may be multiple enzymes for omega-oxidation with overlapping substrate
      specificity.

PMID- 1752949
TI  - Photosensitized killing of cultured fibroblasts from patients with peroxisomal
      disorders due to pyrene fatty acid-mediated ultraviolet damage.
AB  - The influence of pyrene-fatty acids on the resistance of cells to ultraviolet
      (UV) radiation was investigated in cultured fibroblasts from patients with five
      types of peroxisomal disorders. All showed reduced survival compared to control.
      The effect varied with the biochemical defect involved and the chain length of
      the pyrene fatty acid. Reduced survival was observed in cells deficient in
      plasmalogens (rhizomelic chondrodysplasia punctata) and in cells deficient in
      peroxisomal fatty acid oxidation (bifunctional enzyme deficiency), which
      accumulated pyrene-fatty acids. X-linked adrenoleukodystrophy fibroblasts
      accumulated pyrene-fatty acids and showed increased UV sensitivity only when
      exposed to longer-chain pyrene fatty acids. UV radiation resistance was lowest in
      cells with combined impairment of plasmalogen synthesis and fatty acid oxidation
      (Zellweger syndrome, neonatal adrenoleukodystrophy), suggesting that UV
      sensitivity correlates inversely with the ratio of plasmalogens to radical
      producing substances. Fibroblasts deficient in plasmalogens gained normal UV
      resistance when their plasmalogen levels were normalized by hexadecylglycerol. UV
      resistance increased when Zellweger cells were fused with X-linked
      adrenoleukodystrophy cells, and also when Zellweger cells belonging to different
      complementation groups were fused. The results provide leads to the pathogenesis
      of the multiple malformations associated with peroxisomal disorders and a method
      for the selection of cells in which the metabolic defect has been corrected.

PMID- 1752950
TI  - Hydrogen peroxide-induced renal injury. A protective role for pyruvate in vitro
      and in vivo.
AB  - Hydrogen peroxide (H2O2) contributes to renal cellular injury. alpha-Keto acids
      nonenzymatically reduce H2O2 to water while undergoing decarboxylation at the 1
      carbon (1-C) position. We examined, in vitro and in vivo, the protective role of
      sodium pyruvate in H2O2-induced renal injury. Pyruvate effectively scavenged H2O2
      in vitro, and suppressed H2O2-induced renal lipid peroxidation. Injury to LLC-PK1
      cells induced by hydrogen peroxide was attenuated by pyruvate to an extent
      comparable to that seen with catalase. Studies utilizing [1-14C]pyruvate further
      demonstrated 1-C decarboxylation concurrent with cytoprotection by pyruvate from
      H2O2-induced injury. Pyruvate was also protective in vivo. Infusion of pyruvate
      before and during the intrarenal infusion of H2O2 attenuated H2O2-induced
      proteinuria. Systemic administration of pyruvate was also protective in the
      glycerol model of acute renal failure, a model also characterized by increased
      generation of H2O2. These findings indicate that pyruvate, a ubiquitous alpha
      keto acid, scavenges H2O2 and protects renal tissue in vitro and in vivo from
      H2O2-mediated injury. These data suggest a potential therapeutic role for
      pyruvate in diseases in which increased generation of H2O2 is incriminated in
      renal damage.

PMID- 1752951
TI  - Cholesterol enrichment increases basal and agonist-stimulated calcium influx in
      rat vascular smooth muscle cells.
AB  - The effect of cholesterol enrichment on vascular smooth muscle cell (VSMC)
      calcium homeostasis was studied by evaluating calcium uptake, efflux, and
      intracellular content in cultured VSMC derived from the rat pulmonary artery.
      Incubation of VSMC with liposomes consisting of free cholesterol (FC) and
      phospholipid (2:1 molar ratio, 1 mg FC/ml medium) for 24 h resulted in a 69 +/-
      19% increase (P less than 0.01; n = 10) in FC which was associated with a 73 +/-
      11% increase (P less than 0.005; n = 10) in intracellular calcium content as
      assessed by isotopic equilibrium with 45Ca2+ and a 65 +/- 11% increase (P less
      than 0.024; n = 3) as assessed by atomic absorption spectroscopy. Cholesterol
      enrichment caused a marked increase in the unidirectional calcium uptake rate
      from 0.026 +/- 0.03 to 0.158 +/- 0.022 nmol calcium/s per mg protein (P less than
      0.01; n = 3), but had no effect on calcium efflux. Nifedipine (1 microM) reduced
      (P less than 0.05; n = 6) the effect of cholesterol enrichment on unidirectional
      calcium uptake by 78 +/- 16%; and verapamil (10 microM), diltiazem (1 microM),
      and nifedipine (1 microM) each significantly inhibited the effect of cholesterol
      enrichment on intracellular calcium accumulation. Exposure of cholesterol
      enriched VSMC to cholesterol-poor liposomes for 24 h returned both FC and calcium
      contents to control levels. Serum- and serotonin-stimulated calcium uptakes were
      potentiated 3.7- and 1.7-fold, respectively, in cholesterol-enriched VSMC,
      whereas endothelin, vasopressin, and thrombin-stimulated calcium uptakes were not
      affected. We conclude that VSMC FC content plays a role in regulating cellular
      calcium homeostasis, both under basal conditions and in response to selected
      agonists.

PMID- 1752952
TI  - A 3' splice site mutation in the thyroglobulin gene responsible for congenital
      goiter with hypothyroidism.
AB  - A case of congenital goiter with defective thyroglobulin synthesis has been
      studied in molecular terms. The patient is the fifth of a kindred of six, three
      of which have a goiter. The parents are first cousins. Segregation of
      thyroglobulin alleles in the family was studied by Southern blotting with a probe
      revealing a diallelic restriction fragment length polymorphism (RFLP). The
      results demonstrated that the three affected siblings were homozygous for the
      RFLP. Northern blotting analysis of the goiter RNA with a thyroglobulin probe
      suggested that thyroglobulin mRNA size was slightly reduced. Polymerase chain
      reaction amplification of the 8.5-kb thyroglobulin mRNA as overlapping cDNA
      fragments demonstrated that a 200-bp segment was missing from the 5' region of
      the goiter mRNA. Subcloning and sequencing of the cDNA fragments, and of the
      patient genomic DNA amplified from this region, revealed that exon 4 is missing
      from the major thyroglobulin transcript in the goiter, and that this aberrant
      splicing is due to a C to G transversion at position minus 3 in the acceptor
      splice site of intron 3. The presence in exon 4 of a putative donor tyrosine
      residue (Tyrosine nr 130) involved in thyroid hormone formation provides a
      coherent explanation to the hypothyroid status of the patient.

PMID- 1752953
TI  - Endogenous adenosine is an autacoid feedback inhibitor of chloride transport in
      the shark rectal gland.
AB  - The present studies define the physiologic role of endogenous adenosine in the
      perfused shark rectal gland, a model epithelia for hormone-stimulated chloride
      transport. Chloride ion secretion, and venous adenosine and inosine
      concentrations increased in parallel in response to hormone stimulation. From a
      basal rate of 157 +/- 26 mu eq/h per g, chloride secretion increased to 836 +/-
      96 and 2170 +/- 358 with 1 and 10 microM forskolin, venous adenosine increased
      from 5.0 +/- 1 to 126 +/- 29 and 896 +/- 181 nM, and inosine increased from 30 +/
      9 to 349 +/- 77 and 1719 +/- 454 nM (all P less than 0.01).
      Nitrobenzylthioinosine (NBTI), a nucleoside transport inhibitor, completely
      blocked the release of adenosine and inosine. Inhibition of chloride transport
      with bumetanide, an inhibitor of the Na+/K+/2Cl- cotransporter, or ouabain, an
      inhibitor of Na+/K+ ATPase activity, reduced venous adenosine and inosine to
      basal values. When the interaction of endogenous adenosine with extracellular
      receptors was prevented by adenosine deaminase, NBTI, or 8-phenyltheophylline,
      the chloride transport response to secretagogues increased by 1.7-2.3-fold. These
      studies demonstrate that endogenous adenosine is released in response to hormone
      stimulated cellular work and acts at A1 adenosine receptors as a feedback
      inhibitor of chloride transport.

PMID- 1752954
TI  - Asialoagalacto-human chorionic gonadotropin, a carbohydrate-modified variant of
      human chorionic gonadotropin, antagonizes the stimulatory actions of bovine
      thyroid-stimulating hormone on thyroid function and HLA-DR expression in human
      thyroid in vitro and in vivo.
AB  - The concept of using thyroid-stimulating hormone (TSH) receptor antagonists in
      the management of Graves' disease is intriguing. Therefore, we investigated a TSH
      receptor antagonist derived from human chorionic gonadotropin (hCG) with respect
      to TSH receptor binding, adenylate cyclase activity, thyroid hormone release, and
      HLA class II antigen expression in vitro and in an in vivo model. A variant of
      hCG, asialoagalacto-hCG, like asialo-hCG and unlike hCG itself, inhibited both
      125I-bTSH binding and cAMP response to bTSH in human thyroid membranes. However,
      like intact or deglycosylated hCG and unlike asialo-hCG, asialoagalacto-hCG
      displayed a limited affinity for hepatic asialoglycoprotein receptors, a likely
      marker for its in vivo turnover rate. It proved capable of inhibiting bTSH
      stimulated thyroid hormone release in human thyroid slices as well as in the nude
      mouse bearing human thyroid transplants. It also prevented bTSH induced
      hypertrophy of transplanted thyrocytes. Further, HLA-DR expression induced by
      bTSH in the presence of gamma-interferon on human thyrocytes was inhibited. In
      conclusion, we present evidence that asialogalacto-hCG antagonizes bTSH actions
      on thyroid function and HLA-DR expression in human thyroid in vitro and, more
      importantly, in an in vivo model. Hence, the hCG variant described here or
      similar agents should warrant further exploration in the study and treatment of
      Graves' disease.

PMID- 1752955
TI  - Effects of alpha-thalassemia and sickle polymerization tendency on the urine
      concentrating defect of individuals with sickle cell trait.
AB  - A defect in urine concentrating ability occurs in individuals with sickle cell
      trait (HbAS). This may result from intracellular polymerization of sickle
      hemoglobin (HbS) in erythrocytes, leading to microvascular occlusion, in the vasa
      recta of the renal medulla. To test the hypothesis that the severity of the
      concentrating defect is related to the percentage of sickle hemoglobin present in
      erythrocytes, urinary concentrating ability was examined after overnight water
      deprivation, and intranasal desmopressin acetate (dDAVP) in 27 individuals with
      HbAS. The HbAS individuals were separated into those who had a normal alpha
      globin genotype (alpha alpha/alpha alpha), and those who were either heterozygous
      (-alpha/alpha alpha) or homozygous (-alpha/-alpha) for gene-deletion alpha
      thalassemia, because alpha-thalassemia modulates the HbS concentration in HbAS.
      The urinary concentrating ability was less in the alpha alpha/alpha alpha
      genotype than in the -alpha/alpha alpha or -alpha/-alpha genotypes (P less than
      0.05). After dDAVP, the urine osmolality was greater in patients with the -alpha/
      alpha genotype than with the -alpha/alpha alpha genotype (882 +/- 37 vs. 672 +/-
      38 mOsm/kg H2O) (P less than 0.05); patients with the -alpha/alpha alpha genotype
      had greater concentrating ability than individuals with a normal alpha-globin
      gene arrangement. There was an inverse linear correlation between urinary
      osmolality after dDAVP and the percentage HbS in all patients studied (r = 
      0.654; P less than 0.05). A linear correlation also existed for urine
      concentrating ability and the calculated polymerization tendencies for an oxygen
      saturation of 0.4 and O (r = -0.62 and 0.69, respectively). We conclude that the
      severity of hyposthenuria in HbAS is heterogeneous. It is determined by the
      amount of HbS polymer, that in turn is dependent upon the percentage HbS, which
      is itself related to the alpha-globin genotype.

PMID- 1752956
TI  - Surfactant chemical composition and biophysical activity in acute respiratory
      distress syndrome.
AB  - Acute Respiratory Distress Syndrome (ARDS) is characterized by lung injury and
      damage to the alveolar type II cells. This study sought to determine if
      endogenous surfactant is altered in ARDS. Bronchoalveolar lavage was performed in
      patients at-risk to develop ARDS (AR, n = 20), with ARDS (A, n = 66) and in
      normal subjects (N, n = 29). The crude surfactant pellet was analyzed for total
      phospholipids (PL), individual phospholipids, SP-A, SP-B, and minimum surface
      tension (STmin). PL was decreased in both AR and A (3.48 +/- 0.61 and 2.47 +/-
      0.40 mumol/ml, respectively) compared to N (7.99 +/- 0.60 mumol/ml).
      Phosphatidylcholine was decreased in A (62.64 +/- 2.20% PL) compared to N (76.27
      +/- 2.05% PL). Phosphatidylglycerol was 11.58 +/- 1.21% PL in N and was decreased
      to 6.48 +/- 1.43% PL in A. SP-A was 123.64 +/- 20.66 micrograms/ml in N and was
      decreased to 49.28 +/- 21.68 micrograms/ml in AR and to 29.88 +/- 8.49
      micrograms/ml in A. SP-B was 1.28 +/- 0.33 micrograms/ml in N and was decreased
      to 0.57 +/- 0.24 micrograms/ml in A. STmin was increased in AR (15.1 +/- 2.53
      dyn/cm) and A (29.04 +/- 2.05 dyn/cm) compared to N (7.44 +/- 1.61 dyn/cm). These
      data demonstrate that the chemical composition and functional activity of
      surfactant is altered in ARDS. Several of these alterations also occur in AR,
      suggesting that these abnormalities occur early in the disease process.

PMID- 1752957
TI  - Eosinophil hematopoietins antagonize the programmed cell death of eosinophils.
      Cytokine and glucocorticoid effects on eosinophils maintained by endothelial cell
      conditioned medium.
AB  - Granulocyte-macrophage colony-stimulating factor (GM-CSF) was established as the
      constitutive and elicited human umbilical vein endothelial cell-derived
      eosinophil viability-sustaining factor. Stimulation of endothelium cell
      monolayers with IL-1 alpha (5 U/ml) increased the 48-h elaboration of GM-CSF from
      a mean of 3.2 to a mean of 8.2 pM (P less than 0.05). Dexamethasone (100 nM)
      decreased the constitutive GM-CSF elaboration by 49% (P less than 0.001) but did
      not diminish production by IL-1 alpha-stimulated endothelium. However, eosinophil
      viability decreased by 21% in dexamethasone-pretreated IL-1 alpha-stimulated
      endothelial cell-conditioned medium (P less than 0.05), which suggested viability
      antagonism by glucocorticoids. After 24 h of culture, eosinophil viability for
      replicate cells in enriched medium alone or with 1 pM GM-CSF decreased from means
      of 43 and 75% to means of 21 and 54%, respectively, when dexamethasone was
      included (P less than 0.05). However, 10 pM GM-CSF, IL-3, or IL-5 protected the
      cells against dexamethasone and against endonuclease-specific DNA fragmentation.
      In this model system of eosinophil-tissue interactions, dexamethasone prevents
      the endothelial cells from inducing a pathobiologic phenotypic change in the
      eosinophil by suppression of GM-CSF elaboration to concentrations that are not
      cytoprotective. Cytokine priming by GM-CSF, IL-3, or IL-5 may account for the
      differential responsiveness of select eosinophilic disorders to glucocorticoids.

PMID- 1752958
TI  - Estrogen and progesterone replacement therapy reduces low density lipoprotein
      accumulation in the coronary arteries of surgically postmenopausal cynomolgus
      monkeys.
AB  - The effect of estrogen and progesterone replacement therapy on the initiating
      events in atherogenesis was studied in surgically postmenopausal cynomolgus
      monkeys. Monkeys were ovariectomized and divided randomly into two groups, one
      receiving 17 beta-estradiol and cyclic progesterone treatment (n = 9) and
      ovariectomized controls receiving no hormone replacement therapy (n = 8). The
      monkeys were fed a moderately atherogenic diet for 18 wk to accelerate the early
      pathogenic processes but not to be of sufficient duration to produce grossly
      visible atherosclerotic lesions. Sex hormone replacement therapy decreased the
      accumulation of LDL and products of LDL degradation in the coronary arteries by
      greater than 70% while having no significant effect on plasma lipid, lipoprotein,
      or apoprotein concentrations. Arterial intimal lesions were small with no
      difference between groups. The reduction in arterial LDL metabolism occurred very
      early in the pathogenesis of atherosclerosis and was independent of indices of
      endothelial cell injury, such as enhanced endothelial cell turnover or leukocyte
      adhesion to the endothelium. Results of this study suggest that one mechanism by
      which sex hormone treatment inhibits the initiation of atherosclerosis is a
      direct effect at the level of the arterial wall by suppressing the uptake and/or
      degradation of LDL.

PMID- 1752959
TI  - A single myocardial stretch or decreased systolic fiber shortening stimulates the
      expression of heat shock protein 70 in the isolated, erythrocyte-perfused rabbit
      heart.
AB  - The regulation of heat shock protein 70 (HSP 70) expression was examined in the
      isolated, red blood cell-perfused rabbit heart by Northern and Western blot
      analysis. In the isovolumic (balloon in left ventricle), isolated perfused heart,
      HSP 70 mRNA was increased threefold after 30 min and sevenfold at 2 and 4 h
      compared to normal, nonperfused hearts. To further elucidate the etiology of the
      increase in HSP 70 mRNA, the effects of decreased systolic shortening (isovolumic
      heart) and of a single ventricular stretch were examined. Perfusion without the
      application of a stretch or the presence of a balloon resulted in no increase in
      HSP 70 mRNA; while a single stretch resulted in a threefold increase in HSP 70
      mRNA. These changes were accompanied by an increase in HSP 70 protein by Western
      blot analysis. To elucidate the signalling mechanism mediating the increase in
      HSP 70, hearts were perfused with H7, a protein kinase C inhibitor. H7 did not
      prevent the induction of HSP 70. These results indicate that initiation of
      expression of myocardial HSP 70 can be stimulated by a single myocardial stretch
      or by prevention of systolic shortening. These mechanisms may contribute to the
      rapid expression of HSP 70 after coronary occlusion when dyskinesis, reduced
      systolic shortening, and increased diastolic segment length all occur.

PMID- 1752960
TI  - On the binding of tumor necrosis factor (TNF) to heparin and the release in vivo
      of the TNF-binding protein I by heparin.
AB  - Tumor necrosis factor (TNF), a protein released by activated macrophages, is a
      central mediator of the host response to infection and inflammation. The TNF
      binding protein I (TNF-BP-I) is a soluble fragment of the p60 transmembrane TNF
      receptor and an antagonist to TNF. The level of serum TNF-BP-I was found to be
      increased in patients with renal insufficiency as a result of a decrease in the
      glomerular filtration rate. During hemodialysis of patients with renal failure
      there was a rapid but transient increase in serum TNF-BP-I. This increase was
      found to be caused by heparin given before dialysis and a similar dose-dependent
      response to heparin was observed also in healthy individuals. The finding of a
      repeated release of TNF-BP-I into the circulation with intermittent injections of
      heparin indicates that TNF-BP-I is present both in a storage pool and in a
      circulating pool. The mechanism for the heparin-mediated release of TNF-BP-I was
      not explained; TNF-BP did not show affinity for heparin. On the other hand, TNF
      was found to have affinity for heparin and it could also be dissociated from
      heparin by TNF-BP-I. It is suggested that heparin-like molecules of the
      extracellular matrix can retain TNF in physical proximity with target cells and
      restrict the actions of TNF and protect against systemic harmful manifestations.

PMID- 1752961
TI  - Monocyte transmigration induced by modification of low density lipoprotein in
      cocultures of human aortic wall cells is due to induction of monocyte chemotactic
      protein 1 synthesis and is abolished by high density lipoprotein.
AB  - Incubation of cocultures of human aortic endothelial (HAEC) and smooth muscle
      cells (HASMC) with LDL in the presence of 5-10% human serum resulted in a 7.2
      fold induction of mRNA for monocyte chemotactic protein 1 (MCP-1), a 2.5-fold
      increase in the levels of MCP-1 protein in the coculture supernatants, and a 7.1
      fold increase in the transmigration of monocytes into the subendothelial space of
      the cocultures. Monocyte migration was inhibited by 91% by antibody to MCP-1.
      Media collected from the cocultures that had been incubated with LDL induced
      target endothelial cells (EC) to bind monocyte but not neutrophil-like cells.
      Media collected from cocultures that had been incubated with LDL-induced monocyte
      migration into the subendothelial space of other cocultures that had not been
      exposed to LDL. In contrast, media from separate cultures of EC or smooth muscle
      cells (SMC) containing equal number of EC or SMC compared to coculture and
      incubated with the same LDL did not induce monocyte migration when incubated with
      the target cocultures. High density lipoprotein HDL, when presented to cocultures
      together with LDL, reduced the increased monocyte transmigration by 91%.
      Virtually all of the HDL-mediated inhibition was accounted for by the HDL2
      subfraction. HDL3 was essentially without effect. Apolipoprotein AI was also
      ineffective in preventing monocyte transmigration while phosphatidylcholine
      liposomes were as effective as HDL2 suggesting that lipid components of HDL2 may
      have been responsible for its action. Preincubating LDL with beta-carotene or
      with alpha-tocopherol did not reduce monocyte migration. However, pretreatment of
      LDL with probucol or pretreatment of the cocultures with probucol, beta-carotene,
      or alpha-tocopherol before the addition of LDL prevented the LDL-induced monocyte
      transmigration. Addition of HDL or probucol to LDL after the exposure to
      cocultures did not prevent the modified LDL from inducing monocyte transmigration
      in fresh cocultures. We conclude that cocultures of human aortic cells can modify
      LDL even in the presence of serum, resulting in the induction of MCP-1, and that
      HDL and antioxidants prevent the LDL induced monocyte transmigration.

PMID- 1752962
TI  - Mechanisms of impaired exercise capacity in short duration experimental
      hyperthyroidism.
AB  - To investigate the mechanism of reduced exercise tolerance in hyperthyroidism, we
      characterized cardiovascular function and determinants of skeletal muscle
      metabolism in 18 healthy subjects aged 26 +/- 1 yr (mean +/- SE) before and after
      2 wk of daily ingestion of 100 micrograms of triiodothyronine (T3). Resting
      oxygen uptake, heart rate, and cardiac output increased and heart rate and
      cardiac output at the same submaximal exercise intensity were higher in the
      hyperthyroid state (P less than 0.05). However, maximal oxygen uptake decreased
      after T3 administration (3.08 +/- 0.17 vs. 2.94 +/- 0.19 l/min; P less than
      0.001) despite increased heart rate and cardiac output at maximal exercise (P
      less than 0.05). Plasma lactic acid concentration at an equivalent submaximal
      exercise intensity was elevated 25% (P less than 0.01) and the arteriovenous
      oxygen difference at maximal effort was reduced (P less than 0.05) in the
      hyperthyroid state. These effects were associated with a 21-37% decline in
      activities of oxidative (P less than 0.001) and glycolytic (P less than 0.05)
      enzymes in skeletal muscle and a 15% decrease in type IIA muscle fiber cross
      sectional area (P less than 0.05). Lean body mass was reduced (P less than 0.001)
      and the rates of whole body leucine oxidation and protein breakdown were enhanced
      (P less than 0.05). Thus, exercise tolerance is impaired in short duration
      hyperthyroidism because of decreased skeletal muscle mass and oxidative capacity
      related to accelerated protein catabolism but cardiac pump function is not
      reduced.

PMID- 1752963
TI  - Fatty acids in the portal vein of the rat regulate hepatic insulin clearance.
AB  - The effects of FFA on hepatic insulin clearance were studied in the in situ
      perfused rat liver. Clearance decreased with increasing body weight (age) of the
      rats. When FFA were added to the perfusate a 40% reduction of hepatic removal of
      insulin was found over the normal, physiological range (less than 1,000
      mumol/liter), less pronounced in heavier rats. When perfusion was started with
      high concentrations of FFA, inhibition was rapidly reversible, a phenomenon again
      blunted in heavier rats. In contrast to FFA, different glucose concentrations in
      the perfusate did not affect the hepatic insulin uptake in the presence of FFA
      within physiological concentrations. Thus, hepatic clearance of insulin is
      proportional to rat weight (age) and portal FFA concentrations. Other studies
      have recently shown that fatty acids inhibit insulin binding, degradation, and
      function in isolated rat hepatocytes, and that hepatic clearance is inversely
      dependent on hepatic triglyceride concentrations, both inhibitions reversible by
      prevention of fatty acid oxidation. It is suggested that the diminished hepatic
      clearance of insulin in heavier (older) rats is at least partly due to their
      relative obesity and increased hepatic triglyceride contents. This effect as well
      as that of portal FFA is probably mediated via fatty acid oxidation in the liver.
      This mechanism may have implications for the regulation of hepatic metabolism,
      and peripheral insulin concentrations.

PMID- 1752964
TI  - Mechanism of plasma cholesteryl ester transfer in hypertriglyceridemia.
AB  - Plasma net cholesteryl ester (CE) transfer and optimum cholesteryl ester transfer
      protein (CETP) activity were determined in primary hypertriglyceridemic (n = 11)
      and normolipidemic (n = 15) individuals. The hypertriglyceridemic group
      demonstrated threefold greater net CE transfer leading to enhanced accumulation
      of CE in VLDL. This increased net transfer was not accompanied by a change in
      CETP activity. In normolipidemia, but not in hypertriglyceridemia, net CE
      transfer correlated with VLDL triglyceride (r = 0.92, P less than 0.001). In
      contrast, net CE transfer in hypertriglyceridemia, but not in normolipidemia,
      correlated with CETP activity (r = 0.73, P less than 0.01). Correction of
      hypertriglyceridemia with bezafibrate reduced net CE transfer towards normal and
      restored the correlation with VLDL triglyceride (r = 0.90, P less than 0.005)
      while suppressing the correlation with CETP activity. That net CE transfer
      depends on VLDL concentration was confirmed by an increase of net CE transfer in
      normolipidemic plasma supplemented with purified VLDL. Supplementation of
      purified CETP to normolipidemic plasma did not stimulate net CE transfer. In
      contrast, net CE transfer was enhanced by addition of CETP to both plasma
      supplemented with VLDL and hypertriglyceridemic plasma. Thus, in normal subjects,
      VLDL concentration determines the rate of net CE transfer. CETP becomes rate
      limiting as VLDL concentration increases, i.e., in hypertriglyceridemia.

PMID- 1752965
TI  - Impaired skeletal muscle function in patients with congestive heart failure.
      Relationship to systemic exercise performance.
AB  - In patients with congestive heart failure (CHF), the poor relationship between
      systemic exercise performance and cardiac function, together with morphologic and
      metabolic abnormalities in skeletal muscle, raises the possibility that skeletal
      muscle function may be impaired and limit systemic exercise performance. We
      assessed strength and endurance of the knee extensors during static and dynamic
      exercise in 16 patients with Class I-IV CHF and eight age-matched sedentary
      controls and related these measurements to systemic exercise performance. To
      assess skeletal muscle function independent of peripheral blood flow, endurance
      was repeated under ischemic conditions. Strength was not significantly different
      in the two groups. Dynamic endurance, quantified as the decline in peak torque
      during 15 successive isokinetic knee extensions, was significantly reduced in the
      patients compared to controls during aerobic (peak torque 65 vs. 86% of initial
      for exercise at 90 deg/s and 60 vs. 85% for exercise at 180 deg/s; P less than
      0.002 for both), and during ischemic exercise (56 vs. 76% of initial torque; P
      less than 0.01). Static endurance, defined as the time required for force during
      a sustained maximal voluntary contraction to decline to 60% of maximal, was
      reduced in the patients compared to controls (40 +/- 14 vs. 77 +/- 29 s; P less
      than 0.02). There were highly significant relationships between systemic exercise
      performance and skeletal muscle endurance at 90 and 180 deg/s in the patients
      with CHF (r = 0.90 and 0.66, respectively). These findings indicate that skeletal
      muscle endurance is impaired in patients with CHF, that this abnormality is in
      part independent of limb blood flow, and that these changes may be important
      determinants of systemic exercise performance.

PMID- 1752966
TI  - Water deprivation stimulates transforming growth factor-beta 2 accumulation in
      the juxtaglomerular apparatus of mouse kidney.
AB  - Transforming growth factor-beta (TGF-beta) modulates the growth and
      differentiation of many cells and often functions in an autocrine or paracrine
      fashion. The myoepithelial cells of the renal juxtaglomerular apparatus (JGA)
      synthesize and secrete renin. Under conditions which chronically stimulate renin
      production, the JGA undergoes hypertrophy and hyperplasia. The molecular factors
      responsible for these changes in the JGA have not been identified. In the present
      study, plasma renin activity was stimulated in the mouse by water deprivation.
      Using immunoperoxidase staining with specific antibodies against TGF-beta 1, beta
      2, and beta 3, we found increased TGF-beta 2 accumulation in the JGA and
      interlobular arteries. Immunostaining with renin antiserum demonstrated
      colocalization of TGF-beta 2 and renin. TGF-beta 1 and beta 3 expression was not
      different between control and water-deprived mice. Our results suggest that in
      the setting of water deprivation, TGF-beta 2 is localized in a manner which would
      allow it to act either as a growth factor for or as a phenotypic modulator of the
      JGA and renal arterioles.

PMID- 1752967
TI  - Expression of the hepatocellular chloride-dependent sulfobromophthalein uptake
      system in Xenopus laevis oocytes.
AB  - The expression of the basolateral chloride-activated organic anion uptake system
      of rat hepatocytes has been studied in Xenopus laevis oocytes. Injection of
      oocytes with rat liver poly(A)+RNA resulted in the functional expression of
      chloride-dependent sulfobromophthalein (BSP) uptake within 3-5 d. This expressed
      chloride-dependent BSP uptake system exhibited saturation kinetics (apparent Km
      approximately 6.2 microM) and efficiently extracted BSP from its binding sites on
      BSA. Furthermore, the chloride-activated portion of BSP uptake was inhibited by
      bilirubin (10 microM; inhibition 53%), 4,4'-diisothiocyano-2,2-disulfonic acid
      stilbene (DIDS, 100 microM; 80%), taurocholate (100 microM; 80%), and cholate
      (200 microM; 95%). In contrast to results with total rat liver mRNA, injection of
      mRNA derived from the Na+/bile acid cotransporter cDNA (Hagenbuch, B., B.
      Stieger, M. Foguet, H. Lubbert, and P. J. Meier. 1991. Proc. Natl. Acad. Sci.
      USA. In press.) had no effect on BSP uptake into oocytes. Size fractionation of
      total rat liver mRNA revealed that a 2.0- to 3.5-kb size-class mRNA was
      sufficient to express the hepatic chloride-dependent BSP uptake system. These
      data indicate that "expression cloning" in oocytes represents a promising
      approach to ultimately clone the cDNA coding for the hepatocyte high affinity,
      chloride-dependent organic anion uptake system. Furthermore, the results confirm
      that the Na+/bile acid cotransport system does not mediate BSP uptake.

PMID- 1752968
TI  - Restricted opening of the mouth with an extra-articular cause in children.
AB  - Restricted opening of the mouth with an extra-articular cause (ROMEC) can have
      very different aetiologies. A series of 6 children, who have been operated on
      under 4 different diagnoses, are presented. Excluded are common problems such as
      recent trauma and posttraumatic scarring, craniomandibular dysfunction or
      elongated coronoid process, and also tumours. Problems of establishing the
      diagnosis, surgical treatment, postoperative physiotherapy and timing are
      discussed. It is shown that none of the cases is a perfect result, some outcomes
      are even very disappointing. It is therefore concluded that absolute trismus
      should be treated independently of age. The result expected will be mediocre. For
      final correction it is suggested that the operator should wait preferably until
      the second growth spurt has passed. The same goes for children presenting
      primarily with a mouth opening greater than 20 mm.

PMID- 1752969
TI  - Evaluation of masticatory function following orthognathic surgical correction of
      mandibular prognathism.
AB  - Masticatory function was examined in 17 patients with mandibular prognathism
      before and after bilateral sagittal splitting osteotomy of the mandibular rami.
      Masticatory efficiency was measured by means of a spectrophotometer, using
      adenosine triphosphate (ATP) granules, the biting force and occlusal contact
      area. Masticatory functions showed a tendency to gradual improvement
      postoperatively. Concerning masticatory efficiency, mean values of absorbance of
      ATP granules in patients with mandibular prognathism were inferior to those of
      subjects who possess a normal occlusion, even 12 months after operation.

PMID- 1752970
TI  - Soft tissue changes after advancement genioplasty performed as pedicled or free
      transplants.
AB  - The influence of soft tissue attachment in augmentation genioplasty on
      postoperative soft tissue changes was studied in 25 patients. The soft tissue was
      completely detached from the advanced genial segment in 14 patients and lingual
      soft tissue was maintained in 11 patients. The patients were followed for a
      minimum of 1 year after operation and the soft tissue and bone changes were
      analysed by measuring linear distances and areas on lateral cephalograms. The
      result indicated that the soft tissue changes after surgery were significantly
      different between the two types of graft. In the free grafts there was found to
      be an increased risk of creating a larger interlabial gap and exposure of the
      labial surface of mandibular incisors. The higher correlations between hard and
      soft tissue changes in the pedicled grafts indicated that the predictability is
      better with this operative technique.

PMID- 1752971
TI  - The Egyedi flap in secondary cleft lip repair.
AB  - The Egyedi flap is a reliable technique for secondary lip repair in cases with
      tilting mismatches at the vermilion cutaneous border and asymmetrical vermilion
      excess in a lip of normal volume and sufficient length.

PMID- 1752972
TI  - The status of the resection margin as a prognostic factor in the treatment of
      head and neck carcinoma.
AB  - The value of the status of the resection margin as a prognostic factor after
      surgical treatment was investigated in 80 patients with squamous cell carcinoma
      of the oral cavity, oropharynx and laryngohypopharynx. The relation of
      locoregional recurrence with the presence or absence of tumour at the surgical
      margin was analysed together with other indications for postoperative
      radiotherapy. Locoregional recurrence was observed in 20% and was correlated with
      tumour thickness over 5 mm, spidery growth and tumour-positive margins. Tumour
      positive margin as a single indication for postoperative irradiation was not
      related to an increased recurrence rate. When however occurring together with
      other indications for postoperative irradiation, the recurrence rate was higher
      than in the patient group with the same number of indications for postoperative
      radiotherapy but without tumour at the surgical margins.

PMID- 1752973
TI  - Chondroblastoma of the temporal bone. Case report.
AB  - A case of chondroblastoma of the temporal bone in a 53-year-old male patient is
      presented. The diagnostic and therapeutic processes are discussed.

PMID- 1752974
TI  - Unusual ameloblastoma with extensive stromal desmoplasia.
AB  - A clinicopathological study of 5 cases of unusual ameloblastoma was performed.
      Three cases were characterized by marked stromal desmoplasia. The lesions
      occurred in the tooth-bearing areas of the anterior or premolar regions of the
      jaw. They were relatively small and showed a honeycomb appearance
      radiographically. Histologically, the islands of tumour cells were small and
      discrete in the widely extended desmoplastic stroma. They lacked obvious
      ameloblastic polarity in many parts. The other 2 cases were hybrid lesions of
      desmoplastic and conventional types. The former appeared in the alveolar part and
      the latter in the lower part of the mandible. It was concluded that the
      desmoplastic variant of ameloblastoma could be categorized as a new distinct type
      histologically, clinically and radiographically.

PMID- 1752975
TI  - Current concerns in haematology. 3: Blood count calibration.

PMID- 1752976
TI  - Guidelines on testing for the lupus anticoagulant. Lupus Anticoagulant Working
      Party on behalf of the BCSH Haemostasis and Thrombosis Task Force.

PMID- 1752977
TI  - ACP Broadsheet 130: November 1991. Gross examination of bladder specimens.

PMID- 1752978
TI  - Endocervical carcinoma and precursor lesions: c-myc expression and the
      demonstration of field changes.
AB  - The monoclonal antibody Myc 1-6E10 was used in an immunocytochemical technique to
      examine the expression of the c-myc oncogene in normal endocervices and those
      with glandular intraepithelial neoplasia and invasive malignancy. Eleven of 14
      normal endocervical biopsy specimens did not express the gene, while three showed
      nuclear, or light basal cytoplasmic localisation of the gene product, or both.
      All but one of 14 cases of low and high grade glandular intraepithelial
      neoplasia, and all 17 cases of invasive adenocarcinoma, showed a pan-cellular
      pattern of immunostaining. Of considerable additional interest was the
      demonstration of field changes in morphologically normal glandular epithelium in
      those biopsy specimens with concurrent cervical glandular intraepithelial
      neoplasia or adenocarcinoma. This was manifest as increased concentrations of myc
      proteins compared with normal tissues. These results further support the role of
      the c-myc gene in oncogenesis, and in the light of field changes, suggest
      possible difficulties in the clinical management of this group of patients.

PMID- 1752979
TI  - Feasibility of in situ hybridisation with chromosome specific DNA probes on
      paraffin wax embedded tissue.
AB  - The feasibility was studied of in situ hybridisation using chromosome specific
      DNA probes on paraffin wax embedded normal and malignant tissues from different
      organs. Both isolated nuclei and 5 microns sections were used in in situ
      hybridisation experiments with biotinylated repetitive DNA probes specific for
      the centromeric regions of chromosomes 1 and 17. The hybridisation results were
      visualised with peroxidase-diaminobenzidine. The optimal pretreatments with
      sodium thiocyanate and pepsin were experimentally defined for the different
      tissues. Although interphase cytogenetics on paraffin wax embedded tissue is
      possible, the results indicate that it has its limitations, compared with
      investigations on fresh tumour tissue.

PMID- 1752980
TI  - Rapid detection of hepatitis B virus DNA in liver tissue by in situ hybridisation
      and its combination with immunohistochemistry for simultaneous detection of HBV
      antigens.
AB  - A rapid technique using a non-radioactive receptor molecule (digoxigenin) for
      intrahepatic hepatitis B virus (HBV) DNA detection using in situ hybridisation
      was developed. It can be adapted for use in combination with standard
      immunohistochemistry for simultaneous detection of both HBV DNA and HBV antigens.
      The total time required for dual detection of HBV antigens and HBV DNA starting
      from paraffin wax liver sections was two working days. A good signal to
      background ratio for the detection of HBV DNA was always obtained using this
      labelling. This technique is cheap, safe, and relatively simple which makes it an
      ideal tool for the detection of intrahepatic HBV DNA for both routine diagnostic
      purposes and in research.

PMID- 1752981
TI  - Central pontine myelinolysis in liver transplantation.
AB  - Five cases of central pontine myelinolysis (CPM) were detected by
      neuropathological examination in a series of 50 patients coming to necropsy after
      liver transplantation. One patient also had extrapontine myelinolysis. In no case
      was the diagnosis made during life. Only two patients showed rapid rises in serum
      sodium concentrations. The incidence of hyponatraemia, before and after
      transplantation, and rapid rises in serum sodium in patients with CPM was
      significantly greater than in the 45 patients showing no neuropathological
      evidence of CPM. It is concluded that there is a high incidence of CPM after
      liver transplantation, that clinical diagnosis is difficult, and that there is no
      simple direct correlation between rapid serum sodium changes and the development
      of this condition. Avoidance of major electrolyte fluctuations at the time of
      liver transplantation is recommended but it must be emphasised that CPM may occur
      without any rapid rise in serum sodium concentration.

PMID- 1752982
TI  - Early delayed hypersensitivity responses in tuberculin skin tests after heavy
      occupational exposure to tuberculosis.
AB  - The early (six hours) reaction to tuberculin skin testing was studied in 33
      Indonesian hospital workers with frequent occupational exposure to M tuberculosis
      and compared with responses maximal at the usual time (48 hours) in factory
      workers, from the same locality but with only occasional occupational exposure,
      to determine the nature of the early reaction. The early reaction had the same
      general histopathological appearance as that seen in the conventional (48 hour)
      reaction, and both had an infiltrate consisting largely of T lymphocytes and
      macrophages. The cell densities were lower in the six hour reactions, but the
      relative concentration of macrophages was greater in the earlier response. These
      histometric measurements suggested that the six hour reaction was an accelerated
      delayed hypersensitivity reaction. Moreover, the absence of a specific IgE
      response or of particulate masses of Ig or complement, made it unlikely an
      anaphylactoid or Arthus-type reaction could have been responsible. It is
      concluded that those with frequent occupational exposure to M tuberculosis have
      larger numbers of circulating T cells reactive with mycobacterial antigens, so
      that the development of the skin test response to tuberculin is less dependent on
      "by-stander" cell infiltration to mediate the delayed hypersensitivity reaction
      than the reactions in those with less intense and less frequent natural exposure.
      The skin test response maximal at six hours is probably a hyperimmune reaction to
      an antigen recognised by T cells.

PMID- 1752983
TI  - Removal of inhibitor(s) of the polymerase chain reaction from formalin fixed,
      paraffin wax embedded tissues.
AB  - A problem associated with use of the polymerase chain reaction to amplify
      specific DNA fragments from formalin fixed, paraffin wax embedded tissues is the
      not infrequent failure of amplification. One possible reason for this could be
      the presence of inhibitor(s), which interfere with the activity of the reaction.
      It has been shown that such inhibitor(s) exist when amplifying the human beta
      globin gene (which exists in human genomic DNA as a single copy gene) from
      routine clinical samples. A variety of methods to remove such inhibitor(s) were
      investigated. The results indicate that inhibitor(s) are removed by proteinase K
      digestion, followed by purification with phenol/chloroform, and centrifugation
      through a Centricon-30 membrane (30,000 molecular weight cut off). Other factors,
      including the length and concentration of the DNA sequence to be amplified, can
      also affect amplification.

PMID- 1752984
TI  - Prospective study of quantitative aspects of audit in a large general
      histopathology laboratory.
AB  - A non-computerised method of accurate prospective analysis of the quantitative
      aspects of the work of a general histopathology laboratory was devised. The
      method entails monitoring the progress of all biopsy and cytology specimens
      through the laboratory during selected monthly periods of study. The data
      collected include details of specimen type, block/section/stain details for each
      specimen, and information about the timed progress through technical, medical,
      and secretarial stages of specimen/report handling. The results give a detailed
      breakdown of the biopsy and cytology workload of this department. They give
      information about the rate of passage of specimens through the system and
      identify reasons for delay in the reporting of some cases. The method is easy to
      operate and will allow for the analysis of specific effects--for example, staff
      changes--on the efficiency of the department. The data will also provide some of
      the information required for the costing of histopathology laboratory services,
      and the type of information obtained will probably become a necessary requirement
      for laboratory accreditation.

PMID- 1752985
TI  - Western blot analysis of immune response to Legionella bozemanii antigens.
AB  - The immune response to individual major antigens of Legionella bozemanii was
      studied in 67 sera from 26 inpatients with febrile disease using immunoblotting
      techniques. All the patients had fever of unknown origin and showed strong
      serological reactions to L bozemanii that cross-reacted with Rickettsia typhi, as
      determined by a standard indirect microimmunofluorescence assay. Sera analysed by
      western blotting reacted with 12-14 molecular components of L bozemanii with
      apparent molecular weights ranging from 14,000 to 94,000 daltons. These reactions
      compared well with a reference system using antisera of rabbits immunised with
      the same strain of Legionella. The three major cross-reactive components of R
      typhi were polypeptide antigens of 94,000, 67,000 and 43,000 daltons. It is
      concluded that western blotting can help in the differential diagnosis of
      patients with fever of unknown origin whose sera cross-react to L bozemanii and R
      typhi.

PMID- 1752986
TI  - Assessment of Diesse Ves-matic automated system for measuring erythrocyte
      sedimentation rate.
AB  - Measurement of the erythrocyte sedimentation rate (ESR) using a closed tube
      system reduces the biohazard risk to laboratory staff. The Diesse Ves-matic
      system offers manual or vacuum collection of blood into plastic tubes, automated
      mixing of the sample, and automated reading of the end point after 20 minutes of
      sedimentation. This system was compared with the 1977 Westergren ESR method of
      the International Council for Standardization in Haematology (ICSH) and with the
      1988 ICSH undiluted ESR method. Manually collected Ves-matic samples showed good
      agreement with ICSH values, although there was a tendency to false low results at
      low ESR values which may represent dilution of plasma protein with excess
      citrate. Vacuum collected Ves-matic samples also showed good agreement with ICSH
      values, although there was a tendency to false high results which may reflect a
      change in the blood: citrate ratio caused by loss of anticoagulant diluent or
      vacuum from plastic tubes during storage. The Diesse Ves-matic system
      incorporates several improvements over previous technology and offers a safer,
      quicker, and more standardised ESR.

PMID- 1752987
TI  - Evaluation of the Ciba Corning Biotrack 512 coagulation monitor for the control
      of oral anticoagulation.
AB  - The Ciba Corning Biotrack 512 coagulation monitor requires a minimal degree of
      technical expertise to operate, and is already in use for near-patient testing.
      This study evaluated the monitor for possible use in decentralised control of
      oral anticoagulant treatment. The monitor compared well with Manchester Reagent,
      suggesting that it could be used in areas where this thromboplastin is used for
      centralised control. The inability of the monitor to allow for locally determined
      geometric mean normal prothrombin times in the calculation of the International
      Normalised Ratio (INR), and possibly the high International Sensitivity Index
      (ISI) of the thromboplastin used with the monitor, resulted in poor comparability
      with some other thromboplastins, particularly Thrombotest. These problems need to
      be addressed if the monitor is to be used for decentralised anticoagulant
      control.

PMID- 1752988
TI  - Bone marrow aplasia in B cell chronic lymphocytic leukaemia: successful treatment
      with antithymocyte globulin.
AB  - Pure red cell aplasia is a rare but well known association of chronic lymphocytic
      leukaemia (CLL). Pancytopenia due to bone marrow aplasia has not been previously
      described in CLL. A 42 year old man with B cell CLL became severely pancytopenic
      with bone marrow aplasia. Bone marrow culture resulted in a greatly reduced
      colony formation. High dose corticosteroids and intravenous immunoglobulin
      treatment were unsuccessful. Prompt and complete marrow recovery ensued after
      administration of antithymocyte globulin.

PMID- 1752989
TI  - Bleeding diathesis coincident with chronic myelomonocytic leukaemia.
AB  - Two important haematological problems were found in an otherwise healthy 78 year
      old man: chronic myelomonocytic leukaemia; and a complex, acquired,
      hyperfibrinolytic bleeding disorder characterized by prolonged coagulation times,
      deficiency of coagulation factors V, X, and XI, anti-thrombin III and proteins C
      and S, with high concentrations of circulating tissue plasminogen activator, and
      low concentrations of plasminogen activator inhibitor. There may be a causal
      relation between the two conditions, with the peripheral blood monocytes
      mediating the hyperfibrinolytic process by the abnormal production of tissue
      plasminogen activator, though no previous description of a similar association
      has been reported.

PMID- 1752990
TI  - Squamous cell carcinoma arising in endometriosis of the ovary.
AB  - Squamous cell carcinoma arising in ovarian endometriosis is extremely rare, but a
      case is reported in a 62 year old woman. If such an ovarian tumour is discovered
      evidence of teratoma, Brenner tumour, or endometriosis should be sought.
      Extensive sampling is mandatory as the developing tumour often overgrows the foci
      of endometriosis, thus obliterating evidence of its origin.

PMID- 1752991
TI  - Tuberous sclerosis and parathyroid adenoma.
AB  - Very little is known about the pathogenesis of tuberous sclerosis. Over the past
      10 years, however, increasing numbers of reports on adenomatous diseases in
      association with tuberous sclerosis have been published. A case of hypercalcaemia
      and parathyroid adenoma in association with tuberous sclerosis is presented, of
      which there has been one such report published previously. This association might
      be another manifestation of this complex disease: it is therefore recommended
      that plasma calcium concentrations should be measured in such patients.

PMID- 1752992
TI  - Chronochemistry, rubber, and formalin.

PMID- 1752993
TI  - Declining necropsy rate.

PMID- 1752994
TI  - Defective erythropoiesis in myelodysplastic syndromes.

PMID- 1752995
TI  - Visceral leishmaniasis in human immunodeficiency virus disease.

PMID- 1752996
TI  - Periodontal aspects of osseointegrated fixtures supporting an overdenture. A 4
      year retrospective study.
AB  - 196 Branemark implants in 86 consecutive patients rehabilitated by means of
      overdentures (6 upper jaws, 80 lower jaws) were observed longitudinally. In each
      jaw, only 2 implants were used to anchor the overdenture. 2 implants in the lower
      jaw showed some mobility at the abutment installation and were removed
      immediately. During the loading period (mean loading time 19.1 months ranging
      from 4 to 48 months), none of the implants showed any signs of non-integration.
      The marginal tissue reaction and plaque accumulation were monitored using
      conventional indices. Clinical methods and standardized radiographs were used to
      evaluate the bone level and density. The numbers of approximal surfaces without
      plaque (40%) or with gingival inflammation (55%) were almost constant throughout
      the study. The probing pocket depths remained within the range of 2.7 to 3.2 mm
      during the observation time, whereas the distance of the gingival margin from the
      top of the abutment clearly increased (from 1.8 to 2.9 mm). For loaded lower jaw
      implants connected to each other with a straight bar, a radiographic bone loss of
      0.8 mm was observed during the first postsurgical year followed by a mean annual
      bone loss of less than 0.1 mm. For the "sleeping" fixtures, 50% less bone loss
      was recorded. For loaded but not interconnected implants in the upper jaw, the
      bone loss during the first 6 months reached 2.0 mm. The loss in marginal bone
      height did not clearly correlate with parameters such as the plaque index, the
      gingivitis index, the presence or absence of gingiva around the abutment, or the
      implant length. The present data, with an observation time up to 4 years, showed
      that the failure rate for Branemark implants supporting overdentures in the lower
      jaw can be limited to 1%. However, the use of 2 unconnected fixtures in the upper
      jaw cannot presently be advocated since considerable bone loss was observed.

PMID- 1752997
TI  - The microflora of periodontal sites showing active destructive progression.
AB  - 20 adult periodontitis (AP) subjects were examined every 2 to 4 months and
      microbiological samples were collected and cultured when 2 mm or more loss of
      attachment (active sites) was detected by 2 examiners. Similar sites in which no
      progressive destruction was observed (control sites) also were sampled in the
      same subjects. By lambda-analysis, there was no statistically significant
      difference in floras of active (42 sites from 12 subjects) and control (36 sites
      from 12 subjects) sites or between the floras of the active and control sites and
      of 63 samples from 22 AP subjects that were examined previously in a cross
      sectional study. By paired t test, no microbial species had a significantly
      greater association with active than with control sites. The only species that
      were detected in one or more samples from all subjects with active sites were
      Wolinella recta, Fusobacterium nucleatum, and Peptostreptococcus micros.
      Porphyromonas gingivalis and 9 other taxa were isolated from one-half or more of
      the persons with active sites. The composition of microbiological floras of all
      periodontitis samples was statistically significantly different from that of
      subjects with healthy gingiva. The composition of microfloras of sites in
      subjects with naturally-occurring gingivitis was intermediate between that of
      subjects with healthy gingiva and that of active and control sites in AP
      subjects.

PMID- 1752998
TI  - Marginal bone loss in 16-year-old Swedish adolescents in 1975 and 1988.
AB  - The study was designed to compare the prevalence of marginal bone loss in 2
      cohorts of 16-year-old adolescents, born in 1959 and 1972, respectively. Bitewing
      radiographs from 400 adolescents in each group were evaluated and the presence of
      bone loss (distance between the cemento-enamel junction and the alveolar crest
      greater than 2 mm), calculus, restorations and proximal dental caries were
      recorded. The prevalence of bone loss was 3.5% in 1975 as well as in 1988. Bone
      loss was found most frequently at the mesial and distal surfaces of the first
      maxillary molar. The prevalence of calculus was 12% in 1975 and 7% in 1988. The
      mean DFS for proximal surfaces was 3.1 in 1975 and 0.8 in 1988. No statistically
      verified dependence was found between bone loss and calculus, or bone loss and
      proximal caries.

PMID- 1752999
TI  - Periodontal condition of pregnant women assessed by CPITN.
AB  - The periodontal conditions of 2424 pregnant and 1565 non-pregnant women were
      assessed according to the community periodontal index of treatment needs (CPITN).
      The aim of this survey was to obtain information which is necessary for the
      planning of preventive programs of periodontal disease for pregnant women. 95% of
      the pregnant women and 96% of the non-pregnant women had some signs of
      periodontal disease. The % of pregnant women having 4 or 5 mm pockets was
      significantly higher than that of non-pregnant women, increased with the month of
      pregnancy, reached a maximum of 31% in the 8-month group, but decreased to the
      control level in the 9-month group. These changes were interpreted to suggest
      that the increase of pocket depth during pregnancy was caused by gingival
      enlargement rather than by periodontal destruction. The results show that
      pregnant women had a healthier periodontal condition when compared with non
      pregnant women, i.e., the number of sextants with healthy periodontal tissues was
      higher, the % of people having deep pockets (6 mm or deeper) was lower, and the
      need for prophylaxis was lower in pregnant than in non-pregnant women. These
      findings suggest that a special program of periodontal disease prevention for
      pregnant women is not necessary.

PMID- 1753000
TI  - Application of matched pair procedures to site-specific data in periodontal
      research.
AB  - Application of standard statistical procedures to site-specific data in
      periodontal research is invalid unless site-to-site dependencies are accounted
      for. In this paper, we present the adjustments required for valid application of
      matched pair procedures, including the paired t-test and McNemar's chi 2 test for
      correlated proportions. Examples are given involving data arising from: (1) the
      comparison of pre- and post-treatment clinical measurements; (ii) split-mouth
      protocols.

PMID- 1753001
TI  - Proximal attachment loss in Swedish adolescents.
AB  - The present study describes periodontal conditions in 22 adolescents with
      proximal attachment loss greater than or equal to 2 mm (AL) and 22 matched
      referents without AL, all identified in a cross-sectional study of 570 16- and 18
      year-old. The cases were followed for 3 years and the referents for 1 year while
      they were in the care of an organized dental health system. With the exception of
      1 case with Morbus Hodgkin, the case and referent groups had a similar background
      with respect to general health and participation in the dental health program.
      Bleeding on probing was found at AL sites in 12 of the cases and at corresponding
      sites in 4 referents. 2 cases had a history of eruption disorders at the AL
      sites, 1 case had experienced a defective filling and 1 had a root fissure at the
      AL sites. At re-examinations after 1 and 3 years, 10 out of 21 earlier identified
      AL cases did not meet the criterion of 1 or more sites with AL greater than or
      equal to 2 mm. None of the cases showed progression greater than or equal to 2 mm
      of the lesions. In 1 case, the number of AL sites increased during the period. 4
      of the cases harboured Actinobacillus actinomycetemcomitans (A.a.) at AL sites in
      year 1 and 3 in year 3. 8 of the cases and 4 referents had antibodies specific
      for A.a.-leukotoxin. The 2 most severe cases, in terms of number of sites with
      AL, showed bleeding at 1 or more of the AL sites, harboured A.a. at these sites
      and had serum titers against A.a.-leukotoxin.

PMID- 1753002
TI  - Acute necrotizing ulcerative gingivitis is associated with attachment loss.
AB  - Acute necrotizing ulcerative gingivitis (ANUG) has been generally considered as a
      gingivitis. However, clinical impressions suggest that periodontal attachment
      loss is one of the sequelae of the disease. This study was designed to
      investigate the extent of probing attachment loss detectable following resolution
      of the acute phase of the disease. 13 patients (3 male, 10 female) aged on
      average 22.7 years were studied. The presence of interdental soft tissue
      cratering was used to determine whether a site was previously affected by ANUG.
      ANUG sites were compared with other sites using a paired Student t-test (N = 13).
      Patient mean probing attachment level was greater for ANUG sites (2.2 +/- 0.9)
      than for the mean of all other sites (0.8 +/- 0.7). It is concluded that greater
      loss of probing attachment is associated with sites affected by ANUG than with
      other sites studied.

PMID- 1753003
TI  - Reproducibility of attachment level measurements with two models of the Florida
      Probe.
AB  - Clinical assessment of the progression of periodontitis is based on the
      measurement of periodontal probing attachment levels over time. In calculating
      these changes, duplicate measurements from fixed reference points, including
      cemento-enamel junctions and acrylic stents, have been used to assist in
      detecting progressive disease. The Florida Probe has been previously shown to
      improve the reproducibility of these measurements when used with an acrylic
      stent. The objective of the present study was to evaluate the reproducibility of
      2 models of the Florida Probe, the original stent model and the modified disk
      model, in measuring attachment level. The disk probe differs from the stent probe
      in that it uses the occlusal surface of the tooth as a static reference point in
      calculating changes in attachment level measurements. In 10 subjects, sites were
      probed 2 x by 2 examiners using both types of probe. Standard deviations and
      intra- and inter-examiner correlations were calculated. These results demonstrate
      that the new disk probe yields reproducible measurements similar to the stent
      probe and is therefore suitable for use in longitudinal clinical studies.

PMID- 1753004
TI  - A new method to assess damaging effects on the gingival tissues of non-surgical
      instrumentation.
AB  - A method of assessing the damaging effects of non-surgical instrumentation was
      developed. To test the technique, the effect of cavitational activity in the
      water supply of an ultrasonic scaler was investigated in an in vivo situation.
      Using a replication technique for the scanning electron microscope, it was shown
      that the water supply of the ultrasonic scaler caused superficial disruption of
      the surface of the gingiva, distant from the area of damage caused by mechanical
      contact. The results indicated that further investigations of this phenomenon
      using the technique were required.

PMID- 1753005
TI  - Subgingival irrigation in the maintenance phase of periodontal therapy.

PMID- 1753006
TI  - Cell-seeding.

PMID- 1753007
TI  - Antiarrhythmic drug therapy: a continuously evolving field.

PMID- 1753008
TI  - Crime, misdemeanor, and arrhythmia decoding CAST.

PMID- 1753009
TI  - Electrophysiologic mechanisms for ventricular arrhythmias in left ventricular
      dysfunction: electrolytes, catecholamines and drugs.
AB  - Cardiac arrhythmias are generated as the result of disorders of automaticity or
      of impulse conduction. Regardless of the mechanism, calcium is likely to be
      involved, although calcium antagonists are rarely useful antiarrhythmics in
      ventricular arrhythmias. Myocardial cells that do not ordinarily initiate action
      potentials may do so when they are partially depolarized, giving rise to an
      ectopic focus. Early afterdepolarizations (EADs) are also induced in cardiac
      cells by partial depolarization, whereas delayed afterdepolarizations (DADs) are
      induced by Ca++ overloading. EADs may be the initiating mechanism of torsade de
      pointes, a complication of QT prolongation associated with quinidine therapy.
      Both in the animal model and in humans, treatment with magnesium, isoproterenol,
      or pacing, all of which suppress EADs, will also suppress torsade de pointes.
      Ventricular tachycardia is a manifestation of ordered re-entry, and may be
      exacerbated by antiarrhythmics, especially class 1c drugs. In the individual
      patient, prediction of proarrhythmia is not possible. The risk of proarrhythmia
      is increased in patients with episodes of sustained ventricular tachycardia or
      with significant left ventricular dysfunction.

PMID- 1753010
TI  - Pharmacology and pharmacokinetics of amiodarone.
AB  - Amiodarone is a unique antiarrhythmic agent originally developed as a
      vasodilator. Classified electrophysiologically as a Type III antiarrhythmic, it
      also has both nonspecific antisympathetic and direct, fast channel-membrane
      effects. Hemodynamic effects of orally administered amiodarone (a negative
      inotropic agent) are usually negligible, and are usually compensated for by
      induced vasodilation. Effects on thyroid and hepatic function may help to explain
      some of the unique pharmacologic as well as toxicologic effects of the drug.
      Amiodarone is poorly bioavailable (20-80%) and undergoes extensive enterohepatic
      circulation before entry into a central compartment. The principal metabolite,
      mono-n-desethyl amiodarone is also an antiarrhythmic. From this central
      compartment, it undergoes extensive tissue distribution (exceptionally high
      tissue/plasma partition coefficients). The distribution half-life of amiodarone
      out of the central compartment to peripheral and deep tissue compartments (t1/2
      alpha) may be as short as 4 hours. The terminal half-life (t1/2 beta) is both
      long and variable (9-77 days) secondary to the slow mobilization of the
      lipophilic medication out of (primarily) adipocytes. A pharmacokinetically based
      loading scheme is described, and data suggesting a role for routine amiodarone
      plasma levels are presented.

PMID- 1753011
TI  - Hemodynamic effects of antiarrhythmic drugs.

PMID- 1753012
TI  - Sudden death in congestive heart failure.
AB  - Despite significant advances in recent years in the diagnosis and treatment of
      congestive heart failure, sudden unexpected cardiac death is still considered a
      major epidemiologic problem among those patients. This article lists some of the
      predisposing factors to the development of cardiac arrhythmias and sudden death
      in patients with congestive heart failure. These include electrolyte or autonomic
      nervous system inbalance, the use of certain anti-arrhythmic drugs, or
      intermittent myocardial ischemia. This paper shows that an advanced degree of
      left ventricular dysfunction and the preference frequent or complex ventricular
      arrhythmias appear to be major predictors of total and sudden mortality among
      patients with congestive heart failure. A screening of 24 hours ambulatory Holter
      monitor recording appears to be useful in identifying patients at risk of sudden
      cardiac death.

PMID- 1753013
TI  - Identification of patients at risk for sudden death in congestive heart failure.

PMID- 1753014
TI  - Amiodarone therapy guided by electrophysiologic testing: an update.

PMID- 1753015
TI  - Left ventricular dysfunction and ventricular arrhythmias: reducing the risk of
      sudden death.

PMID- 1753016
TI  - Long-term treatment of ventricular tachycardia with amiodarone in presence of
      severe left ventricular dysfunction.
AB  - A group of 34 consecutive patients with coronary artery disease (n = 29) or
      dilated cardiomyopathy (n = 5) (3 women, 31 men, age 38-80 yr) who had severely
      impaired left ventricular function (left ventricular ejection fraction less than
      or equal to 40%) and high-grade ventricular ectopic activity (sustained or
      nonsustained ventricular tachycardia or ventricular fibrillation) were treated
      with amiodarone (mean dose: 206 mg/d) and followed for 1-117 (mean: 49) months.
      In the total group, there were seven sudden deaths, five deaths due to pump
      failure, one non-cardiac death, and two successful heart transplantations during
      follow-up. Thus the annual cardiac mortality in these carefully selected and
      followed patients was 8, 6%, the annual cardiac event rate was 10, 1%. The
      cumulative cardiac survival-rate was 62% after 5 years and 41% after 10 years. In
      five patients, treatment was interrupted after 10 to 43 months, three of the
      patients were alive at follow-up and two suffered cardiac death, resulting in an
      annual cardiac death rate of 12% in this subgroup of treatment. Based on the
      results of this retrospective analysis we conclude that in patients with low left
      ventricular ejection fraction and nonsustained or sustained ventricular
      tachycardia treated with low dose amiodarone, mortality was unexpectedly low.
      Thus, it may be the antiarrhythmic treatment to be considered in patients with
      ventricular tachycardia and severe left ventricular dysfunction.

PMID- 1753017
TI  - Ventricular arrhythmias associated with congestive heart failure: the role for
      amiodarone.

PMID- 1753018
TI  - Survival of patients with nonsustained ventricular tachycardia and impaired left
      ventricular function treated with low-dose amiodarone.

PMID- 1753019
TI  - Thyrotropin-releasing hormone-immunoreactive projections to the dorsal motor
      nucleus and the nucleus of the solitary tract of the rat.
AB  - Thyrotropin-releasing hormone-immunoreactive nerve terminals heavily innervate
      the dorsal motor nucleus and nucleus of the solitary tract, whereas cell bodies
      containing thyrotropin-releasing hormone residue most densely in the hypothalamus
      and raphe nuclei. By using double-labeling techniques accomplished by retrograde
      transport of Fluoro-Gold following microinjection into the dorsal motor
      nucleus/nucleus of the solitary tract combined with immunohistochemistry for
      thyrotropin-releasing hormone, it was demonstrated that thyrotropin-releasing
      hormone-immunoreactive neurons projecting to the dorsal motor nucleus/nucleus of
      the solitary tract reside in the nucleus raphe pallidus, nucleus raphe obscurus,
      and the parapyramidal region of the ventral medulla, but not in the
      paraventricular nucleus of the hypothalamus. The parapyramidal region includes an
      area along the ventral surface of the caudal medulla, lateral to the pyramidal
      tract and inferior olivary nucleus and ventromedial to the lateral reticular
      nucleus. Varying the position of the Fluoro-Gold injection site revealed a
      rostral to caudal topographic organization of these raphe and parapyramidal
      projections.

PMID- 1753020
TI  - Parallel thalamic activation of the first and second somatosensory areas in
      prosimian primates and tree shrews.
AB  - In Tupaia belangeri and Galago senegalensis, microelectrode recordings
      immediately after ablation of the representation of the forelimb in the
      midportion of the first somatosensory area, S-I, revealed that all parts of the
      second somatosensory area, S-II, remained highly responsive to cutaneous stimuli.
      In this way, prosimian primates, close relatives of simian primates, and tree
      shrews differ markedly from monkeys in which S-II is deactivated by comparable
      ablations, and resemble such mammals as cats and rabbits in which S-II also
      remains highly responsive following ablations in S-I. Thus, it appears that the
      generalized mammalian condition is that S-I and S-II are independently activated
      via parallel thalamocortical pathways. A dependence of S-II on serial connections
      from the thalamus to the S-I region and then to S-II apparently evolved with the
      advent of anthropoid primates, and may be present only in monkeys and perhaps
      other higher primates.

PMID- 1753021
TI  - Neuronal differentiation and maturation in the mouse trigeminal sensory system,
      in vivo and in vitro.
AB  - We have isolated and characterized four monoclonal antibodies (mAbs B33, E1.9,
      B30, and B10) that recognize mouse trigeminal sensory neurons at specific times
      during development. These antibodies permit the study of neuronal
      differentiation, axon outgrowth, and neuronal maturation in the trigeminal
      sensory system. With B33, we can follow migrating neural crest and placode cells
      into the anlagen of the trigeminal ganglion. E1.9 immunoreactivity marks neuronal
      differentiation and appears in the central nervous system at embryonic day 8.5
      (E8.5) and in the peripheral nervous system at E9, E1.9 and B30 show the axonal
      outgrowth of trigeminal sensory neurons and reveal the pioneering of the
      peripheral tracts by an early population of ganglionic neurons. At this stage, in
      the central nervous system, mesencephalic trigeminal neurons are also E1.9 and
      B30 positive as they migrate to their final location in the rostral
      metencephalon. B30 and B10 allow us to follow the maturation of these neurons.
      Also, in about 1% of the embryos, we identified mispositioned or misrouted
      trigeminal neurons. Furthermore, these biochemical markers facilitate the study
      of neuronal development in vitro. We find that, based on morphological and
      biochemical criteria, the maturation of trigeminal neurons in culture is target
      independent.

PMID- 1753022
TI  - Meeting the challenge of cancer care and prevention in Europe.

PMID- 1753023
TI  - Nursing research: is there an obligation on subjects to participate?
AB  - Studies of the ethics of medical and nursing research have focused principally on
      the more practical issues to do with the research process, such as informed
      consent and protection of subjects from harm. A more fundamental question, which
      is often overlooked, is whether individuals are under any sort of obligation to
      participate as subjects in nursing research in the first place. The conclusions
      which nurses reach on this issue will help establish the overall moral climate in
      which nursing research is conducted. In this paper, three models of such an
      obligation are explored; one based on a notion of payment, one centred in the
      social contract, and one which seeks to establish an unconditional obligation.
      Each of these is seen to be flawed in various respects. The delicate and
      potentially conflicting relationship between obligation and consent is then
      briefly examined. In conclusion, it is argued that the notion of a 'moral claim'
      on participation in research is an ethically more acceptable approach than any
      strict sense of obligation.

PMID- 1753024
TI  - Case study of learning milieux: the modifying effect of the workplace.
AB  - In examining the clinical environment that may influence the first-year college
      graduate's attitudes toward continuing learning, four case studies were conducted
      in hospitals within the Illawarra Area Health Service, New South Wales. The
      exploratory research attempts to determine the extent to which desired
      educational changes occur and where improvements could be made to the educational
      process. This paper reports the research findings.

PMID- 1753025
TI  - An experiment in the development of empathy in student nurses.
AB  - Student nurses were assessed for their specific interview behaviour with patients
      after experiencing an empathetic training and a psychological-mindedness
      experience. The results show that empathy was not increased or decreased. The
      reasons for the experimental findings are discussed.

PMID- 1753026
TI  - An analysis of the concept of comfort.
AB  - Comfort is a term that has a significant historical and contemporary association
      with nursing. Since the time of Nightingale, it is cited as designating a
      desirable outcome of nursing care. Comfort is found in nursing science, for
      example in diagnostic taxonomies, and in references to the art of nursing, as
      when practice is described. Roy, Orlando, Watson, Paterson and others use comfort
      in major nursing theories. The term can signify both physical and mental
      phenomena and it can be used as a verb and a noun. However, because comfort has
      many different meanings, the reader has had the burden of deciding if the term is
      meant in one of its ordinary language senses or if its context reveals some
      special nursing sense. The purpose of this paper is to analyse the semantics and
      extension of the term 'comfort' in order to clarify its use in nursing practice,
      theory and research. The semantic analysis begins with ordinary language because
      the common meanings of the term are the primary ones used in nursing practice and
      are the origin of technical nursing usages. Comfort is discussed as the term is
      found in nursing, including texts, standards of care, diagnoses and theory. An
      account of patient needs assessment is used to cull three technical senses of the
      term from its ordinary language meanings. After contrasting these senses in order
      to justify their separateness, they are shown to reflect differing aspects of
      therapeutic contexts. Defining attributes of the three senses are then explicated
      and presented in table format. The last section of the paper addresses some of
      the ways that the extensions of the senses can be measured.

PMID- 1753027
TI  - Chronic sorrow: analysis of the concept.
AB  - Emotionally close relationships can be disrupted at any time in the life cycle.
      When a relationship of attachment is disrupted following an event that renders a
      loved one forever changed from the hoped-for child or from the known person,
      recurrent sadness, or chronic sorrow, is a frequently encountered response. The
      genesis of sadness is one's recognition of a negative disparity between the
      person who was known prior to the onset of disability (or the imagined, hoped-for
      child) and the now-disabled person. Though each episode of sadness resolves
      somewhat over time, renewed recognition of a negative disparity in the disabled
      loved one triggers sadness again. Besides being recurrent, the sadness of chronic
      sorrow is also permanent, variable in intensity between situations and persons,
      and interwoven with periods of neutrality, satisfaction and happiness. The
      concept is analysed and contrasted with the prevalent model of linear, time-bound
      grief.

PMID- 1753028
TI  - The health meanings and practices of older Greek-Canadian widows.
AB  - Folk health and illness beliefs and practices were abstracted from a large-scale
      study of older Greek-Canadian widows conceptualized within Leininger's theory of
      Cultural Care Diversity and Universality using ethnographic, ethnonursing, and
      life health-care history methods. Data were collected using observation
      participation and interviews in three Greek-Canadian communities with 12 widowed
      key informants and 30 general informants. Interview inquiry guides, Leininger's
      Life History Health Care Protocol, and field journal recordings assisted data
      collection. Data were analysed using Leininger's phases of analysis for
      qualitative data. A major health theme which was abstracted from the raw data and
      patterns was: health for Greek-Canadian widows meant a state of well-being,
      ability to perform daily role activities, and avoidance of pain and illness. The
      findings, which also included folk health care and illness beliefs and practices,
      will stimulate future nursing research related to health and nursing care of
      people of diverse cultures.

PMID- 1753029
TI  - Coping and life satisfaction in elderly women with osteoarthritis.
AB  - The relationships among illness-related stress and emotions, coping strategies,
      socio-economic status and life satisfaction of 90 elderly women with
      osteoarthritis were explored in this descriptive, correlational study. Results of
      self-report interview data indicated that the women experienced both positive and
      negative emotions in relation to their day-to-day life with osteoarthritis. The
      coping behaviours used to manage the perceived stress of osteoarthritis included
      confrontive, palliative and emotive strategies. Path analysis supported a
      significant and positive relationship between coping and life satisfaction and
      between objective and subjective measures of life satisfaction.

PMID- 1753030
TI  - A reassessment of nurses' attitudes towards stroke patients in general medical
      wards.
AB  - This paper summarizes a research study inquiring into the attitudes of qualified
      nursing staff and nursing auxiliaries towards stroke patients in general medical
      wards. The survey was undertaken on eight mixed-sex general medical wards in a
      large general hospital. All wards are used for clinical nursing experience for
      nurses in training. Each of the wards, despite having a particular interest in
      one or more medical specialities, regularly admit patients following stroke. All
      nurses were therefore familiar and in regular contact with this particular client
      group. A Likert scale with demonstrated reliability and validity was employed as
      the data collection instrument. Results indicated that nurses were largely
      ambivalent in their attitudes towards stroke rehabilitation. The patterns of
      responses indicate that the nurses who have the more positive attitudes about
      stroke patients consider that they have a role in stroke rehabilitation and that
      they value the nursing contribution. The nurses with less positive attitudes
      towards stroke patients see stroke patients as unco-operative and demanding. The
      findings suggest the need for specific education for the role of the nurse as a
      rehabilitator.

PMID- 1753031
TI  - Health promotion of older adults: perceived barriers.
AB  - The purpose of this descriptive study was to examine the perceptions of rural men
      and women, ages 50 to 70 years, regarding barriers to health promotion in the
      treatment of a chronic disease entity--hypertension. Orem's constructs of self
      care provided the theoretical framework for the study. Specific study aims were
      to (a) identify health belief/values, (b) assess perceptions of self-care
      abilities, (c) determine relative risk through health appraisal, and (d) describe
      phenomenological perceived barriers to health promotion as a lived experience.
      Major findings indicated no relationship between health beliefs/values and self
      care. The health value scores of females for all four subscales were somewhat
      higher than the scores for males. Average, appraised and achievable ages for
      relative risk of dying from all causes were significant for men. Phenomenological
      themes revealed diet, weight and medication usage to be two factors associated
      with perceived barriers. Small sample size and voluntary participation limited
      generalization. Nursing implications included the need for (a) greater assessment
      of the influence of perceived barriers, (b) better approaches to health teaching,
      and (c) more appropriate design of educative--supportive nursing interventions
      for facilitating client self-care.

PMID- 1753032
TI  - Models of nursing: their relevance to the care of elderly people.
AB  - The adoption of nursing models has become widespread throughout the profession
      with little empirical evidence of their usefulness or critical evaluation. This
      paper gives an overview of the issues surrounding the development and use of
      models and presents research data which indicates that one model (Roper, Logan &
      Tierney's Activities of Living) is problematic in the long-term care of the
      elderly. The characteristics of this model which are problematic are common to
      other models and have relevance for other areas of nursing.

PMID- 1753033
TI  - The sources of a practice code of ethics for nurses.
AB  - Interviews with a convenient sample of 27 master's-prepared nurses working in two
      clinical settings revealed that none of them knew the content of the American
      Nurses' Association Code for Nurses. A content analysis developed four
      sensitizing experiences that were sources for their code of nursing practice.
      These were categorized as: (a) clinical, (b) personal, (c) research, and (d)
      professional socialization as a student.

PMID- 1753034
TI  - In defence of Cartesian dualism and the hermeneutic horizon.
AB  - In this paper, the author proposes to consider the intricate interplay between
      the art and science of nursing. The caring role, intrinsic to the meaning of the
      word 'nurse' constrains nursing under the rubric of the arts, while nursing that
      embraces high technology constrains the discipline under the rubric of science.
      Thus, the traditional dichotomy that obtains between the arts and sciences
      seriously complicates the notion of nursing. As a science, nursing adopts the
      materialist theory of the mind that endorses the inseparability of mind and body.
      However, as an art, nursing is more closely aligned with dualist interactionism
      which considers the mind and body to be separate, interacting entities. Nursing
      is a caring profession, the mastery of which rests on the mastery of the
      therapeutic relationship which, in turn, implies mastery of holistic nursing
      care. While the concept of holism implies caring for the 'whole' person in body,
      mind and spirit, such acknowledgement of the mental and spiritual components of
      personhood, immediately invites the entry of dualism into our theoretical
      discourse. Thus, rejection of dualism consigns nursing to theoretical
      impoverishment and therapeutic emasculation. The contentious question is
      therefore: Is the theoretical destiny of nursing one of theoretical
      impoverishment, therapeutic emasculation, and permanent consignment to
      professional ignominy--and all for the sake of an inconvenient soul?

PMID- 1753035
TI  - Using a manpower database to model nurse turnaround and return to service.
AB  - A manpower database for nurses employed by the Department of Health and Social
      Services in Northern Ireland has been developed. This database contains
      information on all nurses employed between March 1977 and July 1988 and consists
      of data on all posts held in this period, including breaks in service. The
      authors show how these data may be used to analyse the durations of spells in
      post and spells out of service prior to departure to a number of destinations for
      the sister and staff nurse grades. The results are presented in a graphical
      format which enables us to evaluate the relative proportion of departures to each
      destination and at what stage in service these departures are likely to occur.
      Such a methodology provides a valuable tool for the nurse manpower planner, and
      utilizes personnel data which are routinely collected by most health authorities.

PMID- 1753036
TI  - Feedback--debate about triage in accident and emergency departments.

PMID- 1753037
TI  - Unipolar depression in the aged: determinants of familial aggregation.
AB  - Late-onset depression (greater than or equal to 60 years) is believed to be less
      associated with a risk of depression in first-degree relatives than early-onset
      depression. However, family studies in elderly probands fitting the current
      methodological standards of family studies are not available. The reported family
      study in geriatric inpatients with unipolar major depression (n = 92) supported
      the proposed relationship between age at onset and the proposed familial loading.
      A comparison to families of age-matched controls (n = 33) revealed that relatives
      of probands with late-onset depression are still at an increased risk of
      depression. However, late-onset depression was not more common in families of
      probands with late-onset depression than in families of probands with early-onset
      depression. Besides the age at onset, the recurrence of depressive episodes
      defined distinct patterns of familial aggregation.

PMID- 1753038
TI  - The interrelatedness of observed behavior of depressed patients and of a
      psychiatrist: an ethological study on mutual influence.
AB  - The interaction of 61 severely depressed hospitalized patients and a psychiatrist
      was studied during a clinical interview. Interactional processes were defined by
      the use of ethological methods. Various observed behaviors were clustered on the
      basis of statistical criteria, yielding behavior factors of the patients and of
      the psychiatrist. The present paper deals with the organization of the
      psychiatrist's behavior and the interrelatedness of the patients' and the
      psychiatrist's behavior. Analysis of the behavior of the psychiatrist revealed
      seven factors: restlessness-1 (head, leg movements, object touching),
      restlessness-2 (body touching, head movements), speech (speech, gesticulating,
      yes and no movements), active listening (intensive body touching and hand
      movements), turn-taking (leg movements and gesticulating during listening),
      encouragement (back-channel behavior and yes-nodding), and change-looking
      (looking and head movements). Within the constraints of studying interactions
      which are bidirectional, it was found that restlessness-2, speech, encouragement
      and active listening of the psychiatrist could be 'predicted' from observed
      behavior of the patients (multiple regression model). The psychiatrist's behavior
      was related both to the severity of depression and to observed behavior not
      directly associated with severity. The psychiatrist's behavior was more strongly
      related to that of the more severely depressed patients than to that of the less
      severely depressed patients. These results contribute to an understanding of the
      behaviors displayed and elicited by depressed patients during a first encounter
      with a stranger.

PMID- 1753039
TI  - Can winter depression be prevented by light treatment?
AB  - The administration of light at the development of the first signs of a winter
      depression appears to prevent it from developing into a full-blown depression. No
      patient from a group of 10 treated in this way developed any signs of depression
      during the rest of the winter season, while five of seven patients from a control
      group became depressed and needed treatment during the winter season.

PMID- 1753040
TI  - Ergopsychometry in depressive patients.
AB  - Thirteen patients with major depressive disorder, 25 patients with dysthymia and
      12 healthy controls underwent ergopsychometric testing. The effect of self-paced
      and set-paced load on mood, vigilance and perseveration tendency was recorded.
      Within the clinical groups, various types of load seemed to result mainly in
      variations in mood. Dysthymics reacted to monotonous load with a deterioration in
      mood and reacted to load under time pressure with an improvement in mood.
      Patients with major depressive disorder displayed an amelioration in mood
      throughout the whole experiment regardless of which particular stressor was being
      employed. In healthy patients, load did not appear to produce any significant
      change in mood.

PMID- 1753041
TI  - The effects of depression and age on the Horne-Ostberg morningness-eveningness
      score.
AB  - Effects of depression and age on the Horne-Ostberg morningness-eveningness scale
      in human volunteers were assessed. Thirty-nine healthy outpatients with current
      DSM-IIIR depression, free of recent substance abuse or confounding medications,
      were compared to 39 age- and sex-matched controls. Patients reported greater
      'eveningness' than controls (P = 0.014, Wilcoxon signed-ranks test). There was
      multimodality in the distribution of Horne-Ostberg scale scores in the depressed
      group, but a normal distribution in controls. Pearson's correlation of age vs.
      Horne-Ostberg score was positive (r = 0.42-0.55). Depression and age influence
      the Horne-Ostberg score. Potential multimodality of circadian phase in the
      depressed group deserves further study.

PMID- 1753042
TI  - Prevalence of postural hypotension at baseline in the Systolic Hypertension in
      the Elderly Program (SHEP) cohort.
AB  - OBJECTIVE: The objective of this study was to examine the prevalence and
      correlates of postural hypotension (defined as a drop in systolic blood pressure
      of greater than or equal to 20 mm Hg) in a cohort of elderly persons with
      isolated systolic hypertension (ISH). DESIGN: Baseline cross-sectional analysis
      of the 4,736 persons randomized in the Systolic Hypertension in the Elderly
      Program (SHEP). SETTING: A randomized multi-center double-blind outpatient
      clinical trial of the impact of treating ISH. PARTICIPANTS: Men and women age
      greater than or equal to 60 years with the systolic blood pressure (SBP) greater
      than or equal to 160 mm Hg and diastolic blood pressure (DBP) less than 90 mm Hg.
      MEASURES: Medical histories were obtained using interviewer-administered,
      standardized clinical history forms. At entry into the study, seated and standing
      BP was measured by certified BP technicians using a random zero sphygmomanometer.
      Postural hypotension (PH) was assessed at 1 and 3 minutes after the participant
      arose from a seated position. MAIN RESULTS: PH was found in 10.4% of participants
      at 1 minute and in 12.0% of participants at 3 minutes. 5.3% of participants
      demonstrated PH at both time intervals while 17.3% demonstrated PH at either or
      both of the time intervals. Factors significantly (P less than 0.05) associated
      with the presence of PH were higher mean SBP and a lower mean body mass index.
      CONCLUSIONS: Somewhat different persons were defined as having PH based upon the
      1 minute and 3 minute standing measures of BP, and prevalence estimates of PH can
      vary depending on whether one or more intervals of measurement are used. Cross
      sectional data analysis indicated that PH, in healthy community-dwelling older
      persons with ISH, may not be associated with a history of disorders or problems
      usually thought to be related to PH. However, prospective data are needed to
      determine the prognostic significance of PH, and whether one or multiple
      measurements carry more significance.

PMID- 1753043
TI  - Effects of exercise training on bone density in older men and women.
AB  - OBJECTIVES: To determine the effects of up to 14 months of aerobic exercise on
      measures of bone density in older adults. DESIGN: Randomized controlled trial
      with subjects assigned to either an aerobic exercise condition, non-aerobic yoga,
      or a wait list non-exercise control group for 4 months. Aerobic fitness and bone
      density were evaluated in all subjects at baseline (Time 1) and after 4 months
      (Time 2). A semi-crossover design was utilized with all subjects completing 4
      months of aerobic exercise, followed by another evaluation (Time 3). All subjects
      were then given the option of 6 additional months of aerobic exercise, after
      which they had a fourth evaluation (Time 4). SETTING: An outpatient exercise
      rehabilitation facility at a large, major medical center. SUBJECTS: One-hundred
      one healthy men (n = 50) and women (n = 51) over age 60 (Mean age = 67.0),
      recruited from the community. INTERVENTION: The exercise program included
      stretching, cycle ergometry, and walking three times per week for 60 minutes
      throughout the course of the study. OUTCOME MEASURES: Aerobic fitness (VO2max) as
      assessed by cycle ergometry, and bone density (bone mineral content) measured by
      single photon absorptiometry. RESULTS: Subjects achieved a 10%-15% increase in
      VO2max after 4 months of exercise training, and 1%-6% further improvement with
      additional training. Aerobic fitness was associated with significant increases in
      bone density in men, but not women, who maintained aerobic exercise for 14
      months.

PMID- 1753044
TI  - Prevalence and characteristics of nursing home-acquired infections in the aged.
AB  - OBJECTIVES: This study provides estimates of the prevalence of infections in all
      patients from a representative sample of 53 Maryland nursing homes; identifies
      risk factors for these infections; and describes diagnostic procedures carried
      out. METHODS: The records of 4,259 patients in a stratified random sample of 53
      Maryland nursing homes were reviewed for diagnostic procedures, medical,
      functional, and behavioral status. Infections were identified by signs, symptoms,
      and laboratory findings. RESULTS: Study patients were characteristic of aged
      patients in US nursing homes. The prevalence of infections actually acquired in
      the nursing home (80% of all infections) was 4.4%. Multivariate analysis revealed
      that skin infections (35% of nursing home-acquired infections) were associated
      with skin ulcers and inversely with urine incontinence. Fevers of uncertain
      source (13%) were associated with bladder catheters. Symptomatic urinary
      infections (12%) and lower respiratory infections (12%) were associated with
      bedfast status, and the latter with tracheostomy and lung disease. Skin ulcers,
      urethral catheters, and bedfast status were markers for nursing home-acquired
      infection. The prevalence of infection in patients with all three markers was
      32%; in patients with none, 2%. Fewer than a quarter of the four most common
      nursing home-acquired infections received an evaluation which met minimal
      diagnostic criteria established by a panel of infectious disease specialists and
      geriatricians. Patients with dementia, those in large homes (greater than 150
      beds), and those in urban homes were less likely to be evaluated in a manner
      meeting these criteria. CONCLUSIONS: Use of three characteristics (ie skin
      ulcers, urethral catheters, bedfast status) to identify patients at risk for
      nursing home-acquired infections may allow targeted infection surveillance and
      prevention programs. In addition, nursing home-acquired infections are not
      evaluated uniformly across patients and facilities, suggesting the need to
      establish, through further study, guidelines for such evaluations.

PMID- 1753045
TI  - Comparing sources of drug data about the elderly.
AB  - OBJECTIVE: This project assessed the extent of agreement between drug-taking data
      obtained from an in-home assessment and that obtained from an automated
      outpatient pharmacy system and from a mail questionnaire. DESIGN: The underlying
      assumption is that an in-home assessment provides the most complete information
      (criterion standard) about the prescription medications being taken. The drug
      data from the mail questionnaire and automated outpatient pharmacies were
      compared with that from the in-home assessment by use of t tests and measures of
      sensitivity, specificity, and positive predictive value. SETTING: Kaiser
      Permanente, Northwest Region, a prepaid group practice HMO. PARTICIPANTS: All
      elderly HMO members enrolled in the Social HMO demonstration project who had a
      comprehensive assessment within 30 days of returning a mail questionnaire between
      March 1986 and March 1988 (n = 83 frail elderly). MAIN OUTCOME MEASURES: The
      number of medications currently being taken and the number of different
      therapeutic classes of drugs being taken per elderly HMO member. MAIN RESULTS:
      The in-home assessment and the automated prescription system closely agreed on
      the number of different medications and the different therapeutic classes of
      prescription drugs being taken. The in-home assessment and mail questionnaire
      were in less agreement. Agreement was less for non-prescription drugs.
      CONCLUSIONS: An automated prescription system is an adequate source of
      information about the prescription drugs currently being taken by frail elderly
      HMO enrollees with a prepaid prescription drug benefit.

PMID- 1753046
TI  - Teaching physical diagnosis in the nursing home: a prospective, controlled trial.
AB  - STUDY OBJECTIVE: To investigate the suitability of the nursing home as a site for
      teaching physical diagnosis to second-year medical students. DESIGN: Prospective
      comparison of teaching sessions in the nursing home to concurrent control
      sessions in acute care wards. SETTING: Nursing Home Care Unit (NHCU) and acute
      care hospital wards of a Veterans Affairs Medical Center. PATIENTS: Sessions with
      38 NHCU patients and 68 hospital patients. MEASUREMENTS AND MAIN RESULTS: Patient
      interviews and student questionnaires were used to obtain responses on a 1-10
      scale (1 = poor, 10 = excellent). Patient responses were very favorable in both
      settings for overall quality of experience (mean score NHCU vs control: 8.8 vs
      8.6) and willingness to participate again (8.4 vs 8.2). Student ratings showed no
      significant differences for patient attitude (7.4 vs 8.4) or quality of exam (7.2
      vs 7.7) while quality of history (6.0 vs 7.6) and overall quality of session (7.6
      vs 8.6) were rated higher (P less than 0.05) for the control sessions. Students
      rated both environments highly (8.6 vs 8.4) but reported that fewer NHCU sessions
      were interrupted (15% vs 25%) or disrupted by noise (6% vs 30%, P less than
      0.005). CONCLUSIONS: Advantages of the nursing home include readily available
      patients who view participation favorably, instructive physical findings, and a
      suitable environment. However, students rate the quality of the histories
      obtained there lower. This problem could be addressed by more careful patient
      selection and greater emphasis by course instructors on other goals of the
      history in addition to exploring the chief complaint.

PMID- 1753047
TI  - The prevalence of undiagnosed protein-calorie undernutrition in a population of
      hospitalized elderly patients.
AB  - OBJECTIVE: To determine the extent to which patients with objective signs of
      malnutrition had been diagnosed as such by physicians and the diagnosis
      documented in the medical record. DESIGN: Cross-sectional. SUBJECTS: All non
      critically ill patients (n = 121) aged 70 years or older admitted to an Oslo
      hospital during a 3-week period. METHODS: Compared problem list and other
      elements of the medical record with observations of height, weight, triceps
      skinfold, midarm circumference, and arm-muscle circumference made on first
      weekday in hospital. Serum albumin available on 66 subjects. MAIN RESULTS: Nine
      patients had weight/height ratios below 60% of normal, 16 patients between 60%
      and 75%, and 41 patients between 74% and 90% of normal. Of these 66 patients,
      only 24 were recognized as malnourished on admission, only five received
      nutritional support, and none was diagnosed as having malnutrition at the time of
      discharge. CONCLUSIONS: Malnutrition is underdiagnosed and undertreated. The
      consequences of this are likely to be deleterious to health.

PMID- 1753048
TI  - Is age an independent risk factor of adverse drug reactions in hospitalized
      medical patients?
AB  - OBJECTIVE: To study the incidence and the risk factors of adverse drug reactions.
      DESIGN: Multicenter survey. SETTING: Hospitalized care: 22 internal medicine and
      19 geriatric wards. PATIENTS: All patients (n = 9,148) consecutively admitted
      during two observation periods of 2 months. MAIN OUTCOME MEASURE: Incidence of
      adverse drug reactions. RESULTS: The mean age was 67.1 +/- 0.17 years (median
      72); the mean duration of hospital stay was 18.1 +/- 0.19 days (median 14). Each
      patient was administered 5.1 +/- 0.03 (median 5) drug prescriptions. The
      incidence of probable or definite adverse drug reactions was 5.8% (532/9,148). In
      univariate analysis, the incidence of adverse drug reactions increased from 3.3%
      at under age 50 to 6.5% at age 70-79 and decreased over age 80 (5.8%). In
      multivariate logistic regression, taking more than four drugs (OR = 2.94, CI =
      2.38-3.62), staying in hospital more than 14 days (OR = 2.82, CI = 2.26-3.52),
      having more than 4 active medical problems (OR = 1.78, CI = 1.29-2.45), staying
      in a medical ward instead of geriatric ward (OR = 1.33, CI = 1.09-1.63), and
      drinking alcohol (OR = 1.28, CI = 1.03-1.58) were positively correlated with
      adverse drug reactions occurrence (P less than 0.05). Age, gender, and smoking
      cigarettes were not significant predictors of adverse drug reactions. CONCLUSION:
      Age is not an independent risk factor of adverse drug reactions, and good
      geriatric care can reduce the incidence of adverse drug reactions.

PMID- 1753049
TI  - The home care practice and attitudes of Minnesota family physicians.
AB  - OBJECTIVE: Assess home care practice and attitudes of Minnesota family physicians
      (FPs). DESIGN: Mailed survey. SETTING: State of Minnesota. PARTICIPANTS: Members
      of the Minnesota Academy of Family Physicians, 80% of the FPs practicing in the
      state. INTERVENTION: A 55-item mailed, self-complete questionnaire regarding
      general practice and personal physician characteristics (18 questions), specific
      questions regarding geriatric and home care practice and related attitudes (37
      questions); up to four reminder or follow-up surveys were sent. MAIN OUTCOME
      MEASURES: Descriptive summary of FP home care practice and attitudes. RESULTS:
      Eighty percent of surveys were completed, 76% of responding physicians made at
      least one home visit in the previous year, and 92% of home visits were to
      geriatric patients. Discriminant function analysis identified six significant (P
      less than 0.001) variables that explained 52% of the variance (r2 = 0.52, Wilks
      Lambda = 0.48) in home visiting behavior between frequent home visiting FPs
      (greater than 24 visits/year) and non-visiting FPs. FPs most likely to do home
      visiting were older and tended to have small group or solo practices in rural
      settings. CONCLUSION: The survey documented continued decline (from previously
      published surveys) of physician home visiting behavior and widespread
      dissatisfaction with reimbursement. However, attitudes regarding home care
      provided by other professionals were highly positive.

PMID- 1753050
TI  - Methicillin-resistant Staphylococcus aureus in Minnesota nursing homes.
AB  - OBJECTIVE: To assess the experience of Minnesota nursing homes with methicillin
      resistant Staphylococcus aureus (MRSA) and the policies and procedures used for
      its control. DESIGN: A 12-question survey, with primarily categorical responses,
      was mailed to the Directors of Nursing of all Minnesota long-term-care
      facilities. A follow-up mailing was sent to non-responders 5 weeks later. The
      mailing included a cover letter, a description of the study and its purposes, and
      a stamped return envelope. Four weeks after the second mailing, all non
      responding institutions were contacted by telephone and invited to participated
      by mail or by completing the survey by telephone. SETTING: All long-term-care
      facilities in Minnesota licensed for skilled and intermediate care. PARTICIPANTS:
      The survey was directed to the Directors of Nursing of the long-term-care
      facilities with the request that, if another individual was better able to
      complete it, the survey be forwarded to them. RESULTS: Completed responses were
      obtained from 88% (395/445) of all long-term-care facilities in Minnesota. Forty
      eight institutions (12%) had residents colonized or infected with MRSA. Only four
      (8%) of these facilities stated that MRSA was a problem; however, 33 (69%) of
      facilities with MRSA had sought outside help or consultation from a variety of
      sources for its control. Few facilities (7%) had cultured residents specifically
      for MRSA. Policies regarding the admission of colonized or infected persons were
      reported by 14% and 21% of facilities, respectively, and over 40% of these
      policies stated that persons with MRSA would not be accepted. Policies regarding
      the care of MRSA-colonized or -infected persons were not uniform. Both
      metropolitan and non-metropolitan facilities had residents with MRSA.
      CONCLUSIONS: Our results suggest that MRSA in long-term-care facilities may be a
      widespread and underrecognized problem. There is a need to develop uniform
      policies for the control of MRSA in nursing homes. These policies should consider
      the sources and objectives of long-term-care facilities.

PMID- 1753051
TI  - The use of estrogen to decrease aggressive physical behavior in elderly men with
      dementia.

PMID- 1753052
TI  - Breast cancer of the older woman: an annotated review.

PMID- 1753053
TI  - Refusal of tube feeding as seen from a patient advocacy organization: a
      comparison with landmark court cases.
AB  - OBJECTIVE: To determine how closely high court decisions regarding tube feeding
      are a reflection of the situations that occur in the general population. DESIGN:
      A retrospective review was conducted of memos recording inquiries made to the
      Society for the Right to Die (SRD), a patient advocacy organization.
      Characteristics of clients were compared to characteristics of individuals
      considered in landmark "right-to-die tube feeding cases during the same period of
      time. RESULTS: Information from 116 memos of inquiries made from 1985 through mid
      1990 was compared to 20 court cases, and significant differences were identified.
      The average age of the SRD clients was 77.6 (+/- 18.4) years compared to 55.1 (+/
      22.8) years for the court cases (P less than 0.001). Of the clients, 79% were 70
      years of age or older and 28% were 90 or older; in contrast, 7 (35%) of subjects
      in the court cases were 70 years of age or older, and none was over 90 (P less
      than 0.001). In addition, whereas 14 (70%) of the court cases dealt with
      individuals in a persistent vegetative state, only 17 (15%) of SRD clients
      carried that diagnosis (P less than 0.001), with the remainder suffering from
      dementia, various stages of coma, or a variety of other debilitating disorders.
      The sex distribution, year of inquiry or year of court decision, and geographic
      distribution were similar. Some states were overrepresented in both groups.
      CONCLUSION: High court cases may inadequately reflect the majority of situations
      that arise on a day-to-day basis. Elderly individuals, in particular those who
      are not in a persistent vegetative state, are significantly underrepresented.

PMID- 1753054
TI  - The financial impact of a nursing home practice on an academic medical center.
AB  - This study reports the economic contributions of nursing home practice to an
      academic department of family practice as well as the fiscal impact of referrals
      from nursing home practice on an academic medical center. Payment to primary
      physician faculty for nursing home service did not fully compensate for faculty
      effort. Nevertheless, these services did result in significant revenues to
      consulting physicians and the University Hospital. In aggregate, an average
      nursing home visit was associated with $33 in charges for the visit by the
      primary physician, $15 for additional primary care services in the clinic and
      hospital, $72 for services by consulting physicians, and $307 in charges by the
      University Hospital. The average nursing home patient provided $3,744 in charges
      and $2,403 in income to the academic medical center per year, with $1,813 going
      to the hospital and $331 to consulting physicians. Even though primary care is
      not well reimbursed, a relatively small number of patients have the capacity to
      create substantial income for consulting physicians and the hospital. The study
      does not address whether these nursing home referrals to the hospital utilized
      disproportionately high hospital resources.

PMID- 1753055
TI  - A multidisciplinary approach in the evaluation of demented drivers referred to
      geriatric assessment centers.

PMID- 1753056
TI  - Dementia and driving.

PMID- 1753057
TI  - Why do physicians fail to recognize and treat malnutrition in older persons?

PMID- 1753058
TI  - Depression in Alzheimer's disease significantly improved under treatment with
      mianserine.

PMID- 1753059
TI  - Uncertain diagnosis of an uncertain entity?

PMID- 1753060
TI  - DNR orders at nursing homes.

PMID- 1753061
TI  - The myth of the myth of senility.

PMID- 1753062
TI  - Vagal influences on gastric acid secretion in response to gastric distension in
      the ferret.
AB  - The role of the vagus nerve in the stimulation of gastric acid secretion was
      investigated by comparing the acid output in response to gastric distension
      during augmented secretion mediated by electrical vagal stimulation and
      pentagastrin. Under control conditions distension increased acid output from 29.8
      +/- 3 mumol/10 min to 59.9 +/- 5.5 mumol/10 min (P less than 0.0001). Bilateral
      cervical vagotomy significantly reduced both basal acid secretion and the
      response to distension although the increase during distension was still
      significant. Electrical vagal stimulation augmented basal acid output and the
      response to distension, and at 1 Hz both parameters were not different from that
      before vagotomy. However, the sensitivity of the response to distension was
      unchanged by vagal stimulation. Pentagastrin infusion augmented basal acid
      secretion and the response to distension in a similar manner to vagal
      stimulation. We conclude that the vagus nerves potentiate the gastric acid
      secretory response to distension not by facilitating enteric reflexes but by an
      action at the level of the parietal cell.

PMID- 1753063
TI  - The pathway of parasympathetic nerve fibers to cerebral vessels from the otic
      ganglion in the rat.
AB  - It has previously been shown that the otic ganglion contributes to the
      innervation of pial arteries in the rat with parasympathetic fibers, but the
      exact pathway from the ganglion to the vessels has been unknown. Further, the
      precise course of the lesser superficial petrosal nerve in the rat has not been
      described. In this research we show, by combining retrograde neuronal tracer
      technique and immunohistochemical demonstration of transmitters, that the fibers
      leave the ganglion in the lesser superficial petrosal nerve, running on the
      anterior and medial inner surface of the tympanic bulla to reach the greater
      superficial petrosal nerve, and deviate via the deep petrosal nerve to the wall
      of the internal carotid artery. Various other nerves were excluded as possible
      pathways.

PMID- 1753064
TI  - Changes in sympathetic and endothelium-mediated responses in the rabbit central
      ear artery after acrylamide treatment.
AB  - The effect of acrylamide intoxication on the innervation and local control of the
      rabbit central ear artery was investigated. There was no difference in the
      noradrenaline, neuropeptide Y and calcitonin gene-related peptide tissue content
      between control and experimental animals. There was, however, a slight reduction
      in catecholamine histofluorescence. Although the contractile efficiency of the
      rabbit central ear artery as measured by responses to potassium chloride was
      unchanged, nerve-mediated contractile responses were significantly attenuated in
      acrylamide-treated animals. Contractile responses induced by exogenous alpha,beta
      methylene ATP were markedly increased after acrylamide treatment, in contrast to
      contractions induced by exogenous noradrenaline which were attenuated at maximal
      concentrations. Modulatory effects of nerve-mediated contractile responses by
      neuropeptide Y were unaffected by acrylamide intoxication. It therefore appears
      that acrylamide intoxication damages sympathetic cotransmission, perhaps with
      preferential action on the purinergic component. Endothelium-dependent relaxant
      responses to acetylcholine and substance P were attenuated in acrylamide-treated
      animals, whereas relaxant responses mediated by calcitonin gene-related peptide
      (endothelium independent) were unaffected. The question of whether the damage to
      the endothelial cell action is a primary effect, or a secondary consequence of
      sympathetic nerve damage, is discussed.

PMID- 1753065
TI  - The effect of brain transection on the response to forced submergence in ducks.
AB  - The effect of brain transection at two levels on cardiovascular responses to
      forced submergence has been investigated in ducks. Compared with intact ducks,
      neither decerebration nor brain stem transection at the rostral mesencephalic
      (RM) level had any effect on development of diving bradycardia, or heart rate at
      the end of two-min dives. Arterial blood pressure was maintained in brain
      transected ducks as well as in intact ducks. Furthermore, end-dive arterial blood
      gases and pH were also similar in intact and brain transected ducks confirming
      that the oxygen sparing cardiovascular adjustments, involving a massive increase
      in total peripheral resistance, were unimpaired by brain transection. In this
      respect, ducks with RM transections tolerated four-min dives. However, the
      increase in post-dive VE seen in intact and decerebrated ducks was prevented by
      RM transection. We conclude that control of the circulatory response to diving
      resides in the lower brainstem, is reflexogenic in nature, and does not depend on
      the cognitive perception of 'fearful' stimuli.

PMID- 1753066
TI  - The placental transfer of calcium.

PMID- 1753067
TI  - The effect of selective umbilical embolization on the common umbilical artery
      pulsatility index and umbilical vascular resistance in fetal sheep.
AB  - In eight anaesthesized fetal sheep (gestational age 112-127 days; term 147 days),
      embolization of the umbilical placental circulation was performed in order to
      evaluate the response of the umbilical artery pulsatility index to an exclusive
      increase in umbilical vascular resistance. Measurements were performed using a 20
      MHz pulsed Doppler transducer and an electromagnetic flow meter mounted on the
      common umbilical artery and catheters at the aortic trifurcation and in one of
      the umbilical veins. Umbilical vascular resistance was calculated according the
      Poiseuille equation as the ratio of aortic to umbilical venous pressure gradient
      and umbilical blood flow. Microspheres were administered at 15-min intervals
      through a catheter in one of the cotyledonary arteries, until fetal heart rate
      had decreased beneath 100 beats/min or had become arrhythmic. The period of
      examination per fetus varied between 60 and 120 min, after which cardiac
      decompensation occurred. During this period, umbilical perfusion pressure
      increased from 20.3 +/- 4.9 to 28.1 +/- 4.7 mmHg (SD; P less than 0.01),
      umbilical blood flow (ml/min) decreased from 342 +/- 127 to 115 +/- 99 mmHg (SD;
      P less than 0.01), umbilical vascular resistance increased from 0.065 +/- 0.022
      to 0.342 +/- 0.150 mmHg.min/ml (P less than 0.01) and common umbilical artery
      pulsatility index increased from 0.97 +/- 0.23 to 4.03 +/- 1.69 (P less than
      0.01). Fetal heart rate did not change significantly (168 +/- 33 prior to cardiac
      decompensation versus 178 +/- 19 beats/min at baseline condition). The linear
      correlation between common umbilical artery pulsatility index and umbilical
      vascular resistance varied between 0.83 and 0.99 and the average correlation was
      0.93 (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753068
TI  - Respiratory and non-respiratory thoracic movements in the fetal pig.
AB  - The aim of this study was to characterize the pre-natal activity of the
      respiratory muscles in a non-ruminant, the pig. Tracheal pressure was recorded
      from 11 unanaesthetized fetal pigs in utero during late gestation in 9 sows. Two
      types of inspiratory effort occurred episodically in each fetus during each
      recording period. Episodes of breathing movements lasted 8.6 +/- 1.1 min and
      their overall incidence was 41.1 +/- 3.4% of recording time. The mean amplitude
      of the respiratory efforts was 7.6 +/- 1.1 mmHg and the mean inspiratory time was
      0.8 +/- 0.1 s. Episodes of non-respiratory inspiratory efforts, considered to be
      fetal hiccups, lasted 5.6 +/- 0.8 min. Individual hiccups had a duration of 150
      200 msec, a mean amplitude of 41.4 +/- 2.4 mmHg and a mean frequency, during
      episodes, of 21.9 +/- 2.0 min-1. In contrast to fetal breathing movements,
      hiccups appeared to be stereotyped events. It is concluded that, in common with
      other ruminant and non-ruminant species, two types of inspiratory effort occur in
      the fetal pig. Fetal hiccups, which have been observed in non-ruminant species,
      may be analogous to deep inspiratory efforts in the sheep fetus. The stimulus
      for, and function of, fetal hiccupping remain to be determined.

PMID- 1753069
TI  - Behavioral state transition and local cerebral blood flow in fetal sheep.
AB  - Local cerebral blood flow in four near term fetal sheep was evaluated
      continuously before and after natural alternations in fetal behavioral state.
      Measurements were made in fetuses several days following an aseptic surgery to
      place electrodes for behavioral state recordings as well as heated and reference
      thermojunctions in cortical and subcortical tissue. These thermojunctions were
      used to qualitatively assess local cerebral blood flow. The time of transition
      between rapid eye movement sleep (REMS) and non-rapid eye movement sleep (NREMS)
      was based on visual inspection of strip chart recordings of electrocortical,
      electroocular, and neck electromyographic activity and application of published
      criteria for their assessment. To confirm that transition had occurred, the
      amplitude of the spectrum of the electrocorticogram in one-third octave bands
      centered around 1 Hz and 20 Hz was measured before and after the transition
      point. Mean cerebral blood flow rose significantly by 24 s (P less than 0.05)
      after the transition from NREMS to REMS and fell by 12 s after the transition
      from REMS to NREMS (P less than 0.05).

PMID- 1753070
TI  - Urogastrone-epidermal growth factor and aspects of sexual maturation in female
      rats as a function of age at treatment.
AB  - The effect of epidermal growth factor (EGF) on sexual maturation of female rats
      was studied. A within-litter experimental design was employed, so that in each
      litter each female received four daily injections of EGF (E, 500 ng/g body weight
      s.c.) or vehicle (V), at one of three ages: days 0-3 (E1, V1), days 8-11 (E2,
      V2), days 16-19 (E3, V3). Body weight, pinna detachment, incisor eruption, eye
      opening, auditory startle, visual placing, vaginal opening and first cytological
      oestrus were assessed. Neonatal treatment with EGF (E1) delayed pinna detachment
      and the appearance of the auditory startle, but accelerated eye opening. Also,
      E1, but not E2 and E3, resulted in lower body weight at weaning. Treatment E3
      advanced sexual maturation, as indicated by vaginal opening and first cytological
      oestrus, by 5-6 days. E1 and E2 had no such effect. Hence the sensitive period
      for the effect of EGF on female rat sexual maturation is later than that for
      effects on other developmental characteristics and body weight. In a second
      experiment, ovary and uterus weights were found not to differ between E3 and V3
      females killed on the day of vaginal opening of the E3 rats, suggesting that the
      effect of EGF may be specifically on the perineal epithelium and not on sexual
      maturation generally.

PMID- 1753071
TI  - Effects of reducing uterine blood flow on fetal blood flow distribution and
      oxygen delivery.
AB  - We examined the effect of graded reduction in uterine blood flow on distribution
      of cardiac output and oxygen delivery to fetal organs and venous blood flow
      patterns in 9 fetal sheep using the radionuclide-labeled microsphere technique.
      We reduced uterine blood flow in two steps, decreasing fetal oxygen delivery to
      70% and 50% of normal, and compared the results with those from a similar study
      from our laboratory on graded umbilical cord compression. With 50% reduction in
      fetal oxygen delivery, blood flow and the fraction of the cardiac output
      distributed to the brain, heart, and adrenal gland increased and that to the
      lungs, carcass, skin, and scalp decreased. Oxygen delivery to the brain and
      myocardium was maintained, while that to the adrenal doubled, and that to the
      brain stem increased transiently. The decrease in oxygen delivery to both carcass
      and lower body segment correlated linearly with oxygen consumption (P less than
      0.001). The proportion of umbilical venous blood passing through the ductus
      venosus increased from 44.6% to 53% (P less than 0.05). The preferential
      distribution of ductus venosus blood flow through the foramen ovale to the heart
      and brain increased, but that to the upper carcass decreased so that ductus
      venosus-derived blood flow to the upper body did not change. Hence, the oxygen
      delivered to the brain from the ductus venosus was maintained, and that to the
      heart increased 54% even though ductus venosus-derived oxygen delivery to the
      upper body fell 34%. Abdominal inferior vena caval blood flow and its
      contribution to cardiac output decreased, but the proportion of the abdominal
      inferior vena caval blood distributed through the foramen ovale also increased
      from 23.0 to 30.9%. However, the actual amount of inferior vena caval blood
      passing through the foramen ovale did not change. There was a 70% fall in oxygen
      delivery to the upper body segment from the inferior vena cava. A greater portion
      of superior vena caval blood was also shunted through the foramen ovale to the
      upper body, but the actual amounts of blood and oxygen delivered to the upper
      body from this source were small. Thus, graded reduction of uterine blood flow
      causes a redistribution of fetal oxygen delivery and of venous flow patterns,
      which is clearly different from that observed previously during graded umbilical
      cord occlusion.

PMID- 1753072
TI  - The interaction of behavioural state, heart rate and resistance index in the
      human fetus.
AB  - The association and possible interactions of fetal behavioural state, fetal heart
      rate and vascular resistance was studied in 23 healthy pregnant women between 36
      and 40 weeks' gestation. Doppler flow velocity waveforms were obtained from fetal
      cerebral (anterior cerebral, internal carotid and basilar), descending aorta and
      umbilical arteries during fetal behavioural state 1F and repeated during 2F. The
      Resistance Index (RI) was used as a measure of vascular resistance. Decreased
      vascular resistance was observed in all vessels except the umbilical artery
      during fetal behavioural state 2F compared to 1F (P less than 0.001). A
      significant interaction was observed between fetal heart rate and fetal
      behavioural state on the RI of the vessels studied, with a greater negative slope
      for RI plotted against fetal heart rate in fetal behavioural state 2F (-0.00139)
      compared to 1F (0.00005) (P less than 0.001). We conclude that the transition
      from fetal behavioural state 1F to 2F is associated with a significant reduction
      in cerebral and systemic vascular resistance, with no apparent change in
      placental resistance. Furthermore, fetal behavioural state and fetal heart rate
      interact, demonstrating a stronger association of fetal heart rate and RI in
      fetal behavioural state 2F in keeping with an increase in baroreflex sensitivity
      at this time.

PMID- 1753073
TI  - Arterial oxygen saturation and breathing movements during the first year of life.
AB  - Sixteen healthy term infants underwent 12 hour tape recordings of arterial oxygen
      saturation (SaO2)(Nellcor N100 in beat to beat mode) and breathing movements at
      around 6 weeks, 3 and 6 months of age. Six of these infants had an additional
      recording at around their first birthday. Recordings were analysed throughout for
      pauses in breathing movements of greater than or equal to 4 s (apnoeic pauses),
      episodes in which SaO2 fell to 80% (desaturations), and (only during regular
      breathing) baseline SaO2. In the 16 infants studied at 6 weeks, 3 and 6 months,
      the median frequency of both apnoeic pauses (5.6, 5.7, and 6.1/h, respectively)
      and desaturations (0.7, 0.4 and 0.5/h, respectively) showed little change. The
      majority of desaturations followed an apnoeic pause (median 73.2, 86.2 and 93.8%
      of desaturations). The median proportion of apnoeic pauses followed by a
      desaturation did not change significantly (9.0, 7.5 and 9.1%), despite an
      increase in the proportion of apnoeic pauses of greater than or equal to 8 s in
      duration from 2.0% at 6 weeks to 5.3% at 3 months (P less than 0.01). Baseline
      SaO2 was 97.3% or higher in all recordings. Median baseline SaO2 increased from
      99.6 to 99.9% between 6 weeks and 3 months (P less than 0.02) and remained
      unchanged thereafter. In the subgroup of infants studied also at one year of age,
      again no significant differences were found with increasing age in the frequency
      of either apnoeic pauses or desaturations. The data show that in healthy subjects
      no major changes occur between 6 weeks and 1 year of life in apnoeic pause
      frequency or arterial oxygenation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753074
TI  - Changes in fetal and maternal plasma protein concentration and colloid osmotic
      pressure with gestation.
AB  - In pregnant ewes, plasma protein levels over the gestation age range of 58-141
      days fell progressively (r = -0.332, P less than 0.05, n = 36) but colloid
      osmotic pressure (COP, mmHg) did not change significantly. In fetal sheep carried
      by these ewes, plasma protein levels increased with age (r = 0.85, P less than
      0.00001, n = 32). COP also rose (r = 0.8, P less than 0.00001, n = 23). Since
      maternal COP did not change and fetal COP increased, the net transplacental COP
      gradient between mother and fetus decreased with increasing age (r = -0.589, P
      less than 0.004, n = 22). Fetal plasma protein levels can be used to calculate
      fetal COP while maternal plasma protein levels cannot be used to calculate
      maternal COP.

PMID- 1753075
TI  - Growth and metabolism of the placenta after unilateral fetectomy in twin pregnant
      ewes.
AB  - Twin-pregnant ewes underwent unilateral fetectomy (Fetx) at 50 days of gestation
      and were studied at 136 days. Aspects of conceptus growth and placental
      cellularity and metabolism in vitro were compared to those of unoperated control
      groups of twin-pregnant or single-pregnant ewes. Mean fetal weight in Fetx ewes
      tended to be greater than that of twin-pregnant ewes and was similar to that of
      single-pregnant ewes. Mean placental wet and dry weights were intermediate
      between those for naturally single- and twin-pregnant animals. Fetectomy caused a
      significant increase in placental protein:DNA ratio but an unchanged DNA
      concentration, apparently due to cellular hypertrophy in the placenta of the
      remaining fetus. Weight-specific rate of oxygen consumption (VO2) of fetal
      placental tissue in twin-pregnant ewes was higher than in Fetx or singles while
      maternal placental VO2 in twins tended to be lower than in either of the other
      two groups. These results highlight the plasticity of placental metabolism and
      growth, perhaps in response to altered trophic signals from the fetus. Unilateral
      fetectomy should prove useful in studies designed to identify these signals.

PMID- 1753076
TI  - Infected urine and prostatectomy wound infection.

PMID- 1753077
TI  - Antibiotic dosing.

PMID- 1753078
TI  - The costs of hospital infection control in a developing country.

PMID- 1753079
TI  - Cost improvements through the establishment of prudent infection control
      practices in a Brazilian general hospital, 1986-1989.
AB  - OBJECTIVES: To review procedures currently practiced in a Brazilian general
      hospital and to eliminate ineffective and inefficient practices. To measure the
      resulting cost improvements based on rigid hospital financing control. DESIGN:
      Implementation of surveillance and control programs and prevalence surveys to
      detect ineffective and inefficient practices. PARTICIPANTS: The study institution
      is a 130-bed general care facility affiliated with the Brazilian federal
      government. There were approximately 4,600 admissions per year during the study
      period (1986-1989). RESULTS: Instituting infection control measures and
      eliminating ineffective practices resulted in the following: an overall decrease
      in wound infection rates from 24.4% in 1987 to 3.45% in 1989; a 71% reduction in
      the global incidence of infection in the intensive care unit; a 74% reduction in
      the surgical prophylactic use of antibiotics; and a total savings of
      approximately $2 million (US dollars). CONCLUSIONS: During the period from 1986
      to 1989, the infection control committee was able to decrease the overall wound
      infection rate from 24.4% in 1987 to 3.45% in 1989. This eliminated special
      health problems and improved patient care and cost-effectiveness for our
      hospital.

PMID- 1753080
TI  - Failure of bland soap handwash to prevent hand transfer of patient bacteria to
      urethral catheters.
AB  - OBJECTIVE: The study was designed to compare the efficacies of bland soap
      handwash and isopropyl alcohol hand rinse in preventing transfer of aerobic gram
      negative bacilli to urinary catheters via transient hand colonization acquired
      from direct patient contact. Glove juice recovery of gram-negative bacteria was
      considered transient colonization; catheter recovery was considered transfer
      colonization. DESIGN: The contact source for gram-negative bacteria was a single
      "high burden" groin skin carrier (greater than or equal to 10(4)/ml cup scrub
      fluid). Using a two-period cross-over design, 6 healthcare workers had 2 15
      second contacts for each hand followed by either soap handwash or alcohol hand
      rinse (12 experiments with each treatment). Between 4 to 5 minutes after contact,
      each hand manipulated a catheter; the catheter was then cultured and the hand was
      glove juice tested. RESULTS: Soap handwash failed to prevent gram-negative
      bacteria transfer to the catheter in 11 of 12 (92%) experiments; alcohol hand
      rinse in 2 of 12 (17%) (p less than .001). Soap handwash failed to prevent
      transient colonization in 12 of 12 (100%) experiments; alcohol in 5 of 12 (42%)
      (risk ratio 2.4, 95% confidence interval 1.2-4.7). Single gram-negative bacteria
      species carried at source levels greater than or equal to 5.5 x 10(3)/ml (heavy
      contamination) established transient colonization in 23 of 30 (77%) exposures
      following soap handwash; single gram-negative bacteria species carried at levels
      less than or equal to 3.5 x 10(3)/ml established colonization in 1 of 22 (5%)
      similar exposures (p less than .001). CONCLUSIONS: Bland soap handwash was
      generally ineffective in preventing hand transfer of gram-negative bacteria to
      catheters following brief contact with a heavy-contamination patient source;
      alcohol hand rinse was generally effective.

PMID- 1753081
TI  - Measles immunity among community hospital employees.
AB  - OBJECTIVE: To define measles immunity rates among employees at 2 hospitals during
      a community outbreak in 1990. DESIGN: Cohort survey using enzyme-linked
      immunosorbent assay (ELISA) and questionnaire. SETTING: Two community hospitals.
      PARTICIPANTS: Seventy-six percent of 2,060 employees. RESULTS: Seven percent
      (115/1566) of participants lacked ELISA-defined measles immunity. Among employees
      whose ages were known, 14% (64/467) of those born after 1956 and 5% (50/1086) of
      those born before 1957 lacked serologic evidence of immunity. Fifty-eight percent
      of the susceptible persons had substantial patient contact. With ELISA results as
      the reference for immunity, the predictive value of an undocumented positive
      history of measles disease or vaccination was 95%; the predictive value of a
      negative history of both was 52%. Measles developed in 7 employees. CONCLUSIONS:
      A substantial number of hospital employees lacked ELISA-defined measles immunity,
      including many who had patient contact or who had been born before 1957.
      Undocumented disease and vaccination histories were not adequate predictors of
      serologic status. This study supports the recommendations and suggestions of the
      Immunization Practices Advisory Committee that hospitals should require
      documented evidence of measles immunity from employees who have patient contact.

PMID- 1753082
TI  - Evaluation of the epidemiology of hepatitis B virus cross-infection in a
      maternity hospital.
AB  - OBJECTIVE: To determine the hepatitis B infection risk in a university hospital
      of obstetrics and gynecology. SETTING: The University Hospital of Obstetrics and
      Gynecology, The University of Sarajevo, Yugoslavia. DESIGN: Staff members were
      divided into three groups: 73 doctors, 184 medical technicians working in
      delivery rooms, and 55 medical technicians working with postnatal care. The
      patients were 63 women, aged 17 to 39 years (mean = 26.11 years), pregnant for
      the first time and in the first stage of labor. Participants all had a negative
      history of hepatitis B and no known contact with the hepatitis B virus. RESULTS:
      The incidence of hepatitis B infections among physicians, technicians, and
      postnatal care technicians was 1.36%, 3.8%, and 3.6%, respectively. The incidence
      among patients was 4.76%. The daily infection risk varied between 1% and 17% of
      all deliveries. CONCLUSIONS: The risks of transmission of the hepatitis B virus
      to hospital workers in this setting is indeed high enough to make a case for
      hepatitis B vaccination in susceptible staff members. Even if vaccination of
      staff members is carried out, hygienic measures to prevent the transmission of
      bloodborne infection between patients and from patients to staff are of the
      utmost importance.

PMID- 1753083
TI  - Infection control violations.

PMID- 1753084
TI  - Malassezia furfur infections.

PMID- 1753085
TI  - Medical waste: a minimal hazard.
AB  - Medical waste is a subset of municipal waste, and regulated medical waste
      comprises less than 1% of the total municipal waste volume in the United States.
      As part of the overall waste stream, medical waste does contribute in a relative
      way to the aesthetic damage of the environment. Likewise, some small portion of
      the total release of hazardous chemicals and radioactive materials is derived
      from medical wastes. These comments can be made about any generated waste,
      regulated or unregulated. Healthcare professionals, including infection control
      personnel, microbiologists, public health officials, and others, have
      unsuccessfully argued that there is no evidence that past methods of treatment
      and disposal of regulated medical waste constitute any public health hazard.
      Historically, discovery of environmental contamination by toxic chemical disposal
      has followed assurances that the material was being disposed of in a safe manner.
      Therefore, a cynical public and its elected officials have demanded proof that
      the treatment and disposal of medical waste (i.e., infectious waste) do not
      constitute a public health hazard. Existent studies on municipal waste provide
      that proof. In order to argue that the results of these municipal waste studies
      are demonstrative of the minimal potential infectious environmental impact and
      lack of public health hazard associated with medical waste, we must accept the
      following: that the pathogens are the same whether they come from the hospital or
      the community, and that the municipal waste studied contained waste materials we
      now define as regulated medical waste.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753086
TI  - The nonexistent problem.
AB  - Effective assessment of problems is essential for the infection control
      practitioner to function optimally. Today's infection control practitioner not
      only learns problem solving on the job but is trained in both individual and
      participatory problem solving techniques. Correct response to a potential problem
      requires careful investigation and identification of causal relationships. Most
      literature, however, is directed at solving problems that exist. The phenomenon
      of nonexistent problems exists when the presented problem is not real but exists
      only in the perception of the presenter. In some cases, the nonexistent problem
      may partially represent a real problem, but the relationship may not be readily
      apparent. Time spent by infection control practitioners responding to nonexistent
      problems is significant. Without the ability to distinguish between nonexistent
      and existent problems, needless and ineffective actions may be taken. It is
      essential that the infection control practitioner understand both the dynamics
      resulting from the presentation of nonexistent problems and their
      characteristics.

PMID- 1753087
TI  - A recombinant C-terminal fragment of staphylococcal enterotoxin A binds to human
      MHC class II products but does not activate T cells.
AB  - Binding of staphylococcal enterotoxin A (SEA) to MHC class II encoded proteins is
      a prerequisite for its subsequent activation of a large fraction of T lymphocytes
      through interaction with variable segments of the TCR-beta chain. We cloned SEA
      in Escherichia coli and produced four recombinant fragments covering both the N-
      and C-terminal regions. These fragments were used to analyze the interaction
      between SEA and the human MHC class II products. A C-terminal fragment of SEA,
      representing amino acids 107-233 bound to HLA-DR and HLA-DP but did not activate
      T cells. The three other fragments (amino acids 1-125, 1-179 and 126-233) neither
      bound to MHC class II Ag nor activated T cells. SEA apparently bind to HLA-DR and
      HLA-DP through its C-terminal part, whereas T cell activation is dependent on
      additional parts of the protein.

PMID- 1753088
TI  - The preference for switching to IgA expression by Peyer's patch germinal center B
      cells is likely due to the intrinsic influence of their microenvironment.
AB  - This study was aimed at determining whether the chronically activated physiologic
      state of Peyer's patch (PP) tissue is primarily responsible for the IgA isotype
      preference expressed by PP germinal centers (GC) and memory B cells. We have used
      reovirus type 1/Lang to stimulate acute, de novo GC reactions in lymph nodes (LN)
      or PP to test the possibility that the surface (s)IgA component of enteric
      responses is peculiar to the local gut microenvironment whether or not PP are in
      a state of chronic activation. GC were raised in PP of germ-free mice by oral
      administration of virus and in lymph nodes (LN) of conventionally reared mice by
      local parenteral infection. Transient GC reactions were found to develop with
      similar time courses in both PP and LN after both primary and secondary local
      infections with reovirus. sIgA+ B cells, which were the major non-sIgM+/sIgD+
      population found to arise in GC of PP, were not found in the LN. In LN, sIgG1+ B
      cells comprised the predominant non-IgM/IgD bearing population that arise after
      local infection. Lymphoid fragment cultures of PP initiated in vitro as early as
      5 days after in vivo infection contained detectable secreted reovirus-specific
      IgA, whereas IgG1 but no IgA was found in LN cultures. Northern blot analysis to
      detect C alpha and C gamma 1 germline transcripts further substantiated a site
      related bias in the expression of non-IgM/IgD isotypes that was manifest within a
      few days after infection. In summation, these observations taken together suggest
      that the preference for generating sIgA+ B cells in PP may be the result of
      intrinsic features of their gut microenvironment.

PMID- 1753089
TI  - Natural antibodies can inhibit bone marrow engraftment in the rat----mouse
      species combination.
AB  - Specific tolerance can be induced in animals by transplanting hemopoietic cells
      across concordant species barriers. Despite the fact that the rat-mouse species
      combination is considered concordant, we have recently demonstrated that normal
      murine serum contains natural antibodies (nAb), predominantly of the IgM and IgG3
      subclasses, with markedly greater binding to rat bone marrow cells (BMC) than to
      rat splenocytes or thymocytes. Since much greater numbers of rat BMC than of
      allogeneic murine BMC are required to achieve engraftment in mice, we considered
      the possibility that these nAbs might be responsible, and that the increased
      numbers of BMC might be required to absorb these nAb. To evaluate the effect of
      these nAb on engraftment of rat BMC in mice, we have now performed adoptive
      transfer studies using T and B cell-deficient severe combined immunodeficiency
      disease (SCID) mice as recipients. Administration of as few as 5 x 10(5) T cell
      depleted rat BMC led to induction of stable xenochimerism in SCID mice
      conditioned with 4-Gy whole body irradiation. Rat T cells developed after a delay
      of several weeks, and conferred the ability to reject non-donor-type rat skin
      grafts, whereas donor-type grafts were accepted. Adoptive transfer of 4 ml of
      normal BALB/c serum led to a marked reduction in the level of rat chimerism in
      SCID recipients of 2 x 10(6) F344 BMC. The ability of sera to inhibit engraftment
      of rat BMC correlated with their cytotoxic nAb content, and the inhibitory effect
      of highly cytotoxic sera could be overcome by administration of large numbers of
      rat BMC. Thus, normal mouse serum has a limited ability to hinder engraftment of
      rat BMC, and this degree of resistance can be overcome by adsorption when large
      numbers of BMC are administered. Eliminating nAb from serum may be more difficult
      in discordant species combinations in recipients with functional B cells, but may
      likewise permit the use of BMT as a means of inducing transplantation tolerance.

PMID- 1753090
TI  - Hemorrhage induces enhanced Kupffer cell cytotoxicity while decreasing peritoneal
      or splenic macrophage capacity. Involvement of cell-associated tumor necrosis
      factor and reactive nitrogen.
AB  - Studies indicate that simple hemorrhage produces a profound depression of cell
      mediated immunity, thereby contributing to an enhanced susceptibility to septic
      challenge in the host. However, it remains unknown whether or not the
      macrophages' cytotoxic capacity is altered after hemorrhage. To study this,
      C3H/HeN mice were bled to and maintained at a blood pressure of 35 mm Hg for 60
      min, and adequately resuscitated. Mice were then killed at 2 or 24 h after
      hemorrhage to obtain peritoneal macrophage, splenic macrophage, and Kupffer
      cells. Cytotoxicity was assessed by determining the capacity of these macrophages
      to lyse [3H]TdR labeled WEHI-164 clone 13 or P815 tumor target cells (WEHI-164,
      sensitive to both soluble and cell-associated TNF vs P815 cells, insensitive to
      soluble TNF). Peritoneal and splenic macrophages from hemorrhaged animals
      exhibited a significantly reduced cytotoxic capacity, whereas Kupffer cells'
      ability to kill the target cells was enhanced. Similarly, the Kupffer cells'
      capacity to release TNF and IL-1, as well as express cell-associated forms of
      this cytokine are significantly enhanced on macrophages isolated 2 h after
      hemorrhage, whereas peritoneal macrophages are not. Furthermore, antibodies
      directed at mouse TNF but not against murine IL-1 alpha or murine IL-6 were able
      to oblate the enhanced target cell lysis of unfixed, as well as paraformaldehyde
      fixed (metabolically inactive) Kupffer cells. Studies using inhibitors (GN
      monomethyl-arginine, superoxide dismutase, catalase, and ibuprofen) of other TNF
      inducible mechanisms of target cell killing indicated that only the inhibition of
      the release of reactive nitrogen consistently depressed the cytotoxic capacity of
      Kupffer cells from hemorrhaged mice. Thus, the increased Kupffer cell
      cytotoxicity from hemorrhaged mice is most likely mediated through the expression
      of cell-associated TNF and the release of reactive nitrogen.

PMID- 1753091
TI  - Induction of in vivo hyporesponsiveness to contact allergens by hapten-modified
      Ia+ keratinocytes.
AB  - Because our previous in vitro studies of hapten-modified Ia+ keratinocytes (KC)
      indicated that these cells induced anergy in Ag-specific Th1 cells, we assayed
      such cells for their ability to induce unresponsiveness in an in vivo animal
      model system of delayed type hypersensitivity (allergic contact dermatitis).
      Naive animals that were treated with i.p. injections of FITC-modified Ia+
      cultured Langerhans cells (cLC) developed allergic contact dermatitis to
      subsequent hapten challenge; whereas, animals treated with similar doses of FITC
      Ia+ KC failed to become sensitized to epicutaneous application of FITC, as
      evidenced by absent ear swelling responses to a FITC challenge. Those animals
      that were first treated with intraperitoneal injections of hapten modified Ia+ KC
      could not be sensitized when they were subsequently exposed to sensitizing doses
      of FITC; whereas a similar first exposure to FITC-cultured Langerhans cells did
      not interfere with epicutaneous sensitization. This hyporesponsiveness to
      sensitization was hapten specific, as FITC-Ia+ KC-treated animals were
      hyporesponsive only to FITC but not to the irrelevant hapten, TNCB. Additionally,
      Ia- KC failed to induce unresponsiveness. Additional studies indicate that the
      hyporesponsiveness was not passively transferrable with splenocytes and was not
      related to the I-J MHC locus. In contrast to our in vitro studies, the
      unresponsiveness induced by hapten-modified Ia+ KC in vivo was transient in
      nature. These data indicate that hapten-modified Ia+ KC function in vivo as
      nonstimulatory accessory cells, by generating down-regulatory signals that can
      interfere with the induction of contact hypersensitivity.

PMID- 1753092
TI  - Expression and synthesis of cross-reactive idiotypic antibodies by peripheral
      blood lymphocytes and their suppression by anti-idiotypes in patients with IgA
      nephropathy.
AB  - We have recently described that patients with IgA nephropathy present high serum
      levels of anti-BSA idiotypic antibodies that were well correlated with the
      existence of hematuria. Furthermore, these Id were found in circulating and renal
      deposited immune complexes. In the present work, we examined the expression of
      surface idiotypic determinants on PBL by flow cytometry and their in vitro
      production, using as reagent anti-idiotypic antibodies previously well
      characterized. The presence of cross-reactive Id-bearing cells was observed in 5
      out of 6 patients studied, with frequencies ranging from 3 to 12% of lymphocytes.
      After 7 days of culture, the spontaneous synthesis of idiotypic antibodies by PBL
      was found elevated in 6 out of 13 (46%) patients. A major Id cell expression and
      production was noted in patients with active disease as defined by hematuria. The
      preincubation of PBL with 20 and 50 micrograms of anti-idiotypic antibodies/2 x
      10(6) cells for 3 days induced a significant inhibition of cross-reactive Id
      production in a dose-dependent fashion, with a degree of suppression between 12
      and 50% in five out of six patients studied. In the above assays, as negative
      controls, we used the anti-Id antibodies previously adsorbed on an Id-Sepharose
      column. On the whole, these results suggest that patients with IgA nephropathy
      present dysfunctions in the Id-Anti-Id network that could play an important role
      in the pathogenesis of this disease.

PMID- 1753093
TI  - Independent analysis of the 16/6 idiotype lupus model. A role for an
      environmental factor?
AB  - The recent description of a lupus-like disease in normal mice after injections of
      human mAb that bind DNA and carry the common Id 16/6 Id has excited much
      attention. In an effort to reproduce this model we have performed two experiments
      using eight human mAb three of which bear the 16/6 Id. Despite using an injection
      protocol very similar to that of the original authors and waiting for up to 1 yr
      we were unable to detect any autoantibodies or any evidence of renal disease. We
      suspect that our failure to reproduce the model may be due to differences in
      either or both the batches of CFA used, or in the animal house environments. It
      supports the view that a mosaic of effects is required to induce clinical
      expression of an autoimmune disease.

PMID- 1753094
TI  - Inhibition of in vivo lymphocyte migration to inflammation and homing to lymphoid
      tissues by the TA-2 monoclonal antibody. A likely role for VLA-4 in vivo.
AB  - The adhesion receptors, LFA-1 and VLA-4, on lymphocytes mediate lymphocyte
      adherence to cytokine-activated endothelial cells (EC) in vitro. Based on our
      previous data, which suggested that the mAb TA-2 reacted with rat VLA-4, the
      effect of TA-2 on lymphocyte migration out of the blood was examined. Small
      peritoneal exudate lymphocytes (sPEL) preferentially migrate to cutaneous
      inflammatory reactions, whereas lymphocytes from peripheral lymph nodes (PLN)
      migrate poorly to inflammatory sites but home avidly to PLN. Treatment of sPEL
      with TA-2 inhibited sPEL migration to DTH, LPS, poly I:C, IFN-gamma, IFN
      alpha/beta, and TNF-alpha by 35 to 65% and their accumulation in PLN by 50%. The
      homing of PLN lymphocytes to PLN was not inhibited by TA-2. Spleen T cell
      migration to cutaneous inflammatory sites was inhibited but homing to PLN was not
      affected. Systemic treatment with TA-2 inhibited sPEL migration to inflamed or
      cytokine-injected skin by up to 70%. Similarly, TA-2 strongly inhibited the
      migration of Ag-stimulated PLN lymphoblasts to skin and to PLN. The migration of
      lymphocytes from all sources, including the peritoneum, spleen, PLN, mesenteric
      nodes, and Peyer's patches, to mesenteric lymph nodes and Peyer's patches was
      inhibited by 80% and 95%, respectively. In conclusion, our results suggest that
      VLA-4 and possibly other alpha 4 integrins mediate the migration of the
      inflammation-seeking sPEL and Ag-activated lymphoblasts to cutaneous inflammatory
      sites and lymph nodes but do not affect the homing of PLN lymphocytes to PLN.
      These integrins also appear to be necessary for the migration of all types of
      lymphocytes to Peyer's patches and mesenteric lymph nodes.

PMID- 1753095
TI  - Collagen-induced arthritis in mice. Relationship of collagen-specific and total
      IgE synthesis to disease.
AB  - The relationship between production of IgE and collagen-induced arthritis in mice
      was examined. Collagen-specific IgE was produced as a consequence of immunization
      of DBA/1 mice with chicken type II collagen emulsified in CFA. We observed a rise
      in collagen-specific IgE antibody levels at the onset of CIA clinical and
      histologic signs in DBA/1 mice. This rise in IgE paralleled that of IgG2a
      anticollagen antibodies, an isotype implicated in the pathogenesis of CIA by
      other laboratories. The collagen-specific IgE contained in the plasma of mice
      with CIA could arm basophils for Ag- (collagen) dependent degranulation. Collagen
      specific IgE may thus contribute to CIA by promoting mast cell degranulation in
      the synovia of susceptible mice immunized with chick type II collagen; but,
      further work is required to establish such a role for IgE in CIA. However,
      genetic differences in disease susceptibility could not be accounted for by
      quantitative differences in collagen-specific IgE production. Further, comparable
      levels of IgE anticollagen antibodies were observed in animals with active CIA
      and after spontaneous remission, thereby confirming that the presence of such
      antibodies is insufficient for disease. Total IgE levels peaked just before
      spontaneous remission indicating active production of IL-4. IL-4 was administered
      to animals with CIA to determine if this lymphokine could be involved in the
      remission process. IL-4 facilitated remission of CIA. Enhanced total IgE
      production may thus be a marker for activation of Th2 cells that produce
      lymphokines such as IL-4 and IL-10, factors that may be involved in the
      spontaneous remission process.

PMID- 1753096
TI  - In vitro induction of a Haemophilus influenzae type b polysaccharide-specific
      antibody response in human peripheral blood lymphocytes of individuals recently
      vaccinated with an oligosaccharide-protein conjugate.
AB  - In this paper an in vitro culture system for the induction of an antibody
      response to the Haemophilus influenzae type b polysaccharide (PRP) is described.
      Anti-PRP IgM and IgG antibody-secreting cells (ASC) and anti-diphtheria toxoid
      (DT) IgG ASC were detected in cultures of blood B and T cells derived from donors
      4 to 6 wk after immunization with Haemophilus influenzae type b oligosaccharide
      mutant diphtheria toxin (CRM197) conjugate (HbOC) and required in vitro
      restimulation with HbOC. When lymphocytes from HbOC-vaccinated donors were
      stimulated with PRP, anti-PRP IgM and IgG ASC could be detected in 50% offGe
      cases. Lymphocytes from PRP-vaccinated donors or non-vaccinated donors
      consistently failed to generate anti-PRP antibodies after in vitro stimulation
      with HbOC. Optimal in vitro responses were observed at concentrations of 0.06 to
      0.6 micrograms/ml of Ag. At higher doses of Ag (6 micrograms/ml) anti-PRP and
      anti-DT antibody responses were suppressed. The in vitro generation of anti-PRP
      and anti-DT ASC, as detected by a spot-forming cell assay was shown to be T cell
      dependent, Ag dependent, and Ag specific. This culture system provides a model
      for the study of human B cell activation and immunoregulation by polysaccharide
      protein conjugates and polysaccharides.

PMID- 1753097
TI  - Cell cycle analysis and DNA aneuploidy in autoimmune mice homozygous for the lpr
      and gld mutations.
AB  - Homozygosity for either of the mutations lpr (lymphoproliferation) or gld
      (generalized lymphoproliferative disease) in mice results in lymphoproliferation
      and autoimmune disease. To investigate the site and time of excessive lymphocyte
      proliferation in these mice, cell nuclei of normal and mutant mice of various
      ages were stained with propidium iodide and DNA profiles were analyzed by flow
      cytometry. Two major results were obtained. First, DNA aneuploidy was observed in
      the lymph nodes and spleen of these autoimmune mice and the cells involved in DNA
      aneuploidy were predominantly of a CD4-CD8- Thy-1- surface phenotype. Second,
      although DNA aneuploidy became apparent in mutant mice at 2 mo of age, the
      numbers of cycling cells were only minimally increased over control levels at all
      ages tested. Thus, the massive cellular accumulation in the lymph nodes of lpr
      and gld mice does not seem ascribable solely to excess cell proliferation in
      these tissues. Moreover, a previously unrecognized cell compartment (CD4-CD8-Thy
      1-) characterized by apparent DNA aneuploidy appears in the same tissues and at
      the same times that the predominant "double negative" (CD4-CD8-Thy-1+) T cell
      subset accumulates.

PMID- 1753098
TI  - Immunologic control of C3 gene expression in tissue macrophages.
AB  - Antigenic suppression of individual complement components can be induced when
      newborn animals or cells in tissue culture are treated for a period of time with
      antibody directed against that component. The initial exposure to antibody
      induces a network involving regulatory lymphocytes and soluble factors. Antigenic
      suppression has been accomplished either in vivo or in vitro with all three
      members of the evolutionarily related family C3, C4, and C5. In this report we
      have demonstrated that antigenic suppression is mainly the result of
      posttranscriptional regulation. After antibody treatment is terminated, during a
      period in which C3 protein is undetectable by sensitive assays, C3 mRNA is often
      briefly increased, after which it is modestly reduced. Therefore, the major
      mechanisms mediating immunologic control of C3 synthesis and secretion are not
      directly related to steady-state levels of C3 mRNA. The initially increased
      levels of C3 mRNA prove that there is no simple direct quantitative relationship
      between C3 mRNA and C3 synthesis and secretion. The later decreases in C3 mRNA
      levels are not sufficient to explain the quantitatively greater decreases in C3
      synthesis. Therefore, the rate determining step in immune regulation of C3
      production occurs after transcription. Regulation could be mediated by altered
      stability of C3 mRNA in the presence of antibody, formation of a defective
      primary transcript, defective processing of the transcript resulting in an
      abnormal mRNA, or a defective C3 translational apparatus. Although regulation is
      multifactorial, interference with translation is most likely to predominate.

PMID- 1753099
TI  - Endotoxin stimulates bronchial epithelial cells to release chemotactic factors
      for neutrophils. A potential mechanism for neutrophil recruitment, cytotoxicity,
      and inhibition of proliferation in bronchial inflammation.
AB  - To test the effect of endotoxin on bronchial epithelial cells (BEC), BEC were
      isolated from bovine lungs and cultured in the presence of bacterial endotoxin.
      The BEC culture supernatant fluids were harvested, and neutrophil chemotactic
      activity (NCA) was determined with a blindwell chamber technique; cytotoxicity
      determined by lactate dehydrogenase release and BEC proliferation determined by
      Coulter counting. Endotoxin caused a dose- and time-dependent release of NCA from
      BEC cultures compared with media alone (82.3 +/- 8.1 vs 12.0 +/- 3.1 cells/high
      power field, p less than 0.001). To further characterize this activity, reverse
      phase HPLC analysis of release eicosanoid metabolites after [3H]arachidonic acid
      incorporation was performed. Endotoxin stimulated the release of the neutrophil
      chemoattractants, leukotriene B4 and 12-hydroxyeicosatetraenoic acids. Endotoxin
      also resulted in a dose and time dependent release of lactate dehydrogenase (42.9
      +/- 4.2 vs 20.2 +/- 2.2 U/liter, p less than 0.001) although higher doses were
      required to cause cytotoxicity than to stimulate chemotaxis. Finally, endotoxin
      resulted in a dose dependent inhibition of BEC proliferation (176 x 10(3) +/- 16
      x 10(3) vs 1,080 x 10(3) +/- 38 x 10(3) cells/ml measured at day 14, p less than
      0.001). These data suggest that bacterial release of endotoxin may contribute to
      the pathophysiologic changes observed in bronchial inflammation by stimulating
      BEC to release NCA, denuding airway epithelium by causing cytotoxicity of BEC,
      and inhibiting epithelial repair by inhibiting BEC proliferation.

PMID- 1753100
TI  - Dependence of cell survival on DNA repair in human mononuclear phagocytes.
AB  - Mononuclear phagocytes play a central role in the pathogenesis of chronic
      inflammatory diseases. It is therefore important to define chemotherapeutically
      exploitable metabolic pathways that distinguish monocytes from other cell types.
      Blood monocytes do not synthesize deoxynucleotides de novo, and their
      transformation to macrophages occurs without cell division. Whether or not
      monocytes can repair DNA damage, and whether or not DNA repair is necessary for
      their survival, is unknown. The present experiments demonstrate that normal human
      monocytes, unlike neutrophils, rapidly repair DNA strand breaks induced by gamma
      irradiation. Monocyte extracts contain functional immunoreactive DNA polymerase
      alpha. DNA repair synthesis in normal monocytes is blocked by aphidicolin, an
      inhibitor of DNA polymerase-alpha with respect to dCTP. Aphidicolin is also
      directly toxic to normal monocytes, but has no effect on nondividing lymphocytes
      or fibroblasts. Compared to most other cell types, monocytes and macrophages have
      very low dCTP pools, but abundant deoxycytidine kinase activity. This suggests
      that dCTP derived from salvage pathways is important for DNA repair in these
      cells. Consistent with this notion, exogenous deoxycytidine could partially
      protect monocytes from aphidicolin killing. The unexpected toxicity of
      aphidicolin toward normal human monocytes may be attributable to their high rate
      of spontaneous DNA strand break formation, to the importance of DNA polymerase
      alpha for DNA repair in these cells, and to their minute dCTP pools.

PMID- 1753101
TI  - Cytokine (tumor necrosis factor, IL-6, and IL-8) production by respiratory
      syncytial virus-infected human alveolar macrophages.
AB  - Human alveolar macrophages (AM) are susceptible to infection with respiratory
      syncytial virus (RSV), but the infection is abortive after the initial cycles of
      virus replication. We have investigated if RSV infection of AM results in the
      production of cytokines TNF, IL-6, and IL-8, all of which may modulate
      inflammatory and immune responses to the virus, as well as may directly protect
      respiratory epithelial cells against spread of infection. Within 1 h after
      interaction with RSV, increased mRNA levels were found for all three cytokines.
      Peak expression of the mRNAs occurred at 3 to 6 h. The virus most effectively
      induced TNF mRNA expression greater than IL-6 mRNA greater than IL-8 mRNA, as
      compared to cytokine mRNA expression induced by bacterial endotoxin. Inactivated
      virus was almost as effective as live virus in inducing and maintaining increased
      IL-6 and IL-8 mRNA over 16 h, whereas live infectious RSV was necessary for
      maintaining TNF mRNA expression over the same time. Protein concentrations of the
      different cytokines in the supernatants of infected AM reflected the increased
      levels of mRNA in the cells. Despite the high levels of cytokines with possible
      antiviral activity (TNF and IL-6) in the AM supernatants, neither supernatants
      nor rTNF when added to bronchial epithelial cells protected them from infection
      with RSV. However, TNF, IL-1, and RSV, but not IL-6, induced IL-8 and IL-6 mRNA
      expression by the bronchial epithelial cells suggesting that cytokines produced
      by RSV-infected AM may be more important in modulating the inflammatory response
      in infection than directly interfering with virus infection/replication of airway
      epithelium.

PMID- 1753102
TI  - Characterization of host cell-derived membrane proteins of the vacuole
      surrounding different intracellular forms of Trypanosoma cruzi in J774 cells.
      Evidence for phagocyte receptor sorting during the early stages of parasite
      entry.
AB  - Trypanosoma cruzi, an obligate intracellular protozoan parasite, exhibits
      developmental regulation of virulence. Although both noninfective epimastigote
      and infective trypomastigote stages of T. cruzi enter phagocytic cells via the
      formation of a parasitophorous vacuole (PV), only the latter developmental stages
      survive ingestion and perpetuate the infection. To determine whether the membrane
      composition of PV surrounding these different stages might contribute to
      differences in the outcome of infection, we identified selected membrane
      constituents by immunofluorescence and intracellular radioiodination, and studied
      their incorporation into PV. Complement receptors (CR3) are incorporated
      preferentially into the PV membrane surrounding serum-opsonized epimastigotes but
      not culture-derived metacyclic trypomastigotes. FcR are not preferentially
      incorporated into PV membranes unless epimastigotes or culture-derived metacyclic
      trypomastigotes are opsonized with anti-T. cruzi antibody. PV surrounding either
      parasite stage contain beta 1 integrins and lysosomal membrane glycoproteins
      (lgp). These results indicate that the plasma membrane glycoproteins incorporated
      into the surrounding PV membrane differ depending upon the stage of parasite
      being internalized, and that these differences reflect, at least in part,
      selective ligation of cell surface receptors mediating uptake. Furthermore, they
      imply that although virulent trypomastigote stages may avoid host cell uptake by
      conventional phagocytic receptors, i.e., CR3 or FcR, they do not escape fusion
      with an lgp-containing vacuole where they could still be exposed to lysosomal
      antimicrobial mechanisms.

PMID- 1753103
TI  - Activated T lymphocytes from mice infected by lymphocytic choriomeningitis virus
      display high affinity IL-2 receptors but do not proliferate in response to IL-2.
AB  - The i.v. injection of mice with lymphocytic choriomeningitis virus (LCMV)
      initiates a rapid and long lasting immunodepression which can be monitored in
      vivo or in vitro. Splenic T lymphocytes taken from mice infected for 7 days with
      LCMV are characterized by a low proliferative capacity in response to Con A
      stimulation in vitro. In an initial attempt to understand the molecular
      mechanisms regulating the general anergy induced by the viral infection, we have
      analyzed the transcription of IL-2 and of p55 IL-2R alpha gene, two genes
      involved in T cell proliferation. IL-2 gene transcripts were hardly detected
      after Con A activation of spleen cells from LCMV-infected mice. In contrast, the
      expression of the gene encoding IL-2R alpha chain was induced as in control
      noninfected cells. In addition, the expression of the p75 IL-2R beta chain was
      not modified. The transcripts of the IL-2R alpha and of the IL-2R beta genes were
      normally translated as high affinity. IL-2R were expressed on the membrane of T
      lymphocytes from LCMV-infected mice. Despite the finding that these receptors
      could also internalize IL-2, the exogenous addition of this growth factor did not
      induce cell proliferation, indicating that the virus-induced blockade is
      multifocal.

PMID- 1753104
TI  - Predominance of the prototypic T15 anti-phosphorylcholine junctional sequence in
      neonatal pre-B cells.
AB  - The primary antibody response to phosphorylcholine (PC) is dominated by T15
      antibodies. There are three families of anti-PC antibodies which can be made in
      mice: T15, 511, and 603. All use the same H chain V, D, and J segments, but each
      anti-PC family has a different L chain, as well as a family-specific Vh-D
      junctional sequence. Here we test the hypothesis that T15 antibodies are dominant
      because the prototypic T15 V-D junction is generated in pre-B cells more often
      than the alternative non-T15 V-D junctional sequences. Rearranged IgH genes from
      DNA derived from fetal or newborn liver pre-B cells and from adult bone marrow
      pre-B cells of BALB/c mice were amplified by polymerase chain reaction, cloned,
      and sequenced. DNA from adult splenic B cells was also amplified, for comparison.
      All V1-DFL16.1 and DFL16.1-Jh1 junctional sequences were analyzed. Fifty-three
      percent (9/17) of all neonatal pre-B cell V-D junctions with V1 and DFL16.1 had
      the prototypic T15 junctional sequence, which has no N regions. In contrast, no
      prototypic T15 V-D junctions were observed in adult pre-B cells, and each
      junctional sequence was unique. Adult splenic B cells contained an intermediate
      number of T15-type V-D junctional sequences (7/21). The prototypic D-J junctional
      sequence used in many anti-PC antibodies was also observed in a high percentage
      of sequences. The high frequency of T15 junctions in the neonatal pre-B cells can
      be explained by two observations: 1) N regions are absent in neonatal but not
      adult junctions and 2) in the absence of N regions, joining of V, D, and J
      segments may be targeted to short regions of sequence homology near the ends of
      the genes. This mechanism would preferentially give rise to the T15 V-D and D-J
      junctions. Preservation of the T15 V-D junction in adult splenic B cells is most
      likely due to antigenic stimulation of long lived precursors, because a high
      frequency of T15-type D-J junctions are coexpressed with T15 V-D junctions in
      splenic sequences. These results predict that T15 anti-PC precursors would be
      made at a very high frequency in the neonate, and at a much lower frequency in
      the adult. This may explain why the neonatal period is critical in establishing
      T15 dominance.

PMID- 1753105
TI  - Effect of cytokines on switching to IgA and alpha germline transcripts in the B
      lymphoma I.29 mu. Transforming growth factor-beta activates transcription of the
      unrearranged C alpha gene.
AB  - H chain isotype switch recombination is preceded by the appearance of RNA
      initiating 5' of the specific switch region that will undergo recombination. In
      an effort to understand the potential function of germline transcripts in switch
      recombination and whether the regulation of germline transcripts correlates with
      the regulation of switching, we are studying this process in the murine B
      lymphoma cell line I.29 mu, which switches, after treatment with bacterial LPS,
      primarily to IgA and less frequently to IgE. Levels of alpha germline transcripts
      initiating upstream of alpha switch (S alpha) sequences are elevated in clones of
      this line that switch well, compared with clones that switch less frequently.
      Transforming growth factor-beta (TGF-beta) has been shown to increase alpha
      germline transcripts and switching to IgA expression in LPS-stimulated murine
      splenic B cells. We now demonstrate that TGF-beta increases LPS-induced switching
      to IgA by 10-fold at optimal doses and increases the level of alpha germline
      transcripts 5- to 9-fold in I.29 mu cells. Nuclear run-on analysis shows that
      this increase is at the level of transcription. Thus, TGF-beta appears to direct
      switching to IgA by inducing transcription from the unrearranged S alpha-C alpha
      DNA segment. Germline alpha RNA is quite stable in I.29 mu cells, having a half
      life of about 5 h, and we find no evidence for further stabilization in the
      presence of TGF-beta. Levels of epsilon germline transcripts are decreased by TGF
      beta treatment. IL-4, which modestly increases switching in I.29 mu cells,
      slightly increases transcription of alpha germline RNA. IFN-gamma, which reduces
      switching to IgA in these cells, also reduces the level of alpha germline
      transcripts. IFN-gamma also reduces the level of epsilon germline transcripts
      induced by IL-4. Our results support the hypothesis that the regulation of
      transcription of particular switch sequences by cytokines regulates the
      specificity of recombination. We also present evidence that IL-4 may provide
      other signals, distinct from transcriptional targeting, that increase LPS-induced
      switching to IgA.

PMID- 1753106
TI  - Identification and characterization of a new gene family induced during
      macrophage activation.
AB  - In this report, we describe the primary structure and regulation of two novel IFN
      gamma-inducible genes expressed during the process of macrophage activation. We
      used the RAW 264.7 cell line to prepare a cDNA library, from which inducible
      genes were selected by differential hybridization. Two cDNA clones, mag-1 and mag
      2 (for macrophage-activation gene-1 and -2), were induced by IFN-gamma treatment
      in both RAW 264.7 cells and thioglycolate-elicited peritoneal macrophages, but
      not in the noncytolytic cell line, WEHI-3. A comparison of the nucleotide and
      deduced amino acid sequences of clones mag-1 and mag-2 with sequences in
      available data bases revealed no homologs. However, comparison of mag-1 and mag-2
      sequences with each other revealed that these genes are homologous, with
      conserved residues concentrated at the amino terminus. Kinetic analyses revealed
      similar temporal patterns of induction of mRNA expression for these genes after
      IFN-gamma treatment. In addition, the genes showed distinct response patterns to
      the macrophage-activating stimuli IFN-gamma and LPS used either alone or in
      combination. Analysis of a panel of cell types of various lineages demonstrated
      that expression of these genes was associated with cellular activation in
      multiple cell types. As a result of the sequence similarities between these
      genes, we propose that they define a new family of IFN-gamma-regulated genes in
      macrophages.

PMID- 1753107
TI  - The cryptic HLA-DQA2 ("DX alpha") gene is expressed in human B cell lines.
AB  - Although there are two gene pairs in the HLA-DQ region, DQA1/B1 and DQA2/B2, the
      latter pair have never been found to be expressed. The DQA2 and DQB2 genes appear
      to be normal at the DNA sequence level, there being no indication that they
      should be pseudogenes, and normal splicing occurs when DQA2 is included in a
      retroviral vector. The putative amino acid sequences of DQA2 and DQB2 have been
      nearly invariant, raising the questions of how these genes have been maintained
      normal-appearing and nearly monomorphic if they are not expressed and, if they
      are expressed, in what cell types are they expressed. We present Northern blot,
      nuclease protection assay, and mRNA sequence data that demonstrate the existence
      of spliced DQA2 mRNA in human B lymphoblastoid cell lines. In contrast, we found
      no evidence of DQB2 mRNA in the same cell lines, nor of DQA2 mRNA in the monocyte
      line U937 or in activated T cells.

PMID- 1753108
TI  - IFN-alpha induces autocrine production of IL-6 in myeloma cell lines.
AB  - IL-6 is a major tumor growth factor in human multiple myeloma. Myeloma cell
      lines, which have the same phenotypic characteristics and Ig gene rearrangements
      as the original fresh myeloma cells and whose growth is strictly dependent on
      exogenous IL-6 similar to fresh myeloma cells, have been reproducibly
      established. We show here that IFN-alpha stimulated the growth of five of six of
      these human myeloma cell lines by inducing an autocrine production of IL-6 in
      myeloma cells. Indeed, IFN-alpha induced IL-6 mRNA accumulation and IL-6
      production in myeloma cells and the IFN-alpha-induced growth of these cells was
      inhibited by anti-IL-6 mAb. Moreover, IFN-alpha made possible the rapid emergence
      of autonomously growing myeloma cell sublines, which produced IL-6 as an
      autocrine growth factor. As IFN-alpha has a potential therapeutical interest for
      multiple myeloma, the present study opens up new directions for studying its
      effects on the myeloma clone in vivo.

PMID- 1753109
TI  - Antigen detection in pneumococcal pneumonia.
AB  - Streptococcus pneumoniae remains the commonest proven cause of community-acquired
      pneumonia in patients admitted to hospital, but no currently available diagnostic
      method can be regarded as a gold standard. Microscopy of sputum is usually
      considered insensitive and poorly specific, and more invasively-obtained
      specimens are not routinely collected. Cultures of blood and respiratory
      secretions, and countercurrent immunoelectrophoresis (CIE) and particle
      agglutination-based assays for capsular polysaccharides in serum and urine
      specimens, are specific but less than ideally sensitive. Some workers have
      reported specificity problems when immunoassays are applied to respiratory
      secretions. New diagnostic methods include detection of pneumococcal C
      polysaccharide in sputum and urine by ELISA and particle-agglutination assays,
      and these appear promisingly sensitive and specific in preliminary studies.
      Clinical assessments are now required to define the role of these techniques in
      guiding the treatment of individual patients.

PMID- 1753110
TI  - Prevalence and correlates of diphtheria toxin antibodies among young adults in
      Israel.
AB  - The paucity of information about immunity against diphtheria of young adults in
      Israel prompted us to analyse sera from a random sample of 480 recruits (263
      males and 217 females) aged 18-19 years. Antitoxin antibody levels were
      determined by means of ELISA. Of the recruits 58.1% had antibody values greater
      than 0.1 IU/ml; 38.5% had amounts between 0.01 and 0.1 IU/ml, which is considered
      low when using the ELISA method, and 3.3% had less than 0.01 IU/ml. The results
      of this study suggest that a booster dose of antidiphtheria vaccine should be
      given to adults in Israel in order to ensure adequate antibody levels.

PMID- 1753111
TI  - Autonomic neuropathy is common in human immunodeficiency virus infection.
AB  - We prospectively evaluated autonomic nervous system function in 17 consecutive
      ambulant patients with HIV infection [mean age (S.D.) 34.5 (5.5) years] and 17
      controls matched for sex and age [31.2 (7.4) years]. A questionnaire was
      administered, and neurological examination and standard bedside autonomic
      function tests were performed. Eleven of 17 HIV-infected individuals (64.7%) had
      symptoms suggestive of autonomic dysfunction, particularly urogenital problems.
      Thirteen of 17 (76.5%) had autonomic neuropathy (one or more abnormal tests),
      including nine of 11 symptomatic individuals. Only two controls had any autonomic
      symptoms, and all had normal tests. Autonomic dysfunction is common in those with
      HIV infection and AIDS.

PMID- 1753112
TI  - AIDS and tuberculosis in Spain. A report of 140 cases.
AB  - From January 1984 to October 1990, 140 of 392 (35.7%) patients with the acquired
      immunodeficiency syndrome (AIDS) were found to have had tuberculosis. One hundred
      and sixteen were intravenous drug abusers and 16 were homosexual men. Fever,
      cough, weight loss and generalised lymphadenopathy were common features of their
      illness. Tuberculin skin tests were negative in 74% and 55% had intraabdominal
      lymphadenopathy. The chest radiographs showed hilar lymphadenopathy and lower
      lobe interstitial or alveolar infiltrates, but rarely cavitation. Forty-one of
      our patients had pulmonary tuberculosis, 38 had extra pulmonary and in 61 it was
      disseminated. In 80 cases tuberculosis was the presenting feature of AIDS.
      Tuberculosis usually responded well to chemotherapy.

PMID- 1753113
TI  - Urinary tract infections caused by Staphylococcus saprophyticus. A matched case
      control study.
AB  - Epidemiological and clinical aspects of 270 episodes of urinary tract infection
      caused by Staphylococcus saprophyticus were studied. The cases were randomly
      selected and matched consecutively with 276 others of urinary tract infection
      according to sex, age and temporal occurrence. Such infections were found
      typically among young women in the outpatient health service. They were common
      among professionals handling meat products and were especially associated with
      prior outdoor swimming. Common symptoms of inflammation of the lower urinary
      tract, haematuria and pyuria were seen more often among patients with S.
      saprophyticus infections. Some cases of asymptomatic S. saprophyticus infection,
      however, were seen. We found S. saprophyticus as the cause of 13% upper urinary
      tract infections, an incidence which is higher than has been reported for other
      bacteria. Staphylococcus saprophyticus was less correlated to nephrolithiasis and
      was not a common cause of catheter-induced infections.

PMID- 1753114
TI  - Meningococcal infection: evidence for school transmission.
AB  - Intimate contacts of a patient with meningococcal disease are at greater risk of
      disease than the general population and are offered chemoprophylaxis in order to
      prevent secondary cases. School contact is not considered a risk factor unless a
      further case develops. Bacteriological sampling of contacts to identify potential
      sources of infection is not considered warranted. We have questioned these
      approaches and investigated the contacts of a 9-year-old child with meningitis
      caused by sulphonamide-sensitive Neisseria meningitidis group C. Household
      carriers were not identified but 7/34 classmates were carrying the index strain
      suggesting that transmission was occurring within this population. The current
      recommendations for prophylaxis are based on information gathered in
      socioepidemiological settings, and involving strains which differ from those now
      prevalent. Such extrapolations may not be justified and further microbiological
      studies seem warranted to re-examine meningococcal transmission and prophylaxis
      usage in school children.

PMID- 1753115
TI  - The use of routine wound swabs and Kardex review for the surveillance of surgical
      wound infections.
AB  - Prospective post-operative wound surveillance was carried out in two phases on
      1285 patients. A total of 120 infections were documented. In phase I a review of
      routine swabs and Kardex was conducted in parallel with continuous surveillance.
      In this phase continuous surveillance detected 31/35 infections and routine swabs
      and Kardex methods picked up 28/35 infections. In phase 2 continuous surveillance
      was not carried out and routine swab and Kardex review detected 78/85 infections.
      Overall II infections were documented following discharge. Continuous
      surveillance is sensitive but laborious. The method described here would enable
      infection control nurses to visit patients in whom infections are more likely to
      occur, and still provide reliable and accurate rates of infections.

PMID- 1753116
TI  - Herpes zoster associated encephalitis in dialysis patients.
AB  - Two patients on dialysis because of chronic renal failure who developed herpes
      zoster associated encephalitis are reported. Both developed overt encephalopathy
      despite treatment with oral acyclovir for the preceding herpes zoster eruption.
      The encephalopathy responded rapidly to intravenous acyclovir.

PMID- 1753117
TI  - Septicaemia caused by Pediococcus pentosaceus: a new opportunistic pathogen.
AB  - A case of septicaemia caused by Pediococcus pentosaceus is described. The role
      played by pediococci, and other vancomycin-resistant Gram-positive cocci, in
      disease states is examined. We suggest that in immunocompromised patients these
      organisms act as opportunist pathogens. This would appear to be the first
      reported case of P. pentosaceus septicaemia.

PMID- 1753118
TI  - Pulmonary nocardiosis concurrent with Pneumocystis carinii pneumonia in two
      patients undergoing immunosuppressive therapy.
AB  - Two cases with concomitant pulmonary nocardiosis and Pneumocystis carinii
      pneumonia are described. The first patient developed pneumonia 3 months after
      heart transplantation while undergoing standard immunosuppressive therapy with
      cyclosporin, azathioprine and prednisone. The second patient was treated with
      chemotherapy and subsequent radiotherapy of the mediastinum for a malignant
      epithelial tumour. He also received prednisone for paraneoplastic
      dermatomyositis. Chest X-rays of both patients showed a bilateral interstitial
      pattern and broncho-alveolar lavage revealed P. carinii. Additional dense and
      localised pulmonary infiltrates led to suspicion of a further infectious agent,
      namely, Nocardia asteroides, which was isolated from both patients. Since
      nocardiosis calls for prolonged treatment, extensive diagnostic measures are
      needed for its early detection.

PMID- 1753119
TI  - Actinomycosis of the thigh presenting as a soft-tissue neoplasm.
AB  - A 14-year-old boy presented with a mass measuring 6 cm x 9 cm, proximal to the
      patella on the anterior aspect of the knee. Magnetic resonance imaging revealed a
      6 x 8 x 4 cm smoothly marginated slightly heterogeneous ellipsoidal mass which
      displaced musculature, the adjacent cutaneous fat and the quadriceps tendon. At
      surgery, the mass was noted not to penetrate the superficial surface of the
      quadriceps tendon and was full of slimy fluid. Histological examination revealed
      multiple basophilic lobulated granules with homogeneous centres and eosinophilic
      peripheral clubbed projections. The organisms grown anaerobically were identified
      as Actinomyces species. The anatomical site of the lesion is very unusual for
      actinomycosis and the exact route of infection in this patient remains unclear.

PMID- 1753120
TI  - Mycobacterium malmoense infection in HIV positive patients.
AB  - Mycobacterium malmoense is a non-tuberculous mycobacterium which has previously
      been associated with underlying pulmonary pathology and depressed immunity. We
      describe two patients infected with human immunodeficiency virus from whom M.
      malmoense was isolated, and discuss its treatment and possible pathogenic role.

PMID- 1753121
TI  - Multiple brain abscesses caused by Streptococcus bovis.
AB  - A case of multiple brain abscesses caused by Streptococcus bovis in a 28-year-old
      man is described. Infected bronchiectasis is presumed to be the source of
      infection. Streptococcus bovis infection is a rare cause of brain abscess. The
      aetiology and manifestations of this infection are discussed.

PMID- 1753122
TI  - Moraxella atlantae bacteraemia in a patient with systemic lupus erythematosis.
AB  - We describe the first reported case of human infection caused by Moraxella
      atlantae (formerly known as CDC group M-3) and its successful treatment with
      intravenous cefuroxime. The isolation and identification of this species, as well
      as the pathogenesis of the infection, are discussed. It is recommended that
      isolates of Moraxella species be speciated so that the epidemiological
      characteristics and pathogenesis of the infections caused by the various species
      may be understood more completely.

PMID- 1753124
TI  - Streptococcus faecalis in neonatal infective endocarditis.

PMID- 1753123
TI  - Descriptive epidemiology of intravenous heroin users--a new risk group for
      transmission of HIV in India.
AB  - India is considered to have a low incidence of HIV infection so far.
      Nevertheless, an epidemic of HIV infection has been reported recently among intra
      venous drug users (IVDUs) in Manipur, a north-eastern state of India, bordering
      Myanmar (Burma). This report describes the epidemiology of intravenous drug abuse
      in the state of Manipur. Four hundred and fifty IVDUs were interviewed. Their age
      (median 24 years) and sex patterns (95% male) differ from those reported from
      western countries. It is estimated that there may be approximately 15,000 such
      addicts in a population of 1.8 million and 50% of them could be positive for HIV.
      Knowledge of AIDS and its transmission is significantly higher among the addicts
      than non-addict controls. Free availability of heroin was found to be the major
      factor responsible for the high rate of addiction. It is presumed that two other
      neighbouring States which are well-connected to Manipur and also have a common
      border with Myanmar (part of the 'Golden Triangle') may have a similar problem
      with HIV infection.

PMID- 1753125
TI  - Mycoplasma hominis infection of a breast prosthesis.

PMID- 1753126
TI  - Central venous line infection caused by Brevibacterium epidermidis.

PMID- 1753127
TI  - Brodie's abscess caused by Eikenella corrodens.

PMID- 1753128
TI  - Epidural abscess due to Streptococcus milleri and Bifidobacterium species.

PMID- 1753129
TI  - C-reactive protein sufficient as screening test in bacterial vs. viral
      infections.

PMID- 1753130
TI  - Vibrio alginolyticus in the U.K.

PMID- 1753131
TI  - Fusobacterium necrophorum and Lemierre's syndrome.

PMID- 1753132
TI  - Louping ill in man: a forgotten disease.
AB  - Louping ill disease of sheep has been recognised in Scotland for centuries. It
      causes encephalitis and is transmitted by the sheep tick, Ixodes ricinus. Human
      infection was first reported in 1934. Thirty-one cases of human infection have
      now been described. Four clinical syndromes are seen, an influenza-like illness,
      a bi-phase encephalitis, a poliomyelitis-like illness and a hemorrhagic fever.
      Certain occupational groups, e.g. laboratory personnel working with the virus and
      those who kill injected sheep, are at increased risk of acquiring louping ill
      infection. In many instances, infection is subclinical. Eight new human cases are
      described. Six were in crofters or shepherds in the north and west of Scotland,
      one was in a general practitioner in the Western Isles and the eighth was in a
      butcher in Edinburgh. Louping ill disease should not be forgotten in cases of
      unexplained encephalitis in those whose lifestyle exposes them to the virus.

PMID- 1753133
TI  - Decrease of hepatitis A and B virus infections in the population of Okinawa,
      Japan.
AB  - In 1988 1282 serum samples were collected from healthy Japanese persons living on
      Hateruma Island (574 samples) and Iriomote Island (708 samples) in Okinawa,
      Japan. Serological markers of hepatitis B virus (HBV) infection [hepatitis B
      surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc) were
      investigated and the findings compared with samples taken in 1980 on Hateruma
      Island and in 1970 and 1980 on Iriomote Island. The samples collected in 1988 on
      Iriomote Island were also tested for antibody to hepatitis A virus (anti-HAV) and
      the findings compared with the results of the 1970 and 1980 surveys. The overall
      prevalence of HBsAg and anti-HBc was 3.7 and 64.8% for Hateruma Island and 3.8
      and 44.9% for Iriomote Island. In both areas the overall prevalence of anti-HBc
      was lower than in 1980, the decrease being significant for the 10-19 year age
      group on Hateruma Island and the age groups under 39 years on Iriomote Island.
      The overall prevalence of anti-HAV had fallen to 50.9%. This remarkable decrease
      had occurred in children and young adults. These data suggest that Virus A (HAV)
      and HBV infections have dramatically decreased among children in Okinawa within
      the past 2 decades.

PMID- 1753134
TI  - Biopsychosocial aspects of chronic fatigue syndrome (myalgic encephalomyelitis).
AB  - Fifteen patients, with a primary complaint of chronic fatigue, were referred to a
      physician by their general practitioners. Psychological distress, measured by
      simple psychiatric rating scales was common, but specific psychiatric diagnoses,
      derived from a comprehensive diagnostic interview, occurred less frequently. One
      questionnaire (Montgomery-Asberg depression rating scale) found emotional
      distress in 93%, but the diagnostic instrument (Present State Examination)
      suggested depressive syndromes in only two patients (13%). There were significant
      occupational difficulties in 87%. No consistently abnormal indices of biochemical
      or immunological function were found, nor evidence of acute or chronic infection.
      Chronic fatigue syndrome (CFS) is associated with physical, psychological and
      social distress. The illness cannot be defined using just one of these
      dimensions. Such a unilateral approach has resulted in unnecessary controversy
      over the nature of the 'real' core of CFS. A problem-oriented approach,
      recognising the multi-factorial and overlapping cause and effect issues in CFS,
      may be of more benefit to patients.

PMID- 1753135
TI  - Comparison of clinical and environmental strains of Escherichia coli isolated in
      Spain.
AB  - Susceptibilities to antimicrobial agents, bacteriophage lysis patterns and
      enzymatic polymorphism analysis were used to study genetic variability in
      Escherichia coli in order to study the relationship between clinical and
      environmental isolates of the species. Enzymatic polymorphism analysis proved the
      most useful. The findings were complemented by numerical analysis of phage typing
      and antimicrobial susceptibilities.

PMID- 1753136
TI  - Lyme borreliosis in Dutch forestry workers.
AB  - Serum samples from 127 Dutch forestry workers and 127 matched controls were
      tested for antibodies against Borrelia burgdorferi in an indirect
      immunofluorescence assay (IFA). Those of the forestry workers were also tested by
      Western blotting. The forestry workers were examined clinically for evidence of
      Lyme borreliosis without the examiner or the workers knowing the results of the
      laboratory tests. Seroprevalence of B. burgdorferi antibodies among forestry
      workers (25/127) was significantly higher than among controls matched for age and
      place of residence (8/127), odds ratio 3.7 (95% CI 1.5-9.7). Of the 25 sera of
      forestry workers positive in the IFA, 23 reacted with at least five bacterial
      polypeptides in the Western blot test. According to adapted CDC criteria, seven
      forestry workers (6%) were classified as being a case of Lyme borreliosis. In
      only one of them had the diagnosis been made before this investigation. Five
      persons had a history of erythema migrans, one of arthritis, and one of
      persistent infection. We conclude that Lyme borreliosis is an occupational
      disease among forestry workers in the Netherlands, with a three-fold higher
      seroprevalence than among matched controls. The disease, often not diagnosed
      among this high-risk group, warrants more attention to achieve early recognition
      and to prevent late complications.

PMID- 1753137
TI  - Fatal listeria meningitis in an immunocompromised infant: therapeutic
      implications.
AB  - Infection with Listeria monocytogenes is rare in infants and children.
      Listeriosis has been made a notifiable condition in the State of California since
      1985. From January 1985 to December 1990, only seven cases of listeriosis have
      been reported in children less than or equal to 13 years of age. This brief
      report summarises the features of a fatal case of listeria meningitis in an
      immunocompromised 4-month-old infant, discusses diagnostic and therapeutic
      implications, and describes the other six cases.

PMID- 1753138
TI  - Successful antibiotic therapy of clostridial septic arthritis in a patient with
      bilateral total hip prostheses.
AB  - We report a case of clostridial bacteraemia with infection of a prosthetic hip
      joint. The patient was successfully treated with IV benzyl penicillin and fucidin
      followed by oral amoxycillin and probenecid, without surgical intervention. She
      had no recurrence of her infection in the 19 months before her death. This is
      believed to be the first reported case of clostridial infection affecting a
      prosthetic joint.

PMID- 1753139
TI  - Two cases of Nocardia asteroides sternotomy infection treated with ofloxacin and
      a review of other active antimicrobial agents.
AB  - Two patients who developed post-operative sternotomy infections due to Nocardia
      asteroides were treated successfully with ofloxacin, in vitro susceptibility of
      the organisms being used as a guide to dosage. The place of this drug in the
      treatment of infection due to Nocardia asteroides merits further investigation.

PMID- 1753140
TI  - Mycobacterium haemophilum infection in a patient with AIDS.
AB  - We report the isolation of a nutritionally fastidious mycobacterial species,
      Mycobacterium haemophilum, from the skin of a patient with AIDS. The diagnosis of
      the mycobacterial nature of the patient's lesions was complicated by extensive
      Kaposi's sarcoma. It is recommended that slowly growing fastidious mycobacteria
      be sought in any patients with unusual skin lesions.

PMID- 1753141
TI  - Group A streptococcus endocarditis: report of five cases and review of
      literature.
AB  - Group A streptococcus is an uncommon cause of infective endocarditis. We report
      five probable cases during a 10-year period (1980-1989) from a 750-bed community
      teaching hospital. None of the patients were drug abusers. Group A streptococcus
      is the cause of infective endocarditis in between 0 and 5% cases in reported
      series. Since the introduction of penicillin 69 cases of group A streptococcus
      endocarditis have been reported in the literature. Clinical details of 14
      patients, none of whom were drug abusers, are available. Included are our five
      cases. Eight patients had no underlying valve lesions. The overall mortality was
      21% but only 15% for patients treated approximately. Among the 25 reported IV
      drugs abusers with group A streptococcus endocarditis and known valve
      involvement, right-sided heart valves were involved in 19 and left sided in six.
      The overall mortality was 9%.

PMID- 1753142
TI  - Neonatal septicaemia due to non-capsulate Haemophilus influenzae in three
      siblings.
AB  - I report the case of a woman who, in three successive pregnancies, gave birth to
      premature infants with septicaemia due to non-capsulate Haemophilus influenzae.
      All three infants displayed characteristic features of the disease. Maternal
      antenatal and postnatal management is discussed.

PMID- 1753143
TI  - Hepatitis A immunity and travel history.
AB  - Travel histories were taken from 1111 British travellers. Serological testing
      showed that increasing age and a past history of jaundice were associated with a
      greater likelihood of travellers being immune to hepatitis A. Neither travel to
      nor the duration of stay in areas of increased hepatitis A endemicity influenced
      the level of hepatitis A immunity. It is concluded that travel histories from
      British citizens normally resident in the U.K. cannot be used to identify those
      travellers in whom serological prescreening would be of value prior to
      immunoglobulin prophylaxis.

PMID- 1753144
TI  - Outbreak of tuberculosis in a poor urban community.
AB  - A woman from a poor urban community presented recently with pulmonary
      tuberculosis. Screening of contacts revealed 10 cases of tuberculosis, eight of
      whom were children. A further 10 children had grade 2-3 positive Heaf tests and
      were given chemoprophylaxis. Tuberculosis remains a potential problem,
      particularly in young unimmunized children in deprived areas.

PMID- 1753145
TI  - Asymptomatic cryptosporidiosis in nomadic shepherds and their sheep.
AB  - The formed stool samples of 276 asymptomatic members of 36 households of a group
      of nomadic shepherds and 215 non-diarrhoeal faecal samples from their sheep were
      examined for cryptosporidial infection by a modified Ziehl-Nielsen technique.
      Thirty-six (13%) human samples and 37 (17.2%) samples from sheep were positive. A
      strong possibility of asymptomatic zoonotic transmission of cryptosporidiosis due
      to prolonged and constant association of shepherds and their sheep was an
      important finding.

PMID- 1753146
TI  - Malassezia furfur septicaemia in a child with leukaemia.

PMID- 1753147
TI  - HTLV-II infection in a Liverpool intravenous drug user.

PMID- 1753148
TI  - Haemophilus segnis appendicitis.

PMID- 1753149
TI  - Fluoroquinolone resistance in Campylobacter jejuni and Campylobacter coli
      isolated from human faeces in Switzerland.

PMID- 1753150
TI  - Ventriculoperitoneal shunt-associated infection.

PMID- 1753151
TI  - Recurrent plasmodium ovale infection from Papua New Guinea--chloroquine
      resistance or inadequate primaquine therapy?

PMID- 1753152
TI  - Fluconazole resistant candida in AIDS.

PMID- 1753153
TI  - Septicaemia and septic arthritis due to Pseudomonas putida in a neutropenic
      patient.

PMID- 1753154
TI  - Clostridium difficile in faecal flora after perioperative prophylaxis with
      ampicillin or ceftriaxone.

PMID- 1753155
TI  - Infection in hospital.

PMID- 1753156
TI  - Advantages and limitations of two software calipers in quantitative coronary
      arteriography.
AB  - Software calipers allowing the measurement of the distances between pairs of
      manually defined picture elements in digitized images may be useful tools for a
      rapid assessment of the morphology of coronary vessels, e.g. for choosing the
      appropriate balloon or stent sizes before or during cardiac intervention
      procedures. In this paper we have studied extensively the advantages and
      limitations of two manual software calipers--one developed for a PC-based
      cinefilm analysis workstation, the other for the Philips DCI system. Based on
      analyses of a perspex vessel phantom with 17 sectors of known size filled with
      different concentrations (50 and 100%) of the contrast agent and acquired at two
      kV-levels (68 and 92 kV), it was found that the cinefilm approach is
      characterized by a very small overall (averaged over te data from three
      observers) systematic overestimation of 0.03 mm, and the DCI system by a
      systematic underestimation of 0.07 mm; the worst case accuracy value for an
      individual observer on frames with 100% contrast dye concentration was 0.20 mm
      for cinefilm, and -0.34 mm for the DCI, respectively. The overall variabilities
      in the measurements (precision) were almost identical for the two approaches
      (overall 0.07 and 0.08 mm for the cinefilm and digital approaches, respectively,
      and worst case for individual observers on the 100% contrast frames, 0.16 and
      0.13 mm, respectively. Inverting the images (bright or dark contrast containing
      structures) of the phantom at 100% contrast concentration and acquired at 62 kV
      had no significant effect on the results obtained with the cinefilm analysis
      system (overall accurary -0.12 mm for both situations), whereas it had on the
      results from the DCI system (overall accuracies -0.29 (dark vessels on bright
      background) and -0.08 mm (bright vessels on dark background), respectively).
      Enhancing the digital images on the DCI with unsharp masking techniques did not
      significantly influence the measurement accuracy and precision. Finally, it was
      found that woven dacron, polyurethane and polyvinylchloride catheters filled with
      100% contrast dye can be measured with an overall accuracy of better than 0.13 mm
      on the DCI system. On the PC-based system the woven dacron and polyvinylchloride
      catheters would result in an overall accuracy better than 0.17 mm, and the
      polyurethane catheter better than 0.30 mm. The evaluation study has made clear
      that the nylon catheter should not be applied in QCA-studies.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1753157
TI  - Left ventricular wall thickness measurements by magnetic resonance: a validation
      study.
AB  - Left ventricular (LV) wall thickness was determined by magnetic resonance (MR) in
      15 patients (7 controls and 8 patients with coronary artery disease). End
      diastolic (ed) and end-systolic (es) wall thickness were measured in a short axis
      view perpendicular to the LV long axis. Wall thickness measurements were compared
      to data obtained by digital subtraction angiography (DSA) and M-mode
      echocardiography (Echo). End-diastolic and end-systolic wall thickness were
      significantly overestimated by MR (34% and 37%, respectively) when compared to
      DSA. In contrast, LV end-diastolic and end-systolic chamber diameter were
      significantly underestimated by MR (25% and 30%, respectively) when compared to
      DSA. However, fractioned shortening was similar (all NS) for MR (48 +/- 22%), DSA
      (54 +/- 15%) and Echo (44 +/- 10%), respectively. The mean difference (=
      accuracy) and the standard deviation of difference (= precision) for LV wall
      thickness was 0.4 +/- 0.2 cm between MR and DSA, 0.4 +/- 0.3 cm between MR and
      ECHO and 0.03 +/- 0.1 cm between DSA and ECHO. The correlation of wall thickness
      between MR and DSA (correlation coefficient r = 0.74, p less than 0.001) and
      between MR and Echo (r = 0.70, p less than 0.001) was good although the standard
      error of estimate (SEE) was 17% for MR vs. DSA and 21% for MR vs. Echo. The
      corresponding SEE for chamber diameter was 16% between MR and DSA and 19% between
      MR and Echo, respectively. Intraobserver variability for wall thickness
      determination by MR was excellent (correlation coefficient r = 0.99, p less than
      0.001) SEE of 4%. Interobserver variability was also good (correlation
      coefficient r = 0.90, p less than 0.001) with a SEE of 12%. It is concluded that
      LV wall thickness and chamber diameter (short axis plane) can be determined by MR
      with good precision but only satisfactory accuracy. LV wall thickness is
      significantly overestimated probably due to signals from static blood which might
      be indistinguishable from the subendocardium.

PMID- 1753158
TI  - Limitations in the use of five French coronary catheters.
AB  - Five french (5F) catheters are being widely promoted for use in patients
      undergoing day case angiography including coronary angiography. Although there
      are theoretical advantages to this practice there are also potential
      disadvantages. We reviewed various performance parameters of four different
      brands of 5F coronary catheter and compared them with performance of the six (6F)
      and eight french (8F) coronary catheters used in routine coronary angiography.
      All the 5F catheters performed significantly less satisfactorily than the 6F and
      8F catheters. 5F coronary catheters cannot be recommended for routine
      transfemoral coronary angiography.

PMID- 1753159
TI  - Percutaneous coronary rotational angioplasty: preliminary clinical and
      quantitative imaging results.
AB  - To determine anatomical and functional changes within the first 24 hours after
      percutaneous coronary rotational angioplasty (PCRA-ROTABLATOR, Biophysics
      International, USA), we studied 5 patients (4 men) with a mean age of 55 years
      (range 52-59) using quantitative coronary angiography, coronary flow reserve from
      digitized coronary angiograms, quantitative left ventricular angiography, and
      99mTechnetium-MIBI SPECT imaging before PCRA, immediately after, and 24 hours
      after. The minimal luminal diameter and obstruction area showed a moderate
      increase immediately after PCRA, with a substantial further improvement after 24
      hours. The mean coronary flow reserve before PCRA and 24 hours after (1.65 +/-
      0.31 vs. 1.81 +/- 0.37; p = NS) remained unchanged. Although the global ejection
      fraction showed slight impairment immediately after PCRA, this was restored 24
      hours later. Only the contribution to regional ejection fraction in the regions
      supplied by the treated coronary artery attributed to the decrease of global
      ejection fraction. Before and after PCRA, Tc-99m MIBI tomography performed at
      rest revealed no perfusion defects in the myocardial regions related to the
      coronary arteries undergoing the intervention.

PMID- 1753160
TI  - Left ventricular dual-energy digital subtraction angiography: a motion immune
      digital subtraction technique.
AB  - Digital subtraction angiography (DSA) allows quantitative analysis of ventricular
      function via densitometric and parametric imaging techniques. However, DSA is
      limited by the artifacts in temporal subtraction images that result from patient
      and cardiac motion. Dual-energy subtraction imaging is insensitive to motion.
      This study evaluated the initial application of dual-energy subtraction in
      cardiac patients. The image quality of dual-energy subtraction left
      ventriculograms obtained from a pulmonary artery injection of contrast was
      assessed in 13 patients, ranging in weight from 54 to 100 kg. The dual-energy
      images were compared with left ventricular images obtained using standard left
      ventricular injection cine angiography. End-systolic and end-diastolic
      ventricular volumes calculated from the cine (C) and dual-energy (DE) images
      using the Area-Length method were compared. The resulting regression line was DE
      = 0.98 C+ 7.0 ml, and the r value was 0.987. Dual-energy subtraction provided
      good left ventricular visualization, free from misregistration artifacts, even
      during patient motion.

PMID- 1753161
TI  - Should the exercise test (ET) be performed at discharge or one month later after
      an episode of unstable angina or non-Q-wave myocardial infarction?
AB  - The diagnostic and prognostic value of symptom limited exercise tests (ET)
      performed before discharge and after one month were compared in men admitted to
      hospital after an episode of unstable angina or a non-Q-wave myocardial
      infarction (MI). A 'Positive ET' was defined as either a maximal work load below
      100 W or ST-depression greater than or equal to 0.1 mV in 1-2 leads below 130 W
      or ST-depression greater than or equal to 0.1 mV in more than 2 leads at any load
      at the ET. During follow-up, severe angina was the only indication for coronary
      angiography and revascularization. There were no significant differences in
      diagnostic findings between the tests--Positive ET in 47% and Negative ET in 25%
      at both ETs. The occurrence of MI or death and the need of revascularization were
      related to signs of ischemia at both ETs. There were no differences in prognostic
      value between the early and late tests regarding MI or death or future severe
      angina during the 11 months' follow-up after the one month ET. However, half
      (10%) of the overall event rate (20%) during the one year follow-up occurred
      during the first months. The risk of these events could be identified by the
      predischarge but, for obvious reasons, not by the one month ET. Therefore, the
      present study suggests that a symptom limited ET should be performed before
      discharge in men stabilized after an episode of unstable angina or non-Q-wave MI.

PMID- 1753162
TI  - Assisted hatching of human embryos.
AB  - There are benefits as well as drawbacks of zona pellucida breaching. Narrow gaps
      in the zona may cause disintegration of the hatching trophectoderm, when embryos
      are cultured in vitro. An increase in the formation of monozygotic twins
      following micromanipulation may also occur, due to the forced separation of the
      inner cell mass during blastocyst expulsion in utero. Mouse studies indicate that
      one or several narrow zona openings (less than 5 microns) are detrimental. Such
      embryos may become trapped during hatching but may be rescued by drilling an
      additional larger gap elsewhere on the zona. The use of acidic Tyrode's solution
      for clinical assisted hatching of eight-cell embryos is currently under
      investigation. The findings suggest that large holes are efficient for promoting
      hatching (at least one-fourth of the embryos implanted thus far) and that embryos
      with unthinned zonae (those with normally the poorest prognosis) benefit mostly
      from assisted hatching. Results also indicate that embryos with the best zona
      morphology should be replaced without micromanipulation.

PMID- 1753164
TI  - Syringe-associated toxicity of culture media on mouse and monkey preembryos.

PMID- 1753163
TI  - Effects of sera from patients given various anesthetics on preimplantation mouse
      embryo development in vitro.
AB  - This study compared the effects of sera from patients given various anesthetics
      on in vitro mouse preimplantation embryo development. Patients electing bilateral
      laparoscopic tubal sterilization were subjected to general anesthesia with
      nitrous oxide (N2O) that included either isofluorane (ISO/N2O) as an inhalant or
      fentanyl or morphine (FEN/MOR/N2O). The addition of sera collected 1 hr after
      anesthetic induction significantly reduced the numbers of two-cell mouse embryos
      that developed to blastocyst in the ISO/N2O group as compared to that of
      preanesthesia sera. In contrast, no detrimental effects were revealed from sera
      of patients given FEN/MOR/N2O. Comparison of sera from patients given ISO/N2O and
      FEN/MOR/N2O for laparoscopic oocyte retrieval and from patients given spinal
      anesthesia and/or i.v. sedation for ultrasonic retrieval also revealed a decrease
      in mouse embryo development in the ISO/N2O group, but no differences were seen in
      the other anesthetic regimens. ISO/N2O anesthesia was also associated with a
      significantly decreased fertilization rate of mature oocytes retrieved. However,
      no significant effect of ISO/N2O anesthesia on IVF pregnancy rates could be
      demonstrated. These studies indicate that embryo toxic effects can be detected in
      sera from patients given ISO/N2O and that this anesthetic may be detrimental to
      the success of in vitro fertilization and embryo transfer.

PMID- 1753165
TI  - The reproductive outcome following a superhigh response to stimulation in gamete
      intrafallopian transfer program.
AB  - A retrospective analysis was carried out to assess the outcome of gamete
      intrafallopian transfer (GIFT) in cycles when more than 10 oocytes were retrieved
      (superhigh responders) from October 1987 through June 1989. There were 276 (13%)
      cycles with more than 10 oocytes retrieved among all GIFT cycles initiated during
      the period. Clomiphene citrate and gonadotropin were employed for ovarian
      stimulation in 105 (38%) cycles, and gonadotropin releasing hormone agonist in
      the remaining 171 (62%) cycles, employing either the flare (104 cycles) or the
      pituitary down-regulation (67 cycles) protocol. A maximum number of four oocytes
      was transferred per GIFT (3.5 +/- 0.4). The mean number of oocytes retrieved was
      14.7 +/- 4.4 (range, 11 to 35). A significantly younger age group (less than 30
      years) of patients was noticed in the study (31.9), and fewer women aged 40 and
      over (6.2%), compared to the general population of our patients. The pregnancy
      rate was 33.3% (n = 92) per cycle, with a delivery rate of 23.6% (n = 64) per
      cycle; the pregnancy loss rate was 30.8%. The reproductive outcome was lower in
      women aged 40 and over (pregnancy rate was 23.5%, but delivery rate was only 5.8%
      per cycle). The delivery rate was lower in the clomiphene citrate- and
      gonadotropin-stimulated cycles (51.7% per pregnancy) in relation to gonadotropin
      releasing analogue and gonadotropin cycles (76.6% per pregnancy) and
      significantly so compared with the pituitary down-regulation protocol (83.3% per
      pregnancy). We conclude that a superhigh response develops more in younger women,
      and in such circumstances, the use of pituitary down-regulation with gonadotropin
      releasing hormone will improve the reproductive outcome.

PMID- 1753166
TI  - Developmental capacities of two-cell mouse embryos frozen by three methods.
AB  - The following three methods were evaluated in order to obtain a most efficient
      freezing protocol for the preservation of two-cell mouse embryos: (a) slow
      cooling and slow thawing in 1.5 M dimethyl sulfoxide, (b) slow cooling and fast
      thawing in 1.5 M propanediol (PROH), and (c) ultrarapid freezing and fast thawing
      in either 3.5 M DMSO or 3.0 M PROH. In the slow-cooling procedures (a and b) ice
      nucleation (seeding) was induced manually or automatically. With method a, only a
      slight difference, 51.8% for manual and 58.9% for automatic seeding, was observed
      in survival rates, while the development to blastocysts was significantly
      affected: 35.4% with manual and less than 10% with automatic induction (P less
      than 0.001). Method b gave high survival (86.2%) and developmental rates (69.0%)
      with manual seeding compared with automatic seeding (20.7 and 9.8%, respectively;
      P less than 0.001). Using protocol c, higher survival and developmental rates
      were obtained with DMSO (84.8 and 55.9%) than with PROH (39.8 and 19.4%, P less
      than 0.001). These results demonstrate that inducing nucleation manually is
      superior to the use of a highly sophisticated autoseeding system and that method
      b with manual seeding is most effective in preserving the developmental capacity
      of two-cell mouse embryos after freezing and thawing. There is evidence that this
      is also true of human embryo cryopreservation.

PMID- 1753167
TI  - The use of transvaginal ultrasound to aspirate bilateral hydrosalpinges prior to
      in vitro fertilization: a case report.
AB  - Transvaginal ultrasound has recently been introduced diagnostically for
      follicular monitoring, early pregnancy localization (1), pelvic structure
      identification, early fetal development (2), detection of ovarian enlargement in
      postmenopausal women (3), and detection of endometrial carcinoma (4).
      Transvaginal ultrasound has had a major impact on patient monitoring and
      treatment for in vitro fertilization and embryo transfer (IVF/ET).
      Therapeutically transvaginal ultrasound has been introduced for oocyte retrieval
      and selective pregnancy reduction. The purpose of this paper is to present the
      therapeutic use of transvaginal ultrasound to aspirate large bilateral
      hydrosalpinges which complicated embryo transfer during an in vitro fertilization
      cycle.

PMID- 1753168
TI  - Improved fertilization rates of human oocytes in coculture.
AB  - Passaged human tubal ampullary epithelial cells from cell lines were used to
      evaluate fertilization rates and the support of early human embryonic cleavage in
      vitro. A total of 225 mature oocytes from 32 patients was used in this study.
      Oocytes from each patient were equally allotted at random to two groups. One
      hundred thirty-two oocytes were inseminated in the presence of passaged human
      ampullary cells, while 123 oocytes were inseminated in culture medium alone.
      Fertilized oocytes were transferred to tubal ampullary cell monolayers and
      monitored for up to 48 hr. Eighty-five percent of oocytes fertilized in
      coculture, as compared to 67% in medium alone (P less than 0.01). A higher
      percentage of good-quality embryos was observed in cocultures than in controls
      (79 vs 67%; P less than 0.05). Binding of sperm to ampullary monolayer cells was
      observed. Human ampullary-cell cocultures may be useful to improve fertilization
      rates and embryonic viability and thus increase take-home baby rates for in vitro
      fertilization programs.

PMID- 1753169
TI  - A case of human pregnancy after microinjection of capacitated sperm into the
      perivitelline space.
AB  - Microinjection of capacitated sperm into the perivitelline space of oocyte was
      offered to one couple with persistent infertility of mixed origin. The husband's
      semen was subnormal, whereas his wife had definitive tubal occlusion and
      polycystic ovaries. Four previous in vitro fertilization (IVF) attempts were
      performed but no fertilization was obtained. After superovulation, 13 oocytes
      were collected. Ten were submitted to microinjection and two were damaged during
      the procedure. One of the remaining eight had two pronuclei 18 hr after
      microinjection and progressed to a four-cell embryo after 48 hr. After
      reimplantation, a normal pregnancy was initiated, caryotype (46XX) was checked at
      17 weeks. A normal and healthy girl has been delivered at term.

PMID- 1753170
TI  - Reliability of gender determination using the polymerase chain reaction (PCR) for
      single cells.
AB  - Contamination with extraneous DNA sequences is a frequent problem when performing
      PCR analysis of single cells. This report describes our experience with
      eliminating contaminating DNA sequences from PCR reagents for the purposes of
      gender identification. We have used amplification of Y-specific sequences to
      identify the gender of single human amniocytes. Female cells consistently showed
      no Y-specific bands but only 80% of male cells showed the expected intense Y
      specific band. This phenomenon could lead to incorrect gender identification of
      single cells. We developed a technique of simultaneous amplification of X- and Y
      specific sequences to prevent misdiagnosis because of failed PCR, which allows
      accurate preimplantation gender determination for women at risk for conceiving
      children with X-linked genetic diseases. We analyzed the gender of 141
      consecutive single cells in a blinded manner without a single incorrect gender
      assignment.

PMID- 1753171
TI  - The effect of leuprolide acetate on steroidogenesis by granulosa and theca cells
      in vitro.
AB  - Enhancement of follicular response to controlled ovarian hyperstimulation for
      human in vitro fertilization (IVF) has been suggested following pretreatment with
      leuprolide acetate (LA). However, additional human menopausal gonadotropin (hMG)
      is required to achieve follicle maturity in the presence of LA. We studied the
      effect of LA on steroidogenesis of granulosa and theca cells in vitro. Human
      granulosa cells obtained from IVF follicular fluid aspirations were cultured for
      14 days in the presence and absence of human chorionic gonadotropin (hCG). hCG
      significantly enhanced progesterone (P) and estradiol (E2) production by the
      cells, however, the addition of LA in concentrations of 10, 100, and 1000 ng/ml
      had no effect. Porcine granulosa cells were cultured for 48 hr in the presence
      and absence of follicle stimulating hormone (FSH) with the addition of LA at the
      same doses. LA did not affect the FSH-induced increase in P production. Porcine
      theca cells were cultured for 48 hr in the presence and absence of hCG. The
      addition of LA did not affect androstenedione (A) production by these cells. We
      conclude that in this dynamic model in vitro, LA does not inhibit or stimulate P
      or E2 production by granulosa or A production by theca cells.

PMID- 1753172
TI  - Pregnancy in a premature ovarian failure patient with donated oocytes from a 40
      year-old sibling: a case report.

PMID- 1753173
TI  - Twin in vitro fertilization (IVF) pregnancies: spontaneous intrauterine abortion
      after selective second-trimester termination of ectopic intraabdominal pregnancy.

PMID- 1753174
TI  - Successful ovarian superovulation for in vitro fertilization in a patient with an
      undiagnosed intrauterine pregnancy.

PMID- 1753175
TI  - Pregnancies following direct oocyte-sperm transfer (DOST): a simple alternative
      to conventional in vitro fertilization (IVF)

PMID- 1753176
TI  - Conformational constraints involved in MHC class I restricted antigen
      presentation.
AB  - The realization that class I-restricted antigen presentation can be mimicked
      using synthetic peptides and the description of the class I three-dimensional
      structure has provided a basis with which to study the conformational constraints
      associated with cytotoxic T cell (CTL) recognition. Recent experiments have
      suggested that antigenic fragments can bind to class I molecules in extended
      conformations. This binding is dependent on the presence of predominant motif
      arrangements in the peptides which are likely to correspond to specific subsites
      within the class I binding cleft. Changes within this cleft can affect T cell
      receptor recognition by inhibiting peptide binding or by altering the
      conformation of the presented peptide. These changes can result in dramatic
      modifications in peripheral T cell recognition and in the thymic development of
      the T cells themselves. Consequently, class I molecules apparently control the T
      cell response via their effect on the binding and conformation of the presented
      peptide determinants.

PMID- 1753177
TI  - Nasopharyngeal carcinoma.
AB  - Carcinoma of the nasopharynx is a rare disease that presents the physician with a
      difficult diagnostic and therapeutic challenge. The purpose of this report is to
      review the natural history, clinical evaluation, and treatment of carcinoma of
      the nasopharynx.

PMID- 1753178
TI  - Hib immunization of children.

PMID- 1753179
TI  - Calcified mucocele of the appendix presenting as ureteral obstruction.
AB  - Mucocele of the appendix, a rare lesion, occurs in 0.3% of patients undergoing
      appendectomy. Only 46 cases of calcified mucocele have been reported.
      Complications reported include appendiceal intussusception, rupture resulting in
      acute abdomen, and infection. We report the case of a 74-year-old man with a
      calcified mucocele of the appendix that was discovered in the evaluation of a
      ureteral obstruction. During exploratory surgery, the patient was found to have a
      6 x 5 cm appendiceal tumor and underwent a right ileocolectomy. Pathologic
      examination showed calcified mucous cystadenoma of the appendix. Calcification of
      a mucocele is believed to denote chronicity. Our case is the first report of
      ureteral obstruction secondary to calcified mucocele and the second calcified
      mucocele to be seen on computerized tomography. Calcified mucocele should be
      included in the differential diagnosis of any calcified tumor in the right lower
      quadrant.

PMID- 1753180
TI  - Of mice, men, and physicians.

PMID- 1753181
TI  - ECG of the month. Innocent abnormality. Early repolarization pattern.

PMID- 1753182
TI  - Remain true--pride in medicine.

PMID- 1753183
TI  - Pregnancy from cryopreserved embryos: an important new aspect of assisted
      reproduction.
AB  - Assisted Reproduction techniques have become well-established methods of treating
      infertility in the decade since their inception. The gradually improving efficacy
      of these procedures has made the risks of multiple pregnancy a serious concern.
      Cryopreservation of "extra" embryos has been developed to counter this problem,
      but has led to new difficulties. Assisted Reproduction in Kentucky has kept pace
      with progress worldwide; the first Kentucky live birth from transfer of
      cryopreserved embryos is reported.

PMID- 1753184
TI  - Splenectomy for hematologic disorders: a 20 year experience.
AB  - A retrospective chart analysis was conducted for all patients undergoing
      splenectomy for hematologic disorders at the Baptist Hospitals of Louisville
      between 1970 and 1989. Fifty-nine charts comprise the basis of this review.
      Variables considered included disease entities treated by splenectomy,
      indications for splenectomy, and morbidity and mortality associated with the
      surgery. Additional variables evaluated were splenic weight, estimated blood loss
      at surgery, technique of splenectomy, and drainage of the splenic bed. The
      authors found a high correlation of splenic weight to the hematologic disorder
      treated. Larger spleens were associated with greater blood loss at surgery.
      Preliminary splenic artery ligation did not reduce the operative blood loss in
      patients with massive spleens. Drainage of the splenic bed was not associated
      with postoperative bleeding or intra-abdominal abscess. The low morbidity (22%)
      and mortality (3.4%) compares favorably to other published studies, demonstrating
      that splenectomy for hematologic disorders may be safely performed in the
      community hospital setting.

PMID- 1753185
TI  - Indications and uses of the noninvasive vascular laboratory: cerebrovascular and
      venous evaluation.
AB  - Noninvasive vascular laboratory tests are highly accurate in diagnosing
      cerebrovascular arterial and extremity venous disease. These tests can also
      locate and grade the severity of the disease. Noninvasive studies are preferable
      to invasive angiographic procedures for the initial evaluation of patients who
      may have carotid artery disease, deep venous thrombosis, or venous valvular
      insufficiency. Arteriography of the extracranial cerebrovascular arteries should
      be used only for operative candidates who have severe disease of the carotid
      artery as determined by noninvasive studies. Venography is indicated in the few
      cases in which tibial vein thrombosis cannot be excluded by the noninvasive
      tests, or in patients undergoing evaluation for venous surgery (valvuloplasty or
      valve transplant).

PMID- 1753186
TI  - View-point based suppression of speech in the practice of medicine in the United
      States.

PMID- 1753187
TI  - Physician Payment Reform.

PMID- 1753188
TI  - Errors of deglutition--real and imagined; or, don't forget the psyche.

PMID- 1753189
TI  - Can meta-analysis help uncertainty in surgery for otitis media in children.
AB  - While otitis media is perhaps the most common disease of childhood that receives
      medical attention, there is little agreement concerning the efficacy of the
      medical and surgical therapies employed to try to alleviate its symptoms or
      hasten its natural resolution. Because various surgeries including adenoidectomy,
      myringotomy, and insertion of tympanostomy tubes are frequently involved in the
      treatment of otitis media with effusion (OME), it is likely the most expensive
      condition being managed in national terms. In an attempt to elucidate the most
      appropriate management of this condition, a meta-analysis was attempted to the 12
      randomized control trials of surgical treatments for OME in children, published
      between 1966 and 1990. Heterogeneity both in the populations and comparisons
      studied and in the outcomes presented made meta-analysis an inappropriate method
      for clarifying this area of clinical uncertainty. Important elements in the
      design of randomized control trials that should be included in future studies of
      treatment for OME are therefore discussed.

PMID- 1753190
TI  - Cholesteatoma in children: results in open versus closed techniques.
AB  - Cholesteatoma in children presents characteristics that differentiate it from the
      adult condition. Surgery has been performed in 55 ears. The main reason for
      referral was otorrhoea (83 per cent), either alone (29 per cent) or with hearing
      loss (54 per cent). Apart from three cases with an intact eardrum, a perforation
      was always present mostly posterior-superior (50 per cent). Open techniques were
      performed in 27.3 per cent of the ears and the closed technique in 72.7 per cent.
      Only in 18 per cent of cases was the ossicular chain normal and mobile. The attic
      was occupied by cholesteatoma in 79 per cent. Recurrence took place in 37 per
      cent and 13 per cent of the closed and open techniques respectively. Open
      techniques tend to be employed in the presence of extensive disease, whereas the
      closed technique is reserved for those with a more localized problem.

PMID- 1753191
TI  - Direct referral hearing aid provision in the over sixties age group.
AB  - A prospective study was designed in which General Practitioners were issued with
      a standard referral letter for hearing aid provision. Unknown to the General
      Practitioner an independent otolaryngologist assessment was obtained at the time
      of first attendance. Three hundred consecutive patients selected by General
      Practitioners applying these guidelines were seen in a designated hearing aid
      clinic staffed by audiological technicians of senior grade or above. Referral pro
      formata were incomplete in 75 patients who were not assessed. Ninety-four
      patients (31 per cent) (95 per cent confidence interval 29-36 per cent) were
      accepted by the audiologist. Obstructing wax was the most common criterion
      failed. Clinical agreement between audiologist and otolaryngologist was 57 per
      cent greater than chance. None of the cases of clinical disagreement altered
      treatment. A direct referral system as proposed could have processed only 31 per
      cent of 300 referrals. However, experienced technical staff reliably detected
      otological pathology and with aural toilet facilities 91 per cent of 225 patients
      (confidence interval 88-94 per cent) were aided.

PMID- 1753192
TI  - Experience with a subcutaneous implantable bone conduction hearing aid (Xomed
      Audiant) in a district general hospital.
AB  - Patients with a conductive hearing loss may find conventional hearing aids
      unsatisfactory for a variety of reasons. Efforts to overcome some of these
      difficulties have led to the development of the osteointegrated hearing aid.
      Implantable bone conduction hearing aids are an important advance in the
      treatment of well selected patients. Only 18 patients, who have been implanted
      with the Xomed Audiant bone conduction hearing aid, have so far been reported on
      in the UK. This report concerns a further six patients who have been implanted in
      one centre. Five of these patients continue to use their Audiant hearing aid 14
      to 24 months after being fitted. They regard it to have significant advantages
      over their previous hearing aids. Four of the five patients use an ear level
      processor. Two of the patients who had previously used conventional bone
      conduction hearing aids now use the ear level processor.

PMID- 1753193
TI  - Functional endoscopic sinus surgery in the management of chronic rhinosinusitis.
      An objective assessment.
AB  - Considerable clinical success has been claimed for functional endoscopic sinus
      surgery but objective assessment of prospective series is lacking in the
      literature. Twenty-four patients with chronic rhino-sinusitis underwent
      assessment of symptoms by visual analogue scoring, nasomucociliary function by
      ciliary beat frequency, olfaction by qualitative olfactometry and nasal airway
      resistance by anterior rhinomanometry pre- and post-operatively. This
      demonstrated a significant improvement in all symptoms examined and in ciliary
      beat frequency. Quantitative olfaction and anterior rhinomanometry were not
      improved despite diminished symptoms. These results offer quantitative evidence
      of clinical improvement following functional endoscopic sinus surgery which
      supports the pathophysiological concepts on which the technique is based.

PMID- 1753194
TI  - Adult tonsillectomy--results and patient selection.
AB  - One hundred and thirty two patients who had undergone tonsillectomy for recurrent
      sore throats were evaluated by a questionnaire regarding the effectiveness of
      their operation. There were 98 respondents of whom 88.8 per cent were satisfied
      with the benefit gained. Smoking habit did not affect the post-operative
      satisfaction rate. Dissatisfied patients were more likely to have changed their
      General Practitioner recently and more likely to have had multiple hospital
      referrals in the past. Improved patient satisfaction rates may be achieved by
      more careful assessment of patients with the latter characteristics.

PMID- 1753195
TI  - Acute epiglottitis in the adult.
AB  - Acute epiglottitis in the adult is a rare disease, which has shown an appreciable
      increase since the sixties and in our locality since 1984. We present a review of
      the cases registered in our hospital, analyzing their aetiology, evolution and
      treatment. The disease is most likely to be suspected in the presence of any
      patient having a sudden dysphagia, especially if he shows symptoms of an acute
      infection and a lack of oropharyngeal pathology.

PMID- 1753196
TI  - Alternative method of application of topical preparations in otitis externa.
AB  - Management of otitis externa and the discharging mastoid cavity accounts for a
      significant proportion of the ENT out-patient workload. A simple technique of
      topical application of dermatological preparations is described which is easy and
      effective.

PMID- 1753197
TI  - Exostosis of the external auditory canal: an interesting histopathological
      finding.
AB  - Perforation of the tympanic membrane is a frequent complication of surgery for
      exostoses of the external auditory canal. We report an unusual histopathological
      finding in a temporal bone containing external canal exostoses which suggests
      that some of these perforations may be unavoidable.

PMID- 1753198
TI  - Young's procedure in the treatment of epistaxis.
AB  - Intractable epistaxis associated with septal perforation is a difficult problem
      to treat, particularly if nose-picking appears to be associated. Two such cases
      are presented in which Young's procedure of nasal closure was used to prevent
      epistaxis. Although the procedure was fully successful in only one patient, we
      feel the procedure has a part to play in the management of such cases of
      epistaxis.

PMID- 1753199
TI  - Foreign body in the tongue: an unusual site for a common problem.
AB  - Foreign bodies in the upper aerodigestive tract represent one of the commonest
      ENT emergencies. A case report of a fish bone penetrating the anterior tongue is
      presented which exemplifies this frequent problem, but at a rare site.

PMID- 1753200
TI  - 'Priapism' of the turbinates: a cause of nasal obstruction in sickle cell
      anaemia.
AB  - A cause of nasal obstruction in sickle cell anaemia not previously described in
      the literature is presented. The pathophysiology is the same as in priapism
      because of the similarities in the vascular arrangement of the turbinate and the
      penis. Various treatment options are considered but the best results were
      achieved by surgical reduction of the inferior turbinates.

PMID- 1753201
TI  - Papillary adenocarcinoma of the nasopharynx.
AB  - The first case of low-grade papillary adenocarcinoma of the nasopharynx is
      described from an area where carcinoma in the nasopharynx is endemic.
      Clinicopathological features are detailed and differences between the prevalent
      nasopharyngeal cancer and low-grade nasopharyngeal papillary adenocarcinoma are
      emphasized. This tumour requires positive identification as surgical management
      is necessary to avoid the possibility of future recurrence.

PMID- 1753202
TI  - Giant cell tumour of the sphenoid sinus: an unusual skull base tumour.
AB  - An unusual skull base tumour is presented. Intraoperative smears made the
      diagnosis and dictated a change in surgical strategy. Giant-cell tumours of the
      sphenoid bone are discussed, together with current management.

PMID- 1753203
TI  - Bilateral thoracic empyema complicating adult epiglottitis.
AB  - Haemophilus influenzae is a common cause of epiglottitis and meningitis in
      children and exacerbation of chronic bronchitis in adults. However, the ability
      of this organism to cause serious infections in adults is less well recognized.
      We report a case of a 34-year-old previously healthy female who presented with
      epiglottitis and later developed bilateral empyema; both blood and pleural fluid
      grew Haemophilus influenzae.

PMID- 1753204
TI  - Intraglandular toxoplasmosis lymphadenitis of the parotid gland.
AB  - Toxoplasmosis is a protozoan infection manifested by systemic findings as well as
      generalized or localized lymphadenopathy. Although lympadenitis is the most
      common clinical form, involvement of the intraglandular nodes within the parotid
      gland found is a rare occurrence during the course of the disease. This unusual
      form may mimic a parotid mass, and can cause difficulties in differential
      diagnosis. In this article, a case of intraglandular parotid lymphadenitis which
      developed due to toxoplasmosis is presented, and the relevant literature is
      reviewed.

PMID- 1753205
TI  - Giant cervical cyst: presenting symptom of an occult thyroid carcinoma.
AB  - A case of giant lateral cervical cystic metastasis from occult thyroid carcinoma
      mimicking branchial cleft cyst is reported. Lateral cervical cystic metastases
      arising from occult thyroid carcinoma and their ultrasonic differentiation from
      true cysts are discussed.

PMID- 1753206
TI  - Chloral hydrate and middle ear pressure.

PMID- 1753207
TI  - Kikuchi's necrotizing lymphadenitis.

PMID- 1753208
TI  - Submucous resection as an outpatient procedure.

PMID- 1753209
TI  - Isolation and partial characterization of a protein with HMG-CoA reductase
      phosphatase activity associated with rat liver microsomal membranes.
AB  - Several rat liver HMG-CoA-reductase (HMG-CoA-Rd) phosphatase activities have been
      shown to be associated with the endoplasmic reticulum. These activities were not
      due to glycogen contamination, as judged not only from different patterns of
      solubilization of the microsomal membranes and the glycogen pellet but also by
      differential centrifugation behavior under standard conditions and in a sucrose
      gradient. We present evidence that at least three forms of protein phosphatase
      are associated with microsomal membranes: a polycation-stimulated type 2A
      phosphatase, a type 2C phosphatase, and a non-2A, non-2B, non-2C phosphatase.
      This last HMG-CoA-Rd phosphatase activity corresponding to an 85 kDa protein was
      partially purified by several chromatographic procedures. The IC50 value for the
      inhibition of the HMG-CoA-Rd phosphatase by I-2 was 10-fold higher than for the
      inhibition of the purified type 1 catalytic subunit from rabbit skeletal muscle.
      The microsomal HMG-CoA-Rd phosphatase activity was slightly affected by the
      protein inhibitor that inhibits type 2A activity when HMG-CoA reductase is the
      substrate. The HMG-CoA-Rd phosphatase activity is spontaneously active and it is
      not reactivated in the presence of Mg2+ or polycations. The holoenzyme does not
      contain the inhibitor-2 and it is not reactivated by incubation with ATP and
      glycogen synthase kinase-3. Proteolytic treatment of the enzyme yielded a
      polypeptide fragment of low Mr (37 kDa) with reduced activity. A model of
      holoenzymatic HMG-CoA-Rd phosphatase and its relation to the microsomal membranes
      is presented.

PMID- 1753210
TI  - Isolation and characterization of calmodulin-inactivating cholesterol
      hydroperoxides.
AB  - A series of cholesterol hydroperoxides has been prepared and tested as
      inactivators of calmodulin. Two previously undescribed compounds, tentatively
      identified as 20-(R)-25-dihydroperoxy-5-cholesten-3 beta-ol and its 20-(S) isomer
      inactivate calmodulin with 50% loss of activity at 5-10 microM. Cholesterol
      derivatives with a single hydroperoxy group at C-20 or C-25 are less effective,
      while 7 alpha-hydroperoxy-cholesterol and 25-hydroxy-cholesterol are inactive.
      The side-chain hydroperoxide compounds were isolated from a mixture shown earlier
      to suppress formation of fatty streaks in aortas of rabbits fed a diet
      supplemented with cholesterol.

PMID- 1753211
TI  - Interruption of the enterohepatic circulation of bile acids stimulates the
      esterification rate of cholesterol in human liver.
AB  - The activity of acyl CoA: cholesterol acyltransferase (ACAT), which catalyzes the
      esterification of cholesterol, was studied in liver microsomes obtained from
      cholestyramine-treated gallstone patients (n = 12) and patients with Crohn's
      disease who had undergone partial ileal resection (n = 11). Gallstone patients (n
      = 33) and gallstone-free subjects undergoing cholecystectomy because of polyps of
      the gallbladder (n = 8) served as controls. The mean levels of the ACAT activity
      were the same in the gallstone and the gallstone-free patient groups (6.0 +/- 0.4
      and 6.1 +/- 1.1 pmol/min per mg protein, respectively). When exogenous
      cholesterol was added to the assay system the activities were increased four- to
      fivefold in both groups. The ACAT activity tended to be increased in the
      cholestyramine-treated patients (8.1 +/- 1.8 pmol/min per mg protein), and was
      significantly enhanced (P less than 0.005) in the ileal-resected patients (12.3
      +/- 2.3 pmol/min per mg protein). When the enzyme activity was determined with
      added exogenous cholesterol, it was significantly higher compared to the controls
      in both the cholestyramine-treated patients and the patients with ileal resection
      (57.9 +/- 11.6 and 50.0 +/- 10.3 pmol/min per mg protein, respectively). The
      content of free and esterified cholesterol in liver homogenates and microsomes
      was not significantly different between the patient groups. We conclude that ACAT
      activity is increased in patients with interruption of the enterohepatic
      circulation of bile acids, and speculate that this reflects a stimulated uptake
      of lipoprotein cholesterol and may indicate that more cholesteryl esters are
      incorporated into very low density lipoproteins.

PMID- 1753212
TI  - Bile acids of marsupials. 2. Hepatic formation of vulpecholic acid (1 alpha,3
      alpha,7 alpha-trihydroxy-5 beta-cholan-24-oic acid) from chenodeoxycholic acid in
      a marsupial, Trichosurus vulpecula (Lesson).
AB  - Free vulpecholic acid (1 alpha,3 alpha,7 alpha-trihydroxy-5 beta-cholan-24-oic)
      is the major biliary component of the Australian opossum (Trichosurus vulpecula),
      accompanied only by a few percent of its taurine conjugate. In order to exclude a
      microbial involvement in its formation (i.e., secondary origin) four sets of
      experiments were performed. It was found that a) the level of vulpecholic acid
      remained unchanged in the bile of opossums fed with neomycin and kanamycin for 7
      days prior to bile collection; b) it also remained unchanged after long bile
      drainage; c) in opossums prepared with biliary cannula, intraportally injected
      [24-14C]chenodeoxycholic acid was transformed to [24-14C]vulpecholic acid; and d)
      in a similar experiment, the detectable transformation of [1 alpha,2 alpha
      3H2]cholesterol to vulpecholic acid was observed. In experiment c) 28-66% of the
      administered radioactivity was secreted in 2 h in the form of free biliary
      vulpecholic and chenodeoxycholic acids. Only a trace amount of the corresponding
      taurine conjugates (approximately 0.4%) was formed. Moreover, rapidly declining
      specific radioactivity of the unconjugated chenodeoxycholic acid indicated its
      probable participation in the native formation of vulpecholic acid.

PMID- 1753213
TI  - Intestinal lymph and plasma lipoproteins in the preruminant calf: partial
      resolution of particle heterogeneity in the 1.040-1.090 g/ml interval.
AB  - Our previous studies in the preruminant calf have provided evidence for the
      heterogeneity of lipoprotein particles in the 1.040-1.090 g/ml density interval
      in both plasma and postprandial intestinal lymph (Bauchart, D. et al., 1989. J.
      Lipid Res. 30: 1499-1514; and Laplaud, P. M. et al., 1990. J. Lipid Res. 31: 1781
      1792). We therefore attempted to resolve this heterogeneity by use of heparin
      Sepharose affinity chromatography. Experiments were performed on three calves;
      portal vein plasma and intestinal lymph were obtained simultaneously 10 h after a
      meal, i.e., at peak lipid absorption. In both fluids, the chromatographic profile
      presented three fractions, I, II, and III. Fraction I was characterized by the
      presence of cholesteryl ester-rich particles (approximately 35-37% of lipoprotein
      mass), which migrated electrophoretically as typical high density lipoproteins
      and exhibited Stokes diameters in the 130-160 A range; apoA-I was the predominant
      protein. In addition to this polypeptide, fraction II contained small amounts of
      a supplementary protein (Mr approximately 51,000), exhibiting heparin-binding
      properties. In the light of results reported in the literature, we suggest that
      this latter protein could correspond to beta 2 glycoprotein I. The chemical
      composition of each fraction II closely resembled that of the corresponding
      fraction I, while their electrophoretic migrations appeared slightly slower and
      their Stokes diameters slightly larger (155-165 A). Apart from the presence of
      small amounts of apoA-I, two high Mr proteins (Mr approx. 560,000 and 300,000)
      were typical of the apolipoprotein moiety of fractions III. The lower Mr form was
      present as a trace component only in fraction III originating from plasma; its
      proportion increased in lymph fraction III so as to approximately match that of
      the higher Mr (i.e., 560,000) protein. In both plasma and lymph, fraction III was
      electrophoretically heterogeneous, exhibiting a doublet of bands with migration
      and Stokes diameters (250 A) typical of low density lipoprotein particles.
      However, no evidence for the presence of a particle resembling lipoprotein[a] in
      fraction III could be obtained. In lymph only, fraction III contained a
      supplementary population of lipoproteins with migration intermediary between
      those of conventional low and high density lipoproteins and with Stokes diameters
      in the 190-200 A range. Other specific features of lymph fraction III included a
      sevenfold increase in its triglyceride content (8.5 +/- 3.4% vs. 1.2 +/- 1.1% in
      the corresponding fraction from plasma), to the detriment of cholesteryl esters,
      and a higher proportion of protein.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1753214
TI  - Occurrence of isomeric dehydrocholesterols in human plasma.
AB  - Three isomeric dehydrocholesterols were found in plasma from healthy subjects and
      patients with abnormal production or metabolism of cholesterol. These chemically
      labile steroids were isolated by a mild liquid-solid extraction procedure using
      octadecylsilane-bonded silica as sorbent. Sterol-protein interactions were
      minimized by diluting plasma with aqueous isopropanol. The dehydrocholesterols
      were identified by high-performance liquid chromatography-ultraviolet
      spectroscopy and gas chromatography-mass spectrometry as cholesta-5,7-dien-3 beta
      ol (7-dehydrocholesterol), 5 alpha-cholesta-6,8(9)-dien-3 beta-ol
      (isodehydrocholesterol), and tentatively as cholesta-5,8(9)-dien-3 beta-ol. There
      was a strong positive correlation between plasma levels of the two former
      compounds, isodehydrocholesterol levels usually being about 1.4 times higher than
      those of 7-dehydrocholesterol. The median concentration of 7-dehydrocholesterol
      in plasma from healthy subjects was 52 ng/ml. Similar concentrations were found
      in colectomized patients (median concentration 47 ng/ml) and patients with
      extrahepatic cholestasis and alcoholic liver cirrhosis (median concentrations 79
      and 67 ng/ml, respectively). Patients with ileal resection or under treatment
      with cholestyramine had elevated levels (median concentrations 142 and 160 ng/ml,
      respectively) whereas patients with primary biliary cirrhosis had subnormal
      levels (median concentration 26 ng/ml). The results are consistent with a
      positive correlation between levels of the dehydrocholesterols in plasma and the
      rate of cholesterol synthesis. The sterols were also analyzed in human skin and
      bile and the results indicate that the liver may be an important source of
      isodehydrocholesterol.

PMID- 1753215
TI  - Regulation of adipose cell differentiation. I. Fatty acids are inducers of the
      aP2 gene expression.
AB  - The regulation of the expression of adipose-related genes, i.e., aP2, adipsin,
      and glycerophosphate dehydrogenase (GPDH) by growth hormone (GH) and polyamines,
      as well as the role of fatty acids, have been investigated in polyamine-dependent
      Ob1754 cells and Ob1771 preadipose cells. Growth hormone acts as an obligatory
      hormone for adipsin and GPDH gene expression but its presence is not required for
      the expression of the aP2 gene. In fully differentiated Ob1771 cells, impairment
      of fatty acid synthesis by glucose deprivation leads to an inhibition of the aP2
      gene expression, whereas the expression of adipsin and GPDH genes remains
      unaffected. Supplementation of the culture medium with fatty acids prevents the
      decrease of aP2 gene expression, and this effect appears primarily due to an
      increase in the transcriptional level of aP2 gene. The induction of aP2 gene has
      been examined in early committed, lipid-free Ob1771 cells in which fatty acid
      synthesis is very low despite glucose supplementation. Long-chain fatty acids
      (greater than or equal to C12) are able to activate the aP2 gene. It is concluded
      that fatty acids or fatty acid metabolites activate the aP2 gene and subsequently
      modulate its expression.

PMID- 1753216
TI  - Regulation of adipose cell differentiation. II. Kinetics of induction of the aP2
      gene by fatty acids and modulation by dexamethasone.
AB  - Fatty acids behave as activators of the aP2 gene expression in committed, lipid
      free, non-terminally differentiated Ob1771 cells. Like fatty acids, dexamethasone
      provokes a dose-dependent accumulation of aP2 mRNA. However, fatty acids and
      dexamethasone act through different mechanisms to activate the aP2 gene
      expression since i) fatty acids and dexamethasone act in a synergistic manner;
      ii) the effect of dexamethasone is rapid and transient (maximal effect after 8
      h), whereas that of fatty acids is slower, and maintained as long as the inducer
      is present and is fully reversible upon fatty acid removal; iii) the induction of
      the aP2 gene expression by dexamethasone does not require ongoing protein
      synthesis, while the response to fatty acids is completely prevented by
      cycloheximide; and iv) the induction of the aP2 gene expression by fatty acids
      but not by dexamethasone is confined to preadipocyte cell lines. This suggests
      that the process of activation by fatty acids, rather than the expression of the
      aP2 gene, is unique to adipose cells. Besides their effects on the aP2 gene,
      fatty acids activate the expression of the acyl CoA synthetase gene which encodes
      another protein involved in fatty acid metabolism. Activation of both genes by
      fatty acids appears not to be mediated by the CCAAT enhancer binding protein, a
      nuclear factor reported as transactivator of the aP2 promoter activity, since the
      enhancer binding protein mRNA is not expressed under these conditions.

PMID- 1753217
TI  - Site-specific methionine sulfoxide formation is the structural basis of
      chromatographic heterogeneity of apolipoproteins A-I, C-II, and C-III.
AB  - ApoA-I and apoC-II are eluted in two isoforms and apoC-III2 is eluted in three
      isoforms by reversed phase high performance liquid chromatography (HPLC). The
      structural basis of these nongenetic heterogeneities was unravelled using HPLC of
      proteolytic peptides and time-of-flight secondary ion mass spectrometry (TOF
      SIMS). In apoA-I, the chromatographic microheterogeneity was caused by the
      formation of methionine sulfoxides (MetSO). However, only residues Met112 and
      Met148 were found oxidized, whereas Met86 was unaffected and also resistant
      towards artificial oxidation. To assess whether and to what extent amino acid
      substitutions in apoA-I might affect methionine sulfoxidation, the tryptic
      peptides of 13 different mutant apoA-I proteins from 24 heterozygous apoA-I
      variant carriers were analyzed by HPLC. In normal apoA-I, the ratios
      MetSO112/Met112 and MetSO148/Met148 were highly variable. By contrast, the
      relative ratio of oxidation of methionine residues 112 and 148 was constant. The
      amino acid changes Lys107----Met, Lys107----O, Glu139----Gly, Glu147----Val, and
      Pro165----Arg resulted in the preferential oxidation of Met112, and Asp103----Asn
      resulted in a preferential oxidation of Met148; whereas Pro3----Arg, Pro3----His,
      Pro4----Arg, Asp89----Glu, Ala158----Asp, Glu198----Lys, and Asp213----Gly had no
      impact. ApoC-II and apoC-III isoforms differed by the oxidation of the two
      methionine residues in these proteins. Whereas in apoC-II both methionine
      residues were oxidized in parallel, in apoC-III the two methionine residues
      differed in their susceptibility towards oxidation. We conclude that the
      formation of MetSO depends on the molecular microenvironment within a protein.

PMID- 1753219
TI  - Ontogeny of two vitamin A-metabolizing enzymes and two retinol-binding proteins
      present in the small intestine of the rat.
AB  - The patterns of expression of cellular retinol-binding protein (CRBP), cellular
      retinol-binding protein, type two [CRBP(II)], lecithin: retinol acyltransferase
      (LRAT), and microsomal retinal reductase were examined for rat small intestine
      during the perinatal period. CRBP was present (15 pmole per mg soluble protein)
      at the earliest time examined, the 16th day of gestation, declining by 70% by
      birth, maintained to adulthood. In contrast, CRBP(II) appeared 2-3 days before
      birth, rising to its highest level (500 pmole per mg soluble protein) by day 3
      after birth, then declining by 50% during the late suckling period to the adult
      level. Immunohistochemistry revealed that CRBP(II) initially appeared in the
      epithelial cell layer in a patchy manner, resolving by birth into an even
      staining of all villus-associated enterocytes. In contrast, CRBP was evenly
      expressed in the epithelial cell layer at day 17/18 but was absent by birth.
      Intestinal LRAT activity increased rapidly in the 2 days prior to birth, then
      declined at weaning to the adult level. Microsomal retinal reductase was
      measurable in the intestine at birth, but not detected during the early suckling
      period, reappearing at day 21. Considerable increase was then observed coincident
      with weaning, when carotenes, from which retinal is derived, became an important
      source of vitamin A. The pattern of appearance of these elements appears to
      prepare the intestine for the necessary processing of vitamin A required after
      birth.

PMID- 1753218
TI  - Influence of total lipid concentration, bile salt:lecithin ratio, and cholesterol
      content on inter-mixed micellar/vesicular (non-lecithin-associated) bile salt
      concentrations in model bile.
AB  - We modified classic equilibrium dialysis methodology to correct for dialysant
      dilution and Donnan effects, and have systematically studied how variations in
      total lipid concentration, bile salt (taurocholate):lecithin (egg yolk) ratio,
      and cholesterol content influence inter-mixed micellar/vesicular (non-lecithin
      associated) concentrations (IMC) of bile salts (BS) in model bile. To simulate
      large volumes of dialysant, the total volume (1 ml) of model bile was exchanged
      nine times during dialysis. When equilibrium was reached, dialysate BS
      concentrations plateaued, and initial and final BS concentrations in the
      dialysant were identical. After corrections for Donnan effects, IMC values were
      appreciably lower than final dialysate BS concentrations. Quasielastic light
      scattering was used to validate these IMC values by demonstrating that lipid
      particle sizes and mean scattered light intensities did not vary when model biles
      were diluted with aqueous BS solutions of the appropriate IMC. Micelles and
      vesicles were separated from cholesterol-supersaturated model bile, utilizing
      high performance gel chromatography with an eluant containing the IMC. Upon
      rechromatography of micelles and vesicles using an identical IMC, there was no
      net transfer of lipid between micelles and vesicles. To simulate dilution during
      gel filtration, model biles were diluted with 10 mM Na cholate, the prevailing
      literature eluant, resulting in net transfer of lipid between micelles and
      vesicles, the direction of which depended upon total lipid concentration and
      BS/lecithin ratio. Using the present methodology, we demonstrated that inter
      mixed micellar/vesicular concentrations (IMC) values increased strongly (5 to 40
      mM) with increases in both bile salt (BS):lecithin ratio and total lipid
      concentration, whereas variations in cholesterol content had no appreciable
      effects. For model biles with typical physiological biliary lipid compositions,
      IMC values exceeded the critical micellar concentration of the pure BS, implying
      that in cholesterol-supersaturated biles, simple BS micelles coexist with mixed
      BS/lecithin/cholesterol micelles and cholesterol/lecithin vesicles. We believe
      that this methodology allows the systematic evaluation of IMC values, with the
      ultimate aim of accurately separating micellar, vesicular, and potential other
      cholesterol-carrying particles from native bile.

PMID- 1753220
TI  - The tocsin sounds.

PMID- 1753221
TI  - Sovietization of American medicine.

PMID- 1753222
TI  - Primary care. A role for nurses.

PMID- 1753223
TI  - Symptomatic adult polycystic liver disease in a young woman.
AB  - Adult polycystic liver disease is an entity that is striking for the presence of
      extraordinary hepatomegaly. Very rarely do patients under 40 years of age
      experience problems and only a minority of middle-aged patients manifest symptoms
      due to organ compression or biliary tree obstruction. The clinical course is
      usually benign, and no specific therapy is required. The onset of right upper
      quadrant pain, back pain, and shortness of breath prompted evaluation of a 32
      year-old woman with progressive hepatomegaly. CT scan revealed a massive cyst
      riddled liver with posterior displacement of the spleen, compression of the
      pancreas, and renal cysts. Prothrombin time, albumin, and liver enzyme values
      were normal except for a mildly elevated gamma-glutamyl transpeptidase.

PMID- 1753224
TI  - The aging population. A critical issue in medicine for the 21st century.
AB  - One critical issue facing medical science concerns the aging population. The
      number of individuals 65 years and older has increased during the past decade and
      likely will double by the year 2030, when the elderly will represent nearly 20%
      of the total population. This dramatic increase has numerous ramifications;
      health care is of utmost importance. Inherent in meeting the medical needs of
      these individuals is a fundamental understanding of the effects of aging on the
      functional integrity of numerous organ systems. In recognition of this problem,
      the Department of Pharmacology and Therapeutics at the University of South
      Florida College of Medicine has initiated a major effort focused on age-related
      research. The objectives are to elucidate fundamental biochemical, physiological,
      and pharmacological alterations that occur as a consequence of normal aging and
      to investigate the role of these perturbations on the manifestations of disease.
      Information gained from such studies will provide a rational approach in
      developing therapeutic strategies for the treatment of diseases affecting older
      citizens. This article presents a brief overview of four areas of research
      currently being pursued. These include aging and brain function, age-related
      alterations in drug metabolism, aging and smooth muscle function, and the effects
      of aging on the immune system.

PMID- 1753225
TI  - Orthostatic hypotension in the elderly.

PMID- 1753226
TI  - Under pressure. Soaring costs in health care will require some tough decisions.

PMID- 1753227
TI  - AIDS in Florida. The first decade.

PMID- 1753228
TI  - Infection control.
AB  - "Universal precautions" and "strict infection control procedures" have become
      health-care facility as well as household terms. However, not much time has been
      given to explaining the specifics of exactly what they are or how and when they
      should be applied. The purpose, therefore, of this article is to review these
      specifics for practicing physicians, regardless of their specialty.

PMID- 1753229
TI  - Legal considerations. Current Florida law.
AB  - Legislation enacted in 1991 requires physicians licensed under Chapters 458 or
      459, Florida Statutes, to earn continuing medical education in the area of HIV
      and AIDS and specifies what should be covered in the program. The law no longer
      requires that certain information be imparted to the patient prior to testing for
      the human immunodeficiency virus. Information is presented on who can consent to
      testing, when consent is not required, pre- and post-testing requirements,
      confidentiality of patient records and possible disclosure and testing as a
      condition of treatment or admission.

PMID- 1753230
TI  - Management of HIV infection in adults.
AB  - The natural history of HIV infection continues to change with improved diagnostic
      and therapeutic modalities available to manage opportunistic infections and
      malignancies. Antiretroviral therapy with zidovudine and other investigational
      agents has improved the median survival of AIDS patients from 11 months in 1985
      to 18-25 months at present. Most importantly, early intervention with zidovudine
      can delay onset of clinical illness in asymptomatic patients and progression to
      AIDS in symptomatic patients. A 500 mg/d dose has been found as effective as
      previously recommended doses of 1200-1500 mg/day. Lower doses decrease the
      incidence and severity of adverse effects and therapeutic benefit appears to be
      greatest in asymptomatic patients with CD4 lymphocyte counts less than 500/ul.
      Indications for zidovudine, therefore, have been expanded to include asymptomatic
      adults with CD4 lymphocyte counts less than 500/ul. Concerning early intervention
      with zidovudine, studies were not designed to measure survival or define the
      optimal timing of intervention based on immunologic status. In addition, long
      term benefits are not clearly defined, particularly since the drug seems to lose
      clinical effectiveness after approximately two years, probably due to emergence
      of resistant HIV strains. Adverse effects continue to occur even at low doses
      including headaches, nausea, anemia and neutropenia, myopathy and possible
      hepatitis. Nevertheless, the overall clinical benefit seems to be greatest,
      albeit temporary, in asymptomatic patients. The optimal dosage appears to be 500
      600 mg/d; however, this may not be sufficient for infection in the central
      nervous system.

PMID- 1753231
TI  - Epidemiology of AIDS in Florida.
AB  - Florida is third in the nation in the cumulative number of AIDS cases. The
      epidemic in the state has grown steadily since 1981, clustering initially in
      metropolitan South Florida but dispersing to other urban and nonurban areas.
      Heterosexually transmitted AIDS is fast increasing and is more than twice as
      common in Florida than the United States; however, homosexual/bisexual men and
      intravenous drug-using men and women continue to represent the majority of new
      cases. Special serologic studies of the prevalence of HIV infection provide a
      timely view of the dynamics and characteristics of the epidemic in various
      segments of the state's population. Data from a large, ongoing serosurvey suggest
      that about one in every 220 childbearing women is HIV-infected, a finding
      consistent with Florida's rank of second nationally in the number of pediatric
      AIDS cases.

PMID- 1753232
TI  - Pediatric HIV infection. An update.
AB  - Human immunodeficiency virus infection is a leading cause of immunodeficiency in
      children. The epidemic in children parallels that in women since most infected
      women are in the child-bearing age groups. The risk of vertical transmission of
      HIV from an infected mother to her infant ranges from 13% to 39%. Diagnosis of
      infection in the infant is complicated by the passive transfer of antibody across
      the placenta, making the use of standard serologic tests to confirm infection
      difficult. In children less than 15 months of age, a positive p24 core antigen
      test, a positive viral culture or AIDS defining criteria with immune
      abnormalities are required for diagnosis. HIV infection in children is chronic
      and multisystem characterized by immunologic and clinical deterioration with a
      higher incidence of serious bacterial infections, neurologic disease, and
      lymphoid interstitial pneumonitis. The cornerstones of management include close
      medical follow-up, good nutrition, and prompt diagnosis and treatment of
      infections. Certain children will benefit from therapeutic modalities such as
      Pneumocystis carinii pneumonia prophylaxis and/or intravenous gamma globulin. The
      antiretroviral drugs have improved the quality of life and increased survival.
      Several newer antiviral agents are presently in clinical trials.

PMID- 1753233
TI  - Pathogenesis and natural history of HIV infection.
AB  - Acquired immune deficiency syndrome (AIDS) is caused by infection with the human
      immunodeficiency virus (HIV), a human retrovirus. The virus infects cells of the
      immune system by attachment of a glycoprotein viral envelope (gp 120) to a
      molecule expressed on human helper T cells called CD4. The fusion of the virus
      envelope protein to its specific receptor allows HIV to penetrate the T cell.
      Once inside the cell viral RNA is transcribed into double-stranded DNA by an
      enzyme unique to retroviruses, reverse transcriptase. The double-stranded,
      proviral DNA travels to the nucleus of the cell and is integrated into the
      infected cell's chromosomal DNA where it may remain latent for years. As a result
      of triggers that are poorly understood, viral replication becomes activated and
      proviral DNA is transcribed back into genomic RNA and RNA that is translated into
      viral proteins, both of which are packaged and bud from the infected T cell as
      infectious virus. The viral life cycle orchestrates the natural history of
      clinical HIV infection. Three to four weeks following exposure to HIV there is a
      phase of rapid viral replication, high levels of plasma viremia, and development
      of a "flue like" illness. Four to six weeks after exposure, during this stage of
      acute infection, antibodies to HIV core (p24) and envelope (gp 160, gp 120, gp41)
      proteins appear. Six to eight weeks after exposure symptoms disappear and plasma
      viremia subsides, presumably due to clearance by the immune system.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1753234
TI  - Medical utopia.

PMID- 1753235
TI  - Inappropriate testing.

PMID- 1753236
TI  - Age-associated neurological diseases.

PMID- 1753237
TI  - Diagnosis, assessment and treatment of age-associated memory impairment.
AB  - We have reviewed diagnostic criteria and assessment procedures for AAMI, as well
      as pharmacologic and behavioral treatments for this condition. This research
      gives reason to hope that an important behavioral deficit associated with aging
      may be modified through drug and behavioral treatment.

PMID- 1753238
TI  - Essential tremor: functional disability vs. subjective impairment.
AB  - 78 patients with essential tremor (ET) were investigated to uncover correlation
      and discrepancies between functional (motor) disabilities and subjective
      impairment. Various self-rating scales (Zung, v. Zerssen etc.) were used for the
      assessment of the latter: 2/5 of the patients rated themselves as severely
      impaired; 1/3 was depressive. Patients who showed nearly the same functional
      (motor) disability felt very differently subjectively impaired. Semiquantitative
      clinical scores of action tremor correlated best with the subjective impairment
      in activities of daily living. Objective measurements of motor disability were
      performed with the "Motorische Leistungsserie nach Schoppe" (motor performance
      test) and showed good correlation to the subjective impairment in simple tasks of
      every day life, such as drinking from a glass, eating soup, and writing. Asking
      for the subjective impairment in these tasks allows to estimate the objective
      disability correctly. This may be of value in long-term studies of essential
      tremor.

PMID- 1753239
TI  - Sympathetic vascular function in patients with central dysautonomia.
AB  - This study used digital photoplethysmography (d-FPG) to investigate alterations
      in skin blood flow after exposure to cold as well as the post-prandial blood
      pressure pattern to assess how the sympathetic branch of autonomic nervous system
      (ANS) functioned in 31 patients with cerebral dysautonomia and in 27 healthy
      controls. d-FPG was carried out on all ten fingers in basal conditions and after
      exposure to ice-cold water (4-5 degrees C). Amplitude, crest time and inclination
      time were used to calculate the alterations induced by the cold pressor test.
      After a standard lunch blood pressure was monitored every 20 minutes using a
      fully automatic non-invasive sphygmanometer. Unlike the controls the amplitude of
      the photoplethysmographic wave increased in all patients except 2; crest time and
      inclination time decreased in all except 3; post-prandial diastolic and systolic
      blood pressure levels fell markedly in all but 3. Blood vessel smooth muscle tone
      is disturbed in patients with ANS failure because dysautonomia may permit the
      action of vasodilating substances to predominate. The post-prandial blood
      pressure pattern and the d-FPG used in conjunction with a cold pressor test are
      useful tools in the non-invasive investigation of ANS function.

PMID- 1753240
TI  - Epidemiology and out-patient care in Parkinson's disease--results from a pilot
      study in northern Germany (Schleswig-Holstein).
AB  - An attempt was made to estimate prevalence on Parkinsonism using consultation
      rates in physicians' practices in a two-step, one-phasic pilot study in a rural
      urban area of Northern Germany. Though participation of physicians was low,
      reported rates for Parkinsonian patients (183/100,000) were in the range yielded
      in comparable areas, but by different methodology. Only 64% of a large subsample
      of patients used L-Dopa preparations for therapy. Confirming previous results the
      objective records of doctors and the subjective notices of patients regarding
      disease state showed considerable differences in several important items.

PMID- 1753241
TI  - Effects of treatment with trihexyphenidyl on cognitive function in early
      Parkinson's disease.
AB  - 13 patients with PD of recent onset underwent a series of neuropsychological
      tests for frontal lobe associated functions (Sternberg paradigm, WCST, CVLT)
      before and during treatment with Artane. Test results at baseline were not
      significantly different from those of an age-matched control group (n = 13).
      Retesting after a mean of 2 weeks' treatment with trihexyphenidyl revealed only
      slight impairment in CVLT while performance on the other tests remained
      unchanged.

PMID- 1753242
TI  - Positron emission tomography in the differential diagnosis of organic dementias.
AB  - At present, PET is the only technology affording the quantitative, three
      dimensional imaging of various aspects of brain function. Since function and
      metabolism are coupled, and since glucose is the dominant substrate of the
      brain's energy metabolism, studies of glucose metabolism by PET of 2(18F)-fluoro
      2-deoxy-D-glucose (FDG) are widely applied for investigating the participation of
      various brain systems in simple or complex stimulations and tasks. In focal or
      diffuse disorders of the brain, functional impairment of affected or inactivated
      brain regions is a reproducible finding. While glucose metabolism is decreased
      slightly with age in a regionally different degree, in most types of dementia
      severe changes of glucose metabolism are observed. Degenerative dementia of the
      Alzheimer type is characterized by a metabolic disturbance most prominent in the
      parieto-occipito-temporal association cortex and later in the frontal lobe, while
      primary cortical areas, basal ganglia, thalamus, and cerebellum are not affected.
      By this typical pattern Alzheimer disease can be differentiated from other
      dementia syndromes, as e.g., Pick's disease (with the metabolic depression most
      prominent in the frontal and temporal lobe), multi infarct dementia (with
      multiple focal metabolic defects), and Huntington's chorea (with metabolic
      disturbance in the neostriatum). In demented patients PET studies can also be
      applied to the quantification of treatment effects on disturbed metabolism.

PMID- 1753243
TI  - MRI in basal ganglia diseases.
AB  - 76 patients suffering from different basal ganglia diseases (28 cases with M.
      Parkinson, secondary parkinsonism and Parkinson diseases; 5 cases with Chorea
      Huntington; 5 cases with Fahr disease and 38 cases with M. Wilson) MRI featured 2
      characteristical patterns: 1. abnormal deposition of minerals, 2. focal atrophies
      of involved organs. Thus MRI provides with informations about: 1. differential
      diagnosis in clinically misleading courses, 2. stage and, as a consequence,
      prognosis of some diseases, 3. biochemical processes of diseases in vivo.

PMID- 1753244
TI  - Extrapyramidal disturbances after cyanide poisoning (first MRT-investigation of
      the brain).
AB  - A 29 year old student of chemistry took 50 ml of a 1% potassium cyanide solution
      (500 mg) in attempted suicide. He became comatose, mydriatic and was admitted to
      hospital in an apneic state. He woke up after seven hours and developed
      Parkinsonism in the following weeks. This regressed slowly in the second month
      after the poisoning apart from dysarthria, bradykinesia of the upper limbs and
      very brisk monosynaptic reflexes. Three weeks after the intoxication, CCT was
      largely normal, and there was CSF-dense hypodensity in both putamina after five
      months. Sharply delimited signal elevation in T2 corresponding to the two
      putamina was detected in the MRI eight weeks and five months after ingestion of
      the poison.

PMID- 1753245
TI  - Stroke: evaluation of long-term rehabilitation effects.
AB  - A planned prospective documentation of the course of rehabilitation of 303 stroke
      patients was undertaken using the Bathel-Index as a measure of basic everyday
      functions and the Guttman-Scale as a measure of complex activities of daily
      living. These were determined at the beginning of rehabilitation, after an
      average of 7 weeks of in-patient treatment and one year following the stroke.
      Four patterns in the course of rehabilitation could be differentiated. The causes
      of the differing functional results were investigated. Besides a positive
      spontaneous progress of the underlaying disease with an early reparation of the
      neurological deficits it is the premorbid status, the overprotection of the
      physically disabled and the determinative cognitive and mental functions that
      decide the long term fate of stroke patients.

PMID- 1753246
TI  - Medical educational and functional determinants of employment after stroke.
AB  - To evaluate the medical educational and functional determinants of employment
      after stroke a total of 204 Patients were assessed for functional changes during
      rehabilitation and after one year. Additionally the educational and social
      background of each patient was documented. One year after discharge from the
      rehabilitation unit 11.3% of the patients worked full-time and 2.7% part time.
      Another 14.7% had the decision pension versus employment still pending and 0.5%
      were classified as unemployed. 70.8% received regular retirement plan payments or
      disability pensions. Generally a similar level of functional capabilities can be
      observed after one year for working and non-working patients except for manual
      dexterity. Early admission to rehabilitation (within the first 12 weeks) favours
      return to work. A high school degree qualifying for university entrance and a
      well paid and better qualified profession as well are correlated with a higher
      percentage of patients regaining their employment. An other determining factor of
      employment after CVA is the physical requirement of the former work. Most of the
      working patients (92%) had been either transferred onto a job suited for an
      handicapped people or their work plan had been restructured accordingly.

PMID- 1753247
TI  - The spectrum of subcortical lesions in MRI, sensitivity and specificity.
AB  - Subcortical foci of increased signal intensity are frequently identified on MRI
      in the elderly. The lesions are compatible with various pathologic processes and
      MRI can only provide supportive data for a suspected diagnosis. Without the
      patient's clinical history the radiologist is not able to differentiate between
      real pathologic lesions and physiologic aging processes. The high sensitivity of
      MRI in detecting white matter lesions and the lack of specificity recommends an
      excellent teamwork between clinicians and radiologists.

PMID- 1753248
TI  - Cytoskeleton pathology in Alzheimer's disease and related disorders.
AB  - The reported findings suggest that ubiquitination of pathological proteinaceous
      intracytoplasmic inclusions is not at all specific of AD. On the contrary it
      appears to be a general biochemical marker for disorders in the degradation of a
      variety of cytoskeletal and other cytoplasmic proteins. The pattern of affected
      cytoskeletal components is not specific of AD/SDAT tangles. Tau definitely is
      present also in PSP tangles and possibly in Pick bodies but not in Lewy bodies.
      Therefore it has to be considered that the intracytoplasmic accumulation of
      cytoskeletal protein/ubiquitin complexes in itself is a rather unspecific
      cellular reaction pattern, possibly a secondary reaction to cell injury of many
      types, especially, however, of neuronal aging. Nevertheless, the manifestation of
      NFT in an excessive quantity, intensity, and dynamics with severe concomitant
      lesions as in AD/SDAT undoubtedly is a true pathological and in this sense a
      disease-specific change.

PMID- 1753249
TI  - Morphometry of the corpus callosum in normal aging and Alzheimer's disease.
AB  - Changes of the human corpus callosum in normal aging and Alzheimer's disease were
      analysed by means of morphometry. A standardized computerized evaluation program
      was implemented allowing objective, quantitative and reproducible data. The
      various parts of the corpus callosum showed a different pattern of changes in
      normal aging as compared to Alzheimer's disease. In conclusion, in normal aging
      affects mostly the front-temporal interhemispheric fiber systems, whereas in
      Alzheimer's disease the parietotemporal commissural fibers are altered.

PMID- 1753250
TI  - Clinical and epidemiological aspects of dementia in the elderly.
AB  - Dementia of the Alzheimer's type (DAT) is the most significant disease of the
      aging brain. Descriptive epidemiology of DAT found a constant doubling of
      prevalence rates every 5 years. Analytic epidemiology so far failed to reliably
      detect risk factors for DAT other than age. This might depend on the difficulties
      encountered in the clinical diagnosis and differential diagnosis of dementia in
      the elderly, which are discussed with special reference to 1) the definition of
      dementia, to 2) the grading of severity of dementia, to 3) the differentiation
      between dementia and depression, and to 4) the differentiation between multi
      infarct dementia and DAT.

PMID- 1753251
TI  - Multi-infarct dementia.
AB  - Clinicians have long recognized that dementia is a common symptom among the
      elderly. The diagnosis of dementia requires us to document the individual's
      current level of mental functioning and some higher level of intellectual
      function in the past. The recognition of early or mild cases is specially
      difficult. Out of epidemiological studies it has been shown that the incidence
      for multi-infarct dementia (MID) increases with age and is slightly higher among
      men.

PMID- 1753252
TI  - Early diagnosis of Alzheimer dementia?
AB  - The main problems in early diagnosis of Alzheimer dementia (AD) are: 1. The
      differentiation between normal aging and AD i.e. difficulties in the assessment
      of cognitive disturbances in the healthy elderly and in early demented subjects.
      2. Interference with other dementia syndromes. 3. Lack of information in the
      population and among physicians about the different causes and courses of
      dementia syndromes. The first two aspects are discussed in this paper.

PMID- 1753253
TI  - Galanthamine treatment in Alzheimer's disease.
AB  - 18 patients who had fulfilled the NINCDS-ADRDA criteria for "possible AD" took
      part in a clinical study to evaluate the effect of the cholinesterase inhibitor
      Galanthamine, 30 mg/day. Neuropsychological und social parameters were rated.
      This open clinical pilot-study showed no statistic significant change in
      neuropsychological test-results. However after 1 year treatment 6 patients are
      still taking the drug. According to their care-persons there was a positive
      changes in competence of everyday-routine and/or in the emotional situation.

PMID- 1753255
TI  - Pattern electroretinogram and luminance electroretinogram in Alzheimer's disease.
AB  - Visual symptoms are often among the first complaints of patients suffering from
      Alzheimer's disease and several studies showed a delay in flash visual evoked
      potentials. Hinton et al. (1986) described optic nerve degenerations in patients
      with Alzheimer's disease and Sadun published a dropout of retinal ganglion cells
      that range from 30% to 60%. The reduction of neurotransmitters, especially of
      acetylcholine, found in the brain might also occur in the retina. Therefore we
      examined the retinal functions of patients suffering from Alzheimer's disease. In
      eight patients the pattern-electroretinograms and the scotopic and photopic
      luminance-electroretinograms were recorded and compared to an age-matched control
      group. We could not find any abnormalities in the pattern- and the luminance
      electroretinograms of patients with Alzheimer's disease. Although cholinergic
      cells have been found in the retina, our results did not reveal an involvement of
      retinal functions in Morbus Alzheimer.

PMID- 1753254
TI  - Physiology of short-term verbal memory.
AB  - These studies document a series of brain events accompanying short-term memory
      functions. For auditory verbal material the sequence involves at least two
      different sites within auditory cortex subserving sensory and cognitive processes
      of memorization. During the scanning of the short-term store structures within
      the medial temporal lobes, presumably the hippocampus, are active. There is an
      inconsistency between these results and the clinical observations of the need for
      an intact dominant parietal lobe for auditory short-term memory to function
      normally. Magnetic recordings showed no focal dipolar source of activity in the
      parietal lobe during any aspect of auditory short-term memory. The discrepancy
      could be accounted for by considering the parietal lobe lesion as "disconnecting"
      the lateral temporal cortex from the deep medial hippocampal structures thereby
      impeding auditory short-term functions (Geschwind, 1965). These studies show that
      the physiological analysis of brain events in the msec range can provide
      information about relatively complex cognitive processes underlying short-term
      memory. The magnetic and electrical recording methods provide a noninvasive way
      to study human brain functions involved in cognition that can then be correlated
      with behavioral measures of specific cognitive activities.

PMID- 1753256
TI  - Memory dysfunction in Parkinson patients: an analysis of verbal learning
      processes.
AB  - The German version of the California verbal learning test (Munchner Gedachtnis
      Test) was administered to compare memory functions of 45 Parkinson patients and
      32 healthy controls. Although the Parkinson patients were within their age norm
      in their performance on standard intelligence and memory tests, a significant
      pattern of impaired learning was observed with the MGT. While learning capacity
      showed a linear increase, it was altogether lower than that of healthy normals.
      Parkinson patients have difficulty organizing new material and applying useful
      strategies. When offered useful cues, they can apply these for a while, but soon
      loose these strategies again. They are more irritated by distractors than healthy
      people. Once material is learned and stored, it hampers the learning of new
      material. Also, new information disturbs the reproduction of formerly acquired
      information.

PMID- 1753257
TI  - Does the absence of clinical expression of choreoathetosis, despite severe
      striatal atrophy, correlate with plasticity of neuropeptide synthesis?
AB  - Neuropeptide and neurotransmitter plasticity has been demonstrated in the central
      nervous system. Modifications of their synthesis occur following receptor
      blockade or deafferentiation by surgical lesions. This concept should provid
      answers to some remaining open questions in human pathology especially in
      degenerative diseases of the basal ganglia. In a severely atrophied striatum we
      observed a selective increase in the number of detectable striatal substance P
      and met-enkephalin neurones which exhibited a striking increase in the intensity
      of labelling. This increase, instead of the well established reduction of
      substance P and enkephalins in the atrophied striatum of Huntington's disease,
      could explain the absence of choreoathetosis which was replaced by rigidity and
      bradykinesia in the patient. The absence of choreoathetosis, despite severe
      striatal atrophy, is described in several basal ganglia diseases and could also
      be related to neurotransmitter or neuropeptide plasticity rather than due to the
      primary lesion.

PMID- 1753258
TI  - Pharmacoepidemiology: a health imperative.

PMID- 1753259
TI  - The importance of models in the assessment of synergy.

PMID- 1753260
TI  - Prevalence of iron deficiency and iron overload in the adult Icelandic
      population.
AB  - The aim of this cross-sectional study was to estimate the prevalence of iron
      deficiency and overload in the adult population in Iceland, a developed
      Scandinavian country. The study population consisted of 4240 individuals aged 25
      74 years randomly selected from the national roster. Basic hematological, S-iron,
      S-total iron binding capacity (TIBC), and S-ferritin measurements were obtained
      on 2588 individuals (61.0%). The results indicated unusually large iron stores in
      the adult Icelandic population and significantly larger iron stores in the rural
      compared to the urban population. Iron deficiency was rare except in urban
      premenopausal women, where 1 in 4 showed evidence of iron deficiency and 3.2% had
      iron deficiency anemia. Seven patients with hereditary hemochromatosis were
      identified from a subgroup of 1887 subjects, resulting in a prevalence of 0.37%.
      Two of the hereditary hemochromatosis patients had been gastrectomized. Measures
      to improve the iron balance in urban premenopausal women cannot therefore include
      increased iron fortification of food but must be more directed towards the target
      group.

PMID- 1753261
TI  - Epidemiological use of drug prescriptions as markers of disease frequency: an
      Italian experience.
AB  - All Italian citizens are covered by the National Health Service (NHS) and medical
      records of individual drug prescriptions are routinely collected and processed. A
      procedure entitled EPIFAR has been developed which, on the basis of a computer
      routine, makes it possible to trace back the prescription history of each
      individual included in the NHS. The validity of information gathered through the
      EPIFAR procedure to provide estimates of tuberculosis (TB) prevalence has been
      evaluated. A comparison with routine surveillance data has been made. The EPIFAR
      procedure identified a total figure of TB patients seven times higher than that
      from official notifications. A sample survey was conducted among the prescribing
      physicians in order to quantify the proportion of TB cases among subjects
      receiving prescriptions of anti-TB drugs. According to general practitioner
      recall 66.4% of the patients were treated because of TB diagnosis, TB prophylaxis
      and TB relapse.

PMID- 1753262
TI  - The Toronto Breast Self-Examination Instrument (TBSEI): its development and
      reliability and validity data.
AB  - The Toronto Breast Self-Examination Instrument (TBSEI) was developed out of the
      need for a self-administered survey that is reliable and valid. This article
      describes the development of the TBSEI, its dimensions, and reliability and
      validity data to support its continued use. To analyze the reliability and
      validity properties of the three TBSEI scales, we surveyed 729 Toronto, Ontario
      women. The TBSEI was found to have good face and content validity, internal
      consistency reliability (0.91, 0.69, 0.85), and test-retest reliability (0.89).
      Age norms for each of the three scales are also provided. These results are
      consistent with previous research findings in breast cancer and breast self
      examination research.

PMID- 1753263
TI  - Reliability and physiologic correlates of the Harvard Alumni Activity Survey in a
      general population.
AB  - The reliability of the Harvard Alumni Activity Survey (HAAS) and its association
      with physiologic measures was assessed in a large sample of men and women aged 25
      65 years residing in the Boston metropolitan area in 1987. Reliability was
      estimated by comparing HAAS energy expenditure reports (kcal/week) from two
      separate interviews conducted 7-12 weeks apart. The test-retest reliability
      coefficient was 0.58 for the entire sample, but was considerably higher (r =
      0.69) for those whose activity patterns had not changed from one interview to the
      next. HAAS self-reports were compared to two physiologic measures known to be
      affected by physical activity: high density lipoprotein cholesterol (HDLC) and
      body mass index (BMI). The natural logarithm of weekly HAAS expenditures was
      positively correlated with HDLC (r = 0.14, p less than 0.01) and negatively
      correlated with BMI (r = 0.13, p less than 0.01) for all respondents. These
      statistically significant associations persisted when adjusted for other
      covariates influencing physiologic status. The reliability coefficients and
      physiologic correlations for the HAAS in this sample are comparable to those
      reported for physical activity instruments requiring more intensive data
      collection and scoring procedures.

PMID- 1753264
TI  - The cure model and time confounded risk in the analysis of survival and other
      timed events.
AB  - The use of the Kaplan-Meier estimator for the analysis and testing of cure model
      data is discussed and results are compared with the more commonly used logrank
      test. The Kaplan-Meier estimator is particularly appropriate for describing the
      shape of the underlying survival distribution of data from bone marrow
      transplantation but is also relevant for different types of timed events data
      from other chronic diseases. The estimate of the event-free fraction by the
      product limit, may have a bias depending on the extent of follow-up, the
      parameters of the model, and confounding by competing risk events. The test based
      on the product limit has appropriate size and is more powerful as long as follow
      up is sufficient to minimize the bias. On the other hand, the logrank test, which
      is optimal for testing differences in time-to-event curves under proportional
      hazard assumptions, may be inappropriate and misleading for evaluating the
      difference in event-free fractions under the cure model.

PMID- 1753265
TI  - 27-year mortality in the Western Collaborative Group Study: construction of risk
      groups by recursive partitioning.
AB  - The relationship of selected biological and behavioral characteristics measured
      at baseline examination to 27-year mortality due to coronary heart disease (CHD),
      cancers of all sites, and total mortality in the 3154 men that form the Western
      Collaborative Group Study was investigated using tree-structured survival
      analysis or recursive partitioning (RP). Intake (1960-61) characteristics
      included in the present analyses were age, serum cholesterol, systolic blood
      pressure (SBP), cigarette smoking, body mass index (BMI), Type A/B behavior, and
      behavioral hostility. Tree-structured survival analysis for CHD mortality
      partitioned the cohort into six groups and identified five groups with distinct
      survival experience. Exceptionally high CHD mortality rates (17.3 and 14.6 per
      thousand) were experienced by 89 older men with elevated hostility ratings and
      SBP less than or equal to 150, and 238 men whose initial SBP was greater than 150
      mmHg. Younger men (age less than or equal to 48) with SBP less than or equal to
      150 and with serum cholesterol levels greater than 227 had a death rate of 4.8
      per thousand, compared with a rate of 1.7 in similar men with lower cholesterol
      levels. Applied to 27-year cancer mortality, the RP algorithm partitioned the
      cohort into four distinct survival groups. Younger (age less than 45) Type B men
      had superior survival compared with Type A men of similar ages, and the
      proportion of ever cigarette smokers in these two groups was not statistically
      different. The results obtained by tree-structured survival analyses were
      compared with results obtained by Cox regression survival analyses.

PMID- 1753266
TI  - A longitudinal evaluation of drug use in an ambulatory elderly population.
AB  - Participants in a geriatric health screening program were studied longitudinally
      to determine the patterns of drug use over a 10 year period. There were 314
      (34.0%) men and 610 (66.0%) women who completed 10 yearly health screening
      evaluations. The mean number of prescribed and non-prescribed drugs used per
      participant increased from 2.90 in 1978-79 to 4.08 in 1987-88 (p less than
      0.0001). There was no significant difference between men and women in the rate of
      increased drug use. There was no significant increase in the mean number of drug
      ingredients per participant used over the 10 year period. The most frequently
      reported therapeutic categories for 1978-79 were antihypertensives, analgesic
      antipyretics, antirheumatics, multiple vitamins, cathartics and vitamin E, which
      represented 10.2, 7.2, 6.5, 4.9, 4.8 and 3.8% of all categories used. There was a
      decline in all of these categories between interval 1 and 10. Increased use of
      drugs, particularly prescribed medications, by the elderly population may present
      problems of adverse drug reactions, drug interactions and medication compliance
      in the future. Changing patterns of drug use may have resulted, in part, from
      introduction of new therapeutic classes and from new treatment concepts over the
      10 year study period.

PMID- 1753267
TI  - Appropriate reductions in compliance among well-controlled hypertensive patients.
AB  - Physicians have traditionally viewed partial compliance with medications as a
      concern only in hypertensive patients whose blood pressure (BP) is poorly
      controlled. However, partial compliance also occurs in patients whose BP has
      become normal on medications; in them, reduced compliance may indicate that they
      have been prescribed more medication than they need. During enrollment for a
      study of medication reduction in hypertensive patients, we identified 118 male
      veterans who were eligible for the study because their diastolic BP had been less
      than 95 mmHg for more than 6 months. Fifty-nine of these patients (50.0%) agreed
      to participate in the study, of whom 71% successfully reduced or stopped
      ("stepped down") one or more of their antihypertensive drugs over a 1-year
      period. The 59 patients who did not enroll continued to receive routine care for
      hypertension in the clinic without intensive efforts at stepdown. Nevertheless,
      24% of these patients reduced or stopped at least one medication over the same
      time period. In the year prior to the study, 29 of the 118 eligible patients
      (24.6%) had obtained less than 80% of their medications, measured by pharmacy
      refill records. Compliance in obtaining antihypertensive medications prior to the
      study was lower among eligible patients who stepped down medications during the
      study year (90.4% +/- 18.7%) than in those who did not (102.1% +/- 26.1%, p =
      0.006). After adjustment for other predictors of stepdown (number of medications,
      duration of clinic enrollment, and pre-reduction systolic BP), each 10% increase
      in compliance among all eligible patients was associated with a reduction in the
      odds ratio for successful stepdown of 0.8 (95% CI 0.5-1.0, p = 0.01). We conclude
      that many well-controlled hypertensives appropriately obtain less medications
      than they are prescribed. Such patients should be considered for reduction of
      antihypertensive drugs.

PMID- 1753268
TI  - Statistical significance and fragility criteria for assessing a difference of two
      proportions.
AB  - This paper compares the traditional methods of statistical inference on the data
      from biomedical studies with a proposed index of fragility in the results. In
      general, for any given study there are 8 possible combinations of conclusions
      regarding statistical significance, quantitative significance and fragility. The
      8 possibilities are considered in turn with respect to how studies in each group
      might be interpreted. Numerical examples show that not all 8 possibilities need
      be attainable with a given study design, and that the relative likelihood of them
      occurring can vary widely. It is concluded that the fragility index may be a
      useful adjunct to conventional statistical inference, with certain intuitive
      appeal, but that more empirical experience is needed with the fragility method.

PMID- 1753269
TI  - Mass screening for rectal neoplasm in Jiashan County, China.
AB  - Jiashan county is a rural area in China with very high incidence and mortality
      rates of colorectal cancer. From 1980 to 1984, we conducted a mass screening for
      rectal neoplasm in the 11 people's communes in this county. Of the 72,879
      individuals who were eligible for screening, 60,496 participated, representing an
      overall participation rate of 83.0%. Both the fecal occult blood (OB) test and
      rectoscopy were performed on 47,560 of the participants, and rectoscopy only was
      performed on the remaining 12,936 individuals. From the mass screening, 15 rectal
      cancers, 3 carcinoids, 899 polyps, 98 ulcers, and 7 inflammatory tumors were
      detected, a total of 1022 cases. Eight of the 15 detected cases of rectal cancer
      were in Dukes' stage A. We did not find any evidence for an association between
      schistosomiasis and colorectal cancer. Results from the OB test were found to
      have a negative correlation with results from rectoscopy (odds ratio = 0.8, 95%
      CI = 0.6, 1.1). The OB test had a high false positive rate of 32.7%, and a poor
      positive predictive value of 3.5%. Both its positive and negative predictive
      powers were below 1.0, in other words, its positive likelihood ratio was below
      1.0 and negative likelihood ratio was above 1.0, indicating that the OB test is
      not informative and has a poor predictive accuracy for rectal neoplasm. In
      addition, there were a number of practical problems concerning the use of the OB
      test for mass screening in the rural community.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753270
TI  - Laboratory data predicts survival post hospitalization.
AB  - From a database of 93,077 in-patient admissions, patients assigned to
      catastrophic, very severe, moderately severe, and average 30-day mortality risk
      categories (as defined in Medicare Hospital Mortality Information, 1989 release,
      from the Health Care Financing Administration (HCFA] were selected for study.
      These admissions account for 30% of all admissions, but 70% of all deaths up to 1
      year post admission. To determine whether laboratory information adds to the
      predictive power of the information used by HCFA, we compare the performance of 1
      year survival predictors (Cox model) that use only diagnostic, demographic, and
      comorbidity information, with the performance of predictors that also include
      laboratory information. Using a separate set of patients not used for model
      definition, we find that laboratory data contain significant prognostic
      information independent of that already available in non-laboratory data. In
      HCFA's catastrophic disorders for example, non-laboratory information reduces the
      average risk of predicting a wrong outcome by 17% relative to considering only
      catastrophic group membership, and adding laboratory data reduces this risk by a
      further 21%. These improvements result primarily from considering the outcomes of
      a small set of routine laboratory tests (maximum BUN, AST, and WBC, and minimum
      CO2, hematocrit, and sodium).

PMID- 1753271
TI  - Smoking characteristics and inhalation biochemistry in the Scottish population.
AB  - Data from a cross-sectional random population sample of 10,359 middle-aged
      Scottish men and women are used to investigate the relationships between self
      reported tobacco consumption and three biochemical markers of tobacco inhalation:
      expired air carbon monoxide (CO), serum thiocyanate and serum cotinine. These
      data represent one of the largest samples of these biochemical markers yet
      analysed. The results show that, for each sex, the biochemical markers are highly
      correlated for smokers and for the entire sample of mixed smokers and non
      smokers. CO is the preferred biochemical marker, in such groups, because it is
      the cheapest, is non-invasive and gives virtually instantaneous results. Self
      reported daily cigarette consumption also correlates well with each of these
      biochemical markers, and so it appears that people are, in the context of
      population studies, mainly truthful about their smoking. The relationships with
      self-reported cigarette consumption are curvilinear with apparent levelling out
      of the gradient at around 25 cigarettes/day for cotinine and thiocyanate and at
      greater than 40 cigarettes/day for CO. Sex differences are small, although
      thiocyanate is generally higher and cotinine generally lower in women with the
      same self-reported cigarette consumption as men. Amongst non-smokers, only
      cotinine is able to discriminate between self-reported levels of exposure to
      passive smoking. CO and thiocyanate are not suitable for measuring low levels of
      smoke inhalation, such as found in passive smokers.

PMID- 1753272
TI  - The drinking, passive smoking, smoking deception and serum cotinine in the
      Scottish Heart Health Study.
AB  - Following a recent claim that the use of cotinine in body fluids, to assess
      passive smoking and smoking "deception", was confounded by metabolic
      individuality, and by non-tobacco sources of dietary nicotine, particularly tea,
      data were examined from a large cross-sectional survey in a tea-drinking
      population. In 3383 men and women aged 40-59 years from the Scottish Heart Health
      Study, defined as non-smokers, both by self-report and by low thiocyanate and
      expired air carbon monoxide levels, serum cotinine showed minimal association
      with self-reported daily average tea consumption. However, there was a strong
      correlation between degree of self-reported passive tobacco smoke exposure and
      median serum cotinine level. In the same survey, serum cotinine in 4144 self
      reported non-smokers and in 3326 smokers showed entirely different distributions,
      but the same range, suggesting heavy nicotine intake in some "non-smokers". These
      analyses confirm that cotinine levels in true non-smokers reflect far more the
      nicotine in inhaled ambient tobacco smoke than they do nicotine in tea. Some
      smoking "deceivers" have the same degree of exposure to nicotine as heavy
      smokers. Despite individual variability, the claim of confounding is poorly
      supported, and cotinine is confirmed as an indicator both of passive smoking and
      of smoking deception.

PMID- 1753273
TI  - Changes in tonic descending inhibition of spinal neurons with articular input
      during the development of acute arthritis in the cat.
AB  - 1. In 15 alpha-chloralose-anesthetized cats we studied the presence of tonic
      descending inhibition (TDI) of spinal neurons with input from the knee and its
      modulation during an acute inflammation of this joint. TDI of spinal neurons with
      articular input was assessed by applying reversible cold blocks to the lower
      thoracic cord. The amount of descending inhibition was estimated from the
      induction and/or increase of resting discharges and of the responses to
      mechanical stimuli to the knee and other structures during the transitory and
      reversible blocks. In each experiment one or a few neurons were investigated
      while the joint was in normal condition [altogether 15 nociceptive-specific (NS)
      and 6 wide-dynamic-range (WDR) neurons]. One of the neurons was then selected for
      long-term recordings during which an acute inflammation in the knee was induced
      by the intra-articular injection of kaolin and carrageenan. Before and during
      developing arthritis, cold blocks were applied to examine whether the amount of
      TDI would change during the inflammatory process. 2. The neurons with input from
      the normal knee were under TDI because application of the cold block induced or
      increased resting discharges and the responses to noxious compression of the knee
      and the adjacent thigh and lower leg. In 10 of 15 NS neurons, the response
      threshold was lowered into the innocuous range. In 9 of 17 cells tested, the
      excitatory receptive field expanded to the ipsilateral paw, and 4 neurons became
      inhibited by paw compression. Seven of 18 neurons tested revealed inhibitory
      receptive fields on the contralateral leg during cold block. The neurons were
      located in laminae IV-VII. 3. Fourteen neurons were continuously monitored during
      development of inflammation, and changes in the effectiveness of TDI were
      assessed by blocking the cord before and during the development of arthritis. In
      most neurons baseline resting activity in the intact state of the cord increased
      while the arthritis developed. This inflammation-evoked enhancement of resting
      discharges was more pronounced during periods of spinalization. Consequently, the
      differences between the resting discharges in the cold-blocked and the intact
      state were progressively enhanced in arthritis. 4. After induction of arthritis,
      the responses to compression of the knee joint increased in the intact state as
      well as during cold blocks. In 11 of 14 neurons, the differences between the
      responses in the spinal and intact state were progressively enlarged during the
      development of inflammation. A similar result was obtained for flexion of the
      injected knee.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1753274
TI  - Electrophysiological study of spinothalamic inputs to ventrolateral and adjacent
      thalamic nuclei of the cat.
AB  - 1. Extracellular and intracellular methods were used to record from fibers and
      neurons in the ventral lateral (VL) and adjacent nuclei of the cat thalamus. The
      receptive fields of the recorded units were analyzed and the units tested for
      inputs from the medial lemniscus (ML) and spinothalamic tract (STT) by electrical
      stimulation of the dorsal columns (DC) and ventrolateral funiculus (VLF) at the
      C2-3 spinal level. 2. Thirty-eight STT fibers were isolated in the thalamus.
      Their conduction velocities ranged from 15 to 75 m/s (mode 36 m/s). Adequate
      stimuli were found for 23 of these fibers. Seventeen were low-threshold (LT), 3
      were wide-dynamic-range (WDR), and 3 were high-threshold (HT) units. 3. Five STT
      fibers were intra-axonally injected. Three were sufficiently well filled for
      analysis of their terminal fields. An intermediate-velocity STT fiber (conduction
      velocity 38 m/s) had a 4.3-microns axon and a single large terminal field in the
      central lateral nucleus (CL). The other two STT fibers were smaller, with
      diameters of 2.5 and 2.3 microns, conduction velocities of 15 and 19 m/s, and
      terminal fields made up of a few small boutons at the borders of the ventral
      posterior lateral nucleus (VPL). 4. Of 319 neurons isolated, 14 out of 129
      (10.8%) in VL, 14 out of 76 (18.4%) in the VPL or ventral posterior medial (VPM)
      nucleus, 27 out of 64 (42.2%) in the CL nucleus, and 5 out of 50 (10%) in the
      reticular nucleus (R) responded at latencies less than 50 ms to VLF stimuli. A
      train of three pulses was more effective in driving VLF-responding neurons in all
      these nuclei than a single pulse. VLF-responding cells were widely dispersed in
      VL, concentrated in a focus in CL, and distributed around the borders of VPL.
      Most of those in VL and a small number in CL could be antidromically activated by
      stimulation of motor cortex. 5. Latencies of presynaptic responses (STT fibers)
      to VLF stimulation were short and varied from 0.8 to 3.9 ms (mode 1.6 ms).
      Despite this, very few fast-responding neurons were found. These were six VPL
      neurons (2.5 to 4 ms), one VL neuron (3 ms), and four CL neurons (3-4 ms). The
      initial spike latencies of the majority of thalamic neurons responding to VLF
      stimulation appeared in two peaks, one between 6 and 8 ms and the other at 10-15
      ms.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1753275
TI  - Reorganization of somatosensory area 3b representations in adult owl monkeys
      after digital syndactyly.
AB  - 1. These experiments were designed to test the hypothesis that temporally
      correlated afferent input activity plays a lifelong role in the establishment and
      modification of receptive fields (RFs) and representational topographies in the
      primary somatosensory cortex of adult monkeys. They were based in part on the
      finding that adjacent digits of the hand are represented discontinuously in area
      3b of the adult owl monkey. If cortical receptive fields and the details of
      cortical topographic representations are shaped by the weights of the temporal
      correlations among afferent inputs, then representational discontinuities between
      digits would be expected to arise because inputs from the skin surfaces of
      adjacent digits are largely independent in the critical time domain. 2. In the
      present experiments, the skin of adjacent digits 3 and 4 of the monkey hand was
      surgically connected to create an artificial syndactyly, or webbed-finger
      condition. Highly detailed microelectrode maps of the cortical representation of
      the syndactyl digits were obtained 3-7.5 mo later. This experimental manipulation
      greatly increased the amount of simultaneous or nearly simultaneous input from
      the normally separated, now fused, surfaces of adjacent fingers. 3. Cortical maps
      of the representations of finger surfaces were highly modified from the normal
      after a several-month-long period of digital fusion. Specifically, the normal
      discontinuity between the cortical representations of adjacent fingers was
      abolished. Within a wide cortical zone, RFs were defined that extended across the
      line of syndactyly onto the surgically joined skin of both fused digits. The
      representational topography of the fused digits was similar to any normal single
      digit and was characterized by a continuous progression of partially overlapping
      RFs. 4. Control observations revealed that these reorganizational changes cannot
      be accounted for by any changes in cutaneous innervation induced by the surgery.
      They must arise from representational changes in the central somatosensory
      system. 5. These findings reveal that cortical maps can be altered in detail in
      adult monkeys by modifying the distributed temporal structure of afferent inputs.
      They support the longstanding hypothesis that the temporal coincidence of inputs
      plays a role in the grouping of input subsets into specific cortical RFs and,
      consequently, in the shaping of selected effective cortical inputs and
      representational topographies throughout life.

PMID- 1753276
TI  - Saccade-related activity in the lateral intraparietal area. I. Temporal
      properties; comparison with area 7a.
AB  - 1. The cortex of the inferior parietal lobule (IPL) contains neurons whose
      activity is related to saccadic eye movements. The exact role of the IPL in
      relation to saccades remains, however, unclear. In this and the companion paper,
      we approach this problem by quantifying many of the spatial and temporal
      parameters of the saccade-related (S) activity. These parameters have hitherto
      been largely unstudied. 2. The activity of single neurons was recorded from
      Macaca mulatta monkeys while they were performing a delayed-saccade task. The
      analysis presented here is based on 161 neurons recorded from the lateral
      intraparietal area (LIP), a recently defined subdivision of the IPL; and 54
      neurons recorded from the neighboring part of the IPL, area 7a. Overall, 409 IPL
      neurons were isolated in this study. 3. The typical activity of IPL neurons
      during the delayed-saccade task has three basic phases: light sensitive (LS),
      memory (M), and S. These basic phases are common to neurons of both areas LIP and
      7a. In each phase (LS, M, and S), individual neurons may or may not be active.
      Most LIP neurons, however, are active in more than one phase. 4. To compare the
      activity levels of different neurons, the actual firing rate was weighted by each
      neuron's background level, yielding an "activity index" for each neuron, in each
      phase of the task. We calculated the activity index for the LS and M phases and
      for three phases related to the saccade: a presaccadic (Pre-S), a saccade
      coincident (S-Co), and a postsaccadic (Post-S) phase. For area LIP neurons the
      median values of the activity index were high for the LS, M, Pre-S, and S-Co
      activities, and slightly lower in the Post-S period. In area 7a the median values
      were low for the LS phase and, in particular, for the M and Pre-S phases,
      somewhat higher coincident with the saccade, and high post-saccadically. 5. In
      area LIP, in each phase, 49-63% of the neurons had excitatory activity, and 10
      17% had inhibitory responses. 6. In contrast, in area 7a excitatory responses
      were most frequent in the Post-S phase (56%). Excitation was particularly
      infrequent during M (28%) and Pre-S (22%). The incidence of inhibitory responses
      varied too (4-18%). The time course of inhibition was roughly opposite that of
      excitation; the highest frequency of inhibitory responses occurred during the
      saccade.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1753277
TI  - Saccade-related activity in the lateral intraparietal area. II. Spatial
      properties.
AB  - 1. Single-neuron activity was recorded from the inferior parietal lobule (IPL) of
      Macaca mulatta monkeys while they were performing delayed saccades and related
      tasks. Temporal characteristics of this activity were presented in the companion
      paper. Here we focus on the spatial characteristics of the activity. The analysis
      was based on recordings from 145 neurons. All these neurons were from the lateral
      intraparietal area (LIP), a recently defined subdivision of the IPL. 2. Delayed
      saccades were made in eight directions. Direction-tuning curves were calculated
      for each neuron, during each of the following activity phases that were described
      in the companion paper: light sensitive (LS), delay-period memory (M), and
      saccade related (S); the latter further partitioned into presaccadic (Pre-S),
      saccade coincident (S-Co), and postsaccadic (Post-S). 3. Width and preferred
      direction were calculated for each direction-tuning curve. We studied the
      distributions of widths and preferred directions in LIP's neuronal population. In
      each case we included only neurons that showed clear excitatory activity in the
      phases in question. 4. Width was defined as the angle over which the response was
      higher than 50% of its maximal net value. Width distributions were similar for
      all phases studied. Widths varied widely from neuron to neuron, from very narrow
      (less than 45 degrees) to very wide (close to 360 degrees). Median widths were
      approximately 90 degrees in all phases. 5. Preferred-direction distributions were
      also similar for various phases. All directions were represented in each
      distribution, but contralateral directions were more frequent (e.g., 69% for S
      Co). 6. For each neuron the alignment of the preferred directions of its various
      phases was determined. Distributions of alignments were calculated (again, phases
      that were not clearly excitatory were disregarded). On the level of the neuronal
      population LS, M, and Pre-S were well aligned with each other. S-Co was also
      aligned with these phases, but less precisely. 7. A set of "narrowly tuned"
      neurons was selected by imposing a constraint of narrow (width, less than 90
      degrees) LS and S-Co direction tuning. In this set of neurons, the LS and S-Co
      preferred directions were very well aligned (median, 12 degrees). The fraction of
      narrowly tuned neurons in the population was 40% (25/63). Thus, in a large
      subpopulation of area LIP, a fairly precise alignment exists between sensory and
      motor fields. 8. An additional set of 82 area LIP neurons were recorded while the
      monkey performed delayed saccades to 32 targets located on small, medium, and
      large imaginary circles.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1753278
TI  - Recovery of function after lesions in the superior temporal sulcus in the monkey.
AB  - 1. Ibotenic acid lesions in the monkey's middle temporal area (MT) and the medial
      superior temporal area (MST) in the superior temporal sulcus (STS) have
      previously been shown to produce a deficit in initiation of smooth-pursuit eye
      movements to moving visual targets. The deficits, however, recovery within a few
      days. In the present experiments we investigated the factors that influence that
      recovery. 2. We tested two aspects of the monkey's ability to use motion
      information to acquire moving targets. We used eye-position error as a measure of
      the monkey's ability to make accurate initial saccades to the moving target. We
      measured eye speed within the first 100 ms after the saccade to evaluate the
      monkey's initial smooth pursuit. 3. We determined that pursuit recovery was not
      dependent specifically on the use of neurotoxic lesions. Although the rate of
      recovery was slightly altered by replacing the usual neurotoxin (ibotenic acid)
      with another neurotoxin [alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid
      (AMPA)] or with an electrolytic lesion, pursuit recovery still occurred within a
      period of days to weeks. 4. There was a relationship between the size and
      location of the lesion and the recovery time. The time to recovery for eye
      position error and initial eye speed increased with the fraction of MT removed.
      Whether the rate of recovery and size of lesions within regions on the anterior
      bank were related was unresolved. 5. We found that a large AMPA lesion within the
      STS that removed all of MT and nearly all of MST drastically altered the rate of
      recovery. Recovery was incomplete more than 7 mo after the lesion. Even with this
      lesion, however, the monkey's ability to use motion information for pursuit was
      not completely eliminated. 6. The large lesion also included parts of areas V1,
      V2, V3, and V4, but analysis of the visual fields associated with this lesion
      indicated that these areas probably did not have a substantial effect on
      recovery. 7. We tested whether visual motion experience of the monkey after a
      lesion was necessary for recovery by limiting the monkey's experience either by
      using a mask or by using 4-Hz stroboscopic illumination. In one monkey the eye
      position error component of pursuit was prolonged to greater than 2 wk, but
      recovery of eye speed was not. Reduced motion experience had little effect on
      recovery in the other two monkeys. These results suggest that such visual motion
      experience is not necessary for the recovery of pursuit.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1753279
TI  - Fast rhythms in phrenic motoneuron and nerve discharges.
AB  - 1. Fast rhythms in discharges of individual phrenic (PHR) motoneurons were
      studied by spectral and interval analyses; and they were compared, using
      coherence analysis, with similar rhythms in whole-PHR nerve discharge. The
      purpose of this study was to ascertain the origin of the two rhythms, manifested
      as distinct spectral peaks, in PHR motoneuron and nerve discharge: medium
      frequency oscillations (MFO, usual range 20-50 Hz); and high-frequency
      oscillations (HFO, usual range 50-100 Hz). 2. In paralyzed artificially
      ventilated cats, unit recordings were taken from 1) 26 isolated single PHR fibers
      (in 8 sodium pentobarbital-anesthetized cats) and 2) 27 identified PHR motoneuron
      somata in the spinal cord (in 5 decerebrate cats). Simultaneous whole-PHR
      activity was monophasically recorded from the contralateral PHR nerve for 1 and
      from both PHR nerves for 2. 3. The signals were subjected to time- and frequency
      domain analyses. The latter included a novel application of coherence analysis to
      the study of population synchrony. 4. The autospectra of all PHR units showed
      prominent MFO peaks in the frequency range of the nerve MFO spectral peaks, as
      well as harmonic peaks, indicating the presence of this type of fast rhythm in
      the units' discharges. Spectral analysis of the augmenting PHR activities in
      different segments of the inspiratory (I) phase showed that the frequency of unit
      MFO and of nerve MFO rose during the course of I. Further, cycle-triggered
      histogram and interval analysis indicated that the frequencies of unit MFO
      autospectral peaks were very close to the peak firing rates of the units during
      the portion of I analyzed. Thus unit MFO spectral peaks reflected the rhythmic
      and augmenting discharges of the motoneurons, and similar nerve MFO peaks
      reflected the superposition of individual motoneuron discharges. 5. The
      coherences of motoneurons' MFOs to nerve MFOs were low or zero, indicating that
      only partial and weak MFO correlations occurred within the PHR motoneuron
      population. 6. In those cats (n = 11) that had clear PHR nerve HFO spectral
      peaks, about one-half of the recorded PHR motoneurons had HFO, as indicated by
      HFO peaks in the unit autospectra and/or the unit-nerve coherences. 7. For
      motoneurons having HFO, the coherence between unit and nerve HFOs was
      substantial, particularly when the latter were strong, indicating HFO
      correlations among a number of PHR motoneurons. 8. In the light of theoretical
      considerations on the generation of aggregate rhythms from superposition of
      unitary rhythms, these observations indicate the following.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1753280
TI  - Synaptic potentials evoked by convergent somatosensory and corticocortical inputs
      in raccoon somatosensory cortex: substrates for plasticity.
AB  - 1. "Unmasking" of weak synaptic connections has been suggested as a mechanism for
      the early changes in cortical topographic maps that follow alterations of sensory
      activity. For such a mechanism to operate, convergent sensory inputs must already
      exist in the normal cortex. 2. We tested for topographic and cross-modality
      convergence in primary somatosensory cortex of raccoon. The representation of
      glabrous skin of forepaw digits was chosen because, even though it is dominated
      by inputs from the glabrous skin of a single digit, it nevertheless comes to
      respond to stimulation of other digits when, e.g., a digit is removed. 3.
      Intracellular recordings were made from 109 neurons in the representation of
      glabrous skin of digit 4. Neurons were tested for somatosensory inputs with
      electrical and natural stimulation of digits. 4. Excitatory postsynaptic
      potentials (EPSPs) were evoked in 100% of the neurons (109/109) by electrical
      stimulation of glabrous skin of digit 4, and in 79% (31 of 39) by vibrotactile
      stimulation. 5. Glabrous skin of digit 4 was not the sole source of somatosensory
      inputs. A minority of neurons generated EPSPs after electrical stimulation of
      hairy skin of digit 4 (10 of 98 neurons, 10%). Electrical stimulation of digits 3
      or 5 evoked EPSPs in 22 of 103 neurons (21%). Natural stimulation (vibrotactile
      or hair bending) was also effective in most of these latter cases (digit 3, 6/7;
      digit 5, 9/10). 6. Intracortical microstimulation of the "heterogeneous zone" was
      used to test for corticocortical connections to neurons in the glabrous
      zone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753281
TI  - Influence of map scale on primary afferent terminal field geometry in cat dorsal
      horn.
AB  - 1. Thirty-one physiologically identified primary afferent fibers were labeled
      intracellularly with horseradish peroxidase (HRP). 2. A computer analysis was
      used to determine whether the distribution of cutaneous mechanoreceptive afferent
      terminals varies as a function of location within the dorsal horn somatotopic
      map. 3. An analysis of the geometry of the projections of these afferents has
      shown that 1) terminal arbors have a greater mediolateral width within the region
      of the foot representation than lateral to it, 2) terminal arbors have larger
      length-to-width ratios outside the foot representation than within it, and 3) the
      orientation of terminal arbors near the boundary of the foot representation
      reflects the angle of the boundary. Previous attribution of mediolateral width
      variations to primary afferent type are probably in error, although there appear
      to be genuine variations of longitudinal extent as a function of primary afferent
      type. 4. Nonuniform terminal distributions represent the first of a three
      component process underlying assembly of the monosynaptic portions of cell
      receptive fields (RFs) and the somatotopic map. The other two components consist
      of the elaboration of cell dendritic trees and the establishment of selective
      connections. 5. The variation of primary afferent terminal distributions with map
      location is not an absolute requirement for development of the map; for example,
      the RFs of postsynaptic cells could be assembled with the use of a uniform
      terminal distribution for all afferents, everywhere in the map, as long as cell
      dendrites penetrate the appropriate portions of the presynaptic neuropil and
      receive connections only from afferent axons contributing to their RFs.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1753282
TI  - Neuronal activity in the primate premotor, supplementary, and precentral motor
      cortex during visually guided and internally determined sequential movements.
AB  - 1. Single-cell activity was recorded from three different motor areas in the
      cerebral cortex: the primary motor cortex (MI), supplementary motor area (SMA),
      and premotor cortex (PM). 2. Three monkeys (Macaca fuscata) were trained to
      perform a sequential motor task in two different conditions. In one condition
      (visually triggered task, VT), they reached to and touched three pads placed in a
      front panel by following lights illuminated individually from behind the pads. In
      the other condition (internally guided task, IT), they had to remember a
      predetermined sequence and press the three pads without visual guidance. In a
      transitional phase between the two conditions, the animals learned to memorize
      the correct sequence. Auditory instruction signals (tones of different
      frequencies) told the animal which mode it was in. After the instruction signals,
      the animals waited for a visual signal that triggered the first movement. 3.
      Neuronal activity was analyzed during three defined periods: delay period,
      premovement period, and movement period. Statistical comparisons were made to
      detect differences between the two behavioral modes with respect to the activity
      in each period. 4. Most, if not all, of MI neurons exhibited similar activity
      during the delay, premovement, and movement periods, regardless of whether the
      sequential motor task was visually guided or internally determined. 5. More than
      one-half of the SMA neurons were preferentially or exclusively active in relation
      to IT during both the premovement (55%) and movement (65%) periods. In contrast,
      PM neurons were more active (55% and 64% during the premovement and movement
      periods) in VT. 6. During the instructed-delay period, a majority of SMA neurons
      exhibited preferential or exclusive relation to IT whereas the activity in PM
      neurons was observed equally in different modes. 7. Two types of neurons
      exhibiting properties of special interest were observed. Sequence-specific
      neurons (active in a particular sequence only) were more common in SMA, whereas
      transition-specific neurons (active only at the transitional phase) were more
      common in PM. 8. Although a strict functional dichotomy is not acceptable, these
      observations support a hypothesis that the SMA is more related to IT, whereas PM
      is more involved in VT. 9. Some indications pointing to a functional subdivision
      of PM are obtained.

PMID- 1753283
TI  - Delayed activation of nociceptors: correlation with delayed pain sensations
      induced by sustained stimuli.
AB  - 1. In this study we used psychophysical experiments in humans and behavioral and
      electrophysiological studies in rats to evaluate nociceptive and C-fiber
      mechanoheat nociceptor (C-MH) responses to sustained mechanical stimuli that are
      initially nonpainful or nonnoxious. 2. In normal rat skin, sustained subthreshold
      mechanical stimuli activate C-MHs (n = 36) with a delayed onset that parallels
      the delayed pain sensation recorded in human psychophysical tests. 3. The
      subthreshold stimuli did not induce a decrease in mechanical threshold (n = 11),
      and the effect of the subthreshold stimulus on latency to firing of C-MHs (n = 6)
      persists for a very short time after the stimulus is removed (less than 10 s). 4.
      Intradermal injection of prostaglandin E2 (PGE2; 100 ng), which induced a
      significant decrease in the mechanical threshold of C-MHs (n = 7), had no effect
      on the latency of the delayed activation of C-MHs. Also, indomethacin, which
      inhibits the synthesis of prostaglandins, had no effect on the latency of the
      delayed paw-withdrawal response in the behavioral test. 5. Intradermal injection
      of the calcium ionophore A23187 significantly reduced the latency of the delayed
      activation of C-MHs (n = 6) the calcium chelator Quin 2 (n = 6) significantly
      increased the latency. A23187 and Quin 2 had similar effects on the latencies to
      paw withdrawal in behavioral tests. The sensitization of C-MHs (n = 9) by PGE2
      was not, however, affected by Quin 2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753284
TI  - Somatotopic mapping of the primary motor cortex in humans: activation studies
      with cerebral blood flow and positron emission tomography.
AB  - 1. The somatotopic representation of the human primary motor cortex was examined
      noninvasively with estimates of cerebral blood flow (CBF) obtained with positron
      emission tomography. Twelve normal subjects performed a motor tracking task with
      the arm, first finger, tongue, and great toe commensurate with the bolus
      injection of radioactive H215O. Images of the relative percent increase of blood
      flow, compared with control studies, demonstrated reproducible foci of CBF
      increases in the motor cortex in every subject. Each motor task could be
      localized to a predictable site on a coronal section containing the precentral
      gyrus. 2. In reproducibility experiments of repeated measures, it was determined
      that two foci of activation in the primary motor cortex could be discriminated
      with a 95% confidence if they were separated by 5.4 mm. 3. In five subjects with
      matched magnetic resonance imaging studies, the sites of activation were variable
      with respect to surface anatomy and could be found at the depth of sulci or the
      surface of gyri. The findings were similar to previously reported
      electrophysiological studies using direct cortical stimulation. 4. The method may
      be applied to the in vivo functional mapping of the primary motor cortex in
      patients with cerebral disorders.

PMID- 1753285
TI  - Electrophysiological properties of neurons within the nucleus ambiguus of adult
      guinea pigs.
AB  - 1. The purpose of this study was to determine the electrophysiological properties
      of neurons within the region of the nucleus ambiguus (NA), an area that contains
      the ventral respiratory group. By the use of an in vitro brain stem slice
      preparation, intracellular recordings from neurons in this region (to be referred
      to as NA neurons, n = 235) revealed the following properties: postinhibitory
      rebound (PIR), delayed excitation (DE), adaptation, and posttetanic
      hyperpolarization (PTH). NA neurons were separated into three groups on the basis
      of their expression of PIR and DE: PIR cells (58%), DE cells (31%), and Non cells
      (10%). Non cells expressed neither PIR nor DE and no cells expressed both PIR and
      DE. 2. PIR was a transient depolarization that produced a single action potential
      or a burst of action potentials when the cell was released from
      hyperpolarization. In the presence of tetrodotoxin (TTX), the maximum magnitude
      of PIR was 7-12 mV. Under voltage-clamp conditions, hyperpolarizing voltage steps
      elicited a small inward current during the hyperpolarization and a small inward
      tail current on release from hyperpolarization. These currents, which mediate
      PIR, were most likely due to Q-current because they were blocked with
      extracellular cesium and were insensitive to barium. 3. DE was a delay in the
      onset of action potential firing when cells were hyperpolarized before
      application of depolarizing current. When cells were hyperpolarized to -90 mV for
      greater than or equal to 300 ms, maximum delays ranged from 150 to 450 ms. The
      transient outward current underlying DE was presumed to be A-current because of
      the current's activation and inactivation characteristics and its elimination by
      4-aminopyridine (4-AP). 4. Adaptation was examined by applying depolarizing
      current for 2.0 s and measuring the frequency of evoked action potentials.
      Although there was a large degree of variability in the degree of adaptation, PIR
      cells tended to express less adaptation than DE and Non cells. Nearly three
      fourths of all NA neurons adapted rapidly (i.e., 50% adaptation in less than 200
      ms), but PIR cells tended to adapt faster than DE and Non cells. PTH after a
      train of action potentials was relatively rare and occurred more often in DE
      cells (43%) and Non cells (33%) than in PIR cells (13%). PTH had a magnitude of
      up to 18 mV and time constants that reflected the presence of one (1.7 +/- 1.4 s,
      mean +/- SD) or two components (0.28 +/- 0.13 and 4.1 +/- 2.2 s).(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1753286
TI  - Effect of neonatal denervation of hindlimb digits on the somatotopic organization
      of lumbar spinocervical tract neurons in the cat.
AB  - 1. The effect of transection and ligation of the digital nerves of either one
      (toe 3) or two (toe 3 and toe 4) hindpaw digits, in the first postnatal week, on
      the tactile receptive fields (RFs) of spinocervical tract (SCT) neurons was
      studied in adult, alpha-chloralose-anesthetized cats. Immediately before
      recording, the digital nerves of the corresponding digit(s) of the opposite,
      intact hindpaw were transected, and the neonatally lesioned digital nerves were
      recut proximal to the transection neuroma. 2. In the medial part of the dorsal
      horn at the L6-L7 level, the digits of the hindlimb are represented in the RFs of
      SCT cells in a precise axial sequence from the most medial digit (toe 2)
      rostrally to the most lateral digit (toe 5) caudally. Acute denervation of one or
      two digits in the adult produced an area in the ipsilateral dorsal horn in which
      SCT cells lacked any RFs. When acute denervation was restricted to a single
      digit, the unresponsive region of dorsal horn was approximately 3 mm in length,
      and when two digits were denervated the unresponsive zone was approximately 6 mm
      long. Because the representation of the toes of the left hindpaw is a mirror
      image of that of the right, the rostrocaudal extent and position of the region of
      unresponsive SCT cells was used to assess the location of the borders of the
      chronically deprived region on the opposite side of the cord. 3. In all cats
      examined after neonatal denervation of toe 3, most (89%) of the SCT cells sampled
      within the chronically deprived toe 3 representation had RFs. These RFs were
      either on toe 2 (44%) or toe 4 (18%), and a large proportion of cells (38%) had
      multiple RFs with components on both toe 2 and toe 4. In most cases the cells
      fired briskly to displacement of hairs or light touch of the skin within these
      RFs. SCT cells with a RF on toe 2 and/or toe 4 were found throughout the whole 3
      mm length of the chronically deprived toe 3 region, but cells with a RF on toe 2
      were more commonly found than cells with a RF on toe 4 at axial distances greater
      than or equal to 1.5 mm from the boundary of the normal representations of the
      respective digit. 4. After chronic, neonatal denervation of both toe 3 and toe 4,
      59% of SCT cells sampled overall had RFs, but there was a large degree of
      interanimal variation in the proportion of unresponsive neurons.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1753287
TI  - Lateral geniculate neurons in behaving primates. I. Responses to two-dimensional
      stimuli.
AB  - 1. Using behaving monkeys, we studied the visual responses of single neurons in
      the parvocellular layers of the lateral geniculate nucleus (LGN) to a set of two
      dimensional black and white patterns. We found that monkeys could be trained to
      make sufficiently reliable and stable fixations to enable us to plot and
      characterize the receptive fields of individual neurons. A qualitative
      examination of rasters and a statistical analysis of the data revealed that the
      responses of neurons were related to the stimuli. 2. The data from 5 of the 13 "X
      like" neurons in our sample indicated the presence of antagonistic center and
      surround mechanisms and linear summation of luminance within center and surround
      mechanisms. We attribute the lack of evidence for surround antagonism in the
      eight neurons that failed to exhibit center-surround antagonism either to a
      mismatch between the size of the pixels in the stimuli and the size of the
      receptive field or to the lack of a surround mechanism (i.e., the type II neurons
      of Wiesel and Hubel). 3. The data from five other neurons confirm and extend
      previous reports indicating that the surround regions of X-like neurons can have
      nonlinearities. The responses of these neurons were not modulated when a contrast
      reversing, bipartite stimulus was centered on the receptive field, which suggests
      a linear summation within the center and surround mechanisms. However, it was
      frequently the case for these neurons that stimuli of identical pattern but
      opposite contrast elicited responses of similar polarity, which indicates
      nonlinear behavior. 4. We found a wide variety of temporal patterns in the
      responses of individual LGN neurons, which included differences in the magnitude,
      width, and number of peaks of the initial on-transient and in the magnitude of
      the later sustained component. These different temporal patterns were repeatable
      and clearly different for different visual patterns. These results suggest that
      visual information may be carried in the shape as well as in the amplitude of the
      response waveform.

PMID- 1753288
TI  - Lateral geniculate neurons in behaving primates. II. Encoding of visual
      information in the temporal shape of the response.
AB  - 1. We used the Karhunen-Loeve (K-L) transform to quantify the temporal
      distribution of spikes in the responses of lateral geniculate (LGN) neurons. The
      basis functions of the K-L transform are a set of waveforms called principal
      components, which are extracted from the data set. The coefficients of the
      principal components are uncorrelated with each other and can be used to quantify
      individual responses. The shapes of each of the first three principal components
      were very similar across neurons. 2. The coefficient of the first principal
      component was highly correlated with the spike count, but the other coefficients
      were not. Thus the coefficient of the first principal component reflects the
      strength of the response, whereas the coefficients of the other principal
      components reflect aspects of the temporal distribution of spikes in the response
      that are uncorrelated with the strength of the response. Statistical analysis
      revealed that the coefficients of up to 10 principal components were driven by
      the stimuli. Therefore stimuli govern the temporal distribution as well as the
      number of spikes in the response. 3. Through the application of information
      theory, we were able to compare the amount of stimulus-related information
      carried by LGN neurons when two codes were assumed: first, a univariate code
      based on response strength alone; and second, a multivariate temporal code based
      on the coefficients of the first three principal components. We found that LGN
      neurons were able to transmit an average of 1.5 times as much information using
      the three-component temporal code as they could using the strength code. 4. The
      stimulus set we used allowed us to calculate the amount of information each
      neuron could transmit about stimulus luminance, pattern, and contrast. All
      neurons transmitted the greatest amount of information about stimulus luminance,
      but they also transmitted significant amounts of information about stimulus
      pattern. This pattern information was not a reflection of the luminance or
      contrast of the pixel centered on the receptive field. 5. In addition to
      measuring the average amount of information each neuron transmitted about all
      stimuli, we also measured the amount of information each neuron transmitted about
      the individual stimuli with both the univariate spike count code and the
      multivariate temporal code. We then compared the amount of information
      transmitted per stimulus with the magnitudes of the responses to the individual
      stimuli. We found that the magnitudes of both the univariate and the multivariate
      responses to individual stimuli were poorly correlated with the information
      transmitted about the individual stimuli.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1753289
TI  - Lateral geniculate neurons in behaving primates. III. Response predictions of a
      channel model with multiple spatial-to-temporal filters.
AB  - 1. For the experiments reported in these papers, we recorded the responses of
      lateral geniculate (LGN) neurons to a large set of two-dimensional, black and
      white patterns based on Walsh functions and to a set of test stimuli. In the
      first two papers we reported that these neurons encode stimulus-related
      information in both the strength and the shape of the response waveforms and that
      there are more than two independent components in the response. These results
      cannot be explained by existing models. This paper provides a model of LGN
      neurons that not only accounts for the foregoing observations, but also yields
      predictions confirmed by direct tests. 2. The model represents a neuron as a set
      of three parallel channels. The input to each channel is an array of pixel
      luminances. Each channel consists of an input nonlinearity cascaded into a linear
      spatial-to-temporal filter. The output of each channel is a basic waveform, a
      principal component. The response of the neuron is the sum of the outputs of the
      three channels. 3. The model accounted for much of the variance in the
      coefficients of the first three principal components of the neuronal responses to
      the set of Walsh stimuli. Using parameters derived from the responses of neurons
      to the Walsh stimuli only, the model also predicted the responses to "center
      surround" annuli of different contrasts and mean luminances, as well as to
      superpositions of pairs of Walsh patterns. The model made statistically
      significant predictions of the coefficients of two of the principal components of
      these responses. 4. After the parameters of the model had been fit to reproduce
      the responses of neurons to the Walsh stimuli, we found that the input
      nonlinearity of the model was compressed at both the high and low luminance
      levels. This compression produced response saturation that closely resembled the
      response saturation of neurons reported in the first paper in this series.
      Although not absolutely smooth, the spatial filter for the first channel had a
      dominant excitatory or inhibitory center and an antagonistic surround. Thus this
      spatial filter accounted for both the center and the surround structures of
      previous models of LGN receptive fields. There was greater variety in the
      structures of the spatial filters for the second and third channels, but none had
      a center-surround organization. Many of the spatial filters for these higher
      channels contained oriented ridges or valleys. Other spatial filters were
      dominated by a bipolar pair of pixels. 5. The model of LGN neurons that we
      present in this paper represents an extension over previous models in four ways.
      First, the model is capable of explaining the responses of neurons to a wider
      range of luminances than previous models. Second, the model is capable of
      explaining the shapes of the response waveforms as well as their magnitudes.
      Third, the concept of a single receptive field is extended to a series of spatial
      to-temporal filters. Fourth, the model suggests that LGN neurons provide a
      description of both the brightness and the form of a stimulus in their response
      waveforms.

PMID- 1753290
TI  - Ocular responses to translation and their dependence on viewing distance. I.
      Motion of the observer.
AB  - 1. The horizontal eye movements induced by acceleration along the interaural axis
      were recorded from five monkeys (Macaca mulatta) by the use of the
      electromagnetic search-coil technique. Animals sat on a sled that was moved
      briefly in darkness along a linear track (bell-shaped acceleration profile: peak,
      400 mm/s2; duration, 200 ms). Immediately before acceleration, animals fixated
      one of five target lights located at distances ranging from 16 to 150 cm. During
      fixation, the horizontal positions of both eyes were used to check vergence,
      while accommodation was monitored with an infrared optometer. 2. Sled motion
      induced eye movements that were generally smooth and compensatory, e.g.,
      rightward sled motion elicited leftward eye movement. We attribute these
      responses to a translational vestibuloocular reflex (TVOR) that senses the sled
      motion through the otolith organs. However, in three animals, these responses
      were preceded by weak anticompensatory movements (duration, less than 40 ms;
      amplitude, less than 10% of the maximum compensatory response). 3. Geometry
      indicates that, during brief sled motion, the eye movements required to keep gaze
      aligned on a particular location ("full" compensation) are inversely proportional
      to the viewing distance. Response measures based on the computed eye velocity
      profiles, such as the velocity achieved at specific times ("time slices") or the
      peak values of the estimated covariance functions, all indicated that
      compensatory responses were a linear function of the inverse of the prior viewing
      distance. Cross-correlation analyses indicated that the effect of the prior
      viewing distance was to scale responses, although detailed spectral analyses
      revealed that high-frequency components (greater than 10 Hz) tended to scale less
      vigorously than lower ones. 4. The adequacy of the compensatory eye movements was
      assessed by calculating the gain (response recorded/response required for full
      compensation). Regardless of the response measure used, gains varied considerably
      from one animal to another and, in some particular animals, from one direction to
      another but showed a general tendency to increase with viewing distance. For
      example, on the basis of the peak eye velocity achieved within 250 ms of the
      onset of sled motion, mean gain at 16 cm was 0.74 (range, 0.48-1.01), whereas at
      150 cm it was 1.25 (range, 0.67-1.73). 5. Using wedge prisms to dissociate
      vergence and accommodation indicated that ocular responses to sled motion were
      sensitive to selective increases in either vergence (base-out prism with the most
      distant target) or accommodation (base-in prism with the nearest target).
      However, the magnitude of the effects showed considerable variability from one
      animal to another and, in some particular animals, from one direction to
      another.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1753291
TI  - Ocular responses to translation and their dependence on viewing distance. II.
      Motion of the scene.
AB  - 1. The ocular following responses induced by brief (100-ms) movements of the
      visual scene were examined for their dependence on viewing distance in 5 monkeys
      (Macaca mulatta). The horizontal positions of both eyes and the vertical position
      of one eye were recorded using the electromagnetic search-coil technique.
      Accommodation was monitored in selected experiments by use of an infrared
      optometer. Test patterns (random dots) were back-projected onto a translucent
      tangent screen facing the animal. Six viewing distances were used (range, 20-150
      cm), the size and speed of the image on the screen being adjusted for each so as
      to preserve a constant retinal image. 2. Response measures based on the amplitude
      of the first peak in the eye acceleration profile or the eye velocity achieved at
      specific times all indicated that ocular following responses were inversely
      related to viewing distance, the relationship being linear for the earliest
      measures. On average, the sensitivity to viewing distance was comparable with
      that reported for the translational vestibuloocular reflex (TVOR) in the
      preceding paper: as viewing distance increased from 20 cm, ocular following
      decremented at a mean rate (+/- SD) of 17 +/- 3% per m-1, while the TVOR
      decremented at a mean rate (+/- SD) of 18 +/- 1% per m-1. 3. Ocular following
      responses showed the postsaccadic enhancement described by Kawano and Miles
      regardless of viewing distance. To a first approximation, the effects of
      postsaccadic enhancement and viewing distance summed linearly. 4. The dependence
      of ocular following on speed showed the progressive saturation previously
      described by Miles et al. at all viewing distances, the peak eye velocity
      achieved being inversely related to the viewing distance, indicating that the
      saturation must originate upstream of the dependence on viewing distance. Under
      normal viewing conditions, this speed saturation will tend to offset the
      dependence on viewing distance because the retinal slip speeds experienced by the
      moving observer will tend to vary inversely with viewing distance, resulting in
      greater saturation with nearer viewing. 5. Wedge prisms were used to dissociate
      vergence and accommodation and indicated that ocular following responses were
      sensitive to selective increases in either vergence (base-out prism with the
      screen at 100 cm) or accommodation (base-in prism with the screen at 20 cm).
      However, as with the TVOR, the magnitude of the effects showed considerable
      variability from one animal to another and, in some particular animals, from one
      direction to another.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1753292
TI  - Activity of neurons in cerebellar-receiving and pallidal-receiving areas of the
      thalamus of the behaving monkey.
AB  - 1. Thalamic neurons that receive synaptic input from the globus pallidus or the
      cerebellar nuclei were identified in awake monkeys trained to perform an arm
      reaching task. The location of electrophysiologically identified cerebellar
      receiving (CR) and pallidal-receiving (PR) neurons was used to identify a total
      of 264 thalamic neurons in cerebellar (CB) or pallidal (GP) regions of the
      thalamus. 2. Stimulation in the brachium conjunctivum or white matter adjacent to
      the cerebellar nuclei excited 85 neurons in the thalamus at short latencies.
      These CR neurons were located in the oral portion of the ventral posterolateral
      nucleus (VPLo), in caudal portions of the ventral lateral nucleus (VLc), and in
      area X. 3. Stimulation in the internal globus pallidus (GPi) inhibited 10
      thalamic neurons at short latency. These PR neurons were located in rostral
      portions of VLc, in the oral part of the ventral lateral nucleus (VLo), and in
      the parvicellular part of the ventral anterior nucleus (VApc). 4. There was no
      clear single somatotopic organization of neurons in CB and GP regions of the
      thalamus, as defined by "free-form" responses to passive manipulation and
      observation of eye movements. There was, in fact, a tendency for two
      representations, each, of the head/eye/mouth cells and cells with modifications
      of activity in response to manipulation of the arm. 5. During the hold period
      before illumination of a visual target, the mean firing rates and variability of
      discharge of arm-related CR and PR neurons did not differ significantly. This was
      also true for the total sample of arm-related neurons in the CB versus GP
      regions. 6. The activity of many neurons in both the CB and GP regions began to
      change before the reaching movement and, for some, before the earliest recorded
      changes in electromyographic (EMG) activity. The initial change was an increase
      in discharge for greater than 75% of the cells studied in both the CB and GP
      regions. 7. During the reaching task, there also was no significant difference in
      the time of the initial change in discharge of neurons in the CB versus GP
      regions of the thalamus. 8. These data are consistent with the hypothesis that
      the initial task-related change in discharge of PR thalamic neurons is dominated
      by input from the cerebral cortex and that pallidal input modulates later phases
      of their movement-related changes in activity.

PMID- 1753293
TI  - Intracellular analysis of excitatory-inhibitory synaptic interactions in crayfish
      stretch receptors.
AB  - 1. To determine the membrane mechanisms underlying the interactions between
      inhibitory postsynaptic potentials (IPSPs) and excitatory inputs, we
      investigated, at the membrane potential level, the combined influences of low
      frequency (0.05-0.50 Hz) imposed sinusoidal transmembrane currents (termed sine
      currents), representing the excitatory drive, and trains of regular (3-30/s)
      IPSPs. The two simplest possible neuron systems exemplified by the slowly and
      rapidly adapting stretch receptors of crayfish (RM1 and RM2, respectively) were
      used. 2. At constant elongation the RM1 and RM2 behaved as a pacemaker and a
      neuron without self-sustained oscillations, respectively, but in dynamic
      conditions uninhibited controls and IPSP sine current interactions were
      essentially identical in both RMs. Controls showed the usual smooth variation of
      the RM firing rate in response to the gradually varying excitatory input. IPSP
      effects were characterized by the expected overall reduction of the postsynaptic
      firing rate. More important, special effects were also present, such as the
      simple fixed alternations of IPSP and postsynaptic spikes (e.g., 1 IPSP, 1
      postsynaptic or 1:1; 1 IPSP, 2 postsynaptic or 1:2; 2 IPSPs, 1 postsynaptic spike
      or 2:1), where interspike intervals were more constant than uninhibited controls
      and where the sensitivity to the excitatory input was reduced to small values,
      and the sudden firing rate discontinuities consisting of instantaneous discharge
      accelerations or decelerations (termed "jumps") between successive alteration
      ratios, where sensitivity increased to large values. Therefore with inhibition
      the RM firing rate varied discontinuously in response to the gradually changing
      input, and the discharge rate could take one of several discrete values by
      switching between different alteration ratios. 3. At the alternations the times
      elapsed between an IPSP and the closest spike before (phase, phi) or after it
      (cophase, theta) increased and decreased, respectively, with increasing
      excitation. The major membrane potential modification that accompanied the
      interactions at the alternations was the gradual increase of the post-IPSP slope
      as a function of excitatory drive, which reduced the time to reach the firing
      level or theta. 4. Inhibition introduced subtle and complex nonlinear
      modifications in the coding of convergent excitatory input. The most notable
      nonlinearity was the discontinuous variations of the firing rate as a function of
      the gradually changing excitatory input. Effects were due to voltage interactions
      occurring at the extrasynaptic membrane, with a decisive involvement of the spike
      generator and insignificant participation of the shunting action of IPSPs. The
      results provide yet another example of the predominant influence of intrinsic
      membrane properties in determining the effects of synaptic-evoked
      activity.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1753294
TI  - Effects of low-frequency stimulation on the tension-frequency relations of fast
      twitch motor units in the cat.
AB  - 1. Tension-frequency relations were measured in single fast-twitch motor units of
      the cat flexor digitorum longus (FDL) muscle before and after stimulating each
      unit with a series of 10-s trains at 20 Hz. The 20-Hz conditioning stimulation
      produced a combination of potentiating and fatiguing effects, similar to those
      previously reported to follow higher frequency stimulation of single motor units
      of the cat and maximal voluntary contractions in man. 2. The conditioning
      stimulation left three types of after effects: 1) short-term potentiation, 2) a
      somewhat longer lasting depression of maximal tension, and 3) a delayed
      depression of low-frequency responses (low-frequency fatigue). 3. The immediate
      potentiating effect of the conditioning stimulation was most prominent in fatigue
      resistant (FR) motor units, whereas depression of maximal tension and low
      frequency fatigue were most prominent in fatigue-intermediate (FI) and highly
      fatigable (FF) motor units. 4. On the basis of our results and those of other
      investigators, we propose that potentiation, depression of maximal tension, and
      low-frequency fatigue are independent phenomena, acting at distinct points in the
      excitation-contraction coupling process. 5. Our results suggest that both
      potentiation and low-frequency fatigue can result from rather modest amounts of
      preceding activity. Thus large changes in muscle force production are not unique
      to maximal contractions but are likely to follow sustained, submaximal
      contractions as well.

PMID- 1753295
TI  - Functional organization within the medullary reticular formation of the intact
      unanesthetized cat. III. Microstimulation during locomotion.
AB  - 1. This article presents the results from stimulation in 21 loci within the
      medullary reticular formation (MRF; between 0.5 and 2.5 mm from the midline) and
      in 5 loci in the medial longitudinal fasciculus (MLF) of four intact,
      unanesthetized cats during locomotion. Stimulus trains (11 pulses, 0.2-ms
      duration, 330 Hz, stimulus strength 35 microA) were applied at those loci in each
      track at which the most widespread effects in each of the four limbs were
      obtained with the cat at rest. Electromyograms were recorded from flexor and
      extensor muscles of each limb. 2. As previously reported, stimulation with the
      cat at rest generally evoked brief, short-latency, twitch responses in both
      flexor and extensor muscles of more than one limb. In contrast, stimulation
      during locomotion evoked a more complex pattern of activity in which responses
      were normally evoked in one or other of the muscle pairs and incorporated into
      the locomotor pattern. 3. In the majority of sites, the stimulation evoked
      excitatory responses in the flexor muscles of each of the four limbs during that
      period of the step cycle in which each respective muscle was naturally active;
      stimulation in the stance phase of locomotion, although less effective, was also
      capable of producing responses in these muscles. All three ipsilateral extensor
      muscles studied [long and lateral heads of triceps and vastus lateralis (Tri,
      TriL, and VL, respectively)] were normally inhibited during their phase of muscle
      activity, although excitatory responses were occasionally seen. Responses in the
      contralateral (co) Tri were invariably excitatory and were largest during the
      period of muscle activity, whereas responses during the period of activity of the
      coVL were mixed, with both excitatory and inhibitory responses being seen from
      any one locus. 4. Excitatory responses were normally largest when stimulation was
      applied during the time that the muscle was active during the locomotor cycle.
      Responses evoked at times when the muscle was inactive were sometimes larger than
      those evoked with the animal at rest; such responses were most commonly seen in
      the hindlimb flexors and in the coVL. 5. In both flexors and extensors of each of
      the four limbs, the latency of the responses was greatest when the cat was at
      rest and least for stimuli given during the period of activity of the respective
      muscle. Average latencies during the period of muscle activity ranged from a
      minimum of 9.0 +/- 2.6 (SD) ms for inhibitory responses in the ipsilateral Tri
      and TriL to a maximum of 17.1 +/- 3.0 ms for the responses evoked in the
      ipsilateral semitendinosus.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1753296
TI  - Transient reversal of the stretch reflex in human arm muscles.
AB  - 1. Load perturbation responses can violate the law of reciprocal innervation
      between antagonist muscles under particular conditions. Thus flexor and extensor
      muscles of wrist and elbow joints are reflexly coactivated by the impact of a
      ball on the hand during a catching task. The aim of this study was to determine
      whether reflex coactivation can be preset within the central nervous system (CNS)
      or whether it is entirely due to the peripheral stimulus. To this end, we studied
      the behavior of stretch reflex responses of arm muscles evoked by torque motor
      perturbations applied before and during the catching task. 2. Subjects were
      instructed to catch a ball dropped from 1.6 m. A torque motor delivered
      perturbations to the elbow joint, resulting in angular motion at both elbow and
      wrist joints because of their dynamic mechanical coupling. Two series of
      experiments were performed that differed in the perturbation waveform. In the
      first series, a single torque pulse could be randomly applied at different times
      during the task. The corresponding responses were recovered by subtracting the
      average of the unperturbed trials from the averages of perturbed trials. In the
      second series of experiments, a train of pseudorandom pulses was applied
      continuously during each trial. The time-varying impulse responses were computed
      at 20-ms intervals by cross-correlation methods. 3. The pattern of the short
      latency electromyographic responses evoked by either single pulses or
      pseudorandom perturbations obeyed the law of reciprocal innervation of antagonist
      muscles under basal conditions. However, the pattern of the responses evoked by
      the same perturbations around the time of ball impact on the hand consisted of a
      substantial coactivation of both stretched and shortening muscles. Reflex
      coactivation resulted from response patterns that differed at different joints.
      At the elbow, reflex coactivation resulted from a transient reversal of the
      direction of the short-latency responses of flexor muscles, with little changes
      of the responses of extensor muscles. At the wrist, instead, reflex coactivation
      resulted from simultaneous changes in the response waveform of both flexor and
      extensor muscles. 4. The peripheral conditions associated with the applied
      perturbations were constant before the time of ball impact. Thus, because the
      changes of the stretch reflex responses began before that time, they must have
      been generated within the CNS. It is here hypothesized that the reversal of the
      reflex responses is centrally gated by switching from the pathways of reciprocal
      inhibition to those of coactivation of antagonist alpha-motoneurons.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1753297
TI  - Parabrachial gustatory neural activity during licking by rats.
AB  - 1. A total of 51 single neurons was recorded from the pontine parabrachial nuclei
      of three rats being given sapid stimuli either via intraoral infusions or during
      spontaneous licking behavior. In 46 neurons, sapid stimuli elicited significant
      taste responses; of these, 28 responded best to NaCl, 15 to sucrose, 2 to citric
      acid, and 1 to quinine HCl. The remaining five neurons responded significantly
      only to water. The mean spontaneous rate of taste neurons during the intraoral
      infusion and licking sessions was 11.1 +/- 1.1 and 10.8 +/- 1.2 (SE) spikes/s,
      respectively. 2. Of the 39 neurons tested during both licking and intraoral
      infusions, four responded significantly only to water via either route. The
      remaining 35 neurons responded significantly to at least some sapid stimuli. The
      best-stimulus categories remained the same regardless of the route of fluid
      delivery (24 NaCl best, 10 sucrose best, 1 citric acid best). When the rats were
      licking the stimuli, nine taste neurons responded significantly to only one sapid
      chemical [6 Na specific (Ns) and 3 sucrose specific (Ss)] but were more broadly
      tuned during intraoral infusions. Conversely, three taste neurons that responded
      specifically during intraoral infusions (3 Na specific) were not as specific when
      the animal licked the same fluids. 3. Thirty-five taste neurons were tested via
      both stimulus routes. These data were compared in three ways. First, for each
      neuron, the responses elicited during licking and intraoral infusions were
      compared for each of the four standard sapid stimuli. The Pearson correlation
      coefficients for the 35 taste neurons ranged from 0.9997 to 0.6785, with a mean
      at 0.953 +/- 0.012 (SE). The second comparison was between stimulus routes across
      chemicals. With the use of raw responses, the correlation coefficients for NaCl,
      sucrose, citric acid, and QHCl ranged from 0.925 to 0.778 (t test, P less than
      0.0001). With the activity elicited by water subtracted (corrected responses),
      the correlation coefficients for NaCl, sucrose, citric acid, and QHCl were 0.900,
      0.795, 0.369, and 0.211, respectively. The coefficient for QHCl was not
      significant (t test, P greater than 0.05). Finally, the mean responses to NaCl,
      sucrose, and citric acid delivered by both routes were compared and found not to
      differ (paired t test, P greater than 0.05). 4. In separate hierarchical cluster
      analyses for the licking and infusion data, the largest cluster in each contained
      all of the Na-best neurons and the next largest, all of the sucrose-best
      cells.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1753298
TI  - Residency training in occupational and environmental medicine.

PMID- 1753299
TI  - Tobacco use: selection, stress, or culture?
AB  - The effects of selection, job stress, and culture models on the association
      between occupation and smoking were empirically estimated on a random sample of
      2,362 employed adults in Orange County, California using data collected through
      the Orange County Health Survey. The largest percent of smokers were blue-collar
      workers (32.4%). The logistic regression analysis results indicated that age,
      sex, education, ethnicity, job stress, and the industry in which employees work
      had significant impact on the risk of smoking. The findings imply that all three
      models contribute to smoking behavior. Smoking cessation and prevention programs
      may include elements that address both stress and environment in intervention
      design. Stress models imply that such program should focus on change in
      individual coping mechanisms; social environment models imply that change in
      group norms and attitudes is necessary.

PMID- 1753300
TI  - Business analysis in occupational health and safety consultations.
AB  - We present a method for incorporating business analysis into comprehensive health
      and safety consultations using as an example a plant with an elevated incidence
      of cumulative trauma disorders. Business information, including product and
      management history, short- and long-term corporate goals, functional analysis,
      profit history, organizational structure with respect to health and safety, and
      personnel and labor-management relationships are evaluated simultaneously with
      traditional ergonomic factors. The additional business data allow consultants to
      identify the full scope of etiologies and make practical, credible
      recommendations that are more likely to be adopted by management and labor. We
      propose that techniques of "business analysis" be routinely incorporated into
      occupational health and safety consultations. However, because collection and
      interpretation of these data require business skills outside the occupational
      safety and health expert's usual repertoire, the consulting team must include
      participants with business expertise. We have found that occupational health
      medical personnel with an understanding of business analysis concepts can be very
      effective advocates for changes in health and safety practices. We strongly
      recommend incorporating methods of business analysis into the occupational health
      and safety curriculum.

PMID- 1753301
TI  - Use of focus groups to study absenteeism due to illness.
AB  - Reasons for sick leaves are often complex and influenced by nonmedical factors.
      We have used focus groups, a qualitative research method, to study the
      relationship between working conditions and absenteeism due to illness in both an
      industrial company and an insurance company. We organized 10 focus groups within
      each company, with participants randomly selected from departments having similar
      work tasks within each company. According to the groups, the most important
      working conditions that influenced absenteeism were (a) feeling of well-being at
      work (mainly defined as security in social relations), (b) the organization of
      the work, and (c) the department leader. Factors considered to be less important
      included: number of employees, male/female ratios, group norms for absenteeism,
      age distribution, work-related illness, substance abuse, and work loads. There
      was substantial agreement between the groups, indicating that our findings may be
      relevant to other companies.

PMID- 1753302
TI  - Relative effects of flow-resistive and pressure-biased respiratory loading.
AB  - The effects of pressure-biased breathing (PBB), which simulates positive pressure
      respirator use, were studied in 15 volunteer subjects during laboratory exercise.
      PBB was compared with inspiratory resistance: dead space (ID) load and a no-load
      (N) situation. PBB had adverse subjective effects comparable with those of ID.
      Physiologically, PBB led to a small decrease in inspiratory time and an increase
      in expiratory time as well as an increase in the intensity of ventilatory effort
      as measured by the mean inspiratory flow rate. It is postulated, based on these
      findings, that PBB has significant effects on the resting lung volume, leading to
      both physiologic and subjective consequences.

PMID- 1753303
TI  - The identification of occupational lung disease from hospital discharge data.
AB  - The Bureau of Labor Statistics-State Health Department Select Committee on
      Occupational Illnesses and Injuries conducted a study of hospital discharge
      records to determine their usefulness for identifying cases of occupational
      disease. Four states searched the diagnosis fields on computerized hospital
      discharge records for selected occupational lung diseases; pneumoconiosis,
      extrinsic allergic alveolitis, and respiratory conditions due to chemical fumes
      and vapors. The hospital discharge data identified more cases of pneumoconiosis
      than did the BLS data systems. Numerous cases of extrinsic allergic alveolitis
      and respiratory conditions due to chemical fumes and vapors were also identified.
      Patterns evidenced in the data were generally consistent with current knowledge
      of the diseases. The inclusion of industry and occupation on the hospital
      discharge record, further study of the quality of diagnosis coding, and the use
      of these data by additional states will enhance the usefulness of these data for
      occupational disease surveillance.

PMID- 1753304
TI  - The noise hazard in a large health care facility.
AB  - A noise-level survey, dosimetry, and audiometric testing were conducted in a
      large health care facility to determine the areas with hazardous noise levels,
      the number of employees at risk, and the prevalence of noise-induced hearing loss
      (NIHL) among the exposed. Nine high-risk areas were identified, with readings of
      up to 110 dBA recorded. In the work force of approximately 6,000 employees, 321
      were identified as exposed to potentially hazardous noise levels. Abnormal
      hearing patterns were observed in 59 (19%) of the 308 workers screened, with 36
      cases of NIHL documented. The findings showed that noise is a serious hazard in
      many areas, that some cases of NIHL have developed from occupational exposure in
      this hospital, and that a control program is essential.

PMID- 1753305
TI  - Who's counting anyway? The problem with occupational safety and health
      statistics.

PMID- 1753306
TI  - Morbidity patterns among employees at a petroleum refinery.
AB  - This study examined the morbidity experience of a prospective cohort of 2132 male
      employees who worked at a petroleum refinery from 1981 through 1988. The
      morbidity data included all illness-absence episodes in excess of 5 days during
      the study period. Standardized morbidity ratios (SMRs) of disease prevalence were
      calculated using data from all manufacturing employees of the Shell Oil Company
      as an internal comparison group. As such, there is no potential bias associated
      with the "healthy worker effect" in this type of study design. Morbidity for all
      causes combined was virtually the same as that for the comparison group with
      2,311 observed and 2,318 expected disease prevalence events. However, there were
      statistically increased prevalence of musculoskeletal system disorders (SMR =
      136) and injuries (SMR = 125) among staff employees and skin and subcutaneous
      tissue disorders (SMR = 138) among production employees. A review of the original
      morbidity reports for these skin conditions revealed that none were due to
      exposure to chemical products or solvents. The SMR for neoplasms of the lymphatic
      and hematopoietic tissue among production employees was slightly elevated but was
      based on only three cases (2.4 expected). Of the three cases, none was due to
      leukemia.

PMID- 1753307
TI  - Use of the Mantel-Haenszel chi 2 overestimates precision in studies with sparse
      data.
AB  - Probability values or "test-based" confidence limits computed on the basis of the
      Mantel-Haenszel chi 2 statistic may be invalid if minimum cell-size requirements
      are not met. In 30 studies of occupational proportionate mortality published from
      1985 through 1987, the Mantel-Haenszel chi 2 was used in potential violation of
      cell-size requirements in 21 studies. Sixteen (76%) studies included at least one
      value that, when compared with testing with the Poisson distribution, was
      erroneously reported as statistically significant at the 0.05 level. We conclude
      that by using the Mantel-Haenszel chi 2 with sparse data, some epidemiologists
      overestimate precision.

PMID- 1753308
TI  - How dangerous is work in Canada? Estimates of job-related fatalities in 482
      occupations.
AB  - Data have been gathered from Labour Canada and the Quebec Workers' Compensation
      Board to examine estimates of mortality in 482 Canadian occupations. These data
      contain information on job-related fatalities within four-digit occupations for
      1980, 1981, 1985, and 1986. Compared with comparable data from the United States,
      the estimates indicate that the incidence of job-related fatalities is
      significantly higher in Canada.

PMID- 1753309
TI  - Methodological issues for the assessment of clusters of adverse pregnancy
      outcomes in the workplace: the case of video display terminal users.
AB  - In this paper, we review the consecutive methodological steps to follow when
      assessing clusters of adverse pregnancy outcomes (APO) in the workplace and the
      decisions to be taken at each step. The example of clusters of APO reported in
      VDT users in 1979 to 1982 is taken to illustrate each point. It appears that the
      number of "expected-unexpected" clusters of APO in VDT users has been largely
      overestimated as compared to observations and that this might be due to
      inadequate choices in the models used.

PMID- 1753310
TI  - A study of the interaction of selected drugs and plastic syringes.
AB  - It is common hospital pharmacy practice to preload syringes with selected drugs
      and store them ready for use. Because the several components of syringes, (such
      as barrels, gasket seals, etc.) may vary among manufacturers, there exists the
      possibility that syringe components of differing provenance might interact e.g.,
      by sorption, with stored drugs to differing degrees. To examine possible
      interactions, three brands of commercially available syringes were compared to
      determine what influence, if any, short term storage of injectable solutions
      might exert on the solutions or the syringes. Four drugs; dexamethasone sodium
      phosphate, diazepam, diatrizoate meglumine and nitroglycerin USP were
      individually loaded into 3 mL syringes and stored at temperatures between -20
      degrees C and + 25 degrees C for periods from 6 hours to 30 days. The syringes
      were examined for any gross changes. Drug solutions were analyzed after storage
      to determine the presence of organic leachates from the syringes and any change
      from original drug concentration values. No syringes showed gross physical
      changes after storage with drug solution nor were any drug solutions found to
      contain leachates on gas chromatographic-mass spectroscopic analysis. Drug
      concentrations were seen to change following storage, the greatest changes
      occurring with the highly lipophilic drugs dexamethasone and diazepam. In most
      instances loss of drug concentration was most rapid at room temperature. Although
      there were clear differences among the three brands of syringe, no overall
      pattern emerged which might allow the selection or rejection of one syringe over
      another for the extemporaneous preloading of the drugs examined.

PMID- 1753311
TI  - Validation of tangential flow filtration (TFF) systems.

PMID- 1753312
TI  - Biowaste treatment.
AB  - Finding a practical solution for effectively managing facility liquid biowaste is
      a process of deductive reasoning. Many considerations need to be addressed. The
      liquid effluent must be characterized to determine required capacity, materials
      of construction and mode of operation of the biowaste treatment system. Federal,
      state, local and corporate requirements must be identified to determine system
      operating parameters. Standard technologies can then be reviewed in order to
      select the most appropriate unit operation for processing the biowaste. Finally,
      a validation program is developed to demonstrate the efficacy of the treatment
      system's intended use. This presentation covers typical considerations in
      developing the design of a biowaste treatment system and validation of acceptance
      criteria. Several examples from industrial installations are presented.

PMID- 1753313
TI  - Comparison of bacterial and endotoxin retention by charge-modified sterilizing
      grade filters during intermittent long-term use.
AB  - There has been growing concern in recent years about control of bacterial
      bioburden and endotoxin in pharmaceutical water systems by both the
      pharmaceutical manufacturers and the Food and Drug Administration (FDA). This
      concern exists not only for Water for Injection (WFI) systems, but for any water
      system used in the manufacture of a product which could be affected by the
      microbial bioburden. In hot WFI systems, bioburden control is assured by keeping
      the water in the recirculating loops at 80 degrees C. At points of use in these
      systems, the temperature fluctuates and can be below sanitization temperature for
      extended periods. On the other hand, in cold water systems [WFI and deionized
      (DI)], both bioburden and endotoxin control are more difficult. This study shows
      that sterilizing grade, positively-charged filters can provide absolute bioburden
      control. In addition, these filters effectively retain high levels of both
      purified and cell-associated endotoxins over a five month period under severe
      intermittent system use conditions in a model high-purity water system. This
      study suggests a solution to the concerns over long-term use of bacterially
      retentive filters in properly maintained high-purity water systems.

PMID- 1753314
TI  - Additive model for the evaluation of interactions between aqueous solutes and
      multi-component container materials.
AB  - The interaction between aqueous model solutes and various current or potential
      parenteral solution container materials was studied. Materials examined included
      composite polymers (plasticized PVC and co-extruded composites) and their
      individual components. For each material studied (component and composite), the
      equilibrium interaction constant (Eb), which describes the distribution of a
      solute between a container and its contained solution, can be related to the
      solute's octanol-water (Po-w) and hexane-water (Ph-w) partition coefficients via
      a bimodal Collander-type expression: log Eb = a log Po-w + b log Ph-w + c
      Additionally, the interaction of the composites was found to be equivalent to the
      weighted average of the interaction properties of its individual components. That
      is, Eb,composite = sigma Wi x Eb,i where i represents an individual component of
      the composite and Wi represents the weight fraction of that component in the
      composite. The impact of the interaction properties of the components on the
      behavior of the composites is discussed; thus, for example, the interaction
      properties exhibited by plasticized PVC is dominated by the behavior of the
      plasticizer since unplasticized PVC itself exhibits only minimal interaction with
      aqueous solutes.

PMID- 1753315
TI  - A novel method of assessment of interfacial adsorption of blood proteins.
AB  - Interfacial adsorption of proteins can be studied using microscopic surface
      analysis techniques, and by physical techniques such as interfacial tension
      measurement. A novel method of surface analysis of adsorbed protein layers is
      described, which involves interfacial shear rheology of aqueous solutions of
      proteins. This technique provides information on the structural-mechanical
      properties of the adsorbed layers which may be related to: the rate of
      interfacial adsorption, interfacial interactions, and conformational changes in
      the adsorbed layers. The interfacial shear rheology of aqueous solutions of the
      blood proteins, bovine serum albumin and human immunoglobulin G was investigated
      at the air/aqueous interface. The effects of bulk concentration (0.1 to 4.0% w/v)
      and pH (3 to 8) were investigated, both interfacial viscosity and elasticity
      values are reported.

PMID- 1753316
TI  - Reduction of salivary bacteria by pre-procedural rinses with chlorhexidine 0.12%.
AB  - The purpose of this study was to assess the effect of pre-procedural rinsing (2
      consecutive rinses) with 0.12% chlorhexidine gluconate (CHX) on salivary bacteria
      during scaling and root planing procedures (S&RP). Because blood and debris
      arising from S&RP could inactivate CHX and decrease its antimicrobial effect,
      patients were evaluated throughout their appointment. Forty subjects rinsed with
      either 15 ml of CHX rinse or control (sterile water) for 30 seconds, expectorated
      and immediately rinsed again for 30 seconds. Unstimulated saliva samples were
      obtained at baseline (immediately before rinsing), and at 1 minute, 30 minutes,
      and 60 minutes after baseline. All 30 and 60 minute samples contained visible
      blood and debris. Samples were immediately diluted in transport fluid containing
      a CHX-neutralizer and then plated on trypticase soy agar for enumeration of the
      total aerobic and facultative bacterial load. The dual rinses with 0.12% CHX
      immediately reduced the salivary bacterial load 97% and this reduction persisted
      for 60 minutes during S&RP. At 30 minutes and at 60 minutes aerobic bacteria were
      reduced 77% compared to control, and 96% compared to baseline. CHX was not
      inactivated by the high organic load (blood and debris) present during the
      procedure. Pre-procedural rinsing with CHX has a profound and sustained effect on
      the aerobic and facultative flora of the oral cavity, which may contribute to a
      variety of clinical benefits. Pre-procedural rinsing may also be of value in
      protecting patients and dental professionals during dental manipulations.

PMID- 1753317
TI  - Histologic evaluation of combining tetracycline and allogeneic freeze-dried bone
      on bone regeneration in experimental defects in baboons.
AB  - Tetracyclines (TTC) have been used both systemically and locally during
      periodontal bone grafting procedures, but previous work regarding the effect of
      TTC on new bone formation has been contradictory. The purpose of this study was
      to determine if the use of locally applied TTC in combination with freeze-dried
      bone allografts (FDBA) would enhance bone regeneration in an experimental
      alveolar bone osseous defect grafting system. Pre-weighed freeze-dried bone
      allograft particles (300-500 mu diameter) were placed in nylon mesh chambers (250
      mu pore size) and rehydrated with either 10 micrograms/ml aqueous TTC or sterile
      distilled water. Empty chambers were used as further controls. The chambers were
      placed in the posterior mandible of baboons in surgically created windows. After
      3 and 5 weeks, the chambers were retrieved, processed histologically, and
      analyzed histometrically for new bone formation. The TTC-rehydrated FDBA
      demonstrated much greater (greater than 5x) new bone formation than the water
      rehydrated FDBA. These results strongly suggest that locally-applied TTC in
      combination with FDBA enhances new bone formation in experimental alveolar bone
      defects.

PMID- 1753318
TI  - Influence of polishing procedures on sonic scaling root surface roughness.
AB  - The present in vitro study aimed to evaluate the efficacy of various polishing
      procedures in reducing root roughness caused by sonic scaling. Proximal root
      surface areas of extracted, formalin-stored teeth were scaled in a bucco-lingual
      direction by a sonic scaler. The resulting roughness was measured along the
      direction of scaling and perpendicular to that direction by a profilometer. The
      specimens were then split into two groups. Group 1 was polished by an air-powder
      polishing instrument followed by a rotating rubber cup and chalk; Group 2 was
      polished by pumice followed by chalk. Root roughness (Ra) was recorded for each
      step in the procedures. The measurements revealed lower Ra values when the stylus
      of the profilometer was running perpendicular to the scaling direction, and a
      weak negative correlation was found when scaling time and Ra values were
      compared. In both groups Ra values were significantly reduced at each step of the
      polishing procedures and the terminal result was similar for the groups. Pumice
      and air-powder polishing gave a similar reduction of the sonic scaling roughness.

PMID- 1753319
TI  - An in vivo study of dentin sensitivity: the relation of dentin sensitivity and
      the patency of dentin tubules.
AB  - Dentin hypersensitivity can be a major problem for periodontal patients. The
      relationship between dentin hypersensitivity and the patency of dentin tubules in
      vivo has been established. Thirteen adult patients with teeth scheduled for
      extraction were selected and a stent fabricated to confirm location of the root
      surface being examined. Response to a constant air blast was recorded on a
      numeric pain rating scale (from 0 to 4) during the course of treatment. The tooth
      surface was initially treated with 0.5 molar EDTA (pH = 7.4), to remove the smear
      layer and expose tubules. The region was then treated with either a 3%
      monopotassium-monohydrogen oxalate solution or a 3% sodium chloride solution,
      both at pH = 2.4. Solutions were prepared to be indistinguishable to the
      examiner. Response to air was evaluated before and after EDTA treatment and after
      treatment with a desensitizing agent. The patient was anesthetized and the
      treated tooth extracted. Specimens were sectioned, critical point dried, sputter
      coated with gold, and examined under the scanning electron microscope.
      Photomicrographs were analyzed by computer assisted digital analysis to evaluate
      the degree of tubule occlusion. Statistical analysis by repeated measures ANOVA
      for univariate tests of hypothesis for within subject effects showed the sodium
      chloride solution was more effective in reducing dentin sensitivity than the
      potassium oxalate solution. Scanning electron micrographic analysis revealed a
      mean dentin tubule aperture size of 1.720 square microns following EDTA treatment
      alone, 0.564 square micron following potassium oxalate treatment, and 0.386
      square micron following sodium chloride treatment.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1753320
TI  - In vivo determination of radiographic projection errors produced by a novel
      filmholder and an x-ray beam manipulator.
AB  - Subtraction radiography requires radiographs made with identical projection
      geometry. The purpose of the present investigation was to develop and evaluate a
      new in vivo method to measure angular radiographic projection error. This
      included the development of a system for accurate control of the x-ray beam
      angulation relative to the intraoral film and the evaluation of the in vivo
      projection errors (equivalent to the "angular difference" between repeated
      exposures) produced by the new system. A filmholder, an x-ray beam manipulator,
      and an aiming device were newly constructed. Reference wires were attached for
      measuring the projection error on the filmholder and on the 22 bicuspids at the
      sites of investigation in 16 patients. Two exposures using standardized
      projection conditions were made of each site. The relative position of the
      reference wires on the duplicate radiographs was used to calculate the angular
      difference in the direction of the x-ray beam which occurred between the 2
      exposures. Triplicate measurements allowed the determination of measurement
      error. The angular projection errors were measured in a horizontal and vertical
      direction. The reference wires allowed determination of the angular projection
      errors relative to the filmholder, relative to the dentition and the angular
      error due to the repositioning of the filmholder in the patient's mouth. The
      average projection errors deviated only slightly from zero. The largest deviation
      registered was -0.11 degrees. This applies to the horizontal and vertical
      direction and all relationships. The standard deviations varied between 0.403
      degrees and 0.697 degrees. This applies to the standard deviation for all
      relationships in the horizontal, the vertical, and the oblique directions. The
      measuring error found from the triplicate measurements had a standard deviation
      of 0.08 degrees to 0.19 degrees depending on the distance between the reference
      wires. This new system for controlling in vivo projection errors seems to provide
      highly standardized radiographs in vivo. The new measuring system proved to be
      accurate enough to measure the in vivo projection errors between repeated
      radiographs produced with the new filmholder and x-ray beam manipulator. The in
      vivo errors produced by the new system are markedly smaller than all in vivo and
      in vitro errors previously reported in the literature.

PMID- 1753321
TI  - The use of a synthetic skin substitute as a physical barrier to enhance healing
      in human periodontal furcation defects: a follow-up report.
AB  - The purpose of this investigation is to compare the clinical response of guided
      tissue regeneration using a synthetic wound dressing with open flap debridement
      versus open flap debridement alone in the treatment of human furcation defects.
      The study group was composed of 19 patients with moderate to advanced adult
      periodontitis and at least one bilateral pair of Class II molar furcation
      defects. After the hygiene phase of therapy was completed, measurements were made
      with calibrated periodontal probes of the clinical attachment levels, probing
      depths, and soft tissue recession. Paired sites were randomly selected for
      treatment with either open flap debridement alone (control) or open flap
      debridement and placement of the synthetic wound dressing over the furcation
      (experimental). At the time of surgery, measurements of vertical and horizontal
      open probing attachment were recorded. The dressing was removed 5 to 6 weeks post
      surgery. The sites were reentered at 6 months to evaluate healing and to repeat
      all measurements. Statistical comparisons using the Wilcoxon Sign Rank Test were
      made between the control and experimental sites. The results of 19 pairs of Class
      II molar furcation defects reveal statistically significant differences between
      the experimental and control sites in attachment levels, probing depths, and
      horizontal open probing attachment. These differences were of such small
      magnitude that they may not be clinically relevant. There were no other
      significant differences for any other clinical parameter, and none of the
      furcations in either group was completely closed.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1753322
TI  - Histologic comparison of regeneration in human intrabony defects when osteogenin
      is combined with demineralized freeze-dried bone allograft and with purified
      bovine collagen.
AB  - A bone-inductive protein, osteogenin, has been isolated from long bones of humans
      and offers promise as a grafting material. Studies, however, suggest that
      osteogenin must be combined with a bone-derived matrix in order to initiate bone
      differentiation. The purpose of this study was to determine if osteogenin
      combined with demineralized freeze dried bone allograft (DFDBA), a bone-derived
      matrix, and with a bovine tendon-derived matrix will enhanced regeneration of
      intrabony defects in humans. The tendon-derived matrix and DFDBA used alone
      served as controls. The ability of each material to form a new attachment
      apparatus was evaluated independently in submerged and nonsubmerged environments
      in 2 patient populations. Lymphocyte testing was performed to assess development
      of an immune reaction to osteogenin. The most apical level of calculus on the
      root served as the histologic reference point to measure regeneration. Biopsies
      were obtained at 6 months and regeneration was measured histomorphometrically by
      2 blinded evaluators. Serial sections from 36 submerged defects in 8 patients and
      50 nonsubmerged defects in 6 patients were submitted for statistical analysis.
      Mean results indicate that osteogenin combined with DFDBA significantly enhanced
      regeneration of a new attachment apparatus and component tissues in a submerged
      environment. DFDBA plus osteogenin and DFDBA alone formed significantly more new
      attachment apparatus and component tissues than either the tendon-derived matrix
      plus osteogenin or the tendon-derived matrix alone in both submerged and
      nonsubmerged environments. There were no significant differences between the
      tendon-derived matrix plus osteogenin and the tendon-derived matrix alone in
      either the submerged or nonsubmerged environment. Osteogenin does not impair
      normal lymphocyte blastogenesis at 6 months postsurgical challenge.

PMID- 1753323
TI  - Guided tissue regeneration for implants placed into extraction sockets: a study
      in dogs.
AB  - Twelve 10 mm implants were placed into immediate extraction sockets in dogs. Six
      implants were isolated with PTFE membranes and 6 sites served as controls.
      Standardized clinical measurements were taken at test and control sites. At 18
      weeks the dogs were anesthetized and flaps were laid for the purpose of obtaining
      clinical measurements. The average gain of bone around augmented implants was 2.6
      mm, while control sites had an average bone gain of 1.0 mm. Ridge width adjacent
      to augmented sites increased by 1.2 mm and control sites had an increased width
      of 0.6 mm. Histologic evaluation of test and control specimens showed greater
      bone formation around augmented implants. Implants augmented with PTFE membranes
      had clinically significant amounts of bone regeneration when compared with
      controls.

PMID- 1753324
TI  - Effects of the platelet-derived growth factor/insulin-like growth factor-I
      combination on bone regeneration around titanium dental implants. Results of a
      pilot study in beagle dogs.
AB  - The purpose of this study was to evaluate the early wound healing events of bone
      around press-fit titanium implants inserted with and without the concurrent
      application of a combination of platelet-derived growth factor (PDGF) and insulin
      like growth factor (IGF-I). Nine months prior to implant placement all mandibular
      premolar teeth were extracted in 8 beagle dogs. Subsequently, 40 specially
      manufactured titanium implants with 2 transverse holes in the apical section were
      press fit into precise recipient sites in the dogs' mandibles. The dogs were
      sacrificed at 7 and 21 days following implant placement yielding 12 PDGF-B/IGF-I
      treated and 8 control (placebo gel or non-treated) implants for each observation
      period. Coded undecalcified sections were analyzed for: 1) percentage of implant
      surface in contact with new bone; 2) percentage of peri-implant space filled with
      new bone; and 3) percentage of implant hole filled with new bone. An analysis of
      variance was used to determine significant differences among the treatment
      groups. At 7 days, the percentage of bone fill in the peri-implant spaces and the
      percentage of implant surface in contact with new bone were both significantly
      increased in PDGF-B/IGF-I treated sites (P less than 0.01 for both groups). There
      was less than 1.5% fill of the implant holes in both treated and control sites
      (no significant differences). At 21 days the percentage of bone fill in the peri
      implant spaces was significantly increased in the PDGF-B/IGF-I treated sites (P
      less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753325
TI  - Aging and attitude change.
AB  - Social psychologists have proposed a variety of different models to account for
      people's relative openness to attitude change through the life cycle. Two of the
      most important models are the impressionable years model, which suggests an
      especially great openness to change among the young, and the lifelong openness
      model, which suggests that age is unrelated to openness to attitude change. Two
      studies were conducted to examine the openness of people of varying ages to
      attitude change. In both studies, the influence of personal experiences with
      government agencies on attitudes toward government was examined. The attitudes of
      older people changed as much or more in response to their personal experiences as
      did those of younger people. These results support the lifelong openness model of
      attitude change.

PMID- 1753326
TI  - The accuracy-confidence correlation in eyewitness testimony: limits and
      extensions of the retrospective self-awareness effect.
AB  - This research extended Kassin's (1985) finding that retrospective self-awareness
      (RSA) increases the correlation between eyewitness accuracy and confidence. In
      Experiment 1, 91 mock witnesses saw a crime, answered questions, made an
      identification decision, and rated their confidence. RSA increased the accuracy
      confidence correlation for witnesses who made an identification and for those who
      were high but not low in public self-consciousness. A 2nd experiment varied
      accountability and revealed that high accountability increased the accuracy
      confidence correlation but that the RSA effect occurred even under low
      accountability conditions. In both studies, observers could not distinguish
      between accurate and inaccurate witnesses. Together, these findings define the
      limits of the RSA effect and provide mixed support for a self-perception account
      of this effect.

PMID- 1753327
TI  - Affective influences on partner choice: role of mood in social decisions.
AB  - Does mood influence our information search and decision strategies when choosing
      a partner? In Experiment 1 (N = 60), sad Ss preferred rewarding to competent
      partners and remembered information supporting that choice better. In Experiment
      2 (N = 96), mood effects on information selectivity, decision speed, and
      processing strategy in partner choices were found. In Experiment 3 (N = 42), a
      computerized stimulus presentation revealed mood-induced differences in the
      latency, self-exposure, and eventual recall of interpersonal information. These
      results are interpreted as evidence for mood-induced selectivity in information
      search and decision strategies when making realistic partner choices. The
      implications of the findings for research on interpersonal relations and for
      contemporary affect-cognition theories are considered.

PMID- 1753328
TI  - Socioemotional behavior and satisfaction in marital relationships: a longitudinal
      study.
AB  - The interplay between 3 types of socioemotional behavior (affection, sexual
      interest, and negativity) and marital satisfaction was studied using data from
      newly married couples followed over 2 years. Affection and negativity (but not
      sexual interest) were consistently associated cross-sectionally with marital
      satisfaction. Longitudinal analyses revealed a gender-differentiated pattern
      suggesting a more complex relationship between satisfaction and marital behavior
      than previously shown. Negativity, regardless of whether it was expressed by the
      husband or the wife, was associated with declines in wives' (but not husbands')
      satisfaction. Wives of husbands who were relatively negative early in marriage
      became more negative themselves. Wives who were relatively less satisfied early
      in marriage (but not husbands) were married to spouses who became more negative
      with time.

PMID- 1753329
TI  - Do conversational hand gestures communicate?
AB  - In 5 experiments, male and female undergraduates viewed gestures and tried to
      select the words that originally accompanied them; read interpretations of
      gestures' meanings and tried to select the words that originally had accompanied
      them; tried to recognize gestures they previously had seen, presented either with
      or without the accompanying speech; and assigned gestures and the accompanying
      speech to semantic categories. On all 4 tasks, performance was better than chance
      but markedly inferior to performance when words were used as stimuli. Judgments
      of a gesture's semantic category were determined principally by the accompanying
      speech rather than gestural form. It is concluded that although gestures can
      convey some information, they are not richly informative, and the information
      they convey is largely redundant with speech.

PMID- 1753330
TI  - Psychological determinants of health and performance: the tangled web of
      desirable and undesirable characteristics.
AB  - Correlations were determined for male (n = 225) and female (n = 242) college
      students between sets of undesirable personality traits (anxiety, stress
      reactivity, anger, and alienation) and desirable personality traits
      (instrumentality, achievement strivings, and optimism measured by the Scheier
      Carver [1987] Life Orientation Test), and a series of outcome variables related
      to health (self-reported health complaints and health maintenance behaviors and
      beliefs) and academic performance (academic expectations and actual grade point
      average). Significant correlations were found between many of the personality
      variables and the outcome variables. However, partial correlations revealed
      different relationships for the various criteria. With other variables held
      constant, health complaints were related to several undesirable characteristics,
      whereas health maintenance behaviors and beliefs were related to several
      desirable attributes. Only achievement strivings made an independent contribution
      in both sexes to the 2 measures of academic performance. The theoretical and
      methodological wisdom of using measures of multiple personality constructs and
      outcome variables is discussed.

PMID- 1753331
TI  - Nonverbal display of emotion in public and in private: self-monitoring,
      personality, and expressive cues.
AB  - Individual differences in the expression and regulation of emotion are important
      components of social skill. The present study focused on the concealing of
      spontaneous expressions of happiness after winning in a competitive situation
      against peers. In a repeated measures design, spontaneous expressive behaviors in
      response to triumph were secretly videotaped when Ss (N = 38) were alone in a
      room and when they were with 2 fellow competitors (confederates). Edited tapes
      were analyzed by naive raters and trained coders. As predicted, the social
      context strongly influenced the expressive behaviors of Ss, providing support for
      a social inhibition effect. More important, the self-monitoring construct
      (Snyder, 1987) was helpful in explaining individual differences in expressive
      regulation, with high self-monitors being successful at hiding their happiness
      when appropriate; and they did so in particular ways. Low self-monitors did not
      conceal their emotions. Other findings with regard to personality and sex
      differences were also uncovered.

PMID- 1753332
TI  - Factor influencing suicide intent in gay and bisexual suicide ideators: differing
      models for men with and without human immunodeficiency virus.
AB  - Of 778 gay and bisexual men (none with acquired immunodeficiency syndrome
      [AIDS]), 27% (n = 212) reported suicidal ideation over the previous 6 months.
      Covariance structure models were used to explore predictors of suicide intent
      among (n = 112) suicide ideators with (n = 100) and without (n = 112) human
      immunodeficiency virus (HIV). Current AIDS-related stressors (deaths and
      illnesses and perceived AIDS risk) and past levels of adaptive functioning
      (social isolation and depression) were significantly more powerful predictors of
      suicide intent among HIV-positive than among HIV-negative ideators. Biological
      AIDS risk predicted neither suicide intent, current distress, nor perceived AIDS
      risk. Pathways to suicide intent appear to be psychologically, rather than
      biologically, mediated. Among HIV-positive ideators, AIDS-related death and
      illness events predicted suicide intent but not current distress symptoms. Some
      suicidal ideation in response to AIDS-related events may be an effort to cope
      rather than a manifestation of psychological distress.

PMID- 1753333
TI  - Constructive thinking and coping with laboratory-induced stress.
AB  - In a laboratory stress test, poor constructive thinkers produced more negative
      affective and cognitive responses in all experimental periods and a greater
      increase in such responses in the stress period than did good constructive
      thinkers. The groups differed in physiological arousal in the recovery period but
      not in the stress period. Stressor-instigated negative thoughts and spontaneous
      negative thoughts produced different patterns of relations with variables
      measured in the laboratory and with symptoms reported in everyday life.
      Discriminating patterns of relations were found between measures of cognition and
      affect in the laboratory and self-reported emotional, physical, and behavioral
      symptoms in everyday life. The results help explain the relation between
      maladaptive automatic thinking, on the one hand, and elevated physiological
      arousal and emotional, physical, and behavioral symptoms, on the other.

PMID- 1753334
TI  - Coping success and its relationship to psychological distress for older adults.
AB  - The role of coping success on psychosocial distress was investigated in 147 older
      adults who experienced a major health problem and 82 older adults who reported a
      major loss in the past 6 months. Home interviews provided data on satisfaction
      with coping efforts and negative changes associated with events. Significant
      predictors of coping success were identified and controlled for in subsequent
      analyses predicting mental health. Efficacy in coping with loss was associated
      with less psychological distress. Coping efficacy interacted with coping efforts
      in predicting distress for those with health downturns; efficacy in coping was
      associated with less distress only for those who were actively engaged in coping.
      Analyses of longitudinal data replicated the cross-sectional findings for coping
      with loss.

PMID- 1753335
TI  - Differentiated additive androgyny model: relations between masculinity,
      femininity, and multiple dimensions of self-concept.
AB  - Masculinity (M) and femininity (F) were related to multiple dimensions of self
      concept in 2 large studies. Androgyny theory predicts that M and F contribute
      positively to self-concept, but the effect of F has been nil in research using
      global self measures. Here, consistent with the new differentiated additive
      model, the relative contribution of M and F varied substantially, depending on
      the area of self-concept; F contributed more positively to self-concept facets
      that were more stereotypically feminine. Support for the model was consistent
      across self-responses and responses by significant others (Study 1) and across 5
      age groups in early-to-middle adolescence (Study 2).

PMID- 1753336
TI  - Relation between social problem-solving ability and subsequent level of
      psychological stress in college students.
AB  - A prospective design was used to examine the relation between social problem
      solving ability and later psychological stress in college students during the
      first semester of the academic year. A new social problem-solving inventory
      measured not only general ability, but also more specific components of the
      problem-solving process (e.g., problem orientation, problem-solving skills;
      D'Zurilla & Nezu, 1990). The results of a hierarchical multiple regression
      analysis showed that general problem-solving ability was negatively related to
      later stress, even after prior stress level and number of life problems were
      controlled. More specific analyses indicated that subjects' problem orientation
      was a better predictor of stress than their problem-solving skills. Results are
      discussed in terms of the possible stress-reducing effects of perceived control
      and successful problem resolution.

PMID- 1753337
TI  - Postexposure chemoprophylaxis with ZDV or ZDV combined with interferon-alpha:
      failure after inoculating rhesus monkeys with a high dose of SIV.
AB  - Presently, no information is available regarding the efficacy of chemoprophylaxis
      in controlled human trials following accidental exposure to the human
      immunodeficiency virus (HIV). Using the closely related simian immunodeficiency
      virus (SIV) in rhesus monkeys, which develop a disease closely resembling human
      AIDS, we tested the efficacy of either single-agent 3'-azido-3'-deoxythymidine
      (ZDV) or the combination of ZDV plus recombinant human interferon-alpha (IFN
      alpha). Treatment was started 3 h following inoculation of a high dose of SIV and
      continued for 21 days. SIV-inoculated control animals remained untreated. Virus
      was recovered from all monkeys on day 8, and by week 7 all had seroconverted. In
      contrast to monkeys treated with ZDV alone, animals given combination therapy had
      lower levels of p27 gag antigen compared to untreated controls on day 8 (p =
      0.043). We conclude that neither treatment regimen could prevent infection after
      high-dose virus exposure; however, combination therapy may have depressed the
      level of virus replication more effectively than ZDV alone.

PMID- 1753338
TI  - Porphyria cutanea tarda in human immunodeficiency virus-seropositive men: case
      report and literature review.
AB  - Porphyria cutanea tarda (PCT) is a disorder of heme synthesis characterized by
      (a) a diminished activity of uroporphyrinogen decarboxylase biochemically and (b)
      cutaneous lesions secondary to a delayed type of photosensitivity clinically. A
      human immunodeficiency virus (HIV)-infected patient with PCT is reported and the
      world literature is reviewed. To date, 17 HIV-seropositive men with PCT have been
      described. The initial appearance of PCT occurred before or concurrent with the
      diagnosis of HIV infection in 71% of these individuals (12 men). The median age
      at onset of PCT was 36 years (range of 20 to 69 years); the median age for the
      detection of HIV infection was 35 years (range of less than 20 to 71 years). All
      of these patients had elevated levels of urine porphyrins and blisters on their
      dorsal hands. Abnormal liver function tests, erosions, hyperpigmentation,
      hypertrichosis, and skin fragility were also present in some of the men.
      Polycythemia, serologic evidence of increased iron stores, scarring, milia, and
      sclerodermoid changes were rarely observed. Successful therapeutic approaches for
      PCT in men with HIV infection included (a) elimination of PCT-precipitating
      agents, (b) avoidance of sun exposure, and (c) periodic phlebotomy. Multiple
      hypotheses for an etiologic role of the HIV and/or an HIV-associated infection,
      directly or indirectly, in the pathogenesis of PCT in HIV-seropositive men have
      been suggested.

PMID- 1753339
TI  - Sequential measurement of beta 2-microglobulin levels, p24 antigen levels, and
      antibody titers following transplantation of a human immunodeficiency virus
      infected kidney allograft.
AB  - A renal allograft recipient developed symptoms suggestive of AIDS. Serological
      studies revealed that the donor was positive for human immunodeficiency virus
      (HIV). Retrospective testing of stored sequential serum samples showed that the
      recipient was negative for HIV pretransplant; anti-p24 and anti-p41 antibodies
      appeared 10 and 49 days posttransplant, respectively. The recipient's serum beta
      2-microglobulin levels were elevated 14 days posttransplant, with normal renal
      function, 35 days before the detection of anti-p24 antibody. p24 Antigen was
      detected for the first time 21 days posttransplant. In addition to p24 antigen,
      elevated serum beta 2-microglobulins may be a useful marker for HIV infection
      prior to seroconversion.

PMID- 1753340
TI  - Association of vitamin B6 status with parameters of immune function in early HIV
      1 infection.
AB  - Nutritional deficiencies have been documented to affect immune function. The
      present study indicates that vitamin B6 deficiency is prevalent in CDC stage III
      HIV-1-infected subjects, despite adequate dietary vitamin B6 intake. As vitamin
      B6 deficiency has been previously shown to affect immune function, these
      relatively asymptomatic HIV-1-infected patients were examined for evidence of a
      relationship between vitamin B6 deficiency and immune dysregulation. Vitamin B6
      status in HIV-1-infected subjects was significantly associated with functional
      parameters of immunity [multivariate F(3,36) = 3.70, p less than or equal to
      0.02]. Additional analyses indicated that overtly deficient participants
      exhibited significantly decreased lymphocyte responsiveness to the mitogens
      phytohemagglutinin and pokeweed, and reduced natural killer cell cytotoxicity,
      compared to subjects with clearly adequate vitamin B6 status (chi 2 = 8.78, df =
      3, p less than 0.04). Vitamin B6 status was not related to immune cell
      subpopulations, e.g., CD4, CD8 cell number, or level of serum immunoglobulins.
      The results of this study indicate that while vitamin B6 status is not a primary
      etiological factor in HIV-1-related immunological dysregulation, it appears to be
      an important cofactor of immune function.

PMID- 1753341
TI  - The response of American women to the threat of AIDS and other sexually
      transmitted diseases.
AB  - Using data from the National Survey of Family Growth, we observe that large
      numbers of American women say that they are responding to the rising danger of
      AIDS and other sexually transmitted diseases. Among the changes reported in the
      1988 National Survey of Family Growth are use of condoms, sexual relations with
      fewer partners, reduced frequency of sexual intercourse, changes in specific
      sexual activities, and avoidance of sex with unknown men, bisexual men, and
      intravenous drug users. Interviews with a sample of the 51 million sexually
      active women aged 15-44 in the United States show that 28% report either that
      they have adopted less hazardous sexual practices or that their partners have
      used condoms to prevent disease. Among women exposed to higher risk of disease,
      the response is even greater: among unmarried women with five or more lifetime
      partners, 65% report modified behavior or condom use. Most of these changes
      occurred after the women heard of AIDS. However, there are still many women who
      report doing nothing to protect themselves against infection despite sexual and
      contraceptive behavior that appears to put them at high risk.

PMID- 1753342
TI  - HIV infection and AIDS risk behaviors among intravenous drug users entering
      methadone treatment in selected U.S. cities.
AB  - To assess trends in HIV infection and AIDS risk behaviors among intravenous drug
      users (IVDUs), a series of nonblinded point-prevalence surveys was conducted with
      admissions to methadone treatment in seven areas, including New York City;
      Trenton and Asbury Park, New Jersey; Baltimore; Chicago; San Antonio, Texas; and
      Los Angeles County between February and December 1987 (n = 713), January and June
      1988 (n = 1,089), July and December 1988 (n = 932), and January and June 1989 (n
      = 1,110). Over the 2-year period, significant changes in HIV seropositivity
      levels were found in only one of the seven cities (Chicago, with levels
      increasing from 8.4 to 14.7%). High levels of AIDS risk behaviors (frequency of
      injection, needle sharing, needle cleaning, and use of shooting galleries) were
      found in all cities. Comparisons of trends in recent risk behaviors (past year)
      within cities suggest that relatively little reduction in AIDS risk behaviors had
      occurred during the study.

PMID- 1753343
TI  - Risk factors for HIV-2 infection in Guinea-Bissau.
AB  - To define the epidemiology of HIV-2 infection, we conducted a case-control study
      among hospitalized patients at an acute care hospital in Bissau, Guinea-Bissau, a
      country with endemic HIV-2 infection. Among 128 patients with various diagnoses,
      23 (18%) were positive for HIV-2 by ELISA and Western blot. One of these patients
      was serologically reactive for HIV-1 also, but PCR and viral culture revealed the
      presence of HIV-2 only. To study risk factors, behaviors, and AIDS knowledge
      related to the acquisition of HIV infection, 22 HIV-2-seropositive and 21
      seronegative hospitalized patients were given a physical examination and
      administered a questionnaire. Among women, transfusion was associated with HIV-2
      infection (OR = 14.4, p = 0.02); among men, sex with a prostitute was the
      principal risk factor (OR = undefined, p = 0.02). Although 79% of HIV-infected
      patients and controls had heard of AIDS, only 17% of all study participants and
      50% of males reporting sex with prostitutes had used condoms in the previous
      year. These data suggest that the risk factors for HIV-2 infection are similar to
      those for HIV-1 and support previous studies showing that HIV-2 is the
      predominant HIV in Guinea-Bissau. Efforts to decrease transmission of HIV-2
      should include screening for HIV-2 in blood for transfusion in endemic areas (now
      done in Bissau) and education about the risk of sexual transmission.

PMID- 1753344
TI  - Triple therapy with vinblastine, interferon-alpha 2a and zidovudine for AIDS
      related Kaposi's sarcoma.

PMID- 1753345
TI  - HIV-related autoimmune hemolytic anemia: good response to zidovudine.

PMID- 1753346
TI  - Community-acquired pneumonia with penicillin-resistant pneumococci in a patient
      with AIDS.

PMID- 1753347
TI  - HIV-1 transmission by a heterosexual man treated with zidovudine.

PMID- 1753348
TI  - Oral Candida and Enterobacteriaceae in HIV-1 infection: correlation with clinical
      candidiasis and antimycotic therapy.
AB  - Oral swabs of 73 HIV-1 infected men (32 under conditions of antimycotic treatment
      (43.8%)) and 58 controls were cultured for Candida species and
      Enterobacteriaceae. In Group A without antimycotics, yeasts were isolated from
      35/41 swabs (85.4%) (range 2 x 10(1) - 4 x 10(6) cfu/ml). In Group B with
      antimycotics, yeasts were cultured from 27/32 swabs (84.4%) (4 x 10(1) - 1 x
      10(6) cfu/ml). Oral Enterobacteriaceae (o.e.) were grown from 22% of the swabs of
      both Group A (2 x 10(1) - 2 x 10(6) cfu/ml) and Group B (4 x 10(1) - 1.6 x 10(6)
      cfu/ml). Growth of o.e. and yeasts (2 x 10(3) - 4 x 10(6) cfu/ml). Correlation
      between yeasts and o.e. were isolated in 14% (2 x 10(1) - 6.4 x 10(6) cfu/ml).
      Correlation between yeasts species to local and systemic treatment deserves
      further investigations.

PMID- 1753349
TI  - Recurrent aphthous ulceration and food sensitivity.
AB  - Forty patients with recurrent aphthous ulceration (RAU) were investigated to
      ascertain the possibility of food sensitivity being a significant precipitating
      factor in their recurrent oral ulceration. All patients were hematologically
      normal and did not respond to vitamin B1 and B6 therapy. Patch testing (Standard
      European Series) was undertaken in 21 patients. Twenty patients showed a positive
      reaction to a number of substances which were considered clinically relevant.
      Professional advice on avoidance of the allergen was given, resulting in an
      improvement in eighteen patients. It is concluded that food sensitivity and
      allergies to other substances should be considered as an etiologic factor in
      hematologically normal patients with recurrent oral ulceration.

PMID- 1753350
TI  - Gliadin antibodies identify gluten-sensitive oral ulceration in the absence of
      villous atrophy.
AB  - This study demonstrates gluten-sensitive recurrent oral ulceration (ROU) in the
      absence of gastrointestinal abnormalities which is associated with a humoral
      response to wheat protein. Ten patients with severe ROU were investigated; all
      had normal small intestinal biopsies. Four patients had raised levels of
      antibodies to alpha gliadin, a wheat protein fraction; in three of these four,
      the ulceration remitted on treatment with a gluten-free diet (G.F.D.) and
      relapsed on gluten challenge. None of the remaining six patients had raised alpha
      gliadin antibody (AGA) levels and none responded to G.F.D. Thus raised AGA levels
      can be used to identify patients with ROU who are likely to respond to a GFD.

PMID- 1753351
TI  - Creatine kinase isoenzymes activity in serum and buccal pouch tissue of hamsters
      during DMBA-induced squamous cell carcinogenesis.
AB  - The sequential changes of creatine kinase (CK) isoenzyme activity in serum and
      hamster buccal pouch tissue (HBPT) of normal, premalignant, and malignant stages
      during 13 wk of DMBA induced hamster buccal pouch squamous cell carcinogenesis,
      were studied. We found that the total CK activity in both serum and HBPT of the
      DMBA painted groups increased during the premalignant period (3-7 wk), with the
      peak being at 7 wk, while declining in the malignant period (9-13 wk). No
      significant difference in the serum and HBPT CK-MM, CK-MB and CK-BB activity, in
      DMBA-induced carcinogenesis, could be established. However, the macro CK type 2
      (MCK-2), a cathodically migrating atypical creatine kinase isoenzyme, initially
      appeared in the sera and tissues of the 3rd wk DMBA-treated group. Its activity
      gradually increased during the premalignant and malignant stages, paralleling the
      increasing number of DMBA applications. There was a correlation between the
      degree of differentiation, and the size and number of the induced tumors with MCK
      2. No MCK-2 could be detected in any of the sera or tissues of the control, nor
      in the 1st wk DMBA-treated group. We propose that MCK-2 is a potential tumor
      marker in oral malignancy and its presence may provide valuable information for
      early diagnosis of a possibly premalignant transforming oral lesion.

PMID- 1753352
TI  - An investigation of parotid gland function and histopathology in autoimmune
      disease-prone mice of different age groups.
AB  - This work aimed to characterize parotid gland function in autoimmune disease
      prone murine strains (MRL/n, MRL/l and NZB/W) in relation to increasing age and
      to relate the extent of functional impairment to the intensity of histopathologic
      changes observed at the different ages. Pilocarpine-stimulated parotid saliva was
      collected to assess salivary flow rate and composition. Parotid tissue was then
      removed for histopathologic assessment. Parotid flow rates were not significantly
      reduced in autoimmune strains compared to controls but were reduced with age in
      NZB/W mice and in males of the C57 (control) strain. Age-related salivary
      compositional changes were present in MRL/l mice and in male NZB/W mice. Focal
      lymphocytic adenitis increased with age in prevalence and intensity in both
      sexes. The functional and histopathologic changes were not closely correlated.
      These results suggest that the parotid gland of autoimmune disease-prone mice
      provides only a poor replication of the salivary changes in human Sjogren's
      syndrome. Nevertheless, both the functional and histopathological changes
      developing in these strains, even though of limited extent, are significantly
      influenced by age.

PMID- 1753353
TI  - Healing of pulp exposures: an ultrastructural study.
AB  - The fine structure of tissue changes during the first 14 days following pulp
      exposure and capping with a hard setting Ca(OH)2 cement has been studied. The
      early changes included hemorrhage and moderate inflammation which were largely
      resolved during the first week. During the second week differentiation of cells
      occurred at the wound surface. These cells had the characteristic features of
      odontoblasts and formed a predentin-like collagen matrix. The capping material
      was closely adapted to cellular structures at the wound surface or to the
      predentin-like matrix at all observation periods. Dentin fragments displaced into
      the pulp tissue during cavity preparation, acted as sites for pulp stone
      formation.

PMID- 1753354
TI  - Leukocytoclastic vasculitis (anaphylactoid purpura): a unique occurrence in the
      oral cavity.
AB  - Leukocytoclastic vasculitis, immune complex disorder (type III), is a skin
      disease with both an acute form characterized by bullae, vesicles and
      ulcerations, and a chronic form characterized by petechiae, macules and
      ulcerations. The disease presents certain systemic features including diffuse or
      focal glomerulonephritis and renal failure. The histopathologic characteristics
      of leukocytoclastic vasculitis in the skin appear primarily in small blood
      vessels and consist of an infiltration of inflammatory cells, leukoclasis,
      swelling of endothelial cells, occlusion of blood vessels, accumulation of fibrin
      and fibrinoid degeneration, as well as the presence of immune complexes in and
      around blood vessel walls. Although leukocytoclastic vasculitis is described as
      several diseases which can spread systemically, including the gastrointestinal
      tract and the kidneys, the manifestations of the disease in the oral cavity have
      not yet been reported. The present paper reports unique oral lesions in a 38-yr
      old woman, diagnosed as leukocytoclastic vasculitis, without any accompanying
      skin or systemic lesions.

PMID- 1753355
TI  - Epstein syndrome: oral lesions in a patient with nephropathy, deafness and
      thrombocytopenia.
AB  - Epstein syndrome is a rare dominantly inherited disorder in which the main
      features are nephritis, deafness and macrothrombocytopathic thrombocytopenia. A
      case with oral haemorrhage and purpuric lesions is reported. This appears to be
      the first report of this syndrome in the dental literature.

PMID- 1753356
TI  - Rieger's syndrome.
AB  - Rieger's syndrome which is a congenital progressive, autosomally dominant,
      ophthalmic anomaly has certain associated somatic dentofacial and systemic
      features. These extra dentofacial and systemic findings can play very important
      role in diagnosing this syndrome so as to prevent the ocular complications. This
      article reports such a case in a 20-yr-old woman and discusses somatic features
      along with the clinical importance of early diagnosis.

PMID- 1753358
TI  - [Armageddon].

PMID- 1753357
TI  - Ameloblastic fibro-odontomas in animals.

PMID- 1753359
TI  - [Echo-endoscopy and cancer of the esophagus].

PMID- 1753360
TI  - [Scapulo-humeral periarthritis. From the clinical to the imaging aspect].

PMID- 1753361
TI  - [Gradient echo sequences in the diagnosis of inferior vena cava thrombosis].
AB  - The capability for studying noninvasively vessels has been dramatically improved
      with the use of gradient echo sequences. Twenty-one patients presenting a
      suspected inferior vena cava obstruction on cavography underwent MR examination
      with axial, sagittal and coronal gradient echo images. Eighteen patients were
      also imaged with ultrasound and/or CT. Gradient echo sequences visualized a
      thrombus in 19 cases and a normal vein in the remaining 2 cases. The potential MR
      pitfalls are illustrated and the two cases of false positive on cavography are
      discussed. Gradient echo sequences allow a fast and performant examination of the
      vessels.

PMID- 1753362
TI  - [Disk highlighting after injection in MRI. Macroscopy and histology of 25
      postoperative recurrences].
AB  - 400 cases of failed back syndrome were examined with MRI in a prospective study
      (SE w Rho and T2, SE wT1 before and after injection of paramagnetic contrast
      agent in axial and sagittal planes). After second time surgery, 70 cases of
      herniated disks were found. 25 herniated disks were studied in microscopy and
      results correlated with enhanced herniated disks. Authors describe 4 types of
      enhancement: veinous plexus (5/24), inflammatory or granulomatous tissue (12/24),
      degenerative disc with fibrosis (5/24) and osteophytosis (2/24). The criterions
      of each pattern are described.

PMID- 1753363
TI  - [Intradural metastases of visceral cancers. MRI aspects. Apropos of 2 cases].
AB  - The authors report two cases of intradural metastasis: a man with
      bronchopulmonary cancer suffering from left L5 sciatic pain and a woman with
      breast cancer whose examination shows motor weakness of both legs. CT was
      negative in the first case. Gadolinium injection on T1 sequence shows in the
      first case small nodular lesions along the roots of cauda equina and in the
      second case linear enhancements around the spine, at different levels. These
      aspects are the most frequently reported. MRI is an innocuous and the most
      sensitive technic for such lesions. An early diagnosis improves the functional
      prognosis. Despite of radiotherapy and chemotherapy, vital prognosis remains bad
      because of widespread of the intradural lesions and their frequent association
      with cerebral metastasis.

PMID- 1753364
TI  - [Color Doppler in breast tumor pathology].
AB  - Colour Doppler findings in a series of 63 cases of breast tumours and 19 cases of
      lymph node enlargements are reported. Colour Doppler signals of abnormal flow are
      found in 68.5 percent of the cancers, in 42.8 percent of metastatic lymph nodes
      and in 10 percent of benign lesions. There was bidirectional flow in 80 percent
      of all the cases. In cases of malignant tumours, the signal was correlated with
      the size and location of the lesions most often found peripherally. Presently,
      this technique appears to be of little value in determining whether a primary
      malignant tumour of the breast is malignant or benign. It does appear to be
      useful, first to follow-up cancers during initial chemotherapy (partial
      regression of the signal and of tumour volume) and secondly, in the diagnosis of
      metastatic lymph nodes with a specificity of 100 percent in our series. Colour
      Doppler is on the contrary difficult to interprete after conservative treatment
      of breast cancer because of post-radiotherapy tissue remodelling.

PMID- 1753365
TI  - [Primary sarcoma of the pulmonary artery].
AB  - On the basis of one personal case of leiomyosarcoma, the various
      anatomicoclinical features of sarcomas of the pulmonary artery are summed up.
      They most often produce a picture of severe pulmonary embolism that is resistant
      to all treatments; the lesion most often is a hilar mass without any associated
      bronchoscopic abnormality. Angiograms are not always easily interpreted, and the
      modern imaging techniques (ultrasound, computed tomography, and above all MRI)
      can best lead to the preoperative diagnosis, although this lesion is unfrequent.

PMID- 1753366
TI  - [X-ray computed tomography in the surveillance of the course of acute
      pancreatitis. Values of a new classification of inflammatory lesions].
AB  - 378 tomodensitometric investigations were performed in cases of acute
      pancreatitis. The evolution of inflammatory lesions were analyzed with special
      attention to tissue aggressive inflammation in order to recognize early signs of
      gravity on CAT scans. Pancreatic lesions less than 15 mm in diameter called
      "hypodense islets-1" are compatible with oedematous lesions while lesions greater
      than 15 mm in diameter ("hypodense islets-2") are characteristic of developing
      necrosis. Tissue aggressive inflammatory lesions were classified in five grades
      retrospectively and showed that the incidence of abcesses was greater in grade II
      (76.5%) than in grade I lesions (11.75%).

PMID- 1753367
TI  - [Localized cancer of the prostate. Correlation between MRI and anatomo
      pathological results after radical prostatectomy].
AB  - Magnetic Resonance Imaging of 20 patients with local prostatic carcinoma was
      correlated with pathological findings after radical prostatectomy. The tumor was
      always seen with an hyposignal, associated in 6 cases with benign prostatic
      hyperplasia. Extracapsular extension was correctly evaluated (17 cases/20). There
      were 6 false positive diagnosis of seminal vesicles extension among 40 cases
      because of an hyposignal in intact vesicles and one false negative diagnosis.
      Magnetic Resonance Imaging is a good exam to appreciate loco-regional extension
      of prostatic carcinoma.

PMID- 1753368
TI  - [Imaging of non-functional retroperitoneal paragangliomas. Apropos of a case].
AB  - The non functional extraperitoneal paragangliomas are rare tumors (less than 50
      cases reported). We report a case with ultrasound and CT scan imaging. The tumor
      is usually large with important necrotic areas leading to a cystic aspect. The
      malignant tumors more frequent than the benign tumors present with a regional
      extension and delayed metastasis.

PMID- 1753369
TI  - Free microvascular fibular transfer for idiopathic femoral head necrosis: long
      term follow-up.
AB  - The authors discuss free microvascular bone transfers in general, and propose a
      new classification for idiopathic femoral head necrosis. They then present a
      technique they have been using for 11 years, with the goals of providing both
      mechanical support and an improved blood supply to the femoral head. This
      technique involves clearing the necrotic area of the femoral head, filling the
      area with cancellous bone taken from the greater and lesser trochanters, and
      transferring a fibular microvascular graft. The approach is transtrochanteric and
      spares the capsule. Vascular anastomosis is done with the lateral branches of the
      deep femoral artery, sparing the anterior circumflex artery which is important to
      the blood supply of the femoral head. Forty-five cases have been surgically
      managed over 11 years. Eighteen cases with follow-up longer than five years were
      analyzed, providing an 84 percent successful outcome with both very good and good
      results.

PMID- 1753370
TI  - Nerve regeneration in rat composite-tissue allografts.
AB  - Reinnervation of composite-tissue allografts was examined in a rat hind-limb
      transplant model under Cyclosporin A (CyA) immunosuppression. Two groups of
      animals were studied. Group 1 consisted of 10 composite-tissue allografts using
      inbred Fisher rats (F344) as recipients and inbred Lewis rats (LEW) as donors.
      Recipient animals received 15 mg/kg/day CyA subcutaneously for three weeks and
      then twice weekly for three months. Group 2 consisted of 10 composite-tissue
      isografts undergoing no immunosuppression, and using F344 as both donors and
      recipients. Eight months after operation, electromyographic, histologic, and
      morphometric assessments of nerve regeneration were made. There were no
      significant electromyographic differences between these two experimental groups
      in amplitude and conduction velocity, but the levels were lower than in controls.
      The histologic patterns of nerve regeneration within the composite-tissue
      transfers were similar in the two groups. However, the fiber population in the
      regenerated nerves in the two groups was different from that in the normal
      sciatic nerve. This study confirmed the reinnervation of composite-tissue
      allografts under CyA immunosuppression. The quality of regeneration in allografts
      was similar to that in isografts, but the histologic and electromyographic
      properties of regenerated nerves were different from those of normal sciatic
      nerves.

PMID- 1753371
TI  - The use of a new perfusate in experimental microvascular flaps: a threefold
      increase in ischemic tolerance.
AB  - The benefit of perfusion washout in both experimental and clinical skin flaps has
      long been debated. By perfusing ischemic rat pedicled flaps with UW solution, a
      recently developed, high-molecular-weight, organ-preservation medium, a 170
      percent increase in the critical ischemia time of treated versus untreated
      control flaps was demonstrated. Sixty rats were used in this study. A 3- x 6-cm
      unilateral abdominal skin flap based on the superficial inferior epigastric
      artery and vein was raised. The flaps were divided into three groups: Group 1
      (control--no perfusion washout (n = 15); Group 2 (LR)--perfusion washout with
      lactated Ringer's solution (n = 15); Group 3 (UW)--perfusion washout with UW
      solution (n = 30). Flaps were subjected to varying periods of ischemia, ranging
      between 8 and 30 hr. The primary ischemia time at which 50 percent of the flaps
      survived clinically was 10 hr for Group 1, 15 hr for Group 2, and 27 hr for Group
      3. The differences between the survival rates for flaps in Groups 1, 2, and 3
      were statistically significant (p less than .0005). By bathing the vascular and
      parenchymal cells in an impermeant preservation solution, it was hypothesized
      that cellular swelling would be inhibited, thereby significantly improving a skin
      flap's tolerance to warm ischemia. Furthermore, after reviewing the pertinent
      literature, it is evident that the primary critical ischemia time of 27 hr is the
      highest reported to date for the normothermic experimental rat pedicled flap.
      Clinical application of these findings, as well as the need for further studies,
      are discussed.

PMID- 1753372
TI  - Stented laser-welded vasovasostomy in the rat: comparison of Nd:YAG and CO2
      lasers.
AB  - In 54 male Sprague-Dawley rats, 108 vasovasostomies were performed. Sutureless
      laser welding with the assistance of a removable stent was done using a CO2- and
      an Nd:YAG-laser system. Conventional two-layer microsurgical anastomoses served
      as controls. The Nd:YAG laser resulted in significantly lower patency rates, with
      a higher percentage of sperm granulomas; the CO2 laser produced results
      equivalent to conventional suturing. Sutureless laser welding utilizing a
      removable stent proved to be a time- and cost-saving procedure for
      vasovasostomies in the rat.

PMID- 1753373
TI  - A composite neuro-teno-cutaneous forearm flap in the one-stage reconstruction of
      a large defect of the soft tissue around the ankle.
AB  - The vascular anatomy of the radial forearm flap, incorporating the
      brachioradialis and palmaris tendons together with the superficial radial nerve
      in 20 fresh cadavers, is described. The radial artery in the cadaveric forearm
      was irrigated and injected with blue latex. The number and distribution of the
      cutaneous branches supplying the skin, brachioradialis tendon, palmaris tendon,
      and superficial radial nerve, were then documented in relation to the distance
      from the radiocarpal joint. The radial artery was found to provide adequate blood
      supply to the above structures. This flap has been used as a composite neuro-teno
      cutaneous flap to resurface a large defect involving tendon, nerve, and skin loss
      in the ankle and the foot as a one-stage procedure. This technique avoids
      multiple-staged operations and thus shortens the convalescent period in
      rehabilitation of severely traumatized limbs.

PMID- 1753374
TI  - Complications of the free-flap donor site from a community hospital perspective.
AB  - Techniques for achieving appropriate wound healing with minimal aesthetic or
      functional deformity of the microsurgical flap donor site are often assumed to be
      of minor importance or blatantly overlooked. Surprisingly, an analysis of 115
      consecutive free-tissue transfers by a single surgeon within a community hospital
      setting, revealed an overall donor-site complication rate of 31 percent, with
      significant disability from major complications occurring in 10 percent of cases.
      Recognition of the projected morbidity of alternative donor sites therefore
      deserves scrutiny, with the same intensity as does consideration for flap
      selection, previously done solely to fulfill the requirements of the recipient
      site. While flap viability has previously been the criterion for success, the
      future dictates that morbidity at the donor site be an equally important
      consideration.

PMID- 1753375
TI  - Timing relationships for secondary ischemia in rodents: the effect of
      arteriovenous obstruction.
AB  - The first ischemic insult a tissue suffers is primary (1 degree) ischemia. A
      second ischemic episode, such as thrombosis after free tissue transfer, may be
      regarded as secondary (2 degrees) ischemia. Timing relationships were studied in
      a rodent epigastric-flap model. In a first experiment, the interval between 1
      degree ischemia and 2 degrees ischemia was varied. Flaps which had 2 degrees
      ischemia 12 and 36 hr after the 1 degree episode, had decreased ischemic
      tolerance, compared with 1 degree ischemic flaps; 2 degrees ischemic flaps, after
      an interval of 72 hr, had an ischemic tolerance similar to 1 degree ischemic
      flaps. In a second experiment, the length of the 1 degree ischemia was varied. It
      was found that as little as 5 min of 1 degree ischemia significantly decreased
      the subsequent tolerance of 2 degrees ischemia. The possible clinical
      significance of these results is discussed.

PMID- 1753376
TI  - One-stage repair of both skin and tendon digital defects using the arterialized
      venous flap with palmaris longus tendon.
AB  - A novel technique of composite free-flap and tendon transfer is introduced and
      used in four patients to repair complicated finger injuries involving loss of
      skin and tendon. This is a one-stage procedure, providing unbulky, high-quality
      tissue. Although the final range of motion was disappointing, with an average of
      10 degrees, there is justification for further clinical trials in patients with
      loss of skin and tendon in the digits.

PMID- 1753377
TI  - End-to-side-anastomosis in the dog using the 3M precise microvascular anastomotic
      system: a comparative study.
AB  - In this study, the patency rates, microscopic characteristics, and intraluminal
      dimensions of end-to-side anastomoses in the dog were compared with those of a
      conventional interrupted suturing technique, using the 3M precise microvascular
      anastomotic system. The anastomoses included end-to-side repairs of the saphenous
      artery to the femoral artery, as well as the saphenous vein to the femoral vein.
      The patency and microscopic characteristics of the two techniques were similar,
      but the mechanical coupling system required much less time than the suture
      technique to complete the vascular anastomosis.

PMID- 1753379
TI  - Affinity and conformation of the estrogen receptor when bound to single-stranded
      vs. double-stranded nonspecific DNA.
AB  - The affinity of the hormone-bound estrogen receptor for single-stranded and
      double-stranded DNA was compared using isocratic elution chromatography. The
      receptor bound single-stranded DNA with a two-fold higher affinity than double
      stranded DNA (17.9 x 10(4) M-1 vs. 9.1 x 10(4) M-1) at 0.2 M KCl. The same number
      of ions were released when the receptor bound either single-stranded or double
      stranded DNA (11.8 vs. 10.6, respectively). These results indicate the hormone
      bound estrogen receptor has no strong preference for single-stranded vs. double
      stranded nonspecific DNA, and has a similar conformation when bound to either
      form of DNA at physiological salt concentrations.

PMID- 1753378
TI  - Initial characterization of the nicotinic acetylcholine receptors in rat
      hippocampal neurons.
AB  - The properties of the neuronal nicotinic acetylcholine receptor in primary
      cultures of hippocampal cells from fetal rats (17-18 days gestation) were studied
      using the whole-cell patch-clamp technique in Na(+)-external, Cs(+)-internal and
      nominally Mg(2+)-free solutions. The nicotinic agonists acetylcholine,
      (+)anatoxin-a, and (-) and (+)nicotine all evoked inward whole-cell currents in
      hippocampal neurons that were voltage clamped near their resting potentials.
      Sensitivity to (+)anatoxin-a was first detected at around day 6, and thereafter
      the magnitude of the response increased as a function of number of days in
      culture up to about 40 days. The whole-cell current waveforms consisted of more
      than one peak whose relative amplitude depended on the agonist concentration.
      These currents were reversibly blocked by micromolar concentrations of d
      tubocurarine, mecamylamine, and dihydro-beta-erythroidine. At nanomolar
      concentrations, neuronal bungarotoxin, alpha-bungarotoxin and alpha-cobratoxin
      caused an irreversible blockade of the currents but they were unaffected by
      tetrodotoxin, atropine, DL-2-amino-5-phosphonovaleric acid, Mg2+, and 6,7
      dinitroquinoxaline-2,3-dione. In addition, the currents were also blocked in a
      reversible manner by methyllycaconitine at picomolar concentration. The current
      voltage plots elicited by both (+)anatoxin-a and acetylcholine revealed larger
      inward currents and smaller or no outward currents. The present results
      demonstrate the existence of an inwardly rectifying, snake neurotoxin-sensitive
      functional nicotinic acetylcholine receptor ion channel in rat hippocampal
      neurons.

PMID- 1753380
TI  - Sulfhydryl reagents alter epidermal growth factor receptor affinity and
      association with the cytoskeleton.
AB  - Sulfhydryl (SH) reagents are known to influence the characteristics of many
      ligand-receptor systems. The SH reagent N-ethylmaleimide has been demonstrated to
      interact with EGF receptors, and to inhibit EGF receptor kinase activity. The
      data presented in this paper concern the effect of SH reagents on two intriguing
      features of the EGF receptor system, namely the presence of low and high affinity
      EGF binding sites, and the interaction of EGF receptors with the cytoskeleton. SH
      reagents were observed to induce a disappearance of high, but not low, affinity
      EGF receptors from the cell surface, and an increase in receptor-cytoskeleton
      interaction. Comparison of the effects of membrane-permeant and membrane
      impermeant SH reagents on wild type and structurally modified EGF receptors
      suggested that sulfhydryl groups on the cytoplasmic, rather than the
      extracellular, receptor domain are involved. This indicates that the cytoplasmic
      domain of the EGF receptor plays a role in the high affinity binding of EGF, and
      in the interaction of EGF receptors with the cytoskeleton. Experiments with an
      anti-EGF receptor antibody that specifically blocks the binding of EGF to low
      affinity receptors indicated that EGF induces a shift in the EGF receptor from
      low to high affinity. SH reagents probably affect EGF binding by inhibiting this
      EGF-induced receptor conversion.

PMID- 1753381
TI  - Estrone modulates the EGF receptor in the liver of db/db mouse.
AB  - The genetically diabetic db/db mouse is an excellent model to study the effect of
      diabetes on hormone receptors. The decrease of EGF binding sites could be
      detected in the hepatic microsomes of diabetic mice as early as 3 weeks of age.
      In addition, there was an age-related decrease in the autophosphorylating
      activity of EGF receptor isolated from the liver of diabetic mice. Estrone
      feeding (0.005%) partially restored this autophosphorylating activity. Northern
      blot analysis showed that the hepatic EGF receptor transcripts were dramatically
      decreased during the progression of diabetes and could be reversed by estrone
      feeding. Transfection experiments carried out on HepG2 cells using EGF receptor
      promoter (pERCAT-6) demonstrated that addition of 2 x 10(-8) M estrone stimulated
      chloramphenicol acetyltransferase activity. Our results suggest that estrone
      modulates EGF receptor by enhancing EGF receptor transcripts and the promoter
      activity of this gene.

PMID- 1753382
TI  - Solubilization and sedimentation analysis of muscarinic acetylcholine receptors.
AB  - To investigate if G-protein-receptor interactions can be characterized using
      sucrose density gradients (SDG) we have determined the experimental conditions
      for muscarinic acetylcholine receptor (mAChR) solubilization and analysis on SDG.
      Solubilization of 65-80% of [3H]QNB bound mAChR was accomplished with 1% of
      detergent. Analysis of solubilized receptors on SDG containing 0.4 M KCl and 0.1%
      detergent demonstrated that the physical properties of the receptor-detergent
      complexes are influenced by the solubilizing detergent as well as detergents
      included in the SDG. Neither GTP gamma S nor NaF and AlCl3 altered the
      sedimentation properties of mAChR, suggesting that the solubilized mAChR is no
      longer associated with G-protein under these conditions. Receptors bound to
      [3H]oxotremorine and [3H]QNB had similar sedimentation properties, suggesting
      that, once solubilized, mAChRs do not remain associated with G-proteins. Covalent
      labeling with [3H]PrBCM followed by solubilization and analysis on SDS-gel
      electrophoresis demonstrated the presence of intact receptor molecule. These
      observations suggest that the changes in the sedimentation properties of
      detergent-receptor complexes are independent of G-protein interactions and are
      influenced by the nature of the detergent associated with the mAChR during
      analysis.

PMID- 1753383
TI  - Effect of age on the kinetics of the binding of iodocyanopindolol to a membrane
      preparation of rat lungs.
AB  - The association (k+1) and dissociation (k-1) rate constants, and the equilibrium
      thermodynamic binding parameters (delta G0, delta H0 and delta S0) of the beta
      adrenergic ligand [125Iodo]cyanopindolol (ICYP) were studied in a crude lung
      membrane preparation of rats of different ages. There was no difference in k+1
      values for the different age groups, while the k-1-values were in all cases
      difficult to measure: almost no dissociation of ICYP from its binding site
      occurs. The thermodynamic properties were not affected by age. It is concluded
      that, in these experimental conditions, age has no effect on the kinetic
      parameters of the binding of ICYP to the beta-adrenoceptors in rat lung.

PMID- 1753384
TI  - The alloantibody response of pregnant women and its suppression by soluble HLA
      antigens and anti-idiotypic antibodies.
AB  - The aim of this study was to investigate the time course of maternal
      allosensitization to fetal HLA antigens during normal human pregnancy and to
      explore mechanisms of suppression of anti-HLA alloantibodies. We found that the
      mother produces antibodies against some but not all of the mismatched HLA
      antigens of the fetus as early as the 8th week of pregnancy. These antibodies
      (Ab1), however, are often complexed with soluble HLA alloantigens and become
      detectable when immune complexes are dissociated. Soluble HLA antigens of fetal
      origin are present in the maternal circulation throughout the entire pregnancy
      beginning at 8 weeks. In some women the production of anti-anti-HLA antibodies
      (Ab2) became evident as early as the first trimester, while in others Ab2 was
      documented during the second or third trimester. Analysis of antibody specificity
      showed that some healthy primipara develop antibodies reactive with self HLA
      antigens. Although the allo- and autoantibody responses appear to be modulated by
      soluble HLA antigens, cyclic variations in the level of alloantibodies, as well
      as the mother's selective response to some, but not all, paternal HLA antigens,
      are best explained by the development of anti-idiotypic antibodies.

PMID- 1753385
TI  - IgG asymmetric molecules with antipaternal activity isolated from sera and
      placenta of pregnant human.
AB  - The proportion of symmetric and asymmetric IgG molecules was studied in 10
      mothers at delivery. IgG was obtained from peripheral blood and placental blood
      sera and by elution at 4 M KCl from placenta cell membranes. The percentage of
      symmetric and asymmetric molecules was determined in the IgG and in their
      corresponding F(ab')2 fragments by absorption to Con A-Sepharose. The presence of
      antipaternal antibodies was investigated by IIF and MC tests using paternal
      lymphocytes. The average percentage of asymetric IgG molecules in the sera was
      24.4, which is about double the value of that found in normal subjects. In the
      IgG eluted from the placenta, the proportion of asymmetric IgG was much higher,
      averaging 44.4%. Antipaternal antibodies were detected in 5 mothers by IIF and MC
      and in two mothers only by IIF. In three mothers no antibodies could be detected.
      It was found that the concentration of antipaternal antibodies was about three
      times higher in the asymmetric IgG fraction than in the summetric one.
      Considering the percentage of asymmetric IgG molecules with antipaternal antigen
      specificity eluted from placenta and the possibility that they function as
      blocking antibodies, their participation in fetal protection is suggested.

PMID- 1753386
TI  - Effects of EPF treatment in human mononuclear cells.
AB  - Early Pregnancy Factor (EPF) is one of the earliest pregnancy associated signals,
      communicating the ensuing pregnancy to the maternal organism. Data published by
      others on the mouse suggest that EPF bound to spleen cells causes the release of
      two H2-restricted "suppressor factors" responsible for the rosette inhibiting
      activity of EPF in the rosette inhibition test. Using human material, we were
      able to detect the release of a second entity from mononuclear cells that is able
      to suppress rosette formation in the human rosette inhibition test. In an attempt
      to show an intracellular EPF effect in the target cell, cytosolic free calcium
      concentrations were measured in EPF-treated mononuclear cells from peripheral
      blood. Our findings did not, however, show any changes of intracellular free
      Ca(2+)-concentrations under the chosen conditions.

PMID- 1753387
TI  - Syncytiotrophoblast plasma membrane inhibits membrane expression of activation
      markers on PHA-stimulated human lymphocytes.
AB  - Studies have been carried out on the effects of full-term human
      syncytiotrophoblast plasma membrane (STPM) preparations on the membrane
      expression of the lymphocyte activation markers HLA-DR, IL-2R, TfR and CD69
      during PHA-induced lymphoproliferation. STPM considerably decreases the
      expression of both late (HLA-DR) and early (IL-2R, TfR, CD69) activation markers
      at doses which inhibit PHA-induced lymphoproliferation. These results favour the
      hypothesis that STPM inhibits a very early phase of PHA-induced lymphocyte
      activation.

PMID- 1753388
TI  - Hyporesponsiveness to a GnRH vaccine in a non-responder mouse strain is T-cell
      mediated.
AB  - Immunization of rats and monkeys with the decapeptide gonadotropin releasing
      hormone (GnRH) linked to carriers such as diphtheria toxoid (DT) or tetanus
      toxoid (TT) results in a marked atrophy of the prostate. This vaccine is now
      being explored for its potential in the "immunosurgery" of prostatic hypertrophy
      in men and is currently undergoing Phase I/II clinical trials. We have been
      investigating immunogenetic aspects of immune responses to this hapten-carrier
      conjugate, and in a recent communication we described the responses of different
      strains of mice to GnRH conjugated to DT (GnRH-DT). Mice of the 129 (H-2b) strain
      were found to be non-responders to GnRH. However, further immunization of GnRH-DT
      immunized 129 mice with GnRH linked to an alternate carrier, TT, resulted in the
      production of high levels of anti-GnRH antibodies. This showed that 129 mice are
      not deficient in GnRH-specific B cells and that the lack of response to GnRH in
      129 mice is possibly due to (i) the lack of appropriate helper T-cells or (ii)
      the presence of suppressor cells. In this report we present evidence to support
      the existence of suppressor cells in GnRH-DT-immunized 129 mice.

PMID- 1753389
TI  - Reaction of Candida albicans cells of different morphology index with monoclonal
      antibodies specific for the hyphal form.
AB  - Two monoclonal antibodies (MAbs), 3D9 with reported specificity for Candida
      albicans hyphae, and 3B7 with reported specificity for morphological forms of C.
      albicans found in vivo, were tested by indirect immunofluorescence with C.
      albicans cells that were grown in 12 different environments (four different
      culture media incubated at various temperatures) and whose cellular morphology
      was estimated in terms of morphology index (Mi). Both MAbs reacted strongly with
      cells with Mi greater than 3.0, i.e., with pseudohyphal and hyphal forms, but in
      Eagle's medium at 26 degrees C and in a modified Sabouraud's broth medium at 30
      degrees C, some reactivity was also found with cells of lower Mi (i.e., yeast
      forms). Therefore, it was concluded that the hyphal phenotype and the epitopes
      reactive with the MAbs were co-expressed but that the epitopes could also be
      expressed independently of the hyphal phenotype. The results confirm the
      propensity of C. albicans for variation of its surface antigenic composition.

PMID- 1753390
TI  - Contact-haemolysin production by entero-invasive Escherichia coli and shigellae.
AB  - Entero-invasive Escherichia coli (EIEC) and shigellae were tested for contact
      haemolysin (CH) with red blood cells (RBCs) of guinea-pig, rabbit, rat, mouse,
      monkey, man, sheep and chicken; all bacteria showed the best lysis with guinea
      pig RBCs. The best culture medium for CH activity of shigellae was tryptic soy
      broth, and for EIEC it was casamino acid-yeast extract broth with 1 mM CaCl2. CH
      production by all species was best at the slightly alkaline pH which is optimal
      for growth; it was also dependent on the presence of a large (140-Mda) plasmid.
      Pre-treatment of bacteria with homologous antisera inhibited CH activity. Various
      treatments of bacterial cells and RBCs suggested that CH may be a protein
      molecule, and that a chitotriose-like moiety may serve as CH receptor. RBCs that
      were incubated with bacteria at 4 degrees C, or with heat-killed bacteria at 37
      degrees C, were not lysed; also, isolated cell-surface components
      (lipopolysaccharide and outer-membrane protein) did not lyse RBCs. This suggests
      that metabolically active cells are required for CH activity. Production of CH by
      both EIEC and shigellae is consistent with a common mechanism for the virulence
      of these organisms.

PMID- 1753391
TI  - Surface layers of Eubacterium yurii subsp. yurii and their possible role in test
      tube brush formation and iron acquisition.
AB  - Eubacterium yurii subsp. yurii is an anaerobic, gram-positive rod. On isolation
      E. yurii forms cellular arrangements resembling test-tube brushes (TTB). Although
      TTB decreased in size and number on repeated laboratory subculture in enriched
      media, media poor in available iron enhanced formation of these. Plasmids were
      not demonstrated, even after chloramphenicol enhancement. To characterise the
      nature and possible physiological roles of the structures of the TTB, they were
      examined by transmission electronmicroscopy (TEM) with thin-section, negative
      staining, shadow-casting, freeze-etching and freeze-fracturing techniques, and by
      scanning electronmicroscopy (SEM). Previous studies by phase-contrast microscopy
      revealed an amorphous core, the size of which varied in direct proportion to the
      number of associated bacterial cells. Thin sections of the TTB showed a gram
      positive cell wall with additional surface layers. Negative staining, shadow
      casting and freeze etching revealed a surface layer comprising subunits in
      tetragonal array (P4 symmetry). Shadow casting showed also that the outermost
      layer of the cells was composed of fibrillar structures closely associated with
      but distinct from, the tetragonal layer. The fibrils extended from the cell
      surface in clumps or strands. The presence of these fibrils was confirmed by the
      freeze-fracture technique and SEM. Chemical analysis of the core material of the
      TTB showed it to be low in carbohydrate (0.06%) and protein (0.2%). Energy
      dispersive X-ray spectrometry showed that the core was composed mostly of
      iron.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753392
TI  - Histopathological study of porcine gastric mucosa with and without a spiral
      bacterium ("Gastrospirillum suis").
AB  - Tightly spiralled bacteria ("Gastrospirillum suis") were seen in the pyloric
      mucosa of the stomach of 13 (10.8%) of 120 pigs that appeared clinically healthy
      at slaughter and in the fundic mucosa of three (5.0%) out of 60 pigs. The spiral
      organism could not be cultured from any pig. Chronic gastritis was observed in
      the pyloric mucosa of 53 (44.2%) of 120 pigs and in the fundic mucosa of 7
      (11.7%) of 60 pigs. The 13 pigs with spiral bacteria in the pyloric region
      comprised one animal (7.7%) with normal pyloric mucosa, two (15.4%) with
      "borderline gastritis", and 10 (76.9%) with chronic gastritis--in one instance
      accompanied by signs of activity (numerous polymorphonuclear cells). The three
      pigs with spiral bacteria in the fundic mucosa comprised two animals with a
      normal fundic region and one with "borderline gastritis". The presence of the
      spiral bacterium was significantly associated with pyloric gastritis (p = 0.013)
      and with numbers of lymphoid follicles (p = 0.014).

PMID- 1753393
TI  - Invasion of HEp-2 cells by strains of Salmonella typhimurium of different
      virulence in relation to gastroenteritis.
AB  - Experiments to measure the invasiveness of seven strains of Salmonella
      typhimurium for HEp-2 cells showed that high inocula (100 bacteria/HEp-2 cell),
      as used by most workers to synchronise events and to increase the number of
      bacteria which invade, resulted in recovery of significantly less than 1% of the
      original inoculum after treatment with gentamicin to kill extracellular bacteria.
      Also, the cell culture medium became acidic, and microscopic examination of
      Giemsa-stained monolayers immediately following gentamicin treatment revealed
      high concentrations of bacteria associated with the cells. Moreover, with
      bacterium-cell interaction beyond 2 h, many HEp-2 cells became rounded,
      especially with virulent strains W118 and TML. Thus, the biological significance
      of the quantitative data was uncertain. The fall in pH and the rounding of HEp-2
      cells were prevented by the use of a low (1:1) bacterium: cell ratio; but the
      recovery of bacteria after treatment with gentamicin was still lower than
      expected by microscopic examination. After treatment of cells with Triton X-100
      to release bacteria, many remained bound to residual cell nuclei. Additional
      treatment with a rubber policeman, and vigorous pipetting to disperse aggregates
      of bacteria and cell debris, increased the recovery to c. 10% of the initial
      inoculum after interaction for 2 h, and 30-80% after 4 h, depending on the strain
      and experimental conditions. The pattern of invasiveness, but not the absolute
      count, was highly reproducible on different days and in different hands. However,
      after interaction exceeding 2 h, the distribution of bacteria was uneven, many
      cells having no associated organisms, others showing microcolonies.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1753394
TI  - A scheme for the identification of viridans streptococci.
AB  - A collection of strains representing all the currently recognised species of oral
      or viridans streptococci (Streptococcus sanguis, S. parasanguis, S. gordonii, S.
      oralis, S. mitis, S. salivarius, S. vestibularis, S. anginosus, S. constellatus,
      s. intermedius, S. mutans and S. sobrinus) were tested for the production of a
      range of glycosidase activities with 4-methylumbelliferyl-linked fluorogenic
      substrates, and for reactions in a range of conventional fermentation and
      hydrolytic tests. The resulting biochemical scheme, consisting of 14 tests,
      enabled the differentiation of all these species and distinguished three biotypes
      within S. sanguis. The scheme reported here represents an improvement over
      currently available schemes for the identification of viridans streptococci.

PMID- 1753395
TI  - Intraosseous administration of lorazepam: same-dose comparison with intravenous
      administration in the weanling pig.

PMID- 1753396
TI  - Case report: MRI and CT comparison of an orbital cavernous lymphangioma.

PMID- 1753397
TI  - The sport of cheerleading.

PMID- 1753398
TI  - People with AIDS written by a health professional.

PMID- 1753399
TI  - Opinions on interprofessional relations.

PMID- 1753400
TI  - New advances in diabetic neuropathy.

PMID- 1753401
TI  - Ambulatory blood pressure monitoring evaluation of a semi-automated device.
AB  - The accuracy of a semi-automated ambulatory blood pressure monitoring device (the
      Instrumedix 'Personal Blood Pressure Transmitter') was assessed in 36 patients
      undergoing diagnostic cardiac catheterisation. Blood pressure readings measured
      by the device and by a standard manual sphygmomanometer were compared with
      simultaneous intra-aortic pressure measured directly via the catheter. No
      measurement size trends were identified for either of the two comparisons.
      Compared to direct intra-aortic pressure measurement, the manual sphygmomanometer
      gave lower systolic (p less than 0.05), and higher diastolic readings (p less
      than 0.01), while the semi-automated device gave slightly higher readings for
      both systolic (not significant: p greater than 0.05) and diastolic (p greater
      than 0.05) pressure. In this assessment the semi-automated device provided at
      least as accurate a reflection of intra-aortic pressure as did standard manual
      sphygmomanometry. This device is an accurate tool for the ambulatory assessment
      of blood pressure where adequacy of treatment or correctness of the diagnosis is
      in question.

PMID- 1753402
TI  - A survey of infant and under-5 mortality in Faisalabad Tehsil.
AB  - A household survey was carried out to study infant and under-5 mortality in urban
      and rural areas of Faisalabad Tehsil. The overall infant mortality rate was 110.1
      (per 1000 live births). The under-5 mortality rate was calculated as 158.6 (per
      1000 live births). These rates were higher in rural areas than in urban areas.
      The infant as well as under-5 mortality rates for females were higher than those
      for males.

PMID- 1753403
TI  - Alpha-thalassaemia: prevalence and pattern in northern Pakistan.
AB  - The level of Hb Bart's is directly related to the inheritance of alpha
      thalassaemia gene. Hb electrophoresis for Hb Bart's in the cord blood is a very
      simple method of finding out the prevalence of alpha-thalassaemia gene in a given
      population. A study was, therefore, carried out to find out the prevalence of
      alpha-thalassaemia gene in the population of northern Pakistan by estimating the
      concentration of Hb Bart's in 500 cord blood samples during the period 1986-87 at
      AFIP Rawalpindi. Hb Bart's was detected in 12 neonates, thus indicating a rate of
      2.4% of general population as carrier of alpha-thalassaemia gene. Two distinct
      groups were recognized. The first group was composed of 9 (75%) neonates, in
      which Hb Bart's levels varied between 2.0% to 3.5%, while the second group of 3
      neonates (25%) showed a level of 5.8% to 6.3%. The former group was considered to
      be carrying alpha-thalassaemia-2 gene and the latter group as carrier of alpha
      thalassaemia-1 gene. Neither Hb H disease nor Hb Bart's hydrops foetalis syndrome
      was detected in this series.

PMID- 1753404
TI  - Unilateral proptosis in E.N.T. practice.
AB  - Seventeen cases of unilateral proptosis aged 11-54 years are presented. The
      proptosis was due to mucormycosis in 7, ethmoid polyposis in 4, malignancy in 4,
      and one each due to Ringert's tumour and fibrous dysplasia. Surgery was performed
      in all cases with the aim of total extirpation of disease and orbital
      repositioning. The surgical approaches included transverse maxillary osteotomy,
      transantral ethmoidectomy, modified lateral rhinotomy, and orbital decompression.
      There was one fatality, and two recurrences. Three cases showed satisfactory and
      eleven excellent results.

PMID- 1753405
TI  - Dental disorders in Pakistan--a national pathfinder study.
AB  - A pilot study on dental diseases and treatment needs along with oral hygiene aids
      used and on provision of dental care was conducted in 1988 using WHO oral health
      assessment forms. A total of 1146 persons of 12-15 years and 35-65 years were
      included in the study. The sample was equally distributed in four provinces of
      Pakistan taking 13 urban and rural areas. Dental caries was found in 55% of
      children between 12-15 years of age and in 78% of adults. The DMFT index was 1.2
      in the younger age group (12 years) and rose to 18.3 for 45-54 years. The
      percentage of periodontally healthy persons at age 12 was 32% decreasing to 10.4%
      at age 50. Calculous was the most frequently observed condition in all age
      groups.

PMID- 1753406
TI  - Prevalence of HIV-infection among blood donors.
AB  - Blood donor screening for HIV antibody was carried out at Blood Transfusion
      Service of Jinnah Postgraduate Medical Centre. Sera of 1655 blood donors were
      tested by Enzyme linked Immuno-Sorbent Assay (Abbott recombinant HIV-1-EIA) from
      March, 1987 to December, 1989. Initial reactivity was noted in seven cases, of
      which three were repeatedly reactive. When these were tested by western blot at
      National Institute of Health, all were reported negative. Thus no HIV positive
      blood donor was found in the subject population.

PMID- 1753407
TI  - Congenital pyloric atresia and epidermolysis bullosa.

PMID- 1753408
TI  - Lymphomatoid papulosis.

PMID- 1753409
TI  - Disaster medicine.

PMID- 1753410
TI  - Nuclear magnetic resonance imaging (MRI).
AB  - This article discusses the basic concepts of Magnetic Resonance Imaging (MRI)
      with the intention to introduce the subject to uninitiated. The MRI technique is
      a powerful noninvasive probe of the body's internal anatomy. In MRI, the images
      are produced not by X-rays, but through the use of non-ionizing radiowaves that
      stimulate transitions between spin states of nuclei in a magnetic field when
      passed through the body. The time required for the nucleus to return to
      equilibrium gives information about the environment of that nucleus. In this way
      tissue abnormalities can be determined in vivo. This article covers the basis of
      MRI phenomena, the concept of magnetic moment of the sample, NMR exalation and
      emission and the equipment necessary to observe these NMR properties. The primary
      agents used to increase tissue contrast in MRI are also mentioned. Finally the
      importance and prospects of this technique in Pakistan have been discussed.

PMID- 1753411
TI  - Microbiological specimens.

PMID- 1753412
TI  - In vitro induction of perforin mRNA and cytotoxic activities in human splenocytes
      by the streptococcal preparation, OK-432.
AB  - Mononuclear cells were isolated from a spleen excised during surgery and cultured
      with 0.05 KE (Klinische Einheit)/ml of the streptococcal preparation, OK-432, or
      700 JRU (Japan Reference Units)/ml of recombinant interleukin-2 (rIL-2). When the
      cytotoxicity against K562 and Daudi cells was measured by four-hour 51Cr release
      assay, OK-432 induced about the same killing activity as that of rIL-2. The peak
      activity was observed on day 2. When the expression of human perforin messenger
      RNA (mRNA) was investigated by Northern blot analysis, a low-grade expression was
      seen in the splenocytes shortly after isolation (day 0). An expression 2.7-fold
      stronger than that seen on day 0 was produced after one day of culturing with OK
      432. This enhanced expression decreased only slightly after the first day. The
      increases in expression of perforin mRNA on day 2 were similar for OK-432 and rIL
      2. The results indicate the multicytokine inducer, OK-432, to induce perforin to
      about the same degree as rIL-2 does, and perforin to act as one of the effector
      molecules in the killing activity induced by OK-432.

PMID- 1753413
TI  - Evaluation of prognostic factors for 233 patients with recurrent advanced breast
      cancer.
AB  - We analyzed possible prognostic factors in 233 patients with recurrent advanced
      breast cancer treated primarily by adriamycin, cyclophosphamide and ftorafur
      (ACF) therapy and ACF modifications. The patients were in the Cancer Institute
      Hospital from 1977 to 1986, and were followed-up until 1989. In terms of
      chemotherapeutic response, complete and partial responses were observed in 31
      (13%) and 100 (43%) patients, respectively. The overall median survival from the
      beginning of chemotherapy was 20.3 months. The factors evaluated were response to
      chemotherapy, performance status (PS), age, disease-free interval (DFI),
      menopausal status, number of metastatic sites (step classification), presence or
      absence of liver metastasis, presence or absence of malignant effusion, and
      presence or absence of prior radiotherapy. Out of the nine factors, response to
      chemotherapy, PS, age, DFI and liver metastasis were significant factors
      affecting survival in univariate analysis, and multivariate analysis of these
      five factors revealed the survival to be markedly affected by response to
      chemotherapy (P less than 0.00001), PS (P = 0.00001) and DFI (P less than
      0.00001).

PMID- 1753414
TI  - Tumor thrombus and microvascular invasion as prognostic factors in renal cell
      carcinoma.
AB  - The significance of two types of vascular invasion (macroscopic tumor thrombus
      into the renal vein or vena cava inferior and microvascular invasion) as
      prognostic factors in renal cell carcinoma is analyzed in 121 patients treated at
      the Department of Urology, Nara Medical University. The data indicate there to be
      close correlations between tumor thrombus, microvascular invasion and distant
      metastasis. In patients with tumor thrombus, however, the prognosis is not as
      poor when surgical removal of the tumor thrombus is successfully performed as
      when it is not. In contrast, the prognosis of patients with positive
      microvascular invasion is significantly worse than that of those with a negative
      finding. Microvascular invasion appears to be a significant prognostic factor in
      renal cell carcinoma in addition to well-known factors such as tumor stage, tumor
      grade, tumor thrombus and distant metastasis. To detect microvascular invasion,
      the histological examination should be extended to give as much detail as
      possible.

PMID- 1753415
TI  - Chemotherapy of soft tissue sarcomas in the extremities.
AB  - A retrospective study on chemotherapy against soft-tissue sarcomas in the
      extremities was carried out on 98 patients. The local recurrence rate was 10.3%
      with intensive chemotherapy in post-1980 patients with high-grade sarcomas but
      46.7% without chemotherapy--a fairly significant difference (P less than 0.01).
      The survival rate was significantly higher with intensive chemotherapy in post
      1980 patients with high-grade sarcomas. Thus, intensive chemotherapy based on a
      new protocol should be given in cases of high-grade sarcoma. Considering surgical
      margin, the local recurrence rate was 33.3% in post-1980 cases inadequately
      operated upon but 8.6% in those adequately operated upon, which shows a
      significant difference (P less than 0.05).

PMID- 1753416
TI  - Activation of hepatitis B virus infection by chemotherapy containing
      glucocorticoid in hepatitis B virus carriers with hematologic malignancies.
AB  - Among 262 inpatients with hematologic diseases who were referred for chemotherapy
      or immunosuppressive therapy between January, 1985, and December, 1989, nine
      (3.4%) patients, including two with Hodgkin's disease (HD), three with acute
      myeloblastic leukemia, one with chronic myelogenous leukemia, two with multiple
      myeloma and one with aplastic anemia, were found to be hepatitis B virus (HBV)
      carriers before their chemotherapy began. All six HBV carriers who received
      chemotherapy containing glucocorticoid showed mild-to-moderate elevations in
      serum transaminase levels after the chemotherapy. Five showed a rise in titer of
      the hepatitis B surface antigen, HBsAg. In contrast, three HBV carriers not
      receiving glucocorticoid showed no change in serum transaminase after
      chemotherapy. One HBV carrier with HD suffered from severe icteric hepatitis
      after the withdrawal of multiagent chemotherapy containing glucocorticoid. The
      HBV-DNA polymerase rose markedly and was accompanied by a marked rise in titer of
      HBsAg. The results warn us to keep in mind the possibility of glucocorticoid
      inducing an activation of HBV infection, which may result in severe hepatitis in
      some HBV carriers. Although further investigation is required, it is recommended
      that HBsAg-positive patients with hematologic malignancies should, if possible,
      be treated without glucocorticoid.

PMID- 1753417
TI  - Spontaneous massive hemorrhage within a malignant tumor of the liver: diagnostic
      features in sonography and CT.
AB  - Computed tomography (CT) and sonography performed on four patients with
      histopathologically proven massive intratumoral hemorrhages in the liver were
      compared with pathological findings. Unenhanced CT showed a round low-density
      mass, and enhanced CT produced slight enhancements in the peripheral portions of
      the masses in two patients which corresponded to histopathologically viable
      cancerous portions. In contrast, sonography showed multilocular cystic masses
      with variously shaped septa, assuming a honeycomb appearance.
      Histopathologically, the septa were made up of blood clots with or without
      granulation tissue, scar and viable tumor, and the cystic spaces were filled with
      exudate and erythrocytes. Combined study by CT and sonography could be useful in
      differentiating massive hemorrhagic malignancies from cystic and necrotic masses
      and/or simple hemorrhagic lesions. The danger of malignant tumors with massive
      hemorrhage possibly being diagnosed as benign lesions, such as hematomas and
      abscesses, is also stressed.

PMID- 1753418
TI  - Severe herpes simplex virus hepatitis following autologous bone marrow
      transplantation: successful treatment with high dose intravenous acyclovir.
AB  - A 17-year-old male patient with T-cell type lymphoblastic lymphoma in complete
      remission underwent high dose chemotherapy (busulfan 16 mg/kg and
      cyclophosphamide 120 mg/kg) followed by autologous bone marrow transplantation
      (ABMT). The patient had been taking oral acyclovir (200 mg x 5) daily from seven
      days prior to the ABMT (day -7). On day +24, he complained of epigastralgia and
      general malaise, and the next day his GOT and GPT rose to 570 U/l and 397 U/l,
      respectively. Although he had no mucocutaneous lesions, hepatitis caused by a
      herpes virus was suspected, and high dose intravenous acyclovir (10 mg/kg x
      3/day) was immediately started. His GOT, GPT and total bilirubin reached peaks of
      2,870 U/l on day +26, 1,830 U/l on day +27 and 10.3 mg/dl on day +39,
      respectively, and rapidly improved thereafter. Serological analyses on IgG
      antibody titers to herpes simplex virus type 1 using an enzyme-linked
      immunosorbent assay revealed specific increases (454-fold before transplantation
      to 3,830-fold on day +46). Antiviral antibody titers to cytomegalovirus,
      varicella-zoster virus and Epstein-Barr virus showed no significant changes. The
      serologic markers of hepatitis B virus, hepatitis A virus and hepatitis C virus
      were all negative. The results indicate the patient's severe icteric hepatitis to
      have been caused by a reactivation of herpes simplex virus type 1 due to
      immunosuppression after high dose chemotherapy with ABMT. It is suggested that
      prompt commencement of high dose intravenous acyclovir is required to treat
      severe herpes simplex virus hepatitis affecting immunocompromised patients.

PMID- 1753419
TI  - Local adoptive immunotherapy using lymphokine-activated killer cells and
      interleukin-2 against malignant pleural mesothelioma: report of two cases.
AB  - Malignant pleural mesothelioma is refractory to conventional therapy. We tried
      local adoptive immunotherapy using lymphokine-activated killer (LAK) cells and
      interleukin-2 (IL-2) to control malignant pleural effusion due to mesothelioma in
      two patients: Case 1 was that of a 69-year-old man, and Case 2 that of a 49-year
      old woman with complicating chronic idiopathic thrombocytopenic purpura. A
      systemic survey revealed no sign of metastasis in either case. Intrapleural
      instillations of 6.7 x 10(9) autologous LAK cells in Case 1, or 11.3 x 10(9)
      allogeneic LAK cells in Case 2, with daily injections of IL-2 resulted in
      reductions of the pleural effusions in each case and in a decline in the level of
      hyaluronic acid in the effusion, in Case 1. The instillations of autologous and
      allogeneic LAK cells were well tolerated. The results suggest that local adoptive
      immunotherapy could be useful in the treatment of malignant effusion due to
      mesothelioma.

PMID- 1753420
TI  - Pure red cell aplasia associated with non-Hodgkin's lymphoma and hemolytic
      anemia.
AB  - Pure red cell aplasia (PRCA) rarely occurs in non-thymic lymphoproliferative
      disorders. The present article describes a patient with non-Hodgkin's lymphoma
      (follicular, mixed type), who concurrently developed PRCA and warm type
      autoimmune hemolytic anemia during the clinical course. The PRCA and hemolytic
      anemia were successfully treated with prednisolone (60 mg/day). The patient died
      two years later, however, from advanced lymphoma without any recurrence of the
      PRCA or hemolytic anemia. To our knowledge, only 20 cases of PRCA associated with
      malignant lymphoma have been reported. The pathogeneses of the PRCA and hemolytic
      anemia in our patient are discussed.

PMID- 1753421
TI  - [Relationship between morphological and functional changes in the stomach with
      aging].
AB  - The authors investigated the relationship between morphological changes and
      functional changes of the stomach with ageing, especially in term of change of
      gastric emptying in 92 healthy subjects. We checked the difference in
      chronological age and the stomach age in these subjects (in order to assess these
      subjects). The morphological change was evaluated by extent of atrophic gastritis
      in endoscopical atrophic border and histological findings of biopsy specimens,
      and the functional change was evaluated by maximal acid output in gastric
      secretion. Atrophic gastritis was expanded and maximal acid output was
      significantly reduced with ageing. From these results we confirmed that there was
      no difference between the chronological age and the stomach age and the quality
      of these subjects was very good. Gastric emptying was investigated by the
      acetaminophen method. In spite of ageing, gastric emptying was almost constant in
      these healthy subjects.

PMID- 1753422
TI  - [Long-term single dose chemoprophylaxis of recurrent urinary tract infection in
      elderly female subjects].
AB  - To evaluate the efficacy of the single dose chemoprophylaxis of recurrent urinary
      tract infection (UTI) in the elderly, 20 female inpatients (mean age 81.4) who
      had one or more culture documented UTIs in the past 12 months were studied. They
      were randomly assigned to be treated for 6 months either with chemoprophylaxis
      (200 mg of norfloxacin) or conventional therapy (without any antimicrobials
      except when overt UTI occurred). After a 4 months of washout period, the
      protocols were exchanged with each other and next 6 months of trial was carried
      out. All cases were followed at least 4 months after the discontinuance of the
      chemoprophylaxis. The difference of efficacy between the two modalities was
      evaluated by periodical examinations of urine cultures, urinalysis and
      inflammatory markers. During chemo-prophylaxis, the frequency of the symptomatic
      UTI (bacteriuria greater than 10(4)/ml, pyuria greater than 5/HPF, CRP greater
      than +) was 0.267/patient.year which was significantly lower than during
      conventional therapy (2.97/patient.year, p less than 0.01). This prophylactic
      effect remained 4 months after the discontinuance of the drug. On the other hand,
      bacteriuria was persistent in more than half of patients with chemoprophylaxis.
      Minimal inhibitory concentration of norfloxacin for separated bacteria revealed
      that the resistant species steeply increased from 4 to 6 months after the
      beginning of chemoprophylaxia. These species disappeared 4 months after the drug
      was discontinued. Optimal durations of chemoprophylaxis and drug-holidays were
      discussed.

PMID- 1753423
TI  - [Echocardiographic assessment of the effect of aging on the diastolic and
      systolic functions of the left ventricle].
AB  - The effects of aging on the diastolic and systolic functions of the left
      ventricle were studied by echocardiography as follows. (1). Maximum velocity of
      circumferential fiber lengthening (negative peak Vcf) and shortening (peak Vcf)
      was assessed by digital M-mode echocardiography in 20 healthy young subjects and
      26 healthy elderly subjects. The mean value of negative peak Vcf (-cir/sec) was 
      3.87 +/- 0.85 in the 20's. -4.48 +/- 1.14 in the 30's, -3.71 +/- 1.21 in the
      40's, -2.70 +/- 0.90 in the 60's, -2.57 +/- 0.64 in the 70's, -2.33 +/- 0.77 in
      the 80's and -2.57 +/- 0.65 in the 90's showing significant difference among
      young and elderly groups (p less than 0.05- p less than 0.005). The mean value of
      peak Vcf showed no significant difference among young and elderly groups except
      for the group in the 30's which showed significant (p less than 0.05) difference
      between other groups. (2). Indices of the left ventricular systolic and diastolic
      functions were calculated by standard M-mode echocardiographic technique in 227
      healthy subjects from 5 to 94 years in age by dividing them into 3 young groups
      and 4 elderly groups. As for the left ventricular internal diameters a tendency
      of increase was observed in the end diastolic diameter of the left ventricle in
      accordance with ageing. Fractional shortening of the left ventricular diameter
      which ranged from 36.2% to 36.7% in the 3 young groups and 36.9 to 40.3% in the 4
      elderly groups and cardiac output showed no age dependent decrease.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1753424
TI  - [Decreased cerebral blood flow in remote areas in deep-seated cerebrovascular
      lesions].
AB  - Recent positron or single photon emission computed tomographic studies have
      demonstrated that the impairment of regional hemodynamics or metabolism in
      cerebrovascular disease is not limited to the focal lesion, but also involves
      more remote areas. The present study evaluated cerebral blood flow in areas
      remote from the primary lesion in patients with subcortical cerebrovascular
      disease, and assessed correlations with the clinical features. Twenty patients
      aged 61-89 (mean, 74.7 +/- 6.7 years) were divided into the L group (lacunar
      infarction in deep penetrating arterial territory, n = 7), the NL group (non
      lacunar subcortical infarction caused by main trunk occlusion or severe stenosis,
      n = 6), and the H group (putaminal or thalamic hemorrhage, n = 7). Ipsilateral
      cortical and contralateral cerebellar blood flow were assessed using single
      photon emission computed tomography with 123I-IMP. Although only some patients of
      the L group showed a mild reduction of ipsilateral cortical blood flow, most of
      the patients in the NL and H groups showed a moderate or severe flow reduction.
      The cortical blood flow reduction was suggested to be caused by several
      mechanisms, including brain edema, a decreased perfusion pressure associated with
      disease of large arteries, partial cortical neuronal damage, and deactivation.
      The degree of the flow reduction was considered to depend on the relative
      contribution of each of these factors. Contralateral cerebellar blood flow
      reduction, i.e., crossed cerebellar diaschisis, was observed more frequently and
      prominently in the NL and H groups than in the L group.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1753425
TI  - [Efficacy and safety of percutaneous endoscopic gastrostomy in the elderly].
AB  - Percutaneous endoscopic gastrostomy (PEG) was performed in 32 patients with
      nasogastric feeding (NGF) or total parenteral nutrition (TPN), who were unable to
      swallow. Our cases of PEG included 10 with dementia, 8 with cerebral infarction,
      8 with cerebral bleeding, 3 with gastric cancer, and others. TPN was performed
      after PEG for a short time. Because of the combination of TPN and PEG, there was
      no mortality or major complication related to the procedure. Minor complications
      included subcutaneous abscess and TPN catheter fever. PEG can be safely and
      rapidly performed. Furthermore, painless life, better cosmetic features and
      physical condition can be obtained with this procedure. The majority of the
      patients are able to return home after PEG. PEG can improve the quality of life
      of the patients who cannot swallow but have an intact gut.

PMID- 1753426
TI  - [The coefficient of variation of RR intervals (CVRR) on electrocardiogram in
      patients with essential hypertension with reference to aging, hemodynamics and
      sympatho-adrenomedullary function].
AB  - To evaluate the significance of parasympathetic nerve activity in essential
      hypertension, we measured the coefficients of variation of RR intervals (CVRR) on
      electrocardiogram and examined the relationships between CVRR and aging,
      hemodynamics and sympatho-adrenomedullary function in normotensive subjects (NT)
      and in patients with essential hypertension (EHT). Mean arterial pressure (MAP),
      heart rate (HR), plasma noradrenaline concentration (pNA), plasma adrenaline
      concentration (pAd) and CVRR resting in a supine position were simultaneously
      measured in 37 NT (33.8 +/- 2.0 years) and 47 mild-to-moderate EHT (51.3 +/- 1.5
      years). In both NT and EHT, significantly negative correlations between CVRR and
      age (NT: r = -0.54, p less than 0.001, EHT: r = -0.41, p less than 0.005) were
      observed, however, CVRR correlated with neither MAP, HR nor pAd. CVRR tended to
      correlate negatively with pNA (r = -0.27, p less than 0.1) in NT, unlike in EHT.
      The mean value of CVRR in EHT (n = 10, age: 38.3 +/- 1.6 years, CVRR: 3.61 +/-
      0.37%) was significantly (p less than 0.005) lower than in age-matched NT (n =
      10, age: 38.3 +/- 2.5 years, CVRR: 5.76 +/- 0.45%). These results indicate that
      the parasympathetic tone suggested by CVRR may be related to aging and
      sympathetic nerve activity, and that parasympathetic function might be impaired
      in EHT.

PMID- 1753427
TI  - [Diurnal changes in postheparin lipolytic activity (PHLA) and the role of PHLA in
      triglyceride catabolism in young and middle-aged obese individuals].
AB  - The diurnal changes in postheparin lipolytic activity (PHLA) were studied as on
      aspect of its physiological changes in eight healthy volunteers in a fasting
      state. Serum lipids and PHLA in obese males were measured to determine the
      etiology of obesity-associated hypertriglyceridemia with respect to triglyceride
      (TG) catabolism. In the healthy nonobese volunteers, the lipoprotein lipase (LPL)
      activity did not show any diurnal changes, but decreased with time during
      fasting. The hepatic triglyceride lipase (HTGL) activity underwent diurnal
      changes, and was high in the morning and low at night. Perceiving the metabolic
      difference between young obese individuals (obese since childhood) and middle
      aged obese individuals (obese since adulthood), PHLA and serum lipids were
      simultaneously determined and examined from the aspect of TG catabolism in a
      young male group aged 17-27 and an older male group aged 35-62. The lower-age
      group consisted of 15 normal-weight men and 25 obese men with 11 years (mean) of
      a history of obesity. The higher-age group consisted of 15 normal-weight men and
      25 obese men with 12 years of a history of obesity. No differences were found in
      total cholesterol and LDL-cholesterol between the normal-weight and obese
      individuals of both groups. However, HDL-cholesterol was significantly decreased,
      only in the obese individuals of the higher age group, compared to the normal
      weight individuals of this group. Serum TG and insulin were significantly higher
      in the obese individuals than normal-weight individuals of both groups. In the
      obese individuals in both groups, a positive correlation was demonstrated between
      serum TG and insulin. This suggested the increased production of TG in
      association with hypertriglyceridemia. In addition, TG positively correlated with
      LPL and HTGL activities in young obese individuals, while a negative correlation
      was demonstrated only between TG and LPL activity in older obese individuals.
      These results indicated an age-related difference in TG catabolism in obese
      individuals with obesity-associated hypertriglyceridemia.

PMID- 1753428
TI  - [MRI and ultrasonography of atherosclerosis of the thoracic aorta and carotid
      arteries in elderly hypercholesterolemic patients].
AB  - In 53 elderly participants aged more than 60 the thoracic aorta and bilateral
      carotid arteries were observed with noninvasive techniques, MRI and ultra
      sonography, in order to elucidate the relationship between hypercholesterolemia
      and atherosclerosis in the elderly. Hypercholesterolemic subjects were classified
      as group H (serum total cholesterol (TC) greater than 220 mg/dl), group H-I (220
      mg/dl less than TC less than 250 mg/dl) and group H-II (TC greater than or equal
      to 250 mg/dl). Atherosclerotic changes of the thoracic aorta were observed in 46%
      of group H, 27% of group H-I, 60% of group H-II and 37% of normolipidemic
      subjects (group NL). Carotid atherosclerotic changes were observed in 19% of
      group H, 9% of group H-I, 27% of group H-II and 18% of group NL. In group H-I,
      the percentages of atherosclerotic changes in both thoracic aorta and carotid
      arteries were lower than those in group NL. However, atherosclerotic changes of
      thoracic aorta and carotid arteries were detected in 43% and 29% of the subjects
      showing higher apo B/Apo Al ratio than 1.0 among group H-I + NL (TC less than 250
      mg/dl). These changes occurred in 32% and 13% of the subjects showing lower apo
      B/Apo Al ratio than 1.0 among the same groups. Namely, atherosclerotic changes of
      the thoracic aorta and carotid arteries were observed more frequently in the
      subjects showing a higher apo B/Apo Al ratio than 1.0 even if their serum
      cholesterol values were not higher than 250 mg/dl. We should use not only the
      serum cholesterol value but also the apo B/Apo Al ratio as an indicator to
      evaluate the roles of lipids in the development of atherosclerosis.

PMID- 1753429
TI  - [The correlation between pulse wave velocity and diabetic angiopathy].
AB  - Pulse wave velocity (PWV) of the aorta was measured in 40 patients with diabetes
      mellitus, in order to study the relation between PWV and diabetic angiopathy. The
      PWV was significantly faster in diabetic patients on oral hypoglycemic agents
      than in those on diet alone or on insulin. The PWV correlated significantly and
      positively with age, systolic blood pressure and urinary albumin index. The PWV
      significantly faster in diabetics with microalbuminuria than in those without
      this findings. It was concluded that PWV in addition to known risk factors such
      as elevated blood pressure, atherogenic abnormalities of plasma lipids and
      lipoproteins, and elevated blood glucose, may be a reliable index of diabetic
      micro- and macroangiopathy.

PMID- 1753430
TI  - [Serum uric acid and factor VII hyperactivity in the elderly].
AB  - To study the relationship between serum uric acid, lipid fractions, and
      coagulation factor VII (FVII) in the elderly, we measured FVII coagulation
      activity (FVIIc). FVII antigen (FVIIag), in 138 normal subjects without alcohol
      intake ranging in age from 60 to 98 years. We also measured blood lipid fractions
      including apolipoprotein A-I, A-II, B, E, and serum cholinesterase activity
      (ChE). Serum uric acid levels significantly correlated with FVIIc (p less than
      0.01) and FVIIag levels (p less than 0.05) as well as with tryglycerides, VLDL,
      LDL, total cholesterol, and ChE in elderly men, but not in women. However,
      multiple regression analysis showed these correlations in elderly men were not
      significant, after excluding the effect of triglycerides and VLDL. These results
      also suggest that elevation of uric acid may be a coronary risk factor in elderly
      men through high FVII levels.

PMID- 1753431
TI  - [Statistical analysis of post-stroke patients in a rehabilitation institution].
AB  - A retrospective analysis of 312 stroke patients (200 men, 112 women; average age
      65) admitted to Yamaguchi Rehabilitation Hospital during the past three years
      showed the following results. 1) After an average period of stay of 244 days 225
      patients were discharged to home, general hospitals, extended care facilities, or
      nursing homes. 2) The group of patients over 80 years of age at admission had a
      lower ratio of home returns than in other groups (p less than 0.01). 3) Patients
      who returned home had higher scores not only on discharge Barthel index scores
      but on admission Barthel index scores, compared with other discharged patients (p
      less than 0.01). 4) The higher the admission Barthel index score, the shorter the
      period of stay (p less than 0.01). Concerning discharge Barthel index scores,
      patients who stayed over two years had lower scores than patients who stayed less
      than two years (p less than 0.01). The results of this analysis suggest the
      importance of determining goals and programs taking admission Barthel index
      scores as well as other available factors into consideration for patients with
      stroke admitted to rehabilitation institutions.

PMID- 1753432
TI  - [Gastric xanthomas in the elderly].
AB  - Gastric xanthomas are single or multiple yellowish-white small nodules or plaques
      in the gastric mucosa. Microscopically they consist of macrophage-derived foam
      cells full of lipids. However, because of their benign nature, there are few
      reports of gastric xanthomas in the literature and their clinical significance
      still remains unknown. In this study, we studied 131 elderly cases (42 males and
      89 females) with the average age of 75.6 +/- 12.3 (S.D.) years old who were
      examined gastroendoscopically. The endoscopic finding of gastric xanthomas was
      observed in 17 males (40.5%) and in 23 females (25.8%). Gastric xanthomas tended
      to increase with age, and the frequency was highest in the seventies (40.0%). Of
      the xanthoma cases, 42.5% had a solitary xanthoma, and 17.5% had more than 5
      xanthomas. More than 70% of xanthomas were observed in antral and pyloric
      regions. There was no difference in serum lipids between the cases with and
      without xanthomas. Gastric mucosa biopsied from around xanthomas showed moderate
      to severe atrophic change of gastric glands in most cases (89%). Hyperplasia of
      gastric-pit epithelia and intestinal metaplasia were also often observed.
      However, there was no correlation between gastric xanthomas and small round cell
      infiltration in the gastric mucosa. It was concluded that gastric xanthomas in
      the elderly arise from the mucosa with atrophic change in most cases, which may
      have a disturbance of local lipid metabolism, and that the presence of gastric
      xanthomas may be a marker of the pathological aging change of gastric mucosa.

PMID- 1753433
TI  - [A case of psoas abscess due to renal pelvic carcinoma complicated with non
      ketotic hyperosmolar diabetic coma].
AB  - A 85-year-old man was admitted to our hospital because of semicomatous status.
      Laboratory data on admission showed elevation of blood sugar (823 mg/dl) and
      serum osmotic pressure (345 mOsm/l), but ketonuria was not detected. Non-ketotic
      hyperosmolar diabetic coma was diagnosed. The insulin infusion and physiological
      saline improved the blood sugar level and consciousness within a day. The
      abdominal ultrasound examination revealed an abscess in the left kidney and right
      psoas muscle. The same findings were seen by abdominal computed tomography but
      the possibility of malignant neoplasm of the left kidney could not be ruled out
      because of a swelling of the left adrenal gland. Pain associated with psoas
      abscess and low grade fever were observed. Because of his poor general condition,
      drainage of the abscess was not performed and conservative therapy using
      antibiotics was administered. Without any improvement of the abscess, he died due
      to general deterioration four months later. Autopsy findings showed carcinoma of
      the left renal pelvis and metastasis to the right psoas muscle, left adrenal
      gland, liver, bilateral lungs and lymph modes. Psoas abscess is a relatively
      uncommon disease, especially in elderly patients. The etiology of the disease is
      divided into primary and secondary causes. Most secondary psoas abscess cases are
      caused by intestinal diseases, and Crohn's disease has been related to the
      highest incidence. A few cases of psoas abscess caused by colorectal carcinoma
      have been reported. Ultrasound and computed tomography are useful in diagnosing
      this disease and drainage of an abscess is necessary for therapy and proving the
      cause. Cancer metastasis should considered in differential diagnoses, when psoas
      abscess is seen in elderly patients.

PMID- 1753434
TI  - [Cerebral infarction and high serum levels of muscle-derived enzymes associated
      with abrupt increase in hematocrit in a patient with secondary erythrocytosis].
AB  - A 70-year-old man was admitted to our hospital because of fever and progressive
      dyspnea in December 1989. He was already diagnosed as having erythrocytosis
      secondary to pulmonary fibrosis 4 years previously and the values of his
      hematocrit (Ht) were maintained between 44.5 and 62.9% by repeated phlebotomy.
      Immediately after admission, severe diarrhea developed and the Ht value was
      61.5%. Around 1:30 a.m. of the 3rd hospital day, he developed disturbance of
      consciousness. In addition, the serum levels of LDH, CPK, aldolase, and myoglobin
      of muscle origin increased markedly and the Ht value showed 78.5%. While the
      level of consciousness was gradually restored by 600 ml phlebotomy and 1,500 ml
      saline infusion, dysarthria and hemiplegia became evident. The Ht value early in
      the morning of the 3rd hospital day was reduced to 59.4%. Although cranial CT and
      MRI performed 74 days and 15 months, respectively, after the onset of the
      symptoms failed to reveal any abnormal shadow, he was clinically suspected to
      have cerebral infarction. These findings emphasize that abrupt increase in Ht or
      blood viscosity is a possible factor triggering cerebral infarction, and adequate
      control of Ht value is recommended for the prevention of such a condition in the
      aged.

PMID- 1753435
TI  - [A senile patient with Rendu-Osler-Weber disease who underwent resection of 4
      multiple bilateral pulmonary arteriovenous fistulas].
AB  - A 70-year-old female patient with multiple bilateral pulmonary arteriovenous
      fistulas was referred to our hospital for its treatment. She had experienced
      frequent epistaxis and had nasopharyngeal telangiectasia. Her mother, sister and
      all four children also suffered from epistaxis. We diagnosed this patient as
      Rendu-Osler-Weber disease combined with multiple bilateral pulmonary
      arteriovenous fistulas. Her chest roentgenogram revealed 4 arteriovenous fistulas
      in the left lung and 2 arteriovenous fistulas in the right. On admission arterial
      blood gas analysis while breathing room air showed a PaO2 of 39.8 torr and an
      SaO2 of 75.4%. The percent of R-L shunt was calculated to be 56.5%. Because of
      severe hypoxemia, she underwent resection of four large fistulas in segments 3,
      4, 5, and 8 of the left lung. Twenty-eight days after the operation, the PaO2 was
      76.4 torr and SaO2 was 95.7%. There was no sign of enlargement in size of the
      remaining arteriovenous fistulas.

PMID- 1753436
TI  - Single DNA marker generated by "YAC-Alu PCR" that is end-specific.
AB  - A simple strategy for the rapid preparation of an end-specific linking-DNA probe
      from the YAC-human chromosome 21 DNA recombinant clone and the characterization
      of this single DNA probe are described. Synthetic oligodeoxynucleotide primers,
      based on the consensus Alu sequence, and the Sup4 DNA fragment in the YAC arms
      were used to amplify end-specific DNA sequences by the polymerase chain reaction
      (PCR) for screening of the linking YAC recombinant clones ("YAC-Alu PCR").
      Nucleotide sequencing of the product of PCR from human genomic DNA in a YAC
      insert confirmed the boundary between the vector and the insert and the presence
      of the 3'-end Alu-like structure. The probe R1, prepared by "YAC-Alu PCR"
      amplification, was assigned to chromosome 21 by Southern hybridization of somatic
      cell hybrid DNAs. In situ hybridization allowed localization of the R1 DNA probe
      to the human chromosome 21q21-q22.1 region. Thus, this approach has significant
      advantages not only for isolation of a single DNA probe specific for human
      chromosome 21 but also for the screening of YAC linking recombinant clones for
      mapping of the human genome.

PMID- 1753437
TI  - A 3' splice site consensus sequence mutation in the intron 3 of the alpha
      galactosidase A gene in a patient with Fabry disease.
AB  - Fabry disease is an X-linked disorder accompanied with accumulation of
      glycosphingolipids resulting from the deficient activity of the lysosomal
      hydrolase, alpha-galactosidase A (alpha-GalA). In the present study, mRNA for
      alpha-GalA in fibroblasts from an 11-year-old Japanese patient with Fabry disease
      was examined using the reverse transcriptase-polymerase chain reaction (PCR). The
      shorter message of alpha-GalA was demonstrated in this patient when compared with
      the normal control. The complete deletion of exon 4 in the mRNA for alpha-GalA in
      the patient was disclosed by analysis of cDNA with restriction enzyme digestion
      and asymmetrical PCR sequencing. The direct sequencing of the genomic DNA
      demonstrated a single base substitution (G----A) at the 3' end of the consensus
      sequence of intron 3. This mutation destroyed a splice site in the alpha-GalA,
      which produced a mutant allele. It was also shown that the mother of the patient
      had this mutant as well as normal alleles as a heterozygote.

PMID- 1753438
TI  - Unilateral gonadal dysgenesis with both testis and fallopian tube on the same
      side in a 45,X/46,X inv (Y) mosaic male.
AB  - A 5-year-old male with ambiguous external genitalia, hypospadias and microphallus
      without an urethral orifice was referred for cytogenetic studies. Exploratory
      laparotomy revealed presence of an infantile uterus and unilateral gonadal
      dysgenesis with both testes and fallopian tube on the right side. The metaphase
      cells from peripheral blood culture showed both 45,X/46,X inverted Y
      (p11.2q11.23) cell-lines (98:2). The inverted Y was found to be of paternal
      origin. Maternal chromosomal pattern was normal 46,XX. The presence of a
      fallopian tube next to testis suggest absence of secretion of anti-Mullerian
      hormone by Sertoli cells. The absence of Wolffian duct derivatives suggest
      insufficient secretion of testosterone by Leydig cells.

PMID- 1753439
TI  - Partial 18q trisomy and 18p monosomy resulting from a maternal pericentric
      inversion, inv(18)(p11.2q21.3).
AB  - A 7-year-old boy with dysmorphic features was found to have a recombinant
      chromosome 18, rec(18), resulting from meiotic recombination of a maternal
      pericentric inversion, inv(18) (p11.2q21.3), as defined by high-resolution
      banding. He was trisomic for the long arm (q21.3-qter) and monosomic for the
      short arm (p11.2-pter) of chromosome 18. His clinical features were compared with
      those in other rec(18) cases, and also those in monosomy 18p, trisomy 18qter and
      full trisomy 18 syndromes. The risk of recombinant formation for inv(18) carriers
      was also discussed.

PMID- 1753440
TI  - Chromosomal and biochemical screening on mentally retarded school children in
      Taiwan.
AB  - Governmental officials as well as medical scientists in Taiwan have worked hard
      in recent years to develop and to implement various measures, such as prenatal
      diagnosis and neonatal screening, to lower the incidence of hereditary diseases
      and mental retardation in the population. An inquiry into the possibility of
      devising a chromosomal and biochemical screening program and to apply it
      routinely to all the mentally retarded school children island-wide was the major
      aim of the present study. A collection of 1,614 blood samples was screened for
      phenylketonuria (PKU), galactosemia, homocystinuria, biotinidase deficiency, and
      congenital hypothyroidism. The IQ of these children ranged from 50-75 (1,397
      children, moderate group) to less than 50 (217 children, severe group). Six cases
      of PKU (one tetrahydrobiopterin deficient and five classical) and three cases of
      thyroid dysfunction were found. The overall incidence of these two diseases was
      0.56%. Of the 1,614 blood samples, 1,323 were cultured and karyotyped
      successfully. One hundred and twenty-five of them had chromosome abnormalities.
      The majority (64 out of 125) were trisomy 21. A remarkable difference in the
      percentage of mentally retarded children with chromosome abnormalities was
      observed between the moderate (7.87%) and severe (17.51%) retarded.

PMID- 1753441
TI  - The prevalence at birth of cogenital malformations at a maternity hospital in
      Osaka City, 1948-1990.
AB  - The frequencies of congenital malformations at St. Barnabas' Hospital, Osaka were
      studied during the period 1948-1990. There were 1,418 malformed infants diagnosed
      during the first week of life among a total number of 131,996 births during the
      period. Of the 1.07% of malformed children, 0.90% had single and 0.17% had
      multiple malformations. The birth prevalence was 1.07% in singletons and 1.20% in
      twins. There was significant difference in prevalence between males (1.15%) and
      females (0.97%). The prevalence was 0.88% for the period 1948-1958 and increased
      with each year cohort up to the recent period when the value was 1.38%. Varus
      deformities of feet was the most common defect (23.4 per 10,000 births), followed
      by polydactyly (finger) (7.8), anencephaly (7.1), cleft lip and palate (6.5),
      syndactyly (toe) (6.5), cleft lip (6.3), and Down's syndrome (6.1). The
      prevalence of conjoined twins was 1 in 65,551 deliveries. Significant differences
      occurred between males and females for cleft palate, cleft lip and palate,
      syndactyly (finger), oligodactyly (finger), and hypoplastic auricle. The
      prevalences for valgus deformities of feet, syndactyly (toe) and atresia ani
      increased significantly with the year cohort, whereas the prevalence of cleft
      palate decreased significantly with the year cohort. Overall prevalence was
      significantly higher in 1970-1990 (1.28% than in 1948-1969 (0.88%). Similar
      results were examined for cleft lip and palate, syndactyly (finger), syndactyly
      (toe), hypospadias, hydrocele testis, and Down's syndrome.

PMID- 1753442
TI  - [Electromagnetic fields: their biological effects and regulation].
AB  - Concern over the effects of humans of ELF-(extremely low frequency; less than 300
      Hz) electromagnetic fields has rapidly increased in recent years. The effects
      seem to be related to gene level aberrations such as carcinogenesis and
      developmental malformations, but it is difficult to obtain experimental evidences
      on field effects. Several safety guidelines or permissible doses have been
      proposed for electromagnetic wave, but they mainly cover the range of microwave
      frequencies. Three of the guidelines made in 1989-1990 included ELF
      electromagnetic fields and two newly approved guidelines on power-frequency
      electromagnetic fields appeared in 1990. However, they adopted considerably
      different values based on different theoretical standpoints. Generally, the
      concept of electromagnetic fields appears to be confused with that of magnetic
      field and thus the ideas for protective measures conflict between the two. The
      author first presented the concepts of electromagnetic and magnetic fields, then
      briefly discussed their biological effects together with the underlying
      mechanism, and lastly described these drafts on safety standards or permissible
      doses. Since subtle and difficult problems remain to be resolved, further
      investigation will be required in order to put these guidelines into practice.

PMID- 1753443
TI  - [Industrial hygienic study on nursing activities. I. Investigation on heart rate
      and energy expenditure of ward nurses by nursing activity].
AB  - Using a Holter electrocardiograph (ECG), we recorded the heart rates of ward
      nurses by working hours and nursing activity. Energy expenditure was calculated
      from the heart rate data and nurse work lord was evaluated. The following results
      were obtained. 1) Average heart rates were 77 (beats/min) for day-shift nurse in
      surgical ward, 76 for evening-shift nurse in mixed, ward, and 74 for night-shift
      nurse in mixed ward. 2) The energy expenditures per day were calculated to be
      3,474 kcal for day-shift nurse in surgical ward, 3,060 kcal for evening-shift
      nurse in mixed ward, and 3,238 kcal for night-shift nurse in mixed ward. 3) The
      energy expenditures during working hours were 2,110 kcal/510 min for day-shift
      nurse in surgical ward, 1,805 kcal/495 min for evening shift nurse, and 2,014
      kcal/570 min for night-shift nurse in mixed ward. 4) The highest energy
      expenditures of nurse engaged in direct nursing care were 834 kcal (39.5%) for
      day-shift nurse in surgical ward, 632 kcal (34.9%) for evening-shift nurse in
      mixed ward, and 790 kcal (39.2%) for night-shift nurse in mixed ward. 5) The
      longest working hours were 174 min (34.1%) in assisting with medical examinations
      and treatment by day-shift nurse, 155 min (31.3%) in direct care by evening-shift
      nurse, and 222 min (39.0%) by night-shift nurse. The results indicate that the
      energy expenditure calculated from the average heart rate of ward nurses in
      higher than that of other types of workers. The reason for this difference is
      discussed in this report. Also, this study showed that the energy expenditure
      determined by this method does not necessarily increase in proportion to working
      hours.

PMID- 1753444
TI  - [Multivariate analysis on subjective symptoms in forestry workers using chain
      saw].
AB  - This study was conducted to evaluate the relationship between the prevalence of
      subjective symptoms in workers using vibrating tools and the duration of chain
      saw operation and to examine whether the symptoms were relevant to factors other
      than the usage of vibrating tools. The statistical model of multivariate analysis
      was adapted to analyze individual data on the subjective symptoms of 317 chain
      saw operators. The obtained results were as follows: 1. In analysis of
      covariance, age-adjusted operating year in workers with peripheral circulatory,
      peripheral neurological and musculoskeletal disturbances was significantly longer
      than that without such disturbances. For these disturbances, partial regression
      coefficients of operating year were significantly high in multiple regression
      analysis. These results show that these disturbances and age-adjusted operating
      year are mutually closely related. 2. Multiple regression analysis showed that
      the partial regression coefficients of both operating year and age were low for
      nine symptoms, i.e. dulling sense of touch, joint pain, headache, dizziness
      and/or tinnitus, profuse sweating, discomfort of stomach, palpitation and/or
      dyspnea, hearing disturbance and lumbago. These results suggest that such
      symptoms were not related to either age or chain saw operation. 3. The results of
      principal component analysis were visualized in three-dimensional space in order
      to evaluate the relationships among the symptoms. The analysis showed that
      peripheral circulatory and neurological disturbances appeared independently and
      that general symptoms such as easy fatigability, headache, forgetfulness, vertigo
      and/or tinnitus, easy irritability, sleep disorder, profuse sweating, discomfort
      of stomach, palpitation and/or dyspnea, shoulder stiffness, hearing disturbance
      and lumbago consisted of four independent groups. Each group has no relationship
      with duration of chain saw operation. This suggests other harmful factors of the
      groups play a role in the prevalence of the symptoms.

PMID- 1753445
TI  - [The evaluation of serum creatine phosphokinase for estimation of energy
      expenditure in human subjects].
AB  - We investigated the relationship between serum creatine phosphokinase (CPK)
      activity and energy expenditure in young adults and evaluated whether serum CPK
      activity is a useful index of energy expenditure. These data were obtained from
      225 (men: 94, women: 131) healthy young adults. The results of the survey were as
      follows: In men, there was a statistically significant correlation between serum
      CPK activity and energy expenditure (r = 0.370; p less than 0.01; y = 1986.0 +
      8.2x), energy expenditure/body weight (r = 0.270; p less than 0.01 y = 35.4 +
      0.06x) and daily activity index (r = 0.357; p less than 0.01; y = 0.38 + 0.0030x)
      In women, there was a statistically significant correlation between serum CPK
      activity and energy expenditure (r = 0.207; p less than 0.05; y = 1895.0 + 3.0x),
      and daily activity index (r = 0.194; p less than 0.05; y = 0.432 + 0.0017x). The
      higher the proportion of exercising subjects, the higher was the serum CPK
      activity. These results suggest that measurement of serum CPK activity can be
      used to evaluate energy expenditure.

PMID- 1753446
TI  - [Evaluation of sensory disturbances using short-latency somatosensory evoked
      potentials (SSEPs) in vibration-exposed workers].

PMID- 1753447
TI  - [Significance of blood pressure at the time of work place health checkup in
      comparison with 24-hour ambulatory blood pressure].

PMID- 1753448
TI  - [DNA-adduct detection in rats administered with 4,4'-methylenedianiline or 4,4'
      methylenebis (2-chloroaniline)].

PMID- 1753449
TI  - Down regulation of serotonin uptake sites in rat brain induced by concomitant
      chronic administration of desipramine and repeated stress.

PMID- 1753450
TI  - Effects of hippocampal neurotoxicant, trimethyltin, on corticosterone response to
      a swim stress and glucocorticoid binding capacity in the hippocampus in rats.

PMID- 1753451
TI  - Plasma beta-phenylethylamine levels in mood disorders.

PMID- 1753452
TI  - The tail suspension test for screening antidepressant drugs: comparison of
      movement in ICR and NMRI mice.

PMID- 1753453
TI  - Characterization of human platelet [125I]R-DOI binding sites by in vitro
      autoradiography.

PMID- 1753454
TI  - Modulation of 5-HT2 receptor-mediated intracellular calcium movement in platelets
      and its function in affective disorders.

PMID- 1753455
TI  - Rat hippocampal 5-HT1c receptor binding and 5-HT1c receptor mediated rat blood
      corticosterone responses.

PMID- 1753456
TI  - Effects of Ca2+ antagonists on NA-induced intracellular Ca2+ mobilization in rat
      cultured neurons.

PMID- 1753457
TI  - Effects of repeated treatment with electro-convulsive shock and imipramine on
      serotonin2 receptor functions.

PMID- 1753458
TI  - A clinical study on intellectual impairment in parkinsonian patients during long
      term treatment.
AB  - The severity of intellectual impairment of 89 patients with Parkinson's disease
      was evaluated with the Osaka Intelligence Scale for the Aged (OISA). Based on
      their intelligence levels, the patients were divided into three groups: normal,
      slight dementia and dementia. EEGs, psychiatric complications such as
      hallucination, degree of motor disability, history of medication, relationship
      between changes in intelligence and total amount of administered drugs were also
      examined. There was no significant correlation between the length of duration of
      the illness and the degree of intellectual impairment. Two characteristic
      subgroups were found among our subjects: a group of patients who rapidly became
      demented after the onset of Parkinsonism, and a group of patients whose
      intelligence was preserved for a longer period. The mean age of the onset of the
      disease in the former group was older than that of the latter. Patients of the
      former group exhibited psychiatric complications and EEG abnormalities more
      frequently. The severity of motor disability and medications administered at the
      time of the OISA examination did not differ between the two groups. Deterioration
      of the intelligence of the patients with Parkinson's disease did not correlate
      with the total amount of the administered antiparkinsonian drugs.

PMID- 1753459
TI  - Biochemical characteristics of the membrane-inserted protein kinase C in the rat
      brain membrane.

PMID- 1753460
TI  - Effect of chronic administration of trazodone on the 5-HT 1A mediated inhibition
      of forskolin-stimulated adenylate cyclase activity.

PMID- 1753461
TI  - The functional maturation of fetal biological rhythm.

PMID- 1753462
TI  - Alteration of circadian rhythm in shift-working ambulance personnel.

PMID- 1753463
TI  - Pattern, trough and amplitude of rectal temperature during sleep in healthy
      subjects.

PMID- 1753464
TI  - Effects of clothing types on the circadian rhythm of human core temperature.

PMID- 1753465
TI  - Menstrual cycle and vaginal temperature rhythm.

PMID- 1753466
TI  - Does triazolam change the human circadian rhythms?

PMID- 1753467
TI  - Bright lights accelerate the re-entrainment of circadian clock to 8-hour phase
      advance shift of sleep-wake schedule: 1) Circadian rhythms in rectal temperature
      and plasma melatonin level.

PMID- 1753468
TI  - Effects of bright light on sleepiness at night.

PMID- 1753469
TI  - Circadian rhythm disturbance in patients with hypothalamic lesion.

PMID- 1753470
TI  - Desynchronization of body temperature and blood pressure: circadian rhythms in
      patients after subarachnoid hemorrhage.

PMID- 1753471
TI  - Circadian rhythm of melatonin secretion and body temperature in a patient with
      seasonal affective disorder.

PMID- 1753472
TI  - Biological rhythm of anorexia nervosa: studies on the body temperature and PSG.

PMID- 1753473
TI  - Two cases of delayed sleep phase syndrome (DSPS).

PMID- 1753474
TI  - Vitamin B12 treatment for sleep-wake rhythm disorders.

PMID- 1753475
TI  - Treatment of persistent sleep-wake schedule disorders in adolescents and vitamin
      B12.

PMID- 1753476
TI  - The effects of vitamin B12 on the suppression of melatonin secretion under
      illumination.

PMID- 1753477
TI  - Does methylcobalamin (vitamin B12) increase the light sensitivity of human
      circadian clock?

PMID- 1753478
TI  - Effect of subchronic administration of methylcobalamin on the acetylcholine and
      choline content in the brain and locomotor activity in rats.

PMID- 1753479
TI  - The facilitating effects of vitamin B12 on the re-entrainment of body temperature
      and locomotor activity rhythms to new light-dark cycle.

PMID- 1753480
TI  - Seasonal variations of the circadian rhythms in seasonal affective disorder.

PMID- 1753481
TI  - A case with delayed sleep phase syndrome showing a significant seasonal variation
      in sleep-wake cycle.

PMID- 1753482
TI  - Clinical features of seasonal affective disorder in Japan: an interim report for
      the second year of multicenter collaborative study.

PMID- 1753483
TI  - Phototherapy of seasonal affective disorder.

PMID- 1753484
TI  - Seasonal variation of the human circadian rhythms (2) sleep EEG.

PMID- 1753485
TI  - Effect of the period of light-dark cycle on photoperiodic response in the
      circadian rhythm of rat behavior.

PMID- 1753486
TI  - A case of alcoholic dementia with hypomagnesemia and hypocalcemia.
AB  - A 47-year-old man with chronic alcoholism was admitted to a psychiatric
      institution because of his mental symptoms and abnormal behavior. He had
      dementia, emotional disturbances, muscle cramps (tetanic fits), and impairment of
      abstract thinking and psychomotor function. The biochemical examination of his
      blood revealed hypomagnesemia, hypocalcemia and a low level of serum parathyroid
      hormone. The administration of Ca lactate improved hypocalcemia and muscle
      cramps, but not the other symptoms. An addition of Mg sulfate did not change the
      clinical condition and the serum electrolyte level. From these findings a
      relation of chronic alcohol intake to the imbalance of serum electrolytes as well
      as a low level of serum parathyroid hormone was discussed, and a pathogenetic
      mechanism of dementia observed in this case was speculated.

PMID- 1753487
TI  - Computerized tomographic study on the brain of patients with alcohol dependence.
AB  - One hundred ten patients with alcohol dependence and 56 psychiatric patients with
      either senile dementia, amphetamine psychosis, epilepsy or chronic schizophrenia
      were investigated with a CT scan of the brain. The maximum width of the 3rd
      ventricle was measured, and the presence/absence of enlargement of the lateral
      ventricle and of atrophy of the frontal lobe was determined independently by 3
      physicians. The width of the 3rd ventricle in alcoholic and the other patients
      examined was gradually enlarged with aging, and the width in these patients was
      significantly larger than that in the age-matched control patients who were
      selected from the patients with amphetamine psychosis, epilepsy or schizophrenia.
      The enlargement of the lateral ventricles observed in the alcoholic patients
      always accompanied the enlargement of the 3rd ventricle, but not vice versa. The
      alcoholic patients with frontal lobe atrophy showed a higher incidence of
      withdrawal delirium than the patients without atrophy. These findings suggest
      that the chronic intake of alcohol might affect primarily the area around the 3rd
      ventricle, resulting in enlargement of this ventricle and consequential
      enlargement of the lateral ventricles and also that the alcoholic patients with
      frontal lobe atrophy could have a high risk for a manifestation of alcoholic
      withdrawal delirium.

PMID- 1753488
TI  - Comparison of body temperature rhythms between healthy elderly and healthy young
      adults.
AB  - The fact that the elderly are usually aware of early sleep onset and early
      morning awakening shows that the phase of sleep-wake rhythms in the elderly is
      more advanced than that in young adults. Since it has been suggested that human
      sleep onset, morning awakening, sleep period and depth of sleep are highly
      influenced by body temperature rhythms, rectal temperature rhythms were analyzed
      in 7 healthy elderly and 7 healthy young adults under the condition with time
      cue. Although a significant 24-hour period was found in the rhythms for all
      subjects, the phase of the rhythms in the elderly was more advanced than in the
      young adults. Moreover, a significant inverse correlation was observed between
      age and acrophase time in the elderly.

PMID- 1753489
TI  - Methylphenidate and interpersonal relationships of children with attention
      deficit hyperactivity disorder.
AB  - In order to clarify the effects of methylphenidate on interpersonal relationships
      of children with attention deficit hyperactivity disorder (ADHD), data from
      sociometric tests conducted in 28 classes to which ADHD children belonged was
      analyzed, comparing patients who had a history of methylphenidate treatment with
      those who had not. It was suggested that ADHD children with a history of
      methylphenidate treatment had more favorable votes and fewer unfavorable ones
      than those without it. However, there were more isolated children among ADHD
      children with methylphenidate treatment than in those without it. The results are
      discussed in the light of previous findings in the literature and a hypothesis
      for methylphenidate induced isolation is proposed.

PMID- 1753490
TI  - Linkage analysis of affective disorder using DNA markers on chromosomes 11 and X.
AB  - We have investigated two pedigrees in an attempt to detect the putative linkages
      between affective disorder and c-Ha-ras-1 oncogene and the insulin gene on
      chromosome 11, or hypoxanthine phosphoribosyltransferase (HPRT) on X chromosome.
      The linkage between affective disorders and the markers on chromosomes 11 and X
      was ruled out with the assumption of no recombination.

PMID- 1753491
TI  - Abnormalities in event-related potentials, N100, P200, P300 and slow wave in
      schizophrenia.
AB  - Event-related potentials were recorded in 54 schizophrenics and 88 age-matched
      controls during a two-tone discrimination (odd ball) task. All the subjects were
      free from medication. In the schizophrenics, the mean amplitudes of the N100,
      P300 and Slow Wave latency ranges were decreased, and the amplitude of the P200
      latency range was greater than that for the controls. These reductions and the
      increase were found both for the ERPs elicited by rare target stimuli and for
      those elicited by frequent nontarget stimuli. The peak latency of N200 to rare
      stimuli was more prolonged in the schizophrenics than in the controls. This
      finding confirms the prolongation of N200 latency that Brecher et al. (1987)
      found for a different visual stimuli task. Neither the N100 nor P300 latency
      differed between the two groups.

PMID- 1753492
TI  - Clinical variants of tardive dyskinesia in Japan.
AB  - Involuntary movement disorders were investigated in a psychiatric hospital in
      Japan. The prevalence of tardive dyskinesia was 9.9% and four clinical variants
      of tardive dyskinesia could be classified. Of the 716 patients, tardive dystonia
      was identified in 15 cases, tardive akathisia in one, respiratory dyskinesia in
      two and rabbit syndrome in 17. The existence of tardive forms for acute dystonic
      reactions and akathisia suggests that any type of acute extrapyramidal symptoms
      can have a tardive form.

PMID- 1753493
TI  - Depression antedating the onset of Parkinson's disease.
AB  - Neurological and depressive symptoms in a subtype of Parkinson's disease (PD), in
      which a depressive state precedes the clinical manifestation of neurological
      symptoms, were examined on the basis of clinical observations for 3 years or
      more. PD, in which depression preceded, was different from PD with preceding
      neurological symptoms, in the severity of not only neurological but also
      depressive symptoms. These results suggest that PD in which depression precedes
      neurological symptoms is a specific subtype of PD. It was speculated that the
      differences in clinical symptoms might be due to a biological background, in
      particular the dopaminergic system.

PMID- 1753494
TI  - Vascular changes in the brains with Alzheimer's disease.
AB  - Sections of temporal and occipital cortex from 14 patients with Alzheimer's
      disease were examined by light and electron microscopy. Especially, areas without
      senile plaques or neurofibrillary degeneration were examined in detail. The
      initial change in the cerebral cortex occurred in the capillaries. The
      endothelial cells demonstrated degeneration with hypertrophic distorted basement
      membranes and swelling of the vascular feet. Lipochromes were found in the
      processes and cell bodies of the astrocytes. A decrease in the number of nerve
      cells and their processes noted in the cortices may be due to primary vascular
      degeneration. Severe dementia in Alzheimer's disease may be related to the
      histopathological findings of diffusely destroyed nerve cells and their
      processes.

PMID- 1753495
TI  - Ultrastructure of senile plaque using thick sections in the brain with
      Alzheimer's disease.
AB  - The subjects used in the present study consisted of 8 cases with Alzheimer's
      disease. Senile plaques which seemed to have no relation with the capillaries
      were examined in thick serial sections (3,000-5,000 A) by electron microscope.
      The results obtained were as follows: All of those senile plaques had amyloid
      angiopathy with amyloid fibrils and these amyloid fibrils formed the main
      elements of senile plaques. From these findings, it was confirmed that the
      amyloid fibrils in all plaques are produced from the capillaries.

PMID- 1753496
TI  - Ultrastructure of neurofibrillary tangles in Alzheimer's disease by means of tilt
      stage electron microscopy.
AB  - Neurofibrillary tangles (NFT) in the brains of patients with Alzheimer's disease
      were examined by means of tilt-stage electron microscopy. Observing a
      longitudinal direction, constricted parts of the NFT did not move in an axial
      direction. In a transverse section, a fibril of the NFT consisted of globular
      subunits having a hollow structure in the center and did not appear as paired
      filaments. From these findings, it was considered that a fibril of NFT consists
      of twisted protofilaments made up of globular subunits and does not consist of
      paired helical filaments.

PMID- 1753497
TI  - [Respiratory tract infection and immunodeficiency].
AB  - Many defense mechanisms are located in the respiratory tract, since they are
      constantly exposed to a variety of pathogens from both inside and outside the
      body. Among the various defense mechanisms, the immune system is so potent that
      immunodeficiency results in proneness to infections and repeated and/or
      intractable infection. It is not uncommon to encounter patients with congenital
      immunodeficiency in clinical practice because of recent advances in supportive
      therapy. This paper describes cases of primary immunodeficiency that developed
      respiratory infections, together with the results of investigations of their
      immune status. Doctors should suspect the possibility of immunodeficiency in
      patients with repeated or intractable respiratory infections. Intractable
      respiratory infections, however, have been seen with increasing frequency in the
      elderly because of the increase in the elderly population. One reasons for this
      is the physiologic immunodeficiency associated with aging, which is characterised
      by decreased antigen-induced lymphocyte proliferation, IL-2 production, IL-2R
      expression, hsp 70 mRNA production, and demethylation of T lymphocytes, and
      delayed degradation of c-myc mRNA.

PMID- 1753498
TI  - [Management of respiratory diseases in the elderly].
AB  - Aspiration pneumonia is the fourth cause of death in Japanese, of which 92%
      occurs in elderly people aged more than 65 years. Pneumonia in the elderly is
      mostly due to aspiration. Aspiration is caused by disturbance of the pharyngeal
      reflex and cough mechanisms are due to disturbances of brain activity.
      Respiratory diseases including bronchial asthma must be treated with
      consideration of brain activity.

PMID- 1753499
TI  - [Immunohistochemical findings in resected lung cancer].
AB  - The relationship between histological type and immunohistological findings was
      studied in total 141 cases of resected lung cancer. Adenocarcinoma was
      cytologically subtyped according to the ultrastructural findings.
      Immunohistochemical staining was performed on paraffin-embedding tissue using the
      avidin-biotin-peroxidase complex method for carcinoembryonic antigen (CEA),
      keratin, secretory component (SC), neuron specific enolase (NSE), lysozyme (Ly)
      and lactoferrin (La). Adenocarcinoma stained strongly positive with antibody
      against CEA and SC. There was no statistical difference among the different
      subtypes of adenocarcinoma, but in the cases of clara cell type, CEA staining was
      less intense and in goblet cell type, the intensity of SC staining was great.
      Goblet cell type characteristically stained positively with anti-Ly antibody, and
      Ly was a specific marker for differentiating adenocarcinoma of goblet cell type.
      La was positive not only in bronchial gland cell type, but also in other subtypes
      in adenocarcinoma. Squamous cell carcinoma showed more intense staining with anti
      keratin antibody than other histological types. Small cell carcinoma extensively
      stained with anti-NSE antibody, but some of the other histological types also
      stained positively. NSE was a relatively good marker for small cell carcinoma but
      was not specific. It is concluded that immunohistochemical examination is a
      useful method for differentiation of different histological types of lung cancer.

PMID- 1753500
TI  - [Changes in respiratory resistance and dynamic compliance induced by histamine in
      the guinea pig].
AB  - Respiratory resistance and dynamic compliance in guinea pigs were measured by
      pulmonary mechanics analyzer Buxco Model 6. Changes induced by intravenous
      injection of histamine were studied. Administration of histamine caused dose
      dependent increase in respiratory resistance and decrease in dynamic compliance
      in guinea pigs. The increase in respiratory resistance by repeated injections of
      the same dose of histamine was maintained at the same level 5 hours after the
      first injection. However, the decrease in dynamic compliance by histamine
      administration decreased significantly from 1 to 4 hours after the first
      injection. The baseline resistance increased from 1 to 5 hours after the first
      injection of histamine. The baseline compliance decreased from 1 to 5 hours after
      the first injection.

PMID- 1753501
TI  - [Lung function following sleeve bronchoplastic lobectomy for bronchogenic
      carcinoma].
AB  - Twenty-five patients who underwent upper sleeve lobectomy for lung cancer were
      studied by spirometric examination to evaluate postoperative pulmonary function,
      including Vital Capacity (VC), %Vital Capacity (%VC), Forced Expiratory Volume in
      one second (FEV1.0), and Forced Expiratory Volume in one second as a percentage
      of the forced vital capacity (FEV1.0%). The results of the patients with
      bronchoplasty were compared with those of patients with lobectomy alone and of
      patients with pneumonectomy. Lung function was periodically examined
      postoperatively following bronchoplasty. VC, %VC and FEV1.0 were decreased
      postoperatively in the patients with upper sleeve lobectomy, while FEV1.0% was
      increased. There were no differences in postoperative %VC or FEV1.0% between the
      patients with bronchoplasty and those with upper lobectomy alone. However, the
      postoperative %VC of the patients with pneumonectomy was significantly decreased
      compared with patients who underwent postoperative %VC of the patients with
      pneumonectomy was significantly decreased compared with patients who underwent
      bronchoplasty or lobectomy alone. %VC in the patients with bronchoplasty was
      decreased at 3 months after operation, but it to gradually returned to the
      preoperative value by 13 to 24 months after operation.

PMID- 1753503
TI  - [Longitudinal analysis of a four-year follow up of pulmonary function development
      in children with a past history of asthma].
AB  - In order to longitudinally study the pulmonary function development of children
      with a history of asthma, we measured the flow-volume curves of 441 fourth-grade
      children in seven primary schools randomly selected from the Kashima district in
      Ibaraki prefecture in 1980, and again in 1982 and 1984. Levels and slopes of
      pulmonary function indices for individual children were calculated in 325
      children who performed acceptable forced expiratory maneuvers at all of the three
      surveys. In FVC and FEV1, no significant difference of levels and slopes was
      observed between children with asthmatic history and control children. However,
      the level and slope of V25 of children with asthmatic history were significantly
      lower than those of control children (0.5 l/sec for the level, 0.08 l/sec for the
      slope) even when only those who did not suffer from wheezing attack during the
      follow-up period were concerned. These results suggested that the functional
      change of peripheral airways in children with asthmatic history did not recover
      within a couple of years even when they were in remission. Moreover, the
      functional differences between those two groups of children might become larger
      in early adolescence.

PMID- 1753502
TI  - [Lung injury in idiopathic pulmonary fibrosis and measurement of immunoreactive
      neutrophil elastase and alpha 1-protease inhibitor in blood].
AB  - Idiopathic pulmonary fibrosis (IPF) is thought to develop through slowly
      progressing lung injury, in which fibrosis occurs as a result of abnormal repair
      processes. Lung injury in emphysema, in which the normal extracellular matrix is
      destroyed, is considered to occur mainly because of protease-antiprotease
      imbalance. In order to examine whether the pathogenesis of IPF involves the
      proteolytic mechanism of enzymes as in emphysema, concentrations of plasma
      neutrophil elastase and serum alpha 1-protease inhibitor were measured in
      patients with IPF, and compared with the levels in patients with emphysema and in
      normal individuals. In some patients with IPF, the blood concentration of
      neutrophil elastase was much higher than normal and the degree of imbalance
      between neutrophil elastase and alpha 1-protease inhibitor was significantly
      great than in patients with emphysema. In these patients, many years had passed
      since the onset of the disease, the number of leukocytes and neutrophils and the
      concentration of LDH in peripheral blood were significantly higher than normal,
      and the concentration of CEA-II was slightly increased. These data suggest that
      chronic, massive lung injury had occurred. The blood concentration of neutrophil
      elastase and alpha 1-protease inhibitor ratio may be useful in assessing the
      degree of lung injury.

PMID- 1753504
TI  - [Effects of differently composed liposomes on pulmonary arterial pressure in
      sheep--involvement of pulmonary intravascular macrophages].
AB  - The authors previously reported that liposomes, when injected intravenously,
      produce transitory pulmonary hypertension with increased secretions of
      thromboxane A2 from activated intravascular macrophages that phagocytize
      liposomes in sheep. In the present study, we attempted to determine whether such
      responses were modified by the lipid compositions of the liposomes. Five
      different types of liposomes were prepared by reverse-phase evaporation. The
      liposomes used were composed of phosphatidylcholine (PC), cholesterol (CHOL), and
      either phosphatidylglycerol (PG-liposomes), phosphatidylserine (PS-liposomes),
      phosphatidylethanolamine (PE-liposomes), stearlyamine (SA-liposomes) or none (PC
      liposomes). The net charges of PG and PS-liposomes were negative, SA-liposomes
      were positive, PE- and PC-liposomes were neutral. Each liposome was injected
      intravenously to obtain a pulmonary arterial pressure response. Arterial blood
      was sampled before and after liposome injections to measure thromboxane B2
      concentrations. All liposomes, but not PC-liposomes, produced pulmonary arterial
      hypertension associated with increased arterial thromboxane B2 concentrations,
      irrespective of the net surface charge of the liposome. PG and PS-liposomes, both
      of which were negatively charged, showed different dose-response curves, the two
      different types of neutral liposomes showed different responses, and PC-liposomes
      produced a small increase in pulmonary arterial pressure. PE-liposomes produced
      marked increases in the pulmonary arterial pressure. From these results, the
      authors concluded that pulmonary arterial pressure responses to the liposomes are
      modified by the lipid compositions of the liposomes, and that this is not caused
      by the difference in the net charge of each liposome.

PMID- 1753505
TI  - [Etiological examination of idiopathic interstitial pneumonia and lung cancer in
      autopsy cases].
AB  - In order to investigate the etiology of usual interstitial pneumonia (UIP) and
      UIP with lung cancer (LC), autopsy findings in 18 cases of UIP with LC and 11
      cases of uncomplicated UIP were clinicopathologically compared with the
      environmental factors of smoking habits and occupation. UIP with LC was highly
      correlated with smoking, especially heavy smoking and with occupations in which
      dust is inhaled, such as electrical installation and ceramic production,
      indicating that these environmental factors are important background factors in
      the complication of UIP with IC. Pathologic examination of cases of UIP with LC
      (6 squamous cell carcinomas, 5 small cell carcinomas, 4 adenocarcinomas, and 3
      large cell carcinomas, 2 of which showed pulmonary double carcinoma revealing a
      slight correlation between fibrosis and primary site of LC and a slightly greater
      correlation of squamous cell carcinoma and small cell carcinoma to smoking habits
      and inhalation of dust. In terms of the correlation between UIP and LC among
      autopsy cases, the environmental factors proved to be more significant than the
      fibrotic findings. These environmental factors are thought to merit consideration
      as common predisposing factors in the development of LC and its complication with
      UIP.

PMID- 1753506
TI  - [Nucleolar organizer regions, nuclear DNA content, and proliferative activity in
      adenocarcinoma of the lung].
AB  - The relationship between the quantity of silver-binding nucleolar organizer
      regions (AgNORs), nuclear DNA content, and proliferative activity was studied in
      61 patients with adenocarcinoma of the lung. The proliferative activity of
      adenocarcinoma was estimated by tumor volume doubling time based on chest X-ray
      findings. There was a high, inverse correlation between the AgNORs and the tumor
      doubling time (p less than 0.001, r = -0.815), and the contribution rate was high
      value (2 = 0.664). However, the AgNORs value was an independent prognostic factor
      for survival time. A better 5-year survival rate was observed in patients with
      DNA diploidy than in DNA aneuploidy, but there was no statistical difference
      between the two groups. There was an inverse correlation between the DNA index
      and tumor doubling time (p less than 0.05, r = -0.565), but the contribution rate
      had a low value (r2 = 0.319). These results indicate that the AgNORs value is
      important in providing an estimate of the proliferative activity of
      adenocarcinoma.

PMID- 1753507
TI  - [Percutaneous instillation of fluconazole in the treatment of pulmonary
      aspergilloma].
AB  - A 68-year-old woman had pulmonary aspergilloma in the right upper lobe with old
      cavitary pulmonary tuberculosis. Despite intravenous fluconazole there was no
      change in the size of the fungus ball. Endobronchial instillation of fluconazole
      also failed. Subsequently percutaneous instillation of fluconazole was attempted
      with localized drainage. The fungus ball decreased in size after 8 weeks.
      Although slight hemoptysis and subcutaneous emphysema occurred in this case,
      these condition required no treatment. This method of treatment appears to be
      useful for inoperable cases of pulmonary aspergilloma.

PMID- 1753508
TI  - [Fulminant mycoplasma pneumoniae infection presenting with Stevens-Johnson
      syndrome & respiratory failure].
AB  - An 18-year-old man was admitted to Hamamatsu University Hospital on February 15,
      1985, with high fever, vesicular and papular rash involving the skin and mouth,
      conjunctivitis, productive cough and dyspnea. A diagnosis of Stevens-Johnson
      syndrome was made by skin biopsy, and chest X-ray showed an infiltrate in the
      right lower lung filed. Despite treatment with corticosteroids and antibiotics,
      the mucocutaneous lesions did not heal, and the pneumonia progressed to both lung
      fields. Because the patient had developed dyspnea, a tracheotomy was performed,
      mechanical ventilatory support was instituted, and high-dose corticosteroid
      therapy was started. However, jaundice due to intrahepatic cholestasis,
      hematuria, hematochezia, sepsis, and subcutaneous and mediastinal emphysema
      ensued, and the patient died of respiratory failure on March 1. Postmortem
      examination of the lung demonstrated diffuse alveolar damage. The complement
      fixation titer for Mycoplasma was 1:64, compared with a level of less than 1:4 on
      admission. This case was though to be one of fulminant Mycoplasma pneumoniae
      infection presenting with Stevens-Johnson syndrome, respiratory failure and other
      extra-pulmonary complications.

PMID- 1753509
TI  - [A case of chest wall rhabdomyosarcoma].
AB  - A 56-year-old man was admitted to our hospital with right chest pain. Chest X
      ray, CT scan and MRI revealed a chest wall tumor and enlarged mediastinal lymph
      nodes. Percutaneous lung biopsy was performed, and the pathological diagnosis of
      pleomorphic rhabdomyosarcoma was obtained. The only significant abnormal
      laboratory finding was elevation of serum NSE (24.5 ng/ml). Although chemotherapy
      (VAC-ADM) and radiation therapy were performed, the patient died about 7 months
      after admission. To our knowledge, only 17 cases of chest wall rhabdomyosarcoma
      have been reported in Japan.

PMID- 1753510
TI  - [A case of Swyer-James syndrome diagnosed by selective alveolobronchography].
AB  - A 33-year-old male was admitted to our hospital for further investigation of
      unilateral hyperlucency of the left upper and middle lung fields on chest X-ray.
      A pulmonary scan showed decreased perfusion of the left upper and middle lung
      fields. Pulmonary arteriography demonstrated small left pulmonary arteries with
      diminished peripheral vascular branches. Left bronchogram showed almost normal
      distribution of main and subsegmental bronchi, but poor filling by contrast in
      the peripheral bronchi. From these findings, the patient was diagnosed as having
      Swyer-James syndrome. In order to demonstrate the alveoli in this syndrome,
      selective alveolobronchography (SAB) was performed. SAB revealed coarse ring
      shadows of B1+2.

PMID- 1753511
TI  - [A case of hypereosinophilic syndrome followed by bronchial asthma,
      intraventricular thrombus, and duodenitis].
AB  - We report a 43-year-old male with hypereosinophilic syndrome. The patient has had
      eosinophilia since the age of 25. He developed bronchial asthma at 41 years of
      age. In the following year, he consulted a gastroenterologist because of fever
      and abdominal discomfort. Upper gastrointestinal study showed duodenitis. At the
      age of 43 years, there was slight fever, watery diarrhea, and eosinophilia.
      Examination in our department disclosed hypereosinophilic syndrome associated
      with duodenitis, endomyocarditis with an intraventricular thrombus, and bronchial
      asthma caused by house dust. Both prednisolone and aspirin were administered with
      improvement of eosinophilia and partial thrombolysis. Assays of IL-3, GM-CSF, and
      IL-5 revealed increased activity of IL-5, GM-CSF, and IL-3 in this order.
      Especially IL-5 has by far the strongest activity in these cytokines. IL-5 may
      play an important role in the development of hypereosinophilic syndrome.

PMID- 1753512
TI  - [A case of eosinophilic granuloma of the cervical lymph nodes associated with
      pulmonary cystic lesions].
AB  - A 33-year-old man was referred to our department because of left cervical
      lymphadenopathy for one month which did not respond to antibiotics. Histological
      examination of the lymph node biopsy revealed eosinophilic granuloma. However,
      repeated bronchoscopic examinations performed to evaluate the pulmonary lesions
      appearing on chest roentgenograms and chest CT scans revealed no evidence of
      eosinophilic granuloma. Steroid therapy resulted in resolution of the cervical
      lymphadenopathy, but the pulmonary lesions showed no response. The possible
      relationship between eosinophilic granuloma and pulmonary cystic lesions in our
      patient is discussed.

PMID- 1753513
TI  - [A case of Kearns-Sayre syndrome with impaired respiratory regulation].
AB  - We reported a case of Kearns-Sayre syndrome with impaired respiratory regulation.
      A 55-year-old male was admitted to our hospital complaining of chronic
      progressive external ophthalmoplegia, limb muscle weakness and dyspnea. On
      admission, because arterial blood gas analysis showed marked alveolar
      hypoventilation, ventilatory response was measured and diminished
      chemosensitivity to both hypoxia and hypercapnia was found. His vital capacity
      and forced expiratory volume in 1 second were slightly decreased, and a chest X
      ray film revealed a moderate degree of elevation of the bilateral diaphragm.
      Therefore, we considered that the diminished response to hypoxia and hypercapnia
      in this case was caused by an impairment of the respiratory center, as well as
      chemoreceptors and also the presence of respiratory muscular weakness.

PMID- 1753514
TI  - [A case of chronic pulmonary emphysema with a past history of bilateral carotid
      body resection].
AB  - A 76-year-old man, whose carotid bodies had been resected for treatment of
      bronchial asthma 40 years previously was admitted for evaluation of abnormal
      arterial blood gases and exertional dyspnea. The case was diagnosed clinically as
      chronic pulmonary emphysema. His peripheral chemoreceptor function, estimated by
      hypoxic ventilatory and P0.1 response tests and withdrawal test was non
      functioning. His PaCO2 value tended to rise over 50 Torr either after light
      exercise or during airway infection, though it was normal at rest. In addition
      his dyspnea had continued for 40 years in spite of carotid body resection. It was
      concluded that the effect of carotid body resection lasts more than 40 years and
      it does not have a good effect on COPD.

PMID- 1753515
TI  - [Superior vena cava syndrome as initial symptom of Vasculo-Behcet's disease--case
      report].
AB  - A 26-year-old woman with a history of recurrent spontaneous abortion was admitted
      because of superior vena cava syndrome. Chest computed tomography and digital
      subtraction angiography revealed obstruction of the superior vena cava by a
      thrombus. After admission she also developed oral aphthous ulceration, erythema
      nodosum, and positive cutaneous hypersensitivity reaction to intradermal
      injection of saline. Laboratory investigations revealed HLA-B51 and positive
      lupus anticoagulant. We made the diagnosis of Vasculo-Behcet's disease and
      treated her with heparin and urokinase with no clinical improvement. The fever
      subsided after prednisolone administration. Two years later, superior vena cava
      syndrome had slightly improved, although RI venography showed complete
      obstruction of the superior vena cava with development of collateral circulation.
      Endoscopic examination showed downhill esophageal varices. It is of note that the
      initial symptom in this case of Vasculo-Behcet's disease was superior vena cava
      syndrome, and that lupus anticoagulant may have contributed to the thrombus
      formation.

PMID- 1753516
TI  - [A case of pulmonary varices in which enhanced CT was useful for diagnosis].
AB  - A case of pulmonary varices in a 73-year-old female is presented. Routine chest X
      ray revealed a mass in the right hilar region. CR tomogram showed a round,
      clearly defined mass at the right hilum. Computed tomography demonstrated marked
      enlargement of the proximal portion of the pulmonary vein at the entrance of the
      left atrium, which was suspected to be pulmonary varices. The diagnosis was
      confirmed by pulmonary angiography. During the arterial phase no abnormal
      findings were seen, but during the venous phase the veins of the right upper and
      middle lobes were found to be draining into the dilated pulmonary vein and then
      into the left atrium. Thus, the diagnosis of pulmonary varices was established.
      CT and angiography are the most useful methods for definitive diagnosis of
      pulmonary varices.

PMID- 1753517
TI  - [An electron microscopic study of the pulmonary alveolar capillaries in
      idiopathic interstitial pneumonia and lungs of collagen vascular diseases].
AB  - The ultrastructure of pulmonary alveolar capillaries in idiopathic interstitial
      pneumonia (IIP) and collagen vascular diseases (CVD) were investigated. In IIP,
      the endothelial cells were only slightly swollen. The basement membrane (BM) was
      moderately thickened. In CVD, swelling of the endothelial cells and thickening of
      the BM were more severe than those of IIP. The injury of the endothelial cells
      seemed to be more severe than IIP. The patients with PSS and MCTD revealed
      degeneration of endothelial cells as well as lamellation of BM. The endothelial
      cell damage was most severe among CVD cases, and these changes were assumed to
      induce pulmonary hypertension. Microtubular structures were observed in the
      endothelium of SLE, dermatomyositis, polymyositis, PSS and MCTD patients. Weibel
      Palade bodies and increase of pericytes were noticed in PSS and MCTD patients
      which seemed to be related to endothelial injuries. No electron-dense deposits
      were observed in any case.

PMID- 1753518
TI  - [Evaluation of immunity based on bronchoalveolar lavage fluid in patients with
      pleural plaque in the chest X-ray].
AB  - Alveolar and lower respiratory tract immunity in addition to systemic immunity in
      31 patients with pleural plaques found on chest X-rays were evaluated. All cases
      had occupational histories of asbestos exposure, but ferruginous bodies in BAL
      fluid were only detected in 21 of 31 cases. The percentage of cell components in
      BAL fluid was evaluated according to the number of ferruginous bodies found in
      the BAL fluid. As the number of ferruginous bodies increased, neutrophils and T
      lymphocytes decreased, but B lymphocytes increased. Furthermore, CD25-positive
      cells were remarkably increased in patients with high exposure to asbestos. In
      addition, CD25-positive cells in the peripheral blood and serum soluble IL-2
      receptors were elevated in the patients with high exposure to asbestos.

PMID- 1753519
TI  - [A case of Ramsey Hunt syndrome with multiple cranial nerve paralysis and acute
      respiratory failure].
AB  - The authors report a 56-year-old woman with Ramsey Hunt syndrome with multiple
      cranial nerve paralysis and acute respiratory failure. Five days before
      admission, she experienced right otalgia and right facial pain and consulted an
      otolaryngologist of our hospital, who diagnosed the illness as acute parotitis
      and laryngopharyngitis. One day before admission, she experienced mild dyspnea
      and general fatigue and came to our hospital emergency room. A chest X-ray film
      revealed no abnormalities but some blisters were observed around her right ear.
      The next day, her dyspnea became more severe and she was admitted. A chest X-ray
      film on admission revealed right lower lobe consolidation, and neurological
      examination disclosed multiple cranial nerve paralysis, i.e., paralysis of the
      right fifth, seventh, eighth, ninth, tenth, eleventh, twelfth and left tenth
      cranial nerve. The serum titer of anti-herpes zoster antibody was elevated to
      1,024, and the patient was diagnosed as having Ramsey Hunt syndrome with multiple
      cranial nerve paralysis. Arterial blood gas analysis revealed hypoxemia with
      hypercapnea, which was considered to be due to aspiration pneumonia and central
      airway obstruction caused by vocal cord paralysis. Mechanical ventilation was
      soon instituted and several antibiotics and acyclovir were administered
      intravenously, with marked effects. Three months after admission, the patient was
      discharged with no sequelae except mild hoarseness. Patients with herpes zoster
      oticus, facial nerve paralysis and auditory symptoms are diagnosed as having
      Ramsey Hunt syndrome. This case was complicated by lower cranial nerve paralysis
      and acute respiratory failure, which is very rare.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1753520
TI  - [Leiomyosarcoma of the esophagus associated with pulmonary edema by the
      compression of the left atrium].
AB  - Leiomyosarcoma of the esophagus is a rare neoplasm. We reported a very rare case
      of esophageal leiomyosarcoma associated with pulmonary edema by the compression
      of the left atrium. A 67-year-old man was admitted with a 3-month history of
      chest pain, exertional dyspnea and dysphagia. Chest X-ray computed tomography
      showed posterior mediastinal tumor. Esophageogastroscopy and fiberoptic
      bronchofiberscopy showed no direct invasion of the tumor. By echocardiography,
      the left atrium was found to be compressed by the tumor and pulmonary
      hypertension (58/25 mmHg) and increased pulmonary wedge pressure (25 mmHg) was
      present. Open biopsy specimen demonstrated elongated cells suggestive of sarcoma.
      At autopsy, the tumor was confirmed to be leiomyosarcoma and to be originated
      from the lower esophagus.

PMID- 1753521
TI  - [A case of paragonimiasis Miyazakii with bilateral pleural and pericardial
      effusion].
AB  - A 38-year-old man was admitted to our hospital for further examination of
      bilateral pleural and pericardial effusion. He had complained of dyspnea on
      exertion occurring six months after ingestion of raw freshwater crabs, Patomon
      dehaani. X-ray films and CT scan of the chest taken on admission revealed massive
      bilateral pleural and pericardial effusion. High serum IgE level and eosinophilia
      were noted on laboratory examination. Antibody against Paragonimus Miyazakii
      antigen was detected in patient's serum as well as pleural and pericardial fluids
      by the Ouchterlony test. The patient was treated effectively by Bithionol.

PMID- 1753522
TI  - [A case of prolonged eosinophilic pneumonia with pulmonary emphysema and
      bronchial asthma diagnosed by open lung biopsy].
AB  - A 65-year-old man was admitted to our hospital complaining of productive cough,
      dyspnea and stridor. Chest X-ray disclosed overinflation with micronodular
      infiltrates. Blood examination showed mild eosinophilia and IgE elevation.
      Pulmonary function test disclosed severe airway obstruction and diffusion
      capacity impairment. Although clinical improvement was achieved after
      bronchodilator therapy, laboratory abnormalities continued. Open lung biopsy
      demonstrated mononuclear cellular and eosinophilic infiltration at alveolar lumen
      and vessel walls without prominent fibrosis, which was compatible for prolonged
      eosinophilic pneumonia. From above findings, this case was thought as a prolonged
      eosinophilic pneumonia combined with pulmonary emphysema and bronchial asthma.

PMID- 1753523
TI  - [A case of diffuse aspiration bronchiolitis secondary to achalasia of the
      esophagus].
AB  - A 12-year-old male was admitted to our hospital because of cough, sputum and
      increasing fever. Chest CT revealed ill-defined small round opacities located
      around the end of the bronchovascular branchings in almost all of the lung
      fields. These findings were compatible with diffuse panbronchiolities (DPB). On
      the other hand, the boy was diagnosed as having achalasia of the esophagus and
      fragments of food were observed in the bronchi by bronchoscopy. Repeated
      aspiration and infection due to achalasia are factors which brought about diffuse
      aspiration bronchiolitis (DAB).

PMID- 1753524
TI  - [A case of theophylline-induced rhabdomyolysis following therapy of bronchial
      asthma].
AB  - A case of a 81-year-old asthmatic male with Theophylline-induced rhabdomyolysis
      was reported. After intravenous administration of 250 mg of Aminophylline, he
      developed muscle weakness in the lower extremities. Serum CPK was 31,450 IU, and
      other enzymes escaping from skeletal muscles were elevated. Serum and urine
      myoglobin were also elevated. Cessation of Theophylline administration and
      conservative therapy resulted in improvement of rhabdomyolysis without
      concomitant acute renal failure. The present case was the 11th case of
      Theophylline-induced rhabdomyolysis in the world and the second case Japan.

PMID- 1753525
TI  - [Multiple pulmonary metastasis from histologically benign giant cell tumor of the
      right radial olecranon].
AB  - An unusual case of a benign giant cell tumor of bone with pulmonary metastasis is
      reported. A 23-year-old man had a painful tumor in the right radial olecranon
      that proved to be a histologically benign giant cell tumor. Curettage and bone
      grafting were performed, but the tumor recurred twice, 8 months and 20 months
      after initial treatment. Histological examination of biopsy materials from the
      recurring tumor showed typical benign giant cell tumors. Five years later, wedge
      resections were performed for bilateral pulmonary nodules, which had been
      detected by chance. The pulmonary nodules turned out to be histologically similar
      to the primary tumor of the olecranon. Almost 7 years later, he was asymptomatic
      and the chest radiograph was clear, and there was no local recurrence of the
      lesion.

PMID- 1753526
TI  - [Immunohistochemical and electromicroscopic study of a case of primary nodular
      pulmonary amyloidosis].
AB  - A 41-year-old man was hospitalized for further evaluation of an abnormal chest
      films which revealed a nodular shadow in the right middle lung field, which
      remarkably enlarged during one year. As no diagnostic procedures ruled out lung
      carcinoma of right S6, a right lower lobectomy was performed. Pathologically the
      nodules were composed of amorphous and eosionphilic materials which were
      diagnosed as amyloid by Congo-red stain and electron microscopic examination.
      Since there were no deposits in other organs and there was no abnormality of
      serologic and urinary protein analysis, a diagnosis of primary nodular pulmonary
      amyloidosis was established.

PMID- 1753527
TI  - [A case of pulmonary eosinophilic granuloma diagnosed by TBLB].
AB  - A case of pulmonary eosinophilic granuloma which was diagnosed by TBLB was
      presented. A 24-year-old male was admitted complaining of cough and fever of
      unknown etiology. He had a history of fever which had disappeared spontaneously 9
      months previously. Laboratory examinations including blood gas analysis and
      pulmonary function tests showed no significant abnormalities. Chest roentgenogram
      showed faint linear opacities. Computed tomography revealed multiple small cysts
      and small nodular lesions mainly in the upper lung field. CT findings were
      strongly suggested pulmonary eosinophilic granuloma. TBLB was performed and 6
      specimens were obtained, of which 4 showed granulomatous lesions consisting of
      histiocytosis X cell and inflammatory cells with infiltration of eosinophils.
      Furthermore, granulomatous lesions were positive for S-100 protein staining. The
      effectiveness of open lung biopsy has been emphasized in the diagnosis of
      pulmonary eosinophilic granuloma, however, TBLB is also useful for diagnosis,
      especially in the active or early stage of this disease.

PMID- 1753528
TI  - [A case report of the limited form Wegener's granulomatosis].
AB  - The classical from of Wegener's granulomatosis (WG) is a necrotizing
      granulomatous angiitis that involves the upper and lower airways, and kidneys. A
      limited form of WG is characterized by pulmonary lesions identical to those of
      classical form WG without renal involvement. The authors report a case of limited
      form WG. A 58-year-old Japanese woman was admitted because of an abnormal
      pulmonary shadow. Pathological examination revealed granulomatous angiitis
      consistent with WG. No other organ involvement was found. The pulmonary shadow
      improved with cyclophosphamide therapy. The patient is now well and without
      evidence of exacerbation of the disease 18 month after the discharge.

PMID- 1753529
TI  - [The suppressive effects of smoking on antibody production in experimental
      hypersensitivity pneumonitis in rabbits].
AB  - Farmer's lung disease is one type of hypersensitivity pneumonitis (HP) in dairy
      farmers, and is usually caused by Micropolyspora faeni (Mf). It has been reported
      that the positive rate of precipitin antibody to Mf in smoking dairy farmers is
      one-eighth to one-half of that in nonsmoking dairy farmers. To clarify the
      mechanism of this phenomenon, by using an experimental HP model in rabbits, we
      investigated 1) the effects of short (5 weeks) and long (20 weeks)-term cigarette
      smoke exposure on the antibody formation, 2) the effects of 30 weeks of smoke
      exposure on the accessory cell function of alveolar macrophages (AM). Smoking
      exerted variable influences on antibody production, depending on the duration of
      smoke exposure, and we confirmed that long-term smoke exposure had suppressive
      effects. In addition AM from smoked rabbits suppressed lymphoproliferative
      response to autologous spleen cells. It was concluded that in this experimental
      HP, smoking affects the functions of both AM and lymphocytes, and that it
      suppresses antibody production as long as the smoke exposure continues.

PMID- 1753530
TI  - [Effect of natural panting frequency and cheek support on the plethysmographic
      determination of thoracic gas volume in patients with chronic obstructive
      pulmonary disease].
AB  - The authors studied the effects of natural panting frequency (NF) and the cheek
      support on the plethysmographic measurement of thoracic gas volume (TGV) in 8
      normal subjects (non-smokers) and 46 patients with chronic obstructive pulmonary
      disease (COPD). The patients were divided into 2 groups according to the degree
      of airway obstruction (group I; specific airway conductance (SGaw) greater than
      0.1 (n = 18), group II; SGaw less than 0.1 (n = 28)). TGV was measured with a
      pressure-type body plethysmograph (BP). NF was 2.00 +/- 0.43 Hz (mean +/- SD) in
      control subjects, 1.92 +/- 0.78 Hz in group I, and 1.39 +/- 0.59 Hz in group II,
      respectively, indicating lower NF in the patients with severe airway obstruction.
      In control subjects and group I, the differences between TGV at NF and at 0.5-1.0
      Hz (TGVNF-TGV1.0) were -0.01 +/- 0.07L, and -0.06 +/- 0.16L, respectively, and
      cheek support did not alter the difference. On the other hand, in group II, the
      difference was slightly larger than other groups in spite of the lower NF, and
      this overestimation was abolished by cheek support (0.13 +/- 0.25L-----0.06 +/-
      0.27L, p less than 0.05). These results suggest that, in patients with severe
      airway obstruction, TGVNF may be overestimated even if NF is relatively low. This
      overestimation may be mainly due to the extrathoracic airway compliance including
      the cheek.

PMID- 1753531
TI  - [Clinicopathological features of metastatic pulmonary calcinosis with malignant
      neoplasm].
AB  - Metastatic pulmonary calcinosis is a rare complication seen in malignancies
      accompanied by hypercalcemia, or chronic renal failure. We reviewed the
      clinicopathological findings of 8 cases of metastatic pulmonary calcinosis
      accompanied malignancy revealed at autopsy. The underlying diseases were
      malignant lymphoma in 3 cases (adult T cell lymphoma in 2 cases), multiple
      myeloma in 2, lung cancer in 2, and acute myelocytic leukemia in 1, all cases
      were complicated by hypercalcemia and renal failure. Chest X-ray revealed almost
      normal findings in 2 cases, bilateral diffuse infiltrates in 4, bilateral
      infiltrates in the apex in 1, and right atelectasis in 1. Bone scintigraphy was
      performed in 4 cases, and revealed warm pulmonary uptake in 1 patient with
      multiple myeloma and 1 with lung cancer, but normal findings in the 2 other
      cases. Histopathological examination revealed diffuse alveolar septal edema and
      fibrosis due to calcium deposition, which were considered to be the cause of
      respiratory failure. Metastatic pulmonary calcinosis is a rare but a serious
      complication in malignancies accompanied by hypercalcemia and renal failure, and
      bone scintigraphy seems to be a useful method for its diagnosis.

PMID- 1753532
TI  - [Dynamic changes in superior vena caval configuration based on posture].
AB  - To noninvasively study positional effects on superior vena caval configuration in
      humans, endoscopic ultrasonography was performed in 34 subjects including 20 with
      lung cancer, 5 with esophageal cancer and 9 with other diseases. None of the
      these subjects had cardiovascular involvement or respiratory dysfunction. A
      fiberoptic esophagoscope equipped with a 7.5 MHz linear array ultrasonic
      transducer at its tip (EPE-703, Toshiba-Machida) was used for the study. The
      actual movement of the superior vena cava (SVC) was clearly observed at the hilar
      level in all cases. During the cardiac cycle the anteroposterior diameter of the
      SVC was observed to reach a maximum at the atrial systole and reached a minimum
      at the late ventricular systole. With respiration, the SVC increased in diameter
      during inspiration and decreased during expiration. Moreover M and B mode figures
      of the SVC wall were recorded in left (LLD) and right decubitus (RLD) and supine
      position (SUP) in 34 subjects. On quiet ventilation of FRC level the diameter of
      the SVC was unchanged. Both the maximal and minimal diameters of the SVC, which
      were corrected for body surface area (BSA), were 11.3 +/- 0.3 (mean +/- SEM)
      mm/m2 and 9.8 +/- 0.3 mm/m2 in right lateral decubitus position, 9.4 +/- 0.3 and
      7.9 +/- 0.3 in the supine position, 8.5 +/- 0.3 and 7.1 +/- 0.3 in the left
      lateral decubitus position, respectively. The size of the SVC was the greatest in
      the right lateral decubitus position and was the smallest in left lateral
      decubitus position (p less than 0.01, multiple comparison). It was suggested that
      the geometry of the SVC is influenced by thoracic pressure and gravity and that
      it behaves very similarly to pulmonary vascular vessels as a collapsible tube.

PMID- 1753533
TI  - [Influence of respiratory frequency in measurement of specific airway conductance
      during non-panting breathing].
AB  - In order to investigate the influence of respiratory frequency in the measurement
      of specific airway conductance (sGaw) during non-panting breathing, we examined
      specific airway conductance using a body plethysmograph (BX-82, Minato) in 20
      stable pulmonary emphysema patients and 19 normal control subjects. Our body
      plethysmograph device can measure sGaw automatically without panting by making
      various corrections using a 16-bit microcomputer. We measured sGaw first at a
      flow of 0.5 L/sec during both inspiratory and expiratory ventilatory phases, then
      the respiratory frequency was changed from 0.5 to 1.0, 1.5 and 2.0 Hz. In normal
      control subjects sGaw, tidal volume and mouth flow significantly changed by
      increasing respiratory frequency, and there was a significant correlation between
      sGaw and mouth flow. In pulmonary emphysema patients, tidal volume decreased
      significantly by increasing respiratory frequency, and there was a significant
      correlation between sGaw and tidal volume, but sGaw and mouth flow did not change
      significantly by increasing respiratory frequency. These results suggest that
      specific airway conductance is influenced by respiratory frequency, possibly due
      to the change in tidal volume and mouth flow. It is necessary to standardize
      respiratory frequencies and mouth flows in the measurement of specific airway
      conductance during non-panting breathing.

PMID- 1753534
TI  - [Adult bronchial asthma in Japan].
AB  - The first nationwide research to disclose the actual state of the adult bronchial
      asthma in Japan covered 2,832 patients who visited hospitals during the time of
      investigation, and who answered questionnaire. They were asked about their
      present state of asthma and experience of treatment for acute asthmatic attacks
      etc. Physicians in various institutions were asked to state their experience
      regarding corticosteroid therapy for them as well as asthmatic deaths among their
      patients per year. The male:female ratio was 1,368 (48.3%): 1,464 (51.7%).
      Concerning age, 24.4% of patients were in their 50s, 22.6% were in their 60s and
      56% of patients were in the 30 to 60 age group and 79.8% were adult-onset asthma,
      a total of 80% needed regular medications and 30% were corticosteroid dependent,
      what 76.9%, 43.1% and 4.8% of the patients had experienced treatment by DIV,
      oxygen therapy and controlled ventilation for acute asthmatic attacks,
      respectively. Among the 3 groups, 59.5%, 51.7% and 24.8 of the patients had
      experienced of admission to hospital, visiting an emergency rooms at night or
      being rushed to hospital ambulance of the total, 48.1% were diagnosed as mild
      asthma, 38.2% as moderate and 12.7% were diagnosed as severe asthma. The 41
      deaths due to acute asthmatic attack in one year represented 0.29% of all adult
      asthmatic patients visiting those hospitals in one year. Deaths at home or on the
      way to the hospital were much greater in number than after hospitalization.

PMID- 1753535
TI  - [Sulfuric acid submicron aerosols induce morphological changes in the central
      airways in the guinea pig].
AB  - We examined the airway injury of the guinea pig exposed to sulfuric acid
      submicron aerosols (1 mg/m3). The animals were exposed to filtered air (sham
      control) or to submicrometer-sized sulfuric acid aerosols for 4 hr/day, 6
      days/week, with sacrifices after 4 hours, 3 days, 1, 2, and 4 weeks of acid
      exposure. Light and electron microscopic examinations revealed that epithelial
      injury such as disappearance of cilia in the central airways was observed and the
      severity of the injury increased with exposure duration. This experimental study
      shows that submicrometer particles of sulfuric acid induces significant
      alterations in the central airways and may be involved in the incidence of asthma
      attack.

PMID- 1753536
TI  - [Effect of serum albumin concentration on percentage of free theophylline
      fraction].
AB  - The authors experienced three cases in which serum free theophylline
      concentrations (F) rose with unchanged or decreased serum total theophylline
      concentrations (T). To clarify the causes of changes in F or T within a short
      time, we studied the relationship between F and serum albumin concentration or T
      in patients, and the relationship between T and F using aminophylline alone or
      aminophylline and cefazoline (CEZ) in rabbits. In patients, the fraction of free
      theophylline (F/T) showed a reverse relation to the serum albumin concentration,
      and a positive relation to T. In rabbits, when aminophylline was injected with
      CEZ, F/T increased in proportion to the dose of CEZ and T decreased when
      aminophylline alone was injected. The data suggested that F/T increased
      accompanied with decreasing serum albumin concentration or increasing T, since
      the albumin binding-site of theophylline is limited. The present study also
      suggested that the protein-bound theophylline decreased in competition with CEZ,
      therefore F/T increased when aminophylline was injected with CEZ. It is likely
      that decreased T is a result of augmented movement of theophylline to the tissue
      due to decreased serum albumin concentration. To evaluate the clinical conditions
      of the patients taking theophylline, it is necessary to directly monitor F, or to
      measure serum albumin concentration if direct measurement of F is not possible.

PMID- 1753537
TI  - [Effects of antiplatelet serum on the pulmonary intravascular macrophage].
AB  - Antiplatelet serum (APS) has been used to investigate the role of platelets in
      lung injury. However, the effect of APS on pulmonary intravascular macrophages
      (PIMs) is unknown. Therefore we investigated the effects of APS on PIMs. A bolus
      injection of APS raised pulmonary arterial pressure with the production of
      thromboxane. Fluorescence- and electronmicroscopy revealed that PIMs engulfed APS
      platelets complexes after the APS injection. Repeated injections of APS increased
      the ratio of PIMs which engulfed platelets and the number of platelets in a PIM,
      but attenuated phagocytosis of liposomes by PIMs to decrease liposome-induced
      pulmonary hypertension and production of thromboxane. From the above data it was
      concluded that APS injection causes PIMs to engulf APS-platelets complexes, and
      that APS injection attenuates the phagocytosis of liposomes by PIMs, and thereby
      diminishes liposome-induced pulmonary hypertension and production of thromboxane.

PMID- 1753538
TI  - [Predictive factors of etiologic agents of community-acquired pneumonia
      presenting at a district general hospital].
AB  - Community-acquired pneumonia is one of the major respiratory diseases causing
      hospital admission in previously healthy patients. Prompt and appropriate
      antibiotic selection is essential for recovery. The authors tried to determine
      the distribution of the etiologic agents of community-acquired pneumonias and to
      analyze predictive factors. Out of 188 cases of community-acquired pneumonia
      presenting to our hospital, etiologic agents were determined in 106 cases (56%).
      Twenty-nine cases were due to Streptococcus pneumoniae, 27 cases due to
      Mycoplasma, 17 cases due to Haemophilus influenzae and 21 cases due to
      Mycobacterium tuberculosis. M. tuberculosis was the cause in 11% of all cases and
      the importance of pulmonary tuberculosis must be emphasized as a community
      acquired pneumonia. Out of 58 cases under 50 years old, Mycoplasma pneumoniae was
      the etiologic agent in 23 cases (40%) and S. pneumoniae in 7 cases (12%). Out of
      62 cases not less than 70 years old. M. tuberculosis was the most common
      etiologic agent (15 cases, 24%). S. pneumoniae followed, being causative in 13
      cases (21%). M. tuberculosis was the cause in 10 cases out of 31 cases who did
      not complain of fever at presentation. In 86 cases who did not show leukocytosis
      on admission, 21 cases were due to Mycoplasma (24%) and 15 cases were due to M.
      tuberculosis (17%). In particular 17 cases were due to Mycoplasma among 28 cases
      under 50 years old without leukocytosis (61%), and 11 cases were due to M.
      tuberculosis in the 27 cases no less than 70 years old without leukocytosis
      (41%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753539
TI  - [Gene analysis of pulmonary lymphoproliferative disorders].
AB  - The authors performed gene analysis of pulmonary lymphoproliferative disorders.
      Cell suspensions were obtained from tissues of malignant lymphoma or
      pseudolymphoma in Cases 1 to 3. High-molecular-weight DNA was extracted from
      these specimens, digested with restriction endonucleases, size-fractionated by
      agarose-gel electrophoresis and transferred by the Southern procedure to
      nitrocellulose. Hybridization to nick-translated 32P DNA probes of the
      immunoglobulin JH, C kappa, C lambda, regions, and T cell receptor beta 1 region.
      In case 1 and 2, which were diagnosed as B cell lymphoma, cells from tumor had
      rearranged heavy chain genes, clearly establishing the clonal nature. In Case 3,
      which was diagnosed as pseudolymphoma, the tumor contained clonal immunoglobulin
      gene rearrangements as detected with both the JH heavy chain and C kappa light
      chain gene probes. It was concluded that gene analysis is an effective procedure
      for establishing a diagnosis of lymphoma in neoplastic disorders of uncertain
      cell type and for detecting clonal T cell or B cell populations with atypical
      lymphofollicular hyperplasia.

PMID- 1753540
TI  - [Clinical study on soluble interleukin-2 receptor in patients with sarcoidosis].
AB  - Levels of soluble IL-2 receptor in sera of 18 patients with sarcoidosis were
      measured by a sandwich ELISA method established by the authors and were found to
      be significantly higher than those in sera of normal subjects. Levels of soluble
      IL-2 receptor in sera of sarcoidosis cases of bilateral hilar lymphadenopathy
      (BHL) were significantly higher than those in sera of sarcoidosis cases without
      BHL. In patients with sarcoidosis, levels of soluble IL-2 receptor did not differ
      in relation to the presence or absence of ocular lesions, or in relation to
      positive or negative response to protein purified derivative of tuberculosis
      (PPD).

PMID- 1753541
TI  - [Proliferative characteristics of fibroblast lines derived from open lung biopsy
      specimens of patients with the usual interstitial pneumonia form of idiopathic
      pulmonary fibrosis].
AB  - One form of idiopathic pulmonary fibrosis (IPF), usual intersitial pneumonia
      (UIP) is characterized pathologically by patchily distributed fibrotic areas in
      apparently normal parenchyma. Excessive accumulation of collagen and fibroblasts
      in fibrotic areas are shown histologically. Fibroblast proliferation is generally
      evaluated as a process following alveolitis. However, substantial alveolitis with
      increased inflammatory and immune cells were not observed in our UIP cases. To
      evaluate the possibility that fibroblasts in UIP are controlled by mechanisms
      other than normal paracrine regulation, proliferative features of lung fibroblast
      lines from UIP lung with regular growth medium, platelet derived growth factor
      (PDGF) and prostaglandin E2 (PGE2) were investigated. Ten fibroblast lines from
      open lung biopsy specimens of patients with IPF (UIP) and 10 control fibroblast
      lines from surgically resected lung tissues of patients with limited lung disease
      were established. The doubling time of fibroblast lines with regular growth
      medium was UIP:32.0 +/- 6.0 hrs. (mean +/- S.D.), normal control: 33.2 +/- 10.4
      hrs. There was no difference between the groups. To examine growth promotion
      activity by PDGF and growth inhibition by PGE2, lung specimens from 4 patients
      with IPF were subdivided into tissue with high intensity fibrotic lesion (H) and
      low intensity fibrotic lesion (L), and the fibroblast lines were established
      separately. 3H-thymidine uptake with or without PDGF and PGE2 was examined, and
      results were expressed as the stimulation index. Growth promotion by PDGF was H:
      1.97 +/- 1.19, L: 1.89 +/- 0.78, normal control: 2.29 +/- 0.55. There were no
      differences between groups. Growth inhibition by PGE2 was H: 0.88 +/- 0.24, L:
      0.69 +/- 0.49, normal control: 0.44 +/- 0.33. Growth inhibition for H was
      significantly lower than control (p less than 0.05). Growth inhibition for L was
      lower than controls, but the difference was not statistically
      significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753542
TI  - [Quantitative evaluation of regional blood flow in pulmonary sarcoidosis with
      bull's eye analysis].
AB  - Lung perfusion scintigraphy was performed in 23 patients with pulmonary
      sarcoidosis and in 11 normal volunteers. Bull's eye analysis was used to analyze
      regional pulmonary blood flow quantitatively. First, whole lung perfusion images
      were divided into three regions by three concentric circles. Then radial axes
      were projected from the center to define 36 x 10 degrees sectors. The counts for
      each sector were calculated and a Bull's eye image was displayed. The counts were
      compared with the lower limit of normal (mean - 2SD), and as the indices of
      reduction in perfusion, extent score (ES) and severity score (SS) were
      calculated. ES and SS showed significant reduction in perfusion 16 patients (70%)
      with sarcoidosis. In stage II sarcoidosis, both ES and SS were significantly
      higher than in stage I sarcoidosis (p less than 0.05). In comparison with the
      findings of transbronchial lung biopsy, both ES and SS had correlations with the
      degree of alveolitis and ES had a correlation with the degree of angiitis. Both
      ES and SS have no correlation with 67Ga scintigraphy findings. In comparison with
      clinical data, ES had a positive correlation with serum angiotensin-converting
      enzyme activity (p less than 0.05), and SS had a significant positive correlation
      with bronchoalveolar lavage fluid.CD+/CD8+ ratio (p less than 0.05). The Bull's
      eye analysis was considered useful for the quantitative evaluation of regional
      pulmonary blood flow in pulmonary sarcoidosis, and it was suggested that the
      mechanism of reduction in perfusion might be resulted mainly in its alveolitis
      and angiitis. Ventilation abnormality, which may happen prior to reduction in
      perfusion, may be an important factor of reduction in perfusion.

PMID- 1753543
TI  - [Pulmonary hemodynamics and home oxygen therapy in patients with chronic
      respiratory failure].
AB  - The authors examined pulmonary hemodynamics with respect to underlying diseases,
      severity and type of chronic respiratory failure, and the incidence and effect of
      home oxygen therapy (HOT) in 155 patients with chronic lung diseases (old
      pulmonary tuberculosis (OTB) 45, chronic pulmonary emphysema (CPE) 54, chronic
      bronchitis (CBR) 42 and fibrosing lung disease (FLD) 14). They underwent right
      heart catheterization during a stable period, while breathing room air. The
      arterial PO2 ranged from 64.3 +/- 9.7 Torr (CBR) to 69.9 +/- 10.0 Torr (CPE), and
      the mean pulmonary arterial pressure ranged from 17.3 +/- 4.6 mmHg (CPE) to 20.6
      +/- 5.4 mmHg (OTB). The incidence of pulmonary hypertension (PH, PA mean greater
      than or equal to 20 mmHg) was 53.3% in OTB, 40% in CBR, 35.7% in FLD, 23.8% in
      CPE, 69% in respiratory failure, 40% in quasi-respiratory failure, and 2.1% in
      non-respiratory failure. The percentage of patients who received HOT was 84.5% in
      respiratory failure and 54.1% in quasi-respiratory failure. Comparing Type I with
      Type II chronic respiratory failure, the incidence of PH was lower in the former
      than the latter (38.3% vs 80.6%), whereas HOT was applied to an equal percentage
      of patients (67.4%) in both groups. The effect of HOT was evaluated in 11
      patients with chronic respiratory failure. The mean pulmonary arterial pressure
      was 22.7 +/- 4.7 mmHg before HOT, and decreased to 20.7 +/- 5.6 mmHg after 24.5
      +/- 10.1 months of HOT. Although this difference was not significant
      statistically, this result suggests the desirable effect of HOT on pulmonary
      hemodynamics.

PMID- 1753544
TI  - [The defensive role of human pulmonary alveolar macrophages and polymorphonuclear
      leukocytes against a strongly or weakly virulent strains of Cryptococcus
      neoformans].
AB  - The phagocytic and killing activities of human pulmonary alveolar macrophages
      (PAM) and polymorphonuclear leukocytes (PMN), and superoxide (O2-) production in
      phagocytizing PAM and PMN were studied by using a strongly and weakly virulent
      strains of Cryptococcus neoformans (C. neoformans) in mice. The strongly virulent
      strain was encapsulated with a thick capsule while the other had a thin one. The
      phagocytic and killing activities of PAM and PMN against the strongly virulent
      strain were lower than against the weakly virulent one. There was no significant
      difference between PAM and PMN in terms of phagocytic or killing activities and
      O2- production. It seems likely that O2- plays no defensive role in the
      intracellular killing of C. neoformans by PAM and PMN because no correlation was
      found between the killing activity and O2- production. These results indicate
      that human PAM and PMN play an effective role in host defense against the weakly
      virulent strain of C. neoformans encapsulated with a thin capsule but are not
      effective against the strongly virulent strain encapsulated with a thick capsule.

PMID- 1753545
TI  - [A case of broncho-bronchiolitis obliterans associated with rheumatoid arthritis
      and Sjogren's syndrome].
AB  - A 45-year-old female patient with rheumatoid arthritis and Sjogren's syndrome was
      admitted because of progressive exertional dyspnea and palpitation. The chest X
      ray film was normal except for slight overinflation. Pulmonary function tests
      indicated severe mixed-type impairment, and arterial blood gas analysis revealed
      hypoxemia. 99mTc-MAA lung perfusion scintigraphy and 81mKr lung ventilation
      scintigraphy showed multiple nonsegmental defects in both lungs. During six
      months of observation, the perfusion defect increased in size and intensity,
      although the chest radiography remained unchanged. The diagnosis of
      bronchobronchiolitis obliterans (BBO) was confirmed by open lung biopsy.
      Glucocorticoid therapy was ineffective, and she died of respiratory failure a
      month after discharge. It is noteworthy that perfusion scintigram demonstrated
      the progression of the disease much better than chest radiography, which showed
      no apparent change during the observation period.

PMID- 1753546
TI  - [A case report of spontaneous pneumothorax in Marfan's syndrome and an
      immunohistochemical study of type I collagen in lung tissue].
AB  - A 19-year-old male was admitted to Teikyo University Hospital because of dyspnea.
      The chest film revealed pneumothorax of the right side. The patient was tall and
      thin, with long tapered extremities. The lens showed ectopia lentis. Echography
      of the heart showed dilatation of the aorta. A diagnosis of Marfan's syndrome was
      established on the basis of characteristic skeletal, ocular and cardiovascular
      findings. At thoracotomy, several bullae were removed by wedge resection.
      Collagen type distribution in the lung was investigated by an indirect
      immunohistochemical study using type-special antibody of type I collagen. There
      were no significant differences in collagen type I in the lung between Marfan's
      syndrome and control. This suggests that type I collagen in Marfan's syndrome
      cannot be distinguished from normal collagen I by indirect immunochemical study.

PMID- 1753547
TI  - [Diffuse panbronchiolitis in two brothers with different clinical courses].
AB  - Diffuse panbronchiolitis in two brothers is reported. The elder brother aged 46,
      was admitted in May 1983 due to severe dyspnea and productive cough, which had
      gradually worsened over several years. He had severe hypoxemia and hypercapnia.
      He died at age 47 of respiratory failure due to pseudomonas infection despite
      antibiotic therapy. The younger brother, at age 41, was admitted in March 1983
      due to fever, productive cough, and abnormal shadows on chest X-ray films. He
      showed mild hypoxemia and his symptoms improved with antibiotic treatment. Since
      then he has been followed as an outpatient for over 7 years while taking 400 mg
      of Erythromycin per day, and he has had no exacerbation. These two cases had
      different clinical courses despite the facts that both had similar conditions of
      chronic sinusitis and appeared to be exposed to no special environmental or
      occupational hazards. These facts suggest that not only intrinsic factors, such
      as defenselessness of airways, but extrinsic factors such as viral, mycoplasmal,
      or bacterial infection may act together on the mechanisms of the onset and
      progression of diffuse panbronchiolitis.

PMID- 1753548
TI  - [A case of follicular bronchiolitis with broncho-pleural fistula in rheumatoid
      arthritis].
AB  - A 67-year-old male diagnosed clinically as having rheumatoid pleuritis and
      bronchiolitis was treated with adrenocorticosteroid. His clinical findings
      improved, but following the tapering of the steroid dose, exacerbation occurred.
      After the steroid dose was increased, serological findings improved, but chest X
      ray findings revealed no improvement. To re-evaluate the etiology of the
      bronchiolar lesion, open lung biopsy was performed. The biopsy specimen showed
      lymphocytic infiltration and formation of lymphoid follicles in and around the
      bronchioles. The pulmonary lesion was diagnosed as follicular bronchiolitis.

PMID- 1753549
TI  - [Insidious hearing loss and facial palsy as the presenting symptoms of meningeal
      carcinomatosis resulting from adenocarcinoma of the lung].
AB  - An 80-year-old man was admitted to our hospital with a complaint of insidious
      hearing loss and facial palsy. Chest X-ray film showed an abnormal shadow in the
      right lower lobe. Adenocarcinoma of the lung was diagnosed by transbronchial
      brushing cytology. During admission, headache and dysphagia appeared, although no
      abnormality was detected in the brain CT and MRI. Lumbar puncture yielded
      adenocarcinoma cells in the cerebrospinal fluid. A diagnosis of leptomeningeal
      metastasis from the adenocarcinoma of the lung was considered and intrathecal
      administration of methotrexate was performed. The patient's condition
      deteriorated gradually and he died of respiratory failure. Autopsy revealed
      massive invasion of tumor cells in the leptomeninges of the brain and spinal
      cord. This case illustrates that facial nerve palsy with insidious hearing
      impairment may appear as the initial symptoms in meningeal carcinomatosis
      resulting from lung cancer metastasis.

PMID- 1753550
TI  - [Flow chart of the diagnosis and treatment of a case of catamenial pneumothorax].
AB  - A 44-year-old female had sudden cough during menstruation. She visited a clinic
      and mild right pneumothorax was pointed out on chest X-ray. She was admitted to
      our hospital for continuous pneumothorax and tube drainage was performed.
      Although pneumothorax improved within a week after drainage, catamenial
      pneumothorax was suspected because her serum CA 125 showed a high value of 109
      U/ml. Therefore diagnostic pneumoperitoneum was performed during the next
      menstruation, and right pneumothorax occurred. Laparoscopy revealed pelvic
      endometriosis and thoracoscopy revealed a few small holes in the right diaphragm.
      The case was diagnosed as catamenial pneumothorax and hormonal treatment was
      given. She had been well for one year without recurrence of pneumothorax. The
      authors made a flow chart for diagnosis and treatment based on this case and
      discussed its value in relation to cases described in the literature.

PMID- 1753551
TI  - [A case of metastatic rib tumor from thyroid cancer confirmed by the presence of
      thyroglobulin].
AB  - A 63-year-old female, with a chief complaint of right chest pain was referred to
      our hospital because of an abnormal right chest wall shadow on chest X-ray. A rib
      tumor was suspected based on her chest CT scan. Percutaneous needle biopsy
      yielded a diagnosis of well-differentiated adenocarcinoma. As metastatic rib
      tumor was suspected, the primary tumor was sought for. A thyroid gland nodule was
      recognized by ultrasonography, and the cytological diagnosis was class V.
      Immunohistological demonstration of the thyroglobulin studies of the rib tumor
      tissue revealed papillary and trabecular patterns of cell arrangement and the
      presence of thyroglobulin existence. Definitive diagnosis of metastatic rib tumor
      from thyroid cancer was established. Immunohistological examination is useful to
      confirm the diagnosis of metastatic cancer of thyroid origin.

PMID- 1753552
TI  - Research on alcohol metabolism: a historical perspective.
AB  - The primary enzymatic steps in ethanol metabolism to acetaldehyde, acetate and
      CO2 + water have been known for many decades, but only a few clinical
      implications were recognized, such as the risk of malnutrition due to use of
      alcohol as a source of calories, and the use of disulfiram and other ALDH
      blockers in the treatment of alcoholism. In the last four decades, however,
      further understanding of alcohol metabolism has led to recognition of the changes
      secondary to altered NAD:NADH ratio; to ethanol oxidation by, and induction of,
      the microsomal cytochrome P450IIE1 system; to fatty acid ethyl ester formation;
      to the increase in hepatic O2 consumption; and to the formation of acetaldehyde
      protein adducts and antibodies to these. This new knowledge has led to important
      progress in relation to the pathogenesis and treatment of alcoholic liver
      disease, and to potentially valuable new diagnostic procedures for detecting
      heavy drinking and incipient alcoholic tissue damage. These advances demonstrate
      strikingly how basic research into fundamental biological processes can yield
      important and unanticipated practical benefits.

PMID- 1753553
TI  - Bile acids and biliary carcinoma in pancreaticobiliary maljunction.
AB  - Pancreaticobiliary maljunction is frequently associated with biliary carcinoma,
      whether or not there is choledochal dilatation. In this anomalous condition,
      pancreatic juice regurgitates and the mixture of bile and pancreatic juice
      stagnates in the biliary tree. In cystic choledochal dilatation, cancers arise,
      mainly in the dilated bile ducts, while in patients not having cystic dilatation,
      tumors arise in the gallbladder. Gallbladder bile and/or bile duct bile from
      fifteen cases of pancreaticobiliary maljunction, including five cancer patients,
      was analysed biochemically and compared with control bile from 6 patients with a
      normal pancreaticobiliary junction. Bile levels of pancreatic enzymes were
      extremely high in the anomalous junction group. In the bile duct bile from
      patients with cystic choledochal dilatation with pancreaticobiliary maljunction,
      the concentrations of deoxycholic acid (DCA), lithocholic acid (LCA) and
      unconjugated bile acid fractions were increased regardless of the presence of
      cancer. Increases of these bile acid fractions, which are known to have a cancer
      promoting effect, were also seen in gallbladder bile from the cancer patients
      without cystic dilatation.

PMID- 1753554
TI  - Appraisal of adjuvant chemoendocrine therapy with tamoxifen plus tegafur in
      patients with breast cancer.
AB  - To assess chemoendocrine therapy in the adjuvant treatment of patients with Stage
      II or III breast cancer, 228 patients were enrolled in a 12-month trial period
      from January 1982 to January 1983. One hundred ninety evaluable patients were
      followed up for five years. The regimen in this trial consisted of intravenous
      administration of 13 mg of mitomycin C per m2 during the operation and 6.5 mg of
      the same drug per m2 on the first day, and oral administration of 600 mg of
      tegafur per m2 alone or supplemented with 13 mg of tamoxifen per m2 for two
      years. No survival advantage was observed with addition of tamoxifen to tegafur
      in terms of five-year survival (88.7% vs 86.6% for Stage II and 69.9% vs 82.2%
      for Stage III). However, there was a significant prolongation of relapse-free
      survival among patients receiving tegafur and tamoxifen as compared with those
      who received tegafur alone: 72.9% vs 55.8% (p = 0.098 in the logrank test).

PMID- 1753555
TI  - Coping style of schizophrenic patients in the recovery from acute psychotic
      state: a preliminary study.
AB  - This study was undertaken to clarify a clinically effective coping style of 13
      schizophrenic patients during recovery from an acute psychotic state. Sixteen
      recovered depressives served as the control group. A comparison of the coping
      behavior profile between the two groups revealed that changes in physical
      activity were significantly more frequent in the schizophrenics (62%) than in the
      depressives (25%).

PMID- 1753556
TI  - Augmentation of anti-tumor effect of interleukin 2 with sizofiran in mice.
AB  - Augmentation of anti-tumor effect of interleukin 2 (IL-2) with sizofiran (SPG)
      was demonstrated with in vivo and in vitro experiments. C3H/He mice with
      subcutaneously inoculated X5563 tumor were used as experimental models. IL-2 at a
      dose of 2 X 10(4) units per mouse by subcutaneous injection, and/or SPG at a dose
      of 0.1 g per mouse by intramuscular injection were given every other day for a
      total of ten times. Tumor infiltrating lymphocytes (TIL) were investigated with
      the avidin-biotin peroxidase complex method. Cytotoxic activity of mice spleen
      cells after the therapies against YAC-1, X5563 and MH134 were tested with 51Cr
      release assay. IL-2 or SPG alone suppressed tumor growth in vivo, although not
      significantly. Combination therapy with IL-2 and SPG suppressed tumor growth in
      vivo significantly (p = 0.04). Mice treated with the combination survived longer
      than the mice treated with the single drug (p less than 0.05) and the controls (p
      less than 0.001). Immunohistologically, more TILs were seen in the combination
      group than the other groups. In the cytotoxicity study, 3 days after initiation
      of the therapies, augmentation of natural killer (NK) activity was greater by the
      combination than by IL-2 or SPG alone. After incubation with IL-2, the spleen
      cells from mice treated with the combination showed higher cytotoxicity against
      X5563 or MH134 tumors than those treated with the single drug or controls.
      Obtained results suggested that combination therapy with IL-2 and SPG effectively
      induced NK cells and lymphokine-activated killer cells in vivo and may lead to
      greater clinical benefit in the treatment of malignancies.

PMID- 1753557
TI  - Vascular compression of the eighth cranial nerve as a cause of vertigo.
AB  - Some patients have vertigo that is more or less constant, associated with varying
      degrees of nausea, and only relieved by bedrest. This disorder, named disabling
      positional vertigo (DPV), was found to be caused by a blood vessel or vessels
      compressing the eighth cranial nerve in its intracranial portion, and it can be
      relieved by microvascular decompression (MVD) of the nerve. Important in the
      differential diagnosis of DPV are a detailed history, the results of audiometry
      (10 to 15 dB interaural threshold difference or a small mid-frequency notch),
      acoustic middle ear reflex response testing (may be abnormal), and recordings of
      brainstem auditory evoked potentials (BAEP). BAEP in such cases show increased
      conduction time in the auditory nerve and/or prolonged latency of wave V recorded
      from the contralateral ear, possibly the result of brainstem compression.
      Abnormalities on vestibular testing often do not reflect the severity of the
      illness. Forty-one patients who underwent MVD to treat DPV in one year at the
      author's institution have been followed for 4.5 to 5.5 years. By self-evaluation,
      20 had excellent and 10 good results of the operation. The success of this
      procedure is even higher today, since it was found that very small blood vessels,
      including veins, can cause DPV; thus all vessels touching the nerve are now
      managed. Complications of MVD are rare. The most frequent, hearing loss, occurred
      in only one patient in this series.

PMID- 1753558
TI  - Neuromonitoring in operations in the skull base.
AB  - Methods to monitor the integrity of cranial motor nerves during operations on
      skull base tumors have been developed over the past decade. These methods can
      help the surgeon to identify cranial motor nerves that are located in the
      surgical field but which may not be visible directly. Methods have also been
      developed that allow monitoring of the function of sensory systems such as the
      auditory system and it has been shown that brainstem auditory evoked potentials
      can provide important information about the integrity of the auditory nervous
      system. It has been shown in several studies that such neuromonitoring, when
      performed during operations in the skull base, can help reduce the incidence of
      permanent neurological deficits that may occur with the removal of large tumors.
      We have also shown that such monitoring can be performed routinely without
      interfering noticeably with the actual surgical procedures.

PMID- 1753559
TI  - A 59-year-old man with an abnormal shadow in the right lung.

PMID- 1753560
TI  - [QT interval and the autonomic nervous system in coronary disease and sick sinus
      syndrome].
AB  - The autonomous nervous system influence on sinus node (SN) in both physiological
      and pathological states is the most important factor determining its function.
      There are only few publications about autonomous nervous system action on
      electrophysiological properties of the human heart (ventricles), specially in
      patients with different types of sick sinus syndrome (SSS). Electrocardiograms of
      113 patients (pts) with coronary heart disease, suspected for SSS, recorded
      during transesophageal atrial pacing before and after pharmacological denervation
      of the heart, were analysed. For heart denervation propranolol (0.2 mg/kg body
      weights) and atropine (0.04 mg/kg body weights) intravenously were used. We
      analysed sinus cycle length (P-P), QT interval and QTc (QT interval corrected
      according to Bazett's formula) during both sinus and paced rhythm (100 bpm),
      before and after denervation of the heart. During clinical observations
      (including Holter monitoring) and after electrophysiological testing we excluded
      SSS in 28 pts (group A) and confirmed diagnosis of SSS in 85 pts (group B). Group
      B was divided in two parts; pts with normal (group B1) and abnormal (group B2)
      intrinsic properties of the SN. Group B1 included 23 pts (15 men and 8 woman from
      36 to 74, mean 53 +/- 9) with normal sinus cycle length after denervation
      (according to Joses's formula) and maximal, corrected sinus node recovery time
      after denervation less than 422 ms. Group B2 included remaining 62 pts (26 men
      and 36 woman from 36 to 80, mean 59 +/- 9). In groups A and B1 denervation of the
      heart shortens P--P, QT, QT100 and QTc100 significantly. Only QTc in A and B1 and
      all parameters in group B2 didn't change significantly.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1753561
TI  - [Spectrum analysis of heart rate. A method of studying the role of the autonomic
      nervous system in the regulation of blood circulation].
AB  - Spectral analysis of heart rate variability has recently been shown to be a
      reliable noninvasive test for quantitative assessment of cardiovascular automatic
      regulatory responses. In 12 ambulant normotensive healthy young males (mean age
      23 +/- 1 years) after a period of 10 min. for stabilisation, a continuous ecg
      recording (lead CM-5) for 8 min. was obtained in the supine and standing
      position, with a controlled respiration rate 15/min. Power spectrum of 512 point
      time series (R-R intervals) in both positions was calculated using a fast Fourier
      transform-based window periodogram method. Based upon results from the literature
      the power spectrum analysis was performed on two components: low frequency LF
      (0.05-0.15 Hz) and high frequency HF (0.15-0.50 Hz). Mean R-R interval decreased
      on standing position from 0.79 +/- 0.10 s to 0.59 +/- 0.11 s (p less than 0.001).
      The ratio HF/LF in supine was 0.63 +/- 0.70 and on standing position 2.54 +/-
      0.73 (p less than 0.001). The relative LF component of the total HR power
      spectrum increased from 22.8% +/- 12.1% to 42.9 +/- 14.4% (p less than 0.001)
      after changing the position from supine to standing, and the relative HF
      component decreased from 56.3 +/- 22.4% to 25.5 +/- 16.2 (p less than 0.001). The
      total power was significantly lower when standing in comparison to supine
      position (681 +/- 519 s2, 1188 +/- 963 s2 respectively, p less than 0.05). Our
      results suggest that heart rate fluctuations in supine position in normal men are
      mainly vagally determined (HF power spectrum component).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1753562
TI  - [Electric cardioversion after surgical correction of the mitral valve defect.
      Prognostic value of the two-dimensional and Doppler echocardiography in the
      assessment of its long-term effectiveness].
AB  - In 82 patients after mitral valve surgery (59--commissurotomy, 23--valve
      replacement--Bjork-Shiley or St. Jude prosthetic valve), 2-D and Doppler
      echocardiography were performed one day before electrical cardioversion. Regular
      sinus rhythm was maintained to 180 days in 28 patients (34%), over 180 days in 54
      patients (66%). The statistical differences (p less than 0.05) between the
      following echocardiography parameters of these two groups were determined:
      parasternal long axis view: aortic, atrial, right and left ventricular dimensions
      (not significant--NS); apical four-chamber view: left and right atrial, left and
      right ventricular areas--NS; apical two-chamber view: left atrial area--p less
      than 0.05; pulmonary valve: peak flow velocity--NS, acceleration time--NS; mitral
      valve: effective area--p less than 0.05, pressure half-time--p less than 0.05,
      mean gradient--NS, mean flow--NS, E-wave max. flow velocity--NS. These data
      suggest, that left atrial area less than 30 cm2 derived from two-chamber view and
      Doppler effective mitral area more or equal 2, 10 cm2 may be important and good
      predictors of long-term results of cardioversion in patients after mitral valve
      surgery.

PMID- 1753563
TI  - [Measurement of arterial blood pressure using the sphygmomanometer-S and the
      direct method].
AB  - Sphygmomanometer--S is the microcomputer device measuring blood pressure (BP) by
      the noninvasive sphygmooscillographic method following standard algorithm. When
      compared sphygmomanometer--S with auscultatory method, this device overestimated
      systolic BP by 7 mm Hg, and underestimated diastolic BP by 9 mm Hg on the
      average. In other words, sphygmomanometer--S overestimated systolic pressure and
      lowers diastolic pressure in relation to auscultatory method in the same ratio
      and value, as the direct method in relation to the auscultatory method. In this
      study, we evaluated the accuracy of the results obtained by sphygmomanometer--S,
      with simultaneously recorded radial artery pressure by direct method. In 15
      patients 27-60 years of age undergoing cardiac surgery BP was measured by
      sphygmomanometer--S and direct method simultaneously on the same left upper
      extremity. We measured direct radial artery pressure using AE 840 Nycotron
      transducer and Philips amplifier. BP by sphygmomanometer--S was obtained on the
      same left arm using cuffs of size 11 x 24 cm and 13 x 35 cm. In 15 patients 124
      pairs of BP measurement were carried out with sphygmomanometer--S and direct
      method. The regression equation for systolic, diastolic and mean pressure
      demonstrated the coincidence of the BP results obtained by sphygmomanometer--S
      with direct method. The correlation coefficient (r) was 0.97 for systolic, 0.90
      for diastolic and 0.92 for mean pressure. Systolic and diastolic pressure
      measured by the sphygmomanometer--S were 2 mm Hg and mean 0.6 mm Hg higher on the
      average, than the same pressures obtained by direct method (ryc. 1). These
      differences were statistically not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753564
TI  - [Cardiac manifestations of tumor recurrence in the right lung].

PMID- 1753565
TI  - [Indications for emergency surgical treatment of ectopic atrial tachycardia].
AB  - Recurrent automatic atrial tachycardia can induce dilated cardiomyopathy. We
      present clinical and therapeutic problems of 16 years old male with ectopic left
      atrial tachycardia refractory to pharmacological therapy. In this patient long
      periods of atrial tachycardia 200-240/min due to lack of effective medication
      caused cardiac failure. Uncontrolled taking of various antiarrhythmic drugs and
      persistent tachycardia led to cardiogenic shock. The electrophysiologic study
      revealed focus of the tachycardia localized in the area of left cardiac auricle.
      The rate of the tachycardia was changing from 84 to 240/min, with periods of
      Mobitz I block in the AV node. In periods of 1:1 AV conduction the tachycardia
      had sometimes LBBB QRS morphology. The atrial tachycardia provoked unsustained
      ventricular one. The patient was operated. Resection of left auricle and mitral
      valvuloplasty were performed. After the operation the patient regained
      undisturbed sinus rhythm and symptoms of heart failure disappeared.

PMID- 1753566
TI  - [Obesity and ischemic heart disease].

PMID- 1753567
TI  - [Blood platelets and ischemic heart disease and myocardial infarction].

PMID- 1753568
TI  - [Electric ablation and intracardiac cardioversion in the treatment of atrial
      arrhythmias].

PMID- 1753569
TI  - [Comparison of the clinical and hemodynamic effects of nitroglycerin, isosorbide
      dinitrate and isosorbide-5-mononitrate in acute myocardial infarction].
AB  - One hundred and eighty patients with acute myocardial infarction (MI) were
      followed up. The patients were divided into 3 groups: (1) those receiving
      glyceryl trinitrate (GTN) (n = 43); (2) those on isosorbide dinitrate (ISDN) (n =
      66); (3) those on isosorbide-5-mononitrate (IS-5-MN) (n = 71). In all the groups,
      the drugs were given by long-term continuous oligovolumic infusion. Following 24
      hours of administration, 66.7, 47.3, and 17.1% increases in infusion rates were
      required in 74.4, 72.7, and 26.8% of the patients from Groups 1, 2, and 3,
      respectively. All the agents produced a pronounced antianginal effect and
      resulted in alleviated acute left ventricular failure. The in-hospital mortality
      rates were 16.2, 16.7, and 12.7% in Groups 1, 2, and 3, respectively. GTN, ISDN,
      and IS-5-MN caused adverse effects in 4.7, 18.2, and 2.8% of the patients from
      Groups 1, 2, and 3, respectively.

PMID- 1753570
TI  - [Effect of diltiazem on silent myocardial ischemia].
AB  - Thirty-four patients with coronary heart disease who had silent myocardiac
      ischemic episodes as evidenced by long-term ECG monitoring were examined. Silent
      ST-segment elevations and depressions were encountered 2.7- and 4.9-fold as
      compared to manifest ones. The fact that the CHD patients had silent ST-segment
      depressions and/or prolonged high-amplitude silent ST-segment elevations suggests
      a grave severity of abnormal myocardial processes. There was a reduction in the
      number, duration of silent ST-segment elevations and depression episodes and in
      the amplitude of silent ST-segment depressions. This may indirectly indicate that
      the agent affects predominantly coronary blood flow and coronary vascular tone.

PMID- 1753571
TI  - [Long-acting nitrate-induced changes in microcirculation and tissue oxygen
      balance in patients with coronary heart disease].
AB  - A total of 56 patients with Functional Class II angina pectoris and 25 healthy
      subjects were examined. Long-acting nitrates were ascertained to result in
      profound venular dilatation, slight arteriolar dilatation, moderately decreased
      erythrocyte aggregation and improvement of tissue oxygen supply. The most marked
      increase in exercise tolerance and reduction in the frequency of anginal attacks
      were noted in patients with normal and narrowed venules. There were no
      significant changes in microcirculation and exercise tolerance in patients with
      baseline dilated venules. It is concluded that the microvasculature may be one of
      the criteria for applying long-acting nitrates in patients with coronary heart
      disease on an individual basis.

PMID- 1753572
TI  - [Use of bepridil in patients with angina pectoris].
AB  - The efficacy of the calcium antagonist bepridil given in a dose of 200-400 mg/day
      was evaluated in 22 patients with Functional Classes II-III stable angina
      pectoris. In addition to clinical assessments, repeated bicycle ergometric
      exercise tests were performed in the patients. The agent was found to be highly
      potent, well tolerated, and to cause no grave adverse effects.

PMID- 1753573
TI  - [Role of hemorheologic and hemodynamic factors for the efficacy of therapeutic
      plasmapheresis in patients with ischemic heart disease].
AB  - Changes in blood rheological properties and central hemodynamic parameters were
      studied in patients with Functional Classes III-IV angina pectoris who had
      undergone therapeutical plasmapheresis. Drastic baseline changes in blood
      rheological properties, a reduction in myocardial contractility, and high total
      peripheral vascular resistance (hypokinetic circulation) were found to be
      indications for plasmapheresis supplemented to antianginal therapy. A positive
      clinical effect of this therapeutical method may be, to a definite extent,
      predicted in these patients. The first plasmapheresis procedure improved blood
      rheology due to the plasma component, making the high baseline levels of
      fibrinogen and total protein normal, lowered increased platelet aggregation,
      repeated procedures enhanced the electric superficial charge of red blood cells
      and the stroke index of the left ventricle.

PMID- 1753574
TI  - [Microcirculatory effects of hemosorption in patients with stable angina
      pectoris, based on data from radionuclide imaging].
AB  - The impact of hemosorption on microhemo- and lymphocirculation, reserve
      microcirculatory bed potentials, and capillary permeability was examined by using
      radionuclide techniques in 46 patients with coronary heart disease refractory to
      drug antianginal therapy. Hemosorption was found to yield a beneficial clinical
      effect in 47.8% of the patients, resulting in a substantial increase in
      microcirculation and its reserves and a decrease in microvascular resistance both
      at rest and in reactive postischemic hyperemia. But it deteriorated the
      microcirculation in patients refractory to it.

PMID- 1753575
TI  - [Predicting the efficacy of rehabilitation in patients with prior myocardial
      infarction].
AB  - The results of a 2-year follow-up of 400 patients with prior myocardial
      infarction (MI) and bicycle ergometric findings of intracardiac hemodynamic
      parameters and oxygen supply during exercise tests, and the criteria for
      tetrachoric index significance within the confidence intervals were used to
      reveal the factors predicting the efficacy of rehabilitative treatment. To
      predict decreased working capacity in the long-term period is determined by the
      extent of lesion after myocardial reinfarction, while angina pectoris and
      arterial hypertension are of significance in patients without reinfarction. A
      role of dynamic indices was defined in predicting decreased working capacity.
      Further lowered working capacity may be judged from the changes occurring in
      threshold exercise capacity and left ventricular end-diastolic volume in the
      first 6 months of postinfarction.

PMID- 1753576
TI  - [The efficacy of isometric training during hospitalized rehabilitation in
      patients with myocardial infarction].
AB  - The study included 57 patients with myocardial infarction who underwent isometric
      exercise tests on days 10 and 30 of hospitalization. The patients of the main
      group had isometric exercise tests by using a key expander for 20 days between
      the first and second exercise tests. The tests were performed in 4 stages, each
      lasting 5 days. The patients from the control group had no tests. The study had
      indicated that isometric exercise tests performed in the hospital treatment
      period enhance the patients' tolerance to static exercise and they are
      sufficiently effective despite its short duration.

PMID- 1753577
TI  - [Effect of hyperbaric oxygenation on the incidence of the antianginal agent
      withdrawal syndrome in patients with angina pectoris].

PMID- 1753578
TI  - [Plasma apolipoproteins B and AI in healthy individuals and patients with
      coronary atherosclerosis in a male population from Lithuania].
AB  - The paper discusses the results from a study into apolipoproteins B (apo-B) and
      AI (apo-AI) and apoB/apo-AI ratios in the blood of 188 healthy donors and 122
      male patients with coronary atherosclerosis. Atherosclerotic lesions were
      coronary angiographically documented. The study was performed (in two age groups
      of patients: 1) those under 45 years and 2) those over 45 years. A relationship
      was examined between the levels of apolipoproteins and the lesion of one, two,
      three or more coronary arteries in the two age groups. The studies indicate that
      there are various mechanisms responsible for the pathogenesis of atherosclerosis
      in the age groups in question. It is concluded that the younger a patient is, the
      higher probability that elevated blood apo-B levels are essential in the
      pathogenesis of coronary atherosclerosis is. Determination of plasma apo-B and
      apo-AI levels and apo-B/apo-AI ratios enables a potential number of diseased
      coronary arteries to be predicted.

PMID- 1753579
TI  - [Atherogenic properties of sera and low-density lipoproteins in patients with
      diabetes mellitus].
AB  - The effects of sera and low density lipoproteins (LDL) on cholesterol levels were
      evaluated in cultured aortic intimal cells from patients with Types 1 and 2
      diabetes mellitus. About 80% Type 1 diabetic patients' sera and 90% of Type 2
      diabetic patients' sera caused a 1.5-4-fold increase in intracellular cholesterol
      levels. LDL isolated from atherogenic sera induced intracellular cholesterol
      accumulation. There was a close correlation between the atherogenic effect of the
      sera and LDL. The atherogenic properties of the sera and LDL from patients with
      diabetes mellitus were unassociated with the examinees' age. There was a
      relationship between the atherogenic serum effect and the compensation of
      carbohydrate metabolism in male patients with Type 1 diabetes mellitus. The
      atherogenic effect of the sera and LDL failed to increase in patients with Types
      1 and 2 diabetes mellitus concurrent with coronary heart disease. The property of
      the sera to accumulate intracellular cholesterol is likely to be typical of
      diabetes mellitus and mainly due to disturbed LDL metabolism.

PMID- 1753580
TI  - [Changes of blood antioxidative enzyme activity and lipid levels in patients with
      coronary atherosclerosis treated with probucol].
AB  - The paper provides the results of 3-month probucol (lipomal) treatment of
      patients with coronary heart disease concurrent with Types 2a and 2b
      hyperlipidemia. There were 20% and 17% decreases in total cholesterol and low
      density lipoprotein cholesterol levels, respectively. The drug failed to affect
      the levels of high density lipoprotein cholesterol and triglycerides. Having
      antioxidative properties, probucol significantly enhances the activity of the
      antioxidative enzymes superoxide dismutase and glutathione peroxidase, which
      controls the efficacy of coronary heart disease patients with hyperlipidemia.

PMID- 1753581
TI  - [Seasonal variations of the lipid spectrum in patients with post-infarction
      cardiosclerosis and arterial hypertension].
AB  - The lipid spectrum was examined in 77 Moscow male residents aged 30-60 years in
      winter and in summer. The examinees were divided into 4 groups: (1) healthy
      subjects; (2) patients with arterial hypertension; (3) those with post-infarction
      cardiosclerosis; (4) those with the two abnormalities. The levels of total
      cholesterol, triglycerides, high density lipoprotein cholesterol, low and very
      low density lipoprotein cholesterol, and circulating immune complex cholesterol
      were measured. All the groups were demonstrated to have lower cholesterol and low
      density lipoprotein levels in summer than in winter, which should be taken into
      account in the diagnosis and treatment of atherosclerosis-associated diseases.

PMID- 1753582
TI  - [Responses of the pressor and depressor regulatory systems to high sodium intake
      in borderline arterial hypertension].
AB  - A total of 25 healthy individuals and 48 borderline hypertensives aged 22-56
      years were examined. The healthy subjects having a salt load showed elevated
      blood histamine concentrations and an unchanged vascular response to histamine,
      and reduced plasma renin activity. The patients having a salt load displayed high
      histamine levels, sharply decreased vascular response to histamine, and
      undepressed plasma renin activity. It is concluded that the pressor mechanisms
      responsible for controlling vascular tone are more active than the depressor ones
      during the salt load in patients with borderline hypertension. The humoral
      response of the patients to a salt load was impaired with elevated plasma
      cortisol concentrations, which was not followed by sodium retention in the body.

PMID- 1753583
TI  - [Perspectives of studying the functional pathology of the heart].

PMID- 1753584
TI  - [Clinical and hemostatic evaluation of curantyl in hypertensives].
AB  - Curantyl supplemented to the multimodality therapy for patients with Stage II
      essential hypertension with uncomplicated events or complicated by hypertensive
      crisis was ascertained to lower the intensity of intravascular blood
      microcoagulation due to its modifying effect on the procoagulative and
      thrombocytic links of hemostasis and blood fibrinolytic activity. The drug
      exerted no marked positive action on clinical manifestations of the disease and
      caused no significant changes in the parameters of hemostatic procoagulative and
      thrombocytic links and blood fibrinolytic activity.

PMID- 1753585
TI  - [Cardiolipin antibodies in non-specific aortic arteritis].
AB  - Cardiolipin antibodies are detected in the sera from patients having a wide range
      of clinical manifestations, including venous and arterial thrombosis, obstetric
      abnormality, damaged CHS and diseased vascular wall. To clarify the clinical
      value of cardiolipin antibodies, 21 patients with non-specific aortic arteritis
      were studied. The antibodies were determined by enzyme immunoassay. Their higher
      levels were found in 5 (24%) patients. The patients who were positive for
      cardiolipin antibodies showed a significant increase in the incidence of
      occlusive lesions (p less than 0.001) and a moderate increase in that of valvular
      heart diseases. The findings suggest that cardiolipin antibodies might contribute
      to the pathogenesis of non-specific of aortic arteritis.

PMID- 1753586
TI  - [Effect of manual therapy on blood pressure in hypertensives with cervical
      osteochondrosis].
AB  - The efficacy of drug (inderal, corinfar) treatment in combination with manual
      therapy (the course was 4-7 sessions) was examined in hypertensives with cervical
      osteochondrosis. The latter was evidenced by X-ray studies. Clinically, cervical
      osteochondrosis appeared as vertebrobasilar insufficiency. The vertebral artery
      bed displayed circulatory disorders documented by rheoencephalography,
      electroencephalography, ultrasound Doppler echography of the head and neck
      vessels. Treating the patients with drugs in combination with manual therapy
      resulted in improved circulation in the vertebral artery bed, lower clinical
      signs of vertebrobasilar insufficiency. There was a more persistent and more
      pronounced decrease in blood pressure with small-dose antihypertensive agents.

PMID- 1753587
TI  - [Differential diagnosis, prevention and therapy of vascular disorders in miners].

PMID- 1753588
TI  - [Classification of ventricular septal defects].
AB  - The hearts were examined from 125 patients with isolated ventricular septal
      defects (VSD) who had died at the age of 0-14 years before or without operation.
      One hundred twenty five heart showed 178 defects: 103 with isolated, 22 with
      multiple VSD. Five major defect types were identified: (1) perimembranous; (2)
      sinus; (3) central trabecular; (4) boundary muscular trabecular; (5)
      infundibular. According to the relevance of fibrous skeleton and cardiac
      conduction system, the defects of various sites are divided into 2 large groups:
      1) unadjacent to them (muscular) and 2) adjacent. In terms of septal geometry,
      there are also two large groups: 1) those located in the inflow portion of the
      septum and 2) those located in the outflow portion.

PMID- 1753589
TI  - [Effect of hemodynamic factors on the development of digoxin resistance in
      patients with aortic diseases complicated by congestive heart failure].

PMID- 1753590
TI  - [Examination of peripheral blood flow in healthy subjects using laser Doppler
      flowmetry].

PMID- 1753591
TI  - [Adaptive stabilization of myocardium under the influence of electroacupuncture
      and cardiac protection].
AB  - Adaptation of animals to short-term stress is known to result in the development
      of the adaptive structure stabilization phenomenon. At the level of the heart,
      the phenomenon appears as increased resistance to elevated catecholamine and
      calcium levels, reperfusion paradox. This study attempted to reproduce the
      phenomenon without applying any stress, but using a course of transauricular
      electric acupuncture. The isolated hearts of rats undergoing a course of the
      acupuncture were ascertained to show a clear-cut high resistance to the
      reperfusion paradox. After coronary ligation, the extent of necrosis in the
      animals having the acupuncture was significantly lower, as in those adapted to
      stress. The assumption that the phenomenon forming the basis for cardioprotective
      effects develops with electric acupuncture is discussed in the paper.

PMID- 1753592
TI  - [Calcium binding to the erythrocyte cytoskeleton in spontaneously hypertensive
      rats].
AB  - The paper outlines a new La(3+)-induced mechanism of Ca2+ binding to rat red
      blood cells. Other compounds elevating intracellular Ca2+ concentrations, such as
      A-23187, ionomycin, and orthovanadate, and some activators of phosphotransferases
      (TPA, dibutyryl cAMP) fail to initiate the binding. Inhibitors of calmodulin
      dependent processes, such as calmidazolium and trifluoroperazine, diminish La
      dependent Ca2+ binding. La(3+)-induced Ca2+ binding is followed by an increased
      cytoskeleton incorporation rate of 14C metabolites of glucose. The rate of Ca2+
      binding and 14C metabolite incorporation was 30% and 80% higher, respectively,
      but Ca+ binding capacity was increased by 45% in SHR as compared to WKY rats. Due
      to the fact that La3+ enhances the phosphorylation of proteins with molecular
      masses of 14, 36, and 58 kD, it is suggested that Ca2+ binding alterations should
      be determined by changes in phosphorylation and glucose metabolic disturbances in
      spontaneously hypertensive rats.

PMID- 1753593
TI  - [Evaluating the protective effect of polyhydroxy-1,4-naphthoquinones in a model
      of experimental myocardial occlusion-reperfusion].

PMID- 1753594
TI  - [Pro-arrhythmic effects of anti-arrhythmic preparations].

PMID- 1753595
TI  - [Specific features of the condition and study of the cardiovascular system in
      patients with excessive body mass].

PMID- 1753596
TI  - [Why to ban circadian chronotherapy?].

PMID- 1753597
TI  - [Possibilities of chronopharmacology].

PMID- 1753598
TI  - [The ability of captopril to enhance the anti-anginal effect of isosorbide
      dinitrate in patients with stable exercise-induced angina pectoris].
AB  - The interaction between isosorbide dinitrate (ISDN) and the angiotensin
      converting enzyme inhibitor captopril was investigated in 14 patients with
      coronary heart disease concurrent with stable exercise-induced angina pectoris.
      The efficacy of placebo, ISDN, 10 mg, captopril, 50-100 mg, and ISDN + captopril
      was evaluated in each patient by pharmacodynamic treadmill studies. The single
      blind, randomized technique was applied. Captopril alone produced a weak
      antianginal effect. The concomitant use of ISDN and captopril showed
      significantly more marked and prolonged effects than ISDN alone. The highest
      effect was exhibited by ISDN supplemented with captopril in 6 patients who had
      been refractory to ISDN alone. Thus, captopril may potentiate the antianginal
      effect of ISDN.

PMID- 1753599
TI  - [Adequacy of applied mathematical methods in the detection of biorhythms].

PMID- 1753600
TI  - [Clinical relevance of hypercholesterolemia and its correction].

PMID- 1753601
TI  - [Clinical pharmacology of nisoldipine, a new calcium antagonist].

PMID- 1753602
TI  - [Correlation of the early ventricular repolarization syndrome with prolapse of
      the mitral valve and of the left ventricular accessory chord].

PMID- 1753603
TI  - [Changes of the Q-T interval during isometric exercise, induced by anti
      arrhythmic agents].

PMID- 1753604
TI  - [Rare complications of cardiac pacing].

PMID- 1753605
TI  - [Oxygen-dependent mechanisms of biocidal activity of neutrophils in patients with
      dilated cardiomyopathy].

PMID- 1753606
TI  - [Relationship between the detection of circulating antibodies to antigen with a
      molecular weight of 67 kD and the severity of clinical manifestations of
      infectious-allergic myocarditis].
AB  - Infectious allergic myocarditis (IAM) is frequently complicated by signs of
      congestive heart failure (CHF). IAM patients generally suffer from rhythm and
      conduction disturbances which can be the leading symptom of the disease in some
      patients. Slowly progressive immune inflammation in the myocardium makes the
      differential diagnosis difficult in IAM and dilated cardiomyopathy in which
      endomyocardial biopsy and cardiospecific immunological examinations of the
      patient are of great significance. Identification of the autoimmune process in
      the myocardium and early immunodepressive therapy may arrest the progression of
      myocardial damage. The purpose of the present study was to examine the
      relationship between antigen antibodies and clinical manifestations of myocardial
      damage in IAM.

PMID- 1753607
TI  - [Diagnostic usefulness of ECG changes in response to exercise in women with
      various forms of ischemic heart disease].
AB  - The results of bicycle ergometry and pharmacological tests with isoproterenol and
      dipyridamol, 24-hour monitoring and blood levels of endogeneous opioids were
      studied in 99 females with chest pain who had undergone angiography. Coronary
      microcirculation was examined in 29 patients by introducing albumin microspheres
      into the left ventricle. The angiography revealed coronary atherosclerosis in 30
      patients, whereas its signs were not found in 8 females with documented coronary
      heart disease (CHD). The predictive value of positive exercise tests in females
      with angina pectoris was higher for the diagnosis of CHD, including its types
      without coronary atherosclerosis. In patients with cardialgias, the predictive
      values of exercise tests were equally low for the diagnosis of coronary
      atherosclerosis, vasospastic and microvascular CHD types. The patients with
      cardialgias caused by autonomic dyshormonal myocardiodystrophy showed low blood
      beta-endorphin and leu-enkephalin levels.

PMID- 1753608
TI  - [The value of early exercise testing in patients with myocardial infarction
      complicated by evolving left ventricular aneurysm].
AB  - The values of an early exercise test limited by criteria for test termination
      were compared with coronaro- and ventriculographic measurements made 2-3 days
      after the test in 51 males of working age who suffered from transmural myocardial
      infarction complicated by local aneurysm in 12 cases and by overall left
      ventricular aneurysm in 39. The exercise test performed in the early periods was
      found to substantially increased its sensitivity. The isolated ST-dominant
      segment elevation in patients with local aneurysm and isolated coronary artery
      lesion indicated that the patients had a favourable prognosis. On the contrary,
      the combination of two criteria or more of a positive test in patients with
      global aneurysm and multivessel disease suggests that the patients with temporary
      disability should be followed up. The presence of T-dominant ST-segment
      elevation, anginal pain concurrent with an inadequate BP elevation shows that
      there is a high risk for postinfarction complications.

PMID- 1753609
TI  - [Diagnostic value of left ventricular diastolic function using pulsed Doppler
      echocardiography in patients with ischemic heart disease].
AB  - Transesophageal atrial pacing was performed in 54 patients (mean age 50.0 +/- 6.8
      years) to diagnose coronary heart disease (CHD). ECG was recorded in 12 leads
      during the test. Echocardiography was used to assess local contractile disorders.
      The diastolic function of the left ventricle was examined by pulsed Doppler
      echocardiography in the postpacing period. Thirty eight patients were found to
      have altered Doppler parameters for transmitral blood flow in the postpacing
      period as compared to the resting period. Sixteen patients without CHD displayed
      no changes in the left ventricular diastolic function in the postpacing period.
      Two types of transmitral blood flow disorders were identified in CHD patients in
      the postpacing period. The so-called "pseudonormal" type of transmitral blood
      flow was typical of patients with the most severe contractile impairments and
      grave course. Abnormalities in local contractility and signs of left ventricular
      diastolic dysfunction were ascertained to be a sensitive marker for myocardial
      ischemia.

PMID- 1753610
TI  - [Correlation of some parameters of carbohydrate metabolism and central
      hemodynamics in the early stages of circulatory insufficiency in patients with
      ischemic heart disease].
AB  - The study was undertaken to examine central hemodynamic and carbohydrate
      metabolic parameters in patients with coronary heart disease (with or without
      signs of chronic heart failure, Stages I and IIA). The changes in carbohydrate
      metabolism in CHD patients were detected earlier than those in central
      hemodynamics. In patients with Stage I heart failure, who had normal resting
      hemodynamic parameters, metabolic parameters were indicative of abnormalities in
      carbohydrate metabolism: there was a reduction in carbohydrate tolerance and red
      blood cell release of insulin in response to glucose load and an increase in
      blood immunoreactive insulin, erythrocytic glucose-6-phosphate dehydrogenase
      activity and greater adrenalin- and insulin-containing erythrocytes. It is
      suggested that it is advisable to determine the above parameters of carbohydrate
      metabolism in patients with coronary heart disease.

PMID- 1753611
TI  - [Transcutaneous transcatheter use of laser recanalization of coronary arteries in
      patients with ischemic heart disease].
AB  - The paper discusses the potential possibility and effectiveness of X-ray
      endovascular laser recanalization (ELR) of the coronary arteries in order to
      treat coronary atherosclerosis in patients with coronary heart disease. The
      intervention was performed in 4 patients (into the anterior interventricular
      artery in 3 and into the right coronary artery in 1). In 3 of 4 cases, X-ray ELR
      proved to be successful, in one case the intervention failed due to technological
      reasons. Recanalization of a completely occluded segment of the coronary artery
      with a residual stenosis of no more than 40% was observed in two cases. Laser
      recanalization of profound local coronary stenosis was made in the mid-third of
      the vessel in one case. It can be stated that X-ray ELR of the coronary artery
      may extend the scope of X-ray surgical therapeutical tools of the treatment of
      coronary atherosclerosis. At the same time, accumulation of clinical experience
      and further improvement of laser and laser catheter engineering are essential in
      defining the value and possible scope for the application of this method.

PMID- 1753612
TI  - [Comparative study of the effect of drug therapy and its combination with
      hyperbaric oxygenation and hemosorption on stable angina pectoris].
AB  - Seventy seven males aged under 60 years with Functional Classes II-IV stable
      angina were examined. The patients were randomly divided into 3 groups: 1) 24
      patients receiving drug therapy alone; 2) 27 patients taking drug therapy in
      combination with hyperbaric oxygenation; and 3) 26 patients having drug therapy
      in combination with hemosorption. In all the patient groups, there was a
      reduction in the frequency of resting and exercise anginal attacks, in Group 3,
      exercise tolerance was increased due to drug therapy. In a re-examination, there
      was a significant fall in total cholesterol and high-density lipoprotein
      cholesterol levels only in Group 3. A comparison of daily drug doses indicated
      that the functional class improved only due to the adequate antianginal therapy.
      Thus, hyperbaric oxygenation and hemosorption have no significant action on the
      degree of stable angina.

PMID- 1753613
TI  - [The effect of finoptin on platelet aggregation, blood coagulability and
      fibrinolysis in patients with ischemic heart disease during physical exercise].
AB  - Exercise platelet aggregation, blood coagulability, and fibrinolysis were
      examined in patients prior myocardial infarction 2-3 months following the
      disease. Seventy patients of whom 35 had received placebo and 35 finoptin prior
      to exercise were studied. The platelet aggregation, blood coagulability, and
      fibrinolysis were explored before and after bicycle ergometric test. Following
      exercise, the patients on placebo showed higher platelet aggregation, blood
      coagulability and lower fibrinolysis, whereas those on finoption exhibited a
      lower increase in platelet aggregation and blood coagulability and activated
      fibrinolysis.

PMID- 1753614
TI  - [Selection of ischemic heart disease patients with ventricular tachycardias for
      surgical therapy].

PMID- 1753615
TI  - [Development of arrhythmia in patients after heart surgery in relation to the
      length of the Q-T interval].
AB  - To predict intra- and postoperative ventricular arrhythmias, the length of Q-T
      interval was determined in 29 patients after cardiosurgical interventions made
      under artificial circulation by using ECG monitoring. The occurrence of
      ventricular arrhythmias were found to be related to a Q-T interval index of more
      than 20% of the normal value. The application of simple computer systems allows
      the Q-T interval to be monitored on line, identifying patients at a high risk for
      arrhythmias and using an adequate antiarrhythmic therapy.

PMID- 1753616
TI  - [Dilated cardiomyopathy: clinical and morphologic aspects].

PMID- 1753617
TI  - [Hemodynamic and oxygen supply during exercise in patients with cardiac pacing
      during treatment of heart failure].
AB  - Invasive and non-invasive tools were used to examine the specific features of
      exercise hemodynamic and oxygen supply in time in 25 patients with heart failure
      who underwent permanent pacing during a long-term glycoside and vasodilator
      therapy. It is shown that treatment with glycosides and vasodilators should be
      used in patients having severe myocardial systolic dysfunction and undergoing
      pacing. In the absence of this abnormality, it is advisable to use peripheral
      vasodilators (corvaton or sydnopharm) and diuretics for a long time.

PMID- 1753618
TI  - [Pathologic movements of the ventricular septum in complete block of the left
      branch of the bundle of His and their effect on left ventricular function].
AB  - Echocardiographic tools (M-mode and 2D-scanning) were applied to examine 83
      patients with complete bundle-branch block and/or its anteroapical bifurcation
      block. Six types of abnormal ventricular septal motions associated with the
      intraventricular asynchronism typical of complete bundle-branch block and with
      the specific features of electric pulse propagation in the His-Purkinje system
      were identified. There was a reduction in left ventricular ejection fraction that
      is peculiar to Types I and VI abnormal ventricular septal motions, whereas in
      patients with complete bundle-branch block, it is associated with anteroapical
      bifurcation block. A moderate decrease in ejection fraction is more common for
      Types III and IV abnormal ventricular septal motions (despite the severity of
      cardiac disease). Complete bundle-branch block alone and in combination with
      anteroapical bifurcation block contributes to a decrease in left ventricular
      function and diminished myocardial contractility. Whether the severity of
      complete bundle-branch block affects cardiodynamics is discussed in the present
      paper.

PMID- 1753619
TI  - [Electrocardiographic signs of first degree sinoatrial block].

PMID- 1753620
TI  - [Surgical treatment of supraventricular tachycardias in children].
AB  - The paper deals with the results of surgical treatment in 19 children with
      supraventricular tachycardias. Eighteen patients were found to have the Wolff
      Parkinson-White syndrome and one presented with ectopic right atrial tachycardia.
      The accessory pathways in the free wall and anterior septum in the presence of
      the Wolff-Parkinson-White syndrome were eliminated on the working heart, whereas
      those in the posterior septum were removed during extracorporeal circulation via
      endocardial access. Ectopic right atrial tachycardia was arrested by
      arrhythmogenic area resection in the right atrium during extracorporeal
      circulation. A positive result of the operation was achieved in 17 of the 18
      patients. At day 2 of postsurgery, one patient developed recurrent tachycardia
      that was eliminated during a repeated operation. Which optimal method should be
      chosen to remove accessory pathways is discussed in the paper.

PMID- 1753621
TI  - [Blood pressure changes induced by various exercise regimes in patients with
      "mild" arterial hypertension].
AB  - How two regimes of exercise training affect blood pressure changes was examined
      in 70 individuals with mild arterial hypertension. Prolonged controlled exercise
      training were shown to be an effective tool of non-drug correction of elevated
      blood pressure, the exercises aimed at developing aerobic tolerance being more
      beneficial. The magnitude of changes (increase) of working capacity may be an
      indicator for the effectiveness of exercise training programmes.

PMID- 1753622
TI  - [Comparative epidemiology of arterial hypertension in the native and migrant male
      population of Chukotka and Novosibirsk].
AB  - The paper provides the results of a prospective epidemiological study of the
      prevalence of arterial hypertension in three populations: Chukotka's aborigines
      and migrants and a Novosibirsk's population. The most unfavourable
      epidemiological situation for arterial hypertension was found to be in migrant
      males aged 30-59 years. A medical examination is proposed among young migrants in
      the first years of adaptation in the North.

PMID- 1753623
TI  - [Specifics of arterial hypertension in the migrant population of Chukotka].

PMID- 1753624
TI  - [Prognostic significance of plasma renin activity and aldosterone levels in
      patients with chronic cardiac insufficiency].
AB  - Minor biochemical changes in the renin-angiotensin-aldosterone system play a
      significant role in the formation of clinical chronic heart failure (CHF).
      Classifying heart failure by the activity of plasma renin identifies 3 large
      patient groups that are characterized by low, normal or high renin activity. If
      aldosterone is included into its characterization, the groups should be divided
      into subgroups by plasma aldosterone levels. The biochemical "profiling" of
      patients in terms of renal and adrenal hormones may be widely applied to the
      prediction and individually selected therapy of CHF patients. The present study
      has demonstrated that in contrast to individuals with normal or high renin
      activity and of the same age and the same degree of heart failure, patients with
      its low levels are better protected against arrhythmias and severe and therapy
      resistant heart failure. In severe CHF aldosterone concentrations are virtually
      higher at any time.

PMID- 1753625
TI  - [Acetaldehyde in the cardiotoxic mechanism of action of alcohol: effects on
      cardiac and adrenal catecholamines].
AB  - How the levels of rat cardiac, adrenal, and epinephrine and norepinephrine change
      with acetaldehyde and ethanol given alone or in combination during their acute
      and chronic administration was examined. In some series of experiments,
      acetaldehyde and ethanol were used in combination with teturam. The findings
      suggest that the coupling of two negative processes--a reduction in cardiac
      norepinephrine levels, which is associated mainly with the effects produced by
      ethanol, and an increase in epinephrine concentrations, which is apparently
      induced by acetaldehyde--may be one of the mechanisms responsible for
      cardiovascular abnormalities in alcoholic intoxication. Acetaldehyde modifies the
      regulatory effect of the sympathoadrenal system on cardiac function, causing
      adrenal catecholamine imbalance.

PMID- 1753626
TI  - [Late ventricular potentials: electrophysiologic basis, recording methods and
      clinical significance].

PMID- 1753627
TI  - [Psychosocial factors in sudden cardiac death].

PMID- 1753628
TI  - [Clinical effectiveness of domestic lidocaine].

PMID- 1753629
TI  - [Has S. S. Iudin created a surgical school?].

PMID- 1753630
TI  - [Blood reinfusion in stab-incision heart injuries].
AB  - The authors had 110 patients with heart injuries (HI) under observation. The
      blood loss was, 1,092 +/- 120 ml in isolated HI and 2,410 +/- 246 ml in combined
      HI. Blood reinfusion (BR) was performed during 91 operations, the average volume
      was 1,233 +/- 215 ml. The peculiarities of reinfusion techniques are analysed and
      its advantages and shortcomings are critically appraised. The causes of fatal
      outcomes are shown according to the character of the heart damage and the volumes
      of blood loss and reinfusion. Mortality in HI with the use of BR was 16.5%.

PMID- 1753632
TI  - [Auto-dermal monophilic plastic surgery of ventral hernia].
AB  - To improve the results of surgical management of postoperative ventral hernias,
      the authors applied their suggested variant of autodermic plasty of the hernial
      openings. The method consists in using for the plasty a band or graft of
      autologous skin armored with a monophilic thread. To reduce lymphorrhea the
      autodermic graft was covered with a hernial sac on a pedicle. The method was
      applied in 93 patients with good late-term results. The number of postoperative
      complications reduced to 3.5% and mortality to 1%, recurrences were not
      encountered.

PMID- 1753631
TI  - [Magnetic resonance tomography in the diagnosis of surgical diseases].
AB  - The authors analyse the first experience in the use of magnetic resonance
      tomography (MP-tomography) in the diagnosis of some surgical diseases. MR
      tomography of the mammary gland (257 patients), thymus (55 patients), adrenals
      (41 patients), and hypophysis (18 patients) was conducted. The results of the
      examination were compared with the findings of other diagnostic methods and
      verified intraoperatively and histologically. The authors claim that the high
      informativeness of MR-tomography, its noninvasiveness, the absence of a radiation
      load, and the possibility of repeating the examination many times in three
      mutually-perpendicular planes distinguish the method favorably and dictate the
      necessity of its further study in clinical medicine.

PMID- 1753633
TI  - [Complications of wound healing after appendectomy. Medical and economic
      aspects].
AB  - The incidence of hospital and posthospital wound complications was studied in 236
      patients, residents of Zelonograd, who underwent operation for acute
      appendicitis. The material was collected at City Hospital No. 3 and four out
      patient clinics of Zelenograd. The incidence of suppuration of the surgical wound
      in the hospital period was 13.1%, that of nonpurulent complications was 9.3%, and
      the total incidence of the wound complications was 22.4%. In the posthospital
      period additional suppuration of wounds was encountered in 23.3% of patients,
      nonsuppurative wound complications in 17.1%, and the total incidence of
      posthospital wound complications was 40.3%. The frequency of rehospitalization
      was 5.5%, the incidence of postoperative hernias was 0.9%. The economical loss
      due to the development of wound complications in 236 patients operated on for
      acute appendicitis came up to 56,120 roubles.

PMID- 1753634
TI  - [Role and significance of S. S. Iudin in the development of reconstructive
      surgery of the esophagus].
AB  - Merits can be conferred upon S. S. Yudin not only in the improvement of the
      method of esophagoplasty with the small intestine suggested by C. Roux in 1907,
      but also in the development of reconstructive surgery of the esophagus on the
      whole. Although new methods for esophagoplasty have been suggested and new
      technical possibilities have appeared, many elements of surgical tactics,
      operative techniques, and instruments suggested by S. S. Yudin are still applied
      in reconstructive surgery of the esophagus. Among them are the detailed
      description of jejunal architectonics from the surgeon's point of view, the wide
      use of test compression of the mesenteric vessels to evaluate the adequacy of
      blood supply to the graft, description of the clinical signs of disturbed blood
      supply to the graft, etc. S. S. Yudin laid the foundations of scientific research
      into the morphological and functional reorganization of organs and tissues in
      prolonged existence under unusual conditions, which is of great theoretical
      importance. Twenty-year experience in reconstructive surgery of the esophagus
      allow the author of this article to appraise at their true worth the technical
      procedures and physiological approaches suggested by S. S. Yudin, which are being
      developed further under modern conditions. This applies to substantiation of the
      most reliable and physiological method of retrosternal esophagoplasty with the
      colon with isoperistaltic position of the graft, transpleural resection of a
      cicatricially deformed esophagus, surgical treatment of achalasia of the superior
      esophageal sphincter.

PMID- 1753635
TI  - [Improvement in transfusion therapy tactics in the control of suppurative
      infectious complications].
AB  - A pathogenetically substantiated multicomponent infusion-transfusion therapy for
      surgical patients with pyoseptic complications is suggested with consideration
      for the correction of all the links of homeostasis. The authors give a concrete
      scheme of multicomponent infusion-transfusion therapy as it is applied day by
      day, with due regard for the set of necessary transfusion media, their volume,
      the number of times that they are infused, and the order of their use. The
      favourable experience in the application of infusion-transfusion therapy in 421
      patients is discussed.

PMID- 1753636
TI  - [Prevention and treatment of early complications in patients after reconstructive
      surgery of the esophagus].
AB  - The work deals with clinical appraisal of the course of the early postoperative
      period and the prevention and treatment of complications after reconstructive
      operations on the esophagus. The postoperative period was studied in 99 patients.
      Complications occurred in the early postoperative period in 48.5% of patients,
      obstructive processes in the lungs were of principal importance among them. The
      authors conclude that particular significance in the prevention of acute
      respiratory failure in patients after one-stage plasty of the esophagus should be
      attached to the early diagnosis of pulmonary complications, prolonged artificial
      lung respiration, and measures for maintaining normal passage of the respiratory
      tract (cleansing bronchoscopy, early activation of patients, adequate
      anesthesia). The main importance in reducing mortality after one-stage esophageal
      plasty belongs to the measures of prevention and treatment of incompetence of the
      sutures of the esophageal anastomosis and mediastinitis.

PMID- 1753637
TI  - [Surgical treatment of acute complications of gastroduodenal ulcer].
AB  - Operations were carried out on 258 patients with perforating ulcer and on 256
      patients with acute bleeding from the ulcer. Perforating ulcer was managed by its
      closure with sutures in 226 patients (87.6%), by its excision with pyloroplasty
      and vagotomy in 4 (1.5%), and by primary resection of the stomach in 28 patients
      (10.9%). Postoperative mortality was 4.65%. In acute hemorrhage 221 patients
      (86.3%) were subjected to resection of the stomach, 6 (2.4%) to vagotomy with
      economical resection of the stomach, and 29 patients (11.3%) to excision of the
      ulcer or stitching of the bleeding vessel. The postoperative mortality was 7.8%.

PMID- 1753638
TI  - [A comparative study of immobilizing properties of the "boot" plaster bandage
      after manual and device reposition of fractures of the malleolus].
AB  - The article deals with the comparative evaluation of the immobilizing properties
      of the "boot" plaster bandage after manual and apparatus reposition of the
      malleoli. It was revealed by means of the EMED and F P/10 apparatus (FGR) that
      the immobilizing property of the "boot" plaster bandage is higher in apparatus
      than in manual reposition.

PMID- 1753639
TI  - [Treatment of "difficult" duodenal stump].
AB  - The Plenk method in the author's modification was successfully applied in
      resection of the stomach "for exclusion" in 22 patients. When there was a
      threatening incompetence of the duodenal stump sutures, to prevent generalization
      of peritonitis the stump in 24 patients was covered with a "hood" of the greater
      omentum and external drainage of this space was installed; the procedure was an
      alternative of duodenostomy. Incompetence occurred in 3 cases with subsequent
      recovery. In resection of the stomach for recurrent ulcer after previous vagotomy
      combined with gastroduodenostomy after Jaboulay, the defects in the duodenal wall
      were closed with a demucosed antral-pyloric gastric segment after the author's
      method. The operation was conducted on 4 patients.

PMID- 1753640
TI  - [A method of suturing penetrating ulcers of the duodenal bulb].
AB  - The author developed a method for plastic treatment of the niche of a duodenal
      bulb ulcer, particularly when it is a source of profuse bleeding, when the ulcer
      is located on the posterior wall or penetrates into the head of the pancreas. The
      method is based on operation for bilateral subdiaphragmatic selective vagotomy
      and Finney's pyloroplasty. In performing the above procedure a pyloroduodenal
      spur is formed by a method modified by the author by making an incision through
      the pylorus closer to the lesser curvature of the stomach. As a result the formed
      pyloroduodenal spur is of a sufficient length and can be easily displaced into
      the bulb to the ulcer. The ulcer with the bleeding vessel is stitched through
      with Halsted's or Z-shaped sutures and the pyloroduodenal spur is sutured with
      the same sutures to the ulcer, effecting tamponade of its whole surface. When
      combined with selective vagotomy the method ensures reliable hemostasis. The
      method was applied with a favorable outcome in an 83-year-old patient followed up
      for 12 months.

PMID- 1753641
TI  - [52 years with antethoracic small-intestine esophagus].

PMID- 1753642
TI  - [Radical enucleation of gastrinoma with conservative surgery of the stomach].

PMID- 1753643
TI  - [Covered perforation of recurrent duodenal ulcer after vagotomy with
      pyloroplasty].

PMID- 1753644
TI  - [S. S. Iudin's letter to Academician N. N. Burdenko].

PMID- 1753645
TI  - [Sketches of gastric surgery].

PMID- 1753646
TI  - [Tietze's syndrome].

PMID- 1753647
TI  - [New types of intestinal suture (review of foreign literature)].

PMID- 1753648
TI  - [Role of S. S. Iudin in the development of emergency anesthesiology at the Moscow
      Sklifosovskii Research Institute of Emergency Care].
AB  - S. S. Yudin was concerned about the problems of anesthesia from as early as the
      twenties. Under the term "anesthesia" he combined a whole complex of measures
      including preoperative management, the production of insensibility to pain, and
      intraoperative treatment and supported in this manner the creation of
      anesthesiological care, which was organized at the Sklifosovsky Research
      Institute of Emergency Care in 1959. The object of all practical and scientific
      activity of the care was the creation of simple, popular, and effective variants
      of anesthesia with consideration for the variety of pathophysiological responses.
      The principal responses are shock, hypovolemia, insufficiency of respiration and
      gas exchange, inversion of metabolism, intoxication, intracranial hypertension,
      the compression-dislocation syndrome, and hepatorenal failure. Study of the
      effect of anesthetics on various organs and systems of the organism made it
      possible to determine the tactics and methods of anaesthesia for patients with
      trauma and diseases of the abdominal and thoracic organs, central nervous system,
      and locomotor apparatus.

PMID- 1753649
TI  - [Spinal anesthesia].
AB  - The article deals with some aspects of spinal anesthesia. It analyses in the
      light of possible complications the results of spinal anesthesia conducted in
      4,186 cases with 1% sovcaine (cinchocaine hydrochloride) solution and 5%
      novocaine (procaine hydrochloride) solution by 60 surgeons. Spinal anesthesia was
      applied in patients, whose ages ranged from 11 to 96 years, in various
      operations. Contraindications for the method were determined. The author
      appraises comparatively spinal anesthesia with the related peridural anesthesia
      and discusses the prospects of the development of the method with the existence
      of new anesthetics and very thin needles for puncture of the subarachnoid space,
      which leads to the minimum number of possible complications.

PMID- 1753650
TI  - [Features of general anesthesia and infusion-transfusion therapy in extensive
      surgery of the organs of the abdominal cavity].
AB  - The article discusses variants of infusion-transfusion therapy (ITT) in early
      stages of expanded operations on the abdominal organs attended by massive blood
      loss (2 to 4 BCV and more). Seventy-three patients were examined, they underwent
      resection of the liver (30), pancreatoduodenal resection (37), or removal of a
      retroperitoneal tumor (6 patients). On the basis of precise study of central and
      peripheral hemodynamics, acid-base equilibrium, and blood oxygen transport
      function the authors find it necessary to increase the volumes of ITT to 70-80%
      BCV in the first stage of the operation with a colloid/crystalloid ratio of 1:4.
      The described method makes it possible to avoid critical fluctuations of cardiac
      output and blood pressure in massive bleeding. At the same time, such
      hemodilution causes no considerable decrease in hemoglobin concentrations (which
      was 79.0% of the initial level at the beginning of the main stage) and specific
      oxygen transport (85.0%, respectively). In absolute expression the specific
      oxygen transport before the hemorrhage is 465 + 29 ml/min/m2, which significantly
      exceeds the critical value. The authors believe the ITT method to be indicated in
      inevitable blood loss and absence of serious cardiovascular diseases. From
      comparative analysis of the different variants of general anesthesia, the authors
      conclude that the following combination of agents is preferable for the discussed
      category of patients: phentanyl, droperidol, seduxen, kalipsol (ketamine), and
      dalargin. Their balanced use ensures stability of the main homeostasis indices in
      all stages of the intervention; the hepato- and pancreatoprotective properties of
      dalargin are also of importance.

PMID- 1753651
TI  - [Hemostasis in hemorrhage from varicose veins of the esophagus and stomach].
AB  - The results of treatment of 15 patients with bleeding from varicose veins of the
      esophagus and stomach are discussed. Blakemore's tube and endoscopic sclerosing
      of the veins with 3% Thrombovar solution were applied for hemostasis. It is
      concluded that nonoperative measures are preferable. The most effective method of
      hemostasis in intensive bleeding is the use of Blakemore's tube for temporary
      arrest of bleeding followed by endoscopic sclerosing for preventing recurrent
      hemorrhage.

PMID- 1753652
TI  - [Extensive lymph node excision in the surgical treatment of esophageal and
      gastric cancer].
AB  - Experience with 100 operations for carcinoma of the esophagus and stomach with
      expanded lymphadenectomy is analysed. The operative techniques are described and
      the necessity and expediency of expanded lymphadenectomy, the method of its
      performance, classification of the group of lymph nodes which must be removed are
      discussed. The postoperative mortality was 2%, complications in the postoperative
      period 25%. Metastases in the lymph nodes were confirmed histologically in 69% of
      cases. It is concluded that expanded lymphadenectomy is a necessary measure in
      surgical intervention in patients with carcinoma of the esophagus and stomach and
      improves the results of management of this group of patients.

PMID- 1753653
TI  - [Sergei Sergeevich Iudin (a centennial of his birth)].

PMID- 1753654
TI  - [Diagnosis and surgical treatment of reflux esophagitis].
AB  - Operations were performed on 192 patients with reflux esophagitis, 23 of them had
      peptic stricture of the esophagus. Esophago-fundoplication was the main
      operation. Nissen's (106), Tupe (47), Belsi's (3), Dor's (5), and atypical
      methods were applied. Whenever indicated it was supplemented by crurorhaphy, SPV,
      pylorotomy, correction of the duodenal junction, etc. Resection of the esophagus
      (19) was performed with one-stage esophagoplasty by means of the stomach through
      a left thoracoabdominal approach (14), the whole stomach passed through the
      posterior mediastinum from an abdomino-cervical approach (2) and the whole
      stomach with Lewis' intrathoracic anastomosis (3). Distal gastric resection was
      carried out in 6 and other operations in 3 patients. The mortality was 1%.
      Reoperations were performed in 5 patients. The results were good in 81.2% of
      cases. The tactics is individualized according to the presence or absence of a
      stricture, its length, and localization of the upper border.

PMID- 1753655
TI  - [A variant of an operation of varicose veins of the esophagus and cardia in
      patients with portal hypertension syndrome].
AB  - On analysing universal experience, the authors suggest their variant of operation
      on varicose veins of the esophagus and cardia with the use of Doppler
      ultrasonography and intraoperative packing of the veins with a radiocontrast
      foamy polymer. With this method the flow of blood in the venous collaterals of
      the stomach and esophagus can be arrested more radically during the operation,
      which considerably reduces the percentage of recurrent bleeding from these veins.

PMID- 1753656
TI  - [Course of wound process in chemical burns of the stomach (results of
      morphological and endoscopic studies)].
AB  - The dynamics of the wound process in chemical burns of the stomach were studied
      on the basis of histological and endoscopic examinations. The patients who were
      studied were given nonoperative treatment, in all cases for corrosive gastric
      ulcers. The most frequent complications were cicatricial stenoses (86.6%) in
      involvement of the antral part of the stomach. Regeneration of the damaged
      tissues of the gastric wall was disturbed, the specific features of these
      disorders were studied.

PMID- 1753657
TI  - [Formation of horizontal esophago-small intestine anastomosis in gastrectomy for
      cancer].
AB  - A new modification of horizontal esophago-enterostomy has been introduced into
      clinical practice. The operative techniques is described in detail. Gastrectomy
      was performed in 76 patients for carcinoma; there were 49 males and 27 females
      whose ages ranged from 39 to 70 years. Such complications as incompetence of the
      sutures of the anastomoses did not occur in the immediate postoperative period.
      Examination of patients in follow-up periods of 4 weeks to 2 years after the
      operation revealed neither cicatricial stenosis of the esophago-enteric
      anastomosis nor reflux esophagitis.

PMID- 1753658
TI  - [Diagnosis and treatment of gastrointestinal hemorrhage].
AB  - The article analyses the results of treatment of 4,430 patients with
      gastrointestinal bleeding in the last four decades. Two periods, from 1950 to
      1969 and from 1970 to 1990, are compared from the standpoint of change of the
      disease structure, the methods of diagnosis and hemostasis. The number of
      hemorrhages of ulcer genesis reduced from 80 to 40.3%. Changes in the pattern of
      the disease is associated with improved diagnostic methods and recognition of
      pathological processes which were previously inaccessible to radiological
      examination, such as the Mallory-Weiss syndrome, acute ulcerations of the mucosa.
      The age composition remains relatively stable. Just like in the previous years,
      each third patient is over 6.0 years of age. Despite introduction of new methods
      of treatment, such as endoscopic arrest of bleeding, enteral feeding, a new
      method for management of penetrating ulcers and others, the mortality rate
      reduced only from 4.5% (1950-1969) to 3.4% (1970-1990). It is noted, however,
      that fatal outcomes in the last years prevail among patients aged 65-70 or older.

PMID- 1753659
TI  - [Surgical treatment of alkaline gastritis].
AB  - A method for reconstructive operation on the stomach with formation of a Y-shaped
      anastomosis in patients with alkaline gastritis is discussed. The author suggests
      that the an area of the mesentery with the least number of vessels should be
      chosen between the vascular arcade and two arteries of the jejunum (at a distance
      of 12-15 cm from the ligament of Treitz) and then dividing the mesentery parallel
      and medial to the vascular arch. Maximal maintenance of blood supply and
      innervation of the loop isolated after Roux ensured good operative results in 84
      patients.

PMID- 1753660
TI  - [Treatment of Mallory-Weiss syndrome by endoscopic diathermocoagulation].
AB  - The work analyses the results of treatment of 111 patients with the Mallory-Weiss
      syndrome by endoscopic diathermocoagulation. It proved ineffective from the very
      beginning in 11 (9.9%) cases, in another 23 (20.7%) patients hemorrhage recurred
      in the immediate 4 days but in one third of them its source was another disease.
      The follow-up of 77 patients revealed recurrence of the disease in the late-term
      period (from 12 months to 9 years) after diathermocoagulation in 12 (15.6%), but
      only 2 of them had to be operated on. The operative mortality was 17%, but when
      surgery was combined with diathermocoagulation the mortality rate was 4.5%.

PMID- 1753661
TI  - [S. S. Iudin's views on the problems of anesthesia].
AB  - The article expounds S. S. Yudin's views on problems of anesthesia in various
      periods of his surgical activity: ideas on the necessity of introducing modern
      multicomponent endotracheal anesthesia were expressed before the mid-forties. S.
      S. Yudin's experience in applying spinal anesthesia gave rise today to the wide
      use of epidural anesthesia.

PMID- 1753662
TI  - [Individual choice of ribonuclease and fluorofur doses in the treatment of
      patients with acute pancreatitis].
AB  - A method is suggested for individual calculation of optimal doses of ribonuclease
      and fluorofur on the basis of a standardized index--the degree of severity. A CM
      1404 computer was used in solving the problem. From analysis of 500 case records
      by means of programs of discriminant and multidimensional linear regressive
      analysis a mathematical dependence was found between some parameters indirectly
      reflecting the severity of the patient's condition, the ribonuclease dose, and
      the efficacy of the treatment. A similar dependence for fluorofur was also
      studied. The discovered statistical regularity was realized as a nomogram for
      calculating the degree of severity and individual optimal doses of ribonuclease
      and fluorofur. The method was used in 114 patients. All the compared indices were
      found to be better than those in the group of patients for whom the dose of the
      agents (ribonuclease) was calculated on the basis of a constant dose per kg
      weight.

PMID- 1753663
TI  - [Improvement of infusion-transfusion therapy in a multidisciplinary emergency
      care hospital].
AB  - The article deals with the analysis of works of S.S. Yudin's students and
      followers devoted to scientific practical and scientific-organizational research
      into optimization of infusion-transfusion therapy in emergency service hospitals
      in emergency states: multiple and combined trauma, the crush syndrome, burns,
      exogenous poisoning, and pyoseptic complications in surgical and traumatological
      practice. The principles of transfusion media rationing in an emergency service
      hospital, particularly in mass admission of patients and accident victims, are
      substantiated. The medico-economical efficacy of including infusion-transfusion
      therapy in complex treatment of emergency conditions is shown.

PMID- 1753664
TI  - [Effects of surgical intervention and intravascular irradiation of blood with
      helium-neon laser on the state humoral autoimmunity in oncological patients].
AB  - Humoral autoimmunity of patients with malignant gastrointestinal tumors was
      studied by different variants of enzyme immunoassay. In the preoperative period
      the frequency of detecting autoantibodies binding to DNA and components of
      external and internal membranes of cells of different tissues was not higher in
      patients (n-55) than in donors (n-45). Beginning from the 7th postoperative day
      all patients were found to have a significantly increased level of autoantibodies
      to DNA (p less than 0.01), fibroblasts (p less than 0.01), hepatocytes (p less
      than 0.01), islet cells (p less than 0.01), hepatic or pancreatic microsomes (p
      less than 0.05). There was a tendency towards normalization of these level by the
      21st day in all cases. In patients (n-10) treated by blood intravascular laser
      irradiation after the operation the level of IgG (but not IgM) autoantibodies to
      DNA by the 14th postoperative day was significantly (p less than 0.01) higher
      than that in patients whose blood was not exposed to radiation. It is suggested
      that the discovered humoral immune reaction is a necessary component of wound
      immunity and develops in response to hetero-organic autoantigens which are
      unmasked in injury of the tissues during the operation. Laser therapy ensures a
      more intensive development of this reaction without altering its direction.

PMID- 1753665
TI  - [Effects of intravascular laser irradiation of blood on the state of the immune
      system of patients with chronic osteomyelitis].
AB  - The authors discuss the results of study of the immune status in 55 patients with
      chronic osteomyelitis, it was found that the condition of the patients' immune
      system reflects the duration and severity of the disease and the individual
      reactivity of the organism. The inclusion of laser treatment in the complex of
      therapeutic measures should be based on appraisal of the condition of the immune
      system and conducted under dynamic immunological control. In deficiency of the
      thymus-dependent immunity the sessions of blood intravascular laser irradiation
      activate the organism's defence forces and facilitate correction of the imbalance
      in the system of the regulating cells. Laser irradiation of blood in mild changes
      of the immunological status is expedient because it may lead to negative dynamics
      of the immune system. Attainment of an optimal immunological condition in the
      preoperative period is conductive to a favourable course of the postoperative
      period and a favourable outcome of the disease.

PMID- 1753666
TI  - [Excimer laser keratomileusis for myopia correction. Results and complications].
AB  - Results of excimer laser keratomileusis in 26 myopic sighted eyes are presented.
      The follow-up was at least 9 months. The base-line refraction was -4.48 +/- 1.81
      D (range: -1.4 to -9.25 D). After 3 months 85% were within +/- 1 D from the
      intended refraction. The such defined success rate after 6 months was 87.5%,
      after 9 months 88%, and after 12 months 92%. One month after surgery we found an
      overcorrection of +1.45 +/- 1.22 D decreasing to +0.27 +/- 0.94 D at three
      months, becoming an undercorrection of -0.24 +/- 0.76 D after six, and -0.32 +/-
      0.69 D after nine months, and of -0.36 +/- 0.6 D after one year. Stability within
      the measurement error (+/- 0.25 D) appeared in 79% of the treated eyes six months
      after treatment. Three patients have been excluded from the study group because
      they did not follow the protocol. Subepithelial haze occurred in all patients,
      becoming most intense after 3 months, gradually clearing over the next months.
      With appropriate steroid medication, the refractive effect may be modulated.
      Complications as steroid glaucoma, recurrent erosion, loss of acuity, or
      extensive corneal scarring seem to be very rare.

PMID- 1753667
TI  - [Clinical study of the effectiveness of a preservative-free tear substitute].
AB  - 57 patients with dry eye syndrome of various etiology were treated with a
      preservative-free hydrogel in an open clinical trial. All patients enrolled in
      the 12 weeks study had a history of pretreatment with usual commercial tear
      substitutes which was either insufficient for relief of complaints or caused
      hypersensitivity. Detailed analysis of patients self assessment of their
      condition (by means of a linear scale), tear film break-up time, Schirmer Test,
      and physician's assessment of therapeutical results revealed that in about 90% of
      cases existing patient complaints and findings related to dry eye syndrome were
      significantly improved by symptomatic therapy with this preservative-free gel.

PMID- 1753668
TI  - [Clinical follow-up, histologic findings and therapeutic problems in a patient
      with bilateral ulcus rodens Mooren].
AB  - A severe, spontaneously acquired, bilateral, sight threatening Ulcus rodens
      Mooren of a 31 years old type I diabetic will be demonstrated in its clinical
      course. An improvement was achieved by a systemic immunomodulating therapy with
      Ciclosporin A that had to be tapered after 3 weeks due to severe side effects.
      The exclusive local therapy showed no effect at all. Later, the patient underwent
      a penetrating keratoplasty and extracapsular cataract extraction of both eyes
      under systemic Ciclosporin A therapy. The graft of the left eye failed due to a
      foudroyant bacterial infection whereas the keratoplasty of the right eye was
      successful up to this day despite of various complications.

PMID- 1753669
TI  - [Fluorescein angiography findings after retinotomy and retinectomy].
AB  - Drainage-retinotomies and relaxing retinectomies are helpful techniques in
      extreme vitreoretinal surgery. They have become established as a surgical
      instrument, but their possible pathophysiologic effects on the retina, pigment
      epithelium and choroid have not been investigated as yet. 30 Patients with
      retinotomies or retinectomies after vitrectomy with silicone oil filling for
      advanced proliferative vitreoretinopathy were studied angiographically.
      Fluorescein angiographic findings revealed 1. a predominant effect of
      endophotocoagulation in the area of the retinotomy/retinectomy with occlusion of
      the choriocapillaris and hyperpigmentation and window effects of the retinal
      pigment epithelium, but sometimes there was a localized traction effect with
      retinal and choroidal folds, 2. that retinal perfusion is unaffected in untreated
      and coagulated areas without evidence for a breakdown of the blood-retina-barrier
      or retinal ischemia, 3. an intact blood-retinal-barrier in areas of uncovered
      retinal pigment epithelium, 4. no evidence for significant reproliferations in
      the areas of retinotomies and retinectomies, 5. choroidal neovascular membranes
      which may occur postoperatively at the retinotomy site probably as a complication
      for intraoperative injury of Bruch's membrane, 6. a cystoid macular edema, an
      optic atrophy, pigment-fallout, depigmented tracks and choroidal folds as
      unspecific findings post retinal detachment surgery. The angiographic data
      support the clinical impression, that retinotomies and retinectomies performed in
      otherwise untreatable cases cause no significant damage in the attached retina.

PMID- 1753670
TI  - [Significance of the corneal thickness in non-contact tonometry].
AB  - In this study the Reichert non-contact tonometer (NCT II) was compared with the
      Goldmann applanation tonometer (GAT) in 25 subjects (50 eyes; pressure range 9-17
      mmHg). The relationship NCT/GAT fulfilled the conditions required for legal
      verification. Marked differences between the readings of both instruments can be
      caused by anomalous central corneal thickness, because non-contact tonometry is
      influenced more than conventional applanation tonometry by the corneal thickness.
      Starting from a central thickness of 0.51 mm, the NCT is assumed to underestimate
      the actual intraocular pressure in eyes with thinner and to overestimate it in
      eyes with thicker cornea by 1 mmHg per 0.01 mm difference of corneal thickness.
      This value changes with individual corneal tissue qualities and is not valid
      especially in presence of corneal edema.

PMID- 1753671
TI  - [Distribution of melanoma-associated antigens (HMB 45 and S 100) in benign and
      malignant melanocytic tumors of the conjunctiva].
AB  - The reactivity of the monoclonal antibody HMB 45 was evaluated in melanocytic
      tumors of the conjunctiva. Among these are 10 acquired melanoses, 19 nevi and 34
      melanomas. Results were compared with the presence of the S 100 antigen.
      Especially the intraepithelial and junctional components of primarily benign
      lesions were stained with HMB 45. Within malignant melanoma this antibody reacts
      with melanocytes in the epithelial, junctional and subepithelial areas. The
      polyclonal antibody S 100 stains all melanocytes in pigmented lesions of the
      conjunctiva. Intraepithelial or subepithelial malignant infiltrating tumor cells
      show very intense staining with HMB 45. HMB 45 has therefore high specificity for
      stimulated melanocytes, but it does not distinguish benign and malignant
      proliferating melanocytic cells.

PMID- 1753672
TI  - [Local prevention with interferon of "epidemic" conjunctivitis caused by a
      currently unidentifiable virus].
AB  - Topical Interferon application did effectively interrupt the further clinical
      spread of a highly contagious viral keratoconjunctivitis. A total of 130
      endangered inpatients, still free from symptoms, were treated with one drop per
      eye daily for a period of 12 days. 123 patients stood free from any further
      infection. Only during the first two days after the beginning of the Interferon
      prophylaxis 7 inpatients showed an acute viral keratoconjunctivitis still.
      Obviously these patients were infected prior to the prophylactic therapy and were
      just in the incubation period. We conclude that Interferon eye drops (one drop
      per eye daily) may offer a reliable protection from exogenous viral infection.
      Certainly this protection comes too late if the patient's incubation period has
      already started.

PMID- 1753673
TI  - [Spontaneous bilateral lens resorption in a case of Hallermann-Streiff syndrome].
AB  - The Hallermann-Streiff-syndrome was first described in 1948 by Hallermann and in
      1950 by Streiff. The most common features are dyscephalia, cataract,
      microphthalmia, dental anomalies, hypotrichosis, cutaneous atrophy, and nanism.
      Anomalies of the eye include cataract, microphthalmia, nystagm, strabism, blue
      sclera, fundus anomalies and combined anomalies of all segments of the eye. The
      frequency of cataract is about 90%. Spontaneous resorption of the lens is
      described in about 8%. We present a five year old girl showing the typical
      dyscephalia of the Hallermann-Streiff-syndrome (bird face). Her lenses were
      replaced by opaque membranes. These membranes presumably were remnants of the
      posterior lens capsule.

PMID- 1753674
TI  - [Treatment of Goldmann-Favre syndrome with cyclosporin A and bromocriptine].
AB  - Up to now several reports have described a disturbance of humoral and cellular
      immune response in patients with tapetoretinal degeneration, but a pathogenetic
      relation of the described immunological changes to the retinal disease was not
      established. Therefore immunosuppressive treatment has not been advocated for
      degenerative vitreoretinal disease. We now report about the natural course of
      Goldmann-Favre's vitreo-retinal degeneration and the results of a therapeutical
      trial with cyclosporin A and bromocriptine in two patients. Without therapy we
      saw a slowly progressive flat central retinoschisis with a serous macular
      exsudation in fluorescein-angiography. Additionally we found peripheral
      vitreoretinal changes, mild cellular vitreal infiltration, extinguished electro
      retinogram and disturbed dark adaptation. Visual acuity and visual field were
      quite stabile. Under therapy with cyclosporin A we found a regression of the
      macular edema and flattening of the retinoschisis. One of the two cases showed a
      good improvement of visual acuity, in the other case a clear subjective
      improvement did not correlate with an increase in visual acuity. An additional
      therapy with bromocriptine did not bring further success, but we were able to
      reduce the cyclosporin A to a blood concentration of 70-100 ng per ml.

PMID- 1753675
TI  - [Occurrence of optic disk hemorrhage in the course of Vogt-Koyanagi-Harada
      syndrome].
AB  - Cases, where in the course of Vogt-Koyanagi-Harada syndrome disc hemorrhages
      occur, are rare. One case was reported wherein about 2 weeks following the
      development of the disease, bilateral linear disc hemorrhages appeared and in 3
      months disappeared, without sequellae of defective vision.

PMID- 1753676
TI  - [Temporary vision disorders, accentuated by deficient illness adjustment].
AB  - A medical expert's opinion had to be given on five patients complaining about
      temporary visual disturbances. 1. Haze caused by keratoconjunctivitis sicca; 2.
      changing refraction related to diabetes; 3. phosphenes in a paralyzed monoculus;
      4. double vision with fatigue in myasthenia; 5. presumed elevation of the risk
      for accidents in congenital nystagmus. The loss of earning capacity in these
      cases should be calculated as the mean of the earning capacity during the phases
      of least and maximal disturbance, if it is not yet included in the loss caused by
      additional stationary defects. Psychological adaptation to or an additional
      disturbance by the disease has to be considered and may justify a higher loss of
      earning capacity.

PMID- 1753677
TI  - [22nd annual meeting of the Society for Nephrology. Heidelberg, 15-18 September
      1991].

PMID- 1753678
TI  - New horizons in renal vasculitis.
AB  - After a long period during which few new data on the vasculitides emerged, the
      past decade has seen a real explosion of data on the subject. This began with
      basic clinical descriptions and the delineation of long term outcome as survival
      improved to a major extent under the influence of improved treatment regimes. In
      parallel, better understanding of the immunopathology has emerged. Of particular
      interest have been descriptions of autoantibody systems in vasculitis which seem
      to be specific to vasculitis and therefore diagnostically useful: the
      antineutrophil cytoplasmic antibodies (ANCA). Whether or not these are
      pathogenetically significant as well as useful remains a matter for debate. In
      parallel, anti endothelial cell antibodies have been described, but their role
      (if any), in pathogenesis remains equally obscure. There are some suggestions
      that vasculitis is becoming more common, but increased awareness and the
      availability of ANCA have undoubtedly increased awareness of the subject.

PMID- 1753679
TI  - Structure-function correlations in erythropoietin formation and oxygen sensing in
      the kidney.
AB  - The kidney is the main site of erythropoietin (EPO) formation. Oxygen sensing in
      the kidney itself plays a major role in the control of EPO synthesis. By in situ
      hybridization it has been established that the EPO-producing cells are situated
      in the interstitium of the cortical labyrinth, but they have not been precisely
      identified. Morphological findings provide new insights into the location and
      mechanism of oxygen sensing in the kidney. In addition to causing an increase in
      the number of cells containing EPO messenger RNA, anemia provokes structural
      changes exclusively in the cortical labyrinth. Specifically, the fibroblasts
      become enlarged and show increased activity of 5'-nucleotidase, and the S1
      segment of the proximal tubule shows similar alterations as in various models of
      hypoxia. Thus, structures that are situated in the close vicinity of the EPO
      producing cells appear to be sensitive to decreased oxygen delivery.

PMID- 1753680
TI  - The progression of renal diseases: on the pathogenesis of renal interstitial
      fibrosis.
AB  - Renal interstitial fibrosis (RIF) frequently occurs in inflammatory and non
      inflammatory kidney diseases and is associated with a decline in renal excretory
      function. Fibroblasts which occupy the renal interstitium are involved mainly in
      the formation of RIF not only by the production of extracellular matrix, but also
      by regulatory processes. They respond to a variety of cytokines released by
      different cell types. To investigate mechanisms leading to RIF,
      immunohistochemical analysis and cell cultures of renal biopsies in various renal
      diseases have been performed. T lymphocytes are the major cells infiltrating the
      renal interstitium, and their number correlates with the impairment of renal
      function. In most forms of glomerulonephritis accompanied by interstitial
      inflammation, an abnormal expression of HLA-DQ/-DP molecules, frequently
      associated with an aberrant expression of the intercellular adhesion molecule 1
      (ICAM-1), was observed on proximal tubular epithelial cells, indicating that
      these cells may play a role in antigen presentation. The cell biological
      experiments revealed the presence of the three mitotic fibroblast types (MFI
      MFIII) and the three postmitotic types (PMFIV-PMFVI) in the cell culture. The
      number of fibroblasts in primary and passage-1 culture was increased seven-fold
      in cultures derived from kidneys with RIF (FKIF cells) in comparison to normal
      kidneys (NKF cells). FKIF cells show hyperproliferative growth and synthesize an
      increased amount of total collagen, especially types III and V. These cells
      express a protein, named "FIBROSIN", which seems to be specific for FKIF cells.
      Further extended cell biological analyses are currently being performed to
      investigate interactions of tubular cells, lymphocytes, macrophages, and
      fibroblasts in order to shed more light on the pathomechanisms involved in
      fibrogenesis leading to renal interstitial fibrosis.

PMID- 1753681
TI  - Renal blood flow control by tubuloglomerular feedback (TGF) in normal and
      spontaneously hypertensive rats--a role for dopamine and adenosine.
AB  - Following the elementary laws of hemodynamics and the functional characteristics
      of the renal myogenic and macula densa-mediated (TGF) vascular resistance control
      mechanisms, TGF-mediated changes of renal vascular resistance are amplified by
      cooperative changes of the myogenic mechanism. Myogenically induced changes, on
      the other hand, would be antagonized by TGF. Resetting of renal vascular flow
      resistance by alterations to the TGF mechanisms might thus be more effective than
      alterations to the myogenic mechanism. Dopamine and adenosine, two autacoids
      occurring normally in the tubular fluid, may play a key role in operating such a
      resetting mechanism. Dopamine and adenosine were found in proximal tubular fluid
      at concentrations of 10(-8) and 0.5 10(-6) M respectively. Dopamine inhibits the
      tubuloglomerular feedback mechanism, this inhibition is antagonized concentration
      dependently by adenosine. These effects most likely occur via D1 and A1 receptors
      and hence by regulation of the adenyl cyclase activity in the macula densa cells.
      The balance between adenosine and dopamine in tubular fluid appears to be under
      the control of extrarenal parameters. In normal rats, high dietary salt intake,
      by influencing the secretion of an unknown adrenal hormone, and inhibition of Na
      K-ATPase might be of importance. In spontaneously hypertensive rats unknown
      genetic parameters may also play a role.

PMID- 1753682
TI  - Are renal mechanisms involved in primary hypertension? Evidence from kidney
      transplantation studies in rats.
AB  - Previous renal transplantation experiments in genetically hypertensive and
      normotensive rat strains indicated that a genetic defect in the kidney may be
      primarily involved in the pathogenesis of primary hypertension. In order to
      investigate whether this is also true for the most widely used animal model of
      primary hypertension, the spontaneously hypertensive rat (SHR), we performed
      renal transplantations using SHR and normotensive Wistar-Kyoto rats (WKY) as
      kidney donors and bilaterally nephrectomized F1 hybrids, bred from SHR x WKY
      parents as renal graft recipients. Our studies were also designed to
      differentiate between primary and secondary renal mechanisms as a possible cause
      of posttransplantation hypertension. Recipients of renal grafts from adult, naive
      SHR but not from adult normotensive WKY kidney donors developed
      posttransplantation hypertension. Permanent blood pressure normalization by
      antihypertensive treatment in adult SHR kidney donors and prehypertensive, young
      age of SHR kidney donors reduced, but did not prevent, posttransplantation
      hypertension. Increasing renal perfusion pressure in WKY kidney donors (2-kidney
      1-clip hypertension) also resulted in posttransplantation hypertension in
      recipients of the non-clipped kidneys. Blood pressure remained normal in
      recipients of renal grafts from young WKY kidney donors. These data suggest that
      SHR kidneys carry a genetic defect which may be primarily involved in the
      pathogenesis of primary hypertension.

PMID- 1753683
TI  - The endothelial L-arginine/nitric oxide pathway and the renal circulation.
AB  - Endothelial cells contain an enzyme(s) which produces nitric oxide from L
      arginine in response to a variety of mechanical stimuli as well as to autacoids
      and local and circulating hormones. Nitric oxide is a potent vasodilator and
      inhibitor of platelet function; it exerts its effects via activation of soluble
      guanylate cyclase and subsequent formation of cyclic 3'-5'-guanosine
      monophosphate. In the kidney, activation of the endothelial L-arginine pathway is
      associated with increases in renal blood flow, diuresis and natriuresis, while
      the glomerular filtration rate remains constant. The activity of the endothelial
      L-arginine pathway is impaired in hypertension and during chronic therapy with
      cyclosporine A. In addition, diabetes and atherosclerosis impair this pathway.
      Thus, the endothelial L-arginine pathway plays an important role in the local
      regulation of blood flow. Alterations in the activity of this pathway may play an
      important role in the pathophysiology of hypertension and renal disease.

PMID- 1753684
TI  - Lipid changes in the nephrotic syndrome: new insights into pathomechanisms and
      treatment.
AB  - The abnormalities of lipid metabolism in nephrotic syndrome consist in an
      increase in total and low-density lipoprotein (LDL) cholesterol, apolipoproteins
      B (ApoB), C-II and C-III, associated in patients with heavier or marked
      hypoalbuminemia with an increase in triglycerides and very low-density
      lipoprotein (VLDL) cholesterol, while the high-density lipoproteins (HDL) are
      distributed abnormally (increased HDL3 fraction and decreased HDL2 fraction) and
      the Apo A-I to Apo B ratio is reduced. Both increased hepatic lipoprotein
      synthesis and reduced removal capacity contribute to this hyperlipidemia.
      Proteinuria may lead to the lipoprotein abnormalities through stimulation of VLDL
      synthesis by the liver induced by hypoalbuminemia, although it has been more
      recently suggested that urinary protein loss is associated with the urinary loss
      of some important cofactor for the regulation of lipid synthesis or catabolism.
      Treatment of lipid abnormalities in patients with long-lasting heavy proteinuria
      is mandatory, because they may cause or contribute to accelerated
      atherosclerosis, but also because they appear to accelerate progression of renal
      disease by favouring mesangial sclerosis. Four groups of lipid-lowering drugs
      have been tested: 1) bile acid-binding resins; 2) fibric acid; 3) probucol; 4)
      inhibitors of HMG CoA reductase. The drugs of the last group appear to be
      effective and safe in short-term experiments, but long-term studies are necessary
      to confirm their validity. A dietary approach, consisting in a strictly
      vegetarian soy diet, very rich in poly- and monounsaturates fatty acids, has been
      recently tested by the author, with very promising results.

PMID- 1753686
TI  - The incidence of Encephalitozoon cuniculi in a commercial barrier-maintained
      rabbit breeding colony.
AB  - Between 1982 and 1987 sera from 4952 New Zealand White rabbits (Oryctolagus
      cuniculus) obtained from a single commercial supplier were tested for the
      presence of antibodies to Encephalitozoon cuniculi. A commercially available
      carbon immunoassay test kit was used. Initially 32.9% of the rabbits were
      seropositive with the number progressively decreasing to 2.3% by 1987. The reason
      for the significant decline in the incidence of infection was most likely due to
      a selection process for breeding stock instituted by the supplier based upon
      productivity, posture and weight of each animal.

PMID- 1753685
TI  - Perspectives in transplantation immunology 1991.
AB  - The clinical success of organ transplantation depends to a large degree on the
      immunological acceptance of the grafted organ. This paper summarizes from an
      immunological point of view the recent progress that has been made to improve
      graft acceptance, and discusses some future aspects in the field. Over the last
      few years, major emphasis has been put on the development of new
      immunosuppressive drugs, including FK 506, rapamycin, and Deoxyspergualin.
      Together with monoclonal antibodies against defined T-cell surface antigens,
      there are now new and effective means available to prevent or treat rejection
      episodes. Progress has also been made in the field of HLA typing, where the
      introduction of molecular biology-based methods significantly increased the
      accuracy of HLA class II typing. The ultimate goal of transplantation immunology
      is the induction of (donor-) specific tolerance. While some protocols are
      effective in inducing peripheral tolerance in experimental animals, these
      regimens are at present not yet applicable in the clinical situation. To overcome
      the shortage of donor organs, alternative strategies are currently being
      considered. Among these, xenotransplantation may eventually prove successful,
      despite the massive immunological problems such as, e.g., the presence of
      preformed xenoreactive antibodies.

PMID- 1753687
TI  - Factors affecting the food intake, growth and protein utilization in the Helix
      aspersa snail. Protein content of the diet and animal age.
AB  - Food intake, growth and protein utilization were studied in the Helix aspersa
      snail by means of a nutritional balance experiment. This was designed in a 5 x 11
      factorial arrangement involving 5 diets of different protein content (10.0, 12.5,
      15.0, 17.5 and 20.0%) and 11 animal ages (ranging over 15 to 180 days of age).
      Dietary protein content and animal age determined food intake and protein
      utilization. The variations of dry matter and protein intake rates, growth rates,
      growth efficiency factors and protein retention rates, depending on dietary
      protein content or animal age were in agreement with what happens in other
      animals. These results suggest that there is no need to use diets with more than
      17.5% of crude protein in these animals.

PMID- 1753688
TI  - Spontaneous uterine granular cell tumour in a Fischer 344 rat.
AB  - The microscopic features of a spontaneous uterine granular cell tumour in a
      Fischer 344 rat are described. The location of the tumour is novel for the rat.
      The neoplasm is characterized by the presence of cells with cytoplasmic granules
      which were PAS positive and diastase resistant. Electron microscopy and
      immunohistochemistry results are presented and the origin of the tumour is
      discussed.

PMID- 1753689
TI  - Mandible shape analysis in Y-congenic strains of mice.
AB  - In order to test for the presence of genes influencing morphology on the Y
      chromosome of mice, a canonical discriminant analysis of variation in mandible
      shape was conducted in 4 inbred strains of mice and 4 Y-chromosome congenic
      partners. Genetic background-dependent differences were observed, as well as a
      small sex variation in some strains, but it was impossible to detect any
      difference related to the between-strain exchange of the Y-chromosome.

PMID- 1753690
TI  - A simple method for the intragastric administration of drugs to fully conscious
      guineapigs.
AB  - The design and use of a simple system for the intragastric administration of
      miniature capsules or fluids to fully conscious guineapigs is described. The
      system is suitable for repeated drug administration. It causes minimal discomfort
      to the animals.

PMID- 1753691
TI  - Post-operative analgesia following thoracotomy in the dog: an evaluation of the
      effects of bupivacaine intercostal nerve block and nalbuphine on respiratory
      function.
AB  - Pain following thoracotomy reduces pulmonary ventilation in man and a similar
      effect is believed to occur in animals. The effects of two analgesic regimens on
      arterial blood gas parameters were studied in dogs following thoracotomy. Post
      Operative analgesia was provided with intermittent nalbuphine, either alone or in
      combination with an intercostal nerve block using bupivacaine. Arterial blood gas
      analysis was carried out at 4, 8 and 16 h post-operatively, both before the
      administration of nalbuphine and again 30 min later. Animals which received
      nalbuphine alone had a significant rise in arterial oxygenation following
      administration of this analgesic. This effect was not observed at 4 and 8 h post
      operatively in dogs which had an intercostal block with bupivacaine, but was seen
      at 16 h post-operatively when it could be anticipated that the effects of
      bupivacaine would have waned. These results suggest that intercostal block with
      bupivacaine can provide analgesia for over 8 h, and that the duration of action
      of nalbuphine in controlling post-operative pain in the dog is probably less than
      4 h.

PMID- 1753692
TI  - Endocrine stress response in rats subjected to singular orbital puncture while
      under diethyl-ether anaesthesia.
AB  - In an attempt to assess possible discomfort in rats subjected to orbital puncture
      while under diethyl-ether anaesthesia, their endocrine stress response was
      determined. Concentrations of corticosterone, adrenaline and noradrenaline were
      measured in plasma obtained via a jugular catheter from rats subjected to diethyl
      ether anaesthesia with or without orbital puncture. No statistically significant
      differences were found between the punctured and non-punctured rats as to peak
      levels of plasma corticosterone and adrenaline as well as for the times required
      by the increased concentrations to return to baseline values. The rate by which
      the plasma noradrenaline level returned to baseline values was somewhat decreased
      by orbital puncture. Diethyl-ether anaesthesia alone produced a marked endocrine
      response when compared with handling and novelty stress associated with the
      induction of anaesthesia. It is concluded that diethyl-ether anaesthesia causes
      pronounced increases in the plasma levels of the selected stress hormones and
      that orbital puncture does not amplify this response. It is suggested that
      diethyl-ether anaesthesia masks any effects of orbital puncture.

PMID- 1753693
TI  - Vitamin D, within its range of fluctuation in commercial rat diets, does not
      influence nephrocalcinogenesis in female rats.
AB  - Massive, toxic doses of vitamin D have been shown to cause nephrocalcinosis in
      rats, but the effect of this vitamin within its range of fluctuation in
      commercial rat diets was unknown. Therefore, in two experiments with young female
      rats, the effect on nephrocalcinosis of a moderately increased level of vitamin D
      in the diet was studied, that is 5000 IU/kg versus the recommended concentration
      of 1000 IU/kg. This was done using purified diets with 0.5% (w/w) calcium and
      0.04% magnesium containing either 0.2 or 0.6% phosphorus (P). Rats fed the diets
      containing 0.6% P showed severe kidney calcification compared to those fed the
      0.2%-P diets. The level of vitamin D in the 0.2 and 0.6%-P diets did not affect
      kidney calcification. Bone density was increased after feeding diets containing
      5000 instead of 1000 IU of vitamin D/kg. This study suggests that, within 28
      days, a moderate increase of the amount of vitamin D in the diet has no influence
      on the development of kidney calcification. This in turn suggests that the
      variation in nephrocalcinosis severity and incidence seen in practice in rats fed
      different commercial diets is unlikely to be related to the different vitamin D
      concentrations in these diets. However, in rats fed such diets bone metabolism
      may be influenced differently.

PMID- 1753694
TI  - Pathogenicity of Pasteurella multocida A:3 in Flemish giant and New Zealand white
      rabbits.
AB  - Pasteurella multocida A:3 was isolated during an outbreak of pasteurellosis in
      Flemish Giant (FG) rabbits. Since New Zealand White (NZW) rabbits housed in the
      same room were not as severely affected as FG rabbits, experimental inoculation
      was undertaken to determine if FG rabbits were more susceptible than NZW rabbits
      to pasteurellosis induced by this isolate. Rabbits of each breed were inoculated
      with P. multocida A:3 and observed for 3 weeks. Four of 5 FG rabbits developed
      severe clinical disease on days 6, 9, 12 and 14 after inoculation; whereas, the
      one affected NZW rabbit became ill 14 days after inoculation. All rabbits with
      clinical disease developed fibrinosuppurative pleuritis, pyothorax and pneumonia
      which was more severe in FG than NZW rabbits. At necropsy, P. multocida A:3 was
      isolated from multiple sites of the diseased rabbits. No significant difference
      (P = 0.099) in the prevalence of lesions between the two breeds was found;
      however, the score of pneumonia and pleuritis was 3 times greater in FG rabbits
      than NZW rabbits.

PMID- 1753695
TI  - Toxicity of anticancer agents, growth and chemosensitivity of human tumour
      xenografts in a segregating stock of AF nude mice.
AB  - An investigation of the usefulness of a segregating stock of nude mice [AF nude
      mice (AF-nu)] for screening anticancer agents was undertaken. The toxicity of
      anticancer agents, takes and growth rates of human tumour xenografts and
      chemosensitivities of xenografts in AF-nu were studied and compared with those in
      BALB/cA nude mice (BALB/cA-nu). The results showed differences in the pattern of
      mortalities of AF-nu and BALB/cA-nu administered a range of anticancer agents.
      Body weight changes in the two nude mouse strains differed in the case of 5
      fluorouracil, but not for nimustine, adriamycin and vincristine. All tumours
      transplanted in AF-nu grew as in BALB/cA-nu. Growth rates of 2 xenografts
      (gastric cancer and glioblastoma) were not significantly different between the 2
      nude mouse strains, but those of 2 lung tumour xenografts were significantly
      greater in AF-nu than those in BALB/cA-nu. There were no significant differences
      in chemosensitivities of human tumours in AF-nu and BALB/cA-nu (consistency rate
      as evaluated by our criteria was 88%). From these results, it is suggested that
      AF-nu are more suitable for anticancer agent screening and experimental
      chemotherapy of human tumour xenografts than BALB/cA-nu because of lower costs
      and high reproductive rate. Although they are genetically heterogeneous, sets of
      experimental animals sharing the same gene pool can be produced routinely.

PMID- 1753696
TI  - The isolated, buffer-perfused ferret heart: a new model for the study of cardiac
      physiology and metabolism.
AB  - The isolated, buffer-perfused ferret heart is a new model for the study of
      cardiac physiology and metabolism. Compared to the more commonly used isolated
      heart preparation, the rat heart, the ferret has a lower rate-pressure product
      due to lower heart rate, a remarkably low coronary flow and almost complete
      oxygen extraction. The ferret heart remains in stable haemodynamic and metabolic
      conditions for a longer period of time than the rat heart. ATP contents of the
      two species are similar, but creatine phosphate content is higher in the ferret
      while NAD content is much lower.

PMID- 1753697
TI  - In-vivo monitoring of corticomedullary nephrocalcinosis in rats using
      computerized tomography.
AB  - An in-vivo method, computerized tomography (CT), was used to monitor
      nephrocalcinosis in female rats. CT density data correlated well with renal Ca
      content measured by atomic absorption spectrophotometry. In-vivo CT measurements
      revealed that the severity of nephrocalcinosis may change spontaneously with
      time. Manifest calcifications may exhibit spontaneous regression and are probably
      affected positively by high dietary Mg, in contrast to increased Ca. It is
      concluded that CT is a suitable and reliable non-invasive in vivo method to
      follow up time-dependent alterations in kidney calcifications in rats.

PMID- 1753698
TI  - Effects of pentobarbital and ketamine-xylazine anaesthesia on somatosensory,
      brainstem auditory and peripheral sensory-motor responses in the rat.
AB  - Somatosensory, brainstem auditory evoked and peripheral sensory-motor responses
      were recorded in rats anaesthetized with either pentobarbital or a ketamine
      xylazine combination. This was carried out in order to assess which of these
      agents degraded responses to a lesser extent and thus would be more suitable for
      monitoring experimental effects. Neither of the anaesthetic agents affected
      peripheral sensory or motor conduction, nor were there any interpeak latency
      changes of the early components of the brainstem auditory response. However,
      pentobarbital anaesthesia resulted in an increase in latency of the initial
      positive component of the somatosensory cortical evoked potential and attenuation
      of the following negative component. During the recovery stages of ketamine
      xylazine anaesthesia the longer latency evoked potential components were observed
      to emerge.

PMID- 1753699
TI  - Multifunctional roles for transforming growth factor-beta 1.

PMID- 1753700
TI  - Biology of aging: facts, thoughts, and experimental approaches.

PMID- 1753701
TI  - Expression of transforming growth factor-beta 1 during chemical
      hepatocarcinogenesis in the rat.
AB  - Cellular distribution of both transcripts and protein of transforming growth
      factor (TGF)-beta 1 was studied in preneoplastic nodules (6 cases) and primary
      hepatic carcinomas (16 hepatocellular carcinomas and 2 mixed tumors of
      hepatocellular carcinoma and cholangiocellular carcinoma) produced by Solt
      Farber's protocol in rats using in situ hybridization and immunohistochemistry.
      The TGF-beta 1 transcripts were primarily observed in nonparenchymal cells, some
      of which were desmin-positive perisinusoidal cells, surrounding or within the
      preneoplastic nodules or carcinomas. The distribution of latent TGF-beta 1
      protein was similar to the transcripts. However, mature TGF-beta 1, which was
      identified with CC-antibody, was only detected in nonparenchymal cells and
      connective tissue associated with carcinomas, but was not observed in
      preneoplastic nodules or in normal liver with the exception of the periportal
      space. There was no difference in TGF-beta 1 expression associated with tumor
      types or the differentiation status of primary hepatic carcinomas. The present
      study demonstrates that nonparenchymal cells, particularly desmin-positive
      perisinusoidal cells, are the principal source of TGF-beta 1 production during
      hepatocarcinogenesis. Furthermore, the data suggest that the close interaction
      between nonparenchymal cells and carcinoma cells may be necessary for the
      activation of latent TGF-beta 1. It is hypothesized that regulatory effects of
      TGF-beta 1 on growth of preneoplastic or carcinoma cells in the liver are exerted
      via paracrine mechanism.

PMID- 1753702
TI  - Role of beta 1 integrins in tumor cell adhesion to cultured human endothelial
      cells.
AB  - We investigated the effects of beta 1 integrins on tumor cell (TC) adhesion to
      unstimulated and interleukin-1 (IL-1) activated endothelial cells (EC). IL-1
      treatment (20 units/ml for 6 hours) of cultured human umbilical vein EC
      significantly increased adhesion of seven human TC lines of different origin. A
      goat antiserum raised to purified alpha 5 beta 1 integrin abolished the IL-1
      induced increment in adhesion of two osteosarcomas, one melanoma, one lung, and
      one kidney carcinoma, whereas it did not affect adhesion of two colon carcinoma
      cell lines. Further studies were performed on MG63 osteosarcoma cells. Adhesion
      of MG63 osteosarcoma cells to EC was dependent on time of EC treatment with IL-1:
      it was maximal at 12 hours and declined at 24 hours. alpha 5 beta 1 antiserum
      blocked IL-1 induced increase in MG63 adhesion at any time of EC treatment. This
      effect appears to be mainly directed to MG63 integrins since selective incubation
      of the antiserum with EC, but not with MG63, did not modify TC adhesion. Using a
      series of antibodies to different alpha and beta chains, we found that only
      monoclonal antibodies (mAb) to alpha 4, alpha 5, and beta 1 could inhibit MG63
      adhesion to IL-1 activated EC, whereas alpha 2, alpha 6, and beta 3 antibodies
      were ineffective. Antibodies to fibronectin had very little activity on MG63
      adhesion to EC matrix and did not significantly affect MG63 adhesion to control
      or IL-1 treated EC. Antibodies to alpha 4, alpha 5, and beta 1 were only
      partially effective in inhibiting MG63 adhesion to EC matrix. These data indicate
      that the capacity of alpha 4 beta 1 and alpha 5 beta 1 integrins to bind
      fibronectin contributed very little to MG63 adhesion to EC. The importance of
      beta 1 integrins in promoting a direct interaction between EC and MG63 was
      further shown by inhibition of rosette formation among these cells in suspension
      by the alpha 5 beta 1 antiserum. Only a VCAM-1/INCAM110 mAb, but not ELAM-1 or
      ICAM-1 mAbs, could inhibit MG63 adhesion to IL-1 activated EC. Overall these data
      indicate that at least two members of the beta 1 integrin subfamily (alpha 4 beta
      1 and alpha 5 beta 1) are involved in MG63 adhesion to cytokine treated EC. This
      integrin function might be important at early stages of TC interaction with the
      vessel wall.

PMID- 1753703
TI  - Cellular infiltrate, major histocompatibility antigen expression and
      immunopathogenic mechanisms in cardiac myosin-induced myocarditis.
AB  - Immunization with cardiac myosin induces severe myocarditis in genetically
      predisposed mice. The disease closely parallels that seen after infection with
      Coxsackievirus B3 and is characterized by a diffuse interstitial cellular
      infiltrate. To analyze the immunopathologic events in the heart tissue of cardiac
      myosin-immunized A/J and A.SW mice, the phenotype of inflammatory cells and the
      expression of class I and class II major histocompatibility (MHC) antigens (Ag)
      was examined at different time points using the immunoperoxidase method. On day
      14 after the initial immunization, very few inflammatory cells were seen, whereas
      on day 21 the lesions were severe and extended over the whole ventricular wall.
      At both time points tested, the inflammatory infiltrate was composed of Mac-1+
      cells, representing 70 to 80% of the infiltrate, and Thy-1.2+ cells, representing
      20 to 25%. These Thy-1.2+ cells consisted of CD4+ cells and to a lesser extent of
      CD8+ cells. Essentially, no B cells were found on day 14, and on day 21 their
      frequency was only 1 to 2%. Furthermore, massive Ig deposits were observed along
      the infiltrated myofibers. Both on day 14 and 21, MHC class II Ag expression was
      associated with cells of the inflammatory infiltrate, but no aberrant I-A Ag
      expression was found on endothelial cells of coronary vessels or on myofibers.
      Similarly, no increased MHC class I Ag expression was seen on myofibers on day
      14. However, on day 21 the infiltrated myofibers did show an increase in surface
      MHC class I Ag expression, thereby suggesting that this phenomenon is a
      consequence of the inflammatory process. Furthermore, in vivo administration of
      monoclonal antibodies to either CD4 or CD8 protected cardiac myosin-immunized
      mice from myocarditis, and a similar effect was achieved by monoclonal antibody
      to I-A Ag. Thus, cardiac myosin-induced myocarditis is mediated by a cooperation
      between CD8+ cells and MHC class II restricted, i.e., CD4+ cells.

PMID- 1753704
TI  - Rat glomerular cells do not express podocytic markers when cultured in vitro.
AB  - A panel of cell-type specific monoclonal and polyclonal antibodies and lectins
      was used to examine the early, morphologically epithelial outgrowth of rat renal
      glomerular cells in culture. The cell type-specific reactivity of the monoclonal
      antibodies has been previously verified on tissue sections of rat kidneys at
      light and electron microscopic levels. Morphologically distinct epithelial cells
      grew out from the isolated glomeruli within 3 days in culture, followed by the
      growth of morphologically typical stellate mesangial-like cells. Endothelial and
      mesangial cells were positively identified from the early cultures (up to 10
      days) with antibodies to a 350 kD protein, dipeptidyl peptidase IV, podocalyxin,
      factor VIII, OX-43 and with Bandeiraea simplicifolia (BS-I B4) lectin, and with
      antibodies to smooth muscle actin, desmin, Thy1.1 antigens and with Ricinus
      communis (RCA-1) lectin, respectively. The antibodies recognizing podocytes in
      vivo (antipodocalyxin, anti-O-acetyl GD3 ganglioside, anti-gp330, anti-C3b
      complement receptor, anti-vimentin and anti-CALLA) consistently failed to bind to
      the predominant epithelial cells in early cultures, although these antibodies
      readily bound to the cells of the intact glomeruli remaining in culture. The
      attempts to augment the expression of cell-type specific epitopes by culturing
      glomeruli on various matrices or by enriching the medium with various growth
      factors, failed to induce podocytic epitopes on the growing epithelial cells.
      Glomeruli from newborn rats cultured in vitro, but were also constantly negative
      for the markers of podocytes. In addition, we cultured glomerular-like bodies
      from in vitro were induced metanephric mesenchymes but failed to obtain evidence
      of growing podocytes. However, the epithelial cells reacted with antibodies to
      thrombospondin and cytokeratin that react with the parietal epithelium of
      glomeruli on tissue sections. The results show that early glomerular cultures
      consist of mesangial, endothelial and presumably parietal epithelial cells
      readily identifiable by immunocytochemical methods. No podocytes could be grown
      under the various growth conditions tested. This suggests that glomerular
      podocytes are effectively growth arrested and call for new approaches to obtain
      these cells in culture.

PMID- 1753705
TI  - Atubular glomeruli in renal artery stenosis.
AB  - The aim of the present study was to investigate and quantitate the structural
      renal changes developing after stenosis of the renal artery. Twelve kidneys
      removed at operation from patients with elevated blood pressure due to stenosis
      of the renal artery were investigated together with three kidneys with renal
      artery stenosis but no clinical evidence of renovascular hypertension. Eight age
      matched autopsy kidneys served as controls. Stereologic methods were used to
      estimate the volume fractions of different structural parameters, the volume of
      individual glomeruli, and the structural integrity between the glomerulus and the
      proximal tubule. In six of the kidneys with renal artery stenosis and in the
      controls, the total number of nonoccluded glomeruli was estimated.
      Immunohistochemical staining for epithelial membrane antigen, Tamm-Horsfall
      protein and lectin Arachis hypogaea was performed in order to determine whether
      the atrophic tubules in renal artery stenosis were of proximal or distal origin.
      The results showed that the volume fractions of both proximal and distal tubules
      had decreased in renal artery stenosis, whereas the volume fractions of the
      glomerular tufts and interstitium increased. Immunohistochemical staining
      indicated, however, that more distal than proximal tubules were preserved,
      although atrophic. In the kidneys with artery stenosis, very few glomeruli were
      seen connected to a normal proximal tubule; in 52% of the glomeruli Bowman's
      capsule did not open toward a tubule and 40% were connected to an atrophic
      tubule. The mean glomerular volume (uncorrected for shrinkage) of 1.5.10(6)
      microns3 in the kidneys with artery stenosis was significantly decreased compared
      with the 2.9.10(6) microns3 in the controls. The mean glomerular number was
      normal in the kidneys with artery stenosis. The study shows that despite the
      absence or severe atrophy of the tubules, the glomeruli are not destroyed but
      only smaller. More proximal than distal tubules are destroyed by the ischemic
      process.

PMID- 1753706
TI  - Erythrocyte deformation in ischemic acute tubular necrosis and amelioration by
      splenectomy in the dog.
AB  - Bilateral renal artery occlusion (RAO) for 120 minutes in dogs results in acute
      tubular necrosis (ATN) and peritubular capillary (PTC) congestion with rapidly
      deteriorating renal function. We have shown that prior splenectomy minimizes RAO
      induced renal functional and histopathologic changes. The purpose of this study
      was to examine whether this renal protection is due to prevention of red blood
      cell echinocyte formation and resultant renal PTC congestion. Echinocytes (burr
      cells) are poorly deformable, impart high viscosity to the blood, and may hinder
      reperfusion by increasing resistance to renal capillary blood flow.
      Splenectomized (SPLX) or sham-SPLX dogs were treated with bilateral RAO for 120
      minutes. After RAO, renal function and renal blood flow were monitored, and
      peripheral blood red blood cells were examined at 1 hour and at 24-hour intervals
      for 96 hours. Renal biopsies were taken 1 hour after RAO and the kidneys removed
      96 hours after RAO. The RBCs and renal tissues were studied using scanning
      electron microscopy. Renal function was assessed by endogenous creatinine
      clearance. Sham-SPLX animals showed a marked and sustained decrease in creatinine
      clearance, consistently elevated serum creatinine levels and fractional excretion
      of sodium, and diffuse ATN and PTC congestion with echinocytes. These animals had
      a peak in circulating echinocytes 1 hour after RAO (p less than 0.05), which
      showed an excellent negative correlation with creatinine clearance (r = -0.999; p
      less than 0.001). On the contrary, SPLX animals had essentially no change in
      serum creatinine or fractional excretion of sodium, minimal tubular changes, no
      PTC congestion, and no rise in circulating echinocytes during the 96-hour
      observation. In vitro treatment of the postischemic red blood cells from sham
      animals with adenosine-inosine or fresh postischemic plasma from the SPLX animals
      showed almost complete reversal to discocytes (normal red blood cells), whereas
      in vitro treatment of postischemic red blood cells from the SPLX animals with
      fresh postischemic plasma from the sham animals resulted in a marked echinocytic
      response. We conclude that 1) a marked echinocyte response in the immediate
      postischemic period is an important mechanism in initiating ischemic ATN, 2) an
      echinocyte inducing factor may reside in the plasma of spleen-intact animals, and
      3) mitigation of ATN and PTC congestion by splenectomy is, at least in part,
      consequential to attenuated echinocytic response in the immediate postischemic
      period.

PMID- 1753707
TI  - Glomerulosclerosis at both early and late stages is associated with increased
      cell turnover in mice transgenic for growth hormone.
AB  - The evolution of glomerulosclerosis consists of a progressive increase in
      mesangial matrix with gradual glomerular obliteration. The sclerotic process is
      thought to be irreversible and include a progressive loss of glomerular cells. To
      investigate this process, we selected mice transgenic for bovine growth hormone
      because they develop progressive glomerulosclerosis and renal failure. The
      sequence of histologic events in the growth hormone mice consists initially of an
      increase in the number of centrolobular glomerular cells, followed by an
      accumulation of extracellular matrix. This is accompanied by an increase in
      glomerular size which is disproportionate to the overall increment in kidney or
      body weight. The [3H]thymidine labeling index of the cells of the glomerular tuft
      was assessed before the development of recognizable sclerosis and at a time when
      the sclerosis was far advanced. The labeling index was more than five-fold
      increased over controls at the early time point. Contrary to what was expected,
      the labeling index remained at the same high levels in densely sclerotic
      glomeruli at the late time point. In conclusion, increased cell turnover is a
      significant component of the sclerotic process both at the onset and in the late
      stages of this model.

PMID- 1753708
TI  - Regulation of mRNA stability and its relevance to disease.

PMID- 1753709
TI  - Arthritis in rhesus monkeys experimentally infected with simian immunodeficiency
      virus (SIV/DELTA).
AB  - The joint tissues from 36 rhesus (age 2-5 years) infected with SIV/Delta were
      graded into four groups and then correlated with the following systemic
      immunologic parameters: numbers of CD4+, CD4+ plus CD29+, and CD20+ cells and
      SIV/Delta antigenemia. Grade I (n = 16) consisted of normal synovial membrane;
      grade II (n = 8) consisted of synovial hyperplasia; grade III (n = 8) consisted
      of a mononuclear cell infiltrate, and grade IV (n = 4) consisted of synovial
      membrane infiltration of syncytial cell and mononuclear type cells. Synovial
      membranes from 20 uninfected age-matched rhesus were compared with infected
      animals and were graded 1. Immunostaining of the tissue phase lymphocytes and
      viral antigen was performed using monoclonal antibodies commercially available
      and a monoclonal antibody produced against a core protein of the SIV/Delta agent.
      SIV/Delta infection resulted in a reduction in cells doubly stained for CD4+ and
      CD29+ and a relative increase in CD8+ stained cells. A significant (ANOVA)
      difference was not observed in CD4+, CD4+ plus CD29+, CD8+, or CD20+ among the
      various grades of arthritis. Viral antigen was demonstrated in syncytial cells of
      the grade IV reaction. This finding suggests that the SIV/Delta arthritis is a
      primary viral reaction.

PMID- 1753710
TI  - Characterization of fat-storing cell lines derived from normal and CCl4-cirrhotic
      livers. Differences in the production of interleukin-6.
AB  - Liver fat-storing cells (FSC) play an important role in collagen deposition.
      During the induction of liver cirrhosis, FSC lose their fat droplets, acquire an
      actin-rich cytoskeleton and transform into myofibroblasts. Myofibroblasts have
      been associated with increased collagen production in cirrhotic livers. Cultured
      FSC resemble myofibroblasts. However, it is not known whether regulation of
      collagen gene expression is similar in FSC obtained from normal or cirrhotic
      livers. In this communication, we describe the characterization of two fat
      storing cell lines, one from normal (NFSC) and one from CCl4-cirrhotic liver
      (CFSC), obtained after spontaneous immortalization in culture. We studied the
      effect of serum and various growth factors on cell proliferation. We determined
      the production of collagen and fibronectin and we analyzed the presence of mRNA
      transcripts of collagens type I, III, and IV, fibronectin laminin, transforming
      growth factor-beta and interleukin-6. We found that CFSC have a greater serum
      dependency than NFSC. NFSC grow with a mixture of insulin and epidermal growth
      factor, whereas CFSC proliferate only with platelet-derived growth factor.
      Although we did not find significant differences in the expression of mRNAs for
      collagen type I, fibronectin and transforming growth factor-beta, collagen and
      fibronectin synthesis was increased 2- and 1.5-fold respectively. NFSC contained
      1.6- and 2.0-fold more type III collagen and laminin mRNAs, respectively, than
      CFSC. Neither cell line expressed type IV collagen mRNA. NFSC but not CFSC
      produced interleukin-6. These results suggest that, except for the lack of
      transcripts of collagen type IV, both cell lines resemble primary cultures of
      FSC. However, significant differences in cell proliferation and interleukin-6
      production between the two cell lines were found. We suggest that these cell
      lines could be useful tools to study possible differences in regulation of matrix
      production by FSC.

PMID- 1753711
TI  - Hepatocytes modulate the hepatic microvascular phenotype.
AB  - The liver microvasculature is unique among epithelial organs because it is
      composed of sinusoids rather than capillaries. Since hepatocytes lack a basement
      membrane, they are not separated from plasma by any continuous filtration
      barrier. During the cirrhotic process, the sinusoids become transformed into
      typical continuous capillaries with specialized endothelial junctions, continuous
      basement membrane, and pericytes. To explore the factors that determine the
      phenotype of the hepatic microvasculature, we implanted fetal rat liver fragments
      onto the chorioallantoid membrane of 6-day-old, shell-less, quail embryos. After
      5 days in culture they were studied by light and electron microscopy
      immunohistochemistry using markers specific for: quail cells, hepatocytes, and
      basement membrane components of murine or avian origin. The normal quail
      chorioallantoid membrane is vascularized by continuous capillaries. The periphery
      of the transplanted fetal rat liver fragments becomes vascularized by
      microvessels of quail origin. However, the quail microvessels in the proximity of
      rat hepatocytes assume a sinusoidal phenotype with fenestrations lacking
      diaphragms, endothelial cell gaps, and devoid of basement membrane. These results
      demonstrate that liver cells modulate the phenotype of the hepatic microvascular.
      Since hepatocytes and endothelium do not establish direct cell contacts, we
      postulate that this modulation is exerted either by secreted soluble cytokines or
      by the extracellular matrix.

PMID- 1753712
TI  - Amino acid protection of cultured kidney tubule cells against calcium ionophore
      induced lethal cell injury.
AB  - Treatment of two cultured renal tubule epithelial cell lines, MDCK and LLC-PK1,
      with ionomycin produced rapidly evolving models of lethal cell injury
      characterized by increases of cytosolic free calcium to the microM level within
      15 minutes followed by lactate dehydrogenase release and failure to exclude vital
      dyes that began between 30 and 60 minutes and became extensive after 60 minutes.
      The pattern of injury was similar when the mitochondrial uncoupler, carbonyl
      cyanide-m-chlorophenylhydrazone, was added to ionomycin. Carbonyl cyanide-m
      chlorophenylhydrazone alone produced severe ATP depletion but not lactate
      dehydrogenase release. Inclusion of glycine in the experimental medium at
      concentrations ranging from 0.25 mM to 5 mM did not affect the increases of
      cytosolic free calcium or ATP depletion but was protective against enzyme release
      and failure to exclude vital dyes for 180 minutes. Maximal protection was
      achieved at glycine concentrations between 1 and 5 mM. Several other small
      neutral amino acids including alanine, beta-alanine, L-serine, 1
      aminocyclopropane-1-carboxylic acid, and alpha-aminoisobutyric acid also had
      protective effects but, glucose, pyruvate, glutamate, glutamine, leucine, valine,
      and taurine did not. These data indicate that potent protective effects of
      glycine and other small neutral amino acids previously shown in fresh tubule
      preparations are fully expressed in cultured tubule cells of diverse origin when
      appropriate acute injury models are used and the protective effects are sustained
      for long durations. The suitability of cultured cell lines for prolonged exposure
      studies will provide a powerful way of further exploring mechanisms of these
      effects.

PMID- 1753713
TI  - Decreased prolactin level in secretory granules and their increased exocytosis in
      estrogen-induced pituitary hyperplasia in rats treated with a dopamine agonist.
AB  - Treatment with bromocriptine (CB) stimulates the release of secretory granules
      from human prolactinomas by exocytosis in spite of a remarkable decrease in serum
      prolactin (PRL) levels. In an attempt to elucidate the reasons for this
      phenomenon, secretory granules were analyzed in estrogen-induced pituitary
      hyperplasia in rats which served as a model of human disease. The amount of
      protein contained in cell fractions rich in secretory granules was the same in CB
      treated pituitaries as that in the controls, whereas PRL levels decreased to
      about a half the level of the controls. Morphometric analysis using point
      counting and electron immunocytochemistry revealed that the PRL concentrations in
      secretory granules decreased to about 50% after CB-treatment. Serum PRL levels
      estimated by counting the exocytotic secretory granules were remarkably lower in
      CB-treated rats than in the controls. It was suggested that the composition of
      secretory granules changed or that nonhormonal constituents in the granules
      disintegrated more slowly after CB treatment, thus allowing exocytosed granules
      to be observed more frequently. Additionally CB might also suppress a bypass
      release of PRL by which PRL is secreted without being packaged into secretory
      granules.

PMID- 1753714
TI  - Sialoadenitis in experimental graft-versus-host disease. An animal model of
      Sjogren's syndrome.
AB  - Using light microscopic, immunohistochemical, and ultrastructural techniques, we
      studied sialoadenitis in mice with chronic graft-versus-host disease (GVHD). To
      induce chronic GVHD, DBA/2 spleen cells were injected into nonirradiated (C57BL/6
      x DBA/2)F1 mice. By light and electron microscopy, the submandibular gland lesion
      was characterized by mononuclear cell infiltration around the interlobular ducts,
      often with parenchymal destruction. Immunohistochemically, T cells predominated.
      The ratio of CD4+ to CD8+ T cells ranged from 1.9:1 to 6:1, with an average of
      3.6:1. Lesser numbers of B cells, plasma cells, and macrophages were also
      present. Histologically, lymphocytic sialoadenitis in chronic GVHD mice was very
      similar to that reported in patients with chronic GVHD and Sjogren's syndrome.

PMID- 1753715
TI  - Development, characterization, and utilization of an intestinal xenograft model
      for infectious disease research.
AB  - Paired xenografts of near-term fetal rabbit jejunum were subcutaneously implanted
      in the backs of athymic nude (nu/nu) mice. At 3 to 4 weeks post-implantation, the
      grafts had histologic, ultrastructural, and biochemical (lactase, sucrase,
      alkaline phosphatase, leucine aminopeptidase) parameters comparable to age
      matched control rabbits. Four weeks post-transplantation the xenografts were
      intraluminally inoculated with various strains of lapine attaching and effacing
      E. coli or group A rotavirus. Infection with 2 strains of E. coli resulted in
      typical light microscopic and ultrastructural lesions of attachment and
      effacement. Immunohistochemical analysis of rotavirus-infected xenografts
      demonstrated rotavirus antigen within enterocytes. These lesions are comparable
      to those in conventional rabbits. Intestinal xenografts are a novel, highly
      controlled, and reproducible model which may have unique applications in the
      study of enteric diseases. The model provides anatomically and biochemically
      correct intestinal mucosal epithelium uncomplicated by variables such as enteric
      flora, host immune response, gastric, hepatic, and pancreatic secretions and is
      susceptible to infection by specific enteropathogens. Xenografts, therefore, may
      be a viable alternative in certain investigations where whole animals, ligated
      intestinal loops, organ cultures, or cell cultures might otherwise be chosen.

PMID- 1753716
TI  - Abnormal skeletal and cardiac muscle mitochondria induced by zidovudine (AZT) in
      human muscle in vitro and in an animal model.
AB  - To examine the mechanism of mitochondrial myocytotoxicity caused by long-term
      administration of zidovudine (AZT) in human immunodeficiency virus-positive
      patients, we examined the effect of AZT in vitro on human muscle in tissue
      culture and in vivo in rats treated with daily intraperitoneal injections of AZT
      at doses equivalent to the total daily dose used in acquired immunodeficiency
      syndrome patients. After 19 days, the AZT-treated myotubes in tissue culture
      exhibited abnormal mitochondria characterized by proliferation (mean +/- SD, 27.5
      +/- 8 mitochondria/16 microns2 surface area, compared with 12.8 +/- 4 in the
      control cultures (p less than 0.001], enlarged size, abnormal cristae and
      electron-dense deposits in their matrix. The changes were partially reversible
      after AZT withdrawal. Rats treated with AZT developed weight loss, 100-fold
      elevation of creatine kinase, and increased serum lactate and glucose. In
      tissues, AZT had its highest concentration in the skeletal muscle and the heart.
      Skeletal and heart muscles from the treated animals, but not the controls, showed
      enlarged mitochondria with disorganized or absent cristae and electron-dense
      deposits in their matrix. Study of the mitochondrial functions assessed by
      evaluating stimulated oxygen consumption rate, enzymatic activities of electron
      transport chain and coupling state of oxidative phosphorylation (respiratory
      control ratio) revealed a decrease in rotenone-sensitive NADH cytochrome C
      reductase (complex I + III) and an uncoupling effect demonstrated by decreased
      respiratory control ratio. We conclude that AZT, a DNA chain terminator, is a
      muscle mitochondrial toxin that affects the oxidation-phosphorylation coupling
      and the activity of complex I and III of the mitochondrial respiratory chain.

PMID- 1753717
TI  - Relationships of structural dimensions to bench press strength in college males.
AB  - The purpose of this study was to determine the relationships between structural
      dimensions and bench press performance in college males. Members of required
      fitness classes (n = 170) were measured after 14 weeks of strength and aerobic
      endurance training. Anthropometric dimensions included upper arm and chest
      circumferences, upper and lower arm lengths, shoulder and hip widths, %fat, and
      height. Arm muscle cross-sectional area (CSA) was calculated from upper arm
      circumference corrected for triceps skinfold. Drop distance was measured from the
      bar to the pectoral muscles. Multiple regression analysis selected upper arm CSA,
      %fat, and chest circumference as the best items to predict bench press strength
      (R = 0.83; SEE = 11.6 kg). Cross-validation of the prediction equation on a
      similar sample (n = 89) produced an r = 0.74 between predicted and actual bench
      press (t = 0.53, p greater than 0.50). In a second cross validation sample (n =
      57) who had trained more extensively with weights, the correlation between
      predicted and actual bench press was r = 0.57 (p less than 0.05). The prediction
      equations significantly (t = 6.59, p less than 0.01) underestimated bench press
      performance in the more extensively weight trained subjects. The results of this
      study suggest that bench press performance is related to structural dimensions in
      males and that extensive strength training may alter the relationship between
      size and strength.

PMID- 1753719
TI  - Influence of two levels of caffeine on maximal torque at selected angular
      velocities.
AB  - The purpose of this study was to determine the effect of two doses of caffeine on
      peak torque and muscle endurance in the knee extensors and flexors. Twenty males
      and 16 females were randomly assigned to one of three groups: 600 mg caffeine,
      300 mg caffeine, or a control receiving a placebo. Subjects with similar caffeine
      consumption history were used and all subjects abstained from caffeine usage for
      24 hours prior to testing. Subjects were tested for maximal strength and
      endurance at 75, 180, and 300 degrees per second using a Cybex II Isokinetic
      Dynomometer interfaced with a Cybex Data Reduction Computer. After pretesting,
      each subject was given one of three solutions using a double-blind design.
      Following a one hour rest and absorption period, the subjects were again tested.
      Data were analyzed using a 3 x 2 repeated measures analysis of variance with a
      grouping factor at three levels (600 mg vs 300 mg vs 0 mg) and a trial factor at
      two levels (pre- vs posttest). The following variables were analyzed at all
      angular velocities: peak torque and subsequent joint angle, peak torque at 30
      degrees, and peak torque at 70 degrees. At 300 degrees per second, the dependent
      variables were total torque for 15 repetitions, total torque for the first 3
      repetitions, and total torque for the last 3 repetitions. The results indicated
      no significant changes from pre- to posttest. It was concluded that maximal
      strength and endurance was not affected by the two levels of caffeine used in
      this study and that caffeine may not be considered an ergogenic aid in strength
      output in subjects naive to resistance training.

PMID- 1753718
TI  - Serum thyroid hormones, thyrotropin and thyroxine binding globulin in elite
      athletes during very intense strength training of one week.
AB  - The effects of a one-week very intense strength training period on maximal
      strength and pituitary-thyroid function were investigated in eight elite male
      weight lifters. No statistically significant changes occurred in the maximal
      isometric leg extension force of the test subjects. Decreased serum
      concentrations of thyrotropin (TSH), thyroxine (T4) and triiodothyronine (T3)
      were found during the training period, but no statistically significant changes
      occurred in the levels of free thyroxine (fT4), reverse T3 (rT3) and thyroxine
      binding globulin (TBG). The results suggest that the training stress affects at
      the hypophyseal and/or hypothalamic level decreasing the secretion of TSH, which
      leads to slightly decreased function of the thyroid gland.

PMID- 1753720
TI  - Weight training economy as a function of intensity of the squat and overhead
      press exercise.
AB  - The purpose of this investigation was to study the relationship between exercise
      intensity and weight training economy. Seven subjects performed squat and seated
      behind the neck press exercises at 60% and 80% of one repetition maximum (1 RM).
      Addition of net exercise oxygen uptake (VO2) to net recovery VO2 provided an
      estimate of metabolic cost for the exercise. Estimation of work performed was
      accomplished by calculation of vertical external work (VEW). Weight training
      economy was calculated (weight training economy = kcals consumed x VEW-1). The
      squat was significantly more economical than the overhead press (p = 0.002), and
      exercise at 60% 1 RM was more economical than exercise at 80% 1 RM (p less than
      0.001). Correlations between VEW and kcals consumed at each intensity ranged
      between 0.85-0.98. It was determined that estimation of metabolic cost of weight
      training exercise must take into account not only the vertical external work
      accomplished, but also the intensity of the exercise (% 1 RM). Vertical external
      work performed on the bar appears to be as accurate as the total vertical
      external work value in prediction of metabolic cost of the squat and overhead
      press exercises. Use of the weight training economy values obtained in this study
      for prediction of metabolic cost will provide values with 4.2%-15.8% prediction
      error.

PMID- 1753721
TI  - Determination of player potential in volleyball: coaches' rating versus game
      performance.
AB  - The purpose of this study was to determine if the factors which coaches feel
      indicated superior player potential were the same as those factors which
      contribute to successful competition outcome. Players from two colleges were
      evaluated for general and specific performance variables prior to a regular
      season match between the teams. A player's ability rating was the total of four
      coaches' ranking on a 1-to-10 scale. Multiple regression analysis to predict
      player ability rating selected age, vertical jump, total body movement time, and
      agility (R = 0.87). However, step-wise discriminant analysis to differentiate
      winning and losing team members selected shoulder flexibility, agility, forearm
      bump, and sit-and-reach flexibility. The canonical correlation between the
      winning-losing dichotomy and these skills was 0.74 and resulted in proper
      classification of 84.6% of the correct team members. It was concluded that the
      skills coaches consider indicative of superior ability are not necessarily the
      factors which dictate winning performance.

PMID- 1753722
TI  - The structural, functional, and nutritional adaptation of college basketball
      players over a season.
AB  - The purpose of this study was to determine the structural, functional and
      nutritional adaptation of college basketball players over a season. Structure was
      determined by somatotype and body composition, function was determined by peak
      work capacity and work efficiency, and nutrition was determined by plasma metals
      analysis. The tests were performed twice on each of the eight subjects, one
      preseason (PRS) and one postseason (PST). A small structural adaptation was
      indicated by a mean decrease (less than 1 kg) in fat free weight and an increase
      in ectomorphy (less than 0.03). Body weight and skinfolds did not change
      significantly. Functional adaptation was indicated by a one minute decrease in
      running time for the work capacity test (p less than 0.002), and an increase (p
      less than 0.02) in VO2 for the work efficiency test. Nutritional adaptation was
      indicated by a greater mobilization of plasma Zn after exercise during PST than
      PRS. Plasma Cu apparently was mobilized during exercise in PST but the change
      during the season (-10 to -6.6%) was not statistically significant because of the
      large interindividual variability in response. Structural and functional
      adaptation to basketball training over a collegiate season is small; however, the
      change in Zn mobility and the tendency for a concomitant change in Cu
      mobilization offers a unique finding to help explain the nutritional adaptation
      to training.

PMID- 1753723
TI  - Anthropometric, body composition and performance variables of young elite female
      basketball players.
AB  - The purpose of the study was to determine the physique and body composition of
      young female basketball players and to examine these variables in relation to
      their playing position. Eighteen members of the under seventeen England
      Basketball squad were measured on twenty different anthropometric sites from
      which somatotype and body composition were calculated. Four performance measures,
      vertical jump, anaerobic power, right and left grip strength and laterality were
      also measured. The variables of the basketball players grouped according to
      playing position were then compared statistically using ANOVA. Centres had the
      largest measures of physique and body composition followed by the forwards and
      then the guards. These differences were significant, particularly between the
      centres and the guards. The centres were much taller, had longer limb lengths,
      hip widths and were more muscular.

PMID- 1753724
TI  - Body build and performance characteristics of male adolescent track and field
      athletes.
AB  - Body build and performance characteristics were studied in 38 elite young male
      track and field athletes. The athletes were classed into 4 groups depending on
      their chosen event: Sprinters/Hurdlers (SPR), Jumpers (JUMP), Throwers (THR) and
      middle distance runners (MD). Performance characteristics investigated were
      vertical jump (VJ), the Margaria stair run (MARG) and the Wingate Test (WING).
      Analysis of variance results showed THR to be significantly different from other
      groups in body build and MD to be significantly different from other groups in
      performance characteristics. Further investigation revealed that in the 4 groups
      studied, body weight and vertical jump height are 2 simple measures of
      differentiating between event participation.

PMID- 1753725
TI  - Long-term effects of a lifestyle modification exercise program on the fitness of
      sedentary, obese children.
AB  - We studied the effects of a lifestyle modification and exercise program on the
      fitness of 12 sedentary and obese children who were physician-referred into a 1
      month YMCA lifestyle modification program. These variables were measured at
      entry, at the program's conclusion, and 1 and 4 months following conclusion:
      weight (lbs), sum of 2 skinfolds (mm), number of sit-ups, 9-minute run (total
      distance in yds), sit-and-reach for flexibility (cm). Total serum cholesterol
      (mg/dl) was measured only at entry and 4 months following conclusion. We found a
      NS decrease in weight (124 to 117 lbs) and sum of skinfolds (54 to 40 mm); a
      significant (p less than 0.01) increase in sit-ups (23 to 35); a significant (p
      less than 0.05) increase in 9 minute run distance (1201 to 1419 yds); no change
      in flexibility; and a NS decrease in total serum cholesterol (178 to 155 mg/dl).
      It was concluded that, while good changes were made, a longer period of time
      would be required to significantly reduce weight, sum of skinfolds, and total
      serum cholesterol.

PMID- 1753726
TI  - Effects of swimming and land exercises versus swimming and water exercises on
      body composition of college students.
AB  - The purpose of this study was to examine the effects of 2 different swimming and
      calisthenic exercise programs on body composition and swim performance. Subjects
      were forty-two students (M = 19; F = 23; mean age = 20.8 yr). The experimental
      groups (Swim-Land [SL], n = 14; Swim-Water, [SW], n = 16) participated in 35-40
      min exercise sessions which consisted of a 5-10 min warm-up, 15-20 min of
      swimming, and 10-15 min of calisthenics three times per week for 8 weeks. The SL
      experimental group performed calisthenics on land with surgical tubing while the
      SW experimental group performed comparable calisthenics in the water. Subjects
      were pretested and posttested utilizing hydrostatic weighing to determine body
      density and calculate percent fat. Skinfold measures and the 12-min swim for
      distance were also measured. Results indicated a significant 20% increase in swim
      performance in both experimental groups (SL = 455 +/- 144 m to 553 +/- 114 m; SW
      = 465 +/- 122 m to 556 +/- 123 m; p less than 0.05) but no difference between
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753727
TI  - Specialized physical training programs: effects on serum lipoprotein cholesterol,
      apoproteins A-I and B and lipolytic enzyme activities.
AB  - To determine the effects of different types of physical training on lipid
      metabolism, serum lipids, lipoprotein cholesterol, apoproteins A-I and B, hepatic
      (HTGL), extrahepatic (LPL) and total (PHLA) post-heparin lipoprotein lipase
      activities were studied in elite athletes engaged in aerobic ("B", no. 13),
      anaerobic ("C", no. 17) and mixed ("D", no. 9) training programs and in a group
      of sedentary controls ("A", no. 15). In the aerobic and mixed groups serum
      triglycerides were significantly lower compared to sedentary controls while total
      serum cholesterol and LDL cholesterol, as well as serum apoprotein B levels were
      only slightly lower. HDL cholesterol and HDL2 cholesterol were slightly higher
      while serum cholesterol/HDL cholesterol (2.89 +/- 0.37 vs 3.6 +/- 0.47, p less
      than 0.01) and LDL cholesterol/HDL cholesterol (1.69 +/- 0.38 vs 2.23 +/- 0.43, p
      less than 0.05) ratios were significantly lower only in aerobic athletes compared
      to the control group. PHLA and LPL activities were slightly higher in the aerobic
      group than in controls, while PHLA and HTGL were significantly lower in aerobic
      and mixed athletes. No significant correlations were found between HDL
      cholesterol and energy expenditure during training, indexes of adipose mass or
      lipolytic enzyme activities. The results of this cross-sectional study seem to
      indicate that specialized training programs have a different effect on
      lipoprotein pattern and lipolytic enzyme activities, and only aerobic exercise
      has a potentially antiatherogenic effect.

PMID- 1753728
TI  - Effects of flexibility training on enhancing spinal mobility in older women.
AB  - The purpose of this study was to examine the extent to which spinal flexion and
      extension, or spinal mobility, could be improved in a population of older adults
      participating in a 10 week flexibility training program. Twenty female
      volunteers, mean age 71.8, were randomly assigned to either the experimental
      group (flexibility training) or the control group (no training). Prior to the
      initiation of training, all subjects were tested for total spinal mobility, the
      combined sum of spinal flexion and extension. Subjects in the experimental group
      were exposed to a series of flexibility exercises, three times per week, for 20
      30 minutes in duration, for a total of 10 weeks. The control group participated
      in an alternative exercise program with the experimental group, including
      walking, swimming, dance, and other locomotor activities, however, they did not
      receive the additional flexibility training. At the conclusion of the 10 week
      period, all subjects were retested for spinal mobility, using back flexion and
      extension measures. Results indicated a significant improvement in spinal
      mobility in the experimental group, and virtually no measurable change in the
      control group. This study suggests that specialized training in back flexibility
      for older adults is warranted, and that significant gains in spinal mobility can
      be obtained, regardless of age.

PMID- 1753729
TI  - Former athletes physical fitness.
AB  - Genetic and environmental factors determine man's physical fitness. To the
      environmental factors exerting an active influence on the human organism belong
      intensive motoric exercises in the form of sport. With the passing of time there
      occur involutive structural and functional changes in man's organism. In order to
      determine the degree past sport activities shaped involution processes, a series
      of anthropometric and efficiency studies of 169 former sportsmen and randomly
      chosen men aged 39-73 were carried out in 1973; these studies were repeated ten
      years later (in 1983). It appeared that there existed substantial differences
      between former sportsmen and control groups (1973). In some physical efficiency
      tests these differences amounted to 15-20 years to the advantage of sportsmen.
      Studies repeated in 1983 allowed to assess the dynamics of involution changes
      appearing in the two groups-chiefly in the sphere of movement. The studies
      indicated that the motor regress began among the sportsmen not only at a higher
      level of original physical efficiency but its progress was slower.

PMID- 1753730
TI  - Biomechanical vibration of the abdominal region during running and bicycling.
AB  - The incidence of gastrointestinal (GI) distress reported among long distance
      runners and not in practitioners of other sports with more gliding movements,
      such as bicycling, leads one to speculate that there is a difference in
      concussions and vibration of the GI region and that this may possibly be
      associated with the disparity in GI disorders. The present experiment was
      conducted to quantify the difference in vibration (accelerations/decelerations)
      of the GI region during running as compared to bicycling. An actometer was used
      which included a piezoelectric sensor. The sensor was placed on the abdomen of
      six subjects during identical trials of bicycling and running. Movement in three
      planes was detected by the sensor and recorded. The accelerometer output (AO) is
      an integral of these measurements. AO was used in making comparisons of the two
      types of movement, expressed as counts per minute. Mean AO was more than doubled
      in running, 859.5 +/- 130.1 (SD), versus bicycling, 425.8 +/- 149.5 (SD) (p less
      than .0001). The common assumption that running results in more body vibrations
      than bicycling has been substantiated and quantified. Although the differences
      are large, it can only be speculated that these differences explain the high
      frequency of GI symptoms among runners.

PMID- 1753731
TI  - Assessment of static balance in children.
AB  - The ability in maintaining body balance of 6-, 8-, and 10-year-old children
      performing three balance tests on a force platform was studied. Thirty adult
      subjects served as a reference group. The mean radius (MR) of the posturogram and
      the mean speed (MS) of the center of foot pressure (COP) were used as the
      measuring parameters. Data were analyzed using two-way ANOVA, the Sheffe test and
      the Student "t" test with a .05 level of significance. A decrease with age in
      both mean radius and mean speed, indicating an increase in balance ability, was
      noted. A significant age main effect was found on all tests while significant
      gender main effect occurred only on the Tandem test. No significant age/sex
      interaction was found. Significant differences between the 10-year-old and adult
      groups occurred only in the more difficult balance tests.

PMID- 1753732
TI  - Acute recovery profile of lung volumes and function after running 5 miles.
AB  - The purpose of this study was to characterize the acute changes and recovery
      profile of lung volumes and function subsequent to strenuous aerobic exercise.
      Eight experienced runners (X age = 25 yrs; wt = 73 kg; ht = 181 cm) completed
      three identical 5 mile runs. Determinations were made of forced vital capacity
      (FVC), residual volume (RV), closing capacity (CC), and pulmonary diffusion
      capacity (DLCO). Measurement of cardiac output (Q) and stroke volume (SV)
      occurred simultaneously with the 10 second DLCO breathhold maneuver. Measurements
      were obtained before and 5, 15 and 25 minutes after each run. FVC was reduced (
      4.5%) 5 min post-run with a return to pre-run values by 15 min. CC (+16%) and RV
      (+18%) remained elevated for at least 30 min post-run. DLCO did not appear to be
      effected by the run. However, the single-breath DLCO breathhold maneuver
      consistently caused a fall in SV at rest and during recovery. The hypothesis has
      been forwarded that an increase in central blood volume post-run accounted for
      the acute reduction in FVC. The sustained elevation in RV resulted from early
      closure of the small airways possibly due to an increase in extra-vascular lung
      water.

PMID- 1753733
TI  - Effects of venous return on respiratory response.
AB  - This study reevaluated the link between the rate of CO2 flow to the pulmonary
      circulation and changes in cardiac output to the respiratory responses following
      leg lifting in normal man subjects. Thirty healthy subjects (mean age = 22.2
      years) were subjected to the experimental maneuver which increased venous return
      to the right heart. Cardiac output was significantly increased and with it a
      significant increase in CO2 output by the lungs was found. These results were
      associated with a significant increase in expired ventilation. The rapidity of
      the ventilatory response to the increase in cardiac output suggests the existence
      of pressoreceptors localized in the pulmonary circulation which, when activated,
      results in the elicitation of respiratory reflexes. The end result is an
      adjustment in the respiratory response in accordance with venous return.

PMID- 1753734
TI  - Effects of respiration on size and function of the athletic heart.
AB  - This study compares the effects of quiet breathing on the heart structure and
      function of pentathlon athletes (n = 11) and a less-conditioned control group (n
      = 12). Two-dimensional echocardiography was employed to direct an M-mode beam
      through the heart to minimize measurement errors due to respiratory motion of the
      heart. Respiration was simultaneously recorded with M-mode echocardiograms from a
      minimum of five respiratory and an average of 25 cardiac cycles. Athletes had
      greater (p less than 0.01) end-diastolic transverse dimensions (10%), and
      interventricular septal and left ventricular posterior wall thicknesses (25%).
      During inspiration right ventricular internal end-diastolic dimensions increased
      (8 vs 12%) and left ventricular end-diastolic dimension (LVIDd) decreased (7 vs
      8%) in athletes and controls, respectively. Although significant reciprocal
      changes in LVIDd (p less than 0.01) occurred during respiration, no respiratory
      change was noted in the transverse diameter of the heart, interventricular
      septal, posterior wall thickness, LV end-systolic volume or ejection fraction.
      Inspiration caused a 21% fall (p less than 0.01) in LV stroke volume in both
      groups. Eighty-four to 92% of the inspiratory decrease in LV stroke volume in the
      subjects studied could be attributed to ventricular interdependence; no
      significant interaction was found between level of conditioning and respiration.

PMID- 1753735
TI  - Evaluation of venous flow by light reflection rheography (LRR) in athletes
      performing track race.
AB  - The venous flow physiology in the athletes represents an interesting research
      field of sports angiology. The frequent observation of phlebectasias and/or
      varicose veins in athletes incited us to investigate the venous
      pathophysiological mechanisms predisposing them to such diseases. The maximal
      venous outflow (Rmax in millivolts) and the 1/2 venous refilling time (1/2 VRT in
      seconds) were evaluated in track racers, at rest and after exercise, by means of
      the light reflexion rheography (LRR). Thirty-two athletes (16 males, 16 females;
      mean age 23.4 years, range 15-37) were studied, dividing them in three groups:
      (A) 100 m (13), (B) 2,000 m (13), (C) 6 x 100 m with 2 minute recovery time (6).
      Among them six athletes performed the test wearing elastic compression stockings
      (25-32 mmHg). The results demonstrated a significant post-exercise modification
      of LRR curves and parameters in all groups, testifying superficial venous flow
      augmentation and deep venous flow overloading.

PMID- 1753736
TI  - The deterioration of visual acuity by exercise under a mesopic vision
      environment.
AB  - Visual acuity deteriorated following 15-minute bicycle ergometer pedaling under
      the condition of a mesopic vision environment. Visual acuity decreased sharply as
      the load increased. The visual functions which changed significantly after the
      exercise in the mesopic vision environment were visual acuity (deterioration) and
      accommodative near point distance (extension).

PMID- 1753737
TI  - Reducing induced state anxiety: effects of acute aerobic exercise and autogenic
      relaxation.
AB  - The purpose of this study was to investigate the effects of acute aerobic
      activity an an autogenic relaxation session on reducing induced state anxiety.
      Eighty-five university students were randomly assigned to one of three groups (a)
      aerobic, (b) relaxation, (c) control. Each group was tested separately. The
      general procedure consisted of anxiety induction, assessment, intervention, and
      assessment. The induced affect procedure involved having subjects visualize
      distressing images and generating high arousal states for ten minutes (Smith and
      Ascough, 1985). State anxiety was assessed by State-Trait Anxiety Inventory (form
      Y-1). The aerobic intervention lasted 40 minutes, including warm-up and cool
      down. The relaxation intervention consisted of listening and following
      instructions on a tape for approximately 30 minutes (Budzyski T, 1974, "Limb
      Heaviness-Exercise MU3-3"). The control group was excused after anxiety induction
      and told to report back in 30 minutes. The data was analyzed by a 3 x 2 (groups
      by time) ANOVA with repeated measures on the last factor. The groups by times
      interaction was significant, F(2,82) = 13.07, p less than 0.01. Post-hoc analysis
      using Tukey with a normalized n indicated that both the aerobic and relaxation
      groups significantly reduce anxiety scores from pretreatment to post-treatment
      but were not different from each other. Both groups were significantly different
      from the control. The findings support the argument that an acute aerobic
      activity and relaxation session can reduce induced anxiety. These results have
      implications for motivating individuals to engage in exercise and activity to
      relieve anxiety generated by an acute stressor.

PMID- 1753739
TI  - Exercise and migraine. A critical review.
AB  - Exercise has been frequently discussed as a method of migraine management, but
      the pathways by which exercise may alter migraines are unclear at present. The
      purpose of this paper is to provide a theoretical discussion of variables
      potentially involved in the prophylactic effects of a program of regular
      exercise. Exercise medicated changes to neurochemical secretory patterns, as well
      as symptoms commonly associated with, and thought to precipitate migraines will
      be discussed. Due to the paucity of experimental investigations of exercise and
      migraine, the bulk of supportive evidence for exercise as a treatment for
      migraines is gathered from related areas of research.

PMID- 1753738
TI  - Physical training programs and their effects on aerobic capacity and coronary
      risk profile in sedentary individuals. Design of a long-term exercise training
      program.
AB  - Currently the prevalent perception is that regular exercise training, besides
      increasing maximal oxygen uptake (VO2max), may have a beneficial effect on blood
      pressure and plasma lipid fractions. This is the basis for recommending exercise
      training for health maintenance and as a part of any prevention program for
      middle aged and older individuals. The purpose of this work was first, to review
      whether a basis exists for these recommendations and if so, to secondly design an
      exercise training program adjusted to these groups. Its parameters should be
      efficient enough to cause improvements in VO2max and risk profile, yet prevent
      cardial and orthopedic problems. The structure and the results of exercise
      programs in 27 experimental studies (n = 1153) were reviewed. The findings
      indicate that significant changes in VO2max, apart from individuals having least
      favourable values initially, do not necessarily effect simultaneous improvements
      in either blood pressure or plasma lipid fractions. Results strongly indicate the
      permanent benefits of participating in a long-term exercise program. This program
      should therefore provide a very useful and natural addition to the accepted
      dietary and pharmacological therapies.

PMID- 1753740
TI  - Doping test report of 10th Asian Games in Seoul.
AB  - With the guidance of the International Olympic Committee (IOC) the Olympic
      Council of Asia (OCA) introduced doping tests at the 1986 10th Asian Games at
      Seoul, Korea. From September 21st to October 5th, 1986, 585 samples were tested
      for stimulants, narcotics, anabolic steroids and beta-blockers by gas
      chromatography-mass spectrometry, high pressure liquid chromatography and
      fluorescence polarization immuno assay (TDX system by Abbott Lab.). These tests
      covered about 100 different drugs and another 400 as metabolites. Information
      about 1000 different drugs were required to interpret the drug screening data
      properly. The test results and outcome of findings are summarized. 3.2% of the
      samples were found to contain a banned drug and doping offenders were penalized
      accordingly.

PMID- 1753741
TI  - The relationship between peak torque and work of the quadriceps and hamstrings
      after knee injury.

PMID- 1753742
TI  - Simultaneous recording of vesical and urethral pressure in urethane-anesthetized
      rats: effect of neuromuscular blocking agents on the activity of the external
      urethral sphincter.
AB  - In urethane-anesthetized rats we made a disconnection of the urinary bladder from
      the urethra and performed a simultaneous recording of the vesical and external
      urethral sphincter (EUS) pressures. Throughout the collecting phase, the EUS
      pressure was higher than that recorded into the bladder. Gallamine (10 mg/kg
      i.v.) or d-tubocurarine (100 micrograms/kg i.v.), did not alter the value of
      intraurethral pressure. When a reflex bladder contraction occurred in response to
      filling (expulsion phase) the intravesical pressure exceeded the urethral
      pressure and at the top of the vesical contraction a series of rapid intraluminal
      pressure high frequency oscillations (IPHFO) were recorded at the urethral
      recording site, which were abolished by neuromuscular blocking agents as well as
      after acute sectioning of pudendal nerves. IPHFO was still present in rats in
      which the periurethral muscles (pelvic floor), have been precedently dissected.
      To get further information about the physiological consequence of the EUS
      functional impairment induced by neuromuscular blocking agents, we used the non
      stop transvesical cystometrogram. In these conditions, blockade of the EUS did
      not produce passive urine dripping during the filling phase, but absence of the
      rhythmic striated urethral activity during the vesical expulsion phase produced a
      significant increase of the residual volume from 35% (control) to 75%. We present
      an original pharmacological method in a species whose small dimensions create
      technical problems for recording pressure signals from the lower urinary tract.
      Moreover, we have gained information on the origin of the IPHFOs and about the
      role of the EUS during the collecting and the expulsion phase of the voiding
      cycle in urethane anesthetized rats.

PMID- 1753743
TI  - A novel method for the evaluation of bronchoactive agents in the conscious guinea
      pig.
AB  - We describe a simple, noninvasive, nontraumatic and reproducible method in which
      the activities of bronchoactive agents may be recorded in six conscious guinea
      pigs simultaneously. The method involves the use of "head out" whole body
      plethysmographs from which respiratory rate can be recorded, by monitoring
      respiration-related changes in pressure within the body chamber. Exposure of a
      guinea pig to an aerosolised bronchoconstrictor agent causes an increase in
      respiratory rate, which is quantified by measuring the area under the respiratory
      rate curve using a purpose-built respiratory computer. This can be carried out
      for six animals simultaneously and independently. When exposed to a standard
      bronchoconstrictor aerosol challenge at intervals over a 6 hr period, the areas
      under the respiratory rate curves for each animal are highly reproducible.
      Inhalation of nebulized solutions of acetylcholine (ACh), histamine (Hist), 5
      hydroxytryptamine, bradykinin, leukotriene D4 and the thromboxane A2-mimetic, U
      46619, but not prostaglandin F2 alpha (PGF2 alpha) caused dose-related
      bronchoconstriction observed as increases in respiratory rate. In addition,
      salbutamol, clenbuterol, N-ethylcarboxamide adenosine (NECA) and PGE2 all
      inhibited ACh (1 mg mL-1) and Hist (1 mg mL-1)-induced increases in respiratory
      rate in a dose-related fashion. The method described, which is both noninvasive
      and nontraumatic, may therefore be used to quantify in the conscious guinea pig,
      both bronchoconstrictor and bronchodilator agents.

PMID- 1753744
TI  - A novel technique for the administration of bronchodilator drugs formulated as
      dry powders to the anaesthetized guinea pig.
AB  - A technique is described for the administration of dry powder formulations of
      bronchodilator drugs to the anaesthetized guinea pig. The technique has been
      evaluated by comparing the efficacy of several bronchodilator drugs administered
      either as dry powders coformulated with a lactose carrier or as nebulized
      solutions. In each case, the dry powder formulation had comparable bronchodilator
      activity and duration of action to an equivalent dose administered as a nebulized
      solution. This technique offers a simple and inexpensive method for the rapid
      screening of bronchodilator drugs without the problems associated with aerosol
      administration.

PMID- 1753745
TI  - Rabbit aortic smooth muscle cell culture. A model for the pharmacological study
      of diabetes-induced alterations in cell proliferation.
AB  - Atherosclerotic vascular disease is the most common complication of diabetes
      mellitus. Enhanced vascular smooth muscle cell proliferation plays a central role
      in atherosclerotic lesion formation. Studies using explant cultures have
      demonstrated that aortic smooth muscle cells from rats with experimental or
      genetic diabetes have enhanced rates of proliferation when compared to controls.
      However, this method of culture may select for cells with enhanced migratory
      potential. In the present studies, aortic smooth muscle cells were successfully
      cultured from control and diabetic rabbits after enzymatic and mechanical
      dispersion from thoracic aortic segments. The proliferative patterns of control
      cells were characterized and growth rates of diabetic cells were compared to
      controls. Primary cultures from control rabbits grew after an initial 5-day lag
      period to achieve threefold increases in cell number by 9 days. Subcultures of
      aortic smooth muscle cells entered the logarithmic phase of growth after 2 days,
      reaching the plateau phase of growth in 5-7 days and achieving three to fourfold
      increases in cell number. The final density to which cultures grew was not
      affected by the number of cells attached on day 1 for the range studied. Cells
      from diabetic rabbits displayed shorter doubling times and reached greater
      densities at confluence than did cells from controls. These data support the
      hypothesis that diabetes induces an atherogenic response. The dissociated rabbit
      aortic smooth muscle cell culture provides a model in which to study diabetes
      induced modulation of cell proliferation that is amenable to pharmacological
      manipulation to investigate agonist and growth factor-induced responses.

PMID- 1753746
TI  - Development of a near anesthetic-free isolated canine hindlimb model. The effects
      of halothane and atropine sulfate on vascular resistance.
AB  - A denervated, isolated canine hindlimb (HL) model was developed to minimize
      residual anesthetic contamination. To test the preparation, we determined the
      peripheral arterial vascular effects of atropine sulfate and the effect of the
      basal anesthetic on arterial resistance. In four dogs that were under halothane
      and oxygen anesthesia, the HL was prepared to allow either vascular isolation of
      the limb or continuity with the systemic circulation. During isolation the HL was
      perfused by roller pump at a preset flow rate through an infant oxygenator.
      Inspired gas fed to the oxygenator contained either 0%, 1.25%, or 2.5% halothane
      to determine that anesthetic's effect on HL arterial vascular resistance. No
      halothane (0%) was used in the oxygenator inflow during the atropine
      measurements. Vascular resistance was calculated from HL arterial pressure at
      constant flow. Halothane caused a significant stepwise fall in vascular
      resistance, with a decrease of 68% at 2.5% inspired concentration (p less than
      0.01). Atropine produced a progressive attenuation of resistance that decreased
      by 18% after the 2.5 mg/kg dose (p less than 0.01). The model proved stable over
      time and demonstrated an apparent direct, dose-dependent vasodilating effect of
      both atropine and halothane in the canine HL muscle arterial bed.

PMID- 1753747
TI  - A method for rapid and frequent blood collection from the rat tail vein.
AB  - A technique is described for the collection of blood samples after dilation of
      rat tail veins using a controlled temperature device. Frequent blood samples of
      seven or eight per rat were collected during a 6-hr period. Further samples were
      taken from the same vein after recannulation during the next 5 days. This
      technique was also used to administer drugs intravenously through one vein and to
      collect blood samples from the contralateral vein.

PMID- 1753748
TI  - Physiological significance of metabolite channelling.

PMID- 1753749
TI  - Physiological significance of metabolic channelling.

PMID- 1753750
TI  - Metabolite channelling and metabolic regulation.

PMID- 1753751
TI  - Evidence of NADH channeling between dehydrogenases.

PMID- 1753752
TI  - Physiological significance of metabolite channelling.

PMID- 1753753
TI  - Are the transitory enzyme-enzyme complexes found in vitro also transitory in
      vivo? If so, are they physiologically important?

PMID- 1753754
TI  - Substrate channeling among glycolytic enzymes: fact or fiction.

PMID- 1753755
TI  - Energetics and control aspects of channelling.

PMID- 1753756
TI  - Semantics of channeling and microcompartmentation.

PMID- 1753757
TI  - Is channeling a disproveable hypothesis?

PMID- 1753758
TI  - Physiological significance of metabolite channelling: author's response to
      commentaries.

PMID- 1753759
TI  - Channeling: the pathway that cannot be beaten.

PMID- 1753760
TI  - Metabolite channelling in deoxyribonucleotide and DNA biosynthesis.

PMID- 1753761
TI  - Metabolic "channeling" and cellular physiology.

PMID- 1753762
TI  - Channelling in photosynthesis: the sublime and the ridiculous.

PMID- 1753763
TI  - How much effect on free metabolite concentrations does channelling have?

PMID- 1753764
TI  - Channelling by loose enzyme complexes in situ is likely, though physiological
      significance is open for speculation.

PMID- 1753765
TI  - Homeostasis, flexibility and conflict in the kinetic advantage of channelling.

PMID- 1753766
TI  - On the physiological significance of metabolite channelling: if, how, and where,
      but not why.

PMID- 1753767
TI  - Calmer waters in the channel?

PMID- 1753768
TI  - Is metabolic channelling the complicated solution to the easy problem of reducing
      transient times?

PMID- 1753769
TI  - The physiological significance of metabolite channeling: an idea whose time has
      come.

PMID- 1753770
TI  - No convincing evidence is available for metabolite channelling between enzymes
      forming dynamic complexes.

PMID- 1753771
TI  - Pillow strategy.

PMID- 1753772
TI  - Misleading interpretations of coupled enzyme kinetics.

PMID- 1753773
TI  - Channelling and evolution of metabolism.

PMID- 1753774
TI  - The role of isozymes in metabolite channelling.

PMID- 1753775
TI  - Metabolite channeling: implications for regulation of metabolism and for
      quantitative description of reactions in vivo.

PMID- 1753776
TI  - Physiological constraints on evolution of enzymes for cellular metabolic
      pathways.

PMID- 1753777
TI  - Selectivity and sensitivity improvement in co-operative systems with a threshold
      in the presence of noise.
AB  - High selectivity (specificity) and sensitivity to natural or artificial stimuli
      which are normally observed for biological systems can be realized in an ensemble
      composed of many co-operatively connected primary receptors. The co-operative
      interaction results in the formation of several stable states and a switching
      from one state to another is performed in a threshold manner. When any noise is
      absent the ensemble with a threshold can secure as high a selectivity and
      sensitivity as is desired. The presence of noise sets limits on the possible
      informational quality of a system because spontaneous switchings will occur. The
      question: What advantage as regards selectivity and sensitivity can a co
      operative system with a threshold have is considered quantitatively as an example
      for a bistable chemical system. As a result it is established that a co-operative
      system may have much higher selectivity and sensitivity than its individual
      primary receptors.

PMID- 1753778
TI  - Electrostatic potential and Born energy of charged molecules interacting with
      phospholipid membranes: calculation via 3-D numerical solution of the full
      Poisson equation.
AB  - Understanding the physicochemical basis of the interaction of molecules with
      lipid bilayers is fundamental to membrane biology. In this study, a new, three
      dimensional numerical solution of the full Poisson equation including local
      dielectric variation is developed using finite difference techniques in order to
      model electrostatic interactions of charged molecules with a non-uniform
      dielectric. This solution is used to describe the electric field and
      electrostatic potential profile of a charged molecule interacting with a
      phospholipid bilayer in a manner consistent with the known composition and
      structure of the membrane. Furthermore, the Born interaction energy is then
      calculated by appropriate integration of the electric field over whole space.
      Numerical computations indicate that the electrostatic potential profile
      surrounding a charge molecule and its resultant Born interaction energy are a
      function of molecular position within the membrane and change most significantly
      within the polar region of the bilayer. The maximum interaction energy is
      observed when the charge is placed at the center of the hydrophobic core of the
      membrane and is strongly dependent on the size of the charge and on the thickness
      of the hydrocarbon core of the bilayer. The numerical results of this continuum
      model are compared with various analytical approximations for the Born energy
      including models established for discontinuous slab dielectrics. The calculated
      energies agree with the well-known Born analytical expression only when the
      charge is located near the center of a hydrocarbon core of greater than 60 A in
      thickness. The Born-image model shows excellent agreement with the numerical
      results only when modified to include an appropriate effective thickness of the
      low dielectric region. In addition, a newly derived approximation which considers
      the local mean dielectric provides a simple and continuous solution that also
      agrees well with the numerical results.

PMID- 1753779
TI  - The energetics of embryonic growth and development. I. Oxygen consumption,
      biomass growth, and heat production.
AB  - A quantitative phenomenological model to describe the relationships between
      biomass growth rate, oxygen consumption, and heat production in developing
      embryos has been developed and tested using a wide range of experimental data.
      The model employs generalized material and energy balances, principles of enzyme
      kinetics, and an overall metabolic model scheme based on known biochemical
      principles. The phosphorylation concentration ratio of ATP and ADP occurs
      naturally and becomes a significant parameter in the analysis. The model is
      applied to the growth of Escherichia coli, Oryzias latipes, chick spinal cord,
      and whole chicken eggs. Excellent agreement between the model and the
      experimental data is obtained. In a succeeding paper (Part II) environmental
      effects and growth efficiency are discussed.

PMID- 1753780
TI  - Neural time-resolution depending on waveform of spikes.
AB  - A neural mechanism for detecting temporal coincidence in spike arrival is
      examined. The neurons fire when some spikes arrive simultaneously. The neurons of
      the electric fish can detect the coincidence in the microsecond range under hard
      temporal constraints: the width of spikes is more than 0.5 msec and the arrival
      time jitters on the scale of tens of microseconds. Since the synaptic connections
      between those neurons are electronic, the neural circuit is represented by a
      circuit composed of electric resistances. Computer simulation of behavior of the
      electric circuit model is presented to show that the nervous system can achieve
      the fine temporal sensitivity under the constraints. Analysis of the model shows
      that waveform of spikes is a critical condition to produce the sensitivity; peaks
      of spikes must be sharp. Also, the effect of the jitter of spike arrival is
      estimated to indicate that the coincidence detecting mechanism is tolerant of the
      jitter.

PMID- 1753781
TI  - A discrete model for immune surveillance, tumor immunity and cancer.
AB  - In this paper we propose a model of tumor immunity in terms of discrete automata
      where each automation describes the concentration of one particular type of cell
      involved in immune response. In contrast to the earlier models of normal immune
      response, there is more than one type of cell surface antigen in this model. As a
      consequence, the tumor can evade destruction through humoral response by changing
      its identity. However, the tumor can be killed by the killer cells through cell
      mediated response unless protected by a high concentration of the suppressor T
      cells.

PMID- 1753782
TI  - Sexual isolation in Drosophila. I. Theoretical models for multiple-choice
      experiments.
AB  - Several simple models are developed to calculate expected mating frequencies in
      ethological isolation experiments. They take into account the effect that the
      peculiar sexual behavior of Drosophila species can have in multiple-choice
      experiments. These models depend on only three basic parameters: male competitive
      ability (C), female receptivity (R) and the coefficient of females acceptance
      (A). Two types of model can be distinguished: (1) models with discrete
      preferences, in which A is a measure of the percentage of females accepting a
      particular kind of male and (2) models with continuous preferences, in which A
      represents the probability of acceptance for each courtship. It is demonstrated
      that the information rendered by just one experiment, although effective for
      determining whether sexual isolation exists, it is insufficient to estimate its
      degree or to demonstrate that it is asymmetrical. Further developments of the
      models under more complex conditions as well as their implications for
      reinforcement and founder effect theories are discussed.

PMID- 1753783
TI  - Protective effects of TJ-960 herbal mixture on hippocampal neuron damage induced
      by cobalt focus in the cerebral cortex of rats.
AB  - In the cobalt focus experimental epilepsy model, severe hippocampal neuron damage
      occurs with marked EEG changes. The effects of TJ-960, a herbal medicine
      formulation, were studied on neuron damage in the CA1 area of rat hippocampus.
      Continuous oral administration of TJ-960 from one month prior to the cobalt
      application showed almost complete protection against hippocampal neuron damage
      induced by cobalt application to the cerebral cortex. TJ-960 also completely
      inhibited the EEG changes as well as the brain edema induced by cobalt
      application.

PMID- 1753784
TI  - Antiulcerogenic effects of two Maytenus species in laboratory animals.
AB  - Leaves of Maytenus species are commonly used in Brazil for the treatment of
      gastric ulcers, dyspepsias and other gastric problems. The present study
      evaluated the antiulcerogenic potential of a boiling water extract of equal parts
      of M. aquifolium and M. ilicifolia leaves against ulcer lesions induced by
      indomethacin and cold-restraint stress in rats. Ranitidine and cimetidine were
      used as reference drugs. The oral and intraperitoneal administration of the
      extract had a potent antiulcerogenic effect against both types of ulcers. The
      extract was shown to cause an increase in volume and pH of gastric juice of the
      animals with the pH effects comparable to those of cimetidine. The results tend
      to confirm the popular use of the plant.

PMID- 1753785
TI  - Pharmacologic and toxicologic effects of two Maytenus species in laboratory
      animals.
AB  - Leaves of Maytenus species are used in the popular medicine of Brazil for their
      reported antacid and antiulcerogenic activity. The present work examined the
      effects of a boiling water extract of equal parts of M. aquifolium and M.
      ilicifolia leaves on acute administration in rats and mice, in an attempt to
      detect any general depressant, hypnotic, anticonvulsant and analgesic effects.
      General depressant and hypnotic effects were seen only after intraperitoneal
      administration. After chronic administration, the overall behavior of animals did
      not change and they continued to gain weight at the same rate as controls.
      Several biochemical and hematological parameters as well as pathological
      examination of different organs did not show any significant alterations after 3
      months of treatment. A search for the potential effects of the extract on the
      fertility of female and male rats and on the course of pregnancy as well as a
      search for potential teratogenic effects did not reveal any significant
      differences from controls. Taken together, the results indicate that these
      Maytenus species may be safe for human use and deserve further investigation.

PMID- 1753786
TI  - Myrcene mimics the peripheral analgesic activity of lemongrass tea.
AB  - Oral administration of an infusion of lemongrass (Cymbopogon citratus) fresh
      leaves to rats produced a dose-dependent analgesia for the hyperalgesia induced
      by subplantar injections of either carrageenin or prostaglandin E2, but did not
      affect that induced by dibutyryl cyclic AMP. These results indicate a peripheral
      site of action which was confirmed with the essential oil obtained by steam
      distillation of the leaves. Silica gel column fractionation of the essential oil
      allowed the identification of myrcene as the major analgesic component in the
      oil. Identification of the components was made by thin-layer chromatography and
      checked by mass spectrometry. The peripheral analgesic effect of myrcene was
      confirmed by testing a standard commercial preparation on the hyperalgesia
      induced by prostaglandin in the rat paw test and upon the contortions induced by
      intraperitoneal injections of iloprost in mice. In contrast to the central
      analgesic effect of morphine, myrcene did not cause tolerance on repeated
      injection in rats. This analgesic activity supports the use of lemongrass tea as
      a "sedative" in folk medicine. Terpenes such as myrcene may constitute a lead for
      the development of new peripheral analgesics with a profile of action different
      from that of the aspirin-like drugs.

PMID- 1753787
TI  - Post-coital antifertility action of Ruta graveolens in female rats and hamsters.
AB  - Different preparations of Ruta graveolens were administered orally to female rats
      (Days 1-10 post coition) and female hamsters (Days 1-6 post coition). The
      powdered root (CDR), aerial parts (CDA) and the aerial parts aqueous extract
      (AEA) all showed potential anticonceptive activity in rats. Limited
      administration on selected days of CDA showed uniformly lesser activity than with
      10-day treatment. Sequentially prepared petroleum ether and methanol extracts of
      CDA were as active as CDA itself. The benzene and chloroform extracts were toxic
      and inactive. Rutin, a known chemical constituent of the plant, was found to be
      inactive. None of the above preparations showed activity in hamsters.

PMID- 1753788
TI  - Antihepatotoxic properties of picroliv: an active fraction from rhizomes of
      Picrorhiza kurrooa.
AB  - The hepatoprotective activity of picroliv, the irridoid glycoside mixture from
      Picrorhiza kurrooa, was determined in adult male albino rats. Pretreatment with
      picroliv prevented the hepatotoxic effects of paracetamol and galactosamine as
      evidenced by various biochemical and histopathological observations. Maximum
      hepatoprotective effect was observed with daily oral doses of 6 and 12 mg/kg for
      7 or 8 days. The antihepatotoxic action of picroliv seems likely due to an
      alteration in the biotransformation of the toxic substances resulting in
      decreased formation of reactive metabolites.

PMID- 1753789
TI  - Effects of an aqueous extract of Physalis alkekengi fruit on estrus cycle,
      reproduction and uterine creatine kinase BB-isozyme in rats.
AB  - Intraperitoneal injections of the aqueous extract of winter cherry fruits
      (Physalis alkekengi) to female rats produced 100% diestrus. The rats resumed
      their normal estrus cycle upon withdrawal of this extract. Although there was no
      significant decrease in the number of implantation sites, the number of pups born
      to rats decreased by 96% with extract administration. Treatment with this extract
      had no effect on body weight, uterus weight, plasma protein level or plasma total
      creatine kinase activity. However, the level of plasma progesterone was
      diminished by 44%. In addition, uterine creatine kinase BB-isozyme (an estrogen
      induced protein) showed a time-dependent inhibition of activity from 55% to 82%.

PMID- 1753790
TI  - Phytochemical screening of a Warao pharmacopoeia employed to treat
      gastrointestinal disorders.
AB  - A three-year medical-ethnobotanical investigation among the Warao of the Orinoco
      Delta in eastern Venezuela documented a pharmacopoeia of 100 plant species
      representing 45 families. Warao phytotherapists manipulate these plants in
      diverse manners to produce 259 remedies of various complexities to treat 52
      classes of diseases/disorders. National health statistics indicate that
      gastrointestinal disease ranks as a principal cause of morbidity and mortality in
      this part of the country. Ten plant species, specifically employed by the Indians
      against these disorders, were subjected to phytochemical screening. Test results
      are listed together with the ethnoepidemiological protocol that governs the
      selection and administration of these medicinal plants in Warao society.

PMID- 1753791
TI  - Increased hepatic adenine nucleotide content by ginseng.

PMID- 1753792
TI  - Leukogenic effect of complex indigo powder.
AB  - Oral administration of complex indigo powder, an anti-scrofula powder, at a daily
      dose of 0.5 g/kg, raised the leukocyte count in rats injured by irradiation, but
      prophylactic administration could not prevent the leukopenia induced by
      irradiation. This dosage did not affect growth in rats and oral doses up to 6
      g/kg did not induce any toxic reactions in mice.

PMID- 1753793
TI  - Screening of 11 ferns for cytotoxic and antitumor potential with special
      reference to Pityrogramma calomelanos.

PMID- 1753794
TI  - Ethnopharmacognostical survey of Azadirachta indica A. Juss (Meliaceae).
AB  - Literature data on respectively botany, chemistry, ethnopharmacology,
      pharmacology and toxicology of Azadirachta indica A. Juss. (Meliaceae) are
      reviewed and evaluated. In traditional literature, preparations of the tree are
      claimed to be vulnerable in wide spectrum of diseases. Especially for
      inflammation-related diseases a good correlation is found with the results of
      recent experimental investigations. In addition, a variety of other biological
      activities are reported. Most frequently the effects can be attributed to
      compounds representing the structural classes of the limonoids, phenolics and
      macromolecules. Reported toxicity of preparations and isolated compounds are low,
      except for the seed oil. In conclusion, A. indica can be regarded as a valuable
      plant source for the rationalisation of its use in traditional medicine and for
      modern drug development.

PMID- 1753795
TI  - Inventory of plants used in traditional medicine in Somalia. I. Plants of the
      families Acanthaceae-Chenopodiaceae.
AB  - Thirty-eight plants are listed, which are used by traditional healers in the
      central and southern parts of Somalia. For each species are listed: the botanical
      name with synonyms, collection number, vernacular name, medicinal use,
      preparation of remedy and dosage. Results of a literature survey are also
      reported including medicinal use, substances isolated and pharmacological
      effects.

PMID- 1753796
TI  - Hypoglycemic activity of Pterocarpus marsupium wood.

PMID- 1753797
TI  - Antibacterial, antifungal, antiamoebic, antiinflammatory and antipyretic studies
      on propolis bee products.

PMID- 1753798
TI  - Studies on the anticonvulsive, sedative and hypothermic effects of Periostracum
      Cicadae extracts.
AB  - The anticonvulsive, sedative and hypothermic effects of water and ethanol
      extracts of Periostracum Cicadae (PC), the cast off skin of Cryptotympana atrata
      were studied. The water-extract of whole Periostracum Cicadae (PCws) had
      anticonvulsive, sedative and hypothermic effects in rats. Orally, it decreased
      carrageenin-induced hyperthermia. The hypothermic effect of PCws was potentiated
      by 5-hydroxytryptophan and antagonized by p-chlorophenylalanine. PCws enhanced
      the decrease in locomotor activity induced by alpha-methyl-p-tyrosine or 5
      hydroxytryptophan and reduced the increase in locomotor activity produced by
      levodopa plus benserazide or p-chlorophenylalanine. From these results, it was
      concluded that the sedative and hypothermic effect of PCws may be due to an
      increase in central serotonergic activity.

PMID- 1753799
TI  - Screening for antimicrobial activity and for alkaloids of Nauclea latifolia.

PMID- 1753800
TI  - On lymphedema "enigmas".

PMID- 1753801
TI  - Ultrastructural cytochemistry of anchoring filaments of human lymphatic
      capillaries and their relation to elastic fibers.
AB  - In previous studies "anchoring filaments" of human lymphatic capillaries have
      been shown to consist of microfibrils having histochemical and ultrastructural
      characteristics similar to elastin-associated microfibrils. When not associated
      with an elastin component, these microfibrils are referred to as "oxytalan
      microfibrils." In this study, alpha-glycol-containing carbohydrates and
      glycoconjugated sulfate groups, originating from sulphydryls and/or disulfide
      bridges, have been detected in anchoring filament microfibrils of human lymphatic
      capillaries by Thiery reaction (PA-TCH-SP) and "Hight Iron Diamine" cytochemical
      method (HID), respectively. Both of these chemical groups belong to the putative
      glycoprotein of which the microfibrils are constituted. Similar molecular
      characteristics have been demonstrated in elastic fiber microfibrils and oxytalan
      microfibrils of connective tissue. These findings suggest a close molecular
      similarity among these different types of microfibrils. Thus, whatever their
      individual location or denomination (anchoring filaments, oxytalan fibers, or
      elastin-associated microfibrils), these microfibrils form an uniform population
      of fibrous elements. These findings further support a structural (and functional)
      continuity between the lymphatic capillary wall and the elastic network of
      adjacent connective tissues previously described and termed "Fibrillar Elastic
      Apparatus" (FEA). Of interest, endothelial cells also selectively react
      positively to the PA-TCH-SP and HID methods.

PMID- 1753802
TI  - In vitro effects of a thromboxane A2-analogue U-46619 and noradrenaline on
      contractions of the human thoracic duct.
AB  - A piece of a human thoracic duct removed at operation was investigated in organ
      baths. The duct was cut in 8 ring segments each about 1mm long and isometric
      tension recorded. The segments were exposed to a potassium rich (124mM) Krebs
      buffer solution. In only two of the segments were contractions induced (7.2 and
      1.0mN, respectively). Noradrenaline and the thromboxane mimetic U-46619 induced
      tonic and phasic contractions. At a noradrenaline concentration of 10(-5)M the
      phasic contractions had a frequency of 5 min-1. The highest frequency, 9 min-1,
      was recorded with 3 x 10(-10)M of U-46619 present in the bath. Noradrenaline had
      a mean Emax of 50% of the previous K+ (124mM)-induced contraction, and the mean
      pEC50-value was 6.7. The Emax and pEC50-values of U-46619 were 142% and 9.5,
      respectively. Postjunctional alpha-adrenoceptors and thromboxane A2-receptors may
      play a role in the contractility of the human thoracic duct.

PMID- 1753803
TI  - Lymphatics and pre-lymphatics of the rabbit pericardium and epicardium with
      special emphasis on particulate absorption and milky spot-like structures.
AB  - The lymphatics and pre-lymphatic connective tissue of rabbit pericardium and
      epicardium were examined by light and electron microscopy under normal conditions
      and after the injection of India ink and latex particles into the pericardial
      cavity. A characteristic lattice structure of connective tissue was present
      between the small mesothelial cells and the submesothelial lymphatic capillaries
      in the basal region of the pericardium, but not in the epicardium. Milky spot
      like structures bulging toward the pericardial cavity were found in the
      pericardium, similar to those in the omentum and mediastinal pleura. Within 60
      minutes after injection, carbon and latex particles were directly absorbed
      through the intercellular clefts of the adjacent small mesothelial cells into the
      submesothelial layer particularly at sites of characteristic lattice structure.
      Carbon particles were already present in the lumens of lymphatic capillaries at
      this time. Macrophages in the pericardial cavity and submesothelial layers of the
      pericardium engulfed both carbon and latex particles. Our results suggest two
      possible routes of drainage of particulate matter from the pericardial cavity
      into the lymphatics: direct absorption and indirect absorption after phagocytosis
      by macrophages. Macrophages probably migrate from the milky spot-like structures
      described in this study. Epicardial lymphatics, in contrast, drain tissue fluid
      primarily from the myocardium.

PMID- 1753804
TI  - Thoracic duct cyst of the neck: a case report.
AB  - A thoracic duct cyst was excised from the left side of the neck of a 63-year-old
      woman. It was 6.5cm in length and 3.5cm in width, and was located behind the
      common carotid artery and jugular vein. The proximal portion of the thoracic duct
      with a narrowed lumen was in direct contact with the lateral surface of the cyst
      and the venous angle. The lower end of the cyst extended into the mediastinum to
      immediately above the aortic arch; the inferior portion of the thoracic duct
      descended from the bottom of the cyst into the mediastinum behind the aorta. The
      cyst was unilocular with a fluid content high in triglyceride (3350mg/dl). Its
      wall was muscular and permeated with lymphatic vessels.

PMID- 1753805
TI  - Effect of Endotelon (procyanidolic oligomers) on experimental acute lymphedema of
      the rat hindlimb.
AB  - Endotelon (Procyanidolic Oligomers, Sanofi-Labaz Laboratories) are recognized
      "angioprotectors" for human venous insufficiency. Using an operative experimental
      model of lymphedema, we sought pharmacological evidence for potential lymphagogue
      activity of Endotelon. After surgical interruption of hindlimb lymphatics, rats
      developed for 7 days, peripheral edema that represented a mean 24% increase in
      volume compared to the nonoperated hindlimb (control). In this experimental
      counterpart of acute lymphedema, Endotelon (400mg/kg/day p.o.) administered
      "prophylactically" (i.e., before, during, and 7 days after development of
      lymphedema) decreased rat hindlimb lymphedema by approximately 4.7%. When
      administered just before lymphedema became established (i.e., curatively),
      Endotelon and Coumarin (another "angioprotector") failed to affect hindlimb
      edema. These results suggest that Endotelon may reduce or prevent postoperative
      acute edema.

PMID- 1753806
TI  - Species variation in the extrinsic lymphatic drainage of the rodent testis: its
      role within the context of an immunologically privileged site.
AB  - Earlier work suggested that the immunologically privileged site of the rat testis
      was associated with anomalous testicular lymph drainage whereby some lymphatic
      trunks bypassed regional lymph nodes and opened directly into the systemic blood
      circulation via the cisterna chyli and thoracic duct. Because other workers also
      noted the privileged status of the testes in untreated mice and guinea pigs, we
      opted to examine the nature of the testicular extrinsic lymphatic system in these
      rodents using the rat model for comparison. Contrary to expectation, there were
      no direct lymphatic-venous communications draining the testes of either guinea
      pigs or mice. Instead, testicular lymphatics drained into at least one lymph node
      before reaching the blood circulation. This disparity from testicular lymphatic
      drainage of the rat suggests that the immunologic privilege, if any, in mice and
      guinea pigs has an alternative explanation (e.g., lymphatic effect of steroidal
      factors emanating from the testicles or adrenal gland and altering the response
      to foreign graft).

PMID- 1753807
TI  - Longitudinal Gompertzian analysis of primary malignant brain tumor mortality in
      the U.S., 1962-1987: rising mortality in the elderly is the natural consequence
      of competitive deterministic dynamics.
AB  - Age-adjusted mortality rates for primary malignant brain tumors (PMBT) in the
      United States from 1962 to 1987 were subjected to longitudinal Gompertzian
      analysis. Age-adjusted PMBT mortality rate distributions between age 25 and 65
      years were determined by a variable environmental factor and a common intersect
      point. The environmental factor declined (improved) 1.58-fold for men and 2.34
      fold for women in 1987 as compared to 1962. The age at the common intersect point
      was 68.4 years for men and 64.1 years for women. Between 1962 and 1987, non-age
      standardized annual crude PMBT mortality rates increased 14.5% for men and 37.8%
      for women. However, PMBT mortality rates at age 77.5 years rose 259% for men and
      409% for women between 1962 and 1987. Longitudinal Gompertzian analysis of PMBT
      mortality data suggests that rapidly rising PMBT mortality rates in the elderly
      are the natural consequence of competitive deterministic mortality dynamics and
      should not be attributed to environmental factors, past or present, that are
      directly contributing to PMBT mortality. Furthermore, longitudinal Gompertzian
      analysis demonstrates that PMBT mortality should not be studied in isolation, but
      rather should be examined in relation to other causes of death. When viewed from
      this perspective, the basis for the dramatic rise in PMBT mortality in the
      elderly becomes quite evident.

PMID- 1753808
TI  - Longitudinal Gompertzian analysis of prostate cancer mortality in the U.S., 1962
      1987: a method of demonstrating relative environmental, genetic and competitive
      influences upon mortality.
AB  - Age-specific mortality rates for prostate cancer (PC) in the United States from
      1962 to 1987 were subjected to longitudinal Gompertzian analysis. Age-specific PC
      mortality rate distributions between age 55 and 85 years were determined by a
      variable competitive factor and a common intersect point. The intersect point for
      PC occurred at age 61.5 years and mortality rate 27.9 per 100,000 and reflects
      genetic and environmental influences upon mortality. Between 1962 and 1987, non
      age-standardized annual crude PC mortality rates increased 41.6%. Longitudinal
      Gompertzian analysis suggests that rising PC mortality rates in the United States
      are the natural consequence of competitive deterministic mortality dynamics.
      Moreover, longitudinal Gompertzian analysis is a method that demonstrates the
      relative contribution of environmental, genetic and competitive influences upon
      disease specific mortality.

PMID- 1753809
TI  - Effect of lard, palm and rapeseed oils life conservation in aged mice.
AB  - Effects of lard, palm and rapeseed oil diets on the survival and fatty acid
      composition of liver and brain lipids were studied in male and female mice for 15
      months. Over 80% of mice fed on lard and rapeseed oil (n-3 PUFA sufficient) diets
      survived to the end of feeding trial, however, 60% of male mice fed on palm oil
      (n-3 PUFA deficient) diet died before the end. Although a survival curve in
      female mice fed on palm oil diet was similar to that in male, it was not as
      dramatic as that of the male. The fatty acid analyses revealed that severe n-3
      PUFA deficiency occurred in the mice fed on a palm oil diet. Moreover, the fatty
      acid was more deficient in the male than in the female. These results suggest
      that short life in mice may be caused by n-3 PUFA deficiency and, therefore, the
      fatty acid may be essential in enjoying a long life.

PMID- 1753810
TI  - Changes in the rat liver mitochondrial DNA upon aging.
AB  - During experiments on the molecular basis of morphological and functional changes
      observed in rat liver mitochondria upon aging, we found that the buoyant density
      profile of mitochondrial DNA (mtDNA) shows a wide distribution pattern especially
      in the lighter region than that of young rat liver mtDNA. The heterogeneous
      pattern may be partly recovered to become similar to that of young rat liver
      mtDNA by treatment with proteinase K. Therefore, it is quite likely that mtDNA of
      old rat liver contains firmly bound protein(s) or peptides. During the
      morphological observation of mtDNA by electron microscopy, we found that mtDNA of
      old rat had a novel property, that is, the ability to attach to negatively
      charged mica in the absence of magnesium ions, although their morphological
      features showing circular 5 microns contour length form did not change. Further,
      mtDNA gained resistance against EcoRI digestion during aging. This property was
      not shared by the DNA from young animal, and might be due to the binding
      protein(s).

PMID- 1753811
TI  - Mitochondrial theory of senescence: respiratory chain protein studies in human
      skeletal muscle.
AB  - In view of a previously demonstrated negative correlation between stage III
      respiratory activity in human mitochondria and increasing age, the relationship
      between human respiratory chain complex protein content and age was investigated.
      Quantitative immunoblot studies were carried out using holo complex I, III and IV
      antibody probes in human skeletal muscle mitochondrial homogenate from patients
      of varying ages. No significant negative correlation between increased age and
      respiratory complex chain protein content was seen for either total complex
      activity or for any of the subunits which could be reliably identified. As
      respiratory complex protein content is preserved with ageing, the decrease in
      respiratory efficiency is likely to follow aggregation of mutations in structural
      mitochondrial (mt) DNA genes which do not interfere with mt DNA transcription and
      protein translation rather than mutations in mt tRNA or ribosomal RNA genes. This
      is consistent with the fact that mt genes involved in protein translation only
      occupy a fairly small percentage of the mitochondrial genome.

PMID- 1753812
TI  - [The evidence of human immunodeficiency virus infection in the seronegative
      subjects of high-risk groups].
AB  - BACKGROUND: Polymerase chain reaction (PCR) is a new diagnostic procedure which
      has been used to recognise HIV-infected individuals who remain seronegatives.
      METHODS: Genomic DNA isolated from the peripheral blood mononuclear cells of 90
      high-risk individuals were analyzed by PCR using gag primers SK 38/39. Subjects
      were classified in four groups: 42 drug abusers, 35 heterosexual partners of HIV
      infected individuals, 9 homosexual men, and 4 health care workers accidentally
      exposed to HIV. Liquid hybridization using radiolabelled probes was done to
      confirm the results. All samples were also tested for HIV antigen and antibodies
      (Ab) using EIA and Western blot (WB). RESULTS: Two out of 11 (18%) drug abusers
      and 5 out of 34 (14%) couples were PCR positive in absence of HIV antibodies.
      This silent HIV infections were not recognized in homosexuals and health care
      workers. All 38 seropositive samples were PCR positive. None of the samples
      PCR+/Ab- was positive for HIV antigenemia or showed indeterminate results in the
      WB assay. CONCLUSIONS: Silent HIV infections were recognized in drug abusers
      (18%) and couples of HIV-infected individuals (14%). Mechanisms involved in the
      production of this "occult" HIV infections are reviewed.

PMID- 1753813
TI  - [The use of the determination of plasma theophylline concentrations in the
      hospital].
AB  - BACKGROUND: The evaluation of the determination of plasmatic concentrations of
      theophylline (PCT) in clinical practice is scarce. An observational study was
      carried out with the aim of discerning the reasons why PCT determinations are
      requested, the theophyllinemias obtained and the attitude of the medical staff in
      a hospital. METHODS: PCT determinations obtained in 113 patients over a period of
      3 months were analyzed. Information concerning treatment and daily doses of
      theophylline, reasons for theophylline determination, apart from those included
      in the request for theophyllinemia determination, clinical history and treatment
      sheets were collected. RESULTS: Treatment with theophylline had been indicated in
      78 patients (69%) with chronic bronchitis, and 30 (26%) with asthma. All the
      patients received medication in addition to theophylline. Daily dosage (SD) was
      734 (260) mg and the daily doses as to body weight (SD) was 11 (4) mg/kg/day. 188
      DNPT were performed, however 22 (12%) were inadequate; of the remaining 166 PCT
      determinations 117 (69%) had been requested with no indication of insufficient
      clinical response, suspicion of undesirable effects or modifying factors of the
      pharmacokinetics of theophylline. The mean plasmatic concentration (SD) was 11.3
      (7) micrograms/ml. PCT was infratherapeutic in 74 PCT determinations (44%),
      therapeutic in 73 (44%) and toxic in 19 (11%). Therapeutic concentrations were
      obtained in only 16 (35%) of the 45 patients in whom a second PCT determination
      had been carried out. CONCLUSIONS: In this study scarce individualization in the
      indication of treatment and the doses of theophylline administered are observed.
      The reason for soliciting determination of theophyllinemia and dosage adjustment
      in terms of plasmatic concentrations are also commented upon.

PMID- 1753814
TI  - [The mycoplasmas isolated from respiratory specimens].
AB  - BACKGROUND: Mycoplasma pneumoniae is the species that is considered pathogen for
      respiratory tract. Other species, M. hominis and U. urealyticum, have been
      isolated from respiratory specimens and its aetiological relation with
      respiratory infections is not clear. METHODS: In this study, mycoplasma from
      respiratory specimens have been isolated from HIV infected patients, patients
      suffering from chronic bronchitis and patients with respiratory infections
      without any underlying disease, using SP-4 media and being identified with
      glucose fermentation test, guinea pig blood cells adsorption, tetrazolium
      reduction, urea test, arginine test, and antigenic study by an immunoassay on the
      colonies grown on SP-4 solid medium. RESULTS: M. hominis has been the species
      most frequent isolated, mainly from patients without any underlying disease and
      from HIV infected patients, and less frequently from patients suffering from
      chronic bronchitis, the differences between both groups being significative.
      Other Mycoplasma, no identified at he species level, have been isolated although
      without any significative differences. In only one case U. urealyticum has been
      isolated. CONCLUSIONS: No M. pneumoniae isolation was obtained.

PMID- 1753815
TI  - [The measurement of health status in cardiology].

PMID- 1753816
TI  - [Lipomatous hypertrophy of the interauricular septum as a cause of cerebral
      embolism in a patient with isolated Wernicke's aphasia].
AB  - The clinical observation of a 74 year old male presenting isolated Wernicke's
      aphasia due to a temporal left infarction of cardiac embolic origin secondary to
      paroxysmal auricular flutter is described. Transthoracic and transesophageal
      echocardiography, computerized tomography and magnetic resonance provided
      characteristic images which permitted the establishment of the diagnosis of
      lipomatous hypertrophy of the interauricular septum without requiring the use of
      invasive techniques. Lipomatous hypertrophy of the interauricular septum is a
      cardiac tumor of unusual presentation constituted of an abnormal accumulation of
      non-encapsulated fatty tissue which occupies a thickness greater than 15 mm of
      the interauricular septum. Wernicke's aphasia as a form of presentation of the
      lipomatous hypertrophy of the interauricular septum has not previously been
      described in the literature.

PMID- 1753817
TI  - [The current situation of tuberculosis in Spain].

PMID- 1753818
TI  - [Benign intracranial hypertension following the suspension of corticotherapy in a
      female patient previously operated on for Cushing's disease].

PMID- 1753819
TI  - [Acute pancreatitis induced by erythromycin: a new case].

PMID- 1753820
TI  - [The investigation of food poisonings: the first step for their control].

PMID- 1753821
TI  - [Mediastinal involvement due to an inflammatory pseudotumor of the lung].

PMID- 1753822
TI  - [Paraproteinemias in patients infected with the human immunodeficiency virus].

PMID- 1753823
TI  - [The current indications for lumbar puncture in cerebrovascular disease].

PMID- 1753824
TI  - [Visceral leishmaniasis with partial response to ketoconazole in a patient with
      positive antibodies to the human immunodeficiency virus].

PMID- 1753825
TI  - [The effect of inhaled pentamidine in the radiology of Pneumocystis carinii
      pneumonia].

PMID- 1753826
TI  - [A multicenter study of the breaking of the smoking habit with nicotine chewing
      gum in health personnel].
AB  - BACKGROUND: The health professionals have a leading role in the reduction of the
      smoking prevalence. Spain has one of the big rate of "per capita" tobacco
      consumption in the world, and the Spanish doctors have the biggest prevalence of
      smokers among their colleagues from the EEC countries. METHODS: The effectiveness
      of a stop smoking programme in health care professionals was evaluated. This
      programme combined group therapy, nicotine chewing gum and behavioural assistance
      through the evaluation of CO contained in expired breath; and it is being applied
      with good results between the smokers of general population in Spain. A total of
      211 voluntary smokers working in Spanish six general hospitals were treated, from
      those 149 (71%) were physicians and nurses (PS) and 62 (29%) others professionals
      without sanitary responsibilities (PNA). RESULTS: At one year follow-up, 64 (30%)
      were not smoking, and the P.S. had a higher rate of give up than the PNA (p less
      than 0.05). Specifically the women of P.S. obtained a greater issue than the
      women of PNA (p less than 0.05). Both, nicotine chewing gum and behavioural
      assistance were as effective as usual in smoking cessation programme like this,
      in our country. CONCLUSIONS: Although the outcome is lower than the obtained with
      the same approaches in smokers from general population, the better results of the
      PS than the PNA imply a good change of attitude of them. Specially the women PS
      obtained a big success, and this is outstanding in this group with a great
      prevalence of smokers, increasing in the recent years. The subjects who give up
      smoking increased their corporal weight less than the observed in smokers of the
      general population, who also give up with this treatment.

PMID- 1753827
TI  - [An analysis of the effect of tobacco on glucose metabolism].
AB  - BACKGROUND: The nicotine contained in tobacco smoke produces an elevation of the
      plasmatic catecholamines which, in turn, may be the cause of the increase in
      basal glycemia by several mechanisms. The aim of this study was to investigate
      the relation between cigarette consumption and the increase in glucose in smokers
      and non smokers. METHODS: Basal glycemia and glucosylate hemoglobin (HbA1c) were
      determined in 74 males, 38 smokers and 36 non smokers who were consulted and
      included in the prevention activities program of the center. RESULTS:
      Significantly greater fasting glycemia was found in smokers than in nonsmokers.
      However, upon analyzing the values of glucosylate hemoglobin no significant
      differences were observed between the two groups. CONCLUSIONS: These data suggest
      that nicotine contained in tobacco smoke produces a transitory hyperglycemia.

PMID- 1753828
TI  - [The real efficacy of breaking the smoking habit].

PMID- 1753829
TI  - [Hybridization in situ: its diagnostic applications in the field of leukemia and
      lymphomas].

PMID- 1753830
TI  - [Waldenstrom's macroglobulinemia, cryoglobulinemia type I and membranous
      glomerulonephritis].
AB  - Renal complications in Waldenstrom's macroglobulinemia (WM) are infrequent and
      are characterized by the presence of PAS positive amorphous hyaline deposits in
      the capillary lumen, infiltrated with lymphoplasmatic cells with PAS positive
      inclusions in the interstices and intratubular hyaline cylinders. Membranous
      glomerulonephritis may be a paraneoplastic manifestation of the
      lymphoproliferative processes. A 67-year-old male was diagnosed of WM, type-I
      cryoglobulinemia with renal insufficiency without proteinuria. Renal histological
      examination revealed changes characteristic of nephropathy associated to WM as
      well as membranous glomerulonephritis. This association has not been described
      previously. The coexistence of two pathogenic mechanisms with a common base,
      lymphoproliferative disease, may explain this association.

PMID- 1753831
TI  - [Notes from the Antilles. Vive la difference?].

PMID- 1753832
TI  - [The efficacy of hemoperfusion in acute poisoning by tricyclic antidepressants].

PMID- 1753833
TI  - [Persistent hiccups as the sole manifestation of reflux esophagitis].

PMID- 1753834
TI  - [A primary brain abscess due to Actinomyces in a patient with congenital cyanotic
      cardiopathy].

PMID- 1753835
TI  - [The attitude toward the terminal patient in primary care teams].

PMID- 1753836
TI  - [Escherichia coli bacteremia resistant to ciprofloxacin].

PMID- 1753837
TI  - [Rapidly progressive kidney failure and amyloidosis AA].

PMID- 1753838
TI  - [Autoimmune hemolytic anemia as a symptom of the onset of a MALT lymphoma].

PMID- 1753839
TI  - [Synchronous pulmonary and renal neoplasms].

PMID- 1753840
TI  - The London School of Hygiene and Tropical Medicine: a child of many parents.

PMID- 1753841
TI  - Alfred Swaine Taylor, MD, (1806-1880): forensic toxicologist.

PMID- 1753842
TI  - Surgery in ancient Mesopotamia.

PMID- 1753843
TI  - "Matrix and the pain thereof": a sixteenth-century gynaecological essay.

PMID- 1753844
TI  - Application of the argon laser to dentistry.
AB  - A review was conducted to determine specific areas of application of the argon
      laser to dentistry. When appropriate, comparisons between the argon laser and
      other treatment methods were made. It was concluded that the argon laser has
      applicability in composite resin placement, in enamel and dentin bonding
      procedures, in preventive dental therapies, and in endodontic procedures.

PMID- 1753845
TI  - Selectivity, efficiency, and surface characteristics of hard dental tissues
      ablated with ArF pulsed excimer lasers.
AB  - Lasers are finding expanding applications in the field of dentistry. Cutting in
      soft tissue, hard dental material ablation, caries removal, and root canal
      therapy are only a few examples of dental laser uses. In this article, the
      application of short pulse ArF excimer laser to ablation of dentin and enamel is
      investigated. In particular, the effect of laser pulse repetition rates (PRR) and
      fluence levels on the efficiency of the ablation process and on the average
      thermal response of ablated surfaces is investigated. Ablation of dentin was
      found to be considerably more efficient than the ablation of enamel and depends
      exponentially on the laser fluence. Both dentin and enamel surfaces showed an
      increase in surface temperature with repetition rate. At lower PRR, however,
      temperature increases are very small. Surface temperature was also found to
      increase with laser fluence, although this increase is very small at laser PRR of
      5 Hz or less. Tissue ablation rates were found to be comparable to or better than
      other nanosecond lasers, and left smooth surfaces, free of thermal damage.
      Microscopic examination of the ablated surface shows no crack formation,
      charring, discoloration, or any other thermal damage. The ablated surfaces appear
      to be very smooth, highly polished, and glossy looking as if they were subjected
      to thermal melting. This observation is indeed confirmed under scanning electron
      microscopy (SEM), where evidence of localized melting of the tissue is observed.
      Furthermore, a close SEM examination of the dentin surface reveals a selectively
      ablated intertubular dentin, while the remaining pillar-like dentin tubules are
      sealed off with fused peritubular dentin. At all fluence levels and PRR, the
      first three to four pulses impinging on an untreated enamel surface produced
      unusually large plumes of debris which were different in size, texture, and
      fluorescence emission characteristics from the ablation products of subsequent
      pulses. It is believed that these different ablation characteristics are a
      consequence of the pulsed ArF laser's ability to selectively remove residual
      matter from the more resistant enamel surface.

PMID- 1753846
TI  - Laser-assisted microvascular anastomosis using CO2 and KTP/532 lasers.
AB  - The milliwatt carbon dioxide (CO2) laser has been shown to be an effective device
      for performing laser-assisted microvascular anastomosis (LAMA) with consistently
      high patency rates, minimal tissue disruption, and rapid surgical time as well as
      the potential for reduced inflammation due to fewer foreign bodies (sutures) in
      the wound. The purpose of this investigation was to determine the feasibility of
      using the potassium titanyl phosphate (KTP) laser to perform LAMA and to compare
      it to CO2 LAMA in both arteries and veins. Patency rates, inflammatory response,
      and course of healing were evaluated through histological analysis. Twenty-eight
      rats were divided into two groups, which underwent either CO2 or KTP LAMA and
      then were sacrificed at 3 days, and 1, 2, 4, 8, and 12 weeks postoperatively.
      Patency rates for arteries and veins were comparable for both wavelengths (CO2:
      100% for arteries, 93% for veins; KTP: 93% for arteries, 93% for veins).
      Histological grading of inflammation and fibrosis showed no significant
      difference between the two groups. This study demonstrated the efficacy of using
      the KTP/532 laser in performing LAMA. We found the KTP and CO2 LAMA to have
      comparable patterns of tissue damage and course of healing. Although this
      experiment did not investigate the mechanism(s) of tissue welding, our results
      suggest that successful LAMA may be independent of wavelength.

PMID- 1753847
TI  - Contact Nd:YAG tonsillectomy: effects on weight loss and recovery.
AB  - Contact Nd:YAG tonsillectomy using synthetic sapphire blades appears to meet or
      exceed standards established by spot monopolar cautery. Subjects' percentage of
      weight loss and return to work/social activities was measured and the laser group
      displayed less percentage of weight loss, faster return to pre-operative weight,
      and less recovery time than the comparative cautery group. Because of the unique
      nature of Nd:YAG laser light combined with sapphire blades, special consideration
      should be given to these accessories by physicians before attempting tissue
      cutting and vessel coagulation. The author believes that the extent of physician
      training and proficiency may be key to the success of soft tissue head and neck
      applications, such as tonsillectomy, which will have an effect on the outcome of
      clinical data.

PMID- 1753848
TI  - Laser-induced fluorescence emission: I. The spectroscopic identification of
      fibrotic endocardium and myocardium.
AB  - Laser-induced fluorescence has been developed as a guidance system for laser
      angioplasty. Laser ablation has been used for resection of arrhythmogenic
      ventricular scar. We have investigated the use of laser-induced fluorescence for
      the detection of fibrotic and ischemic changes in endocardium and myocardium.
      Fluorescence emission spectra from human necropsy specimens were correlated with
      histologic examination. Normalized fluorescence intensity detected from both the
      endocardial and the myocardial surfaces of the fibrotic ventricular specimens was
      significantly higher than that of corresponding normal specimens at 440 to 475
      nm. Fibrotic endocardium could be identified by a fluorescence emission intensity
      ratio less than 1.5 for wavelength ratio 375/450nm. Acutely infarcted endocardium
      was recognizable by a ratio of 1.5 to 2.0. The specificity and sensitivity of
      detection of scarred endocardium was 70 and 100%, respectively. Fibrotic
      myocardium was also consistently identified by fluorescence spectroscopy.
      CONCLUSION: Fluorescence emission spectroscopy can differentiate normal and
      fibrotic endocardium and myocardium, in vitro. This technique may be useful for
      guidance during laser ablation of arrhythmogenic ventricular scar.

PMID- 1753849
TI  - Alternative lasers for endoscopic surgery: comparison of pulsed thulium-holmium
      chromium:YAG with continuous-wave neodymium:YAG laser for ablation of colonic
      mucosa.
AB  - Precise and controllable tissue vaporization is essential for minimizing risk in
      removal of sessile polyps from the lumen of thin walled gastrointestinal organs
      such as the colon. We compared the ablative efficiency on canine colonic mucosa
      of the THC:YAG laser with the clinically employed cw Nd:YAG laser. Fresh canine
      colon was treated with a progressive dose schedule using each laser at several
      energy/power densities. Ablation depth was measured on fresh tissue and thermal
      (non-ablation or coagulative) damage examined histologically. The THC:YAG
      ablation rates were 13.7 +/- 0.8 and 10.2 +/- 0.4 microns/J at 55 and 85 J/cm2,
      respectively. The Nd:YAG laser generated 3.7 +/- 0.3, 2.8 +/- 0.1, and 3.6 +/-
      0.2 microns/J at 4,460, 5,095, and 5,730 W/cm2, respectively. There was a
      significant (P less than 0.001) difference among the THC:YAG ablation rates and
      between the THC:YAG and Nd:YAG ablation rates (ANOVA). The THC:YAG laser craters
      had significantly less collateral thermal damage than Nd:YAG. The pulsed THC:YAG
      laser should have an important clinical role since its use could reduce the risk
      of perforation in endoscopic laser procedures such as the removal of sessile
      polyps.

PMID- 1753850
TI  - Solid state ultraviolet laser (213 nm) ablation of the cornea and synthetic
      collagen lenticules.
AB  - We used a Q-switched Nd:YAG laser with non-linear optical crystals to produce the
      5th (213 nm) and the 4th (266 nm) harmonic frequencies. Using these two
      wavelengths, we ablated fresh porcine corneas and type I collagen synthetic
      epikeratoplasty lenticules. For the 213-nm ablation, radiant exposure was 1.3
      J/cm2. The ablation rate was 0.23 micron per pulse for the epikeratoplasty
      lenticules. We examined all tissues with light microscopy, transmission electron
      microscopy, and scanning electron microscopy. Histology for the 213-nm ablation
      showed a clean ablation crater with minimal collagen lamellae disruption and a
      damage zone less than 1 micron. In comparison, the 266 nm radiation showed more
      charring at the edges with a damage zone approximately 25 microns deep with
      disruption of the stromal lamella. Our results show that this solid state UV
      laser is a potential alternative to the excimer laser for cornea surgery.

PMID- 1753851
TI  - Technique for cellular microsurgery using the 193-nm excimer laser.
AB  - A new cell surgery technique has been developed to produce well-defined
      alterations in cells and tissue without detectable heating and/or other
      structural damage in the surroundings. The technique involves the use of an argon
      fluoride excimer laser, in the deep ultraviolet (UV) region of the spectrum at
      193 nm, which is guided through a glass pipette filled with a positive air
      pressure. To demonstrate the method, holes were drilled in the zona pellucida of
      mouse oocytes. The diameter of the drilled hole was determined by the pipette tip
      size, and its depth by an energy emitted per pulse and number of pulses. Scanning
      electron microscopy of the drilled mouse oocytes showed uniform, round, well
      circumscribed holes with sharp edges. Oocytes that had their zona pellucida
      drilled with this new method fertilized in vitro and developed to the blastocyst
      stage in a rate similar to that of control group. These results demonstrate the
      nonperturbing nature of this cold laser microsurgical procedure. In addition to
      the extension of our results for clinical in vitro fertilization purposes, such
      as enhancement of fertilization and embryo biopsy, there are wide-ranging
      possible uses of our method in fundamental and applied investigations that
      require submicron accuracy in cellular alteration.

PMID- 1753852
TI  - Temperature response of biological materials to pulsed non-ablative CO2 laser
      irradiation.
AB  - This paper presents surface temperature responses of various tissue phantoms and
      in vitro and in vivo biological materials in air to non-ablative pulsed CO2 laser
      irradiation, measured with a thermocamera. We studied cooling off behavior of the
      materials after a laser pulse, to come to an understanding of heat accumulation
      and related thermal damage during (super) pulsed CO2 laser irradiation. The
      experiments show a very slow decay of temperatures in the longer time regime.
      This behavior is well predicted by a simple model for one-dimensional heat flow
      that considers the CO2 laser radiation as producing a heat flux on the material
      surface. The critical pulse repetition frequency for which temperature
      accumulation is sufficiently low is estimated at about 5 Hz. Although we have not
      investigated the ablative situation, our results suggest that very low pulse
      frequencies in microsurgical procedures may be recommended.

PMID- 1753853
TI  - Contact Nd:YAG laser potentiates the tumor cell killing effect of hyperthermia.
AB  - This study was carried out to investigate the effects of Nd:YAG laser-induced
      hyperthermia on murine F9 embryonal carcinoma cells in vitro using various power
      settings, temperatures, and exposure times. F9 cells were plated on gelatin
      coated dishes, treated on the following day, and cultured overnight. The
      following day the killing efficiency of the treatments was estimated by staining
      the dishes or by labeling the cells with 3H-thymidine. A contact Nd:YAG laser
      with a frosted-end probe was used. After laser treatments at 39 degrees C, no
      significant changes were observed in the viability of the cells. Laser treatment
      at 43 degrees C killed F9 cells, and the effect was related to the power setting
      used. Using 6 W, the quantity of viable cells progressively decreased after 1-, 2
      , and 5-min treatments, and no viable cells were found after a 10-min treatment.
      Using 10 W, approximately 10% of the cells survived a 1-min laser treatment, but
      all cells were killed after a 2-min treatment. In the control wells, heated in a
      water bath for up to 40 min, all cells regularly survived at 43 degrees C. There
      were much less viable cells in those laser-treated wells where the temperature
      exceeded 44 degrees C than in those where the temperature was kept at 44 degrees
      C. In conclusion, the tumoricidic effect of hyperthermia can be potentiated by
      the use of the contact Nd:YAG laser. At a set temperature the cell killing effect
      of laser treatment is dependent on the power used and the duration of the
      treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753854
TI  - Laser beam diameter for port wine stain treatment.
AB  - Optimal port wine stain treatment requires the selective absorption of light by
      the ectatic blood vessels. We investigated whether deeper blood vessels can be
      coagulated, without damaging other cutaneous structures, by varying the laser
      beam diameter. The penetration of the light was simulated with a random walk
      (Monte Carlo) program. Scattering of the light plays a major role: practically
      all light that is absorbed in a blood vessel in the dermis is scattered light. In
      the epidermis, where the distribution is more centered, a larger beam diameter
      does not increase the energy density as much as deeper within the dermis where
      the blood vessels lie and where the light is totally diffuse. Increasing the
      laser beam diameter from 200 microns to 1 mm or more, makes a typical blood
      vessel absorb 2.5 times more energy, while the energy absorbed by the epidermis
      remains the same. The larger the laser beam diameter the better the treatment.

PMID- 1753855
TI  - Histochemical evaluation of the coagulation depth after argon laser impact on a
      port-wine stain.
AB  - A two-step excisional treatment of a port-wine stain (PWS) on the back of a 43-yr
      old female patient was performed. Immediately before the first surgical
      treatment, two corresponding series of argon laser impacts were performed, each
      on one PWS half. Different laser parameters with irradiances ranging from 95 to
      382 W/cm2 and energy fluences ranging from 19 to 114,6 J/cm2 were used. Laser
      spots on the first part ot be excised were biopsied 10 min after laser treatment
      and prepared for histochemical analysis by staining with nitro blue tetrazolium
      chloride (NBTC). Reduction of this redox dye by nicotinamide adenine dinucleotide
      diaphorase (NADH-diaphorase) leads on frozen tissue sections to an intense blue
      precipitate. The activity of NADH-diaphorase subsides immediately upon cell
      damage. All vital epidermal and dermal cells presented a dense blue granular
      pigment in their cytoplasm, sparing the nuclei. Laser induced arc-shaped
      epidermal and dermal necrosis did not stain, showing a clear demarcation from
      surrounding vital tissue. The depth of the thermal injury ranged from 0.28 to
      0.45 mm; it did not correlate with the chosen fluences. With these penetration
      depths, the vast majority of PWS vessels was affected. Assessment of the
      remaining part of the PWS 8 months later yielded blanching of all laser-treated
      areas. With the NBTC method, an accurate definition of laser-induced tissue
      damage is feasible. It could be shown that the exposure time is the most relevant
      parameter influencing the penetration depth.

PMID- 1753856
TI  - 585 nm for the laser treatment of port wine stains: a possible mechanism.

PMID- 1753857
TI  - [Current status and main trends in the development of the equipment for
      inhalation anesthesia].

PMID- 1753858
TI  - [Trends in the development of the equipment for artificial ventilation of the
      lungs].

PMID- 1753859
TI  - [Development of the electrotherapeutic, physiotherapeutic and surgical equipment
      (materials of the international exhibition "Public health-90")].

PMID- 1753860
TI  - [Ultrasonic scanning diagnostic equipment (materials of the exhibitions "Public
      health-90" and "Maternal and child health care-90")].

PMID- 1753861
TI  - [Endoscopic techniques: their status and developmental trends].

PMID- 1753862
TI  - [Development of the equipment for radionuclide diagnosis].

PMID- 1753863
TI  - [Trends in the development of technical equipment for psychophysiological
      studies].

PMID- 1753864
TI  - [Stomatological materials presented at the international exhibition "Public
      health-90"].

PMID- 1753865
TI  - [Continuous sterilization of peritoneal dialysate using ultraviolet rays].
AB  - A unit for continuous ultra-violet sterilization on the basis of a mercury-UV low
      pressure lamp was devised and tested. It differs from the known analogs in the
      capacity of separating into layers of the monolithic flow of a solution and of
      using the entire arsenal of direct rays emitted by the source. The output is 400
      ml/min. The irradiation dose exceeds 163 times the optimal one for spores. The
      authors provide a mathematic depiction of the unit operation. A linear
      relationship was established between the growth of optical density of the
      solution and the irradiation dose. About 100 tons of the peritoneal and
      replacement (for hemofiltration) solutions were sterilized and utilized.

PMID- 1753866
TI  - [Radionuclide radiation monitoring].
AB  - Radionuclide radiation monitors used nowadays can operate fairly well in
      measuring the parameters of the radiation type for which they are intended and
      calibrated. However, in many cases (particularly in emergency situations) the
      detector is exposed at a time to several types of radiation. Under such
      conditions its readings may be noticeably influenced by concomitant radiation. In
      view of this fact interpretation of the measurement data is embarrassing. Bearing
      this in mind, it is advisable that the available monitors be modernized and new
      ones be devised for mixed radiation with the common equivalent surface thickness
      amounting to 1 g/cm2 of tissue equivalent substance.

PMID- 1753867
TI  - [A device for the treatment of dislocations and subluxations of the
      temporomandibular joint].
AB  - An extraoral approach to the treatment of dislocations and subluxations of the
      lower jaw by means of a special outfit holds promise since it has no
      contraindications, does not cause any complications, fully preserves lower jaw
      function, shortens the treatment period, and enables surgical interventions to be
      avoided. The outfit is attached to the patient's head and is only removed
      overnight. The treatment may last 1.5 to 3 months.

PMID- 1753868
TI  - [A device for fixation of partial removable dentures in cases of single-standing
      teeth].
AB  - An outfit for fixing removable dentures in single standing teeth contains
      internal and external telescopic crowns. The latter is fitted out with a clasp
      and a cut-out on the oral surface. In order to enhance the design rigidity and
      denture fixation safety, the two-layer internal crown is placed on the vestibular
      and approximate surfaces, whereas the clasp on the external layer thereof.

PMID- 1753869
TI  - [Use of a laser optometer for the control of visual fatigue in workers in the
      precision instrument industry].

PMID- 1753870
TI  - [A pulsimeter].

PMID- 1753871
TI  - [A new equipment of the "Polius" series for electromagnetic therapy].

PMID- 1753872
TI  - [Diathermic biopsy forceps for flexible endoscopes].

PMID- 1753873
TI  - [Instruments for measuring arterial blood pressure at the international
      exhibition "Public health-90"].

PMID- 1753874
TI  - [Measuring equipment for instrumental diagnosis of eye diseases].

PMID- 1753875
TI  - Lysophospholipase activity of Ascaris suum-induced mouse peritoneal neutrophils
      and eosinophils.
AB  - Lysophospholipase activity of mouse peritoneal neutrophils and eosinophils was
      studied to determine if neutrophils and eosinophils have lysophospholipase
      activity when treated with Ascaris suum whole worm extract, if zymosan activated
      complement can induce increased lysophospholipase activity, or if the immune
      status of the host has an effect on lysophospholipase activity. Neutrophils from
      noninfected or infected (immunized) mice were found to have increased
      lysophospholipase activity when treated with A. suum whole worm extract or
      zymosan activated complement demonstrating neutrophils as a source of
      lysophospholipase activity in the presence or absence of an immune response.
      Eosinophils from immunized mice had increased lysophospholipase activity when
      treated with either A. suum whole worm extract or zymosan activated complement.

PMID- 1753876
TI  - Effects of vaccinia virus-expressed interleukin 2 on the immune system of
      sublethally irradiated mice.
AB  - Vaccinia virus that expressed interleukin 2 (IL 2) was cleared from
      immunodeficient irradiated mice more efficiently than virus that did not express
      interleukin 2. These results extend the previously observed protection from nude
      mice to another model of immunodeficiency. No antibody or cytotoxic T lymphocyte
      response could be detected in sublethally irradiated mice that had been
      inoculated with IL 2-expressing vaccinia virus, but levels of splenic natural
      killer cell activity were elevated. Sublethally irradiated mice that had
      recovered from IL 2-plus hemagglutinin-expressing vaccinia virus were partially
      protected against both influenza virus and vaccinia virus. These results indicate
      that vaccinia virus-expressed IL 2 mediates clearance of primary viral infection
      via a mechanism that does not involve antibody or cytotoxic T lymphocytes. They
      also indicate that inclusion of lymphokine genes in live recombinant viral
      vaccine vectors may increase vaccine safety.

PMID- 1753878
TI  - rIL-1 alpha enhances adoptive transfer of resistance to Listeria monocytogenes
      infection.
AB  - We have previously demonstrated that administration of recombinant rIL-1 alpha
      enhances resistance against Listeria monocytogenes infection in mice. In this
      study we considered the possibility that this cytokine might also augment
      adoptive immunity conferred by the transfer of listeria-immune spleen cells.
      Concomitant administration of rIL-1 alpha with large numbers (2 x 10(7) or 10(8))
      of listeria-immune spleen cells reduced the protection mediated by the
      transferred cells. Conversely, rIL-1 alpha co-administered with suboptimal
      numbers (1-5 x 10(6)) of immune splenocytes augmented anti-listeria resistance in
      an additive fashion. Although transfer of 10(6) listeria-immune spleen cells
      alone did not result in significant protection, when 10(6) immune cells were
      incubated with rIL-1 alpha prior to transfer they conferred significant
      protection to naive recipients. Time course experiments indicated that the
      greatest protection was achieved when listeria-immune spleen cells were
      pretreated with rIL-1 alpha for 2 h prior to adoptive transfer. The protection
      transferred by 10(6) rIL-1 alpha-pretreated immune spleen cells was not inhibited
      by TGF beta. This study is the first to use rIL-1 alpha to potentiate the
      adoptive transfer of resistance to an infectious agent by immune cells.

PMID- 1753877
TI  - Effect of human chorionic gonadotropin (hCG) on Neisseria gonorrhoeae invasion of
      and IgA secretion by human fallopian tube mucosa.
AB  - The possible effect of human chorionic gonadotropin (hCG) on the mucosal immune
      response and susceptibility of the fallopian tube mucosa to invasion by Neisseria
      gonorrhoeae (gonococci) was investigated in the fallopian tube organ culture
      (FTOC) model. Immunohistochemical and radioreceptor assay techniques showed
      specific high affinity binding of hCG in vitro to the apices of non-ciliated
      fallopian tube cells (Kd approximately 10(-9) M). Continuous exposure of the FTOC
      mucosa to hCG during infection with gonococci resulted in a marked increase (6-
      to 15-fold) in IgA secretion and significantly reduced gonococcal invasion
      (invasion score range 0.7 to 1.75) compared to infected control tissue which was
      not exposed to hCG (invasion score range 2.9 to 4.95, P less than or equal to
      0.01). By contrast, exposure of the mucosa to hCG during the 24 h preceding
      gonococcal infection followed by the removal of hCG from the system at the time
      of infection resulted in enhanced gonococcal invasion (invasion score range 7.95
      to 9.7, P less than 0.001). We conclude that hCG can modulate the mucosal immune
      response and susceptibility of fallopian tube epithelium to gonococcal invasion.

PMID- 1753879
TI  - Neutralizing monoclonal antibodies to Pasteurella haemolytica leukotoxin affinity
      purify the toxin from crude culture supernatants.
AB  - The leukotoxin of Pasteurella haemolytica is a major virulence factor of the
      organism. It is an unstable protein which has proven very difficult to purify
      using traditional techniques. Hybridomas secreting monoclonal antibodies (mAbs)
      to P. haemolytica leukotoxin were derived from spleen cells of a mouse immunized
      with crude culture supernatant. Five hybridomas secreting mAbs specific for the
      leukotoxin were stabilized. Each of the mAbs reacted with a protein of
      approximately 100 kDa in toxic culture supernatants, and two of them completely
      neutralized the toxin in vitro. Affinity chromatography of crude culture
      supernatant on a column prepared with one of the neutralizing mAbs resulted in
      the isolation of biologically active toxin.

PMID- 1753880
TI  - Interleukin 5 (IL-5) and its receptor.

PMID- 1753881
TI  - Separation of the prodigiosin-localizing crude vesicles which retain the activity
      of protease and nuclease in Serratia marcescens.
AB  - Crude vesicles in which prodigiosin is localized were separated from pigmented
      Serratia marcescens. The bacteria were grown on peptone-glycerol agar plate,
      suspended in saline, and fractionated into cells, vesicles, and supernatant by
      differential centrifugation. Electron microscopic observations showed that the
      fractionation was conducted properly and the separated vesicles were lysed in
      distilled water. The vesicles suspended in saline retained 100 kilodalton protein
      of which amount is correlated with prodigiosin level, but the 100 kDa protein was
      found in the supernatant when the vesicles were lysed in distilled water. The
      vesicle fraction retained few colony-forming units and little detectable activity
      of NADH oxidase, but showed much higher activities of protease and nuclease than
      the cell fraction. The profiles of the activities of the protease and the
      nuclease in the fractions were different from each other, that is, the protease
      activity in the vesicle fraction was lower than that in the supernatant fraction,
      whereas the nuclease activity in the vesicle fraction was higher than that in the
      supernatant fraction, suggesting that the two extracellular enzymes were released
      from the pigmented bacteria by different mechanisms.

PMID- 1753882
TI  - Examination of host defense factors responsible for experimental chronic
      respiratory tract infection caused by Klebsiella pneumoniae in mice.
AB  - We have studied the host defense factors that operate during the course of
      chronic respiratory tract infection caused by Klebsiella pneumoniae 27 in CBA/J
      mice. A large number of polymorphonuclear leukocytes (PMNs) rapidly infiltrated
      the alveolar spaces after infection. Treatment with cyclophosphamide (CY) before
      infection greatly reduced the infiltration of PMNs and caused an increase in
      bacterial counts. CY treatment of mice in the chronic phase also caused bacterial
      proliferation in the lungs. The administration of a high titer immune serum
      efficiently reduced the bacterial counts in the lungs during the early phase but
      not during the chronic phase. The proliferation of bacteria induced by CY
      treatment was not suppressed by the administration of the immune serum in either
      phase. When the mice were exposed to an aerosol containing Pseudomonas aeruginosa
      P9 in the chronic phase, the organisms from the secondary infection were
      eliminated from the lungs in the same manner as in the case of primary infection
      with P. aeruginosa. Thus, PMNs seem to play an important role in the suppression
      of bacterial proliferation in the early and chronic phases, and the specific
      antibody might have a supplementary effect on the defensive action of PMNs in the
      chronic phase. It is also presumed that the bacteria in the chronic phase of
      infection are sequestered at sites hardly accessible to PMNs.

PMID- 1753883
TI  - Electron microscopic studies on the in vitro proliferation of spotted fever group
      rickettsia isolated in Japan.
AB  - Rickettsia was isolated from a patient with Japanese spotted fever, and its
      proliferation in cultured green monkey kidney cells was observed by electron
      microscopy. In the course of this study, we observed fusion of infected cells to
      uninfected cells which may be a way of spreading the rickettsiae from a cell to
      another. On the other hand, whirlpool-like, multilayer membranous structures,
      similar to the mesosomes of gram-negative bacteria, were sometimes seen in the
      rickettsial cells. The other profiles common to the other rickettsiae in spotted
      fever group were observed, such as the electron-lucent halo zone around the
      rickettsiae, and external fibrous materials on their surface, but intranuclear
      multiplication was rarely observed.

PMID- 1753884
TI  - Relative ability of distinct isotypes of human major histocompatibility complex
      class II molecules in binding staphylococcal enterotoxin A.
AB  - Relative ability of distinct isotypes of human major histocompatibility complex
      class II molecules to bind staphylococcal enterotoxin A (SEA) was investigated.
      SEA-binding was observed in L cells transfected with DR2 and DQw1 genes. By
      contrast, it was not detected in L cells transfected with DPw4 and DP (Cp63)
      genes. All the transfectants supported SEA-induced IL-2 production by human T
      cells. Levels of the accessory activity were low in the DPw4 and DP (Cp63)
      transfectants compared with the DR2 and DQw1 transfectants. In view of the
      observation that all the transfectants express well the transfected gene products
      on their surface, the results indicate that DR and DQ molecules bind SEA with
      high affinity, while DP molecules bind it with fairly low affinity.

PMID- 1753885
TI  - [Complexes of soil micromycetes in the area of the influence of the Chernobyl
      Atomic Electric Power Station].
AB  - Complexes of soil micromycetes in the Chernobyl 30-km zone of the Ukrainian
      Polesye were studied for 1986-1989 with regard for such ecological parameters as
      the level of radiation contamination, a particular observation site, depth of
      soil horizon and season. As a result of the study correlation pleiads of soil
      micromycete complexes have been revealed with their structure and fungal genera
      characteristic of such complexes determined. The overwhelming majority of
      correlation pleiads of fungal complexes are attributed to complex-organized ones
      and this indicated high radioresistance of mycobiota in the studied, soils.
      Melanine-containing genera of fungi rank among the first in formation of
      correlation pleiads of soil micromycete complexes.

PMID- 1753886
TI  - [The stability of the alkylating derivatives of oligodeoxyribonucleotides
      containing a cholesterol or phenazine radical added to the 3'-termination during
      their interaction with Acholeplasma laidlawii PG-8].
AB  - Stability of alkylating derivatives of decathymidylates protected on the 3'
      terminal by cholesterol and phenazine residues has been studied in the process of
      their interaction with cells of Acholeplasma laidlawii PG-8. It is shown that the
      studied reagents are not split by nucleases of A. laidlawii PG-8 for the time
      necessary for alkylation of mycoplasma biopolymers.

PMID- 1753887
TI  - [The interaction of alkylating derivatives of oligodeoxyribonucleotides and their
      methylphosphonate analogs with Mycoplasma cells].
AB  - Alkylating derivatives of decathymidylates and methylphosphonate analogs of
      oligodeoxyribonucleotides (MPAO) were studied for their interaction with cells of
      Acholeplasma laidlawii PG-8, Mycoplasma capricolum California Kid, M. pneumoniae
      FH and phytopathogenic strain (St. 118). It is shown that MPAO of octa- and
      hexadecathymidylates as well as decathymidylates 3'-terminal modified by
      phenazine and cholesterol groupings are sorbed by mycoplasma cells and can
      penetrate inside the cells. Efficiency of binding of alkylating derivatives and
      MPAO with mycoplasma cells depends on interaction time of reagents, their
      concentration in the reaction mixture and temperature.

PMID- 1753888
TI  - [The selection of the composition of the medium for optimizing the amine
      synthetic activity of aerobic bacilli].
AB  - Nutrient medium chosen as a basic one after preliminary test of several media
      known from literature has been optimized to intensify biosynthesis and amine
      nitrogen production by three strains of aerobic sporulating bacteria to culture
      liquid. The method of mathematical planning used in the experiments has permitted
      obtaining the components ratio for the medium on which production of amine
      nitrogen to the environment increased 2.3-3.2 times. The best variants of the
      optimized medium promoted an increase of the aminosynthetic activity of the
      studied bacteria by more than 320%. The obtained nutrient medium is appropriate
      for a wide screening of aerobic bacilli for their ability to synthesize amino
      compounds.

PMID- 1753889
TI  - [The interaction of soil micromycetes with "hot" particles in a model system].
AB  - A model system which permits observing for a long time and fixing interaction of
      fungi with a radiation source has been created on the basis of an isolated "hot"
      particle, deficient mineral medium (saccharose content 60 mg/l) and suspension of
      fungal conidia. Five species (six strains) of micromycetes isolated from
      radionuclide-contaminated soils and fifteen "hot" particles have been tested. It
      has been found out for the first time that Cladosporium cladosporioides and
      Penicillium roseo-purpureum are able actively overgrow "hot" particles whose
      radioactivity did not exceed 3.1-1.0(-7) Ci by gamma-spectrum and to destroy them
      50-150 days later. Certain changes in morphology of fungi-destructors of "hot"
      particles are revealed. A problem on ecological significance of the found
      phenomenon is discussed.

PMID- 1753890
TI  - Elements of microdosimetry.
AB  - This is an introductory tutorial to the field of microdosimetry. Following a
      brief historical outline, we review the physics of experimental and theoretical
      microdosimetry and the application of microdosimetry to radiation biology within
      the so-called "site" approximation. Modern interpretations of microdosimetry that
      make use of methods developed in integral geometry are described under the
      heading "structural microdosimetry;" this also illustrates the conceptual basis
      of dual radiation action. A discussion concerning some future prospects of this
      field concludes the review.

PMID- 1753891
TI  - The effect of patient motion on dose uncertainty in charged particle irradiation
      for lesions encircling the brain stem or spinal cord.
AB  - A specialized charged-particle radiotherapy technique developed at Lawrence
      Berkeley Laboratory (LBL) is applied to patients with lesions abutting or
      surrounding the spinal cord or brain stem. This technique divides the target into
      two parts, one partially surrounding the critical structure (brain stem or spinal
      cord) and a second excluding the critical structure and abutting the first
      portion of the target. Compensators are used to conform the dose distribution to
      the distal surface of the target. This technique represents a novel approach in
      treating unresectable or residual tumors surrounding the spinal cord or brain
      stem. Since the placement of the patient with respect to beam-shaping devices is
      critical for divided-target treatments, a method for calculating dose
      distributions reflecting random patient motion is proposed, and the effects of
      random patient motion are studied for two divided-target patient examples. Dose
      volume histograms and a normal-tissue complication probability model are used in
      this analysis. For the patients considered in this study, the normal-tissue
      complication probability model predicts that random patient motion less than or
      equal to 0.2 cm is tolerable in terms of spinal cord complications.

PMID- 1753892
TI  - Investigation of an FFT-based correlation technique for verification of radiation
      treatment setup.
AB  - Electronic portal imaging devices that capture an image of a patient's treatment
      field electronically by means of a computer data acquisition system operating in
      real time are becoming available. This paper reports on a study of a field
      verification correlation algorithm that can compare each treatment portal image
      to an image of the correct treatment field positioning. The algorithm requires no
      human intervention or analysis of the images but rather uses fast Fourier
      transforms to produce a correlation distribution. The position and amplitude of
      the correlation distribution maximum were tested as objective measures of
      translational and rotational differences of subject positions between pairs of
      images. The concept was tested by using a prototype algorithm to obtain the
      correlation distributions for images of an Alderson Rando head phantom. Images of
      the phantom setup with various errors were compared with an image of the phantom
      in the initial, correct treatment position. Translations, in-plane and out-of
      plane rotations, and combinations of translations and rotations were studied. The
      algorithm accurately measured translations. The value of the correlation
      distribution maximum was found to be a reasonable candidate for an alignment
      parameter for which tolerable error thresholds might be established.

PMID- 1753893
TI  - Improvement of precision in spatial localization of radio-opaque markers using
      the two-film technique.
AB  - Radio-opaque markers implanted inside or placed on the skin of patients can be
      used to detect set-up errors and patient motion. The effects of imaging geometry
      accuracy for standard radiotherapy equipment on the precision of calculating the
      positions of radio-opaque spherical markers using two orthogonal radiographic
      film projections is investigated. Inaccuracies in the imaging geometry are
      computed from the manually digitized positions of the marker images on each film
      pair. Actual marker locations are calculated with a precision limited only by the
      variance in manual digitization by incorporating those imaging geometry
      inaccuracies into their computation. Results of a phantom study using a grid of
      markers in a plastic block indicate that submillimeter precision can be obtained
      for the spatial coordinates of individual markers, and that the precision is not
      sensitive to the small inaccuracies in imaging geometry present within the
      mechanical tolerances of modern radiotherapy treatment machines and simulators.

PMID- 1753894
TI  - Image restoration of digital radiography using dual sensor Wiener filter.
AB  - A dual sensor Wiener filter (DSWF) technique was used to improve the image
      quality of a scanning type digital radiographic system. In a digital radiographic
      system, image quality is evaluated by resolution and SNR (signal-to-noise ratio),
      which are two important parameters representing the objective performance of the
      system. In this method, when two images are acquired in the same region using two
      sensors with different characteristics of resolution and SNR, they are processed
      simultaneously using DSWF, which is the extended concept of a Wiener filter to
      two dimensions. DSWF uses the cross power spectrum between dual sensor outputs of
      the same chest radiographic image in the design of filter parameters. It has been
      implemented with fast algorithm using FFT (fast Fourier transform). The
      performance of the proposed method is compared with that of conventional methods
      (Wiener filter and parametric projection filter). In simulation studies, it is
      shown in 12 cases that this new method has SNR improvement of 1-2 dB better than
      conventional methods.

PMID- 1753895
TI  - Transfer function measurement and analysis for a magnetic resonance imager.
AB  - The transfer function characteristics of a 1.5T imager have been determined. An
      edge response function (ERF) was obtained from a water/Plexiglas interface at
      various pixel widths ranging from 0.312 to 1.0 mm. An SE pulse sequence was used
      with a 5-mm transaxial slice. The ERF was smoothed, differentiated, and Fourier
      transformed to obtain MTF curves. The LSF was analyzed for skewness and kurtosis.
      The area under the MTF amplitude curves and the equivalent bandpass were
      calculated. All ERFs, LSFs, and MTFs were well behaved. The resulting LSF was
      Gaussian. All calculated MTFs had cutoff frequencies slightly less than the
      theoretical Nyquist limit. The MTF calculated from the theoretical Gaussian LSF
      is slightly superior to that calculated from experimental data and provides an
      upper limit to the MTF. Spatial resolution in our MR imager is dominated by the
      pixel size via the Nyquist sampling theorem. System performance is slightly less
      than theoretically predicted, possibly due to image processing algorithms during
      the reconstruction process.

PMID- 1753896
TI  - Accurate characterization of image intensifier distortion.
AB  - Image intensifier distortion due to photocathode curvature and electron optics is
      shown to be approximated by a simple two parameter odd-power polynomial. The
      accuracy of this fit was found to be far better than that of two other one
      parameter characterizations of distortion when applied to experimental data from
      four different model image intensifiers ranging in diameter from 9 to 14 in. The
      standard errors of the two parameters fits were less than 0.1 mm or 0.03% of the
      field of the IIs and were within the estimated measurement error.

PMID- 1753897
TI  - The lens coupling efficiency in megavoltage imaging.
AB  - In TV-based megavoltage imaging systems it is useful to be able to estimate the
      geometrical efficiency g2 of the camera lens. It is shown that the appropriate
      expression is g2 = (16n2)-1 X [F(1 + 1/m)]-2, where n is the refractive index of
      the scintillator, F is the F-number of the lens and m is the optical
      magnification. This expression yields estimates for g2 that are 5 to 10 times
      smaller than the estimates that have appeared previously in the literature.

PMID- 1753898
TI  - Survey of tissue-air ratio data: a review of the literature for diagnostic
      radiology.

PMID- 1753899
TI  - The role of nonlinear ultrasound propagation during hyperthermia treatments.
AB  - In this study the feasibility of utilizing nonlinear ultrasound propagation to
      control the power deposition patterns during ultrasound hyperthermia treatments
      of malignant tumors was investigated. From the in vivo results it appears that
      the power deposition pattern and the temperature distributions can be
      significantly altered by increasing the temporal peak power of the source while
      reducing the duty cycle to maintain the same acoustic time average power. The
      maximum temperature gains obtained during hyperthermia sonication (between 1.5
      and 2) were significantly less than one could obtain by varying the frequency and
      the other parameters of transducers and thus, the linear characteristics of the
      ultrasound fields should be used when hyperthermia systems are designed and
      treatments are planned. Then during the treatment nonlinear propagation can be
      used to provide on-line control of the power deposition patterns. The transducer
      characteristics determined the magnitude of the temperature gain and the
      nonlinear propagation region could not be reached when sharply focused (F number
      = 1) transducers were used at the frequencies between 0.25 to 1.68 MHz due to the
      high pressure amplitudes that exceeded the transient cavitation threshold.

PMID- 1753900
TI  - Heating patterns of microwave applicators in inhomogeneous arm and thigh
      phantoms.
AB  - Heating rate (HR) patterns in cylindrical structures were studied with
      inhomogeneous limb phantoms. These phantoms, arm and thigh models consisting of
      fat, bone, and muscle material, were heated with Clini-Therm L, M, and MS
      applicators at 915 MHz. The thigh model is 18 cm in diameter with 2.65-cm-thick
      fat on the outside and a 4-cm-diam bone in the center. The arm model is 9 cm in
      diameter with 1.35-cm-thick fat and 2-cm-diam bone. All models are 29 cm long
      with phantom muscle in the space between fat and bone and were heated with their
      long axes parallel or perpendicular to the E field. HR patterns in the transverse
      and longitudinal planes were obtained thermographically. A large water bolus,
      with the water channels parallel to the E field, was used in every case. In the
      thigh model, maximum heating was in the muscle for both L and M applicators when
      the E field was parallel to the long axis. When it was perpendicular, the maximum
      heating occurred in the fat layer. However, the peak HR in the fat remained about
      the same for both E field orientations. For the small applicator, heating was
      mostly in the fat, and the two field orientations did not cause much difference
      in the heating pattern. In the arm model, the maximum heating of all three
      applicators occurred mostly in the muscle for both E-field orientations. However,
      the maximum HR was reduced by a factor of 2 to 3 when the E field was
      perpendicular rather than parallel to the long axis.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1753901
TI  - Ultrasound focal lesion detectability phantoms.
AB  - Two phantoms for assessing the performance of ultrasound scanners regarding
      detectability of small focal lesions are described. The spherical simulated
      lesions in the phantoms have diameters of 2.4, 3.0, and 4.0 mm and backscatter
      coefficients which are 16, 9, and 6 dB below that of the surrounding tissue
      mimicking material, the latter simulating normal tissue such as liver. Random
      positioning and relatively large numbers of lesions deal with the statistical
      problem related to mistaking a normal textural fluctuation, characteristic of
      ultrasound images of parenchymal tissue, to be a small lesion. All lesions have
      ultrasonic properties that are the same as those of the surrounding material
      except for the backscatter coefficient; therefore, artifacts resulting from
      attenuation, reverberation, and/or refraction are absent, and detectability of
      deeper lesions is not influenced by the presence of more proximal ones. A method
      is outlined for using the phantoms to determine bounding proximal and distal
      depths of resolution, or detectability, of focal lesions of a given object
      contrast and size. Tests for observer dependence involving five subjects resulted
      in standard deviations in the distal and proximal depths of less than 0.5 cm. A
      repeat of the observer dependence tests 18 months later showed little change in
      the results. In addition, results obtained by two experienced observers are also
      given for a variety of specific scanners, scanning heads, and scanning
      parameters.

PMID- 1753902
TI  - Dose distributions in regions containing beta sources: uniform spherical source
      regions in homogeneous media.
AB  - The energy-averaged transport model for the calculation of dose rate
      distributions is applied to uniform, spherical source distributions in
      homogeneous media for radii smaller than the electron range. The model agrees
      well with Monte Carlo based calculations for source distributions with radii
      greater than half the continuous slowing down approximation range. The dose rate
      distributions can be written in the medical internal radiation dose (MIRD)
      formalism.

PMID- 1753903
TI  - Dose distributions in regions containing beta sources: irregularly shaped source
      distributions in homogeneous media.
AB  - Methods are introduced by which dose rate distributions due to nonuniform,
      irregularly shaped distributions of beta emitters can be calculated using dose
      rate distributions for uniform, spherical source distributions. The dose rate
      distributions can be written in the MIRD formalism.

PMID- 1753904
TI  - A sensitivity study of micro-TLDs for in vivo dosimetry of radioimmunotherapy.
AB  - The sensitivity and precision of teflon-imbedded CaSO4:Dy microthermoluminescent
      dosimeters (micro-TLDs) were determined. The micro-TLDs were sectioned from
      miniature TLDs (200 microns x 400 microns x 5 mm) that were fabricated using
      standard techniques. In order to measure absorbed dose, the miniature TLDs can be
      implanted directly into tissues (e.g., tumor xenografts) that have received
      injections of radiolabeled monoclonal antibodies. Micro-TLDs recovered from
      tissue sections cut with a microtome can be read out to determine local absorbed
      dose. The precision of dose estimation was quantified for uniformly irradiated 32
      , 96-, and 192-microns TLD chips; coefficients of variation ranged from 22% to
      41%, depending on chip size. The coefficients of variation were reduced to less
      than 12% using individual relative sensitivity factors for each micro-TLD. The
      spatial resolution of the micro-TLDs was studied by placing miniature TLDs across
      the sharp penumbral region of a linear accelerator x-ray field. TLDs were
      sectioned into 32-microns chips which were read out to determine the relative
      absorbed dose. The sharpness of the penumbra was readily quantified by the micro
      TLDs.

PMID- 1753905
TI  - Dose-volume considerations with linear programming optimization.
AB  - A method of incorporating dose-volume considerations within the framework of
      conventional linear programming is presented. This method is suitable for the
      optimization of beam weights and angles using a conformal treatment philosophy
      (i.e., tailoring the high-dose region to the target volume only). Dose-volume
      constraints are introduced using the concept that volumes of normal tissue nearer
      the target volume will be allowed higher dose constraints than volumes of normal
      tissue distal to the target volume. Each involved normal structure is divided
      into high-dose and low-dose volumes. These two volume partitions are represented
      by constraint points with either high-dose or low-dose constraints, respectively.
      Optimized treatment plans for three clinical sites demonstrate that this
      technique meets or surpasses the original dose-volume constraints for a conformal
      type treatment plan using straightforward linear programming in a time frame that
      is comparable to other linear programming problems.

PMID- 1753906
TI  - Algorithm for dosimetry of multiarc linear-accelerator stereotactic radiosurgery.
AB  - Treatment planning for multiarc radiosurgery is an inherently complex three
      dimensional dosimetry problem. Characteristics of small-field x-ray beams suggest
      that major simplification of the dose computation algorithm is possible without
      significant loss of accuracy compared to calculations based on large-field
      algorithms. The simplification makes it practical to efficiently implement
      accurate multiplanar dosimetry calculations on a desktop computer. An algorithm
      is described that is based on data from fixed-beam tissue-maximum-ratio (TMR) and
      profile measurements at isocenter. The profile for each fixed beam is scaled
      geometrically according to distance from the x-ray source. Beam broadening due to
      scatter is taken into account by a simple formula that interpolates the full
      width at half maximum (FWHM) between profiles at isocenter at different depths in
      phantom. TMR and profile data for two representative small-field collimators (10-
      and 25-mm projected diameter) were obtained by TLD and film measurements in a
      phantom. The accuracy of the calculational method and the associated computer
      program were verified by TLD and film measurements of noncoplanar multiarc
      irradiations from these collimators on a 4-MV linear accelerator. Comparison of
      film measurements in two orthogonal planes showed close agreement with
      calculations in the shape of the dose distribution. Maximal separation of
      measured and calculated 90%, 80%, and 50% isodose curves was less than or equal
      to 0.5 mm for all planes and collimators. All TLD and film measurements of dose
      to isocenter agreed with calculations to within 2%.

PMID- 1753907
TI  - Calculation of water/air stopping-power ratios using EGS4 with explicit treatment
      of electron-positron differences.
AB  - Using the EGS4 Monte Carlo simulation program, a general purpose code has been
      written to calculate Bragg-Gray and Spencer-Attix stopping-power ratios for use
      in radiation dosimetry. The stopping-power ratios can be calculated in any
      material in any region in a general cylindrical geometry with a large number of
      source geometries possible. The calculations take into account for the first time
      the differences between the stopping powers and the inelastic scattering of
      positrons and electrons. The results show that previous calculations ignoring
      these effects were accurate. The present results agree, typically within 0.1%,
      with the Spencer-Attix water-to-air stopping-power ratios for broad parallel
      beams of electrons given in the AAPM and IAEA protocols except at the surface
      where the present calculations follow the buildup of secondary electrons in more
      detail and see a 2% reduction in the stopping-power ratios.

PMID- 1753908
TI  - A comparison of ionization-chamber and water-calorimeter dosimetry for high
      energy x rays.
AB  - The temperature-regulated, flexible, water calorimeter developed in the authors'
      laboratory was shown previously to yield a dose-to-water from 4-MV x rays that is
      in very close agreement with ionization measurements made in accordance with the
      AAPM dosimetry protocol. The range of beam energies for this type of comparison
      has been increased to include 60Co, and 4-, 6- and 25-MV x rays. The grand mean
      of the ratios of doses obtained from the calorimeter and ionization chamber, the
      Cal/Ion ratio, for the four beam energies studied is 1.001 +/- 0.001. As no
      significant trend with beam energy was detected, it is concluded that the
      calorimeter and ionization chamber yield equally accurate results. Because the
      calibration of the calorimeter depends solely upon the accuracy with which water
      temperatures in the range 2-10 degrees C can be measured, and dose is given by
      the product of the specific heat of water and the temperature change produced by
      irradiation, the water calorimeter has the potential to place radiation dosimetry
      on a much firmer foundation than presently exists.

PMID- 1753909
TI  - Results of photon absorbed-dose measurements using the AAPM TG-21 protocol for
      accelerating potentials up to 26 MV.
AB  - The AAPM Task Group 21 protocol for the calibration of high-energy photon and
      electron beams was produced to accomplish essentially two goals: (1) incorporate
      the latest physical data available for calculating absorbed dose from ionization
      measurements and (2) to eliminate inconsistencies in absorbed dose measurements
      made with various ion chamber and phantom combinations. The ability of the
      protocol was assessed to consistently determine x-ray absorbed dose from
      measurements made with four Farmer-type chambers and one parallel-plate chamber
      in water, polystyrene, and acrylic phantoms. The measurements were performed
      using seven high-energy x-ray beams from 60Co to 26-MV nominal accelerating
      potential. The absorbed dose to water calculated from measurements made with the
      various chamber and phantom combinations were found to be consistent. The doses
      calculated for the two most common phantom materials, water and polystyrene, were
      found to be in excellent agreement. This resolved a 1.6% discrepancy in the
      absorbed dose determined from the two phantoms using the SCRAD protocol. The
      doses for acrylic phantoms were found to be approximately 1.2%, low for nominal
      accelerating potentials less than 8.8 MV. For accelerating potentials of 8.8 MV
      or greater the agreement was considerably better. The mean dose determined for
      the parallel-plate chamber from measurements in polystyrene was found to be
      within 0.7% of the mean dose determined using Farmer-type ion chambers in all
      phantom materials.

PMID- 1753910
TI  - Measurement of the replacement correction factor for parallel-plate chambers in
      electron fields.
AB  - When parallel-plate chambers are used for dosimetry in electron fields, the AAPM
      dosimetry protocol recommends a value of 1.0 for the replacement correction
      factor, P(repl),pp,E, until further data become available. Here, P(repl),pp,E for
      five commercially available parallel-plate chambers was measured as a function of
      electron energy from a nominal value of 5.5 to 22 MeV by comparison with a
      cylindrical chamber whose P(repl),cyl,E was obtained from data in the protocol.
      Since this method is based on the concept of a constant value for Ngas,pp, the
      energy and modality dependence of Ngap,pp is also investigated for these chambers
      for Co-60, 4-, 6-, 24-MV photons and for 22-MeV electrons. It is found that for
      three of the chambers P(repl),pp,E is independent of energy, consistent with
      unity within one or two standard deviations (s.d.). For the fourth chamber
      P(repl),pp,E is similarly consistent with one above 10 MeV, but decreases at
      lower energies, while for the fifth one it shows a systematic drop with
      decreasing energy.

PMID- 1753911
TI  - Replacement correction (P(repl)) for ion chamber dosimetry.
AB  - The use of replacement correction when depth dose distribution is measured with a
      cylindrical ion chamber is discussed. A review of relevant data shows that the
      displacement of the effective point of measurement is an appropriate method to
      make replacement correction for the entire depth ionization curve.

PMID- 1753912
TI  - Tests of an electron monitor for routine quality control measurements of electron
      energies.
AB  - The depth dose for electrons is sensitive to energy and the AAPM Task Group 24
      has recommended that tests be performed at monthly intervals to assure electron
      beam energy constancy by verifying the depth for the 80% dose to within +/- 3 mm.
      Typically, this is accomplished by using a two-depth dose ratio technique.
      Recently, a new device, the Geske monitor, has been introduced that is designed
      for verifying energy constancy in a single reading. The monitor consists of nine
      parallel plate detectors that alternate with 5-mm-thick absorbers made of an
      aluminum alloy. An evaluation of the clinical usefulness of this monitor for the
      electron beams available on a Varian Clinac 20 has been undertaken with respect
      to energy discrimination. Beam energy changes of 3 mm of the 80% dose give rise
      to measurable output changes ranging from 1.7% for 20-MeV electron beams to 15%
      for 6-MeV electron beams.

PMID- 1753913
TI  - Comparison of dose calibration by ionometric and chemical dosimetry for 6- and 45
      MV x-ray beams.
AB  - This work reports the results of an experiment carried out to investigate the
      compatibility of TG-21 ion chamber calibration with Fricke dosimetry near the
      extremes of the clinically available megavoltage photon energy range. Doses
      determined from ion chamber measurements and from chemical dosimetry are compared
      for a 6-MV linear accelerator x-ray beam and 45-MV betatron beam. The Fricke
      dosimetry was carried out by the National Institute of Standards and Technology.
      Agreement within 1% between the two techniques was obtained at both photon
      energies using a currently accepted G-value.

PMID- 1753914
TI  - Central axis depth dose curve for electron beams.
AB  - In this article an analytical equation for electron depth dose is proposed
      electron energies from 6-20 MeV. The equation contains four parameters and it
      fits the build-up region, fall-off region as well as the bremsstrahlung
      background region. The calculated values from this equation fit within 1,5% of
      the measured data in the build-up region and in the fall-off region within 0,5 mm
      for the energy range 5-10 MeV and within 1 mm for the range 12-20 MeV. This
      equation can be applied beyond the practical range.

PMID- 1753915
TI  - A convolution algorithm for brachytherapy dose computations in heterogeneous
      geometries.
AB  - Currently-available brachytherapy dose computation algorithms ignore
      heterogeneities such as tissue-air interfaces, shielded gynecological colpostats,
      and tissue-composition variations in 125I implants despite dose computation
      errors as large as 40%. To calculate dose in the presence of tissue and
      applicator heterogeneities, a computer code has been developed that describes
      scatter dose as a 3-D spatial integral which convolves primary photon fluence
      with a dose-spread array. The dose-spread array describes the distribution of
      dose due to multiple scattering about a single primary interaction site and is
      precomputed by the Monte Carlo method. To correct for heterogeneities traversed
      by the primary photons, the dose-spread array is renormalized to reflect the
      density and composition of the element, and the distance to the point of interest
      is scaled by the path-length of the intervening medium. Convolution calculations
      for 125I and 137Cs point sources in the presence of finite phantoms, air voids
      and high-density shields have been compared to the corresponding Monte Carlo
      calculations. The convolution code absolute and relative dose rate predictions
      are shown to agree with Monte Carlo calculations within 3%. Direct evaluation of
      the 3-D spatial convolution integral using 1-D adaptive integration reveals
      efficiency gains of 20-50 relative to Monte Carlo photon-transport calculations.

PMID- 1753916
TI  - Scattering effects on the dosimetry of iridium-192.
AB  - Dosimetry calculations for iridium-192 sources generally assume that a sufficient
      medium surrounds both the iridium source(s) and the point of calculation so that
      full scattering conditions exist. In several clinical applications the iridium
      sources may be anatomically located so that the full scattering requirement is
      not satisfied. To assess the magnitude of this problem, relative measurements
      were made with a small ionization chamber in phantoms near air and lung
      equivalent interfaces. Dose reduction caused by decreasing the volume of
      scattering material near these interfaces was then evaluated for a few clinical
      applications. The results show that reductions on the order of 8% may be expected
      at the interface with minimal dose reduction within the volume of the implant
      itself. In addition, the results indicate the verification of source strength of
      iridium sources in phantom require phantom dimensions determined by the source
      chamber separation distance.

PMID- 1753917
TI  - Role of potassium in the pathogenesis of acute renal failure.
AB  - Potassium depletion can potentiate several experimental models of acute renal
      failure. It causes renal vasoconstriction, probably under the influence of
      vasoconstrictor prostaglandins and angiotensin II, and causes a reduction in
      vasodilatory prostaglandins. Aminoglycoside nephrotoxicity in experimental
      animals and in man causes a reduction in serum potassium and in animals it
      enhances the functional and histological damage produced by aminoglycosides.
      Chronic potassium loading protects against mercuric chloride, uranyl nitrate, and
      gentamicin models of acute renal failure. In the gentamicin model, protection is
      associated with a stimulation of renal cortical Na-K-ATPase activity and a
      reduction in the level of gentamicin accumulated in cortical tissue. In the
      clinical setting, potassium deficiency should be avoided in patients at risk for
      acute renal failure. However, potassium loading should also be avoided, since a
      falling glomerular filtration rate in the presence of a potassium load could
      result in potentially serious hyperkalemia.

PMID- 1753918
TI  - Calcium and acute renal failure.
AB  - Tubular cell calcium concentration and content rise following acute renal injury
      induced by ischemic and toxic insults. Since calcium plays a critical role in
      many cell functions and the proximal tubule appears to be a major site of injury
      in acute renal failure, it is possible that cell calcium overload plays a direct
      role in the pathogenesis of acute renal failure. Tubular cell calcium overload
      has been associated with altered function at the level of the plasma membrane,
      mitochondria, endoplasmic reticulum and cytoskeleton. While there is evidence to
      support a role for calcium in acute renal injury, the importance of cell calcium
      overload needs to be further explored. Furthermore, alterations in extracellular
      calcium and mineral metabolism may be involved in some aspects of acute renal
      failure and recovery. Calcium channel blockers and other interventions designed
      to modulate calcium changes may have a role in the treatment of acute renal
      failure.

PMID- 1753919
TI  - The role of phosphate in the potentiation or amelioration of acute renal failure.
AB  - Alterations in the balance of several cations have been shown to affect the
      severity of acute renal failure. It has been suggested in both clinical and
      experimental studies that changes in phosphate balance can markedly potentiate as
      well as ameliorate the renal dysfunction seen in both acute and chronic
      nephropathies. To determine the role phosphate plays in the course of gentamicin
      induced acute renal failure, we examined rats maintained on control, phosphate
      supplemented, and phosphate-depleted diets. In both control and phosphate
      supplemented groups of rats, the degree and severity of gentamicin-induced acute
      renal failure was similar. By contrast, renal function was better preserved in
      the phosphate-depleted group. Furthermore, morphologic evaluation revealed a
      significantly lower number of necrotic proximal tubule cells in phosphate
      depleted rats when compared to the control or phosphate-replete rats. Renal
      cortical gentamicin concentrations were not different between the phosphate
      depleted and phosphate-supplemented groups. We conclude that phosphate depletion
      is protective against nephrotoxicity. This effect appears to be independent of
      alterations in serum calcium, urinary calcium excretion and renal cortical
      gentamicin concentration.

PMID- 1753920
TI  - Acid-base balance and acute renal failure.
AB  - In several models of acute renal failure (ARF) in animals, acidosis has been
      found to worsen the renal failure, whereas alkalosis may ameliorate it. Most
      evidence points to a reduction in the degree of tubular obstruction by casts as
      the explanation for the beneficial effects of bicarbonate administration.
      However, alkalinization of the urine is effective only in some experimental
      conditions but not in others. The reason for these differences is not known but
      may relate to the nature of the obstructing casts. Alkalinization of the urine
      could decrease cast formation in Bence-Jones protein and hemoglobinuric ARF by
      increasing the negative charge on these molecules, thereby diminishing
      precipitation with anionic Tamm-Horsfall protein. In contrast, release of tubular
      cell contents into the urine, as occurs in renal ischemia, could lead to complex
      casts not responsive to alterations in urine pH. In aminoglycoside ARF, the
      beneficial effects of urine alkalinization may be due primarily to reduced uptake
      of the antibiotic by tubular epithelium, resulting in less cellular damage.
      Because tubular obstruction reduces net filtration pressure, new approaches to
      therapy which include efforts to raise net glomerular filtration pressure may
      improve the therapeutic efficacy of alkali administration.

PMID- 1753921
TI  - Oxygen free radicals in acute renal failure.
AB  - Renal ischemia injures the renal tubular cell by disrupting the vital cellular
      metabolic machinery. Further cell damage is caused by restoration of blood flow
      when oxygen free radicals are produced. Cellular sources of oxygen free radicals
      include the electron transport chain, the microsomal electron transport chain,
      oxidant enzymes (xanthine oxidase, cyclo-oxygenase), phagocytes, and cellular
      auto-oxidation of Fe2+ and epinephrine. Oxygen radicals cause lipid peroxidation
      of cell and organelle membranes, disrupting the structural integrity and capacity
      for cell transport and energy production. Studies in models of acute renal
      failure have yielded convincing evidence that oxygen free radical production
      occurs during ischemia/reperfusion. More than a dozen reports have demonstrated
      the ability of exogenous antioxidants to ameliorate renal injury in vivo. Direct
      demonstration of increased oxygen free radical production during reoxygenation
      following hypoxia has been shown in cultured renal epithelial cells. Oxygen free
      radicals also play a role in toxic acute renal failure. The therapeutic
      usefulness of free radical scavengers remains to be tested.

PMID- 1753922
TI  - Electrolyte abnormalities before and after the onset of acute renal failure.
AB  - The chemical composition of body fluids, which is regulated by the kidneys, may
      affect renal function. Conversely, the onset of acute renal failure (ARF)
      interrupts the normal regulation of the volume and content of the body fluids. In
      order to further study these relationships and determine the epidemiology and
      consequences of ARF in a tertiary-care setting, the computerized hospital data
      base was used to identify and obtain laboratory data on patients with ARF. 9,276
      patients, encountered over a 90-day period, were surveyed and 96 were found to
      have developed ARF in the hospital (3.1% of admissions). The majority of the
      patients with ARF were found on the medicine service (68%), and sepsis with
      aminoglycoside use was the single most common of multiple etiologic factors.
      Patients with ARF experienced an increase in morbidity, as evidenced by an
      increase in the hospital length of stay and frequent need for ICU care. Mortality
      (29%) was due to the patients' underlying illnesses, and not uremia. Serum levels
      of the electrolytes prior to the onset of ARF were within the normal range with
      the exception of the creatinine (2.04 +/- 0.25 mg/dl) and bicarbonate (22.9 +/-
      0.6 meq/l). After the development of ARF (mean creatinine 3.91 +/- 0.03) sodium,
      chloride, and bicarbonate were decreased, and phosphate, uric acid, and the anion
      gap were increased (p less than 0.05 for all values). The decrease in serum
      calcium became significant (p less than 0.05) in those patients whose creatinine
      increased by a factor of 2 or more.

PMID- 1753923
TI  - Structural correlates of renal electrolyte alterations in acute renal failure.
AB  - In this review, structural and ultrastructural alterations in the kidney in acute
      renal failure are described and illustrated in some detail. Morphologic findings
      in clinical and experimental acute renal failure of the type produced by ischemia
      and some nephrotoxins, so-called 'acute tubular necrosis' are compared and
      discrepancies between findings in clinical specimens and experimental models
      noted and discussed. Since perturbations in intrarenal electrolyte species almost
      surely play a major pathogenic role in renal injury and dysfunction, correlations
      between altered intrarenal electrolyte transport and abnormal cellular ion
      concentrations, and morphologic alterations are emphasized in this review.

PMID- 1753924
TI  - Role of the sodium ion in acute renal failure.
AB  - Acute renal failure (ARF), an abrupt decline in renal function in its simplest
      terms, continues to elude precise pathophysiologic definition in human as well as
      experimental models. In the setting of ischemic or toxic renal injury, the role
      of sodium chloride as the major constituent of extracellular fluid volume (ECFV)
      is critically important in the maintenance of renal blood flow. Renal perfusion
      can be severely curtailed in states of ECFV depletion by activation of the renin
      angiotensin axis leading to profound intrarenal hemodynamic alterations. This
      review will discuss evidence for the role of sodium chloride in the pathogenesis
      and modification of ischemic and toxic ARF. Much of the data arises from studies
      in experimental animal models of human disease. The results of clinical studies
      will be emphasized when available.

PMID- 1753925
TI  - [The lamina limitans. Its scanning electron microscopic aspects].
AB  - Many researches agree in maintaining that all the membraneous structure visible
      in the most external parts of the dental tubules must be considered not ad
      cytoplasmatic membranes of the odontoblastic processes but as an extracellular
      organic matrix which in certain conditions may appear detached from the internal
      wall of the tubule and simulated a superimposable aspect like that of an
      odontoblastic extension. The aim of this study was to examine at the SEM the
      state of this organic component in normal conditions and after demineralization
      with citric acid. Therefore the entire teeth of young people were fixed in
      formalin and dissected by fracturing. Some of the samples were demineralized with
      a citric acid solution. All the samples were dehydrated and metallized for the
      observation at SEM. Demineralization made the peritubular dentine disappear and
      expose inside every tubule a sheet-like structure which extended all along the
      tubules. The samples which were not demineralized did not demonstrate a similar
      structure because of their tight adhesion to the internal wall surface. This kind
      of formation which other researchers calls "lamina limitans" because of its high
      content of glycosaminoglycans might be a key factor in controlling the formation
      of peritubular dentine and tubular sclerosis and it will surely lead to further
      interesting research.

PMID- 1753926
TI  - [A histological study of hard dental tissues in nondecalcified sections using the
      cutting-grinding technic].
AB  - With the cutting-grinding technique (Exakt System) it is possible to obtain
      sections with a width of less than 10 microns of specimens such as teeth, crowns,
      bridges, implants, mineralized structures, which cannot be cut with routine
      histological techniques. In the present paper the authors study the efficacy of
      this technique in hard dental tissues.

PMID- 1753927
TI  - [Oral lesions and intestinal pathology].

PMID- 1753928
TI  - [The effect of orthodontic magnets on the oral microbial flora].
AB  - In this study we wanted to test the in vitro effects of orthodontic magnetic
      brackets, developing different magnetic fields, on the oral microbial flora. We
      noticed that a magnetic field has its most considerable influence on Candida
      albicans growth; the stimulating response depends on various factors: cell
      inoculum, exposure time and magnetic field frequency.

PMID- 1753929
TI  - [Aneurysmal cysts of the jaws. The nosological picture and a clinical case
      report].
AB  - After discussing the classification of aneurysmatic cyst with particular
      reference to its characteristics for differential diagnosis with other
      pathologies of various origin, a personal case is reported. The diagnosis and
      treatment protocol of the clinical case in question is presented together with
      clinico-therapeutic problems and the results obtained with the diagnostic and
      therapeutic aids used.

PMID- 1753930
TI  - [Peripheral facial paralysis and HIV infection].
AB  - Two cases of peripheral facial paralysis associated with infection by the human
      immunodeficiency virus in young intravenous drug abuser patients are reported.
      One patient manifested AIDS-related complex (ARC) and the other fulfilled the
      Center for Disease Control (CDC) criteria for AIDS. Clinical symptoms and signs
      occurred as facial paralysis and headache. One patient presented progressive
      motor slowing and the computerized tomography (CT) of the brain showed a wide
      hypodense lesion in the left temporal-anterior region and the involvement of the
      left basal ganglia. In this patient the impairment of the facial nerve was
      associated with a HIV-related encephalitis. In the second patient the CT did not
      show cerebral lesions and the etiology of the paralysis was unknown.

PMID- 1753931
TI  - [Aggressive ulcerous stomatitis due to the herpes simplex virus in an allogeneic
      bone marrow transplant. A clinical case].
AB  - Aggressive ulcerative HSV stomatitis was observed in a patient 10 months after
      allogeneic bone marrow transplantation. The patient was affected by acute myeloid
      leukemia (LMA) in second remission and, after bone marrow transplantation,
      supported a severe graft versus host disease. Intravenous acyclovir was
      administered during 22 days and ulcerative stomatitis completely healed.

PMID- 1753932
TI  - [A case report of a true median cleft of the upper lip with a pedunculated median
      skin-mucosa mass].
AB  - The Authors report an unusual case of median cleft of the upper lip with
      pedunculated skin and muscle contracting mass. About one hundred cases of true
      median cleft lip have been reported, only six showing a median pedunculated mass.
      As the embryogenesis of this malformation is still not completely clear, we think
      that any case with this characteristic has to be described. Besides the usual
      characteristic of the median "hare lip" this case shows a big egg-like
      pedunculated mass in which muscular tissue has been found well represented, and a
      wide incomplete maxillary cleft.

PMID- 1753933
TI  - [A chondroameloblastic embryoma of the jaw. A case report].
AB  - A case of chondro-ameloblastic embryoma, on the posterior third of the palatine
      bone is reported. The report emphasises the importance of the neuromesenchymal
      origin of the ameloblastic cells and cartilaginous, fibro-connective and fibro
      myxoid tissue, that usually form the structure of the neoplasm.

PMID- 1753934
TI  - [The functional and surgical rehabilitative treatment of cleft lip and cleft
      palate in a case of the syndrome of the deletion of the long arm of chromosome 18
      diagnosed in utero].
AB  - Following an introductory illustration of the clinical characteristics of the 18q
      syndrome (De Grouchy syndrome), the paper describes the treatment carried out in
      a young patient with harelip and cleft palate in addition to chromosomopathy.
      Although the facial malformation and the karyotype with the deletion of a portion
      of the long arm of chromosome 18 were diagnosed in utero, the parents, having
      been correctly informed of the mental retardation usually associated with this
      syndrome and the possibility of surgical correction of the facial malformation,
      decided not to abort. The case offers an occasion for analysing the various
      stages and results obtained to date using a multi-specialised diagnostic approach
      and functional and surgical treatment of the harelip and cleft palate which have
      enabled much of the congenital handicap to be corrected.

PMID- 1753935
TI  - [Extracranial cephalic neurogenic tumors. A case report of a schwannoma with a
      rare location].
AB  - Following a brief critical review of the latest international literature, the
      paper describes a case of extracranial cephalic neurogenic tumour in an unusual
      location. Clinical and anatomo-pathological aspects are assessed and the problems
      of therapy are discussed.

PMID- 1753936
TI  - [Linear and volumetric calculations of the free gingiva on deciduous and
      permanent teeth].
AB  - The authors expose the results of an analysis made by measurements and volumetric
      calculations, of deciduous and permanent teeth, estimated at the level of the
      cementum-enamel junction and of the circumferences passing through the points of
      the occlusal and apical maximum convexity of the junction itself. It may be
      useful to remember free gingiva is that part of gingival sulcus included between
      the gingival margin and the bottom of sulcus, it is a tridimensional structure,
      having triangular section, where the gingival sulcus depth is the height and the
      thickness at the bottom of gingival sulcus is the base of the triangle. These
      measurements can be useful to examine closely the analysis of periodontal
      physiopathology.

PMID- 1753937
TI  - [The preliminary results of research on salcatonin treatment in the surgical
      therapy of jaw cysts].
AB  - The results of research concerning a local and systemic treatment with salcatonin
      in surgical therapy of maxillary cysts are reported. A reduction in bone recovery
      time has been noted in the cases studied; this means a reduction in osteolytic
      area and a roentgenographic opacification of the same.

PMID- 1753938
TI  - [Our experience in the correction of a short frenulum labialis by Z-plasty].
AB  - The authors report their experience of the reconstruction by z-plasty in cases of
      shortness of the lip frenum. Amongst several techniques they used for this
      correction they got best results utilizing a z-plasty, with wide flaps, planned
      so that after the transposition of the flaps the medial branch of the z-plasty
      falls horizontally into the deeper vestibular fornix. In all cases treated by
      that z-plasty the A. obtained a widening of the adherent part of the gingiva,
      deepening of the vestibulum, no recurrence of the shortness was observed.

PMID- 1753939
TI  - Intergeneric somatic hybridization in Gramineae: somatic hybrid plants between
      tall fescue (Festuca arundinacea Schreb.) and Italian ryegrass (Lolium
      multiflorum Lam.).
AB  - Tall fescue (Festuca arundinacea Schreb.) protoplasts, inactivated by
      iodoacetamide, and non-morphogenic Italian ryegrass (Lolium multiflorum Lam.)
      protoplasts, both derived from suspension cultures, were electrofused and
      putative somatic hybrid plants were recovered. Two different genotypic fusion
      combinations were carried out and several green plants were regenerated in one of
      them. With respect to plant habitus, leaf and inflorescence morphology, the
      regenerants had phenotypes intermediate between those of the parents. Southern
      hybridization analysis using a rice ribosomal DNA probe revealed that the
      regenerants contained both tall fescue- and Italian ryegrass-specific-DNA
      fragments. A cloned Italian ryegrass-specific interspersed DNA probe hybridized
      to total genomic DNA from Italian ryegrass and from the green regenerated somatic
      hybrid plants but not to tall fescue. Chromosome counts and zymograms of leaf
      esterases suggested nuclear genome instability of the somatic hybrid plants
      analyzed. Four mitochondrial probes and one chloroplast DNA probe were used in
      Southern hybridization experiments to analyze the organellar composition of the
      somatic hybrids obtained. The somatic hybrid plants analyzed showed tall fescue,
      additive or novel mtDNA patterns when hybridized with different mitochondrial
      gene-specific probes, while corresponding analysis using a chloroplast gene
      specific probe revealed in all cases the tall fescue hybridization profile.
      Independently regenerated F. arundinacea (+) L. multiflorum somatic hybrid plants
      were successfully transferred to soil and grown to maturity, representing the
      first flowering intergeneric somatic hybrids recovered in Gramineae.

PMID- 1753940
TI  - Subfamilies of serine tRNA genes in the bovine genome.
AB  - A bovine tRNA gene cluster has been characterized and the sequences of four tDNAs
      determined. Two of the tDNAs could encode tRNA(SerIGA), one tRNA(SerUGA), and the
      fourth tRNA(GlnCUG). The three serine tDNAs representing the UCN codon
      isoacceptor family are almost identical. However, the sequence of the
      tDNA(SerTGA) differs from a previously sequenced bovine tDNA(SerTGA) at 12
      positions (ca. 14%). This finding suggests that in the bovine genome, two
      subfamilies of genes might encode tRNA(SerUGA). It also raises the possibility
      that new genes for a specific UCN isoacceptor might arise from the genes of a
      different isoacceptor, and could explain previously observed differences between
      species in the anticodons of coevolving pairs of tRNAs(SerUCN). The gene cluster
      also contains complete and partial copies, and fragments, of the BCS (bovine
      consensus sequence) SINE (short interspersed nuclear element) family, six
      examples of which were sequenced. Some of these elements occur in close proximity
      to two of the serine tDNAs.

PMID- 1753941
TI  - Construction of expression vectors based on the rice actin 1 (Act1) 5' region for
      use in monocot transformation.
AB  - It has been previously reported that the 5' region of the rice actin 1 gene
      (Act1) promoted high-level expression of a beta-glucuronidase reporter gene (Gus)
      in transformed rice cells. In this paper we describe the construction of Act1
      based expression vectors for use in monocot transformation. As part of the
      development of these vectors, we have evaluated the influence of the Act1 first
      intron, the Act1-Gus junction-encoded N-terminal amino acids, and the sequence
      context surrounding the Act1 and Gus translation initiation site on Act1-Gus gene
      expression in rice and maize cells. We have found that addition of Act1 intron 1
      to the transcription unit of a Gus reporter gene under control of the cauliflower
      mosaic virus (CaMV) 35S promoter stimulated GUS activity more than 10-fold in
      transformed rice cells. Optimization of the sequence context around the Gus
      translation initiation site resulted in a 4-fold stimulation of Gus expression in
      transformed rice cells. By utilizing both the Act1 intron 1 and optimized Gus
      translation initiation site, a 40-fold stimulation in Gus expression from the
      CaMV 35S promoter has been achieved in transformed rice cells; very similar
      results were obtained in transformed maize cells. Taken together these results
      suggest that the Act1-based expression vectors described here should promote the
      expression of foreign genes in most, if not all, transformed monocot cells to
      levels that have not previously been attainable with alternative expression
      vectors.

PMID- 1753942
TI  - Molecular characterization of new group A streptococcal bacteriophages containing
      the gene for streptococcal erythrogenic toxin A (speA).
AB  - Bacteriophage T12 is the prototype phage carrying the streptococcal erythrogenic
      toxin A (speA) gene. To examine more closely the phages involved in lysogenic
      conversion, we examined 300 group A streptococcal strains, and identified and
      isolated two new phages that carry the speA gene. The molecular sizes of these
      phage genomes were between 32 and 40 kb, similar to that of phage T12 (35 kb).
      However, as ascertained by restriction analysis, the physical maps of the new
      phage genomes were different from phage T12 and from each other. Hybridization
      analysis also showed that all of these phages were only partially related to one
      another and the speA gene was always located close to the phage attachment site.
      Additionally, colony hybridization showed that whereas phage T12 or one of its
      close relatives is the most common phage associated with the group A
      streptococci, phage 49 has a much stronger association with the speA gene. A
      defective phage was also found following pulsed field gel electrophoresis of
      total phage DNA. This phage appears to be a resident of strain T25(3)c and is
      found only following induction of a T25(3)c lysogen. Restriction enzyme analysis
      of the isolated defective phage DNA suggests that it is the source of the
      submolar amounts of DNA previously found in association with phage T12 digestion
      patterns. Additionally, the defective phage may serve as the site of integration
      of the speA gene-carrying phages described above.

PMID- 1753943
TI  - A multi-component upstream activation sequence of the Saccharomyces cerevisiae
      glyceraldehyde-3-phosphate dehydrogenase gene promoter.
AB  - The majority of the activation potential of the Saccharomyces cerevisiae TDH3
      gene promoter is contained within nucleotides -676 to -381 (relative to the
      translation initiation codon). An upstream activation sequence (UAS) in this
      region has been characterized by in vitro and in vivo assays and demonstrated to
      be composed of two small, adjacent DNA sequence elements. The essential
      determinant of this upstream UAS is a general regulatory factor 1 (GRF1) binding
      site at nucleotides -513 to -501. A synthetic DNA element comprising this
      sequence, or an analogue in which two of the degenerate nucleotides of the GRF1
      site consensus sequence were altered, activated 5' deleted TDH3 and CYC1
      promoters. The second DNA element of the UAS is a 7 bp sequence which is
      conserved in the promoters of several yeast genes encoding glycolytic enzymes and
      occurs at positions -486 to -480 of the TDH3 promoter. This DNA sequence
      represents a novel promoter element: it contains no UAS activity itself, yet
      potentiates the activity of a GRF1 UAS. The potentiation of the GRF1 UAS by this
      element occurs when placed upstream from the TATA box of either the TDH3 or CYC1
      promoters. The characteristics of this element (termed GPE for GRF1 site
      potentiator element) indicate that it represents a binding site for a different
      yeast protein which increases the promoter activation mediated by the GRF1
      protein. Site-specific deletion and promoter reconstruction experiments suggest
      that the entire activation potential of the -676 to -381 region of the TDH3 gene
      promoter may be accounted for by a combination of the GRF1 site and the GPE.

PMID- 1753944
TI  - Genetic study and further biochemical characterization of a tobacco mutant that
      overproduces sterols.
AB  - A genetic and biochemical characterization is presented of a tobacco mutant that
      was previously shown to have an increased sterol content with an accumulation of
      biosynthetic intermediates. We first show that a precise regulation of the
      membrane sterol composition occurs in this mutant, via a selective esterification
      process. Indeed, sterols representing the usual end-products of the biosynthetic
      pathway are preferably integrated into the membranes as free sterols, whereas
      most of the intermediates pool is esterified and stored in cytoplasmic lipid
      droplets. It is further demonstrated that overproduction of sterols by the LAB1-4
      mutant is due to a single nuclear and semi-dominant mutation. Finally, increase
      of biosynthesis and esterification of unusual sterols are shown to be responsible
      for the resistance of LAB1-4 calli to LAB170 250F, the triazole pesticide used to
      select this mutant. However, differentiated LAB1-4 tissues do not express the
      resistance trait, suggesting that sterol biosynthesis might not be the only site
      of action for the triazole at the plant level.

PMID- 1753945
TI  - Cloning and characterization of the Chlamydomonas moewusii mitochondrial genome.
AB  - We report that the mitochondrial genome of Chlamydomonas moewusii has a 22 kb
      circular map and thus contrasts with the mitochondrial genome of Chlamydomonas
      reinhardtii, which is linear and about 6 kb shorter. Overlapping restriction
      fragments spanning over 90% of the C. moewusii mitochondrial DNA (mtDNA) were
      identified in a clone bank constructed using a Sau3AI partial digest of a C.
      moewusii DNA fraction enriched for mtDNA by preparative CsCl density gradient
      centrifugation. Overlapping Sau3AI clones were identified by a chromosome walk
      initiated with a clone of C. moewusii mtDNA. The mtDNA map was completed by
      Southern blot analysis of the C. moewusii mtDNA fraction using isolated mtDNA
      clones. Regions that hybridized to C. reinhardtii or wheat mitochondrial gene
      probes for subunit I of cytochrome oxidase (cox1), apocytochrome b (cob), three
      subunits of NADH dehydrogenase (nad1, nad2 and nad5) and the small and the large
      ribosomal RNAs (rrnS and rrnL, respectively) were localized on the C. moewusii
      mtDNA map by Southern blot analysis. The results show that the order of genes in
      the mitochondrial genome of C. moewusii is completely rearranged relative to that
      of C. reinhardtii.

PMID- 1753946
TI  - Cloning, sequencing and characterization of the Saccharomyces cerevisiae URA7
      gene encoding CTP synthetase.
AB  - The URA7 gene of Saccharomyces cerevisiae encodes CTP synthetase (EC 6.3.4.2)
      which catalyses the conversion of uridine 5'-triphosphate to cytidine 5'
      triphosphate, the last step of the pyrimidine biosynthetic pathway. We have
      cloned and sequenced the URA7 gene. The coding region is 1710 bp long and the
      deduced protein sequence shows a strong degree of homology with bacterial and
      human CTP synthetases. Gene disruption shows that URA7 is not an essential gene:
      the level of the intracellular CTP pool is roughly the same in the deleted and
      the wild-type strains, suggesting that an alternative pathway for CTP synthesis
      exists in yeast. This could involve either a divergent duplicated gene or a
      different route beginning with the amination of uridine mono- or diphosphate.

PMID- 1753947
TI  - DNA lesions that block DNA replication are responsible for the dnaA induction
      caused by DNA damage.
AB  - The initiation protein DnaA of Escherichia coli regulates its own expression
      autogenously by binding to a 9 bp consensus sequence, the dnaA box, between the
      promoters dnaAP1 and dnaAP2. In this study, we analysed dnaA regulation in
      relation to DNA damage and found dnaA expression to be inducible by DNA lesions
      that inhibit DNA replication. On the other hand, coding DNA lesions were not able
      to induce dnaA expression. These results suggest that an additional regulatory
      mechanism is involved in dnaA gene expression and that DnaA protein may play a
      role in cellular responses to DNA damage. Furthermore, they strongly suggest that
      in response to DNA replication inhibition by DNA damage, and enhanced
      (re)initiation capacity is induced by oriC.

PMID- 1753948
TI  - Effects of replacement of promoters and modification of the leader peptide region
      of the amy gene of Streptomyces griseus on synthesis and secretion of alpha
      amylase by Streptomyces lividans.
AB  - Five different mutations were introduced into the leader peptide region of the
      alpha-amylase gene of Streptomyces griseus IMRU 3570. A mutation which increased
      the positive charge of the N-terminal region of the leader peptide enhanced the
      secretion of alpha-amylase by two- to threefold. Replacement of the native
      promoter of the amylase gene by the promoter of the Tn5 neo gene or by the
      promoter of the saf gene resulted in a 16-fold increase in alpha-amylase
      secretion. The enhanced secretion of alpha-amylase obtained by using the most
      efficient promoters was due to a correlated increase in the amount of transcript
      formed. The translation and secretion processes in S. lividans are not a
      bottleneck for enzyme secretion even at very high transcription rates, since
      stimulation of transcription of the alpha-amylase gene results in a proportionate
      increase in secretion of the enzyme.

PMID- 1753949
TI  - Isolation and analysis of a cDNA clone that encodes an alfalfa (Medicago sativa)
      aspartate aminotransferase.
AB  - We have isolated an alfalfa leaf cDNA clone that encodes aspartate
      aminotransferase (AAT, EC 2.6.1.1) by direct complementation of an Escherichia
      coli aspartate auxotroph with a plasmid cDNA library. DNA sequence analysis of
      the recombinant plasmid, pMU1, revealed that a 1514 bp cDNA was inserted in the
      correct orientation and in-frame with the start of the lacZ coding sequence in
      the vector, pUC18. The resulting fusion protein is predicted to be 424 amino
      acids in length with a molecular weight of 46387 Daltons. The cDNA-encoded
      protein has a characteristic pyridoxal phosphate attachment site motif and has
      substantial amino acid sequence homology to both animal and bacterial AATs.
      Plasmid pMU1 encodes an AAT with a Km for aspartate of 3.3 mM, a Km for 2
      oxoglutarate of 0.28 mM, and a pH optimum between 8.0 and 8.5. Several lines of
      evidence including Western blot analysis, the isoelectric point of the encoded
      protein, and the effect of pH on the activity of the fusion protein, suggest that
      the cDNA encodes the isozyme AAT-1 rather than AAT-2. Northern blot analysis
      showed that the aat-1 clone hybridized to a 1.6 kb transcript present in alfalfa
      leaves, roots and nodules. The relative concentrations of aat-1 mRNA in these
      tissues were 1:2:5, respectively. Thus, transcription of aat-1 appears to be
      induced during nodule development. Southern blot analysis suggested that AAT-1 in
      alfalfa is encoded by either a single-copy gene or a small, multigene family.

PMID- 1753950
TI  - [Selective cytotoxic effect of an immunotoxin on human erythroid tumor cells].
AB  - The possibility of efficient directed elimination of human erythroblastoid cells
      by the conjugate of IgM-monoclonal antibody HAE9 directed against the
      erythroblast antigen and the A-chain of a plant toxin ricin has been
      demonstrated. The conjugate contained 2 molecules of A-chain per one antibody
      molecule. The efficiencies of the cytotoxic effect of native ricin and the
      conjugate were compared according to the number of binding sites on the surface
      of K562 cells as well as to the internalization rate of these molecules. As was
      shown, that the number of binding sites for the antibody approaches 2.7.10(4)
      molecules/cell, K a being equal to 1.7.10(8) M-1 while for ricin these indices
      constitute 2.4.10(5) and 4.6.10(8) M-1. Almost 100% of antibodies and 36% of
      ricin are internalized within 10 min at 37 degrees C. At a concentration 10(-11)
      of native ricin and 10(-10) of immunotoxin the 50% inhibition of growth of K562
      cells carrying the erythroblast antigen on their surface is observed.

PMID- 1753951
TI  - [Cytotoxic properties of a recombinant hybrid of the A protein of Staphylococcus
      aureus with a fragment of exotoxin A of Pseudomonas aeruginosa].
AB  - By gene-engineering technique a chimeric protein made up of fragments of
      Staphylococcus aureus protein A and . Pseudomonas aeruginosa exotoxin A has been
      constructed. The chimeric protein was shown to preserve features characteristic
      of its both constituents--it ADP-ribosylates elongation factor 2 and binds to Ig.
      Cytotoxic properties of the chimeric protein were studied in two model systems.
      Treatment of target cells in both systems was performed successively with
      antibodies against corresponding antigens and after washing--with recombinant
      chimeric toxin which bound to antibodies on the surface of target cells. In the
      first model system human B-lymphoma cells (Daudi line) carrying Ig molecules on
      their surface were treated with polyclonal antibodies against human Ig L-chains.
      In the other system, human T-lymphoma cells (Jurkat line) were treated
      successively with monoclonal antibodies against cell surface CD5 antigen and
      further on--with polyclonal antibodies against mouse Ig. In both systems, only a
      slight inhibition of the target cells' growth was registered. The probable
      reasons of low cytotoxic activity of the chimeric protein and prospects of
      increasing it are discussed.

PMID- 1753952
TI  - [Electron microscopic study of DNA compactization under the effect of
      putrescine].
AB  - DNA-putrescine complexes were studied by electron-microscopy with the use of
      protein-free method. The latter gives the opportunity to investigate the
      interaction of DNA molecules spread on the surface layer of hypophase and the
      polyamine molecules in the thick layer of hypophase. Polyamine concentration
      varied from 5 x 10(-4) mM to 5 x 10(-1) mM. Under the low concentration of
      putrescine the complexes are represented by agglomerations of kinked knobbed
      fibres 10 to 20 nm thick, consisting of several fibres of duplex DNA. Upon
      increasing of putrescine concentration from 5 x 10(-4) to 1.5 x 10(-1) mM, the
      fibres become more thick (up to 25 nm), highly twisted and have the appearance of
      cylinders. Very often in the composition of complexes, it is possible to
      encounter the circular structures, which were formed at the expense of
      intermolecular interaction of different parts of the complex. The circular
      structures can serve as "embryos" of toroids of different sizes, that is of
      different degree of saturation with DNA and putrescine. At the concentration of
      putrescine 5 x 10(-1) mM the complexes have the appearance of toroids and
      structures on the basis of toroids, cylinders. The scheme of possible transitions
      of fibres of various thickness is proposed. The regularities of the
      compactization process, stimulated by polyamines, don't depend on the degree of
      compactization (the thickness of compacting fibre), that is they are similar for
      duplex DNA and for the fibres 25 nm thick, consisting of dozens of DNA molecules.

PMID- 1753953
TI  - [Conformation of the third domain of turkey ovomucoid in solution. Structural
      analysis by two-dimensional Overhauser nuclear effect spectroscopy].
AB  - The conformations of a polypeptide chain of turkey ovomucoid third domain and its
      modified form with split reactive site peptide bond Leu-18--Glu-19 have been
      determined by the literary two-dimensional nuclear Overhauser effect spectroscopy
      data using an earlier suggested method. It has been found that the polypeptide
      domain backbone contains an alpha-helical fragment (residues 32-47), five
      segments having extended conformation (1-5, 11-17, 19-25, 29-31, 48-50) and beta
      turn type 1 (26-29). Segments 23-26, 28-31 and 50-51 form an antiparallel beta
      structure. Conformational states of the residues entering irregular domain
      segments have been analysed. Splitting of the reactive site peptide bond Leu-18-
      Glu-19 is shown to cause insignificant changes in the conformations of a number
      of amino acid residues except for Val-6 and Asp-7 ones which undergo essential
      conformational alterations. The conformations of domain in solution and of
      japanese quail ovomucoid third domain in crystal have been compared. The root
      mean-square deviations for phi and psi angles indicate their high similarity. The
      conformations of turkey ovomucoid third domain and proteinase inhibitor BUSI IIA
      in solution have been analysed. In spite of moderate (50%) homology of primary
      structures, some 75% of amino acid residues are shown to have close
      conformational phi and psi parameters.

PMID- 1753954
TI  - [Expression of human tissue plasminogen activator by recombinant cell lines from
      various animals].
AB  - A number of recombinant cell lines which produce human tissue plasminogen
      activator (tPA) was obtained using different hosts--mouse, rat, hamster, simian
      and human cell lines. All types of recombinant lines secreted active r-tPA into
      conditioned medium. A slight difference between molecular weights of secreted
      variants of r-tPA was mediated by the different mechanisms of protein
      modification. Treatment of some recombinant cell lines with different substances
      resulted in increased levels of r-tPA production.

PMID- 1753955
TI  - [Use of the polymerase chain reaction for typing allelic variants of the human
      HLA-DQA1 by hybridization with oligonucleotide probes, specific for specific
      alleles].
AB  - Class II HLA molecules are the most useful markers for susceptibility to
      different autoimmune diseases, including insulin-dependent diabetes mellitus
      (IDDM) and rheumatoid arthritis (RA). Polymerase chain reaction and hybridization
      with a set of allele-specific oligonucleotide have been used for analysis of
      allelic sequence variation. The analysis of frequencies of HLA-DQA1 alleles among
      10 patients of the russian population revealed a uneven distribution. We have
      developed a method for preparing non-radioactive oligonucleotide probes with
      terminal deoxynucleotidyl transferase and Bio-11-dUTP. Comparison of biotinylated
      and 32P-labeled hybridization probes gave the same sensitivity for HLA-DQA1
      typing of amplified DNA. Amplification of the HLA-DQA1 gene has been successful
      on 10 pg of total DNA. This amount of DNA is close to the amount of DNA in a
      single cell. Alternatively, HLA-DQA1 typing could be based on the analysis of
      buccal cells of saliva that would avoid the problem of individuals who object to
      giving blood samples.

PMID- 1753956
TI  - [Elimination of introns from the interleukin 1 beta genome by DNA amplification
      and expression of interleukin 1 beta in Escherichia coli].
AB  - The use of the polymerase chain reaction was proposed for intron excision from
      genomic genes with known nucleotide sequences. Three exons (5, 6 and 7) of
      genomic interleukin 1 beta gene were amplified by means of thermostable DNA
      polymerase TthI from Thermus thermophilus on the base of cloned in M13 phage
      human genomic interleukin 1 beta gene. Synthetic oligonucleotides complementary
      to sequences flanking exons were used as primers. The fragments obtained by exon
      DNA amplification were joined in the correct order due to reciprocal
      complementation of end sequences, that was foreseen during synthesis of
      oligonucleotide primers followed by amplification of the enlarged fragments. As a
      result the structural interleukin-1 beta gene consisting of three exons was
      assembled. DNA sequences carrying the ATG initiation codon and XbaI recognition
      site at the 5'-end, and PstI recognition site at the 3'-end (essential for
      insertion into the expression vector) were formed by the additional end sequences
      of primers. The nucleotide sequence analysis of the obtained structural gene
      revealed its complete identity with natural interleukin 1 beta human gene. We
      created the expression vector pPR114 with phage lambda promoter PR thermo
      inducible in case of the cIts857 repressor presence in cells. It was used for
      expression of the present gene. The interleukin 1 beta synthesized in E. coli had
      biological activity.

PMID- 1753957
TI  - [Cloning of Chrysanthium stund virion cDNA in pUC19 plasmid and the use of cloned
      cDNA for detecting the virion].
AB  - 26 base long deoxyribonucleotide complementary to the lower part of the Central
      Conserved Region of chrysanthemum stund viroid (CSV) was used for synthesis of
      the first strand cDNA. The cDNA was cloned into plasmid vector pUC19 and the
      primary structure was determined. Cloned, full length cDNA was used as
      hybridisation probe for detection of CSV. It was possible to detect about 26 pg
      of purified CSV RNA immobilized on nitrocellulose filters using 32P-labeled
      probe. In the case of biotinylated probe it was possible to detect about 26 pg of
      purified CSV RNA visualizing results by streptavidin-alkaline phosphatase
      conjugates. It has been shown that such a cloned cDNA can be used for wide scale
      detection of CSV.

PMID- 1753958
TI  - [Nucleic acid synthesis and spatial organization of DNA in the presence of
      heparin and the quaternary ammonium salt of the conidin oligomer-25].
AB  - A comparative study of polyconidin effects in the replicative and transcription
      activity of hepatocyte DNA in intact animals, and on peculiarities of spatial
      organization DNA in the DNA complex with oligomer-25 conidin was carried out. It
      was shown that polyconidin binding to DNA results in "cross-linking". This
      process is accompanied by formation of liquid-crystalline dispersion without
      abnormal optical activity. Liquid crystals possess high density packing of DNA
      molecules complexed with quaternary ammonium salt of oligomer-25 conidin. The
      addition of heparin to liquid-crystalline dispersions or phases, destroys the
      structure of the DNA complex with quaternary ammonium salt of oligomer-25
      conidin. As a result "free" DNA molecules appear, they form the cholesteric
      liquid-crystalline phase. An increase in transcription activity and
      synchronization of DNA synthesis in hepatocyte was demonstrated. A correlation
      between chromatin modification and biological activity of chromatin after
      formation of the DNA--oligomer-25 conidin complex is proposed.

PMID- 1753959
TI  - [Suppression of translation in vitro of the mRNA of the M1 protein of influenza
      virus using antisense oligonucleotides].
AB  - Effect of antisense oligonucleotides on the in vitro translation of the influenza
      virus M1 protein mRNA was investigated. The most efficient arrest of mRNA
      translation was achieved by simultaneous action of two or three oligonucleotides
      (14-16-mers) complementary to the juxtaposed sequences in the 5'-terminus of the
      molecule around and upstream of the initiation codon.

PMID- 1753960
TI  - [Electron microscopic study of compactization of individual DNA molecules in
      films during the interaction with histone H1].
AB  - The protein-free method was applied for the investigation of histone H1 DNA
      complexes formation. The main advantage of this method is the possibility to get
      intramolecular compact structures at interaction of individual spread molecules
      of DNA with histone H1. It was shown that in the presence of 0.2-5 micrograms/ml
      of histone H1 in hypophase there are three types of structures on
      electronmicroscopic preparations: fibres of non-compacted DNA, compact fibres
      with twisted strands of duplex DNA and compacted rod-like and circular structures
      where separate fibres of duplex DNA could not be distinguished. The study of
      compact structures morphology allows to conclude that they are formed by side-by
      side association of DNA fibres, as it takes place in the case of triple rings
      formation at the compactization of circular DNA due to trivaline binding. At
      increasing ionic strength there is a tendency for transition from second type
      structures to the third type structures. The latter can be explained by
      transition from non-cooperative to cooperative binding of histone H1 to DNA.

PMID- 1753961
TI  - [Conserved and variable segments of the snake phospholipase A2 amino acid
      domain].
AB  - Homologous amino acid sequences of phospholipases A2 of snakes belonging to
      families Elapidae, Viperidae and Colubridae were considered in order to study the
      location of conservative and variable regions. To identify significant
      conservative and variable regions a comparison between two groups of aligned
      sequences of snake phospholipases A2 was successfully applied. The phospholipases
      A2 sequences were divided into two groups (taxons) according to the phylogenetic
      tree reconstructed from the pair distance matrix. Results of the comparison were
      plotted to facilitate the identification of significant conservative and variable
      regions. It was shown, that the results of the comparison between two
      phylogenetic groups of snake phospholipases A2 didn't depend much on the number
      of each group representatives, and the location of conservative and variable
      regions didn't significantly change if one of the groups was represented by the
      single sequence. It should be mentioned, that the more the phylogenetic
      difference between groups of phospholipases A2 the more was the number of
      significant conservative and variable regions. The knowledge of the number and
      location of conservative and variable regions and their dependence on
      phylogenetic relations between the compared taxons can be used to predict the
      synthetic peptide structure to obtain antibodies of various specificity. These
      antibodies may have either a wide range of cross-reactivity against all of
      phospholipases A2 or a limited range of cross-reactivity against phospholipases
      A2 of one taxon.

PMID- 1753962
TI  - [A method of equalizing the level of DNA sequences of varying amount in a
      heterogeneous DNA mixture].
AB  - A method for the equalization of double-stranded DNA concentrations in the
      mixture which may be used for equalizing double-stranded cDNA concentrations
      involves thermal denaturation of the double-stranded DNA mixture followed by
      reassociation. The initial reassociation rate is Vi = Ki.(single-stranded DNA)2,
      and by the end of the process the concentrations of the unreassociated molecules
      for different DNAs should be approximately equal. Using hydroxylapatite
      chromatography one can separate single-stranded DNAs from double-stranded DNAs
      and carry out complete single-stranded DNAs reassociation. The new ratio of
      different double-stranded DNA concentrations would be almost 1.

PMID- 1753963
TI  - [Heterogeneity and avidity of autoantibodies reacting with DNA].
AB  - Subpopulations of auto-antibodies to DNA were isolated by affinity procedures
      from sera of two patients with SLE and from IgG of healthy donors after ion
      exchange chromatography ("hidden" auto-antibodies). It was found that two
      subpopulations of auto-antibodies are present in SLE sera just as fractions of
      "hidden" auto-antibodies consist of three subpopulations. The dissociation
      constants were measured by ELISA for the interaction of all subpopulations of
      auto-antibodies to DNA. It is shown that KD are very high and identical no matter
      of whether they were prepared from SLE sera of from IgG of healthy donors. The
      analogy of two types of auto-antibodies (SLE auto-antibodies and "hidden" auto
      antibodies) is discussed in this paper.

PMID- 1753964
TI  - [Structure of nucleosomes. Localization of the H2A and H2B histone segments
      interacting with DNA using DNA-protein crosslinking].
AB  - Histones' H2A and H2B peptidic points which interact with nucleosomal DNA have
      been identified by using the methods of DNA--protein covalent cross-linking. H2B
      can be linked to DNA via its N-terminal tail and via several lysines contained
      within residues 24-34. The most prominent site of histone H2A covalent linking to
      DNA is His-123, the less prominent being Lys-119 and Lys-124.

PMID- 1753965
TI  - [Conformational transitions of human serum albumin depending on pH. Study using
      tritium markers].
AB  - Accessible surfaces of the HSA molecule in N-, F- and B-forms were studied in the
      present work by tritium labelling method which allowed to obtain detailed
      information on N-F- and N-B-transitions. In was shown that the F-form in
      comparison top the N-form is characterized by more high accessibility of Ser,
      Ala, Ile, Tyr, Phe, His, Arg, Pro, Val and Phe residues and in the B-form Tyr,
      Ser, Arg, Gly, Ile, Phe and Pro residues turn to be highly accessible. Full
      accessible surfaces of protein molecule at N-F- and N-B-transitions increase
      respectively from 39,000 to 70,400 A2 and from 39,000 to 47,000 A2. Basing on the
      prevailing increase of hydrophobic residues accessibility it is supposed that the
      molecule expansion testifies the separation of the subunits forming the molecule.

PMID- 1753966
TI  - [Amplification using one-sided polymerase chain reaction, cloning and
      determination of primary structure of 5'-untranslated cDNA segments coding the
      somatogenic growth hormone receptor from rat liver].
AB  - The method of ligation-mediated, single-sided polymerase chain reaction was
      applied for the amplification of 5'-untranslated regions of cDNA coding for
      somatogenic growth hormone receptor from rat liver. The products of polymerase
      chain reaction were cloned and sequenced. Two variants of 5'-untranslated
      sequences of growth hormone receptor cDNA corresponding to products of
      alternative splicing of pre-mRNA were found.

PMID- 1753967
TI  - [Restriction analysis of autonomously replicating molecules containing exogenous
      DNA in a transgenic silkworm line].
AB  - Early embryos of the silkworm, Bombyx mori, were injected with plasmid p1,5LTR,
      harboring DNA copies of the Rous sarcoma long terminal repeats (LTR). Three
      generations of insects were obtained whose total DNA carried DNA sequences of the
      injected plasmid. Plasmid rescue method revealed that exogenous DNA was present
      in extrachromosomal molecules that harbored also cellular DNA sequences. A
      restriction map of the plasmid rescued from the F2 generator was constructed.

PMID- 1753968
TI  - Staking out the law.

PMID- 1753969
TI  - AIDS and surrogate decision making.

PMID- 1753970
TI  - Surrogate decisions in New York State on sustaining life.

PMID- 1753971
TI  - The physician's experience: infants and children.

PMID- 1753972
TI  - The physician's experience: patients in intensive care.

PMID- 1753973
TI  - The physician's experience: elderly patients.

PMID- 1753974
TI  - Surrogate decision making for incompetent adults: an ethical framework.

PMID- 1753975
TI  - Foster parents as surrogates for infants and young children.

PMID- 1753976
TI  - History of drug use and drug control.

PMID- 1753977
TI  - The epidemiology of cocaine use in New York State.

PMID- 1753978
TI  - Paternalism and drug abuse.

PMID- 1753979
TI  - Pharmacology of the drugs of abuse and the development of public policy.
AB  - It is fascinating that the morality, ethics, and effectiveness of current drug
      prohibition policies are being criticized in an era when drug use is declining in
      most segments of society. The current era is also marked by increasingly
      restrictive policies against drug use and users, including much enhanced
      interdiction efforts, calls for tougher penalties and more jails, and extensive
      drug screening programs at the work site. Summary dismissal of workers or
      students who use drugs is increasingly advocated. Two distinct and opposing
      currents advocating policy change have emerged, one for legalization, the other
      for greater restriction. The current inner-city rise in drug use, particularly of
      cocaine and "crack," and the remarkable increase in drug-related crime is
      probably providing the impetus for both lines of thinking. Yet both views appear
      extreme and neither seems to offer a promising social policy. It is critical that
      we continue to attempt to develop effective strategies for reducing the impact of
      drug taking on the individual and society. Whereas I am sensitive to the ethical
      and legal perspectives of the proponents of legalization, pharmacologic and
      social issues persuade me that legalization of heroin and cocaine would lead to a
      marked increase in drug dependence and an increase in drug-related disability and
      crime. In response to the idea that the legalization and taxation of drug use
      would provide resources for more effective research, prevention, and treatment,
      my sense is that we should not wait for legalization but should embark on that
      long and expensive course immediately.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1753980
TI  - Drug policy in New York City.

PMID- 1753981
TI  - Drug use and public policy.

PMID- 1753982
TI  - Drugs and the social body.

PMID- 1753983
TI  - The physician as a servant of public policy.

PMID- 1753984
TI  - Doctors' dilemmas: bioethical challenges.

PMID- 1753985
TI  - The personal ethics of the physician: curing medicine from within.

PMID- 1753986
TI  - Medical ethics: a broader definition.

PMID- 1753987
TI  - HIV infection in drug abusers: research implications of descriptive studies.

PMID- 1753988
TI  - Potential cofactors in the outcomes of HIV infection in intravenous drug users.

PMID- 1753989
TI  - How can results of longitudinal studies help mathematicians model the HIV
      epidemic among intravenous drug abusers and the general population?

PMID- 1753990
TI  - Natural history of HIV infection in gay men and intravenous drug users.

PMID- 1753991
TI  - Sampling issues for natural history studies including intravenous drug abusers.

PMID- 1753992
TI  - Toward comprehensive studies of HIV in intravenous drug users: issues in
      treatment-based and street-based samples.

PMID- 1753994
TI  - Emerging technologies and new directions in drug abuse research. An overview.

PMID- 1753993
TI  - Strategies for enhancing existing studies of the natural history of HIV-1
      infection among drug users.

PMID- 1753995
TI  - Combined use of solid-state nuclear magnetic resonance spectroscopy, small-angle
      x-ray diffraction, and differential scanning calorimetry in studies of
      cannabinoid: membrane interactions.

PMID- 1753996
TI  - Characterization and localization of cannabinoid receptors in brain: an in vitro
      technique using slide-mounted tissue sections.

PMID- 1753997
TI  - New developments in radiotracers for positron emission tomography.

PMID- 1753998
TI  - Use of positron emission tomography to study cocaine in the human brain.
AB  - It is feasible to directly image and measure the concentration of different drugs
      of abuse and their consequences on regional brain function and neurotransmitter
      activity with PET. Although PET is a relatively new technique, it already is
      proving to be useful in disclosing the mechanisms of toxicity reinforcement and
      addition of drugs of abuse.

PMID- 1753999
TI  - A mechanistic basis for design of selective agonists for 5-HT receptors.

PMID- 1754000
TI  - Peptidomimetic opioids--synthesis, spectroscopy, and computer simulations.

PMID- 1754001
TI  - Modified solid-phase methods for the rapid synthesis of opioid peptides.

PMID- 1754002
TI  - Important compounds in the cocaine class: a synthesis overview.

PMID- 1754003
TI  - FDA regulatory requirements for investigational new drugs and new drug
      applications: an update.

PMID- 1754004
TI  - 3D-searching: an overview of a new technique for computer-assisted molecular
      design.

PMID- 1754005
TI  - Voronoi binding site models.

PMID- 1754006
TI  - Protein structure determination in solution using nuclear magnetic resonance
      spectroscopy.

PMID- 1754008
TI  - Methodological issues in controlled studies on effects of prenatal exposure to
      drug abuse.

PMID- 1754007
TI  - Drug exposure to the fetus--the effect of smoking.

PMID- 1754009
TI  - Neurobehavioral organization of the newborn: opportunity for assessment and
      intervention.
AB  - A functional model has been formulated that attempts to specify the behavioral
      subsystems of functioning that exemplify in their respective interplay an
      infant's individuality of behavioral functioning in the manner in which they move
      from stable to disorganized functioning and in the flexibility with which they
      maintain organized functioning in the face of varied exogenous and endogenous
      events. Based on this model, Als and colleagues have attempted to develop
      systematic assessments, the APIB and the K-Box Paradigm, to quantify the degree
      of differentiation and modulation of these behaviorally defined subsystems of
      functioning. It is hypothesized that the differences documented via these
      assessments are brain based (i.e., part of the child's biological makeup, which
      is influenced by the intrauterine and extrauterine environment, be it sensory
      and/or drug exposure, and which shows a recognizable pattern along a definable
      trajectory).

PMID- 1754010
TI  - Substance abuse in pregnancy: effects on cardiorespiratory function in the
      infant.

PMID- 1754011
TI  - The effect of cocaine on developing human brain.

PMID- 1754012
TI  - Measurement of drug-induced physical and behavioral delays and abnormalities in
      animal studies: a general framework.

PMID- 1754013
TI  - Pharmacokinetic correlates of fetal drug exposure.

PMID- 1754014
TI  - Postnatal development of cardiac and respiratory control following prenatal drug
      exposure.
AB  - Of primary importance in the consideration of animal models of prenatal drug
      exposure is the recognition of interdependence among physiologic systems, the
      pervading influence of sleep and waking states, and the potential interaction
      between drug-induced structural changes and physiologic function. It is difficult
      for a drug effect on the cardiovascular system not to modify respiratory pattern;
      any change in blood pressure, systemic perfusion, or heart rate is immediately
      reflected in breathing; respiratory pattern, in turn, through negative thoracic
      pressure and other sensory activity, can alter cardiac patterning. The
      respiratory system itself is one component of a somatic motor system, and neural
      motor control structures undergo substantial modification by drug action.
      Enhancing or diminishing any aspect of interaction is the influence of sleep
      states, which nonlinearly can alter relationships between physiologic systems,
      occasionally dissociating systems, as in the case of temperature effects on
      breathing during REM sleep. Finally, drug-induced structural changes that alter
      morphology of the upper airway can result in obstructive respiratory events,
      leading to pronounced cardiovascular sequelae.

PMID- 1754015
TI  - Endocrine function as a target of perinatal drug effects: methodologic issues.
AB  - The goal of this chapter is to indicate potential endocrine targets of perinatal
      drug exposure, to describe the methodologic issues involved in detecting changes
      in hormone secretion, and to provide examples of several endocrine systems in
      which exposure to drugs during development significantly impaired normal
      endocrine development. Finally, we attempted to show that endocrine function is
      both a target and useful marker for detecting effects of drug of abuse on
      development that provides the advantages of accurate quantitation and relative
      response stability across ontogeny.

PMID- 1754016
TI  - Assessment of teratogenic effects on cognitive and behavioral development in
      infancy and childhood.

PMID- 1754017
TI  - New methodologies for evaluating residual brain damage in infants exposed to
      drugs of abuse: objective methods for describing movements, facial expressions,
      and communicative behaviors.

PMID- 1754018
TI  - Rationale and methodologies for developing nonhuman primate models of prenatal
      drug exposure.

PMID- 1754019
TI  - Following drug-exposed infants into middle childhood: challenges to researchers.

PMID- 1754020
TI  - Patterns of growth and development in narcotic-exposed children.
AB  - The results of the studies reviewed indicate that intrauterine growth is
      adversely affected by drug use during pregnancy. Whether the impairment is a
      direct effect of narcotic exposure or is the result of the interaction of
      deleterious health, environmental, and socioeconomic factors closely associated
      with the lifestyle of the woman who abuses drugs cannot be determined at present.
      Reports on the long-term effects of drug use on growth and intellectual
      functioning in the offspring of women who abuse drugs are not consistent. While
      some studies indicate that most of the exposed infants exhibit catchup growth by
      6 months of age (Lifschitz et al. 1983, 1985), one methodologically strong study
      suggests that methadone may have a small direct teratogenic effect reflected in
      reduced head size at 2 years of age (Hans 1989). Unexplained is the pattern of
      growth deceleration observed in some narcotic-exposed children (Lifschitz et al.
      1983, 1985). The few available reports on long-term outcome concur that narcotic
      exposed children have a high incidence of behavioral and learning problems
      (Strauss et al. 1979; Rosen and Johnson 1985; Wilson 1989), but population
      studies have been too small to demonstrate that they differ significantly from
      controls. There is a suggestion that narcotic use during pregnancy promotes a
      biological vulnerability to adverse environments, manifested in the
      neurobehavioral and intellectual areas.

PMID- 1754021
TI  - Integrity of psychopathology diagnoses across the lifespan.

PMID- 1754022
TI  - Selected methodologic issues in investigations of prenatal effects of cocaine:
      lessons from the past.

PMID- 1754023
TI  - Methodological issues in studying cocaine use in pregnancy: a problem of
      definitions.

PMID- 1754024
TI  - Use of birth defects monitoring programs for assessing the effects of maternal
      substance abuse on pregnancy outcomes.
AB  - We have attempted to demonstrate that birth defects surveillance systems are a
      unique adjunct to clinical research data on maternal exposures, including
      substances of abuse. Surveillance system data reflect the experiences of the
      populations from which they are drawn and the characteristics of the people in
      those populations. Sensitive systems may reveal trends in health status and
      changes in behavioral, cultural, social, or environmental exposures. They can be
      used to monitor changing trends, to identify clusters for investigation, to
      generate and test hypotheses, and to conduct epidemiological studies. For
      researchers to interpret data derived from surveillance systems appropriately and
      wisely, they need a thorough knowledge of the data sources, the data-collection
      procedures, and the intent of the surveillance systems. Researchers using
      surveillance data should have a thorough understanding of the quality of their
      data and the methodologic subtleties that bear on its interpretation; researchers
      reviewing scientific literature based on surveillance data should be aware of the
      strengths and limitations inherent in the data.

PMID- 1754025
TI  - What we can learn from the status of the newborn.

PMID- 1754026
TI  - In situ differentiation between nevi and malignant melanomas by fluorescence
      measurements.

PMID- 1754027
TI  - German Society for Pharmacology and Toxicology. Abstracts of the third winter
      meeting. 4-6 December 1991, Hannover.

PMID- 1754028
TI  - Protein inhibitors of proteinases from brain.

PMID- 1754029
TI  - Effects of naloxone-precipitated withdrawal after a single dose of morphine on
      catecholamine concentrations in guinea-pig brain.
AB  - The effect of naloxone-precipitated withdrawal after acute morphine was studied
      on the concentrations of noradrenaline (NA), 4-hydroxy-3
      methoxyphenylethyleneglycol (MHPG), dopamine (DA), 3,4-dihydroxyphenylacetic acid
      (DOPAC) and homovanillic acid (HVA), and on the metabolite/parent amine ratios
      MHPG/NA, DOPAC/DA and HVA/DA, in eight regions of the guinea-pig brain. Guinea
      pigs were treated with a single dose of morphine sulphate (15 mg/kg s.c.) or
      saline (control) and 2h later with naloxone hydrochloride (15 mg/kg s.c.) to
      precipitate withdrawal. The animals were decapitated at 0.5 h or 1 h after
      naloxone injections and their brains analysed for monoamine concentrations by
      HPLC-ECD. At 0.5 h after naloxone-precipitated withdrawal NA and MHPG levels, and
      the MHPG/NA ratio, were increased in the hypothalamus, and the NA levels were
      increased in the hypothalamus, medulla/pons and cortex 1 h after naloxone.
      Naloxone-precipitated withdrawal also produced increased DA metabolism in the
      cortex, midbrain and medulla 0.5 h later, and in the cortex, hypothalamus and
      striatum 1 h later. Hence naloxone-precipitated withdrawal from acute morphine
      treatment produced a complex pattern of increased synthesis and metabolism of NA
      and DA which varied over time and with the brain region examined.

PMID- 1754030
TI  - Immunocytochemical localization of leucomyosuppressin-like peptides in the CNS of
      the cockroach, Leucophaea maderae.
AB  - Immunocytochemistry was used to determine sites of synthesis and pathways for the
      transport of the neuropeptide, Leucomyosuppressin (pQDVDHVFLRFamide) in the
      cockroach, Leucophaea maderae. This study led to identification of neurons in the
      brain and thoracic ganglia reactive to polyclonal antibodies raised against this
      peptide. No immunoreactive cells were found in the subesophageal or abdominal
      ganglia. Although the corpus cardiacum contained no intrinsic cells
      immunoreactive to LMS antibodies, the periphery of this organ and that of the
      nervi corporis allati contain an abundance of LMS-reactive terminals.

PMID- 1754031
TI  - In vivo metabolism of fluorescent ceramide in central nervous system myelin of
      adult rats.
AB  - The metabolism of sphingolipids in the central nervous system (CNS) has been
      studied in adult rats by intraventricular administration of fluorescent ceramide
      (CER). Rats were sacrificed at various time points post inoculation and the
      fluorescence of CER, cerebrosides (CB), sulfatides (SULF) and sphingomyelin (SPM)
      was determined in the CNS myelin and in the pellet, containing mainly microsomes,
      obtained by Norton myelin preparation. The incorporation of fluorescence was more
      in the pellet than in the myelin at all times studied. Initially the fluorescence
      present in the pellet was prevalently due to untransformed CER but an increase of
      fluorescent products with time was observed. CB was the main product up to 2 h
      post inoculation, then it decreased with concomitant increase of fluorescent
      SULF. In the myelin we did not observe differences in incorporation and
      transformation of fluorescent CER with time: CB was the main fluorescent product
      at all times studied. At 0.5 h post inoculation the fluorescence, observed by
      fluorescence microscope, was located in the cell lining the ventricles while
      after 24 h it appeared also in the paraventricular areas.

PMID- 1754032
TI  - Cerebral ischemia: changes in brain choline, acetylcholine, and other monoamines
      as related to energy metabolism.
AB  - The relationship of cerebral neurotransmitters acetylcholine (ACh), noradrenaline
      (NA), dopamine (DA), 5-hydroxytryptamine (5HT) to the energy state of the brain
      was examined in mice at various times following complete ischemia produced by
      decapitation, in gerbils submitted to transient global ischemia (10 min bilateral
      carotid artery occlusion, 5 or 30 min recirculation), and in rats 24 hr after
      irreversible microembolism. Ischemia caused significant reductions in brain
      monoamine concentrations. The alterations in NA, DA, and 5HT levels persisted
      during recirculation and were unrelated to energy restoration. They were
      accompanied by an increase in the concentrations of related metabolites,
      suggesting that synthesis was unable to compensate for the release of the
      transmitters at early post-ischemic time periods. As described for the
      catecholamines and 5HT, ischemia resulted in a significant decrease in ACh level,
      but recirculation was associated with a rapid increase in ACh concentration.
      Impaired synthesis and/or increased release of ACh can be responsible for the
      decrease in ACh concentration during ischemia. Early post-ischemic elevation of
      ACh may be related to the large increase in brain choline brought about by
      ischemia.

PMID- 1754033
TI  - Size and charge isomers of acetylcholinesterase in the cerebral cortex of young
      and aged rats.
AB  - Previous studies in this laboratory showed an age-related decline of
      acetylcholinesterase (AChE) activity in the cerebral cortex of rats. In the
      present study the age-related differences in enzymatic activity were evaluated in
      terms of individual molecular forms. Extracts containing total, soluble and
      membrane-bound AChE were analyzed both by ultracentrifugation in sucrose gradient
      and by non-denaturing gradient polyacrylamide gel electrophoresis. By
      ultracentrifugation two molecular forms, namely 10S and 4S (corresponding to
      tetrameric-G4 and monomeric-G1 forms, respectively) were separated in extracts of
      total and soluble AChE, while only 10S forms were present in extracts of membrane
      bound AChE. Electrophoresis of soluble AChE extracts revealed slowly- and fast
      migrating bands, grouped in two clusters of at least three bands each; membrane
      bound AChE contained only a single slowly-migrating band. Electrophoresis of the
      single forms isolated by ultracentrifugation showed that slowly- and fast
      migrating bands corresponded to G4 and G1 forms, respectively. Therefore, in
      soluble AChE no one-to-one relationship between charge- and size-isomers was
      observed; on the contrary, such relationship has been shown for membrane-bound
      AChE. This implies that soluble G4 forms and membrane-bound-G4 forms are
      electrophoretically different, being heterogeneous the former and homogeneous the
      latter. The age-related decline of total AChE, accompanied by a decrease of G4/G1
      ratio, depended mainly on a decrease of membrane-bound AChE while soluble AChE
      and its G4/G1 ratio was unchanged. The qualitative pattern of charge isomers was
      not modified by aging.

PMID- 1754034
TI  - The effect of medial forebrain bundle lesion on thyrotropin secretion in the rat.
AB  - The medial forebrain bundle (MFB) was partially lesioned with 6-hydroxydopamine
      (6-OHDA) in order to investigate the effect of deficient central noradrenergic
      regulation on thyrotropin (TSH) secretion in the rat. 6-OHDA injection into the
      MFB significantly reduced the noradrenaline (NA), dopamine (DA) and serotonin (5
      HT) content of the whole hypothalamus. NA and 5-HT concentrations were also
      significantly decreased in the paraventricular nucleus (PVN). The MFB lesion did
      not affect the clonidine (250 micrograms/kg, i.p.) induced stimulation of TSH
      release or the isoproterenol (1 mg/kg i.p.) induced decrease in TSH levels.
      Thyrotropin releasing hormone (TRH, 5 micrograms/kg i.v.) caused a similar
      significant stimulation of TSH secretion in lesioned and non-lesioned rats. The
      present results do not support the hypothesis that the blunted TSH response to
      TRH observed in depressed patients results from a deficiency in noradrenergic
      neurotransmission.

PMID- 1754035
TI  - Receptor-mediated supra-additive activation of guinea pig superior cervical
      ganglion adenylate cyclase: role of Mn2+ ions and calmodulin.
AB  - The effects of Mn2+ and calmodulin were studied on the basal and agonist
      modulated adenylate cyclase activity of the guinea pig superior cervical
      ganglion. The divalent cation strongly stimulates the basal and agonist-modulated
      enzyme in a concentration-dependent manner. Moreover, in the presence of Mn2+ the
      inhibitory effects of "high" GTP concentrations and of D-Ala2-Met-enkephalinamide
      on adenylate cyclase are eliminated, while the stimulation exerted by
      prostaglandin E2 and the supra-additive activation of the enzyme by the
      combination of the two drugs are unaffected. In EGTA-washed, calmodulin-depleted
      membrane preparations, Mn2+ still activates the cyclase but the enkephalin
      inhibition and the superactivation of the enzyme induced by the combination of
      opiate and prostaglandin are lost, both in the absence and in the presence of the
      cation. Reconstituting the depleted membranes with exogenous Ca2+/calmodulin
      fully restored the enzyme responsivity to the combination and, partially, to the
      enkephalin. The findings suggest the existence in the guinea pig superior
      cervical ganglion of both the calmodulin-sensitive and differently regulated
      calmodulin-insensitive adenylate cyclase.

PMID- 1754036
TI  - Dependence of the electrical activity of the hippocampus on the probability of
      reinforcement of an alimentary conditional stimulus.
AB  - The dynamics of the changes in the number of instrumental motor reactions and in
      the frequency of cardiac contractions and of the theta rhythm of the hippocampus
      during the replacement of constant reinforcement by various schedules of
      probabilistic reinforcement of an alimentary conditional stimulus were
      investigated in three dogs. At the 70 and 50% level of reinforcement, the
      instrumental reflex appeared in response to all of the presentations of the
      signal stimulus. The greatest decrease in the number of respondent reactions was
      observed at 5% probability. The pulse rate both in the intersignal period and
      during the receipt of an empty feeder depended on the probability of
      reinforcement employed and on the individual characteristics of the animals. The
      frequency of the theta rhythm in all of the dogs was highest at the 30% level;
      the lowest values were observed at the 5% level of reinforcement. The data
      obtained again attest to the complex genesis of emotional excitation, the
      magnitude of which depends both on the informational (indeterminacy) and on the
      motivational (the significance of the reinforcement) factors.

PMID- 1754037
TI  - Neurobiology of the integrative activity of the brain. Dynamics of the
      activational and inhibitory types of synchronization of cortical neurons during
      the realization of a defensive reflex and of internal inhibition.
AB  - An increase in synchronization of the activational type (coincidence of the
      presence of impulse activity), and a decrease of the inhibitory type (coincidence
      of both the presence and absence of impulse activity), in the operation of close
      lying neurons were observed in the visual and sensorimotor areas of the new
      cortex and in the hippocampus of wakeful non-immobilized rabbits in response to
      the combination of flashes of light with electrodermal stimulation (EDS) of the
      extremity. An increase in the synchronization of the neurons of the inhibitory
      type took place in the visual cortex in response to flashes against the
      background of the conditional inhibitor, i.e., continuous light, and changes in
      synchronization, similar to the effect of pain reinforcement but significantly
      weaker, appeared in the sensorimotor cortex and in the hippocampus. An increase
      in synchronicity of the activational type took place primarily in pairs of
      neurons with increase in the same direction in the frequency of impulse activity
      in response to a stimulus, and of the inhibitory type, took place with its
      decrease. In addition, both kinds of changes in synchronization appeared in a
      significant portion of the pairs of neurons with changes in the frequency of
      impulse activity of different directions.

PMID- 1754039
TI  - Change in behavior with the development of long-term sensitization of a defensive
      reflex in the edible snail.

PMID- 1754038
TI  - Influence of nembutal on the impulse activity of cells of embryonal nervous
      tissue transplanted into the rat brain.
AB  - The average frequency of the impulse activity of neurons of an allograft of
      embryonal cortex, in the brain of adult Wistar rats, under nembutal anesthesia
      was four times lower than in nonanesthetized animals; at the same time the
      variability of the activity of the cells of the graft, with respect to the
      frequency and pattern of impulse activity, decreased. As compared with the
      unanesthetized animals, half as many cells of the graft reacted to tactile
      stimulation of the contralateral hind extremity; the neuronal reactions to the
      stimulation of somatic receptors of the ipsilateral side of the body completely
      disappeared.

PMID- 1754040
TI  - A new pathway of the central nervous regulation of carbohydrate homeostasis.

PMID- 1754041
TI  - Metabolism of the sex steroids in the hypothalamus and its role in the
      neuroendocrine regulation of reproduction.

PMID- 1754042
TI  - Morphochemical features of the brain of rats genetically predisposed to
      catalepsy.

PMID- 1754043
TI  - Phenomena of motility in the sensory neuron of a spinal cord ganglion with
      stimulation of its peripheral receptors.

PMID- 1754044
TI  - Posttetanic and frequency potentiation in slices of rat olfactory cortex.
AB  - The electrical tetanization of the lateral olfactory tract at a frequency of
      30/sec for 15 sec elicited the development of posttetanic potentiation of
      populational EPSP and IPSP in surviving slices of rat olfactory cortex. The
      stimulation of the lateral olfactory tract by series of stimuli at a constant
      frequency of 10/sec and with intervals of 4-5 sec between series facilitates the
      emergence of the phenomenon of frequency potentiation. The data obtained indicate
      that such forms of functional plasticity as posttetanic and frequency
      potentiation are manifested in the pyriform cortex.

PMID- 1754045
TI  - Intracentral interstructural relationships in the process of kindling
      electrostimulations of the hippocampus.
AB  - The features of the development of hippocampal kindling as a function of
      intracentral interstructural relationships formed during electrostimulations has
      been studied in 13 rabbits by means of electrodes chronically implanted in the
      brain (cerebral cortex, hippocampi, amygdalar nuclei, rostral portions of the
      caudate nuclei). The interstructural relationships were evaluated on the basis of
      the expressivity of the epileptic activity in various structures of the brain and
      on the basis of its dependence on the activity in the primary pathological focus.
      It was shown that in the case of the formation in the primary hippocampal
      epileptic focus of the pathological determinant (as described by G.N.
      Kryzhanovskii), which determine the activity of other structures, the kindling
      syndrome develops rapidly. If, on the other hand, competitive suppressive
      influences predominate in the interrelationships between the primary and
      secondary epileptic foci, which was most strikingly manifested between the
      hippocampal epileptic foci, then the pathological determinant does not form in
      this region and the kindling syndrome does not develop.

PMID- 1754046
TI  - Effects of the electrostimulation of various areas of the dorsal motor nucleus of
      the vagus on the electrical activity of the stomach wall.
AB  - The effects of the stimulation of various segments of the dorsal motor nucleus of
      the vagus on the electrical activity of the wall of the pyloric region of the
      stomach were studied with the use of microelectrode techniques in acute
      experiments in cats. It was established that the maximal changes of the
      parameters of the electromyogram are recorded during the stimulation of the zone
      of the nucleus 0(-) +1.5 mm rostral to the obex.

PMID- 1754047
TI  - Role of the rapid neurogenic component and its constituents in the organization
      of effort hyperpnea.
AB  - An investigation of the role of the rapid neurogenic component and its
      constituents in the organization of effort hyperpnea was carried out in athletes
      during physical loads increasing stepwise. The contribution of the condition
      reflex constituent in the general ventilatory response increases after the
      subject became acquainted with the increase in the severity of the demands, while
      with the use of loads in randomized order, its magnitude was approximately
      identical. With an increase in the metabolic cost of the work, the contribution
      of the rapid neurogenic component to the overall magnitude of the effort
      hyperpnea progressively decreases. The tendency to increase in the rapid
      neurogenic component in experienced athletes is the consequence of adaptive
      change due to the condition reflex constituent.

PMID- 1754048
TI  - Errors in the differential diagnosis of various types of nonepileptic paroxysms
      in the initial period of their occurrence.

PMID- 1754049
TI  - Changes in cerebral blood flow and their correction in the interparoxysmal period
      of epilepsy.

PMID- 1754050
TI  - Of dreaming and wakefulness.
AB  - Following a set of studies concerning the intrinsic electrophysiology of
      mammalian central neurons in relation to global brain function, we reach the
      following conclusions: (i) the main difference between wakefulness and
      paradoxical sleep lies in the weight given to sensory afferents in cognitive
      images; (ii) otherwise, wakefulness and paradoxical sleep are fundamentally
      equivalent brain states probably subserved by an intrinsic thalamo-cortical loop.
      From this assumption, we conclude that wakefulness is an intrinsic functional
      realm, modulated by sensory parameters. In support of this hypothesis, we review
      morphological studies of the thalamocortical system, which indicate that only a
      minor part of its connectivity is devoted to the transfer of direct sensory
      input. Rather, most of the connectivity is geared to the generation of internal
      functional modes, which may, in principle, operate in the presence or absence of
      sensory activation. These considerations lead us to challenge the traditional
      Jamesian view of brain function according to which consciousness is generated as
      an exclusive by-product of sensory input. Instead, we argue that consciousness is
      fundamentally a closed-loop property, in which the ability of cells to be
      intrinsically active plays a central role. We further discuss the importance of
      spatial and temporal mapping in the elaboration of cognitive and perceptual
      constructs.

PMID- 1754051
TI  - The organization of serotonergic projections to cerebral cortex in primates:
      regional distribution of axon terminals.
AB  - Serotonergic axons are widely distributed in the primate forebrain and represent
      the most abundant ascending projection from the reticular formation.
      Immunocytochemical methods have been utilized to examine the density, laminar
      distribution and morphology of serotonergic axons in both primary projection
      (motor, somatosensory) and association areas (dorsolateral prefrontal, area 5) as
      well as in the hippocampus and in cingulate cortex of rhesus and cynomolgus
      macaques. Serotonergic axons are present in all areas of cortex examined, and all
      cortical layers receive serotonergic afferents. However, the intracortical
      distribution of serotonergic axon terminals is not uniform; rather, different
      regions of cortex exhibit dissimilarities in both the density and laminar
      distribution of serotonergic axons. Thus, there are local patterns of serotonin
      innervation that are characteristic of each cortical area. Highly diverse
      patterns of serotonin innervation are found in heterotypical areas of cortex;
      more subtle variations are present among homotypical areas. Two morphologic types
      of serotonergic axon terminals, fine and beaded, are present in all cortical
      areas, and they typically exhibit different laminar distributions: in most areas
      of neocortex, beaded axons predominate in layer I while fine axons predominate in
      layers II-VI. However, exceptions to this pattern were observed in primary visual
      cortex and in the hippocampal formation. The distinctive local patterns of
      serotonin innervation observed in this study indicate that raphe-cortical
      projections are likely to have differential influences on particular
      cytoarchitectonic areas of cerebral cortex in the primate. Moreover, the discrete
      laminar distribution of serotonin axons suggests that serotonergic projections
      selectively innervate particular neuronal elements in cerebral cortex. The
      present findings suggest that the two classes of serotonergic axons, fine and
      beaded, which have different patterns of termination, affect different sets of
      cortical neurons. In addition, these two serotonergic projections may be
      associated with different sets of serotonergic receptors and thus produce
      selective effects on cortical function.

PMID- 1754052
TI  - Functional connections of the rat medial cortex and basal forebrain: an in vivo
      intracellular study.
AB  - Projections between the medial cortex and basal forebrain in the rat were
      demonstrated by intracellular recordings and the anterograde tracer Phaseolus
      vulgaris leucoagglutinin. Direct projections between these areas were indicated
      by antidromic action potentials, short latency (less than 5 ms) orthodromic
      potentials, and labeled axon terminals in the basal forebrain subsequent to
      iontophoresis of Phaseolus vulgaris leucoagglutinin into posterior cingulate
      cortex. High proportions of antidromic action potentials were encountered in
      responsive cortical neurons (66%) and basal forebrain neurons (97%). Antidromic
      latencies recorded in the basal forebrain (less than 1.0 ms) revealed fast
      ascending projections; cortical neurons showed both fast and slow descending
      projections (latencies of 0.3-3.7 ms). Relatively few synaptic potentials (none
      in the diagonal band of Broca) and sparse labeling of axon terminals observed in
      the basal forebrain indicated that the ascending projections may be the more
      physiologically important or, at least, densest pathway. Polysynaptic feedforward
      pathways were suggested through long latency (greater than 20 ms) inhibitory and
      excitatory postsynaptic potentials, the former being the more common response.
      Candidate inhibitory neurons were identified in both cortex and basal forebrain.
      Possible monosynaptic (less than 5 ms) inhibitory postsynaptic and antidromic
      responses in these cells provided evidence that candidate inhibitory neurons
      participate in the reciprocal pathways.

PMID- 1754053
TI  - Effect of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine on the regional
      distribution of brain monoamines in the rhesus monkey.
AB  - In an attempt to define neurochemically the part played by 1-methyl-4-phenyl
      1,2,3,6-tetrahydropyridine (MPTP) as a potential Parkinson's disease-inducing
      neurotoxin, we measured the tissue concentrations of the monoamines dopamine,
      noradrenaline and serotonin in 45 brain regions in nine rhesus monkeys (Macaca
      mulatta) receiving repeated intramuscular injections of a total amount of 2.1-7.5
      mg/kg MPTP-HCl. Four monkeys treated with MPTP during a period of one to five
      weeks developed permanent Parkinsonism, and five animals receiving the neurotoxin
      during a period of two to seven months remained asymptomatic. We found that,
      compared with the distribution pattern established in the brain of seven normal
      (drug-free) rhesus monkeys, in the MPTP-treated monkeys none of the three major
      brain monoamine neuron systems was completely resistant to the neurotoxin. In
      addition, each brain monoamine had a characteristic regional pattern of MPTP
      induced changes. As expected, the most significant alterations were found within
      the nigrostriatal dopamine system, i.e. profound dopamine loss in caudate
      nucleus, putamen and substantia nigra. However, many extrastriatal regions of the
      subcortex and brainstem also suffered significant loss of dopamine, with the
      noradrenaline loss in the regionally subdivided brainstem being less widespread,
      and the serotonin levels least affected. Thus, in subcortex/brainstem the ranking
      order of sensitivity to MPTP was: dopamine greater than noradrenaline much
      greater than serotonin. In the cerebral (neo- and limbic) cortex, all three
      monoamine neuron systems suffered widespread statistically significant losses.
      The ranking order of MPTP sensitivity of the cortical monoamines was:
      noradrenaline greater than serotonin greater than dopamine. In the cerebellar
      cortex, dopamine and noradrenaline concentrations were significantly reduced,
      whereas the serotonin level remained unchanged. A remarkable observation was that
      many of the subcortical and cortical changes found in the symptomatic monkeys
      were also found in the asymptomatic animals. Our data are compatible with several
      possible mechanisms by which MPTP may have produced the observed patterns of
      monoamine loss in the brain of the rhesus monkey. Our study demonstrates that in
      the rhesus monkey MPTP mimicked, in addition to the profound striatal dopamine
      loss, some of the extrastriatal dopamine, noradrenaline and serotonin changes
      often seen in the brain of patients with idiopathic Parkinson's disease. However,
      using our treatment regimen, we have not been able to reproduce in the rhesus
      monkey the inter-regional pattern of striatal dopamine loss typical of idiopathic
      Parkinson's disease, i.e. a significantly greater loss of dopamine in the putamen
      compared with the caudate nucleus.

PMID- 1754054
TI  - Acetylcholine release in the rat hippocampus as measured by the microdialysis
      method correlates with motor activity and exhibits a diurnal variation.
AB  - Extracellular levels of acetylcholine were measured by the microdialysis method
      coupled to high performance liquid chromatography in the dorsal hippocampus of
      freely moving rats over a period of 24 h to examine whether the acetylcholine
      release in the hippocampus exhibited a diurnal variation. Spontaneous motor
      activity was simultaneously measured with an automatic animal activity monitor.
      The amount of acetylcholine collected per 20-min sample varied markedly, in a
      range from about 5 to 90 pmol. There appeared to be variations in the amount with
      a 2-4 h periodicity as well as an apparent diurnal periodicity. In all five rats
      studied, the overall mean value for the dark cycle (11.1-34.5, average 20.9
      pmol/20 min) was significantly greater than that for the light cycle (5.1-21.3,
      average 12.3 pmol/20 min), showing a 70% average increase. Cross-correlation
      analysis performed between the amount of acetylcholine and the motor activity
      count for the animal during the sampling revealed a significant positive
      correlation coefficient in four rats studied. The present study demonstrates for
      the first time that the acetylcholine release shows a diurnal variation.

PMID- 1754055
TI  - Transforming growth factor beta isoforms in the adult rat central and peripheral
      nervous system.
AB  - The distribution of transforming growth factor-beta isoforms 1, 2 and 3 and
      transforming growth factor-beta 2 and 3 mRNAs in adult rat central and peripheral
      nervous system was examined using Northern blotting and isoform specific
      antibodies for immunocytochemistry. Transforming growth factor-beta 2 and 3 mRNA
      were present in all brain areas including cerebral cortex, hippocampus, striatum,
      cerebellum and brainstem. In sciatic nerve, transforming growth factor-beta 3
      mRNA was highly expressed, but transforming growth factor-beta 2 mRNA was not
      detectable. Transforming growth factor-beta 1-like immunoreactivity was confined
      to meninges and choroid plexus in the brain and connective tissue in peripheral
      ganglia and nerves. Transforming growth factor-beta 2 and 3 immunoreactivity
      entirely overlapped and, in general, were found in large multipolar neurons.
      Highest densities of immunoreactive neuronal perikarya were present in spinal
      cord and brainstem motor nuclei, hypothalamus, amygdaloid complex, hippocampus
      and cerebral cortical layers II, III and V. Most thalamic nuclei, superior
      colliculi, periaqueductal gray and striatum were almost devoid of transforming
      growth factor-beta 2- and 3-immunoreactive neurons. Fibrous astrocytes in white
      matter areas were intensely immunostained. Most dorsal root ganglionic neurons,
      their satellite cells and Schwann cells in peripheral nerves were also labeled.
      Transforming growth factor-beta 2- and 3-immunoreactive neurons were localized in
      brain regions that have been shown to contain neurons synthesizing and/or storing
      basic fibroblast growth factor suggesting possible opposing or synergistic
      effects of these peptide growth factors. However, the precise functions of local
      synthesis and storage of the transforming growth factor-beta isoforms in the
      nervous system are as yet unknown.

PMID- 1754056
TI  - Acupuncture-evoked responses of subnucleus reticularis dorsalis neurons in the
      rat medulla.
AB  - Recordings were made from neurons in subnucleus reticularis dorsalis of the rat.
      Two populations of neurons could be distinguished: those with total nociceptive
      convergence which were driven by activating A delta- and C-fibers from any part
      of the body and those with partial nociceptive convergence which were driven by
      activating A delta-fibers from any part of the body or C-fibers from some, mainly
      contralateral, regions. The effects on subnucleus reticularis dorsalis neurons of
      manual acupuncture, performed by a traditional Chinese acupuncturist at the
      "Renzhong", "Sousanli", "Changqiang", and "Zusanli" acupoints and at a non
      acupoint next to "Zusanli", were studied. Acupuncture stimulation for 30 s at the
      acupoints or the non-acupoint strongly excited all the total nociceptive
      convergence neurons tested; these neurons responded with a discharge of rapid
      onset which was often followed by after-discharges lasting for approximately 30
      60 s. The majority but not all of the partial nociceptive convergence neurons
      responded to 30 s of acupuncture stimulation at the acupoints or the non
      acupoint. This was especially the case when the stimulus was applied to
      contralateral or midline parts of the body. The potency of acupuncture as a means
      of activating subnucleus reticularis dorsalis neurons varied significantly with
      the area of the body being stimulated such that: contralateral greater than
      midline greater than ipsilateral areas. The levels of induced activity were of
      similar magnitude to those evoked by noxious mechanical stimuli applied under
      identical experimental conditions. No differences were found between the
      capacities to activate subnucleus reticularis dorsalis neurons of the "Zusanli"
      point and the adjacent non-acupoint, no matter whether these were stimulated ipsi
      or contralaterally; this suggests a lack of topographical specificity in the
      activation of these neurons. Since subnucleus reticularis dorsalis neurons are
      activated exclusively or preferentially by noxious inputs, it is concluded that
      the signals elicited by manual acupuncture travel through pathways responsible
      for the transmission of nociceptive information. Since acupuncture, a manoeuvre
      which is known to elicit widespread extrasegmental antinociceptive effects,
      activates subnucleus reticularis dorsalis neurons which, anatomically, send dense
      projections to the dorsal horn at all levels of the spinal cord, we would suggest
      that this structure may be involved not only in signalling pain but also in
      modulating pain by means of spino-reticulo-spinal feed-back mechanisms.

PMID- 1754057
TI  - Immunohistochemical evidence that acetylcholine and glycine exist in different
      populations of GABAergic neurons in lamina III of rat spinal dorsal horn.
AB  - Pre-embedding immunohistochemistry with monoclonal antibody to choline
      acetyltransferase was combined with post-embedding immunohistochemistry with
      antisera to GABA and glycine in order to study the pattern of coexistence of
      GABA, glycine and acetylcholine in neurons in lamina III of rat spinal dorsal
      horn. Of 50 neurons which were choline acetyltransferase immunoreactive, 47
      showed GABA-like immunoreactivity and none were immunoreactive with antiserum to
      glycine, despite the fact that glycine is thought to be present in the majority
      of GABAergic neurons in lamina III. This suggests that while acetylcholine and
      glycine can both coexist with GABA in lamina III neurons, they are present in
      different populations of GABAergic cells. Taken together with recent
      ultrastructural evidence concerning the synaptic connections of glycinergic and
      cholinergic structures in the dorsal horn, this suggests that there are
      functional differences between neurons which contain GABA and glycine and those
      which contain GABA and acetylcholine.

PMID- 1754058
TI  - Synaptic efficacy of inhibitory synapses in the reinnervating hypoglossal
      motoneurons.
AB  - The synaptic efficacy of inhibitory synapses in tongue protruder motoneurons
      reinnervating the tongue retractor muscle was studied in cats. We have
      demonstrated that the percentage magnitude of a short- and a long-lasting
      inhibitory postsynaptic potential in the inhibitory postsynaptic potentials
      produced in the tongue protruder motoneurons, whose axons had been cut but
      allowed to regenerate to make functional contact with the tongue retractor
      muscles, by lingual nerve or inferior alveolar nerve stimulation, was rearranged
      to appear like that exhibited by the tongue retractor motoneurons that normally
      supply that muscle. In addition, the peak amplitude of the summated
      afterhyperpolarization in a tongue protruder motoneuron on operated cats at nine
      months axon-union was in the normal range.

PMID- 1754059
TI  - Monoamine oxidase B in brains from patients with Alzheimer's disease: a
      biochemical and autoradiographical study.
AB  - In vitro quantitative autoradiography using [3H]L-deprenyl, an irreversible and
      preferential inhibitor of monoamine oxidase B, was performed to investigate the
      localization of the enzyme in brains from senile dementia of Alzheimer type and
      control cases. Brains from three male patients with the clinical diagnosis of
      senile dementia of Alzheimer type and from three male control patients, without
      any known clinical history of neurological disorder, were obtained at autopsy.
      Cryosections of 100 microns thickness were mounted on gelatinized glass plates
      and dried over desiccant for one week at -20 degrees C. The sections were
      incubated with 10 nM [3H]L-deprenyl for 1 h and then exposed to film for four
      weeks. The autoradiographs were analysed by computer-assisted densitometry.
      Monoamine oxidase-B activities were also estimated in 1% homogenates from 10
      different regions, using 10 microM beta-[ethyl-14C]phenylethylamine, in order to
      study the consonance between the autoradiographical and biochemical techniques.
      Both [3H]L-deprenyl binding and monoamine oxidase-B activities in senile dementia
      of Alzheimer type were higher than in the controls in all brain regions studied.
      The increase was highest in the white matter (about 70%) and in the order of 20
      50% in the various gray matter regions. A high correlation coefficient (r
      approximately 0.9) was obtained between [3H]L-deprenyl binding and monoamine
      oxidase-B activity, both in the senile dementia of Alzheimer type and in the
      control brains.

PMID- 1754060
TI  - Distribution of intracerebrally injected dopamine as studied by a punch
      scintillation modeling technique.
AB  - Three-dimensional distribution gradients of intracerebrally injected tritiated
      dopamine were calculated on the basis of concentrations in multiple punch-samples
      from sequential sections of Macaca fascicularis brain tissue. The monkey was
      pretreated systemically with a monoamine oxidase inhibitor to retard elimination.
      Gradients were best fit by cubic exponential equations relating concentration to
      distance from the center of the site. The concentration at the center, total
      amount of label, and total extent of the site injected just before perfusion were
      consistent with initial distribution in the extracellular space, if the volume
      fraction of the latter is estimated at 20%. The extent of distribution was
      distinctly greater in the mediolateral and dorsoventral dimensions than in the
      anteroposterior dimension. The total amount of label near the site decreased
      rapidly in the first few minutes after injection, then much more slowly, reaching
      about 30% of the injected amount after 2 h. Its distribution within the site
      changed steadily, the outer boundary gradually expanding and the peak at the
      center gradually decreasing. This pattern was consistent with an initial rapid
      dispersion by injection pressure and an initial loss of tritiated dopamine due to
      disruption of the blood-brain barrier at the center of the site, followed by a
      steady expansion of the site driven by diffusion and bulk flow.

PMID- 1754061
TI  - Striatal neurons express increased level of dopamine D2 receptor mRNA in response
      to haloperidol treatment: a quantitative in situ hybridization study.
AB  - In the present study, quantitative in situ hybridization was used to analyse the
      effect of haloperidol treatment on D2 dopamine receptor gene expression in the
      rat caudate-putamen nucleus. Variations of D2 receptor mRNA level were studied
      and measured at the macroscopic level of densitometric analysis of X-ray film and
      at the microscopic level by counting of autoradiographic silver grains in
      striatal cells. Macroscopic analysis demonstrated that haloperidol treatment two
      times 1 mg/kg per day during seven, 14 and 21 days increased D2 receptor mRNA
      level in the caudate-putamen. Detailed microscopic analysis demonstrated a
      significant increase in D2 receptor mRNA in the two neuronal populations known to
      express the D2 receptor gene: medium-sized neurons previously identified as
      enkephalinergic neurons, and large-sized neurons previously identified as
      cholinergic neurons. The increase was more important in cholinergic neurons
      (+119%) than in enkephalinergic neurons (+54%). Haloperidol treatment did not
      modify the number of medium-sized enkephalinergic neurons expressing the D2
      receptor mRNA. In contrast, it significantly increased the percentage of large
      sized neurons containing D2 receptor mRNA (from 80 to 94%). These results
      demonstrate that haloperidol treatment acts at the gene level to modulate D2
      receptor content in striatal dopaminoceptive neurons, and that the D2 receptor
      mRNA increase in postsynaptic neurons contributes to dopamine supersensitivity
      induced by neuroleptics in the rat. This suggests that dopamine acts trans
      synaptically to control D2 receptor gene expression in target striatal neurons.
      These results suggest that modifications of D2 receptor gene expression may be
      part of the biological events that lead to the movement disorders induced by
      neuroleptic drugs or Parkinson's disease.

PMID- 1754062
TI  - Peripheral projections of the chick primary sensory neurons expressing gamma
      aminobutyric acid immunoreactivity.
AB  - The expression of gamma-aminobutyric acid was studied in sensory neurons and
      peripheral target tissues of the chick dorsal root ganglia by combining
      immunocytochemistry and electron microscopy. In the chick embryos, the first
      immunoreaction was observed at embryonic day 12 in 1.4% of ganglion cell bodies.
      The intensity of immunostaining gradually increased during development and the
      percentage of immunostained neurons reached an average of 7.3% after hatching.
      These immunostained cell bodies could be identified as sensory neurons belonging
      either to some large neurons of the A1 subclass or to a few small neurons of the
      B1 subclass. The other neuronal cell bodies, corresponding to the A2 and B2
      subclasses, as well as the satellite and glial cells were apparently devoid of
      any gamma-aminobutyric acid immunostaining. Among the peripheral tissues
      innervated by the primary sensory neurons, the nerve endings of Achilles' tendon
      and the paravertebral autonomic ganglia appeared devoid of immunoreactivity. In
      contrast, immunoreactivity was found within nerve endings located in some
      neuromuscular spindles of the skeletal muscles and within some Herbst's
      corpuscles in the subcutaneous tissue of the skin. Thus, the present results
      provide evidence that gamma-aminobutyric acid may be expressed by neuronal cell
      bodies belonging to two subclasses of primary sensory neurons and could be a
      putative neurotransmitter involved in the peripheral sensory innervation of, at
      least in part, skin and skeletal muscles.

PMID- 1754063
TI  - Thrombin indirectly affects cholinergic cell expression in primary septal cell
      cultures in a manner distinct from nerve growth factor.
AB  - The effects of thrombin were examined in primary cultures of dissociated medial
      septal cells from fetal (embryonic day 17) rat brains. Seven days of continuous
      exposure of these cultures to thrombin produced a dose-dependent increase in the
      activity of the enzyme choline acetyltransferase (EC 2.3.1.6) and no change in
      the number of acetylcholinesterase (EC 3.1.1.7)-positive cells. Maximal induction
      of choline acetyltransferase activity occurred around 1-2 nM thrombin and was
      first detected after five days of treatment. In addition, thrombin promoted
      neuronal cell aggregation, proliferation of the astroglia, and changes in
      astroglial cell morphology. Neuronal aggregation was first noted after 24 h of
      treatment, while the proliferative response of the astroglia was first apparent
      after four days of treatment, slightly prior to the increase in choline
      acetyltransferase enzymatic activity. In order to see if the induction of the
      enzyme choline acetyltransferase was dependent upon the astroglial cell response,
      we included the anti-mitotic agent 5-fluoro-2'-deoxyuridine, to find that
      astrocyte proliferation, as well as thrombin-induced increase in choline
      acetyltransferase, were both abolished. In contrast, the aggregation of neurons
      was not affected. Finally, thrombin-induced changes in choline acetyltransferase
      could not be antagonized by immunoneutralizing anti-nerve growth factor
      antibodies and when thrombin was added simultaneously with 100 ng/ml 2.5-S nerve
      growth factor, the increase in choline acetyltransferase activity was additive.
      In conclusion, it appears that thrombin affects cholinergic septal neurons
      indirectly via the responsive astrocytes in a manner distinct from nerve growth
      factor.

PMID- 1754064
TI  - The emergence of electroreceptor organs in regenerating fish skin and concurrent
      changes in their transduction properties.
AB  - The process of regeneration of skin patch denervated empullary electroreceptor
      organs of the African catfish Clarias gariepinus has been investigated at an
      ambient temperature of 28 degrees C with both electrophysiological and
      histological methods. At day 1 after denervation none of the receptor organs on
      the skin patch showed afferent activity. At this stage none of the ampullary
      organs previously recorded showed a normal appearance. Degenerative changes
      consisted of a decreased number of receptor cells and an often invisible lumen.
      At day 7 regeneration seems to start with a high density of primordial ampullary
      organs, more than a seven-fold increase compared to controls. In these units, the
      level of spontaneous activity is very low: compared to controls, more than a two
      fold increase in mean interspike interval. At this stage, the sensitivity to
      electrical stimuli is already at the level of untreated control organs. At day 15
      there is a lower, i.e. approximately normal, density of ampullary organs with a
      normal morphology. In these units both spontaneous firing and sensitivity
      returned to normal. It can be concluded that the functional dichotomy between
      spontaneous firing and sensitivity that was found in degenerating ampullary
      electroreceptor organs is also found during the process of their regeneration,
      although the underlying cellular changes may be totally different. The speed of
      recovery suggests that only regeneration of the distal part of the sectioned
      nerve fibers takes place.

PMID- 1754065
TI  - Prostaglandin E2 changes in the retina and optic nerve of an eye with injured
      optic nerve.
AB  - Changes in arachidonic acid metabolism were studied in the optic nerve, the
      chorioretina, and in the vitreous following crush injury to the optic nerve of
      rats. Crush injury led to: (i) a 3.9-fold increase in optic nerve prostaglandin
      type E2 in vitro production which peaked on day 5 and was followed by a gradual
      decline, but was still significantly higher than baseline levels by day 12; (ii)
      a two-fold increase in the chorioretina prostaglandin type E2 in vitro production
      which peaked on day 1, and resumed baseline levels by day 3; (iii) a 3.5-fold
      increase in vitreous prostaglandin type E2 levels on day 1 which remained at 1.5
      2 times higher than baseline levels for the rest of the study period (12 days).
      The findings indicate that the pattern of changes in prostaglandin type E2
      production by the optic nerve (consisting mostly of white matter) is different
      from that described for injured brain tissues. The prolonged accumulation of
      vitreal prostaglandin type E2 in eyes with damaged optic nerve may lead to
      undesirable effects on the retina beyond those directly manifested in the retina
      by altered axonal flow in the injured optic nerve.

PMID- 1754066
TI  - Immunohistochemical and ultrastructural studies of the various nuclei of the
      trigeminal complex in the human newborn.
AB  - The various nuclei of the trigeminal complex were studied by immunohistochemical
      (enkephalin localization) and ultrastructural means in the brainstems of eight
      newborn human babies that died within 24 h after birth. Positive enkephalin
      neurons were detected in the chief sensory and spinal trigeminal nuclei as well
      as in some fibers of the trigeminal nerve. Ultrastructurally, two morphologically
      distinct types of neuron were observed, respectively, in the motor nucleus, the
      spinal nucleus and the mesencephalic nucleus of the trigeminal complex, whereas
      three morphologically distinct types of neuron were observed in the chief sensory
      nucleus. "Glomerulus" formation was a frequently observed feature in the chief
      sensory nucleus. In the spinal nucleus, rolls of synaptic terminals stacking up
      one on top of another and synapsing onto the final synaptic element were very
      much in evidence. Axosomatic, axodendritic, dendrodendritic and dendroaxonic
      synapses were demonstrated in all the different nuclear areas of the trigeminal
      complex but axoaxonic synapses were absent in the mesencephalic nucleus. Some of
      the findings in the present human study were similar to those reported in the
      rats and cats.

PMID- 1754067
TI  - Microtubule-associated protein-2 and neurofilament immunoreactivity in neurons
      and small, intensely fluorescent cells of an amphibian cardiac ganglion.
AB  - The localization of two cytoskeletal proteins was analysed in the cell bodies and
      processes of ganglionic neurons and small, intensely fluorescent cells of the
      parasympathetic cardiac ganglion of Necturus maculosus (mudpuppy). Antibodies
      against microtubule-associated protein-2 and against the highly phosphorylated
      isoforms of high and middle molecular weight neurofilament subunits were used as
      somatodendritic and axonal markers, respectively. The ganglionic neurons, which
      usually have only one major process, and small, intensely fluorescent cells,
      which have several processes, showed distinctly different staining patterns with
      the two antibodies. In control and denervated ganglia, the ganglionic cell bodies
      and several hundred micrometers of the proximal processes were labeled with the
      antibody against microtubule-associated protein-2, whereas small, intensely
      fluorescent cells and processes showed a paucity of immunoreactivity. The
      neurofilament antibody labeled numerous axons in the ganglion but did not label
      the proximal part of the postganglionic process or small, intensely fluorescent
      cell processes. Denervation resulted in the presence of phosphorylated
      neurofilament subunit immunoreactivity in the soma and proximal process of the
      ganglionic neuron. These data suggest that (i) small, intensely fluorescent cells
      and ganglionic neurons in the mudpuppy cardiac ganglion contain distinctly
      different cytoskeletal proteins, (ii) the proximal part of postganglionic "axons"
      contains dendrite-like and not axon-like cytoskeletal proteins, and (iii)
      deafferentation promotes the localization of phosphorylated forms of
      neurofilament subunits in the soma and proximal process of parasympathetic
      ganglionic neurons.

PMID- 1754068
TI  - Immunocytochemical localization of N-acetyl-aspartate with monoclonal antibodies.
AB  - N-Acetyl-aspartate is found in high concentrations in all areas of the brain, but
      is undetectable in non-neuronal tissue. In order to characterize the cellular
      localization of N-acetyl-aspartate in brain, highly specific monoclonal
      antibodies against N-acetyl-aspartate were produced by fusing spleen lymphocytes
      obtained from mice immunized with N-acetyl-aspartate conjugated to thyroglobulin
      by carbodiimide with P3/x63-Ag8.653 mouse myeloma cells. Clones were selected
      which secrete IgG2a(k) antibodies highly specific for conjugated N-acetyl
      aspartate. Only 3-6% cross-reactivity with conjugated N-acetyl-aspartate
      glutamate was observed at high antibody concentrations, whereas no cross
      reactivity (less than 1%) was observed with conjugated N-acetyl-glutamate or
      aspartate. Preincubation of the antibodies with 0.5 mg/ml conjugated N-acetyl
      aspartate blocked immunoreactivity more than 90%, while preincubation with
      conjugated N-acetyl-aspartate-glutamate and free N-acetyl-aspartate had no
      effect. Immunocytochemical staining has shown that N-acetyl-aspartate-like
      immunoreactivity is localized in neurons, which are widely distributed throughout
      the brain. The immunoreactive neurons exhibited intense staining of the
      perikarya, proximal dendrites and axons. No consistent pattern of distribution of
      immunoreactivity was observed with regard to primary neurotransmitter
      characteristics of stained neurons although neurons with long projections or
      extensive arbors, such as pyramidal cells in cortex, locus coeruleus, motor
      neurons and Purkinje cells, stained much more intensively than local circuit
      neurons.

PMID- 1754069
TI  - Repeated electroconvulsive shock increases tachykinin and cholecystokinin mRNA
      expression in ventral periaqueductal gray.
AB  - The effect of repeated electroconvulsive shock (five shocks during 10 days) on
      preprocholecystokinin and preprotachykinin-A messenger RNA expression was studied
      in the mesencephalic periaqueductal gray and adjacent areas of rat using in situ
      hybridization histochemistry with specific oligonucleotide probes. An increased
      number of preprocholecystokinin and preprotachykinin-A messenger RNA
      hybridization positive neurons (+30% and +47%, respectively) in the Edinger
      Westphal nucleus was observed following repeated electroconvulsive shock. In
      addition, both preprocholecystokinin and preprotachykinin-A messenger RNA
      expression, measured as grain density over single neurons, was significantly
      increased (+37% and +45%, respectively). The results indicate that
      cholecystokinin- and substance P-containing neurons in the Edinger-Westphal
      nucleus are activated by repeated electroconvulsive shock, which may be related
      to the antidepressant and analgesic effects of electroconvulsive shock treatment.

PMID- 1754070
TI  - Dual determination of extracellular cholecystokinin and neurotensin fragments in
      rat forebrain: microdialysis combined with a sequential multiple antigen
      radioimmunoassay.
AB  - Microdialysis was combined with a highly sensitive sequential multiple antigen
      radioimmunoassay to simultaneously measure extracellular cholecystokinin and
      neurotensin fragments from discrete regions of the rat brain in vivo. The assay
      was conducted in 96-well plates and provided a limit of detection for both
      peptides of 0.1 fmol. Dialysis membranes composed of polyacrylonitrile, Cuprophan
      and polycarbonate were evaluated in vitro using both radiolabelled peptides and
      radioimmunoassay. Polycarbonate probes were implanted in the posterior medial
      nucleus accumbens-septum, medial caudate nucleus or medial prefrontal cortex of
      halothane-N2O-anaesthetized rats. Cholecystokinin immunoreactivity levels were
      generally above the assay detection limits (0.1-0.7 fmol) in 30-min samples from
      all three regions under basal conditions. Recovered basal amounts of neurotensin
      immunoreactivity were detectable in the nucleus accumbens-septum in approximately
      50% of experiments (0.1-0.2 fmol) but were not measured in the caudate nucleus or
      prefrontal cortex. In the nucleus accumbens-septum, a 10-min pulse of 200 mM K(+)
      containing artificial cerebrospinal fluid in the perfusion medium during a 30-min
      sampling period increased the recovered cholecystokinin and neurotensin
      immunoreactivity to 9.7 fmol +/- 1.9 S.E.M. and 5.8 +/- 1.6 S.E.M., respectively.
      A second stimulation following a 2.5-h interval produced similar elevations with
      S2:S1 ratios of 0.62 +/- 0.07 and 0.68 +/- 0.07 for cholecystokinin and
      neurotensin, respectively. In a separate series of experiments the second
      stimulation of both peptides was prevented by perfusion of a 10 mM EGTA
      containing medium. Similar results were obtained in the caudate nucleus for
      cholecystokinin, but K(+)-induced elevations in neurotensin immunoreactivity were
      much smaller (0.5 fmol) in this brain region and calcium dependency was not
      established. Sequential K+ stimulations at 50, 100 and 200 mM produced
      progressively greater increases in recovered cholecystokinin and neurotensin
      immunoreactivity from the nucleus accumbens-septum and of cholecystokinin
      immunoreactivity from the prefrontal cortex. No neurotensin immunoreactivity was
      detected in the prefrontal cortex following K+ stimulation. Large post mortem
      increases in the recovered amounts of cholecystokinin and neurotensin
      immunoreactivity were observed. This effect was significantly attenuated by EGTA
      although there was a large calcium-independent component of the cholecystokinin
      immunoreactivity. On reverse-phase high-performance liquid chromatography the
      major cholecystokinin-immunoreactive peak co-eluted with sulphated
      cholecystokinin octapeptide. Neurotensin-immunoreactive material co-eluted with
      neurotensin (1-13), neurotensin (1-12), neurotensin (1-11), neurotensin (1-10)
      and neurotensin (1-8). These results further demonstrate the potential of
      microdialysis for studying neuropeptide release and metabolism in vivo when
      combined with sufficiently sensitive assay procedures.

PMID- 1754071
TI  - [Arterio-jugular difference of oxygen and intracranial pressure in comatose, head
      injured patients. I. Technical aspects and complications].
AB  - The monitoring of the comatose head injured patients is based on the recording of
      several data; the intracranial pressure measurements (ICP), associated with the
      arterial pressure recording, gives a good estimate of the cerebral perfusion
      pressure (CPP) but further information about the cerebral perfusion are needed.
      Based on the assumption that the cerebral metabolic rate is kept constant strong
      relationships exist between the cerebral blood flow (CBF) and the arterovenous
      difference of oxygen (AVDO2). In order to obtain samples of cerebral venous blood
      a catheter must be inserted in the internal jugular vein (IJ) with the tip of the
      cannula reaching the superior jugular bulb. In 224 patients we measured the ICP
      trough ventricular or subdural catheters; invasive measurement of the arterial
      pressure was also carried on in all the patients. In 45 patients we measured the
      AVDO2 and we tested the safety and the reliability of the jugular vein
      cannulation. During the insertion of the jugular catheters a slight increase of
      ICP, without any clinical significance, was recorded; in two cases (on a total of
      45) accidental carotid puncture occurred. In 9 cases we tested the concordance of
      the oxygen content between the two IJs; looking at the mean values no statistical
      difference is detected between the two sides but in some cases relevant
      differences are recorded. In two cases we inserted the catheters more cranially,
      reaching a sinus of the cranial basis; the blood collected from these points
      carries less oxygen that the blood collected in the neck. The rate of infection
      in this series of ICP monitoring is very low (1.78%) and we had no bleeding at
      the moment of the insertion of the catheters. Since no significant complications
      related to the IJ cannulation were recorded we conclude that these techniques are
      safe and can be easily performed in the clinical setting. Further studies are
      required in order to investigate the clinical meaning of the differences in the
      IJs content of oxygen.

PMID- 1754072
TI  - [Arterio-jugular difference of oxygen and intracranial pressure in comatose, head
      injured patients. II. Clinical correlations].
AB  - The ICP monitoring is currently used in the treatment of the head injured
      patients in order to avoid dangerous increases of the pressure and critical
      reduction of cerebral perfusion pressure (CPP). The cerebral blood flow is
      dependent on the CPP and is kept constant, under normal circumstances, by
      autoregulation. When autoregulation is impaired or overwhelmed oxygen delivery
      becomes uncoupled to the metabolic needs of cerebral tissue: in such a condition
      the rate of oxygen extraction changes and the artero-jugular difference for O2
      (AVDO2) reflects this change. The AVDO2 can be used as an estimate of the CBF and
      can detect a situation of hyperemia (low AVDO2) or ischemia (high AVDO2). In 224
      comatose head injured patients the ICP was measured using ventricular or
      subarachnoid catheters: the CPP was continuously assessed and the outcome was
      evaluated six months after the trauma. In 45 patients the AVDO2 was studied and
      the data were corrected for a PaCO2 of 40 mmHg and investigated. The severity of
      the ICP is decisive for the prognosis and, accordingly, the number of times the
      CPP is below 60 mmHg plays a major role in the outcome. The mortality rate was
      21% for the patients without ICP greater than 20 mmHg and 54% for the patients
      with severe increases in ICP. The mean values of AVDO2 were low, ranging around
      4.6 vol%; only 4 patients showed some temporary evidence of ischemia, as assessed
      by an AVDO2 greater than 8 vol%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754073
TI  - [Hypomagnesemia and hypokalemia as risk factors of arrhythmia in acute phase
      myocardial infarction].
AB  - In a uniform group of 30 patients the A. have assessed the incidence of lower
      serum K+ and Mg++ concentrations on the probability of arrhythmias onset in the
      acute phase of myocardial infarction. The study shows that lower K+ and Mg++
      levels significantly influence only the onset of ventricular tachycardia and
      monofocal PVC.

PMID- 1754074
TI  - [Survival of 213 patients who recovered in resuscitation from cardiac arrest].
AB  - 213 patients who received in-hospital cardiopulmonary resuscitation (CPR) were
      studied over a period of five years (1985-89) to determine hospital and long-term
      survival. The following factors were evaluated in determining outcome: age, ECG
      on admission, clinical history, year, month, hour of admission. A 5-year survival
      table was complied for all discharged from hospital. The results showed that age,
      clinical history, month and hour of admission were not influencing factors;
      asystole as opposed to ventricular fibrillation was however associated with
      significantly higher in-hospital mortality (p less than 0.005). Hospital survival
      was 14.6% with an ascendant range from 1986 to 1989 (p less than 0.05); all the
      patients were discharged mentally unimpaired with over 50% surviving 1.5 years
      after discharge and 33% 5 years after. The study shows that the highest cause of
      cardiac arrest is ischaemic cardiopathy in male patients with an average age of
      60 years. Total neurological recovery after CPR was confirmed to be a determinant
      predictor factor of survival.

PMID- 1754075
TI  - [Anesthesiologic problems in excessive obesity].
AB  - Clinical problems to consider in excessive obesity are numerous. Careful
      preparation before surgery is indispensable to reduce complications during and
      after surgery. Choice of volatile anesthetic may be important for the good
      results of narcosis. In the reported case anesthetic management is considered in
      an obese patient who had undergone a gastric operation.

PMID- 1754076
TI  - [General balanced anesthesia and propofol in ablation of the arterioventricular
      junction].
AB  - The Authors compare the results of general balanced anaesthesia and propofol in
      the anaesthetic management of closed-chest ablation of A-V junction. The best
      results were obtained with propofol because of the lower incidence of
      cardiovascular complications. Therefore propofol is a suitable agent in the
      anaesthetic management of closed-chest ablation of the A-V junction.

PMID- 1754077
TI  - [Propofol in single bolus for treatment of elevated intracranial hypertension].
AB  - Eleven patients with intracranial pressure (ICP) above 20 mmHg despite
      hyperventilation and neurosedation were treated with a bolus of propofol (1.5
      mg/kg) i.v. At baseline and 1-2-5-10-15-30-45 minutes after propofol
      administration we recorded the values of PIC, systolic arterial pressure (SAP)
      and mean arterial pressure (MAP), heart rate (HR) and cerebral perfusion pressure
      (CPP), calculated as MAP less PIC. In the first ten minutes after propofol we
      observed a statistically significant (p less than 0.05) decrease of ICP and SAP.
      MAP decreased in the first five minutes only. Consequently HR increased at the
      same time. CPP decreased in the first two minutes after administration of the
      drug, but without statistical evidence. We conclude that propofol, in our
      opinion, can be used to treat intracranial hypertension but the hemodynamic
      effects in hypovolemic patients must be taken into consideration.

PMID- 1754078
TI  - [Intraoperative radiotherapy: anesthesiologic problems during transport of
      patients].
AB  - In this study the condition of anesthesia in 8 patients, undergoing
      intraoperative radiation therapy (IORT) for pancreatic or rectal tumors, is
      evaluated. Patients with reapproximated surgical incision were transferred from
      the operating room to the radiotherapy department while still under anesthesia.
      The risks of such transport as well as guidelines for the patient's care during
      this phase are examined. The results of this study indicate that in order to move
      anesthetized patients safely it is necessary to ensure stable cardiovascular,
      respiratory and metabolic conditions prior to their transfer. It is also
      important to guarantee adequate analgesia and to establish appropriate monitoring
      during transport.

PMID- 1754079
TI  - [Use of buprenorphine after right hepatectomy].
AB  - Ten patients who underwent surgery (5 right hepatectomy and 5 colectomy) for
      cancer participated in a clinical controlled study. They were treated with
      buprenorphine (i.v. slow infusion) to relieve postsurgical pain. We found an
      increased urinary excretion of this drug in patients who underwent hepatectomy as
      compared with patients who underwent colectomy. However no differences in the
      occurrence of side-effects and/or in the therapeutic effect were observed between
      the two groups. We conclude that buprenorphine can be effectively and safely used
      also in patients with a resection of liver parenchyma.

PMID- 1754080
TI  - [Recovery after serious mushroom poisoning (grade IV encephalopathy) with
      intensive care support and without liver transplantation. Clinical case].
AB  - Despite consistent improvement in its treatment, amatoxin poisoning still extolls
      an elevated overall mortality, ranging between 10 and 15%, which approaches 100%
      when severe (grade 3-4 encephalopathy) hepatic failure supervened. Therefore, the
      proper treatment of intoxication by amatoxin containing mushrooms, and
      particularly of its complications, remains a challenge in emergency medicine.
      Klein and coworkers reviewed the role of liver transplantation in amatoxin
      poisoning as a useful therapeutic tool for patients with severe impairment of
      liver function. Their indication for intervention is the presence of any of the
      following signs: grade 2 encephalopathy or higher; prothrombin time twice than
      normal, despite fresh frozen plasma infusion; hypoglycemia requiring hypertonic
      glucose infusion; hyperbilirubinemia (greater than 25 mg/dl). During the past
      autumn two patients with fulminant hepatic failure due to amatoxin poisoning were
      referred to our institutions as candidates for liver transplantation, since both
      satisfied Klein's criteria. However, due to shortage of organ donors it was
      impossible to transplant them over the following days. Despite they did not
      receive liver transplantation, both patients wakened from coma, their liver
      function improved, and they recovered from terminal amatoxin poisoning. After one
      year, both patients are long-term survivors, in good health and without any
      sequelae either in brain or liver function.

PMID- 1754081
TI  - [The length of pre- and postoperative surgical stays. The role of factors
      relative to the patient, to the type of intervention and to hospital services].
AB  - The one-year most important and frequent surgical procedures performed in eight
      surgical departments of a large Italian general hospital were studied in order to
      describe the determinants of pre-, postoperative and total length of stay. The
      average length of stay (ALS) for the 724 hospitalized cases was 18.1 days (7.9
      preoperative and 10.2 postoperative), with large variations in the preoperative
      ALS across the departments. Multiple regression analysis showed that total ALS
      was positively associated with age, type of surgical procedure and department of
      admission. Preoperative ALS was longer in intervention on colon (12 days) and
      stomach (11 days) than in saphenectomies (8 days) and in appendectomies (4 days).
      The degree of access to operating rooms was associated to preoperative ALS, while
      the type of intervention and age to postoperative ALS. ALS was reduced by the
      urgency of the case, the availability of diagnostic facilities in the department
      of admission and the patient's condition of student. Hospital's structure and
      organization need to be modified in order to reduce preoperative length of stay.
      The easier access of older patients to long-stay hospitals or home care would
      reduce postoperative length of stay.

PMID- 1754082
TI  - [Neoplasms of the major and minor salivary glands. The diagnostic and therapeutic
      approaches and case presentations].
AB  - Between January 1982 and December 1988, 37 patients with neoplasm of salivary
      glands have been treated in our Division of Surgical Oncology. The sites of
      tumors were: parotid 26, submandibular gland 4, minor salivary gland 7. The
      preoperative diagnostic procedures were: sialogram, ultrasonogram, fine needle
      aspiration. Malignant tumors were 16:5 adenoca., 4 metastases, 3 adenoid cystic,
      2 mucoepidermoid, 1 acinic cells, 1 lymphoma. Twenty-one patients affected by
      neoplasms and 5 by malignant tumors were treated with surgery only. Nine patients
      affected by malignant tumors were treated with surgery and RT. Two patients were
      treated with RT only. The first therapeutic step is surgery; in order to control
      local evolution of tumor, postoperative irradiation is recommended. Possible
      indications of preoperative diagnostic procedures and the therapeutic choices are
      discussed.

PMID- 1754083
TI  - [Surgery by exeresis for gastric carcinoma. An analysis of 165 consecutive
      cases].
AB  - Surgery is still considered the best approach in gastric cancer. The aim of this
      study was to identify the most important factors involved in the determination of
      long-term survival. Total and subtotal gastrectomy were analysed. Long-term
      survival in these patients was strictly correlated with the stage of disease and
      the infiltration of resection margins. Early diagnosis is confirmed to be the
      most important factor in the long-term survival of these patients.

PMID- 1754084
TI  - [Colorectal carcinoma. A review of our cases].
AB  - A retrospective study was carried out on patients who underwent surgery for
      colorectal carcinoma between January 1980 and December 1987 in order identify
      additional prognostic factors. A total of 203 patients were studied. The
      probability of survival in relation to time and other variables (sex, age, stage
      of disease) was assessed using Cox's proportional method with the aid of an
      EPILOG III statistics pack. The overall 60-month survival rate was 55% and no
      difference was found between colon and rectum. The following factors were taken
      into account as prognostic markers: the site of the carcinoma (colon or rectum),
      sex, age, the tract of the colon involved (right, transverse, left and sigma
      colon) and the stage of disease. None of these parameters, with the exception of
      the stage of disease, were statistically significant. On the contrary, the
      division into stages of disease showed a statistically significant difference in
      the 60-month survival curve which fell from approximately 80% for stages A, B1,
      B2 and B3 to 50% for stage C and to 0% for stage D.

PMID- 1754085
TI  - [Echography in the diagnosis of breast cancer].
AB  - Fifty-one patients with clinically palpable breast cancer were examined using
      small-parts echotomography. The sensitivity, specificity, positive predictive
      value, negative predictive value and accuracy of overall diagnosis were assessed
      in the two groups of patients: T1 (diameter less than 2 cm) and T2-T3-T4
      (diameter greater than 2 cm). The frequency of the main echographic signs
      associated with breast cancer was also investigated. Diagnostic accuracy was
      found to be high in the T2-T3-T4 group (93%), but very low in the T1 group (71%).
      The study confirms the importance of ultrasound as an additional test in the
      study of breast cancer. However, this method becomes increasingly less sensitive
      and specific as the size of the tumour decreases.

PMID- 1754086
TI  - [Thyroid carcinoma as cystic nodule. The diagnostic role of cytology by needle
      aspiration].
AB  - 195 patients affected by a cystic thyroid lesion were studied by a Fine Needle
      Aspiration biopsy (FNAb). 42 patients were operated on account of clinical data,
      compressive phenomena or cytologic results suggesting a neoplasia. Out of the
      operated patients, 3 were affected by a carcinoma in the cystic lesion (one
      "pure" cystic nodule and two "mixed" ones), while three more patients with
      multinodular goiters showed a carcinomatous lesion in a nodule different from the
      cystic one. Macroscopic characteristics of the aspirated fluid (quantity and
      quality) didn't affect the cytologic diagnosis. Cytology was useful in the
      preoperative diagnosis of benign thyroid nodules (only two false positives out of
      42 patients) and was diagnostic in all the three patients affected by a carcinoma
      in the cystic nodule.

PMID- 1754087
TI  - [Disabling outcomes and psychological disorders in the patient with an
      enterostomy].
AB  - The authors carried out a retrospective study of patients undergoing enterostomy
      during the past 9 years. From 1981 to present a total of 60 patients (39 males
      and 21 females) were operated and subsequently followed-up. The aim of the study
      was to examine the following factors: the diagnosis which led to operation, the
      type of stoma used, early and late complications, the behaviour of the alvus,
      psychological disorders and Karnofsky's Performance-Status Index. After having
      presented the findings, the surgical results obtained are discussed together with
      the patient's psychological reactions to stoma. All types of early surgical
      complications were absent in 66.6% of patients, whereas late complications were
      absent in 41.6%. Even in those cases where surgical techniques and prostheses
      permitted a satisfactory post-operative outcome, the sociopsychological and
      sexual problems relating to the wound and the perceived difference between the
      real and ideal Ego are highlighted.

PMID- 1754088
TI  - [Leiomyosarcoma of the duodenum].
AB  - The paper reports the case of a patient with leiomyosarcoma of the duodenum who
      underwent radical duodenocephalopancreatectomy and survived for 22 months after
      the operation. Following a review of the international literature on the topic,
      the diagnostic procedures and prognostic criteria of this uncommon tumour are
      discussed. In conclusion, leiomyosarcoma always presents considerable problems of
      diagnosis even with the aid of biopsy and only surgery can lead to recovery in a
      limited number of cases.

PMID- 1754089
TI  - [Relevance and therapeutic implications of dysplasia in the follow-up of
      ulcerative rectocolitis].
AB  - Long standing ulcerative colitis (UC) is a condition capable of malignant
      transformation. Even if the rate of occurrence of carcinoma differs considerably
      among the various series, there is general agreement that it can be detectable in
      advance through the finding of glandular dysplasia. The Authors examine such a
      problem in a series of 27 patients submitted to clinical and endoscopic follow-up
      from 1984 to 1989. During this study a total of 237 rectosigmoidoscopies, 83
      colonoscopies and 71 histologic exams were performed. At the outset mild or
      moderate dysplasia was found in 5 cases (18%). However, in the follow-up no
      evidence of dysplasia was detectable in 4 of the 5 cases. In the remaining case
      dysplasia was present only in one control. It was not found in the subsequent two
      histologic examinations. In our limited experience the incidence of dysplasia was
      not significant enough to require a prophylactic proctocolectomy. Instead a
      frequent and thorough endoscopic follow-up is recommended.

PMID- 1754090
TI  - [Embolism of the superior mesenteric artery. A clinical experience].
AB  - The Authors report their clinical experience in superior mesenteric artery
      embolism: 10 arterial embolisms (71%) collected from a series of 14 obstructions
      of the superior mesenteric artery. The main interval from the beginning of the
      symptomatology to hospital admission was 48 h. Laparotomy was performed in all
      ten patients; gangrenous bowel was resected in 2 and 2 had an embolectomy of the
      superior mesenteric artery without intestinal resection. The remaining 6 patients
      had laparotomy alone and died. The Authors emphasize the difficulty in
      recognizing the disease at an early stage and suggest to contemplate in patients
      at risk with a persistent abdominal pain, the possibility of a superior
      mesenteric artery embolism.

PMID- 1754091
TI  - [Aneurysms of the abdominal aorta in elderly patients].
AB  - Aneurysms of the abdominal aorta are often diagnosed in the over-75s. Although
      for many Authors the presence of risk factors such as cardiopathies,
      cerebrovascular problems, renal or respiratory insufficiency, which are clearly
      more frequent in elderly patients, represent a contraindication to the
      intervention of choice, personal experience has shown that surgery remains the
      best solution. In fact, in a group of patients operated on for aneurysm of the
      abdominal aorta in a heart, no significant differences in age-related mortality
      were observed. Surgery therefore remains the treatment of choice in the elderly
      too for it must also be remembered that the natural history of the disease has
      shown that, in a comparatively short time, the aneurysm ruptures and operating
      mortality is markedly higher.

PMID- 1754092
TI  - [Thrombectomy of the infra- and suprarenal cava to prevent pulmonary embolism in
      the presence of deep venous thrombosis. Personal experience with 11 surgically
      treated cases].
AB  - DVT is a fairly frequent event and often fails to be recognised. Its main
      complication, pulmonary embolism, is the third cause of death in Italy with more
      than 70,000 deaths per annum. In the presence of infra- and suprarenal floating
      thrombi, cases in which the application of neither intraluminal nor extraluminal
      filters is indicated, the treatment of choice is thrombectomy with direct
      surgical access to the cava. Personal experience of 11 patients operated in the
      past 16 months with excellent surgical success is analysed. The indications and
      surgical techniques adopted are described.

PMID- 1754093
TI  - [Recovery after amputation for arteriosclerosis. Follow-up study].
AB  - Clinical follow-up of 71 patients subjected to major amputation of the lower
      extremities for atherosclerotic arteriopathy has been analysed for the purpose of
      ascertaining real possibilities of functional recovery and quality of life.
      Research results show that only a small number of patients (38%) can achieve an
      acceptable quality of life. The reasons have been identified in the objective
      difficulty of adequate physical and psychotherapeutic rehabilitation owing to
      structural shortcomings or the presence of associated pathology or the advance in
      the basic condition which does not permit application or frustrates results.

PMID- 1754094
TI  - [The role of galactography in the diagnosis of breast diseases. Our experience].
AB  - Following a description of the most common galactographic semeiotics in relation
      to the different types of secretion, the Authors report their personal experience
      in the use of galactography to diagnose breast cancer. Histopathological tests
      revealed the presence of carcinoma in 14 (29.2%) out of a total 48 galactographic
      examinations. In conclusion, the Authors underline the high degree of diagnostic
      precision of galactography, a test which contributes to the identification of a
      considerable number of carcinomas during the preclinical stage.

PMID- 1754095
TI  - [A new method of interpretation in the regulation of gastric secretion].

PMID- 1754096
TI  - [Transverse mesocolon herniation. Description of a clinical case].
AB  - A case of herniation of small bowel through a defect of the transverse meso-colon
      with secondary herniation through the gastrocolic ligament and re-entry into the
      greater peritoneal cavity is reported. This form of lesser sac hernia is rare and
      only one hundred half cases have been reported in literature.

PMID- 1754097
TI  - [Rare localization of a carcinoid tumor: the pancreas. A case report].
AB  - Pancreatic carcinoid tumors are very rare. A case of obstructive jaundice caused
      by a large mass of the head of the pancreas is described. The histological
      examination of the surgical specimen revealed a pancreatic carcinoid tumor. A
      brief, discussion of the main characteristics of this kind of tumor is performed
      by the Authors.

PMID- 1754098
TI  - [A rare case of ileo-ileal intussusception secondary to adenocarcinoma of the
      small intestine in a 21-year-old adult].

PMID- 1754099
TI  - [A case report of Castleman's disease in a patient with endometrioid
      adenocarcinoma of the ovary].
AB  - The Authors report a case of Castleman's disease in a 45-year-old woman. She was
      admitted to hospital because of a thrombophlebitis of the left lower limb. An
      abdominal echotomography showed evidence of a mass with a diameter of about 6 cm
      at the pancreatic isthmus, and a cyst (diameter 25 mm) in the right ovary. An
      explorative laparotomy was performed and the masses were removed. Histological
      examination identified them respectively as a Castleman's disease of hyaline
      vascular type and an endometrioid carcinoma of the ovary.

PMID- 1754100
TI  - [A case of small intestinal leiomyosarcoma].
AB  - The Authors report a case of leiomyosarcoma of the small bowel, a rare neoplasm
      with severe limitations of pre-operative diagnosis. A discussion of the
      pathological staging, diagnosis and surgical therapy follows. At the moment,
      better diagnostic techniques and greater awareness of the disease
      notwithstanding, the prognosis remains severe due to the presence of local or
      distant metastases at laparotomy.

PMID- 1754101
TI  - [Verrucous carcinoma of the penis. A case report and review of the literature].
AB  - The Authors report a case of a verrucous carcinoma of the penis. Among male
      malignant epithelial tumors the verrucous carcinoma represents a very rare form,
      with a typical oesophitic development, of vegetating sometimes ulcerated
      appearance, with slow evolution that rarely presents metastases. Although a
      therapeutic preservation approach is possible, a surgical operation is the
      treatment of choice.

PMID- 1754102
TI  - Type II diabetes mellitus: is the renal risk adequately appreciated?

PMID- 1754103
TI  - Tubular dysfunction in nephrotic syndrome: incidence and prognostic implications.
AB  - Although some cases of tubular dysfunction (TD) associated with nephrotic
      syndrome have been described, the incidence and the characteristics of this
      complication remain unknown. We investigated the presence of TD (renal
      glycosuria, aminoaciduria, metabolic acidosis with normal anion gap,
      hypouricaemia, and throughout hypophosphataemia) in 36 patients with nephrotic
      syndrome. Ten patients (group 1) showed glycosuria at some time during the course
      of their illness, ranging from 2.5 to 11.2 g/24 h. In addition, seven of them had
      metabolic acidosis with normal anion gap, five aminoaciduria, and two
      hypouricaemia. Membranous glomerulonephritis was the most frequent aetiology in
      group 1 patients (7 of 10). Proteinuria and serum creatinine (SCr) were
      significantly higher in group 1 patients than in the 26 remaining patients
      without TD (group 2): 10.2 +/- 3.7 versus 6.7 +/- 2.9 g/24 h (P less than 0.01)
      and 3.2 +/- 1.9 versus 1.6 +/- 0.9 mg/dl (P less than 0.05) respectively. The
      appearance of TD coincided with a clear worsening of renal function in most of
      group 1 patients. In addition, at the end of follow-up, SCr had increased from
      3.2 +/- 1.9 to 5.6 +/- 3.3 mg/dl (P less than 0.05) in this group. In contrast,
      SCr did not show significant changes in group 2 (1.6 +/- 0.9 versus 2.1 +/- 2.2
      mg/dl). In conclusion, a significant proportion (27.7%) of patients with
      nephrotic syndrome present TD data at some moment of their course; the appearance
      of this complication appears to be a sign of poor prognosis.

PMID- 1754104
TI  - Anti-neutrophil cytoplasmic antibodies and disease activity during long-term
      follow-up of 70 patients with systemic vasculitis.
AB  - Anti-neutrophil cytoplasmic antibodies (ANCA) have been identified as a
      diagnostic marker in primary systemic vasculitis, and immunofluorescence assays
      identify two patterns of binding: cytoplasmic (C-ANCA and perinuclear (P-ANCA).
      We have examined retrospectively the use of such assays in long-term monitoring
      of disease activity, in order to determine the relationship between presence of
      ANCA and relapse, and to assess their suitability as a guide to therapy. Seventy
      patients were studied over a period of 50 months, using clinical and laboratory
      criteria for the diagnosis of relapse and the internationally standardised
      immunofluorescence assay for detection of ANCA. In 19 patients C- or P-ANCA were
      detectable throughout the study period; six of these (with C-ANCA) relapsed. In
      18 patients ANCA were undetectable during long-term follow-up; none of these
      patients relapsed. In 33 patients C- or P-ANCA were intermittently present; nine
      of these relapsed and all had C-ANCA detectable at the time of relapse. In six of
      the nine cases, relapse was accompanied or closely preceded by reappearance of C
      ANCA. We conclude that continuing presence and reappearance of ANCA may identify
      patients who are at risk of relapse and who are most likely to benefit from long
      term immunosuppressive therapy.

PMID- 1754105
TI  - Heterogeneity of glutathione S-transferase isoenzyme expression in renal disease.
AB  - Recent work has suggested that glutathione S-transferase (GST) enzymuria may be
      used to assess renal injury in transplant kidneys. There is little work
      investigating the possibility of using glutathione S-transferase enzymuria to
      assess other renal diseases and this study was undertaken to evaluate the
      localisation of GST isoenzymes in various glomerular and tubular pathologies so
      that the specificity of these enzymes as markers of tubular injury could be
      defined. Immunostaining was carried out to establish the location of alpha and pi
      class GST in renal biopsies from patients with a wide variety of renal diseases
      including membranous glomerulonephritis, minimal-lesion glomerulonephritis,
      mesangial proliferative glomerulonephritis, loin pain haematuria syndrome, and
      renal allograft rejection. In the cases of glomerulonephritis studied, alpha
      class GST was detected in proximal tubules and pi class GST in distal convoluted
      tubules, podocytes, and Bowman's capsule. The majority of cases of
      glomerulonephritis showed a heterogeneous pattern of expression of both
      isoenzymes: that is, there was variation in intensity of staining both in single
      tubules and also between tubules as opposed to the uniform staining pattern
      observed in normal kidneys. The location of enzymes in the cases of
      glomerulonephritis was the same as that in normal kidneys and we were unable to
      demonstrate any de novo expression of GST isoenzymes. However, seven out of ten
      renal allograft biopsies showed expression of pi class GST in proximal tubules
      which were atrophic. Provided there is no significant tubular atrophy, urinary
      release of these enzymes may be used to localise renal tubular injury.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1754107
TI  - Pharmacokinetics of recombinant human erythropoietin in children with renal
      failure.
AB  - The single-dose pharmacokinetics of recombinant human erythropoietin (rHuEpo; 40
      units/kg1) were investigated in children (9-16 years) with end-stage renal
      failure. After an intravenous (i.v.) dose, serum rHuEpo concentrations declined
      in a monoexponential manner with a mean half-life (t1/2) of 5.6 +/- 3 h (+/- SEM;
      n = 9). Serum clearance and the apparent volume of distribution were estimated to
      be 10.1 +/- 0.9 ml h-1 kg-1 and 79.5 +/- 5.0 ml kg-1 (n = 9) respectively.
      Subcutaneous (s.c.) delivery resulted in serum values that peaked at 10 h, and
      thereafter concentrations declined slowly with a t1/2 of 21.1 +/- 4.5 h (n = 9).
      Serum rHuEpo concentrations were maximal at 14 h after i.p. administration and
      the t1/2 was 9.5 +/- 1.0 h (n = 3). The mean fraction absorbed of SC rHuEpo was
      0.40 whereas after i.p. administration this fraction was only 0.17. These results
      show that after both s.c. and i.p. delivery, disposition of the hormone is rate
      limited by absorption, and bioavailability for these extravascular routes is
      poor. In addition, comparison of the results with those available for adults
      indicates that rHuEpo is better absorbed but more rapidly cleared in children.

PMID- 1754106
TI  - Characterisation of the binding of low-density lipoproteins to cultured rat
      mesangial cells.
AB  - Mesangial cell lipid accumulation is a recognised feature of glomerular disease
      and has been implicated as a factor in the pathogenesis of renal injury. To
      investigate possible mechanisms of such accumulation, binding of 125I-labelled
      human low-density lipoprotein (LDL) to rat mesangial cells was studied in vitro.
      Experiments were performed at 4 degrees C to prevent ligand internalisation. LDL
      remained associated with the cells after repeated washing. Binding was time
      dependent, was inhibited by addition of an excess of unlabelled LDL, but to a
      much lesser extent by apoprotein-A-rich high-density lipoprotein particles devoid
      of apoprotein E (HDL-A). Specific binding reached saturation at an LDL
      concentration of 21 micrograms/ml, required the presence of calcium, and was
      inhibited by heparin and dextran sulphate. Scatchard analysis suggested a single
      class of binding site (Kd 22.7 micrograms protein/ml). Higher binding affinities
      were obtained when rat LDL was substituted for human LDL (Kd 1.3 micrograms/ml)
      and when human fibroblasts were exposed to human LDL under identical experimental
      conditions (Kd 3.0 micrograms/ml). Further experiments at 37 degrees C
      demonstrated degradation of LDL by cells. These results suggest that mesangial
      cells possess apoprotein B, E receptors. Mesangial cell lipid accumulation may
      therefore result from receptor-mediated endocytosis of LDL particles.

PMID- 1754108
TI  - Multicentric study on paired filtration dialysis as a short, highly efficient
      dialysis technique.
AB  - Paired filtration dialysis (two-chamber haemodiafiltration) was evaluated as a
      short, highly efficient renal replacement therapy in 35 uraemic subjects
      belonging to three different dialysis centres. The study period was 1 year.
      Patients were divided into two groups according to their body-weight and drinking
      habits. The smaller patients underwent 150-min dialysis sessions three times
      weekly. The larger patients underwent 3-h treatments thrice weekly. The treatment
      was adequate in all patients according to the KT/V criteria of adequacy. The
      intradialytic symptomatology was remarkably low and the treatments were well
      tolerated in all patients. The study confirms the reliability of paired
      filtration dialysis as a short dialysis technique. In some patients 150 min may
      be insufficient to achieve an adequate dialysis efficiency and 180 min may be
      required for the majority of the population.

PMID- 1754109
TI  - Post catheterisation vein stenosis in haemodialysis: comparative angiographic
      study of 50 subclavian and 50 internal jugular accesses.
AB  - From January 1986 to December 1990 we studied angiographically the subclavian
      brachiocephalic vein of 100 patients dialysed by subclavian catheter for 50
      (first group) and by internal jugular catheter for the 50 others (second group).
      These two groups were not statistically different as regards age (61.6 +/- 11.3
      years in the first and 61 +/- 11.1 in the second), sex (48% and 56% were women),
      duration of catheter insertion (31 +/- 21.8 and 31.7 +/- 16 days), and the number
      of dialysis sessions (13.5 +/- 9.1 and 13.6 +/- 7.1). The type of catheters, the
      frequency of removal for poor flow (16% in both groups) or infections (6% in both
      groups), and the local nursing were similar in the two groups. The only
      difference was the side of cannulation: the right side in 58% of cases in group 1
      and 78% in group 2. The angiographic study revealed a stenosis of the vein in 42%
      of the subclavian group and in 10% of the internal jugular group: a dramatic
      difference in favour of the internal jugular route, whose superiority over the
      subclavian route is asserted in respect of venous access of dialysed patients.

PMID- 1754110
TI  - Experience with a new method for percutaneous renal biopsy.
AB  - Between January 1989 and August 1990 a new technique for percutaneous renal
      biopsy was evaluated in all patients undergoing native kidney biopsy in our
      hospital. The method combines the use of an automated biopsy device, disposable
      biopsy needles, and a needle guide attached to an ultrasound probe. This allows
      real-time ultrasound scanning throughout the procedure. All biopsies were
      performed by trainee nephrologists. The success of the technique was evaluated by
      analysis of histopathological data, and the complications of the procedure from
      case-notes and nursing records. During the study 192 biopsies were attempted, of
      which 188 (97.8%) were successful. For each biopsy a mean of 2.8 needle passes
      were required and 75% of these obtained cores of tissue. An average of 25
      glomeruli (range 1-90) were seen per biopsy. Although microscopic haematuria was
      almost invariable, there were no episodes of frank haematuria and no blood
      transfusion or surgical intervention was required. The new method is simple,
      providing accurate localisation of the kidney coupled with direct visualisation
      of the biopsy, and results in a very high success rate. Intrarenal needle dwell
      time is kept to a minimum and there were only minor complications. This technique
      deserves more widespread use.

PMID- 1754111
TI  - Guyon's syndrome in a long-term haemodialysis patient.

PMID- 1754113
TI  - End-stage renal failure in Kartagener's syndrome.

PMID- 1754112
TI  - Visceral leishmaniasis: an unusual case of fever in a renal transplant recipient.

PMID- 1754114
TI  - False aneurysm of the thyrocervical trunk.

PMID- 1754115
TI  - On not getting stuck.

PMID- 1754116
TI  - Accreditation by NLN and AANA.

PMID- 1754117
TI  - Watchful eye needed for textbooks.

PMID- 1754118
TI  - AIDS: advocacy and activism.

PMID- 1754119
TI  - The sequence of curriculum change in gerontology. Faculty first.

PMID- 1754120
TI  - The nurse as advocate. Issues in LTC.
AB  - Patients and residents of nursing homes need advocates; otherwise they tend to
      fall through the cracks, says Mitty. What are the issues and the barricades to
      good and equitable care?

PMID- 1754121
TI  - Review of nursing literature. Evolution of gerontological education in nursing.
AB  - Gerontological nursing is a rapidly expanding component of nursing education,
      especially as our elderly population increases. Philipose, Tate, and Jacobs
      provide a useful assessment of the nursing literature on this topic.

PMID- 1754122
TI  - A national survey to identify evaluation criteria for programs of health care for
      homeless.
AB  - We know that programs to deliver health care to the homeless are springing up all
      over the nation, but are they effective? Hunter, Crosby, Ventura and Warkentin
      attempt to get a sense of what data is being collected. In doing so, they
      identify the difficulties in collecting data on this transient population.

PMID- 1754123
TI  - Hospice care for the living dead.

PMID- 1754124
TI  - Nurses who kill.

PMID- 1754125
TI  - A workable solution to test review.
AB  - The authors describe a test review procedure that provides immediate feedback for
      faculty and students. The review procedure is described and the benefits for
      students and faculty are discussed with specific examples. Methods for using
      information gained from the test review procedure are also suggested.

PMID- 1754126
TI  - Measuring affective factors in RN/BSN programs.
AB  - Assessment of affective outcomes is needed in nursing education. This study
      examined changes in professional attitudes in RN/BSN programs and the
      relationships between selected affective factors and professional attitudes.
      Implications for nursing education are identified relative to student
      advising/counseling and curriculum.

PMID- 1754127
TI  - A successful student experience with the well-elderly.

PMID- 1754128
TI  - Teaching strategies for critical thinking.
AB  - Critical thinking is a phase that is being heard frequently in nursing education.
      Nurse educators are encouraged to teach students to think critically because of
      the higher-order thinking skills that are required in our complex health care
      delivery system. The challenge to educators is the selection, development, and
      implementation of appropriate teaching strategies. This article describes a
      variety of strategies for teaching critical thinking within the context of
      nursing.

PMID- 1754129
TI  - Evaluating students' esthetic knowing.
AB  - Few references in education are made to evaluating students' performance in the
      art of nursing (esthetic knowing). To address this rarity, a client-based
      clinical evaluation modality was developed using clients as the "critics" of
      students' esthetic knowing. The findings suggest that having clients evaluate
      students' esthetic knowing is an appropriate evaluation modality and is
      especially important as empirically based cirricula shift to include esthetics as
      a central element.

PMID- 1754130
TI  - Nurses in medical education.

PMID- 1754131
TI  - Copyright law and the nursing professor.
AB  - The copyright law affects the resources that are available to faculty for
      educating students. The author discusses the concept of fair use in academe, the
      process for obtaining permission to copy materials that have been copyrighted,
      and the rights of the professor who has created works during employment. An
      application of the copyright law to the publication of students' papers is
      presented.

PMID- 1754132
TI  - Who's the boss? Editor-author relationships.

PMID- 1754133
TI  - An innovative collaborative model for RN-BSN education--the whys and hows.

PMID- 1754134
TI  - The consumer role in nursing education.

PMID- 1754136
TI  - Do nursing students need AIDS education?

PMID- 1754135
TI  - Evaluation of an integrated curriculum: the Waltz Model.

PMID- 1754137
TI  - A clinical learning experience in discharge planning.

PMID- 1754139
TI  - The Southeastern Doctoral Forum.

PMID- 1754138
TI  - The Parent-Child Council.

PMID- 1754140
TI  - Cheating and plagiarism.

PMID- 1754141
TI  - Student conflict management: before and after instruction.

PMID- 1754142
TI  - Health fairs bring wellness concepts to life.
AB  - Incorporated into the nursing curriculum, the health fair is a stimulating,
      unique, nontraditional educational project that examines effective health
      education tools, leadership skills, and interaction with the community. Students
      test theories and collaborate with other school disciplines while planning,
      implementing, and evaluating health education and health fair promotion. Health
      fairs help students to identify positive lifestyles and create opportunities to
      test the skills needed to improve the population's wellness level.

PMID- 1754143
TI  - Complementary therapies in nursing.

PMID- 1754144
TI  - Complementary health.

PMID- 1754145
TI  - Let me rub it better.

PMID- 1754146
TI  - Rising to the challenge.

PMID- 1754147
TI  - Preventing surgical wound infection.

PMID- 1754149
TI  - A chance for unity.

PMID- 1754148
TI  - Learning at Liverpool.

PMID- 1754150
TI  - Keeping the workers happy.

PMID- 1754151
TI  - Where is thy sting?

PMID- 1754152
TI  - The alternative approach.

PMID- 1754153
TI  - Imaging inflammation with radiolabelled white cells: 99Tcm-HMPAO or 111In?

PMID- 1754154
TI  - Semi-quantitative analysis of SPECT with the iodinated fatty acid 15-(ortho-123I
      phenyl)-pentadecanoic acid.
AB  - 15-(ortho-123I-phenyl)-pentadecanoic acid (oPPA) in contrast to the para-isomer
      pPPA has a prolonged retention in the normal human myocardium. Following
      qualitative evaluation, a semi-quantitative analysis of oPPA-SPECT is presented
      in 52 patients (41 with coronary artery disease (CAD) and 11 normals). Data were
      compared to the results of coronary angiography (CAD patients). Up to 220 MBq
      123I-labelled oPPA were injected intravenously after overnight fasting and
      bicycle exercise. Four minutes later SPECT acquisition (180 degrees technique)
      was started. In 15 patients a second dose of oPPA was injected 2.5 h later and
      the study was repeated under rest conditions. Compared to our qualitative
      analysis the semi-quantitative approach revealed a lower sensitivity of 76% for
      the detection of CAD (global, stenoses greater than 50%) (specificity was not
      analysed because the normal patients served as the control group for the
      calculation of normal values). Because the sensitivity does not exceed that of
      201Tl-SPECT or MIBI-SPECT, oPPA is not recommended for the detection of CAD, but
      it may serve for the evaluation of myocardial viability in ischaemic regions.

PMID- 1754155
TI  - Comparison of 99Tcm-HMPAO-labelled white blood cells and 67Ga citrate scans to
      detect myocarditis in the acute phase of Kawasaki disease.
AB  - Myocardial imaging with 99Tcm-HMPAO-labelled white blood cells (WBC) and 67Ga
      citrate was used to detect myocarditis in the acute phase of Kawasaki disease
      among 22 infants and children; 18 cases of myocarditis were detected by 99Tcm
      HMPAO-labelled WBC heart scans, but only one case was detected by 67Ga citrate
      heart scans. In conclusion, 99Tcm-HMPAO-labelled WBC scanning provides a more
      sensitive method than 67Ga citrate scanning in the detection of myocarditis in
      Kawasaki disease.

PMID- 1754156
TI  - Changes in arterial oxygen saturation during isotope perfusion scans using human
      macroaggregates of albumin.
AB  - Sixty-three patients undergoing isotope ventilation/perfusion scintigraphy for
      suspected pulmonary embolism were monitored using pulse oximetry. Xenon
      inhalation had no adverse effect on arterial oxygen saturation. Fifty-seven per
      cent of patients demonstrated a drop in oxygen saturation of 2-10% within 5 min
      of injection of macroaggregates. Small changes in arterial oxygen saturation
      reflect larger changes in the arteriole partial pressure of oxygen. In 10
      patients, oxygen saturation dropped to 91% and below, corresponding to an
      arterial pO2 of less than 60 mm Hg. The effect lasted up to 30 min and is thought
      unlikely to be simply due to arteriolar blockade. Falls in arterial oxygen
      saturation cannot be correlated with any specific pulmonary pathology and appear
      unlikely to be of any clinical significance in most patients.

PMID- 1754157
TI  - The effect of minor gastric surgery on gastric emptying in the rat.
AB  - A new minimally invasive technique has recently been described which enables
      gastric emptying to be assessed on repeated occasions without the need for animal
      sacrifice. This technique has been applied to study the effect of a laparotomy or
      gastrotomy on gastric emptying in the rat. Groups of 10 animals underwent either
      a laparotomy or a gastrotomy, or were unoperated controls. Solid and liquid
      gastric emptying studies were performed preoperatively, and for two postoperative
      months. Emptying was unchanged in unoperated controls. Laparotomy animals showed
      delayed emptying of both solids and liquids, returning to normal by two months.
      Gastrotomy animals showed a similar delay in solid emptying, but liquid emptying
      was within the normal range postoperatively. It is concluded that minor abdominal
      surgery causes marked alteration in gastric emptying. The comparable emptying
      delay for patients is unknown, but this should be considered when patients are
      recovering from operation, and when interpreting postoperative gastric emptying
      studies.

PMID- 1754158
TI  - Hepato-splenic distribution of 99Tcm-phytate and hepato-enteric distribution of
      99Tcm-DISIDA in mice with carbon tetrachloride-induced acute liver damage.
AB  - The hepato-enteric distribution of 99Tcm-labelled DISIDA and the hepato-splenic
      distribution of 99Tcm-labelled phytate were studied in controls and in mice with
      carbon tetrachloride-induced acute liver damage. The test group animals showed a
      diminished excretion of DISIDA to intestine with retention of this tracer in the
      liver and an increased splenic uptake of phytate. No changes in the hepatic
      uptake of phytate were found. The joint evaluation of both tracers in the study
      of diffuse liver disease is discussed.

PMID- 1754159
TI  - Chemotherapy for retinoblastoma: where do we go from here? A review of published
      literature and meeting abstracts, including discussions during the Vth
      International Symposium on Retinoblastoma, October 1990.
AB  - The history of the application of chemotherapy in the management of
      retinoblastoma (RB) may conveniently be divided into three eras: initial
      enthusiasm (from early 1950s to mid 1970s), realism (from late 1970s to mid
      1980s) and possibility (from mid 1980s to the future). Available data from each
      of these eras are reviewed in the clinical categories of: intraocular RB,
      micrometastatic RB and overt dissemination. The latter is further sub-classified
      into: orbital invasion, central nervous system involvement and systemic
      metastases. Experimental models are described with particular emphasis on future
      directions. Early reports led to initial optimism subsequently dampened by a more
      critical approach. Recent results with increasingly effective chemotherapeutic
      regimens offer the possibility of a valid contribution in each of the above
      clinical settings. A multi-modality approach is recommended optimizing a
      combination of the most active drugs with continuing refinements of other
      techniques. In selected patients with intraocular, and particularly bilateral RB,
      visual outcome may be enhanced by the combined use of non-surgical modalities.
      Adjuvant treatment of presumed micrometastases needs to be studied within risk
      categories defined by prognostic factors. Invasion of the ocular coats and/or of
      the optic nerve are the most relevant factors but there are continued
      difficulties in defining the extent of involvement and eligibility criteria for
      such a strategy. Overt dissemination has recently been demonstrated to be curable
      in each of the three subgroups above. Intensive regimens incorporating
      cyclophosphamide, vincristine, cisplatinum, etoposide and possibly doxorubicin,
      plus intrathecal agents in combination with radiation therapy and, in some
      instances supplemented by bone marrow transplantation have produced promising
      results. Multi-institutional collaboration has been encouraged by the recently
      formed International Committee for the Staging and Management of Retinoblastoma,
      opening the way for prospective clinical trials. At the same time both laboratory
      and clinical experimental studies are being pursued and may produce further
      improvements in currently available strategies.

PMID- 1754160
TI  - Retinoma. Case studies.
AB  - The new concept of retinoma, or retinocytoma, brings up the rare 'spontaneous
      regressions' long-reported in the literature. Systematic investigation of all
      relatives of children suffering from retinoblastoma is showing up more and more
      retinoma cases undetected until now. From 1975 to 1990 the authors have
      identified 11 retinoma cases amongst 103 retinoblastoma patients and their
      families. The average age of the retinoma patients is 23 years with a mean follow
      up of four years. There are four bilateral cases, one of which with phthisis
      bulbi, three unilateral retinomas associated with retinoblastoma of the fellow
      enucleated eye, and four unilateral cases. Of the 11 retinomas, seven patients
      have a family history of retinoblastoma. Of the seven patients of procreating
      age, 16 offspring, three abortions and two miscarriages are noted. Of the 16
      offspring, 12 developed retinoblastoma, 11 of which bilaterally. One 21-year-old
      patient presented in the process of malignant transformation. A child, enucleated
      for retinoblastoma of one eye and showing lesions conforming to retinoma in the
      fellow eye at two years of age, suffered an osteosarcoma when nine years old. The
      authors' data show that retinoblastoma and retinoma follow the same genetic
      changes and consequently require the same investigation and follow-up. This study
      indicates a frequency of retinoma of 10% amongst retinoblastoma patients and
      their families which is higher than that usually quoted.

PMID- 1754161
TI  - Incidence of retinoblastoma in Nagasaki Prefecture, Japan.
AB  - From 1965 to 1986, thirty-four patients with retinoblastoma were born in Nagasaki
      Prefecture, Japan, 23 with unilateral and 11 with bilateral retinoblastoma. The
      incidence of retinoblastoma was calculated to be approximately 1 in 16,053
      births; it was bilateral in 1 in 49,618 births. There was no significant
      difference in the incidence of retinoblastoma between urban and rural areas. In
      Shimabara district it was 1 in 10,331 births--much higher than in any other
      district of Nagasaki Prefecture. Historically, almost all the natives had been
      killed in the Shimabara War in 1637, and then people immigrated to Shimabara
      mainly from Hyogo, Aichi and Shizuoka Prefectures. The authors compared the
      incidence and distribution of retinoblastoma in these three prefectures with the
      figures in Shimabara. The incidence in the Tamba and Tajima districts of Hyogo
      Prefecture was 1 in 10,570 and 1 in 10,411, respectively, very similar to that in
      Shimabara. The authors wonder if this similarity is only an accidental
      coincidence when the historical relationship among the three districts is
      considered.

PMID- 1754162
TI  - Second non-ocular tumours in survivors of bilateral retinoblastoma. A 30-year
      follow-up.
AB  - The authors have reviewed a series of 80 patients treated at the Curie Institute
      before 1965 for bilateral retinoblastoma. They present their cases of second non
      ocular tumours in these patients and discuss their results and the possible
      factors influencing the percentage of second tumours in these patients.

PMID- 1754163
TI  - A hereditary syndrome with retinopathy and ataxia or deafness in two
      consanguineous brothers.
AB  - Of two brothers born of Sephardic first cousin parents one presented with
      congenital neural deafness, nyctalopia, visual field loss, flat ERG,
      unintelligible speech and a shuffling gait, and the other with severe ataxia,
      severe decreased visual acuity, mild field loss, decreased ERG, dysarthric speech
      and high grade myopia. The diagnosis of Usher syndrome type 1 or 2 is discussed
      as well as the possibility that both brothers have different genetic disorders.

PMID- 1754164
TI  - X-linked megalocornea. Ocular findings and linkage analysis.
AB  - A family with X-linked megalocornea (XMC) is presented. The most typical ocular
      features of the disease (cornea globosa, arcus lipoides, mosaic dystrophy of the
      cornea, pigment dispersion, and cataract) are described and their diagnostic
      value is discussed by reviewing the literature. Linkage data suggest that the XMC
      locus maps in the region Xq13-q25, most probably in Xq21-q22.

PMID- 1754165
TI  - [Comparative analysis of the results of the treatment of pain after amputation of
      the arm].
AB  - Postamputation pain syndrome significantly embarrasses prosthetics. In the
      article is described the transposition of the nerve trunks of the brachial plexus
      with terminal neuromas into the formed tunnel under the musculus pectoralis
      major, applied by the authors at 47 invalids (52 operations) with pain in the arm
      stump. The results of an operation have been studied in comparison with the
      results obtained after resection of the terminal neuromas. The data allow to
      recommend the translocations of the nerve trunks with the terminal neuromas in
      case of the pain syndrome after an arm amputation as more effective ones.

PMID- 1754166
TI  - [Surgical treatment of habitual dislocation of the shoulder].
AB  - In the article is presented the analysis of treatment of 32 patients with
      shoulder joint instability. There have been studied the outcomes of treatment
      after the arm "suspension" operations, interventions at the anterior region of an
      articulation, derotational osteotomies of an arm. There have been considered the
      problems of etiopathogenesis of shoulder joint instability. There have been
      analyzed the peculiarities of the tactical approach to the treatment of patients
      with shoulder joint instability. There is presented the principled position of
      the authors' approach to the selection of pathogenetically substantiated method
      of the habitual shoulder slip operative treatment.

PMID- 1754167
TI  - [Surgical treatment of anterior instability of the shoulder joint].
AB  - In the article are presented data on the operative treatment of 52 patients (54
      operations) with anterior instability of the arm joints. Patients have been
      distributed into 4 groups depending upon the character of intra-articular
      damages, revealed in the process of arthrotomy. Each group of patients was
      subjected to adequate operative intervention, based upon Bankart's method. The
      authors proceeded from the principle that the arm joint instability treatment
      should be aimed at removal of intra-articular damages. There have been restored
      integrity of the damaged cartilage cushion and the joint capsule, the capsule
      plasty and blocking of the anteroinferior joint sinus. The treatment tactics of
      the kind allowed to achieve the maximum stability of the arm joint and prevent
      postoperative recurrencies. Long-term results have been studied with 41 patient,
      no recurrencies have been noted. The operated limb function has been restored
      with the majority of the patients.

PMID- 1754168
TI  - [Osteosynthesis in hand bone fractures in children].
AB  - At 12 preparations of the upper extremities of still-born fetuses has been
      studied microcirculatory channel of long bones of a hand. Clinical confirmation
      of the experimental results is based on the analysis of data obtained in process
      of treatment of 54 children with instable fractures of phalanges and metacarpal
      bones. An arterial channel of long bones of a hand is formed by the branches of
      finger arteries and vessels of the surrounding tissues. Epiphysis, metaphysis and
      growth cartilage have common circulatory system. The types of phalanx
      epiphysiolysis determine the terms of the open reposition realization. Comparison
      of morphological data and clinical observations demonstrated that the optimal
      methods of fixation of instable fractures of long bones of a hand are as follows:
      diafixation by means of wires, intramedullary osteosynthesis and perosseous
      compressive-distractive osteosynthesis.

PMID- 1754169
TI  - [Areas of safe use of bone nails on the forearm].
AB  - On the basis of the data of topography-anatomical study, carried out at 30 upper
      extremities, are proposed zones and directions of safe application of wires of
      the compression-distraction apparatus at 4 forearm levels, developed with
      allowance made for individual differences in structure and topography of vessels
      and nerves as well as functional position of the segment. An experimental
      examination (30 extremities) and clinical approval (30 patients) of the proposed
      zones and directions have confirmed the practical use of the obtained data that
      allows to recommend them to be widely introduced into the clinical practice.

PMID- 1754170
TI  - [Roentgeno-densito-planimetric evaluation of the bones after correction of the
      defect].
AB  - In an experiment with 52 dogs (2 experimental series) there were studied, by
      means of a roentgeno-densito-planimetric method, changes of bone substance in the
      process of the upper half of tibia defect compensation with the aid of
      transplant, displaced within the defect, and distraction regenerate, formed
      therewith. The data obtained indicated that formation and mineralization of new
      bone substance have been accompanied by intensification of the transplanted bone
      osteoporosis. Osteoporosis manifestation has been determined by an amount of
      newly formed bone substance and increased with the increase of the distraction
      regenerate size. Osteoporosis manifestation decreased with application of large
      bone transplant that allows to preserve in greater degree the transplanted bone
      strength in the process of restructuring.

PMID- 1754171
TI  - [Biochemical and anatomic changes in the muscles after leg bone lengthening by
      the Ilizarov method].
AB  - In process of crus lengthening, following the method, given by Ilizarov G. A.,
      with 22 adult patients have been studied the peculiarities of metabolic processes
      of muscle tissue of the lengthened segment as well as the muscle tissue
      structural changes. As the tests were used; determination of lactate
      dehydrogenase content and its isoenzymatic spectrum in the blood serum, the
      residual products of lactic and pyruvic acids glycolysis, relating to the higher
      indications of the internal medium of an organism; carboxylase activity
      detection. Energy provision of an organism was estimated according to the ATP
      content; anatomical state of muscles of the lengthened extremity segment and
      muscle tissue structure were estimated by means of contrast myography. Dynamics
      of biochemical indexes suggests that the sparing character of an operation,
      patient mobility from the first days, preservation of locomotive and supporting
      function contribute to prevention of metabolic disease and ensure earlier
      transformation of catabolic reaction to anabolic one. Carboxylase and lactate
      dehydrogenase activity increase indicates the biochemical adaptation of an
      organism. Metabolic changes well correlate with the detected structural changes
      in the lengthened crus muscles.

PMID- 1754172
TI  - [Characteristics of regional hemodynamics in the lower extremities of patients
      with flaccid paralysis].
AB  - On the basis of treatment and examination of 2675 patients with residual effects
      of poliomyelitis and consequences of the nervous system traumata are considered
      the functioning peculiarities of vascular system of the lower extremities in case
      of absence or abrupt decrease of pumping function of the skeletal muscles. There
      have been detected discrepancies between the reovasographic regional blood
      circulation pattern and the microcirculation state indexes in the tissues of the
      damaged extremity. They have studied the dynamics of the hemodynamics indexes in
      the process of preoperative preparation, during early and late postoperative
      periods as well as during remote postoperative periods. There is suggested the
      idea of correlation of the regional hemodynamics with the extremity supporting
      state.

PMID- 1754173
TI  - [Diagnosis of fractures by sound].
AB  - For the purpose of objective evaluation of the sound diagnosis the authors have
      generalized an experience of application of four methods of the acoustic
      diagnosis of bone fractures. There have been compared the efficiency of the
      auscultatory percussion method, the method of its objectivization by means of
      measuring devices, the sound diagnosis method, following the pattern of
      auscultatory percussion and self-sustained oscillation measuring method. There
      have been noted the high efficiency and up to 98% coincidences with clinico
      roentgenologic data in case of application of the sound diagnosis method with the
      self-sustained oscillation systems.

PMID- 1754174
TI  - [Single-stage total removal of the cervical vertebrae in plasmacytoma].
AB  - The article includes the description of successful case of surgical treatment of
      a patient (53 years old) with VC plasmocytoma, complicated with upper
      paraparesis, tetanoid paraplegia and pelvic disturbances. The patient has been
      subjected to complete removal of VC in one stage of 2 accesses. The patient's
      spine has been fixed by means of implant, made of corundum porous ceramic, metal
      plate and lavsan band. A year after the operation--no tumor recurrence, the
      patient walks without additional support. In the process of discussion of the
      given observation the authors suggest that the technical difficulties of the
      operation are quite surmountable and its expediency is obvious.

PMID- 1754175
TI  - [Allogeneic arthrodesis of the distal interphalangeal joint of the fingers].

PMID- 1754176
TI  - [Biomechanical study of the fixation stability in rupture of the pubic
      symphysis].

PMID- 1754177
TI  - [Treatment of pseudarthroses and defects of the forearm bones after gunshot
      wounds].

PMID- 1754178
TI  - [Orthotic devices in the treatment of injuries of the ankle joint].
AB  - For immobilization of foot-crus segment in case of damages of talocrural
      articulation region is proposed a short orthese, made of polyvic. Elastic
      properties of the material at convergence of the orthese walls allow to develop
      the compressive force in the region of distal tibiofibular syndesmosis up to 90
      N. Immobilization reliability was judged by tensometry. An orthese allows to set
      the foot subluxation, make reposition of the malleolus fragments. In case of
      fracture of the lower third of fibula an appliance with concave control pelot,
      made on the basis of an orthese, is used. The treatment methods foresee the most
      complete utilization of extremity functions even during the early post-traumatic
      periods. An orthese and an appliance with positive results were used by 69
      patients with the talocrural articulation damages.

PMID- 1754179
TI  - [A case of congenital hypodactyly of the hand and foot].

PMID- 1754180
TI  - [Lengthening of finger stumps using the apparatus for external fixation].

PMID- 1754181
TI  - [A method of the treatment of equinus deformity].

PMID- 1754182
TI  - [Femoral fracture at the site of a dystrophic cyst].

PMID- 1754183
TI  - [Treatment of transcondylar fractures of the humerus in children by continuous
      skeletal traction].

PMID- 1754184
TI  - [Training of students in orthopedics and traumatology in medical schools and
      physicians-orthopedists and traumatologists at the GIDUV (the National Institute
      for Continuing Education of Physicians].

PMID- 1754185
TI  - [Protective titanium nitride coating of fixation devices for osteosynthesis].

PMID- 1754186
TI  - [A device for preliminary reposition and fixation of crural bones].

PMID- 1754187
TI  - [An extractor for removal of broken hollow nails after intramedullary
      osteosynthesis].

PMID- 1754188
TI  - [An attachment for orthopedic table used in skeletal traction].

PMID- 1754189
TI  - [Problem of skin expansion in the orthopedic and traumatological practice].

PMID- 1754190
TI  - [An apparatus for thr restoration of hand movements].

PMID- 1754191
TI  - [Treatment of flat anterior segment of the foot in women].

PMID- 1754192
TI  - [Electric stimulation of the muscles using the CHENS-2M apparatus in spinal
      osteochondrosis].
AB  - The authors of the article established that the application of electrostimulation
      by means of the apparatus CHENS--2M allows to remove the pain syndrome and to
      improve the amplitude of motion in the spine. The reovasography examination data
      confirm the efficiency of the applied treatment. The proposed method of treatment
      of the spine osteochondrosis should be recommended for practice due to its
      simplicity and accessibility.

PMID- 1754193
TI  - [Use of a transplant from the iliac crest with axial blood supply for anterior
      spondylodesis of the lower lumbar and lumbosacral segments of the spine].
AB  - The method of anterior osseoplasic stabilization of inferiolumbar and lumbosacral
      parts of spine by means of non-free vascularized transplant from the anterior
      part of the iliac crest has been developed. In the anatomical experiment at 100
      objects there have been studied alternative surgical anatomy of vascular
      transplant pedicle from deep vessels, surrounding the iliac bone, ascertained the
      possibility of its lengthening at the cost of the muscular-periosteal "cuff". 9
      patients have been operated on with positive results. There have been achieved an
      acceleration of the osseous stabilization of the spine by 1.5-2 times as compared
      with the traditional methods without essential restructuring of resolution of
      transplants with vascular connections.

PMID- 1754194
TI  - [Possibilities of reducing the duration of the treatment of patients with
      tuberculous spondylitis].
AB  - In the article are described the results of operative treatment of 185 patients
      with tuberculous spondylitis. In order to restore stability there was carried out
      posterior spondylidesis after Genle with removal o ffoci by means of posterior
      access in 70 patients. 115 patients were subjected to anterolateral
      spondylidesis, 55 of them--by generally accepted method and 60--with creation of
      trapezoid lock between the body of a vertebra and transplants. In this group of
      patients was used removable jacket made of polivike before the patient's
      elevation. In this case the term of the stationary treatment of the III group
      patients was reduced by 2 times as compared with the I group and by 22--I day as
      compared with the 2 group. Long-term results were studied from 6 months to 7
      years. In the first group there were excellent results in 67%, good in 20% and
      bad in 13% of cases. In the patients of the 2 and 3 group there were excellent
      results in 96%, good in 3.4% and bad in 0.6% of cases, when there was observed
      resolution of transplant with 1 patient of the 2 group.

PMID- 1754195
TI  - [Use of dalargin in the complex treatment of complicated injuries of the thoraco
      lumbar segments of the spine].
AB  - In the present report there has been pursued an object of studying the efficiency
      of the preparation dalargine (synthetic preparation, analogous to encephaline) in
      case of unstable spine and spinal cord injuries. Under the observation there were
      32 operated patients. Dalargine was administered endolumbally by 2 mg, dissolved
      in 2 ml of physiologic salt solution. The results were evaluated by several
      categories: locomotive function, sensitivity, pelvic organ function, pain,
      spasticity, trophic disturbances.

PMID- 1754196
TI  - [Breaking of distractors of the Harrington type after surgical treatment of
      scoliosis].
AB  - 180 patients with scoliosis (aged 12-29 years) were subjected to the correction
      of deformation by means of the Harringtone type distractors and spondylodesis
      with utilization of osseous transplants. In 24 of them (13,3%) the distractor has
      been broken in different terms after the operation. The danger of the break
      increases with the age of the patients and abruptly increases in case of
      scoliosis of the V degree (in excess of 90 degrees) and in case of necessity to
      bend the distractor to correct the kyphoscoliosis. The distractor break is
      associated not with the material structure but with the rod design.

PMID- 1754197
TI  - [Surgical treatment of scoliosis using a controlled dynamic device].
AB  - The article reports about the development of the original implanted device,
      ensuring externally controlled dynamic correction of scoliosis. The construction
      has been utilized with 6 patients with scoliosis of the IV degree. In 5 cases
      after operation was achieved the spine distraction of 10-37 mm. As the result,
      there was obtained an additional correction of the correcting arch from 6 degrees
      to 17 degrees as compared with achieved in the process of the operation.

PMID- 1754198
TI  - [Effectiveness of acupuncture analgesia in the treatment of chronic post
      traumatic pain syndromes].
AB  - The present work is dedicated to the study of the acupuncture analgesia
      efficiency in ambulatory practice in treatment of chronic post-traumatic pain
      syndrome as well as the comparative characteristics of the acupuncture analgesia
      and electric analgesia in treatment of this pathology. There have been analyzed
      the results of treatment of the pain syndrome after the traumata of the lower
      limbs by the IRT method (106 patients), compared the terms and the results of the
      treatment by the above mentioned methods as well as by the separate acupuncture
      analgesia and electro-analgesia methods. As a result, it should be noted that the
      IRT method is more effective in treatment of the chronic pain syndrome as
      compared with the common traditional methods. The electroanalgesia method, in
      turn, contributes to more rapid pain soothing and restoration of the vegetative
      and trophic functions than acupuncture.

PMID- 1754199
TI  - [Oxygen therapy of gonarthrosis deformans].
AB  - In the article is presented the comparative estimate of the oxygen therapy
      methods in treatment of the deforming gonarthrosis. The new method of treatment
      is described, including 4-5 courses of hyperbaric oxygenation therapy at 1-1.5
      atms during 50 min and intraarticular introduction of oxygen. 3 groups of
      patients have been singled out. The proposed method have been applied with 32
      patients. It turned out to be more effective and the course of treatment shorter
      as compared with the known methods: with application of hyperbaric oxygenation
      without local introduction of oxygen and localized introduction of oxygen in the
      joint without application of hyperbaric oxygenation.

PMID- 1754200
TI  - [Therapeutic approach in degenerative-dystrophic diseases of the hip joint in
      relation to the immunologic status].
AB  - In the process of study of the immunological status peculiarities of 202 patients
      with some degenerative-dystrophic diseases of hip joint has been revealed that
      the hyperimmune reactions to tissular antigens of the joint components (bone,
      cartilage, synovial membrane) are more often observed in case of non-specific
      arthritis, asephic necrosis of the head of the femur and dysplastic coxarthrosis.
      These were precisely the states with more frequent postoperative complications,
      provoking the process development, joint ankylosing or formation of ossificates.
      Preoperative immunocorrection therapy of 20 patients by means of a course of low
      dose injections of plasma substitutes (polyglukine, hemodesis or reopolyglukine),
      individually selected by RIML and lymphocytotoxic test, allowed to arrest the
      lryperimmune manifestations. After reconstructive-restorative operations there
      was observed positive clinical and roentgenologic dynamics in the operated joint
      of the patients.

PMID- 1754201
TI  - [Value of electromyographic examinations in the diagnosis, treatment and
      rehabilitation of patients with complicated trauma of the spine].
AB  - In the article are presented the results of clinico-electromyographic examination
      of 57 patients with complicated damages of lumbar part of the spine during acute,
      early, interim and late periods of treatment. During the acute period of the
      spine damage are singled out 3 types of manifestation of total spontaneous and
      induced (N-reflex, M-wave) bioelectrical activity, demonstrated the possibility
      of their application for prognostication of the operative and restorative
      treatment results.

PMID- 1754202
TI  - [Biomechanical data regarding the socket-neck orientation of hip endoprosthesis].
AB  - On the basis of clinico-statistical, roentgenologic, morphological and spectral
      studies it is possible to draw the conclusion that the cause of the structural
      deformation of the bone tissue around the endoprosthesis parts and an approach of
      their instability is in the mechanical interaction of bone and explant. Under the
      influence of the biomechanical forces the socket of the endoprosthesis gradually
      changes its position from 45-90 degrees to 25-30 degrees. The original 25-30
      degree positioning of the socket significantly decreases the moment of forces
      that it is subjected to and, as a rule, there is no socket displacement observed.
      That is why this socket positioning in the process of operation is a preferable
      one. But the angles of necks of the Sivash endoprosthesis and its modifications
      are equal to 130 degrees +/- 3 degrees and when the socket is positioned at an
      angle 25-30 degrees there can occur limitation of the limb abduction, the socket
      loosening, the structure fretting and metallosis of tissues due to the setting of
      the neck against the end of the insert. It is expedient to change the angle of
      the endoprosthesis neck to 150 degrees +/- 3 degrees and some shortening of the
      neck.

PMID- 1754203
TI  - [Corrective osteotomy of the femur in the treatment of the syndromes of
      dysplastic instability of the hip joint].
AB  - On the basis of analysis of short-term outcomes (1-5 years) of treatment of 139
      patients (150 joints) with congenital dislocation and oluzation of the thigh,
      conclusion has been drawn that the application of corrective femur osteotomy with
      these patients should be limited with the cases of formation of pathology loading
      of the joint under conditions of negative intercomponental trophism. Restoration
      of correct anatomical interrelations between the components of the joint can be
      accompanied by the clinical decompensation of the hip joint state. Position of
      the cotyloid cavity and epiphysis of the head of the femur is of fundamental
      importance for further formation of the hip joint and its neck and diaphysis
      position is of minor importance. When positing indications for corrective femur
      osteotomy and its efficiency prognostication it is necessary to be orientated
      towards epidiaphysar and not cervicodiaphysar correlations. Removal of
      antetorsion of the head of the femur without due regard for the grade of its
      proximal epiphysis retroversion can lead to the development of external rotary
      contraction in hip joint.

PMID- 1754204
TI  - [Changes in the osteoarticular system after completion of the treatment of
      congenital hip dislocation in children and adolescents].
AB  - There have been analyzed the results of the treatment of congenital femur
      dislocation in 189 children. It has been stated that the results of treatment are
      in direct relation with the timely commencement of treatment, dysplasia
      expression of pelvic and femur components, adequacy of the treatment methods to
      the pathology nature, observation of the orthopedics regimen and rehabilitation
      treatment. There have been detected the group of children, in which in spite of
      the treatment applied in total accordance with the rules of orthopedics, have
      been noticed the changes of the degenerative-dystrophic nature both on the side
      of dislocation and in the remote parts of skeleton. The obtained data are to be
      taken into consideration for vocational orientation of adolescents and at the
      stage of dispensary observation in order to compile the plans of rehabilitation
      treatment.

PMID- 1754205
TI  - [Various forms of lesions of the femur head in Legg-Perthes disease].
AB  - The authors described small-focal, limited and disseminated forms of the femoral
      head affection. They differ in localization and extent of the necrotization foci
      and don't transform themselves in the course of disease. Comparison of anatomical
      data, roentgenologic and angiographic examinations allows to infer that the
      described forms of affection are conditioned by the blockade of the vascular
      basins of the intraosseous circulatory system of the epiphysis. It has been
      stated also that the disease duration, its outcomes are determined mainly by the
      femoral head affection form and a child's age. The high-risk groups have been
      singled out with consideration for the probability of formation of joint
      deformation and the conservative treatment.

PMID- 1754206
TI  - [Comparative evaluation of the results of conservative surgery for benign tumors
      and tumor-like bone lesions in children].
AB  - The results of sparing operations of 576 children with benign tumors and tumor
      like bone affections have been analysed. There have been revealed the advantages
      of the complex method of treatment, envisaging the sparing approach to the
      damaged segment, thermal treatment of the residual osseous walls by means of CO2-
      laser and recipient-like plasty of the operational defect (UV--irradiated
      autologous bone marrow+allomaterial): absence of recurrencies, complete
      restoration of the bone structure in 9-12 months after the operation.

PMID- 1754207
TI  - [Treatment of femoral neck fractures].

PMID- 1754208
TI  - [Treatment of patients with juvenile epiphysiolysis of the femur head using the
      Elizarov apparatus].

PMID- 1754209
TI  - [Surgical treatment of tumors of the sacrum].

PMID- 1754210
TI  - Measurement of vocal function.
AB  - Objective measurement of vocal function, e.g., acoustical analysis, is emerging
      as a necessity in clinical practice. Voice data assist in determining the
      diagnosis and prognosis of many voice disorder patients and provide documentation
      of the vocal quality before, during, and after treatment.

PMID- 1754211
TI  - Neuromuscular disorders of the larynx.
AB  - The voice may be affected adversely by a variety of neuromuscular disorders,
      including movement disorders, paralysis, and degenerative conditions of the
      central and peripheral nervous system. The diagnosis of these conditions usually
      requires high-technology tools, and the results of treatment are variable.
      Diagnostic considerations, aspects of a complete neurologic examination, an
      examination of the basic organization of neural control as it relates to the
      larynx, and treatment options are provided in this article.

PMID- 1754212
TI  - Laryngeal electromyography.
AB  - Laryngeal electromyography (EMG) is simultaneously a powerful clinical and
      investigative tool. EMG may be diagnostic and prognostic in cases of laryngeal or
      vagus nerve injury and can differentiate between vocal cord fixation and
      paralysis. EMG also is being used to help unravel complex laryngeal neural and
      muscle physiology. Basic principles of EMG, techniques of EMG limited to three
      muscles--the thyroarytenoid, the posterior cricoarytenoid, and the cricothyroid,
      and pitfalls of this procedure are discussed within this article.

PMID- 1754213
TI  - Functional voice disorders.
AB  - Functional voice disorders (FVDs) are common. The diagnostic criteria for six
      types of FVD and the results of treatment in a large series of patients are
      reported. Voice therapy was effective in 69% of the patients. Failure of voice
      therapy usually correlated with continued tobacco use, noncompliance with
      therapy, or premature termination of therapy.

PMID- 1754214
TI  - Voice therapy. Techniques and applications.
AB  - Voice therapy is the cornerstone of treatment for patients with voice disorders.
      The therapeutic role of the speech pathologist is important in patients with
      functional and organic voice disorders. Voice rest and various other treatment
      options, techniques, and applications for voices disorders are examined in this
      article.

PMID- 1754215
TI  - Care of the professional voice.
AB  - Care of the professional voice user, particularly the professional singer,
      requires that the otolaryngologist acquire special training. This group of
      patients demands gentle and appropriate treatment, rarely surgery, for a wide
      range of conditions that may affect vocal performance.

PMID- 1754216
TI  - Pediatric voice disorders.
AB  - Voice disorders are common among children, estimated to range from 6% to 23% in
      school-aged children. The various causes of voice disorders are presented in this
      article in addition to a discussion of normal laryngeal voice and development.
      Also presented are the causes of abnormal voice and brief discussion of a
      framework for multidisciplinary assessment and treatment of pediatric voice
      disorder.

PMID- 1754217
TI  - Vocal cord injection techniques.
AB  - Injection techniques for the rehabilitation of paralytic dysphonia (e.g., Teflon)
      remain popular in the United States. This article presents a historical
      perspective of vocal cord paralysis, its work-up, and the indication, timing,
      techniques, and results of vocal cord injection.

PMID- 1754218
TI  - Laryngoplastic phonosurgery.
AB  - Laryngoplastic phonosurgery is a new term used to describe all forms of laryngeal
      framework surgery to improve the voice. One of the most important new surgical
      techniques is medialization laryngoplasty (ML) for the correction of unilateral
      vocal cord paralysis. This article focuses on ML techniques, results,
      complications and indications; the artenoid adduction procedure (AA) is described
      as a complementary technique. In addition, some of the more experimental
      laryngoplastic procedures are reviewed.

PMID- 1754219
TI  - Surgery for benign lesions of the glottis.
AB  - This article examines benign lesions of the glottis and adjacent structures
      commonly encountered in clinical practice. The goals of management are to
      understand the cause and the characteristics of these lesions and to provide the
      most conservative management possible. Nonsurgical management is selected, if
      possible, with surgical intervention reserved for refractory conditions.
      Traditional cold steel operative techniques as well as carbon dioxide laser
      techniques are discussed in this article.

PMID- 1754220
TI  - Laryngopharyngeal manifestations of gastroesophageal reflux disease.
AB  - Gastroesophageal reflux disease (GERD) contributes to the development of many
      otolaryngologic symptoms and conditions, including chronic throat clearing,
      cough, sore throat, contact ulcer and granuloma, globus pharyngeus, cervical
      dysphagia, cancer of the larynx, subglottic stenosis, and cricoarytenoid
      arthritis. These conditions are discussed and the pathogenesis of GERD is also
      detailed.

PMID- 1754221
TI  - Restoring function to the injured larynx.
AB  - Laryngeal trauma often results in impaired laryngeal physiology, and may result
      in severe dysphonia. Effective rehabilitation requires the utilization of
      sophisticated diagnostic and surgical methods.

PMID- 1754222
TI  - Treatment options in spasmodic dysphonia.
AB  - Options in the treatment of spasmodic dysphonia include surgical interruption of
      the recurrent laryngeal nerve, anterior laryngoplasty, voice therapy, and
      Botulinum toxin injection. Although none of these treatments is ideal, Botulinum
      toxin injection appears to have the greatest potential to benefit the greatest
      number of patients.

PMID- 1754223
TI  - Nerve-muscle pedicle reinnervation of the paralyzed vocal cord.
AB  - Reinnervation offers great potential for the rehabilitation of the paralyzed
      larynx, a potential that has yet to be realized. The nerve-muscle pedicle (NMP)
      technique is one method of reinnervation that attempts to transfer a nerve with a
      portion of its muscle intact to a denervated muscle. The selection of the nerve
      to incorporate into a NMP is examined in the first part of this article.
      Experimental data that argue for and against the use of a NMP, a description of
      the indications and the techniques for the procedure, and a review of the
      clinical results are detailed.

PMID- 1754224
TI  - Electrical stimulation of laryngeal muscle.
AB  - Most functional electrical stimulation (FES) research has focused on the spinal
      cord-injured patient whose muscles are paralyzed but still maintain their
      innervation. This article details the investigation of FES of the laryngeal
      muscles. In time, FES may become a useful treatment for bilateral vocal cord
      paralysis (BVCP) and for some laryngeal movement disorders.

PMID- 1754225
TI  - Voice disorders.

PMID- 1754226
TI  - The spectrum of vocal dysfunction.
AB  - Levels of vocal use, types of vocal complaints, and the spectrum of vocal
      dysfunction are discussed in this article. Functional voice disorders account for
      40% and organic conditions for 60% of patients presenting with voice disorders.
      Twelve percent of the patients are children.

PMID- 1754227
TI  - Approach to the patient with a voice disorder.
AB  - The author's approach to patients with voice disorders emphasizes the value of a
      multidisciplinary voice team, including an otolaryngologist, a speech
      pathologist, and a neurologist.

PMID- 1754228
TI  - [Ferritin (tumor marker) in patients with laryngeal cancer and precancerous
      conditions].
AB  - Evaluation of the ferritin as a neoplasm marker was performed in laryngeal cancer
      patients. In 35 laryngeal cancer patients and in 21 laryngeal leucoplakia
      patients the ferritin serum level and the blastic transformation of leucocytes
      were tested. In both groups the high ferritin level was discovered. It is the
      sign of low specificity of ferritin as a neoplasm marker. There was no
      correlation between the ferritin serum level and the degree of the blastic
      changes of leucocytes.

PMID- 1754229
TI  - [Comparative studies of CT pictures and intraoperative findings in malignant
      neoplasms of the paranasal sinuses and nasopharynx].
AB  - Five cases of malignant paranasal sinus and nasopharyngeal cancer were
      demonstrated. They illustrated the discrepancies in the evaluation of the
      extensive neoplastic process using CT scanning and intraoperative examination.
      The limitation of CT scanning in the diagnosis of advanced malignant cancer in
      this region was discussed.

PMID- 1754230
TI  - [Non-epithelial malignant neoplasms of the larynx].
AB  - Among total number of 1399 patients with laryngeal malignant tumors treated in
      Cracow Otolaryngological Clinic in the years 1966-1985 there were only six (4%)
      patients with non-epithelial neoplasms. These patients were operated upon by
      various types of laryngectomy.

PMID- 1754231
TI  - [Remarks on creating skin flaps in so-called closed two-step tympanoplasty].
AB  - The most often used skin-flap techniques in one-step and two-steps closed
      tympanoplasties are discussed. The correct plastic surgery of the meatal skin
      gave good results. In the ENT Clinic of the Medical Academy in Lodz techniques
      most often used are two-flaps tympanoplasties with anterior and posterior
      pedunculated flaps or tympanoplasties with a single pedunculated flap.

PMID- 1754232
TI  - [Value of adenectomy in the treatment of recurrent respiratory tract infections,
      sinusitis and otitis media in children].
AB  - Two groups of the upper respiratory tract, sinuses and middle ear recurrent
      infections were analysed. The first one of 205 children has had the adenotomy,
      the second of 107 has not. In the surgery group the treatment results were
      statistically better. The indications and the contraindications to the adenotomy
      were discussed as well as the complications and postoperative care.

PMID- 1754233
TI  - [Hydrogel dressings in the otolaryngological practice].
AB  - The authors described their own suggestions of advantages of the hydrogel
      bandages in ENT practice. The hydrogel is produced by Radiation Technique
      Institute of Polytechnique High School in Lodz.

PMID- 1754234
TI  - [100 years of modern tonsillectomy].
AB  - The author has described a historic progress of tonsillectomy. He has also
      noticed that in present decade passes 100 years from the first execution of
      tonsillectomy (in today meaning of that intervention). Observing the development
      of the technics of tonsillectomy the author came to the conclusion that nowadays
      palate tonsils are removed in classical way ("dissection Method") or by
      "guillotine Method".

PMID- 1754235
TI  - [Evoked response audiometry in newborn infants examined earlier by fetal
      audiometry].
AB  - The aim of this study was to investigate the influence of acoustic stimulus on
      behavioural heart responses of fetuses near term (38 to 42 weeks of gestational
      age) and comparison assessment of FHR to Auditory Brain Stem Responses (ABR) in
      the same babies after their birth. The study group consisted of 30 babies with
      pathological pregnancies and control group of 30 neonates of physiological
      pregnancies. Our results indicated, that the pattern of FHR accelerations after
      application of acoustic stimulus was significantly altered and depended on of the
      kind of pregnancy. Duration and amplitude of FHR obtained in the patients with
      complicated pregnancy were significantly smaller in comparison to the pattern
      observed in normal patients (142 msec to 249 msec, and 36 to 22 as well).
      Comparing the results obtained in FA (Fetal Audiometry) and ABR (Auditory Brain
      Stem Responses) we can say, that prolonged latency between a stimulus and
      accelerations is also combined with the prolonged latency of consecutive waves in
      ABR. Shortened duration of accelerations and its decreased amplitude could
      respond to the diminished amplitude in ABR recordings.

PMID- 1754236
TI  - [A case of recurrent inflammation of ear cartilage].
AB  - The clinical course of the recurrent auricle cartilage inflammation was
      described. In Polish literature there were only 4 cases published. The
      etiopathogenesis, symptomatology and treatment were described.

PMID- 1754237
TI  - [Malherbe's calcifying epithelioma of the base of the nose in a child].
AB  - The rare case of epithelioma calcifying of Malherbe of the nose of the 9 years
      old girl was presented. The tumor was operated whole. The follow-up proved good
      health without recurrencies.

PMID- 1754238
TI  - [Eosinophilic granuloma of the temporal bone].
AB  - The authors describe current opinions about origin, pathology, histology,
      diagnosis and treatment of the eosinophilic granuloma. Clinical course, diagnosis
      and treatment of the own case were discussed.

PMID- 1754239
TI  - [A case of a child with congenital anomaly of the first branchial cleft].
AB  - The authors of the article describe the case of a child surgically treated for
      inborn anomaly of the first branchial cleft. Basing upon this example, they
      discuss the difficulties that the surgeon may encounter during the operative
      treatment. Concluding, they present the characteristic features of this type of
      developmental anomaly.

PMID- 1754240
TI  - [A case of Warthin's tumor (papillary adenolymphoma) of the larynx].

PMID- 1754241
TI  - [Extensive Stewart's tumor with an atypical way of spreading].

PMID- 1754242
TI  - [Tracheo-arterial fistula as a complication of tracheotomy].
AB  - The authors presented 2 cases of massive bleeding from brachiocephalic artery as
      a late complication after tracheotomy. In both deadly cases the artery wall was
      secondary damaged by the tracheal tube. The pathomechanism of this complication
      origin and significance of its acquaintance was discussed.

PMID- 1754243
TI  - [Use of ultrasonography in the diagnosis of laryngeal cancer].

PMID- 1754244
TI  - Does the vestibulo-ocular reflex (VOR) merit redefinition?
AB  - The VOR has historically been described by parameters of the slow phase of
      nystagmus while fast phases have been systematically ignored. However, ample
      neurophysiologic and theoretical evidence suggests that fast phases are an
      integral part of the VOR and are not to be discarded in evaluation of vestibular
      function. In a series of experiments, normal subjects and compensated patients
      with total or partial loss of unilateral peripheral vestibular function were
      tested. They were exposed to sinusoidal oscillations (20 degrees, 60 degrees, and
      120 degrees/second at 1/6 Hz and 25 degrees/second at 1 Hz) with no actual or
      imaginary visual targets (doing mental arithmetic) and the usual slow-phase
      parameters (gain, phase, etc.) were computed. The gaze (total eye position, slow
      and fast phase of nystagmus vs. head + head position in space) was also plotted
      vs. head position in space. It was found that in patients, fast phases of
      nystagmus are unequally (right vs. left) produced, extending the linear range of
      VOR function. It was also found that in normal subjects and patients, gaze
      essentially tracks the head in the absence of visual targets. It is concluded
      that fast phases of nystagmus contribute to gaze control during head rotations in
      darkness and that the definition and the testing of the VOR have to be modified
      to accommodate these observations.

PMID- 1754245
TI  - Mucociliary function following sinus mucosal regeneration.
AB  - To evaluate sinus mucosal regeneration and cilia motility after surgical removal,
      15 rabbits underwent unilateral removal of maxillary sinus mucosa. The opposite
      sinus served as an unoperated control. After 10 weeks, specimens were taken for
      examination from all operated on and control sinuses. Light, dark-field, and
      electron microscopy were performed. Mucosa from eight of the 15 sinuses operated
      on showed ciliary regeneration by light microscopy; six of these exhibited motile
      cilia on dark-field examination. Histopathologic findings of marked fibrosis,
      decreased seromucinous glands, and significant inflammation were commonly present
      in the sinuses operated on. Electron microscopy revealed frequent abnormalities,
      including complex and edematous cilia and fewer than normal cilia per unit area
      compared to controls. The dark-field, light, and electron microscopic findings of
      the regenerated, post-surgical mucosa are discussed.

PMID- 1754246
TI  - Esophageal foreign bodies in adults.
AB  - The main point in managing suspected impaction of esophageal foreign bodies is to
      decide whether the patient needs an esophageal endoscopy. Decision-making is
      based on clinical history, physical examination, and radiographic studies. We
      review 100 cases of adults having esophagoscopy for removal of esophageal foreign
      bodies. Fish bones were the most frequently responsible foreign body and the
      cervical esophagus was the most frequent level of impaction. Decision-making
      based on clinical history and patient-referred symptoms revealed a positive
      esophagoscopy in 72% of the suspected cases. Radiographic studies gave falsely
      positive and falsely negative information in 30% of the cases. Rigid
      esophagoscopy was used successfully for foreign body removal in 99% of the cases.
      Average hospital stay was 3.2 days. No complications associated with the use of a
      rigid esophagoscope were found.

PMID- 1754247
TI  - Nd-YAG laser treatment of venous malformations of the head and neck: an update.
AB  - Malformations of the arterial and venous systems often are manifested in the head
      and neck. Low-flow venous malformations are generally benign lesions; however,
      complications, such as bleeding, obstruction, pain, or cosmetic deformities, may
      warrant surgical intervention. Treatment of these lesions can be challenging.
      Laser photocoagulation, particularly with the neodymium-yttrium aluminum garnet
      (Nd-YAG) laser, has been successful in the majority of patients, with minimal
      morbidity and good results. Thirty-two patients with low-flow venous
      malformations of the head and neck were treated with the Nd-YAG laser using low
      power density and intermittent short exposures in a punctate nonoverlapping
      technique. When possible, two glass slides were used to compress the lesion.
      There was excellent regression with minimal damage to the surrounding tissue. No
      major complications or morbidity, postoperative pain, or mortality occurred.
      Lesions occurring in some areas of the head and neck would not have been amenable
      to standard surgical excision. Follow-up period has ranged from 1 to 8 years. Nd
      YAG laser photocoagulation has proved safe and effective for treatment of low
      flow vascular malformations of the head and neck.

PMID- 1754248
TI  - Endoscopic CO2 laser arytenoidectomy for postintubation glottic stenosis.
AB  - Extended endotracheal intubation for assistive respiration can lead to
      cricoarytenoid joint fixation and subsequent bilateral midline vocal cord
      fixation--thus, complete glottic stenosis. Endoscopic CO2 laser arytenoidectomy
      was performed on 10 patients for bilateral midline vocal cord fixation caused by
      prolonged translaryngeal endotracheal intubation because of central nervous
      system respiratory insufficiency resulting from various causes. Eight of these
      patients had concomitant cricopharyngeal myotomy for associated severe upper
      pharyngeal dysphagia. All of these patients had successful return of airway,
      voice, and swallowing functions. The advantages of the CO2 laser for endoscopic
      arytenoidectomy are its facility, hemostasis, precision, and minimal scarring.

PMID- 1754249
TI  - Magnetic resonance imaging of the facial nerve during Bell's palsy.
AB  - Twenty-five patients with Bell's palsy were evaluated to assess the efficacy of
      gadolinium (Gd+)-enhanced MRI in determining: (1) the site of facial nerve
      enhancement, (2) the relationship between EMG findings and Gd+ MRIs, and (3) the
      usefulness of Gd+ MRI in predicting recovery of facial function. Eighteen of
      twenty-five patients had enhancement of the facial nerve during Gd+ MRI whereas
      seven did not. The most common areas of facial nerve enhancement were the
      labyrinthine, geniculate ganglion, and proximal tympanic segments of the facial
      nerve. EMGs were performed on ten patients who lost nerve excitability. The
      segments of facial nerve enhanced during Gd+ MRI varied in location and intensity
      in patients who maintained nerve excitability and in patients who lost nerve
      excitability. There was no correlation between EMG findings and location of
      facial nerve enhancement in patients who lost nerve excitability. The location of
      facial nerve enhancement during Gd+ MRI was not useful in predicting recovery of
      facial paralysis.

PMID- 1754250
TI  - Control of epistaxis in patients with hereditary hemorrhagic telangiectasia.
AB  - Twenty-nine patients were admitted to Pennsylvania Hospital between March 1984
      and July 1990 with a diagnosis of epistaxis and hereditary hemorrhagic
      telangiectasia. Data were obtained through a retrospective review of the charts
      of these patients. Patients were treated for epistaxis with the CO2 laser,
      neodymium:aluminum garnet laser with a wavelength of 1064 nm (Nd-Yag), Nd-Yag
      laser with a wavelength of 532 nm (KTP), septodermoplasty, or any combination of
      these procedures. Patients underwent an average of 2.5 procedures each. Overall,
      25 of 29 patients reported their symptoms had greatly improved with therapy. The
      average length of time without the need for further surgical intervention was
      16.3 months for the Nd-Yag laser and 11.7 months for the KTP laser.
      Septodermoplasty using buccal mucosal grafts allowed, patients to avoid
      additional procedures for 24.4 months, which was twice as long as for standard
      septodermoplasty using split-thickness skin grafts. Although no therapy
      completely resolves the epistaxis, laser therapy combined with septodermoplasty
      enables the patients to gain excellent control of the epistaxis for several
      years.

PMID- 1754251
TI  - Management of otolaryngic patients susceptible to malignant hyperthermia without
      dantrolene.
AB  - Malignant hyperthermia (MH) is an adverse reaction most frequently associated
      with the administration of halogenated inhalational anesthetic agents and the
      depolarizing muscle relaxant succinylcholine. Characteristic findings are a
      hypermetabolic state accompanied by extreme hyperpyrexia, acidosis,
      rhabdomyolysis, and generalized muscle rigidity, often involving the masseter
      muscles. Dantrolene sodium, which was approved in 1979 by the FDA for use in the
      prevention of MH in high-risk patients, has neurologic and gastrointestinal side
      effects. At the Children's National Medical Center (CNMC), 24 children identified
      as being at risk for the development of a MH reaction were anesthetized for
      otolaryngic procedures by using "non-triggering" anesthetics and without use of
      dantrolene sodium. These patients represent 56% of all patients at risk for MH or
      masseter muscle rigidity (MMR) reactions during an 8-year period at the CNMC.
      There were no complications. Concomitant muscle biopsies were performed, and
      caffeine/halothane contracture studies were completed in 18 of these patients,
      demonstrating 11 susceptible or equivocal responses. The data suggest that
      children undergoing common otolaryngic procedures who are at risk for development
      of MH may be safely anesthetized without the use of prophylactic dantrolene
      sodium.

PMID- 1754252
TI  - Cranial nerve preservation in lesions of the jugular fossa.
AB  - The most significant objection to the proposal of lateral transtemporal cranial
      base surgery for the treatment of jugular foramen tumors is the perceived lasting
      morbidity attendant to aggregate cranial nerve loss. As techniques become more
      standardized and earlier diagnosis generates smaller tumors for treatment,
      outcome has become more predictable. Surgery has become the recognized management
      preference for these cranial base lesions. The purpose of this article is to
      assess the role of surgery in the treatment of jugular foramen lesions, as well
      as to review some of the technical highlights of conservation surgery, its
      clinical prerequisites, and reasonable expectations. We review 100 lateral skull
      base surgical cases of lesions involving the jugular foramen. The majority of
      these lesions--77 of 100--were paragangliomas. For these glomus tumors, cranial
      nerve preservation correlated well to tumor size and location. The diversity of
      the remaining 23 cases prevented any substantive conclusions.

PMID- 1754253
TI  - Midline nasal destruction in cocaine abusers.
AB  - Idiopathic midline destructive disease (IMDD) is a diagnosis of exclusion in
      patients who manifest midline nasal necrosis with no specific etiology such as
      infection, tumor, or Wegener's granulomatosis. Recently, a group of cocaine
      abusers has been identified that manifests a syndrome that mimics IMDD, but is
      less fulminant in its course. To better define the natural history of this
      syndrome, we reviewed the medical records, radiographs, and pathologic material
      from five such patients treated at the University of California, Los Angeles.
      Other causes of midline nasal destruction were excluded in each patient on the
      basis of histopathology, cultures, and laboratory tests. Biopsy material,
      available in four patients, demonstrated inflammation and necrosis without
      vasculitis. Treatment was conservative in four of the five patients, using
      antibiotics, local care, debridement, and cessation of cocaine use. During the
      follow-up period, progressive disease developed in one of the five patients,
      requiring radiation and steroid therapy. We conclude that the treatment of
      midline nasal destruction in cocaine abusers should initially be conservative,
      once other etiologies have been systematically excluded.

PMID- 1754254
TI  - Orbital wall fractures: evaluation and management.
AB  - Over a 49-month period, 121 orbital wall fractures were treated and 92 were
      followed for a median of 6.5 months (minimum, 3 months). Associated injuries
      included a 17% incidence of serious globe or optic nerve injuries and 13%
      incidence of lacrimal drainage disruption. Diplopia occurred in 23% and dystopia
      in 11%. Management was by observation alone in 14% and exploration in the
      remainder, with layered gelfilm for defects smaller than 4 cm2, alloplastic
      sheeting for defects to 6 cm2, and outer cortex of parietal bone for larger
      dehiscences. There were no decrements in vision from operation, dystopias were
      corrected to within 2 mm of normal, and diplopia persisted only in those with
      extraocular muscle paresis. There was no benefit to exploration of orbital wall
      defects smaller than 2.5 cm2 or with reduction of other midfacial fractures
      (e.g., malar) when neither dystopia nor entrapment was present, because defects
      not obturated in such cases had no sequelae.

PMID- 1754255
TI  - An evaluation of the head-shaking nystagmus test.
AB  - Head-shaking nystagmus can be observed in some patients with vestibular lesions.
      This nystagmus is transient and appears after 15 to 20 cycles of rapid head
      shaking. Horizontal head-shaking may be associated with a low-amplitude reversal
      phase, which follows the primary response. Several previous studies using active
      head movement have indicated that head-shaking nystagmus is a sensitive indicator
      of vestibular loss. In this study, the head-shaking nystagmus test using passive
      head movement was evaluated in 115 patients and 17 control subjects, using three
      examiners. The data indicate that using passive head movement, the head-shaking
      nystagmus test is neither sensitive nor specific enough for use as a screening
      test for vestibular loss.

PMID- 1754256
TI  - Characterization of cough associated with angiotensin-converting enzyme
      inhibitors.
AB  - Chronic cough is a side effect of the angiotensin-converting enzyme (ACE)
      inhibitor class of antihypertensives. The cough is thought to be a result of
      inhibition of the enzymes that break down some of the mediators of inflammation,
      such as the bradykinins and tachykinins. We report 20 patients with chronic cough
      caused by ACE inhibitors and some of the characteristics of the cough. The cough
      is typically dry, nonproductive, and worse at night. Interference with sleep is
      common and was severe in three patients. Women outnumbered men in this series:
      urinary stress incontinence developed in five, rectal and vaginal prolapse
      developed in one. Three patients felt they were incapacitated by the cough. Most
      had been on multiple medications; only oxycodone was reported to be effective in
      controlling the cough, and four patients thought they were addicted to that. All
      coughs resolved with withdrawal of the ACE inhibitor. Chronic cough is common
      among individuals taking ACE inhibitors. It may be severe and associated with
      complications. The incidence and potential severity is understated in drug
      information sources, and patients and physicians often fail to recognize cough as
      a drug side effect.

PMID- 1754257
TI  - The Caldwell-Luc procedure in 1991.
AB  - In the pre-antibiotic era, George Caldwell and Guy Luc both designed an operation
      to remove infected polypoid tissue from the maxillary antrum, as well as to
      provide drainage and ventilation of the sinus. With the development of
      antibiotics and the surgical endoscopes, many of the former indications for the
      Caldwell-Luc procedure have changed. However, the Caldwell-Luc procedure still
      offers optimal exposure for decompression of Grave's ophthalmopathy,
      pterygomaxillary space surgery, management of some maxillary trauma, removal of
      antral foreign bodies, repair of some oral-antral fistulae, management of
      maxillary osteomyelitis and benign maxillary tumors, and irreversible mucosal
      disease and endoscopic surgical failures.

PMID- 1754258
TI  - Computer-assisted instruction in otolaryngology: the use of a database for
      examination review.
AB  - A database of questions and answers has been developed to assist residents in
      reviewing current topics in otolaryngology-head and neck surgery. Each
      question/item has an associated answer, general category, specific category, and
      reference that allows cross-referencing on the computer system. The user can
      search the database for categories of interest and obtain a specific subset of
      questions. This allows an efficient means of knowledge acquisition and review for
      Board examinations. Additional data entry is also facilitated to expand the
      database as desired. Currently there are more than 2300 items in the database.

PMID- 1754259
TI  - Dynamic rehabilitation of the paralyzed face: III: Balanced coupling of oral and
      ocular musculature from the intact side in the canine.
AB  - We have recently demonstrated the feasibility of artificial agonist/antagonist
      coupling between intact facial and reinnervated strap muscles in the rabbit. The
      present study broadens this principle to involve bi-level cross-facial
      innervation. After severing the facial innervation unilaterally in four dogs, a
      nerve pedicle from a cervical motor nerve was implanted into the orbicularis oris
      and from the deep temporal nerve into the orbicularis oculi. After neurotization
      (5.6 months), the pedicles were electrically stimulated to verify muscular
      response. Graded contraction on the intact side was induced by stimulating the
      ipsilateral facial nerve with currents of various pulse widths. The resulting
      compression of a strain gauge on the intact face triggered a two-channel, opto
      isolated, pulse width-modulated stimulator to produce agonistic graded
      contraction at one level of the reinnervated side (e.g., oral) and reciprocal
      relaxation in its reinnervated counterpart (e.g., ocular). The sophistication of
      the present model--as compared to the original pilot study--brings us one step
      closer to dynamic human facial rehabilitation.

PMID- 1754260
TI  - Creation of a lobule: a simple technique.

PMID- 1754261
TI  - Malignant triton tumor of the head and neck.

PMID- 1754262
TI  - Diagnosis and treatment of the carotid artery in the middle ear.

PMID- 1754263
TI  - Atypical presentation of chylothorax following pharyngolaryngectomy with
      esophagectomy and gastric interposition.

PMID- 1754264
TI  - Isotretinoin for prevention of second primary squamous cell carcinoma of the head
      and neck.

PMID- 1754265
TI  - The endo-extralaryngeal needle carrier.
AB  - A laryngeal needle holder has been devised. This instrument will allow endoscopic
      insertion of sutures for lateralization of a paralyzed vocal cord or for fixation
      of endoscopically inserted stents or keels in laryngotracheal stenosis. The
      suture material is delivered by a curved nontraumatic cutting needle. After the
      needle is inserted in the desired endoscopic area, the tip protrudes through the
      anterior neck skin. The needle and distal suture are then pulled through the skin
      and the needle holder is withdrawn. The proximal portion of the suture is then
      inserted in the same fashion. Both ends of the suture are then fixed over buttons
      on the neck. The technique avoids the blind and cumbersome method of placing
      suture material from the skin to airway and back out to skin again.

PMID- 1754266
TI  - RBRVS: Boris Yeltsin, we need you.

PMID- 1754267
TI  - A family physician takes the state society's helm.

PMID- 1754268
TI  - An interview with Senator Wofford.

PMID- 1754269
TI  - From experience: fee schedule reforms (or: how I learned to stop worrying and
      love the system).

PMID- 1754270
TI  - Medicare fee reform still in question.

PMID- 1754271
TI  - Medicare reform includes global surgery package.

PMID- 1754272
TI  - Counseling to avoid AIDS.

PMID- 1754273
TI  - Are physicians' office laboratories reliable?

PMID- 1754274
TI  - Create an effective hiring routine. Health Care Group.

PMID- 1754275
TI  - Women in medicine: honored, but unheard.

PMID- 1754276
TI  - Assuming leadership in access to care.

PMID- 1754277
TI  - A national institute of nursing research?

PMID- 1754278
TI  - Sex and sexuality for the adolescent with a chronic condition.
AB  - Sexuality and sexual identity are developmental milestones that occur throughout
      the life span with sexual maturation usually occurring during adolescence.
      Parents and health care providers must prepare children with chronic conditions
      for this important component of adulthood to which they are entitled.

PMID- 1754279
TI  - Information on a shoestring: a practical database at an adolescent pregnancy
      program.
AB  - Adolescent pregnancy programs provide services to a socially high risk population
      with complex and continuing needs. Data describing the characteristics of the
      patient population is useful for directing program efforts, examining program
      outcomes, and documenting the need for additional services. The Rochester
      Adolescent Maternity Program has developed a simple, inexpensive data collection
      system in which demographic, social and reproductive information is routinely
      collected on all program patients. Such a system could be of use to other
      adolescent maternity programs.

PMID- 1754280
TI  - Nurses' attitudes toward sexuality in adolescent patients.
AB  - This descriptive study surveyed the sexual attitudes and nursing practice of 39
      nurses who care for adolescents in a large metropolitan teaching hospital. A
      questionnaire containing 32 Likert scale items and 29 yes/no questions was used
      to survey the nurses' attitudes toward the sexuality of their patients and the
      use of sex education and counseling in their patient care. Frequency of answers
      generated by the participants was used to ascertain their sexual attitudes and
      characteristics of their nursing practice. Findings indicate that, although the
      sample recognized the importance of sexuality for the adolescent patient and were
      theoretically capable of addressing issues of adolescent sexuality, nurses were
      uncomfortable incorporating issues of sexuality, counseling, and education into
      their nursing practice.

PMID- 1754281
TI  - Fostering a spirit of inquiry in pediatric staff nurses.
AB  - Research-based practice is essential if nursing is to meet its mandate to society
      for effective and efficient patient care. The involvement of the clinical nurse
      is key to the conduct of research.

PMID- 1754282
TI  - Promoting non-tobacco use in childhood.
AB  - Smoking prevention programs are valuable in promoting life-long health behaviors
      in pediatric populations. Currently, social learning theory is the most common
      framework used for smoking prevention programs. Smoking prevention programs have
      reported varied results and have used different delivery and research techniques.
      The nurse is in an optimal position to plan and deliver a program and determine
      its effectiveness.

PMID- 1754283
TI  - Sudden, unexpected pediatric death: caring for the parents.
AB  - Sudden, unexpected death triggers acute grief in most survivors. This article
      provides an overview of that response and its manifestations in parents. Using
      the acute grief response as a framework for practice, guidelines are presented
      for assessment and intervention with parents in the acute care setting.

PMID- 1754284
TI  - Children and waterbeds.

PMID- 1754285
TI  - Meeting the challenge of immunizing the nation's children.
AB  - Achieving fully immunized status in the nation's pediatric population remains an
      elusive goal. A new campaign is underway to improve immunization coverage, and
      the nation's schools are logical sites to implement these projects.

PMID- 1754286
TI  - Leadership behaviors of pediatric nurse managers.
AB  - PURPOSE: To determine the leadership behaviors of firstline managers in pediatric
      hospital organizations. METHOD: A descriptive survey of 34 first-line managers in
      pediatric hospitals was done. A demographic questionnaire provided information
      about the nurses and their units. The Fiedler Leader Match Scales were used to
      collect data about the nurse manager's leadership behaviors. RESULTS: The nurse
      managers were slightly more task-oriented than people-oriented. The majority of
      the nurse managers perceived themselves to have high situational control. The
      match between the scales indicated that 21 of the managers were considered
      effective leaders. CONCLUSIONS: The majority of the nurse managers possessed
      effective leadership behaviors and were motivated by the completion of tasks.

PMID- 1754287
TI  - Adenosine.

PMID- 1754288
TI  - Pediatric management problems. Subacute otitis media with effusion.

PMID- 1754289
TI  - Adenosine in the pediatric population: nursing implications.
AB  - Tachydysrhythmias in the neonatal and pediatric age group can present a challenge
      to pediatric nurses. A new antiarrhythmic drug, adenosine, has proven useful as
      an acute tool in the termination and diagnosis of these potentially life
      threatening dysrhythmias.

PMID- 1754290
TI  - Bronchopulmonary dysplasia in the family: a longitudinal case study.
AB  - Oxygen-dependent infants with BPD are routinely sent home as soon as their
      conditions have stabilized. This article presents a prospective case study
      examining one family's adaptation to the birth, prolonged hospitalization, and
      home oxygen management of an infant with severe BPD.

PMID- 1754291
TI  - The process of quality management.
AB  - Hospitals are focusing their attention on quality improvement programs to meet
      the demands of the health care consumer. Managers need to be educated in the
      methodology and process of total quality management (TQM).

PMID- 1754292
TI  - Requirements and recommended dietary intakes of protein during infancy.
AB  - Two approaches have been used to arrive at estimates of the requirement for
      protein by infants. The factorial approach consists of adding the requirement for
      growth to the requirement for replacement of inevitable losses in urine and feces
      and from the skin. Protein requirement estimated in this way was 1.98 g.kg-1.d-1
      during the 1st mo of life and decreased rapidly to 1.18 g.kg-1.d-1 by 4 to 5 mo
      of age, then remained at about that level to age 1 y. Believing that protein
      intakes of the breast-fed infant are near the level of the requirement,
      researchers used the intakes of breast-fed infants as a second estimate of
      requirement. Although intakes of protein by breast-fed infants during the first 2
      mo of life are generally similar to the requirement values estimated by the
      factorial approach, intakes from 2 to 6 mo of age are less than the requirement
      values estimated by the factorial approach. Possible explanations for the
      discrepancy are presented. Recommended dietary intakes of protein somewhat
      greater than the requirements estimated by the factorial approach are proposed.
      These recommended intakes are less than those proposed by the FAO/WHO/UNU "safe
      levels of protein intake" and are less than the Recommended Dietary Allowances of
      the Food and Nutrition Board.

PMID- 1754293
TI  - Utility of breath ethane as a noninvasive biomarker of vitamin E status in
      children.
AB  - The purpose of our study was to determine if the ethane content of expired air
      could be a useful index of vitamin E status in children. Eight children with
      vitamin E deficiency secondary to chronic severe liver disease were studied: six
      of these children were treated with parenteral vitamin E (2-5 mg/kg/dose every 4
      7 d). Measures of vitamin E status pre- and posttherapy were: serum vitamin E, 2
      +/- 1 versus 7 +/- 1 micrograms/mL (p less than 0.001); serum vitamin E:total
      lipids, 0.3 +/- 0.1 versus 1.0 +/- 0.1 mg/g (p less than 0.001); and erythrocyte
      peroxide hemolysis test, 80 +/- 10 versus 6 +/- 12% (p less than 0.001). Fasting
      breath ethane in the patients pre- and posttherapy was 78 +/- 10 versus 31 +/- 11
      pmol/kg/min (p less than 0.001). Breath ethane correlated negatively with serum
      vitamin E (p less than 0.042) and serum E:total lipids (p less than 0.004) and
      positively with the erythrocyte peroxide hemolysis test (p less than 0.003).
      Values for treated patients did not differ from those for fasted sibling controls
      (34 +/- 12 pmol/kg/min), postprandial sibling controls (31 +/- 12 pmol/kg/min),
      and healthy children sampled randomly, in the nonfasted state (21 +/- 14
      pmol/kg/min). Breath ethane production in one patient (up to 168 pmol/kg/min) did
      not normalize after treatment of vitamin E deficiency until her selenium
      deficiency was corrected as well. We conclude that this noninvasive test can be
      useful as a screen for vitamin E deficiency in children and for ascertaining
      response to therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754294
TI  - Intralipid increases lung polyunsaturated fatty acids and protects newborn rats
      from oxygen toxicity.
AB  - Intralipid, derived from soybean oil and containing a high percentage of n-6
      family polyunsaturated fatty acids (PUFA) and also linolenic acid, an n-3 family
      PUFA, is commonly the first fat source provided to very low birth weight
      premature infants. Following up on our previous reports that newborn rats born to
      dams fed high-PUFA diets demonstrate superior tolerance to hyperoxia, we examined
      whether the high-PUFA fat source Intralipid might also protect against oxygen
      toxicity. Adult female rats were fed either regular Rat Chow or fat-free diet
      containing 20%-Intralipid as the fat source for 3 wk before and then throughout
      pregnancy and lactation. One- and 5-d-old offspring of Intralipid diet-fed dams
      demonstrated significant increases in lung lipid n-6 family PUFA plus elevated
      linolenic acid compared with regular diet-fed offspring. These characteristic
      fatty acid patterns, apparent in total lung lipids, were even more pronounced in
      the triglyceride fraction compared with the phospholipid fraction. Associated
      with these fatty acid changes were significantly improved hyperoxic survival
      rates (89 out of 95 = 94% survival after 7 d of greater than 95% O2 exposure) in
      Intralipid offspring (versus 89 out of 106 = 84%, p less than 0.05 in regular
      diet offspring) and evidence of superior clinical/pathologic status. No
      differences in pulmonary antioxidant enzyme or surfactant system development,
      response of antioxidant enzymes to hyperoxic exposure, or lung prostaglandin E2,
      6-keto PGF1-alpha or leukotrienes C4-F4 were present. These findings continue to
      support the hypothesis that increasing lung PUFA content may provide increased O2
      free radical scavenging capacity, thus protecting against hyperoxic lung
      damage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754295
TI  - Protein turnover rates in sick, premature neonates during the first few days of
      life.
AB  - Rates of protein turnover were measured in 19 infants during the first few days
      of life while they were receiving i.v. glucose. The technique consisted of a
      continuous i.v. infusion of L-[1-13C]leucine to measure whole body leucine flux
      and determination of total urinary nitrogen excretion to assess leucine oxidation
      rates. Subsequent to each of the studies, the decision to start total parenteral
      nutrition (TPN) was made by the clinician concerned, with the result that seven
      infants did not start TPN and 12 did. There were significantly greater urinary
      nitrogen excretion (p less than 0.001) and lower rates of whole body protein
      synthesis (p = 0.024) and breakdown (p = 0.015) in those who did start TPN
      compared with those who did not. The marked difference in nitrogen excretion
      between the two groups suggests that this could be a useful determinant for
      deciding which neonate should start TPN.

PMID- 1754296
TI  - Effects of glucose infusion on leucine transamination and oxidation in the ovine
      fetus.
AB  - During fasting of the ewe, the rate of amino acid oxidation by the ovine fetus
      increases substantially. We hypothesized that the increase in amino acid
      oxidation derived mainly from reduced protein synthesis. We further hypothesized
      that fetal glucose supplementation would result in diminished amino acid
      oxidation. To test these hypotheses, nine ovine fetuses were infused with [15N,1
      13C]leucine to determine the rates of leucine appearance and disposal.
      Simultaneously, the fetal uptake of leucine was determined. Animals were studied
      in the fed and fasted state. After baseline measurements, glucose was infused
      into the fetal inferior vena cava at a rate estimated to match the fetal glucose
      uptake. Results of these studies indicate that leucine nitrogen flux, leucine
      carbon flux and fetal leucine uptake were constant. Leucine oxidation was
      increased by 50% in the fasted state (6.3 versus 13.4 mumol/min); glucose
      infusion resulted in a 25% decline in oxidation (to 10.4 mumol/min) in the fasted
      state, but had no effect in the fed state. Mean leucine umbilical uptake during
      fasting was 9.3 mumol/min, 4.1 mumol/min less than leucine oxidation. These data
      suggest that leucine (and potentially other amino acids) may be in negative
      balance during maternal fasting, and can be spared by supplementation of the
      fetus with exogenous glucose.

PMID- 1754297
TI  - Oral L-alloisoleucine loading studies in healthy subjects and in patients with
      maple syrup urine disease.
AB  - Total body and renal elimination of L-alloisoleucine was assessed after oral
      loads (0.57 mmol/kg body wt) in four healthy subjects and in five patients with
      maple syrup urine disease (MSUD) of different degrees of severity. As judged from
      the fictive initial concentration, L-alloisoleucine is distributed evenly in the
      total body water space. In the controls, estimated half-time of total elimination
      was 9.2 +/- 2.2 h (n = 4). In the MSUD patients, it ranged from 26 h (mild
      variant) to about 8 d (classical type). Because of its low renal clearance rate,
      L-alloisoleucine was cleared through ketomethylvalerate to greater than 99% in
      normals and to at least 73% in the MSUD patients. Assuming small variation in the
      losses of ketomethylvalerate through L-isoleucine formation and through renal
      excretion, this test allows ranking of MSUD patients with regard to their
      residual in vivo branched-chain oxo-acid dehydrogenase activity.

PMID- 1754298
TI  - Tetrahydrobiopterin loading test in hyperphenylalaninemia.
AB  - Some cases of primary hyperphenylalaninemia are not caused by the lack of
      phenylalanine hydroxylase, but by the lack of its cofactor tetrahydrobiopterin.
      These patients are not clinically responsive to a phenylalanine-restricted diet,
      but need specific substitution therapy. Thus, it became necessary to examine all
      newborns screened as positive with the Guthrie test for tetrahydrobiopterin
      deficiency. Methods based on urinary pterin or on specific enzyme activity
      measurements are limited in their availability, and the simplest method, based on
      the lowering of serum phenylalanine after loading with cofactor, was discouraged
      by the finding that some dihydropteridine reductase-deficient patients were
      unresponsive. The preliminary observation that this limitation could be overcome
      by increasing the dose of the administered cofactor prompted us to reevaluate the
      potential of the tetrahydrobiopterin loading test in hyperphenylalaninemia.
      Fifteen patients, eight with ultimate diagnosis of phenylketonuria, three with 6
      pyruvoyl tetrahydropterin synthase-, and four with dihydropteridine reductase
      deficiency, have been examined by administering synthetic tetrahydrobiopterin
      both orally, at doses of 7.5 and 20 mg/kg, and i.v., at a dose of 2 mg/kg. All
      the tetrahydrobiopterin-deficient patients, unlike those with phenylketonuria,
      responded to the oral dose of 20 mg/kg cofactor by lowering their serum
      phenylalanine concentration markedly below baseline to an extent easily
      detectable by Guthrie cards. This method allows for a simple screening method
      when enzyme or pterin studies are not available.

PMID- 1754299
TI  - Prenatal diagnosis and neonatal monitoring of a fetus with glutaric aciduria type
      II due to electron transfer flavoprotein (beta-subunit) deficiency.
AB  - The prenatal diagnosis of a male fetus with glutaric aciduria type II and the
      time course of metabolite urinary excretion, starting immediately after birth,
      are described. Prenatal diagnosis was undertaken at the 17th wk of gestation by
      immunoblot analysis and pulse labeling experiments of amniocytes and,
      retrospectively, by stable isotope dilution analysis of six metabolites in
      amniotic fluid. The results were as follows: 1) The immunochemical analysis on
      cultured amniocytes showed that the fetus, as the previous index case in this
      family, was affected with a deficiency of the beta-subunit of electron transfer
      flavoprotein. 2) Glutarate concentration was significantly increased in the cell
      free supernatant of the amniotic fluid. In the postnatal period, most of the
      organic acids and acylglycines characteristic of the disorder appeared in urine
      within a week, although an increased excretion of hexanoylglycine was the only
      biochemical abnormality detectable in the first urine sample collected at 9 h
      after birth. Growth and development of this infant were normal during the
      following 6 mo of life, when he was receiving oral supplementation with L
      carnitine and riboflavin. It should be underscored that transient abnormalities
      in routine blood tests (glutamic oxaloacetic transaminase, lactate dehydrogenase,
      and creatine phosphokinase) were present soon after birth, despite his
      asymptomatic clinical course. Early detection and aggressive treatment could be
      effective in such a form of glutaric aciduria type II.

PMID- 1754300
TI  - Developmental regulation of expression of C-reactive protein and serum amyloid A
      in Syrian hamsters.
AB  - The fetal and maternal concentration of various plasma proteins alters during
      pregnancy. Cells in the livers of fetal hamsters accumulate serum amyloid A (SAA)
      and C-reactive protein (CRP) mRNA, major acute phase reactants, when
      lipopolysaccharide is administered to the fetal circulation. No fetal SAA or CRP
      mRNA response is seen when the mother is stimulated at a remote site by endotoxin
      or a nonspecific inflammatory agent. In addition, cells of the fetal hamster
      liver do not respond by accumulating SAA mRNA when exposed to the specific
      cytokines, tumor necrosis factor, IL-1, and IL-6. CRP mRNA levels increased in
      fetal livers after administration of tumor necrosis factor and IL-1. These data
      suggest that cells contained in the fetal liver can respond during an acute phase
      reaction but that the capacity of some acute phase reactant genes to respond to
      cytokines may be developmentally regulated. Studies of immature hamsters after
      birth show that the responses of CRP and SAA genes to lipopolysaccharide, tumor
      necrosis factor, IL-1, and IL-6 are reduced when compared with induction of mRNA
      accumulation for these acute phase reactants in adult animals.

PMID- 1754301
TI  - Long-term effects of mild oligonephronia induced in utero by gentamicin in the
      rat.
AB  - Renal clearance studies and morphologic observations were performed in rats aged
      14, 21, and 28 d and 3, 6, 9, and 12 mo born with a 20% reduction in nephron
      number after administration of 75 mg/kg/d of gentamicin to their mothers during
      the second half of gestation. Gentamicin was still present in urine 3 mo after
      birth. Morphologic damage characteristic of gentamicin accumulation was observed
      in the kidney on d 14 and 21. Adequate compensatory adaptation to oligonephronia
      occurred for glomerular function within 14 d of birth, but tubular phosphate
      reabsorption was significantly low on d 21. On d 28, no evidence of histologic or
      functional damage to the kidney was observed. At 3 mo, mesangial lesions were
      observed in rats of the gentamicin group, whereas they were rarely present in 6
      mo-old control rats. Furthermore, glomerular sclerotic lesions were already
      evident in about 5% of the juxtamedullary nephrons. The same percentage of
      injured nephrons was not observed before 12 mo in controls. Complementary
      morphologic data obtained in 24-mo-old rats showed that glomerulosclerosis
      involved 40% of the juxtamedullary nephron population at this age in animals of
      the gentamicin group versus 21% in controls. It is concluded that in the young
      rats born with oligonephronia of gentamicin-treated mothers neither the
      gentamicin remaining in the kidney cells nor the injuries it caused them
      prevented compensatory adaptation of the kidney to a reduced number of nephrons.
      However, although this oligonephronia was mild, it might have been sufficient to
      cause early development of glomerular sclerosis in the adults.

PMID- 1754302
TI  - Short-term measurement of linear growth in preterm infants: validation of a hand
      held knemometer.
AB  - A hand-held electronic knemometer, resembling a pair of callipers, for measuring
      knee-heel length in preterm infants was developed to improve the accuracy of
      measuring linear growth velocity in infants. The measuring system is based on a
      magnetic encoder and has a resolution of 0.01 mm. The knee-heel length is
      recorded automatically when the pressure applied on the heel reaches a preset
      value. The result of a measurement sequence is expressed as the average of five
      sequential readings. The error of one measurement sequence was 0.82 mm,
      corresponding to a coefficient of variation of 0.8% or 2 d of growth in knee-heel
      length. It includes the technical error and an error component due to the
      correlation of the readings within a series. The estimated error on the
      measurement of the knee-heel growth velocity (expressed as mm/d), measured over a
      3-wk period, was 0.04 mm, corresponding to a coefficient of variation of 8%.
      Longitudinal growth data from 11 healthy preterm infants (birth weight 918-1482
      g) are presented. Knee-heel length velocity from birth until day of regained
      birth weight was similar to the velocity during the following weeks, showing that
      there was no deceleration of growth immediately after birth. In conclusion, the
      method is accurate and gentle in measuring linear growth velocity over short
      periods and can be useful in monitoring the progress of ill infants and in growth
      studies of preterm and mature infants, in which linear growth is a more relevant
      short-term outcome than weight gain.

PMID- 1754303
TI  - Postnatal development of flash visual evoked potentials in the jaundiced Gunn
      rat.
AB  - In this study, the postnatal development of flash visual evoked potential (VEP)
      has been monitored in the jaundiced (jj) Gunn rat model of neonatal
      hyperbilirubinemia to determine whether this evoked response is affected by
      bilirubin-induced neurotoxicity. VEP could first be recorded at 16 d of age. The
      jj rats exhibited prolonged wave latencies and lower wave amplitudes during the
      3rd wk of postnatal life, when compared with their nonjaundiced littermates.
      There was no correlation at 21 d of age between VEP parameters and either
      bilirubin levels or body weight. About one third of the jj animals died between
      21 and 28 d of age. The average VEP wave latencies at 21 d of age of the rats who
      were to die was prolonged compared with those of rats who survived till at least
      28 d of age. Thus, the latency of VEP waves at the age of 21 d appears to be
      related to the further outcome of jj Gunn rats. Although wave amplitudes were
      lower in jj as compared with nonjaundiced 21-d-old animals, there were no
      amplitude differences between the jj rats who would die and those who would
      survive during the 4th wk of life. These findings may contribute to the
      understanding of the pathogenesis of bilirubin encephalopathy in the neonatal
      period.

PMID- 1754304
TI  - Bilirubin-induced changes in brain energy metabolism after osmotic opening of the
      blood-brain barrier.
AB  - Acute and residual effects of blood-brain barrier disruption and bilirubin on
      brain metabolism were studied in a rat model after osmotic opening of the blood
      brain barrier under pentobarbital anesthesia. Arabinose (1.5 M) was infused via
      the right external carotid artery over 30 s, resulting in opening of the barrier
      within the right hemisphere. Two min later, bilirubin was infused i.v. over 3
      min, raising the serum bilirubin concentration to 37-44 mg/dL (633-752 mumol/L).
      The animals were euthanized at 15 min or 4 h by freezing the brain in situ.
      Opening the blood-brain barrier produced small changes in cerebral energy
      metabolism in some animals at 15 min. Compared with saline-infused control
      animals, two out of nine rats had decreased brain phosphocreatine and three out
      of nine developed increased brain lactate levels. Infusion of bilirubin in rats
      with a disrupted blood-brain barrier produced profound decreases in brain energy
      metabolites, glucose, and glycogen and a markedly increased lactate/pyruvate
      ratio at 15 min. The markedly increased lactate in the presence of normal or low
      pyruvate in bilirubin-treated animals indicates accumulation of NADH and probably
      reflects severe mitochondrial dysfunction. Four h after the arabinose/bilirubin
      infusions, the barrier would be expected to be repaired and bilirubin levels were
      negligible, but two out of five arabinose and three out of six bilirubin rats
      continued to have severely altered brain metabolism indicating residual brain
      injury in some animals.

PMID- 1754305
TI  - Hemodynamic response to volume stress in awake late-pregnant and nonpregnant
      rats.
AB  - The present study was designed to determine whether the often observed
      gestational rise in blood volume alters the hemodynamic response to volume stress
      relative to the nonpregnant state. Late-pregnant and nonpregnant Wistar rats,
      prepared with an electromagnetic flow probe around the ascending aorta and/or
      intravascular catheters were used for this study. One of the following sets of
      measurements were performed either before and after volume loading or before and
      after volume depletion (24 h thirst): 1) continuous monitoring of cardiac output,
      blood pressure, heart rate, and fluid balance (only during volume loading); 2)
      measurement of cardiac output and regional blood flows (microspheres); and 3)
      measurement of the inferior vena cava diameter (x-ray). Both rapid (bolus) and
      slow volume loading (infusion) led to a rise in cardiac output. The generated
      surplus in cardiac output was distributed to the kidneys, skeletal tissues, and
      intestines (only in nonpregnant rats), and was paralleled in the pregnant rats by
      a consistent fall in placental blood flow. Slow volume depletion had neither a
      consistent effect on cardiac output nor on its distribution, with even a
      preserved maturational rise in placental blood flow during the 24 h of thirst.
      Slow volume loading and depletion led to an increase and decrease of the caliber
      of the inferior vena cava, respectively. The nonnuterine hemodynamic response to
      all forms of volume stress had not changed in pregnancy.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1754306
TI  - Flow velocity wave forms in the human fetal ductus arteriosus during the normal
      second half of pregnancy.
AB  - Maximum flow velocity wave forms in the ductus arteriosus were studied
      longitudinally in 40 fetuses from 18 to 38 wk of gestation at 3- to 4-wk
      intervals. Median maternal age was 29 y (range 18-41 y), median parity was 1
      (range 0-6). All flow velocity wave forms were obtained using a mechanical sector
      scanner with a continuous Doppler system (carrier frequency 3.5 MHz). The flow
      velocity parameters studied were peak-systolic, peak-diastolic, and time-averaged
      velocity and acceleration time. There was considerable variability in
      measurements between fetuses at any particular gestational age. An increase of
      ductal flow parameters with advancing gestational age was found. They showed no
      correlation with heart rate. These results suggest that the normal second half of
      pregnancy is characterized by a reduction in right ventricular afterload. This
      may be a result of decreased placental vascular resistance or increased pulmonary
      vascular flow. Acceleration time in ductal flow velocity wave forms was
      significantly higher than that observed in the pulmonary artery and ascending
      aorta, suggesting a lower afterload in the ductus arteriosus compared with the
      other two outflow tract vessels.

PMID- 1754307
TI  - Ventilatory sensitivities of peripheral and central chemoreceptors of young
      piglets to inhalation of CO2 in air.
AB  - In 20 piglets aged 2-12 d (mean 6.8 d) and anesthetized with alpha-chloralose
      urethane, we investigated the contribution of the peripheral and central
      chemoreceptors to the ventilatory response to inhalation of CO2 in air. For this
      purpose we used the dynamic end-tidal forcing technique, applying square-wave
      changes in end-tidal CO2 tension of 1.5-2.0 kPa at a constant end-tidal O2
      tension of 15 kPa. Each response, measured on a breath-to-breath basis, was
      separated into a fast peripheral and a slow central component by fitting the sum
      of two exponentials to the measured ventilation. Each component was characterized
      by a CO2 sensitivity, a time constant, a time delay, and an apneic threshold. The
      results showed that in 2- to 12-d-old piglets the peripheral chemoreceptors are
      responsive to CO2 during air breathing. The contribution of the peripheral
      chemoreceptors in mediating the response to CO2 averaged 30 +/- 10%. Within this
      age range we could not demonstrate a significant correlation of the parameters
      characterizing the dynamic ventilatory response to CO2 with postnatal age.

PMID- 1754308
TI  - Lung volume, gas mixing, and mechanics of breathing in mechanically ventilated
      very low birth weight infants with idiopathic respiratory distress syndrome.
AB  - We assessed pulmonary function in 14 mechanically ventilated newborn very low
      birth weight infants with idiopathic respiratory distress syndrome by means of a
      face-out, volume displacement body plethysmograph and nitrogen washout analyses.
      Specially designed computer programs were used for calculations of lung volumes,
      ventilation, gas mixing efficiency, and mechanical parameters. In addition to
      very low compliance and moderately elevated resistance of the respiratory system,
      there were considerably impaired gas mixing efficiency and low functional
      residual capacity (FRC). No correlations between positive end-expiratory pressure
      and mean airway pressure versus compliance, resistance, or FRC could be found.
      Neither could correlations be found between FRC and compliance or FRC and the
      calculated right to left shunt.

PMID- 1754309
TI  - A plethysmographic method for assessment of lung function in mechanically
      ventilated very low birth weight infants.
AB  - We have developed and tested a plethysmographic method for assessment of lung
      function in mechanically ventilated very low birth weight infants during
      intensive care. Information about the mechanics of the respiratory system is
      obtained from the respiratory flow as measured by volume displacement
      plethysmography and from airway pressure measured in the artificial airway. Data
      on lung volumes, ventilation, and distribution of ventilation is obtained
      simultaneously by combining the respiratory flow measurements with nitrogen
      concentration analyses of the respiratory gas. No significant differences were
      found when the estimations of mechanical parameters and FRC were compared with
      reference methods and when determinations of the same parameters were repeated in
      the same subjects. The plethysmograph was shown to be safe and convenient to use,
      even in studies lasting several hours.

PMID- 1754310
TI  - [Problem of classification of rickets].

PMID- 1754311
TI  - [Current classification of rickets in children (response to the discussion)].

PMID- 1754312
TI  - [Results of the discussion regarding the classification of rickets].

PMID- 1754313
TI  - [Urinary microflora and rational antibiotic therapy in pyelonephritis].

PMID- 1754314
TI  - [Congenital and familial nephrotic syndrome in children].

PMID- 1754315
TI  - [Results of using the principle of biological feedback in the rehabilitation of
      children with bronchial asthma].

PMID- 1754316
TI  - [Etiology of a nephrotic form of primary chronic glomerulonephritis in children].
AB  - As many as 91 children with the nephrotic and hematuric forms of primary chronic
      glomerulonephritis were examined for the presence of streptococcal infection and
      allergic diseases. It has been shown that as compared to patients with the
      hematuric form of chronic glomerulonephritis, those with the nephrotic form
      manifest a higher occurrence of A3, a dramatic rise of serum IgE and its
      dependence on the activity of glomerulonephritis. The data obtained may attest to
      the etiological role played by allergy in the development of the nephrotic form
      of glomerulonephritis. Frequently occurring colonization of hemolytic
      streptococcus in the fauces and the rise of the ASL-O titer in the blood serum
      seen in patients with the hematuric form of glomerulonephritis, its dependence on
      the disease activity suggest the streptococcal etiology in patients with that
      form in contrast to those with the nephrotic form.

PMID- 1754317
TI  - [Presence of markers of hepatitis B in patients with nephrotic syndrome].
AB  - The purpose of the present work was to study the rate of HB viral infection from
      the standpoint of its pathogenetic importance in children with the nephrotic
      syndrome (NS). As many as 71 children aged 2 to 15 years with the NS were
      examined. 23 children with hematuric glomerulonephritic (GN) served as control.
      HB viral infection markers (HBsAg, anti-HBs, total anti-HBc and IgM anti-HBc)
      were detected in the blood serum by means of IEA in all the patients. The
      examinations made it possible to reveal material differences in the distribution
      of various combinations of VHB markers in children with the NS and hematuric GN.
      The combination of HBsAg and IgM anti-HBc turned out most characteristic for the
      NS, pointing to active NB viral infection. In patients with mixed GN, that
      combination was detectable twice as often. The data obtained attest te a high
      rate of the association of HB viral infection with GN, particularly with that
      running its course with the NS. In this case, the rate mentioned was
      significantly higher than in the population. A definite relationship between the
      activity of HB viral infection and the gravity of the NS suggests that VHB is
      implicated in the pathogenesis of GN. This suggestion may be indirectly supported
      by a far higher rate of HBsAg and IgM anti-HBc demonstration in patients
      suffering from membranoproliferative GN.

PMID- 1754318
TI  - [Intrarenal mechanisms of the regulation of homeostasis in children with
      nephrotic syndrome].
AB  - Overall 40 patients with associated glomerulonephritis and the nephrotic syndrome
      were examined for renal response to the induced shifts in water balance: tests
      with 18-hour water deprivation characterizing concentration function of the
      kidneys, followed by water loading (22 ml/kg bw) which allows estimation of water
      excretion function and osmotic dilution. Osmotic concentration defect was
      revealed. It manifested in a decrease of osmotic concentration of the urine, a
      reduction of the concentration index according to creatinine. It should be
      mentioned that the more preserved was the magnitude of the concentration index
      the more this was ensured by sodium reabsorption, decrease of its excretion.
      Meanwhile osmotic concentration of the urine was determined by urea excretion.
      Study of partial functions in water diuresis discovered a dramatic lowering of
      sodium-free water clearance characterizing participation of the kidney in the
      maintenance of effective osmotic pressure of the plasma and reflecting the
      intensity of distal sodium reabsorption.

PMID- 1754319
TI  - [Endogenous vasoactive factors in children with nephrotic syndrome].
AB  - In accordance with the results of examining 40 children with nephrotic and mixed
      glomerulonephritis, it has been established that in the pathogenesis of the
      nephrotic syndrome of paramount importance is imbalance of the output of renal
      prostanoids, manifesting in the predominance of the vasopressor and proaggregate
      fraction--thromboxane A2 and in the deficiency of its antagonist prostacyclin
      that exerts a protective action on glomerular filtration. Sodium and water
      retention in patients with the nephrotic syndrome favours an increase of the
      content of antidiuretic hormone and plasma renin activity.

PMID- 1754320
TI  - [Study of various factors of the pathogenesis of nephrotic edema in children with
      glomerulonephritis].
AB  - As many as 26 children (20 boys and 6 girls) aged 2.5 to 15.5 years suffering
      from active nephrotic glomerulonephritis were examined for the intravascular
      liquid volume and antidiuretic hormone in blood plasma. In accordance with the
      magnitude of the circulating blood volume, 3 groups of patients were
      distinguished: group I included patients with hypervolemia, group II with
      hypovolemia, and group III with normovolemia. In the hypovolemic children, the
      nephrotic syndrome occurred at an earlier age as compared to the normovolemic
      children who developed it much later. The patients differed in the content of
      antidiuretic hormone and total blood protein. In the second group children,
      secretion of antidiuretic hormone was the highest one, whereas the level of total
      protein was the least one. A relationship was discovered between the pattern of
      the nephrotic syndrome and the efficacy of diuretic treatment.

PMID- 1754321
TI  - [Biochemical markers of atherogenesis in a nephrotic form of glomerulonephritis
      in children].
AB  - A study was made of the regularities and changes in the fatty acid spectrum of
      total lipids of the blood serum, in interaction of carbohydrate lipid metabolism,
      and in the hypophyseal and thyroid system in 92 patients with the nephrotic form
      of acute and chronic glomerulonephritis. It has been discovered that the
      nephrotic form of glomerulonephritis is marked by a complex of changes in the
      fatty acid spectrum of the blood serum, in carbohydrate lipid metabolism at the
      sites of their conjunction, and in the hypophyseal and thyroid system which can
      be regarded as metabolic potentialities of atherosclerosis formation.

PMID- 1754322
TI  - [Urinary excretion of oxalates and urates in a nephrotic form of
      glomerulonephritis in children].
AB  - Diurnal excretion of oxalates and urates with urine was examined in 31 children
      with nephrotic chronic glomerulonephritis. Active glomerulonephritis was
      demonstrated to be attended by hyperuraturia. Hyperuraturia and hyperoxaluria
      occurred in the treatment with immunosuppressants, diuretics and correlated with
      the impairment of other tubular functions of the kidneys.

PMID- 1754323
TI  - [Disorders of copper metabolism and dysfunction of the immune system in children
      with a nephrotic form of chronic glomerulonephritis].

PMID- 1754324
TI  - [Morphology of the kidneys in children with primary nephrotic syndrome (lipoid
      nephrosis) before and after hormone therapy, studied by biopsy (light and
      electron microscopy)].
AB  - Light and electron microscopies were employed to examine biopsy specimens from 15
      children suffering from the primary nephrotic syndrome with minimal alterations
      in renal bodies. The studies were carried out at the height of the disease and in
      the stage of a clinical remission after prednisolone therapy. The author
      describes the development of ultrastructural changes in the glomerular filter,
      primarily of those in podocytes, under the conditions of highly selective
      proteinuria as well as during hormonal therapy that favours reparative processes
      and discontinuation of protein "leakage". It is assumed that the anionic layer of
      the glycocalyx of podocyte pedicles and l. rara ext. heparan sulfates of the
      basal membrane may play a role in the origin of selective proteinuria.

PMID- 1754326
TI  - [Nephrotic syndrome in childhood].

PMID- 1754325
TI  - [Structure of interstitial nephritis in children].
AB  - The authors provide the data on 24 cases of interstitial nephritis in children
      treated at the Nephrological Center of the city of Kuibyshev in 1986-1990.
      Describe the etiological structure of interstitial nephritis using the
      classification developed by N. A. Korovina and coworkers (1982), randomization
      according to the age, sex, and the disease course. Demonstrate the predominance
      of the postviral and toxicoallergic disease patterns in children of the early,
      preschool and junior school age. Estimate the importance of the types of urine
      proteinograms in the diagnosis of interstitial nephritis.

PMID- 1754327
TI  - [Early diagnosis and prognosis of bacterial tubulo-interstitial nephritis in
      children].
AB  - The authors provide the data of a prospective follow-up of children with diseases
      of the urinary system organs. Analysis was made of the role of endogenous and
      exogenous factors in the formation of abacterial and bacterial tubulointerstitial
      nephritis (TIN) in children with predisposing conditions. It has been established
      that progression of the tubulointerstitial process can be seen in patients
      infected with causative agents capable of intracellular parasitizing and
      persistence in the body. Depending on the intensity of membranopathological and
      immune disorders the clinicopathogenetic manifestations of different stages of
      TIN are described in detail. It is shown that there is a possibility of early
      diagnosis of the bacterial stage of the disease on the basis of detecting the
      persistent microflora according to an assay of the antilysozyme activity of the
      causative agent and the urine content of beta-lysines in urine. The authors base
      the necessity of the preventive treatment of children with predisposing
      conditions and abacterial TIN to avert the formation and progression of bacterial
      TIN by means of agents that may prevent the persistence of causative agents and
      raising the efficacy of antiinfectious defence of the macroorganism.

PMID- 1754328
TI  - [Tubulo-interstitial syndrome in children with hemolytic-uremic syndrome].
AB  - As many as 53 patients with the hemolyticouremic syndrome in the acute stage were
      examined and treated as were 29 patients in the long-term observation period
      (after 12-18 months). The characteristic features of the urinary syndrome in the
      acute and long-term observation period and the nephrobiopsy data 12-18 months
      after the hemolyticouremic syndrome point out that the tubulointerstitial
      component is of paramount importance in the impairment of the kidneys in patients
      with the hemolyticouremic syndrome.

PMID- 1754329
TI  - [Hepatitis B infection and primary glomerulonephritis in children].
AB  - Out of 165 children presenting with renal pathology, HBV-infection was detected
      by RIA in 69.7% of children suffering from glomerulonephritis and in 30.8% of
      children with pyelonephritis. The infection manifested by the carriage of HBs
      antigen and persistent hepatitis. Unlike the control group (without HBv
      infection), in patients with HBv-infection, glomerulonephritis was characterized
      by the development of a prognostically unfavourable mixed form there of in
      children under 7 years, by rare cases of the onset of a complete remission
      consequent to immunosuppressive therapy, a decline of the level of serum IgG and
      the T lymphocyte count, a reduction of the helper/suppressor ratio to 1.21 at the
      expense of a decrease of the number of helpers, and a higher amount of
      lymphocytes expressing receptors to IL-2.

PMID- 1754330
TI  - [Effect of various infections on the development, course and outcome of
      glomerulonephritis in children].
AB  - Bacteriological and virological tests were made at the disease onset and
      repeatedly in 100 children (66 boys and 34 girls) aged 2 to 15 years suffering
      from acute glomerulonephritis. The throat mucus was found to contain streptococci
      and staphylococci; direct immunofluorescence demonstrated antigens of influenza
      A1, A3, B virus, of parainfluenza virus, serotypes 1 and 3, of adenovirus and
      respiratory and syncytial virus; HBs-antigens, specific viral and bacterial
      antibodies were detected in the blood serum. At the onset of acute
      glomerulonephritis, 52.5% of the patients were diagnosed to have bacterial
      infection, 12.5% respiratory viral infection, and 27.5% mixed infection
      (respiratory viral and bacterial). Besides, 25.5% of the patients showed HBs
      antigenemia. HBs-antigenemia and mixed (respiratory viral and bacterial)
      infection were found to produce an adverse effect on the course and outcome of
      acute glomerulonephritis. Long-term circulation of some viral antibodies (mostly
      to parainfluenza-3 antigen) was revealed on repeated studies as was their
      untoward effect on the outcome of acute glomerulonephritis.

PMID- 1754331
TI  - [Synchronization of plasmapheresis and pulse therapy in the complex treatment of
      children with highly active glomerulonephritis].
AB  - To suppress the activity of glomerulonephritis, lupus and primary chronic mixed
      one, 13 children received plasmapheresis synchronously with pulse therapy with
      cyclophosphamide or prednisolone. Plasmapheresis was carried out daily for 3
      days. Six hours after the last session and on days 4 and 5 of the treatment pulse
      therapy was provided, followed by conventional intake of prednisolone per os in
      combination with azathioprine or cyclophosphamide. Beneficial therapeutic results
      were obtained in 10 patients within 3 to 6 weeks. The effect turned out
      insufficient in a patient with associated systemic lupus erythematosus, and rapid
      progressing nephritis and in a child with primary chronic glomerulonephritis of
      the mesangiocapillary type with fibroplastic transformation and persistent
      nephrotic syndrome. No therapeutic effect was attained in a patient with focal
      segmental glomerulosclerosis running its course with long persistent nephrotic
      syndrome.

PMID- 1754332
TI  - [Nephrotic syndrome in children: traditional and changing views on its
      pathogenesis and treatment].

PMID- 1754333
TI  - [Diagnostic value of the polarographic test in children with a nephrotic form of
      chronic glomerulonephritis].

PMID- 1754334
TI  - [Evaluation of the effectiveness of various programs of active therapy of primary
      glomerulonephritis with nephrotic syndrome in children].

PMID- 1754335
TI  - [Effectiveness of the treatment of a nephrotic form of glomerulonephritis in
      children].

PMID- 1754336
TI  - [Results of the treatment of glomerulonephritis in children with hepatitis B].

PMID- 1754337
TI  - [Use of microelement and coenzyme preparations in the complex treatment of
      children with chronic pyelonephritis].

PMID- 1754338
TI  - [Crigler-Najjar syndrome in an infant during the 1st year of life].

PMID- 1754339
TI  - [Intravenous immunoglobulins in pediatric practice].

PMID- 1754340
TI  - [Clinico-immunological aspects of gastrointestinal diseases in children].
AB  - The data on the status of immunoregulation in 144 children with gastroduodenal
      pathology are provided as are indications for differentiated immunomodulatory
      therapy. As many as 100 children with celiac disease treated by means of long
      administration of the gluten-free diet were examined for the immunogenetic
      aspects and changes in the immune status. The authors demonstrate the incidence
      of recurrent intestinal disorders among 24 children with primary immunodeficiency
      states.

PMID- 1754341
TI  - [Rehabilitative treatment of children with bronchial asthma and recurrent
      bronchitis at the sanatorium stage].

PMID- 1754342
TI  - [The pepsinogen-pepsin system in gastroduodenal pathology in children].
AB  - The changes in the pepsinogen pepsin system reflect the degree of morphological
      alterations in the gastric mucosa. Based on the results of examining 98 children
      suffering from gastroduodenal diseases, the possibility is shown of
      distinguishing genetic and biochemical markers of duodenal ulcer. The
      characteristic features of the isoenzymic spectrum of pepsinogen-pepsin in
      different gastroduodenal diseases are demonstrated.

PMID- 1754343
TI  - [Clinico-pathogenetic aspects of peptic ulcer in children].
AB  - Overall 98 children with duodenal ulcer were examined. It is shown that the rise
      of the products of lipid peroxidation in gastric juice enhances the aggressive
      properties of gastric juice and stimulates defence reactions of the gastric
      mucosa and duodenum. Lipid oxidation and the antioxidant systems of gastric juice
      were discovered to be disordered. The changes thus revealed are of diagnostic
      importance for detecting the recurrent nature of the disease.

PMID- 1754344
TI  - [Ulcerous and non-ulcerous gastrointestinal hemorrhage in children].
AB  - The authors analyze the causes of gastrointestinal hemorrhages in 64 children
      aged 11 months to 15 years. 45 children had ulcerous and 19 non-ulcerous
      hemorrhages. The presence of gastrointestinal hemorrhages is an absolute
      indication for emergency esophagogastroduodenoscopy which appeared helpful in
      visualization of the source of hemorrhage in 60 out of the 64 patients (93.7%). 8
      children underwent surgery, whereas in the remaining ones, hemorrhage was
      arrested by conservative treatment methods.

PMID- 1754345
TI  - [Absorption of carbohydrates in children with chronic enterocolitis].
AB  - Absorption of carbohydrates was studied over time (according to the D-xylose test
      in 140 patients. Excretion of D-xylose with urine was found to be lowered in the
      overwhelming majority of the patients both during exacerbation and remission.
      Absorption of D-xylose was established to depend on the status of the upper
      alimentary tract, spreading of the process in the intestine, the character of
      morphological alterations in the intestinal mucosa, and so forth. These factors
      should be taken into account in the treatment administration.

PMID- 1754346
TI  - [Membrane-destructive processes in lesions of the biliary system in children].
AB  - The authors analyze the data on lipid peroxidation in children with biliary
      system derangement. Lipid peroxidation was found to be significantly activated in
      children with exacerbation of chronic cholecystocholangitis and hypokinetic
      dyskinesia of the biliary tract. The data obtained suggest the development of the
      cytolysis syndrome in patients with inflammatory and functional diseases of the
      biliary tract. It is therefore recommended that the complex of treatment measures
      may include membrano-stabilizing agents.

PMID- 1754347
TI  - [Problems and perspectives of pediatric gastroenterology].

PMID- 1754348
TI  - [Differential diagnosis of gallbladder diseases in children].
AB  - To estimate the information content of different methods of diagnosing biliary
      diseases, 103 children aged 5 to 15 years, including 25 practically healthy
      children as control, were examined. Abdominal organs, particularly the liver and
      gallbladder were examined by echography. The duodenal contents was explored by
      microscopy of the sediment and biochemistry which included analysis in the
      vesicular and liver portions of the concentrations of phospholipids, activity of
      phospholipases A and C as well as measurements of creatine kinase, lactate
      dehydrogenase, alkaline phosphatase, C-reactive protein and of the diphenylamine
      index. Ultrasonography was found to be highly informative. The characteristic
      echographic alterations seen in dyskinesia of the biliary tract, dyscholias and
      chronic cholecystitis were defined. For differential diagnosis of dyscholia and
      chronic cholecystitis it is necessary to carry out biochemistry of the duodenal
      contents including measurements of phospholipids, activity of phospholipases A
      and C, alkaline phosphatase, creatine kinase, lactate dehydrogenase, C-reactive
      protein and the diphenylamine index. Based on the similarity of the alterations
      seen in children with different cholepathies, a concept is advanced of the
      mechanisms by which functional and organic diseases of the gallbladder are
      formed.

PMID- 1754349
TI  - [Distant thermography in the diagnosis of digestive organ diseases in children].
AB  - The authors review the most urgent problems of alimentary diseases in children:
      diagnosis, differential diagnosis and early detection with the use of remote
      thermography, an up-to-date noninvasive and atraumatic research method. The
      method was demonstrated to be highly informative in diseases such as
      gastroduodenitis, peptic ulcer, chronic pancreatitis and others. The significance
      of remote thermography in revealing functional pathology of the alimentary organs
      in children is emphasized.

PMID- 1754350
TI  - [Results of the treatment of pyloric helicobacteriosis in children with
      gastroduodenal pathology].

PMID- 1754351
TI  - [Immunomorphological criteria of the effectiveness of treatment of pyloric
      campylobacteriosis in children].

PMID- 1754352
TI  - [Sanatorium-health resort treatment of children with biliary diseases].

PMID- 1754353
TI  - [Immunization of children with long-term diarrhea].

PMID- 1754354
TI  - [Staged treatment of children with digestive system diseases].

PMID- 1754355
TI  - [Dysbacteriosis in children with gastrointestinal diseases].

PMID- 1754356
TI  - [Clinical syndromes and treatment tactics in cow's milk intolerance in young
      children].

PMID- 1754357
TI  - [Diagnosis of chronic pancreatitis in children].

PMID- 1754358
TI  - [Nondrug treatment of chronic digestive system diseases in children].

PMID- 1754359
TI  - [Treatment of duodenal ulcer in children].

PMID- 1754360
TI  - Two-stage model of visual backward masking: sensory transmission and accrual of
      effective information as a function of target intensity and similarity.
AB  - A functional model is used to describe the effect of target intensity and target
      set similarity on backward visual masking. The model consists of two distinct
      stages of visual information processing. The first stage is related to sensory
      transduction and transmission and is assumed to require a finite and measurable
      amount of time during which performance remains at chance. The second stage,
      associated with central processing, is characterized by a negatively accelerated
      growth function reflecting the accrual of effective information. Results show
      that the duration of the transmission stage is inversely related to target
      intensity. Surprisingly, the rate of information accrual is an interactive
      function of both target intensity and target-set similarity. The pattern of
      results is consistent with the interpretation that both intensity and similarity
      mediate their effect through a common mechanism--the accrual of effective
      information.

PMID- 1754361
TI  - Informational masking and auditory attention.
AB  - Informational masking is broadly defined as a degradation of auditory detection
      or discrimination of a signal embedded in a context of other similar sounds; it
      is not related to energetic masking caused by physical interactions between
      signal and masker. In this paper, we report a systematic release from
      informational masking of a target tone in a nine-tone rapid auditory sequence as
      the target is increasingly isolated in frequency or intensity from the remaining
      sequence components. Improved target-tone frequency difference limens as
      isolation increases are interpreted as a reflection of increasingly focused
      auditory attention. The change from diffuse to highly focused attention is
      gradual over the frequency and intensity ranges examined, with each 1-dB
      increment in target intensity relative to the remaining components producing
      performance improvements equivalent to those produced by a 2% increase in
      frequency isolation. The results are modeled as bands of attention in the
      frequency and intensity domains. For attention directed by frequency isolation,
      there is a strong correspondence with auditory filters predicted by the power
      spectrum model of masking. These data also support the existence of an attention
      band of intensity, with a bandwidth of about 5-7 dB at the moderate levels used
      in this experiment.

PMID- 1754362
TI  - The object-detection effect: configuration enhances perception.
AB  - Line drawings used by Weisstein and Harris (1974) are seen as box-like three
      dimensional figures if the lines are arranged properly. A flat two-dimensional
      pattern is seen when these same lines are disarranged. A target line contained
      within the three-dimensional figure is identified more readily than is the same
      line contained within a two-dimensional figure. This finding was extended in the
      present experiments: The three-dimensional stimulus was detected more quickly
      than the two-dimensional stimulus, under conditions of visual backward masking.
      Three-dimensional stimuli were also classified more quickly than two-dimensional
      stimuli. Just as with the face-detection effect and the word-detection effect,
      object detection can be affected by the form of the visual stimulus.

PMID- 1754363
TI  - The effect of lightness contrast on the colored Muller-Lyer illusion.
AB  - Two subjects estimated the length of the central line in red and blue Muller-Lyer
      figures that were viewed both foveally and parafoveally. The illusion figures
      were defined by either lightness and hue differences between figure and ground or
      by a hue difference alone. For both subjects, the figures defined solely by hue
      produced larger illusions. Since depth-cue scaling and other cognitive factors
      did not cause the enlargement, it was concluded that the robust, hue-produced
      illusions resulted from contour interactions generated within parvocellular
      channels that are specialized for coding color.

PMID- 1754364
TI  - Induced motion of a fixated target: influence of voluntary eye deviation.
AB  - Induced motion (IM) was observed in a fixated target in the direction opposite to
      the real motion of a moving background. Relative to a fixation target located
      straight ahead, IM decreased when fixation was deviated 10 degrees in the same
      direction as background motion and increased when fixation was deviated 10
      degrees opposite background motion. These results are consistent with a
      "nystagmus-suppression" hypothesis for subjective motion of fixated targets: the
      magnitude of illusory motion is correlated with the amount of voluntary efference
      required to oppose involuntary eye movements that would occur in the absence of
      fixation. In addition to the form of IM studied, this explanation applies to
      autokinesis, apparent concomitant motion, and the oculogyral illusion. Accounts
      of IM that stress visual capture of vection, afferent mechanisms, egocenter
      deviations, or phenomenological principles, although they may explain some forms
      of IM, do not account for the present results.

PMID- 1754365
TI  - The role of spatially selective attention in the tactile perception of texture.
AB  - During manual sensing of object attributes like surface texture, the tactile
      receptor sheet is conjointly activated at numerous loci. What is the role of
      spatially selective attention in perception under these conditions? We show that
      the requirement for spatial focus of attention is minimal in the detection of an
      abrupt change in texture. In contrast, spatial attention may help in a variety of
      other tasks of comparable difficulty. These include detecting the absence of a
      texture change at one of many loci, distinguishing its direction, and
      discriminating between different textures. Attentional demand appears to vary
      along a continuum in these tasks, rather than being all-or-none.

PMID- 1754366
TI  - Characteristics of the indirect McCollough effect.
AB  - Induction of contingent color aftereffects with a single chromatic grid sometimes
      results in an illusory color on a grid different from the one presented during
      induction. Such illusory color, contingently elicited by a noninduced grid, has
      been termed the indirect McCollough effect (indirect ME). We show that the
      indirect ME occurs only when the color complementary to the grid color is present
      during induction (either physically present or as a color afterimage), and that
      the indirect ME is seen only on gratings that are orthogonal to the induction
      orientation. These findings are in accord with the account of the indirect ME
      proposed by Humphrey, Dodwell, and Emerson (1989). We also show that
      characteristics of the indirect ME (seen following one-grid induction), both on
      induced and orthogonal orientations, are similar to those observed with the
      direct ME (seen following the usual two-grid induction procedure). Both
      procedures result in contingent aftereffects that display substantial retention
      and that do not display interocular transfer.

PMID- 1754367
TI  - Early and late selection in partial report: evidence from degraded displays.
AB  - In studies of iconic memory using the bar-probe task, subjects see a brief
      display of target letters and are probed by an arrow to report one of them.
      According to the classic early-selection account, subjects use the probe to
      select material for perceptual analysis from a precategorical (iconic) memory,
      but according to late-selection theories, subjects first identify the letters and
      then use the probe to select one letter for report from the set of categorized
      items. Pashler (1984) based his test for the locus of selection on a manipulation
      of display quality in previewed displays. He presented a target for 200 msec and
      then added a probe, together with the target, for an additional 150 msec.
      Reducing the target's stimulus quality increased response latency. If the
      subjects identified the characters before the probe appeared and then selected an
      item for report, the clarity of the original array should not have affected
      response latency. Hence, Pashler concluded that his subjects used the probe to
      select from a precategorical store (early selection). Pashler's experiment did
      not force subjects to rely on memory of the target; hence, although his
      experiment documented a situation in which subjects used early selection, it did
      not rule out late selection in studies of information persistence. We replicated
      Pashler's findings and, using his logic, showed that when subjects are forced to
      rely on memory of the target, they select from a categorized store.

PMID- 1754368
TI  - Perceptual organization and focused attention: the role of objects and proximity
      in visual processing.
AB  - The influence of the Gestalt grouping principles of similarity, closure, and
      proximity on the size of the response-compatibility effect was examined in a
      focused attention task. In three studies, subjects responded to a centrally
      located target and attempted to ignore adjacent distractors. The distractors,
      which served as targets on other trials, could be compatible, incompatible, or
      neutral with respect to the response of the target. In addition, the distractors
      and the target could be embedded in the same object, presented in the same color,
      presented on different objects, or presented in different colors. The typical
      response-compatibility effect (B. A. Eriksen & C. W. Eriksen, 1974) was found
      when the target and distractors were embedded in the same object or presented in
      the same color. Performance was poorer when the target was surrounded by response
      incompatible distractors than when it was surrounded by response-compatible
      distractors. However, the response-compatibility effect was eliminated when the
      target and distractors were embedded in different objects, even when the distance
      between the items was less than .25 degrees of visual angle. Furthermore, the
      response-compatibility effect was of intermediate size when the distractors were
      not grouped strongly with the target or with neutral flankers. The results are
      discussed in terms of space- and object-based models of visual attention.

PMID- 1754369
TI  - Attentional scanning and space errors.
AB  - Using the method of paired comparisons, pairs of simultaneous horizontal or
      vertical lines, with one line above and one below or one on the left and one on
      the right of a fixation point, respectively, were presented tachistoscopically
      for length comparison. Space errors were found to have a pattern similar to that
      of time errors. The tendency to guess the comparative response from the absolute
      magnitude of stimuli is proposed as a basis for time and space errors.
      Manipulation of attentional scanning, which implies a more frequent usage of this
      guessing strategy for one of the two lines in a pair, was shown to affect space
      errors.

PMID- 1754370
TI  - Auditory pattern perception: the effect of tone location on the discrimination of
      tonal sequences.
AB  - This study examined the effect of tonal location on the discrimination of
      sequences differing in the order of the tones and on their perceived grouping.
      The frequency range between the sequential tones was held constant. When all
      tones came from the same location, the sequence was rated as integrated, but when
      the higher frequency tones came from a different location than the lower
      frequency tones, the sequence was rated as segregated. Listeners discriminated
      the sequences in a 3IFC task. Discrimination performance was impaired when the
      sequence was split between two locations and tonal order was changed in only one
      location, even though the order of tones in different locations was changed. This
      result suggests that listeners have difficulty relating tones across locations or
      in different perceptual groups. Performance in this experiment is generally
      better than that observed by Barsz (1988), and it is suggested that the level of
      stimulus uncertainty explains this difference.

PMID- 1754371
TI  - Further evidence for Coren and Hakstian's "Methodological implications of
      interaural correlation: count heads not ears" and an alternative correction
      formula.
AB  - Coren and Hakstian (1990) identified a serious methodological problem that arises
      in auditory research because of interaural correlation. When measures from both
      ears of the subjects are pooled together in an experimental design that assumes
      independence of measures, there can be spuriously high apparent statistical
      significance. The present paper provides further evidence in support of Coren and
      Hakstian's argument and also derives a formula that effectively corrects inflated
      test statistics resulting from interaural correlation. This formula is a special
      case of a more general one that applies in many other experimental contexts in
      which nonindependence of measures is a problem. We found that statistical tests
      based on our formula have somewhat greater power to detect differences than the
      kind of correction method advocated by Coren and Hakstian.

PMID- 1754372
TI  - More than half of yeast U1 snRNA is dispensable for growth.
AB  - Yeast U1 snRNA (568 nucleotides) is 3.5-fold larger than its mammalian
      counterpart (164 nucleotides) and contains apparent sequence homology only at the
      5' and 3' ends. We have used deletion analysis to determine whether the yeast
      specific U1 sequences play essential roles in vivo. Yeast cells carrying a
      deletion of more than 60% (355 nucleotides) of the single-copy U1 gene are
      viable, though slow-growing, while a deletion of 316 nucleotides allows
      essentially wild-type growth. The boundaries of the viable deletions define a
      dispensable internal domain which comprises sequences unique to yeast. In
      contrast, the essential 5' and 3' terminal domains correspond to phylogenetically
      conserved sequences and/or structures previously implicated in RNA:RNA and
      RNA:protein interactions. The minimal essential sequences of yeast U1 can be
      drawn in a secondary structure which resembles metazoan U1 in four of seven
      structural domains.

PMID- 1754373
TI  - Operation of an efficient site-specific recombination system of Zygosaccharomyces
      rouxii in tobacco cells.
AB  - Recombinase encoded by the R gene of pSR1 of Zygosaccharomyces rouxii mediates
      reciprocal recombination between two specific recombination sites (RSs) to induce
      excision or inversion of the DNA segment that is flanked by the RSs. We report
      here that site-specific recombination mediated by this system takes place
      effeciently in tobacco cells. To monitor the recombination events in tobacco
      cells, we have constructed two types of cryptic beta-glucuronidase reporter gene
      in such a way that recombination such as inversion of the construct or excision
      of the intervening sequence results in their expression. When these cryptic
      reporter constructs were transiently introduced together with the R gene by
      electroporation into protoplasts of tobacco cells, beta-glucuronidase activity
      was detected. The cryptic reporter genes, when stably resident in the chromosome
      of tobacco cells, were also activated by the R gene. Structural analyses of the
      genomic DNA isolated from these tobacco cells showed that the R protein did in
      fact catalyze precise recombination between two copies of RSs in tobacco cells,
      with resultant activation of the cryptic reporter genes. This observation
      provides the basis for development of a DNA technology whereby large regions of
      DNA can be manipulated in plant chromosomes. Potential uses of this recombination
      system are discussed.

PMID- 1754374
TI  - Liver specific transcription factors of the HNF3-, C/EBP- and LFB1-families
      interact with the A-activator binding site.
AB  - The A-activator binding site (AABS), present in the Xenopus A2 vitellogenin gene
      and several mammalian liver specifically expressed genes, interacts with
      different liver specific transcription factors including LFB1- and C/EBP
      isobinders. We have now isolated some additional proteins interacting with AABS
      and show that they are HNF3-isobinders. The interactions between AABS and members
      of the HNF3 family are confirmed by binding studies using bacterially made HNF3
      alpha protein. Thus a short DNA module of 24 bp is able to bind proteins of three
      different families of liver specific transcription factors. Competition
      experiments in the cell free in vitro transcription show that AABS dependent
      transcriptional activation is mediated by transcription factors belonging to at
      least two different families, the C/EBP- and the HNF3-isobinders. Being able to
      mediate the action of several distinct transactivators, AABS may thus be a
      prototype for a novel kind of tissue specific promoter modules with unique
      regulatory capacities.

PMID- 1754375
TI  - Minisatellite binding protein Msbp-1 is a sequence-specific single-stranded DNA
      binding protein.
AB  - Msbp-1 is a minisatellite-specific DNA-binding protein. Using synthetic binding
      substrates, we now show that Msbp-1 binds not to double-stranded DNA, but
      exclusively to single-stranded DNA. Binding is specific to the guanine-rich
      strand of the minisatellite duplex, interactions with the cytosine-rich strand
      being undetectable by southwestern analysis. Furthermore, the binding site
      required for successful DNA-protein interactions appears to be two or more
      minisatellite repeat units. We have also isolated, by whole-genome PCR and
      cloning, one Msbp-1 binding site from the human genome. Again, the binding strand
      of this molecule contains a repetitive G-rich structure equivalent to that of a
      small minisatellite. These observations are discussed with respect to other
      single-stranded DNA-binding proteins known to play a role in recombination
      processes.

PMID- 1754376
TI  - A highly efficient, cell-free translation/translocation system prepared from
      Xenopus eggs.
AB  - We describe the use of a Xenopus laevis egg extract for the in vitro translation
      and post translational modification of membrane and secretory proteins. This
      extract is capable of the translation and segregation into membranes of microgram
      per millilitre levels of protein from added mRNAs. Signal sequences of segregated
      proteins are efficiently cleaved and appropriate N-linked glycosylation patterns
      are produced. The extract also supports the quantitative assembly of murine
      immunoglobulin heavy and light chains into tetramers, and two events which take
      place beyond the endoplasmic reticulum, mannose 6 phosphorylation of murine
      cathepsin D and O-linked glycosylation of coronavirus E1 protein, also occur, but
      at reduced efficiency. The stability of the membranes allows protease protection
      studies and quantitative centrifugal fractionation of segregated and unsegregated
      proteins to be performed. Conditions for the use of stored extract have also been
      determined.

PMID- 1754377
TI  - Ca(2+)-mediated inhibition of a nuclear protein that recognizes UV-damaged DNA
      and is constitutively overexpressed in resistant human cells: DNA-binding assay.
AB  - A nuclear protein that recognizes UV-damaged DNA was detected from HeLa cells
      using DNA-binding assay. Treatment of cells with Ca2+ ionophore (A23187) caused a
      dramatic inhibition of the damage-recognition activity. In contrast, in vitro
      treatment of nuclear extracts with agents that affect protein conformation (such
      as urea, NP40 and Ca2+) did not significantly affect on the damage-recognition
      activity. The Ca(2+)-mediated inhibition of UV damage recognition was
      reconstituted by the addition of the cytosolic extracts, suggesting that the Ca2+
      effect does not directly act on the UV damage-recognition protein. The expression
      of the detected nuclear protein was increased in UV-resistant HeLa cells. In
      contrast, the level of this protein was dramatically reduced in UV-sensitive
      xeroderma pigmentosum group A cells. In addition, UV damage-recognition protein
      is resistant to RNase, and is independent of the previously identified proteins
      that bind cisplatin-DNA adduct. These findings implied that the recognition of UV
      DNA adduct is modulated by the intracellular level of Ca2+.

PMID- 1754378
TI  - Sequence specific protein binding to and activation of the TGF-beta 3 promoter
      through a repeated TCCC motif.
AB  - We have previously characterized the TGF-beta 3 promoter and shown that the
      activity of this promoter is highly variable in different cell types. Although
      the promoter contains a proximal cAMP responsive element, which is critical to
      basal and forskolin-induced promoter activity, this element is not responsible
      for the variable, cell-specific regulation of the promoter. In this paper, we
      identify a 25 base pair sequence in the proximal region of the TGF-beta 3
      promoter that binds a novel DNA-binding protein. This region includes the
      sequence T-CCCTCCCTCCC, (3 x TCCC), and mutation of these T-CCC repeats inhibits
      protein binding. Further, we show that in the cell line A375, which we have
      previously shown expresses high levels of TGF-beta 3 mRNA, this region is
      responsible for mediating high level TGF-beta 3 promoter activity. Immediately 3'
      to the 3 x TCCC sequence is a consensus AP-2 binding site, however, we show that
      this region does not bind AP-2, and AP-2 does not transactivate the TGF-beta 3
      promoter. Therefore, we provide strong evidence that high level expression of TGF
      beta 3 in A375 cells results from transactivation of the TGF-beta 3 promoter by a
      protein that binds to a repeated TCCC motif in the promoter and suggest that this
      DNA-binding protein likely also regulates aspects of developmental and tissue
      specific expression of this cytokine.

PMID- 1754379
TI  - Induction of S.cerevisiae MAG 3-methyladenine DNA glycosylase transcript levels
      in response to DNA damage.
AB  - We previously showed that the expression of the Saccharomyces cerevisiae MAG 3
      methyladenine (3MeA) DNA glycosylase gene, like that of the E. coli alkA 3MeA DNA
      glycosylase gene, is induced by alkylating agents. Here we show that the MAG
      induction mechanism differs from that of alkA, at least in part, because MAG mRNA
      levels are not only induced by alkylating agents but also by UV light and the UV
      mimetic agent 4-nitroquinoline-1-oxide. Unlike some other yeast DNA-damage
      inducible genes, MAG expression is not induced by heat shock. The S. cerevisiae
      MGT1 O6-methylguanine DNA methyltransferase is not involved in regulating MAG
      gene expression since MAG is efficiently induced in a methyltransferase deficient
      strain; similarly, MAG glycosylase deficient strains and four other methylmethane
      sulfonate sensitive strains were normal for alkylation-induced MAG gene
      expression. However, de novo protein synthesis is required to elevate MAG mRNA
      levels because MAG induction was abolished in the presence of cycloheximide. MAG
      mRNA levels were equally well induced in cycling and G1-arrested cells,
      suggesting that MAG induction is not simply due to a redistribution of cells into
      a part of the cell cycle which happens to express MAG at high levels, and that
      the inhibition of DNA synthesis does not act as the inducing signal.

PMID- 1754380
TI  - Characterisation of a genomic clone covering the structural mouse MyoD1 gene and
      its promoter region.
AB  - We have isolated the mouse MyoD1 gene flanked by its promoter region by screening
      a genomic library with synthetic oligonucleotides. The structural gene is
      interrupted by two G + C rich introns. Transfection of the cloned gene inserted
      into an expression vector converts fibroblasts to myoblasts. Sequence analysis of
      about 650 bp of the 5' upstream region revealed the presence of several potential
      regulatory elements such as a TATA-box, an AP2-box, two SP1-boxes and a CAAT-box.
      In addition, there are three half palindromic estrogen response elements, a
      potential cAMP response element and various muscle specific elements such as a
      muscle-specific CAAT-box (MCAT) and four potential binding sites for MyoD1. Using
      S1 protection analysis the major start site of transcription in muscle and
      myoblast cells was mapped 3 bp upstream of the published cDNA 5' end. Promoter
      activity of the 650 bp upstream fragment was tested by in vitro transcription and
      by transfection analysis of myoblasts and fibroblasts. In all promoter test
      systems used, MyoD1 promoter activity was detected in myoblasts as well as in
      fibroblasts. Furthermore, DNA methylation was found to turn off MyoD1 promoter
      activity both in myoblasts and in fibroblasts.

PMID- 1754381
TI  - The Trypanosoma brucei DNA polymerase alpha core subunit gene is developmentally
      regulated and linked to a constitutively expressed open reading frame.
AB  - As an initial step towards the characterization of replicative DNA polymerases of
      trypanosomes, we have cloned, sequenced and examined the expression of the
      Trypanosoma (Trypanozoon) brucei brucei gene that encodes the DNA polymerase
      alpha catalytic core (pol alpha). The protein sequence contains the six conserved
      regions that have been recognized previously in eukaryotic and viral replicative
      DNA polymerases. In addition, we have identified a seventh region which appears
      to be conserved primarily in alpha-type DNA polymerases. The T.brucei DNA pol
      alpha core N-terminus is 123 and 129 amino acids smaller than that of the human
      and yeast homologue, respectively. The gene is separated by 386 bp from an
      upstream open reading frame (ORF) of 442 codons. Stable transcripts of the
      upstream sequence are detected in both dividing and non-dividing forms, while pol
      alpha transcripts are detected principally in dividing forms. Allelic copies of
      the T.brucei pol alpha region exhibit restriction site polymorphisms; one such
      sequence polymorphism affects the amino acid sequence of the T.brucei DNA pol
      alpha core. The T.brucei pol alpha region cross-hybridizes weakly with that of
      T.(Nannomonas) congolense and T.(Duttonella) vivax.

PMID- 1754382
TI  - Regulation of polyadenylation in hepatitis B viruses: stimulation by the upstream
      activating signal PS1 is orientation-dependent, distance-independent, and
      additive.
AB  - Hepatitis B viruses replicate by reverse transcription of a genomic RNA which
      harbors terminal redundancies. The synthesis of this RNA requires that
      transcription proceed twice through the polyadenylation (pA) site which, in
      mammalian strains, is flanked by the variant hexanucleotide UAUAAA and a T-rich
      downstream domain. These core elements are by themselves virtually defective in
      3' end processing and require multiple upstream accessory elements which regulate
      pA site use. In ground squirrel hepatitis B virus (GSHV), one of these signals
      (PS1; -215 to -107 relative to UAUAAA) is transcribed only at the 3' end of
      genomic RNA and as such is analogous to retroviral U3 sequences. PS1 cooperates
      with other signals to enhance pA site use to very high levels and can be further
      sub-divided into two regions (A and B) which contribute equally to 3' end
      processing. Critical residues within PS1B have been localized to a 15 bp A/T-rich
      stretch which displays homology to other known upstream activating signals. A 15
      bp segment within PS1A which has the identical A/T content but a divergent
      primary sequence plays a diminished role in processing. Furthermore, PS1 can
      activate GSHV core element usage autonomously. This stimulation has been shown to
      be additive since multiple copies of PS1 progressively increase polyadenylation,
      a phenomenon which also demands that PS1 exert its influence from a variety of
      distances from the hexanucleotide signal.

PMID- 1754383
TI  - Stereochemistry of methyl transfer catalyzed by tRNA (m5U54)-methyltransferase-
      evidence for a single displacement mechanism.
AB  - tRNA (m5U54)-methyltransferase (RUMT) catalyzes the transfer of a methyl group
      from S-adenosyl-L-methionine (AdoMet) to the 5-carbon of uridine 54 of tRNA. We
      have determined the steric course of methyl transfer, using (methyl-R)- and
      (methyl-S)-[methyl-2H1,3H]-AdoMet as the chiral methyl donors, and tRNA lacking
      the 5-methyl group at position 54 as the acceptor. Following methyl transfer,
      ribothymidine was isolated and degraded to chiral acetic acid for configurational
      analysis. Transfer of the chiral methyl group to U54 proceeded with inversion of
      configuration of the chiral methyl group, suggesting that RUMT catalyzed methyl
      transfer occurs by a single SN2 displacement mechanism.

PMID- 1754384
TI  - Molecular cloning of the gene encoding the bovine brain ribonuclease and its
      expression in different regions of the brain.
AB  - In this paper we report the molecular cloning of the gene encoding the bovine
      brain ribonuclease. The nucleotide sequence determined in this work shows a high
      degree of identity to the homologous gene encoding the bovine pancreatic
      ribonuclease. Processing of the primary transcripts of these genes also follows a
      similar pathway, splicing of the unique intron in the 5' untranslated region
      occurs at corresponding positions. Expression of the bovine brain ribonuclease
      gene can be detected both at the transcriptional and translational levels in all
      the regions of the brain examined.

PMID- 1754385
TI  - Spontaneous deletions in Ig heavy chain genes: flanking sequences influence
      splice site selection.
AB  - The cell line G403.4.7, isolated as a spontaneous variant of the MPC-11 derived
      myeloma G403.4, produces a truncated gamma 2b HC protein, but no light chain
      (LC), and a single gamma 2b specific transcript of 2.4kb. This gamma 2b
      transcript consists of the VDJ and CH1 exons, the CH1 to Hinge (Hi) intervening
      sequence (IVS) and HI exon, part of the IVS between the two membrane exons M1 and
      M2, and most of the membrane 3' untranslated (UT) region. Even though the mature
      mRNA contains intronic sequences, it is abundant in the cytoplasm. Analysis of
      the gamma 2b genomic organization reveals that this unusual transcript results in
      part from two genomic deletions of 2.5kb and 588bp and in part from an altered
      splicing pattern. This altered splicing pattern is probably a consequence of the
      sequence alterations resulting from the genomic deletions. Analysis of these
      events provides some interesting insights into the mechanism of splice site
      selection and the evolution of introns and exons.

PMID- 1754386
TI  - A trace display and editing program for data from fluorescence based sequencing
      machines.
AB  - 'Ted' (Trace editor) is a graphical editor for sequence and trace data from
      automated fluorescence sequencing machines. It provides facilities for viewing
      sequence and trace data (in top or bottom strand orientation), for editing the
      base sequence, for automated or manual trimming of the head (vector) and tail
      (uncertain data) from the sequence, for vertical and horizontal trace scaling,
      for keeping a history of sequence editing, and for output of the edited sequence.
      Ted has been used extensively in the C.elegans genome sequencing project, both as
      a stand-alone program and integrated into the Staden sequence assembly package,
      and has greatly aided in the efficiency and accuracy of sequence editing. It runs
      in the X windows environment on Sun workstations and is available from the
      authors. Ted currently supports sequence and trace data from the ABI 373A and
      Pharmacia A.L.F. sequencers.

PMID- 1754387
TI  - RNA binding properties of the coat protein from bacteriophage GA.
AB  - The coat protein of bacteriophage GA, a group II RNA phage, binds to a small RNA
      hairpin corresponding to its replicase operator. Binding is specific, with a Ka
      of 71 microM -1. This interaction differs kinetically from the analogous coat
      protein-RNA hairpin interactions of other RNA phage and also deviates somewhat in
      its pH and salt dependence. Despite 46 of 129 amino acid differences between the
      GA and group I phage R17 coat proteins, the binding sites are fairly similar. The
      essential features of the GA coat protein binding site are a based-paired stem
      with an unpaired purine and a four nucleotide loop having an A at position -4 and
      a purine at -7. Unlike the group I phage proteins, the GA coat protein does not
      distinguish between two alternate positions for the unpaired purine and does not
      show high specificity for a pyrimidine at position -5 of the loop.

PMID- 1754388
TI  - Genetic organization of the KpnI restriction--modification system.
AB  - The KpnI restriction-modification (KpnI RM) system was previously cloned and
      expressed in E. coli. The nucleotide sequences of the KpnI endonuclease (R.KpnI)
      and methylase (M. KpnI) genes have now been determined. The sequence of the amino
      acid residues predicted from the endonuclease gene DNA sequence and the sequence
      of the first 12 NH2-terminal amino acids determined from the purified
      endonuclease protein were identical. The kpnIR gene specifies a protein of 218
      amino acids (MW: 25,115), while the kpnIM gene codes for a protein of 417 amino
      acids (MW: 47,582). The two genes transcribe divergently with a intergeneic
      region of 167 nucleotides containing the putative promoter regions for both
      genes. No protein sequence similarity was detected between R.KpnI and M.KpnI.
      Comparison of the amino acid sequence of M.KpnI with sequences of various
      methylases revealed a significant homology to N6-adenine methylases, a partial
      homology to N4-cytosine methylases, and no homology to C5-methylases.

PMID- 1754389
TI  - Self-cleavage of a 71 nucleotide-long ribozyme derived from hepatitis delta virus
      genomic RNA.
AB  - Self-cleavage efficiency of ribozymes derived from hepatitis delta virus (HDV)
      has been shown to depend on the RNA structure, which in turn may be determined by
      the length of the considered sequences. Here we describe the construction and
      functional analysis of a 71 nucleotide-long RNA genomic fragment, Rz71, which
      carries an 18 nucleotide deletion in a very stable GC-rich stem-loop (stem IV),
      predicted to be present in several computer-derived secondary structure models.
      Rz71 is able to undergo self-cleavage under non-denaturing conditions (the t1/2
      of the reaction at 37 degrees C is 3 min). The deletion, however, is not neutral,
      since under the same conditions the non-deleted ribozyme cleaves to 50% in less
      than 15 sec. Therefore, stem-loop IV seems to play a structural role, not being
      directly involved in the catalytic reaction, but contributing to the correct
      positioning of the catalytic core of the HDV ribozyme. Rz71 is the smallest self
      cleaving sub-fragment of HDV genomic RNA reported so far.

PMID- 1754390
TI  - H-DNA and Z-DNA in the mouse c-Ki-ras promoter.
AB  - The mouse c-Ki-ras protooncogene promoter contains a homopurine-homopyrimidine
      domain that exhibits S1 nuclease sensitivity in vitro. We have studied the
      structure of this DNA region in a supercoiled state using a number of chemical
      probes for non-B DNA conformations including diethyl pyrocarbonate, osmium
      tetroxide, chloroacetaldehyde, and dimethyl sulfate. The results demonstrate that
      two types of unusual DNA structures formed under different environmental
      conditions. A 27-bp homopurine-homopyrimidine mirror repeat adopts a triple
      helical H-DNA conformation under mildly acidic conditions. This H-DNA seems to
      account for the S1 hypersensitivity of the promoter in vitro, since the observed
      pattern of S1 hypersensitivity at a single base level fits well with the H-DNA
      formation. Under conditions of neutral pH we have detected Z-DNA created by a
      (CG)5-stretch, located adjacent to the homopurine-homopyrimidine mirror repeat.
      The ability of the promoter DNA segment to form non-B structures has implications
      for models of gene regulation.

PMID- 1754391
TI  - The structure of the gene coding for the mouse cell adhesion molecule uvomorulin.
AB  - We have recently shown that the Ca2+ dependent cell adhesion molecule uvomorulin
      is encoded by a single gene, localized on mouse chromosome 8. Here we describe
      the organization of the uvomorulin gene and give an initial characterization of
      the uvomorulin promoter. Uvomorulin is encoded by 16 exons, which are distributed
      over a region of more than 40 kb genomic DNA. The exon structure of the genes for
      uvomorulin and its chicken homologue L-CAM are nearly identical and thus highly
      conserved. The relationship between the exon structure and the structure of the
      uvomorulin protein is analysed. The initiation site of transcription of the
      uvomorulin gene is located 127 bp upstream of the translation start site in a GC
      rich region with no TATA-box, but with a GC-box in position -48 and a CCAAT-box
      starting at position -65 with respect to the transcription start site. 1.6 kb of
      the uvomorulin promoter (-1492 to + 92) confer cell type specific promoter
      activity to the CAT reporter gene. Homologies to known cis acting elements of
      other promoters are discussed.

PMID- 1754392
TI  - Induction of the Cyp1a-1 dioxin-responsive enhancer in transgenic mice.
AB  - Cyp1a-1, whose product, aryl hydrocarbon hydroxylase, assists in detoxification
      of polycyclic aromatic hydrocarbons, is the best characterized of the murine
      cytochrome P450 genes. The Cyp1a-1 dioxin-responsive enhancer region has been
      previously analyzed in vitro and found to induce expression of heterologous genes
      upon exposure of transfected cells to various aromatic hydrocarbons. A 2.58 kbp
      DNA fragment containing the Cyp1a-1 enhancer elements and promoter region was
      coupled to the chloramphenicol acetyltransferase (CAT) reporter gene and used to
      create transgenic mice. CAT assays were performed on tissues harvested from three
      different lines of transgenic mice following mock-induction or induction using
      the aromatic hydrocarbon, 3-methylcholanthrene. Basal levels of expression were
      detected in the spleen and small bowel of non-induced mice, with little or no
      expression detected in the liver. Treatment with 3-methylcholanthrene increased
      hepatic expression levels by as much as 10,000-fold. More modest levels of
      induction were also recorded in the spleen, small bowel, kidney, and lung. The
      results indicate that the dioxin-responsive enhancer region functions as a
      strongly inducible promoter in vivo. Differences in the response to induction
      between male and female mice suggest that Cyp1a-1 expression may be governed in a
      gender related manner.

PMID- 1754393
TI  - Sp1 is essential and its position is important for p120 gene transcription: a 35
      bp juxtaposed positive regulatory element enhances transcription 2.5 fold.
AB  - Human proliferating cell nucleolar antigen p120 is expressed in tumor cells in
      the early G1 phase of the cell cycle. Deletion analyses of the essential cis
      acting region -537/-278 showed that a 58 bp sequence from -457 to -400 is an
      important cis-acting element. An Sp1 transcription factor binds to the sequence
      AGAGGCGGGG (-425 to -416) within the -458/-400 cis-acting region. Deletion of the
      Sp1 binding sequence eliminated transcription. Substitution of the Sp1 box(-437/
      406), containing the Sp1 recognition site, for the entire cis-acting region (
      537/-278) restored transcription only at a very low level (18%). Deletion of the 
      537/-278 cis-acting region followed by substitutions showed that the Sp1 box (
      437/-406) stimulated transcription 2.4 fold, when juxtaposed and downstream of a
      35 bp (-472 GGGCGAGCGTAAGTTCCGGGTGCGGCGGCCGACTA -438) positive regulatory cis
      element (PRE) over that by substitution of the Sp1 box alone. When the -406/-278
      sequence was downstream of the PRE-Sp1 box, transcription was stimulated 4.4 fold
      over that produced by substitution of the Sp1 box alone. These results suggest
      that Sp1 is essential and its proper position in the 5' flanking sequence,
      juxtaposed and down stream of a 35 bp positive regulatory sequence, is required
      for efficient transcription.

PMID- 1754394
TI  - Automated assembly of protein blocks for database searching.
AB  - A system is described for finding and assembling the most highly conserved
      regions of related proteins for database searching. First, an automated version
      of Smith's algorithm for finding motifs is used for sensitive detection of
      multiple local alignments. Next, the local alignments are converted to blocks and
      the best set of non-overlapping blocks is determined. When the automated system
      was applied successively to all 437 groups of related proteins in the PROSITE
      catalog, 1764 blocks resulted; these could be used for very sensitive searches of
      sequence databases. Each block was calibrated by searching the SWISS-PROT
      database to obtain a measure of the chance distribution of matches, and the
      calibrated blocks were concatenated into a database that could itself be
      searched. Examples are provided in which distant relationships are detected
      either using a set of blocks to search a sequence database or using sequences to
      search the database of blocks. The practical use of the blocks database is
      demonstrated by detecting previously unknown relationships between
      oxidoreductases and by evaluating a proposed relationship between HIV Vif protein
      and thiol proteases.

PMID- 1754395
TI  - Non-additivity of sequence-specific enzyme-DNA interactions in the EcoRI DNA
      methyltransferase.
AB  - We describe a novel strategy to characterize protein-DNA interactions involving
      monomeric enzymes such as DNA methyltransferases (Mtases). This strategy is
      applied to our investigation of the EcoRI DNA Mtase, which binds its double
      stranded recognition site 5'-G-AATTC-3' and methylates the central adenosine of
      each strand using S-adenosyl-L-methionine as the methyl donor. We show that prior
      methylation of adenosine in either strand does not perturb catalysis. In
      contrast, substrates substituted with deoxyinosine at either guanosine position
      (T-BMI5 and TI5-BM) show the minor groove residing N2 amino group of both
      guanosines contribute to DNA recognition since specificity constants for the
      modified substrates are reduced 13 and 39 fold. Similar analysis of a substrate
      containing deoxyinosine at both positions (TI5-BMI5) clearly shows that some
      communication occurs between the sites. To determine the extent to which
      structural changes in the DNA alone contribute to this lack of additivity, we
      performed DNA melting analysis of the singly and doubly substituted substrates,
      and also found non-additivity. Although our functional and structural analyses
      suggest that deoxyinosine incorporation causes long range conformational effects,
      the similarity of KmAdoMet for all substrates suggests that no large-scale
      structural changes occur in the Mtase-DNA-AdoMet complex. Our results support the
      following conclusions: 1) The non-additivity shown in this system contrasts with
      the widespread demonstration of additivity involving repressors [Lehming et al.,
      1990; Takeda et al., 1989; Ebright et al., 1987], suggesting that sequence
      discrimination by enzymes may involve more complex mechanisms. Further, this non
      additivity precludes quantitative assignment of individual interactions and we
      suggest that future analyses of this and related enzyme systems with base analogs
      include detailed information about the long range structural consequences of
      individual substitutions. 2) Although TI5-BM and T-BMI5 are shown to be radically
      different by thermodynamic analysis, the similar specificity constants with the
      Mtase suggest that the underlying structural differences (e.g., altered helical
      parameters of the DNA) are not critical for sequence-recognition. 3) The
      significance of minor groove Mtase-DNA interactions to specificity is confirmed.

PMID- 1754396
TI  - Differential DNA-binding abilities of estrogen receptor occupied with two classes
      of antiestrogens: studies using human estrogen receptor overexpressed in
      mammalian cells.
AB  - We have developed a transient transfection system using the Cytomegalovirus (CMV)
      promoter to express the human estrogen receptor (ER) at very high levels in COS-1
      cells and have used it to study the interaction of agonist and antagonist
      receptor complexes with estrogen response element (ERE) DNA. ER can be expressed
      to levels of 20-40 pmol/mg or 0.2-0.3% of total soluble protein and all of the
      soluble receptor is capable of binding hormone. The ER binds estradiol with high
      affinity (Kd 0.2 nM), and is indistinguishable from native ER in that the
      receptor is capable of recognizing its cognate DNA response element with high
      affinity, and of transactivating a transgene in an estradiol-dependent manner.
      Gel mobility shift assays reveal interesting ligand-dependent differences in the
      binding of receptor complexes to ERE DNA. Receptors occupied by estradiol or the
      type I antiestrogen transhydroxytamoxifen bind to DNA response elements when
      exposed to the ligand in vitro or in vivo. Likewise, receptors exposed to the
      type II antiestrogen ICI 164,384 in vitro bind to ERE DNA. However, when receptor
      exposure to ICI 164,384 is carried out in vivo, the ER-ICI 164,384 complexes do
      not bind to ERE DNA, or do so only weakly. This effect is not reversed by
      subsequent incubation with estradiol in vitro, but is rapidly reversible by in
      vivo estradiol exposure of intact COS-1 cells. This suggests there may be some
      cellular process involved in the mechanism of antagonism by the pure antiestrogen
      ICI 164,384, which is not observed in cell-free extracts.

PMID- 1754397
TI  - Interaction of DNA-binding proteins with a milk protein gene promoter in vitro:
      identification of a mammary gland-specific factor.
AB  - The minimal 5' regulatory region of the sheep beta-lactoglobulin gene (BLG), as
      defined in transgenic mice, was used to identify nuclear factors which may be
      involved in milk protein gene expression in the lactating mammary gland. This
      406bp promoter region was dissected into short, overlapping, double-stranded
      oligonucleotides to facilitate identification of the bound proteins. A variety of
      sites, for both known and previously undescribed DNA-binding proteins, are
      occupied in vitro. Some of these factors were investigated in detail. Two forms
      of nuclear factor I (NFI), which have different recognition site affinities, are
      present in nuclear extracts from lactating mammary gland and bind to at least 5
      sites in this BLG control element. In addition, a factor (milk protein binding
      factor, MPBF) which is specific to extracts from both mouse and sheep lactating
      mammary gland binds to 3 BLG promoter sites and may be a milk protein gene
      transcription factor.

PMID- 1754398
TI  - Identification of a protein that interacts with the nuclear factor-1 (NF-1)
      binding site in cells that do not express NF-1: comparison to NF-1, cellular
      distribution, and effect on transcription.
AB  - We examined expression of nuclear factor-1 (NF-1) in different cell lines.
      Expression was low or undetectable in T and B lymphocyte cell lines, whereas
      fibroblasts and other adherent cell lines generally had a relatively high level
      of NF-1 mRNA. In cell lines that did not express NF-1, gel retardation assays,
      nevertheless, indicated complexes between a protein or proteins and the NF-1
      site. These complexes were less abundant than those formed with NF-1, they
      migrated more slowly, and they appeared as single species instead of the multiple
      species observed with NF-1. NF-1 site-binding proteins were compared in the
      fibrosarcoma cell line HT-1080 (expressed the highest level of NF-1 in our study)
      and the B cell line Raji (does not express NF-1). UV-crosslinking studies
      indicated that the NF-1 site-binding proteins in both cell lines were similar in
      size. Proteolytic clipping band shift assays suggested that the Raji protein and
      NF-1 share structural similarity in their DNA binding domains, but are distinct
      proteins. The NF-1 site mediated transcriptional stimulation in cell lines where
      NF-1 is expressed; however, this element did not affect transcription in cell
      lines that do not express NF-1, suggesting that the NF-1 site-binding protein in
      these cells is functionally distinct from NF-1.

PMID- 1754399
TI  - Identification of a sequence-specific protein binding the 5'-transcribed spacer
      of rat ribosomal genes.
AB  - A novel 85-kD protein factor which interacts specifically with the 5'-transcribed
      spacer of rat ribosomal genes was identified using the gel mobility shift, DNase
      I protection and UV-crosslinking techniques. The binding site of the factor is
      located inside the 36 bp Alul-HindIII fragment of transcribed spacer, most
      probably in the region +94 to +115 with respect to the transcription initiation
      site. Factors giving very similar gel mobility shift patterns were also found in
      mouse and human cell extracts. Sequences resembling the binding site of this
      factor were revealed in corresponding regions of mouse and human ribosomal genes.
      The biological function of FTS remains to be elucidated.

PMID- 1754400
TI  - Primary and secondary structure of citrus viroid IV (CVd IV), a new chimeric
      viroid present in dwarfed grapefruit in Israel.

PMID- 1754401
TI  - Identification of a fourth nuclear factor I gene in chicken by cDNA cloning: NFI
      X.

PMID- 1754402
TI  - Cloning and sequencing of a mouse embryonal carcinoma cell mRNA encoding the
      tissue specific RNA splicing protein SmN.

PMID- 1754403
TI  - Sequence of human HMG2 cDNA.

PMID- 1754404
TI  - Molecular cloning of Xenopus elongation factor 1 gamma, major M-phase promoting
      factor substrate.

PMID- 1754405
TI  - A human homologue of the Escherichia coli DnaJ heat-shock protein.

PMID- 1754406
TI  - A novel substrate for assays of gene expression using chloramphenicol
      acetyltransferase.

PMID- 1754407
TI  - Improvement of PCR sequencing by formamide.

PMID- 1754408
TI  - A quick procedure for purification of functional recombinant proteins over
      expressed in E.coli.

PMID- 1754409
TI  - The direct screening of cosmid libraries with YAC clones.

PMID- 1754410
TI  - 'Turboprep' DNA: ultraquick preparation of plasmid DNA from single colonies for
      DNA sequencing.

PMID- 1754411
TI  - Heteroduplex formation as a means to exclude contamination in virus detection
      using PCR.

PMID- 1754412
TI  - Reconstruction of a large DNA fragment from coinjected small fragments by
      homologous recombination in fertilized mouse eggs.

PMID- 1754413
TI  - A rapid procedure for the screening of recombinant plasmids.

PMID- 1754414
TI  - A simple and efficient method for isolation of DNA fragments from agarose gel.

PMID- 1754415
TI  - Dinucleotide repeat polymorphism in the human thyroid hormone receptor beta gene
      (THRB) on chromosome 3.

PMID- 1754416
TI  - Dinucleotide repeat polymorphism at the D8S135 locus on chromosome 8p.

PMID- 1754417
TI  - Dinucleotide repeat polymorphism at D16S287.

PMID- 1754418
TI  - GT repeat polymorphism in the human proteoglycan link gene (CRTL1) promoter
      region.

PMID- 1754419
TI  - Non-synonymous polymorphism in the coding sequence of human 3-beta hydroxysteroid
      dehydrogenase (HSD3B).

PMID- 1754421
TI  - M1: Principles of management. Part (ii): How do you manage?

PMID- 1754422
TI  - Promise of named nurse not to be taken at face value.

PMID- 1754420
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 1754423
TI  - Europe Against Cancer.

PMID- 1754424
TI  - Home truths.

PMID- 1754425
TI  - Women's work.

PMID- 1754427
TI  - Double prejudice.

PMID- 1754426
TI  - Kept in the dark.

PMID- 1754428
TI  - Body matters.

PMID- 1754429
TI  - Losing her eyes--care study.

PMID- 1754430
TI  - Mandatory updating. Why coercion does not work.

PMID- 1754431
TI  - Education--enriching lessons.

PMID- 1754433
TI  - Charting progress.

PMID- 1754432
TI  - Sperm banking.

PMID- 1754434
TI  - Defining quality in training institutions.
AB  - The views of nurse and midwife teachers occupy a crucial role in discussions
      about the quality of educational provision. So far, however, little information
      has been available on what the members of the profession think about this issue.
      In the course of a two-year research project commissioned by the ENB on
      performance indicators for training institutions, we asked teachers and their
      colleagues in all the English NHS regions to describe the characteristics of a
      high standard school. The study was conducted in the spring of 1988, that is,
      following the clinical grading review and the initiative to amalgamate school but
      before the NHS review and the acceptance of Project 2000. The data provided are
      an account of what is valued in schools of nursing and midwifery, for which a
      high degree of consensus was found among respondents. Management issues emerged
      as the top concern, followed by resources. Curriculum issues ranked third,
      closely followed by service links and professional/teacher issues. External links
      were of low importance.

PMID- 1754435
TI  - Careless words.

PMID- 1754436
TI  - Involving users in day care planning.

PMID- 1754437
TI  - Parent-held records of child development.

PMID- 1754439
TI  - Mental handicap nursing. A first-class service?

PMID- 1754438
TI  - Community link nurses in psychiatric care.

PMID- 1754440
TI  - Mental handicap nursing. Stand up and be counted.

PMID- 1754441
TI  - Mental handicap nursing. Community challenge.

PMID- 1754442
TI  - The Celtic challenge.

PMID- 1754443
TI  - Professional initiative stifled by cost-cutting management.

PMID- 1754445
TI  - Health of the nation.

PMID- 1754444
TI  - East meets West.

PMID- 1754446
TI  - Fulfilling potential.

PMID- 1754447
TI  - Quality through teamwork.

PMID- 1754448
TI  - Barred from treatment.

PMID- 1754449
TI  - Body politic. The case of the leaked draft.

PMID- 1754450
TI  - Homelessness--a home for Tom.

PMID- 1754452
TI  - Homelessness--left out in the cold.

PMID- 1754451
TI  - Homelessness--help for the outcasts.

PMID- 1754453
TI  - Arts in action--what's it worth?

PMID- 1754454
TI  - Pass the cranberry juice.

PMID- 1754455
TI  - Learning to sleep.

PMID- 1754456
TI  - Behind a screen.

PMID- 1754457
TI  - Mandatory updating--a lifetime commitment.

PMID- 1754458
TI  - Computing in practice. High-tech teach-in.

PMID- 1754459
TI  - More research needed to help women with HIV.

PMID- 1754461
TI  - Midwives' journal. Exercise in pregnancy.

PMID- 1754460
TI  - Midwives' journal. Labour and fasting.

PMID- 1754462
TI  - Midwives' journal. Unnecessary anointing.

PMID- 1754463
TI  - [Recent findings on the phenotype and function of T-lymphocytes in the human
      colostrum].
AB  - Recent studies in our laboratory have demonstrated that the great majority of
      human colostral T cells display the phenotypic and functional characteristics of
      memory T lymphocytes, e.g. were able to proliferate in response to anti-CD3 and
      anti-CD2 monoclonal antibodies, and to a lesser extent, to the lectin mitogen
      phytohaemagglutinin. In addition, their production of interferon-gamma after anti
      CD3 and anti-CD2 stimuli was similar to that calculated in autologous blood
      lymphocyte cultures. More interestingly, the proportion of T lymphocytes bearing
      the gamma/delta T-cell receptor was found to be significantly higher in the
      mammary secretion than in autologous and heterologous blood samples. Furthermore,
      these cells were mostly delta-TCS-1+, thereby suggesting that they are actively
      motile cells capable of migrating from lymphoid to extra-lymphoid body tissues.
      The fact that the phenotypic pattern of colostral gamma/delta T cells is similar,
      if not identical, to that of the intestinal intraepithelial counterpart suggests
      that these cells might originate in the gut-associated lymphoid system and home
      selectively to the mammary gland late in pregnancy and throughout lactation.
      However, additional studies are needed to confirm whether milk T lymphocytes are
      actively involved in the adoptive lactation transmission of cellular immunity to
      the suckling infant.

PMID- 1754464
TI  - [Characteristic aspects of the therapy of heart failure in infancy. Review of the
      literature and personal data].
AB  - The treatment of congestive heart failure in view of its pathophysiology can be
      divided in 3 parts: cardiokinetic therapy, diuretic therapy and vasodilator
      therapy. For each therapeutic component we report the latest findings and
      underline the peculiar aspects in the newborn. Furthermore we outline the basis
      for a rational use of the various types of drugs and indicate the future
      therapeutic prospectives.

PMID- 1754465
TI  - [Changes in the motor apparatus of the bronchial cilia. Comparative study of two
      types of myopathies: nemaline myopathy and the Werdnig-Hoffmann syndrome].
AB  - The Authors during an extensive applications of nasal brushing in infancy
      according to Rutland and Cole, remarked--first time in literature--the
      contemporary presence in a child of the nemaline myopathy syndrome and immotile
      cilia syndrome. Supposing the possibility that in other myopathy may be present
      the same ciliary immotile syndrome, they studied with nasal brushing three cases
      of Werdnig-Hoffman syndromes: but they presented normal ciliary conformation. The
      Authors suppose that in case in future it should be found in other cases of
      nemaline myopathy the contemporary presence of dinein arms lack, it should be
      demonstrated that this syndrome takes derivation from a genetic alteration both
      of the muscular apparatus and the ciliary mobility system of bronchial
      epithelius.

PMID- 1754466
TI  - [Results of nasal brushing in the study of ciliary conformation and function in
      chronic bronchopneumopathies in childhood].
AB  - For the frequent remark in childhood of relapsing bronchitis and/or broncho
      pneumonic sickness we resolved to use for the differential diagnosis the nasal
      brushing method according to Rutland (for samples of ciliated epithelium from the
      deep surface of the inferior nasal turbinate using a 2 mm diameter nasal brush.
      The samples were used for ultrastructural study of cilia. RESULTS: Children
      studied 22:14 (6-14) y.old with relapsing bronchitis, 4 with relapsing broncho
      pneumonitis, 1 Nemaline myopathy (n.m.) with heavy respiratory insufficiency; 3
      Werdnig Hoffmann syndromes (W.H.). Control group of 4 normal children. In the
      control group and 14 relapsing bronchitis normal tubular pattern (9 + 2) and
      ciliary conformation were present; in the relapsing broncho-pneumonic syndrome
      group, 2 children presented deficiency of some brace dynein arms = chronic
      inflammation; in the Nemaline myopathy we noted total lack of interior dynein
      arms with random cilia orientation; in the 3 W.H. = normal cilia conformation.
      The authors noted for the heavy respiratory insufficiency of the Nemaline
      myopathy the presence of immotile cilia and discuss possibility that in all
      Nemaline myopathy syndromes this association may be present (a new syndrome?).
      The W.H. myopathy is characterized by normal cilia aspects and the respiratory
      insufficiency is caused by muscular respiratory insufficiency secondary to
      anterior spinal corn horn. In the Nemaline myopathy the same genetic defect can
      act in muscular fibres and on dynain arms (cytoskeleton). The technique described
      is suitable for processing epithelial brushings from other parts of the
      respiratory tract.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754467
TI  - [Comparison of high-dose immunoglobulin and cyclosporine in newly diagnosed
      diabetic children].
AB  - A controlled trial was carried out on type I diabetic children to evaluate and to
      compare the clinical effects of two different kinds of immunotherapy: high doses
      intravenous gammaglobulin (IVIgG) and cyclosporine A (CyA). 30 newly diagnosed
      patients were admitted to the trial, 10 of whom served as controls (group A), 10
      received 400 mg/kg b.w. of IVIgG on 5 consecutive alternate days and subsequently
      after 15 days and monthly thereafter for up to six months (group B), 10 patients
      received CyA 5-10/kg b.w. by mouth in two daily doses for a period comprised
      between 6 and 18 months (group C). Serum post-prandial C-peptide level was
      significantly higher after 6 months in group B and C than in group A; after 12
      months, only group C showed significantly higher values. This difference was no
      longer significative at 18 and 24 months. Insulin requirement in the treated
      groups was significantly lower than in control group at 6 months, this difference
      was no longer significative at 12 months. We didn't find any difference
      concerning insulin requirement during the study comparing the two groups treated
      with the two different immunosuppressive therapies. In 3 patients in group B and
      in 3 patients in group C we didn't observe any appreciable response to
      immunosuppressive therapy (defined as insulin requirement greater than 0.5 UI/kg
      b.w. at 6 months and/or greater than 0.8 UI/kg b.w. at 12 months). We couldn't
      find any significant difference between responders and not responders to the
      immunosuppressive therapies regarding age, symptoms lasting before the diagnosis,
      weight loss, ketoacidosis intensity and serum post-prandial C-peptide level at
      the onset.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754468
TI  - [Neuroblastoma. Tumor rupture as an unfavorable prognostic factor].
AB  - Since there is little information regarding the possible prognostic significance
      of tumor rupture in localized neuroblastoma, we have analyzed the clinical
      courses of 163 children registered from 1979-1990 in 12 italian pediatric
      oncology Centers participating in the Neuroblastoma Cooperative Group of the
      A.I.E.O.P. (Italian Association for Paediatric Haematology-Oncology). Ten
      instances (6%) of tumor rupture were described. Ruptures occurred preoperatively
      in one child, during the operation in 9; among these 9, two were provoked by the
      surgeon to allow radical tumor excision, 7 were accidental. Of these 10 children,
      7 relapsed at 3-25 months (median, 8 months) from diagnosis. Relapses were local
      in 5 children (2 of the 5 died), disseminated in one (who died), local +
      disseminated in one (presently alive with disease). Two local relapses were
      followed by bony or haematologic spread at 4 and 8 months, respectively. Of the 7
      children who relapsed, 2 are alive in complete remission at 29, 100 months,
      respectively; two are alive with disease at 3 and 65 months, 3 died at 8, 15 and
      24 months, respectively. We conclude that rupture of a localized neuroblastoma is
      a factor predisposing to relapse and may compromise the chance of cure. The
      surgeon should be aware of the risks connected with this complication and make
      any effort to avoid it.

PMID- 1754469
TI  - [Juvenile rheumatoid arthritis with pauciarticular onset and HLA-A, B, DR in
      Italian children].
AB  - Juvenile Rheumatoid Arthritis is a heterogeneous disease currently divided into
      different subtypes based on clinical characteristics. Significant alterations in
      frequencies of HLA-A, B and DR antigens have been described previously in
      children with pauciarticular onset Juvenile Rheumatoid Arthritis. We report the
      results of a study on 42 italian children with pauciarticular onset Juvenile
      Rheumatoid arthritis that partially confirm the literature data.

PMID- 1754470
TI  - [Comparison of radiology and 24-hour esophageal pH-monitoring in the diagnosis of
      gastro-esophageal reflux in various pediatric age groups].
AB  - We retrospectively examined the 24 hour oesophageal pH study and the upper
      gastrointestinal (UGI) series of 67 children aged 5 weeks to 15 years. Thirty
      seven were suffering from gastro-oesophageal reflux (GER) and 27 from other
      diseases. Nineteen of them were younger than 6 months, 22 older than 18 months
      and the remaining 26 ranged from 6 to 18 month old. We found a high incidence of
      false positive and false negative results of the UGI series in all age groups.
      The number of false positive results was much higher in infants younger than 6
      months (67%) than in the older children studied (27% between 6 and 18 months and
      14% after 18 months). On the contrary, false negative results were absent in the
      first 6 months of life, but their number increased with age, up to 40% in
      children older than 18 months. Moreover, the 24 hour ph monitoring was found to
      have a high sensitivity (100%) and specificity (82-100%) in all age groups. For
      this reason, we believe than this examination could be used as the first line of
      investigation for the diagnosis of GER in all children, independently of their
      age.

PMID- 1754471
TI  - [Fluoroquinolones: pharmacokinetics and clinical use in pediatrics].

PMID- 1754472
TI  - [Scoliosis: ten years' experience of screening].
AB  - Scoliosis is a permanent lateral deflection of backbone, associated to a
      vertebra's rotation and twisting on their vertical axle, and it is one of more
      common diseases of pediatric age. It exist a great difference between the
      structural conformations, that are true pathologies, and the functional ones or
      paramorphisms, without bony alterations. Since about 80% of real scoliosis is
      idiopathic. The pediatrician's task is of precociously identify the appearance of
      a scoliotic bend and differentiate the structural and evolutive shapes from
      simple scoliotic posture. Therefore for ten years, in the preventive medicine
      programme of school age, we affected a scoliosis research in the secondary school
      using as clinical method the "bending test" that appraises three essential
      parameters: size's triangle, gibbus and limbs' asymmetry. Before examination an
      anamnestic form is compiled and the sexual maturity's degree is appraised. The
      subjects with suspect of scoliosis are asked to a subsequential control performed
      in our department's ambulatory service by a doctor of Scoliosis's Center of
      Pozzolatico (Florence), in order to decide whether to take radiographs and to
      define, if necessary, treatment. We verified 4453 pupils and of these the 8.9%
      has been asked to the specialist's control. Of these 106, namely the 2.8% of
      total pattern, have been X-rayed and 46, namely the 0.9% of total pattern, have
      been orthopaedically treated because affected by evolutive scoliosis. If we
      consider the last quinquennium's statistics, we remark that treatment's incidence
      is lower to 0.4% conforming to literature's data. We never observed false
      negatives whereas false positive have been only 0.8% of total pattern.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1754473
TI  - [Evaluation and treatment of the enuretic child: eight years' experience].
AB  - Enuresis is a common functional problem among children which is defined as a
      complete involuntary voiding of urine at an age which control should be present.
      Bed wetting generally resolves with increasing age, but the restriction in social
      life and the psychological secondary problems, so frequent in older patients,
      justify an appropriate treatment of the problem in the child over seven. At
      children's Hospital of Florence University an enuresis service exists since 1983,
      and during these years 541 children applied to the structure. 326 children
      completed the treatment, among these there were 202 boy and 124 girls with age
      between 6 and 19. All the patients have been initially helped only with
      conversation (motivational counseling) and 76 among them (23% of the whole)
      obtained permanent cure. The remaining 250 children were treated with the
      conditioning alarm system, always associated to periodic conversation, urine stop
      exercises and other psychological support (token economy, etc). There were 161
      boys and 89 girls: 220 children had nocturnal primary enuresis and 30 secondary.
      The family history was positive in 77%. The results obtained of this kind of
      treatment after a follow-up of 6 months, were permanent recovery in 211 children
      (84%) and failure in 39 patients (16% of the cases). There have been 35 relaxes.
      Regarding the sex, no significant difference was noted. These positive results
      with the conditioning devices favor the view that the etiology of primary
      enuresis is mainly biologic. The bell alarm represents the most effective
      treatment for nocturnal enuresis included more than seven.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1754474
TI  - [Trisomy 18: phenotypic and biochemical variability].
AB  - We report a case of Edward's syndrome showing some symptoms infrequently
      described in trisomy 18. The authors suggest that the phenotypic expression of
      symptoms rarely observed in the syndrome may be better interpreted as non
      specific consequence of the chromosomal imbalance, rather than directly related
      to genes on chromosome 18. A gene dosage effect for the enzyme Peptidase A, whose
      gene is mapped on chromosome 18, was also observed.

PMID- 1754475
TI  - [Computerized prototype of a screening test for the assessment of psychomotor
      development in childhood].
AB  - The aim of Denver's screening test is to study the psychomotor development of
      normal or supposed normal children aged from 0 to 6 years and to suggest further
      investigation when an abnormal development is noticed. The test is divided into 4
      sections: social behavior, fine motility, language, gross motility. The results
      are valid only if the test is done in a standardized manner. The aim of this
      paper is to describe the computerized prototype of the Denver test in use at the
      Divisional Pediatric Ambulatory of "A. Gemelli" University Policlinic in Rome.
      This test is used in the context of an automatized ambulatory management system
      called ARPIA, capable of interacting and guiding "non expert" user. The program
      performs the following functions: 1) General instructions for the execution and
      interpretation of the test. The original instructions of the test (1975 version)
      have been used. 2) Input, modification, exclusion of questions. The archive is
      organized in the following manner: questions are divided in the above four
      sections, according to the child, undergoing the test, age limit; the questions
      regarding information that can be asked directly to the parents or the display of
      a picture that better explains the test are marked. During the test the questions
      may be modified using a menu with a certain number of options to facilitate the
      use of the system. The questions to eliminate from the test may be appropriately
      marked and removed. The text is not physically deleted from the archive. The
      inverse operation of inclusion of a formerly removed question may be performed
      too.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754476
TI  - [Neonatal screening for congenital hypothyroidism in a suburban hospital:
      assessment of eleven years' experience].
AB  - Congenital hypothyroidism is one of the commonest endocrine diseases in infancy;
      the diagnosis is delayed it can lead to mental impairment. Since a precocious
      diagnosis, based on clinical symptoms and signs, is often difficult, screening at
      birth is very useful. Substitute L-T4 therapy presents some problems as it is
      impossible to assess the right dose before. The results of an eleven years long
      screening in a peripheral hospital are reported: 6408 babies were examined and
      congenital hypothyroidism was present in three cases, depending respectively on
      agenesia, ectopia and hypoplasia of the thyroid gland.

PMID- 1754477
TI  - [A diagnostic controversy: the significance of 14-6/sec positive spikes in
      clinical electroencephalography].
AB  - There has been a great dealt of discussion as to the clinical significance of
      E.E.G. 14-6 per second positive spikes (14-6 PS), a short burst lasting one
      second or less which occurs during light sleep in monopolar recordings, mainly in
      the posterior temporal regions and usually involving the parietal and occipital
      regions as well, for the most part in unsymmetrical fashion. Early
      interpretations stress the epileptic nature of vegetative attacks in patients
      with an inter-critical E.E.G. reading characterized by 14-6 P.S. Subsequently,
      however, this hypothesis has been refuted, mainly because E.E.G. intra-critical
      recordings have never shown evidence of any sort of paroxysmal activity. At
      present time expert think that the presence of 14-6 PS may be merely an
      indication of an electrical alteration associated with disorders in the
      neurovegetative area. In order to evaluate the possibility of using them as a
      diagnostic marker of migraine equivalents and periodic syndromes, we reviewed
      wake and sleep E.E.G. recordings, carried out consecutively and hence not
      selectively, in 617 children aged 5-16 years. 14-6 PS were present in 109
      children (17.6%), 63 of whom showed evident symptoms of periodic syndrome
      (headache, recurrent abdominal pain, cyclic vomiting, kinetosis, etc.); hence 46
      E.E.G. recording were false positive. 510 children were lacking in 14-6 PS, 91 of
      these presented symptoms of periodic syndromes (false negative). 14-6 PS are
      hence a marker 40.9% sensitive, 90.1% specific, with a predictable value of
      57.7%. The search for 14-6 PS in children with periodic syndrome is not
      particularly sensitive as a test, but it is fairly specific: it may well
      constitute an useful element in diagnosis.

PMID- 1754478
TI  - [Early decortication in the surgical treatment of pleural empyema in childhood:
      indications and results].
AB  - Antibiotics and pleural drainage with continuous suction is effective in
      treatment of childhood pleural empyema. However a recognizable number of
      childhood pleural empyema fail to improve or to cure after this treatment. This
      study reviews our experience with 27 children over past 8 years. All patients
      were treated with antibiotics, seven with only pleural drainage, twenty with
      pulmonary decortication. Indications for decortication were: clinical and
      radiological failure after 4-5 days of treatment with pleural drainage and
      continuous suction; persistent fever; persistent respiratory distress; persistent
      signs of general illness; persistent loculated pleural effusions; worsening
      parenchymal disease. The clinical and radiological improvements following
      decortication were dramatic with immediate lung reexpansion and improvement of
      clinical course. The chest tubes were removed by the fifth postoperative day and
      the children were discharged by the seventh-nine postoperative day. There were no
      complications and no deaths. In our experience pulmonary decortication is a
      simple and effective treatment of childhood empyema in the advanced fibro
      purulent and/or early organizing phase with immediate and long-term excellent
      results.

PMID- 1754479
TI  - [Intracranial calcifications--seizures--celiac disease: a case presentation].
AB  - The Authors report a case of coeliac disease which first appeared in a boy of 4,
      suffering from a seizure disorder. The bulky mass of fatty faeces led towards
      gastroenteric investigations (xylose-test, jejunum biopsy). The atrophy of the
      villi was clearly shown by the biopsy and a coeliac disease was easily diagnosed.
      The boy was prescribed a coeliac diet and no fits of generalized convulsions
      occurred during three years follow-up. Yet, while he was given a challenge free
      diet, they started to occur. A computerized axial tomography (TAC) carried out
      when he was eight and another when fifteen, evidenced bilateral, intracranial
      calcifications, cortical-subcortical, in the blood vessels, symmetrically located
      in the occipital region. The anticonvulsive therapy, started when he was 4, has
      never been interrupted. Now A.M. is 21 and still following an anticonvulsive
      polytherapy. Many tests were performed. The result of folic acid dosage carried
      out when he was 16, and badly follow a coeliac diet, was less than 2 ng/ml. A
      modification in the neurological symptomatology was noted during his puberal
      phase: fits of convulsions changed into daily crises of mind-failures. This
      feature is still present in his adult age. The case is reported for its clinical
      characteristics of neurological symptomatology associated with coeliac disease.
      The iconographical documentation evidences endocranial calcifications frequently
      connected with coeliac disease.

PMID- 1754480
TI  - [Psoriatic arthritis and celiac disease in childhood. A case report].
AB  - A case of a girl followed up for 18 years is reported. At the age of two, the
      patient presented psoriasis and coeliac disease confirmed by biopsy and by
      laboratory data. She followed a coeliac diet and at the age of twelve she
      manifested a rheumatoid arthritis of the left knee without pain, confirmed by
      laboratory data (RA test, ANA test). In this period, the patient underwent
      another gastrointestinal biopsy after suspension of the diet; the structural
      alterations of the gastrointestinal tract being always present, she continued the
      diet associated with non steroidal antiphlogistic drug therapy for rheumatoid
      arthritis. The Authors remark the association of diseases, making a comparison
      with literature data and confirming the current hypotheses. It is interesting to
      observe that when the patient presented articular symptoms, there was the
      reappearance of the gastrointestinal symptomatology. Very interesting is the
      presence of psoriasis: in fact there is the problem whether this case is a
      psoriatic arthritis with coeliac disease or a juvenile rheumatoid arthritis with
      coeliac disease and psoriasis. At last, the Authors report the good results
      obtained by coeliac diet and non steroidal antiphlogistic drugs; a complete
      remission of articular symptoms and a good puberal and intellectual growth have
      been observed.

PMID- 1754481
TI  - [Hypoglycemia secondary to transitory hyperinsulinism in infancy: a case report].
AB  - We refer about an infant with transitory hyperinsulinism who first developed
      symptoms at the age of nine month treated with diazoxide. The therapy was
      successfully discontinued at the age of twenty-one month. The follow-up until the
      age of 38 month revealed a normal growing up and a normal neurological
      development. The main cause of hypoglycaemia are discussed referring the
      different cases of hyperinsulinism of the recent literature.

PMID- 1754482
TI  - [Cerebral blood flow velocity after surfactant instillation in preterm infants].

PMID- 1754483
TI  - The clinical utility of pulse oximetry in the pediatric emergency department
      setting.
AB  - Pulse oximetry provides a noninvasive, painless, accurate, and rapid method for
      measuring arterial oxygen saturation (SaO2). It has been shown to be valuable in
      anesthesia and critical care and recently has been used extensively in the
      outpatient setting. As is often the case with new technologies, little has been
      published on the basic issues of reliability, reproducibility, and effect on
      patient care. This prospective clinical study evaluated the basic principles of
      pulse oximetry in the pediatric emergency department setting and tested the
      hypotheses that pulse oximetry SaO2 measurements are reliable and provide
      valuable information, in addition to clinical and laboratory data which affect
      patient assessment and management. One hundred twenty patients were enrolled in
      phase 1 and 437 in phase 2 of the study. Pulse oximetry readings were
      reproducible with an intraclass correlation of 0.87. SaO2 measurements changed
      the assessed degree of illness in 188 (53%) patients; 47 (13%) were felt to be
      more ill and 130 (37%) to be less ill than at initial assessment. Sixty-nine
      (17%) patients were identified in whom SaO2 readings changed management plans; 27
      (8%) were managed more aggressively (intubation, surgery, or admission), while 40
      (11%) were managed less aggressively (discharged). In three cases, pulse oximetry
      was instrumental in the diagnosis of a serious illness. The results from this
      study indicate that pulse oximetry SaO2 readings are stable and reproducible and
      provide information which impacts significantly on patient assessment and
      management.

PMID- 1754484
TI  - A one-year prospective ED cohort of pediatric trauma.
AB  - During a 12-month period ending on November 30, 1988, data were collected on 4623
      pediatric patients visiting a pediatric emergency department with trauma
      (excluding burns). Sixty-one percent were male. Common causes of the trauma
      included suspected child abuse (4%), organized sports (6%), nonorganized sports
      (4%), pedestrian motor vehicle accidents (MVAs) (3%), bicycle MVAs (2%), and
      automobile MVAs (3%). However, most of the incidents had none of the identified
      associated activities surrounding the trauma (60%). Incidents took place at home
      (41%), on the street (11%), at school (10%), and at a playground or park (10%).
      Injuries involved the external body (59%), extremity (26%), head or neck (13%),
      face (4%), chest (1%), and abdomen (2%) and were more common during the summer.
      Injury severity scores had a mean of 1.8 and were grouped as: less than 3 (80%),
      3-6 (19%), and greater than 6 (1.6%). Factors associated with higher trauma
      severity included MVAs, water-related injuries, sports, streets, schools, parks,
      playgrounds, skateboards, skates, and alcohol.

PMID- 1754485
TI  - Improving knowledge of emergency physicians about child physical and sexual
      abuse.
AB  - The purpose of this project was to study the effect of self-instructional
      programs regarding physical and sexual abuse on the knowledge and case
      recognition of physicians. Data from a total of 191 emergency physicians revealed
      significant improvements from pre- to posttests, as well as increases in case
      recognition skills. More than 90% of physicians using each kit reported that the
      information had been valuable and that they would recommend the program to a
      colleague. The finding that knowledge mastery was high, combined with the
      recommendations of participating physicians, suggests that the programs tested
      are promising tools for educating emergency physicians about child physical and
      sexual abuse.

PMID- 1754486
TI  - Sickle cell screening practice in pediatric emergency departments.
AB  - Management of black children who present to a pediatric emergency department (ED)
      commonly requires knowledge of their sickle cell status. To determine the
      practice of sickle cell screening, 32 pediatric EDs were surveyed. Twenty-eight
      (88%) completed the survey, and, of these, 22 (79%) included sickle cell
      screening (differential solubility test for hemoglobin S) in the management of a
      black febrile six-month-old infant. To determine the method of screening for
      sickle cell disease, 60 consecutive black children less than two years of age,
      who presented to a pediatric ED, were reviewed prospectively. In 51 patients
      (85%), their condition warranted knowledge of their sickle cell status. Of these,
      parents of only nine (18%) children knew their child's sickle cell status. Thirty
      five (69%) patients had a presumptive newborn screening test for sickle cell
      disease, but only 15 presented between 8 AM and 5 PM on a weekday, the time
      during which the newborn screening laboratory could be telephoned for test
      results. For these same 15 patients, 13 had private physicians, but only three
      physicians had results of newborn sickle cell screening tests. The patients'
      hospital records were reviewed, and nine (18%) patients had prior sickle cell
      screening tests, but five of these tests were performed before the child was six
      months of age. To determine sickle cell status, 30 (59%) patients required a
      sickle cell screening test in the ED. ED screening detected three (6%) newly
      diagnosed sickle cell trait patients. In summary, sickle cell screening is
      recommended for young black children who present to an ED with fever or signs and
      symptoms supportive of sickle cell disease complications.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1754487
TI  - Plain abdominal radiography in the detection of acute medical and surgical
      disease in children: a retrospective analysis.
AB  - A retrospective review was performed to determine the utility of plain abdominal
      radiographs in evaluating children presenting to the emergency department.
      Clinical features, radiographic interpretation, and final diagnoses of 431
      patients seen over one year were recorded. One hundred three (24%) patients had
      major diseases (ventriculoperitoneal shunt malfunction, foreign body ingestion,
      appendicitis, intussusception, bowel obstruction, necrotizing enterocolitis,
      toxic megacolon, blunt abdominal trauma, pyloric stenosis, and Hirschsprung's
      disease), while the remaining 328 (76%) had minor diseases. Radiographs were
      categorized as diagnostic, suggestive, normal, incidental, or misleading, with
      respect to the patient's final diagnosis. No single clinical feature was able to
      detect all diagnostic radiographs in patients with major diseases. Limiting
      radiographs to patients with prior abdominal surgery, suspected foreign body
      ingestion, abnormal bowel sounds, abdominal distention, or peritoneal signs
      identified all patients with radiographs diagnostic of a major disease while
      eliminating 48% of studies ordered. Our results suggest that restricting
      abdominal roentgenograms to patients with at least one of these features will
      detect most diagnostic radiographs in children with acute abdominal diseases.

PMID- 1754488
TI  - Gastrotomy and whole bowel irrigation in iron poisoning.
AB  - Ipecac and gastric lavage are questionable interventions for the overdose
      patient, and activated charcoal does not absorb iron. Gastrotomy and whole bowel
      irrigation have been described as unique interventions for this poisoning. We
      describe a patient who was treated with each of these. Because less than half of
      the iron was removed during surgery, and because the chelation requirement was
      modest, it is likely that whole bowel irrigation removed a significant amount of
      iron. We believe that this combined approach contributed to our patient's
      positive outcome.

PMID- 1754489
TI  - Skin necrosis complicating intraosseous infusion.
AB  - Bone marrow infusion is currently recommended as a useful technique for rapidly
      obtaining vascular access in critically ill children. Minor complications occur
      frequently, but serious complications of this technique are uncommon. We describe
      two patients with local skin necrosis complicating intraosseous infusion. To
      minimize the complications of this technique, we recommend placement verification
      before fluid infusion, careful monitoring for infiltration, and prompt removal
      after venous access is obtained.

PMID- 1754490
TI  - Emergency department management of blunt cervical tracheal trauma in children.
AB  - A case history of a young girl who sustained a small posterior laceration of her
      cervical trachea after blunt trauma is presented. She was brought to the
      emergency department (ED) by her parents roughly two hours after the incident
      with only minor symptoms. While in the ED, she developed significant airway
      compromise over a span of minutes. Orotracheal intubation was performed to secure
      her airway, and she responded to conservative management of her laceration. Her
      signs and symptoms, resolved, and she was discharged after five days. This case
      illustrates the importance of urgent evaluation and careful observation of
      patients with possible tracheal damage, as even very small tears have the
      potential to cause life-threatening airway compromise.

PMID- 1754491
TI  - Magnetic resonance imaging of acute symptomatic Schmorl's node formation.
AB  - The intraspongious herniation of intervertebral disk material into the endplate
      of a vertebral body was first described by Schmorl in 1927. Any process which
      weakens the cartilaginous endplate or the subchondral cancellous bone may
      predispose to the development of Schmorl's nodes. These include Scheuermann's
      disease, infection, metabolic disorders, neoplastic disorders, and degenerative
      disease. In the young individual, however, trauma may precipitate an acute focal
      and symptomatic endplate herniation by the well-hydrated and delineated nucleus
      pulposus. Magnetic resonance imaging (MRI) is the most sensitive imaging method
      for the detection of intervertebral disk disease and, thus, has facilitated the
      diagnosis of traumatic Schmorl's nodes. MRI was very helpful in diagnosing an
      acute, traumatic, symptomatic Schmorl's node when plain film radiographs and
      nuclear medicine bone scan were unremarkable.

PMID- 1754492
TI  - Suspected child sexual abuse.

PMID- 1754493
TI  - Infant with acute vomiting.

PMID- 1754494
TI  - Apnea monitors.

PMID- 1754495
TI  - Is preterm delivery genetically determined?
AB  - Surprisingly, the genetics of preterm delivery have received very little
      attention in the literature. Possible explanations are the inability to obtain
      accurate information on the length of gestation in family studies and the
      heterogeneous nature of this disorder. In contrast to the many studies which
      consider the relative contribution of both genetic and environmental variance to
      the total variance of birthweight, few studies have examined the genetic basis of
      the duration of gestation in man. It is argued that both genetic and
      epidemiological approaches are needed to separate the effects of heredity and the
      environment on the duration of gestation.

PMID- 1754496
TI  - Fumes from the spleen.

PMID- 1754497
TI  - Gestational duration and birthweight in white, black and mixed-race babies.
AB  - Using the 1983 United States population of single live births, birthweight and
      gestational duration were compared for babies of these different parental racial
      groups: both parents White, mother White-father Black, mother Black-father White,
      both parents Black. The four groups differed significantly with respect to the
      usual sociodemographic variables. Mean birthweight and mean gestational duration
      decreased in that order from the White-White reference group, and conversely
      there were increasing trends for low birthweight and preterm delivery. Adjustment
      for the usual sociodemographic variables did not alter these trends appreciably.
      Group differences were more strongly related to the mother's race than to the
      father's, and the trends were related to the mother's race. Because the father's
      race was significant, genetic factors are probably of some importance. The
      evidence from this study, together with the often-demonstrated relationships
      between low birthweight and preterm delivery with sociodemographic variables, and
      the short-term downward secular trends in low birthweight, support the concept
      that non-genetic maternal factors are more important for these abnormal outcomes.
      But because neither the usually utilised sociodemographic variables nor genetic
      factors seem to explain much of the group differences, new approaches are
      necessary to understand why, irrespective of ethnic group, some women are at
      excess risk for suboptimal birth outcome.

PMID- 1754498
TI  - Antecedents of macrosomia.
AB  - Antecedents of high birthweight (macrosomia) were studied using the state birth
      certificates of White singleton infants born in three large metropolitan counties
      of Washington State from 1984 to 1986. Cases consisted of 2082 live-born
      macrosomic infants, defined by a birthweight of over 4.5 kg. A random sample of
      4440 live births with birthweights of 2.5-4.0 kg was selected as a comparison
      group. Estimates for the independent risks associated with gestational and
      established diabetes, male sex, parity, duration of gestation, maternal smoking
      during pregnancy, maternal age, and median income of maternal residential area
      were obtained and combined in a single logistic model. Maternal smoking was
      associated with a decreased risk of macrosomia (OR 0.4, 95% CI 0.3-0.5).
      Established diabetes (OR 6.4, 95% CI 2.7-15.4), gestational diabetes (OR 3.2, 95%
      CI 2.1-5.1) and male sex of the infant (OR 2.4, 95% CI 2.2-2.7) were associated
      with an increased risk. Increasing parity was related to an increasing risk from
      para one (OR 1.4, 95% 1.2-1.6) to para six and greater (OR 3.3, 95% CI 1.5-7.4).
      Increasing duration of gestation was associated with an increasing risk from 33
      36 weeks (OR 0.8, 95% CI 0.5-1.2) to 43-45 weeks (OR 3.3, 95% CI 2.5-4.2).
      Maternal age, median income of maternal area of residence, and maternal marital
      status were not significantly associated with macrosomia.

PMID- 1754499
TI  - Prenatal exposure to prescribed drugs in Tennessee Medicaid, 1983-1988.
AB  - This report describes the prenatal exposure histories of 107,804 women to
      prescribed drugs other than vitamins, iron and other minerals. The data were
      obtained from Tennessee Medicaid pharmacy files linked to birth and fetal death
      certificates for 1983-1988. The utility of these data to other investigators in
      predicting power or estimating sample size for studies of drug exposure in
      pregnancy associated with adverse birth outcomes is discussed.

PMID- 1754500
TI  - Cohort reconstruction: which infants can be restudied at school age?
AB  - Longer-term follow-up of infants with specific health concerns, such as low
      birthweight, is critical to assessing the effect of medical interventions. This
      report examines the approach of reconstructing previously studied cohorts in
      terms of the factors discriminating between respondents and non-respondents.
      Follow-up was attempted during 1987-1988 for 1875 children born during a 6-month
      period in 1978 in three geographically defined regions in the United States, for
      whom 1-year assessments of health and developmental status were obtained at 1
      year of age as part of a previous study. For a 25% sample, participation involved
      a clinic visit for developmental assessments; for the remainder an interview by
      telephone or home visit. Follow-up was obtained for 72.5% of the cohort. Refusal
      rates were low (7%); most non-response was due to an inability to locate the
      families. Predictors of non-response reflected primarily low socio-economic
      status; completion rates were not influenced by mode of assessment. The role of a
      tracing agency is discussed. We conclude that cohort reconstruction is feasible
      with response rates comparable to some prospective studies with ongoing cohort
      maintenance.

PMID- 1754501
TI  - Birth defects monitoring in California: a resource for epidemiological research.
AB  - The California Birth Defects Monitoring Program maintains a population-based
      birth defects registry of structural congenital malformations, monitoring over
      600,000 resident births annually. Cases are actively ascertained from hospitals
      and genetic centres throughout California and from selected facilities in
      adjacent states. Field staff identify presumptive cases from careful review of
      medical records. Diagnostic and demographic information is collected from in
      patient and genetic centre medical charts for children diagnosed with major
      structural malformations between conception and 1 year of age. The application of
      these data to epidemiological investigations of birth defects is described in the
      context of prevalence studies, aetiological studies and evaluative studies, and
      the strengths and limitations of the registry data are discussed.

PMID- 1754502
TI  - The Bedouin Infant Feeding Study: study design and factors influencing the
      duration of breast feeding.
AB  - A longitudinal study of infant feeding practices, growth and morbidity among
      Bedouin Arab infants residing in the Negev, Israel, was conducted during a 3-year
      period (1981-1983). Follow-up samples were restricted to healthy newborns. The
      majority of newborns are breast fed at birth but, by 2 months, 50% are also
      introduced to a milk supplement. Based on the bivariate analysis using the
      logrank test to examine the factors associated with exclusive versus partial
      breast feeding during the first 6 months, those born during the wet cool months
      are exclusively breast fed longer than those born during the dry season. More
      traditional women, living in tents rather than houses or huts, exclusively breast
      feed for at least 6 months. In a multiple logistic regression model, parity,
      house type and birth season are independently associated with the odds of
      exclusively breast feeding for the first 6 months of life. Factors influencing
      the duration of any breast feeding for the first 18 months include: house type,
      place of residence, birthweight, and whether the infant was stunted at 6 months.

PMID- 1754503
TI  - Association between holoprosencephaly and exposure to topical retinoids: results
      of the EUROCAT Survey.

PMID- 1754504
TI  - Joel Kleinman (1946-1991).

PMID- 1754505
TI  - Experimental cerebral atherosclerosis in the rabbit. Scanning electron
      microscopic study of the initial lesion site.
AB  - The development and initial lesion sites of cerebral atherosclerosis were studied
      in hypertensive rabbits fed 0.5 g/day cholesterol in their diet. The earliest
      lesions developed at remarkably localized areas of the basilar artery-posterior
      cerebral artery Y-bifurcation (area A) and vertebral arteries-basilar artery
      confluence (area B). These findings were obtained from a thorough scanning
      electron microscopic survey of the dorsal surface of the cerebral artery segment
      covering from the vertebral arteries to the posterior cerebral arteries. By light
      microscopy intimal lesions were mainly composed of accumulations of foam cells
      and smooth muscle cells. Electron microscopically foam cells accumulated in the
      intima resembled those of a monocyte-macrophage lineage. Early lesions involving
      only a few endothelial cells with adherent leukocytes occurred at the dividing
      and confluent portions of the endothelial arrays formed in areas A and B,
      respectively. The results indicate that hypertension coupled with
      hypercholesterolemia induces atherosclerosis in particular vulnerable regions of
      the cerebral arteries.

PMID- 1754506
TI  - Dermatofibrosarcoma protuberans. A histological and ultrastructural study of 11
      cases with emphasis on the study of recurrences and histogenesis.
AB  - Eleven cases of dermatofibrosarcoma protuberans (DFSP) (6 male: 5 female; mean
      age +/- SD: 48.7 +/- 16.1 years) were reviewed in an attempt to correlate the
      histological and ultrastructural findings with the recurrence pattern of these
      tumours and to shed light on their histogenesis. Six (54.5%) of the tumours
      recurred: 3 with a similar appearance to the primary tumours, 2 with fibroblastic
      malignant fibrohistiocytic pattern (F-MFH), and one with fibrosarcomatous
      features (F), confirmed ultrastructurally. In one primary tumour with associated
      F features there were two recurrences. The ultrastructural findings of 6 primary
      tumours (2 with and 4 without recurrences) showed a predominance of primitive
      mesenchymal cells. The comparison between the features (sex, age, site, necrosis,
      mitotic rate size) of recurring DFSP vs DFSP without recurrences did not yield
      any significant difference. At follow-up (range: 11-108 months) all patients were
      alive and well. These findings support the assumption that DFSP originates from
      primitive mesenchymal cells that are able to show, at least, F and F-MFH
      differentiation, and corroborate the low-grade malignancy of DFSP regardless of
      their macroscopic, histologic and ultrastructural characteristics.

PMID- 1754507
TI  - Paragangliomas of the head and neck. Immunohistochemical analysis of 16 cases in
      comparison with neuro-endocrine carcinomas.
AB  - Sixteen cases of paragangliomas of the head and neck including 8 of the vagal
      body, 3 of the carotid body, 2 jugulotympanic, 2 vagal or jugulotympanic and 1 of
      the larynx were analysed. Clinically, 13 tumors were benign, 2 showed local
      aggressivity and 1 showed metastases. All tumors were tested with antisera
      directed against neuron-specific enolase (NSE), chromogranin A (CGA), S-100
      protein, neurofilaments (NF), glial fibrillary acid protein (GFAP) and
      cytokeratin (CK). Immunohistochemical results were compared with those of 5 cases
      of neuroendocrine carcinoma (NC) (1 of the oral vestibule, 1 of the larynx, 1
      Merkel-cell tumor of the skin and 2 medullary thyroid carcinomas).
      Immunoreactivity for NSE and/or CGA was always positive in all paragangliomas and
      NC. S-100 protein was positive in sustenticular cells in all cases of
      paragangliomas and focally in two cases of NC. NF and GFAP were focally positive
      in 3 and 2 paragangliomas respectively; and in 1 NC. CK was constantly negative
      in all cases of paraganglioma and constantly positive in all cases of NC.
      Antibody anti-CK is the single most useful immunomarker for differential
      diagnosis between paraganglioma, frequently benign neoplasms and NC commonly
      aggressive in the head and neck. These findings are consistent with the current
      concepts of the neuroendocrine system.

PMID- 1754508
TI  - Rapid supplementary fixation in frozen sections: microwave versus conventional
      fixation. A double-blind comparative study.
AB  - The preservation of morphological details in frozen sections subjected to
      microwave-assisted fixation was compared with that in frozen sections subjected
      to snap fixation with either formalin/ethanol or ethanol alone. Especially
      nuclear details were better preserved after short microwave fixation. Ethanol
      alone gave the poorest results, with loss of nuclear details in the majority of
      the cases. In this study there was no significant difference between the
      morphological results obtained with a cheap domestic oven and that with a
      specialized microwave processor. Microwave-assisted fixation in frozen sections
      is a simple, rapid method. It is recommended for use in routine laboratories.

PMID- 1754509
TI  - Classical and chondroid chordoma. A light-microscopic, histochemical,
      ultrastructural and immunohistochemical analysis of the various cell types.
AB  - The aim of the present investigation was to characterize the various cell types
      of classical and chondroid chordomas. Eight cases of classical chordoma, 1 case
      of sacrococcygeal chordoma with chondroid areas and 2 cases of spheno-occipital
      chondroid chordoma were studied. Ultrastructurally and immunohistochemically
      (immunoreactivity for cytokeratins, epithelial membrane antigen [EMA], tissue
      polypeptide antigen [TPA] and human milk fat globule protein [HMFG]) the 3 cell
      types (physaliferous, epithelial-like, and spindle-shaped) recognized light
      microscopically presented features of epithelial differentiation and rather
      formed a continuous spectrum than being distinct cell types. The chondroid areas
      of the chondroid chordomas had similar ultrastructural and immunohistochemical
      properties except for the lack of immunoreactivity for EMA and HMFG. The results
      of the critical electrolyte concentration technique according to Scott and
      Dorling indicated that there was no difference in the sulfated glycosaminoglycan
      content between classical and chondroid chordomas: all the tumors contained
      chondroitin sulfate. The presence of chondroitin sulfate, immunoreactivity for
      vimentin and S-100 protein and areas of cartilaginous differentiation in three
      cases indicate a relationship both to chondromatous tumors and to normal
      notochord, from which chordoma is believed to originate.

PMID- 1754510
TI  - Immuno- and enzymehistochemical characterization of 'plasmacytoid T-cells' in
      formalin-fixed paraffin-embedded tissue of reactive lymph nodes.
AB  - In eight (10.4%) of 77 randomly selected cases of lymphadenitis, foci of
      'plasmacytoid T-cells' (PTCs) were found. We characterized the PTCs in formalin
      fixed paraffin-embedded tissue by immuno- and enzymehistochemical techniques. In
      each case the PTCs formed nodular and patchy infiltration patterns around the
      high endothelial venules in the paracortex of the lymph nodes. The PTCs in half
      of the cases were present near the intermediary peritrabecular sinuses. The PTCs
      were found to be positive for CD 45 (LCA), CD 45 R (4 KB 5) and CD 43 (MT 1), but
      not for CD 45 RO (UCHL 1), L 26 (CD 20), myeloperoxidase, naphthol AS-D
      chloroacetate esterase, Mac 387, alpha-1-antichymotrypsin or S 100 protein and
      anti-dendritic reticulum cell antibody. Some lysozyme+ PTCs were mingled in and
      around the foci in each case. In five cases the PTCs showed weaker positive
      reactions for CD 68 (EBM 11) and HLA-DR than for T-zone macrophages and sinus
      histiocytes. Related to the degree of desintegration of the nodular PTC-foci
      increasing numbers of T- and B-lymphocytes, T-zone macrophages and
      interdigitating reticulum cells with HLA-DR were detected in the foci. In two
      cases, where there was no HLA-DR expression by PTCs, small amounts of HLA-DR in
      secondary lymph follicles and a decrease of HLA-DR+ T-zone macrophages and
      interdigitating reticulum cells were observed. Our results suggest that there is
      a high degree of interaction between PTCs and other cellular components in the
      lymph node. The PTC may represent a special type of resident macrophage with
      secretory capacities.

PMID- 1754511
TI  - Atypical bronchial carcinoids lack S-100 positive sustentacular cells.

PMID- 1754512
TI  - Capillaries within human skeletal muscle fibers.
AB  - Internalized capillaries, i.e. capillaries within muscle fibers, represent a rare
      myopathological feature. This was systematically studied in 923 muscle biopsy
      specimens and found in 24, chiefly in the gastrocnemius muscle, more rarely in
      the biceps and quadriceps muscles affecting males more often than females and
      most frequently associated with juvenile spinal muscular atrophy or Becker's
      muscular dystrophy. Internalized capillaries, often multiple, ran along the long
      axis of the muscle fiber within an "internalized" extracellular space and were
      almost exclusively seen in type I myofibers. Internalization seems to start at
      the site of fiber splitting while penetration through the intact sarcolemma and
      invasion into transverse tubules were never observed. The presence of
      internalized capillaries within type I myofibers and increased density of
      intramuscular capillaries/fiber though not per muscle fiber area suggested
      hypoxia to play a possible if not crucial role in the formation of internalized
      capillaries. Our findings do not distinguish between active proliferation of
      capillaries into myofibers at the site of myofibers and internalization by fusion
      of vicinal myofibers as the morphogenetic principles suggest that both of these
      mechanisms may occur.

PMID- 1754513
TI  - Immunohistochemical and biochemical characterization of the mucin-type tumor
      associated antigen TAG-12 by monoclonal antibody 7A9.
AB  - The reactivity of monoclonal antibody 7A9 with normal and neoplastic human
      tissues and some biochemical characteristics of the antigen (TAG-12) bound by 7A9
      were evaluated. Antibody 7A9 showed broad reactivity with various carcinomas in
      paraffin sections. High percentages of positive tumor cells, displaying membrane
      and cytoplasmic staining, were noticed in adenocarcinomas of the breast (83/85),
      serous cystadenocarcinomas of the ovary (15/16), and lung adenocarcinomas
      (14/16). TAG-12 antigen was also detectable in normal adult and fetal tissues,
      but the reactivity of 7A9 was mainly restricted to the luminal surface of
      epithelial cells. For biochemical analyses, TAG-12 antigen purified from T47-D
      breast carcinoma cells by lectin affinity chromatography was treated with
      different glycosidases and proteases and analyzed by immunoblotting with 7A9. The
      data indicate that the antigen recognized by 7A9 is a heavily sialated mucin-type
      glycoprotein with a molecular weight of more than 200 KD. Similar to all other
      antibodies against tumor associated antigens, monoclonal antibody 7A9 is not
      tumor-specific but displays tissue staining patterns with a high carcinoma-to
      normal ratio. The strong reactivity with the majority of tumor cells in several
      carcinoma types suggests that 7A9 is useful for in vitro and in vivo targeting of
      those tumors.

PMID- 1754514
TI  - What's new in cytostatic drug resistance and pathology.
AB  - A major problem in cytostatic treatment of malignant tumors is the development of
      chemoresistant cell clones. An increased understanding of chemoresistance related
      mechanisms, improved methods for the detection and localization of resistant cell
      populations including predictive conclusions on the effectiveness of cytostatic
      drugs would contribute to the advancement of anti-tumor strategies. This paper
      reviews current concepts suggested for the development of cellular resistance to
      natural product drugs (anthracyclines, Vinca alkaloids, epipodophyllotoxines,
      antibiotics; so-called multidrug resistance substances), alkylating agents
      (nitrosureas, busulfan and mitomycin C), heavy metal compounds (cisplatin) and
      antifolates (5-fluorouracil, methotrexate) and describes the role of drug
      transporting and binding proteins (P-170-glycoprotein), detoxifying enzymes
      (glutathion-S-transferase, dihydrofolate reductase), DNA repair enzymes
      (topoisomerase I and II, polymerase alpha and beta), and genomic alterations
      (amplification, double minutes and homogeneous staining regions) due to
      resistance. It is focussed on the employment of morphological methods (light
      microscopy, immunocytochemistry, electron microscopy, fluorescence analysis, in
      situ hybridization, computer aided morphometric analysis) which will help to
      detect resistant cell clones in tumor biopsies. First correlations between
      histological data and clinical course will be reported. In the future, the
      morphological determination of chemoresistance may play an important role in
      applied functional tumor pathology.

PMID- 1754515
TI  - Pulmonary myofibroblastic nodules with "amianthoid features".
AB  - Two consecutive publications appeared 1989 in the same number of a medical
      journal, which reported peculiar spindle-cell tumors with dense collagen or
      hyaline nodules, exclusively in inguinal lymph nodes of adults. The first series
      of 22 cases bore the title "Palisaded myofibroblastoma, a benign mesenchymal
      tumor of lymph node", the second with 6 identical cases "Intranodal hemorrhagic
      spindle-cell tumor with "amianthoid" fibers". The following case report deals
      with a similar tumorous lesion, with multiple small pulmonary nodules, without
      recognizable lymph node constituents.

PMID- 1754516
TI  - Localization of elastase and tumor necrosis factor alpha mRNA by non-radioactive
      in situ hybridization in cultures of alveolar macrophages.
AB  - Digoxigenin is a new tool for labeling probes which can be detected with the help
      of specific antibodies in the cell by indirect or direct immunostaining. In
      contrast to the biotin-reaction, the advantage of digoxigenin is that it does not
      appear in animal or human cells in nature. In comparison to radioactive labeling
      methods it is favorable in terms of short exposure time and precise localization
      of signals in the cell. In this paper we describe the localization of elastase
      and tumor necrosis factor alpha (TNF alpha) mRNA by non-radioactive in situ
      hybridization of rat alveolar macrophages in cell culture after stimulation with
      welder steam dusts. Using digoxigenin labeled probes the determination of
      specific mRNA's expression and their precise localization in the cytoplasm of the
      cell could be achieved within one day.

PMID- 1754517
TI  - Growth hormone receptor expression in the Dunning R 3327 prostatic carcinoma of
      the rat.
AB  - The Dunning R3327 rat carcinoma is an important model for human prostate
      adenocarcinoma. In the present study this tumor was further characterized by
      immunohistochemical demonstration of receptors for growth hormone (GH-R). Weak GH
      R immunoreactivity was present in the secretory epithelial cells of the tumor
      acini. Large epithelial cells which were localized at the periphery of the acini
      and large cells in the stroma, which are probably derived from the epithelium
      ("Large neoplastic epithelial cells"), displayed a strong staining with one of
      the monoclonal antibodies (Mab 263) to GH-R. The presence of GH-R receptors in
      proliferating prostatic tumor cells supports the concept that GH reacts directly
      on prostate target tissue to facilitate tumor cell growth.

PMID- 1754518
TI  - Morphometric and stereological analysis of the effects of 17 beta-estradiol on
      the glandular epithelium of the castrated guinea pig lateral prostate.
AB  - Upon administration of pharmacological doses of estradiol to castrated guinea
      pigs, the secretory cells of the lateral prostate underwent hypertrophy which
      resulted from significant increases in nuclear and cytoplasmic volume. There were
      quantitative increases in the small highly electron-dense granules and
      multivesicular bodies when compared with the castrated control. The dramatic
      increase in the number of highly electron-dense granules probably occurred at the
      expense of the low electron-dense granules. The average size of the condensing
      granules and mitochondria decreased significantly after estradiol administration.
      However, significant increase in the number of mitochondria was detected when
      compared with the castrated control. Ultrastructural data revealed no significant
      changes in the absolute dimensions of granular endoplasmic reticulum or of the
      Golgi complex, suggesting that estradiol exerted no significant stimulatory
      effects on these organelles. Pharmacological doses of estrogen appear to regulate
      the expression of secretory granules and multivesicular bodies in the lateral
      prostate of castrated guinea pigs.

PMID- 1754519
TI  - Effect of glycine on retroperitoneal and intraperitoneal organs in the rat model.
AB  - Twenty Sprague Dawley rats were administered various doses of 1.5% amino acetic
      acid (glycine), lactated Ringer's, and water, both intravenously and
      retroperitoneally, in an attempt to recreate the post-transurethral resection
      syndrome in a rat model. The kidneys, liver, and pancreas were harvested 6 hours
      after exposure and examined pathologically. Water and lactated Ringer's had no
      histologic effect on these organs. Glycine was found to have a toxic effect on
      the kidneys and liver and this effect was dose related. Based on these results,
      it is postulated that glycine toxicity may play a significant role as a causative
      factor in producing the post-transurethral resection syndrome.

PMID- 1754520
TI  - Current views on aetiology and management of haemolytic uraemic syndrome.

PMID- 1754521
TI  - Secretion of drugs into the human female genital tract.

PMID- 1754522
TI  - Problems in diagnosis and management of hypertrophic cardiomyopathy.

PMID- 1754524
TI  - Medical disorders in Alzheimer's disease and vascular dementia.
AB  - The clinical and postmortem findings of 29 patients with Alzheimer's disease were
      evaluated and compared to the findings of 19 patients with vascular dementia. The
      patients with Alzheimer's disease had received treatment for an average of 2.0
      internal medical disorders, the patients with vascular dementia for 2.1
      disorders. The average number of medical diseases found at postmortem was 3.7 in
      the group with Alzheimer's dementia and 4.1 in vascular dementia. Apart from a
      marginally increased rate of peripheral occlusive artery disease in vascular
      dementia, the proportions of the most common disorders of the cardiovascular,
      genitourinary, gastrointestinal and endocrinological disorders and the most
      common causes of death did not differ significantly between these groups.
      Therefore patients with Alzheimer's disease should receive the same internal
      medical attention as patients with vascular dementia.

PMID- 1754525
TI  - Patent foramina ovale in elderly stroke patients.
AB  - Fifty elderly patients who had suffered cerebrovascular incidents from no obvious
      cause and 33 age-matched controls were investigated for the presence of a patent
      foramen ovale by contrast 2-dimensional echocardiography at rest and after the
      Valsalva manoeuvre. Right-to-left shunting was found in only one patient and in
      none of the controls. This finding is in contradistinction to young adult stroke
      patients in whom the prevalence of a haemodynamically significant patent foramina
      ovale is high. Paradoxical embolism is an uncommon cause of stroke in the
      elderly.

PMID- 1754523
TI  - Hepatology.

PMID- 1754526
TI  - T cell dominated inflammatory reactions in the bronchioles of asymptomatic
      asthmatics are also present in the nasal mucosa.
AB  - Endobronchial and nasal mucosa biopsies were obtained from 5 patients with
      clinically-stable, diagnosed asthma (ATS criteria). A comparison was made of the
      presence and distribution of immunocompetent lymphocytes and macrophages within
      each sample. The distribution of immunocompetent cells within the nasal biopsies
      of the asthmatic patients reflected a very similar inflammatory infiltrate to
      that seen in the bronchial biopsies. Significantly raised numbers of T
      lymphocytes, CD45RO + lymphocytes, RFD1 + macrophage-like cells and RFD7 +
      macrophages were seen in both the nasal mucosa and the bronchial biopsies.
      Increases in HLA-DR expression were also seen in the nasal mucosa biopsies from
      asthmatics although the increases over normal did not reach statistical
      significance. It is concluded that inflammation present in the nasal mucosa of
      asymptomatic asthmatics exhibits cellular characteristics also seen in
      endobronchial biopsies. This observation offers the possibility that mucosal
      biopsy may be an alternative and less invasive approach for studying the cells
      involved in the bronchial inflammatory reaction that possibly predisposes
      asthmatics to bronchial hyper-responsiveness.

PMID- 1754527
TI  - Dose response to inhaled salbutamol in chronic obstructive airways disease.
AB  - High dose inhaled salbutamol is increasingly used in the management of chronic
      obstructive airways disease. To determine the range of doses to achieve optimal
      bronchodilatation and the proportion of patients requiring high dose therapy we
      have studied 23 patients with chronic obstructive airways disease. Cumulative
      dose responses were measured to six incremental doses of salbutamol (0.2 to 1.2
      mg) delivered by metered dose inhaler. Results were analysed by polynomial
      regression to calculate the smallest dose required to produce 90% maximal
      bronchodilatation in each patient. While 5/23 (22%) required greater than 1 mg
      the majority, 14/23 (61%), achieved 90% maximal bronchodilation with salbutamol
      0.6 mg or less. The 8 patients with severe airflow limitation (FEV1 less than or
      equal to 1 litre) showed a similar pattern of response. We conclude that in
      chronic obstructive airways disease there are wide individual variations in the
      dose of inhaled salbutamol producing 90% maximal bronchodilatation with only a
      minority requiring high dose therapy.

PMID- 1754528
TI  - Small bowel function after aortic surgery.
AB  - One cause of post-operative morbidity in the elective repair of abdominal aortic
      aneurysms is the development of a paralytic or 'adynamic' ileus. In a series of
      20 consecutive patients undergoing such a procedure, the maintenance of small
      bowel motility and absorptive capacity in the immediate post-operative period was
      assessed using barium sulphate and xylose passed down a naso-duodenal tube sited
      at the time of surgery. This simple study demonstrated that small bowel function
      was preserved in all cases, and hence that patients could be fed enterally via
      naso-duodenal tube (in particular using very low residue formulae) rather than
      using costly parenteral regimens, should an ileus persist.

PMID- 1754529
TI  - Clustering of colorectal neoplasia: characteristics of coexisting adenomas in
      patients with severely dysplastic polyps or invasive (malignant) polyps as
      compared to patients with benign adenomas or carcinomas.
AB  - This study compared the size, histology and morphology of coexisting neoplastic
      polyps found in colonoscopy, and evaluated the clustering of these polyps in
      patients with either colorectal carcinoma, cancerous polyps or benign adenomas.
      Patients were divided by their most malignant form of neoplasia: Group A included
      58 patients with early invasive cancerous polyps, and Group B included 73
      patients with in situ carcinoma within an adenoma. Group C consisted of 335
      patients with benign adenomas, and Group D had 289 patients with colorectal
      carcinoma. There were no significant differences between the four groups
      regarding sex, age and ethnicity. The cancerous polyps were significantly larger
      than the benign polyps. There were significantly (P less than 0.01) more patients
      with multiple (greater than or equal to 5) colonic lesions in Groups A or B than
      in Groups C or D. Coexisting polyps were much closer to the index growth, and
      demonstrated more severe dysplastic changes in the case of cancerous polyps than
      those associated with benign polyps or cancer. Based on our data we speculate
      that cancerous polyps are not merely a middle link in adenoma-carcinoma sequence,
      but rather mark a subset of patients who are especially prone to develop
      neoplastic changes in their colonic mucosa. These patients should be included in
      a more strict colonoscopic surveillance programme.

PMID- 1754530
TI  - Syringomyelia associated with post-meningitic spinal arachnoiditis due to Candida
      tropicalis.
AB  - A 63 year old man who suffered from syringomyelia related to post-meningitic
      spinal arachnoiditis caused by Candida tropicalis is reported. The clinical
      syndrome of syringomyelia developed gradually and a definite diagnosis was
      delayed for more than 10 years. The patient has partially recovered after
      surgical treatment. This form of fungal infection and its delayed neurological
      complication in the form of syringomyelia has not been reported previously, to
      our knowledge.

PMID- 1754531
TI  - Life-threatening hypercalcaemia in association with Addisonian crisis.
AB  - A 35 year old woman was admitted with acute radial artery occlusion necessitating
      two operations and thrombolytic therapy. Subsequently a diagnosis of primary
      hypothyroidism was made and she was commenced on thyroxine replacement therapy.
      Her condition, however, continued to deteriorate with the development of an
      Addisonian crisis heralded by, and complicated by, severe, life-threatening
      hypercalcaemia. This case highlights the importance of considering Addison's
      disease in any patient whose condition deteriorates after the introduction of
      thyroxine replacement, and illustrates the often forgotten association of
      hypercalcaemia and hypoadrenalism.

PMID- 1754532
TI  - Diverticulum of the rectum due to a rectal leiomyosarcoma.
AB  - A 78 year old woman with a rectal leiomyosarcoma is presented. The case is of
      interest because of very unusual radiological and operative features of a large
      rectal diverticulum. As a result of the difficulty in making the correct
      diagnosis pre- or intraoperatively, a simple, but possibly suboptimal, resection
      was performed. Although the patient has done well, the long-term outlook is
      uncertain. The problems of optimum management and prediction of outcome in this
      uncommon condition are discussed.

PMID- 1754533
TI  - Strangulated femoral hernia: the clinical trap.

PMID- 1754534
TI  - Fenfluramine--induced irreversible pulmonary hypertension.

PMID- 1754535
TI  - Bone lesions in chronic granulocytic leukaemia.

PMID- 1754536
TI  - Salmonella enteritidis empyema complicating lupus pleuritis.

PMID- 1754537
TI  - Spontaneous oesophageal haematoma presenting as acute myocardial infarction:
      implications for thrombolytic therapy.

PMID- 1754538
TI  - Genetic variation in the incidence of pipped eggs in turkeys selected for low and
      high semen ejaculate volume.
AB  - Genetic variation in embryonic mortality, expressed as embryos that pip their
      eggshell but do not hatch, was investigated in turkeys selected for low and high
      semen ejaculate volume (SEV). Through five generations (Generations 10 to 14,
      inclusive) mean heritability estimates for pipped eggs were .21 and .08 in the
      low- and high-SEV lines, respectively. Estimates of sire, dam, and within-hatch
      components of variance suggest greater environmental and maternal effects than
      genetic influences on the incidence of pipped eggs in turkeys.

PMID- 1754539
TI  - Body weight and carcass development in different lines of turkeys.
AB  - Body weight and carcass component weights of turkeys from a growth-selected line
      (F), a randombred control population (RBC2), and a commercial sire line (C) were
      compared at hatch, 4, 8, 12, and 16 wk of age. At hatch there were no significant
      differences in BW between the F and RBC2 lines, but the C line poults weighed
      significantly less than the F line poults. Total Pectoralis muscle weight of the
      F line was larger than for Lines C and RBC2 at hatch, but there were no line
      differences in drum weight or length. The F line was still heavier than the other
      lines at 4, 8, and 12 wk, but the absolute and relative weights of the Pectoralis
      major (P. major) muscle were larger in the C line than the other lines at all
      ages. Selection for BW increased the weight of the P. major in the F line
      compared with the RBC2, but differences in the relative weight of the muscle were
      not consistent. The large line differences for the absolute and relative weight
      of the P. major were not observed for the Pectoralis minor. At all ages, the
      lengths of the tibia and femur were greater in the F line than the other lines.
      At 4 and 8 wk, bone length in the C line was greater than the RBC2, but at 12 and
      16 wk there were no significant differences between these lines. The fast-growing
      F and C lines had more abdominal fat than the RBC2 at 16 wk of age.

PMID- 1754540
TI  - Effect of floor type and energy source on growth and productivity of broiler
      breeders.
AB  - Arbor Acres broiler breeder chicks were raised through an egg production cycle on
      either wood or plastic slats and either full- or partial-slat flooring. Two diets
      with either corn starch (CHO) or fat (FAT) as the primary energy source were fed
      at a rate consistent with the breeder's recommendations to examine the effect of
      energy source on fat deposition and productivity. Fertility and hatchability were
      unaffected by slat material or floor type. Mean hen-day egg production and floor
      egg production were significantly (P less than .05) reduced for birds on full
      slat floors. In addition, birds on full-slat, plastic floors averaged 6.4% fewer
      eggs over the production cycle versus birds on full-slat, wood floors. Floor egg
      recovery from full-slat floors was not considered to be the major reason for this
      reduced egg production. Wood or plastic slats had no effect on average egg
      production for birds on partial-slat and litter floors. Energy source had no
      effect on growth or productivity except during Weeks 17 and 18 of production when
      birds fed the FAT diet had a greater egg production than birds fed the CHO diet.
      Overall mean hen-day egg production, fertility, and hatchability were unaffected
      by dietary energy source. Abdominal fat pad weight and adipocyte characteristics
      were also similar for FAT- and CHO-fed birds.

PMID- 1754541
TI  - Effect of roost temperature on performance of chickens in hot ambient
      environments.
AB  - A split-plot experiment was conducted in thermally controlled chambers using
      Columbian Plymouth Rock chickens to determine the effect of water-cooled roosts
      on performance in hot ambient conditions. The birds were subjected to 25 +/- 1,
      35 +/- 1, and 25 +/- 1 C ambient temperature treatments for 2, 3, and 2 wk,
      respectively. Roost temperature treatments were either cool (20 +/- 1 C) or air
      equilibrated (25 +/- 1 or 35 +/- 1 C). The performance parameters evaluated were
      percentage hen-day egg production, egg weight, feed intake, feed conversion,
      fertility, and hatchability. Birds subjected to the water-cooled roost treatment
      had consistently higher performance than birds using the air-equilibrated roost
      under all three ambient temperatures. Both ambient and roost temperature
      treatments significantly influenced percentage hen-day egg production, average
      daily feed intake, and percentage hatchability (P less than or equal to .05).
      However, the biggest differences in performance were observed during the heat
      stress period. Decreases in performance during the heat-stress period from the
      thermoneutral control values were: 5.95 and 13.1 percentage points for hen-day
      egg production, 22.2 and 34.8 percentage points for average daily feed intake,
      and 5.17 and 15.38 percentage points for hatchability in water-cooled and air
      equilibrated roost treatments, respectively. The ambient and roost temperature
      treatments did not significantly affect egg weight, feed conversion, or
      percentage fertility. The improved performance with water-cooled over air
      equilibrated roost treatments, especially during heat-stress periods, indicates
      that the water-cooled roosts minimized the deleterious effects of heat stress
      through conductive heat loss from the birds to the roost.

PMID- 1754542
TI  - The fate of Pasteurella multocida after intratracheal inoculation into turkeys.
AB  - Young adult turkeys were intratracheally inoculated with the P-1059 strain of
      Pasteurella multocida, and the fate of the organism was studied by quantifying
      the organism in various respiratory and systemic tissues at various times after
      the inoculation. The results showed that, in the first 2 h, on the order of 10(8)
      to 10(9) organisms deposited at the upper trachea multiplied in situ to gradually
      spread downwards to the lower respiratory tract. In the majority of turkeys, by 6
      h postinoculation the organism invaded the circulatory system and multiplied
      vigorously in the liver and spleen. In some birds, however, the organism appeared
      to have reached the liver from the trachea instantaneously by an unidentified
      mechanism. Vaccination with inactivated vaccines protected turkeys from
      intratracheal challenge exposure, as well as from intramuscular inoculation.

PMID- 1754543
TI  - Methods for inoculation and recovery of Salmonella from chicken eggs.
AB  - Various methods of applying inoculum and recovering low numbers of artificially
      inoculated Salmonella typhimurium on eggs were evaluated. Inoculation methods
      tested were suspending cells in 1) .85% saline; 2) 1% peptone; 3) sterile chicken
      fecal paste; or 4) a 1:10 dilution of chicken feces in .85% saline. Sampling
      methods tested were 1) shell and membrane massage; and 2) mortar and pestle
      grinding of shells and membranes. The method that yielded the best recovery of
      low numbers of Salmonella was as follows: 1) apply cell suspension in 1% peptone
      to egg; 2) sample egg by a hand crush and massage of shell and membranes in 50 mL
      of buffered peptone; 3) incubate shell and membranes in buffered peptone
      overnight and then plate onto selective agar. Methods that did not improve
      sensitivity of recovery included varying the inoculum drying time, addition of
      FeSO4 or Cleland's reagent to the recovery medium, and varying the temperature of
      the inoculum to affect penetration.

PMID- 1754544
TI  - High dietary fat increases toxicity of diacetoxyscirpenol in chickens.
AB  - The influence of high dietary fat on the toxicity of diacetoxyscirpenol (DAS) was
      investigated in a 2 x 5 factorial arrangement of treatments (6 and 12% fat, and
      0, 1, 2, 4, and 8 micrograms DAS/g diet). The 3-wk body weight was decreased (P
      less than .0001) by DAS, but fat had no significant (P less than .05) effect.
      There was a highly significant (P less than .0059) interaction manifested at the
      higher levels of DAS by a greater decrease in body weight in the high-fat diet
      than in the low-fat diet. Neither feed conversion nor percentage of fat in fecal
      material were affected significantly (P less than .05) by DAS. These data were
      consistent with the high-fat diet promoting lipid micellar absorption of DAS and
      with DAS, once absorbed, inhibiting protein synthesis at the ribosomal level, a
      well established mechanism of action for trichothecene toxins such as DAS.

PMID- 1754545
TI  - Measurement of malabsorption of carotenoids in chickens with pale-bird syndrome.
AB  - Because pale-bird syndrome (PBS), defined as the failure of birds to realize the
      color potential of their diet, has been demonstrated to be caused by
      malabsorption or by hyperexcretion of carotenoids, a method for measuring
      malabsorption of carotenoids would be useful. The absorption of dietary
      canthaxanthin, a red diketocarotenoid, into serum during aflatoxicosis was
      measured in an experiment with a 2 x 9 factorial arrangement of treatments (0 and
      5 micrograms of aflatoxin/g of diet; serum collected at 0, 2, 4, 6, 8, 10, 12,
      14, and 24 h after a standard meal fed to four groups of 10 3-wk-old birds).
      Serum canthaxanthin levels determined by HPLC attained plateau values between 8
      and 14 h after the meal. The absorption of canthaxanthin was depressed
      significantly (P less than .05) in birds with aflatoxicosis from 4 to 24 h after
      feeding the standard meal. Four field flocks diagnosed as having PBS were tested
      for malabsorption by intubating 10 birds with a standard amount of canthaxanthin
      and measuring serum canthaxanthin 12 h later. One flock had about 85% normally
      pigmented birds and 15% extremely pale birds, the second flock had a coccidiosis
      history, the third had a Newcastle disease history, and the fourth had a history
      of both coccidiosis and Newcastle disease. The flocks were 5- to 6-wk-old,
      received feed of the same manufacture, and their disease outbreaks had occurred 2
      wk earlier.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754546
TI  - Uterine calcium-binding protein activity of nonlaying hens and hens laying hard
      shelled or shell-less eggs.
AB  - Uterine calcium-binding protein (CaBP) activity was compared at oviposition and
      14 h postoviposition in nonlaying (NL) hens and hens laying a high incidence of
      shell-less (SL) or hard-shelled (HS) eggs fed a commercial laying diet.
      Epithelial cells were removed from uteri of NL, SL, and HS hens and homogenized
      in Tris buffer, pH 7.4. Proteins in homogenate were fractionated by the addition
      of ammonium sulfate and centrifugation, separated by Sephadex chromatography, and
      measured by ultraviolet spectrophotometry at A280. Calcium-binding protein
      activity was determined using a 45Ca-chelex binding assay. Two peaks of CaBP
      activity were detected and designated CaBP-a (28,000 Da) and CaBP-b (16,000 Da).
      Uterine CaBP-b may differ from CaBP-a only in Ca content. The activities of CaBP
      (a and b) were higher (P less than or equal to .05) in HS and SL hens than in NL
      hens at 0 h. There was no significant difference (0 h) between CaBP activity (a
      versus b) of either HS or SL hens. There was also no difference (0 h) of CaBP-a
      or CaBP-b activity when SL and HS hens were compared. Uterine CaBP-a activity was
      lower (P less than or equal to .05) in SL hens than HS hens at 14 h. Under normal
      dietary conditions, the level of CaBP activity at 14 h may be associated with SL
      egg production.

PMID- 1754547
TI  - Influence of orotic acid on performance, liver lipid content, and egg cholesterol
      level of laying hens.
AB  - Three experiments were conducted to determine the effects of dietary orotic acid
      (OA) on laying hen performance, liver lipid content, and plasma and egg
      cholesterol levels. Laying hens were fed a basal diet supplemented with 0, .5,
      1.0, and 2.0% OA for 8 wk. Performance of the hens and cholesterol levels were
      measured at biweekly intervals. In all three experiments, OA decreased (P less
      than .05) BW in a linear manner. In two experiments, OA caused a linear decrease
      in total liver lipid (P less than .05), and in a third experiment OA resulted in
      a quadratic effect (P less than .01) on liver lipid content. There were no
      effects observed by OA supplementation on egg weight, yolk weight, percentage
      yolk, or egg production. Orotic acid failed to influence egg cholesterol content
      in any of the biweekly measurements of the three experiments. In two experiments,
      total plasma cholesterol content was not influenced by OA supplementation. Orotic
      acid significantly reduced (P less than .05) free and total plasma cholesterol in
      a third experiment when measured at Weeks 4, 6, and 8 of the experiment. The data
      indicate that OA is an ineffective dietary supplement for reducing egg
      cholesterol levels in laying hens.

PMID- 1754548
TI  - Plasma progesterone, luteinizing hormone concentrations, and granulosa cell
      responsiveness in heat-stressed hens.
AB  - Plasma progesterone and luteinizing hormone (LH) profiles were obtained during
      the first ovulatory cycle of heat-stressed (HS, 35 C; n = 24) and unstressed (US,
      17 to 27 C; n = 24) hens using 30-min sampling intervals beginning approximately
      6 h prior to ovulation. Progesterone levels from HS hens were lower from 6 h [.07
      +/- .01 (SE) versus 1.66 +/- .25 ng/mL; P = .008] to predicted ovulation (.06 +/-
      .006 versus .70 +/- .18 ng/mL; P = .07). Likewise, LH levels from HS hens were
      lower from 6 h (1.55 +/- .16 versus 3.86 +/- .34 ng/mL; P = .007) to predicted
      ovulation (1.63 +/- .18 versus 2.50 +/- .27 ng/mL; P = .01). Eggs from HS hens
      were more often laid early (less than 24 h) than eggs from US hens (71.42 versus
      13.33%, respectively; P = .01), but US hens more often laid eggs of a normal
      oviposition interval length (24 to 26 h) compared with HS hens (73.34 versus
      14.29%; P = .0005). The percentage of delayed eggs (greater than 26 h) was not
      different (US, 14.29 versus HS, 13.37%; P = .75) between the two treatment
      groups. Basal production of progesterone by dispersed granulosa cells from US
      hens was 97.62 +/- 16.01 ng/mL. Challenge by LH increased this to 417.50 +/-
      53.38 ng/mL (P = .0001). In contrast, basal progesterone secretion by cells from
      HS hens was 40.25 +/- 6.60 ng/mL (P = .0001) and LH challenge failed to increase
      progesterone production.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754549
TI  - Efficacy of lateral ventricular injection of epinephrine, cyproheptadine, or
      adenosine triphosphate on feed intake in thiamin-deficient turkeys.
AB  - In previous work, thiamin deficiency (TD) resulted in decreased brain levels of
      adenosine triphosphate (ATP) and epinephrine, but serotonin (5-HT) was increased
      in the turkey. The goal of the present study was to determine whether the
      introduction of calculated levels of epinephrine, ATP, or cyproheptadine into the
      lateral ventricle could affect feed intake of TD birds. Adenosine triphosphate,
      epinephrine, and cyproheptadine (5-HT antagonist) were injected into the lateral
      ventricle of TD and control birds. These injections did not alter feed intake in
      the control birds. Cyproheptadine and ATP decreased feed intake in the 1st h in
      the TD birds as compared with sham-injected TD birds (P less than .05), but
      epinephrine had no effect. The results indicate replacement or inhibition of a
      single altered neurochemical does not increase short-term feed intake in TD
      birds.

PMID- 1754550
TI  - The effect of thiamin deficiency on amino acids in the brain, liver, and plasma
      of the turkey.
AB  - The present study was conducted to determine the effect of thiamin deficiency
      (TD) on amino acids in brain, liver, and plasma. Twenty-seven 1-wk-old female
      turkeys were assigned to TD or control groups. Experimental birds were fed a TD
      diet; control birds received the same diet with thiamin at levels recommended by
      the National Research Council. Chromatographic analysis at 12 days of age found
      altered levels of amino acids in selected brain areas and liver of TD birds.
      Proline was increased in the TD archistriatum and liver. Leucine was elevated in
      the TD hypothalamus, medulla-pons, midbrain thalamus, and cerebellum. Threonine
      was lower in the hippocampus, but was increased in the liver of TD birds.
      Glutamine declined in the TD hippocampus, but glutamate increased in the TD liver
      only. Urea decreased and valine increased in the TD medulla-pons. Aspartic acid
      and serine decreased in the TD liver. These results indicate that dietary TD does
      alter amino acids in these tissues.

PMID- 1754551
TI  - Research note: effects of age and immunization interval on the anamnestic
      response to T-cell-dependent and T-cell-independent antigens in chickens.
AB  - Measurement of a humoral anamnestic response is a common procedure used to
      evaluate immunological competence. The purposes of the present study were to
      determine the optimum time period between primary and secondary immunizations
      needed to obtain the maximum antibody titer and to determine whether this
      interval differs with the age of the chicken or with the type of inducing
      antigen. The anamnestic responses of birds of two ages to a T-cell-dependent
      antigen (SRBC) and to a T-cell-independent antigen (Brucella abortus, BA) were
      evaluated. Birds of 4 wk or 6 mo of age were injected i.v. with either BA or
      SRBC, and a secondary injection was given 2, 4, 6, or 8 wk later. Agglutination
      titers for total and mercaptoethanol (ME)-resistant antibodies were determined
      from serum samples collected at 3, 6, and 9 days postsecondary immunization.
      Generally, titers were highest at 6 days postsecondary immunization. For both
      antigens, the chick total antibody levels at Day 6 postsecondary immunization
      were higher at 4-, 6-, and 8-wk immunization intervals than at 2-wk intervals;
      adult titers were independent of immunization interval. There was an interaction
      between age of birds and type of antigen.

PMID- 1754552
TI  - Research note: evaluation of humoral and delayed hypersensitivity responses in
      cockerels reared under constant light or a twelve hour light:twelve hour dark
      photoperiod.
AB  - Immature cockerels were reared under constant light [24 h light (L):0 h dark (D)]
      or a 12L:12D photoperiod in order to evaluate the effect of constant light on
      immunoresponsiveness. At 10 wk of age males were immunized with SRBC, with
      reimmunization occurring either 3 or 8 wk later. Animals reared under constant
      light had lower (P less than .05) anti-SRBC antibody titers than the 12L:12D
      males. Additionally, the pattern of the antibody response following secondary
      immunizations were different, with 24L:0D males exhibiting no increase in
      antibody titers between Days 3 and 9 postinjection. Delayed hypersensitivity
      responses of 24L:0D males were lower (P less than .05) than those of 12- or 16-wk
      old 12L:12D males. Taken together, these results suggest that circadian
      light:dark cycles may play a role in modulating the immune system.

PMID- 1754553
TI  - Research note: lack of an effect of high levels of menadione on tumor development
      in Japanese quail females.
AB  - The objective of the experiment was to study the influence of a high but nontoxic
      dietary level of menadione (vitamin K3) on the incidence of leiomyomas and
      leiomyosarcomas in the oviduct of females from various lines of Japanese quail.
      Analyzed values of vitamin K3 per 1,000 kg of feed were 7.37 g in the control
      diet, and 149.6, 1,722, and 3,722 g for the experimental diets from 0 to 4, 5 to
      8, and after 8 wk of age, respectively. Females were killed after they had been
      in production for 158 days. Females from three large-bodied lines had a greater
      incidence of smooth muscle tumors than those from a smaller randombred control
      line. The high dietary level of vitamin K3 had no influence on tumor development.

PMID- 1754554
TI  - False-negative prenatal exclusion of Wiskott-Aldrich syndrome by measurement of
      fetal platelet count and size.
AB  - The study of the fetal platelet count and size can, according to the literature,
      be used for the prenatal diagnosis of the Wiskott-Aldrich syndrome (WAS). So far,
      no affected fetuses have been identified by this method. All pregnancies in which
      this method had been applied to resulted, as correctly predicted, in the birth of
      normal children. Here we report on a familial case of WAS where the
      haematological parameters failed to reveal the affected second child. Hence we
      assume that the platelet count and size of platelets remain normal in fetuses
      with WAS to the gestational age of 22 weeks and cannot be used for prenatal
      diagnosis.

PMID- 1754555
TI  - Clinical and pathological factors in spontaneous abortion following chorionic
      villus sampling.
AB  - Twenty-nine cases of spontaneous abortion following first-trimester chorionic
      villus sampling (CVS) were reviewed out of a series of 722 patients. Of the 29
      cases, there were only four abnormal CVS results. Pathological examination was
      performed in 79 per cent of cases, and this did not identify any characteristic
      pathological feature associated with spontaneous abortion after CVS. There was no
      obvious difference in the pathological features following the transabdominal (TA)
      or the transcervical (TC) methods. The majority of miscarriages occurred within 4
      weeks of the procedure, but 38 per cent of cases aborted between 7 and 14 weeks
      after CVS. The TC method was used in 22 patients; the TA in 6; and both methods
      in 1 patient. The TA method was associated with a significantly lower fetal loss
      rate than the TC method (TA 2 per cent, TC 9 per cent, p less than 0.001).

PMID- 1754556
TI  - Prenatal diagnosis of PIBIDS.
AB  - In a well-documented PIBIDS family, two investigations of DNA excision repair
      showed a severe defect in lymphocytes from the index case (residual repair
      activities were 10.6-12.1 per cent). The values for the mother, father, and
      sister were within the normal range when compared with a healthy control. In the
      pregnant mother, a prenatal diagnosis of PIBIDS was made by measuring UV-induced
      unscheduled DNA synthesis in cultivated amniotic fluid cells. Results ranged
      between 12.5 and 26.1 per cent depending on the UV doses applied and were
      consistent with an affected fetus. The parents opted for a termination of
      pregnancy. Following a therapeutic abortion, fetal skin fibroblasts were tested
      and showed a severe DNA excision-repair defect of 9.2-13.5 per cent of residual
      activity.

PMID- 1754557
TI  - Prenatal diagnosis of a fetus with terminal deletion of chromosome 1 (q41)
AB  - Many authors have suggested that individuals affected by a terminal 1q deletion
      display a phenotypically definable and recognizable syndrome. In all of the 27
      cases reported to date, the breakpoints were at band q42 or distally to it. To
      our knowledge, we report the first case of a terminal 1q41 deletion. Diagnosis
      was made prenatally by amniocentesis, following ultrasonographic diagnosis of
      omphalocele, cerebral ventriculomegaly, and increased nuchal fold thickness in a
      19-week female fetus. Multiple facial and extremity features were consistent with
      the proposed distal 1q deletion syndrome; omphalocele, however, has not been
      reported previously. The absence of liver herniation into the omphalocele sac in
      this case supports the previously reported association of this finding with
      chromosomal anomalies.

PMID- 1754558
TI  - A case of mosaicism involving an unstable 13/14 Robertsonian translocation.
AB  - Prenatal diagnosis of mosaicism involving an apparently unstable 13/14
      Robertsonian translocation is reported. This illustrates the difficulties
      encountered in counselling when mosaicism is ascertained prenatally. Other
      reported examples of apparently unstable Robertsonian translocations are
      discussed.

PMID- 1754559
TI  - Trisomy 12 mosaicism.

PMID- 1754560
TI  - A normal 46,XX infant with a 46,XX/69,XXY placenta: a major contribution to the
      placenta is from a resorbed twin.
AB  - A predominantly triploid 69,XXY placenta was found associated with a normal 46,XX
      infant. Therefore, a triploid placenta is apparently capable of supporting normal
      fetal development. The chromosome and pathological results support the conclusion
      that the triploid placenta originates from a 'vanishing twin' pregnancy. This
      case is unusual in that persistence of the placenta from the vanished twin has
      virtually replaced most of the normal placenta.

PMID- 1754561
TI  - Prenatal diagnosis of harlequin ichthyosis by fetal skin biopsy; report of two
      cases.
AB  - Two cases of harlequin ichthyosis were successfully diagnosed prenatally by fetal
      skin biopsy. The aborted fetuses were later confirmed to be afflicted with this
      very unusual skin disease. Both families had a previous history of harlequin
      ichthyosis. In performing the biopsy, it was found that amniotic fluid cytology
      can also be very helpful in the diagnosis of this kind of severe ichthyosis. With
      regard to these families, the disease may have been transmitted in an autosomal
      dominant fashion, and not in a recessive manner as is commonly believed.

PMID- 1754562
TI  - Early transvaginal sonographic diagnosis of alobar holoprosencephaly.
AB  - Holoprosencephaly is a cerebral anomaly resulting from incomplete cleavage of the
      primitive prosencephalon or forebrain. Early detection of this anomaly is very
      important since the most severe form is incompatible with life. The diagnosis
      also signals the need for a chromosomal determination since chromosomal
      abnormalities have been associated with this anomaly. An early diagnosis of
      alobar holoprosencephaly at 14 weeks' gestation, employing transvaginal
      sonography, is reported. Our findings are compared with prenatal transabdominal
      sonographic findings of holoprosencephaly which have been reported during the
      last decade in the literature.

PMID- 1754563
TI  - Maternal serum human chorionic gonadotropin levels in twin pregnancies.
AB  - Introduction of combined screening with maternal serum alpha-fetoprotein and
      human chorionic gonadotropin (MShCG) assays for fetal chromosome defects requires
      establishment of the normal range for twins. This report documents that the
      normal range for MShCG between 15 and 19 weeks in twin gestations was 1.84-2.41
      multiples of the singleton median. Of the 192 twin pregnancies studied, 31.7 and
      47.9 per cent had MShCG values greater than or equal to 2.5 and greater than or
      equal to 2.0 multiples of the singleton median, respectively.

PMID- 1754564
TI  - Prenatal diagnosis for dystrophia myotonica using the polymerase chain reaction.
AB  - The polymerase chain reaction has been used to detect an abundant class of short
      repeat DNA families of the form (dC-dA)n.(dG-dT)n, known as microsatellites.
      These units are found throughout the human genome and have been characterized for
      several loci including APOC2 on chromosome 19q12-q13.2. The locus APOC2 is linked
      to the gene for dystrophia myotonica and a microsatellite within this locus was
      used to derive polymorphisms in a family to predict the inheritance of the
      disease. Chorionic villus sampling (CVS) was performed at 15 1/2 weeks'
      gestation. Following DNA extraction from the CVS material and parental blood
      samples, microsatellite analysis was carried out by the polymerase chain
      reaction.

PMID- 1754565
TI  - Post-mortem findings in a fetus with 48,XXY,+21.
AB  - A fetus with 48,XXY,+21 was detected on routine amniocentesis at 15 weeks for
      advanced maternal age. Fibroblast cultures from six different tissues were
      initiated after termination and each showed the same karyotype without any tissue
      limited mosaicism. The only phenotypic abnormality detected at post-mortem
      examination was bilateral clinodactyly of the fifth finger which had been
      detected on ultrasound. The maternal serum alpha-fetoprotein and the femur length
      were normal. Maternal age remains an essential criterion for prenatal diagnosis.

PMID- 1754566
TI  - Pallister-Killian syndrome diagnosed by chorionic villus sampling.
AB  - The first prenatal diagnosis of Pallister-Killian syndrome by chorionic villus
      sampling is presented. Fetal hydrops was noted on ultrasound in early pregnancy,
      and the karyotype revealed isochromosome 12p mosaicism.

PMID- 1754567
TI  - Duplication of chromosome 11 centromere in fetal and maternal karyotypes: a new
      variant?
AB  - Fetal chromosome analysis in a 39-year-old mother revealed a chromosome 11
      aberration interpreted as a duplication of the centromere. This was also found in
      the mother's karyotype, raising the possibility that the abnormality was a new
      variant of no clinical consequence.

PMID- 1754568
TI  - Prenatal diagnosis of duplication cyst of the pylorus.
AB  - The first description of the antenatal appearance of a duplication cyst of the
      pylorus is presented. Prior to the infant's delivery, the possibility that this
      intra-abdominal cystic mass represented a choledochal cyst was also strongly
      considered. The antenatal detection of this cystic mass allowed close neonatal
      surveillance and timely surgical intervention prior to the onset of serious
      neonatal complications. The embryogenesis of duplication cysts of the
      gastrointestinal tract and bronchopulmonary foregut malformations is reviewed.
      The clinical utility of the prenatal diagnosis of such fetal gastrointestinal
      anomalies is also discussed.

PMID- 1754569
TI  - A second report of normal outcome with mosaic isochromosome 20q found on
      amniocentesis.

PMID- 1754570
TI  - The maternal-fetal electrical potential difference: new findings and a
      perspective.

PMID- 1754571
TI  - Syncytiotrophoblast brush border proteins recognized by monoclonal antibody TRA-2
      10 and rabbit anti-TLX sera.
AB  - Different subsets of placental trophoblast epithelium are directly exposed to the
      maternal immune system during pregnancy and consequently represent major elements
      in allogeneic interactions. It has been proposed that the trophoblast--lymphocyte
      cross-reactive (TLX) alloantigen system is involved in maternal allogeneic
      recognition during pregnancy. Monoclonal antibody TRA-2-10 putatively recognizes
      TLX antigens, but its reactivity with trophoblast and normal tissues has not been
      documented in detail. In this report, immunohistological investigations revealed
      that TRA-2-10 recognizes all subsets of trophoblast in addition to amniotic and
      seminal vesicle epithelia. Immunoblotting demonstrated reactivity with
      glycoproteins of 55,000 and 65,000 mol. mass under non-reducing conditions on
      various cell types. These proteins displayed tissue-specific size variations and
      individuals varied in the amounts expressed of the two species. On the basis of
      blocking and immunoprecipitation experiments, TRA-2-10 reactive antigens are
      recognized by rabbit anti-TLX sera and are potential TLX antigen candidates.
      However, TLX antigens are found in seminal plasma whilst TRA-2-10 reactive
      antigens are not. Both TLX and TRA-2-10 antigens appear related if not identical
      to membrane cofactor protein (MCP) by virtue of shared molecular characteristics
      and blocking of lymphocyte binding of monoclonals to MCP by polyclonal anti-TLX.
      Extra-embryonic membranes are thus richly endowed with a complement regulatory
      protein which could facilitate their roles in protection of the fetus by
      avoidance of harmful maternal immune response amplification.

PMID- 1754572
TI  - Expression of HLA class I and beta 2-microglobulin on human choriocarcinoma cell
      lines: induction of HLA class I by interferon-gamma.
AB  - The trophoblast cells which contact with maternal tissue express HLA class I
      either weakly or not at all. This phenomenon is beneficial for the protection of
      the fetus from immunological rejection by the mother. However, the mechanisms of
      reduced expression of HLA class I are unexplained. Therefore, we utilized
      choriocarcinoma cells to analyse the suppressive mechanisms to HLA class I
      expression in trophoblasts. In this paper we reported the heterogeneity of HLA
      class I expression in five choriocarcinoma cell lines. The levels of surface HLA
      class I molecules correlate approximately with mRNA of HLA class I heavy chain,
      and all choriocarcinoma cells produce moderate amounts of surface and secreted
      beta 2 microglobulin. It was also found that interferon gamma upregulates HLA
      class I molecules and mRNA in two choriocarcinoma cell lines, NUC1 and HCCM5.

PMID- 1754573
TI  - Expression of alkaline phosphatase in differentiated rat labyrinthine trophoblast
      tissue.
AB  - In this report, we describe the generation of specific antibodies to rat alkaline
      phosphatase and the temporal and regional characteristics of alkaline phosphatase
      expression during maturation of the rat chorioallantoic placenta. An antipeptide
      antiserum was generated to the amino terminal 15 amino acids of rat alkaline
      phosphatase. The antiserum specifically recognized alkaline phosphatase. Alkaline
      phosphatase expression was monitored in the junctional and labyrinth zones of the
      chorioallantoic placenta by Western and Northern blot analyses. Alkaline
      phosphatase protein and mRNA were present in both the junctional and labyrinth
      zones on day 13 of gestation. As gestation advanced, alkaline phosphatase mRNA
      and protein expression decreased below the limits of detection in the junctional
      zone, while alkaline phosphatase expression increased in the labyrinth zone.
      Labyrinthine alkaline phosphatase migrated predominantly as a 95-kDa species,
      whereas rat kidney expressed exclusively the 75-kDa species. Enzymatic
      deglycosylation of the 75- and 95-kDa alkaline phosphatase species resulted in
      the generation of a 55-kDa species. In summary, alkaline phosphatase expression
      is a useful indicator of trophoblast differentiation.

PMID- 1754574
TI  - Amitosis and endocycles in early cultured mouse trophoblast.
AB  - The possible occurrence of amitosis has been studied in nuclei of trophoblast
      outgrowths of mouse embryos placed in culture at the two-cell stage. By day 7 of
      culture, the inner cell mass has usually floated away, while the trophoblast
      outgrowth remains attached. Of 591 trophoblast cells from 25 embryos, 469 were
      uninucleate, 87 binucleate, 4 trinucleate, and in 31 the nuclei were attached to
      each other. In our interpretation, these come about through a process in which
      the nucleus stretches, then the nuclear membrane invaginates and finally
      constricts the nucleus into two parts. The resulting nuclei, asymmetric in size
      and in amount and arrangement of heterochromatin and nucleoli, lie side-by-side.
      We conclude that these cells with two or more attached or separate nuclei
      represent stages in true amitosis. In Table 1, amitosis is compared with mitosis
      without cytokinesis and with cell fusion, both of which can also give rise to
      binucleate and multinucleate cells. Mitosis without cytokinesis does not agree in
      any respect with the characteristics of amitosis, whereas at least a few
      similarities exist between cell fusion and amitosis. However, amitosis may give
      rise to near-haploid nuclei, which cannot be produced by mitosis or cell fusion.
      Simultaneously with amitosis, the nuclei grow through endocycles. In many nuclei,
      the heterochromatin is clearly underreplicated, while the nucleoli are numerous
      and often of enormous size, probably reflecting amplification of the rRNA genes.

PMID- 1754575
TI  - Development of the early human placenta: a morphometric study.
AB  - The placentae of 46 normal pregnancies artificially terminated between 6 and 15
      weeks of gestation were investigated morphologically to provide trends in early
      villous development. Study of the specimens included phase contrast microscopic
      examination and histomorphometric investigation in all cases, and scanning
      electron microscopy in ten cases. Histomorphometric measurements included the
      villous barrier thickness i.e. the distance between the intervillous space and
      the villous capillary lumen, the trophoblastic layer thickness and the volume
      fraction of each villous constituents, i.e. trophoblast, stroma and capillaries.
      Significant negative correlations were observed between gestational age and the
      villous barrier and trophoblastic thickness. The data obtained were separated
      into two groups, embryonic (5-10 weeks) and fetal (11-15 weeks) groups, and
      compared. The mean barrier thickness, the mean trophoblastic thickness, the mean
      volume fraction for trophoblast and the sprouting-villous index were
      significantly greater during the embryonic period compared with the fetal period.
      The mean volume fraction for the stroma and for the fetal capillaries, and the
      mean number of capillary profiles per villous profile were significantly smaller
      during the embryonic period than during the fetal period. The comparison of
      placental histomorphometric data obtained in cases of normal early pregnancies
      with those observed in cases of abnormal early pregnancies could help us to
      elucidate the origin of anatomical and biological changes in these cases.

PMID- 1754576
TI  - Effects of protein-calorie malnutrition on transplacental kinetics of
      aminoisobutyric acid in rats.
AB  - In order to find out if inefficient transport of amino acids contributes to a
      decrease in fetal weight during maternal malnutrition, we injected [14C]- and
      [3H]-labelled aminoisobutyric acid (AIB), respectively, in the mother and its
      fetuses and determined its transplacental kinetics on day 20 of gestation in rats
      fed a 21 per cent (control) or a low (5 per cent) protein diet. Rats fed a low
      protein diet consumed significantly less food than did the rats fed a control
      diet and thus suffered from protein-calorie malnutrition. A low protein diet led
      to a significant (P less than 0.05) decrease in maternal and fetal volume of
      distribution of AIB, a decrease in the clearance of AIB from the mother to the
      fetus and an increase in the time required for the fetal plasma AIB concentration
      following maternal injection to exceed the maternal plasma AIB concentration. The
      clearance of AIB from the fetus into the mother or to outside (e.g. amniotic
      fluid) was not altered by protein deficiency. It is concluded that a decrease in
      the efficiency of the placenta to deliver amino acids to the fetus may be a
      contributing factor in fetal growth retardation during maternal protein
      malnutrition.

PMID- 1754577
TI  - Antibacterial properties of human amniotic membranes.
AB  - Amniotic membranes are widely used in a multitude of surgical applications and
      have been shown to reduce bacterial counts and promote healing in infected
      wounds. Antibacterial properties of amniotic fluid are well documented and the
      presence of many potentially antibacterial factors has been demonstrated. No such
      factors have yet been found in amniotic membranes. We have applied a direct disc
      diffusion susceptibility test to try to establish the possible existence of such
      a factor. Amniotic membranes did not inhibit five bacterial species when tested
      at 3 X 10(6) and 3 X 10(8) colony forming units/ml. However, complete growth
      inhibition of all organisms was seen immediately under the amniotic membrane
      discs. These results support the hypothesis that the antimicrobial effect of
      amniotic membranes in vitro is due to their close adherence to the wound surface.

PMID- 1754578
TI  - Human placental lactogen (hPL) model for the normal pregnancy.
AB  - This study includes 75 females with normal pregnancies, and presents individual
      cases of longitudinal series of human placental lactogen (hPL). Samples for hPL
      levels are taken during the period from gestational week 26 and until labour. A
      modified Gompertz equation is defined, characterized as growth at a continuously
      decreasing exponential rate, which finally plateaus in gestational week 36. This
      modified Gompertz equation adequately fitted individual hPL series. The work
      describes that a final hPL forecast for the normal pregnancy could be obtained in
      gestational week 30 using knowledge on maternal height and age, combined with a
      single hPL sample. The present model was applied in six pathological pregnancies
      with intrauterine growth retardation, and in all cases measured hPL levels were
      below the model estimate.

PMID- 1754579
TI  - [Results of epidemiological and clinical studies of the prevalence of chronic
      nonspecific diseases of the respiratory organs among rural population].
AB  - The results of many years' investigations conducted in 3 experimental republican
      regions are presented. The investigations were aimed at establishing the reliable
      indices of the prevalence of chronic nonspecific respiratory diseases in rural
      population and the development of preventive measures in subjects at a high risk
      of tuberculosis infection in certain patients with chronic nonspecific
      respiratory diseases who have some post-tuberculous lung changes. It is
      emphasized that rendering of the preventive and therapeutic aid to pneumologic
      patients requires joint efforts of phthisiatrists, pneumologists and
      therapeutists.

PMID- 1754580
TI  - [Smoking among medical students].
AB  - A fundamental statistical analysis of the questionnaire given to 2089 first-year
      and last-year students of 9 medical institutes of the country was carried out
      within the framework of study of the "Smoking and Health" International
      Committee. The number of smokers per day was 21.6%. Awareness of smoking
      association with the development of certain diseases is 2-3 times higher in the
      last-year students than in the first-year ones. Among the nonsmokers 87.6%
      supported the need to limit smoking in public places, 79.2% to prohibit tobacco
      selling to children, 66.6% to prohibit advertisement of tobacco products and 82
      supported the idea of instructing doctors in methods for treating smoking.
      Smokers were less enthusiastic in supporting the proposed measures. Among the
      smokers 53% claimed failure in giving up smoking. The main responsibility in
      banning smoking falls on medical profession.

PMID- 1754581
TI  - [Analysis of the knowledge of phthisiology among pediatricians].
AB  - Analysis of an anonymous questionnaire given to 100 pediatricians at the
      postgraduate training department is given. Questions involved routes of
      infection, early detection, clinical aspects and prevention of tuberculosis in
      children and adolescents. The most typical aspects of inadequate knowledge of
      phthisiatrics by pediatricians were defined, which may negatively affect the
      antituberculosis aid given to children and adolescents. The findings were used
      for the adjustment of a program and the content of phthisiatrics training at the
      postgraduate training department.

PMID- 1754582
TI  - [What is respiratory insufficiency?].

PMID- 1754583
TI  - [Diagnosis of pleurisy of tuberculous etiology].
AB  - Among the 367 patients with the pleurisy syndrome examined in a specialized
      diagnostic department, 167 (45.5%) had tuberculous pleurisy and the active stage
      of pulmonary tuberculosis was diagnosed in 42 (25.1%); in 125 subjects pleurisy
      was an independent form of tuberculosis. The possibilities of the clinico
      roentgenologic, bioptic and bacteriologic diagnosis of the disease etiology have
      been studied in different variants of the X-ray picture (unblocked, partially
      sacculated, sacculated and adhesive pleurisy).

PMID- 1754584
TI  - [Status of the bronchi in patients with pulmonary tuberculosis and different
      haptoglobin phenotype].
AB  - External respiration function test and bronchologic examination were conducted in
      206 pulmonary tuberculosis patients with different haptoglobin (Hp) phenotypes.
      It was found that obstructive changes in peripheral portions of the bronchial
      tree were most common and marked among the revealed disorders of pulmonary
      ventilation function. These changes promote a decrease in the ventilation reserve
      to a great extent. As compared to Hp 2-1 carriers, specific endobronchitis and
      bronchial obstruction symptoms were significantly more frequent in patients with
      Hp 2-2. Bronchial obstruction symptoms alone were twice as frequent as in
      patients with Hp 1-1 than in Hp 2-1 carriers. The findings indicate that there is
      a close relationship between the status of the bronchi in pulmonary tuberculosis
      patients and the genetically determined Hp phenotype.

PMID- 1754585
TI  - [Clinical course, treatment and outcome of tuberculous meningitis in children].
AB  - Data are given on the follow-up of 108 children between the ages of 6 months and
      15 years who had tuberculous meningitis. A basilar form of meningitis was
      diagnosed in 70.4% of the children and meningo-encephalitic form in 29.6%. In
      most of the children meningitis developed in the presence of specific changes in
      the lungs; the course was typical in 74.1% and acute in 25.9%. Superinfection was
      seen in 64% of the children, late diagnosis and untimely hospitalization of
      children were noted in 31.5%. A clear relationship was revealed between
      disappearance of clinical signs and liquor cleansing and hospitalization terms.
      Treatment currently applied is effective. Cure was seen in 86.1% of the cases in
      the presence of significant residual changes (in meningoencephalitis) in 13.9%.
      The disease had a fatal outcome in 13.9% of the cases of late diagnosis.

PMID- 1754586
TI  - [Chemical elements in the blood, bronchial lavage fluid and lung tissue of
      patients with pulmonary tuberculosis and lung cancer].
AB  - The examined groups included 58 patients with cancer, 61 subjects with pulmonary
      tuberculosis and 50 healthy persons as controls. The content of trace elements in
      blood, bronchial lavage fluid from the most affected portions of the lungs, and
      in pathologic and healthy lung tissues was determined by a C-115 atomic
      absorption spectrophotometer. The examination findings demonstrated that the
      content of blood serum ferric zinc and magnesium, and erythrocyte zinc,
      manganese, potassium and calcium was higher in patients with pulmonary
      tuberculosis than in those with lung cancer. At the same time the content of
      magnesium and calcium in bronchial lavage fluid was higher in persons with a
      malignant process than in those with pulmonary tuberculosis. As far as
      differential diagnosis of pulmonary tuberculosis and lung cancer is concerned, it
      is advisable to measure the levels of erythrocyte trace elements since the latter
      most precisely reflects their content in the lung pathologic tissue.

PMID- 1754587
TI  - [Diagnosis of mycotic infections in patients with tuberculosis of the respiratory
      organs].
AB  - The basic clinico-diagnostic criteria are given which detect an intercurrent
      infection caused by opportunistic fungi of the Candida and Aspergillus genus. The
      antibacterial drugs of nonspecific action used in patients with destructive forms
      of respiratory tuberculosis promote the growth and reproduction of fungus flora
      and aggravate the course of the underlying process in the lung tissue. When there
      is intercurrent mycotic infection, the antifungal therapy produces a clinical
      effect in patients with combined pathology.

PMID- 1754588
TI  - [Results of clinical use of nicorette in the treatment of tobacco smokers].
AB  - The results of nicorette therapy in 51 patients with tobacco dependence were
      analysed. Among the total number of patients 14 had ideational, 8 psychosomatic
      and 29 dissociated tobacco dependence. A year follow-up shows that 20 patients
      gave up smoking (predominantly with dissociated tobacco dependence). The clinical
      aspects of a reverse dynamics of the symptoms of a pathological tobacco addition,
      with consideration of the type of tobacco dependence and premorbid features of
      the course of mental cognition, show that nicorette possesses a certain clinical
      spectrum of action suppressing the activity of a secondary ideational component
      of pathological tobacco addiction. Nicorette may raise the level of a clinico
      differential therapeutic approach aimed at giving up smoking in the form of
      monotherapy or a combined therapy with the use of tranquillizers, neuroleptics
      and antidepressants.

PMID- 1754589
TI  - [Clinical course and outcome of pulmonary tuberculosis in rural population from
      the epizootically unfavorable regions].

PMID- 1754590
TI  - [A method of studying mucociliary clearance in patients with inflammatory lung
      diseases].

PMID- 1754591
TI  - [A modified method of determining the isoniazid levels in the blood serum and
      organs of animals].

PMID- 1754592
TI  - [Value of different combinations of immunological signs for differential
      diagnosis of lung diseases].
AB  - Stemming from the results of a complex immunologic examination of 653 patients
      with lung diseases, 4 immunologic reactions of highly diagnostic value were
      identified, i. e. specific antibody formation, blast transformation with PPD and
      PHA and spontaneous rosette formation. The most valuable combinations of these
      reactions were defined for each type of the pathology. For tuberculosis, 16 such
      combinations were found, including 5 without specific antibody formation; 5 in
      cancer; 3 in nonspecific inflammation; and 1 in sarcoidosis. Diagnostically
      important combinations of the above immunologic reactions are summarized in the
      Table whose use in differential diagnosis of doubtful cases of tuberculosis,
      cancer, nonspecific pneumonia and sarcoidosis can increase their diagnostic
      probability up to 0.95-0.99 in 30 per cent of the patients without employing
      invasive methods.

PMID- 1754593
TI  - [Anti-tuberculosis antibodies in the immunoenzyme test in relation to the
      effectiveness of chemotherapy of tuberculosis].
AB  - A method of indirect solid-phase EIA was used to detect serum antibodies in 110
      patients with destructive tuberculosis. The preparation with a molecular mass of
      38-42 kD isolated from the mycobacteria H37Rv was used as an antigen. Changes in
      the level of antituberculous antibodies were found during treatment, which are
      most manifested in 4-6 months of antituberculous therapy and depend on treatment
      efficiency. The effective therapy is accompanied by a decrease in the level of
      antituberculous antibodies by that time, while in ineffective therapy it remains
      high. Hence, changes in the level of antituberculous antibodies may serve as an
      additional criterion of chemotherapy efficiency.

PMID- 1754594
TI  - [Prevention of side effects of specific chemotherapy in patients with pulmonary
      tuberculosis].
AB  - Data are given related to a combined examination of 168 pulmonary tuberculosis
      patients in whom immunomodulating T-activin and levamisole chemotherapy was
      carried out in 40 subjects. In tuberculosis patients with significantly abnormal
      parameters of the immunity T-system, side effects of the antituberculosis drugs
      developed in 67.7%, while in those who were subjected to a general scheme of
      treatment with inclusion of the immunomodulating drugs in only 17.5%. T-activin
      was found to be highly effective in preventing side effects of the
      antituberculosis drugs. A diverse influence of the immunity modulating drugs on
      some T-lymphocyte classes was registered, which is essential in choosing the
      suitable modulator and regimen of its use.

PMID- 1754595
TI  - [Cytomorphological diagnosis of sarcoidosis in patients with lesions of the
      peripheral lymph nodes and respiratory organs].
AB  - In sarcoidosis, the cytomorphologic pattern of aspirates shows a predominant
      progressive inflammation without exudative reaction and caseous necrosis, round
      granulomas with signs of polymorphism with the presence of mononuclear elements,
      giant cells by the "foreign body" type and development of pronounced fibrosis.

PMID- 1754596
TI  - [Ultraviolet irradiation of blood in patients with pulmonary tuberculosis].
AB  - The described methods for ultraviolet blood radiation were used in 80 patients:
      51 had tuberculosis of the bronchopulmonary system and 29 nonspecific pulmonary
      diseases. A marked clinical effect was confirmed by subjective and objective
      methods. In all cases blood pressure moderately decreased, there was a tendency
      to hypercoagulation decline, the erythrocyte count and hemoglobin level
      increased. The microstructure of blood elements studied by a scanning electron
      microscope showed formation of the rosette-forming structures in the blood and a
      significant increase in deformed erythrocytes.

PMID- 1754597
TI  - [Effect of carbon dioxide laser on Mycobacterium tuberculosis and microflora].
AB  - The effect of CO2 laser on M. tuberculosis (MT) and nonspecific micro-organisms
      has been studied. Radiation of MT in suspension causes a decrease in the number
      of colonies. Laser action on MT and microflora after their growing in a solid
      nutrient media produces a bactericidal action in the exposed zone with the area
      of growth inhibition being in a direct proportion to the laser power and the time
      of its action.

PMID- 1754598
TI  - [Detection of destructive pulmonary tuberculosis in children at a hospital for
      somatic diseases].
AB  - Tuberculosis-related examination of 123 children during hospital treatment in 2
      pneumologic departments has revealed 9.8% of tuberculosis patients. Among the
      children with destructive lung processes one-third had tuberculosis in a
      destructive phase. Timely diagnosis of childhood tuberculosis in children's
      somatic hospitals, especially in those of a pneumologic type, requires the
      obligatory Mantoux test with 2 TU PPD-L and in children with destructive lung
      processes bacteriologic sputum examination for Mycobacterium tuberculosis.

PMID- 1754599
TI  - [Tuberculosis in the United States (review of foreign literature 1983-1989)].

PMID- 1754600
TI  - [A rare case of intralobar sequestration associated with pulmonary tuberculosis].

PMID- 1754601
TI  - [Incidence of cor pulmonale in chronic nonspecific lung diseases].

PMID- 1754602
TI  - The regulation of adenylyl cyclase by receptor-operated G proteins.
AB  - The receptor regulated adenylyl cyclase system is a multiprotein complex which is
      a member of the family of the receptor-effector systems whose signal is
      transduced by heterotrimeric GTP-binding proteins. The system consists of
      stimulatory and inhibitory receptors (Rs and Ri), stimulatory and inhibitory G
      proteins (Gs and Gi) and the adenylyl cyclase enzyme (C). While quite specific in
      situ, receptors (stimulatory or inhibitory) from one source can activate the
      appropriate G protein from other cell types or species which in turn can act on C
      from other sources. Studies with chimeric proteins have shown that the various
      specificities (stimulatory or inhibitory) can be mapped to defined domains in
      both receptors and G proteins. The mechanism by which the heterotrimeric G
      proteins couple to the stimulatory and inhibitory signals is discussed in detail.
      Specifically, the data supporting collision coupling vs the shuttle mechanism is
      reviewed, as well as the role of beta gamma subunits in both the stimulatory and
      inhibitory signals.

PMID- 1754603
TI  - The potential importance of swainsonine in therapy for cancers and immunology.
AB  - Swainsonine, an indolizidine alkaloid, was initially used in biomedical research
      as a tool to investigate the biosynthesis and function of asparagine-linked
      'complex' type oligosaccharide moieties of glycoproteins. Recently, swainsonine
      has generated interest in its potential use as an anticancer agent with reports
      that it (i) inhibits tumor growth and metastasis, (ii) augments natural killer
      (NK) and macrophage-mediated tumor cell killing, and (iii) stimulates bone marrow
      cell proliferation. The antineoplastic activity of swainsonine can be explained
      at least in part by augmentation of immune effector mechanisms. The potential
      application of swainsonine as an anticancer agent is discussed.

PMID- 1754604
TI  - Intracellular messengers and the control of protein synthesis.
AB  - The molecular events responsible for controlling cell growth and development, as
      well as their coordinate interaction is only beginning to be revealed. At the
      basis of these controlling events are hormones, growth factors and mitogens
      which, through transmembrane signalling trigger an array of cellular responses,
      initiated by receptor-associated tyrosine kinases, which in turn either directly
      or indirectly mediate their effects through serine/threonine protein kinases.
      Utilizing the obligatory response of activation of protein synthesis in cell
      growth and development, we describe efforts to work backwards along the
      regulatory pathway to the receptor, identifying those molecular components
      involved in modulating the rate of translation. We begin by describing the
      components and steps of protein synthesis and then discuss in detail the
      regulatory pathways involved in the mitogenic response of eukaryotic cells and
      during meiotic maturation of oocytes. Finally we discuss possible future work
      which will further our understanding of these systems.

PMID- 1754605
TI  - Morphologic and morphometric techniques for the detection of drug- and toxin
      induced changes in lung.
AB  - The lung is one of the main target organs of drug-induced toxicity. An assemblage
      of quantitative techniques is available to make precise determinations of
      structural effects. While stereology is the principal technique, particularly in
      its application to the parenchyma, other compartments such as the airways and
      vasculature demand modifications or different methods altogether. The new methods
      of molecular biology can now be used to uncover the mechanisms underlying drug
      toxicity and with a more rational use of image analysis are likely to yield
      quantitative data. Established techniques that quantify structural change
      combined with more novel approaches that utilize molecular interventions may
      emerge as exciting integrated approaches in this important field.

PMID- 1754606
TI  - Contribution of the glutathione S-transferases to the mechanisms of resistance to
      aflatoxin B1.
AB  - The harmful effects of Aflatoxin B1 (AFB1) are a consequence of it being
      metabolized to AFB1-8,9-epoxide, a compound that serves as an alkylating agent
      and mutagen. The toxicity of AFB1 towards different cells varies substantially;
      sensitivity can change significantly during development, can be modulated by
      treatment with xenobiotics and is decreased markedly in preneoplastic lesions as
      well as in tumors. Three types of resistance, namely intrinsic, inducible and
      acquired, can be identified. The potential resistance mechanisms include low
      capacity to form AFB1-8,9-epoxide, high detoxification activity, increase in AFB1
      efflux from cells and high DNA repair capacity. Circumstantial evidence exists
      that amongst these mechanisms the glutathione S-transferases, through their
      ability to detoxify AFB1-8,9-epoxide, play a major role in determining the
      sensitivity of cells to AFB1.

PMID- 1754607
TI  - Piracetam in elderly motorists.
AB  - 101 elderly motorists with reduced reaction capacity were examined under real
      traffic conditions with regard to their driving ability. They were given a daily
      dose of 4.8 g piracetam or placebo over a six-week period in a randomised double
      blind study. The percentage of correctly solved sign-observance items, which
      reflects orientation and perception in real traffic conditions, increased in the
      placebo-treated test-group from 79.86% in the pretest to 80.07% in the retest,
      whereas the test subjects of the piracetam-treated group improved their
      performance from 77.08% to 84.16%. After being treated with piracetam for 6
      weeks, the drivers showed a significantly better performance than the placebo
      group. Of particular interest is the finding that the test-subjects who had
      scored less than 80% in the pretest improved without exception in the retest
      after treatment with piracetam.

PMID- 1754608
TI  - Adinazolam, diazepam, imipramine, and placebo in major depressive disorder: a
      controlled study.
AB  - In summary, the clinical results of this double-blind study clearly show that
      imipramine, as expected, demonstrated significant antidepressive properties in
      outpatients suffering from major depressive disorders. In contrast, adinazolam
      showed rather mild and weak antidepressive properties, and in no measures did its
      response differ significantly from that of diazepam. These findings are quite in
      contrast to those obtained by the authors in an earlier study with alprazolam
      (Rickels et al., 1987) in which alprazolam and imipramine produced rather similar
      results and both were significantly better than placebo, while diazepam was not.
      While the rather high dropout rate may well be considered a limitation of the
      study, the dropout rate is equally distributed between all four treatments. And
      since both decreasing sample size and endpoint analyses which include all
      patients with at least one week data, provide rather similar results, the
      findings can be considered as robust despite the high dropout rate. While the
      authors consider those findings the most robust in which endpoint and completer
      analyses results are rather similar, when high dropout rates occur, endpoint
      analyses should be given more weight than completer analyses as they are more
      representative of actual clinical practice. The present findings therefore
      suggest that adinazolam clearly possesses less antidepressive properties than
      imipramine and not more than diazepam and these findings are in agreement with
      other studies which found lack of significant antidepressant activity for such
      benzodiazepines as diazepam (Covi et al., 1974) and chlordiazepoxide (Lipman et
      al., 1986). The presence of only borderline antidepressive effects combined with
      rebound symptoms occurring already after only 6 weeks of therapy does not
      recommend adinazolam for use in depression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754609
TI  - Extrapyramidal symptoms and their relationship to clinical efficacy under
      perphenazine treatment. A controlled prospective handwriting-test study in 22
      acutely ill schizophrenic patients.
AB  - In order to verify the hypothesis of a strict relationship between clinical
      improvement and extrapyramidal side-effects, especially micrographia, twenty-two
      acutely ill schizophrenics were treated with perphenazine in a controlled
      prospective 28-day trial. During the study period, psychopathometric data,
      prolactin plasma levels, and handwriting samples were collected. According to the
      remission criteria fixed before the study began (both BPRS less than or equal to
      25 and GAS greater than or equal to 80 points), 45.5% (10/22) of the total
      patient sample were classified as treatment responders. Handwriting tests were
      quantified in 21 patients. "Positive" handwriting results, i.e., a reduction of
      at least 13% in the overall area of 50% or more of the handwriting samples
      collected during the trial, were demonstrable in three of nine responders (33%)
      and nine of twelve nonresponders (75%). These results show that there is no
      positive correlation between clinical response and reduction in handwriting area.
      Consequently, the handwriting test is unable to predict clinical response. It is
      only one of a number of parameters with which to monitor the neurological side
      effects of neuroleptic treatment. Outcome parameters show that psychopathological
      remission can be achieved with low neuroleptic dosages and few or virtually no
      extrapyramidal side-effects.

PMID- 1754610
TI  - Misuse of zopiclone and convulsions during withdrawal.
AB  - It has been documented that benzodiazepines have the potential to cause
      dependence and withdrawal reactions, including convulsions. However, the
      available data concerning zopiclone, a nonbenzodiazepine hypnotic, are
      insufficient. The present study describes the case of a 36-year-old man who
      repeatedly misused zopiclone, in daily doses of 60-90 mg. Furthermore, the
      patient suffered from convulsion on two occasions following abrupt withdrawal of
      zopiclone. The concomitant use of alcohol, trimipramine, and promazine may have
      contributed to the development of convulsions. It is concluded that zopiclone may
      cause problems associated with misuse and withdrawal reactions similar to those
      of benzodiazepines.

PMID- 1754611
TI  - Side-effects of phototherapy in nonseasonal depressive disorder.
AB  - The data of the Berlin light therapy study were systematically reinvestigated for
      side-effects of light therapy as described in the literature. Forty-two patients
      with major depressive disorder (RDC), who also met the criteria of ICD-9 (296.1
      and 296.3), were included. Patients were either given bright white-light
      treatment (2,500 lux) or dim red-light treatment (50 lux) from 7.20 a.m. to 9.20
      a.m. every morning for a period of seven days. The study did not reveal any
      differences in side-effects between the two treatments. The results are discussed
      in relation to the two different treatment conditions.

PMID- 1754612
TI  - Trends in diagnostic ultrasound exposure.
AB  - Trends in exposure for diagnostic ultrasonic equipment and a contemporary survey
      of exposure values are presented. It is demonstrated that both time-averaged
      intensities and peak pressures have increased steadily over the last two decades.
      Currently available diagnostic equipment generates pulses for which the average
      worst-case rarefaction pressure, p-, is about 2 MPa in water, irrespective of the
      mode of operation. Overall the highest values of p- are found in short-focus
      beams. Average spatial-peak time-averaged intensities, I(SPTA), are greatest for
      pulsed Doppler operation at a little over 1 W cm-2. M-mode and colour Doppler
      operation have average values of I(SPTA) of about 100 mW cm-2 and imaging
      operates at about an order of magnitude lower again. Vaginal transducers differ
      little in operational exposure from other transducers. Exposure measurement on
      colour Doppler systems demands a knowledge of the effect of scanner controls on
      the field, and some details are given.

PMID- 1754613
TI  - Physics and Technology of Medical Ultrasound Conference. 15-16 April 1991,
      University of York, United Kingdom.

PMID- 1754614
TI  - Towards an ideal blood analogue for Doppler ultrasound phantoms.
AB  - If a phantom is to produce Doppler spectral waveforms accurately matching those
      that would be obtained in vivo, it is necessary to use a fluid that behaves like
      blood in vivo, both acoustically and rheologically. The use of blood itself is
      undesirable and an analogue is required. Blood exhibits non-Newtonian behaviour
      as a result of aggregation of erythrocytes at low shear rates. This behaviour
      affects flow not only in sub-millimetre diameter vessels, but also in large scale
      structures. An alternative to blood is described that uses finely powdered nylon
      suspended in a mixture of glycerol and water. The nylon particles used have
      dimensions and density close to those of erythrocytes and they aggregate at low
      shear rates to give non-Newtonian behaviour. Viscosity may be varied over a wide
      range by the addition of liquid detergent. Consideration is given to the
      importance of haematocrit in modelling pulsatile and disturbed flows as it
      affects the haemodynamics of flow and the backscattered power of an ultrasound
      beam. This adaptable blood analogue is suitable for use in models of both large
      structures and fine vessels.

PMID- 1754615
TI  - Electromagnetic radiofrequency interference with Doppler equipment.
AB  - Doppler ultrasound equipments incorporate radiofrequency (RF) receivers operating
      at the microvolt level and are liable to interference from radiated fields and
      mains disturbances. The most significant interference routes are: radiation from
      radio broadcast, paging, communication and diathermy picked up on the transducer
      and patient acting as an aerial; and mains disturbances from diathermy, x-ray
      sets, motors and thyristor controls, etc, reaching the equipment interior. Direct
      mains interference can be reduced by proper design incorporating a mains filter,
      a low RF leakage enclosure, a ground plane, careful layout and further screening
      of the receiver circuits. Pick-up via the transducer occurs even if the signal
      leads are completely screened because an RF potential can exist between
      transducer and equipment enclosure due to the considerable impedance at RF of any
      wire or cable, typically 70 omega at 5 MHz for 2 m. This potential, reduced by
      about 50-60 dB, appears at the receiver input because of imperfect common mode
      rejection of the coupling cable. As a result, induced voltages above 100-300
      microV may cause problems. It is shown that such levels can easily result from
      the interfering field strengths of 1 mV m-1 or more that may be experienced in a
      hospital environment. On the other hand, field strengths of 300 microV m-1, as
      generally allowed by regulatory standards at 3 m from interfering sources, should
      not cause much effect. Other interference can arise from modulation of a strong
      RF signal by mains frequency power components in the Doppler equipment and from
      associated computer circuits. These require careful layout to reduce electric and
      magnetic coupling, decoupling and filtering of power supplies and components,
      screening of RF circuits and particular attention to the reduction of power and
      computer signal currents flowing in RF signal earth paths. Finally, some initial
      simple acceptance tests for interference susceptibility are proposed, based on
      the application of 300 microV of RF signal between transducer body and equipment
      enclosure and 10 mV to the mains supply.

PMID- 1754616
TI  - Prediction of non-linear propagation in water due to diagnostic medical
      ultrasound equipment.
AB  - There is a well established requirement for making output measurements on medical
      ultrasound equipment, in particular for safety and calibration purposes. In
      addition there is a need for non-linear propagation models to allow predictions
      to be made for in vivo pressure fields of systems ranging from lithotripters to
      diagnostic imaging sets. In the past it has been shown that good agreement can be
      found between experiment and theory for transducers that behave as perfect
      pistons but little work has been published on comparisons for 'real' medical
      ultrasound systems. This paper compares experiment with theory for a medical
      ultrasound system operating in water. Pressure field measurements are presented
      for a Philips 3.5 MHz, 13 mm diameter, 'long internal focus' (LIF) transducer.
      The measurements were made using a membrane hydrophone in water. Initially the
      transducer was driven continuously with a function generator at low amplitude so
      that the effective aperture radius and focal length could be determined. The
      transducer was then driven by a Philips 'sono-Diagnost B' imaging system which
      produced a short finite amplitude pulse. The results are compared with a finite
      difference model based on the parabolic approximation to the non-linear wave
      equation. Reasonable agreement (typically 10-15%) is shown for spectral
      magnitudes although some difficulty was encountered in accurately characterizing
      the transducer in terms of its geometry and drive waveform.

PMID- 1754617
TI  - Forces acting in the direction of propagation in pulsed ultrasound fields.
AB  - This paper considers some non-thermal effects resulting from absorption of
      acoustic energy from an ultrasound beam. An experimental investigation of the
      location of the 'source pump', responsible for the generation of streaming in
      high amplitude diagnostic fields in water, is reported. Acoustically transparent
      membranes were inserted in the ultrasound field in order to restrict the
      streaming volume. It is shown that the major contribution to an acoustic stream
      is generated in the region near to the focus of a transducer where the intensity
      in the beam and the degree of non-linear distortion are both high. In the second
      part of the paper a simple model of non-linear propagation is used to predict the
      magnitude of the maximum pressure gradient induced in a medium by the absorption
      of acoustic energy from a beam. Propagation in water, in tissue and in amniotic
      fluid are considered. Within the limitations of this model it is shown that the
      pressure gradients induced in pulsed acoustic fields do not result in the
      ultimate shear stress of tissue being exceeded.

PMID- 1754618
TI  - The physics of liquid impact, shock wave interactions with cavities, and the
      implications to shock wave lithotripsy.
AB  - This paper reviews research on the physics of liquid impact and the behaviour of
      cavities when a shock passes over them. It is shown that the problems are related
      since when a cavity collapses near a solid surface, or is collapsed by a shock
      wave, the collapse is asymmetric and a liquid jet is produced which can impact an
      adjacent solid. The implications of this research to shock wave lithotripsy are
      emphasized. Finally, the paper describes the development of a device, based on
      liquid jet impact, for fragmenting kidney stones.

PMID- 1754619
TI  - Measurement of lithotripsy pulses through biological media.
AB  - Lithotripsy is now the method of choice for the treatment of renal calculi. The
      mechanism of destruction is not clearly understood, and detailed knowledge of the
      shock-wave characteristics at the calculus would aid understanding of the
      phenomenon. Current methods of measuring the pressure pulse by observing it
      through a water path are not well characterized, and the results may not
      represent the actual pressure fluctuations produced in vivo. In order to
      determine the actual pressure pulse experienced at the site of the calculus,
      measurements have been made through a variety of biological media. The results
      show that there are considerable differences between measurements taken through a
      water path and through biological media. This paper describes the pressure
      fluctuations in the time domain. The implications of the results for lithotripsy
      are discussed.

PMID- 1754620
TI  - High intensity focused ultrasound for the treatment of rat tumours.
AB  - Discrete implanted liver tumours in the rat have been exposed to arrays of 1.7
      MHz ultrasound lesions. Focal peak intensities in the range 1.4-3.5 k Wcm-2 were
      used for an exposure time of 10 s. It has been demonstrated that where the whole
      tumour volume was exposed to the focused ultrasound beam, no evidence of tumour
      growth could be detected histologically. Where the ultrasonic lesion array was
      not contiguous, regrowth occurred. Preliminary histological studies confirmed
      this finding.

PMID- 1754621
TI  - Resolution and information limitations from transducer arrays.
AB  - The factors limiting the resolution achievable with array-based imaging methods
      are considered. The limitations on beamwidth and field of view for beam scanning
      systems are first examined using plane wave diffraction theory, treating focusing
      and any array curvature as separable to the plane wave analysis. It is found that
      in all cases the number of half-beamwidths (maximum to null) across the field of
      view cannot exceed the number of electrically addressable elements in the array.
      The minimum beamwidth achievable by strong focusing is shown to be limited to
      twice the inter-element pitch. Digital reconstruction is then considered as an
      alternative to beam scanning. Here the number of image points recoverable across
      the field of view is equal to the number of elements in the array. The
      mathematical equivalence of the two methods is demonstrated, and the inference is
      made that the half-beamwidth represents a fundamental measure of lateral
      resolution. Alternative array configurations, suitable for CT methods, are then
      compared to probe arrays and it is found that the total number of resolution
      cells within a two-dimensional image is dependent on the pulse length and number
      of elements, rather than on the array configuration and imaging method. This
      again reveals the fundamental similarity of the various methods, essentially in
      combining position line information from the separate elements, albeit in
      different orders. Finally an expression for the information capacity of a
      scanning system is presented which relates the limitations on spatial and
      contrast resolution to the bandwidth and dynamic range of the system and the
      number of elements in the array.

PMID- 1754622
TI  - Experimental studies in transmission ultrasound computed tomography.
AB  - The reconstruction of the speed-of-sound distribution within a target can be
      achieved by CT techniques from measurements on transmitted ultrasonic pulses. The
      mathematical relationship between speed-of-sound imaging and the conventional CT
      situation is explained. An experimental system, which has been developed to
      investigate speed-of-imaging and other forms of in-vivo ultrasound CT, is
      described, along with the techniques used for data acquisition and image
      reconstruction. These include measurement of pulse time-of-flight by the
      threshold or cross-correlation methods. Techniques for reducing artifacts in
      speed-of-sound images are also described, such as median filtering and modified
      Shepp-Logan filtering. These techniques have been used to obtain high quality
      speed-of-sound images of various phantoms. Images of tissue in-vitro have been
      less satisfactory, because of refraction and attenuation effects. Ways of
      overcoming these difficulties in an improved system are proposed.

PMID- 1754623
TI  - Dependence of the velocity and attenuation of ultrasound in bone on the mineral
      content.
AB  - Measurements of the attenuation and velocity of ultrasound from 0.3 to 0.8 MHz
      have been performed on a number of bovine cancellous bone samples. The influence
      of bone mineral content has been isolated by measuring the acoustic properties of
      the samples at various stages of demineralization resulting from controlled
      nitric acid attack. The correlation coefficient r, between the attenuation at
      different frequencies and bone density was found to be in the range 0.68-0.97.
      Broadband ultrasonic attenuation (BUA) was also calculated and produced r values
      between 0.84 and 0.99. The velocity measurements indicated a correlation greater
      than 0.97 in all cases. Thus velocity is the parameter most sensitive to changes
      in bone mineral density alone. Attenuation and BUA are less well correlated
      presumably because of a sensitivity to minor structural change.

PMID- 1754624
TI  - Assessment of hybrid speckle reduction algorithms.
AB  - A consequence of employing coherent detection methods in medical ultrasound
      imaging systems is the occurrence of interference effects in the received echo
      field, which produce the speckle artefact. Speckle can severely degrade the
      information content of the image, and its efficient removal from ultrasound pulse
      echo images is the focus of a number of research projects. Traditionally, the
      approach towards speckle reduction in pulse-echo images has been based on two
      classes of technique, either employing some form of spatial/frequency compounding
      or a data (image) filter. Both approaches have inherent shortcomings, and two
      alternative techniques are suggested here: 'local frequency diversity' and
      'frequency differencing'. These algorithms deterministically identify where
      speckle occurs, and correct for speckle only within short, localized, corrupted
      segments of the A-line. This provides the potential for real-time implementation.
      Simulated and clinical in vivo images have been obtained, and the capabilities of
      the alternative speckle reduction algorithms are assessed against the more
      conventional approaches.

PMID- 1754625
TI  - Platelet serotonin in subtypes of schizophrenia and unipolar depression.
AB  - In subtypes of schizophrenia and unipolar depression, both increased and
      decreased levels of platelet serotonin were found. Hyperserotonemia was usually
      observed in patients with psychotic features (i.e., in paranoid schizophrenia and
      psychotic depression). Hyposerotonemia, although less common than
      hyperserotonemia, was present in nonparanoid schizophrenia and nonpsychotic
      depression (i.e., in patients without psychotic symptoms). A sex difference in
      platelet monoamine oxidase activity was observed among healthy subjects, but not
      among schizophrenic patients. The activity of platelet monoamine oxidase in
      paranoid and nonparanoid schizophrenic patients did not differ from that in
      healthy subjects. The findings in this study suggest that biological differences
      between subtypes of unipolar depression or schizophrenia might depend upon the
      presence of psychotic symptoms.

PMID- 1754626
TI  - Genetic factors for the span of apprehension test: a study of normal twins.
AB  - The Partial Report Span of Apprehension test has been found to detect cognitive
      deficits in some first degree relatives of schizophrenic patients. To assess the
      relative contribution of genetic vs. environmental factors on this measure, 19
      monozygotic and 14 dizygotic female twin pairs, selected from a normal
      population, were tested on the Span of Apprehension test and an IQ test. Both
      Span of Apprehension test performance and IQ score had high heritabilities: 0.65
      and 0.71, respectively. The mode of transmission for performance on the Span of
      Apprehension test appears to operate in a nonadditive manner. A multivariate
      behavioral-genetic model applied to the Span of Apprehension and IQ measures
      indicated that slightly less than half of the genetic effects important for the
      Span of Apprehension test are found in common with the genetic factors important
      for IQ. The phenotypic correlation between the Span of Apprehension and IQ
      measures can be attributed entirely to genetic factors. The influence of unique
      genetic components in the performance of the Span of Apprehension test in the
      general population heightens the promise of this measure as a genetic marker for
      schizophrenia.

PMID- 1754627
TI  - An animal model for the effects of estradiol on dopamine-mediated behavior:
      implications for sex differences in schizophrenia.
AB  - Schizophrenic women have been consistently found to have a later age of onset and
      a less severe clinical course of illness as compared with schizophrenic men.
      Because these differences are not explained by diagnostic artifacts or
      sociocultural factors, we tested the hypothesis that they are determined by the
      influence of the gonadal hormones testosterone and estradiol on dopaminergic (DA)
      neurotransmission. We used animal models in which the effects of the hormones on
      behavioral changes induced by the DA antagonist haloperidol (catalepsy) and by
      the DA agonist apomorphine (oral stereotypies, grooming and sitting behavior)
      were investigated in neonatal and in adult treated rats. No consistent effects of
      testosterone were observed. Estradiol significantly reduced the behavioral
      changes induced by both haloperidol and apomorphine, and this effect was more
      pronounced in neonatally treated animals. These results suggest a downward
      regulation of DA neurotransmission by estradiol, which is supported by the
      results of 3H-sulpiride binding determinations in brain homogenates from the same
      animals: estradiol caused a 2.8-fold reduction of DA receptor affinity to
      sulpiride. Our findings suggest that estradiol might act as a protective
      modulator in schizophrenia by enhancing the vulnerability threshold for psychosis
      through the downward regulation of DA neurotransmission. Such mechanism could
      explain, at least in part, the later onset and the more favorable course of
      schizophrenia in female patients.

PMID- 1754628
TI  - A longitudinal study of cerebrospinal fluid acetylcholinesterase in delirium:
      changes at the acute stage and at one-year followup.
AB  - Cerebrospinal fluid acetylcholinesterase (CSF AChE) was determined for elderly
      delirious patients during the acute stage and after a 1-year followup, and the
      AChE levels were compared with those of age-equivalent controls. At the acute
      phase, the AChE levels of the delirious patients were in the same range as those
      of the control group, but during the followup, a slight declining trend was
      observed. These results do not unambiguously support the previously suggested
      role of cholinergic dysfunction in the pathogenesis of acute delirium, although
      the augmented striatal release of AChE in hyperkinetic and mixed delirium may
      mask the involvement of cholinergic neurons.

PMID- 1754629
TI  - Reliability and validity of the Apathy Evaluation Scale.
AB  - This article presents evidence for the reliability and construct validity of the
      Apathy Evaluation Scale (AES). Conceptually, apathy is defined as lack of
      motivation not attributable to diminished level of consciousness, cognitive
      impairment, or emotional distress. Operationally, the AES treats apathy as a
      psychological dimension defined by simultaneous deficits in the overt behavioral,
      cognitive, and emotional concomitants of goal-directed behavior. Three versions
      of the AES (clinician, informant, and self-rated) were evaluated for 123
      subjects, ages 53-85, meeting research criteria for right or left hemisphere
      stroke, probable Alzheimer's disease, major depression, or well elderly control.
      Multiple forms of reliability (internal consistency, test-retest, and interrater)
      were satisfactory. Several types of validity evidence are presented for each
      version of the scale, including the following: ability of the AES to discriminate
      between groups according to mean levels of apathy, discriminability of apathy
      ratings from standard measures of depression and anxiety, convergent validity
      between the three versions of the scale, and predictive validity measures derived
      from observing subjects' play with novelty toys and videogames. Guidelines for
      the administration of the AES are presented, along with suggestions for potential
      applications of the scale to clinical and research questions.

PMID- 1754630
TI  - Smooth pursuit and saccadic eye movements and neurological soft signs in
      obsessive-compulsive disorder.
AB  - Patients with obsessive-compulsive disorder (OCD) demonstrate an increased number
      of neurological soft signs as well as neuroanatomic abnormalities detected with
      modern imaging techniques. Quantitative analysis of eye movements has proved
      fruitful in investigations of other neuropsychiatric disorders with similar
      findings. Therefore, we studied the smooth pursuit and saccadic eye movements of
      8 OCD patients and 12 normal controls using infrared oculography and computerized
      pattern recognition software. We also measured neurologic soft signs using a
      standardized rating instrument. Despite having an increased number of
      neurological soft signs, OCD patients' performance on a variety of measures of
      eye movement was not significantly impaired. Neither the severity of obsessions
      or compulsions nor the number of neurologic soft signs correlated with any of the
      parameters of eye movement function. We conclude that OCD patients do not have
      prominent oculomotor dysfunction and that eye movement dysfunction and neurologic
      soft signs are not inextricably linked.

PMID- 1754631
TI  - Is there a relationship between MHPG and anxiety in depressed patients?
AB  - Previous studies of the relationship between anxiety and 3-methoxy-4
      hydroxyphenylglycol (MHPG) in depression have produced conflicting results. The
      possibility that different definitions of anxiety may have created these
      discrepant findings was explored. There was no convincing evidence that MHPG was
      associated with any of a wide range of different anxiety measurements that
      encompassed the anxiety concepts of somatic anxiety, psychic anxiety, agitation,
      or situational stress. The relationships of anxiety ratings to each other were
      also examined.

PMID- 1754632
TI  - Weight change in depression: influence of "disinhibition" is mediated by body
      mass and other variables.
AB  - The direction of weight change (gain or loss) in depression has recently been
      found to be a stable characteristic of patients across depressive episodes. A
      search for determinants of the direction of weight change revealed two
      candidates: the body mass index (BMI) (weight in kilograms/height in meters
      squared) and a psychological variable, "disinhibition" of dietary restraint. The
      present study, of 68 patients with a history of recurrent depression, found a
      significant correlation between BMI and weight change; in other words, heavier
      persons were more likely to gain weight if depressed. There was also a
      correlation between "disinhibition" and weight change. "Disinhibition" correlated
      with BMI and, when controlled for BMI, age and sex, the correlation between
      "disinhibition" and weight change fell to insignificance. We conclude that BMI
      along with age and sex mediated the correlation between "disinhibition" and
      weight change.

PMID- 1754633
TI  - Electroencephalographic sleep measures in prepubertal depression.
AB  - Two nights of electroencephalographic (EEG) sleep recording were performed in a
      group of prepubertal subjects with major depressive disorder (MDD) (n = 36, mean
      age = 10.4, SD = 1.5) and age-matched normal control children (n = 18, mean age =
      10.1, SD = 1.6). All subjects were medically healthy and free of medications at
      the time of the study. There were no significant group differences for any major
      sleep variable after the initial adaptation night in this study. One subgroup of
      MDD subjects (n = 8) showed reduced REM latency on both recording nights,
      decreased stage 4 sleep, and increased REM time; this subgroup had significantly
      higher severity scores for depression but did not otherwise appear to be
      clinically distinct from the rest of the MDD subjects. Overall, the results
      indicate that the EEG sleep changes associated with depression in adults occurred
      less frequently in prepubertal MDD subjects.

PMID- 1754634
TI  - Dose-dependent reduced haloperidol/haloperidol ratios in schizophrenic patients.
AB  - Plasma haloperidol (HAL) and reduced HAL (RHAL) concentrations were measured in
      113 Chinese schizophrenic patients. Daily doses of HAL ranged from 8 to 65 mg.
      Samples were obtained under steady-state conditions and drawn 10-12 hours after
      the bedtime dose and before the morning dose. In all, 313 blood samples were
      collected. Multiple samples were obtained at the same doses in 63 patients and at
      two or three different doses in 31 patients. HAL and RHAL concentrations were
      assayed by high performance liquid chromatography. Interpatient variation in
      plasma HAL levels at a given dosage was up to sixfold. However, there was a high
      positive correlation between plasma levels and daily dosages with the equation of
      HAL plasma level (ng/ml) = 0.88 x dosage (mg/day) -0.56 or 46.0 x dosage
      (mg/day/kg) + 0.28. The expected values are about 15-55% higher than those
      obtained from non-Chinese patients as reported in the literature. The RHAL/HAL
      ratios were dose-dependent. The greater the dose used, the higher the ratio. An
      upper therapeutic limit of plasma HAL level is suggested to be 25 ng/ml, which
      can be achieved at dosages about 30 mg/day in most Chinese patients. Based upon
      the dose-dependent increase in RHAL/HAL ratios, the importance of RHAL in
      determining the therapeutic benefit of HAL treatment is discussed.

PMID- 1754635
TI  - Effects of ritanserin on the behavioral, neuroendocrine, and cardiovascular
      responses to meta-chlorophenylpiperazine in healthy human subjects.
AB  - Ten healthy male subjects were administered i.v. meta-chlorophenylpiperazine
      (MCPP) (0.1 mg/kg) after oral ritanserin (5-10 mg), a putative 5HT1c/5HT2
      (serotonin) antagonist, or placebo. Behavioral responses, cardiovascular effects,
      and neuroendocrine responses (cortisol, growth hormone, and prolactin) were
      measured serially for 4 hours after MCPP infusion. Premedication with ritanserin
      attenuated the MCPP-induced increases in self-rated anxiety and prolactin, and
      completely antagonized MCPP cortisol elevations. In contrast, ritanserin did not
      significantly alter growth hormone response to MCPP. These findings suggest a
      role for 5-HT1c/5-HT2 receptors in the endocrine and behavioral responses to the
      mixed serotonin agonist MCPP in humans.

PMID- 1754636
TI  - Effects of auditory stimulation during rapid eye movement sleep in healthy
      volunteers and depressed patients.
AB  - Auditory and somesthesic forms of stimulation have substantially increased rapid
      eye movement (REM) sleep in cats. We investigated whether auditory stimulation,
      applied during REM sleep or outside REM sleep, would have similar effects in
      normal volunteers. We also administered auditory stimulation to depressed
      patients during REM sleep. Subjects were studied during 1 acclimatization night,
      2 baseline nights, 4 consecutive nights with auditory stimulation, and 1 followup
      night without auditory stimulation. Normal volunteers were randomly divided into
      Group R, which received auditory stimulation during each REM sleep episode, and
      Group NR, which received auditory stimulation at the end of each REM sleep
      episode. Depressed patients (Group D) received auditory stimulation during each
      REM sleep period. Only Group R showed increased REM sleep time during the nights
      of auditory stimulation and throughout the followup night. This group also
      increased their sleep efficiency. Group NR showed reduced sleep efficiency due to
      an increase in both the duration and frequency of awakenings. Group D did not
      show increased REM sleep time, but did show shortened REM sleep episodes,
      increased REM sleep frequency, and increased duration of awakenings. Group D did
      not show clinical changes.

PMID- 1754637
TI  - The cholinergic REM induction test with RS 86 after scopolamine pretreatment in
      healthy subjects.
AB  - A shortened latency of rapid eye movement (REM) sleep is one of the most stable
      biological abnormalities described in depressive patients. According to the
      reciprocal interaction model of non-REM and REM sleep regulation, REM sleep
      disinhibition at the beginning of the night in depression is a consequence of
      heightened central nervous system cholinergic transmitter activity in relation to
      aminergic transmitter activity. A recent study has indicated that muscarinic
      supersensitivity, rather than quantitatively enhanced cholinergic activity, may
      be the primary cause of REM sleep abnormalities in depression. The present study
      tested this hypothesis by treating healthy volunteers for 3 days with a
      cholinergic antagonist (scopolamine) in the morning, in an effort to induce
      muscarinic receptor supersensitivity. On the last day of scopolamine
      administration, RS 86, an orally active cholinergic agonist, was administered
      before bedtime to test whether this procedure would induce sleep onset REM
      periods. Whereas scopolamine treatment tended to advance REM sleep and to
      heighten REM density in healthy controls in comparison to NaCl administration,
      the additional cholinergic stimulation did not provoke further REM sleep
      disinhibition. This result underlines the need to take a hypofunction of
      aminergic transmitter systems into account in attempts to explain the pronounced
      advance of REM sleep typically seen in depressives.

PMID- 1754638
TI  - Effects of green or white light for treatment of seasonal depression.
AB  - Twelve subjects with winter depression were treated with equal quanta of green or
      white light in a randomized crossover study. Each treatment condition consisted
      of 2 hours of exposure each morning for 1 week, with at least 1 interventing week
      without treatment. Ratings made without knowledge of treatment condition were
      done before and after each condition. Both treatments significantly reduced
      depression ratings. White light was significantly more effective than green light
      in reducing endogenous symptoms, but not the "atypical" symptoms that are common
      features of winter depression. Furthermore, sequence of treatment conditions
      influenced antidepressant responses. Broad-band white light may be optimal for
      maximizing therapeutic response.

PMID- 1754639
TI  - Seasonal variations in mood and behavior in the general population: a factor
      analytic approach.
AB  - In a mailed survey conducted at four centers--Nashua, NH; New York, NY;
      Washington, DC; and Sarasota, FL--1,671 respondents provided information on
      monthly variations in 10 behavioral categories representing extremes in the areas
      of mood, socializing, appetite, weight gain/loss, and sleep length. A 10-factor
      solution revealed the following factors: (1) a winter weight gain factor; (2) a
      winter depression factor; (3) a winter hypersomnia factor; (4) a summer weight
      gain factor; (5) a summer hypersomnia factor; (6) a summer depression factor; (7)
      a winter socializing factor; (8) a winter weight loss factor; (9) a fall
      depression factor; and (10) a possibly mixed factor. Factors consistent with
      winter seasonal affective disorder were positively correlated with latitude,
      while those consistent with summer seasonal affective disorder were negatively
      correlated with latitude.

PMID- 1754640
TI  - Elevated serum lactate associated with panic attacks induced by hyperventilation.
AB  - Several lines of evidence suggest that lactate metabolism may be altered in panic
      disorder. We recently reported exaggerated increases in serum lactate in panic
      patients following hyperventilation during glucose infusion. In the current
      study, lactate metabolism was stimulated by hyperventilation following glucose
      ingestion in 12 panic patients and 12 controls. The seven patients who panicked
      during hyperventilation exhibited larger increases in serum lactate levels than
      nonpanicking patients or controls. The lactate response was significantly
      correlated with peak ratings of anxiety and panic symptoms, but not correlated
      with insulin or cortisol levels, heart rate, pCO2, adiposity, exercise habits, or
      diet. Hyperventilation-induced panic appears to be associated with metabolic
      changes leading to elevated serum lactate.

PMID- 1754641
TI  - Cortisol levels in generalized anxiety disorder.

PMID- 1754642
TI  - Music psychopathology. IV. The course of musical expression during music therapy
      with psychiatric inpatients.
AB  - The music therapeutic productions of 67 psychiatric inpatients were analyzed
      concerning a systematic variation in the course of therapy. The impairment of
      performance was not as regular as with customary music, nevertheless with growing
      remission it was reversible in all diagnostic subgroups. The change for the
      better of rhythmic and motor skills of endogenous-depressed patients was seen to
      the same extent as with traditional music. The polarity profile developed for the
      assessment of music proved meaningful in the characterization of music
      therapeutic utterances.

PMID- 1754643
TI  - Long-term prognosis of schizophrenia.
AB  - The question of determining prognostically relevant features for schizophrenia
      was approached with multivariate statistical methods applied to the data from the
      Bonn longitudinal study of 502 schizophrenic patients. In this study, personal
      interviews according to a clinical classification scheme allowed every patient to
      be ranked within each of three different outcome classes: psychopathological
      remission, occupational remission, and course type. Our multivariate analysis
      encompassed a total of 50 items pertinent to the time up to and including the
      first 6 months after the first psychotic manifestation. Despite the introduction
      of mathematical methods considerably more sophisticated than those employed in
      earlier studies, no satisfactory solution could be found to the problem of
      predicting end states of schizophrenia. Reliable predictions could be made only
      for 'extreme' end states (i.e. full remission versus (1) characteristic residues
      in the narrower sense; (2) total unemployment, or (3) surging or simple courses
      to mixed residues or to typical schizophrenic defect psychoses). Accordingly,
      sufficiently reliable assertions applied only to a minority of about 1/3 of
      patients, whereas for the majority of 2/3, no generalizable prognostication was
      possible (67-71% true-positive predictions on 36-63% of total population in
      extreme states). By contrast, our analyses have clearly uncovered a fundamental
      problem of investigations into the long-term prognosis of schizophrenia: the
      extreme dependence of results on the clinical definition of end states. The
      further the phenomenon 'end state' is qualitatively subdivided, the poorer and
      less reproducible is the mutual discrimination between intermediate states and
      the less reliable are allocations of patients to these intermediate states by
      means of multivariate classifiers. Furthermore, our analyses have also
      demonstrated the usefulness of multivariate, adaptive procedures for
      investigations into the structural properties of long-term courses, so that
      predictions might be considerably improved if more reliable definitions of
      schizophrenic end states are available.

PMID- 1754644
TI  - Attention, meaning, and somatization: a psychophysiological view.
AB  - This paper provides a discussion of a psychophysiological approach to
      somatization based on the notions of attention and meaning. It is suggested that
      several clinical features may be described, explained, and modified with the aid
      of these concepts.

PMID- 1754645
TI  - Schneiderian versus Bleulerian schizophrenia and basic symptoms.
AB  - Using the 'polydiagnostic approach' method, the relationship between basic
      symptoms (BS) and Bleulerian and Schneiderian types of schizophrenia is studied.
      Eighty-six schizophrenic patients (RDC criteria) were studied using the Frankfurt
      Complaint Questionnaire for the evaluation of the BS. The patients were
      classified according to the type of symptoms predominant in Schneiderian (n =
      32), Bleulerian (n = 12) and mixed (n = 42) schizophrenics. The patients with
      Schneiderian and mixed schizophrenia displayed more BS than those having
      Bleulerian schizophrenia. Significant differences (p less than or equal to 0.05)
      were found on the subscales of Perception (simple), Language, Memory, Motoric and
      Loss of automatism, in factors 1, 2 and 4, and in the total score. The results
      suggest that, from the perspective of the BS, Schneiderian schizophrenia is
      different from Bleulerian and that the BS may have the same production mechanisms
      as Schneider's FRS, the difference between them being in the different degree of
      phenomenological expression.

PMID- 1754646
TI  - The syndrome of intermetamorphosis.
AB  - A series of 154 patients suffering from the syndrome of intermetamorphosis or its
      variants is discussed in terms of this misidentification syndrome's historical,
      classification, diagnostic, and psychosocial aspects. One case is presented in
      detail.

PMID- 1754647
TI  - A study of thought disorder in paranoid and non-paranoid schizophrenia.
AB  - Thought disorder was studied in 21 paranoid and 24 non-paranoid schizophrenics
      fulfilling the research diagnostic criteria using the Thought, Language and
      Communication Scale. Chronic paranoid schizophrenics more often had
      tangentiality. Other thought disorders were similar in paranoid and non-paranoid
      schizophrenics.

PMID- 1754648
TI  - Psychiatric aspects of male genital self-mutilation.
AB  - From the beginning of the century to this day 57 cases of male genital self
      mutilation have been reported in the English literature. In German publications
      we found 5 case descriptions. Although no precise data are available on the
      prevalence of male genital self-mutilation, such acts are presumably much more
      frequent than the small number of published cases would suggest. In the
      literature several features are regarded as risk factors for self-mutilation,
      such as e.g. homosexual or transsexual tendencies, repudiation of the male
      genitals, absence of a competent male for identification during childhood,
      feeling of guilt for sexual offences, and self-injury in the anamnesis. The most
      frequent diagnoses are schizophrenia and affective psychosis; alcohol
      intoxication was diagnosed in about one-fourth of the cases published. In the
      present paper we summarize data from the literature on epidemiology,
      psychopathology, psychodynamic and sociocultural factors in male genital
      automutilation and we describe 2 new cases of self-castration in which several of
      the risk factors described above were observed. We conclude that although it is
      difficult to estimate the risk of self-castration in view of the heterogeneity of
      the respective patient groups, the danger of such deeds should be kept in mind if
      the above factors are present.

PMID- 1754649
TI  - Delusional hypochondriasis: nosographic evaluation, clinical course and
      therapeutic outcome of 5 cases.
AB  - Five cases of delusional hypochondriasis are reported. Their nosographic position
      is discussed in the light of recent literature, DSM-IIIR, Present State
      Examination and ICD-9 classification criteria of hypochondriacal symptomatology.

PMID- 1754650
TI  - Scale for Assessment of Thought, Language and Communication in psychotic in
      patients.
AB  - The reliability and usefulness of the Scale for Assessment of Thought, Language
      and Communication was evaluated in a group of psychotic in-patients. A very high
      interrater reliability (0.75-1.0) and an optimum rate-rerate reliability (0.50
      1.0) were found on the individual items of the scale as well as the global
      rating. Since the scale has a good scope in different clinical and research
      settings, it was necessary to evaluate its reliability at a place other than
      where it originated. This study confirms its usefulness in the field of both
      clinical practice and research.

PMID- 1754651
TI  - Changes in the electrodermal activity of schizophrenic patients associated with
      changes in the expressed emotion status of their relatives.
AB  - Thirty-nine relatives of schizophrenic patients, who had been rated as high on
      Expressed Emotion (EE) during the patients' admission for an acute episode, were
      re-rated on EE 9 months after discharge from the index admission. Electrodermal
      activity was recorded from the patient during a 15-min period when the relative
      was absent and a similar period while the relative was present. Recording took
      place during the index admission and at a 9-month follow-up. A comparison was
      made between those patients whose relatives remained high EE at follow-up
      (Stables) and those whose relatives change to low EE (Decreasers). No differences
      were apparent between these two groups, however, differences were found within
      groups. At admission both groups showed an increase in electrodermal measures
      from the relative-absent period to the relative-present period. At 9-month follow
      up, the Stables still exhibited this direction of change, whereas the Decreasers
      showed a decrease in electrodermal activity between these periods.

PMID- 1754652
TI  - Delusional psychoses associated with unpatriotic conduct during World War II: a
      long-term follow-up study.
AB  - Of a large sample of patients with paranoid psychoses consecutively admitted to
      the Psychiatric Department, University of Oslo, during a period after World War
      II, 10 patients (6.3%, 9 women and 1 man) became ill through accusations of
      unpatriotic conduct during the war. The psychosis seemed precipitated in
      connection with legal procedures against the patient in 3 cases, and against
      close relatives in 2 patients. In 2 cases mixed precipitating events were
      present, while the psychosis in 3 cases had a connection with the woman being
      intimate with occupation soldiers. Discharge diagnosis according to DSM-III was
      schizophrenia (n = 2), schizophreniform disorder (n = 4), schizoaffective
      disorder (n = 1), major depressive disorder (n = 1), mania (n = 1), and atypical
      psychosis (n = 1). The patients have been followed up twice, with a mean 31 years
      of observation. Course and outcome varied, mostly according to the diagnosis.
      Most patients had a favorable global outcome, although they had a tendency to
      keep up their social isolation. None of the patients felt they had done anything
      wrong or regretted their behavior during the war.

PMID- 1754653
TI  - 12-year clinical course of schizophrenia in hospital and night clinic patients
      over the period from 1971/1973 to 1983. Longitudinal study from 1971/1973 to
      1983.
AB  - A sample of 46 schizophrenic patients (26 men and 20 women) from a night clinic
      (N subjects) with an average age of 21.7 years at the time of first manifestation
      of the illness and a sample of hospital inpatients (H subjects) matched for
      diagnosis, sex, and age were followed up from 1971/1973 to 1983. The average age
      of the patients in 1983 was 40 years. The course of the illness and the pattern
      of hospitalization were investigated by personally questioning each patient and
      by scrutinizing all the case history records and other relevant documents; for
      each clinical cycle of illness, consisting of an overt phase followed by a
      quiescent interval, a case control sheet was filled out. The duration of illness
      was 18 years for the N subjects and 15 years for the H subjects. Longitudinal
      analysis of these years of illness in both patient samples showed a marked
      decrease in the number and duration of overt phases and stays in hospital, but a
      progressive aggravation of residual symptomatology during quiescent intervals and
      a progressively decreasing ability to work and earn a living.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1754654
TI  - Discriminating schizophrenics from borderline patients: study with the Holtzman
      Inkblot technique.
AB  - The present study tried to discriminate acute (n = 25) and chronic schizophrenics
      (n = 25) from borderline patients (BLP; n = 30) on the basis of deviant
      verbalizations as assessed by the Holtzman Inkblot Technique (HIT). A 30-card
      version of the HIT was used. It was possible to separate BLPs and schizophrenics
      with quite good results: 77% of the BLPs, 80% of the acute schizophrenics and 92%
      of the chronic schizophrenics could be classified correctly based on the less
      severe deviant verbalizations (DVs) which were more frequent in the BLPs and
      based on the most severe forms of DVs, i.e. Incoherence, neologism and
      Perseveration (which were more frequent in the schizophrenic patients).
      Furthermore, it could be demonstrated that BLPs can be separated from neurotics
      using the 30-card version of the HIT, the resulting scores being nearly as high
      as those on the basis of the 45-card version. In another comparison, neurotics (n
      = 30) were discriminated from normals (n = 35) using the less severe DVs, which
      were more frequent in the neurotics: here, 74% of the normals and 73% of the
      neurotics could be classified correctly.

PMID- 1754655
TI  - Fatherhood, impending or newly established, precipitating delusional disorders.
      Long-term course and outcome.
AB  - Psychopathological reactions to fatherhood are probably not so infrequent as they
      would seem from psychiatric literature. In a material of paranoid psychoses,
      impending or newly established fatherhood was considered the main precipitating
      factor in 4 patients (i.e. 2.4%), compared with 7% of the female psychoses
      precipitated by pregnancy, childbirth or nursing. Two of the men were bachelors,
      insecure and inhibited, feeling compromised or helpless in the new situation. Two
      men were married, passive, avoidant in their personality, strongly dependent on
      their wives. The course and outcome varied according to the diagnoses; 2 cases
      having a favorable and 2 an unfavorable course and outcome. Physicians, including
      psychiatrists, should bear in mind that fatherhood is a possible precipitating
      factor for paranoid psychoses in male patients.

PMID- 1754656
TI  - Diurnal variations of mood and sleep disturbances during phototherapy in major
      depressive disorder.
AB  - The influence of diurnal variations of mood (DVM) and sleep disturbances on
      treatment response was investigated in 42 patients with major depressive disorder
      (not SAD) under the treatment of either bright white light (2,500 lx) or dim red
      light (50 lx). We found only a slight influence in certain subscales of DVM and
      no influence of sleep disturbances. These results are discussed under a clinical
      point of view and with respect to phase shift theories of depressive disorders.

PMID- 1754657
TI  - Stability of positive and negative symptom constructs during neuroleptic
      treatment in schizophrenia.
AB  - To assess the structural stability of positive and negative symptom ratings, we
      rated 40 schizophrenic inpatients on the Brief Psychiatric Rating Scale (BPRS)
      and the Scale for the Assessment of Negative Symptoms (SANS) at medication-free
      baseline and after 4 weeks of neuroleptic treatment. Positive symptom variables
      consisted of six BPRS items, and the negative symptom variables consisted of the
      five SANS subscale global scores. On principal components analysis, a three
      factor, oblique-rotated solution resulted, with a negative symptom factor, a
      positive symptom factor, and an unstable behavioral agitation factor. The pre-
      and posttreatment factor loading patterns were similar. The findings suggest that
      BPRS-positive symptom items and the SANS measure distinct clinical dimensions and
      that the construct is stable, as demonstrated by minimal structural change with
      time.

PMID- 1754658
TI  - Variations in clinical decisions: a study of orthopaedic patients.
AB  - Three groups of patients were clinically reviewed within a new orthopaedics
      department: patients who were on an inpatient waiting list for surgery; new
      referrals from general practitioners; and patients who had been referred earlier
      and were awaiting an appointment for outpatient consultation. Approximately two
      fifths of patients who were already on the inpatient waiting list, and who had
      confirmed their wish to remain on it, were considered on clinical review not to
      require inpatient treatment. A third of patients attending for first outpatient
      consultations were immediately returned to the continuing care of their general
      practitioner and this proportion was higher (47%) amongst patients who were
      waiting for outpatient appointments and who had not been referred to a named
      hospital consultant. These findings draw attention to the possible inappropriate
      use of specialist hospital facilities because of clinical decisions taken by some
      general practitioners and also to variations in the threshold for surgical
      intervention used by hospital consultants. It is important that the medical
      profession develops a consensus approach to the clinical management of patients
      with common conditions. It is also important that clinical review of patients on
      inpatient waiting lists, especially those who have been waiting a long time,
      becomes a routine part of waiting list management. Under the new British health
      care system, it is likely that purchasers of health care will seek to ensure that
      these issues are being dealt with by hospitals with which they are considering
      placing contracts.

PMID- 1754659
TI  - Hospital and other influences on the uptake and maintenance of breast feeding:
      the development of infant feeding policy in a district.
AB  - Hospital practices in the post-natal period are now recognised as one of a wide
      range of influences affecting the success of breast feeding. A study of 48 non
      medical maternity unit staff and 250 recently delivered mothers at a District
      General Hospital was carried out in order to identify obstacles and sources of
      support in the establishment and maintenance of breast feeding. This study formed
      part of an evaluation of local policy development which included the appointment
      of a Baby Feeding Adviser. Eighty-two percent of mothers (95% confidence
      interval; 87.0-96.4) began breast feeding, and this fell to 57.4% (50.6-64.2) at
      6 weeks. A majority of mothers reported that advice was at least partly
      conflicting, and of those who began breast feeding 92.7% had used supplements
      within 2 days. In multivariate analysis, factors significantly associated with a
      lower rate of initial breast feeding were: non-attendance at antenatal classes,
      Caucasian ethnicity, social class and religious denomination. Social factors were
      much less important in the maintenance of breast feeding, but mothers who had
      undergone Caesarian section were more likely to give up breast feeding by 6
      weeks. The reported quality of advice and support from the hospital and community
      were not associated with the maintenance of breast feeding. Many of the maternity
      unit midwifery staff reported inadequate time for discussion of feeding with
      mothers. Although two-thirds of the staff felt that there should be an infant
      feeding policy or were not sure, most of those favouring a policy felt that it
      should not actively promote breast feeding. Their main reason for this view was
      the fear of inducing guilt in bottle-feeding mothers. The social and service
      related factors associated with the initiation and maintenance of breast feeding
      may be useful for targeting additional support for some mothers. The ambivalence
      and concerns among maternity unit midwifery staff about promoting breast feeding
      must be addressed if successful policy implementation is to be achieved. Plans
      for implementing change and evaluation are described.

PMID- 1754660
TI  - Neuromuscular impairment: a major cause of non-syncopal falls in elderly Chinese.
AB  - A survey was conducted on 138 residents in Old Age Hostels and 217 subjects
      living at home. Twenty-five percent of women and 12% of men reported one or more
      non-syncopal falls in the previous year. Neuromuscular impairment, which included
      knee pain, a positive Romberg sign, an abnormal gait and use of walking aids, was
      the main risk factor for falls in this population. Screening and preventive
      programmes may be based on these findings.

PMID- 1754661
TI  - Incidence of falling injuries leading to medical treatment in the elderly.
AB  - The incidence of falling injuries leading to medical treatment was described by
      sex, age, marital status, education, amount of daily motion, self-perceived
      health, mechanism of fall and severity of injury. Material was collected
      regarding persons aged 65 years or over seeking medical treatment due to a fall
      during a period of one year. Altogether 3.8% of the elderly population (men:
      2.5%; women: 4.4%) sought medical treatment due to a fall at least once during
      this year. When repeated falls were taken into account, the total incidence rate
      was 5.5 per 100 persons per year. The cumulative incidence rate (percentage of
      persons seeking medical treatment due to a fall) of women was higher than that of
      the men and in both sexes it increased with age. It was also higher for
      unmarried, widowed or divorced persons than for married ones, and higher in less
      educated persons than in better educated ones. It was also higher in persons with
      a low amount of daily motion or poor self-perceived health than in persons with a
      moderate or high amount of daily motion or good health status. The multivariate
      analyses based on log-linear models showed two-term interactions. A low amount of
      daily motion, poor self-perceived health and high age were independently related
      to the occurrence of a fall leading to medical treatment in both sexes.

PMID- 1754662
TI  - The health of Travellers' children in Northern Ireland.
AB  - A study was carried out to examine aspects of the health status of children from
      a group of 'travelling people' in Northern Ireland. A total of 350 children, aged
      under 16 years, were included in the study. Data were gathered by community
      health doctors and health visitors using a standardised questionnaire. The study
      revealed that this community has a high degree of consanguinity and points to
      higher levels of congenital abnormalities than in the settled community. Uptake
      of immunisation was less than the settled community and hospital admissions in
      the younger age group were particularly due to infectious diseases. The authors
      conclude that provision of health services for travelling people in Northern
      Ireland should be urgently reviewed with consideration of the needs and lifestyle
      of this group. The provision of suitable sites for travelling people with
      adequate water and sewage facilities to reduce potential risks to health is also
      advocated.

PMID- 1754663
TI  - Management of childhood obesity through a school-based programme of general
      health and nutrition education.
AB  - A school-based nutrition education programme aimed at the control of coronary
      risk factor rise during childhood was started in 1983 for 150 boys and girls aged
      6-7 years. The study was performed in a rural area of central Italy, where adult
      obesity represents a major health problem. Preventive treatment was based on
      general health education in schools towards healthy lifestyles. Nutritional
      intervention was mainly focused on the adoption of the 'prudent diet'. School
      teachers received specific training on how to teach 'good nutrition'. The
      nutrition curriculum was taught by teachers throughout the school year. Several
      meetings were organised to actively involve the children's parents. Practical
      recommendations for changes in food selection and preparation were also given.
      After a five-year follow up, a strong 'tracking phenomenon' for body mass index
      was observed, suggesting a great stability over time of lifestyles and dietary
      habits leading to the development of obesity during childhood. We conclude that a
      school-delivered programme of general nutrition education for the control of risk
      factors does not appear to be able to control child obesity.

PMID- 1754664
TI  - How schools perceive the school health service.
AB  - An awareness by health professionals of changing priorities facing the School
      Health Service (SHS) has led to increased attempts to evaluate current practice.
      In the present study we set out to examine how schools perceive the SHS, to
      identify their concerns and obtain their suggestions for improvements. Despite
      direct and repeated personal communication, only 26 questionnaires were returned
      out of 64 sent to primary and post primary schools. The majority of responses
      indicated a lack of knowledge about the various aspects of the SHS and a request
      for more information. Half the questionnaires indicated dissatisfaction with the
      current SHS--particular problems identified were poor communication, lack of
      information and inability to deal with social problems. Suggestions made by
      schools to improve the SHS include improved communication between schools, SHS
      and parents, better and increased health education. Schools identified the
      current health needs of pupils as health education; social, family and
      behavioural problems; and developmental problems. Overall those schools who
      responded welcomed the approach from the SHS.

PMID- 1754665
TI  - Percutaneous multiple puncture method of administering BCG vaccine.

PMID- 1754666
TI  - The natural history of low grade non-Hodgkin's lymphoma and the impact of a no
      initial treatment policy on survival.

PMID- 1754667
TI  - The pattern of rheumatoid arthritis in West Africa and comparison with a cohort
      of British patients.
AB  - Inadequate information is available on the care burden and severity of
      rheumatological diseases such as rheumatoid arthritis in West Africa. We
      therefore studied patients with rheumatoid arthritis presenting to a rheumatology
      unit in Nigeria and compared these with patients presenting to a British
      rheumatology unit. The West African patients were younger at onset of disease,
      less frequently had a family history, showed fewer extra-articular features and
      erosions and were less commonly rheumatoid factor positive. The overall mildness
      of the disease in the West Africans was striking.

PMID- 1754668
TI  - Frequency of asymptomatic hepatitis types B and C in an inner city community and
      relation to possible risk factors.
AB  - The frequency of asymptomatic carriage of the hepatitis virus types B and C in an
      inner city area (South London) was assessed in a survey of 1002 subjects
      attending their General Practitioner for minor, non-hepatic complaints. Ten
      subjects were seropositive for hepatitis B surface antigen (HBsAg) (1 per cent),
      but only one, who declined liver biopsy, had any clinical laboratory evidence of
      hepatitis B virus-related chronic liver disease. Carriage of, and exposure to,
      hepatitis B virus was significantly more frequent among people born outside the
      UK/Eire and those with a history of jaundice. Among people of Caribbean origin
      the frequency of hepatitis B virus markers fell from 31 per cent among those born
      in the Caribbean to 11 per cent amongst second generation subjects born in this
      country. Despite careful counselling, offers of further investigation and
      treatment of those affected, and vaccination of vulnerable children or partners,
      were often declined. Four percent of the same population had antibodies to the
      hepatitis C virus using the Ortho anti-hepatitis C virus enzyme-linked
      immunosorbent assay but this figure fell to 0.9 per cent when a second test,
      based on synthetic peptides rather than a recombinant antigen, was used. None had
      any abnormality of standard liver function tests. Chronic asymptomatic carriage
      of hepatitis, particularly in inner city areas, may be more common than
      previously recognized. Effective use of antiviral agents and vaccination will be
      limited until appropriate health education dispels the widespread misconceptions
      and fears associated with a diagnosis of chronic viral hepatitis.

PMID- 1754669
TI  - The natural history of low grade non-Hodgkin's lymphoma and the impact of a no
      initial treatment policy on survival.
AB  - The natural history of low grade lymphoma and the influence of a 'no initial
      treatment' policy on survival were studied retrospectively in a group of 153
      patients with stage II-IV low grade non-Hodgkin's lymphoma. The median follow-up
      was 85 months (range 45-229 months) and median survival of 50 months (range 14
      220 months). Favourable outcome was significantly associated with the absence of
      B symptoms and a centroblastic/centrocytic (cb/cc) diffuse and follicular
      histological subtype and was inversely associated with increasing age. No
      significant differences in survival were found according to patient gender, site
      or stage of disease or whether the patients were participants in a clinical
      trial. Importantly, there was no survival disadvantage amongst the 56 patients
      who were initially untreated compared to those receiving other treatment
      modalities: initially untreated patients had a median survival of 75 months; 56
      per cent were alive at 5 years and the median treatment free interval was 33
      months. This favourable outcome persisted even after adjustment for other
      important prognostic variables. Further studies are needed to identify the
      characteristics of those patients with indolent disease in whom treatment may be
      deferred without adversely affecting survival.

PMID- 1754670
TI  - Children with atopic eczema. I: Clinical response to food elimination and
      subsequent double-blind food challenge.
AB  - The role of foods in the exacerbation of atopic eczema was studied by offering a
      food elimination diet and subsequent random order, double-blind food challenges
      to 91 eczematous patients, [49 males and 42 females, median age 4.5 years (range
      0.5-15)]. Eczema improved in 49 of 66 (74 per cent) (skin score fall greater than
      or equal to 3) after stopping cows' milk, eggs and various other foods, with
      significant decreases in erythema, excoriation, lichenification and extent of
      eczema. One hundred and ninety-four food challenges were given to 64 patients who
      had shown objective or subjective improvement. Eczema and associated symptoms
      were significantly worse after cows' milk and tomato compared with placebo. Egg
      did not worsen eczema, but 48 per cent of 44 challenges were incomplete, mainly
      due to hypersensitivity reactions and challenge refusal. The longer a food had
      been avoided, the less likely was the chance of a positive food reaction.
      Clinical history did not predict response to dietary manipulation. A standard
      elimination diet avoiding cows' milk, egg, tomatoes and possibly colours and
      preservatives should help up to three-quarters of patients, and is easy to
      implement with the help of a dietician. This diet may be considered in all
      children with moderate or severe eczema.

PMID- 1754671
TI  - Children with atopic eczema. II: Immunological findings associated with dietary
      manipulations.
AB  - A group of 91 children with atopic eczema entered a study where clinical and
      immunological features were compared before and after a food elimination diet,
      and after double blind randomized food challenges in which a food was given for
      several days at a time. Eczema improved significantly during the diet and became
      worse on food challenges. The clinical outcome of food elimination could not be
      predicted by the initial skin prick test results, serum immunoglobulins, total or
      food-specific IgE, or complexed IgG or IgE. There was a tendency for patients
      whose eczema did not improve after food elimination to have higher initial serum
      IgG levels, without a corresponding increase in skin infections. The
      radioallergosorbent test to soy gave a higher result in those who improved on
      diet. No significant changes in serum or complexed immunoglobulins occurred over
      the period of food elimination or subsequent food challenge. Results of food
      challenges could not be predicted by initial serum immunoglobulin levels. A
      history of spring/summer exacerbations of eczema correlated with positive skin
      prick tests to silver birch pollen, but not to grass pollen. Serological tests
      did not help in planning food diets in atopic eczema, and the immunological
      studies did not delineate any particular mechanism by which foods might
      exacerbate eczema.

PMID- 1754672
TI  - Glucose counter-regulation in health and disease: current concepts in
      hypoglycaemia recognition and response.

PMID- 1754673
TI  - Long-term survival after resuscitation from ventricular fibrillation occurring
      before hospital admission.
AB  - Factors related to long-term (post-discharge) outcome following successful
      resuscitation from pre-hospital ventricular fibrillation by a physician-manned
      mobile coronary care unit were studied. Between 1 January 1966 and 31 December
      1987, 190 patients were resuscitated from pre-hospital ventricular fibrillation
      (158 male; mean age 56 years). The aetiology of ventricular fibrillation was
      acute myocardial infarction in 131 patients (69 per cent), ischaemic heart
      disease without infarction in 48 (25 per cent) and other or unknown in 11 (6 per
      cent). Predicted actuarial survival rates at 1, 2, 5, 10 and 20 years were 76 per
      cent, 66 per cent, 41 per cent, 27 per cent and 12 per cent respectively. Of 128
      recorded deaths over 20 years, 85 per cent were cardiac and 48 per cent were
      defined as sudden death outside hospital. Factors significantly associated with
      increased long-term mortality (p less than 0.05), based on analysis of 10 year
      actuarial life tables using the Lee-Desu statistic were ventricular fibrillation
      due to ischaemic heart disease without infarction rather than acute myocardial
      infarction, a history of previous myocardial infarction, a history of
      hypertension, digoxin and diuretic therapy before ventricular fibrillation and
      digoxin as discharge medication, and failure to stop smoking after discharge from
      hospital by patients who had been smoking prior to ventricular fibrillation. In
      addition, Cox's regression analysis showed that patient age greater than or equal
      to 60 years was significantly associated with increased long-term mortality. On
      multivariate analysis, factors independently associated with increased long-term
      mortality were ventricular fibrillation occurring before 1977, previous
      myocardial infarction or hypertension and digoxin as discharge
      medication.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754674
TI  - Acute cerebrovascular episodes in systemic lupus erythematosus.
AB  - Twelve patients with systemic lupus erythematosus (SLE) who developed major acute
      cerebrovascular episodes are described. All patients were female, with a mean age
      of 43.3 years and they had suffered from SLE for between 1 month and 22 years
      (mean 9.3 years) at the time of stroke. All patients had multiple clinical and
      laboratory features of systemically active SLE. Stroke was the initial
      neurological feature in nine patients. Cerebral infarction was confirmed in eight
      patients and cerebral haemorrhage in two; the two remaining patients had
      convincing clinical evidence of thromboembolic neurological complications.
      Characteristic clinical and serological features of antiphospholipid antibodies
      were observed in six patients (50 per cent). Five patients died as a direct
      result of stroke and two other patients died within one year.

PMID- 1754675
TI  - Bites by the king cobra (Ophiophagus hannah) in Myanmar: successful treatment of
      severe neurotoxic envenoming.
AB  - Three patients bitten by the world's largest species of venomous snake, the king
      cobra (Ophiophagus hannah), were observed in Myanmar (Burma). All three were
      involved in the famous snake dance in Yangon (Rangoon) Zoological Gardens. One
      patient showed no signs of envenoming despite a sustained bite, another developed
      only signs of local envenoming, but in a third there was severe neurotoxic
      envenoming requiring mechanical ventilation for 64 1/2 hours, episodes of
      hypotension and massive swelling of the bitten limb. This patient showed some
      signs of recovery before delayed treatment with specific antivenom. It is
      possible that all three patients had some immunity to king cobra venom resulting
      from traditional 'immunization' achieved by scratching venom into the skin. The
      literature on king cobra bites is reviewed and recommendations given for
      antivenom and ancillary treatments.

PMID- 1754676
TI  - Prevalence of persistent cough during long-term enalapril treatment: controlled
      study versus nifedipine.
AB  - The prevalence and severity of cough during long-term enalapril treatment were
      examined by comparing a cohort of 136 hypertensive patients who started treatment
      with enalapril with consecutive age and sex-matched patients who commenced
      nifedipine therapy during the same period. Cough and other symptoms were assessed
      by a questionnaire designed to avoid bias towards reporting cough. After a mean
      of 27 months' treatment patients on enalapril had an excess of persistent cough
      (16 per cent, 95 per cent CI 7-25, p less than 0.01), voice change (14 per cent,
      95 per cent CI 2-27, p less than 0.05) and sore throat (10 per cent, 95 per cent
      CI -0.1 to 20.3 per cent, p less than 0.01) when compared to nifedipine-treated
      patients. The cough was usually dry, moderate or severe, paroxysmal, and
      troublesome at night. Cough tended to be more common in women (23 per cent vs.
      7.2 per cent), non-smokers, and at higher doses of enalapril, but was not related
      to age, duration of treatment, or chronic respiratory disease. Dry cough commonly
      persists as a troublesome side-effect during long-term enalapril treatment, and
      is often associated with voice change and sore throat.

PMID- 1754677
TI  - Massive cystic hepatomegaly in a female patient with polycystic kidney disease
      treated by combined hepatic and renal transplantation.
AB  - A patient with cystic kidney disease of adult onset and severe cystic
      hepatomegaly is presented. The patient was severely disabled solely by her
      abdominal bulk. Simultaneous liver and renal transplantation was undertaken
      successfully.

PMID- 1754678
TI  - [MR tomographic diagnosis of internal derangement of the temporomandibular
      joint].
AB  - On the basis of MR imaging studies in 150 temporomandibular joints (TMJ) a
      classification system for internal derangement of the TMJ was defined.
      Clinically, internal derangement is characterized by disc displacement and
      disorders of the mandibular condyle. MR imaging enables a differentiation of
      early stages (I,II) with disc displacement, the intermediate stage (III), and the
      later stages (IV,V) with osseous destruction. Optimal diagnostic results (n =
      140) allowed the use of proton-density sequences in both open and closed joint
      positions (TR/TE = 1000/28). Dynamic imaging of the TMJ was performed using fast
      gradient echo sequences and a self-developed hydraulic opening device (n = 20).
      MR imaging has proved to be the method of choice for the pre- and post
      therapeutic evaluation of internal derangement of the TMJ.

PMID- 1754679
TI  - [The diagnostic reliability of the occipitomental radiograph of the paranasal
      sinuses. Correlation with magnetic resonance tomography].
AB  - 100 conventional occipitomental radiographs of the paranasal sinuses were studied
      independently by five radiologists. Predictive values were determined, based on
      MRI as the gold standard. Sensitivity and specificity for detection of mucosal
      thickening in the sinuses were: maxillary sinus: 0.73/0.76, frontal sinus:
      0.20/0.85, ethmoid sinus: 0.38/0.87, sphenoid sinus: 0.14/0.96. In the maxillary
      sinus polypoid thickening was demonstrated with a significantly higher
      sensitivity than that of diffuse mucosal thickening (0.82 versus 0.65, Chi-square
      test, p less than 0.01). Because of the low predictive values the occipitomental
      view is insufficient to assessing mucosal thickening in the paranasal sinuses,
      with the exception of polypoid mucosal thickening in the maxillary sinus.

PMID- 1754680
TI  - [Diagnostic imaging of the salivary glands in children and adolescents].
AB  - In children and adolescents, imaging of the salivary glands is a valuable
      supplement to clinical examination in various diseases. The choice of the most
      appropriate radiological technique depends on patient compliance, the necessity
      of avoiding radiation exposure as far as possible, and the tentative diagnosis
      made on the basis of the clinical examination. Ultrasonography (US) is the method
      of choice for the detection of both acute inflammatory disease and masses in the
      salivary gland and the adjacent tissue. US can also be implemented as a screening
      method for calculi, though sialography is superior for this purpose. Sialography
      is the only technique that allows diagnosis and evaluation of the degree of
      chronic inflammation. Computed tomography and magnetic resonance imaging are
      required for more deeply located neoplasms of the parotid region.

PMID- 1754681
TI  - [Localized proton MR spectroscopy. A non-invasive insight into brain metabolism].
AB  - Recent progress in image-controlled, localized proton MR spectroscopy offers a
      non-invasive means of gaining unique insights into brain metabolism in man.
      Combined studies with MR imaging can be performed within about 1 h. Results
      obtained in healthy subjects provide the basis for reliable identification and
      quantification of metabolite concentrations in the CNS and allow determination of
      their regional variability and age dependence. Clinical applications include
      infarcts, tumors, and neurodegenerative diseases, and also metabolic disturbances
      resulting from diseases of the internal organs, such as diabetes mellitus or
      liver cirrhosis.

PMID- 1754682
TI  - Peripheral upper lobe collapse simulating pleural effusion.
AB  - Two cases of segmental collapse of the upper lobe simulating an apical pleural
      effusion in association with pneumothorax are reported. Our cases differ from
      previously reported ones in that the peripheral collapse occurred in association
      with a pneumothorax without pleural adhesions, it was segmental rather than
      lobar, and was observed in adults.

PMID- 1754683
TI  - [A calcified coronary artery aneurysm following Kawasaki syndrome].
AB  - On the chest X-ray of a 15-year-old patient, a round, egg-shell-like
      calcification was seen in projection into the left heart border. This finding was
      caused by a calcified coronary aneurysm following Kawasaki's disease. Although
      this has been described as a typical change, it is rarely found in daily clinical
      routine.

PMID- 1754684
TI  - [MR imaging of a giant solitary trichoepithelioma of the skin].
AB  - Magnetic resonance images of a "giant solitary trichoepithelioma" (GST) are
      presented for the first time. Furthermore, to our knowledge this is the largest
      GST ever to be reported in the current literature. Magnetic resonance imaging
      gave information on the origin of the tumor and on the depth of invasion. The
      signal intensity is non-specific and does not allow histological classification.
      Preoperatively, the MR examination depicts the extent of the tumor and thus helps
      in the surgical management that follows.

PMID- 1754685
TI  - [An unclear abdominal tumor. Non-Hodgkin lymphoma of the small intestine, Burkitt
      type, Musshoff stage II.1].

PMID- 1754686
TI  - [A bladder tumor following pancreas transplantation? Intravesical necrotic
      material in transplant pancreatitis].

PMID- 1754687
TI  - Generalization and specialization in artificial neural networks.

PMID- 1754688
TI  - Stereology: a method for analyzing images.
AB  - This review deals with notions of shape, sizes, numbers, densities and
      orientation in space, all basic concepts in stereology. With the initiation by
      Delesse in 1847, but mainly since the beginning of the XXth century, many
      stereological methods have been published allowing us to relate two-dimensional
      measurements easily obtainable on flat histological images with three-dimensional
      characteristics of the structure analysed. Looking at these methods, the
      neurobiologist, generally impermeable to concepts of sampling, statistical bias,
      efficiency, cost of effort and distribution-free, is discountenanced and
      continues old laboratory usages and customs. Furthermore, for the last ten years,
      the advent of a plethora of new powerful tools, considered as assumption-free and
      more efficient than the previous ones, increase the risk proportionately the
      disarray of the potential user. The purpose of this review is to present
      synthetically all traditional and actual aspects of stereology in order to guide
      the reader in the labyrinth of this speciality. The necessarily short exposition
      is compensated by many references to which the beginner or the initiated can
      refer.

PMID- 1754689
TI  - [Sigmund Freud--portrait of writer].
AB  - As physician and writer Freud held an ambivalent attitude towards poets. Jens
      clarifies this by reference to Wilhelm Stekel's address and the subsequent
      discussion in Freud's Wednesday evening society, both concerned with the world
      premiere of Gerhart Hauptmann's stage play Griselda (1909).

PMID- 1754690
TI  - [Freud's interpretation of the manifest dream. Attempt at theoretical historical
      and biographical motives of ambivalent dream devaluation].
AB  - Freud's description of the manifest dream is characterized by an implicit
      appreciation and an explicit devaluation of dream images. The theoretical motives
      for this ambivalent evaluation are, according to the author, already apparent in
      Freud's primacy of the written word evident in his preanalytical writings, which
      submit dream images to the standard of the written word and therefore devaluate
      them. According to the author the underlying biographic motive is an ambivalent
      internalization of the jewish law that prohibits the creation of idols which was
      conveyed to Freud by his father and the Philippson Bible.

PMID- 1754691
TI  - [Schopenhauer as the originator of Freudian metapsychology].
AB  - The influence of 19th century philosophy on Freud's thought is to this day
      underestimated in comparison with the influence of the scientific theories. Godde
      vindicates Max Horkheimer's proposition that Freud was "in certain respects a
      successor to Schopenhauer" even though Freud knew Schopenhauer (and Nietzsche)
      through secondary literature rather than through the original writings.

PMID- 1754692
TI  - [Oroantral communication and its treatment].
AB  - The most frequent cause of an oroantral perforation is the extraction of an upper
      molar. In this article, this for a dental practitioner important entity is
      discussed in detail. After the etiopathology, clinical and roentgenological
      diagnosis is discussed. As 6.5% of perforations closes spontaneously, the
      question is raised wether all perforations should be surgically treated. Those
      different surgical techniques are then described and emphasis is thereby laid on
      the difference between a mere perforation and a fistula.

PMID- 1754693
TI  - [Lingual nerve injury during extraction of lower wisdom teeth].
AB  - A lingual nerve injury is an infrequent but unpleasant complication of the
      removal of lower third molars. The nerve stays at risk even with a correct
      technique. The classifications of nerve injuries of Seddon and Sunderland give
      insight in the complexity and give guidelines for prognosis and treatment.
      Degeneration and regeneration as in other peripheral nerves occur also here and
      knowledge of these phenomena is crucial for the success of the microsurgical
      repair. Confronted with the problem, an attempt to a correct evaluation of the
      extent of the injury should be done, and transfer to a specialist is necessary
      when the dysesthesia is still persistent after more than 2 months.

PMID- 1754694
TI  - [Complications of osteotomies].
AB  - The authors wish to present a review of the literature on complications in
      orthognathic surgery. They are classified into non-specific, general
      complications and into complications which are specific, according to the region
      the osteotomy is performed in. Though the list of possible complications is very
      extensive, one should realise that they are often based on single case-reports
      and that orthognathic surgery in general should be considered as a group of safe
      technical, surgical procedures.

PMID- 1754695
TI  - [Subcutaneous emphysema of the oral floor during cleaning of a bridge fixed on an
      IMZ implant. Case report].
AB  - A case of subcutaneous emphysema following intraoral elimination of plaque and
      tooth shading, on a bridge fixed on implants, is presented. An instrument that
      produces a cleaning spray with a water-air-powder mixture was used. A few minutes
      after this cleaning procedure there was facial swelling. The patient experienced
      difficulties in breathing and in swallowing; symptoms of unilateral hearing loss
      were also noticed. The emphysema lasted for three days. Etiology, diagnosis,
      differential diagnosis, complications and management are discussed.

PMID- 1754696
TI  - [Prevention of caries and of osteoradionecrosis in patients irradiated in
      oncology].
AB  - Dental lesions following radiation therapy of the head and neck cancers are known
      for a long time, and the role of a decreased salivary function in the induction
      of radiation caries has been recognized by Del Regato in 1939. The salivary
      glands are most frequently included in the radiation fields for the treatment of
      lesions of the upper aero-digestive tract; they are also irradiated, in variable
      proportion, in other conditions such as Hodgkin's disease. From a clinical point
      of view, the dental caries observed after radiation therapy are diffuse and
      rapidly evolutive. However, from a histological point of view, they are similar
      to the current type of dental caries. Daily application of fluoride has been
      shown to prevent the appearance of the caries and of the related osteo
      radionecrosis. The experience of the Cancer Centre Georges-Francois Leclerc of
      Dijon is reported and especially the results of randomized prospective studies
      concerning the efficiency of the fluoride prevention. Taking into account the
      available clinical experience, it seems reasonable, at present, to state that
      preservation of teeth, in irradiated patients should be the rule and not the
      exception, given good dental conditions prior to the treatment and patient
      collaboration. The 5 minutes daily application of fluoride gel is the most
      reliable method for prevention of post-irradiation dental caries. The twice daily
      use of high-content fluoride tooth-paste is a good alternative, provided its
      limitations are well understood by the clinician and the patient. The systematic
      use of high-content fluoride tooth-paste for the prevention of caries in the
      general public is discussed.

PMID- 1754697
TI  - [Dental care phobia: example of genetically-programmed learning?].
AB  - Out of a sample of 2,000 patients, one group was identified whose fear of dental
      care presented all the characteristics of phobia. This phobia seems to be linked
      to the pain of previous dental care. Following our hypothesis, it would not be a
      pathological state, but rather a particular example of genetically programmed
      learning.

PMID- 1754698
TI  - [Dental care for patients being treated with oral anticoagulants. Prevention of
      hemorrhagic complications].
AB  - The oral management of patients receiving oral anticoagulants is controversial,
      especially concerning oral surgical procedures. The clinician has to balance the
      risk of reducing or stopping the medication with that of triggering bleeding
      complications. For each individual patient and for each dental intervention, two
      important factors should be evaluated and balanced: the risk for bleeding
      complications represented by the dental intervention and the medical risk for the
      patient in case of interruption of the anticoagulant therapy. Practical
      instructions for the different types of dental interventions and medical risk
      categories are proposed.

PMID- 1754699
TI  - A case-control study on alcohol consumption and the risk of chronic liver
      disease.
AB  - We carried out a hospital based case-control study involving 655 patients with
      chronic liver disease encompassing chronic hepatitis, asymptomatic liver
      cirrhosis and symptomatic liver cirrhosis and 655 pair-matched control
      individuals in order to estimate the dose-response relationship between alcohol
      consumption and the occurrence of chronic liver disease. Alcohol intake was
      measured by a questionnaire and expressed as Daily Alcohol Intake (DAI) during
      the patient life. DAI estimates from patient interviews were in good agreement
      with those obtained by interviewing a sample of relatives. We found an
      exponential positive association between DAI and the risk of chronic hepatitis
      and cirrhosis. However, consuming less than 100g of alcohol every day did not
      increase the risk of developing chronic liver disease. For asymptomatic cirrhosis
      the risk was lower than for chronic hepatitis, especially at high DAI, probably
      because high consumption carried a high probability of liver decompensation. For
      symptomatic cirrhosis, the risk function showed a similar pattern as for chronic
      hepatitis. Chronic hepatitis patients were 6-7 years younger than cirrhotics. Our
      results suggest that the evolution towards cirrhosis once a chronic liver damage
      has occurred is probably time-dependent, but not or minimally dependent on
      alcohol intake.

PMID- 1754700
TI  - [Socioecological determinants of the risk of accidents in young pedestrians].
AB  - We studied all traffic accidents to pedestrians under age 15 which occurred on
      the Island of Montreal during an eighteen months period. Data were collected from
      eleven hospitals and completed with accident police records. A spatial quadrat
      analysis, a Comparative Accident Index, and a comparative analysis of the means
      of different socio-ecological variables between high and low risk accident areas
      revealed interesting patterns. The location of traffic accidents is not random
      but rather presents a particular spatial structure. High risk zones are
      characterized by dense population, fast-moving traffic, and the absence of parks.
      Accidents often take place on two-way streets, far from traffic lights, on dry
      surfaces, in good weather, and with good visibility. The socio-economic status of
      the victim's family as measured by education, income, and unemployment, tends to
      be low. More boys than girls are victims. Children are often injured while
      getting out of a car or crossing unconventionally.

PMID- 1754701
TI  - [Assessment of costs of health insurance, substitution therapy in chronic renal
      insufficiency].
AB  - The authors have studied the cost of the different treatments proposed in ESRD to
      patients attended by the same nephrologic team. For each patient they have
      isolated two consecutive periods of treatment, each six months apart. Treatment
      modifications noted between the two periods allowed the patient to be used as his
      own control. The results show that the costs are essentially composed of the
      dialysis sessions, hospitalisations and transport, and that their level and
      composition differ significantly between the different treatments. They derive a
      typology composed of three groups of patients, which differ in their treatment,
      age, duration of ESRD, complications, and total cost of treatment. They conclude
      that services should be organised in such a way that a range of different
      treatments can reasonably be provided, according to patient needs.

PMID- 1754702
TI  - [Interim analysis in therapeutic trials: a brief survey of current developments].
AB  - It is often interesting to introduce, in the plan of a clinical trial, the
      possibility to make interim analyses. However, this induces an increase of type
      one error and it is thus necessary to use appropriate statistical methods. Usual
      group sequential procedures are mentioned, just as more recent approaches like
      flexible methods with free number and time of analyses, or like the succession
      procedure.

PMID- 1754703
TI  - [Parkinson's disease and environmental factors].
AB  - The etiology of the nigrostriatal pathway degeneration in Parkinson's disease
      (PD) is unknown but there is a growing pool of evidence that environmental
      factors may be involved in the genesis of this disorder. The discovery of the N
      Methyl 4-Phenyl 1,2,3,6-Tetrahydro-Pyridine (MPTP)-induced injury in late 1970s
      provided the first experimental model of PD and stimulated dramatically the
      epidemiological research. An excitotoxic amino acid contained in Cycadales, which
      is thought to be responsible for the amyotrophic lateral sclerosis-parkinsonism
      dementia complex of Guam, provides another example of toxin-induced parkinsonism.
      This amino acid is present in most seeds common in the Western diet. In developed
      countries, prevalence of PD is 2 to 5 times as high than in developing countries.
      PD patients in developed countries are more likely than controls to have lived in
      rural environment. Case control studies have suggested that this positive
      association is possibly related to pesticides and herbicides exposures or well
      water drinking. Dietary surveys are now going on and several hypothesis are
      tested including high MPTP-structural analogs or seeds consumption in PD patients
      and low antioxidants consumption. The negative association between smoking habits
      and PD has been recognized for more than 20 years. There is evidence that this
      association is not an artefact due to the disease affecting smoking habits. Its
      origin is unknown but it could provide important aetiological clues for PD. The
      most recent hypothesis concerning the relationships between these environmental
      factors and PD are reviewed and pertinent suitable surveys for the future are
      discussed.

PMID- 1754704
TI  - [Patient compliance in ambulatory medical care].
AB  - During February and March 1987, 313 private practitioners and 35 outpatients
      clinics in the cantons of Vaud et Fribourg participated in the study "Ambulatory
      medical practice". A representative sample of more than 17,800 records was
      collected and analysed from the 110,000 weekly consultations. In this paper we
      discuss the patient flow in ambulatory medical care. Overall, patient flows
      appear to be influenced more by practitioner and patient characteristics than by
      contextual factors such as medical density. In private practice the proportion of
      patients who are appointed and indeed attend the consultation is 50%; in
      outpatient clinics only 30%. The patient's compliance (probability of keeping an
      appointment) depends on one hand of the physicians' specialty and, on the other
      hand, it decreases when the appointment rate increases.

PMID- 1754705
TI  - [Proportion of cases attributable to public health: definition(s), estimation(s)
      and interpretation].

PMID- 1754706
TI  - [Survey methodology in the prevalence of Alzheimer's disease in the Rhone delta].

PMID- 1754707
TI  - [Sea bathing and risk of infection: a case-control study in the coastal area of
      Pas-de-Calais].

PMID- 1754708
TI  - The alcoholic habit in the spanish hospital environment.

PMID- 1754709
TI  - Molecular genetics of the K end of the murine MHC.
AB  - A systematic search of cloned DNA from the region between the Pb (A beta 3) and
      Ob (A beta 2) genes of the murine major histocompatibility complex (MHC) has
      revealed the presence of at least seven new genes. Three of these genes show
      significant similarity to MHC class II antigens. Two of the other genes are
      members of a superfamily of transport protein genes and are believed to function
      in the transport of antigenic peptides during antigen processing. Genes encoding
      at least two subunits of a large intracellular protein complex (the LMP complex)
      that is believed to be involved in antigen processing were previously mapped to
      the same genetic region. This data suggests that this region of the MHC contains,
      in addition to MHC class I and class II genes whose products provide the
      scaffolding for antigen presentation, a cluster of genes required for antigen
      processing.

PMID- 1754710
TI  - Transcriptional regulation of HLA-DRA gene.
AB  - Transcriptional regulation of class II genes is complex. DRA, for example, is
      expressed in both tissue-specific and lymphokine-inducible fashion. High levels
      of expression in B and activated T cells depend upon a lymphoid-specific
      transcriptional enhancer located in the first intron and on the upstream and
      downstream promoter elements. Conserved upstream promoter Z and X sequences (CUS)
      are the main determinants of this complex regulation. At least four distinct
      trans-acting factors that might be differentially expressed in various cell types
      bind to these Z and X boxes. These are members of JUN, helix-loop-helix (HLH),
      C/EBP and ETS families of proteins.

PMID- 1754711
TI  - Crystallization of HLA-DR antigens.
AB  - The class II major histocompatibility antigens HLA-DR1, DR2, DR3, DR4, DR7 and
      DR8 were purified by immunoaffinity chromatography from homozygous human B
      lymphoblastoid cell lines. The purified, detergent-soluble molecules were cleaved
      with the protease papain to remove the hydrophobic transmembrane regions and
      cytoplasmic tails. Crystals were obtained for each of the papain-solubilized
      fragments. DR1 crystallized under a variety of different conditions, resulting in
      two different orthorhombic crystal forms, one of which diffracts as far as 3.5A.
      Crystals of DR2, DR3, DR4 and DR8 have the same unit cell dimensions as the DR1
      crystals, and crystals of DR3 and DR4 have the same diffracting power as the DR1
      crystals. The best DR7 crystals obtained thus far are hexagonal and diffract to
      only about 8A. Crystals of similar hexagonal form have also been observed for
      most of the other DR subsets.

PMID- 1754712
TI  - Expression and characterization of recombinant mouse beta 2-microglobulin type a
      in insect cells infected with recombinant baculoviruses.
AB  - The murine beta 2-microglobulina cDNA was cloned into pAc373 and pVL941 transfer
      vectors and introduced via homologous recombination into the genome of Autographa
      californica nuclear polyhedrosis virus downstream of the polyhedrin promoter.
      Both types of recombinant baculoviruses were isolated and used to infect
      Spodoptera frugiperda (Sf9) lepidopteran cells. beta 2m was synthesized at a
      substantially higher rate in cells infected with the pVL941-derived virus than
      when the pAc373-based virus was used. beta 2m was secreted into the culture
      medium where it accumulated and, under the best conditions, reached an
      approximate level of 10 micrograms/10(6) cells. Pulse-chase experiments after
      metabolic labelling with 35S-methionine followed by immunoprecipitation showed
      that beta 2m was stable, but that the secretion process in infected cells was
      relatively slow. Recombinant beta 2m was endowed with biological activity and was
      indistinguishable from that produced by mouse cells in 2D gel analysis. beta 2m
      was purified to near homogeneity from serum-free culture medium conditioned by
      recombinant baculovirus-infected cells by using an immunoaffinity column. The use
      of the insect cell/baculovirus expression system should constitute a suitable
      source of mouse beta 2m and should aid experiments aimed at unraveling its
      interactions with mouse class I histocompatibility molecules.

PMID- 1754713
TI  - Distinct mechanisms of peripheral tolerance in transgenic mice.

PMID- 1754714
TI  - Influence of antigen processing on thymic T-cell selection.
AB  - The design of a specific blocking peptide for the immunosuppressive therapy of an
      autoimmune disease requires the identification of peptides of an autoantigen that
      are physiologically processed in vivo and bind to MHC-encoded membrane
      glycoproteins. However, knowledge of how an antigen is physiologically processed
      by antigen-presenting cells (APC) in vivo, particularly in the thymus, is
      lacking. It is also unknown whether the processing of an antigen by different APC
      in the thymus can influence thymic T-cell selection. This is an important
      consideration for attempts to delete or inactivate autoreactive T cells that
      elicit autoimmune disease. To address these issues, we investigated the
      processing of biosynthetically labelled recombinant human insulin (rHI), a model
      autoantigen, injected into mice and characterized the insulin peptides associated
      with MHC class II molecules on thymic epithelial cells and dendritic cells. These
      APC were found to differ in the way they process insulin. The detection of MHC
      class-II-bound insulin peptides on the surface of the epithelial cells but not
      the dendritic cells correlated with their capacity to either present or not
      present insulin to T cells, respectively. Thus, antigen processing may control
      the appearance of different peptide-MHC class II complexes on thymic APC that
      mediate positive and negative selection, and thereby influence the development of
      the T-cell repertoire. Our findings could have important bearing on the future
      design of synthetic blocking peptides that reduce or eliminate the onset of
      autoimmune disease.

PMID- 1754715
TI  - T-cell immunotherapy of cancer.
AB  - In animal systems, complete and permanent eradication of tumours can be achieved
      by adoptive transfer of MHC-restricted T cells, combined with IL2. In certain
      types of human cancer (melanoma and perhaps renal cell carcinoma), tumour
      specific T cells are probably the therapeutically most active cells among LAK or
      TIL cells. To prove these points, it is necessary to conduct trials with cloned
      tumour-specific T cells. Other potentially immunogenic tumors are cervical
      carcinoma, associated with human papilloma virus, and Burkitt's lymphoma,
      associated with Epstein-Barr virus. Most other human tumours, caused by subtle
      mutations in proto-oncogenes, are likely to be poorly or non-immunogenic. It is
      worthwhile trying to overcome this by vaccination with IL2 or IFN gamma-producing
      tumour cells or by deliberate vaccination with desirable targets for tumour
      specific CTL such as the products of point-mutated oncogenes, including ras (Jung
      and Schleusener, 1991) and p53 (Rodriguez et al., 1990; Halevy et al., 1990),
      provided the relevant peptides are processed and bound to MHC class I molecules.
      Other potential targets are breakpoint peptides of translocated oncogene products
      such as bcr/abl (Van Denderen et al., 1990). In viral systems, it has already
      been established that peptide vaccination for protective CTL induction is
      feasible (Aichele et al., 1989; Schulz et al., 1991; Kast et al., 1991).

PMID- 1754716
TI  - In vivo stimulation of H-2Dd expression following RadLV infection of thymocytes:
      increased transcription and DNA-binding activity to sequences 5' of the Dd gene.
AB  - Early studies showed that resistance to RadLV-induced leukaemia is mediated by
      gene(s) in the H-2D region of the MHC. Furthermore, these experiments correlated
      disease resistance with changes in H-2 expression occurring very early after
      virus inoculation. In the present study, we have begun to study at the molecular
      level this stimulation of H-2Dd class I expression in thymocytes of resistant
      mouse strains following infection by RadLV. The resistant strain of B10.T(6R)
      mice is used in these studies. When these infected thymocytes are assayed by
      fluorescence-activated cell sorting analysis, we can detect increased levels of H
      2Dd expression on the surface of the thymocytes as early as 12 days following
      intrathymic injection of RadLV. RNA was prepared and examined by Northern blot
      analysis; H-2 mRNA levels are shown to be elevated on the order of four-fold.
      Nuclei were prepared from normal and infected thymocytes and the run-off
      transcripts were analysed by slot-blot hybridization. The rate of H-2 mRNA
      transcription is shown to be two- to three-fold higher in RadLV-infected
      thymocytes at 14 days post-infection when compared to that of normal thymocytes.
      These data demonstrate that elevation of H-2 surface expression following RadLV
      infection is the result of transcriptional activation. Extracts have been
      prepared from both normal and infected B10.T(6R) thymocytes and have been used in
      gel mobility assays in order to detect the interaction of potential trans-acting
      regulatory factors with sequences 5' of the H-2Dd gene. Specific binding occurs
      in both extracts, but the assay shows that the extracts differ both
      quantitatively and qualitatively; the extracts from infected thymocytes bind to
      additional sequences and to a higher degree than that from normal thymocytes.
      DNase I protection analysis locates a number of protein-binding sites, some of
      which are protected by extracts of either origin and some of which are only
      protected by extracts from infected cells. Two of these sequences are similar to
      the previously recognized consensus recognition sequences for the binding of AP-1
      and NF-chi B. Oligonucleotides have been synthesized for both the genomic
      sequences being protected from DNase I digestion as well the published consensus
      sequences. While the DNA-binding activity in infected thymocytes for both AP-1
      and NF-chi B-binding sites is increased, the binding to the genomic "AP-1 like"
      binding site is activated to a considerably greater level.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1754717
TI  - The T-cell repertoire is not dictated by self antigens alone.
AB  - The influence of genetic and environmental factors on the functional cytotoxic T
      cell (CTL) allorepertoire was studied by comparing the CTL precursor frequencies
      against the same HLA alloantigens in 116 sibling pairs. A significantly different
      precursor frequency was found in 68%, 61% and 59% of siblings sharing 0, 1 and 2
      HLA haplotypes, respectively. These data show that, although HLA is important in
      determining the T-cell repertoire, this is hardly reflected in the
      allorepertoire. Even 50% of the monozygotic twin pairs showed a significant
      disparity in their CTL allorepertoire, indicating that environmental factors play
      a role as well. The non-inherited maternal HLA antigens could be identified as
      one of the environmental factors shaping the CTL allorepertoire.

PMID- 1754718
TI  - The pros and cons of polymorphism: a brighter future for cheetahs?

PMID- 1754719
TI  - Towards a structural understanding of alloreactivity.

PMID- 1754720
TI  - Intracellular routes for antigen processing and presentation.

PMID- 1754721
TI  - HLA B27: a disease-associated immune response gene.

PMID- 1754722
TI  - Genetic analysis of a complex, multifactorial disease, autoimmune type 1 (insulin
      dependent) diabetes.

PMID- 1754723
TI  - Mechanisms and significance of HLA type I diabetes association.

PMID- 1754724
TI  - Limited heterogeneity of autoantigens and T cells in autoimmune diseases?
AB  - For many induced and spontaneous autoimmune diseases, a predominant role for T
      cells in the organ-specific destruction process has been shown. In one of the
      induced models of autoimmunity, experimental allergic encephalomyelitis (EAE), a
      very small heterogeneity of T-cell receptor (TcR) molecules is expressed by the
      pathogenic T cells in both rats and mice. Contrary to induced autoimmune
      diseases, little is known about the autoantigens recognized by these autoimmune T
      cells and the heterogeneity of their TcR in spontaneous autoimmune diseases. The
      aim of this work was to establish a system which allows characterization of
      relevant autoantigens in spontaneous insulin-dependent diabetes mellitus (IDDM)
      in non-obese diabetic (NOD) mice. A completely different approach was taken to
      characterize the gene products of the minor lymphocyte stimulatory (Mls) loci.
      These gene products are responsible for the clonal elimination or the clonal
      stimulation of T cells expressing particular TcR V beta genes and therefore could
      be implicated in induction of autoimmune diseases by oligoclonal T-cell
      populations. The finding that Mls antigens are encoded by retroviral sequences
      leads to the hypothesis that viruses could be the inducing agents of autoimmune
      diseases.

PMID- 1754725
TI  - Monoclonal antibodies: probes for studying experimental autoimmunity in animals.

PMID- 1754726
TI  - The use of MHC-binding peptides in the immunotherapy of autoimmune diseases: a
      commentary.

PMID- 1754727
TI  - Ir genes: towards the year 2000.

PMID- 1754728
TI  - Microscopic analysis of arterial microsphere distribution in rabbit liver and
      hepatic VX2 tumor.
AB  - Microspheres conjugated to radioisotopes and chemotherapeutic agents are playing
      an important investigative and clinical role in the management of metastatic
      neoplasms. The purpose of our investigation was to histologically assess the
      basis for regional intra-arterial microsphere therapy, by comparing the spatial
      distribution of microspheres in the tumor and liver of experimental models of
      hepatic metastases. Three New Zealand white rabbits with hepatic VX2 tumor
      implants were arterially injected with hepatic doses of either 15 or 30 million
      blue-dyed, polystyrene microspheres (27 microns-diameter). Microscopic
      examination of random liver and tumor samples revealed that 6-12 times as many
      microspheres were embolized within tumor than in normal liver (p less than
      0.002). The majority of microspheres aggregated into clusters of various size
      within liver and tumor vasculature, though analysis of cluster sizes illustrated
      an exponentially skewed distribution toward isolated microspheres. Approximately
      eight times as many clusters were observed in tumor than in liver (p less than
      0.008). Finally, a morphometric analysis was used to quantitate the minimal
      distances separating microsphere clusters, the intercluster distance (ICD).
      Analysis of over three thousand intercluster measurements revealed a median ICD
      approximately five times lower in tumor than in liver (p less than 1 x 10(-8)).
      This microquantitative analysis provides a fundamental description of how
      regional intra-arterial microsphere therapy allows the targeted delivery of
      microspheres to neoplastic tissue, to potentially improve the therapeutic index
      in the treatment of hepatic metastases.

PMID- 1754729
TI  - Synthetic polymers conjugated to monoclonal antibodies: vehicles for tumour
      targeted drug delivery.
AB  - (N-(2-Hydroxypropyl)methacrylamide (HPMA)) copolymers have seen extensive
      development as sophisticated lysosomotropic drug carriers. They can be used for
      site-specific drug delivery by incorporation of appropriate targeting groups and
      here we report their conjugation to antitumour monoclonal antibodies (the murine
      IgG, antibody B72.3 and its Fab' and Fab'2 fragments) and assessment as vehicles
      for tumour-specific drug delivery. Conjugates were synthesised containing an
      average 5 copolymer units (Mw 20kD) per antibody molecule. Kinetics of
      elimination and body distribution of radiolabelled conjugates in mice were
      substantially modified compared with native antibody and fragments, showing
      prolonged circulation in the bloodstream. Notably, the half-time for
      bloodclearance of the Fab' fragment (35min) was extended ten-fold following
      conjugation (6h). The conjugates provoked only a low immune response in A/J mice,
      following three injections in adjuvant (IgG titre-1 less than 100), and were
      resistant (up to 50%) to proteolytic degradation by preparations of rat liver
      lysosomal enzymes. The parent antibody targeted efficiently to human colorectal
      carcinoma (LS174T) xenografts in nude mice (up to 25%/g); the conjugates,
      however, showed no tumour-targeting, probably due to masking by polymer chains
      (which are attached by non-specific aminolysis). Conjugates designed to maintain
      immunoreactivity following linkage through oxidised carbohydrates are currently
      being synthesised. Nevertheless, the conjugates display increased rates of
      extravasation, compared with proteins of the same hydrodynamic size, and the
      decreased charge is anticipated to accelerate diffusion through tumour
      interstitium.

PMID- 1754730
TI  - Effect of verapamil on the uptake and efflux of etoposide (VP16) in both
      sensitive and resistant cancer cells.
AB  - The effect of calcium antagonist verapamil on the uptake and efflux of Etoposide
      (VP16), a semi-synthetic derivative of podophylotoxin and a broad spectrum
      antineoplastic agent, has been investigated and compared in sensitive (UM-UC-2)
      and resistant (UM-UC-9) human bladder cancer cells, and L1210 leukemia cells, by
      using both radioisotope (3[H]-VP16) liquid scintillation and high performance
      liquid chromatography assay with electrochemical detection. The uptake of VP16
      was rapid in all three cell lines, showing an initial rapid linear phase followed
      by a second slower phase, but at steady state the ratios of intracellular to
      extracellular VP16 concentrations were only 0.004-0.006. No significant
      difference in drug uptake was observed in sensitive UM-UC-2 and resistant UM-UC-9
      cells at all concentrations studied. Verapamil at a concentration of 10 microM
      enhanced the intracellular VP-16 levels in all sensitive and resistant cell
      lines. The increments were 21.5% for UM-UC-2, 11.8% for UM-UC-9, and 31.0% for
      L1210 cells after 30 minutes incubation with 1 microM VP16. A slower efflux of
      VP16 was observed in verapamil treated cells in all three cell lines. There was a
      small increase in the nonexchangeable components in verapamil treated cells,
      although only 5-10% of VP16 was retained. No peak other than that of VP16 was
      detected in the HPLC chromatogram of extracts from both cell pellet and influx or
      efflux medium.

PMID- 1754731
TI  - Phase I evaluation of crisnatol (BWA770U mesylate) on a monthly extended infusion
      schedule.
AB  - Crisnatol is an arylmethylaminopropanediol derivative that has shown promise as
      an antitumor agent in preclinical testing. In a phase I trial using a monthly six
      hour infusion schedule the recommended dose for future phase II trials was found
      to be 388 mg/m2. Neurologic toxicity was dose-limiting in that trial and
      correlated with the attainment of a threshold plasma concentration of greater
      than 4.5 micrograms/ml. In this study we treated 15 patients with escalating
      doses of crisnatol from 450 mg/m2 to 900 mg/m2 administered at a rate of 50
      mg/m2/hr over 9, 12, 15, and 18 hours. Toxicity was mild to moderate at all dose
      levels. However, serious central nervous system effects were noted in one patient
      at 900 mg/m2 over 18 hours whose plasma level was 6.5 micrograms/ml. This study
      has demonstrated higher total doses of crisnatol can be given if the drug is
      administered as a prolonged infusion in an attempt to avoid high plasma levels of
      the agent.

PMID- 1754732
TI  - Introduction: antimicrobial penetration into respiratory secretions.

PMID- 1754733
TI  - Fluoroquinolones in respiratory infections.
AB  - The fluoroquinolones have excellent activity against a number of respiratory
      pathogens, especially gram-negative bacteria, including beta-lactamase-producing
      Hemophilus influenzae and Moraxella catarrhalis. Several studies have shown
      ciprofloxacin to be effective in the treatment of acute exacerbations of chronic
      bronchitis, some community-acquired and nosocomial pneumonia, and acute
      exacerbations of bronchopulmonary infections in cystic fibrosis. The
      fluoroquinolones have less activity against Streptococcus pneumoniae and limited
      anaerobic activity, which should limit the use of these drugs in empiric therapy
      of community-acquired pneumonia where the pneumococcus or anaerobes play a
      predominant role.

PMID- 1754734
TI  - Aminoglycosides versus beta-lactams in gram-negative pneumonia.
AB  - Newer beta-lactam antibiotics with high levels of activity against gram-negative
      aerobic bacilli (including Pseudomonas aeruginosa) such as cefoperazone,
      ceftazidime, imipenem, and aztreonam may be suitable for monotherapy of gram
      negative pneumonia. Aminoglycoside antibiotics (gentamicin, tobramycin, amikacin
      are also highly active against these same organisms and have been more
      extensively used, but are both ototoxic and nephrotoxic. Key therapeutic
      questions are whether beta-lactams can safely replace aminoglycosides for the
      treatment of gram-negative pneumonia, and whether monotherapy or aminoglycoside
      and beta-lactam combination antibiotic treatment is superior. There is remarkably
      little definitive clinical data in the literature to answer these questions, but
      available studies suggest that beta-lactam monotherapy may be adequate for
      Escherichia coli and Klebsiella pneumoniae pneumonias, but that combination
      therapy may be preferred for Pseudomonas aeruginosa, Serratia sp, Enterobacter
      sp, and Acinetobacter sp, largely based on rates of bacterial persistence and
      emergence of resistance. At this time, there are more data available to support
      aminoglycoside monotherapy than beta-lactam monotherapy in gram-negative
      pneumonia and remarkably little data to suggest superiority of two antibiotics
      over single agents when they have been compared prospectively. Thus, combination
      therapy remains a conservative recommendation until better studies are available.

PMID- 1754735
TI  - Antiviral agents in respiratory infections.
AB  - Viral respiratory illnesses are among the most common afflictions in the United
      States. Until recently, few agents were available to control these infections.
      Now, there are specific and nonspecific agents either to prevent or treat viral
      respiratory infections. For example, a better understanding of the pathogenesis
      of the common cold provided new insights into therapeutic intervention for that
      entity. In other instances (eg, influenza), the antiviral agent is so specific
      that there is a need for diagnostic information to guide therapy. Epidemiological
      clues, clinical symptoms, and some newer laboratory methods all contribute to the
      clinician's understanding of the cause of an individual respiratory illness and
      guide the choice of therapy. In other circumstances, information is being
      gradually developed that points toward the availability of a broad-spectrum
      antiviral drug with activity against at least five of the important respiratory
      viruses; its major limitation is that a cumbersome and expensive means of
      delivery to the patient is required. For such a drug to gain widespread use, a
      more practical method of delivery is necessary.

PMID- 1754736
TI  - Delivery of topical antibiotics: pharmacokinetics and clinical problems.
AB  - Despite major advances in new therapeutic agents to treat pneumonia, pneumonia
      remains a major cause of morbidity and mortality in hospitalized patients.
      Topical antibiotics offer many potential advantages in the treatment and
      prevention of nosocomial pneumonia. These include a high delivery of the drug to
      the site of infection and the potential for little systemic absorption and, as a
      result, reduced side effects. The potential disadvantages include failure of
      topical therapy to reach all diseased areas of the lung and the emergence of
      resistant organisms. Failure of many of the previous clinical studies has been
      ascribed to these potential disadvantages. However, little attention has been
      paid in previous clinical studies to actual dosage and regional distribution of
      aerosolized antibiotics in the lung and the pharmacokinetics of the aerosol after
      deposition. One major exception to this has been the use of aerosolized
      pentamidine, in which careful attention has been paid to nebulizer design, dosage
      to the lung, regional distribution, and pharmacokinetics. It should serve as the
      model for the testing of topical antibiotics therapy in the future.

PMID- 1754737
TI  - Antibiotic pharmacokinetic considerations in pulmonary infections.
AB  - The factors affecting the penetration of antibiotics into the respiratory tract
      and their clinical relevance in treating pulmonary infections are discussed in
      this article. The importance and interpretation of sputum, bronchial fluid,
      pleural fluid, and lung tissue levels are emphasized, including a tabular summary
      of published data on antibiotic levels in the respiratory tract. The relative
      predictive efficacy of antibiotics against pulmonary pathogens is best expressed
      by comparing tissue levels with the mean minimum inhibitory concentration of the
      infecting organism, ie, the "kill ratio." The kill ratio is the best way to
      compare dissimilar antibiotics in terms of their likely efficacy in treating
      pulmonary infections, ie, those with high kill ratios (greater than or equal to
      2) are more likely to be associated with a favorable clinical outcome than those
      with lower kill ratios. The difficulties with interpreting pharmacokinetic data
      from various parts of the respiratory tract in terms of specimen timing,
      handling, processing, and interpretation are also discussed in this article.

PMID- 1754738
TI  - Cadmium causes increases of N-myc and multidrug-resistance gene mRNA in
      neuroblastoma cells.
AB  - Since cadmium exposure results in neuropathological alterations in central
      nervous system, we investigated the effects of cadmium on the gene expression of
      neuroblastoma (GOTO) cells. We observed an increase in mRNA levels of heat-shock
      protein (hsp) 70, hsp 90, hsp 32 and metallothionein after treatment of GOTO
      cells with cadmium, although the time courses of the changes of individual mRNA
      of the heat-shock proteins and metallothionein were somewhat different from each
      other. An accumulation of N-myc and multidrug-resistance gene (MDR1) mRNA was
      detected in the presence of cadmium. This is contrary to the previous report, in
      which an inverse correlation between the expression of MDR1 gene and N-myc
      oncogene in human neuroblastoma had been described. However, the increase of N
      myc and MDR1 mRNA in the present study is not likely due to the loss of
      regulatory mechanism of these genes by cytotoxic effects of cadmium, because
      active protective mechanisms such as heat-shock proteins and metallothionein
      could be induced under these conditions.

PMID- 1754739
TI  - [Chemosensitivity test by subrenal capsule assay (SRCA) in transitional cell
      carcinomas].
AB  - From November, 1986 to October, 1989, the antitumor activities of several
      chemotherapeutic agents were tested by subrenal capsule assay (SRCA) in cases of
      23 transitional cell carcinomas. Overall sensitivities of tested drugs to
      transitional cell carcinomas were compatible to clinical data and correlated with
      individual clinical courses. This method has some problems, but can be carried
      out at any institute and serve as an aid to the selection of chemotherapeutic
      agents.

PMID- 1754740
TI  - [A survey of the best bibliographic searching system in occupational medicine and
      discussion of its implementation].
AB  - When occupational health personnel, especially occupational physicians search
      bibliographies, they usually have to search bibliographies by themselves. Also,
      if a library is not available because of the location of their work place, they
      might have to rely on online databases. Although there are many commercial
      databases in the world, people who seldom use them, will have problems with on
      line searching, such as user-computer interface, keywords, and so on. The present
      study surveyed the best bibliographic searching system in the field of
      occupational medicine by questionnaire through the use of DIALOG OnDisc MEDLINE
      as a commercial database. In order to ascertain the problems involved in
      determining the best bibliographic searching system, a prototype bibliographic
      searching system was constructed and then evaluated. Finally, solutions for the
      problems were discussed. These led to the following conclusions: to construct the
      best bibliographic searching system at the present time, 1) a concept of micro-to
      mainframe links (MML) is needed for the computer hardware network; 2) multi
      lingual font standards and an excellent common user-computer interface are needed
      for the computer software; 3) a short course and education of database management
      systems, and support of personal information processing for retrieved data are
      necessary for the practical use of the system.

PMID- 1754741
TI  - [MRI of normal pituitary glands and their surrounding structures].
AB  - Normal MRI appearances of the pituitary glands and their surrounding structures
      were evaluated in 332 patients without sellar and parasellar diseases. The height
      of the pituitary gland was maximum at 10-19 years of age reflecting hormonal
      activity. The width of the pituitary gland decreased, while that of the cavernous
      sinus increased with aging. This is probably due to atherosclerotic change of the
      internal carotid artery. Females younger than 30 years of age tended to show a
      convex upper surface of the pituitary gland and the displacement of the pituitary
      stalk was common after 50 years of age. Almost all of the anterior lobe of the
      pituitary gland showed isointensity relative to the pons or cerebral cortex and
      the majority (85.1%) of the posterior lobe showed hyperintensity. However, the
      anterior lobe in 2 newborns showed hyperintensity similar to the normal posterior
      lobe in adults. The posterior lobe was located off the midline in 19.1% of the
      subjects. One case of pars intermedia cyst was discovered among 14 subjects who
      were administered Gd-DTPA. The dural membrane between the pituitary gland and
      cavernous sinus was recognizable only in 8.6% on the right side and 7.5% on the
      left side. Primary empty sella was identified in 4.5%. A knowledge of the above
      normal ranges and variations of the pituitary gland and its surrounding
      structures is important in diagnosing sellar and parasellar lesions.

PMID- 1754742
TI  - [Stress management of overseas Japanese in Kuwait].
AB  - Forty percent of the Japanese businessmen in overseas positions are working in
      developing countries. However, few reports on the mental health care for them
      have been published. The Japan Overseas Medical Fund and The Kuwait Japanese
      Association has promoted the Kuwait Japanese Clinic. I had an opportunity to work
      at this clinic and to study the environmental health of Japanese businessmen in
      Kuwait. I found that in Kuwait, Japanese businessmen had to adapt to climatic,
      religious, cultural, and historical differences. Therefore, I investigated the
      incidence of stress related diseases which are caused by these environmental
      differences. Stress diseases occurred in 15.7 percent of total cases frequently,
      and some of them were very severe. After my stay in Kuwait, I believe that the
      setting up of medical information networks between various countries to alleviate
      medical anxiety and a system whereby instructions in the differences of medical
      systems in various countries would be very beneficial.

PMID- 1754743
TI  - In praise of audit.

PMID- 1754744
TI  - Social insurance medicine: a challenge to primary health care.

PMID- 1754745
TI  - Streptococcal throat infection: calculation of test standards and a comparison
      between an antigen detection test and culture.
AB  - The standard minimum sensitivity (94%) and minimum specificity (89%) of a group A
      streptococcus (GAS) test were calculated, assuming that no more than 10% false
      positive and no more than 2% false negative test results should be allowed. The
      clinical judgement of the need for immediate antibiotic treatment in
      tonsillitis/pharyngitis was an unreliable indicator of a GAS aetiology, 20-29% of
      the results being false positive and 2-10% false negative. The rapid antigen
      detection test Tandem Icon Strep A was not sensitive enough to be used as a
      single test, though it was specific enough. The sensitivity of culture almost
      reached the standard demand. Two combinations of rapid test and culture (sequence
      testing) were superior to the rapid test, but were not significantly better than
      culture.

PMID- 1754746
TI  - The costs of treating hypertension in Sweden. An empirical investigation in
      primary health care.
AB  - The treatment costs of hypertension in Sweden were calculated both at the
      individual and at the national level after an empirical investigation in primary
      health care. The average drug cost per patient and year was calculated as c. SEK
      1220, the annual consultation cost as c. SEK 620, and the annual travel and time
      cost as c. SEK 230. About 500,000 people are treated pharmacologically for
      hypertension in Sweden, and about 25,000 non-pharmacologically. The total annual
      treatment cost for these patients was calculated as c. SEK 1100 million. The drug
      cost accounts for c. SEK 650 million, the consultation cost for c. SEK 330
      million, and the travel and time cost for c. SEK 120 million. The drug
      reimbursement scheme pays almost half these costs, while the county councils and
      the patients pay approximately a quarter each.

PMID- 1754747
TI  - Telephone advisory service, visits to district nurses and home visits made by
      district nurses at a Swedish primary health care district.
AB  - All contacts with the district nurses were registered during a three-week period,
      daytime Monday to Friday, in a defined primary health care district (Vanersborg,
      Sweden): 855 incoming telephone calls, 1,016 visits to the district nurses
      (visits to child welfare unit excluded), and 380 home visits made by the district
      nurses. The telephone consultations comprised 38% of the total number of contacts
      and 14% of the time was devoted to this activity, visits to the district nurses
      at their reception units 45% of all contacts and 39% of the time, and home visits
      17% and 47%, respectively. Symptoms from the upper respiratory tract and from the
      skin were the most common reasons for telephone consultations, while wounds and
      leg ulcers were the most common reasons for visits to the reception unit and for
      home visits. A great deal of the district nurse's work was requested by health
      centres and hospitals.

PMID- 1754748
TI  - Anaemia in elderly patients. Incidence and causes of low haemoglobin
      concentration in a city general practice.
AB  - Haemoglobin concentration was determined in all patients (530) over 70 years of
      age in a general practice in Oslo during an eight month period. 72 had anaemia
      and were investigated further. Iron deficiency was found in 13 patients and was
      most often caused by gastrointestinal blood loss. Chronic diseases, particularly
      chronic infections and rheumatoid arthritis, were responsible for anaemia in 34
      patients. Renal failure caused anaemia in 14 patients. In 10 patients we found no
      explanation for the anaemia. Nine patients with a previously undiscovered disease
      were found, six of whom could be offered some kind of treatment. We conclude that
      anaemia in elderly patients in general practice is often caused by chronic
      diseases. The main cause of iron deficiency is blood loss, and routine
      prescription of iron is not justified in this age group. The therapeutic benefit
      from routine measurement of haemoglobin concentration is small and the test
      should be used selectively.

PMID- 1754749
TI  - Organization and problems in emergency dental care at Finnish health centres.
AB  - The Public Dental Service in Finland is, in principle, responsible for emergency
      dental services for the population. The organization of the prevailing emergency
      care system in the 215 health centres was studied. 90% of the health centres had
      some kind of emergency services, usually during regular working hours. Few health
      centres offered treatment outside normal hours or had a telephone-based back-up
      system. The main problems reported were the unpredictability of the need for
      emergency services, great variations in the number of patients, the heavy work
      load created by continuing treatment of emergencies, and shortage of personnel.

PMID- 1754750
TI  - Myocardial infarction risk factors in a semirural area in mid-Sweden. The
      population study "50-year-old people in Kungsor".
AB  - The mortality from ischaemic heart disease is higher in predominantly rural
      northern and western Sweden than in the more urban eastern and southern
      districts. This study was performed in a small semirural area in mid-Sweden with
      lower mortality from ischaemic heart disease in middle-aged men and higher
      mortality in middle-aged women than the national average. Smoking habits, serum
      cholesterol, and blood pressure were measured in all 50-year-old men and women in
      the community (n = 314) during a four-year period. In addition, the feasibility
      of using the local health care centre as a base for the study was tested. The
      health centre provided an excellent base for this population study. The non
      response rate was less than 3%, indicating that using local facilities and staff
      well known to the population might be an advantage. The risk factor levels seemed
      to be higher in Kungsor than in Uppsala, a community with low mortality from
      ischaemic heart diseases. The differences in risk factor levels could explain
      some, but not all of the differences in mortality from ischaemic heart diseases.
      Thus, other risk factors appear to be operating as well.

PMID- 1754751
TI  - Psychological symptoms and behavioural changes in Finns caused by fear of AIDS.
AB  - The purpose of the study was to explore personal fears about AIDS and their
      consequences in terms of psychological symptoms and behaviour. 1902 individuals,
      15 to 64 years old, were selected at random from the Finnish population and
      interviewed by telephone (94%) or in person (6%). 2.5% regarded AIDS as a
      personal threat, while 12-13% exhibited psychological symptoms such as insomnia,
      depression, anxiety or episodes of fear. About 20% had taken measures to prevent
      HIV infection: 9% had increased their use of condoms, 6% had had themselves
      tested for HIV, and 5% had taken precautionary measures at work. The
      psychological status of individuals who feel at risk of AIDS should be assessed
      within the health care system because persistent feelings of danger may be a sign
      of incipient psychological decompensation.

PMID- 1754752
TI  - Body communication is a continuous process. The first encounter between patient
      and physiotherapist.
AB  - First encounters between patients and physiotherapists have been video-taped and
      analysed as part of a research project encompassing manual, psychomotor, and
      district physiotherapists. The main focus in this article is on body
      communication. The common features and differences between the patterns of
      communication established by the three categories of therapists are described and
      compared. Since human beings function and relate to each other as physical
      subjects, messages of interest and involvement will in some way be conveyed
      through their bodies. The recognition of this fact means that body communication
      is a central aspect of patient-centredness. The relationship, context, and actual
      basis of cooperation can only be understood by analysing the way in which
      professionals relate to their patients through their bodies. This is because body
      messages are conveyed continuously in any encounter between two people, while
      verbal communication is discontinuous.

PMID- 1754753
TI  - Treatment of bacterial vaginosis with metronidazole or pivampicillin.
AB  - In a double-blind randomized controlled trial from general practice, we assessed
      the efficacy of treatment with either metronidazole or pivampicillin in patients
      fulfilling the diagnostic criteria of bacterial vaginosis. 50 women were treated
      with metronidazole 500 mg twice daily and 54 with pivampicillin 700 mg twice
      daily, both for seven days. Evaluated four weeks after the start of treatment, we
      found a significantly higher cure rate in the metronidazole group (90%) than in
      the pivampicillin group (69%) (p = 0.01). Cure was defined as lack of fulfillment
      of the diagnostic criteria of bacterial vaginosis. Test for confounding according
      to parity and complaint of vaginal discharge showed no influence. Side-effects
      were significantly commoner in the pivampicillin group (28%) than in the
      metronidazole group (8%). We consider that metronidazole is a potent drug in the
      treatment of bacterial vaginosis, with pivampicillin as a useful alternative.

PMID- 1754754
TI  - Trauma in the elderly: the impact on the health care system.
AB  - The impact of injuries in the elderly on the acute health care system was
      assessed in terms of the cost of injuries. The cost of injuries in the elderly
      (greater than or equal to 60 years) was compared with that in the younger group
      (less than 60 years) in a health district in northern Sweden. Even though the
      elderly made up only one sixth of the total injured during a one year period,
      they accounted for 42% of the total cost of the medical care of injuries. The
      mean medical care cost increased significantly from the age of 60 years; the cost
      was four times higher in the older group than in the younger group. Severe
      injuries in the elderly cost almost 2.5 times more than those in the younger
      group. In conclusion, since the elderly place a heavy burden on the health care
      system, they urgently need to be given priority in injury research and injury
      intervention programmes.

PMID- 1754755
TI  - School injuries. Epidemiology and clinical features of 307 cases registered at
      hospital during one school year.
AB  - Injuries at school were studied for one school year in 57 primary and three
      secondary schools (13,733 students, aged 7-19 years) at Umea in northern Sweden.
      The injury rate was 22/1000 student years. There was a wide variation in injury
      rate between different schools. The boy/girl ratio was 1.1/1. Physical education
      was the dominating activity at the time of injury for the older students and play
      in the school yard for the younger. The majority of the students had a minor
      injury, but 17% had a fracture. The injured students did not seem to have more
      somatic, psychological or social problems than students in general. Fewer
      competitive sports and ball games and more adult supervision and organized
      activities during breaks are suggestions to reduce injuries at school. A hospital
      based injury registration system is well fitted for serving as a base for
      analysing school injuries.

PMID- 1754756
TI  - The occurrence of symptoms and the proportion treated in Swedish infants and
      their mothers.
AB  - Eighty-five per cent of 229 post-parturient women answered a questionnaire
      concerning the occurrence of symptoms in themselves and in their infants after
      discharge from two maternity wards up to the infant age of four months.
      Information about the treatment and drugs used was also requested. Although the
      level of maternal education differed between the two regions examined, the
      panorama of symptoms, the drug treatment, and the breastfeeding were reported
      mainly the same. Symptoms were common both in the mothers and in their infants.
      No symptoms were reported by six per cent of the mothers and for eight per cent
      of the infants. Many of the symptoms were not pharmacologically treated, but 70%
      of the mothers and 38% of the infants took one or more drugs besides vitamins.
      None of the drugs taken by the mothers was considered to have adverse effects on
      breastfeeding and none of the drugs given to the infants was considered to be
      ineligible.

PMID- 1754757
TI  - General practice characteristics and use of Pap-smear.

PMID- 1754758
TI  - Advances in lithotripsy.

PMID- 1754759
TI  - B&L technologies DP-1 lithotripter: the third generation.

PMID- 1754760
TI  - Direx Tripter X-1.

PMID- 1754761
TI  - Dornier MFL 5000 and compact lithotriptors.

PMID- 1754762
TI  - The MPL-9000.

PMID- 1754763
TI  - The Medstone STS: a technical review.
AB  - The Medstone STS does not require the urologist to compromise his lithotripsy
      success because of insufficient power, inadequate imaging, or restrictions caused
      by patient positioning. The attention to the details required for success in
      treatment in the investigators opinion make the Medstone STS a very attractive
      device for the performance of lithotripsy.

PMID- 1754764
TI  - The Northgate SD-3 dual-purpose lithotriptor.

PMID- 1754765
TI  - The Sonolith 3000.

PMID- 1754766
TI  - Extracorporeal shock wave lithotripsy with the Siemens Lithostar lithotriptor.

PMID- 1754767
TI  - Storz Modulith SL-20: the new optimal acoustic source for extracorporeal
      lithotripsy.

PMID- 1754768
TI  - Therasonics lithotripsy system.

PMID- 1754769
TI  - EDAP LT-01 piezoelectric lithotriptor.
AB  - This is a first-rate, well thought out lithotriptor. It is very user friendly.
      Although not as powerful as some of the earlier devices, it has the distinct
      advantage of not causing any tissue damage during treatment. The advantage is the
      ability to vary the delivery of the amount of power according to the needs of the
      situation. The learning curve for the operator is steep, and he/she very quickly
      becomes very proficient. Patience is needed with some stones to give enough
      shocks for total fragmentation, but that comes with experience. Balancing the
      ease of treatment against the occasional need for retreatment results in a
      definite bias for the patient being treated with this machine, and avoiding the
      reported problems attendant with spark gap equipment. This, in my opinion, is an
      excellent machine.

PMID- 1754770
TI  - Richard Wolf piezoelectric lithotripters: Piezolith 2300 and 2500.

PMID- 1754771
TI  - [Long-term venous access].
AB  - The authors summarize the technique of placement of long term venous access
      systems. The complications encountered are described. As an example, the
      experience of the Institut Jules Bordet in this field is presented.

PMID- 1754772
TI  - [Performance of routine Doppler studies for screening of the fetus in de uterus
      in the 3d trimester of pregnancy].
AB  - We did screening Doppler investigations of the foetus circulation during the
      third trimester of pregnancy, and established reference curves for Resistance and
      Pulsatility Indexes of the umbilical and middle cerebral as well as for the
      ratios of these indexes. We compared these indexes in groups of fetuses with
      different characteristics at birth. It turned out that low birth-weight, or the
      presence of dips in the fetal heart rate during labor is associated with some
      distinctive anomalies of the measured indexes compared with the control group
      with a normal birth-weight and no deceleration during labor.

PMID- 1754773
TI  - [Prevention of iatrogenic multiple pregnancies].
AB  - A significant increase of twin and multiple pregnancies induced by infertility
      treatment has been observed. These high-risk pregnancies should be efficiently
      prevented. Gonadotrophin treatment for anovulation being the main culprit, it
      should be undertaken: 1) if other induction methods have failed. 2) under strict
      echographic and hormonal monitoring. After in vitro fertilization, number of
      embryos replaced should be selectively limited (to 2 or 3) on the basis of their
      vitality scores. Partial reduction of a multiple pregnancy should remain an
      exceptional solution.

PMID- 1754774
TI  - [Prevention of complications of ovarian stimulation in in-vitro fertilization].
AB  - The ovarian hyperstimulation syndrome which is the most severe iatrogenic
      complication of ovulation induction, may range from mere abdominal discomfort to
      lethal thromboembolism. It is therefore, mandatory to be able to evaluate the
      risk of such complications. In in vitro fertilization treatment, maximal level
      and growth rate of oestradiol and also the number of oocytes retrieved, are
      significantly higher among patients who will develop an hyperstimulation syndrome
      than in a group of healthy controls. However, due to the large distribution of
      individual values, none of these variables can be predictive by itself. Only
      multiple discriminant analysis effected within the frame of a multicentric study
      might be able to define a specific and sensitive predictive function.

PMID- 1754775
TI  - [Chronic knee pain. Diagnosis: pigmented villonodular synovitis].

PMID- 1754776
TI  - [Hormonal treatment of advanced cancer of the prostate].

PMID- 1754777
TI  - [Example of team work between forensic medicine, odontology and entomology.
      Identification of human bones, dating of death and establishing the crime
      location].

PMID- 1754778
TI  - [Allergic thrombocytopenia due to nitrofurantoin].

PMID- 1754779
TI  - [Ex-situ hepatic resection].

PMID- 1754780
TI  - [Introduction to the world of color in medicine].

PMID- 1754781
TI  - [Poet-physicians in German literature].
AB  - Starting with standards arising from the relationship between medicine and art in
      classical antiquity, biblical tradition and teutonic-pagan antiquity, this
      article roams through german literature from the Middle Ages up to the 20th
      century, from Hildegard of Bingen to Gottfried Benn and Alfred Doblin, guided by
      the question, how strongly medical knowledge and medical practise are reflected
      in the poetry of writing physicians. Individual dispositions and epoque-specific
      features are discussed. Special attention is given to Paul Fleming and Angelus
      Silesius, Albrecht von Haller and Friedrich Schiller, romanticism and Georg
      Buchner.

PMID- 1754782
TI  - [Hildegard von Bingen: physician--mystic--poet].
AB  - Out of the multifaceted visionary writing of St. Hildegard from Bingen (1098
      1179) three aspects are selected and commented on: 1. The cosmologically oriented
      art of healing showing man in its original state (constitutio) its actual
      condition (destitutio) and the expected healthy final state (restitutio); 2. An
      universal vision oriented on mystic enligthment proposing the individual as
      creation (opus Dei), as partner (opus alterum per alterium) and as worker on
      nature (opus cum creatura); 3. The esthetic dimension of universal and human
      perception as expressed by Hildegards songs (carmina) which culminate in hymns on
      the "celestrial Jerusalem". We should consider, that these aspects--beyond their
      historic roots--indicate ways for healing and salvation of the integral
      individual.

PMID- 1754783
TI  - [Midlife crisis: crisis in the middle of life].
AB  - Since ancient times man tried to understand the roots of his obviously often
      irrational behaviour. According to the prevailing "Zeitgeist", hypotheses for it
      ranged from demonical possession, psychological schools of thought to the role of
      transmitter substances at the synaptic level. For ages it has been observed and
      described, that men goes in his development through typical and predictable
      phases with their typical crises. Poets knew and wrote about it since the dawn of
      culture but science got interested in it only in this century. Elliot coined the
      term "midlife crisis" in 1965, turning attention to an age-group which was before
      practically ignored by psychology. He pointed out that due to a collision between
      developmental factors and a static identity a crisis occurred in human beings,
      characterized by a feeling of despair, goallessness, fatigue and consciousness of
      significant basic anxiety. In response to such pressures a change of comportment
      takes place which puzzles the people closest to the stricken. Established
      patterns of behaviour seem to dissipate in favour of unusual, unexpected,
      adolescent or even crazy actions. Many examples from history, ranging from Dante
      to Gauguin seem to prove the point. Realizing the presence of the crisis and its
      origin and interpreting it as a call for change, reorientation and new definition
      of priorities present a great chance to adjust one's life at this important turn.
      It is of great importance to recognize, that changes must take place in one's
      inner values and that trying to escape into frenzied activities leads
      nowhere.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754784
TI  - [Paracelsus at the horizon of medicine].
AB  - After a brief review of the life and work of Paracelsus (1493-1541) the five
      spheres of existence of the healthy as well as the sick individual are
      characterized (theory of the 5 entities). Founding on this theoretical
      orientation of existence Paracelsus constructs his "house of medicine" which is
      resting on 4 pillars: on "Philosophia" as natural and human science, on
      "Astronomia" as structured chronologic order, on "Alchimia" as science of the
      preparation of materials and on "Physica" providing the ethical prerequisite for
      medical practise. Paracelsus believes the physician to represent an educated
      expert applying standards to the other faculties as well; in his eyes medicine
      represents the "cornerstone of university".

PMID- 1754785
TI  - [Medical ethos of Paracelsus].
AB  - 450 years ago the Renaissance doctor Theophrastus von Hohenheim called Paracelsus
      (1493-1541) died. Inspite of a famous name and his renowned challenging nature,
      his way of thinking and his work remain in many parts unknown. His professional
      ethics revolve around mercy, charity and his passion for medical art. In his book
      'Paragranum' he waves the ethics as a virtue into his succint concept of a 'new
      topical and veritable medical science'. It is the aim to show the Paracelsian
      professional ethics in its timeless fundamentals, as in its very personal
      character.

PMID- 1754786
TI  - Perioperative antibiotic prophylaxis of wound and foreign body infections:
      microbial factors affecting efficacy.
AB  - Numerous microbial factors are responsible for perioperative infections and
      influence the efficacy of antibiotic prophylaxis. These factors include the
      staphylococcal carrier state, bacterial adherence to a number of host proteins,
      the production of glycocalyx by sessile bacteria, and shifts in antibiotic
      resistance. A full understanding of the mechanisms involved will lead to further
      reductions in the number of postoperative infections. Unfortunately, the
      microbial factors affecting prophylaxis cannot be evaluated separately under
      clinical conditions; they are easier to study under circumstances whose
      bacteriologic features are well defined and in which the presence of foreign
      materials (e.g., sutures) greatly potentiates pathogenic mechanisms. Such
      circumstances exist, for example, in infections developing after "clean" surgery
      and in experimental models. Since even clean wounds are found to be contaminated
      when sampled carefully, the control of infection is more a quantitative than a
      qualitative problem. The critical period for the development of infection is
      short: an antibiotic course not exceeding 24 hours seems effective in preventing
      infection.

PMID- 1754787
TI  - Role of antimicrobial pharmacokinetics and pharmacodynamics in surgical
      prophylaxis.
AB  - The pharmacokinetic and pharmacodynamic properties of antimicrobial agents used
      for surgical prophylaxis are reviewed. Since levels in tissue homogenates depend
      on the amount of drug present intracellularly, they do not accurately describe
      the relation between concentrations in serum and those in interstitial fluid.
      Levels of free drug in serum are good predictors of the time course of
      concentrations of unbound drug in interstitial fluid. An increase in protein
      binding does not reduce the area under the curve (AUC) of free drug for beta
      lactam agents eliminated predominantly by glomerular filtration. Pharmacodynamic
      studies of persistent growth suppression and bactericidal activity predict that
      the period for which the free-drug concentration exceeds the minimal inhibitory
      concentration (MIC) is an important parameter in the efficacy of beta-lactam
      antibiotics. In contrast, the AUC is the major parameter in the efficacy of
      aminoglycosides and quinolones. Although studies with animals support the above
      concepts, data for humans are limited. Until additional clinical trials dictate
      other conclusions, the goal of prophylaxis with beta-lactam agents should be to
      provide serum levels of free drug above the MIC for common contaminating bacteria
      for the entire surgical period.

PMID- 1754788
TI  - Role of the environment of the operating suite in surgical wound infection.
AB  - Most surgical wound infections are acquired in the operating room from the
      patient's own microbial flora. The remainder are acquired mainly from the staff
      in the operating room during surgery. The inanimate environment (e.g., walls,
      floors, and surgical instruments) has little relevance to the spread of
      infection. Because the air is an important route of spread in joint prosthesis
      operations, the routine use of an ultraclean air system and exhaust-ventilated
      clothing is frequently recommended. The value of such a system in other types of
      clean surgery is doubtful, but other measures, such as the following, may provide
      similar results at less cost: reduction of the number of persons in the operating
      room; a policy of not opening doors during operations; the use of comfortable,
      washable, bacteria-impermeable clothing by the operating-room staff; and
      concentration of the airflow over the operation site rather than over the whole
      operating room.

PMID- 1754789
TI  - Alteration of cutaneous staphylococcal flora as a consequence of antimicrobial
      prophylaxis.
AB  - Antimicrobial agents given as prophylaxis have profound effects on the microbial
      flora of the skin. Coagulase-negative staphylococci cultured from the skin of
      patients after cardiac surgery have been found to be more resistant to
      antimicrobial drugs than organisms cultured from the same skin sites
      preoperatively. Evidence exists both for the selection of resistant organisms
      from the preoperative flora and for the postoperative acquisition of such
      organisms from the nosocomial environment. Staphylococci causing postoperative
      infections have the same antimicrobial resistance phenotypes as do colonizing
      isolates; this observation suggests that colonized patients and hospital staff
      make up a nosocomial reservoir for resistant organisms.

PMID- 1754790
TI  - Methodologic aspects of clinical studies of perioperative antibiotic prophylaxis.
AB  - Many issues affect the design, conduct, and analysis of clinical evaluations of
      perioperative antibiotic prophylaxis. The most important of these are the
      selection of appropriate procedures for evaluation, the choice of meaningful
      outcomes, the comparison of outcomes among groups of patients who are really
      comparable to one another, the unbiased assessment of outcomes, the assessment of
      a number of patients sufficient to provide adequate statistical power for the
      detection of meaningful differences, and the generalizing of results. In
      evaluating perioperative prophylaxis, investigators often strive to identify
      small absolute differences among the risks of infections with different
      prophylactic regimens. For many specific procedures and drug regimens, such
      evaluations are limited by the difficulty of studying a sufficient number of
      individuals. Although randomized clinical trials are the standard for clinical
      evaluation, observational data may also prove useful under some circumstances.

PMID- 1754791
TI  - Antimicrobial prophylaxis for appendectomy and colorectal surgery.
AB  - Current opinion favors the use of antimicrobial prophylaxis in all operations for
      acute appendicitis. In clinical trials with placebo controls, the reduction in
      the rate of postoperative infectious complications is most apparent in perforated
      and/or gangrenous appendicitis, but benefits are also seen in nonperforated
      appendicitis and even in those with a normal appendix. In elective colorectal
      operations, it has been established that all patients should receive prophylactic
      antibiotics. The choices are an oral bowel preparation consisting of neomycin or
      kanamycin combined with erythromycin or metronidazole; a parenteral antimicrobial
      drug such as cefoxitin or cefotetan; or a combined oral/parenteral regimen. Risk
      factors for postoperative wound infection include a prolonged duration of surgery
      (greater than 3.5 hours) and rectal resection. The most popular prophylactic
      regimen employed by American surgeons, particularly in the presence of adverse
      risk factors, is oral neomycin/erythromycin along with a short course (one to
      three doses) of a systemic cephalosporin active against anaerobes.

PMID- 1754792
TI  - Prophylactic antibiotics in gynecologic and obstetric surgery.
AB  - Preventing infections at operative sites has long been a goal of gynecologic and
      obstetric surgeons. These infections constitute the leading cause of morbidity
      after both elective and emergent surgical procedures. Serious sequelae such as
      bacteremia, septic shock, phlegmon, pelvic abscess, septic pelvic
      thrombophlebitis, wound abscess, and fascial dehiscence may complicate primary
      infections, with devastating results. Early attempts to prevent postoperative
      infections concentrated on aseptic techniques and the modification of surgical
      skills. Soon after the introduction of antibiotics into clinical medicine,
      surgeons began to administer these drugs to clinically uninfected women to
      prevent operative-site infection; that practice has been documented and assessed
      in a large volume of literature. This article reviews the chronologic development
      of prospective data in the areas of benign gynecology, obstetrics, gynecologic
      oncology, and infertility and makes recommendations regarding antibiotic
      prophylaxis of infections associated with surgical procedures.

PMID- 1754793
TI  - Antibiotic prophylaxis in orthopedic surgery.
AB  - This review covers four areas: the use of prophylactic antibiotics in orthopedic
      surgery not involving prosthetic devices; the use of prophylactic antibiotics in
      prosthetic joint implantation; the use of antibiotic-containing cement in
      prosthetic joint surgery; and the use of prophylactic antibiotics for dental
      procedures in individuals with implanted prosthetic joints. The major conclusions
      are as follows: (1) Prophylactic antimicrobial agents lower the rate of wound
      infection following surgery for closed hip fractures. (2) Antimicrobial
      prophylaxis reduces the frequency of deep wound infection following total joint
      replacement; operating rooms with ultraclean air have a similar effect. (3)
      Antibiotic-impregnated cement is as effective as systemic antibiotics in
      preventing early infection following total joint replacement. (4) For routine
      dental work in most patients with total joint replacement, there is insufficient
      evidence to support antibiotic prophylaxis; for such individuals with periodontal
      disease or potential dental infection, antimicrobial prophylaxis seems indicated.

PMID- 1754794
TI  - Antibiotic prophylaxis in trauma: penetrating abdominal injuries and open
      fractures.
AB  - Infection is an important cause of late morbidity and mortality following
      traumatic injury. As part of a coordinated treatment effort for the injured
      patient, preventive antibiotic use can reduce subsequent infectious
      complications. Available evidence supports the use of antibiotic(s) with activity
      against both aerobic and anaerobic enteric pathogens for patients with
      penetrating abdominal injuries and bowel penetration. Patients with open
      fractures benefit from the use of an antibiotic with activity against
      Staphylococcus aureus. Data on the ideal dose and duration of antibiotic
      administration in these situations are incomplete. It is likely that the best
      results will be obtained with early parenteral administration of large doses of
      the chosen antibiotic continuing for less than or equal to 24 hours. For injuries
      other than penetrating abdominal wounds and open fractures, definitive
      information is not available.

PMID- 1754795
TI  - Prophylaxis in otolaryngologic surgery and neurosurgery: a critical review.
AB  - In an assessment of prospective, controlled studies of antimicrobial prophylaxis
      against infections following otolaryngologic surgery and neurosurgery, the
      English-language literature on this topic was reviewed. Rates of infection
      following clean otolaryngologic operations are the same for patients receiving
      prophylaxis and those receiving placebo. For patients with head and neck cancer,
      rates of postoperative infection without antibiotic prophylaxis in clean surgery
      are less than 1%, and prophylaxis is not indicated; in contrast, in clean
      contaminated procedures (infection rate, 18%-87%), prophylaxis is highly
      protective, although several studies have shown no advantage to its prolongation
      beyond 24 hours. For the latter operations, drugs with adequate activity against
      oral anaerobes are essential, whereas the need for coverage against
      Enterobacteriaceae is doubtful. In clean and clean-contaminated neurosurgical
      procedures, the rate of protective efficacy of prophylaxis ranges between 63% and
      76%. For shunt operations the available evidence favors prophylaxis, but the wide
      range of infections reported mandates a large-scale multicenter trial to decide
      the issue.

PMID- 1754796
TI  - Antibiotic prophylaxis in clean surgery: peripheral vascular surgery,
      noncardiovascular thoracic surgery, herniorrhaphy, and mastectomy.
AB  - Studies published in the English-language literature on the use of prophylactic
      systemic antibiotics in vascular surgery, noncardiovascular thoracic surgery,
      mastectomy, and herniorrhaphy were reviewed. The effectiveness of antibiotic
      prophylaxis in preventing deep and superficial wound infections in peripheral
      vascular surgery appears to be well documented, especially if prophylaxis is
      directed against Staphylococcus aureus. In clean thoracic surgery the evidence is
      equivocal, and no studies have sufficient statistical power to eliminate the
      possibility even of a 50% reduction in incidence. In herniorrhaphy and mastectomy
      some evidence from a much more powerful study suggests that antibiotic
      prophylaxis may result in a decrease of up to 50% in wound infections, but
      whether these data can be generalized uncritically to all clean wounds is still a
      matter of debate. Accordingly, only guarded recommendations can be made regarding
      the use of prophylactic antibiotics in procedures associated with a very low risk
      of serious infection.

PMID- 1754797
TI  - Perioperative antimicrobial prophylaxis in middle Tennessee, 1989-1990.
AB  - The patterns of use of perioperative antimicrobial prophylaxis were assessed in a
      randomly selected sample of short-stay hospitals in middle Tennessee. Overall,
      438 procedures (48%) were associated with antimicrobial prophylaxis. Prophylaxis
      was more common in hospitals with more than 400 beds than in smaller hospitals.
      Moreover, prophylactic antibiotics were given more often for procedures with a
      proven indication for prophylaxis than for those without a proven indication (60%
      vs. 41%, P less than .05); this relationship remained constant regardless of
      hospital size (common odds ratio, 2.09). However, prophylaxis for procedures with
      a proven indication was more likely to be given in teaching hospitals than in
      nonteaching hospitals (odds ratios, 5.41 vs. 1.94). The duration of prophylaxis
      was less than 2 days for 89% of procedures. A wide variety of agents were used.
      This study suggests that while improvements have been made over the past decade
      in decisions about the duration of prophylaxis, considerable variation remains in
      the selection of the procedures in which such treatment is administered and of
      the antimicrobial agents used.

PMID- 1754798
TI  - Cost and benefit of perioperative antimicrobial prophylaxis: methods for economic
      analysis.
AB  - Cost-benefit analysis of perioperative prophylaxis with antimicrobial agents
      involves efforts in two main areas: first, economic aspects of a decision whether
      or not to use prophylaxis are examined; and second, the financial benefit of a
      drug or regimen is compared with that of the currently used drug or regimen. Both
      cost and benefit have a number of components, both direct and indirect; methods
      are available for the analysis of some of these components. Systematic economic
      analysis permits evaluation of the relative importance and magnitude of the
      various elements of cost and benefit. Often the analysis shows that information
      about one or more elements is not worth collecting because it will have minor or
      no impact. Failure to clearly identify the viewpoints of persons interpreting the
      data hinders analysis; systematic economic analysis makes these differences in
      viewpoint clearer. Convincing economic data in favor of prophylaxis exist for
      some operative procedures; hospitals should insist that these regimens be
      implemented. Surgical wound infection is the only type of nosocomial infection
      for which a consistent drop in rate of occurrence has been seen during the past
      decade. This drop undoubtedly is related in part to the perioperative use of
      antimicrobial agents. Perhaps these results constitute the best cost-benefit
      assessment of all.

PMID- 1754799
TI  - The path to new FDA guidelines for clinical evaluation of anti-infective drugs.
AB  - This article describes the current collaborative effort of the U.S. Food and Drug
      Administration and the Infectious Diseases Society of America to generate new
      general and disease/organism-specific guidelines for the evaluation of anti
      infective agents. The description includes examples of proposed changes from
      draft documents. If approved and implemented, the envisioned changes should
      enable investigators and sponsors to improve the quality of clinical trials of
      anti-infective drugs. The ultimate goal is to provide physicians with the best
      information about new drugs and thus to enhance the care of patients with
      infectious diseases.

PMID- 1754800
TI  - Biochemical events controlling initiation and propagation of the S phase of the
      cell cycle.

PMID- 1754801
TI  - Synergism in the control of force and movement of the forearm.

PMID- 1754802
TI  - [Results of assays of estrogen, progesterone and androgen receptors in stage I
      and II adenocarcinoma of the endometrium].
AB  - The prognosis for adenocarcinoma of the endometrium is dependent on the findings
      of the histopathological assessment of the tumor. In a retrospective study of
      patients treated in initially by surgery, the estrogen and progesterone receptors
      were assayed 89 times and the androgen receptors 64 times. No statistically
      significant correlation was found between any of these receptors and the degree
      of structural differentiation or degree of infiltration of the myometrium. The
      absence of any one of these receptors had no negative impact on the overall
      survival nor on recurrence-free survival. The same was true for the 9 tumors
      which were devoid of both estrogen and progesterone receptors. In the authors'
      experience, the results of these hormone assays did not provide any further
      information on which to base the prognosis of endometrial cancers.

PMID- 1754803
TI  - [Indications for bilateral ligation of the uterine arteries and the hypogastric
      arteries in refractory obstetrical hemorrhages].
AB  - The author describes the various indications for obstetric hemostatic vascular
      ligations accepted today by specialists. In serious post-partum uterine
      hemorrhage due to pathology of contraction and or retraction of the uterus,
      hemorrhage refractory to classical conservative treatment, specialists use either
      bilateral ligation of the uterine arteries at the site of their ascending
      branches, or bilateral ligation of the anterior branch of the internal iliac
      artery (BLILA), sometimes thus avoiding hemostatic hysterectomy. However
      hemostatic vascular ligations may be attempted only rarely, in particular when
      hemostasis procedures follow one after the other in the absence of an immediate
      threat to the mother's life. Prophylactic BLILA may be performed immediately
      after hemostatic hysterectomy (as a complement before closing the abdominal
      wall). It thus guarantees hemostasis and avoids the possibility of reoperation to
      achieve hemostasis, which could be fatal. BLILA performed at the postoperative
      (posthysterectomy) stage, during hemostatic reoperation, is of a curative nature
      and is effective only when hemorrhage is coming from a branch of the internal
      iliac artery. In severe post-partum hemorrhage coming from the peri-uterine
      regions supplied by the internal iliac arteries, only BLILA may be useful when
      local surgical hemostasis is ineffective or impossible.

PMID- 1754804
TI  - [Therapeutic termination of pregnancy. Diagnosis and protocols. 54 cases].
AB  - The authors present 54 cases histories of therapeutic terminations of pregnancy.
      The mean age of the patients was 28.6 years at the time of diagnosis with the
      following in indications for the antenatal diagnosis in order of decreasing
      frequency: clinical history, age of the mother, seropositive for toxoplasmosis or
      rubella, a high fetal alpha protein level and ultrasound signs. They highlight
      the usefulness of ultrasound in reaching a decision as to whether pregnancy
      should be terminated (as it was in 25 cases out of 49) and the predominance of
      diagnoses of karyotype abnormalities. They also compare the various prostaglandin
      s used in this study (analogs of PGE1 and PGE2, diniprost). Their results, in
      accordance with the literature were good for gemeprost and sulprostone with
      expulsion in 29 out of 32 cases within 24 hours and in 9 cases out of 11 within
      20 hours respectively.

PMID- 1754805
TI  - [Eclampsia at the Hospital Center of Libreville. 53 cases among 41,285 deliveries
      from 1985 to 1989].
AB  - Eclampsia is a serious complication at the end of pregnancy. This retrospective
      study over a 5-year period at the Libreville CHU hospital shows that the
      incidence of 0.12 p. cent is comparable to the incidence fond in other countries
      at a similar level of development. Promoting causes include youth of the
      patients, twin births, the "cold" season, the lack of follow-up after prenatal
      consultations. The consequences are increased maternal and perinatal death.
      Cesarean section remains the best way of dealing with an attack of eclampsia and
      improves both maternal and fetal prognosis. It is possible to eliminate, or at
      least reduce, the number of cases by developing conscientious and regular
      prenatal consultations.

PMID- 1754806
TI  - [Profile of referred pregnancies from the Tunisian Sahel].
AB  - Investigation of the referral system for pregnancies from peripheral maternity
      units to the Maternity clinical of the main teaching hospital (CHU) in the region
      of Monastir has shown that one in five pregnancies is referred. The referred
      pregnancies account for 30 percent of the obstetrical activity of the CHU and
      reveal a high risk sociodemographic profile. The outcome of pregnancy is
      generally less good than that of non-referred cases. Evaluation of the referral
      system has shown that some of the cases did not require referral. The
      effectiveness of this system can be improved by used a grid to refer high-risk
      pregnancies.

PMID- 1754807
TI  - [Late abdominal pregnancy. A case report].
AB  - A case of 29 weeks gestation abdominal pregnancy is reported as an illustration
      to a study of that rare gestation mostly occurring in developing countries. Most
      abdominal pregnancies are secondary. The most common clinical signs are the
      abdominal pain and uncomfort. The physical signs arise the suspicion of abdominal
      pregnancy which is confirmed by ultrasound. Most authors don't delay the surgical
      procedure after the diagnosis. The placenta is mostly often left in situ and
      mostly. No methotrexate is administered to improve the placenta involution. The
      abdominal pregnancy is of very bad fetal prognosis and very at risk for the
      pregnant woman.

PMID- 1754808
TI  - [Benckiser hemorrhage with a living fetus].

PMID- 1754809
TI  - [Computer-assisted model of weight gain during pregnancy].
AB  - The goal of this study was to modelize the evolution of "ideal" weight gain
      during pregnancy and to generate automatically the appropriate diet. This
      computerized model has been developed on a microcomputer and has two units: the
      first unit calculates the "ideal" weight gain during pregnancy, based on the
      curves of Rosso which show that weight gain is not linear with term and depends
      of the prepregnancy weight. The second unit calculates the appropriate diet which
      is depending for the first visit on height, prepregnancy weight and weight gain
      and for the followed visits on weight gain and the diet situation of the previous
      visit. The next step will be the medical evaluation of this computer-aided
      modelization of weight gain during pregnancy.

PMID- 1754811
TI  - Antinuclear antibodies to RNA-binding proteins in SLE.
AB  - The presence of autoantibodies is a prominent feature of connective tissue
      disease (CTD). At first glance there is a wide range of antibody specificities,
      but in the individual patient the autoantibody profile is much more restricted.
      Thus, certain antinuclear antibodies are not only strongly associated with
      disease expression, but also identify distinctive serological subsets within the
      spectrum of CTD. In turn, these subsets are associated with particular patterns
      of disease expression. With increasing knowledge of the molecular nature of the
      autoantigen targets, the relationship between fine specificity of the antibody
      response and disease manifestations is being further defined.

PMID- 1754810
TI  - Anti-dsDNA: choice of assay in relation to clinical value.
AB  - Antibodies to DNA are quite specific for systemic lupus erythematosus (SLE) and
      occur in the majority of SLE patients. Therefore, their detection is an important
      diagnostic aid to the clinician. Detection of anti-dsDNA may precede the
      diagnosis of SLE by more than a year. Fluctuations in the level of anti-dsDNA in
      an individual patient may give important information on the clinical status of
      the patient. Four of the most important methods developed for the measurement of
      anti-dsDNA antibodies will be discussed in this paper: the Farr assay, the PEG
      assay, the indirect immunofluorescence test on Crithidia luciliae and the ELISA.
      They will also be compared with one commercially available (Farr) assay, the
      Amersham anti-dsDNA kit. Each method, detects a part of the spectrum of anti
      dsDNA antibodies produced by a patient. The Farr assay is the most specific for
      SLE; however, milder forms of the disease in which patients have only low avidity
      anti-dsDNA may easily be missed by this technique. Clinically, high avidity anti
      dsDNA is related more frequently to the occurrence of nephritis, whereas low
      avidity anti-dsDNA antibodies are found more often in patients with central
      nervous system involvement. Traditionally, SLE is considered an immune-complex
      disease, in which inflammatory processes are initiated by local deposition of
      DNA/anti-dsDNA complexes. More recently, a major role was thought to be played by
      crossreactions of anti-dsDNA with tissue constituents. Our current view, however,
      is that such a crossreactivity plays only a minor role; we postulate that binding
      to glomerular constituents is caused by anti-dsDNA antibodies complexed with DNA
      and histones.

PMID- 1754812
TI  - Kidney disease in systemic lupus erythematosus.
AB  - Glomerulonephritis is a major determinant of outcome in patients with systemic
      lupus erythematosus. Persistently active lupus nephritis imposes serious threats
      of end-stage renal failure and cardiovascular morbidity. Sustained corticosteroid
      treatment has been characterized as having an uncertain net benefit on the
      control of lupus nephritis, mainly because these drugs have relatively weak
      efficacy and they have been shown to confer their own set of cardiovascular risk
      factors. Controlled trials of corticosteroids, azathioprine and cyclophosphamide
      have demonstrated that the best control of clinical activity of proliferative
      lupus nephritis is attained with cyclophosphamide. To date, intermittent pulse
      cyclophosphamide treatment has produced the most favorable balance of efficacy
      and toxicity in patients with lupus nephritis.

PMID- 1754813
TI  - The central nervous system in systemic lupus erythematosus.
AB  - Management of central nervous system (CNS) involvement is one of the most
      challenging problems in systemic lupus erythematosus. This article reviews the
      spectrum of CNS manifestations present in this disease, their diagnosis and
      pathogenesis, as well as an approach to their treatment and prognostic
      implications.

PMID- 1754814
TI  - Systemic lupus erythematosus and pregnancy.
AB  - This article critically analyses the data in the literature on pregnancy in women
      with systemic lupus erythematosus. Based on the results of recent controlled
      prospective studies, it is apparent that the long-standing opinion that pregnancy
      induces exacerbation of the disease should be revised. The presence of active
      disease and/or a significant loss of renal function at conception are not only
      associated with a high risk of maternal complications, but also with high
      frequencies of loss of the fetus, as well as pre- and dysmaturity. Recently, the
      presence of antiphospholipid antibodies, notably the lupus anticoagulant and
      anticardiolipin antibodies, has been recognized as being important for the
      occurrence of death of the fetus, in particular, late in the pregnancy. This is
      probably due to thrombosis occurring in the placental vessels. However, the
      results of randomized studies on treatment with antithrombotic drugs and/or
      procedures lowering, antibody levels must be available before we will know
      whether the presence of these antibodies should be coupled to specific
      instructions or not. Although there is a strong association between the neonatal
      lupus syndrome and the presence of anti-SSA antibodies in maternal blood, the
      finding of anti-SSA antibodies has up to now had no therapeutic implications. It
      is concluded that pregnancy in SLE deserves extensive preconceptional counseling
      and close cooperation between the internist, rheumatologist, obstetrician and the
      neonatologist.

PMID- 1754815
TI  - Prognostic factors in systemic lupus erythematosus.
AB  - In the past 40 years an impressive improvement in the prognosis of SLE patients
      has occurred. Factors which might be responsible for this improvement are
      discussed. Two of the factors most frequently cited are the advances in disease
      recognition and treatment. However, as already noted by Albert (1979) this is
      questionable, as average disease duration and survival have increased in a linear
      fashion related to the number of publications devoted to this subject from 1950
      on. Further evaluation of the literature shows that the most prominent factors
      which have an impact on the survival rate are specific disease manifestations
      (lupus nephritis) and the overall disease course (number of exacerbations). This
      effect of morbidity on the survival rate is greater than that of factors such as
      sex and race. Socio-economic factors or age at onset have no effect on the
      outcome.

PMID- 1754816
TI  - Quantitative clinical assessment of disease activity in systemic lupus
      erythematosus: progress report and research agenda.
AB  - No single test allows an adequate measure of disease activity in multisystem
      diseases such as systemic lupus erythematosus (SLE). In order to evaluate the
      spectrum of manifestations of disease activity in SLE, investigators have
      developed numerous ad hoc scales which have not been tested for their validity or
      reliability. Three instruments have been extensively studied: the British Isles
      Lupus Activity Group instrument (BILAG), the SLE Disease Activity Index (SLEDAI),
      and the Systemic Lupus Activity Measure (SLAM). All three have been demonstrated
      to have convergent and construct validity when compared to the clinician's
      judgement. The summation of the number of criteria of the American Rheumatism
      Association (ARA) SLE criteria has been shown to be an inadequate measure of
      disease activity. Standardized measures of disease activity for SLE should
      enhance our ability to compare results from different centers in finer
      distinctions than dead or alive.

PMID- 1754817
TI  - Treatment of systemic lupus erythematosus: which options do we have for therapy
      regimens?
AB  - The prognosis of systemic lupus erythematosus has improved markedly. This has
      been due to various factors: improved serological testing leading to better
      diagnosis, better understanding of secondary complications, and the possibility
      of treating these. How much has improved treatment of the primary disease process
      contributed to the improvement in prognosis? We have evaluated the clinical
      outcome of 56 patients with lupus nephritis proven by biopsy, followed at out
      hospital over the past 16 years. During this period various therapies were used
      during active periods of the disease, based on literature data or participation
      in trials. Prognostic risk factors for the development of end stage renal disease
      (ESRD) appeared to be: WHO-class IV histopathology of the renal biopsies, male
      sex and raised serum creatinine. Development of ESRD at 5 years was 13% and at 10
      years was 30%. Overall survival was 95%. Based on data from well controlled
      trials performed at the National Institute of Health (US) and our observations
      the need for well conducted long-term prospective randomized trials is stressed
      again.

PMID- 1754818
TI  - Pathogenic anti-DNA idiotype (16/6 Id) in systemic lupus erythematosus.
AB  - Systemic lupus erythematosus (SLE) is regarded as a classical autoimmune disease.
      Despite this belief, no one has been able to induce the disease in naive animals,
      neither with DNA nor with anti-DNA antibodies. We report on the induction of SLE
      in BALB/c mice following immunization with a pathogenic anti-DNA idiotype (16/6
      Id) or its anti-Id. We also report on a specific treatment with T suppressor
      cells specific for the 16/6 Id. The induction of SLE in naive mice with a
      pathogenic anti-DNA Id suggests an additional mechanism for the diversity of
      manifestations in this disease.

PMID- 1754820
TI  - [Uniform requirements for manuscripts sent to medical journals].

PMID- 1754821
TI  - [Rhino-bronchial syndrome: new diagnostic approach].
AB  - The studies in relation to rhino-bronchial syndrome are very few. That's true
      because of the diagnosis and treatment of the specimens is not made in a
      randomized way. And because of the many different etiology. In this paper two
      hundred and thirty files were studied within the diagnosis of RBS among patients
      consulting in the Pediatric Allergy Service in 1989. The results show that this
      process is multifactorial: allergic 72%, infections 23% and functional (gastric
      reflux) in 4%. There was improvement with specific treatment with immunotherapy
      and general measurements in 82%. Since fourth month of treatment.

PMID- 1754819
TI  - Pathogenesis of SLE: immunopathology in man.
AB  - Antibodies against native DNA are not only a disease-specific marker for systemic
      lupus erythematosus (SLE); in addition, there is good direct evidence that these
      antibodies also play a major part in pathogenic mechanisms leading to systemic
      and organ-specific disease manifestations. The origin of anti-dsDNA antibodies is
      still poorly understood, especially as dsDNA per se is not immunogenic. As
      recently shown, evidence is now accumulating that anti-dsDNA antibodies are not
      germline-encoded but antigen-driven, as demonstrated by the establishment of
      human anti-dsDNA antibody clones from SLE patients and sequence analysis. In sera
      of SLE patients there is an elevated level of nucleic acids, which indicates that
      defective clearance mechanisms for nucleic acids are present. The question as to
      whether these nucleic acids could serve as an antigen has been recently addressed
      by studies of plasma nucleic acids isolated from circulating immune complexes
      from SLE patients. These studies indicate that plasma nucleic acids in SLE
      patients have structures of amino acid sequences which have a striking homology
      with the gag-pol overlap region of HIV-1. Whether these nucleic acids play a role
      in the pathogenesis of SLE, indicating the involvement of a retrovirus in the
      pathogenesis, or whether they rather reflect an amino acid homology with an
      endogenous human retrovirus family is not yet known.

PMID- 1754822
TI  - [Correlation of the degree of bronchial hyperreactivity and the intensity and
      onset of symptoms in asthmatic children].
AB  - We studied 51 children with stable bronchial asthma, we did a challenge with
      methacholine in different dilution until we found their PD20. Once we have it, we
      correlate this results with the age of onset of asthma and the severity of the
      symptoms. The results shows that if the symptoms start early in the life had more
      severe asthma and the PD20 is lower, this means that they have more
      hyperreactivity. Our results are similar to those found in the literature.

PMID- 1754823
TI  - [Characterization of the desmoglein in renal cells in culture].
AB  - Desmosome junctions are found in epithelial tissues. They both link cells
      externally and anchor cytoplasmic intermediate filaments to the plasma membrane.
      Quantitative and qualitative abnormalities in intercellular junctions have been
      described in a broad spectrum of human and animal cancers. Current efforts are
      aimed at exploring the possibility that some of these defects may account for the
      hallmarks of malignancy, namely tumour invasion and metastasis. Desmosomes are
      constituted by several proteins, one of them is desmoglein-1 (DG-1), a
      transmembrane glycoprotein who glycosylated portion is major component of the
      adhesion mediating desmoglia. In order to know the similarity between tissue DG-1
      and cultured renal cells DG-1 was used antisera raised against DG-1 to identify
      cross-reacting components. Anti DG-1 antibodies stained cell-cell boundaries in a
      punctate fashion in epithelial tissue and on densely grown monolayers of renal
      cells. Radioimmunoprecipitation and immunoelectrotransference show positive
      reaction with anti DG-1 antibodies with desmosomes obtained from epithelial
      tissue and renal cells monolayers, but last one was less positive. Results
      suggest some minor differences between DG-1 extracted from diverse sources but
      they have a commun immunodominant epitope.

PMID- 1754824
TI  - [Influence of occupational lead exposure on the concentration of immunoglobins
      and immune cellular functions in humans].
AB  - The evaluation of immunological conditions of 14 workers occupationally exposed
      to lead, and the comparison of these results with those of a non-exposed control
      group, with similar age and sex, were the aims of this study. It was determined
      the mean values of lead in blood. In exposed workers it was 46.9 micrograms/dl;
      while in the control group it was 10.9 micrograms/dl. Levels of immunoglobulin
      decreasing while increasing lead concentration in blood were found in those
      exposed. It was also found a significant lessening in the formation of rosette in
      relation to the control group.

PMID- 1754825
TI  - [Changes in the configuration of synapses in the cerebral cortex in laboratory
      rats after termination of epileptic seizures during kindling].
AB  - The sensorimotor area of the cerebral cortex of the laboratory rat was repeatedly
      stimulated by electric current after 10-minute intervals which led to the
      development a gradual prolongation of self-sustained after-discharges (SSAD). One
      and 10 minutes after termination of the third SSAD the authors analyzed under the
      electron microscope synapses type I after to Gray from the second cortical
      homotopic area of the unstimulated hemisphere. They evaluated the curvature of
      the active zone of synapses. Evidence was provided that one minute after
      termination of the fit the number of negatively curved synapses increased and the
      number of synapses with a straight active zone decreased. The number of synapses
      with a positively curved active zone does not change. Ten minutes after
      termination of SSAD in the experimental animals the number of positively curved
      elements declines and the number of negatively curved synapses increases. There
      is no significant difference in the number of synapses with a straight active
      zone. The authors discuss possible functional consequences of the mentioned
      changes.

PMID- 1754826
TI  - [Presynaptic terminals in the sensorimotor area of the cerebral cortex in old
      laboratory rats].
AB  - In male laboratory rats, Wistar strain, 2 and a half years old, quantitative
      morphometric analysis of synapses (type I after to Gray) from the second layer of
      the sensorimotor area of the neocortical region was performed. Evidence was
      provided of enlargement of the area of presynaptic formations, their
      circumference and of prolongation of the active zone of the synapse. The absolute
      number of agranular synaptic vesicles does not change, however, the number of
      vesicles per area unit declines (1 micron 2). This change was proved in all
      regions of the presynaptic ending. The enlargement of the area of synaptic
      endings is discussed in relation to possible shifts of water and electrolytes
      between the extracellular and intracellular space as a result of ageing of
      nervous tissue. The authors discuss also the passive change caused by a decrease
      of neuropil structures and narrowing of the extracellular space. The relative
      decline of the number of synaptic vesicles in the entire synapse and thus in the
      vicinity of the active zone is taken to be the morphological basis of a certain
      restriction of synaptic transmission in the sensorimotor area of the cortex in
      old age.

PMID- 1754827
TI  - [Proposal for a classification system for phagocytosis disorders].
AB  - The presented classification is based on the modern view to the process of
      phagocytosis as evenements involving ligand-receptor interaction, transmission of
      signal through second messenger systems and activation of effector mechanisms
      leading to the specific cell behavior. According proposed classification, the
      phagocytic disorders are divided into extracellular disorders which are caused by
      abnormalities affecting ligands, and cellular disorders caused by pathological
      process affecting the phagocytic cell. These cellular disorders are subdivided
      into the defects of membrane receptors, the defects of enzymatic equipment and of
      subcellular structures. Laboratory investigation of phagocytic cells using
      several tests make possible to classify inborn, acquired, permanent as well as
      transient disorders into these groups. Examples of disorders in the each group
      are presented. This classification helps to clinicians make both diagnostic and
      therapeutic decisions.

PMID- 1754828
TI  - [Techniques of endoscopic treatment of malignant colorectal adenomas with respect
      to the subsequent prognosis of the patients].
AB  - Since 1981 we detected in 45 patients (28 men, 17 women) 31 adenomas with severe
      dysplasia (ATD; formerly intramucous carcinoma) and 22 invasive carcinomas in the
      adenoma (IK penetrating beneath the muscularis mucosae). 95% of all findings were
      in the left colon before the lienal flexure. Patients with ATD were subjected
      only to endoscopic operation; of 22 of the subjects with IK 15 were recommended
      for surgery, and endoscopic treatment alone was provided to seven patients. Forty
      subjects were followed up on a long-term basis (on average for 34 months). Of 23
      patients with ATD one female patient died from ischaemic heart disease, the
      remainder survive without signs of colorectal carcinoma. Of 17 subjects with IK
      followed up on a long-term basis five died (all after surgery as a result of
      generalization of the disease). All 7 patients with IK who had only endoscopic
      treatment survive without signs of relapse of the disease. In patients with ATD
      the authors consider EP as the definite therapeutic method, if it is feasible
      from the technical aspect. Patients with ATD and IK who were subjected to EP are
      checked after 6 weeks. A total coloscopic check-up is made subsequently in
      subjects with IK during the first year twice a year and in later years once a
      year, in subjects with ATD after annual intervals for a period of 5-6 years.

PMID- 1754829
TI  - [Ultrasonic findings in pancreas divisum].
AB  - In 36 subjects with pancreas divisum an ultrasonic examinations of the pancreas
      were made after filling the stomach with 600 ml of fluid. In 27 subjects (75%) it
      was possible to evaluate the entire pancreas reliably, incl. the area of the
      dorsal segment. The gastric filling and positioning of the patients during
      examination improved in 47% the quality of the visualization, in particular in
      the left half of the pancreas. In three patients sonography revealed marked
      inflammatory changes in the entire gland. The applied examination procedure
      protracted the examination time of the pancreas to 30-40 minutes. Aimed
      ultrasonic examination with gastric filling is recommended as part of the
      examination procedure in subjects with pancreas divisum.

PMID- 1754830
TI  - [Risks of malignant neoplasms in workers in Czechoslovak uranium mines].
AB  - The authors present a historical account on the findings which made it possible
      to define the most serious occupational disease in miners in uranium mines-
      bronchogenic carcinoma. In 1952-61 44 cases of lung cancer were reported in
      conjunction with radioactive substances, in 1962-85 already 1511 patients were
      recompensated. Z. Vich found in a prospective epidemiological survey that of 4803
      workers who left for preventive reasons work places involving risk in 1968-75
      20.5% died by 1985. The mortality rate from lung tumors was 3.5 times higher than
      in the male population of the Czech Republic. The authors analyze occupational
      risk indicators important for the prevention of this occupational disease. From
      the medical aspect the restriction of mining in uranium mines is welcome, as the
      work involves a high risk.

PMID- 1754831
TI  - [Group determination of 17-oxosteroids on thin-layer chromotography].
AB  - 17-oxosteroids from human urine are measured by thin layer chromatography (Merck
      Kieselgel F-254 plates) with fluorometric detection at 310 nm (densitometer
      SHIMADZU CS-9000): 11-OH-etiocholanolone, 11-OH-androsterone +
      oxoetiocholanolone, oxoandrosterone, dehydroepiandrosterone and androsterone.
      Fluorescence of hydrazone derivatives after the reaction of steroids with
      dansylhydrazine represents the principle of the method. The recoveries of
      steroids added to human urine samples are 97-101.3% and the coefficients of
      variation are 0.78-11.77.

PMID- 1754832
TI  - [Consciousness and the electroencephalogram].
AB  - In the course of 12 years the authors subjected to clinical EEG and stereo-EEG
      (SEEG) 72 patients (66 epileptics with the diagnosis of psychomotor epilepsy and
      grand mal) and six psychotic patients suffering from schizophrenia. With the
      exception of five epileptics and two psychotic patients all subjects had
      epileptic foci in the amygdalohippocampal complex (AHK). After coagulation of
      these foci marked improvement of the fits and the mental state occurred in half
      the patients. During EEG and SEEG recording the authors used different activation
      methods (hyperventilation through the nose and mouth, sleep, listening to music)
      and above all direct electric stimulation (ES) of one of the AHK. Secondary
      epileptic foci had, as a rule, more spikes and a lower threshold for ES than
      primary ones which contained more delta and slow theta waves. The ES led as a
      rule to an emotional response, such as anxiety and fear, more rarely to
      illusions, depersonalization and oneiroid hallucinations and twice to a hedonic
      response of non-sexual character. The purpose of ES was to assess the site from
      where it is possible to start the original aura or typical parox. The authors
      considered these foci, consistent with data in the literature, as the leading
      focus and it was subsequently coagulated. The authors investigated the reactivity
      and vigility by the patient's response to sound (the patient had to press a
      button) and by an interview with the patient. It was revealed that in isolated
      discharges of the spikes and waves in the scalp electrodes, i.e. in the
      neocortex, reactivity is lacking. In isolated discharges in the AHK the
      reactivity was satisfactory, but as a rule anxiety developed. It is thus possible
      to divide consciousness into emotional consciousness with its site in the AHK,
      i.e. in the limbic system, and rational consciousness which is a function of the
      neocrotical system. Congenital changes of consciousness such as vigility or sleep
      are described as "states" of consciousness. The rational or emotional aspect of
      behaviour is described as "type" of consciousness. Under normal conditions the
      states of consciousness alternate periodically and are sharply defined, the types
      of consciousness are closely linked and are difficult to separate. Under
      pathological conditions the "states" of consciousness differ less markedly and
      the "types" of consciousness are in dissociation. Thus obnubilation,
      depersonalization, illusions, pathic affects etc. develop, as a rule as part of
      the epileptiform or psychotiform syndrome.

PMID- 1754833
TI  - [Early differential diagnosis of tumors of the lesser pelvis using an appropriate
      combination of noninvasive and invasive methods].
AB  - One hundred and twenty-three female patients were subjected to ultrasound and CT
      examinations on account of suspected tumours in the area of the lesser pelvis, or
      to evaluate the postoperative situation. Twenty-five patients were subjected in
      addition to the mentioned examinations also to angiography of the pelvic
      arteries. From comparison of the results of the radiodiagnostic examination and
      the surgical (histological) diagnosis ensues that in patients with a malignant
      tumour of the ovaries and uterus and with a benign tumour of the uterus the CT
      examination gives-more satisfactory results than the ultrasound examination. In
      patients with a benign tumour of the ovaries ultrasonic and CT examinations were
      approximately equally satisfactory.

PMID- 1754834
TI  - [Stomatologic care of patients with the Melkersson-Rosenthal syndrome].
AB  - The authors describe the problems of diagnosis, treatment, prevention and
      dispensarization of patients suffering from Melkerson-Rosenthal's syndrome in a
      dental department. They describe in detail the manifestations of the syndrome in
      the orofacial area. Comprehensive dental care is based on studies of the
      pertinent literature and the authors' own experience.

PMID- 1754835
TI  - Transmission electron microscopic appearance of dentin matrix in type II dentin
      dysplasia.
AB  - Dentin matrix of demineralized primary and permanent teeth with type II dentin
      dysplasia was studied by transmission electron microscopy. The coronal dentin of
      a maxillary third molar exhibited a normal structure. In the radicular dentin,
      tubules were few in number; the major part of the dentin was composed of thick,
      curvy bundles of cross-striated collagen fibers. In the most aberrant areas of
      the radicular dentin, coarse collagen fibers measuring up to 140 nm in thickness
      were observed. The dentin of the primary tooth showed a similar, but somewhat
      less irregular, structure.

PMID- 1754836
TI  - Retrospective study of children with hypophosphatasia with reference to dental
      changes.
AB  - In the present retrospective study different dental and medical parameters have
      been analyzed in 17 Swedish children with established hypophosphatasia (HP). It
      was demonstrated that the basis for the establishment of the diagnosis varied
      among different dentists and physicians, and that the diagnostic parameters
      studied among the children varied. The most reliable parameters for HP included
      raised levels of phosphoethanolamine in urine, and clinical and radiologic
      findings associated with the legs. These findings were found among the children
      more often than lowered values of alkaline phosphatase in serum. Histologic
      analysis of an extracted tooth made a valuable diagnostic complement. It is
      concluded that a better diagnostic uniformity is recommended. In a well
      functioning collaboration with well defined tasks, both dentists and physicians
      can contribute to a reliable diagnosis.

PMID- 1754837
TI  - Column-like structures of human dentin in carious and artificial lesions.
AB  - Serial sections of 36 human teeth with minor to medium-sized carious lesions,
      adequate sections from previous studies of artificial lesions adjacent to
      fillings of amalgam (AM), silicate cement (SI) and glass ionomer cement (GI) were
      studied by ordinary light microscopy and microradiography. Six artificial primary
      root lesions were included. In carious lesions, dentin columns were visible in
      the demineralization zone and partly also in the translucent/radiopaque zone. A
      typical feature of the artificial lesions adjacent to SI fillings was highly
      radiopaque columns alternating with radiolucent ones. In the GI group such
      columns were seen at the cavity wall and the advancing front of the outer lesion.
      In the AM group dark columns were unveiled as pegs in the latter localization.
      The findings led to the assumption that the dark columns of intact dentin are
      preferred pathways of acid diffusion in artificial and, possibly, carious
      lesions. Increased radiopacity of columns in the SI and GI groups is explained by
      continued exposure of the tooth surface to fluoride dissolved from these fluoride
      rich filling materials.

PMID- 1754838
TI  - Effect of fluoride mouthrinsing on caries lesion development in shark enamel: an
      in situ caries model study.
AB  - Shark enamel consists of nearly pure fluorapatite and has been shown to
      demineralize in an in situ caries model. The present study was conducted to
      investigate whether additional fluoride supplementation in the form of
      mouthrinsing would inhibit lesion development in shark enamel. The study slabs of
      shark enamel were mounted in dental appliances. Six individuals wore the
      appliances while rinsing daily with a neutral 0.2% NaF solution for 4 wk. The
      specimens were analyzed by means of quantitative microradiography, and the data
      compared with a previous study using untreated shark enamel and the same
      participants. It was found that fluoride rinsing did not measurably inhibit
      enamel demineralization in 4 wk. Scanning electron microradiographs showed that
      calcium fluoride-like material was not formed on shark enamel after neutral
      fluoride treatment, supporting a previous study. The present study indicates,
      therefore, that formation of a calcium fluoride-like material on the enamel
      surface may be essential for the cariostatic effect of topical agents.

PMID- 1754839
TI  - Comparative antibacterial effects of chlorhexidine and stannous fluoride-amine
      fluoride containing dental gels against salivary mutans streptococci.
AB  - Forty-five young adults were divided into three groups of equal size and given a
      professional toothcleaning (3 times during 1 wk) with dental gels containing
      either chlorhexidine (CHX, 1%), or a SnF2-amine fluoride (AmF) combination (F-
      content 1.20%). The control group received toothcleaning with a placebo gel. The
      study was done double blind. The number of salivary mutans streptococci was
      monitored for 11 wk after the gel treatment using both mitis-salivarius
      bacitracin agar plates and the chairside method based on the adhesion of mutans
      streptococci on plastic strips (Dentocult-SM Strip mutans). Professional
      toothcleaning with a CHX gel was clearly most effective (P less than 0.001) but
      the baseline levels of streptococci returned in 11 wk. SnF2-AmF gel also reduced
      significantly (P less than 0.001) mutans streptococci but recolonization occurred
      already in 7 wk. Placebo gel, i.e. professional toothcleaning as such, did not
      show any statistically significant effect on the numbers of salivary mutans
      streptococci. None of the treatments affected the levels of lactobacilli or the
      total aerobic flora in saliva samples. Professional toothcleaning with a CHX gel,
      or with a SnF2-AmF gel, can be regarded as an alternative to the commonly used,
      but more patience demanding, application of gel in mouth trays at home for
      individuals with high caries activity.

PMID- 1754840
TI  - Ontogeny of class II antigen expressing cells in rat incisor pulp.
AB  - Class II antigen expressing cells are generally associated with the early phase
      of the immune response. Dendritic cells and macrophages expressing these cell
      surface antigens have recently been demonstrated and characterized in the dental
      pulp. The present study was undertaken to determine when the pulp receives its
      immunologic defense potential by examining the temporal appearance of class II
      antigen expressing cells in the rat incisor pulp. Pulp tissue specimens obtained
      at various time periods from a gestational age of 16 days to 14 wk after birth
      were examined by immunohistochemistry using O x 6 as a primary antibody and the
      ABC-technique. Comparisons were made with tissue samples from the spleen,
      intestine, skin and oral mucosa. At birth, all tissues, except for the pulp,
      presented cells expressing class II antigen with a dendritic appearance in a
      number and orientation resembling the mature tissue. A complete distribution of
      these cells was not seen in the dental pulp until 7 weeks following birth. Data
      show that the dental pulp acquires its ultimate structural arrangement of immune
      cells later than other tissues.

PMID- 1754841
TI  - Combined inhibitory effect of lactoferrin and lactoperoxidase system on the
      viability of Streptococcus mutans, serotype c.
AB  - We have studied the effects of iron-free lactoferrin (apo LF) and lactoperoxidase
      system (lactoperoxidase, LP/SCN-/H2O2), separately and together, on the viability
      of Streptococcus mutans (serotype c) in vitro. The bacteria were incubated in
      buffered KCl (pH 5.5) with and without the above components which were used at
      concentrations normally present in human saliva. Both apo LF and LP-system had a
      bactericidal effect against S. mutans at low pH. Together they showed an
      additive, but not a synergistic, antibacterial effect against S. mutans. Apo LF
      enhanced the LP enzyme activity but decreased the yield of the antimicrobial
      component, hypothiocyanite (HOSCN/OSCN-), when incorporated into the reaction
      mixtures. This decrease, which was most pronounced at low pH, was due to an LP
      independent reaction between apo LF and HOSCN/OSCN-. Our study indicates that the
      LP-system and apo LF can be combined to combat oral S. mutans.

PMID- 1754842
TI  - Protein composition of crevicular fluid before and after treatment.
AB  - Crevicular fluid (CF) analysis is a potential tool for site-specific diagnosis of
      periodontal disease activity. In this study, CF was collected using a novel
      washing method from 91 sites in 18 adult periodontitis patients both before and
      after conventional periodontal treatment. The sites studied were classified
      according to their clinical status and the number of polymorphonuclear leukocytes
      (PMN's) in CF samples. CF proteins were analyzed from individual sites with gel
      electrophoresis (SDS-PAGE). Furthermore, both the cell-bound and soluble neutral
      proteolytic activities of the samples were determined. Albumin was the main
      protein both in healthy and slightly inflamed sites. The most severely inflamed
      sites were characterized by high levels of low molecular weight (LMW) proteins
      (mol. weight ca. 12,000) and strong cell-bound neutral proteolytic activity.
      Scaling and root planing reduced both the LMW proteins and neutral proteolytic
      activity markedly in pockets responding well to treatment. The levels of the LMW
      proteins in CF correlated with the cell-bound neutral proteolytic activity, which
      reflected the number of PMN's in the sample. The present results suggest that the
      appearance of the LMW proteins in CF is associated with the periodontal
      inflammatory status of the site.

PMID- 1754843
TI  - Histoquantitative study of inflamed tongue mucosa.
AB  - A quantitative, semiautomatic analysis of histologic features of the specific
      inflammatory changes occurring on the dorsum of human tongue was made for 37
      tongues. Well-documented histologic differences between clinically normal
      appearing tongue (control), atrophic, geographic and fissured tongue were shown
      quantitatively. The epithelium of atrophic tongue was thinner compared to the
      controls. Reduction of the thickness was due to the shortened or totally missing
      rete pegs. Epithelium of geographic and fissured tongue showed irregular rete
      pegs. In fissured tongue heavy inflammation seemed to shorten the rete pegs. In
      atrophic tongue the connective tissue was thicker compared to the controls. This
      could be due to mild, chronic inflammation causing loose connective tissue
      described in atrophic tongue. Muscle cells of geographic tongue appeared to be as
      in the controls, whereas in atrophic and fissured tongue the uppermost muscle
      cells were small and separated compared to the controls.

PMID- 1754844
TI  - Release of corrosion products from amalgam in phosphate containing solutions.
AB  - The effect of phosphate concentration on corrosion was compared for two types of
      amalgam: a conventional alloy (ANA 68) and a high-Cu admixed alloy
      (Dispersalloy). The test specimens were stored for 4 months in electrolytes
      containing 85 mM NaCl and 85 mM NaCl with 2.5, 10, or 100 mM phosphate buffer
      respectively. The solutions were renewed each month and analyzed for Cu, Zn, Sn,
      Hg, and Ag in an atomic absorption spectrophotometer. The surfaces and cross
      sections of the specimens were studied in a scanning electron microscope (SEM)
      with an energy dispersive detector (EDAX). The corrosion products, mainly Sn
      compounds, at the surface of the amalgams were less in the solutions containing
      high concentrations of phosphate. In cross-section subsurface corrosion of the
      high-Cu amalgam was observed especially in specimens immersed in the NaCl
      solution without phosphate. The conventional amalgam showed surface corrosion
      only. The decrease in release of elements with time from the conventional amalgam
      in all the experimental solutions might indicate passivation. For the high-Cu
      amalgam the release of elements increased with time, except for Cu and Sn in the
      solution with 100 mM phosphate, indicating that phosphate inhibits corrosion of
      the Cu-Sn-phases. Release of corrosion products from the high-Cu amalgam was more
      dependent on the presence of phosphate than the conventional amalgam.

PMID- 1754845
TI  - European Federation of Crohn's and Ulcerative Colitis Associations (EFCCA).

PMID- 1754846
TI  - Helicobacter pylori infection and non-ulcer dyspepsia: the effect of treatment
      with colloidal bismuth subcitrate.
AB  - A study was undertaken to determine the role of Helicobacter pylori in non-ulcer
      dyspepsia (NUD) and to determine the efficacy of colloidal bismuth subcitrate
      (CBS) in the treatment of NUD. Seventy-one patients were randomly allocated
      (double blind) to CBS or placebo, two tablets twice daily for 4 weeks. The
      severity of dyspepsia was scored and endoscopies performed before and after
      treatment, and antral biopsy specimens were taken for bacteriologic and
      histologic examination. Forty patients had H. pylori infection, and all had
      changes of chronic active gastritis. H. pylori was cleared from 17 to 21 patients
      (81%) treated with CBS, whereas none of the 19 patients treated with placebo
      cleared the bacteria. Improvement in histology was noted in 15 of 21 patients
      (71.4%) treated with CBS, whereas no improvement was noted in any of the placebo
      controls. Thirty-one patients were negative for H. pylori. All had either normal
      gastric histology or minor degrees of inflammation. Seventeen of these patients
      received CBS, and 14 received placebo. All groups reported improvement in the
      symptom score; however, the H. pylori-positive, CBS-treated group recorded a
      significantly higher improvement than the other groups (p less than 0.001).
      Relapse of H. pylori infection after initial clearance of the bacteria was high.
      Twelve of 16 patients evaluated relapsed 1 month after withdrawal of CBS.

PMID- 1754847
TI  - Clogging and other complications of endoscopic biliary endoprostheses.
AB  - This study included 236 patients treated with endoscopic biliary endoprostheses.
      Malignant strictures were responsible for the obstruction in 87% of the patients.
      The 1-week and 1-month mortality for patients with malignant strictures was 10%
      and 22%, respectively, whereas that of patients with benign conditions was 3% and
      10%, respectively. The major complication encountered was the frequent hospital
      readmissions of patients owing to clogging of their endoprostheses. Late clogging
      had an overall occurrence of 33% and presented with recurrence of jaundice with
      or without fever or pain. Late signs of cholangitis occurred in 15% of the
      patients, whereas other late complications were rather infrequent. Although 10
      french endoprostheses had a significantly longer patency period than 7-french-
      that is, 6 months versus 2 months (p = 0.01)--the proportion of patients in whom
      clogging occurred was nearly the same, 30% for 10-french and 32% for 7-french
      endoprostheses.

PMID- 1754848
TI  - Clogging of biliary endoprostheses. A morphologic and bacteriologic study.
AB  - The main problem encountered with the use of biliary endoprostheses is their
      tendency to clog, which necessitates their exchange. We studied this problem by
      performing light and electron microscopy and bacterial cultures on both unused
      and clinically used endoprostheses. These examinations showed several basic
      defects in their manufacture, such as irregular inner surfaces and badly
      constructed side holes. The deposit that ultimately led to their occlusion was
      found mainly to be concentrated around the side holes. Minimizing the amount of
      material, bacteria, and plant fibres adhering to the endoprosthesis is the
      desired goal and may be achieved by improving their manufacture and design.

PMID- 1754849
TI  - Effects of nocloprost on gastric functions in man.
AB  - Previous studies in animals and humans demonstrated that nocloprost, a stable
      prostaglandin E2 analogue, shows very high gastroprotective potency, relatively
      weak gastric inhibitory activity, and low systemic bioavailability after oral
      administration. In this study the effects of nocloprost on gastric acid secretion
      and intraluminal pH and on gastric emptying and plasma gastrin levels were
      determined in humans. Nocloprost at doses of 50 and 100 micrograms was
      ineffective, but at a dose of 200 micrograms it reduced the response to
      pentagastrin significantly and that to a peptone meal by 30-50% and abolished
      plasma gastrin response without affecting the rate of gastric emptying.
      Nocloprost given at a dose of 100 micrograms three times daily 30 min before the
      major meals (breakfast, lunch, and dinner) did not affect intragastric pH
      significantly as monitored by continuous intraluminal pH-metry. We conclude that
      nocloprost does not affect gastric acid secretion or intraluminal pH when applied
      at a dose (50-100 micrograms) that is gastroprotective and that is proposed for
      peptic ulcer therapy. A higher dose (200 micrograms) of nocloprost causes
      moderate gastric acid inhibition and suppression of plasma gastrin release
      without affecting gastric emptying or causing any side effects.

PMID- 1754850
TI  - Availability of energy substrates during liver regeneration in malnourished rats.
AB  - A retarded liver regeneration rate during malnutrition has previously been
      reported. To explore the mechanisms, some energy substrates were studied during
      liver regeneration and malnutrition. Forty-one rats were allocated to one of
      three groups (G): GI were normally nourished rats, which were partially
      hepatectomized; GII were semistarved rats, which were partially hepatectomized;
      and GIII were normally nourished rats, which were sham-operated. Biopsy specimens
      were taken from the liver at the time of partial hepatectomy and when they were
      killed after 48 h of regeneration. The samples were analysed for adenosine
      triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP),
      glycogen, lactate, and pyruvate, and energy charge potential (ECP) was
      calculated. ATP, ECP, and glycogen levels were decreased in the malnourished
      group before the resection. After 48 h of regeneration all values were unchanged
      in the normally nourished group, whereas ATP, ADP, and ECP were increased in the
      malnourished group compared with the initial values. The lactate/pyruvate
      quotient was increased in malnourished rats compared with normal rats. The
      results suggest that the energy supply is not a limiting factor for the reduced
      regeneration rate seen in malnourished animals.

PMID- 1754851
TI  - Diagnostic accuracy of ultrasound, computed tomography, and endoscopic retrograde
      cholangiopancreatography in the detection of obstructive jaundice.
AB  - The purpose of this prospective study was to investigate the diagnostic accuracy
      of ultrasound (US), computed tomography (CT), and endoscopic retrograde
      cholangiopancreatography (ERCP) in the distinction between extrahepatic and
      intrahepatic causes of jaundice. The limit for the inclusion to the study was
      defined as a serum bilirubin concentration greater than or equal to 40 mumol/l.
      Altogether 187 jaundiced patients were studied. The sensitivities of US, CT, and
      ERCP were 63%, 77%, and 87%, respectively. The differences between all these
      methods were statistically significant. The specificities and positive predictive
      values were high, reaching 96-99%, but the negative predictive values were low,
      ranging between 38% and 60%. Choledochal stone disease constituted the main
      etiology of false-negative studies in all investigations. Imaging procedures have
      a prominent role in the diagnostic study of the jaundiced patient, but it is
      obvious that their diagnostic accuracy may vary between institutions because of
      the variance in local experience and expertise, and because of the differences in
      diseases causing jaundice.

PMID- 1754852
TI  - Radiographic evidence of cholecystokinin octapeptide receptors in the hamster
      gallbladder.
AB  - The distribution of cholecystokinin receptors in the hamster gallbladder was
      investigated by 125I-labeled Bolton-Hunter-cholecystokinin octapeptide
      autoradiography. Light microscopic examination showed a marked accumulation of
      radiolabeled cholecystokinin within the domain of the muscle layer of the
      gallbladder. The electron microscopic study further disclosed the presence of
      radiolabeling mostly in those areas corresponding to cell-to-cell junctions of
      smooth-muscle cells. Our results suggest that contraction of the gallbladder may
      primarily be induced by cholecystokinin interacting with its specific receptor in
      smooth-muscle cells. That cholecystokinin receptors were more abundant in the
      junctional complexes of smooth-muscle cells suggests that cholecystokinin may
      have a major role in muscle contraction of the gallbladder, which eventually
      produces an effective bile emptying.

PMID- 1754853
TI  - Increased levels of fibrinolysis reaction products (D-dimer) in patients with
      decompensated alcoholic liver cirrhosis.
AB  - We studied the activation of coagulation and fibrinolysis in the blood of
      patients with compensated (n = 25) and decompensated (n = 25) liver cirrhosis. We
      observed increased blood concentrations of thrombin-antithrombin III (TAT)
      complexes (p less than 0.001) and of D-dimer (p less than 0.001) in both groups
      of patients compared with healthy volunteers (n = 25). The blood levels of tissue
      type plasminogen activator (t-PA) activity (p less than 0.001) and the
      concentrations of t-PA antigen (p less than 0.001) were also significantly raised
      in both groups of patients compared with controls, whereas plasminogen activator
      inhibitor did not deviate. There were no significant differences in the
      determined variables between the two groups of patients except that the
      concentrations of D-dimer were significantly higher (p less than 0.001) in
      patients with decompensated liver cirrhosis. The ratio between D-dimer and TAT
      did not deviate between patients with compensated liver cirrhosis and healthy
      volunteers but was significantly increased in patients with decompensated liver
      cirrhosis. These observations indicate that efflux from the extravascular space
      (for example, ascitic fluid) contributes to the high concentrations of fibrin
      degradation products (D-dimer) in patients with decompensated liver cirrhosis. In
      addition, we conclude that patients with liver cirrhosis have an enhanced
      activation of both coagulation and fibrinolysis but that the balance between
      these two systems is not significantly displaced compared with healthy
      volunteers.

PMID- 1754854
TI  - Adhesion of Helicobacter pylori to human gastric mucosal biopsy specimens
      cultivated in vitro.
AB  - The therapeutic advances in Helicobacter pylori infection is hampered by the lack
      of suitable animal model systems. We have previously reported on successful
      adherence of H. pylori to pig gastric mucosa cultured in vitro. The aim of this
      study was to verify the technique in human biopsy specimens cultured in vitro.
      Mucosal samples were taken from H. pylori-negative and H. pylori-positive
      patients undergoing gastric surgery. The non-infected tissue was infected with H.
      pylori in vitro, and the infected tissue was put into culture immediately. Total
      number and those H. pylori firmly attached were checked throughout a 72-h
      culture. Viability of cultured human gastric mucosa was good and unaffected by
      the presence of H. pylori. The amount of bacteria adhering, increased with time
      from 0.01% to 2-4% after 72 h in culture. In vivo-infected specimens initially
      had a low number of firmly attached H. pylori, but total H. pylori increased with
      time in culture. It is concluded that human gastric biopsy specimens show good
      viability for 72 h and that viability and cell division of H. pylori were
      maintained in both in vivo and in vitro H. pylori-infected tissue. In both cases
      the total number of viable bacteria attached to the specimens increased with
      incubation time.

PMID- 1754855
TI  - Importance of measuring plasma thrombin-antithrombin III complex levels when
      using antithrombin III concentrate therapy in fulminant hepatic failure.
AB  - We investigated changes in the concentrations of thrombin-antithrombin III
      complex (TAT) and plasmin-alpha 2 plasmin inhibitor complex (PIC) after the
      intravenous administration of 4000 units of antithrombin III (AT III) concentrate
      to patients with fulminant hepatic failure (FHF), subacute hepatitis (SH), or
      liver cirrhosis (LC). FHF patients showed shortening of the initial half-life of
      exogenous AT III. In addition, a marked rise in plasma TAT was noted 3 to 6 h
      after the intravenous administration of AT III, even in patients who had a normal
      plasma TAT level before AT III therapy. In contrast, SH and LC patients showed no
      marked changes of plasma TAT levels after AT III administration. No marked
      changes were observed in the PIC concentration in any of the patients. These
      findings suggest that thrombin formation is increased in FHF and that simple
      measurement of the plasma TAT concentration is not an adequate method for
      assessing thrombin formation in FHF patients who have suspected disseminated
      intravascular coagulation associated with an apparent decrease in AT III
      synthesis. Instead, it seems necessary to measure the plasma TAT concentration in
      FHF patients after replacement therapy with AT III concentrate has been
      performed, to evaluate their hypercoagulability more accurately.

PMID- 1754856
TI  - Endoscopic follow-up study of gastric ulcer to detect malignancy: is it
      worthwhile?
AB  - Endoscopic follow-up study of gastric ulcer to detect cancer is held to be
      mandatory. To evaluate the benefits of this routine strategy, 913 index
      endoscopies for gastric ulcer in 773 patients during the 3-year period 1985-87
      were analyzed. Correctness of diagnosis was verified through surgery, autopsy, or
      clinical follow-up. Endoscopic follow-up was done in 83% of the cases, totaling
      1269 endoscopies, showing gastric cancer in 10 patients. Clinical outcome,
      however, was poor for five of these (early death). Five additional cancer cases
      were missed by the endoscopic follow-up. In the same period 63 gastric cancers
      were found at the first endoscopy; 9 of these were diagnosed through biopsies
      only. Predictive values of the macroscopic judgements of benign lesion or
      probable/definite malignancy were 0.98 and 0.40, respectively. Evaluation of case
      records did not indicate characteristics that would have helped in the correct
      differentiation between benign and malignant lesions. Thus, each case of curable
      gastric cancer is found at the expense of approximately 250 follow-up
      endoscopies. We are in need of sensitive and specific markers for possible
      malignancy in the patient with apparently benign gastric ulcer.

PMID- 1754857
TI  - Anaesthetic agents suppress basal and stimulated gastric acid secretion. Are
      intramural neurons involved?
AB  - Anaesthetized animals are often used in studies of gastric secretion. We have
      examined the effect of anaesthetics on the acid output in gastric fistula rats
      and pylorus-ligated rats, both vagally intact and denervated. Diethyl ether,
      chloral hydrate, and mebumal effectively reduced both basal and stimulated acid
      output in fistula rats. The acid output in pylorus-ligated rats was greatly
      reduced by the anaesthetics. In vagally denervated rats local nervous reflexes
      are thought to play an important role in the acid secretory response to pylorus
      ligation. Anaesthetic drugs suppressed acid output in both vagally intact and
      vagally denervated rats. The possibility of an action on intramural neurons
      cannot be excluded. The neuro-suppressive effect of anaesthesia should be
      considered in studies of gastric acid secretion.

PMID- 1754858
TI  - Dental plaque: a permanent reservoir of Helicobacter pylori?
AB  - The aim of the study was to observe the relationship between the two reservoirs
      of Helicobacter pylori--that is, dental plaque and the stomach. With the
      Campylobacter-like organism (CLO) test, H. pylori was detected in dental plaque
      and in gastric antral and body mucosa in 98%, 67% and 70%, respectively, of 43
      consecutive patients with dyspepsia. The rapidity of the CLO test indicates that
      the density of H. pylori is heaviest in dental plaque, less in the antrum, and
      least in the body mucosa of the stomach. Triple drug therapy (bismuth,
      tinidazole, and amoxycillin or doxycycline) was administered for 15 days to 24
      patients. By the CLO test, H. pylori was eliminated from the gastric mucosa in
      all 24 patients but persisted in dental plaque in all of them. Our observations
      indicate that dental plaque is unaffected by triple drug therapy and is perhaps a
      permanent reservoir of H. pylori if local therapy also fails to eradicate the
      organism.

PMID- 1754859
TI  - Ranitidine for non-ulcer dyspepsia. A clinical study of the symptomatic effect of
      ranitidine and a classification and characterization of the responders to
      treatment.
AB  - Seven Norwegian centres recruited 61 female and 54 male patients with non-ulcer
      dyspepsia (NUD). Their mean age was 40 years. After 6 weeks' double-blind
      alternating treatment with 150 mg ranitidine twice daily and placebo, 1 week of
      each alternative (part I), an effect score (Xs) and an efficacy index (Ei) were
      calculated. Ranitidine was significantly superior to placebo for symptomatic
      relief (p less than 0.01). Twenty-eight, 49, and 38 patients were Xs-classified
      as 'responders', 'unclassified', and 'nonresponders' to ranitidine, respectively.
      The symptomatic effect was impressive in the responder group and moderate but
      significant also in the unclassified group. The nonresponders had a significantly
      unfavourable effect of ranitidine compared with placebo. The Xs-classified
      responders and unclassified continued single-blind treatment with ranitidine for
      4 weeks (part II) and were reclassified as 'new responders/nonresponders'. The
      new responders received single-blind treatment with placebo until relapse or
      maximum 8 weeks (part III). Parts II and III verified the good Xs classification
      of responders to ranitidine treatment. The overall effect of ranitidine in
      patients with NUD was due to good symptomatic effect in a subpopulation
      characterized by meal-related heartburn and/or regurgitation, large body mass
      index, first-degree relatives with gastrointestinal diseases, a relatively low
      frequency of gastrointestinal symptoms per week, and absence of soft stools.

PMID- 1754860
TI  - [Cardiovascular risk factors--an integrated sympathetic viewpoint].
AB  - A large body of experimental and clinical data concerning the "classical
      cardiovascular risk factors" may be integrated into a unifying concept in which
      an increase in sympathetic activity and nutritional factors play a crucial role.
      The enhancement of sympathetic activity (e.g. as a consequence of psychosocial
      stress), induces--via direct and indirect mechanisms--activation of the renin
      angiotensin-aldosterone system and the insulin axis. Balanced endothelial
      function may also be disrupted. Subsequently, these alterations lead to
      cardiovascular remodelling and development of the early stages of
      arteriosclerosis. Mechanical forces such as pressure and strain, and also mild
      hyperinsulinemia with secondary elevations in the LDL/HDL ratio further amplify
      these processes. Wrong nutrition, characterized by an elevated salt, sugar and
      fat intake, further stimulates these pathological events. The chain of events
      finally leading to the clinical manifestation of arteriosclerosis is certainly
      strongly based on, and modified by, a genetic predisposition. Cigarette smoking
      acts as a pulsatile, exogenous amplifier of the sympathetic nervous system.
      Furthermore, complex interactions of the various "hormonal risk systems", namely
      renin-angiotensin, insulin, and LDL/HDL cholesterol, have been observed at the
      cellular and molecular level. These interactions are integratively influenced by
      environmental and sympathetic factors. Therefore, a comprehensive approach should
      be incorporated into prophylactic and therapeutic strategies.

PMID- 1754861
TI  - [Can drugs, especially calcium antagonists, bring about regression of
      atherosclerosis, especially coronary sclerosis?].
AB  - The feasibility of true regression of human atherosclerotic plaques (reduction in
      volume) through drug therapy is still debated; the increase in coronary artery
      diameter, especially eccentric stenoses during massive reduction of serum
      cholesterol, can also be due to stabilization of endothelial function and
      improvement of the abnormally raised basal coronary tone. Today, there are two
      groups of substances with anti-atherosclerotic properties: lipid-lowering drugs,
      and calcium-entry blockers. As evidenced both from animal experiments and
      prospective studies in man by quantitated coronary angiography (QCA), the latter
      act mainly by retarding the evolution of new plaques, and possibly even of fatty
      streaks. In man, four studies with calcium-entry blockers so far exist, all
      demonstrating a significant reduction (average -46%) of new lesions (stenoses and
      occlusions) in previously angiographically normal segments. To what extent these
      favourable anatomical results will lead to an improvement of cardiac events
      caused by plaque rupture (unstable angina, myocardial infarction) later on is
      still an open question. The slow anatomical progression of coronary artery
      disease, as evidenced by prospective repeated QCA, calls for studies with long
      term follow-ups (10 and more years) and large numbers of patients.

PMID- 1754862
TI  - [The internist--a many-sided profession].
AB  - "Internal medicine" in the USA, and "general medicine" in the UK, are
      increasingly assuming the form of basic medical knowledge with a view to
      subsequent specialization. In Switzerland, three types of practising internists
      or physicians (in the strict sense) can be described: the internist as general
      practitioner, the general internist with a main centre of interest, and the
      subspecialist. Continuing medical education must take these manifold aspects of
      the profession into account. For practising physicians, joint meetings of
      internists of the second and third types are desirable, on the lines of those for
      physicians in the major hospitals.

PMID- 1754863
TI  - [Internal medicine: problems and perspectives].
AB  - The professional status of the internist is changing. For instance,
      subspecialists and general practitioners are conducting more and more the
      traditional activities of internists. The number of certifications in general
      internal medicine in Switzerland over recent years has decreased. The same
      phenomenon is observed in other countries and particularly the USA, where surveys
      show unquestionable disappointment among internists with the quality of their
      working life arising from concerns over a private life-invading profession, low
      income, increasing administrative burdens and loss of clinical decision-making
      autonomy. Has the internist still a place in our health care system, and what
      would be the effect of disappearance of internists on the quality and the costs
      of medicine? The Swiss Society of Internal Medicine seems unable to solve this
      disaffection problem unaided, since it also interests general practitioners and
      consequently all the disciplines oriented toward primary care and family
      medicine.

PMID- 1754864
TI  - [Quality of treatment in hypercholesterolemia in ambulatory patients].
AB  - In 1989 serum cholesterol was determined as a routine procedure in 534
      consecutive patients. The response of the physicians to elevated cholesterol
      levels and factors associated with a treatment decision were analyzed. A follow
      up was obtained in treated patients after at least one year. 105 patients (20%)
      had hypercholesterolemia, 84 of whom were available for evaluation; only in 34
      (40%) was treatment initiated. Patients were more likely to be treated (p less
      than 0.05) if they had cholesterol greater than 1 mmol/l above normal, if they
      were between 41 and 50 years old, and if cholesterol had been determined at the
      physician's special request. The decision to treat was not influenced by sex,
      presence of further risk factors or by manifest atherosclerosis. After one year,
      11 of 26 patients were still well controlled and treated. Their mean cholesterol
      level was significantly lower as compared to pretreatment levels. We conclude
      that initial as well as long-term management of patients with
      hypercholesterolemia should be improved.

PMID- 1754865
TI  - [Late results following surgical repair of aneurysm of the descending thoracic
      aorta].
AB  - A consecutive series of 74 patients was analyzed after repair of descending
      thoracic and thoracoabdominal aortic aneurysms. After hospital discharge there
      were 13/71 deaths (18%) during a mean follow-up of 60 +/- 20 months (range: 28
      107). Actuarial analysis showed a mean survival rate of 89% after 1 year, 78%
      after 5 years and 71% after 9 years. During the same time period there were
      reoperations of the aorta in 10/71 patients (14%). Actuarial analysis showed
      freedom of reoperation in 97% after 1 year and in 80% after 5 years. Elective
      repair of these aneurysmal lesions can be recommended.

PMID- 1754866
TI  - [Are ECG criteria for indications for thrombolysis in acute myocardial infarct
      defined too narrowly?].
AB  - BACKGROUND: Despite the advantages of fibrinolytic therapy in acute myocardial
      infarction only about 20% of these patients receive this therapy. We studied
      patients excluded from fibrinolysis to identify subgroups with high mortality,
      which could derive benefit from more liberal interpretation of the indications
      for fibrinolytic therapy. METHODS: Retrospective chart review to identify
      patients with acute myocardial infarction in our coronary care unit 7/88-7/89.
      All patients received a questionnaire one year after this myocardial infarction.
      Patients not answering the questionnaire were contacted by phone or the
      information was sought from their physician. Indications for thrombolysis (with
      streptokinase or rTPA) were ST elevations of greater than or equal to 2 mm in
      greater than 2 adjacent leads and the absence of contraindications. RESULTS: In
      231/242 (95%) of the identified patients a complete follow-up was obtained, 32%
      were age greater than 70 years, 30% were admitted greater than 6 h after the
      beginning of the symptoms, 64% did not fulfil the ECG criteria for thrombolysis,
      21% (49/231) received thrombolytic therapy. The mortality after one year was
      20.3% in patients not treated with thrombolysis and 8.2% in patients with
      thrombolysis (difference 12.1%, 95% confidence interval 2.9-21.3%, p = 0.048).
      Patients with preceding old infarctions (n = 58) fulfilled the ECG criteria for
      thrombolysis in a significantly smaller proportion (21% vs 41%, p = 0.004). Of
      all patients 12% were excluded from thrombolytic therapy due to a negative
      initial ECG and yet developed a Q ware infarction. The one year mortality of
      patients not given thrombolysis and with a Q wave infarction was 24% (22/93, p =
      0.02 as compared to patients with thrombolysis), in patients with non Q wave
      infarction it was 13% (11/82, p = 0.41) and in patients with ambiguous ECG it was
      57% (4/7, p = 0.006). The mortality in patients with a preceding infarction was
      31% and significantly higher than in patients with a first infarction (16%, p =
      0.049) and in patients receiving thrombolysis (8.2%, p = 0.005). CONCLUSIONS: By
      excluding patients with acute myocardial infarction from thrombolytic therapy a
      group with high first year mortality is selected. Most patients are excluded
      because of an initial ECG not showing enough ischemia to fulfil the criteria for
      thrombolytic therapy. A prospective study of thrombolytic therapy using less
      rigid ECG criteria in the subgroups with the highest mortality (patients with
      preceding myocardial infarction or ambiguous ECG) seems necessary.

PMID- 1754867
TI  - [Glomerular hyperfiltration following unilateral nephrectomy in healthy
      subjects].
AB  - 23 living related kidney transplant donors were prospectively studied to
      determine the degree of hyperfiltration which occurs after uninephrectomy and to
      monitor potential consequences of this procedure such as hypertension,
      microalbuminuria or renal functional impairment. Standard inulin and PAH
      clearance studies were performed immediately before (n = 23), one week after (n =
      22) and one year after nephrectomy (n = 12). Hyperfiltration was defined as the
      ratio of (post-nephrectomy inulin clearance)/(0.5 x pre-nephrectomy inulin
      clearance), hyperperfusion was defined in an analogous way for PAH clearance. One
      week after uninephrectomy, hyperfiltration averaged 134 +/- 6% (SEM) and
      hyperperfusion was 138 +/- 6%. The degree of hyperfiltration did not correlate
      with donor age. One year after nephrectomy, hyperfiltration was nearly unchanged
      (130 +/- 7%) whereas hyperperfusion had significantly decreased to 119 +/- 8% (p
      less than 0.05). Blood pressure did not increase after nephrectomy and no new
      cases of hypertension were observed during follow-up. In contrast, there were two
      new cases of microalbuminuria at one week and one year after nephrectomy. Further
      follow-up of these kidney donors is warranted.

PMID- 1754868
TI  - [Randomized, double-blind comparison of isosorbide-5-mononitrate and delayed
      action nifedipine in patients with stable exertional angina. Multicenter Study
      Group].
AB  - The therapeutic effects of IS-5-MN and s.r. nifedipine were investigated in this
      double-blind, randomized, group-comparative, multicenter study over 2 weeks, in
      251 patients with stable reproducible exercise-induced angina. After 2 weeks'
      treatment with IS-5-MN 20 mg b.i.d. or t.i.d., 61% of the patients were
      responders who showed an increase in total exercise time (to moderately severe
      angina) of greater than or equal to 20% in comparison with placebo in the run-in
      phase. The corresponding responder rate after s.r. nifedipine 20 mg b.i.d. or 40
      mg b.i.d. was 53%. Both IS-5-MN and s.r. nifedipine significantly increased the
      total exercise time, the time to angina onset and to greater than or equal to 1
      mm ST-depression, and significantly reduced the rate pressure product and the ST
      segment depression at peak exercise in comparison with placebo in the run-in
      phase. The improvement in quality of life as indicated by the reduction in
      anginal episodes and intake of short-acting nitrates was comparable with both
      drugs. The pattern and incidence of all AEs were as expected in the two active
      treatment groups. The daily treatment costs for a 20 mg b.i.d. dosing regimen for
      both drugs in the Federal Republic of Germany was 64% higher for s.r. nifedipine
      than with IS-5-MN.

PMID- 1754869
TI  - [Variations in body weight and feeding behavior in internal medicine].
AB  - We have identified an eating disorder in 13% of women hospitalized on a medical
      ward for various reasons. These as well as obese patients undergo wide
      fluctuations of weight sometimes exceeding 30% of their present weight.
      Surprisingly, even in the absence of eating disorders, the changes in weight
      during adulthood are marked (22% of present body weight). Weight history should
      be included systematically in the medical history, since it can underscore
      concern over weight or even an unrecognized eating disorder.

PMID- 1754871
TI  - Beyond sympathy. Growth factors may help heal stubborn wounds.

PMID- 1754870
TI  - [Central analgesic effects of antidepressant drugs with various mechanisms of
      action: desipramine, fluvoxamine and moclobemide].
AB  - Analgesic properties of antidepressants are not yet well established. The aim of
      this study was to investigate the analgesic effect of three antidepressants after
      single oral dose administration to healthy volunteers. The late spinal R-III
      reflex threshold (objective pain threshold) and the subjective pain threshold
      (numerical categorical scale) were markers of analgesic effect. Desipramine
      induced significant increases in both thresholds. Fluvoxamine and moclobemide
      also exerted a significant analgesic effect, although displaying distinct
      patterns depending on the analgesic marker considered. Antidepressants exert a
      central analgesic effect independent of their antidepressive effect and,
      depending on their mode of action, already detectable at spinal level.

PMID- 1754872
TI  - Fatal flaw. Who will have the right to examine your genes?

PMID- 1754873
TI  - Cross reaction. Could AIDS really be an autoimmune disease?

PMID- 1754874
TI  - Homeless families.

PMID- 1754875
TI  - Levels of copper in the urine of women from nonpolluted farming regions of Japan.
AB  - Nearly 1500 spot urine samples were collected in the winter of 1987-1988 from
      women of seven farming prefectures located throughout Japan. Samples were
      analyzed for copper by flameless atomic absorption spectrometry. The copper
      content of the urine samples (Cu-U) distributed log-normally with a geometric
      mean (geometric standard deviation) of 36.9 (1.47) micrograms/l after adjustment
      for the specific gravity of urine of 1.016. The 95% confidence range was 17.1
      79.7 micrograms/l. Neither alcohol consumption nor smoking habit affected the Cu
      U. A literature survey showed that the observed level appears to be somewhat
      higher than previously reported values.

PMID- 1754876
TI  - Cadmium kinetics in freshwater clams (Unionidae) under field and laboratory
      conditions.
AB  - Cadmium dosing experiments were carried out with the freshwater clam Unio
      pictorum in flow-through micro-streams in order to obtain additional information
      on the kinetics of cadmium accumulation and elimination. Accumulation of cadmium
      in the kidney was rapid and within 3 weeks a concentration factor of 6000 was
      found. During elimination (29 weeks), the organs lose about one-third of their
      cadmium content rather rapidly, but no further elimination occurs. It can be
      concluded that the process of Cd accumulation is rapid and almost irreversible.

PMID- 1754877
TI  - Mercury in muscle tissue of lesser-spotted dogfish (Scyliorhinus caniculus L.)
      from the north-east Irish Sea.
AB  - This paper reports concentrations of mercury in muscle tissue of lesser-spotted
      dogfish (Scyliorhinus caniculus L.) from various locations within Liverpool Bay
      and the north-east Irish Sea. Concentrations of mercury in fish muscle showed
      distinct spatial variation, with values from the northern sectors of the Irish
      Sea significantly lower than those for the southern area, particularly sites in
      Liverpool Bay and around the mouth of the Mersey Estuary. The data support the
      hypothesis that there are several major populations of lesser-spotted dogfish
      within the study area, each of which remains quite distinct during seasonal
      movements. Consequently, exposure to environmental mercury is reflected in muscle
      concentrations of mercury. Regressions of mercury concentration against fish
      length showed significant relationships for the majority of sites, with the slope
      relating to distance from known sources of mercury contamination. Mean mercury
      concentrations were higher than in corresponding populations of flatfish from the
      same areas.

PMID- 1754878
TI  - Sweat lead levels in persons with high blood lead levels: experimental elevation
      of blood lead by ingestion of lead chloride.
AB  - Blood lead levels were experimentally elevated in two subjects by ingestion of
      single oral doses of lead as lead chloride. Serial samples of blood, urine and
      sweat were collected subsequently. Sweat samples were collected in polythene
      armbags while subjects cycled on a bicycle ergometer in a hot chamber. In spite
      of increases in blood and urinary lead levels, no increases in sweat lead levels
      were recorded. Possible reasons for this observation are discussed.

PMID- 1754879
TI  - Levels of aldrin and dieldrin in environmental samples from Delhi, India.
AB  - Aldrin and dieldrin residues in soil, earthworms, water, fish and clams from
      different sites in Delhi were monitored. Concentrations of aldrin and dieldrin
      were found to be higher in earthworms than in soil. Concentrations of dieldrin
      were higher in fish than the ambient water, but the concentration of aldrin in
      the ambient water was the same as that in fish and clams.

PMID- 1754880
TI  - Fate and microbiological effects of furazolidone in a marine aquaculture
      sediment.
AB  - Furazolidone is used in the treatment of bacterial diseases in farmed fish.
      During application a large proportion of the administered drug reaches the
      environment directly or via feces. The persistence and metabolism of furazolidone
      in sediment from a Norwegian salmon farm is described. Furazolidone, in contrast
      to oxytetracycline and oxolinic acid, is actively metabolized by microorganisms
      in the sediment. The main metabolite is 3-(4-cyano-2-oxobutylidene-amino)-2
      oxazolidone. This is a well known metabolite of the degradation of furazolidone
      in mammals, fish and Escherichia coli. 3-(4-Cyano-2-oxobutylideneamino)-2-
      oxazolidone had no detectable antibacterial activity. The half-life of
      furazolidone in the sediment at 4 degrees C was calculated to be 18 h.

PMID- 1754881
TI  - Epidemiology of postoperative deep vein thrombosis and pulmonary embolism.

PMID- 1754882
TI  - Pathophysiology of venous thromboembolism.
AB  - Venous thromboembolism is complex with a multifactorial etiology. The Virchow
      triad (changes in blood flow, changes in vessel wall, and changes in the
      properties of blood) gives the main factors involved in venous thromboembolism.
      Venous stasis during immobilization in general anesthesia, stroke with
      hemiparesis, and heart failure plays a central role. The thromboembolic process
      can be initiated by a disturbance in the normal "hemostatic balance," with an
      increased thrombogenic potential, due to release of thromboplastin and collagen
      exposure during vessel wall injury by stasis and hypoxia, decreased fibrinolysis
      during surgery, malignancy, among others. Many substances modify these processes,
      including heparan sulfate, AT III, protein C, t-PA inhibitor, and alpha 2
      antiplasmin.

PMID- 1754883
TI  - Principles of thromboprophylaxis in surgical patients.
AB  - Thromboprophylactic treatment during surgery reduces mortality and morbidity. The
      type of prophylaxis may be individualized according to type of operation and
      presence of major risk factors, such as prior thromboembolism, malignancy, long
      duration of immobilization, and medical conditions. All patients over the age of
      40, or even younger, who have major risk factors, and whose operations will last
      for more than 1 hour, may benefit from thromboprophylaxis. Available prophylactic
      methods allow for treatment with an acceptably low level of side effects and
      economic cost, when compared with the cost of diagnostics and treatment of
      thromboembolism.

PMID- 1754884
TI  - Diagnosis of venous thrombosis.

PMID- 1754885
TI  - Mechanical prophylaxis of deep vein thrombosis.

PMID- 1754886
TI  - Clinical assessment of venous thromboembolic risk in surgical patients.
AB  - Prophylaxis against postoperative venous thromboembolism should be tailored
      according to the patient's level of risk. However, risk assessment is not yet in
      widespread use in surgical practice. In this study, 538 general surgical patients
      were prospectively assessed based on a scoring system containing 20 risk factors.
      Depending on the total risk factor score, the patients were grouped into low (0
      to 1, 34.5%), moderate (2 to 4, 48.5%), or high risk (more than 4, 17.2%)
      categories. Statistically significant (p less than 0.0001) correlation was found
      between our results and those of three existing risk assessment systems. Overall,
      of the 538 patients, 37.2% received prophylaxis; 10%, 42.1%, and 76% received
      prophylaxis in the low-, moderate-, and high-risk categories, respectively.
      Mechanical prophylactic modalities (graduated elastic compression and sequential
      intermittent compression) were preferred over pharmacologic modalities. These
      results suggest that implementation of prophylaxis remains underutilized despite
      published reports, including NIH guidelines. Our results indicate that the
      majority of surgical patients seen in this suburban hospital have two or more
      risk factors for developing venous thromboembolism.

PMID- 1754887
TI  - Venous thromboembolism prophylaxis and risk assessment in medical patients.
AB  - In summary we have developed a VTE risk assessment system for medical patients
      based on our prior experience in surgical patients. In this model we divide
      individuals into low, moderate, and high-risk categories. We realize that our
      system needs further validation with appropriate diagnostic endpoints to
      correlate the actual occurrence of venous thromboembolism with the predicted risk
      on the basis of our score system. Nevertheless, the proposed model reflects one
      approach to achieving a prophylaxis tailored to the patients' risk.

PMID- 1754888
TI  - Interpretation of the lung scan.

PMID- 1754889
TI  - Deep venous thrombosis and pulmonary embolism.

PMID- 1754890
TI  - The problems of the clinical and laboratory diagnosis of pulmonary embolism.
AB  - Suspecting and diagnosing venous thrombosis and pulmonary embolism remain major
      clinical problems. For a variety of reasons, including the patient's pre-existing
      cardiac and pulmonary status and the release of humoral mediators, pulmonary
      emboli evoke varied responses in different patients. Symptoms and signs of
      pulmonary embolism are not specific; they depend on the size and the hemodynamic
      and humoral consequences of the embolus. Conversely, they may not be present at
      all. Chest radiographic and electrocardiographic findings are nonspecific, and
      may be most helpful in establishing the presence of other conditions that may be
      confused with pulmonary embolism. Arterial blood gases can only heighten the
      suspicion of pulmonary embolism; they should never be used to exclude the
      diagnosis. Clinical and laboratory findings therefore do not diagnose pulmonary
      embolism; rather, they raise the level of concern and set the stage for the
      performance of subsequent diagnostic studies.

PMID- 1754891
TI  - Lung scanning in the diagnosis of pulmonary embolism: the emperor redressed.
AB  - Diagnosis and management of the patient with pulmonary embolism remains a vexing
      clinical problem. Emboli are often unsuspected clinically. Ventilation-perfusion
      (VQ) scintigraphy is known to miss some emboli found on pulmonary angiography.
      Some physicians recommend diagnostic approaches in which the lung scan plays a
      relatively minor role, and angiography is required for many patients. Major
      prospective studies recently have made available objective data for formulation
      and evaluation of diagnostic and therapeutic strategies. These data suggest that
      the lung scan is a better predictor of patient outcome than has been previously
      appreciated. The goal of V/Q scanning is not detection of pulmonary emboli per
      se, but rather the identification of patients at a high or low risk for future
      embolic events if they are not anticoagulated. Several studies have shown that
      some emboli found on angiography are clinically benign and, in the absence of
      persistent thrombosis of the lower extremities, do not require anticoagulation.
      Treatment trials and clinical follow-up studies have shown that although the V/Q
      scan is not always predictive of angiogram results, it is a reliable predictor of
      patient outcome. In the absence of deep vein thrombosis, the low-probability scan
      identifies a patient population not requiring anticoagulation. When combined with
      objective studies of the venous system, the ventilation-perfusion lung scan
      provides a guide to management in the great majority of patients. Pulmonary
      angiography is required only occasionally.

PMID- 1754892
TI  - Advances in ultrasound imaging of venous thrombosis.
AB  - In the contemporary clinical setting, a diagnosis of deep vein thrombosis can be
      established using ultrasound. While different ultrasound modalities, including
      direct B-mode venous imaging, Doppler, and vein compression, have been employed
      to diagnose clot, it is the compression technique that has been established as
      the dominant method. In venographically controlled series, compression ultrasound
      has demonstrated a 93% sensitivity and 99% specificity for clot detection. These
      remarkable results have been achieved without the evaluation of calf veins.
      Recent improvements in instrumentation have permitted the direct visualization of
      calf veins, and it would seem likely that this will result in even better
      sensitivity for clot detection.

PMID- 1754893
TI  - Antifibrin scintigraphy in the diagnostic evaluation of acute deep venous
      thrombosis.
AB  - Antifibrin scintigraphy is a new and innovative approach to the diagnosis of
      acute deep venous thrombosis (DVT). Many antifibrin monoclonal antibodies (Mo
      Abs) have been described, but only two, 59D8 and T2G1s, have undergone broad
      preclinical or clinical investigation. Both of these MoAbs recognize an epitope
      on the amino terminal end of fibrin. The epitope for 59D8 and T2G1s is available
      for binding only on newly formed, acute thrombi. Preclinical studies have
      confirmed the specificity of these MoAbs for acute DVT, and have demonstrated
      their ability to image experimentally induced DVT. Preliminary clinical studies
      in patients with signs or symptoms of DVT have evaluated indium-111 59D8 Fab and
      technetium-99m T2G1s Fab'. Fragments of the intact MoAbs are employed to promote
      faster blood clearance and to reduce immunogenicity. The initial clinical studies
      indicate that antifibrin scintigraphy has a diagnostic accuracy approaching 90%.
      Antifibrin scintigraphy has the potential for overcoming many of the deficiencies
      of both invasive (contrast venography) and noninvasive (Doppler/ultrasound,
      impedance plethysmography) methods for detecting DVT. With a single procedure, it
      provides an accurate and rapid evaluation of both lower extremities, both above
      and below the knee. Because of its unique specificity for acute DVT, it should
      have excellent potential for use in patients with suspected acute, recurrent DVT,
      a condition difficult to diagnose by all currently employed tests for DVT.

PMID- 1754894
TI  - A noninvasive strategy for the management of patients suspected of pulmonary
      embolism.
AB  - As a consequence of recent studies that have (1) established the role for
      ventilation-perfusion lung scanning in the diagnosis of pulmonary embolism, (2)
      clarified the contribution of clinical assessment to the diagnostic utility of
      lung scans, and (3) established a role for the noninvasive assessment of the
      lower extremities for deep venous thrombosis in patients suspected of having
      pulmonary embolism, we can now manage clinically stable patients suspected of
      pulmonary embolism without need for invasive diagnostic procedures. The various
      studies establishing this approach are reviewed, and an algorithm is presented
      that allows for the noninvasive workup of clinically stable patients suspected of
      having pulmonary embolism.

PMID- 1754895
TI  - Etidronate sodium therapy--a cause of poor skeletal radiopharmaceutical uptake.

PMID- 1754896
TI  - Intense focal uptake of technetium-99m diphosphonate in a soft tissue mass.

PMID- 1754897
TI  - Panda sign--avid and symmetrical radiogallium accumulation in the lacrimal and
      parotid glands.

PMID- 1754898
TI  - [Light adaptation properties of receptor potentials of cyprinid retina].
AB  - It was previously reported that changes in sensitivities of electroretinographic
      b-wave in the course of light adaptation depended on the intensity of background
      lights. B-wave sensitivity decreased with time by dimmer background lights, while
      it recovered during illumination with background lights of higher intensities. In
      this work we examined light adaptation properties of glutamate-isolated receptor
      potentials (P III components), using isolated and superfused cyprinid retinas.
      During dimmer background illumination, P III components were unchanged. When
      background lights were increased above certain levels, P III components showed
      partial recovery with time in the light. A detailed analysis of spectral
      sensitivities of P III components and their increment thresholds for several
      wavelengths indicated that the recovery of P III sensitivity appeared with
      background lights at which rod function was taken over by cone function. The
      results suggest that the recovery of b-wave sensitivity during brighter
      background illumination is partially a reflection of the adaptation property of
      cone photoreceptors.

PMID- 1754899
TI  - [Measurement of central motor conduction time (CMCT) in healthy Chinese
      subjects].
AB  - Transcutaneous electrical stimulation of the central nervous system was used to
      measure CMCT between the human cerebral cortex and spinal cord. 64 normal
      volunteers (46 healthy adult males and 18 females, age of 20-67 years, body
      height of 156-185 cm) were recruited as experimental subjects. Action potentials
      of muscles were recorded from upper limb (Thenar) and lower limb (Muscle tibialis
      anterior) following cortical and spinal stimulation. The cortical and spinal
      latent periods (Lcor., Lsp.) were measured and CMCT was obtained by subtracting
      Lsp. from Lcor. for each muscle. The CMCT between the cerebral cortex and the
      first thoracic (Th1) cord was 6.69 +/- 1.48 ms, while that between the cerebral
      cortex and the first lumber (L1) cord was 12.90 +/- 1.59 ms. Statistical analysis
      indicated that CMCT was not related to sex, age, body height and left or right
      side of the body as well. The motor conduction velocity in spinal cord (MCVsp)
      between Th1 and L1, [distance (Th1 to L1)/CMCT (Muscle tibialis anterior)-CMCT
      (Thenar)] was found to be 71.34 +/- 10.89 m/s, which corresponds to the
      conduction velocity of the large fibers in the pyramidal tract. The results of
      the present study are valuable in diagnosis and prognosis of motor system
      diseases in CNS.

PMID- 1754900
TI  - [Changes of the arterial baroreflex sensitivity in one-kidney Grollman
      hypertensive rats].
AB  - The objective of this study was to investigate the changes of arterial baroreflex
      sensitivity (ABS) in one-kidney Grollman hypertensive rats. The blood pressure
      was altered with phenylephrine or sodium nitroprusside. Mean arterial pressure
      (MAP) and pulse interval were recorded simultaneously and the MAP-pulse interval
      regression line was constructed. All rats were divided into three groups:
      Grollman-operation group, sham-operated group and normal group. ABS was
      determined at the 3rd week after operation. The results were as follows: The ABS
      of the Grollman hypertensive group was significantly lower than that of the sham
      operated group (P less than 0.01). After i.v.c. injection of 150 micrograms
      captopril the MAP of both groups are lowered, but more significantly in Grollman
      than in the sham-operated group (P less than 0.05, at 35 min after injection).
      From 35 to 60 min after injection, the MAP of the sham-operated group has
      practically reached a steady level while that of the Grollman group still shows
      significant tendency of decline. At 60th min, the ABS of the hypertensive was
      significantly increased than that measured 60 min before injection (P less than
      0.05), while similar measurements for the sham-operated group showed only a
      slight or much less significant increase. MAP was increased and ABS was decreased
      by i.v.c. injection of 8 micrograms angiotension II in the normal group. The
      results of the present investigation indicate that ABS decreases during the
      development of one-kidney Grollman hypertensive rats, and that this change
      appears to be related to the increased concentration of angiotension II in the
      brain.

PMID- 1754901
TI  - [Central norepinephrine and angiotensin II contents in the brain regions of
      spontaneously hypertensive rats (SHR) and the interaction between them].
AB  - The norepinephrine (NE) and angiotensin II (A II) contents in the brain regions
      of SHR and WKY (Wistar Kyoto) rats at different ages were determined by
      fluorospectrophotometry and radioimmunoassay. The systolic blood pressure (SBP)
      of the rats was measured indirectly with a tail cuff technique in conscious
      state. The results were as follows: There was no significant difference in the
      central A II and NE contents between SHR and WKY rats at 8-week age. Since 12th
      week age the SBP of SHR has increased gradually, up to 16th to 20th week and then
      maintained steady level. Whereas there was no significant change of SBP in WKY
      rats in the same span of age. In the early and late states of hypertension the A
      II contents in the medulla oblongata, pons, hypothalamus and nucleus caudatus of
      SHR were markedly higher than those of the age-matched WKY rats. But the change
      of NE content of SHR in the early stage showed a different picture as compared
      with that of WKY rats, i.e., NE decreased in medulla oblongata and anterior
      hypothalamus but increased in pons, posterior hypothalamus and nucleus caudatus.
      However, in the late stage there was no such significant difference between SHR
      and WKY rats. Consequently, it is suggested that the central A II and NE
      participated in the development of hypertension of SHR, and that the maintenance
      of hypertension is mainly dependent upon the increased A II content.
      Microinjection of captopril or 6-OHDA in the lateral cerebroventricle of SHR
      elicited a decrease of BP and reduction of both A II and NE contents in the
      medulla and hypothalamus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754902
TI  - [Effects of antihypertensive factor from erythrocytes of essential hypertensive
      subjects on blood pressure in rats].
AB  - The effects of antihypertensive factor (AHF) from erythrocytes of essential
      hypertensive human subjects on the systolic blood pressure (SBP) and diastolic
      blood pressure (DBP) in spontaneously hypertensive rats (SHR), renal hypertensive
      rats (RHR), Wistar-Kyoto rats (WKY) and Wistar rats were examined. Single
      intraperitoneal injection of AHF (1.6 mg/kg body weight) resulted in a
      significant decrease in SBP of SHR and RHR. At 10 min postinjection, AHF lowered
      the SBP in SHR by 34.0 mmHg. SBP recovered to the original level at 3 h. The
      maximal decrease of SBP in RHR by 92.5 mmHg was at 24h postadministration and the
      SBP did not recover until the 9th day. When AHF was administered via femoral vein
      (0.8 mg/kg body weight), the maximal decrease values of the SBP and the DBP were
      42.8 and 48.2 mmHg in SHR at 12 min and 38.3 and 42.5 mmHg in RHR at 25 min
      postinjection respectively. The DBP in Wistar rats decreased considerably (from
      96.7 +/- 12.9 to 83.3 +/- 11.7 mmHg) at 5 min postadministration of AHF, but no
      effect on DBP in WKY rats was observed. The depressor effect of AHF on SBP in RHR
      was dose-dependent. AHF could also antagonize the pressor effect of
      norepinephrine in Wistar rats.

PMID- 1754903
TI  - [Effects of stimulation of arcuate nucleus on intragastric pressure and
      peripheral pathway analysis in rats].
AB  - The effect of electrical stimulation of arcuate nucleus (ARC) on intragastric
      pressure (IGP) was examined on 68 Wistar rats anaesthetized with urethan. The
      results were as follows: (1) Stimulation of ARC could induce an obvious decrease
      of IGP. (2) This effect was not blocked by atropine but partially by vagotomy.
      (3) Extirpation of celiac neural plexus or intramuscular injection of
      phentolamine could obviously reduce the suppression of IGP induced by ARC
      stimulation, but intramuscular injection of propranolol had no such effect. (4)
      After vagotomy plus extirpation of celiac neural plexus, IGP could still be made
      a decrease by stimulating ARC. In view of the present investigation, it is
      suggested that (1) Both sympathetic nerve and vagus are involved in the reduction
      of IGP induced by ARC stimulation, the former and the latter routes being
      respectively mediated by alpha-adrenoceptor and non-cholinergic, non-adrenergic
      fibres. (2) Humoral factors may be also involved in this effect of ARC
      stimulation.

PMID- 1754904
TI  - [Effect of zinc on immune function in normal mice].
AB  - Swiss mice were used for studying the effects of zinc on the immune function and
      on the structure of thymus. The experimental results showed that: 1) When mice
      were administered with a dose of zinc 0.2mg/d of mouse for 15 d, the number of
      mature T lymphocyte in peripheral blood increased significantly, the
      transformation of lymphocytes and DTH response were both markedly enhanced;
      phagocytosis of peritoneal macrophage was suppressed, but the production of IgM
      and the weight of thymus were not affected. 2) The shape of lymphocyte nucleus of
      the thymus cortex became irregular by administration of zinc. So, a certain
      immunity promotive dose of zinc may impose a latent injury to the lymphocyte of
      thymus.

PMID- 1754905
TI  - [Effect of salt-loading on prostacyclin and thromboxane metabolism in kidney].
AB  - For evaluating the role of prostacyclin (PGI2) and thromboxane A2 (TXA2) in the
      metabolism of salt and water, the metabolic products of PGI2 and TXA2 (6-keto
      PGF1 alpha and TXB2 respectively) were measured by radioimmunoassay in salt
      loaded rabbits. 36 normal rabbits were randomly divided into 3 groups: 1. normal
      control group; 2. 3h salt-loading group (3 h group); 3. 24 h salt-loading group
      (24 h group). Both the 3 h and 24 h groups were given 0.9% NaCl solution by
      subcutaneous injection to the hind legs. The kidneys were dissected into 4
      slices: outer cortex, inner cortex, outer medulla and inner medulla. The plasma 6
      keto-PGF1 alpha in the 3 h group was increased from the control value of 46.61 +/
      19.04 pg/ml to 111.63 +/- 58.36 pg/ml (P less than 0.01). All of the dissected
      renal slices also showed significant increase of 6-keto-PGF1 alpha synthesis in
      both the 3 h and the 24 h groups (P less than 0.001 vs. normal). The urinary
      sodium concentrations have a good correlation with 6-keto-PGF1 alpha in plasma or
      in kidney tissues. Plasma TXB2 in normal group was 499.27 +/- 197.86 pg/ml, but
      no significant change was found in the 3h group. However, in the 24 h group it
      decreased significantly to 218.76 +/- 114.54 pg/ml (P less than 0.05 vs. normal
      group). Although the TXB2 increment was significant only in inner medulla, all
      other dissected renal slices showed some increase of TXB2 synthesis too. It is
      concluded that salt-loading can cause increase of PGI1 and TXA2 synthesis in
      normal renal tissues.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754906
TI  - [Antiinflammatory drugs inhibit the elevation of plasma CGRP concentration in
      endotoxin shock in rats].
AB  - In the present study, we observed the effects of indomethacin, ibuprofen,
      naloxone and morphine on plasma CGRP concentration 3 h after endotoxin shock in
      conscious rats. The results showed that indomethacin, ibuprofen and naloxone
      significantly inhibited the elevation of plasma CGRP concentration as well as
      reduced the lesion in the intestine during endotoxin shock. However, morphine had
      no significant effect. The data are consistent with our hypothesis that
      prostaglandin, as one of the inflammatory mediators which increase in shock may
      be an important endogenous factor for triggering the CGRP release during
      endotoxin shock.

PMID- 1754907
TI  - Hemorrhage associated with "bone crisis" in Gaucher's disease identified by
      magnetic resonance imaging.
AB  - Children suffering from Gaucher's disease were examined by magnetic resonance
      imaging (MRI) during a characteristic episode of "bone crisis". An unexpectedly
      high intramedullary as well as subperiosteal signal was observed on both the T1-
      and T2-weighted sequences in 5 patients, suggesting a subacute hemorrhage or
      hematoma. It is conceivable that such a painful hemorrhage is an important
      component of the "bone crisis" phenomenon. Furthermore, in these cases this is a
      specific sign which may enable differentiation of bone crises from other types of
      bone pain associated with Gaucher's disease.

PMID- 1754908
TI  - Forearm deformities in multiple cartilaginous exostoses.
AB  - Sixteen patients with 20 forearm deformities were reviewed. The deformities were
      classified into three types. The degree of ulnar tilt of the radius, ulnar
      displacement of the carpus, and relative ulnar shortening were determined. The
      severity of the deformity correlated with these measurements. Metacarpal lengths
      were also measured. Significant metacarpal shortening without exostoses was seen
      in 10 of 11 patients and with exostoses remote from the metaphysis in 10 of 13
      patients. Metacarpal shortening correlated with the type and severity of
      deformity.

PMID- 1754909
TI  - Pulmonary Aspergillus chest wall involvement in chronic granulomatous disease: CT
      and MRI findings.
AB  - Pulmonary Aspergillus infection in patients with chronic granulomatous disease
      tends to involve the chest wall and consequently carries a high mortality rate.
      We report the findings of computed tomography (CT) and magnetic resonance imaging
      (MRI) in three such cases. One patient underwent both CT and MRI, one, CT only,
      and one, MRI only. In all three, both CT and MRI demonstrated pulmonary
      consolidations with direct extension to the adjacent chest wall. In both patients
      who were examined by CT, scans revealed permeative osteolytic changes of adjacent
      rib or spine compatible with osteomyelitis. In both patients who were examined by
      MRI, adjacent chest wall involvement was depicted on T1-weighted images and
      showed increased signal intensity on T2-weighted images. In one of these
      patients, the chest wall lesion was well defined on T2-weighted images, an
      appearance compatible with abscess. Epidural extension was demonstrated on MRI in
      the other patient, who later developed paraparesis. We suggest that CT and MRI
      have a complementary role in evaluating chest wall invasion by pulmonary
      Aspergillus infection in chronic granulomatous disease.

PMID- 1754910
TI  - Osteoarthritis associated with distal interphalangeal joint involvement in
      rheumatoid arthritis.
AB  - A study was undertaken to investigate the relationship between the clinical and
      radiological findings in patients with rheumatoid arthritis (RA), osteoarthritis
      (OA), and combined osteoarthritis and rheumatoid arthritis (OA/RA) affecting the
      hands. Fifty patients were selected for each group from those attending a
      rheumatology clinic. The study showed a good correlation between the clinical and
      radiological diagnosis of combined OA/RA and that marginal erosive changes in the
      distal interphalangeal (DIP) joints occur more commonly in patients with
      rheumatoid arthritis who have coexisting osteoarthritis.

PMID- 1754911
TI  - Magnetic resonance imaging features of fractures using the short tau inversion
      recovery (STIR) sequence: correlation with radiographic findings.
AB  - The MRI characteristics of fractures have been described on the basis of spin
      echo (SE) images emphasizing T1 and T2 contrast. These previous studies were
      carried out for injuries in which radiographic proof was often lacking. In
      comparison with SE images, short tau inversion recovery (STIR) images have been
      shown to provide superior contrast between normal and abnormal marrow. To
      determine the MRI characteristics of fracture using STIR pulse sequences, we
      reviewed 28 patients who had radiographic evidence of fracture and were examined
      with T1-weighted SE and STIR sequences. MRI marrow signal abnormalities were
      demonstrated at all fracture sites ranging in age from less than 24 h to 8 weeks.
      The extent of marrow signal abnormalities exceeded the size of corresponding
      radiographic findings of fracture in all cases. The MRI features of fractures on
      T1-weighted SE images consisted of irregular intramedullary zones of
      hypointensity. On STIR images a corresponding zone of hyperintensity extended to
      the outer cortical margin. Intramedullary lines of hypointensity extending to the
      inner cortical margin were identified within the hyperintense marrow abnormality
      on STIR images in 64% of the fractures. The results of this study show that MRI
      using T1-weighted SE and STIR sequences can consistently demonstrate prominent
      signal abnormalities at fracture sites including those in which radiographic
      signs are subtle.

PMID- 1754912
TI  - Skeletal manifestations of granulocytic sarcoma (chloroma).
AB  - Skeletal manifestations of chloroma were reviewed in five patients. In four
      cases, a chloroma was the initial manifestation of a systemic disease. In the
      fifth, an elderly patient developed a bone lesion during a blastic crisis while
      under treatment for chronic myelogenous leukemia. Two patients presented with
      lytic lesions of the ribs, two with lytic lesions of the femur, and one with a
      predominantly sclerotic lesion of the scapula. The laboratory findings in two
      patients were within normal limits. All lesions were confirmed by bone biopsy.

PMID- 1754913
TI  - Bursitis in association with solitary osteochondromas presenting as mass lesions.
AB  - Three patients with solitary osteochondromas which were increasing in size have
      been recently examined. Plain films were available on all patients; two patients
      had MR studies, and two had CT scans. In all three cases, malignant
      transformation of the osteochondroma was suspected from the cross-sectional
      imaging studies, but pathologic examination proved that these patients all had
      bursa formation without any evidence of malignancy. The incidence of this rare
      complication of solitary osteochondroma is discussed. Ultrasound is also
      recommended for the evaluation of enlarging solitary osteochondromas.

PMID- 1754914
TI  - Seronegative arthritides of the anterior chest wall: a follow-up study.
AB  - Fourteen patients with arthritis of the anterior chest wall (ACW) as part of
      ankylosing spondylitis, reactive arthritis, and arthritis associated with
      psoriasis and/or pustulosis palmoplantaris (PPP) were re-examined after periods
      of 5-15 years (mean 9 years) using tomography. The findings were compared with
      those of 24 similarly examined patients with predominant osseous sclerotic ACW
      lesions or monarthritis of the manubriosternal joint. Pronounced osseous
      hyperostosis in the region of the sternoclavicular joint accompanied by
      ossification of the costoclavicular ligament was found to occur only in patients
      with PPP lesions. Patients with ankylosing spondylitis and reactive arthritis
      developed slight or moderate hyperostosis only and no ligament ossification.
      Predominant osseous sclerotic sternal and clavicular lesions occurred in patients
      with PPP and in patients without skin disease or traits suggesting well-known
      arthritides, but not as part of ankylosing spondylitis and reactive arthritis.
      Arthritis of the manubriosternal joint and upper sternocostal joints developed in
      all forms of arthritis.

PMID- 1754915
TI  - Case report 676: Malignant granular cell tumor (schwannoma, myoblastoma),
      disseminated.
AB  - A rare case of metastatic, lethal, malignant granular cell tumor is presented in
      a 77-year-old woman. Metastases involved numerous sites, including the skeleton.
      The key clinical and pathological findings and differential diagnosis in benign
      and malignant granular cell tumor were discussed, including a review from the
      English literature of 23 cases of malignant granular cell tumor. The differential
      diagnosis was considered in detail.

PMID- 1754916
TI  - Case report 693: Schneckenbecken dysplasia.
AB  - Three siblings with SBD from consangineous parents are reported. The prenatal
      diagnosis of a short-limbed form of dwarfism was made by ultrasonography and the
      final diagnosis in the index case by radiography, demonstrating a short-limbed,
      platyspondylic dwarf with a snail-like configuration of the ilium and vertebral
      bodies, flat on AP and round on lateral view. The histological examination showed
      a generalized, severe disturbance of cartilage formation with marked
      hypercellularity of proliferating and resting zones, reduction of intercellular
      matrix, and shortening of the irregular columns of proliferating cartilage. The
      ultramicroscopic findings were nonspecific. This is the first report of SBD after
      the original description, bringing the total to 14 cases in 5 families. The
      correct radiological diagnosis and the differential diagnosis, in particular
      thanatophoric dysplasia, are essential for genetic counselling and obstetrical
      guidance of families affected with this autosomal recessive dysplasia.

PMID- 1754917
TI  - Case report 694: Cervical paravertebral circumscribed myositis ossificans.
AB  - MO is a soft-tissue mass, reported only 3 times in the cervical paravertebral
      area in a search of the literature. We describe an additional case in a 10-year
      old girl. We emphasize that in the unusual radial radiopaque roentgenographic
      image, a malignant tumor could be considered. We also stress that CT scanning can
      be of great value in establishing the diagnosis. The clinical types and the
      radiological and pathological features of MO are described in some detail and the
      "zonal" sign is described.

PMID- 1754918
TI  - Case report 695: Cementifying fibroma of the proximal end of the tibia.
AB  - A case of a cementifying fibroma in the proximal end of the tibia in a 31-year
      old woman is presented. The lesion was expanding but well-defined with amorphous
      central calcification. The unique, calcified, cementum-like particles in a
      fibrous stroma have been reported in only four previous cases in long bones. The
      histological and radiographic differences between a cementifying fibroma, bone
      cysts with cementum, and a true cementoma are discussed. The radiological
      differential diagnosis of fibrous dysplasia, giant cell tumor, and low grade
      central osteosarcoma was considered.

PMID- 1754919
TI  - Case report 696: Chondroblastoma of the right acetabulum and superior pubic
      ramus.
AB  - A case of chondroblastoma involving the right acetabulum and superior pubic ramus
      in a 60-year-old man has been presented. Tissue was obtained by open biopsy. The
      clinical and radiographic characteristics of chondroblastoma in general, and this
      tumor in particular, were discussed. The histopathology and differential
      diagnosis were also considered. The relatively uncommon site of the tumor and its
      occurrence in an older patient made the radiographic diagnosis difficult, and
      other possibilities were discussed.

PMID- 1754920
TI  - Case report 697: Neuropathic arthropathy of the shoulder with no identified
      cause.
AB  - Two cases of neuropathic disease of the shoulder without evidence of a
      neurological disorder are described. The absence of any neurological disorder led
      to the cases being initially mistaken for primary neoplasms of bone, lending
      support to the vascular theory of pathogenesis of this lesion. Careful attention
      to the radiographic features and knowledge that a neurological disorder need not
      be present should lead to the correct diagnosis.

PMID- 1754921
TI  - Case report 698: Osteoma of the clavicle.
AB  - We have presented a case of an osteoma of the clavicle in a 41-year-old man. The
      possibility of alternate diagnoses--in particular, ancient osteochondroma,
      posttraumatic hyperostosis, and parosteal osteosarcoma--was addressed. However,
      the pathological examination was most consistent with the diagnosis of osteoma.
      This benign bone lesion is most often found in the calvarium, jaw, and face.
      Osteomas of long bones remain extremely rare, except in the setting of Gardner's
      syndrome.

PMID- 1754922
TI  - Toward a redefinition and contextualization of the abortion issue.

PMID- 1754923
TI  - Confronting the lack of resources for patients with AIDS dementia complex.

PMID- 1754924
TI  - Reviving the action research model: combining case and cause with dislocated
      workers.
AB  - Action research, a model combining research with activist goals and microlevel
      and macrolevel social work practice, has received little recent attention in the
      social work literature. This article reports on an action research project
      conducted by a major labor union and a university department of social work to
      assist dislocated workers in New England. A partnership of union-trained peer
      counselors and social work faculty and students combined a research study with
      providing direct service to displaced workers, assisting in an organizing
      project, and developing a policy agenda to assist low-income workers. The author
      suggests that an action research model can be used by social workers in a wide
      variety of settings and under different practice auspices.

PMID- 1754925
TI  - The mediator role in social work practice.
AB  - The frameworks and skills of a mediator are indigenous to social workers.
      Mediation's purpose and place in human problem solving are inherent in the
      definition of social work practice. Decisions about assuming the mediator role
      with clients require that social workers weigh desired outcomes and constraints
      of the role. Helping client systems assume power and efficacy to negotiate
      problem resolution is a needed empowerment-oriented strategy in social work
      practice. Teaching client systems to negotiate and mediate for themselves may
      result in mutually agreeable solutions and growth and attitude change on the part
      of the client.

PMID- 1754926
TI  - A role perception study of school social work practice.
AB  - A study conducted in an intermediary educational agency examined principals' and
      special education teachers' perceptions of actual and ideal performance of school
      social work tasks. Those services seen as provided most frequently are directed
      toward individuals. Although respondents want these services to continue, they
      also want more group work services. The study contained several recommendations,
      including one for the development of individualized building service plans and
      another on the development of a screening process for special education
      assessments.

PMID- 1754927
TI  - Changing the focus of social work supervision: effects on client satisfaction and
      generalized contentment.
AB  - An experiment and three replications were conducted in which the focus of social
      work supervision was varied to compare client outcomes under two conditions. A
      social work supervisor gave two male and two female mental health center staff
      eight weeks of supervision with a mixed focus on administration, training, and
      clinical consultation. This was followed by eight weeks of client-focused
      supervision in which questions were asked about client problems and staff
      interventions in the context of client outcomes. The dependent variables were
      mean weekly caseload reports of generalized contentment and three dimensions of
      client satisfaction. Outcome data were plotted and examined with visual analysis
      for trend and aggregated for effect-size calculations. Adult outpatients reported
      significantly greater satisfaction under client-focused supervision. The findings
      suggest that social work supervision affects clients, and that client
      satisfaction improves if supervisors ask questions about client problems and
      staff interventions in the context of client outcomes.

PMID- 1754928
TI  - Practitioner involvement in clinical evaluation.
AB  - Contrary to popular belief, social workers are evaluating their practice, but
      what they do falls short of the use of quantitative procedures that researchers
      have promoted. Data obtained from a survey of social workers drawn from the
      National Association of Social Workers national membership list suggest that the
      gap between practitioners and clinical researchers may stem in part from
      different mindsets as well as from actual differences in the commitment to the
      importance of clinical evaluation. Moreover, in the minds of practitioners there
      appears to be a sharp distinction between formal single-subject design studies
      and the general evaluative tasks in which they routinely engage.

PMID- 1754929
TI  - A model of case management: toward empirically based practice.
AB  - Case management is highly valued as an intervention method for providing service
      to clients requiring long-term care. However, it lacks definitional consensus and
      conceptual clarity. An explicit, empirically based model of case management is
      presented on the basis of 15 functions and their dynamic interrelationship along
      a sequential dimension. A series of studies is described by means of which the
      model was devised, tested, and refined.

PMID- 1754930
TI  - The six languages of social work.
AB  - This article describes the six languages that scientifically minded and practice
      competent social workers need to be fluent in: the lay language of the client,
      the abstract language of the theorist, the empirical and often quantitative
      language of the researcher, the categorical language of the information
      scientist, the technical terminology or jargon used by helping professionals, and
      the preferential language that conveys values. It is the thesis of this article
      that social workers need multilingual and translingual proficiency in moving
      rapidly back and forth among these languages for maximum effectiveness and humane
      service.

PMID- 1754931
TI  - Facilitating progress in group therapy by means of the basic human relations
      laboratory.

PMID- 1754932
TI  - Changes in fatigue characteristics of cervical paraspinal muscles with posture.
AB  - The median frequency of the myoelectric signal of the cervical paraspinal muscles
      was studied in 28 normal subjects in prone and sitting positions. Median
      frequency parameters (initial median frequency and slope of the median frequency)
      of the myoelectric spectrum were monitored during sustained isometric neck
      extensions at 20%, 50%, 80%, and 100% of maximum voluntary contractions. Force
      output of 100% maximum voluntary contractions was also measured in the prone and
      sitting positions. Reliability of the median frequency parameters for repeated
      trials at various force levels was computed. There were significant differences
      (P less than 0.05) in the median frequency parameters between the prone and
      sitting positions, and there was significantly higher 100% maximum voluntary
      contractions force production in the prone position than in the sitting position
      (P less than 0.05). There were also high reliability estimates for the median
      frequency parameters in both test positions. The cervical paraspinal muscles may
      use different strategies of recruiting motor units during force production in
      various postures of the neck. It therefore is necessary to standardize the
      testing procedures before the median frequency parameters can be considered
      objectively to measure the muscle function in the neck.

PMID- 1754933
TI  - Anatomic and biomechanical assessment of transarticular screw fixation for
      atlantoaxial instability.
AB  - The purpose of this study is to elucidate anatomically the atlantoaxial
      transarticular screw fixation described by Magerl in 1979 and compare it
      biomechanically with Gallie wiring. Five human C1-C2 specimens were tested in
      flexion/extension and rotation intact, then after wiring and screw fixation. Mean
      screw length was 39 mm, 25 mm in the C2 lamina and 14 mm in the lateral mass.
      Angular displacement of screwed specimens was significantly less than control or
      wired groups. Stiffness at 0-0.5 Nm loads was significantly greater for screwed
      specimens than for wired or controls (101 +/- 49 Nm, 10.3 +/- 9.2 Nm, and 1.96 +/
      0.18 Nm, respectively). All specimens withstood 5 Nm in flexion and extension
      without failure. Screw fixation provides stability comparable to Gallie wiring
      and is stiffer at low-range forces and rotational angles.

PMID- 1754934
TI  - Postoperative spinal epidural empyema. Clinical and computed tomography features.
AB  - Epidural empyema is a rare complication of elective spinal surgery. Four such
      cases are described. The clinical features of this postoperative complication
      were surprisingly vague and misleading. Fever was uncommon. Local inflammatory
      signs or rapid neurologic deterioration were absent. Computerized tomography
      proved useful in diagnosis and follow-up. Unlike spontaneous spinal epidural
      abscess, postoperative spinal epidural empyema had a benign course. Causative
      bacteria were miscellaneous. Surgical evacuation of the purulent collection and
      appropriate antibiotic therapy resulted in cure in all cases.

PMID- 1754935
TI  - Selection of lumbar fusion levels in adult idiopathic scoliosis patients.
AB  - Fifty-three adult idiopathic scoliosis patients whose fusions ended caudally
      between L2 and S1 were reviewed relative to criteria for selection of the lowest
      fused vertebra and their outcome. The Harrington stable zone, central sacral
      line, and the presence of rotary subluxation, arthritis, spondylolisthesis,
      vertebral body and disc space wedging were studied. Preoperative and
      postoperative pain, quality of life, and decisions for surgery were surveyed with
      a 94% response. Results showed the older the patient, the lower the fusion. The
      Harrington stable zone was useful, whereas the central sacral line frequently
      indicated longer fusions by as much as three segments. The presence of
      pathoanatomic features also dictated lower fusions. Patients in whom the lowest
      level of fusion was consistent with selection criteria had reduced frequency and
      intensity of low-back pain.

PMID- 1754936
TI  - The Cotrel-Dubousset system--results in spinal reconstruction. Early experience
      in 47 patients.
AB  - Forty-seven patients were treated with spinal fusion and Cotrel-Dubousset
      instrumentation and were followed for an average of 28 months. Spinal procedures
      included: 1) posterior spinal fusion for idiopathic scoliosis (26 patients); 2)
      posterior pseudarthrosis repair (5 patients); 3) combined anterior/posterior
      fusion to the sacrum (6 patients); and 4) combined anterior/posterior osteotomies
      (10 patients). Group 1: Partial derotational correction was achieved for
      adolescent idiopathic scoliosis. Group 2: Successful pseudarthrosis repair was
      achieved in four patients. Group 3: A solid arthrodesis was obtained in two
      patients, whereas the other three patients underwent revision of sacral screw
      fixation for pseudarthrosis. One patient died postoperatively. Group 4: Pain
      relief and a balanced correction was achieved in all patients. The Cotrel
      Dubousset system appears to be a versatile system and provides a wide range of
      possibilities for a variety of spinal problems.

PMID- 1754937
TI  - Common diagnostic and therapeutic procedures of the lumbosacral spine. The North
      American Spine Society's Ad Hoc Committee on Diagnostic and Therapeutic
      Procedures.

PMID- 1754938
TI  - Functional biomechanics of the spine.
AB  - The exact nature of the mechanisms at work during movement of the human spine are
      not well understood, nor well defined. The spine supports the torso against loads
      and allows freedom of motion, within physiologic limits, at the same time. A
      great deal of information characterizing various attributes of the spine is
      available. Research has provided values for flexural stiffness, axial compliance,
      range of motion under various loading modalities, and considerably more. This
      study will focus not on isolated topics, but rather serve as a broad introduction
      to the behavior of the spine as a whole.

PMID- 1754939
TI  - In vitro spinal biomechanics. Experimental methods and apparatus.
AB  - The functional units making up the spinal column allow fully six degrees of
      freedom, but with range of motion constraints due to the associated ligamentous
      and bony structures. Research into the behavior of the spine requires complex
      testing methodologies, consequently. Reproducing physiologic behavior in the
      spine requires the application of suitable forces or displacements through
      loading frames that do not interfere with the its intrinsic behavior. Monitoring
      of the outcomes can be done on the basis of force, length or pressure
      measurements, or combinations thereof. An exploration of testing methodologies
      and apparatus is presented. The applicability and related overheads, due to data
      acquisition or analysis, of such methods are discussed. This will provide a means
      for the researcher to assess the hardware requirements to attain the objectives
      of their project.

PMID- 1754940
TI  - The use of mathematical models for studies of scoliosis biomechanics.
AB  - The use of mathematical and other types of models for the study of the
      biomechanics of scoliosis is reviewed in this article. The article is based on a
      talk presented at the 1987 Meeting of the Scoliosis Research Society.

PMID- 1754941
TI  - Biomechanical testing and scoliosis. In vivo methods.
AB  - Patients with scoliosis deformity can be evaluated from a biomechanical viewpoint
      by measurement of spinal morphology, back surface topography, and changes in
      these measurements both acutely and over time. In addition, the forces acting on
      the spine can be estimated in vivo. Many ethical and practical challenges have
      been overcome, and these measurement techniques have provided information on
      spinal deformity and its treatment. Further insights have come from biomechanical
      analyses of these measurements, and complementary modeling studies. This study
      reviews the available methodologies and the progress that has been made toward
      using these methods in assessing outcomes in treatment. Possible future
      directions for in vivo measurements are suggested for studies of etiology, growth
      regulation, progression of deformity, three-dimensional assessment of treatment
      outcome, and monitoring of individual patients.

PMID- 1754942
TI  - Biomechanics of posterior lumbar fixation. Analysis of testing methodologies.
AB  - A variety of biomechanical methods have been used for the experimental evaluation
      of spine instrumentation in vitro. Consensus has not been reached for criteria to
      compare the performance of dissimilar devices. The range of load-displacement
      conditions currently used for in vitro testing of spine instrumentation was
      reviewed, and compared to calculated estimates for flexion, lateral bending, and
      torsion loads. It is recommended that future studies simulate combinations of
      loads or displacements associated with common patterns of motion, and that the
      distraction across the region of injury be measured. For cyclic testing, input
      frequencies of 4-5 cycles/sec are within physiologic range, and offer advantages
      over tests at lower frequencies. The development of consistent protocols based on
      physiologic conditions should facilitate the biomechanical assessment of
      techniques for stabilizing the human spine.

PMID- 1754943
TI  - Pitfalls of biomechanical testing.
AB  - A review of the pitfalls of biomechanical testing and its experimental designs
      are presented in order to provide a format for the young spinal experimentor, and
      an outline of procedural error and logical thinking for nonclinical spinal
      experimentation, be it in vitro, in vivo, or with mathematical modeling.
      Subsequent sections deal with the specifics of in vitro and in vivo testing and
      mathematical modeling.

PMID- 1754944
TI  - Computed tomography and magnetic resonance imaging findings of pigmented
      villonodular synovitis of the spine.

PMID- 1754945
TI  - Esophageal erosion. A complication of acrylic fixation in anterior cervical
      fusion.

PMID- 1754946
TI  - A congenital defect resembling the Hangman's fracture.

PMID- 1754947
TI  - Spinal rehabilitation by work tolerance based on objective physical capacity
      assessment of dysfunction.

PMID- 1754948
TI  - Social Security Bulletin. Annual statistical supplement, 1991.

PMID- 1754949
TI  - The osteopathic cranial concept: fact or fiction?

PMID- 1754950
TI  - The functional relationship between the occlusal plane and the plantar arches. An
      EMG study.
AB  - We studied many postural tests with an electromyographical methodology on a group
      of young men who had a right molar precontact. We compared the results of these
      tests before and after changing the right plantar arch by placing some plastic on
      the medial right margin of the homolateral plantar arch (talipes valgus) or on
      the whole plantar arch (flat foot). We demonstrated the dependence of the
      occlusal plane on the morphological variations of the plantar arch.

PMID- 1754951
TI  - The superior laryngeal nerve loop and its surgical implications.
AB  - Based upon findings from 60 cadavers (120 sides), the incidence of superior
      laryngeal nerve loop, connecting the cervical sympathetic chain and the superior
      laryngeal nerve and its branches, the external and internal laryngeal nerve, was
      98.3% (118 out of 120 sides). In most cases the loop connected the sympathetic
      chain and the external laryngeal nerve. The external laryngeal nerve was looped,
      and not linear as traditionally thought. The loop could be divided into three
      categories, V-shaped, U-shaped and mixed, and subdivided into 5 types and 17
      subtypes according to morphological variation. The loop without exception
      innervated not only the cricothyroid muscle, but also the thyroid gland. The loop
      is one of the origins of the thyroid nerve. It seems that for thyroid surgery the
      loop, when lower in position, should be carefully separated from the superior
      thyroid vessels before the latter are ligated, in order to preserve a normal
      nerve supply to the muscle as well as to the part of the gland that remains after
      surgery.

PMID- 1754952
TI  - Reliability of the acetabular teardrop as a landmark.
AB  - This study investigated the effect of tilt and observer reliability on
      radiographic measurements of the position of a prosthetic acetabular cup in seven
      dry bone pelves using the teardrop as a landmark. Coronal or sagittal tilt of
      more than five degrees was easily recognisable and there was effectively no
      observer variation in the measurements up to this limit. In addition, 90 out of
      100 randomly selected antero-posterior pelvic radiographs from an outpatient
      department were not significantly rotated and 93 demonstrated a clearly defined
      teardrop. Measurements about the teardrop on routine radiographs are therefore
      sufficiently accurate to allow assessment of prosthetic position.

PMID- 1754954
TI  - A new cephalic reference plane for use with magnetic resonance imaging: the
      chiasmato-commissural plane.
AB  - A cephalic reference plane is described through the chiasmatic notch and the
      posterior commissure, which is easily identified on mid-sagittal cuts using
      magnetic resonance imaging. The horizontal cuts so obtained are almost parallel
      to the lateral fissure and are perpendicular to the axis of the brain stem.

PMID- 1754953
TI  - The portal bifurcation and the termination of the hepatic veins: an anatomical
      investigation into the projection of the ultrasonographically important hepatic
      vessels onto the anterior body wall.
AB  - An investigation was carried out on 50 cadavers, in which the projection onto the
      anterior abdominal wall of the following vascular points was examined: the portal
      bifurcation, the direction of the course of the right and left branches of the
      portal vein and the terminal course of the hepatic veins near their entry into
      the inferior vena cava (IVC). The results are related to a transverse axis
      passing through the apex of the xiphoid process and the median plane in the
      supine position. The average position of the portal bifurcation is projected onto
      a point between a vertical line passing through the midpoint of the right
      hemithoracic width and a horizontal line passing through a point on the
      midclavicular line (MCL) corresponding to 57% of the height of the liver measured
      upwards from its inferior margin. The axis of the prehepatic course of the portal
      vein makes an angle of about 50 degrees, open downwards, with a vertical line
      drawn through the apex of the internal angle of the portal bifurcation. A line
      parallel to the course of the right and left branches of the portal vein is
      projected on to a surface line cranial to the right costochondral margin, which
      runs upwards at an angle of approximately 20 degrees towards the apex of the
      xiphoid process. The termination of the three great hepatic veins is projected at
      about the level of the xiphisternal joint, one sternal width to the right of the
      midline. Close to the IVC, the right hepatic vein runs upwards and medially at an
      angle of between 20 degrees and 30 degrees with the transverse plane.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1754955
TI  - The cystohepatic ducts: surgical implications.
AB  - The cystohepatic ducts (CHDs) drain the entirety of a hepatic territory of
      variable extent into the cystic duct or gallbladder (cholecystohepatic ducts).
      Certain very rare patterns of the CHDs constitute anomalies but as a rule a CHD
      represents one of the numerous variants of division of the extrahepatic bile
      ducts. Their existence is explained by the normal anatomic development of the
      bile-ducts. They are usually discovered during peroperative cholangiography
      performed during cholecystectomy for gallstones. Their actual incidence is small:
      1-2% of cases. A CHD was found by the authors on 12 occasions in a total of 1410
      cholecystectomies (0.9%). The CHDs are always bile ducts of the right lobe of the
      liver and may drain a subsegment or segment, a sector or, exceptionally, the
      whole of the right lobe of the liver. Peroperative cholangiography does not
      always allow distinction of the CHDs from other and equally rare variants of
      division of the extrahepatic bile-ducts, whose existence carries the same
      practical implications. The existence of the CHDs is unpredictable. Their
      position renders them particularly vulnerable during cholecystectomy and the
      seriousness of an accidental injury of a CHD depends on the extent of the hepatic
      territory it drains. Strict observance of the rules of biliary surgery and
      routine peroperative cholangiography should preserve the integrity of CHDs
      draining an extensive hepatic territory.

PMID- 1754956
TI  - The normal uterus on magnetic resonance imaging and variations associated with
      the hormonal state.
AB  - Magnetic Resonance Imaging of the pelvis has lead to a new radioanatomical
      description of the uterus. Variations in the anatomical zones of the uterus were
      noted with different sequences used in MRI. There was also structural and signal
      variation depending on hormonal impregnation. Twenty seven MRIs of pelvices were
      carried out on 16 female volunteers. Eight of them were on oestroprogesterone as
      the method of contraception (Group I) and had a single MRI. Six were not taking
      contraceptives (Group II) and had different MRI's during the same cycle. Two
      women already had already gone through the menopause (Group III). Results showed
      differences in the size of the uterus (uterine height, length of the uterine body
      and cervix, diameter of the cervix) between groups I and II but no cyclic changes
      were observed within group II. The myometrium was found to be thicker in group I
      and in the luteal phase of group II females in comparison to the follicular phase
      in the same group. The endometrial cavity was seen in 40% of cases on T1 weighted
      sequences; on T2 weighted sequences it was seen in all the cases. It was thicker
      during the second phase in group II than in group I and III. The myometrial
      signal compared to that of the bladder content (urine) showed a significant
      increase between early and late echoes on T2 weighted sequences in group I and
      during the second phase of the menstrual cycle in group II. No variations, or at
      times a decrease in signal, were observed during the first phase of the cycle in
      group II.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754958
TI  - Abnormal styloid process in a human skull.
AB  - In a survey of 232 Indian human skulls, unusually long and stout, bilateral
      styloid processes were found in one of them. The length, thickness, the inter
      styloid distance and the relations of the styloid processes to other associated
      structures at the base of the skull are discussed, highlighting the possible
      importance in clinical and surgical conditions.

PMID- 1754957
TI  - The lymphatic drainage of the human ovary in vivo investigated by isotopic
      lymphography before and after the menopause.
AB  - The authors report 14 lymphoscintigraphies of the ovary, 8 before and 6 after the
      menopause. Injection of colloid labeled with technetium 99 m with elective
      lymphatic absorption was made into the mesovarium under laparoscopic control.
      Frontal and lateral images of the lymphatic drainage were made with a gamma
      camera 4-6 h after injection. Even in this short preliminary series, the
      premenopausal women showed major local and regional lymphatic circulation with
      drainage to the lumbo-aortic and pelvic nodes. After the menopause the lymphatic
      flow decreased and drainage was essentially by the aorto-lumbar nodes.

PMID- 1754959
TI  - An anomalous muscle crossing the supraclavicular triangle: the cleidotrachelian
      muscle.
AB  - An abnormal muscle is described that passes superficially across omohyoid in the
      left posterior triangle of the neck. Its origin resembles that of scalenus
      anterior, but its form is triangular and it inserts directly onto the superior
      surface of the clavicle just lateral to the clavicular head of
      sternocleidomastoid. Its anatomical course gives it morphological and
      embryological interest; its relations in the supraclavicular triangle give it
      considerable surgical relevance. The name cleidotrachelian muscle is suggested.

PMID- 1754960
TI  - Lymphatic drainage of the right atrium and ventricle of the heart.

PMID- 1754961
TI  - Lymphatic drainage of the left atrium and ventricle of the heart.

PMID- 1754962
TI  - Dorsal arterial supply to the thumb. New surgical possibilities for palmar skin
      coverage.

PMID- 1754963
TI  - The peroneus tertius island muscle flap.

PMID- 1754964
TI  - The subtendons of the abductor pollicis longus muscle.

PMID- 1754965
TI  - Pain, suffering, and anxiety in animals and humans.
AB  - We attempt to bring the concepts of pain, suffering, and anxiety into sufficient
      focus to make them serviceable for empirical investigation. The common-sense view
      that many animals experience these phenomena is supported by empirical and
      philosophical arguments. We conclude, first, that pain, suffering, and anxiety
      are different conceptually and as phenomena, and should not be conflated. Second,
      suffering can be the result--or perhaps take the form--of a variety of states
      including pain, anxiety, fear, and boredom. Third, pain and nociception are not
      equivalent and should be carefully distinguished. Fourth, nociception can explain
      the behavior of insects and perhaps other invertebrates (except possibly the
      cephalopods). Fifth, a behavioral inhibition system associated with anxiety in
      humans seems to be present in mammals and most or all other vertebrates. Based on
      neurochemical and behavioral evidence, it seems parsimonious to claim that these
      animals are capable of experiencing anxious states.

PMID- 1754966
TI  - What is chronic pain?
AB  - Chronic pain leads to individual suffering and to major costs for all developed
      countries. Previous studies suggest that both the incidence of disabling chronic
      pain and the amount of health care consumption due to chronic pain are rapidly
      increasing. Western medicine is not only often ineffective but may be one of the
      causes of this epidemic. This article will address the issue of chronic pain of
      unknown etiology and has the goals of: (1) identifying the factors which have led
      to our confusion about this topic, and (2) proposing alternative ways of
      conceptualizing chronic pain and its ensuing behaviors and social consequences.
      It is concluded that it is essential to discriminate between tissue damage, pain,
      suffering, pain behaviors, health care consumption, impairment and disability if
      one is to develop a meaningful conceptualization of the medical, social, economic
      and political problems of chronic pain. Successful treatment must be defined in
      behavioral terms such as restoration of normal activities. Disabling chronic pain
      is often a sign of overwhelming stress engendered by the individual's failure to
      cope with the demands of industrialized society.

PMID- 1754967
TI  - Philosophy in epidemiology.

PMID- 1754968
TI  - [Fatigue, fatigability and weakness--a frequent symptom].

PMID- 1754969
TI  - [Cardiovascular causes of abnormal fatigability].
AB  - Excess fatigue is a common symptom of many chronic cardiovascular disorders with
      low cardiac output. Impairment of skeletal muscle function due to metabolic
      alterations seems to play a major role. In heart failure fatigue is a predominant
      symptom. It may be an early symptom on diseases with slow but progressive
      inhibition of blood flow, i.e. in constrictive pericarditis, pulmonary
      hypertension or mitral valve stenosis. Excess fatigue as a precursor of
      myocardial infarction is being discussed. Finally fatigue may be a limiting side
      effect of diuretic and beta-blocking agents.

PMID- 1754970
TI  - [Pulmonary causes of abnormal fatigability].
AB  - Abnormal physical exhaustion and fatigue are often simply regarded as a natural
      consequence of pulmonary diseases. Apart from factors not specifically related to
      pulmonary diseases (e.g. consequences of infections or malignant diseases of the
      lungs), increased work of breathing due to impaired lung/thoracic cage mechanics,
      the effects of chronic hypoxia and hypercapnia, the consequences of disturbed
      sleep and psychosocial factors are mainly responsible for the impaired physical
      fitness and the fatigue in association with lung diseases. A careful case history
      including psychosocial aspects and a thorough physical examination are essential
      for an efficient diagnostic evaluation. Tests of pulmonary function not only in
      the awake patient at rest, but also during sleep or adequate physical exercise
      can reveal the causes of impaired physical performance and fatigue related to
      lung diseases.

PMID- 1754971
TI  - [Endocrine and other medical causes of abnormal fatigability].
AB  - Many endocrine diseases can cause fatigue. Tiredness is a frequent symptom of
      primary and secondary hypothyroidism, hyperthyroidism, excessive glucocorticoid
      or mineralocorticoid production, primary and secondary adrenal insufficiency,
      primary and secondary hypogonadism and hyperprolactinemia in the male,
      acromegaly, diabetes mellitus and diabetes insipidus. A great number of medical
      diseases other than those mentioned in the articles on cardiological and
      pneumological fatigue can also cause abnormal tiredness (infectious diseases,
      hematological, renal, hepatic, gastrointestinal and rheumatological disturbances,
      vasculitis and malignant tumors). The pathogenesis of tiredness caused by
      endocrine or medical illnesses, i.e. how the sensation of fatigue is produced, is
      not clear. The fatigue of the various endocrine or other medical diseases is not
      disease-specific, i.e. its characteristics do not differentiate it from the
      fatigue of other illnesses.

PMID- 1754972
TI  - [Abnormal daytime drowsiness--attempt at typology].
AB  - Abnormal drowsiness during the day is defined on the basis of three criteria: 1.
      subjective feeling of increased tiredness, 2. objective observation of attacks of
      falling asleep, 3. detection of premature falling asleep in the multiple sleep
      latency test. About 3 to 4% of the population of modern industrial countries
      complain of this symptom which very quickly leads to inability to work in
      numerous occupations (driving instructors, lorry drivers, airline pilots). In
      many cases, the symptoms can be eliminated by effective methods of treatment.
      Early diagnosis and therapy is hence an important task of physicians. Clinically
      suitable tools and methods of measurement for appraising the phenomena are at
      present: 1. the multiple sleep latency test (Richardson et al., 1978), 2. the
      multiple staying awake test (Mitler et al., 1982), 3. the vigilance test
      according to Quatember and Maly from the Vienna test system. In
      neurophysiological terms, an attempt is made to differentiate between: REM
      drowsiness, non-REM drowsiness, hypofunction of the arousal systems of the
      reticular formation, and hyperfunction and overstimulation of the arousal systems
      of the reticular formation (over-aroused tiredness). Approaches to a clinical
      typology of abnormal drowsiness are available from two points of departure: 1.
      Forms of permanent somnolence which are not alleviated but intensified by a brief
      restorative sleep and resemble the 'oversleeping syndrome' of the healthy
      individual. 2. Attacks of imperative falling asleep in narcoleptic patients. The
      characteristic of this form of abnormal drowsiness during the day is that in the
      interval between the attacks of falling asleep patients can take on any healthy
      person with regard to alertness, reaction capacity and ready wit. After a brief
      restorative sleep of less than 5 min., they immediately feel fresh, alert and fit
      again.

PMID- 1754973
TI  - [Intense fatigue in humans. Psychosocial and cultural aspects].
AB  - A differentiation between the normal sensation of tiredness and the symptom
      "fatigue" is often difficult. Both are influenced by cultural, social,
      psychological and biological factors, which can lead--interactively--to symptom
      formation. Psychiatric disorders frequently associated with fatigue are all forms
      of depression, somatization and anxiety disorders, chronic pain states and drug
      abuse among many others. In at least 2/3 of patients with the fashionable chronic
      fatigue syndrome--formerly called neurasthenia--a psychiatric diagnosis can be
      made, most of them also suffer from many symptoms attributes to the autonomous
      nervous system. The clinical approach should be cautious avoiding diagnostic and
      therapeutic overaction and therapy should emerge from a diagnosis properly
      assessed.

PMID- 1754974
TI  - [From the symptom fatigue to an etiological diagnosis--an attempt at differential
      diagnosis].
AB  - One out of three patients seeking the doctors advice complain about fatigue. Two
      out of three are fatigued because of psychological reasons. A systematic way of
      analysis of this symptom is described, as well as the characteristics of somatic
      fatigue syndromes as opposed to psychogenic ones. Finally a brief description is
      given of the main diseases accompanied by fatigue.

PMID- 1754975
TI  - [Pharmacovigilance of hypolipidemic drugs (fibrates and probucol), from databanks
      of the French System of Pharmacovigilance].
AB  - The methodology of a retrospective study of the side-effects of the most
      prescribed lipid lowering drugs, essentially fibrates, is described. This study
      concerns the last 5-years reports to the French System of Pharmacovigilance,
      centralized in the common data-base located in Lyon. During this period 36,875
      reports were recorded, only 409 in which an hypolipidemic drug is stated as
      "suspect" (according to WHO's definitions) were selected and analyzed. All
      fibrates were involved, those most frequently implicated being the most widely
      prescribed (e.g. fenofibrate represents half of the reports).

PMID- 1754976
TI  - [Muscular involvement and fibrates. Analysis of databanks of the French System of
      Pharmacovigilance].
AB  - A retrospective study of the muscular adverse reactions of fibrates has been
      conducted from the last 5-years reports of the 30 French Regional Centers of
      Pharmacovigilance, centralized in the common data bank located in Lyon. Fifty
      four reports in which at least one fibrate stated as suspect (according to the
      WHO's definitions) have been reviewed. Those 54 reports represent 13% of the side
      effects reported with fibrates during this same period. Fibrates seem to be
      involved as frequently as prescribed, so fenofibrate was the most frequently
      suspected and the most prescribed. The most usual terms found were "myalgia" and
      "elevation of CPK". This study shows evidence of the interest of the data-bank of
      the French System of Pharmacovigilance (which has collected 36,890 reports with
      all the drugs during the same period); harmonization in the choice of the terms
      selected for computerizing the cases would improve the exploitation of this sum
      of data.

PMID- 1754977
TI  - [Side effects of fibrates (except liver and muscle)].
AB  - If the iatrogenic acute muscular syndromes (rhabdomyolysis) and hepatic diseases
      following hypolipidemic drugs therapy are very well known, the other unwanted
      effects associated with fibrate therapy are not well established. It is the
      reason why we have selected, in the computerised data base of side effects from
      the French Network of "Centres de Pharmacovigilance" organisation, the
      pathological events associated with fibrate therapy during five years (1985 to
      1989) (with exception for the acute muscular and hepatic diseases). The 277 side
      effects represent 67% of the side effects in which the product is regarded as
      "suspect" (S). These effects were observed in 132 men (mean age = 57 years) and
      145 women (mean age = 61 years). The most frequently encountered products are:
      fenofibrate (Lipanthyl) for 30%; ciprofibrate (Lipanor); gemfibrozil (Lipur);
      bezafibrate (Befizal); each for about 10%. The mean doses used were the same that
      suggested in the french therapeutic dictionary ("Vidal"). The unwanted effects
      observed were: Skin reactions: 22.8% Blood disturbances (and hemorrhage): 9.8% Gl
      diseases (pancreatitis), Libido and psychic disturbances, nervous system
      disorders: about 6% each. All clotting disturbances (5.8%) are interactions with
      coumarin derivatives. The incidence of serious side effects was low and the
      recovery very good in 80.9% of cases: no death. In conclusion, the toxicity of
      fibrates (with exception for rhabdomyolysis and hepatic reaction) appears
      unimportant: the most frequently observed side effects are skin reactions and
      blood disturbances (interactions) and rarely nervous system, psychic or libido
      disturbances. The recovery is good, and the general toxicity of all products
      appear to be of the same order of magnitude.

PMID- 1754978
TI  - ["Eosinophilia-myalgia" syndrome due to L-tryptophan containing products.
      Cooperative evaluation of French Regional Centers of Pharmacovigilance. Analysis
      of 24 cases].
AB  - By November 17, 1989, the MMWR published the 154 first reports of a syndrome
      consisting of myalgia and eosinophilia (EMS), occurring with the consumption of L
      tryptophan containing products (L-TrpCp) and which might represent a new clinical
      entity. To standardize reporting over the country, the CDC of Atlanta developed
      the following case definition: 1) a peripheral blood total eosinophil count of
      more than 1 x 10(9) cells per liter 2) generalized myalgia sufficiently severe to
      affect a patient's ability to pursue daily activities 3) the exclusion of
      infections or neoplastic conditions. The FDA then, announced its intention to
      seek a nationwide recall of all tryptophan containing products, followed by other
      european countries (UK, Germany, France). In France, a first decree (January 4th
      1990) completed by a decree on May 11th confirms this decision for one year. This
      measure did not concern the medicinal products or some dietary supplements for
      newborn or young children. Since December 11th, 1989, 24 cases have been reported
      to the Regional Adverse Drug Reaction Monitoring Centres in France. These cases
      share the same features as the cases notified previously in the USA:
      overrepresentation of females, no relationship with the time and the daily
      intake, clinical similarities to the Shulman syndrome, and unknown prognosis.
      Now, more than one year after the onset of this illness, it seems that
      discontinuation of the ingestion of L-TrpCp can resolve or improve the symptoms
      in most cases, but sometimes the syndrome can persist. The causal relationship
      between the ingestion of L-TrpCp and this syndrome has been established. Whatever
      the mechanism for the development of EMS among tryptophan users remains unclear,
      as well as the role of eosinophilia and the factors for fibroblast proliferation.
      The epidemic emergence of this syndrome in July 89 raises the possibility of the
      contamination of tryptophan during the manufacturing process. To confirm this
      hypothesis, the same unusual peak in HPLC analysis was found both in case
      associated L-Trp lots and in implicated-japanese manufacturer L-Trp lots in USA.
      But this would not explain the previous EMS reports before this contamination.
      Other hypotheses consist an inabnormality of tryptophan metabolism and/or an
      autoimmune process.

PMID- 1754979
TI  - [Agranulocytosis under metapramine. A "well-known" effect without bibliographical
      data].
AB  - Metapramine (Timaxel) is a tricyclic antidepressant drug devoid of
      anticholinergic properties. As other psychotropic drugs, it may induce
      hyperthermia and several case-reports have been published. Agranulocytosis is an
      exceptional side-effect of this drug. Even if several cases have been reported to
      Pharmacovigilance structures in France, as far as we know there is no publication
      of this unwanted effect. The authors reported the case of an old woman who has
      presented two episodes of fever and asthenia. Blood formula was both times
      characterized by agranulocytosis without anemia nor thrombocytopenia. The
      accidental rechallenge of metapramine permitted to conclude to a causal
      relationship between these hematological events and metapramine intake.

PMID- 1754980
TI  - [Prospective OMEGA survey (Drug use-pregnancy relationship survey at the French
      Riviera)].
AB  - The survey of drugs used during pregnancy is necessary and the need for
      prospective studies is recognized. Health book distribution where drug intake is
      written since the beginning of the pregnancy allows a narrow therapeutic survey.
      The 350 first books analysis show that pregnant women use an average of well
      resorbed 1.8 drugs during 1rst and 3rd pregnancy trimesters. The most commonly
      used drugs are vitamins and iron (by 56% of women), non-narcotic analgesics
      (40%), antibiotics (40%), veinotonics (38%) and hormonal treatments (25%).

PMID- 1754981
TI  - [Secondary effects of drugs. The 1979 Halcion experience in the Netherlands, a
      false alarm?].
AB  - In the course of 1979 the Netherlands Centre for Monitoring of Adverse Reactions
      to Drugs (NARD) received a remarkably large number of reports on patients with
      unusual and complex psychic disturbances, attributed to the use of the then
      recently marketed hypnotic triazolam. The interpretation of the data was
      difficult, however, and several questions could at that time not be properly
      answered. In the past 10 years a specific benzodiazepine withdrawal syndrome has
      been identified, showing many similarities with the disturbances as reported in
      association with triazolam. In addition similar adverse experiences with
      triazolam have been reported in many other countries. Tablets containing 1 mg and
      0.5 mg triazolam, as were widely used in the Netherlands, have in the mean time
      been globally removed from the market. It is concluded that the triazolam
      syndrome may be explained as a combination of strong benzodiazepine effects and
      withdrawal phenomena. The ultra short half-life of triazolam and the high doses
      used may have contributed to the problems as observed in the Netherlands. The
      signal perceived by the NARD appears to have been a valuable warning, rightly
      casting doubt on the safety of triazolam and the original dosage recommendations.

PMID- 1754982
TI  - [Drug utilization at the end of pregnancy].
AB  - To evaluate drug utilization during the last 15 days of pregnancy, one hundred
      six women were interviewed post-delivery in the CHU Bretonneau in Tours. Eighty
      three percent received at least one drug during the 15 days preceding delivery
      and 27% more than 3 different drugs. Treatments for venous disorders (31% of
      patients), iron (31%), analgesics (25%), antacids (11%), magnesium (11%) and
      laxatives (11%) were most frequently used. In 92% of cases the drug was
      prescribed. Five women received a drug with potential risk for the neonate.
      However only one infant developed and adverse effect, possibly due to
      benzodiazepine (hypotonia).

PMID- 1754983
TI  - [Peri-rectal infectious cellulitis with septicemia of anal origin. Suppository on
      trial].
AB  - Rectal route with local or general effects, is an interesting possibility of
      treatment. Easy use and rapid absorption are two major advantages. But this
      therapeutic modality is not riskless. We report a case of septicemia with peri
      rectal cellulitis which was generated by two ano-rectal ulcerations after using
      Trophires suppositories. The infection was favoured by local application of
      cortisone. Our original observation, with ano-rectal ulcerations and short use of
      suppository, confirms the idea of short-term treatment stopped in case of
      unwanted symptom.

PMID- 1754984
TI  - [Cardio-circulatory arrest with mifepristone sulprostone combination for
      pregnancy interruption].

PMID- 1754985
TI  - [Proposition for a new imputation approach in pharmacovigilance related to the
      use of topical agents].

PMID- 1754986
TI  - [Thrombocytopenia and tubulo-interstitial nephropathy associated with
      fluindione].

PMID- 1754987
TI  - [Bismuth revisited in Helicobacter pylori gastro-duodenal infection].
AB  - The various hypothesis for the explantation of reversible bismuth encephalopathy
      are reviewed and discussed. Today, this side effect appears to be devoid of
      mystery, due to uncontrolled and inhibited ingestion of bismuth salts which
      increased the emergence of genetic and physiopathologic risk factors and brought
      about the cases of neurotoxicity. Bismuth therapy has shown major efficacy in the
      treatment of gastroduodenal ulcers. Colloidal bismuth subcitrate is as effective
      as the H2-receptor antagonists in peptic ulcer. In addition, it offers a lower
      rate of relapse. This therapeutic benefit has been attributed to a cytoprotective
      and demulcent action. Moreover bismuth acts as an antimicrobial agent,
      suppressing the organism Helicobacter pylori which occupies a central place in
      contemporary views on pathophysiology of ulcer disease. Side effects so far
      reported have been very infrequent mild and transient when the drug is used at
      low dosage providing blood-bismuth concentration above toxic values. Colloidal
      bismuth subcitrate complies to the requirements for a modern drug insofar as it
      is prescribed in period no longer than 6-8 weeks, followed by 8 weeks bismuth
      free intervals.

PMID- 1754988
TI  - [Pharmacokinetics of methotrexate and clinical response associated in the medical
      treatment of ectopic pregnancies].
AB  - Methotrexate (MTX) is used in the medical treatment of unruptured ectopic
      pregnancy. This drug is administered by intramuscular (IM) or intrasaccular (IS)
      injection under sonographic control. No data are available concerning the
      pharmacokinetics of MTX in this new indication. This study compares the two
      administration routes in 12 patients (21 to 37 years) taken as their own control
      and presenting with ectopic pregnancy (51 +/- 12 days of amenorrhea). Our aim was
      to compare the pharmacokinetic profile of MTX for each route to facilitate its
      use in the future. The initial level of hCG was 4.474 +/- 4.184 mIU/ml. Each
      patient firstly received 1 mg/kg of MTX intrasaccularly under vaginal sonography.
      The same dose was injected intramuscularly 48 hours later. The pharmacokinetic
      profiles of MTX after IS and IM administrations were determined after both
      injections during 48 hours. MTX serum levels were measured by Fluorescence
      Polarization Immuno Assay. Data were analyzed by model independent methods and
      compared by a Wilcoxon T test (p 0.01 was considered as significant). All the
      unruptured ectopic pregnancy were cured and the hCG serum levels were normalized
      (10 mIU/ml) in 37 +/- 18 days. After IM administration, AUC0-infinity is
      significantly (p 0.01) increased i.e., 15.1 +/- 4.1 mumol.h/l versus 11.2 +/- 4.8
      after IS injection. T1/2 lambda z and MRT remained unchanged whatever the route
      is i.e., 11.3 +/- 4.9 h and 8.6 +/- 3.9 h (IS) versus 12.1 +/- 5.9 h and 7.3 +/-
      1.8 h (IM). The decrement of AUC0-infinity 8 determined after IS injection might
      be the consequence of the capture of the MTX by the trophoblastic cells (target
      cells).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1754989
TI  - [Chronopharmacokinetics of dexamethasone in young subjects].
AB  - Dexamethasone chronopharmacokinetics was studied in six young subjects 20 to 30
      years old. The randomized cross-over study consisted of evening (11.00 p.m.) or
      morning (08.00 a.m.) dose separated by a period of one week. After the evening
      administration of the drug, only Tmax (1.77 +/- 0.74 a 11.00 p.m. and 0.99 +/-
      0.64 a 08.00 a.m.) and Cmax/Tmax were higher than those determined at 08.00 a.m.
      This difference might be related to a cyclic variation of the absorption phase of
      dexamethasone. Thus, in our study, the time of administration has only a weak
      effect on the pharmacokinetics of dexamethasone.

PMID- 1754990
TI  - [Myoclonic epilepsy induced by levodopa].

PMID- 1754991
TI  - [Regression of propylthiouracil-induced dysgeusia after treatment with zinc].

PMID- 1754992
TI  - [Thrombocytopenia probably induced by norfloxacin. Apropos of a case].

PMID- 1754993
TI  - Cathepsin G can produce a gla-domainless protein C in vitro.
AB  - Human polymorphonuclear leucocyte cathepsin G was used in vitro to digest human
      protein C. Anticoagulant assays showed that the proteinase affected a rapid loss
      in the anticoagulant activity of the zymogen. Calcium ions almost totally
      protected the anticoagulant activity of protein C against the action of cathepsin
      G. Polyacrylamide gel electrophoresis, in the presence of SDS (non reducing
      conditions), indicated that the proteolytic action of cathepsin G lead, to the
      removal of a peptide of low molecular mass (PC-L'') from protein C with the
      consequent formation of a product of high molecular mass (PC-P). Electrophoresis
      in the presence of SDS (reducing conditions) showed that the PC-L'' fragment was
      removed from the light chain of protein C (PC-L). N-terminal amino acid analysis
      of the PC-P product and COOH terminal amino acid analysis of PC-L'' product
      confirmed that cathepsin G had cleaved position Phe40:Trp41 in the light chain.
      This cleavage was responsible for removal of the gamma-carboxyglutamic acid (gla)
      containing region of protein C.

PMID- 1754994
TI  - Could proteolytic enzyme modulate the interaction platelets/vessel wall in
      presence of ASA at ultra low doses?
AB  - Acetylsalicylic acid (ASA) is known to act on platelets and vessel walls. At
      ultra low doses it reverses the inhibitory effects produced by a vascular
      fragment. Use of papain on normal platelets in vitro led to the appearance of
      platelet aggregation without collagen induction with a range of 20.25 +/- 28.91%.
      In the presence of vascular fragments (without ASA), this "spontaneous"
      aggregation remained but was reduced (13.26 +/- 27.73%). This effect was reversed
      by ASA treatment (29.41 +/- 24.17%). Reversion of vascular inhibition by ASA was
      not modified by papain.

PMID- 1754995
TI  - Platelet glycogen synthase: further characterization and effect of insulin.

PMID- 1754996
TI  - Prevalence of antiphospholipid antibodies in deep vein thrombosis and their
      relationship to blood coagulation and fibrinolysis.
AB  - Elevated levels of antiphospholipid antibodies are associated with an increased
      risk of thrombosis. To establish the prevalence of these antibodies in deep vein
      thrombosis (DVT), IgG and IgM antibodies to cardiolipin (aCL) and
      phosphatidylserine (aPS) were determined by enzyme-linked immunosorbent assay in
      118 patients with DVT either during an acute episode (N = 53) or at least 2
      months after acute DVT (N = 65). Most patients (76%) had proximal leg DVT and no
      one had evident autoimmune disorder. aCL and aPS values higher than 4 standard
      deviations above the mean value of the control group (147 blood donors) were
      considered increased. Increased IgG aCL were observed in 10% of DVT patients
      (controls: 5%, not significant), increased IgG aPS in 16% of DVT patients
      (controls: 5%, p less than 0.005) and both types in 4% of DVT patients (controls:
      3%, not significant). In the subgroup of 41 patients with previous idiopathic
      DVT, prevalence of increased IgG aPS was the highest: 27% (p less than 0.001).
      Increased antibodies of IgM isotype were observed in 3% (aCL) and 2% (aPS) of all
      DVT patients (controls: 8% and 4%, respectively, not significant). Elevated IgG
      aCL or aPS were not associated with significant changes in platelet count,
      antithrombin III and protein C. However, in patients with increased IgG aPS
      deficient fibrinolysis due to high plasminogen activator inhibitor activity was
      observed before and after 20 min upper arm venous occlusion. DVT patients with
      increased IgG aPS might be exposed to a greater risk of rethrombosis due to
      deficient fibrinolysis than DVT patients without these antibodies.

PMID- 1754997
TI  - Effect of diabetes on photochemically induced thrombosis in femoral artery and
      platelet aggregation in rats.
AB  - Effect of diabetes on thrombogenesis was examined by using a thrombus model with
      photochemical reaction in the rat femoral artery. In streptozotocin-induced
      diabetic rats for 8 weeks, the formation of thrombus following endothelial injury
      was significantly slower than that in non-diabetic rats. Insulin treatment
      normalized the abnormality of thrombogenesis. Aggregation in washed platelets
      from rats with diabetes was enhanced. However, platelet aggregation in whole
      blood was reduced in diabetic rats, and plasma from diabetic rats attenuated
      platelet aggregation. These results suggest that plasma factor(s) and/or other
      blood cells modify the hyperaggregability of platelets per se in vivo in diabetic
      rats. Treatment with insulin improved the aggregation in whole blood and washed
      platelets. In conclusion, diabetes induces the prolongation of thrombogenesis in
      the rat femoral artery. Hypoaggregability of whole blood is likely to be partly
      involved in the abnormal thrombogenesis.

PMID- 1754998
TI  - In vitro effects of two novel calcium antagonists (nitrendipine and nisoldipine)
      on intraplatelet calcium redistribution, platelet aggregation and thromboxane A2
      formation. Comparison with diltiazem, nifedipine and verapamil.

PMID- 1754999
TI  - Antiplatelet effect of the pyrimido-pyrimidinic derivative RA-642.

PMID- 1755000
TI  - The transient increase of plasma thrombin-antithrombin III (TAT) complex levels
      in patients with congenital antithrombin III deficiency during antithrombin III
      administration is due to extraction of thrombin from fibrin.

PMID- 1755001
TI  - Human alpha- and zeta-thrombin inhibition by recombinant HV1 and HV2K47 hirudins.

PMID- 1755002
TI  - Plasminogen activator inhibitor activity as a possible indicator of disease
      activity in rest angina with angiographically insignificant coronary artery
      stenosis.
AB  - To assess the role of fibrinolytic system, 19 patients with rest angina and
      insignificant coronary artery stenosis and 23 controls performed symptom-limited
      multistage exercise. Vasospasm was angiographically demonstrated in 12 patients.
      Pre- and peak exercise blood samples from each patient were assayed to determine
      the fibrinolytic components. The patients displayed significantly increased PAI
      activity both under the basal conditions (p less than 0.01) and at peak exercise
      (p less than 0.01) as compared with the controls. However, the values of other
      fibrinolytic components, such as t-PA antigen, t-PA/PAI-1 complex and free PAI-1
      antigen, in the controls and patients were similar. Nineteen patients were
      divided into two groups according to PAI activity levels under basal conditions.
      Nine patients displayed high PAI activity (more than the mean + 1 SD of the
      control value) under the basal conditions. When compared to the remaining 10
      patients, the high PAI activity group had both a significantly short time
      interval from the last attack to the time of getting the blood sample (p less
      than 0.05), and a worse short-term prognosis (p less than 0.05). Thus, the level
      of PAI activity under basal conditions reflected the extent of disease activity,
      suggesting that PAI activity may be a useful clinical indicator of the severity
      of rest angina in patients without significant coronary stenosis.

PMID- 1755003
TI  - Anti-Xa clotting activities in different hepatic-triglyceride lipase preparations
      from post-heparin plasma.
AB  - Two different preparations of hepatic triglyceride lipase (HTGL) with comparable
      lipolytic activities, purified from post-heparin human plasma, were assessed for
      their anti-Xa activities by two clotting and one chromogenic method. Preparation
      1, prepared by heparin affinity followed by ion exchange chromatography, did not
      contain antithrombin III and exhibited no anti-Xa activity in any of the assay
      systems. Preparation 2, prepared by two consecutive heparin affinity
      chromatography steps, was active in all three assay systems, and was shown to
      contain antithrombin III (AT III). Addition of purified AT III to preparation 1
      did not result in the anti-factor Xa activity of preparation 2, and monoclonal
      antibodies to AT III did not antagonize the activity of preparation 2. These
      results show that the anti-Xa activity of some HTGL preparations is neither due
      to the lipase itself nor to the content of AT III, but suggest, that it could be
      due to contamination with another protein, which binds to heparin sepharose
      columns but is removed during ion exchange chromatography. Most likely the effect
      is due to the extrinsic pathway inhibitor (EPI), also called lipoprotein
      associated coagulation inhibitor (LACI), which has recently been shown to be
      released by heparin.

PMID- 1755004
TI  - Liver veno-occlusive disease after bone marrow transplantation changes in
      coagulation parameters and endothelial markers.
AB  - Veno occlusive disease (VOD) is a frequent complication of allogenic bone marrow
      transplantation (BMT) for which no predictive blood markers are available. 39
      patients grafted for severe aplastic anemia (18), and leukemia (21) were
      prospectively studied. Of the 39 patients, 5 leukemic patients, but no aplastic
      patients developed VOD. In all the 5 patients with VOD complications we
      demonstrated a decrease in factor VII and in protein C before the clinical onset
      of the disease and before any changes in hepatic enzymes were observed. This
      decrease is the earliest sign of hepatic involvement by the VOD suggesting that
      the determination of Factor VII and protein C can be used as a prediction test to
      identify the patients who are at risk of developing VOD after transplantation. In
      addition, a toxicity of the endothelial cells was suggested by the observed
      increase in von Willebrand factor and in Serum Angiotensin Converting Enzyme.
      Signs of endothelial toxicity was more pronounced in leukemic than in aplastic
      patients.

PMID- 1755005
TI  - Importance of plasminogen activator inhibitor type 1 (PAI-1) for preventing
      single chain urokinase plasminogen activator (scu-PA) conversion into two chain
      urokinase plasminogen activator (tcu-PA) in plasma in vitro.
AB  - We have studied the effects of PAI-1 on the conversion of scu-PA into tcu-PA in
      vitro in plasma containing or not a 125I-fibrin clot by determining tcu-PA
      activity on S2444. Two preparations of PAI-1 have been used, a fraction of medium
      conditioned with the monkey Vero cells (Vero-Prep), the antiurokinase activity of
      which is inhibited at 83% by anti PAI-1 IgG, or purified human PAI-1 from HT 1080
      fibrosarcoma cells. Scu-PA purified from human kidney cells has been treated with
      diisopropylfluorophosphate before use. In plasma, conversion of scu-PA into the
      tc form is accelerated by addition of anti PAI-1 IgG. In plasma containing a
      clot, generation of tcu-PA, is considerably delayed after addition of the Vero
      Prep or human PAI-1. Clot lysis is also decreased but to a lesser extent than it
      would be expected from the level of tcu-PA activity. Addition of anti PAI-1
      antibodies shortens the lag phase before tcu-PA appears and moderatly accelerates
      clot lysis. These results demonstrate the importance of PAI-1 for the stability
      of scu-PA in plasma in vitro by delaying its conversion into tcu-PA.

PMID- 1755006
TI  - Human prostacyclin platelet receptors in diabetes mellitus.
AB  - Conflicting data have been reported about the impaired sensitivity to the
      inhibitory effect of prostacyclin (PGI2) in platelets from patients with
      diabetes. In the present paper we investigated binding of and sensitivity to PGI2
      of platelets from insulin dependent (IDDM) (n = 9), non insulin dependent (NIDDM)
      (n = 8) diabetics and two groups of ten healthy subjects of equivalent age in
      relation to platelet lipidic content. Platelet sensitivity to PGI2 (PGI2 IC50)
      was found not significantly changed in diabetics as compared to controls;
      similarly, no significant differences of the number of high affinity receptors
      for PGI2 in platelets from patients with IDDM and NIDDM were observed. Platelet
      sensitivity to PGI2 and PGI2 receptors were found to be significantly related to
      platelet cholesterol content (r = 0.89, p less than 0.001 and r = -0.80, p less
      than 0.001 respectively). In conclusion platelet PGI2 receptor changes are not
      detectable in diabetics in good metabolic control, but could take place when
      platelet lipid composition is altered.

PMID- 1755007
TI  - Attenuated platelet aggregation in the presence of high concentrations of
      lactate.

PMID- 1755008
TI  - The nitric oxide donor SIN-1 is a potent inhibitor of plasminogen activator
      inhibitor release from stimulated platelets.

PMID- 1755009
TI  - Electron microscopic studies of quinine induced ultrastructural changes to
      platelets.

PMID- 1755010
TI  - A new procedure for the separation of protein Z, prothrombin fragment 1.2 and
      calreticulin from human plasma.

PMID- 1755011
TI  - Clinical analysis of STA-SCA bypass for vertebrobasilar occlusive disease.
AB  - In order to clarify the effectiveness of extracranial- intracranial bypass in
      cases of vertebro-basilar occlusive disease, we investigated the operative
      complication, clinical course and follow-up study of 30 cases undergoing
      superficial temporal artery-superior cerebellar artery (STA-SCA) bypass surgery.
      Postoperative angiogram showed the patency of the anastomoses in all cases. No
      serious surgical complications were observed. The outcome on discharge was
      excellent, with no morbidity and one mortality which was due to cardiac
      infarction. In the follow-up study, there were four cases with ischemic symptoms,
      two with transient ischemic attack and two with completed stroke, one of which
      was a supratentorial infarction due to internal carotid artery occlusion and the
      other was a small infarction of pons. There were also two deaths due to cardiac
      infarction and diabetes mellitus. Favorable outcomes were obtained for the
      remaining cases. The present study suggests that, STA-SCA bypass, can be
      performed without surgical and systemic complications and used as an effective
      therapy for vertebrobasilar ischemia.

PMID- 1755012
TI  - Follicle-like hemicysts reorganized in monolayer culture of rat thyroid cells in
      the medium supplemented with isologous serum.
AB  - Monolayer culture of the cells isolated from rat thyroid glands formed a number
      of large and three-dimensional (about 200-microns diameter) hemicysts in media
      supplemented with isologous and high-concentration serum. The higher was the
      concentration of isologous serum, the larger was the hemicysts and the higher was
      the uptake of 131I of hemicysts. Substitution of heterologous serum, such as calf
      or fetal calf serum, for the isologous serum failed to form hemicysts.

PMID- 1755013
TI  - Dynamic movement of hemicysts reconstructed from monolayer cultures of rat
      thyroid cells in isologous serum.
AB  - Time-lapse studies using cine-microscopic observation showed that the hemicysts
      formed in a culture of rat thyroid cells in a high concentration of isologous
      serum were found to arise by swelling from the monolayer sheet, gradually
      increase in size, and then rapidly collapse. The hemicyst volume increased
      linearly. We speculate that each hemicyst epithelium transport a constant volume
      of liquid into the hemicyst lumen.

PMID- 1755014
TI  - Changes in brain stem blood flow under various grades of brain stem ischemia.
AB  - This report describes a study of brain stem blood flow (BBF) change under various
      grades of brain stem ischemia in a new experimental rat model. The main damage
      was caused by occlusion of the median and paramedian perforating arteries of the
      basilar artery. In this model, hyperperfusion was generally observed in cases of
      mild or moderate ischemia within 1 hr after recirculation and lasted for
      approximately 1 hr. During hyperperfusion, BBF increased to over 60 ml/100 g
      brain/min and was significantly greater than basal values (p less than 0.01). The
      fact that hyperperfusion was unobserved in some cases might be due to the degree
      of damage to the medulla oblongata. Hypoperfusion or lack of reflow phenomena was
      also followed by severe ischemia with remarkable hypotension. It is fairly clear
      from our results that the pattern of postischemic hyperperfusion is responsible
      for decreased oxygen availability in the brain stem and dysfunction of
      autoregulation. Acetazolamide reactivity was disturbed and had an inverse
      response during hyperperfusion. Such phenomena can be explained by paralytically
      dilated vessels due to ischemia. If BBF falls below a critical level, as we have
      seen, postischemic hyperperfusion may be induced with dysfunction of
      autoregulation and inverse acetazolamide reactivity due to vasoparalysis in the
      brain stem.

PMID- 1755015
TI  - Probable binary fission in a Reed-Sternberg cell.
AB  - A Reed-Sternberg cell in binary fission was observed in a case of Hodgkin's
      disease of nodular sclerosis type. This was thought to possibly represent a
      primitive eukaryotic manifestation or a retrograde replay of the endosymbiotic
      evolution of the modern eukaryotes as a part of devolution of malignancy (Okuyama
      and Mishina 1990).

PMID- 1755016
TI  - Commentary on 'Assessment of safety/risk of chemicals: inception and evolution of
      the ADI and dose-response modeling procedures' by Frank C. Lu and Robert L.
      Sielken Jr.

PMID- 1755017
TI  - Hexachlorobenzene and its metabolites pentachlorophenol and
      tetrachlorohydroquinone: interaction with thyroxine binding sites of rat thyroid
      hormone carriers ex vivo and in vitro.
AB  - Previous results have indicated that hexachlorobenzene (HCB)-induced
      hypothyroidism may be caused by its main metabolite pentachlorophenol (PCP), and
      by tetrachlorohydroquinone (TCHQ), rather than by the parent compound. In the
      present experiments it was investigated whether hormone displacement from serum
      carriers could be a factor in the development of this hypothyroidism. In an in
      vitro competition assay PCP was an effective competitor for the thyroxine (T4)
      binding sites of serum carriers, whereas HCB was ineffective. Ex vivo
      experimental results demonstrated occupation of T4-binding sites in sera from PCP
      exposed animals but not in sera from HCB- or TCHQ-treated animals. Competing
      ability for T4-binding sites was still present in sera of PCP-exposed animals but
      was absent in HCB- or TCHQ-exposed animals. The results suggest that thyroid
      hormone displacement by the major metabolite PCP may play a role in HCB-induced
      hypothyroidism.

PMID- 1755019
TI  - Dehydration is the first step in the bioactivation of haloperidol to its
      pyridinium metabolite.
AB  - Haloperidol was found to have a similar metabolic pathway to that of the
      neurotoxin N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in mice microsomal
      preparations. The 1,2,3,6-tetrahydropyridine derivative of haloperidol was
      detected in NADPH-fortified metabolic incubation mixtures of haloperidol.
      Incubation of this dehydrated haloperidol produced the pyridinium metabolite.
      These metabolites were confirmed by comparison with synthesised compounds using
      HPLC and HPLC-MS. Dehydration of an alcohol to a double bond represents a novel
      metabolic pathway. This novel metabolic pathway indicates a MPTP-like mechanism
      for the Parkinsonism observed with haloperidol in clinical use.

PMID- 1755018
TI  - Effects of sinefungin and 5'-deoxy-5'-S-isobutyl-adenosine on lipopolysaccharide
      induced proliferation and protein N-methylation of arginyl residues in murine
      splenic lymphocytes.
AB  - The effects of sinefungin (SF) and 5'-deoxy-5'-S-isobutyl-adenosine (SIBA) on
      lymphoproliferation and protein N-methylation of arginyl residues were
      investigated in splenic lymphocyte culture in vitro. Both SF and SIBA produced a
      dose-related inhibition of the lymphoproliferative response to lipopolysaccharide
      (LPS). The time-course of the inhibition indicated that SIBA had a more
      inhibitory effect than that of SF at short incubation periods, but SF showed more
      inhibition when the incubation was prolonged. The effects of SF and SIBA on the
      lymphoproliferative response corresponded with their effects on the protein N
      methylation of arginyl residues by protein methylase I.

PMID- 1755020
TI  - Stimulation of natural killer cell activity by murine retroviral infection and
      cocaine.
AB  - The effects of cocaine and murine AIDS on natural killer (NK) cell activity in
      C57BL/6 mice was studied. Cocaine may play a major role in the development and
      progression to AIDS in the human population. Chronic intraperitoneal injection of
      cocaine was shown to cause an increase in NK cell activity over those of saline
      treated animals. Infection with LP-BM5 murine leukemia retrovirus was also shown
      to increase NK cell activity. NK cell activity was increased in retrovirally
      infected mice treated with cocaine beyond that of mice treated with cocaine
      alone. This study indicates an important immunomodulatory effect of cocaine on NK
      cell activity, especially when combined with the effects caused by retroviral
      infection.

PMID- 1755021
TI  - The effects of thiamine and EDTA on biliary and urinary lead excretion in sheep.
AB  - Relative efficacy of thiamine (B1) and/or calcium disodium
      ethylinediaminetetraacetate (EDTA) administration on lead (Pb) excretion via bile
      and urine was studied in Pb-loaded sheep. The sheep were administered B1 s.c., 75
      mg/kg body wt., EDTA i.v., 110 mg/kg body wt., and a combination of B1-EDTA at
      rates as above. Each treatment was followed by 69 h sampling of blood, bile, and
      urine. Urinary Pb excretion increased following B1-EDTA greater than EDTA greater
      than B1 administration. Thiamine and B1-EDTA treatments increased biliary Pb
      excretion. Overall, B1, EDTA and B1-EDTA administration increased Pb excretion
      via bile and urine by 72%, 595%, and 842% respectively over basal level (mean +/-
      SE: 20.1 +/- 2.9 micrograms Pb/h). It has been concluded that thiamine enhances
      elimination of Pb from the body and this feature may be beneficial in chelation
      therapy.

PMID- 1755022
TI  - Relationship between cholinesterase inhibition and thermoregulation following
      exposure to diisopropyl fluorophosphate in the rat.
AB  - This study examined the relationship between inhibition of cholinesterase
      activity (CA) and thermoregulatory response in the rat following exposure to the
      organophosphate (OP), diisopropyl fluorophosphate (DFP). Male Long-Evans rats
      were injected with DFP dissolved in peanut oil in doses ranging from 0 to 1.5
      mg/kg (s.c.). Colonic (Tcol) and tail skin temperature (Ttail) were recorded at
      0, 1, 2 and 3 h post-injection. At 3 h post-injection the rat was sacrificed and
      a blood sample was taken by cardiac puncture and analyzed for CA. There was a
      biphasic dose effect of DFP on Tcol with slight but significant elevation in Tcol
      in the dose range of 0.01-0.5 mg/kg and a significant depression in Tcol at doses
      of 1.0 and 1.5 mg/kg. There was a dose-dependent fall in CA with DFP
      administration in the erythrocyte, plasma, and whole blood fractions. Hypothermia
      was associated with 80-87% inhibition in CA, whereas the elevation in Tcol was
      associated with 20-70% inhibition in CA. DFP also elicited significant elevations
      in Ttail. Overall, the data fail to demonstrate any clear relationship between
      inhibition of blood CA and thermoregulatory response following exposure to DFP.
      However, the elevation in Tcol following relatively low doses of DFP may be of
      relevance to the frequently reported symptom of fever in humans exposed to OP
      agents.

PMID- 1755023
TI  - Elevated urinary excretion of beta-aminoisobutyric acid and delta-aminolevulinic
      acid (ALA) and the inhibition of ALA-synthase and ALA-dehydratase activities in
      both liver and kidney in mice exposed to lead.
AB  - Urinary excretion of beta-aminoisobutyric acid (ABA) and delta-aminolevulinic
      acid (ALA) was investigated in mice exposed to lead (500 p.p.m.) in drinking
      water for 14 days. Concentrations of both urinary ABA and urinary ALA increased
      significantly in the lead-exposed mice. However, the degree of increasing
      excretion was higher in urinary ALA (10-fold of the control) than in urinary ABA
      (2-fold of the control). On the other hand, it was demonstrated that ALA
      dehydratase in liver and kidney is inhibited by exposure to lead, while ALA
      synthase in these tissues has no inhibitory effect.

PMID- 1755024
TI  - The effect of structurally divergent herbicides on mouse liver xenobiotic
      metabolizing enzymes (P-450-dependent mono-oxygenases, epoxide hydrolases and
      glutathione S-transferases) and carnitine acetyltransferase.
AB  - Male mice were treated with structurally diverse herbicides to study their effect
      on liver xenobiotic-metabolizing enzymes. Chlorfiurecol, trifluralin, alachlor,
      propham, MCPP and 2,4-DP caused increases in phase I (cytochrome P-450,
      ethoxycoumarin O-deethylase, and/or aminopyrine N-demethylase) and phase II
      (microsomal epoxide hydrolase and cytosolic glutathione S-transferase)
      activities. MCPP and 2,4-DP also increased cytosolic epoxide hydrolase and
      carnitine acetyltransferase activities suggestive of peroxisome proliferation.
      Benthiocarb and molinate increased only some phase II enzyme activities. Dicamba,
      at the dose employed, caused mortality and decreases in some of the enzymes
      monitored. Most of the herbicides tested induced xenobiotic-metabolizing enzyme
      activities, the pattern of induction being dependent on herbicide structure.

PMID- 1755025
TI  - Binding of the strong bacterial mutagen, 3-chloro-4-(dichloromethyl)-5-hydroxy
      2(5H)-furanone (MX) to bovine serum albumin.
AB  - Binding of 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone (MX) to bovine
      serum albumin (BSA) was studied. MX bound mainly reversibly to BSA but, for a
      minor part, also irreversibly. It was possible to extract the main part of the
      reversibly bound MX with ethyl acetate and the extractable compound was
      chromatographically identical to MX. The affinity-binding characteristics of the
      interaction with albumin were K = 1.6 x 10(7) M-1, n = 3.4. Furthermore,
      mutagenicity studies indicated that reversibly bound MX remained mutagenic but
      that irreversibly bound MX was no longer mutagenic in the Ames test. These
      results suggest that the binding of MX to albumin is an important factor for both
      the toxicological effects and the toxicokinetics of MX.

PMID- 1755026
TI  - Transient heat shock in mid-G1-phase of the C6 glioma cell cycle impairs entry
      into S-phase.
AB  - Synchronous populations of rat C6 glioma cells have been obtained by a mitotic
      selection procedure and used to establish the effect of transient temperature
      elevation on their progression through the cell cycle. A transient 3-h exposure
      to a 42 degree C heat shock within defined area in the mid-G1-phase of the cell
      cycle has been demonstrated to impair progression to S-phase. This anti
      proliferative heat shock effect was not apparent in asynchronous cell
      populations. A small, but significant, decrease in 3H-thymidine incorporation was
      observed (approximately 5%) following an 8-h exposure to heat shock.

PMID- 1755027
TI  - Uncoupling of oxidative phosphorylation in rat liver mitochondria by
      chloroethanols.
AB  - Chloroethanols are toxic chemicals used in industry and also formed as a result
      of the metabolism of several widely used halogenated hydrocarbons. The effect of
      2-chloroethanol (CE), 2,2-dichloroethanol (DCE) and 2,2,2-trichloroethanol (TCE)
      on rat liver mitochondrial respiration was studied. Rat liver mitochondria were
      isolated in a medium consisting of 250 mM sucrose, 10mM Tris-HCl and 1 mM EDTA
      (pH 7.4). Mitochondrial respiration was determined with an oxygen electrode at 30
      degrees C and the polarographic buffer consisted of 250 mM mannitol, 10 mM KCl,
      10 mM K2HPO4, 5 mM MgCl2, 0.2 mM EDTA and 10 mM Tris-HCl (pH 7.4). With succinate
      as the respiratory substrate and using chloroethanols (150 mM), CE stimulated
      respiration by 28.2 +/- 6.5% and DCE by 202.7 +/- 8.2% while TCE inhibited
      mitochondrial respiration (greater than 95%). The effect of change in the
      concentration of chloroethanols on mitochondrial respiration was also studied. CE
      showed maximum stimulation at 600 mM (97.6%), DCE at 150 mM (202.6%) and TCE at
      30 mM (313.6%). Respiratory stimulation was independent of mitochondrial protein
      concentration. Chloroethanols (optimal concentrations for respiratory stimulation
      with succinate) inhibited mitochondrial respiration when glutamate-malate was
      used as the respiratory substrate. Estimation of adenosine triphosphate (ATP)
      showed that chloroethanols inhibited the synthesis of ATP. These results indicate
      that chloroethanols stimulate mitochondrial respiration by uncoupling oxidative
      phosphorylation and that the uncoupling potency is proportional to the extent of
      chlorination at the beta-position of haloethanol.

PMID- 1755028
TI  - Mutagenicity studies of kojic acid.
AB  - Kojic acid, a fungal metabolite produced by some species of Aspergillus and
      Penicillium, was found to induce sister chromatid exchanges and chromosomal
      aberrations in Chinese hamster ovary cells in the presence or absence of the rat
      liver S9 mix. Furthermore, this compound was demonstrated to induce mutations in
      Salmonella typhimurium strains TA98 and TA100 using both plate-incorporation and
      preincubation methods.

PMID- 1755029
TI  - Immunochemical and immunohistochemical studies of cadmium associated proteins in
      Rana tadpoles.
AB  - Previous observations suggested that Rana tadpoles treated with aqueous cadmium
      (Cd) accumulate Cd in their liver and mesonephros. In order to study the response
      to Cd in these tissues we (a) exposed tadpoles in mid-limb bud stages to
      sublethal quantities of Cd, (b) isolated Cd-associated protein (CAP) from a liver
      cytosol fraction, (c) prepared a heterologous rabbit antiserum against
      glutaraldehyde-treated CAP (G-CAP), (d) used the rabbit anti-G-CAP antiserum in
      order to assess the tissue distribution of CAP in Cd-treated and untreated
      tadpoles, and (e) assessed species cross-reactivities of our anti-G-CAP with CAPs
      and metallothioneins (MTs) isolated from Cd-treated vertebrate liver cytosol
      fractions. We found that (a) CAP was present in higher quantities in liver
      cytosol obtained from Cd-treated tadpoles compared to liver cytosol obtained from
      untreated control tadpoles, (b) indirect immunofluorescent analysis revealed that
      CAP was localized in liver hepatocytes and kidney tubule epithelial cells in Cd
      treated tadpoles, and (c) the anti-G-CAP crossreacted with rodent and fish CAP.
      These observations suggest that the developing liver and mesonephros are involved
      in responses to toxic metals and that our anti G-CAP antiserum may be used to
      gauge exposure to environmental Cd.

PMID- 1755030
TI  - Ten-day repeated-exposure inhalation study of dimethylformamide (DMF) in
      cynomolgus monkeys.
AB  - Cynomolgus monkeys showed no measurable adverse effects following inhalation of
      500 ppm dimethylformamide (DMF), 6 h/d, 5 d/wk, for 2 weeks either when exposed
      whole-body or head-only (one monkey per exposure route). Measurement of DMF
      concentrations into and out of the head-only exposure unit along with measurement
      of the tidal volume suggest that DMF absorption by the respiratory tract is
      approximately 100% at a concentration of 500 ppm. Plasma samples taken 1/2 to 18
      h after the first exposure show DMF AUC values which were 3 times higher in the
      monkey exposed by whole-body, indicating considerable absorption by non
      inhalation route(s). The same comparison of plasma samples taken following the
      final (10th) exposure similarly had a 6-times DMF AUC value for the monkey
      exposed by whole-body. From this study it is apparent that the practice of
      avoiding dermal contact with DMF is important in reducing the likelihood of
      producing DMF-induced injury in the workplace.

PMID- 1755031
TI  - Wy-14,643 but not 2-ethylhexanol increases intracellular free calcium in cultured
      Kupffer cells.
AB  - Hypolipidemic drugs and phthalic ester plasticizers induce peroxisomes and cause
      hepatocellular carcinoma in rodents by mechanisms which remain unknown. Recent
      evidence from this laboratory suggests that many agents in this class of
      chemicals are uncouplers of mitochondrial oxidative phosphorylation both in vitro
      and in vivo. Uncoupling of oxidative phosphorylation decreases ATP required for
      ion pumps and could thereby indirectly increase intracellular free calcium. The
      goal of these experiments, therefore, was to compare the effect of the potent
      uncoupler and non-genotoxic carcinogen Wy-14,643 with the weaker agent 2
      ethylhexanol on intracellular free calcium in cultured Kupffer cells. Kupffer
      cells, the resident hepatic macrophages, are activated by calcium and release a
      variety of mitogenic growth factors that may modulate cell proliferation. In this
      study, the cytosolic free calcium concentration in Fura-2-loaded cultured Kupffer
      cells was increased significantly from 78 +/- 11 to 838 +/- 112 nM following
      incubation with Wy-14,643 (1.25 mM). The increase in intracellular calcium due to
      Wy-14,643 was both time- and dose-dependent. At equimolar concentrations,
      ethylhexanol had no effect on intracellular calcium (65 +/- 20 nM). However, at
      higher concentrations (3 mM), ethylhexanol also increased intracellular calcium.
      These data suggest that elevation of intracellular calcium in Kupffer cells may
      be involved in the mechanism of action of this interesting class of non-genotoxic
      carcinogens.

PMID- 1755032
TI  - Time course for the elevation of glutathione in numerous organs of L1210-bearing
      CDF1 mice given the L-cysteine prodrug, RibCys.
AB  - RibCys, a thiazolidine prodrug of L-cysteine synthesized by the condensation of
      the sulfhydryl-containing amino acid with the aldose monosaccharide D-ribose,
      successfully elevated glutathione (GSH) levels in numerous organs of tumor
      bearing CDF1 mice. GSH content was assayed 1,2,4,8 and 16 h after RibCys
      administration (8 mmol/kg, i.p.); various organs achieved maximal GSH content at
      different time points. GSH in the liver was elevated 1.5-fold compared to
      untreated controls at the 16-h time point. Kidney GSH also was maximal at 16 h
      and achieved 1.6-times control values. GSH in muscle achieved 2.5 times the
      levels in control animals, while the bladder was elevated 2.1-fold, and the heart
      1.8-fold. Other tissues tested (spleen, pancreas, lung) showed a 1.1- to 1.2-fold
      increase in GSH content. GSH in implanted L1210 tumors was also elevated only 1.2
      fold. These data suggest the possibility of protecting organs other than the
      liver from toxic insults that require the intervention of GSH for detoxication
      and may allow such protection without compromising the utility of chemotherapy.

PMID- 1755033
TI  - Evidence of hepatic conversion of C6 and C8 chlorotrifluoroethylene (CTFE)
      oligomers to their corresponding CTFE acids.
AB  - The toxicity of polychlorotrifluoroethylene oil (3.1 oil) hydraulic fluid is
      believed to be related to the conversion of neutral chlorotrifluoroethylene
      (CTFE) oligomers to their corresponding halogenated fatty acids. Male Fischer-344
      rats were orally gavaged (1.25 g/kg/d) with two batch formulated 3.1 oils (3.1
      oil-C6 and 3.1 oil-C6:C8) and C6 CTFE (trimer) and C8 CTFE (tetramer) oligomers,
      respectively. All rats exposed to test compounds for 7 days demonstrated
      significant 2-fold increases in liver weight over controls. After 24-h and 7-day
      dosings, the amount of tetramer acid formed in the liver was 2x and 11x the
      amount of trimer acid formed, respectively. In addition to the formation of
      tetramer acid, rats dosed with tetramer also indicated comparable amounts of
      trimer acid. These data indicate that toxicity induced by the 3.1 oil may be due
      to the retention of the tetramer and the resulting persistent high concentrations
      of halogenated fatty acids.

PMID- 1755034
TI  - Assessment of safety/risk of chemicals: inception and evolution of the ADI and
      dose-response modeling procedures.
AB  - This article reviews the procedures for the assessment of safety/risk of
      chemicals to human health. Because the nature and severity of toxicity and the
      extent of the database vary from chemical to chemical, the assessment is done on
      a case by case basis. Essentially 5 steps are involved in the assessment: (a)
      identification of hazards based on appropriate human and animal data; (b)
      determination of the dose-response relationship of the adverse effects of the
      chemical; (c) extrapolation of the dose-response data from test subjects to human
      populations; (d) estimation of the exposure; and (e) assessment of the
      safety/risk of the chemical under a specified exposure. Emphasis in this article,
      however, is placed on the extrapolation of the dose-response data to the human
      situation. The extrapolation is done by the identification of a no-observed
      adverse-effect level (NOAEL) and the application of a safety factor, thereby
      arriving at an acceptable daily intake (ADI). The safety factor is selected on
      the basis of, inter alia, the severity of the adverse effect and the adequacy of
      the database. On the other hand, with genotoxic carcinogens, mathematical
      modeling is used for extrapolation. This is because the effects of genotoxic
      carcinogens are generally believed to have no threshold. The ADI approach, which
      involves the identification of a NOAEL, is therefore not applicable. A number of
      mathematical models have been developed to assess, from the dose-response data,
      either the risks that may be associated with a specified dose, or the 'virtually
      safe dose' at a specified risk level. The evolution, application and shortcomings
      of these procedures and the potential improvements in the ADI approach and in the
      dose-response characterization based on these mathematical models are also
      discussed.

PMID- 1755035
TI  - Benzo[e]pyrene pretreatment of immature, female C57BL/6J mice results in
      increased bioactivation of aflatoxin B1 in vitro.
AB  - Hepatic microsomes were prepared from immature C57BL/6J mice 24 h after receiving
      intraperitoneal injections of either corn oil, benzo[e]pyrene (BeP, 50 mg/kg) or
      2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, 4 x 10(-3) mg/kg). The capacity of
      these hepatic microsomes to bioactivate aflatoxin B1 (AFB1), 2-aminoanthracene
      (AA), benzo[a]pyrene (BaP), 3-methylcholanthrene (MC), 7,12
      dimethylbenzanthracene (DMBA), BeP and pyrene (PY) was measured using strain
      TA100 in the Salmonella typhimurium/microsome reversion assay. BeP pretreatment
      of mice resulted in a 33% increase in mutagenic potency (MP) of AFB1 over the
      corn oil controls and a 70% increase in MP relative to TCDD-pretreated
      microsomes. With AA, BaP and DMBA as promutagens, BeP pretreatment reduced MP an
      average of 24%, while TCDD pretreatment increased MP of these 3 promutagens 263%
      compared to controls. Since the general effects of BeP and TCDD on murine hepatic
      cytochrome P-450 (P450)-mediated activities in this study were discordant, it
      appears that changes in P450 activity by BeP pretreatment are not mediated
      through the Ah receptor.

PMID- 1755036
TI  - Neurotoxic effects of 2,5-hexanedione on growing peripheral nerve axons of rat
      fetuses.
AB  - Peripheral nerves of rat fetuses were used to investigate the potential
      neurotoxicity of 2,5-hexanedione (2,5-HD) on developing axons. Pregnant female
      Sprague-Dawley rats were injected subcutaneously with 680 mg/kg of 2,5-HD once a
      day from day 12 of gestation (GD12) through GD16. On GD20 live fetuses were
      removed from the uterus, and the sciatic nerves were examined morphologically.
      Upon electron-microscopy affected nerves showed axons which were aggregated and
      fused together; the number of large axons was increased, but there were no axons
      aggregated with neurofilaments.

PMID- 1755037
TI  - Depletion of brain serotonin does not alter 2,3,7,8-tetrachlorodibenzo-p-dioxin
      (TCDD)-induced starvation syndrome in the rat.
AB  - We have previously reported a series of biological events in 2,3,7,8
      tetrachlorodibenzo-p-dioxin (TCDD)-intoxicated rats which resulted in elevated
      brain serotonin (5-HT) levels, offering a possible explanation of the acute
      toxicity (reduced feed intake and death) in these animals. It was thus
      hypothesized that depletion of central 5-HT stores should alter the TCDD-induced
      starvation syndrome. Brain 5-HT was selectively depleted by
      intracerebroventricular infusions of the neurotoxin 5,7-dihydroxytrytamine (5,7
      DHT). Subsequently the animals were given a lethal dose of TCDD. In rats treated
      with 5,7-DHT hypothalamic 5-HT was depleted up to 90% compared to control
      animals, yet TCDD induced the expected reduction of bodyweight and feed intake.
      These results suggest that although TCDD increases central 5-HT levels as a
      result of increased plasma tryptophan, this may not be the main cause for reduced
      feed intake and lethality in these animals.

PMID- 1755038
TI  - Regulation of metallothionein production in HeLa cells.
AB  - Metallothioneins are cysteine-rich, heavy-metal-binding proteins which have been
      assumed to participate in the detoxification of toxic metals. The mechanism of
      thionein (apoprotein of metallothionein) induction by cadmium was studied using
      cultured human cells. It was found that when thionein synthesis reaches a maximum
      (6-8 h after induction), it no longer responds to additional cadmium. Changes in
      cadmium uptake or induction of inhibitory proteins were not responsible. Together
      with our previous findings, a possible mechanism is proposed: loss of the
      secondary induction response might be due to increased intracellular levels of
      thionein, which has been overproduced by the initial induction.

PMID- 1755039
TI  - Defluorination of the CFC-substitute 1,1,1,2-tetrafluoroethane: comparison in
      human, rat and rabbit hepatic microsomes.
AB  - 1,1,1,2-Tetrafluoroethane (HFC-134a), which lacks ozone-depleting potential, has
      been selected as a replacement refrigerant for dichlorodifluoromethane (CFC-12)
      in air-conditioning and chiller applications, and as a propellant for
      pharmaceutical aerosols. A variety of paradigms using rats and rabbits have shown
      that HFC-134a has very little toxic potential. To strengthen the prediction of
      human hazard associated with HFC-134a exposure, we evaluated the rate of
      metabolism of this halocarbon by human hepatic microsomes relative to similar
      tissue preparations derived from rats and rabbits. Human microsomes defluorinated
      HFC-134a in a cytochrome-P-450-catalyzed reaction, common also to rat and rabbit.
      In absolute terms, the maximal rate of HFC-134a metabolism by human microsomes
      was very low, showed little interindividual variation among the samples evaluated
      (1.3 +/- 0.3 nmol F-/mg protein/15 min, mean +/- SD, n = 10), and did not exceed
      that in rat or rabbit liver microsomes. These findings support the argument that
      for characterization of HFC-134a toxicity, especially that which may be mediated
      by products of halocarbon metabolism, laboratory animals are an adequate
      surrogate for humans.

PMID- 1755040
TI  - Human parasitology in Czechoslovakia.

PMID- 1755041
TI  - Malaria morbidity and mortality in children under three years of age on the coast
      of Benin, West Africa.
AB  - Malaria morbidity and mortality were measured in a population of 1500 children
      under 3 years of age from April to December 1989. During monthly home visits, an
      average of 26 children in 1000 had fever, of whom 15 had parasitaemia. Children
      less than 6 months old had significantly fewer fever episodes, whether associated
      with parasitaemia or not. Overall, prevalence of fever with parasitaemia rose
      steadily from April to August, then decreased but reached a second peak in
      November. Peaks coincided with the 2 rainy seasons in April to June and September
      to October. Comparison with a control group demonstrated that children with
      parasitaemia exceeding 1000 infected red blood cells per microliter of blood had
      fever significantly more often than children with lower levels of parasitaemia.
      The average number of fever episodes per child per year was 2.4, and 33% of these
      were estimated to be caused by malaria. All cause mortality was 26/1000/year and
      the malaria mortality rate was 8/1000/year. Malaria deaths were most frequent in
      the second year of life.

PMID- 1755043
TI  - Paraphimosis apparently associated with Plasmodium falciparum infection.

PMID- 1755042
TI  - Association between immune recognition of the malaria vaccine candidate antigen
      Pf155/RESA and resistance to clinical disease: a prospective study in a malaria
      endemic region of west Africa.
AB  - We have measured cellular and humoral immune responses to short synthetic
      peptides representing epitopes of the malaria vaccine candidate antigen
      Pf155/RESA in a longitudinal, prospective study of clinical immunity to
      Plasmodium falciparum malaria in a cohort of 354 Gambian children aged 3-8 years.
      A significant association was observed between presence of antibodies to the 3'
      repeat region peptide (EENV)6 and resistance to clinical malaria. The prevalence
      of protective antipeptide antibodies varied significantly between different
      ethnic groups, suggesting that immune recognition of some Pf155/RESA epitopes may
      be genetically regulated. There was no obvious association between proliferative
      or interferon gamma responses to T cell epitopes of Pf155/RESA and resistance to
      malaria infection or disease. At an individual level, the presence of peptide
      binding antibodies was associated with the induction of interleukin 4 messenger
      ribonucleic acid expression in T cells activated with the overlapping T cell
      epitope EENVEHDA(EENV)2. This suggests that measurement of interleukin 4
      production by T cells may represent a functional assay for T helper activity.

PMID- 1755044
TI  - A prospective clinical trial of the treatment of falciparum malaria with
      mefloquine, with special reference to neuro-psychiatric side effects.

PMID- 1755045
TI  - A case of Plasmodium falciparum malaria sensitive to chloroquine but resistant to
      pyrimethamine/sulfadoxine in Sennar, Sudan.

PMID- 1755046
TI  - Potentiation of monodesethylamodiaquine and amopyroquine with desipramine against
      Plasmodium falciparum in vitro.

PMID- 1755047
TI  - Trial of antimalarial potential of extracts of Artemisia annua grown in Myanmar.

PMID- 1755048
TI  - Detection of mature malaria infections in live mosquitoes.
AB  - A method has been developed which detects malaria parasites in the salivary
      glands of live Anopheles stephensi. The method exploits the sugar feeding
      behaviour of the mosquito and requires only routine Western blotting techniques
      on nitrocellulose membrane (NCM). Infectivity can be determined without any
      direct manipulation of individual mosquitoes. Female A. stephensi were infected
      with the rodent malaria parasite, Plasmodium berghei, and after 14-16 d were
      starved of fructose overnight (12-18 h), then resupplied with fructose presented
      through a small piece of NCM. Mosquitoes were allowed to probe the membrane for
      several hours; the NCM was then removed and subjected to a standard
      immunoblotting protocol using an anti-P. berghei circumsporozoite protein (CSP)
      monoclonal antibody as the primary reagent, and a horseradish peroxidase-coupled
      secondary antibody. NCMs taken from cages containing infected mosquitoes showed a
      variable number of small black dots where individual females had probed and
      deposited either CSP or sporozoites. Infectivity could be detected easily from 13
      14 d after feeding, and in as few as 10 mosquitoes at 19 d after infection; in
      one instance, infection in a single mosquito was clearly determined. After
      blocking with goat serum, the NCMs could be stored for 3-4 months and still
      provided positive reactions, offering some potential for applicability to field
      research studies.

PMID- 1755049
TI  - Genetic evidence for the importance of interrupted feeding by mosquitoes in the
      transmission of malaria.
AB  - Plasmodium falciparum isolates were obtained from 17 pairs of Gambian children,
      each pair living in the same house and presenting with malaria at the same time.
      Frequencies of allelic serotypes of 3 polymorphic blood stage proteins (MSP1,
      MSP2, and Exp-1) were previously determined from a large number of isolates from
      patients in the local area, and the probability of a random pair of isolates
      containing an identical genotype was calculated to be less than 0.01. However, 3
      of 8 household pairs in one year, and 6 of 9 in the next year, contained
      identical P. falciparum genotypes, a much higher frequency than expected randomly
      (P less than 0.00005, for each year). This finding is discussed in terms of the
      probable contribution of single mosquitoes infecting more than one person.

PMID- 1755050
TI  - Studies on the leishmaniases in the Sudan. 3. Clinical and parasitological
      studies on visceral and mucosal leishmaniasis.
AB  - The epidemiological, clinical and laboratory findings of 27 patients with
      visceral leishmaniasis (VL) and six with mucosal leishmaniasis (ML) in Sudan are
      described. The diagnosis was confirmed by the demonstration of amastigotes in
      bone-marrow in 20 cases with VL (80%) and impression smears in 2 cases with ML.
      The enzyme-linked immunosorbent assay and direct agglutination test were positive
      in all the sera tested. The leishmanin test was positive in all patients with ML,
      the diameter of the reaction ranging from 18 to 28 mm (mean 23 mm). Only one
      isolate (from a patient with VL) grew sufficiently well in culture to be typed
      and this was characterized by isoenzyme electrophoresis as Leishmania donovani
      zymodeme LON-46. The possibility that the ML isolate could have been L. major
      zymodeme LON-1 is discussed. The importance of further research to isolate and
      identify by biochemical procedures a more representative range of isolates of
      Leishmania from different clinical types in the Sudan, in order to elucidate
      questions such as the relationship between the vectors and possible animal
      reservoirs, is emphasized.

PMID- 1755051
TI  - Post-kala-azar anterior uveitis: demonstration of Leishmania parasites in the
      lesion.

PMID- 1755052
TI  - Direct agglutination test for diagnosis and sero-epidemiological survey of kala
      azar in the Sudan.
AB  - 132 patients with suspected kala-azar (visceral leishmaniasis) were included in a
      prospective study to compare the performance of the direct agglutination test
      (DAT) with smears of lymph node, bone marrow and splenic aspiration. A titre
      greater than 1:3200 was considered positive. 67 patients provided positive smears
      and 65 were smear-negative. Compared with the results obtained from smears, the
      sensitivity of the DAT was 94% and its specificity 72%. Of 18 patients who were
      negative by smears but positive by DAT, 3 were treated on strong clinical
      suspicion of kala-azar and responded well to therapy. One other patient had post
      kala-azar dermal leishmaniasis. Of the remaining 14, 8 were tested with the
      leishmanin skin test; 6 gave a positive result, suggesting past or sub-clinical
      infection. In 4 smear-positive patients, the DAT was negative; in 2 of these, the
      test remained negative during 6 months' follow-up. In a sero-epidemiological
      survey in a camp for displaced people, 30 of 600 sampled individuals gave a
      positive DAT. Of these, 11 had been treated for kala-azar; 4 others were
      leishmanin positive. The DAT is a useful screening test (sensitivity 94%;
      predictive value of a negative test 92%), but it does not differentiate between
      past kala-azar, sub-clinical infection and active disease.

PMID- 1755053
TI  - Indirect fluorescent immunoassay in the diagnosis of infantile and adult kala
      azar.

PMID- 1755054
TI  - Human urine stimulates growth of Leishmania in vitro.
AB  - Enhancement of trypanosomatid metacyclogenesis by insect urine components led us
      to test the effect of human urine as a culture additive. The addition of 1-5%
      urine to Schneider's Drosophila medium containing 10% foetal calf serum enhanced
      the growth of 11 Leishmania strains representing 8 different taxonomic groups.
      Cell division was stimulated in cultures with non-dividing organisms. Peak cell
      density was increased, as was the efficiency with which L. donovani could be
      isolated from infected hamsters. Preliminary work suggested that the modified
      medium would be useful for field isolation of L. donovani and L. braziliensis.
      The active nutrients or growth factors are not known.

PMID- 1755055
TI  - Granulomatous encephalitis due to a leptomyxid amoeba.

PMID- 1755056
TI  - Differences in the rate of hepatosplenomegaly due to Schistosoma mansoni
      infection between two areas in Machakos District, Kenya.
AB  - The relationship between intensity of Schistosoma mansoni infection and the
      degree of related morbidity was suspected to differ locally within the Machakos
      district of Kenya. To test this possibility, prevalences of hepatomegaly and
      splenomegaly among 1483 school children were compared between 2 areas, Kangundo
      and Kambu, within this district. These areas, which were similar in many
      geographical and economic respects and populated by the same tribe (Akamba), had
      comparable levels of S. mansoni infection and no S. haematobium infection. A
      relationship was observed between the prevalence of hepatomegaly and intensity of
      S. mansoni infection, which showed no consistent difference between the 2 areas.
      In contrast, a relationship between the prevalence of splenomegaly and intensity
      of S. mansoni infection was observed only in the Kambu schools, and not in the
      Kangundo schools where the overall prevalence of splenomegaly was much lower. It
      was possible that part of the splenomegaly observed in Kambu was due to malaria.
      However, the observation that malaria and schistosomiasis in 2 Kambu schools were
      not positively correlated allowed approximations to be made of the relative
      contributions of each to the prevalence of splenomegaly. It was concluded that,
      in a school close to the river that formed the main transmission site of S.
      mansoni, schistosomiasis-related hepatosplenomegaly was present in at least 17%
      of children. The reason for the high prevalence in Kambu of hepatosplenic
      schistosomiasis remains uncertain, but it could include a synergistic interaction
      of schistosome infection with malaria.

PMID- 1755057
TI  - Eosinophilia and eosinophil helminthotoxicity in patients treated for Schistosoma
      mansoni infections.
AB  - The changes in eosinophil levels and in eosinophil-mediated antibody-dependent
      schistosomular cytotoxicity, following treatment for Schistosoma mansoni
      infections, have been investigated in 2 similar groups of patients aged 15-50
      years. Patients in group 1 were treated with either hycanthone or oxamniquine,
      and those in group 2 with hycanthone or praziquantel. Eosinophil levels were
      significantly increased in both groups. In group 1 peripheral blood eosinophil
      counts rose from a mean of 175/microliters before treatment to 745/microliters 3
      weeks after treatment, and in group 2 from 181/microliters to 1066/microliters.
      The increase in eosinophil levels was positively correlated with a rise in
      circulating anti-adult worm antibodies (r = -0.587, P less than 0.05), whereas a
      negative correlation was recorded with anti-egg antibodies (r = -0.727). Despite
      some enhanced eosinophil helminthotoxicity following treatment in some of the
      individuals in group 1 (7/15), the change overall was not significant. In group
      2, in which a different standard anti-schistosomular antibody was used, the
      eosinophil killing capacity recorded at 3 weeks was lower than that before
      commencement of treatment (t = 2.89, P less than 0.01). The eosinophil
      stimulating activity, detected in cultured mononuclear cell supernatants (MCS)
      from individual patients, correlated with eosinophil levels (r = 0.582, P less
      than 0.02) but there was no association with eosinophil killing. MCS activity did
      not appear to be boosted by treatment. These studies showed that peripheral blood
      eosinophil counts were increased following treatment, but their ability to kill
      schistosome larvae is variable and may depend on the immune serum used as the
      source of anti-schistosomular antibody.

PMID- 1755058
TI  - Onchocerciasis in Malawi. 1. Prevalence, intensity and geographical distribution
      of Onchocerca volvulus infection in the Thyolo highlands.
AB  - Skin snips from 23,373 persons living in the Thyolo (formerly Cholo) highlands
      focus of southern Malawi showed infection with Onchocerca volvulus to be unevenly
      distributed within the highland area. In the centre of the focus most adults were
      infected, though intensity of infection was light, not exceeding a geometric mean
      of 8 microfilariae per mg of skin. It was estimated that 327,000 persons live in
      areas where prevalence of infection exceeds 10% and, of these, 94,500 persons
      over the age of one year are infected with O. volvulus. There is a significant
      relationship between infection with O. volvulus and bilateral blindness in the
      Thyolo focus, although the number of persons blind from onchocerciasis is
      probably less than 300.

PMID- 1755059
TI  - A community trial of ivermectin for onchocerciasis in Sierra Leone: adverse
      reactions after the first five treatment rounds.
AB  - We have studied the adverse reactions reported after ivermectin in 1745 villagers
      in southern Sierra Leone, allocated at random to receive ivermectin or placebo
      and treated 'double-blind' with 4 doses at six-monthly intervals. Six months
      after the fourth dose all eligible villagers received ivermectin regardless of
      their previous treatment. At the first treatment round more adverse reactions
      were reported by villagers treated with ivermectin than by those who received
      placebo. Reactions occurred most often on the second day after treatment. There
      were significant correlations between an individual's skin microfilarial load and
      the risk of developing adverse reactions. On re-treatment there was no
      significant excess of reported adverse reactions in the ivermectin group compared
      to the placebo group. Unlike other adverse reactions, the risk of cutaneous
      reactions after the first dose of ivermectin was not correlated with skin
      microfilarial load. In addition, after re-treatment with ivermectin, cutaneous
      reactions were reported significantly more often than with placebo. We confirm
      that ivermectin is safe for mass distribution, but adverse reactions should be
      monitored and treated after the first dose. Throughout this study ivermectin was
      well tolerated, with significantly more villagers returning for re-treatment
      after ivermectin than placebo, and all adverse reactions were self-limiting or
      successfully managed with symptomatic treatment. We question whether strict
      clinical monitoring should be routine at re-treatment, when only cutaneous
      reactions were consistently reported. If clinical monitoring could be used more
      selectively, distribution campaigns might be easier to manage and more cost
      effective.

PMID- 1755060
TI  - A quantitative approach to the relationship between Wuchereria bancrofti
      microfilaria counts by venous blood filtration and finger-prick blood films.
AB  - Counts of nocturnally periodic Wuchereria bancrofti microfilariae (mf) in 20 mm3
      finger-prick blood films were compared with membrane counts after filtration of 1
      ml of venous blood for their efficacy in determining the prevalence of
      Bancroftian filariasis. The technique used for spreading and staining the blood
      films was critically important to the sensitivity of this screening procedure.
      There was good agreement between the 2 methods. Four statistical approaches were
      used to measure the correlation between the 2 sampling methods: 2 linear
      regression methods using untransformed and transformed data, and 2 non-parametric
      rank correlation methods. Based on the statistical analyses, this study strongly
      supports the general observation that finger-prick blood samples tend to contain
      more mf than equivalent volumes of venous blood, at mf densities high enough to
      be detectable by the finger-prick technique. It also demonstrates that finger
      prick samples provide good estimates of mf densities and prevalence of infection
      except in areas of very low mf densities, where the membrane filtration method
      would provide a more accurate estimate of prevalence. Regression analyses using
      untransformed and transformed data, and the rank correlation tests, demonstrated
      a strong statistically significant correlation (P less than 0.001) between venous
      and finger-prick mf counts.

PMID- 1755061
TI  - Antigenic cross-reactivity between Necator americanus and Ascaris lumbricoides in
      a community in Papua New Guinea infected predominantly with hookworm.
AB  - Sero-epidemiological data are presented in which antigenic cross-reactivity
      between Necator americanus and Ascaris lumbricoides has been investigated in a
      community in Papua New Guinea infected predominantly with N. americanus. It is
      our contention that the antigenic cross-reactivity which undoubtedly exists
      between these species accounted for (i) a peak in antibody levels against N.
      americanus in 10-13 years old children (driven by infection with A.
      lumbricoides), and (ii) the maintenance of apparent antibody levels against A.
      lumbricoides in older age groups (driven by infection with N. americanus in the
      absence of overt infection with A. lumbricoides). Cross-reactivity was analysed
      further, and apparently N. americanus-specific epitopes identified, by
      immunoblotting. These observations could have considerable bearing on the
      interpretation of data from sero-epidemiological studies which failed to take
      account of concurrent infection with these parasites.

PMID- 1755062
TI  - Gelatin particle indirect agglutination test for mass examination for
      strongyloidiasis.
AB  - An indirect agglutination test using recently developed gelatin particles was
      assessed to determine its applicability as a screening test for mass examination
      for strongyloidiasis. 1199 individuals in Sashiki Town, Okinawa Island, were
      screened by the test and 34.7% were determined to be antibody positive. Follow-up
      examination of the persons whose sera showed positive antibody responses
      demonstrated the presence of faecal larvae in 41.7%. The calculated infection
      rate (14.5%) was similar (14.1%) to that indicated by another survey using the
      micro-enzyme-linked immunosorbent assay (micro-ELISA), conducted simultaneously
      among the inhabitants. The indirect agglutination test was simple to perform in a
      short time and without specialized equipment. Additionally, the gelatin particles
      have many advantages as an antigen carrier, e.g. in handling, reading of the
      resulting pattern, and stable, long-term preservation. The test was considered to
      be more convenient than the micro-ELISA for mass screening for strongyloidiasis.

PMID- 1755063
TI  - A controlled chemotherapeutic intervention trial on the relationship between
      Ascaris lumbricoides infection and malnutrition in children.
AB  - A 2-year investigation, consisting of a controlled, non-blind, 3-monthly
      chemotherapeutic intervention trial, based on transmission dynamics of Ascaris
      lumbricoides infection, was undertaken to prove or refute the role of A.
      lumbricoides as a contributor to childhood malnutrition. The study involved 1206
      children aged 2-12 years in 21 villages in Myanmar [Burma] starting in August
      1984. The intervention and non-intervention villages were comparable regarding
      almost all the important baseline variables, including prevalences of Ascaris
      infection (80.8 vs 83.0%) and of malnutrition of grade 2 and above for height-for
      age (58.4 vs 55.8%) and for weight-for-age (48.2 vs 47.8%). The intensity of
      Ascaris infection was related to the degree of malnutrition. A significant
      increment of height gain was found, starting after the 6th month, and of weight
      gain after the 24th month, of the study among the treated 2-10 years old children
      when compared with the non-treated ones. By the end of 24 months, the height and
      weight gains per child were 0.65 cm and 0.93 kg respectively. Lesser increments
      in height-for-age and weight-for-age were also observed after successive
      treatments among the treated children with initially higher mean worm burdens.
      The findings are discussed in the context of causal relationship between
      ascariasis and malnutrition in children.

PMID- 1755064
TI  - Taeniasis-cysticercosis in Honduras.
AB  - Data on human taeniasis and human and animal cysticercosis from Honduras were
      gathered from laboratory, medical and slaughterhouse records, proglottid
      identification and surveys. The infection rate for human taeniasis was 2.7/1000
      individuals at the University Hospital, 10/1000 in the southern provinces of
      Choluteca and Valle, and 0.6/1000 in Cortes and Atlantida in the north. In
      surveys, the rates found ranged from 14 to 62/1000 in 9 of 15 communities
      studied. Taenia solium was identified in 135 of 181 individuals (74.5%) who
      submitted proglottids for speciation, 23 of whom were children 0-5 years old. The
      male:female ratio of infection rate was 1:2. The rates of infection with
      cysticercosis in pigs and cattle at one abattoir in 1981-1986 were 5% and 0.05%
      respectively. Diagnosis of human cysticercosis at the University Hospital
      increased five-fold with the introduction of computerized tomography and an
      enzyme-linked immunosorbent assay: 22 cases were diagnosed in 1980-1984 and 107
      cases in 1985-1988. Rates at the neurosurgical ward were higher (29/1000
      patients) than in the general hospital census (1.6/1000 patients). aeniasis
      cysticercosis may be a serious health problem in some areas of Honduras.

PMID- 1755065
TI  - A purified Fasciola gigantica worm antigen for the serodiagnosis of human
      fascioliasis.
AB  - Partially purified Fasciola gigantica worm antigens were evaluated in an enzyme
      linked immunosorbent assay (ELISA) for the specific serological diagnosis of
      fascioliasis. The diagnostic potential of 10 antigen fractions derived from gel
      filtration peaks (II & III) were evaluated individually or in combination against
      a panel of admission sera obtained from 50 patients subsequently diagnosed as
      having a variety of systemic parasitic diseases, and from 10 healthy volunteers
      with no recent history of parasitic infections. Fractions 2 and 10 were highly
      specific for Fasciola infection and failed to react with sera from any patient
      with other parasitic diseases or from controls. All other fractions exhibited
      reactivity with the majority of sera from the fascioliasis patients, but also
      with some sera from patients infected with other parasites. Based on these
      results, the ELISA, as outlined here, should be considered as a rapid and
      specific technique for the diagnosis of fascioliasis and also as an
      epidemiological surveillance technique in areas endemic for F. gigantica
      infection.

PMID- 1755066
TI  - Human Opisthorchis and Haplorchis infections in Laos.
AB  - A study of the epidemiology of trematode infections was carried out in Vientiane
      province, Laos, comprising examination of snails, fish, cats, and human stools.
      Opisthorchis viverrini cercariae were found in the snail Bithynia siamensis
      goniomphalus (Bithyniidae) and Haplorchis taichui cercariae in Tarebia granifera
      (Thiaridae). O. viverrini metacercariae were recorded in the flesh of 7 species
      of cyprinid fish; metacercariae of the heterophyid fluke Haplorchis taichui were
      found in 4 species of cyprinid fish and those of H. pumilio in 2 species. Cats
      from the same localities were infected with O. viverrini and 4 species of
      heterophyid flukes, frequently as multiple infections. The highest prevalence of
      small fluke eggs in human stools was recorded in the 20-29 years age group,
      particularly in males (90.4%). Three-quarters of human infections were light
      (less than 1000 eggs/g), the highest value (2975 eggs/g) being recorded in the 10
      14 years age group. Identification of small flukes excreted by Laotian patients
      after treatment with praziquantel in Czechoslovakia revealed more cases with H.
      taichui than with O. viverrini. The results confirmed the simultaneous occurrence
      of O. viverrini and intestinal heterophyid flukes in the area studied.

PMID- 1755067
TI  - High prevalence of anti-hepatitis delta virus antibody in chronic liver disease
      in Somalia.
AB  - We have assessed the prevalence of hepatitis delta virus (HDV) infection in
      people with histologically proven chronic liver disease living in Somalia. Among
      104 patients studied (14 with chronic persistent hepatitis, 74 with chronic
      active hepatitis, and 16 with active cirrhosis), 52 were positive for hepatitis B
      surface antigen; of these, 26 (50%) carried anti-delta antibodies. HDV infection
      was detected more frequently in sera from hepatitis B e antigen (HBeAg) negative
      patients (60.9%) than in HBeAg positive patients (9.1%). Using the dot-blot
      hybridization technique, serum hepatitis B virus deoxyribonucleic acid was
      revealed in 73.1% of patients without HDV infection, while it was detected in
      only 7.7% of anti-delta positive patients. It is concluded that HDV is strongly
      associated with chronic liver disease in Somalia.

PMID- 1755068
TI  - Epizootic of fox rabies in the Sultanate of Oman.

PMID- 1755070
TI  - A rapid test for Salmonella in stools, not requiring refrigeration.

PMID- 1755069
TI  - Identification of Vibrio cholerae by enzyme electrophoresis.
AB  - Zymovar analysis of 260 strains of Vibrio cholerae plus 3 reference strains of V.
      mimicus, using 13 structural loci, led to the grouping of strains in 73 zymovars
      (strain or group of strains sharing the same alleles). Effective separation of
      strains, distinction of V. cholerae strains from closely related V. mimicus and
      the detection of 2 vibrio strains, including one with two O1 serovars, in
      supposedly pure collection cultures, illustrate the potential of zymovar analysis
      in the identification of V. cholerae isolates. Two El Tor strains from USA, one
      CT+ and the other CT-, shared the same zymovar 71, while 127 typical El Tor
      strains belonged to zymovar 14.

PMID- 1755072
TI  - A field study of the effects of ivermectin on ectoparasites of man.

PMID- 1755071
TI  - Distribution and prevalence of Tunga penetrans in coastal south Trinidad, West
      Indies.

PMID- 1755073
TI  - Fatal extradural haematoma after snake bite (Bothrops moojeni).

PMID- 1755074
TI  - Non-ulcer dyspepsia in Nigeria: a case-control study.
AB  - Non-ulcer dyspepsia is common in Africa, yet there are few data on its possible
      cause. In this study 40 patients with strictly defined non-ulcer dyspepsia were
      matched with 40 asymptomatic volunteers. Both groups were questioned concerning
      their intake of alcohol, cola nut, non-steroidal anti-inflammatory drugs, and
      smoking. They then underwent upper gastrointestinal endoscopy with mucosal biopsy
      of the gastric mucosa: these biopsies were examined for gastritis and
      Helicobacter pylori. Ingestion of cola nut was the only statistically significant
      difference between the two groups. A high prevalence of gastritis and H. pylori
      infection was found in both groups, suggesting that these factors are not
      important in the aetiology of non-ulcer dyspepsia in northern Nigeria.

PMID- 1755075
TI  - Toxocara canis and pregnancy in mice.

PMID- 1755076
TI  - Sulfadoxine-pyrimethamine for the treatment of malaria.

PMID- 1755077
TI  - Cutaneous leishmaniasis and Leishmania infantum.

PMID- 1755078
TI  - Mebendazole in giardial infections: confirmation of the failure of this
      treatment.

PMID- 1755079
TI  - Reinfection of Somali children with Trichuris trichuria: a reply.

PMID- 1755080
TI  - Prevention of transfusion-transmitted malaria: is it time to revisit the
      standards?

PMID- 1755081
TI  - White cell-reduced blood components: should we go with the flow?

PMID- 1755082
TI  - A multicenter study on the efficiency of white cell reduction by filtration of
      red cells.
AB  - To evaluate accurately the current performance of filtration, the French Produits
      Sanguins Labiles study group, composed of 21 transfusion teams, conducted a large
      scale 6-month study involving over 1400 filtrations and 3000 controls. Some 745
      standard red cell concentrates (RBC concentrates) and 690 concentrates previously
      white cell (WBC)-reduced by removal of buffy coat (BC-poor RBC concentrates) were
      filtered using six commercially available filters: at least 170 results were
      collected per filter, spread among a minimum of three teams. Prefiltration
      controls show that the removal (manual and automated) of the buffy coat results
      in an initial WBC reduction of approximately 63 percent, along with a hemoglobin
      loss of 4 g (7%). After filtration, residual WBCs were counted in the Nageotte
      manual counting chamber. The reliability of this counting method, which is simple
      and adapted to low WBC concentrations, was characterized in this study by a 25
      percent coefficient of variation (CV) for a concentration of 2.5 WBCs per microL
      (i.e, 0.6 x 10(6) WBCs/filtered unit). The analysis of the results shows that,
      for five of six filters (1 filter was excluded), the postfiltration median value
      of residual WBCs was 1.1 x 10(6) in filtered RBC concentrates (n = 590), whereas
      it was 0.34 x 10(6) in filtered BC-poor RBC concentrates (n = 581). The
      difference is significant (p less than 10(-8), Wilcoxon test). Hemoglobin loss
      due to filtration varies according to the filter, from 5.7 +/- 2.2 to 17.3 +/-
      2.5 g.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755083
TI  - Reassessment of blood donor selection criteria for United States travelers to
      malarious areas.
AB  - In the United States (US), travelers who have had malaria or who have taken
      antimalarial chemoprophylaxis are deferred as blood donors for 3 years to prevent
      transfusion-transmitted malaria. To assess the impact of shortening this 3-year
      exclusion period, national malaria surveillance data from 1972 to 1988 were
      reviewed. The average annual rate of transfusion-transmitted malaria is 0.25
      cases per million units of blood collected. Of 45 reported cases, 38 percent were
      caused by Plasmodium malariae, 29 percent by P. falciparum, 24 percent by P.
      vivax, and 9 percent by P. ovale. Thirty-two donors were implicated in 34 cases
      of transfusion-transmitted malaria. Of 30 implicated donors whose native country
      was identified, 23 (77%) were foreign nationals and 7 (23%) were from the US. In
      a review of all imported malaria cases by species and by interval between date of
      entry and onset of illness, 98 percent of P. falciparum, 86 percent of P.
      malariae, 76 percent of P. vivax, and 74 percent of P. ovale infections became
      symptomatic within 6 months of the patient's arrival in the US, regardless of the
      use of prophylaxis. Shortening to 6 months the donor exclusion period for US
      travelers to malarious areas would result in a minimum of 70,000 additional blood
      donors' being made available, with a maximum annual increase of 0.03 additional
      cases of transfusion-transmitted malaria. The potential benefit of bringing
      healthy travelers back into the donor pool after a shorter period of exclusion
      merits consideration by the blood banking industry.

PMID- 1755084
TI  - Reduced membrane protein methylation in red cells of the McLeod blood group
      phenotype.
AB  - Red cells (RBCs) contain an abundance of protein methylase II, which catalyzes
      the transfer of methyl groups from S-adenosylmethionine to carboxyl groups of
      aspartyl and glutamyl residues in proteins. Enzyme-catalyzed transfer of methyl
      groups, labeled with 14C or 3H, from S-adenosylmethionine to membrane proteins of
      McLeod, Ko, and control RBCs was assayed by determining the acceptance of labeled
      methyl groups under standardized conditions. Membranes of control cells and Ko
      cells showed about 50 percent greater uptake than did those of McLeod cells.
      However, when ovalbumin was used as a methyl-accepting substrate, the levels of
      protein carboxymethyltransferase activity in all three types of cells were found
      not to differ significantly. In addition, no significant qualitative differences
      were apparent when methyl-labeled polypeptides from control and McLeod cells were
      separated by slab gel electrophoresis. The mechanisms responsible for changes in
      membrane protein methylation of McLeod cells remain unclear. However, these
      observations provide further evidence of the pleiotropic biochemical lesion
      associated with the acanthocytic morphology that characterizes McLeod RBCs.

PMID- 1755085
TI  - Probable reasons that autologous blood was not donated by patients having surgery
      for which crossmatched blood was ordered.
AB  - Preoperative autologous blood donation is used by only a small percentage of
      surgery patients for whom crossmatched blood is ordered. To document the reasons
      the patients failed to donate, the medical records of surgical patients at three
      university and three community hospitals were studied. All procedures for which
      crossmatched blood was ordered, but for which autologous blood was not available,
      were included (n = 8121). Probable reasons for nondonation were found in 72
      percent of university hospital patients and 65 percent of community hospital
      patients (n = 6064 and n = 2057, respectively). The most frequent reasons for
      nondonation among university hospital patients were emergency surgery (27%) and
      age less than 12 years (17%), and those among community hospital patients were
      emergency surgery (42%) and American Society of Anesthesiologists physical status
      greater than or equal to 4 (20%). Surprisingly, anemia (hemoglobin less than 11
      g/dL [less than 110 g/L]) as the only limitation to donation was rarely found:
      this was the sole reason in only 3.3 percent of university hospital and 4.5
      percent of community hospital patients. Overall, of 8121 patients who failed to
      donate autologous blood, 5731 (71%) had legitimate medical reasons. The remaining
      2390 (29%) had no identifiable reason for nondonation, and recruitment efforts
      should be focused on them and their surgeons.

PMID- 1755086
TI  - Prevalence of antibody to Trypanosoma cruzi among blood donors in Los Angeles,
      California.
AB  - Transfusion-associated Chagas' disease is a serious public health problem in
      Central and South America. With the recent influx of immigrants from Chagas'
      disease-endemic areas, concern about the risk of disease from blood transfusion
      has increased in the United States. To assess the prevalence of Trypanosoma cruzi
      infection in one area, 1024 consecutive blood donations from 988 voluntary blood
      donors at a medical center in Los Angeles County were screened serologically. The
      median age of donors screened was 32.5 years; 53.4 percent were male, and 38.4
      percent were born in Chagas' disease-endemic countries. All donor sera were
      tested by complement fixation (CF) and indirect immunofluorescence (IIF) tests. A
      radioimmunoprecipitation assay (RIPA) was also done on all sera from CF- or IIF
      reactive donors and an equal number of sera from nonreactive donors. A second
      serum specimen was obtained, and interviews were completed for 18 (67%) of 27
      donors with an initial CF titer greater than or equal to 8 or an IIF titer
      greater than or equal to 64. The overall seroreactivity (by CF and IIF) was 1.1
      percent (11/988). One donor (0.1%) had antibody specific to the 72- and 90-kDa
      antigens of T. cruzi on RIPA. Seven recipients of blood components from the
      seroreactive donors were located and were seronegative at 3 to 6 months.
      Seroreactive donors were 3.6 times more likely to have been born or to have
      resided in Mexico or Central America, 8.7 times more likely to have donated blood
      in the past, and 11.8 times more likely to have a history of malaria prophylaxis
      or treatment.

PMID- 1755088
TI  - Validating the probability of paternity.
AB  - In cases of disputed parentage, it is commonly thought that the probability of
      paternity (P) represents the probability that the tested man is the biologic
      father of the child whose parentage is in doubt and that the paternity index (PI)
      is the likelihood ratio that enters into this probability. Using the results of
      HLA typing in a sample of disputed parentage cases, the distribution of P was
      examined within two groups: actual mother-alleged father-child trios, and
      simulated mother-unrelated man-child trios. These distributions were found to be
      roughly consistent with the usual understanding of P.

PMID- 1755087
TI  - Effects on donors of second bone marrow collections.
AB  - Second bone marrow transplants have been used successfully to treat marrow graft
      failure or relapse following the original marrow transplantation. Hospital
      records of 16 related two-time bone marrow donors were reviewed to determine what
      risks a person faces in making a second marrow donation. One donor suffered a
      minor complication following the first collection, but no donors suffered
      complications during the second donation. The volume of marrow collected for the
      first and second donations (1253 +/- 504 vs. 1261 +/- 471 mL) was similar.
      However, more marrow donors received transfusions of homologous red cells during
      the second collection than during the first collection (5/16 compared to 1/16; p
      = 0.06). To determine what factors might contribute to the high incidence of
      homologous red cell transfusion during second donations, the experiences of
      donors who received homologous blood during the second donation were compared to
      the experiences of donors who received only autologous blood. Persons receiving
      homologous blood during the second collection received more red cell units than
      persons receiving autologous blood (2.0 +/- 0.7 units compared to 0.9 +/- 0.5
      units; p less than 0.01). Their precollection hemoglobin levels were lower (12.3
      +/- 1.2 vs. 14.4 +/- 1.4 g/dL [123 +/- 12 vs. 144 +/- 14 g/L]; p less than 0.01),
      and the time between the first and second collections was significantly less (45
      +/- 8 days vs. 342 +/- 432 days; p less than 0.05).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1755089
TI  - A flow cytometric method for determination of white cell subpopulations in
      filtered red cells.
AB  - A flow cytometric method for the detection of low amounts of lymphocytes,
      monocytes, and granulocytes in filtered red cells (RBCs) was evaluated. In this
      procedure, the RBCs in the samples were lysed by ammonium chloride treatment and
      the white cells (WBCs) were detected by flow cytometry according to their
      specific light-scattering properties. The identity of the WBC subpopulations was
      confirmed by immunofluorescence with monoclonal antibodies specific for each cell
      type. Flow cytometric determination of WBCs in filtered RBCs correlated with
      numbers obtained by both a hemocytometer (r = 0.76) and a radioimmunoassay (r =
      0.79). Total numbers of WBCs in RBCs measured by flow cytometry were 59 +/- 13
      percent (n = 7) of those measured by electronic particle counting, 32 +/- 6
      percent (n = 25) by hemocytometer, and 48 +/- 11 percent (n = 29) by
      radioimmunoassay. Lymphocytes added to filtered RBCs in a concentration of 1.37
      cells per microL were detected at an average of 0.56 +/- 0.22 cells per microL (n
      = 3). Results with monoclonal antibodies indicated an altered expression of
      membrane markers on granulocytes after RBC filtration, as seen with cell
      activation. The inefficiency of the flow cytometric method to detect the total
      number of WBCs calculated by other methods may reflect filtration-induced changes
      in light-scattering properties of the WBCs. Although the method described does
      not accurately quantitate the total numbers of WBCs present in filtered RBCs, it
      may provide useful information on qualitative aspects of WBC subpopulations.

PMID- 1755090
TI  - Immune-mediated hemolysis associated with the administration of a radiographic
      contrast medium.
AB  - A female patient developed serious hemolysis in association with the injection of
      a radiographic contrast medium (RCM). Serologic investigation of her serum
      suggested complement-mediated hemolysis, induced by an RCM-dependent IgM antibody
      in her serum. The antibody was of high titer and low avidity. The antibody showed
      cross-reactions with related radiographic contrast media and reacted only with
      group I adult RBCs.

PMID- 1755091
TI  - Acute normovolemic hemodilution.

PMID- 1755092
TI  - Confidential unit exclusion: how should it be evaluated?

PMID- 1755093
TI  - The CUE debate (continued): on surrogate tests and surrogate endpoints.

PMID- 1755094
TI  - Potential accumulation of tri(n-butyl)phosphate in solvent-detergent virus
      inactivated plasma products.

PMID- 1755095
TI  - Infectious disease markers in directed donors in the Atlanta region.

PMID- 1755096
TI  - Controversial spindle cell tumors: an overview.

PMID- 1755097
TI  - Review and update: oncogenic osteomalacia-rickets.
AB  - Oncogenic or tumor-induced osteomalacia-rickets is a syndrome characterized by
      hypophosphatemia, renal phosphate wasting, and decreased serum 1,25
      dihydroxyvitamin D3 levels. The tumors secrete a phosphaturic substance that
      causes total body phosphate depletion, leading to osteomalacia or rickets.
      Although the tumors are histologically polymorphous, personal review of 16 tumors
      documented to cause this syndrome revealed four morphologic patterns. The first
      contained 10 unique-appearing, mixed connective tissue tumors having variably
      prominent vessels, osteoclastlike giant cells, focal microcystic changes,
      dystrophic calcification, osseous metaplasia, and/or poorly developed
      cartilagelike areas. With one exception, all tumors of this group occurred in
      soft tissue and were benign. The single malignant tumor originated in bone,
      recurred locally, and metastasized to lung. The remaining tumors occurred in bone
      and showed benign clinical behavior. They resembled tumors known to occur in
      bone, that is osteoblastomalike (3 tumors), nonossifying fibromalike (2 tumors),
      and ossifying fibromalike (1 tumor).

PMID- 1755098
TI  - The enigmatic perineurial cell and its participation in tumors and in tumorlike
      entities.
AB  - The perineurial cells that make up the perineurium of peripheral nerve fascicles
      are characterized by distinct ultrastructural features, including non-branching
      thin cytoplasmic processes coated by an external lamina and joined at their ends
      by a tight junction, few organelles, actin and vimentin filaments, and numerous
      pinocytotic vesicles. Perineurial cells are immunoreactive for vimentin and
      epithelial membrane antigen (EMA) but not for the Schwann cell markers S-100
      protein and Leu-7. The cytogenesis of the perineurium remains disputable, with
      morphologic, immunohistochemical, and experimental evidence supporting origin
      from the fibroblast, Schwann cell, and arachnoid cap cell. Ultrastructural
      studies more recently supported by immunolocalization of EMA have detected
      hyperplastic and neoplastic perineuriallike cells in a number of pseudoneoplastic
      lesions and true neoplasms, notably localized hypertrophic neuropathy,
      neurofibromas of various types, and perineurioma.

PMID- 1755099
TI  - Lipid-rich rhabdomyosarcoma--a potential source of diagnostic confusion.
AB  - Rhabdomyosarcoma is an often primitive tumor capable of diverse morphologic
      manifestations. The article describes three cases of childhood rhabdomyosarcoma
      in which a significant population of lipid-rich tumor cells was present. The lack
      of specificity and potentially confusing nature of this feature are discussed,
      and the ultrastructural diagnosis of rhabdomyosarcoma is briefly reviewed.

PMID- 1755100
TI  - Sarcomatoid renal cell carcinoma metastatic to the heart: report of a case.
AB  - An unusual case of metastatic sarcomatoid renal cell carcinoma is presented.
      Fifteen months after nephrectomy for a typical clear cell carcinoma, a 63-year
      old man presented with bilateral pleural effusions, cardiomegaly, and tamponade.
      A pericardial biopsy showed an anaplastic spindle cell tumor that was strongly
      keratin positive and showed desmosomes ultrastructurally. The patient died
      shortly thereafter, and the autopsy revealed massive tumor infiltration of the
      heart, pulmonary and adrenal metastases, and tumor nodules at the incision site
      of his nephrectomy. The differential diagnosis of sarcomatoid renal cell
      carcinoma is discussed.

PMID- 1755101
TI  - A study of spindle cell sarcomas showing myofibroblastic differentiation.
AB  - Five diagnostically problematic spindle cell sarcomas showing invasive character,
      cellular pleomorphism, and high mitotic rate were studied clinically and
      histopathologically by conventional light microscopy, immunohistochemistry, and
      transmission electron microscopy. They showed varied clinical courses, with two
      causing death within 5 years and three showing recurrent and metastatic behavior.
      All lacked a clearly defined line of differentiation by conventional light
      microscopy. By immunohistochemistry, all were positive for vimentin and alpha
      smooth muscle actin; in addition, one showed focal S-100 protein positivity, and
      one stained for desmin. All were cytokeratin negative. By electron microscopy,
      the great majority of spindle cells in all cases showed abundant rough
      endoplasmic reticulum and fine myofilaments with focal densities; collagen
      secretion granules were also found in all cases but in fewer cells. The fine
      structure and immunophenotype were considered consistent with myofibroblastic
      differentiation; these tumors, therefore, were designated as sarcomas of
      myofibroblasts or myofibrosarcomas. The suitability of the alternative diagnostic
      label of myofibroblastic or matrix-secreting variant of leiomyosarcoma is
      discussed. Comparisons with similar tumors documented in the literature are
      drawn.

PMID- 1755102
TI  - Primitive pelvic sarcoma resembling clear cell sarcoma of kidney.
AB  - Clear cell sarcoma of kidney (CCSK) is an aggressive childhood renal tumor of
      unknown histogenesis that has not been reported to occur outside the kidney. The
      article describes an extrarenal neoplasm arising in the pelvic soft tissues of a
      13-year-old boy that was composed predominantly of uniform mesenchymal cells with
      optically clear cytoplasm supported by an arborizing network of small blood
      vessels, which was indistinguishable in appearance from CCSK. The electron
      microscopic findings, although nonspecific, were essentially identical to those
      of CCSK, with tumor cells displaying fine chromatin, electron-lucent cytoplasm,
      and intercellular collagen but no evidence of tissue-specific differentiation.
      Immunocytochemical studies showed positivity for vimentin but negative results
      for desmin, myoglobin, cytokeratin, epithelial membrane antigen, S-100 protein,
      neuron-specific enolase and factor VIII-related antigen. Tumor cells were also
      nonreactive with Ulex lectin. This unusual pelvic tumor and CCSK may both derive
      from primitive mesenchymal cells and may represent phenotypic but not necessarily
      histogenetic analogs.

PMID- 1755103
TI  - The diagnosis of thymoma: a review.
AB  - Thymoma is the most common tumor of the anterior-superior mediastinum, especially
      in middle-aged or older adults. Microscopically, thymomas can be differentiated
      from other tumors with which they can be confused by the finding of a mixed
      population of cells, including neoplastic thymic epithelial cells with numerous
      processes surrounding activated-appearing lymphocytes. Thymomas can be classified
      as benign or malignant, and the majority of those that are malignant appear
      cytologically benign and are locally invasive. Cytologically benign thymomas have
      been classified as being lymphocyte rich, epithelial cell rich, or spindle cell
      type. This classification has not been found to be prognostically useful. A new
      method classifies these tumors as being cortical, medullary, or mixed. This new
      classification appears to have prognostic significance. Malignant thymomas that
      are cytologically malignant are uncommon. Such tumors usually are squamous cell
      carcinomas. Other types include sarcomatoid carcinoma, clear cell carcinoma,
      basaloid carcinoma, and mucoepidermoid carcinoma. Because other tumors can occur
      in the anterior mediastinum, electron microscopy and/or immunocytochemistry is
      helpful in making the distinction. The differential features by ultrastructural
      and immunocytochemical analysis are reviewed.

PMID- 1755104
TI  - Lymphomas of the mediastinum.
AB  - The purpose of this clinicopathologic overview is to describe the types of
      lymphomas that present in the mediastinum. A comparison of the frequency of the
      different subtypes of lymphoma that are found in children and adults is provided.
      In general, immunohistochemistry and immunophenotyping studies are essential to
      the laboratory workup of neoplasms presenting in the mediastinum. An assessment
      of proliferative index in lymphoma is most helpful to determine tumor
      aggressiveness and patient prognosis. Electron microscopy is most helpful in the
      differential diagnosis of mediastinal neoplasms, where lymphomas may be
      distinguished from nonlymphomatous neoplasms using key ultrastructural features.
      The role of electron microscopy in the subclassification of lymphomas is mostly
      academic, with a few exceptions. The varied ultrastructural appearance of
      Hodgkin's cells and of different subtypes of non-Hodgkin's lymphoma is
      illustrated, using cases from our patient files. An ultrastructural study of
      lacunar cells in Hodgkin's disease provides evidence that the formation of
      lacunae may have a structural and/or physiologic basis. Mummified cells showing
      some of the features of a physiologic form of cell death, called apoptosis, are
      also described.

PMID- 1755105
TI  - Atypical tumor of the mediastinum: epithelioid hemangioendothelioma containing
      metaplastic bone and osteoclastlike giant cells.
AB  - A 66-year-old woman presented with a superior-anterior mediastinal mass that
      contained considerable calcification by computed tomography. Initial biopsy
      interpretation was inconclusive but suggested a giant cell sarcoma of soft parts
      because the tumor contained atypical epithelioid cells and osteoclastlike giant
      cells. After radiation and chemotherapy, the tumor was removed. It contained
      large epithelioid cells, pale chondroid areas, metaplastic bone, and
      osteoclastlike giant cells. Immunohistochemical and electron microscopic studies
      revealed the epithelioid cells to be factor VIII positive and to contain abundant
      intermediate filaments, micropinocytotic vesicles, Weibel-Palade bodies, basal
      lamina, and primitive cell-cell junctions. These epithelioid cells also stained
      for muscle-specific actin (HHF-35), yet were negative for desmin and cytokeratins
      (CAM 5.2 and AE1/3). The findings were most consistent with those reported to
      occur in epithelioid hemangioendothelioma.

PMID- 1755107
TI  - Upper abdominal neoplasms: an introduction and selected references.
AB  - The organs in the upper half of the abdominal cavity can give rise to a highly
      heterogeneous collection of neoplasms that encompasses a broad spectrum of
      clinical features, light microscopic appearances, immunostaining properties, and
      fine structure. Because of the anatomic proximity of the viscera in this region,
      the differential diagnosis of an upper abdominal mass may include consideration
      of tumors that arise from the stomach, duodenum, liver, kidney, adrenal, and
      pancreas. There are many distinctive ultrastructural features among the various
      tumors that can be used effectively by the diagnostic electron microscopist, but
      it is also important to take into account the considerable overlap in fine
      structure that occurs among different tumors and among similar tumors from
      different organs. In the session on upper abdominal neoplasms, the electron
      microscopic characteristics of the common tumors of each viscus were reviewed
      before the presentation of individual case studies that incorporated original
      observations and illustrated some unusual entities. The selection of cases that
      follows is inevitably small and arbitrary, but the cases demonstrate the
      contribution that electron microscopy can make in the study of an upper abdominal
      mass and illustrate some of the similarities that can be encountered among tumors
      of different organs.

PMID- 1755106
TI  - Solitary fibrous tumor of the mediastinum.
AB  - A 62-year-old woman presented with an asymptomatic anterior mediastinal mass.
      Clinically considered to be a thymoma, the tumor was solid, firm, and composed of
      hypocellular dense collagen and cytologically bland, spindled fibroblastlike
      cells growing in a patternless pattern. There was no apparent connection to
      pleura or pericardium, yet the clinicopathologic features clearly fit with
      solitary fibrous tumor (SFT) of mediastinum. SFTs occur most commonly in pleura
      but have been reported in other locations, including the mediastinum, where
      aggressive behavior has been more common when these tumors are compared to those
      occurring in pleura. Although it is difficult to predict behavior for all cases
      of SFT occurring in the mediastinum by cytologic features alone, morphologic
      criteria for benign and malignant forms have been described. Roughly half the
      malignant forms will progress, yet the single most important indicator of
      clinical outcome is whether the tumor can be initially totally excised.

PMID- 1755108
TI  - Gastrointestinal stromal tumor of the duodenum: a case report.
AB  - The report describes a malignant gastrointestinal stromal tumor occurring in the
      duodenum in a 71-year-old woman. The neoplasm showed both epithelioid and spindle
      cell patterns by light microscopy. The ultrastructural features were diagnostic
      of nerve sheath origin. The tumor had numerous wrapping processes joined by
      junctions and surrounded by axons. No features of smooth muscle differentiation
      were identified. Immunocytochemistry was inconclusive. The differential diagnosis
      of such neoplasms is discussed.

PMID- 1755109
TI  - Retroperitoneal sarcoma with features suggestive of alveolar soft part sarcoma.
AB  - A 72-year-old man presented with a 15 x 12 x 5 cm cystic and necrotic tumor
      involving the superior region of the stomach and the retroperitoneum down to the
      transverse colon and extending laterally from the left lobe of the liver to the
      spleen without involving either organ. Light microscopy showed the tumor cells to
      be arranged in an organoid pattern. Immunocytochemistry showed a strong reaction
      for desmin and vimentin. Electron microscopy demonstrated features suggestive of
      an alveolar soft part sarcoma.

PMID- 1755110
TI  - Angiomyolipoma of the kidney with lymph node involvement.
AB  - A case of renal angiomyolipoma with regional lymph node involvement is added to
      20 cases previously reported. This represents the 11th case reported in a non
      tuberous sclerosis patient. The electron microscopic features of the tumor are
      discussed and correlated with the light microscopic findings.

PMID- 1755111
TI  - Oncocytic adrenal cortical carcinoma.
AB  - A case of adrenal cortical carcinoma composed of mitochondria-rich cells is
      reported. The cells contained condensed zones and loose whorls of smooth
      endoplasmic reticulum. Crystalline matrical inclusions were present in some of
      the mitochondria, whereas others contained round, homogeneous, dense matrical
      inclusions. Flow cytometry revealed a hyperdiploid stem line with a DNA index of
      1.3.

PMID- 1755112
TI  - Pheochromocytoma.
AB  - The cytoplasmic granules in an adrenal pheochromocytoma were predominantly ovoid
      with loose-fitting limiting membranes and eccentrically positioned dense cores.
      The occurrence of similar granules in a recurrent tumor involving the organ of
      Zuckerkandl in a second patient suggests that the latter tumor should be
      designated an extraadrenal pheochromocytoma.

PMID- 1755113
TI  - Hepatic angiomyolipoma with striated granules and positivity with melanoma-
      specific antibody (HMB-45): a report of two cases.
AB  - Angiomyolipoma occurs rarely in the liver, with only 25 previous cases being
      reported in the English literature. The article describes two additional cases,
      one of which was multicentric, with results of ultrastructural and
      immunocytochemical studies. Many of the tumor cells contained numerous electron
      dense granules, some with transverse striations like those found in melanosomes.
      Both tumors stained positively for S-100 protein and melanoma-specific antibody
      HMB-45. One case also expressed vimentin and neuron-specific enolase. Both were
      negative for cytokeratin, carcinoembryonic antigen, alpha-fetoprotein, desmin,
      muscle-specific actin, factor VIII antigen, and chromogranin. Comparison of our
      ultrastructural findings with those of classic renal angiomyolipoma raises the
      possibility that the melanosomelike structures may represent renin granules
      rather than melanosomes, although the latter are not excluded. Expression of HMB
      45 in angiomyolipoma has important biologic and diagnostic implications, whether
      or not it reflects melanocytic differentiation.

PMID- 1755114
TI  - Biological calcium absorption edge imaging using monochromatic synchrotron
      radiation.
AB  - Soft X-ray contact absorption edge images of unfixed, unstained biological
      specimens were made using monochromatic synchrotron radiation. X-ray contact
      replicas of unfixed, hydrated biological specimens at the nitrogen absorption
      edge and above and below the CaLIII absorption edge were compared to comparative
      conventional morphological and elemental high-resolution imaging methods
      (scanning and transmission electron microscopy, TEM-histochemistry and TEM-X-ray
      microanalysis). Soft X-ray absorption edge images made above the calcium
      absorption edge clearly revealed morphological detail and identified regions
      ladened with calcium as verified by TEM histochemistry of identical spores.
      Similarly, nitrogen absorption edge images identified residual nitrogenous
      material in the spore resuspension medium, and non-viable spores with nitrogen
      loss due to protoplast disaggregation.

PMID- 1755115
TI  - [A method for modelling obstructive and nonobstructive hydroureteronephrosis
      (experimental research)].
AB  - An experimental model of the upper urinary tract obstruction by means of
      cryosurgical liquid nitrogen destruction of an ureteral part has been created.
      The rabbit models provided obstructive ureterohydronephrosis in 100% of the
      animals, 56% of the dogs developed ureteral stricture in line with urodynamic
      alterations, the rest 44% had symptoms of nonobstructive ureterohydronephrosis as
      shown by excretory urography and dynamic nephroscintigraphy. One--three months
      after the destruction in dogs there were shifts in the intra-ureteral pressure
      and bioelectric activity, contractility of the fragments. The histological
      examination of the sections revealed necrosis at the destroyed site in the early
      postexposure period (2 weeks) followed by sclerosis and circulatory disturbances
      later on (3 months). The technique is simple, feasible in all laboratory animal
      species, highly reproducible.

PMID- 1755116
TI  - [The effect of extracorporeal piezoelectric lithotripsy on cardiac activity].
AB  - To evaluate cardiac effects of shock waves, 40 patients with uroliths (10
      subjects with and 30 without arrhythmia) were examined during their exposure to
      remote electropiezolithotripsy (Piezolith-2300 unit). Arterial pressure and ECG
      were registered before, during (upon 1500 and 3000 impulses) and after the
      session. Except a slight deceleration of the heart rate, no cardiac disorders
      significant clinically were reported.

PMID- 1755117
TI  - [Extracorporeal shockwave lithotripsy on the Sonolith-3000 apparatus].
AB  - The authors observed 812 patients with nephrolithiasis who underwent 876 sessions
      of shock-wave lithotripsy on Sonolith-3000 lithotriptor supplied with an
      ultrasonic system of the stone localization. The size of nephroliths ranged from
      0.7 to 4.2 cm. Large-size nephroliths required repeated sessions and pretreatment
      establishment of the stent. The procedure proceeded without anesthesia.
      Subsequent renal colic was reported in 126 (15.5%), an exacerbation of
      pyelonephritis in 45 (5.5%), subcapsular hematoma in 4 (0.5%) of the patients.
      790 patients showed clinical response (97.3%), with a complete destruction of the
      stone in 446 (54.9%) and partial one in 344 (42.4%) cases. 27 subjects were
      treated in outpatient setting. According to the authors, lithotripsy is
      contraindicated in urinary tract obstruction below the stone, renal failure,
      chronic pyelonephritis in the active phase of inflammation, marked impairment of
      cardiac rhythm.

PMID- 1755118
TI  - [The significance of a congenital enterovirus infection in the pathogenesis of
      transient intrainfectious nephropathy and interstitial nephritis detected in
      children with influenza-like and acute respiratory diseases].
AB  - The paper presents the data confirming the hypothesis on the involvement of the
      congenital enteroviral infection in etiology of chronic nephropathy manifesting
      in children in the presence of influenza-like and acute respiratory infections
      diseases. 100 relevant children were examined. Family history indicated a high
      risk of enteroviruses inheritance from mothers who were chronic carriers in 19
      out of 20 children with pyelonephritis or interstitial nephritis (95%), in 17 out
      of 23 children with transitory nephropathy (73.9%) and 16 out of 57 patients
      without nephropathy (28.1%). Coxsackie enteroviruses (A and B) occurred in the
      urinary sediment in 82.3, 68.4, 29.5% of the patients from the groups under
      comparison, respectively. In children free of nephropathy the viruses manifested
      primarily in the seasons with the highest prevalence of the enteroviral diseases,
      in those with nephropathy Coxsackie viruses detection rate was not season
      related. Recognition of enteroviruses (Coxsackie B, as a rule) was significantly
      related to the risk of the transmission from the mother. Persistence of the
      viruses in the cells of the urinary system of children with congenital viral
      infection seems to run subclinically for a long time. Influenza and other acute
      respiratory diseases promoted activation of the endogenic infection which
      resulted in transitory nephropathy or interstitial nephritides.

PMID- 1755119
TI  - [Bacterial toxic shock in urological diseases].
AB  - It is a review of present-day and historical aspects of bacterial toxic shock
      arising in urological setting. It is noted that conditions of its onset are
      changing, therapeutic approaches undergo revision, critical care facilities are
      updated. Among the causes of this complication the authors single out endoscopic
      procedures, transurethral interventions in the presence of infectious process,
      hospital infection, long stay at hospital. Forty-eight cases of bacterial toxic
      shock are reviewed in relation to classification, causes of development,
      treatment, bacteriological evaluation.

PMID- 1755120
TI  - [Immunity and the possibilities for immunomodulation in acute pyelonephritis].
AB  - The paper presents evidence on dysfunction of natural killer cells and abnormal
      proliferative response of peripheral blood mononuclears to T- and B-cell mitogens
      (PHA, Phytolacca) in patients at varying stages of acute pyelonephritis. A number
      of immunomodulators (recombinant alpha 2-interferon, IL-2 and tactivin) produce
      different effects on natural killer activity and lymphocyte blast transformation
      in healthy donors and pyelonephritis patients. Immunotropic effects of
      immunopeptides depend on the drug dose, the response of various subpopulations of
      the immunocompetent cells being individual. It is suggested that immune system,
      natural killer activity in particular, plays an important part in pathogenesis of
      acute pyelonephritis. In vitro experiments demonstrate that there can be a
      positive clinical response to tactivin and recombinant alpha 2-interferon
      administered in doses activating the function of certain immunocompetent cells.

PMID- 1755121
TI  - [The hemostatic pursestring suture in adenomectomy of the prostate].
AB  - It is a description of a new technique of putting a removable purse-string
      hemostatic stitch on the prostatic adenoma bed. Four stitches are made with a
      double catgut thread. The loop of the thread encircles the ureteral catheter
      introduced into the urethral tube. Upon tightening the purse, loose thread ends
      are connected with the urethral tube and fastened, the tube is tracted.
      Postoperative drop irrigation of the bladder with antiseptic drugs proceeds
      through the ureteral catheter. The purse-string suture is taken out when the
      catheter is removed from the urethral drainage at postoperative hour 20-24. The
      bladder is sutured tightly using double-row buried purse-string gut stitches. A
      total of 143 patients underwent surgery according to the technique of whom 70%
      had aggravating chronic cysto-pyelonephritis, 17.5% suffered from urolithiasis,
      72% from cardiac diseases and 30% of respiratory disorders. 28% of the patients
      combined prostatic adenoma with chronic prostatis. 38 patients (26.5%) needed
      blood transfusions. Mean stay in hospital after one-stage adenomectomy made up
      16.4 days at stage I-II of the disease, after delayed adenomectomy 19 days, after
      two-stage adenomectomy 21.8 days. Two patients died (1.37%).

PMID- 1755122
TI  - [Gunshot wounds of the kidneys].
AB  - Upon the analysis of the treatment for gunshot wounds of the kidneys (n = 113),
      it is concluded that in the majority of cases such wounds (91.1%) were associated
      with additional injuries of other viscera, this complicating the diagnosis and
      treatment, aggravating the prognosis. At admission, 81.4% of the wounded were in
      shock, with signs of hemorrhage. Serious condition of the patients dictated
      urgent surgery imposing limitations on diagnostic examinations, e.g. intravenous
      urography was performed in 5.3% of the cases only. Therefore, preoperative
      detection of renal injuries was far from universal. (55.6%). Hematuria prompted
      renal damage in 74% of cases. 92% of the wounded underwent surgery, in 62.8% of
      them it was nephrectomy. Serious combined wounds terminated in lethal outcomes in
      50.4% of cases, though renal damage was responsible for 4% of deaths only.
      Introduction of up-to-date methods of examination (CT, ultrasonography, excretory
      urography) may raise the frequency of the kidney-preserving operations and
      favourable outcomes.

PMID- 1755124
TI  - [The biochemical characteristics of the sperm in patients with varicocele].
AB  - Biochemical evaluation of ejaculates from males suffering from varicocele
      provided evidence on reduced fertility of their gametes mainly due to these cells
      hypoactivity consequent to insufficient generation of energy supplied during
      fructose oxidation. Lowered intensity of fructose oxidation in gamete
      mitochondria led to lactate accumulation in line with ultrastructural derangement
      of the flagellum and mitochondria with inhibition of dehydrogenases activity.
      Morphological abnormalities of the gametes are attributed to impaired
      gametogenesis in reproductive system of men with varicocele.

PMID- 1755123
TI  - [The surgical treatment of urinary incontinence in children].
AB  - The paper reports examination, treatment and follow-up data on 8 children aged 4
      13 suffering from total enuresis, who failed previous conservative or operative
      treatment. Upon examination enuresis was attributed to trauma or malformations of
      the neck of the urinary bladder (NUB) or urethra (in 2 and 6 patients,
      respectively). Out of the latter, NUB congenital defect was in 4, total epispadia
      in 1, spina bifida in 1 patient. Urodynamic studies showed the absence of
      detrusor-sphincter dyssynergia and confirmed organic nature of NUB lesion. Six
      children underwent NUB electromyography which recorded no uniform, preformed
      complexes with adequate voltage. All the children were operated on: NUB
      reconstruction according to Davis, bilateral uretero-cystostomy according to
      Coen. An immediate postoperative response was seen in 7 children who were able to
      retain urine for 40 min-2.5 hours. Long-term response (6 months-3 years) was
      achieved in 7 children who recovered normal uresis. Total enuresis persisted in 1
      patient with spina bifida. 2.5-3 years after the treatment the bladder capacity
      increased in spite of its resection by 1/3.

PMID- 1755125
TI  - [Chromosomal anomalies in men with infertility].
AB  - Out of 35 sterile males with impaired spermatogenesis two patients had "XX-male"
      syndrome and one patient had Y-chromosome deprived of a long arm. The three
      patients presented with similar clinical manifestations: short height, non
      manifest malformations, impaired spermatogenesis, sterility.

PMID- 1755126
TI  - [Immunochemical tests in the diagnosis of diseases of the male reproductive
      system].
AB  - Immunochemical tests were employed to measure proteins (acid phosphatase,
      prostatic beta-globulin, endometrial alpha-2-globulin, lactoferrin,
      carcinoembryonal antigen) in spermatic plasma and prostatic fluid from healthy
      subjects and patients with prostatic adenoma, cancer, chronic inflammation,
      defects of spermatogenesis. It was found that the overall concentration of acid
      phosphatase and prostatic beta-globulin may serve a diagnostic criteria to
      differentiate prostatic adenoma from cancer as in 93% of prostatic cancer this
      parameter did not exceed 400 micrograms/ml whereas in 75% of adenomas it was
      above 1200 micrograms/ml. Activity of chronic prostatitis can be assessed from
      lactoferrin test. The level of the organ-specific antigens (acid phosphatase and
      prostatic beta-globulin) and lactoferrin correlated with the severity of
      spermatogenesis disorders.

PMID- 1755127
TI  - [Buried suture of the bladder in the surgical treatment of urethral stricture].
AB  - Surgical treatment for posttraumatic urethral stricture was carried out in 316
      patients: tunneling in 42, Marion-Khol'tsov [correction of Kholtrov] operation
      with circular drainage in 185, tight suture of the bladder with transurethral
      drain using double-opening tube in 86 cases. Complications emerged in 28
      patients. The best short- and long-term outcomes were obtained in the group
      subjected to tight suturing.

PMID- 1755128
TI  - [The prevention and treatment of posttraumatic strictures of the posterior
      urethra in patients with pelvic bone fractures].
AB  - Urethral strictures resultant from hip fractures were examined and treated in 140
      patients admitted to hospital with multiple attendant traumas: rupture of the
      bladder and abdominal organs, rib and limb fractures, renal injuries. All of them
      underwent epicystostomy followed in 3--4 months by urethroplasty. Drainage of the
      bladder and paracystic fat was passive in 38 and active in 102 patients. Passive
      drainage, common in urological practice, failed to yield satisfactory results
      because of deficient urine outflow from the bladder and gave rise to various
      complications: phlegmons, femoral osteomyelitis, pyelonephritis, urosepsis.
      Fourteen patients developed urinary fistulas, four subjects had a large
      postoperative hernia involving the bladder. The adverse effects made
      urethroplasty problematic. With active drainage, the bladder and paracystic fat
      were continuously irrigated with drug solutions siphoned off from a jar into a
      dropper obtained from a disposable hemotransfusion system. Patients on active
      drainage avoided complications, 47 of them were successfully operated on the
      urethra, in 55 urethral competence recovered without surgical interventions.

PMID- 1755129
TI  - [Postinflammatory strictures of the urethral canal in women].
AB  - The paper is concerned with one of the important problems of current urology-
      inflammation-induced strictures of the female urethra, covers questions of its
      etiology, pathogenesis, clinical patterns, diagnosis and treatment. It is
      emphasized that the strictures take the form of paraurethral fibrosis and should
      be managed individually. Clinicomorphological parallels are outlined. Indications
      to conservative and surgical treatment are specified.

PMID- 1755130
TI  - [Nephrectomy with resection of the pancreas and cupula of the diaphragm and
      splenectomy for cancer of the left kidney].

PMID- 1755131
TI  - [A case of the good effect of low doses of erythropoietin].

PMID- 1755132
TI  - [A case of a vesicouterine fistula].

PMID- 1755133
TI  - [Electroacupuncture and laser puncture in the early postoperative period of
      urological patients].
AB  - To provide an objective assessment of the analgetic effect obtained at electric
      or laser acupuncture early after operative treatment of 117 uronephrological
      patients, the study was performed of a general vegetative and psychoneurological
      responses and blood levels of some hormones. There were positive effects on
      psychoemotional postoperative stress, pain impulses from the wound reflected by
      higher pain thresholds and lowered levels of contrainsular hormones against
      higher insulin and C-peptide concentrations. These changes were dependent on a
      nociception degree and agreed with the analgetic action of the reflex anesthesia
      modalities.

PMID- 1755134
TI  - Spectrum of renal vascular malformation.
AB  - In summary, renal AVMs are rare. The possibility of these lesions should be
      raised in cases of hematuria of unknown etiology, prolonged hematuria following
      trauma or needle biopsy, unexplained congestive heart failure or abdominal/flank
      bruit, or hypertension after renal trauma. Selective renal arteriography is the
      study of choice for establishing the diagnosis, the hallmark being demonstration
      of an abnormal arterial communication with a vein. The goal of management should
      be maximum preservation of renal parenchyma. Observation with follow-up is
      indicated for asymptomatic AVMs.

PMID- 1755135
TI  - Intraoperative anaphylactic reaction due to latex hypersensitivity.
AB  - Severe anaphylactic reaction secondary to latex allergy has lately been
      recognized and reported especially in individuals with spina bifida. We report a
      case of severe intraoperative anaphylactic reaction due to latex allergy.
      Preoperative testing for latex allergy may be helpful in determining latex
      allergy. We suggest a preoperative management protocol for patients who are
      thought to have latex allergy. An increased awareness to latex allergy will help
      avoid this potentially catastrophic event.

PMID- 1755136
TI  - Flow cytometric analysis of cellular deoxyribonucleic acid content of nine renal
      oncocytomas.
AB  - The cellular deoxyribonucleic acid content of formalin-fixed, paraffin-embedded
      tissue from nine renal oncocytomas was determined using an Epics-C flow
      cytometer. The tissues were all from surgical specimens, and all neoplasms met
      stringent light and electron microscopic criteria for the diagnosis of
      oncocytoma. Thirteen samples of pure tumor, 5 of tumor and normal kidney, and 3
      of normal kidney alone were analyzed. All oncocytomas had single, sharp G1 peaks
      with no evidence of aneuploidy, and this peak was similar to that of normal renal
      parenchyma. This was true even for three oncocytomas that had multiple major
      chromosomal anomalies on karyotyping. These data support the concept that renal
      oncocytomas are euploid neoplasms, consistent with their benign biologic
      behavior. The apparent discrepancy between the results of flow cytometry and
      karyotyping is discussed.

PMID- 1755137
TI  - Fibrin glue for partial nephrectomy.
AB  - Fibrin glue, a mixture of concentrated autologous fibrinogen and bovine-derived
      thrombin, was used to achieve hemostasis during 7 partial nephrectomies. After
      transected vessels were suture ligated, topically applied fibrin glue filled all
      renal defects with an adherent clot that resulted in immediate hemostasis. There
      was no case of delayed hematoma or abscess formation, and no complications were
      referrable to the use of fibrin glue. Although fibrin glue is no substitute for
      early vascular control and careful surgical technique, its ability to stop venous
      oozing from the cut surface of renal parenchymal tissue dramatically facilitates
      hemostatic control.

PMID- 1755138
TI  - Possible hypothalamic impotence. Male counterpart to hypothalamic amenorrhea?
AB  - Twenty-one men with erectile complaints who were found to have a low level of
      serum testosterone without a reciprocal elevation of the serum levels of
      luteinizing hormone were evaluated to identify whether the defect was of
      hypothalamic or of pituitary origin. Patients underwent a luteinizing hormone
      (LH)-follicle-stimulating hormone (FSH)-releasing hormone stimulation test that
      showed a normal but sluggish increase in LH and FSH levels, thus ruling out a
      pituitary defect and suggesting a suprapituitary abnormality. This was confirmed
      when, in response to clomiphene, patients had a normal increase in gonadotropin
      and testosterone levels. Although the basal as well as clomiphene and
      gonadotropin releasing hormone-stimulated levels of total testosterone and
      gonadotropins were identical in men less than and more than fifty years old, the
      elevation of free testosterone levels in response to clomiphene was higher in
      patients younger than fifty. This suggested that although the primary abnormality
      found in these patients is altered secretion of gonadotropin hormone-releasing
      hormone from the hypothalamus, an age-related decline in the responsivity of
      Leydig cells to LH may make it more manifest in older patients. Elevation of
      testosterone levels from a subnormal to a normal range in response to clomiphene
      administered for seven days suggests that the defect is functional and reversible
      and that the drug may be useful in treatment of sexual dysfunction in this group
      of patients.

PMID- 1755139
TI  - Vacuum constriction devices and the clinical urologist: an informed selection.
AB  - The U.S. Food and Drug Administration (FDA) lists vacuum constriction devices
      (VCD) as safe, nonsurgical therapy for erectile dysfunction. Our study compared
      the responses of 30 male (10 novice and 20 regular) VCD users of seven
      commercially available systems (Mentor Response, Mentor-Touch, Mentor-Piston,
      Dacomed Catalyst, Mission VED, Osbon ErecAid, and Pos-T-Vac). Variables evaluated
      included simplicity of instruction, ease of use, cost, instructional value of
      videotape, company follow-up, presence of a pressure-limitation gauge, and length
      of warranty. The results from our study show (1) 100 percent reported an
      additional cost to be of minor importance in determining choice of device, (2) 80
      percent of novice and 95 percent of regular users stated the instructional
      videotape was essential, (3) 95 percent of the participants desired a twenty-four
      hour hot-line, (4) 40 percent of novice users but only 25 percent of regular
      users wanted personalized company follow-up, (5) 100 percent of novice users
      preferred single-handed devices, while regulars showed no preference. (6) Regular
      users scored Mentor Response, Osbon ErecAid, and Mentor-Piston highest regarding
      ease of use. While the vacuum constriction devices are conceptually similar,
      there are subtle operational distinctions between the different brands. The
      clinical urologist should be aware of these nuances.

PMID- 1755140
TI  - Does the Kaufman prosthesis still have a place? Review of thirteen years'
      experience.
AB  - The cases of 57 patients who underwent implantation of a Kaufman prosthesis for
      urinary incontinence at this center are reviewed. All except one of the patients
      were incontinent following prostatic surgery. Although many of the patients
      required revision or adjustments after the initial implantation, 55 percent of
      the cases eventually had a satisfactory outcome. Patients rendered incontinent
      after retropubic prostatectomy had a higher success rate with the Kaufman
      prosthesis than patients after other types of prostatectomy. This simple and
      relatively inexpensive device can still play a useful role in the treatment of
      patients with mild and moderate stress incontinence following prostatectomy.

PMID- 1755141
TI  - Pelvic physiotherapy in genuine stress incontinence.
AB  - In a prospective cohort study, the effect of pelvic physiotherapy on genuine
      stress incontinence, factors that influence therapy outcome, and patients'
      attitudes toward physiotherapy were studied. The study group consisted of 52
      ambulatory and mentally fit Caucasian women (mean age, 53 years), suffering from
      genuine stress incontinence and who had no contraindications for surgery. They
      had physiotherapy twice weekly for ten weeks. The aim of physiotherapy was
      strengthening the pelvic floor muscles under control of digital vaginal
      palpation. Therapy outcome was assessed by a questionnaire and by the patients'
      self-monitoring urinary diary recording pad changes (52) and number of leakage
      episodes (35) before treatment and at end of therapy. The questionnaire also
      served to determine how patients appreciated physiotherapy. Physiotherapy had a
      low cure rate (+/- 25%) but a high improvement rate causing a decreased demand
      for surgery. At follow-up (mean 14 months) its beneficial effect was maintained.
      To date, only 10 patients (19%) have undergone surgery. Severity of symptoms was
      the only limiting factor. We conclude that every woman with urinary stress
      incontinence is a potential candidate for physiotherapy but surgical treatment as
      an option must remain open. Overall, physiotherapy was well accepted since
      episodes of urinary incontinence were less frequent and therefore bearable;
      however, changes in patients' behavior play a role.

PMID- 1755142
TI  - Kidney stone formed around refluxed surgical staple and removed by transureteral
      endoscopic manipulation.
AB  - We present a case of a kidney stone that developed around a surgical staple which
      refluxed up to the kidney following a Bricker urinary diversion and bilateral
      ureteroileal anastomosis. A GIA stapler had been utilized to construct the ileal
      conduit. The stone was retrieved by means of flexible ureterorenoscopy through
      the ileal conduit. To our knowledge, this is the first report of such a
      complication following construction of an ileal conduit with a stapling device.

PMID- 1755143
TI  - Relationship of voiding dysfunction to urinary tract infection and vesicoureteral
      reflux in children.
AB  - A total of 109 children were evaluated for urinary tract infections or for
      voiding dysfunction without infections. The relationship of voiding dysfunction
      to urinary infection and vesicoureteral reflux was then examined in girls. The
      number of males studied was too small for statistical analysis. While 40.6
      percent of females with infections had voiding dysfunction, in 66.6 percent of
      those females having voiding dysfunction infections also developed. Voiding
      dysfunction was noted in 33.3 percent of females with reflux, probably due to the
      strong association of reflux and infections. However, all of females with voiding
      dysfunction, only 20.6 percent also had reflux. These findings were statistically
      significant (p = 0.01) and suggest that voiding dysfunction is common in girls
      with infections, perhaps even predisposing to the development of infections.
      However, voiding dysfunction in this population did not predispose to reflux.

PMID- 1755144
TI  - Nephrogenic adenoma with bladder exstrophy and immunosuppression.
AB  - Nephrogenic adenoma, an unusual proliferative lesion, often occurs in association
      with chronic inflammation of the bladder and is rarely found in children. Two
      cases are reported, one occurring in a young child born with bladder exstrophy,
      and one in a young female, with both interstitial cystitis and chronic use of
      immunosuppressive therapy. We believe these are the first case reports of
      nephrogenic adenoma occurring in this specific clinical setting.

PMID- 1755145
TI  - Occurrence of congenital abnormalities of kidney and urinary tract in 13,775
      autopsies.
AB  - Records of 13,775 consecutive autopsies were reviewed to determine the incidence
      of renal and urinary tract abnormalities. A total of 636 abnormalities were found
      in 427 autopsies, with an overall frequency of 4.6 percent and 9.5 percent in
      males under eighteen years old. The kidney was involved in 45.1 percent, ureters
      29.1 percent, renal vessels 12.4 percent, urethra 5.3 percent, bladder 4.8
      percent, and fistulas 3.3 percent. We conclude: (1) Although it is difficult to
      assess accurate incidence rates of renal and urinary tract abnormalities, this
      study notes the frequency of these abnormalities in autopsies. (2) The markedly
      higher incidence in the younger age group indicates the high mortality of many of
      these anomalies. (3) Over 85 percent of abnormalities are in the upper urinary
      tract, which are more likely to produce end-stage renal disease and a higher
      mortality. (4) These observations indicate the importance of further research to
      establish methodology for early detection of congenital abnormalities of the
      kidney and urinary tract.

PMID- 1755146
TI  - Gallium nitrate in advanced bladder carcinoma: Southwest Oncology Group study.
AB  - Gallium nitrate is a heavy metal anticancer agent that has demonstrated
      widespread activity in a number of phase I studies. This phase II study employed
      a starting dose of 700 mg/m2 IV every two weeks in patients with advanced bladder
      carcinoma. Significant nephrotoxicity observed in 4 of the first 10 patients
      required extending the time between cycles to three weeks in the remaining 24
      patients. One complete response and six partial responses were achieved.
      Nephrotoxicity was the major dose-limiting toxicity. Gastrointestinal toxicity
      and myelosuppression were minimal. Gallium nitrate appears to be an active agent
      in advanced carcinoma of the bladder. Further clinical trials with this agent are
      warranted.

PMID- 1755147
TI  - Duraphase penile prosthesis dorsal approach using local anesthesia.

PMID- 1755148
TI  - Chronic renal failure secondary to post-hysterectomy vaginal prolapse.
AB  - The first case of posthysterectomy vaginal prolapse and associated chronic renal
      failure requiring hemodialysis is presented. A review of the literature on
      vaginal prolapse and the mechanism and physiology of chronic renal obstruction in
      this setting is reviewed.

PMID- 1755149
TI  - Renal cell carcinoma with solitary metachronous contralateral adrenal metastasis.
      Experience with 2 cases and review of the literature.
AB  - We report on 2 cases of renal cell carcinoma with solitary metachronous
      contralateral adrenal metastasis occurring up to four years after radical
      nephrectomy. Both patients were treated with adrenalectomy and steroid
      replacement. One patient died with distant metastases twenty-eight months after
      adrenalectomy and the other is alive with no evidence of disease four years
      postoperatively. Such a presentation of hypernephroma is rare, with only 1 such
      case having been found in the literature.

PMID- 1755150
TI  - Adenomatoid tumor of epididymis simulating benign cyst on scrotal ultrasound.

PMID- 1755151
TI  - Renal cell carcinoma in avascular cyst.

PMID- 1755152
TI  - Prostatic tissue levels of ofloxacin.
AB  - The prostatic tissue levels of ofloxacin were determined in 20 patients
      undergoing transurethral resection of the prostate. Ofloxacin was administered in
      two separate dosages of 300 mg PO from twenty-two to two hours preoperatively.
      The ofloxacin plasma concentrations ranged from 3.73 to 1.85 micrograms/mL at the
      time of surgery, and the tissue concentrations ranged from 4.55 to 1.94
      micrograms/mL. The ofloxacin tissue/plasma ratios ranged from 0.9 to 1.2. These
      findings indicate that ofloxacin may be useful in prophylaxis prior to
      transurethral prostatic surgery and also in the treatment of bacterial
      prostatitis.

PMID- 1755153
TI  - Malignant juxtadrenal schwannoma.
AB  - We believe we report the first case of malignant juxtadrenal schwannoma. This
      rare tumor was discovered incidentally in a patient who presented with fever,
      mental confusion, weight loss, leukocytosis, and elevated erythrocyte
      sedimentation rate. Preoperative radiographic and endocrine evaluations were
      suggestive of a nonfunctioning adrenal tumor. Its suprarenal location was
      unequivocally demonstrated by CT scan, sonography, angiography, and magnetic
      resonance imaging studies. Angiography revealed that the tumor derived its blood
      supply from the adrenal and renal vessels. The final diagnosis and its
      juxtadrenal origin was confirmed by histologic and immunohistochemical studies. A
      review of the literature on retroperitoneal schwannoma is included.

PMID- 1755155
TI  - Femoral neuropathy complicating urologic surgery.

PMID- 1755154
TI  - Effect of decentralization and partial outflow obstruction on cholinergic
      receptors in urinary bladder of rabbit.
AB  - In this study we have examined the cholinergic receptor density on the detrusor
      smooth muscle from rabbits with decentralized autonomous bladders and animals
      with partial outlet obstructions using (3H) quinuclidinyl benzilate ([3H] QNB).
      Decentralized spinal bladders were obtained from rabbits made paraplegic by a
      twenty-minute ischemic lesion to the lumbar and sacral spinal cord. Bladder
      tissues from these rabbits were studied from one, two, five, and nine-day
      intervals after the ischemic lesion. The affinity of the muscarinic binding sites
      for (3H) QNB was virtually unchanged at any of the time intervals, while the
      total Bmax was significantly reduced at one and two days but recovered to normal
      levels by the fifth and ninth day after the ischemic lesion, provided the bladder
      had been effectively manually emptied on a regular basis. In a parallel study
      animals with a partial outlet obstruction or spinal animals with marked bladder
      distention at the time of sacrifice showed that the cholinergic receptor density
      was significantly reduced.

PMID- 1755156
TI  - Urinary cytology: simple screening procedure for lymphadenopathy.

PMID- 1755157
TI  - [Effectiveness of laser treatment of narrow-angle glaucoma].
AB  - Forty-eight patients with narrow-angle glaucoma were treated with M-900 argon
      laser (Coherent Radiation, USA). Reduction of intraocular pressure as low as 20
      +/- 1.82 mm Hg on an average was achieved. Fluid discharge efficacy coefficient
      has improved. The authors claim that laser cyclotrabeculospasis a sufficiently
      effective method for the treatment of primary narrow-angle glaucoma.

PMID- 1755158
TI  - [A theory on the role of immunologic factors in the pathogenesis of primary
      glaucoma].
AB  - Basing on the literature data and their own clinical, immunomorphologic, and
      immunochemical findings in glaucoma patients and normal subjects, the authors
      suggest a concept on the immune factor contribution to the pathogenesis of
      primary open-angle glaucoma. According to the scheme they suggest, of primary
      importance in the development of autoimmune reactions in glaucoma are the
      following factors: changed antigenic specificity of the drainage zone tissues,
      resultant from involution processes; impaired immune homeostasis, effects of
      various internal and environmental factors. The pathogenetic role of autoimmune
      reactions and immunity system regulatory mechanism disorders is explained.

PMID- 1755160
TI  - [Treatment of central ruptures of the retina].

PMID- 1755159
TI  - [Effect of lipoic acid on tyrosine metabolism in patients with open-angle
      glaucoma].
AB  - Lipoic acid effects on tyrosine metabolism and ocular hydrodynamics were examined
      in patients with primary open-angle glaucoma. Glaucoma patients not administered
      the drug and patients with ocular hypertension made up two reference groups. In
      the majority of glaucoma patients administration of lipoic acid did not result in
      improvement of tyrosine metabolism, whereas hydrodynamic parameters somewhat
      increased. Tyrosine metabolism normalized in the patients administered lipoic
      acid in complex with tyrosine catabolism cofactors (pyridoxal phosphate, ascorbic
      acid, iron ions). The studied parameters improved in ocular hypertension patients
      administered lipoic acid. The authors' findings and the literature data permit
      recommending lipoic acid in complex with vitamins B1, B2, B5 (PP), B6 (pyridoxal
      phosphate), C to glaucoma patients. Judging from the reaction to lipoic acid
      administration, tyrosine catabolism enzyme activities in glaucoma patients are
      related to a peculiar sensitization of the body.

PMID- 1755161
TI  - [Refraction ring-shaped tunnel keratoplasty in the correction of high-degree
      myopia].
AB  - A new method has been developed for diminishing the myopic eye refraction:
      refraction ring-like tunnel keratoplasty. The technique is simple, virtually
      atraumatic, and highly effective. It has been introduced in clinical practice.
      The method consists in placing a ring-shaped collagen thread ++para-centrally in
      the surface layers of the cornea. Experimental studies of refraction ring-like
      tunnel keratoplasty included staining the sections with hematoxylin and eosin and
      Kampos' silver impregnation. Changes in the transplant shape and the host cornea,
      as well as the terms of their innervation were studied in histologic sections.
      The results of 32 surgeries are analyzed. Essential reduction of the refraction
      in the myopic eye--12.0-15.0 diopters, vision acuity improvement in the operated
      on eyes without correction (in cases without astigmatism), and a stable
      refraction effect were achieved. The authors recommend the new method of
      refraction keratoplasty for practice.

PMID- 1755162
TI  - [Clinical characteristics and results of microsurgical treatment of bilateral
      congenital cataracts associated with microphthalmos].
AB  - Examinations of 146 children (267 eyes) with bilateral congenital cataracts and
      microphthalmia have revealed complete microphthalmia in 66 percent of cases,
      anterior microphthalmia (microcornea) in 34 percent, and various solitary and
      multiple abnormalities of the anterior section of the eye: microcornea, ectopic
      pupil, no pupil, a pupil membrane, iridal hypoplasia and aplasia, iridocorneal
      adhesions, etc. A total of 224 cataract extractions by the aspiration irrigation
      method were carried out with the use of microsurgical equipment. In cases with
      abnormalities of the anterior segment of the eye and with some abnormalities of
      the posterior segment cataract extraction was coupled with reconstructive surgery
      (creation and center adjustment of the pupil, adhesion dissection, removal of the
      pupil and hyaline membranes, etc.). Good effect was achieved in 98.2 percent of
      cases, vision acuity improved in 9.2 percent of cases. Vision acuity of 0.05-0.3
      diopters (with eyeglass correction) was achieved in 74.1 percent of cases, that
      of 0.1-0.3 diopters in 29.9 percent. Anatomical and functional inadequacy of the
      eye, abnormalities of the fundus oculi, and deprivation amblyopia are responsible
      for poor functional results. The results evidence a possibility of rehabilitation
      of children with grave congenital conditions, bilateral congenital cataracts with
      microphthalmia.

PMID- 1755163
TI  - [Extra-scleral balloon catheterization. Report 3. New ways of its use--prevention
      of hypotonia and intraocular hemorrhages in vitreo- retinal surgery].
AB  - Hypotonia and ex vacuo hemorrhages are the most grave complications of
      vitreoretinal surgery; the known methods of their prevention are altogether
      inadequate. The authors have developed extra-scleral ballooning (ESB) methods
      that improve the efficacy of surgery and reduce the rate and severity of
      complications in subretinal fluid draining during surgery for detachment of the
      retina and in arresting intraocular hemorrhages during closed vitrectomy. ESB
      application helped elevate intraocular pressure in the patients with drastic
      hypotonia, permitting a reliable and easy-to-perform monitoring of intraocular
      pressure over the course of surgery. This was conducive to complete evacuation of
      subretinal fluid, thus preventing the development of hypotonia and its
      complications, as well as to a rapid arrest of intraocular hemorrhage due to
      rapid elevation of intraocular pressure up to the values essential for the
      bleeding vessel collapse. Surgical methods are described and their results
      analyzed in 65 cases. The developed ESB methods for the prevention of hypotonia
      and intraocular hemorrhages in vitreoretinal surgery are effective, low
      traumatic, and may be recommended as alternative ones.

PMID- 1755164
TI  - [Monocular diplopia].
AB  - Monocular diplopia is a condition when a single object is seen double with one of
      the eyes. Fifty-seven cases of this condition are described. Traditional
      ophthalmologic methods, as well as examinations of the optic system aberrations
      and determination of diplopia type with a cross pattern were employed in
      examinations of the patients. A classification of monocular diplopia has been
      developed, including (1) refraction, (2) aberration, (3) pupillary, (4) retinal,
      and (5) neurogenic diplopia. Methods of examining this patient population are
      described and recommendations on the treatment of this condition presented.

PMID- 1755165
TI  - [Immunologic disorders in young patients with retinal vein thrombosis].
AB  - Immunologic shifts in 53 patients with retinal vein thrombosis, aged 20 to 41,
      were under study. Present-day immunologic methods were employed to investigate
      the status of the humoral and cellular immunity and define the infection rate.
      The results were assessed functionally and immunologically. The authors have
      revealed the contribution of infection to the development of retinal vein
      thrombosis in young patients, analyzed for the first time the immunity status of
      such patients, detected the signs of humoral immunodeficiency are senting as
      gammapathies and impaired complex formation, showed the relationship between
      thromboses and genetic predisposition and the role of the erythrocytic phenotype
      in the development of a cyst-like edema; this permitted them develop
      recommendations on the disease source and outcome prediction and on the choice of
      drugs.

PMID- 1755166
TI  - [Immunity status in patients with injuries and diseases of the cornea].
AB  - Clinical and immunologic examinations of 97 patients with leukoma after corneal
      injuries and diseases have shown that immunity disorders are present in leukoma
      of whatever origin. The authors claim that preoperative treatment of the patients
      before keratoplasty should include study of the background immunologic tests, the
      most informative of these being the leukocyte migration inhibition test with the
      corneal antigen.

PMID- 1755167
TI  - [Problems of scientific evaluation of the quality of the treatment of eye
      diseases].
AB  - Analyzing the trends in the development of ophthalmology development in this
      country and abroad, the author comes to a conclusion that the market economy may
      result in deterioration of the quality of treatment. Development of exitology, a
      science of the treatment outcomes, may inhibit the development of such trends;
      this science is supposed to assess the known therapeutic methods basing not only
      on their authors' recommendations, but mainly on the basis of sociologic studies
      with the patients participating in these studies.

PMID- 1755168
TI  - [A phototopographic method of measuring the thickness of the cornea].
AB  - This method is based on asymmetric growth and distension of the cornea in various
      directions. One has just to ascertain the visual line projection site on the
      corneal surface and to measure the corneal thickness in but two points, in the
      centre and lower, near the limbus; then the thickness of the cornea at any site
      of the cornea may be calculated, for the cornea is the thinnest at sites where
      the limbus is the furthest from the centre. The accuracy of this method is not
      inferior to that of the known optic method.

PMID- 1755169
TI  - [Evaluation of the visual evoked potentials in relation to the type of visual
      stimulation].
AB  - A classification of visual evoked potentials (VEP) in children and adults in
      response to various types of vision stimulation has been developed. Four major
      signs underlie this classification: (1) stimulation time frequency; (2)
      stimulation type; (3) mode of producing the visuals stimulus; (4) mono- or
      binocular presentation of the stimulus. One more sign can be added to
      classification: significant parameters of stimulation. Basing on this
      classification, the author describes the major VEP modalities and gives
      recommendations on the practical employment of these modalities.

PMID- 1755170
TI  - [Visual evoked potentials in chessboard pattern reversion in children with optic
      neuritis].
AB  - Visual evoked potentials (VEP) to chess pattern reversion were studied in 17
      children with optic neurites during the acute stage and in the course of
      convalescence 1-2 months and 1-3 years after the disease onset. Coarse VEP
      changes were detected in the patients during the acute stage of optic neuritis. A
      positive time course of VEP was followed up in late periods after the acute
      attack of the disease. Despite normalization of vision acuity, no complete
      restoration of VEP to small-cell chess patterns was seen. The findings evidence
      that studies of VEP to chess pattern reversion should be carried out to detect
      subclinical involvement of the optic nerve and to timely diagnose optic neuritis
      in children.

PMID- 1755171
TI  - [Use of phacolin in patients with allergic reaction to anti-cataract eye drops].
AB  - Allergic reaction to ++anti-cataract eye drops was confirmed in 11.1-34.8 percent
      of patients with these drops intolerance. Administration of phacolin in capsules
      to such patients helped eliminate the local allergic reactions. Phacolin had a
      reparative therapeutic effect in patients with metabolic involvement of the
      cornea (postherpetic, dystrophic, and other ones). None of the seventy-two
      patients treated with phacolin, twenty of them were treated with the drug for 2
      to 5 years, complained of the drug intolerance.

PMID- 1755172
TI  - [Value of a scleral flap in the surgical treatment of glaucoma].

PMID- 1755173
TI  - [1991 review of memorable dates in the history of ophthalmology].

PMID- 1755174
TI  - [A method of increasing the effectiveness of anti-glaucoma operations].
AB  - The authors have proved the possibility to prevent cicatrization between scleral
      laminae after antiglaucoma surgery in 16 rat experiments. They analyze late and
      remote results of 341 surgeries for open-angle glaucoma, 52 of these traditional
      trabeculectomies and 289 trabeculectomies with placing hemostatic viscose under
      the scleral flap. The results evidence the efficacy of viscose application: the
      incidence of complications early after surgery and in the late periods was
      essentially reduced and a more stable hypotensive effect achieved. The method is
      simple and available.

PMID- 1755175
TI  - [Results of endonasal intubation of the nasolacrimal duct in children with
      congenital dacryocystitis].
AB  - Results of endonasal catheterization of the naso-lacrimal canal of 74 children
      with congenital dacryocystitis (bilateral problem in 10 of them) are presented.
      Prior to this manipulation, the patients were exposed to contrast X-ray study of
      the lacrimal sac for diagnostic purposes. Retrograde catheterization as a method
      for treating congenital dacryocystitis was very good in 97.3% children of up to 2
      years old, 50% children of up to 3 years old, and 33.3% children between 3-4
      years old. The patency of the naso-lacrimal canal also recovered in an 8-year-old
      child. All this gives evidence that, irrespective of children's age, retrograde
      catheterization should be applied to treat congenital dacryocystitis. After the
      patency of the naso-lacrimal canal was restored, the external fistula of the
      lacrimal sac was cauterized with 7% solution of trichloroacetic acid.

PMID- 1755176
TI  - [Use of semiconductor laser in the treatment of various inflammatory ORL
      diseases].

PMID- 1755177
TI  - [Comparative study of alginate coating and charcoal sorbent in the treatment of
      wounds in otorhinolaryngology].

PMID- 1755178
TI  - [Effectiveness of human leukocytic interferon in children with papillomatosis of
      the larynx, trachea and bronchi].
AB  - The results of interferon therapy of 32 children with severe forms of laryngeal,
      tracheal, and bronchial papillomatosis are very encouraging. Clinical recovery
      (no relapses during 3 years or longer) was observed in 8 patients, improvement
      (no relapses during less than 3 years or 2-3-fold prolongation of no-relapse
      periods) was seen in 12 patients, no changes were recorded in 10 children; data
      on 2 other patients were too limited or lacking at all. The efficacy of
      interferon therapy of airways papillomatosis can be further increased, if doses
      are selected on an individual basis.

PMID- 1755179
TI  - [Treatment of recurrences of malignant tumors of the maxilla].

PMID- 1755180
TI  - [Disorders of physiological parameters of the body (lipid peroxidation and
      microcirculation) after naso-orbital injuries and the methods of their
      correction].
AB  - A naso-orbital injury is often associated with a craniocerebral injury due to the
      close anatomical localization of the facial and cerebral compartments of the
      skull. Patients with such injuries showed enhancement of free-radical lipid
      oxidation and microcirculation disorders. They were controlled by traditional
      therapeutic methods in combination with antioxidants of direct and indirect
      action (ascorbic acid, flacumin, alpha-tocopherol acetate, pentoxifylline ) that
      were given in standard doses. Improvement of microcirculation and decrease of
      free-radical oxidation of lipids were followed by faster normalization of
      bioelectric activity and hemodynamics of the brain and earlier clinical recovery.
      Microcirculation parameters recorded during biomicroscopy of vessels of the
      bulbar conjunctiva can be used for evaluating cerebral circulation because vessel
      responses of the eyeball and the brain are similar.

PMID- 1755181
TI  - ["Closed" curative surgery and laser therapy in the early postoperative period in
      patients with chronic suppurative epimesotympanitis].
AB  - Taking into account the severity of middle ear pathology and the Eustachian tube
      function, three methods of "closed" surgery were applied to 132 patients with
      chronic purulent-caries epimesotympanitis. On post-operation days 2-15, 85
      patients were exposed to internal or external laser therapy. As a result, the
      post-operation therapy period was 5-6 days shorter and the healing quality of the
      treated ear a year after was better than in the absence of laser therapy. It is
      concluded that the method of "closed" surgery should be chosen on an individual
      basis and that its combination with early post-operation laser therapy yields
      good results.

PMID- 1755182
TI  - [Amplitude and time characteristics of latent auditory evoked potentials in
      occupational hearing disorders with and without the recruitment phenomenon].
AB  - Cortical evoked potentials (CEP) of workers exposed to industrial noise were
      recorded by an Amplaid MK-6 unit (Italy). They suffered from neurosensory
      hypoacusis with or without the recruitment phenomenon. The results were compared
      with those derived from patients with neurosensory hypoacusis of vascular origin,
      aggravated by the recruitment phenomenon, and in the cortical structures of the
      hearing organ in the case of neurosensory hypoacusis of both vascular and noise
      origin. Increase of the N2 with observations made on normal controls who were not
      exposed to industrial noise. CEP were found to give reliable information about
      changes peak latency may be used for differential diagnosis of neurosensory
      hypoacusis of vascular or noise origin. Decrease of the P2--N2 amplitude in
      response to 1 kHz stimulation may also help discriminate neurosensory hypoacusis
      of vascular or noise origin.

PMID- 1755183
TI  - [Problems of diagnosis and treatment of otogenic abscesses of the brain in
      children].
AB  - In 1947-89, 49 children with otogenic abscesses of the brain and cerebellum were
      treated in the ENT department of the Kuban Medical Institute. During the first
      two decades the number of these patients was 34 and during the second two decades
      it was 15, i.e., the number decreased two-fold. In 25 cases, abscesses were
      located in the temporal lobe, in 14 cases--in the cerebellum, and in 10 cases,
      multiple abscesses of different localization were diagnosed. For diagnostic
      purposes electroencephalography, echoencephalography, angiography, pneumography
      and ventriculography were used although they were sometimes inefficient,
      especially in the cases of multiple abscesses. Computer tomography made it
      possible to determine not only the number but also specific localization of
      abscesses. The method was applied in 8 cases. After proper examination and
      treatment all the patients recovered. Out of 49 patients 28 recovered and 21
      died. Out of 34 patients treated during 1947-67, 17 recovered and 17 died while
      out of 15 patients treated during 1968-1989, 11 recovered and 4 died. It can be
      concluded that a significant reduction of the number of cases with brain
      abscesses and a substantial increase of the success rate can be attributerd to
      the advanced methods of their detection (echoencephalography and computer
      tomography) and more efficient methods of therapy of middle ear suppuration.

PMID- 1755184
TI  - [Surgical correction of external nose deformities].
AB  - During surgical elimination of external nose deformation biologically inert
      prostheses were used. In the post-operative period low-intensity laser therapy
      was applied. No adverse effects of corundum ceramics were noted. The procedure of
      posterior tamponade was modified to ensure complete isolation of the nasopharynx
      during surgical manipulations on the external nose skeleton.

PMID- 1755185
TI  - [Rational selection of vasoactive drugs for the treatment of patients with
      vestibular dysfunction].

PMID- 1755186
TI  - [Indicators of general and local immunity in chronic and neoplastic processes in
      the head and neck areas].
AB  - Total and secretory immunity was investigated in healthy people, patients with
      chronic ENT pathologies, and patients with tumors of the oral cavity, larynx and
      laryngopharynx. It was found that chronic inflammation was followed by a decline
      of topical defence and a decrease of total immunity. In cancer patients these
      changes were aggravated. Topical immunity disorders included mainly secretory
      immunoglobulin A and were most pronounced in patients with tumors localized in
      the oral cavity.

PMID- 1755187
TI  - [Histomorphology and histochemistry of acquired scars of the laryngo-tracheal
      regions in children].
AB  - Acquired scars of the tracheolaryngeal compartment dissected during surgery of 28
      children (35 samples) were taken under histological and histochemical
      examination. In most cases, scar tissues-showed signs of chronic inflammatory
      infiltration, pronounced changes of the microcirculatory bed, dystrophic and
      destructive processes, continuous formation of granulation foci and subsequent
      fibrosis, fibrotic changes in muscles and noticeable dystrophic and metaplastic
      changes of the epithelium. This points to changes in the relationship between
      inflammation and regeneration and persistence of inflammatory, sclerotic and
      dysplastic processes which may cause recurrent development of stenotic scars
      after their removal.

PMID- 1755188
TI  - [Measurement of local blood flow in the nasal mucosa by the method of hydrogen
      clearance].
AB  - The hydrogen clearance method was used to measure local blood flow in the
      inferior concha nasalis of 22 patients, aged 18 to 48 years. According to the
      method, the nasal mucosa was saturated with hydrogen and the rate of hydrogen
      washout was recorded in the form of hydrogen clearance curves. The response was
      tested by applying 0.1% epinephrine solution and the volume blood flow velocity
      was calculated. In response to epinephrine, blood flow velocity in the nasal
      mucosa diminished significantly. The hydrogen clearance method allowed an
      accurate quantitative evaluation of the volume blood flow velocity in a limited
      area of concha nasalis. The epinephrine test demonstrated a high sensitivity of
      the method that gave an adequate idea of mucosal microcirculation. This method,
      together with other procedures, can be used to examine the nasal mucosa.

PMID- 1755189
TI  - [Surgical correction of unilateral congenital choanal atresia].

PMID- 1755190
TI  - [Characteristics of the clinical course and treatment of epitympanitis with
      cholesteatoma in children].
AB  - A specific form of chronic epitympanitis has been identified in children. This
      pathology includes tympanic membrane perforation above he lateral process of the
      malleus and is termed cholesteatomic epitympanitis . This is because it is
      accompanied by epidermis growth across the perforation into Prussak's space. This
      form of epitympanitis occurred in 40 (75%) children out of 53 cases operated
      during 10 years. It is underlined that this pathology can hardly be diagnosed
      since it often develops together with sclerosis of mastoid cells. These children
      had frequent recurrent otitis media. An immediate cause was Eustachian tube
      closure, often with adenoid vegetations. Adenotomy was performed in 17 (42.5%)
      children. All patients underwent radical surgery; 16 showed large cholesteatoma,
      5 developed intracranial complications, 2 of whom had sinus thrombosis and
      sepsis. One of operative findings was delineation of the attic from the
      mesotympanum and the tympanic ostium of the Eustachian tube.

PMID- 1755191
TI  - [A case of vestibular neuronitis after acute respiratory infection].

PMID- 1755192
TI  - [Status of the cochleo-vestibular analyzer in a patient with chronic otitis media
      and renal tuberculosis].

PMID- 1755193
TI  - [Pyocele of the frontal sinuses and ethmoid labyrinth complicated by
      osteomyelitis of the frontal bone and extradural abscess].

PMID- 1755194
TI  - [Multiple abscesses of the cerebellar hemisphere in a child with otogenic
      meningoencephalitis and thrombosis of the sigmoid sinus].

PMID- 1755195
TI  - [Orthopantomography in the roentgenological diagnosis of ORL diseases].

PMID- 1755196
TI  - [Safe conchotomy].

PMID- 1755197
TI  - [A polyvinyl mask for external nose fixation].

PMID- 1755198
TI  - [A spatula for drug pulverization].

PMID- 1755199
TI  - [Teaching otorhinolaryngology at the pediatric departments of medical schools].

PMID- 1755200
TI  - [Therapeutic tactics in isolated and combined exudative ethmoid sinusitis in
      children].
AB  - This paper presents the results of treatment of 81 children, aged 5 to 14 years,
      suffering from exudation ethmoid sinusitis; isolated ethmoid sinusitis was
      diagnosed in 17.8% and ethmoid sinusitis combined with maxillary sinusitis was
      detected in 61.7% cases. Most sinusitis cases (82.7%) were diagnosed in 5 to 10
      year-old children. The ethmoidal labyrinth and maxillary sinus were treated by
      the puncture method, infection of other paranasal sinuses being excluded by the
      application of antibacterial, enzymic, corticosteroid drugs, immune agents, and
      adenotomy. Antibiotic therapy of 2 weeks in duration applied to the ethmoid
      labyrinth and maxillary sinus was more efficient when compared to the sinus
      treatment alone. The stable clinical effect was seen in 86.4% cases. This
      therapeutic approach can find application in practical otolaryngology.

PMID- 1755201
TI  - [Isosorbide dinitrate tolerance in the treatment of patients with angina pectoris
      and the effect of addition of captopril on therapeutic results].
AB  - The authors investigated in patients with stable angina the influence of a single
      dose and of long-term administration of isosorbide dinitrate alone and combined
      with captopril. Administration of 40 mg Iso-Mack ret. every 8 hours for four
      weeks did not lead to the development of tolerance. However, captopril added to
      isosorbide dinitrate tends to improve the investigated indicators after a single
      dose as well as after long-term treatment. It is probable that concurrent
      administration of the two drugs causes addition of their vasodilatating action
      and thus the vascular resistance declines, as well as the cardiac pre-load and
      after-load and the oxygen consumption of the heart muscle. The authors discuss
      possible mechanisms of the increased vasodilatation after addition of captopril.

PMID- 1755202
TI  - [Focal segmental glomerulosclerosis].
AB  - Focal and segmental glomerulosclerosis accounted for 4.1% of all primary
      glomerulopathies. Typical signs of focal and segmental glomerulosclerosis were
      striking arteriolosclerosis on histological examination, the urinary syndrome of
      high proteinuria with mild haematuria and frequent nephrotic syndrome. The ten
      year cumulative percentage of remissions was 30%. Patients with remission had at
      the time of biopsy a normal serum creatinine level and no or minimal regressive
      tubulointerstitial changes. The ten-year cumulative percentage of renal failure
      was 40%. Presence of nephrotic syndrome, extracapillary proliferation and
      advanced tubulointerstitial changes, tended to shorten a kidney survival. In one
      third of the patients the serum creatinine level rose by more than 50 mol/1/year.

PMID- 1755203
TI  - [Changes in hemostasis in ischemic heart disease in advanced age].
AB  - In a group of 178 patients with different forms of ischaemic heart disease and in
      a group of 40 healthy controls the authors made complete examinations of
      haemostasis to provide laboratory evidence of a state of hypercoagulation. They
      assessed the relationship of different coagulation factors between patient groups
      and healthy controls formed by a group of blood donors. They draw attention to
      the significant age dependence of the majority of coagulation factors. As
      apparent from the results, the highest incidence of hypercoagulation was recorded
      in patients with myocardial infarction.

PMID- 1755204
TI  - [Use of hemoperfusion and cholinesterase in acute poisoning with organophosphate
      cholinesterase inhibitors--clinical analysis of 50 patients].
AB  - The authors present a retrospective analysis of 50 patients with acute
      intoxication with various organophosphate cholinesterase inhibitors who were
      treated in the course of 8 years by comprehensive conservative and extracorporeal
      elimination treatment. The mean age of the patients was 38 years. During therapy
      conservative treatment was used (gastric lavage, repeated lavage of the large
      intestine, forced diuresis, TMB-4 fusion through activated carbon, amberlite XAD
      2 and XAD-4, haemodialysis). A total of 63 haemoperfusions and 15 simultaneous
      haemoperfusions with haemodialysis were performed. Treatment was successful in
      92%. The results of treatment depended on early attendance of the patient in the
      dialyzation centre, on the onset of intense comprehensive treatment and the
      concurrent presence of other diseases.

PMID- 1755205
TI  - [Evaluation of heart disease in rheumatoid arthritis using echocardiography].
AB  - The authors examined, using one- and two-dimensional echocardiography, 95
      patients with rheumatoid arthritis and 11 patients with lupus erythematodes
      generalisatus. They revealed acute and chronic changes on the pericardium,
      impaired left ventricular function and valvular changes in percentages which are
      not negligible. Although the problem of the aetiopathogenesis of these
      pathological changes is frequently speculative, their detection is of
      considerable importance for further treatment and the life-style of these
      patients. Echocardiography is a suitable method for the comprehensive examination
      of patients with rheumatoid arthritis, in particular when the course is severe or
      when patients of advanced age groups are involved.

PMID- 1755206
TI  - [The nephrotic syndrome in renal biopsies].
AB  - Among 1,499 representative renal biopsies in 278 cases nephrotic syndrome was
      diagnosed. In the latter only in 201 glomerulonephritis was confirmed by biopsy
      and in 77 (more than one quarter) the bioptic finding was different. The authors
      attempt to analyze the essential feature of nephrotic syndrome focused on the
      glomerular basal membrane and surrounding structures.

PMID- 1755207
TI  - [Comparison of the diagnostic contribution of rheography and ultrasound in
      diabetic macroangiopathy of the lower extremities].
AB  - In a group of 140 patients with diabetes mellitus ultrasonographic Doppler
      examination revealed a 30% incidence, rheographic examination a 34% incidence (p
      greater than 0.05) of macroangiopathies of the lower extremities. The asset of
      rheography was the ability to differentiate between pathological functional (21%
      incidence) and organic changes (13% incidence). The contribution of sonographic
      examination was the localization of the portion most severely affected by the
      macroangiopathy. The most frequent variant was general affection of the distal
      portion of extremities, followed by predominating affection of the posterior
      tibial artery and affection of the entire circulation of the lower extremity. In
      the authors' practice rheography is the basic examination. In the event of
      revealed pathological changes it is supplemented by sonographic Doppler
      examination.

PMID- 1755208
TI  - [Arteriosclerosis risk factors in the offspring and siblings of type 2
      diabetics].
AB  - Risk factors of atherosclerosis were examined in 63 offspring and 30 siblings of
      type 2 diabetics and in 22 controls. Clinical complications of atherosclerosis
      were not found very frequently in direct relatives of diabetic patients. Diabetes
      was detected in 17% siblings, an impaired glucose tolerance in 11% of the
      offspring and in 33% siblings. The offspring of diabetics had higher blood sugar
      values and serum insulin levels on fasting and after stimulation, as compared
      with controls; as to other metabolic parameters lipids and apolipoproteins, body
      mass indexes, uricaemia, glycated proteins, C-peptide), the two groups did not
      differ significantly. In middle age, i.e. in siblings of diabetic patients, the
      incidence of obesity rose significantly as well as hyperlipoproteinaemia type IV
      and hypertension, while smoking was less common than in offspring. The glucose
      tolerance deteriorated further, although the insulin levels did not increase
      substantially. The mentioned findings indicate the orientation for preventive
      provisions in families of type 2 diabetics.

PMID- 1755209
TI  - [The effect of age and educational level on the risk profile of men and women in
      industrial occupations].
AB  - The authors investigated a population group of 660 men and 440 women aged 35-60
      years selected in the Skoda works and examined as part of the integrated
      programme of prevention of chronic non-infectious diseases. The risk profile of
      subjects associated with the life-style of the population was evaluated with
      regard to sex, age and education. It was revealed that the blood pressure rises
      with age and body weight in men and women. With rising body weight rises also the
      triglyceride and uric acid level and in women also the total cholesterol level.
      The authors confirmed the relationship between smoking and the thiocyanate blood
      level. The magnesium level declines with age in both sexes and correlates with
      the reported alcohol intake. Men and women with higher education smoke less, have
      a lower body weight and lower triglyceride blood levels. Women have also a lower
      total cholesterol level. University educated men consume less alcohol, while the
      reverse is true in university educated women.

PMID- 1755210
TI  - [Echocardiographic detection of wedged emboli in the right heart in patients with
      pulmonary embolisms].
AB  - The authors describe two case-histories of patients with the clinical picture of
      pulmonary embolism where on echocardiography a mobile formation in the right
      atrium was detected. In both patients the embolus of peripheral origin wedged in
      the right atrium was removed by surgery.

PMID- 1755211
TI  - [Sudden death in rheumatoid arthritis with cervical myelopathy].
AB  - The authors describe an uncommon case of sudden death in a 53-year-old female
      patient with cervical myelopathy associated with rheumatoid arthritis stage IV/C.
      The patient died six hours after a drop of the blood pressure to undetectable
      values was found. Malignant hypotension of central origin which could not be
      influenced by pharmacological treatment was involved. It was due to compression
      of the upper cervical spine by a partly dislocated dens of the epistropheus and
      subsequent afferent spinal oedema which affected the vasomotor centre in the
      brain stem. The clinically suspect cause of death was confirmed by autopsy:
      Myelogenic shock.

PMID- 1755212
TI  - [Antibiotics and antimycotics in oncology].
AB  - The submitted review gives an account of therapeutic and prophylactic indications
      in oncology, in aimed, not aimed (empirical) treatment of febrile neutropenic
      patients, prophylaxis of infection during neutropenic episodes and selective
      decontamination before and during transplantation of bone marrow, focused on new
      antimicrobial and antimycotic agents.

PMID- 1755213
TI  - [Echocardiographic findings in cerebrovascular accidents].
AB  - The authors present a review on the frequency and causes of cardiogenic systemic
      embolism and on the influence of damage of the central nervous system on the
      heart muscle. 10-20% of ischaemic cerebrovascular attacks are of cardioembolic
      origin. In patients with chronic atrial fibrillation the risk of a
      cerebrovascular attack is six times higher than in the corresponding population
      with a sinus rhythm. Views on the preventive administration of anticoagulants
      differ so far. In extensive myocardial infarctions of the anterior wall thrombi
      in the left ventricle are present in 30-40%. Thrombolytic treatment affects their
      formation; so far it is not clear whether it reduces the risk of embolization.
      With technical advances in echocardiography, and in particular transoesophageal
      echocardiography, attention is focused on abnormal findings in patients with
      cerebrovascular attacks without manifest heart disease. Most frequently in these
      patients a prolapse of the mitral valve is found, a foramen ovale patents, an
      aneurysm of the atrial septum, sometimes thrombi in the left auricula atrialis of
      an otherwise quite normal heart. A rare finding are cardiac tumours, systemic
      embolism being frequently their first clinical manifestation. An indicator of
      high risk of thromboembolism is probably a spontaneous echo contrast in the left
      atrium, detected reliably only from an oesophageal approach. In the second part
      the authors summarize contemporary knowledge on the effect of damage of the
      central nervous system on cardiac action. Cerebral injury or haemorrhage
      accompany kinetic disorders of the left ventricle of varying impact. Myocardial
      damage is caused by a high catecholamine level and can be prevented by
      administration of beta blockers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755214
TI  - [Preoperative examination and preparation of patients with ischemic heart disease
      from the viewpoint of the internist].
AB  - In the presented review the authors discuss briefly the effect of anaesthetizing
      substances on the heart muscle. Examinations to which the patient with IHD should
      be subjected before a cardiac operation and the surgical risk are discussed in
      the part on preoperative examination of the patient with IHD. The paper deals in
      detail with the preoperative preparation and contemporary views on the subject
      with specific views on different drugs. In the conclusion the authors present the
      results of the work of the consultant out-patients department of the First
      Medical Clinic of the Faculty Hospital and policlinic in Kosice which are a
      practical evaluation made by the specialist in internal medicine of the
      theoretically elaborated preoperative preparation of patients with IHD.

PMID- 1755216
TI  - [Blast injuries (a review of the literature)].

PMID- 1755215
TI  - [How to avoid failure and complications in guided punctures].
AB  - The author discusses some actual procedures associated with diagnostic and
      therapeutic interventions using ultrasonography. Based on his own experience from
      practice, documented in tables with brief comments (attached to the paper) and
      with regard to data in the literature, he draws attention to some facts
      (technique of puncture, selection of instruments, local anaesthesia, method of
      drainage) which may to a varying extent influence the results of aimed puncture
      or cause possible complications.

PMID- 1755217
TI  - [The organization of the delivery of specialized vascular trauma care for victims
      (1)].

PMID- 1755218
TI  - [The diagnostic and treatment characteristics of modern combat trauma to the
      blood vessels].

PMID- 1755219
TI  - [The diagnosis and treatment of lung contusions of gunshot origin].
AB  - The analysis of penetration wounds accompanied by lung hurts has shown that the
      contusion of lung parenchyma had a quite definite clinic characteristic. The
      gravity of breathing disorders always depends on the volume of lung affection and
      blood losses. A successful treatment of lung contusions depends upon an early
      application of adequate measures, in which artificial lung ventilation performs a
      leading role.

PMID- 1755220
TI  - [Experience in the diagnosis and treatment of heart wounds].

PMID- 1755221
TI  - [Transosseous osteosynthesis in the system for treating victims with penetrating
      gunshot wounds of the large joints of the upper extremity].

PMID- 1755222
TI  - [The use of electromyostimulation for preventing and treating hypodynamic
      disorders in gunshot injuries to the extremities].
AB  - It was found out during the study of multichannel electromyostimulation (EMS)
      influence upon human organism and the adequacy of its physical load to adoptive
      and compensative possibilities of cardiovascular system that that method was
      effective for prophylaxis of disorders and rehabilitation of nervous and muscular
      system, and locomotor apparatus after a short period of hypodynamia. The EMS
      increases the working capacity of nervous and muscular apparatus, mass of muscles
      and their contraction strength due to improvement of nervous and muscular
      conductivity and blood supply of the extremity. The efficiency of EMS decreases
      considerably when degenerative changes are taking place.

PMID- 1755223
TI  - [The rehabilitation of those with hand injuries].

PMID- 1755224
TI  - [The neurological manifestations of blast trauma to the brain].
AB  - The article describes mechanisms of cerebral injuries and clinical symptomatology
      of light and medium trauma. It is stressed that a certain succession in medical
      and diagnostical measures must be observed, as well as physicians of several
      medical specialties must participate in the treatment of such cases. There is a
      description of morphological picture of cerebrum in this type of trauma. The
      article also shows pathogenetical and clinical differences between burst and
      mechanical brain injuries.

PMID- 1755225
TI  - [Experience in rendering anesthesiological care to the wounded in Afghanistan].

PMID- 1755226
TI  - [The experience of Soviet military medicine in Afganistan: 1979-1989].

PMID- 1755227
TI  - [Medical support for the 40th Army (facts and figures)].
AB  - The article summarizes the activities of the 40-th Army medical service during
      the war in Afghanistan (1979-1989). The structure of injuries was examined
      depending on the type of a wounding missile and localization of wound. The scheme
      of air evacuation of sick and wounded is enclosed. There is dynamics of statistic
      indexes which characterize the number of rejoined servicemen, medical aid
      rendered to civil population, etc.

PMID- 1755228
TI  - [Infusion-transfusion therapy in chest wounds at medical evacuation stages].
AB  - On the basis of the analysis of medical publications and practical experience in
      surgical care to the wounded the article discusses the tactics of infusion and
      transfusion therapy that should be used at the stages of medical evacuation. The
      authors emphasize the importance of the infusion therapy nearness to the place of
      accident, the necessity to provide medical personnel with adequate facilities for
      this task, careful attitude for autologous blood of wounded, blood reinfusion
      during pleural puncture or thoracotomy [correction of teracotomia]. The schemes
      of infusion and transfusion therapy for each stage of medical evacuation are
      enclosed.

PMID- 1755229
TI  - [The clinico-laboratory characteristics and treatment of typhoid fever combined
      with tertian malaria].

PMID- 1755230
TI  - [The work quality indices of specialists in preventive medicine].

PMID- 1755231
TI  - [Trends in the improvement of medical prophylaxis].

PMID- 1755232
TI  - [The status of and ways for further improvement in the medical support of Air
      Force personnel].

PMID- 1755233
TI  - [At the Central Military Naval Hospital].

PMID- 1755234
TI  - [The surgical aspects of the lessons of the war in Afghanistan].
AB  - There were no two identical wars in human history. From the medical point of
      view, the civil war, which is still going on in Afghanistan, also has its own
      face. The structure of sanitary losses, the character, gravity, and peculiarities
      of gunshot pathology give the possibility to call it as a mine war, because of
      its massive and, above all, effective mine warfare. The war in Afghanistan
      conclusively proves the predominance of blast injuries over other sanitary losses
      in the structure of combat surgical pathology, that may be considered as a common
      feature for the wars of century XX. The mine blast trauma must be regarded as a
      combat heavy concomitant trauma or gunshot blast polytrauma. This statement is
      the basic one for the rest of medical lessons gained from the war in Afghanistan.
      Using the comparative analysis of the different functions of medical service of
      two armies, the article shows the priority of organizational aspects for care and
      treatment of the wounded in war.

PMID- 1755235
TI  - [The posttraumatic stress syndrome in war veterans with a history of combat
      mental trauma].

PMID- 1755236
TI  - [The responsibility of medical workers in cases of their violation of their
      professional obligations (1)].

PMID- 1755237
TI  - Safe use of pesticides. Fourteenth Report of the WHO Expert Committee on Vector
      Biology and Control.

PMID- 1755238
TI  - WHO Expert Committee on Biological Standardization. Forty-first Report.

PMID- 1755239
TI  - [Purpura fulminans--aspects of etiopathogenesis, clinical aspects, diagnosis and
      therapy].

PMID- 1755240
TI  - [Clinical aspects and follow-up of Wegener's granulomatosis].

PMID- 1755241
TI  - [Anticytoplasmic antibodies in Wegener's granulomatosis and other kidney
      diseases].

PMID- 1755242
TI  - [Therapeutic aspects of Wegener's granulomatosis].

PMID- 1755243
TI  - [Pulmonary parasitoses as differential diagnosis of lung tuberculosis].

PMID- 1755244
TI  - [Pleurodesis with electrically activated autologous blood in recurrent pleural
      effusion--preliminary report].

PMID- 1755245
TI  - [International classification of health problems in basic medical care].

PMID- 1755246
TI  - [In memory of Arthur Kronfeld].

PMID- 1755247
TI  - [Diagnosis and surgical therapy in congenital ectasias of the intra- and
      extrahepatic bile ducts].
AB  - 31 patients with congenital ectasias of extra- and intrahepatic bile ducts have
      been diagnosed and treated between 1980 and 1991 at the Charite. 7 ectasias
      belonged to type I, two to type II, three to type III, four to type IV and
      fifteen to type V of classification by Alonso-Lej/Todani. The age of affection
      was between 8 and 80 years. Symptoms are not specified and directed to affection
      of liver or bile ducts. Main symptoms of type I--III were complaints in the upper
      abdomen and jaundice, of type IV--especially after previous surgery--fever and
      also jaundice. Complaints in the upper abdomen and fever dominated in type V. The
      right diagnosis succeeds at 27 out of 31 patients with direct cholangiography.
      Sonography and computerized tomography were not always in a position to attach
      the clinical picture to congenital ectasias. In extrahepatic ectasias is the
      resection of bile duct cysts--carried out in 2/3 of all cases--the therapy of
      choice. Once was found a carcinoma in a resected bile duct cyst 23 years after a
      choledochocysto-jejunostomy. By Caroli syndrome the therapy must be fixed
      individually. 6 patients were supplied operative (liver resection,
      choledochotomy, papillotomy, extraction of lithiasis). Instrumentally were
      carried out 9 endoscopic papillotomies with extraction of concrements and 6 lay
      ins of internal drainage catheters were done.

PMID- 1755248
TI  - [Intraoperative cholangioscopy].
AB  - There are the best diagnostic results by endoscopic examination of the common
      bile duct. Both rigid and flexible instruments can be used for the examination.
      The advantages and disadvantages will be discussed. The stump of the cystic dust
      will be useful to clarify pathological finding by x-ray in the distal bile duct.
      Usually, however, the instrument is introduced by means of a choledochotomy. In
      the last 16 years in 1023 cases the bile duct were examined endoscopically, 330
      via the cystic duct, 693 via a choledochotomy. Stones were detected in 541 cases
      (52.9%), in 16 cases (2.9%) a stone was overlooked. Severe complications by
      operative choledochoscopy were not seen.

PMID- 1755249
TI  - [Elective cholecystectomy with and without subhepatic drainage. A controlled,
      prospective study].
AB  - Based on the data of 56 patients undergoing elective cholecystectomy the value of
      subhepatic drainage is evaluated in a randomized controlled clinical trial. The
      design of the study and the perioperative management of the patients are
      described in detail and the results analyzed according to clinical course, blood
      tests and abdominal ultrasound.

PMID- 1755250
TI  - [Anomaly of the pancreatico-biliary junction and etiology of choledochal cysts].
AB  - The etiology of choledochal cysts isn't yet clarified unequivocably. Numerous
      theories have been worked out. One of them is the 1969 by Babbitt postulated
      "common-channel"-theory, which is based on an anomaly of the pancreaticobiliary
      connection. In case of a fusion of ductus choledochus and ductus pancreaticus
      widely before the papilla of Vater and the formation of a common channel with a
      minimum length of 15 mm the reflux of pancreatic secretion into the off-leading
      biliary ducts may occur and choledochal cysts may develop. In order to check up
      this hypothesis we evaluated retrospectively pictures of a direct cholangiography
      (ERCP, PTC and/or intraoperative cholangiography) of 26 patients suffering from
      type I, IV and V ectasias of the biliary ducts according to Todani. We found a
      common channel with an abnormal length in 8 of 12 patients suffering from
      extrahepatic ectasias of the biliary duct type I and IV (66%), but we didn't find
      it in patients with type V intrahepatic ectasias of the biliary duct. This
      analysis may be recognized as a reference to the truth of the Babbitt-theory.

PMID- 1755251
TI  - [Obstruction of the small intestine caused by a gallstone 13 years following
      cholecystectomy].

PMID- 1755252
TI  - [Acute gallbladder symptoms caused by torsion of the gallbladder].

PMID- 1755253
TI  - [Radiation therapy in breast carcinoma].
AB  - Strategies in treating breast cancer have been changed in the last years. In
      Stage I and early II radical operation techniques have been used not more. Today
      conservative methods are preferred in combination with axillary lymphonodectomy.
      This implies necessity of postoperative irradiation. Longterm results are not
      different between breast preserving methods and radical mastectomy. Cosmetic
      results can be excellent following high doses of radiation. Side effects are
      minimal and of non important clinical value. If there is a local recurrence or a
      second primary tumor, a secondary mastectomy can solve the problem in many cases.

PMID- 1755254
TI  - [Cytopathology of the breast. 1. Secretion and nipple cytology].
AB  - Cytological examinations of breast secretions, nipple smears and breast fine
      needle aspirates can establish important diagnostic findings provided that
      technical conditions and methodical advantages and disadvantages are taken into
      consideration. The first part of the paper is dealing with clinically relevant
      aspects of secretion and nipple cytology. These simple examinations are
      applicable by every gynaecologist. The source of cell material is the spontaneous
      exfoliation, which should be increased in nipple smears by additional procedures.
      Diagnostic findings of secretion cytology can be obtained in breast cancer, duct
      papilloma, cystic fibrosis, and inflammatory lesions. The value of secretion
      cytology for breast cancer detection is limited, because pathological secretion
      is only induced in a small number of patients. Cytological examinations of nipple
      lesions are useful especially in the presence of Paget's disease and other tumors
      of the nipple. Limitations are caused by difficulties in cell sampling. Easy
      practicability and little alteration of the patient are the major advantages of
      the secretion and nipple cytology, which stands opposite a limited sensitivity as
      disadvantage.

PMID- 1755255
TI  - [Results of a psycho-oncological project at the University Women's Hospital
      Leipzig].
AB  - This paper deals with a synoptic description of experiences of an inter
      disciplinary oncologic project by means of its three main components--theoretical
      research, further education and qualification as well as psychological
      intervention program. It was shown that team work between physicians, nurses and
      psychologists led to an new insight and higher working effectivity with minimal
      subjective stress. This team work led also to the creation of favourable
      conditions for an appropriate management of diseases through an intensive and
      integrated patient care. The application of this model project in the routine
      oncological follow-up would be recommended.

PMID- 1755256
TI  - The intracellular enzymatic response of neutrophils and lymphocytes in patients
      with precancerous states and cancer of the uterine cervix.
AB  - In patients with precancerous states and cancer of the uterine cervix prior to
      and after radiotherapy exhibit the decreased activity of neutrophil beta
      glucuronidase. Moreover, patients treated by radiotherapy before the age 6 to 9
      years demonstrate deficiency of N-acetyl-beta-glucuronidase in the above cells.
      The main finding in lymphocytes of the patients studied was in the appearance by
      diffusion of the above enzymes and of acid phosphatase in the cytoplasm,
      reflecting their release from lysosomes and immunological mobilization of these
      cells. The authors discuss the possible role of neutrophil enzymatic deficiency
      in lowering the antitumor cytotoxic effect of these cells.

PMID- 1755257
TI  - [3-dimensional ultrasonic mammography. Tissue differentiation and tissue-specific
      breast imaging].
AB  - This paper presents first results concerning the three-dimensional ultrasonic
      data acquisition, the textural analysis of different classes of tissues and the
      tissue-specific display of mastopathic regions within the female breast,
      revealing its benefit for diagnosis.

PMID- 1755258
TI  - [Fetal echocardiography. II. Normal and pathological anatomy in real-time
      ultrasonography].
AB  - The paper is a practical approach to fetal echocardiography using real-time
      ultrasound. The normal sonoanatomy of the fetal heart is presented for the non
      cardiologist. The basic cross-sectional views are explained as well as the
      systematic analysis of the different fetal heart structures. The main heart
      malformations are reviewed with a description of their appearance in prenatal
      real-time-ultrasound illustrated by some figures. The examination of the fetal
      heart could be easy learned, but the assessment and the differentiation of
      congenital heart defects are only possible by a systematic approach, experience
      and patience. The examination of the fetal heart should be therefore involved in
      the screening-ultrasound performed by the prenatal sonographer and suspicious
      findings has to be referred to a perinatal center.

PMID- 1755259
TI  - [Microsurgical sterility operations in female patients with deficient
      contralateral tube--pros and cons].
AB  - Microsurgical operations of sterility on 39 women with only one remaining tube
      have been analysed in order to examine the justification of primary operations of
      sterility on these patients. 13 out of 26 women (50%), who had been followed up
      for at least 9 months after the operation, have become pregnant. Live birth rate
      was 30.8% abortion rate 7.7% and the rate of ectopic pregnancies 11.5%. The
      results correspond to these obtained from women bilaterally operated on, so that
      microsurgical operations are justified in sterile women with a lacking opposite
      tube, too. The removal of the opposite tube during the actual operation of
      sterility is prognostically more advantageous than the exstirpation before it.
      Salpingectomy has better results than salpingo-oophorectomy.

PMID- 1755260
TI  - [The effect of physical training on the pharmacokinetics of steroidal
      contraceptives].
AB  - In 8 female sports students (runners) aged 20 and 21 years and 10 women between
      20 and 40 years of age, who regularly underwent body building training, serum
      levels of ethinylestradiol (EE2) and levonorgestrel (LNG) have been determined
      under conditions of exercise as well as in rest, prior to and following the
      intake of 1 tablet of Gravistat (0.05 mg EE2, 0.125 mg LNG). Blood samples were
      obtained at points 0, 2, 6 and 24 hours. Exercise (5000 meter running and
      intensive body building training of one hour duration, respectively) was started
      immediately after intake of the steroid combination. There were no significant
      differences in the serum concentration levels obtained during exercise and rest.
      But exercise consistently resulted in a slight decrease of EE2 and LNG serum
      concentrations and the area under curve values.

PMID- 1755261
TI  - [Tumor recurrence following negative second-look laparotomy in ovarian
      carcinoma].
AB  - Between January 1980 and December 1990, 107 ovarian carcinoma patients in
      clinical complete remission were submitted to a second-look laparotomy at our
      department. Borderline carcinomas were excluded from the study. Second-look
      laparotomy was negative in 78.5% of the cases (84 patients). During the follow-up
      period after the second-look-laparotomy (mean 59 months, range 6 to 120), a
      recurrence of the tumour was diagnosed in 7 patients (8.4% false-negative rate).
      This took place after a mean time of 39 months following the previous negative
      second-look (range 8 to 108). Three of the recurrences were localized in the
      pelvis, two in the upper abdomen and two in the paraaortic and supraclavicular
      lymph nodes, respectively. All patients with a recurrence belonged to the group
      having received adjuvant chemotherapy for one year after initial surgery. At the
      present time we lack any means to anticipate which patients with a negative
      second-look will eventually show a recurrence of their tumour.

PMID- 1755262
TI  - [15 years Perinatal Center of the Leipzig University].
AB  - Report about experiences with developing a perinatal center step by step an the
      University of Leipzig, primarily directed to improve the results of premature
      labour, then expanded by intensive diagnostics and treatment and uniform
      documentation of all risk pregnancies. Perinatal and neonatal mortality decreases
      following this management.

PMID- 1755263
TI  - [Surgical therapy and prognosis of vulvar carcinoma].
AB  - From 1954 to 1985 211 woman with carcinoma of the vulva were treated at the
      medical college Dresden. 66 patients were found at the FIGO stage I, 69 at stage
      II, 50 at stage III, 18 at stage IV; 8 could not be classified. In the total
      group of woman the cumulative survival rate due to the different stages were: 72%
      at stage I, 56% at stage II, 28% at stage III and 13% at stage IV. The 5-year
      survival rates were different in women undergoing a total vulva operation (76%)
      from vulvectomized women (60%) and partial vulvectomized woman (48%). So the
      total vulva operation had a great effect on outcome. In female patients which
      underwent palliative surgical treatment the survival rate could be increased by
      means of the postoperative radiation therapy. It is a matter of outstanding
      importance to the vulva carcinoma prognosis to operate radically and as soon as
      possible.

PMID- 1755264
TI  - [Purification and survival of retinal ganglion cell].
AB  - We had used a specific anti-Thy 1.1 antibody binding method and a nylonmembrane
      sieve method to isolate and purify retinal ganglion cells from neonatal rats in
      order to compare the effect of tectal extract on these purified cells retinal
      ganglion cells. Isolated retinal cell suspension with retinal ganglion cells
      retrograde-prelabelled with Fast Blue were seeded on culture dishes coated with
      the specific anti-Thy 1.1 antibody for 30 minutes before nonadherent cells were
      removed. The percentage purity of the adherent retinal ganglion cells determined
      microscopically to be 95%. However, the percentage purity of the Fast Blue
      labelled retinal ganglion cells recovered using the nylon membrane of pore size
      15 microns was only 60 +/- 5%. Retinal ganglion cells purified by both methods
      could survive and grow into large, active neurons with neurite outgrowths in the
      presence of tectal extract. A MTT colorimetric microassay was used to quantify
      the survival growth activity of these purified retinal ganglion cells after
      culture for 24 hours. The result showed that the optical density ratio (+Te/-Te)
      of the retinal ganglion cells purified by anti-Thy 1.1 antibody binding method
      was 12.3 (0.111/0.009) and by the nylon membrane method was 6.4 (0.102/0.016),
      and the optical density ratio of the non-purified retinal cells was 3.8
      (0.095/0.025), p less than 0.01 for all 3 sets of results. It was concluded that
      in the absence of other cells, the purified retinal ganglion cells responded
      specifically to the trophic activity in tectal extract, the purer the retinal
      ganglion cells and the clearer the effect.

PMID- 1755265
TI  - [Lysosomes in the regulation of hormone secretion in endocrine cells].
AB  - Enzyme cytochemistry and immunocytochemistry were utilized to study the
      morphological alterations of the lysosomes and associated crinophagic and
      autophagic structures in the hypo-secreting pituitary gonadotrophin and Leydig
      cells induced by exogenous androgen. The lysosomes and autophagic vacuoles in the
      electron micrographs were quantitatively analysed. The morphological and
      quantitative data led to the following conclusions: 1) The hypo-secreting
      gonadotrophin showed an increase in the number of lysosomes and an enhancement of
      crinophagy. It demonstrated once again that the lysosomes in the protein and
      polypeptide hormone secreting cells play a role in the regulation of secretion
      process by means of the crinophagy. 2) The hypo-secreting Leydig cells showed an
      increase in the number of lysosomes and an enhancement of autophagic activity.
      This indicated that the lysosomes in the steroid hormone secreting cells also
      function in the regulation of hormone secretion but by means of autophagy which
      scavenge a part of steroid-producing apparatus and hormone. The autophagy might
      have similar effect in regulation of steroid secretion to the crinophagy in
      regulation of protein secretion.

PMID- 1755266
TI  - [Characteristics and inhibitory action of monoclonal and polyclonal antibodies
      against the retinal ganglion neuronotrophic factor (RGNTF)].
AB  - We have immunized Balb/c mice and rabbits with a minute quantity of a 30 kD
      neuronotrophic factor which was isolated from the extract of newborn rat tectum
      (Te) by Phast System gel electrophoresis. Splenic cells from the immunized mice
      were hybridized with NS-1 mouse myeloma cells. Three clones were selected from
      576 wells of hybridomas and were capable of secreting monoclonal antibodies
      specific to the retinal ganglion neuronotrophic factor (RGNTF-MAbs), namely A1,
      D3 and E8. Subtyping of the three monoclonal antibodies revealed that A1 and D3
      are IgG3 and E8 is IgM. They maintained secreting antibodies even after six
      months of culturing in vitro. In order to determine the specificities of these
      antibodies, we have used their ascites fluids containing antibodies at a
      different dilutions to study their effects on the survival of retinal ganglion
      cells in vitro. The results indicated that at the dilution ranges of 1:250 to
      2000, all three monoclonal antibodies exhibited inhibition on the survival of
      retinal ganglion cells and the inhibition increased with increases in antibody
      concentrations; especially at a dilution of 1:250, the E8 monoclonal antibody
      reaching 70% inhibition and A1 and D3 reaching 66% and 62% inhibition,
      respectively. Polyclonal antibodies from rabbits exhibited similar but weaker
      results of inhibition. We can conclude that the monoclonal and polyclonal
      antibodies can specifically inhibit the activity of the 30 kD retinal ganglion
      neuronotrophic factor.

PMID- 1755267
TI  - [Psychosomatic approach in digestive pathology. Diagnostic and therapeutic
      value].

PMID- 1755268
TI  - Serum pancreatic isoamylase activity in pancreatic disease.
AB  - The diagnostic value of serum amylase determination for pancreatic disease has
      been questioned due to its lack of specificity. Several methods have been
      developed to separate the tissue-unspecific salivary fractions from the tissue
      specific pancreatic fractions. Agarose or cellulose acetate gel electrophoresis
      are most suitable for clinical practice. The isoamylase patterns were studied by
      agarose electrophoresis in 55 patients with known pancreatic diseases (acute
      pancreatitis, pancreatic pseudocysts, exocrine pancreatic insufficiency and
      pancreatic carcinoma). Increased P-type isoamylase seems to be more sensitive
      than total amylase in diagnosing acute pancreatitis, while identification of the
      minor isoamylase P3 is more specific and could have a prognostic value. Detection
      of low P-type isoamylase levels is an easy method to diagnose exocrine pancreatic
      insufficiency. Furthermore, a group of patients with pancreatic disease (Pa), was
      compared with a group of patients with biliary disease without clinical evidence
      of pancreatic involvement (Bi), and patients with abdominal pain, without
      evidence of biliary or pancreatic disease (Ab). More than half of the Bi patients
      presented with abnormal P isoenzyme patterns, whereas 72% of the Ab patients had
      a normal pattern. Only P3 could distinguish between the Bi and Ab group. This
      might point to pancreatic involvement in patients presenting with biliary
      disease, only detected by isoamylase analysis.

PMID- 1755269
TI  - [Pharyngo-laryngeal consequences of gastroesophageal reflux. Value of esophageal
      pH measurements in 74 patients].
AB  - Ambulatory 24 hour oesophageal pH monitoring was performed in order to detect
      gastro-oesophageal reflux disease (GERD) in 74 patients presenting with poorly
      explained ear-nose-throat complaints. A significant number of these patients also
      benefited from other currently used methods for diagnosing GERD. Oesophageal pH
      monitoring demonstrated GERD in half of the patients. For atypical GERD, 24 hour
      oesophageal pH-monitoring seems to be the most sensitive procedure.

PMID- 1755270
TI  - Scintigraphy with Indium-labelled leukocytes in acute pancreatitis.
AB  - The authors assessed the clinical and prognostic value of abdominal (ASCI) and
      pulmonary (PSCI) scintiscans with 111Indium-labelled leukocytes in the early
      phase of acute pancreatitis. A grading scale was constructed for both ASCI
      (scored 0 to 3) and PSCI (scored 0 to 2) according to the intensity of isotope
      fixation versus adjacent structures. Results were compared in accordance to the
      presence or absence of a Ranson's score greater than or equal to 3, the presence
      or absence of respiratory failure and of late pancreatic complications. ASCI
      showed an important lack of specificity making its use uninteresting. PSCI
      revealed a very significant correlation with evaluation by Ranson's score and
      appears to have a high sensitivity and specificity to evaluate the patients who
      will develop ARDS or risk of ARDS. This demonstrates the pathophysiological role
      of leukocytes in the early phase of severe acute pancreatitis. The test might
      also be a reliable test for the assessment of therapeutic efficiency in acute
      pancreatitis.

PMID- 1755271
TI  - Direct and indirect evidence for the involvement of prostaglandins in the
      secretagogue action of rhein anthrone in the small intestine.
AB  - The present study was undertaken to investigate the involvement of prostaglandins
      in the secretagogue action, observed after intraduodenal administration of rhein
      anthrone and rhein in rats. After intraduodenal administration of rhein anthrone
      (50 mg/kg), the active metabolite of sennosides, a very marked increase of
      secretion was observed compared to control. The amount of secretion was
      calculated by dividing the total weight of the small intestine, obtained 30
      minutes after administration of the drug, by the total length. The effect seen
      with rhein (50 mg/kg) is far less pronounced than that with rhein anthrone and is
      not significant when compared with control. Pretreating the animals with
      indomethacin (15 mg/kg, p.o., 1 hour in advance) or with ibuprofen (15 mg/kg,
      p.o., 1 hour in advance) largely prevents the secretagogue effect of rhein
      anthrone, suggesting that prostaglandins play an important role in the observed
      pharmacological action. This idea is reinforced by the observation that
      pretreatment with hydrocortisone (50 mg/kg, p.o., 6 hours in advance) is also
      able to counteract the effect of rhein anthrone. After administration of rhein
      anthrone, an almost tenfold increase of the tissue content of prostaglandin E2
      was observed. Here again, the results with rhein were far less pronounced. It is
      concluded that prostaglandins play an important role in the secretagogue action
      of rhein anthrone.

PMID- 1755272
TI  - Juxtapapillary duodenal diverticula and diverticula of the colon: is there a
      general "gastrointestinal diverticular disease"?
AB  - Both juxtapapillary duodenal diverticula and colon diverticula are acquired
      lesions, the pathogenesis of which is believed to involve the influence of high
      intraluminal pressure on loci minoris resistentiae in the gastrointestinal wall.
      We wanted to investigate whether juxtapapillary duodenal diverticula and colon
      diverticula occur independently, or whether they are part of a hypothetical
      general "gastrointestinal diverticular disease". 239 patients with juxtapapillary
      duodenal diverticula were identified in 2231 patients undergoing ERCP. Complete
      radiology data were available in 119/239 patients. Double contrast barium enema
      had been performed in 28/119 patients. In these patients, colon diverticula were
      present in 9/20 women and 1/8 men. The frequency of colon diverticula in these
      patients was compared with randomly chosen age- and sex-matched controls, for
      whom barium enema results were available. In these controls, 9/20 women and 1/8
      men also had colon diverticula (n.s.). We conclude that after stratification for
      age and sex, the occurrence of colon diverticula is not higher in patients with
      juxtapapillary duodenal diverticula than in the general population.
      Juxtapapillary duodenal diverticula and colon diverticula thus occur
      independently. These data are not in favor of the existence of a general
      gastrointestinal diverticular disease.

PMID- 1755273
TI  - Draft protocol for oesophageal pH monitoring. pH Monitoring Working-group of the
      Belgian Group of Paediatric Gastroenterology and Nutrition.

PMID- 1755274
TI  - [Cystoid pneumatosis of the intestine. Apropos of 2 case reports].
AB  - The authors report two cases of pneumatosis cystoides intestinalis involving the
      small intestine. The first patient, a 35-year-old man treated for duodenal ulcer
      since 1976, presented with digestive haemorrhage in 1981 for which a vagotomy and
      a gastroduodenoanastomosis were performed. He was seen in 1986 for a post-bulbar
      stenosis. On the plain abdomen radiography there were gaseous formations in the
      sub-phrenic region. At operation the post-bulbar stenosis was confirmed and a
      cystic pneumatosis interesting 60 cm of the ileum was present. A gastro
      enteroanastomosis was performed with an ileal resection and reestablishment of
      the continuity. He had no recurrence of the disease. The second patient, a 77
      year-old man, was admitted for a surgical treatment of a stenosing bulbar ulcer.
      On the chest X-ray there were many gaseous formations under the diaphragmatic
      cupula, characteristic of cystic pneumatosis. The surgical exploration confirmed
      pyloric stenosis for which a vagotomy and a gastroenteroanastomosis were
      practised; it was found a cystic pneumatosis interesting one meter of the small
      intestine, which was not resected. The postoperative course was uneventful. The
      authors review the literature about this benign disease, which can involve the
      small intestine in case of duodenal or pyloric stenosis. They stress the
      usefulness of plain radiography of abdomen demonstrating the presence of
      characteristic gaseous formations in the subphrenic region.

PMID- 1755275
TI  - [Isotopic method in the demonstration of diaphragmatic defects in a case of
      pleural effusion associated with cirrhosis: apropos of a case].
AB  - A 62-year-old woman presented with massive right-sided hydrothorax associated
      with cirrhosis of the liver. Chest scintigraphy after intraperitoneal injection
      of labelled tracer showed movement of the tracer from the peritoneal to the
      pleural cavity. Medical therapy and thoracocentesis were successful in this case.

PMID- 1755276
TI  - [Recurrent peritonitis caused by familial Mediterranean fever].
AB  - The authors report a case of Familial Mediterranean Fever (FMF) in a Turkish
      patient. FMF is characterised by paroxysmal attacks of fever, peritonitis and/or
      pleuritis or arthritis. FMF is almost exclusively confined to populations of
      Mediterranean origin and it is often familial. The diagnosis is mainly clinical.
      Recently an enhanced dopamine beta-hydroxylase (DBH) activity was described as a
      diagnostic test. We confirmed this in our patient. FMF was successfully treated
      by chronic colchicine therapy: 1-2 mg daily, which reduced DBH activity to normal
      levels.

PMID- 1755277
TI  - [Endoscopic laser treatment for rectosigmoid villous adenoma: factors affecting
      the results].

PMID- 1755278
TI  - [Impaired internal anal sphincters in a subgroup of patients with idiopathic
      fecal incontinence].

PMID- 1755279
TI  - Ultrastructure of the endolymphatic sac in the mouse.
AB  - The ultrastructure of the endolymphatic sac (ES) in the mouse was examined by
      light and electron microscopy. This organ was divided into three parts: proximal,
      intermediate and distal. In the proximal portion of the ES, the epithelium
      consisted of thin squamous cells. The epithelial cells had acquired basolateral
      processes, numerous small vesicles and well-developed Golgi apparatus. In the
      intermediate portion, the epithelium consisted of columnar or cuboidal cells. The
      epithelial cells could be classified into two types: type I and type II. The type
      I cells had abundant microvilli, pinocytotic vesicles, vacuoles, multivesicular
      bodies, lysosomes and mitochondria. The type II cells had fewer numbers of these
      organelles. A few free-floating cells could be observed in the lumen of this
      intermediate portion, most of which were macrophages. In the distal portion, the
      epithelium consisted of squamous or cuboidal cells. The epithelial cells had a
      few cytoplasmic organelles. In the ultrastructural study, each portion of the
      mouse ES was found to have a very distinct morphological feature. It was
      suggested that each of these three portions has a different function.

PMID- 1755280
TI  - Morphology and histochemistry of the myotendineal junction of the rat calf
      muscles. Histochemical, immunohistochemical and electron-microscopic study.
AB  - The macromolecular composition and morphometry of the myotendineal junction (MTJ)
      of slow-twitch (type 1) and fast-twitch (type 2) muscle fibers were studied in
      gastrocnemius-soleus-Achilles unit of the rat. Proteoglycans and
      glycosaminoglycans, type III collagen, fibronectin and laminin could be detected
      at the myotendineal junction. Due to the membrane folding finger-like processes
      were seen at the MTJ. The processes of type 1 fibers were greater in size.
      However, due to the subdivisions the processes of type 2 muscle fibers had a
      significantly greater surface length per muscle cell diameter than type 1 fibers.
      The myotendineal endings of both fiber types had a characteristic basal lamina,
      which was about three times thicker than in the longitudinal site of the same
      muscle cells. The basal lamina of type 1 fibers at the MTJ was significantly
      thicker than that of type 2 fibers.

PMID- 1755281
TI  - A bilateral maxillofacial trunk in man: an extraordinary anomaly of the carotid
      system of arteries.
AB  - In a Caucasian male, the maxillary artery (M) bilaterally arose with the facial
      artery anteromedially from the external carotid artery. On the right side, the M
      entered the infratemporal fossa between the neck of the mandible and the medial
      pterygoid muscle, whereas the left M pierced the medial pterygoid muscle, first
      being covered by the muscle and the angle of the mandible. On both sides, the M
      ran deep to the inferior head of the lateral pterygoid muscle and the buccal
      nerve. The right M lay deep to the inferior alveolar, but superficial to the
      lingual nerve, whereas the left inferior alveolar and lingual nerves had formed
      two roots, thus encircling the left M. The ascending palatine artery was replaced
      on both sides by palatine branches of the ascending pharyngeal artery. Since a
      bilaterial maxillofacial trunk with topographical relations as described herein
      has not been previously reported in man, the embryology and comparative anatomy
      of this variation are discussed.

PMID- 1755282
TI  - Microcirculation of the extra-ocular muscles of rats. A scanning electron
      microscopic corrosion cast study.
AB  - Specific researches, employing corrosion casts, were performed on different
      skeletal muscles, but not on extra-ocular muscles (EOMs). The microvascular bed
      of EOMs was studied by the corrosion cast technique in the rat. Two
      histologically and physiologically different layers were present in the EOMs. On
      the whole, the capillary pattern of EOMs was less dense than in the other
      skeletal muscles. The EOM orbital layer turned out to have a higher number of
      transverse anastomoses and tuning-fork divisions than the global layer had. These
      different microcirculatory patterns can be related with the physiological
      function and the anatomical situation of the EOMs.

PMID- 1755283
TI  - Postnatal development of the interstitial cells (palisade cells) of the pars
      intermedia in the cat pituitary gland. An immunocytochemical and ultrastructural
      study.
AB  - The postnatal development of the interstitial agranulated cells (so-called
      palisade cells) of the pars intermedia in the cat was investigated
      immunocytochemically and at the ultrastructural level. Since the first postnatal
      days, a strong vimentin immunoreactivity and a weaker S-100 protein
      immunoreactivity were detected in the marginal cells lining the pituitary cleft
      and in the interstitial bipolar cells located within the pars intermedia. No
      glial fibrillary acidic protein cells have been found in the pars intermedia of
      any of the animals studied. This immunocytochemical pattern was maintained
      throughout the postnatal development. Ultrastructurally these cells showed a vast
      number of cytoplasmic filaments and well-developed junctional complexes.
      Secretory granules were never seen. In older animals they lined microcavities and
      microchannels where they project microvilli and present pinocytotic vesicles on
      their apical surface. No transitional forms between these cells and granulated
      secretory cells were found. There is a large number of axons and synaptic endings
      in contact with the granulated secretory cells. From our findings we guess that
      palisade cells are not a glial derivative, but they may share a common origin
      with secretory granulated cells.

PMID- 1755284
TI  - [Anatomical aspects of the arteria inferior posterior cerebelli for posterior
      fossa surgery].
AB  - As the arteria inferior posterior cerebelli sometimes causes surprises of grave
      consequence at surgical approaches, its origin and course had to be described in
      detail. For this aim, we especially considered the local relationships of this
      artery with the medulla oblongata and the cranial nerves of the posterior fossa.
      Branches of the a. inferior posterior cerebelli supplying the medulla oblongata
      have been noticed in relation to the arterial supply of the medulla oblongata by
      corresponding vessels and the aa. spinales lateralis and posterior with special
      reference to all the possible collateralizations.

PMID- 1755285
TI  - Relationships between bone and skin atrophies during aging.
AB  - Bone mineral density (BMD) was measured in 133 female subjects (age: 61.7 +/-
      16.3 years) by dual energy X-ray absorptiometry (DEXA). Vertebral bone mineral
      density (BMD; L1-L4) and BMD of the whole upper femoral extremity were taken into
      account. In addition, skinfold thickness was measured with a callipers on the
      dorsum of the nondominant hand. A significant negative correlation was found
      between skinfold thickness and age (r = -0.623, p less than 0.0001). Both
      vertebral and femoral BMD decreased with age and the slopes were similar to those
      observed by other authors. Skinfold thickness was significantly correlated with
      vertebral (r = 0.364, p less than 0.0001) and femoral BMD (r = 0.486, p less than
      0.0001). Skin and bone are connective tissues whose extracellular matrix mainly
      contains type I collagen. It is postulated that age-related skin atrophy and bone
      atrophy have a common genetic mechanism. Skinfold thickness measurement may help
      in defining the women at risk for osteoporotic bone fractures who should be
      referred for a DEXA examination.

PMID- 1755286
TI  - Changes in lectin-binding patterns during late fetal development of the rat
      colon.
AB  - Lectin-binding and histochemical studies were integrated with a morphological
      description of colon development in rat fetuses to determine whether changes in
      glycoprotein sugars could be identified with stages of colon organogenesis. At 16
      days gestation the colon consisted of a minute lumen surrounded by 3-5 layers of
      cuboidal, stratified epithelium, a basement membrane and undifferentiated
      mesenchyme. As development proceeded, epithelial spaces eventually fused with the
      main lumen, and fingers of mesenchyme, with a basement membrane and epithelial
      mantle, formed the walls of crypts lined with simple to stratified columnar
      cells. Goblet cells and mucin production appeared only on the 20th-21st day of
      gestation. Mesenchyme differentiation to a circular muscle band, the prospective
      tunica muscularis, occurred on days 17-18, and vascularization of the lamina
      propria was first detected on day 19. Wheat germ agglutinin (WGA) lectin bound
      avidly to sugar residues in the mesenchyme matrix from day 16 but weakened as the
      tissue differentiated, particularly into smooth muscle. Alcian blue staining of
      the matrix, also weakening with time, confirmed the sialic acid nature of binding
      sites for WGA on matrix acid mucopolysaccharides. Under controlled conditions,
      WGA also detected N-acetylglucosamine-binding sites on brush borders as they
      developed on the apical surface of primitive enterocytes. Ulex lectin bound to
      fucose residues of Alcian-blue-positive, PAS-positive mucin from the first
      appearance of goblet cells. Concanavalin A and glycine max lectins bound only to
      blood group substances on both nucleated red cells between days 16 and 19 and
      anucleate red cells from day 19.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755287
TI  - Growth allometry of the myocardium in human embryos (from stages 15 to 23).
AB  - The relative growth of the myocardium was studied in 27 staged human embryos
      (Carnegie stages). The volume of the myocardium was determined for each embryo
      according to Cavalieri's principle (by using point-counting planimetry to
      determine the area of the profiles of the myocardium). The volume of the
      myocardium (variable Y) was correlated to embryonic crown-rump length (variable X
      in millimeters) and age (in days). The bivariate allometric equation was used as
      Y = aXb. The scatterplot was discontinuous, presenting two trends during the
      postsomitic period. The first part was composed of embryos staged from stages 15
      to 20, and the second part by embryos staged from stages 21 to 23. The breakpoint
      between these different trends was found at the level of stage 20 (embryo of 22
      mm in crown-rump length and age nearly of 52 days). From stages 15 to 20, the
      growth rate of the myocardium was allometrically negative. On the other hand,
      from stages 21 to 23 this growth rate was moderately allometrically positive.
      These differences in growth of the myocardium were analyzed and, at least
      partially, might be due to the functional circulatory increase in the peripheral
      vascular bed in correlation to the cardiac hemodynamic demand required at the end
      of the embryonic period proper.

PMID- 1755288
TI  - Histochemical localization of carbonic anhydrase in the testis and epididymis of
      the boar.
AB  - The testis and epididymis of sexually mature, fertile boars were studied for
      localization of carbonic anhydrase (CA) using a cobalt precipitation technique.
      In the testis, cytoplasmic CA was found in the Sertoli cells and in the
      capillaries surrounding the seminiferous tubules. The epididymal duct was divided
      into initial, middle and terminal segments, and regional differences in CA
      activity were observed. The cell membranes of the basal cells were stained in the
      initial and middle segments. Strong cytoplasmic CA staining was present only in
      the apical cells in the initial and middle segments. The basolateral cell
      membranes were stained in the principal cells of the terminal segment and the
      ductus deferens. As a rule the capillaries surrounding the epididymal duct were
      unstained. The enzyme, specifically localized in regions of the male genitalia
      acting as sperm reservoirs, might be related to the quiescence of the stored
      spermatozoa by influencing the acid-base status of the epididymal fluid.

PMID- 1755289
TI  - Ultrastructural studies on the barrier properties of the paraganglia in the rat
      recurrent laryngeal nerve.
AB  - The permeability of blood capillaries in the paraganglia of the rat recurrent
      laryngeal nerve (RLN) was investigated by employing the ionic lanthanum tracer at
      ultrastructural level. Two types of blood capillaries, namely, fenestrated and
      nonfenestrated types, were observed in the rat RLN and its associated paraganglia
      (RLN paraganglia). A preferential distribution of fenestrated capillaries in the
      RLN paraganglia was noted. Nonfenestrated capillaries were distributed in the
      area of RLN devoid of paraganglia. Minute aberrant ganglia consisting of 4-8
      neurons were frequently encountered in the rat RLN near the paraganglia. The
      capillaries in these neuronal areas were also nonfenestrated. The lanthanum
      tracer was limited within the vascular lumen, but not in the extravascular space,
      in the RLN proper and in the area of RLN paraganglia where the neurons were
      identified. In the RLN paraganglia, the tracer was located in the vascular lumen,
      extravascular space, periaxonal space of nerve fibers, and the intercellular
      space of the RLN paraganglionic cells. We concluded that (1) a blood-nerve
      barrier and a blood-ganglion (or blood-neuron) barrier exist in the area of RLN
      devoid of paraganglia, and (2) blood-paraganglion barrier and blood-nerve barrier
      were lacking in the rat RLN paraganglia.

PMID- 1755290
TI  - Effects of lactation on the border zone formation in the female mastomys (Praomys
      coucha) adrenal cortex.
AB  - Adrenocortical zonation and especially border zone formation were investigated in
      relation to reproduction in female mastomys of the wild-colored inbred strain
      (MWC). The adrenal weight and the whole thickness of the cortex remained
      relatively constant throughout pregnancy, delivery and lactation. During
      pregnancy the zona fasciculata increased, but the z. reticularis decreased in
      thickness. The border zone between the z. fasciculata and the z. reticularis
      thickened 2-fold during pregnancy and further 2-fold during lactation. This zone
      was composed of vacuolated cell layers and nodules in females with a normal
      reproductive career. In young virgins this zone was barely identified by the
      presence of a few highly vacuolated cells. These cells became prominent during
      pregnancy and lactation. During lactation two types of cell aggregations,
      distinguishable by their stainability, vacuolation, localization and cellularity,
      appeared in the thickened border zone. The nodules first appeared within the z.
      reticularis after lactation. Neither thickening of both border zone and z.
      fasciculata nor formation of nodules occurred when lactation was interrupted
      after delivery. Thus, the changes in the female MWC adrenal, above all the
      appearance of nodules, seemed to be more dependent upon lactation than pregnancy.
      The vacuolated cells and the nodules might originate from the thickened z.
      fasciculata and the thinned z. reticularis, respectively, by the specific
      metamorphosis of the cells adjacent to the border zone. Their fusion and
      induction of fibrous tissue migration may result in the wider border zone.

PMID- 1755291
TI  - Configurational and volumetric changes of the early prenatal human cerebellar
      dentate nucleus.
AB  - The three-dimensional configurational and volumetric changes of the human dentate
      nucleus (DN) during intrauterine life were examined in 11 fetuses (11 to 27-28
      weeks of gestation). During intrauterine life, the dentate nuclear profile
      successively passes through the pongid, cercopithecus and prosimian phases of
      configuration. The smooth, elongated, crescent-shaped DN of 11 weeks lies along a
      dorsal-ventral axis. A 45 degrees clockwise shift in the position of the nucleus
      changes the axis to dorsomedial-ventrolateral at 14-15 weeks, which is maintained
      in subsequent ages. The formation of gyri is preceded by a thinning of the
      substantia grisea. This begins at 17-18 weeks in the dorso-medial region of the
      DN. Gyri first make their appearance at 24-25 weeks. The DN of 27-28 weeks
      resembles the adult human DN. Two regions are discernible at this stage--a
      microgyric, magnocellular region and a macrogyric, parvocellular region. The DN
      volume increases with increasing gestational age. Between 14-15, 19-20 and 24-25
      weeks the volumetric increase is statistically significant. This is
      simultaneously accompanied by a modification of the configuration of the DN.

PMID- 1755293
TI  - Proceedings and dissertation abstracts.

PMID- 1755292
TI  - Ultrastructural changes in rat colorectal epithelium and tumors after treatment
      with N-methyl-N'-nitro-N-nitrosoguanidine and secondary bile acids.
AB  - Transmission electron microscopy (TEM) was used to study ultrastructural changes
      that accompanied the tumorous transformation of the descending rat colon
      epithelial cells, following short treatment with a direct carcinogen, N-methyl-N'
      nitro-N-nitrosoguanidine (MNNG), with subsequent prolonged treatment with
      secondary bile acids, lithocholic (LCA) and deoxycholic (DCA), which enhanced
      tumor formation. Colon epithelial cells after long treatment with bile acids
      alone were characterized by the presence of an irregular nuclear membrane, ring
      shaped rough endoplasmic reticulum (RER), collagen-like tonofilaments and
      membrane-bound mucous vacuoles. Tumor cells which developed following treatment
      with MNNG alone were characterized by the irregular shape of the nuclear membrane
      and, sometimes, by polynuclei, accumulation of large amounts of mitochondria,
      loss of cell-cell contacts and by endocytosis of the cell membrane. After
      combined treatment with MNNG and LCA, many mitochondria lost their membranous
      envelope; in the cytoplasm many collagen-like tonofilaments, ring-shaped RER and
      many free ribosomes were present. After treatment with MNNG and DCA, many
      polysomes were found in the cytoplasm. It was apparent that treatment with MNNG
      alone caused the development of adenocarcinoma-like tumors, while additional
      treatment with secondary bile acids significantly enhanced these changes, which
      were accompanied by the development of atypia and anaplasia of epithelial cells,
      with many irregularities in intracellular organization.

PMID- 1755294
TI  - Sodium and potassium in red blood cells of premature infants during the first few
      days: risk of hyperkalaemia.
AB  - Erythrocyte sodium and potassium were studied in 64 newborn infants including 21
      very low birthweight infants (birthweight less than 1500 g) during the first
      three days after birth. Erythrocyte sodium showed a positive correlation with
      gestational age (r = 0.63, p less than 0.01) and birthweight (r = 0.66, p less
      than 0.01). Erythrocyte potassium was negatively correlated with birthweight (r =
      -0.33, p less than 0.05). The Na/K ratio in red blood cells showed a positive
      correlation with gestational age (r = 0.60, p less than 0.01) and birthweight (r
      = 0.65, p less than 0.01). In VLBW infants plasma potassium rose significantly (p
      less than 0.01) from 0-6 h to 12-30 h and decreased from 12-30 h to 30-60 h (p
      less than 0.05). Erythrocyte potassium decreased slightly from 0-6 h to 12-30 h,
      but not significantly. A new finding that "more immature infants have higher
      potassium and lower sodium concentration in RBC" may suggest a potential risk of
      hyperkalaemia in tiny infants.

PMID- 1755295
TI  - Cerebral blood flow velocity and cardiac output in infants of insulin-dependent
      diabetic mothers.
AB  - Cardiac output and cerebral blood flow velocity in the anterior cerebral and
      internal carotid arteries were investigated in eight large-for-date infants of
      insulin-dependent diabetic mothers and 12 healthy term infants during the first
      four days of life using two-dimensional/pulsed Doppler ultrasound. Temporal mean
      flow velocity was used as an indicator of changes in cerebral blood flow. Six of
      the eight infants of diabetic mothers had ventricular septal hypertrophy with
      reduced cardiac outputs and stroke volumes. Mean flow velocity in both cerebral
      vessels showed a comparable pattern in both groups throughout the study period
      and was independent of mean arterial pressure, suggesting unaltered cerebral
      hemodynamics in the infants of diabetic mothers.

PMID- 1755297
TI  - Roentgen stereophotogrammetric short-term analysis of growth rate in children
      operated for Crohn's disease.
AB  - Roentgen stereophotogrammetry is a new method for short term analysis of growth
      rate. Growth is measured over the growth zone in the distal fibula and is a
      fraction of the total statural growth. Normal growth rate in the distal fibula is
      about 15 micrograms/day at a total growth rate of 5 cm/year. The method was used
      to follow growth six months before and six months after surgery in six growth
      retarded children with Crohn's disease. Growth rate increased significantly (p
      less than 0.01) within three months after surgery from 5.8 microns/day before
      operation to 15.8 microns/day three months after operation and six months
      postoperatively had reached 18.0 micron/day. Improved growth could be recorded as
      early as four weeks after operation. The Roentgen stereophotogrammetric analysis
      (RSA) gives a unique possibility to follow short-term changes in growth rate in
      children with disturbed growth and to use growth rate as a quick assessment of
      response.

PMID- 1755296
TI  - Ampicillin-aminoglycoside combinations as initial treatment for neonatal
      septicaemia or meningitis. A retrospective evaluation of 12 years' experience.
AB  - In a retrospective study covering the years 1975-1986, 341 episodes of invasive
      infections in 338 newborn infants were evaluated. Of the 365 pathogens isolated
      from blood and/or cerebrospinal fluid, 91% were sensitive to either ampicillin or
      aminoglycosides or both. Ampicillin resistance was mainly found in very low and
      low birthweight infants with late-onset infections, in which aerobic Gram
      negative rods were common pathogens. In contrast, aminoglycoside resistance was
      common in early-onset infections, due to the dominance of group B streptococcal
      infections. The ampicillin-aminoglycoside combination had been given as initial
      treatment in 189 cases of septicaemia or meningitis. Treatment failed in 36
      infections (20%), although all organisms were sensitive to one or both
      antibiotics. Treatment failed in 6 of 34 patients with meningitis but the failure
      was not related to ampicillin or aminoglycoside resistance. In conclusion, both
      in vitro and clinical results show that the ampicillin-aminoglycoside combination
      can be used as initial treatment of invasive infections in neonates.

PMID- 1755298
TI  - Treatment for stage III-IV neuroblastoma patients: initial response to
      chemotherapy evaluated by biochemical parameters.
AB  - Fourteen patients with stage III-IV neuroblastoma were treated with alternating
      combination chemotherapy consisting of (a) VP16/cisplatin and (b)
      doxorubicin/vincristine/cyclophosphamide. The initial response to induction
      chemotherapy, especially to VP16/cisplatin was evaluated by determining t 1/2 for
      urinary vanillylmandelic acid (VMA), homovanillic acid and serum neuron specific
      enolase (NSE). The period prior to normalization of these parameters was also
      determined. The patients could be classified as 7 rapid responders, with less
      than 3 weeks of t 1/2 VMA, or t 1/2 NSE, and 7 slow responders longer than 4
      weeks of t 1/2 VMA. An analysis of the data indicates that an initial rapid
      response correlated with subsequent high complete response rate, but did not
      necessarily predict better prognosis in these patients.

PMID- 1755299
TI  - Phenotypes of peripheral blood lymphocytes during acute hepatitis A.
AB  - We investigated peripheral blood lymphocyte phenotypes of 74 patients at weekly
      intervals during the course of acute hepatitis A. In the second week after onset
      of jaundice, a significant elevation of total lymphocytes was observed (4,096 X
      10(6) +/- 1,003 X 10(6)/l vs. controls 3,038 X 10(6) +/- 1,208 X 10(6)/l, p less
      than 0.005). However, no change in the relative percentage of B-cells (CD20+), T
      cells (CD3+ or CD2+), or T-cell subpopulations (CD4+ helper cells and CD8+
      suppressor cells) could be demonstrated during the course of the disease.
      Activated T-cells (CD3+ DR+) were elevated during the first week (204 X 10(6) +/-
      134 X 10(6)l vs. normal 91 X 10(6) +/- 54 X 10(6)/l, p less than 0.005) and
      during the second week (202 X 10(6) +/- 82 X 10(6)/l, p less than 0.0005) after
      onset of disease and returned to normal values until the third week. Cells
      expressing phenotypes of lymphocytes capable of exerting non-MHC-restricted
      cellular cytotoxicity, i.e. Natural Killer cell activity (CD57+, CD16+, and
      CD56+) were significantly elevated in percentage in the first week of disease, as
      compared to controls (CD57: 14.5 +/- 7.0% vs. 9.3 +/- 5.8%, p less than 0.05;
      CD16: 13.4 +/- 7.3 vs. 9.5 +/- 5.1%, p less than 0.05; CD56: 10.5 +/- 3.5% vs.
      8.0 +/- 1.5%, p less than 0.005). Also the absolute numbers of these lymphocyte
      subpopulations were found to be elevated during the first and second week. The
      increase in NK cells in the initial phase of acute hepatitis A suggests an
      important role of these cells in the first line of defence in this disease.

PMID- 1755300
TI  - Effect of metabolic control on serum protein concentrations in diabetes.
AB  - Serum albumin, transferrin, transthyretin (prealbumin), and retinol binding
      protein concentrations were determined in 74 children with insulin-dependent
      diabetes mellitus before and after a 10-day camp session during which blood
      glucose concentrations were controlled. Initial concentrations of albumin and
      transferrin in the subjects were not different from those in 21 children and
      adults without diabetes, and did not change during the study period.
      Transthyretin and retinol binding protein concentrations were lower in subjects
      with diabetes than in the control population, and increased from 182 +/- 49 mg/l
      and 42.5 +/- 13.4 mg/l to 232 +/- 71 mg/l and 47.2 +/- 13.5 mg/l, respectively.
      We observed correlations between the changes in transferrin, transthyretin, and
      retinol binding protein. Although reductions in glycated albumin and transferrin
      indicated improvement in blood glucose control, there was no correlation between
      changes in the glycated markers and the concentrations of serum transport
      proteins. Thus, serum protein concentrations were influenced by the metabolic
      control of diabetes, but did not directly reflect blood glucose.

PMID- 1755301
TI  - Monitoring of drug prescriptions for children in the county of Jamtland and
      Sweden as a whole in 1977-1987.
AB  - One individual-based (Jamtland) and one population-based (Sweden) monitoring
      system provided information on the prescription sales of drugs for children in
      ambulatory care. The overall prescription rate decreased between 1977 and 1987
      and it was 20-25% lower in Jamtland than in Sweden as a whole. Antibiotics, drugs
      for ear, nose and throat diseases and respiratory drugs accounted for three out
      of four prescriptions. Penicillin V dominated among antibiotics and the
      prescription rate was stable whereas that of other antibiotics increased. During
      their first year of life one out of ten children in Jamtland had at least one
      prescription of antibiotics, during their first five years three out of four
      children. Prescribing of decongestants, especially systemic, decreased during the
      study period whereas that of anti-asthmatics increased, partly due to the non
      approved use of these drugs for common cough. The results from our study
      underline the need for pharmaco-epidemiological studies linking prescription data
      to clinical data in order to answer questions on the rational of present drug
      treatment practices.

PMID- 1755302
TI  - Menarche 1990 in Stockholm schoolgirls.

PMID- 1755303
TI  - Linear growth in Sotos syndrome.

PMID- 1755304
TI  - Intolerance to casein hydrolysate formula. Clinical aspects.

PMID- 1755305
TI  - Persistence of protein loss in acute diarrhoea. A follow-up study by faecal alpha
      1-antitrypsin measurement.

PMID- 1755306
TI  - Calcium-induced constipation in a prepubescent boy.

PMID- 1755307
TI  - Late haemorrhagic disease in Sweden 1987-89.

PMID- 1755308
TI  - Antitussives in the treatment of acute transient cough in children.

PMID- 1755309
TI  - Oral absorption of amoxicillin in Ethiopian children with respiratory symptoms
      and different nutritional status.

PMID- 1755310
TI  - Thrombocytopenic purpura during the incubation of hepatitis B.
AB  - A 6-year-old girl presented with acute thrombocytopenic purpura. Hepatitis B
      surface antigenaemia was present at the time of this illness, and 8 weeks later
      she developed acute icteric hepatitis B. Screening for hepatitis B virus should
      be considered in children with apparently idiopathic thrombocytopenic purpura.

PMID- 1755311
TI  - Twenty-nail dystrophy associated with hematologic abnormalities.
AB  - This report describes a 15 1/2 year old white male with twenty-nail dystrophy who
      has had recurrent episodes of immune thrombocytopenic purpura, autoimmune
      hemolytic anemia, and mild depression of immunoglobulin levels. The concurrence
      of these events suggests that each shares a common pathophysiologic mechanism,
      possibly an autoimmune process.

PMID- 1755312
TI  - Congenital hypothyroidism and cystic fibrosis.
AB  - We report a case of dysgenetic congenital hypothyroidism associated with cystic
      fibrosis. Impaired exocrine pancreatic secretion and/or transit abnormalities
      secondary to the treatment of meconium ileus resulted in decreased absorption of
      L-thyroxine and difficulties in management of hypothyroidism.

PMID- 1755313
TI  - A case of neonatal McCune-Albright syndrome with Cushing syndrome and
      hyperthyroidism.
AB  - We describe a female newborn infant with McCune-Albright syndrome. In addition to
      the cutaneous pigmentation, she had apparent manifestations of hyperthyroidism
      and Cushing syndrome since birth. X-ray examinations showed many scattered
      lucencies in multiple bones. Endocrinological findings were as follows: serum T 4
      276 nmol/l; free T 4 125 pmol/l; TSH less than 1 mU/l; serum cortisol greater
      than 2210 nmol/l; plasma ACTH less than 10 pg/ml; urinary free cortisol 865
      nmol/day; estradiol 0.36 nmol/l. Regardless of treatment with antithyroid drugs
      and an inhibitor of 3 beta-hydroxysteroid dehydrogenase, the patient died of
      cardiac failure at the age of 4 months. Autopsy findings included a follicle cyst
      in the right ovary and multinodular hyperplasia in the thyroid and both adrenals.
      To our knowledge such a severe neonatal form of McCune-Albright syndrome has not
      been described in the literature.

PMID- 1755314
TI  - Intestinal absorption of D (+) xylose in newborns.

PMID- 1755315
TI  - Pathological aspects of radiofrequency catheter ablation of the canine
      atrioventricular node and bundle of His. With special reference to chronic
      incomplete atrioventricular block.
AB  - Radiofrequency catheter ablation of the atrioventricular (AV) node or bundle of
      His was performed in 12 adult mongrel dogs. The aim was to create chronic
      incomplete AV block (first- and second-degree AV block) and to examine the
      histopathology of the ablated lesions. However, the late electrophysiological
      results (2-4 weeks follow-up) were various: normal in 2 dogs, mild PR
      prolongation (less than 50%) in 2 dogs, first-degree AV block (PR prolongation
      greater than or equal to 50%) in 2 dogs, second-degree AV block in 2 dogs,
      complete AV block in 4 dogs. The maximally ablated area (%) of the
      atrioventricular conduction system in serial histologic sections from dogs with
      these conditions was 69%, 75%, 89.5%, 95% and 99.5%, respectively. The number of
      intact conduction cells at the maximally ablated site varied from 6 to 30 in the
      four cases of incomplete AV block. The mean ablated volume (%) of either the AV
      node or penetrating His bundle correlated roughly with the degree of AV block.
      The ablated lesions were well demarcated and almost replaced by dense fibrous
      tissue at 4 weeks. Interruption (3 dogs) or thinning (1 dog) of the endocardial
      elastic lamellae was detected, in association with endocardial thickening (mean
      913 microns). Endocardial thrombi were found in 3 dogs (2 fresh, 1 organized). We
      conclude that radiofrequency catheter ablation does not cause severe complicated
      lesions. Several possible conditions for creating chronic incomplete AV block are
      discussed.

PMID- 1755316
TI  - Monoclonal antibody against bone marrow stromal cells. Its production and
      characterization.
AB  - Bone marrow stromal cells play an essential role in the proliferation and
      differentiation of hematopoietic stem cells (1, 2). As a means of analyzing of
      the bone marrow microenvironment immunohistochemically, we attempted to produce a
      rat monoclonal antibody against the murine preadipocyte line H-1 derived from
      long-term bone marrow culture (LTBMC) of C57BL/6 mice (3, 4). A newly established
      monoclonal antibody, designated R4-A9, was obtained from a hybridoma prepared by
      fusion of Y.B2/3.0Ag20(YO) rat myeloma cells with spleen cells of LEW rats
      immunized with H-1 cells. The immunofluorescence of live H-1 cells showed that
      the antigen reacting with this antibody was strongly expressed on the cell
      surface. The specificity of R4-A9 was assessed immunohistochemically on frozen
      sections of various tissues from normal adult mice. R4-A9 demonstrated
      specificity for hematopoietic stroma in bone marrow and spleen. No staining was
      observed in thymus, lymph nodes or other tissues examined, with the exception of
      Leydig cells in the testis and the endothelium of small arteries in several
      organs. Detailed immunohistochemical observations at both the light microscopy
      and electron microscopy level showed that R4-A9 selectively reacted with the
      sinusoidal endothelium, perisinusoidal adventitial cells (5) (adventitial
      reticular cells (6] and intersinusoidal reticular cells (5) and the reticular
      cells of the splenic red pulp. These findings indicate that reticular cells and
      the endothelium of the bone marrow possess the common cell surface molecules
      recognized by R4-A9. SDS-PAGE analysis showed that R4-A9-immunoprecipitated
      proteins had a molecular mass of 100 kDa under reducing conditions.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1755317
TI  - Morphological and cytogenetic characterization and N-myc oncogene analysis of a
      newly established neuroblastoma cell line.
AB  - A permanent cell line established from a xenograft of neuroblastoma which
      occurred in a 5-year-old girl was investigated for its morphological and
      biological characteristics. The cultured cells were tumorigenic in nude mice.
      Microscopically, each tumor consisted of small round to polygonal cells with
      irregular nuclei and prominent nucleoli, corresponding to the features of the
      primary and xenografted tumor cells. Electron microscopic examination revealed
      that both the transplanted tumor cells and the cultured cells contained scanty
      microtubules and dense-core neurosecretory granules. Chromosome analysis of this
      cell line showed monosomy for chromosomes 1, 10, 19 and X, and structural
      rearrangements involving chromosomes 8, 17 and 20, in addition to numerous double
      minutes. The N-myc oncogene was found to be amplified 40- to 80-fold in the
      transplanted and cultured tumor cells, as well as in the primary tumor cells. In
      situ hybridization with a digoxigenin-labeled uridine-triphosphate N-myc RNA
      probe detected abundant mRNA in the tumor cells. This neuroblastoma line may
      become a valuable in vitro experimental model system for studies aimed at better
      characterization of neuroblastoma.

PMID- 1755318
TI  - A histological, ultrastructural and immunohistochemical study of superficial
      temporal arteries and middle meningeal arteries in moyamoya disease.
AB  - Pathologic changes in superficial temporal arteries (STA) and middle meningeal
      arteries (MMA) biopsied from 15 patients with moyamoya disease (MD) who had
      undergone cerebro-temporal arterio-synangiosis were studied histologically,
      ultrastructurally and immunohistochemically. The main pathologic features were:
      proliferation of smooth muscle cells (SMCs) and thickening of the intima,
      degeneration and destruction of SMCs in the media and intima, and the presence of
      condensed organelles in necrosed SMCs or the interstitium among SMCs, or both
      outside and within the elastica interna (EI). The EI had become thin, porous,
      fragmented and was even absent in some segments. These changes are different from
      those of other forms of angiopathy, but identical with those at the ends of
      internal carotid arteries (ICA) reported by us previously, being pathognomonic
      for MD. These changes in the STA and MMA reveal that MD involves not only the ICA
      but also the intra- and extracranial branches of external carotid arteries. The
      medial necrosis of SMCs seems to be the primary injury of the arterial wall in
      MD. STA tissue blocks from two cases of MD were stained immunohistochemically. By
      electron microscopy, IgG-, IgM-, and C3-positive granules were observed on the ER
      of endothelial and intimal cells. Further studies on more cases are needed to
      determine whether an immunoreaction has occurred in these arteries.

PMID- 1755319
TI  - Abnormal granulopoiesis of leukemic cells with basophil/mast cell features.
      Cytochemical and ultrastructural observations.
AB  - We have carried out cytochemical and ultrastructural examination of human
      leukemic cells showing basophil/mast cell features derived from patients with
      acute myelogenous leukemia or basophilic crisis in chronic myelogenous leukemia.
      Leukemic cells in each case initially showed metachromasia with toluidine blue
      and various degrees of positivity for astra blue. Other cytochemical results
      showed considerable variety among cases. The number of granules increased in
      short-term culture in every case. Ultrastructurally, small membrane-bound
      granules with or without myelinoid bodies or glycogen particles were present in
      immature blasts, followed by production of other granule types. In some cases,
      leukemic cells before and after liquid culture contained the typical basophil
      granules with or without myelinoid bodies, but the matrix was more loose than
      normal. Granules showing whorl or scroll matrix profiles, which were typical for
      mast cells, were present in two cases. In one case, immature leukemic cells
      contained theta granules, and some mature forms after short-term culture
      contained typical basophil/mast cell granules as well as theta granules. Leukemic
      cells occasionally contained multivesicular granules predominantly. These results
      indicate that leukemic cells with basophil/mast cell features show a
      heterogeneous configuration and contain abnormal granules differing from normal
      ones. This abnormal granulopoiesis may be attributable to the results of leukemic
      events and may be a hallmark for recognition of leukemic basophils/mast cells.

PMID- 1755320
TI  - Giant cell fibroblastoma. A case report and immunohistochemical comparison with
      ten cases of dermatofibrosarcoma protuberans.
AB  - A 7-year-old boy with giant cell fibroblastoma (GCF) of the skin and subcutaneous
      tissue of the right chest wall is described. To date, the histogenesis of GCF has
      not been clarified. The reason for the diversity of immunohistochemical data
      among various authors may be because the specimens studied were from only part of
      the lesion, or reduction of antigenicity through the preparation process.
      However, our findings based on studies of many specimens from various parts of
      the tumor for accurate immunohistochemical evaluation suggest that GCF may be a
      myofibrohistiocytic tumor. Recently, the suggestion that GCF is a juvenile form
      of dermatofibrosarcoma protuberans (DFSP) has been reported. In addition to the
      present case, we performed immunohistochemical examination of 10 cases of
      definitely diagnosed DFSP for comparison. The immunohistochemical characteristics
      of these two neoplasms were concordant. However, from clinical and morphological
      viewpoints, it seems premature to recognize GCF as a juvenile form of DFSP.

PMID- 1755321
TI  - Intestinal mucormycosis in a hemodialysis patient treated with desferrioxamine.
AB  - A case of fatal intestinal mucormycosis in a 57-year-old female hemodialysis
      patient who had received desferrioxamine (DFO) for aluminum overload is reported.
      The focus of fungal infection was not found until the intestine had been resected
      surgically. DFO is being used with increased frequency in dialysis patients to
      treat aluminum or iron overload. Recently a possible link between DFO therapy and
      mucormycosis has been suggested. In the management of hemodialysis patients, the
      potential risk of mucormycosis with DFO therapy should be considered.

PMID- 1755322
TI  - Necrotizing fasciitis rapidly diagnosed by aspiration cytology.
AB  - A case of necrotizing fasciitis caused by beta-hemolytic streptococci is
      reported. A 66-year-old man was admitted because of pain and swelling in the
      right buttock. Rapid application of aspiration cytology made it possible to
      diagnose necrotizing fasciitis with bacterial infection. Unfortunately, however,
      the patient died of cardiac arrest due to hyperpotassemia 11 h after admission.
      Mortality from this disease is most often related to failure in recognizing it
      early. Rapid diagnosis and early treatment is mandatory in order to save the
      patients' life. We emphasize the usefulness of rapid aspiration cytology, despite
      the unfortunate outcome in the present case.

PMID- 1755323
TI  - In memoriam Miklos Jancso (1903-1966).

PMID- 1755324
TI  - Effect of benzopyrone derivatives on simultaneously induced croton oil ear oedema
      and carrageenin paw oedema in rats.
AB  - Carrageenin paw oedema and croton oil ear oedema induced simultaneously in rats
      are inhibited in a dose-dependent manner and to statistically significant degrees
      by lipoxygenase- and cyclooxygenase-blocker flavonoids (diosmin, fisetin,
      quercetin, myricetin, galangin, sophoricoside, hesperidin-methylchalcone,
      oligomeric procyanidin, anthocyanidins (delphinidin, pelargonidin], and the
      prostaglandin antagonist polyphloretin phosphate and di-4-phloretin phosphate.
      Outstanding anti-inflammatory effects are displayed by myricetin and delphinidin,
      which contain vicinal hydroxy groups in ring B. The results confirm the
      importance of hydroxy group substitution in ring B. The most effective of the
      examined substances proved to be the prostaglandin antagonist di-4-phloretin
      phosphate.

PMID- 1755325
TI  - A possible pathomechanism of the idiopathic cold contact urticaria.
AB  - Urtica is characterized by an erythematous wheal surrounded by a flare and is
      frequently caused by physical agents (e.g. cold). The exact mechanism and
      mediators involved in the mechanism of physical urticaria are not known. This
      study of the role of the neurogenic factors in cold urticaria showed, that local
      capsaicin treatment (desensitization) of the skin in patients with cold urticaria
      resulted in the abolition of whealing in response to cold. This result suggests
      that C-fibers might play an important role in the pathomechanism of idiopathic
      contact cold urticaria.

PMID- 1755326
TI  - Diabetes-induced decreased sensitivity to blocking drugs of autonomic ganglia and
      motor endplates: new hypothesis for an old observation.

PMID- 1755327
TI  - Vaccina treatment in some hospital infections.
AB  - Phenol-treated vaccine was prepared from the usual hospital strains and patients
      with colorectal cancer were immunized intramuscularly 7-10 days prior to the
      operation. The efficiency of the vaccine treatment was judged by the incidence of
      wound infections. The best results were obtained in patients whose previously
      estimated immunoreactivity was strong or normal. Immunospecificity could not be
      detected in the above treatment. The frequent and inappropriate use of
      antibiotics in hospitals increases the number of resistant hospital bacterial
      strains. Apart from Staphylococci and Streptococci, different Gram-negatives-
      such as Klebsiella, Serratia, Pseudomonas, Proteus and E. coli strains--have been
      found in the hospitals and in the patients. Due to the resistance, it is
      difficult to find antibiotics against them. This fact puts forward the
      possibility of immunization especially by vaccination.

PMID- 1755328
TI  - Prevention of anaphylactic death by macrophage blockade.
AB  - Data in the literature concerning the role of macrophages in anaphylaxis are
      contradictory. In the present study the effect of macrophage blockade induced by
      gadolinium chloride (GdCl3) on anaphylactic shock was investigated. Our
      observations show that GdCl3 prevents the lethal anaphylactic shock of mice
      sensitized to ovalbumin. GdCl3 given i.v. in a dose of 1 mg/100 g body weight 24
      or 48 h before the elicitation of anaphylactic shock resulted in 90% survival,
      compared to the 43% survival in the control group. The same dose of this rare
      earth metal salt also greatly reduced the mortality in mice sensitized with
      ovalbumin containing Bordetella pertussis vaccine, and the symptoms of
      anaphylaxis including the accumulation of 5-hydroxytryptamine in the liver. Our
      results suggest that macrophages play an important role in anaphylaxis.

PMID- 1755329
TI  - Experimental and clinicopharmacological study of rectal absorption of
      chloroquine.
AB  - Chloroquine administered as a rectal suppository is resorbed both in rabbits and
      human volunteers. Although the chloroquine blood level in rabbit is proportional
      to the dose investigated, the human rectal mucosa has a limited absorption
      capacity of chloroquine being saturated at 15 mg/kg dose. In spite of this
      saturation character the chloroquine applied as rectal suppository may be a
      suitable formulation to treat or prevent the malarial infection for persons
      unable to take the drug perorally, e.g. children, or unconscious adults, or
      persons suffering with GI complaints after swallowing the chloroquine tablet.

PMID- 1755330
TI  - Effects of simulated ischaemia on the electrical activity of ventricular
      myocardium in the presence of antiarrhythmic drugs.
AB  - The effects of a nutrient solution simulating the 'ischaemic milieu' (combined
      hyperkalaemia, hypoxia and acidosis) on the electrical activity of rabbit
      isolated ventricular myocardium were examined in the absence and presence of
      antiarrhythmic drugs. In such a simulated ischaemia the resting membrane
      potential, the rate of depolarization (Vmax) and the action potential duration
      (APD) were all diminished with a resultant decrease in conduction and a
      shortening of the effective refractory period (ERP). Sotalol, a Class 3
      antiarrhythmic drug (5 x 10(-6)-10(-5) M/l) afforded a marked protection against
      the "ischaemic" abbreviation of the ERP and APD. To a much lesser extent, the
      same applied to propafenone, a predominantly Class 1C antidysrhythmic agent (1.65
      3.3 x 10(-6) M/l). The 'ischaemia'-induced depression of Vmax was increased
      considerably by propafenone and diminished slightly by sotalol. The results are
      in keeping with the efficacy of propafenone and sotalol in ventricular
      arrhythmias of ischaemic origin and also with the proposal that the major
      mechanism by which propafenone inhibits postinfarction ventricular arrhythmias is
      a further depression of ischaemic myocardial cells resulting in conduction block
      of the reentrant wave front.

PMID- 1755331
TI  - Effect of Ca2+ antagonists on isolated rabbit detrusor muscle.
AB  - Ca(2+)-antagonists change the contractility of isolated detrusor smooth muscle of
      rabbit influencing the translocation of intra- and extra-cellular Ca2+. This
      observation might be of clinical importance in the treatment of disorders of
      urinary bladder function. During field stimulation of different segments of
      isolated rabbit bladder it was found that the specific Ca(2+)-antagonist
      nifedipine and verapamil and the non-selective Ca(2+)-antagonist fendiline,
      prenylamine and cinnarizine blocked the contractions induced by field stimulus to
      different extent, which decreased from the bladder towards the bladder base
      (fundus). The highest rate of blocking effect was produced by nifedipine followed
      by verapamil, prenylamine and fendiline, respectively. Cinnarizine exerted the
      lowest effect. The change in amplitude and frequency of spontaneous peristalsis
      was similar in its tendency to the blockade of the field stimulus induced
      contraction.

PMID- 1755332
TI  - Pharmacogenetically hazardous drugs: a proposed new scoring method.
AB  - Similar doses of a drug given to different individuals can result in widely
      disparate plasma concentrations and hence effects. Beside intraindividual
      differences also inter-ethnic differences of drug response must be taken into
      consideration. Both inter-individual and inter-ethnic variations of drug response
      are mostly related to genetic factors (polymorphism) involved in drug metabolism
      and kinetics. The farmacogenetic disorders involved clinically result in
      pharmacogenetic side effects. In order to avoid pharmacogenetic side effects,
      beside phenotyping of the patients, selection of drugs subjected to different
      pharmacogenetic disorders may be of great clinical importance. Therefore, a
      scoring method was carried out for the selection of pharmacogenetically hazardous
      drugs. With regard to both genetic and environmental factors influencing the drug
      response, 140 suspicious drugs were studied and classified with the method.
      Eighteen was the maximum point value for genetic and 12 for contributing factors
      involved, so 30 was the maximum point number in each drug studied. Out of 140
      substances 50 drugs (qualified with 20 points or more) proved to be hazardous in
      different pharmacogenetic disorders, among them several widely used agents, e.g.
      Diazepam, Isoniazid, Phenytoin, Warfarin, Quinidine, Tolbutamide, etc. The
      article sums up the findings in a Table and comments them. This scoring method
      may be useful in drug safety and preventive medicine.

PMID- 1755333
TI  - Abrogation of neonatally induced permanent transplantation tolerance in mice:
      quantitative aspects.
AB  - Neonatal transplantation tolerance was induced in CBA (H-2k) mice by the
      intravenous injection of 20 million (CBAxA)F1 spleen cells to the transplantation
      antigens of the A mouse strain. Those mice which carried an A (H-2a) skin
      allograft without any sign of rejection for at least 120 days, were considered to
      be permanently tolerant and were selected for further experiments. Abrogation of
      permanent transplantation tolerance was achieved by injecting the tolerant mice
      with different doses (50, 100 and 200 millions, respectively) of normal syngeneic
      (CBA) lymphoid (spleen) cells. Dynamics of the rejection of the test skin
      allografts tolerated so far revealed well reproducible dose-response curves.
      Further groups of tolerant CBA mice were given 10, 50, 100, or 200 million
      "sensitized" (G + 16) CBA spleen cells: "sensitization" by A-skin allografting
      was performed 16 days before. The sensitized spleen cells abolished the state of
      tolerance more vigorously and effectively than the normal CBA spleen cells did.
      In a third group of experiments, the abrogating capacity of 50 million sensitized
      CBA spleen cells 16, 120, 240, or 360 days after sensitization was compared. The
      efficacy of the sensitized cells in abolishing the state of tolerance decreased
      continuously, but, even 360 days after sensitization a remarkably strong
      immunologic memory was demonstrable. The excellent quantitative correlations
      found between the number of the injected lymphoid cells and the dynamics of the
      abrogation of tolerance offer a highly promising new possibility for studying the
      immunological activity, the immunologic memory, etc., of the different lymphoid
      cell (sub)populations in performing the transplantation immune reactions.

PMID- 1755334
TI  - Analysis of galactosyltransferase activity in rat gastric mucosa using crude
      mucosal homogenate.
AB  - Mucus glycoprotein is one of the major components of gastric mucus which plays an
      important role in mucosal defensive mechanisms as a mucus-bicarbonate barrier.
      Analysis of the mucus glycoprotein synthesis is a useful tool for evaluating
      gastric mucosal defensive factors. UDP-galactosyltransferase (UDP-Gal-T) is one
      of the regulating enzymes for the synthesis of the mucus glycoprotein. In the
      present paper, we studied assay methods for UDP-Gal-T activity in rat gastric
      mucosa using radiolabeled UDP-galactose and two different kinds of acceptor
      proteins, namely ovomucoid and asialomucin, and analyzed effects of antisecretory
      agents on the UDP-Gal-T activity. We used crude supernatants of homogenized
      scrapings of the fundic part of rat stomach as an enzyme preparation and
      determined optimal conditions. In each acceptor, Mn2+ and the non-ionic detergent
      Triton X-100 were required for the enzyme activity. With each acceptor molecule,
      the type of glycosidic linkages of galactose was beta-type linkage. With
      asialomucin as an acceptor, UDP-Gal-T activities of rat gastric mucosa decreased
      after intraperitoneal administration of antisecretory agents, while change of the
      enzyme activity was not observed with ovomucoid as an acceptor.

PMID- 1755335
TI  - A monoclonal antibody which recognizes the inner and outer segments of the
      photoreceptor cells in the vertebrate retina.
AB  - A monoclonal antibody (MAb-1E7), generated against bovine retinal homogenate,
      labeled the outer and inner segment layers of the vertebrate retina. Immuno
      electron microscopic observation clearly demonstrated that antigen(s) bound by
      MAb-1E7 was localized in the cell membrane of the outer segment and the distal
      portion of the inner segment. Western blot analysis revealed that MAb-1E7
      recognized 40 kD- and 27 kD-polypeptides. Mouse retina with hereditary
      photoreceptor degeneration (C3H/He and CBA strains) did not involve the MAb-1E7
      immunoreactive structures. The present immunocytochemical observation
      demonstrated that MAb-1E7 was highly specific to the outer segment of the
      photoreceptor cells and, therefore, can be a useful marker for the cells.

PMID- 1755336
TI  - Successful use of the centrifugal ventricular assist device for postcardiotomy
      cardiogenic shock.
AB  - A centrifugal pump was successfully used as a left ventricular assist device
      (LVAD) in a 54-year-old female who developed cardiogenic shock following open
      heart surgery. Cardiac index prior to the LVAD support was 1.4 l/min/m2 and
      increased to 3.0 l/min/m2 at removal of the device, which assisted for 88h. She
      resumed her daily activity 10 months after the operation and is in New York Heart
      Association functional class I.

PMID- 1755337
TI  - The role of catalase in protecting erythrocytes against methemoglobin formation.
AB  - Some mechanisms to reduce methemoglobin (metHb) formation for the maintenance of
      normal oxygen transport have been proposed. To study the role of catalase (EC
      1.11.1.6), metHb formation in the hemolysate of normal and Japanese acatalasemic
      human subjects were examined spectrophotometrically. Significantly increased
      level of metHb was induced by potassium ferrocyanide in the hemolysate of
      acatalasemic subject. The addition of catalase reduced the metHb formation, while
      3-amino-1,2,4-triazole (AT), a specific inhibitor of catalase-H2O2 compound I,
      increased it. These results obtained from human subjects were well consistent
      with those from mice and suggested that catalase plays a role in protecting
      erythrocytes against metHb formation.

PMID- 1755338
TI  - Doppler echocardiographic evaluation of Bjork-Shiley and St. Jude Medical
      prostheses in the mitral position.
AB  - The left ventricular studies by Doppler echocardiography were performed in 50
      patients with a Bjork-Shiley (B-S) mitral valve and 50 patients after
      implantation of a St. Jude Medical (SJM) mitral valve; the effect of valve
      replacement on the hemodynamic performance at rest and during bicycle exercise
      was determined from serial echocardiographic data. Twenty-eight patients (56%) of
      the B-S group and 42 patients (84%) of the SJM group showed a good response to
      the exercise. There was no significant difference in the effective orifice area
      at rest among each sizes of the B-S valve. In the SJM valve, on the contrary, the
      effective valve orifice area increases in parallel to the size of the SJM valve.
      There was a clear relation between the valve size and pressure gradient. The
      pressure gradient directly depends on the valve size and the effective orifice
      area in the SJM valve. High pressure gradient group in both prostheses had a
      tendency to take negative values of percent increase in stroke volume. Further,
      there were no cases showing positive values of percent increase in end-diastolic
      volume among the patients whose pressure gradients were assumed to be more than
      10 mmHg at rest. It is suggested that impairment of inflow caused by the
      artificial valve, prosthetic valve stenosis, is possibly a significant factor
      causing left ventricular dysfunction, notably a decrease in stroke volume during
      exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755339
TI  - Effects of L-dopa or dopamine on human decidual prostaglandin synthesis.
AB  - L-Dopa and three catecholamines in the amniotic fluid before and after labor were
      measured to confirm the amniotic fluid catecholamine levels at the end of
      gestation. L-Dopa values were higher than those of three catecholamines, and
      dopamine which was the predominant catecholamine, rose significantly after the
      onset of labor. Then, to evaluate the effects of L-dopa or dopamine on
      prostaglandin synthesis, strips of human decidua vera obtained from fetal
      membranes at the time of elective cesarean sections before the onset of labor
      were incubated in Krebs-Ringer buffer in the presence of L-dopa or dopamine. When
      L-dopa was added, the net production of prostaglandin(PG)F was significantly
      greater than that of the control at each incubation time. On the other hand, the
      significant rise was observed only after 10 min of incubation for PGE2
      production. Dopamine had a stimulatory effect on PGF synthesis only after 15 and
      30 min of incubation, and it also stimulated the release of PGE2 at each
      incubation time. These results suggest that dopamine and L-dopa in amniotic fluid
      stimulate the production of prostaglandin by the decidua in humans.

PMID- 1755340
TI  - Effect of a protease inhibitor on the stability of catalase in liver and blood
      from acatalasemic and normal mice.
AB  - Effects of Gabexate mesilate (GM) (([ethyl-4-(6-guanidino hexanoyloxy) benzoate]
      methane sulfonate)), a protease inhibitor, on the activities of catalase in
      liver, erythrocytes and reticulocytes from acatalasemic mice were examined.
      Preincubation without GM at 37 degrees C for 160 min lowered the catalase
      activities of liver, erythrocytes and reticulocytes from acatalasemic mice, to
      24%, 40% and 10% of the initial levels, respectively. But, preincubation with GM
      at 37 degrees C for 160 min delayed the rapid decrease in activities of residual
      catalases in the liver, erythrocytes and reticulocytes of acatalasemic mice to
      65%, 93% and 85% of the initial values, respectively. At 20 degrees C or below,
      no reduction in catalase activity of reticulocytes from acatalasemic mice
      occurred with or even without GM. At pH 5.0, the decrease in catalase activity of
      acatalasemic mice was small both in the presence and the absence of GM. In the
      alkaline range, the reduction in the enzyme activity of the mutant mice without
      GM was enhanced with increase in pH values up to 8.5. But the presence of GM
      during preincubation at pH 7.5, retained the catalase activity of acatalasemic
      mice, to 64% of the activity at pH 6.5. These data suggest that some factors
      affected by GM, might be responsible for the low stability and activity of
      catalase in the acatalasemic mice.

PMID- 1755341
TI  - High tech is most effective when blended with high touch and vice versa: office
      technology in the 21st century.

PMID- 1755342
TI  - Cholesterol: truth in labeling.

PMID- 1755343
TI  - Chasing the medical literature.

PMID- 1755344
TI  - Emotional health in nursing-home patients.

PMID- 1755345
TI  - The family stress and support inventory (FSSI).
AB  - The Family Stress and Support Inventory (FSSI) is a new self-report family
      assessment instrument that is theoretically grounded in sociological and family
      stress theory and designed to provide a brief, reliable, valid, quantifiable, and
      global assessment of the intrafamilial stress and support variables. With
      reference to clearly defined constructs, the respondents rate on a continuum of 1
      10 the amount of stress and support that they feel from each individual family
      member. Scale analysis and psychometric evaluation were completed on a randomly
      selected sample of 382 people chosen from family practice clinics throughout
      Minnesota and the University of Minnesota faculty and staff. The test-retest
      correlations are r = .78, p = .00 for the FSSI Support scale, and r = .68, p =
      .00 for the FSSI Stress scale. Correlation with social desirability is negligible
      (r = -.01, p = ns for FSSI Support; r = .11, p = .02 for FSSI Stress). The FSSI
      Stress scale demonstrates moderately high concurrent validity with the Family
      Inventory of Life Events and Changes (FILE), another family stress measure (r =
      .50, p = .00), indicating that both assess similar, but not identical, family
      stress dimensions. The correlation between the FSSI Support scale and the Family
      Inventory of Resources for Management (FIRM), another measure of family
      resources, however, was only r = .10, p = .05, indicating that these two measures
      evaluate different family support dimensions. The FSSI has many potential
      applications in family medicine research and clinical care where the
      intrafamilial stress and support variables must be quantified.

PMID- 1755346
TI  - Hyperemesis gravidarum: a case report suggesting new concepts and research needs.
AB  - Hyperemesis gravidarum has been considered an emotional disorder. Recent studies
      suggest that reflux esophagitis in combination with gastric dysrhythmias causes
      hyperemesis. A 10-week-pregnant 28-year-old woman treated successfully with
      antiemetics was shown to have fluctuations in gastric pH consistent with gastric
      dysrhythmia and reflux. Although drugs with antiemetic activity give symptomatic
      improvement, further research is needed to discover safe medications to treat the
      underlying gastric dysrhythmia.

PMID- 1755347
TI  - Experience with colposcopy in a family practice center.
AB  - The experience of a family practice center that performed colposcopy for one year
      was reviewed to provide insight into the appropriateness of this procedure to a
      family practice clinic. Almost three thousand Papanicolaou smears were performed,
      which prompted 97 colposcopy clinic appointments involving 68 patients.
      Dysplastic Pap smears accounted for 1.82% of the total. Atypical Pap smears
      occurred in 3.91% of the tests, and 16.1% of a sample of these demonstrated
      dysplasia. Controversy concerning the atypical Pap smear is discussed. The
      colposcopy service was convenient for the patients and was at least revenue
      neutral while providing a new professional opportunity for selected family
      practitioners. A referral base of at least 1,000 Pap smears might justify a
      colposcopy program, depending on referral strategies.

PMID- 1755349
TI  - Utilization of MEDFILE--a preprinted medical literature filing system.
AB  - To facilitate the creation of a personal medical literature filing system, we
      developed MEDFILE, a noncomputerized, preprinted medical literature filing
      system. A graduating medical school class that had access to MEDFILE and a
      control group of incoming interns were studied to ascertain satisfaction, usage,
      utility, and implementation of MEDFILE in comparison with traditional literature
      filing systems. Data were obtained from 52 recent graduates of the site school
      and 25 graduates of other institutions. MEDFILE users had a significantly higher
      satisfaction level (7.3 +/- 1.5 vs 4.5 +/- 2.7, p less than .0001, two-tailed t
      test), a more extensive filing system (p less than .02, chi square), and greater
      confidence that their filing system would remain useful during residency (p less
      than .0001, Fisher's exact test) than new graduates who had created their own
      filing systems. The data indicate that MEDFILE is an efficient, effective, and
      inexpensive method of organizing medical reprints. It may be particularly useful
      for physicians entering primary care disciplines that require information
      processing over a wide range of clinical topics.

PMID- 1755348
TI  - Do public cholesterol screenings really screen?
AB  - Two hospital-sponsored cholesterol-screening programs were evaluated to assess
      whether they detected individuals with undiagnosed high blood cholesterol.
      Surveys asking about prior testing, knowledge of cholesterol level, and
      participant characteristics were examined to test screening utilization. In both
      screenings 54% of participants reported having prior cholesterol testing, only
      56% of whom knew their cholesterol level. Of previously untested participants, 8%
      had high blood cholesterol levels and 13% had borderline levels. Only 65% of
      participants with a personal or family history of heart attack were aware of
      their cholesterol level. To attract individuals without prior testing, screening
      planners should consider locations (eg, worksites and schools) and methods (eg,
      weekend screenings) to target underrepresented groups in community-wide
      cholesterol screenings. We encourage an increased emphasis on individualized exit
      education for participants, especially those who know their cholesterol level or
      have multiple risk factors for vascular disease. Physicians planning public
      screenings can utilize this data to develop parameters for referrals from the
      screenings.

PMID- 1755350
TI  - Primary family contacts and emotional health in the institutionalized elderly.
AB  - Research among nondemented elderly living independently in the community suggests
      that increased social support is associated with improved emotional and physical
      health. Relatively little research has examined associations between social
      supports and health among the institutionalized elderly. A sample of 70
      nondemented, elderly nursing-home patients was studied to determine associations
      between qualitative and quantitative aspects of patients' relationships with
      their primary family contact and measures of emotional well-being, including
      depression, hopelessness, and life satisfaction. Significant correlations between
      quality of relationships and all domains of emotional well-being were found. None
      of the correlations between frequency of interaction and measures of emotional
      health were significant. A hierarchical regression analysis demonstrated that the
      correlation between quality of relationships and depression and life satisfaction
      was independent of functional status, mental status, age, type of relation, and
      frequency of visits. These results are consistent with studies of the
      noninstitutionalized elderly.

PMID- 1755351
TI  - Predicting the occurrence of antibiotic-induced candidal vaginitis (AICV).
AB  - This paper reports the sensitivity, specificity, and predictive values of
      symptoms in the diagnosis of antibiotic-induced candidal vaginitis (AICV) among
      74 women recruited from three primary care practices. All subjects, who were
      examined both pre- and post-antibiotic treatment for acute respiratory, urinary
      tract, or skin infections, were initially free of vaginitis. Twenty-four subjects
      developed candidal vaginitis (CV), indicated by vaginitis symptoms or signs and a
      positive candidal culture or KOH preparation; there were no mixed infections.
      Fifty women did not develop AICV and, of this group, four developed a nonyeast
      vaginitis. Aggregate symptoms (pruritus and/or discharge) had 87.5% sensitivity,
      95.8% specificity, and positive and negative predictive values of 91.3% and
      93.9%, respectively. These values are much higher than those reported in studies
      of CV that excluded women on antibiotics. We conclude that women who develop
      vaginitis symptoms while on short courses of antibiotics may be treated as AICV
      without confirmatory examination.

PMID- 1755352
TI  - Physician impairment: physicians' exposure, attitudes, and beliefs.
AB  - Concern about physician impairment has resulted in increased efforts to educate
      physicians about its nature and scope. This study reports the results of a survey
      of how family physicians obtain information about impairment, which sources they
      value, and how exposure to impairment relates to their attitudes and beliefs. A
      significant association was found between involvement in group-oriented programs
      and recognition of risk factors unique to the profession. Important differences
      were found between physicians who acknowledged the role of personal vulnerability
      in impairment and those who attributed causality to external sources. Results
      also revealed that this sample of physicians was almost equally divided on
      whether impairment should be defined exclusively by professional conduct.

PMID- 1755353
TI  - Dynamic structural views of muscle contraction and its control.

PMID- 1755354
TI  - Changes in the X-ray diffraction pattern from rigor muscles by application of
      external length changes.
AB  - The effect of external force on the X-ray pattern from frog muscles in rigor was
      studied by a time-resolved diffraction technique. When sinusoidal length changes
      (1.5-3% of the muscle length, 5 Hz) were applied to the muscle, the 14.3 nm
      intensity decreased during the releasing phase and increased during the
      stretching phase. The intensity ratio of the equatorial 1.0 and 1.1 reflections
      did not change, nor were there any appreciable intensity changes in the 5.9 nm
      and 5.1 nm reflections during the length change. Experiments were also done with
      the relaxed muscles and no change was seen in any reflection, indicating that the
      rigor linkages are needed to produce the 14.3 nm intensity change. Thus the
      distinct effect of the length change was detected only on the 14.3 nm reflection.
      These results suggest no large conformational changes are induced in both the
      distal part of the myosin head attached to actin and the actin filament during
      the oscillation. It is therefore most probable that the proximal portion of
      myosin heads including S-2 contributes to the intensity change in response to the
      length change (see, also ref. 21). When the muscle was stretched beyond the
      filament overlap, the 14.3 nm intensity change was suppressed to less than 50% of
      that of the slack length. It was also found that the tension change delayed the
      intensity change during the length oscillation. However, this delay of the
      tension change as observed in the muscle at the slack length was lacking in the
      overstretched muscle, indicating that the 14.3 nm intensity change may arise
      partly from a portion other than the crossbridges.

PMID- 1755355
TI  - Mechanism of force generation studied by neutron scattering.
AB  - Neutron scattering has been used to compare the structure of myosin S1 that is
      free in solution to that when it is bound to F-actin. To achieve this, deuterated
      actin was obtained from D. discoideum that had been fed deuterated E. coli. This
      deuterated actin was rendered "invisible" to neutrons when dissolved in 94% D2O.
      The neutron scattering patterns obtained from S1 bound to deuterated actin were
      identical to those of free S1 except for oscillations due to S1's bound to the
      same actin filament. At low S1 to actin stoichiometries, these oscillations
      diminish and the patterns become indistinguishable. The apparent radius of
      gyration of S1 bound to actin is identical to that of free S1 when the
      stoichiometry is low. Thus, no changes in the structure of S1 were observed to a
      resolution of 2.5 nm. Computer modelling studies were used to evaluate the
      compatibility of models for the mechanism of force generation with the neutron
      data. These studies show that for powerstrokes greater than 5.0 nm, the data are
      consistent with more than 80% of the crossbridge maintaining a rigid conformation
      during force generation.

PMID- 1755356
TI  - Recent neutron scattering studies of muscle contraction and its control.
AB  - We have presented two applications of the method of neutron scattering utilizing
      selective deuteration of actin. In these experiments the actin was rendered
      effectively invisible to neutrons by matching the scattering-length densities of
      deuterated actin and the solvent. The scattering of neutrons by myosin S1 and by
      Tm bound to this actin was studied. For free chymotrypsin-generated S1 it was
      found that Rg = 4.0 +/- 0.15 nm, while for papain-generated S1 it was found that
      Rg = 4.6 +/- 0.2 nm. Upon binding of papain-generated S1 to actin at low NS1/N
      actin ratios, the change in Rg in difference experiments was delta Rg = 0.05 +/-
      0.15 nm. This lack of significant change in Rg in the very low-s domain confirms
      and extends our earlier neutron scattering work in the higher-s domain. The
      longest chords of S1, as well as shorter ones, are not significantly altered upon
      actin binding. These results indicate that muscle contraction does not occur as a
      result of large-scale changes in S1 structure. In actin-Tm complexes, a
      measurement of the mean cross-helix separation, d, of Tm molecules has been made
      using neutron scattering. With deuterated actin matched out in 93% D2O buffer, it
      was found that d = 7.9 +/- 0.3 nm. This value is in good agreement with a model
      based on Tm crystallography and also with recent electron microscopy results.
      These experiments demonstrate the feasibility and value of neutron diffraction
      and scattering techniques in the study of muscle contraction and its control. One
      can expect that the further employment of emerging cell biology techniques for
      generating deuterated proteins will aid our understanding of muscle in the
      future.

PMID- 1755357
TI  - Two-dimensional time resolved X-ray diffraction of muscle: recent results.
AB  - This report provides a preliminary sketch of the results obtained in a two
      dimensional time resolved X-ray diffraction study of "live" frog sartorius
      muscles undergoing isometric tetani. These results demonstrate the recently
      developed capability to record time resolved (10 msec time resolution), two
      dimensional X-ray diffraction diagrams throughout the cycle of contraction. The
      correlation between the time courses of the diffraction features in the whole of
      the diffraction diagram establishes a sequence of structural events, which
      suggest that during the transition from rest to the plateau of tension and the
      subsequent recovery, the following sequence of events takes place: a) Following
      the activation phase, which is best monitored by the increase of intensity on the
      second actin layer line at 18.0 nm spacing (5), there is the onset of three
      dimensional disorder due to the filaments losing their axial alignment and the
      myosin heads rotating azimuthally and moving radially outwards. A set of low
      angle layer lines, following the actin based spacings seen in rigor (i.e., at
      spacings of ca. 36.5-37.5, 24.0 and 18.0 nm) become visible and those at ca. 24.0
      and 18.0 nm appear to increase in intensity during this phase with a time course
      that cannot be determined accurately because of the proximity of the neighbouring
      first, second and third myosin layer lines and the weakness of these diffraction
      features. Whether the first of these layer lines increases or not is difficult to
      ascertain. Moreover, proper account of the loss in crystallinity during the
      development of tension must be made before the comparisons in intensity between
      the rest and peak of tension states have any significance. Nevertheless, these
      features together with the behaviour of the equatorial reflections and the
      meridional region of the third myosin layer line indicate that a sizeable
      fraction of the crossbridges may become axially disposed with an actin based
      periodicity. The formation of this complex does not immediately result in the
      generation of tension. The labelling of the thin filaments is also reflected in
      the main actin layer lines at 5.9 and 5.1 nm. b) The tension generating phase is
      monitored by the intensity changes in the meridional region of the third myosin
      layer line, which are best explained by a change in the orientation/conformation
      of the tension bearing crossbridges, (which probably adopt a more perpendicular
      orientation to the filament axis). c) At the end of stimulation, the crossbridges
      return to an axial spacing and axial orientation (although not yet azimuthal)
      similar to the one at rest.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1755358
TI  - Structural analysis of muscle thin filament.
AB  - Thin sheets of Ac-Tm-Tn paracrystals were prepared in the presence of high
      concentration of Ca2+ ion and three-dimensional image analysis was performed. The
      optical diffraction pattern of an electron micrograph showed spots up to 1/1.6 nm
      1 in the radial direction and up to 1/2.5 nm-1 in the axial direction, the best
      resolution ever obtained so far. The translationally filtered image showed clear
      polarity of filament which looked like a "spearhead" per each crossover repeat of
      actin helix. The three-dimensionally reconstructed model looked very similar to
      the inner regions (A+B domains) of the Ac-Tm-S1 complex obtained by Toyoshima and
      Wakabayashi (14, 15) when they were placed so that the "spearhead" pattern of the
      Tc-Tm-Tn complex and the "arrowhead" pattern of the Ac-Tm-S1 complex pointed in
      the same direction. The myosin-binding site of actin was identified by comparison
      of the two structures. The model of actin molecule cut out from the thin filament
      model had a low density region within itself, which was located about 2.5 nm from
      the helix axis. That low density region divided actin molecule into two domains,
      a large and a small domain. A dense "pillar" was detected which connected two
      neighboring actin molecules along a left-handed generic helix 1 nm from the helix
      axis. Two actin-actin binding sites which were responsible for the connection
      through the "pillar" were located on the inner surface of actin molecule. To
      obtain better crystalline arrays of actin, we tried a method utilizing adsorption
      to lipid. A positively-charged monolayer of lipids was formed on the surface of a
      small volume of buffer solution which was put in a microwell. Solution of
      negatively-charged F-actin was then injected into the buffer solution and was
      allowed to be joined to the lipid monolayer by electrostatic attraction. Fluidity
      of the lipid monolayer enabled the two-dimensional crystallization of actin.
      Electron microscopy revealed that larger paracrystalline arrays were formed more
      rapidly (less than 1 hr) than those formed within solution, which demonstrated
      the advantage of this adsorption method.

PMID- 1755359
TI  - Cryo-electron microscopy of S1-decorated actin filaments.
AB  - We have applied techniques for cryo-electron microscopy, combined with image
      processing, to both S1-decorated native thin filaments and S1-decorated actin
      filaments. In our reconstruction the actin subunit has a prolate ellipsoid shape
      and is composed of two domains. The long axis of the monomer lies roughly
      perpendicular to the filament axis. The myosin head (S1) approaches the actin
      filament tangentially, the major interaction being with the outermost domain of
      actin. To distinguish the position of tropomyosin unambiguously in our map, we
      compared the maps from decorated thin filaments with those from decorated actin
      filaments. Our difference map clearly shows a peak corresponding to the position
      of tropomyosin; tropomyosin is bound to the inner domain of actin just in front
      of the myosin binding site at a radius of about 40 A. As a first step toward
      looking at the actomyosin structure in a state other than rigor, we examined S1
      crosslinked to actin filaments by the zero-length crosslinker EDC in the presence
      of ATP and after pPDM bridging of the reactive thiols of S1. S1 molecules of the
      cross-linked complexes in the presence of ATP and after pPDM treatment appear
      dramatically different from those in rigor. The S1s appear more disordered and no
      longer assume the characteristic rigor 45 degrees angle with the actin filaments.

PMID- 1755360
TI  - Conformations of crossbridges in contracting skeletal muscle.
AB  - Conformations of crossbridges during isometric contraction were observed and
      compared with those in rigor state. Rabbit skeletal muscle fibers were chemically
      skinned, rapidly frozen during isometric contraction or in the rigor state, then
      freeze-substituted. Longitudinal and cross sections were observed. Crossbridges
      in contracting fibers are arranged on the thin filament, retaining a periodicity
      of approximately 14.3 nm with some variability, while crossbridges in rigor
      fibers tend to attach to actin target zones which have a periodicity of
      approximately 36 nm. Rigor crossbridges are wide near the thin filament;
      crossbridges in contracting fibers are thinner and have more uniform width from
      the proximal region to the distal region. The majority of the mass of the
      crossbridges during contraction is not as close to the thin filament as in rigor
      fibers. Shapes of crossbridges during contraction are variable, especially when
      viewed along the filament axis.

PMID- 1755361
TI  - Flexibility in actin-myosin motility system revealed by in vitro motility assay.
AB  - Flexibility of myosin molecule was studied by in vitro motility assay in terms of
      the direction of actin movement. Electron microscopy showed that HMM scattered on
      a nitrocellulose surface can bind actin filaments and form arrowhead-like
      patterns. Actin filaments can move in both directions on tracks of HMM made on a
      nitrocellulose surface. Further, actin filaments can move bidirectionally along
      native thick filaments over their central bare zone. These observations indicate
      that there is considerable flexibility in a myosin molecule and that the
      direction of the movement is determined by the polarity of actin filaments.

PMID- 1755362
TI  - Myosin I: a new insight into the mechanism and cellular significance of actin
      based motility.
AB  - From our work on brush border myosin I structure, activity, regulation, and
      function, we can begin to understand the significance of the diversification of
      myosin proteins. While myosin I and II proteins retain conserved elements of
      structure that may dictate their similar mechanisms of motility and actin
      activated MgATPase activity, their unique structures may provide the basis for
      the distinct localization and regulation of the two myosin types. How does the
      tropomyosin-inhibited actin-binding site of myosin I differ from that of the
      tropomyosin-activated myosin II actin-binding site? What elements of the sites of
      interaction of the 110K-protein and calmodulin contribute to the conserved, light
      chain dependent coupling of MgATPase activity to translocation and which confer
      the novel calcium regulation of dissociation in vitro? It seems that the
      evolutionary demand for diversification of cellular motility functions has been
      met, at least in the actin-based system, by the evolution of isoforms tailored in
      structure, activity, regulation, and localization to serve complementary needs.

PMID- 1755363
TI  - Spontaneous oscillatory contraction (SPOC) of sarcomeres in skeletal muscle.
AB  - Skeletal myofibrils spontaneously oscillate under a condition where ATP, ADP, and
      Pi coexist and the concentration of free Ca2+ is less than about 1 microM.
      Although this oscillation phenomenon called SPOC is apparently simple, the
      molecular mechanism seems to be complex. The SPOC condition and the space-time
      pattern of SPOC wave suggest that the dynamics of association and dissociation of
      Pi (ADP) is regulated by the mechanical strain imposed on actin and myosin; the
      enzymatic activity (ATPase) of actomyosin complex and the mechanical event
      (contraction) are thus coupled to each other. In this sense, the nature of the
      mechanochemical enzyme, actomyosin ATPase, is revealed in SPOC.

PMID- 1755364
TI  - Dynamic actin interaction of crossbridges: a general principle and its
      implications for crossbridge action in muscle.
AB  - The oar-like crossbridge cycle, developed up to the mid-1970's, was shown to be
      inconsistent with more recent biochemical results. In crossbridge theories
      developed on the basis of the more recent kinetic schemes of the actomyosin
      ATPase in solution (Eisenberg and coworkers), however, the key elements proposed
      by Huxley (1957) were retained, one of which is the assumption that detachment of
      a force-generating crossbridge can only occur via completion of the ATPase cycle
      (release of ADP and rebinding of ATP). Furthermore, in these theories regulation
      is assumed to act by blocking/unblocking of a step subsequent to crossbridge
      attachment (e.g., Pi-release step). Both concepts, however, were recently shown
      to be in conflict with studies on skinned muscle fibers (still low ATPase
      activity at high-speed isotonic shortening, regulation acts via turnover kinetics
      and not recruitment (39]. By incorporation of the observed reversible actin
      interaction of crossbridges in all states, including the force-generating states,
      a working hypothesis can be developed (Fig. 5) which can account for the isotonic
      data. A mechanism by which such a scheme can also account for regulation via
      turnover kinetics was previously discussed (39).

PMID- 1755365
TI  - Dynamic X-ray diffraction of skeletal muscle contraction: structural change of
      actin filaments.
AB  - The X-ray diffraction pattern recorded during contraction shows that the force
      generation of a muscle proceeds upon interaction of the actin and myosin heads in
      the incommensurate structural framework of the thin and thick filaments. In this
      molecular framework the binding of myosin heads to actin filaments is thought to
      occur on a random basis. Such an actomyosin structure would not produce
      constructive interference between scattered X-rays from the bound heads and the
      thin filaments. The characteristic intensity changes of the thin filament layer
      lines that occur during contraction suggest strongly that the actin structure is
      varied by interaction with the myosin heads, in a manner that is quite different
      from that in the rigor state. Variability of the time courses of the intensity
      changes of the various layer lines indicates that structural change within the
      thin filament does not take place uniformly and that some different structural
      processes are involved during contraction At the plateau of isometric
      contraction, the thin filament structure as a whole assumes a more four-stranded
      nature due to the changes in the actin structure and tropomyosin position. Our
      present results imply that the changes of actin structure induced by interaction
      with myosin heads would be responsible for the regulation as well as force
      generation in muscle contraction.

PMID- 1755366
TI  - Intensification of the first actin layer-line during contraction of frog skeletal
      muscle.
AB  - The peak position of the first myosin layer-line in frog skeletal muscle shifts
      towards the higher angle during contraction. An analysis showed that the observed
      axial intensity profile of the first myosin layer-line is fitted well by
      summation of two layer-lines at 1/43.0 and 1/36.0 nm-1. The former corresponds to
      the first myosin layer-line, and the latter to the first actin layer-line whose
      intensity the analysis shows to increase in 0.03-0.08 nm-1 but to decrease in
      0.08-0.14 nm-1 during contraction.

PMID- 1755367
TI  - Crossbridge states in isometrically contracting fish muscle: evidence for
      swinging of myosin heads on actin.
AB  - We have previously shown that time-resolved X-ray diffraction studies of the 2-D
      pattern from isometrically contracting flatfish (turbot) fin muscle have
      considerable advantages over similar studies of other vertebrate muscles due to
      the simple lattice and the better long-range order in these muscles (5, 24). Here
      we show not only that two structurally different myosin head to actin attached
      states must exist in the crossbridge cycle but that we are also able to define
      the likely crossbridge configurations in these states. A non-force producing
      "weak-binding" state is evident from the lead of the (11) equatorial reflections
      (and actin mass) time-course relative to that of tension (and the (10) equatorial
      reflection decrease) by about 30 msec. The first myosin layer line at 429 A has a
      weakened but altered intensity distribution, with no change in axial spacing, in
      patterns from active muscle. We show this to be consistent with myosin heads
      binding in the non-specific manner envisaged for the "weak-binding" state.
      Evidence for the second force-producing attached state, or series of states,
      comes from the observation of only a small increase in the intensity of the 360 A
      actin layer line between resting and active muscle patterns. It might be thought
      that a substantial increase in this layer line would be expected if myosin heads
      were even transiently attached to the thin filaments in a force-producing state.
      However, this is not so because internal changes in the structure of the thin
      filaments in active muscle have the opposite effect of causing this layer line to
      decrease in intensity. Observation of a small net intensity increase is therefore
      evidence for myosin head attachment with the symmetry of the actin helix. From
      the equatorial diffraction pattern, Fourier synthesis maps were computed at 10
      msec intervals throughout the isometric tetanus, enabling changes in the mass
      distribution to be visualised between the force- and non-force producing
      populations of crossbridges. This difference map shows that in the force
      producing state myosin heads have their centres of mass on average at a smaller
      radius from the thin filament axis compared to the case for non-force producing
      myosin heads. Since there is good evidence that there is no substantial change in
      myosin head shape during contraction (30) these observations are consistent with
      myosin heads swinging on actin as fairly rigid structures.

PMID- 1755368
TI  - X-ray studies of thin filaments in a tonically contracting molluscan smooth
      muscle.
AB  - In the X-ray pattern of the ABRM, layer lines from the thin filaments can be
      clearly observed not only at the small angles but also at the medium angles up to
      0.145 A-1, and the layer lines are changed in intensity in the tonically
      contracting state in both the small and medium angle regions. Because tropomyosin
      does not contribute significantly to the layer lines except the three near the
      equator, it is suggested that structural change of actin occurs in the tonically
      contracting state. The intensity profiles of the layer lines with the 0th Bessel
      order corresponding to the axial periods 27.9, 13.8, 9.3, and 6.9 A indicate
      axial staggering of the inner and outer domains of actin by about 1/3 of the
      axial period of actin, and the presence of a small mass on the shoulder of the
      outer domain at a distance of 50 A from the filament axis. The difference
      Patterson functions calculated from the intensities of the four layer lines with
      the 0th Bessel order suggest that peptide chains are oriented perpendicularly to
      the filament axis in the actin molecules. The peptide chain direction is
      presumably tilted against the filament axis in the outer part of actin as a
      result of structural change by tonic contraction.

PMID- 1755369
TI  - X-ray diffraction studies on muscle regulation.
AB  - Using the intensity of the outer part of the second actin layer line as an
      indicator of thin filament conformation in vertebrate muscle we were able to
      identify the four different states of rest, and the three states induced by the
      presence of Ca2+ ions, rigor bridge attachment and actively cycling bridges,
      respectively. These findings are in qualitative agreement with a number of
      biochemical studies by Eisenberg and Greene and others, indicating that
      activation of the thin filament depends both on Ca2+ ions and crossbridge
      binding. Yet quantitatively, the biochemical data and our structural data are
      contradictory. Whereas the biochemical studies suggest a strong coupling between
      structural changes of the thin filament and the ATPase activity, the structural
      studies indicate that this is not necessarily the case. Troponin molecules also
      change their conformation upon activation depending on both Ca2+ ions and
      crossbridge binding as demonstrated by the early part of the time course of the
      thin filament meridional reflections in contracting frog muscle. Low ionic
      strength which has been shown by Brenner and collaborators to increase weakly
      binding crossbridges in relaxed rabbit psoas muscle does not influence the
      intensity of the second actin layer line in this muscle. Yet in contracting frog
      muscle the increase of the second actin layer line increases very rapidly in one
      step, suggesting that weak binding bridges which are attached to actin prior to
      force production may indeed influence the thin filament conformation. It
      therefore appears that weakly bound bridges in the low ionic strength state do
      not have the same effect on the thin filament conformation as weakly bound
      bridges in an actively contracting muscle. Arthropod muscles like the thin
      filament regulated lobster muscles differ from vertebrate muscle in not showing
      an increase of the second layer line during contraction, which may have to do
      with differences in crossbridge attachment. The myosin-regulated molluscan muscle
      ABRM shows a large increase on the second actin layer line upon phasic
      contraction and a much smaller increase in catch or rigor, indicating that
      actively cycling bridges influence the thin filament conformation differently
      than catch or rigor bridges. Several pieces of evidence which we have briefly
      outlined in this paper suggest that the thin filament conformational changes we
      have observed do not arise solely from tropomyosin movements and that
      conformational changes of actin domains should be considered.

PMID- 1755370
TI  - Granulocyte and monocyte chemotactic factors: stimuli and producer cells.

PMID- 1755371
TI  - Chemotactic cytokines in inflammatory skin disease.

PMID- 1755372
TI  - Activation of human neutrophils by NAP-1 and other chemotactic agonists.

PMID- 1755373
TI  - Interleukin-8--a mediator of inflammatory lung disease?

PMID- 1755374
TI  - Some aspects of NAP-1 pathophysiology: lung damage caused by a blood-borne
      cytokine.

PMID- 1755375
TI  - NAP-1/IL-8 in rheumatoid arthritis.

PMID- 1755376
TI  - Induction and regulation of interleukin-8 gene expression.
AB  - Recent advances in understanding granulocyte elicitation have been made with the
      discovery and isolation of chemotactic cytokines. There is little doubt that
      these polypeptides will prove to be important mediators of disease process.
      Therefore, studies directed at understanding the production and regulation of
      interleukin-8 will continue to be a fertile area to explore mechanisms of disease
      processes and therapeutic targets.

PMID- 1755377
TI  - Regulation of human interleukin 8 gene expression and binding of several other
      members of the intercrine family to receptors for interleukin-8.
AB  - IL-8 is produced by a wide variety of cells in response to polyclonal mitogens
      and cytokines. Northern blotting analysis revealed that IL-1, TNF and PMA could
      induce rapid expression of IL-8 mRNA in the absence of new protein synthesis.
      Nuclear run-off assays using different cell types demonstrated that IL-8 mRNA
      expression could at least be partly due to the activation of transcription.
      Cloning and determination of the entire sequence of IL-8 genomic DNA enabled us
      to explore the functional significance of the 5'-flanking enhancer region of the
      IL-8 gene by employing CAT assays. The results indicated that the region spanning
      from -94 to -71 bp is minimally sufficient for conferring responsiveness to IL-1,
      TNF and PMA. Further analysis using point-mutations revealed that this region
      consisted of two distinct cis-elements; one being the potential binding site for
      NFkB-like and the other for a C/EBP-like factor. These results suggested that all
      three stimuli, IL-1/TNF/PMA, modulate the identical combination of nuclear
      factors possibly by phosphorylation. We previously reported that these three
      stimuli activated the same serine protein kinase which phosphorylates identical
      65 kDa and 74 kDa cytosol proteins in human PBMC. This IL-1/TNF/PMA-activated
      protein kinase is distinct from protein kinase A, protein kinase C or casein
      kinase in substrate specificity; in Ca and phospholipid dependency; in cyclic
      nucleotide dependency; and sensitivity to protein kinase inhibitors. Taken
      collectively, IL-1/TNF/PMA may activate a common serine protein kinase and this
      protein kinase may in turn directly or indirectly modulate several nuclear
      factors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755378
TI  - Formation and biological properties of neutrophil activating peptide 2 (NAP-2).

PMID- 1755379
TI  - Biological aspects of monocyte chemoattractant protein-1 (MCP-1).
AB  - In this communication, we have asked if MCP-1 is the mediator of cellular
      infiltration in DCH, outlining the criteria in Table 3. Preliminary data suggest
      that PHA-stimulated lymphocytes secrete MCP-1, and that MCP-1 can be produced in
      response to antigen stimulation. MCP-1 attracts monocytes and basophils, but not
      neutrophils. The question of a lymphocyte response to MCP-1 requires further
      study. We have emphasized that the discovery of leukocyte-specific NAP-1 and MCP
      1 should now be followed by exploration of conditions in which one agonist is
      secreted without the other. This would be expected, for example, in DCH, which is
      characterized by mononuclear leukocyte infiltration without neutrophils.

PMID- 1755380
TI  - Stimulus specific induction of monocyte chemotactic protein-1 (MCP-1) gene
      expression.
AB  - The recruitment of monocytes from the peripheral vasculature to an area of
      chronic inflammation is a complex phenomenon. This complicated process is likely
      mediated to a large extent by chemotactic cytokines that are expressed via a
      cytokine cascade. A number of chronic diseases that are difficult to manage are
      characterized by a significant infiltrate of monocytes, including sarcoidosis,
      Wegener's granulomatosis, and tuberculosis. New scientific insight into the
      mechanisms that lead to early activation events, such as monocyte elicitation,
      may aid in both better understanding these diverse processes and designing more
      effective therapies.

PMID- 1755382
TI  - PDGF and the small inducible gene (SIG) family: roles in the inflammatory
      response.
AB  - A growing body of evidence suggests that cells responding to an initial growth,
      inflammatory or immune signal can respond by inducing the transcription of
      selective members of the SIG family. This family of related inducible cytokines
      are involved in the amplification, propagation and coordination of intercellular
      communication among cell types involved in the immune and inflammatory responses.
      The principal anti-inflammatory action of glucocorticoids may involve the
      transcriptional and translational inhibition of cytokines such as JE and other
      members of the SIG family to effectively disrupt the normal lines of
      intercellular communication which normally coordinates the immune and
      inflammatory response. The identification of new members of the family and the
      discovery of the functions of the known members will lead to a clearer
      understanding of the complicated processes which lead to normal and pathological
      immune and inflammatory responses.

PMID- 1755381
TI  - GRO: a novel chemotactic cytokine.

PMID- 1755383
TI  - Human neutrophil granule cationic protein CAP37 is a specific macrophage
      chemotaxin that shares homology with inflammatory proteinases.
AB  - Cationic antimicrobial protein CAP37 (Mr = 37 kD) is derived from the azurophilic
      granules of human PMN. In vitro and in vivo studies demonstrate that CAP37 is a
      novel monocyte-specific chemoattractant. The N-terminal amino acid sequence of
      CAP37 shares significant homology with a number of inflammatory molecules with
      protease activity including elastase and cathepsin G. However, substitutions in
      the catalytic triad (serine for a histidine at position 41 and glycine for a
      serine at position 175), may account for its lack of serine protease activity. A
      full length cDNA for CAP37 was identified in an HL60 cDNA library screened with
      oligonucleotide probes designed from the N-terminal amino acid sequence.
      Sequencing of the cDNA reveals a protein of 225 amino acids with significant
      nucleotide homology to cathepsin G and human neutrophil elastase.

PMID- 1755384
TI  - Biochemical and biological characterization of NAP-1/IL-8-related cytokines in
      lesional psoriatic scale.

PMID- 1755385
TI  - National Health Service nursing homes again.

PMID- 1755386
TI  - A randomized controlled trial of nursing home and long-stay geriatric ward care
      for elderly people.
AB  - This paper reports outcome data on mental and physical ability levels, mortality
      and accident rates, from a randomized controlled trial evaluating health
      authority funded nursing home and long-stay geriatric ward care in one inner
      London health district. There were no differences between settings in mortality
      rates, although respondents randomized to the nursing homes deteriorated more
      rapidly in overall, mental and functional ability levels. Previous analyses
      reported that they also experienced a higher accident rate than respondents in
      the wards. However, observational data from the evaluation clearly indicated that
      quality of life in the homes was superior to that in the wards. We conclude that
      the more rapid physical decline and greater risk of accident in the nursing homes
      have to be balanced against an inferior quality of life in the hospital, and that
      a judgement is not easy to make on behalf of other people.

PMID- 1755387
TI  - Respiratory symptoms among elderly people in the New Forest area as assessed by
      postal questionnaire.
AB  - This study was carried out to estimate the prevalence of respiratory symptoms
      among people aged 65 years and older and assess the value of a postal survey in
      obtaining this information. A questionnaire was sent to 2011 subjects (957 men)
      drawn by age-stratified random sampling from the age-sex registers of four New
      Forest group practices (1:3.3 sample). A total of 1803 replied, a 96.2% response
      after excluding 136 who had died or moved from the area. The accuracy of replies
      was verified for 355 (20%) randomly selected subjects. Forty per cent had no
      respiratory symptoms. Exertional breathlessness was common (38%), increasing in
      prevalence with age but not with smoking history, and was the only symptom
      reported by 10% of subjects. Only 14.2% were current smokers; more of the
      subjects aged 85 years and over were lifelong non-smokers. Two hundred and ninety
      six (16.4%) had chronic bronchitis, which was more common among smokers; 151
      (8.4%) gave a history of asthma, of whom half (76) had active asthma, which was
      slightly less common among the very elderly subjects. Only 489 (27.1%) of
      subjects had seen their doctors with chest symptoms during the preceding 2 years.

PMID- 1755388
TI  - The abbreviated mental test: its use and validity.
AB  - The validity of the Abbreviated Mental Test was demonstrated by comparison with
      final clinical diagnoses in a consecutive sample of 168 patients admitted with
      acute illness to a department of health care of the elderly. Fifty-eight (34%)
      had abnormal cognition. The best cut-off point was 8, with less than 8 suggesting
      abnormal cognitive function. A short version (the AMT7) of the AMT was developed.
      Its validity, internal consistency and coverage of domains was equivalent to the
      AMT but it had a slightly higher sensitivity (with acceptable specificity) than
      the original. This new short version may improve performance of junior doctors in
      clinical practice who appear to have difficulty remembering all 10 items of the
      AMT.

PMID- 1755389
TI  - Long-term outcome for patients and carers following hospital admission for
      stroke.
AB  - Outcome was assessed in 82 3(+)-year survivors from a cohort of 229 patients
      admitted to hospital with acute stroke; 71% were independent or only mildly
      disabled, 76% were living at home. Institutionalized patients were significantly
      older, less often married, and had more cognitive impairment than those at home.
      No patient who produced normal picture drawings (house, man, clock) was in
      institutional care, only two patients living alone had abnormal drawings. Of
      patients at home 39% had not seen their general practitioner (GP) in the last 6
      months. GPs were less likely to see patients who were more severely disabled (p
      less than 0.05). Targeting of services seemed poor, there was no relationship
      between level of dependence and level of support from voluntary or statutory
      services. Forty-four of 49 chief informal carers were also interviewed; 30%
      showed marked strain. Carers had more problems with emotional reactions, sleep
      and social isolation than expected.

PMID- 1755390
TI  - Evidence of cellular zinc depletion in hospitalized but not in healthy elderly
      subjects.
AB  - Cellular immune function declines with age and is implicated in the increased
      incidence of cancer, and morbidity and mortality associated with infections in
      elderly people. Elderly people are at risk of nutritional depletion, including of
      zinc, and zinc is known to influence immunity. The present study assessed zinc
      status in both healthy elderly subjects and elderly inpatients. Polymorphonuclear
      cell zinc was decreased in the hospitalized subjects and 27% had values below the
      reference range for healthy elderly and young subjects. Since PMNC zinc is
      decreased in experimental zinc depletion and correlates with muscle zinc, we
      suggest that 27% of the patients studied may be zinc depleted and may benefit
      from zinc supplementation.

PMID- 1755391
TI  - Glycated proteins in elderly type II diabetic patients: role of age and serum
      protein concentration.
AB  - In an attempt to evaluate the clinical significance of fructosamine (F) and
      glycated haemoglobin (HbA1c) values in elderly diabetic patients, 49 patients
      with mean age 72.0 years and 58 patients with mean age 51.6 years (control group)
      were studied. No difference was found in F and HbA1c between the two groups, when
      the degree and duration of glycaemic failure was equal. However, on extrapolating
      from the two groups those patients with total protein less than or equal to 6.0
      g/dl, it was observed that these subjects had F values significantly lower than
      the other patients studied (p less than 0.001) although there was no difference
      in the degree and duration of metabolic failure. It was concluded that F and
      HbA1c can also be used in elderly patients providing they are normoproteinaemic.
      In the case of hypoproteinaemics, the F values are underestimated and do not
      correlate with the other indices of glycaemic control.

PMID- 1755392
TI  - A population survey of cardiovascular disease in elderly people: design, methods
      and prevalence results.
AB  - A cross-sectional survey of an age- and sex-stratified random sample of the
      elderly population living in Southampton was undertaken with the object of
      measuring the frequency of cardiovascular disease by questionnaire and
      examination, and assessing cardiac anatomy and physiological function by
      noninvasive methods. The response rate was 64% and 259 men and women aged between
      65 and 95 years were interviewed and examined and had a twelve-lead ECG and chest
      radiograph. Forty per cent of men and 47% of women reported a diagnosis of one or
      more cardiovascular diseases, of which high blood pressure 33%, coronary heart
      disease 14% (angina pectoris 11% and myocardial infarction 8%), peripheral
      arterial disease of the lower limbs 7%, and cerebrovascular disease 6% occurred
      most frequently. With the exception of high blood pressure, which women reported
      more frequently than men (40% vs 27%), the prevalence of these diagnoses by sex
      was similar. The self-administered WHO questionnaires gave point prevalence
      estimates for angina pectoris of 13%, possible myocardial infarction 7% and
      intermittent claudication 5%, which were similar to reported prevalences of these
      diseases, although disagreement in the classification of individuals for each
      disease was common. When comparing the WHO chest pain questionnaire with the
      doctors' independent diagnosis of angina pectoris in this population, the
      sensitivity of the WHO questionnaire was 79%, with a specificity of 98% and a
      predictive value of 88%. For each sex the sensitivity of the WHO chest pain
      questionnaire was similar but specificity and predictive value were both lower
      for women.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755393
TI  - Symptoms of gastro-oesophageal reflux disease in elderly people.
AB  - The frequency and the possible age-related characteristics of gastro-oesophageal
      reflux disease (GORD) were investigated in 195 consecutive elderly subjects (mean
      age 74 years), referred to endoscopy for abdominal symptoms or sideropenic
      anaemia. In the 105 of these patients in whom there was any suspicion of GORD, 24
      hour pH monitoring was carried out. All the patients were interviewed before the
      examinations. Erosive or complicated (grade 2-4) oesophagitis was found in 18% of
      patients. The main symptoms in these patients were dysphagia, respiratory
      symptoms and vomiting. Chronic cough, hoarseness or wheezing were present in 57%
      of patients with oesophagitis compared with 33% of those without oesophagitis (p
      less than 0.001). The occurrence of heartburn and regurgitation did not differ
      significantly between patients with or without oesophagitis, although the mean
      symptom scores were higher in those with oesophagitis. Dyspepsia and chest pain
      were not typical symptoms in oesophagitis. Of patients with oesophagitis 29% had
      no typical symptoms of GORD; only 24% of patients with regurgitation had
      oesophagitis. In 24-hour pH monitoring, a significant increase in the occurrence
      of symptoms was not seen until total reflux time pH less than 4 exceeded 10%. The
      occurrence of heartburn did not correlate with the extent of reflux in the pH
      study. In conclusion, typical symptoms of GORD in the aged were regurgitation,
      dysphagia, respiratory symptoms and vomiting rather than heartburn.

PMID- 1755394
TI  - Peptic ulcer disease in older age groups in Gothenburg in 1985: the association
      with smoking.
AB  - The prevalences of peptic ulcer and smoking were assessed by a questionnaire sent
      to 6726 residents of Gothenburg selected at random from the birth cohorts 1945, 
      35, -25, -15, and -05. The point prevalence of peptic ulcer was in all age groups
      significantly higher among smokers than among non-smokers. The incidence of
      peptic ulcer in 1985 was deduced from records of ulcers detected at gastroscopy
      and/or radiography and/or emergency surgery (n = 1402). Smoking habits and
      previous episodes of peptic ulcer disease were evaluated. The estimated risk of
      getting peptic ulcer was significantly higher among smokers in all age groups and
      of both sexes than among non-smokers. Among non-smokers the risk of getting
      peptic ulcer was significantly higher in men than in women, whereas the risk
      among smokers showed no sex difference. In people aged 35-84 years, 25.4% (n =
      101) of ulcers diagnosed for the first time and 42.0% (n = 246) of relapsing
      ulcers were estimated to be caused by smoking. The number of smoking years,
      however, could not be shown to influence the risk of peptic ulcer.

PMID- 1755395
TI  - Age is no bar to sexually acquired infection.
AB  - Two hundred and forty-two patients aged 60 years or over attended genito-urinary
      clinics in Nottingham and Leicester (England) in a 2-year period. Sixty-nine per
      cent of men and 53% of women were sexually active and 58 were found to have
      sexually transmitted diseases.

PMID- 1755396
TI  - Effectiveness of inhaled bronchodilator delivery systems for elderly patients.
AB  - A prospective study of inhaler technique using aerosol metered dose inhalers
      (MDIs), Rotahalers and a breath-activated device (Aerolin Autohaler) was
      undertaken to assess how effectively elderly patients use their inhalers. Fifty
      one patients aged 67-89 years (mean 77.4 years) were enrolled. Peak flow, FEV1
      and FVC were recorded, before and after inhalation of 2.5 mg of salbutamol via a
      nebulizer, to assess the extent of reversible airways obstruction. Inhaler
      technique was assessed using a scoring system, based on performance in five
      aspects of inhaler use. Those with poor technique were randomly allocated to an
      alternative inhaler and reassessed. Twenty-nine of 51 patients demonstrated
      reversibility in their airways disease. Twenty-one of 47 had poor technique using
      an MDI and were given Rotahaler or Aerolin devices to use. Ten of 11 given
      Aerolin Autohalers improved but seven of ten using Rotahaler showed no
      improvement (p = 0.006). Subsequently, five of these seven were able to improve
      their technique with the breath-activated autohaler. The breath-activated Aerolin
      Autohaler is a better delivery system than Rotahalers for inhaled bronchodilators
      for elderly patients.

PMID- 1755397
TI  - [The effect of kanpou medicine on the growth and aggregation of calcium oxalate
      crystals in vitro].
AB  - The effects of the compositional drugs of kanpou medicine on the growth and
      aggregation of calcium oxalate crystals were investigated in vitro. In the seeded
      crystal system, the inhibitory activities were calculated from the change of the
      number (Ia), total volume (Ig) and fractional volume (I) of crystals determined
      by a Coulter Multisizer. Among the tested drugs (Takusha, Akyou, Chorei,
      Bukuryou, Kasseki, Kinsensou, Kagosou), only Takusha and Kagosou had strong
      inhibitory activities on the growth and aggregation at the concentration of 5
      micrograms/ml and 10 micrograms/ml (Ia greater than 80%, Ig, I greater than 90%).
      No significant correlation was observed between inhibitory activities and alcian
      blue precipitable polyanions (ABPP) of each drug. Thus some naturally existing
      substances composing the kanpou medicine may help prevent the stone formation in
      clinical use.

PMID- 1755398
TI  - [Citrate as an inhibitor of stone formation--with reference to intestinal citrate
      absorption and the influence of citrate on intestinal calcium absorption].
AB  - The response of serum citrate to the oral citrate load was studied in seven
      healthy subjects. Serum citrate was significantly elevated from 15 to 60 min post
      load with some individual variations. In 27 stone-formers serum citrate and the
      response to the oral citrate administration was studied and compared with the
      results obtained on healthy subjects. The serum citrate concentration of stone
      formers was 1.99 +/- 0.49 mg/dl as compared to 1.61 +/- 0.35 mg/dl in healthy
      subjects. After citrate administration serum citrate increased significantly in
      both groups, but no significant difference was shown in response to the oral
      citrate load between these two groups (3.44 +/- 0.94 mg/dl in stone-formers, 3.16
      +/- 0.38 mg/dl in healthy subjects). In Sprague-Dawley rats each weighing about
      200 g urinary citrate and calcium excretion were studied after administration of
      sodium citrate or calcium chloride or both. The concomitant equimolar
      administration of sodium citrate and calcium chloride did not have significant
      influence on urinary citrate or calcium excretion as compared when citrate or
      calcium was given alone. However, the calcium excretion was significantly
      decreased with the administration of citrate and calcium ata molar ratio of 1:2.

PMID- 1755399
TI  - [Combined administration of calcium and citrate reduces urinary oxalate
      excretion].
AB  - Three grams of calcium lactate and 3 g of uralyt U were administered to 39
      calcium oxalate stone formers. Urinary oxalate level was reduced significantly
      without raising urinary calcium level by the administration of the two drugs for
      two weeks. The mechanism of action of these drugs and the diet which might
      produce a similar effect were discussed.

PMID- 1755400
TI  - [Oxalate as a promoter in calcium oxalate nephrolithiasis].
AB  - Oxalate transports on membranes of red blood cell, intestinal epithelium and
      proximal tubule cell were reviewed, and the new findings about oxalate transport
      across these membranes are reported. Red blood cell oxalate influx rate in a
      group of recurrent calcium oxalate stone formers was significantly higher than
      that of a control group. In the red blood cells of mammals, the band 3 protein
      transports oxalate. Although abnormal influx rate of red blood cells might be
      recognized as an expression of somatic cell abnormality of oxalate transport in
      some recurrent stone formers, the band 3 protein is not related to oxalate
      transport in both kidney and intestine. The study using brush border membrane
      vesicles suggested the presence of Na-oxalate co-transport. In humans, sodium
      intake increased the oxalate/creatinine ratio of urine. This indicated that
      excessive sodium intake might be a risk factor of stone formation. Further study
      of oxalate transport of both kidney and intestine will be required to elucidate
      an etiology of calcium oxalate nephrolithiasis.

PMID- 1755401
TI  - [The pitfall of ESWL].
AB  - The pitfall of extracorporeal shock-wave lithotripsy (ESWL), such as
      complications of ESWL, problems of focus and results of stone disintegration are
      discussed. The progress of ESWL today is mainly due to the development of new
      generation lithotripters and endourological support, which has broadened the
      indications of ESWL. The necessary shock-waves have been selected, and
      complications have been reduced. Post ESWL stone street is now easier to treat.
      We expect more improved lithotripters such as by incorporation of X-ray and echo
      focusing systems. Endourological techniques including laser lithotripsy also
      should be improved.

PMID- 1755402
TI  - [Extracorporeal shock wave lithotripsy for ureteral stones and cystine stones].
AB  - We report our experience with extracorporeal shock wave lithotripsy (ESWL) in the
      treatment of ureteral and cystine stones, which are known to be difficult to
      treat by this method. First, in order to determine the effectiveness of the
      ureteral catheter in the destruction of ureteral stones, we compared the clinical
      results of 121 patients treated without the catheter and 141 patients inserted
      with the catheter. There was no significant difference in the success rate
      between the two groups regardless of stone size, which indicates that the use of
      the ureteral catheter had no effect on the outcome of treatment. We then studied
      the clinical results of impacted ureteral stones which are especially difficult
      to destroy. Excretory urography was performed to non-invasively diagnose these
      stones, and those without visualization in the ureter below the stone were
      diagnosed as impacted stones and treated by ESWL without the ureteral catheter.
      Among the stones with a diameter of 1 to 2 cm, the success rate was significantly
      lower in impacted stones compared to non-impacted stone. These findings suggest
      that ESWL treatment without the ureteral catheter may be effective for ureteral
      stones with a diameter of less than 1 cm and non-impacted stones with a diameter
      of 1 to 2 cm, while combination therapy with other methods such as TUL may be
      better for other stones. We also performed ESWL on 6 patients with renal stones
      and 2 patients with ureteral stones which were cystine stones. Renal stones
      required an average 4.1 treatment with an average of 1,875 shocks per treatment,
      and ureteral stones required 1.5 treatment with an average of 1,833
      shocks.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755403
TI  - [The effectiveness of prophylactic dietary treatment in renal stones].
AB  - By following individual dietary guidelines which were established from analysis
      of the dietary intake and habits of male renal stone patients, the stone
      recurrence rate in 75 male calcium stone patients who had only received
      individual dietary instruction decreased markedly, as compared with that in 114
      male calcium stone patients who had not received such instructions. Among 75
      patients, recurrence was noted in 6 normocalciuric recurrent stone patients and 1
      normocalciuric single stone patient during the period of outpatient visits.
      Investigation of the daily consumption of various nutrients and urinary excretion
      revealed no differences among the 6 normocalciuric recurrent stone patients,
      hypercalciuric recurrent stone patients, hypercalciuric single stone patients and
      normocalciuric single stone patients. Our findings suggest that the high
      recurrence rate in the normocalciuric recurrent stone patients is associated with
      stone lithogenic factors, such as heredity and anatomy, that could not be
      controlled by the daily treatment in this group.

PMID- 1755404
TI  - [Diagnosis of the acute rejection].
AB  - A questionnaire survey, concerning the immunosuppressive treatment and criteria
      of diagnosis in acute rejection of renal allografts, was done at 22 institutes.
      In 15 institutes, 3 immunosuppressive agents were used. Those agents were as
      follows: prednisolone (Pr.) or methyl-prednisolone (M-Pr.), cyclosporin (CsA) and
      azathioprine (Az.) or mizoribine (Mz.) or anti-lymphocyte globulin (ALG). A
      combination of 4 drugs (Pr. or M-Pr. +CsA +Az. or Mz. +ALG) was used at 4
      institutes and a combination of 2 drugs (Pr. or M-Pr. +CsA) at the remaining 3
      institutes. Acute rejection episodes were diagnosed by conventional criteria in
      all institutes. Conventional criteria were as follows: physical findings, rising
      serum creatinine, response to pulse therapy, rising urinary FDP, decreasing
      urinary Na/K ratio and radionuclide findings. In our cases, there was no
      significant difference between the number of acute rejection episodes by the 25
      patients who underwent conventional immunosuppressive therapy (C group:M-Pr.+Az.)
      and the 25 patients with triple immunosuppressive therapy (T group: M-Pr.
      +CsA+Az.). Conventional methods were sufficient in most cases of the T as well as
      C group to diagnose acute rejection episodes.

PMID- 1755405
TI  - [Effects of verapamil on cyclosporine. A (CsA)-induced nephropathy in ischemic
      kidney model in rats: changes in systemic hemodynamics and hepatic and renal
      microsomal cytochrome P-450].
AB  - We have examined the effect of verapamil on CsA-induced nephropathy by
      measurement of systemic hemodynamics including each organ blood flow using the
      microsphere method in ischemic kidney model of hemi-nephrectomized Wistar rats.
      Hepatic and renal microsomal cytochrome P-450 contents and their enzyme
      activities were measured to study the correlation between CsA-induced nephropathy
      and induction of hepatic and renal microsomal cytochrome P-450. All rats were
      hemi-nephrectomized (l-nephrectomy) and were classified into the following 6
      groups: 1) control groups, 2) CsA at a dose of 40 mg/kg per day orally for 7 days
      (CsA group), 3) Oral administration of verapamil for 7 days in the CsA group (CsA
      + V group), 4) 20 min clamping of the remaining right kidney pedicle (Ischemic,
      Is group), 5) CsA was administered in the Is group (Is + CsA group), 6) Addition
      of verapamil to CsA in the Is + CsA group (Is + CsA + V group). Verapamil was
      given in the drinking water and the average dose calculated from the amount of
      drinking was 4.7 +/- 1.0 mg/kg per day and 5.2 +/- 0.7 mg/kg per day for the CsA
      + V group and the Is + CsA + V group, respectively. CsA caused significant
      increases in BUN and serum creatinine (sCr) with a significant decreases in renal
      inulin clearance (CIn) in all groups. When compared with the Is group, CsA caused
      significant decreases in cardiac output and all organ blood flow especially in
      renal blood flow with significant increases in BUN and sCr in the Is + CsA
      group.2+ degree of nephropathy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755406
TI  - [Cyclosporine induced nephrotoxicity and renal blood flow].
AB  - To elucidate the relationship between cyclosporine (Cs) nephrotoxicity and renal
      blood flow (RBF), we carried our experiments using rats. Adult male Wistar strain
      rats each weighing about 100 g were used. Rats were divided into 2 groups; the Cs
      group (Cs 50 mg/kg/day was intraperitoneally given for 10 consecutive days) and
      the control group (normal saline solution for 10 consecutive days). The renal
      cortical blood flow was measured in each group by electrolytic hydrogen gas
      clearance method. We also carried out renal angiography with barium sulfate
      (BaSO4). Then we measured blood vessel area/renal sagittal section area ratio and
      the diameter of interlobar arteries. The Cs group showed a significant decrease
      of renal cortical blood flow compared with the control group. On the other hand
      there was no significant change in renal angiogram. In conclusion, Cs decreased
      renal cortical blood flow. We suppose that vascular resistance increased
      following afferent arteriolopathy caused by Cs administration.

PMID- 1755407
TI  - [Distribution of ciclosporin in the lymphoid tissue].
AB  - To clarify the distribution and the kinetics of ciclosporin (CSA) in the
      lymphatic system, we measured the CSA level of the lymph from the thoracic duct
      drainage (TDD) and that of the peripheral blood after oral or intravenous
      administration of CSA in 13 TDD pretreated patients. We also measured the CSA
      level of the iliac lymph nodes in 20 patients undergoing transplant surgery. The
      mean CSA level of the lymph was 1,647 ng/ml in the first 2 hours, 1,551 mg/dl in
      the next 10 hours and 254 ng/dl in the last 12 hours in orally administered
      patients and the mean CSA level of the peripheral blood was 746 ng/ml at 2 hours,
      263 ng/ml at 12 hours and 119 ng/ml at 24 hours later. In intravenous
      administration, the mean CSA level of the lymph was 68 ng/ml, 58 ng/ml and 33
      ng/ml and the mean CSA level of the peripheral blood was 452 ng/ml, 105 ng/ml and
      88 ng/ml respectively. The mean CSA level of the lymph node was 3,222 ng/g and
      the mean diffusion rate from the peripheral blood to the lymph node was 17.1.
      There was no difference between oral and intravenous administration. These
      results indicated that (1) there is a second pathway in which orally administered
      CSA is transported from small bowel to general circulation; via mesenteric lymph
      duct, thoracic duct and subclavic vein and (2) CSA is selectively uptaken by
      lymph node. CSA might suppress the activation of T cells in the lymph node and
      the lymph more effectively than in the peripheral blood.

PMID- 1755408
TI  - [Urinary tract infections after kidney transplantation].
AB  - Clinical significance of urinary tract infections (UTI) after kidney
      transplantation was studied in 57 cases. Of these patients, the UTI occurred in
      63% of cases during follow-up after transplantation. Although the bacteriuria
      were observed more frequently in living-related donor (LD) group at pre
      operation, cadaveric donor (CD) group showed significantly higher frequency in
      bacteriuria and UTI after transplantation. The initial UTI occurred within 4
      weeks after transplantation in 86% of cases. The significant risk factors in the
      occurrence of UTI were presence of bacteriuria in post-operation, CD group,
      mismatch numbers in HLA, amount of steroid, and ages of donor and recipient. Of
      the bacteria isolated, about half were pathogens in UTI, which was a 2 times
      higher risk compared with the time of chronic hemodialysis. Gram negative rods
      were found to be major pathogen in UTI cases. The effect of UTI on graft survival
      was not obvious. However, of the patients who have bacteriuria at operation, 52%
      were found to have bacteriuria due to the same strain during follow-up.
      Therefore, bacteriological examination of urine at transplantation must be done
      carefully.

PMID- 1755409
TI  - [Primary hyperparathyroidism: problems on surgical indication and procedure].
AB  - Between 1959 and Oct. 1990, 307 cases of primary hyperparathyroidism (PHPT) were
      operated on in our hospital. Among them, 23 cases (7.5%) were asymptomatic
      chemical type of PHPT, and the incidence of this type has been increasing these
      days. Various symptoms or signs including urolithiasis, bone disease,
      cardiovascular disease, gastrointestinal disease, diabetes mellitus and others
      were associated with PHPT. Especially, as a lethal factor, malignant tumors
      developed in 14 cases (4.6%); 9 cases of non-medullary thyroid cancer and tumors
      of other organs. In consideration of these associated disorders, the chemical
      type of PHPT should be operated prophylactically. In order to reduce operative
      complications, unilateral exploration is available for the cases of single
      normally localized adenoma; 85.7% of our 307 cases. Moreover, the positive rate
      of preoperative localized test by CT and ultrasonography for such adenomas is 78%
      in the recent 5 years. The predictive values of successful operation by
      unilateral exploration are 89% in the cases of normally localized single adenoma
      and 76% in all PHPT.

PMID- 1755410
TI  - [A clinical study on primary hyperparathyroidism--indication of operation and
      surgical technique].
AB  - Fifty-two cases of primary hyperparathyroidism were experienced at Kyoto
      University Hospital and affiliated hospitals between 1965 and 1990. Thirty-three
      of them (63%) were of the stone type, twelve (23%) of the bone or mixed type,
      seven (13%) of the chemical type. Histopathological findings showed adenoma in 49
      cases and hyperplasia in 3 cases. Serum calcium levels decreased postoperatively
      in all cases of adenoma but unchanged in 2 of 3 cases of hyperplasia. For
      parathyroid adenoma, the accuracy of localization was more than 90% by the
      combination of computed tomography, magnetic resonance imaging, ultrasonography,
      subtraction scintigraphy with 201TI and 123I, venous sampling for parathyroid
      hormone and/or angiography. Simple removal of parathyroid adenoma may be
      recommended in a case of primary hyperparathyroidism due to a single adenoma
      which was revealed by preoperative image diagnosis.

PMID- 1755411
TI  - [Indications for surgical treatment of secondary hyperparathyroidism].
AB  - From 1978 to 1990 subtotal parathyroidectomy was carried out on 41 patients for
      secondary hyperparathyroidism. The indications for parathyroidectomy and suitable
      operative time, especially in the point of view of renal osteodystrophy are
      discussed. Serum ALP and PTH level and the presence of generalized fibrous
      osteitis were good indicators for parathyroidectomy. Furthermore, 99mTc
      Pyrophosphate bone scintigraphy and Dual Photon Absorptiometry were proved to be
      valuable for patient selection for parathyroidectomy. Parathyroidectomy for
      patients in whom 99mTc-pyrophosphate bone uptake is diminished or patients in
      whom bone mineral contents are dramatically decreased must be carefully
      performed.

PMID- 1755412
TI  - [The effect of conservative and surgical management for secondary
      hyperparathyroidism and their problems].
AB  - We compared the effect of conservative treatment with that of surgical treatment
      after applying them on secondary hyperparathyroidism patients (2nd HPT) in order
      to study the application of surgery on 2nd HPT patients. We selected the test
      subject of 39 maintenance dialysis patients with complications of 2nd HPT. The
      conservative treatments were; elcitonine administration (40 u x 3/W) (group 1),
      ipriflavon administration (200 mg x 3/day) (group 2), and pulse treatment (1.25
      (OH)2D3 6 micrograms/W) (group 3). For surgical treatment, we adopted total
      parathyroidectomy with auto-transplantation into the arm (PTX). The transition of
      serum parathyroid hormone (PTH-C), alkali-phosphatase (ALP), bone scintigraphy of
      every 6 months, and change of bone mineral content (BMC) were compared to judge
      the effects of treatments. We measured 1/3, 1/6 radial region with single photon
      absorptiometry (SPA) and L3 region with dual photon absorptiometry (DPA) to
      obtain BMC. We were forced to transfer the patients in groups 1 and 2
      (conservative treatment) to pulse treatment or PTX as 12 months later they showed
      increase in serum PTH-C, ALP and significant drop (P less than 0.05) in BMC
      average change rate (1/3). In group 3 of pulse treatment, though significant
      decrease in serum ALP (P less than 0.01) was detected for 10 cases out of 12,
      serum PTH-C was either unchanged or increased for 4 cases with the value of more
      than 30 ng/ml. Furthermore the average change rate of BMC stayed at the same
      level.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755413
TI  - [Technique and problems of total parathyroidectomy with autotransplantation in
      secondary hyperparathyroidism].
AB  - Between 1982 and 1990, 20 patients with chronic renal failure underwent total
      para-thyroidectomies and autotransplantations as treatment for secondary
      hyperparathyroidism. Fourteen cases were cured of their symptoms and their serum
      PTH levels was restored to normal. Recurrent hyperparathyroidism developed in 6
      cases. In 3 of the 6 cases, excision of parathyroid tissue from the forearm could
      easily be performed under local anesthesia. Of the other cases, 2 had five and
      one had six glands. Several localizing methods should be performed before
      operation, in order to overlook the parathyroid glands in different anatomic
      positions.

PMID- 1755415
TI  - [Clinical and pathological studies on incidental renal cell carcinoma].
AB  - During the five-year period from 1985 to 1989, a total of 69 patients with renal
      cell carcinoma received treatment at Daisan Hospital of Jikei University School
      of Medicine. Among these patients, there were 23 patients (33.3%) with incidental
      renal cell carcinoma. These 23 cases were studied clinically and pathologically
      in comparison with 46 symptomatic cases. The tumor was detected by
      ultrasonography (US) or computed tomography (CT) conducted for the diagnosis of
      other diseases in 16 cases and by US included in the battery of physical
      examinations in the remaining 7 cases. As compared to symptomatic cases, less
      hematological abnormalities were found in these cases, since ESR was accelerated
      in only 2 cases and anemia and elevation in alpha 2-globulin level were found in
      none of the cases. As for diagnostic imaging, CT could detect the tumor in all of
      23 cases and US in 20 out of 21 cases. Intravenous pyelography gave normal
      pyelograms in 4 cases. Normovascular findings were obtained by renal angiography
      in 2 cases. The mean largest diameter of tumors of these 23 cases was 3.9 cm,
      being smaller than the corresponding mean diameter of 7.7 cm for symptomatic
      cases. In 8 out of 23 cases tumors were small renal cell carcinoma of 2.5 cm or
      less in diameter. Pathologically, incidental renal cell carcinoma was
      characterized by small size, expansive growth pattern (INF alpha in 18 cases and
      INF beta in 5 cases) and prevalence of clear cell subtype (clear cell subtype in
      18 cases, granular cell subtype in 2 cases and mixed cell subtype in 3
      cases).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755414
TI  - [A clinical study on renal cell carcinoma].
AB  - A retrospective study was carried out on 95 patients affected with renal cell
      carcinoma (RCC) between January 1973 and December 1988. Male to female ratio was
      3 to 1 and the average age was 61 years. Hematuria was the most common initial
      symptom (44 patients, 46.3%), followed by incidental findings (18 patients,
      18.9%). Five- and 10-year survival rates for all patients with RCC were 51.9 and
      37.1%, respectively. Five-year survival rates for stage I, II, III, and IV were
      82.7 54.7, 20.0, and 4.7%, respectively. Statistical analyses identified
      variables that significantly influenced survival, including lymph node metastasis
      (p less than 0.01) and distant metastasis (p less than 0.01). Cell type and renal
      vein involvement did not influence survival significantly. The three different
      forms of therapy (mitomycin therapy vincristine therapy and immunological
      therapy) did not influence survival significantly, but the beneficial effect of
      VBL therapy was obtained.

PMID- 1755416
TI  - [Epidermal growth factor in the urine of patients with renal cell carcinoma and
      bladder tumor].
AB  - We evaluated the concentrations of immunoreactive epidermal growth factor (EGF)
      in urine samples from 14 patients with renal cell carcinoma, 16 patients with
      bladder tumor and 43 non-malignant controls by using radioimmunoassay. In the non
      malignant controls, urinary EGF excretion significantly decreased with age (r = 
      0.46, p less than 0.01), and females excreted significantly more EGF than males
      [16.3 +/- 7.6 and 9.9 +/- 6.0 (mean +/- SD) ng/mg.creatinine; p less than 0.05].
      There was no significant difference between urinary EGF excretion in the patients
      with renal cell carcinoma and non-malignant controls matched for sex and age
      (15.9 +/- 12.0 and 14.5 +/- 7.9 ng/mg.creatinine). The difference in excretion of
      EGF between the patients with bladder tumor and non-malignant controls also was
      not significant (9.9 +/- 5.6 and 11.7 +/- 7.0 ng/mg.creatinine). These findings
      indicate, that urine EGF has little usefulness as a tumor marker for renal cell
      carcinoma and bladder tumor.

PMID- 1755417
TI  - [Treatment of 300 patients with bladder cancer].
AB  - From September 1973 to September 1989, 300 patients with bladder cancer were
      treated at the Department of Urology, Hyogo College of Medicine. They were 231
      males and 69 females with an average age of 65.3 years old. The overall 5-year
      survival rate (Kaplan-Meier's method) was 64.7%. The 5-year survival rates were
      not different between male patients and female patients, or between patients with
      single tumor and patients with multiple tumors. Patients with vesical irritation
      symptoms had more unfavorable prognosis than patients with painless hematuria.
      Size and configuration of the tumors also affected the prognosis. Histological
      diagnosis was transitional cell carcinoma in 291 patients, squamous cell
      carcinoma in 7 patients, adenocarcinoma in one patient and undifferentiated
      carcinoma in one patient. In patients with transitional cell carcinoma, the 5
      year survival rates according to histological grades were 93.5% for G1, 77.8% for
      G2 and 31.6% for G3. The 5-year survival rate according to clinical stage was
      94.4% for Ta, 79.7% for T1, 66.7% for Tis, 46.1% for T2, 38.5% for T3 and 26.6%
      for T4. Transurethral resection of bladder tumor (TUR-b.t.) was performed in 208
      patients as an initial operation and the 5-year survival rate in these patients
      was 78.6%. The 5-year survival rates for total cystectomy (52 patients), partial
      cystectomy (6 patients) and simple tumor resection (4 patients) were 51.9%, 25.0%
      and 37.5%, respectively. These findings suggest that superficial tumors (Ta, T1)
      can be controlled with TUR-b.t. but infiltrating tumors (T2, T3, T4) should be
      treated more vigorously with multidisciplinary approaches.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1755418
TI  - [Clinical study of voiding disorders in patients with cerebrovascular accidents].
AB  - Cystometry and urethral pressure profile were determined in 41 patients (29 males
      and 12 females) with voiding disorders resulting from cerebrovascular accidents
      within one year after the episode. By clinical symptoms, they were classified
      into 3 groups, urge incontinence (14 patients, 34%), pollakisuria (10 patients,
      24%) and dysuria (17 patients, 41%). Cystometrogram were classified into 3 types,
      hyperactive bladder (31 patients, 76%), normal bladder (5 patients, 12%) and
      hypoactive bladder (5 patients, 12%). All patients in both groups of incontinence
      and pollakisuria showed hyperactive bladder except one normal bladder, while in
      the group of dysuria 3 types of cystometrograms were observed. Bladder capacity
      in incontinence group showed tendency to be smaller than that in dysuria group
      who had hyperactive bladder. Maximum urethral pressure in incontinence group was
      significantly lower than that in pollakisuria group and dysuria group who had
      hyperactive bladder. Ten patients with cerebral cortical lesions (80%) showed
      hyperactive bladder and 60% of them showed incontinence. In patients with
      cerebral lesions who had hyperactive bladder, the maximum urethral pressure of
      patients with incontinence showed tendency to be lower than that of patients with
      pollakisuria and dysuria. The majority of 7 patients with thalamic lesions showed
      hyperactive bladder and normal urethral pressure, and had dysuria. Two patients
      with pontine lesions showed hypoactive bladder. These findings suggested that
      urge incontinence resulting from cerebrovascular accidents was due not only to
      hyperactive bladder but also to lower urethral pressure.

PMID- 1755419
TI  - [Statistical analysis of the prostatic cancer patients detected from 1985 to 1989
      in and around Gunma prefecture].
AB  - Prostatic cancer is one of the most common malignant tumors in the field of
      urology. The number of patients is increasing rapidly and its importance as a
      mortal disease is gathering attention. In 1985, we organized a registration
      system for prostatic cancer patients found in and around Gunma prefecture. In
      this study, we analyzed the clinical characteristics of the 730 patients
      registered from 1985 to 1989. The results were as follows. Mean age was 74.0
      years old and the number of the patients was the greatest in the eighth decade.
      Voiding disturbance was the most common chief complaint, followed by
      pollakisuria, gross hematuria and miction pain. Stage and grade distribution were
      as follows. Stage A 16.2%, B 21.1%, C 17.0%, D 45.7%, well differentiated 27.4%,
      moderately differentiated 48.2% and poorly differentiated 24.5%, respectively. A
      statistically significant relationship between stage and grade was observed. Bone
      was the most common metastatic site. The highest incidence of bone metastasis was
      in lumbar vertebra, followed by ribs, ilium, thoracic vertebra and ischium. The
      value of PAP, ALP and ESR tended to be higher in high stage patients, and that of
      Hb was lower. Fifty two patients were detected by mass screening. Most of these
      patients were in an early stage. Most of the patients were treated by hormonal
      therapy. LH-RH agonists constituted 39.2% of the cases given hormonal therapy.

PMID- 1755420
TI  - [Fundamental study on the collection of prostatic fluid using catheter].
AB  - The catheter for expressed prostatic secretions (EPS) collection was newly
      developed for the purpose of protecting EPS from the contamination of the
      urethral bacteria. This catheter is blind-ended, and has several lateral windows
      and a balloon between the end and the windows. The procedure of EPS collection
      using this catheter is as follows; first the catheter is inserted into the
      urethra, then a balloon is blown up. The catheter is extracted during massage of
      the prostate and finally EPS is aspirated through the internal lumen of the
      catheter. In 23 male patients who had neither urinary tract infection nor genital
      infection, this catheter method was carried out. Before inserting the catheter,
      the urethral swab was obtained, then culture of the swab and the EPS was done.
      The catheter method protected against contamination with bacteria in 56%, with
      Ureaplasma urealyticum in 40%, and all contaminations in 44% of all cases.

PMID- 1755422
TI  - [Clinical study on acute scrotum].
AB  - Between April 1986 and July 1990, we experienced 13 cases of acute scrotum with
      surgical exploration. Six of the patients had torsion of the spermatic cord;
      three had torsion of an appendix of the epididymis, one had torsion of a
      testicular appendix, one had testicular rupture, one had acute epididymitis and
      one was normal. Their ages ranged from 3 months to 55 years (mean: 17.7 years),
      and the patients with torsion of the spermatic cord ranged from 5 to 25 years in
      age (mean: 16.3 years). No specific symptoms, signs, or laboratory findings were
      noted in patients with torsion of the spermatic cord. In the majority of cases,
      scrotal swelling and redness of the scrotal skin were present, and we could not
      distinguish parts of the scrotal contents. From 2 to 92 hours had passed before
      the patients presented, and patients who first attended other clinics tended to
      be treated in an inappropriate manner. Orchidopexy was performed in all patients
      with torsion of the spermatic cord. At present, only one testis which was treated
      after a delay of 92 hours has proven to be atrophic. Early consultation of a
      urological clinic and early surgical exploration are important in the treatment
      of the acute scrotum.

PMID- 1755421
TI  - [Clinical study of new technique for collection of EPS, prostate catheter method-
      comparison with Meares and Stamey's method].
AB  - We newly developed a catheter for expressed prostatic secretions (EPS) collection
      and examined whether or not EPS can be collected with this catheter without
      contamination of urethral bacteria. The clinical value of the prostate catheter
      method was examined in comparison with Meares & Stamey's method. Both prostate
      catheter and Meares & Stamey's method were performed by crossover method in 11
      patients who were highly suspected of chronic prostatitis based on symptoms and
      physical findings. Three of the 4 cases of bacterial prostatitis on Meares &
      Stamey's method were diagnosed as bacterial prostatitis by the prostate catheter
      method, but the remaining one was diagnosed as prostatodynia. One of the 3 cases
      of non-bacterial prostatitis on Meares & Stamey's method was diagnosed as non
      bacterial prostatitis, but the other two cases were diagnosed as urethritis. Four
      cases of prostatodinia on Meares & Stamey's method were given the same diagnosis
      by the prostate catheter method. In conclusion, eight of 11 cases received the
      same diagnosis by the two different method. The remaining three cases were given
      different diagnosis, but the prostate catheter method gave a more accurate
      diagnosis. We concluded that the prostate catheter method is useful in the
      differential diagnosis of bacterial prostatitis and non-bacterial prostatitis.

PMID- 1755423
TI  - [Ureaplasma urealyticum and mycoplasma hominis in male urethritis].
AB  - We conducted a multi-center clinical study to evaluate the role of Ureaplasma
      urealyticum and Mycoplasma hominis in male urethritis. The incidence of each
      organism in first-voided urine samples of 160 male urethritis patients, including
      28 with gonococcal and 126 with non-gonococcal urethritis, was investigated. U.
      urealyticum and M. hominis were isolated from 13.6% and 6.5%, respectively, of
      the urine samples, and the concentration of each mycoplasma exceeded 10(3) ccu/ml
      (color changing units/ml) in 5.2% and 3.9%, respectively. Among 64 patients with
      non-gonococcal non-chlamydial urethritis, U. urealyticum and M. hominis
      concentration exceeding more than 10(3) ccu/ml were detected in only two and one
      samples, respectively. The incidence among urethritis patients with a
      concentration of either mycoplasma exceeding 10(3) ccu/ml was not significantly
      greater than that among subfertile males without urethritis. The findings of the
      present study suggest that, although mycoplasmas may cause urethritis in some
      patients, the incidence of urethritis due to U. urealyticum or M. hominis is low
      among patients with non-gonococcal, non-chlamydial urethritis.

PMID- 1755424
TI  - [Renal pseudoaneurysm successfully treated by superselective embolization as a
      complication of percutaneous nephrolithotomy: report of a case].
AB  - A case of renal pseudoaneurysm which occurred as a complication of percutaneous
      nephrolithotomy (PNL) for right renal staghorn calculi is presented. A 59-year
      old man, who previously had left nephrectomy due to renal staghorn calculi and
      right pyelolithotomy due to renal calculi, was admitted to our hospital for
      treatment of recurrent right renal staghorn calculi on March 29, 1990. Laboratory
      data on admission revealed no significant abnormality except for a mild elevation
      on blood glucose (116 mg/dl). Pseudomonas aeruginosa (10(6) CFU/ml) was cultured
      from urine. Preoperative plain abdominal film showed right partial staghorn
      calculi extending to the lower calyx and pelvis. Three sessions of PNL were
      performed. Two nephrostomy tubes were placed in the upper and middle calyces at
      the first session. Although all calculi were removed completely, massive renal
      bleeding with bladder tamponade occurred several times postoperatively and blood
      transfusion was necessary. Renal angiography was performed, and it was
      demonstrated renal pseudoaneurysm at the upper nephrostomy tract. At the same
      time the pseudoaneurysm was treated by superselective embolization with an
      absorbable gelatin sponge. We reviewed the related literature on complications of
      PNL. Etiology and treatment of a renal vascular injury associated with PNL are
      also discussed.

PMID- 1755425
TI  - [A case of synchronous ipsilateral renal cell carcinoma and transitional cell
      carcinoma].
AB  - A case of synchronous ipsilateral renal cell carcinoma with renal pelvic and
      ureteral transitional cell carcinoma is reported. A 80-year-old man, who had had
      transurethral resection of bladder tumor three times, was admitted on August,
      1989 for recurrence of bladder tumor. Excretory pyelography revealed a filling
      defect of left renal pelvis. Findings of retrograde pyelography and computed
      tomography were in accord with those of the excretory urograms. Under a diagnosis
      of the left renal pelvic and ureteral tumor associated with the bladder tumor,
      left nephroureterectomy with bladder cuff resection was performed. Pathological
      diagnosis was renal pelvic and ureteral transitional cell carcinoma with renal
      cell carcinoma, which existed incidentally in the same kidney. Double unrelated
      primary carcinoma in urinary tract, especially, double dissimilar primary
      carcinoma in the same kidney, is rare. To our knowledge, this case is the 20th
      double cancer in upper urinary tract reported in Japan.

PMID- 1755426
TI  - A case large protruding cystitis glandularis: clinical, histological and mucin
      histochemical study.
AB  - A case of large protruding cystitis glandularis is reported. A 36-year-old man
      was admitted to our hospital due to acute cholecystitis, and large protruding
      masses were incidentally found in the urinary bladder by abdominal
      ultrasonography. The histological study revealed that they consisted of a large
      number of Brunn's nests with or without cysts which were often accompanied with
      columnar epithelial metaplasia, and of glandular structures closely resembling
      the colonic crypts. The mucin-histochemical study demonstrated glandular lesions
      in the bladder secreted colonic type mucin, and endocrine cells positive with
      Grimelius' staining. A review of literature disclosed 19 clinical cases of
      cystitis glandularis, since 1970, in Japan, but such a large protruding lesion as
      this case is rare. We first performed detailed histological and mucin
      histochemical studies for this clinical case.

PMID- 1755427
TI  - [Foreign body stone of the ureter as a complication of acupuncture: report of a
      case].
AB  - A 47-year-old female was admitted to our clinic with the suspicion of ureteral
      foreign body. She had undergone acupuncture for left lumbago twelve years
      earlier. Plain X-ray film revealed a linear shadow and calcified shadows
      laterally to left third lumber vertebra. Computed tomographic scan and pyelogram
      showed them located in the left ureter. Left ureterolithotomy was performed
      successfully. The removed stone was accompanied by an acupuncture needle.
      Including our case, twelve cases of foreign bodies as a complication of
      acupuncture in the upper urinary tract reported in the Japanese literature were
      reviewed.

PMID- 1755428
TI  - [Intrascrotal and seminal vesicular granuloma probably induced by
      propionibacterium acnes].
AB  - A case of right intrascrotal and seminal vesicular granuloma probably induced by
      Propionibacterium acnes is reported. A 62-year-old man was admitted to our
      department because of low grade fever and the right intrascrotal and retrovesical
      masses without tenderness. Ultrasonography computed tomography, magnetic
      resonance imaging and vesiculography suggested a neoplasm. However, leukocytosis
      and high erythrocyte sedimentation rate (ESR) and c-reactive protein level (CRP)
      suggested inflammatory disease. He was treated for 1 week with parenteral
      cefazolin (CEZ) (4 g/day), and the intrascrotal mass was remarkably reduced in
      size. To rule out neoplasms, right orchiectomy and needle biopsy of the right
      seminal vesicle were performed and nonspecific chronic granuloma was identified
      histologically. On the 5th postoperative day he developed fever (39.2 degrees C)
      and P. acnes was isolated from blood culture. Gram stain revealed gram-positive
      rods in the specimen. Further chemotherapy normalized levels of ESR and CRP and
      white blood cell count and reduced the right seminal vesicle to its normal size.
      Recently several cases of infection induced by P. acnes have been reported, but
      this is the first report in the genitourinary tract.

PMID- 1755429
TI  - [Laboratory and clinical study of sulbactam/cefoperazone (SBT/CPZ) on bacterial
      prostatitis].
AB  - The cefoperazone and sulbactam concentrations in human prostatic fluid were
      measured following intravenous administration of sulbactam/cefoperazone (SBT/CPZ)
      and its clinical efficacy and safety in the treatment of 11 patients with acute
      or chronic bacterial prostatitis were evaluated. Cefoperazone concentrations in
      prostatic fluid (PF) one hour after an intravenous infusion of SBT/CPZ at a dose
      of 1 g and 2 g were 0.57 +/- 0.26 micrograms/ml and 1.37 +/- 0.86 micrograms/ml,
      respectively, both exceeding the MIC against most of the isolated strains from
      expressed prostatic secretion (EPS). The sulbactam levels in PF at doses of 1 g
      and 2 g of SBT/CPZ were 0.30 +/- 0.18 micrograms/ml and 0.38 +/- 0.13
      micrograms/ml, respectively, both of which were high enough to potentiate
      antimicrobial activity of cefoperazone. The peak of MIC distribution of
      sulbactam/cefoperazone against E. coli (14 strains) and S. epidermidis (21
      strains) isolated from EPS of patients with bacterial prostatitis was in a range
      of 0.1-0.2 micrograms/ml and 0.2-0.78 micrograms/ml as described for the
      cefoperazone concentration, respectively, which were superior to those of
      cefoperazone, ceftazidime and piperacillin, all compared as control, SBT/CPZ
      exhibited 8 fold or more potent antimicrobial activity than cefoperazone against
      beta-lactamase producing E. coli and CNS. Clinically, SBT/CPZ was given to 11
      patients diagnosed as having bacterial prostatitis in a daily dose of 2-4 g for 5
      to 8 days. The drug was found to be effective in all (100%) of 5 patients with
      acute prostatitis and in 3 (75.0%) of 4 patients who were judged to be assessable
      among 6 chronic patients. No side effects of any kind were observed in any of the
      patients treated. In laboratory tests, a transient thrombocytopenia was reported
      for one patient. SBT/CPZ is particularly useful in the treatment of acute
      bacterial prostatitis caused by GNR. This drug is useful for chronic prostatitis
      those, caused primarily by CNS which is susceptible to this agent. This drug is
      available as an injectable form, subjects for its appropriate usage will be those
      who show acute exacerbation of infection or who do not respond to oral therapy.

PMID- 1755430
TI  - Prevention-centered science in mental health.
AB  - Provides an overview of the Preventive Intervention Research Center (PIRC)
      Program, and an introduction to the nine papers of a special issue of AJCP.
      Discusses major problems faced by prevention researchers and ways in which the
      PIRCs are structured to address some of these problems. Highlights the importance
      of rigorous prevention experiments as tests of theory, and therefore as critical
      components of the scientific continuum.

PMID- 1755431
TI  - The use of structural equation modeling in generative research: toward the design
      of a preventive intervention for bereaved children.
AB  - Describes a generative study of processes which may lead to symptomatology in
      children who have experienced the death of a parent. Based on existing
      literature, four putative mediating variables were identified: parental
      demoralization, family warmth, negative family events, and positive stable family
      events. Structural equation modeling techniques were used to compare several
      potential causal models involving these variables. The results were most
      consistent with a model in which bereavement was not directly related to the
      child symptomatology, but rather its effects were transmitted through these four
      mediational mechanisms. The implications of the results of the structural
      modeling for the design and evaluation of preventive interventions are discussed
      briefly.

PMID- 1755432
TI  - Epidemiology and preventive interventions: parental death in childhood as a case
      example.
AB  - Illustrates how standard epidemiologic principles form the knowledge base to
      justify a preventive intervention for an at-risk population. These principles
      were applied to a sample of 92 from the population of children aged 8 to 15 at
      alleged risk for mental health disorders because a parent died. Prior work on
      this alleged risk population is sparse and flawed. Validly determining the
      population effect of an alleged risk factor requires assessing the influence of
      sampling bias. The bias found, underrepresentation of deaths of a mother, did not
      influence the relations among death of a parent and children's depression and
      conduct disorder, and the modifiable mediators of risk to be changed by the
      preventive intervention. The epidemiologic measure of effect indicated that death
      of a parent is a risk factor for major depression but not for conduct disorder
      among youth. Families recruited for the preventive intervention by epidemiologic
      methods (ES families) did not differ significantly from the earlier families on
      whom the knowledge base was formed. Families referred to the intervention by self
      or others significantly differed from the ES families in two ways that
      constituted serious biases. The implications of these biases for prevention were
      discussed.

PMID- 1755433
TI  - Stability and quality of life events and psychological symptomatology in children
      of divorce.
AB  - Studied the relations between postdivorce events and maladjustment of children of
      divorce using a two-dimensional model of events. One dimension concerned the
      stability of events and included whether they were increases, decreases, or the
      continuation of stable conditions. The second dimension was quality, and included
      whether they had a positive or negative valence. Two samples of children of
      divorce (ns = 142 and 64) ages 8-15 were studied. Children's overall
      maladjustment as reported by children and parents were the criterion variables.
      Scores were derived from a life events schedule for children of divorce to assess
      the occurrence and stability of positive and negative divorce-related events. The
      relations between event scores and maladjustment were different when children's
      self-reports and parent reports were used as criterion. In predicting children's
      self-reported maladjustment (a) stable positive events but not changes in
      positive events were related to lower maladjustment (b) increased negative events
      were related to higher maladjustment, and (c) change for the worse was related to
      higher maladjustment. In predicting parent reports of children's maladjustment,
      only the relations of the change for the worse score were replicated.
      Implications of the results for the design of preventive interventions and for
      the study of children in stressful situations are discussed.

PMID- 1755434
TI  - Factors facilitating adjustment to unemployment: implications for intervention.
AB  - Conducted a community survey in the Fall of 1984 in a sample of high unemployment
      blue-collar census tracts in southeastern Michigan. Results of earlier analyses
      using these data showed that involuntarily unemployed workers had significantly
      elevated levels of depression, anxiety, somatization, and self-reported physical
      illness relative to a stably employed comparison group (Kessler, House, & Turner,
      1987). Results presented in this paper document that this relationship is
      modified by social support (as measured by social integration and the
      availability of a confidant), self-concept, and various coping processes. Further
      analyses allowed us to determine the way in which these modifiers operate. The
      modifying effects of social support and coping operate primarily by buffering the
      impact of unemployment-related financial strain on the health outcomes. Self
      concept operates primarily by attenuating vulnerability to other stressful life
      events. The implications of these results for the design and implementation of
      preventive interventions are discussed.

PMID- 1755435
TI  - From field experiments to program implementation: assessing the potential
      outcomes of an experimental intervention program for unemployed persons.
AB  - Demonstrated a procedure suggested by Bloom (1984) to provide estimates for the
      effects of an intervention on its actual participants compared to global effects
      on study participants in the intervention group, whether or not they showed up.
      Analyses were based on data collected in a field experiment that tested a
      preventive intervention for unemployed persons (Caplan, Vinokur, Price & van Ryn,
      1989). Effect size estimates were two to three times larger for the actual
      participant group than for the entire experimental group on employment outcomes
      (e.g., earnings) and mental health (anxiety and depression). Further analyses
      produced results showing that compared to participants, the nonparticipants
      achieved significantly higher levels of reemployment at posttests and did not
      differ significantly from participants on all other outcomes. The results suggest
      that persons who most needed the intervention and benefited from it were drawn
      into it through self-selection processes.

PMID- 1755436
TI  - Developmental epidemiologically based preventive trials: baseline modeling of
      early target behaviors and depressive symptoms.
AB  - Describes a conceptual framework for identifying and targeting developmental
      antecedents in early childhood that have been shown in previous work to predict
      delinquency and violent behavior, heavy drug use, depression, and other
      psychiatric symptoms and possibly disorders in late adolescence and into
      adulthood. Criteria are described that guided choices of targets for two
      epidemiologically based, randomized preventive trials carried out in 19
      elementary schools in the eastern half of Baltimore, involving more than 2,400
      first-grade children over the course of first and second grades. Baseline models
      derived from the first of two cohorts show the evolving patterns of concurrence
      among the target antecedents. The central role of concentration problems emerged.
      From Fall to Spring in first grade, concentration problems led to shy and
      aggressive behavior and poor achievement in both genders and to depressive
      symptoms among girls. There was evidence for reciprocal relationships in girls.
      For example, depressive symptoms led to poor achievement in both girls and boys,
      whereas poor achievement led to depressive symptoms in girls but not boys, at
      least over the first-grade year. These results provide important epidemiological
      data relevant to the developmental paths leading to the problem outcomes and
      suggest preventive trials.

PMID- 1755437
TI  - Effect of first-grade classroom environment on shy behavior, aggressive behavior,
      and concentration problems.
AB  - Investigates the effect of the first-grade classroom environment on the shy
      behavior, aggressive behavior, and concentration problems of 609 children in 19
      East Baltimore public schools. First-grade classroom environment was assessed in
      terms of dominant pattern of classroom achievement and behavior. Structured
      teacher ratings assessed child shy behavior, aggressive behavior, and
      concentration problems at the end of first grade. Children in low-achieving
      classroom environments had significantly higher teacher ratings of shy behavior
      and aggressive behavior than children in mixed-achieving or high-achieving
      environments, even after controlling for potentially confounding child
      characteristics and classroom behavior environment effects. Analyses controlling
      for child characteristics and classroom achievement environment effects indicated
      that children in poor-behaving classroom environments also had significantly
      higher teacher ratings of shy behavior than children who were not in poor
      behaving environments. Subgroup analyses indicated that repeaters in mixed
      achieving environments had significantly higher levels of shy behavior compared
      with nonrepeaters, and repeaters in poor-behaving environments had significantly
      higher levels of aggressive behavior compared with nonrepeaters. Implications for
      prevention research are discussed.

PMID- 1755438
TI  - Who enrolls in prevention trials? Discordance in perception of risk by
      professionals and participants.
AB  - Internal and external validity problems permeate all intervention studies but are
      accentuated in primary preventive intervention research, particularly when
      studies target or recruit individuals based on their risk for psychopathology.
      Since many people who are at risk do not yet experience distress, they may not
      perceive the need for intervention. Recruitment tactics based on explaining
      extent of risk are unlikely to be persuasive and may have negative consequences.
      If respondents are not motivated to participate, a small or biased subset of the
      target population will participate in the intervention. Bias is of special
      concern when those enrolled represent only part of the continuum of risk.
      Selective enrollment may compromise both internal validity (the interpretation of
      the research results) and external validity (the generalizability of the
      findings) of intervention trials in primary prevention. This article discusses
      the effects of partial enrollment and the resultant bias. It suggests several
      strategies for increasing the enrollment of the target population and examines
      some of their ethical ramifications. It also stresses the importance of
      collecting systematic data documenting how the participants in the intervention
      differ from the target group as a whole.

PMID- 1755439
TI  - Reinventing fidelity: the transfer of social technology among settings.
AB  - In an ideal world, effective programs would be disseminated on a large scale, but
      many obstacles block program diffusion. To date, little guidance has been
      provided by program designers on how to implement the program in different sites
      with different personnel and client populations. This article discusses the
      debate between the "fidelity camp" and the "reinvention camp" and suggests an
      approach that reconciles the two positions: fidelity should be maintained to the
      program's mechanism of operation; reinvention is permitted in implementation if
      the causal mechanism is preserved. Such an approach is essential for effective
      dissemination of preventive interventions that are successful in controlled
      trials.

PMID- 1755440
TI  - Invited commentary: common wisdom and plain truth.

PMID- 1755441
TI  - The relation between serum albumin levels and risk of coronary heart disease in
      the Multiple Risk Factor Intervention Trial.
AB  - The relation between serum albumin levels and subsequent incidence of myocardial
      infarction and coronary heart disease deaths was evaluated using stored serum
      from the Multiple Risk Factor Intervention Trial (MRFIT). There were 91 coronary
      heart disease deaths, 113 myocardial infarction patients, and 405 controls
      matched to cases within 5 years of age, treatment group, and clinic site. There
      was a highly significant inverse relation between serum albumin level and risk of
      coronary heart disease. Individuals with a baseline level of serum albumin
      greater than or equal to 4.7 g/dl had an odds ratio of 0.45 as compared with
      individuals with a baseline level of serum albumin less than 4.4 g/dl. The
      relation persisted after adjusting for other cardiovascular risk factors (blood
      pressure, smoking, and serum cholesterol). The association was stronger for
      coronary heart disease deaths than for surviving myocardial infarction patients,
      and for cigarette smokers as compared with cigarette nonsmokers. The deaths
      studied occurred in the time period at least 6 years after the sera had been
      obtained and up to 10.5 years of follow-up, and the myocardial infarctions
      studied occurred within the first 6.5 years of follow-up. There was no consistent
      relation between time and death due to coronary heart disease or myocardial
      infarction and albumin levels. Albumin levels are related to the acute phase
      reaction. Lower albumin levels may be a marker of persistent injury to arteries
      and progression of atherosclerosis and thrombosis. The consistent relation
      between albumin and coronary heart disease risk requires further evaluation.

PMID- 1755442
TI  - Anthropometric predictors of coronary heart disease and total mortality: findings
      from the US Railroad Study.
AB  - Prospective data from the US Railroad Study were used to investigate the
      relations of several anthropometric variables to coronary heart disease and all
      cause mortality in males initially free of cardiovascular disease. Middle-aged
      men were examined in 1957-1960 and followed until 1977 or death. Anthropometric
      indicators of total body fat (body mass index and the sum of the subscapular and
      triceps skinfolds) and central body fat (the ratios chest
      circumference/biacromial (shoulder) diameter, and chest circumference/standing
      height) were significantly and directly associated with age-adjusted coronary
      heart disease mortality. When systolic blood pressure, serum cholesterol,
      cigarette smoking, and vital capacity were also taken into account, the ratio
      chest circumference/biacromial diameter remained significantly associated with
      coronary heart disease mortality. Total, central, and peripheral body fat had a
      "U"-shaped relation with all-cause mortality. Measures of the ratio of central to
      peripheral body fat were inconsistently related to mortality. These results
      indicate that certain anthropometric measurements, especially those that may
      indicate central adiposity, are positively related to the development of fatal
      coronary heart disease and quadratically related to all-causes death rates.

PMID- 1755443
TI  - Trend in serum total cholesterol level in 110,000 young adults in The
      Netherlands, 1974 to 1986.
AB  - Data from two screening projects on cardiovascular risk factors were used to
      analyze the trend in serum total cholesterol level in the Netherlands between
      1974 and 1986. Cholesterol levels were measured in a single reference laboratory
      of the World Health Organization throughout the entire study period. Between 1974
      and 1980, about 30,000 men and women aged 37 to 43 years (mean age, approximately
      40 years) were screened. A decrease in mean serum total cholesterol level was
      observed until the end of 1977, when it was followed by an increase. This
      resulted in a net change over the entire study period of -0.07 mmol/liter (3
      mg/dl) in men and -0.03 mmol/liter (1 mg/dl) in women. Between 1981 and 1986,
      about 80,000 men aged 33 to 37 years (mean age, 35 years) were screened. During
      this period, a decrease of 0.20 mmol/liter (8 mg/dl) in the mean total
      cholesterol level was observed. In spite of the decline in the mean total
      cholesterol level, the prevalence of cholesterol values of greater than or equal
      to 6.5 mmol/liter (greater than or equal to 251 mg/dl) in young adult men was
      still high in 1986 (16 percent). A further reduction is therefore desirable. The
      decline in the mean total cholesterol level in young adults might indicate that a
      further decline in mortality from coronary heart disease can be expected.

PMID- 1755444
TI  - Relation of blood pressure to cognitive function in the elderly.
AB  - Clinical case-control studies of the relation between blood pressure and
      cognitive function have generally found lower function among hypertensives. Most
      of these studies were small and incompletely controlled for confounders. Two
      population-based studies have yielded conflicting results. This study examines
      cognitive function over the entire range of blood pressure in a defined elderly
      population. A questionnaire administered in the home to 3,809 persons aged
      greater than or equal to 65 years in East Boston, Massachusetts, in 1982 and 1983
      contained four brief cognitive tests: immediate memory, delayed memory, a mental
      status questionnaire, and digit span. In linear regression analyses adjusting for
      age, sex, and education, the direction of the association was not consistent
      among the tests. An increase in diastolic pressure of 10 mmHg was associated with
      an increase of 1.0 in percentile scores on the immediate memory test (95%
      confidence interval (CI) -0.04 to 1.9); with an increase of 1.1 in percentile
      scores on the delayed memory test (95% CI -0.1 to 2.3); with a decrease of -0.8
      in percentile scores on the mental status questionnaire (95% CI -1.8 to 0.2); and
      with a decrease of -0.9 in percentile scores on the attention test (95% CI -1.5
      to -0.2). These results suggest that blood pressure is not a substantial
      contributor to cognitive status in the elderly.

PMID- 1755445
TI  - Identification of risk factors for diethylstilbestrol-associated clear cell
      adenocarcinoma of the vagina: similarities to endometrial cancer.
AB  - This epidemiologic case-control study describes risk factors for clear cell
      adenocarcinoma of the vagina among 106 cases and 447 controls with in utero
      exposure to diethylstilbestrol (DES). Controlling for age, socioeconomic status,
      and time during gestation of initial DES exposure, the authors found a
      significantly increased risk of this cancer in women who were taller or more
      obese then their contemporaries at age 14-15 years. The relative risk of this
      cancer for women in the highest tertile for height compared with those in the
      lowest tertile was 2.5 (95% confidence interval 1.23-4.90). The relative risk
      from a similar comparison of body mass was 2.8 (95% confidence interval 1.20
      6.53). Trend tests indicated that both factors had significant dose-response
      relations with risk of vaginal clear cell adenocarcinoma. These findings are
      particularly interesting since height and body mass are risk factors for
      endometrial cancer. DES-positive cases interviewed more than 10 years after
      diagnosis were also significantly thinner than cases interviewed less than 7
      years after diagnosis (p = 0.01), providing the first evidence that adolescent
      adiposity level is associated with survival times for women with this disease.

PMID- 1755446
TI  - Heterogeneity of breast cancer risk in families of young breast cancer patients
      and controls.
AB  - Familial heterogeneity of breast cancer risk was assessed among 4,159 first
      degree female relatives of 1,074 population-based, young breast cancer cases
      (aged 20-54 years) diagnosed from December 1, 1980 to December 31, 1982 and 4,120
      first-degree female relatives of 998 age- and race-matched, population-based
      controls from the metropolitan Detroit, Michigan, area. The family risk index
      method used for analysis considers family size, age, and race differences among
      families in the assessment of family risk. Families of cases showed a higher risk
      of breast cancer than did families of controls, with case families 1.80 to 4.24
      times more likely to be defined as high risk than control families; the magnitude
      of the risk differential was dependent on the definition of high risk. Within the
      case families only, familial heterogeneity of risk was suggested, with a small
      proportion of families (less than 5%) at lower risk of breast cancer than most
      case families. A number of reproductive risk factors, age, race, and histologic
      type of cancer for the proband, and several family characteristics were
      investigated to help characterize the case families at higher and lower risk.

PMID- 1755447
TI  - A case-control study of nutrient status and invasive cervical cancer. I. Dietary
      indicators.
AB  - A study of 748 cases and 1,411 hospital and community controls in four Latin
      American countries evaluated the association between certain elements of diet and
      invasive cervical cancer. Subjects were interviewed about their adult consumption
      of 58 food items, including the major sources of putative protective agents
      (vitamin A, carotenoids, vitamin C, and folacin) as well as other behavioral and
      medical characteristics related to cervical cancer. Participation rates were
      above 95% for both cases and controls. After adjustment for age, study site,
      sexual and reproductive behavior, socioeconomic status, screening practices, and
      detection of human papillomavirus 16/18 by filter in situ hybridization, a
      slightly lower risk was observed for the highest quartiles of consumption of
      fruit and fruit juices, while no reductions in risk were associated with
      vegetables, foods of animal origin, complex carbohydrates, legumes, or folacin
      rich foods. When nutrient indices were derived, significant trends of decreasing
      risk were observed for vitamin C (adjusted odds ratio (OR) = 0.69 for the highest
      vs. the lowest quartile; p for trend = 0.003), beta-carotene (OR = 0.68; p =
      0.02), and other carotenoids (OR = 0.61; p = 0.003). Inclusion of vitamin C and
      beta-carotene in the same model attenuated the association with beta-carotene,
      while the association with vitamin C remained unchanged. The results are
      consistent with those of other investigations and provide support for a
      protective effect of vitamin C, carotenoids, and other substances found in the
      same fruits and vegetables against the development of invasive cervical cancer.
      However, the fact that the associations were driven by relation in two of the
      study sites and among women of higher socioeconomic status leaves open the
      possibility of selection bias or effects of unidentified aspects of dietary
      patterns.

PMID- 1755448
TI  - A case-control study of nutrient status and invasive cervical cancer. II.
      Serologic indicators.
AB  - A study of 387 cases and 670 controls from four Latin American countries
      evaluated the hypothesis that lower serum levels of eight micronutrients were
      associated with a higher risk of invasive cervical cancer. The serologic analyses
      were restricted to a sample of subjects with stage I and II disease to minimize
      effects of the disease on the serologic markers. Ninety-four percent of eligible
      subjects donated blood samples, which were analyzed for carotenoids, retinol, and
      tocopherols by high-pressure liquid chromatography. Cases did not differ
      significantly from controls in mean serum levels of retinol, cryptoxanthin,
      lycopene, alpha-carotene, lutein, or alpha-tocopherol. The mean level of beta
      carotene was lower and the mean level of gamma-tocopherol was higher among cases
      as compared with controls. After adjustment for age, study site, sexual and
      reproductive behavior, socioeconomic status, screening practices, detection of
      human papillomavirus types 16/18, cholesterol, and triglycerides, a trend of
      decreasing risk was associated with higher levels of beta-carotene (p for trend =
      0.05), with the adjusted odds ratio decreasing to 0.72 for the highest versus the
      lowest quartile. beta-Carotene results were similar by stage of disease, which
      argues against an effect of disease progression on nutrient values. Unexpectedly,
      increasing risks were observed as the level of gamma-tocopherol increased (odds
      ratio = 2.09; p for trend = 0.03); however, levels were higher among stage II
      cases as compared with stage I cases, suggesting a metabolic alteration resulting
      from the disease process. The concordance in the strength and direction of the
      blood and dietary results, presented in the accompanying report (Herrero R,
      Potischman N, Brinton LA, et al., American Journal of Epidemiology 1991;134:1335
      46), supports a role for beta-carotene or foods rich in beta-carotene in the
      etiology of cervical cancer. This study also indicates that simultaneous analysis
      using serologic and dietary nutrient indicators allows better discrimination of
      the association.

PMID- 1755449
TI  - Prevalence, determinants, and consequences of chronic neck pain in Finland.
AB  - Chronic neck pain is a relatively mild musculoskeletal condition, but common
      enough to be a possible public health problem. The distribution, determinants,
      and consequences of chronic neck pain have hitherto been described inadequately.
      In the Mini-Finland Health Survey, a representative population sample of 8,000
      Finns aged greater than or equal to 30 years was invited to participate in a
      comprehensive health examination comprising an interview and a clinical
      examination; 90.2% complied. Predetermined criteria were used to diagnose major
      cardiovascular, musculoskeletal, respiratory, mental, and other disorders,
      regardless of other simultaneous disorders. Chronic neck syndrome was diagnosed
      in 9.5% of the men and 13.5% of the women. When adjusted for age and sex, the
      prevalence of the neck syndrome was associated with a history of injury to the
      back, neck, or shoulder and with mental and physical stress at work. Among those
      aged 30 to 64 years, overweight and parity were also significant determinants.
      Other musculoskeletal and mental disorders were associated with neck syndrome,
      and the association persisted after working conditions, injuries, overweight, and
      parity were adjusted for. There was some independent association between neck
      syndrome and disabilities, use of physician services, and use of pain killers.

PMID- 1755450
TI  - Natural family planning: current knowledge and new strategies for the 1990s.
      Proceedings of a conference. Washington, D.C., December 10-14,1990.

PMID- 1755451
TI  - Natural family planning: looking ahead.
AB  - Natural family planning is used by a relatively small number of people worldwide.
      The Institute's goal is to increase the knowledge, availability, effectiveness,
      and acceptability of natural family planning. To do so, the Institute is
      conducting biomedical research in several areas including: (1) the development of
      a home test kit for ovulation prediction, (2) sperm-mucus interaction, (3) the
      mechanisms and fertility impact of lactational amenorrhea, and (4) outcome of
      pregnancies in natural family planning users.

PMID- 1755452
TI  - Fetal outcome among pregnancies in natural family planning acceptors: an
      international cohort study.
AB  - This international, multicenter, prospective cohort study examines the outcome of
      pregnancies associated with aging gametes. Comparing pregnancies conceived at or
      near the peak mucus phase with those occurring before or after the peak provides
      a means of evaluating the effect of aging gametes. The outcome criteria are (1)
      rates of spontaneous abortion, (2) low birth weight, and (3) congenital
      malformations. Preliminary analysis shows a trend toward increased spontaneous
      abortion with aging gametes in certain subsets (women with prior pregnancy
      losses) but no effect on birth weight. Too few method failures have yet been
      studied to make a definitive statement on congenital malformations.

PMID- 1755453
TI  - Human cervical mucus: research update.
AB  - Evaluation of cervical mucus is a standard for determining the fertile period in
      natural family planning. Cervical mucus accepts, filters, prepares, and releases
      sperm for successful transport to the egg and fertilization. Recent scientific
      advances provide answers to how the mucus regulates fertility as its physical
      properties change during the menstrual cycle. Transmission electron microscopy
      reveals small interstices between mucus macromolecules relative to a sperm head.
      Thus advancing sperm must push aside or cut through the microstructure. The
      interstices are largest in the periovulatory phase of the cycle. Small magnetic
      spheres, comparable with the size of a sperm head, are now being used to study
      the physical properties of the mucus on the scale of individual sperm.

PMID- 1755454
TI  - Symptothermal and hormonal markers of potential fertility in climacteric women.
AB  - One hundred seventy-seven menstrual cycles in 36 women between 45 and 53 years of
      age were studied prospectively. All the women were experienced in the
      symptothermal method of natural family planning. The objective was to determine
      the symptothermal and hormonal indices of potential fertility by measuring
      urinary estrone glucuronide and pregnanediol glucuronide. Thirty-three percent
      had regular cycles consistent with potential fertility, 19% had cycles consistent
      with infertility, and 47% had a mixture of both types of cycle.

PMID- 1755455
TI  - Breastfeeding: a natural method for child spacing.
AB  - Lactational amenorrhea plays an important role in child spacing. Recent research
      has led to a consensus regarding the status of lactational amenorrhea as a method
      of family planning. This is currently referred to as the lactational amenorrhea
      method. Research priorities were to field test the lactational amenorrhea method
      and define the factors that influence lactational amenorrhea and the interface
      between the lactational amenorrhea method and other family planning methods.

PMID- 1755456
TI  - The evolution of reference methods to monitor ovulation.
AB  - Reference methods to predict or detect ovulation have evolved substantially
      during the past few decades. The potential use and limitations of such methods
      are reviewed. The use of transvaginal ultrasonography with color flow mapping to
      monitor periovulatory changes in the intrafollicular morphology and blood flow is
      described.

PMID- 1755458
TI  - Home tests to monitor fertility.
AB  - Industry has been intimately involved in the development of products used in the
      monitoring of fertility at home. The perspective of industry and the development
      of such tests including their rationale are presented. The methods taken by
      industry to utilize current technology in the development of reliable, rapid, one
      step tests for urinary human chorionic gonadotropin and luteinizing hormone and
      the subsequent expansion into other areas are covered.

PMID- 1755457
TI  - Idiometric assay, the third way: a noncompetitive immunoassay for small
      molecules.
AB  - A novel, noncompetitive immunoassay applicable to the measurement of small
      molecules including ovarian steroids is described. Using monoclonal antibodies
      with the ability to recognize both beta-typic and alpha-typic binding sites, a
      new simplified, sensitive, and specific immunoassay system has been developed.
      The initial work of this development is presented, along with preliminary results
      for a novel immunoassay for estradiol.

PMID- 1755459
TI  - A prototype for ovulation detection: pros and cons.
AB  - A noninstrumented enzyme immunoassay for urinary estrone conjugates was adapted
      from an instrumented microtiter plate enzyme immunoassay assay. The end point of
      the assay was a color change from green to clear, which was visible to the
      unaided eye. The visible color change was adjusted to allow 80 ng/ml estrone
      conjugates (on the basis of a sample size of 6.5 microliters urine) to be
      distinguished from an infinite dilution without instrumentation. The evaluation
      of human urine collected from ovulatory ovarian cycles demonstrated that early
      follicular phase concentrations (35.9 +/- 6.8 to 79.4 +/- 14.7 ng/ml, n = 10)
      produced a dark-green color, whereas late follicular phase concentrations (162.9
      +/- 20.1 ng/ml, n = 10) produced no color. Daily urine samples throughout 10
      ovulatory ovarian cycles produced parallel profiles when compared to measurements
      of estradiol in paired blood samples. Complete analysis of the data indicated
      that ovarian follicular dynamics can be accurately monitored through the
      noninstrumented analysis of daily estrone conjugates in urine samples.

PMID- 1755460
TI  - Use of the Home Ovarian Monitor in pregnancy avoidance.
AB  - The application of the Home Ovarian Hormone Monitor to the avoidance of pregnancy
      by periodic abstinence has been explored. No woman had difficulty with the daily
      urine testing, and their results consistently identified the distinctive hormone
      pattern of the ovulatory cycle and the day of ovulation and correlated closely
      with the mucus symptoms. The tests gave 4 days or more warning of ovulation in
      99% of cycles and allowed intercourse to be resumed 1 to 3 days after ovulation
      in 88%, giving a mean period of abstinence of 7 days. No pregnancy occurred from
      intercourse during the late safe days defined by the Monitor, but some early-day
      pregnancies occurred through long sperm survivals of 6 to 8 days, mostly during
      the return of fertility after breastfeeding. Rules for the avoidance of
      pregnancy, with the minimum of testing on the basis of these results, are given.

PMID- 1755461
TI  - Is the lactational amenorrhea method a part of natural family planning? Biology
      and policy.
AB  - The lactational amenorrhea method is a natural method of family planning for
      women who breastfeed their infants. The underlying physiology results in a
      natural suppression of ovulation, and the concomitant amenorrhea, induced by
      exclusive (or almost exclusive) breastfeeding. This in addition to the infant's
      age of 6 months or less and specific feeding pattern are the parameters used to
      identify the possible return of fertility. The lactational amenorrhea method
      provides at least 98% protection against pregnancy. Data from a recent
      multicenter study of breastfeeding support the use of the lactational amenorrhea
      method as a natural family planning method. The lactational amenorrhea method can
      be incorporated into natural family planning programs and teaching.

PMID- 1755462
TI  - The natural family planning--lactational amenorrhea method interface:
      observations from a prospective study of breastfeeding users of natural family
      planning.
AB  - Methods of natural family planning are sometimes difficult for women to use
      during lactation. When this is so, the lactational amenorrhea method may prove
      useful. Researchers agree that a fully breastfeeding woman who is amenorrheic is
      98% protected from pregnancy for up to 6 months after delivery. The fertility
      status of 74 users of natural family planning during the time they would have
      been protected by the lactational amenorrhea method is examined. Underlying
      hormonal profiles show that there was little ovarian activity during this time.
      Eight ovulatory events occurred during the period of protection by the
      lactational amenorrhea method, of which four fulfilled minimum criteria for
      adequacy; there were no pregnancies during this period. However, some women did
      report experiencing fertile mucus symptoms during this time that were often
      unrelated to estrogen production. Using the lactational amenorrhea method rather
      than natural family planning allows them to avoid unnecessary abstinence.

PMID- 1755463
TI  - Ultrasonographic patterns of ovarian activity during breastfeeding.
AB  - In this study, ultrasonography was used to detect follicular activity in
      lactating women, and these findings were related to the underlying hormonal
      profiles and to the mucus symptom. A number of different patterns of follicular
      development were seen before the women returned to normal fertile cycles during
      the period that was previously considered to be characterized by ovarian
      quiescence. Some of the transitory patterns of follicular activity were reflected
      in rising hormone levels and patterns of fertile mucus that were sometimes
      confusing for these lactating women who were using natural family planning.

PMID- 1755464
TI  - Ovulation method use during breastfeeding: is there increased risk of unplanned
      pregnancy?
AB  - Data from two prospective studies of the ovulation method were used to assess
      pregnancy rates and users' fertility-related behaviors among breastfeeding women.
      The rate of unplanned pregnancy was less than 1% during the first 6 months of
      lactational amenorrhea. However, the unplanned pregnancy rate was elevated among
      breastfeeders during the months after menses return compared with the pregnancy
      rate during nonlactating cycles. Rates were also elevated at the time when infant
      feeding supplementation was started. This increase in unplanned pregnancies was
      not directly attributable to nonadherence to the ovulation method rules; there
      was some indication that adherence to the rules actually may be increased during
      those months. Therefore, special emphasis on both the need for improved
      breastfeeding support to delay menses return and the increased potential for
      method failure among new users during this period of time should be incorporated
      into ovulation method training and support programs.

PMID- 1755466
TI  - Santiago Breastfeeding Promotion Program: preliminary results of an intervention
      study.
AB  - A prospective intervention study was undertaken in Santiago, Chile, to assess the
      impact of a breastfeeding promotion program and the acceptance and use of the
      lactational amenorrhea method for natural child spacing. The intervention study
      significantly increased the duration of exclusive breastfeeding and amenorrhea.
      In addition, the use of the lactational amenorrhea method proved highly
      efficacious, with an unplanned pregnancy rate of less than 0.5% by 6-month
      cumulative life table. Total family planning coverage at 6 months was increased
      in the intervention group.

PMID- 1755465
TI  - Efficacy of the symptothermal method of natural family planning in lactating
      women after the return of menses.
AB  - This study was designed to determine the efficacy of the symptothermal method of
      natural family planning during lactation. Although the method appears to give a
      reasonable reflection of fertility potential over time, it overlaps with the
      profound influence of lactation in both ovulation suppression and the delay of
      luteal phase adequacy. Further analysis is planned to attempt to identify those
      particular mucus signs and symptoms that are helpful during the transition from
      lactational amenorrhea to normal cycling.

PMID- 1755467
TI  - Natural family planning use-effectiveness and continuation.
AB  - Numerous studies have been conducted to assess the use-effectiveness of natural
      family planning. However, because of imprecise definitions of terms, these
      studies show noncomparable results. Special effort is required to study natural
      family planning use-effectiveness by the same criteria as other family planning
      methods.

PMID- 1755468
TI  - Efficacy studies in natural family planning: issues and management implications
      illustrated with data from five studies.
AB  - Studies of method effectiveness must be carefully assessed for comparability of
      findings. Several parameters are identified that are important in the assurance
      of comparable results. This article discusses these issues with the use of data
      from previously published studies and emphasizes the management implications of
      use-effectiveness data.

PMID- 1755469
TI  - Effectiveness and acceptibility of the symptothermal method of natural family
      planning in Germany.
AB  - Throughout Germany, 851 women who were instructed in natural family planning
      participated in a prospective study. Of these, 255 women with 3174 cycles used
      only natural family planning for family planning and 274 women with 3995 cycles
      occasionally used barrier methods in the fertile phase. For natural family
      planning--only users, the Pearl rate for unplanned pregnancy was 2.3 and for
      mixed-method users 2.1. Most pregnancies resulted from unprotected intercourse
      during the fertile phase, and the use of barrier methods does not reduce risk
      taking.

PMID- 1755470
TI  - Further analysis of contraceptive failure of the ovulation method.
AB  - Reanalysis of data on the ovulation method of natural family planning collected
      by the World Health Organization yields the following conclusions. The method is
      effective during perfect (correct and consistent) use, with a first-year
      probability of failure of 3.4%. However, it is extremely unforgiving of imperfect
      use, with a first-year probability of failure of 84.2% if the method is not used
      correctly. During the initial year, 87% of the cycles were characterized by
      perfect use. Nevertheless, the 13% of cycles characterized by imperfect use had a
      tremendous impact on the overall failure rate. During the first year of typical
      use 22.5% of the women in the clinical trial became accidentally pregnant.

PMID- 1755471
TI  - Factors related to autonomy and discontinuation of use of natural family planning
      for women in Liberia and Zambia.
AB  - From 1983 to 1988, natural family planning programs were conducted in Liberia and
      Zambia. In Liberia 1055 and in Zambia 2709 women used natural family planning to
      avoid pregnancy. These users could become pregnant, discontinue use of the
      method, or become autonomous users. Women who changed intention did not stop use
      of natural family planning and were not treated as discontinuations. In a
      multivariate analysis, client's age, breastfeeding status, employment,
      urban/rural residence, time of registration in the program, and visit intensity
      were significantly associated with the outcomes. The most consistent association
      was that women who entered the programs in the later time periods were more
      likely to become autonomous users and less likely to discontinue use of the
      method or to experience an accidental pregnancy.

PMID- 1755472
TI  - Measuring natural family planning in terms of couple-years of protection.
AB  - Couple-years protection is a summary index of contraceptive protection. Couple
      years protection allows comparisons of natural family planning with other
      methods. One couple-year protection for condoms is equal to 1 couple-year
      protection for pills and 1 couple-year protection for natural family planning.
      Critical in the calculation of couple-year protection for natural family planning
      is average duration of use. A working group on natural family planning
      recommended that 2 years of use be used as average duration until more data are
      available.

PMID- 1755473
TI  - The modified mucus method in India.
AB  - The modified mucus method-Prajanan Jagriti (fertility awakening) is intended to
      serve the cultural needs of illiterate and semilliterate women. Over 10 months,
      3003 women in northern India were taught the modified mucus method. There were a
      total of 42 pregnancies in 24,702 cycles for a Pearl index of 2.04. High
      effectiveness is attributed to the support that was provided to clients by the
      instructor.

PMID- 1755474
TI  - Setting goals for the classroom.

PMID- 1755475
TI  - Student group approach to teaching using Tuckman model of group development.
AB  - If health care professionals are to be effective members of an interdisciplinary
      team of diagnostic specialists, it is critical that their university education
      equip them for that role. Using Tuckman's four stages of "forming," "storming,"
      "norming," and "performing," university faculty are shown how a group of
      undergraduate science students can be developed into an organism intent on
      identifying solutions to problems posed to them (e.g., technical, medical
      ethical). The use of the group approach enhances maturity, competence, self
      esteem, and motivation of the students and enables the instructor to delegate
      appropriate responsibilities to the students. In addition to a sense of
      achievement, students also reported greater appreciation of the ideas, values,
      and abilities of their group colleagues.

PMID- 1755476
TI  - Osmotic properties of cells: a computer laboratory.
AB  - A computer laboratory has been designed to teach the osmotic properties of cells.
      One program, CELL.BA, is for the teacher to enter values for the volume of cell
      water and osmotically inactive material, the concentration of impermeant solute
      in the cell, and the permeability of the plasma membrane to water and a
      nonelectrolyte. When the program is protected, students use it as a cell with
      unknown osmotic properties. They run experiments on the computer with different
      concentrations of impermeant or permeant solutes or combinations of the two.
      Changes in cell volume or solute concentration are collected as data and analyzed
      with the program, PERMEABILITY LAB.BA. This program provides a parameter list,
      and students try to fit the data that are graphed on the screen by choosing
      values for the unknown cell parameters and generating model curves. Programs are
      written for the Macintosh computer.

PMID- 1755477
TI  - Measurement of gastric secretion as a student teaching exercise.
AB  - Teaching gastrointestinal physiology to preclinical medical students presents
      problems in finding suitable practical exercises to demonstrate the physiology of
      gastric acid secretion. In our course, students measure their own gastric
      secretory activity by the use of nasogastric tubes. Gastric secretion can be
      stimulated by insulin-induced hypoglycemia or by pentagastrin, a synthetic
      gastrin analogue. The time course of the secretory responses, i.e., volume, acid
      output, and pH, are followed by collecting control and poststimulatory secretions
      into 15-min samples. The effect of antiulcer drugs, such as cimetidine, can be
      easily studied in such experiments. The results of these experiments are very
      reproducible, allowing year-to-year comparisons of treatments. Examples of
      results of various experimental protocols are shown. We believe this to be a
      useful class exercise not only because of the excellent results it yields but
      because of the experience and insights it produces.

PMID- 1755478
TI  - Ventilatory control (Ventrol) simulation for education.
AB  - An educational microcomputer-based simulation of respiratory control has been
      developed. The program contains three major sections: tutorial, stimulation, and
      unknown testing. The tutorial section provides a brief discussion of the major
      factors involved in respiratory control. The simulation section provides a menu
      of variables to demonstrate the effects of altering inspired gases, changing
      compliance or airway resistance, metabolic acidosis, neural activity, and lesions
      (including vagotomy) or exercise. The last section of the program allows students
      to test their understanding of abnormal respiratory and blood gas values. The
      program has been used as a problem-solving exercise in a medical physiology
      course. Student groups were assigned to a microcomputer and given a specific
      problem during a regularly scheduled laboratory period. The students collected
      data using the program, analyzed and graphed or tabulated the results, and
      presented their findings in a minisymposium format to their fellow students. This
      approach has proven valuable and provides a number of pedagogical benefits that
      are lacking in a lecture-based basic science curriculum.

PMID- 1755479
TI  - Basic medical physiology: the whole is more than the sum of its parts.
AB  - In this article we examine the role of basic medical physiology in medical school
      education. We discuss the historical background, courses in this subject, and
      methods of teaching it. We conclude that the teaching of medical physiology
      should emphasize the study of organ systems and of the intact body. The
      techniques should emphasize meticulous observation, the posing of hypotheses, and
      the subsequent testing of the hypotheses, i.e., the use of the method used
      successfully in research. Students should learn the power of the experimental
      approach and to appreciate the immense variability possible in responses in
      complex organisms. They should also learn that principles of statistical
      probability applied logically can detect important differences in data that may
      be obscured by this variability. They should learn that there are no rigid
      answers when studying an individual and that they must continue to learn
      throughout their lives.

PMID- 1755480
TI  - Performance on multiple choice/short answer tests is not a sufficient criterion
      for evaluating the educational value of live animal laboratories in the teaching
      of physiology.

PMID- 1755481
TI  - Human situations: a course introducing physiology to medical students.
AB  - A block course of 12 days is described. It is considered to be appropriate for
      both physiologically naive and sophisticated students entering either a
      traditional or a problem-based curriculum. It is adaptable for medical schools in
      both developed and developing countries. Six problem-based small-group sessions,
      based on everyday human situations, are the core of the course. They are
      supplemented by a lecture series, laboratory experiments using student volunteers
      as subjects, laboratory demonstrations, and patient presentations. Student
      assessment is carried out by criterion-referenced examinations using take-home
      assignments, oral examinations, and a multiple-choice test containing context
      dependent questions. The course is well received by students and faculty. Pre-
      and posttesting show that all students acquire a basic understanding of
      physiological control systems and of homeostatic mechanisms as they operate in
      intact human beings.

PMID- 1755482
TI  - [Current aspects of ultrasonic diagnosis of multiple pregnancy].

PMID- 1755483
TI  - [Use of transvaginal echography in early pregnancy].

PMID- 1755484
TI  - [Effect of fetal behavioral reactions and respiratory movements on the blood flow
      in the ductus arteriosus].
AB  - Relationship between blood flow velocity waveform and fetal behavioral states was
      studied in 16 normal pregnancies at 37 to 38 weeks' gestation. The peak flow
      velocity has demonstrated a statistically significant reduction during active
      sleep, as against that in quite sleep. These data reflect reduced ductal flow and
      suggest a redistribution in the left-ventricular and right-ventricular output in
      favor of the left side of the heart during active sleep. In a prospective cross
      sectional study of 49 pregnancies (50 fetuses) between 25th and 38th weeks an
      exponential increase in breathing-related ductal blood flow velocity modulation
      was observed with advancing gestational age, reflecting the developing pulmonary
      vascular bed. Fetal ductal flow velocity waveforms were also recorded in 13 cases
      of prolonged severe oligohydramnios after membrane rupture before 28 weeks'
      gestation. Normal ductal blood flow velocity modulation values were associated
      with normal neonatal lung performance, whereas reduced blood flow velocity
      modulation values were associated with pulmonary hypoplasia. Fetal breathing
      related ductal flow velocity modulation appears to be a promising predictor of
      neonatal lung performance.

PMID- 1755485
TI  - [Doppler-echocardiographic study of intracardiac hemodynamics in intrauterine
      fetal growth retardation].
AB  - Presents the results of Doppler echocardiographic examination of fetal
      hemodynamics, carried out in 90 women with normal pregnancy and small-for-date
      fetuses. Analyzes the specific features of fetal intracardiac blood stream in
      asymmetric and symmetric forms of development retardation. Discloses the
      regularity in changes of the ventricular diastolic function index in relation to
      placental resistance growth and of the maximal rate of transvalvular blood
      stream. Defines the Doppler echocardiographic signs of decompensation of
      myocardial contractility in conditions of high peripheral vascular resistance.
      Makes a conclusion on the relationship between changes of cardiac hemodynamics
      and centralized blood supply in small-for-date fetuses.

PMID- 1755486
TI  - [Status of the cardiovascular system of the fetus and newborn infant in different
      degree of severity of maternal hypertensive syndrome].
AB  - Examinations of 260 pregnant women with hypertensive syndromes and their 60 full
      term newborns, carried out with the use of echography of the umbilical artery,
      umbilical vein, aorta, and internal carotid artery of the fetus have demonstrated
      a high informative value of these methods for the assessment of the type of fetal
      condition and prediction of the newborn's adaptive mechanisms of the
      cardiovascular system. Significant changes of the cardiovascular system were
      revealed in small-for-date fetuses and in chronic fetal hypoxia, as well as
      functional changes in the newborns of the mothers with the hypertensive syndrome,
      with born signs of intrauterine suffering. These changes should be borne in mind
      when predicting the development of infants born of mothers with the hypertensive
      syndrome.

PMID- 1755487
TI  - [Echographic evaluation of the structure and size of the kidneys in healthy
      newborn infants in the first week of life].
AB  - Echographic assessment of the renal structure and size was carried out in 39
      healthy full-term babies during the first five days of their lives. Renal
      echograms of the examined newborns were characterized by highly echogenic
      cortical layer, ++hypo-echogenic central sinus, and unechogenic pyramids well
      imaged against the background of the cortical layer. A drastic increase of the
      echogenicity of some pyramids (3-5) was seen in 4 newborns on days 2-3 of life,
      not involving impairments of renal function. No differences in the sizes of the
      left and right kidneys, kidneys in boys and girls, or kidneys in various days of
      life were detected. To compare renal size of the newborns with other
      anthropometric parameters, renal volume should be correlated to body surface
      size. The data on renal size in healthy newborns may be used as reference values
      for newborns of the first week of life.

PMID- 1755488
TI  - [Present-day possibilities and prospects of development of ultrasonic diagnosis
      in perinatology and gynecology].

PMID- 1755489
TI  - [Evaluation of fetal protective-adaptive reactions in gestosis and pelvic
      presentation].
AB  - Biophysical profile of the fetus (BPF) was determined with the use of ultrasonic
      scanning and cardiotocography in 21 pregnant women with the pelvic presentation
      of the fetus and 32 patients with gestosis. Uteroplacental and fetoplacental
      circulation were also under study. The results of studies were analyzed together
      with the data on the labor outcome and course of the neonatal period. The
      findings evidence a regular depression of some BPF elements in hypoxia.
      Circulatory disorders in gestosis are initiated by disorders of the
      uteroplacental circulation, followed by involvement of the fetoplacental
      circulation in this process. Reduced BPF parameters in pelvic presentation of the
      fetus evidence functional immaturity of the fetus. A close relationship between
      the results of BPF assessment and fetal Doppler ultrasonics data has been
      revealed.

PMID- 1755490
TI  - [Ultrasonic diagnosis of intrauterine fetal infection in pregnancy of a high-risk
      group].
AB  - Ultrasonic scanning of 315 pregnant patients with infectious inflammatory
      diseases and 200 healthy pregnant women has demonstrated the echographic markers
      of intrauterine fetal infection: hydramnios, the presence of meconium in amniotic
      fluid, untimely maturation and signs of infectious involvement of the fetus,
      increased size of fetal abdomen as against the reference values after 35 weeks
      gestation. Twenty-six of the 37 mothers of the newborns with pyoseptic diseases
      had presented with at least three of these signs. Ultrasonic scanning is
      recommended for antenatal diagnosis of intrauterine infection as an objective
      method.

PMID- 1755491
TI  - [Data on renal hemodynamics in uncomplicated pregnancy based on Doppler
      ultrasonography].
AB  - The authors analyze the results of Doppler scanning studies of renal and
      intrarenal hemodynamics carried out in 69 women with normal pregnancy of 6 to 41
      weeks and 8 healthy nonpregnant women, examined during the first phase of the
      cycle. Specific features of renal hemodynamics over the course of normal
      pregnancy were analyzed, as was the relationship of these hemodynamic changes and
      the status of the mother-placenta-fetus system. The authors come to a conclusion
      that Doppler scanning holds good promise for studies of the renal and intrarenal
      blood flow.

PMID- 1755492
TI  - [Echographic and morphological parallels in the evaluation of the condition of
      the uterine scar].
AB  - Examinations of 86 women included echography, examination of the lower segment of
      the uterus during surgery, control manual examination of the postpartum uterus,
      and histologic examination of the tissues collected from the so-called cicatrix
      site. The authors claim that the criteria of the myometrial adequacy are the V
      shaped lower segment of the uterus, at least 3-4 mm thick, continuous anterior
      contour of the uterus, the presence of a homogenous echostructure or a structure
      with small sites of elevated echogenicity. A balloon-shaped lower segment of the
      uterus and its thinness (less than 3 mm), no continuity in the uterine contour,
      predominance of elevated echogenicity incorporations in the echostructure of the
      cicatrix site indicate the inadequacy of the myometrium at the site of the
      transverse cicatrix in the lower segment of the uterus. The findings evidence
      that echography is a highly informative method for the diagnosis of the uterine
      cicatrix status and that echographic examinations should be widely used to choose
      the delivery mode for pregnant women with a history of abdominal delivery.

PMID- 1755493
TI  - [Use of echography in the management of labor in women with uterine scar after
      cesarean section].
AB  - Successful management of 26 normal deliveries has demonstrated a high diagnostic
      value of ultrasonic examination of the cicatrix on the uterus before, during, and
      immediately after delivery. Employment of this method to choose the strategy of
      labor management helped reduce the number of vaginal examinations in a number of
      cases and do without control manual examinations of the postpartum uterine
      cavity.

PMID- 1755494
TI  - [Characteristics of the fetoplacental blood flow in labor].
AB  - Ultrasonic Doppler scanning was used to study the fetoplacental blood flow before
      labor, at the height of pang (uterine contraction), and 5-15 seconds following
      it. 53 parturients were examined during the active phase of labor. They were
      divided into two groups with different blood flow parameters. The findings
      evidence a deterioration of umbilical arterial blood flow after a uterine
      contraction is over, as against its level at the peak of labor pang. These
      results may be used to assess fetal status, because cyclic changes in the blood
      flow in umbilical arteries are particularly manifest in deterioration of the
      fetal status.

PMID- 1755495
TI  - [Cerebral blood flow in healthy newborn infants in the early neonatal period].
AB  - Dynamic Doppler scanning studies of brain blood flow were carried out in 78
      healthy newborns in the first days of their lives. The measurements were carried
      out in the internal carotid, basilar , anterior, median, and posterior cerebral
      arteries at the age of 30 min, 2 h, 1, 2, 3, and 4 days. Vascular resistance of
      brain vessels was assessed and the resistance index estimated. This index was
      found to increase by the second hour of life (p less than 0.001) in the anterior,
      median, and internal carotid arteries, whereas no noticeable changes in this
      index value were recorded in the basilar and posterior cerebral arteries. The
      resistance index reduced in all the examined arteries starting from the end of
      the first day of life. Parallel with these studies, arterial pressure was
      measured in all the examinees by the oscillographic method, and found reduced by
      the second hour of life. This permitted a conclusion on the reduction of the
      brain blood flow by the second hour of life and its elevation starting from the
      second day of life. Pulsed Dopplerography method is noninvasive, highly
      informative, and holds good promise for studies of the brain blood flow in the
      newborns.

PMID- 1755496
TI  - [The role of echography in the complex dynamic examination of patients with
      retardation of sexual development].
AB  - Seventy-nine patients with sexual development retardation were examined, 24 of
      these suffered from ovarian genesis condition and 55 from central genesis
      condition. The findings evidence that detection of the uterus and gonads
      presenting as cords is one of the diagnostic criteria indicating gonadal
      dysgenesis. Echographic examinations carried out over the course of therapy yield
      a more accurate picture of ovarian function. No increase in uterine size on the
      echogram after discontinuation of hormonal therapy and the appearance of
      follicles in the ovaries after treatment point to normally functioning ovaries
      and helps specify the origin of sexual development retardation. In sexual
      development retardation of a central origin ultrasonic scanning helps assess the
      therapy efficacy and predict its outcome.

PMID- 1755497
TI  - [First experience with magnetic resonance tomography in the diagnosis of
      gynecologic pathology].

PMID- 1755498
TI  - [Experience in the complex evaluation of fetal condition during pregnancy].

PMID- 1755499
TI  - [Ultrasonic diagnosis during the treatment of patients with cancer of the uterine
      body].
AB  - Transabdominal ultrasonic scanning was used to examine 48 patients with
      endometrial carcinoma; 39 of them were later operated on, and 5 of these examined
      in various periods after surgery. No image of the median uterine echo in women
      with clinical symptoms of cancer of the body of the uterus or thinning of the
      median structure may evidence in favor of poorly-differentiated adenocarcinoma.
      The authors emphasize the usefulness of echography in the diagnosis of the depth
      of the tumor invasion into the myometrium, detection of the recurrences, and pay
      special attention to imaging the uterine myoma and other associated diseases of
      the genitals in these patients.

PMID- 1755500
TI  - [Prenatal cytogenetic diagnosis using chromosomal preparations of the native
      biopsy samples of chorionic villi, cultured chorionic cells and amniocytes].
AB  - Analysis of the results of prenatal cytogenetic diagnosis carried out in the
      first and second pregnancy trimesters in more than 300 women permitted comparing
      the efficacies of two methodologic approaches, diagnostic amniocentesis and
      chorion sampling , with due consideration for the methodologic errors typical of
      these methods and of the tested biologic material. Up to 5% of the diagnoses are
      erroneous if the diagnosis is based on chorion sampling data, whereas in
      amniocentesis the share of diagnostic errors is lower by an order. The authors
      have given a theoretical rationale for and tried a methodologic approach,
      involving the employment of the 'direct' chromosomal preparations from villous
      chorion biopsy specimens and the so-called 'maintained' cell culture technique,
      that permits obtaining chromosomal preparations of higher quality and,
      consequently, helps improve the accuracy of chromosomal diagnosis.

PMID- 1755501
TI  - [Transvaginal echography in clinical practice].

PMID- 1755502
TI  - [Critical state of the fetoplacental blood flow: diagnosis, outcome and
      obstetrical tactics].

PMID- 1755503
TI  - Addiction as a public health problem.

PMID- 1755504
TI  - Polymorphism of the rat liver mitochondrial aldehyde dehydrogenase cDNA.
AB  - In humans, a deficiency in mitochondrial aldehyde dehydrogenase (Class 2 ALDH)
      activity due to a single base-pair exchange in its structural gene serves as a
      deterrent to excessive alcohol consumption. Differences in Class 2 ALDH isozyme
      patterns on isoelectric focusing gels have been observed in the selectively bred,
      alcohol-preferring (P) and alcohol-nonpreferring (NP) lines of rats. To determine
      whether the differences are the result of sequence variation in the structural
      gene, we sequenced the cDNAs for Class 2 ALDH from P and NP rats. A synonymous
      exchange was seen in the codon for amino acid 473 in both lines, when compared
      with published sequences. Additionally, when the cDNA from P rats was used as
      reference, a substitution (G for A) was identified in the cDNA of NP rats which
      changes amino acid 67 from Gln (CAG codon; ALDH2Q allele) to Arg (CGG codon;
      ALDH2R allele). The Arg for Gln substitution makes the enzyme more basic and
      could account for the different electrophoretic mobilities. To determine whether
      the polymorphism was associated with drinking behavior, we genotyped the ALDH2
      locus by amplifying rat genomic DNA encompassing the nucleotide exchange followed
      by probing with allele-specific oligonucleotides. There are highly significant
      differences in the frequencies of the two alleles in the P and NP rat lines. The
      frequency of the ALDH2R allele is 63% in the NP line and only 18% in the P line,
      whereas the frequency of the ALDH2Q allele is 82% in the P line and 37% in the NP
      line.

PMID- 1755505
TI  - Chronic alcoholism impedes the recovery of renal function following renal
      ischemia.
AB  - The recovery of renal function following renal ischemia was studied using rats
      fed for 1-, 3-, and 5-week periods with an alcoholic diet (ethanol provided 36%
      of total calories). Renal ischemia was produced by clamping the renal artery and
      vein for 20 min. Renal function was determined 24 hr after the ischemia. In the
      absence of ischemic insult, the renal function of rats fed with an alcoholic diet
      for 1, 3, and 5 weeks was not significantly different from those of nonalcoholic
      rats. In nonalcoholic rats, renal function (24 hr postischemia) were: glomerular
      filtration rate (GFR) 430.4 +/- 29.6 microliters/min/g KW (kidney weight), renal
      plasma flow rate (RPFR) 1.4 +/- 0.17 ml/min/g KW, and fractional sodium excretion
      (FENa) 2.0 +/- 0.04% (mean +/- SE). Postischemic renal function of rats on 1- and
      3-week alcoholic diets were essentially the same as that of the control rats.
      However, the 24-hr postischemic renal function of 5-week alcoholic diet rats was
      significantly depressed. The values were only 117.2 +/- 35.2 microliters/min/g KW
      (p less than 0.05) for GFR, 0.31 +/- 0.12 ml/min/g KW (p less than 0.05) for
      RPFR, and 7.46 +/- 3.59% for FENa. The present results demonstrate that the rat
      kidney subjected to prolonged alcohol ingestion was more susceptible to renal
      insult than a nonalcoholic kidney.

PMID- 1755506
TI  - Cerebral blood flow and metabolic rate in the conscious, freely moving rat: the
      effects of hypercapnia, and acute ethanol administration.
AB  - We propose a simple method that can be used to measure cerebral blood flow (CBF),
      cerebral oxygen consumption (CMRO2), and cerebral glucose consumption (CMRglu) in
      the conscious, freely moving rat. The method is based on the classical Kety
      Schmidt approach, and uses a chronic cannula in the confluens sinuum. We tested
      the method by investigating the response of CBF, CMRO2, and CMRglu to hypercapnia
      and used the approach to investigate the effects of acute alcohol administration.
      Severe hypercapnia (PaCO2 approximately 80 mmHg) increased the CBF by a factor of
      3.5, decreased the CMRO2 by 30%, and had no significant effect on the CMRglu.
      Under normocapnic conditions moderate blood alcohol levels (100-200 mg%) caused
      no significant effects on CBF, CMRO2, or CMRglu, but high blood alcohol levels
      (250-400 mg%) decreased all three parameters by approximately 25%. Under
      hypercapnic conditions high blood alcohol levels had no effect on CBF, CMRO2, and
      CMRglu.

PMID- 1755507
TI  - Effect of chronic ethanol feeding on hepatic and extrahepatic distribution of
      vitamin E in rats.
AB  - The effect of chronic ethanol feeding on the status of alpha- and gamma
      tocopherol in plasma, liver, lung, and testes of Sprague-Dawley rats was
      characterized. Rats were pair-fed liquid diets containing 36% of total calories
      either as ethanol or isocaloric carbohydrates. After 3 weeks, ethanol ingestion
      resulted in a significant (p less than or equal to 0.05) increase in liver weight
      and induced fatty liver without affecting total body weight. Ethanol feeding did
      not affect the plasma concentration of alpha-tocopherol but doubled that of gamma
      tocopherol. When expressed per milligram of tissue, liver alpha-tocopherol did
      not vary with ethanol ingestion, whereas gamma-tocopherol concentration increased
      2.5 times that of control animals. However, the concentration of alpha-tocopherol
      expressed per milligram of total lipids was significantly (p less than or equal
      to 0.01) decreased in the liver with ethanol feeding. In contrast to the liver,
      ethanol feeding significantly increased alpha- and gamma-tocopherol levels per
      milligram of total lipids in the testes. The concentration of gamma-tocopherol
      (but not alpha-tocopherol) per milligram of lung tissue and per total lung was
      significantly (p less than or equal to 0.05) increased with ethanol feeding.
      These data indicate that chronic ethanol ingestion significantly alters the
      distribution of alpha-tocopherol and gamma-tocopherol in hepatic and extrahepatic
      tissues of the rat.

PMID- 1755508
TI  - Ethanol fails to modify [3H]GR65630 binding to 5-HT3 receptors in NCB-20 cells
      and in rat cerebral membranes.
AB  - Low concentrations of ethanol have been found to enhance the electrophysiologic
      effect of serotonin (5-HT) acting at 5-HT3 receptors on NCB-20 cells. To
      determine whether this action of ethanol reflects a change in the agonist
      receptor interaction, the effect of ethanol (100 mM) on agonist and antagonist
      binding to 5-HT3 receptor was studied in vitro in membrane from NCB-20 cells and
      from cortex plus hippocampus of rat. The antagonist [3H]GR65630 was used to label
      5-HT3 recognition sites. Ethanol did not change the characteristics of saturable
      [3H]GR65630 binding in either membrane preparation. In competition studies, the
      agonists 5-HT and 2-methyl-5-HT completely inhibited the binding of [3H]GR65630
      to NCB-20 cell membranes, while in brain membranes the maximum displacement of
      specific [3H]GR65630 binding by 5-HT was approximately 30%. Ethanol decreased the
      affinity of the receptor for 2-methyl-5-HT, but not to 5-HT in NCB-20 cells, and
      had no effect on agonist binding in brain membranes. The results indicate that
      enhancement of 5-HT responses at 5-HT3 receptors by ethanol is not a result of
      changes in the equilibrium binding characteristics of the agonist.

PMID- 1755509
TI  - Ethanol-induced enhancement of cocaine bioactivation and irreversible protein
      binding: evidence against a role of cytochrome P-450IIE1.
AB  - Chronic ethanol consumption potentiates cocaine-induced liver injury in rodents.
      Since cocaine has to be bioactivated by a cytochrome P-450-dependent N-oxidative
      pathway to exert its hepatotoxic effects, we studied the role of the ethanol
      inducible P-450IIE1 for cocaine metabolism. Male Sprague-Dawley rats were
      pretreated with either a liquid diet containing ethanol (30% of calories) for 4
      weeks or injected with pyrazole (200 mg/kg/day, ip, for 3 days). Both agents
      induced microsomal p-nitrophenol hydroxylation which is a probe for the catalytic
      activity of P-450IIE1. However, only ethanol, but not pyrazole, increased both
      microsomal cocaine N-demethylase activity (by 47%) and the extent of irreversible
      binding of [3H]-cocaine to microsomal proteins (by 100%), which was taken as a
      quantitative endpoint for the formation of a reactive metabolite. Cocaine N
      demethylation and irreversible protein binding of cocaine were not inhibited by P
      450IIE1 isozyme-selective substrates, nor was the rate of cocaine metabolism and
      binding decreased by functionally active polyclonal anti-rat P-450IIE1
      antibodies. Furthermore, pyrazole pretreatment sensitized cultured hepatocytes to
      the glutathione-dependent cytotoxic effects of nontoxic concentrations of
      cocaine. These results indicate that (a) cocaine is not a major substrate for the
      ethanol-inducible P-450IIE1, (b) the enhancing effects of ethanol on cocaine
      bioactivation may be due to induction of other P-450 isoforms, and (c) induction
      of P-450IIE1 may potentiate cocaine-induced hepatocellular toxicity in vitro
      independently of cocaine metabolism, e.g., by P-450IIE1-dependent oxidative
      stress.

PMID- 1755510
TI  - Increased ventricular vulnerability in a chronic ethanol model despite reduced
      electrophysiologic responses to catecholamines.
AB  - An increased incidence of sudden death has been reported in chronic alcoholism.
      To assess electrical vulnerability of the heart, action potential responses, and
      the role of the sympathetic system, a well-nourished canine model has been
      studied intact under chloralose anesthesia after 1 year of ethanol consumption at
      36% of caloric intake. Two alcoholic groups were compared with controls (Group
      1). In Group 2 myocardial vulnerability was assessed after chronic EtOH and
      superimposed acute administration. In Group 3 basal vulnerability was related to
      circulating norepinephrine and release of neurohormone from the myocardium.
      Subsequently the responsiveness to catecholamine infusion was determined. To
      assess vulnerability an electrode catheter was placed in the right ventricular
      apex. The basal ventricular fibrillation threshold (VFT) was reduced to 27 +/- 3
      ma in Group 2 versus 43 +/- 1.0 in Group 1. Acute infusion of ethanol in Group 2
      further reduced the threshold. Group 3 had a reduced basal VFT. Baseline arterial
      plasma levels of norepinephrine were 8-fold higher and coronary venous levels 13
      times higher in the alcoholic group than in Group 1. However, VFT was not
      responsive to infused epinephrine, compared with Group 1 controls. In vitro study
      of superfused ventricular tissue from Group 3 revealed that basal action
      potential amplitude, overshoot, and resting potential were comparable with
      normals. Basal repolarization time (90%) was 198 +/- 12 msec in Group 3 versus
      215 +/- 6 msec in Group 1 (p less than 0.05). After acute EtOH, repolarization
      time was shortened to 170 +/- 8.6 in Group 1 at 90 mg% ethanol (p less than
      0.002), with minimal further change up to 280 mg%.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1755511
TI  - Flow cytometric and immunohistochemical evaluation of ethanol-induced changes in
      splenic and thymic lymphoid cell populations.
AB  - Ethanol-induced alterations in the immune system are thought to play a major role
      in increasing the susceptibility of alcoholics to infections and tumors. One
      important change in the immune system is the noted loss of lymphoid cells from
      the thymus and spleen. To examine these alterations we used a model system where
      C57Bl/6 mice were pair-fed either a Leiber-DeCarli diet containing 7% (v/v)
      ethanol or an isocaloric control diet. Mice receiving ETOH for 7 days showed a
      loss of cells from the spleen and thymus; this loss was even more severe after
      withdrawal for 1 day. The most profound changes were seen after 2 weeks of ETOH.
      Spleen and thymus cell numbers were reduced to 36% and 6.2%, respectively
      compared to control mice. Staining of thymocytes with monoclonal antibodies to
      lymphocyte surface markers and evaluation with flow cytometry revealed that
      immature thymocytes (PNA+, CD4+/CD8+) were most reduced. Mature thymocytes
      (CD4+/CD8- or CD4-/CD8+) were depleted, and the CD4+ to CD8+ ratio was increased.
      Sections of thymus stained with hematoxylin and eosin or with immunohistochemical
      methods showed atrophy and lymphoid cell depletion. No cortex was histologically
      identifiable after 2 weeks of ETOH. The spleen cells most affected by ETOH were
      the B cells. They were reduced to 8.2 x 10(6) cells/spleen (31.5% of the
      lymphocytes), as compared to 38.5 x 10(6) cells/spleen (50.3% of the lymphocytes)
      in the control mice. The spleen was atrophic, but the immunoarchitecture was
      preserved. Ethanol causes a depletion of lymphocytes from the spleen and thymus
      with alterations in lymphocyte subpopulations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755512
TI  - Multi-enzyme catalyzed rapid ethanol lowering in vitro.
AB  - Ethanol was oxidized to acetate by an enzyme system using yeast alcohol
      dehydrogenase (YADH), yeast aldehyde dehydrogenase (YALDH), and lactic
      dehydrogenase (LDH) recycling NAD in two model duodenal fluids and in canine
      duodenal aspirate in vitro. Sufficient enzyme activities were maintained to
      convert as much as 34% of the original ethanol to acetate with negligible
      acetaldehyde accumulation.

PMID- 1755513
TI  - Chronic ethanol-induced impairments in receptor-mediated endocytosis of insulin
      in rat hepatocytes.
AB  - The effects of chronic ethanol administration on the receptor-mediated
      endocytosis of insulin were investigated in isolated hepatocytes. When
      hepatocytes were isolated from rats that were fed an ethanol liquid diet for 5-6
      weeks, these cells bound 25% less insulin to their surface membrane than did
      cells from the chow-fed or pair-fed controls. This decreased binding was likely a
      result of reduced surface receptor number rather than changes in receptor
      affinity. Rates of insulin degradation were also reduced by 25-30% in hepatocytes
      from the ethanol-fed animals. In addition, chronic ethanol feeding induced a
      defect in the internalization of the receptor-insulin complex and altered the
      hepatocellular processing of the internalized insulin. These results indicate
      that chronic ethanol administration impairs both the surface binding and the
      endocytosis of insulin by the liver.

PMID- 1755514
TI  - Isoelectric focusing/western blotting: a novel and practical method for
      quantitation of carbohydrate-deficient transferrin in alcoholics.
AB  - Carbohydrate-deficient transferrin (CDT) has been described as the single, most
      accurate marker of chronic alcohol consumption. Rapid, sensitive, and specific
      measurement of serum CDT levels can thus provide important clinical information
      concerning patient diagnosis and treatment. To date, however, methods used for
      assessing CDT concentrations [e.g., analytical isoelectric focusing combined with
      immunofixation and micro anion-exchange chromatography followed by
      radioimmunoassay (RIA)] have not been practical enough for widespread laboratory
      application. In the present study, we examined the use of a different technique,
      namely isoelectric focusing (IEF) combined with Western blotting (IEF/WB). Serum
      proteins (20-40 micrograms) were first focused according to isoelectric points
      (pI) on high-resolution agarose IEF gels (ampholyte pH range of 5-8) containing
      nonionic detergent. The focused proteins were transferred electrophoretically to
      nitrocellulose filters, and then stained immunochemically with antihuman
      transferrin IgG. IEF/WB completely resolved CDT (focusing at pI 5.7 and 5.9) from
      other serum transferring isoforms, as assessed with neuraminidase-generated CDT
      standards. Computerized densitometric scanning of the immunoblots allowed CDT
      levels to be quantitated directly rather than as a quotient. Serum CDT content
      determined by IEF/WB was highly correlated (r2 = 0.962; n = 17) with values
      determined previously by RIA. In a larger subject group, CDT levels (mg/liter)
      measured by IEF/WB were 139 +/- 54 in recently-drinking alcoholics (n = 58), 81
      +/- 8 in abstaining alcoholics (n = 7), and 68 +/- 16 in healthy control subjects
      (n = 16).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755515
TI  - The phytoestrogens present in de-ethanolized bourbon are biologically active: a
      preliminary study in a postmenopausal woman.
AB  - Bourbon and some other alcoholic beverages have been shown to contain
      phytoestrogens which, as a result of an excessive intake and alcohol associated
      liver disease, have been suggested as contributing to the feminization of chronic
      alcoholic men. To evaluate this hypothesis directly, de-ethanolized bourbon was
      prepared and orally administered to a single postmenopausal woman. Serum or
      plasma levels of luteinizing hormone, follicle stimulating hormone, sex steroid
      binding globulin, high density lipoprotein cholesterol, and estradiol were
      monitored before, during, and after administration of the de-ethanolized bourbon
      at a dose equivalent to 4 ounces of bourbon for 20 days. The changes observed for
      each parameter during the injection of the bourbon extract are consistent with
      the presence of a biologically active estrogenic substance being present in the
      bourbon extract. These observations provide the first direct evidence in man for
      the presence of a biologically active estrogenic substance(s) in bourbon.

PMID- 1755516
TI  - Development of tolerance to and physical dependence on ethanol: daily versus
      repeated cycles treatment with ethanol.
AB  - We examined the effect of various treatment schedules with ethanol on the
      development of tolerance and the severity of withdrawal in rats. Tolerance to
      ethanol was examined after a challenge dose of ethanol using rectal temperature,
      dowel performance, and tail flick response; open field activity and the startle
      response were determined during withdrawal. Animals treated daily with ethanol
      developed greater tolerance, and also lost it faster, compared with animals
      subjected to repeated cycles of 3 days of ethanol treatment followed by 3 drug
      free days. Also, the severity of withdrawal was greater in animals treated daily
      with ethanol. In the second study, we examined the development of tolerance and
      withdrawal severity of animals subjected to three different schedules of daily
      ethanol administration. Overall, the animals receiving continuous infusion of
      ethanol showed the most severe withdrawal and had, except for dowel performance,
      the fastest loss of tolerance to ethanol.

PMID- 1755517
TI  - The effects of piracetam on lipofuscin of the rat cerebellar and hippocampal
      neurons after long-term alcohol treatment and withdrawal: a quantitative study.
AB  - There is a growing body of evidence indicating that chronic alcohol consumption
      induces morphological changes in the central nervous system (CNS) similar to
      those observed during brain senescence, including an increased formation of
      lipofuscin. In addition, it was also found that alcohol withdrawal does not
      reverse these changes. On the contrary, most of the alterations observed during
      alcohol consumption worsen as happens with the increased lipofuscin formation.
      Thus, using our model of alcohol feeding and withdrawal, we decided to examine
      the effects of different drugs said to offer neuronal protection during CNS
      degenerative processes. The action of piracetam, a cyclic derivate of GABA and
      commonly used as a nootropic agent, was tested by studying the lipofuscin
      accumulation on the cerebellar Purkinje and hippocampal CA3 pyramidal cells in
      alcohol-treated and withdrawn rats. Piracetam was found to markedly decrease the
      formation of neuronal lipofuscin. Whatever the functional implications of this
      pigment, its reduction in piracetam-treated animals might be related either to a
      protective effect on the intraneuronal membranous system or to an antioxidant
      property of this molecule.

PMID- 1755518
TI  - Event-related potentials in alcoholic men: P3 amplitude reflects family history
      but not alcohol consumption.
AB  - Multilead event-related potentials (ERPs), elicited by auditory and visual
      stimuli requiring a button press response and by a startling noise requiring no
      response, were recorded from male alcoholics and age-matched male controls (26-60
      years old). Single-trial analyses of blink responses to the startling stimuli
      indicated that alcoholics startle less frequently but with equivalent amplitude
      as the controls. In contrast, single-trial analyses of P3 indicated that
      alcoholics generate a P3 as often as controls, but that their individual P3s are
      smaller. Alcoholics who reported a positive family history of problem drinking
      had larger startle blink amplitudes and smaller auditory and visual P3s than did
      alcoholics who reported a negative family history. Hierarchical regression
      analysis was used to demonstrate that smaller P3s in family history positive
      alcoholics were independent of lifetime alcohol consumption.

PMID- 1755519
TI  - Applications of Cloninger's subtypes in a female alcoholic sample.
AB  - This study examined the incidence of Type 1/Type 2 symptoms and age of alcoholism
      onset in a population of alcoholic women in order to determine whether there were
      females similar to the Type 1 and Type 2 male alcoholics described by Cloninger
      and colleagues. Using a sample of 51 alcoholics divided into early and late
      alcoholism onset groups (less than 25 and greater than or equal to 25), the early
      onset group did not manifest merely Type 2 symptomatology nor did the late onset
      group manifest Type 1 symptoms without the occurrence of Type 2 symptoms, as
      would have been predicted by the Cloninger theory. Rather, the majority of women
      endorsed both types of symptoms regardless of their age of alcoholism onset,
      making classification by sympton type unsuccessful. However, combining symptoms
      across types (making a total of 7) produced 71% classification of subjects into
      early symptom onset (ESO) and late symptom onset (LSO) groups. Analyses indicated
      differences between the groups in each of five areas: (1) demographic and
      psychosocial variables, (2) alcohol abuse severity, (3) family history, (4)
      psychopathological symptoms, and (5) substance abuse history. In each case the
      ESO alcoholics resembled the characteristics of male Type 2 alcoholics reported
      in other studies. The findings indicate that modification of the Cloninger
      classification criteria to reflect age of symptom onset regardless of symptom
      "type" provides better classification of individual female alcoholics and
      suggests that female alcoholics are represented in both Type 1 and Type 2
      alcoholic subtypes.

PMID- 1755520
TI  - EEG characteristics in males at risk for alcoholism.
AB  - Baseline EEG activity was recorded with eyes closed in 15 males, aged 19 to 24 at
      risk (HR = high risk) for the development of alcoholism and 15 matched controls
      (LR = low risk). Four EEG frequency bands were examined: slow alpha (7.5-10 Hz),
      fast alpha (10.25-12.75 Hz), slow beta (13-19.5 Hz) and fast beta (19.75-26 Hz).
      The HR and LR groups were compared on four measures of EEG activity for each
      frequency band: band power, absolute and relative area and laterality
      differences. Statistical analysis of the data via ANOVA revealed no significant
      difference between the HR and LR groups for any comparison. The results indicate
      that EEG measures prior to alcohol administration do not effectively discriminate
      between individuals at high and low risk for alcoholism.

PMID- 1755521
TI  - Six- and twelve-month abstinence rates in inpatient alcoholics treated with
      aversion therapy compared with matched inpatients from a treatment registry.
AB  - Two hundred forty-nine patients who were treated for alcoholism in an inpatient
      multimodal treatment program that included aversion therapy were matched post hoc
      on 17 baseline variables with patients from a national treatment outcome
      registry. The latter patients received inpatient treatment that emphasized
      individual and group counseling as the primary therapeutic elements but did not
      include aversion therapy for alcohol. Six- and 12-month abstinence rates from
      alcohol and all mood-altering chemicals are reported. The patients treated with
      aversion therapy for alcohol had higher alcohol abstinence rates at 6 and 12
      months (p less than 0.01). The abstinence rates from all mood-altering chemicals
      were higher in the aversion group at 6 months (p less than 0.05) but not at 12
      months. The largest differences between treatment groups in 6-month alcohol
      abstinence rates were noted for males (p less than 0.001), those over 35 (p less
      than 0.001), daily drinkers (p less than 0.001), and those with alcohol-related
      work performance problems (p less than 0.05).

PMID- 1755522
TI  - Macrocytosis as a consequence of alcohol abuse among patients in general
      practice.
AB  - Macrocytosis, a common finding in patients without anemia or other hematologic
      abnormalities, is often ignored. The purpose of this prospective study was to
      investigate 300 consecutive, adult health-center patients with a mean cell volume
      (MCV) value greater than or equal to 100 fl. The incidence of macrocytosis was
      2.4%. Of the 177 male and 123 female patients, only 14 (4.7%) were anemic; 80.2%
      of the men (89.3% of those under 60 years) and 34.1% of the women were alcohol
      abusers, representing the largest diagnostic group. The highest MCV value found
      in alcoholics without folate or vitamin B12 deficiency was 120 fl. The most
      useful laboratory test for identifying alcohol abuse among macrocytic patients
      was the measurement of serum gamma-glutamyltransferase. Of the several
      morphologic abnormalities in the marrow the only specific finding were vacuoles
      in the granulocyte or erythrocyte precursors. No underlying cause was found for
      macrocytosis in 6.8% of the men and 35.8% of the women. Even when it is not
      associated with anemia, macrocytosis should not be ignored. It may be the only
      indicator of a disease which often, particularly in young and middle-aged men, is
      alcohol abuse.

PMID- 1755523
TI  - Urinary markers of chronic excessive ethanol consumption.
AB  - A gas chromatographic mass spectrometric procedure is described for the
      measurement of free ethanol and conjugates of ethanol and acetaldehyde. It was
      demonstrated that conjugates of ethanol and acetaldehyde were present in urine of
      alcoholics. Urinary levels of free ethanol and the conjugates in abstaining
      alcoholics were higher than those of social drinkers. On the average, alcoholics
      excreted equal amounts of free ethanol and ethanol conjugates while controls
      eliminated three parts of ethanol conjugates to one part of free ethanol. After
      14 days of abstinence, 16/23 (70%) of alcoholics had levels of free ethanol and
      acetaldehyde conjugates higher than the mean +2 SD of social drinkers for these
      substances. When the molar ratio of ethanol conjugates/free ethanol was
      considered, five more subjects who were alcoholics could be classified as being
      alcoholics. There was one false positive among 46 control subjects.

PMID- 1755524
TI  - Aggressive and nonaggressive behavior as a function of alcohol intoxication and
      frustration in women.
AB  - An experiment tested whether alcohol increases aggression in women in a situation
      in which both an aggressive and a nonaggressive response alternative of equal
      instrumentality and of equal variability are available. Subjects were assigned to
      one of three groups, namely, an alcohol, a placebo, or a control group. The
      alcohol dose was 1.0 ml of pure alcohol/kg body weight. After drinking their
      respective drink, subjects were instructed to supervise a bogus partner on a
      visual scan test over a series of trials. Each time this partner made a mistake,
      subjects could either give an uncomfortable electric shock (scale 1 to 10) or a
      comfortable vibration (scale 1 to 10) to the partner. Aggressive and
      nonaggressive behavior was measured as numbers, intensities, and durations of
      shocks or vibrations, respectively. Neither alcohol nor frustration
      differentiated the groups on aggressive or nonaggressive behavior. All groups
      were significantly more inclined to use the nonaggressive alternative
      irrespective of alcohol dose and level of frustration. In conclusion it was
      stated that women do not increase their aggression as a function of alcohol in a
      situation with more than one response alternative available. The need to
      incorporate gender differences as to aggressive effects of alcohol was stressed.

PMID- 1755525
TI  - Psychiatric comorbidity in alcoholism: importance of ascertainment source.
AB  - Although psychiatric comorbidity is often observed among individuals in treatment
      facilities for alcoholism, the prevalence and pattern of psychiatric comorbidity
      among alcoholic cirrhotics has not been well characterized. The present study
      aimed first to compare the prevalence of psychiatric comorbidity in cirrhotic
      individuals with alcoholism ascertained from a gastroenterology service with
      alcoholics ascertained from a treatment facility for alcoholism. Consistent with
      the findings of other investigators, the data suggest that there is a great
      degree of variability regarding the severity of alcoholism in alcoholic cirrhotic
      individuals. Furthermore, cirrhotics with alcoholism exhibited a less severe
      clinical picture of alcoholism as measured by less alcohol dependence and lower
      prevalence of psychiatric comorbidity than individuals in treatment for
      alcoholism. The main conclusion of this study is that ascertainment source is an
      important determinant of psychiatric comorbidity observed in alcoholic samples.

PMID- 1755526
TI  - Noncirrhotic liver dysfunction and neuropsychologic impairment.

PMID- 1755527
TI  - Tetrahydropapaveroline and alcohol preference.

PMID- 1755528
TI  - [Conscious and unconscious acoustic perception during general anesthesia].
AB  - The possibility of processing sensory information during general anesthesia and
      the ability to recall it postoperatively is of major ethical, medical and even
      theoretical importance. Auditory stimuli especially are perceived
      intraoperatively and remembered postoperatively. Neuropsychological experiments
      indicate that sensory information can be processed and recalled both at a
      conscious and at an unconscious level. Therefore, we have to distinguish between
      explicit and implicit memory. Explicit memory is characterized by an active and
      conscious recall of space- and time-related events, i.e., episodes in a person's
      life. In contrast, implicit memory recalls passively and unconsciously without
      being related to space and time, i.e., language and general knowledge.
      Experimental results from amnesic patients indicate that these two memory systems
      work independently from each other. Even when explicit memory is grossly impaired
      the function of the implicit memory may still be completely preserved. Various
      studies on intraoperative awareness show that explicit memory is widely
      eliminated during general anesthesia. The incidence of conscious awareness that
      can be actively recalled postoperatively is reported to be 1-3%. In contrast, the
      implicit memory function can be partially preserved. When implicit memory tasks
      or hypnosis are employed, traces of unconscious memory of intraoperative auditory
      information can be shown in 20-30% of the patients. These observations are of
      important clinical relevance, because the unconsciously recalled information
      about the intraoperative procedure may have a negative influence on the patient's
      postoperative recovery and well-being. So far it is still not known which
      anesthetics most reliably suppress auditory perception and conscious and
      unconscious memory during the intraoperative period. Therefore, future studies
      should focus on several different points. The anesthetic state should be defined
      exactly and the functional state of the auditory modality should be monitored
      when auditory information is presented to the patients. The recollection of
      intraoperative events should be investigated using implicit memory tests, because
      these are regarded as more sensitive than explicit memory tests.

PMID- 1755529
TI  - [The importance of autologous blood transfusion in the Federal Republic of
      Germany. Results of a survey carried out in 1989].
AB  - The study was designed to evaluate the role of autologous blood transfusion in
      current clinical practice. METHODS. Standardized questionnaires were distributed
      to the anesthesia departments of 421 randomly selected hospitals in the 'old'
      Federal Republic of Germany and West Berlin in August 1989. The questionnaires
      contained 26 questions relating to (1) the particular hospital, (2) preoperative
      autologous blood donation (PABD), (3) preoperative plasmapheresis, (4) isovolemic
      hemodilution, (5) intra- and postoperative autotransfusion, (6) general practice
      followed in blood transfusion, and (7) blood salvage in children. RESULTS. In
      all, 207 completed questionnaires (49%) were returned, 12% of which came from
      university hospitals, 25% from hospitals with more than 500 beds, 58% from
      hospitals with fewer than 500 beds and 5% from smaller specialized hospitals.
      Over half (52%) of the responding hospitals were running their own transfusion
      services or were located in the vicinity of a regional blood bank. The overall
      proportion of surgical procedures requiring perioperative blood transfusions was
      10%. PABD was performed "not at all" in 24% of the hospitals, "rarely" in 28%,
      "occasionally" in 24%, "frequently" in 10%, and "routinely" in 13%. PABD was
      standard in 75% of the departments of orthopedic surgery, in 68% of the
      departments of cardiac surgery, and in 33% of the departments of vascular
      surgery. In two-thirds of the hospitals reporting the use of PABD, the anesthesia
      departments were in charge of the autologous blood service. For 64% of the
      hospitals, liquid storage of whole blood was reported as the standard technique.
      Patients normally not eligible for homologous blood donation according to
      established donor criteria were accepted for autologous blood donation at most
      "occasionally" in 60% of the hospitals, but "frequently" or "mostly" in 36%.
      Preoperative autologous plasmapheresis was performed when major intraoperative
      blood loss was anticipated in 12% of the hospitals. Isovolemic hemodilution was
      performed "not at all" in 30% of the hospitals, "rarely" in 17%, "occasionally"
      in 25%, "frequently" in 14%, and "mostly" in 12%. The reasons most frequently
      given for not performing hemodilution were "too time-consuming" (41%) and "too
      little blood-saving effect" (32%). Autotransfusion devices were available in 40%
      of the hospitals. Others deemed such devices "badly needed" (5%) or "desirable"
      (43%), while 45% found them "not necessary." The principal use of intraoperative
      autotransfusion was in cardiac surgery (79% of the departments), orthopedics (47%
      of the departments) and vascular surgery (45% of the departments). In 29% of the
      responding hospitals autotransfusion devices were also used for postoperative
      autotransfusion ("seldom" in 7%, "occasionally" in 10%, "frequently" in 6%,
      "mostly" in 6%). In the absence of cardiopulmonary disease, hemoglobin
      concentrations below 8-10 g/dl were considered an indication for blood
      transfusion. In patients with compromised cardiopulmonary function the lowest
      acceptable level was 10-12 g/dl. Blood salvage techniques are obviously rarely
      used in children. Experiences with PABD in children were reported by 14.5% of the
      hospitals, experience with isovolemic hemodilution by 22% and with intra- and
      postoperative autotransfusion in 18% and 12.5% of the hospitals, respectively.
      Preoperative plasmapheresis was performed in children in 3.5% of the hospitals.
      CONCLUSIONS. Although the present sample is not representative on a national
      level, our findings allow the conclusion that the simple techniques of both
      preoperative autologous blood donation and isovolemic hemodilution are unduly
      neglected in surgical and anesthetic practice, whereas even smaller hospitals are
      fairly well equipped with sophisticated autotransfusion devices.

PMID- 1755530
TI  - [Intra-arterial catheter oximetry and pulse oximetry in comparison with CO
      oximetry in heart surgery].
AB  - This study evaluates the measurement of oxygen saturation by arterial catheter
      oximetry and pulse oximetry. The values are compared to values obtained by CO
      oximetry. METHODS. In eight patients undergoing cardiac surgery, we determined
      the oxygen saturation of arterial and mixed-venous blood by CO-oximetry (IL 282,
      Instrumentation Lab) at prospectively defined points of measurement before,
      during, and after extracorporeal circulation. At the same points of measurement,
      saturation readings obtained by arterial catheter oximetry (U425C, Abbott) and
      pulse oximetry (Siemens/Nellcor) were recorded. RESULTS. The mean saturation
      values determined by both catheter oximetry and pulse oximetry differed from the
      mean values obtained by CO-oximetry by less than 1% (= bias). The standard
      deviations of the readings in relation to readings of CO-oximetry (= precision)
      were +/- 0.5% to +/- 1.0% for catheter oximetry and +/- 1.0% to +/- 1.3% for
      pulse oximetry. Furthermore, it was possible to obtain saturation readings in 99%
      100% of measurements by catheter oximetry; in contrast, this was possible by
      pulse oximetry in only 59%-84% of measurements. Low mixed-venous saturation
      values were not indicated by any of the arterial methods of measurement.
      CONCLUSIONS. Catheter oximetry was superior to pulse oximetry with regard to both
      precision of saturation values and reliability to obtain values. Invasiveness and
      high costs are disadvantages of catheter oximetry, but if reliable and exact
      measurements are important at any time during surgery or intensive therapy, intra
      arterial catheter oximetry is preferable to pulse oximetry.

PMID- 1755531
TI  - [The effect of combination epidural anesthesia techniques in upper abdominal
      surgery on the stress reaction, pain control and respiratory mechanics].
AB  - Twenty-eight patients undergoing upper abdominal operations (mainly selective
      proximal vagotomy [SPV]) were referred for assessment of the hormonal metabolic
      reaction (adrenocorticotropic hormone [ACTH], arginine vasopressin [AVP],
      cortisol, and glucose), the postoperative pain reaction, and respiration
      according to the method of anesthesia (group 1: neuroleptanesthesia [NLA], group
      2: NLA in combination with epidural opiate analgesia, group 3: NLA in combination
      with local anesthesia). To alleviate postoperative pain piritramide was
      systematically administered in group 1, whereas in groups 2 and 3 a thoracic
      epidural catheter was injected with morphine or bupivacaine. Postoperative
      analgesia was better in patients with epidural administration than in those with
      systemic application. On the 1st and 2nd postoperative days the vital capacity
      was statistically significantly higher by 10%-15% in groups 2 and 3 than in group
      1. As expected, the neurohormonal and metabolic stress response was highest in
      all patients in the intraoperative and immediate postoperative phases: ACTH, AVP,
      and glucose levels were in most cases significantly higher compared with the
      initial values. However, cortisol levels decreased intraoperatively, probably as
      a result of the generally used induction agent etomidate. Comparison of the three
      methods of anesthesia revealed that all mean hormone levels analyzed in group 2
      patients were lower both intraoperatively and 2 h postoperatively, which implies
      that epidurally administered morphine reduces the stress reaction, probably
      indirectly through additional selective alleviation of pain at the spinal cord
      level. The various differences in hormonal reactions of patients in groups 1 and
      3 gave no clear evidence, however, of possible mitigation of the stress reaction
      by epidural local anesthetics in upper abdominal operations.

PMID- 1755532
TI  - [Patient-controlled analgesia versus epidural analgesia using bupivacaine or
      morphine following major abdominal surgery. No difference in postoperative
      morbidity].
AB  - In 1987, Yeager et al. reported that intraoperative epidural anesthesia with
      local anesthetics and postoperative epidural analgesia with opiates diminished
      postoperative morbidity. In our first clinical trial on this topic, the better
      postoperative analgesia with epidural bupivacaine-fentanyl failed to improve the
      outcome after major abdominal operations over that obtained with parenteral
      piritramide. This randomized controlled investigation was designed to assess
      whether intraoperative epidural anesthesia with bupivacaine plus light general
      anesthesia and postoperative epidural analgesia with morphine would diminish the
      overall rate of postoperative complications after major abdominal operations
      compared with general anesthesia (without epidural) followed by patient
      controlled analgesia with morphine, and with intraoperative epidural anesthesia
      with bupivacaine and light general anesthesia followed by postoperative
      bupivacaine-morphine analgesia. METHODS. A total of 292 patients undergoing
      infrarenal aortic bypass operation, gastric resection, gastrectomy, duodenum
      preserving pancreatic resection, Whipple's operation or cystectomy and neobladder
      formation were randomly divided into three groups: 1. PCA group (patient
      controlled analgesia, n = 107): patients were operated on under general
      anesthesia (midazolam, fentanyl, N2O/O2, if necessary with addition of halothane,
      enflurane or isoflurane; muscle relaxation with pancuronium bromide).
      Postoperative management consisted in patient-controlled analgesia with morphine
      (Prominject), bolus 2 mg, lock-out 5 min (recovery room, intensive care unit) or
      15 min (surgical ward). 2. EBM group (epidural bupivacaine+morphine, n = 95):
      operation under light general anesthesia (midazolam, low-dose fentanyl, N2O/O2,
      pancuronium bromide). In addition, a mixture of bupivacaine (0.25%) and morphine
      (60 micrograms/ml) was infused (approximately 0.1 ml/kg.h) via an epidural
      catheter during and after the operation (approximately 72 h). 3. EM group
      (epidural morphine, n = 90): operation under the same kind of general-epidural
      anesthesia as in the EBM group. Postoperatively, epidural injection of morphine
      (0.05 mg/kg in 10 ml of saline) on request up to the 3rd postoperative day.
      Quality of analgesia (at rest and when patients coughed vigorously), strength of
      cough, and rate-pressure product were recorded at 8:00 h, 12:00 noon, 16:00 h and
      20:00 h on the 1st, 2nd and 3rd postoperative days. Incidence and intensity of
      all postoperative complications (cardiovascular, pulmonary, renal and other organ
      failure, reoperations, major infection, sepsis, thromboembolism, metabolic and
      mental disturbances) were assessed from the day of operation until discharge or
      death (n = 10), respectively. RESULTS AND DISCUSSION. In the PCA and EM groups
      analgesia was equal but of slightly inferior quality compared with the EBM group.
      The ability to cough was best in the EBM group and significantly worse in the PCA
      and EM groups, with no difference between the last two. (ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1755533
TI  - [Mechanical ventilation in an anesthetic circle system using the lowest tidal
      volume--studies of 3 anesthesia ventilators in a lung model and an animal
      experiment].
AB  - No anesthesia ventilator attached to a circle system is manufactured for use in
      neonates. However, a small bellows can be supplied for the following anesthesia
      ventilators: Spiromat NS 656 (NS), Ventilog 2 (V2) and AV1 (Draeger Co.) We
      investigated the minimal tidal volume delivered by each of the three ventilators.
      In addition, we tested the performance of the AV1 in neonatal piglets for manual
      and controlled ventilation, and in decreased lung compliance. MATERIALS AND
      METHODS. All circuits were equipped with one CO2 canister (750 ml) and the low
      compliance tubes of the "Ulmer Kinder Set" (Ruesch Co.) The circuits were
      connected to a lung model consisting of a glass cylinder filled with copper wool
      with a compliance of 3.0 ml/mbar. By using calibrated glass syringes we created a
      pressure-volume correlation for the entire system, i.e., the lung model, the
      anesthesia circuit and the ventilator, which was linear for each of the three
      ventilators. The pressure was measured in the test lung. The pressure increase
      caused by the tidal volume therefore reflected the actual tidal volume delivered,
      which was calculated using the pressure-volume correlation. Tidal volumes were
      determined for varying the fresh gas flow (FGF), the respiratory rate (RR), which
      was varied between 20 and 60/min and the I:E ratio (IE), which was varied between
      1:1 and 1:2. Six newborn piglets aged 2-12 h and with body weight 1000-1300 g
      were anesthetized, tracheotomized and ventilated with an oxygen-nitrous oxide
      mixture (FIO2 0.25). The manual ventilation lasted 30 min (period 1) and was
      followed by mechanical ventilation for 60 min (period 2). Thereafter, a left
      pneumothorax with constant pressure of 20 mbar and then 40 mbar for 15 min each
      was created (period 3). A fall in blood pressure was treated with 10 ml colloids
      in five of the six animals. During the experiment arterial blood pressure in the
      carotid artery, mean airway pressure at the distal end of the tracheal tube and
      end-tidal CO2 were continuously recorded. Arterial blood gases were analyzed at
      the end of each period. RESULTS. The tidal volumes delivered with an identical
      position of the bellows varied in ventilators NS and V2 with changes in FGF, RR
      and IE. Decrease in FGF, higher RR and longer expiration resulted in a decrease
      in the tidal volume. The "smallest" tidal volume delivered by NS varied from 50
      ml (FGF 2 l/min, RR 60, IE 1:2) to 188 ml (FGF 4 l/min, RR 20, IE 1:1) and from
      11 ml (FGF 2 l/min, RR 60, IE 1:2) to 110 (FGF 4 l/min, RR 20, IE 1:1) in the V2.
      The AV1 showed a minimal tidal volume of about 5 ml, and no changes in tidal
      volume attributable to alterations in FGF, RR or IE could be observed. No
      problems occurred during manual or mechanical ventilation in the piglets. With
      the experimental decrease in lung compliance no increase in airway pressure was
      noted, but an increase in arterial pCO2 by 8 mmHg (mean) reflects hypoventilation
      that was not corrected by the ventilator. DISCUSSION. We believe that the changes
      in tidal volume in ventilators NS and V2 are caused by adding FGF to the volume
      delivered by the below during inspiration. Because of the unpredictability of the
      tidal volumes, these ventilators are not suitable for the use in neonates. The
      AV1 has a very low systemic compliance which makes it suitable for use in
      neonatal anesthesia. However, a decrease in lung compliance is not compensated by
      an increase in airway pressure and leads to hypoventilation. When small tidal
      volumes are used in patients with low lung compliance, it does not act as
      expected of a volume-cycled ventilator.

PMID- 1755534
TI  - [Anesthetic gas contamination in the operating room--an unsolved problem? Results
      of our own studies].
AB  - Ambient air concentrations of nitrous oxide (N2O) and volatile anesthetics were
      assessed under routine conditions in a total of 41 surgical suites located at
      seven Vienna hospitals. Continuous measurements were performed by means of
      infrared trace gas analyzers throughout a period of approximately 450 h.
      Additional analyses of ventilation facilities (if installed) revealed no
      essential deficiencies; however, anesthetic gas scavenging (AGS) systems yielded
      insufficient flow rates in 32% (less than 25 l/min). In surgical suites without
      mechanical ventilation or scavenging systems (2 out of 41), maximum occupational
      threshold limits (i.e., 100 ppm N2O; 5 ppm halothane) were exceeded continuously
      and to considerable degrees throughout the duration of anesthesia. During
      measurements conducted in operating rooms (ORs) in otolaryngology departments,
      extreme peaks (greater than 2600 ppm N2O, greater than 150 ppm halothane) of
      several minutes duration were documented when open-circuit anesthesia was
      performed. In the general surgical ORs equipped with modern ventilation
      facilities ambient air contamination was lowest, time-weighted average (TWA)
      values ranging from 8 to 15 ppm (mean 11 +/- 3 ppm) for N2O and 0.1 to 0.6 ppm
      (mean 0.3 +/- 0.2 ppm) for the halogenated anesthetic. Despite good ventilation
      and scavenging in the gynecological ORs, distinctly higher concentrations (mean
      83 +/- 49, range 24-211 ppm N2O; mean 0.75 +/- 0.3, range 0.3 to 1.3 ppm volatile
      agent) were measured in cases where anesthesia was delivered by mask. TWA values
      exceeding currently established maximum workplace concentrations were found in an
      unscavenged but ventilated urological OR. At present, short-term concentration
      peaks seem to be inevitable even under optimal OR ventilation
      conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755535
TI  - [A case of serum cholinesterase anenzymia].
AB  - A report is given on a 66-year-old man suffering from serum cholinesterase
      anenzymia. The following tests were performed to characterize the genetic pseudo
      cholinesterase variants: plasma cholinesterase activity using benzoyldicholine as
      substrate (according to Kalow) and dibucaine and sodium fluoride as inhibiting
      substances. In addition, polyacrylamide density gradient gel electrophoresis
      followed by esterase staining technique (Mascall) was used for the
      electrophoretic separation of cholinesterase isoenzymes. Similarly, the only
      daughter's and the granddaughter's sera were analyzed. Determination of activity
      and inhibitor numbers indicated that the propositus had the homozygote "silent
      gene" genotype (A = 2, DN = 0, FN = 0). The granddaughter showed an isoenzyme
      constellation within normal ranges (A = 128, DN = 80, FN = 58); for the daughter
      apparently normal values were also found for activity and inhibitor numbers (A =
      73, DN = 82, FN = 58). Figure 1 shows the results of electrophoretic separation
      from the sera tested and Fig. 2 results obtained by densitometric assessment.
      Electrophoretic separation and the zymogram obtained from the propositus' serum
      show only sample peak and albumin fractions. In contrast, the granddaughter's
      serum turned out to be absolutely normal. In the daughter's sample, however,
      three cholinesterase components normally found in serum were missing, as also
      shown by densitometry. Despite apparently normal activity and rather
      insignificant inhibitor numbers, gradient gel electrophoresis clearly revealed
      her to be a heterozygote carrier of the silent gene Es variant. As our data are
      in accordance with results obtained by other investigators, this observation
      cannot be regarded as exceptional.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755536
TI  - [Orthotopic liver transplantation following heart transplantation].
AB  - Heart transplantation was performed in a 24-year-old man suffering from dilated
      cardiomyopathy who was also infected with hepatitis B virus and had not yet
      seroconverted. Most likely due to the immunosuppression, the hepatitis
      exacerbated and soon led to hepatic dystrophy and precoma. In this phase of
      congruent rejection of the heart transplant, liver transplantation was performed.
      During the procedure the patient had stable circulatory parameters and a reduced
      cardiac output. The heart rate and cardiac output stabilized after release of the
      anastomosis of the hepatic vessels. The patient survived for 6 months and died at
      home with signs of a myocardial infarction.

PMID- 1755537
TI  - [Mean equipotent blood pressure-lowering concentrations of halothane, isoflurane
      and enflurane during balanced anesthesia differ from conventional MAC-values].
AB  - Balanced anesthesia is a technique that allows control of blood pressure in
      patients with coronary artery disease. In order to evaluate the relative
      requirements of volatile anesthetics during basic opioid analgesia, 51 patients
      with unimpaired left ventricular function who were undergoing coronary artery
      bypass grafting during balanced anesthesia were investigated. They were randomly
      assigned to three groups, i.e. halothane (H), isoflurane (I), and enflurane (E).
      Permanent medications were maintained up to 12 h preoperatively. After
      premedication with flunitrazepam, promethazine and piritramide, anesthesia was
      induced with 7 micrograms/kg fentanyl, 0.3 mg/kg etomidate, and 0.1 mg/kg
      pancuronium and continued with fentanyl infusion (0.1 microgram/kg-1 min-1).
      Volatile anesthetics were applied in oxygen/air and adjusted to keep the mean
      arterial blood pressure within +/- 20% of the preoperative value. End-expiratory
      concentrations of volatile anesthetics were measured (Capnomac, DATEX) and
      averaged over time. The mean ages of the patients in the different groups were 60
      +/- 7.6 years (H), 59 +/- 7.1 years (I), and 60 +/- 6.9 years (E). Four patients
      in the halothane group, six in the isoflurane group, and five in the enflurane
      group took beta-blockers preoperatively. The cumulative doses of fentanyl were: H
      = 0.80 +/- 0.17 mg, I = 0.85 +/- 0.16 mg, and E = 0.83 +/- 0.16 mg at the time of
      skin incision and H = 1.20 +/- 0.26 mg, I = 1.38 +/- 0.19 mg, and E = 1.24 +/-
      0.25 mg at the beginning of extracorporeal circulation.2+ which are possibly the
      reason for the high O2-MAC value, which may be abolished during balanced
      anesthesia. However, both the negative inotropic and the vasodilatory effects of
      enflurane are more likely explanations for the results. It is concluded that 0.5
      to 1.0 MAC of halothane, isoflurane, or enflurane used as equipotent components
      of balanced anesthesia for blood pressure control during aorto-coronary bypass
      grafting may differ considerably from the conventional MAC concept.

PMID- 1755538
TI  - [Pseudoaneurysms of the radial artery following iatrogenic punctures. Comments
      apropos 2 cases].

PMID- 1755539
TI  - [Thoracic sympathectomy in the surgical treatment of Raynaud's phenomenon].
AB  - Authors present their results from a review of 38 thoracic sympathectomies
      practiced since 1977 to 1987, both included, on patients affected by a Raynaud
      syndrome resistant to medical treatment. Results show the evident clinical
      improvement of such patients after surgery. In all cases, surgical approach was a
      Crafoord thoracotomy.

PMID- 1755540
TI  - [Vascular injuries of the lower extremity].
AB  - Authors present their experience (32 patients affected by a traumatic
      femoropopliteal injury) with vascular traumatisms at the lower limb. Causes,
      treatment and successful results with the new technics and the early clinical
      management to the patients are commented.

PMID- 1755541
TI  - [Reinterventions in late failures of femorodistal grafts].
AB  - In this retrospective study of 195 patients treated for late failure of a
      previous femoral-distal reconstruction, there were 178 men and 17 women ranging
      in age from 42 to 79 years. The graft material utilised for initial operation was
      an autoenous vein (reversed saphenous vein (75), in situ (1) and arm veins (4) in
      80, polytetrafluoroethylene in 51, Dacron in 46, Biografts in 12 and composite
      grafts in 6 patients. The previous site for distal anastomosis was above the knee
      in 70 and tibial or peroneal arteries in 18 cases. The most common cause of graft
      failure was late thrombosis (95), progression of the underlying disease (64),
      deterioration of the graft (15), pseudoaneurysms (8), and rerelly perigraft
      reactions, hemodynamic insufficiency, late infection, etc. The aim of the
      reoperation was: graft extension for distal disease (68) desobstruction and patch
      angioplasty (21), thrombectomy (9) exchange of the graft (17), local repair of
      the graft (3). Seventeen patients required inflow procedures. Other
      reinterventions (sympathectomy, catheterisation and prostaglandin perfusion, were
      used in patients with no chance for reconstructive arterial surgery. Secondary
      reoperations were performed in 12, tertiary operations in 7 patients. Major
      amputations rate, operation mortality, wound morbidity and hemodynamic success
      rates with limb salvage in reoperated patients support usefulness of repeated
      revascularisation when femoro-distal bypass failure occurs.

PMID- 1755542
TI  - [The Granada-90 geriatric angiological study (1)].
AB  - Because the high incidence of cardiovascular disease between aged people and
      because the problematic features of Andalusian community, like its vast
      extension, high percentage of people older than 65 years, low sociocultural level
      and lack of physicians specialized on Angiology; an important study was made in
      order to analyze such type of disorders as well as their factors of risk. Study
      was made transversally with 443 hospitalized aged patients.

PMID- 1755543
TI  - [Selective renal hypothermia in the surgical treatment of juxtarenal aortic
      aneurysms].

PMID- 1755544
TI  - [Antibiotic treatment in patients amputated for ischemic diabetic foot].
AB  - Thirty diabetic patients submitted to a major amputation were tested by humo
      celullar assays (retarded hypersensibility assays). Reactive patients were
      subdivided into two groups: one group was treated postoperatively with
      antibiotics, and the other group was not treated. Both groups were homogeneous in
      age, hemoglobin concentrations, hematocrit, total proteins, glucemy and history
      of sepsis or leukocytosis. Five patients treated with antibiotics (33.3%)
      presented sepsis, one patient was reamputated and one patient died. Between the
      not treated patients, only three presented sepsis (20%) without any other
      complications. Authors conclude that the development of sepsis in reactive,
      diabetic, amputated patients is independent of antibiotic treatment.

PMID- 1755545
TI  - [Postoperative spinal cord ischemia in thoracoabdominal aneurysms].
AB  - At the present article, 12 cases of paraplegia secondary to the surgical
      treatment of thoracoabdominal aneurysms are presented. Study includes patients
      admitted between 1973-1987 for treatment and rehabilitation of its medular
      injury. Factors of risk, surgical technics practiced, peroperative complications
      and type of medular injury are analyzed. The most common medular injury was an
      anterior medular syndrome (rather than 60%). In the same way, preventive methods
      are analyzed and somatosensory evoked potentials (SEP) and motor evoked
      potentials (MEP), both in developing phase at the present moment, are recommended
      as the most viable method for detecting changes during the surgical procedure.

PMID- 1755546
TI  - Pandemonium over gloves: use and abuse.

PMID- 1755547
TI  - A study of the use of gloves in a large teaching hospital.
AB  - A study was conducted in the wards and laboratory of a 900-bed teaching hospital
      to determine the appropriateness of glove use. In the wards the rate of
      appropriate use was 59%, and in the laboratory it was 90%. In general, in the
      patient areas gloves were used for specific tasks (70%) whereas in the laboratory
      use for a specific task was only 32%. Financial savings could be realized by
      educational programs in infection control directed toward a more rational use of
      gloves.

PMID- 1755548
TI  - Health care facilities in a rural state: an examination of infection control
      policies.

PMID- 1755549
TI  - Recommendations for urinary catheter and drainage bag changes.

PMID- 1755550
TI  - [Discount on anesthetic safety].

PMID- 1755551
TI  - [Controlled trial of a non-invasive continuous blood pressure monitor: Cortronic
      AMP 770].
AB  - The performances of a Cortronic AMP 770 monitor, a new apparatus for non invasive
      continuous blood pressure monitoring was assessed. Its working principle is
      derived from oscillometry. The blood pressure cuff is kept at a low pressure
      (about 20 mmHg), and the oscillations induced by the arterial pulse are converted
      into blood pressure. Systolic, mean and diastolic blood pressure was measured in
      9 healthy volunteers, under physiological conditions, using both the AMP 770 and
      a traditional oscillometer (Physiogard SM 785 NI, Odam). A group of 124 paired
      measurements was obtained, with values ranging from 87 to 150 mmHg for systolic
      pressure, from 48 to 97 mmHg for diastolic pressure, and from 63 to 114 mmHg for
      mean pressure. The mean differences (APM 770-Physiogard) were -1.2 +/- 10 mmHg
      for systolic pressure, 3.2 +/- 8 mmHg for diastolic pressure, and -3.8 +/- 8 mmHg
      for mean pressure. There was no correlation between blood pressure levels and
      discrepancy in the measurements obtained with the two methods. The Cortronic AMP
      770 was reliable under normal circumstances, when compared with a traditional
      oscillometer. However further studies are required to assess its reliability
      under pathological circumstances (severe hypotension or hypertension, arrhythmias
      and sudden changes in blood pressure).

PMID- 1755552
TI  - [Comparative value of clinical signs of difficult tracheal intubation in women].
AB  - A prospective study was designed to compare the value of clinical signs aimed to
      predict difficult intubation in women. A group of 663 women, scheduled for
      elective surgery, were assessed by an anaesthetist at the preanaesthetic visit.
      Following parameters were assessed: the degree of mouth opening, the chin-hyoid
      bone and the chin-thyroid cartilage distances, dental and facial abnormalities,
      age, weight. All patients were ranked on the Mallampati scale. Another
      anaesthetist carried out the anaesthetic induction and endotracheal intubation.
      The latter was deemed to have been difficult if special procedures had been
      required (use of a stylet, a fibroscope, or Sellick's manoeuvre). In accordance
      with these criteria 12.5% of women were difficult to intubate. Furthermore, he
      assessed the degree of glottic exposure, using a Macintosh blade and according to
      Cormack's classification. Six per cent of women were ranked C or D in Cormack's
      classification (C: the glottic aperture was not seen; D: the epiglottis was not
      seen). Finally 66% of women with difficult intubation and 84% of those with
      severely abnormal glottic exposure were ranked greater than 1 on the Mallampati
      scale. This scale had high sensitivity (0.84), but a specificity of only 0.66.
      Other clinical criteria (mouth opening, the chin-hyoid bone distance) had a lower
      sensitivities, but seemed more specific. Multivariate analysis showed that
      specificity could be improved (0.84) if the distance between the upper and lower
      incisor teeth (mouth opening) was associated with Mallampati's rank, without any
      loss in sensitivity. A simple chart is proposed to assess the risk of difficult
      intubation.

PMID- 1755553
TI  - [Incidence and etiology of cardiac arrest occurring during the peroperative
      period and in the recovery room. Apropos of 102,468 anesthesia cases].
AB  - This study reviewed retrospectively 186 cardiac arrests (CA) observed in a series
      of 102,468 anaesthetics, carried out in a University Hospital between 1983 and
      1987. Among them 29 were partly or totally related to anaesthesia and 11 had a
      fatal outcome. On the other hand, 157 CA (144 deaths) were not related to
      anaesthesia. Mortality rate due to anaesthesia was therefore 1.1 per 10,000. The
      main causes of anaesthesia related CA were overdosage, with or without
      hypovolaemia (9 CA, 6 of which occurred under regional anaesthesia); hypoxaemia
      (6 CA, 5 of which occurred under regional anaesthesia) and multifactorial sudden
      cardiac arrest (n = 8). The other aetiologies were: myocardial ischaemia (n = 3);
      anaphylactic shock due to propanidid (n = 1); protamine accident (n = 1);
      ventricular arrhythmia due to hypokalemia (n = 1). Fourteen CA occurred during
      induction (2 deaths), 14 during maintenance (8 deaths), and one during recovery.
      Risk factors for CA included a high ASA class, and the type of anaesthesia: there
      were 8 CA for 12,981 regional anaesthetics, and 21 for 89,487 general
      anaesthetics (p = 0.017). Emergency and paediatric anaesthesia were not risk
      factors. Outcome was independent of ASA class, but was related to aetiology:
      hypoxaemia (5 out of 6 recovered) and overdose with or without hypovolaemia (7
      out of 8 recovered) had favourable outcomes. Furthermore, outcome of CA due to
      regional anaesthesia was satisfactory (7/8 recovered) (p = 0.08, NS). Such an
      analysis of the causes of anaesthetic disasters and their rate of occurrence can
      lead to more effective prevention.

PMID- 1755554
TI  - [Pharmacokinetics of continuous infusion of etomidate in cirrhotic patients].
AB  - The pharmacokinetics of etomidate were studied in 9 control subjects (with normal
      liver function) and in 5 patients with cirrhosis scheduled for gastro-intestinal
      surgery. Anaesthetic induction included an initial bolus of etomidate 0.3 mg.kg
      1, together with fentanyl 2 micrograms.kg-1, and pancuronium 60 micrograms.kg-1.
      An etomidate infusion was then started according to one of two following schemes:
      a (0.03 mg.kg-1.min-1 for 10 min, and then 0.01 mg.kg-1.min-1), or B (0.1 mg.kg
      1.min-1 for 10 min, followed by 0.02 mg.kg-1.min-1 for a further 110 min, and
      0.01 mg.kg-1.min-1 thereafter). Plasma concentrations of etomidate were
      determined at regular intervals throughout anaesthesia, and up to four hours
      afterwards, using inverse phase high pressure liquid chromatography. The infusion
      was given for 273 +/- 87 min in controls, and for 259 +/- 56 min in the cirrhotic
      group. Scheme A, only used in 3 controls and 1 cirrhotic in a preliminary study,
      resulted in very low plasma concentrations: 0.2 to 0.4 micrograms.ml-1. Those
      measured during the apparent plateau phase (steady state) of infusion protocol B
      were close to predicted values (0.5 to 0.6 micrograms.ml-1) in controls, whereas
      higher concentrations (approximately 1.5 micrograms.ml-1) were reached in
      cirrhotic patients. For all the patients the time interval to spontaneous
      recovery was 41 +/- 27 min; plasma levels were then 0.199 +/- 0.092 micrograms.ml
      1. There were significant alterations in pharmacokinetic parameters in the
      cirrhotic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755555
TI  - [Sedation with intranasal midazolam for endoscopy of the upper digestive tract].
AB  - Twenty-nine patients, ranked ASA 1 or 2, scheduled for diagnostic gastroduodenal
      fibroscopy were randomly allocated into three treatment groups: intranasal
      midazolam (IN) 0.15 mg.kg-1; intramuscular midazolam (IM) 0.15 mg.kg-1, and
      placebo (P). Sedation and the fibroscopy were all carried out by the same
      anaesthetist and fibroscopist. Efficiency and tolerance of the method were
      assessed by monitoring the heart rate, systolic and diastolic arterial blood
      pressure, arterial oxygen saturation (pulse oximetry), the degrees of sedation,
      anxiety, and anterograde as well as retrograde amnesia. The patient's and
      endoscopist's reactions were also considered. Patients in group P were older than
      those of the other two groups (p less than 0.01). Sedation was more important and
      patients less anxious in groups IN and IM than in group P. Three patients in
      group IM had retrograde amnesia. There were no significant differences between
      the degrees of anterograde amnesia in the three groups. At no time during the
      study were there any significant differences in SpO2 between and within groups.
      Four out of the 9 patients in group P had a bad opinion of their experience, as
      compared with two out of the 20 in the midazolam groups; the difference was not
      statistically significant. Three hours after the procedure, all patients were
      fully awake. Intranasal administration of midazolam therefore seemed to be an
      interesting alternative for gastroduodenal fibroscopy, because it was simple, non
      traumatic, well tolerated, and did not result in arterial desaturation.

PMID- 1755556
TI  - [Cerebral aspergillosis in immunocompromised patients].
AB  - Three cases of central nervous system (CNS) aspergillosis in immunocompromised
      patients are reported. All three had neurological symptoms with normal
      cerebrospinal fluid (CSF). The CT scan showed poorly defined low density lesions
      which were not enhanced by contrast medium. They also had pulmonary signs and
      fever despite antibiotic treatment. Aspergillus fumigatus was isolated from
      bronchoalveolar lavage fluid. Antifungal therapy was started promptly,
      associating amphotericin B, itraconazole and flucytosine. Unfortunately, they
      died within 2 days to 2 weeks after admission in the intensive care unit.
      Postmortem examinations revealed disseminated aspergillosis with colonization of
      brain, lung, heart and kidney. The CT scan signs were quite different from those
      seen with the more usual bacterial ring lesions. In immunocompromised patients,
      the agents responsible for producing these findings are Aspergillus, Nocardia,
      Cryptococcus, Toxoplasma and Mycobacterium tuberculosis. Signs involving organs
      other than the CNS, and an examination of the CSF, should provide elements for
      establishing a differential diagnosis. Early antifungal treatment is the only
      chance of survival. Recrudescent fever and pulmonary signs occurring in
      neutropenic patients after antibacterial antibiotic treatment has been started
      are sufficient criteria for empirically starting amphotericin B administration
      unless clinical judgement dictates otherwise.

PMID- 1755557
TI  - [Paraplegia after epidural anesthesia for vascular surgery].
AB  - A case is reported of a 67-year-old man who underwent major vascular surgery
      (iliobifemoral bypass with unilateral sympathectomy) under epidural anaesthesia
      and resulting in permanent neurological damage. Lumbar epidural anaesthesia was
      carried out using a mixture of bupivacaine, lidocaine with adrenaline, and
      alfentanil. The surgical course was uneventful, except for a 30 minute period of
      relative hypotension (90 vs. 110 mmHg preoperatively). Continuous epidural
      analgesia (12 ml.h-1 of 0.125% bupivacaine without adrenaline) was started after
      the end of surgery. Twelve hours later, flaccid lower limb paralysis was noted,
      but thought to be due to the bupivacaine. At the 24th hour, the epidural
      analgesia was discontinued and the catheter removed. There were a motor paralysis
      and a partial sensory block, raising to the level of T10 (temperature and pain).
      A CT scan and myelography of the thoracolumbar spine revealed no anomaly. The
      sensory loss ended within ten days, but the motor deficit regressed only
      slightly. Unfortunately, the patient died on the 16th day after an episode of
      severe chest pain. The probable cause of the neurological damage was an anterior
      spinal infarct. It was not possible to determine the degree of responsibility of
      the peripheral vascular disease, the anaesthetic or the surgery.

PMID- 1755558
TI  - [Pseudosurgical acute abdomen syndrome in primary pulmonary hypertension].
AB  - The case is reported of a 49-year-old chronic alcoholic woman, who presented with
      severe pulmonary arterial hypertension (PAH) mimicking as an acute abdomen. She
      was admitted with right-sided hypochondrial abdominal pain and hepatomegaly, with
      a moderate jaundice. On admission to intensive care unit, she had an arterial
      blood pressure of 110/70 mmHg, a heart rate of 100 b.min-1, and a respiratory
      rate of 36 c.min-1. An electrocardiogram showed sinus rhythm and right-sided
      heart failure. Whilst breathing 6 l.min-1 oxygen, her arterial blood gases were:
      PaO2 47 mmHg PaCO2 29 mmHg. Severe PAH was confirmed by measuring her mean
      pulmonary arterial pressure, which was 46 mmHg, whilst her pulmonary wedge
      pressure was 7 mmHg. Hepatic function was also altered: total bilirubin 41
      mumol.l-1, alkaline phosphatase 145 UI.l-1 and gamma glutamyl transferase 1 340
      UI.l-1. She developed arterial hypotension, which did not respond to increasing
      doses of isoproterenol. She died on the third day. Necropsy confirmed the
      diagnosis of primary PAH, with acute "cardiac liver".

PMID- 1755559
TI  - [Contact dermatitis caused by a peripheral intravenous catheter with metallic
      connector].
AB  - A case is reported of a 26-year-old woman who developed contact dermatitis due to
      a peripheral venous catheter. This catheter had a metal connector, made of nickel
      brass. The patient had been admitted for uterine contractions and was to receive
      an infusion of salbutamol. Twelve hours after the catheter had been set up, she
      developed at the puncture site an acute inflammatory reaction, with oedema and
      bullae. She later admitted to having had a few "spots" when wearing a cheap metal
      bracelet. Skin tests with nickel (5% solution of nickel sulphate) confirmed the
      diagnosis. This case underlines the importance of looking for an allergic history
      in patients.

PMID- 1755560
TI  - [Post-traumatic constrictive pericarditis with fast course].
AB  - A case is reported of a 46-year-old male patient who sustained a blunt thoracic
      injury with an anterior flail chest, and right haemopneumothorax. He was
      intubated and ventilated because of acute respiratory failure. There were
      initially no signs suggesting any myocardial injury. It was not before day 20
      that the electrocardiogram showed a QS wave in leads V2 and V3. The hypothesis of
      an antero-septal myocardial infarct was not confirmed by echocardiography, which
      only revealed slight thickening of the posterior pericardium. From day 50 on, the
      patient had tachycardia, raised jugular venous pressure, and effort dyspnoea.
      Echocardiography (day 59) showed an anterior and posterior pericardial effusion
      (about 500 ml), marked pericardial thickening, and inferior vena caval collapse
      during inspiration, with normal myocardial wall movements. Drainage
      pericardiocentesis was therefore carried out, followed by, four days later, a
      pericardiectomy. A small ecchymosis was found on the anterior aspect of the right
      ventricle. The pericardium was thickened, fibrous, hyperhaemic, Case is y stuck
      to the epicardium. Eight months later, echocardiography showed that the posterior
      pericardium remained thickened, and there was a very small residual effusion.
      Movements of the septum had returned to normal.

PMID- 1755561
TI  - [Coma during transurethral resection of the prostate].
AB  - Two cases of coma occurring during transurethral resection of the prostate are
      reported. The 76 and 85-year-old patients lapsed into coma, ranking 9 and 8 on
      the Glasgow scale, respectively 90 and 120 min after the start of the resection,
      without any previous haemodynamic alterations. In one patient, coma occurred when
      the urethral catheter became blocked with fragments of prostates. In the other,
      coma was initiated by a rupture of the prostatic capsule, with passage of washing
      fluid (1.5% glycine solution) into the peritoneal cavity. The role played by
      acute hyponatraemia (128 and 123 mmol.l-1 respectively) and glycine poisoning
      (10,188 and 11,840 mmol.l-1 respectively) are discussed. These cases underline
      the interest of regional anaesthetic techniques, allowing an early diagnosis and
      a rapid surgical procedure which will avoid a worsening of the condition.

PMID- 1755562
TI  - [Xenon, inhalation anesthetic: a comeback?].

PMID- 1755563
TI  - [Asystole during anesthesia with propofol].

PMID- 1755564
TI  - [Lyell's syndrome and griseofulvin].

PMID- 1755565
TI  - [Laryngeal mask for the reduction of nose fractures].

PMID- 1755566
TI  - [Laryngeal mask for bronchoscopy in children].

PMID- 1755567
TI  - [3rd Consensus Conference on anti-infectious therapy. Osteoarticular bacterial
      infections except mycobacterium infections (Tours, January 25, 1991)].

PMID- 1755568
TI  - Drug prescription monitoring systems in general practice.

PMID- 1755569
TI  - VIDEOFAR: an epidemiologic tool for drug utilization studies.
AB  - VIDEOFAR is a computerized drug prescription monitoring system oriented to gain
      an epidemiological insight into the phenomenon of "drug prescription". The set of
      activities carried out within the VIDEOFAR project were focused to: define
      methods of analysis of prescription data, which could be transferred to the
      peripherical operating settings of the National Health Service (Local Health
      Units, Epidemiologic Observatories, Regional Pharmaceutical Services, etc.);
      implement a Drug Data Base to allow a flexible utilization of information;
      implement software systems in different computer environments.

PMID- 1755570
TI  - The logical structure of the VIDEOFAR drug data base.
AB  - The quality of the analyses that can be carried out by a Drug Prescription
      Monitoring System depends on the completeness and accuracy of the information on
      drugs. Data quality depends also on the organization of the data base that must
      be designed to allow higher retrieval power with regard to the information level
      theoretically contained in stored data. Considering these requirements we
      developed inside the VIDEOFAR project, starting from the preceding experiences at
      the Istituto Superiore di Sanita, an activity of design and realization of a Drug
      Data Base whose structure, both logical and physical, is described.

PMID- 1755571
TI  - Drug utilization studies within the VIDEOFAR project.
AB  - The epidemiological use of drug prescription data is getting increasing attention
      in Italy. All Italian citizens are included in the National Health Service (NHS)
      which reimburses almost every drug prescription. The potential information
      content of such systems have to be evaluated within a technological context which
      will allow, for medium term, drug prescription data collection for all of the
      individuals served by the NHS. The VIDEOFAR project did explore the possible use
      of drug prescription data for descriptive epidemiological studies, in the
      evaluation of General Practitioners activity and as a tool for Post-Marketing
      Drug Surveillance. Some examples are presented in this paper using data derived
      from Latium Region.

PMID- 1755572
TI  - Possible applications of drug prescription monitoring systems in Italy.
AB  - Numerous experiences have already been implemented as regards the use of data
      concerning drug prescriptions and relative expenditure. This article focuses
      firstly on how such data are used from an administrative point of view in the
      Veneto Region, and secondly on the cultural and scientific aspects involved. The
      supply of feedback to general practitioners (GPs) with drug prescription
      indicators has made possible to cut down farmaceutical expenditure. Moreover, the
      analysis of the substances used by the GPs highlights the areas which require
      special attention in order to improve the quality of prescription.

PMID- 1755573
TI  - Information systems for the analysis of drug prescriptions in Spain.
AB  - The Spanish National Health Service, largely represented by INSALUD, covers at
      present over 98% of the Spanish population. Services are free at the point of
      delivery with exception of prescription charges. The patients contribution
      towards the price of their medicines is approximately 40% of the cost of the drug
      for most ethical preparations. Non-prescription drugs are not reimbursed by the
      National Health Service. Pensioners and the disabled are exempt from prescription
      charges. Prescription analysis or monitoring is possible within INSALUD because
      of the necessity to reimburse pharmacists for the prescriptions they dispense,
      monthly batches of prescriptions are processed. The Drug Data Bank possesses
      three databases that may be used for prescription analysis, these are ESPES, ECOM
      and PACTIV. Information from these databases is used by external workers in: drug
      Monitoring Centres for Adverse Drug Reactions; the Spanish Collaborative Study on
      drug-induced birth effects; drug utilization research workers; INSALUD also
      produces reports on drug prescribing and these have a particular emphasis on
      expenditure; the General Directorate of Pharmacy also use these databases for
      their policy making on issues related to, and derived from prescribing.

PMID- 1755574
TI  - Drug utilization studies and drug monitoring in The Netherlands.
AB  - Drug utilization research is a research area of increasing importance, as well in
      the Netherlands as elsewhere. In this article on overview is given of the
      situation in the Netherlands. Three types of studies are distinguished,
      descriptive studies, studies of the determinants of drug use and studies of the
      impact of drug use. Descriptive studies are needed to understand the present
      situation and to detect problems. If these problems are to be solved it is
      important to understand the factors that determine drug use. By looking what the
      impact is, the value of drug use for health care can be assessed. It is also an
      important tool for developing systems for drug monitoring at a patient level. At
      present community pharmacists play an important role in drug monitoring at the
      patient level. A problem still awaiting a solution is how to implement such
      systems effectively.

PMID- 1755575
TI  - Economic evaluation of drug prescription monitoring systems in the extra-hospital
      environment.
AB  - Drugs expenditure accounts for a significant and rising share of public health
      expenditure (from 14% in 1980 it has now reached 17% approximately). Many efforts
      have been made to contain its expansion through tickets (co-payments),
      formularies, price policies, etc., but overall results have been unsatisfactory.
      The main cause for this failure may be found in the approach adopted, virtually
      excluding the evaluation of rational use of drugs. Economic evaluation of drug
      prescription, comparing cost per DDD, assessing both cost/effectiveness ratios
      and the monitoring system's efficiency, may contribute to a better control of
      drug expenditure.

PMID- 1755576
TI  - Postmarketing surveillance and other epidemiologic uses of drug prescription data
      in the United States.
AB  - Currently the data resources available for conducting pharmacoepidemiology
      studies in the United States include spontaneous case reports of adverse
      reactions, aggregate population-based data resources, computerized collections of
      data from organized medical care programs, data collected for pharmacoepidemiolgy
      on an ongoing basis, existing data collected as part of other ad hoc studies, and
      data collected de novo for pharmacoepidemiology studies. The advantages and
      disadvantages of each and the particular contributions of drug prescription data
      to each approach are described.

PMID- 1755578
TI  - [Principles and application possibilities of cryoultramicrotomy].
AB  - This paper reviews the technical aspects of cryoultramicrotomy. The key
      preparation steps in the technique, namely freezing, sectioning, thawing, and
      staining are analysed. The application of this method to immunocytochemistry and
      analytical electron microscopy are discussed with respect to the present
      possibilities and problems.

PMID- 1755577
TI  - Drug utilization studies and people. A Swedish perspective.
AB  - Innovative ways of collaboration between actors involved are needed to increase
      the quality of drug therapy. Sweden is fortunate to have access to reliable and
      detailed statistics on drug sales and prescribing patterns. The various data
      bases are being described. A common classification system (ATC) and a unit of
      measurement (DDD) enable comparisons at various levels. Major differences between
      countries, counties, and health centres are presented. Little is known about the
      reasons for these differences. In order to leave its infancy, drug utilization
      studies need that clinical pharmacology establishes linkages with primary health
      care where a majority of the prescribing takes place. Systems should also be
      developed activating the prescribers involving them in a revolving cycle of self
      audit. To study drug use in its context a multidisciplinary approach is needed.
      The descriptive phase should be complemented by targeted intervention and methods
      should be developed for drug information. Future drug utilization studies need
      more of a patient-prescriber perspective (PPP).

PMID- 1755579
TI  - Allergens and atopic diseases.
AB  - Allergens are molecules normally present in the environment, responsible of
      inducing the so called atopic diseases. These diseases are characterized by the
      high production of allergen-specific IgE antibodies, which bind to mast-cells and
      basophils. The cross-linking of the cell-bound IgE induces the production and/or
      release of various inflammatory mediators (histamine, leukotrienes, platelet
      activating-factor, etc.), which trigger a cascade of events resulting in the
      allergic syndromes. Once the diagnosis of allergy has been made, two different
      therapeutic approaches can be followed: a) the pharmacologic management, aimed
      mainly at preventing or controlling the symptoms resulting from the release of
      mediators by effector cells; b) the specific immunotherapy, consisting in the
      administration to the patient of increasing amount of the relevant allergens,
      opportunely prepared and eventually chemically modified. In order to have the
      latter approach correctly applied it is necessary to gain a wider knowledge on
      both regulation of IgE synthesis and allergens characteristics.

PMID- 1755580
TI  - Bracken as a risk factor in digestive tract tumors: state of the art.
AB  - The present knowledge of the risks of exposure to bracken fern (Pteridium
      aquilinum) is presented. The history of research on bracken toxicity is reviewed,
      covering the animal observations and chemical analysis, and focusing on the
      carcinogenic effects in various animal species and on the nature and biological
      properties of the known carcinogens. The implications of human exposure to
      bracken are inferred, the possible ways of contamination are discussed, and the
      existing epidemiological studies are commented. Bracken contribution to digestive
      tract tumors is deduced, and the need of further research on the plant toxicity
      and detailed epidemiological investigations with the exposed population is
      stressed.

PMID- 1755581
TI  - Day-time and night-time concentrations of airborne iron particles in the
      atmosphere of Madrid.
AB  - Specific measurements of iron aerosol have been made over a 70 days period at a
      semi-urban site of Madrid. Measurements were made with the idea of assessing the
      relative contributions of day-time and night-time concentrations to daily ones.
      Statistics of day-time, night-time, daily and survey time period concentrations
      are given. Time variations were studied as well, clearly showing daily cyclical
      pattern identified by applying time spectral analysis. This periodicity is
      undoubtedly due to level differences between day-time and night-time
      concentrations of aerosol. Day-time average level ranged from 0.23 to 5.13
      micrograms/m3 over the entire survey period (70 days) in contrast with night
      times ones ranging from 0.17 to 3.04 micrograms/m3. Night-time/day-time
      concentration ratio shows a highly consistent value, 0.430 + 0.25 (sigma) during
      this period. On occasion when diffusion conditions are similar, this ratio
      increases to 0.518 + 0.18 (sigma). Day-time, night-time and daily concentrations
      correlation matrix suggests that former is the best daily level indicator.

PMID- 1755582
TI  - [10 years of legionellosis in Italy (June 1980-June 1990)].
AB  - Legionella infection was recognized as a cause of human disease in 1976,
      following the occurrence of an epidemic at Bellevue Stratford Hotel,
      Philadelphia, USA. In the subsequent years, various cases, both sporadic and
      epidemical, have been reported worldwide. In Italy, the first reports date from
      1980. The compulsory notification of the disease was established in February
      1983, and a few months later a National Surveillance Programme started operating
      at the Istituto Superiore di Sanita, Rome. Up to June 30, 1990, 542 confirmed
      cases of legionellosis were reported. For 249 of them, data of clinical and
      epidemiological significance are available. The incidence of the disease is
      higher in males (76% of total cases) and 51.5% of the patients are aged more than
      50 years. During the clinical course, the occurrence of hepatic and/or renal
      dysfunction, cough, dyspnoea, diarrhoea and confusion was documented in a
      significant proportion of patients. The fatality rate was 12.4%. The disease
      occurred both sporadically and epidemically. Namely, clusters and outbreaks were
      detected all over the country, accounting for a total of 97 cases. Hospital
      patients should be regarded as an important category at risk for infection. The
      occurrence is also frequent among travellers and tourists, because of the
      stressing factors that may increase individual susceptibility, as well as the
      more frequent contact with infective sources. In Italy, the major risk of
      infection appears connected with water plumbing systems of hotels, residential
      houses and hospitals, where oxygen bubble-humidifiers have been found to
      represent an important source of infection. On the contrary, the association of
      human infection with air conditioning systems has not been evidenced up-to-now.

PMID- 1755583
TI  - [Disability, perceived health, and risk of death in a cohort of elderly].
AB  - An elderly cohort has been submitted to a five-year mortality follow-up in order
      to evaluate the relationship between environment, social and health conditions
      and survival probability. Particular attention has been directed to disability
      measure proposed by OECD (Organization for Economic Co-operation and
      Development). An extension of Cox multiple regression model has been used.
      Results show that the social and living conditions are not associated with
      survival probability. On the contrary, disability is a strong determinant of
      mortality risk and subjective health status is a modifier of its effect.
      Following disability level is an indicator of long-term health status and health
      services needs.

PMID- 1755584
TI  - [Examples of intervention in cases of electromagnetic pollution in research
      laboratories].
AB  - Two examples of technical measures taken to reduce levels of radiofrequency
      electromagnetic radiation in research laboratories are reported. The first
      intervention was aimed at avoiding undue exposure of operators. The case is of
      interest because of the special exposure conditions, which are not as well
      characterized as in industrial applications, and require ad hoc analyses,
      measurements, and mitigation actions. As shown by the second example, such
      actions also allow effective screening of experimental apparatuses, which is of
      special importance when high sensitivities are required.

PMID- 1755585
TI  - [Congenital hypothyroidism: organization and coordination of neonatal screening
      in Italy].
AB  - Congenital hypothyroidism (IC) is the most frequent endocrine disease of the
      infancy and it is caused by primary deficiency of thyroid hormones. The damages
      derived by protracted hormone deficiency are diffused to all organs and systems
      and particularly severe for the development of central nervous system. Mental
      retardation can be prevented by early diagnosis and therapy. Early diagnosis is
      assured by neonatal thyroid screening performed on all newborns in the first days
      of life. The progress report on the screening situation in Italy as well as the
      national coordination realized in this field are presented.

PMID- 1755586
TI  - [Epidemiologic surveillance of pleural mesothelioma in Italy].
AB  - A collaborative study has been performed in order to detect cases of pleural
      mesothelioma diagnosed or treated in Italy in the years 1984-88. Cases have been
      notified to ISS by 88 centres (clinics of thoracic surgery and respiratory
      diseases, oncologic centres, institutes of pathology), active in 14 Italian
      regions. Altogether, 575 cases (415 males and 160 females) have been included in
      the study. Information on occupation and/or on non occupational exposure to
      asbestos was available for 65% of the subjects, and the occurrence of definite or
      possible exposure to asbestos was estimated for 58% of them.

PMID- 1755587
TI  - [Methods for the evaluation of a health intervention in developing countries: the
      case in the Arsi region, Ethiopia].
AB  - Since 1989 an evaluation study of the impact of a Primary Health Care (PHC)
      program is being carried out in Arsi region, Ethiopia. The principal aim of the
      study is to estimate the mortality rates in those villages mainly involved in PHC
      activities. A sample of 80 villages will be recruited to allow significant
      differences in mortality of 20 per thousand between less treated and best treated
      villages. Considering the absence of routine demographic data, a population
      census and demographic surveillance of the recruited villages have been carried
      out. All the activities related to the study are considered together with the
      principal logistic and methodologic problems.

PMID- 1755588
TI  - [An experimental device for measuring the characteristics of echographic
      emissions].
AB  - An experimental system for the evaluation of the parameters characterizing the
      acoustic power emission of echographs is described. The apparatus is based on a
      commercial device, which has been modified to allow the analysis of different
      echographic probes, particularly used for diagnosis. The modified instrument is
      quite versatile in use and is suitable for the examination of virtually any kind
      of probe.

PMID- 1755589
TI  - Outline of the ISS code for the classification of chemical substances for use in
      compiling a national inventory.
AB  - A coding system for categorizing all types of compounds was developed
      specifically as part of the National Inventory of Chemical Substances to be
      applied by the Istituto Superiore di Sanita (ISS) in order to comply with the EEC
      present legal provisions on chemicals in trade. A number of applications were
      also described to illustrate the coverage and the adaptability of the code.

PMID- 1755590
TI  - [Surgical trials in senology].

PMID- 1755592
TI  - [Goiter recurrences after surgical resection].
AB  - A personal experience about 135 pz. with non-toxic goitre treated by mono o
      bilateral thyroidectomy and followed during 5 years (2-8) to evaluate the
      incidence of recurrences is reported. The recurrences were 10.5%, especially
      after monolateral thyroidectomy (9 pz.). Therefore the authors stress the
      importance of a more accurate surgical indication, a wider resection of the gland
      and a careful follow-up to undertake opotherapy when hypofunction appears.

PMID- 1755591
TI  - [Intra- and postoperative changes in blood viscosity].
AB  - Blood and plasma viscosity has been controlled in a group of patients undergone
      to aorto-iliac reconstruction and in a group of control after thyroidectomy,
      cholecystectomy, and hernioplasty. The hemodilution induced by intraoperative
      infusion in the vascular reconstruction produced an important decrease of hematic
      and plasmatic viscosity which lasted for several days after the operation.
      Removing the hemodilution effect by a mathematical correction of the viscosity
      measured values to a standard haematocrit, it has demonstrated as surgical
      operation, apart from its entity, promoted an increase of the viscosity which
      persisted long in the postoperative course. For what it concerns the risk of
      postoperative thrombosis from one side protective effect of hemodilution is
      confirmed, from the other, in absence of the hemodilution, it would be useful to
      continue the antithrombotic prophylaxis longer the perioperative time as usual.

PMID- 1755593
TI  - [The onset of local recurrences after radical therapy for rectosigmoid
      carcinoma].
AB  - The authors after considering the natural history in 116 patients with
      rectosigmoid carcinoma examine a number of parameters and their significance in
      terms of predicting recurrence. Following curative surgery the authors conclude a
      particular significance is satisfying quality of life in patients with
      rectosigmoid carcinoma.

PMID- 1755594
TI  - [Pelvic recurrences after curative surgery for rectal cancer].
AB  - This report updates an experience with local recurrences of rectal cancer after
      curative surgery. Overall 13 year period (1976-1988) 254 patients were operated
      on in the II Surgical Clinic of Parma University for rectal cancer. Only 122
      patients who underwent potentially curative resection were examined. Approximate
      recurrence rates according to patients age, site, type and stage of primitive
      tumour, tumour complications and surgical procedures were evaluated. The overall
      local failure rate was 17.2% with 12 patients having local failure alone and 9
      patients having concurrent local failure and distant metastasis. Local failure
      occurred predominantly in tumour bed, involving the anastomosis in 2 cases.
      Relapse developed primarily at colo-rectal anastomosis in only 1 patients, 20% of
      recurrences were diagnosed within the first postoperative year; 65% within the
      second and 90% within the third. Stage of primary tumour was the most predictive
      factor for eventual relapse. Minute foci of tumour not encompassed by the first
      operation led to local recurrences in most of the cases, but relapses were
      independent of operative procedures adopted. The authors conclude that surgery,
      even if correctly performed, is not sufficient to prevent the risk of local
      recurrence of rectal cancer. They believe that routine adjuvant radiation therapy
      after surgical treatment of rectal cancer should improve survival rate.

PMID- 1755595
TI  - [Gastric emptying after duodenogastric resection].
AB  - The gastric emptying has been studied with 99Tc labelled in 35 patients followed
      for 2-8 years after duodenogastric resection. All patients had been undergone a
      gastric resection of 2/3 of stomach. In 18 had been performed a Billroth II (BII)
      and in 17 a gastrojejunostomy with a Roux-en-Y anastomosis. The jejunal loop had
      been carried out about 25-35 cm from the Treitz, the mesenteric margin isolated
      for 2-3 cm and the jejunojejunostomy performed about 50 cm from the
      gastrojejunostomy. Nobody complained symptoms from altered gastric emptying. In
      all patients with Roux-en-Y anastomosis there was an intense radioactivity in the
      new stoma till the 150th minute, and peristaltic activity was valid and
      coordinated. In patients with BII there was no radioactivity in the new stoma
      before the 150th minute, and peristaltic activity was always convulsive and
      uncoordinated.

PMID- 1755596
TI  - [Clinical research on the possibility that renal cysts may be responsible for the
      appearance of hematuria].
AB  - New techniques of study, namely echography, urography, TC, give evidence of a
      great number of asymptomatic renal cysts in the everyday experience. Then also if
      haematuria was classically considered one of the symptoms of renal cysts, there
      are now many reasons to consider such evidence very infrequent, and downright
      there are some valid doubts that renal cysts may cause haematuria at all. So the
      authors have analysed 113 patients, most of them coming from Institute of
      Radiology of Chieti University Faculty of Medicine; all of them had renal cysts
      diagnosed by echographs and/or urography but only a minority were just from the
      beginning studied for haematuria, whereas the majority for many different
      symptoms. Total cases was then divided into two groups: one of 102 patients, all
      without haematuria; 78 of them had been studied only with echography, whereas
      other 24 patients had been examined both with echography and urography. The
      second group, of 11 cases, included all the patients who had both renal cysts and
      haematuria. Only in two cases of this second group was lacking evidence of any
      associated pathology which must be responsible for haematuria, whereas in all the
      other 9 cases a different aetiology of the haematuria was demonstrated, for
      simultaneous presence of various pathologies (cystopyelitis with associated
      prostatis, haemorrhagic cystitis, bladder diverticula and renal papillomas and
      upper urinary ways tumours), all much easier responsible by themselves of
      haematuria, also if with different features from case to case.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1755597
TI  - [Fractures of the calcaneus. The indications for surgical treatment].
AB  - The authors report the results obtained from a study of 41 cases of calcaneal
      fractures. Surgical treatment, when possible, is to be applied because it allows
      a satisfactory reconstruction of the subtalar and calcaneocuboid joint. The
      choice of various surgical methods is facilitated by computerised tomography
      which allows a precise assessment of the calcaneum. The quality and the stability
      of the reduction determine in a significant way the functional result.

PMID- 1755599
TI  - [Primary hepatic actinomycosis: a clinical case report and review of the
      literature].
AB  - Primitive actinomycotic abscess of the liver is extremely rare: in the world
      literature are reported twenty cases. The authors report a case of a 73-year-old
      patient admitted at our hospital in poor general conditions, with twelve
      kilograms weight loss in the last year, recurrent fever and tenderness in right
      hypochondrium. CT scan, ultrasonography and angiography showed the presence of a
      seven-centimeters hypovascularized mass in the fourth segment of the liver. The
      patient was submitted to surgical segmentectomy of the fourth segment. The
      histologic examination and the histochemical colorations made on the specimen
      have given the diagnosis of hepatic actinomycotic abscess. No clinical evidence
      of other intra-abdominal or extra-abdominal localizations were found. From 1928
      to date only twenty similar cases have been reported in the world literature. The
      mean time between the beginning of the symptoms and the diagnosis was 11.1 months
      (range: 2-54 months): this to confirm the diagnostic difficulties of the disease.
      The hepatic lesions are described as single in eight cases and multiple in
      thirteen. Thirteen patients have been treated only with medical therapy: nine
      recovered and four died for disease spread. Of the six patients with resectable
      lesion treated surgically, five recovered and one died for pulmonary recurrence.

PMID- 1755598
TI  - [Splenectomy for hemorrhage from esophageal varices with massive thrombosis of
      the portal bed in the absence of cirrhosis: an intervention to be reevaluated?
      Reflections on a clinical case].
AB  - It has been suggested that the ideal definitive treatment of hemorrhage from
      esophageal varices due to extrahepatic portal hypertension should be a selective
      shunt, avoiding splenectomy, when possible, for its unfavorable effects. We
      present a case with extrahepatic portal hypertension and polycythemia vera who
      complained acute recurrent variceal bleeding in spite of multiple sclerotherapy
      sessions, with a massive thrombosis of the portal bed and radicles without any
      possibility to perform a shunt. The combined treatment was emergency splenectomy
      followed by a closed program of sclerotherapy. The result was good at two years
      of follow-up. The optimal treatment of patients with episodes of bleeding varices
      for extrahepatic portal hypertension and patency of splenic vein should be a
      selective shunt; poor long-term results have been reported in patients without
      patency of the major tributaries of the portal system and treated with other
      operations than shunts. Splenectomy could gave a role in producing these unhappy
      results. After splenectomy it has been observed an increased thrombocytosis,
      venous infarction of the bowel, increased susceptibility to infection and also a
      paradoxical higher risk of bleeding by removing low risk collaterals. From this
      anecdotal report it can be argued that splenectomy is not necessarily followed by
      bad results and can be the first therapeutic option in emergency and in some
      selected cases with huge, high risk varices, difficult to treat by sclerosis
      only, and without suitable vessel for a shunt.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755600
TI  - [Surgical central venous catheterization (SCVC) for total parenteral nutrition
      (TPN) via the basilic vein].
AB  - The central venous catheterization (CVC) by subclavian vein puncture for total
      parenteral nutrition (TPN) has a high risk of complications in some situations
      such as neck or supraclavicular diseases, tracheostomies, costoclavicular
      deformities and coagulopathies. Surgical CVC approach to the basilic vein is
      indicated in these cases. The aim of this study was to evaluate the usefulness of
      this technique. Sixteen patients had TPN with this technique, utilizing a silicon
      catheter (Vygon Nutricath). The main time of TPN was 19 days (min 5-max 41). In
      12 cases (75%), there were no complications. In two cases (12.5%) we observed an
      accidental catheter displacement. The incidence of thrombophlebitis was 12.5% (2
      cases); in one of two cases (6.25%), it was correlated with the contamination of
      the catheter (Staphylococcus epidermidis); in the second case it was aseptic. Our
      results demonstrated the usefulness of this of these technique in cases in where
      the CVC by subclavian vein presents a high risk of complications.

PMID- 1755601
TI  - [Radioimmunoguided surgery. Presentation of the topic].

PMID- 1755602
TI  - [The new prospects for radioimmunoguided surgery: the avidin-biotin system].

PMID- 1755603
TI  - [Radioimmunoguided surgery in hepatic resection interventions for metastases of
      colorectal tumors].

PMID- 1755604
TI  - [FO23C5 anti-CEA (FAb'2) 125-I monoclonal antibody for the intraoperative
      localization of colorectal tumors during radioimmunoguided surgery (R.I.G.S.)].

PMID- 1755605
TI  - [The role of B72.3 125-I monoclonal antibody in the radioimmunoguided surgery of
      colorectal neoplasms].

PMID- 1755606
TI  - [Neuroendocrine carcinoma of the skin].
AB  - The neuroendocrine carcinoma of the skin (NCS) is an uncommon disease, having
      been described about 400 cases in world literature. Two cases of NCS in a 52-year
      old woman and in a 44-year-old man are reported; their histogenesis is still
      uncertain. It is advisable a wide cutaneous excision of the neoplasm extending 2
      3 cm. over its macroscopic borders, in order to decrease the incidence of local
      recurrences, reaching 33% in some reports; when regional nodes are involved a
      lymphadenectomy is recommended. The authors also recommend a prophylactic
      radiotherapy of locoregional node chains, because of the high radiosensitivity of
      these tumors.

PMID- 1755607
TI  - [The endoscopic treatment of gastric adenomas].
AB  - Endoscopic polypectomy is the treatment of choice in symptomatic polyps of the
      stomach. From 1974 to 1989, at the Endoscopy Division of National Cancer
      Institute of Milan, 37 patients underwent endoscopic polypectomy, to remove 55
      gastric adenomas. Areas of malignancy were revealed in 3 patients. Two of them,
      not operable for advanced age and poor general conditions, are controlled
      endoscopically. Endoscopic polypectomy can be performed on an outpatient basis or
      with a short period of hospitalization. It represents the only form of therapy in
      not operable patients. Furthermore this method allows to prevent the malignant
      transformation of the adenomas, which, as reported in the literature, ranges
      between 3.4% to 66.5%. Our experience confirms the validity of this technique
      which is safe and effective.

PMID- 1755608
TI  - [Complicated jejunoileal diverticulosis. A clinical case report].
AB  - The diverticulosis of jejunum ileum is an uncommon pathology, that is often
      revealed just from the complications which it presents. The clinical case
      reported by the Authors describes a woman who reached to admission for a serious
      condition of shock secondary to a jejunum bleeding diverticulosis and who
      underwent an intestinal resection. The patient was discharged home on IX p.o.
      day. From the review of literature results that the incidence of the
      diverticulosis of jejunum ileum consists of 0.1%-0.11% of all the
      gastrointestinal's diverticula and the predominance is for the female, especially
      in the middle age. The diverticulosis of jejunum ileum can be congenital or
      acquired; the first one came to the antimesenteric side of the intestines, the
      second one to the mesenteric side of the same. The diverticulosis is generally
      asymptomatic, but often produces many complications as the intestinal occlusion,
      secondary to a bridle, a volvulus, an invagination, also if the peritonitis
      caused by a diverticulosis's perforation represents the most frequent
      complication of them. Others rarest complications are the massive haemorrhage of
      diverticula, the stagnant loop syndrome, the malabsorption's syndrome due to lack
      of B12 vitamin and growth of bacteria within them, the diverticulitis caused by
      infection. The therapy of all complicated cases of jejunum ileum diverticula is
      necessarily the surgery only and exactly the intestinal resection.

PMID- 1755609
TI  - [Preoperative transhepatic biliary drainage in the jaundiced patient: our
      experience].
AB  - The authors assessed the efficacy of PTBD in a group of 72 patients with
      obstructive jaundice due to lithiasis or malignant obstruction, that underwent
      preoperatively PTBD procedure. They analysed the early and late complications and
      its effectiveness in decreasing the bilirubin levels. The results, in agreement
      with the most recent reports, suggest the uselessness of the preoperative PTBD in
      the treatment of the patients with a jaundice due to a biliary lithiasis.
      Concerning the patients with a neoplastic jaundice, this procedure seems to be
      more effective in the patients with a biliary obstruction due to pancreatic head
      or distal choledochus carcinoma: in the patients with a far advanced cancer, the
      PTBD procedure could be the first step to the insertion of biliary
      endoprosthesis; on the other hand, in the patients that may undergo a curative
      treatment, PTBD could be useful preoperatively both to reach an adequate water
      electrolyte [correction of hydroelectrolithic] balance and nutritional status
      both to complete the diagnostic procedure.

PMID- 1755610
TI  - [Perioperative antibiotic prophylaxis in reconstruction of the thoracic wall].
AB  - Thirty youngs and children were submitted to surgical reconstruction of excavated
      chest. To prevent risk of infections (by Staphylococcus and mixed gram-negative
      flora) preoperative 100 mg/Kg body weight of cefotaxime was given. In all
      patients the operative wounds healed regularly. To evaluate cefotaxime level and
      that of its metabolites raised in the tissues, the very sensibles method HPLC was
      applied. Thus 45 minutes after antibiotic somministration, very high levels were
      present in cartilage 9.8 mmg/gr and in bones (9.3 mmg/gr). Related to
      Staphylococcus aureus (MHK 90 of about 2 mmg/ml) results are of value also for
      other surgical orthopedic operations.

PMID- 1755611
TI  - Intraocular pressure--the cardiac connection.
AB  - A retrospective analysis of graphic intraocularpulse waves (IOPW) taken with a
      pneumotonograph (PTG) revealed abrupt elevations of intraocular pressure (IOP) in
      a strict-time relationship with the onset of spontaneous or sustained cardiac
      tachyarrhythmias. This may be explained as a consequence of an increase in
      central venous pressure from the "back" pressure effect of abnormal diastolic
      indexes of cardiac function rather than the forward systolic forces (including
      systolic blood pressure that usually are depressed under these circumstances).
      Given the frequency of cardiac arrhythmias in the general population, we suggest
      that continuous graphic IOP tracings, such as with the PTG, will reflect overall
      IOP levels better than those obtained, for example, by a quick-acting noncontact
      tonometer. Abnormal indexes of diastolic cardiac function found in many forms of
      heart disease, including the aging process, merit further consideration as a
      potential cardiovascular factor affecting ocular pressure dynamics in other
      circumstances.

PMID- 1755612
TI  - Critical evaluation of therapeutic keratoplasty in cases of keratomycosis.
AB  - Therapeutic keratoplasty was done in 123 neglected cases of fungal ulcers that
      did not respond to maximal medical therapy. It is recommended that, if the
      surgery is contemplated, it should be done before the ulcer perforates. A 0.5mm
      larger donor graft than recipient bed is better than a similar-sized graft.
      Various complications and final results are discussed.

PMID- 1755613
TI  - The use of a new portable noncontact tonometer in home tonometry.
AB  - We used a new portable noncontact tonometer for home tonometry on 26 patients
      with chronic open-angle glaucoma or suspected low-tension glaucoma. In an
      outpatient setting, the mean difference and correlation coefficient between the
      family member's noncontact tonometry values and the nursing staff's applanation
      tonometry values used as a control was 1.0mmHg and 0.894mmHg, respectively. The
      difference between the means was not statistically significant (P greater than
      .05, by Student's t test). At home, the variances of four noncontact tonometric
      values obtained every other hour did not differ significantly from those obtained
      in the outpatient setting by the nursing staff (P greater than .05). Five of 26
      patients had their medical regimen changed based on the results of home
      tonometry. This study suggests that many nonmedical personnel can do noncontact
      tonometric scanning reliably. At home, noncontact tonometry may help evaluate a
      patient's intraocular pressure control.

PMID- 1755614
TI  - Adipose tissue in the lens.
AB  - A case of persistent hyperplastic primary vitreous with replacement of the lens
      by adipose tissue was observed in a 31-year-old man. A review of the literature
      revealed only two other cases in which this particular finding was documented.

PMID- 1755615
TI  - Laser-assisted tarsoconjunctival flap harvesting for lower eyelid defect
      reconstruction.
AB  - Tarsoconjunctival flap procedures are reliable and versatile procedures for
      reconstruction of large lower lid defects. We present a new carbon dioxide laser
      assisted flap-harvesting technique. This technique combines precise and accurate
      incisions with simultaneous complete hemostasis. We have done carbon dioxide
      laser-assisted flap harvesting for large and total lower lid defects. The
      hemostatic evaporative cutting of the carbon dioxide laser decreases time,
      swelling, and bleeding in obtaining tarsoconjunctival grafts and flaps.

PMID- 1755616
TI  - Etiology of reduced visual acuity in congenital nystagmus.
AB  - A study was undertaken to identify the etiologic factor of reduced visual acuity
      in congenital nystagmus. Fourteen children with congenital nystagmus and reduced
      visual acuity were examined, using a modified "E" game test. Their success rate
      in identifying vertical lines was compared with their success rate in identifying
      horizontal lines. The children identified both vertical and horizontal lines with
      a similar rate of success. These results may indicate that poor vision in
      congenital nystagmus patients is partly the result of amblyopia.

PMID- 1755617
TI  - [Splenectomy for chronic thrombocytopenic purpura].
AB  - During the period 1985-1989, 49 patients underwent splenectomy for chronic
      idiopathic thrombocytopenic purpura in our department. A correct follow-up was
      available for 39 patients. All patients had been previously treated with
      corticosteroids. We evaluated the platelet count one year after the operation and
      the relation between this count and several preoperative and postoperative
      factors. We observed a favourable prognosis when the preoperative study of
      platelet sequestration showed splenic destruction, when the duration of symptoms
      was less than one year and when there was a rapid increase in the platelet count
      during the first week after the operation.

PMID- 1755618
TI  - [Surgery for lung metastases in children].
AB  - The authors report a series of 76 children with lung metastases followed from
      1974 to 1989. Forty-four children were operated on with 64 thoracotomies (50
      wedge resections, 5 segmentectomies, 2 pneumonectomies, 6 biopsies, 1 excision of
      an inflammatory granuloma): 23 of these children are alive, and 17 of them
      without any adjuvant radiotherapy. Thirty-two were not operated on; of the 13
      that are alive, 7 had no adjuvant radiotherapy. The indications for surgery were:
      to treat a complication of the metastasis, to verify persistent images on CT
      scan, but essentially to avoid more aggressive treatment (chemotherapy,
      radiotherapy) with its risk of sequelae in children.

PMID- 1755619
TI  - [Chest injuries in children. Apropos of 93 cases].
AB  - Ninety-three cases of thoracic trauma (age ranging from 1.1/2 to 15 years) were
      observed over a 10 year-period (1980-1990): 86 cases of blunt trauma and 7 cases
      of perforating injuries. Road accidents were the most prevalent (63 cases)
      followed by home and sport injuries (9), falls (9), perforating trauma (9) and
      others. Associated lesions were frequent: skeletal (67), abdominal (19), and head
      injuries (5)--the latter influence the vital prognosis. Rib fractures were
      observed in 60% of cases of blunt trauma (86). Pulmonary lesions were as follows:
      pneumothorax (41), hemothorax (21), and lung contusions (29). In 48 cases,
      several of these pulmonary lesions were associated. Diagnosis and therapy
      problems were encountered in 21 cases. Results were as follows: 3 deaths, within
      24 hours due to hemorrhage (1 case with aortic lesion). FOLLOW-UP: 85 good
      results, 5 sequelae, without any clinical consequence--either pleural (2),
      diaphragmatic (2), or lung (1). The treatment was as follows: none (27), pleural
      aspiration (2), thoraco-synthesis by drain in other cases for 2 to 9 days.
      Surgery was necessary in 10 cases, with 2 thoracotomies, 1 orthopedic traction, 1
      embolization of iliac artery.

PMID- 1755620
TI  - [Aneurysms of the aortic arch. Experience of 19 cases].
AB  - From 1980 to 1990, 19 consecutive patients were operated for chronic aneurysm of
      the aortic arch: 16 men and 3 women with a mean age of 46 years (range: 20 to 72
      years). Four aneurysms were proximal, with a distal limit in the left common
      carotid artery; 4 were distal, starting beyond the brachiocephalic trunk and 11
      involved the entire aortic arch. Three were atheromatous, 9 were dystrophic, 1
      was syphilitic, 1 was post-traumatic, 1 was secondary to coarctation and 4 was
      secondary to longstanding dissection. Four cases (21%) were in a state of pre
      rupture. They were all operated under cardiopulmonary bypass with profound
      hypothermia and circulatory arrest in 11 cases (9 cases of aneurysm involving the
      entire segment II and two cases of distal aneurysms). Selective cannulation of
      the large cervical arteries supplying the brain was performed in 5 cases (3 cases
      of proximal aneurysms and 2 cases of aneurysms of the entire segment II). Seven
      patients simultaneously underwent aortic valve replacement and replacement of the
      ascending aorta. One patient underwent replacement of the descending aorta and
      another underwent an ascending aorta-supracoeliac aorta bypass graft. The early
      mortality was 10.5% (2 patients out of 19) and the late mortality was 5.8% (1
      patient out of 17). The mean follow-up was 46 months (maximum: 9 years, minimum:
      9 months), and the 9-year actuarial survival rate was 86%. This study
      demonstrated the superiority of selective carotid cannulation as a means of
      cerebral protection.

PMID- 1755621
TI  - The geriatric patient in surgery. Experience with patients over the age of 85
      years.
AB  - Between 1982 and 1989 hospitalized treatment was applied to 615 patients aged
      between 85 and 101 years. The average age was 88.8 years. Operations were
      performed on 406 of them (66.1%). The surgical lethality amounted 16.5%. The
      lethality in conjunction with emergency operation was as high as 30.8% or as low
      as 10.7% in the context of elective operations. X-ray findings recorded from
      heart and lung as well as ECG provided reliable criteria for assessment of the
      surgical risk.

PMID- 1755622
TI  - [Spontaneous and instrumental perforations of the thoracic esophagus (non
      neoplastic, non-caustic). Apropos of 20 cases].
AB  - The authors present twenty cases of spontaneous or instrumental perforation of
      the thoracic esophagus (neoplastic and caustic perforations excluded). The delay
      before treatment was less than 24 hours in only one case. Mortality rate was 15%,
      concerning three patients (three cases of Boerhaave's syndrome) treated by T tube
      drainage. The contribution of exclusion using stapling technique should increase
      the indications of direct suture, which remains elective treatment. Esophagectomy
      retains its indications for perforations with pathologic esophagus or late
      diagnosis.

PMID- 1755623
TI  - [Benign mucus-secreting tumors of the appendix. Six cases].
AB  - The authors report six cases of mucus-secreting tumor of the vermicular appendix,
      in four women and two men (mean age 59 years). All were benign. Pain in the right
      lower quadrant was the initial sign in 4 cases, while the mucus-secreting tumor
      was an incidental finding in the other two cases. A mass was palpated in the
      right lower quadrant in one case. A barium enema was performed in four cases and
      showed an extrinsic compression of the caecal base in one case, and of the right
      colon in another case. Four appendectomies, one associated with removal of the
      adjacent caecal tissues and two right colectomies were performed. Analysis of
      these six cases and a review of the literature allow us to recall the histologic
      classification of these tumors, which determines the prognosis and to emphasize
      the sonographic and CT scan findings which might lead to earlier preoperative
      diagnosis in the future. Management depends upon the circumstances under which
      the tumor is discovered, the local anatomy, and the type of tumor. Appendectomy
      is the treatment most often performed. Faced with a tumor of the appendix,
      without histologic proof or when the local anatomic conditions increase the risk
      of opening an abscess, right colectomy is recommended.

PMID- 1755624
TI  - [Complicated hydatid cysts of the liver].
AB  - In 328 cases of hydatid disease of the liver operated between 1979 and 1989, 51
      (15.8%) had complicated cysts. The most frequent complication was intrabiliary
      rupture (2/3 of all complications). The others were intraperitoneal rupture in 7
      cases (13.8%), suppuration in 7 cases (13.8%) and intrathoracic rupture in 3
      cases (5.8%). Among the intrabiliary ruptured cysts, T-drainage was performed in
      15 cases, choledochoduodenostomy was performed in 12 cases, and sphincteroplasty
      was performed in 7 cases. The cases of intraabdominal rupture were operated
      immediately. The suppurated cysts were marsupialized in 3 cases and drained in 4
      cases. The 3 cases of bronchobiliary fistula were treated by T-tube drainage of
      the common bile duct, drainage of the pleural space, repair of the diaphragm and
      closure of the communicating bronchus. In this series, the mortality rate was
      7.8% and the recurrence rate was 9.8%.

PMID- 1755625
TI  - Gastroenterological options in faecal incontinence.
AB  - Faecal incontinence may be due to a trauma, a rectal prolapse, or a neurological
      disorder. Obstetric trauma: If the sphincter has been severed, direct repair is
      indicated. In the case of neurological damage, plication of the levators can
      provide significant improvement; while the post-anal repair has become popular,
      anterior sphincter plication and levatorplasty, provide equivalent results.
      Rectal prolapse: Full thickness rectal prolapse is frequently associated with
      incontinence. Two categories of operations have been described: local operative
      procedures (Delorme's plicature, perineal resection) provide poor results in term
      of restoration of continence and should be reserved to unfit and elderly
      patients; abdominal operations combine an extensive rectal mobilisation and they
      differ by the type of fixation. The Ripstein operation (fixation to the
      promontory by an encircling sling of non absorbable mesh) has long been popular
      in the United States, but is followed by severe constipation. In the simple
      suture rectopexy, the rectum is fixed to the pelvic floor and the presacral
      fascia by non absorbable procedures. In the Ivalon sponge rectoprexy, a polyvinyl
      alcohol mesh in secured between the sacrum and the rectum, and provides a dense
      fibrous reaction. In the antero-posterior Marlex rectopexy, a sheet of Marlex
      mesh is fixed posteriorly to the rectum, and a sling is interposed anteriorly in
      order to support the anterior wall. In the resection rectopexy, a sigmoid
      resection in added to the rectal fixation in order to suppress the redundant
      sigmoid which is responsible for the constipation frequently following rectopexy.
      Results of abdominal rectopexy are satisfactory in terms of recurrence and
      restoration of continence.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755626
TI  - [Mediastinal exploration for hyperparathyroidism].
AB  - Five per cent of parathyroid adenomas are situated in the mediastinum. Many of
      them are accessible via a cervical incision: virtually all posterior mediastinal
      adenomas, by dissecting well behind the oesophagus, and most intrathymic
      adenomas, by cervical exteriorisation of the thymus. Finally, the indications for
      sternotomy are are: less than 2% of operations for hyperparathyroidism. After
      describing the technical details, the authors review the indications, the imaging
      modalities used and the results of their last 20 sternotomies.

PMID- 1755627
TI  - [Popliteal vascular trauma: therapeutic management].
AB  - The functional severity of popliteal artery injury is intimately related to the
      direct consequences of tissue ischaemia increased by the associated traumatic
      attrition. The conservation of a functional limb requires: limitation of the
      duration and repercussions of ischaemia, by the use of a rigorous therapeutic
      protocol; "functional" surgical or even microsurgical reconstruction whose limits
      are still confused with the degree of traumatic myolysis and the potential of
      nervous recovery. Therefore, it seems obvious that the major difficulty lies in
      the definition of the limits for limb preservation.

PMID- 1755628
TI  - [The superior mesenteric artery syndrome. Apropos of a case and review of the
      literature].
AB  - During laparotomy for an appendicular peritonitis, the authors found an acute
      mesenteric artery syndrome. Conservative treatment consisted of mobilisation of
      the 4th part of the duodenum with section of the suspensory muscle of Treitz, but
      this was not sufficient to cure the patient. Two weeks later the patient
      completely recovered after a duodenojejunal anastomosis. A review of the
      literature confirmed that surgical treatment for scoliosis and anorexia nervosa
      play an important role in the aetiology of this disease.

PMID- 1755629
TI  - [Multinodular pulmonary type AL amyloidosis. Report of a case and review of the
      literature].
AB  - A multinodular lung lesion was discovered in a healthy 56 year-old man on routine
      chest X-rays. Histology revealed multinodular amyloidosis which histochemically
      was found to correspond to the AL type. This type of amyloidosis raises the
      differential diagnosis ith a lung neoplasm. In our case, no cell dyscrasia was
      observed. The patient was treated by surgery as recommended in the literature.

PMID- 1755630
TI  - [Reimplantation of a non-functioning lung. Report of a case].
AB  - The authors present the case of a patient with a carcinoid tumor of the left main
      bronchus. Conservative surgery by sleeve resection without pulmonary resection
      was performed. The underlying lung which was considered to be nonfunctioning
      during pre-operative evaluations, completely recovered within a year following
      surgery.

PMID- 1755631
TI  - [Technique and results of lung transplantation in rats].
AB  - Lung transplantation has recently emerged as an efficient therapy for a variety
      of endstage pulmonary diseases. Nevertheless, many problems remain unsolved. A
      simple and reproducible experimental model allows examination of some of the
      problems encountered. We report here our experience of lung transplantation in
      the rat. One hundred and thirty six lung transplantations have been performed.
      After the initial phase necessary to master the technique, an overall survival
      rate of 86% was achieved. Graft function, as assessed by chest X-rays and lung
      isotope scans, was satisfactory up to 4 months after transplantation. Lung
      transplantation in the rat is a reliable and reproductible experimental model
      allowing the development of research projects in this field.

PMID- 1755632
TI  - [Posterior cardiopexy technique].
AB  - The technique of Hill's posterior cardiopexy is based on precise anatomical
      criteria. Hill's "strips" actually correspond to the peri-oesophageal connective
      tissue described by Boutelier. The operation consists of closing the oesophageal
      hiatus and attaching the "strips" to the preaortic fascia. We prefer to perform
      the operation via a left subcostal incision without intraoperative manometry and
      we complete the procedure by fixing the fundus of the stomach to the left side of
      the oesophagus.

PMID- 1755633
TI  - Smoking in children.

PMID- 1755634
TI  - Acute appendicitis in the preschool child.

PMID- 1755635
TI  - Screening for neuroblastoma.

PMID- 1755636
TI  - Height reduction in 539 tall girls treated with three different dosages of
      ethinyloestradiol.
AB  - During the period 1970 to 1985, 539 constitutionally tall girls were treated with
      ethinyloestradiol in varying dosages to reduce final height. They all had a
      predicted final height above 181 cm (greater than +2.5 SD). The girls were all
      healthy and were treated with three different dosages of ethinyloestradiol.
      Throughout these 15 years recommended treatment regimens changed, and the
      treatments described followed these guidelines. Girls in group 1 (n = 263) were
      treated with 0.5 mg of ethinyloestradiol, group 2 (n = 178) with 0.25 mg, and
      group 3 (n = 98) with 0.1 mg. The total mean (SEM) reduction of final height was
      5.9 (0.2), 5.3 (0.1), and 4.4 (0.2) cm when treated with 0.5, 0.25, and 0.1 mg
      respectively. Group 1 was treated for 2.02 (0.03) years and group 2 and 3 for
      1.85 (0.04) and 1.63 (0.05) years respectively. When expressed in relation to the
      treatment period the reduction of final height was 3.0 (0.1), 3.1 (0.1), and 2.9
      (0.2) cm/year of treatment respectively. All the girls were treated with
      ethinyloestradiol as a daily single dose, while progestogen was given daily the
      first 10 days of every month. In conclusion we found that a daily dose of
      ethinyloestradiol 0.1 mg for about 20 months is sufficient to reduce final
      height. We recommend starting treatment at a bone age of about 12 years.

PMID- 1755637
TI  - Cyclical disturbance of diabetic control in girls before the menarche.
AB  - Seven diabetic girls who presented with cyclical disturbance of diabetic control
      before the menarche are described. In six girls cyclical hyperglycaemia occurred
      and in one cyclical hypoglycaemia. The index case is described in detail, and is
      then included in a description of the main clinical features of all seven cases.
      Cyclical disturbance of diabetic control may present in diabetic girls from age 9
      years onwards. Home blood glucose monitoring records may reveal cyclical
      disturbance, usually hyperglycaemia, and usually occurring at 21-34 day intervals
      and lasting for two to five days. Serious illnesses and hospital admission can be
      averted by educating parents to make appropriate changes to insulin regimen or
      diet. Our hypothesis is that the disturbance of diabetic control is caused by the
      onset of cyclical hormonal changes, a 'menstrual' cycle before menstruation. The
      precise mechanism for the changes in carbohydrate tolerance is unknown.

PMID- 1755638
TI  - Covert bacteriuria: long term follow up.
AB  - In a longitudinal prospective study 58 schoolgirls with covert bacteriuria were
      followed up for an average of 11.2 years (range 8.8 to 13.5 years). Intravenous
      urography was carried out at the start of the study (aged 4 to 11 years) and
      after completion of the follow up period (aged 14.8 to 22.3 years). After random
      allocation 27 of these girls received intermittent treatment for covert
      bacteriuria for the first four years and the control group received no treatment.
      The effect of covert bacteriuria, treatment, vesicoureteric reflux, and reflux
      nephropathy at presentation on the final renal length, progression of scarring,
      and development of new scars was analysed. No new scars were found in girls with
      bilaterally normal kidneys. In girls with reflux nephropathy, three kidneys
      showed progression of existing scars and two kidneys developed new scars. It was
      shown that final renal length was not influenced by vesicoureteric reflux or
      treatment, but reduced renal length at final assessment was associated with the
      presence of kidney scarring at initial assessment.

PMID- 1755639
TI  - Urinary tract infection in febrile convulsions.
AB  - A retrospective review of the casenotes of 403 children admitted to hospital with
      febrile convulsions was performed to estimate the frequency of symptomatic
      urinary tract infection and examine medical practice in making this diagnosis. A
      total of 228 (56%) children had urine cultured: 150 bag specimens, 76 clean
      voided samples, and two suprapubic aspirates. There were 13 'probable' and six
      'possible' infected urine samples together representing 5% of the whole study
      population (n = 403), 8% of those having urine cultured (n = 228), and 12% of
      those providing uncontaminated urine samples (n = 155). Those with first febrile
      convulsions and those aged under 18 months were more likely to have urine
      examined. Practices varied significantly between different hospitals. These
      results suggest that there has indeed been a need for practice guidelines, and
      that further audit of practice is required to assess their impact.

PMID- 1755640
TI  - Maternal and fetal influences on blood pressure.
AB  - To study maternal and fetal influences on blood pressure in childhood 405
      children aged 4 years who were born and still resident in the Salisbury health
      district were visited at home for blood pressure and growth measurements.
      Information on the pregnancy, delivery, and baby was abstracted from the routine
      obstetric notes. Similar to recent findings in adults, the child's systolic
      pressure was inversely related to birth weight and positively related to
      placental weight. Systolic pressure at 4 years increased by 1.2 mm Hg for every
      SD decrease in the ratio of head circumference to length at birth, and by 1.1 mm
      Hg for every SD decrease in ponderal index at birth. Mothers whose haemoglobin
      concentrations fell below 100g/l during pregnancy had children whose systolic
      pressures were on average 2.9 mm Hg higher than the children of mothers with
      higher haemoglobin concentrations. Patterns of placental weight, birth weight,
      head circumference, and length that are associated with high blood pressure in
      adults are also associated with higher blood pressure in 4 year old children.
      Identification of the intrauterine influences that lead to these patterns of
      fetal growth could lead to the primary prevention of hypertension.

PMID- 1755641
TI  - Deficiency of prostacyclin production in meningococcal shock.
AB  - A deficiency of prostacyclin (PGI2) production by the vascular endothelium might
      underline the severe vasoconstriction and intravascular thrombosis that
      characterise meningococcal shock. The effect on PGI2 synthesis by human umbilical
      vein endothelial cells (HUVEC) in culture was examined in sera from children with
      meningococcal shock, healthy adults, and children with other febrile illnesses.
      In comparison with adult controls, PGI2 synthesis was reduced when HUVEC were
      incubated with the sera from 10 of 13 patients with meningococcal shock. A
      similar defect was observed with only four of 20 sera from children with other
      febrile illnesses. The effect of sera from patients with meningococcal shock on
      HUVEC was reversible with normal serum, and seems to be due to the absence of a
      factor necessary for PGI2 production rather than an inhibitor. These findings
      suggest that a deficiency of PGI2 may have a role in the pathogenesis of
      meningococcal shock and that exogenous PGI2 may be of therapeutic benefit.

PMID- 1755642
TI  - Hyperganglionosis mimicking Hirschsprung's disease.
AB  - Three patients with hyperganglionosis are reported in whom an initial diagnosis
      of Hirschsprung's disease was suspected. In one patient there was a classic
      presentation with constipation, in another Hirschsprung's disease coexisted, and
      in the third the initial inadequate suction rectal biopsy specimen was suggestive
      of Hirschsprung's disease on acetylcholinesterase staining. Evidence of
      hypertrophy and hyperplasia of the intermuscular and submucosal plexuses on a
      full thickness bowel biopsy specimen was used to confirm the diagnosis of
      hyperganglionosis, suggested by the characteristic demonstration of moderate
      increase in the number of acetylcholinesterase stained nerve fibres in the lamina
      propria mucosae on rectal biopsy. Surgical management was guided by clinical
      signs. Two patients had colonic resections; the third had temporary stomal
      diversion. Hyperganglionosis is rarer than Hirschsprung's disease but is known to
      mimic it. We suggest full thickness bowel specimens are needed to confirm the
      diagnosis and that inadequate rectal suction biopsies must be interpreted with
      caution.

PMID- 1755643
TI  - Trends in prevalence and survival of very low birthweight infants, England and
      Wales: 1983-7.
AB  - Between 1983 and 1987 over 99% of all infants born in England and Wales had their
      birth weights recorded when the birth was registered. Trends in occurrence and
      one year survival of those who weighed under 1500 g at birth have been calculated
      in 100 g groups, separately for single and multiple births. By 1987 singleton
      live births in England and Wales who weighed between 700 and 799 g had a 43%
      chance of surviving to 1 year compared with a 32% chance five years earlier;
      those who weighed 800 to 899 g had a 55% chance compared with 46%. The absolute
      number of survivors weighing between 500 and 999 g at birth increased by nearly
      50% between 1983 and 1987, and there was a 30% increase overall in survivors
      weighing less than 1500 g.

PMID- 1755644
TI  - What do parents expect antenatally and do babies teach them?
AB  - Antenatal inquiry of 658 parents in the North Staffordshire District Health
      Authority showed at least 13% to lack knowledge about a baby's potential for
      personal interaction when under 1 week old. Mothers and fathers varied
      significantly, independent of parity. Experienced parents expected later smiles.
      Two hundred and seventy eight of the same families were questioned three to four
      months after birth. Most parents had observed their baby's early responsiveness.
      Specific responses (Looking, listening) were noted earlier when anticipated and
      looked for. Significant among postnatal non-responders was their antenatal
      selection of predominantly impersonal stimulation for a baby. The greatest degree
      of warmth noted in postnatal observations correlated notably with a father's
      antenatal interest and postnatal support from him and their friends, a mother's
      commitment to breast feeding and her knowledge that a very young baby can see,
      like faces, and cries for emotional reasons. This highlights areas for antenatal
      tuition and postnatal encouragement, aiming to enhance warm early mutual regard
      between parents and child.

PMID- 1755645
TI  - Inherited metabolic diseases in the sudden infant death syndrome.
AB  - All sudden, unexpected infant deaths presenting during a two year period within a
      defined geographical area in Avon and north Somerset were investigated for
      inherited metabolic disease. Of 95 deaths, 88 were classified as cases of sudden
      infant death syndrome (SIDS). In addition to the normal postmortem
      investigations, samples of cerebrospinal fluid, urine, vitreous humour, and skin
      were collected for metabolic studies. No abnormal organic acid metabolites were
      found in the fluids from the 88 cases of SIDS. Fatty acid oxidation was assessed
      in skin fibroblasts from 70 cases of SIDS, but no examples of medium chain acyl
      CoA dehydrogenase (MCAD) deficiency were found. One case with abundant glycogen
      in the liver was subsequently diagnosed as having glycogen storage disease type
      1c. These findings suggest that the incidence of MCAD deficiency and other
      metabolic diseases in SIDS is much lower than previously claimed.

PMID- 1755646
TI  - Transoral decompression and posterior stabilisation in Morquio's disease.
AB  - A 3.5 year old boy with Morquio's disease was referred with a persisting left
      hemiparesis four months after a fall and was found to have craniocervical
      junction compression due to atlantoaxial subluxation and significant anterior
      soft tissue compression. Transient unconsciousness at the time of the fall was
      probably due to medullary concussion as a result of hyperextension, not a head
      injury. Spinal cord compression due to atlantoaxial subluxation at the
      craniovertebral junction is a major cause of disability and death in these
      patients. Once cervical myelopathy appears, early posterior occipitocervical
      fusion has been advocated in order to arrest the progression of neurological
      disability and this is successful in most cases. This conventional approach was
      considered unsafe because of the significant anterior compression. A combined
      anterior transoral decompression with posterior fusion to deal with this
      particularly difficult problem is described.

PMID- 1755647
TI  - Complications of splintage in congenital dislocation of the hip.
AB  - The use of abduction splintage in the treatment of congenital dislocation of the
      hip has an important morbidity. Six children who developed complications are
      presented in this paper. Sustained splintage of an unreduced hip, overcorrection
      of the femoral head displacement, avascular necrosis of the femoral head, full
      thickness pressure sores, and excessive tibial torsion may occur as a consequence
      of treatment. Expert supervision of abduction splintage, correct case selection,
      and regular review are necessary to reduce the incidence of such complications.

PMID- 1755648
TI  - A practical method of serial bedside measurement of cerebral blood flow and
      metabolism during neurointensive care.
AB  - Acute encephalopathy is a major cause of death and neurological handicap in
      children. The principle aims of treatment are to provide adequate cerebral blood
      flow for the brain's metabolic needs and to prevent intracranial pressure rising
      above the level at which brain herniation occurs. Rational management requires an
      understanding of the pathophysiological changes in cerebral blood flow and
      metabolism which occur. The paucity of data on this subject reflects the
      perceived difficulty of measuring cerebral blood flow and cerebral metabolism in
      children. A modification of the Kety Schmidt technique of measuring cerebral
      blood flow and cerebral metabolism is described. This modification makes it
      possible to perform serial bedside measurements in children receiving intensive
      care. This method was used to perform 348 measurements in 58 children. The method
      was reproducible and no significant complications were encountered. The results
      indicated that appreciable changes in cerebral blood flow and metabolism could
      occur in individual patients over time, emphasising the importance of serial
      measurements. This technique may provide a practical means of monitoring cerebral
      blood flow and metabolism in very sick children receiving neurointensive care and
      evaluating the efficacy of treatment.

PMID- 1755649
TI  - New insights on gastro-oesophageal reflux in cystic fibrosis by longitudinal
      follow up.
AB  - A higher frequency (25%) of gastrooesophageal reflux (GOR) has been previously
      reported in patients over 5 years old with cystic fibrosis compared with controls
      without cystic fibrosis. It was believed that GOR was caused by the complications
      of cystic fibrosis. We looked for GOR in all 26 children younger than 60 months
      who had cystic fibrosis diagnosed. They had a classical genetic profile and the
      usual scattered clinical manifestations for age. GOR was confirmed in 21 (81%):
      20 by abnormal pH tracings and in one on a clinical basis. After at least one
      month of adjusted cystic fibrosis treatment, antireflux treatment (cisapride) was
      given to 16 patients and variables of GOR improved dramatically. Weight gain was
      significant and recurrent cough and wheeze disappeared. One year later half of
      the patients still suffered from GOR. GOR is a major problem in the early life of
      those with cystic fibrosis and is not the consequence of either respiratory or
      gastrointestinal complications as it improves with age whereas cystic fibrosis
      becomes worse with age.

PMID- 1755650
TI  - Pregnancy in phenylketonuria: dietary treatment aimed at normalising maternal
      plasma phenylalanine concentration.
AB  - The transport characteristics of the placenta, which favour higher phenylalanine
      concentrations in the fetus than in the mother, and regression data of head
      circumference at birth against phenylalanine concentration at conception in
      maternal phenylketonuria (PKU), suggest that treatment of maternal PKU should
      ideally aim to maintain plasma phenylalanine concentration within the normal
      range throughout pregnancy. A patient with classical PKU was treated from before
      conception by aiming to maintain plasma phenylalanine concentration within the
      range 50-150 mumol/l and tyrosine within the range 60-90 mumol/l. The diet was
      supplemented with phenylalanine-free amino acids (100-180 g/day) and tyrosine (0
      5 g/day). Plasma amino acid concentrations were monitored weekly by amino acid
      analyser. Dietary phenylalanine intake ranged from 6 mg/kg/day at conception to
      30 mg/kg/day at delivery. Normal weight gain and fetal growth were maintained
      throughout the pregnancy. A normal baby was born at term with a head
      circumference of 35.5 cm; at 1 year of age no abnormality is detectable. These
      results show that with careful monitoring and compliance it is possible, and may
      be advisable, to maintain plasma phenylalanine concentration within the normal
      range in the management of PKU pregnancy.

PMID- 1755651
TI  - Subdural fat effusion complicating parenteral nutrition.
AB  - A preterm infant fed parenterally through a central venous catheter developed a
      subdural effusion containing fat emulsion. Subsequent postmortem examination
      failed to demonstrate any vascular abnormality that might have explained this
      rarely reported complication. Although retrograde flow of feeding solutions into
      cerebral veins seems a likely explanation, the exact mechanism remains uncertain.

PMID- 1755652
TI  - A national survey of nebuliser use.
AB  - Nebuliser drug delivery units were reused in 15% of paediatric wards
      participating in a national survey, while routine servicing and written
      information was provided by only half the wards issuing home nebulisers. Written
      information should be developed as a national resource, and further research on
      optimal cleaning practices is required.

PMID- 1755653
TI  - Familial infantile oesophageal achalasia.
AB  - Oesophageal achalasia is uncommon in children and in its familial form it is a
      rarity. The presentation and management of two male siblings who presented with
      oesophageal achalasia as infants are reported. A high degree of consanguinity in
      the parents of the children existed, suggesting autosomal recessive transmission.

PMID- 1755654
TI  - Populations and samples.

PMID- 1755655
TI  - Paediatric care in the United States.

PMID- 1755657
TI  - Archives francaises de Pediatrie.

PMID- 1755656
TI  - Lyme disease in paediatrics.

PMID- 1755658
TI  - Meningoencephalitis after measles-mumps-rubella vaccine.

PMID- 1755659
TI  - Gonadal function after allogenic bone marrow transplantation for thalassaemia.

PMID- 1755660
TI  - Computerised information systems.

PMID- 1755661
TI  - Equipment requirements for community based paediatric oxygen treatment.

PMID- 1755662
TI  - Septicaemia and adrenal haemorrhage in congenital asplenia.

PMID- 1755663
TI  - Dr Langdon Down.

PMID- 1755664
TI  - [Bone marrow changes at several stages of HIV infection, studied on bone marrow
      biopsies in 85 patients].
AB  - Bone marrow biopsies from eighty-five patients with different stages of HIV
      infection were reviewed. Biopsies were generally indicated to evaluate peripheral
      blood abnormalities, but suspicion of lymphoma and other specific pathologies was
      another important indication. The histopathological features are described and
      are often suggestive of HIV infection but non-specific. Hypercellularity (72.9%),
      dysmyelopoiesis (78.8%), plasma cell hyperplasia (97.7%), lymphoid infiltration
      (27%) and histiocytosis with or without granulomata (11.7%) were the most
      striking abnormalities. Other frequent features include: increased stainable iron
      deposits, venous stasis and serous atrophy (gelatinous transformation). Marrow
      hypoplasia is rather infrequent (28.2%) and usually a terminal event of AIDS.
      Bone marrow biopsies revealed opportunistic and neoplastic complications in seven
      cases, with demonstration of pathogens in four cases (Mycobacterium avium,
      Cryptoccocus neoformans, Toxoplasma gondii and Leishmania donovanii) and
      malignant lymphomas in three other cases (one Burkitt's lymphoma and two
      Hodgkin's disease). Bone marrow biopsy provides useful information for the
      diagnosis and prognosis of HIV infection and for the diagnosis of complications.

PMID- 1755665
TI  - [Lipoma of the internal auditory canal. An anatomo-clinical case study and review
      of the literature about cranial nerve lipomas].
AB  - A 36-year-old female presented with vertigo and worsening of a right hearing loss
      with tinnitus. Clinical and radiologic investigations revealed a tumor of the
      right internal acoustic meatus, first diagnosed as a neuroma. Histologic study of
      surgical samples led to a final diagnosis of lipoma. Cranial nerve lipomas are
      rare and usually located in the cerebellopontine angle. Lipomas confined to the
      internal acoustic meatus are much rarer. The review of the literature however,
      shows that their histologic characteristics and their behavior are identical to
      those of cerebellopontine angle lipomas, and that a minimal surgical resection is
      therefore advised.

PMID- 1755666
TI  - [Neuroendocrine tumors of the mammary gland. Current evaluation apropos of a
      case].
AB  - The authors report a case of infiltrating non-mucinous neuroendocrine breast
      tumor of both nesidioid and carcinoid type, exclusively composed of argyrophil
      cells and showing estrogen receptors. By comparing it to those published in
      literature, they conclude that there are two types of breast tumors with
      argyrophil cells: one very rare, exclusively composed of neuroendocrine cells,
      which may present all of the morphological, functional, evolutive aspects and
      particularly the carcinoid pattern of diffuse endocrine system tumors; the other
      is more common, composite, reminiscent according to the abundance of their
      neuroendocrine components, either of the features of diffuse endocrine system
      tumors, or of those of conventional adenocarcinomas. Their findings help to
      explain that the combined  hormonoreceptive and hormonosecreting nature of these
      tumors is the particular property of their neuroendocrine cells comparable to
      that of the pituitary gland. In the composite tumors, these cells are associated
      in symbiosis with the epithelial glandular cells which are of ectodermal origin.
      Such an association, also observed in other parts of the body, is not fortuitous
      but functional and thus could contra-indicate antiestrogen hormonetherapy.

PMID- 1755667
TI  - [Anatomopathological aspects of colorectal polyps in Cameroon].
AB  - In order to present the main types of colo-rectal polyps in Cameroon, we reviewed
      all those cases received and examined in our Pathology laboratories during a six
      and a half year period (1st January 1984-30th June 1990). The polyps were sent by
      gastro-enterologists after resection during total colonoscopy, with information
      about age and sex of patients, signs and symptoms and sites and number of polyps.
      One hundred and two colorectal polyps were taken from 88 patients with a maximum
      of two polyps per patient. Out of these 102 polyps, we noted: 55 juvenile polyps
      (54%), 23 hyperplastic polyps (22.5%), 13 adenomatous polyps (12.5%), 10
      inflammatory polyps (10%) and one polyp of the Peutz-Jeghers type. One case of
      hyperplastic polyposis and one of familial polyposis with adenomas on
      histological examination were registered. On the whole, juvenile polyps
      predominated and adenomas which can become carcinomas were less frequent than
      what is seen in Western developed countries. This may be due to the fact that the
      polyps we examined were only taken only from patients seen in outpatient
      department for gastrointestinal complaints.

PMID- 1755668
TI  - [Undifferentiated "embryonal" sarcoma of the liver. Apropos of a case with
      immunohistochemical study].
AB  - The authors report a case of undifferentiated embryonal sarcoma of the liver,
      observed in a 25 year old man, in whom the diagnosis, established by histological
      findings, was confirmed at immunohistochemical examinations. The clinical and
      pathological features of these conditions are discussed.

PMID- 1755669
TI  - [Primary adenocarcinoma of the bladder. Apropos of 2 cases].
AB  - The authors report two cases of primary adenocarcinoma of the urinary bladder
      with secretion of mucus, observed over a year period, between 1978 and 1990. The
      different histologic patterns are encountered: mucinous adenocarcinoma (colloid
      carcinoma), clear cell adenocarcinoma exhibiting glandular and trabecular or
      papillary patterns. They are often reminiscent of those seen in gastrointestinal
      tumors. The colloid carcinoma pattern is associated with intense schistosomiasis
      of the bladder. Macroscopic studies show budding and necrotic tumors, with
      infiltration and invasion of the musculosa. We agree with the role played by
      glandular metaplasia of the vesical urothelium that is accepted by the majority
      of the authors in the histogenesis of these tumors.

PMID- 1755670
TI  - Cardioplegia: from the bedside to the laboratory and back again.

PMID- 1755671
TI  - Human coronary, internal mammary, and gastroepiploic artery reactivity.

PMID- 1755672
TI  - University of Wisconsin solution for human donor heart preservation: initial
      clinical experience.
AB  - Although in vitro and primate orthotopic transplant experiments have suggested
      the superiority of University of Wisconsin solution (UWS) compared with
      crystalloid cardioplegia and saline solution storage for hypothermic heart
      preservation, concerns about the viscosity and the high potassium concentration
      of UWS have precluded its use in human cardiac transplantation. To test the
      safety and efficacy of UWS, 16 patients received hearts arrested with, flushed
      with, and stored in UWS at 4 degrees C for a mean ischemic time of 153.3 +/- 30.7
      minutes. After reperfusion, the hearts contracted vigorously and attained a
      stable sinus rhythm within 4.0 +/- 2.4 minutes, and the patients were weaned from
      bypass in 24.5 +/- 8.0 minutes. There was no evidence of acute or chronic
      ischemic myocardial injury by enzymatic analysis, electrocardiography, or biopsy
      specimen histology. The results suggest UWS can be safely used, within currently
      accepted limits of donor ischemic time, to arrest and preserve human hearts for
      transplantation. Further studies of preservation are required to compare UWS with
      crystalloid cardioplegia and saline solution storage and to test the ability of
      UWS to prolong the period of safe donor hypothermic ischemia in clinical heart
      transplantation.

PMID- 1755673
TI  - Improved management of the Paget-Schroetter syndrome secondary to thoracic outlet
      compression.
AB  - For years, patients with "effort" thrombosis were treated by anticoagulants and
      conservative exercise; and if recurrent symptoms developed when they returned to
      work, they were considered for first-rib resection. Recently, use of thrombolytic
      agents with early surgical decompression of the neurovascular compression has
      markedly reduced morbidity, such as postphlebitic syndrome and the necessity for
      thrombectomy. A review of 67 patients seen over 25 years showed that 34 were
      initially treated with heparin sodium and then Coumadin (crystalline warfarin
      sodium). Recurrent symptoms developed in 21 after they returned to work and
      necessitated transaxillary first-rib resection to relieve symptoms. Eight also
      underwent thrombectomy. Recently, 33 patients were initially treated with
      thrombolytic agents and heparin, followed promptly by early first-rib resection.
      The evaluation and efficacy of this therapy have been established by frequent and
      repetitive venograms and careful follow-up of patients. Most of the patients
      showed improvement with thrombolytic agents. Remaining stenoses that suggested
      intravascular thrombosis were usually secondary to external compression of the
      vein by the clavicle, costoclavicular ligament, rib, or scalenus anterior muscle.
      Venous thrombectomy was necessary in only 4 patients in whom the clot was not
      controlled by thrombolytic therapy and operative release of compression. There
      were no deaths in the series.

PMID- 1755674
TI  - Malignant esophagorespiratory fistula: management options and survival.
AB  - The development of a malignant esophagorespiratory fistula is a devastating
      complication. Data comparing various treatment options in a large group of
      patients are sparse. To assess the results of therapy, we reviewed our experience
      in 207 patients with malignant esophagorespiratory fistula. Records of 207
      patients admitted to our institution with malignant esophagorespiratory fistula
      from 1926 to 1988 were reviewed and results of management analyzed. Age ranged
      from 21 to 90 years (median, 59 years); the male/female ratio was 3:1. Primary
      tumor site was esophagus in 161 (77%), lung in 33 (16%), trachea in 5 (2%),
      metastatic nodes in 4 (2%), larynx in 3 (1%), and thyroid in 1. Symptoms and
      signs of malignant esophagorespiratory fistula included cough in 116 (56%),
      aspiration in 77 (37%), fever in 52 (25%), dysphagia in 39 (19%), pneumonia in 11
      (5%), hemoptysis in 10 (5%), and chest pain in 10 (5%). Respiratory location of
      fistula included trachea in 110 (53%), left main bronchus in 46 (22%), right
      bronchus in 33 (16%), lung parenchyma in 13 (6%), and multiple sites in 5 (2%).
      The percentage of patients alive at 3, 6, and 12 months by treatment modality was
      13%, 4%, and 1% for supportive care (n = 104); 17%, 3%, and 0% for esophageal
      exclusion (n = 29); 21%, 14%, and 0% for esophageal intubation (n = 14); 30%,
      15%, and 5% for radiation therapy (n = 20); and 46%, 20%, and 7% for esophageal
      bypass, respectively. Patients treated with radiation therapy and esophageal
      bypass had a significantly prolonged survival compared with patients treated with
      the other modalities.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755675
TI  - Weight is not an accurate criterion for adult cardiac transplant size matching.
AB  - Owing to the limited availability of donor hearts, standard donor criteria for
      heart size matching need to be reexamined. The current practice at most centers
      is to match the donor's body weight to within +/- 20% of the recipient's. Our
      hypothesis was that minimal differences exist in heart sizes of the adult donor
      population, and therefore, the donor pool could be expanded for any given
      patient. M-mode echocardiographic measurements of left and right ventricular
      internal dimensions, left ventricular mass, and percent fractional shortening
      were reviewed in 235 normal adult subjects (101 men, 134 women). Low correlation
      coefficients and a high degree of variance were consistently observed between
      cardiac parameters and body size. There were no significant differences in left
      ventricular internal dimension when women weighing 40 to 109 kg were compared
      with men statistically different among men weighing 50 to 99 kg. No difference
      was noted in right ventricular size among men and women. Echocardiography is a
      simple and accurate technique to assess cardiac dimensions. Body weight does not
      correlate well with adult cardiac size and should not be used as an exclusion
      criterion for a donor heart.

PMID- 1755676
TI  - First successful bridge to cardiac transplantation using direct mechanical
      ventricular actuation.
AB  - Currently available ventricular assist devices are technically difficult to
      implant, require continuous anticoagulation, and are associated with hemorrhagic
      and thromboembolic complications. Direct mechanical ventricular actuation is a
      biventricular assist device that can be applied in 3 to 5 minutes through a left
      anterior thoracotomy and has no direct blood contact or need for anticoagulation.
      The present study was designed to determine the effects of direct mechanical
      ventricular actuation in total biventricular circulatory support. Cardiogenic
      shock refractory to standard therapy developed in 2 patients awaiting cardiac
      transplantation. Direct mechanical ventricular actuation was applied and provided
      immediate hemodynamic stabilization in both. All inotropic agents and intraaortic
      balloon support were then discontinued. Fifty-six hours of circulatory support
      bridged the first patient to successful cardiac transplantation without
      complication. The patient is alive and well more than 1 year later without
      incident of infection or rejection. The second patient suffered cardiac arrest
      and required closed chest cardiopulmonary resuscitation before device
      application. After 45 hours of support, it was determined that irreversible
      neurologic injury had occurred and direct mechanical ventricular actuation was
      discontinued. Neither patient's native heart exhibited any histologic evidence of
      device-related trauma. Direct mechanical ventricular actuation has undergone
      limited clinical investigation since its original description 25 years ago, but
      in these initial trials, the device has proved effective. The concept of
      mechanically actuating the ventricles appears to be a valuable, yet under
      utilized method of total circulatory support.

PMID- 1755677
TI  - Mitral valve repair for ischemic mitral insufficiency.
AB  - Over a 5-year period, 1,292 patients had operation on their native mitral valves.
      Ischemia was the cause of mitral insufficiency in 84 patients (6.5%). Sixty-five
      patients (77.4%) had mitral valve repair. Mean age was 66 +/- 10 years; 35
      patients (53.8%) were women. Mean degree of preoperative insufficiency was 3.2 +/
      0.7; mean preoperative New York Heart Association functional class was 3.3 +/-
      0.7. Eleven patients (16.9%) had acute and 54 (83.1%) had chronic mitral
      insufficiency. Valve prolapse was present in 26 patients (40%). Restrictive
      leaflet motion secondary to regional or global left ventricular dilatation
      occurred in 39 patients (60%). All patients had associated myocardial
      revascularization followed by transatrial valvuloplasty. Multiple techniques were
      employed to achieve valve competence: leaflet resection (3), chordal shortening
      (15), papillary muscle reimplantation (10), papillary muscle shortening (3), and
      annuloplasty (63). There were six (9.2%) hospital deaths (acute, 9.1%; chronic,
      9.3% [not significant]; prolapse, 11.5%; restrictive, 7.7% [not significant]).
      The mean degree of postoperative mitral insufficiency was 0.6 +/- 0.8 in 51
      patients. At a mean follow-up of 3.1 +/- 1.6 years, patient survival was 96% for
      patients with valve prolapse and 48% for those with restrictive leaflet motion (p
      = 0.02). New York Heart Association functional class was improved in all groups.
      Ischemic mitral insufficiency is an uncommon cause of mitral valve disease that
      is amenable to repair in the majority of cases of both acute and chronic onset.
      The operative mortality is low, and operation is associated with superior
      survival in patients with valve prolapse.

PMID- 1755678
TI  - Bronchopleural fistula after stapled closure of bronchus.
AB  - The incidence of bronchopleural fistula after stapling among 2,243 pulmonary
      resections at the Rush-Presbyterian-St. Luke's Medical Center has been reviewed.
      There were 35 fistulas in 1,773 stapled and in 470 sutured bronchi
      (segmentectomy, 2; lobectomy, 1; bilobectomy, 9; and pneumonectomy, 23). We have
      found that the stapler is expedient and simple to use, and that it produces a
      hermetic and uniform closure. The stapler is contraindicated when the bronchus is
      thickened, inflamed, or of insufficient length. The overall incidence of
      bronchopleural fistula was 1.6%. Approximately two thirds of the patients with
      bronchopleural fistula had preoperative radiation therapy or chemotherapy or
      both.

PMID- 1755679
TI  - Bilateral latissimus dorsi cardiomyoplasty.
AB  - This study was undertaken to test the hypothesis that a bilateral latissimus
      dorsi cardiomyoplasty provides greater hemodynamic augmentation than a unilateral
      procedure. Two types of bilateral procedure and a left posterior cardiomyoplasty
      were tested in each of 8 mongrel dogs. R-wave synchronous muscle pacing was
      achieved with a programmable burst stimulator. Hemodynamic variables of
      stimulated beats were compared with those of a nonstimulated baseline using
      paired t tests. The effects of a double anterior muscle wrap were equal to a
      right anterior/left posterior configuration. Therefore, the data on the two types
      of bilateral procedure were combined and compared with the left wrap. Stimulation
      of the bilateral cardiomyoplasty resulted in significant increases in right
      ventricular pressure (44 +/- 3.1 versus 26 +/- 1.8), first derivative of right
      ventricular pressure (595 +/- 117 versus 196 +/- 14), pulmonary artery pressure
      (34 +/- 1.9 versus 23 +/- 1.6), left ventricular pressure (90 +/- 5.9 versus 69
      +/- 5.3), first derivative of left ventricular pressure (1454 +/- 141 versus 1072
      +/- 107), aortic pressure (80 +/- 5.4 versus 67 +/- 4.9), and peak aortic flow
      (9.4 +/- 1.1 versus 7.7 +/- 0.8) (p less than 0.05). Significant increases in all
      of these variables also occurred with stimulation of the left cardiomyoplasty,
      but the increases in right ventricular pressure, first derivative of right
      ventricular pressure, pulmonary artery pressure, and aortic pressure were larger
      for the bilateral than the left cardiomyoplasty. The bilateral and the left
      procedure can each augment systolic ventricular function. The bilateral procedure
      appears to have greater effects, especially on right ventricular function.

PMID- 1755680
TI  - Main bronchial sleeve resection with pulmonary conservation.
AB  - Twenty-seven main bronchial resections (19 left, 8 right) were performed without
      pulmonary resection between 1975 and 1991. The patients were 17 men and 9 women
      with an average age of 35 years (range, 20 to 65 years). Tumors comprised 55% of
      the lesions, including 9 carcinoid tumors (33%), 2 mucoepidermoid tumors, 2
      fibrous histiocytomas, 1 hemangiopericytoma, and 1 large cell carcinoma. Scarring
      and stenosis secondary to multiple causes occurred in 10 patients (37%). Two
      patients had miscellaneous lesions. Presenting symptoms included dyspnea (52%),
      wheezing or stridor (44%), cough (41%), hemoptysis (37%), and pneumonia (18%).
      Preoperative chest roentgenogram was abnormal in 60% of patients, whereas
      tomograms delineated the lesion in 94%. All patients had bronchoscopy for lesion
      evaluation. Anesthesia was accomplished through a long single-lumen endotracheal
      tube in 19 cases and a double-lumen tube in 8 cases. Mobilization and exposure
      techniques to create a tension-free anastomosis were critical for left main
      bronchial resections and included pretracheal mobilization (100%), neck flexion
      (100%), tracheal and main bronchial retraction (85%), aortic and pulmonary artery
      retraction (44%), and intrapericardial hilar release (33%). All resections were
      for cure; there was no operative mortality. Morbidity in 4 patients (15%)
      included an anastomotic stenosis (successfully reresected), prolonged air leak
      and pneumonia, transient recurrent nerve palsy, and atelectasis. Median 5-year
      follow-up revealed 92% of patients alive, with only one of two late deaths being
      disease-related. Main bronchial resection is an ideal technique for selected
      benign and malignant lesions, allowing complete pulmonary parenchymal
      preservation.

PMID- 1755681
TI  - Treatment of aortic coarctation by axillofemoral bypass grafting in the high-risk
      patient.
AB  - Operative correction of coarctation of the aorta has been performed for 45 years.
      Reoperation for recurrent coarctation is necessary in as many as 5% to 10% of
      patients. Repair of recurrent coarctation carries an operative mortality of
      between 5% and 10%. Coarctation repair involves an increased risk in patients
      with advanced age, recurrent coarctation, congestive heart failure, and pulmonary
      disease. We report 3 cases where axillofemoral bypass has been used to treat high
      risk patients with aortic coarctation. Two patients had had previous coarctation
      repair in addition to serious medical problems. Another patient had suffered
      three myocardial infarctions and had disabling congestive heart failure. All
      patients had an immediate marked decrease in their preoperative peak systolic
      pressure gradient across the coarctation. Systemic hypertension and symptoms of
      congestive heart failure were improved in all patients. The length of follow-up
      was 15 months, 8.5 years, and 10.5 years. Reassessment with noninvasive vascular
      segmental pressure studies with and without an exercise component showed no
      recurrence of the pressure gradient. This procedure should be considered when
      treating coarctation of the aorta in the high-risk adult.

PMID- 1755682
TI  - Anomalous origin of the right pulmonary artery from the ascending aorta.
AB  - Five cases of anomalous origin of the right pulmonary artery from the ascending
      aorta were seen at our hospital. Patients 1 and 2 had an intact right pulmonary
      artery originating from a right posterior aspect (proximal form), and primary
      anastomosis of the right pulmonary artery and main pulmonary trunk was performed.
      Patients 3 and 4 showed a narrowing right pulmonary artery originating from near
      the base of the innominate artery (distal form). The stenotic right pulmonary
      artery was reconstructed with an 8-mm graft in patient 3, whereas patient 4
      became inoperable because complete obstruction had developed in the right
      pulmonary artery during the 3 months that the patient was waiting to undergo
      operation. In patient 5, primary anastomosis was undertaken, but morphologically
      the anomalous origin was of the distal form, so the occurrence of stenosis in the
      reconstructed right pulmonary artery was a matter of concern. The morphological
      type was found to be related to the surgical options in this anomaly. Therefore,
      primary anastomosis was considered the best choice for a correction of the
      proximal form, whereas a graft interposition with a resection of the stenotic
      portion on the right pulmonary artery was deemed preferable in the distal form.

PMID- 1755683
TI  - Denervation of transplanted porcine lung causes airway obstruction.
AB  - Lung transplantation can be complicated by a form of small airway obstruction
      known as bronchiolitis obliterans. We tested the hypothesis that lung denervation
      causes small airway obstruction in young pigs (10 +/- 1 weeks). Control pigs had
      an innervated native lobe, and study pigs had either a denervated native lobe or
      a denervated transplant lobe. Transplanted pigs received standard
      immunosuppression. At 10 weeks we measured isolated left lobe pulmonary
      mechanics. Dynamic resistance in both study groups was significantly higher than
      in the lobectomy group, whereas dynamic compliance in both study groups was
      significantly lower than in the lobectomy group. No significant difference in
      resistance or compliance was noted between the transplant and reimplant groups.
      Histologic changes consistent with rejection were noted in the transplant lobes.
      We conclude that the small airway obstruction noted in this model is due to
      operative denervation rather than to immunosuppression or rejection.

PMID- 1755684
TI  - Cardioprotective effects of nucleoside transport inhibition in rabbit hearts.
AB  - The cardioprotective effects of a nucleoside transport inhibitor, R75231, were
      investigated in the isolated rabbit heart. The hearts were subjected to 20
      minutes of global normothermic ischemia followed by reperfusion. Before ischemia
      either solvent (group 1), 5 mumol/L of adenosine (group 2), or 0.64 mg/L R75231
      (group 3) was added to the perfusate. Preischemic hemodynamics were not changed
      by treatment, except for an increase in coronary flow in the adenosine group
      (126% of control; p less than 0.05). Upon reperfusion, coronary flow was
      depressed in the controls (72% of the preischemic control values), increased in
      the adenosine group (113%) and unchanged in the R75231 group (89%). Functional
      recovery was significantly better in the adenosine group as well as in the R75231
      group as compared with the controls (p less than 0.05). Cardiac output was 74% of
      the preischemic control value in the R75231 group, 67% in the adenosine group,
      and only 38% in the controls. Analysis of the coronary effluent after reperfusion
      showed a significant inhibition of rapid release of purines and a reverse of the
      adenosine/inosine ratio in the R75231 group as compared with the others. We
      conclude that R75231 has a cardioprotective effect that is probably related to
      accumulation of endogenous adenosine.

PMID- 1755685
TI  - Transesophageal echocardiography in patients with mechanical circulatory
      assistance.
AB  - Transesophageal echocardiography was used to assess myocardial function and to
      detect complications after mechanical circulatory support for 8 patients with
      cardiogenic shock. In 3 of 8 patients, serial transesophageal echocardiography
      documented improvement of systolic ventricular function, and it was possible to
      wean these 3 patients from the ventricular assist device. In all patients,
      transesophageal echocardiography added clinically important information including
      the extent of left and right ventricular dysfunction (6 patients), presence of
      atrial or ventricular thrombus (5 patients), presence of pericardial effusion or
      clot (2 patients), and verification of the position of the intravascular device
      (1 patient). Thus, transesophageal echocardiography may provide clinically useful
      information regarding both the underlying cardiac disease and potential
      complications from the mechanical circulatory assistance.

PMID- 1755686
TI  - Vascular reactivity of human internal mammary and gastroepiploic arteries.
AB  - Patency rates of bypass graft conduits are thought to be influenced by the
      determinants of vascular tone. This study has comparatively examined the response
      of the human internal mammary and gastroepiploic arteries to potassium,
      noradrenaline, dopamine, 5-hydroxytryptamine, thromboxane, and histamine. The
      response to potassium was significantly greater in the gastroepiploic artery
      (Emax = 79.5 +/- 9.6 mN) than in the internal mammary artery (Emax = 27.0 +/- 6.4
      mN). Dose-related constrictions were observed in both vessels to all agonists
      except histamine, which was ineffective in the gastroepiploic artery.
      Noradrenaline and dopamine produced comparable dose-related constrictions in each
      vessel, with similar EC50 and Emax (expressed as a percentage of potassium
      response) values, but 5-hydroxytryptamine (Emax, gastroepiploic = 10.8% +/- 1.9%;
      internal mammary = 71.8% +/- 21.2%) and thromboxane (Emax, gastroepiploic =
      116.7% +/- 4.0%; internal mammary = 169.6% +/- 19.4%) were more efficacious in
      their constriction of the mammary artery; the potencies were similar. We conclude
      that there is a heterogeneity of response to some vasoconstrictors between the
      human internal mammary and gastroepiploic arteries. The internal mammary artery
      may be more predisposed to events that initiate vasospastic disorders.

PMID- 1755687
TI  - Tricuspid valve myxoma: a rare indication for tricuspid valve repair.
AB  - Excision of a myxoma involving the tricuspid valve often necessitates tricuspid
      valve replacement or a less than optimal margin of resection. We report a
      successful tricuspid valve repair after en bloc resection of a myxoma involving
      the septal leaflet of the tricuspid valve.

PMID- 1755688
TI  - Contralateral pneumonectomy after single-lung transplantation for emphysema.
AB  - An intractable contralateral air leak developed in a 46-year-old woman after
      right single-lung transplantation for emphysema. A left pneumonectomy was
      performed on postoperative day 17, leaving the patient with only one transplanted
      lung. Fifteen months postoperatively the patient is well and has satisfactory
      pulmonary function. Survival with a good quality of life is possible after single
      lung transplantation and bilateral sequential pneumonectomies.

PMID- 1755689
TI  - Aplasia of the right aortic cusp in a neonate: a life-threatening but curable
      anomaly.
AB  - A case of absent right aortic cusp causing serious aortic incompetence in a
      neonate is reported. A "bicuspidalization" repair broke down within 24 hours, but
      reoperation with annular enlargement and insertion of a 19-mm prosthetic valve
      resulted in complete recovery. This rare but life-threatening anomaly of the
      aortic valve can be recognized with Doppler echocardiography. Valve replacement
      in conjunction with aortic annular enlargement should be performed as primary
      repair.

PMID- 1755690
TI  - Extended aortic and left main coronary angioplasty with a single pericardial
      patch in a patient with Williams syndrome.
AB  - In a 9-year-old girl with supravalvular aortic stenosis combined with severe left
      main coronary artery trunk obstruction (Williams syndrome), the repair for both
      lesions was performed successfully by simultaneous extended aortoplasty and
      direct coronary angioplasty using a single double-flanged pericardial patch.

PMID- 1755691
TI  - Vagal schwannoma involving esophagus.
AB  - A rare case of vagal schwannoma (neurilemoma) with involvement of the distal
      esophagus is presented. Chronic progressive dysphagia was the only complaint
      related to the schwannoma. Barium swallow showed narrowing of the distal
      esophagus. The tumor was embedded in the wall of the esophagus. After biopsy and
      diagnosis of benign schwannoma, it was dissected from the esophageal muscle and
      mucosa. Diagnosis of benign schwannoma should be made before excision of the
      lesion to avoid an unnecessary esophagectomy.

PMID- 1755692
TI  - Use of a pericardial patch to bridge the conduction tissue during tricuspid valve
      replacement.
AB  - Tricuspid valve replacement carries a risk of causing complete heart block. To
      reduce this risk, a technique was developed to bridge the conduction system
      during prosthetic valve insertion in the tricuspid position. This technique, in
      which a pericardial patch is used to bridge the triangle of Koch, was performed
      successfully in 4 patients who underwent tricuspid valve replacement for
      Ebstein's anomaly of the tricuspid valve.

PMID- 1755693
TI  - Cosmetic approach for placement of the automatic implantable cardioverter
      defibrillator in young women.
AB  - A surgical approach is described for a more cosmetically acceptable placement of
      the automatic implantable cardioverter-defibrillator in young women. The
      transvenous sensing lead and the vena caval spring electrode are placed through a
      small subclavicular incision. The left ventricular patch electrode is placed
      through an anterior minithoracotomy in the crease under the left breast. A small
      transverse incision in the left lower quadrant is used to place the generator
      under the external oblique fascia in the low abdominal wall. Minimal cosmetic
      impairment from incisions and hardware results.

PMID- 1755694
TI  - Subclavian vein-to-right atrial bypass for symptomatic venous hypertension.
AB  - A new surgical technique for bypassing subclavian vein thromboses in patients
      undergoing hemodialysis is presented. Subclavian vein stenosis or occlusion can
      occur after the use of temporary access catheters in subclavian vein dialysis. If
      this occurs in a patient with an arteriovenous access fistula of an ipsilateral
      upper extremity, venous hypertension, massive edema of the arm, and dysfunction
      of the access graft may result. In 2 patients with this condition, we
      successfully performed axillary vein-to-right atrial bypass, which resolved
      swelling and restored function of the access graft. This may be an appropriate
      surgical option for symptomatic venous hypertension in such patients.

PMID- 1755695
TI  - Replacement of the aortic valve with a pulmonary autograft: the "switch"
      operation.
AB  - The transfer of the patient's own pulmonary valve to the aortic position
      developed from our earlier work with aortic homografts. The valve shows no
      progressive tissue failure and offers the prospect of a permanent valve
      replacement for young people. Like homografts, the valves can be inserted in the
      subcoronary position or as a root replacement. In infants and growing children
      root replacement should be used to benefit from the valve's growth potential.

PMID- 1755696
TI  - Thoracoplasty: the how and the why.

PMID- 1755697
TI  - Blood cardioplegia: a review and comparison with crystalloid cardioplegia.
AB  - The Oxford International Symposium on myocardial preservation provided an
      appropriate milestone and impetus to survey one aspect of operative myocardial
      preservation, namely blood cardioplegia, and to contrast it with the more popular
      crystalloid cardioplegia. This review is by no means complete or exhaustive but
      represents my best effort to summarize important information that has accumulated
      in the literature as blood cardioplegia, and our understanding of it, has
      evolved. It is appropriate to compare blood and crystalloid cardioplegia with
      respect to biochemical and physiological differences. Clinical comparison has
      been limited, for the most part, to randomized studies, and a number of
      differences and details of clinical management of the two techniques have been
      omitted, either because they seemed unimportant or there was no good information
      that would allow an objective comparison of their significance. Hopefully, the
      reader will recognize the intent to focus on meaningful differences and
      similarities between the two techniques and to present them fairly.

PMID- 1755698
TI  - Tetralogy of Fallot.

PMID- 1755699
TI  - Spontaneous esophageal rupture.

PMID- 1755700
TI  - Retrograde disc escape in a Harken mitral valve prosthesis 21 years after
      implantation.

PMID- 1755701
TI  - Vagal schwannoma.

PMID- 1755702
TI  - [Cytomorphological and cultural characteristics of tylosin-producing strains with
      different antibiotic activity].
AB  - Cytomorphological and cultural characteristics of highly and low active
      collection strains of Streptomyces fradiae producing tylosin were studied. The
      strains were grown on agarized and liquid media. It was shown that unlike the low
      active strain, the highly active one was less sporogenic, the difference being
      more pronounced when tylosin was added to the agarized medium. When the strains
      were grown in the fermentation medium there were detected differences between
      them in the growth type and microcolony structure at the early stages of the
      fermentation process. During intensive synthesis of tylosin spheric structures
      were found to form near the hyphal surfaces. The phenomenon was previously
      observed in cultures producing other antibiotics. In the low active strain the
      structures were single while in the highly active strain they formed in large
      numbers.

PMID- 1755703
TI  - [Spectrophotometric analysis of tetracycline hydrochloride in the presence of
      thiamine bromide and riboflavin].
AB  - Spectrophotometric determination of tetracycline hydrochloride concentrations in
      the presence of thiamine bromide and riboflavin at a light absorption wave length
      of 300 nm was shown possible. When the ratio of tetracycline hydrochloride and
      the total of thiamine bromide and riboflavin (w/w) was at least 10:1 the error of
      the method was less than 2 per cent. The procedure is useful in quality control
      of the dosage forms.

PMID- 1755704
TI  - [Stabilization of standard samples of levorin and nystatin with antioxidants].
AB  - To prolong the storage period of the reference samples of levorin and nystatin,
      polyenic macrolide antibiotics, their effect of 23 antioxidants was studied by
      using rapid inactivation. The antioxidants belonged to compounds of different
      classes. The inactivation was performed at 20, 37 and 50 degrees C in the
      presence of 1, 2 or 5 per cent of the antioxidants. An antioxidant of the class
      of partially hydrated oxyquinolines was shown to have the highest stabilizing
      action on levorin and nystatin. It may be recommended for stabilizing the levorin
      and nystatin reference samples.

PMID- 1755705
TI  - [Obtaining human recombinant (serine-17) beta-interferon by the method of
      oligonucleotide-directed mutagenesis and its expression in Escherichia coli].
AB  - The gene of human mutant (serine-17) fibroblast interferon was isolated with the
      use of highly efficient oligonucleotide-directed mutagenesis. On the basis of the
      constructed expression plasmid pPR-IFN Ser17 a strain producing human mutant beta
      interferon (VKPM V-4678) was developed. It was shown that the specific activity
      of the human mutant (serine-17) fibroblast interferon was 1 order of magnitude
      higher than that of the recombinant interferon which reaches the specific
      activity of natural fibroblast interferon.

PMID- 1755706
TI  - [Immunological study of lysates from the cell wall of group A Streptococcus].
AB  - The chemical composition and presence of immunogenic components in the lysates of
      the cell walls of group A Streptococcus, type M29, were studied. The lysates were
      prepared with the use of muramidase. Fc-Receptors were detected in the lysates.
      Within the first 30 minutes of cell wall lysis by muramidase, 4 times higher
      amounts of the protein reacting with fibrinogen excreted than in the subsequent 4
      hours. The lysates contained immunogenic proteins. Fraction III isolated by
      chromatography of the 30-minute lysate on DEAE-trisacryl formed a single
      precipitation band with lysate antiserum. The lysate Fraction IV forming three
      precipitation bands contained a protein not specific of the type. The protein was
      identical to the protein antigen from Triton X-100 extracts of group A
      Streptococcus, types M1, M12 and M29. The group-specific polysaccharide was
      detected in the lysate Fraction I and Fraction II of the 4-hour lysate.

PMID- 1755707
TI  - [Selection of the optimal conditions for the procurement and regeneration of
      protoplasts of the industrial strain of Streptomyces rimosus, the producer of
      oxytetracycline, and the effect of the protoplasting process on the antibiotic
      activity].
AB  - Optimal conditions for protoplasting of the Streptomyces rimosus industrial
      strain No. 1 producing oxytetracycline were developed. Observation of the early
      stages of the protoplast regeneration in microchambers showed that there were two
      regeneration types: normal and anomalous. The latter was likely defined by the
      glycine effect on cell wall synthesis. It was accompanied by the stage in which
      the protoplasts had the form of multiplying protoplast-like cells. The
      protoplasting of the S. rimosus culture producing oxytetracycline resulted in an
      increase in the variability of an antibiotic producing property and the frequency
      of low active variants.

PMID- 1755708
TI  - [Immunomodulating properties of pectin from seawater grass Zostera].
AB  - Immunomodulating activity of zosterin was studied. Zosterin is a pectin from sea
      grass belonging to Zostera with pronounced antibacterial activity and therapeutic
      efficacy in experimental infections. It was shown that parenteral administration
      of the drug 24 hours before the antigenic irritation stimulated the humoral and
      cellular immunity in F1 (CBA X C 57 BL/6) mice: an increase in the number of the
      antibody cells in the spleen, the DTH and the index of the splenocyte spontaneous
      proliferation. In the animals treated with injections of zosterin and infected
      intraperitoneally with a virulent strain of S. enteritidis there was observed a
      marked increase in migration of polymorphonuclear leukocytes to the abdominal
      cavity accompanied by an increase in their phagocytic activity. The results
      suggested the possible use of zosterin as a drug with associated antibacterial
      and immunomodulating activities.

PMID- 1755709
TI  - [Antimicrobial activity of piperacillin in vitro].
AB  - There was an increase in the resistance of clinical isolates to piperacillin as
      compared to that in 1987-1988. It was shown on the kinetic models that there was
      difference in the effect of the inhibitory and subinhibitory concentrations of
      the drug on microorganisms in various growth phases. No post-antibiotic action
      against Staphylococcus aureus and Pseudomonas aeruginosa and a slightly
      pronounced dose-dependent effect with respect to Escherichia coli were noted.

PMID- 1755710
TI  - [Mathematical modeling of ampicillin pharmacokinetics in patients with altered
      excretory function of the kidneys].
AB  - A physiological model of ampicillin pharmacokinetics in man is proposed. Its
      design stems from the data characterizing the antibiotic distribution in rats.
      The model is useful in describing the pharmacokinetics of ampicillin after its
      intravenous and intramuscular administration. An adequate description of the
      antibiotic distribution in blood suggested an agreement with the real values of
      the estimated antibiotic concentrations in the tissues. The concentrations of
      ampicillin and sulbactam in the tissues after their intramuscular combined
      administration in doses of 1 and 0.5 g, respectively, were compared. The
      physiological model of the pharmacokinetics was applied to evaluation of a
      possible interval in changing of the antibiotic half-life. There was analytical
      relationship between the ampicillin half-life and efficiency of the renal
      function.

PMID- 1755711
TI  - [Experimental and clinical data on the combined use of novocaine salt of
      benzylpenicillin and proteolytic enzymes].

PMID- 1755712
TI  - [Biochemical activity of microbial populations of the gastrointestinal tract and
      the effect of antibacterial drugs].

PMID- 1755713
TI  - [Microecology of the skin and its changes after administration of antibiotics].

PMID- 1755714
TI  - [Various methodological approaches in controlled screening of antibiotic
      producers among the group of Coryneform bacteria].
AB  - A methodical system for directed screening of cultures producing broad-spectrum
      antibiotics among soil saprophytic coryneform bacteria was developed. To isolate
      such cultures, it was recommended to use the glucose-yeast medium supplemented
      with malt extract (No. 18/3) and soybean-glucose medium with sodium sulfate and
      cobalt chloride (No. 20/3). The preliminary alkaline treatment of the soil
      substrates and the use of acidic soil samples were found to favour isolation of
      the Mycobacterium type cultures. It was recommended to use gram-negative tests
      microbes with relatively low antibiotic resistance for screening cultures
      producing broad spectrum antibiotics. Various agarized and liquid fermentation
      media were compared in regard to detection of antibiotic activity in the soil
      coryneform bacteria. The corn medium supplemented with protein-vitamin
      concentrate, glucose, lactose and starch (No. 116) proved to be the most
      efficient.

PMID- 1755715
TI  - Labeling drop bottles to avoid medication errors.

PMID- 1755716
TI  - Ocular injuries caused by elastic cords.

PMID- 1755717
TI  - Suture removal after blepharoplasty.

PMID- 1755718
TI  - An inexpensive, pressure-regulated air pump for fluid-air exchange during pars
      plana vitrectomy.

PMID- 1755719
TI  - Retinal pigment epithelial tears through the fovea with preservation of good
      visual acuity.

PMID- 1755720
TI  - Discoloration of a silicone intraocular lens 6 weeks after surgery.

PMID- 1755721
TI  - Comments on silicone intraocular lens discoloration.

PMID- 1755722
TI  - Secondary glaucoma and uveitis associated with Orcolon.

PMID- 1755723
TI  - Magnetic resonance imaging of eyelid springs and gold weights.

PMID- 1755724
TI  - Endophthalmitis associated with sutureless cataract surgery.

PMID- 1755725
TI  - Horner's syndrome secondary to spontaneous carotid dissection with normal
      angiographic findings.

PMID- 1755726
TI  - Primary aspergillosis of the orbital apex.

PMID- 1755727
TI  - Eyelid pain after magnetic resonance imaging-induced palpebral spring vibration.

PMID- 1755728
TI  - Behavior offset is rejected by organized medicine.

PMID- 1755729
TI  - When considering Oculinum (botulinum toxin type A) injection for the treatment of
      strabismus, can the surgeon anticipate different results in patients who have had
      previous strabismus surgery?

PMID- 1755730
TI  - Is the ophthalmologist as a clinician-scientist still viable?

PMID- 1755731
TI  - The use of the 193-nm excimer laser for myopic photorefractive keratectomy in
      sighted eyes. A multicenter study.
AB  - Photorefractive keratectomy was performed at three centers using the 193-nm
      excimer laser on 31 sighted myopic eyes. Preoperative refractive errors
      (spherical equivalent) ranged from -12.00 to -4.00 diopters (D) (mean, -6.49 +/-
      1.75 D). Peribulbar anesthesia, a 5.2- to 6.0-mm beam diameter, and topical
      corticosteroids were used for up to 6 months after surgery. The epithelium healed
      within 3 to 4 days, and all patients returned to their best corrected visual
      acuity within 1 line of their preoperative acuity. There was minimal
      subepithelial reticular haze, peaking at 3 weeks and diminishing over the next 3
      to 4 months, which was not felt to be visually significant. At 6 months, the
      average residual refractive error was -1.85 +/- 2.5 D. Sixty-eight percent of
      eyes were corrected within 2 D and 55% within 1 D of attempted correction. There
      was no significant change in astigmatism, contrast sensitivity, corneal
      sensation, or endothelial cell counts. This preliminary work shows that
      photorefractive keratectomy has promise in the reduction of moderate myopia.

PMID- 1755732
TI  - Surface ultrastructure after excimer laser ablation. Expanding vs contracting
      apertures.
AB  - Excimer laser corneal ablation (photorefractive keratectomy) for myopia using a
      diaphragm delivery system was performed on eye bank and animal eyes by either
      progressively expanding or contracting the iris aperture. Use of an expanding
      aperture, in which the final ablations cover the entire treatment zone, produced
      a pseudomembrane over the zone that had few discontinuities. Ultrastructural
      examination of the corneas ablated using a progressively contracting aperture,
      however, revealed numerous discontinuities in the surface pseudomembrane. Use of
      an expanding iris aperture to perform ablations to correct myopia may be
      preferable as it produces a pseudomembrane with few discontinuities. Clinical
      studies of surface healing in humans are necessary to determine the clinical
      relevance of improved continuity of the surface pseudomembrane.

PMID- 1755733
TI  - Energy levels and probe placement in contact transscleral semiconductor diode
      laser cyclophotocoagulation in human cadaver eyes.
AB  - We investigated the effects of semiconductor diode laser contact transscleral
      cyclophotocoagulation in human cadaver eyes by gross examination, light
      microscopy, and scanning electron microscopy to determine optimum clinical
      treatment parameters. Irradiation was performed using a continuous-wave
      semiconductor diode laser with a fiber-optic probe. At 1.0 to 1.25 mm posterior
      to the limbus, spots were centered on the pars plicata by gross examination.
      Exposures of less than 2 J produced no visible damage. A 2- to 3-J exposure
      produced mild whitening of the ciliary processes, while 4- to 5-J exposures
      created more intense whitening of the pars plicata. Energies higher than 5 J
      frequently produced explosive tissue damage. Light microscopy of tissue treated
      with 1.8 to 6 J at 1.0 to 1.25 mm posterior to the limbus revealed coagulation
      necrosis of the nonpigmented and pigmented epithelium, with evidence of thermal
      coagulation of the ciliary stroma and stromal vasculature. Coagulation necrosis
      was more intense with longer exposure times. We found the optimum parameters for
      contact transscleral diode laser cyclophotocoagulation in cadaver eyes to be 3 to
      4.5 J of energy delivered with the anterior edge of the probe 1.0 to 1.25 mm
      posterior to the limbus.

PMID- 1755734
TI  - Gyrate atrophy of the choroid and retina. Long-term reduction of ornithine slows
      retinal degeneration.
AB  - Gyrate atrophy of the choroid and retina is an autosomal recessive, chorioretinal
      dystrophy that begins in childhood and leads to blindness in the fourth to
      seventh decade of life. The primary defect is deficiency of ornithine-delta-amino
      transferase, which results in accumulation of ornithine. We examined six pairs of
      affected siblings to determine if intrafamilial variability in the phenotype was
      less than interfamilial, and to determine if long-term (5- to 7-year) reduction
      of ornithine with an arginine-restricted diet had an effect on the progression of
      the chorioretinal degeneration. All but one set of siblings underwent periodic
      ophthalmologic examinations. The clinical diagnosis was confirmed with the
      demonstration of hyperornithinemia and deficiency of ornithine-delta
      aminotransferase. The molecular defects in their ornithine-delta-amino
      transferase genes also were determined. The two younger pairs of siblings were
      given an arginine-restricted diet and followed up for 5 to 7 years. We found
      strikingly similar phenotypes in affected members of the same pair of siblings.
      In the young patients receiving the diet, there was substantial reduction of
      ornithine levels. These children had only modest progression of their ocular
      disease during this period. Furthermore, a comparison of the outcome of the
      younger with their older siblings at an equivalent age showed that the younger
      siblings, who started receiving the diet at an earlier age, had much less ocular
      disease. We conclude that intrafamilial phenotypic variation in gyrate atrophy is
      less than interfamilial and, therefore, that genetic heterogeneity plays a role
      in the phenotypic variability of gyrate atrophy. Furthermore, we conclude that
      chronic reduction of ornithine with an arginine-restricted diet dramatically
      slows the progression of the chorioretinal dystrophy.

PMID- 1755735
TI  - Progressive enlargement of laser scars following grid laser photocoagulation for
      diffuse diabetic macular edema.
AB  - Laser photocoagulation in a grid pattern is effective in many eyes in resolving
      diffuse diabetic macular edema and stabilizing vision. We retrospectively studied
      203 eyes of 203 patients, all of whom had diabetic macular edema treated with
      grid laser photocoagulation. During the follow-up period, 11 of these 203 eyes
      developed enlargement of the laser scars that progressed into the central fovea.
      Each of the 11 eyes experienced loss of vision, and in five, the visual loss was
      significant. Five of these eyes also developed a retinal pigment hyperplastic
      scar. After the laser treatment, but before the scars enlarged, the visual acuity
      of these eyes was unchanged from that before treatment. But after the atrophic
      scars enlarged into the central fovea, visual acuity in one eye decreased from
      20/40 to 20/100, and the other 10 eyes had visual acuities of 20/200 or worse.

PMID- 1755736
TI  - Familial aggressive nevi of the iris in childhood.
AB  - We report the occurrence of amelanotic melanocytic tumors of the iris arising in
      the second decade of life in two successive generations. Clinically, both tumors
      enlarged rapidly, with subsequent enucleation of the eye in one patient. In both
      cases, histologic examination revealed an aggressive iris nevus composed of
      spindle A cells. Both lesions had similar argyrophilic nucleolar organizing
      region counts, which may be of prognostic significance. A possible autosomal
      dominant pattern of inheritance for this rare tumor is discussed.

PMID- 1755737
TI  - Eyelid movements in facial paralysis.
AB  - We studied the eyelid movements of six patients with unilateral, isolated, facial
      paralysis using the magnetic search coil. The most significant abnormality
      consisted of a reduction in the magnitude of the orbicularis oculi contraction
      with slowing of the peak velocity of the closing phase of the blink. The closing
      phase blink velocity, which normally increases linearly as a function of
      amplitude (main sequence), in our patients displayed a relationship characterized
      by a slow saturating power function that fell off the main sequence. The
      contralateral normal lid in some cases can show adaptive signs of hyperactivity
      during the closing phase of the blink. Lid saccades showed a small but consistent
      decrease in amplitude and velocity compared with the contralateral unaffected
      eyelid. Unlike the closing phase of the blink, peak velocities of lid saccades
      stayed on the main sequence. In this study, we discuss how the eyelid executes
      downward lid saccades based purely on a passive mechanism.

PMID- 1755738
TI  - Infectious endophthalmitis following sutureless cataract surgery.
AB  - Within the last 6 months, three cases of infectious endophthalmitis following
      sutureless cataract surgery have been referred to us. Two of these cases followed
      uncomplicated sutureless phacoemulsification with intraocular lens implantation.
      One case was complicated by a postoperative hyphema with additional surgery for
      clot removal 2 days following the initial procedure.

PMID- 1755739
TI  - PhXA34, a new potent ocular hypotensive drug. A study on dose-response
      relationship and on aqueous humor dynamics in healthy volunteers.
AB  - The prostaglandin analogue PhXA34 was tested in two studies in normal human eyes;
      1, 3, and 10 micrograms of PhXA34 reduced the intraocular pressure by about 2, 3,
      and 4 mm Hg, respectively, 6 to 10 hours after a single topical dose. The only
      side effect observed was a slight conjunctival hyperemia after 10 micrograms of
      PhXA34. In a second study we determined the effect of 10 micrograms of PhXA34
      once daily for 7 days on intraocular pressure, outflow facility, aqueous flow,
      blood-aqueous barrier permeability, ocular discomfort, and hyperemia. The mean
      intraocular pressure was below 9 mm Hg 12 hours post dose. About one third of the
      intraocular pressure reduction could be explained by increased outflow facility.
      Aqueous flow was unaffected. Treatment caused a 21% increase in aqueous
      fluorescence 1 hour after an oral dose of fluorescein. Mild ocular discomfort and
      some hyperemia were initially observed in half of the subjects, but frequency and
      magnitude of these side effects declined during the study.

PMID- 1755740
TI  - Massive suprachoroidal hemorrhage with central retinal apposition. A clinical and
      echographic study.
AB  - We reviewed the charts of 18 patients diagnosed with a massive suprachoroidal
      hemorrhage (MSCH) with central retinal apposition (kissing configuration). Four
      cases occurred intraoperatively (expulsive), eight after a surgical procedure
      (delayed), and six associated with blunt or perforating injury (traumatic). In
      this study, echography was used to monitor the course of MSCH; the mean time for
      clot lysis was 14 days, and the mean duration of central retinal apposition was
      15 days. The expulsive MSCHs were all allowed to resolve spontaneously, with good
      initial visual outcome in three of the four eyes in which they occurred. In the
      delayed MSCH group, the majority of patients attained their prehemorrhage visual
      acuity, with or without early surgical intervention. In the traumatic MSCH group,
      retinal detachment was a constant complication in all patients. All six patients
      in the traumatic MSCH group had a poor visual outcome, despite early surgical
      intervention in five patients. The results of this study suggest that not all
      MSCHs need to be drained surgically and that, when surgical drainage is
      indicated, echography may be a useful adjunct in determining the optimal time of
      drainage.

PMID- 1755741
TI  - Sinus histiocytosis involving the lacrimal sac and duct. A clinicopathologic case
      report.
AB  - A 17-year-old girl with right-sided epiphora and a lacrimal sac mass was found
      radiologically to have marked enlargement of her lacrimal sac and nasolacrimal
      duct and mucosal thickening of her right nasal turbinates and maxillary, ethmoid,
      and sphenoid sinuses. Biopsy specimens from all these sites showed chronic
      inflammatory infiltrates with a predominant population of large phagocytic
      histiocytes, some of which had engulfed lymphocytes and plasmacytes. The results
      of a systemic workup were normal. This is the first reported case, to our
      knowledge, of sinus histiocytosis involving the lacrimal sac and nasolacrimal
      duct as an extranodal focus.

PMID- 1755742
TI  - Eosinophil and neutrophil degranulation in ophthalmic lesions of Wegener's
      granulomatosis.
AB  - Although eosinophils and neutrophils have been identified in orbital and
      corneoscleral tissues in some patients with Wegener's granulomatosis, their role
      in the pathogenesis of the disorder is not completely understood. Nine specimens
      from six patients with Wegener's granulomatosis and autopsy controls from
      patients without ophthalmic disease were evaluated with indirect
      immunofluorescence for eosinophil granule major basic protein and neutrophil
      elastase. Extracellular deposition of both major basic protein and elastase was
      identified in orbital tissues from all the patients with Wegener's
      granulomatosis. Two of the specimens were from enucleated eyes with corneoscleral
      disease; extracellular deposition of eosinophil major basic protein was
      identified in one eye, and extracellular neutrophil elastase was deposited in
      both eyes in lesional areas. None of the control tissues showed major basic
      protein or elastase deposition. These findings suggest that both eosinophils and
      neutrophils participate in the pathogenesis of the orbital and corneoscleral
      manifestations of Wegener's granulomatosis.

PMID- 1755743
TI  - Early lesions of bilateral diffuse melanocytic proliferation.
AB  - The early lesions of bilateral diffuse melanocytic proliferation were studied
      with fluorescein angiography in a 63-year-old woman. We first observed a small
      choroidal melanoma in the left eye and several flat melanocytic lesions in both
      eyes. Extension and growth of new melanocytic lesions and leakage at the level of
      the pigment epithelium were then noted. Subsequently, pink patches, with an eye
      catching early hyperfluorescence, appeared in the posterior fundus in both eyes.
      The patient experienced progressive visual loss during the 8-month follow-up
      period before her death. Histopathologically, the uveal tracts were diffusely
      thickened by melanocytic proliferation. The primary systemic neoplasm was an
      ovarian carcinoma, found in five of 18 patients with this unusual paraneoplastic
      syndrome.

PMID- 1755744
TI  - Influence of corticosteroid on experimentally induced keratomycosis.
AB  - To assess the effect of corticosteroid on the establishment of experimentally
      induced keratomycoses, rabbits were injected subconjunctivally with triamcinolone
      acetonide on two successive days before inoculation with Candida albicans,
      Aspergillus fumigatus, or Fusarium solanae. Whereas isolate recovery rates
      declined steadily in normal control corneas, they remained stable over 15 days in
      corticosteroid-treated corneas. Clinically, inflammation was equivalent (A
      fumigatus and F solanae) or significantly less (C albicans; P = .001) until the
      10th day. At 15 days, inflammation in corticosteroid-treated corneas was
      significantly worse in animals infected with A fumigatus (P = .003) or F solanae
      (P = .02). Inflammatory signs correlated inconsistently with isolate recovery.
      Pathogenicity of the infecting organism appears to be important in determining
      the degree to which corticosteroid is able to mask clinical signs of infection
      while enhancing fungal replication.

PMID- 1755745
TI  - Holmium-YAG laser surgery on experimental vitreous membranes.
AB  - We used a pulsed holmium-YAG laser that emitted in the midinfrared (2.12 microns)
      to cut experimental vitreous membranes in rabbits via an intraocular fiberoptic
      delivery system. Thirty-five membranes were treated at distances of 0.5 to 3.8 mm
      from the retina. All of the membranes that were treated were transected or
      partially cut. In cases that were treated with the optical fiber encased in a
      retinal-shielding pick, membranes could be readily transected without retinal
      injury. Laser vitreous membrane cutting may offer the advantage of near
      tractionless membrane segmentation. The combination of a moderately strong target
      tissue absorption and the ready availability of commercial optical fibers for
      transmission of 2.12-microns laser energy suggests that the holmium-YAG laser
      merits further investigation for this application.

PMID- 1755746
TI  - Palladium 103 ophthalmic plaque radiotherapy.
AB  - We compared the ocular radiation distribution of palladium 103 (103Pd) vs iodine
      125 (125I) ophthalmic plaques sewn to 12 human donor eyes. We then performed
      preoperative comparative simulations on the first seven patients to be treated
      with palladium 103 plaque therapy for choroidal melanoma. The in vitro experiment
      involved palladium 103 seeds placed into a Silastic seed holder, which was
      affixed into standard 14-mm gold eye plaques. Then the plaques were sewn onto 12
      human donor eyes so as to approximate either the nasal (six eyes) or temporal
      (six eyes) equator. Three sets of two thermoluminescent dosimeters were used to
      quantify the amount of radiation delivered by the episcleral plaques.
      Thermoluminescent dosimeters were sewn to the sclera in three locations: on the
      center of the cornea, on the sclera beneath the macula, and at the equator in a
      position opposite the plaque. This experiment was then repeated with iodine 125
      seeds and thermoluminescent dosimeters. After the plaques were adjusted to
      equalize their activity (plaque strength), the palladium 103 plaques were found
      to deliver less radiation to the three target points. Comparative clinical
      dosimetry also reflected this difference. Preoperative simulations comparing
      equal doses to the tumors' apex revealed that the palladium 103 ophthalmic
      plaques delivered more radiation to the tumor and less radiation to most normal
      ocular structures.

PMID- 1755747
TI  - Conjunctival prolapse.

PMID- 1755748
TI  - Impairment, disability and handicap in audiology: towards a consensus.
AB  - Within this paper, we argue that the WHO definitions of impairment, disability
      and handicap have a useful role in understanding the processes of audiological
      rehabilitation. We have endeavoured to clarify some of the confusions arising
      from the various uses of the terms in the audiological literature and propose
      further classifications of the three. In particular we discuss the complexities
      of handicap together with the interactions between hearing-impaired individuals
      and their significant others in its production.

PMID- 1755749
TI  - Longitudinal study of changes in speech perception between 70 and 81 years of
      age.
AB  - As part of a large gerontological study in Goteborg, Sweden, 376 randomly
      selected men and women born in 1901-1902 underwent pure-tone and speech
      audiometry at the age of 70 years in 1971-1972. The survivors of the 1901-1902
      cohort were tested again at the ages of 75, 79 and 81 years. A second group
      consisting of 297 men and women born in 1906 was also tested with pure-tone and
      speech audiometry at the ages of 70 and 75 years. We found that the median speech
      discrimination scores for the 1901-1902 cohort decreased moderately with
      increasing age: between the ages of 70 and 81 years scores decrease 10% for men
      and 8% for women for the worse ear and 7 and 6% for the better ear in this group.
      The median speech reception threshold increased 15 dB over the 11-year period for
      both men and women, an increase in good agreement with the increase in the pure
      tone threshold over this period. Those born in 1906 had a slightly lower
      discrimination score (4%) when tested at the age of 70 years compared to those
      born in 1901 tested at the same age. As many as half of the 81-year-old persons
      would have a theoretical benefit from hearing aid amplification.

PMID- 1755750
TI  - [Clinical study of speech understanding in noise].
AB  - The goal of this study was to determine the extent to which the difficulty
      frequently experienced by hearing-impaired listeners in understanding noisy
      speech can be clinically described in terms of the auditory site of lesion. To
      this end, shifts of speech reception threshold in noise, using standardized
      franco-quebecois bisyllabic word lists, were obtained from noise-exposed workers
      and compared to Plomp's model to ascertain content validity. Shifts resulted from
      monaural listening to a broad-band speech spectrum noise held constant at 0 dB
      signal-to-noise ratio. In this manner, increasing the presentation levels of both
      speech and noise was expected to progressively minimize the contribution of
      Plomp's class A attenuation component to speech hearing loss and eventually show
      an unequivocal manifestation of its distortion component (class D speech hearing
      loss). Listeners were 457 noise-exposed workers giving a total of 914
      observations. Rejection of those ears with suspected middle-ear pathology led to
      a reduction to a total of 709 observations representing various degrees of
      permanent hearing impairment. An additional 98 observations showed normal hearing
      sensitivity in spite of noise exposure averaging 9.6 years. Results indicated the
      presence of five categories of speech threshold shifts varying independently of
      hearing sensitivity. 59.8% of those observations with permanent hearing
      impairment (424/709) simultaneously showed a problem understanding speech in
      noise. On 78 occasions, listening in noise was so disturbed that the 50%
      performance level corresponding to the speech threshold could no longer be
      established within reasonable limits, that is up to 65 dB above the speech
      threshold in a quiet environment. Conversely, 26.5% of the observations with
      essentially normal hearing sensitivity (26/98) showed reduced speech reception in
      noise. Fitting Plomp's model confirmed our expectations for two of the five
      categories of scores. A principal component analysis identified similar behaviour
      of speech threshold shifts in noise compared with Plomp's class D speech hearing
      loss. Hence, these speech threshold shifts in noise were interpreted as
      predominantly reflecting peripheral auditory disorders, that is defective
      frequency selectivity and temporal resolution. The remaining categories were
      found to be under the predominant influence of two other mechanisms: (1) band
      width reduction resulting from impaired hearing; (2) disorders associated with
      certain non-auditory cognitive factors, namely selective attention and the
      ability to make use of the redundancy of the message.

PMID- 1755751
TI  - Application of phase-induced lateralization to the Stenger test.
AB  - The Stenger test was employed to estimate the genuine hearing thresholds in
      normally hearing volunteer subjects simulating a total unilateral loss. The test
      was carried out in its standard form and in a modified form in which a phase
      shift was introduced between the signal delivered to the two ears, set to produce
      phase-induced lateralization towards the 'poor' ear. The standard test estimated
      the thresholds at a mean of 13.5 dB above the true thresholds at five frequencies
      from 250 Hz to 4 kHz. Thresholds at the different frequencies were compared, and
      although thresholds were lower for the higher frequencies, the apparent effect of
      frequency was not statistically significant. The modified test, using a 90
      degrees phase shift, was found to enhance the test at 250 and 500 Hz (thresholds
      estimated at about 7 dB above true values), but not significantly at 1 kHz.

PMID- 1755752
TI  - Primitive neuroectodermal tumour in the oral cavity. Case report.
AB  - Primitive neuroectodermal tumour is regarded as a rarely seen lesion as it occurs
      mainly within the central nervous system. However, this neoplasm does
      occasionally occur elsewhere in the body. One such case which occurred in the
      posterior part of the palate in a child is reported. Following a combined
      therapeutic approach comprising surgery, radiotherapy and chemotherapy, the
      patient has been well for nine years since treatment.

PMID- 1755753
TI  - The early development of palatal rugae in the rat.
AB  - The palatal rugae in rats are contained in two of three zones of morpho
      differentiation and develop around the time of palatal closure. Previous studies
      in humans and pigs have been based on crown-rump lengths but now controlled
      breeding in rats has allowed exact timing to be established. Twenty-nine female
      DB IX rats were fertilized and sacrificed in a controlled procedure and foetuses
      processed for light microscopy and SEM. Serial sagittal sections were made and
      stained with haematoxylin and eosin and Verhoef's stains. At day 13 the palate
      was open and no rugae were visible. At day 14 the palatal shelves had started to
      migrate medially and the ante-molar rugae appeared. At day 15 the palatal shelves
      were touching and the inter-molar rugae became visible, and at day 16 fusion was
      all but complete and the definitive rugal pattern established. The development
      and differentiation is more advanced than in humans and it is concluded that the
      rugae probably have a role to play in the oral function of animals whereas in
      humans they are becoming attenuated and the development timetable is retarded
      because of redundancy.

PMID- 1755754
TI  - Treatment planning in orthodontics and orthognathic surgery: the significance of
      tooth inclination and dental compensations.
AB  - The scope of orthodontic treatment is examined and the importance of the initial
      tooth inclinations and skeletal base relationships is explained. Dental
      compensations which occur in all three planes of space are discussed. Special
      attention is given to the importance of dental compensations in the antero
      posterior plane in orthognathic surgery treatment planning. There is a necessity
      for early definitive decision-making in the borderline orthognathic surgery
      patient and the role of orthodontic camouflage is pointed out. Case selection for
      treatment with removable appliances is explored.

PMID- 1755755
TI  - Cervical enamel projections in Chinese first permanent molars.
AB  - Cervical enamel projections in relation to molar furcations may act as
      predisposing factors in periodontal attachment loss. Limited data are available
      documenting these features in Chinese teeth. The purpose of this study was to
      determine the prevalence and distribution in a sample of first permanent molars
      from Hong Kong Chinese. Three hundred and sixty-two extracted first molars (194
      maxillary, 168 mandibular) were selected from the Prince Philip Dental Hospital
      tooth collection and examined using a dissection microscope for identification
      and classification. Cervical enamel projections were identified in 59 per cent of
      maxillary and 79 per cent of mandibular first molars. Buccal aspects were more
      frequently involved. Forty-nine per cent were Grade III (extending to the
      furcation area); over one-half were particularly slender while 18 per cent were
      discontinuous. A modification to the classification system is proposed in order
      to delineate these features in future studies.

PMID- 1755756
TI  - Mandibular osteomyelitis and pathologic fracture associated with metabolic
      catabolism induced by 'binge' drinking. Case report.

PMID- 1755757
TI  - Bony lid approach for apicoectomy of mandibular molars.
AB  - Apicoectomy in the lower molar region is indicated in many instances to avoid the
      need for prosthetic appliances. Nevertheless it is a method sometimes rejected by
      oral surgeons because of the thickness of the buccal compact bone in the lower
      molar area leading to extensive bone loss in addition to a restriction of vision
      and access during the operation. The present study reports twenty-four cases of
      apicoectomized mandibular molars treated with the bony lid approach which
      facilitates considerably the apicoectomy procedure. Once part of the buccal
      compact bone in the periapical area of the molars is removed, favourable
      conditions are created for the completion of the operation under direct vision of
      the operational field. The replacement of the buccal compact bone then minimizes
      the dimensions of the remaining bone cavity.

PMID- 1755758
TI  - The hard tissue lesion revisited.
AB  - Recent research indicates that the thorough removal of calculus is still a
      critical step in the treatment of periodontal disease. Surgical access
      facilitates this in deep pockets. Repair is mediated by a long junctional
      epithelium as microscopically total calculus removal is rarely achieved. In
      intrabony defects the apical portion of the root surface which has not attracted
      deposits of calculus has the potential for connective tissue reattachment and
      regeneration if care is taken to preserve collagen fibres still attached to the
      root.

PMID- 1755759
TI  - A national survey of dentists' management of children with anxiety or behaviour
      problems.
AB  - Seven-hundred and sixty dentists, selected randomly from all States and
      Territories except Victoria, responded to a questionnaire survey on beliefs,
      attitudes and the techniques used in the management of children with anxiety or
      behaviour problems. The most common techniques used were permitting the child
      some degree of control over terminating treatment if difficulties were
      experienced, coaxing and reinforcing positive behaviours, and furnishing waiting
      areas with child-oriented play materials. Most respondents never used TV or video
      tape distraction strategies, film or video-modelling tape or hypnosis. More than
      half of the respondents believed there was insufficient information available to
      them on current anxiety/behaviour management techniques. The use of particular
      management techniques varied by gender, age, university of graduation, State or
      Territory of residence, and membership of the Australian and New Zealand Society
      of Paediatric Dentistry. Patterns of use of particular techniques showed
      similarities and contrasts with other studies. Patterns of use in the national
      sample were almost identical to the frequency and pattern of use by Victorian
      dentists. In contrast, however, North American studies have reported a higher
      frequency of use of hand-over-mouth, and lower use of general anaesthesia within
      the armamentarium of techniques and strategies used by dentists to manage anxious
      or difficult children.

PMID- 1755760
TI  - Dimensional accuracy of small gold alloy castings. Part 2. Gold alloy shrinkage.

PMID- 1755761
TI  - Large database management in clinical dental research.
AB  - Previously the management and analysis of large databases for longitudinal
      clinical dental research has been severely restricted by the costs of custom-made
      software and access to suitable computing equipment. However, the recent
      availability of powerful personal computers and the use of the Scientific
      Information Retrieval Database Management System (SIR/DBMS) in association with
      BMDP Statistical Software has now created an enormously powerful tool for
      extensive and fast data manipulation requiring relatively few commands and the
      capability to easily perform detailed statistical analyses.

PMID- 1755762
TI  - Treatment of facial disharmony and malocclusion by jaw surgery.

PMID- 1755763
TI  - Bruxism.

PMID- 1755764
TI  - Surgeons International.

PMID- 1755765
TI  - Recent changes in the Part II FRACS Examination.

PMID- 1755766
TI  - Are you wasting your time with journals? Some guidelines for selective reading.

PMID- 1755767
TI  - Preventing breast cancer: is it possible?
AB  - Breast cancer is a common cause of suffering and death in Australia. Improvements
      in detection and therapy will make only small inroads into mortality, and will
      not reduce suffering. Reducing the incidence of breast cancer by preventive
      measures is a logical step, and this paper reviews how it might be achieved.
      Reducing the population's exposure to known risk factors for breast cancer is
      logical; however, the potential for improvement is limited. Reduction in age at
      first pregnancy is impractical and measures such as weight reduction and reducing
      consumption of fat and alcohol are likely to be only partially successful.
      Increasing activity in youth is a concept that requires further investigation,
      but is a possible area of promise. Exogenous hormone use probably contributes
      little to the incidence of breast cancer, but prescribing patterns for post
      menopausal oestrogens are changing and require monitoring. The use of hormone
      manipulation to prevent breast cancer has considerable potential benefit. Two
      approaches have been proposed. The first involves reversible suppression of
      ovarian function by luteinizing hormone-releasing hormone (LHRH) agonists after
      child-bearing has finished, combined with low-dose conjugated equine oestrogen to
      compensate for oestrogen loss. The other involves the use of the anti-oestrogen,
      tamoxifen. Both measures have the potential to halve breast cancer incidence.
      There is some evidence that non-hormonal chemoprevention is possible, but
      clinical trial data are lacking.

PMID- 1755768
TI  - Breast cancer in the elderly: pattern of disease.
AB  - The elderly (aged 70 years or more) constituted 201 (37%) of 548 first-time
      admissions to a single institution for breast cancer between 1976 and 1985. The
      pattern of disease was studied and contrasted with that seen in younger patients
      (less than 70 years old). Currently, 5000 new breast cancers are diagnosed in
      Australia each year. It is projected that the proportion of new breast cancer
      patients who are elderly will rise from 37 to 60% by the year 2031. In general,
      the disease was similar to that seen in younger patients. Minor histological
      differences occurred and there were tendencies towards late presentation and
      clinically less aggressive disease. Tumour size, the presence of metastases and
      UICC staging were useful predictors of outcome but nodal status and hormone
      receptor levels did not discriminate. An unexpected finding was the relative
      longevity of elderly patients with breast cancer. The stage-specific 5-year
      survival rates (UICC stages: I--73%; II--65%; III--42%; IV--10%;) did not differ
      significantly from those seen in younger patients.

PMID- 1755769
TI  - Radical neck dissection in nasopharyngeal carcinoma.
AB  - We report a series of 37 patients who had radical neck dissection for residual or
      recurrent lymph node metastasis from nasopharyngeal carcinoma after radiotherapy.
      The operation was performed despite high doses of pre-operative radiotherapy.
      There was no operative mortality and the morbidity was 13% (2 prolonged chylous
      drainage, 3 sloughing of neck flap). The risk of sloughing of neck flap was
      significantly related to previous lymph node biopsy, which should be avoided if
      at all possible. In 35% of patients, the lymph node was densely adherent to
      neighbouring structures. In the 28 patients who had single lymph node clinically,
      29% had multiple neck node involvement noted during operation; another 14% were
      documented only on histological examination. Radical neck dissection rather than
      excision alone is justified for the clinically solitary lymph node.

PMID- 1755770
TI  - Venous drainage of free flaps following radical neck dissection.
AB  - Large tissue defects may occur following head and neck surgery. When combined
      with ipsilateral radical neck dissection the venous drainage of a free flap used
      to cover the defect may be compromised. Twelve patients having radical neck
      dissections underwent on-table venography to study the pattern of venous drainage
      of these flaps. The predominant drainage pattern is initially in a cephalic
      direction, then across the midline and finally in a caudal direction on the
      contralateral side of the neck. Venous drainage to the contralateral side of the
      neck may be a determinant of flap survival. In order to facilitate venous
      drainage following free flap procedures, patients should be positioned so that
      the contralateral internal jugular vein is not compressed. Drains should be
      placed caudal to the microvascular anastomoses in order to minimize interference
      with the cephalic direction of venous drainage. Any patient having a radical neck
      dissection requiring a central venous catheter should have it placed ipsilateral
      to the neck dissection. Thrombosis around a contralaterally placed cannula may
      significantly increase head and neck venous pressure.

PMID- 1755771
TI  - Laser treatment of pharyngeal pouch.
AB  - The symptoms of pharyngeal pouch become more troublesome, eventually requiring
      surgical treatment. Excision of the pouch and cricopharyngeal myotomy through a
      neck incision was the operation of choice until Dohlman described endoscopic
      diathermy operative treatment 30 years ago. The diathermy technique has been
      largely superseded by endoscopic microsurgical division of the cricopharyngeus
      muscle in the party wall using carbon dioxide laser. This operation is now
      established as a precise, accurate and safe procedure providing reliable relief
      of symptoms with minimal risk to the patient. Fifteen patients treated by the
      microsurgical laser procedure in the past 5 years are reported.

PMID- 1755772
TI  - Canal wall down techniques for managing cholesteatoma.
AB  - Cholesteatoma remains a common otological problem. This series shows that a
      simple open cavity technique, with meatoplasty, remains a cost-effective option
      for treatment. Most ears are rendered dry and safe, with cavity problems
      minimized by careful technique. Subsequent outpatient care is required
      infrequently and is well tolerated. The hearing is no worse after the operation
      than before and some ears are suitable for subsequent tympanoplasty.

PMID- 1755773
TI  - CT-guided stereotactic neurosurgery using the Brown-Roberts-Wells system:
      experience with 125 procedures.
AB  - Experience with a consecutive series of 125 computerized tomographic (CT) image
      guided stereotaxic neurosurgical procedures, performed using the Brown-Roberts
      Wells (BRW) system is described. Operative objectives included tissue sampling
      for diagnostic purposes, intra-operative localization of craniotomy flaps and
      intracerebral lesions, cyst and abscess aspiration and lesion to modulate tremor.
      A neuropathological diagnosis was possible in 96% of the biopsies, and lesions
      were precisely localized in all patients undergoing microsurgical stereotaxic
      craniotomy. Two patients (2.2%) undergoing stereotaxic biopsy died as a result of
      the procedure and one patient's hemiparesis was permanently worsened (0.8%). In
      only one of three patients undergoing stereotaxic thalamotomy was tremor
      abolished. This report confirms that CT image guided stereotaxic neurosurgery is
      safe, accurate and versatile. There is, however, a moderate incidence (7.2%) of
      lesser complications that can occur with this type of surgery. These
      complications, which are emphasized in this paper, are related to both the site
      of surgery and the neuropathology.

PMID- 1755774
TI  - The hand in heraldry.
AB  - The display of hands in heraldry provides a graphic reminder of both the origins
      and development of medical institutions, and of certain aspects of the functional
      anatomy of the hand--aspects which are of importance to the surgeon who deals
      with the injured hand. The elegance of the hand appeals to surgeon and heraldic
      artist alike.

PMID- 1755775
TI  - Heparin reduces the intimal hyperplasia seen in microvascular vein grafts.
AB  - The influence of heparin on microvascular vein graft intimal hyperplasia was
      studied in a rat model. The iliolumbar vein was grafted into the iliac artery in
      80 rats. Heparin was delivered via a subcutaneous miniosmotic pump, starting
      either 2 days before grafting (early heparin group, n = 20) or immediately after
      grafting (heparin group, n = 30). Saline-containing pumps were placed in the
      control group (n = 30). Heparin activity was measured at 24 h, and again 3 weeks
      later when the animals were sacrificed. The grafts were harvested and prepared
      for histological examination. The intimal thickness was measured at the
      anastomoses and in the mid-graft region using an eye-piece graticule set at right
      angles to the graft internal elastic lamina. Heparin significantly reduced the
      intimal thickness at the anastomoses, from a median of 38 microns (range: 10-100
      microns) in the control group to a median of 20 microns (range: 10-150 microns)
      in the heparin group. A similar reduction was seen in the mid-graft region.
      Although intimal thickening was reduced in the early heparin group, this
      reduction failed to reach statistical significance. The possible clinical
      application is discussed.

PMID- 1755776
TI  - Pre- and post-testing of students in surgery: do medical rotations help?
AB  - A prospective multiple choice question (MCQ) study developed to pre- and post
      test fifth year medical students at the University of Queensland, was undertaken
      during 1990. We investigated whether there was a significant gain in their
      surgical knowledge base resulting from non-surgical rotations during the same
      year. We have previously reported a retrospective study suggesting that there was
      such a gain. Comparable clinical surgical pre- and post-tests were adapted from a
      fresh question bank, and were presented prospectively to four groups of fifth
      year medical students at the beginning and end of each 7 week General Surgical
      term. In contrast to our retrospective study, we found there was no significant
      increment in surgical knowledge using non-parametric Notched Box and Whisker Plot
      analysis of data. We conclude that this is either because students are
      compartmentalizing their factual knowledge base between one speciality and the
      next, or that indeed there is no benefit to Surgical knowledge base from prior
      non-surgical rotations. Assuming the former, a combined Medical and Surgical
      Objective Structured Clinical Examination (OSCE) at the end of the fourth year
      could serve to broaden the student's horizons and reduce factual dissociation
      during the fifth year.

PMID- 1755777
TI  - Primary adenocarcinoma in a colonic oesophageal segment.
AB  - A case of primary adenocarcinoma of the colon in a segment used to reconstruct
      after an oesophageal resection is described. The original lesion was a relatively
      advanced adenocarcinoma of the gastro-oesophageal junction. An ACPS 'C' colon
      carcinoma was diagnosed 12 years later. A curative resection was achieved. The
      literature is reviewed with respect to late complications in colonic
      interpositions, including primary carcinomas.

PMID- 1755778
TI  - Benign bladder neck polyp and ureteropelvic obstruction in Beckwith-Wiedemann
      syndrome.
AB  - Beckwith-Wiedemann syndrome is recognized for its association with various
      malignancies but specific urological abnormalities may also be encountered. We
      report a case of Beckwith-Wiedemann syndrome with two major urological
      associations--a benign bladder neck polyp and also left hydronephrosis due to
      ureteropelvic junction obstruction. Whereas the latter is a common urological
      abnormality, a benign bladder neck polyp is a rare entity and may, thus, be
      considered to be a component of the syndrome.

PMID- 1755779
TI  - Duodenal penetration by a Greenfield caval filter.
AB  - Duodenal penetration by a Greenfield filter occurred in a 77 year old woman 6
      years after it had been inserted into her inferior vena cava. The reported
      incidence of complications associated with the Greenfield filter is low. We
      report a case of penetration of the device into the duodenum. Plain abdominal X
      rays demonstrated angulation and deformation of the filter. Cavography and
      abdominal CT confirmed transcaval penetration of the duodenum. The patient had
      suffered from severe diarrhoea, night sweats and weight loss which resolved
      completely with operative removal of the filter.

PMID- 1755780
TI  - Metastatic carcinoid tumour: stability throughout pregnancy.
AB  - A patient with asymptomatic histologically proven extensive hepatic metastases of
      carcinoid tumour had no progression of disease for over 4 years without specific
      treatment. Throughout a normal pregnancy the hepatic metastases remained stable
      by clinical, computerized tomography and biochemical criteria.

PMID- 1755781
TI  - Immunisation against ovine caseous lymphadenitis: comparison of Corynebacterium
      pseudotuberculosis vaccines with and without bacterial cells.
AB  - Sheep were immunised with Corynebacterium pseudotuberculosis vaccines prepared
      from cell-free toxoid or from toxoid with formalin-killed cells of C
      pseudotuberculosis added. Resistance of sheep to infection was tested 6 months
      after immunisation by inoculation with caseous lymphadenitis pus. The outcome was
      assessed 3 months later by slaughter and inspection of the sheep for lesions of
      caseous lymphadenitis. immunised sheep were adequately protected against
      infection as shown by a significant reduction in the number of sheep exhibiting
      lesions compared with control sheep, and by fewer abscesses in affected
      vaccinated sheep than in affected control sheep. The protective potency of the
      vaccines was not improved by the inclusion of cells of C pseudotuberculosis.

PMID- 1755782
TI  - Immunisation against ovine caseous lymphadenitis: efficacy of monocomponent
      Corynebacterium pseudotuberculosis toxoid vaccine and combined clostridial
      corynebacterial vaccines.
AB  - Sheep were immunised with Corynebacterium pseudotuberculosis toxoid formulated as
      a monocomponent vaccine with aluminium adjuvant or in combination with 5
      clostridial antigens, and also in the combined form with sodium selenate.
      Immunised and control sheep were experimentally infected 16 days after
      vaccination and slaughtered and inspected after a further 3 months to determine
      their resistance to infection. All 3 vaccines afforded an equal and high level of
      protection; 91% of vaccinated sheep exhibiting no lesions of caseous
      lymphadenitis compared with 51.5% affected sheep in the control group. Average
      lesion counts were 1.2 per affected vaccinated sheep and 4.5 per affected control
      sheep. Antitoxin responses to the clostridial toxoids incorporated in the
      combined vaccines were not affected by inclusion of the C pseudotuberculosis
      toxoid or the sodium selenate.

PMID- 1755783
TI  - Immunisation against ovine caseous lymphadenitis: correlation between
      Corynebacterium pseudotuberculosis toxoid content and protective efficacy in
      combined clostridial-corynebacterial vaccines.
AB  - Groups of sheep were dosed with vaccines containing Corynebacterium
      pseudotuberculosis toxoid combined in varying amounts with 5 clostridial
      antigens. Resistance of the sheep to infection with C pseudotuberculosis was
      tested at 1, 6 and 12 months after vaccination by infection with pus from ovine
      lymph glands actively infected with C pseudotuberculosis. The outcome was
      assessed 3 months after challenge by slaughter and inspection of the sheep for
      caseous lymphadenitis lesions. Protection was demonstrated by a significant
      reduction in the proportion of immunised sheep exhibiting lesions compared with
      control sheep, and by fewer abscesses in affected immunised sheep than in
      affected control sheep. A positive correlation was found between amount of C
      pseudotuberculosis toxoid administered and degree of protection obtained.
      Chromatographically-purified toxoid induced essentially the same protection,
      suggesting that anti-toxic immunity is the major factor in protection.

PMID- 1755784
TI  - Chronic cervical compressive myelopathy in horses: clinical correlations with
      spinal cord alterations.
AB  - Histological examination was performed on the cervical spinal cord from 13 horses
      with chronic cervical compressive myelopathy of 4 to 29 months duration.
      Structural alterations were correlated with clinical features. At the level of
      compression, the spinal cord was grossly deformed. Histological alterations
      included nerve fibre swelling and degeneration, occasional spheroids, astrocytic
      gliosis, increased macrophage activity and increased perivascular collagen.
      Myelin degeneration or loss at the level of the compressive lesion was greatest
      in the ventral and lateral funiculi and less consistently present in the dorsal
      funiculi. Asymmetry of lesions in the dorsal funiculi was associated with
      asymmetry of clinical signs in 5 horses. Histological alterations in areas of
      Wallerian degeneration were similar to that at the level of spinal cord
      compression, except that perivascular collagen was not increased. Wallerian
      degeneration was present cranial to the compressed site in the superficial
      portions of the lateral funiculi and in the middle of the dorsal funiculi. Caudal
      to the compressed site it was present in the ventral funiculi adjacent to the
      ventral median fissure and in the middle of the lateral funiculi. Deformation of
      the spinal cord did not correlate with the severity or duration of clinical signs
      but was positively correlated with the amount of perivascular collagen increase.
      The amount of nerve fibre swelling was not correlated with the severity of
      clinical signs but was negatively correlated with their duration. A rapid loss of
      nerve fibres apparently occurred early in the course of compression, since there
      was a marked decrease in the amount of nerve fibre swelling and Marchi stained
      degenerating myelin with increasing clinical duration.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1755785
TI  - Chronic cervical compressive myelopathy in horses: patterns of astrocytosis in
      the spinal cord.
AB  - The distribution and morphology of fibrous astrocytes in the cervical spinal cord
      of normal horses and horses with chronic compressive myelopathy were demonstrated
      using immunohistochemical staining for glial fibrillary acidic protein. In the
      spinal cord from normal horses, astrocytes with stellate cell bodies and short
      processes were irregularly distributed in grey matter. In the white matter, their
      cell bodies were small and angular in areas adjacent to grey matter and larger
      and more stellate-shaped in the subpial area. Astrocyte processes were fine, and
      evenly distributed in a predominantly radial pattern in transverse sections of
      cord. Gliosis was marked in the spinal cords of horses with cervical compressive
      myelopathy. In the grey matter at the level of compression astrocytes were often
      enlarged and rounded, with short, blunt processes, but the gliosis was generally
      mild. In the white matter, gliosis was obvious in areas of nerve fibre swelling
      and degeneration at the level of compression and in areas of ascending and
      descending Wallerian degeneration. The fine radial pattern of astrocyte fibres
      was replaced by a dense, irregular arrangement. Gliosis persisted in the cords of
      chronically affected horses after active nerve fibre degeneration had subsided.
      The areas of gliosis coincided with the areas of Marchi staining for degenerating
      myelin and with areas of myelin loss in osmium tetroxide post-fixed tissue.
      Histological observations were consistent with astrocytes replacing areas of
      extracellular space that remained after nerve fibre degeneration. it is concluded
      that astrocytic gliosis is a prominent and persistent alteration of the spinal
      cord of horses with chronic cervical compressive myelopathy.

PMID- 1755786
TI  - The efficacy of insecticides against the screw-worm fly (Chrysomya bezziana).
AB  - A number of insecticides used for ectoparasite control in the livestock industry
      were screened for their efficacy against larvae of the screw-worm fly, Chrysomya
      bezziana, using in vivo and laboratory tests. Proprietary screw-worm fly
      treatments (after exposure to outdoor conditions for up to 10 days) were also
      tested against eggs and adults of C bezziana. Three of these were also evaluated
      on naturally acquired screw-worm infestations. Residual protection was generally
      of short duration. Among the organophosphorus compounds, the most effective
      formulations contained relatively high concentrations (3 to 4% al) of coumaphos,
      2.5% fenchlorphos or low concentrations (0.05 to 0.5% al) of diazinon,
      chlorfenvinphos and fenthion methyl. Two chlorinated hydrocarbon insecticides
      containing 3% lindane and 5% dieldrin were very effective but are now prohibited
      for use in Australia. Preparations had serious deficiencies when used under field
      conditions, especially for treating large, deepseated myiases for which systemic
      insecticides are recommended. A comparison of methods demonstrated that a
      laboratory test could supersede live animal experimentation, at least for the
      initial screening of potential insecticides.

PMID- 1755787
TI  - Adverse reactions to canine and feline vaccines.

PMID- 1755788
TI  - Pasteurella multocida-associated septicaemia in a chital deer (Axis axis).

PMID- 1755789
TI  - Malignant mast cell tumours in horses.

PMID- 1755790
TI  - Local eradication of Haemonchus contortus using closantel.

PMID- 1755791
TI  - Oxyhemoglobin saturation following rapid decompression to 18,288 m preceded by
      diluted oxygen breathing.
AB  - This investigation studied oxyhemoglobin saturation (SaO2) and cardiovascular
      indices after rapid decompression (RD). Before RD, fractional inspired O2
      concentration (FIO2) simulated the range of product gas from molecular sieve O2
      generating systems (MSOGS). Four subjects breathed 1.0-0.80 FIO2 at 6,858 m.
      After decompression to 18,288 m, the subject received 1.0 FIO2 at a positive
      pressure of 70 mm Hg for 3 min. There were no incidents of severe hypoxia. The
      mean SaO2 was 98.0% before RD. After RD, SaO2 was maintained at the pre-RD level
      for 8 s, decreased rapidly over the next 10 s, and over the rest of the 1st min
      decreased more gradually to reach approximately 82%. Varying FIO2 before RD had
      no effect on the alteration in SaO2, heart rate, stroke index, and blood pressure
      after RD. The MSOGS O2 product range offers adequate protection against hypoxia
      during RD to 18,288 m.

PMID- 1755793
TI  - Effect of the prelaunch position on the cardiovascular response to standing.
AB  - Astronauts spend a minimum of 2 h in the reclined seated position (prelaunch
      position) prior to the launch of the Space Shuttle. This position favors a
      cephalad shift of blood volume and subsequent loss of body fluid volume, a
      physiologic situation associated with cardiovascular deconditioning and
      orthostatic intolerance following spaceflight. It is not known if the prelaunch
      position results in cardiovascular deconditioning and, therefore, impaired
      cardiovascular performance during standing. If so, this might hinder the ability
      of the crewmember to make an emergency egress from the shuttle during the launch.
      The purpose of this study was to evaluate the cardiovascular responses of men and
      women to the stand test before and after 2 h in the prelaunch position. Nine men
      and nine women performed the stand test before and after 2 h in the seated
      position (SIT), the prelaunch position (PL), or seated immersed to the neck in
      water (WI). Heart rate, blood pressure, and cardiac output were measured. Men had
      higher blood pressures than women and demonstrated increases in blood pressure
      with standing. There were no other gender differences. SIT did not alter the
      cardiovascular response to standing, while PL and WI resulted in greater
      increases in heart rate after 2 h in the position. This increase was only 4 to 7
      beats/min greater than after SIT, and was the same for PL and WI. Thus, a small,
      but significant, degree of cardiovascular deconditioning occurred during the
      minimum time astronauts spend in the prelaunch position.

PMID- 1755792
TI  - Hormonal responses of pilots flying high-performance aircraft during seven
      repetitive flight missions.
AB  - Hormonal responses during seven repetitive flight missions (7RFM) were evaluated
      on F-4EJ fighter pilots. The following biochemical constituents were measured: 1)
      cortisol in saliva; 2) 17-OHCS; 3) unbound cortisol; 4) catecholamines in urine;
      and 5) electrolytes in urine. Samples were collected at about 30 min before the
      mission, 20 min after each flight, and in a nonflight day for control. The levels
      of saliva and urine corticosteroids slightly increased during 7RFM when compared
      with controls. The concentrations of urine catecholamines during 7RFM were
      significantly higher than those of preflight and control. These data suggest that
      flight stresses were moderate for the pilots flying 7RFM.

PMID- 1755794
TI  - Cardiopulmonary responses to acute hypoxia, head-down tilt and fluid loading in
      anesthetized dogs.
AB  - The separate and combined acute effects of hypoxia (HY-11% O2), head-down tilt
      (HD-30 degrees) and fluid loading (FL-1.0 L saline) on hemodynamics and pulmonary
      gas exchange were determined in 17 anesthetized, mechanically ventilated dogs.
      Both during HY and normoxia (NO), the total respiratory compliance was decreased
      by HD, attributable to pulmonary vascular congestion. The reductions in
      compliance were twice as great with FL, indicating pulmonary interstitial edema,
      which was supported by histological observation of lung tissue. Pressure-flow
      relationships in the pulmonary circulation indicated that superimposing HD on HY
      doubled the increase in vascular resistance due to HY alone, while in the
      systemic circulation the resistance was returned to below NO by HD. A significant
      positive correlation between the changes in blood volume and pulmonary artery
      pressure for experimental transitions suggests that a shift in blood volume from
      systemic to pulmonary circulations and changes in total blood volume probably
      contributed substantially to these apparent changes in resistance. Pulmonary gas
      exchange efficiency, whether expressed in terms of shunt or ventilation/perfusion
      distribution from arterial-end-tidal PCO2 and PO2 differences, showed a
      significant inverse relationship with pulmonary driving pressure for the
      experimental conditions imposed. No clear synergistic effects of HY on HD were
      evident in contributing to pulmonary edema when superimposed prior to FL, but
      after FL this risk must be considered.

PMID- 1755795
TI  - Effect of 29 days of simulated microgravity on maximal oxygen consumption and fat
      free mass of rats.
AB  - To determine the time course of changes in maximal oxygen consumption (VO2max)
      and its relationships with body composition, a 29-d simulated microgravity study
      was initiated with 30 adult female rats (230-280 g) randomly assigned to one of
      three experimental groups; namely, head-down suspension (HDS) at 45 degrees,
      horizontal suspension (HS) at 0 degree, or cage control (CC). Five separate
      exercise performance tests with measurements related to VO2max, treadmill run
      time, and mechanical efficiency were conducted before suspension and on days 7,
      14, 21, and 28. The animals were sacrificed and chemically analyzed for fat and
      fat-free free mass (FFM) between days 22 and 29. When oxygen consumption results
      were expressed on an absolute basis (ml.min-1), both suspension groups had
      significant decreases at day 7. Thereafter, the HDS rats remained significantly
      decreased, while the HS rats returned to values not significantly different than
      the presuspension values by day 28. When oxygen consumption was expressed on a
      relative basis (ml.kg-1.min-1), all groups exhibited significant reductions
      between 6-8%. Both suspended groups had significantly less fat than the CC rats
      but had similar values for FFM (p greater than 0.05). When VO2max was evaluated
      on a FFM basis, the HDS rats had a group mean that was 6% lower than the other
      two groups, but the difference was not statistically significant. Treadmill run
      time was significantly reduced in all groups after 28 d with the reduction from
      pre-suspension values being more pronounced with HDS animals.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1755796
TI  - Effects of long duration spaceflight on human T lymphocyte and monocyte activity.
AB  - Experiments were performed on blood samples from 5 cosmonauts in order to
      investigate the effects of long duration spaceflight (26 to 166 days) on immune
      activity. The experiments were performed on cultured mononuclear cells purified
      from blood samples collected during the preflight period and 24 h after landing.
      The production of interleukin 2, which is the major cytokine involved in T
      lymphocyte proliferation, was found to be enhanced after flight in some
      individuals, whereas the ability of mitogen-stimulated cells to express
      interleukin 2 receptor was impaired 24 h after flight for two cosmonauts out of
      five. Normal interleukin 2 receptor expression was obtained in all cases when
      lymphocytes were directly activated by a protein kinase C activating phorbol
      ester. On the other hand, no significant changes were observed in interleukin 1
      production by cultured peripheral blood mononuclear cells. Lastly, the
      distribution of T lymphocytes subsets was examined in peripheral blood sampled 24
      h after landing and was found to be within normal values.

PMID- 1755797
TI  - Vector-averaged gravity alters myocyte and neuron properties in cell culture.
AB  - To investigate whether changes in the gravitational field of developing neurons
      and myocytes affect cellular development, we rotated cultures of embryonic spinal
      neurons and myocytes in a horizontal clinostat. Rotation in the clinostat
      produces, from the cells' perspective, a "vector-free" gravity environment by
      continuous averaging of the vector. In this way, rotation in the clinostat
      simulates the microgravity of space where the gravity vector is substantially
      reduced. At rotation rates of 1-50 rpm, cellular and nuclear areas of myocytes
      were significantly enlarged and the number of presumptive nucleoli increased. In
      neurons, frequent and large swellings appeared along neuritic shafts. Some of
      these changes were reversible after cessation of rotation. Since our data are
      generally consistent with findings from other cell types subjected to
      spaceflight, we suggest that the vector-free gravity environment of the clinostat
      appears to simulate, at least in part, the microgravity of space. Our data
      further show that cellular processes are sensitive to altered gravity and suggest
      that cell development in the microgravity of space may be significantly altered.

PMID- 1755798
TI  - Brief reactive psychosis in naval aviation.
AB  - Five naval aviation personnel diagnosed with brief reactive psychosis (BRP) have
      appeared before the Special Board of Flight Surgeons (SBFS) at the Naval
      Aerospace Medical Institute (NAMI). These cases demonstrate the challenges in
      diagnosis and disposition that face the clinical aeromedical specialist in
      evaluating the aviator who develops psychiatric symptoms. We discuss the
      aeromedical factors that must be considered when contemplating returning aviators
      with psychiatric diagnoses to flying duties. Sudden behavioral changes in
      aviation personnel require a systematic assessment, thorough documentation, and
      continuing reevaluation. The differentiation between organic and functional
      etiologies may be difficult. Final disposition may require consultation with
      experienced physicians skilled in both aviation psychiatry and neurology.

PMID- 1755799
TI  - Spinal X-ray screening of high performance fighter pilots.
AB  - Neck pain and neck injury are common complaints among military aviators flying
      high performance (HPF) aircraft. Since all candidates for military flying
      training with the Royal Norwegian Air Force have to meet HPF medical standards,
      medical selection procedures include a radiological examination of the spine.
      Nine films of the vertebral column are made with emphasis put on cervical
      structures. Among 232 applicants, 527 deviations from normal conditions were
      described--anomalies, degenerative changes and deviations of posture--which
      average 2.27 diagnoses per spine X-rayed. Of the candidates, 80 were considered
      entirely within normal limits; 20 were rejected due to the roentgen findings; and
      five candidates were excluded on final evaluation, their radiological diagnoses
      contributing to the decision. Although most changes are slight, many significant
      conditions are demonstrated among young healthy individuals. Since the population
      is highly selected, the figures we present may be minimum numbers in a western
      industralized society.

PMID- 1755800
TI  - Estimate of requirements for detection and treatment of hypercholesterolemia in
      U.S. Army aviators.
AB  - In May 1988, the Army Surgeon General issued guidelines and a preliminary plan
      for evaluation and treatment of hypercholesterolemia, based on the
      recommendations of the National Cholesterol Education Program Expert Panel.
      Implementation of this plan in the aviation population would require an unknown
      number of aviators to undergo testing and possibly therapy for
      hypercholesterolemia. This study uses a mathematical model and information from
      the Aviation Epidemiology Data Register to estimate the number of aviators who
      would require detailed lipoprotein analysis and at least dietary therapy, based
      on evaluation of their total serum cholesterol and other coronary artery disease
      (CAD) risk factors, as described in the expert panel report. The model predicts
      that at least 27% of all aviators would require LDL screening, and 24.6% of all
      aviators would require dietary or drug therapy.

PMID- 1755801
TI  - Decompression sickness: U.S. Navy altitude chamber experience 1 October 1981 to
      30 September 1988.
AB  - This study reports the incidence of decompression sickness (DCS) occurring in
      U.S. Navy altitude chambers in association with physiological training of
      aircrews for the 7-year period from 1 October 1981 to 30 September 1988. There
      were 140 total cases of DCS in 136,696 chamber exposure, an incidence of 0.10%.
      Among trainees, there were 78 cases in 111,674 exposures, and incidence of 0.07%.
      Among inside observers, there were 62 cases in 25,022 exposures and incidence of
      0.25%. The incidence of DCS among inside observers was reduced almost two-fold
      over the last Navy report and is the lowest reported since 1973. Reasons for the
      reduction are discussed. In addition, analysis of the data includes types of DCS,
      symptoms, frequency of joint involvement, predisposing factors, altitude and time
      of onset of DCS, and treatment tables employed.

PMID- 1755802
TI  - Flight psychology at Sheppard Air Force Base.
AB  - Flight psychology is the application of psychological principles to the unique
      environment of the aviator in order to enhance training, flight safety, and
      mission accomplishment. At Sheppard Air Force Base, TX, flight psychology is a
      cooperative effort between a clinical psychologist and the aeromedical services,
      with the former acting as a consultant to the latter. The primary focus of the
      flight psychology program is stress management, including managing the stress
      response of airsickness, for students in the Euro-NATO Joint Jet Pilot Training
      (ENJJPT) program. Psychological assessments of flying personnel, air traffic
      controllers, and individuals being considered for special duties constitute a
      valuable contribution to aeromedical services. We present clinical vignettes to
      illustrate the interaction of the flight psychologist and aeromedical services,
      and the effect on flying training and flight safety.

PMID- 1755803
TI  - A comparison of flight and non-flight sick call visits to a U.S. Army aviation
      medicine clinic.
AB  - In a U.S. Army aviation medicine program, flight surgeons provide primary
      clinical care for the units they support. Routine outpatient care (sick call) is
      performed daily on a walk-in basis. This study describes the diagnoses associated
      with flight and non-flight personnel reporting to sick call in an Army aviation
      medicine clinic. Data were collected over a 1-year period at an Aviation Troop
      Medical Clinic (TMC) supporting an aviation brigade consisting of 530 aircrew and
      1,220 support personnel. A total of 5,793 sick call visits were made, 73% of
      which were initial visits, the remainder being second or subsequent visits.
      Aircrew evaluations accounted for 29% of the total. Major reasons for visits were
      illness (56%), injury (34%), and supplemental care (10%). However, substantial
      differences were noted between flight and non-flight patients. Overall, non
      aircrew visits accounted for the bulk of the flight surgeons' clinical workload
      during sick call.

PMID- 1755804
TI  - Airshow disaster plans.
AB  - Airshows require careful medical planning. Disaster drills and coordination
      between all rescue agencies are necessary. Rescue personnel and command post must
      be highly visible. Good communication includes dedicated radio frequencies at the
      site, dedicated phone lines to hospitals, and multiple back-ups. Security
      personnel should use yellow police tape for crowd control, and volunteers must be
      supervised. Key medical elements include efficient triage and stabilization at
      the site, adequate medical personnel, equipment dispersed within the crowd, rapid
      transportation including helicopters, and crisis intervention. Separate areas are
      needed for persons with minor injuries, relatives and friends, the press, and a
      morgue. Disaster plans for airshows have unique aspects. A predetermined time
      benefits planning. Airports often have pre-existing medical facilities, and
      participating military agencies may have additional resources. Burns and
      inhalation injuries predominate at airshow accidents. Enlarging spectator safety
      zones and modifying aerobatic maneuvers can prevent injury.

PMID- 1755805
TI  - An operationally oriented approach to medical care in space.
AB  - As plans to bring the United States into the realm of continuously manned space
      operations are written, questions concerning the medical support of those
      operations have been raised. A review of the simple, time-tested principles that
      guide military operational medicine can be applied to medical care in space.
      Based on this operational approach, I conclude that a successful medical team
      must understand the mission, identify medical resources, define medical
      evacuation capabilities, anticipate medical issues and plan solutions, and
      develop facility requirements. Once all this has been accomplished, appropriate
      selection and training of medical personnel completes the preparation.

PMID- 1755807
TI  - Growth factors in endocrinology.

PMID- 1755806
TI  - Cases from the aerospace medicine residents' teaching file. Case #47. Primary
      pulmonary coccidioidomycosis.
AB  - This case report on primary pulmonary coccidioidomycosis outlines a typical
      presentation in an individual at high risk and the pitfalls that can occur to
      practitioners unfamiliar with this disease. The patient was a 36-year-old black
      male who presented with an initial abnormal chest X-ray and who eventually was
      correctly diagnosed and improved on a 30-day course of ketoconazole. This patient
      showed no signs of dissemination.

PMID- 1755808
TI  - Epidermal growth factor and transforming growth factor alpha.
AB  - I have attempted here to outline the basic biochemical knowledge that we have now
      secured on the EGF family of proteins. In the future we will learn much more
      about the differential role of EGF versus TGF-alpha, about the physiological
      significance of amphiregulin, the newest member of this family, and about the
      roles of TGF-alpha and amphiregulin in cancer. Many questions remain. What is the
      importance of these factors in embryogenesis and fetal development? Is there an
      involvement of the EGF-like domains of extracellular proteins in cell-to
      extracellular-matrix interactions? Do these extracellular matrix EGF-like
      entities function in a similar manner to fibroblast growth factor in cell growth
      and in mediating the relationship of cells to the extracellular matrix? What is
      the significance of cell membrane-bound forms of EGF and TGF-alpha as potential
      cell-to-cell contact regulators? What is the role of the viral EGF-like proteins
      in the viral infective and transforming process? These and other questions will
      be addressed in the next decade. The key question has already been well stated:
      'what is the normal physiological role of EGF during development and homeostasis?
      The answers to these and a host of other questions must be found before we can
      fully comprehend this important regulatory system' (Cohen, 1987).

PMID- 1755809
TI  - Transforming growth factor beta/inhibin family.

PMID- 1755810
TI  - Anti-mullerian hormone.

PMID- 1755812
TI  - Growth factor control of pancreatic B cell hyperplasia.
AB  - Pancreatic B cell hyperplasia is an essential feature of normal fetal and
      childhood development in order to maintain insulin availability to the growing
      organism. While glucose, amino acids and pituitary growth hormone have all been
      shown to increase B cell DNA synthesis in cultures of isolated islets of
      Langerhans, there is also evidence for a local regulation of growth by trophic
      factors. IGF-I and IGF-II are expressed and released by pancreatic B cells and
      have the capacity to act as B cell mitogens. Specific IGFBPs are also released by
      islets which may modulate the bioactivity of IGFs. While IGF release is not under
      acute nutrient control, at least in vitro, the mitogenic actions of growth
      hormone on islets are mediated in part by an increase in the local release of IGF
      I. Other peptide growth factors reported to influence B cell DNA synthesis
      include PDGF, EGF, TGF-beta and TRH. The contribution of peptide growth factors
      to pathological abnormalities of pancreatic islet growth is unknown.

PMID- 1755811
TI  - Growth and differentiation.

PMID- 1755813
TI  - Growth factors and the anterior pituitary.
AB  - Normal growth and secretion in the pituitary gland are dependent upon the co
      ordinated action of a large number of extracellular growth factors, neuropeptides
      and peripheral hormones acting on their respective cellular receptors and via
      complex intracellular signalling pathways. The pituitary and hypothalamus are
      exposed to a large number of growth factors, several of which have well
      documented effects on secretory function and may act as physiological modulators
      of pituitary hormone synthesis and release. IGF-I, for example, almost certainly
      acts as a feedback regulator of GH secretion. Despite well-documented mitogenic
      effects in other tissues, little is known about the role of these growth factors
      in normal pituitary cell turnover, compensatory hyperplasia or adenoma formation.
      There is now good evidence, however, that at least some of the hypothalamic
      releasing peptides are mitogenic for their respective pituitary cell
      subpopulations. The aetiology of pituitary tumours remains poorly understood but
      some appear to develop as a result of somatic mutation. Such mutations could
      enhance growth by causing altered expression of growth factors or their
      receptors, or constitutive activation of proteins involved in the intracellular
      mitogenic signal. Abnormalities have been documented at each of these levels in
      human pituitary tumours. The identification of an activating point mutation in
      the alpha subunit of Gs, the stimulatory regulatory peptide of adenylyl cyclase,
      in a proportion of somatotroph adenomas represents a major advance in our
      understanding of pituitary tumour pathogenesis. This and other findings may
      ultimately lead to new therapeutic approaches to the management of pituitary
      disease.

PMID- 1755814
TI  - The ovary.
AB  - The functions of the ovary can be described as a storehouse for oocytes as well
      as a factory to produce mature oocytes at the appropriate time for fertilization
      and hormones at the appropriate time and in the appropriate quantities to assure
      fertility. A complex multiple-job specification such as this requires control
      processes which allow all facets to operate successfully at the same time, and in
      a co-ordinated manner. This can only be achieved by hypothesizing control at
      several levels, namely, externally via gonadotrophins (and perhaps GH and
      prolactin), and internally via local regulators, where the local regulators
      control the gonadotrophin-independent processes and fine tune the gonadotrophin
      dependent processes. The available evidence is consistent with a role for local
      regulators in the control of follicular and luteal function in the ovary. In most
      cases, however, the nature of the local regulator involved in a particular
      process is not known. On the other hand, the list of candidates continues to
      increase (see Table 1). A priority for future research will be to firmly
      establish many of these substances as local regulators and to understand how and
      when they exert their actions, particularly in vivo. A particularly complex
      question concerns the potential interaction between the local regulators which
      have either similar or opposing actions. The clinical significance of local
      regulation in the ovary is yet to be fully appreciated. The addition of GH to
      gonadotrophin therapy for ovulation induction (Homburg et al, 1988) is the first
      example of the application of findings from basic research on local regulators in
      the ovary. It may be that clinical syndromes such as resistant ovary syndrome,
      polycystic ovarian disease and luteinized unruptured follicle have some
      perturbation of local regulator production or action, which, if defined, would
      underline the importance of local regulation and could offer a means of
      treatment.

PMID- 1755815
TI  - Growth factors as mediators of testicular cell-cell interactions.
AB  - The development of testicular function may require local cell-cell interactions
      to regulate tissue growth and differentiation. Locally produced growth factors
      may mediate the differential growth of mesenchymal, epithelial and germinal cells
      that occurs during fetal, prepubertal and postpubertal testis development. The
      complex co-ordination of differential and temporal cellular growth suggests that
      a variety of locally produced factors may be involved. Presently, a number of
      growth factors have been identified in the testis, including IGF-I, TGF-alpha,
      TGF-beta, NGF, IL-1, FGF, SGF and SCSGF. These factors may mediate interactions
      involving growth stimulation, growth inhibition and differentiation in this
      tissue (Table 2 and Figure 1). Endocrine agents are also necessary for testis
      development and function. In many organs, endocrine hormones appear to alter
      local cell-cell interactions. Similarly, gonadotrophins may modulate growth
      factor interactions within the testis. Understanding testicular cell-cell
      interactions involving growth factors requires evaluation of the cellular site of
      factor expression, production, secretion, target cell action and in vivo
      significance. Presently, none of the proposed cell-cell interactions involving
      growth factors have evaluated all these criteria. Further cellular and molecular
      analysis of these intercellular interactions are necessary to clarify the role of
      growth factors in the development and maintenance of testicular function.

PMID- 1755816
TI  - Growth factors in the uterus: steroidal regulation and biological actions.
AB  - Rapid progress has been made within the last 5-6 years in characterizing
      polypeptide growth factors in uterine tissues and fluids. There is convincing
      evidence that their synthesis and/or secretion is regulated by steroid hormones.
      The possibility that these growth factors play a central role in growth and
      development of the uterus or placenta is suggested by the presence of their
      receptors on uterine or placental cells and their stimulatory effects on these
      cells in vitro. Since growth factors interact synergistically and also have non
      mitogenic functions, the presence of a variety of these factors in the uterus
      suggests that they probably regulate various aspects of uterine function through
      complex autocrine and paracine pathways. However, experimental models need to be
      designed that will permit a more detailed analysis of the actual role of these
      factors in utero. Fruitful approaches may be to administer neutralizing
      antibodies or blocking peptides so as to antagonize uterine growth factor action,
      or to develop appropriate transgenic animals. These and other lines of study
      should help us to understand the role of growth factors in development of the
      immature uterus, growth of the placenta or gravid uterus, repair and angiogenesis
      of the endometrium, and uterine pathology.

PMID- 1755817
TI  - The mammary gland.
AB  - In vivo studies have shown that the growth of the mammary gland is regulated by a
      complex synergistic interaction of protein, steroid and thyroid hormones, but it
      has proved difficult to fully reproduce these effects in vitro. It is becoming
      apparent that the hormones classically recognized as involved in mammary growth
      (oestrogen, progesterone, prolactin, GH, adrenal corticoids, triiodothyronine)
      bring about effects on epithelial cell proliferation at least in part through
      growth factors produced at distant sites (such as the liver) and also locally by
      mammary tissue, both parenchyma and stroma. Growth factor receptors can be
      demonstrated in mammary tissue. Receptor occupancy generates intracellular
      signals which enable cells to progress through the cell cycle, leading in ways
      still not understood to DNA synthesis and cell division. Within the mammary gland
      there probably exists a balance of stimulatory factors (such as IGFs and EGF/TGF
      alpha) and inhibitory factors (such as TGF-beta). Interactions between epithelial
      and stromal cells, involving growth factors and the extracellular matrix, bring
      about pattern formation. Growth factors may also play some part in mammary
      differentiation and function, although the evidence here is less clear. Growth
      factors are also implemented in the failure of growth regulation which neoplastic
      transformation represents. Breast cancer cells can synthesize and secrete a
      variety of growth factors which may stimulate tumour growth through local
      autocrine/paracrine mechanisms. The oestrogen dependence of some breast cancers
      may involve oestrogen regulation of and interaction with growth factors,
      progression to hormone independence involving loss of this control. It is
      significant that the proteins which protooncogenes encode include growth factors
      and growth factor receptors. Much remains to be learnt about the nature and
      control of growth factors produced by and acting on the mammary gland. In breast
      cancer, this research offers the possibility of new methods of diagnosis and
      treatment.

PMID- 1755818
TI  - The use of transgenic animals to study the role of growth factors in
      endocrinology.
AB  - Transgenesis is identified as being of special interest in the study of growth
      factors where their multicellular origins and complex interactions make them
      particularly difficult to characterize using classical experimental approaches
      developed to investigate hormones originating in specialized cells in discrete
      glands. Through allowing molecular 'tinkering' in intact animals, transgenesis
      enables specific growth factors to be 'ablated or replaced' from specific tissues
      and organs and target cell response and impact of modulatory factors such as
      binding proteins to be explored in the intact animal. To the endocrinologist, the
      potential applications of such technology are legend. This chapter provides a
      brief overview of the technique and provides linkages to the rapidly developing
      body of literature in establishing transgenesis in growth factor research.

PMID- 1755819
TI  - [Postanesthetic complications in the horse. Evaluation of anesthesia in the last
      28 years (1962-1989)].
AB  - The anesthesia routine in the horse is briefly explained. 35 postanesthetic
      complications resulted from the total of 4364 cases of anesthesia. They are
      evaluated by means of the duration of anesthesia, the time of paresis, the
      exemplary courses of enzymes as well as the distribution of race and sex and
      their ratio towards all cases of anesthesia. Finally a list of demands concerning
      the operative and postoperative phases is compiled to minimize postoperative
      myositis (PAM) and lameness (PAL).

PMID- 1755820
TI  - [Radiographic studies of ossification of the hoof cartilage of horses and its
      clinical evaluation].
AB  - Radiographic examination is a valuable means for the identification of ossified
      lateral cartilage. The extent and stages of development of the ossification can
      be determined. The active stage of development of ossified lateral cartilage,
      which by itself can provoke lameness, can be defined. By means of the X-ray it is
      tried to differentiate the three kinds of ossification: the enchondral, the peri-
      and parachondral ossification of the lateral cartilage. Centres of ossification
      and fractures of the ossified lateral cartilage are described.

PMID- 1755821
TI  - [The effect of the sedative and analgesic detomidine for laryngoscopy of adult
      horses and foals].
AB  - Detomidine was used in this field trial effectively as a sedative and analgesic
      for laryngoscopic examinations in a total of 193 foals and 806 mature horses
      (Hanoverians). Detomidine was given either i.v. in foals 3 to 11 months old (20
      micrograms/kg) and in mature horses (15 micrograms/kg), or i.m. in foals below 6
      months of age (35 micrograms/kg). After i.v. administration, laryngoscopy was
      tolerated in more than 90% of all animals without additional use of a twitch,
      while in foals treated i.m. more than 70% required a twitch in order to enable
      this procedure. The effectiveness of detomidine was influenced by dose, route of
      administration, the time interval between treatment and examination and the
      degree of excitement before treatment, but not by sex. Profound bradycardia was
      evident in all treated animals, but arrhythmias were seen only in animals older
      than 4 months and were more pronounced in horses with a lower resting heart rate.
      These cardiovascular responses never endangered any of the treated animals. A
      transient dyspnea was seen in 13 foals (6.7%) and 10 horses (1.2%). Other side
      effects were rare. The foaling rate of 297 mares treated at any time during the
      first 8 months of pregnancy was 66.7%. A comparison with 5499 untreated,
      contemporary controls revealed a foaling rate of 61.0%. Hence treatments had no
      adverse effects on pregnancies.

PMID- 1755822
TI  - [Estimation of the occupational radiation exposure during radiographic studies of
      horses].
AB  - Radiography of horses in veterinary practice is done normally with quite simple
      equipment. Thereby radiation protection is easily neglected. In this
      investigation sources of mistakes are demonstrated. The possible exposure of
      staff is evaluated by dose measuring over a long period of time. It can be stated
      that following the most simple radiation protection there will never be a
      significant exposure of staff.

PMID- 1755823
TI  - [Heart arrhythmias in horses caused by delays of conduction in the
      atrioventricular nodes and in the bundle of His].
AB  - The clinical importance of the AV blocks in horses discussed. The second degree
      AV block is a symptom of the adaptation of the heart to increased workload and it
      is not an indication of a good performance.

PMID- 1755824
TI  - [Phenol in the serum of dogs and horses and its clinical significance].
AB  - Reference values of serum phenols between 0.3 and 0.7 mmol/L in dogs respectively
      between 0.25 and 0.37 mmol/L in horses are determined. In dogs increased phenol
      values were found frequently in hepatopathy. Furthermore elevations, particularly
      in diseases of the gastrointestinal tract, were obtained; especially in
      hemorrhagic enteritis of dogs, associated with parvovirosis, and in mechanical
      ileus of the small intestine and the large intestine respectively in horses. In
      renal and endocrine diseases increased phenol values were seldom obtained.

PMID- 1755825
TI  - [Monitoring of the oxygen saturation of horses during halothane anesthesia using
      pulse oximetry in the nasal septum].
AB  - The use of pulse oximetry for on-line monitoring of oxygen saturation of arterial
      blood using a probe on the nasal septum is described in the horse. When compared
      to the results of blood gas analysis an excellent correlation between the two
      methods for measuring oxygen saturation is found. Nevertheless a discrepancy
      between the values for oxygen saturation provided by either method is found. This
      can lead to misinterpretation of oxygen saturation values generated by the pulse
      oximeter. The cause of this discrepancy is not clear but differences in measuring
      principle, presence of dyshemoglobins and differences in absorption
      characteristics of hemoglobin are to be ruled out as major contributors. Contrary
      to findings in several other animal species occasionally double counting of pulse
      frequency by the pulse oximeter is seen.

PMID- 1755826
TI  - The helix-loop-helix domain: a common motif for bristles, muscles and sex.
AB  - Three apparently unrelated developmental processes--mammalian myogenesis, the
      choice of neural fate and sex determination in Drosophila--are controlled by a
      common mechanism. Most of the genes governing these processes encode
      transcriptional factors that contain the helix-loop-helix (HLH) motif. This
      domain mediates the formation of homo- or heterodimers that specifically bind to
      DNA through a conserved basic region adjacent to the HLH motif. Dimers differ in
      their affinity for DNA and in their ability to activate transcription from HLH
      binding-site containing promoters. In addition, the activity of HLH proteins is
      inhibited by dimerization with another class of HLH proteins that lack a basic
      domain entirely or have an altered one. These structural properties provide a
      molecular mechanism to explain the synergistic and antagonistic functional
      relations among the HLH encoding genes that control several developmental
      pathways.

PMID- 1755827
TI  - New enzymes for old: redesigning the coenzyme and substrate specificities of
      glutathione reductase.
AB  - A set of amino acid side chains that confer specificity for the coenzyme NADPH
      and the substrate glutathione in the flavoprotein disulphide oxidoreductase,
      glutathione reductase, has been identified. Systematic replacement of these amino
      acid residues in the coenzyme-binding site switches the specificity of the enzyme
      from its natural strong preference for NADPH to a marked preference for NADH. The
      amino acids replaced all lie in a structural motif within the dinucleotide
      binding domain of the protein. Since this domain is a feature common to most
      dehydrogenases (reductases) that use nicotinamide coenzymes, it may be that the
      coenzyme specificities of all such enzymes can be manipulated in this way.
      Similarly, amino acid residues involved in the selective recognition of
      trypanothione by trypanothione reductase, an enzyme related to glutathione
      reductase and exclusive to trypanosomatids, were identified. Suitable mutation of
      the corresponding residues in E. coli glutathione reductase switched its
      substrate specificity towards trypanothione. A better understanding of the
      substrate specificity of these enzymes could open up a route to the chemotherapy
      of trypanosomal infections.

PMID- 1755828
TI  - Alternative splicing of fibronectin: three variants, three functions.
AB  - Fibronectin (FN) is a multi-functional extracellular matrix protein required for
      cell adhesion and migration, blood clotting, wound healing, and oncogenic
      transformation. The functional complexity is paralleled by structural diversity
      in that multiple forms of FN are generated by cell type-specific alternative
      splicing. In the rat, up to 12 different combinations of the three alternatively
      spliced segments (EIIIA, EIIIB, and the V region) are produced. What effects do
      these segments have on FN function? Recently, progress has been made in the
      identification of specific activities for the three variants of the V region,
      V120, V95, and V0. FN-mediated cell adhesion, FN synthesis and secretion, and
      incorporation into blood clots are differentially affected by these isoforms.
      These results suggest that cellular behavior is modulated by environmental cues
      provided by different types and proportions of alternatively spliced FN variants.

PMID- 1755829
TI  - How do cells respond to ultrafine surface contours?

PMID- 1755830
TI  - Transfer of yeast artificial chromosomes from yeast to mammalian cells.
AB  - Human DNA can be cloned as yeast artificial chromosomes (YACs), each of which
      contains several hundred kilobases of human DNA. This DNA can be manipulated in
      the yeast host using homologous recombination and yeast selectable markers. In
      relatively few steps it is possible to make virtually any change in the cloned
      human DNA from single base pair changes to deletions and insertions. In order to
      study the function of the cloned DNA and the effects of the changes made in the
      yeast, the human DNA must be transferred back into mammalian cells. Recent
      experiments indicate that large genes can be transferred from the yeast host to
      mammalian cells in tissue culture and that the genes are transferred intact and
      are expressed. Using the same methods it may soon be possible to transfer YAC DNA
      into the mouse germ line so that the expression and function of genes cloned in
      YACs can be studied in developing and adult mammalian animals.

PMID- 1755831
TI  - The biology of cancer metastasis or, 'you cannot fix it if you do not know how it
      works'.
AB  - The major cause of death from cancer is the relentless growth of metastases that
      are resistant to conventional therapy. The pathogenesis of a metastasis is
      complex and requires that tumor cells complete a sequence of potentially lethal
      interactions with various host factors. The finding in 1973 that metastasis is a
      selective process and the finding in 1977 that malignant neoplasms are
      heterogeneous and contain few preexisting metastatic subpopulations have added a
      new dimension to our understanding of cancer and its spread. This understanding
      is now contributing to the design of better therapies against disseminated
      metastasis.

PMID- 1755832
TI  - Nucleotide sequence of the Clostridium thermocellum laminarinase gene.
AB  - The sequence presented (1022 bp) shows the Clostridium thermocellum laminarinase
      gene (lam1) and its flanking regions. The gene lam1 comprises an open reading
      frame of 726 nt, encoding a 242-aa protein with predicted Mr 27661. The ORF
      startswith the translation initiation codon ATG. This ATG codon is preceded at a
      spacing of 7 bp by a potential ribosome binding site (GGAGGT). A putative signal
      peptide was identified (the potential cleavage site is between position 27-28
      aa). The comparison of the primary protein sequence with other beta-1, 3-1, 4
      glucanases showed extensive homology for Bacillus amyloliqefaciens and Bacillus
      subtilis glucanases (identity-46.7%; similarity-57.0%).

PMID- 1755833
TI  - Endothelin-1 is expressed and released by a human endothelial hybrid cell line
      (EA.hy 926).
AB  - A permanent vascular endothelial cell line, EA.hy 926, was shown to express
      endothelin-1 (ET-1) mRNA and to secrete big ET-1 and ET-1 into culture medium.
      The concentration of both big ET-1 and ET-1 was significantly increased in EA.hy
      926 culture medium by phosphoramidon, a metalloproteinase inhibitor, suggesting
      that phosphoramidon sensitive protease(s) may be responsible for the degradation
      of ET-1 and big ET-1. EA.hy 926 cells responded to various regulators of ET-1
      similarly as primary human vascular endothelial cells. The production of ET-1 was
      increased by thrombin and decreased by vasodilators such as atrial natriuretic
      peptide, brain natriuretic peptide and nitroprusside, and by 8-bromo cyclic GMP
      and papaverine. This continuous human endothelial hybrid cell line could
      facilitate studies of regulation of ET-1 production in human endothelial cells,
      which in primary cultures have limited replication potential.

PMID- 1755834
TI  - Normal cholesterol synthesis in human cells requires functional peroxisomes.
AB  - To evaluate the importance of peroxisomes in cholesterol metabolism we measured
      the rate of cholesterol synthesis in cultured skin fibroblasts from 16 patients
      in whom deficiency of peroxisomes had been established. Seven complementation
      groups were studied, consisting of one six member group, one three member group,
      three groups comprising single cases and two groups with two cases each. On the
      average, cholesterol synthesis was below control values in all the 16 peroxisome
      deficient fibroblast cell cultures. The range of cholesterol synthesis in these
      cells was 2% to 84% of normal values. These data strongly suggest that
      peroxisomes are essential for normal cholesterol synthesis in human fibroblasts.

PMID- 1755835
TI  - Stabilization of actin by phalloidin: a differential scanning calorimetric study.
AB  - We have used differential scanning calorimetry to study the effects of phalloidin
      on F and G actin stability. For F actin, saturating concentrations of phalloidin
      induced an important shift on the transition temperature, Tm, from 69.5 degrees C
      to 83.5 degrees C. However, the calorimetric enthalpy remained unchanged. Using
      lower phalloidin concentrations, monomers linked to phalloidin, as well as
      neighboring unlinked monomers, were both stabilized. Contrary to previous
      reports, phalloidin was also shown to affect G actin, shifting its Tm from 59.5
      degrees C to 75 degrees C. Two mechanisms are proposed to explain this finding:
      first, it could indicate a real interaction of phalloidin with G actin, and
      second, heating of the specimen during the scan could have induced polymerization
      of some G actin to the F form. The resulting F polymer would then interact with
      phalloidin, thus shifting the equilibrium between G and F actin towards the
      polymeric form.

PMID- 1755836
TI  - The role of phosphorylation in development of tight junctions in cultured renal
      epithelial (MDCK) cells.
AB  - We have explored the effect of the protein kinase inhibitor H7 on tight junction
      formation in a MDCK cell model for the development of cell-cell contact, tight
      junctions and epithelial polarity: the "Ca++ switch" model. In this developmental
      model, which is thought to mimic processes during the early morphogenesis of
      epithelial tissues, the protein kinase inhibitor H7 markedly inhibits the
      development of transepithelial resistance of confluent MDCK cells during the
      "switch" from low (1-5 microM) to normal (1.8 mM) Ca++ media compared with
      control MDCK cells. Moreover, indirect immunofluorescence using specific antisera
      against two tight junctional proteins, ZO1 and cingulin, revealed that H7
      inhibits the sorting of these proteins from an intracellular site to the lateral
      surfaces of MDCK cells when the Ca++ in the medium is raised. These data suggest
      protein kinase mediation in sorting events that lead to the assembly of tight
      junctions.

PMID- 1755837
TI  - Lactosylceramide stimulates aortic smooth muscle cell proliferation.
AB  - We have investigated the effects of various sphingolipids on aortic smooth muscle
      cell proliferation employing viable cell counting, [3H] thymidine incorporation
      into DNA and the release of lactate dehydrogenase. Assays for UDP Gal: GlcCer Bl
      4 galactosyltransferase (GalT-2) in control and treated cells were pursued
      simultaneously. Lactosylceramide stimulated cell proliferation in the order of 5
      fold. Antibody against LacCer but not GbOse3Cer blocked the proliferative effects
      of LacCer in these cells. This phenomena was specific for aortic smooth muscle
      cells as LacCer decreased cell viability of aortic endothelial cells and had no
      effect on pulmonary endothelial cells. D-PDMP inhibited the activity of GalT-2 in
      smooth muscle cells and markedly prevented cell proliferation. In contrast, L
      PDMP stimulated the activity of GalT-2 in smooth muscle cells and stimulated cell
      proliferation. Antibody against GalT-2 inhibited cell proliferation. Our findings
      suggest that the activation of GalT-2 leads to increased LacCer levels, which in
      turn, may be involved in aortic smooth muscle cell proliferation.

PMID- 1755838
TI  - Inhibitory effect of thyrotropin releasing hormone on spontaneous proliferation
      of mouse spleen lymphocytes in vitro.
AB  - The effects of thyrotropin releasing hormone (TRH) and of TRH-like tripeptide
      pGlu-His-Gly-OH (colon mitosis inhibitor, CMI) on spontaneous proliferation of
      murine splenocytes were investigated in vitro. The 3H-thymidine incorporation
      into splenocyte DNA was used as an index of proliferation. It was found that TRH
      suppressed the proliferation of splenocytes. In contrast, CMI was ineffective by
      itself but used together with TRH blocked the effect of the latter.

PMID- 1755839
TI  - Identification of potentially neurotoxic pyridinium metabolite in the urine of
      schizophrenic patients treated with haloperidol.
AB  - Evidence that the parkinsonian inducing agent MPTP is biotransformed to a
      pyridinium species that selectively destroys nigrostriatal neurons in humans and
      subhuman primates has prompted studies to evaluate the metabolic fate of the
      structurally related neuroleptic agent haloperidol. With the aid of a highly
      sophisticated atmospheric pressure ionspray HPLC/MS/MS assay, unambiguous
      evidence has been obtained for the presence of the haloperidol pyridinium species
      in extracts of urine obtained from haloperidol-treated patients and in extracts
      of NADPH-supplemented human liver microsomal incubation mixtures containing
      haloperidol. The potential significance of the formation of this putative
      neurotoxic pyridinium species is considered.

PMID- 1755840
TI  - Structural properties of human carbonic anhydrase II at pH 9.5.
AB  - The structure of human carbonic anhydrase II at pH 9.5 has been studied by X-ray
      crystallographic methods to 2.2 A resolution. These studies complement those
      performed under acidic conditions in which the catalytically-important proton
      shuttle group, His-64, exhibits conformational mobility about side-chain torsion
      angle chi 1. However, no structural changes are observed in the conformation of
      His-64 at high pH. Therefore, we conclude that the protonation of His-64 (as well
      as zinc-bound hydroxide) may be a factor which contributes to the predominantly
      "out" conformation for His-64 observed at low pH.

PMID- 1755841
TI  - A common precursor for a putative hemorrhagic protein and rhodostomin, a platelet
      aggregation inhibitor of the venom of Calloselasma rhodostoma: molecular cloning
      and sequence analysis.
AB  - Rhodostomin is a platelet aggregation inhibitor secreted by the venom gland of
      Calloselasma rhodostoma. We report here the isolation of a 1.67-kilobase (kb)
      lambda gt11 cDNA clone using degenerate oligonucleotide probe based on a partial
      amino acid sequence of rhodostomin. The amino acid sequence deduced from an open
      reading frame of the cDNA indicates that (i) the 68-amino acid sequence of
      rhodostomin is located at the carboxyl terminus of the precursor polypeptide and
      (ii) a peroxisomal targeting sequence (ser.his.ala.) exists between the stop
      codon and the rhodostomin sequence of the precursor. Since the amino-terminal
      segment of the deduced sequence shows a high degree of identity with hemorrhagic
      proteins, which are zinc-metalloproteinases, found in the venom of some crotalid
      and viperid snakes, our results also predict the existence of at least one such
      hemorrhagic protein in the venom of Calloselasma rhodostoma. The derivation of a
      platelet aggregation inhibitor and a hemorrhagic protein from the same precursor
      protein is consistent with the fact that these proteins may be synergistic in
      function.

PMID- 1755842
TI  - Human erythropoietic protoporphyria: two point mutations in the ferrochelatase
      gene.
AB  - The molecular basis of the ferrochelatase defect responsible for human
      Erythropoietic Protoporphyria (EPP), a usually autosomal dominant disease, was
      investigated in a family with an apparently homozygous patient. Two mutations of
      the ferrochelatase gene were identified by sequencing the proband's cDNA after in
      vitro amplification of the mRNA and subcloning of the amplified products. One
      mutation results from a G to T transition at nucleotide 163 which produces a
      glycine to cysteine substitution at amino-acid residue 55 (G-55-C). The other one
      was a G to A change at nucleotide 801, leading to a methionine to isoleucine
      substitution at amino-acid residue 267 (M-267-I). This EPP patient was then
      double heterozygous and as expected each of his parents carried one of the
      mutations. A second similar EPP patient was screened for these mutations with
      negative results, showing a genetic heterogeneity in EPP.

PMID- 1755843
TI  - Scanning tunneling microscopy of human erythrocyte membranes.
AB  - Images of surfaces of human erythrocyte ghosts, lecithin liposomes, spectrin,
      erythrocyte membrane skeleton, concanavalin A and concanavalin A--decorated
      erythrocyte ghosts were obtained by scanning tunneling microscopy. The dimensions
      and surface topography of some membrane structures are described and discussed.

PMID- 1755844
TI  - A DBL-homologous region of the yeast CLS4/CDC24 gene product is important for
      Ca(2+)-modulated bud assembly.
AB  - The CLS4/CDC24 is essential for the budding process of the yeast Saccharomyces
      cerevisiae. Disruption of the CLS4/CDC24 gene is lethal, and expression of the
      CLS4 product under the control of the GAL1 promoter is sufficient for cellular
      growth. The CLS4 product is detected in yeast cell lysate with an apparent
      molecular mass of 93 kD (854 amino acid residues) and shows homology with the
      human DBL oncogene product. Temperature-sensitive cdc24-1 mutation is located in
      the N-terminal portion of the protein whereas Ca(2+)-sensitive cls4-1 mutation is
      present after the DBL-homologous region (amino acid residues 281-518) near the
      putative Ca(2+)-binding site. Mutations within the DBL-homologous region are
      responsible for the Ca(2+)-sensitive phenotype. Thus the CLS4 gene product seems
      to have several functional domains within the molecule essential for bud
      assembly.

PMID- 1755845
TI  - Dissociation between activation of growth-related genes and mitogenic responses
      of neonatal vascular smooth muscle cells.
AB  - In neonatal vascular smooth muscle (VSM) cells, activation of protein kinase C
      can block the mitogenic response to alpha-thrombin. The molecular mechanism for
      this growth inhibition was investigated by looking at early transcriptional
      events in the cell cycle. Both thrombin and phorbol-12-myristate-13-acetate (PMA)
      induced mRNA for the c-myc oncogene; peak levels of expression were found 4-5 h
      after exposure to either agent. When thrombin and PMA were added together, c-myc
      expression was increased synergistically; down-regulation of protein kinase C
      suppressed induction of c-myc by thrombin. Thus, c-myc expression varied
      inversely with cell growth under these conditions. Thrombin and PMA also both
      induced expression of mRNA for the PDGF-A chain over 4-7h. As for c-myc, PMA and
      thrombin synergistically increased expression of the PDGF A-chain under
      conditions where PMA inhibits thrombin-induced DNA synthesis. Thus, mitogenesis
      and early growth-related gene expression was dissociated during PMA-mediated
      growth inhibition.

PMID- 1755846
TI  - Induction of DNA polymerase beta during proliferation of mitogen-stimulated human
      lymphocytes.
AB  - On induction of proliferation of human peripheral blood mononuclear cells by
      phytohemagglutinin treatment, DNA polymerase beta activity increases markedly
      before and during DNA replication. The increase of enzymatic activity seems to be
      well correlated with the increase of DNA polymerase beta mRNA, which is induced
      by enhanced expression of the DNA polymerase beta gene. These data suggest that
      DNA polymerase beta is involved in DNA repair, which is linked to replicative DNA
      synthesis, or directly in replicative DNA synthesis in normal proliferating
      cells.

PMID- 1755847
TI  - Multiple pathways of thrombin-induced platelet activation differentiated by
      desensitization and a thrombin exosite inhibitor.
AB  - Recently a thrombin receptor with a unique mechanism of activation was cloned
      from a megakaryocyte-like cell line (Vu et al., Cell 64:1057-1068, 1991).
      Thrombin cleaves a portion of this receptor creating a new N-terminus that acts
      as a "tethered-ligand" to activate the receptor. A thrombin receptor activating
      peptide (SFLLRNPNDKYEPF) homologous to the new N-terminus was shown to activate
      platelets. We synthesized this peptide and demonstrated that it desensitized
      platelets to activation by low concentrations of alpha-thrombin but not gamma
      thrombin. We also synthesized a thrombin exosite inhibitor (BMS 180742) that
      inhibited platelet aggregation induced by low, but not high, concentrations of
      alpha-thrombin. In contrast, a thrombin active site inhibitor, N alpha-(2
      naphthylsulfonyl-glycyl)-D,L-amidinophenylalanylpiperi dide, competitively
      inhibited thrombin-induced platelet aggregation. We conclude that thrombin
      induced platelet activation is mediated by at least two pathways: one activated
      by low concentrations of alpha-thrombin and blocked by a thrombin exosite
      inhibitor that appears to be coupled to the "tethered-ligand" thrombin receptor,
      and another that is stimulated by higher concentrations of alpha-thrombin and by
      gamma-thrombin and does not require the thrombin exosite for activation. Both
      pathways are blocked by a thrombin active site inhibitor.

PMID- 1755848
TI  - Inter-molecular degradation of signal peptidase I in vitro.
AB  - Highly purified preparations of signal peptidase I (36 kDa) were found to undergo
      an apparent inter-autocatalytic degradation at 4 degrees C and 37 degrees C. The
      disappearance of the 36 kDa protein coincided with the stable appearance of a 31
      kDa and a 5 kDa species. Amino-terminal sequencing of the 31 kDa product
      indicated a site specific cleavage following Ala38-Gln-Ala of signal peptidase I.
      The 31 kDa fragment was purified and shown to have 100-fold less activity than
      the native enzyme, with pre-maltose binding protein as a substrate.

PMID- 1755849
TI  - Enzyme chemistry of dithiohemiacetals: synthesis and characterization of S-D
      dithiomandeloylglutathione as an alternate substrate for glyoxalase I.
AB  - Both the D- and L-forms of S-dithiomandeloylglutathione (1) have been synthesized
      by a dithioester-interchange reaction between GSH and S-carboxy-methyl(D,L)
      dithiomandelate. Kinetic and product analysis studies indicate that yeast
      glyoxalase I efficiently catalyzes the stereoselective conversion of D-1 to GSH
      phenylglyoxal dithiohemiacetal (2), isolated as a disulfide adduct between 2 and
      a second molecule of GSH. This observation suggests that dithioester substrate
      analogues should be generally useful as mechanistic probes of enzyme catalyzed
      reactions involving thiohemiacetal intermediates.

PMID- 1755850
TI  - Morquio disease: isolation, characterization and expression of full-length cDNA
      for human N-acetylgalactosamine-6-sulfate sulfatase.
AB  - We cloned and sequenced a full-length cDNA of human placental N
      acetylgalactosamine-6-sulfate sulfatase, the enzyme deficient in Morquio disease.
      The 2339-nucleotide sequence contained 1566 nucleotides which encoded a
      polypeptide of 522 amino acid residues. The deduced amino acid sequence was
      composed of a 26-amino acid N-terminal signal peptide and a mature polypeptide of
      496 amino acid residues including two potential asparagine-linked glycosylation
      sites. Expression of the cDNA in transfected deficient fibroblasts resulted in
      higher production of this sulfatase activity than in untransfected deficient
      fibroblasts. The cDNA clone was hybridized to only a 2.3-kilobase species of RNA
      in human fibroblasts. The amino acid sequence of N-acetylgalactosamine-6-sulfate
      sulfatase showed a high degree of homology with those of other sulfatases such as
      human arylsulfatases A, B or C, glucosamine-6-sulfatase, iduronate-2-sulfatase
      and sea urchin arylsulfatase.

PMID- 1755851
TI  - Angiotensin II blocks ATP-sensitive K+ channels in porcine coronary artery smooth
      muscle cells.
AB  - ATP-sensitive K+ channels with small conductance (30 pS in symmetrical K(+)-rich
      solutions) in porcine coronary artery smooth muscle cells were highly active at
      physiological concentrations of Ca2+ (greater than 10(-4) M) even in the presence
      of physiological ATP levels, suggesting that these channels contribute to the
      generation of the resting membrane potential in vascular smooth muscle cells and
      their modulation is important in controlling vasomotor tone. Angiotensin II,
      applied from outside the membrane, blocked these channels in a concentration
      dependent manner. This would be expected to cause depolarization and result in
      vasoconstriction.

PMID- 1755852
TI  - Molecular cloning and nucleotide sequence of Streptomyces griseus trypsin gene.
AB  - Streptomyces griseus trypsin (E.C. 3.4.21.4) is one of the major extracellular
      proteinase, which is secreted by S. griseus. The gene encoding S. griseus trypsin
      was isolated from a S. griseus genomic library by using a synthetic
      oligonucleotide probe. Fragments containing the gene for S. griseus trypsin were
      characterized by hybridization and demonstration of proteolytic activity in S.
      lividans. Deduced amino acid sequence from the nucleotide sequence suggests that
      S. griseus trypsin is produced as a precursor, consisting of three portions; an
      amino-terminal pre sequence (32 amino acid residues), a pro sequence (4
      residues), and the mature trypsin. The S. griseus trypsin consists of 223 amino
      acids with a computed molecular weight of 23,112. The existence of proline at the
      pro and mature junction suggests that the processing of S. griseus trypsin is non
      autocatalytic.

PMID- 1755853
TI  - Inhibition of the interaction between lipoproteins and amphotericin B by some
      delivery systems.
AB  - Amphotericin B (AmB) is a potent antifungal agent used to treat patients with
      systemic mycoses. The clinical usefulness of the drug is limited by its high
      toxicity and several new less toxic formulations of AmB have been recently
      developed. In order to understand the mechanism of the decreases of toxicity
      caused by various new delivery systems, we have investigated by uv-visible
      spectroscopy the interaction of two of these formulations with human blood
      lipoproteins. The results were compared with those obtained with the commonly
      used pharmaceutical form of AmB (Fungizone). This study shows that AmB
      lipoprotein interaction is hindered when the drug is in a monomeric form and/or
      when it is included in phospholipid-surfactant micelles. In an in vivo study on
      mice it is shown here that AmB monomerized by surfactant is less toxic to animals
      than the same concentration of Fungizone, where the polyene is strongly
      aggregated. It may be concluded from the present study that the AmB species which
      is responsible for the in vivo toxicity is a complex of the antibiotic with the
      low density and the very low density blood lipoproteins and that hindering of
      this complex formation results in a decrease of AmB toxicity.

PMID- 1755854
TI  - Inhibition of farnesyl transferases from malignant and non-malignant cultured
      human lymphocytes by prenyl substrate analogues.
AB  - Cytosolic prenyl transferases from two human lymphoid tissue-derived cell lines,
      IM-9 and Molt-4 cells, are shown to isoprenylate recombinant p21H-ras.
      Isoprenylation was inhibited by an N-acetylated pentapeptide (N-Ac-Lys-Cys-Val
      Leu-Ser), c,t-farnesyl diphosphate, c,t,t-geranylgeranyl diphosphate, t,t,t
      geranylgeranyl diphosphate and a photolabile farnesyl diphosphate analogue. c,t
      Farnesyl and t,t,t-geranylgeranyl monophosphates were also effective inhibitors
      of the Molt-4 enzyme but not the IM-9 enzyme.

PMID- 1755855
TI  - Enzymatic properties of the protein encoded by newly cloned human alcohol
      dehydrogenase ADH6 gene.
AB  - Five non-allelic genes which encode five types of alcohol dehydrogenase subunits
      have been identified in humans. An additional gene (ADH6) and cDNA, whose coding
      sequences were not highly analogous to any of the known alcohol dehydrogenase
      subunits, were recently cloned (Yasunami et al., Proc. Natl. Acad. Sci. USA 88,
      7610-7614, 1991). The full-length ADH6 cDNA was expressed in the E.coli
      expression system and in the in vitro translation system of rabbit reticulocytes.
      The protein produced had its isoelectric point at pH 8.6, optimum pH at pH 10,
      and a lower Km for benzylalcohol than for ethanol and propanol. These
      characteristics are compatible to the properties of mu- or sigma-alcohol
      dehydrogenase isozyme existing in human stomach, indicating that ADH6 gene
      encodes the mu- or sigma-alcohol dehydrogenase subunit.

PMID- 1755856
TI  - Non-essentiality of cysteine and histidine residues for the activity of human
      class PI glutathione S-transferase.
AB  - In order to examine the roles of cysteine and histidine residues in the activity
      of human class Pi glutathione S-transferase (GST pi), site-directed mutagenesis
      was used to replace each of the four cysteine residues (at positions 14, 47, 101
      and 169) with serine and each of the two histidine residues (at positions 71 and
      162) with asparagine using a cDNA for the enzyme (Kano, T. et al. (1987) Cancer
      Res., 47, 5626-5630) and an E. coli expression system. The replacements of
      Cys101, Cys169, His71 and His162 did not affect the GSH-conjugating activity
      toward 1-chloro-2,4-dinitrobenzene and ethacrynic acid. On the other hand, the
      activities were partly decreased by the replacements of Cys47 and Cys14. These
      results indicated that the cysteine and histidine residues in GST pi are not
      essential for the catalytic activity, although Cys47 and Cys14 may contribute to
      some extent to the catalytic efficiency.

PMID- 1755857
TI  - Alzheimer disease paired helical filament core structures contain glycolipid.
AB  - The core structures of sodium dodecyl sulfate extracted, pronase digested paired
      helical filaments of Alzheimer disease were solubilized by heating in dimethyl
      sulfoxide. Electron microscopy revealed that after heating in dimethyl sulfoxide,
      intact paired helical filaments were no longer present in the dimethyl sulfoxide
      soluble fractions or in the insoluble lipofuscin-containing fractions. Enzyme
      linked immunosorbent assays of the various fractions with the monospecific
      antibody A128 to paired helical filaments demonstrated 96% of the
      immunoreactivity to be in the dimethyl sulfoxide soluble fraction, and only 4% in
      the dimethyl sulfoxide insoluble fractions. Lyophilization of the dimethyl
      sulfoxide soluble supernatant and resuspension in water failed to reassociate the
      paired helical filaments, but did result in an insoluble precipitate. Analysis of
      the dimethyl sulfoxide solubilized paired helical filament fraction by nuclear
      magnetic resonance revealed it to be composed of glycolipid in a form that was
      distinct from similar fractions isolated from normal aged control brains. The
      aggregation of an altered glycolipid to form paired helical filaments in
      Alzheimer disease could explain their insolubility.

PMID- 1755858
TI  - Simultaneous measurement of Ca2+ transients and of membrane depolarizations in
      synaptosomes.
AB  - Calcium and membrane potential sensitive dyes have been widely used to study the
      biochemical effects of the intracellular calcium concentration and of the
      membrane potential on diverse biochemical processes. However, due to the
      discontinuous measurement techniques applied, it was until now impossible to get
      an insight into the sequence and dynamics of the induced biological reactions. In
      order to study the relationship between the intracellular calcium concentration
      and the membrane potential, an apparatus was developed capable of measuring both
      biological processes simultaneously. Potassium chloride induced changes of the
      synaptosomal membrane potential and of the intracellular calcium concentration
      are presented.

PMID- 1755859
TI  - Changes in binding activity of luteinizing hormone receptors by site directed
      mutagenesis of potential glycosylation sites.
AB  - Site directed mutagenesis of the rat ovarian luteinizing hormone (LH) receptor
      cDNA was performed at each of the six potential N-linked glycosylation sites to
      determine the effect of putative carbohydrate chains on the activity of the
      membrane receptor. The conversion of Asn173 to Gln resulted in the total loss of
      hormone binding to the surface of the transfected cell. Mutant receptors
      synthesized with substitutions at the remaining potential N-linked glycosylation
      positions of 77, 152, 269, 277 and 291 revealed no significant change in the
      hormone affinity. However Asn77Gln and Asn152Gln exhibited significant decreases
      (approximately 80%) in the number of high affinity hormone binding sites. The
      changes in hormone binding activity upon elimination of the potential
      glycosylation sites at 77, 152 and 173 indicate the presence of functional
      carbohydrate chains at these positions in the rat ovarian LH/hCG receptor.

PMID- 1755860
TI  - The modulation of growth by HMBA in PKC overproducing HT29 colon cancer cells.
AB  - To examine whether protein kinase C (PKC) plays a role in mediating growth
      inhibitory effects of hexamethylene bisacetamide (HMBA) we compared a control H29
      colon cancer cell line to a derivative, HT29-PKC7, that overexpresses high levels
      of PKC beta 1. We found that although HMBA markedly inhibited the growth of the
      control cells, no inhibition was seen with the HT29-PKC7 cells. On the other hand
      the tumor promoter 12-0-tetradecanoyl-phorbol-13 acetate inhibited the growth of
      HT29-PKC7 cells, but no inhibition was seen with the control cells. Maximum
      inhibition of the growth of both cell lines was obtained by combined treatment
      with HMBA and TPA. These results may be relevant to the use of HMBA in
      combination with other agents in the therapy of specific cancers.

PMID- 1755861
TI  - Inhibition and enhancement of eukaryotic gene expression by potential non-B DNA
      sequences.
AB  - In a transient or constitutive expression assay we have examined the effect of
      non-B DNA sequences d(CA)40 and d(CAAAAATGCC)n on gene expression in eukaryotic
      cells. These sequences were cloned adjacent to the weak eukaryotic promoter
      (CGTATTTATTTG) and located upstream from the coding sequence of galactokinase
      enzyme. Recombinants were micro-injected in cultured cells (Chinese hamster
      fibroblasts R1610, mutant gal-K-) and expression levels have been determined. The
      alternating purine-pyrimidine tract found in d(CA)40 able to assume the Z-DNA
      conformation shows an inhibitory effect on gene expression. In addition, our
      results suggest a new potential role of Z-DNA motifs in vivo to stimulate
      recombination. The sequences d(CAAAAATGCC)n able to adopt another non-B
      structure, corresponding to curved (or bended) helix conformation, strongly
      enhance gene expression and this enhancement depends on sequence redundancy.

PMID- 1755862
TI  - Effects of epidermal growth factor and calcium omission on cholecystokinin
      stimulated Cl- conductance in rat pancreatic zymogen granules.
AB  - Evidence suggests that cholecystokinin-octapeptide (CCK-8)-induced activation of
      a Cl- conductance in the membrane of zymogen granules (ZG) is closely related to
      pancreatic enzyme secretion. Following stimulation of isolated pancreatic acinar
      cells with increasing concentrations of CCK-8, the Cl- conductance in the ZG from
      these acini increased, reached a maximum of 40 +/- 7% above basal Cl- conductance
      at 10(-12) M CCK-8, and then decreased at CCK-8 concentrations higher than 10(-9)
      M to a level comparable to the basal Cl- conductance. We had interpreted the
      inhibitory action of high CCK-8 concentrations to be due to the generation of
      high concentrations of diacylglycerol and/or its metabolites by an
      "overstimulation" of phospholipase C at supramaximal CCK-8 concentrations. We now
      show that EGF abolishes the downstroke of the dose response curve for CCK-8
      induced ZG Cl- conductance and shifts the stimulatory response to higher CCK-8
      concentrations. Similarly in a nominally "Ca(2+)-free buffer" (free [Ca2+]
      approximately 0.2 nM), stimulated Cl- conductance at 10(-12) M CCK-8 is nearly
      abolished and the decreased Cl- conductance at 10(-8) M CCK-8 is increased to the
      level of maximal stimulation at 10(-12) M CCK-8. We conclude that both EGF and
      low [Ca2+] affect CCK-8-induced ZG Cl- conductance by decreasing phospholipase C
      activity.

PMID- 1755863
TI  - Concept of VNTR alleles: comparison of apolipoprotein B 3' hypervariable region
      genotyping results obtained by three methods.
AB  - In this study the apolipoprotein B 3' hypervariable region genotyping results
      obtained by three polymerase chain reaction and gel electrophoresis -based
      methods were compared. In 43 subjects of Finnish origin three individuals had
      each one allele (3.5%) which exhibited different migration when the
      apolipoprotein B 3' hypervariable region amplification products were separated on
      nondenaturing polyacrylamide gel electrophoresis as compared to agarose or
      denaturing polyacrylamide gels. Segregation of the variantly migrating alleles
      could be demonstrated in pedigrees suggesting that the variation might be due to
      differences in the DNA sequence among alleles with same apparent size on agarose
      or denaturing polyacrylamide gels.

PMID- 1755864
TI  - Identification of the trypsin-like activity in commercial preparations of eel
      acetylcholinesterase.
AB  - Electricus electrophorus acetylcholinesterase (AChE, EC 3.1.1.7) is reported to
      possess a trypsin-like activity. We found that purification of AChE removes over
      99% of this protease activity, which resides in a single 25 kDa protein with an N
      terminal sequence identical to bovine pancreatic trypsin. Digests of
      neuropeptides using purified eel AChE or bovine pancreatic trypsin gave identical
      peptide maps. These results indicate that the commercial preparation of eel AChE
      is contaminated by a trypsin, which is difficult to remove completely during AChE
      purification.

PMID- 1755865
TI  - Endogenous nitric oxide modulates morphine-induced constipation.
AB  - Administration of morphine in mice causes inhibition of the gastrointestinal
      transit of a charcoal meal. Morphine-induced constipation in mice seems to depend
      predominantly on action(s) on the central nervous system since N-methyl morphine,
      a quaternary derivative, inhibits intestinal transit only when administered
      intracerebroventricularly (i.c.v.). L- but not D-arginine, given
      intraperitoneally, reversed the constipation induced by both morphine and its
      quaternary analogue. L-arginine was ineffective when given i.c.v. and did not
      reverse atropine-induced constipation. These results suggest that L-arginine
      preferentially modulates opioid-induced constipation through a stereospecific and
      peripheral action(s). It is possible that the effect of L-arginine is achieved by
      increasing the amount of nitric oxide released by non-adrenergic, non-cholinergic
      nerves in the gut. Thus, L-arginine may represent a useful agent for the
      treatment of undesirable constipation associated with the use of narcotic
      analgesics.

PMID- 1755866
TI  - Vascular endothelial growth factor (VEGF) induces plasminogen activators and
      plasminogen activator inhibitor-1 in microvascular endothelial cells.
AB  - Extracellular proteolysis is believed to be an essential component of the
      angiogenic process. The effects of VEGF, a recently described angiogenic factor,
      were assessed on PA activity and PA and PAI-1 mRNA levels in microvascular
      endothelial cells. u-PA and t-PA activity were increased by VEGF in a dose
      dependent manner, with maximal induction at 30 ng/ml. u-PA and t-PA mRNAs were
      increased 7.5- and 8-fold respectively after 15 hours, and PAI-1 mRNA 4.5-fold
      after 4 hours exposure to VEGF. At equimolar concentrations (0.5 nM), VEGF was a
      more potent inducer of t-PA mRNA than bFGF, while bFGF was a more potent inducer
      of u-PA and PAI-1 mRNAs. In addition, VEGF induced u-PA and PAI-1 mRNAs with
      kinetics similar to those previously demonstrated for bFGF. These results
      demonstrate the regulation of PA and PAI-1 production by VEGF in microvascular
      endothelial cells and are in accord with the hypothesis that extracellular
      proteolysis, appropriately balanced by protease inhibitors, is required for
      normal capillary morphogenesis.

PMID- 1755867
TI  - Hydrogen bonds involving sulfur atoms in proteins.
AB  - Intrachain hydrogen bonds are a hallmark of globular proteins. Traditionally,
      these involve oxygen and nitrogen atoms. The electronic structure of sulfur is
      compatible with hydrogen bond formation as well. We surveyed a set of 85 high
      resolution protein structures in order to evaluate the prevalence and geometry of
      sulfur-containing hydrogen bonds. This information should be of interest to
      experimentalists and theoreticians interested in protein structure and protein
      engineering.

PMID- 1755868
TI  - Ocular effects of the endothelins. Abundant peptides in the eye.
AB  - Endothelins (ETs) are a family of potent vasoactive peptides present in the eye.
      In the rabbit eye, both ET-1 and ET-3 are present in high concentrations in the
      iris and ciliary body and in lower concentrations elsewhere. Forty-eight hours
      after injection of 2.5 micrograms of ET-1 and ET-3 into the anterior vitreous of
      conscious rabbits, intraocular pressure was reduced by 43% and 45%, respectively,
      and did not return to normal for at least 5 days. The decrease in intraocular
      pressure was not due to increased aqueous outflow and was not prevented by
      pretreatment with indomethacin. Injection of either ET-1 or ET-3 (2.5 to 10
      micrograms) into the anterior chamber or posterior vitreous cavity resulted in
      marked vasoconstriction, which was initiated within seconds and persisted for
      greater than 4 hours. Both endothelins potently constricted the pupil when added
      to freshly excised rabbit anterior segments. Endothelins are therefore potential
      participants in the local regulation of intraocular pressure, ocular blood vessel
      tone, and iris smooth muscle tone and may be important mediators in ocular
      pathologic conditions. Endothelins at pharmacologic doses may be useful in the
      control of intraocular pressure or blood flow.

PMID- 1755869
TI  - Impairment of mitochondrial transcription termination by a point mutation
      associated with the MELAS subgroup of mitochondrial encephalomyopathies.
AB  - Defects in mitochondrial DNA (mtDNA) are associated with several different human
      diseases, including the mitochondrial encephalomyopathies. The mutations include
      deletions but also duplications and point mutations. Individuals with MELAS
      (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like
      episodes) carry a common A-to-G substitution in a highly conserved portion of the
      gene for transfer RNA(Leu(UUR)). Although the MELAS mutation may be comparable to
      the defect in the tRNA(Lys) gene associated with MERRF (myoclonus epilepsy
      associated with ragged-red fibres), it is also embedded in the middle of a
      tridecamer sequence necessary for the formation of the 3' ends of 16S ribosomal
      RNA in vitro. We found that the MELAS mutation results in severe impairment of
      16S rRNA transcription termination, which correlates with a reduced affinity of
      the partially purified termination protein for the MELAS template. This suggests
      that the molecular defect in MELAS is the inability to produce the correct type
      and quantity of rRNA relative to other mitochondrial gene products.

PMID- 1755870
TI  - Perceptions of weight and attitudes toward eating in early adolescent girls.
AB  - Sixth grade girls (n = 206) responded to questions about their weight, body
      image, dieting practices, and attitudes toward weight and eating. Results
      suggested that feeling too fat and wishing to lose weight were becoming normative
      for young adolescent girls in that the majority of girls wished to weigh less and
      said that they dieted at least occasionally. For most girls, weight concerns had
      emerged between the ages of 9 to 11. A sizeable proportion of girls seemed to
      have adopted a "dieting mentality," claiming to be avoiding fat, counting
      calories, thinking excessively about food, feeling guilty after eating and
      overeating, and exercising to lose weight. Such practices were common even among
      girls who did not describe themselves as overweight or who were satisfied with
      their appearance. The emergence of these attitudes and behaviors at increasingly
      younger ages is of grave concern, as several of them are risk factors for the
      development of serious eating disorders.

PMID- 1755871
TI  - Leber's hereditary optic neuropathy and Kearns-Sayre syndrome: mitochondrial DNA
      mutations.
AB  - Mitochondrial DNA (mt DNA) supplies extranuclear (cytoplasmic) genes which
      program the manufacture of 13 of the 67 peptides of the mitochondrial respiratory
      enzymes. The remaining 54 are coded by nuclear DNA. All human children and
      adults, male and female, are entirely dependent on the cytoplasm of the ovum for
      their complement of mt DNA; the sperm contributes none. Accordingly, mutations in
      the mt DNA in a mother's ova will be passed on to all her children, although not
      all are clinically affected. Leber's hereditary optic neuropathy is in most cases
      due to a mutation that leads to the replacement of guanine by adenine at position
      11778 in mt DNA. This causes histidine to be inserted instead of the normal
      arginine at the site of the 340th amino acid in the respiratory enzyme NADH
      subunit 4, hence its defective function. Other point mutations in the mt DNA
      coding for polypeptides of the respiratory chain complex or controlling sequences
      coded by mt DNA have been found in other families with Leber's hereditary optic
      neuropathy. Mitochondrial DNA is the site of other mutations as well. For
      ophthalmologists, the most important of these is the rare Kearns-Sayre syndrome
      (pigmentary retinopathy plus muscular dystrophies, especially of the extraocular
      muscles). Kearns-Sayre syndrome is due to deletions in the mt DNA, which vary in
      size and so affect a number of different respiratory enzymes, hence the variable
      manifestations. Cases are usually sporadic because the disease is often so severe
      that affected individuals do not reproduce if they survive, but in some cases
      inheritance from the mother has been reported.

PMID- 1755872
TI  - Endometriosis: will the real natural history please stand up?

PMID- 1755873
TI  - Levels of sexual activity among adolescent males in the United States.
AB  - Although three-fifths of adolescent males aged 15-19 say they have had sexual
      intercourse, analyses of data from the 1988 National Survey of Adolescent Males
      indicate that their level of sexual activity is relatively moderate. The data
      show that among sexually experienced young men the mean number of partners in the
      last 12 months is 1.9, and the mean frequency of intercourse in the last four
      weeks is 2.7 times. Black males have had more partners than white or Hispanic
      males; however, after the number of years since first intercourse are controlled
      for, these differences disappear. On average, sexually experienced youth spent
      six out of the last 12 months with no sexual partner, and only 21 percent of
      sexually active males had more than one partner in any month in the last year.
      Comparisons with 1979 data suggest that proportionately more adolescents were
      sexually experienced in 1988, but fewer non-black males had first intercourse
      before their 15th birthday. The number of partners since first intercourse and in
      the past four weeks appears to have decreased, as has the frequency of
      intercourse in the last four weeks.

PMID- 1755874
TI  - AAEM minimonograph #36: basic concepts of electricity and electronics in clinical
      electromyography.
AB  - Fundamental principles of electricity provide a basis for understanding the
      design and operation of electromyography equipment. An intuitive and quantitative
      explanation of charge, voltage, current, and impedance provides an introduction
      to the concepts of resistance, capacitance, and input impedance. These concepts
      form the basis for discussion of filters, amplifiers, electrodes, digital
      electronics, stimulators, and patient safety. The monograph assumes no
      specialized training in engineering or mathematics. The topics are discussed at
      an introductory level to provide understanding for readers with no electronics
      background and intuitive insight for more experienced readers.

PMID- 1755875
TI  - Cancer risk and behavior change.

PMID- 1755876
TI  - Adolescent smokers seen in general practice: health, lifestyle, physical
      measurements, and response to antismoking advice.
AB  - OBJECTIVE: To compare physical, lifestyle, and health characteristics of
      adolescent smokers and non-smokers and their initial response to anti-smoking
      counselling. DESIGN: Adolescents aged 13, 15, and 17 years were identified from
      age-sex registers and invited by letter for a general practice health check.
      SETTING: Three general practices in the MRC general practice research framework.
      MAIN OUTCOME MEASURES: Blood pressure, body mass index, saliva cotinine
      concentration, peak flow rate, alcohol consumption, exercise, duration of sleep,
      and stated persistent health problems. RESULTS: 73% of the adolescents (491)
      attended for the health check. A total of 68 (14%) were regular smokers. By age
      17 those who smoked regularly had a significantly lower systolic blood pressure
      than those who had never smoked regularly (by 6 mm Hg; p = 0.025) despite a
      significantly higher body mass index (by 1.5; p <0.001) [corrected]. Cotinine
      concentrations increased with smoking exposure, from 0.7 ng/ml when no family
      member smoked to 155 ng/ml in active smokers of six or more cigarettes a week.
      Significantly more regular smokers than never regular smokers drank greater than
      or equal to 8 g alcohol a day (chi 2 = 15.2 adjusted for age and sex p less than
      0.001); regular smokers exercised less (1.0 hrs/week in boys and 0.8 hrs/week in
      girls v 3.4 hrs/week in boys and 2.2 hrs/week in girls; p less than 0.001) and
      slept less (8.0 hrs/night v 8.5 hrs/night at age 17; p less than 0.005).
      Persistent health problems, mostly asthma or allergic symptoms, were reported by
      25% (17/68) of the smokers and 16% (60/381) of the non-smokers. Of the smokers
      given counselling, 60% (26/43) made an agreement with the practice doctor or
      nurse to give up smoking. CONCLUSION: General practice is an appropriate setting
      for adolescents to receive advice on healthy lifestyle, which should not focus
      solely on smoking.

PMID- 1755877
TI  - Gender recognition from speech. Part II: Fine analysis.
AB  - The purpose of this research was to investigate the potential effectiveness of
      digital speech processing and pattern recognition techniques for the automatic
      recognition of gender from speech. In part I Coarse Analysis [K. Wu and D. G.
      Childers, J. Acoust. Soc. Am. 90, 1828-1840 (1991)] various feature vectors and
      distance measures were examined to determine their appropriateness for
      recognizing a speaker's gender from vowels, unvoiced fricatives, and voiced
      fricatives. One recognition scheme based on feature vectors extracted from vowels
      achieved 100% correct recognition of the speaker's gender using a database of 52
      speakers (27 male and 25 female). In this paper a detailed, fine analysis of the
      characteristics of vowels is performed, including formant frequencies,
      bandwidths, and amplitudes, as well as speaker fundamental frequency of voicing.
      The fine analysis used a pitch synchronous closed-phase analysis technique.
      Detailed formant features, including frequencies, bandwidths, and amplitudes,
      were extracted by a closed-phase weighted recursive least-squares method that
      employed a variable forgetting factor, i.e., WRLS-VFF. The electroglottograph
      signal was used to locate the closed-phase portion of the speech signal. A two
      way statistical analysis of variance (ANOVA) was performed to test the
      differences between gender features. The relative importance of grouped vowel
      features was evaluated by a pattern recognition approach. Numerous interesting
      results were obtained, including the fact that the second formant frequency was a
      slightly better recognizer of gender than fundamental frequency, giving 98.1%
      versus 96.2% correct recognition, respectively. The statistical tests indicated
      that the spectra for female speakers had a steeper slope (or tilt) than that for
      males. The results suggest that redundant gender information was imbedded in the
      fundamental frequency and vocal tract resonance characteristics. The feature
      vectors for female voices were observed to have higher within-group variations
      than those for male voices. The data in this study were also used to replicate
      portions of the Peterson and Barney [J. Acoust. Soc. Am. 24, 175-184 (1952)]
      study of vowels for male and female speakers.

PMID- 1755878
TI  - Combination of binaural information across frequency bands.
AB  - Perceptual grouping of the frequency components from a source into a single
      auditory object is needed when localizing a complex sound in an environment where
      other sounds are also present. Two acoustic regularities that might allow for
      such grouping are a harmonic relation among the components and a commonality of
      their spatial positions. The utility of these cues was examined in a forced
      choice psychophysical task by measuring sensitivity to interaural differences of
      time (IDT) for low-frequency stimuli presented via earphones. In the first
      experiment, stimuli were composed of either one, two, or three frequencies. A
      signal detection analysis used to predict the effects of combining information
      across frequencies found summation to be optimal, regardless of the harmonicity
      of the complex. A second experiment presented two-frequency complexes in which
      one tone, the target, contained the IDT to be detected while the other, the
      distractor, was constant across all three intervals of the forced choice. For
      inharmonic complexes, performance for the target-distractor combinations was
      equivalent to that found for targets presented alone, suggesting segregation of
      the targets and distractors into separate auditory objects. However, for harmonic
      target-distractor combinations, performance was diminished. A signal detection
      analysis of these data supports the idea that for purposes of lateralization, the
      interaural information in the targets and distractors was combined into a
      variance-weighted value, even though it meant a lowering of performance. Thus it
      seems that for the grouping of complex acoustic stimuli in space, harmonic
      structure is more important than commonality of spatial position.

PMID- 1755879
TI  - Brain aging and Alzheimer's disease, "wear and tear" versus "use it or lose it".
AB  - In organs other than the brain, cell activation seems to increase "wear and
      tear," e.g., by increased free-radical formation, and so to cause an increased
      rate of aging. However, activation of nerve cells within the physiological range
      seems to lead to maintenance of neurons during aging and in Alzheimer's disease,
      possibly by preferentially stimulating the action of protective mechanisms such
      as DNA repair. This "use it or lose it" principle might explain why certain
      neurons degenerate in aging or Alzheimer's disease while others do not, and why
      recovery of various neuronal systems during aging has been obtained by
      restoration of the missing stimulus. Consequently, neuronal activation might
      provide a means of prolonging its optimal function for the full length of our
      natural life span.

PMID- 1755880
TI  - Blood lactate and mixed venous-arterial PCO2 gradient as indices of poor
      peripheral perfusion following cardiopulmonary bypass surgery.
AB  - Conventional indices of tissue perfusion after surgery involving cardiopulmonary
      bypass (CPB) may not accurately reflect disordered cell metabolism. Venous
      hypercarbia leading to an increased veno-arterial difference in CO2 tensions (V
      aCO2 gradient) has been shown to reflect critical reductions in systemic and
      pulmonary blood flow that occur during cardiorespiratory arrest and septic shock.
      We therefore measured plasma lactate levels and V-aCO2 gradients in 10 patients
      (mean age 57.2 years) following CPB and compared them with conventional indices
      of tissue perfusion. Plasma lactate levels, cardiac index (CI) and oxygen uptake
      (VO2) all increased significantly (p less than 0.05 vs baseline levels) up to 3 h
      following surgery. Oxygen delivery (DO2) did not change. Plasma lactate levels
      correlated significantly with CI (r = 0.47, p less than 0.01). V-aCO2 fell
      significantly with time (p less than 0.01 vs baseline). There was an inverse
      relationship between V-aCO2 and cardiac index and V-aCO2 and lactate (r = -0.37,
      p less than 0.05; r = -0.3, p less than 0.05 respectively). We conclude that
      blood lactate, CI and VO2 increase progressively following CPB. An increase in
      lactate was associated with a decrease in V-aCO2. An increase in V-aCO2 was not
      therefore associated with evidence of inadequate tissue perfusion as indicated by
      an increased blood lactate concentration.

PMID- 1755881
TI  - The role of arthroscopic debridement after anterior cruciate ligament
      reconstruction.
AB  - This retrospective study included 55 patients who had prior anterior cruciate
      ligament (ACL) reconstruction; 30 made up the experimental group who had
      arthroscopic debridement of impinging soft tissue and 25, who did not have a
      second-look arthroscopy, were used as controls. Impinging tissue was not
      necessarily the primary reason for arthroscopy in the experimental group. Only
      nine patients (30%) were debrided solely because of anterior symptoms suggestive
      of soft tissue impingement; 16 (53%) underwent arthroscopy primarily to assess
      meniscal repairs; five (17%) were done in conjunction with hardware removal. Both
      groups were evaluated for pain, crepitation, and anterior laxity at three
      specific times. Debridement reduced crepitation from 35% to 8% in patients with
      moderate crepitus, and from 50% to 38% in patients with mild symptoms. The
      percentage of patients without crepitation increased from 15% to 54% by final
      follow-up. Predebridement, 14% of patients had moderate pain, and 53% mild pain.
      By final follow-up, 38% had mild pain and 62% were pain free. Patients benefitted
      from debridement regardless of method of ACL reconstruction. Arthroscopic
      debridement did not increase anterior knee translation. Both groups gained
      extension and had improved activity levels with the passage of time from ACL
      surgery.

PMID- 1755882
TI  - Anterior cruciate ligament reconstruction without drill holes.
AB  - Anterior cruciate ligament (ACL) reconstruction in adolescents with open physes
      remains a difficult problem for the orthopedic surgeon, especially in view of
      growing teenage participation in contact sports. Traditionally, treatment of ACL
      tears in adolescents has been conservative; the patient is advised to delay
      surgery up to several years for fear of damaging physes by drilling holes across
      them. Unfortunately, this waiting period may inflict irreparable knee damage.
      This paper suggests an ACL reconstruction technique that utilizes no drill holes,
      thus causing no harm to physes or other essential knee structures. A graft
      consisting of semitendinosus and gracilis (SG) tendons is passed under the
      anterior horn of the medial meniscus through the knee joint, then brought out
      through the posterior capsule and secured to the lateral femoral metaphysis. The
      graft is augmented with an iliotibial band tenodesis. Designed primarily but not
      exclusively for teenagers with open physes, the procedure has produced
      encouraging results thus far in a small series.

PMID- 1755883
TI  - Role of arthroscopy in osteoarthritis of the knee.
AB  - We compared arthroscopic partial menisectomy with limited debridement versus
      arthroscopic abrasion arthroplasty in patients with osteoarthritis. Group I
      consisted of 131 knees in 131 patients treated by partial meniscectomy and
      debridement of loose articular cartilage or removal of loose bodies. All patients
      had grade 3 or 4 chondromalacia in the affected compartment. The patients were
      followed for a mean of 3 +/- 1 years. Group II consisted of 28 knees in 28
      patients treated by debridement with abrasion arthroplasty of exposed bone. The
      mean age of this group of patients was 63 years and they were followed for a mean
      of 3.8 years. The Group I patients noted 80% improvement by 1 year but this fell
      to 67% by 5 years after meniscectomy. Overall, 104 were improved, 16 unchanged,
      and 15 worse at the time of last evaluation compared to their preoperative
      status. In the Group II patients, 11 were improved, 8 unchanged, and 9 worse.
      Fifty percent of Group II subsequently underwent a total knee arthroplasty for
      salvage at a mean of 3 years following the abrasion procedure. Abrasion
      arthroplasty appears to offer little benefit over partial meniscectomy and
      debridement in the degenerative knee. Results of abrasion arthroplasty are
      unpredictable.

PMID- 1755884
TI  - The effect of intra-articular instillation of bupivacaine on postarthroscopic
      morbidity: a placebo-controlled, double-blind trial.
AB  - Forty patients undergoing diagnostic arthroscopy of the knee were included in a
      randomized double-blind study to investigate the effect of bupivacaine on
      postarthroscopic morbidity. The arthroscopies were performed under local
      anesthesia using 1% lidocaine with adrenaline. At the conclusion of the
      arthroscopic examination, 10 ml 0.5% bupivacaine with adrenaline or 10 ml placebo
      was instilled and left in the joint cavity. The two groups of patients were
      compared with regard to postarthroscopic duration of the anesthesia, degree of
      postarthroscopic pain, number of analgesic tablets taken, need for crutches or
      other walking aids, and days away from work. There was no difference between the
      patients receiving bupivacaine and patients receiving placebo for any of the
      parameters investigated.

PMID- 1755885
TI  - A new technique of harvesting patellar tendon autografts for anterior cruciate
      ligament reconstruction.
AB  - A new surgical technique to uniformly harvest the middle one-third of the
      patellar tendon for anterior cruciate ligament reconstruction is described. The
      technique uses a guide system of 8 templates of varying widths to guide the saw
      cuts and "collared," depth-controlled saw blades and drill bits to produce a
      standard cutting and drilling depth. This kind of template system lessens the
      risks of graft harvesting complications such as patella fracture, bone graft
      fragmentation, suture pull out, and judgment errors pertaining to graft depth,
      length, or width. The Patellar Tendon Graft Guide was used to obtain a patellar
      tendon graft in 65 patients. Fifty-nine arthroscopic-assisted and 6 open anterior
      cruciate ligament reconstructions were performed. Of the 65 grafts harvested, 63
      consistently demonstrated bone portions 20 mm in length, 7 mm in depth, and a
      width corresponding to the template chosen (usually 10 mm). Two grafts supposed
      to be 10 mm in width turned out to be 9 mm in width because of a technique
      related problem.

PMID- 1755886
TI  - The value of high resolution CT in the diagnosis of meniscal lesions of the knee.
AB  - We report on 50 patients who had meniscal pathology and were given computed
      tomographic (CT) scans. Our diagnostic accuracy was approximately 92%. We believe
      that CT is a good method of screening these patients prior to using a much more
      expensive method, such as magnetic resonance imaging or diagnostic arthroscopy.

PMID- 1755887
TI  - Simple bone cyst of the distal tibia: a case for ankle arthroscopy.
AB  - Intraarticular ankle anatomy may be better visualized arthroscopically than with
      an arthrotomy. Ankle arthroscopy was crucial in locating a simple bone cyst and
      directing therapeutic curettage of the lesion.

PMID- 1755888
TI  - A fracture of the intercondylar eminence of the tibia treated by arthroscopic
      fixation.
AB  - A fracture of the intercondylar eminence of the tibia in a 27-year-old woman was
      treated arthroscopically, using the Acufex (Acufex Microsurgical, Inc., U.S.A.)
      drill guide system for anterior cruciate ligament reconstructions. An adequate
      fixation was achieved, and an arthrotomy was avoided. The patient recovered
      quickly, with no residual symptoms. We recommend performing an arthroscopy in
      every patient with a fracture of the intercondylar eminence. The fracture can be
      treated arthroscopically by rigid internal fixation, while at the same time
      treating possible associated lesions.

PMID- 1755889
TI  - A solution for arthroscope misting.
AB  - A prospective study was undertaken to compare the incidence of arthroscope
      eyepiece misting in two groups of patients. In one group the irrigation fluid was
      at room temperature and in the other group the fluid was warmed to body
      temperature. Arthroscope eyepiece misting was eliminated when irrigation fluid at
      body temperature was used.

PMID- 1755890
TI  - Arthroscopy--an orthopaedic surgical subspecialty or a technique?

PMID- 1755891
TI  - Lasers in arthroscopic surgery.

PMID- 1755892
TI  - Endoscopic release of carpal ligaments.

PMID- 1755893
TI  - Electrocautery.

PMID- 1755894
TI  - Knee arthroscopy and local anesthesia.

PMID- 1755895
TI  - [Interventional angiography in the ENT field].
AB  - Development of new micro catheters and digital technique of angiography today
      allows a superselective angiography of small vessels of the external carotid
      artery. Therapeutical and diagnostical possibilities for ENT will be discussed.

PMID- 1755896
TI  - [Protection for noise-induced hearing loss using active hearing protection
      systems].
AB  - Though noise induced hearing loss is no longer the most frequent occupational
      disease in the Federal Republic of Germany, the environmental pollution by the
      product "noise" in our technical and industrialized world has not been reduced.
      On the contrary, the situation is worsened by the rising influence of leisure
      noise. To avoid occupational hearing loss, the "Noise Injury Prevention Code"
      issued by the insurers would demand wearing personal ear protection, e.g. ear
      plugs, if ambient noise levels are above 85 dB(A). But there are working places
      in which such equipment would have precisely the adverse effect, because one of
      the reasons for possible damage to hearing is radio communication. In military
      aircraft cockpits for example noise exposure measurements showed ambient noise
      levels above 90 dB(A) during regular flight service nearly all the time. To be
      able to understand radio traffic in spite of the noisy environment, the headphone
      volume must be raised above the noise of the engines. The use of ear plugs can
      only be of limited value. Whereas pilots with normal hearing show only little
      impairment of speech intelligibility, those with noise-induced hearing losses
      show substantial impairment that varies in proportion to their hearing loss.
      Communication abilities may be drastically reduced which may compromise the
      reliability of radio traffic. To avoid compromising air security one has to
      demand a noise protection system which allows to reduce ambient noise levels
      without disturbing speech intelligibility in the inevitable radio communication.
      Nowadays active noise cancelling (ANC) systems by electronic compensation in
      different ways provide effective protection against noise induced hearing
      loss.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755897
TI  - [Experiences with high-frequency hearing tests in the selection of personnel for
      noise occupations].
AB  - A total of 181 persons aged between 16 and 18 were checked fully audiometrically
      (conventional and high-frequency audiogram). Dates of history about hereditary
      hearing damage, own ear diseases, noise exposure during frequent visits to
      discothecs or usage of Walkman etc. were ascertained by questionnaires. The
      evaluation of the results was carried out with the help of discrimination
      analysis allowing a multi-dimensional classification. As a result there could be
      made a sure discrimination analytic separation in persons with ear diseases
      during their childhood, when the high frequencies from 10 to 15 kHz were taken
      in. Thus the damage of the inner ear was to be found mainly on the base of the
      cochlea. Also in cases of hereditary influence there was to be seen a clear
      deminution in the high frequency area. The group of persons, who regularly went
      to discos (more than three times a month) as well as the group often using
      Walkman revealed a sure separation, when the high frequencies above 8 kHz were
      considered in the calculation. Altogether there could be seen an early damage
      more clearly in the high frequency area after ear diseases in childhood as well
      as a result of sound overloading than in conventional hearing area.

PMID- 1755898
TI  - [Functional dysphonia following cervical spine injuries].
AB  - After a head or a cervical injury dysphonia and its accompanying globus syndrome
      are often ignored, even if the existence of these traumatic sequelae are
      repeatedly reported. Till now there is no coherent idea about their pathogenesis,
      wherefore in the individual case wide differences exist in the diagnosis,
      treatment and in the expert opinion. It could be shown in this paper, that a
      posttraumatic dysphonia, due to a minor trauma, is a well defined disease with an
      uniform pathogenesis. The diagnosis results from the typical anamnesis of the
      accident, from the prove of the functional dysphonia and last not least from the
      prove of a functional deficit of the cervical spine, especially in the height of
      C 2/3. The right diagnosis allows a causal treatment and enables a just expert
      opinion.

PMID- 1755899
TI  - [Vertebrogenic dysphagia in diffuse idiopathic skeletal hyperostosis (Forestier's
      disease)].
AB  - Swallowing disorders can be caused by morphologic changes of the cervical spine
      such as diffuse idiopathic skeletal hyperostosis. The paper describes current
      concepts of this clinical entity also known as Forestier's disease. The
      symptomatology, radiographic features and treatment are discussed. Particular
      interest is focused on dysphagia. The diagnosis is exclusively radiographic.
      Cervical osteophytes can be detected in 20-30% of the population in asymptomatic
      patients. Therefore, the attribution of the presence of osteophytic deformities
      of the barium column to dysphagia should not be made unless objective evidence of
      impairment of pharyngeal function such as abnormal posterior pharyngeal wall
      motion is proven by dynamic imaging means. The therapeutic approach depends on
      the extent of dysphagic complaints. Indications for surgery are failure to
      respond to conservative management (anti-inflammatory drugs, concomitant
      antibiotics, dietary nutrition). The anterolateral extrapharyngeal approach is
      commonly preferred.

PMID- 1755900
TI  - [Frequency dependence of the SISI test.(short increment sensitivity index).
      Clinical examples].
AB  - Experimental data on the influence of test frequency on the SISI-score are
      controversial. Comparability is limited by the diversity of experimental
      conditions. In a series of cases of pancochlear sudden hearing loss SISI-scores
      at 0.5 kHz and 3 kHz were compared. Some examples show that the sensitivity of
      the SISI-test at 0.5 kHz is much lower to that at 3 kHz. Low SISI-scores, of
      little evidence per se, have to be considered very critically in the low pitch
      range.

PMID- 1755901
TI  - [In-situ measurement as necessary component of hearing aid fitting].
AB  - The most important ear simulator measurement methods like 2-cm3 coupler,
      Zwislocki coupler, KEMAR were outlined. The disadvantages of these measurement
      methods were listed. So the ear simulator methods not take into account the
      individual anatomic conditions like the residual volume between the earmold and
      the eardrum, the impedance of the middle ear and the outer ear resonance. The
      influence on the sound pressure level in front of the eardrum caused by
      modifications of ear molds as another very important part of the hearing aid
      fitting, can not be assessed by measurement far away from the patients ear. All
      these individually varying factors only can be integrated into the hearing aid
      fitting by real ear measurement in front of the eardrum.

PMID- 1755902
TI  - [A new implant system in head and neck surgery].
AB  - Defects in the head and neck region following extensive tumor removal are
      sometimes difficult to reconstruct by local or free flaps. An epithesis is a
      recommended alternative in defects of the ear, the nose or the orbital region.
      Nevertheless problems may arise in the appropriate fixation of the epithesis.
      With the intermobile-cylinder-implant-system (IMZ), the epithesis is firmly fixed
      by means of osseointegration of the implants and an abutment in the area of the
      defect. The various steps of the operation and clinical applications are
      presented.

PMID- 1755903
TI  - [Immunological reactions against preserved tracheal transplants? Studies on
      inbred rat strains].
AB  - To determine whether chemical (cialit, merthiolate, alcohol, formaldehyde
      solution) preserved tracheal segments maintain immunogenicity we performed
      systematic transplantation-immunological investigations using in vivo-, in vitro-
      and immunohistological tests. In contrast to other authors no indication of
      residual antigenicity was found. The survival rates after orthotopic grafting of
      preserved tracheal segments were shortened. This seems due to the loss of the
      mucociliary clearance, caused by chemical induced damages in the tracheal mucosa.

PMID- 1755904
TI  - [Evaluation of transitory evoked otoacoustic emissions in children with impaired
      tubal ventilation].
AB  - Transient evoked otoacoustic emission (TEOAE) has proven to be a useful clinical
      screening test for auditory dysfunction. Problems concerning the evaluation are
      mainly due to irregularities of the physiological middle ear functions. In this
      study different degrees of middle ear alterations of otherwise normal-hearing
      children were quantified by means of tympanometry, otoscopy and pure-tone
      audiometry and then related to the results of TEOAE registration which were
      classified by the coefficient of the crosscorrelation and the frequency response
      spectrum. Data were obtained from 266 ears of 148 children between the age of 3
      months and 11 years. The results indicate that even slight middle ear
      irregularities, e.g. negative pressure between -50 and -100 mm H2O, can reduce
      the rate of successfully recorded TEOAE from 95% (70/74) in the normal group to
      78% (34/47). When children displayed a tympanogramm with no observable peak, a
      successful registration of TEOAE was possible in only 12% (n = 34) of the cases.
      Such results are related to serous or mucoid effusions which probably prevent a
      transmission of the emission from the cochlea to the meatus. In analysing the
      relation between conductive losses in pure-tone audiometry and TEOAE it was
      demonstrated that no TEOAE could be recorded in ears with a conductive loss above
      20 dB HL. Where the conductive loss is smaller than 20 dB HL it is not possible
      to predict whether a reliable emission can be recorded or not. This study
      emphasizes the need to reexamine children who do not show positive emissions
      connected with middle ear imbalances.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1755905
TI  - [Management of cochlear implants in children--methods and results].
AB  - Selection criteria, basic principles of auditory training, development of an
      auditory test battery for children and results of 15 children between 4 and 14
      years are presented and discussed. To summarize, results range from acoustic
      attention to tones and sounds and recognition of environmental sounds to the use
      of supra-segmental and segmental features of speech. Some children are able to
      recognize words and phrases from a closed list. One of the children has
      postlingual deafness and has had also a very short duration of deafness before
      implantation. This child shows better results than the pre and perilingually deaf
      children. Because of the fact that the patient group is small and there are also
      many intervening variables like age, duration of deafness and use of two
      different test instruments, it is difficult to find a relationship between the
      results and all other variables. The auditory test battery for children, which
      consists of seven subtests, measuring acoustic orientation and auditory speech
      perception on different linguistic levels, is much more suitable for the
      evaluation of auditory performance for this age group than the auditory test
      battery for adults (Eisenwort and Burian 1988).

PMID- 1755906
TI  - [Sudden deafness. A clinical analysis with special reference to tympanoscopy].
AB  - From a total of 720 patients with acute deafness, 85 patients suffered from
      unilateral deafness with a hearing loss of at least 80 dB in the speech frequency
      range. Under conservative therapy in 58 patients, there was an improvement in
      hearing in 19 cases and a return to normal in 6 patients. In 27 patients, the
      clinical history was suggestive of a possible tympanic membrane rupture, which
      was confirmed by tympanoscopy in 5 cases. On 5 other occasions, the
      intraoperative findings were highly suggestive of tympanic membrane rupture. In
      each case, a membranoplasty was performed. The results of operative therapy
      tended to give better results than conservative therapy. The presence of
      concomitant vestibular disorders did not influence the results of treatment in
      either group. The results of the study show, that apart from tympanoscopy, there
      are no other diagnostic criteria to recognize a membrane rupture. Typical case
      histories demonstrate that tympanoscopy can be useful diagnostic and therapeutic
      measure in cases of therapy-resistant deafness.

PMID- 1755907
TI  - [Dysphagia as initial symptom in tetanus. A case report].
AB  - A 69-year-old woman was examined because of progressive dysphagie. A barium
      esophagogram showed no obstruction but a swallowing in trachea suggested a
      neuromuscular disorder. ENT examination showed no specific signs of infection.
      The clinical diagnosis of tetanus was confirmed by electromyography. This case
      demonstrates an uncommon cause of dysphagia where the classical signs of tetanus
      in the early stages of this disease were absent and dysphagia was the initial and
      sole presenting symptom.

PMID- 1755908
TI  - [Otoplasty using the CO2 laser].

PMID- 1755909
TI  - [Endoscopically-controlled endonasal orbital decompression in malignant
      exophthalmos].
AB  - In 6 patients with endocrine ophthalmopathy, indications, surgical technique and
      results of the endoscopic controlled endonasal orbital decompression are
      described in comparison to the common surgical procedures. When medical and
      radiation therapy fail, indications for decompression are a) loss of visual
      acuity or visual field defects, b) increasing strabismus, c) severe keratopathy
      due to eyelid retraction. The endoscopic-controlled endonasal surgical
      decompression technique is proceeded in three steps. First, an endonasal
      ethmoidectomy with resection of the middle turbinate is performed and the medial
      wall of the maxillary sinus is widely opened. Second, the medial and inferior
      wall of the orbital walls are removed, preserving the infraorbital nerve. In the
      last step, the periorbital area is incised and the orbital fat herniates. The
      advantages of this procedure consist in the absence of exterior scars and the
      known morbidity of a Caldwell-Luc antrotomy. The results were documented by
      computed tomographic scans (CT), magnetic resonance imaging (MRI), Hertel
      measurements, evaluation of ocular motility and ophthalmoscopy. An average of 3-4
      mm improvement in Hertel-measurements could be reached. All patients had a
      postoperative improvement of visual acuity. 2 patients developed more significant
      diplopia postoperatively, whereas in all other patients ocular motility either
      improved or rested unaffected. Therefore, the endoscopic controlled endonasal
      procedure allows to obtain comparable results to the common extranasal and
      transantral procedures without the disadvantages of the latter.

PMID- 1755910
TI  - [Preservation of hearing and facial nerve function in surgery for acoustic
      neuroma].
AB  - The results concerning the preservation of hearing and facial nerve function in
      71 patients with 74 acoustic neuromas operated on from 1979 to 1990 are
      presented. All patients have been operated on in half-sitting position by one
      surgeon using the suboccipital-transmeatal approach. Postoperative facial nerve
      function was good (House degree I or degrees II) in 42/73 patients (58%),
      moderate (House degrees III or degrees IV) in 13/37 (18%), and poor (House
      degrees V or degrees VI) in 18/73 (24%). Preservation of useful hearing was
      achieved in 17%. The smaller the tumour and the easier the preparation the better
      was the functional result. Beside anatomic integrity of nerves and endolymphatic
      system the internal auditory artery as the most important vessel for the inner
      ear blood supply should be respected. The cochlear nerve intact in 47 patients we
      only found one case with recurrent tumour in a patient with neurofibromatosis 2.
      Preservation of the cochlear nerve did not have an increased risk of tumour
      recurrence in our group of patients.

PMID- 1755911
TI  - [Pulsatile tinnitus. Causes, diagnostic procedures, case presentation].
AB  - The pulsatile tinnitus is a rare sign. It is characterised by a rhythmic sound
      that is synchronous with the patient's heart beat. The underlying causes vary
      widely and may be life-threatening. Pulsatile tinnitus may be due to cardiac or
      vascular malformation, metabolic disorders, hyperdynamic circulatory states,
      elevated intracranial pressure, and tumours. The diagnostic evaluation includes
      physical examination, audiologic assessment and often computed image processing
      for precise topodiagnosis. A case report illustrates our current management of
      patients with pulsatile tinnitus.

PMID- 1755912
TI  - [Sensitization against storage mites in allergic rhinopathy].
AB  - In the past 15 years, storage mites became more common as an agent in allergic
      airway disease. Sensitization to storage mites has been reported in farmers and
      grain workers. There were some studies investigating local populations,
      especially in the north of Europe. The sensitization to storage mites in a rural
      population seems to be similar to the rate found for Dermatophagoides. The main
      diseases caused by storage mites are allergic rhinitis and asthma. Although there
      is a cross-reactivity between Dermatophagoides pteronyssinus and storage mites,
      most of the antigens were distinct from house dust mite antigens. In our study,
      we analysed sera obtained from patients with known house dust mite allergy.
      Patients with a RAST class 2, 3 or 4 for Dermatophagoides pteronyssinus were
      tested for specific IgE-antibodies against storage mites. The test was performed
      using the Melja EAST-technique. We obtained a sensibilization rate of 7% for
      Acarus siro (d70), 17% for Lepidoglyphus destructor (d71), 3% for Tyrophagus
      putrescentiae (d72) and 13% for Glycyphagus domesticus (d73). According to our
      results we can conclude that storage mites are relevant allergens in allergic
      rhinitis, especially in the rural population in Bavaria. Therefore, routine
      testing in patients with perennial rhinitis is proposed.

PMID- 1755913
TI  - [Laryngeal cancer in men and occupation. A comparison with male patients with
      stomach cancer].
AB  - A statistical comparison of the professions of 1119 male patients with malignant
      laryngeal tumours and the profession of 708 male patients with malignant tumours
      of stomach, shows the influence of occupational exposures. The quantity of
      malignant laryngeal tumours is high in the group of steelworks- and foundry
      workers, workers in the glass-, porcelain-, quartz- and chemical industry and
      motorists. The inhalation of exogenous cancer-poisons are the probable cause.

PMID- 1755914
TI  - [Current diagnosis and therapy of cysts of the mouth floor].
AB  - Cystic tumors of the floor of the mouth are relatively rare. Until today the
      exact localisation of the cysts in relationship to the muscles of the floor of
      the mouth is established mainly during operation. Therefore the preoperative
      decision for the optimal surgical approach can be difficult, at least in large
      space occupying lesions. In the present study the case of a 24-year-old female
      patient with an extensive dermoid cyst of the floor of the mouth is demonstrated.
      The preoperative use of magnetic resonance imaging enabled us to determine the
      exact localisation of the cyst in relationship to the muscular structures of the
      floor of the mouth. The differential diagnosis of dermoids of the floor of the
      mouth as well as the adequate therapeutic approach is discussed according to the
      relevant literature.

PMID- 1755916
TI  - [The removal of the bony covering in osteoplastic surgery of the frontal sinus].

PMID- 1755915
TI  - [Clinical aspects of acute epiglottitis in adults].
AB  - During the last three years, 79 adults suffering from acute epiglottitis have
      been treated in the ENT departments of the university hospital Rudolf Virchow,
      Berlin, 36 women (41 years of age as an average) and 43 men (average age 39
      years). Acute epiglottitis developed either all of a sudden, within hours, or
      gradually, within days. All patients complained of dysphagia and pain in the
      throat; dyspnea could be observed in 20%. During examination, we could see an
      inflamed, thickened epiglottis with edema of the arytenoid cartilages. 55
      patients reported an infection of the upper airway prior to the onset of symptoms
      of acute epiglottitis, epiglottic abscess developed in 11 adults. The
      inflammation responded satisfactorily to conservative antibiotic management
      (broad spectrum penicillin). Only one patient had to undergo intubation, none of
      the adults required tracheotomy.

PMID- 1755917
TI  - Physiological characterization and identification of Listeria species.
AB  - A total of 136 strains of the genus Listeria were physiologically characterized
      using 329 miniaturized tests. Overall similarities of all strains were determined
      by numerical taxonomic techniques using the UPGMA algorithm and the SSM and SJ
      coefficients. A total of 10 clusters (2 or more strains) and 1 single-member
      cluster were defined at the 95.1 to 95.8% similarity levels (SSM). The same
      clusters were found at the 76.8% to 77.8% similarity levels (SJ). Strains of L.
      seeligeri, L. welshimeri, L. ivanovii, L. murrayi and L. grayi were found in
      separate clusters and formed homogeneous taxospecies. In contrast, strains of L.
      monocytogenes and L. innocua formed five heterogeneous clusters and one single
      member cluster. For differentiation of the phena the following tests are useful:
      utilization of D-xylose, D-xylitol, D-ribose, D-galactose, alpha-methyl-D
      mannoside, methyl-alpha-D-glucopyranoside, inulin and L-rhamnose, acid production
      from D-glucuronate, alpha-D-galacturonate, alpha-methyl-D-mannoside, methyl-alpha
      D-glucopyranoside, D-xylose, L-lyxose, D-sucrose, alpha-D-melizitose, D-tagatose,
      and D-ribose and hydrolysis of pNP-alpha-D-glucopyranoside, pNP-alpha-D
      mannopyranoside and 2-deoxythymidine-5'-pNP-phosphate. Independent of the
      assignment of some strains of L. monocytogenes and L. innocua to the same
      cluster, members of these species can be separated by hydrolysis of D-alanine-p
      nitroanilide.

PMID- 1755918
TI  - Minimal requirements for growth of Brucella suis and other Brucella species.
AB  - Minimal nutritional requirements and temperature limits of growth were studied in
      Brucella suis and, comparatively, in a few other Brucella species. In a saline
      basic medium including thiosulphate, ammonium sulphate and glucose with addition
      of 2 or 4 vitamins (nicotinic acid, thiamin and panthotenic acid, biotin), 24 out
      of 25 B. suis, 4/6 B. melitensis and 1/6 B. abortus strains were able to grow.
      Some strains, however, needed to be initially induced to grow by other
      ingredients, CO2, other vitamins, or amino acids, or by a prolonged incubation.
      In the saline basic medium without ammonium, glutamic acid and/or alanine and
      arginine, with or without glucose, supported the growth of all the B. suis and B.
      melitensis strains, except 2 which required a sulphur amino acid. Five out of 6
      B. abortus strains did not grow in either medium without addition of one or
      several aromatic amino acids or, for one strain, aspartic acid, or valine. One
      strain could also be induced to grow in ammonium medium by other amino acids. In
      a rich medium with yeast extract, all Brucella species grew at 18 degrees C and
      42.5 degrees (except one) while most B. suis (14/17) grew also at 15 degrees C
      and 44 degrees C, in contrast to other brucellae of which a few strains only grew
      at these temperatures. In saline ammonium glucose medium, yeast extract at 0.1
      g/l provided all the required vitamins and amino acids for all brucellae and at 1
      g/l, it even provided enough nitrogen to support growth without ammonium. Such
      basic saline medium with yeast extract may be advantageously used in routine
      Brucella culture, instead of the classic undefined peptone mediums. B. suis
      biovar 1 strains did not differ significantly in their minimal nutritional
      requirements, precluding the use of these requirements to differentiate the
      strains, in particular the Chinese vaccine strain S2 from the reference strain
      1330 or from other strains from different parts of the world. Finally, B. suis
      which is endowed with a nearly complete synthetic potential may represent the
      parental Brucella species from which the melitensis and abortus species may have
      evolved.

PMID- 1755919
TI  - Capillary gas chromatography of cellular carbohydrates as a means for the
      differentiation of fastidious, slow-growing or anaerobic gram-negative bacteria-
      a review.
AB  - The phenotypic differentiation of microaerophilic or anaerobic Gram-negative
      bacteria of human origin is traditionally based on the analysis of metabolic
      characteristics. Due to outstanding growth requirements of many kinds of
      parasitic bacteria, e.g. of the facultatively and strictly anaerobic members of
      the human periodontal flora, conventional biochemical tests are time-consuming
      and sometimes lead to doubtful results. Commercial diagnostic test kits often
      produce misidentifications because of insufficient databases or inappropriate
      test combinations. In this situation, cytochemical methods can provide an
      alternative. Especially in the case of Gram-negative bacteria which contain
      considerable amounts of carbohydrates in their cell wall lipopolysaccharide
      layers, capillary gas chromatography of peracetylated carbohydrate derivatives
      prepared from bacterial whole cell hydrolysates proved to be useful to
      characterize individual species, and sometimes even subspecies. As soon as a pure
      culture is available, the derivatization of the cellular carbohydrates to their
      peracetylated aldononitriles and peracetylated O-methyloximes, respectively,
      needs only about four hours and the gas chromatographic spectra are easy to
      evaluate.

PMID- 1755920
TI  - A polyclonal-monoclonal antibody based sensitive sandwich enzyme linked
      immunosorbent assay for specific detection of cholera toxin.
AB  - A sensitive sandwich enzyme-linked immunosorbent assay (ELISA) for specific
      detection of prototype cholera toxin (CT) elaborated by Vibrio cholerae serovar
      O1 has been developed. The use of a high affinity monoclonal antibody (MAb) for
      capturing of CT epitopes permitted a high efficiency. Using this ELISA, we sought
      in vitro production of CT from clinical strains of V. cholerae O1, Non-O1 and
      from LT-producing E. coli. All culture supernatants of V. cholerae O1 were
      positive for CT whereas V. cholerae non-O1 and LT producing E. coli were found
      negative for CT. This ELISA will be particularly useful in specifically designed
      studies where detection of CT and not of related labile toxins is mandatory.

PMID- 1755921
TI  - Bacteriocin typing and biotyping of clinical isolates of Serratia marcescens.
AB  - A total of 727 clinical isolates of Serratia marcescens from 474 patients were
      typed for bacteriocin susceptibility; 707 of the isolates (97.25%) were typable
      and comprised 46 different bacteriocin types. The biotyping method of Grimont and
      Grimont permitted categorization of 726 of the 727 isolates into 50 biotype
      profiles. However, 98 of the 726 biotypable isolates (13.5%) yielded previously
      unknown biotype profiles; similarly, 24 out of 59 reference strains of S.
      marcescens gave biotype profiles that had not been encountered before. Multiple
      S. marcescens isolates (366 of the 727 isolates) had been recovered from 113
      patients. Phenotypic variation in bacteriocin susceptibility occurred in 15 of
      these patients, whereas phenotypic variation in biotype profiles was noted in 26
      of these patients. In 5 of the 113 patients, phenotypic variation accounted for
      changes both in bacteriocin type and in biotype profile. It is suggested that
      serotyping should remain the method of choice until new methods have been
      evaluated accordingly.

PMID- 1755922
TI  - Serotyping of clinical isolates of Acinetobacter baumannii and genospecies 3:
      detection of additional serovars.
AB  - Continued serological monitoring of clinical isolates of Acinetobacter baumannii
      and genospecies 3 permitted identification of 7 new serovars of A. baumannii and
      8 additional serovars of genospecies 3.

PMID- 1755923
TI  - Mode of action of the antimycotic agent G2 isolated from alfalfa roots.
AB  - The mode of action of the antimycotic alfalfa root saponin, medicagenic acid 3-O
      beta-D-glucopyranoside (compound G2), which possesses a pronounced antifungal
      activity against medically important yeasts and dermatophytes, was studied in
      Saccharomyces cerevisiae. Compound G2 caused lethal leakage of ions out of the
      yeast cells. Exposure of S. cerevisiae to compound G2 resulted in a disappearance
      of the main sterol, ergosterol, from the cell membranes, suggesting that compound
      G2 was highly specific for ergosterol. Independently, chemical data indicated
      that compound G2 forms stable complexes with both ergosterol and cholesterol.
      Addition of cholesterol or ergosterol protected the cells of S. cerevisiae and
      several pathogenic yeasts from the inhibitory activity of compound G2 by
      producing a higher ratio of sterols (mainly ergosterol) to phospholipids in the
      membranes. The fact that an amphotericin B-resistant Candida tropicalis was
      susceptible to G2 suggested that its mode of action was different from that
      described for polyene antibiotics. This was also confirmed by the finding that
      0.2 M KCl did not protect S. cerevisiae cells against ion leakage with G2, but
      did so with amphotericin B.

PMID- 1755924
TI  - Induction of human cord blood lymphocyte proliferation by type III group B
      streptococci.
AB  - In a preceding communication, the authors have described the selective adherence
      of group B streptococci (S. agalactiae) to human neonatal lymphocytes. In the
      present one, it has been shown that cord blood lymphocytes obtained from healthy
      newborns possess the ability to develop proliferative responses in the presence
      of type III group B streptococci. When investigating the influence of these
      bacteria on both adult and neonatal mononuclear cells (MNC), the following
      patterns of adherence and lymphocyte reactivity could be observed: (1) Type III
      group B streptococci adhered spontaneously to lymphocytes (11.4 +/- 5.7%, n = 14)
      of healthy newborns but not to those from adults, (2) The capacity to proliferate
      was restricted to cord blood lymphocytes giving a mean peak response at day five
      of culture in the presence of the bacteria (6.8 +/- 2.8 times over the
      background, n = 15), (3) The correlation between streptococcal adherence and cord
      blood lymphocyte proliferation was statistically significant for 10 independent
      experiments (r = 0.75, p = 5%), and (4) Type III group B streptococci inhibited
      the Pokeweed mitogen (PWM)-induced lymphocyte proliferation in adult but not in
      neonatal MNC cultures. The different pattern of reactivity between adult and cord
      blood MNC towards group B streptococci will be discussed.

PMID- 1755925
TI  - Susceptibility of wild mice to Yersinia pseudotuberculosis and Yersinia
      enterocolitica.
AB  - Laboratory-born progeny and adult populations of old world woods mice (Apodemus
      speciosus) trapped in a certain area where Yersinia pseudotuberculosis was
      prevalent among wild animals, were challenged with Y. pseudotuberculosis and
      Yersinia enterocolitica to determine the ecology of Yersinia in wild mice. The
      laboratory-born progeny population was associated with infection with Y.
      pseudotuberculosis but not with Y. enterocolitica serotype O:3 and was found to
      be nearly 200 times more susceptible to infection with Y. pseudotuberculosis than
      were the adult populations. A. speciosus convalescing from infection with Y.
      pseudotuberculosis showed protection upon subsequent challenge with homogeneous
      and heterogeneous serotypes of Y. pseudotuberculosis. These data suggest that the
      prevalence of Y. pseudotuberculosis in wild mice may begin with the infection in
      the newborn and thus spread to the Y. pseudotuberculosis naive adult mice
      populations.

PMID- 1755926
TI  - Occurrence of bifidobacteria in the stool of multiple sclerosis patients.
AB  - Stool specimens from 17 multiple sclerosis (MS) patients were examined for
      bifidobacteria. The count of colony forming units (CFU)/g faeces and the
      differentiation and typing of species, especially of Bifidobacterium adolescentis
      biotypes were performed. The pH of the samples was also measured. Stool specimens
      from 17 healthy volunteers were examined as a control by the same methods (a
      modified medium, suitable for the detection and recognition of bifidobacteria in
      adults is given). The results demonstrate a significant deficiency in
      bifidobacteria of the adolescentis group in MS patients. In 3 patients, no
      bifidobacteria could be detected (less than 10(7]. In comparison with the samples
      from healthy donors, B. adolescentis "c" was reduced and B. adolescentis "a"
      could not be detected at all in MS patients' stool specimens. The occurrence of
      B. adolescentis "b" and B. adolescentis "d" as well as the species B. bifidum and
      B. longum did not significantly differ within both groups. The pH was only
      slightly increased in the MS group.

PMID- 1755927
TI  - Clinical and epidemiological aspects of Listeriosis in Belgium, 1985-1990.
AB  - Between January 1985 and December 1990, 233 cases of human listeriosis were
      reported to the Listeria Reference Centre of Belgium. Foeto-maternal infections
      (88 cases) and septicemia in adults (88 cases) were the most frequent clinical
      manifestations, followed by CNS infections (40 cases). 71.7% of the patients
      presented a concurrent condition which favoured the triggering of the disease. No
      correlation was found between the isolation of L. monocytogenes in patients and
      their occupation or their animal environment. The predominant serovar was 4b
      (70%). On the other hand, the Reference Centre also examined 1412 foodstuffs for
      the presence of L. monocytogenes: 16.9% (9/53) of cooked chicken products, 15.4%
      (73/473) of soft cheeses and 6.9% (62/886) of cooked meat products were positive
      (presence of L. monocytogenes in 25 g). The contamination level of these ready-to
      eat foodstuffs ranged from less than 10 cfu L. monocytogenes/g. to 10(6) cfu/g.
      54.1% of the isolated strains belonged to serovar 1/2a.

PMID- 1755929
TI  - 1990 ACNP Past-President's Lecture. Where do we go from here.

PMID- 1755928
TI  - Use of pulsed field electrophoresis of DNA restriction fragments for comparing
      Listeria monocytogenes strains isolated from human infections and food in
      Austria.
AB  - Twenty-five Listeria monocytogenes strains of human and food origin were studied,
      using low-frequency-cleavage restriction endonucleases and pulsed field gel
      electrophoresis. Sixteen different restriction patterns were obtained using ApaI
      and SmaI. The human isolates showed profiles different from those of the food
      isolates, thus strongly suggesting that the two human infections selected for
      this study did not originate from the contaminated foodstuffs examined at the
      same time. This method allowed it to clearly distinguish between strains
      apparently similar [i.e. belonging to the same serovar and same origin (cheese
      samples from the same dairy plant)].

PMID- 1755930
TI  - Evidence for ultrastructural changes in cortical axodendritic synapses following
      long-term treatment with haloperidol or clozapine.
AB  - A quantitative electron microscope analysis was performed to determine the
      effects of 1-year administration of either haloperidol or clozapine on the
      ultrastructure of synapses in layer VI of rat medial prefrontal cortex. The
      average caliber of dendritic shafts was significantly decreased in the
      haloperidol-treated group, but not in clozapine-treated animals; however, there
      was no difference between the means of the two drug-treated groups. Both drug
      treated groups showed a significant decrease in the relative distribution of
      axodendritic synapses displaying asymmetric postsynaptic membrane
      specializations, while there was an increase in synapses with either a symmetric
      membrane specialization or no specialization at all. Axospinous synapses of the
      clozapine-treated group showed a shift in the relative distribution of synaptic
      subtypes paralleling that found for axodendritic synapses. There was no change in
      the number of axon terminals forming a synapse on dendritic cross-sectional
      profiles in the neuroleptic-treated groups. Similarly, no change in the average
      size of axon terminals or synaptic vesicle density was detected. These data
      suggest that both typical and atypical neuroleptics, when administered over an
      extended period of time, may induce relative shifts in the distribution of
      excitatory and inhibitory elements synapsing on dendritic shafts and, to a lesser
      degree, spines. Such alterations in synaptic relationships may provide insight
      into the interaction of neuroleptics with intrinsic components in layer VI of
      medial prefrontal cortex.

PMID- 1755931
TI  - Concentration-related effects of morphine on cognition and motor control in human
      subjects.
AB  - Morphine and other opioid analgesics may interfere with normal cognition and
      motor function when the drugs are used for long-term treatment of pain. We used
      individually tailored steady-state drug infusions to identify the nature and
      extent of cognitive and motor effects of the mu-receptor-selective opioid
      morphine in healthy volunteers. The tailored infusions allowed evaluation of
      cognitive and motor effects at three sequential, constant plasma concentrations
      of morphine in each subject. Compared with functional assessments obtained in a
      separate saline infusion day, infusions of morphine to plasma concentrations in
      the usual therapeutic range for analgesia caused significant impairments of some
      but not all elements of cognitive and motor function. The time needed to encode
      and process serially presented verbal information increased and the ability to
      maintain low consistent levels of force decreased during the morphine infusion.
      We also assessed verbal recall 3 hours after the morphine and saline infusions.
      Delayed recall of information presented during the morphine infusion was
      significantly impaired. Our results demonstrate that morphine can interfere with
      cognitive and motor performance at plasma drug concentrations within the usual
      therapeutic range.

PMID- 1755932
TI  - Nonlinear analysis of EEG sleep states.
AB  - Recent advances in the field of nonlinear dynamics have provided new conceptual
      models as well as novel analytical techniques applicable to
      neuropsychopharmacologic studies. One measurement technique that has been
      recently developed in an attempt to characterize nonlinear systems in physics and
      biology is the estimation of dimension. Dimension may be seen as a measure of the
      information required to describe the current behavior of a system. We have
      applied these techniques to the analysis of the sleep EEG, and have found that
      the dimension of rapid eye movement (REM) sleep is significantly higher than non
      rapid-eye-movement (NREM) sleep. These data support a preliminary hypothesis that
      EEG dimension may represent the number of nonlinear modes activated in the brain.
      Thus, sleep states of low arousal or low input would be envisioned as having low
      dimension (e.g., slow-wave sleep) whereas increased arousal (REM) would activate
      more nonlinear modes. Although more investigations will be needed to explore this
      hypothesis, these studies suggest that further development of nonlinear
      approaches to the analysis of brain systems are likely to generate new clinical
      measures as well as new ways of viewing brain electrical function.

PMID- 1755933
TI  - Conversion of bromperidol to reduced bromperidol in human liver.
AB  - Bromperidol (BRP) is an analog of haloperidol, a potent butyrophenone
      neuroleptic. Reductive conversion of BRP carbonyl group to reduced bromperidol
      (RBRP) was confirmed in vitro using human liver. This NADPH-dependent reduction
      of BRP showed a similar inhibition pattern and Michaelis constants to haloperidol
      carbonyl reductase.

PMID- 1755934
TI  - Rapid eye movement (REM) sleep increases by auditory stimulation reverted with
      biperiden administration in normal volunteers.
AB  - Auditory stimulation during REM sleep increases REM sleep time. The purpose of
      the present work was to determine if the selective muscarinic M-1 antagonist
      biperiden could modify the effect of the auditory stimulation on REM sleep.
      Twelve healthy volunteers were divided into placebo and biperiden groups. All the
      volunteers were studied under sleep laboratory conditions as follows: one
      acclimatization night, one baseline night, four nights with auditory stimulation
      either with placebo or biperiden, and two follow-up nights. Biperiden (4 mg) or
      placebo in identical capsules was administered 1 hour before beginning the sleep
      recordings. REM sleep time and REM density in the placebo group were increased
      relative to baseline by auditory stimulation. Biperiden blocked the REM time
      increase over the three treatment nights and suppressed the REM density increase
      over all four treatment nights. Biperiden also increased the latency compared to
      the placebo group. The present findings suggest that M-1 mechanisms are related
      to REM sleep regulation.

PMID- 1755935
TI  - The CTLA-1 gene: a member of the granzyme multigene family in human and murine
      cytotoxic T cells.

PMID- 1755936
TI  - The growth hormone/prolactin receptor gene family.
AB  - The identification of cDNAs encoding receptors for growth hormone and prolactin
      have allowed the identification of the primary structure of these receptors. The
      expression of these receptors can be measured in various tissues by estimation of
      mRNA levels using cDNA probes and measurements of protein levels by
      radioimmunoassay or immunoblot analysis using monoclonal or polyclonal antibodies
      to the receptors. Site-directed mutagenesis of ligand-binding domains will lead
      to an understanding of the residues important for hormone binding. In addition,
      mutagenesis of the cytoplasmic domains of the receptors performed together with
      functional tests should help identify regions of the receptor involved in the
      process of signal transduction. Finally, the identification of the enlarged
      receptor family, including receptors for cytokines, should shed some light on
      additional functions of growth hormone prolactin, especially in regulating immune
      functions.

PMID- 1755937
TI  - Organization and evolution of satellite, minisatellite and microsatellite DNAs in
      teleost fishes.

PMID- 1755938
TI  - Nucleosome positioning and regulated gene expression.

PMID- 1755939
TI  - The biology of complement.

PMID- 1755940
TI  - Biology of complement: the overture.

PMID- 1755941
TI  - Evolution of the complement system.
AB  - The ancestral form of the alternative pathway of complement activation probably
      originated as a primitive independent immune system. Subsequent evolution of an
      adaptive immune response drove the specialization of the classical pathway to
      connect antibody-mediated nonself recognition to the complement-dependent
      effector mechanisms. In this article Timothy Farries and John Atkinson consider
      how the contemporary complexity arose by a succession of credible alterations at
      the genetic level, and the selective advantages provided at each step.

PMID- 1755942
TI  - C1: molecular interactions with activating systems.
AB  - The molecular events controlling complement activation have been gradually
      unravelled over the past three decades, stimulated by improved isolation
      procedures and a better understanding of the roles of individual proteins. In
      this review, Bob Sim and Ken Reid examine the interactions between C1q and its
      numerous ligands in the initiation of the classical pathway cascade.

PMID- 1755943
TI  - The role of complement in inflammation and phagocytosis.
AB  - Inflammation and phagocytosis are highly complex events involving many humoral
      and cellular factors, with complement components playing a key role. As described
      here by Mike Frank and Louis Fries, complement peptides trigger cell function,
      aid in the recognition of invading pathogens and regulate the phagocytic process
      via interactions with specific cell surface receptors.

PMID- 1755944
TI  - The role of C3 in the immune response.
AB  - The complement system, particularly the third component, plays an important
      modulatory role in the inductive phase of the immune response. As discussed here
      by Anna Erdei and colleagues, the picture that is emerging is that immobilized C3
      split products facilitate the cooperation between immunocompetent cells and are
      co-stimulatory molecules in T- and B-cell activation, probably as a result of
      their ability to promote cell-cell adhesion. In contrast, soluble C3 products
      inhibit lymphocyte proliferation.

PMID- 1755945
TI  - The response of human platelets to activated components of the complement system.
AB  - Many in vivo platelet responses are considered to be mediated, directly or
      indirectly, by activated components of the complement system. These include the
      secretion of proteolytic enzymes and the assembly of key enzymes of the
      coagulation and fibrinolytic pathways. In this review, Peter J. Sims and Therese
      Wiedmer summarize the known interactions of human platelets with the complement
      system and discuss the implications of these interactions for platelet hemostatic
      function within the vasculature.

PMID- 1755946
TI  - [Granuloma in Crohn's disease of the colon and rectum--a study of resection
      specimens].
AB  - The aim of the present study was to investigate frequency and distribution of
      granulomas in resected specimens of patients with well known Crohn's disease.
      Granulomas were observed in 57% (8/14) of all cases. Their distribution varied
      remarkably between different sections of the same resectional sample as well as
      between the patients. 11.6% of all granulomas were found within the lamina
      propria, 42.9% within the submucosa, and 45.5% within the muscularis propria. The
      mean value per cm muscularis mucosae was 0.85 +/- 0.82 granulomas. Caused by the
      heterogeneity in frequency and distribution there is no guarantee for a
      successful identification of this helpful parameter. During the last years the
      diagnosis Crohn's disease became more and more certain even in absence of
      granulomas. Therefore they are an useful but dispensable feature.

PMID- 1755947
TI  - Bilirubin or plasminogen--which is better in the assessment of the severity of
      viral hepatitis?
AB  - The purpose of the present paper was to asses the values of plasminogen (PLg) as
      severity index in viral hepatitis (VH). The results were compared with serum
      bilirubin (SB) and prothrombin time. The following groups of patients were
      investigated: I- VH (n-672); II- Fulminant hepatitis (FH)(n-53); III-Liver
      cirrhosis (n-52); IV- Cholangiohepatitis (21); Toxic hepatitis (n-22); V- Gall
      stone (n-56) VI- Neoplasms with jaundice (n-56); VII- Healthy subjects (n-137).
      PLg was found to be diminished in parenchymal liver diseases, especially in VH's
      patients according to the severity and the stage of the diseases. The most
      impressive decline was observed in FH--more than 50% of the tests showed Plg
      activity less than 10% (reverence values 83-126% activity). In VH, PLg was
      superior to SB and prothrombin time when evaluating the severity of the disease
      at the time of admission in the hospital. We proposed PLg as valuable criterion
      for the severity of VH. The range being as follows: Light forms of VH- PLg
      activity above 70%; Medium forms-from 69 to 50%; Severe forms-from 49 to 20% and
      patients with high risk of liver coma-PLg activity below 20%.

PMID- 1755948
TI  - [The effect of various non-ulcer pharmaceuticals on nocturnal gastric pH in
      healthy subjects].
AB  - The effects of 4 non-ulcer drugs and the M1-antagonist pirenzepine on the
      nocturnal intragastric pH were investigated in 12 healthy volunteers. We tested
      single doses of pirenzepine (100 mg), Chlorprothixene (30 mg), clonidine (75
      micrograms), ketotifen (3 mg) and nifedipine (30 mg) in an randomized, single
      blind, cross-over study. The nocturnal intraluminal pH is significantly elevated
      not only by pirenzepine but also by the other substances. As expected pirenzepine
      (mean nocturnal pH = 2.49 +/- 0.22) shows the most distinct effect, nifedipine
      (mean nocturnal pH = 1.72 +/- 0.20) the most sparsely effect. The other drugs are
      nearly half as effective as pirenzepine. The acid suppressive side effect of the
      non-ulcer remedies is considered to be important for the treatment of ulcer
      patients with concomitant diseases.

PMID- 1755949
TI  - [Ultrasonography studies on spontaneous and pharmacologically modified
      gallbladder motility].
AB  - The intra- and interindividual variations of gallbladder motility were
      sonographically studied in 10 healthy subjects. We investigated the following
      criteria: a) the gallbladder volumes after overnight fasting on 5 consecutive
      days, b) the spontaneous motility under fasting over 12 or 24h at hourly
      intervals, c) the emptying rate and time of maximal contraction after stimulation
      with sorbitol, and d) the emptying rate and time (like c) after premedication
      with "cholagogic" drugs (Cholecysmon, Divalol), nifedipine, indomethacin or N
      butylscopolaminiumbromide. We found a great intrapersonal and interpersonal
      variability in gallbladder volumes after overnight fasting in consecutive days.
      In subjects fasting over 24h phases of dilatation with maxima at 12 AM and 4 PM
      alternated with phases of contraction with maxima at 8 AM and 4 PM. After
      premedication with nifedipine, indomethacin and N-butylscopolaminiumbromide a
      significant decrease of the emptying rate was observed. The time of maximal
      contraction did not differ however. After premedication we found a distinct intra
      and interindividual variability too. Cautious interpretation of gallbladder
      motility studies is necessary.

PMID- 1755950
TI  - [Microsomal phospholipid pattern and liver ultrastructure of aging rats following
      treatment with essential phospholipids].
AB  - The treatment of aging rats with 100 or 300 mg/kg "essential" phospholipids (EPL)
      for 10 weeks significantly changed the microsomal concentration of phosphatidyl
      serine plus phosphatidyl inositol. The most marked alterations of the
      phospholipid fatty acid pattern predominantly observed with unsaturated fatty
      acids were detectable even 7 days after cessation of EPL application.
      Ultrastructurally, an enrichment in the hepatocytes with rough endoplasmic
      reticulum was visible which was more prominent in acinus zone 3. The changes
      after EPL administration are regarded as the expression of an increased membrane
      fluidity.

PMID- 1755951
TI  - [Gastric and duodenal polyps in acromegaly].
AB  - Relationship between acromegaly and occurrence of colonic cancer and polyps is
      well-known. A rare case of gastric and duodenal polyps in a patient with
      hypophyseal adenoma is described. After selective hypophysectomy a regression of
      the polyps was observed. Probable mechanisms of the development and the
      regression of polyposis are explained. The diagnostic value of gastroscopy in the
      screening for polyps in patients with acromegaly is discussed.

PMID- 1755952
TI  - [Is provocation ultrasonography diagnostically helpful in divided pancreas?].

PMID- 1755953
TI  - A practical approach to dose reduction for imaging staff.

PMID- 1755954
TI  - Setting up a clinical educators' course.

PMID- 1755955
TI  - Myelography--an assessment of communication with a view to improving patient care
      and standardising information.

PMID- 1755956
TI  - Treatment information and the radiotherapy patient.

PMID- 1755957
TI  - Radiological appearances of a dorsal fracture dislocation of the lunate.

PMID- 1755958
TI  - Nonexpression of the human serum amyloid A three (SAA3) gene.
AB  - Serum amyloid A (SAA) is a major acute-phase plasma protein synthesized by the
      liver. In addition to the two major plasma isoforms described in humans (SAA1 and
      SAA2), a third form (SAA3) has been demonstrated in several other species and is
      distinguished by predominant extrahepatic expression. Two clones, Ch11g5-1-1 and
      HDg1-1, containing the human SAA3 gene are described in this report. The human
      SAA3 gene is comparable in organization to the SAA1 and SAA2 genes and shares
      with them 87% nucleotide identity in the region spanning exon 3 through exon 4.
      Sequences 5' to exon 3, however, are strikingly different from those in the SAA1
      and SAA2 genes. For instance, the sequence deduced for amino acids 1-12 (exon 2)
      has only 25% identity with human SAA1 and SAA2; it most closely resembles that of
      rabbit SAA3 isolated from synovial fibroblast cultures (75% identity). Although
      rabbit SAA3 induces collagenase production in an autocrine fashion the human SAA3
      gene is not expressed. This is shown by: (i) a single base insertion in the
      sequence corresponding to codon 31, (ii) the inability of a 918-bp fragment
      immediately upstream from SAA3 exon sequences to direct transcription of a
      chloramphenicol acetyltransferase reporter gene, and (iii) the absence of
      detectable human SAA3 in mRNA.

PMID- 1755959
TI  - Similarity between the amino-terminal portion of mammalian 58-kD sterol carrier
      protein (SCPx) and Escherichia coli acetyl-CoA acyltransferase: evidence for a
      gene fusion in SCPx.
AB  - A computer analysis of the amino acid sequences of rat and human 58-kD sterol
      carrier protein and Escherichia coli acetyl-CoA acyltransferase reveals that the
      two proteins have a segment of about 350 residues with strong sequence
      similarity. The ALIGN comparison scores for the rat and human sterol carrier
      proteins and the E. coli enzyme are 8.25 and 8.8 SD, respectively. The
      catalytically active cysteine of E. coli acetyl-CoA acyltransferase (cysteine 91)
      aligns with cysteine 93 and cysteine 94 on human and rat 58-kD sterol carrier
      protein, respectively.

PMID- 1755960
TI  - [Female career makers].

PMID- 1755961
TI  - [Wound care. Introduction].

PMID- 1755962
TI  - [Wounds and wound healing].

PMID- 1755963
TI  - [Wound care--those that cannot take it simply disappear].

PMID- 1755964
TI  - [AIDS center--hospitals--nursing homes].

PMID- 1755965
TI  - [Wound care products].

PMID- 1755966
TI  - [Nursing perspective of wound care. Nursing process and wound care plan in
      district nursing].

PMID- 1755967
TI  - [The WCS classification for local wound care (Woundcare Consultant Society)].

PMID- 1755968
TI  - [Various facts from the history of wound care].

PMID- 1755969
TI  - [Wound care in extramural health care].

PMID- 1755971
TI  - T-cell tolerance to viruses.
AB  - T-cell tolerance to self antigens is maintained by events that occur within the
      thymus and in the periphery. Mechanisms that operate on immature T cells within
      the thymus are effective in induction of tolerance to viruses, but mechanisms of
      tolerizing mature T cells are likely to break down. This failure of peripheral
      mechanisms to induce T-cell tolerance to viruses has implications for
      autoimmunity and for treatment of chronic viral infections.

PMID- 1755970
TI  - T-cell receptor and T-cell-resistant virus variants.
AB  - Analysis of the T-cell receptor has revealed the molecular basis of antigen
      recognition by T cells specific for viral antigens. Studies using T-cell receptor
      transgenic mice have provided evidence for clonal deletion of virus-specific T
      cells in persistently infected hosts and for selection of T-cell-resistant virus
      variants in vivo.

PMID- 1755972
TI  - Cytokines in viral diseases.
AB  - As in many other areas of cytokine biology, recent studies of the role of
      cytokines in viral disease reveal numerous complex interactions that in many
      instances may contribute directly to the development of pathology. For example,
      data from the rapidly evolving field of human retrovirology has shown that these
      viruses, as well as inducing the expression of many cellular cytokine genes, can
      be activated from latency and driven into replication/expression by the very same
      cytokines. The continuing rapid expansion of knowledge in the cytokine area
      augers well for eventual development of novel antiviral therapeutic strategies
      based on manipulation of the cytokine network.

PMID- 1755973
TI  - Targeting and controlled release of antigens for the effective induction of
      secretory antibody responses.
AB  - Increased awareness of the fact that the mucosal membranes are the portals of
      entry for the majority of infectious agents, and that antibodies in external
      secretions often correlate better with protection than do corresponding
      antibodies in serum, has prompted many recent studies aimed at the selective
      induction of antibodies in mucosal secretions. The recent development of novel
      technologies (expression of antigens in various microbial vectors that colonize
      mucosal surfaces and incorporation of antigens in biodegradable microspheres)
      indicate that the goal of vaccination with enhanced induction of both mucosal and
      systemic immune responses is attainable.

PMID- 1755974
TI  - The implications for malaria vaccine programs if memory T cells from non-exposed
      humans can respond to malaria antigens.
AB  - Although the goal of current candidate vaccines is to expand a population of
      malaria antigen-specific lymphocytes, accumulating evidence suggests that
      peripheral blood of adult humans contains significant numbers of malaria-specific
      T cells prior to any exposure to vaccine or actual infection. The reason why such
      naive humans are susceptible to malaria infection may thus relate not to
      inadequate T-cell surveillance but to some other factor--possibly lack of
      suitable splenic modification. It is possible that current vaccine programs are
      misdirected because these other factors are not being addressed. The possibility
      of an attenuated vaccine should be re-examined.

PMID- 1755975
TI  - Antibody affinity and protection in virus infections.
AB  - Affinity of viral antibodies matures slowly after primary virus infections.
      Recent investigations with human sera and mouse monoclonal antibodies have
      provided the first evidence for a role of antibody affinity in the pathogenesis
      of chronic virus infections. More detailed studies are necessary before the rules
      and exceptions of this phenomenon are revealed.

PMID- 1755976
TI  - Mimicry in Trypanosoma cruzi: fantasy and reality.
AB  - Chronic infection of mammals by Trypanosoma cruzi often results in severe
      autoimmune and inflammatory pathology. Extensive antigen cross-reactivity between
      the parasite and its mammalian hosts has also been reported. These findings have
      stimulated speculation that Trypanosoma cruzi uses antigenic mimicry as a
      mechanism for escaping the host immune system. This may not be the case and the
      observed antigen cross-reactivity may be a result of perturbations of the immune
      system such that common, normally tolerated antigens are recognized in infected
      animals. The parasite, however, does appear to use functional mimicry to survive
      in the immune competent host.

PMID- 1755977
TI  - Genetics of the immune response to infectious pathogens.
AB  - In this selective review of the recent literature in the field of genetically
      determined host resistance to infection, we highlight five areas in which
      research is directed towards the search for proteins encoded by genes that
      function to maintain a 'resistant' phenotype in the face of challenge by a
      variety of pathogenic organisms. In particular, we discuss newly described genes
      that may regulate host resistance, newly described functions of genes previously
      identified, the reverse genetics approach to cloning an elusive gene, a direct
      genetics approach to a similar problem, and the role of the major
      histocompatibility complex in regulating our ability to resist challenge by
      infectious organisms.

PMID- 1755978
TI  - New viruses and new disease: mutation, evolution and ecology.
AB  - Given the extraordinarily high mutation rate of viruses, particularly those with
      RNA genomes, it is not surprising that new viruses are continually evolving.
      However, the symptomatology of old viral diseases has remained stable for
      centuries. The combination of genetic and ecological factors that constrain as
      well as facilitate the emergence of new viruses is analyzed.

PMID- 1755979
TI  - Control of human immunodeficiency virus replication by the tat, rev, nef and
      protease genes.
AB  - Immediately after infection, human immunodeficiency virus directs the synthesis
      of three regulatory proteins tat, rev and nef that together allow the synthesis
      of the structural proteins of the virus after a delay of several hours. Viral
      mRNA production is controlled by the tat gene, which appears to stimulate
      elongation by RNA polymerase II, and the rev gene, which allows the accumulation
      of unspliced or partially spliced mRNAs in the cytoplasm. The nef gene is
      dispensible for virus growth but may limit virus spread by downregulating the
      levels of cellular surface proteins such as the CD4 receptor. Virus maturation
      also depends critically on the protease gene which allows the orderly
      rearrangement of the viral core structures in newly budded virions as well as the
      vpu and vif genes which allow efficient production of mature envelope
      glycoprotein.

PMID- 1755980
TI  - HIV types and testing.
AB  - The past year has seen the discovery of new isolates which do not readily fit
      into the established categories HIV-1, HIV-2 and SIV, as well as the availability
      of new assays including the use of the polymerase chain reaction. New combination
      enzyme-linked immunosorbent assays can detect viruses from two or more groups
      where specific enzyme-linked immunosorbent assays have been developed using
      peptides and monoclonal antibodies.

PMID- 1755982
TI  - Immunity to infection.

PMID- 1755981
TI  - Severe combined immunodeficiency disease, adenosine deaminase deficiency and gene
      therapy.
AB  - Patients with severe combined immunodeficiency disease represent a model for the
      first clinical applications of gene therapy. Present attempts use insertion of
      the human adenosine deaminase gene into the peripheral blood T lymphocytes of
      patients who lack this gene. The ultimate treatment, however, will require
      insertion of the normal human adenosine deaminase gene into pluripotent stem
      cells and expression of the gene in their progeny.

PMID- 1755983
TI  - Immunodeficiency.

PMID- 1755984
TI  - Protein tumor antigens.
AB  - Immunogenic tumor antigens have been sought through a variety of paradigms for
      several past decades. Recent developments in antigen presentation have radically
      changed the prism through which we view these enigmatic antigens. This article
      discusses the small but growing treasure chest of these antigens--stress-induced
      proteins, the P1AB antigen of the P815 mastocytoma, the p53 tumor suppressor
      protein, the gp95/p97 antigen of human melanoma, mucins and others.

PMID- 1755985
TI  - Cellular and humoral immune responses against cancer: implications for cancer
      vaccines.
AB  - The key issue in tumor immunology is to identify antigens as target structures
      for a cancer-selective immunological attack in the tumor-bearing host, resulting
      in tumor rejection. There is a growing detailed understanding of structural and
      regulatory gene alterations giving rise to candidate rejection antigens and
      peptides in tumor cells. As well as reviewing the development of new adjuvant and
      recombinant vector systems, new approaches are suggested for the construction of
      cancer vaccines.

PMID- 1755986
TI  - Imaging and therapy with monoclonal antibodies in non-hematopoietic tumors.
AB  - Although radiolabelled monoclonal antibodies are useful in tumor imaging, in our
      opinion their most important role is in the evaluation of the capacity of newly
      developed monoclonal antibodies to localize in tumors specifically. Intravenous
      injections of monoclonal antibody fragments, labelled with beta-emitting
      radionuclides, can completely eradicate large human colon carcinoma xenografts in
      nude mice whereas this is not achieved by unconjugated monoclonal antibodies. New
      strategies are being developed to make radioimmunotherapy applicable to carcinoma
      patients.

PMID- 1755987
TI  - Cytokines and cancer: experimental systems.
AB  - The transfer of certain cytokine genes into cancer cells can provide very
      powerful suppression of tumor growth in the absence of any toxic side effects.
      Some of these cytokines, such as interleukin-4, granulocyte colony-stimulating
      factor and tumor necrosis factor, can mediate powerful immune suppression even in
      T-cell-deficient animals and appear to be effective for poorly or non-antigenic
      tumors. However, approaches must be found to induce or deliver cytokines locally
      at the tumor site.

PMID- 1755988
TI  - Transplantation tolerance.
AB  - New experimental protocols for the induction of transplantation tolerance
      continue to be developed. In the past year, encouraging data have been reported
      from a clinical trial using a protocol specifically designed to induce tolerance
      to the histocompatibility antigens of the kidney donor. Progress has also been
      made in our understanding of the mechanisms responsible for the induction and
      maintenance of tolerance to alloantigens in vivo; it is becoming increasingly
      clear that more than one mechanism can be involved, particularly at different
      phases in the response.

PMID- 1755989
TI  - Structural aspects of allorecognition.
AB  - The phenomenon of T-cell allorecognition of foreign major histocompatibility
      molecules has been one of the more enigmatic aspects of T-cell immunology. The
      molecular basis for allorecognition is unfolding as a result of the application
      of major histocompatibility complex structure/function analyses in the light of
      current insights into the three-dimensional structure of major histocompatibility
      complex products.

PMID- 1755990
TI  - Discordant xenografting: challenges and controversies.
AB  - The transplantation of organs between individuals of disparate species is being
      considered as a potential solution to a serious shortage of donor organs for
      clinical transplantation. We summarize recent papers concerning the immunologic
      barrier to xenotransplantation, the pathogenesis of hyperacute rejection and
      reports on efforts made to prevent or mitigate hyperacute xenograft rejection.

PMID- 1755991
TI  - Use of monoclonal antibodies in human transplantation.
AB  - Monoclonal antibodies are of growing importance in human organ transplantation in
      the prophylatic and curative treatment of cellular rejection. Among the pan T
      lymphocyte monoclonal antibodies, OKT3 has been much studied, although clinical
      research is engaged with more selective targets of allorecognition and/or their
      consequences, for example monoclonal antibodies directed against the interleukin
      2 receptor, adhesion molecules and CD4 molecules. We summarize the use of these
      monoclonal antibodies and bioreagents in clinical transplantation.

PMID- 1755992
TI  - Recent developments in the human maternal-fetal immune interaction.

PMID- 1755993
TI  - Rodent maternal-fetal immune interactions.

PMID- 1755995
TI  - Cancer.

PMID- 1755994
TI  - Lymphohematopoietic cytokines in the female reproductive tract.
AB  - The past year has seen an avalanche in publications describing the synthesis of
      lymphohematopoietic cytokines by the uterus and placenta. Dissection of the
      particular contributions of these factors will require genetic as well as
      biochemical approaches. The major events of the year therefore, were the
      identification and creation of mouse mutants that have provided novel insights
      into the roles of various cells and cytokines during gestation.

PMID- 1755996
TI  - Transplantation.

PMID- 1755997
TI  - Reproduction.

PMID- 1755998
TI  - The potential role of biosensors in the food and drink industries.
AB  - Despite their apparent potential as analytical tools in the food and drink
      industries, only a few biosensors are used routinely. This article describes the
      development of biosensors for these sectors and discusses the technical and
      economic problems of applying this technology to the monitoring of food and drink
      products.

PMID- 1755999
TI  - The development of a catechol enzyme electrode and its possible use for the
      diagnosis and monitoring of neural crest tumours.
AB  - A catechol enzyme electrode is described, in which a Clark-type oxygen electrode
      is coupled to immobilised polyphenol oxidase in albumin cross linked with
      glutaraldehyde on a dialysis membrane. Electrode calibration, response time, pH
      response profile, stability, detection limit and selectivity are evaluated and
      the feasibility of using the electrode for the measurement of catecholamines in
      the urine of patients with neural crest tumours is assessed.

PMID- 1756000
TI  - Electrochemical detection of viable bacteria in urine and antibiotic selection.
AB  - An electrode system consisting of a basal-plane pyrolytic graphite (BPG)
      electrode and a porous nitrocellulose membrane filter to trap bacteria was used
      for the detection of bacteria in urine. The peak current of a cyclic voltammogram
      increased with increasing initial cell concentration of Escherichia coli in
      urine. Urine containing from 5 x 10(2) to 5 x 10(5) cells ml-1 was measured with
      this system. The susceptibility of bacteria to various antibiotics was also
      determined from the peak current. The minimum inhibitory concentration values
      obtained by the electrochemical method were in good agreement with those obtained
      by the conventional method.

PMID- 1756001
TI  - An FIA biosensor system for the determination of phosphate.
AB  - A flow injection analysis (FIA) biosensor system for the determination of
      phosphate was constructed using immobilized nucleoside phosphorylase and xanthine
      oxidase and an amperometric electrode (platinum vs silver/silver chloride,
      polarized at 0.7 V). When a phosphate-containing sample was injected into the
      detection cell, phosphate reacted with inosine in the carrier buffer to produce
      hypoxanthine and ribose-1-phosphate in the presence of nucleoside phosphorylase.
      Hypoxanthine was then oxidized by xanthine oxidase to uric acid and hydrogen
      peroxide, which were both detected by the amperometric electrode. The response of
      the FIA biosensor system was linear up to 100 microM phosphate, with a minimum
      detectable concentration of 1.25 microM phosphate. Each assay could be performed
      in 5-6 min and the system could be used for about 160 repeated analyses. This
      system was applicable for the determination of phosphate in various food products
      and plasma, and the results obtained agreed well with those of the enzymatic
      assay.

PMID- 1756002
TI  - An evanescent fluorescence biosensor using ion-exchanged buried waveguides and
      the enhancement of peak fluorescence.
AB  - The principle of an optical molecular sensor using ion-exchanged buried planar
      waveguides in glass has been demonstrated. We have shown both theoretically and
      experimentally that the intensity of the peak evanescent fluorescence can be
      increased by several orders of magnitude with the use of an index-matching
      material. The method of differential measurement has been used to improve the
      differentiation between specific and non-specific binding. We used h-IgG (human
      immunoglobulin G) as the immobilized antibody on the surface of the waveguide and
      protein A-FITC (fluorescein isothiocyanate) as the fluorescently labelled antigen
      or anti-antibody to be detected, and have shown that a concentration of protein A
      as low as 24 nM can easily be detected.

PMID- 1756003
TI  - Potentiometric enzyme channeling immunosensor for proteins.
AB  - A potentiometric immunosensor for the detection of human IgG has been developed
      using an asymmetric, ion-selective membrane with immobilized adenosine deaminase
      and IgG. A protein A-alkaline phosphatase conjugate binds to the immobilized IgG,
      creating a bienzymatic catalytic layer. In the presence of sample IgG, the
      conjugate does not bind to the membrane. Instead, the intermediate in the two
      step reaction (adenosine) must diffuse to the membrane surface, reducing the rate
      of product (ammonium) formation within the diffusion layer detected by the
      membrane. The immunosensor demonstrated is for the determination of IgG. A
      simplified model is described to predict the maximum rate enhancement for the
      'channeled' versus 'unchanneled' reaction mechanisms.

PMID- 1756004
TI  - [Microbiologic validation in the production of sterile pharmaceuticals].
AB  - Some microbiological validation procedures for sterile drug production are
      described. There concern the environmental microbial and particle "self
      decontamination" time specified in the English "Guide to Good Pharmaceutical
      Manufacturing Practice 1983" and the EEC "Guide to Good Manufacturing Practice
      for Medical Products", the various methods for evaluating that sealing of sterile
      drugs is intact and the validation methods for aseptic filling of sterile powders
      and solutions. For these, the limits laid down in FDA regulations are indicated.

PMID- 1756005
TI  - Diethylhexylphthalate (DEHP) and triethylhexyltrimellitate (TEHT) PVC
      plasticizers assay in blood.
AB  - The interest in the PVC biocompatibility of the apparatus used both for dialysis
      and any other extracorporeal blood circulation is so real that a method to
      determine PVC plasticizer concentration in blood is properly needed. The
      described method might be easier than other ones we are allowed to use at the
      moment.

PMID- 1756006
TI  - [A centralized system of particle counting in controlled zones].
AB  - The air quality is the primary concern of the environmental control program in
      aseptic operations of pharmaceutical industry. The article reports on the
      development of the air particulate monitoring in the sterile manufacturing areas.
      In this respect, it presents a new approach which provides more assurance of
      acceptable air quality in the immediate environment of the manufacturing process
      and puts the emphasis on the preventive aspect. This approach is now possible by
      using available advanced systems which permit a continuous and simultaneous
      airborne particulate monitoring of critical manufacturing areas.

PMID- 1756007
TI  - Evaluation of the interfacial properties of a new potent antimicrobial surfactant
      C31G.
AB  - The surface activity of a new potent antimicrobial mixture (C31G) of alkyl
      betaines and alkyl amine oxides were evaluated in order to determine the
      relationship between its antimicrobial effectiveness and physical properties.
      Therefore the surface tension measurements were performed at different
      temperatures using an interfacial tensiometer. Critical micelle concentrations,
      interfacial and thermodynamic parameters of C31G were obtained from the surface
      tension data.

PMID- 1756008
TI  - [Metabolic destination and toxicologic profile of hydroxypropyl beta
      cyclodextrin].

PMID- 1756009
TI  - [Anaerobic co-digestion of RSU and macro-algae in the Venice lagoon. Preliminary
      results].
AB  - In these last few years in the lagoon of Venice the phenomenon of eutrophization
      has increased. The possibility of turning to an anaerobic digestion of the
      biomass seems to be interesting. In this view, the following experiment describes
      a study on the co-digestion of mechanically selected algaebiomass and organic
      fraction of solid urban waste. The results relevant to both yield parameters and
      process stability are reported, which have been obtained by monitoring a 3 m3
      pilot digestor during a running period of about 85 days, under different working
      conditions.

PMID- 1756010
TI  - [Wet oxidation of toxic industrial waste with oxygenated water].
AB  - The industrial toxic waste streams hot treatment technology with hydrogen
      peroxide and catalysts, developed by the research laboratories of Montefluos in
      Bollate, allows the abatement of many organic and bio-toxic pollutants. Some
      treatment examples are here reported. The examples, performed on a laboratory
      scale, relate to industrial waste streams with a high COD (100000-200000 mg/l) in
      which it was possible to obtain an abatement over the 90% of pollutants like
      phenols, formaldehyde, dimethylformamide and phenyl acetate. The application
      range of this technology is similar to that of oxygen or air wet oxidation, but
      it has remarkable advantages due to the lower plant, maintenance and energy
      costs, because the treatment is performed using much more bland conditions
      (atmospheric pressure and 90-100 degrees C of temperature). The aim of the bio
      toxic pollutants abatement and COD reduction (70-80%) is to allow the final bio
      digestion waste streams with high organic content, but too diluted to be directly
      incenerated at a suitable cost.

PMID- 1756011
TI  - Green wastes from Barcelona city. Influence of process parameters on the
      anaerobic digestion plant.
AB  - A sensibility analysis of the assumed operating conditions is carried out to test
      its influence on the performance of an anaerobic digestion plant to treat the
      organic fraction of the wastes of a large food market. The results shows that the
      filter press is an important equipment in the plant.

PMID- 1756012
TI  - Relationship between serum concentrations of flecainide and fluoride in humans.
AB  - The biotransformation of flecainide to serum fluoride after the oral
      administration of 100 mg to six healthy subjects was studied. Fluoride,
      flecainide acetate, calcium and alkaline phosphatase serum levels were determined
      at 0, 3, 4.5 and 6 hours after administration. Higher mean serum concentrations
      for fluoride and alkaline phosphatase (P less than 0.01, P less than 0.005) and
      lower mean calcium levels (P less than 0.05) were reached at 4.5 hours. The
      flecainide acetate serum levels ranged from 108 to 261 ng/ml. The results were
      analyzed for statistical significance by single factor analysis of variance with
      repeated measures. The Spearman rank correlation coefficient between flecainide
      acetate and fluoride serum increases was calculated. Our results would suggest
      that fluorine-containing flecainide could be biotransformed to yield some ionic
      fluoride which contribute to the daily fluoride intake.

PMID- 1756013
TI  - [The "challenge test" in the European pharmacopoeia].

PMID- 1756014
TI  - [Control of rabies with a vaccine produced from recombinant DNA].

PMID- 1756015
TI  - Hereditary breast cancer.

PMID- 1756016
TI  - Suicides in the young: an increasing medical problem.

PMID- 1756017
TI  - HLA antigens in insulin-dependent diabetes mellitus.
AB  - Diabetes mellitus is largely determined by genetic factors but environmental
      factors are necessary to convert genetic susceptibility into overt disease.
      Studies of twins show that the genetic impact in non-insulin-dependent diabetes
      mellitus is stronger than in insulin-dependent diabetes mellitus. The genetic
      factors involved in non-insulin-dependent diabetes mellitus are not known and the
      outcome of molecular genetic research has so far been disappointing. The major
      genetic susceptibility to insulin-dependent diabetes mellitus is conferred by
      genes in the HLA region on chromosome 6. Despite many advances in molecular
      genetics in insulin-dependent diabetes mellitus the serologically detectable HLA
      antigens and haplotypes are still the best available markers. This review
      describes the important developments in immunogenetics in insulin-dependent
      diabetes mellitus and summarises the main findings from earlier studies.
      Genetically the potential for primary prevention of insulin-dependent diabetes
      mellitus already exists and will become a reality as soon as the environmental
      determinants are identified. A wide application of immunogenetic methods will be
      needed in the prevention of insulin-dependent diabetes mellitus.

PMID- 1756018
TI  - Corticotropin-releasing hormone and opioid peptides in reproduction and stress.
AB  - Increased knowledge on the mechanisms whereby corticotropin releasing hormone
      (CRH) and opioid peptides mediate the effects of stress has helped us to
      understand the relationship between stress and disturbed reproductive function.
      Increases of CRH and beta-endorphin in the hypothalamus in stressful situations
      inhibits the secretion of gonadotropins, oxytocin and vasopressin. This may lead
      to amenorrhea, which often is a consequence of intensive training or
      psychological stress, or it may disrupt parturition and lactation. There is a
      relationship between ovarian function and opioid peptides in the hypothalamus.
      Opioid peptides increase during puberty and fall at the menopause. Oestradiol and
      progesterone increase beta-endorphin concentrations in the luteal phase of the
      menstrual cycle, and this is followed by a rapid fall at menstruation. These
      changes may mediate symptoms typical of the premenstrual syndrome. Rather
      intensive exercise is required to increase plasma concentrations of beta
      endorphin and corticotropin. During labour the amounts of beta-endorphin and
      corticotropin reach the values found in athletes during maximal exercise. The
      placenta produces increasing amounts of CRH towards the end of pregnancy which
      may help the mother and fetus to withstand the increased demands of labour. The
      placenta may thus be involved in the adaptation of the stress mechanism during
      pregnancy. CRH has also a paracrine function in different biological processes of
      the placenta and fetal membranes. It is possible to counteract the deleterious
      effects of stress on reproductive function by the administration of opiate
      antagonists. Induction of ovulation with naltrexone has been shown in patients
      with hypothalamic amenorrhea but the effect on fertility is not known.

PMID- 1756019
TI  - Ultraviolet radiation in skin ageing and carcinogenesis: the role of retinoids
      for treatment and prevention.
AB  - The mechanisms of UV-induced ageing and carcinogenesis of the skin have been
      elucidated in animals and humans, and both UVB and UVA radiation have been shown
      to have deleterious effects on the skin. Thus the use of solaria which deliver
      mostly UVA radiation is not safe. There is also an increased risk of ageing when
      using therapeutic UV sources. UV radiation is beneficial in many cases of skin
      disorders such as psoriasis, atopic eczema, acne and pruritus. Nevertheless by
      careful patient selection and follow-up the risks of UV can be minimised when
      treating patients with artificial UV radiation. During recent years there has
      been intensive research into the development of agents which prevent harmful
      effects of radiation. The retinoids are particularly interesting as they enhance
      skin repair after UV damage, have an anticarcinogenic effect and are effective
      for treating precancerous lesions such as solar keratosis and as adjuvant therapy
      for skin cancers. Topical retinoids are already used for the treatment of actinic
      skin damage, and systemic retinoids are also used in certain groups of patients
      who have an increased risk of contracting skin cancers such as xeroderma
      pigmentosum.

PMID- 1756020
TI  - Current status of small bowel transplantation.

PMID- 1756021
TI  - Cardiopulmonary exercise testing has limited value in diagnosing heart failure.
AB  - Usefulness of cardiopulmonary exercise testing in the diagnosis of heart failure
      was evaluated in a study of 59 patients with clinically suspected heart failure
      (22 men and 37 women) and 75 healthy control persons (34 men and 41 women), aged
      45-74 years. Patients were classified according to certainty of the diagnosis by
      the Boston criteria: 27 patients were "unlikely" to have heart failure (group I),
      19 had "possible" (group II) and 13 had "definite" heart failure (group III).
      Oxygen consumption at peak exercise and at the appearance of the ventilatory
      threshold was lower in group III than in the control group (15.6 +/- 1.5 versus
      26.0 +/- 0.8 ml/min/kg, p less than 0.001 and 11.8 +/- 1.5 versus 18.0 +/- 0.4
      ml/min/kg, p less than 0.001, respectively). However, the distribution of oxygen
      consumption values was wide in both the control and patient groups, and
      considerable overlapping of values between study groups was observed. Thus,
      cardiopulmonary exercise testing appeared to be of limited value in the diagnosis
      of heart failure.

PMID- 1756022
TI  - Acute phase reaction, infarct size and in-hospital morbidity in myocardial
      infarction patients treated with streptokinase or recombinant tissue type
      plasminogen activator.
AB  - We examined the acute phase reaction in myocardial infarction after thrombolytic
      treatment by streptokinase or tissue plasminogen activator. The magnitude of the
      acute phase reaction as determined by measurements of serum C-reactive protein
      and amyloid-A protein did not correlate with infarct size (determined by serial
      measurements of creatine kinase-MB) in this patient population. On the other
      hand, the development of acute cardiac failure was more closely associated with
      the magnitude of the acute phase reaction than with infarct size. The peak serum
      values of C-reactive protein in patients with and without acute cardiac failure
      were 128 mg/l (95% confidence intervals 85-170) and 60 mg/l (30-89); P less than
      0.01 and concentration time integrals 578 mg/l x days (368-787) and 205 mg/l x
      days (62-350); P less than 0.01. The corresponding creatine kinase-MB values were
      310 U/l (191-429) and 207 U/l (125-289) not significant; and 319 U/l x days (201
      437) and 204 U/l x days (124-286) not significant; respectively. Patients
      requiring medication for cardiac failure on discharge from hospital had higher C
      reactive protein and serum amyloid A protein values than those who did not,
      although the difference did not quite reach statistical significance. The infarct
      sizes were similar whether the patients needed medication for cardiac failure at
      discharge or not. Subjectively felt morbidity due to myocardial infarction was
      linearly associated with serum C-reactive protein peak values (P less than 0.05)
      and concentration time integrals (P less than 0.05), but not with infarct size.
      We conclude that thrombolytic treatment of myocardial infarction may reduce
      hospital inpatient morbidity independently of the limitation of infarct size.
      This diminished morbidity seems to be associated with modest or low acute phase
      reaction.

PMID- 1756023
TI  - Infection as a risk factor for infarction and atherosclerosis.
AB  - A growing amount of clinical and experimental evidence suggests a link between
      infection and atherosclerotic diseases including both myocardial and cerebral
      infarction. A prime example is a greatly increased risk of stroke in septicaemic
      patients with and without endocarditis. Controlled clinical studies have recently
      shown, however, that certain other milder bacterial infections are also a risk
      factor for infarction. A preceding febrile respiratory infection was a major risk
      factor for stroke in young and middle aged patients. In patients with acute
      myocardial infarction Chlamydia pneumoniae and dental infections seem to be risk
      factors according to one controlled clinical study. Several possible mechanisms
      could explain the observed association of infection and infarction. For instance,
      infection causes a hypercoagulable state which increases the risk of thrombosis.
      In addition, infection has profound and harmful effects on prostaglandin and
      lipid metabolism. Infection may also have some role in the atherosclerotic
      process itself by inducing damage and inflammation in vascular endothelium in the
      presence of hypercholesterolemia. So far, however, little clinical evidence is
      available to suggest that by controlling infection the risk of infarction or
      development of atherosclerotic lesions might be reduced except in patients with
      endocarditis, where the risk of thromboembolic complications rapidly diminished
      when the infection is controlled with antimicrobial therapy.

PMID- 1756024
TI  - Platelets, endothelium-dependent responses and atherosclerosis.
AB  - Basal release of endothelium-derived relaxing factor (EDRF) and prostacyclin from
      intact vascular endothelium may inhibit continuously platelet aggregation. If
      local platelet aggregation occurs, platelet-derived adenine nucleotides stimulate
      the release of EDRF. Stimulated EDRF release may override the direct
      vasoconstrictor effects of other platelet products such as thromboxane and
      serotonin resulting in local vasodilatation. In addition, stimulation of EDRF
      release by adenine nucleotides may inhibit further platelet adhesion and
      aggregation by a feedback mechanism. Thus, intact vascular endothelium may play
      an important role in the defense against platelet deposition and vasospasm. In
      atherosclerosis, basal and stimulated release of EDRF is markedly reduced.
      Endothelial dysfunction will impair this protective mechanism and will favour
      vasoconstriction and further platelet disposition. Occurrence of occlusive
      thrombus formation in patients with coronary artery disease may be
      pathophysiologically related to this impairment of endothelial defense.

PMID- 1756025
TI  - Mast cell granule-mediated uptake of low density lipoproteins by macrophages: a
      novel carrier mechanism leading to the formation of foam cells.
AB  - Mast cells are present in the arterial intima, the site of atherogenesis. To gain
      insight into the possible role of mast cells in the formation of the cholesterol
      loaded macrophage foam cells typical of both early and late atherosclerotic
      lesions, a model system was developed in which isolated rat serosal mast cells
      were incubated with mouse peritoneal macrophages in medium to which low-density
      lipoproteins (LDL) had been added. Stimulation of the mast cells was found to
      induce a 50-fold enhancement of LDL uptake by the macrophages, which
      concomitantly accumulated LDL-derived cholesterol. This process, called the
      "granule-mediated uptake of LDL", involves the following steps: (i) exocytosis of
      the cytoplasmic granules of the mast cells, (ii) escape of soluble granule
      components, such as histamine and a fraction of the granule heparin proteoglycans
      into the medium, leaving granule remnants consisting of neutral proteases
      embedded in a heparin proteoglycan matrix, (ii) binding of LDL to binding sites
      on the glycosaminoglycan side chains of the heparin proteoglycan component of the
      granule remnants, (iv) proteolytic degradation of the bound LDL by the neutral
      proteases of the granule remnants, (v) fusion of degraded LDL particles on the
      surfaces of the granule remnants, and (vi) phagocytosis of the LDL-laden granule
      remnants by the macrophages. Simultaneously, the soluble heparin proteoglycans,
      to which no proteolytic enzymes are bound, interact with LDL with formation of
      insoluble complexes which are also phagocytosed by the macrophages.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1756026
TI  - Recent evidence for the involvement of catecholamines and of macrophages in
      atherosclerotic processes.
AB  - The atherogenetic uptake of low density lipoprotein (LDL) is accelerated by the
      catecholamines adrenaline and noradrenaline at their pathophysical blood
      concentrations in rabbits and rats. A similar effect in man could account for the
      coronary risk factor status of cigarette smoking, hypertension, stress, etc. when
      associated with elevated circulating catecholamines. In human atheromatous
      lesions, the concentration of macrophages is greater in plaques which have
      fissured or ulcerated than in those which have not. This is compatible with the
      proposition that macrophages contribute to plaque fissure, the commonest
      immediate cause of coronary thrombosis.

PMID- 1756027
TI  - Effect of antioxidants on oxidative modification of LDL.
AB  - Human low density lipoprotein (LDL) with a molecular mass of 2.5 million contains
      on average 1300 molecules of polyunsaturated fatty acids (PUFAs) bound in the
      different lipid classes. The predominant antioxidant in LDL is alpha-tocopherol,
      with an average of 6 molecules in each LDL particle. The other substances with
      potential antioxidant activity are: gamma-tocopherol, beta-carotene, alpha
      carotene, lycopene, cryptoxanthin, cantaxanthin, phytofluene and ubiquinol-10.
      Each is present in amounts of only 1/20th to 1/300th of that of alpha-tocopherol.
      If LDL is exposed to oxidative conditions (Cu++ ions, macrophages) a lag phase
      precedes the oxidation of PUFAs. During the lag phase the antioxidants disappear
      with alpha-tocopherol the first to go and beta-carotene the last. The lag phase,
      which can readily be determined, is an index of the oxidation resistance of LDL.
      If LDL is loaded with vitamin E in vitro its oxidation resistance increases
      linearly with its alpha-tocopherol content according to the equation, y = kx+a.
      The same relationship is applicable if the alpha-tocopherol content of LDL is
      increased by taking oral vitamin E. Daily doses of 150, 225, 800 and 1200 IU RRR
      alpha-tocopherol increased the LDL alpha-tocopherol on average to 138%, 158%,
      144% and 215% of the initial value, the oxidation resistance being increased to
      118%, 156%, 135% and 175%, respectively. The efficiency of vitamin E-dependent (=
      k) and the vitamin independent (= a) oxidation resistance seem to be subject
      specific with strong individual variation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756028
TI  - Mitochondria, oxygen and reperfusion damage.
AB  - Reperfusion of the ischaemic or hypoxic heart elicits a number of oxygen
      dependent processes such as cell lysis and Ca2+ uptake. It is known that the
      energisation of mitochondria, which requires oxygen, plays a key role in these
      processes and that the organelle actively sequesters Ca2+ under these
      circumstances. In this brief review we discuss how oxidants derived from
      mitochondrial electron transport may perturb mitochondrial calcium handling on
      reoxygenation of the hypoxic myocardium. In addition we show that the
      immunosuppressive agent cyclosporin has little or no effect on the oxygen
      dependent increase in total cell Ca2+ which occurs when hypoxic myocytes are
      reoxygenated. This result suggests that the Ca2+ dependent mitochondrial pore,
      which is known to function under conditions of oxidative stress, does not play a
      major role in the perturbation of Ca2+ homeostasis which occurs on reoxygenation
      of hypoxic hearts.

PMID- 1756029
TI  - Calcium--a neglected key factor in arteriosclerosis. The pathogenic role of
      arterial calcium overload and its prevention by calcium antagonists.
AB  - Using specific calcium antagonists as experimental tools, both the physiological
      messenger and current carrying function of calcium ions as well as their
      pathogenetic potencies could be elucidated. Notably, excess intracellular calcium
      signalling and intra- and extracellular calcium overload turned out to be
      pathogenetic principles of general importance. In this context, progressive
      calcium overload of arteriosclerotic vascular walls and the antiarteriosclerotic
      effects of calcium antagonists, deserve particular interest. In fact, with the
      help of calcium antagonists, arterial calcium overload as decisive component of
      various types of experimental arteriosclerosis became accessible to a direct
      therapeutic intervention. According to their responsiveness to calcium
      antagonists, two pathophysiologically different types of experimental coronary
      plaques could be characterized: (1) The calcium type, i.e. coronary calcinosis of
      vitamin D3-intoxicated rats highly sensitive to calcium antagonist treatment, (2)
      the cholesterol type, represented by coronary atheromata of cholesterol
      intoxicated rabbits; this primary coronary cholesterol accumulation could not be
      inhibited by calcium antagonists. The formation of conventional human coronary
      artery plaques is characterized from the very early lesion onwards by a
      progressive local uptake of calcium, finally leading to lethal consequences.
      Conversely, the analysis of the mural cholesterol does not allow to discriminate
      arteriosclerotic from normal coronary artery segments. Thereby, conventional
      human coronary plaques typically represent a calcium-dominated type of human
      arteriosclerosis and differ widely from plaques produced in cholesterol-fed
      rabbits. The results indicate the decisive pathophysiological role of calcium and
      calcium overload in both calcium-dominated types of experimental arteriosclerosis
      and conventional human coronary artery plaques. Moreover, the
      antiarteriosclerotic effects of calcium antagonists are demonstrated to be based-
      in various types of experimental arteriosclerosis--on the inhibition of intra-
      and extracellular calcium overload of arterial walls evoked by various risk
      factors (vitamin D3 intoxication, hypertension, nicotine, diabetes).

PMID- 1756030
TI  - Use of adaptive behavior measures and overrepresentation of black students in
      programs for students with mild mental retardation.
AB  - The use of adaptive behavior information for classification and placement of
      black and white students with mild mental retardation was compared and
      overrepresentation of black students in special classes was analyzed. Adaptive
      behavior measures were not used to the same extent as general intelligence tests
      for either group, despite court decisions and recommendations by authoritative
      sources. Direct comparisons on general intellectual functioning and several
      indices of adaptive behavior yielded few differences, suggesting that an equal
      treatment conception of fairness was achieved despite substantial
      overrepresentation of black students in programs for students with mild mental
      retardation. Use of adaptive behavior needs to improve significantly to comply
      with legal requirements.

PMID- 1756031
TI  - Side effects during lithium treatment for psychiatric disorders in adults with
      mental retardation.
AB  - Previous clinical trials using lithium with individuals who have mental
      retardation have not emphasized the incidence of side effects. During a 58
      consecutive-week period at an outpatient clinic for adults with psychiatric
      illness and mental retardation or borderline intellectual functioning, 67% (10
      out of 15) patients had side effects. The percentage is similar to reports of
      side effects during lithium treatment in the general population. Results suggest
      that adults with mental retardation who take lithium may be as prone to side
      effects as those in the general population.

PMID- 1756032
TI  - Rett syndrome: a comprehensive review of the literature.
AB  - A comprehensive review of Rett syndrome, a recently identified developmental
      disability found only in females, was presented. The syndrome involves severe
      physical and mental handicaps. The rapidly accumulating research on Rett syndrome
      was reviewed for readers without a medical background. A brief history of Rett
      syndrome, the diagnostic criteria for this disorder, and the clinical stages that
      have been noted were presented. Information on the incidence of Rett syndrome and
      a discussion of issues in differential diagnosis (particularly with autism) was
      also included. The etiological data and genetic theories were then discussed as
      were treatment approaches and prognosis.

PMID- 1756033
TI  - Assessing the acceptability of behavioral treatments to persons with mental
      retardation.
AB  - Individuals with mild to moderate mental retardation living in community
      residential settings (Experiment 1) or an institutional setting (Experiment 2)
      rated the acceptability of differential reinforcement and time-out applied to a
      mild and a severe behavior problem. Using analogue methodology similar to
      previous treatment acceptability studies (e.g., Miltenberger, Lennox, & Erfanian,
      1989; Tarnowski, Rasnake, Mulicke, & Kelly, 1989), and a simplified rating scale
      developed for persons with mental retardation, community-based subjects rated
      differential reinforcement as more acceptable than time-out for the mild problem,
      whereas institutionalized subjects rated time-out as more acceptable than
      differential reinforcement when applied to the severe problem. These results were
      discussed and future research suggested.

PMID- 1756034
TI  - Emergence and maintenance of stereotypy and self-injury.
AB  - A three-level model was used to explain the emergence and maintenance of rhythmic
      stereotypy and self-injury. Level I represents rhythmic behaviors as internally
      regulated and common in normally developing infants, but delayed in onset among
      children with handicapping conditions. Consistent with homeostasis theory, Level
      II considers stereotypy and self-injury as adaptive responses to under- or
      overstimulating environments. Level III represents stereotypy and self-injury as
      learned behaviors emitted to control the behavior of others. The model includes
      fluid transitions between the levels. Implications for assessment intervention
      and prevention were discussed and further research suggested.

PMID- 1756035
TI  - EPA-requested workshop identifies research priorities for bioremediation
      technologies.

PMID- 1756036
TI  - New data base supports innovative technologies.

PMID- 1756037
TI  - Electrokinetic remediation applications studied at Sandia National Labs.

PMID- 1756038
TI  - Making cleanup decisions at hazardous waste sites: the clean sites approach.
AB  - This paper provides a summary of the results of an 18-month study conducted by
      Clean Sites, Inc. of Alexandria, Virginia. The study was designed to take a
      critical look at the way remedies are selected for abandoned hazardous waste
      sites that are cleaned up under the authority of the Comprehensive Environmental
      Response, Compensation, and Liability Act (CERCLA or Superfund) and to develop
      recommendations for improving that process. The recommendations were released in
      an October 1990 report entitled "Improving Remedy Selection: An Explicit and
      Interactive Process for the Superfund Program." Through a cooperative agreement
      with the U.S. Environmental Protection Agency, Clean Sites is working to test
      these recommendations. At two actual Superfund sites, Clean Sites will assist EPA
      in performing the remedy selection in accordance with the process Clean Sites has
      developed.

PMID- 1756039
TI  - An analysis of biomedical waste incineration.
AB  - The California Air Resources Board (ARB) completed a series of source tests of
      eight operating biomedical waste incinerators (BMWI) under conditions of typical
      operation. The emissions of certain metals, and chlorinated dioxins and furans in
      the flue gases of BMWI are relatively high in comparison to emissions from other
      combustion sources, such as hazardous waste or municipal waste incinerators of
      modern design. This study reports on an analysis of the status of the existing
      regulatory framework and the California data base. Clarification of definitional
      issues at the federal level is needed to effectively treat BMWI management
      issues. Although few relationships among combustion parameters and emissions were
      uncovered, patterns of emissions were evident, suggesting commonality and
      relationships among the waste stream constituents and emissions. Potential
      implications for future research, operation of BMWI, controls and source
      reduction and waste segregation strategies are also discussed.

PMID- 1756040
TI  - Annual average radon concentrations in California residences.
AB  - A study was conducted to determine the annual average radon concentrations in
      California residences, to determine the approximate fraction of the California
      population regularly exposed to radon concentrations of 4 pCi/l or greater, and
      to the extent possible, to identify regions of differing risk for high radon
      concentrations within the state. Annual average indoor radon concentrations were
      measured with passive (alpha track) samplers sent by mail and deployed by home
      occupants, who also completed questionnaires on building and occupant
      characteristics. For the 310 residences surveyed, concentrations ranged from 0.10
      to 16 pCi/l, with a geometric mean of whole-house (bedroom and living room)
      average concentrations of 0.85 pCi/l and a geometric standard deviation of 1.91.
      A total of 88,000 California residences (0.8 percent) were estimated to have
      radon concentrations exceeding 4 pCi/l. When the state was divided into six zones
      based on geology, significant differences in geometric mean radon concentrations
      were found between several of the zones. Zones with high geometric means were the
      Sierra Nevada mountains, the valleys east of the Sierra Nevada, the central
      valley (especially the southern portion), and Ventura and Santa Barbara Counties.
      Zones with low geometric means included most coastal counties and the portion of
      the state from Los Angeles and San Bernardino Counties south.

PMID- 1756041
TI  - A comparison of in situ vitrification and rotary kiln incineration for soils
      treatment.
AB  - In the hazardous waste community, the term "thermal destruction" is a catchall
      phrase that broadly refers to high temperature destruction of hazardous
      contaminants. Included in the thermal destruction category are treatment
      technologies such as rotary kiln incineration, fluidized bed incineration,
      infrared thermal treatment, wet air oxidation, pyrolytic incineration, and
      vitrification. Among them, conventional rotary kiln incineration, a disposal
      method for many years, is the most well established, and often serves as a
      barometer to gauge the relative success of similar technologies. Public sentiment
      on environmental issues and increasingly stringent environmental regulations has,
      over time, spurred design and development of innovative thermal treatment
      processes directed toward reducing harmful emissions and residuals that may
      require further treatment or disposal. In situ vitrification (ISV), a technology
      that combines heat and immobilization, is one such innovative and relatively new
      technology. This paper presents a comparison of ISV and rotary kiln incineration
      for soils treatment in the areas of process performance, process residuals,
      process limitations, applicable or relevant and appropriate (ARARs) regulations,
      criteria and limitations, and costs.

PMID- 1756042
TI  - Preoperative risk analysis in patients receiving Jarvik-7 artificial heart as a
      bridge to transplantation.
AB  - To distinguish high-risk patients prior to implantation of a Jarvik-7 artificial
      heart as a bridge to transplantation, our 37 attempts were reviewed
      retrospectively. Arbitrary scores of 1 to 4 were given for nine preoperative
      factors on the basis of results obtained by uni- and multivariate analyses
      between successful cases and failed attempts; transplant rejection (scored 4: S4)
      or postoperative heart failure (S3) as the indication, recipient height less than
      175 cm (S3), body surface area less than 1.8 m2 (S3), hyperbilirubinemia greater
      than 24 microM/l (S2), preoperative renal failure requiring dialysis (S2), weight
      less than 60 kg (S2), and age greater than 40 years (S1). All except one of the
      16 patients with successful bridge had a total score of less than 4, with an
      average score of 1.3 in contrast to 6.6 in the 21 failed cases (p less than
      0.001). Among the 17 patients who scored less than 4, 15 received transplants
      (specificity 90%), while only one qualified for transplantation among 20 patients
      who scored 4 or more (sensitivity 94%). The two unpredicted failures resulted
      from mediastinitis and pulmonary infarction, both attributable to postoperative
      management. Multiple preoperative factors in combination could have successfully
      predicted the outcome of mechanical support in our experience. These results
      underscore the importance of patient selection to achieve successful and
      effective use of the Jarvik-7 as a bridge to heart transplantation.

PMID- 1756043
TI  - Antibiotic prophylaxis in non-cardiac thoracic surgery: cefazolin versus placebo.
AB  - A total of 127 patients (57 given placebo and 70 given a single preoperative dose
      of 1 g cefazolin) undergoing thoracic surgery were included in a randomized
      double-blind trial. The two groups were similar in regard to mean age, sex ratio,
      in-hospital stay before surgery, underlying disease, risk factors, type of
      surgery, mean duration of surgical procedure, and mean duration of chest tube
      drainage. The relative risk of wound infection of the patients from the placebo
      group was 3.27 (range 1.5-11.5; 95% confidence interval). Cefazolin significantly
      reduced (p less than 0.01) the wound infection rate--1 case (1.5%) in the
      cefazolin group versus 8 cases (14%) in the placebo group--but not the incidence
      of postoperative pleural empyema--5 (7%) versus 8 cases (14%)--or nosocomial
      pneumonia--3 (4%) versus 5 cases (9%). Cultures were made from 3 out of 9 wound
      infections and Staphylococcus aureus or S. epidermidis was isolated in all 3. In
      addition, cultures were made from 6 out of 13 pleural cavity infections and S.
      aureus (1 case) or other microorganisms (5 cases) were isolated in all 6.
      Mortality was similar in both groups and all deaths unrelated to the infections.
      No adverse side effects of the drug were encountered. In conclusion, a single
      preoperative dose of 1 g cefazolin proved to be effective for reducing the wound
      infection rate in non-cardiac thoracic surgery.

PMID- 1756044
TI  - Assessment of the response to chemotherapy in oesophageal cancer.
AB  - Thirty-eight patients with localised oesophageal carcinoma have been studied by
      computed tomography (CT) and barium swallow before and after preoperative
      chemotherapy and the results correlated with the pathological findings in the
      resected specimen. Overall 48% of patients showed a complete or partial response
      to chemotherapy on CT, compared with 50% on barium and 94% on pathological
      examination. This study highlights deficiencies in CT scanning and barium swallow
      as methods of assessing the regression of tumor bulk following chemotherapy for
      oesophageal carcinoma. We suggest that strict and specific criteria will have to
      be laid down before the results of chemotherapy in this disease can be reliably
      and accurately evaluated.

PMID- 1756045
TI  - Reoperation for bioprosthetic valve dysfunction. A decade of clinical experience.
AB  - During the 1970s, initial clinical experience with bioprostheses determined their
      worldwide use. However, bioprosthetic reoperation (BPR) is now common,
      particularly in groups with extensive implantation of these valve substitutes.
      From January 1980 to December 1989, a total of 470 patients had a total of 618
      reoperations for bioprosthetic dysfunction and were retrospectively analyzed.
      Eighty-seven patients required a second BPR, 21 a third BPR, 5 a fourth BPR and 1
      patient a fifth BPR. Structural deterioration was the main cause of valve
      dysfunction for the first and second BPR. However, paravalvular leak and
      infective endocarditis were more frequent for the remaining additional
      reoperations. Hospital mortality was 12.6%, 14.9% and 37% after the first, second
      and third or subsequent BPR, respectively. Univariate statistical analysis shows
      as hospital mortality risk factors: age at the time of the surgery, preoperative
      NYHA functional class IV, emergency surgery, concomitant tricuspid surgery,
      double (mitro-aortic) valve dysfunction, active infective endocarditis as the
      cause of failure and prolonged aortic cross-clamping time. Hospital mortality
      declined from 19.8% to 11.8% for the first and second half decade, respectively
      (P less than 0.005). In conclusion, bioprosthetic valve reoperation entailed a
      higher hospital mortality, particularly in the risk group of patients. In our
      hands, surgical experience has determined the improvement of the clinical results
      in this group of patients.

PMID- 1756046
TI  - Preservation of the pulmonary annulus in total correction of tetralogy of Fallot.
      Decreasing transannular gradients in the early follow-up period.
AB  - The integrity of the pulmonary annulus was preserved in 21 of 22 children
      consecutively subjected to total correction of tetralogy of Fallot. There was one
      early death (4.8%). The 20 survivors were studied prospectively and constitute
      the basis of this report. Mean age was 59.3 +/- 35.3 months (range 6 months-12
      years). Eight patients (40%) had previous Blalock-Taussig shunts and 3 (15%) had
      associated cardiac anomalies. Two-dimensional Doppler echocardiography had
      demonstrated right ventricle to main pulmonary artery peak systolic gradients of
      75.4 +/- 12.7 mmHg (range 50-104 mmHg). Ventricular infundibulectomy was carried
      out in all patients but one, who had abnormal coronary anatomy. Extensive
      incision or resection of hypertrophied or abnormal muscle bands was performed.
      Pulmonary valve commissurotomy was performed in 14 patients (70%), 10 (50%) had
      autologous pericardium supravalvular enlargement of the pulmonary trunk and one
      (5%) had an infundibular bovine pericardial patch. Intraoperative, postrepair
      right/left ventricular pressure ratios were 0.67 +/- 0.18 (range 0.41-1.0). All
      ratios were accepted, because all patients were haemodynamically well and only
      two required inotropic (dopamine) support. There was no late mortality. During
      the early follow-up period (mean 13.0 +/- 5.4 months, range 7-25 months), all
      patients had two-dimensional Doppler echocardiography measured gradients at
      discharge (mean 44.2 +/- 22.6 mmHg, range 10-86 mmHg; p less than 0.001 vs.
      preoperative values), at 3 months (mean 31.1 +/- 14.5 mmHg, range 8-64 mmHg; p
      less than 0.011 vs. values at discharge) and at 6 months (mean 28.5 +/- 14.3
      mmHg, range 12-57 mmHg; p = 0.009 vs. values at discharge). A similar favourable
      evolution of the diameters of the pulmonary annulus and of the right pulmonary
      artery was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756047
TI  - Adenosine cardioplegia: reducing reperfusion injury of the ischaemic myocardium?
AB  - Hyperkalaemia-induced hypopolarization of the sarcolemnal membrane during
      standard crystalloid cardioplegic arrest potentiates calcium influx during
      reperfusion and is associated with depletion of high-energy phosphate reserves.
      Adenosine has been shown to induce fast cardiac arrest whilst preserving membrane
      hyperpolarization in an isolated rat heart model. In this study we compared the
      efficacy of adenosine, both as an arresting agent and as an ultrastructural,
      haemodynamic and high-energy phosphate preserving agent, in an in situ global
      ischemia model in the baboon with St. Thomas' Hospital solution No. 2 (ST2; n =
      8) and with Krebs-Henseleit buffer (KHB; n = 7). The addition of 10 mM adenosine
      to the non-cardioplegic KHB (ADO; n = 8) improved haemodynamic recovery
      significantly in terms of cardiac index (91.6% +/- 7.2 vs 59.9% +/- 9.9) and
      stroke volume index (101.6% +/- 8.9 vs 55.6 +/- 10.0) and was not statistically
      distinguishable from the ST2 with regard to cardiac index (91.6% +/- 7.2 vs 94.8%
      +/- 5.8), stroke volume index (101.6% +/- 8.9 vs 114.0% +/- 8.3) or left
      ventricular dP/dt (73.1% +/- 9.9 vs 87.0% +/- 12.4). Adenosine triphosphate was
      best preserved with ADO (103.5% +/- 21.1 vs 67.9% +/- 9.3 and 48.5% +/- 8.7)
      although this was not statistically significant. This suggests therefore that the
      mechanism of cardioprotection by adenosine occurs by means other than its role as
      high-energy phosphate precursor.

PMID- 1756048
TI  - An experimental study of hot air thermocoagulation in cardiac surgery.
AB  - Recently a thermocoagulator using hot air has been developed. It has been used
      for haemostatic purposes in a number of cases of liver, pulmonary and
      retroperitoneal cancer surgery. An experimental animal study was undertaken to
      evaluate the use of the thermocoagulator during cardiac surgery. Since the
      thermocoagulator produces coagulation necrosis, the epi-/myocardium including the
      epicardial coronary arteries was investigated microscopically for acute and
      chronic histopathological changes. The investigation demonstrated that the
      thermocoagulator is an effective hemostatic tool during cardiac surgery. The
      histological examination of the hearts has shown that the technique does not
      damage the myocardium or the coronary arteries neither at the time of application
      nor in the long term.

PMID- 1756049
TI  - Aortic valve replacement in Cogan's syndrome.
AB  - Cogan's syndrome is a systemic vasculitis of autoimmunologic origin. The main
      disturbances involve the eye, the ear and the heart, but many other structures
      can also be affected. Nonspecific abnormal laboratory findings are also present.
      The disease usually involves a cranial nerve, followed by aortitis which can
      affect the aortic valve and, more rarely, the cusps of the valve. Aortic lesions
      strongly influence the course of the disease and therefore the prognosis. When
      choosing the type of valve replacement, long-term corticosteroid therapy and the
      age and sex of the patient must be taken into account.

PMID- 1756050
TI  - Coarctation of the aorta associated with calcific aortic thrombosis in a neonate.
AB  - We report an unusual case of association of aortic coarctation with a calcified
      thrombus at the site of coarctation. To the best of our knowledge this is also
      the first such case that has been successfully treated.

PMID- 1756051
TI  - Persistent pleural effusion and post-traumatic subarachnoidal-pleural fistula.
AB  - Post-traumatic subarachnoidal-pleural fistulae are rare. We have found 22 cases
      in the literature. A patient who was successfully treated by thoracotomy 1 1/2
      years after blunt thoracic trauma is presented. Myelography is the diagnostic
      test of choice and surgical closure is necessary in most cases.

PMID- 1756052
TI  - Simultaneous right ventricular contraction and left ventricular fibrillation
      during cardiopulmonary bypass.
AB  - Two cases of brief left ventricular fibrillation concurrent with a beating right
      ventricle during cardiopulmonary bypass are described. Although no left or right
      ventricular dysfunction was detected postoperatively, this regional electrical
      heterogenicity suggests inhomogeneous myocardial protection during at least a
      short period of time. The precise mechanisms concerned are not clear and limited
      clinical and animal experimental analogies can be found in the literature.

PMID- 1756053
TI  - Fatal and nonfatal immersion injuries among New Jersey residents.
AB  - We identified immersion injuries of New Jersey residents from mortality and
      hospital discharge data. The incidence rate was 2.3 immersion injuries (1.3 fatal
      and 1.0 nonfatal) per 100,000 population per year. Incidence rates were elevated
      among young children, men, blacks, and residents of counties in the southern part
      of the state. Case fatality ratios increased with age and were higher for men
      than for women from 10 to 50 years of age.

PMID- 1756054
TI  - Postrace morbidity among runners.
AB  - We examined two general measures of morbidity, musculoskeletal problems and
      respiratory symptoms, among participants of a 42 km race. We compared the
      morbidity experience of these participants to runners racing shorter distance
      events (5 km and 10 km) on the same day. Male marathon runners were almost twice
      as likely (and female marathon runners four times as likely) to report a lower
      extremity musculoskeletal problem in the month after the race as nonmarathon
      runners. Although adjusting for other factors did not change the crude odds ratio
      for either men or women, logistic regression results indicated that the strongest
      factor associated with lower extremity musculoskeletal problems in the month
      after the marathon was the report of a musculoskeletal problem in the year before
      the marathon. Neither male nor female marathon runners reported an excess of
      respiratory symptoms compared to those who ran shorter distances. However, a
      report of respiratory symptoms in the month before the race was statistically
      associated with respiratory symptoms in the month after the race. These results
      suggest that runners who have had lower extremity musculoskeletal problems in the
      year before, or those who have recently experienced respiratory symptoms, should
      use caution when preparing for and recovering from racing events.

PMID- 1756055
TI  - Estimation of outpatient risk characteristics and influenza vaccination status:
      validation of a self-administered questionnaire.
AB  - As part of an effort to evaluate the effectiveness of a multifaceted, institution
      wide influenza vaccination program, we mailed a self-administered postcard
      questionnaire to 500 randomly selected outpatients following both the 1987-1988
      and 1988-1989 immunization seasons. The postcard asked if the patients received
      influenza vaccine, where they were immunized, whether they had any high-risk
      medical illnesses, their age at their last birthday, and their name. To assess
      the validity of the questionnaire, following the 1988 survey, we selected a 25%
      systematic sample of respondents and compared survey responses with medical
      record documentation. Response rates for the surveys were 77.6% for the 1988
      survey (two mailings) and 86.5% for the 1989 survey (three mailings). Ninety-four
      percent (n = 89) of charts selected for audit were successfully reviewed.
      Agreement between questionnaire responses and medical records was excellent, with
      greater than 90% agreement and kappas of .8 to .9 for classifying patients as
      high-risk and receipt of vaccine at the Department of Veterans' Affairs Medical
      Center. For other data, agreement ranged from 84% to 96% with kappas of .6 to
      .75. Responses to the 1989 survey also demonstrated the importance of sample
      frame definition and response wave on estimates of risk characteristics and
      vaccination rates. A self-administered postcard questionnaire is a valid tool for
      estimating outpatient risk characteristics and influenza vaccination rates.

PMID- 1756056
TI  - Development of a paraprofessional home visiting program for low-income mothers
      and infants.
AB  - This article reports the development of a paraprofessional home visiting program
      based upon empirically documented client needs, maintenance of the qualities of
      mutuality and cooperation found in the indigenous paraprofessionals, and methods
      of ongoing program revision. Three studies are described that suggested four
      areas of program emphasis: (1) continuity of services from pregnancy through
      infancy, (2) needs assessment procedures sensitive to a broad range of health and
      social problems, (3) an ongoing personal relationship with an indigenous
      paraprofessional, and (4) reduction of barriers to prenatal care inherent in the
      health care system itself. We provide examples of program application and
      revision through training of paraprofessionals, case management procedures, and
      interventions within the perinatal health care system.

PMID- 1756057
TI  - The making of a smoke-free hospital may not be as easy as you think.
AB  - Literature describing experiences in the implementation of a smoke-free policy in
      a hospital suggests that, with careful preparation and close monitoring, a smoke
      free policy can be successfully instituted. Despite this pervasive viewpoint, any
      hospital personnel considering the adoption of a smoke-free policy should be
      aware that the institution of such a policy may be quite difficult. The
      experience at University Hospital suggests that a strong policy statement,
      administrative support, and a comprehensive implementation plan have helped to
      achieve widespread compliance with the smoke-free policy among hospital
      employees. Unfortunately, the smoke-free policy has been less successful changing
      the smoking activities of the patients. Although others have not reported this
      compliance problem, we believe it is a real problem that many institutions will
      face. We present methods used to identify, combat, and monitor this compliance
      problem.

PMID- 1756058
TI  - Demographic, psychosocial, and medical correlates of Pap testing: a literature
      review.
AB  - The approaches used to ensure regular Pap testing must be tailored to
      sociodemographic, psychosocial, medical, and motivational factors that may change
      over a woman's life. Careful descriptions of the determinants of Pap testing at
      different stages are needed; the success of Pap-emphasizing programs designed
      without this information may be severely limited. We review the literature on
      demographic and psychosocial correlates of Pap testing and on the relationship of
      Pap smear frequency to contact with the medical care system and to preventive
      health behaviors. We include a discussion of factors related to preventive health
      behavior in general, so that the Pap test can be viewed against a range of
      behaviors. Pap program efforts must focus more precisely; our review of the
      available literature provides recommendations for improving Pap screening
      programs.

PMID- 1756059
TI  - Birthweight-specific infant mortality risk in cesarean section.
AB  - The role of cesarean section in improving infant survival has not been clearly
      documented. We calculated birthweight- and race-specific infant, neonatal, and
      postneonatal mortality risks by method of delivery for single- and multiple
      delivery infants, using data from 14 states, reported to the Centers for Disease
      Control through the 1980 National Infant Mortality Surveillance project. For
      single-delivery infants, the risk of death for infants delivered by cesarean
      section was 1.6 times higher than for infants delivered vaginally among blacks
      and 1.2 times higher among whites. The risk was 1.7 times higher during the
      neonatal period and 1.2 times higher during the postneonatal period. For infants
      with birthweight less than 1,000 grams, the risk of death was lower when infants
      were delivered by cesarean section. The risk of death among multiple-delivery
      infants born by cesarean section was significantly lower than for those born
      vaginally. This analysis demonstrates that, unlike other birthweight categories,
      infants with a very low birthweight may have better outcomes if delivered by
      cesarean section. However, we cannot recommend the routine use of cesarean
      section for delivering very low birthweight infants. Further studies are needed
      to determine survival of such infants after controlling for maternal and infant
      conditions that prompted delivery by cesarean section.

PMID- 1756060
TI  - Helmet use among competitive cyclists.
AB  - The United States Cycling Federation (USCF) decision in 1986 to mandate helmet
      use in all sponsored races marked a major initiative in cycling safety.
      Confirming earlier reports about the effectiveness of helmets in preventing
      injuries, this study also examines the attitudes of 554 USCF members toward the
      policy and about helmet use in both racing and nonracing situations. Although 64%
      of the racers reported some hardshell helmet use in training before the policy,
      80% used helmets in training after the ruling. Most cyclists favored the USCF
      policy, although only 19% favored requiring helmet use in all cycling situations.
      Attitudes about helmet policy and actual use by racers were inconsistent; large
      percentages of those opposing mandatory helmet use in racing (51%) and in
      training (76%) used helmets themselves. We suggest possibilities for incremental
      expansion of helmet use requirements for all riders.

PMID- 1756061
TI  - Physical fitness is inversely related to heart disease risk: a factor analytic
      study.
AB  - We measured cardiorespiratory endurance, muscular strength and endurance,
      anaerobic run time, coronary risk factors, and dietary habits in male fire
      fighters (n = 779, ages 18 to 64 years) and performed factor analysis to
      determine the interrelationships and underlying factor structure of the data set.
      Principal component analysis produced nine factors (eigenvalues greater than 1.0)
      accounting for 61% of the total variance. However, the variable loadings were
      inconsistent, preventing a meaningful interpretation of the factor solution.
      These problems were solved through the principal axis method of common factor
      analysis, which revealed three factors (eigenvalues greater than 1.0) accounting
      for 29% of the total variance. Orthogonal rotation (varimax method), showed
      Factors 1, 2, and 3 accounting for 52%, 29%, and 19%, respectively, of the common
      variance. Factor 1, labeled physical fitness capacity (PFC), included age,
      situps, treadmill performance time, pushups, maximum exercise heart rate, and
      anaerobic run time. Factor 2, designated coronary risk status (CRS), included
      body mass index, resting systolic and diastolic blood pressure, triglycerides,
      and the total cholesterol-high density lipoprotein cholesterol ratio. Factor 3,
      termed food frequency intake (FFI), included the weekly intake of fried foods,
      beef, pork, eggs, caffeine, and cheese. Percentage body fat loaded on both PFC
      and CRS. Measures such as blood pressure, grip strength, resting heart rate,
      maximum exercise systolic blood pressure, cigarettes smoked per day, and weekly
      frequency of milk, fish, fowl, and alcohol intake contributed little to the
      factor solution. Correlation coefficients after oblique rotation showed PFC to be
      inversely related to CRS (r = -0.48). However, FFI was independent of PFC (r =
      0.07) and CRS (r = -0.10).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756062
TI  - Cancer risk reduction counseling: a computer-assisted curriculum.
AB  - Significant progress has been made in the identification of factors associated
      with an increased risk of developing cancer. Cancer is increasingly viewed as a
      preventable disease. Its prevention involves risk reduction counseling. This
      counseling is an important skill for the family physician but can be difficult to
      learn and to teach. We used a prototype, computer-assisted cancer risk reduction
      counseling curriculum with first-year medical students. We found a statistically
      significant change in both knowledge-based and attitudinal questions and answers
      after the use of this curriculum.

PMID- 1756063
TI  - Preventive medicine residency training: a resident's perspective.
AB  - Preventive medicine as a discipline confronts considerable internal and external
      pressure today about society's needs for prevention specialists. Training in the
      field has remained static in the face of great changes. This article asserts the
      need to reassess the philosophy, content, and structure of graduate training in
      preventive medicine. The field of preventive medicine faces an identity crisis of
      its own making, trying to be everything to everybody. The need for funding to
      overcome the shortage of specialists remains a critical but difficult issue that
      demands innovative solutions.

PMID- 1756064
TI  - Medical Student Myopia Syndrome: a recently recognized pan-epidemic.

PMID- 1756065
TI  - War and the health of children.

PMID- 1756066
TI  - Resonance ionization spectroscopy for multiplex sequencing of tin-labeled DNA.
AB  - A method is described for synthesis of a tin reagent, triethylstannylpropanoic
      acid (TESPA), and its attachment to oligonucleotide primers. Except for the
      expected mobility retardation, the presence of [116Sn]-TESPA did not affect the
      sequencing ladder on electrophoresis gels. By using [120Sn]-TESPA and [35S]-dTTP
      simultaneously in the Sanger procedure, DNA bands on an electrophoresis gel were
      first located by autoradiography and then by resonance ionization spectroscopy to
      demonstrate the coincidence of the signals. Previous results using stable
      isotopes as labels on model compounds are now confirmed by their use in actual
      DNA sequencing products.

PMID- 1756067
TI  - An improved method for chromosome-specific labeling of alpha satellite DNA in
      situ by using denatured double-stranded DNA probes as primers in a primed in situ
      labeling (PRINS) procedure.
AB  - An improved primed in situ labeling (PRINS) procedure that provides fast, highly
      sensitive, and nonradioactive cytogenetic localization of chromosome-specific
      tandem repeat sequences is presented. The PRINS technique is based on the
      sequence-specific annealing in situ of unlabeled DNA. This DNA then serves as
      primer for chain elongation in situ catalyzed by a DNA polymerase. If biotin
      labeled nucleotides are used as substrate for the chain elongation, the
      hybridization site becomes labeled with biotin. The biotin is subsequently made
      visible through the binding of FITC-labeled avidin. Tandem repeat sequences may
      be detected in a few hours with synthetic oligonucleotides as primers, but
      specific labeling of single chromosomes is not easily obtained. This may be
      achieved, however, if denatured double-stranded DNA fragments from polymerase
      chain-reaction products or cloned probes are used as primers. In the latter case,
      single chromosome pairs are stained with a speed and ease (1 h reaction and no
      probe labeling) that are superior to traditional in situ hybridization.
      Subsequent high-quality Q banding of the chromosomes is also possible. The
      developments described here extends the range of applications of the PRINS
      technique, so that it now can operate with any type of probe that is available
      for traditional in situ hybridization.

PMID- 1756068
TI  - Heteromorphisms of pericentromeric heterochromatin of chromosome 19.
AB  - The pericentromeric heterochromatin of chromosome 19 exhibits considerable
      variation even by the G-banding technique. Nevertheless, the C-banding technique
      has been universally employed to investigate pericentromeric hetromorphisms. We
      demonstrate that optimal expression of the pericentromeric region can be achieved
      by using the AluI/G technique. The pericentromeric heterochromatin of chromosome
      19 is classified into four classes (I-IV). Fifty normal individuals were
      evaluated and the incidence of types I-IV were 26%, 17%, 51%, and 6%,
      respectively. No consistent relationship was observed between the types of
      heterochromatin identified by the AluI/G technique when compared with the other
      routinely used procedures.

PMID- 1756069
TI  - A novel approach to the rapid isolation and nucleotide sequencing of genomic
      clones.
AB  - In this study, a genomic library subdivided into fractions was rapidly screened
      by a Southern detection technique. Deletion libraries were obtained from
      recovered genomic clones by single random cuts with nuclease S1. These deletion
      libraries proved useful for localizing genes in the inserts and yielded, after
      size fractionation, nested deletions suitable for nucleotide sequencing. An
      heterologous vector (pDB21) carried the insert used as probe for all
      hybridizations involved in the process of genomic clones isolation and
      characterization.

PMID- 1756071
TI  - A scientific review of the association between prone sleeping position and sudden
      infant death syndrome.

PMID- 1756070
TI  - Cot death: should the prone sleeping position be discouraged?

PMID- 1756072
TI  - The association between the prone sleeping position and sudden infant death
      syndrome (SIDS): an editorial overview.

PMID- 1756073
TI  - An analysis of trends in the incidence of sudden infant death in The Netherlands
      1969-89.
AB  - There is considerable interest in the relationship between sleeping position and
      the occurrence of sudden infant death syndrome (SIDS). As changes have been
      reported in The Netherlands in the position infants have been placed to sleep,
      the national Dutch sudden infant death rates were analyzed over the time that
      such changes have taken place. The overall post-perinatal death rate (1 week less
      than 1 year) was around 4-4.5 per 1000 live births from 1969 until 1985. From
      1985 until 1989 the rate fell from 4.1 to 2.9 per 1000 live births. During the
      same period the cot death/SIDS rate rose from 0.44 per 1000 in 1969 to between
      1.08 and 1.31 per 1000 in 1977-87, and subsequently fell to 0.7 per 1000 in 1989.
      These trends coincided with changes in prone sleeping position demonstrated in
      national surveys. The problems of interpreting such national data, with only 50
      60% of infant deaths being autopsied and with the possibilities of
      misclassification over time, are fully discussed. The data are supportive of the
      relationship between prone sleeping position and cot death.

PMID- 1756074
TI  - Prone sleeping position and SIDS: evidence from recent case-control and cohort
      studies in Tasmania.
AB  - The most recent data from the cohort and case-control studies of SIDS and prone
      position recently reported from Tasmania are reviewed. The cohort analysis was
      based on 4103 infants born between 1 January 1988 and 1 December 1990 assessed as
      being at high risk at birth, of whom 29 later died of SIDS. A matched analysis
      which controlled for infant birthweight and maternal age indicated that prone
      sleeping position was associated with an increased risk of SIDS (OR 3.92, 95% Cl
      [1.37-11.24]). The case-control study was based on all (n = 55) Tasmanian SIDS
      death from October 1989 to April 1991 and matched live controls. The unadjusted
      odds ratio for prone position and SIDS was 5.04 (95% Cl [2.29-11.11]). The
      population attributable risk percentage, based on the high risk cohort data, was
      0.38 (95% Cl [0.35-0.41]), suggesting that a significant reduction in SIDS
      incidence might occur if the prevalence of the prone sleeping position in the
      infant population were reduced. Other factors which may be important for the
      development of any public health interventions to reduce SIDS based on these
      findings are discussed.

PMID- 1756075
TI  - A review of epidemiological studies of sudden infant death syndrome in southern
      New Zealand.
AB  - The rate of sudden infant death syndrome (SIDS) in Southern New Zealand has been
      very high with an apparent real increase in incidence from the early 1970s.
      Recent research is reviewed and the results of specific interventions aimed at
      preventing SIDS summarized. The intervention consisted of strongly advising new
      parents that their babies sleep on their back or side and that they avoid over
      heating, especially during infections. For the Otago area, child-care practice
      has been documented and prone sleeping of 1 month old babies has declined from
      41.8% in 1986 to 2.4% in 1989-90. There is also evidence that parental control of
      infants' thermal environment has improved, maternal smoking during pregnancy has
      slightly decreased and the number of babies breast fed at 1 month of age has
      increased by 11%. In Southern NZ there has been a decline in post-neonatal SIDS
      mortality from 6.3 deaths per 1000 live births 1979-84 to 1.3 per 1000 live
      births in 1990. There are grounds for supposing that the intervention has been
      causative of this change, a possibility being addressed by on-going studies.

PMID- 1756076
TI  - The pneumographic and medical investigation of infants suffering apparent life
      threatening episodes.
AB  - Investigation of 340 babies who suffered from apparent life threatening episodes
      (ALTE) was performed using pneumographic studies and a variety of medical
      investigations. A number of medical abnormalities were demonstrated by history or
      investigation, including gastro-oesophageal reflux (211), airways pathology (17),
      evidence of fits (25), brain-stem tumour (2), hypoglycaemia (2), respiratory
      syncytial virus (8) and possible Munchausen by proxy (5). Pneumographic
      abnormalities were detected in 27 of the 340 infants. Home monitors were used for
      135 infants. Future central apnoeas occurred in 20 of the 26 infants on home
      monitors that had had an abnormal pneumogram, compared with one of the 109
      infants on home monitors after a normal pneumogram. Thus pneumograms have a
      sensitivity and specificity of 95% for predicting central apnoeas in babies who
      have already suffered an ALTE. The effect of eyeball pressure on the heart rate
      was measured in 65 babies and was found to cause a brisk drop in heart rate in 32
      babies. Twenty-two of the 32 babies had future white apnoeas (usually associated
      with gastro-oesophageal reflux), compared with five of the 33 babies who had no
      drop in heart rate in response to eyeball pressure. Thus this test has a
      sensitivity of 81% and a specificity of 74% at predicting white apnoeas in babies
      who have already suffered an ALTE.

PMID- 1756077
TI  - Resource allocation in contemporary paediatrics: the case against high
      technology.
AB  - High technology has introduced a new dimension to medical treatment. There are
      inevitable social costs as well as benefits, and the allocation of resources to
      high technology, as opposed to other areas of health care, is a contentious
      issue. The current balance in health service funding between high technology and
      low technology is not appropriate. It is driven by the technological imperative
      and only offers solutions to a limited number of problems. There is a scarcity of
      health resources left to develop intersectoral responses and provide adequate
      funding for research into person-intensive interventions suitable for many
      problems. Arguments against allocating too many resources to high technology in
      paediatrics are examined in this paper.

PMID- 1756078
TI  - Herpes simplex virus type 1 infections presenting at birth.
AB  - Two cases of intra-uterine acquired neonatal herpes simplex type I presented with
      atypical skin lesions apparent at or shortly after birth; the timing and
      appearance of the lesions meant that herpes virus infections were not considered
      to be the most likely diagnosis. Once herpes simplex was diagnosed, both infants
      were treated with acyclovir. Prompt diagnosis and institution of acyclovir are
      imperative for a favourable outcome from neonatal herpes infections.

PMID- 1756079
TI  - Cord whole blood hyperviscosity: measurement, definition, incidence and clinical
      features.
AB  - Cord whole blood viscosity and haematocrit values (PCV) were determined in 2461
      live birth infants. Viscosity measurements were performed on an Australian
      designed coaxial narrow-gap viscometer. Normal viscosity values were determined
      for each week of gestation above 34 weeks. Hyperviscosity was defined as a
      viscosity value above 2 s.d. from the mean for each week of gestation and it
      occurred in 164 (6.7%) newborn infants. Although a close relationship existed
      between cord whole blood viscosity and PCV (r = 0.6597, P less than 0.0001), only
      47.4% of polycythaemic infants (PCV greater than 65) were also hyperviscous and
      only 23.9% of hyperviscous infants were also polycythaemic. Hence, using the
      haematocrit to select which infants require viscosity studies fails to detect
      many hyperviscous newborn infants. Hyperviscosity was less common (3.6%, P less
      than 0.001) in infants who were born by Caesarean section and more common (16.5%,
      P less than 0.001) in those who were growth retarded. Of the hyperviscous
      infants, 84.5% were not growth retarded, most (87.8%) were term and most (86.6%)
      were delivered vaginally. Most hyperviscous newborn infants may thus remain
      undetected unless routine whole blood viscosity studies are performed.

PMID- 1756080
TI  - The use of dexamethasone in full-term infants with severe respiratory failure and
      pulmonary barotrauma.
AB  - Eight full-term infants (mean gestation 39.9 weeks [range 37-42] and mean
      birthweight 3642 g [range 3060-4200]) with severe respiratory failure (median
      oxygenation index 28 [range 16-65] and median arterial/alveolar PO2 ratio
      (a/APO2) 0.094 [range 0.038-0.165]) and pulmonary barotrauma were treated with
      Dexamethasone, 0.5 mg/kg per day, from the median age of 5 days (range 3-22). Six
      of the eight (75%) infants survived. They were weaned from mechanical ventilation
      and extubated a median of 2.5 days after commencing treatment with Dexamethasone.
      Two infants died and one of them suffered recurrent pneumothoraces. There was a
      significant improvement in oxygenation in the seven infants who survived the 72 h
      period of observation. Their median oxygenation index was 24 when Dexamethasone
      was commenced compared with 8 after 12 h (P less than 0.05) and 10 after 36 h (P
      less than 0.025). Their a/APO2 ratio was 0.095 when Dexamethasone was commenced
      compared with 0.289 after 12 h (P less than 0.05) and 0.207 after 36 h (P less
      than 0.025). There was a significant increase in the infants' arterial mean blood
      pressure associated with Dexamethasone therapy and one infant developed
      Staphylococcus aureus septicaemia. In this uncontrolled study of eight full-term
      infants with severe respiratory failure and pulmonary barotrauma, the use of
      Dexamethasone was associated with significant improvement in oxygenation and
      rapid weaning from mechanical ventilation.

PMID- 1756081
TI  - Intravenous indomethacin therapy in preterm neonates with patent ductus
      arteriosus.
AB  - This study examined the response of the patent ductus arteriosus (PDA) to
      intravenous Indomethacin using serial two dimensional and Doppler
      echocardiography and documented the complications associated with therapy. Thirty
      six preterm neonates who were oxygen and ventilator dependent were studied when
      they were aged 3-7 days. The PDA initially closed in 22 (61%) and constricted in
      seven (19%) of the infants. It was non-responsive in five (14%) and the treatment
      was stopped because of complications in two (6%). Only three (43%) of seven
      neonates given a second course had PDA closure. In the 25 instances where there
      was PDA closure following Indomethacin, re-opening was documented
      echocardiographically on three (12%) occasions. Overall, Indomethacin therapy was
      successful in 29 (81%) neonates, PDA ligation was required in four (11%) and
      three died from unrelated causes. Three (8%) neonates developed major
      complications: multiple gastric perforations in the first, focal ileal
      perforation in the second, and necrotizing enterocolitis in the third. Treatment
      failure, PDA ligation and major complications occurred exclusively in neonates
      less than 28 weeks gestation. In view of the relatively low efficacy and high
      major complication rate in these extremely preterm infants, a randomized clinical
      trial needs to be conducted using two dimensional and Doppler echocardiography to
      allow accurate assessment of the PDA response to intravenous Indomethacin.

PMID- 1756082
TI  - Glucose-6-phosphate dehydrogenase enzyme activity in normal, hemizygote and
      heterozygote Kelantanese Malays.
AB  - This prospective study was performed to quantify glucose-6-phosphate
      dehydrogenase (G6PD) enzyme activity in deficient males and female heterozygotes.
      The methods used in the study were the fluorescent spot test, G6PD enzyme
      electrophoresis on cellulose acetate and quantitative assays. Forty-seven
      children who had been detected as spot screen deficient at birth were rescreened.
      Their first degree relatives were also included in the study. The mean enzyme
      activity of deficient males was 0.74 iu/g Hb (s.d. +/- 0.8), of female
      heterozygotes was 6.5 iu/g Hb (s.d. +/- 3.2) and of normal males was 12.1 iu/g Hb
      (s.d. +/- 3.5). The mean activity in deficient males was 6.1% of normal males.
      Most (35 of 47) of these fell into class 2 in Beutler's classification of G6PD
      variants. This indicates a population which may be susceptible to favism. Female
      heterozygotes had an intermediate enzyme activity with a wide scatter. Using a
      cut off point of enzyme activity of below 9.0 iu/g Hb gave sensitivity and
      specificity of 87% and 84% in detecting female heterozygotes. This group could be
      defined more accurately by combining quantitative assays with family studies.

PMID- 1756083
TI  - Survival, growth and quality of life in children after orthotopic liver
      transplantation: a 5 year experience.
AB  - The aims of this study were to investigate outcome and to evaluate areas of
      potential ongoing concern after orthotopic liver transplantation (OLT) in
      children. Actuarial survival in relation to age and degree of undernutrition at
      the time of OLT was evaluated in 53 children (age 0.58-14.2 years) undergoing OLT
      for endstage liver disease. Follow-up studies of growth and quality of life were
      undertaken in those with a minimum follow-up period of 12 months (n = 26). The
      overall 3 year actuarial survival was 70%. Survival rates did not differ between
      age groups (actuarial 2 year survival for ages less than 1, 1-5 and greater than
      5 years were 70, 70 and 69% respectively) but did differ according to nutritional
      status at OLT (actuarial 2 year survival for children with Z scores for weight
      less than -1 was 57%, greater than -1 was 95%; P = 0.004). Significant catch-up
      weight gain was observed by 18 months post-transplant, while height improved less
      rapidly. Quality of life (assessed by Vineland Adaptive Behaviour Scales
      incorporating socialization, daily living skills, communication and motor skills)
      was good (mean composite score 91 +/- 19). All school-aged children except one
      were attending normal school. Two children had mild to moderate intellectual
      handicap related to post-operative intracerebral complications. Satisfactory long
      term survival can be achieved after OLT in children regardless of age but the
      importance of pre-operative nutrition is emphasized. Survivors have an excellent
      chance of a good quality of life and of satisfactory catch-up weight gain and
      growth.

PMID- 1756084
TI  - Family adaptation to a child's chronic illness.

PMID- 1756085
TI  - Disaster nursing.

PMID- 1756086
TI  - Nurse anesthesia care.

PMID- 1756087
TI  - Occupational health nursing education.

PMID- 1756088
TI  - Mentorship.

PMID- 1756089
TI  - Alzheimer's disease.
AB  - This chapter has included a review of nursing research in Alzheimer's disease.
      Much of what is in the literature regarding nursing of Alzheimer's disease
      patients and their families is anecdotal and has not been validated by systematic
      research and is atheoretical. The majority of nursing research on Alzheimer's
      disease has been focused on patient characteristics and problem behaviors or on
      the needs and experiences of family caregivers. Research should continue in these
      areas along with testing nursing interventions to maintain optimal cognitive,
      physical, social, and emotional function of Alzheimer's disease patients.
      Explanatory theories should be devised and tested to advance the development of
      nursing knowledge in the care of Alzheimer's disease patients and family
      caregivers. Finally, more evaluation research is needed to test the cost
      effectiveness of home-based and institutional programs, including effects on
      Alzheimer's disease patients, family members, and staff caregivers.

PMID- 1756090
TI  - Nutritional studies in nursing.

PMID- 1756091
TI  - Health conceptualizations.

PMID- 1756092
TI  - Arthritis.

PMID- 1756093
TI  - Human responses to catastrophe.

PMID- 1756094
TI  - Family caregiving for the elderly.

PMID- 1756095
TI  - In vitro assessment of stereoselective hepatic metabolism of disopyramide in
      humans: comparison with in vivo data.
AB  - Metabolism of disopyramide (DP) enantiomers has been investigated in primary
      cultures of adult human hepatocytes. Results were compared with in vivo data
      obtained from a previous pharmacokinetic study (Le Corre et al. Drug Metab.
      Dispos. 16:858-864 1988). Metabolism of DP enantiomers as a function of
      incubation time showed constant velocity over time. The
      intracellular/extracellular distribution of both DP and mono-N
      desisopropyldisopyramide did not appear to be stereoselective. Metabolism of DP
      enantiomers as a function of substrate concentration followed a first order
      kinetics. The average fractions of (-)-(R)-DP and (+)-(S)-DP metabolized in vitro
      (4.7 +/- 2.7 and 7.1 +/- 4.2%, respectively, n = 4) were about 5-fold lower than
      the fractions metabolized in vivo (26.0 +/- 6.0 and 40.2 +/- 8.8%, respectively,
      n = 6). The stereoselective index [(+)-(S)/(-)-(R)] of the N-dealkylation pathway
      obtained in vitro (1.51 +/- 0.11, n = 4) was very close to the one obtained in
      vivo (1.55 +/- 0.10, n = 6). These results highlight the interest of hepatocyte
      cultures in the evaluation of drug metabolism and especially in the assessment of
      stereoselectivity.

PMID- 1756096
TI  - Interaction of pirprofen enantiomers with human serum albumin.
AB  - The interaction of pirprofen enantiomers with human serum albumin (HSA) was
      investigated by means of high-performance liquid chromatography (HPLC), circular
      dichroism (CD), and 1H NMR spectroscopy. HPLC experiments indicated that both
      pirprofen enantiomers were bound to one class of high-affinity binding sites
      (n(+) = 1.91 +/- 0.13, K(+) = (4.09 +/- 0.64) x 10(5) M-1, n(-) = 2.07 +/- 0.13,
      K(-) = (6.56 +/- 1.35) x 10(5) M-1) together with nonspecific binding (n'K'(+) =
      (1.51 +/- 0.21) x 10(4) M-1, n'K'(-) = (0.88 +/- 0.13) x 10(-4) M-1). Slight
      stereoselectivity in specific binding was demonstrated by the difference in
      product n(+)K(+) = (0.77 +/- 0.08) x 10(6) M-1 vs. n(-)K(-) = (1.30 +/- 0.21) x
      10(6) M-1, i.e., the ratio n(-)K(-)/n(+)K(+) = 1.7. CD measurements showed
      changes in the binding sites located on the aromatic amino acid side chains (a
      small positive band at 315 nm and a pronounced negative extrinsic Cotton effect
      in the region 250-280 nm). The protein remains, however, in its predominantly
      alpha-helical conformation. The 1H NMR difference spectra confirmed that both
      pirprofen enantiomers interacted with HSA specifically, most probably with site
      II on the albumin molecule.

PMID- 1756097
TI  - An evaluation of ibuprofen bioinversion by simulation.
AB  - Using a pharmacokinetic model recently proposed to explain ibuprofen disposition
      in man, plasma concentrations of pure ibuprofen enantiomers were simulated
      following oral administration of (-)-(R)-ibuprofen, (+)-(S)-ibuprofen, or rac
      ibuprofen. Simulated and literature values for AUC's were used to compare S/R
      ratios for different cases of the model and for different methods of calculating
      the fraction of R bioinverted to S. Numerical simulation using STELLA confirmed
      previous results for different cases of bioinversion. Simulated S/R AUC ratios,
      for administration of the racemate, ranged from 4.0 (presystemic bioinversion) to
      1.66 (systemic bioinversion). Literature values for S/R AUC ratios averaged 1.53
      +/- 0.2 for administration of the racemate; therefore, systemic bioinversion was
      concluded to be representative of ibuprofen disposition. Additional simulations
      of S/R AUC ratios, for administration of (-)-(R)-ibuprofen only, ranged from 1.5
      (presystemic bioinversion) to 0.66 (systemic bioinversion). Literature values for
      S/R AUC ratios averaged 0.50 +/- 0.9 for administration of (-)-(R)-ibuprofen
      only, which again supported conclusions of systemic bioinversion. Using different
      equations for estimation of fraction of R inverted to S (FR----S), results based
      on simulated data were identical; however, FR----S values based on literature
      data were different. Therefore, assumptions made for different FR----S equations
      do not appear to be rigorous. Calculations of FR----S, based on literature data,
      averaged 0.52 overall, indicating bioavailability of (+)-(S)-ibuprofen may be
      similar for a 150 mg dose of (+)-(S)-ibuprofen compared to a 200 mg dose of
      racemate.

PMID- 1756098
TI  - Food safety. Fish botulism, Hawaii.

PMID- 1756099
TI  - New estimates of maternal mortality.

PMID- 1756100
TI  - Yellow-fever vaccinating centres for international travel. Amendments to 1991
      publication.

PMID- 1756101
TI  - Acquired immunodeficiency syndrome (AIDS). The STD/AIDS control programme.

PMID- 1756102
TI  - Expanded programme on immunization. Measles outbreak, Kampala.

PMID- 1756103
TI  - The "EMIO" way--a different approach to listing etiologies in differential
      diagnosis.
AB  - To introduce the early diagnosis concept in oncology to medical students as early
      as possible in their curriculum, in the Cerrahpasa Medical School, University of
      Istanbul, English-speaking section, weekly workshops were added to their regular
      courses in Record Taking and Differential Diagnosis in the third year (six-year
      curriculum). A different method was selected in listing possible etiologies of
      signs and symptoms, to emphasize early diagnosis of malignancies. This approach
      aimed to arouse more interest in students who were actively participating in the
      formation of these lists, which finally were compiled as a syllabus.

PMID- 1756104
TI  - A process for developing a curriculum in ethics and human values.
AB  - This article describes the process and results of the deliberations of the group
      of authors at the 1989 spring meeting of the Northeast Group for Educational
      Affairs. The participants worked under the premise that someone had given an
      unlimited amount of money to fund a new medical school. They had to select and
      define what the educational goals would be and produce a plan to help students
      reach these goals. There had to be an evaluation process that documented progress
      toward the stated goals. This paper describes the ethics and human values
      curriculum, which should be of interest to cancer educators. The knowledge,
      skills, values, and attitudes are defined and the four-year process of
      implementing the teaching is described. This curriculum-planning process is
      applicable to any aspect of cancer education--first defining the outcome, then
      the evaluation process, and finally, how to get to that outcome.

PMID- 1756105
TI  - The use of video tape in teaching how psychological factors influence nutritional
      status in chronic/terminal illness.
AB  - The medical students of Louisiana State University Medical School in New Orleans
      are required to take a clinical nutrition course in their senior year. In 1989,
      audio-visual media were used to introduce the students to the ways that the
      psychological aspects of chronic/terminal illness can influence nutritional
      status. In order to illustrate this topic, a patient with acquired immune
      deficiency syndrome (AIDS) was interviewed by a psychiatrist, internist, and a
      dietitian over several weeks. The interviews were videotaped and the videotape
      was edited to 25 minutes to address specific areas including psychiatric
      symptomatology, coping with illness, attitude towards treatment, diet and
      nutritional status, and results of the anthropometric and clinical exams. During
      the nutrition course, the videotape was presented to the students with subsequent
      discussion facilitated by the psychiatrist. The students agreed the subject was
      favorably presented and had increased their understanding of psychological
      factors in physical illness. The pre- and post-film examinations suggested the
      students were already aware of many of the psychological issues of
      chronic/terminal illness. The videotaped interview of a real person diagnosed
      with a chronic/terminal illness was found to be useful in introducing a difficult
      subject within a limited course schedule.

PMID- 1756106
TI  - Impact of a student interdisciplinary oncology team project.
AB  - Team approaches to health care have been developing steadily over the past 30
      years in response to increasing concerns about accessibility, efficiency, and
      comprehensiveness of health care services. Implementation of team approaches has
      been accompanied by development of curricula and educational experiences that
      educate health professionals both in effective teamwork skills and in
      understanding the contributions each profession makes to comprehensive health
      care. Such a project was implemented in 1975 at the University of Hawaii
      involving the Schools of Nursing, Social Work, and Medicine. This paper describes
      an evaluation of the impact of an interdisciplinary team approach to the care of
      oncology patients by students in medicine, nursing, and social work. Evaluation
      is based upon project objectives using a series of pre- and posttest measures and
      weekly logs by participating students between 1979 and 1985. The paper addresses
      the following questions: What was the impact of the team experience on
      participating students as reflected in evaluation data? How effective was the
      Student Interdisciplinary Oncology Team Project in helping students achieve each
      of the seven stated objectives? What are the differences in professional
      socialization processes among the three professions represented in the project?

PMID- 1756107
TI  - Use of a modified Delphi technique to guide coordination of cancer education in
      Texas medical schools.
AB  - Delphi technique is a method of structuring group communication and is useful in
      achieving consensus on goals, plans, or positions. The Delphi technique was used
      to determine a course of action to enhance cancer education at each of eight
      medical schools in Texas. Participants in this study were deans of medicine and a
      faculty member considered to be the lead cancer expert in the curriculum. A three
      generation Delphi study was conducted with the deans using a telephone interview,
      a personal interview, and a conference of participants, including cancer experts.
      The Delphi technique was found to be an effective approach for increasing
      awareness of the statewide cancer plan, for involving all medical schools in
      achieving the goals of the plan, and for identifying means for enhancing cancer
      education at each medical school. A consensus was reached to develop a statewide
      standardized assessment of graduating medical students' knowledge about
      principles of cancer prevention and screening. The results could serve as a means
      of determining cancer education needs at each medical school.

PMID- 1756108
TI  - Teaching specialty cancer medicine in rural hospitals: the cancer outreach
      program as a model.
AB  - Cancer doctors and nurses are clustered in the metropolitan areas of Virginia.
      However, cancer patients are found throughout the state, and cancer mortality
      time trends are worse in the rural areas. Efforts to recruit cancer physicians
      and nurses to rural hospitals have been unsuccessful due to the practice
      characteristics, educational isolation, and economic disincentives. Our rural
      cancer education program involves the physicians and nurses currently in practice
      at two rural hospitals. We provide hands-on training in cancer care, continuing
      education, and intense week-long educational sessions. We have observed changes
      in physician and nurse practice styles that benefit the cancer patient including
      effective pain management, enrollment of patients on clinical trials, increased
      use of adjuvant therapy, and breast conservation. We are providing state-of-the
      art cancer care at the rural hospitals in the Cancer Outreach Program. We have
      improved the educational opportunities and increased utilization of the resources
      of the academic career center. We can modify the practice characteristics by
      providing needed clinical programs and enhancing the rural hospital/academic
      medical center link. We have shown that rural cancer care can be revenue-neutral
      or positive, and we are seeking creative solutions to the financial disincentives
      of rural specialty practice. We can assist the rural hospital in the recruitment
      of oncology specialty nurses and physicians by providing cancer care services,
      and the patient caseload is available to teach prospective rural subspecialty
      practitioners at the rural hospitals.

PMID- 1756109
TI  - Risk profiles of women with cervical neoplasia.
AB  - Risk-factor profiles were compared in M.D. Anderson Cancer Center patients with
      various uterine cervix histologic diagnoses. Intraepithelial neoplasia (n = 171)
      and condyloma (n = 82) were associated with significantly lower patient age (mean
      23.6 and 25.8 years, respectively). In addition, these two groups were lowest in
      annual income, age at beginning intercourse and at first pregnancy, and highest
      in percentages of black and Hispanic patients, number of sexual partners, and
      history of gonorrhea. Women with squamous carcinoma in situ (n = 47), who were
      about a decade older, exhibited a similar socioeconomic distribution and sexual
      history. All three groups also reported high prevalences of current smokers, were
      most likely to use oral contraceptives, and were least likely to use diaphragms
      or condoms. Patients with invasive squamous cell carcinoma (n = 77) had a mean
      age of 46.3 years, a large lowest-income constituency, and the highest mean
      number of pregnancies; they were least likely to have used oral contraceptives.
      Adenocarcinoma (n = 21) was epidemiologically distinct: a predominance of white
      woman characterized by high socioeconomic status, elevated body mass index, and
      non of the liberal sexual practices of the other groups. Primary and secondary
      prevention strategies must be tailored to the unique needs and socioeconomic
      status of the young at-risk populations.

PMID- 1756110
TI  - Primary prevention of malignant melanoma in a Swedish urban preschool sector.
AB  - Malignant melanoma is the most rapidly increasing tumor in Sweden. Sunburns in
      childhood are considered a major risk factor. In the spring of 1989, a health
      education program was therefore initiated in Stockholm County in cooperation with
      the local preschool authorities in the area. Lectures on malignant melanoma,
      hazards of sunburns in childhood, and the importance of sun awareness were
      arranged for the nursery school matrons in the preschool sector. Thirty-five of
      42 authorities (83%) wanted a lecture for their nursery school matrons, whereas
      17% of the authorities wanted to spread information on their own. Of 1,991
      nursery schools, 1,783 (90%) took part in the information program. These, the
      Stockholm nonparticipants, and the rest of the country received written
      information from the Federation of Swedish Municipalities by initiative of the
      Department of Cancer Prevention. A questionnaire distributed to 574 randomly
      selected nursery schools in Stockholm county and to 100 in a reference area
      outside Stockholm showed that sun awareness was reported high in both places.
      Face-to-face information disseminated by an established organization was more
      effective in increasing sun awareness in the preschool sector than mailed
      information alone. In the areas where lectures were given, the message of sun
      awareness practice was passed on to nursery school staff and parents twice as
      effectively as in the reference area (p less than 0.01).

PMID- 1756111
TI  - Information needs of families of cancer patients: a literature review and
      recommendations.
AB  - This paper reviews evidence on the kinds of information needed by family members
      of cancer patients, discusses why families frequently lack needed information,
      and suggests strategies for meeting their information needs. Studies reviewed
      show that families' needs for information are substantial and that a large
      percentage of family members feel that these needs have not been adequately met
      by health care providers. This lack of needed information negatively affects the
      patient's care as well as the physical, psychological, and social well-being of
      family members. Strategies for addressing this problem include wider distribution
      of generic information about cancer and treatments to family members as well as
      developing standard professional procedures for making information about a
      patient's clinical condition available to family members.

PMID- 1756112
TI  - Diacylglycerol-induced melanogenesis in Skh-2 pigmented hairless mice.
AB  - We investigated the effect of topically applied diacylglycerols (DG) on
      melanogenesis in Skh-2 pigmented hairless mouse skin. Groups of mice were treated
      according to 4 different regimens of either 1,2-dioctanoyl-sn-glycerol (DOG) or 1
      oleyl-2-acetyl-sn-glycerol (OAG) with or without ultraviolet irradiation (UVR).
      After the treatment regimens were completed, separated epidermal tissue was
      stained with L-dopa and thin sections of whole skin were stained by the Warthin
      Starry method to detect melanin deposition. Quantification of the stained areas
      by digital image analysis disclosed that DOG treatment without UVR increased the
      dopa-positive area in skin in a dose-dependent manner but had no effect on
      melanin deposition. DG treatment acted synergistically with UVR to enhance
      melanogenesis, with synergism being more pronounced for melanin deposition than
      for dopa staining. DOG treatment prior to UVR also resulted in an enhanced
      melanogenic response to UVR, suggesting that DG increases the sensitivity of
      melanocytes to subsequent UVR by inducing dopa oxidase activity. OAG also
      enhanced UVR-induced melanogenesis in a dose-dependent manner and was at least as
      potent an inducer as was DOG. Because DG is known to activate protein kinase C,
      our results suggest that a protein kinase C-dependent process is involved in
      melanogenesis.

PMID- 1756113
TI  - Photopatch testing with different ultraviolet A sources can yield discrepant test
      results.
AB  - A photopatch test series consisting of 27 substances was tested in 81 patients
      with suspected photosensitivity disorders. Irradiation was performed using the
      following light sources: TL-K 40W/09 bulbs (UVA'; lambda max. at 355 nm), UVASUN
      5000 (UVA''; lambda max. at 375 nm), and TL 20 W/12 bulbs (UVB; lambda max. at
      315 nm). One day after applying 4 sets of the test substances (D1), one test
      series each was exposed to 10 J/cm2 of UVA' or UVA'', or a combination of 40
      mJ/cm2 UVB and 10 J/cm2 UVA''; the fourth series was left nonirradiated
      (control). Photopatch test reactions (PPTR) were defined as positive if there was
      at least an indurated erythema on D3 or later between D3 and D21 (late-onset
      reactions) exclusively at the irradiated, but not at the control site. At least
      one positive PPTR was found in 35 patients (43%), 7 of whom exhibited late-onset
      reactions only; in 2 cases the tests could not be read because of skin
      irritation. On D3, there were 44 positive reactions with UVA', only 10 of which
      were also demonstrable with UVA''. Twenty-one late-onset PPTR were found with
      UVA' and 17 with UVA''. Late-onset reactions elicited by UVA' or UVA'' mostly
      were concordant; divergent positive or negative results were found only in a few
      cases. Compared with the results obtained with UVA' or UVA'' alone, combined
      irradiation with UVB and UVA'' occasionally led to divergent positive as well as
      negative results. When photopatch test results are interpreted, it should be
      considered that testing with different UVA sources may yield divergent results.

PMID- 1756114
TI  - Chronic actinic dermatitis: a time course study of histopathological changes.
AB  - We report herein a case of chronic actinic dermatitis in which histopathological
      changes were observed on several occasions during the course of 2 years. The
      findings were quite different among stages of the eruption. At a half year after
      the appearance of the lesion, histological findings revealed eczematous changes.
      However, gradually a granulomatous change appeared with histiocytes and giant
      cells. Although the mechanism of histogenesis is not clear, the appearance of
      histiocytic giant cells seems to be unusual in chronic actinic dermatitis.

PMID- 1756115
TI  - The hairless guinea pig as an experimental animal for photodermatology.
AB  - Photobiologic reactions to various modalities of ultraviolet light (UVL)
      irradiation were evaluated in the recently identified hairless guinea pig, Crl:
      IAF(HA)BR, a mutant from the Hartley strain. The cutaneous changes were observed
      macro- and microscopically. The animal developed similar but somewhat stronger
      reactions than the Hartley guinea pig to the UVB irradiation and topical and
      systemic PUVA treatments. The density of the epidermal Langerhans cell of the
      hairless guinea pig was significantly higher than that of the hairy strain. The
      photoallergic contact sensitization was easily induced by
      tetrachlorosalicylanilide. These results indicate that the hairless guinea pig
      can be used as an animal model for photobiologic and photoimmunologic
      investigations.

PMID- 1756116
TI  - Ultraviolet light hardening in polymorphous light eruption--a controlled study
      comparing different emission spectra.
AB  - Polymorphous light eruption (PLE) is a common disorder characterized by a
      delayed, abnormal response to ultraviolet (UV) radiation, with a varied
      morphology of itching efflorescences on sun-exposed areas of the skin. Thirty-one
      PLE subjects were treated with either UVA (340-400 nm) or UVA and UVB (300-400
      nm) phototherapy during spring 1987 (10 exposures to UV light). They were
      randomly allocated to these 2 groups. For subjects of the UVA group, the applied
      dose corresponded to their individual minimal tanning dose; for subjects of the
      UVA and UVB group it corresponded to approximately 3/4 of their individual
      minimal erythema dose. The sun protection effect was studied by a high dose of
      UVA (80-160 J/cm2; 340-440 nm) after the treatment period, by analysing the
      histidine content of the stratum corneum and the urocanic acid
      photoisomerization, and by evaluating the subjects' diaries. The patients were
      asked to expose their skin to sunlight at least 3 times after UV hardening in the
      following 2-10 weeks. The results of both the UVA provocation and of the natural
      sun exposure confirmed the success of UV hardening without the occurrence of
      severe side effects. The content of histidine and of its metabolite urocanic acid
      in stratum corneum was significantly increased during the treatment. These data
      are interpreted to be biochemical markers for improved sun protection.

PMID- 1756117
TI  - Age-related changes in photosensitivity and cellular sensitivity to ultraviolet B
      in a xeroderma pigmentosum group E patient.
AB  - Skin phototesting and cellular sensitivity studies were performed in a patient
      with xeroderma pigmentosum (XP) complementation group E (XP80TO) at the ages of
      50 and 55 years. She showed a reduced minimal erythema dose at both ages, but the
      dose at age 55 was much lower than that at age 50 when tested with monochromatic
      ultraviolet (UV) light (280, 290 and 300 nm). The cellular sensitivity to UVC
      (254 nm), UVB and UVA and UVC-induced unscheduled DNA synthesis were examined
      using fibroblasts obtained by skin biopsy at the ages of 50 and 55 (XP80TO-1 and
      XP80TO-2, respectively). DNA synthesis was similar in both cell lines. XP80TO-2
      cells were more sensitive to UVB cytotoxicity than XP80TO-1 cells in both the
      dividing and quiescent phases, but both cell lines exhibited a similar
      sensitivity to UVC and UVA. These results suggest that the in vitro cellular
      sensitivity to UVB may correlate with the clinically observed erythema reaction.
      Further, the results suggest that some XP complementation group E cases at least
      may show an increase in photosensitivity in vivo and in vitro with aging.

PMID- 1756118
TI  - Angelica-induced phytophotodermatitis.

PMID- 1756119
TI  - Effect of visible light irradiation on human epidermal Langerhans cell membrane
      marker defined by monoclonal antibody (Leu 6).

PMID- 1756120
TI  - Effect of ultraviolet irradiation on Langerhans cells in mast cell-deficient W/WV
      mice.

PMID- 1756121
TI  - Effect of ultraviolet (UV) radiation and UVB-absorbing sunscreen ingredients on
      7,12-dimethylbenz(a)anthracene-initiated skin tumorigenesis in hairless mice.

PMID- 1756122
TI  - [Patau's (trisomy 13) and Edwards' (trisomy 18) malformation syndromes].

PMID- 1756123
TI  - [The third world and tuberculosis].

PMID- 1756124
TI  - [Karl Klinke (1897-1972)].

PMID- 1756125
TI  - [Nursing and psychosocial care of patients with homozygote beta-thalassemia].

PMID- 1756126
TI  - [Organization of study courses "Nursing management and nursing science for
      nursing personnel. An explanation].

PMID- 1756127
TI  - [Healthpolitical list of requirements for the consolidation of preventive
      pediatrics in Germany. Proposal by the Association of Pediatricians for the
      installation of a pediatric section at the Federal Ministry of Health].

PMID- 1756128
TI  - [First event in continuing education at the Gelsenkirchen Urban Pediatric
      Hospital].

PMID- 1756129
TI  - [First mobile pediatric home nursing in Bavaria--one year after its beginning].

PMID- 1756131
TI  - Focused issue on myocardial stunning.

PMID- 1756130
TI  - Stunning of the myocardium: an update.
AB  - When severely ischemic myocardium is reperfused, prolonged myocardial dysfunction
      -a phenomenon named myocardial stunning--frequently occurs. Stunning also occurs
      in a variety of other situations. These include myocardium located adjacent to
      infarcted tissue, transient increase in myocardial O2 demands in the presence of
      incomplete coronary obstruction, during both systole and diastole, in isolated
      perfused hearts rendered ischemic or anoxic, and in a variety of clinical
      situations, such as following ischemic arrest in cardiac surgery, thrombolytic
      reperfusion, and after episodes of severe ischemia in Prinzmetal's angina or
      unstable angina. Although the fundamental mechanism(s) responsible for myocardial
      stunning has not been elucidated, in experimental preparations calcium
      antagonists, free-radical scavengers, and neutrophil depletion have each been
      found to be helpful in minimizing it.

PMID- 1756133
TI  - Clinical relevance of myocardial "stunning".
AB  - Experimental studies have demonstrated that myocardium reperfused after
      reversible ischemia exhibits prolonged depression of contractile function
      ("stunning"). Despite the multiplicity of clinical situations in which myocardial
      stunning would be expected to occur, investigation of this phenomenon in humans
      has been hindered by several major problems, including the limited accuracy of
      the methods available to measure regional left ventricular function, the
      inability to quantify regional myocardial blood flow during acute ischemia, the
      difficulty in establishing with certainty, the beginning and end of an ischemic
      episode, and the uncontrolled influence of variables (such as preload, afterload,
      adrenergic tone, and inotropic therapy) that have a major impact on postischemic
      dysfunction. The main problem is to discern whether a reversible defect of
      contractility is caused by stunning, silent ischemia, or hibernation (i.e.,
      chronic ischemia). This differential diagnosis requires the simultaneous
      measurement of regional myocardial function and flow, which thus far has not been
      generally possible. Despite these limitations, however, numerous clinical
      observations suggest that stunning does occur in various settings in which the
      myocardium is exposed to transient ischemia, including coronary angioplasty,
      exercise-induced angina, angina at rest (unstable or variant), acute myocardial
      infarction with early reperfusion, open-heart surgery, and cardiac
      transplantation. Recognition of this entity is important, amongst other reasons,
      because it is likely to cause significant morbidity and because it is potentially
      correctable with inotropic therapy or even preventable with antioxidant therapy.
      In addition, the appreciation of the phenomenon of myocardial stunning should
      allow the clinician to assess the efficacy of reperfusion therapy with greater
      accuracy and to recognize that patients should not be denied mechanical
      revascularization solely because of an abnormal left ventricular wall motion.
      Perhaps the most intriguing clinical implication of the concept of myocardial
      stunning is the possibility that in patients who exhibit frequent episodes of
      ischemia in the same territory, the myocardium may not be able to fully recover
      between episodes and thus may remain reversibly depressed for prolonged periods
      of time, or even chronically, which could account for some cases of "ischemic
      cardiomyopathy." Our understanding of myocardial stunning in humans is still
      relatively crude and will not significantly improve until studies are performed
      that measure simultaneously regional myocardial perfusion and function (so that
      stunning can be differentiated from silent ischemia and hibernation). Future
      important areas of research should also include the elucidation of whether
      stunning can become chronic and the evaluation of therapies (such as antioxidant
      treatments) designed to prevent this contractile abnormality.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1756134
TI  - Pathogenetic role for calcium in stunning?
AB  - Cellular calcium homeostasis is disturbed during brief periods of ischemia, with
      free cytosolic Ca ([Ca2+]i) rising severalfold within 10-15 minutes (or even
      sooner). Nevertheless, the myocardial cells' ability to regulate Ca recovers
      quickly after reperfusion, unlike the lingering depression of contractile
      function known as stunning. This brief commentary considers the hypothesis that
      the rise in cell calcium during ischemia and during early reperfusion leaves
      behind stunning as an unwelcome legacy. This idea by no means excludes the
      involvement of other factors, such as free radicals; instead, it suggests a
      possible common pathway for cell injury by a variety of specific agents. A
      provocative feature of the formulation is the idea that the crucial lesion in
      stunning occurs at the level of the contractile proteins, rather than more
      proximally.

PMID- 1756132
TI  - Stunning: a radical re-view.
AB  - The recovery from trauma, whether ischemia or some other form of tissue injury,
      is never instantaneous; time is always required for repair and the return of
      normal metabolism and function. To what extent the delay in recovery of
      contractile activity (stunning) after a brief period of ischemia represents
      convalescence from ischemia-induced injury, as opposed to the expression of
      reperfusion-induced injury, is perhaps not as clear as the proponents of stunning
      would hope. Definitive evidence for a distinct reperfusion-induced pathology,
      which compromises the recovery of contractile function from the depressed state
      induced by ischemia, is elusive. If reperfusion-induced injury accounts for a
      significant proportion of stunning, then the molecular mechanisms responsible for
      initiating the event and those responsible for orchestrating the event at the
      level of the contractile protein are far from clear. Perturbations of calcium
      homeostasis are frequently cited as responsible for the depressed contractile
      state, however, some metabolic derangement must precede any pathologically
      induced ionic disturbance. In this connection, evidence indicates that free
      radical-induced oxidant stress, during the early moments of reperfusion, may
      modify the activity of a number of thiol-regulated proteins that are directly, or
      indirectly, responsible for controlling the movement of calcium. Sarcolemmal
      sodium-calcium exchange and the calcium release channel of the sarcoplasmic
      reticulum may be activated, whereas the sarcolemmal calcium pump and sodium
      potassium ATPase, together with the calcium pump of the sarcoplasmic reticulum,
      may be inhibited. Under the conditions prevailing during ischemia and
      reperfusion, this would be expected to promote an early intracellular calcium
      overload. It is difficult to reconcile such a change with the decreased inotropic
      state that characterizes stunning; however, it seems likely that the calcium
      overload is transient and that the stunned myocardium rapidly reestablishes
      normal levels of intracellular calcium. It is still difficult to explain
      adequately the reduced inotropic state; clearly, the mechanism of stunning is not
      quite as simple as its definition.

PMID- 1756135
TI  - Postischemic stunning--the case for calcium as the ultimate culprit.
AB  - Two phases of the stunning phenomenon are proposed. The first causative phase
      occurs almost immediately with reperfusion and is thought to be associated with
      cytosolic calcium overload and an apparently normal or nearly normal mechanical
      function. Agents enhancing calcium influx, if introduced at this stage, may
      worsen subsequent stunning, whereas those inhibiting calcium influx may lessen
      the extent of subsequent stunning. The second phase, true stunning, is associated
      with established hypocontractility and responds favorably to agents enhancing
      calcium influx, whereas calcium antagonists further impair mechanical function
      when given at this stage. These patterns, derived from data obtained on isolated
      rat-heart studies, cannot directly be extrapolated to the large animal heart,
      such as that of the dog, where the presence of added circulating leukocytes may
      confound the issue and explain the apparently contradictory benefit of the late
      administration of calcium antagonists. The harmful effects of free radicals are
      not discounted but could be explained, at least in part, by multiple membrane
      damage, with a consequent rise of cytosolic calcium during the reperfusion
      period.

PMID- 1756136
TI  - Role of adenosine in the treatment of myocardial stunning.
AB  - Adenosine is an endogenous nucleoside produced from the breakdown of adenosine
      triphosphate (ATP) that possesses a number of complex cellular and metabolic
      effects that could ameliorate postischemic contractile dysfunction (myocardial
      stunning). Potential mechanisms include the repletion of high-energy phosphate
      stores, reduced myocardial oxygen consumption, a decrease in oxygen-derived free
      radicals, restoration of calcium homeostasis, and an increase in regional
      myocardial blood flow. Experimental studies have shown that adenosine can reduce
      myocardial stunning with or without a concomitant increase in the total
      myocardial ATP stores. Adenosine may be a useful pharmacologic strategy in the
      prevention and treatment of ventricular dysfunction following episodes of
      regional or global ischemia, although further studies are needed to clarify the
      precise cellular mechanisms involved.

PMID- 1756137
TI  - Do neutrophils contribute to myocardial stunning?
AB  - Although removal of neutrophils from the arterial blood by mechanical filtration
      has been reported to prevent or reduce the severity of myocardial stunning caused
      by a 15 minute coronary artery occlusion in the dog, neutrophil filtration does
      not protect against myocardial dysfunction following a 10-minute occlusion.
      Nonfilter methods to reduce neutrophil numbers or effectiveness with anti
      neutrophil serum, monoclonal anti-CD11b antibodies, or the lipoxygenase inhibitor
      nafazatrom fail to modify myocardial dysfunction after brief ischemia, even
      though they effectively reduce infarct size after more prolonged ischemia. The
      brief durations of ischemia required to produce myocardial stunning but to avoid
      necrosis are insufficient to produce local activation of complement, formation of
      chemotactic factors, or activation or infiltration of neutrophils. Microvascular
      plugging with neutrophils cannot be demonstrated in stunned myocardium, and
      abnormalities of microvascular function can be dissociated from impaired
      postischemic myocardial function. Based on the weight of accumulated evidence,
      neutrophils appear to have no important role in the production of stunned
      myocardium.

PMID- 1756138
TI  - Proclivity of activated neutrophils to cause postischemic cardiac dysfunction:
      participation in stunning?
AB  - Myocardial stunning is a reversible defect in contractile function provoked by
      brief episodes of ischemia followed by reperfusion. Many studies have
      demonstrated the potential involvement of free radicals in the etiology of
      myocardial stunning. While activated neutrophils have the capacity to release
      free radicals and evoke contractile dysfunction, it is not clear that this
      potential is realized in the absence of myocellular damage. Attempts to define
      the contribution of activated neutrophils to myocardial stunning by removing the
      cells from the bloodstream are contradictory, and the apparent simplicity of this
      seemingly logical approach is an illusion. For example, it is not known how many
      neutrophils are required to induce contractile failure, the site of action within
      the heart, the mechanisms that may be responsible, or even the time course or
      process of neutrophil activation. The production of free radicals and endothelial
      dysfunction may create conditions propitious for neutrophil recruitment. However,
      because activated neutrophils synthesize and release various mediators that are
      potentially toxic to myocardium, once the stage is reached for leukocyte
      accumulation, it may herald the progression from reversible to irreversible
      cardiac injury.

PMID- 1756139
TI  - Molecular mechanisms in "stunned" myocardium.
AB  - In a recent overview on stunning, Bolli listed the three pillars on which
      theories on stunning rest: its causation by oxygen radicals, the amplification of
      damage by Ca2+ overload, and the resulting excitation contraction uncoupling. Our
      own experiments with SOD and catalase do not convince us that stunning is caused
      by free radicals, because we and others were unable to show improvement. An
      important pathway of radical generation, i.e., xanthine oxidase, does not exist
      in the hearts of several families of mammals, but stunning can of course be
      produced in these species. We agree with Bolli that stunning represents a
      disturbance of electromechanical coupling, but we acknowledge the controversy
      that exists with regard to the subcellular seat of the defect. Our results would
      support hypotheses that pinpoint the defect to the sarcoplasmic reticulum.
      However, the possibility of multiple defects should also be considered: Our
      finding of altered Ca2+ ATPase expression and Kusuoka's finding of altered
      myofibrillar Ca2+ sensitivity are not necessarily mutually exclusive but may be
      complementary, or may represent different stages of ischemic damage. Our finding
      of decreased myosin expression may help to explain the long persistence of the
      contractile defect. From the available evidence, the hypothetial possibility
      evolves that stunning is not just an injury, but rather the unmasking of a
      regulatory mechanism to protect the heart against premature or further damage.
      The observation that coronary occlusion causes both stunning and preconditioning
      by a parallel, and not by a sequential, mechanism and that a multitude of genes
      alter their expression in order to protect the myocyte argue for a regulatory
      change.

PMID- 1756140
TI  - Preconditioning myocardium with ischemia.
AB  - Preconditioning and stunning are the chief adaptive changes induced in myocardium
      by a brief episode of reversible ischemia followed by arterial reperfusion. In
      the dog heart, both coexist for a period of at least 20 minutes of reperfusion,
      but after 120 minutes of reflow, preconditioning is much diminished, while
      stunning remains fully developed. Preconditioned, stunned, myocardium differs
      from control "virgin" myocardium in that adenine nucleotide content is reduced to
      about 50-70% of control, whereas creatine phosphate (CP) greatly exceeds normal-
      the so-called CP overshoot. When preconditioned myocardium is subjected to
      sustained ischemia, ATP utilization and anaerobic glycolysis occur at much slower
      rates than those observed in virgin myocardium. As a result of the early
      difference in metabolic rate, a longer period of ischemia is required for the ATP
      and lactate of the preconditioned tissue to reach the levels associated with
      irreversible injury. Associated with this change is a delay in myocyte death. The
      molecular events responsible for slower ischemic metabolism and associated
      tolerance of preconditioned, stunned tissue to a new ischemic episode are not
      known. Among the reactions that could cause a reduction in energy metabolism is
      reduced approximately P expenditure by stunned myocardium attempting to contract
      during the initial phase of ischemia. However, results from in vivo and in vitro
      experiments suggest that although stunning may be necessary for preconditioning
      to develop, it alone is not sufficient to cause preconditioning. Alternatively,
      metabolic changes may be explained by depressed activity of the mitochondrial
      ATPase during the episode of sustained ischemia. However, no direct experimental
      evidence supporting this hypothesis is available up to the present time.

PMID- 1756143
TI  - Oxidative metabolism in reperfused myocardium.

PMID- 1756141
TI  - Stunning: damaging or protective to the myocardium?
AB  - There are several potential outcomes of myocardial ischemia. When ischemia is
      severe and prolonged, irreversible damage occurs and there is no recovery of
      contractile function. Interventions aimed at reducing mechanical activity and
      oxygen demand, either before ischemia or during reperfusion, have been shown to
      delay the onset of ischemic damage and to improve recovery on reperfusion. When
      myocardial ischemia is less severe but still prolonged, myocytes may remain
      viable but exhibit depressed contractile function. Under these conditions,
      reperfusion restores complete contractile performance. This type of ischemia,
      leading to a reversible, chronic left ventricular dysfunction, has been termed
      hibernating myocardium. Depression of mechanical activity is, actually, a
      protective mechanism whereby the hibernating cells reduce their oxygen demands in
      the setting of reduced oxygen supply. A third possible outcome after a short
      period of myocardial ischemia is a transient postischemic ventricular
      dysfunction, a situation termed stunned myocardium. As in the case of hibernating
      myocardium, the depressed contractile function occurring during stunning could be
      a protective mechanism, allowing the reperfused cells to gradually recover their
      metabolism and function.

PMID- 1756142
TI  - Calcium antagonists and stunned myocardium: importance for clinicians?
AB  - Experimental evidence indicates that calcium antagonists enhance the recovery of
      contractile function in canine myocardium stunned by a brief, 15-minute episode
      of transient coronary artery occlusion. In fact, both nifedipine and verapamil
      have been shown to improve systolic contraction, even when treatment was delayed,
      that is, when the agents were administered 30 minutes after reperfusion. The
      beneficial effects of delayed treatment were not a consequence of myocardial high
      energy phosphate preservation. Furthermore, as low-dose intracoronary nifedipine
      enhanced the recovery of function in the absence of systemic hemodynamic or
      coronary vasodilatory effects, the improved function associated with delayed
      administration of calcium antagonists could not be attributed solely to afterload
      reduction or increased coronary blood flow. These data suggest that calcium
      channel blockers exert a direct effect on the previously ischemic tissue, perhaps
      by subtle modulation of calcium transport or flux within the stunned myocytes.
      Although the precise mechanism of action of these agents remain unresolved, these
      intriguing experimental results raise the possibility that calcium antagonists
      may provide a clinically useful means of attenuating postischemic dysfunction of
      viable myocardium salvaged by thrombolysis, angioplasty, or cardiopulmonary
      bypass. The potential role of calcium-channel blockers in these clinical
      instances of stunned myocardium awaits further evaluation.

PMID- 1756145
TI  - A signal transduction through a unique rat T cell specific antigen, 8H3.
AB  - A signal transduction was detected in various rat T cells by cross-linking of 8H3
      antigen by 8H3 antibody. A rat T cell proliferative response induced by 8H3
      antibody is dependent on the presence of adherent cells. When spleen cells were
      cultured in the presence of 8H3 antibody, only CD4-positive T cell proliferation
      was induced. These proliferative CD4-positive T cells express rat interleukin 2
      receptor, alpha chain. Cross-linking of 8H3 antigen resulted in an increase in
      cytoplasmic free Ca2+ in T cells and phosphorylation of a 120 kDa component of
      the 8H3 antigen. It should be noted that cross-linking of 8H3 antigen together
      with CD4 antigen but not with CD8 antigen by suboptimal doses of 8H3 and
      corresponding antibodies initiated the mobilization of [Ca2+]i. Furthermore,
      physical association of 8H3 antigen with TCR was demonstrated by comodulation of
      these two molecular complexes in some T cells. Thus, 8H3 antigen is involved in
      rat T cell transmembrane signal transduction.

PMID- 1756144
TI  - V(D)J recombinase activity in primary and secondary murine lymphoid organs:
      assessment by a PCR assay with extrachromosomal plasmids.
AB  - We developed a highly specific and sensitive polymerase chain reaction (PCR)
      assay to measure V(D)J recombinase activity using extrachromosomal plasmids and
      PCR. Extrachromosomal plasmids were prepared by eukaryotic replication origin,
      and a combination of the DQ52 and JH2 regions of the murine IgH gene, or of the D
      beta 2-1 and J beta 2.6 regions of the murine TCR beta gene, both with
      recombination signal sequences. Plasmids, transfected into cells to be examined
      and recovered after 48 h, were processed to detect recombined molecules by PCR
      with primers for the expected sequences produced by the precise signal joint. The
      PCR assay, when compared with a Camr assay that we prepared with the DQ52 and JH2
      regions of the murine IgH gene, seems to have the following advantages. It
      detects only the recombined products produced by V(D)J recombinase activity and
      is therefore highly specific. It detects V(D)J recombinase activity in cells,
      including those with low replication frequency, which our Camr assay failed to
      do. This also enables detection of the recombinase activity not only in murine
      cell lines, but also in cells of murine lymphoid organs. The assay detects V(D)J
      recombinase activity in cell lines of human origin by replacing the eukaryotic
      replication origin of plasmids. High V(D)J recombinase activity was detected in
      bone marrow cells followed by thymic cells, and apparently lower activity was
      detected in cells of the lymph node and spleen of normal mice.

PMID- 1756146
TI  - Lymphokine-activated killer-cell-mediated killing of WiDr colon carcinoma cells
      is inhibited by K562 erythroleukemia cells.
AB  - Lymphokine activated killer (LAK) activity was induced in human peripheral
      mononuclear blood cells by human recombinant interleukin-2. Monocytes were
      required for optimal rapid proliferation of cells with LAK activity. They had no
      influence on the expression of tumoricidal activity by the LAK cells. The
      effector cells killed K562 erythroleukemia cells and WiDr colon cells
      differently, i.e. contact areas with WiDr cells were limited, whereas the contact
      areas between effector cells and K562 cells were much longer. Using mixtures of
      hot and cold target cells it was shown that effector cells preferably bind with
      K562 cells, impeding the binding of WiDr cells. Differences in expression of
      cytotoxicity of LAK cells against WiDr and K562 cells respectively was also
      observed after culturing the LAK cells for a relatively longer period.
      Cytotoxicity against WiDr was maximal at 3-16 days after starting LAK cell
      generation, whereas cytotoxicity against K562 was kept constantly high for at
      least 21 days. The addition of biological response modifiers [PHA and anti-CD3
      antibody (OKT3)] during the LAK cell induction also had different effects on the
      expression of LAK activity against WiDr and K562 cells. Whereas PHA, in
      combination with rIL-2 had no significant influence on the cytotoxicity against
      WiDr cells, the cytotoxicity against K562 was significantly inhibited. Addition
      of anti-CD3 antibody diminished the cytotoxicity against WiDr target cells and
      had no influence on the cytotoxicity against K562 cells.

PMID- 1756147
TI  - Effects of fish oil on graft arteriosclerosis and MHC class II antigen expression
      in rat heterotopic cardiac allografts.
AB  - The effect of fish oil on accelerated graft coronary arteriosclerosis was
      assessed in Lewis to Brown-Norway rat heterotopic cardiac allografts. Twelve
      Brown-Norway rats were supplemented with 2 ml/kg/day of fish oil (68.3 mg
      eicosopentaenoic acid and 47.5 mg decosahexaenoic acid per milliliter). Eleven
      additional animals, receiving an isocaloric amount of safflower oil, served as
      control. All diets began 1 week before operation. Immunosuppression was obtained
      with low-dose cyclosporine (2 mg/kg/d). When killed (100 days), there were no
      significant differences in percentage weight gain, graft function, or histologic
      rejection score. Although lipid profiles were comparable, total cholesterol:high
      density lipoprotein ratio was marginally higher in animals treated with fish oil
      (p = 0.069). Mean percentage luminal occlusion (before and after correcting for
      differences in size between coronary vessels analyzed) and average intimal
      thickness were similar between animals treated with fish oil and safflower oil as
      assessed by computer-assisted digitized, morphometric planimetry. In all
      allografts, donor interstitial dendritic cells were repopulated with recipient
      dendritic cells. The major histocompatibility complex class II cell density in
      the fish oil group did not differ significantly from rats supplemented with
      safflower oil (1.48 +/- 0.68 vs 1.48 +/- 0.65 cells per mm2, p = 0.995). In
      conclusion, fish oil did not exert any beneficial effect over safflower oil in
      terms of graft coronary arteriosclerosis, histologic rejection, or plasma
      lipids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756148
TI  - Adjuvant native heart surgery during heterotopic heart transplantation: two case
      reports.
AB  - The results of heterotopic heart transplantation may be further improved if
      repairs on native heart abnormalities are performed just before implantation of
      the allograft. Such procedures increase the potential for the recipient's own
      heart to recover function and, thus, to maintain circulation if the heterotopic
      heart malfunctions or fails. The native hearts of two of our patients, both
      women, showed signs of greater contractility and ejection after repair and were
      able to provide adequate circulatory support during periods of donor heart
      failure. The first patient required ventricular aneurysmectomy and coronary
      artery bypass grafting, and the second, native mitral valve repair. Moreover,
      when persistent ventricular fibrillation occurred in the donor heart of the first
      patient, a donor cardiectomy was performed, and the recipient heart functioned
      well thereafter. As more adjuvant operations are performed and the results
      evaluated, we may find that heterotopic operations would be suitable in a greater
      variety of heart transplant candidates.

PMID- 1756149
TI  - Detection of asymptomatic myocardial ischemia in a heart transplant patient
      before sudden death.

PMID- 1756150
TI  - Prevalence and management of cholelithiasis in heart transplant patients.
AB  - There is no accepted approach in the field of heart transplantation for the
      management of asymptomatic cholelithiasis. To help formulate a strategy, we
      retrospectively reviewed the records of the 159 patients who underwent heart
      transplantation at our institution from March 1984 to January 1990. Information
      on the biliary tract was available in 141 (88.7%) of these patients. Before
      transplantation, 18 (11.3%) had undergone cholecystectomy. Of the 141, 99 (70.2%)
      had undergone ultrasonographic examination of the biliary tree: 74 (74.8%) had no
      gallstones seen on ultrasonograms; 8 (8.1%) had sludge; 16 (16.2%) had
      gallstones; and 1 had a probable polyp. Further information on the biliary tree
      by ultrasonography became available after transplantation in 24 of 42 patients
      who did not undergo ultrasonographic examination before transplant. After
      transplant, gallstones were found by means of ultrasonography or at autopsy in 13
      more patients. Seven (4.4%) patients underwent cholecystectomy after transplant
      because of symptomatic cholelithiasis. Only one of these patients belonged to the
      group known to have gallstones before transplant. For the entire group, the
      prevalence of cholelithiasis was 29.6%. Multivariate analysis demonstrated that
      gallstones were significantly more common in older patients. We conclude that the
      prevalence of cholelithiasis in the heart transplant population is high but that
      only a minority of patients with asymptomatic gallstones will become symptomatic
      after heart transplantation. When they do, cholecystectomy may be safely
      performed. Prophylactic cholecystectomy and screening ultrasonography are not
      indicated in patients with asymptomatic cholelithiasis.

PMID- 1756151
TI  - Pseudoconduction of atrial flutter of a recipient atrium.
AB  - A nine-year-old girl had an episode of atrial flutter and a nonsustained wide QRS
      tachycardia during her initial hospitalization after orthotopic heart
      transplantation. Evaluation of her ECG and telemetric tracing revealed atrial
      flutter of the recipient atrium and sinus rhythm of the donor atrium. The wide
      QRS tachycardia was an accelerated ventricular rhythm that was also found on
      subsequent 24-hour ambulatory ECG monitoring. Timely recognition of recipient
      atrial arrhythmias prevents inappropriate clinical intervention.

PMID- 1756152
TI  - Coronary artery bypass two years after orthotopic heart transplantation: a case
      report.
AB  - Complete occlusion of the left anterior descending and right coronary arteries
      developed in a 58-year-old man 2 years after orthotopic heart transplantation.
      Because of his progressive shortness of breath, reversible myocardial ischemia,
      and decreasing ejection fraction, aortocoronary bypass was recommended. The
      operation was performed without complications, and his postoperative ejection
      fraction improved by more than 58%. In the past, when coronary artery disease
      developed in cardiac allografts, another transplant procedure was the only
      treatment option. Because of the limited donor hearts available today, new
      strategies are necessary for the treatment of cardiac allograft atherosclerosis.

PMID- 1756153
TI  - Progressive multifocal leukoencephalopathy fifty-seven months after heart
      transplantation.
AB  - Progressive multifocal leukoencephalopathy (PML), a subacute and usually fatal
      demyelinating disease of the brain, is caused by an opportunistic viral infection
      in immunocompromised patients. Only one case of PML after heart transplantation
      has been reported; it was discovered at the autopsy of a patient who died of
      multiorgan system failure. We describe an otherwise asymptomatic heart transplant
      recipient who had neurologic complaints that could be specifically attributed to
      PML, demonstrate the pertinent pathologic findings, and review the PML literature
      germane to heart transplantation. PML may become more prevalent as the population
      of heart transplant recipients increases.

PMID- 1756155
TI  - Role of routine endomyocardial biopsy to monitor late rejection after heart
      transplantation.
AB  - Endomycardial biopsy remains the standard used to monitor rejection after heart
      transplantation. There is, however, no consensus as to how often surveillance
      endomyocardial biopsy should be carried out after heart transplantation. We have
      analyzed 131 patients undergoing orthotopic heart transplantation during the
      first 4 years of the transplant program at St. Vincent's Hospital. The majority
      of endomyocardial biopsies that showed acute rejection occurred in the first 3
      months after transplantation; after 9 months only 2.5% of endomyocardial biopsies
      performed showed rejection. Of those patients with rejection, 47% had symptoms.
      Seven patients experienced late rejection and all made a good recovery with
      normal cardiac function. We conclude that the incidence of acute rejection
      decreases significantly more than 3 months after-transplantation; after 9 months
      only 2.5% of endomyocardial biopsies will show rejection. Of these, 47% will be
      associated with symptoms. On the basis of experience, we believe that in our own
      unit, endomyocardial biopsy more than 9 months after transplantation seems
      unwarranted unless clinically indicated.

PMID- 1756154
TI  - Reduced incidence of severe infection after heart transplantation with low
      intensity immunosuppression.
AB  - Despite advances in immunosuppressive therapy and prolonged graft and patient
      survival, infection after heart transplantation remains problematic. From January
      1987 through June 1989, 104 heart transplantations were performed in 100
      patients. Immunosuppression induction was by antilymphocyte globulin for 7 days,
      with oral cyclosporine introduced on stabilization of kidney function (day 3).
      Steroid therapy was rapidly tapered, and azathioprine was added only in cases of
      positive donor crossmatch or steroid-resistant rejection. No reverse isolation
      was used. Twenty-two deaths occurred, one from sepsis. Actuarial survival at 6
      months, at 1 year, and at 2 years was 85% +/- 4%, 81% +/- 3%, and 75% +/- 4%,
      respectively. Fifty-four patients had 81 infections, of which 21 were bacterial;
      83% of these episodes were treated. Sixty infections were opportunistic (85%
      viral), and only 23% necessitated treatment. Actuarial infection-free rates (all
      types necessitating treatment) at 1 month, at 6 months, and at 2 years were 83%
      +/- 4%, 75% +/- 5%, and 75% +/- 5%, respectively. Of the 100 transplant
      recipients, 66% were treated with azathioprine; 47 patients (69%) had an
      infection, whereas only seven (19%) of the patients not receiving azathioprine
      became infected (p less than 0.00001). Rejection was noted in 66% of patients,
      with a median time to the first episode of 4 weeks. A low-intensity
      immunosuppressive regimen has resulted in fewer serious infections, with
      acceptable graft loss from rejection. Increased infection surveillance is
      required for the first 30 days postoperatively and after treatment of rejection
      episodes.

PMID- 1756156
TI  - Comparison of rejection in the atrioventricular node and bundles with the working
      myocardium in transplanted hearts.
AB  - At present the monitoring of heart transplant patients for rejection is done by
      endomyocardial biopsy. It has been proposed that ECG assessments of conduction
      delay may provide a noninvasive means of detecting rejection. To determine
      whether rejection in the atrioventricular node and conduction bundles reflects
      rejection in the working myocardium, we studied 21 transplanted hearts from 21
      cardiac allograft recipients. Twenty of the hearts were obtained at autopsy, and
      one was obtained from a patient who underwent a second transplant procedure. The
      atrioventricular conduction tissues, the ventricular and atrial free walls, and
      the interventricular and interatrial septa from these hearts were examined for
      histologic evidence of rejection. Of the 21 hearts, 17 showed histologic changes
      of acute allograft rejection. Of the 17, rejection involved the conducting system
      and the myocardium equally in 11. In 6 of the 17 hearts, rejection involved the
      working myocardium more severely than it did the conducting system. Of interest,
      nonrejection pathologic changes were also noted in the conducting systems of
      several hearts. Severe accelerated arteriosclerosis was found in the artery to
      the atrioventricular node in one case, and lesser degrees of accelerated
      arteriosclerosis in this artery were found in two additional cases. In one case,
      lymphoid infiltrates, consistent with posttransplant lymphoproliferative
      disorder, were noted in the vicinity of the atrioventricular node, and several
      hearts demonstrated operative trauma or ischemic changes that appeared to involve
      the conducting system. These results suggest that although there may be a
      morphologic basis for using electrophysiologic changes in the conducting system
      to monitor heart allograft recipients for rejection, caution should be exercised
      in interpreting these changes.

PMID- 1756157
TI  - Influence of panel-reactive antibody and lymphocytotoxic crossmatch on survival
      after heart transplantation.
AB  - Review of 463 heart transplants was undertaken to examine the relationship
      between level of panel-reactive antibody (PRA) and a standard donor-specific
      lymphocytotoxic crossmatch (LXM) on the incidence of death from hyperacute,
      acute, and chronic rejection. Death from chronic rejection was defined as being
      caused by graft atherosclerosis. Hyperacute rejection was diagnosed in 18
      allografts, and only two recipients had PRA greater than 10% and another two a
      positive LXM. Five-year actuarial freedom from death caused by all forms of
      rejection correlated with PRA values as follows: PRA 0% to 10% (415 patients),
      85%; PRA 11% to 25% (29 patients), 68%; PRA greater than 25% (19 patients), 57%
      (p less than 0.005). Additionally, there was a positive linear relationship
      between PRA and duration of acute rejection episodes in the first 3 months after
      transplantation. A positive retrospective donor-specific LXM was present in 42 of
      401 patients; most of them (32 patients) were low positive (10% to 50% cell
      death), and none could be correlated with antibody specificity toward donor HLA
      antigens. Five-year actuarial freedom from death caused by rejection was 83% in
      those with a negative LXM, 74% in those with low-positive, and 79% in those with
      high-positive LXM (p = NS). Negative LXM result did not reduce the risk of death
      caused by rejection in any of the PRA subgroups. While PRA greater than 10% is a
      risk factor for rejection-related events, a negative LXM in patients with an
      elevated PRA does not reduce the risk of death resulting from acute or chronic
      rejection.

PMID- 1756158
TI  - Sudden death caused by bradycardia and asystole in a heart transplant patient
      with coronary arteriopathy.
AB  - The mechanism of death as a result of allograft ischemic heart disease is not
      well characterized. Ventricular tachycardia and fibrillation may not be the
      terminal events they often are in the general population. We report observations
      in a 41-year-old man with cardiac allograft arteriopathy who died suddenly while
      wearing an ambulatory monitor. The lethal rhythm was a progressive bradycardia
      terminating in asystole. Autopsy revealed epicardial and small vessel
      intramyocardial, coronary arteriopathy, and only mild allograft rejection. It is
      our belief that ischemia caused the bradycardic sudden death. We would like to
      hypothesize that prophylactic permanent pacemaker implantation may prevent
      bradycardic sudden death and improve survival in heart transplant patients with
      coronary disease.

PMID- 1756159
TI  - "Quilty effect" in heart transplantation: is it related to acute rejection?
AB  - "Quilty effect" is a lymphocytic infiltrate bulging in the endocardium of cardiac
      allografts with or without affectation of myocardium. It has been related with
      cyclosporine treatment. We have reviewed the morphology of 527 endomyocardial
      biopsy specimens from 46 transplant patients to study the significance and
      relation of Quilty effect with acute rejection. Paraffin immunoperoxidase studies
      were performed in 56 cases with Quilty effect or acute rejection. We graded acute
      myocardial rejection into four degrees according to the Hannover classification.
      A total of 126 biopsy specimens (24%) showed Quilty effect. Fifty-nine specimens
      (46.8%) showed different degrees of acute rejection in addition to Quilty effect.
      If we consider specimens with acute rejection grade greater than or equal to II,
      which require treatment, the frequency of the association of Quilty effect and
      acute rejection is statistically significant (p less than 0.01). In cases of
      acute rejection, the percentage of cases with Quilty effect was higher in cases
      with the highest degrees of acute rejection. The response of acute rejection to
      antirejection treatment was similar in all cases with or without Quilty effect.
      Immunohistochemical study showed a predominance of T lymphocytes in both Quilty
      effect and in the myocardium of acute rejection. We conclude that Quilty effect
      is a manifestation of acute rejection, modified by many factors, such as
      cyclosporine treatment. The finding of isolated Quilty effect may signal the
      prompt development of an acute rejection episode.

PMID- 1756160
TI  - The lack of predictive value of preoperative psychologic distress for
      postoperative medical outcome in heart transplant recipients.
AB  - This follow-up study of 58 heart recipients an average of 2 years after
      transplantation did not show that the Symptom Checklist 90R, a self-report
      measure of psychologic distress, predicted medical outcome. Mortality and medical
      morbidity (graft rejection and infection rate) were the outcome variables used.
      The findings tend to argue against the validity of some aspects of the
      psychiatric screening of transplant candidates if prediction of patients'
      ultimate risk of mortality or medical morbidity is the validation standard.

PMID- 1756161
TI  - Psychosocial evaluation of heart transplant candidates: an international survey
      of process, criteria, and outcomes.
AB  - Heart transplant programs were surveyed regarding psychosocial evaluation
      process, criteria, and outcomes. There was considerable disagreement among
      programs when a patient is rejected on psychosocial grounds with regard to the
      use of second opinions and how often patients are informed of the reasons. Wide
      discrepancies in criteria used and rates of patients refused on psychosocial
      grounds were discovered. More than 70% of all programs excluded patients for
      transplantation on the grounds of dementia, active schizophrenia, current
      suicidal ideation, history of multiple suicide attempts, severe mental
      retardation, current heavy alcohol use, and current use of addictive drugs. Lack
      of consensus was found for some exclusion criteria (cigarette smoking, obesity,
      noncompliance, recent alcohol or drug abuse, criminality, personality disorder,
      mild mental retardation, controlled schizophrenia, and affective disorder). The
      proportion of patients rejected for transplantation on psychosocial grounds
      ranged from 0% to 37%, with an average rate of 5.6% in the United States and 2.5%
      in non-U.S. programs. This survey thus supports the need for research on the
      validity and reliability of psychosocial selection criteria.

PMID- 1756162
TI  - Significance of bronchial mucosal blood flow for the monitoring of acute
      rejection in lung transplantation.
AB  - Bronchial mucosal blood flow (BMBF) was measured with a laser-Doppler flowmeter
      in a canine model (n = 20), and the measurement was evaluated to see if it was a
      useful method for diagnosing allografted lung rejection. The ratio of the value
      of BMBF at the level of the donor second carina against that at the level of
      carina (the L/C ratio, an index of BMBF of donor bronchus) decreased in
      accordance with the extent of lung rejection, and it increased and entered the
      normal range with the reversal of lung rejection. Compared with the L/C ratio and
      the rejection grade by histologic changes in open-lung biopsy, the L/C ratio at
      grade 0 (latent phase) was 0.91 +/- 0.07; at grade Ia (early vascular phase),
      0.86 +/- 0.05; at grade Ib (late vascular phase), 0.68 +/- 0.10; at grade II
      (early alveolar phase), 0.60 +/- 0.14; and at grade III (late alveolar phase),
      0.50 +/- 0.15. A significant difference was noted between grades Ia and Ib (p
      less than 0.01) and between grades Ib and III (p less than 0.01). The sensitivity
      and the specificity in the detection of early rejection before grade Ib were 96%
      and 92%, with only one false-negative and two false-positives resulting from 51
      measurements of BMBF. In three cases of serious lung infections, the L/C ratio
      did not fall, and the rejection could be distinguished from infection. These
      results suggest that measurement of the BMBF is useful for detecting the early
      rejection of transplanted lungs.

PMID- 1756163
TI  - New diagnostic method for pulmonary allograft rejection by measurement of
      bronchial mucosal blood flow.
AB  - We investigated the relationship between the rejection of lung allografts and the
      bronchial mucosal blood flow with a laser flowmeter. Nineteen mongrel dogs
      underwent left lung allotransplantation and were given daily oral
      immunosuppressive therapy with azathioprine and cyclosporine. The bronchial
      mucosal blood flow at the carina and the bifurcation of left upper and lower
      bronchi were measured on days 14, 21, and 28 after left lung transplantation. The
      bronchial mucosal blood flow of the transplanted lungs was expressed as the ratio
      of bronchial mucosal blood flow at the bifurcation of left upper and lower
      bronchi to the bronchial mucosal blood flow at the carina (L/C ratio) instead of
      the absolute value because bronchial mucosal blood flow was affected by the depth
      of anesthesia of the dogs. We classified the histologic appearance of the
      transplanted lung tissue into one of five grades: 0, 1a, 1b, 2, and 3. No
      rejection was in grade 0, and as the rejection process progressed the higher
      grades were used in order. The mean L/C ratios for grades 0, 1a, 1b, 2, and 3
      were 0.95 +/- 0.03, 0.82 +/- 0.05, 0.68 +/- 0.04, 0.58 +/- 0.07, and 0.30 +/-
      0.07, respectively. Thus the L/C ratio decreased as the rejection process
      progressed. The histologic changes of the donor main bronchus in each rejection
      grade were investigated. Mononuclear cell infiltration and edema around the small
      vessels was seen in early rejection. These same histologic changes appeared in
      muscular arteries as rejection progressed, and the damage to the small vessels
      and muscular arteries was more severe in late rejection.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1756164
TI  - A comparison of UW cold storage solution and St. Thomas' solution II: a 31P NMR
      and functional study of isolated porcine hearts.
AB  - Although University of Wisconsin cold storage solution provides excellent
      preservation for the pancreas, the kidney, and the liver after extended cold
      ischemic storage, its ability to preserve the heart for extended cold storage
      periods is not yet proved. This study was carried out to evaluate the effect of
      University of Wisconsin solution on heart preservation and to compare it to
      modified St. Thomas' solution II with respect to the capacity to preserve high
      energy phosphates and contractile function in pig hearts. Hearts were arrested
      with either University of Wisconsin cold storage solution or St. Thomas' solution
      II (10 ml/kg) and kept ischemic at 12 degrees C or 4 degrees C for 8 hours.
      Functional recovery after the preservation period was assessed by means of
      ventricular function curves of the isovolumically contracting Langendorff model
      perfused with modified Krebs-Henseleit solution. Phosphorus 31 nuclear magnetic
      resonance spectroscopy was used to monitor high-energy phosphates and
      intracellular pH during preservation and reperfusion. At 12 degrees C, hearts
      arrested and preserved with University of Wisconsin solution showed a rapid
      decrease in phosphocreatine and adenosine triphosphate. With St. Thomas'
      solution, phosphocreatine and adenosine triphosphate decreased slowly. Functional
      recovery was poorer with University of Wisconsin solution than with St. Thomas'
      solution. Hearts preserved at 4 degrees C with either solution showed no
      significant differences in high-energy phosphate content and functional recovery.
      Rigorous control of the low temperature (4 degrees C) is necessary when
      University of Wisconsin solution is used for heart preservation.

PMID- 1756165
TI  - Extracellular flush solution that contains blood, mannitol, albumin, and
      prostacyclin protects rat lungs from six hours of ischemia.
AB  - We have used an isolated rat lung model to compare the quality of preservation of
      different flush techniques with each other and with topical cooling alone. Lung
      injury was assessed by recording lung weights after reperfusion after 4 and 6
      hours of ischemia. The flush solutions studied were intracellular (Collins
      Sacks), traditional extracellular, extracellular with low potassium plus dextran,
      and extracellular containing blood, mannitol, albumin, and prostacyclin
      (Wallwork's solution). Flushing with Wallwork's solution before both 4 and 6
      hours of ischemia gave superior protection from lung edema after reperfusion over
      all the other methods.

PMID- 1756166
TI  - A new concept of long-term donor heart preservation: nucleoside transport
      inhibition.
AB  - Myocardial ischemia results in a breakdown of adenosine triphosphate (ATP), which
      is associated with an accumulation of its catabolites adenosine and inosine.
      Adenosine is a potent but ineffective cardioprotective agent because it is
      rapidly transported to the endothelium and irreversibly catabolized. With the use
      of specific nucleoside transport inhibition (NTI), however, endogenous adenosine
      may accumulate at its site of production, and its further breakdown and washout
      on reperfusion is prevented. In this study we tested this concept and assessed
      the effect of NTI drug administration on 24 hours' preservation of donor hearts
      for transplantation. Twelve dogs were randomly allocated to two groups. In the
      first group (group 1, n = 6) the hearts were arrested with a cold hyperkalemic
      cardioplegic solution, excised and stored for 24 hours at 0.5 degrees C. After 24
      hours the hearts were transplanted orthotopically. In group 2 (n = 6) the same
      procedure was followed, but a specific NTI agent was added to the cardioplegic
      solution (1 mg/L) and administered intravenously to the recipient dog before
      reperfusion of the transplanted heart (0.1 mg/kg). Despite maximal positive
      inotropic support, none of the control animals (group 1) could be weaned from
      cardiopulmonary bypass: within 1 hour irreversible cardiogenic shock occurred in
      all animals. In group 2 all hearts could be weaned from cardiopulmonary bypass
      and were hemodynamically stable without positive inotropic support. Serial
      transmural left ventricular biopsies revealed in group 1 moderate catabolism of
      ATP during cold storage. On reperfusion a further decline of the ATP content was
      seen, and the accumulated nucleosides were washed out.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1756167
TI  - Donor organ preservation fluids differ in their effect on endothelial cell
      function.
AB  - Successful organ transplantation depends on adequate preservation of cellular
      function. We tested the effect of four commonly used donor organ preservation
      fluids on the ability of cultured bovine pulmonary artery endothelial cells to
      release endothelium-derived relaxing factor (EDRF). Columns of endothelial cells
      grown on microcarrier beads were exposed to either University of Wisconsin
      (Belzer's) solution, Marshall's preservation fluid, Euro-Collins solution, or a
      blood-based preservation fluid at 4 degrees C for 6 hours, and then to Krebs
      Henseleit buffer at 37 degrees C for 1 hour. They were then stimulated with
      boluses of bradykinin, and the EDRF released was detected by bioassay. The
      release of EDRF from endothelial cells previously exposed to a preservation fluid
      was compared with the release of EDRF from control columns of cells perfused
      throughout at 37 degrees C with Krebs-Henseleit buffer. Previous exposure to any
      of the three non-blood-based preservation fluids did not attenuate bradykinin
      stimulated EDRF release. By contrast, previous perfusion with the blood-based
      solution completely inhibited EDRF release (p less than 0.01, ANOVA), an effect
      attributable to the acidity of the solution. Donor organ preservation fluids
      differ in their effect on endothelial cell function, and this has important
      implications for lung and for other organ transplantation.

PMID- 1756168
TI  - The nucleotide sequence of the Escherichia coli crp divergent RNA and an
      overlapping ORF.
AB  - The nucleotide sequence specifying the crp divergent RNA of Escherichia coli was
      determined. An open reading frame (ORF) is located at +135 to +536 relative to
      the initiation site of the divergent RNA. Potential factor independent
      transcription terminators were found at +257 to +294 and +544 to +576. These
      putative termination sites may account for the two RNAs of approximately 300 and
      550 nucleotides previously identified as originating from the crp divergent
      promoter.

PMID- 1756169
TI  - A bacterial homolog to HPRT.
AB  - The deduced 182 amino acid sequence of an open reading frame in the
      photosynthetic bacterium Rhodobacter capsulatus shows significant similarity to
      the hypoxanthine-guanine phosphoribosyltransferases of other organisms. This
      similarity includes conserved amino acid residues involved in Lesch-Nyhan
      syndrome.

PMID- 1756170
TI  - Cloning and sequence analysis of hydrogenase regulatory genes (hydHG) from
      Salmonella typhimurium.
AB  - The nucleotide sequence of the hydHG operon, comprised of chromosomal genes that
      regulate labile hydrogenase activity in Salmonella typhimurium, was compared with
      the reported hydHG sequence of Escherichia coli. Nucleotide sequence analysis of
      a 4.8 kb EcoRI fragment of Salmonella chromosomal DNA revealed that one of the
      open reading frames (ORF) encoded a protein of 441 amino acid residues. This
      large ORF was identified on a 2.7 kb Eco RI/HindIII fragment and coded for the
      complete hydG gene. The carboxy-terminus (626 bp) of the hydH gene also was
      present immediately upstream of hydG. Expression of the Salmonella hydG gene in a
      T7 promoter/polymerase system revealed the presence of a unique 45 kDa protein
      band. The incomplete hydH gene was not expressed. It is proposed that the labile
      hydrogenase activity in S. typhimurium may be regulated by the multiple component
      system.

PMID- 1756171
TI  - Lipoamide dehydrogenase of Staphylococcus aureus: nucleotide sequence and
      sequence analysis.
AB  - A complex of four proteins was previously isolated from Staphylococcus aureus.
      The complex had a strong interaction with membrane bound ribosomes, which
      suggested that it may be involved in protein secretion. However, the complex was
      identified as pyruvate dehydrogenase (PDH), which disproved the direct role of
      the complex in protein secretion. Here we report the nucleotide sequence of the
      last gene of the S. aureus pyruvate dehydrogenase operon, pdhD, which encodes
      lipoamide dehydrogenase (LPD). The pdhD gene encodes a protein of 468 amino
      acids, with a molecular mass of 49.5 kDa. The protein is closely related to other
      lipoamide dehydrogenases from bacteria and eukaryotes. The possible role of
      membrane bound lipoamide dehydrogenase is briefly discussed.

PMID- 1756172
TI  - The nucleotide and deduced amino acid sequence of the cationic 19 kDa outer
      membrane protein OmpH of Yersinia pseudotuberculosis.
AB  - The OmpH proteins of enteric bacteria are recently described, small (16 kDa),
      cationic outer membrane proteins. Because a Yersinia pseudotuberculosis cell
      envelope protein of this size has been found to cross-react serologically with
      the human histocompatibility antigen HLA-B27 (B*2701), the sequence of Y.
      pseudotuberculosis OmpH was determined by sequencing the gene region which
      encodes mature OmpH. A protein consisting of 143 amino acid residues was found.
      It was 96% homologous with the OmpH of Y. enterocolitica and 62% homologous with
      that of Escherichia coli. Two separate OmpH regions had sequence similarity with
      B*2701; they were identical in both Yersinia species.

PMID- 1756174
TI  - Murine cyclophilin-S1: a variant peptidyl-prolyl isomerase with a putative signal
      sequence expressed in differentiating F9 cells.
AB  - Fractionation of differentiating murine teratocarcinoma F9 cells and extraction
      of the nuclear/microsomal pellets with ethidium bromide led to the purification
      and microsequencing of the protein mCyP-S1, a novel cyclosporin A-sensitive
      peptidyl-prolyl cis-trans isomerase (PPIase). mCyP-S1 is a new member of the
      cyclophilin class of proteins. Cloning and sequencing of the mCyP-S1 cDNA
      revealed extended coding capacity for a putative N-terminal signal sequence,
      suggesting processing of mCyP-S1 during intracellular translocation across the
      membrane of the endoplasmic reticulum. mCyP-S1 is abundantly expressed in a
      variety of mouse organ tissues and its mRNA levels increase during F9 cell
      differentiation. Specific subcellular localization of PPIases is postulated to
      contribute to functional specificities of this class of enzymes.

PMID- 1756173
TI  - Molecular cloning and sequence analysis of the mouse kallikrein-binding protein
      gene.
AB  - A genomic clone (MKBP-10) encoding the mouse kallikrein-binding protein (MKBP)
      was isolated from a mouse genomic DNA library by screening with a rat kallikrein
      binding protein (RKBP) cDNA probe. The total sequenced region of the MKBP gene
      spans 8615 base pairs. The exon and intron locations of the RKBP gene were
      identified by similarity with the RKBP gene. The MKBP gene encodes a prepeptide
      of 417 amino acid residues which exhibits 71% homology with RKBP. A TATA box
      sequence was located in the 5' flanking region of the MKBP gene by similarity
      with the consensus sequence TATAAAA.

PMID- 1756175
TI  - Cloning and sequence analysis of membrane-bound alkaline phosphatase cDNA of the
      silkworm, Bombyx mori.
AB  - The nucleotide sequence (1974 bp) of cDNA coding for membrane-bound alkaline
      phosphatases (m-ALP) of Bombyx mori was isolated. The cDNA clone contained an
      open reading frame encoding a polypeptide (547 amino acids), which contains a
      hydrophobic signal peptide of 36 amino acids and the mature protein of 511 amino
      acids (Mr = 56,163). We found a highly hydrophobic domain presumed to be a
      membrane anchoring region at the C-terminus. Comparing analysis between Bombyx m
      ALP and mammalian and Escherichia coli ALPs suggested an evolutionary
      relationship of sharing a common ancestral gene.

PMID- 1756176
TI  - Cloning and sequencing of the casein kinase 2 alpha subunit from Zea mays.
AB  - The nucleotide sequence of the cDNA coding for the alpha subunit of casein kinase
      2 of Zea mays has been determined. The cDNA clone contains an open reading frame
      of 996 nucleotides encoding a polypeptide comprising 332 amino acids. The primary
      amino acid sequence exhibits 75% identity to the alpha subunit and 71% identity
      to the alpha' subunit of human casein kinase 2.

PMID- 1756177
TI  - The amyloid beta protein precursor or proteinase nexin II from mouse is closer
      related to its human homolog than previously reported.
AB  - The cDNA sequence for amyloid precursor protein and the two alternatively spliced
      forms were determined. Seven nucleotide differences resulting in six amino acid
      differences compared to the previously published mouse sequence were found.
      Moreover, the 3' non-coding end was completely different. Part of these findings
      were confirmed in three different mouse strains. The resulting mouse cDNA
      resembles the human APP more closely than originally reported.

PMID- 1756178
TI  - Reduced levels of alpha 1 (I) collagen mRNA in cells immortalized by mutant p53
      or transformed by ras.
AB  - Genes whose expression patterns are altered in a cell line immortalized by mutant
      p53 were isolated by differential screening of a cDNA library. Levels of alpha 1
      (I) collagen mRNA were reduced in the majority of immortalized cell lines which
      greatly overproduced the transfected mutant p53. This may reflect a co-selection
      during the establishment of the cell lines, rather than a direct effect of p53 on
      alpha 1 (I) collagen gene expression. On the other hand, a more direct
      relationship could be demonstrated between the expression of activated ras and a
      reduction in alpha 1 (I) collagen mRNA. Such reduction could partially account
      for the effects of ras on cell shape and cell proliferation.

PMID- 1756179
TI  - Histones and DNA methylation in mammalian chromatin. II. Presence of non
      inhibitory tightly-bound histones.
AB  - After removal, by high-salt extraction, of the loosely-bound components present
      in human placenta chromatin, tightly-bound cationic proteins could be
      solubilized, by acid extraction, from the 'stripped' chromatin, as well as from
      the 'stripped' loops or from the 'digested matrix'. These acid-soluble tightly
      bound proteins are, in terms of apparent molecular mass and immunoreactivity,
      quite similar to the 'typical', loosely-bound histones, and, similarly to their
      'loosely-bound' counterparts, they can be subdivided in distinct H1-, H2A-, H2B-,
      H3- and H4-like components, the 'digested matrix' being however characterized by
      the absence of tightly-bound H1. These tightly-bound histones, at variance from
      the 'typical' ones, readily find a right-handed helical conformation upon
      renaturation by progressive dialyses. The H1 components strongly differ also in
      their effects on enzymic DNA methylation: while 'typical' H1 has a strong
      inhibitory effect, its tightly-bound counterpart exerts a slight but definite
      stimulation.

PMID- 1756180
TI  - Histone-DNA contacts in the 167 bp 2-turn core particle.
AB  - The histone-DNA contacts in the 167 bp 2-turn core particle have been compared
      with those in the 146 bp 1.75-turn core particle by the methodology developed by
      Mirzabekov and his colleagues. The contacts in the 167 bp 2-turn core particle
      retain the essential features of those in the 146 bp 1.75-turn core particle but
      contacts for histones H3 and H2A were found in the 10 bp extension that
      discriminates the two particles. In addition the contact for histone H2A near the
      dyad axis was far more pronounced in the case of the 146 bp core particle.

PMID- 1756181
TI  - Thermal stability of turnip yellow mosaic virus RNA: effect of pH and multivalent
      cations on RNA deaggregation and degradation.
AB  - Light scattering studies of RNA isolated from turnip yellow mosaic virus (TYMV)
      revealed a molar mass of 1.9.10(6) g mol-1, which is close to the value of
      2.0.10(6) g mol-1 published for intact genomic TYMV RNA (2M RNA). However, gel
      electrophoresis under denaturing conditions demonstrated that only 30-40% of this
      native RNA was 2M RNA. Sucrose gradient centrifugation revealed the occurrence of
      a series of smaller RNA size classes, the mass ratios of which were greatly
      influenced by the pH of the solution and the presence of EDTA. These results
      suggest that native TYMV RNA preparations originally contain a mixture of intact
      RNA particles and of aggregates of RNA fragments with the same molar mass of
      about 2.10(6) g mol-1, and that the size classes are intermediates in the
      deaggregation process of the degraded genomic TYMV RNA. The native RNA displayed
      pH-dependent deaggregation and degradation. The degradation process of 2M RNA
      followed (pseudo) first-order kinetics. Lower degradation rates were observed for
      RNA depleted of divalent cations and polyamines. For depleted 2M RNA an enthalpy
      of activation of about 100 kJ mol-1 and an almost zero entropy of activation was
      calculated. Similar values were also found for depleted E. coli ribosomal RNAs
      and depleted MS2 RNA, demonstrating that all RNAs are equally vulnerable to
      degradation. In the presence of multivalent cations the activation enthalpy for
      2M TYMV RNA degradation increased to 150 kJ mol-1 and the entropy of activation
      to 150 J K-1 mol-1, indicative for a different degradation mechanism.

PMID- 1756182
TI  - The organization and expression of the human L7a ribosomal protein gene.
AB  - The genomic structure and sequence of the human ribosomal protein L7a (rpL7a) and
      its transcriptional start sites have been determined. The gene contains eight
      exons and seven introns spread over 3179 bp. The human rpL7a gene is similar to
      other mammalian ribosomal protein genes in containing a short first exon, a short
      5' untranslated leader and its transcriptional start sites at C residues embedded
      in a polypyrimidine tract. The 25 bp polypyrimidine tract containing the two
      human rpL7a start sites is the longest polypyrimide tract so far observed for a
      mammalian ribosomal protein gene.

PMID- 1756183
TI  - Cloning of cDNA encoding rat TCP-1.
AB  - We have isolated and sequenced a cDNA encoding a rat homolog of the mouse t
      complex polypeptide 1 (TCP-1). Its deduced gene product is a polypeptide of 556
      amino acids, with a predicted Mr of 60,341. The similarity between mouse Tcp-1
      and the rat homolog is about 94.0% at the nucleotide level and 97.1% at the amino
      acid level showing the evolutionary conservation of this protein. The similarity
      of the amino acid sequence of the rat TCP-1 is not significantly biased to any of
      those from wild (TCP-1B) or from t-haplotype mice (TCP-1A). From a comparison of
      deduced amino acid sequences of eukaryotic TCP-1 proteins, we found highly
      conserved domains. Southern blot analysis revealed that there are at least two
      similar sequences to Tcp-1 in the rat, one is a structural gene and the other
      seems to be a processed pseudogene.

PMID- 1756184
TI  - Purification to homogeneity of alpha (III) collagen chain from human placenta by
      preparative electrophoresis.
AB  - A multiple electrophoretic method suitable for purification of type III collagen
      from a mixture of various collagen types is described. The technique is based on
      preparative electrophoresis in acid media and successive electroelution of the
      collagen fractions. By sodium dodecyl sulfate-polyacrylamide electrophoresis and
      immunoblotting, the collagen composition of the electroeluted fractions was
      characterized as a mixture of alpha (III), beta (III) and gamma (III) without any
      other visible contaminants. This technique enabled us to obtain large quantities
      of type III collagen from partial pepsin digests of human placenta suitable for
      further processing.

PMID- 1756185
TI  - Detection of beta-glucosidase activity on sodium dodecyl sulphate-polyacrylamide
      gels.
AB  - Maize beta-glucosidase (beta-D-glucoside glucohydrolase, EC 3.2.1.21) was
      incubated in the presence of SDS concentrations varying from 0.025 to 3.2% at two
      different pHs (5 and 8), electrophoresed through 10% SDS-polyacrylamide gels, and
      stained for activity. The zymogram patterns of SDS-treated samples were similar
      to those of untreated (control) samples. The same samples were also analyzed by
      native PAGE and IEF, yielding similar patterns for controls and for SDS-treated
      samples. However, zymogram patterns were severely distorted on IEF gels when SDS
      concentration of the sample medium was at or above 1.6%. These results suggest
      that the beta-glucosidase monomer (a 60 kD polypeptide) is either catalytically
      active or it re-forms dimers upon the removal of SDS during equilibration washes,
      since the in vivo form of the functional enzyme is thought to be a dimer. The
      activity of maize beta-glucosidase on SDS-gels after SDS-PAGE does not seem to be
      limited to this enzyme alone, because beta-glucosidases from other sources (e.g.,
      almond, Trichoderma, and Penicillium) were also active on SDS-gels. Enzyme
      activity in the presence of SDS or after SDS treatment may be more common than
      one would expect on the basis of the conventional biochemical dictum that ionic
      detergents denature and inactivate enzymes. Enzyme activity in the presence of
      SDS and development of zymograms on SDS-gels offer new approaches to studies of
      enzyme structure and activity.

PMID- 1756186
TI  - A method for extraction and 2-D gel electrophoresis of plant proteins with
      selective isoelectric points.
AB  - A procedure for extracting and separating plant proteins by isoelectric point and
      2-dimensional gel electrophoresis (2-DGE) is presented. Resolution of basic
      proteins using nonequilibrium pH gradient electrophoresis (NEPHGE) increased when
      run without the presence of acidic proteins. Isoelectric focusing without basic
      proteins favored the migration of the acidic and the more neutrally charged
      proteins into tube gels. Without the basic groups, negatively charged proteins
      could be focused for 20 h and longer without consideration of cathodic drift
      effects. The procedure facilitates gel analysis by simplifying the protein
      pattern on second dimension gels. Another advantage is that greater relative
      amounts of any class of proteins can be electrophoresed in the first dimension
      gels.

PMID- 1756187
TI  - Histo-electrophoretic analysis of the microheterogeneity and region-specificity
      of isozymes.
AB  - An optimal and practical method for high resolution separation and visualization
      of soluble and membrane-binding isoenzymes is described. By use of this method,
      non-specific esterase, lactate dehydrogenase and acid phosphatase from different
      tissues of mice can be separated into more than 50, 30 and 20 components,
      respectively. Cholinesterase, glucose-6-phosphate dehydrogenase, acid
      phosphatase, succinate dehydrogenase, lactate dehydrogenase and non-specific
      esterase isolated from the lumbar spinal cord of chick embryos at different ages
      can be separated into about 15, 12, 9, 6, 14 and 20 components, respectively. In
      addition, an attempt has been made to evaluate quantitatively by densitometry
      differences in enzyme activity among different regions of the same tissue (e.g.
      spinal cord). The findings revealed that there are differences in isoenzyme
      components between the dorsal and ventral regions of the spinal cord.
      Collectively, the combination of direct tissue isoelectric focusing and fast
      enzyme visualization reveals a greater number of isoenzyme components than can be
      demonstrated by other means. This method is an extremely useful procedure for
      understanding and analyzing the nature and topographic localization of isoenzyme
      components.

PMID- 1756188
TI  - Electrohydrodynamic effects in continuous flow electrophoresis.
AB  - We demonstrate experimentally and theoretically the importance of
      electrohydrodynamic (EHD) flows in continuous-flow electrophoresis (CFE)
      separations. These flows are associated with variations in the conductivity or
      dielectric constant, and are quadratic in the field strength. They appear to be
      the main cause of extraneous and undesired flows in CFE which have degraded
      separation performance and have until now not been explained. We discuss the
      importance of EHD flows relative to other effects. We also describe possible
      techniques for reducing the associated degradation of CFE separations.

PMID- 1756189
TI  - Nuclear protein phosphorylation in rat cerebral cells following acute exposure to
      ethanol.
AB  - The sequelae of acute ethanol toxicity encompass a broad spectrum of metabolic
      and cellular derangements, including the induction of stress proteins in cells
      exposed to high levels of ethanol. In this investigation, the effects of ethanol
      exposure on nuclear protein synthesis and phosphorylation were compared by two
      dimensional gel electrophoresis in glial-enriched cultures, adult rat cerebrum
      and regenerated liver. Cellular exposure to ethanol was at clinically relevant
      levels and tissue was analyzed at 1 h and 48 h after exposure. Cell nuclei were
      stained with propidium iodide, a DNA specific fluorochrome and flow
      cytometrically sorted to obtain cell cycle phase populations of nuclei for
      analysis. Ethanol treatment of intact rats and glial-enriched cultures induced
      phosphorylation of specific nuclear proteins, which were detected by two
      dimensional electrophoresis and autoradiography. The autoradiographs of
      [32P]phosphate and [3H]leucine labeled proteins from glial-enriched cultures and
      from the G0/G1 phase of the regenerating liver tissue exhibited intense labeling
      indicative of active protein synthesis and phosphorylation. In contrast, the
      autoradiographs of proteins from adult rat cerebra showed substantial
      phosphorylation, but weak protein synthesis. Ethanol treatment was associated
      with phosphorylation of a 50,000 Mr protein in G0/G1 phase cells of the cultures
      and in predominantly G0 cells of the adult rat cerebra. A protein with similar
      characteristics was not found in ethanol exposed regenerating rat liver tissue
      and has not been observed in other 'heat shock' or 'stress' protein systems which
      we have previously studied.

PMID- 1756190
TI  - Granulocyte-macrophage colony-stimulating factor and interleukin-3 in
      combination: a potent and consistent myelodysplastic syndrome bone marrow
      stimulant in vitro.
AB  - In an effort to overcome bone marrow failure in myelodysplastic syndrome (MDS),
      we have investigated recombinant human granulocyte-macrophage colony-stimulating
      factor (GM-CSF) and interleukin-3 (IL-3) in phase I-II clinical trials. Although
      these agents partially increased peripheral blood granulocyte counts, their
      effect on other hematopoietic lineages was generally sporadic. Since in vitro
      analysis and in vivo studies in primates indicate that GM-CSF and IL-3
      synergistically enhance hematopoietic stem cell proliferation, we evaluated their
      combined effect on marrow progenitors obtained from ten MDS patients. When used
      singly, each growth factor stimulated replication of granulocyte-macrophage (CFU
      GM) and erythroid (BFU-E) colony-forming cells in a dose-dependent fashion. When
      colony-stimulating activity was compared at concentrations that maximally
      amplified individual MDS patients' colony numbers, IL-3 was a more potent
      stimulant in some patients and GM-CSF in others. When used in combination, IL-3
      plus GM-CSF was more effective than each growth factor by itself in five of six
      patients. Our data indicate that the MDS hematopoietic progenitor stimulatory
      effect of these growth factors varies from patient to patient. However, the
      combination of GM-CSF and IL-3 appears to be more potent than the individual
      molecules in the majority of patients.

PMID- 1756191
TI  - In vitro evaluation of a high-efficiency leukocyte adherence filter.
AB  - In view of the currently available data, prevention of alloimmunization requires
      filters with higher efficiency to achieve a reduction in the number of leukocytes
      below 10 million per transfusion. Two versions (Pall PL-100 and PL-50) of the new
      generation leukocyte-depletion filters were studied. Single donor (SDPC)- and
      pooled multiple donor (MDPC) platelets were run in parallel. At a flow rate of 10
      ml/min, the PL-100 filter was shown to effectively reduce the number of residual
      leukocytes to far below the critical immunogenic threshold of 10 million in all
      SDPC units and in 77% of MDPC units. Apheresis platelets appear not only to be
      better depleted than pooled multiple donor platelets, but also to have a better
      post-filtration platelet recovery (96% versus 84%). The efficiency of the smaller
      version of the filter (Pall-50) was higher than that of the Pall-100 filter for
      both single and pooled multiple donor platelet concentrates (PC). Leukocytes were
      absent in more than 92% of units in both types of concentrates. The maximal
      number of detected leukocytes was 2.2 million in a pool of 6 units. The outcome
      of filtration of 5-day-old pooled platelets was less favorable than filtration of
      1- or 2-day-old pooled platelets, indicating that filtration soon after
      preparation is preferred to filtration after storage. Post-filtration platelet
      integrity, activation state, function, and morphology were all well preserved in
      both single and multiple PCs.

PMID- 1756192
TI  - Confirmation and improvement of Sokal's prognostic classification of Ph+ chronic
      myeloid leukemia: the value of early evaluation of the course of the disease. The
      Italian Cooperative Study Group on Chronic Myeloid Leukemia.
AB  - A simple prognostic classification of Ph+ chronic myeloid leukemia (CML) was
      proposed in 1984 by an international study Group and is now widely used for
      clinical purposes. That study was retrospective, and was based on disease
      features at diagnosis. To test prospectively and to check the value of the
      classification, and to investigate if additional information on the early course
      of leukemia can help in refining the prognosis, 505 Ph+, nonblastic and
      nontransplanted patients first registered between 1984 and 1986 were followed up
      to June 1990. It was found that the prognostic formulation predicted survival in
      that series exactly the same way as in the original series (median survival:
      greater than 60 months for low-risk patients, 46 months for intermediate-risk
      patients, and 32 months for high-risk ones). It was also found that several
      objective or subjective assessments of disease course during the first 8 months
      after diagnosis were significantly related to survival length within any risk
      group. This study provides full confirmation of Sokal's international prognostic
      classification, and shows that the definition of prognosis can be improved some
      months after diagnosis by taking into account the course of the disease and the
      response to therapy. These conclusions apply to patients receiving conventional
      treatment. The course of Ph+ chronic myeloid leukemia (CML) is rigidly programmed
      to progress to an acute phase, which is called blastic metamorphosis (BM) and
      which can develop either suddenly (blastic crisis) or by a slow progression
      (accelerated phase). In all recent series, 2-year survival ranged between 65% and
      80%, median survival was slightly shorter than 4 years, and the proportion of
      patients who were still alive after 10 years was less than 10%. However, a number
      of prognostic variables were identified and a prognostic formulation that was
      elaborated by an international study was shown to provide a reliable estimate of
      survival length and is currently used for that purpose. The value of that
      formulation, and the formulation itself, require periodical controls and
      revisions. For that purpose, the Italian Cooperative Study Group on CML
      registered and followed up all CML patients who were first seen between 1984 and
      1986. A very preliminary analysis of that cohort of patients has already been
      performed, but it was limited to the first 2 years after diagnosis.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1756193
TI  - Impaired in vitro growth of peripheral blood hematopoietic progenitor cells in
      HIV-infected patients: evidence of an inhibitory effect of autologous T
      lymphocytes.
AB  - The in vitro growth of both circulating granulocyte-macrophage (CFU-GM) and
      erythroid (BFU-E) progenitor cells was assessed in 29 individuals infected with
      the human immunodeficiency virus (HIV) at different stages of infection. The
      effects of autologous T lymphocytes, adherent cells, and serum on the in vitro
      growth of hematopoietic progenitor cells were also investigated. Compared with
      normal controls, baseline growth was significantly reduced for both CFU-GM and
      BFU-E in HIV-infected patients, independent of the clinical stage of the disease.
      In HIV-infected subjects depletion of autologous T cells was associated with a
      significant increase of progenitor cell growth. Similar results were observed
      after selective depletion of CD8+ T cells, while readdition of T cells to T
      depleted mononuclear cells reduced the number of CFU-GM. A dose-dependent colony
      inhibitory activity was found in conditioned medium of T cells from HIV-infected
      subjects. Neither autologous adherent cells nor serum from either HIV+ or HIV-
      subjects had any significant effect on the in vitro growth of CFU-GM. These
      results indicate that the in vitro growth of circulating hematopoietic progenitor
      cells is impaired even in the early stages of HIV infection, and that autologous
      T cells exert an inhibitory effect on the in vitro growth of progenitor cells,
      possibly via soluble mediator(s).

PMID- 1756194
TI  - Successful short-term treatment with granulocyte-macrophage colony-stimulating
      factor of neutropenia due to cytotoxic chemotherapy of chronic lymphocytic
      leukemia.

PMID- 1756195
TI  - Incidence of hypercortisolism and dexamethasone resistance increases with age
      among wild baboons.
AB  - While many features of the adrenocortical axis are unchanged with age in humans,
      there is a pattern of senescent hypercortisolism. This occurs basally, following
      threshold doses of dexamethasone, and in synergy with depression or Alzheimer's
      disease. An understanding of neuroendocrine aging is important, for both its
      gerontological implications, and determination of normative values for comparison
      with neuropsychiatric states. We have investigated whether aging is associated
      with hypercortisolism in a population of wild primates. The subjects were 108
      yellow baboons (Papio cynocephalus) that have been under long-term study of
      Amboseli National Park in Kenya. Animals were anesthetized by blowgun under
      similar circumstances that allow for determination of basal cortisol
      concentrations. Sixty minutes later, 5.0 mg dexamethasone was administered to
      each animal, and cortisol determinations were made on serum collected immediately
      before administration and 6 hr later. Basal cortisol concentrations rose with age
      (p less than 0.028; r = 0.23). This occurred in a nonprogressive manner, in that
      there were no differences in concentrations among the youngest three quartiles of
      animals, whereas animals in the oldest quartile (older than approximately 16
      years) had significantly higher values. In addition, there was a significant
      increase in postdexamethasone cortical concentrations with age (p less than 0.01;
      r = 0.31). This feature emerged progressively with age in both sexes. A number of
      possible artifactual causes of this senescent pattern could be eliminated,
      including medication confound, coincident disease, and body weight. These
      findings suggest that hypercortisolism and glucocorticoid feedback resistance
      might be general features of primate aging.

PMID- 1756196
TI  - Neuroendocrine responses to serotonergic agents in alcoholics.
AB  - Previous studies have suggested a possible deficit in serotonergic function in
      alcoholism. In order to further assess the serotonergic system in alcoholism, the
      plasma cortisol and prolactin (PRL) responses following 6-chloro-2-[1
      piperazinyl]pyrazine (MK-212), a direct-acting serotonin2 (5-HT2)/5-HT1c receptor
      agonist, L-5-hydroxytryptophan (L-5-HTP), a precursor of 5-HT, and placebo were
      compared in male alcoholics and normal controls. The increase in plasma cortisol
      following L-5-HTP was significantly lower in the alcoholic subjects compared with
      the normal controls. The plasma PRL, but not the plasma cortisol response,
      following MK-212 was also significantly lower in the alcoholics. L-5-HTP had no
      significant effect on plasma PRL levels in either group. The basal plasma
      cortisol and PRL concentrations of the alcoholics and normal controls were not
      significantly different. These data are consistent with previous reports of a
      serotonergic abnormality in alcoholism.

PMID- 1756197
TI  - Childhood obsessive-compulsive disorder and cingulate epilepsy.
AB  - There are no reports of an association between obsessive-compulsive disorder and
      cingulate epilepsy in childhood. We report the behavioral, cognitive, and EEG
      findings in a young girl with medically resistant seizures and severe obsessive
      compulsive symptomatology. Her scalp EEG and neuropsychological test scores
      suggested right frontal lobe dysfunction. The intractability of her seizures and
      progressive intellectual and psychosocial deterioration prompted evaluation for
      excisional surgery. Intracranial EEG recording demonstrated a focal seizure
      origin in the right anterior cingulate gyrus. Cingulotomy resulted in freedom
      from seizures and significant improvement in her obsessive-compulsive symptoms.

PMID- 1756198
TI  - Mismatch negativity: an index of a preattentive processing deficit in
      schizophrenia.

PMID- 1756199
TI  - Haloperidol and soluble interleukin-2 receptors.

PMID- 1756200
TI  - Annual meeting theme for 1992: developmental neurobiology and clinical course.

PMID- 1756201
TI  - Changes in serine metabolism by a serum factor present in a group of episodic
      psychotic patients.
AB  - Addition of serum, obtained from patients suffering from an acute psychosis
      characterized by dysperceptions, to the culture media of fibroblasts altered the
      amino acid metabolism in these cells. After subculturing of fibroblasts in the
      presence of serum obtained from these patients, the concentrations of both serine
      and methionine were decreased in the medium as well as in the fibroblasts.
      Moreover, the concentration of taurine in the fibroblasts was increased. The
      specific activities of serine hydroxymethyltransferase and cystathionine beta
      synthase were also measured in the fibroblasts. It was found that both enzyme
      activities were significantly higher after subculturing with patients' serum as
      compared with serum obtained from healthy controls. It is concluded that a
      factor, present in the serum of these acute psychotic patients, is responsible
      for the observed changes in serine, taurine, and methionine concentrations in the
      fibroblasts as well as for the increased enzyme activities mentioned.

PMID- 1756202
TI  - Anxiogenic effects of m-CPP in patients with panic disorder: comparison to
      caffeine's anxiogenic effects.
AB  - The behavioral and neuroendocrine effects of meta-chlorophenylpiperazine (m-CPP),
      a serotonergic agonist, were compared with the effects of caffeine, an adenosine
      antagonist, in panic disorder patients. Patients with panic disorder were given
      single oral doses of 0.5 mg/kg m-CPP, 480 mg caffeine, and placebo on separate
      days under double-blind conditions. Both m-CPP and caffeine had significantly
      greater anxiogenic and panic-inducing effects than placebo, although caffeine
      produced nonsignificantly greater increases on all anxiety rating scales than m
      CPP. Both m-CPP and caffeine produced significant equivalent increases in plasma
      cortisol concentrations, but only m-CPP produced plasma prolactin increases.
      These findings provide further evidence implicating both the serotonergic and
      adenosinergic receptor systems in the neurobiology of panic disorder.

PMID- 1756203
TI  - Hormonal regulation of uterine secretion of prostaglandin F2 alpha during
      luteolysis in ruminants.
AB  - In recent years, considerable progress has been made in our understanding of the
      endocrine mechanisms that control the pattern and timing of uterine secretion of
      prostaglandin F2 alpha (PGF2 alpha) during luteolysis in ruminants. Oxytocin may
      be important in establishing a pulsatile pattern of secretion. Neurohypophyseal
      oxytocin appears to be released in a pulsatile fashion and may initiate each
      episode of PGF2 alpha secretion from the uterus. Uterine PGF2 alpha stimulates
      release of oxytocin from the corpus luteum. Luteal oxytocin further stimulates
      secretion of PGF2 alpha from the uterus and may induce a transient refractoriness
      of the uterus to subsequent stimulation with oxytocin. Uterine refractoriness
      subsides after approximately 6 h. A similar desensitization phenomenon occurs in
      response to PGF2 alpha at the level of the corpus luteum. Together, uterine and
      luteal refractoriness may account for the interval between pulses of PGF2 alpha
      observed during luteolysis. Uterine secretory responsiveness to oxytocin
      increases at luteolysis, when endogenous, pulsatile secretion of PGF2 alpha
      normally begins. Thus, the acquisition by the uterus of responsiveness to
      oxytocin may determine when endogenous secretion of PGF2 alpha occurs during the
      estrous cycle. Uterine secretory responsiveness to oxytocin develops slowly, in
      the presence of progesterone. Progesterone exerts two types of effects that
      contribute to the regulation of PGF2 alpha secretion. First, prolonged exposure
      to progesterone appears to promote uterine accumulation of arachidonic acid,
      prostaglandin endoperoxide synthase, and other substances needed for synthesis of
      PGF2 alpha. Second, progesterone exerts a suppressive effect on secretion, which
      wanes after prolonged exposure. Together, these effects of progesterone ensure
      that PGF2 alpha is secreted only at the appropriate time to induce
      luteolysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756204
TI  - Cell interactions with laminin and its proteolytic fragments during outgrowth of
      mouse primary trophoblast cells.
AB  - Mouse blastocysts in serum-free culture for 24-48 h become attachment-competent,
      adhere to fibronectin- or laminin-coated surfaces, and subsequently form
      trophoblast outgrowths. The blastocyst laminin receptor was characterized in
      outgrowth studies using modified laminin. Trophoblast cells interacted with the
      peptide portion of laminin, but not the oligosaccharide moiety since its adhesive
      activity was reduced by boiling or trypsin treatment, but not by treatments that
      removed or modified its carbohydrate. Laminin outgrowth-promoting activity was
      further localized within its structural domains by use of the well-characterized
      proteolytic fragments of laminin, E1-4, and E8, and a synthetic peptide,
      CDPGYIGSR. The E1-4 fragment of laminin did not promote embryo outgrowth.
      However, the E8 fragment, which contains a heparin-binding domain as well as
      sites recognized during cell adhesion and neurite outgrowth, vigorously promoted
      outgrowth in both the presence and absence of heparin, heparan sulfate, or
      heparinase. Consistent with these results, outgrowth on intact laminin was not
      inhibited by CDPGYIGSR, a sequence within the E1-4 fragment that is known to
      mediate the adhesion of some cell types. It is concluded from these results that
      early trophoblast cells adhere to peptide in the E8 domain of laminin using a
      mechanism that is independent of the one used for adhesion to fibronectin.

PMID- 1756205
TI  - Persistent sexual behavior in castrated, recombinant inbred mice.
AB  - In contrast to other male mice, many hybrid B6D2F1 males continue to mate after
      being castrated in adulthood. This persistent sexual behavior in the castrated
      hybrids presumably is based upon heterozygosity that might occur within
      individual loci or between different loci. Those possibilities were discriminated
      by studying BXD recombinant inbred mice. In BXD strains, individual loci are
      homozygous, but heterozygosity has arisen between separate loci. Males in two of
      six BXD strains persisted in copulating for 5 mo after being castrated. Thus, it
      is concluded that retention of masculine sexual behavior in castrated mice is a
      function of heterozygosity between loci.

PMID- 1756206
TI  - Synthesis and secretion of immunoreactive methionine-enkephalin from rabbit
      reproductive tissues in vivo and in vitro.
AB  - The expression of the proenkephalin gene has been demonstrated in the
      reproductive tissues of several animal species. The objectives of the experiments
      reported here were to (a) examine the presence of immunoreactive methionine
      enkephalin (ir-MENK) in rabbit ovary, oviduct, and uterus and in a rabbit
      endometrial cell line (HRE-H9), (b) characterize ir-MENK biochemically, (c)
      investigate the effect of eCG + hCG treatment on the synthesis and secretion of
      ir-MENK in vivo, and (d) study the effect of K+ depolarization on the secretion
      of ir-MENK from HRE-H9 cells. Uterine fluid was collected by flushing the uterine
      lumen with saline. Reproductive tissues and HRE-H9 cells were extracted with 0.1
      N acetic acid. Both the uterine fluid and extracts of uterus, ovary, oviduct, and
      HRE-H9 cells exhibited inhibition curves parallel to that of authentic MENK in
      the MENK RIA system. Sephadex G-15 gel filtration profiles indicated that in the
      extracts of rabbit uterus and HRE-H9 cells, most ir-MENK co-eluted with standard
      MENK, with a minor portion eluting near the void volume (Vo). Reverse-phase-HPLC
      (RP-HPLC) profiles showed a major peak coinciding with standard MENK, plus a
      minor peak of highly hydrophilic ir-MENK. The effect of eCG + hCG treatment was
      studied by i.m. injection of eCG (150 IU), followed by i.v. injection of hCG (75
      IU) 4 days later. Ir-MENK concentration in the uteri and ovaries was
      significantly (p less than 0.05) increased (9.06 +/- 1.89 and 2.05 +/- 0.32 ng/mg
      protein, respectively), compared to control levels (2.31 +/- 0.86 and 0.24 +/-
      0.77).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756207
TI  - Expression of perforin by natural killer cells within first trimester endometrium
      in humans.
AB  - The lymphocyte pore-forming protein (PFP)--perforin, also named cytolysin--is a
      potent mediator of cytotoxicity found in the granules of cytotoxic T lymphocytes
      and natural killer (NK) cells. Granulated metrial gland (GMG) cells found in the
      pregnant mouse uterus express perforin and are thought to be highly activated
      cytolytic lymphocytes related to NK cells. Their role in pregnancy is unknown.
      Human endometrial granulocytes (EGs) are phenotypically similar to murine GMG
      cells and, like them, express NK cell markers. However, up to now it was not
      known whether EGs also express perforin. By means of immunohistochemical
      analysis, using antisera specific for perforin and monoclonal antibodies to CD56
      (NKH-1), CD2 (T11), CD3 (Leu-4), CD4 (Leu-3a), and CD8 (OKT-8), we demonstrated
      that perforin is present in EGs in the decidualized endometrial stroma and
      decidual tissue of first-trimester gestational endometrium. In fact, double
      immunohistochemical labeling demonstrated the co-expression of perforin and NKH
      1. This population also expressed some T-cell surface antigens (Leu-4 and T11),
      but not Leu-3a or OKT-8. Chorionic villi, in contrast, lack perforin+ cells. The
      presence of a potent cytolytic mediator in NK-like cells in both murine and human
      pregnant uterus raises the issue of the function of such cells in pregnancy.

PMID- 1756208
TI  - Localization of pregnancy-specific beta 1-glycoprotein in the male reproductive
      tract of the rat by in situ hybridization.
AB  - Human pregnancy-specific beta 1-glycoprotein (PSG) is found in high
      concentrations in the serum of pregnant women, but also has been found in the
      serum of males and nonpregnant females. Northern slot-blot analysis has
      demonstrated the presence of PSG mRNA in a variety of tissues in the rat, with
      the highest levels being found in the testis. Therefore, we have investigated
      further the expression of PSG in the rat male reproductive tract using in situ
      hybridization. In testes from immature and adult rats, PSG mRNA was localized in
      Leydig and peritubular cells, and in the walls of the interstitial blood vessels.
      PSG transcripts were noted also in the tunica albuginea and in the stromal tissue
      of the caput and cauda epididymis, prostate, and seminal vesicle from adult rats.
      The function of PSG is unknown, but it has been speculated that PSG may have
      immunosuppressive properties or that it may serve as a paracrine regulator of
      growth and differentiation. It is possible, then, that PSG could contribute to
      the immunological privilege of the testis or that it plays a role in the cellular
      interactions which increasingly are being shown to be important in the regulation
      of male reproductive tract tissues.

PMID- 1756209
TI  - The role of estrogen and relaxin in the reproductive abnormalities of mice with
      Hertwig's anemia.
AB  - Mice homozygous for a mutant allele (an/an) causing a lifelong macrocytic anemia
      (Hertwig's anemia) also demonstrate an inability to deliver their offspring,
      despite normal ovulation, conception, implantation, and fetal development. We
      investigated the roles of estrogen and relaxin in the etiology of the
      reproductive defect in the Hertwig's anemia mice. Immunoreactive relaxin levels
      were undetectable in the nonpregnant controls, whereas levels in both timed
      pregnant controls and timed-pregnant affected mice were significantly higher than
      in nonpregnant controls, but not significantly different from each other. Mean
      interpubic ligament length in the pregnant Hertwig's anemia mice was
      significantly greater than that in nonpregnant controls, but significantly less
      than that in the pregnant controls on Day 18 of pregnancy. Porcine relaxin was
      administered to nonpregnant affected and unaffected littermates and to
      nonpregnant controls. Whereas controls showed a significant response to porcine
      relaxin, neither the Hertwig's anemia mice nor their unaffected littermates
      responded to the porcine relaxin. Additional study was performed to determine
      estradiol effects in the affected and control animals utilizing detailed
      computerized morphometric analysis of uterine horns and cervices from immature,
      estradiol-injected controls and Hertwig's anemia mice. Results demonstrated a
      statistically significant trophic effect of estradiol upon uterine horn and
      cervical enlargement, as assessed by weight and volume, in controls. Only a
      slight, non-significant effect was seen in Hertwig's anemia mice. Additional
      histological effects of estradiol, including endometrial enfolding observed in
      controls, were not present in Hertwig's anemia mice. Lack of response to both
      estrogen and relaxin is responsible for the parturitional defect in Hertwig's
      anemia mice.

PMID- 1756210
TI  - Blocking of human sperm-zona interaction by monoclonal antibodies to a
      glycoprotein family (ZP4) of porcine zona pellucida.
AB  - To study zona pellucida antigens involved in human fertilization, five monoclonal
      antibodies (MAbs)--2A1, 2G3, 4A2, 4E12, and 5H4--were produced to a glycoprotein
      family (ZP4) isolated from heat-solubilized porcine zonae pellucidae. Each MAb
      reacted not only with solubilized porcine zona glycoproteins but also with the
      glycoproteins deglycosylated by trifluoromethanesulfonic acid treatment. They
      also reacted with intact zonae pellucidae of porcine and human oocytes. Three
      (4A2, 4E12, and 5H4) of the five MAbs showed a significant blocking effect on
      human sperm binding and penetration of human zonae pellucidae. The 5H4 MAb showed
      a strong reaction with ZP4 and ZP1 glycoprotein families of porcine zonae
      pellucidae, and four other MAbs reacted more strongly with ZP3 than with ZP4. The
      reactivity of 5H4 with porcine zona glycoproteins was destroyed by chymotrypsin
      digestion, but the antigen epitope was resistant to proteolysis by trypsin and
      endoproteinase Lys-C. A peptide fragment reactive to 5H4 was isolated by reverse
      phase HPLC from endoproteinase Lys-C-treated ZP4 glycoproteins, and its molecular
      mass was determined to be 7 kDa by SDS-PAGE. These results suggested that the
      antigen epitope corresponding to 5H4 is a good candidate for development of a
      contraceptive vaccine.

PMID- 1756211
TI  - In vitro-matured/in vitro-fertilized bovine oocytes can develop into
      morulae/blastocysts in chemically defined, protein-free culture media.
AB  - Development of bovine embryos derived from in vitro-matured/in vitro-fertilized
      (IVM/IVF) oocytes was examined in two culture media: hamster embryo culture
      medium (HECM), a relatively simple, chemically defined, protein-free medium
      containing 20 amino acids; and tissue culture medium (TCM)-199, a more complex
      medium designed for culture of somatic cells. The first experiment studied (1)
      effects of glucose and/or phosphate (Pi) using HECM and (2) the development of
      bovine IVM/IVF embryos in four different conditions: HECM, TCM-199, TCM-199 + 10%
      unheated bovine calf serum (BCS), and oviduct cell-conditioned TCM-199 + 10% BCS.
      After IVF, 45% of the inseminated oocytes developed to the morula/blastocyst
      stages (M&B) when cultured in HECM; blastocyst development was depressed in the
      presence of glucose and Pi when compared to Pi alone. When the four culture
      conditions were compared, there was no significant difference in M&B development
      (42-51% of inseminated oocytes). However, blastocyst development in TCM-199
      supplemented with 10% BCS (29.7%) or with BCS + oviduct cell-conditioned medium
      (21.6%) was significantly greater than in nonsupplemented HECM (9.7%) or TCM-199
      (13.8%). In the second experiment, the effects of serum supplementation and/or
      oviduct cell conditioning on HECM and TCM-199 were examined in a 2 x 2 x 2
      factorial experiment. Oviduct cell conditioning of either HECM or TCM-199 without
      serum supplementation did not enhance bovine embryo development. Serum
      supplementation exhibited a biphasic effect, with inhibition at the first
      cleavage and stimulation of morula compaction and blastocyst formation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1756212
TI  - Normal sequence of the gonadotropin-releasing hormone gene in patients with
      idiopathic hypogonadotropic hypogonadism.
AB  - Idiopathic hypogonadotropic hypogonadism (IHH) results from absent or greatly
      diminished secretion of GnRH. Defects in the GnRH gene have been identified in an
      animal model of IHH and have been hypothesized as a possible basis for GnRH
      deficiency in humans. In this study, we used the polymerase chain reaction to
      clone and sequence the coding regions, promoter, and 3' untranslated tract of the
      GnRH genes from both alleles of four unrelated patients with IHH. One of the
      patients studied is a member of a kindred in which X-linked inheritance has been
      excluded by father-to-son transmission of the disease. No DNA sequence mutations
      were found. We conclude that most cases of IHH in humans do not involve mutations
      in the GnRH gene and are presumably caused by mutations at one or more other
      genetic loci that are required for normal function of GnRH-producing neurons.

PMID- 1756213
TI  - Effect of sampling interval on serum concentrations of luteinizing hormone,
      follicle-stimulating hormone, and prolactin in prepubertal, ovariectomized, and
      cycling gilts.
AB  - Three experiments were conducted to determine the effect of sampling interval on
      serum concentrations of LH, FSH, and prolactin (PRL) in prepubertal,
      ovariectomized, and cycling gilts. In all experiments, blood samples were drawn
      at 2-min intervals for 4 h from indwelling jugular catheters. Mean serum hormone
      concentrations, mean number of peaks, and mean and maximum peak heights of LH,
      FSH, and PRL were calculated using values reflecting 2-, 6-, 10-, 20-, 30-, and
      60-min sampling intervals. For LH, FSH, and PRL, mean serum concentrations can be
      obtained through blood samples drawn at hourly intervals. Since LH peaks are very
      distinct in pigs, the number of secretory peaks and mean peak height can be
      obtained via samples drawn at 20-min intervals. Since FSH and PRL peaks are less
      well defined, a more frequent sampling interval (10 min) is needed to determine
      number of peaks and mean peak height. To obtain the maximum peak height or the
      number of minutes for LH, FSH, or PRL to rise from its nadir to zenith, blood
      samples need to be drawn at 2-min intervals. Regardless of reproductive state,
      these data indicate that the sampling interval needed to characterize serum
      concentrations of LH, FSH, and PRL in the gilt is dependent upon the parameter in
      question.

PMID- 1756214
TI  - Regional cellular heterogeneity and DNA synthetic activity in rat ventral
      prostate during postnatal development.
AB  - Previous studies have provided evidence that the rat ventral prostate grows
      primarily, if not exclusively, at its distal tips. However, as yet there have
      been no analyses in which individual cells in defined regions of the prostatic
      ductal system have been resolved and quantified. Moreover, the possibility that
      the prostate might grow differently at different times of postnatal development
      has received little attention. Our objectives were to identify and quantify the
      proliferating epithelial and stromal cells in defined regions of the rat ventral
      prostate during its postnatal development. To this end, 3H-thymidine was
      administered in vivo to rats of ages 10-60 days. A dissection technique was then
      used by which the distal, intermediate, and proximal segments of the prostatic
      ductal system were physically isolated from each other without removing the
      stromal tissue. Longitudinal sections of these segments were examined for
      cellular composition and DNA synthetic activity. Regional heterogeneity with
      respect to cell composition and cell proliferation was seen. In rats of all ages,
      DNA synthetic activity was seen in epithelial and stromal cells throughout the
      prostate, rather than only in the distal segment. At Days 10 and 20,
      significantly higher percentages of epithelial and stromal cells were labeled in
      the distal than in the proximal segments; but at Days 45 and 60, the percentages
      of labeled epithelial and stromal cells in the distal, intermediate, and proximal
      segments were similar. Thus, in all segments, and at all ages, substantial
      labeling was seen throughout the prostate. These data suggest that the prostate
      grows in both length and width throughout postnatal development, reminiscent of
      the growth of a tree.

PMID- 1756215
TI  - Immunocytochemical evidence for production of luteinizing hormone and follicle
      stimulating hormone in separate cells in the bovine.
AB  - In all mammalian females, follicular growth and maturation are essentially
      dependent on the pituitary gonadotropins, FSH and LH. These glycoprotein hormones
      have many similarities, but their action, based on high affinity binding to
      specific membrane receptors, are quite different. The purpose of this study was
      to perform a sensitive localization of FSH and LH in secretory granules of
      gonadotrophs using highly specific antisera. This morphological study included
      light microscopy (PAP) and electron microscopy (immunogold single and double
      labeling) procedures. Histologically, approximatively 11.5% of cells were
      positive for LH, whereas only 5.4% of cells were positive for FSH. With the
      electron microscope, single labeling allowed identification of morphologically
      distinct LH-containing cells and FSH-containing cells. Double immunostaining
      confirmed that no cells contained both hormones. The finding that FSH and LH are
      produced in separate pituitary cells is in agreement with recent studies that
      have suggested a specific role and regulatory process for gonadotropins in the
      bovine species.

PMID- 1756216
TI  - [The diagnosis of approximal caries--a comparison of clinical, fiber optic and x
      ray diagnostic procedures (the diagnosis of approximal caries)].
AB  - A comparison of the efficiency of fibre-optic transillumination with clinical and
      radiographic diagnosis of proximal caries in posterior teeth was carried out on
      186 subjects aged 12 to 17 years. The proportion of diagnosed proximal lesions
      detected by fibre-optic transillumination was two times more often than by
      clinical examination while the increase in lesion detection by bitewing
      radiography was more than threefold. Taking radiographic diagnosis as the
      validating criteria, the sensitivity of clinical examination was 0.30 and of
      fibre-optic transillumination 0.68 resp. The specificity was 0.99 for both
      examinations. In patients with low prevalence of proximal caries and good
      preventive dental care fibre-optic transillumination should be used as an
      additional method before using of regular radiographic diagnosing of proximal
      caries.

PMID- 1756217
TI  - [The caries-protective efficacy of 2 fluoride varnishes in a 2-year controlled
      clinical trial].
AB  - The aim of this randomized, double-blind study was to measure the cariostatic
      effect of Bifluorid 12 (VOCO GmbH), containing 6% sodium fluoride and 6% calcium
      fluoride and Laweflour-Schuttellack (LAW), containing 5% sodium fluoride in
      comparing of placebo varnish. The caries study included 400 schoolchildren, aged
      12-14 years. The tests according to the DMFS were carried out by two independent
      examiners. The 400 children were divided into 3 test and 1 placebo group, each
      group consisting of 100 subjects. After two years there was a significant
      inhibition of caries increment in all test groups compared to placebo group.
      Percentage caries reduction ranged from 25 to 30%. The highest effect was stated
      at proximal surfaces.

PMID- 1756218
TI  - [The development of methods for the objective assessment of occlusal parameters].
AB  - For reasons of different data in literature on occlusal parameters and their
      metric registration, at the beginning of the 80's two methods independent of each
      other were developed--the capacity measuring method and the quasiplanimetry
      method to register the total occlusal contact area and the number of occlusal
      surfaces of contact at dental casts. The results obtained independently from each
      other showed a high degree of correspondence. That's why the method of
      quasiplanimetry was further developed and used for the direct analysis of
      enorally obtained wafers of different characteristic. The method is improved now
      with a modern system of digital analysis. The results obtained up to now admit
      the conclusion that the occlusion of the teeth represents an individual condition
      of high variability. With the reproducible method used individual occlusal
      parameters can be numerically registered.

PMID- 1756219
TI  - [Surgery before orthodontic treatment: a concept for timing the combined therapy
      of skeletal dysgnathias].
AB  - Postsurgical orthodontic treatment will prevent several disadvantages of the
      presurgical orthodontic approach: 1. Orthodontic tooth-movements do not interfere
      with compensatory biological responses. 2. The dental arch alignment is similar
      to the procedures of any class-I-orthodontic treatment; i.e. dental movements can
      be based on an already corrected skeletal relation. 3. A possible postsurgical
      relapse may be easily compensated within the postsurgical orthodontic treatment.
      Presurgical corrections of dento-alveolar discrepancies are only required to
      limit an excessive vertical disclusion necessary for a correct sagittal and
      transverse positioning of the jaws.

PMID- 1756220
TI  - [Gingivectomy].
AB  - The gingivectomy is the oldest surgical approach in periodontal therapy. During
      the centuries, the technique has been modified. Just at the middle of our
      century, gingivectomy was the most important surgical method in periodontal
      treatment. Indication for performance of the gingivectomy is the complete
      elimination of the periodontal pocket (gingival overgrowth/e.g. hyperplasia,
      subgingival caries, subgingivally located crown margins. The physiologic design
      of the free gingival margin by surgical means, gingivoplasty, must be taken under
      consideration. Depending on the long and painful healing for the patient,
      gingivectomy should be preserved for the indications above. Wherever possible, is
      recommended a flap procedure like the apically repositioned flap.

PMID- 1756221
TI  - Postulates defining pathogenic autoantibodies and T cells.

PMID- 1756222
TI  - In vivo effects of neonatal administration of antiidiotype antibodies on
      experimental autoimmune myasthenia gravis.
AB  - The in vivo effects of neonatal administration of varying doses of anti-idiotype
      antibodies on serum anti-acetylcholine receptor (AChR) antibody titers, idiotype
      expression, and disease severity was studied in experimental autoimmune
      myasthenia gravis. Polyclonal affinity purified anti-idiotype antibodies and
      monoclonal anti-idiotype antibodies directed at anti-AChR monoclonal antibody 65
      were administered in dosages varying from the nanogram to the microgram range.
      Mab 65 is directed against the main immunogenic region of mammalian AChR. In 1
      out of 4 experiments administration of a nanogram dosage of anti-idiotype
      antibodies led to an enhanced anti-AChR antibody response after immunization with
      AChR. But no enhancing effect on idiotype expression could be demonstrated during
      this experiment. Adoptive transfer of spleen cells from rats pretreated with a
      nanogram dosage of anti-idiotype antibodies resulted in an significantly
      increased antibody response against rat AChR after immunization. From these
      experiments we conclude that in vivo administration of polyclonal or monoclonal
      anti-idiotypes does not reproduceably modify the serum antibody level against the
      acetylcholine receptor, nor influences the idiotype profile of the immune
      response. Secondly, the idiotype mediated manipulation of the immune response
      against large antigens, like the acetylcholine receptor, is clearly more
      complicated than that against small haptens. Adoptive transfer models, might be
      helpful in analysing the possibilities of anti-idiotype treatment in myasthenia
      gravis in more detail.

PMID- 1756223
TI  - Binding of peripheral blood and thyroidal T lymphocytes to thyroid cell
      monolayers: possible role of "homing-like" receptors in the pathogenesis of
      thyroid autoimmunity.
AB  - The specific binding of blood lymphocyte populations to non-antigenic receptors
      on high endothelial cells in peripheral lymphoid organs is well established. Such
      "homing" receptors in target tissues may also play a role in the early phase of
      organ specific autoimmunity. In this study binding of peripheral blood and
      thyroid-derived T cells to human thyroid (THY) cells was examined. Binding was
      measured as the percentage 51Cr-labelled T cells bound to THY monolayers.
      Interferon-gamma (IFN-gamma) enhanced the binding of peripheral blood T cells
      (PBL-T) from patients with Graves' disease (GD) and normals, but not from
      patients with Hashimoto's thyroiditis (HT), to allogeneic THY monolayers. The
      binding of T cells from patients with HT to untreated allogeneic THY monolayers
      was significantly greater than that for T cells from patients with GD or normals.
      TSH inhibited the IFN-gamma enhancement of binding of PBL-T from 4 normals and
      one HT patient to both allogeneic (n = 5) and autologous (n = 4) THY monolayers.
      Intra-thyroid T cells (ITL-T) bound to autologous THY monolayers significantly
      more than PBL-T from the same patient, while ITL from patients with HT or Graves'
      disease bound more than their PBL-T to both allogeneic and autologous THY
      monolayers. ITL-T, but not PBL-T, bound significantly more to autologous THY than
      to autologous thyroid-derived fibroblast monolayers.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1756224
TI  - Non-polarized cell surface expression of HLA-A,B,C and HLA-DR antigens in Graves'
      thyroid follicle cells.
AB  - The intrathyroidal distribution and cell surface location of HLA-A,B,C and HLA-DR
      antigens was studied in polarized thyroid follicle cells from Graves' (n = 11)
      and normal (n = 3) thyroid tissue, using light and electron microscopy.
      Cryosections and isolated, open follicle segments were incubated with monoclonal
      antibodies against HLA-A,B,C and HLA-DR antigens and with patient sera containing
      autoantibodies against the microsomal antigen/thyroperoxidase. Immunoreactivity
      for HLA-A,B,C and HLA-DR on isolated thyroid follicle cells was frequently
      detected in Graves' disease, but absent in normal glands. There was a large
      variation in the immunolabelling between follicles as well as between different
      glands. Both HLA-A,B,C and HLA-DR immunoreactivity were detected on the apical
      and the basal surface of the follicle cells. Microsomal antigen/thyroperoxidase
      immunoreactivity was restricted to the apical cell surface. In contrast to normal
      tissue, HLA-DR positive cells with a dendritic or macrophage-like morphology were
      frequent in Graves' tissue. These cells adhered directly to the basal surface of
      isolated follicle segments. We conclude that HLA antigens are, unlike thyroid
      specific plasma membrane constituents, expressed in a non-polarized manner at the
      surface of the follicular epithelium. These observations might have implications
      on the immune recognition of thyroidal autoantigens in Graves' disease.

PMID- 1756225
TI  - Inhibition of protein-kinase C in peripheral blood mononuclear cells of patients
      with systemic lupus erythematosus: effect on spontaneous immunoglobulin
      production.
AB  - Systemic Lupus Erythematosus (SLE) is a multisystem disease characterized by an
      increase in the spontaneous secretion of immunoglobulin (Ig) molecules, many of
      which are autoreactive. We have previously shown (Biochem & Biophys. Res. Comm.
      (1989) 161: 1319-1326) that normal human peripheral blood mononuclear cells
      (PBMCs) can be stimulated to secrete large quantities of Ig upon incubation with
      the protein kinase-C activator 1 oleoyl-2-acetyglycerol (OAG). Specific blockage
      of protein kinase C with the isoquinoline sulfonyl piperazine compound (H-7)
      inhibited the OAG-induced Ig production. In experiments reported here, PBMC of 5
      patients with active SLE produced high levels of IgG spontaneously in culture.
      PBMC of 6 inactive SLE patients and 7 normal control subjects produced comparable
      low levels of IgG spontaneously. Pokeweed mitogen (PWM) stimulation of PBMC in
      inactive SLE and control groups, but not active SLE patients produced markedly
      enhanced IgG production. The lack of response to PWM stimulation in active SLE
      patients is likely due to inherent maximal stimulation of active SLE B-cells. In
      addition, we examined the ability of H-7 to inhibit both mitogen-stimulated
      (normal and inactive SLE) and spontaneous (active SLE) Ig production. In other
      experiments, we also examined the ability of the isoquinoline sulfonamide (HA
      1004), a potent inhibitor of cAMP-dependent protein kinase to regulate mitogen
      stimulated and spontaneous Ig production in the patient groups indicated above. H
      7 significantly inhibited PWM stimulated Ig production in normal (P less than
      0.0001) and inactive SLE patients, (P less than 0.040) suppressing PWM stimulated
      levels to spontaneous levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756226
TI  - Different nature of the proliferation defects of GLD, LPR and MEV C57BL/6 mouse
      lymphoid cells.
AB  - The three non-allelic gld, lpr and mev mutations in the mouse all lead to
      profound immunodeficiency besides a splenomegaly and a generalized autoimmunity.
      Spleen cells from young B6 gld, B6 lpr and B6 mev mice all display a decreased
      proliferative response to the T-cell mitogen concanavalin A (ConA), but the
      nature of the deficiency seems very different. No restoration of proliferation
      could be obtained by adding exogenous recombinant rIL2 to ConA-treated mev spleen
      cells, this lack of IL2-responsiveness suggesting a lack of (functional) IL2
      receptors. In young mice of both gld and lpr strains, a B6 wild-type level of
      proliferation could be reached by rIl2 addition to ConA-treated spleen cells,
      this normal responsiveness to exogenous IL2 suggesting a normal expression of IL2
      receptors. The endogenous IL2 production by ConA-treated spleen cells decreased
      very much with ageing in both B6 gld and B6 lpr mice. Yet, IL2 production in
      young mice revealed an earlier deficiency of the B6 lpr mice: the young B6 gld
      IL2 levels reached about 60% of age-matched B6 wild cell levels, but the B6 lpr
      levels reached 14% only. Finally the addition of exogenous rIL2 to ConA
      pretreated cells from old B6 gld and B6 lpr mice, while enhancing the
      proliferative responses, could not restore the B6 wild-type levels. This suggests
      that, with ageing, the expression of functional IL2-receptors may become as
      abnormal in these gld and lpr mutants as it is from birth in the mev mutant mice.

PMID- 1756227
TI  - New postulates of autoimmunity--are they bona fide?

PMID- 1756228
TI  - Postulates defining pathogenic autoantibodies and T cells.

PMID- 1756229
TI  - Serum IL-2 level in rheumatoid arthritis: correlation with joint destruction and
      disease progression.
AB  - Understanding of T cell dysfunctions in rheumatoid arthritis (RA) may help to
      elucidate the pathophysiology of this disease. Cytokines determinations may be a
      promising approach and could represent a simple mean of quantifying RA
      immunological dysfunctions. In this study, interleukin-2 (IL-2) measurements were
      performed in sera of 74 RA patients to evaluate the potential use of this method
      to monitor "disease activity" and/or prognosis. Although the serum IL-2 levels of
      patients in active disease stage proved to be somewhat lower than those from
      patients with inactive disease, the difference was not significant. In our study,
      however, the serum IL-2 concentration was correlated with the circulating immune
      complexes level. In addition, patients with the highest serum IL-2 levels
      exhibited the poorest radiological stages and these same patients were often not
      receiving any disease modifying antirheumatic drugs (DMARD). Our results
      demonstrate that serum IL-2 level may be elevated in certain RA conditions. A
      better understanding of this phenomenon, especially the consequences of disease
      duration, could be of interest in the follow up and the prognosis of the disease.

PMID- 1756230
TI  - Expression of tumor necrosis factor-alpha and -beta transcripts in embryonal
      carcinoma and trophoblast cell lines: inflammation-like state as possible
      regulatory mechanism for ontogenesis.
AB  - TNF-alpha and TNF-beta are both involved in inflammation which regulates
      homeostasis in adults. We examined the mRNA expression of TNF-alpha and TNF-beta
      in murine embryonal carcinoma (EC) cell lines (PCC3, PCC4, ECA2 and F9) and
      trophoblast cell line (PL/B6) using a combined system of reverse transcription
      and polymerase chain reaction. Four lines of EC cells and PL/B6 expressed mRNA of
      both TNFs. Moreover, mRNA expression of two types of TNF-receptor and
      transcription factor NF-kappa B, both of which mediate a part of the biological
      function of TNFs, were also detected in EC and trophoblast cells. In order to
      clarify whether other cytokines may form a network during embryonal development,
      we also examined the expression of transcripts of inflammatory cytokines produced
      by activated macrophages (IL-1 alpha, IL-1 beta and G-CSF) or by T lymphocytes
      (IL-3 and IFN-gamma) in adult. We found that no IL-1 alpha transcript was
      expressed in any of the cell lines examined whether differentiated or not.
      Contrary to this, the transcript of G-CSF was continuously expressed in all cell
      lines, and those of IL-1 beta, IL-3 and IFN-gamma were slightly expressed in some
      cell lines.

PMID- 1756231
TI  - Aberrations in interleukin-1 expression in oncogene-transformed fibrosarcoma
      lines: constitutive interleukin-1 alpha transcription and manifestation of
      biological activity.
AB  - We have examined interleukin-1 (IL-1) expression in a series of oncogene
      transformed NIH-3T3 fibroblastoid cell lines. In contrast to primary fibroblasts
      where IL-1 is inducible, NIH-3T3 cells (clone 490N3T) transcribe the IL-1 alpha
      gene constitutively. Transformation of 490N3T cells by the v-mos or v-H-ras
      oncogenes appears to either enhance or suppress IL-1 alpha transcription,
      respectively. In v-myc transfected cells, constitutive IL-1 activity could be
      detected intracellularly. An additional membrane-associated form of IL-1 was
      observed in lines transformed by protein-kinase (PK) encoding oncogenes, such as
      TPR-met, c-met, v-src, v-abl, v-mos and v-raf. In none of the lines tested the
      secreted form of IL-1 activity could be detected, and no constitutive expression
      of IL-1 beta was observed. Our studies manifest aberrations in IL-1 expression in
      oncogene-transformed fibroblastoid cell lines, detected at different regulatory
      levels, such as transcription, translation and compartmentalization. IL-1 is a
      potent pleiotropic cytokine, with regard to its target cell specificity and
      spectrum of activities; growth promoting effects of IL-1 on fibroblasts were
      reported and on the other hand this cytokine activates various anti-tumor
      mechanisms. Thus, endogenous IL-1 expression by tumor cells may affect the
      neoplastic phenotype, either by influencing the growth of the malignant cells or
      by modifying tumor-host interactions.

PMID- 1756232
TI  - The role of monocytes in the induction and regulation of IFN-gamma production by
      lectin-activated human T lymphocytes.
AB  - The data presented show that the production of interferon gamma (IFN-gamma) by
      pokeweed mitogen (PWM)-activated T lymphocytes requires monocytes and that the
      amount of lymphokine produced depends on the number of monocytes present in the
      culture. Accessory function of monocytes was independent from their ability to
      secrete IL-1 but required cell-cell contact, since blocking of adhesion molecules
      reduced the IFN-gamma production. Furthermore, production of IFN by lectin
      preactivated T lymphocytes could not be triggered by IL-2 but also required
      monocyte-T cell interaction.

PMID- 1756234
TI  - Movement related brain potentials accompanying a non-productive voluntary action
      in humans.
AB  - This study assessed the effects of training and ability to execute a voluntary
      movement upon movement-related brain potentials (MRBPs). A self-paced thumb
      flexion initiated a sequence of autotriggered electrical stimuli over the median
      nerve that caused a twitch opposing the intended thumb extension. The MRBPs had
      earlier onsets during the first runs of skill acquisition than during later
      training sessions; they occurred earlier when they preceded a stimulus train than
      when they preceded a single stimulus; the onset was earlier over the vertex than
      over the premotor area. MRBP duration was longer during train stimulation when a
      voluntary effort had to be maintained against tetanic contraction. MRBP amplitude
      did not reflect task requirements under these experimental conditions.

PMID- 1756233
TI  - Specific regulation of the 100 kDa 2-5 A synthetase by protein kinase C.
AB  - The 2-5 A synthetase is a system of several isozymes, whose expression is induced
      by interferons (IFNs) at the transcriptional level. These enzymes mediate part of
      the antiviral effects of IFNs and are thought to have an important role in cell
      growth or differentiation. The different isozymes -100, 69, 46 and 40 kDa
      expressed in human cells, or the 105, 71 and 43 kDa expressed in mouse cells--are
      induced by IFNs with cell type specificity, and exhibit individual differences in
      their biochemical and enzymatic properties. Here we studied the effects of the
      tumor promoter phorbol ester (TPA), or the calcium ionophore A23187, on the
      pattern of expression of 2-5 A synthetase isoforms, and found a role of protein
      kinase C (PKC) in the adjustments of this pattern. We show that in HeLa cells the
      100 kDa 2-5 A synthetase can be specifically induced by short term treatments
      with TPA, or with the calcium ionophore A23187. Induction of the 100 kDa form is
      mainly post-transcriptional. By contrast long term treatments by TPA resulting in
      the down regulation of PKC, or employing H7, a specific PKC inhibitor, reduced
      drastically the induction by IFNs of the 100 kDa enzyme in HeLa or fibroblast
      cells, without reducing the expression of the other forms. Moreover, using a
      mouse Swiss 3T3 cell line in which the cDNA coding for PKC-alpha was introduced,
      leading to its overexpression, we could show that the mouse 105 kDa synthetase
      was constitutively expressed. Thus, a direct correlation was found between the
      expression of PKC-alpha and the specific induction of the 105 kDa form.
      Neutralization of autocrine IFNs by antibodies reduces the expression of the 105
      kDa species. However the autocrine IFN in the medium of the cells overexpressing
      PKC is not able to induce 2-5 A synthetase in control transfected Swiss 3T3
      cells. Thus, IFN is probably essential for the expression of the 105 kDa
      synthetase but may be not produced in sufficient amounts to induce the 105 kDa
      protein.

PMID- 1756235
TI  - Very low concentrations of acetylcholine and GABA modulate transmitter responses.
AB  - Acetylcholine and GABA, at extremely low concentrations (10(-14) to 10(-8) M)
      which do not induce electrical responses, each modulate the chloride-dependent
      responses of Aplysia neurons to higher concentrations of the same transmitters.
      Low concentrations of acetylcholine cause a reduction of the response to both
      acetylcholine and GABA, while low concentrations of GABA cause a facilitation of
      responses to both acetylcholine and GABA. These effects have a clear threshold,
      are slow in onset, reversible with prolonged washing, and blocked by cooling.

PMID- 1756236
TI  - The corticotectal projection of the rat established in organotypic culture.
AB  - To study the mechanisms involved in the formation of neural projections we
      established an in-vitro model system, consisting of the projection from visual
      cortex (VC) to colliculus superior (SC) in organotypic slice culture. The typical
      laminar structure of both brain areas was well conserved in-vitro. A projection
      from VC to SC was reliably formed. Cortical projection neurons retrogradely
      stained by DiI were situated in layer V and showed a prominent apical dendrite
      with a tuft in layer I. No projection from SC to VC was established. Cortical
      terminal arborizations revealed by anterograde staining were often organized in
      layers. We conclude that the typical anatomical characteristics of the
      corticotectal projection are preserved in-vitro.

PMID- 1756237
TI  - Evidence for microtubule capture by filopodial actin filaments in growth cones.
AB  - We have studied, by immunofluorescence, the organization of microtubules in
      growth cones in dissociated neuronal cell cultures. Growth cones have a large
      pool of soluble tubulin and in conventionally fixed cultures the entire growth
      cone, including the filopodia, is labelled with tubulin antibodies, thus
      obscuring the microtubules. In contrast, in cultures fixed with fixatives
      containing detergent, the soluble pool of tubulin is removed allowing clear views
      of the microtubules. On entering the growth cone from the neurite, microtubules
      splay out and may extend as far as the base of filopodia. In most growth cones,
      one or more individual microtubules extend into filopodia, aligning with the
      parallel bundle of microfilaments. This observation suggests one way growth cone
      motility and neurite advance may be coupled.

PMID- 1756239
TI  - Cortical fields participating in form and colour discrimination in the human
      brain.
AB  - In order to map the anatomical structures participating in the analysis and
      processing of visual information related to discrimination of form and colour, we
      measured with positron emission tomography (PET) regional cerebral blood flow
      (rCBF) as an indicator of metabolic activity in ten right-handed volunteers
      during visual discrimination tasks, namely reference, form and colour tasks. Form
      discrimination specifically increased rCBF bilaterally in the inferior temporal
      and cingulate gyri, and in the left superior temporal, left occipital lateral,
      and left angular gyri, whereas colour discrimination did so in the left occipital
      superior and lateral, left parahippocampal, left occipito-temporal medial
      (lingual), and left superior parietal gyri, and the right precuneus.

PMID- 1756238
TI  - NGF increases cortical acetylcholine release in rats with lesions of the nucleus
      basalis.
AB  - Rats received a unilateral lesion of the nucleus basalis by infusion of ibotenic
      acid. Two weeks after the lesion, osmotic minipumps were implanted, that infused
      1 microgram human recombinant nerve growth factor (NGF) or cytochrome-C per day
      into the lateral ventricle. After four weeks of treatment, release of
      acetylcholine was measured in the frontal neocortex by means of in-vivo
      microdialysis. Release was decreased by 75% on the lesioned side; perfusion with
      100 mM KCl increased release on the intact side by 130% and on the lesioned side
      by 80%. Treatment with NGF increased release on the lesioned side twofold, but
      had no effect on release on the intact side.

PMID- 1756240
TI  - Identification of angiotensin II receptor subtypes in human brain.
AB  - The present study assessed the binding characteristics of [125I]angiotensin II to
      slices of human cerebellum adhered to glass slides using quantitative receptor
      autoradiography. Specific [125I]angiotensin II binding, defined by the inclusion
      of unlabelled angiotensin II (1.0 microM), was detected in the molecular layer of
      the cerebellum (0.09 +/- 0.02 fmol/mg tissue equivalent, mean +/- s.e.m., n = 3).
      The angiotensin II-2 receptor subtype selective ligand, PD123177, competed for
      approximately 65% of the specific binding in the molecular layer whilst the
      remainder of the specific binding was displaced by the angiotensin II-1 receptor
      subtype selective ligand, DuP753. It is concluded that angiotensin II receptor
      subtypes exist in human brain tissue and provide potential therapeutic sites of
      action.

PMID- 1756241
TI  - The supraoptic nuclei in vasopressin and hemodynamic responses to hemorrhage in
      rats.
AB  - Cardiovascular and vasopressin (AVP) responses to hemorrhage were studied in rats
      with lesions of the hypothalamic supraoptic nuclei (SONL). Bleeding caused
      hypotension and increase in heart rate (HR) and AVP. SONL rats failed to fully
      recover from bleeding as compared to normal rats. Plasma AVP in SONL rats was in
      the normal in basal conditions, but failed to increase to levels attained in
      normal rats throughout the post-hemorrhage period. These data suggest that the
      supraoptic nuclei are the primary regulatory sites for AVP release in response to
      hemorrhage and that lack of adequate AVP release significantly retards blood
      pressure recovery after bleeding.

PMID- 1756242
TI  - Binocular probability summation in a choice reaction-time task in pigeons.
AB  - We present evidence for binocular summation in pigeons in a choice reaction time
      paradigm. Considering binocular vision as the result of a race between the
      equivalent eyes, pigeons can adopt both a 'subject by subject' and a 'trial by
      trial' race model, and binocular advantage can be attributed merely to a
      probability summation. Pigeons were tested on a visual discrimination task in
      which the time for detection was gradually reduced and a quick response was
      required. The time presentation of a small black spot could vary from 2000 ms to
      the shortest value (157-226 ms) allowing maintenance of a satisfactory
      performance criterion.

PMID- 1756244
TI  - A model of respiratory rhythm generation.
AB  - A new hypothesis is proposed to explain the generation of respiratory rhythm by
      the respiratory neurons of the medulla. The basis of the oscillator is a mutual
      inhibition between early-burst inspiratory, propriobulbar neurons and Botzinger
      complex expiratory, bulbospinal neurons, with only the early burst inspiratory
      neurons possessing adaptive properties. Only one theoretical connection,
      unsupported by experimental observations, needs to be assumed for this model,
      that of an inhibitory connection from Botzinger complex expiratory neurons to
      early-burst inspiratory neurons. A mathematical simulation of the model was used
      to test the hypothesis. The oscillating patterns of activity produced by the
      model were similar to those observed experimentally in these neurons. It is
      therefore concluded that, based on reasonable assumptions, the proposed
      hypothesis will produce oscillations similar to those of respiration.

PMID- 1756243
TI  - Long-term enhancement of REM sleep following cholinergic stimulation.
AB  - A six day long increase in rapid eye movement (REM) sleep followed the unilateral
      microinjection of a single dose of the cholinergic agonist drug carbachol into
      the brain stem of cats. Effective drug injection sites were localized to the
      pontine peribrachial region containing cholinergic choline acetyltransferase
      (ChAT) labeled neurons. At the peak of the effect, which occurred 24-28 h post
      injection, the relative amount of time devoted to REM sleep tripled, resulting in
      an absolute time increase from 3.12 to 11.28 h REM sleep per day. This pronounced
      and prolonged REM sleep increase was associated with marked enhancement of ponto
      geniculo-occipital (PGO) waves and with PGO burst cell activity unilateral to the
      site of injection.

PMID- 1756245
TI  - m-Chlorophenylpiperazine enhances neophobic and anxious behaviour in mice.
AB  - 1-(3-Chlorophenyl)piperazine (mCPP) reduced novelty-seeking behaviour as well as
      the number of rears in mice confronted with a free exploratory test. Moreover,
      mCPP was found to decrease the time spent by mice in the lit box and the number
      of transitions in a two-box light/dark choice situation validated for the
      detection of anxiolytic or anxiogenic drugs. These results suggest that mCPP
      enhances emotional responses towards novel and aversive places. Since mCPP has
      been reported as a 5-HT1C receptor agonist, it can be hypothesized that increased
      activity of serotonin may play a role in regulating certain forms of emotional
      behaviour in animals.

PMID- 1756246
TI  - Superoxide dismutase halts cycling of murine erythroid progenitor cells prior to
      S phase in vitro and possibly in vivo.
AB  - Mice of the C57BL/6 (B6) strain show a much lower proportion of marrow erythroid
      progenitor cells (BFU-E) in DNA synthesis in vivo than mice of the congeneic B6S
      strain. However, when assayed in vitro marrow cells from both strains show high
      proportions of BFU-E in S-phase. BFU-E from normal B6 mice have been previously
      shown to be specifically inhibited from entering S-phase in vitro by the
      antioxidant enzyme superoxide dismutase (SOD), however, in this study we have
      found that BFU-E taken from the marrow of B6S mice or B6 mice which have been
      subjected to bleeding are insensitive to SOD inhibition in vitro. Comparisons of
      results from in vivo and in vitro cycling assays done with cells from both
      strains indicate that a large proportion of marrow BFU-E in normal B6 mice are
      halted in the pre-S portion of the cell cycle in vivo, and these halted cells are
      prevented from going into S-phase in vitro by SOD. The insensitivity to SOD
      inhibition shown by BFU-E from B6S and bled B6 mice can be attributed to the
      absence of accumulation of SOD-susceptible cells in pre-S phase in these mice in
      vivo, and there is evidence to suggest that the difference in BFU-E cycling seen
      in vivo may be due to interactions between SOD and factors which stimulate
      cycling of BFU-E.

PMID- 1756247
TI  - Factor with erythroid burst-promoting activity in human urine unlike other
      hematopoietic growth factors.
AB  - A factor with burst-promoting activity (BPA) stimulates the formation of
      erythroid bursts in the presence of erythropoietin, acting on early erythroid
      progenitor cells (erythroid burst-forming units, or BFU-E). Here we investigated
      the biological properties of this factor partially purified from the urine of
      anemic patients. The human urinary factor did not cause the formation of late
      erythroid progenitor cells (erythroid colony-forming units, or CFU-E) or enhance
      such colony formation in the presence of erythropoietin. Thus, the urinary factor
      was a different substance from erythroid potentiating activity and from activin,
      which act on both BFU-E and CFU-E. The urinary factor promoted the colony
      formation of BFU-E from both humans and mice, but the human hematopoietic growth
      factors such as recombinant interleukin-3, interleukin-6, granulocyte-macrophage
      colony-stimulating factor, and macrophage colony-stimulating factor did not
      stimulate the formation of BFU-E derived colonies from mice. The results
      suggested that the factor in the urine of anemic patients was different from the
      hematopoietic growth factors identified so far.

PMID- 1756248
TI  - The effects of subcutaneous deferoxamine administration on renal function in
      thalassemia major.
AB  - To assess the effects of deferoxamine (DFO) on the kidneys, we studied 27
      patients with thalassemia major on chronic subcutaneous (s.c.) DFO therapy. In
      41% of the patients glomerular filtration rate (GFR) values were above the normal
      range. In a previous study similar findings were reported for thalassemia
      patients who did not receive DFO. The subcutaneous administration of DFO was
      associated with a clinically significant decrease in GFR in 40% of the patients
      and in a mild decrease in another 40%. In all cases of severe decreases in GFR,
      it tended to return to baseline values upon discontinuation of DFO. There was a
      significant increase in urine volume during DFO therapy. These changes are
      consistent with our previous observation in humans and dogs receiving high dose
      i.v. DFO, albeit milder.

PMID- 1756249
TI  - Expression of three cell proliferation-associated antigens, DNA polymerase alpha,
      Ki-67 antigen and transferrin receptor in nodal and cutaneous T-cell lymphomas.
AB  - We studied the expression of three cell proliferation-associated antigens: DNA
      polymerase alpha, Ki-67 antigen, and transferrin receptor, in 35 T-cell lymphomas
      of nodal origin (T-NL) and 40 cutaneous T-cell lymphomas (CTCL).
      Immunohistochemical staining was carried out on frozen tissue sections of these
      specimens using three monoclonal antibodies, DAKO-PC, CL22-2-42B (DNA polymerase
      alpha), and OKT9. The proportion of cells positive for CL22-2-42B, DAKO-PC, or
      OKT9 among all tumor cells was correlated with four histologic subtypes:
      malignant lymphoma (ML), diffuse, small; mixed; large; and large cell
      immunoblastic in both T-NL and CTCL. A strong correlation was noted between
      positivity for CL22-2-42B and that for DAKO-PC or OKT9. On the other hand, no
      difference in the expression of these three antigens was noted between T-NL and
      CTCL in the high, intermediate or low grade-malignancy group. In CTCL as well as
      in T-NL, cells positive for CL22-2-42B, DAKO-PC or OKT9 were significantly more
      numerous in the high-grade group than the intermediate-grade group, and in the
      intermediate-grade group than the low-grade group. Furthermore, a significant
      correlation between survival period and the number of CL22-2-42B-positive cells
      was noted when the T cell malignancies, CTCL and T-NL were considered (t value =
      2.015, p less than 0.05). Thus, the expression of DNA-polymerase alpha, Ki-67
      antigen or OKT9 seems to well reflect the biological behavior and/or clinical
      prognosis of T-cell lymphoma.

PMID- 1756250
TI  - Geographic clustering of myeloma in Tokushima.
AB  - Between 1978-1988, seven cases of multiple myeloma were found in T Town
      (population 9,000), which is located at the mouth of a large river within the
      boundaries of Tokushima City, Japan. This is a significantly high incidence, 7.06
      per 100,000 as compared with an incidence of 1.20 in Tokushima City itself and
      1.53 in Japan as a whole. The clinical and laboratory features of these patients
      were typical of myeloma. Although the causes of this small but apparent cluster
      of multiple myeloma remain obscure, the fact that five of the seven patients had
      been working for long periods as fishermen was notable.

PMID- 1756251
TI  - Inhibition of platelet aggregation by low concentrations of sodium fluoride.
      Significance of the intracellular calcium ion concentration.
AB  - Sodium fluoride activates platelets but its mechanism of action has not yet been
      completely identified. We examined the effect of a low concentration of sodium
      fluoride (which could not cause aggregation) on thrombin-induced changes in the
      intracellular calcium ion concentration ([Ca2+]i). In the presence of 1 mM
      extracellular Ca2+, preincubation with a low concentration of sodium fluoride
      decreased the peak of the thrombin-induced elevation of [Ca2+]i, when measured
      with aequorin. When [Ca2+] was measured using fura-2, preincubation caused no
      marked changes in its peak, but the later changes that were thought to mainly
      reflect extracellular Ca2+ influx were inhibited. The inhibitory mechanism of
      sodium fluoride appears to depend on reducing extracellular Ca2+ influx. Aequorin
      appears to reflect [Ca2+]i near the cell membrane and is thus easily affected by
      the extracellular Ca2+ influx.

PMID- 1756252
TI  - Clinical evaluation of recombinant human factor VIII (BAY w 6240) in the
      treatment of hemophilia A.
AB  - A pilot clinical trial was conducted in five patients with severe hemophilia A to
      evaluate the safety and efficacy of a recombinant human factor VIII preparation,
      BAY w 6240 (rFVIII). In a comparative pharmacokinetic study of rFVIII and a
      plasma-derived factor VIII preparation (pdFVIII), the mean t1/2 values for rFVIII
      at week 1 and week 13 were 16.8 and 14.4 h, while this value for pdFVIII at week 
      2 was 16.9 h. There were no statistical differences between these values. The
      mean in vivo recovery rates of rFVIII were comparable to those of pdFVIII. When
      rFVIII was administered prophylactically three times a week for 4 weeks, no
      bleeding episodes were observed. Seventy-four bleeding episodes were assessed
      during the 6-month treatment period. The efficacy rate of the hemostatic effect
      was confirmed to be 95.9%. No adverse reactions attributable to rFVIII were
      observed in a total of 178 infusions. Neither FVIII-inhibitors nor antibodies to
      foreign proteins were detected. Vital signs and laboratory findings showed no
      significant changes attributable to rFVIII. These results suggest that rFVIII is
      safe and efficacious as replacement therapy for hemophilia A.

PMID- 1756253
TI  - Plasma coagulation and fibrinolysis parameters in patients with collagen
      diseases, and analysis of the multimeric structure of von Willebrand factor
      (vWF).
AB  - We studied the relationship between vascular complications and coagulation and
      fibrinolysis parameters in 75 subjects with collagen diseases. Thirty normal
      healthy persons served as controls. We found that patients with collagen diseases
      were in a state of a hypercoagulation and hyperfibrinolysis. In SLE (systemic
      lupus erythematosus) in particular, coagulation and fibrinolysis parameters
      appeared to be indices of vascular complications. Increases in the levels of
      thrombin-antithrombin III complex (TAT) and alpha 2-plasmin inhibitor-plasmin
      (PIP) were particularly associated with proteinuria, while increases in
      fibrinopeptide A (FPA) levels were associated with Raynaud's phenomenon.
      Administration of glucocorticoid seemed to improve the hypercoagulation and
      hyperfibrinolytic states of patients with collagen diseases. Analysis of the
      multimeric structure of von Willebrand factor (vWF) revealed a tendency for large
      and intermediate multimers (LIM) of plasma vWF to increase in SLE patients with
      accompanying vascular complications, whereas such increases were not observed in
      SLE patients without any vascular complications. Therefore, analysis of the
      multimeric structure of vWF appeared to be a useful indicator of vascular
      complications in collagen diseases.

PMID- 1756254
TI  - Chronic lymphocytic leukemia associated with von Recklinghausen
      neurofibromatosis.
AB  - We report a 62-year-old female, with von Recklinghausen neurofibromatosis and
      chronic lymphocytic leukemia, whose mother and son both had neurofibromatosis and
      died of digestive tract cancers. The patient died of pneumonia 3 years after the
      initiation of therapy. Leukemia reported in association with neurofibromatosis
      are predominantly nonlymphocytic and limited to childhood. The type of
      association found in our patient has not been reported previously.

PMID- 1756255
TI  - Natural history of human breast cancer: recent data and clinical implications.
AB  - This study of the natural history of human breast cancer was based on the
      analysis of a series of 3000 patients treated by radical mastectomy at a single
      institution (Institut Gustave Roussy) at a time when adjuvant chemotherapy was
      not prescribed. The follow-up of the patients ranged from 15 to 30 years; for
      each patient the tumor size, the number of involved axillary nodes, and the
      histological grade were prospectively registered. A highly significant
      correlation was found between tumor size and the probability of distant
      metastatic dissemination. The distribution of tumor sizes at metastatic spread
      was log-normal with a median diameter equal to 3.5 cm. The patients were
      subdivided into 3 groups according to the histological grade. In each subgroup
      there was a significant correlation between tumor size and the probability of
      distant spread; the distributions were log-normal and the median size was
      markedly larger for grade 1 tumors. Moreover the proportion of grade 1 tumors was
      higher in small tumors than in large ones while the reverse was observed for
      grade 3 tumors; these data suggest that during their growth tumors progress
      towards higher grades. One of the chief fundamental characteristics of a tumor
      seems to be its propensity for axillary node invasion. The orderly pattern of
      nodal involvement makes it possible to calculate the tumor size at invasion of
      the first axillary node in each subset of patients. A strong and highly
      significant correlation exists between the size of the tumor at initiation of
      distant metastasis and at invasion of the first lymph node. However the capacity
      for lymphatic spread is, on average, acquired much earlier than the capacity for
      metastatic spread. With a simple model based on these data it was possible to
      compute the proportion of patients with occult metastases as a function of tumor
      size, histological grade, and number of involved axillary nodes. Early invasion
      of axillary nodes is associated with a rapid growth rate of the primary tumor (or
      a high S-phase fraction). However each of these variables has an independent
      prognostic significance; the S-phase fraction appears as one of the strongest
      prognostic indicators. A model of tumor growth was used to assess the impact of
      screening procedures on the proportion of patients with distant metastases. The
      predictions of the model are consistent with the results of the screening
      programs.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1756256
TI  - Proliferative inhibition of human breast carcinoma cells by high concentration
      estradiol does not alter radiosensitivity.
AB  - The proliferation of ER+ malignant mammary epithelial cells (MMEC), MCF-7 and T
      47D, was markedly inhibited by 10 microM 17 beta-estradiol (E2), while the ER-
      line, MDA-MB-231, was minimally affected. This concentration of E2 did not alter
      the proportion of non-viable cells or the plating efficiency. The decrease in
      proliferation was not associated with any consistent alteration in the cell
      kinetic profile between lines, though there was clearly no dominant cell cycle re
      assortment after a two day incubation. Colony forming ability after exposure to
      ionizing irradiation was compared for proliferating and confluent MMEC to cells
      incubated in 10 microM E2 for two days. The presence of E2 resulted in no
      significant differences for any of the linear quadratic curve fitting parameters
      or for mean inactivation doses for both subconfluent and confluent cultures.
      Further, 10 microM E2 had no effect on the ability of cells to recover from split
      radiation fractions. There were no differences in the amount of DNA single strand
      break induction with E2, but there was a significant shortening in the repair
      halftime with E2 for the ER- MDA-MB-231 cells. Though high concentrations of E2
      can markedly inhibit the proliferation of ER+ MMEC, this does not alter
      sensitivity to ionizing irradiation.

PMID- 1756257
TI  - Immunohistochemical evaluation of growth fractions in human breast cancers using
      monoclonal antibody Ki-67.
AB  - We performed immunohistochemical analyses of 568 breast/cancer specimens using Ki
      67, a monoclonal antibody specific for a nuclear antigen present in proliferating
      cells. The specimens were divided into three groups (I-III) according to the
      proportion of Ki-positive cells detected. These findings were compared with
      features of tumor extension as well as with certain prognostic variables. There
      was no detectable correlation between Ki-67 reactivity and either tumor size or
      node involvement. In contrast, a statistically significant correlation was found
      between Ki-67 reactivity and tumor grading, in that G-I tumors had small growth
      fractions, while a high proportion of G-III tumors exhibited strong (group III)
      Ki-67 positivity. When growth fractions were compared with biochemical receptor
      status, a significant difference was detected between tumors with negative and
      positive findings for receptors. The same co-variation was observed with respect
      to the overexpression of neu-protein P185, with most neu-positive carcinomas
      being strongly positive for Ki-67 (group III). In the relapse cases examined,
      there was a close correspondence between Ki-67 reactivity and the duration of the
      disease-free period. Long-term observation of patients with primary breast
      carcinoma revealed that, with regard to overall survival, the less reactive
      groups I and II differed significantly from group III. With respect to disease
      free survival, no difference was detectable between Ki-groups II and III, but
      when these two groups together were compared with group I, a significant trend
      emerged. Similar results for both overall and disease-free survival were obtained
      for subgroups of pT2 and G-II carcinomas as well as for receptor
      expression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756258
TI  - Coordinated expression of intermediate biomarkers for tumorigenic transformation
      in RAS-transfected mouse mammary epithelial cells.
AB  - Deregulated expression of the RAS oncogene is associated with tumorigenic
      transformation of mammary cells. Because of the complex, multiphasic nature of
      cancer progression, it is important to systematically identify the biomarkers
      specific for initiation, promotion, and progression of breast cancer. Mouse
      mammary epithelial cells (MMEC) were transfected with normal c-Ha-RAS proto
      oncogene (pH06N) and with mutant c-Ha-RAS oncogene (pH06T). The parental MMEC and
      the cloned transfectants pH06N1, pH06N2, pH06T1, and pH06T12 were evaluated for
      the acquisition of transformed characteristics by determining altered cellular
      metabolism of estradiol, increased ability for anchorage-independent growth, and
      ability to form tumors at the transplant site in athymic 'nude' mice. Persistent,
      functional integration of c-Ha-RAS was evidenced by the presence of a 1.2 kb c-Ha
      RAS transcript in the four transfectants but not in MMEC. All the transfectants
      also exhibited a substantial increase in the binding of c-Ha-RAS p21 to [alpha
      32P] GTP relative to MMEC (P less than 0.003). The relative extent of estradiol
      metabolism leading to the formation of 16 alpha-hydroxyestrone was increased (P
      less than 0.004) in all the four transfectants. These four transfectants also
      showed a 100-400 fold increase in colony forming efficiency in 0.33% agar,
      relative to MMEC (P less than 0.0009), and formed rapidly growing tumors within 3
      5 weeks of transplantation. Our results demonstrate that i) persistent expression
      of normal and mutant c-Ha-RAS can bring about tumorigenic transformation of mouse
      mammary epithelial cells; and ii) alteration in estradiol metabolism and
      acquisition of anchorage-independent growth precede the emergence of a
      tumorigenic phenotype.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756259
TI  - Phase II evaluation of interferon added to tamoxifen in the treatment of
      metastatic breast cancer.
AB  - This phase II trial evaluated the clinical role of interferon (IFN) in overcoming
      tamoxifen (TAM) resistance in breast cancer. Twenty women and 1 man received
      recombinant alpha interferon (5 million units per meter squared intramuscularly,
      5 times per week) plus TAM (10 mg orally, twice daily) for the treatment of
      metastatic breast cancer, either after failing tamoxifen therapy or as frontline
      hormonal therapy. Of the 9 evaluable patients with disease progression after an
      objective response to TAM, there were no partial or complete responses with the
      addition of IFN. Ten evaluable patients received TAM plus IFN as frontline
      hormonal therapy with 2 complete and 3 partial responses for an overall response
      rate (RR) of 50% (95% confidence interval = 19-81), a 71% RR for ER-positive
      patients (95% confidence interval = 29-96) and no responses in ER-unknown
      patients. Sixteen patients required dose reductions of IFN and 8 patients
      discontinued therapy due to toxicity. It is unlikely that the RR for TAM plus IFN
      is greater that than seen with TAM alone, or that the addition of IFN to TAM
      therapy can overcome clinical TAM resistance.

PMID- 1756260
TI  - A phase I/II study of high-dose megestrol acetate in the treatment of metastatic
      breast cancer.
AB  - A dose-response relationship has been suggested for medroxyprogesterone acetate
      in the treatment of advanced breast cancer. To determine the tolerability and
      efficacy of increasing doses of megestrol acetate in the treatment of metastatic
      breast cancer, we conducted a phase I/II study among 57 patients. Three patients
      each received 480, 800, and 1280 mg/d; 48 patients received 1600 mg/d. Of the 57
      patients, 56 patients had had disease progression on prior hormone therapy,
      chemotherapy, or both. Twenty-seven patients had previously received standard
      dose MA (160 mg/d). Among the 37 patients with measurable disease, high-dose
      megestrol acetate (HDMA) produced 6 (16%) complete responses (CRs) and 6 (16%)
      partial responses (PRs); 11 patients achieved stable disease (SD). HDMA resulted
      in improvement or stabilization in 12 of the 20 patients with evaluable, non
      measurable disease. There were no responses among the 6 patients with liver
      metastases. Among the 27 patients who were previously treated with standard-dose
      MA, including 9 patients with primary treatment failure, HDMA resulted in 1 CR, 3
      PRs, and 10 SD. Toxicities, which were mild and reversible, included fluid
      retention, hypertension, hyperglycemia, and mild congestive heart failure. Two
      patients had superficial phlebitis. The most profound side effect was weight gain
      which occurred in 43 patients (75%). This study suggests a dose-response
      relationship for MA in the treatment of advanced breast cancer. A randomized
      trial to determine the optimal dose is ongoing.

PMID- 1756261
TI  - Duct endoscopy and endoscopic biopsy in the evaluation of nipple discharge.
AB  - Microdochectomy is usually performed on patients with nipple discharge caused by
      intraductal proliferative lesions, such as intraductal papilloma and carcinoma.
      But this operation often sacrifices large amounts of normal mammary gland even
      when the lesion is a benign intraductal papilloma a few millimeters in diameter.
      We have developed duct endoscopy for the mammary duct system, and have reliably
      performed biopsies for intraductal proliferative lesions intraductally. From June
      1989 to April 1990, we examined 22 cases by duct endoscopy, and performed
      endoscopic biopsy in 16 cases. The method of endoscopic biopsy is as follows.
      First, a bougie is inserted, without anesthesia other than Xylocaine jelly, into
      the orifice of the duct to enlarge it. Second, the outer cylinder and the inner
      needle are inserted; then the inner needle is removed, and the endoscope is
      inserted. After examination, the outer cylinder is moved up to the lesion to be
      biopsied and the endoscope is taken out. Then a sample is taken into the outer
      cylinder by aspiration. We diagnosed 10 cases of benign lesion and 5 cases of
      malignant lesion by cytological and/or histological examination. In conclusion,
      endoscopic biopsy, aided by duct endoscopy, is a useful and harmless diagnostic
      procedure in the evaluation of nipple discharge.

PMID- 1756262
TI  - Influence of age and comorbidity on treatment choice and survival in elderly
      patients with breast cancer.
AB  - To determine the effect of age and comorbid diseases on treatment choice and
      survival, the medical records of 300 breast cancer patients of 55 years and older
      were reviewed. All patients were admitted to the Netherlands Cancer Institute
      (NKI) for first treatment between 1980 and 1987. Patients were classified
      according to severity level of comorbid diseases. Physicians were found to treat
      women of 75 years and older less often with adjuvant radiotherapy after a
      mastectomy, and more often to employ only primary endocrine treatment for local
      stage disease, as compared with younger patients. According to the treatment
      guidelines of the institute, the study sample was divided into patients who
      received standard vs. non-standard treatment. The treatment of 38 women (13.1%)
      did not correspond with the guidelines. Of these, 84% were 75 years and older and
      50% had a severe comorbidity status. Logistic regression analysis indicated that
      advanced age, per se, was a better indicator of the risk of not being treated
      according to protocol than the comorbidity status. Cox multivariate analyses
      demonstrated that neither the severity of the comorbidity status nor the
      differences in treatment between younger and older patients had a significant
      effect on the risk of dying from breast cancer or on the risk of developing
      recurrences. In this analysis, age 75 years or more proved to be a significant
      and independent predictor of a worse overall and disease-specific survival as
      compared to age between 65-74 years.

PMID- 1756263
TI  - Polyadenylic-polyuridylic acid plus locoregional and pelvic radiotherapy versus
      chemotherapy with CMF as adjuvants in operable breast cancer. A 6 1/2 year follow
      up analysis of a randomized trial of the French Federation of Cancer Centers
      (F.F.C.C.).
AB  - In this study, patients with operable breast cancer T2 or T3, treated by
      mastectomy + axillary dissection and with invaded axillary nodes (N+), were
      randomized to receive either: 1) postoperative locoregional and pelvic
      radiotherapy (RX) and Poly(A).Poly(U) (AU), 60 mg IV once a week for 6 weeks, or
      2) CMF (cyclophosphamide 100 mg/sqm P.O. on days 1-14, methotrexate 40 mg/sqm IV
      on day 1 and 8, fluorouracil 600 mg/sqm IV on day 1 and 8; monthly cycle, for 6
      months. Between March 1982 and December 1985, 517 patients were enrolled, 257 of
      whom were treated by RX + AU and 260 with CMF. The main clinical, pathological
      and prognostic characteristics were equally distributed in the two groups. The
      present analysis was conducted after a mean follow-up of 69 months (S.D. = 13).
      There was no significant difference in overall survival (OS) between the two
      groups (test adjusted by center and menopausal status); the five-year OS rate was
      74% in the RXAU group and 77% in the CMF group. Relapse-free survival (RFS) was
      significantly higher (p = 0.05) in the RXAU group compared to the MCF group; the
      five-year RFS rates were 57% and 46% in the two groups respectively. This short,
      well-tolerated combined RXAU treatment appears to be as efficient as CMF and
      might offer an alternative to chemo- or hormonotherapy, in case of
      contraindications to these treatments.

PMID- 1756264
TI  - Tumor suppressor genes: a new era for molecular genetic studies of cancer.
AB  - Previous emphasis in cancer research has been placed on genes in which activating
      mutations are found in experimental systems and sometimes in human tumors, and
      many of these genes are the cellular homologs of retroviral oncogenes. Studies of
      genes whose functions are necessary for maintenance of the normal cellular state,
      but for which loss-of-function mutations lead to tumor development, are limited.
      The latter genes have been variously termed 'tumor suppressor genes', 'recessive
      oncogenes', and 'anti-oncogenes', and each term defines a specific aspect of
      their properties and may not always be applicable. The retinoblastoma (RB) gene
      is the first such gene to be identified, and was isolated based on its chromosome
      localization and on the recessive nature of the tumor phenotype. That is, both
      wild type RB alleles must be inactivated in a single cell for neoplastic
      transformation to occur, and deletions at the chromosomal locus now known to
      contain RB are often found in retinoblastoma cells. Candidate genes for Wilms'
      tumor and neurofibromatosis type I have also been identified recently, and loss
      of function of these genes seems to be indicated for these diseases. Allelic loss
      of chromosome 17p13 is frequently observed in many tumor types. The p53 gene was
      mapped to this chromosomal region and has been shown to be a tumor suppressor
      gene, and germ-line mutations of p53 recently were found to be correlated with Li
      Fraumeni syndrome, a syndrome characterized by multiple neoplasms. Rapid progress
      in studies of tumor suppressor genes points to diverse mechanisms for their
      functioning in the negative regulation of cell growth. A scenario depicting cell
      growth control by positive and negative regulators, based on new and emerging
      findings, is the main focus of this review.

PMID- 1756265
TI  - Comparing core needle to surgical biopsies in breast cancer for cell kinetic and
      ploidy studies.
AB  - The evaluability and reliability of proliferative activity (expressed as 3H
      thymidine labeling index, 3H-TdR LI) and ploidy determinations on core needle
      biopsies were compared with those obtained on surgical material from the same
      breast cancers. The evaluability of 3H-TdR LI on core needle biopsies was
      markedly lower than that on surgical material (53% vs 100%), and the association
      between 3H-TdR LI values in the 16 cases with both evaluable determinations was
      poor (rs = 0.45). Conversely, determinations of ploidy on core needle biopsy and
      surgical material provided superimposable results, in terms of evaluability (91%
      vs 100%) and reliability (rs = 0.99). Further efforts are needed to improve
      sampling procedures for a reliable assessment of biological markers.

PMID- 1756266
TI  - Sequential determination of immunocytochemical estrogen receptor and nuclear DNA
      content in fine needle biopsies from breast carcinoma.
AB  - The application of fine needle biopsy as a tool for early detection of breast
      cancer is becoming extensive, therefore parameters reported to be associated with
      prognosis should be standardized in this material. We propose the sequential
      determination of estrogen receptor (ER) status and DNA ploidy on the same smear
      obtained from a fine needle biopsy of a breast carcinoma, since both parameters
      seem to reflect properties associated with tumor behaviour and biological
      aggressiveness. Fifty fine-needle biopsies were investigated for presence of ER
      by the monoclonal antibody D75 followed by DNA content quantification using
      Feulgen-DNA cytophotometry. Overall, 66% of the tumors showed immunoreactivity
      for ER and 66% were classified as aneuploid. Forty-one percent of the aneuploid
      tumors were negative for ER, while only 7% of the diploid tumors showed no
      immunoreaction (p less than 0.05). The significant association between absence of
      immunocytochemical ER and DNA aneuploidy on the same fine-needle smear is
      consistent with data obtained through other methods previously reported using
      much larger tissue samples.

PMID- 1756267
TI  - MRI appearance of multiple papilloma of the breast.
AB  - Magnetic resonance imaging (MRI) is capable of providing a different diagnostic
      perspective in the evaluation of breast lesions. Its application in a single
      patient with multiple papilloma of the breast is described. MRI convincingly
      demonstrated the multicentric nature of the disease and helped to select a proper
      treatment plan. This report makes it clear that MRI could serve as an adjunct to
      mammography and sonography in selected cases.

PMID- 1756268
TI  - Angiosarcoma of the skin overlying an irradiated breast.
AB  - A case of angiosarcoma of the breast which developed six and a half years after
      treatment for carcinoma of the same breast is reported. As a result of
      radiotherapy the breast manifested signs of chronic lymphedema prior to
      development of angiosarcoma. Although the aetiology in this case is uncertain,
      there was a past history of childhood naevus regressing spontaneously.
      Angiosarcoma is a well known complication following radiotherapy and lymphedema,
      and is likely to be seen more frequently as conservation treatment is used more
      commonly for patients with early breast cancer.

PMID- 1756269
TI  - 65 and 47 kDa forms of estrogen receptor in human breast cancer: relation with
      estrogen responsiveness.
AB  - In breast cancer nearly 40% of estrogen receptor (ER) positive patients do not
      respond to hormone therapy. As several species of ER have been described, we
      examined 41 breast cancers for: (1) the presence of ER and progesterone receptor
      (PR); (2) the molecular weight (Mr) of ER; (3) estrogen responsiveness,
      appreciated by the ability of a piece of tumor transplanted in nude mice to show
      an estrogen-induced protein synthesis (PR synthesis). We found that there are:
      two species of ER with different Mr (65 and 47 kDa), and three species of tumors
      (36% containing the highest form of ER alone, 49% bearing the two components in
      variable amounts, and 15% bearing only the minor species). Eleven of these 41
      tumors could be assayed for PR synthesis induction, showing that estrogen
      responsiveness is correlated with the major component. Due to the limited number
      of samples (11) the data are preliminary, but they strongly suggest that the
      different forms of ER could exist in the living cell with different functional
      abilities.

PMID- 1756270
TI  - Incidence of an estrogen receptor polymorphism in breast cancer patients.
AB  - We previously identified a polymorphism in the human estrogen receptor (ER) gene,
      within the coding region for the protein's amino terminal B-domain. In estrogen
      receptor-positive (ER+) breast tumors, the variant allele was preferentially
      associated with lower levels of ER, and was clinically correlated with frequent
      spontaneous abortions. DNA sequencing revealed a point mutation that changes
      codon 86 from Ala to Val and a silent mutation in codon 87. Because we initially
      detected the variant allele by analyzing RNA, only those tissues in which the ER
      gene is actively expressed were suitable for genotype analysis. We now describe
      an assay that uses genomic DNA as the substrate for determining the ER B
      genotype, DNA containing the polymorphic region of the ER gene is amplified by
      the polymerase chain reaction, then the amplified DNA is hybridized with
      radiolabeled oligonucleotide probes complementary to the wild type and variant ER
      alleles. This method allowed us to determine the ER B genotype of women with ER+
      and ER- tumors, starting with minute amounts of DNA from frozen or paraffin
      embedded tissues. ER B genotyping was also performed on women without breast
      cancer using DNA extracted from blood cells. The combined results from analyses
      of RNA and DNA from 300 breast cancer patients showed that 12% were
      heterozygotes. In the ER+ group (n = 183), 11.5% carried the variant gene
      compared to 12.8% in the ER-negative group (n = 117) (chi 2 = 0.11; df = 1; p
      greater than 0.25).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756271
TI  - A randomized trial of chemotherapy (L-PAM vs CMF) and irradiation for node
      positive breast cancer. Eleven year follow-up of a Piedmont Oncology Association
      trial.
AB  - 158 evaluable patients with stage II, lymph node positive, carcinoma of the
      breast were randomized to adjuvant therapy with either melphalan (L-PAM) or
      cyclophosphamide, methotrexate, and fluorouracil (CMF) after mastectomy. In
      addition, patients were randomized to be treated with or without post-operative
      irradiation therapy (RT) in addition to their chemotherapy. At a median follow-up
      time of 11 years, there is no difference in time to relapse (P = 0.69) or
      survival (P = 0.55) among the four treatment groups. Multivariate analysis
      including treatment arm, age, race, tumor size, histologic type, performance
      status, time to onset of treatment, menopausal status, and number of positive
      nodes, revealed that only the number of positive nodes (less than 4 vs greater
      than or equal to 4) was related to disease-free and overall survival. Ten year
      relapse-free survival for patients with less than 4 positive nodes compared to
      those with greater than or equal to 4 positive nodes was 63% versus 30%, and
      overall survival 63% versus 41%, respectively. Patients who received post
      operative radiation therapy had significantly less local recurrence than those
      treated with chemotherapy alone (P = 0.03) but without improvement in relapse
      free or overall survival. In this trial, post-operative radiation therapy when
      added to chemotherapy decreased the risk of local recurrence without adverse
      effects on survival. Treatment outcome was not influenced by chemotherapy
      regimen, but differences may have been obscured by the small sample size.

PMID- 1756272
TI  - Prognostic value of total cathepsin D in breast tumors. A possible role in
      selection of chemoresistant patients.
AB  - Evaluation of prognostic factors for breast cancers is important for therapeutic
      decisions both at the time of surgery and during postoperative surveillance. In
      1979, H. Rochefort described an induced protein with a molecular weight of 52,000
      Daltons identified as procathepsin D. Total cathepsin D (TCD) (52K + 48K + 34K),
      expressed in pmol/mg protein, can be measured by an immunoradiometric method
      commercialized by Cis-Biointernational. Total cathepsin D was assayed in 413
      breast cancer tumors from patients who underwent surgery between January 1, 1978,
      and December 31, 1985. Using a cut-off of 35 pmol/mg protein, patients with an
      elevated level had a significantly poorer survival than those with a low level (p
      = 0.03). This difference was not found for node-negative patients but was very
      significant for node-positive patients (p less than 0.008). The survival of node
      positive patients with a low total cathepsin level was not statistically
      different from that of node-negative patients. Analysis of the N+ subgroup of
      patients who did not receive adjuvant chemotherapy revealed that TCD no longer
      had any prognostic value, whereas it was still important for the N+ subgroup who
      received an adjuvant treatment. Cox multivariate analysis of prognostic value for
      survival placed total cathepsin D in third position, after nodal invasion and
      progesterone receptor status, for the entire population, and in first position
      before progesterone receptor status for the node-positive population. The
      association of a low cathepsin level and positive progesterone receptors
      characterized the subgroup of patients with the longest survival. TCD levels
      played the same role for prediction of the outcome of metastasis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1756273
TI  - Progestin treatment depresses estrogen receptor but not cathepsin D levels in
      needle aspirates of benign breast disease.
AB  - We studied the effect of a progestin (lynestrenol) on estrogen receptors (ER) and
      cathepsin D (cath-D) levels immunochemically in successive fine needle aspirates
      of benign breast disease. Fibrocystic disease was the main pathology (43 out of
      47 patients). Thirty-one patients were treated with 10 mg of lynestrenol daily
      from the fifth to the twenty-fifth day of the menstrual cycle for 1 to 3 months.
      Sixteen untreated patients were used as controls. Lynestrenol significantly
      decreased the percentage of ER stained cells. This is in agreement with the
      antiestrogenic effect of progestin and, for the first time, indicates that in
      vivo progestin may decrease the stimulatory effect of estrogens on mammary cells
      by decreasing their estrogen receptor content. No effect of progestin on cath-D
      level was found throughout the whole population. However, this level varied more
      between aspirates of each patient in the treated group than in the control group,
      suggesting heterogeneity in patient responses to progestin. Since cath-D may have
      a role in carcinogenesis, clinical follow-up of these patients and more detailed
      studies are required to determine whether this progestin-challenge test has any
      value for detecting high risk mastopathies and for predicting effectiveness of
      treatment.

PMID- 1756274
TI  - International Meeting on Functional Diseases of the Large Bowel. Ischia, April 29
      30, 1990.

PMID- 1756275
TI  - Constipation: physiopathology and classification.
AB  - Constipation is commonly defined on the basis of the number of bowel movements in
      a week (greater than 3 week) or on the stool weight (less than 35 g/day) and on
      their consistency and expulsion capacity. A pathophysiological classification of
      constipation subdivides the patients into 2 groups. The first includes those
      patients in which a propulsion defect is prevalent (inertia coli) and the second
      one comprehends those in which a predominant expulsion defect is found. This
      second group consists of patients with myogenic, neurogenic or mechanical
      disorders. Moreover, we can consider in this group those patients with irritable
      bowel syndrome (IBS) who show a reduction of rectal compliance and those who
      produce "inappropriate stools". Finally, in this group we can find those patients
      having the so-called faecal impaction, that is an abnormality of either
      sensitivity or stimulus to defecate frequently observed in the elderly and in
      children.

PMID- 1756276
TI  - Prolonged manometric investigation of the colon in research on chronic
      constipation.
AB  - We studied the whole colonic motility for 24 hours in controls and in constipated
      patients. In the patient group we found a significant reduction in the colonic
      mass movements (6.1 +/- 0.9 vs 2.6 +/- 0.7 controls vs patients, respectively).
      The constipated patients showed a reduction of the colonic motor activity after
      the ingestion of a standard meal. Moreover, they showed, compared with controls,
      a significant reduction of postprandial mass movements. On the other hand we were
      not able to find the so-called rectal motor complex described by others. In
      conclusion, we believe that prolonged colonic manometry would become an important
      step when evaluating the pathophysiology of constipated patients, particularly of
      those not responding to standard treatment.

PMID- 1756277
TI  - Alteration of recto-anal motility in chronic idiopathic constipation.
AB  - We studied anorectal function in 10 controls and 13 constipated patients (chronic
      idiopathic constipation, outlet obstruction and inertia coli). We did not find
      any difference among the 3 groups as regards the internal anal sphincter (IAS)
      basal tone, the recto-anal inhibitory reflex (RAIR) and the maximal voluntary
      contraction, whereas some significant differences were observed in the
      sensitivity threshold. In fact, we observed that all patient groups required
      larger volumes in order to perceive the minimum sensation. Moreover, the patients
      with distal obstruction showed higher threshold for a permanent defecation
      stimulus. The reduction of rectal sensitivity in these patients was confirmed by
      the infusion of 1500 cc of saline solution. On the basis of our experience
      constipated patients are characterized by both normal IAS tone, RAIR appearance,
      squeezing capacity, and lower rectal sensitivity.

PMID- 1756278
TI  - The physiology of colonic motor activity.

PMID- 1756279
TI  - Functional radiology of the ano-rectal region.
AB  - Chronic constipation is probably the most common symptom resulting in a referral
      of patients for a dynamic radiologic investigation of the GI tract. The primary
      usefulness of defecography in chronic constipation is to provide details about
      the dynamic phenomenon of evacuation which cannot be elicited by any other
      medical technique. It is employed to demonstrate or rule out the presence of an
      anatomical deformity (prolapse, rectocele, intussusception) and/or a localized
      dysfunction (outlet obstruction, rectal inertia) of the distal GI tract.
      Defecography can distinguish between a grossly obstructed pattern and an overtly
      normal one, but a definitive diagnosis is made by manometry and electromyographic
      studies. On the other hand, it should be noted that a failure to show
      abnormalities by defecography does not necessarily imply a normal anorectal
      function. A better understanding of anorectal physiology is expected in the
      future from combined video-pressure studies, which will provide the exact timing
      between the pressure drop and barium passage through the distal colon.

PMID- 1756280
TI  - Pathogenesis of irritable bowel syndrome.
AB  - Irritable bowel syndrome (IBS) is defined as chronic-recurrent abdominal pain in
      absence of organic lesions. The crucial pathogenetic point is to establish
      whether pain is related to enhanced sensitivity of the patient or to an abnormal
      peripheral stimulus originating from the bowel. We can subdivide the patients
      with abdominal pain into two main groups: the first comprehends those patients
      with an abnormal response to a normal stimulus (i.e. an enhanced motor response
      to a meal) (irritable bowel syndrome) and second those patients who have a normal
      response to an abnormal stimulus (i.e. alimentary factors, laxatives, bile acids)
      (irritated bowel syndrome). On the basis of our knowledge we can say that the
      pathogenesis of IBS is complex and not yet completely defined. The crucial point
      is represented by our capability to discriminate between the "irritable" and
      "irritated" colon.

PMID- 1756281
TI  - Is the irritable bowel really irritable?
AB  - We studied 5 healthy volunteers and 9 patients with irritable bowel syndrome
      (IBS) during infusion of the colon with saline solution, bile acids, fatty acids
      and balloon distension. Our results show that the pain threshold was
      significantly (p less than 0.001) higher in controls than in IBS patients. Bile
      acids and fatty acids brought on the habitual pain in 5/7 and 7/8 patients
      respectively, while they did not have any effect in the control group. On the
      basis of our data we can conclude that the IBS patients are more sensitive to
      colonic distension and perfusions, thus suggesting a non-specific irritability of
      the colon which could be a characteristic of these patients.

PMID- 1756282
TI  - The irritable bowel syndrome: diagnostic strategies.
AB  - The irritable bowel syndrome (IBS) is characterized by abdominal pain, abdominal
      distension and altered bowel habits. The diagnosis is usually made by excluding
      other diseases. The diagnosis of IBS must be based on a) medical history (i.e.
      symptoms, bowel habits, normal physical examination, absence of intestinal
      infections or parasites) b) physiopathological evaluation (hyperactivity of the
      distal colon, hypersensitivity to stimuli, stress), and c) physiological
      evaluation of the patient. The diagnosis of IBS can be supposed in patients with
      typical symptoms in the absence of other diseases that were excluded by
      complementary examinations.

PMID- 1756283
TI  - Colonic sensitive-motor alterations in the irritable bowel syndrome.
AB  - The pathogenetic factors involved in the genesis of the irritable bowel syndrome
      (IBS) has not been fully explained yet. The abnormalities observed in these
      patients are a hypersensitivity to distension and an amplification of painful
      sensations. The motor activity of sigmoid colon shows an increased motility index
      in IBS patients with constipation and a low motility index in those with
      diarrhea. An hypercaloric meal induces a hypermotility in these patients. In our
      experience rectal distension evokes abdominal pain in 78% of cases at volumes of
      100ml (less than than controls and constipated patients). The perfusion of rectum
      induces continuous abdominal pain in 89% of IBS patients. We can say that the
      motility of the whole colon over prolonged periods of time may represent an
      important progress in understanding the motor function in these patients.

PMID- 1756284
TI  - Epidemiological and sociological impact of colonic functional disorders.

PMID- 1756285
TI  - Clinical and functional evaluation of the efficacy of otilonium bromide: a
      multicenter study in Italy.
AB  - Seventy-two patients complaining of abdominal pain were studied in a double blind
      trial with otilonium bromide (OB) (40 mg tid or placebo). In our patients we
      performed, before and after the treatment, a clinical evaluation (symptom
      variations) and functional studies (sigmoid manometry during bowel distension).
      As regards clinical parameters, otilonium bromide significantly reduced abdominal
      pain and bloating and significantly increased (p less than 0.02) the pain
      threshold. However the comparison with the placebo group did not show any
      difference between the two groups. Sigmoid motility during distension was
      significantly reduced (p less than 0.05) in OB group, whereas it did not change
      in the placebo group. We can conclude that, in irritable bowel syndrome (IBS)
      patients, OB is able to improve symptoms and to reduce stimulated motor activity
      of the sigmoid.

PMID- 1756286
TI  - A comparison of the action of otilonium bromide and pinaverium bromide: study
      conducted under clinical control.
AB  - We studied 40 patients with irritable bowel syndrome (IBS) which received in a
      simple-blind fashion otilonium and pinaverium bromide (15 days each drug). During
      each 15-day period we evaluated: number of pain episodes, intensity of pain,
      number of bowel movements, side effects. Otilonium bromide, (OB), compared with
      pinaverium bromide was able to significantly (p less than 0.05) reduce the number
      of pain attacks, whereas no significant differences were found between the 2
      groups as regards the other parameters. The occurrence of side effects was
      similar in the two treatment courses. We can conclude that the two types of
      treatment were similarly useful in IBS, although OB seems more effective than
      pinaverium bromide.

PMID- 1756287
TI  - Mass spectrometry in the study of advanced glycation processes, responsible for
      long-term diabetes complications.
AB  - Mass spectrometry has been usefully employed in the study of the products arising
      from in vitro and in vivo glycation of proteins. In particular, daughter-ion
      spectroscopy has led to an easy detection of 2-(2-furoyl)4-(5)2(furanyl)1-H
      imidazole in HCl-hydrolysed glycated albumen and polylysine and the method has
      allowed us to exclude the presence of the same molecule in in vivo glycated
      proteins. Parent-ion spectroscopy has been successfully employed in the
      identification of furoyl-containing compounds, which are possibly responsible for
      the results obtained with other analytical approaches.

PMID- 1756288
TI  - Structure determination of the antibiotic desertomycin B by fast-atom bombardment
      mass spectrometric techniques.

PMID- 1756289
TI  - Direct molecular weight determination of resin-bound oligopeptides using 252Cf
      plasma-desorption mass spectrometry.
AB  - Plasma-desorption mass spectrometry is proved to be capable of the direct
      molecular weight determination of totally protected resin-bound oligopeptides.
      The molecular weight measured is the molecular weight of the fully protected
      oligopeptide including the molecular weight of the linker, which connects the
      oligopeptide and the polystyrene resin. This method makes it possible to check
      the success of (a step in) the synthesis of a peptide before its deprotection or
      cleaving from the resin. This can make it a strong tool in the analysis of resin
      bound oligopeptides.

PMID- 1756290
TI  - Mycobacterium tuberculosis transmission in a health clinic.
AB  - Between January 1 and June 30, 1988, 30 (39.5%) of 76 staff members tested at a
      health clinic in Florida had positive tuberculin skin test reactions. This case
      control study showed that people whose skin test converted were more likely than
      those whose skin test did not convert to have been present while patients were
      being treated with aerosolized pentamidine (odds ratio = 15.0; 95% confidence
      interval = 1.4 - 730.0) and to have worked on the first floor of the clinic (odds
      ratio = 9.3; 95% confidence interval = 1.1 - 420). The clinic building was poorly
      ventilated, and aerosolized pentamidine treatments were given in a room from
      which the air tended to flow into the hallway. Aerosolized pentamidine should be
      administered in a well-ventilated area from which the air is exhausted directly
      outside. All persons who are given such treatments should first be screened for
      tuberculosis. Use of trade names is for identification only and does not
      constitute endorsement by the Public Health Services or the U.S. Department of
      Health and Human Services.

PMID- 1756291
TI  - Nosocomial tuberculosis in the AIDS era: strategies for interrupting transmission
      in developed countries.
AB  - In developed countries where tuberculosis is increasing in association with HIV
      infection, nosocomial transmission among patients and from patients to health
      care workers is being increasingly reported. Nosocomial tuberculosis among HIV
      infected patients is difficult to prevent by conventional control measures
      because the clinical presentation of the disease may be atypical and confused
      with other respiratory infections, because the tuberculin skin test is less
      reliable, because cough generating procedures may increase the probability of
      transmission, because HIV-infected patients may progress rapidly from infection
      to disease, and because the organisms are increasingly drug resistant, making
      preventive therapy difficult. Substandard ventilation and the recirculation of
      air in many contemporary buildings has also been implicated in widespread
      nosocomial transmission. Source control through isolation and effective treatment
      of known or suspected cases remains the most effective strategy for preventing
      transmission. Dilution of infectious droplet nuclei through ventilation with
      outside air is important, but incompletely protective. Like ventilation with
      outside air, filtration of recirculated air may reduce the chance of infection by
      dilution, but it is expensive. Traditional surgical masks offer the wearer little
      or no protection. Finally, ultraviolet air disinfection may augment ventilation
      by inactivating organisms in the upper room air, or in ventilation ducts.

PMID- 1756292
TI  - Chronic airways obstruction leading to chronic hypoxemic respiratory failure: an
      estimate of the size and trend of the problem in Canada.
AB  - Chronic airways obstruction is a common cause of morbidity and mortality in
      Canada. It may progress to hypoxic respiratory failure and then to death. Only a
      few studies of the prevalence of chronic airways obstruction have been reported
      from Canada, but a number of studies have been reported from the United States
      and the United Kingdom, countries with similar socioeconomic conditions and
      ethnic compositions to those in Canada. The prevalence of chronic airflow
      limitation in these studies averages 9.3%. In each study, tobacco smoke exposure
      is the most prominent etiologic agent. Other contributing factors identified in
      the studies are air pollution, occupational exposure, respiratory infections and
      childhood respiratory illness. Endogenous modifiers of these risk factors
      demonstrated in the published studies include age, elevated peripheral blood
      leukocyte count and familial factors. Although epidemiologic studies have been
      able to identify the prevalence of functional impairment associated with chronic
      airways obstruction, risk factors associated with its development and modifiers
      of these risk factors, it is not possible to determine the prevalence of severe
      chronic airways obstruction resulting in hypoxemic respiratory failure. An
      estimate of this prevalence has been calculated based on certain assumptions. It
      was assumed that patients dying of chronic airways obstruction were likely, in a
      high proportion of cases, to have hypoxemic respiratory failure. It has been
      demonstrated that only one-half of all patients dying of chronic airways
      obstruction are correctly designated on death certificates. It was assumed,
      conservatively, that the median survival of patients with hypoxemic respiratory
      failure is two years. From these assumptions, it was estimated that the
      prevalence of hypoxemic respiratory failure in 1986 in Canada was 100 per 100,000
      population. This is higher than the present rate of oxygen therapy, indicating
      that some patients currently eligible for this treatment may not be receiving it.

PMID- 1756293
TI  - Three decades of tuberculosis in Singapore.
AB  - Tuberculosis (TB) mortality for the period 1955-1959 to 1985-1989 declined 87%
      from 72 to 9 per 100,000 in males, and 90% from 31 to 3 per 100,000 in females.
      The mean annual rate of decline of mortality was 6.8%. Older persons had a lower
      4.2-5.2% decline annually compared to 14.1-16.0% in the 0-4 year age group. The
      incidence of TB declined 80% from 438 to 88 per 100,000 in males, and 71% from
      152 to 43 per 100,000 in females over the period 1960-64 to 1985-89. The mean
      annual rate of decline in incidence was 5.9%. The lowest decline was observed in
      the children below 15 years (2.8-3.2%) and elderly persons 65 years and above
      (2.3-5.5%). Birth cohorts of 1945-49 and earlier had progressively higher
      mortality risks, but declining morbidity risks as they advanced with age.
      Singapore has overcome the early phase of the TB epidemic as evidenced by its
      relatively low rates among children and females and the low rates of extra
      pulmonary TB and meningitis. The high incidence rates in old people are the
      residue of even higher rates experienced by this cohort of persons who
      experienced higher risks of infection in their early lives. At the prevailing
      rates of decline under the present conditions and control measures, TB will not
      be eliminated in Singapore over the next 50 years.

PMID- 1756294
TI  - Regulation of the human cellular immune response to Mycobacterium tuberculosis.
      The mechanism of selective depression of the response to PPD.
AB  - After infection with M. tuberculosis, about 5% of individuals develop progressive
      tuberculosis during the following two years and an additional 5% delayed
      reactivation. The genetic and acquired factors which place individuals at risk of
      tuberculosis are partly defined; however, the connection of the susceptibility to
      the host immune response is much less clear. Recent studies have examined the
      basis for the immunosuppression that is a concomitant of tuberculosis. Direct
      stimulation of monocytes primed during the course of tuberculous infection by
      mycobacterial peptides appears to be responsible for suppression of PPD-induced
      responses. Increased expression and release of interleukin-2 receptors and
      transforming growth-factor beta are associated with and may contribute to such
      suppression by monocytes. Additional studies have addressed the generation of
      immunity or immunosuppression. Ingestion of live M. tuberculosis by monocytes
      leads to selective expansion of gamma-delta T cells as opposed to CD4
      lymphocytes. This may be relevant to the innate response to infection with M.
      tuberculosis as well as immunoregulatory circuits. Increased understanding of the
      basis for immunosuppression is of intrinsic interest as regards regulation of
      specific pathways of immune reactivity in an infectious disease of humans and may
      provide some insight into factors predisposing to tuberculosis.

PMID- 1756295
TI  - Bulletin of the International Union Against Tuberculosis and Lung Disease.
      Introduction.

PMID- 1756296
TI  - Worldwide trends in asthma morbidity and mortality.

PMID- 1756297
TI  - Worldwide trends in asthma morbidity and mortality. Explanation of trends.
AB  - The aim of this paper is to outline, in the light of present understanding of the
      disease, some of the likely causes for the increasing prevalence and mortality
      associated with asthma in different communities in the world. It seems important
      both to understand the causes of asthma and to taking action to reverse the
      trends. There is an increasing sense of urgency in addressing the problems of
      morbidity and mortality caused by asthma. In this regard the respiratory
      community is a long way behind the cardiovascular community who have been
      documenting the risk factors for vascular disease for many years. In the absence
      of a reliable definition of asthma, it is difficult to make definite statements
      about trends in its prevalence, morbidity and mortality. Nevertheless, as already
      summarised, asthma appears to be an increasing problem. the trend towards
      increasing deaths in some countries is particularly worrying. The mortality data
      are most accurate for the 5 to 34 year olds and this paper is confined to
      reviewing data from this age group.

PMID- 1756298
TI  - Prevalence of asthma in a region of Algeria.
AB  - In 1984-85 an epidemiological survey on asthma was carried out on a
      representative population sample in the "Daira de Cheraga" region in Algeria. It
      had two objectives: to estimate the prevalence of asthma and to describe its
      epidemiological pattern. The study was divided into two parts: the first was a
      household survey based on a questionnaire and the second, another interview at
      hospital, with clinical examination and pulmonary function tests with
      pharmacodynamic tests. The cumulative prevalence of respiratory symptoms was
      2.38%. The cumulative prevalence of asthma was 1.34% and the annual prevalence
      1.21%. Asthma was more prevalent in boys than girls aged under 20 years (sex
      ratio = 2.66) with an equal proportion after age 20 years. Asthma most often
      occurred in childhood in males and at an adult age in females. In 40% of cases
      there were family antecedents of asthma. It is impossible to extrapolate these
      results to the entire country and the existence of regional disparities pleads in
      favour of further research in this field.

PMID- 1756299
TI  - Determinants of airborne infection.

PMID- 1756300
TI  - High dose-short duration ribavirin aerosol treatment--a review.
AB  - A high-dose, short-duration treatment with ribavirin aerosol consisting of a
      three-fold increase in concentration of drug (60 mg versus 20 mg of ribavirin per
      mL in the liquid reservoir of the generator administered for about one-third the
      time of the standard treatment) was as effective as the standard dosage in the
      treatment of experimental influenza A and B infections in mice and in the
      treatment of experimental respiratory syncytial virus infection in cotton rats.
      Despite some minor pulmonary intolerance, it was considered to be suitable for
      use in treatment of patients with severe chronic pulmonary disease, and it was
      well-tolerated and apparently effective in the treatment (by face mask and
      endotracheal tube) of infants with bronchiolitis principally caused by
      respiratory syncytial virus infection. Pharmacokinetic studies in mice revealed
      very high concentrations of drug in the lungs, about triple the level with the
      standard dose, with similar blood and brain concentrations. Ribavirin
      concentrations were similarly high in respiratory secretions of infants given the
      triple dose.

PMID- 1756301
TI  - Some applications of cryosubstitution in ultrastructural studies of the cell
      nucleus.
AB  - Cryofixation followed by cryosubstitution, without the use of any chemical
      fixatives, was carried out on cultured mouse P815 cells. The principal aim of our
      work, which was to show that these techniques provide excellent morphological
      preservation of cellular and in particular nuclear components, was demonstrated.
      All nuclear structural components, nucleolar or nucleoplasmic, were clearly
      revealed using this technology. The cells were cryofixed by impact freezing onto
      a copper mirror cooled with liquid nitrogen or helium, cryosubstituted in acetone
      and embedded in either Lowicryl K11M or 1R White acrylic resin. Ultrathin
      sections were contrasted using either the usual uranyl acetate-lead citrate
      double staining, a differential staining for nuclear nucleoprotein structures, or
      the silver staining revealing nucleolar organizer regions. In view of the absence
      of conventional fixatives, the specimens prepared in this way would offer to be
      material of choice for ultrastructural identification of intra-nuclear antigens,
      especially those sensitive to conventional fixatives such as, for example,
      aldehydes. Advantages and differences of these techniques with regard to more
      conventional electron microscopic procedures are discussed.

PMID- 1756302
TI  - Cytochemical distinction of various nucleolar components in insect cells.
AB  - The fine structure of the insect Sf9 cell nucleolus has been investigated by
      means of different cytochemical and immunocytochemical techniques at the electron
      microscope level. Apart from a few perinucleolar condensed chromatin clumps, the
      insect cell nucleolus comprises two compartments. The first of these consists of
      a roundish compact zone formed of fibrillar material. The other is composed of
      fibrillar and granular structures organized into a network separated by
      interstitial spaces. But, unlike mammalian cell nucleoli, any fibrillar center
      has been observed in the Sf9 cell nucleolus, even after actinomycin D treatment.
      We also show that the compact fibrillar zone of Sf9 cell nucleoli contains silver
      stainable material and DNA. In actinomycin D-treated cells, a preferential
      contact of this compact fibrillar zone with condensed chromatin has been
      visualized. Finally, silver-stainable material has been found to persist
      throughout the whole mitosis. These results suggest that the compact fibrillar
      zone at the insect Sf9 cell nucleolus should, at least partly, correspond to the
      fibrillar center of mammalian cell nucleoli.

PMID- 1756303
TI  - Structure of the basement membrane of corneal epithelium: quick-freeze, deep-etch
      comparative study of networks deposited in culture and during development.
AB  - The basement membranes elaborated by corneal epithelium in the chick embryo and
      in culture conditions have been studied by quick-freezing and deep-etching
      methods. Electron microscope observations of en face unidirectional platinum
      shadow castings revealed a polygonal network comparable to the type IV collagen
      network described in human amniotic basement membrane and EHS mouse tumor matrix.
      The material deposited in culture contained type type IV collagen, as
      demonstrated by immunofluorescence labeling using anti-type IV collagen
      antibodies and formed delicate networks. Fine filaments and granules composing
      this network were interpreted respectively as linear and globular NC1 domains of
      the type IV collagen molecule. These loose networks were considered as first
      steps in basement membrane assembly. Staggered superimposition of comparable
      networks could lead to the dense network organization as observed for basement
      membranes in situ. These observations showed that the basement membrane of the
      chick embryo corneal epithelium is also organized in a complex polygonal
      framework that is preserved even when secreted in culture conditions.

PMID- 1756304
TI  - Fibrillar pattern of self-assembled and cell-assembled collagen: resemblance and
      analogy.
AB  - The geometrical characteristics of fibrillar organizations are studied by
      electron microscopy in structures obtained in vitro in cell-free assembled
      collagen gels, and in vivo in dermal tracts of anuran skin. We analyze several
      characteristics of the fibrils including the diameter, the outline, the curvature
      and the extrafibrillar space. We analyze also the variation of fibrillar
      orientation (twist) in longitudinal and transverse thin sections of these
      structures. The results are compared in the Discussion to determine to what
      extent these fibrillar patterns are similar to liquid crystalline organizations
      and to what extent they result from a self-assembly or a cell-assembly process.

PMID- 1756305
TI  - Genetic analysis of the cellularization of the Drosophila embryo.
AB  - The synchronous cellularization of the Drosophila embryo at the blastoderm stage
      provides a unique system for studying the molecular mechanisms involved in
      cytokinesis, using genetical and biochemical approaches. The cellularization
      process requires the major components of the embryonic cytoskeleton that are
      deposited into the egg during oogenesis. Genetical analysis indicates that it
      requires also the products of additional maternally-acting genes, as well as that
      of a limited set of zygotically-acting genes. The cellularization defective
      phenotypes associated with small deficiencies uncovering these latter loci reveal
      specific steps within this complex process. The molecular analysis of these genes
      will ultimately provide meaningful insights into the normal process of
      cellularization. Among them, the serendipity alpha gene encodes a membrane
      associated protein, which is exclusively accumulated during cellularization, and
      is required for the reorganization of the microfilaments as the onset of
      cellularization.

PMID- 1756306
TI  - Three-dimensional imaging of the mucus secretory process in the cryofixed frog
      respiratory epithelium.
AB  - Using the frog palate as a representative model of human mucociliary epithelium,
      we analyzed, after quick freezing fixation, the three-dimensional (3-D)
      respiratory mucus secretory release with high voltage (200-300 kV) transmission
      electron microscopy (TEM). The 3-D vision of the mucus release from the secretory
      cells was obtained as stereo-pairs and "bas-relief" images after analysis of
      stereo-pairs using an image analyzer. After standard glutaraldehyde fixation, the
      secretory cells showed a typical goblet shape with secretory granules
      heterogeneous in size and electron-density which often fuse together. On the
      other hand, quick-frozen secretory cells exhibited a columnar shape and their
      membrane-bound secretory granules contained a homogeneously dark matrix. The
      expanded gel mucus layer was preserved and its depth never exceeded 2 microns.
      When the epithelium was immersed in culture medium in presence of cholinergic
      agonist, a marked discharge of mucus was observed and the granules swelled at the
      apex of the secretory cell before being discharged in the lumen. In native
      cryofixed epithelium, the secretory granules exhibited a marked deformability
      during the process of their extrusion from the secretory cell. Clusters of
      secretory granules surrounded by cytoplasmic material were observed in the
      extracellular lumen, suggesting an apocrine-type secretion. These observations
      indicate that rapid cryofixation and 3-D stereoscopic imaging enable a unique
      opportunity to analyze, without artifact, the mucous secretory process. We
      speculate that, apart from the classical merocrine-type secretion mechanism, the
      respiratory mucus may be released, at least partly by an apocrine-type secretion.

PMID- 1756307
TI  - (3-Cryo) methods (cryofixation, cryosubstitution and cryoembedding) for
      processing of tissues for ultrastructural and immunocytochemical studies.
      Application to oviduct cells of laying quail.
AB  - Cryomethods occupy a privileged position among the procedures used for the
      preparation of biological samples for the various studies that may be performed
      in electron microscopy (ultrastructural, immunocytochemical and microanalysis in
      situ). In general, cryomethods are specific to one, or a maximum of 2 types of
      application. The (3-Cryo) methods (cryofixation, cryosubstitution without
      fixatives and cryoembedding in the new Lowicryl resins (K11M or HM23) are a set
      of methods for correlating new structural information with analytical and
      biochemical data. However, these 3-Cryomethods are delicate, complicated and
      expensive. To demonstrate that they can be performed, at least in part, with home
      made systems at a reasonable cost, we have carried out a structural and
      immunocytochemical study on the oviduct of the laying quail. We studied the
      localization of 2 proteins, one cytoplasmic (ovalbumin) and the other nucleolar
      (B-36). The results provided by the 3-Cryomethods are compared with those
      obtained with other immunocytochemical methods, including tissue processed by
      conventional chemical fixation and high or low temperature embedding, or by 2
      Cryomethods (cryofixation and cryosubstitution).

PMID- 1756308
TI  - Assembly of nuclear pore complexes in Xenopus egg extract.

PMID- 1756309
TI  - Determination of ciliary polarity precedes differentiation in the epithelial
      cells of quail oviduct.
AB  - In quail oviduct epithelium, as in all metazoan and protozoan ciliated cells,
      cilia beat in a coordinated cycle. They are arranged in a polarized pattern
      oriented according to the anteroposterior axis of the oviduct and are most likely
      responsible for transport of the ovum and egg white proteins from the
      infundibulum toward the uterus. Orientation of ciliary beating is related to that
      of the basal bodies, indicated by the location of the lateral basal foot, which
      points in the direction of the active stroke of ciliary beating. This arrangement
      of the ciliary cortex occurs as the ultimate step in ciliogenesis and following
      the oviduct development. Cilia first develop in a random orientation and reorient
      later, simultaneously with the development of the cortical cytoskeleton. In order
      to know when the final orientation of basal bodies and cilia is determined in the
      course of oviduct development, microsurgical reversal of a segment of the
      immature oviduct was performed. Then, after hormone-induced development and
      ciliogenesis, ciliary orientation was examined in the inverted segment and in
      normal parts of the ciliated epithelium. In the inverted segment, orientation was
      reversed, as shown by a video recording of the direction of effective flow
      produced by beating cilia, by the three-dimensional bending forms of cilia
      immobilized during the beating cycle and screened by scanning electron
      microscopy, and by the position of basal body appendages as seen in thin sections
      by transmission electron microscopy. These results demonstrate that basal body
      and ciliary orientation are irreversibly determined prior to development by an
      endogenous signal present early in the cells of the immature oviduct, transmitted
      to daughter cells during the proliferative phase and expressed at the end of
      ciliogenesis.

PMID- 1756310
TI  - Centriole and basal body formation during ciliogenesis revisited.
AB  - This review is concerned with the formation during ciliogenesis of centrioles and
      basal bodies, primarily in epithelial multi-ciliated cells from the developing
      vertebrate respiratory and reproductive tracts. During ciliated cell
      differentiation, in these as well as in other cell types, cilium formation is
      preceded by the formation of centrioles assembled from precursor structures
      having little resemblance to the mature organelle. The origin, composition and
      function of the centriole precursor structures in generating large numbers of
      centrioles in a short period of time during ciliogenesis is discussed. This
      review also focuses on the biochemistry of centrioles and basal bodies and on
      recent experimental evidence that DNA might be associated with these structures.

PMID- 1756311
TI  - Expression of the nuclear protein mitotin in differentiating in vitro HL 60
      cells.
AB  - Mitotin is a 125 kDa/pI 6.5 nuclear protein specific for proliferating cells and
      markedly increased prior to and during mitosis. This study presents evidence for
      the expression of this protein during dimethylsulfoxide (DMSO) induced
      differentiation of human promyelocytic leukemia HL 60 cells. The expression had
      been followed at two levels: as antigen, using a specific antimitotin monoclonal
      antibody and as mRNA, using a specific cDNA probe. The results from the
      immunofluorescent study show a gradual disappearance of mitotin in
      differentiating HL 60 cells starting from the fourth day after DMSO induction. On
      the other hand, the changes in the expression of mitotin mRNA were much more
      dramatic. This mRNA is expressed at a high level during the first three days of
      differentiation but shows a striking decrease after the fourth day. This
      correlates with the rapid changes in the number of blast cells in the
      differentiating HL 60 cell population. Therefore, the expression of mitotin mRNA
      can serve as a marker for the changes accompanying the termination of cell
      proliferation in differentiating cells.

PMID- 1756312
TI  - De novo formation of centrioles in parthenogenetically activated, diploidized
      rabbit embryos.
AB  - In rabbit oocytes activated parthenogenetically by repetitive electric pulses,
      centrioles develop de novo in blastocysts. Centrioles were not observed in
      earlier stages of development, not until the blastocoele is formed. Up to the
      morula stage (between 8-32 cells), a filamentous, electron-dense material
      develops and aggregates with a small vesicle fraction within the well developed
      Golgi apparatus. A spherical to ovoid electron dense mass forms, which is
      comparable to the deuterosome or to the blepharoplast. The quantity of the
      electron dense material enlarges and it seems to give rise to the centriole
      "generating complex". Centrioles arise in all three differentiated cell types of
      the blastocysts, the mural and polar trophoblasts and the embryonal cell mass at
      the same time. Some of the forming centrioles in parthenotes have a co-linear
      arrangement, as in control blastocysts. It is not yet known whether the co
      linearly arranged centrioles represent a maturation phase, prior to the formation
      of the usual diplosome, with centrioles oriented perpendicularly to each other.
      Nor is it known whether the forming centrioles are functioning as the polar
      organizer of the mitotic spindle or if they can perform any other centriolar
      function.

PMID- 1756313
TI  - Ultrastructural changes in the shape of neurons and related structures in frog
      sympathetic ganglia after axotomy.
AB  - Changes in the shape of neuronal perikarya and other ganglionic structures were
      observed by electron microscopy in the frog sympathetic ganglia at different
      times after axotomy. Degenerating and hypertrophic profiles appeared to reflect a
      remodelling process affecting preganglionic fibres. The shape of neuronal
      perikarya was modified by the formation of infoldings occupied by preganglionic
      fibres and/or by that of short winding dendrites often bearing a synapse. The
      origin of these changes is discussed. In frog sympathetic ganglia, the period of
      recovery after axotomy was marked by specific reactions which affected neuronal
      shape and preganglionic fibres, and are not known to occur in the ganglia of
      mammals.

PMID- 1756314
TI  - Subcellular distribution of clathrin in cultured hypothalamic neurons.
AB  - The subcellular distribution of clathrin has been examined in developing
      hypothalamic neurons cultured in a chemically defined medium up to synapse
      formation (12-13 days in vitro) and exposed, or not, to a depolarizing
      concentration of KCl (60 mM for 3 min) followed, or not, by a return to control
      KCl concentration (3 mM KCl for 3 min). Previous studies have shown that such
      treatments induce in synaptic boutons a rapid vesicle depletion followed by
      massive restoration. Using an enzyme immunoassay, we have compared the relative
      proportion of assembled and unassembled pools of clathrin as a function of
      exposure to depolarizing or repolarizing concentrations of KCl. In parallel we
      have localized clathrin at the electron microscopic level using immunoperoxidase.
      Clathrin concentration in culture is lower (0.36 vs 0.75%) and the proportion of
      unassembled clathrin is much higher than in the adult brain (82 vs 14%). These
      proportions were not affected by depolarizing or repolarizing treatments.
      Morphologically clathrin was exclusively detected in two neuron compartments:
      perikarya and synaptic boutons. In perikarya clathrin was localized as a thick
      coat on plasma membrane coated pits and in the Golgi zone on coated buds and
      vesicles, presumably located in a trans compartment. In synaptic boutons clathrin
      immunoreaction was found as an irregular thin rim around synaptic vesicles,
      whatever the polarization state of the cells, but coated vesicles were extremely
      rare. Taken together these findings raise the problem of the functional meaning
      and localization of the large unassembled pool of clathrin in such neurons and
      question its role in vesicular traffic in synaptic boutons.

PMID- 1756315
TI  - Heat shock response of Babesia divergens and identification of the hsp70 as an
      immunodominant early antigen during ox, gerbil and human babesiosis.
AB  - Using antisera (alpha-R and alpha-C7Ag) directed against the conserved Gly-Gly
      Met-Pro-epitope of the hsp70 family, a single antigen was identified in the human
      Babesia divergens Rouen 1987 isolate by Western immunoblotting and
      immunoprecipitation experiments. This B divergens hsp70 is highly conserved as
      shown by the analysis of five other geographical B divergens isolates from
      different hosts (human and bovine). Indirect immunofluorescence assay performed
      on the asexual intraerythrocytic stages showed that the hsp70 is mainly
      cytoplasmic and stage-independent. Heat-shock experiments, with 20 min incubation
      at 40 degrees C followed by a 10 to 50 min shift to 37 degrees C in the presence
      of [35S]-methionine, led to an increase of two hsp of 85 and 70 kDa while protein
      synthesis in general decreased within 10 min. Immunoprecipitations of [35S]
      methionine radiolabelled proteins with human, ox and gerbil antisera raised
      against various B divergens isolates, showed the presence of a B divergens 70 kDa
      protein which was demonstrated to be a hsp70 by coupling immunoblotting assays
      with alpha-C7Ag serum on the same immunoprecipitated material. During human
      babesiosis, the B divergens hsp70 appears as an early antigen during the acute
      phase. These results are in agreement with the use of the B divergens hsp70 as an
      essential valence antigen in an anti-babesiosis vaccine.

PMID- 1756316
TI  - Long-term repeatability of the pure-tone hearing threshold and its relation to
      noise exposure.
AB  - Audiometric repeatability is examined for a population of 356 male and female
      industrial employees (712 ears), sub-divided according to the amount of previous
      noise exposure. Re-tests were carried out after an interval averaging 13 months.
      After a similar interval, 150 of the subjects gave a third audiogram. Fixed
      frequency self-recording audiometry was employed, using common equipment and
      procedures throughout. Results are presented as distributions of the algebraic
      test-re-test differences for each frequency and for the frequency combination 1-2
      3 kHz. Repeatability was best at 1 and 2 kHz and substantially poorer at 6 kHz.
      Cumulative distributions of the signless differences show that more than 50% of
      initial hearing threshold levels repeated to better than 5 dB. For all
      frequencies except 6 kHz the mean values of signless test-re-test differences for
      the various sub-groups were between 3.4 and 5.6 dB; at 6 kHz the values were
      between 5.8 and 7.8 dB. In the case of the three-frequency average, the mean
      differences were reduced to between 2.8 and 3.8 dB. A few repeats (about one in
      200) stand out as clearly anomalous; these occur only in isolation and mainly at
      the higher frequencies. The performance of groups classified by the amount of
      their previous noise exposure did not differ significantly. In the case of those
      tested three times, the repeatability over the second inter-test interval showed
      at most a marginal improvement compared with the first interval.

PMID- 1756317
TI  - Auditory localization under conditions of unilateral fitting of different hearing
      aid systems.
AB  - The spatial localization function of hearing-impaired listeners, usually fitted
      bilaterally with BTE, ITE or ITC devices, was tested under conditions of
      unilateral fitting of each of their own hearing aids, and unilateral fitting of
      stock versions of each of the other types. For the BTE wearers average
      localization accuracy and individual variability were not greatly changed when
      wearing only their left ear device, compared with bilateral aided performance. In
      ITE wearers, unilateral fitting in either ear led to somewhat poorer performance
      than bilateral. In the ITC wearers unilateral fitting produced inconsistent
      outcomes. Both BTE and ITE wearers fared poorly when fitted unilaterally with
      stock forms of devices 'foreign' to them, whereas ITC wearers did not show such a
      contrasting outcome. A group of non-impaired listeners showed severe disruption
      of localization under unilateral BTE and ITC hearing aid conditions, and to a
      lesser extent with ITEs. Results for the hearing-impaired listeners are
      interpreted in terms of adaptation to different usage patterns, with BTE wearers
      suggested as having adapted to their own systems unilaterally as well as
      bilaterally.

PMID- 1756318
TI  - A comparison between the electrically reproduced loudness and the original
      loudness of speech at high levels.
AB  - Four words lists of a German Speech Intelligibility Test (DIN 45621) were
      recorded at 60 and 75 dB SPL. Both recordings were presented to 20 normally
      hearing subjects at 75 dB SPL via free-field equalized earphones. Discrimination
      in noise was significantly better in the original recording at 60 dB SPL. The
      better understanding may be explained by a more favourable consonant-vowel
      intensity ratio. Moreover, a significant increase in fundamental frequency could
      be demonstrated at the higher recording level. The implications for speech
      audiometry and hearing aids are discussed. Furthermore, it was found from
      loudness comparisons that both recordings were equally loud at a level of 75 dB
      SPL. However, significantly increased loudness was indicated in the 75 dB SPL
      recording by the loudness calculation procedure ISO 532 B.

PMID- 1756319
TI  - An evaluation of ABR audiometry for the screening and detection of hearing loss
      in ex-SCBU infants.
AB  - The study aimed to use auditory brainstem response (ABR) audiometry to test ex
      SCBU infants born during 1986 in West Berkshire. Two hundred and forty-three
      babies were tested as out-patients, thus achieving a coverage rate of 86% of the
      target population. Mean post-conceptional age at test was 48 weeks. Whenever
      possible, full ABR threshold determination was performed on both ears and the
      mean ABR threshold was found to be 14 dB nHL. Of those babies attending, 85%
      showed ABRs at less than or equal to 30 dB nHL bilaterally and the remaining 15%
      were referred for further assessment. Approximately two-thirds of these were
      recalled successfully for repeat testing. The estimated prevalence rate for
      bilateral sensorineural hearing impairment was 1.4% with four confirmed cases.
      Two additional permanent unilateral hearing losses were also detected. On the
      basis of recorded ABR data, sensitivity, specificity and positive predictive
      values were estimated for click intensities which could be used for single
      intensity ABR screens. It is concluded that delaying screening until the post
      neonatal stage is a viable alternative to screening neonates prior to discharge
      from the SCBU.

PMID- 1756320
TI  - Isochronic mapping: a preliminary report of a new technique.
AB  - A new technique which we have named 'isochronic mapping' is described. The
      conventional technique of plotting isopotential maps shows little or no contrast
      for far-field potentials such as the auditory brainstem response (ABR). However,
      by modifications to the mapping software, the latency values of a peak can be
      plotted and lines of equal time or isochronic maps can be produced. Data from a
      normal subject has been obtained for both the compound and derived ABRs and are
      described in detail. The data are clear but the time delays between earliest and
      latest projections of a peak are hard to interpret. For monaural click
      stimulation, wave JV of the ABR projects first to the contralateral side of the
      head then moves towards the stimulated ear arriving some 0.3 ms later. Possible
      interpretations of this finding are discussed but further experimentation is
      needed to develop our understanding of these data.

PMID- 1756321
TI  - Influence of total body irradiation on infections after autologous bone marrow
      transplantation.
AB  - Infectious complications were analysed in 50 consecutive autologous bone marrow
      transplant (ABMT) patients treated with high dose etoposide and melphalan, 30 of
      whom also received total body irradiation (TBI). Fever developed in 44 patients
      and bacteremia was documented in 13 (26%). Patients given TBI had increased
      susceptibility to bacteremia; 11 of 30 patients who received TBI had positive
      blood cultures, in contrast to two of the 20 who did not (p = 0.035). In
      addition, patients who received TBI had significantly more severe diarrhea (p =
      0.037) when compared with those who received chemotherapy alone. Thirty-five
      patients treated with trimethoprim-sulfamethoxazole prophylaxis had a
      signficantly lower incidence of gram-negative bacteremia (p = 0.024). However,
      when those patients who received trimethoprim-sulfamethoxazole until neutrophil
      recovery were analysed alone, those who were also given TBI still had
      significantly more bacteremia (p = 0.047). Forty-seven patients with follow-up of
      more than 12 months are available for analysis of varicella zoster (VZV)
      infections. Of the 29 patients who received TBI, 11 (38%) developed VZV
      infections, in contrast to one of 18 patients (6%) treated with chemotherapy
      alone (p = 0.013). These results suggest that addition of TBI to the intensive
      therapy regimen for ABMT is associated with significantly more bacteremia and
      late VZV infections.

PMID- 1756322
TI  - Graft-versus-leukaemia following allogeneic bone marrow transplantation:
      emergence of cytotoxic T lymphocytes reacting to host leukaemia cells.
AB  - Cytotoxic T lymphocyte precursor (CTLp) frequency assays were examined in
      patients with chronic myeloid leukaemia (CML) following bone marrow
      transplantation (BMT) using recipient lymphocytes or CML cells as targets in a
      51Cr release cytotoxicity assay. Eighteen patients were studied; 11 received
      marrow from a fully HLA A, B and DR matched sibling donor, and six from matched
      unrelated donors or a partially matched sibling (one patient). Two of the
      unrelated donor transplant recipients received marrow depleted of T lymphocytes,
      and the remainder received unmanipulated marrow and cyclosporin with or without
      methotrexate as prophylaxis against graft-versus-host disease (GVHD). Donor cells
      tested before BMT did not generate CTL against the patients' leukaemia, but up to
      9 months after BMT a low frequency of CTLp directed against the patients' CML
      cells (Lk-CTLp) was detected in all patients. The Lk-CTLp frequency was
      significantly lower than the frequency of CTLp directed against the recipients'
      PHA transformed pretransplant lymphocytes (Ly-CTLp) (p less than 0.05). Lk-CTLp
      showed MHC restricted cytotoxicity and did not demonstrate cytotoxicity in an NK
      assay. The Lk-CTLp frequency correlated with both GVHD severity and relapse:
      severe GVHD was only seen with Lk-CTLp frequencies greater than 1:400,000, while
      leukaemic relapse was only observed in two patients with Lk-CTLp frequencies less
      than 1:400,000. These results show that a low frequency of alloreactive cells of
      presumed donor origin with cytotoxic potential against residual leukaemia
      normally circulate after BMT. Their relationship with the graft-versus-leukaemia
      phenomenon and their cross-reaction with GVHD reacting cells remain to be
      determined.

PMID- 1756323
TI  - Intravenous interleukin-2 just after high dose BCNU and autologous bone marrow
      transplantation. Report of a multicentric French pilot study.
AB  - This multicentric pilot study was conducted in order to evaluate the feasibility
      of early interleukin-2 (IL2) after high dose chemotherapy requiring autologous
      bone marrow transplantation (ABMT). BCNU at 800 mg/m2 was followed, 3 days later,
      by the reinjection of the bone marrow cells. At day 4, IL2 at 18 x 10(6)
      i.u./m2/day was given as a continuous infusion during a minimum of 6 days (first
      phase of study) or for 6 more days after 1 day break (second phase of the study).
      Twenty patients were included. Toxicity was not negligible, with one toxic death,
      but IL2 therapy does not damage the haematological recovery of most patients.
      However, a 6-day IL2 treatment period only appears tolerable. In 18 evaluable
      patients, three responses were observed: one complete response (CR) of short
      duration in a non-Hodgkin's lymphoma, one CR (24 months +) and one partial
      response (PR) (6 months) in two patients with metastatic gastric adenocarcinoma.
      This study confirms that IL2, restricted to a 6-day treatment period, is feasible
      immediately after high-dose chemotherapy requiring ABMT without haematological
      problem in most patients. The response rate was unexpected for a pilot study and
      this combined therapy obviously requires further study.

PMID- 1756324
TI  - In vitro marrow purging in chronic myelogenous leukemia: effect of mafosfamide
      and recombinant granulocyte--macrophage colony-stimulating factor.
AB  - Clinical and experimental evidence revealing Ph1-negative hematopoietic stem
      cells in the majority of chronic myelogenous leukemia (CML) patients, suggests
      that autologous bone marrow transplantation (ABMT) may represent a therapeutic
      approach for these patients. It was the aim of the present study to evaluate the
      efficacy of the cyclophosphamide derivative mafosfamide as a marrow purging agent
      in a group (n = 15) of CML patients. Chemical purging was followed by a short
      term liquid culture phase supplemented with recombinant granulocyte-macrophage
      colony-stimulating factor (rGM-CSF). Mafosfamide (100 micrograms/ml) incubation
      induced a marked inhibition of progenitor cell growth, the percentages of
      surviving CFU-GEMM, BFU-E, and CFU-GM being 3.4, 5.4, and 4.9, respectively. At
      the cytogenetic level, the purging procedure failed to show any modulating effect
      on Ph1-negative clones in 9/15 cases. In contrast, 6/15 cases showed a
      significant increase in the mean (+/- SD) percentage of Ph1-negative metaphases
      in response to rGM-CSF (46 +/- 26, p less than or equal to 0.05), mafosfamide
      incubation (53 +/- 12, p less than or equal to 0.01), and the combination of
      mafosfamide incubation plus rGM-CSF (63 +/- 29, p less than or equal to 0.025).
      Immunological analysis revealed that mafosfamide incubation induced a significant
      enrichment of MY10 (28 +/- 9, 0.05) B73.1-positve cells (25 +/- 9, p less than or
      equal to 0.05). Four mafosfamide-responsive patients with CML in second chronic
      phase have been autografted with mafosfamide purged marrow. In all patients a Ph1
      negative phase lasting 5-14 months was observed. In conclusion, it appears that
      (a) in a subgroup of CML patients mafosfamide purging is effective in reducing
      the size of the malignant clone and might induce through its cytotoxic and immune
      actions a modification of the balance between leukemic and normal clones, and (b)
      this experimental approach may be used as a screening test to select patients to
      undergo marrow harvest and ABMT with mafosfamide purged marrow.

PMID- 1756325
TI  - Autologous bone marrow transplantation as consolidation therapy for non-Hodgkin's
      lymphoma patients with poor prognostic features.
AB  - Theoretical considerations and preliminary results of clinical trials support the
      earlier use of autologous bone marrow transplantation (ABMT) in poor prognosis
      non-Hodgkin's lymphoma (NHL). A prognostic analysis of 50 patients with
      intermediate or high grade NHL younger than 60 years, who achieved at least one
      complete remission and were not treated with BMT, was performed. Patients with
      bulky tumor at diagnosis and/or serum LDH greater than or equal to 600 U/l do
      poorly with conventional chemotherapy. Twelve patients with these high-risk
      initial characteristics in first complete remission (CR) and six patients in
      second or third CR were treated with cyclophosphamide (60 mg/kg x 2) and total
      body irradiation (1000-1200 cGy) followed by ABMT. Overall disease-free survival
      was 65% at a median follow-up of 35 months. No differences were found between the
      first and later CR patients. The rate of toxic death was 11%. Disease-free
      survival after first CR was better for 1st CR ABMT patients than for a historical
      chemotherapy control group with similar poor prognosis features (p = 0.008).
      These results support the use of ABMT in selected, high-risk NHL patients in
      first CR.

PMID- 1756326
TI  - A simple, efficient washing procedure for cryopreserved human hematopoietic stem
      cells prior to reinfusion.
AB  - We describe our experience with a washing procedure used on cryopreserved, thawed
      bone marrow (BM) and peripheral blood stem cell (PBSC) grafts prior to autologous
      transplantation in 50 and 12 patients respectively. The procedure consists of a
      stepwise dilution with 2% human serum albumin and centrifugation performed either
      manually or using a blood cell processor (Cobe 2991). In vitro studies showed
      mean recoveries of 80.8% for BM nucleated cells and 73.9% for BM hematopoietic
      progenitors (CFU-GM). The corresponding recoveries for PBSC were 89.1 and 93.9%.
      After 4 h storage at +20 degrees C of the manipulated grafts, no significant loss
      of CFU-GM was observed. We conclude that the technique is simple and efficient
      for washing large numbers of hematopoietic stem cells. This method may avoid the
      clinical complications often arising with unwashed grafts.

PMID- 1756327
TI  - Alpha-interferon broadens the difference between surviving fractions of normal
      and leukemic progenitor cells in vitro by heat: its application to marrow
      purging.
AB  - Alpha-interferon (IFN) may inhibit the proliferation of human leukemic progenitor
      cells (L-CFU) in vitro and enhance the anti-tumor effects by heat. In this study,
      the combined effects of IFN and hyperthermia on the growth of L-CFU and human
      granulocyte-macrophage progenitors (CFU-GM) were examined to determine if this
      combination resulted in a greater selective killing of L-CFU than that obtained
      by heat treatment alone. The survival of normal CFU-GM without IFN decreased at
      elevated temperatures (42-44 degrees C). However, IFN added during heating (42
      and 43 degrees C) appeared significantly to protect against the hyperthermic
      killing of CFU-GM in vitro leaving over 50% of CFU-GM surviving. The optimal dose
      to protect CFU-GM in vitro dropped to a rather low dose (100 U/ml). On the other
      hand, the addition of IFN to leukemic cell suspensions enhanced the hyperthermic
      killing of myeloid leukemic cell lines (HEL and KG-1) as well as a T
      lymphoblastic cell line (CEM) in a dose-related manner. In addition, similar
      results were observed in the study of L-CFU from patients with acute myelogenous
      leukemia. These results suggest that IFN can be used to broaden the difference
      between surviving fractions of CFU-GM and L-CFU by heat. Thus, this combination
      could be applied effectively and safely for the elimination of residual
      clonogenic leukemic cells in autologous remission marrow graft before autologous
      bone marrow transplantation.

PMID- 1756328
TI  - Long-term complete remission after allogeneic bone marrow transplantation in
      multiple myeloma.
AB  - We report a case of IgG lambda type multiple myeloma treated by allogeneic bone
      marrow transplantation. After transplant the monoclonal protein persisted for 2
      years with no other sign of disease. Thereafter the monoclonal protein was no
      longer detectable and the patient was considered to be in complete remission for
      the next 4 years.

PMID- 1756329
TI  - Unusually long survival after autografting in second partial remission of
      translocation t(4;11) acute infant leukemia.
AB  - About 70% of children with acute lymphoblastic leukemia may be cured by
      conventional chemotherapy. The prognosis is considerably worse in infant leukemia
      with a translocation t(4;11). We report an infant with a diagnosis of
      cytochemically undifferentiated acute hybrid leukemia (pre pre B-ALL coexpressing
      one myelomonocytic marker) and t(4;11). Initial clinical presentation and the
      course of the disease were typical for t(4;11) acute leukemia. After an early
      hematologic relapse intensive chemotherapy resulted only in a second partial
      remission 7 months after initial diagnosis. Subsequent bone marrow
      transplantation with 16 mg/kg busulfan and 200 mg/kg cyclophosphamide followed by
      the infusion of autologous purged bone marrow resulted in a continuous second
      remission which has lasted 46 months so far.

PMID- 1756330
TI  - Acute inflammatory demyelinating polyneuropathy following bone marrow
      transplantation.
AB  - Acute inflammatory demyelinating polyneuropathy (AIDP) appeared in two patients
      following allogeneic bone marrow transplantation (BMT). In one transplanted
      patient (but not in the donor) T cells were sensitized against peripheral nervous
      system myelin. This could reflect a change in the T cell repertoire in a
      different milieu. In this context, AIDP might be part of graft-versus-host
      disease or another associated autoimmune disorder following BMT.

PMID- 1756331
TI  - Presumptive invasive Chrysosporium infection in a bone marrow transplant
      recipient.
AB  - Chrysosporium species caused an invasive infection in an 18-year-old patient
      following allogeneic sibling bone marrow transplant for T lineage acute
      lymphoblastic leukemia. This infection began as a facial swelling and extended
      into the central nervous system. Fungal disease spread rapidly despite antifungal
      agents. An autopsy showed fungal involvement of brain, lungs, liver and kidneys.

PMID- 1756332
TI  - Cerebral infarction associated with protein C deficiency following allogeneic
      bone marrow transplantation.
AB  - Hypercoagulable states associated with deficiencies in circulating anticoagulant
      protein C occur after chemotherapy for a variety of malignant diseases. Protein C
      deficiency also occurs following bone marrow transplantation (BMT) and may be
      responsible for a variety of transplantation-associated complications. We report
      the case of a child who suffered a stroke associated with low protein C antigen
      and activity occurring 11 months after allogeneic BMT. Protein C levels recovered
      spontaneously by 18 months after BMT. We speculate that the protein C deficiency
      and and resultant hypercoagulable state led to the stroke, and the deficiency of
      this anticoagulant was a sequela of the transplant.

PMID- 1756333
TI  - Poor circulating CFU-GM harvest and slow hematologic reconstitution in a patient
      with chronic granulocytic leukemia undergoing autologous transplantation.

PMID- 1756334
TI  - Endobronchial aspergillosis in marrow transplant patients.

PMID- 1756335
TI  - Computerised tomography in Alzheimer's disease. Methods of scan analysis,
      comparison with normal controls, and clinical/radiological associations.
AB  - One hundred and thirty-eight patients satisfying NINCDS/ADRDA criteria for
      Alzheimer's disease (AD) and 36 normal controls underwent cranial CT. A
      comparison of methods of scan analysis showed good agreement between computer
      assisted methods and visual ratings and planimetry. The CT scans of controls
      differed significantly from patients and a discriminant analysis, based on all CT
      measures, predicted group membership (control or patient) in 81% of cases. Within
      the AD group, cortical atrophy correlated with age and duration of illness.
      Global tests of cognitive function correlated significantly with both cortical
      atrophy and ventricular size. Subjects who died in a three-year follow-up had
      more atrophy and larger third ventricles than survivors, but this effect was due
      entirely to increased age.

PMID- 1756336
TI  - 'Schizoid' personality in childhood and adult life. I: The vagaries of diagnostic
      labelling.
AB  - The literature is reviewed on children variously described as having 'schizoid'
      personality disorders, Asperger's syndrome, and schizotypal personality
      disorders, with the aim of clarifying the nature of these clinical syndromes, and
      in particular the features of those children whose follow-up characteristics are
      described in the following two papers.

PMID- 1756337
TI  - 'Schizoid' personality in childhood and adult life. II: Adult adjustment and the
      continuity with schizotypal personality disorder.
AB  - In a controlled follow-up study into adulthood of 32 children diagnosed
      'schizoid', three-quarters fulfilled DSM-III criteria for schizotypal personality
      disorder and two developed schizophrenia. Overall their psychosocial adjustment
      was somewhat, but not markedly, worse than that of other attenders at a child
      psychiatry clinic, although as a group they remained more solitary, lacking in
      empathy, oversensitive, with odd styles of communicating, and often with
      circumscribed interests.

PMID- 1756338
TI  - 'Schizoid' personality in childhood and adult life. III: The childhood picture.
AB  - The childhood case records of 32 'schizoid' children and 32 matched controls were
      analysed. 'Schizoid' children were characterised by solitariness, unusual
      fantasies, special interests, and specific developmental delays, especially of
      language-related skills. They were of average or above-average IQ, and half
      presented with other, common, child psychiatric syndromes. It is important to
      distinguish 'schizoid' children from children with reactive psychiatric
      disorders.

PMID- 1756339
TI  - Coherence on electroencephalography and aberrant functional organisation of the
      brain in schizophrenic patients during activation tasks.
AB  - Thirty schizophrenic patients (20 medicated, 10 off medication) were compared
      with 30 normal control subjects matched for age, sex, handedness, and
      intelligence. During the performance of left-hemisphere cognitive activation
      tasks, normal subjects had significantly increased EEG alpha coherence in areas
      related to left focal frontal sites, with decreases in temporal and posterior
      areas. Schizophrenic patients did not show the same degree of focal activation of
      left frontal areas. During the performance of right-hemisphere cognitive
      activation tasks, normal subjects and schizophrenic patients had similar patterns
      of right posterior increases in alpha coherence. Discriminant analyses were able
      to classify 81.4% of all subjects correctly. It is suggested that the findings
      indicate an aberrant functional organisation of the brain in schizophrenia,
      particularly affecting the left hemisphere.

PMID- 1756340
TI  - Cross-cultural feasibility, reliability and sources of variance of the Composite
      International Diagnostic Interview (CIDI). The Multicentre WHO/ADAMHA Field
      Trials.
AB  - The CIDI is a fully standardised diagnostic interview designed for assessing
      mental disorders based on the definitions and criteria of ICD-10 and DSM-III-R.
      Field trials with the CIDI have been conducted in 18 centres around the world, to
      test the feasibility and reliability of the CIDI in different cultures and
      settings, as well as to test the inter-rater agreement for the different types of
      questions used. Of 590 subjects interviewed across all sites and rated by an
      interviewer and observer, 575 were eligible for analysis. The CIDI was judged to
      be acceptable for most subjects and was appropriate for use in different kinds of
      settings. Many subjects fulfilled criteria for more than one diagnosis (lifetime
      and six-month). The most frequent lifetime disorders were generalised anxiety,
      major depression, tobacco use disorders, and agoraphobia. Percentage agreements
      for all diagnoses were above 90% and the kappa values were all highly
      significant. No significant numbers of diagnostic disconcordances were found with
      lifetime, six-month, and four-week time frames.

PMID- 1756341
TI  - The CIDI-core substance abuse and dependence questions: cross-cultural and
      nosological issues. The WHO/ADAMHA Field Trial.
AB  - The CIDI is a fully standardised, structured interview for the assessment of
      psychiatric disorders according to DSM-III-R and proposed ICD-10 criteria. The
      development of this interview has been the collaborative effort of researchers
      from 18 sites around the world. In a field trial to test the cross-cultural
      acceptability and reliability of the questions, there was found to be high
      acceptance and excellent reliability for the substance use questions, problems
      with the lengthy alcohol section, and difficulties translating relevant substance
      use concepts into different languages. There is therefore room for further
      improvement in the substance-related questions. There proved to be differences
      between ICD-10 and DSM-III-R regarding substance abuse and dependence disorders.

PMID- 1756342
TI  - Prognosis of depression in the elderly.
AB  - Fifty-six consecutively admitted elderly (65 and over) patients with depression
      were assessed on mental, physical and social states. They were followed up and
      assessed at home one year later. A group of 24 depressed in-patients aged under
      65 years admitted to the same ward during the same period was also assessed.
      Outcome was different for the two groups, with 68% of the elderly 'well' at one
      year, against 50% of the younger group. The younger group were more likely to
      have 'poor' outcome (41%) than the elderly (16%). However, there were more deaths
      than expected, particularly in the elderly. These findings differ from some
      previous studies, and indicate an excellent prognosis for depression in the
      elderly. Outcome in younger patients is less good.

PMID- 1756343
TI  - Sexual abuse as a factor in eating disorders.
AB  - Clinicians have reported a link between sexual abuse and eating disorders, but
      research evidence to date has been equivocal in supporting that link. This study
      presents data on reported sexual abuse from 67 anorexic and bulimic patients.
      Bulimics were substantially more likely to report a history of unwanted sexual
      experience than anorexics. The method used (clinical interview v. questionnaire)
      did not affect reported rates of abuse. It is suggested that sexual abuse per se
      may not cause eating disorders, but may determine the nature of those disorders
      when they have been prompted by other factors.

PMID- 1756344
TI  - Placebo and analgesic nitrous oxide for treatment of the alcohol withdrawal
      state.
AB  - We present evidence that analgesic (as distinct from anaesthetic) nitrous oxide
      is superior to placebo in the treatment of the alcohol withdrawal state.
      'Carbogen' as a placebo is as effective as oxygen or medical air. However,
      placebo alone offers a means of treating the alcohol withdrawal state with a
      minimum of pharmacological intervention. Analgesic nitrous oxide for those not
      responding to placebo is a very rapid, effective, and extremely safe treatment
      which also reduces the use of highly addictive sedative pharmacological agents.
      This therapy also provides a rapid method of screening those patients requiring
      intensive monitoring and treatment in hospital from those who might benefit from
      out-patient therapy alone.

PMID- 1756345
TI  - Construction of an index for predicting suicide attempts in depressed
      adolescents.
AB  - A group of 48 adolescents who recently attempted suicide and 66 depressed
      adolescents were compared on sociodemographic, behavioural, psychological and
      relational variables. The variables which proved significant were used in
      different combinations in stepwise logistic regression analyses, resulting in
      seven variables which served as the content of an index of risk. The sensitivity
      of the index was 90% and the specificity 83%. At one-year follow-up the
      occurrence of a suicide attempt correlated with score on the instrument.

PMID- 1756346
TI  - Maternal mental health in a squatter settlement in Rio de Janeiro.
AB  - The literature on household-based measures of mental health in developing
      countries is limited. Much emphasis is currently placed on the physical well
      being of mothers in relation to child care, yet their mental well-being receives
      little attention. The present study measures maternal mental health in the
      largest squatter settlement of Rio de Janeiro, Brazil. The proportion of mothers
      who were probable cases of mental ill-health was 36%.

PMID- 1756347
TI  - Dhat syndrome--a useful diagnostic entity in Indian culture.
AB  - In a prospective study of 144 consecutive male patients with psychosexual
      disorders, comprising 93 with Dhat syndrome with or without impotence or
      premature ejaculation, 21 with premature ejaculation, and 30 suffering only
      impotence, the commonest associated psychiatric illness was neurotic depression
      (39%) followed by anxiety neurosis (21%), while 31% did not receive a psychiatric
      diagnosis. The common presenting a symptoms of Dhat syndrome were weakness (71%),
      fatigue (69%), palpitations (69%), and sleeplessness (62%). After random
      allocation into groups, four types of treatment were given: an anti-anxiety drug,
      an antidepressant, a placebo, or counselling. The best response was seen with the
      anti-anxiety and antidepressant drugs. Twenty-one patients dropped out of
      treatment; 15 of whom were from the counselling group.

PMID- 1756348
TI  - Against pathology. The new psychiatry and its critics.
AB  - The notion of 'pathology' presumes an experiential and socially embedded frame of
      reference which is at variance with some recent attempts to understand the
      procedures and subject matter of psychiatry. Psychiatric theories remain bound by
      individual and historical contingencies whose compelling urgency obfuscates the
      inter-relationship of phenomenon, social context, response, and explanatory
      model.

PMID- 1756349
TI  - Role of general practitioners in care of long-term mentally ill patients.
AB  - "OBJECTIVE--To assess general practitioners' involvement with long term mentally
      ill patients and attitudes towards their care. DESIGN--Postal questionnaire
      survey. SETTING--General practices in South West Thames region. SUBJECTS--507
      general practitioners, 369 (73%) of whom returned the questionnaire. MAIN OUTCOME
      MEASURES--The number of adult long term mentally ill patients whom general
      practitioners estimate they have on their lists and general practitioners'
      willingness to take responsibility for them. RESULTS--110 respondents had noticed
      an effect of the discharge of adult long term mentally ill patients on their
      practices. Most (225) respondents estimated that they had 10 or fewer such
      patients each on their lists. Having higher numbers was significantly associated
      with practising in Greater London or within three miles of a large mental
      hospital and having contact with a psychiatrist visiting the practice. 333
      general practitioners would agree to share the care of long term mentally ill
      patients with the psychiatrist by taking responsibility for the patients'
      physical problems. Only 59 would agree to act as a key worker, 308 preferring the
      community psychiatric nurse to do it. Only nine had specific practice policies
      for looking after long term mentally ill patients and 287 agreed that such
      patients often come to their general practitioner's attention only when there is
      a crisis. CONCLUSIONS--The uneven distribution of long term mentally ill patients
      suggests that community psychiatric resources might be better targeted at those
      practices with higher numbers of such patients. Most general practitioners seem
      to be receptive to a shared care plan where the consultant takes responsibility
      for monitoring psychiatric health with the community nurse as key worker. The
      lack of practice policies for reviewing the care of long term mentally ill
      patients must limit general practitioners' ability to prevent crises developing
      in their care."

PMID- 1756350
TI  - Suicide among immigrant psychiatric patients in Canada.
AB  - Ninety-four Canadian-born psychiatric patients who committed suicide were
      compared with 23 foreign-born patients committing suicide in Canada. East
      Europeans were over-represented, and significant differences were found in the
      age distribution, stress, level of education, social isolation, and methods of
      suicide. Most foreign-born patients had come to Canada for family or economic
      reasons but were unemployed, with poor social integration. Employment, housing,
      education, social integration and a support network seem to be important in
      preventing these deaths. Cultural evaluation of the patient and early
      intervention is recommended.

PMID- 1756351
TI  - Mania secondary to thyrotoxicosis.

PMID- 1756352
TI  - Delusional parasitosis associated with phenelzine.
AB  - A woman developed delusional parasitosis when taking phenelzine. The delusion
      occurred in an agitated hypomanic state and was preceded by an intense pruritus.
      It completely remitted following withdrawal of phenelzine combined with a low
      dose of haloperidol (1 mg/day) for several days. This unusual psychopathology is
      probably encountered more by dermatologists than by mental health professionals.

PMID- 1756353
TI  - The co-existence of erotomania and Capgras' syndrome.
AB  - A case of secondary erotomania co-existent with Capgras' syndrome presented with
      features that have not been reported before. The case is suggested to be a
      variant of de Clerambault's syndrome. The role of cultural factors in altering
      the clinical picture is insignificant.

PMID- 1756354
TI  - Isolated cataplexy of more than 40 years' duration.
AB  - For over 40 years, a 55-year-old woman had suffered from cataplexy, which had
      been mistakenly identified as hysteria. Sleepiness, hypnagogic hallucinations and
      sleep-onset paralysis were not present. This is the longest duration of isolated
      cataplexy reported so far.

PMID- 1756355
TI  - Conditional probability and sibling sex.

PMID- 1756356
TI  - Apparent decrease in schizophrenia.

PMID- 1756357
TI  - The human brain and political behaviour.

PMID- 1756358
TI  - 'Compulsive' water drinking in psychosis...

PMID- 1756359
TI  - . . . and mentally handicapped people.

PMID- 1756360
TI  - Negative symptoms of schizophrenia.

PMID- 1756362
TI  - Neuroleptic malignant syndrome.

PMID- 1756361
TI  - Hospital anxiety and depression scale.

PMID- 1756363
TI  - Psychiatrists and citizens.

PMID- 1756364
TI  - Promoting the correct use of psychotropic drugs.

PMID- 1756365
TI  - Affect logic.

PMID- 1756366
TI  - Admission rates, detention rates and socioeconomic deprivation.

PMID- 1756367
TI  - Depression and polycythaemia.

PMID- 1756368
TI  - What's in a name?

PMID- 1756369
TI  - Monozygotic male triplets discordant for psychosis.

PMID- 1756370
TI  - Chloroquine-induced psychiatric complications.

PMID- 1756371
TI  - Aggression and multiple sclerosis.

PMID- 1756372
TI  - Sudden cardiac death and antidepressants.

PMID- 1756373
TI  - Hair loss associated with fluoxetine.

PMID- 1756374
TI  - Cortical cells' physiology following visual split brain in developing cats.
AB  - We have studied physiologically whether visual cortex cells in areas 17 and 18 of
      split-brain cats preserve their performance despite the blockage of both
      binocularity and of interhemispheric communication. The absolute majority of the
      cells in cats underwent split-brain surgery as kittens and adults and were driven
      by the ipsilateral eye, resulting in the absence of interhemispheric interaction.
      Similar results were found in cats and kittens that underwent only chiasm split
      surgery, although some recovery of callosal transfer was found in the latter. A
      remarkable loss of binocularity was found when only callosal transection was
      performed, both in adult cats and in kittens, although some ipsilateral eye
      dominance was observed in the latter. As to the deprived cats, while in the
      inexperienced hemisphere (ipsilateral to the deprived eye), the majority of the
      cells was visually unresponsive, in the contralateral (experienced) hemisphere,
      the majority was responsive. A considerable reduction in responsiveness was found
      in the callosally transected cats and kittens. Generally, a degradation of
      function was found in the various properties as a result of chiasmal and/or
      callosal transection. The main effect is the increased number of cells with
      diffuse and incomplete receptive fields. There was also a reduction in the
      proportion of orientation-selective cells, mainly in the split-brain cats. It was
      concluded that, despite the high amount of hemispheric independency in the normal
      brain, the integrity and simultaneous action of the two hemispheres are needed
      for the normal functioning of visual cortex cells.

PMID- 1756375
TI  - Time course of rat sleep variables assessed by a microcomputer-generated data
      base.
AB  - A microcomputer-based system is described that detects, counts and stores
      cortical delta and sigma waves, hippocampal theta waves and electromyographic
      activities in the rat by building matrices with the incidence of those four
      variables (columns) in 15-second bins (rows). Data tables are submitted to
      statistical, graphics and spread-sheet software to assess internal organization
      of sleep episodes and 24-hour distribution of sleep variables. Within sleep
      episodes, cross-correlograms reveal a delta-sigma-theta sequence, while
      autocorrelograms quantify clustering and periodicity of variables. Sleep
      accumulates in the lights-on phase, with high concentration of delta at the
      beginning of this sleep-predominant phase and of sigma and theta in its second
      half. These are notable similarities with human sleep architecture. Simple
      procedures for data reduction into standard behavioral state diagnosis are
      demonstrated. The low cost of personal computers and data acquisition interfaces
      facilitates the automation of complex paradigms by ad hoc on-line programs that
      produce as output a data base that can be processed by standard software,
      providing a fluid pathway of automated acquisition, analysis and presentation of
      data.

PMID- 1756376
TI  - Tetrahydroaminoacridine improves passive avoidance retention defects induced by
      aging and medial septal lesion but not by fimbria-fornix lesion.
AB  - The present study examines whether tetrahydroaminoacridine (THA) can improve the
      deterioration in passive avoidance (PA) retention performance induced by medial
      septal (MS) and fimbria-fornix (FF) lesions in young rats or by aging. Retention
      of young MS-lesioned rats was improved by pretraining injection of THA at 3
      mg/kg, but not by THA at 1 mg/kg or by either of the posttraining doses of THA (1
      and 3 mg/kg). Pretraining injections of THA at 1 or 3 mg/kg had no effect on the
      PA retention performance of FF-lesioned rats. Age-induced PA failure was
      alleviated by pretraining administration of THA at 1 and 3 mg/kg. Posttraining
      injections of THA (1 or 3 mg/kg) had no effect on PA retention performance of
      aged rats. These results demonstrate that 1) THA may improve hippocampal
      cholinergic denervation-induced functional deficits and 2) some of the age
      related PA deficits may be due to a cholinergic deficit and can be reversed with
      THA.

PMID- 1756377
TI  - Melatonin modifies the spontaneous multiunit activity recorded in several brain
      nuclei of freely behaving rats.
AB  - Melatonin, a pineal hormone, released photoperiodically, was administered
      systemically in rats, previously implanted with semimicroelectrodes into six
      different brain structures. The multiunit electrical activity of these structures
      was recorded for 10 min before and 60 min after melatonin administration in
      unanesthetized, freely moving rats. Different melatonin doses (100, 200, 500, and
      1000 micrograms/kg) produced changes in the electrical activity of all tested
      structures. However, amygdala, rostral hypothalamus and mesencephalic reticular
      formation showed the most important changes. The main effect induced by melatonin
      was a dose-related decrease of the spontaneous electrical activity. The
      significance of these effects is discussed within the context of the behavioral
      and endocrinological effects of melatonin.

PMID- 1756378
TI  - Desmethylimipramine promotes recovery of self-stimulation from the prefrontal
      cortex following footshock.
AB  - Intracranial self-stimulation (ICSS) was assessed from the prefrontal cortex in
      CD-1 mice immediately (0 h), 24 h and 168 h following exposure to uncontrollable
      footshock. Marked reductions in ICSS rates were observed in all mice immediately
      following the stressor. Although the ICSS alterations were transient in some
      animals, ICSS rates were reduced in the majority of animals 24-h and 168-h
      poststressor. Mice of either the shock or no shock treatment groups were
      administered either saline or desmethylimipramine (DMI, 5 mg/kg x 2) for 20
      consecutive days. Chronic DMI ameliorated the stressor-induced ICSS deficits from
      the prefrontal cortex. Potential explanations for the stressor-provoked
      variations in ICSS and the effects of DMI are discussed.

PMID- 1756379
TI  - Depletion of calcitonin gene-related peptide in perivascular nerves during acute
      phase of posthemorrhagic vasospasm in the rabbit.
AB  - The behaviour of various neuropeptides during early and late vasospasm following
      experimental subarachnoid hemorrhage has been investigated by several authors.
      Recently, a reduction of the content of vasodilatory neuropeptides (vasodilatory
      intestinal peptide, substance P and calcitonin gene-related peptide) has been
      demonstrated in the perivascular nerves of cerebral arteries after few days from
      induction of experimental subarachnoid hemorrhage. In the present
      immunohistochemical study, the authors investigated secretion and expression of
      CGRP a few minutes after injection of autologous blood into the cisterna magna of
      the rabbit. The authors propose that the marked decrease of calcitonin gene
      related peptide immunoreactivity in the perivascular nerves, observed after
      experimental subarachnoid hemorrhage, is due to compensatory secretion of the
      peptide.

PMID- 1756380
TI  - Calcitonin gene-related peptide-like immunoreactivity and its relation with
      neurotensin- and corticotropin-releasing hormone-like immunoreactive neurons in
      the bed nuclei of the stria terminalis in the rat.
AB  - The distribution of calcitonin gene-related peptide (CGRP)-like immunoreactive
      (LI) nerve cells and terminals (BST) was studied in the rat. Only the fusiform
      nucleus was found to consistently contain CGRP-LI neurons. The CRGP-LI terminals
      had a wide distribution in the BST, being most numerous in the oval and the
      fusiform nuclei. In the oval nucleus the CGRP-LI terminals formed characteristic
      "baskets." Since the oval nucleus was known to be studded with neurotensin (NT)-
      and corticotropin-releasing hormone (CRH)-LI neurons, the relationship of the
      CGRP-LI nerves to NT- and CRH-LI neurons was investigated by means of a double
      immunostaining technique. A part of the CGRP-LI baskets were found to contain NT-
      or CGRP-LI neurons. The possible involvement of the CGRP/NT or CRH relationship
      in reciprocal connection between the BST and the parabrachial nucleus and in
      cardiovascular regulation is discussed.

PMID- 1756381
TI  - Muscarinic cholinoceptive neurons in the frontal cortex in Alzheimer's disease.
AB  - The cellular distribution of muscarinic acetylcholine receptor protein in the
      frontal cortex of Alzheimer (AD) patients, age-matched and middle-aged controls
      was assessed quantitatively by means of immunohistochemistry using the monoclonal
      antibody M35. As shown previously in biopsy cortices, mainly layer II/III and V
      pyramidal neurons were immunolabeled. Neither distribution nor numbers of labeled
      cells displayed significant differences between the groups investigated. This is
      in accordance with the results of ligand binding studies that mostly failed to
      reveal different binding characteristics in AD compared to controls. Muscarinic
      and nicotinic receptor proteins have been shown to be colocalized in many
      cholinoceptive pyramidal neurons. Since nicotinic receptors--in contrast to
      muscarinic receptor proteins--are severely reduced in AD, this indicates a
      selective impairment of nicotinic receptor expression and not a significant death
      of cholinoceptive neurons per se.

PMID- 1756382
TI  - Hippocampal and cortical EEG activity in rats with transected hypothalamus.
AB  - The brain was transected in eight rats: the transection passed through the
      posterior pole of the superior colliculi and ended down at midhypothalamic level.
      The EEG activity in the dorsal hippocampus and cortex showed continuously slow,
      high amplitude waves. Thus the posterior hypothalamus is critical for the
      previously described hippocampal theta rhythm found in rats transected at the
      posthypothalamic level.

PMID- 1756383
TI  - Development of transient acetylcholinesterase staining in cells and permanent
      staining in fibers in cortex of rat brain.
AB  - The development of the acetylcholinesterase (AChE) texture of the cortex of the
      rat brain was studied during the first three weeks of life. The Tago technique
      enables visualization of both AChE+ cells and fibers with both shown in exquisite
      detail making quantification possible. At each age--0 (birth), 7, 14, 21 and 60
      days (adult)--four brain areas were studied (cingulate, dorsal neocortex, lateral
      neocortex and olfactory) at each of three coronal planes in the brain (anterior,
      intermediate, posterior). Fiber density reached adult levels by Day 21 in
      cingulate cortex in intermediate and posterior planes. In other areas fiber
      density reached adult levels by Day 14 indicating a high rate of fiber growth
      during the first two weeks of life since at birth rat cortex is innervated only
      by a sparse AChE+ fiber invasion into neocortex in the anterior plane. Fiber
      density did not regress after adult levels were reached, however, cell staining
      showed a different pattern. At birth many lightly stained cells were seen in the
      olfactory cortex in all three planes, but other areas were devoid of cells. In
      all areas there was a peak at Day 7 in number of cells stained and in intensity
      of cells staining with a gradual decline in cell staining until by Day 21 very
      few stained cells were seen in the cortex (typical adult pattern).

PMID- 1756384
TI  - The role of platelets in the development of cerebral vasospasm.
AB  - A possible role of platelet-derived 5-HT was examined concerning the pathogenesis
      of cerebral vasospasm. Intracisternal injection of 5 ml of platelet-rich plasma
      (PRP; approximately 7.5 x 10(8) platelets) induced not only acute (1 h) but also
      chronic (7 days) angiographically evident cerebral vasospasm in dogs. Sympathetic
      perivascular nerves on cerebral arteries showed no remarkable change following
      repeated injections of PRP, as the dense distribution of catecholamine
      fluorescence and neuropeptide Y-like immunoreactive nerve fibers on Day 7 was
      comparable to findings in the preinjection controls. While there were no 5-HT
      immunoreactive fibers in the cerebral arteries of control animals, numerous 5-HT
      immunoreactive fibers were present in the PRP-injected animals. These results
      suggest that 5-HT, presumably released from extravasated platelets, may be taken
      up by nerve endings and act as a vasoconstrictor transmitter in the pathogenesis
      of chronic vasospasm.

PMID- 1756385
TI  - A monoclonal antibody that labels Purkinje cells in the rat cerebellum.
AB  - A monoclonal antibody (MAb-1D10), generated by immunizing Balb/c mice with
      homogenized bovine retinal tissue, labeled the Muller cells in the bovine retina
      and the Purkinje cells of the rat cerebellum. In the neonatal rat cerebellum,
      immunoreactivity for MAb-1D10 appeared first in the ventral regions of vermis
      (lobuli I-III and IX-X) on the 11th postnatal day (P11), while in the dorsal
      vermis and cerebellar hemisphere, the immunoreactive Purkinje cells were detected
      on P13. Western blotting analysis disclosed that MAb-1D10 recognized bovine
      retinal polypeptides with mol.wt. of 48 kDa. Transplantation of the rat
      cerebellar primordia on 16th embryonic day demonstrated large and round cells
      with a linear arrangement in the grafts surviving well in the host rat striatum
      after 50 days of the grafting. These large cells were immunohistochemically
      labeled by MAb-1D10. No other cells in both the graft and the host striatum were
      immunoreactive to the MAb.

PMID- 1756386
TI  - Age- and sex-related differences in the nerve growth factor distribution in the
      rat brain.
AB  - Levels of the nerve growth factor (NGF) have been measured in various brain
      regions of young and aged male and female rats of Wistar strain by means of a
      highly sensitive two-site enzyme immunoassay system for beta-NGF. Among the ten
      regions examined, the amount of NGF per wet weight of tissue was found to be
      highest in the hippocampus, irrespective of the sex and age. The NGF
      concentration in the hippocampus of female rats at 3 months of age was comparable
      to that of same aged males. Further, there was no significant difference in the
      NGF levels of the hippocampus between young and age males. However, the NGF level
      was significantly lower in aged females as compared to that in 3- or 4-month-old
      females, and hence the marked male-female difference was found in the NGF levels
      in aged Wistar rats.

PMID- 1756387
TI  - Adinazolam affects biogenic amine release in hippocampal CA1 neuronal circuitry.
AB  - The new triazolobenzodiazepine, adinazolam, which has dual anxiolytic and
      antidepressant activities, was studied for its effects on hippocampal CA1
      norepinephrine and serotonin release in chloral hydrate-anesthetized rats, with
      in vivo voltammetry. Norepinephrine signals were further characterized in vivo by
      the detection of a significantly increased norepinephrine signal (mean = 25.8%)
      (p less than 0.003) after intraperitoneal administration of the alpha 2
      adrenoreceptor antagonist, yohimbine, and by the detection of a significantly
      decreased norepinephrine signal (mean = 20.1%) (p less than 0.037) after
      intraperitoneal administration of the alpha 2 adrenoreceptor agonist, clonidine.
      Time course studies showed that the anxiolytic-antidepressant drug adinazolam (10
      mg/kg IP) significantly decreased hippocampal norepinephrine release (mean =
      26.2%) (p less than 0.007). The norepinephrine signal was further significantly
      decreased by adinazolam (mean = 16.4%) (p less than 0.009) after an additional 2
      mg/kg IP injection. Serotonin release, which was detected with norepinephrine in
      sequence, was also significantly decreased by adinazolam (10 mg/kg IP) (mean =
      22.4%) (p less than 0.002). The supplemental dose of adinazolam (2 mg/kg IP),
      however, did not significantly alter serotonin release any further (p less than
      0.307). The findings show that the mechanism of action of adinazolam occurs
      simultaneously on presynaptic release mechanisms for norepinephrine and for
      serotonin in CA1 region of hippocampus. These findings implicate that
      noradrenergic and serotonergic release mechanisms may be responsible in part for
      the dual anxiolytic-antidepressant efficacy of adinazolam.

PMID- 1756388
TI  - Parvalbumin-positive neurons in rat dorsal hippocampus contain muscarinic
      acetylcholine receptors.
AB  - The present study describes the colocalization of muscarinic acetylcholine
      receptors (mAChRs) and the calcium-binding protein parvalbumin (PARV) in
      nonpyramidal neurons of the rat dorsal hippocampus by means of dual-label
      immunocytochemistry. Fifty-two percent of all muscarinic cholinoceptive
      nonpyramidal neurons contain parvalbumin. Conversely, the vast majority (88.4%)
      of all PARVergic neurons possess mAChRs. The PARVergic neurons embedded within
      the CA1 pyramidal cell layer are nearly all (98.9%) immunopositive for mAChRs.
      These results indicate that the cholinergic septohippocampal projection
      represents a major afferent system upon the inhibitory PARVergic neurons.

PMID- 1756389
TI  - Fever induced by macrophage inflammatory protein-1 (MIP-1) in rats: hypothalamic
      sites of action.
AB  - The purpose of this study was to clarify the central site of action as well as
      functional characteristics of the febrile response of the cytokine, macrophage
      inflammatory protein-1 (MIP-1). Guide cannulae for microinjection were implanted
      stereotaxically in the rat just above the pyrogen and thermosensitive area of the
      anterior hypothalamic, preoptic area (AH/POA). Following postoperative recovery,
      the body temperature of each rat (Tbo) was monitored during an experiment by a
      colonic thermistor probe at 0.5-1.0-h intervals. When MIP-1 was microinjected in
      a 0.5-microliter volume into the AH/POA in one of eight concentrations ranging
      from 0.0028 nanograms (ng) to 9.0 ng, an intense monophasic or biphasic fever was
      evoked. The MIP-1-induced increase in the Tbo of the rat was characterized by its
      short latency of 15 to 30 min and an inverse dose-response curve. Measures of
      mean latency and maximal rise in Tbo following MIP-1 confirmed the potency of
      this dose. Although the dose of 0.028 ng produced a fever of over 2.0 degrees C
      with a latency of only 15 min or less, the hyperthermic response became less
      intense as the dose of MIP-1 was increased. An anatomical mapping of sites of
      microinjection which reacted to MIP-1 in mediating fever revealed that the medial
      portion of the POA of the rat just rostral to the border of the AH was the region
      of maximum sensitivity to the cytokine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756390
TI  - Intrastriatal implants of fetal mesencephalic cells attenuate the increases in
      striatal proenkephalin mRNA observed after unilateral 6-hydroxydopamine-induced
      lesions of the striatum.
AB  - Unilateral injections of 6-hydroxydopamine (6-OHDA) cause significant bilateral
      increases in striatal proenkephalin (PEK) mRNA in rat brain. We have tested the
      possibility that implantation of fetal mesencephalic cells can normalize these
      changes. Two types of grafts were used: 1) embryonic day-15 mesencephalic cells
      and 2) embryonic day-15 cells which have been modified with a retroviral vector
      containing a cDNA for protein kinase C (PKC). At two months after grafting, both
      cell types cause significant attenuation of the increases which occurred on the
      side of the lesion. However, only the PKC-modified cells cause normalization of
      the changes on the contralateral side. These observations indicate that, in
      addition to normalizing supersensitive striatal dopamine (DA) D2 receptors,
      embryonic cells can also attenuate the alterations in PEK mRNA observed after
      lesions of the nigrostriatal DA system. The finding that the PKC-modified cells
      caused bilateral effects in the striatum suggests that second messenger systems
      may play a role in the bilateral improvement reported in parkinsonian patients
      who had gotten unilateral intrastriatal transplants.

PMID- 1756391
TI  - Effects of in ovo estradiol benzoate treatments on sexual behavior and size of
      neurons in the sexually dimorphic medial preoptic nucleus of Japanese quail.
AB  - In male Japanese quail, the injection of estradiol benzoate (EB) in the egg
      causes a complete loss of the testosterone (T)-induced copulatory behavior
      (behavioral demasculinization). This treatment is only effective if performed
      before day 12 of incubation. This suggests that embryonic estrogens affect in a
      permanent way brain structures controlling sexual behavior. The medial preoptic
      nucleus (POM) is the only sexually dimorphic brain nucleus identified in quail
      and it is a key center for the action of T on behavior. Recent morphometric
      studies revealed that the dorsolateral population of neurons in the POM is
      sensitive to variations of plasma T levels in adult males but not in females.
      These effects are not observed in the medial part of the POM. This sexually
      differentiated feature might therefore be organized by the embryonic hormonal
      environment. Quail embryos of both sexes were treated with EB or received a
      control injection either on day 9 or on day 14 of egg incubation and the cell
      size in the dorsolateral and medial POM was evaluated by classical morphometric
      techniques. EB treatment on day 9 decreased cell size in the dorsolateral POM
      neurons of males but had no effect in females. No effect was also observed when
      the treatment was performed on day 14. The medial POM neurons were not affected.
      The decrease in neuronal size observed in the dorsolateral POM of males treated
      with EB on day 9 was correlated with their behavioral demasculinization. Some of
      these males showed a weak sexual behavior during the tests and in parallel had
      significantly larger neurons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756392
TI  - Dopaminergic regulation of quiet biting attack behavior in the cat.
AB  - The present study provides evidence for the involvement of dopamine in the
      regulation of quiet biting attack behavior. Utilizing monopolar electrodes, quiet
      biting attack was elicited by electrical stimulation of lateral hypothalamus in
      five cats. After stable baseline response latency values were established, the
      nonselective dopamine agonist, apomorphine, was administered peripherally (IP,
      1.0, 1.4 and 1.8 mg/kg), and its effects upon the attack response were
      identified. Apomorphine significantly facilitated the occurrence of quiet biting
      attack in a dose- and time-dependent manner. Conversely, quiet biting attack
      behavior was also suppressed in a dose- and time-dependent manner by the
      selective D2 antagonist, spiperone (0.2, 0.4 and 0.8 mg/kg), but not by the
      selective D1 antagonist, SCH 23390 (0.8 mg/kg). Moreover, pretreatment with
      spiperone (0.2 mg/kg) completely blocked the facilitatory effects of 1.4 mg/kg of
      apomorphine, while SCH 23390 (0.8 mg/kg) pretreatment failed to alter apomorphine
      induced facilitation of the attack response. In addition, neither apomorphine nor
      spiperone altered response latencies for hypothalamically elicited circling
      behavior. The results suggest that dopamine plays a significant role in the
      regulation of quiet biting attack behavior.

PMID- 1756393
TI  - Dexamethasone inhibits food intake suppression induced by low doses of
      interleukin-1 beta administered intracerebroventricularly.
AB  - Intracerebroventricular (ICV) microinfusion of recombinant human interleukin-1
      beta (rhIL-1 beta, 0.125 to 2.0 ng/rat) dose-dependently suppressed 2 h and
      nighttime food intake in rats. The following daytime food intake did not change
      or increased. ICV infusion of bovine serum albumin (BSA), or heat-treated rhIL-1
      beta had no effect on food intake. Pretreatment with dexamethasone (200
      micrograms/rat, intraperitoneal) blocked the food intake suppression induced by
      low doses of rhIL-1 beta. This ability of dexamethasone, a synthetic
      corticosteroid, may have potential therapeutic implications in acute and chronic
      pathological processes associated with increased levels of IL-1 and appetite
      suppression.

PMID- 1756394
TI  - Sensory response enhancement and suppression of monkey primary somatosensory
      cortical neurons.
AB  - Vibratory stimulus-related responses were recorded from monkey primary
      somatosensory cortical (SI) neurons while animals performed two tasks. In the
      movement task, vibratory stimuli served as the go-cue for wrist flexion or
      extension. In the no-movement task, movements normally made in response to
      vibratory stimuli were extinguished. Area 3a, 3b, and 1 neurons with deep
      receptive fields (RFs) exhibited greater stimulus-related activity during the
      movement task than during the no-movement task. Area 3b neurons with cutaneous
      RFs were similarly enhanced during the movement task, whereas area 1 neurons with
      cutaneous RFs were less responsive to vibratory stimuli during the movement task.
      These results suggest that motor-set and/or selective attention may modulate the
      responsiveness of SI neurons to peripheral stimuli and that changes in sensory
      responsiveness in SI neurons differ as a function of their cortical location and
      RF type.

PMID- 1756395
TI  - [Occupational asthma: current and future perspectives. The point of view of an
      expert].
AB  - Occupational asthma remains a difficult problem for physicians and for experts.
      The prevalence of occupational asthma is underestimated and depends on industrial
      agent and conditions of work. Diagnosis is made based on detailed description of
      the patient's work environment, on skin and serological tests, and on lung
      function tests including non-specific bronchial provocation tests.
      Rhinomanometry, and peak flow rate measurements may also be useful. Bronchial
      provocation tests should be performed by experienced staff in a hospital setting
      with facilities for resuscitation. The prognosis of occupational asthma is
      variable: --some patients with short and limited exposure may fully recover if
      their disease is early recognized and appropriate measures are taken; --however,
      many patients do not recover completely after removal of the responsible agents.
      Clinical symptoms and bronchial hyperreactivity persist and respiratory
      insufficiency may develop. The patterns of occupational asthma are changing
      rapidly, in parallel with industrial evolution: nowadays, bakers's asthma is less
      frequent than it used to be. Asthma triggered by wood dust and in particular
      western red cedar (which is exported all over the world) is increasingly
      recognized. Isocyanates and, in particular toluene isocyanate, are widely used in
      plastics and paints. Preventive measures have succeeded in decreasing the
      incidence of asthma caused by exposure to isocyanates. Computer industry has
      recently developed in many countries. It requires the use of numerous hazardous
      and highly toxic materials that are potentially responsible for occupational
      asthma; attention should be given to respiratory diseases especially in
      industrializing countries (such as Eastern Asian countries). Preventive measures
      include safety rules, replacement of harmful materials by less toxic agents and
      detection of susceptible workers. Regulation must be defined under experts'
      control to continuously match the rapid changes in modern industry.

PMID- 1756396
TI  - [The lipid profile of the French male 20-year-old population].

PMID- 1756397
TI  - [Eulogy on Stephane Thieffry (1910-1990)].

PMID- 1756398
TI  - [Violence within the family on a continental scale. Reflections on an ongoing
      European study].

PMID- 1756399
TI  - [The usefulness of vaccination in elderly persons].
AB  - The antitetanus, antipneumococcal and antiinfluenza immune status, as well as the
      efficacy of vaccination have been evaluated in the elderly. Ages of the studied
      populations ranged from 60 to 98 years. Before vaccination, only half of the
      tested population was found to be protected against tetanus. Immunization
      resulted in 80% coverage of this population. Prior to antipneumococcal
      vaccination, 32% of the tested sera did not contain a "potentially" protective
      antibody titre. Vaccination resulted in 100% seroconversion. It was verified that
      100% of tested sera contained antibodies (greater than 10 U.H.A./ml) directed to
      the former Singapore antigen and 99.2% and 66.7%, respectively, to the newly
      immerged Shanghai and Yamagata antigens (present in the administered vaccine).
      Following vaccination, 100% of the sera exhibited antibody titres higher than 10
      U.H.A./ml to the Singapore and Shanghai antigens, and 90.5% to the Yamagata
      antigen. It can be concluded from the reported results that antitetanus,
      antipneumococcal and antiinfluenza vaccinations should be systematically given to
      all individuals beyond 60 years of age, since these vaccinations are innocuous
      and confer extended vaccinal coverage.

PMID- 1756400
TI  - Intolerable, excruciating, and troublesome: military ambulance technology, 1793
      1880.

PMID- 1756401
TI  - Sterilizing surgical instruments: a curator's historical perspective.

PMID- 1756402
TI  - Decontamination and sterilization of medical instruments in museums.

PMID- 1756403
TI  - Radioactive and radium sources in medical museums.

PMID- 1756404
TI  - The preservation and disposition of hazardous substances and controlled drugs in
      museum collections.

PMID- 1756405
TI  - Arsenic, old lace, and stuffed owls may be dangerous to your health:
      environmental concerns for museum personnel.

PMID- 1756406
TI  - [Evaluation of myocardial perfusion by planar scintigraphy at rest and in
      exertion using T1 201 and Tc 99m SestaMIBI, respectively].

PMID- 1756407
TI  - [Demonstration of the excitatory effect of the thalamo-subthalamic efferent from
      the parafascicular nucleus].
AB  - The synaptic effect of the projection from an intralaminar thalamic structure,
      the parafascicular nucleus, to the subthalamic nucleus was investigated through
      extracellular recordings of subthalamic unit activities. Electrical stimulation
      of the parafascicular nucleus caused a complex response with two successive
      excitatory phases. The first excitation was assumed to be monosynaptically driven
      since it was not affected by pallidal lesion or transsection of the internal
      capsule. Pharmacological activation of the parafascicular neurons through
      microinjections of carbachol elicited a prolonged increase in the subthalamic
      discharge rate. These results suggest that the intralaminar parafascicular
      nucleus contributes to the activation of subthalamic neurons.

PMID- 1756408
TI  - Expression of a gene encoding a novel potential IGF binding protein in human
      tissues.
AB  - We have shown in a previous study that the expression of an as yet unidentified,
      embryonic gene (nov) encoding a potential IGF binding protein was upregulated in
      all of eight virally-induced avian nephroblastomas tested. We now report that
      homologous sequences are conserved in human DNA and are expressed in normal human
      bone marrow, thymic cells and in one nephroblastoma.

PMID- 1756409
TI  - [Adaptative differential maturation of neurohypophyseal provasotocin in
      amphibians: presence of hydrin 2(vasotocinyl-glycine) in anura but not in
      urodela].
AB  - Occurrence of hydrin 2 (vasotocinyl-glycine), an intermediate in the provasotocin
      processing, has been shown in the neurointermediate lobe of the pituitary of semi
      aquatic or terrestrial amphibian species belonging to the order Anura, namely
      Rana esculenta, R. temporaria, R. pipiens (Ranidae), and Bufo bufo, B. marinus,
      B. ictericus (Bufonidae). In contrast hydrin 2 appears absent in species
      belonging to the order Urodela, namely the axolotl Ambystoma mexicanum
      (Ambystomidae) and the pleurodele newt, Pleurodela waltlii (Salamandridae).
      Whereas water transport through the skin and the urinary bladder is stimulated by
      vasotocin and hydrin 2 in anuran species, this stimulation is known not to occur
      in urodele species.

PMID- 1756410
TI  - [Biosynthesis of ecdysteroids by prothoracic glands in Pieris brassicae
      (Lepidoptera insect). Conversion in vitro of radiolabelled precursor of 3
      dehydroecdysone].
AB  - Ecdysteroids secreted by prothoracic glands of Pieris brassicae were measured by
      enzyme immunoassay, after HPLC separation. Both ecdysone and 3-dehydroecdysone,
      as a major product, are produced. Two radiolabelled putative precursors were
      converted by Pieris glands in vitro: [3H] ketodiol was converted into ecdysone at
      a low rate; [3H]3-oxoketodiol was efficiently converted, mainly into 3
      dehydroecdysone. These data make 3-oxoketodiol a good candidate for an
      intermediate in ecdysteroid biosynthetic pathway.

PMID- 1756411
TI  - [Obtention with polymerase chain reaction (PCR) of gene rbcL in the
      scrophulariaceae holoparasite Lathraea clandestina L. Comparison with autotroph
      Digitalis purpurea L. and Melampyrum pratense L].
AB  - Amyloplastid DNA was extracted from the Scrophulariaceae holoparasite Lathraea
      clandestina L. and then purified. An rbcL gene amplification was performed using
      polymerase chain reaction. Two regions of well conserved sequences in Tobacco,
      Spinach and Maize rbcL gene have been used as primers. PCR yields a sequence of
      about 1,230 base pairs, almost nine tenths of the rbcL coding region. Identical
      results were obtained with plastid DNAs from Tobacco and two other species of
      Scrophulariaceae: the non-parasitic Digitalis purpurea L. and the hemiparasite
      Melampyrum pratense L. PCR products were digested with BamHI restriction enzyme
      and no changes were shown in the localization of the restriction site whatever
      the species assayed. Identical restriction patterns were also observed with
      Tobacco and Digitalis PCR products restricted with PstI and KpnI, whereas
      Melampyrum and Lathraea exhibited a different restriction pattern with PstI. So,
      despite slight differences, some analogies between Lathraea and Digitalis or
      Tobacco gene were evidenced. Cloning and sequencing of these PCR products could
      give a more accurate response to the following question: to what extent have
      changes occurred in the rbcL gene in a plant which lacks chlorophyll?

PMID- 1756412
TI  - [Oral and parenteral immunization with HIV immunosome induce the secretion of IgA
      specific of HIV-1 in the salivary and the production of circulatory IgA in mice
      and rabbits].
AB  - Given the sexual transmission of HIV, the establishment of a genital mucosal
      immunity through secretory IgA may be necessary to achieve protection. We have
      investigated if repeated stimulations of oral mucosa with HIV-Immunosomes would
      lead to the production of secretory IgA in saliva and also, if such an oral
      immunization could prime the immune system to an early systemic immune response
      following a parenteral immunisation with a low dose of the antigen. HIV-1 gp 160
      specific secretory IgA were detected in the saliva of all rabbits orally
      immunized with HIV-Immunosomes. As early as one week after the parenteral
      immunization, high titers of serum IgA, IgM and IgG were detected both in mice
      and rabbits that had been orally stimulated with the antigen. These antibodies
      could neutralize HIV infectivity in vitro. Animals that were immunized only
      parenterally showed a very weak humoral immune response.

PMID- 1756413
TI  - A genetic response to high altitude hypoxia: high hemoglobin-oxygen affinity in
      chicken (Gallus gallus) from the Peruvian Andes.
AB  - A population of chicken (Gallus gallus) from the Peruvian Andes (4,000 m)
      carrying a high hemoglobin-oxygen affinity has been identified. This property
      remained stable after over 1 year residence at sea level and was transmitted to
      the descendants born at sea level. Chicken were introduced in South America
      during the Spanish conquest and therefore their adaptation time to high altitude
      is less than 500 years. This finding shows that a genotypic change in hemoglobin
      function can occur in an extremely short evolutionary time and leads to some
      reflections on the high altitude adaptation of the mammals that migrated to South
      America during the great Plio-Pleistocene interchange.

PMID- 1756414
TI  - [Fetal thymus and thymuline stimulate the in vitro proliferation of oogonia in
      the fetal rat ovary].
AB  - In rat ovaries explanted on day 13.5 p.c. and cultured in vitro for up to 6 days,
      the number of germ cells is enhanced in thymulin-supplemented medium and/or after
      co-culture of the ovarian explants with foetal thymic tissue compared to ovaries
      cultured in synthetic medium. Corticosterone added to the medium prevents the
      secretion of thymulin by the foetal thymus and in that condition the thymus does
      not influence the proliferation of oogonia. These results provide additional
      evidence that the pituitary-adrenal-thymic axis might be involved in the control
      of oogonia proliferation in vivo, taking into account our previous experimental
      finding that the number of germ cells is increased in ovaries of
      hypophysectomized foetuses.

PMID- 1756415
TI  - [Long ascending fibers in the dorsal column of a teleost fish: a disynaptic
      pathway connecting sense organs to cerebellum].
AB  - In spite of the generally accepted opinion that long ascending proprioceptive and
      tactile fibers do not occur in the spinal dorsal columns of teleost fish, it was
      demonstrated with degeneration and axonal transport tracing methods that such
      dorsal column fibers exist in the teleost fish Gnathonemus petersii. These fibers
      are in fact common spinal afferent fibers originating in spinal ganglion cells.
      They connect the peripheral sense organs with the lateral funicular nuclei (Fl2)
      in which the dorsal column fibers terminate, directly through the dorsal columns.
      In contrast to the dorsal column nuclei of higher vertebrates, the Fl2 nuclei do
      not project to the diencephalic thalamus but to the caudal lobe and the second
      lobe (C2) of the corpus cerebelli. Thus, sense organs and cerebellum are
      connected by a disynaptic pathway. Since the caudal lobe projects directly to the
      electrosensory lobe, that is, to the target of electrosensory afferents, the
      presence of a disynaptic pathway in G. petersii suggests the existence of a
      proprioceptive control of the electrosensory input.

PMID- 1756416
TI  - [Lateralization in cats in a pointing task of the anterior limb towards a moving
      target].
AB  - In a group of 44 cats overtrained on a task where they had to reach for a moving
      target, paw performance and paw preference were investigated. More than half of
      the cats (n = 23) were strongly lateralized in that they used one of their paws
      to perform more than 90% of the reaching attempts. Among these lateralized cats,
      left-pawed ones (n = 17) significantly exceeded right pawed-animals (n = 6).
      Investigating both the accuracy and speed scores, the comparison between
      lateralized and non-lateralized cats (using a criterion of 90% lateralization)
      showed that although the accuracy scores did not differ, lateralized cats were
      significantly quicker to trigger their movement. No difference was found
      concerning the movement time. For the whole group of 44 cats the comparison
      between the performance levels obtained with their two forepaws showed that the
      more frequently used paw was significantly more accurate and faster to trigger
      and to execute the movement than the less used paw. This study shows that, in
      pointing towards a moving target, cats display an asymmetry in paw preference
      that is associated with a performance asymmetry.

PMID- 1756417
TI  - Physician management of hyperlipidemia in Saskatchewan: temporal trends and the
      effect of a CME program.
AB  - OBJECTIVE: To assess current trends in the management of hyperlipidemia by
      Saskatchewan physicians, and to evaluate the effect of a specific continuing
      medical education (CME) program. DESIGN: Using a quasi-experimental design,
      physicians in an intervention area received the CME program while those in a
      comparison area did not. Management of hyperlipidemia was assessed before and
      after the program via a self-administered questionnaire. SETTING: All family
      physicians, general internists and cardiologists practising in the two areas were
      eligible. SUBJECTS: Of 439 eligible physicians, 308 (70%) completed the first
      survey, while 268 of 447 (60%) completed the second survey. Analysis was
      conducted on the 221 physicians who completed both surveys. INTERVENTION:
      Physicians in the intervention area received printed materials and attended a
      series of seminars between November 1988 and February 1989. Program content was
      based upon the recommendations of the Canadian Consensus Conference on
      Cholesterol (1988). MAIN RESULTS: Over the study period the mean level of serum
      cholesterol considered 'ideal' for a 40- to 60-year-old male decreased
      significantly from 5.43 to 5.03 mmol/L (P less than 0.001). The mean level at
      which diet therapy was begun decreased from 6.60 to 5.78 mmol/L (P less than
      0.001) with a significantly greater proportion of physicians in the intervention
      area (58.0%) than in the comparison area (43.2%) initiating therapy in the 5.2 to
      5.6 mmol/L range (P = 0.03). The mean level of serum cholesterol at which drug
      therapy is begun also decreased from 7.59 to 6.82 mmol/L (P less than 0.001),
      with a significantly greater proportion of physicians in the intervention (41.6%)
      than in the comparison area (25.0%) starting therapy in the 6.2 to 6.6 mmol/L
      range (P = 0.03). CONCLUSIONS: The management of hyperlipidemia reported by
      physicians in Saskatchewan changed dramatically between July 1988 and March 1989.
      The effect of the CME program is modest in comparison with this large temporal
      trend. The study provides further evidence that significant changes in the
      practice patterns of groups of physicians will only occur when the educational
      process is highly focused and personalized.

PMID- 1756418
TI  - Survey of cardiac pacing in Canada.
AB  - The status of cardiac pacing in Canada in 1989 was determined from data provided
      by 62 of 128 physicians surveyed (48% response) and four major
      manufacturer/distributors. A questionnaire designed for the IXth World Symposium
      on Cardiac Pacing was used. DEMOGRAPHICS: There were five implant hospitals per
      million population, 65% community based and 35% university affiliated; 63% of
      implanters were surgeons. There were 279 new implants and 46 replacement
      procedures per million population. INDICATIONS: Sinus node disorders accounted
      for 44.6% of implants, atrioventricular block 43.2% (fixed 24.4%, intermittent
      12.0%, incomplete 6.8%), tachycardias 2.9%, drug-induced bradycardia 3.1%, and
      other (including automatic implantable cardioverter defibrillators) 6.2%.
      TECHNOLOGY: Single chamber units were implanted in 78.6% of patients, and dual
      chamber in 22.7%, and 19.5% of the total were rate-adaptive. Unipolar leads were
      used in 57.1% of atrial and 53.2% of ventricular insertions; 40.4% of atrial and
      5.8% of ventricular leads were active fixation. The pervenous sheath introducer
      technique was used in 64.9% of lead insertions. PERIOPERATIVE: Major
      complications occurred in 2.6% of single and 6.8% of dual chamber primary
      implants, but mortality was less than 0.1%; 8.4% of replacements were
      unanticipated; there was no known death from malfunction. Mean hospital stay was
      2.7 days for primary implants and 1.4 days for replacement/revisions.
      CONCLUSIONS: Comparison with prior surveys (1979, 1981, 1985) reveals: increased
      physician response to the survey questionnaire; relatively stable
      electrocardiographic indications for implant; a modest increase of new implants
      per million; continued decrease in replacements; an increase in dual chamber and
      rate-adaptive pacing; and increased use of active fixation and bipolar electrodes
      in both atrium and ventricle.

PMID- 1756419
TI  - Preliminary experience at a Canadian centre with directional coronary atherectomy
      for complex lesions.
AB  - OBJECTIVE: To evaluate preliminary experience of directional coronary atherectomy
      for complex coronary artery lesions. DESIGN: Nonrandomized, sequential patients
      with coronary arterial lesions that were ostial, eccentric, bulky, recurrent or
      membranous. SETTING: Cardiac catheterization laboratory of a tertiary referral
      general hospital. PATIENTS: Twenty-three patients with angina pectoris refractory
      to medical therapy who were suitable candidates for coronary bypass surgery.
      INTERVENTIONS: Directional coronary atherectomy with associated balloon
      angioplasty, if required, to reduce lesion stenosis to less than 25%. MAIN
      RESULTS: Primary success was achieved in 29 of 33 lesions (88%) by atherectomy
      alone and in 31 of 33 lesions (94%) by additional use of balloon angioplasty.
      Atherectomy retrieved tissue in 30 of 33 attempts (91%). One patient suffered Q
      wave myocardial infarction; one had acute occlusion after atherectomy requiring
      emergency balloon angioplasty; and one required repair of a false aneurysm of the
      femoral artery. CONCLUSIONS: Directional coronary atherectomy is safe and
      efficacious for ostial, bulky and eccentric lesions not optimally suited to
      balloon angioplasty. Lesions which have tortuous segments immediately beyond,
      restricting movement of the stiff nose-cone, and which are membranous or
      bandlike, may not be indicated for directional coronary atherectomy.

PMID- 1756420
TI  - Long term efficacy of propafenone for prevention of atrial fibrillation.
AB  - OBJECTIVE: Propafenone, a class IC antiarrhythmic drug, has been successful in
      the treatment of ventricular and supraventricular arrhythmias. This study
      retrospectively evaluated the efficacy of propafenone in the prevention of
      recurrent atrial fibrillation. DESIGN: Propafenone was given to 81 patients (49
      males and 32 females, mean age 61 +/- 16 years) with recurrent atrial
      fibrillation. The mean dose of propafenone was 701 +/- 235 mg. Patients were
      monitored for recurrent arrhythmias. MAIN RESULTS: Long term follow-up over 30 +/
      1.7 months showed 31 patients (38%) remained on propafenone with complete or
      partial control of atrial fibrillation. The drug was stopped in 35 due to
      inefficacy, in 12 due to adverse effects, and in three due to desire for ablation
      therapy. CONCLUSION: Propafenone may be effective in some patients for long term
      prevention of atrial fibrillation, although efficacy may decrease over time.

PMID- 1756421
TI  - Perfusate calcium: effect on cardiac stability and response to ischemia and
      reperfusion.
AB  - OBJECTIVE: The aim of this study was to characterize the relationship of
      perfusate calcium concentration, contractile state and stability of the isolated
      crystalloid perfused working rat heart preparation, to ischemic duration and
      functional recovery, at a physiological perfusate calcium concentration. METHODS
      AND RESULTS: In the first protocol, hearts (n = 6 per group) were aerobically
      perfused for up to 300 mins with Krebs Henseleit solution containing calcium
      concentrations (total) of 1.0, 1.2, 1.4, 1.6, 1.8 and 2.5 mmol/L (equivalent to
      ionized concentrations of 0.76, 0.94, 1.15, 1.21, 1.58 and 2.25 mmol/L,
      respectively). After 120 mins, aortic flow decreased by less than 20% in all
      preparations except those perfused with 1.0 mmol/L, which fell by over 60%. For
      subsequent studies, a calcium concentration of 1.4 mmol/L (ionized calcium 1.15
      mmol/L, a value equivalent to plasma ionized calcium) was identified as ideal and
      shown to be associated with stable function and adequate inotropic reserve. The
      second protocol was as follows: In additional studies (n = 6 per group), the
      relationship between normothermic global ischemic duration (with or without
      cardioplegic arrest) and post ischemic functional recovery was characterized.
      Increasing the ischemic duration (10, 15, 20, 25, 30, 35 or 40 mins)
      progressively impaired recovery of aortic flow to 86.7 +/- 3.2%, 71.7 +/- 4.9%,
      27.7 +/- 5.0%, 14.5 +/- 12.3%, 0%, 0% and 0%, respectively, in the
      noncardioplegia group, and to 84.7 +/- 1.7%, 85.0 +/- 2.9%, 78.0 +/- 2.4%, 56.0
      +/- 7.8%, 32.2 +/- 6.0%, 6.5 +/- 3.7% and 0%, respectively, in the cardioplegia
      group. These results were similar to those of previous studies in which 2.5
      mmol/L calcium was used in the perfusate. CONCLUSIONS: Perfusion of isolated
      hearts with perfusate calcium concentrations up to 2.5 mmol/L (total) had no
      apparent detrimental effect on the stability of the preparation; however, a
      calcium concentration of 1.0 mmol/L resulted in a rapidly deteriorating
      preparation. In addition, under the conditions prevailing in the present study, a
      perfusate calcium content within the physiological range (1.4 mmol/L) appeared
      not to alter the vulnerability of the rat heart to injury during ischemia and
      reperfusion.

PMID- 1756422
TI  - Vasodilator therapy: interaction of nitrates with angiotensin-converting enzyme
      inhibitors.
AB  - Nitrates and other nitrosovasodilators are locally acting agents. Their efficacy
      is reported to depend upon the availability of sulfhydryl groups in vascular
      smooth muscle. Long term nitrosovasodilator therapy has limited effectiveness,
      and development of nitrate tolerance has been recognized to be due to exhaustion
      of the tissue sulfhydryl pool, in addition to vasodilation-induced reflex
      activation of the neurohumoral system. Under both experimental and clinical
      conditions it has been demonstrated that N-acetylcysteine and other exogenously
      introduced sulfhydryl donors potentiate hemodynamic responses to nitrates and
      reverse nitrate tolerance. The newer group of angiotensin-converting enzyme (ACE)
      inhibitor drugs has been reported to be effective in reducing afterload and
      preload in a variety of experimental and clinical trials. Captopril, the first
      developed ACE inhibitor, and its analogs contain sulfhydryl groups. Although the
      sulfhydryl group of captopril is not thought to be responsible for its
      vasodilator action, it can act as a sulfhydryl donor to promote nitrate
      effectiveness and prevent development of tolerance. Limited experimental and
      clinical trials on combined therapy with nitrates and captopril have produced
      promising results. An ingenious prototype compound, S-nitrosocaptopril, has
      recently been synthesized. This is an exciting new development in vasodilator
      therapy, but clinical application must await full experimental characterization
      of this and other identical compounds.

PMID- 1756423
TI  - Lung liquid production by in vitro lungs from fetal guinea pigs: studies with
      metabolic inhibitors.
AB  - Lungs from fetal guinea pigs (62 +/- 2 days of gestation) were supported in vitro
      for 3 h, and lung liquid production was measured by dye dilution. Eighteen
      untreated preparations produced fluid at 1.76 +/- 0.30 mL.kg-1 body weight.h-1
      during the first hour, with no significant changes in later hours. When
      inhibitors of respiratory processes were placed in the outer saline during the
      middle hour, production changed significantly, as follows: (a) sodium iodoacetate
      at 10(-3) M stopped production (87.2 +/- 10.3 and 100% reductions, successive
      hours; n = 6), at 10(-4) M it reduced production (60.0 +/- 10.3 and 63.4 +/- 9.3%
      reduction, successive hours; n = 12); (b) sodium fluoride, 10(-3) M, almost
      stopped production (93.2 +/- 12.1 and 89.5 +/- 9.3% reductions, successive hours;
      n = 6); (c) sodium cyanide at high concentration (10(-3) M) reduced production
      slowly (35.5 +/- 12.3 and 73.1 +/- 22.4%; successive hours; n = 6); (d) sodium
      azide, 10(-3) M, also reduced production (67.6 +/- 14.2 and 59.7 +/- 14.0%,
      successive hours; n = 6); total lactate lost rose 1.8 +/- 0.5 fold; (e)
      dinitrophenol produced strong reabsorptions; at 10(-3) M, production fell 115.4
      +/- 15.9 and 113.1 +/- 47.3%, successive hours (n = 4), and at 2 x 10(-4) M it
      fell 143.8 +/- 33.8 and 153.4 +/- 26.7%, successive hours (n = 6); total lactate
      lost rose 2- to 3-fold. Control preparations showed no significant changes. The
      results suggest that lung liquid production requires glycolysis and aerobic
      metabolism. However, reabsorption appears to continue on glycolysis alone, a
      particularly useful situation for neonates suffering respiratory distress.

PMID- 1756424
TI  - Force-interval relationship and its response to ryanodine in streptozotocin
      induced diabetic rats.
AB  - Post-quiescent potentiation (PQP), an enhanced contraction following a long pause
      that occurs as a result of increased Ca2+ release from intracellular stores, and
      post-stimulation potentiation (PSP), an enhanced contraction following a rapid
      series of contractions that is believed to be related to increased Ca2+ influx,
      were measured in streptozotocin-treated Wistar, spontaneously hypertensive (SHR),
      and Wistar-Kyoto (WKY) diabetic heart tissues. Decreased PQP values were found in
      Wistar and SHR diabetic papillary muscles (PM) in comparison with the same strain
      controls, which suggests a diminished degree of releasable Ca2+ from sarcoplasmic
      reticulum (SR) in these tissues. Decreased PSP was found in SHR diabetic PM,
      which may be related primarily to a depressed sarcolemmal (SL) Na(+)-Ca2+
      exchange in this tissue. PSP was not decreased in diabetic Wistar or WKY cardiac
      preparations, indicating that Ca2+ entry via channels must be involved in the PSP
      mechanism. Ryanodine depressed PQP in Wistar and SHR PM, and SHR left atria in
      both control and diabetic tissues. It abolished PQP and SHR diabetic tissues but
      had no effect on WKY control and diabetic tissues. The data suggest that the
      ryanodine effect differs in the various strains of rat. These differences may be
      due to differences in the SR sensitivity to ryanodine among the strains. Diabetic
      SR with impaired Ca2+ uptake may contribute to these phenomena. Ryanodine
      depressed PSP of Wistar and SHR diabetic PM but had no effects on tissues from
      controls. The influence of ryanodine on diabetic SL Na(+)-Ca2+ exchange requires
      further investigation.

PMID- 1756425
TI  - Pharmacokinetic-hemodynamic studies of the enantiomers of isoidide dinitrate in
      conscious rats.
AB  - Our objective was to determine the pharmacokinetic properties of the D- and L
      enantiomers of isoidide dinitrate (IIDN) in relation to their hemodynamic
      effects. Conscious male Sprague-Dawley rats were administered a bolus i.v. dose
      of 2 mg.kg-1 D- or IIDN and simultaneous blood samples and blood pressure
      recordings were taken at various times. The elimination half-life of D-IIDN was
      significantly shorter than that of L-IIDN (10 vs. 16 min) owing to a larger Vd
      area of the L-enantiomer (5.8 vs. 3.8 L.kg-1). The plasma clearance of either
      enantiomer was approximately 250 mL.min-1.kg-1, a value equal to plasma cardiac
      output. The pharmacokinetic data indicates that IIDN is distributed extensively
      and that significant extrahepatic biotransformation of the drug occurs. After
      intravenous administration of D-IIDN, there was an initial decrease in mean
      arterial pressure (MAP) of 29% compared with 15% for L-IIDN (p less than 0.05).
      For L-IIDN, the decrease in MAP was short lived (less than 2 min), while for D
      IIDN, MAP remained significantly decreased for up to 60 min. The oral
      bioavailability of both enantiomers was low (ca. 7%). However, decreases in MAP
      occurred after oral administration of D-IIDN, suggesting that the mononitrate
      metabolite of IIDN was pharmacologically active. We conclude that, despite a
      faster rate of elimination from the central compartment, D-IIDN exhibits a
      greater vasodilator effect in the intact animal compared to L-IIDN. This is
      consistent with previous observations of a 10-fold greater potency of D-IIDN for
      relaxation of isolated vascular smooth muscle.

PMID- 1756426
TI  - Effects of the antiandrogen hydroxyflutamide on progesterone secretion by
      preovulatory rat follicles in vivo and in vitro.
AB  - Serum and ovarian progesterone levels and in vitro production of progesterone by
      preovulatory follicles were measured on proestrus in pregnant mare's serum
      gonadotropin (PMSG) primed immature rats in which the luteinizing hormone (LH)
      surge and ovulation were blocked by administration of the antiandrogen
      hydroxyflutamide. Serum progesterone levels observed at 12:00 on proestrus were
      significantly elevated, twofold above those observed in vehicle-treated controls,
      by in vivo administration of 5 mg hydroxyflutamide 4 h earlier. In control rats,
      proestrous progesterone did not increase until 16:00, in parallel with rising LH
      levels of the LH surge. No LH surge occurred in the hydroxyflutamide-treated
      rats, ovulation was blocked, and serum progesterone declined throughout the
      afternoon of proestrus, from the elevated levels present at 12:00. Administration
      of human chorionic gonadotropin (hCG) at 11:00 advanced the elevation of serum
      progesterone by 2 h in vehicle-treated controls and prevented the decline in
      progesterone levels in hydroxyflutamide-treated rats. The patterns of change in
      ovarian tissue concentrations with time and treatment were essentially similar to
      those observed for serum progesterone. In in vitro experiments, progesterone
      secretion during 24 h culture of preovulatory follicles obtained on PMSG-induced
      proestrus was significantly increased, sixfold, by addition to the culture media
      of 370 microM but not of 37 microM hydroxyflutamide. Testosterone (50 nM) and hCG
      (20 mIU/mL) caused 26- and 14-fold increases, respectively, in progesterone
      secretion by cultured follicles. Hydroxyflutamide significantly reduced the
      stimulatory effect of testosterone but not of hCG on progesterone secretion in
      vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756427
TI  - Effect of low extracellular calcium and ryanodine on muscle contraction of the
      mouse during postnatal development.
AB  - We have examined the effects of low Ca2+ solutions, Co2+, and ryanodine on the
      isometric tension and contraction speed of isolated, developing mouse EDL
      muscles. Twitch responses of young muscles (7-14 days postnatal) were more
      sensitive to lowered [Ca2+]o than those of more fully developed muscles (22-35
      days postnatal). Responses of EDL muscles from a middle-aged group (15-21 days
      postnatal) were intermediate between the two other groups. Overall, the time
      course of contraction in a single twitch was accelerated by low [Ca2+]o. Ca(2+)
      free solution induced a 7.95 and 9.25 mV depolarization in young and "old" muscle
      fibres, respectively. The presence of cobalt ions (5 mM) in the Krebs solution
      had a similar effect as Ca(2+)-free Krebs in terms of reduction of the isometric
      twitch and tetanic tensions of EDL muscles from the various age groups. In
      contrast, the shortening of the contraction time seen with Ca(2+)-free solution
      did not take place following exposure to Co(2+)-containing solutions. Finally,
      young (7-14 days postnatal) muscles were less sensitive to the inhibitory action
      of ryanodine on the twitch compared with more fully developed muscles (22-35 days
      postnatal). Taken together, our results indicate that from birth to maturity,
      there is a gradual change in the spectrum of calcium utilization for the
      contractile process.

PMID- 1756428
TI  - Pattern- and age-dependency of the antiepileptic effects induced by valproic acid
      in the rat hippocampus.
AB  - The effects induced by the antiepileptic drug valproic acid were studied in the
      CA3 subfield of in vitro hippocampal slices obtained from young (16- to 27-day
      old) and adult (over 60-day-old) rats. Spontaneous epileptiform discharges were
      induced by the addition of the convulsant 4-aminopyridine to the medium. Valproic
      acid (0.5 mM) selectively blocked the ictal epileptiform discharges in slices
      obtained from young rats. Interictal epileptiform discharges disappeared during
      perfusion with higher doses of valproic acid (2 mM). This blockade of interictal
      epileptiform activity was not observed when valproic acid (0.5-5 mM) was tested
      in hippocampal slices from adult rats. Thus, in the hippocampus of young rats, 4
      aminopyridine-induced ictal activity is more sensitive to valproic acid than are
      interictal discharges. Moreover, valproic acid is effective in controlling
      interictal discharges in the young, but not in the adult rat hippocampus.

PMID- 1756429
TI  - Activation and function of prorenin: different viewpoints. Satellite symposium,
      13th scientific meeting of the International Society of Hypertension, Montreal,
      Canada, June 22, 1990.

PMID- 1756430
TI  - Activation and function of prorenin: different viewpoints.
AB  - This Symposium includes 15 presentations and an editorial review dealing with
      prorenin activation and function. It comes 20 years after prorenin was first
      reported in various contexts and attracted attention because of its connection
      with renin--angiotensin, its high concentration relative to renin in the blood,
      and its presence in extrarenal, as well as renal, tissues. Intriguing changes in
      plasma prorenin have been reported after treatment with antihypertensive and
      other drugs, following various physiological stimuli, and in pathophysiological
      states such as Wilms' tumor, Bartter's syndrome, and diabetic nephropathy.
      Lately, very high prorenin concentrations have been found in human and animal
      ocular fluid, ovarian follicular fluid, and in association with angiogenesis and
      microangiopathy. High circulating prorenin concentrations and fulminant
      hypertension have been reported in rats harbouring the mouse Ren-2 gene. However,
      what prorenin does in all these extrarenal fluids, tissues, and conditions is not
      well understood. Among the reasons for this lack of understanding are the
      difficulties in measuring prorenin and in establishing good animal models. We
      have not answered the critical question as to whether prorenin itself is
      bioactive like a hormone, and if so, what its action(s) might be. Nor have we
      established the main alternative, i.e., whether the function of prorenin is
      indirect, through renin--angiotensin, be it in the circulation or in the
      extrarenal tissues. This Symposium provides only partial methodological advances
      and answers, but we hope it will stimulate the breakthrough work needed to supply
      more complete answers.

PMID- 1756431
TI  - Trypsin activation of inactive renin: plasma blanks and angiotensin I
      radioimmunoassay.
AB  - Divergent conclusions exist as to whether inactive renin is present in
      nephrectomized rat plasma. A major factor contributing to this conflict may be
      related to significant changes in the "plasma blank" when trypsin-treated plasma
      is subjected to angiotensin I (AI) radioimmunoassay (RIA). In normal, but not
      nephrectomized rat plasma, AI-like substances are present in direct proportion to
      active renin. These substances are destroyed by trypsin. However, trypsin
      generates additional AI-like material, in both normal and nephrectomized rat
      plasma. This material, which is present in proportion to the renin substrate
      concentration, does not appear to be tetradecapeptide (TDP). In normal plasma,
      however, exogenous TDP is converted to AI in proportion to the active renin
      concentration and AI generation from TDP is increased by activation of inactive
      renin. However, in nephrectomized rat plasma, no AI generation from TDP was
      evident either before or after trypsin treatment. The coincident tryptic
      generation of a substance that quenches the levels of AI detected by RIA,
      combined with significant changes in the levels of endogenous and trypsin
      generated AI-like substances, may have significant bearing on the measured levels
      of inactive renin.

PMID- 1756432
TI  - Plasma active and inactive renin and fetal complications in women with high risk
      pregnancies.
AB  - To examine whether the activation of the renin system, which occurs during
      pregnancy, may be relevant for the development and the outcome of the fetus, we
      measured active and inactive renin throughout gestation in 29 women having a
      pregnancy defined as "high risk" because of a clinical history of hypertension,
      nephropathy, and unexplained abortions. In 23 of these women who delivered full
      term infants with normal weight and status, we found that active renin increased
      progressively from early pregnancy until the end of the second trimester and then
      declined slightly thereafter. In contrast, in the remaining six women who had
      fetal complications consisting of either signs of distress requiring cesarean
      section or growth retardation, the increase in active renin failed to occur. In
      all women the levels of inactive renin were more elevated throughout gestation
      than those observed in nonpregnant women, and were higher, although not
      significantly, in women without fetal complications than in those with fetal
      complications. Thus, a blunted activation of the renin system during pregnancy is
      associated with alteration in fetal development and may possibly contribute to
      it.

PMID- 1756433
TI  - Observations on the renal processing and sorting of prorenin.
AB  - Human prorenin is the biosynthetic precursor of renin. In general, prorenin is
      enzymatically inactive until it is converted to renin. The kidney is the major
      source of renin in the circulation, and is also an important source of
      circulating prorenin. The mechanisms of prorenin sorting and processing to renin
      in the juxtaglomerular cell may be a determinant of renal renin production.
      Therefore, our studies have focused on renal enzymes involved in "limited
      proteolysis" of prorenin to renin and on the morphology of prorenin sorting in
      the human juxtaglomerular cell.

PMID- 1756434
TI  - Activation and measurement of plasma prorenin in the rat.
AB  - Prorenin determination in rat plasma has been problematic from the outset.
      Consequently, its existence is questioned by some and its quantity by others,
      making it difficult for knowledge to advance as to its function relative to the
      renin system. The present study examines major variables in the determination of
      rat plasma prorenin and renin, notably different prorenin activation protocols
      involving blood samples obtained under various conditions from animals under
      different anesthetics. We found that a trypsin activation step with 5 mg/mL
      plasma, 60 min at 23 degrees C, followed by a PRA step of 10 min at 37 degrees C,
      resulted in the highest prorenin estimates, up to approximately 400 ng.mL-1.h-1
      in terms of angiotensin I, as compared with published values of 0-190, based on
      other protocols. These estimates were obtained despite considerable destruction
      of angiotensinogen (renin substrate) by trypsin. Cryoactivation of prorenin was
      much less effective than in human plasma but, when followed by trypsin, it
      facilitated greater activation than with trypsin alone. Comparable fresh and
      fresh-frozen plasmas had similar prorenin-renin values, but lower values were
      observed in plasmas that had been repeatedly frozen and thawed. Conscious rats
      and those anesthetized with Inactin or ether had higher renins and prorenins than
      those anesthetized with methoxyflurane or halothane. Rats with kidneys in place
      during blood collection had higher renins (but not prorenins) than those whose
      kidneys were clamped off, suggesting that last-minute renin release during blood
      collection had occurred. We conclude that (i) trypsin generates increased renin,
      or renin-like, activity in plasma, suggesting activation of a precursor; (ii) on
      this basis, high prorenin levels exist in normal rat plasma; (iii) renin and
      prorenin levels are variously influenced by different anesthetics and blood
      handling procedures; (iv) variation in prorenin levels suggests that it is a
      dynamic (functional?) component of the renin system; (v) prorenin measurements
      are heavily influenced by methodological variations during the trypsin step or
      the subsequent PRA step; (vi) using standardized methodology, the rat can serve
      as a model for investigating the function of prorenin in normotension and
      hypertension.

PMID- 1756435
TI  - Investigation of human and rat inactive renin in plasma and kidney.
AB  - Under an initial interval of immobilization stress in rats, reciprocal changes of
      plasma active and inactive renin were observed, suggesting activation of
      circulating inactive renin. Molecular weight (MW) studies revealed that this
      activation might proceed via a MW shift from inactive renin with MW of 50,000 to
      active renin of MW 43,000. In a later interval of stress, under stimulated renin
      secretion, a lower MW form (38,000) of active renin was released into the
      circulation. This MW is close to that of active renin (39,000) found in rat
      kidney renin granules. In renin granules, equilibrated in fractions of 1.6 and
      1.7 mol/L sucrose in discontinuous density gradient, trypsin-activatable renin
      activity formed 36 and 16% of total activity, respectively. In humans, under
      acute bicycle exercise, a lower MW form (39,000) of active renin was released
      into the circulation, while the content of inactive renin with MW in the range of
      51,000-58,000 and at 47,000 did not substantially change. There was a slight
      decrease in circulating inactive renin passing through the kidney. The data
      suggest that, at least in rats, in vivo pathways for activation of inactive renin
      might exist, other than that proceeding before secretion from renin granules.
      Under the conditions of increased renin secretion, a lower MW form of active
      renin is mainly released into the circulation in both rats and humans.

PMID- 1756436
TI  - Biochemical and immunological differences between plasma inactive renin from
      normal and nephrectomized rats.
AB  - Using immunological techniques, we have demonstrated that about half the trypsin
      activatable renin in normal rat plasma is prorenin, while the other is not, and
      that inactive renin in nephrectomized rat plasma is not prorenin. In the present
      study, the trypsin-induced angiotensin I generating activity not related to
      prorenin from normal rat plasma disappeared after HPLC on G3000SW. HPLC analysis
      of trypsin-treated plasma showed the generation of active renin by trypsin for
      normal rat plasma, while it did not for nephrectomized rat plasma. These results
      indicate that trypsin treatment of crude plasma results in the generation of
      angiotensin I generating activity not due to prorenin, as well as activation of
      prorenin. HPLC on G3000SW is a useful tool for the determination of plasma
      prorenin.

PMID- 1756437
TI  - Effect of prostaglandin inhibition by indomethacin on plasma active and inactive
      renin concentration in men.
AB  - The effect of inhibition of prostaglandin synthesis by indomethacin on active
      renin and on acid-activable inactive renin was studied in nine healthy, sodium
      replete men, both at rest and exercise. These volunteers were investigated after
      pretreatment with placebo or indomethacin, 150 mg daily for 3 days. Indomethacin
      induced a decrease in active (p = 0.004), total (p less than 0.001), and inactive
      (p = 0.02) renin at rest recumbent on average by 42, 19, and 8%, respectively,
      and at rest sitting on average by 45, 15, and 3%, respectively. Inhibition of
      prostaglandins with indomethacin reduced (p less than 0.001) active and total
      renin at each level of work load but not (p = 0.32) inactive renin. However, the
      exercise-induced stimulation (p less than 0.05) of active and total renin still
      occur during indomethacin. Indomethacin reduced (p less than 0.001) at rest
      sitting and at maximal exercise the plasma concentrations of immunoreactive
      prostaglandins E2 by 50 and 54%, respectively, prostaglandin F2 alpha by 36 and
      39%, respectively, and 13,14-dihydro-15-keto-prostaglandin F alpha by 38 and 60%,
      respectively. The urinary excretion of immunoreactive prostaglandin E2 and F2
      alpha was also reduced.

PMID- 1756438
TI  - Does heparin inhibit renin activity?
AB  - Although heparin was reported in the 1960s to inhibit renin activity, this has
      not always been confirmed by other investigators. Hence, we re-examined whether
      heparin really inhibits renin or not. Renin activities were determined by
      radioimmunoassay of angiotensin I generated at pH 7.4. (i) No significant
      difference was found between the two kinds of plasma samples obtained with
      heparin and with EDTA as anticoagulant, in ARC (renin activity with addition of
      sheep renin substrate), TRC (ARC after activation of inactive renin by trypsin),
      or PRA (plasma renin activity without additional substrate). (ii) Even in higher
      concentrations of heparin up to 500 U/mL, neither PRA, ARC, nor TRC of plasma was
      affected significantly. (iii) Heparin, in concentrations up to 500 U/mL, exerted
      no significant effect on TRC of the media of human vascular smooth muscle cell
      culture. In conclusion, heparin does not exert any significant inhibitory effect
      on human renin nor does it affect activation of inactive renin by trypsin in the
      range of concentration of practical use, under the conditions employed in this
      study.

PMID- 1756439
TI  - Consistent activation of prorenin mRNA in renal hypertensive rats.
AB  - To investigate the mechanism of maintaining hypertension in chronic two-kidney,
      one-clip (2K1C) rats, we studied the expression of the kidney renin gene. Total
      cellular RNA was extracted by the guanidine thiocyanate--CsCl method. Kidney
      renin messenger RNA was quantified by densitometric Northern blot analysis using
      32P-labeled rat renin genomic DNA as a hybridization probe. Sixteen weeks after
      clipping, plasma renin concentration and plasma angiotensin II concentration did
      not differ between 2K1C and sham-operated rats (plasma renin activity, sham rats
      16.2 +/- 4.2 vs. 2K1C rats 8.9 +/- 1.3 ng angiotensin I.mL-1.h-1; plasma
      angiotensin II, sham rats 14.7 +/- 7.5 vs. 2K1C rats 6.8 +/- 1.3 pg/mL), while
      plasma angiotensin concentration in 2K1C rats was higher than that of sham rats
      (p less than 0.05). Renin gene expression in the ischemic kidney was 2.2 times
      higher than that in the kidney of sham-operated rats (p less than 0.05), and
      decreased to 80% of those in the kidneys of sham-operated rats. These results
      suggest that overexpression of the kidney renin gene in the chronic phases of
      2K1C rats may contribute to the sustained high blood pressure, and the kidney
      renin gene may be inhibited by posttranscriptional factors, i.e., suppressed
      activation of prorenin to renin.

PMID- 1756440
TI  - Prorenin and gene activation.
AB  - After the discovery of an inactive, putative renin precursor that could be
      proteolytically activated, and the proteases involved in vivo, Morris and co
      workers directly demonstrated that renin is indeed synthesized as a "pro" form,
      and from genetic coding sequences they provided the structure of human prorenin.
      The gene is inactive and must be activated in prorenin-synthesizing tissues. To
      study the mechanism involved, we have performed transient expression analyses of
      putative regulatory DNA of the human gene (REN). 5'-Flanking DNA, extending from
      residue -144 to -2400, was linked to a reporter gene, viz. that for
      chloramphenicol acetyl transferase (CAT), and its ability to drive a heterologous
      (thymidine kinase, tk) promoter was examined by transfecting plasmid constructs
      into cells in culture and measuring CAT activity 48 h later. Because suitable
      renin-synthesizing cells were not available, choriocarcinoma (JEG-3) and cervical
      carcinoma (HeLa) cells were used. Although this DNA caused a reduction in CAT
      activity relative to the positive control, examination of a range of subfragments
      suggested that the -2400 to -144 region did not contain negative regulatory
      elements. In contrast, all fragments containing the -149 to +13 DNA segment gave
      CAT activities that were lower than the promoterless control. Together, the data
      were consistent with the presence of negative regulatory element(s) in that
      fragment of DNA that contained the REN promoter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756441
TI  - Plasma active and acid-activatable renin during the development of one-kidney,
      one-clip and two-kidney, one-clip hypertension in the rabbit.
AB  - Systolic blood pressure in the central ear artery of eight rabbits increased by
      21 mmHg (1 mmHg = 133.32 Pa) over 40 days following renal artery clipping and
      contralateral nephrectomy (one-kidney, one-clip). Plasma active and acid
      activatable (pH 2.8) renin did not change significantly. Similar data were
      obtained from a group of 12 rabbits following renal artery clipping alone (two
      kidney, one-clip) except that blood pressure in this group increased for 26 days
      but then declined until 40 days. Two animals with one-kidney, one-clip
      hypertension and three rabbits with two-kidney, one-clip hypertension had large
      increases in plasma active and inactive renin levels, which followed a more
      exaggerated rise in blood pressure than in the previous two groups. Forty days
      after unilateral renal artery clipping, the unclipped kidney was removed in 10
      animals with two-kidney, one-clip hypertension. A further increase in blood
      pressure (+29%) occurred in seven of the animals but no change in plasma active
      or inactive renin. Results were compared with two groups of control animals, a
      unilateral nephrectomy group and a laparotomy group. None of the surgical
      procedures used produced a consistent pattern of change in the relative amounts
      of active and inactive renin in plasma. No marked changes in sodium, potassium,
      or water balance occurred in any group of animals.

PMID- 1756442
TI  - Measurement of inactive renin in normal, nephrectomized, and adrenalectomized
      rats.
AB  - In a new method for measurement of inactive rat plasma renin, the trypsin
      generated angiotensin I immunoreactive material, which was HPLC characterized as
      similar to tetradecapeptide renin substrate, is removed by a cation exchange
      resin before the renin incubation step. The method also corrects for trypsin
      destruction of endogenous angiotensinogen by the addition of exogenous
      angiotensinogen. When measured with this method inactive renin in rat plasma
      decreased after nephrectomy and increased after adrenalectomy. This is in
      accordance with findings in humans. A sexual dimorphism of prorenin (inactive
      renin) in rat plasma, similar to that reported in humans and mice, was
      demonstrated. Thus, inactive renin in the rat is no exception among species, and
      the rat might be a suitable animal model for further studies dealing with the
      physiology of prorenin in plasma and tissues.

PMID- 1756444
TI  - Active and inactive renin in human forearm of hypertensive patients.
AB  - Although many in vitro and animal studies indicate the existence of a local renin
      -angiotensin system, data regarding its physiological role are quite
      controversial, and moreover, evidence suggesting inactive and active renin
      release from vascular tissue in vivo is lacking both in animal and humans. The
      aim of our study was to evaluate whether beta-adrenoceptor stimulation, a well
      known stimulus to renin production, through isoproterenol might cause local renin
      production from vessels of the forearm of hypertensive patients. Drugs were
      infused into the brachial artery at systemically ineffective rates, while forearm
      blood flow (FBF, venous plethysmography), mean intra-arterial pressure, and heart
      rate were monitored throughout. Active and inactive vessel renin production was
      measured by calculating venous-arterial (V-A) differences by simultaneous
      sampling from brachial artery and an ipsilateral deep vein. Active renin (PRA)
      and total renin (Sepharose bound trypsin activation) were measured by
      radioimmunoassay while inactive renin was calculated as the difference between
      total and active renin. V-A differences were corrected for FBF to calculate renin
      extraction or production. In a group of 10 patients, isoproterenol, which was
      infused at increasing cumulative rates (0.03, 0.1, 0.3 micrograms.100 mL-1
      forearm tissue.min-1 for 5 min each), caused a dose-dependent increment in FBF
      that was blunted by intra-arterial propranolol (n = 5) pretreatment (10
      micrograms.100 mL-1 forearm tissue.min-1 for 10 min). beta-Adrenoceptor
      stimulation caused a dose-dependent outflow of both active and inactive renin, an
      effect antagonized by propranolol. In conclusion, our data represent the first
      evidence in humans of tissue active and inactive renin production in the forearm
      vascular bed.

PMID- 1756443
TI  - Trypsin activation of human and cat prorenin: a comparative study.
AB  - Prorenin can be converted to renin by limited proteolysis with trypsin. In the
      current study we compared conditions for activation of human renal and ovarian
      prorenin and cat renal prorenin with either liquid-phase trypsin or trypsin bound
      to sepharose (solid phase). Higher concentrations of trypsin were required to
      activate cat prorenin than human prorenin. Human prorenin was destroyed by high
      concentrations of trypsin, while cat prorenin was not destroyed by up to 2 mg/mL
      solid-phase trypsin. For both human and cat prorenin, addition of the competitive
      serine protease inhibitor benzamidine--HCl increased the concentration of trypsin
      needed to activate prorenin, resulting in slightly higher levels of human
      prorenin but lower levels of cat prorenin. For human samples, activation with
      solid-phase trypsin resulted in slightly higher estimates of prorenin than liquid
      phase trypsin. These results demonstrate species differences in the
      susceptibility of prorenin to trypsin cleavage. Cat prorenin requires more
      trypsin to be activated and is less susceptible to destruction than human
      prorenin.

PMID- 1756445
TI  - Prorenin is present in human red blood cells.
AB  - We looked for the presence of prorenin in erythrocytes from normal subjects (n =
      8), hypertensive patients (n = 8), and pregnant women (n = 8). Angiotensin I
      generation was measured at 37 degrees C, pH 5.7, in the presence of homologous
      substrate (1400 ng/mL) before and after trypsin activation (100 micrograms/mL) in
      (A) haemolyzed erythrocytes, (B) supernatants of haemolyzed erythrocytes, and (C)
      in the sixth washing of erythrocytes diluted 1:1 with a 0.1 M Tris buffer
      containing 0.5% bovine serum albumin and protease inhibitors. Haemolyzed
      erythrocytes generated angiotensin I only after trypsin treatment, and the rate
      of generation was the same (A) before and (B) after centrifugation at 20,000g,
      indicating the absence of prorenin bound to the cell membranes. When aliquots of
      the last washing of erythrocytes (C) were tested for angiotensin I generation
      before and after trypsin, they did not generate angiotensin I, indicating that
      residual prorenin from the plasma was no longer present in our preparation.
      Angiotensin I generation by trypsin-treated A and B was completely abolished by
      preincubation with anti-renin serum. The level of prorenin was not significantly
      different in the erythrocytes from normal, hypertensive, and pregnant subjects
      (68 +/- 10, 58 +/- 7 and 107 +/- 17 pg angiotensin I.mL-1.h-1, ns) in spite of
      their very different plasma levels (21 +/- 2.5, 17 +/- 2.4 and 110 +/- 12 ng
      angiotensin I.mL-1.h-1, p less than 0.01 for pregnant women compared with both
      normal and hypertensive subjects). Our data show that prorenin is present in
      human erythrocytes in fairly constant and clearly detectable amounts, thus
      suggesting a possible intracellular role for it.

PMID- 1756446
TI  - Animating the 3D structure and function of brain.
AB  - Three dimensional (3D) reconstructions of brain anatomy and physiology have
      greatly improved our understanding of complex spatial and densitometric
      relationships. The complexity and sophistication of these imaging techniques has
      steadily improved in the last few years and there are many situations in which
      the static display of 3D models contains more information than can be easily
      appreciated. Animating a sequence of these displays adds another dimension to the
      visualization, understanding and communication of 3D data. This paper describes
      those situations that warrant animations, the techniques necessary to compute
      them and the results that can be obtained.

PMID- 1756447
TI  - A densitometric method for quantitative analysis of the left ventricle
      performance using i.v. digital subtraction angiography.
AB  - In this paper we present a method we used to provide quantitative description of
      the systolic and diastolic temporal function of the left ventricle (LV).
      Additional parameters, such as peak filling and ejection rates, times to end
      systole and end diastole, and temporal changes in slow and fast filling are
      obtained. The volumes associated with these parameters are also calculated.
      Correlation between LV volume changes during the cardiac style and corresponding
      "density" variations was confirmed. Time-density curves were obtained from
      selected cardiac cycles in each study. We used the polynomial fitting technique
      to fit the time density curves and developed a computer algorithm for deriving
      the relevant parameters. Data from a total of 18 patients with ischemic heart or
      valvular diseases, who underwent I.V. ventriculography was analysed using our
      method. Some of these patients were forwarded for repeated digital subtraction
      angiography (DSA) examination before and after intervention therapy to evaluate
      the effectiveness of treatment. In comparison to the geometric method for the
      analysis of LV performance, our method is generally faster and simpler to employ.
      The method was effective in detecting variations in the peak ejection and filling
      rates in our group of patients before and after interventional therapy.

PMID- 1756448
TI  - Assessment of 99mTc-HM-PAO parameters with SPECT for improved evaluation of blood
      flow in cerebral lesions.
AB  - A method for investigating the linearity between blood flow and distribution of
      99mTc-HM-PAO uptake in patients undergoing single photon emission computed
      tomography (SPECT) is presented. This method, based on particular elaboration
      techniques of sequential multiple acquisitions, provides a local index:
      cumulative transit time (CTT) related to all factors, other than blood flow,
      affecting 99mTc-HM-PAO uptake. Because a correct qualitative blood flow
      estimation is based on the uniformity of the above factors, the occurrence of a
      change of this index indicates a nonlinear relation between blood flow and 99mTc
      HM-PAO uptake distributions. It was shown that although linearity between blood
      flow and 99mTc-HM-PAO uptake may be questionable, a qualitative assessment of
      blood flow was correct in 100% of ischemic patients. In nonischemic patients this
      percentage fell to 60%.

PMID- 1756449
TI  - Multi-modality image combination: five techniques for simultaneous MR-SPECT
      display.
AB  - Increasingly, images are being acquired of the same patient using two or more
      diagnostic imaging modalities. If one such modality is MRI then a data set
      showing essentially anatomical information is produced. If the second is SPECT
      using HMPAO then a data set showing cerebral perfusion is also produced. The
      ability to conjoin such anatomical and functional data is an important goal in
      radiology. In this technical report five display strategies are investigated as a
      means of conveying simultaneously to the radiologist all the information from two
      such data sets. Illustrative examples are given for each display technique.
      Preliminary observations are made regarding comprehensibility, information loss
      and efficiency in conveying all the information simultaneously, for all five
      techniques.

PMID- 1756450
TI  - Thymic cyst secondary to cervical irradiation: a complication of treated
      laryngeal cancer.
AB  - This report demonstrates a thymic cyst arising in association with cervical
      irradiation for laryngeal carcinoma; a process not previously described. Thymic
      cysts are rare anterior mediastinal masses which have many etiologies, though an
      increased incidence of thymic cysts in association with Hodgkin's disease has
      been reported. This association was thought to be related to either mediastinal
      irradiation or cystic changes within a thymic focus of Hodgkin's disease. This
      case supports the theory that at least some thymic cysts arise secondary to
      irradiation.

PMID- 1756451
TI  - The MR equivalents of cerebral hemispheric disconnection: a telencephalic
      commissuropathy.
AB  - Since the original observations of cerebral disconnection in experimental
      conditions with animal models, the surgical division of the cerebral commissures
      for control of seizure activity has led to the description of a human hemispheric
      disconnection syndrome. More recently, MR has revealed a spectrum of conditions
      of the forebrain responsible for the natural development and acquired occurrence
      of this unique commissural syndrome. Acutely, nonspecific expressions of
      disconnection may be observed; however, there are no explicit behavioral
      manifestations of this syndrome in the chronic state. The signs of stabilized
      hemispheric disconnection are only elicitable via sophisticated,
      neuropsychological testing performed by experienced technicians. Included in the
      present series of callosal pathology were individuals with agenesis, surgical
      section, infarction, trauma, glioma, and Marchiafava-Bignami disease. On
      specialized examination, the surgical "split-brain" patients illustrated the
      classic syndrome of a halt of interhemispheric transfer of information, a block
      of nondominant hemisphere access to language functions and an inhibition of
      dominant hemisphere access to superior visuospatial capacity. The nonsurgical
      subjects with developmental callosal agenesis and acquired pathologic processes
      involving the callosum revealed a varied, nonspecific reduction in cognitive
      function most probably related to associated extracallosal hemispheric pathology.
      No external abnormalities in behavior which could be attributed specifically to
      the callosal findings were identified chronically, although some progressive
      diseases suggested the presence of a subacute symptomatic phase of the
      disconnection syndrome. Any condition which causes the division, destructive
      insult, or primary ontogenic nondecussation of commissural axons will produce an
      interference in interhemispheric, interneuronal communication. This is manifested
      by individual degrees of covert interhemispheric data transfer arrest and of
      reduced bidirectional dominant-nondominant hemispheric access and telencephalic
      integrative capacity, consistent with a cerebral commissuropathy. This study
      reveals the MR equivalents of the hemispheric disconnection syndrome which occur
      in many nonspecific pathologic conditions of the cerebrum, but which result in
      few if any overt behavioral aberrations in the stabilized state.

PMID- 1756452
TI  - MR of hemorrhagic acoustic neuromas.
AB  - The magnetic resonance (MR) appearance of hemorrhagic acoustic neuromas has not
      previously been reported. Four patients with surgically proven acoustic neuromas
      containing spontaneous hemorrhage were preoperatively evaluated with MR imaging.
      All patients presented with new onset of symptoms and three had subarachnoid
      hemorrhage. Signal changes on T1- and T2-weighted spin echo sequences were
      characteristic for acute, subacute and chronic intraparenchymal hemorrhage.
      Recognition of hemorrhagic changes on MR is important since more rapid surgical
      intervention is required in this patient subgroup.

PMID- 1756453
TI  - Increased signal intensity of T1-weighted MR image of physiologic intracranial
      calcifications.
AB  - Among 1500 MR studies of the brain, performed during 1 year, there were six cases
      of physiologic calcifications (four in the falx cerebri, two in the deep gray
      matter) that revealed high signal intensity on T1- and variable signal on T2
      weighted images. This phenomenon should be recognized and not confused with
      entities of clinical significance especially hemorrhage.

PMID- 1756454
TI  - Computerized tomographic findings in two cases of congenital fibrosis syndrome.
AB  - Two patients with congenital ptosis and extraocular muscle fibrosis are
      described. The first patient showed marked atrophy of the left inferior rectus
      muscle. The second patient showed bilateral changes in all extraocular muscles.
      Computed tomographic evaluation of the extraocular muscles was performed in both
      patients. The characteristic changes of this phenomenon were seen in both
      individuals and solidified the diagnosis.

PMID- 1756455
TI  - Computed tomography of odontogenic keratocysts.
AB  - Epithelium-lined cysts of the jaw can be either odontogenic or non-odontogenic.
      Cysts that exhibit keratinization of their epithelial lining are called
      odontogenic keratocysts. They compose approximately 8% of all odontogenic cysts.
      There is a frequent association with unerrupted teeth, and a high incidence of
      occurrence of keratocysts in the multiple basal cell nevus syndrome. The
      significance of odontogenic keratocysts is their high potential for recurrence
      after their removal. There is no specific radiographic feature, however, that
      distinguishes them from non-keratinized odontogenic cysts. High resolution
      computed tomography (CT) studies can exquisitely determine the extent of these
      lesions and pinpoint areas of cortical breakthrough as well as involvement of the
      teeth. This information is invaluable in surgical planning for excision of these
      lesions.

PMID- 1756456
TI  - Abdominal computed tomography in lupus mesenteric arteritis.
AB  - We report the abdominal computed tomography (CT) findings in a patient with
      systemic lupus erythematosus who developed signs of an acute abdomen secondary to
      mesenteric arteritis. Initial CT scan demonstrated ascites and wall thickening of
      the duodenum and jejunum. After treatment with high dose intravenous steroids,
      follow-up CT scan demonstrated a normal duodenum and small bowel. This is the
      first surgically proven case of lupus mesenteric arteritis resulting in bowel
      ischemia that is demonstrated on CT before and after medical therapy. Lupus
      mesenteric arteritis should be included in the differential diagnosis of causes
      of bowel wall thickening and ischemia, especially if mesenteric vessels appear
      prominent.

PMID- 1756457
TI  - Pathologic vertebral compression in spinal malignancy secondary to intervertebral
      disk expansion.
AB  - A retrospective analysis of the MR appearance of the intervertebral disks in 17
      patients with spinal malignancy was performed. Disk expansion, related to
      neoplastic structural weakening of the bone in the face of unaltered disk
      biomechanics, was present in 20% of all visualized disks in association with a
      77% incidence of malignant involvement of the vertebral bodies studied. This
      compared with a frequency in benign disk expansion (i.e., osteoporosis) of 2% in
      the age-matched, but randomly selected, control group. On careful review, there
      was no strict correlation between disk expansion and patient symptoms. Although
      this finding may be seen in non-neoplastic conditions, it is felt that the higher
      incidence of disk expansion associated with osseous vertebral malignancy
      nevertheless reflects the underlying gravity of the pathologic changes
      accompanying neoplasia.

PMID- 1756458
TI  - The cytogenetics of ataxia telangiectasia.
AB  - Ataxia-telangiectasia (AT) is a heterogeneous autosomal recessive disorder marked
      by cerebellar ataxia, oculocutaneous telangiectases, hypersensitivity to ionizing
      radiation, immunodeficiency, and cancer susceptibility. AT is also a spontaneous
      chromosomal breakage syndrome, notable for tissue-specific cytogenetic changes
      and telomeric fusions. Molecular characterization of rearrangements specific to T
      lymphocytes suggests that a DNA repair/processing defect is potentially
      responsible for the diverse array of chromosomal abnormalities observed in a
      variety of AT cell types.

PMID- 1756459
TI  - Fragile 3p14 in patients with von Hippel-Lindau syndrome compared to controls.
AB  - Lymphocytes from a series of ten patients with von Hippel-Lindau syndrome have
      been cultured under conditions designed to demonstrate the presence of fragile
      sites. Compared to a series of controls the subjects with von Hippel-Lindau
      syndrome show a small but significant increase in the level of FRA3B.

PMID- 1756460
TI  - Chromosome abnormalities of porokeratosis-cultured epidermal keratinocytes.
      Comparison with those of cultured dermal fibroblasts.
AB  - Cultured epidermal keratinocytes and dermal fibroblasts derived from
      porokeratosis (PK) patients' skin lesions or normal-appearing skin had numerical
      and sometimes structural chromosomal abnormalities. Such abnormal cells were seen
      in 4.08% and 0.375% of all the studied epidermal keratinocytes derived from
      affected skin and normal-appearing skin, respectively. Similar abnormalities were
      present in 1.70% and 3.67% of the dermal fibroblasts from the patients' affected
      skin and normal-appearing skin, respectively. Chromosomal abnormalities were more
      frequent in keratinocytes and fibroblasts from the patients' skin than in
      keratinocytes (0.429%) or in fibroblasts (1.22%) derived from normal control
      donors. Clonal proliferation of such abnormal cells was frequently seen in
      keratinocytes from the patients' affected skin. The frequent appearance of
      chromosomal abnormalities and clonal proliferation in epidermal keratinocytes may
      explain skin lesion formation and skin cancer development in PK patients.

PMID- 1756461
TI  - Translocation (4;14) and concomitant inv(14) in a basal cell carcinoma.
AB  - Chromosome analysis of short-term cultures from a basal cell carcinoma was
      performed. The analyzed karyotypes showed a pseudodiploid clone characterized by
      a der(4)t(4;14) (p14;p11) and a concomitant inversion of the same chromosome 4
      involved in the t(4;14) with the breakpoints at p14 and q25.

PMID- 1756462
TI  - Cytogenetic analysis of head and neck carcinomas.
AB  - Ten primary squamous cell carcinomas (SCC) of the head and neck were evaluated
      cytogenetically after 10-14 days of in vitro culture. Addition of 3% L-glutamine
      was essential for consistent epithelial growth of these carcinomas. Outgrowth of
      cells from tissue explants contained a mixture of chromosomally normal and
      abnormal cells; the abnormal cells had extensive changes including
      translocations, marker chromosomes, inversions, deletions, and duplications. In
      addition, all carcinomas contained cells with pulverization and double minute
      chromosomes (dmin). Chromosomes 11, 13, and 14 had "hotspots" of rearrangements.

PMID- 1756463
TI  - Pure red cell aplasia in a case of Ph negative BCR/ABL rearranged CML with
      t(12;14)(q23;p11).
AB  - A patient with chronic myelogenous leukemia (CML) associated with pure red cell
      aplasia (PRCA) is reported. The occurrence of PRCA has been described previously
      in sporadic cases of Philadelphia chromosome (Ph) positive CML. In this patient,
      however, the Ph-chromosome was not detected; cytogenetic analysis revealed a
      t(12;14)(q23;p11) as the sole abnormality. Molecular studies by Southern and PCR
      analyses showed the rearrangement of the BCR and ABL sequences and expression of
      the chimeric bcr/abl mRNA, thus confirming the diagnosis of CML. To our
      knowledge, this is the first report on a case of PRCA associated with Ph negative
      CML at diagnosis. The possible connection between CML and PRCA is discussed.

PMID- 1756464
TI  - Cytogenetic analysis of two sacral chordomas.
AB  - Cytogenetic analysis of two sacral chordomas revealed two distinct abnormal
      clones in one of the cases: 44,XY,t(1;3)(q42;q11), -2,der(7)t(2;7)(q23;q32), -21
      and 46,X,t(Y;8)(q12;q22), t(1;14)(p34;q32),t(5;10)(q13;p11). All cells analyzed
      from the second case were cytogenetically normal. To the best of our knowledge,
      chordomas have not previously been subjected to cytogenetic analysis.

PMID- 1756465
TI  - In vitro bone marrow cell culture and cytogenetic analysis in a case of
      myelodysplasia.
AB  - A case of refractory anemia with sideroblastosis and a number of bone-marrow
      blasts slightly over the limit which separates the I/II and III FAB-subtypes of
      myelodysplastic syndromes is described. The leukemic-like type of in vitro growth
      and the multiple karyotypic changes observed in the bone-marrow cells at
      presentation were both indicators of the malignant nature of the disorder and
      underlined the importance of these studies in assessing diagnosis and prognosis
      in patients with preleukemic disorders. The role that the chromosome aberrations,
      del(11)(q14) and del(18)(q21), both found in 100% of the bone-marrow metaphases
      examined, may play in the pathogenesis of the disease is also discussed.

PMID- 1756466
TI  - Specific chromosomal defects associated with metastatic potential in K-1735
      melanoma clones. Involvement of chromosomes 4 and 14.
AB  - In this study we sought to identify specific cytogenetic defects associated with
      the metastatic phenotypes in clones isolated from the parental K-1735 murine
      melanoma. All nonmetastatic clones (C-3, C-10, and C-19) exhibited trisomy of
      chromosomes 1, 3, 12, and 15. The only structural defect present in these clones
      was an interstitial deletion in a chromosome 4. In contrast, the highly
      metastatic clones (C-4, M-2, BB1, and X-21) exhibited trisomy of chromosomes 1,
      3, 12, and 15, plus structural abnormalities of chromosomes 4 and 14, with the
      net result of a deletion in both. Parental K-1735 cells and clone C-16 cells,
      which are intermediate in their metastatic potential, had some cells with 4 and
      14 alterations and others with only a deletion of chromosome 4. Clone C-16
      revealed other non-clonal structural abnormalities. Our results indicate that
      structural anomaly of chromosome 4 and numerical alterations of certain autosomes
      may be associated with tumorigenic properties. In addition, structural defect in
      chromosome 14 is associated with high metastatic potential of K-1735 melanoma
      cells.

PMID- 1756467
TI  - "Jumping translocation" in a 17-month-old child with mixed-lineage leukemia.
AB  - A 17-month-old child with acute biphenotypic (pre B-ALL/myelomonocytic) leukemia
      is reported. Extensive cytogenetic analysis performed at various stages of the
      disease revealed a clonal evolution at the time of initial diagnosis with two
      types of abnormal clones, one with trisomy 22 and two other related clones with
      trisomy 22 plus partial trisomy of the long arm of chromosome 1 associated with
      the telomeric segment of either chromosome 20q or 21p. At the time of relapse the
      only abnormal clone involved trisomy 22 and partial trisomy of 1q, but this time
      in association with the telomeric segment of 14p. The unique feature of these
      translocations is discussed and the possibility of the correlation between the
      different chromosomal abnormalities and the expression of biphenotypic markers is
      raised.

PMID- 1756468
TI  - Cytogenetics of six follicular thyroid adenomas including a case report of an
      oxyphil variant with t(8;14)(q13;q24.1).
AB  - Cytogenetic analyses were performed on six follicular thyroid adenomas. Five had
      normal karyotypes and one, an oxyphil adenoma, had a t(8;14)(q13;q24.1). This
      patient also had a history of pleomorphic adenoma of the parotid gland. This
      clonal abnormality may suggest a primary genetic lesion in this patient who had
      two different benign neoplasms.

PMID- 1756469
TI  - Acute monoblastic leukemia (FAB-M5b) with t(8;14)(p11;q11.1).
AB  - A case of acute monocytic leukemia (FAB-M5b) expressing natural killer cell
      associated antigens containing a t(8;14)(p11;q11.1) is presented. We interpret
      this translocation to represent a variant of the t(8;16) previously reported in
      FAB-M5b. These findings support the contention that the 8p11 breakpoint site is
      the critical junction in the oncogenesis of acute monoblastic leukemia with
      differentiation.

PMID- 1756470
TI  - Partial trisomy 1q. A nonrandom primary chromosomal abnormality in
      myelodysplastic syndromes?
AB  - Cytogenetic and clinical data of 11 patients with de novo myelodysplastic
      syndromes and partial or total trisomy of the long arm of chromosome 1 are
      presented. In eight of these patients trisomy 1q was the sole karyotypic change
      and therefore can be classified as a primary chromosome anomaly. A remarkably
      young median age of 36.5 years was noticed in this patient group.

PMID- 1756471
TI  - A rare translocation (4;11)(q21;p14-15) in an acute lymphoblastic leukemia
      expressing T-cell and myeloid markers.
AB  - A 21-year-old male presented with a large mediastinal mass and a white cell count
      of 420 x 10(9)/L. A diagnosis of acute lymphoblastic leukemia (ALL) was made,
      with 90% of cells in the bone marrow (BM) and 99% in the peripheral blood (PB)
      being lymphoblasts (FAB L1). Cytogenetic analysis of these cells revealed a rare
      variant of the t(4;11) translocation involving chromosome arm 11p rather than
      11q, namely t(4;11)(q21;p14-15). The standard form of the (4;11) translocation
      has been associated with leukemias with mixed-lineage phenotypes. Three cases of
      ALL with t(4q;11p) have previously been reported. One of these cases showed
      phenotypic heterogeneity involving myeloid and lymphoid lineages. The leukemia
      reported here also exhibits lymphoid/myeloid features. Immunophenotyping of the
      blasts showed that most of the cells were positive for CD2, CD5, CD7, CD10
      (CALLA), CD34, and HLA-DR. A significant proportion of the cells expressed CD33.
      These results suggest a biphenotypic rather than a biclonal disease. Molecular
      analysis showed rearrangement of both immunoglobulin heavy-chain genes (JH) and
      of a single allele of the T-cell receptor (TCR) gamma 1 gene, while retaining
      germline TCR beta genes.

PMID- 1756472
TI  - Telomeric associations and consistent growth factor overexpression detected in
      giant cell tumor of bone.
AB  - Tumor specimens from 15 patients with giant cell tumor (GCT) of bone were
      cytogenetically analyzed. A subset of five individuals had tumor cells harvested
      and polyadenylated RNA isolated. Multiple Northern blots were performed utilizing
      radiolabeled probes for the growth factors TGF beta 1, TGF beta 2, TGF beta 3,
      and TGF alpha (TGF, transforming growth factor). RNAs from other types of
      neoplasms and nonneoplastic cells were examined as controls. The most consistent
      cytogenetic abnormality detected involved multiple telomeric associations (TAs),
      most frequently involving the terminus of the long arm of chromosome 19 (19q).
      Northern blot analysis revealed a consistent expression of TGF beta 1 and TGF
      beta 2 with an inconsistent mRNA expression for the other TGFs. There was a
      relative overexpression of mRNA for TGF beta 2. The gene location for TGF beta 1
      is near the 19q terminus and thus it is speculated that TGF beta may play a role
      in the neoplastic transformation of GCT.

PMID- 1756473
TI  - Deletion of part of the long arm of chromosome 13 as the only karyotypic
      aberration in a follicular thyroid adenoma.
AB  - A follicular thyroid adenoma is described showing a del(13)(q14) as the only
      karyotypicabnormality. The karyotypic similarities to another benign tumor, the
      lipoma, are discussed.

PMID- 1756474
TI  - Translocation (2;16)(p11;q22) and trisomy 22 in acute myelogenous leukemia (FAB
      M2) with bone marrow eosinophilia.

PMID- 1756475
TI  - Radiation-induced chromatid aberrations in Cockayne syndrome and xeroderma
      pigmentosum group C fibroblasts in relation to cancer predisposition.
AB  - We showed previously that the persistence of chromatid breaks and gaps after G2
      phase irradiation with X-rays or near-UV visible light characterizes skin
      fibroblasts from individuals with cancer-prone genetic diseases. This abnormal
      response appears to result from deficient DNA repair during G2 and to be
      associated with cancer proneness. We have, therefore, compared the responses of
      cells from two genetic disorders, Cockayne syndrome (CS) and xeroderma
      pigmentosum complementation group C(XP-C), both of which exhibit cellular
      hypersensitivity to sunlight, but only one of which, XP, manifests a high rate of
      sunlight-induced cancer. CS cells, in contrast to XP cells, showed a normal G2
      response to irradiation with either X-rays or near-UV visible light. However, CS
      cells showed a deficiency in repair of DNA damage inflicted by light during S and
      G1 phases of the cell cycle. The present results support the concept that
      deficient DNA repair during G2 phase plays a role in carcinogenesis. This
      deficient repair in the presence of DNA damage and continuous cell cycling from
      activation of proto-oncogenes or loss of suppressor genes may be necessary and
      sufficient for cancer development.

PMID- 1756476
TI  - Translocation (8;21) in acute nonlymphocytic leukemia delineated by chromosomal
      in situ suppression hybridization.
AB  - In situ suppression hybridization with recombinant bacteriophage DNA libraries
      for chromosomes 8 and 21 was performed in two cases of acute nonlymphocytic
      leukemia, type FAB M2. In both cases, cytogenetic analysis by conventional G
      banding revealed t(8;21)(q22;q22). In situ suppression hybridization was able to
      prove the reciprocal nature of the translocation in both cases by identifying the
      terminal end of chromosome 21 translocated to the derivative chromosome 8q-.

PMID- 1756477
TI  - DNA sequences of chromosome 21-specific YAC detect the t(8;21) breakpoint of
      acute myelogenous leukemia.
AB  - The t(8;21)(q22;q22) is a nonrandom translocation specifically marking blasts of
      acute myelogenous leukemia (AML) with undifferentiated phenotype. The breakpoint
      on chromosome 21 involved by this rearrangement has been precisely localized
      relative to cloned DNA markers by physical and genetic linkage analysis enabling
      the use of positional cloning for its isolation. Yeast artificial chromosome
      (YAC) clones for loci proximal (D21S65) and distal (ERG) to the (21q22)
      breakpoint have been developed and their chromosome 21 origin and location
      relative to the breakpoint has been established. By using in situ hybridization
      analysis, a 240 kb YAC clone for the D21S65 locus clearly identified both
      derivative chromosomes of the (8;21) translocation in metaphase spreads of
      leukemia blasts with the rearrangement. The characterization of the DNA sequences
      contained in this 240 kb YAC can reveal the functional consequences of their
      derangement in leukemia with abnormalities of the (21q22) region.

PMID- 1756478
TI  - Clonal chromosome abnormalities and in vitro growth characteristics of classical
      and cellular schwannomas.
AB  - Cytogenetic analysis was performed on 12 schwannomas, 10 classical and two of the
      cellular type. Electron microscopic examination of cultured cells from two
      classical and two cellular schwannomas revealed features compatible with a
      Schwann cell differentiation. Immunohistochemical analysis of the cultures
      demonstrated immunoreactivity for S-100 protein in 6 of 6 cases and for vimentin
      in 2 of 2 cases of classical schwannoma, thus further supporting the authenticity
      of the cultured cells. Cultured cells from one cellular schwannoma also exhibited
      immunoreactivity for glial fibrillary acid protein (GFAP). Cytogenetic analysis
      of the 12 tumors revealed clonal abnormalities in 10 of the cases. In the
      majority of tumors, cells with a normal karyotype coexisted with different
      abnormal clones and sporadic deviations. Numerical changes predominated and were
      found in all tumors, while structural rearrangements were detected in eight
      tumors. The most common abnormality was clonal or sporadic loss of chromosome 22,
      which was found in all cases. Other clonal abnormalities included loss of one sex
      chromosome found in five cases, -15 found in three cases, and -12, +5, +7, +20
      found in two cases each. These results provide further evidence in support of a
      role for loss of chromosome 22 in the pathogenesis of schwannomas. Our findings
      also indicate that there exist several different evolutionary pathways for
      schwannomas, and that some of these are shared by several other types of benign
      and malignant tumors of the nervous system.

PMID- 1756479
TI  - Trisomy 8 in primary esthesioneuroblastoma.
AB  - Esthesioneuroblastoma is a rare malignancy believed to be derived from
      neuroectodermal stem cells within the olfactory epithelium. We have obtained the
      karyotype of a primary esthesioneuroblastoma following brief (7-day) in vitro
      culture, and have determined that the only observable cytogenetic anomaly is the
      presence of an additional chromosome 8. Previously, the karyotypes of two cell
      lines established from metastatic esthesioneuroblastomas have been reported to
      contain the equivalent of three copies of chromosome 8, in addition to other
      chromosomal aberrations, including the reciprocal translocation,
      t(11;22)(q24;q12). Examination of the cytogenetic literature suggests that an
      extra copy of chromosome 8 is a common occurrence in undifferentiated small round
      cell tumors frequently observed to carry the t(11;22), including
      esthesioneuroblastoma, Ewing's sarcoma, peripheral neuroepithelioma, Askin's
      tumor, and rhabdomyosarcoma. These data, combined with our report of a small
      round cell tumor with the karyotype 47,XY, +8, indicate that trisomy 8 may be a
      common phenomenon in these tumors, and may also provide some sort of selective
      advantage to these tumor types.

PMID- 1756480
TI  - Renal cell carcinoma in a child.

PMID- 1756481
TI  - Philadelphia chromosome positive chronic myelocytic leukemia with a complex
      translocation, t(4;9;22)(q31;q34;q11) and long survival.

PMID- 1756482
TI  - Establishment and characterization of a new Ewing's sarcoma cell line.
AB  - A new human Ewing's sarcoma cell line (CADO-ES1) was established from the
      malignant pleural effusion of a 19-year-old woman. These cells grew both
      anchorage dependently and anchorage independently. When cultured in bacteriologic
      dishes, they grew as tightly packed multicellular tumor spheroids; they were also
      capable of proliferating in soft agar. Flow cytometric DNA analysis demonstrated
      a nearly diploid DNA content (DNA index = 0.902). Chromosomal studies of cultured
      cells showed an isodicentric chromosome 8 in all examined cells, but
      t(11;22)(q24;q12), a translocation reported previously in Ewing's sarcoma, was
      not detected. Under normal culture conditions, no morphologic evidence of neural
      differentiation was detected. In addition, immunocytochemical studies showed that
      vimentin was intensely positive, whereas neurofilament (NF) and neuron-specific
      enolase (NSE) were weakly positive. Treatment with cyclic AMP (cAMP) induced
      pronounced morphologic evidence of neural differentiation and strong expression
      of NF in cultured cells. S-100 protein, glial fibrillary acidic protein (GFAP),
      desmin, cytokeratin, and epithelial membrane antigen were not detected
      immunohistochemically in either untreated or cAMP-treated cells, however. These
      data suggest that this cell line is derived from a highly undifferentiated neural
      cell with high chromosomal clonality, differentiating into neural features under
      certain conditions.

PMID- 1756483
TI  - Karyotyping of a hematologic neoplasia developing shortly after treatment for
      cerebral extragonadal germ cell tumor.
AB  - Hematologic malignancies may be associated with mediastinal extragonadal germ
      cell tumors. It may be that the hematologic malignancy is a part of the natural
      history of the teratoma, one germ cell tumor line being able to differentiate
      into hematological cells, or the hematologic malignancy is related to the
      treatment, or the two malignancies develop independently. Cytogenetic analysis of
      bone marrow from a patient with a germ cell tumor in the brain and the almost
      simultaneous appearance of a hematologic neoplasia showed a rearranged karyotype
      in that all 15 analyzed cells had the same karyotype: 50,XY, +X, +del(1)(p21),
      +10, +11, -12, +der(12)t(12;?)(q?;?). Our findings were consistent with the
      interpretation that the hematologic malignancy was derived from the germ cell
      tumor.

PMID- 1756484
TI  - Lymphoblastic lymphoma with primary splenic involvement and the classic 14;18
      translocation.
AB  - Clinicopathologic features of a case of lymphoblastic lymphoma (LyL) with the
      classic 14;18 translocation are described in this article. The patient had
      prominent splenomegaly with numerous splenic nodules, exhibiting a homogeneous
      blast cell infiltrate and occasional cells with cleft nuclei, a picture
      suggestive of high-grade non-Hodgkin lymphoma (NHL) possibly lymphoblastic. Early
      B-cell features were detected immunologically, thus confirming the diagnosis of
      LyL. The presence of primary splenic involvement and of the t(14;18)(q32;q21) are
      unusual in this histologic subset of B-cell NHL, these cytogenetic and
      clinicopathologic characteristics being typically associated with low- or
      intermediate-grade NHL of follicle center origin. These features, along with the
      presence of some centrocytelike cells in the biopsy sections, suggest that an
      unusual pattern of histologic evolution from a follicle center cell NHL may have
      occurred in this case of LyL.

PMID- 1756485
TI  - Second relapse of acute promyelocytic leukemia (ANLL-M3) with t(15;17) and
      t(1;3)(p36;q21).
AB  - We describe herein a patient with acute promyelocytic leukemia (APL)-(ANLL-M3)
      whose bone marrow cells in the second relapse showed t(1;3)(p36;q21) together
      with t(15;17) (q22;q11-q12). Although a total of 21 patients with t(1;3) have
      been reported so far, among which three cases with de novo acute nonlymphocytic
      leukemia were included, our patient is the first case with APL. The hematologic
      findings in our case confirmed the previous observations that this anomaly is
      associated with relatively high platelet count and the multi-myeloid lineage
      involvement of leukemic cells. Our patient responded well to chemotherapy and
      achieved first and second remission with 42 months of total survival, contrary to
      our expectation that patients with this anomaly have a poor prognosis.

PMID- 1756486
TI  - Cytogenetic analysis of the mature and immature teratoma components of a
      metastatic testicular nonseminomatous germ cell tumor.
AB  - A case is described in which the mature and immature teratoma components of
      metastases of the same testicular nonseminomatous germ cell tumor were
      karyotyped. The highly similar karyotypes of both components suggest that the
      phenotypic difference is predominantly epigenetically determined.

PMID- 1756487
TI  - Karyotype evolution of Ph positive chronic myelogenous leukemia patients relapsed
      in advanced phases of the disease after allogeneic bone marrow transplantation.
AB  - Sixty-eight patients affected by Philadelphia chromosome (Ph) positive chronic
      myelogenous leukemia (CML) underwent allogeneic bone marrow transplantation (BMT)
      and were successfully studied from a cytogenetic point of view, before and after
      the BMT. Nineteen had evidence of cytogenetic and clinical relapse. Cytogenetic
      analyses of 14 patients who, after the relapse, showed progression to the
      accelerated or blastic phase of the disease, are presented. Five of these cases
      had only the Ph chromosome without karyotype evolution; in one case Ph
      duplication without other anomalies was detected, while in the remaining eight
      cases cytogenetic analysis showed apparently random clonal structural
      abnormalities (translocations, inversions, deletions, and marker formations).
      Therefore, the classical "non-random" abnormalities (+8, i(17q), +Ph, +19, +21)
      were not as common as in conventionally treated Ph+ CML. From our data, karyotype
      evolution during advanced phases in Ph+ CML patients after BMT differs from the
      evolution seen in conventionally treated patients, by the presence of numerous
      structural unusual abnormalities, possibly related to radiochemotherapy
      conditioning to BMT. Therefore, BMT treatment is not always able to eradicate the
      Ph+ clone but can reduce the incidence of the formation and/or expansion of Ph+
      clones with additional non-random abnormalities.

PMID- 1756488
TI  - Trisomy 13: a preferentially male chromosome aberration interfering specifically
      with myeloid proliferation and differentiation? Report of a case and review of
      the literature.
AB  - A case of trisomy 13 is presented: a 73-year-old man with acute nonlymphocytic
      leukemia (ANLL), FAB borderline M1/M2, and peripheral leukocyte and platelet
      counts that were difficult to control with chemotherapy. A literature review
      shows that 35 cases of trisomy 13 are known at present. They are characterized by
      male predominance (76%), preferentially myeloid disorders (ANLL, myelodysplastic
      syndromes, chronic myeloid leukemia), leucocytosis, and relatively high platelet
      counts and hemoglobins. It is suggested that trisomy 13 is a specific nosologic
      entity with male predominance and characterized by interference with
      proliferation and differentiation in the myeloid differentiation series.

PMID- 1756489
TI  - Significance of chromosomal abnormalities in a malignant giant cell tumor of
      bone.
AB  - Cytogenetic analysis of a malignant giant cell tumor of the sacrum from a 62-year
      old female revealed the following chromosomal complement: 47,XX, -1, -11,
      +22,del(2)(p22),t(7;7) (p22;q32), +der(1)t(1;11;21)(p32;q13;q22),
      +der(19)t(19;?)(q13.4;?), der(8)t(8;?)(p11;?), der(7)t(17;?)(p13;?). Metaphase
      cells with 92-127 chromosomes sharing identical structural abnormalities detected
      in the near-diploid cells were also observed. Several of these abnormalities have
      previously been described in the benign giant cell tumors supporting a direct
      relationship between these benign and malignant neoplastic counterparts.

PMID- 1756490
TI  - Simultaneous analysis of chromosomal aneusomy and 5-bromodeoxyuridine
      incorporation in MCF-7 breast tumor cell line.
AB  - We describe a new method to determine simultaneously both proliferative status
      and chromosome copy number within individual interphase cells. The MCF-7 human
      breast cancer cell line was used as a model system to characterize proliferative
      activity in karyotypically defined cell subpopulations. Cells were labeled with
      bromodeoxyuridine (BrdU) in vitro and incorporation was monitored with IU4 mouse
      anti-BrdU. Biotinylated, digoxigenin-labeled, or acetylamino-fluorene-conjugated
      repetitive sequence DNA probes were hybridized to target interphase nuclei. Three
      color fluorescence labeling allowed simultaneous detection of two chromosome
      pairs and designation of cells undergoing DNA synthesis. This technique may also
      be used for simultaneous characterization of proliferative and karyotypic
      heterogeneity in primary human tumors.

PMID- 1756491
TI  - Complex chromosomal translocations in the Philadelphia chromosome leukemias.
      Serial translocations or a concerted genomic rearrangement?
AB  - Joining of the BCR and ABL genes is an essential feature of the group of human
      leukemias characterized by the Philadelphia chromosome and there is recent
      evidence that the human BCR-ABL fusion gene induces leukemia in experimental
      animals. Joining of these two genes is the result of cytogenetic translocation,
      usually the t(9;22)(q34;q11), but sometimes of more complex translocations
      involving one or more chromosomes in addition to chromosomes 9 and 22. The
      leukemic cells of some patients carry the BCR-ABL fusion gene but have an
      apparently normal karyotype. Recent studies show that these cells conceal complex
      chromosome rearrangements. Because the BCR-ABL fusion gene appears to be the
      result of cytogenetic rearrangement in all cases of these leukemias, the causes
      and mechanism of chromosome rearrangement will be relevant to the development of
      leukemia in man. We examine mechanisms of chromosome rearrangement and propose
      that both simple and complex chromosome translocations result from a single,
      though sometimes complex, interchange event.

PMID- 1756492
TI  - Translocation (3;21) characterizes crises in myeloid stem cell disorders.
AB  - Three patients, one with Philadelphia (Ph) chromosome positive chronic myelocytic
      leukemia (CML) and two with primary acquired myelodysplastic syndromes (MDS),
      have been identified to have a t(3;21)(q26;q22). In the patient with CML, the
      t(3;21) was detected only in the blast phase. The t(3;21) as the sole abnormality
      appeared at presentation of MDS [refractory anemia with excess blasts (RAEB)] in
      one patient and remained as such when progression to RAEB in transformation (RAEB
      t) occurred. The other patient with MDS had the t(3;21), in addition to other
      changes, during the progression of the disease. Thus, t(3;21) may characterize
      myeloid crises of clonal hematopoietic stem cell disorders (HSCD) and indicates a
      poor prognosis. As a primary cytogenetic event it may be also involved in the
      genesis of myelodysplasia with subsequent leukemic transformation.

PMID- 1756493
TI  - Chromosomal abnormalities in giant cell tumors of bone.
AB  - Cytogenetic analysis of short-term cultures from ten giant cell tumors of bone
      revealed clonal and nonclonal chromosome abnormalities in three tumors and
      nonclonal changes only in seven. None of the clonal aberrations, inv(21)(p11q21)
      in one tumor, +5 in another, and t(15q22q), dic(4;22)(p16;p1?), double minutes,
      dicentrics, and ring chromosomes present in three separate clones in the third
      tumor, were identical to previously reported clonal changes in giant cell tumors.
      Telomeric associations were found in five tumors. The telomeres of chromosome
      arms 19q and 15p were particularly frequently involved.

PMID- 1756494
TI  - Atypical (7;19) translocation in acute myelomonocytic leukemia.
AB  - Chromosome studies were carried out after a 24-hour harvest of unstimulated bone
      marrow aspirate cell cultures from a 75-year-old male with a clinical diagnosis
      of acute myelomonocytic leukemia (FAB M4). Analysis of nine cells after trypsin
      Giemsa banding (GTG) revealed two cell lines with a mosaic chromosome pattern,
      46,XY/46,XY,t(7;19)(q22;p13.3). A review of the recent literature reveals one
      case of childhood ALL with a 46,XY/46,XY,t(7;19)(q11;q13) chromosome pattern [1]
      and a 46,XY,t(3q;11q),t(7q;19p),t(15;17)(q26;q22) in one patient with ANLL (FAB
      M3) [2]. The t(7;19)(q22;p13.3) seen in our case has not been reported as the
      sole specific clonal chromosome rearrangement in myeloid neoplasia.
      Interestingly, the plasminogen activator inhibitor type I, multi-drug resistance,
      and erythropoietin genes are located at band 7q22 and the insulin receptor gene
      is located at band 19p13.3. Both sites contain fragile site loci. The possible
      role of these fragile sites, genes, or other genes in the rearrangement can only
      be surmised.

PMID- 1756495
TI  - del(2)(p23): a consistent recurrent abnormality in acute myelogenous leukemia.
AB  - A case of acute myelogenous leukemia (AML-M2) with an unusual chromosomal finding
      is presented. In addition to the most frequently observed translocation in this
      neoplasia, involving the long arms of chromosomes 8 and 21, there was a partial
      deletion of the short arm of chromosome 2 band (p23), i.e.,
      46,XX,del(2)(p23),t(8;21)(q22;q22). Deletion of the short arm of chromosome 2 has
      been described in association with other chromosome abnormalities in two other
      cases of AML and as the sole abnormality in three cases of AML, indicating that
      this abnormality is nonrandom and may be associated with leukemic transformation
      of hematopoietic cells. Therefore, we propose that the
      del(2)(p23),t(8;21)(q22;q22) abnormality be accorded status III and possibly
      considered a subset of AML (M2).

PMID- 1756496
TI  - Molecular cytogenetic analysis of a medulloblastoma with isochromosome 17 and
      double minutes.
AB  - Cytogenetic analysis of a medulloblastoma revealed two abnormal cell lines of
      48,XY, +8, +8, -14, +der(14)t(1;14)(q11;p11),i(17q) and 51,XY, +5, +6, +8, +8, 
      14 + 20, +der (14)t(1;14)(q11;p11),i(17q), + dmin. The finding of double minute
      chromosomes in some medulloblastomas has been associated with amplification of
      the c-myc or N-myc oncogenes. We were unable to detect gene amplification with
      these probes by Southern blot analysis.

PMID- 1756497
TI  - Complex karyotypic evolution in B-cell chronic lymphocytic leukemia.
AB  - Cytogenetic analysis at diagnosis in a female patient with chronic B-cell
      leukemia showed a single abnormal clone with a 4p+ abnormality, 46,XX, -4,
      +der(4)t(4;?)(p16;?). Six additional clones evolved from this clone during the
      following 4 1/2 years and showed 3p+, 4p-, and 11q- chromosomes in addition to
      the 4p+ abnormality. Immunoglobulin heavy chain gene rearrangement studies showed
      two rearranged bands and a faint germline band. Following splenectomy, a strong
      germline and faint rearranged bands were seen, suggesting that the majority of
      cells were normal, whereas cytogenetic studies showed that the karyotypically
      abnormal cells were still present. The combination of cytogenetic and Ig gene
      rearrangement studies provides detailed information regarding the number of
      circulating normal and leukemic cells.

PMID- 1756498
TI  - Chromosomal abnormalities in childhood acute nonlymphocytic leukemia (M4).
AB  - A new reciprocal, apparently balanced translocation between chromosomes 7 and 22,
      i.e., t(7;22)(p22;q13), in association with inv(16)(p13q22) in a child with acute
      nonlymphocytic leukemia (M4) is reported. Five percent of her bone marrow cells
      contained both of these aberrations while 90% of her cells have the pericentric
      inversion of chromosome 16 as the sole abnormality. A clonal evolution of the
      unusual cell line may be associated with atypical clinical presentation. The
      presence of inversion 16 in adults has a better prognosis as compared with
      children. A concise review on the cytogenetic findings in children with ANLL(M4)
      is also provided.

PMID- 1756499
TI  - Report of a variant t(1;15;17)(p36;q22;q21.1) in a patient with acute
      promyelocytic leukemia.
AB  - Chromosome analysis of bone marrow aspirate from a 46-year-old man with acute
      promyelocytic leukemia (APL) revealed a variant translocation,
      46,XY,t(1:15;17)(p36;q22;q21.1). The breakpoints in chromosomes 15 and 17 appear
      to be the same as those in the more common translocation, t(15;17), associated
      with APL. The common translocation has been reported in up to 80% of cases of
      APL. Seventeen cases with variant translocations have been reported involving 15
      alone, 17 alone, or 15, 17, and some other chromosome.

PMID- 1756500
TI  - Cytogenetic study of a papillary thyroid carcinoma with a rearranged chromosome
      10.
AB  - Cytogenetic findings of a multifocal papillary thyroid cancer and a metastatic
      lymph node from a 29-year-old white female patient are reported. Two clonal
      aberrations were observed: a trisomy 7 in one nodule, and a rearranged chromosome
      10 in a separate nodule and in a lymph node. The rearrangement of 10q described
      here is similar to other published cases and is relevant for interpreting the
      molecular findings associated with thyroid cancer.

PMID- 1756501
TI  - A 46,XY female with mixed gonadal dysgenesis and a 48,XY, +7, +i(12p) chromosome
      pattern in a primary gonadal tumor.
AB  - Cytogenetic analysis of a primary germ-cell tumor originating from the streak
      gonad of a 20-year-old phenotypic female with a 46,XY karyotype and mixed gonadal
      dysgenesis revealed a 48,XY, +7, +i(12p) chromosomal pattern. Germ-cell tumors
      originating from gonads of normal males are usually highly aneuploid. An
      isochromosome 12p as well as an overrepresentation of chromosome 7 material are
      among the specific changes most consistently observed. The present case shows
      that tumors of dysgenetic gonads, albeit being near-diploid, may exhibit similar
      chromosomal changes. This observation lends additional support to the hypothesis
      that these specific cytogenetic anomalies may play an important role in the
      pathogenesis of human germ-cell tumors.

PMID- 1756502
TI  - Inversion 16 and translocation (16;16) in ANLL M4eo break in the same subregion
      of the short arm of chromosome 16.

PMID- 1756503
TI  - Total loss of chromosome 17 and p53 gene in solid cancers.

PMID- 1756504
TI  - Homozygote breakpoint in 13q14 in a case of chronic lymphocytic leukemia.

PMID- 1756505
TI  - t(3;5)(q25;q33) in myelodysplastic syndrome.

PMID- 1756506
TI  - A new case of medulloblastoma in an adult.

PMID- 1756507
TI  - The inhibition of platelet aggregation of metastatic H-ras-transformed 10T1/2
      fibroblasts with castanospermine, an N-linked glycoprotein processing inhibitor.
AB  - A series of T24-H-ras-transformed 10T1/2 fibroblasts with varying metastatic
      potential was tested for the ability to aggregate platelets. Results indicate
      that although platelet activation was always detected in the highly metastatic
      cells, some non-metastatic cells also have the ability to cause platelet
      aggregation, suggesting that this is a necessary but not sufficient
      characteristic of the metastatic phenotype. Apyrase, an ADP scavenger,
      effectively inhibited platelet aggregation by metastatic cells, however, there
      was no significant increase in ADP secretion or relation to the ability of the
      tumor cells to activate platelets. Hirudin, a thrombin inhibitor, did not affect
      aggregation, suggesting that the pathway of activation is thrombin-independent.
      The glycoprotein processing inhibitor, castanospermine, which reduces glycosidase
      I activity and metastatic capability, inhibited the ability of metastatic cells
      to cause platelet aggregation. However, another inhibitor of oligosaccharide
      processing, swainsonine, which inhibits mannosidase II activity and does not
      reduce metastasis, had no effect on platelet aggregation. These results show that
      the integrity of N-linked oligosaccharide structure of glycoproteins is an
      important feature of the ability of ras-transformed fibroblasts to activate
      platelets.

PMID- 1756508
TI  - Diffuse and continuous cell proliferation enhances radiation-induced
      tumorigenesis in hamster lung.
AB  - Syrian Golden hamsters received 8 weekly intratracheal instillations of 0.2
      microCi of the alpha-emitting isotope Po210 while being exposed to an atmosphere
      of 65% oxygen in the inspired air. Three months later, 42% of the animals had
      poorly differentiated lung carcinomas. On the other hand, no lung tumors were
      found in hamsters that received intratracheal instillations of Po210 and were
      kept in air. It is concluded that diffuse cell hyperplasia in the lung, caused by
      an inhalant, may constitute an additional risk factor in the pathogenesis of
      alpha-radiation induced lung cancer.

PMID- 1756509
TI  - Comparative studies on genotoxic and carcinogenic effects of different cytostatic
      protocols. I. In vivo cytogenetic analyses in CBA mice.
AB  - In vivo rodent cytogenetics may provide an important basis for an animal model
      for the assessment of the carcinogenic potential of antitumor drugs in man. In
      this paper, genotoxic alterations (i.e. sister chromatid exchanges and
      micronuclei) caused by different cytostatic protocols in CBA/Ca mice are
      described. The strongest sister chromatid exchange inducing effects were shown by
      the ABVD (doxorubicin-dacarbazine-bleomycinvinblastine) group and combinations
      containing cyclophosphamide. Compounds which affect the mitotic spindle induced
      only micronuclei, but not sister chromatid exchanges.

PMID- 1756510
TI  - Effects of the synthetic trypsin inhibitor camostate on the development of N
      nitrosobis(2-oxopropyl)amine-induced pancreatic lesions in hamsters.
AB  - Trypsin inhibitors have been shown to promote pancreatic growth as well as the
      development of pancreatic tumours in rats. The present study was carried out to
      examine the effects of the synthetic trypsin inhibitor camostate on the growth of
      the pancreas and on the development of pancreatic preneoplastic and neoplastic
      lesions in hamsters treated with N-nitrosobis(2-oxopropyl)amine. A specific
      cholecystokinin-receptor antagonist was administered to determine the role of
      cholecystokinin in camostate action. The animals were killed 19 weeks after the
      first injection with N-nitrosobis(2-oxopropyl)amine. Camostate caused an increase
      in growth of the pancreas and a decrease in the number of (pre)neoplastic
      ductular pancreatic lesions. Lorglumide (CR-1409) did not influence these effects
      of camostate. It was concluded that rats and hamsters behave differently with
      regard to the effect of camostate on pancreatic growth and carcinogenesis.

PMID- 1756511
TI  - Double screening of suramin derivatives on human colon cancer cells and on neural
      cells provides new therapeutic agents with reduced toxicity.
AB  - Suramin is a polyanionic compound currently used under evaluation for
      antineoplastic activity. One of the main problems encountered during clinical
      trials was an adverse neurotoxic effect, probably due to a direct cytotoxic
      effect on neural cells. Suramin is also known to trigger differentiation of human
      colon cancer cells, yet a chronic treatment induces a lysosomal storage disorder.
      The aim of this study was to evaluate suramin analogs for their effect: (i) on
      the lysosomal system of the human colon cancer cell clone HT29-D4; and (ii) on C6
      glioma cell growth and morphology. One of the derivatives tested, NF036, induced
      terminal differentiation of HT29-D4 cells without any impairment of the lysosomal
      system. Furthermore, in contrast to suramin, NF036 did not alter C6 cell growth
      and morphology. We conclude that there is a relationship between the ability of a
      suramin derivative to induce a lysosomal storage disorder in human colon cancer
      cells and its neurotoxic effect. A double screening of suramin analogs on HT29-D4
      and C6 cells allowed us to identify a new candidate antineoplastic drug: NF036.

PMID- 1756512
TI  - Modulation of the reversibility of actinomycin D cytotoxicity in HeLa cells by
      verapamil.
AB  - Actinomycin D treatment (0.001-0.005 micrograms/ml; 0.5-24 h) induced a dose and
      time response shifting of nucleolar to nuclear fluorescence. In the presence of
      verapamil, cells were more responsive to actinomycin D. Translocation of protein
      B23 occurred with lower doses of actinomycin D and in shorter incubation times in
      the presence of verapamil. Short exposure (0.5 h) of HeLa cells to actinomycin D
      (0.05-0.25 micrograms/ml) induced 'reversible' translocation of protein B23 as
      well as 'reversible' inhibition of cell growth and RNA synthesis. Verapamil (5
      microM) included in the cell culture after removal of actinomycin D inhibited the
      recoveries of cell growth, RNA synthesis as well as the corresponding
      relocalization of protein B23 from the nucleoplasm to nucleoli. These results
      indicate that verapamil can potentiate the antiproliferating activity of
      actinomycin D by inhibiting reversibility of its cytotoxicity and suggest
      clinical application.

PMID- 1756513
TI  - Visualization of a protein involved in seric immune complexes of patients with
      epithelial tumors having elevated levels of anti-'benzo[a]pyrene-like' IgA.
AB  - Many authors have previously described that several types of human cancer were
      associated with elevated levels of IgA and IgA-containing immune complexes. We
      have recently identified and characterized IgA directed against a "benzo[a]pyrene
      like' antigen in sera of patients with mammary tumors. Circulating immune
      complexes from these sera were precipitated and analysed by sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis. A 18-20-kDa protein was found closely
      associated with high levels of anti-'benzo[a]pyrene-like' IgA in sera of patients
      having a proliferative pathology.

PMID- 1756514
TI  - On the long-term toxic risk of dinaline.
AB  - The long-term toxic risk of the cytostatic agent dinaline (4-amino-N-(2'
      aminophenyl)-benzamide) was assessed in a rat bioassay. Regular administration of
      9, 3 and 1 mg/kg for 106 weeks was associated with significantly increased
      survival of female rats receiving the median and low doses. Dinaline
      significantly reduced the occurrence of malignant tumors in male rats and
      prolonged the manifestation time of malignancies in female rats. Unlike malignant
      tumors, benign neoplasms were increased in male rats and were not significantly
      different from controls in female rats. Analysis of organ distribution of
      neoplastic lesions revealed a dose-dependently decreased tumor incidence in the
      hematopoietic and lymphatic tissue, the mammary gland (females only) and the
      pituitary gland and a not dose dependently reduced incidence of liver tumors.
      This contrasted with dose dependently increased tumor incidences in the adrenal
      gland, the gonads and the vagina. Considering these findings, dinaline has to be
      assessed as a modulator of carcinogenesis in rats. The observed decreased and
      increased tumor incidences suggest a hormone-related mechanism of action.

PMID- 1756515
TI  - Levels of the adducts of 4-aminobiphenyl to hemoglobin in control subjects and
      bladder carcinoma patients.
AB  - We determined the hemoglobin adduct levels of one aromatic amine of cigarette
      smoke, 4-aminobiphenyl (4-ABP), in smoking controls and in patients with
      transitional cell bladder carcinoma. Covalently bound 4-ABP was measured by
      capillary gas-chromatography and negative-ion chemical ionization mass
      spectrometry, using deuterated 4-ABP as internal standard. Smoking was quantified
      measuring the urinary excretion of cotinine. Thirteen cases and controls were
      paired for urinary cotinine levels. Bladder carcinoma patients had slightly
      higher levels of 4-ABP hemoglobin adducts than controls (means +/- S.D. were 103
      +/- 47 and 65 +/- 44, respectively). This difference was significant using a t
      test for paired samples (P = 0.04) and non-parametric Kruskal-Wallis rank
      analysis (P = 0.033).

PMID- 1756516
TI  - Inhibitory effects of Ixora javanica extract on skin chemical carcinogenesis in
      mice and its antitumour activity.
AB  - Topical application of 100 mg/kg body weight of Ixora javanica flower extract
      inhibited the growth and delayed the onset of papilloma formation in mice
      initiated with 7,12-dimethylbenz[a]anthracene (DMBA) and promoted using croton
      oil. The extract at the same dose, when administered orally inhibited the growth
      of subcutaneously injected 20-methylcholanthrene (MCA)-induced soft tissue
      fibrosarcomas significantly. Oral administration of 200 mg/kg of the extract
      inhibited the growth of intraperitoneally transplanted sarcoma-180 and Ehrlich
      ascites carcinoma tumours besides showing an increase in the life span of the
      treated mice. Toxicity studies showed that the blood urea nitrogen levels were
      elevated post treatment. The active compounds responsible for the above
      inhibitory effects on tumour growth were identified as ferulic acid (4-hydroxy-3
      methoxy cinnamic acid) and its regionmer 3-hydroxy-4-methoxy cinnamic acid.

PMID- 1756517
TI  - Effects of antioxidants on quercetin-induced nuclear DNA damage and lipid
      peroxidation.
AB  - The effects of catalase, superoxide dismutase, mannitol, glutathione, and diallyl
      sulfide on quercetin-induced DNA damage and lipid peroxidation were investigated
      in a model system of isolated rat-liver nuclei under aerobic conditions and in
      the presence of equimolar iron or copper. Mannitol produced a small but
      significant inhibition of the concurrent nuclear DNA damage and lipid
      peroxidation induced by quercetin in the presence of iron or copper. Catalase
      significantly decreased quercetin-induced nuclear DNA damage only in the presence
      of iron and had no significant effect on lipid peroxidation. Superoxide dismutase
      showed no significant effect on nuclear DNA damage, but stimulated the quercetin
      induced lipid peroxidation only in the presence of copper. Glutathione
      significantly inhibited the nuclear lipid peroxidation but enhanced the DNA
      damage. Diallyl sulfide significantly enhanced the nuclear DNA damage but
      stimulated the lipid peroxidation only in the presence of iron. These results
      suggest that the reactive oxygen species, especially the hydroxyl radicals, are
      responsible for the concurrent lipid peroxidation and DNA damage induced by
      quercetin in the presence of iron or copper in isolated rat-liver nuclei.

PMID- 1756518
TI  - Staphylococcus saprophyticus urinary-tract infection in male children.
AB  - Staphylococcus saprophyticus urinary-tract infection has been reported to occur
      in sexually active young females and in geriatric patients with obstructive
      uropathy. We are discussing two young male children with S. saprophyticus urinary
      tract infection. We draw attention to this bacterium which is emerging as an
      important pathogen in children with urinary-tract infections.

PMID- 1756519
TI  - Severe hyperlipidemia due to multiple factors in a child with nephrotic syndrome.
AB  - An unusual case of severe hypercholesterolemia and hypertriglyceridemia is
      described in a child with nephrotic syndrome. The severe hyperlipidemia in this
      patient was most likely induced by multiple interacting factors which included
      the metabolic abnormalities of nephrotic syndrome, steroid therapy, the
      underlying genetic predisposition of ApoE-2 homozygosity as well as diet and
      diuretic therapy. The result of these factors was an extremely severe type III
      hyperlipoproteinemia. The pathogenesis of hyperlipidemia in this setting is
      discussed.

PMID- 1756520
TI  - Transient renal insufficiency in the neonate related to hyperuricemia and
      hyperuricosuria.
AB  - Transient renal insufficiency in the neonate is frequently the result of
      hypoperfusion of the kidneys due to circulatory compromise and is associated with
      a normal renal ultrasound scan. We describe an infant with transient renal
      insufficiency associated with hyperuricemia, hyperuricosuria and increased
      echogenicity of the renal medullary pyramids. Transient uric acid nephropathy may
      be a more common occurrence in the neonate than previously recognized.

PMID- 1756521
TI  - Adaptation of renal sulfate transport in response to dietary sulfate intake in
      guinea pigs.
AB  - Inorganic sulfate reabsorption was studied during sulfate infusion in guinea pigs
      stabilized on high-sulfate, normal-sulfate or low-sulfate diets. Guinea pigs
      stabilized on a low-sulfate diet exhibited 86-91% fractional sulfate reabsorption
      at normal plasma sulfate concentrations. Fractional renal sulfate reabsorption in
      animals stabilized on a high-sulfate diet was 55-70%. Clearance techniques were
      used to determine the glomerular filtration rate and the fractional reabsorption
      of sulfate during sulfate infusion. Animals fed a high-sulfate diet manifested
      marked sulfaturia in response to sulfate infusion. The increase in fractional
      reabsorption associated with decreases in dietary sulfate intake suggests a
      tubular adaptive mechanism, similar to that demonstrated for phosphate, to
      increase sulfate reabsorption and maintain constant plasma sulfate concentration.
      Dietary sulfate-dependent alterations in renal sulfate reabsorption may play a
      significant role in establishing the rate of sulfate excretion and thus
      regulating sulfate balance.

PMID- 1756522
TI  - Water-salt metabolism of feti and pregnant rats with venous congestion.
AB  - Water and salt metabolism was studied in feti and pregnant rats with experimental
      venous congestion by measuring water and electrolyte content in the kidney,
      liver, cerebrum, skin hypodermic tissue, muscle, heart. In the kidney, venous
      occlusion resulted in increased potassium content. The role of the placenta is
      discussed.

PMID- 1756523
TI  - Role of 1,25-dihydroxyvitamin D production in idiopathic hypercalciuria.
AB  - In 9 children with idiopathic hypercalciuria, an oral calcium-loading test was
      performed. After this calcium excretion, vitamin D levels, parathyroid hormone
      levels and phosphate excretion were measured during a period of calcium
      restriction, a period of high calcium intake and a period of low calcium intake
      and phosphate supplementation. In our patients, there was no correlation between
      calcium excretion following acute and long-term calcium loading. Phosphate
      excretion was normal during the periods of low and high calcium intake and there
      were no signs of renal phosphate leakage. Elevated levels of 1,25
      dihydroxyvitamin D were found with no significant change after altering phosphate
      or calcium intake (95% confidence intervals for the difference in 1,25
      dihydroxyvitamin D levels were -2.2-15.4 pg/ml in the period with low and high
      calcium intake; -19.8-28.2 pg/ml in the period with low calcium intake and extra
      phosphate, and -24.2-19.6 pg/ml in the period with high calcium intake and extra
      phosphate). These data support the hypothesis of an autonomously elevated 1,25
      dihydroxyvitamin D level as pathogenetic mechanism for idiopathic hypercalciuria.

PMID- 1756524
TI  - Nitrogen and amino acid balance during total parenteral nutrition and continuous
      arteriovenous hemofiltration in critically ill anuric children.
AB  - Amino acid balance and nitrogen balance during total parenteral nutrition (TPN)
      and continuous arteriovenous hemofiltration (CAVH) were investigated in 11
      critically ill anuric patients during the first 7 days after onset of anuria.
      Nitrogen intake ranged from 0.115 +/- 0.013 (SEM) g/kg/day on day 1 to 0.291 +/-
      0.029 (SEM) g/kg/day on day 7. After 7 days of TPN, 9 patients had a positive
      cumulative protein-N balance of 287.52 +/- 68.52 (SEM) mg/kg, 2 patients had a
      negative balance of 781.8 and 1,103.2 mg/kg, respectively. Mean amino acid loss
      in ultrafiltrate was 0.159 +/- 0.008 (SEM) g/kg/day. Four patients died without
      recovery of renal function.

PMID- 1756525
TI  - Urinary catecholamine in children with diabetic ketoacidosis.
AB  - Urinary excretion of norepinephrine, epinephrine and dopamine was investigated in
      children with diabetic ketoacidosis. Besides pronounced hyperglycemia and
      metabolic acidosis, severe hypovolemia was also observed. At the onset of the
      study, urinary excretion of norepinephrine, epinephrine and dopamine was markedly
      elevated. Fluid replacement decreased urinary catecholamine excretion.
      Norepinephrine: 996 +/- 97 vs. 253 +/- 29; dopamine: 5,108 +/- 480 vs. 3,175 +/-
      715; epinephrine: 402 +/- 81 vs. 77 +/- 200 pmol/min/1.73 m2. During
      ketoacidosis, there was a significant negative correlation between urinary
      norepinephrine excretion and endogenous creatinine clearance. Urinary output of
      both norepinephrine and dopamine correlated significantly with diuresis, while
      sodium excretion only correlated with dopamine excretion. Our data suggest that
      in diabetic ketoacidosis increased urinary excretion of norepinephrine may
      participate in renal hypoperfusion and hypofiltration. Elevated renal dopamine
      production contributes to sodium loss, characteristic for diabetic ketoacidosis.

PMID- 1756526
TI  - Congenital urinary abnormalities and neural tube defects.
AB  - The records of 178 children with a neural tube defect were reviewed to determine
      the pattern of associated congenital urinary malformation. Ten (6%) of the
      children had a significant congenital urinary malformation. Although unilateral
      renal agenesis was the most common single congenital urinary abnormality, as a
      group, abnormalities in fusion or migration were equally common in this study and
      more common in several previously reported studies. Lower congenital urinary
      tract abnormalities were also identified but were less common. No correlation was
      found between the level of the neural tube defect and the specific congenital
      urinary abnormality.

PMID- 1756527
TI  - Renal function in preterm twins with birthweight discordance.
AB  - To evaluate the development of renal function in fetal malnutrition conditions,
      we tested glomerular filtration rate and fractional sodium excretion (FENa) of
      premature twins at birth (less than or equal to 35 weeks gestational age) with
      birthweight discordance, divided according to birthweight (less than or equal to
      10% group A; higher birthweight group B). Groups A and B of twins are comparable
      in fluid intake, biochemical serum tests (glucose, sodium, potassium, albumin,
      total protein, osmolality and hematocrit) and also in percent weight decrease at
      24 h of life. Moreover, both creatinine clearance (CrCl) and FENa result
      respectively correlated directly (r = +0.63) and indirectly (r = -0.46) with
      gestational age of twins. Consequently, CrCl (8.3 +/- 4.3 vs 8.3 +/- 4.5
      ml/min/1.73 m2) and FENa (3 +/- 2.8 vs. 2.7 +/- 2.8%) do not result different in
      relation to birthweight discordance of premature twins. In conclusion, at birth,
      gestational age is the main determinant of kidney function in premature twins
      with birthweight discordance.

PMID- 1756528
TI  - Progression of chronic renal failure.
AB  - The deterioration rate of creatinine clearance (CCr) was studied in 40 children
      with chronic renal failure (CRF) on conservative treatment followed up for at
      least 1 year (range 1-12). The deterioration rate of CCr was significantly (p
      less than 0.01) higher in glomerulopathies (G) than in hypoplasias (H) and in
      vascular nephropathies (VN) and significantly (p less than 0.01) higher in
      hereditary nephropathies (HN) than in VN. The differences in the deterioration
      rate of CCr between H and HN and between H and VN were not explainable on the
      basis of the different age at diagnosis or of the different prevalence of
      hypertension. These data indicate that the primary renal disease is important in
      determining the progression of CRF.

PMID- 1756529
TI  - Imaging of urinary tract malformations: intravenous urography and/or kidney
      ultrasonography?
AB  - We performed both kidney ultrasonography (KUS) and intravenous urography (IVU) in
      56 children with urinary tract infections (UTI) to compare the effectiveness of
      these procedures in detecting urinary tract malformations (UTMs). In 7 patients
      where KUS findings were interpreted as normal, IVU detected the following UTMs:
      hydronephrosis (3), stenosis of the pelvi-ureteric junction (2), pelvi-ureteric
      duplication (1) and kidney dislocation (1). In 2 other patients, mild
      hydronephrosis diagnosed by KUS was not confirmed by IVU. With respect to IVU,
      KUS revealed a sensitivity of 77.4% and a specificity of 92%. In our experience,
      IVU is still irreplaceable in the diagnostic protocol of UTMs in children; KUS
      should be regarded as a useful complementary procedure.

PMID- 1756530
TI  - Cyclophosphamide modifies the induction kinetics but not cell types and cytotoxic
      mechanisms of antitumor cells elicited with OK-432 plus attenuated tumor cells.
AB  - The present study was designed to examine whether the antitumor cells induced by
      treatment with mitomycin-C-treated EL4 cells (EL4MMC) plus OK-432 plus
      cyclophosphamide differed from those induced by treatment with EL4MMC plus OK-432
      in terms of their cell types and antitumor mechanisms. Antitumor activity of
      peritoneal exudate cells (PEC) from mice receiving either treatment was
      nonspecific, and inhibition of their target cell growth increased for up to 24 h.
      Macrophage toxin, silica and trypan blue abrogated the activity in vitro and in
      vivo, respectively. The activity of the PEC was inhibited with inhibitors of the
      arachidonic acid cascade, such as dexamethasone, 4-bromophenacyl bromide and
      nordihydroguaiaretic acid but not esculetin, ibuprofen, indomethacin and BW755C.
      NG-monomethyl-L-arginine, a specific competitive inhibitor of the L-arginine
      dependent nitric oxide synthesis, also inhibited the activity. These results and
      morphological observations indicated that antitumor cells in the PEC from mice
      receiving either treatment were macrophages, and that their activity was closely
      related to the arachidonic acid cascade and to nitric oxide. Antitumor activity
      of the PEC spontaneously decayed in vitro and this decay was inhibited by the
      addition of OK-432 or lipopolysaccharide. On the other hand, cyclophosphamide
      sustained the appearance of antitumor cells in mice treated with EL4MMC plus OK
      432. Therefore, cyclophosphamide treatment did not modify cell types and
      cytotoxic mechanisms of antitumor cells elicited with EL4MMC plus OK-432, but did
      modify the induction kinetics of such antitumor macrophages.

PMID- 1756531
TI  - Endogenous interferon alpha/beta produced by Kupffer cells inhibits interleukin
      1, tumor necrosis factor alpha production and interleukin-2-induced activation of
      nonparenchymal liver cells.
AB  - We have previously reported liver-specific interferon (IFN) alpha/beta production
      by murine Kupffer cells that was not observed with other tissue macrophages
      incubated in the absence of stimulators such as IFN gamma or lipopolysaccharide
      (LPS). Consequently, while interleukin-2 (IL-2) alone induced pronounced
      lymphokine-activated killer (LAK) activity from splenocytes, combination of anti
      IFN alpha/beta antibody with IL-2 was required to generate significant LAK
      activity from nonparenchymal liver cells. This endogenous IFN alpha/beta
      production by Kupffer cells was not induced by LPS because (a) addition of
      polymyxin B did not abolish the positive effects of anti-IFN alpha/beta antibody
      on nonparenchymal liver cells, and (b) similar results were obtained when
      comparing the responses of LPS-responsive C3HeB/FeJ and LPS-hyporesponsive
      C3H/HeJ mice. The possibility of hepatotropic infection was also ruled out in
      that anti-IFN alpha/beta antibody enhanced hepatic but not splenic LAK cell
      induction in vitro in both conventional and germ-free C3H/HeN mice. IFN
      alpha/beta played an autoregulatory role by down-regulating the production of IL
      1 and tumor necrosis factor alpha by Kupffer cells. However, the augmenting
      effect of anti-IFN alpha/beta antibody on LAK induction from non-parenchymal
      liver cells was not mediated through an increase in the level of either IL-1 or
      TNF alpha, as specific antisera against either cytokine did not abrogate this
      positive effect. Finally, flow-cytometry analysis showed that IFN alpha/beta
      significantly diminished the expression of IL-2 receptor alpha chain, indicating
      an inhibition of LAK cell generation at a relatively early stage of induction.

PMID- 1756532
TI  - Generation of T cell clones binding F(ab')2 fragments of the idiotypic
      immunoglobulin in patients with monoclonal gammopathy.
AB  - Lymphocytes from two patients with multiple myeloma stage I and one patient with
      monoclonal gammopathy of undetermined significance were found to proliferate
      specifically in response to low concentrations of F(ab')2 fragments of the
      autologous M component. T cell clones isolated from repeatedly stimulated
      cultures bound specifically the autologous idiotype and proliferated after
      addition of soluble idiotype and exogenous interleukin-2. The majority of clones
      were CD8+ and showed negligible staining for CD4. Idiotype-binding clones could
      not be isolated from cultures of lymphocytes from a healthy control stimulated
      under the same conditions. The study provides support for the existence of
      idiotype-reactive T cells in monoclonal gammopathies. Such cells might have a
      regulatory role on the tumor cell clone and may be important for a future
      therapeutic approach.

PMID- 1756533
TI  - Immunity to melanoma in mice immunized with transfected allogeneic mouse
      fibroblasts expressing melanoma-associated antigens.
AB  - Transfection of genomic DNA from B16 mouse melanoma into LM(TK-) fibroblasts led
      to the generation of several clones of transfected cells that strongly expressed
      B16 melanoma-associated antigens (MAA). The transfected cells retained their H-2k
      markers and served as allogenic cells with expressive MAA in C57BL/6 mice,
      syngeneic with the melanoma. The cells were capable of eliciting primary anti-B16
      immune responses in vitro in spleen cells from C57BL/6 mice. Immunization of
      C57BL/6 mice with the transfected cells led to the generation of anti-B16
      cytotoxic activity in spleen cells, and C57BL/6 mice immunized with the MAA
      positive transfected cells were partially resistant to a lethal challenge with
      B16 melanoma cells. Under similar conditions, B16 cells were nonimmunogenic.
      Therefore, transfected allogeneic LM(TK-) fibroblast cells expressing MAA served
      as more potent anti-melanoma immunogens than the parental B16 tumor cells
      themselves.

PMID- 1756534
TI  - Pharmacokinetics and biological activity in subcutaneous long-term administration
      of recombinant interferon-gamma in cancer patients.
AB  - We have investigated the pharmacokinetics, tolerance, and biological activity of
      recombinant human interferon-gamma (rHuIFN gamma) administered subcutaneously to
      cancer patients. Twenty-one patients with lymphoma and metastatic cancer received
      rHuIFN gamma (in doses of 0.1, 0.25, or 0.5 mg/m2) in two or three injections per
      week for up to 180 days. The most common adverse effects encountered were flu
      like symptoms, fever and fatigue. The increase in body temperature after each
      administration ranged from 0 to 4 degrees C depending on the individual patient,
      but was unrelated to the rHuIFN gamma dose or its plasma concentration. The
      pharmacokinetic response of the patients after the two treatments showed a low
      intra-individual variability with respect to the plasma concentration/time
      profiles. However, as observed for the fever side-effect, the interindividual
      variation (CV greater than 50%) was high for the parameters area under the data
      points (AUC0-t) and maximum plasma concentration (cmax). Despite this high
      interindividual variability, the mean values obtained for AUC0-t and cmax after
      s.c. injection of rHuIFN gamma were approximately proportional to the dose
      administered: the injection of 0.1, 0.25 or 0.5 mg/m2 rHuIFN gamma resulted in
      AUC0-t values of 15.4, 31.5 or 69.6 ng h/ml, respectively and cmax was found to
      be 1.0, 2.4 and 4.9 ng/ml, respectively. With this s.c. administration protocol,
      objective antitumour responses were observed in two patients, but there was no
      partial or complete remission.

PMID- 1756535
TI  - Immunotherapy of bovine ocular squamous cell carcinoma by repeated intralesional
      injections of live bacillus Calmette-Guerin (BCG) or BCG cell walls.
AB  - Thirty cows of the Dutch Friesian and the Maas-Rijn-Ijssel breed with
      histologically confirmed ocular squamous cell carcinoma were treated by repeated
      intralesional injection of live bacillus Calmette-Guerin (BCG) (n = 14) or a BCG
      cell-wall vaccine (n = 16). Complete regression of the primary tumour was
      observed in 64% and 57% of the animals respectively. In the 2-year follow-up
      period there was no recurrence of primary tumours. This sharply contrasts with
      the recurrence frequency (40%-50%) after complete remission induced by a single
      intralesional injection with BCG, observed in an earlier study. In 1 animal a new
      primary tumour developed. At necropsy metastases were present in 33% of the
      treated animals: in 3 of 17 animals that showed complete regression of the
      primary tumour and in 7 of 13 animals with partial regression or progressive
      disease. This did not differ significantly from results obtained after a single
      treatment (27%). Delayed-type hypersensitivity to M. bovis purified protein
      derivative (PPD) was more persistent in animals showing regression of the primary
      tumour than in non-responding animals. Of the animals with a positive PPD
      response 6 months after treatment, 79% showed tumour regression. Regression was
      observed in only 28% of the animals not responding to PPD after the same period
      of time. IN CONCLUSION: (a) recurrence of the primary tumour was not observed
      after repeated BCG treatment; (b) the frequency of metastases was not decreased
      compared to results obtained with a single treatment; (c) regression was
      correlated with a positive delayed-type hypersensitivity reaction to PPD (P less
      than 0.05) 6 months after treatment; (d) no significant differences were observed
      when the clinical results of treatment with live BCG and the BCG cell wall
      vaccine were compared.

PMID- 1756536
TI  - Pharmacokinetics and biodistribution of a new anti-episialin monoclonal antibody
      139H2 in ovarian-cancer-bearing nude mice.
AB  - The new murine anti-episialin monoclonal antibody (mAb) 139H2 has been selected
      for its strong reactivity with a series of human ovarian cancer xenografts. In
      the present report we describe the characteristics of mAb 139H2 investigated in
      vitro as well as in vivo. Scatchard plot analysis using the human ovarian cancer
      cell line NIH:OVCAR-3 showed an affinity constant of 1 x 10(8) M-1 and the
      expression of 7 x 10(6) antigenic sites/cell. Reactivity with OVCAR-3 xenograft
      tissue was intense, localized at the cell membrane, heterogeneously distributed,
      and mainly detectable at the apical site of the cell. Administration of
      radiolabelled mAb 139H2 to nude mice bearing s.c. OVCAR-3 xenografts showed
      specific uptake in the tumour up to 9% of the injected dose/g. The maximum uptake
      in the tumour was retained for 3.5 days and mAb 139H2 cleared from the tumour
      with a half-life of 5.5 days. The half-life in blood was 50 h and no antibody
      antigen complex formation could be detected. Poor uptake and no retention in
      episialin-negative WiDr colon cancer xenografts demonstrated specificity.
      Administration of an excess of an unlabelled irrelevant mAb did not influence the
      uptake in the OVCAR-3 xenografts or in other tissues. In contrast, tumour uptake
      decreased after addition of 300 micrograms or more unlabelled mAb 139H2 to a
      tracer dose of radiolabelled mAb 139H2. The uptake of mAb 139H2 in OVCAR-3
      xenografts appeared inversely related to the tumour size.

PMID- 1756537
TI  - A potent and specific immunotoxin for tumor cells expressing disialoganglioside
      GD2.
AB  - Monoclonal antibody 14G2a (anti-GD2) reacts with cell lines and tumor tissues of
      neuroectodermal origin that express disialoganglioside GD2. mAb 14G2a was coupled
      to the ribosome-inactivating plant toxin gelonin with the heterobifunctional
      cross-linking reagent N-succinimidyl-3(2-pyridyldithio)propionate. The activity
      of the immunotoxin was assessed by a cell-free translation assay that confirmed
      the presence of active gelonin coupled to 14G2a. Data from an enzyme-linked
      immunosorbent assay demonstrated the specificity and immunoreactivity of the
      14G2a-gelonin immunotoxin, which was identical to that of native 14G2a. Assays
      for complement-dependent cytotoxicity (CDC) and antibody-dependent cellular
      cytotoxicity (ADCC) revealed that these functional properties of the native 14G2a
      antibody were also preserved in the 14G2a-gelonin immunotoxin. The gelonin-14G2a
      immunotoxin was directly cytotoxic to human melanoma (A375-M and AAB-527) cells
      and was 1000-fold more active than native gelonin in inhibiting the growth of
      human melanoma cells in vitro. The augmentation of tumor cell killing of 14G2a
      gelonin immunotoxin was examined with several lysosomotropic compounds.
      Chloroquine and monensin, when combined with 14G2a-gelonin immunotoxin, augmented
      its cytotoxicity more than 10-fold. Biological response modifiers such as tumor
      necrosis factor alpha and interferon alpha and chemotherapeutic agents such as
      cisplatinum and N,N'-bis(2-chloroethyl)-N-nitrosourea (carmustine) augmented the
      cytotoxicity of 14G2a-gelonin 4- to 5-fold. The results of these studies suggest
      that 14G2a-gelonin may operate directly by both cytotoxic efforts and indirectly
      by mediating both ADCC and CDC activity against tumor cells; thus it may prove
      useful in the future for therapy of human neuroectodermal tumors.

PMID- 1756539
TI  - Isolated atrial myocardial infarction: pathological and clinical features in 10
      cases.
AB  - Isolated myocardial infarction of the atria is a relatively understudied and
      underestimated entity, rarely diagnosed in life. The pathological and clinical
      features in 10 cases of acute isolated atrial myocardial infarction are reported.
      They represent 3.5% of all myocardial necrosis out of a series of 2,704
      consecutive autopsies in adults. The right atrium is more frequently involved
      than the left atrium (9:1). Pulmonary hypertension, with or without coronary
      arterial narrowing, is the major condition leading to isolated atrial infarction.
      Congestive heart failure, thromboembolic phenomena, and supraventricular
      arrhythmias are the most frequent complications of atrial infarction. The
      electrocardiographic findings are often non-specific and elusive and are not
      useful to a correct diagnosis. These observations suggest that isolated atrial
      myocardial infarction is a well-distinct entity with respect to ventricular
      myocardial infarction, since there are several differences between the 2 diseases
      in pathogenesis, diagnosis, clinical picture, and prognosis.

PMID- 1756538
TI  - Impairment in proliferation, lymphokine production and frequency distribution of
      mitogen-responsive and interleukin-2-producing cells in Hodgkin's disease.
AB  - In this paper, we have correlated the ability of peripheral blood lymphocytes
      (PBL) from Hodgkin's Disease patients to proliferate in response to a mitogen,
      phytohaemagglutinin (PHA), with production of lymphokines interleukin-2 (IL-2)
      and interferon gamma (IFN gamma), accumulating in the activated lymphocyte
      culture supernatants. We have also studied the frequency distribution of PHA
      responsive and IL-2-producing T cells from PBL using limiting-dilution analysis.
      We observed that the levels of IL-2 and IFN gamma in the supernatants of
      activated lymphocytes from patients with Hodgkin's disease were significantly
      reduced compared to those of healthy donors. Substage-B patients showed marked
      reduction in the ability to produce IFN gamma. Levels of IL-2 and IFN gamma in
      the culture supernatants of PBL from Hodgkin's disease patients correlated
      positively with proliferative responses, when analysed by linear regression (r =
      0.79 and r = 0.60 respectively). However, production of the two lymphokines by
      activated lymphocytes from the same patients did not correlate (r = +0.04).
      Further, the frequencies of PHA-responsive cells and IL-2-producing cells in the
      PBL of patients with Hodgkin's disease (ranges 1/111-1/554 and 1/3009-1/6709
      respectively) were also less than those of the healthy donors (ranges 1/80-1/181
      and 1/761-1/1828 respectively). Proliferation, IL-2 production in bulk cultures
      and frequencies of PHA-responsive and IL-2-producing cells correlated well in
      individual healthy donors. Whereas, one patient (BC 11,214) with a frequency of
      PHA-responsive cells within normal limits had a very low frequency of IL-2
      producing cells. Taken together, the results indicate abnormalities in cytokine
      production and frequency distribution of cells required for amplification of
      immune response in patients with Hodgkin's disease.

PMID- 1756540
TI  - [The usefulness of the echo-dipyridamole and exercise tests in risk
      stratification in patients with acute uncomplicated myocardial infarct after
      systemic thrombolysis].
AB  - We studied 142 patients (121 males, 21 females) survivors of a first non
      complicated acute myocardial infarction (AMI) treated with thrombolytic therapy
      between March 1988 and December 1989. Dipyridamole echocardiography test (DET, 67
      patients) and exercise electrocardiography test (EET, 104 patients) were
      performed to assess sensitivity and specificity in identifying patients at risk
      for an unfavorable clinical outcome and subsequent cardiac events: 67 patients
      underwent coronary arteriography within 4 weeks after AMI. DET positivity was
      related to the detection of a new transient asynergy of contraction either in
      infarct area or in remote zones. The mean follow-up period was 12 months (range 4
      20). Clinical follow-up end-points of the study included death, re-AMI, angina.
      Sensitivity and specificity of EET and DET were 75 and 68%, 53 and 71%
      respectively. If EET plus DET were considered, sensitivity was 81% and
      specificity 60%. The fairly good DET sensitivity and specificity could be
      partially explained by some stunned myocardium exhibiting prolonged contractile
      dysfunction despite myocardial reperfusion. EET sensitivity and specificity is
      comparable to previous observations in AMI not treated with thrombolytic therapy.
      DET seems to be a useful and safe test in prognostic evaluation of asymptomatic
      patients after thrombolysed AMI, but its value is improved in association with
      EET.

PMID- 1756541
TI  - [Hemodynamic and clinical effects and treatment tolerance with low-dose iv
      amrinone in patients with refractory heart failure: a multicenter study. The
      Group for Research on Amrinone in the Treatment of Refractory Heart Failure].
AB  - We report the results of a multicenter study performed on 70 patients with severe
      congestive heart failure of different etiology (ischemic, idiopathic, alcoholic,
      valvular and secondary to antiblastic drugs) to evaluate the clinical and
      hemodynamic effects and tolerability of low dose amrinone iv (0.75 mg bolus
      followed by a continuous 48-hour infusion at the dose of 5-10 mcg/kg/min). Forty
      one patients underwent invasive hemodynamic monitoring with right heart Swan-Ganz
      catheterization. Heart rate (HR), systolic (SBP) and diastolic blood pressure
      (DBP), mean arterial pressure (MAP), cardiac index (CI), stroke volume index
      (SVI), stroke work index (SWI), right atrial pressure (RAP), pulmonary wedge
      pressure (PWP), mean arterial pulmonary pressure (PAP), systemic vascular
      resistance (SVR), pulmonary vascular resistance (PVR) and total pulmonary
      resistance (TPR) were evaluated before and after 1, 4, 6, 24 and 48 hours of
      amrinone infusion and 2 and 4 hours after amrinone withdrawal. Clinical
      parameters (dyspnea, orthopnea, pulmonary congestion) were quantitated using a
      score; diuresis was assessed hourly; hematochemical parameters were evaluated
      before and 48 hours after amrinone infusion. HR and MAP were not significantly
      changed; CI, SVI and SWI presented, respectively, a significant 31.6, 55.1 and
      72% increment, which peaked 48 hours after amrinone infusion. Concomitantly RAP,
      PAP, PWP, SVR, PVR and TPR were significantly reduced to 36.6, 22, 23.6, 9.4,
      39.2 and 37.7% of the basal values, respectively. Two and 4 hours after amrinone
      withdrawal, hemodynamic changes similar to those observed acutely, were still
      present. Diuresis increased from 58.25 ml/hr to 113.18 ml/hr after 24 hours
      (+95%) and to 88.9 ml/hr (+53%) after 48 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756542
TI  - [The usefulness of echocardiography in the diagnosis of prosthetic valve
      endocarditis: a comparison between the transthoracic and transesophageal
      approaches].
AB  - Transesophageal echocardiography is a new semi-invasive procedure whose practical
      application has yet to be precisely defined. The diagnosis of prosthetic valve
      endocarditis is particularly difficult with the transthoracic approach, either by
      thoracic conformation of patients who underwent cardiac surgery, or ultrasound
      attenuation caused by the prosthetic material. Transesophageal echocardiography
      is useful to overcome such limits with a new acoustic window, due to the
      proximity of the esophagus and the heart. During 15 months 18 patients with
      suspected prosthetic valve endocarditis were studied using both procedures. In
      patients with mitral prosthetic valves, transesophageal echocardiography provided
      information unobtainable by using the transthoracic procedure, while in patients
      with aortic prosthetic valves it only showed additional information in 1 case of
      abscess of the posterior valve ring. In conclusion, transesophageal
      echocardiography is useful to diagnose all patients with suspected prosthetic
      mitral valve endocarditis and might be performed in patients with aortic valve
      prostheses if the quality of the transthoracic procedure is poor.

PMID- 1756543
TI  - [Heart arrhythmias in chronic respiratory failure due to chronic obstructive
      bronchopneumopathy: the incidence and correlations with nocturnal respiratory
      disorders].
AB  - The aim of this study was to assess: frequency and type of cardiac arrhythmias in
      patients with severe stable chronic obstructive lung disease (COLD) and chronic
      respiratory failure (CRF); diurnal or nocturnal predominance of the detected
      arrhythmias; prospective relationships between arrhythmias and nocturnal
      hypoxemic-hypercapnic episodes. All patients were examined with careful and
      complete medical history, chest roentgenogram, standard electrocardiogram, mono
      and bidimensional echocardiogram, respiratory function tests, arterial blood
      gases at rest, 24-hour dynamic electrocardiographic recording and,
      simultaneously, transcutaneous nocturnal monitoring of respiratory gases (TCNM).
      We studied 14 men: all complained of exercise-induced dyspnoea for 8 +/- 6 years;
      10 of them reported usual nocturnal snoring. Respiratory function tests provided
      the following values (expressed in percentage compared with theoretical ones):
      vital capacity 58.6 +/- 15, forced expiratory volume/s 36 +/- 19, Tiffeneau index
      60 +/- 19, Motley index 160 +/- 35, carbon monoxide diffusion capacity 48 +/- 26.
      Arterial blood gas analysis at rest resulted: PO2 47 +/- 4.5 mmHg, PCO2 49 +/-
      7.9 mmHg, pH 7.38 +/- 0.3. Right ventricular diameter obtained with mono and
      bidimensional echocardiogram was 32 +/- 4.6 mm. Right pulmonary descending artery
      measured on chest roentgenogram was 23 +/- 3.8 mm. Nocturnal transcutaneous
      monitoring of respiratory gases showed mean PO2 of 40 +/- 9.7 mmHg and mean PCO2
      of 75 +/- 19 mmHg. During night-time maximum percentage reductions of PO2 (36 +/-
      17%) were measured.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756544
TI  - Effects of a cable car trip on blood pressure and cardiovascular hormones in
      lowlander and highlander normotensives.
AB  - The effects of a cable car trip from 1370 m (4500 ft) to 3460 m (11350 ft) were
      studied in 6 lowlanders (3 men and 3 women, mean age 31 +/- 4 years, living at an
      altitude of less than 500 m) and in 10 highlanders (all males, mean age 37 +/- 12
      years, ski teachers and cable car workers working for greater than or equal to 6
      months/year at a greater than 3000 m). Cuff blood pressure (BP), heart rate,
      plasma catecholamines, serum renin, aldosterone, ACTH and cortisol were measured
      immediately before and 20 min after the trip, at rest and at the same air
      temperature. A handgrip test was also performed under the same conditions. At
      baseline, lowlanders and highlanders showed significant differences in diastolic
      BP (86 +/- 5 mmHg in lowlanders and 91 +/- 4 mmHg in highlanders, p = 0.05),
      plasma noradrenaline (323 +/- 114 pg/ml in lowlanders and 585 +/- 255 in
      highlanders, p less than 0.05), serum renin (10 +/- 6 pg/ml in lowlanders and 17
      +/- 8 in highlanders, p less than 0.05), and serum cortisol (163 +/- 54 ng/ml in
      lowlanders and 120 +/- 25 in highlanders, p less than 0.01). The acute exposure
      to high altitude did not modify BP, heart rate or any of the measured
      cardiovascular hormones in either group. The handgrip test provoked a significant
      increase in systolic and diastolic BP in both lowlanders and highlanders (p less
      than 0.01), and this response was not modified by the change in altitude;
      however, highlanders showed significantly smaller increases in systolic BP than
      lowlanders at both altitudes (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756545
TI  - [Permanent atrial standstill and atrial disease].
AB  - A case of permanent atrial standstill suspected upon electrocardiogram is
      reported, and confirmed by electrophysiological investigation. The originality of
      this case resides in the fact that the atrial standstill marks the developmental
      outcome of a bradycardia-tachycardia syndrome. This developmental sequence is the
      subject on discussion. It is concluded that a combination of auricular muscle
      lesion and sinus node tissue remains the most plausible anatomical and
      pathophysiological substratum of the bradycardia-tachycardia syndrome which
      developed into atrial standstill.

PMID- 1756546
TI  - [Recent applications of informatics in postoperative intensive therapy in heart
      surgery].

PMID- 1756547
TI  - Interventional radiology of the extracranial head and neck.
AB  - The topic of interventional radiology of the extracranial head and neck is
      reviewed. Knowledge of functional vascular anatomy and recognition of the
      "dangerous anastomoses" between the external carotid artery and the intracranial
      circulation are stressed. Technical aspects of embolization are surveyed. The
      authors' approach to some of the more common lesions such as paragangliomas,
      congenital vascular lesions, epistaxis, juvenile angiofibromas, and arteriovenous
      fistulas are described. Illustrative cases are presented. Proper training and
      experience are needed in order to safely and effectively perform embolization
      procedures of the head and neck.

PMID- 1756548
TI  - Urokinase thrombolysis using a multiple side hole multilumen infusion catheter.
AB  - A multilumen, multiple side hole infusion catheter was used for urokinase
      thrombolysis in 13 patients with thromboembolic occlusions of peripheral arteries
      and grafts. Balloon angioplasty was performed following urokinase infusion in 6
      patients and atherectomy in 1 patient. There was one hemorrhagic complication.
      The major advantage of the multiple sidehole infusion catheter was the
      elimination of the need to reposition the catheter during the infusion and the
      reduction of the time burden on the angiographic facility. The success rate for
      the thrombolysis (77%) was comparable to results recorded in the literature. The
      total duration of infusion was not reduced compared to other series.

PMID- 1756549
TI  - Acute posttraumatic rupture of the thoracic aorta: the role of angiography in a 7
      year review.
AB  - Between 1983 and 1989, 15 patients with acute rupture of the thoracic aorta by
      blunt trauma were seen. Superior mediastinal widening and obscuration of the
      aortic arch were the most important findings on chest radiograph. Computed
      tomography examinations in 7 patients showed mediastinal hematomas but did not
      reveal aortic lesions. Definitive diagnosis of traumatic aortic rupture was
      established by aortography in all 15 patients. Intraarterial digital subtraction
      angiography proved to be as accurate as conventional film aortography and saved
      time.

PMID- 1756550
TI  - Left femoral vein approach for the percutaneous placement of the Bird's Nest
      Filter.
AB  - The Bird's Nest Filter femoral catheter set has proven to be too short in some
      patients to permit placement in close proximity to the renal veins via the left
      femoral vein approach. The use of the longer, but otherwise identical Bird's Nest
      Filter jugular catheter set via the left femoral vein eliminates this problem.

PMID- 1756551
TI  - Massive hemoptysis from a pulmonary sequestration controlled by embolization of
      aberrant pulmonary arteries: case report.
AB  - A case of massive hemoptysis due to pulmonary sequestration is presented.
      Initially, the diagnosis of sequestration was unsuspected and bronchial artery
      embolization was done for management of hemoptysis from the left lower lobe, but
      4 days later massive hemoptysis recurred. Repeat arteriography, including a
      thoracoabdominal aortogram, revealed two large abdominal arteries penetrating the
      left diaphragm and feeding the lower lung. Embolization of the aberrant artery
      from the celiac trunk and the left inferior phrenic artery resulted in complete
      hemostasis until elective surgical ligation of the two arteries was performed 2
      months later. The massive hemoptysis from a pulmonary sequestration could only be
      controlled after embolization of the transdiaphragmatic aberrant pulmonary
      arteries.

PMID- 1756552
TI  - An aberrant right hepatic artery from the right renal artery: anatomical
      vignette.
AB  - The vascular supply of the liver is variable. An unusual aberrant right hepatic
      artery arising from the right renal artery is described. The embryologic
      derivation and clinical relevance are discussed.

PMID- 1756553
TI  - Successful thrombolysis of a chronically occluded femoropopliteal synthetic
      bypass graft via the popliteal approach: case report.
AB  - Thrombolysis of an occluded femoropopliteal synthetic bypass graft was performed
      via the popliteal artery approach for infusion catheter placement and urokinase
      delivery. Graft thrombolysis was achieved without complication. The proximal
      graft anastomosis could not be identified and prevented selective antegrade
      catheter placement and infusion. Because the distal graft anastomosis was
      visualized, the percutaneous popliteal approach was used. Subsequently,
      angioplasty was performed of an unmasked stenosis that presumably led to graft
      closure. We can conclude that selective thrombolysis via catheter placed from
      popliteal thrombolysis is an effective technique for recanalization of occluded
      femoropopliteal bypass grafts if the antegrade approach is not feasible.

PMID- 1756555
TI  - Morphologic change in coronary artery stenosis with the Medtronic Wiktor stent:
      initial results from the core laboratory for quantitative angiography.
AB  - The purpose of this study was to assess the early changes in stenosis geometry
      after implantation of the Medtronic Wiktor stent in human coronary arteries.
      Morphologic changes were evaluated by quantitative coronary angiography using
      automated edge detection. The hemodynamic significance of the morphologic changes
      were assessed by the calculation of the theoretical pressure drop across the
      dilated and stented stenosis derived from the Poiseuile and turbulent resistances
      assuming a coronary blood flow of either 0.5, 1, or 3 ml/sec. Fifty patients were
      studied before and immediately after stent implantation. The stented coronary
      artery was the left anterior descending artery in 26 patients, the circumflex
      artery in eight patients, and the right coronary artery in 16 patients. Stent
      implantation resulted in an additional increase in the minimal luminal cross
      sectional area and minimal luminal diameter of the dilated vessel without
      changing the curvature of the stenosis. Furthermore, there was a significant
      reduction of the "plaque area." This was associated with a normalization of the
      calculated resistances to flow and pressure drop across the stenosis. To a
      minimal extent, recoil (0.1 +/- 0.36 mm) was observed after stent implantation.

PMID- 1756554
TI  - Catheter-guided intraoperative localization of a jejunal angiodysplasia using the
      Tracker-18 coaxial catheter system: case report.

PMID- 1756556
TI  - A solution to the problem of an unexpanded Palmaz-Schatz stent following balloon
      rupture.
AB  - The Palmaz-Schatz stent is a balloon expandable stent. Although easy to deploy,
      problems can occur. One problem is balloon rupture resulting in a partially
      expanded stent, which can be difficult to expand fully. This report illustrates
      how a Probing catheter and balloon can solve this potentially serious problem.

PMID- 1756557
TI  - Disruption of a coronary stent during atherectomy for restenosis.
AB  - Directional coronary atherectomy is being used in the treatment of
      atherosclerotic lesions in coronary vessels and vein grafts. This report
      describes the use of atherectomy for the treatment of restenosis of a coronary
      stent. The procedure was complicated by disruption of the stent which was snared
      by the atherectomy cutter.

PMID- 1756558
TI  - Intravascular stenting of the right internal mammary artery.
AB  - Despite its tortuous course and small caliber, percutaneous transluminal coronary
      angioplasty of the internal mammary artery can be performed with a high initial
      success rate (82-94%). The successful deployment of a balloon expandable coil
      stent at the mid-right internal mammary artery in a patient with recurrent
      stenosis of that graft is reported.

PMID- 1756559
TI  - Balloon expandable stent implantation of a stenosis at the origin of the left
      internal mammary artery graft: a case report.
AB  - We describe a case of percutaneous transluminal coronary angioplasty in which we
      implanted a balloon expandable Palmaz-Schatz stent into a high-grade restenosed
      lesion at the origin of the left internal mammary graft.

PMID- 1756560
TI  - Do stents interfere with the densitometric assessment of a coronary artery
      lesion?
AB  - This in vitro study was designed to assess the contribution of three currently
      investigated coronary stents to the densitometric measurement of a known stenosis
      contained within two different sized plexiglass phantoms. These studies were
      performed at two concentrations of the contrast agent iopamidol (50 and 100%).
      The calculated minimal luminal cross-sectional area values in the control phantom
      ranged from 0-18% higher than the theoretical values. Insertion of a stainless
      steel stent (Wallstent, Schneider, Zurich or Palmaz-Schatz, Johnson and Johnson,
      Warren, NJ) resulted in further minor increases (less than or equal to 8% in the
      calculated minimal luminal cross-sectional area, except in the smaller phantom
      filled with 50% contrast medium. The Wiktor (tantalum) stent (Medtronic,
      Minneapolis, MN) had the largest impact of the three stents depending on the
      concentration of iopamidol (100% contrast medium: 9-13% values above control; 50%
      contrast medium; 23-56% higher). We conclude that although densitometry may
      overestimate the minimal luminal cross-sectional area in stented vessels, this
      effect is usually minor with stainless steel stents. However, tantalum-containing
      stents may result in serious overestimation of lesion area, particularly if
      contrast is diluted or the vessel is not well filled.

PMID- 1756561
TI  - Aneurysmal saphenous vein graft presenting as an anterior mediastinal mass.
AB  - A 58-year-old male presented with an anterior mediastinal mass which was found to
      be secondary to an aneurysmal dilatation of the saphenous vein graft to his
      circumflex artery. This represents an unusual presentation of an aneurysmally
      dilated saphenous vein graft.

PMID- 1756562
TI  - Pulmonary varix: magnetic resonance findings.
AB  - The magnetic resonance appearance of a confluent-type pulmonary varix is
      correlated with computed tomography and angiographic findings. This case
      demonstrates the usefulness of magnetic resonance in the evaluation of
      cardiovascular lesions.

PMID- 1756563
TI  - Bilateral coronary artery to left ventricular fistulas.
AB  - Congenital coronary artery fistulas are important coronary artery anomalies.
      Bilateral coronary artery fistulas are very rare and coronary artery to left
      ventricular communications are even more infrequent. This report describes a
      patient with bilateral right and left coronary artery fistulas draining into a
      common channel and emptying into the left ventricular cavity.

PMID- 1756564
TI  - Coronary-subclavian steal: an unusual cause of angina pectoris after successful
      internal mammary-coronary artery bypass grafting.
AB  - Coronary-subclavian steal syndrome is a rare cause of angina pectoris after
      bypass grafting using the internal mammary artery. We report the 11th case in the
      literature and review the pathophysiology and treatment of this disorder. We also
      review appropriate screening for this possibly increasing, yet preventable
      disorder.

PMID- 1756565
TI  - Variations in blood supply to the anterior interventricular septum: incidence and
      possible clinical importance.
AB  - The variations of the blood supply to the anterior interventricular septum in a
      series of 1,089 patients are described. Special attention has been given to
      variations and frequency of occurrence of the septal perforators originating from
      the left anterior descending artery. These variations may have clinical
      significance in this era of coronary angioplasty and coronary bypass surgery.

PMID- 1756566
TI  - Intracoronary verapamil for the treatment of distal microvascular coronary artery
      spasm following PTCA.
AB  - Distal microvascular spasm is a somewhat uncommon occurrence following PTCA and
      often does not respond well to nitroglycerin. We report several patients who
      developed distal microvascular spasm that was refractory to intracoronary
      nitroglycerin but responded promptly to intracoronary verapamil.

PMID- 1756567
TI  - Pneumococcal pericarditis successfully treated with catheter drainage and
      intravenous antibiotics.
AB  - Bacterial pericarditis is commonly a disease of children for which the primary
      treatment is surgical drainage. We report the case of a 19-yr-old patient
      presenting with pneumococcal pericarditis and tamponade treated successfully with
      intrapericardial catheter drainage and intravenous antibiotics. The technical
      aspects are discussed.

PMID- 1756568
TI  - Percutaneous triple-valve balloon valvuloplasty in a pregnant woman.
AB  - A 22-yr-old pregnant woman with mitral, aortic, and tricuspid stenosis presented
      with accelerating dyspnea and shortness of breath at the end of her first
      trimester. She subsequently underwent percutaneous triple-valve balloon
      valvuloplasty at 22 weeks of gestation without complications and achieved marked
      clinical improvement. We conclude that percutaneous triple-valve balloon
      valvuloplasty represents an alternative treatment for mitral, aortic, and
      tricuspid stenosis in pregnant women with compromised cardiovascular status who
      do not wish to terminate their pregnancy.

PMID- 1756569
TI  - Rotational ablation of chronic coronary occlusions.
AB  - Rotational ablation was performed successfully in three chronic coronary
      occlusions. At 3 months follow-up, two of the three lesions were patent. These
      cases illustrate the overall advantages and unique technical aspects of this
      device.

PMID- 1756570
TI  - Effects of rotational atherectomy in normal canine coronary and diseased human
      cadaveric arteries: potential for plaque removal from distal, tortuous, and
      diffusely diseased vessels.
AB  - To test the hypothesis that tortuous, diseased vessels could be successfully
      treated with a flexible rotational atherectomy device we evaluated the BARD
      atherectomy device with quantitative angiography and histology in normal canine
      coronary arteries and diseased human below-knee amputation specimens. The mid
      left anterior descending and the circumflex vessels were treated in 4 dogs
      serially with 1 wk separating treatments. The acute and follow-up anterior
      descending artery size was unchanged (1.41 mm before, 1.39 mm after, and 1.59 mm
      at 1 week). Similar findings were obtained in the circumflex vessels. In 4 adult
      human amputated legs, diseased peroneal or tibial arteries were treated with a
      significant reduction in the percent luminal diameter stenosis from 62.75 prior
      to intervention to 36.5 following intervention (p = 0.021). The luminal diameter
      increased from 0.81 to 1.54 mm (p = 0.06). In 2 canine arteries there was
      histologic evidence of localized perforation of the arterial wall, but there was
      no angiographic evidence of perforation or dissection and no significant
      myocardial necrosis in the distribution of the treated vessels at 1 wk. The
      majority of the diseased human vessels demonstrated smoothly cut atheromas with
      sparing of the media. The rotational atherectomy catheter system holds promise
      for removal of plaque in relatively small, diffusely diseased, tortuous vessels.

PMID- 1756571
TI  - Flow support catheter for prolonged maintenance of coronary blood flow.
AB  - A newly designed flow support catheter with a supporting wire mesh cage which can
      be expanded into a tubular configuration and then readily reduced was evaluated
      in mongrel dogs. Regional myocardial blood flow (RMBF) was measured using the
      radioactive microsphere technique in the area of both balloon-denuded
      instrumented and control non-instrumented coronary arteries following placement
      of either a fixed-wire or a higher profile rapid exchange flow support catheter.
      At 5, 20, and 180 min following delivery and expansion of either device, RMBF was
      not significantly different in left ventricular subepicardium and subendocardium
      perfused by the instrumented vs. the control coronary arteries. Angiography
      demonstrated widely patent instrumented arteries in 15/18 dogs; in no dog was
      side branch occlusion observed. Significant cage thrombus deposition was seen
      angiographically in 3 animals causing temporary total coronary occlusion in 1.
      Following reduction and removal of the flow support catheter, vessel patency was
      present in all dogs. The flow support catheter is an effective endovascular
      stenting device capable of providing structural arterial support, while
      simultaneously maintaining distal coronary blood flow. It is envisioned that the
      primary application of this catheter will be to enable primary salvage of vessels
      acutely injured during coronary angioplasty, by "tacking up" intimal flaps for an
      extended period. It may also provide a bridge to emergency surgical
      revascularization.

PMID- 1756572
TI  - Interpretation of cardiac pathophysiology from pressure waveform analysis: pulsus
      alternans.

PMID- 1756573
TI  - Failure of stent delivery.

PMID- 1756574
TI  - "Intimate" double balloon coronary angioplasty with a single Y connector.

PMID- 1756575
TI  - Right heart catheterization utilizing a transseptal-type sheath in patients with
      severe pulmonary hypertension.

PMID- 1756576
TI  - The cytoplasmic domain of adherens-type junctions.

PMID- 1756577
TI  - The dynamic instability of microtubules is not modulated by alpha-tubulin
      tyrosinylation.
AB  - The tyrosinylation of chick brain alpha-tubulin and the effects of the
      tyrosinylation status on the assembly and dynamic instability of chick brain
      MAP2:tubulin microtubule protein have been examined. Each of the eight major
      alpha-isotypes can be tyrosinylated in vitro, irrespective of whether a C
      terminal tyrosine is genetically encoded. The extent of tyrosinylation is however
      limited to congruent to 0.3 mol.mol-1. The tyrosinylation status (0 vs. 0.3
      mol.mol-1) has no effect on either the assembly kinetics of chick brain
      microtubule protein or on the rate of length redistribution following assembly
      and shearing. It is therefore unlikely that the tyrosinylation status directly
      affects the intrinsic stability of assembled microtubules since the rate of
      length redistribution is both a sensitive assay and a function of the kinetic
      parameters governing dynamic instability.

PMID- 1756578
TI  - Synchronous triggering of trout sperm is followed by an invariable set sequence
      of movement parameters whatever the incubation medium.
AB  - The movement of live trout spermatozoa is very brief (25 sec at 20 degrees C) and
      conditions have been developed to get synchronous initiation of sperm motility
      which allowed quantification of the major parameters of sperm movement during the
      motility phase. Recorded flagellar beat frequencies decreased steadily from
      values of 55 Hz at the beginning to 20 Hz at the end of the motility phase. Sperm
      forward velocities followed a similar pattern from 250 to 20 microns.sec-1 in the
      same conditions and the diameters of sperm trajectories were reduced from 370 to
      40 microns. Thus none of the characteristics of sperm movement was constant
      during the motile phase which ended abruptly by a straightening of the flagella.
      The decrease in flagellar beat frequencies and sperm velocities are much greater
      than what could be extrapolated from the decrease of intracellular ATP (Christen
      R. et al: Eur. J. Biochem, 166: 667-671, 1987) or from measurements of ATP
      dependence of reactivated sperm velocities (Okuno M. and Morisawa N.: In
      Biological Functions of Microtubules and Related Structures. New York: Academic
      Press, pp. 151-162, 1982). Therefore, the cessation of flagellar beating at 25
      sec is not directly the result of the low concentration of intracellular ATP. The
      decrease in the diameters of sperm trajectories which occurred during the first
      part of the motility phase was correlated with [Ca]i measurements (Cosson M.P. et
      al, Cell Motil. Cytoskeleton, 14:424-434, 1989). The effect of Ca2+ at the
      axonemal level does not indicates that Ca2+ influx is previous to flagellar
      beating but rather suggests a classical Ca2+ regulation of the flagellar
      assymetry. The short duration of the motility phase and the characteristics of
      sperm movement were very similar in various conditions (high external K+, low pH
      media) where increased external Ca2+ or divalent ions were shown to overcome K+
      and H+ inhibition of sperm motility, both conditions which have been shown to
      depolarize the plasma membrane potential (Gatti J.L. et al: J. Cell Physiol.,
      143:546-554, 1990). The present study of the parameters of sperm movement
      suggests that once motility is initiated, a defined set of axonemal events will
      take place whatever the external conditions.

PMID- 1756579
TI  - Cloning, sequencing, and mapping of an alpha-actinin gene from the nematode
      Caenorhabditis elegans.
AB  - The dense-bodies in the body wall muscle of the nematode Caenorhabditis elegans
      function to anchor the actin thin filaments to the adjacent sarcolemma. One of
      the major components of the dense-bodies is the actin-binding protein alpha
      actinin. To facilitate a genetic analysis of alpha-actinin, we have cloned a cDNA
      encoding the nematode protein, identified its position on the nematode physical
      map, and developed a unique PCR based approach to test the position of the cloned
      gene relative to known genetic deletions. The peptide sequence deduced from the
      cDNA shows that, apart from a few exceptional regions, the nematode protein shows
      strong similarity to other known alpha-actinins. Its position on the genetic map
      shows that none of the known muscle affecting mutations identified in C. elegans
      are in this alpha-actinin gene. This gene has been given the name atn-1 (alpha
      actinin-1).

PMID- 1756580
TI  - Musculoskeletal disorders in the haemophilias.
AB  - The management of the haemophilias has been improved by the advent of potent
      consistent clotting factor replacement therapy. The previously lethal major
      complications such as intracerebral haemorrhage are now rare, and the infective
      complications of treatment, most notably hepatitis and AIDS, are now potentially
      preventable with the new synthetic products. There is also the prospect of 'cure'
      by gene insertion therapy. Advanced arthropathy has been minimized but not
      prevented by early effective treatment of haemarthroses, and there is a
      diminishing legacy of severely affected patients many of whom may require joint
      replacement surgery. The present group of such patients has a high prevalence of
      HIV-1 infection and an increased risk of joint sepsis. The available avenues of
      treatment for the subacute stage of the arthropathy have not been particularly
      effective, emphasizing the need to prevent recurrent bleeding. The development of
      a multidisciplinary team-management approach in centres of expertise has been a
      significant factor in the improved longevity, life satisfaction and preserved
      mobility now available to most haemophiliacs.

PMID- 1756581
TI  - Rheumatological complications of sickle cell disease.

PMID- 1756582
TI  - Rheumatological manifestations of the leukaemias and graft versus host disease.
AB  - Bone and joint involvement in the leukaemias is discussed. Particular emphasis is
      placed upon osteoarticular presentations which may predate the haematological
      changes or divert attention from the primary pathology. A description of acute
      and chronic graft versus host disease is presented with particular emphasis on
      the rheumatological manifestations.

PMID- 1756583
TI  - Henoch-Schonlein purpura.
AB  - Henoch-Schonlein purpura probably results from a reaction in a host sensitized by
      an infective stimulus. This stimulus leads to the synthesis of IgA antibody, the
      presence of circulating immune complexes and a leukoclastic vasculitis involving
      IgA resulting in renal and dermatological manifestations. The risk factors, the
      causal organism and the reason for the association with IgA nephropathy remain
      unknown.

PMID- 1756584
TI  - Adult-onset Still's disease.
AB  - Adult onset Still's disease seems to be the adult form of Still's disease in
      children. The key symptoms of the disease are high spiking fever, arthritis and a
      macular or maculopapular, salmon-pink evanescent rash, almost always accompanied
      by neutrophilic leukocytosis and frequently by sore throat, intense myalgias,
      lymphadenopathy, splenomegaly and signs of serositis. Tests for IgM rheumatoid
      factor and antinuclear antibody are characteristically negative. With respect to
      haematologic abnormalities, the disease may give rise to several problems. First,
      there is a neutrophilic leukocytosis, which currently is unexplained, and often a
      normocytic normochromic anaemia, that may be profound. The anaemia has the
      characteristics of anaemia of chronic inflammatory disease. Both abnormalities
      disappear after effective treatment of the disease or at spontaneous remission.
      Secondly, there might be a problem to differentiate AOSD from malignant
      haematological disorders, including malignant lymphoma and leukaemia, especially
      when the picture is dominated by lymphadenopathy, splenomegaly, fever and
      leukocytosis. Although in rare cases the differential diagnosis is extremely
      difficult, diagnosis can mostly be made or excluded by peripheral blood smear
      staining, bone marrow biopsies and occasionally lymph node biopsy. Finally, like
      the juvenile counterpart, AOSD is occasionally complicated by sometimes life
      threatening diffuse intravascular coagulation. Factors that might be important in
      the development of this complication include severe disease activity, liver
      abnormalities and particular drugs including salicylates, other NSAIDs and some
      slow-acting antirheumatic drugs. Prompt therapy, including withdrawal of the
      drug, corticosteroids and sometimes anticoagulant therapy have been successfully
      applied to most patients.

PMID- 1756585
TI  - Immunodeficiency and lymphoproliferative disorders.

PMID- 1756586
TI  - Multicentric reticulohistiocytosis: systemic macrophage disorder.
AB  - Multicentric reticulohistiocytosis is a rare multisystem disorder that reflects a
      reactive inflammatory response to an undetermined stimulus. While the disease is
      characterized as a dermatoarthritis, multiple organ systems including cardiac and
      skeletal muscle, the pleura and gastrointestinal tract have been involved in
      reported cases. The synovitis can be quite destructive with arthritis mutilans
      developing in a substantial percentage. The dermatitis may be particularly
      disfiguring when the face is involved. This chapter describes the clinical and
      laboratory features of the 33 cases of MRH previously reviewed by Barrow and
      Holubar and an additional 33 cases that have appeared in the medical literature
      since that report. We note an apparent decline in frequency of some
      manifestations of MRH. This may be due in part to the nature of the recent
      reports which often present a brief clinical report and focus primarily on
      specific disease associations, unusual manifestations, new organ system
      involvement or treatment regimens. The primary cell involved in the reactive
      inflammatory response of MRH is the phagocytic tissue histiocyte (macrophage).
      While uncontrolled proliferation of these reticulohistiocytes is seen in several
      infectious and malignant conditions there is presently no direct evidence of a
      particular organism or neoplasm involved in the aetiopathogenesis of MRH. There
      is evidence of tuberculosis exposure in one third of cases with active
      tuberculosis present in 5%. Likewise, malignancies are reported concomitantly
      with MRH in 15-28% of cases. The therapeutic trend in MRH is to treat early and
      aggressively to prevent the devastating arthropathy and disfiguring cutaneous
      sequelae. This recommendation, however, is largely based on anecdotal reports and
      thus the physician encountering a case of MRH needs to proceed with
      circumspection.

PMID- 1756587
TI  - Ehlers-Danlos syndrome.

PMID- 1756588
TI  - Rheumatic manifestations of haemochromatosis.
AB  - Haemochromatosis (HC) is a group of phenotypically heterogeneous clinical
      syndromes, which may have a common molecular basis. Classical genetic
      haemochromatosis (GHC) is one of these syndromes and is a disorder of iron
      storage due to an increase in intestinal iron absorption, which results in
      progressive and massive iron deposition leading to fibrosis and organ
      malfunction. The liver, pancreas, heart and pituitary are commonly involved.
      There is a specific arthropathy and an association with osteoporosis. Clinically,
      the arthropathy may resemble rheumatoid arthritis, with acute attacks of
      inflammation associated with bilateral destruction of the metacarpophalangeal
      joints. However, bony joint swelling may occur, suggestive of osteoarthritis. Hip
      arthritis may be unduly severe and disabling. Haemochromatosis arthritis is
      composed of three radiographic categories: isolated chondrocalcinosis,
      hypertrophic osteoarthritis which is indistinguishable from pyrophosphate
      associated arthropathy, and disease specific changes such as subchondral
      radiolucency of the femoral head, hook-like osteophytes on the metacarpal heads
      and a degenerative predilection for the metacarpophalangeal joint rather than the
      scapholunate. The characteristic histological changes are: abnormal amounts of
      iron deposits, little or no signs of synovial inflammation and CPPD deposition.
      Subchondral radiolucency of the femoral head and atypical stripping of the
      cartilage from the subchondral bone are thought to be specific radiographic and
      histological changes of HC. The pathogenesis of HC arthritis has been associated
      with the presence of iron in joint tissue, a defect in cartilage metabolism and
      immunological dysfunction. Treatment has little effect on clinical, radiological
      or histological progression.

PMID- 1756589
TI  - Some aspects of the use of dextran sulfate-cellulose columns for the treatment of
      familial hypercholesterolemia.

PMID- 1756590
TI  - A radiometric assay for aspartoacylase activity in human fibroblasts: application
      for the diagnosis of Canavan's disease.
AB  - A new sensitive method for measuring aspartoacylase activity in human skin
      fibroblasts using [3H]N-acetyl-L-aspartic acid (NAA) is described. Optimal assay
      conditions and kinetic parameters for enzyme activity were determined. The enzyme
      was found to have maximal activity at pH 8.5, and the Michaelis constant for the
      substrate N-acetylaspartate was 1.8-2.0 mmol/l. Aspartoacylase activity in
      control cultured human fibroblasts was 9.2 +/- 1.8 nmol/h per mg protein,
      compared with 1.1 +/- 0.2 in seven Canavan patients and 3.5 +/- 0.9 in four
      patients' parents. This method for determining aspartoacylase activity is
      advantageous to the previously described spectrophotometric method since it is
      rapid, more sensitive and has less nonspecific interference. It is possible that
      application of this technique to cultured ammniotic and chorionic villi cells may
      be used for prenatal diagnosis of Canavan's disease.

PMID- 1756591
TI  - Sensitive enzyme immunoassay for human 28 kDa calbindin-D.
AB  - A sandwich-type enzyme immunoassay for human 28 kDa vitamin D-dependent calcium
      binding protein (calbindin-D) was established with a sensitivity of 1 pg/tube.
      Antisera were generated in rabbits injected with highly purified human kidney
      calbindin-D, and specific antibodies to calbindin-D were purified by the use of a
      column of calbindin-D-coupled Sepharose. The purified antibodies showed a single
      band at the position corresponding to calbindin-D on an immunoblotting test with
      a crude extract of human kidney. The assay system consisted of polystyrene balls
      with immobilized F(ab')2 antibodies and the same antibodies labeled with beta-D
      galactosidase from Escherichia coli. The assay was specific to 28 kDa calbindin
      D, showing no cross-reactivity with other calcium binding proteins such as S
      100a0 (alpha alpha), S-100b (beta beta), parvalbumin and calmodulin. The assay
      was also reproducible (coefficients of variation between assays were less than
      10%). With the present method, immunoreactive calbindin-D could be detected in
      various human tissues, with major concentrations in kidney and brain. The values
      for immunoreactive calbindin-D in various body fluids of healthy subjects varied
      from undetectable in serum and semen to 3.8 +/- 2.0 (SD) micrograms/g creatinine
      in urine and 2.9 +/- 0.8 (SD) micrograms/l in cerebrospinal fluid.
      Immunohistochemically, the calbindin-D in human kidney was localized in
      epithelial cells of distal tubules.

PMID- 1756592
TI  - Brain natriuretic peptides in human plasma, spinal cord and cerebrospinal fluid.
AB  - In cases of heart failure, the plasma level of immunoreactive human brain
      natriuretic peptide (IR-hBNP) measured by radioimmunoassay increased 6- to 46
      fold over normal level (4.1 +/- 1.0 pg/ml), depending upon the severity. These
      levels did not significantly correlate to the levels of IR-human atrial
      natriuretic peptide in individuals. A 4-kDa IR-hBNP, corresponding to authentic
      hBNP (1-32), was predominant in normal plasma. In cases of cardiac disease,
      larger molecules which were assumed to be precursors of the 4-kDa form were
      accumulated in plasma. IR-hBNP was detected in spinal cords (7-24 pg/mg protein)
      and cerebrospinal fluid (8-19 pg/ml) of patients with noncardiac diseases. The
      major molecular form corresponded to the hBNP (1-32).

PMID- 1756593
TI  - Anti-skeletal muscle and anti-acetylcholine receptor antibodies in patients with
      thymoma without myasthenia gravis: relation to the onset of myasthenia gravis.
AB  - We measured the anti-skeletal muscle (SM) antibody titers in sera from 46
      patients with thymoma but without Myasthenia gravis (MG) in order to determine
      whether the presence of anti-SM antibody is linked to the combination of thymoma
      MG, or to thymoma alone. We detected anti-SM antibodies in 18 of these sera, of
      which 15 had concomitantly elevated titers of anti-AChR antibodies. Moreover, 9
      of whom had experienced the onset of MG after surgery. In contrast, no patient
      without elevations in both antibodies developed MG during the followup. We
      conclude that the presence of anti-SM antibodies is linked strongly with thymoma
      associated with MG, but not with thymoma alone.

PMID- 1756594
TI  - Identification of human ventricular myosin heavy chain fragments with monoclonal
      antibody 2F4 in human sera after myocardial necrosis.
AB  - An ELISA assay with monoclonal antibody (Mab 2F4) raised against human
      ventricular myosin heavy chains was developed and used to investigate human sera
      after myocardial infarction. The monoclonal antibody 2F4 was selected for its
      high affinity to soluble fragments of myosin heavy chains (subfragment-1) and for
      its appropriate tissue specificity. By including Mab 2F4 in a simple and rapid
      dot immunobinding assay sera from patients with acute chest pain and of persons
      without a history of heart disease were tested. Myosin was detected only in the
      sera of the patients with myocardial necrosis, confirmed by electrocardiographic
      data. Negative reactions in all control cases were found. The serum myosin
      fragments reactive with Mab 2F4 were characterized by immunoblot experiments and
      protein bands in the region about 43 kDa were found. It was concluded that the
      myocardial infarction can be demonstrated by detection of cardiac myosin heavy
      chain fragments in the patients' sera.

PMID- 1756595
TI  - Immunonephelometric assay of myoglobin.

PMID- 1756596
TI  - Determination by latex immunoassay of protein 1 in normal and pathological urine.
AB  - A sensitive latex particle assay has been developed to study the occurrence of
      protein 1 in human urine. The coefficients of variation (CVs) of the method which
      is fully automated vary between 3 and 11.5%. The assayable concentration range is
      0.3 to 40 micrograms/l. Protein 1 is clearly a sex-dependent protein. In contrast
      to urinary retinol-binding protein (RBP) which shows no variation with age or
      sex, protein 1 is excreted in greater amounts in males from the puberty. In
      adults, the mean concentration of protein 1 in urine of men is approximately 5
      times that of women. In the urine from both sexes, protein 1 occurs as a single
      component with a Mr around 21,000 and an pI of about 4.8. Protein 1 is correlated
      with RBP in the urine from female or male patients with impaired proximal tubular
      function, which suggests that it is handled by the kidney in a similar manner as
      RBP. Diabetics, however, show elevations of urinary protein 1 which do not
      correlate with the RBP excretion but with the albuminuria. A competition between
      albumin and protein 1 for renal tubular uptake might explain this paradoxical
      behaviour of protein 1 in the course of diabetic nephropathy.

PMID- 1756597
TI  - Examination of the role of oxygen free radicals in bronchial asthma in childhood.
AB  - The antioxidant enzyme activities, the lipid peroxidation level, the parameters
      of glutathione metabolism, and the proportion of haemoglobin oxidation products
      were determined during the symptom-free period of childhood bronchial asthma. A
      decreased catalase activity and a significantly reduced glutathione instability
      were demonstrated as compared to the controls. The results indicate that
      antioxidant protection of the haemoglobin molecule in asthmatic children is
      considerably decreased.

PMID- 1756598
TI  - Ectrodactyly-ectodermal dysplasia-clefting syndrome (EEC): the clinical variation
      and prenatal diagnosis.
AB  - Six patients with the ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome,
      namely five members of the same family and one sporadic case, are presented. One
      of the main features of the EEC syndrome, ectrodactyly, was missing in five of
      the patients. The diagnosis did not become clear until the youngest son of the
      family was born. All of our six patients had a low birth weight and some were
      born preterm, and four had poly- and/or syndactyly without ectrodactyly. A low
      birth weight and polysyndactyly have been reported previously in patients with
      the EEC syndrome and might be features of the syndrome. The present patients
      illustrate the great phenotypic variability in the EEC syndrome and the need for
      a careful search for microsymptoms in potential gene-carriers. In two members of
      the affected family, EEC syndrome was diagnosed prenatally after 16 weeks of
      gestation by detection of the cleft lip and palate on ultrasound examination. The
      mother chose to continue the pregnancies. However, prenatal diagnosis of cleft
      lip and palate might be of value in genetic counselling for other inherited
      syndromes leading to severe disability.

PMID- 1756599
TI  - Apolipoprotein B polymorphism and altered apolipoprotein B concentrations in
      Congolese blacks.
AB  - The immunoreactivity of apolipoprotein B (apo B) in plasma obtained from 238
      unrelated black African male subjects from the People's Republic of Congo was
      analysed by non-competitive Enzyme Linked-Immunosorbent Assay (ELISA) with
      monoclonal BIP 45 anti-LDL antibody. The polymorphism detected by BIP 45
      monoclonal antibody is identical to the Ag(c,g) polymorphism. Antibody BIP 45
      distinguishes three apo B allotypes (immunophenotypes) encoded by the two allelic
      genes apo B Ag(c) and apo B Ag(g). Because of co-dominant transmission, genotypes
      may be inferred from allotypes, and it has been shown that BIP 45 binds strongly
      to the Ag(c) factor and only weakly to the allelic Ag(g) factor. Analysis of the
      Congolese plasma samples indicated that 67.65% of them bound BIP 45 with low
      affinity (Ag(c-,g+) genotype), 28.15% with intermediate affinity (Ag(c+,g+)
      genotype) and 4.20% with high affinity (Ag(c+,g-) genotype). According to the
      Hardy-Weinberg equilibrium, this corresponds to gene frequencies of 0.817 and
      0.183 for the type Ag(g)/Ag(c) alleles, respectively. After adjustment for age
      and body-mass index, it was found that the Ag(c) allele decreases the apo B level
      by 9.62 mg/dl and that the Ag(g) allele increases apo B by 0.43 mg/dl. Therefore,
      as much as 4.30% of the genetic variance for apo B level could be accounted for
      by the Ag(c,g) gene locus.

PMID- 1756600
TI  - Saethre-Chotzen syndrome (ACS III) in four generations.
AB  - The acrocephalosyndactylies (ACS) are a group of inherited disorders
      characterized by premature fusion of cranial sutures in association with
      abnormalities of the hands and feet. Based on their clinical features, different
      types of ACS have been described. We here report on a family with 9 individuals
      affected with ACS III (Saethre-Chotzen syndrome), 5 of them severely. Clinical
      features of the patients are presented with regard to differential diagnostic
      delineations.

PMID- 1756601
TI  - Heterogeneity for mutations in medium chain acyl-CoA dehydrogenase deficiency in
      the UK population.
AB  - MCAD is the commonest inherited disorder of fatty acid oxidation. We have sought
      for and studied 21 affected children from 18 families within the UK. In 14
      families the children are homozygous for the G985 mutation. In three families the
      children are compound heterozygotes for G985 and thus carry another and unknown
      mutation. In one family the child does not carry the G985 mutation on either
      allele. The carrier incidence of the G985 mutation is 1 in 68, which suggests
      that the natural history of MCAD deficiency deserves further study.

PMID- 1756602
TI  - Genetic epidemiology of cystic fibrosis in Saguenay-Lac-St-Jean (Quebec, Canada).
AB  - Cystic fibrosis (CF) is an autosomal recessive disorder with a prevalence at
      birth estimated at 1/2000-1/2500 livebirths in Caucasian populations. Some 127 CF
      individuals are known in Saguenay-Lac-St-Jean (SLSJ), a geographically isolated
      region of Quebec. The prevalence at birth was estimated at 1/902 live borns, and
      the carrier rate was estimated at 1/15 inhabitants in the SLSJ region. The mean
      inbreeding coefficient was only slightly elevated in the CF group compared with
      three control groups, and was due to remote consanguinity. The mean kinship
      coefficient was 2.4 times higher in the CF group than in the control groups. In
      SLSJ region, the places of origin of the CF individuals and their parents did not
      show a clustered nonuniform distribution. Endogamy was not higher in the CF group
      than in control groups.

PMID- 1756603
TI  - Usher syndrome: results of a screening program in Colombia.
AB  - Otological, ophthalmological and genetic studies were performed in 46 patients
      with Usher syndrome, identified through a screening program in Colombia. Of them,
      69.6% had Usher syndrome type I, 26.1% type II, and 4.3% type III. Thirty-three
      patients showed profound deafness (71.7%), while 13 (28.3%) had moderate to
      severe hearing loss. The ophthalmologic manifestations showed marked variability.
      Although the majority of the patients had serious ocular impairment before age
      20, 32.6% had good central visual acuity. The prevalence of Usher syndrome in
      Colombia, estimated at 3.2/100,000, warrants the implementation of screening
      programs in schools for the deaf and for the blind. Our study confirms that Usher
      syndrome shows no geographic or racial variation and that the disorder has a wide
      variability of expression and genetic heterogeneity. The large size of the
      families we have detected may provide important opportunities for further genetic
      studies, particularly in terms of the assignment of the locus and gene mapping.

PMID- 1756604
TI  - Two Japanese cases with aspartylglycosaminuria: clinical and morphological
      features.
AB  - Two members of a consanguineous Japanese family with a clinical picture of
      aspartylglycosaminuria (AGU) are described. Both patients exhibited mental
      retardation, coarse facial features, angiokeratoma and myoclonic seizures.
      Biochemical studies showed elevated excretion of urinary sialyloligosaccharides
      and decreased activity of aspartylglycosaminidase in lymphoblasts. Morphologic
      studies of skin biopsy specimens showed many clear vacuoles mainly in the
      vascular endothelial cells and secretory cells of the sweat glands. Osmiophilic
      lamellar cytoplasmic inclusions were also noted in the ganglion cells in rectal
      biopsy. The ethnic distribution of AGU may be more widespread than previously
      suspected and appears not to be restricted to Finnish populations. Ours are the
      first Japanese patients diagnosed as AGU. We conclude that AGU should also be
      included in the differential diagnosis of mentally retarded patients in Asian
      countries.

PMID- 1756605
TI  - Tuberous sclerosis in a child with de novo translocation t(3;12) (p26.3;q23.3).
AB  - We report on an 8-year-old boy with severe mental retardation, epileptic
      seizures, autistic behaviour, and X-ray CT findings of the skull characteristics
      for tuberous sclerosis. At the age of 9 years, first signs of adenoma sebaceum
      developed. Chromosomal analysis revealed a translocation t(3;12)(p26.3;q23.3).
      The parents were both healthy and had normal karyotypes. As non-random
      association of a chromosomal abnormality and tuberous sclerosis is hypothesized,
      a third locus for this disorder on 3p26 or 12q23 has to be taken in account.

PMID- 1756606
TI  - Familial Caffey's disease and late recurrence in a child.
AB  - Cortical Infantile Hyperostosis (Caffey's disease) is a benign and self-limited
      disorder. Late recurrence or persistence of symptoms with deformity seems
      exceedingly rare. Its occurrence in isolated cases or in multiple members in
      families suggests the existence of two different forms, namely a sporadic form
      and a familial form. The tibia is the predominant bone known to be affected in
      the familial form, while the mandible is mostly affected in the sporadic form.
      The different pathological processes found in these two forms add further to the
      heterogeneity of this disorder. We describe an Arabic-Christian, non
      consanguineous family with two affected sibs. In one, recurrent Caffey's disease
      was diagnosed at the age of 11 years.

PMID- 1756607
TI  - X-linked mental retardation with bilateral clasped thumbs: report of another
      affected family.
AB  - A Sephardi Jewish family is reported in which the two brothers had mental
      retardation, lower limb spasticity and bilateral clasped thumbs anomaly. This X
      linked recessive disorder has only been reported twice. We believe this syndrome
      comprises a distinct entity among the X-linked mental retardation syndromes.

PMID- 1756608
TI  - Nasopalpebral lipoma-coloboma syndrome.
AB  - An autosomal dominant dysplasia-malformation syndrome affecting seven individuals
      in one family is reported. The components of the syndrome include congenital
      nasopalpebral lipoma, telecanthus, and bilateral colobomas of upper and lower
      lids without midface hypoplasia. It appears to be the second recorded example
      resulting from an autosomal dominant gene fully penetrant in both sexes.

PMID- 1756609
TI  - Endocrine and exocrine pancreatic function and the delta F508 mutation in cystic
      fibrosis.
AB  - The relationship between the cystic fibrosis (CF) genotype and endocrine and
      exocrine pancreatic function was studied in 215 CF patients. In the 211 patients
      with the delta F508 mutation, endocrine pancreatic function (oral glucose
      tolerance; WHO criteria) was normal in 72.5%, impaired in 12.3%, and diabetic in
      15.2% of the patients, with no difference between CF patients homozygous (N =
      163, median age 15 years, range 2-40) or heterozygous (N = 48, 18 years, 3-40;
      age difference not significant) for the delta F508 mutation. Exocrine pancreatic
      sufficiency (no need for pancreatic enzyme substitution) was found in 0.6% of the
      patients homozygous for the delta F508 mutation and in 10.4% of the heterozygotes
      (p less than 0.01). Homozygous patients with pancreatic insufficiency took more
      pancreatic enzyme capsules (median 42 per day, range 0-192) than the
      heterozygotes (29 per day, 0-300; p less than 0.001). The four patients (1.9%)
      without the delta F508 mutation had normal glucose tolerance but exocrine
      pancreatic insufficiency. In conclusion, the major mutation genotype in CF (delta
      F508) affects the severity of the exocrine pancreatic insufficiency, whereas
      endocrine pancreatic function is unrelated to this genotype.

PMID- 1756610
TI  - Apparent Fryns' syndrome and aneuploidy: evidence for a disturbance of the
      midline developmental field.
AB  - A premature male infant is described in whom the presence of coarse facies,
      diaphragmatic hernia, genital anomalies and Dandy-Walker malformation suggested a
      diagnosis of Fryns' syndrome. Lymphocyte karyotype revealed a partial trisomy 22,
      and his mother carried an apparently balanced 11/22 translocation. Three infants
      have been described recently with features of Fryns' syndrome and various
      aneuploidies. It is suggested that amplified developmental instability of the
      midline developmental field may account for some of the phenotypic resemblances
      between these cases.

PMID- 1756611
TI  - Mosaic tetraploidy in a liveborn infant with features of the DiGeorge anomaly.
AB  - We report on a liveborn male infant with mosaic tetraploidy who presented with
      multiple congenital anomalies including features of the DiGeorge anomaly (type I
      truncus arteriosus with other cardiovascular malformations, thymic hypoplasia,
      hypocalcemia). No structural chromosome aberrations, namely of chromosome 22,
      were detected. These findings contribute to the variability of symptoms of the
      polyploid phenotype. Additionally, the cytogenetic studies in our case emphasize
      the necessity of investigating fibroblasts in order to evaluate the relevant
      proportion of aberrant cells in mosaicism.

PMID- 1756612
TI  - Egg white proteins.
AB  - 1. Egg white proteins are the principal solutes present in egg white, making up
      approximately 10% of its weight. 2. They are globular proteins and most have
      acidic isoelectric points. 3. Many are glycoproteins with carbohydrate contents
      ranging from 2 to 58%. 4. Of the major egg white proteins, lysozyme is the only
      one having catalytic activity, but many have specific binding sites, e.g. for
      vitamins such as biotin, riboflavin and thiamin, or for metal ions such as FeIII.
      5. A major group are those showing proteinase inhibitory activity, and they
      include ovomucoid, ovoinhibitor, cystatin and ovostatin. 6. The synthesis of egg
      white protein occurs in the oviduct, and is hormonally controlled either by
      oestrogens or progesterone. 7. Extensive studies have been carried out in the
      genes coding for egg white proteins.

PMID- 1756613
TI  - Equine testicular aromatase: substrates specificity and kinetic characteristics.
AB  - 1. In the stallion, estrogens were synthesized and sulfated in vivo by the
      testis. 2. The equine testicular enzyme aromatized androgens and 19-norandrogens
      with similar velocity, but not 16 alpha-hydroxytestosterone or epitestosterone in
      contrast to the human placental aromatase. 3. One single enzyme was implicated in
      the aromatization of androstenedione, testosterone, 19-norandrostenedione and 19
      nortestosterone by ETMES. 4. During the process of androstenedione aromatization
      by ETMES, 19-hydroxyandrostenedione and 19-oxoandrostenedione were released and 4
      hydroxyandrostenedione was a competitive inhibitor causing an additional
      irreversible enzyme inactivation which is what occurs with HPMES. 5.
      Dihydrotestosterone was a potent competitive inhibitor of aromatase activity.

PMID- 1756614
TI  - Comparative chromatography of Brazilian coral snake (Micrurus) venoms.
AB  - 1. Elution profiles of 11 coral snake venoms, including those of Micrurus
      albicinctus, M. corallinus, M. frontalis altirostris, M. f. brasiliensis, M. f.
      frontalis, M. fulvius fulvius, M. ibiboboca, M. lemniscatus ssp., M. rondonianus,
      M. spixii spixii and M. surinamensis surinamensis, were compared using high
      performance gel filtration and reverse phase media. 2. Micrurus venom profiles
      were compared with those of "outgroup" taxa Bothrops moojeni, Naja naja kaouthia
      and Bungarus multicinctus. 3. Purified elapid venom constituents were also
      chromatographed under identical conditions in order to suggest possible
      identities of Micrurus venom constituents. 4. Masses of various components were
      confirmed by mass spectrometry. 5. Phospholipase constituents in three venoms
      were positively identified based on their reverse phase chromatograms. 6. Venoms
      of M. rondonianus and M. s. surinamensis are shown to be significantly different
      in their peptide composition from other Micrurus venoms.

PMID- 1756615
TI  - A comparative study of bile acid CoA:amino acid:N-acyltransferase (BAT) from four
      mammalian species.
AB  - 1. Bile acid CoA:amino acid:N-acyltransferase (BAT) was partially purified from
      dog, human, pig and rat livers. The interspecies variation in substrate
      specificity and kinetics were determined for glycine and taurine. 2. BAT activity
      from dog liver formed bile acid conjugates with taurine exclusively, whereas BAT
      activity from each of the other species formed conjugates with both taurine and
      glycine. 3. Biliary composition of glycine and taurine bile acid conjugates could
      partly be accounted for by substrate affinity (Km) and turnover number (Vmax) of
      BAT activity. 4. A monospecific anti-human BAT polyclonal antibody reacted on
      Western blot analysis with a 40 kDa band in a 100,000 g supernatant fraction from
      rat liver. 5. Immunoabsorption chromatography using an anti-human BAT antibody
      Sepharose affinity column showed that both the immunoreactive protein band and
      BAT activity were removed from the 100,000 g supernatant fraction from human and
      rat livers.

PMID- 1756616
TI  - Comparison of glycosidase activities in epidermis, palatal epithelium and buccal
      epithelium.
AB  - 1. beta-Glucosidase, alpha-glucosidase, beta-galactosidase and alpha-mannosidase
      were measured in epidermis, palatal and buccal epithelium of the pig (Sus
      scrofa). 2. All three epithelia contained similar alpha-mannosidase activity (1.7
      3.2 nmol mg tissue-1 hr-1 at pH 4), and none contained significant alpha
      glucosidase. 3. Specific activity of beta-glucosidase was high (9-13 nmol mg
      tissue-1 hr-1 at pH 4) in epidermis and palate, but activity was low (less than 2
      nmol mg tissue-1 hr-1) in buccal epithelium. 4. Only epidermis contained a high
      level of beta-galactosidase (5.8 nmol mg tissue-1 hr-1). 5. Differences in
      glycosidase profiles may underlie differences in permeability barrier properties
      in these epithelia.

PMID- 1756617
TI  - Glucose entry rate in dairy cattle as determined by stable isotope 13C-labelled
      glucose at different stages of reproduction.
AB  - 1. Uniformly labelled stable 13C-glucose was used to study glucose entry in high
      yielding Holstein cows (n = 8) under normal production conditions. 2. The single
      injection technique was repeated at three different reproductive phases. A two
      compartment model was applied to calculate mean entry rates of glucose resulting
      in: (1) Terminal phase of pregnancy (2 weeks a.p.): 0.41 g/hr/kg0.75; (2) Peak
      lactation (6 weeks p.p.): 0.97 g/hr/kg0.75; (3) End of lactation (37 weeks p.p.):
      0.61 g/hr/kg0.75. 3. Data from studies using radioactively labelled tracers are
      in good agreement with our results obtained without any restrictions implied by
      the handling with radioactive substances.

PMID- 1756618
TI  - Chemical structures of three neutral oligosaccharides obtained from horse
      (thoroughbred) colostrum.
AB  - 1. Three neutral oligosaccharides were obtained from horse colostrum by ion
      exchange, activated charcoal column and preparative paper chromatographies. 2.
      The following structures were elucidated by methanolysis, methylation analysis
      and 75 MHz 13C-NMR spectroscopy; Gal beta 1-4GlcNAc beta 1-3Gal beta 1-4Glc (HM
      3a), Gal beta 1-4GlcNAc beta 1-6Gal beta 1-4Glc (HM-3b) and Gal beta 1-4GlcNAc
      beta 1-3[Gal beta 1-4GlcNAc beta 1-6]Gal beta 1-4Glc (HM-5). 3. HM-3a and HM-5
      have been found in human milk, named as lacto-N-neotetraose and lacto-N
      neohexaose, respectively. HM-3b has been isolated from goat milk. 4. An homology
      and heterogeneity were assumed among the following animal species' milk
      oligosaccharides: horse, human, goat and tammar wallaby.

PMID- 1756619
TI  - Species-specific antibodies of Tetrahymena acid alpha-glucosidase.
AB  - 1. Tetrahymena acid alpha-glucosidases A and B were purified from T. pyriformis W
      and T. thermophila 399, respectively. The acid alpha-glucosidases A and B were
      different in immunological properties and thermostability. 2. The acid alpha
      glucosidases A and B reflected specific distribution between T. pyriformis and T.
      thermophila. 3. Type A and B of taurolipid showed a species-specific distribution
      pattern between T. pyriformis and T. thermophila.

PMID- 1756620
TI  - Is the "mammalian" brown fat-specific mitochondrial uncoupling protein present in
      adipose tissues of birds?
AB  - 1. Mitochondria were isolated from the furcular, subcutaneous, abdominal, nape
      and lateral adipose tissue depots of five species of bird (pheasant, Japanese
      quail, pigeon, house sparrow and great tit) acclimatized to the Northern winter.
      2. Mitochondrial proteins were separated by SDS-polyacrylamide gel
      electrophoresis, blotted onto nitrocellulose membranes, and probed for the
      presence of the 32,000-33,000 Mr uncoupling protein characteristic of "mammalian"
      brown adipose tissue, using an anti-(ground squirrel uncoupling protein)serum. 3.
      Immunoreactivity consistent with uncoupling protein was not detected in
      mitochondria from any of the avian adipose tissues. Immunoreactivity was,
      however, evident in mitochondria from perirenal or interscapular adipose tissue
      from a range of mammals--rats, mice, golden hamsters, Orkney voles, wood mice,
      pipistrelle bats, wood lemmings, and newborn lambs, cattle, reindeer and red
      deer. 4. These results provide biochemical evidence that "mammalian-like"
      thermogenic brown adipose tissue is absent from avian species; adipose tissues in
      birds appear to be functionally "white".

PMID- 1756621
TI  - Regional differences in content of small basic peptide toxins in the venoms of
      Crotalus adamanteus and Crotalus horridus.
AB  - 1. Reverse-phase HPLC and organic solvents were used to isolate small basic
      peptide (SBP) toxins from the venoms of Crotalus adamanteus, C. durissus
      terrificus, C. horridus, C. scutulatus scutulatus, C. viridis concolor, C.
      viridis helleri and C. viridis viridis. 2. Acid-DEP analyses indicated a high
      degree of toxin purity which was obtained with a single HPLC run. 3. The combined
      results of HPLC, immunodiffusion and electrophoresis analyses of venoms from
      different geographical regions indicate that the SBP toxin content in the venoms
      of Crotalus adamanteus, Crotalus horridus, Crotalus scutulatus and Crotalus
      viridis viridis may vary regionally.

PMID- 1756622
TI  - A comparative study of the structure of egg-white riboflavin binding protein from
      the domestic fowl and Japanese quail.
AB  - 1. The riboflavin binding proteins from domestic fowl and Japanese quail have
      been isolated and their structures compared by circular dichroism, fluorescence
      and peptide mapping. 2. The two proteins have similar secondary structures, but
      differ in their tertiary structures as reflected in the environments of aromatic
      amino acid side chains. 3. Differences in amino acid sequence between the
      proteins are indicated by the digestion patterns obtained with thermolysin,
      chymotrypsin and V8 proteinase from Staphylococcus aureus. Both proteins are
      resistant to digestion by trypsin.

PMID- 1756623
TI  - The major glutathione S-transferase in salmonid fish livers is homologous to the
      mammalian pi-class GST.
AB  - 1. The hepatic glutathione S-transferase (GST) isoenzymes were isolated and
      characterized from salmon, sea trout and rainbow trout. 2. In all three species
      the predominant GST expressed comprised subunits of Mr 24,800. These subunits
      each co-migrated with the rat pi-class Yf polypeptide during SDS/polyacrylamide
      gel electrophoresis. 3. Western blotting experiments demonstrated immunochemical
      cross-reactivity between the major salmonid and the rat pi-class GSTs. 4. The
      salmon GST of subunit Mr 24,800 was digested with cyanogen bromide and the
      peptides, once purified by reverse-phase HPLC, were subjected to automated amino
      acid sequencing. 5. Over the region sequenced, the salmon GST possessed about 65%
      homology with the rat and human pi-class GST.

PMID- 1756624
TI  - The Nova-T IUD--a review of the literature.
AB  - The Nova-T IUD is being widely used in Western Europe, Canada, and some parts of
      Asia; numerous studies based on comparative trials with other types of IUDs have
      been reported. The results were consistent among most studies, but conflicting
      among others. This review paper revealed that, in general, the Nova-T IUD is a
      safe, effective, and acceptable device for contraception. However, more
      comparative studies with the other copper-releasing IUDs are needed to resolve
      some of the controversial findings on its long-term (e.g., five years or more)
      efficacy, especially with the TCu 380A which has the prospect of being used
      worldwide. The epidemiological (e.g., effects of age, parity, and lactating
      status of the women) and programmatic aspects (e.g., provider factors and timing
      of insertion) related to the performance of this device are also reviewed in this
      paper.

PMID- 1756625
TI  - Observation of the activity of factor VIII in the endometrium of women pre- and
      post-insertion of three types of IUDs.
AB  - The endometrial materials were obtained from 90 women who had been randomly
      inserted with three types of IUDs (Stainless steel ring, SS; copper T 220, TCu
      220, and levonorgestrel-releasing device, LNG). An immunoperoxidase reaction, PAP
      method, with the antiserum of Factor VIII as the primary antibody, was carried
      out to detect the Factor VIII activity in the endometrial endothelium pre-
      (control) and post-insertion of the IUDs. The results revealed that: 1. There was
      a generalized lower Factor VIII activity in the endometrium of women post
      insertion of IUDs (except LNG). 2. Comparison of the Factor VIII activity in the
      endometrium of women using different types of IUDs showed that the TCu type and
      the SS type decreased the activity significantly whereas the activity remained
      unchanged after 3-6 months' use of the LNG-IUD. The different types of IUDs
      seemed to influence the coagulation regulatory system in different ways; the
      lower Factor VIII activity, the more tendency to bleeding. 3. The Factor VIII
      activity in the endometrium of women using IUDs was lower in all phases of the
      menstrual cycle including the proliferative phase when the Factor VIII activity
      is normally high. It cannot be excluded that this could be a contributing factor
      to IUD-induced bleedings.

PMID- 1756626
TI  - Effect of tarnish on copper release.
AB  - The rate of copper loss from bright and tarnished collars from Copper T Model TCu
      380A IUDs has been investigated in amino acid solutions of pH 5.5 and 7.4 and in
      serum. In all three media, the tarnished collars quickly became bright and lost
      copper at the same rate as the initially bright collars. The single exception was
      when a high ratio of copper surface to serum was used. Under those conditions the
      tarnished collars initially became bright but after two days a black precipitate
      appeared on both the initially bright and tarnished collars and weight loss
      ceased. When a higher ratio of serum to copper surface was used, the pattern was
      one of continuing loss although at a lower rate than in the amino acid solutions.
      It is concluded that tarnish does not compromise the oxidation and dissolution of
      copper even in serum. Serum is considered a surrogate for uterine fluid.

PMID- 1756628
TI  - Phase II--clinical trial with biodegradable subdermal contraceptive implant
      Capronor (4.0-cm single implant). Indian Council of Medical Research Task Force
      on Hormonal Contraception.
AB  - The subdermal biodegradable contraceptive implant Capronor (4.0 cm) was implanted
      in 41 women to observe the efficacy and side effects. Only one pregnancy was
      reported at 10 months of use, and the life table continuation rate at 12 months
      was 82.2 per 100 users. No serious clinical side effects were reported during the
      study period. The menstrual pattern was disrupted during the first 3 months of
      implant use in two-thirds of the women which improved by the end of 12 months of
      use. The results of this Phase II study suggest that Capronor is a safe and
      effective long-acting contraceptive. These findings need to be confirmed in a
      Phase III clinical trial on a larger sample size.

PMID- 1756627
TI  - Clinical trial with 3-keto-desogestrel subdermal implants.
AB  - The study was done to assess the clinical performance and in vivo steroid release
      rate of 3-keto-desogestrel subdermal implants designed to deliver 5 different
      doses of the progestin. Volunteers were healthy women of proven fertility who
      provided blood samples at scheduled intervals during treatment. No pregnancy
      occurred in 514 woman-months in users of implants delivering 30 and 40 micrograms
      per day of 3-keto-desogestrel. Three pregnancies, one ectopic, were observed in
      109 woman-months recorded with implants delivering 20 micrograms per day or less.
      Ovulation was inhibited, as judged by depressed progesterone levels, in 57 of 59
      (97%) blood samplings in women whose 3-keto-desogestrel plasma levels were
      greater than 0.28 nmol/L and in 39 of 75 (52%) of cases with lower levels. Users
      of 4 cm implants manufactured by The Population Council, New York, showed mean
      levels above 0.28 nmol/L until 18 months of use. Levels achieved with 4.4 cm
      implants manufactured by Organon, Oss, Holland, were less consistent. No changes
      were observed in the plasma lipoprotein pattern or clinical chemistry during
      treatment. The main complaint was the occurrence of bleeding irregularities,
      particularly with the lower doses. Ovarian cysts found during pelvic examination
      in 11 (22%) subjects disappeared spontaneously within 7-90 days. 3-keto
      desogestrel implants releasing around 40 ug/day and providing plasma levels
      around 0.28 nmol/L afford efficient contraceptive protection.

PMID- 1756629
TI  - Contraception and sexuality in an area-specific group of Swedish women 15-34
      years of age.
AB  - In a community-based study in a Swedish suburban/rural area, all women aged 15-34
      years (n = 671) were invited to the local health centre to be examined for
      chlamydia infection and for an interview. The attenders were asked about
      contraceptive history, age at first intercourse, number of life-time sexual
      partners and socioeconomic background. The net attendance was 69%, and
      contraceptive information on an additional 20% could be gathered through medical
      records. The average age at first intercourse was around 16 years, and the
      average number of sexual partners in the age-groups 20-24, 25-30 and 31-34 years
      was 4.0, 5.6 and 6.1, respectively. Of all women, around 75% had used
      contraception at first intercourse, and there was no tendency to a changing
      pattern during the past 20 years studies through the interviews. Combined
      estrogen-progestagen pills were by far the most used contraceptive method,
      presently being used by 42% of the contracepting women, followed by condom (23%),
      IUD (19%) and other hormonal methods (10%). It is concluded that sexual life in
      Sweden starts earlier than it did 30 years ago, that the number of sexual
      partners is higher, that most women in the studied group were efficient
      contraceptors, and that hormonal contraception was by far the most common method.

PMID- 1756631
TI  - Valproate-induced alterations of coenzyme A and coenzyme A ester concentrations
      in human kidney tubules metabolizing glutamine.

PMID- 1756630
TI  - Use of hCG stimulation test in women immunized with beta-hCG vaccine.
AB  - Eleven normally menstruating women, who had earlier been immunized with NII beta
      hCG vaccine but had no detectable anti-hCG antibody titres, were selected as
      controls for the hCG challenge test using 1000/2000 I.U. The test was repeated in
      five of them after a booster immunization, which raised antibody titres to 18-450
      ng/ml. Stimulation of serum progesterone secretion was used as an index of corpus
      luteum (CL) response to the I.V. hCG. In the control group, the progesterone (P)
      secretory response following hCG stimulus showed peak levels which were
      significantly higher than basal levels in all except 2 subjects. The non
      responsiveness in 2 subjects cannot be easily explained but may be dose-related.
      No significant difference was noted between the two dose levels. Length of luteal
      phase was increased by 4-5 days in 6 out of 20 cycles studied. The results of
      this test in 5 women before and after the vaccine boosters were encouraging as
      peak P levels appeared higher than basal levels in controls, but not so in the
      immunized group. However, these results could not be confirmed statistically.
      Nonetheless, this study is suggestive that the antibodies generated by this
      vaccine were capable of intercepting the effect of exogenous hCG in the human
      female. Further studies with more subjects and higher dosage of hCG are called
      for.

PMID- 1756632
TI  - Determinants of the partition of renal ammonia production between urine and
      venous blood in man with metabolic acid-base disturbances.

PMID- 1756633
TI  - Renal ammoniagenesis in man with chronic potassium depletion.

PMID- 1756634
TI  - Regulation of renal medullary ammonium accumulation.

PMID- 1756635
TI  - Changes in rat renal glutaminase activity on isolation from the mitochondrial
      membrane.

PMID- 1756636
TI  - Mapping ammoniagenic enzyme activities along the rat nephron.

PMID- 1756637
TI  - Ammonia production and secretion by the proximal tubule: effect of peritubular
      and luminal potassium concentration.

PMID- 1756638
TI  - Brain glutaminase activated by short-term microwave irradiation.

PMID- 1756639
TI  - Interactions between cell volume and hepatic nitrogen metabolism.

PMID- 1756640
TI  - Acute and chronic metabolic acidosis in the pig: renal metabolism and
      ammoniagenesis.

PMID- 1756641
TI  - Regulation of acetylglutamate in the liver: effect of glucocorticoid and renal
      failure.

PMID- 1756642
TI  - Nitrogen-15 NMR: a new technique for the study of renal nitrogen metabolism.

PMID- 1756643
TI  - Effect of acidosis on phosphoenolpyruvate carboxykinase and glutaminase mRNAs in
      rat kidney and in LLC-PK-F+ cells.

PMID- 1756644
TI  - Structure and expression of genes for urea cycle enzymes.

PMID- 1756645
TI  - Metabolic interactions between renal proline and glutamine metabolism.

PMID- 1756646
TI  - Evidence that the transport of glutamine into pig renal mitochondria is not rate
      limiting for glutamine hydrolysis.

PMID- 1756647
TI  - The significance of the purine nucleotide cycle in metabolism of renal medulla.

PMID- 1756648
TI  - Biochemical and anatomic evidence for renal tubule hypermetabolism and
      hypertrophy in long-standing experimental diabetes mellitus.

PMID- 1756649
TI  - The role of ammonia in progressive renal injury.

PMID- 1756650
TI  - Studies on the maleic acid-induced Fanconi syndrome in the rat: mechanism of
      phosphaturia and its mitigation by dietary phosphate restriction.

PMID- 1756651
TI  - Hepatic and renal regulation of metabolite flow in the remnant kidney model of
      chronic renal failure.

PMID- 1756652
TI  - Traumatic heart disease.

PMID- 1756653
TI  - Caught between parents: adolescents' experience in divorced homes.
AB  - This study examined adolescents' feelings of being caught between parents to see
      whether this construct helps to explain (1) variability in their postdivorce
      adjustment and (2) associations between family/child characteristics and
      adolescent adjustment. Adolescents 10 to 18 years old (N = 522) were interviewed
      by telephone 4 1/2 years after their parents' separation. Feeling caught between
      parents was related to high parental conflict and hostility and low parental
      cooperation. Being close to both parents was associated with low feelings of
      being caught. The relation between time spent with each parent and feeling caught
      depended on the coparenting relationship. Adolescents in dual residence were
      especially likely to feel caught when parents were in high conflict, and
      especially unlikely to feel caught when parents cooperated. Feeling caught was
      related to poor adjustment outcomes. Parental conflict was only related to
      adjustment outcomes indirectly, through adolescents' feelings of being caught.

PMID- 1756654
TI  - Conflictive engagement, positive affect, and menarche in families with seventh
      grade girls.
AB  - Prior research has established that temporary perturbations characterize parent
      daughter relations around menarche. This study was designed to determine whether
      the observed perturbations are indicative of conflictive engagement,
      operationally defined as sequential reciprocity of interruptions and
      disagreements, and to examine the affective nature of such behaviors. Sequential
      analyses were applied to the observed behavior of 111 intact families with
      firstborn seventh-grade girls (modal age = 12 years old) who participated in a
      structured family interaction task. Results indicated that conflictive engagement
      with parents is more frequent shortly after menarche, especially in the mother
      daughter dyad. Withdrawal of positive affect also was associated with menarcheal
      status; in the mother-daughter dyad, interruptions and disagreements were less
      often responded to with positive affect for the more mature groups. It is
      suggested that because of the nature of the interpersonal and intrapsychic
      processes occurring in the family around menarche, conflict may facilitate
      familial adaptation to pubertal change and make moderate levels of conflict
      normative in healthy families.

PMID- 1756655
TI  - Patterns of competence and adjustment among adolescents from authoritative,
      authoritarian, indulgent, and neglectful families.
AB  - In order to test Maccoby and Martin's revision of Baumrind's conceptual
      framework, the families of approximately 4,100 14-18-year-olds were classified
      into 1 of 4 groups (authoritative, authoritarian, indulgent, or neglectful) on
      the basis of the adolescents' ratings of their parents on 2 dimensions:
      acceptance/involvement and strictness/supervision. The youngsters were then
      contrasted along 4 sets of outcomes: psychosocial development, school
      achievement, internalized distress, and problem behavior. Results indicate that
      adolescents who characterize their parents as authoritative score highest on
      measures of psychosocial competence and lowest on measures of psychological and
      behavioral dysfunction; the reverse is true for adolescents who describe their
      parents as neglectful. Adolescents whose parents are characterized as
      authoritarian score reasonably well on measures indexing obedience and conformity
      to the standards of adults but have relatively poorer self-conceptions than other
      youngsters. In contrast, adolescents from indulgent homes evidence a strong sense
      of self-confidence but report a higher frequency of substance abuse and school
      misconduct and are less engaged in school. The results provide support for
      Maccoby and Martin's framework and indicate the need to distinguish between two
      types of "permissive" families: those that are indulgent and those that are
      neglectful.

PMID- 1756656
TI  - Relations between social competence and academic achievement in early
      adolescence.
AB  - Relations between academic performance and 3 aspects of social competence-
      socially responsible behavior, sociometric status, and self-regulatory processes
      (goal setting, interpersonal trust, and problem-solving styles)--were studied.
      Based on a sample of 423 12- and 13-year-old students, correlational findings
      indicate that each aspect of social competence is related significantly to
      students' grades. Results from multiple regression analyses suggest that when
      accounting for students' IQ, sex, ethnicity, school absence, and family
      structure, socially responsible behavior mediates almost entirely the relations
      between students' grades and the other 2 aspects of social competence. Socially
      responsible behavior and peer status appear to be related by way of their joint
      association with goals to be socially responsible, interpersonal trust, and
      problem-solving styles. Similarly, relations between socially responsible
      behavior and the background variables are explained by joint relations with the
      self-regulatory processes. The social nature of learning and the role of self
      regulation in both interpersonal and behavioral aspects of social competence are
      discussed.

PMID- 1756657
TI  - Functional measurement assessment of young children's ability to predict future
      behavior.
AB  - The reported experiments demonstrate that young children's ability to use
      previous behavioral information to predict future behavior emerges on
      quantitative, but not dichotomous, judgment tasks. In a first experiment,
      kindergartners, second graders, and fourth graders made quantitative liking
      judgments and predictions for peers after being presented 2 pieces of behavioral
      information. Children of all 3 age groups used both pieces of information in
      their liking judgments and predictions. In a second experiment, kindergartners
      were presented with 2 types of tasks; one was a quantitative prediction,
      comparable to the task in Experiment 1, and the second were dichotomous
      predictions, comparable to judgment tasks typically used in other experiments.
      Children's predictions were significantly more consistent with the behavioral
      information on the quantitative task than on either of the dichotomous tasks.
      These results suggest that young children believe in the ability of interpersonal
      behavior, but have difficulty dealing with the complexity of some prediction
      tasks.

PMID- 1756658
TI  - Children's understanding of action lines and the static representation of speed
      of locomotion.
AB  - Children's understanding of the static representation of speed of locomotion was
      explored in 2 experiments. In Experiment 1, 20 7-year-olds and 20 9-year-olds
      drew pictures of 2 people walking and running at different speeds. Children then
      made judgments about pairs of unambiguous drawings of a person walking or
      running, as did a sample of 20 adults. The drawings varied according to whether
      action lines, background lines, or no lines were present. Children were asked to
      say which figure appeared to be moving faster. In Experiment 2, 20 7-year-olds,
      20 9-year-olds, and 21 adults sorted ambiguous drawings of a person walking and
      running at different speeds. The pictures again contained action lines,
      background lines, or no lines. In the drawing task, children more frequently used
      page position and biomechanical information than action lines to represent fast
      and slow walking and running. In the judgment task, 7- and 9-year-olds offered
      equivalent judgments of action lines and background lines, whereas adults
      distinguished between these pictorial devices. In the sorting task, all subjects
      distinguished between action lines and background lines and judged that pictures
      containing action lines looked faster than pictures containing background lines
      and pictures without lines. Taken together, the results indicate that subjects'
      judgments were influenced by the form of locomotion and degree of ambiguity in
      the depicted events they saw. The findings are consistent with the view that
      different categories of pictorial devices exist, but the effectiveness of each
      device is contingent upon the perceiver's experience with it and the context in
      which it appears.

PMID- 1756659
TI  - Contextual variation and memory retrieval at six months.
AB  - In 2 experiments we asked whether training in multiple contexts could eliminate
      context-dependent memory retrieval at 6 months as it does for adults. We found
      that 24-hour retention was disrupted when infants were trained in one context and
      tested in another but not when they were trained in multiple contexts prior to
      testing in a novel context (Experiment 1). After a long delay, however, training
      in multiple contexts did not facilitate memory retrieval in a novel context: An
      otherwise effective retrieval cue (the training mobile) did not alleviate
      forgetting 3 weeks later when it was presented in a novel context (Experiment 2).
      These findings demonstrate that multiple learning contexts can override the
      debilitating effects of an altered context on memory retrieval at 6 months, but
      only over the short term. The resistance of older memories to retrieval in novel
      contexts after long periods of disuse may be adaptive, insuring that potentially
      inappropriate or irrelevant memories will not be expressed.

PMID- 1756660
TI  - Infant temperament and genetics: an objective twin study of motor activity level.
AB  - Child temperament theories generally presume genetic contributions to behavioral
      differences, but empirical support is based largely on parent ratings of twins.
      These subjective ratings may be biased by parental exaggeration of dizygotic
      differences or of monozygotic similarities. An objective assessment of the
      genetic hypothesis was undertaken with motor activity level, a core dimension of
      most temperament theories. The activity level of 60 infant twin pairs was
      measured both by parent ratings and by motion recorders over a 2-day period. Data
      from the motion recorders showed evidence of genetic influences (RMZ = .76, RDZ =
      .56), as did parent ratings (RMZ = .82, RDZ = .21). The motion recorder results
      confirm with instrumentation a critical assumption of temperament theories and
      identify the presence of genetic contributors to temperamentally relevant
      behavioral differences in infancy.

PMID- 1756661
TI  - Defensive behaviors in infant rhesus monkeys: ontogeny and context-dependent
      selective expression.
AB  - We examined the ontogeny of the infant rhesus monkey's defensive behaviors and
      the ability to modulate them in response to specific environmental cues. Rhesus
      infants in 4 age groups (N = 8 per group) were briefly separated from their
      mothers and tested under 3 conditions: alone, in the presence of a human who
      averted his gaze, and in the presence of a human staring at them. Infants as
      young as 0 to 2 weeks displayed defensive behaviors but did not selectively
      respond to the human's presence or direction of gaze. By 9 to 12 weeks of age,
      infants modulated their responses in relation to the parameters of the threat. At
      this age, infant rhesus monkeys undergo cognitive and emotional changes
      associated with brain development similar to those in human infants 7 to 12
      months old. This also is the time when human infants engage in complex emotional
      and behavioral responses to threatening situations. Understanding the development
      and expression of defensive behaviors in infant monkeys should be applicable to
      similar issues in emotional development of human infants.

PMID- 1756662
TI  - Estimation of gestational age: implications for developmental research.
AB  - Recent research in neonatology and obstetrics has challenged the validity of
      standard gestational age assessment methods. Length of gestation is a central
      component of research on the development of at-risk infants, yet issues
      concerning accuracy of this information are rarely addressed by developmental
      researchers. This article reviews prenatal and postnatal methods of gestational
      age estimation and evaluates implementation of this information in research.
      Recommendations concerning the assignment of gestational age in the perinatal
      period and the use of age correction for preterm infants are offered.

PMID- 1756663
TI  - Establishing the reliability and developmental validity of a neurobehavioral
      assessment for preterm infants: a methodological process.
AB  - The Neurobehavioral Assessment of the Preterm Infant was developed in 3 phases: a
      pilot study, an exploratory study, and a validation study. In the exploratory
      study, clusters characterized by conceptual cohesion and face validity were
      systematically subjected to statistical analyses to determine whether they also
      had high test-retest reliability and developmental validity. In the validation
      study, a shortened version of the test was used with an independent cohort of 290
      preterm infants. A step-by-step methodological process was used to test whether
      the results from the exploratory study would generalize over cohorts, different
      versions of the test, different hospitals, and changes in examiners. This process
      yielded 7 highly stable, developmentally valid, and representative preterm
      neurobehavioral functions that generalized over the exploratory and the
      validation studies. These were: motor development and vigor, scarf sign,
      popliteal angle, alertness and orientation, percent asleep ratings, irritability,
      and vigor of crying.

PMID- 1756664
TI  - Infants' contribution to the achievement of joint reference.
AB  - This research examines whether infants actively contribute to the achievement of
      joint reference. One possibility is that infants tend to link a a label with
      whichever object they are focused on when they hear the label. If so, infants
      would make a mapping error when an adult labels a different object than the one
      occupying their focus. Alternatively, infants may be able to use a speaker's
      nonverbal cues (e.g., line of regard) to interpret the reference of novel labels.
      This ability would allow infants to avoid errors when adult labels conflict with
      infants' focus. 64 16-19-month-olds were taught new labels for novel toys in 2
      situations. In follow-in labeling, the experimenter looked at and labeled a toy
      at which infants were already looking. In discrepant labeling, the experimenter
      looked at and labeled a different toy than the one occupying infants' focus.
      Infants' responses to subsequent comprehension questions revealed that they (a)
      successfully learned the labels introduced during follow-in labeling, and (b)
      displayed no tendency to make mapping errors after discrepant labeling. Thus
      infants of only 16 to 19 months understand that a speaker's nonverbal cues are
      relevant to the reference of object labels; they already can contribute to the
      social coordination involved in achieving joint reference.

PMID- 1756665
TI  - Maternal representations of attachment during pregnancy predict the organization
      of infant-mother attachment at one year of age.
AB  - While strong retrospective and concurrent associations between maternal and
      infant patterns of attachment have been noted, this is one of the first reports
      of a prospective investigation of such associations. The Adult Attachment
      Interview was administered to 100 mothers expecting their first child, and, at 1
      year follow-up, 96 of these were seen with their infants at 12 months in the
      Strange Situation. Maternal representations of attachment (autonomous vs.
      dismissing or preoccupied) predicted subsequent infant-mother attachment patterns
      (secure vs. insecure) 75% of the time. These observed concordances, as well as
      the discordances, are discussed in terms of the uniquely powerful contribution
      the Adult Attachment Interview makes to the study of representational and
      intergenerational influences on the development of the infant-mother attachment.

PMID- 1756666
TI  - Emotional determinants of infant-mother attachment.
AB  - The present study examined the assumption that emotion-related characteristics of
      mothers and infants contribute to the development of infant-mother attachment in
      the first year of life. Mothers' emotion and personality characteristics were
      assessed with expressive-behavior ratings and self-report scales. Infant
      characteristics were measured by emotion and temperament questionnaires (mother
      report) and objective coding of facial expressions of emotions. Attachment
      classifications were determined by means of the Strange Situation procedure, and
      a continuous-variable index of attachment security was derived by a discriminant
      function procedure. Mothers' emotion experiences, expressive behaviors, and
      personality traits were significant predictors of the level of security of the
      infant-mother attachment. Infants' expressive and temperamental characteristics
      as rated by their mothers were also significant predictors of attachment
      security.

PMID- 1756667
TI  - Behavioral competence among mothers of infants in the first year: the mediational
      role of maternal self-efficacy.
AB  - This study tests the idea that mothers' self-efficacy beliefs mediate the effects
      on parenting behavior of variables such as depression, perceptions of infant
      temperamental difficulty, and social-marital supports. Subjects were 48
      clinically depressed and 38 nondepressed mothers observed in interaction with
      their 3-13-month-old infants (M = 7.35 months). As predicted, maternal self
      efficacy beliefs related significantly to maternal behavioral competence
      independent of the effects of other variables. When the effects of self-efficacy
      were controlled, parenting competence no longer related significantly to social
      marital supports or maternal depression. In addition, maternal self-efficacy
      correlated significantly with perceptions of infant difficulty after controlling
      for family demographic variables. These results suggest that maternal self
      efficacy mediates relations between maternal competence and other psychosocial
      variables and may play a crucial role in determining parenting behavior and
      infant psychosocial risk.

PMID- 1756669
TI  - Social interactions and peer perceptions of young physically abused children.
AB  - 14 3-6-year-old children with a history of physical abuse and a closely matched
      comparison group of 14 nonabused children, all of whom had been in day-care for
      more than a year, participated in this investigation. Behavior observations,
      teacher reports, and peer sociometric ratings were used to evaluate children's
      peer interactions. It was found that abused children initiated fewer positive
      interactions with peers and exhibited a higher proportion of negative behavior
      than nonabused comparison children. Peers viewed abused children as less well
      liked. Further, peers were less likely to reciprocate the initiations of abused
      children, although they approached abused children as often as they approached
      comparison children. Teachers viewed abused children as more behaviorally
      disturbed. Overall, results indicated that abused children experience disturbed
      social interactions outside the home environment, despite involvement in a day
      care setting that provides alternative peer and adult role models.

PMID- 1756668
TI  - Maternal work and child-care strategies in peri-urban Guatemala: nutritional
      effects.
AB  - Associations of 293 mothers' work for earnings and child-care arrangements with
      the anthropometric status of their children were examined in urban Guatemala. It
      was hypothesized that during the period of life in which growth often falters (8
      through 35 months), maternal employment could be beneficial for children.
      Informal workers tended to be poorer, less educated, and have more undernourished
      children than formal workers or nonworkers. When poverty and mother's education
      were controlled for, no effects of maternal employment on children's
      anthropometric growth patterns were seen. However, the percent of the family
      income the mother earned was positively associated with all anthropometric
      indicators, controlling for confounds. Children taken care of by preteen siblings
      had significantly lower weight for height than those in other situations, even
      controlling for SES and maternal employment status. These effects were not found
      in a 36-48-month-old sample.

PMID- 1756670
TI  - Peer reputation in middle childhood as a predictor of adaptation in adolescence:
      a seven-year follow-up.
AB  - This investigation examines the predictive significance of peer reputation in
      elementary school for the quality of adaptation in adolescence. A normative
      sample (N = 207) of third to sixth graders was administered the Revised Class
      Play (RCP). Each received 3 scores (Sociability-Leadership, Aggression
      Disruption, and Sensitivity-Isolation). 7 years later, 88% of these children and
      their parents participated in a questionnaire follow-up study utilizing a broad
      range of adolescent outcome measures (e.g., social and athletic competence,
      academic performance, behavioral symptoms, well-being). The 3 RCP scores were
      significantly related to both adolescent competence and psychopathology,
      supporting the predictive validity of the RCP as well as the continuity of
      general adaptation. Each dimension of peer reputation had a different pattern of
      prediction depending on the outcome criteria under consideration, suggesting the
      importance of a multidimensional approach to peer reputation. Positive peer
      reputation proved to be an important predictor of later adjustment. Sex
      differences were examined; results suggested somewhat different patterns of
      prediction for boys and girls, especially for the sensitive-isolated dimension.

PMID- 1756671
TI  - Multicentric osteosarcoma. Report of 5 cases.
AB  - Multiple foci of osteosarcoma are found in several pathological conditions: skip
      metastases, late bone metastases from osteosarcoma, so called metachronous
      osteosarcoma and multicentric osteosarcoma. The authors describe five cases with
      multicentric osteosarcoma of the skeleton. These lesions differ from classic
      osteosarcoma for their clinical and radiographical features. They generally arise
      in younger patients and are always sclerotic on X-rays and histological
      evaluation. Our data, as reported in literature, underline the poor prognosis of
      this disease.

PMID- 1756672
TI  - Circumferential fusion of the lumbar and lumbosacral spine. Comparison of two
      techniques of anterior spinal fusion.
AB  - Thirty-two patients with therapy-resistant low-back pain and justified indication
      for fusion were divided into two groups: 16 patients were treated with anterior
      fusion of the lumbosacral spine, with insertion of tricortical bone grafts of the
      iliac crest, and 16 patients with insertion of a fibular peg. Additional dorsal
      fusion of the same segments was performed. Comparison of the two techniques of
      circumferential fusion of the lumbosacral joint reveals comparable clinical
      results. A marked difference in roentgenographical criteria such as disk height,
      retrolisthesis, and anterior osteophytes in the adjacent segment between the two
      techniques was noted at the time of follow-up evaluation after 89 months and
      motivated the authors to abandon the fibular-peg technique.

PMID- 1756673
TI  - Antibiotic and antithromboembolic prophylaxis in prosthetic surgery of the knee.
AB  - The prevention of deep sepsis and venous thromboembolism in knee replacement
      surgery is of great importance for the final success of treatment. General rules
      of prevention must be followed when using antimicrobial drugs (environment,
      surgical method, patient selection). Although it does have some negative aspects
      (overuse, high costs, development of resistant bacteria) the administration of
      antibiotics is recommended, but only when it is timely, correct, and carried out
      for a suitable amount of time. The prevention of thromboembolism is based first
      on the selection of patients who risk the occurrence of angiology-related
      diseases, on continuous passive postoperative movement, and, finally, on
      intentional normovolemic hemodilution, for which the procedures used and the
      advantages obtained are described.

PMID- 1756674
TI  - The locked intramedullary Grosse Kempf nail in the treatment of proximal
      diaphyseal fractures of the femur.
AB  - The authors studied the effectiveness of locked intramedullary nailing (Grosse
      Kempf) in the treatment of proximal shaft femoral fractures. They reviewed 24
      cases with an average two-year follow-up and which had obtained positive clinical
      radiographic results in 80% of cases as compared to 88% in a previous revision of
      femoral shaft fractures. The difference is due to the greater difficulty
      encountered in intraoperative reduction of fractures from which defects in axial
      (varus) and rotatory (extra) alignment arise. They discuss indications as regards
      locking type, weight-bearing, as well as surgical techniques, which may prevent
      some of the most frequent problems observed.

PMID- 1756675
TI  - The Lefevre ulnar nail.
AB  - The Lefevre nail applies the principles of locked intramedullary nailing in the
      treatment of fractures of the ulna. It is made up of two segments which slide
      telescopically, so that assembly may be in compression, distraction or neutral.
      Fixation at the two ends of the ulna is guaranteed by two transverse screws. It
      may be used in pseudarthrosis and osteotomies for lengthening and shortening, as
      well as in simple or complex fractures. The cases presented provide an overview
      of the use of the nail at the Brest Center, where the nail was invented and
      developed, and at the Rizzoli Institute. The study includes 22 fractures, 1
      pseudarthrosis and 1 osteotomy. Consolidation was obtained in all of the cases
      after an average of 2.5 months. Immobilization in plaster was required only in
      cases with associated lesion of radius. The functional results obtained were
      satisfactory.

PMID- 1756676
TI  - An evaluation of some leukocytary phenotypes in subjects with evolutive primary
      coxarthrosis and in subjects with hip prostheses.
AB  - The authors examined 52 patients (36 females and 16 males) of whom 15 affected
      with evolutive primary coxarthrosis, 27 with hip prostheses for 4 to 13 years,
      and 10 with a prosthetic implant which was not tolerated. A method of indirect
      immunofluorescence with monoclonal antibodies against specific antigens of the
      cellular surface was used to typify the T-lymphocytic subpopulations (T
      helper/inducer and T-suppressor/cytotoxic), the activated mononucleate cells
      (DR+), and the B-lymphocytes and monocytes. A good correlation between the
      imbalances in the T-lymphocytic subpopulations, an increase in the activated
      mononucleate cells (principally due to T-lymphocytes) and the tolerance of the
      implant were observed. Based on the results obtained, the authors hypothesize the
      possibility of using the typing of T-lymphocytes and activated mononucleate
      cells, together with other biohumoral parameters, as indicators of periprosthetic
      tissue phologosis.

PMID- 1756677
TI  - Powdered alumina implants in the experimental animal: a histological study
      conducted in the rat.
AB  - The authors present a histological study conducted in the rat after powdered
      alumina implantation in the subcutis, the muscle and the peritoneum. After two
      weeks the same intense acute inflammatory reaction was observed in all of the
      implantation sites. After eight weeks the inflammatory reaction had regressed:
      there was a thin layer of connective tissue around the implant, completely
      isolating it from the surrounding tissues.

PMID- 1756678
TI  - Fracture of the posterior arch of the atlas.
AB  - The authors analyzed the results obtained in 10 fractures of the posterior arch
      of the atlas treated nonsurgically. There was consolidation in all of the cases
      at the end of treatment. According to the authors the element which most
      characterizes this fracture is constituted by its radiological diagnosis which
      principally makes use of lateral projection. In particular cases, when patients
      are characterized by multiple trauma, the fracture may go unrecognized.

PMID- 1756679
TI  - Os odontoideum.
AB  - Between January 1981 and December 1985 at the Rizzoli Orthopaedic Institute 8
      patients affected with atlo-axial instability secondary to os odontoideum were
      submitted to surgery: all of the patients were characterized by persistent
      cervical pain and neurological deficit, which was still at an initial stage in 5
      cases, and more severe in the remaining 3 (severe spastic tetraparesis). All of
      the patients were submitted to a similar treatment protocol in three stages: 1)
      preoperative reduction in halo-plaster, 2) surgical stabilization of C1-C2 by
      posterior vertebral fusion (limited to C1-C2 in 6 cases and extended as far as
      the occiput in the remaining 2), 3) postoperative immobilization in halo-plaster
      for an average of 12 weeks. At follow-up obtained after an average of 4 years and
      2 months there was consolidation of the fusion in all of the cases treated: in 1
      case, however, revision of the fusion was required 3 and 1/2 months after
      surgery, whereupon fusion was finally obtained. The total regression of pain was
      obtained in all 8 of the cases treated and there was evident neurological
      recovery in the 3 patients who had been characterized by severe spastic
      tetraparesis prior to surgery. The treatment protocol used in this series of
      patients proved to be a reliable one. Thus, it was possible to avoid the onset of
      chronic atlo-axial instability and its severe neurological sequelae in those
      cases where neurological deficit was still at an initial stage; furthermore,
      effective recovery was obtained in patients in whom neurological deficit was
      severe.

PMID- 1756680
TI  - Seckel's syndrome: presentation of one case associated with Legg-Calve-Perthes
      disease.
AB  - The authors present the case of one patient affected with Seckel's syndrome which
      came to their observation as a result of pain in the hip with limping, diagnosed
      after Legg-Calve-Perthes disease. There seems to be an accidental relationship
      between the two diseases, although Legg-Calve-Perthes disease is frequently
      described in all cases of endocrinous dwarfism.

PMID- 1756681
TI  - Serum ketone response to glucagon as a marker of insulin dependency in diabetics.
AB  - The serum ketone response to glucagon was measured in 10 patients with IDDM and
      37 with NIDDM. In both groups, serum 3-hydroxybutyrate increased significantly
      after intravenous injection of 1 mg glucagon. The difference between the serum
      level of 3-hydroxybutyrate at 30 min and basal level [delta 3-OHBA(30')] was 133
      +/- 25 mumol/l in the patients with IDDM, 13 +/- 8 mumol/l in those with NIDDM
      treated by diet alone or with oral hypoglycemic agents and 23 +/- 13 mumol/l in
      those with NIDDM treated with insulin. The delta 3-OHBA(30') was significantly
      greater in IDDM patients than in both groups of NIDDM patients (P less than
      0.001). The delta 3-OHBA(30') was greater than 87 mumol/l in eighty percent of
      IDDM patients, but smaller than 87 mumol/l in both groups of NIDDM patients. The
      delta 3-OHBA(30') was correlated with the difference between the plasma level of
      C-peptide at 6 min and basal level [delta CPR(6')] (r = -0.540, P less than
      0.001). The delta 3-OHBA(30') was not correlated with fasting plasma levels of
      glucose, fructosamine or hemoglobin A1c. These observations show that measurement
      of the serum ketone response to glucagon is a useful marker of insulin
      dependency. In order to determine insulin dependency, the simultaneous
      measurement of concentrations of ketones and C-peptide is indicated during the
      glucagon stimulation test.

PMID- 1756682
TI  - Sarimner: a computer model of diabetes physiology for education of physicians and
      patients.
AB  - Often diabetic patients have developed their skills by some trial-and-error-like
      training over a long period of time. To minimize this inconvenience we have made
      a mathematical model to facilitate diabetes education. The model consists of a
      number of blocks involved in diabetes physiology: digestion, blood (transport),
      pancreas, injected insulin absorption, liver, muscles, kidneys, metabolism and
      insulin sensitivity. The model serves as a demonstration object and the user can
      change meals, exercise and injections and see the resulting blood glucose level.
      A more experienced user can search for further explanations of different
      phenomena deeper in the physiology of the model. The model does not solve any
      problem for the user, but creates a learning situation in which the user, led by
      his own curiosity, successively increases his experience of diabetes physiology.
      Sarimner is implemented as an easy-to-use menu driven computer program for IBM PC
      clones with Hercules, EGA or VGA graphics.

PMID- 1756683
TI  - Postprandial glucose and insulin responses to various tropical fruits of
      equivalent carbohydrate content in non-insulin-dependent diabetes mellitus.
AB  - The plasma glucose and insulin responses were determined in 10 NIDDM female
      patients following the ingestion of tropical fruit containing 25 g of
      carbohydrate. The five tropical fruits were pineapple, mango, banana, durian and
      rambutan. Blood was drawn at 0, 30, 60, 120 and 180 min, respectively. The
      results showed that the glucose-response curves to mango and banana were
      significantly less than those to rambutan, durian and pineapple (P less than
      0.05). Only the glucose area after mango ingestion was significantly less than
      the glucose areas of the other fruits (P less than 0.05). The insulin response
      curve and insulin area after durian ingestion was statistically greater than
      after ingestion of the others. We concluded that after mango ingestion, the
      glucose area was lower than it had been after rambutan, durian and pineapple
      ingestion and the insulin area was lower than that after durian ingestion of
      equivalent carbohydrate content in type 2 (NIDDM) diabetes.

PMID- 1756684
TI  - High prevalence of undiagnosed diabetes among Chinese patients with ischaemic
      stroke.
AB  - We reviewed the prevalence of diabetes mellitus, hypertension and cigarette
      smoking in 176 Chinese patients with acute stroke, classified, on computed
      tomographic findings, as intracerebral haemorrhage or cerebral infarction. In all
      patients with no known history of diabetes, a 75 g OGTT was done 3-6 months after
      ictus and interpreted using WHO criteria. The overall prevalence of diabetes and
      impaired glucose tolerance (IGT) was 33.5% and 21.0%, respectively, with a higher
      prevalence being found in patients with cerebral infarction (P less than 0.05).
      Forty percent of those with diabetes were previously undiagnosed - all but 2 had
      ischaemic stroke. Compared to reported findings in the general population, an
      increased prevalence of hypertension, and possibly also cigarette smoking was
      found in patients with both stroke categories. On the other hand, significant
      hypercholesterolaemia was not found in patients of either category. In view of
      the high prevalence of undiagnosed diabetes among these stroke patients and the
      increased morbidity and mortality associated with diabetes mellitus, screening
      for diabetes is recommended especially in those with ischaemic stroke. If a
      fasting plasma glucose of greater than or equal to 6 mmol/l was used for the
      initial screening of undiagnosed diabetes in this group of patients, the
      sensitivity and specificity values would have been 78% and 94%, respectively.
      Whether this cut-off value can be cost-effectively employed for mass screening
      remains to be confirmed by studies involving larger numbers of stroke patients.

PMID- 1756685
TI  - Hypoglycemia associated hospitalizations in a population with a high prevalence
      of non-insulin-dependent diabetes mellitus.
AB  - In order to evaluate the rates, causes, and clinical features of hospitalizations
      associated with hypoglycemia in a population with a high prevalence of non
      insulin-dependent diabetes mellitus (NIDDM), a retrospective analysis of medical
      records was conducted in a multi-hospital primary care system on the Navajo
      Indian Reservation. During an estimated 26,125 person-years of observation among
      diabetic patients, there were 126 hypoglycemia-associated admissions related to
      diabetes among 109 diabetic patients, yielding a hospitalization rate of 4.7 per
      1000 person-years (95% CI 4.1-5.7). Using estimates of drug utilization based on
      a defined daily dose, hospitalization rates were 5.8 per 1000 PY (95% CI 4.4-7.6)
      for chlorpropamide, 16.0 per 1000 PY (95% CI 9.5-26.9) for glyburide, and 9.1 per
      1000 PY (95% CI 6.9-11.9) for insulin. After stratification by age, the relative
      risk for hypoglycemia-associated hospitalization among patients prescribed
      glyburide compared to those prescribed chlorpropamide was 2.8 (95% CI 1.6-4.9).
      Hypoglycemia-associated hospitalizations were relatively common among patients
      with NIDDM, particularly among those treated with glyburide.

PMID- 1756686
TI  - Contribution of hyperglycemia and renal damage to urinary C-peptide clearance in
      non-insulin-dependent diabetic patients.
AB  - The variation of urinary C-peptide clearance in relation to hyperglycemia and
      renal damage was evaluated in 57 patients with non-insulin-dependent diabetes
      mellitus (NIDDM) with and without overt proteinuria, 14 nondiabetic patients with
      renal disease (RD) and 18 healthy control subjects. Urinary C-peptide clearance
      expressed as the ratio of urinary C-peptide to creatinine clearance (CCP/CCR) in
      the fasting state did not differ in control subjects and RD patients, and was
      higher equally in NIDDM patients with and without proteinuria. In NIDDM patients
      without overt proteinuria, urinary levels of C-peptide, beta 2-microglobulin
      (B2M), N-acetyl-beta-D-glucosaminidase (NAG) and albumin as well as CCP/CCR ratio
      all decreased significantly with short-term glycemic control (P less than 0.05).
      Despite a wide range of CCP/CCR ratio (0.07-0.73), a weak but significant
      correlation (r = 0.56, P less than 0.005) was found between fasting serum and
      urinary C-peptide levels in NIDDM patients. These results suggest that urinary C
      peptide may easily be affected by hyperglycemia per se rather than renal damage,
      while urinary B2M, NAG and albumin may be affected by both hyperglycemia and
      renal damage. When the urinary C-peptide level is interpreted, the influence of
      hyperglycemia on it must be taken into consideration.

PMID- 1756687
TI  - Plasma urate in diabetes: relationship to glycaemia, glucose disposal,
      microvascular complications and the variations following oral glucose.
AB  - In order to provide further insights into the conflicting reports of associations
      between diabetes and uric acid metabolism, we studied 175 adult diabetic patients
      (56 IDDM, 119 NIDDM) and 114 matched control subjects. Plasma uric acid (PUA)
      concentrations were not significantly different between diabetic and control
      subjects, despite increased urinary urate in diabetic patients. There were no
      significant associations, in diabetic patients, between PUA and (i) type of
      diabetes, (ii) glycaemic control, (iii) retinopathy and (iv) proteinuria. Plasma
      urate did not correlate with the KG constant for glucose disposal rate during
      IVGTT, thus indicating that PUA may not be related to insulin action. In a
      separate study, PUA rose sharply, peaking at 30 min, and fell subsequently in
      both newly diagnosed NIDDM patients (n = 20) and subjects with impaired glucose
      tolerance (n = 15) in response to standard OGTT, in contrast to normal controls
      (n = 35) in whom PUA rose gradually to a peak at 120 min. Mean rise in PUA from
      baseline to peak was significant (P less than 0.05) in the diabetic group only.
      These differences in PUA response during an OGTT between subjects with abnormal
      glucose metabolism and normal controls may be a feature in the metabolic
      evolution of diabetes and need further investigation.

PMID- 1756688
TI  - Treatment of lower respiratory infections in outpatients with ofloxacin compared
      with erythromycin.
AB  - To assess the safety and efficacy of a ten-day oral course of ofloxacin (400 mg
      12 hourly) as compared with erythromycin (400 mg every 6 hours) for treatment of
      lower respiratory tract infections, fifty-two adult outpatients with pulmonary
      infiltrates (pneumonia) or with a cough and purulent sputum (bronchitis) were
      evaluated. Expectorated sputum specimens were Gram-stained and cultured, and
      antibody titres to Mycoplasma pneumoniae, Legionella pneumophilia, and in most
      cases Chlamydia pneumoniae were measured on acute and convalescent serum samples.
      Patients were evaluated clinically, microbiologically and radiographically three
      to five days after concluding therapy; the incidence of adverse reactions was
      monitored throughout the study period. The ofloxacin group (N = 25) was comprised
      of nineteen patients with pneumonia and six patients with bronchitis. The
      erythromycin group (N = 27) was comprised of thirteen patients with pneumonia and
      fourteen patients with bronchitis. All fifty-two patients were either clinically
      improved or cured after therapy. Microbiological cure was documented in all
      fourteen cases (27%) in which causative pathogens were identified. Clinical cure
      was achieved with ofloxacin in 68% of patients with pneumonia and in 83% of
      patients with bronchitis, while clinical cure with erythromycin was achieved in
      46% of patients with pneumonia and 54% of patients with bronchitis. Adverse
      reactions (mostly mild gastrointestinal or central nervous system symptoms) were
      reported by eight patients receiving ofloxacin and four patients receiving
      erythromycin. While the types of adverse effects were similar, ofloxacin showed a
      trend toward a higher rate of cure than erythromycin. Ofloxacin is a promising
      new antibiotic for the treatment of acute lower respiratory infections.

PMID- 1756689
TI  - Analgesia by nefopam: does it act through serotonin?
AB  - In an attempt to clarify the possible mode of action of nefopam, a new analgesic
      compound, the authors tested its effects on imipramine (IMI) binding to platelet
      membranes. The results showed that nefopam exerted a concentration-dependent
      inhibition of IMI binding, with a potency comparable to that of tricyclic
      antidepressants. This finding suggests a possible intervention of serotonergic
      mechanisms in nefopam-related analgesia.

PMID- 1756690
TI  - Evaluation of phenytoin in rheumatoid arthritis--an open study.
AB  - In an open study, thirty-five patients with active rheumatoid arthritis were
      treated with phenytoin. Various clinical and laboratory parameters showed good
      improvement after phenytoin. Early morning stiffness was significantly reduced
      after 8 weeks (p less than 0.05); pain index (p less than 0.001), articular index
      (p less than 0.01) and grip strength (p less than 0.01) showed significant
      improvement after 24 weeks. There was significant reduction in erythrocyte
      sedimentation rate (p less than 0.01). Except for three patients (skin rash in
      one and gastric irritation in two), all others tolerated phenytoin well. The
      results of the present study support the usefulness of phenytoin as a disease
      modifying drug for rheumatoid arthritis.

PMID- 1756691
TI  - New carnitine derivatives for the therapy of cutaneous ulcers in vasculopathics.
AB  - The treatment of arterial and venous cutaneous ulcers in vasculopathic patients
      is a difficult task, since it requires the prolonged administration of drugs
      which are often unable to correct the various pathogenetic factors, including
      rheological disorders, responsible for the lesions. The authors, basing
      themselves upon recent studies demonstrating the rheological and vasoactive as
      well as metabolic activities of propionyl l-carnitine, have decided to examine
      this substance for the treatment of arterial and venous cutaneous ulcers of the
      lower extremities. Propionyl l-carnitine administered orally or intravenously to
      eighteen vasculopathics with cutaneous ulcers was responsible for the complete or
      nearly complete regression of trophic lesions in 78.9% of the patients.
      Therapeutic failure or only modest results were observed in four patients. In
      addition a highly significant increase in flow velocity was observed in
      arteriopathic patients. It is particularly important to note that these clinical
      results were obtained in patients refractory to all other forms of therapy.

PMID- 1756692
TI  - [Changes in the blood and plasma volumes during diagnostic angiocardiography.
      Differences between high- and low-osmolality contrast media].
AB  - Changes in blood and plasma volumes were investigated in the course of diagnostic
      cardiac catheterizations, comparing the effect of a high and a low osmolar
      contrast medium in 30 patients (5 women and 25 men; mean age 53 [19-76] years)
      with coronary heart disease (n = 27) or valvular defect (n = 3). Using a
      randomized, double-blind protocol 15 patients received amidotrizoic acid (2.1
      osmol/kg; mean dosage 166 +/- 68 or 2.2 +/- 1.1 ml/kg), while 15 patients
      received iopamidol (0.8 osmol/kg; mean dosage 154 +/- 78 ml or 2.1 +/- 1.0
      ml/kg). The indocyanine-green method and the haematocrit were used to measure
      blood and plasma volumes immediately before and after the angiocardiography.
      Blood volume after amidotrizoic acid injection increased by a mean of 4.9% (228
      +/- 242 ml) and by 0.4% (17 +/- 197 ml) after iopamidol (P less than 0.05).
      Plasma volume increased by a mean of 11.8% (331 +/- 150 ml) after amidotrizoic
      acid and 5.7% (157 +/- 97 ml) after iopamidol (P less than 0.01). The increase in
      plasma volume correlated with the dose of contrast medium: 2 ml per ml
      amidotrizoic acid (r = 0.93) and 1 ml per ml iopamidol (r = 0.82).--During
      angiocardiography blood and plasma volume may increase by up to 500 ml, an
      increase which depends not only on dosage but also on the osmolality of the
      injected contrast medium.

PMID- 1756693
TI  - [Percutaneous sonographically guided fine-needle puncture and drainage of
      pyogenic abscesses].
AB  - Between January 1988 and April 1991, a total of 79 ultrasound-directed
      percutaneous punctures and (or) drainage of abscesses were performed on 31
      patients (15 men, 16 women; mean age 63 [31-85] years). There were 14 hepatic, 4
      splenic, 4 abdominal wall and 3 pancreatic abscesses, and one each subphrenic,
      presacral, retrocaecal, ischiorectal, pulmonary and in the psoas. After
      ultrasound localization of the abscess a fine-needle puncture was performed,
      after which the abscess cavity was emptied as much as possible or, in abscesses
      larger than 5 cm in diameter, drained through a pig-tail catheter (6-8, 4 F).
      Several punctures were needed in 16 patients, while in 15 a percutaneous drainage
      over 2-8 days was necessary. Treatment was successful after 4-17 days in 25
      patients. One patient died in septic shock. Operative intervention after
      diagnostic puncture was undertaken in 5 patients. There were no complications
      related to the method. In 11 patients the further course was determined by an
      underlying malignant disease. No recurrence has been noted (4-36 months after
      treatment) in 14 patients with a benign underlying disease. Percutaneous puncture
      and drainage of pyogenic abscesses is a technically simple method which achieves
      good results.

PMID- 1756694
TI  - [The morphology and clinical picture of epithelioid hemangioendothelioma of the
      lung].
AB  - A 36-year-old woman presented with multiple shadows, up to 1 cm in diameter, in
      both lungs revealed by routine chest radiography. Right thoracotomy showed
      numerous firm nodules in the middle and lower lobes. Histological examination of
      the wedge biopsy disclosed an epithelioid haemangioendothelioma of the lung
      (positive immunohistochemical reaction for factor VIII-associated antigen). Eight
      years later the patient remains symptom-free without treatment and the
      radiological picture is almost unaltered. Another woman, 22 years old, had a skin
      nodule near the right external malleolus. It was removed and found to be a semi
      malignant haemangioendothelioma. Five years later a chest radiograph showed
      finely nodular shadowing in both lungs which roused suspicion of sarcoidosis. She
      had steroid therapy for one year, but the radiological findings remained
      unchanged. After a further 10 years a round lesion, some 3 cm in diameter with
      partial calcification, was found in the right lower lobe. Histological
      examination revealed an epithelioid haemangioendothelioma with a positive
      immunohistochemical reaction for factor VIII-associated antigen. She subsequently
      complained of severe pain in the left shoulder (with histologically demonstrated
      bone involvement by the neoplasm) together with rapidly increasing dyspnoea.
      Seventeen years after the original diagnosis she died of rapidly progressive
      diffuse lymphangiomatosis carcinomatosa. Post mortem secondary deposits were
      found in the liver as well.

PMID- 1756695
TI  - [Cryptococcal meningitis in AIDS: successful long-term prophylaxis with
      fluconazole].
AB  - A 30-year-old, HIV-positive, man who had been repeatedly treated with
      amphotericin B for oral thrush, developed headaches, fever up to 38.5 degrees C,
      dizzy spells with falling tendency, as well as disorder of speech and word
      finding. Cerebrospinal fluid (CSF) contained 5700/3 cells, of which 90% were
      encapsulated yeast-fungus. Cryptococcal antigen titres were elevated both in
      serum (1:256) and CSF (1:1024), providing the diagnosis of cryptococcal
      meningitis. Intravenous treatment was started with amphotericin B, 0.3 mg/kg
      daily and flucytosine, 150 mg/kg daily. The clinical, microbiological and
      serological findings regressed after 4 weeks. After 8 weeks the creatinine
      concentration rose to 2.5 mg/dl. Because amphotericin B nephrotoxicity was
      suspected, further intravenous administration was stopped after a cumulative
      dosage of 2 g. He was placed on a prophylactic dosage of fluconazole, 100 mg by
      mouth twice daily. The cryptococcal antigen titre had fallen to normal within one
      year. The prophylactic regimen has been continued now for three years without
      recurrence or other fungal infection.

PMID- 1756696
TI  - [Endoscopic Doppler sonography].

PMID- 1756697
TI  - [From fatal hemorrhagic diathesis to life-threatening thrombosis risk. New
      complications of a "gentle" treatment of acute promyelocytic leukemias with all
      trans-retinoic acid].

PMID- 1756698
TI  - [Friedrich Daniel von Recklinghausen. A reminiscence on the occasion of the
      centenary of his publication Osteitis fibrosa or deformans, osteomalacia and
      osteoplastic carcinosis in their interrelationships].

PMID- 1756699
TI  - [Pneumothorax in AIDS].

PMID- 1756700
TI  - Control of infections.

PMID- 1756701
TI  - Bacteriology of infections in a rural tropical area of Kenya: isolates and
      antibiotic susceptibility.
AB  - No microbial data are available for rural tropical areas. Yet most people in
      Africa live in rural areas where the burdens of infectious diseases remain the
      primary cause for morbidity and mortality. A pilot study was done by culturing
      midstream urine from patient with dysuria (100 with Gram-negative fermentative
      rods), blood from patients with FUO (55/307 positive) and swabs from patients
      with infected wounds (29 with Staphylococcus aureus). Bacteria were identified
      and susceptibility tests were performed according to protocols. Klebsiella was
      the most common isolate from urine (48%). The overall resistance in urine
      isolates for ampicillin was 76% and for cotrimoxazole, 60%. The main isolates
      from blood were Klebsiella Enterobacter sp (21/55) and Salmonella (14/55) in
      patients from agricultural areas, and Staphylococcus aureus (12/55) in patients
      from desert areas. The Staphylococcus aureus from wounds were all penicillin
      resistant and 9/29 were cloxacillin resistant. Influence of the environment,
      underlying pathology and previous use of antibiotics give unexpected predominance
      of Klebsiella and high resistance in all isolates. Large scale surveillance
      studies are needed so that prescription of antibiotics can be based on locally
      obtained data.

PMID- 1756702
TI  - Occurrence of toxic shock syndrome toxin-1 producing Staphylococcus aureus and
      the anti TSST-1 serostatus of hospital personnel in Nigeria.
AB  - Of the 56 S. aureus strains tested, five (8.9%) isolates (four from asymptomatic
      nasal carriage and one from a non TSS staphylococcal disease) demonstrated TSST-1
      production in vitro. Among the toxin positive strains the clinical isolate
      belonged to phage group I, 29/52 and the nasal carriage isolates were either non
      typable or ungroupable. Eighty-nine percent of isolates including all TSST-1
      positive strains showed binding to crystal violet and were traced to S. aureus
      var. hominis (CV type C/D). A. aureus var. bovis (CV type A/B) were found only in
      nasal carriage group (10.7%) and did not bind crystal violet. During the sero
      surveillance 101 out of 220 hospital personnel (48.1%) showed TSST-1 antibodies
      of IgG class at 1:1000 sera dilution. The four individuals with asymptomatic
      nasal carriage of TSST-1 positive staphylococci showed no antibody to the toxin.
      Anti TSST-1 levels persisted in 58 (57.4%) and 10 (9.9%) individuals at higher
      sera dilutions of 10(-4) and 10(-5) respectively.

PMID- 1756703
TI  - Seroepidemiological study for HBV markers and anti-delta in Kenya.
AB  - An HBV carrier rate of 3.0% in outpatients and 1.4% in school children, was found
      in a sero-epidemiological survey in Muranga District, Kenya. The prevalence of
      anti-Delta in HBV carriers was 42%. The prevalence of HBV carriers and HBV marker
      positive cases was high in family members of HBV carriers. The yearly attack
      ratio of HBV was low in primary school children, non-carrier family members and
      even carrier family members. Mother to baby vertical transmission was very high
      when mothers were HBeAg positive HBV carriers. Such vertical transmission may now
      be of major importance.

PMID- 1756704
TI  - Prevalence of psychiatric illness among Kenyan children.

PMID- 1756705
TI  - Hypertension in Kitui district: a comparative study between urban and rural
      populations.
AB  - This study was conducted in 1986, with the objective of finding out whether high
      blood pressure is a problem in the urban and rural populations of Kitui, and the
      risk factors that may be contributing to the problem. 360 people were visited at
      home and work places and their blood pressure, were taken in the sitting position
      under field conditions. A questionnaire on age, sex, marital status, occupation,
      smoking, miraa chewing and alcohol consumption and the number of people in the
      household was administered to every study subject, after which their heights and
      weights were recorded. Prevalence was found to be 6.4%. There was no difference
      in the occurrence of hypertension between the urban and rural populations. The
      relationship between the occurrence of hypertension and other parameters is
      presented and discussed in this paper.

PMID- 1756706
TI  - Foetal and maternal outcome of vacuum extraction.
AB  - In a prospective study, 167 vacuum extractions (VE) performed at the Kenyatta
      National Hospital, Nairobi, formed 6.3% of the total deliveries. Most patients
      were young and of low parity. There were no maternal deaths. The overall maternal
      morbidity rate was 22% and were mostly minor. Post partum haemorrhage was the
      most common maternal complication. There were 5 failed VEs. Perinatal morbidity
      and mortality rates were 16.2% and 4.8% respectively. Intrauterine asphyxia was
      the commonest cause of death. Several complications could have been avoided by
      more stringent use of the instrument. The place of VE in a busy obstetric unit is
      discussed.

PMID- 1756707
TI  - The dynamics of medical students career and medical specialty choices, and their
      implication for medical education in developing countries: a Maiduguri Medical
      School study.
AB  - This is a cross-section study based on questionnaire of the students in all the
      three clinical years of the medical school at the University of Maiduguri,
      Nigeria. The aim of the study was to explore the dynamics of career and medical
      specialisation decision and inclinations of the students with the view to seeing
      how they match the need of medical services in the country, and hence to discover
      those areas and methods which may be useful in this connection. The study shows
      that previous (including pre-medical school) exposures to the chosen specialties
      and ongoing medical school exposures and role models are the most important
      factors in specialty choices while job opportunities and local trends are
      important in the career decisions. It is therefore proposed that since medical
      exposures and role models can be influenced in the medical curriculum, it would
      be necessary to do this in the specialties of general medical practice (Family
      Medicine, Primary Medical Care) and the Community Medicine which are vital in the
      containment of the communicable and poverty/social inequality disease problems of
      this and other developing countries.

PMID- 1756708
TI  - Occurrence of Plesiomonas shigelloides--associated diarrhoea in Calabar, Nigeria.
AB  - The prevalence, clinical profiles and virulence factors of Plesiomonas
      shigelloides were determined in patients attending the University of Calabar
      Teaching Hospital, Microbiology Laboratory. P. shigelloides was isolated from 12
      (1.4%) of 880 patients with diarrhoea and from none of the controls (P less than
      0.05). Isolates were mostly from febrile children less than or equal to 10 years
      with most of the infections occurring during the rainy months. Although our
      findings suggest the significance of Plesiomonas in acute diarrhoea in this
      environment, our isolates did not seem to show any of the proxy indicators of
      virulence usually associated with other enteric pathogens.

PMID- 1756709
TI  - Nutritional requirements in chronic renal failure and end stage renal disease at
      the Kenyatta National Hospital.
AB  - Since August, 1984 renal replacement therapy with haemodialysis, peritoneal
      dialysis and renal transplant has been carried out regularly at the renal unit of
      the Kenyatta National Hospital (KNH). Various nutritional disturbances have been
      met. Nausea, vomiting and anorexia have been noticed frequently particularly in
      those on intermittent peritoneal dialysis (IPD). The same problems were
      experienced in those few patients who were on continuous ambulatory peritoneal
      dialysis (CAPD). The patients were usually malnourished, the malnutrition being
      of protein-calorie type. At the start of the programme of renal replacement
      therapy in 1984, the problems of poor nutrition were worse but are currently
      improving. At the moment our patients with chronic renal failure (CRF) and end
      stage renal disease (ESRD) on dialysis are scattered all over the medical and
      paediatric wards at KNH. This has impeded the smooth surveillance of patients'
      diets by the few available nutritionists. The review of our performance from 1984
      1988 on the nutritional status of patients with CRF and ESRD is an attempt to
      create a normal dietary cover for patients with the above problems.

PMID- 1756710
TI  - Pemphigus vulgaris: case report in a Nigerian Negro.
AB  - A middle-aged Nigerian male had generalised pruritus, widespread flaccid vesicles
      and bullae, with ulcerations of the skin that heal without scarring, weight loss,
      positive nikolsy sign, anaemia, and marked eosinophilia. Pemphigus vulgaris is a
      rare disease among those of Negroid extraction, we therefore, report this case
      involving a Nigerian.

PMID- 1756711
TI  - Pseudo-precocious puberty in a Kenyan African child: a case report.
AB  - A female Kenyan child with pseudoprecocious puberty due to juvenile granulosa
      cell tumour is presented. Clinical features in this patient included a mass in
      the lower abdomen, a growth spurt and appearance of pubic hairs as well as
      enlargements of the breasts. No similar case has been reported in a Kenyan child.
      The management and review of literature are discussed.

PMID- 1756712
TI  - T-DNA gene 5 of Agrobacterium modulates auxin response by autoregulated synthesis
      of a growth hormone antagonist in plants.
AB  - Oncogenes carried by the transferred DNA (T-DNA) of Agrobacterium Ti plasmids
      encode the synthesis of plant growth factors, auxin and cytokinin, and induce
      tumour development in plants. Other T-DNA genes regulate the tumorous growth in
      ways that are not yet understood. To determine the function of T-DNA gene 5, its
      coding region was expressed in Escherichia coli. Synthesis of the gene 5 encoded
      protein (26 kDa) correlated with a 28-fold increase in conversion of tryptophan
      to indole-3-lactate (ILA), an auxin analogue. Expression of chimeric gene 5
      constructs in transgenic tobacco resulted in overproduction of ILA that enhanced
      shoot formation in undifferentiated tissues and increased the tolerance of
      germinating seedlings to the inhibitory effect of externally supplied auxin.
      Promoter analysis of gene 5 in plants revealed that its expression was inducible
      by auxin and confined to the vascular phloem cells. cis-regulatory elements
      required for auxin regulation and phloem specific expression of gene 5 were
      mapped to a 90 bp promoter region that carried DNA sequence motifs common to
      several auxin induced plant promoters, as well as a binding site for a nuclear
      factor, Ax-1. ILA was found to inhibit the auxin induction of the gene 5 promoter
      and to compete with indole-3-acetic acid (IAA) for in vitro binding to purified
      cellular auxin binding proteins. It is suggested therefore that ILA autoregulates
      its own synthesis and thereby modulates a number of auxin responses in plants.

PMID- 1756713
TI  - The surface-exposed tyrosine residue Tyr83 of pea plastocyanin is involved in
      both binding and electron transfer reactions with cytochrome f.
AB  - Site-directed mutants of the pea plastocyanin gene in which the codon for the
      surface-exposed Tyr83 has been changed to codons for Phe83 and Leu83 have been
      expressed in transgenic tobacco plants. The mutant proteins have been purified to
      homogeneity and their conformations shown not to differ significantly from the
      wild-type plastocyanin by 1H-NMR and CD. Overall rate constants for electron
      transfer (k2) from cytochrome f to plastocyanin have been measured by stopped
      flow spectrophotometry and rate constants for binding (ka) and association
      constants (KA) have been measured from the enhanced Soret absorption of
      cytochrome f on binding plastocyanin. These measurements allow the calculation of
      the intrinsic rate of electron transfer in the binary complex. An 8-fold decrease
      in the overall rate of electron transfer to the Phe83 mutant is due entirely to a
      decreased association constant for cytochrome f, whereas the 40-fold decrease in
      the overall rate of electron transfer to the Leu83 mutant is due to weaker
      binding and a lower intrinsic rate of electron transfer. This indicates that
      Tyr83 is involved in binding to cytochrome f and forms part of the main route of
      electron transfer.

PMID- 1756714
TI  - A CAAX or a CAAL motif and a second signal are sufficient for plasma membrane
      targeting of ras proteins.
AB  - Mutational analysis of p21ras has shown that plasma membrane targeting requires
      the combination of a CAAX motif with a polybasic domain of six lysine residues or
      a nearby palmitoylation site. However, it is not known from these studies whether
      these signals alone target p21ras to the plasma membrane. We now show that these
      C-terminal sequences are sufficient to target a heterologous cytosolic protein to
      the plasma membrane. Interestingly, the key feature of the p21K-ras(B) polybasic
      domain appears to be a positive charge, since a polyarginine domain can function
      as a plasma membrane targeting motif in conjunction with the CAAX box and p21K
      ras(B) with the polylysine domain replaced by arginines is biologically active.
      Since some ras-related proteins are modified by geranylgeranyl rather than
      farnesyl we have investigated whether modification of p21ras with geranylgeranyl
      affects its subcellular localization. Geranylgeranyl can substitute for farnesyl
      in combining with a polybasic domain to target p21K-ras(B) to the plasma
      membrane, but such geranylgeranylated proteins are more tightly bound to the
      membrane. This increased avidity of binding is presumably due to the extra length
      of the geranylgeranyl alkyl chain.

PMID- 1756715
TI  - A mutation in a mild form of galactosialidosis impairs dimerization of the
      protective protein and renders it unstable.
AB  - The lysosomal disorder galactosialidosis is caused by deficiency of the
      protective protein in the absence of which the activities of the enzymes beta
      galactosidase and neuraminidase are reduced. Aside from its protective function
      towards the two glycosidases, this protein has cathepsin A-like activity. A point
      mutation in the protective protein gene, resulting in the substitution of Phe412
      with Val in the gene product, was identified in two unrelated patients with the
      late infantile form of the disease. Expression in COS-1 cells of a protective
      protein cDNA with the base substitution resulted in the synthesis of a mutant
      protein that lacks cathepsin A-like activity. The newly made mutant precursor was
      shown to be partially retained in the endoplasmic reticulum. Only a fraction is
      transported to the lysosomes where it is degraded soon after proteolytic
      processing into the mature two-chain form. Since the mutant precursor, contrary
      to the wild type protein, does not form homodimers, the dimerization process
      might be a condition for the proper targeting and stable conformation of the
      protective protein. These results clarify the mechanism underlying the combined
      deficiency in these patients, and give new insight into the structure-function
      relationship of the wild type protein.

PMID- 1756716
TI  - A genetic and structural analysis of the yeast Vps15 protein kinase: evidence for
      a direct role of Vps15p in vacuolar protein delivery.
AB  - The yeast VPS15 gene encodes a novel protein kinase homolog that is required for
      the sorting of soluble hydrolases to the yeast vacuole. In this study, we extend
      our previous mutational analysis of the VPS15 gene and show that alterations of
      specific Gps15p residues, that are highly conserved among all protein kinase
      molecules, result in the biological inactivation of Vps15p. Furthermore, we
      demonstrate here that short C-terminal deletions of Vps15p result in a
      temperature-conditional defect in vacuolar protein sorting. Immediately following
      the temperature shift, soluble vacuolar hydrolases, such as carboxypeptidase Y
      and proteinase A, accumulate as Golgi-modified precursors within a saturable
      intracellular compartment distinct from the vacuole. This vacuolar protein
      sorting block is efficiently reversed when mutant cells are shifted back to the
      permissive temperature; the accumulated precursors are rapidly processed to their
      mature forms indicating that they have been delivered to the vacuole. This rapid
      and efficient reversal suggests that the accumulated vacuolar protein precursors
      were present within a normal transport intermediate in the vacuolar protein
      sorting pathway. In addition, this protein delivery block shows specificity for
      soluble vacuolar enzymes as the membrane protein, alkaline phosphatase, is
      efficiently delivered to the vacuole at the non-permissive temperature.
      Interestingly, the C-terminal Vps15p truncations are not phosphorylated in vivo
      suggesting that the phosphorylation of Vps15p may be critical for its biological
      activity at elevated temperatures. The rapid onset and high degree of specificity
      of the vacuolar protein delivery block in these mutants suggests that the primary
      role of Vps15p is to regulate the sorting of soluble hydrolases to the yeast
      vacuolar compartment.

PMID- 1756717
TI  - Leishmanial protein kinases phosphorylate components of the complement system.
AB  - Externally oriented protein kinases are present on the plasma membrane of the
      human parasite, Leishmania. Since activation of complement plays an important
      role in the survival of these parasites, we examined the ability of protein
      kinases from Leishmania major to phosphorylate components of the human complement
      system. The leishmanial protein kinase-1 (LPK-1) isolated from promastigotes of
      L. major was able to phosphorylate purified human C3, C5 and C9. Only the alpha
      chain of C3 and C5 was phosphorylated. The beta-chain appeared not to be a
      substrate for this enzyme. C3b which is formed by proteolytic cleavage of C3 was
      not phosphorylated by LPK-1. Trypsin treatment of phosphorylated C3 (P-C3)
      resulted in the disappearance of 32P from the alpha-chain. This was correlated
      with the conversion of the C3 alpha-chain to the alpha'-chain of C3b, and the
      appearance of a 9 kDa 32P fragment comigrating with the C3a fragment of C3. P-C3
      was more resistant to cleavage by trypsin than nonphosphorylated C3. LPK-1
      phosphorylated purified C3a and two synthetic peptides, C3a21R and YA-C3a10R,
      derived from its COOH-terminal end, which contain the C3a binding site to
      leukocytes and platelets. LPK-1 did not phosphorylate C3a8R. Phosphoamino acid
      analysis of the synthetic peptides indicated that serine 71 of C3a was
      phosphorylated by LPK-1. Treatment of C3 with either methylamine or freeze-thaw
      C3 (H2O) prevented phosphorylation by the LPK-1 suggesting that substrate
      conformation may be involved in recognition by the leishmanial enzyme.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1756718
TI  - Saccharomyces cerevisiae a- and alpha-agglutinin: characterization of their
      molecular interaction.
AB  - An O-glycosylated protein of approximately 18 kDa responsible for mating type
      specific agglutination has been isolated from Saccharomyces cerevisiae a cells,
      purified to homogeneity and via peptide sequences the gene was cloned by PCR. An
      open reading frame codes for a protein of 69 amino acids. A minimum of five
      serine and five threonine residues of the mature protein are glycosylated. alpha
      Agglutinin is a highly N-glycosylated protein of approximately 250 kDa. Both
      purified agglutinins form a specific 1:1 complex in vitro. Pretreatment of alpha
      agglutinin, but not of alpha-agglutinin, with diethylpyrocarbonate (DEPC)
      prevents formation of the complex; treatment of alpha-agglutinin in the presence
      of alpha-agglutinin protects the former from DEPC inactivation. By carboxy
      terminal shortening of the alpha-agglutinin gene and by replacing three of its
      eight histidyl residues by arginine, the active region of alpha-agglutinin for
      interaction with alpha-agglutinin has been defined. Neither the N- nor the O
      linked saccharides of the two agglutinins seem to be essential for their
      interaction.

PMID- 1756719
TI  - Identification of a novel recognition sequence for the integrin alpha 4 beta 1 in
      the COOH-terminal heparin-binding domain of fibronectin.
AB  - The type III connecting segment of fibronectin contains two cell binding sites,
      represented by the peptides CS1 and CS5, that are recognized by the integrin
      receptor alpha 4 beta 1. Using assays measuring the spreading of A375-SM human
      melanoma cells, we now report that the adhesion promoting activity of a 29 kDa
      protease fragment of fibronectin containing the COOH-terminal heparin-binding
      domain (HepII), but lacking CS1 and CS5, is completely sensitive to anti-alpha 4
      and anti-beta 1 antibodies, suggesting that HepII contains a third alpha 4 beta 1
      binding sequence. Examination of the primary structure of HepII revealed a
      sequence with homology to CS1. A 19mer peptide spanning this region (designated
      H1) was found to support cell spreading to the same level as the 29 kDa fragment.
      H1-dependent adhesion was completely sensitive to anti-alpha 4 and anti-beta 1
      antibodies. When soluble peptides were tested for their ability to block cell
      spreading on the 29 kDa fragment, a 13mer peptide comprising the central core of
      H1 was found to be completely inhibitory. The active region of H1 was localized
      to the pentapeptide IDAPS, which is homologous to LDVPS from the active site of
      CS1. Taken together, these results identify a novel peptide sequence in the HepII
      region of fibronectin that supports alpha 4 beta 1-dependent cell adhesion.

PMID- 1756720
TI  - Mutations in TrpI binding site II that differentially affect activation of the
      trpBA promoter of Pseudomonas aeruginosa.
AB  - In vitro, Pseudomonas aeruginosa TrpI protein activates transcription initiation
      at the trpBA promoter (trpPB) and represses initiation at its own promoter
      (trpPI), which diverges from, and overlaps, trpPB. Indoleglycerol phosphate
      (InGP) reduces the TrpI concentration required for binding to its strong binding
      site (site I), as measured by repression of trpPI; it also facilitates activation
      of trpPB, presumably because it enables TrpI to bind to a weaker binding site
      (site II) and thereby interact with RNA polymerase. The role of site II and InGP
      in regulation of the two promoters was investigated by constructing site II
      mutants. A 2 bp substitution affected the ability of TrpI to activate trpPB, but
      did not significantly affect TrpI binding to site II. A more extensive (8 bp)
      substitution inhibited TrpI-mediated activation of trpPB and TrpI-mediated
      protection of site II in a DNase I footprinting assay. However, the mutation did
      not alter the pattern of TrpI binding observed in gel retardation experiments. In
      particular, a more slowly-migrating complex (Complex 2) whose appearance was
      correlated with TrpI binding to site II was formed equally well on a wild-type or
      substituted DNA fragment. Based on the mutant phenotypes, we propose that a
      particular sequence of protein--protein and protein--DNA interactions is required
      for activation of trpPB by TrpI and InGP.

PMID- 1756721
TI  - Amino acids determining operator binding specificity in the helix-turn-helix
      motif of Tn10 Tet repressor.
AB  - Each of 22 amino acids in the proposed alpha-helix-turn-alpha-helix operator
      binding motif of the Tn10 encoded Tet repressor was replaced by alanine and one
      residue was replaced by valine to determine their role in tet operator
      recognition by a 'loss of contact' analysis with 16 operator variants. One class
      of amino acids consisting of T27 and R28 in the first alpha-helix and L41, Y42,
      W43 and H44 in the recognition alpha-helix are quantitatively most important for
      wild-type operator binding. These residues are probably involved in the
      structural architecture of the motif. A second class of residues is
      quantitatively less important for binding, but determines specificity by forming
      base pair specific contacts to three positions in tet operator. This property is
      most clearly demonstrated for Q38 and P39 and to a lesser extent for T40 at the N
      terminus of the recognition alpha-helix. The contacted operator base pairs
      indicate that the N-terminus of the recognition alpha-helix is located towards
      the palindromic center in the repressor-operator complex. Although the
      orientation of the recognition alpha-helix in the Tet repressor-tet operator
      complex is inversed as compared with the lambda- and 434 repressor-operator
      complexes, the reduced operator binding of the TA27 mutation in the first alpha
      helix suggests that the hydrogen bonding networks connecting the two alpha
      helices may be similar in these proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756722
TI  - Antisense SCL suppresses self-renewal and enhances spontaneous erythroid
      differentiation of the human leukaemic cell line K562.
AB  - The SCL gene encodes a member of the helix-loop-helix family of transcription
      factors that have been implicated in regulation of differentiation and
      development. Although SCL mRNA is not detectable in normal thymocytes or
      peripheral T-lymphocytes, transcriptional activation occurs in T-cell tumours. A
      clue to the normal function of SCL has come from demonstration of high levels of
      SCL mRNA in erythroid cells. To illuminate the function of SCL in the erythroid
      lineage, an antisense SCL construct was introduced into the human
      erythroleukaemia cell line, K562. Cells electroporated with a vector containing
      antisense SCL grew more slowly than control cells which had received vector
      alone. Non-specific toxicity was excluded by showing that antisense SCL did not
      influence growth of Raji cells, a B-cell line that does not express endogenous
      SCL mRNA. Suppression of K562 growth was accompanied by increased spontaneous
      erythroid differentiation as measured by benzidine staining. K562 cells
      containing antisense SCL produced smaller colonies in agar and exhibited reduced
      clonogenicity compared with control cells. In addition, experiments in which K562
      colonies were recloned showed that antisense SCL profoundly suppressed self
      renewal of K562 cells. These data provide the first evidence that SCL promotes
      self-renewal in an erythroid cell line and raise the possibility that SCL may
      function to regulate proliferation of normal erythroid cells.

PMID- 1756723
TI  - Cytoplasmic retention, DNA binding and processing of the NF-kappa B p50 precursor
      are controlled by a small region in its C-terminus.
AB  - The transcription factor NF-kappa B binds to DNA as a heterodimer composed of two
      subunits of 50 kDa (p50) and 65 kDa (p65). p50 contains a DNA binding and
      dimerization domain and represents a truncated form of a 105 kDa (p105) precursor
      molecule. We show here that in different cell types the p105 precursor as well as
      the processed p50 coexist in the cytoplasm, but that only the latter enters the
      nucleus. The cytoplasmic retention of the precursor molecule is controlled by a
      small region in its C-terminal part. We show that this region is responsible for
      the observed lack of DNA binding of the p50 precursor and controls the extent of
      processing of the precursor to the mature form. We also present evidence that a
      stretch of four basic amino acids, similar to a sequence found in the other
      proteins belonging to the rel/NF-kappa B family, is required for translocation of
      the processed p50 protein into the nucleus and thus could be the target for the
      retention mechanism.

PMID- 1756724
TI  - Changes in NF-kappa B and ISGF3 DNA binding activities are responsible for
      differences in MHC and beta-IFN gene expression in Ad5- versus Ad12-transformed
      cells.
AB  - Changes in MHC class I expression are frequently observed in tumors, which
      represents at least one mechanism by which tumor cells escape immune
      surveillance. MHC class I expression is often suppressed in type 12 adenovirus
      (Ad12)-transformed rodent cells, but is highly induced in Ad5-transformed cells.
      This difference helps to explain why Ad12 but not Ad5 can induce tumors in
      immunocompetent syngeneic rats. In this report we demonstrate that only Ad5- but
      not Ad12-transformed rodent fibroblasts constitutively express beta-IFN which
      results in ISGF3 factor induction, and stimulation of MHC class I expression.
      Furthermore, we demonstrate that in contrast to Ad12-transformed cells, Ad5
      transformed cells show constitutive levels of nuclear NF-kappa B-like DNA binding
      activity. This is of particular interest since both the beta-IFN and the MHC
      class I promoters contain an NF-kappa B DNA binding site. Thus, high levels of
      MHC class I expression in Ad5-transformed cells are due to a combinatorial
      stimulation of two cis-regulatory sequences of the MHC class I promoter: the NF
      kappa B binding site and the interferon stimulated response element (ISRE), which
      binds the ISGF3 factor complex. The failure of Ad12-transformed cells to activate
      this pathway explains their low levels of MHC class I expression and their
      greater oncogenicity.

PMID- 1756725
TI  - HOX4 genes encode transcription factors with potential auto- and cross-regulatory
      capacities.
AB  - We have looked for the binding of several HOX4 complex homeoproteins in the
      genomic region containing the HOX4C promoter, between the human HOX4C and HOX4D
      genes. The HOX4C, HOX4D and Hox-4.3 homeoproteins bind to a phylogenetically
      highly conserved DNA fragment, which is located in the proximal part of this
      intergenic region and contains multiple binding sites for these HOX4 proteins.
      Using cotransfection experiments, we show that this endogenous DNA sequence can
      mediate transactivation by the HOX4D and HOX4C proteins and that this effect
      requires the presence of TAAT-related binding sites. The Hox-4.3 protein, in
      contrast, is unable to activate and can repress the activation observed with the
      two other proteins. These results show that the HOX4D and HOX4C genes are genuine
      sequence-specific transcription factors and suggest that, as in Drosophila, cross
      regulatory interactions between these genes might be essential for their proper
      expression.

PMID- 1756726
TI  - HIV-1 Tat protein promotes formation of more-processive elongation complexes.
AB  - The Tat protein of HIV-1 trans-activates transcription in vitro in a cell-free
      extract of HeLa nuclei. Quantitative analysis of the efficiency of elongation
      revealed that a majority of the elongation complexes generated by the HIV-1
      promoter were not highly processive and terminated within the first 500
      nucleotides. Tat trans-activation of transcription from the HIV-1 promoter
      resulted from an increase in processive character of the elongation complexes.
      More specifically, the analysis suggests that there exist two classes of
      elongation complexes initiating from the HIV promoter: a less-processive form and
      a more-processive form. Addition of purified Tat protein was found to increase
      the abundance of the more-processive class of elongation complex. The purine
      nucleoside analog, 5,6-dichloro-1-beta-D-ribofuranosylbenzimidazole (DRB)
      inhibits transcription in this reaction by decreasing the efficiency of
      elongation. Surprisingly, stimulation of transcription elongation by Tat was
      preferentially inhibited by the addition of DRB.

PMID- 1756727
TI  - Transcriptional termination between the closely linked human complement genes C2
      and factor B: common termination factor for C2 and c-myc?
AB  - We have demonstrated, using a combination of nuclear run-off and poly(A) site
      competition assays, that transcriptional termination occurs between the closely
      spaced human complement genes, C2 and Factor B, soon after the C2 poly(A) site. A
      comparison of the C2 termination signal with a functionally similar sequence
      downstream of the human alpha 2 globin gene reveals that both signals function in
      an orientation dependent manner, with subfragments of the whole signal displaying
      partial effects. In the case of the C2 termination sequence a protein binds
      within it, and is partially responsible for the termination effect. We further
      demonstrate that the same (or closely related) protein binds to the ME1a1 site in
      the murine c-myc promoter, which has been implicated in c-myc attenuation. We
      suggest that the termination/pause sequences positioned downstream of a gene's
      poly(A) site may constitute the general signals that elicit transcriptional
      termination in genes transcribed by RNA polymerase II.

PMID- 1756728
TI  - The DNA binding and oligomerization domain of MCM1 is sufficient for its
      interaction with other regulatory proteins.
AB  - The MCM1 gene encodes an essential DNA binding protein that, in cooperation with
      the transactivators alpha 1 and STE12 and the repressor alpha 2, confers mating
      specificity to haploid yeast cells. We show that the amino-terminal third of the
      MCM1 protein is sufficient for the physical interaction with these factors. A
      strain expressing just 98 amino acids encompassing the oligomerization and DNA
      binding domains of MCM1 is viable and mating competent. This motif exhibits
      considerable similarity to a domain of the mammalian transcription factor SRF. A
      98 amino acid hybrid gene coding for the MCM1 DNA binding domain and SRF
      dimerization domain is sufficient for viability but not for the expression of
      mating type specific genes. In vitro binding studies suggest that a region of
      approximately 50 amino acids of MCM1 is essential for providing contacts with
      alpha 1, alpha 2 and STE12.

PMID- 1756729
TI  - A protein domain conserved between yeast MCM1 and human SRF directs ternary
      complex formation.
AB  - MCM1 and SRF bind to the same DNA sequence and form ternary complexes with STE12
      and p62TCF, respectively. We show that in gel retardation assays, MCM1 recruits
      both ternary complex factors whereas SRF interacts only with p62TCF. A protein
      domain of 90 amino acids, shared by MCM1 and SRF, was found to be sufficient for
      ternary complex formation. The domain is also required for dimerization and DNA
      binding. Similar regions are found in other proteins, such as ARG80, Deficiens
      and Agamous. ARG80 and Agamous exhibit similar DNA binding specificities but do
      not interact with either STE12 or p62TCF. By exchanging three residues of ARG80
      with those of corresponding positions in SRF (residues 198, 200 and 203), the
      ARG80 protein acquires the ability to recruit p62TCF into a ternary complex.
      Likewise, the substitution of four SRF amino acids by MCM1-derived residues
      (amino acids 73, 75, 77 and 78) confers on SRF the ability to interact with
      STE12. Thus, we have identified specific amino acids in MCM1 and SRF that are
      critical for ternary complex formation and which map to equivalent positions
      within the shared domains. Therefore, the structural basis for specific protein
      protein interaction appears to be conserved in evolution between a class of
      transcription factors.

PMID- 1756730
TI  - Depletion of U3 small nucleolar RNA inhibits cleavage in the 5' external
      transcribed spacer of yeast pre-ribosomal RNA and impairs formation of 18S
      ribosomal RNA.
AB  - Multiple processing events are required to convert a single eukaryotic pre
      ribosomal RNA (pre-rRNA) into mature 18S (small subunit), 5.8S and 25-28S (large
      subunit) rRNAs. We have asked whether U3 small nucleolar RNA is required for pre
      rRNA processing in vivo by depleting Saccharomyces cerevisiae of U3 by
      conditional repression of U3 synthesis. The resulting pattern of accumulation and
      depletion of specific pre-rRNAs indicates that U3 is required for multiple events
      leading to the maturation of 18S rRNA. These include an initial cleavage within
      the 5' external transcribed spacer, resembling the U3 dependent initial
      processing event of mammalian pre-rRNA. Formation of large subunit rRNAs is
      unaffected by U3 depletion. The similarity between the effects of U3 depletion
      and depletion of U14 small nucleolar RNA and the nucleolar protein fibrillarin
      (NOP1) suggests that these could be components of a single highly conserved
      processing complex.

PMID- 1756731
TI  - Cleavage and polyadenylation factor CPF specifically interacts with the pre-mRNA
      3' processing signal AAUAAA.
AB  - Cleavage and polyadenylation factor (CPF) is required for the cleavage as well as
      for the subsequent polyadenylation reaction during 3' processing of messenger RNA
      precursors. Here, we have investigated the interaction of CPF and poly(A)
      polymerase with short RNA substrates. CPF activates poly(A) polymerase to
      elongate RNA primers carrying the canonical hexamer recognition signal AAUAAA.
      CPF specifically binds to such RNA as shown by gel mobility shift assays and
      competition experiments. Upon binding of CPF, two polypeptides of 35 kDa and 160
      kDa can be covalently crosslinked to the RNA by irradiation with UV light. These
      polypeptides may correspond to the smallest and the largest subunit contained in
      purified CPF fractions. In addition, chemical modification-exclusion experiments
      demonstrate that CPF interacts directly with the AAUAAA recognition signal in the
      RNA. The entire hexamer signal is involved in binding of CPF since modification
      of any of its bases interferes with complex formation.

PMID- 1756732
TI  - Isolation and expression of cDNA clones encoding mammalian poly(A) polymerase.
AB  - cDNA clones encoding mammalian poly(A) polymerase were isolated with probes
      generated by the polymerase chain reaction based on amino acid sequences derived
      from the purified enzyme. A bovine cDNA clone was obtained encoding a protein of
      82 kDa. Expression in Escherichia coli resulted in the appearance of a poly(A)
      polymerase activity that was dependent on the addition of the purified
      specificity factor CPF and the presence of the polyadenylation signal AAUAAA in
      the RNA substrate. The activity copurified with a polypeptide of the expected
      size. A second class of cDNAs encoded a polypeptide of 43 kDa which was closely
      related to the N-terminal half of the 82 kDa protein. Northern blots showed two
      mRNAs of 4.2 and 2.4 kb that probably correspond to the two classes of cDNAs, as
      well as a third band of 1.3 kb. The sequence of the N-terminal half of bovine
      poly(A) polymerase is 47% identical with the amino acid sequence of the
      corresponding part of yeast poly(A) polymerase. Homologies to other proteins are
      of uncertain significance.

PMID- 1756733
TI  - The temporal and spatial distribution pattern of maternal exuperantia protein:
      evidence for a role in establishment but not maintenance of bicoid mRNA
      localization.
AB  - The exuperantia (exu) gene of Drosophila melanogaster plays a fundamental role in
      the establishment of polarity of the oocyte and early embryo by ensuring the
      proper localization of the mRNA of the bicoid (bcd) gene to anterior regions of
      the oocyte. We have isolated and sequenced the exu gene, sequenced its female
      specific transcript and a mutant allele of exu that affects primarily exu's
      female germline function, and determined the temporal and spatial pattern of exu
      protein expression during oogenesis. The exu protein is basic, with at least one
      basic residue being identified as necessary for exu function in the female
      germline, and is present transiently during oogenesis. Our results suggest that
      exu is not required for the maintenance of bcd mRNA localization during late
      stages of oogenesis and early embryogenesis, but rather for the establishment of
      bcd mRNA localization in the developing oocyte. We propose that the exu protein
      may serve to modify a component that binds bcd mRNA or to modify the bcd message
      itself, or may perform a role in docking the bcd mRNA at its site of localization
      in the developing oocyte.

PMID- 1756734
TI  - A component of the multisynthetase complex is a multifunctional aminoacyl-tRNA
      synthetase.
AB  - In higher eukaryotes, nine aminoacyl-tRNA synthetases are associated within a
      multienzyme complex which is composed of 11 polypeptides with molecular masses
      ranging from 18 to 150 kDa. We have cloned and sequenced a cDNA from Drosophila
      encoding the largest polypeptide of this complex. We demonstrate here that the
      corresponding protein is a multifunctional aminoacyl-tRNA synthetase. It is
      composed of three major domains, two of them specifying distinct synthetase
      activities. The amino and carboxy-terminal domains were expressed separately in
      Escherichia coli, and were found to catalyse the aminoacylation of glutamic acid
      and proline tRNA species, respectively. The central domain is made of six 46
      amino acid repeats. In prokaryotes, these two aminoacyl-tRNA synthetases are
      encoded by distinct genes. The emergence of a multifunctional synthetase by a
      gene fusion event seems to be a specific, but general attribute of all higher
      eukaryotic cells. This type of structural organization, in relation to the
      occurrence of multisynthetase complexes, could be a mechanism to integrate
      several catalytic domains within the same particle. The involvement of the
      internal repeats in mediating complex assembly is discussed.

PMID- 1756735
TI  - The retinoblastoma protein is phosphorylated on multiple sites by human cdc2.
AB  - The retinoblastoma gene product (pRB) is a nuclear phosphoprotein that is thought
      to play a key role in the negative regulation of cellular proliferation. pRB is
      phosphorylated in a cell cycle dependent manner, and studies in both actively
      dividing and differentiated cells suggest that this modification may be essential
      for cells to progress through the cell cycle. Using tryptic phosphopeptide
      mapping we have shown that pRB is phosphorylated on multiple serine and threonine
      residues in vivo and that many of these phosphorylation events can be mimicked in
      vitro using purified p34cdc2. Using synthetic peptides corresponding to potential
      cdc2 phosphorylation sites, we have developed a strategy which has allowed the
      identification of five sites. S249, T252, T373, S807 and S811 are phosphorylated
      in vivo, and in each case these sites correspond closely to the consensus
      sequence for phosphorylation by p34cdc2. This and the observation that pRB forms
      a specific complex with p34cdc2 in vivo suggests that p34cdc2 or a p34cdc2
      related protein is a major pRB kinase.

PMID- 1756736
TI  - The wis1 protein kinase is a dosage-dependent regulator of mitosis in
      Schizosaccharomyces pombe.
AB  - The wis1+ gene encodes a newly identified mitotic control element in
      Schizosaccharomyces pombe. It was isolated by virtue of its interaction with the
      mitotic control genes cdc25, wee1 and win1. The wis1+ gene potentially encodes a
      66 kDa protein with homology to the serine/threonine family of protein kinases.
      wis1+ plays an important role in the regulation of entry into mitosis, as it
      shares with cdc25+ and nim1+/cdr1+ the property of inducing mitosis in a dosage
      dependent manner. Increased levels of wis1+ expression cause mitotic initiation
      to occur at a reduced cell size. Loss of wis1+ function does not prevent
      vegetative growth and division, though wis1- cells show an elongated morphology,
      indicating that their entry into mitosis and cell division is delayed relative to
      wild type cells. wis1- cells undergo a rapid reduction of viability upon entry
      into stationary phase, suggesting a role for wis1+ in the integration of
      nutritional sensing with the control over entry into mitosis.

PMID- 1756737
TI  - p80cdc25 mitotic inducer is the tyrosine phosphatase that activates p34cdc2
      kinase in fission yeast.
AB  - We have investigated the mechanism by which fission yeast p80cdc25 induces
      mitosis. The in vivo active domain was localized to the C-terminal 23 kDa of
      p80cdc25. This domain produced as a bacterial fusion protein (GST-cdc25) caused
      tyrosyl dephosphorylation and activation of immunoprecipitated p34cdc2.
      Furthermore, GST-cdc25 dephosphorylated both para-nitrophenyl-phosphate (pNPP)
      and casein phosphorylated on serine in vitro. Reaction requirements and inhibitor
      sensitivities were the same as those of phosphotyrosine phosphatases (PTPases).
      Analysis of cdc25 C-terminal domains from a variety of species revealed a
      conserved motif having critical residues present at the active site of PTPases.
      Mutation of the cdc25 Cys480 codon, corresponding to an essential cysteine in the
      active site of PTPases, abolished the phosphatase activity of GST-cdc25. These
      data indicate that cdc25 proteins define a novel subclass of eukaryotic PTPases,
      and strongly argue that cdc25 proteins directly dephosphorylate and activate
      p34cdc2 kinase to induce M-phase.

PMID- 1756738
TI  - Mutation pattern of immunoglobulin transgenes is compatible with a model of
      somatic hypermutation in which targeting of the mutator is linked to the
      direction of DNA replication.
AB  - We have previously demonstrated that B lymphocyte specific somatic mutations are
      introduced into the variable regions of immunoglobulin kappa transgenes in two
      independent transgenic mouse lines. The frequency, distribution and nature of
      these mutations strongly suggest that they arose as a result of the process of
      somatic hypermutation, which is responsible, in part, for affinity maturation
      during an immune response. Unexpectedly, in these multiple copy transgenic lines,
      many of the transgene copies showed no evidence of somatic mutation. This paradox
      was addressed by determining the sequence of each transgene copy in several B
      cell hybridomas derived from a mouse line carrying three copies of the kappa
      transgene. It was found that the somatic hypermutation process in different B
      cells from the same mouse preferentially targets one, but not the same, transgene
      copy. We present a model, based on the pattern of this targeting, which links
      somatic hypermutation to the orientation of the Ig gene relative to the direction
      of DNA replication.

PMID- 1756739
TI  - Vaccinia DNA ligase complements Saccharomyces cerevisiae cdc9, localizes in
      cytoplasmic factories and affects virulence and virus sensitivity to DNA damaging
      agents.
AB  - The functional compatibility of vaccinia virus DNA ligase with eukaryotic
      counterparts was demonstrated by its ability to complement Saccharomyces
      cerevisiae cdc9. The vaccinia DNA ligase is a 63 kDa protein expressed early
      during infection that is non-essential for virus DNA replication and
      recombination in cultured cells. This implies complementation by a mammalian DNA
      ligase, yet no obvious recruitment of host DNA ligase I from the nucleus to the
      cytoplasm was observed during infection. An antiserum raised against a peptide
      conserved in eukaryotic DNA ligases identified the virus enzyme in discrete
      cytoplasmic 'factories', the sites of virus DNA synthesis, demonstrating
      immunological cross-reactivity between host DNA ligase I and the vaccinia enzyme.
      DNA ligase was not detected in the factories of a mutant virus lacking the ligase
      gene. Despite this, no difference in growth between wild-type (WT) and mutant
      virus was detectable even in Bloom's syndrome cells which have reduced DNA ligase
      I activity. However, DNA ligase negative virus showed an increased sensitivity to
      UV or bleomycin in cultured cells, and the importance of DNA ligase for virus
      virulence in vivo was demonstrated by the attenuated phenotype of the deletion
      mutant in intranasally infected mice.

PMID- 1756740
TI  - DNA replication in cell-free extracts from Drosophila melanogaster.
AB  - We have developed an efficient in vitro replication system from 0-2 h Drosophila
      melanogaster embryos. Demembranated Xenopus sperm DNA when incubated in such an
      extract first becomes enclosed in a nucleus-like structure with a nuclear
      envelope and a karyoskeleton. It then undergoes one round of semiconservative
      replication--this replication appears completely dependent on nuclear formation.
      Up to 30% of input DNA is nucleated in one reaction. Efficient nuclear formation
      and replication are dependent on a cold treatment step, prior to disruption of
      the embryos. They also depend on the age of the embryos used. Extracts from older
      embryos (0-5 h) are capable of nuclear formation, although at a much reduced
      efficiency, and repair synthesis, but seem to have lost the ability to initiate
      DNA replication. In addition to replicating sperm DNA this system appears capable
      of carrying out semi-conservative replication on some plasmids. However, it
      cannot use these to trigger nuclear formation; replication is only seen if the
      plasmids are coincubated with sperm DNA. The in vitro formed nuclei have not been
      observed to trigger nuclear envelope breakdown and entry into mitosis. However,
      they can re-replicate the DNA if the nuclei are permeabilized. This system should
      be a useful complement to the previously isolated Xenopus in vitro replication
      system. In addition the amenability of Drosophila to genetic study should open up
      new approaches not previously possible with Xenopus.

PMID- 1756741
TI  - Percutaneous endovascular stenting: development, investigation and application.
AB  - Percutaneous endovascular stenting (PES), a new and alternative approach of
      interventional radiologic techniques, has encouraging potentials for management
      of vascular obstructive diseases. The most important role of PES is to prevent
      the risk of abrupt closure and to reduce the rate of early and late post
      angioplasty restenosis (PARS) of PTA. Because of different working mechanisms,
      various stents show different advantages and disadvantages. Specific indications
      of PES are: (1) further compensation for failed PTA, (2) management of
      complications due to PTA and (3) primary treatment of vascular obstructive
      diseases. Based on a preliminary comparison with atherectomy, laser angioplasty
      and PTA, PES seems to provide an advantage for long-term patency of large caliber
      vessels such as iliac arteries, while more significant problems still exist in
      PES with small caliber vessels such as femoral-popliteal and coronary arteries.
      Further comparative clinical research is required to establish the utility of PES
      among other intraluminal techniques of vascular interventions.

PMID- 1756742
TI  - Influence of negative ultrasound findings on the management of in- and
      outpatients with suspected deep-vein thrombosis.
AB  - Real-time ultrasonography (US) was used as a single non-invasive method in the
      management of 174 patients (56 inpatients and 118 outpatients) with suspected
      deep-vein thrombosis (DVT). Therapeutic decisions were based on the results of
      ultrasonography alone. If the US examination was abnormal anticoagulant treatment
      was started. If the initial US examination was normal, no treatment was given and
      the patient underwent repeated testing and physical examination after 1 day, 7
      days and 3 months. In the outpatient group, 1.3% of the ultrasonographic negative
      patients developed thromboembolic complications (95% confidence limits, 0.03
      7.21%). None of the initial ultrasonographic negative patients developed proximal
      DVT after 1 day and 7 days. In the inpatient group, 10% of the ultrasonographic
      negative patients developed thromboembolic complications (95% confidence limits,
      1.2-31.7%). In 18% of the ultrasonographic negative patients an alternative,
      unexpected diagnosis was obtained by ultrasound. The most frequent alternative
      diagnosis was a popliteal cyst. The results indicate that US alone appears to be
      a safe diagnostic method in the management of outpatients with suspected DVT. In
      the inpatient group further research is required for definite recommendations
      regarding a safe ultrasound follow-up schedule.

PMID- 1756743
TI  - Ultrasound findings of ganglions of the wrist.
AB  - Fifty-one patients with a palpable swelling of a wrist or finger of suspected
      ganglion origin were examined by ultrasound (US). Forty-five were operated on,
      and a ganglion was found in 35. The ganglions took the form of cysts 0.4-4 cm in
      diameter (mean 1.4 cm) with a projection into the joint or tendon in 19 cases.
      Two patients had multiple ganglia, and two a wrist lipoma, one echo-rich and the
      other echo-poor with a thick wall. One patient had a giant cell tumour of the
      tendon sheath which was moderately echogenic in appearance, one had carpal tunnel
      syndrome and a ganglion-like finding at US, one had tenosynovitis and negative US
      and one had a prominent tendon due to postoperative sequelae, with US showing a
      longish echo-poor lesion. Two had hypertrophied muscle forming a long echo-poor
      structure, one had an exostosis and one had no abnormality in the wrist at
      operation. Our experiences suggest that ultrasound is useful in many cases with
      impression of a ganglion at palpation showing multiplicity of a lesion or for
      assisting in differential diagnosis, although a physical examination is mostly
      sufficient for diagnostic purposes.

PMID- 1756744
TI  - Ultrasonography of spleen and liver in staging Hodgkin's disease.
AB  - Ultrasound (US) findings and accuracy in detecting splenic and hepatic
      involvement were analysed in 137 unselected, untreated patients with Hodgkin's
      disease. Histology was available from the spleens of 61 patients and the livers
      of 59 patients. In 20 patients the spleen appeared abnormal at US; containing
      focal hypoechoic lesions in 14, being enlarged in 13 and inhomogeneous in 2
      patients. Most focal lesions were less than 10 mm. The sensitivity of US in
      detecting involvement of the spleen was 54% and the specificity 100%; the ability
      of US to detect hypoechoic splenic lesions improved during the study period.
      Focal hypoechoic hepatic lesions were found in three patients; histological
      examination of these showed benign changes in one and suspicious finding in the
      second. In the third the lesion disappeared during chemotherapy. In three cases
      with definitive histological evidence of liver involvement, US results were false
      negative. The results indicate a higher diagnostic efficacy for US in the
      detection of splenic than hepatic involvement by Hodgkin's disease.

PMID- 1756745
TI  - Importance of a post-therapeutic residue in the prognosis of head and neck
      rhabdomyosarcoma in children.
AB  - Enhanced contrast computed tomography (CT) was performed in 23 children treated
      for head and neck rhabdomyosarcoma (RMS). The CT studies were retrospectively
      reviewed by two senior radiologists. Analysis of these CT studies revealed to
      separate groups of patients. One group (12 patients) had a post-therapeutic
      residue defined as soft tissue thickening at the original site, which remained
      stable over a period of 3 months and caused no mass effect on adjacent
      structures. Of these 12, eight showed enhancement at the area of thickening. Nine
      of these 12 patients relapsed. The other group (11 patients) demonstrated no post
      therapeutic residue; only three of these patients relapsed. In this study the
      presence of a post-therapeutic residue was significantly associated with a poor
      prognosis, using a Fischer's test (P = 0.04).

PMID- 1756746
TI  - Post-traumatic hemobilia.
AB  - Four patients with post-traumatic hemobilia were evaluated with arteriography
      over a 2 year period. In two patients hemobilia was of iatrogenic origin; in
      particular, one case appeared after a cholecystectomy, and the other was due to
      placement of a biliary stent with an endoscope. In the other two patients
      hemobilia was the result of a gun injury. Arteriography of the hepatic arterial
      system demonstrated two false aneurysms, extravasation of contrast medium through
      the biliary system in one patient and arterioportal fistula in another patient.
      It is concluded that arteriography of the hepatic arterial system is the method
      of choice for the evaluation and the possible treatment of patients with
      hemobilia.

PMID- 1756747
TI  - Premature vascular calcification in a case of POEMS syndrome.
AB  - A patient with classical POEMS syndrome associated with a myeloproliferative
      disorder is presented, in whom extensive arterial calcification was seen at an
      early age in the absence of other predisposing factors. Radiographs also
      demonstrated several small discrete sclerotic foci elsewhere in the skeleton and
      areas of new bone formation around the spine which were described in previous
      cases. Histological studies in this patient demonstrated an osteosclerotic
      solitary plasmacytoma of bone and Castleman's disease of lymph nodes, both of
      which have previously been causally associated with POEMS syndrome. In addition,
      dermal infiltration by mast cells was demonstrated.

PMID- 1756748
TI  - Calcification of peritoneal carcinomatosis from gastric carcinoma: a CT
      demonstration.

PMID- 1756749
TI  - Correlation between computed tomography and magnetic resonance imaging in
      diastematomyelia.
AB  - Preoperative neuroradiological evaluation of diastematomyelia cases is of vital
      importance in order to increase surgical success rate. This paper reports the
      neuroradiological data of diastematomyelia cases in the light of surgical
      findings, and discusses the efficacy of CT and MRI in the evaluation of patients
      with diastematomyelia.

PMID- 1756750
TI  - Computed tomographic myelography characteristics of spinal cord atrophy in
      juvenile muscular atrophy of the upper extremity.
AB  - Although atrophy of the lower cervical and upper thoracic cord in juvenile
      muscular atrophy of distal upper extremity has been reported, the atrophic
      patterns of the cord, especially in the transverse section, have not been studied
      extensively. The aim of this study is to clarify the atrophic patterns of the
      cord by CT myelography (CTM) and to discuss the pathogenesis of cord atrophy.
      Sixteen patients with juvenile muscular atrophy of distal upper extremity were
      examined by CTM. Atrophy of the lower cervical and upper thoracic cord,
      consistent with the segmental weakness, was seen in all patients. Flattening of
      the ventral convexity was a characteristic atrophic pattern of the cord.
      Bilateral cord atrophy was commonly observed; eight of 12 patients with
      unilateral clinical form and all four patients with bilateral form showed
      bilateral cord atrophy with dominance on the clinical side. There was no
      correlation between the degree of cord atrophy and duration of symptoms.
      Flattening of the ventral convexity, associated with purely motor disturbances,
      reflects selective atrophy of the anterior horns in the cord, which is
      attributable to chronic ischemia. Cord atrophy proved to precede clinical
      manifestations. The characteristic atrophy of the cord provides useful
      information to confirm the diagnosis without long-term observation.

PMID- 1756751
TI  - Memory and learning disturbances in multiple sclerosis. MRI lesions and
      neuropsychological correlation.
AB  - Thirty-five patients with definite multiple sclerosis (MS) were studied. They
      underwent neuropsychological testing and magnetic resonance imaging (MRI). The
      MRI findings at different brain areas levels were compared with the
      neuropsychological findings. A quantitative system was used to measure MRI-MS
      lesions. In this series, a positive correlation was established between memory
      and learning disturbances measured by Battery 144, and the lesions measured by
      MRI (total, hemispheric and, particularly, periventricular lesions). MRI can
      detect MS lesions, and this study shows that a correlation between MRI and
      neuropsychological findings is possible if quantitative methods are used to
      distinguish different MS involvement areas in relation to neuropsychological
      tasks. These findings suggest that hemispheric lesions in MS produce cognitive
      disturbances and MRI could be a useful tool in predicting memory and learning
      impairment.

PMID- 1756752
TI  - The effect of digital unsharp-mask filtering on the signal-to-noise ratio in
      computed radiography.
AB  - The effect of image processing in computed radiography (CR) has been analyzed in
      many ROC studies. The results have not shown great diagnostic improvements,
      except in some special occasions. The theoretical effect of image enhancement on
      the signal-to-noise ratio in CR images has so far not been assessed. Concerning
      the previous results, the changes induced in the signal-to-noise ratio by digital
      image processing are certainly of interest. We calculated the signal-to-noise
      ratio in various conditions according to the principles of the Rose model, using
      the computerized image data of storage phosphor radiography. Seventy-seven
      computed radiographs processed by Gaussian unsharp-mask filtering using different
      kernel widths were analyzed. The signal-to-noise ratio was reduced in all images
      by more than 40% when the smallest kernels were used, and increased slowly
      towards the original value with greater kernel sizes. In no conditions did the
      ratio exceed the original one. The results show that although edges and signal
      contrast can be enhanced by unsharp-mask filtering, this happens at the cost of
      increased noise. This might at least in part explain why image processing does
      not significantly improve the diagnostic information content of a computed
      radiograph.

PMID- 1756753
TI  - Vivos mortui docebunt? Reflections 95 years after the discovery of X-rays.

PMID- 1756754
TI  - Three-dimensional computed tomography of complex craniofacial fractures.

PMID- 1756755
TI  - Subsequent bilateral occurrence of fibrous breast tumors.

PMID- 1756756
TI  - Familial hypomelanosis of Ito.
AB  - Two siblings presented the typical skin changes of hypomelanosis of Ito (HI)
      associated with mental and cerebellar signs. Their mother showed only the skin
      changes of HI but no neurological disturbances. HI is a hereditary disorder, in
      which familiarity may go unnoticed because of the different expressions of neural
      and cutaneous features.

PMID- 1756757
TI  - Sleep disorders, pain, and depression in Parkinson's disease.
AB  - A consecutive series of patients with Parkinson's disease (PD) were examined for
      the presence of sleep disturbances, pain, and depression. We found that patients
      with PD and major depression had significantly more sleep disturbances and severe
      pain than non-depressed patients with PD. Moreover, depression scores accounted
      for most of the variance in a stepwise regression analysis of the effect of
      numerous clinical variables on either sleep disorders or pain severity. These
      findings suggest that depression is the most important factor associated with the
      common problems of sleep disorder and pain among patients with PD.

PMID- 1756758
TI  - Tiapride as treatment for certain patients with idiopathic torsion dystonia.
AB  - Five female patients with idiopathic torsion dystonia (ITD) responded to
      treatment with tiapride, a selective D-2 dopamine antagonist. Previous treatments
      with various drugs, including anticholinergics, were ineffective. It is suggested
      that the previously reported genetic subgroups of ITD respond to different drug
      regimens. The autosomal dominant group responded to anticholinergics, while the
      autosomal recessive group responded best to a selective D-2 dopamine antagonist.

PMID- 1756759
TI  - Regional relationships between focal hypofixation images in 123I-IMP single
      photon emission computed tomography and epileptic EEG foci in interictal periods
      in patients with partial epilepsy.
AB  - Single photon emission computed tomographic (SPECT) brain scans with N-isopropyl
      (iodine-123)-p-iodoamphetamine were performed in interictal periods in 40
      patients with partial epilepsies and normal X-ray CT findings, and the regional
      relationships between the SPECT abnormalities and interictal epileptic EEG foci
      were studied. Twenty-six patients (65%) had abnormal SPECT images consisting of
      one or more focal hypofixation images, i.e., zones of decreased regional cerebral
      blood flow, while the remaining 14 patients showed normal images. Nineteen (73%)
      of the 26 patients showed complete or partial regional agreement between the
      abnormal SPECT findings and the interictal epileptic EEG foci determined from
      EEGs recorded repeatedly during their clinical course, while the regional
      relationships with the EEG foci determined from the single EEG recorded just
      after the SPECT scans or a short interval after the scans showed a lower rate of
      agreement (13 of 21 patients, 61.9%). These results confirm the utility of SPECT
      scans in the regional diagnosis of epileptic foci.

PMID- 1756760
TI  - Focal neurological deficit with sudden onset as the first manifestation of
      sarcoidosis: a case report with MRI follow-up.
AB  - Stroke as a presenting manifestation of sarcoidosis has rarely been reported.
      This contrasts with the frequent anatomopathological findings of cerebrovascular
      involvement in neurosarcoidosis. We present a patient who developed acutely a
      right brachiofacial weakness and dysarthria. Pulmonary sarcoidosis was found. A
      brain CT and magnetic resonance imaging (MRI) scan disclosed multiple bilateral
      ischemic, mainly subcortical lesions. Despite a favorable clinical evolution
      under adequate corticotherapy, an MRI performed 3 months later showed an
      increased number of the previously observed lesions. This observation suggests
      that in some cases the evolution of central nervous system sarcoid lesions occurs
      independently from corticotherapy, and that MRI, in spite of its known great
      sensitivity in detecting those lesions, may not play a role in the follow-up of
      some patients with neurosarcoidosis.

PMID- 1756761
TI  - Effect of therapy with oxygen under high pressure on regional cerebral blood flow
      in the interval form of carbon monoxide poisoning: observation from subtraction
      of technetium-99m HMPAO SPECT brain imaging.
AB  - Changes in brain images with single photon emission computed tomography (SPECT)
      using 99mTc hexamethylpropyleneamine oxime (HMPAO) before and after therapy with
      oxygen under high pressure (OHP) were measured in a 66-year-old man with the
      interval form of carbon monoxide (CO) poisoning by a new technique, i.e.,
      subtraction of brain images. This study was performed 187 days after acute CO
      poisoning, in a state of chronic akinetic mutism that followed a lucid interval.
      A diffuse, but frontal-dominant, hypoperfusion pattern involving both the gray
      and white matter was observed in the pre-OHP SPECT image. After OHP, regional
      cerebral blood flow increased in both the gray and white matter and markedly
      increased in the frontal cortical regions. The present finding suggests that OHP
      is effective against the chronic state of the interval form of CO poisoning.

PMID- 1756762
TI  - Genetic aspects of nonconvulsive status epilepticus.
AB  - We studied the occurrence of seizure disorders within the immediate family in 3
      groups of probands: (1) 64 epileptic children with nonconvulsive status
      epilepticus (NCSE); (2) 454 epileptic children who have had no episodes of NCSE;
      (3) 306 healthy children, matched for age and sex. Recurrence of seizures among
      relatives of epileptic probands without NCSE was significantly higher than among
      the general population, both in generalized and partial epilepsies. We also
      observed an increased incidence of convulsions among the relatives of probands
      with NCSE and the general population; no differences were noted between epileptic
      children with or without NCSE. These data support the hypothesis that genetic
      factors play an important role in the etiology of seizure disorders in children
      with NCSE.

PMID- 1756763
TI  - Abolition of photoparoxysmal response in progressive myoclonus epilepsy.
AB  - We have investigated the effect of piracetam on photoparoxysmal responses in 3
      patients with progressive myoclonus epilepsy. With doses of up to 10 g/day,
      elimination of photoparoxysmal responses was achieved in all 3 patients.
      Corresponding to EEG improvement, the clinical performance improved slightly in 2
      patients and definitely in 1 patient when piracetam was added to their medication
      of valproate and clonazepam. According to our data, medical treatment of
      myoclonus with piracetam is justified particularly in myoclonus of cortical
      origin.

PMID- 1756764
TI  - Temporal influences on relapses of multiple sclerosis.
AB  - A 5-year retrospective study (January 1981-December 1985) of 87 patients with a
      known diagnosis of MS who were admitted to the University College Hospital,
      Galway, Ireland, was carried out. The duration of disease relapse was correlated
      with the following meteorological factors prevailing about the period of relapse:
      (a) temperature--mean daily, absolute maximum, absolute minimum; (b) rainfall;
      (c) relative humidity, and (d) sunshine and global radiation. Highly significant
      positive correlations were found between relapse duration and temperature
      variables, total number of sunshine hours and global radiation. Negative
      correlations were found between relapse duration and both rainfall and relative
      humidity. Relapses were of longer duration in the middle months of the year.

PMID- 1756765
TI  - Marked hypokalemic rhabdomyolysis with myoglobinuria due to diuretic treatment.
AB  - A 74-year-old male was admitted to hospital with acute rhabdomyolysis and
      myoglobinuria due to hypokalemia. The hypokalemia resulted from diuretic
      treatment. He had no family history of myopathy, and no diarrhea and vomiting.
      The neurological examination revealed painful quadriplegia. The blood pressure
      was 160/74 mm Hg. Laboratory examination showed hypokalemic and hypochloremic
      metabolic alkalosis (serum K 1.5 mEq/l, serum Cl 89 mEq/l, base excess + 20.9,
      HCO3- 44.9 mmol/l, pH 7.563) and marked elevations of serum CPK, LDH, GOT, GPT
      and myoglobin. Endocrinological and renal functions were normal. Muscle biopsy
      revealed marked necrosis with remarkable phagocytosis and vacuolar degeneration.
      The cessation of diuretics and intravenous infusion of potassium chloride
      resulted in a marked improvement in clinical and laboratory findings. The
      diuretics-induced hypokalemic myopathy is rare in the literature.

PMID- 1756767
TI  - A case of idiopathic palatal myoclonus: treatment with sodium valproate.
AB  - We describe a case of idiopathic palatal myoclonus with normal CT and NMR
      results, especially of the region of the inferior olive. The effective treatment
      with sodium valproate is reported and its relation with GABA is discussed.

PMID- 1756766
TI  - Neuro-Behcet: acute and sequential aspects by MRI and MRS.
AB  - Three patients with neuro-Behcet underwent MRI and MRS during acute illness.
      After therapy, MRI and MRS were performed in 3 and 1 patients, respectively. MRI
      revealed a marked improvement of the initial lesion in 2, a complete remission in
      1 patient. MRS showed a reduction of the N-acetyl-aspartate (NAA)/phosphocreatine
      (CR) ratio within the acute lesion in all patients and a normalization in the
      follow-up spectrum of the examined patient.

PMID- 1756768
TI  - Single photon emission computed tomography (SPECT) in cerebellar disease:
      cerebello-cerebral diaschisis.
AB  - Single photon emission computed tomography assessments were conducted in normal
      controls (n = 25), patients with unilateral cerebellar infarctions (n = 4),
      patients with olivopontocerebellar atrophy (OPCA; n = 15) and patients with
      Friedreich's ataxia (FA; n = 6). In subjects with unilateral cerebellar
      infarctions, crossed cerebellar-cortical diaschisis was observed: reduced
      cerebellar hexamethylpropyleneamine oxime (HMPAO) uptake was invariably
      accompanied by a diminution of HMPAO in the contralateral basal ganglia and
      frontoparietal cortex. OPCA and FA patients had various degrees of decreased
      HMPAO uptake in both the cerebellum and cerebral hemispheres.

PMID- 1756769
TI  - Refractory tonic generalized status epilepticus. Report of a case of
      exceptionally prolonged duration.
AB  - A generalized tonic status epilepticus persisting for 5 months in a young adult
      previously affected only by tonic-clonic seizures is described. The syndromic
      classification of the case remains unsettled.

PMID- 1756770
TI  - Clinical-radiological correlation in the evolution of a neuro-Behcet's syndrome:
      case report.

PMID- 1756771
TI  - Orofacial and respiratory tardive dyskinesia: potential side effects of 2
      dimethylaminoethanol (deanol)?
AB  - A case of essential tremor since early adultness is presented, which has been
      treated successfully with the acetylcholine precursor 2-dimethylaminoethanol
      (deanol) for 10 years. Development of a marked dyskinesia syndrome affecting
      predominantly orofacial and respiratory musculature has been noticed with this
      medication. Partial remission after discontinuation and a favorable response to
      anticholinergics are suggestive of an adverse drug effect.

PMID- 1756772
TI  - Hydrocephalus in Guillain-Barre syndrome.
AB  - Hydrocephalus developed in a 16-year-old boy with a severe Guillain-Barre
      syndrome and was demonstrated by computerized tomography (CT) and magnetic
      resonance imaging. No papilledema was observed. The spontaneous resolution of
      hydrocephalus was achieved in a 6-month period. Ventricular changes were followed
      by CT scan.

PMID- 1756773
TI  - Use of CT in epilepsy: does it matter how long you wait?
AB  - Computer tomography (CT) of the brain is of value for finding potentially
      correctable lesions in adult patients with new onset seizures. The value of CT is
      unknown, however, for finding such lesions in adult chronic epileptic patients
      without prior CT. We compared a group of 177 adult patients who had CT within a
      year from the onset of seizures to a group of 93 patients who had a history of
      seizures for more than a year before CT was performed. In the first group, 33
      potentially correctable lesions (19%) were found including 17 tumors. The group
      with chronic epilepsy had 4 (4%) potentially correctable lesions: 3 arteriovenous
      malformations and 1 meningioma. It seems that CT is of value in discovering
      potentially removable lesions in chronic epileptic patients, but the likelihood
      is relatively small. The incidence of stable structural lesions seems to be
      similar in the two groups.

PMID- 1756774
TI  - A novel antineuronal antibody in serum and CSF of a patient with motor neuron
      disease.
AB  - A patient with motor neuron disease and tonic pupil who had an antinuclear
      antibody (Ab) in the serum and oligoclonal pattern in IgG in the CSF is
      described. Sera and CSF from this patient and controls (37 sera and 30 CSF) were
      screened for an antineuronal Ab using immunoblotting. Only the serum and CSF from
      this patient contained an Ab to a 70-kD protein in the human spinal cord but not
      in the human muscle or cerebellar cortex. This patient's serum
      immunohistochemically stained human and Japanese monkey anterior horn cells but
      not Japanese monkey dorsal root ganglion.

PMID- 1756775
TI  - National Institute on Aging, NIH, Workshop on Alternative Animal Models for
      Research on Aging.
AB  - The characteristics of various animal models and their relevance for aging
      studies have been briefly discussed above. These are summarized in tabular form
      in Tables 1A-1F. The appropriate choice of a model for studying aging depends on
      a multitude of factors, but the most important characteristics appear to be
      relevance to human aging, manipulability of the genetic system, availability of
      physiological characterization data, and ease and cost of husbandry. Whereas most
      of the organisms discussed here do not satisfy all these criteria, they do offer
      some special opportunities, for example the ability to study calcium metabolism
      in female birds; to manipulate the rate of aging in lizards; and to study the
      genetics of life span in insects (e.g., Drosophila) and/or nematodes. We hope
      that the information collected here will prove useful to gerontologists with
      special interests related to human aging, and readers are encouraged to contact
      the various participants of this workshop for additional information.

PMID- 1756776
TI  - Isozyme polymorphisms in human diploid cell strains for research on cellular
      aging.
AB  - Six human lung diploid cell strains established for the study of in vitro
      cellular aging (TIG-1, TIG-7, WI-38, IMR-90, MRC-5, MRC-9, and HeLa cells as a
      control) were studied by cellulose acetate membrane electrophoresis for allozymic
      differences at 18 enzyme loci. Eight enzyme loci (G6PD, PGM1, PGM3, PepA, PGD,
      ADA, GLO1, and ME), proved to be informative in establishing unique allozyme
      genetic signatures for all of the cell strains established from the same species
      and from the same organ. Changes in the allozyme genetic signatures were not
      observed throughout the life span of TIG-1 and MRC-9 cells. The allozyme genetic
      signatures can be used as a quick monitor of cell identification and
      intraspecific cell contamination.

PMID- 1756777
TI  - Effect of dietary restriction on the fidelity of DNA polymerases in aging mice.
AB  - DNA polymerases purified from hepatic tissues of C57BL/6 mice showed an age
      related decrease in both specific activity and fidelity of the various enzyme
      forms. Polymerases from dietary restricted mice exhibited less of a decline in
      specific activity and copied synthetic DNA templates with relatively higher
      fidelity than did enzymes from animals fed ad libitum. Polymerases treated with
      inositol-1,4-bisphosphate [I(1,4)P2] showed varying levels of increased activity,
      with fidelity increases up to 3-fold. These data indicate that aging is
      associated with decreases in both specific activity and fidelity of DNA
      polymerases isolated from a nondividing tissue, and that dietary restriction
      impedes the age-related decline in both specific activity and fidelity of these
      polymerases. The data further indicate that DNA polymerases may interact with
      phosphoinositide hydrolysis products resulting in increased specific activity and
      fidelity of the enzymes. Phosphoinositide interactions with polymerases could
      constitute an important mechanism moderating the age-related decrease in function
      and accuracy of DNA polymerases.

PMID- 1756778
TI  - Individual variability in tail tendon fiber break time in three age cohorts of
      different strains of mice.
AB  - Individual variability in mouse tail tendon fiber denaturation in urea was
      investigated. Differences in break time between fibers within tendons and between
      tendon groups were examined. Mean break times for each strain increased with age
      with the shorter-lived DBA/2 mice exhibiting higher break times within age
      cohorts than the C57BL/6 animals. Fibers from the two ventral tendon groups had
      consistently higher break times than those from the two dorsal groups, implying
      differential rates of collagen maturation between these two areas within the
      tail. Histological examination revealed conspicuous morphological dorsal/ventral
      differences in tendon number, proximity to a major blood vessel, and the amount
      of surrounding muscle tissue. These findings have methodological and experimental
      design implications for the use of tail tendon break time (TTBT) as a biomarker
      of aging. Furthermore, they suggest possible physiological mechanisms for
      differential rates of collagen aging.

PMID- 1756779
TI  - Effect of subordinance, lack of social hierarchy, and restricted feeding on
      murine survival and virus leukemia.
AB  - When caged in groups of three and fed ad libitum, dominant male mice survived
      longer than subordinate group members which again lived longer than males caged
      in groups of nine, among whom no rank order was established. In groups of nine
      the social structure was not affected when the food supply was reduced to the
      lowest level not affecting survival, but in groups of three, food reduction made
      the survival of both dominant and subordinate animals drop to a level matching
      that of groups of nine. After challenge with a small dose of Moloney virus,
      leukemia developed among ad libitum fed subordinate mice in groups of three and
      members of groups of nine, but not among the dominant animals. Food restriction
      enhanced the leukemia incidence, but dominant animals continued to go free. We
      conclude that subordinance and also lack of social hierarchy result in a higher
      incidence of virus induced leukemia, that severe food restriction does the same,
      and that the effect of social order on leukemia development prevails even under
      feeding conditions that nearly abolish group-related differences in survival.

PMID- 1756780
TI  - Ascorbic acid in Drosophila and changes during aging.
AB  - The ascorbic acid content of Drosophila melanogaster was found to be high in the
      absence of a dietary source. The amount of ascorbic acid per fly declined with
      aging in both the Oregon R and Swedish C strains. The median life span at 25
      degrees C was 45 days for Swedish C and 59 days for Oregon R. The amount of
      ascorbic acid in Swedish C flies (0.078 micrograms/fly) was higher than that for
      Oregon R (0.058 micrograms/fly) for newly emerged flies but the rate of decline
      with aging was greater for Swedish C than Oregon R. The decline in ascorbic acid
      content with aging was 70.4% for Swedish C versus 19.9% for Oregon R. A brief
      cold shock was found to significantly increase the amount of ascorbic acid in
      Oregon R flies. Feeding the precursor of ascorbic acid synthesis, L
      gulonolactone, did not improve the life span. Life-time feeding of ascorbic acid
      did not improve the life span of either Swedish C or Oregon R flies.

PMID- 1756781
TI  - An alternative explanation for anomalies in "soluble lipofuscin" fluorescence
      data from insects, crustaceans, and other aquatic species.
AB  - Published attempts to extract lipofuscin from crustaceans and fish to assess age
      for fisheries research purposes have used essentially the same extraction
      methodology applied to insects, but have neither shown a conclusive age
      dependence of spectrally similar fluorescence nor proved its association with
      lipofuscin. The reported lipofuscin solvent extraction method for fleshflies,
      Sarcophaga bullata, was manipulated by varying wash volume. This revealed that
      almost all age-dependent blue fluorescent material persisting in lipid fractions
      was actually pteridine-like. This finding was consistent with some previous
      independent results for Musca domestica. Examination of reported lipofuscin
      extraction protocols for other insects suggested that this problem was probably
      widespread. The pteridines are known to occur in unusually high amounts in
      insects, accumulating with age specifically in some members of this group by
      storage excretion, probably as a terrestrial water conservation strategy. In
      addition, there is growing evidence in the gerontological literature for other
      groups that solvent extracted blue fluorescence is not a true measure of
      lipofuscin content in tissues. These findings provide considerable insight into
      anomalies in putative lipofuscin fluorescence data between the insects and
      various aquatic species and suggest that there may be little basis for
      expectations of age-dependent fluorescence from aquatic species when the same
      gross extraction and crude purification methods are used.

PMID- 1756782
TI  - Oxidative stress as a causal factor in differentiation and aging: a unifying
      hypothesis.

PMID- 1756783
TI  - Bi-versus monohemispheric performance in split-brain and partially split-brain
      macaques.
AB  - Experiments comparing binocular with monocular abilities of monkeys working on
      visual mnemonic tasks were performed. First, it was shown that even in split
      brain monkeys performance was more accurate when both hemispheres were utilized
      than when the task was performed with only the single (better) hemisphere. Some
      form of noncommissural integration is thus possible. However, when the forebrain
      commissures are present, as in four other animals (with only optic chiasm
      transected) it was shown that integration occurs via callosal mechanisms as well.
      This was demonstrated by the fact that here, too, binocular performance was
      normally more accurate than monocular performance, but when different images to
      be remembered were presented concurrently to the two eyes, the binocular
      advantage was lost. Finally, in three monkeys with only the anterior commissure
      allowing interhemispheric communication the superiority of binocular assessment
      remained even when the two hemispheres simultaneously received such differing
      images.

PMID- 1756784
TI  - Damage of substantia nigra pars reticulata during pilocarpine-induced status
      epilepticus in the rat: immunohistochemical study of neurons, astrocytes and
      serum-protein extravasation.
AB  - The substantia nigra has a gating function controlling the spread of epileptic
      seizure activity. Additionally, in models of prolonged status epilepticus the
      pars reticulata of substantia nigra (SNR) suffers from a massive lesion which may
      arise from a massive metabolic derangement and hyperexcitation developing in the
      activated SNR. In this study, status epilepticus was induced by systemic
      injection of pilocarpine in rats. The neuropathology of SNR was investigated
      using immunohistochemical techniques with the major emphasis on the time-course
      of changes in neurons and astrocytes. Animals surviving 20, 30, 40, 60 min, 2, 3,
      6 hours, 1, 2, and 3 days after induction of status epilepticus were perfusion
      fixed, and brains processed for immunohistochemical staining of SNR. Nissl
      staining and antibodies against the neuron-specific calcium-binding protein,
      parvalbumin, served to detect neuronal damage in SNR. Antibodies against the
      astroglia-specific cytoskeletal protein, glial fibrillary acidic protein (GFAP),
      and against the glial calcium-binding protein, S-100 protein, were used to assess
      the status of astrocytes. Immunohistochemical staining for serum-albumin and
      immunoglobulins in brain tissue was taken as indicator of blood-brain barrier
      disturbances and vasogenic edema formation. Immunohistochemical staining
      indicated loss of GFAP-staining already at 30 min after induction of seizures in
      an oval focus situated in the center of SNR while sparing medial and lateral
      aspects. At 1 h there was additional vacuolation in S-100 protein staining. By 2
      hours, parvalbumin-staining changed in the central SNR indicating neuronal
      damage, and Nissl-staining visualized some neuronal distortion. Staining for
      serum-proteins occurred in a patchy manner throughout the forebrain during the
      first hours. By 6 h, vasogenic edema covered the lesioned SNR. By 24 h, glial and
      neuronal markers indicated a massive lesion in the center of SNR. By 48-72 h,
      astrocytes surrounding the lesion increased in size, and polymorphic phagocytotic
      cells invaded the damaged area. In a further group of animals surviving 1 to 5
      days, conventional paraffin-sections confirmed the neuronal and glial damage of
      SNR. Additional pathology of similar quality was found in the globus pallidus.
      Since astrocytes were always damaged in parallel with neurons in SNR it is
      proposed that the anatomical and functional interrelationship between neurons and
      astrocytes is particularly tight in SNR. Both cell elements may suffer in common
      from metabolic disturbance and neurotransmitter dysfunction as occur during
      massive status epilepticus.

PMID- 1756785
TI  - Repetitive firing properties of putative dopamine-containing neurons in vitro:
      regulation by an apamin-sensitive Ca(2+)-activated K+ conductance.
AB  - Intracellular recording techniques were used to study the effects of apamin
      (APA), a selective inhibitor of one type of Ca(2+)-activated K+ channel, on the
      electroresponsive properties of dopamine (DA)-containing neurons within the zona
      compacta of the substantia nigra (SNc) in rat. Bath application of APA (1 microM)
      blocked the slow component of a complex post-spike afterhyperpolarization (AHPs)
      without affecting other characteristics of the action potential. Blockade of AHPs
      was accompanied by an increase in the number and frequency of action potentials
      evoked by depolarizing current pulses. However, APA failed to affect the cellular
      mechanisms underlying spike frequency adaptation or post-stimulus inhibitory
      period. These data indicate that AHPs can exert a strong influence on the
      interspike interval but is probably not involved in regulating slower adaptive
      neuronal responses.

PMID- 1756786
TI  - Viewer-centred and object-centred coding of heads in the macaque temporal cortex.
AB  - An investigation was made into the sensitivity of cells in the macaque superior
      temporal sulcus (STS) to the sight of different perspective views of the head.
      This allowed assessment of (a) whether coding was 'viewer-centred' (view
      specific) or 'object-centred' (view invariant) and (b) whether viewer-centred
      cells were preferentially tuned to 'characteristic' views of the head. The
      majority of cells (110) were found to be viewer-centred and exhibited unimodal
      tuning to one view. 5 cells displayed object-centred coding responding equally to
      all views of the head. A further 5 cells showed 'mixed' properties, responding to
      all views of the head but also discriminating between views. 6 out of 56 viewer
      and object-centred cells exhibited selectivity for face identity or species.
      Tuning to view varied in sharpness. For most (54/73) cells the angle of
      perspective rotation reducing response to half maximal was 45-70 degrees but for
      19/73 it was greater than 90 degrees. More cells were optimally tuned to
      characteristic views of the head (the full face or profile) than to other views.
      Some cells were, however, found tuned to intermediate views throughout the full
      360 degree range. This coding of many distinct head views may have a role in the
      analysis of social signals based on the interpretation of the direction of other
      individuals' attention.

PMID- 1756787
TI  - Differential and reversal Pavlovian conditioning in rabbits with mediodorsal
      thalamic lesions: assessment of heart rate and eyeblink responses.
AB  - Rabbits received ibotenic acid lesions of the mediodorsal nucleus of the thalamus
      (MD), or sham lesions. These animals were compared on acquisition and reversal of
      a Pavlovian conditioned discrimination task in which tones were the conditioned
      stimuli and paraorbital electric shock was the unconditioned stimulus. Eyeblink
      and heart rate conditioned responses were assessed. Lesions of MD impaired the
      reversal, but not original acquisition, of the eyeblink discrimination. Heart
      rate discrimination was somewhat impaired during both acquisition and reversal.
      There were no differences between lesion and sham animals on control measures
      assessing general activity, somatomotor shock thresholds, or heart rate
      unconditioned responses.

PMID- 1756788
TI  - Transient impairment of recognition memory following ibotenic-acid lesions of the
      basal forebrain in macaques.
AB  - To assess the contributions of the basal forebrain cholinergic nuclei to visual
      recognition memory in macaques, we compared the effects of lesions of (a) the
      nucleus basalis of Meynert, (b) the medial septal and diagonal band nuclei, and
      (c) all nuclei combined on performance of delayed nonmatching-to-sample with
      trial-unique stimuli. Whereas monkeys with the separate lesions did not differ
      from each other or from normal control animals, those with combined lesions
      showed a significant impairment. With time and extended practice, however, the
      performance of the animals with combined lesions recovered to normal levels.
      During the recovery period, these monkeys showed an initially increased
      sensitivity to scopolamine that later dissipated, at which time they also failed
      to show the improvement that follows physostigmine administration in normal
      animals. Postmortem assessment of cortical choline acetyltransferase activity
      revealed that only the group with combined lesions had significant depletion of
      this enzyme. The results suggest that (1) the basal forebrain cholinergic system
      participates in mnemonic processes in primates and that (2) extensive damage to
      this system is necessary before impairments in recognition memory, even transient
      ones, can be observed.

PMID- 1756789
TI  - Ganglion cell survival in embryonic rabbit retina transplanted to the midbrain of
      neonatal rats.
AB  - Fetal rabbit retinae can grow and differentiate when transplanted to the
      collicular region of neonatal rats. In addition, the observed survival of retinal
      ganglion cells within grafts is associated with the extension of axons into the
      superior colliculus of the host brain, suggesting that the factors influencing
      the guidance of axons and the survival of ganglion cells may be homologous across
      different mammalian orders.

PMID- 1756790
TI  - Factors affecting higher-order movement planning: a kinematic analysis of human
      prehension.
AB  - Past studies of the kinematics of human prehension have shown that varying object
      size affects the maximum opening of the hand, while varying object distance
      affects the kinematic profile of the reaching limb. These data contributed to the
      formulation of a theory that the reaching and grasping components of human
      prehension reflect the output of two independent, though temporally coupled,
      motor programs (Jeannerod 1984). In the first experiment of the present study,
      subjects were required to reach out and grasp objects, with or without on-line,
      visual feedback. Object size and distance were covaried in a within-subjects
      design, and it was found that both grip formation and reach kinematics were
      affected by the manipulation of either variable. These data suggest that the
      control mechanisms underlying transport of the limb and grip formation are
      affected by similar task constraints. It was also observed that when visual
      feedback was unavailable after movement onset subjects showed an exaggerated
      opening of their hands, although grip size continued to be scaled for object
      size. The question remained as to whether the larger opening of the hand during
      no-feedback trials reflected the lack of opportunity to fine-tune the opening of
      the hand on-line, or the adoption of a strategy designed to increase tolerance
      for initial programming errors. To address this question, a second experiment was
      carried out in which we manipulated the predictability of visual feedback by
      presenting feedback and no-feedback trials in a random order. In contrast to the
      situation in which feedback and no-feedback trials were presented in separate
      blocks of trials (Exp. 1), in the randomly-ordered series of trials presented in
      Exp. 2, subjects always behaved as if they were reaching without vision, even on
      trials where visual feedback was continuously available. These findings suggest
      that subjects adopt different strategies on the basis of the predictability of
      visual feedback, although there is nothing to suggest that this takes place at a
      conscious, or voluntary, level. The results of both experiments are consistent
      with the notion of a hierarchically-organized motor control center, responsible
      for optimizing performance under a variety of conditions through the coordination
      of different effector systems and the anticipation of operating constraints.

PMID- 1756791
TI  - Listing's law for eye, head and arm movements and their synergistic control.
AB  - We have recorded eye, head, and upper arm rotations in five healthy human
      subjects using the three-dimensional search coil technique. Our measurements show
      that the coordination of eye and head movements during gaze shifts within +/- 25
      deg relative to the forward direction is organized by restricting the rotatory
      trajectories of the two systems to almost parallel planes. These so-called
      "Listing planes" for eye-in-space and head-in-space rotations are workspace
      oriented, not body-fixed. Eye and head trajectories in their respective planes
      are closely related in direction and amplitude. For pointing or grasping, the
      rotatory trajectories of the arm are also restricted to a workspace-oriented
      Listing plane. During visually guided movements, arm follows gaze, and the nine
      dimensional rotatory configuration space for eye-head-arm-synergies (three
      degrees of freedom for each system) is reduced to a two-dimensional plane in the
      space of quaternion vectors.

PMID- 1756792
TI  - Transcranial magnetic brain stimulation: lack of oculomotor response.
AB  - We have investigated whether eye movements can be evoked by transcranial magnetic
      brain stimulation (TMS) from frontal, precentral, posterior- and inferior-
      parietal, occipital and temporal positions of the stimulating coil. Our findings
      were negative, even for structures concerned with voluntary eye movements, such
      as the frontal eye field (FEF) and the inferior parietal lobe (IPL). The lack of
      oculomotor responses after stimulation of the cortex shall be discussed in the
      following context: (1) Low-threshhold intracortical stimulation experiments
      suggest that in functional terms, the FEF is confined to small areas which are
      extend to the floor of sulci. TMS does not reach these structures to a sufficient
      extent. Furthermore efferent connections of the cortex to the paramedian pontine
      reticular formation (PPRF) seem to be polysynaptic. (2) The function of the
      cortex in rapid eye movement is to analyze and process conditions with differing
      functional requirements, rather than to directly generate saccades. TMS does not
      elicit oculomotor responses, demonstrating again that the role played by the
      cortex in eye movement is not analogous to the role of the somatic motor cortex
      in controlling skeletal movements.

PMID- 1756793
TI  - Transcranial stimulation of the human frontal eye field by magnetic pulses.
AB  - Single transcranial magnetic pulsed stimuli were applied over the cortical area
      of the putative right frontal eye field (FEF) in 11 healthy subjects. An
      especially designed figure of eight shaped twin coil was used, to focus the
      stimulus, the strength of which was adjusted to the individual motor threshold of
      the left hand muscles. Eye positions and movements were recorded by an infrared
      reflection technique. Three different experiments were performed: 1. Stimulation
      during different primary gaze position did not evoke any discernible eye
      movement. 2. Stimulation just prior to visually elicited horizontal saccades did
      not cause a significant alteration of the latency, velocity, or amplitude of the
      saccades. 3. Only stimulation during an antisaccade task induced a significant
      latency prolongation, when the stimulus was applied between 50 to 90 ms after the
      target flashed up. This latency prolongation was found in all subjects for the
      antisaccades to the right, with a statistically significant average latency
      difference of +66 +/- 55.5 ms. In contrast, the antisaccades to the left were
      prolonged in the female subjects only by an average of +98 +/- 41.8 ms (p =
      0.0064), whereas in the male subjects they did not alter with stimulation
      (average difference: -3 +/- 41.9 ms, p = 0.753). Significant latency
      prolongations were only obtained when the magnetic FEF stimuli were applied
      within a vulnerable period, which varied from subject to subject.

PMID- 1756794
TI  - Coincidence of "ladder-like patterns" in distributions of monoaminergic terminals
      and sympathetic preganglionic neurons in the rat spinal cord.
AB  - A ladder-like pattern of distribution of sympathetic preganglionic neurons (SPNs)
      was compared with that of monoaminergic terminals in the upper thoracic spinal
      cord of the rat. SPNs were identified by a retrograde labeling with cholera toxin
      subunit B (CTb) injected into the superior cervical ganglia of both sides.
      Monoaminergic terminals were stained immunohistochemically by using antisera
      raised against 5-hydroxy-tryptamine (5-HT) or dopamine-beta-hydroxylase (DBH).
      SPNs showing full dendritic arbors were found in all of the sympathetic
      preganglionic nuclei. They formed a ladder in the horizontal plane. The nucleus
      intermediolateralis was connected with the central autonomic nucleus by many
      transverse dendritic bundles. Photomontages of serial sections of material
      stained alternatively with antisera against CTb and 5-HT or DBH clearly showed a
      close correlation between SPNs and monoaminergic terminals. There is no
      transverse dendritic bundle of SPNs without the accompaniment of monoaminergic
      terminals.

PMID- 1756795
TI  - Purkinje cells in the vestibulocerebellum of the pigeon respond best to either
      translational or rotational wholefield visual motion.
AB  - Using standard extracellular techniques, the response properties of neurons in
      the vestibulocerebellum of the pigeon to movement of a wholefield visual stimulus
      were determined. Complex spike activity of Purkinje cells was modulated in a
      direction-selective manner by the stimulus and 94% of cells were binocularly
      driven. Some neurons preferred the same direction of wholefield motion in both
      eyes, simulating optic flow which results from self-translation, while others
      preferred the opposite direction in each eye, simulating optic flow resulting
      from rotation. Four functional classes of neurons were found: (1) Descent cells
      preferred upward motion in both eyes; (2) Ascent neurons preferred downward
      motion in both eyes; (3) Roll cells preferred upward and downward motion in the
      ipsilateral and contralateral eyes respectively; and (4) Yaw cells preferred
      forward (temporal to nasal) and backward motion in the ipsilateral and
      contralateral eyes respectively. The observation that these neurons clearly
      distinguish rotational and translational optic flow patterns suggest they may
      play an important role in controlling locomotor activities of the pigeon.

PMID- 1756796
TI  - Changes in the dynamics of the vertical vestibulo-ocular reflex due to linear
      acceleration in the frontal plane of the cat.
AB  - The vertical and horizontal components of the vestibulo-ocular reflex (VOR) were
      recorded in alert, restrained cats who were placed on their sides and subjected
      to whole-body rotations in the horizontal plane. The head was either on the axis
      or 45 cm eccentric from the axis rotation. During off-axis rotation there was a
      change in the linear force acting on the otolith organs due to the presence of a
      centripetal acceleration along the animal's vertical axis. Otolith forces
      (defined to be opposite to the centripetal acceleration) directed ventrally with
      respect to the animal (negative) decreased both the amplitude and time constant
      of the first-order approximation to the slow phase eye velocity of the vertical
      vestibulo-ocular reflex (VVOR). Otolith forces directed dorsally (positive)
      increased the amplitude and time constant. The effects were greater for the up
      VOR. The asymmetry in the VVOR time constant also depended on the otolith forces,
      being less in the presence of negative otolith forces that caused the resultant
      otolith force to move ventrally, towards the direction along which gravity
      normally acts when the animal is in the upright position. The effects of otolith
      forces on the up VVOR were independent of whether the animals were tested in the
      dark or in the light with a stationary visual surround (i.e., during visual
      suppression). In contrast, the changes in the time constant of the down VVOR were
      smaller during visual suppression. Simulations of the eye velocity storage
      mechanism suggest that the gain of the feedback in the storage integrator was
      modified by the angle between the resultant otolith force and an animal-fixed
      reference. This could be the animal's vertical, i.e., the direction along which
      gravity normally acts. For larger angles the feedback was less and the amplitude
      and time constant of the VVOR increased. The transformation of the otolith input
      was the same for both the up and down VOR, even though the final effect on the
      eye velocity was asymmetric (larger for up VOR) due to a separate, asymmetric
      gain element in the velocity storage feedback pathway.

PMID- 1756797
TI  - The horizontal vestibulo-ocular reflex during linear acceleration in the frontal
      plane of the cat.
AB  - Horizontal and vertical eye movements were recorded in alert, restrained cats
      that were subjected to whole-body rotations with the horizontal semicircular
      canals in the plane of rotation and the body centered on the axis or 45 cm
      eccentric from the axis of rotation. Changes in the horizontal vestibulo-ocular
      reflex (HVOR) due to the resultant of the linear forces (i.e., gravity and linear
      acceleration) acting on the otolith organs were examined during off-axis rotation
      when there was a centripetal acceleration along the animal's interaural axis. The
      HVOR time constant was slightly shortened when the resultant otolith force was
      not parallel to the animal's vertical axis. This effect was independent of the
      direction of the otolith force relative to the direction of the slow phase eye
      velocity. No effect on the HVOR amplitude was observed. In addition to changes in
      the HVOR dynamics, a significant vertical component of eye velocity was observed
      during stimulation of the horizontal canals when the resultant otolith force was
      not parallel with the animal's vertical axis. The effect was greater for larger
      angles between the resultant otolith force and gravity. An upward or downward
      component was elicited, depending on the direction of the horizontal component of
      eye velocity and the direction of the resultant otolith force. The vertical
      component was always in the direction that would tend to align the eye velocity
      vector with the resultant otolith force and keep the eye movement in a plane that
      had been rotated by the angle between the resultant otolith force and gravity.

PMID- 1756798
TI  - Delayed reduction in GABA and GAD immunoreactivity of neurons in the adult monkey
      dorsal lateral geniculate nucleus following monocular deprivation or enucleation.
AB  - GABA and glutamate decarboxylase (GAD) immunoreactivities were examined in dorsal
      lateral geniculate nuclei (LGN) of normal monkeys (Macaca fascicularis) and in
      monkeys that had one eye injected with tetrodotoxin (TTX) or one eye removed 5
      days to 4 weeks prior to sacrifice. As seen in previous studies (Wong-Riley and
      Carroll 1984) monocular TTX injections or enucleation quickly reduced cytochrome
      oxidase (CO) staining in layers 2, 3 and 5 of the ipsilateral LGN and in layers
      1, 4 and 6 of the contralateral LGN. The reduction in CO staining was apparent at
      all survival times examined. By contrast, GABA and GAD immunostaining in the LGNs
      were qualitatively normal up to two weeks following enucleation or after 17 days
      of TTX injections. Quantitative and stereological analyses confirmed that the
      numerical density and proportion of GABA and GAD neurons do not change in the LGN
      following two weeks of denervation or deprivation, even though in the same
      monkeys a reduction in GABA immunostaining was found in deprived-eye columns of
      area 17. However, with longer survivals, of 3-4 weeks in duration, the number of
      GABA and GAD immunostained neurons in the deprived/denervated-eye laminae of the
      LGN was reduced by one-third. These findings demonstrate that the deprivation
      induced reduction in GABA and GAD immunoreactivity is delayed in the LGN, by
      comparison with the visual cortex, and suggest that the effects in the LGN may be
      relayed through the cortex or that neurotransmitter levels may be regulated by
      different mechanisms in the two sites.

PMID- 1756799
TI  - Contributions of sodium and chloride to ultrastructural damage after dendrotomy.
AB  - To determine the contributions of sodium and chloride to ultrastructural changes
      after mechanical injury, we amputated primary dendrites of cultured mouse spinal
      neurons in low calcium medium in which sodium chloride had been replaced with
      either choline chloride or sodium isethionate or sodium propionate. Uninjured
      cultured neurons were also exposed to the sodium ionophore, monensin. A third set
      of neurons was injured in medium in which all sodium and calcium chloride had
      been replaced with sucrose. Neurons injured in low-calcium, low-sodium medium
      exhibited few ultrastructural changes, except very near the lesion, where there
      was some dilation of mitochondria and cisternae of the smooth endoplasmic
      reticulum (SER). Mitochondria in other regions of the neurons developed an
      electron opaque matrix, and those nearer to the lesion converted to the condensed
      configuration, characterized by expanded intracristal spaces as well as a dense
      matrix. If sodium but not chloride was present in the medium, there was some
      dilation of the Golgi cisternae after injury, as well as some increased electron
      opacity of the mitochondria. Monensin treated neurons also exhibited dilation of
      the Golgi cisternae. Neurons injured in sucrose-substituted medium showed none of
      the changes associated with injury in normal culture medium. These results
      indicate that sodium influx through the lesion is involved in the dilation of the
      SER, which is seen even in low-calcium medium, and that a permeant anion, such as
      chloride, is also involved. This dilation of the SER may result from uptake of
      calcium released from mitochondria in response to elevated cytosolic sodium.
      Dilation of the Golgi cisternae appears to be a response only to elevated
      intracellular sodium. Condensation of the mitochondria after injury is thought to
      be due to increased demands for ATP synthesis and may involve a "futile cycling"
      of calcium across the mitochondrial membrane, involving sodium-mediated calcium
      release in response to elevated intracellular calcium.

PMID- 1756800
TI  - The neuronal organization of horizontal semicircular canalactivated inhibitory
      vestibulocollic neurons in the cat.
AB  - 1. The somatic location and axonal projections of inhibitory vestibular nucleus
      neurons activated by the horizontal semicircular canal nerve (HCN) were studied
      in anesthetized cats. Cats were anesthetized with ketamine hydrochloride and
      pentobarbital sodium. 2. Intracellular recordings were obtained from 11 neck
      extensor motoneurons which were identified by antidromic activation from the
      dosal rami (DR) in the C1 segment. Stimulation of the ipsilateral (i-) HCN and
      the ipsilateral abducens (AB) nucleus evoked IPSPs in the motoneurons. These
      IPSPs were fully or partially occluded when they were evoked simultaneously. 3.
      Intracellular recordings were obtained from 8 AB motoneurons. Stimulation of the
      i-HCN and the i-C1DR motoneuron pool evoked IPSPs in the AB motoneurons. These
      IPSPs were also partially occluded when they were evoked simultaneously, which
      implied that some HCN-activated neurons inhibit both i-AB motoneurons and
      ipsilateral neck motoneurons. 4. Unit activity was extracellularly recorded from
      30 vestibular neurons that were activated monosynaptically by i-HCN stimulation.
      Their axonal projections were determined by stimulating the i-AB nucleus and the
      i-C1DR motoneuron pool. Eight neurons were activated by both stimuli, and were
      termed vestibulooculo-collic (VOC) neurons. Their axonal branching was examined
      by means of local stimulation in and around the i-AB nucleus and the i-C1DR
      motoneuron pool. Eighteen neurons were antidromically activated from the i-C1DR
      motoneuron pool but not from the i-AB nucleus. These were termed vestibulo-collic
      (VC) neurons. Four neurons were activated from the i-AB nucleus but not from the
      ventral funiculus in the C1 segment, and were termed vestibulo-ocular (VO)
      neurons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756801
TI  - Ectopic granule cell layer in mouse cerebellum after methyl-azoxy-methanol (MAM)
      treatment.
AB  - Previous results from our laboratory (Bejar et al. 1985) indicated that a single
      injection in mouse pups of the antimitotic/mutagenic agent methylazoxymethanol at
      postnatal day 5 typically produces hypogranular cerebella with no changes in
      foliation, in contrast to the severe alterations observed after the more usual
      injection on the day of birth. Here we report that injection of a higher dose (30
      mg/kg) of methylazoxymethanol, always at postnatal day 5, leads to the additional
      presence of a ectopic cell layer in adult cerebellum. Immunostaining with several
      antibodies recognizing cell specific proteins ruled out the possibility that
      these ectopic cells were glial and electron microscopy indicated that they were
      morphologically mature granule cells. In the molecular layer of other cerebellar
      areas and apparently unrelated with granule cell ectopia, ectopic Golgi
      epithelial cells were observed. The reason for the presence of these ectopic
      cells of different type in the molecular layer was discussed in relation with
      analogous ectopias obtained by other means.

PMID- 1756802
TI  - A quantitative study of synaptic contacts on interneurons and relay cells of the
      cat lateral geniculate nucleus.
AB  - The relative proportions of synapses made by retinal and extraretinal terminals
      on interneurons and relay cells in lamina A of the dorsal lateral geniculate
      nucleus (LGN) of the cat were estimated quantitatively in a sample of 4003
      synapses. Processes of interneurons or relay cells were identified by presence or
      absence of GABA immunoreactivity, respectively, in thin sections treated with
      post-embedding anti-GABA immunogold. On the basis of ultrastructural features,
      synaptic terminals were interpreted as belonging to retinal axons, cortical axons
      or axon collaterals of relay cells. GABAergic terminals were positively
      identified by being immunoreactive. GABA(-) terminals with heterogeneous and
      poorly defined characteristics, which could not be identified in the above
      classes, were grouped together in an "undetermined" category. Among the total
      synaptic inputs to interneurons, the following relative percentages of synapses
      from different terminals were obtained: retinal 25%, cortical 37%, GABAergic 26%,
      axon collaterals 2%, undetermined 6%. The vast majority of retinal terminals
      synapse on dendritic appendages of interneurons rather than on their dendritic
      trunks (about 20:1). By contrast, the majority of cortical terminals synapse on
      dendrites rather than on dendritic appendages (about 5:1). Virtually all axon
      collaterals synapses were established on dendritic appendages. 17% of the
      dendritic profiles of interneurons contain synaptic vesicles; many of these
      profiles were seen in postsynaptic relation to cortical axons and in presynaptic
      relation with relay dendrites. Given the extensive electrotonic lengths of these
      cells observed by others, and the expected high electric resistance of the
      slender stalks that are known to connect the dendritic appendages to
      interneurons, these results suggest that microcircuits involving the
      interneuronal dendritic appendages with dendrites of relay cells are under
      predominantly retinal control. The microcircuits established by presynaptic
      dendritic trunks with relay dendrites, are under predominantly cortical control.
      The axonal (spiking) output of interneurons would be under control of the few
      retinal synapses on proximal dendrites of these cells. Among the total synaptic
      inputs to relay cells, the following relative percentages of different synapses
      were obtained: retinal 12%, cortical 58%, GABAergic 24%, axon collaterals 0.3%,
      undetermined 5%. Relay cells receive twice the number of cortical synapses than
      interneurons, suggesting that direct cortical excitatory influences on relay
      cells are more preponderant than cortico-interneuron mediated inhibition on these
      cells. The observed proportions of dendritic profiles of relay cells and
      interneurons (80% and 20%, respectively) in the geniculate neuropil are similar
      to the known proportions of somata of both types of cells in the A
      laminae.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1756803
TI  - Direct and indirect retinal input into degenerated dorsal lateral geniculate
      nucleus after striate cortical removal in monkey: implications for residual
      vision.
AB  - We removed the striate cortex of one cerebral hemisphere in a macaque monkey,
      causing almost total retrograde degeneration of the corresponding dorsal lateral
      geniculate nucleus (dLGN) and extensive transneuronal degeneration of ganglion
      cells in the corresponding hemi-retina of each eye. The rare surviving geniculate
      projection neurons were retrogradely labelled by horseradish peroxidase (HRP)
      from extra-striate cortex and retinogeniculate terminals were labelled by an
      intraocular injection of HRP. Retinal terminals in the degenerated dLGN made
      synaptic contact exclusively with the dendrites of interneurons immunopositive
      for gamma-aminobutyric acid (GABA) in both parvocellular and magnocellular
      regions of dLGN. As well as being post-synaptic to retinal terminals these
      vesicle-containing dendrites were pre- and postsynaptic to other similar
      dendrites, and presynaptic to relay cells. Surviving labelled projection neurons
      received retinal input indirectly, via both the GABA-immunopositive interneurons
      and GABA-immunonegative terminals characteristic of those from the superior
      colliculus. In the degenerated, as opposed to the normal dLGN, about 20% of
      retinal terminals were GABA-immunopositive and GABA-immunoreactivity was
      prominently elevated in the ganglion and amacrine cell layers of the degenerated
      half of the retina. The optic nerve also contained numerous GABA-immunopositive
      axons but very few such axons were found in a normal optic nerve processed in
      identical manner. The surviving pathways from the retina must underlie the visual
      abilities that survive striate cortical removal in monkeys and human patients and
      may involve the degenerated dLGN as well as the mid-brain.

PMID- 1756804
TI  - Static firing rates of premotor and primary motor cortical neurons associated
      with torque and joint position.
AB  - Single cell activity was studied in the postarcuate premotor area (PMA) and
      primary motor cortex (MI) of two monkeys performing a load-bearing task with the
      contralateral hand. Steady-state discharge rates were examined in relation to
      positional maintenance of the wrist which was held in one of three given
      positions against graded torques directed towards flexion or extension.
      Significant and monotonic relationships between tonic firing rate and static
      torque were found in 41% of 477 MI cells and in only 26% of 470 units studied in
      PMA. However, for specific cell groups in the PMA the proportion of load-related
      neurons reached that of the MI samples; this was true for pyramidal tract neurons
      (PTNs) and for 'non-PTNs' if recorded in their vicinity. The most interesting
      difference pertains to the range of load over which cells in both areas modulated
      activity. MI neurons showed steepest change of firing rates over a limited range
      of small torques around zero external load; the population average displayed a
      sigmoidal relationship. Proportionally more PMA neurons increased their activity
      over the entire range of torques examined or showed the highest increase with
      stronger torques; the population average best fitted a quadratic function. The
      mean firing rate-torque slope of the PMA population was significantly smaller
      than that of MI. Many cells in either area were related to both torque and joint
      position and displayed correlates of length-tension properties of muscle. Change
      of position sensitivity with torque was found to parallel the rate-torque
      characteristics in individual neurons. Mean position sensitivity of PMA neurons
      increased with increasing torques in the 'preferred' direction. In contrast,
      greatest position sensitivity of the MI population occurred over the range of low
      torques, which means a clear quantitative dissociation from the muscular
      activities. The results suggest differential roles of MI and PMA in the control
      of 'fine' versus 'gross' muscular forces. Undoubtedly, some PMA cell elements
      (possibly certain output neurons) are involved in aspects of postural control of
      EMG adjustment to load and joint position.

PMID- 1756805
TI  - Phasic and tonic responses of premotor and primary motor cortex neurons to torque
      changes.
AB  - Responses to torque step perturbation of the wrist were compared in premotor area
      (PMA) and motor cortex (MI) neurons of the monkey. A substantial portion (39%) of
      cells recorded from the PMA had phasic responses with onset latencies as short as
      those found in MI (mostly between 15 and 50 ms). Responsiveness to small
      perturbations, directional specificity and linear correlation of phasic responses
      with the velocity of displacement are properties that were essentially present in
      the PMA. A role of somatosensory feedback to the PMA in accurate and fast up
      dating of movement is suggested. Tonically sustained responses to torque change
      (mean latency around 60 ms) were encountered in both areas and preferentially in
      neurons that had a monotonic load-relationship under steady-state condition. Such
      cortical responses did not exhibit reflex-like features, i.e. no correlation with
      amplitude of torque step and resulting displacement. Instead, the new load
      condition seemed to be represented by the tonic response of any particular neuron
      in accordance with its individual firing rate-load characteristics. These tonic
      cortical responses may be involved in the swift and effective adaptation to the
      actual load.

PMID- 1756806
TI  - Frontal eye field lesions impair predictive and visually-guided pursuit eye
      movements.
AB  - The study initially explored the frontal eye field's (FEF) control of predictive
      eye movements, i.e., eye movements driven by previous rather than current sensory
      signals. Five monkeys were trained to pursue horizontal target motion, including
      sinusoidal targets and "random-walk" targets which sometimes deviated from a sine
      motion. Some subjects also tracked other target trajectories and optokinetic
      motion. FEF ablations or cold lesions impaired predictive pursuit, but also
      degraded visually guided foveal pursuit of all targets. Unilateral lesions
      impaired pursuit of targets moving in both horizontal orbital fields and in both
      directions of movement. Saccadic estimates of target motion were generally
      accurate. The slow-phase velocity of optokinetic pursuit (collected after 54 s of
      OKN) also appeared normal. Pursuit recovered over 1-3 weeks after surgery but the
      deficits were then reinstated by removal of FEF in the other hemisphere.
      Thereafter, a slight deficit persisted for up to 10 weeks of observation in two
      subjects. The pattern of symptoms suggests that FEF lies subsequent to parietal
      area MST and prior to the pontine nuclei in controlling pursuit eye movements.

PMID- 1756807
TI  - Use of plaid patterns to distinguish the corticofugal and direct retinal inputs
      to the brainstem optokinetic nystagmus generator.
AB  - We have recorded the direction of optokinetic nystagmus (OKN) elicited by moving
      plaid patterns in order to dissociate the pathways that mediate horizontal OKN.
      The plaids used comprised two drifting sinusoidal gratings arranged such that
      their individual directions of drift were very different from the direction of
      coherent motion of the overall pattern. The direction of OKN with binocular
      viewing was close to the mean of the component directions, suggesting a dominant
      influence of cortical visual neurons that respond to oriented one-dimensional
      components of the image. But the direction of OKN was consistently shifted
      slightly towards the direction of motion of the overall pattern, suggesting a
      secondary influence responsive to pattern direction. OKN recordings obtained
      during monocular viewing suggest that this secondary influence reflects the
      direct retinal pathway to the brainstem structures mediating OKN.

PMID- 1756808
TI  - Electrolytic lesions of the nucleus accumbens in rats which abolish the PREE
      enhance the locomotor response to amphetamine.
AB  - The partial reinforcement extinction effect (PREE) refers to the increased
      resistance to extinction observed in animals trained on a partial reinforcement
      (PR) schedule compared with those trained on a schedule of continuous
      reinforcement (CR). It has been suggested that the PREE is dependent upon the
      integrity of the septo-hippocampal system, but recent evidence has indicated that
      the role originally proposed for the lateral septal nucleus may in fact be
      subserved by the nucleus accumbens. Experiment I therefore tested the effects of
      electrolytic lesions of the nucleus accumbens on the PREE. These lesions
      abolished the PREE, the abolition resulting from a decreased rate of extinction
      in the lesion CR rats coupled with an increased rate of extinction in the PR
      rats. These results clearly implicate the nucleus accumbens in the development of
      the PREE, and suggest that theoretical models of the PREE based simply upon
      consideration of septohippocampal interactions need radical revision. The lesion
      also enhanced running speeds in acquisition in both the CR and the PR groups.
      Experiment II therefore assessed spontaneous locomotor activity and the locomotor
      response to amphetamine challenge at two doses. The lesion produced no increase
      in spontaneous locomotion; an enhanced increase in response to 1 mg/kg
      amphetamine; and no changes in the stereotyped behaviours induced by 10 mg/kg
      amphetamine.

PMID- 1756809
TI  - Response properties of periodontal mechanosensitive units in the cat's thalamus.
AB  - 1) The response characteristics of periodontal mechanosensitive neurons in the
      thalamic nucleus were studied by using 15 adult cats anesthetized with alpha
      chloralose (40 mg/kg, i.v.). 2) 468 periodontal mechanosensitive units (PM units)
      responsive to light mechanical stimulation of the teeth were recorded from a
      medioventral aspect of the nucleus ventralis posteromedialis (VPM). Of these
      neurons, 213 units (45.5%) were slowly adapting, and 255 units (54.5%) were
      rapidly adapting. 3) The receptive field of the PM units was represented by the
      number of receptive quadrants on the dental arches of both jaws. About half of
      the PM units (279, 59.6%) were one-quadrant units. Of these neurons, 69 (14.7%)
      were single tooth units. Two-quadrant, three-quadrant and four-quadrant units
      numbered 123 (26.3%), 3 (0.6%) and 63 (13.5%) respectively. Of the PM units
      detected, 246 units (52.6%), 124 units (26.4%) and 98 units (20.9%) responded to
      mechanical stimulation of the teeth on only the contralateral side, on only the
      ipsilateral side and on both sides, respectively. 4) One-quadrant units were
      distributed mainly in the rostral part of the PM area, and four-quadrant units
      were found in the caudal part of the PM area. A somatotopic organization for each
      tooth was not found. 5) The incidence of single tooth units in the thalamus was
      extremely low, compared with those in the primary afferents and in the trigeminal
      nuclear complex. Most of the thalamic neurons had larger receptive fields than
      both the primary afferents and the trigeminal nuclear complex neurons. 6) The
      high incidence of four-quadrant units at the caudal part of the PM area suggests
      that many PM fibers converge there. However, it is still unclear whether these
      fibers come through the intrathalamic neurons or directly from the trigeminal
      nuclear complex.

PMID- 1756810
TI  - Differential effects of bicuculline and muscimol microinjections into the
      vestibular nuclei on simian eye movements.
AB  - 1.) Eye movements were recorded in four Java monkeys (M. fascicularis) after
      unilateral microinjections (1 microliter, concentration 1 micrograms/microliter)
      of the GABA antagonist, bicuculline, and the GABA agonist, muscimol, into
      oculomotor related regions of the vestibular nuclei. Eye movements were
      investigated in the dark and light during spontaneous eye movements, vestibular
      stimulation (sinusoidal: 0.2 Hz, +/- 40 deg/s, and velocity trapezoid: 40 deg/s2
      acceleration, 120 deg/s constant velocity), and visual-vestibular conflict
      stimulation. 2.) Bicuculline and muscimol injections consistently led to specific
      eye movement changes, which were maximal 5-10 min after bicuculline injection
      (muscimol 10-30 min), and lasted 90-120 min (muscimol 2-4 h). Control injections
      with NaCl (0.9%) into the responsive area and with bicuculline 2-3 mm more
      lateral showed no effect. 3.) Bicuculline induced a spontaneous nystagmus of 40.9
      deg/s (average, range 10.5-93 deg/s), beating in 60% of the cases to the
      contralateral and in 40% to the ipsilateral side. The analysis of the slope of
      the slow phase gave no evidence for an additional gaze holding deficit. The VOR
      gain in the dark showed a slight decrease (pre: 0.96; post: 0.86) on average. The
      time constant of decay for slow phase nystagmus velocity after vestibular ramp
      stimulation was reduced, reflecting a 'velocity storage' deficit. After
      bicuculline injections nystagmus suppression in the light and during visual
      vestibular conflict stimulation was generally well preserved. 4.) After muscimol
      injections horizontal gaze holding was severely affected. Each saccade was
      followed by an exponentially decreasing postsaccadic drift with a time constant
      as short as 250 ms (average 414 ms). The eyes always drifted towards a null
      position, which generally did not coincide with the midposition of the eye. The
      null-position could move up to 35 deg to the contralateral or ipsilateral side.
      The highly distorted eye movements after muscimol injections prevented VOR
      measurements based on eye velocity. Instead vestibular stimulation led to a shift
      of the null-position with an amplitude corresponding to a gain (eye
      position/stimulus position) of 0.17 (average) at 0.2 Hz (+/- 40 deg/s). Vertical
      eye movements did not show a major gaze holding deficit. 5.) From the experiments
      it can be concluded that the inhibitory transmitter GABA plays an important role
      for eye movement generation within the vestibular nuclei. Bicuculline induces
      mainly a vestibular imbalance with little evidence for a neural integrator
      deficit. In contrast unilateral muscimol injections lead to a complete,
      reversible loss of function for the common horizontal neural integrator, which
      converts eye velocity into eye position signals. The accompanying shift of the
      null-position reflects an additional vestibular imbalance.

PMID- 1756811
TI  - A transient projection from the trigeminal brainstem complex to the superficial
      layers of the hamster's superior colliculus.
AB  - Anterograde tracing with the carbocyanine dye, Di-I, was used to describe the
      normal postnatal development of the projection from the trigeminal (V) brainstem
      complex to the superior colliculus (SC) in hamster. In adult hamsters, this
      projection is completely restricted to the deep laminae, primarily the stratum
      album intermedium. Trigeminal fibers were present in the SC by the day of birth,
      and at this time, they terminated mainly in the deep layers. However, labelled
      fibers also extended into the superficial laminae (the stratum griseum
      superficiale and stratum opticum) reaching as far as the SC surface. Trigeminal
      projections to the superficial SC laminae were visible as late as postnatal day
      (P-) 6, but were absent by P-8. During the period when V axons were present in
      the superficial SC laminae, they could not be detected in the dorsal lateral
      geniculate nucleus.

PMID- 1756813
TI  - Functional organization of the auditory thalamus in the guinea pig.
AB  - The auditory thalamus of the guinea pig was investigated with microelectrode
      mapping techniques. Pure tones of varying frequencies and amplitudes were used as
      acoustic stimuli, and frequency tuning curves were recorded from 840 multi-units
      or single cells. The neurons in ventral nucleus of the medial geniculate body
      (MGv) respond vigorously to pure tones; they have mostly narrow frequency tuning
      curves and short response latencies (8-12 ms). The MGv is tonotopically
      organized: High frequencies (16-21 kHz) are located rostrally; the intermediate
      frequencies (2.8-11 kHz) lie caudomedial of the high frequencies, while the low
      frequencies (0.5-2.8 kHz) run as a continuous band from rostrolateral to
      caudomedial. These data confirm a model of tonotopy of the guinea pig MGv which
      was based on anatomical data from previous tract-tracing experiments. In these
      experiments, thalamocortical connections were investigated with retrogradely
      transported tracers (horseradish peroxidase, fluorescent dyes, Redies et al.
      1989b). Dorsal, lateral and in part also ventral to MGv, the neuronal responses
      to pure tones were often less vigorous than in MGv. Many neurons had broad
      frequency tuning curves, and in nearly all recordings from this region, the
      response latencies were longer than 12 ms. A tonotopic organization was not
      apparent here. From the response properties and the location relative to MGv, we
      concluded that this area corresponds to the shell nucleus of the MG.

PMID- 1756812
TI  - Development of the occipital corticotectal projection in the hamster.
AB  - Anterograde and retrograde labelling with the carbocyanine dye, Di-I, was used to
      assess the development of the visual cortical projection to the superior
      colliculus (SC) in pre- and postnatal hamsters. Posterior cortical axons arrive
      in the SC on postnatal (P-) day one (the first 24 hours after birth = P-0) and
      begin to arborize in the superficial laminae (the stratum griseum superficiale
      [SGS] and stratum opticum [SO]) within one day after they enter the tectum. Over
      succeeding days, the density of the projection increases and numerous labelled
      fibers are visible throughout the depth of the SGS and SO. Beginning on P-6,
      there is a decrease in the density of labelled fibers in the upper SGS and by P
      10, the laminal distribution of the occipital corticotectal pathway appears adult
      like. Anterograde tracing with Di-I also revealed the presence of a few
      corticotectal fibers that crossed the midline in both the SC and posterior
      commissures to terminate mainly in the superficial tectal laminae contralateral
      to the injection site. Crossed corticotectal fibers were visible in hamsters aged
      between P-3 and P-12. Retrograde tracing with Di-I in hamsters killed between P-3
      and P-12 demonstrated that both the ipsilateral and crossed corticotectal
      projections arose exclusively from pyramidal cells in developing lamina V.

PMID- 1756814
TI  - Cholinergic activation of a population of corneal afferent nerves.
AB  - The in vivo rabbit cornea was used to investigate the effect of acetylcholine on
      "free" nerve endings from A-delta and C-fibers in the long-ciliary (corneal)
      nerve. Extracellular electrophysiologic recordings were obtained from 67 corneal
      nerve fibers. Acetylcholine in concentrations of 10(-5) to 10(-3) M stimulated a
      specific population of these corneal afferents that were not activated by
      mechanical or thermal stimuli. Their conduction velocity was determined to be
      1.14 +/- 0.34 m/s (mean +/- SD). The other three previously characterized corneal
      nerve populations (mechanical, mechano-heat, and cold) were not stimulated by the
      cholinergic agonists or antagonists. Acetylcholine sensitive afferents were also
      stimulated by carbachol (10(-5) to 10(-3) M) and nicotine (10(-6) to 10(-4) M)
      but not by bethanecol (10(-5) to 10(-3) M). Acetylcholine-induced activity was
      abolished by d-tubocurare (10(-4) M) and kappa-bungarotoxin (10(-6) M). The cAMP
      analog 8-bromoadenosine 3'5'-cyclic monophosphate activated the same population
      of chemosensitive C-fibers as acetylcholine. It is concluded that a specific
      population of C-fiber afferents exist in the rabbit cornea which are stimulated
      by acetylcholine possibly acting via a neuronal nicotinic receptor.
      Physiologically, these nerves may be involved in the production of pain following
      tissue injury or ischemia.

PMID- 1756815
TI  - Is there a three neuron arc in the cat utriculo-trochlear pathway?
AB  - The utriculo-ocular pathway was examined in decerebrated and anesthetized cats,
      in which all the vestibular afferents in the labyrinth, except for those
      innervating the utricular (UT) macula, had been transected. The UT nerve was
      stimulated with tungsten electrodes which were insulated except for 200 microns
      at the tips. Stimulation of the UT nerve evoked a small negative (N1) potential
      in the vestibular nuclei, with a threshold (N1T) less than 25 microA. The
      stimulus evoked disynaptic EPSPs in ipsilateral abducens (AB) motoneurons. The
      threshold and latency of the excitatory postsynaptic potentials (EPSPs) was 1.3 x
      N1T and 1.2 ms, respectively, in accordance with the data of Schwindt et al.
      (1973). On the other hand, EPSPs with a clear rising phase and short latency,
      suggesting the existence of a disynaptic pathway, were never observed in any
      contralateral trochlear (TR) motoneurons, even when triple shocks at intensities
      of up to 4 x N1T were applied. This stimulus strength was strong enough to
      activate the UT nerve. Thus it seems very likely that a disynaptic pathway from
      the UT nerve to contralateral TR motoneurons, is absent or very poorly organized.

PMID- 1756816
TI  - Effects of percutaneous stimulation on motor unit firing behavior in man.
AB  - Motor unit firing behavior in human first dorsal interosseous (FDI) muscle was
      studied during controlled constant force isometric contractions. The threshold at
      which motor units were recruited and the mean firing rate at 50% of maximal
      voluntary contraction (MVC) were evaluated following stimulation of the skin area
      over the second digit. Stimulation of cutaneous receptors tended to increase the
      recruitment threshold of most of the motor units recruited under 20% MVC, while
      high-threshold motor units (those recruited over 30% MVC) generally exhibited a
      decrease in recruitment threshold. Less dramatic changes in motor unit firing
      rates were observed, but those motor units recruited over 30% MVC exhibited some
      increase in firing rate. The relationship between the change in recruitment
      threshold and change in motor unit firing rate is not rigid and seems to be
      susceptible to considerable synaptic noise.

PMID- 1756817
TI  - On a method to detect long-latency excitations and inhibitions of single hand
      muscle motoneurons in man.
AB  - The peri-stimulus-time histogram (PSTH) analysis of stimulus-related neuronal
      spike train data is usually regarded as a method to detect stimulus-induced
      excitations or inhibitions. However, for a fairly regularly discharging neuron
      such as the human alpha-motoneuron, long-latency modulations of a PSTH are
      difficult to interpret as PSTH modulations can also occur as a consequence of a
      modulated neuronal autocorrelation. The experiments reported here were made (i)
      to investigate the extent to which a PSTH of a human hand-muscle motoneuron may
      be contaminated by features of the autocorrelation and (ii) to develop methods
      that display the motoneuronal excitations and inhibitions without such
      contamination. Responses of 29 single motor units to electrical ulnar nerve
      stimulation below motor threshold were investigated in the first dorsal
      interosseous muscle of three healthy volunteers using an experimental protocol
      capable of demonstrating the presence of autocorrelative modulations in the
      neuronal response. It was found for all units that the PSTH as well as the
      cumulative sum (CUSUM) derived from these responses were severely affected by the
      presence of autocorrelative features. On the other hand, calculating the CUSUM in
      a slightly modified form yielded--for all units investigated--a neuronal output
      feature sensitive only to motoneuronal excitations and inhibitions induced by the
      afferent volley. The price that has to be paid to arrive at such a modified CUSUM
      (mCUSUM) was a high computational effort prohibiting the on-line availability of
      this output feature during the experiment. It was found, however, that an
      interspike interval superposition plot (IISP)--easily obtainable during the
      experiment--is also free of autocorrelative features.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1756818
TI  - Depth-coded motion signals in plaid perception and optokinetic nystagmus.
AB  - When two sine-wave gratings drift in different directions at the same speed
      behind a circular window, a single coherent plaid is seen rather than one grating
      sliding over the other. We find that as the stereo depth separation of the two
      component gratings increases, the probability of seeing a plaid declines. The
      gain of the slow phase of vertical optokinetic nystagmus (OKN) also falls as the
      separation of the components increases. When the two grating components are in
      the same depth plane, the vertical eye velocity is greater than that of either
      component. This shows that the OKN is being driven by the plaid, whose vertical
      speed is roughly twice as fast as the components. We conclude that both
      perception and OKN are fed by the same motion signal, which arises after
      binocular combination and after plaid synthesis.

PMID- 1756819
TI  - Wrist muscle activation patterns and stiffness associated with stable and
      unstable mechanical loads.
AB  - The objectives of this study were to examine the effects of load mechanical
      characteristics and agonist-antagonist muscle cocontraction, on the stretch
      reflex response of wrist flexor muscles, and to measure the associated wrist
      stiffness. Subjects were required to maintain a constant wrist angle while
      operating against flexor loads with different stability characteristics
      (constant, elastic or unstable). We measured the stretch reflex responses and
      joint stiffness by applying step displacements of 3 degrees and 10 degrees.
      Subjects used very little cocontraction of wrist flexor and extensor muscles when
      the load was constant or elastic, but increased cocontraction dramatically when
      the load was unstable, in order to increase the wrist stiffness. Although the
      magnitude of stretch reflex responses also increased with cocontraction, this
      simply reflected the level of tonic flexor muscle activity. We found no evidence
      to suggest that phasic stretch reflexes contributed significantly to the joint
      stiffness in this task. Clear differences in flexor muscle synergy were observed
      in the presence and absence of cocontraction, particularly when comparing the FCR
      and FCU muscles.

PMID- 1756820
TI  - Head acceleration following linear translations in the freely-standing cat.
AB  - The aim of this study was to determine whether vestibular information related to
      head acceleration is available for triggering postural responses to perturbations
      of stance in the freely-standing cat. Linear accelerations of the head were
      recorded during postural responses evoked by linear translations of the support
      surface. A consistent initial peak of acceleration was observed at an average
      latency of 22 ms and magnitude of 0.03 g (g is acceleration due to gravity, 9.8
      m/s/s). The acceleration peak preceded the first evoked EMG activity by an
      average of 24 ms. It was concluded that stimulation of the vestibular apparatus
      was both adequate and early enough for the vestibular system to have triggered
      the automatic postural response.

PMID- 1756821
TI  - Transient increase in glutamic acid decarboxylase mRNA in the cerebral cortex
      following focal cortical lesion in the rat.
AB  - In situ hybridization histochemistry (ISHH) was used to study the expression of
      glutamic acid decarboxylase (GAD) mRNA changes in the rat cerebral cortex
      following unilateral frontal and somatosensory cortical lesion by
      devascularisation. 4 days after the lesion, a significant transient increase in
      GAD mRNA level in the ipsilateral cortex was observed when compared with
      contralateral, ipsi-sham operated and ipsi-normal control cortices. The change
      occurred throughout the ipsilateral neocortex, with no significant difference
      between the magnitude of increase in frontal, parieto-occipital, parieto
      temporal, cingulate or retrosplenial areas; no obvious change was seen in
      pyriform, entorhinal or hippocampal cortices. This unexpected GAD mRNA increase
      in neocortex may be part of a long term adaptive functional alteration and
      changes in the gene expression of the cerebral cortex following focal cortical
      injury.

PMID- 1756822
TI  - Parallel processing of multisensory information concerning self-motion.
AB  - Cats trained to stand on a platform exhibit postural responses to dynamic tilting
      that appear to be based on an internal reference model of body geometry and the
      environment rather than directly on sensory inputs, as in a classical reflex
      chain. The data presented show an independent control of global variables of limb
      geometry, the length and the orientation, resulting from a parallel processing of
      multisensory inputs into separate central representations of body tilt. Limb
      length and orientation changes have completely different response dynamics and
      can be decoupled by appropriate manipulation of sensory information about self
      motion.

PMID- 1756823
TI  - A quantitative study of the pulsatile parameters of CRH-41 secretion in
      unanesthetized free-moving rats.
AB  - Having recently improved the sensitivity of the RIA CRH-41 measurements in
      perfusates from push-pull cannulas implanted in the rat median eminence, we
      explored quantitatively the pulsatile parameters of the CRH-41 measured with this
      technique at 2.5 or 5 min intervals in a series of unanesthetized male rats under
      basal conditions. The data were analysed by computer using 4 algorithms, i.e.
      Santen & Bardin, Ultra, Pulsar and Periodogram. Under a basal mean secretion rate
      of 15.5 pg CRH-41/15 min, the pulsatile pattern of CRH-41 release was
      statistically assessed with the 4 methods, with a mean pulse frequency of 3.1
      c/h, pulse length of 11.6 min and a peak amplitude above mean levels of 4 pg. The
      respective advantages of the 4 algorithms and the physiological relevance of the
      neurohormone's pulsatility are discussed.

PMID- 1756824
TI  - Isochronic transplantation of neonatal grafts in the visual cortex of cats:
      responsiveness, ocular dominance and specificity of cortical cells to visual
      stimulation.
AB  - The visual cortex of adult cats was studied physiologically following neonatal
      isochronic transplantation of grafts from areas 17,18, which were placed
      homotopically, in order to reveal their functional integration and thus possible
      repairing of damaged cortical neuronal circuits. Three homograft cats, in which
      transplantation was carried out between siblings (228 cortical cells) were
      compared to 4 animals receiving reimplanted autografts of the equivalent size
      (131 cells) as well as 3 animals with analogous sectioning of the visual cortex
      (162 cells) (pseudograft controls). The location of the boundaries between the
      transplant region and the host were determined using the Nissl's method for
      staining histological cross sections. Extracellular unit recording revealed
      typical waveform of the action potentials in the transplanted region and in the
      surrounding host tissue of all groups of cats. Visual responsiveness in the
      homograft cats was 17.5% in the transplanted region and 80.4% in the unoperated
      hemisphere; the corresponding results were 40.3% for the transplanted region and
      82.2% for the unoperated hemisphere in the autografts and 23.1% and 73.4% in the
      pseudografts. The specificity of the cells to visual stimulation as expressed by
      their orientation and direction specificity, indicated preservation of these
      properties in the transplanted cats. While all responsive cells in the
      transplanted region of the homografts were orientation specific, their proportion
      was 60% in the autografts and 55.5% in the analogous region in the pseudograft
      controls. As to the direction specific cells, their performance in the grafted
      region of the grafted cats was even much higher than that of the pseudograft
      controls. The ocular dominance distribution of the cells showed preservation of
      binocularity in the transplanted region (90.0% binocular cells) of the
      homografts; it was however smaller in the equivalent region of the autografts
      (65.0%) and remarkably reduced (20.0%) in the pseudografts. It was concluded that
      despite the deafferentation induced during the transplantation procedure, a
      remarkable visual responsiveness was found in the transplanted region, indicating
      postoperative recovery. However, the cells there were mainly affected in their
      activity and less in their specificity to visual stimulation.

PMID- 1756825
TI  - Selective activation of human soleus or gastrocnemius in reflex responses during
      walking and running.
AB  - Phase-dependent reflex modulation was studied by recording the electromyographic
      (EMG) responses in soleus (SOL) and gastrocnemius medialis (GM) to a 20 ms train
      of 5 electrical pulses, applied to the sural or tibial nerve at the ankle, in 14
      volunteers walking or running on a treadmill. Although both the spontaneous
      activity and the reflex responses were usually similar for both muscles,
      instances were identified in which separate control was evident. During walking
      (4 km/h), activity in SOL started earlier in the stance phase than GM activity.
      Correspondingly, the amplitude of the reflex responses was larger in SOL than in
      GM in early stance, both ipsi- and contralateral to the side of stimulation. In
      some cases, the same stimulus could elicit contralaterally a suppression of GM in
      synchrony with a facilitation of SOL. These crossed extensor reflexes had a low
      threshold (1.2 x T) and a latency ranging from 72 to 105 ms. During running (8
      km/h or more), responses were seen selectively in GM instead, without concomitant
      responses in SOL. Such responses had a latency ranging from 82 to 158 ms and they
      appeared during the first extension phase, at the end of the swing phase. In
      addition, selective GM responses, with latencies above 200 ms, were seen near the
      transition from stance to swing during running. These instances of separate
      reflex control of SOL and GM were correlated with step cycle periods during which
      the motoneurones of either one of these muscles received more spontaneous
      activation than the other. Nevertheless, it is argued that premotoneuronal gating
      must also be involved since the increased amplitude of the crossed SOL responses
      (in early stance) and of GM responses (at end swing) was not strictly linked to
      an elevated amount of spontaneous activity during these parts of the step cycle
      as compared to other parts.

PMID- 1756826
TI  - Contrast adaptation and contrast gain control.
AB  - Electrophysiological measurements have shown that contrast adaptation can
      increase the contrast gain of cortical cells of the cat and the monkey. This
      implies that adaptation could enhance the contrast discrimination sensitivity.
      Psychophysical contrast discrimination experiments were performed with and
      without contrast adaptation. The stimuli were spatially separated stationary
      Gabor patterns. The pedestal contrast was varied from 6 to 75 per cent. The
      spatial frequency was 1.5, 5.0 or 20 cpd. After adaptation the contrast detection
      thresholds are elevated and the subjective contrast is lowered. The contrast
      discrimination thresholds remain unchanged.

PMID- 1756827
TI  - Comparisons of the sensation perceived and intradental nerve activity following
      temperature changes in human teeth.
AB  - The relationship between the intradental nerve responses and subjective sensory
      ratings evoked by thermal stimulation of the teeth was studied in man. Recordings
      were taken from a total of 12 thermally sensitive units from the inferior dental
      nerve following thermal tooth stimulation, of which seven responded to both
      heating and cooling, two were exclusively cold-sensitive and three exclusively
      heat-sensitive. The early and late sensory responses following both cold and heat
      stimulation of the tooth were observed. The late sensory responses were more
      unstable than the early sensory responses. The mean threshold of the early
      sensory responses to tooth cooling was 13.6 +/- 1.9 degrees C (n = 9) and that to
      heat stimulation was 48.4 +/- 4.8 degrees C (n = 10). The firing frequency of the
      heat-sensitive, but not the cold-sensitive, units increased linearly in
      proportion to the increase in magnitude of the early sensory ratings.

PMID- 1756828
TI  - Express saccades: is there a separate population in humans?
AB  - It is well known that the latencies of target elicited saccades are significantly
      reduced when the target onset is preceded shortly by the offset of a fixation
      point (Saslow 1967). Fischer and Boch (1983) reported the discovery that, with
      monkeys as subjects, in addition to the general reduction in saccade latencies
      previously reported, there occurred a separate population of saccades with
      extremely short reaction times. They termed this population "express saccades",
      and more recently reported the discovery of an equivalent population of express
      saccades for humans (Fischer and Ramsperger 1984; Fischer 1987). In this paper,
      work is reported which confirms the existence of short latency visually guided
      saccades in humans but questions whether these form a separate population of
      "express saccades". The conditions used were very similar to those used by
      Fischer and Bocn.

PMID- 1756829
TI  - The neurophysiological correlates of colour and brightness contrast in lateral
      geniculate neurons. II. Adaptation and surround effects.
AB  - We report on experiments which were undertaken in an attempt to clarify
      mechanisms underlying the contrast effects of chromatic surround illumination on
      spectral responsiveness of cells in the parvocellular layers of the LGN (P-LGN
      cells), that had been demonstrated under standard conditions in the preceding
      companion paper. The experiments were done in anesthetized macaques (Macaca
      fascicularis). In some neurons, S-potentials were recorded together with the post
      synaptic action potentials, and all effects seen in P-LGN-cells were present
      already in their retinal afferents indicating their retinal origin. The
      responsiveness of the cells for center stimuli of different wavelengths and
      during illumination of the receptive field center or the outer surround was
      determined. Continuous outer surround illumination altered maintained discharge
      rate (MDR), sensitivity and gain of P-LGN and retinal ganglion cells in the same
      way and empirically not distinguishable from direct illumination of the receptive
      field. Responses to surround flashes showed the same dependence on spectral
      composition as those to center flashes. Adaptation and excitation caused by outer
      surround illumination (inner diameter 5 degrees, outer diameter 20 degrees) were,
      in the average, ten times weaker than those exerted by light of the same spectral
      composition shone directly into the receptive field. Surround effects decreased
      proportional to r-2. Excitation by outer surround flashes was reduced by
      adaptation of the receptive field center in the same manner as responses to
      center flashes. The findings indicate that outer surround light has a direct
      excitatory and adaptive effect on the excitatory or inhibitory cones feeding into
      the receptive field. This indicates that straylight from the surround into the
      center could be responsible for the adaptive and excitatory effects of surround
      illumination. The straylight fraction from the remote surround into the receptive
      field must be higher, however, than that estimated from the psychophysically
      determined point spread function. It comes closer to earlier direct straylight
      measurements in excised eyes, but may be enhanced by chromatic aberration. If a
      surround of excitatory colour is flashed simultaneously with an excitatory center
      stimulus, additivity of center and surround excitation is observed only at low
      center intensities, while at higher center intensities the gain for center
      excitation is reduced similar to adaptive gain control. This could be explained
      by lateral interaction through horizontal connections in the retina, which decays
      within seconds, while adaptation of the cones feeding into the receptive field
      center is fully effective only after about 3 s.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1756830
TI  - Hippocampus and the blood supply to TE: parahippocampal pial section impairs
      visual discrimination learning in monkeys.
AB  - In the base of each temporal lobe in 4 monkeys (Macaca fascicularis) we sectioned
      the pia mater in an antero-posterior line along the most medial part of the
      inferior temporal visual association cortex (area TE), lateral to the
      parahippocampal cortex. This pial section interrupts the blood flow in branches
      of the posterior cerebral artery which cross the parahippocampal gyrus en route
      to area TE. Histologically, the brains of 2 of these animals did not show any
      abnormalities in cresyl violet stained material, apart from the small cortical
      damage along the line of the pial section itself. Of the remaining two animals,
      one had a small unilateral infarct in TE and one had bilateral infarcts in TE.
      All of these animals were impaired in visual discrimination learning, and the
      severity of impairment was correlated only imperfectly with the severity of
      infarction. These results show that pial section along the medial boundary of
      area TE can affect visual discrimination learning without producing large
      infarcts. Further, since aspiration lesions of the hippocampal formation require
      the pia mater to be sectioned in a similar way to that reported here, the effects
      of such aspiration lesions on visual learning and memory may be mediated in part
      by effects on TE.

PMID- 1756831
TI  - Hypertrophy of dopamine neurons in the primate following ventromedial
      mesencephalic tegmentum lesion.
AB  - Morphological changes in ventral mesencephalic dopamine (DA) neurons of a monkey
      sustaining a unilateral electrolytic lesion of the ventromedial mesencephalic
      tegmentum four years earlier were examined. Substantia nigra (A9) DA neurons
      lateral to the lesion underwent hypertrophic changes. The mean area of these
      neurons was enlarged by approximately 30% relative to corresponding neurons in
      the contralateral substantia nigra. Semi-quantitative immunohistochemical
      measurements of the intensity of tyrosine hydroxylase-like immunoreactivity (TH
      li) indicated an increase in the amount of TH-li protein per cell in the
      hypertrophied neurons. Hypertrophic changes were also observed in ipsilateral A11
      DA neurons of the caudal hypothalamus, suggesting that the increase in size was
      related to transection of the axons of DA neurons as they pass through the
      midbrain in their projections to target sites. The lesion did not overtly change
      the density or pattern of the substance P innervation of the substantia nigra,
      indicating that the striato- and pallido-nigral projections were spared by the
      lesion. These data suggest that hypertrophy may be a compensatory mechanism of
      dopaminergic neurons in response to partial lesions of the nigrostriatal system,
      and thus represent a morphological counterpart to the compensatory biochemical
      processes effected in response to partial lesions of the striatal dopaminergic
      innervation.

PMID- 1756832
TI  - The neurophysiological correlates of colour and brightness contrast in lateral
      geniculate neurons. I. Population analysis.
AB  - The colour of an object is changed by surround colours so that the perceived
      colour is shifted in a direction complementary to the surround colour. To
      investigate the physiological mechanism underlying this phenomenon, we recorded
      from 260 neurons in the parvo-cellular lateral geniculate nucleus (P-LGN) of
      anaesthetized monkeys (Macaca fascicularis), and measured their responses to 1.0
      2.0 degrees diameter spots of equiluminant light of various spectral composition,
      centered over their receptive field (spectral response function, SRF). Five
      classes of colour opponent neurons and two groups of light inhibited cells were
      distinguished following the classification proposed by Creutzfeldt et al. (1979).
      In each cell we repeated the SRF measurement while an outer surround (inner
      diameter 5 degrees, outer diameter 20 degrees) was continuously illuminated with
      blue (452 nm) or red (664 nm) light of the same luminance as the center spots.
      The 1.0-1.5 degree gap between the center and the surround was illuminated with a
      dim white background light (0.5-1cd/m2). During blue surround illumination,
      neurons with an excitatory input from S- or M-cones (narrow- and wide-band/short
      wavelength sensitive cells, NS- and WS-cells, respectively) showed a strong
      attenuation of responses to blue and green center spots, while their maintained
      discharge rate (MDR) increased. During red surround illumination the on-minus-off
      responses of NS- and WS-cells showed a clear increment. L-cone excited WL-cells
      (wide-band/long-wavelength sensitive) showed a decrement of on-responses to red,
      yellow and green center spots during red surround illumination and, in the
      majority, also an increment of MDR. The response attenuation of narrow-band/long
      wave-length sensitive (NL)-cells was more variable, but their on-minus-off
      responses were also clearly reduced in the average during red surrounds. Blue
      surround illumination affected WL-cell responses little and less consistently
      than those of NL-cells, but often broadened the SRF also in the WL-cells towards
      shorter wavelengths. The M-cone excited and S-cone suppressed WM-cells were
      strongly suppressed by blue but only little affected by red surround
      illumination. The changes of spectral responsiveness came out clearly in the
      group averages of the different cell classes, but showed some variation between
      individual cells in each group. The zero-crossing wavelengths derived from on
      minus-off-responses were also characteristically shifted towards wavelengths
      complementary to those of the surround.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1756833
TI  - The squirrel monkey vestibulo-ocular reflex and adaptive plasticity in yaw,
      pitch, and roll.
AB  - The vestibulo-ocular reflex (VOR) was studied in adult squirrel monkeys before
      and after adaptation to magnifying and minifying viewing conditions. Monkeys were
      subjected to broadband (0.05-0.71 Hz) conditioning rotation for six hours in head
      yaw, pitch, and roll on separate occasions, and the VORs in these three planes
      were studied in darkness to assess adaptive plasticity in the reflexes. The gain
      of the horizontal VOR (H-VOR) averaged 0.8 across the frequency bandwidth studied
      (0.025-4 Hz). Phase was near 0 degrees from 4 to around 0.1 Hz, but developed a
      progressive lead as frequency declined further. Normal vertical VOR (V-VOR) gain
      climbed from 0.6 at 0.025 Hz to near 1 as frequency increased to 4 Hz. Phase lead
      was more pronounced at low frequencies than in the H-VOR. The normal torsional
      VOR (T-VOR) qualitatively resembled the V-VOR, showing similar phase but lower
      gains (0.3-0.7) across the frequency bandwidth. These findings suggest that the
      dynamics of the V-VOR and T-VOR resemble canal characteristics more closely than
      does the H-VOR. After adaptation to visual minification and conditioning rotation
      (0.5X for yaw and pitch, 0X for roll), gain decreased in each of the planes of
      conditioning. Similarly, gain increased in the plane of conditioning after
      adaptation to visual magnification (2X). The adaptive changes were greater at low
      (0.025-1 Hz) than at high (2.5-4 Hz) frequencies, and were more robust when gain
      was driven downward than upward. However, control (sham) adaptation experiments
      showed that VOR gain tended to drop slightly over 6 h in the absence of adaptive
      drive to do so, suggesting that the gain modifications may be more symmetric when
      referenced to the control. Adaptive VOR gain enhancement or decrement in the
      plane of conditioning did not result in systematic and parallel changes in
      orthogonal VOR planes.

PMID- 1756834
TI  - The primate vestibulo-ocular reflex during combined linear and angular head
      motion.
AB  - The squirrel monkey vestibulo-ocular reflex (VOR) was studied in darkness during
      Earth-horizontal rotation over a frequency range, 0.01-4 Hz, with the head
      positioned both centrally and displaced radially relative to the axis of
      rotation. With the head centered, the canal-mediated angular VOR (AVOR) was
      recorded in isolation. However, with the head placed eccentrically, otolith
      mediated linear VOR (LVOR) components interact with the AVOR to yield a combined
      AVOR-LVOR response. The plane of the ocular response could be manipulated by
      placing the head in different orientations relative to gravity (i.e. upright or
      nose-up). When the head was upright and centered, the horizontal AVOR was
      recorded. Comparisons between eye and head angular velocity showed that gain (pk
      eye/pk head velocity) was nearly flat, averaging 0.83, across the frequency
      range. Phase (difference in degrees between eye and head velocity, shifted 180
      degrees by convention) was near 0 degrees, except at frequencies below 0.1 Hz
      where phase leads were seen. When the head was displaced eccentrically and in the
      nose-out position (facing away from the axis of rotation), gain rose above that
      of the AVOR alone. The enhancement was progressive with increasing frequency, but
      only for frequencies above 0.25 Hz. When the subject was turned nose-in, gain
      declined relative to the AVOR alone, and in a similar frequency-dependent
      fashion. These results are consistent with the notion that nose-out and nose-in
      responses to eccentric rotation represent a combined influence of the horizontal
      AVOR and LVOR, the latter driven by inter-aural tangential acceleration. To
      further evaluate this possibility, eccentric rotation was also used to assess the
      LVOR in isolation. With the head in the nose-up orientation, the AVOR was shifted
      into the head's roll plane and generated torsional ocular responses. With the
      head centered over the axis of rotation, no systematic horizontal responses were
      observed. However, when the head was displaced eccentrically and placed in the
      head-out and head-in positions, horizontal ocular responses were recorded which
      were proportional to head eccentricity and were of appropriate polarity to
      presume that they represented the inter-aural LVOR activated by inter-aural
      tangential acceleration. Response gain rose with increasing frequency, as did
      tangential acceleration. The LVOR in its resting state in darkness could be
      characterized by an average sensitivity of 40.3 degrees/s/g (g = 9.81
      m/s2).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1756836
TI  - Functional innervation of spinal cord tissue by fetal neocortical grafts in
      oculo: an electrophysiological study.
AB  - The ability of fetal neocortex transplants, to functionally innervate maturated
      cervical spinal cord grafts in oculo, was investigated in rats. We found that a
      neocortex co-graft will grow and develop in contact with a spinal cord graft, and
      will generate a functional input to maturated spinal cord tissue which can be
      activated by electrical stimulation of the neocortex graft. Our data suggest that
      orthodromic stimulation of this pathway causes short latency, transient
      excitations of spinal graft neurons. These appear to be mediated by an excitatory
      amino acid receptor since the response was noncompetitively antagonized by
      kynurenic acid. Kynurenic acid also noncompetitively antagonized the excitatory
      effects of glutamate superfused over single spinal cord grafts. The mechanism of
      the excitation probably does not involve an NMDA (N-methyl-D-aspartate) receptor
      since APV (2-amino-5-phosphonovalerate) did not alter the spinal graft neuronal
      responses to neocortical co-graft stimulation. These data suggest that fetal
      neocortex can functionally innervate maturated cervical spinal cord in the in
      oculo graft preparation. The in oculo spinal cord graft model may thus provide a
      unique test system for studies of the influence of drugs and other manipulations
      that might alter cortico-spinal pathway development as well as influence
      reestablishment of neuronal pathways after spinal cord injury.

PMID- 1756835
TI  - GABAergic interneurons and neuropil of the intralaminar thalamus: an
      immunohistochemical study in the rat and the cat, with notes in the monkey.
AB  - Immunohistochemistry using antibodies to glutamic acid decarboxylase (GAD) was
      used to investigate the intralaminar nuclei of the thalamus in rat, cat and
      monkey. Antibodies to gamma aminobutyric acid (GABA) were also used in the cat.
      Intralaminar immunoreactive cell bodies were not detected in the rat, but were
      clearly present in cat and monkey. In the latter species, GABA- or GAD
      immunopositive perikarya were distributed throughout the anterior intralaminar
      nuclei, whereas in the posterior intralaminar complex they prevailed in the
      lateral part of the centre median nucleus and around the fasciculus retroflexus.
      Measurements of the area of immunostained intralaminar cell bodies in cat and
      monkey indicated that they are represented by small neurons. Experiments in the
      cat, based on retrograde tracers injections involving large sectors of the
      frontal and parietal cortices and the head of the caudate nucleus, revealed that
      the GABA- or GAD-immunoreactive cells and the retrogradely labeled projection
      neurons represented two separate intralaminar cell populations, although the
      latter also included small cells. Considerable differences were observed in the
      immunoreactive GABAergic neuropil of the anterior and posterior intralaminar
      nuclei. Clusters of densely packed bouton-like immunoreactive elements were
      detected in the former structures in the rat, cat and monkey, and were especially
      evident in the central lateral nucleus; immunopositive varicose fibers and puncta
      were diffusely distributed in the posterior intralaminar structures. Taken
      together with data from the literature, the present findings indicate that in cat
      and monkey local circuit inhibitory cells regulate not only the activity of
      principal thalamic nuclei which project densely upon restricted cortical fields,
      but also of the intralaminar structures which are widely connected with the
      cerebral cortex and the striatum. Regional variations in the distribution of
      GABAergic fibers and terminals suggest major differences in the organization of
      inhibitory circuits and synaptic arrangements of the anterior and posterior
      intralaminar thalamus.

PMID- 1756837
TI  - Domiciliary nocturnal nasal intermittent positive pressure ventilation in COPD:
      mechanisms underlying changes in arterial blood gas tensions.
AB  - The improvement in arterial blood gas tensions following assisted ventilation in
      chronic obstructive pulmonary disease (COPD) has usually been attributed to the
      relief of incipient or established respiratory muscle fatigue. The contribution
      of changes in the load placed upon and the drive to the respiratory muscle pump
      have not been evaluated. We have investigated the contribution of changes in
      respiratory muscle strength, the ventilatory response to CO2 and ventilatory
      function to changes in arterial blood gas tensions in eight patients with severe
      COPD completing six months domiciliary nasal intermittent positive pressure
      ventilation. Six patients showed a reduction and two an increase in arterial
      carbon dioxide tension (PaCO2), median (range) for eight patients, -0.9 kPa (-1.5
      to +0.4) (p less than 0.05) and seven showed an improvement in arterial oxygen
      tension (PaO2), +0.7 kPa (-0.4 to +1.7) (p less than 0.05) during daytime
      spontaneous breathing. The reduction in PaCO2 was not related to increased
      inspiratory muscle strength but was correlated with a decrease in gas trapping
      (Spearman rank correlation coefficient (r(S)) 0.85, p less than 0.05) and in the
      residual volume (r(s) 0.78, p less than 0.05), suggesting reduced small airway
      obstruction and, therefore, a reduction in load. The change in PaCO2 also
      correlated with the increase in ventilation at an end-tidal CO2 of 8 kPa during
      rebreathing (r(s) -0.76, p less than 0.05) suggesting improved chemosensitivity
      to CO2. Our data do not support the hypothesis that improvements were due to the
      relief of muscle fatigue. We suggest that the contribution of changes in load and
      central drive warrant further investigation.

PMID- 1756838
TI  - Does PEEP facilitate the resolution of extravascular lung water after
      experimental hydrostatic pulmonary oedema?
AB  - The effect of mechanical ventilation with positive end-expiratory pressure on the
      resolution of hydrostatic pulmonary oedema created by temporary left atrial
      balloon inflation was studied in mechanically ventilated dogs. Immediately after
      the hydrostatic process was terminated, by deflating the left atrial balloon, the
      animals were ventilated for 4 h with zero end-expiratory pressure (ZEEP, n = 6)
      or with a positive end-expiratory pressure (PEEP, n = 6) of 1.0 kPa (10 cmH2O).
      Gas exchange and extravascular lung water content (EVLW) with the double
      indicator dilution technique (dye/cold) were studied and gravimetric
      determination of lung water was made postmortem. EVLW decreased from 31.6 +/- 7.3
      mean +/- SD ml.kg.1 during maximal oedema to 14.5 +/- 2.1 ml.kg.1 (p less than
      0.001) 4 h after deflation of the left atrial balloon in dogs ventilated with
      ZEEP. The corresponding values in dogs ventilated with PEEP were a reduction in
      EVLW from 28.0 +/- 4.1 to 20.7 +/- 4.0 ml.kg.1 (p less than 0.01) (mean decrease
      7.3 +/- 4.0 ml.kg.1). EVLW was significantly higher after 4 h on PEEP than after
      ZEEP (p less than 0.01). Gravimetric values at the end of the experiment were
      12.4 +/- 2.8 ml.kg.1 (ZEEP) and 14.7 +/- 4.5 ml.kg.1 (PEEP) (NS). Oxygenation
      improved in both groups during the resolution of oedema with a more evident and
      early effect in the PEEP group. It is concluded that mechanical ventilation with
      PEEP of 1.0 kPa (10 cmH2O) in the resolution phase after experimental hydrostatic
      oedema improves oxygenation but retards the resolution of oedema.

PMID- 1756839
TI  - Thymoma: a clinicopathological comparative study of 25 cases.
AB  - We reviewed 25 patients with thymoma for clinical symptoms at presentation, X-ray
      findings and outcome. The tumours of all patients were classified using 3
      different pathologic classification systems and each system was evaluated for its
      predictive power with respect to survival. The recent classification system by
      Muller-Hermelink allowed to distinguish thymomas with associated systemic
      syndromes from those without. However, no good prediction with respect to outcome
      could be made by any of the 3 systems.

PMID- 1756840
TI  - Toxic effects of oxygen on cultured alveolar epithelial cells, lung fibroblasts
      and alveolar macrophages.
AB  - Exposure to hyperoxia results in endothelial necrosis followed by type II cell
      proliferation. This suggests that type II cells are resistant to hyperoxia.
      Oxygen-induced lung injury may result from an overproduction of oxygen
      metabolites normally scavenged by antioxidants such as superoxide dismutase
      (SOD), glutathione peroxidase, catalase and reduced glutathione (GSH). Therefore,
      resistance of type II cells to hyperoxia may be linked to high antioxidant
      activities. To test this hypothesis we compared in vitro the effects of a 24 h
      exposure period to 95% O2 on cultured type II cells, lung fibroblasts and
      alveolar macrophages isolated from rats. We show that type II cells, when
      compared with other cell types, are highly sensitive to hyperoxia as shown by
      increased lactate dehydrogenase (LDH) release, decreased deoxyribose nucleic acid
      (DNA) and protein content of Petri dishes and decreased thymidine incorporation
      into DNA. Synthesis of dipalmitoylphosphatidylcholine was also significantly
      reduced. Antioxidant enzyme activities as well as glutathione content were not
      higher in type II cells than in other cell types. However, hyperoxia results in a
      decreased SOD activity and glutathione content in type II cells which was not
      observed in fibroblasts. We conclude that adaptative changes in SOD and
      glutathione metabolism could be important defence mechanisms in cells exposed to
      hyperoxia.

PMID- 1756841
TI  - Ventilatory function impairment and risk of cardiovascular death and of fatal or
      non-fatal myocardial infarction.
AB  - The relationship of ventilatory function to cardiovascular events was studied in
      12,511 men and women, enrolled in 1976-1978 in a prospective population study.
      Until the end of 1983, 388 subjects died because of a cardiovascular disease, 133
      died within 30 days of developing myocardial infarction (fatal myocardial
      infarction), while 238 had a non-fatal myocardial infarction. Cox proportional
      hazards models were employed for the analysis. In the models including tobacco
      smoking, cholesterol level, blood pressure, diabetes mellitus and body-mass index
      as covariates, forced expiratory volume in one second in percentage of predicted
      (FEV1% pred), forced vital capacity in percentage of predicted (FVC% pred), and
      the ratio between FEV1 and FVC (FEV1/FVC) were significantly related to the risk
      of cardiovascular death, e.g. compared with subjects with FEV1% pred or FVC% pred
      greater than or equal to 80 the risk of death from cardiovascular disease among
      subjects with FEV1% pred or FVC% pred less than 60 was approximately twice as
      high. There was a nonsignificant trend towards an increased risk of fatal
      myocardial infarction with reduction of FVC% pred, but in general the regression
      models did not show consistent relationship between lung function impairment and
      risk of myocardial infarction. In the regression models, which only included age
      and sex as covariates, reduced FVC% pred and FEV1% pred were significantly
      related to both cardiovascular mortality and to fatal myocardial infarction, but
      not to the non-fatal infarction, whereas the FEV1/FVC ratio was not related to
      fatal or to non-fatal myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756842
TI  - Effect of nebulized salbutamol in preterm infants during the first year of life.
AB  - The acute effect on lung function of nebulized salbutamol and saline (placebo)
      has been investigated in preterm infants at follow-up. Twenty two premature
      infants, median gestational age 29 weeks (range 26-32 weeks) and birthweight
      1,264 g (720-1,800 g), were studied at a median postnatal age of 7 months (range
      6-9 months). Nine of the infants had recurrent respiratory symptoms; they coughed
      and/or wheezed at least 3 days per week for the previous 4 weeks. The remaining
      13 infants were free from recurrent or persistent respiratory symptoms. Thoracic
      gas volume (TGV) and airways resistance (Raw) were measured and specific airway
      conductance sGaw calculated before and 10 min after salbutamol and normal saline
      given via a nebulizer. Amongst the symptomatic infants administration of
      nebulized salbutamol was associated with a median reduction in Raw of 25% (p less
      than 0.01) and also a significant improvement in sGaw (p less than 0.01). In the
      asymptomatic infants neither Raw nor sGaw changed significantly. Nebulized saline
      caused no significant change in lung mechanics in either the symptomatic or
      asymptomatic infants. We conclude that nebulized salbutamol is an effective
      bronchodilator for symptomatic preterm infants less than one year of age.

PMID- 1756843
TI  - Sensitivity and specificity of the histamine challenge test for the diagnosis of
      asthma in an unselected sample of children and adolescents.
AB  - The purpose of this investigation was to study factors of importance for the
      degree of bronchial responsiveness and, furthermore, to evaluate the sensitivity,
      specificity and predictive value of a bronchial challenge test with histamine for
      the diagnosis of asthma in 495 randomly selected children and adolescents, aged 7
      16 yrs, from Copenhagen, Rigshospitalet. Detailed history about allergic
      symptoms, physical examination and bronchial histamine challenge tests were
      performed at the out-patient clinic. Asthma, atopic disease and height were found
      to be of great importance for the degree of bronchial responsiveness, whereas the
      age, sex and smoking habits were of no significance. The percentage of asthmatics
      with bronchial hyperresponsiveness, i.e. sensitivity to the test, increased
      towards 100% on inhaling increasing concentrations of histamine, but this was
      accompanied by a decrease in specificity and predictive values of positive test
      in regard to the diagnosis of asthma. However, lower concentrations of histamine
      may be preferable in order to distinguish between asthma and non-asthma in
      population samples, as inhalation of 2.4 mg.ml-1 and provocative concentration
      producing a 20% fall in forced expiratory volume in one second (FEV1) (PC20)
      provided an acceptable sensitivity (57%), specificity (98%), and predictive value
      of a positive test (60%). We conclude that as regards the diagnosis of asthma, a
      low predictive value confirms that the bronchial challenge test plays only a
      supplementary, but valuable, role in detecting the disease in population samples.

PMID- 1756844
TI  - Inhaled budesonide in chronic bronchitis. Effects on respiratory impedance.
AB  - In a placebo controlled study the effects of 6 weeks' treatment with inhaled
      budesonide (1.6 mg daily) on the impedance of the respiratory system, spirometry
      and symptom scores were evaluated in 35 patients with chronic bronchitis with
      forced expiratory volume in one second (FEV1) greater than or equal to 70%
      predicted. Thirty patients completed the study. No statistically significant
      differences in the changes in morning peak expiratory flow rate (PEFR), symptom
      scores, use of terbutaline rescue medication and FEV1 were found between the
      placebo and the active treatment group. Budesonide treatment was found to result
      in a small decrease in resonant frequency and a less negative frequency
      dependence of resistance compared with the placebo group.

PMID- 1756845
TI  - Chronic obstructive pulmonary disease and anaesthesia: formation of atelectasis
      and gas exchange impairment.
AB  - Gas exchange impairment and the development of atelectasis during enflurane
      anaesthesia were studied in 10 patients (mean age 70 yrs) with chronic
      obstructive pulmonary disease (COPD). Awake, no patient displayed atelectasis as
      assessed by computed X-ray tomography. The ventilation/perfusion distribution
      (VA/Q), studied by the multiple inert gas elimination technique, displayed an
      increased dispersion of VA/Q ratios (the logarithmic standard deviation of the
      perfusion distribution, mean log Q SD 0.99; upper 95% confidence limit of normal
      subject: 0.60), and increased perfusion of regions with low VA/Q ratios (0.005
      less than VA/Q less than 0.1: 5.4% of cardiac output). Shunt was negligible (mean
      0.6%). Computed chest tomography showed significantly larger cross-sectional
      thoracic areas than previously seen in subjects with healthy lungs (p less than
      0.01). No atelectasis was seen in any patient. During anaesthesia there was a
      further worsening of the VA/Q mismatch with significantly increased log Q SD
      (1.29, p less than 0.05) but no increase in shunt (mean 1%). Minor atelectatic
      areas were noted in three patients, the others displayed no atelectasis at all.
      Chest dimensions were reduced by no more than 3% during anaesthesia, suggesting
      an unchanged or only minimally affected functional residual capacity. These
      findings contrast with those seen in patients with healthy lungs in whom
      atelectasis and shunt regularly develop during anaesthesia.

PMID- 1756846
TI  - Reversal of apnoea by aspiration reflex in anaesthetized cats.
AB  - Various flow and timing characteristics of breathing as well as
      electrocorticographic (ECoG) records were analysed in a model of reversible
      respiratory failure induced by N2 inhalation in 27 anaesthetized cats. During the
      first minute of respiratory arrest, nasopharyngeal stimulation by an elastic
      nylon fibre elicited a typical sniff- or gasp-like aspiration reflex (in 88.8% of
      cases), whilst similar tracheobronchial irritation evoked a weak cough reaction
      in one third of cases (34.2%). The aspiration reflex could also be evoked in
      progressive stages of apnoea characterized by very low and even isoelectric ECoG
      activity immediately before imminent irreversible respiratory failure, and it
      could interrupt and replace the periodic gasping sometimes occurring during
      apnoea. The reflex, comprising powerful inspiration efforts, could be evoked
      during apnoea many times in succession. Repeated aspiration reflexes alone
      resulted in recovery from hypoxic apnoea with gradual normalization of ECoG and
      subsequent restitution of spontaneous breathing even more frequently than it
      occurred in periodic gasping. Successful resuscitation from hypoxic apnoea by the
      aspiration reflex in cats suggests that nasopharyngeal stimulation can affect the
      mechanisms underlying the failure and restitution of breathing at least in some
      forms of apnoea.

PMID- 1756847
TI  - Inhaled clemastine, an H1 antihistamine inhibits airway narrowing caused by
      aerosols of non-isotonic saline.
AB  - Asthmatic subjects were challenged with aerosols of hyper- and hypotonic saline
      15 min (Group A) and 90 min (Group B) after inhaling clemastine. Measurements
      were made of forced expiratory volume in one second (FEV1) before and after
      medication and after challenge. When the FEV1 values (% predicted) were compared
      on the active and placebo days they were higher 15 min after clemastine (p less
      than 0.05) for both challenges and higher 90 min after clemastine inhalation (p
      less than 0.05) for the hypertonic challenge. The % fall in FEV1 was compared
      after the same concentration of saline aerosol had been given on both active and
      placebo days. In Group A the % fall in FEV1 on the clemastine day was reduced
      after challenge with hypertonic (p less than 0.02) and hypotonic (p less than
      0.03) aerosol. In Group B there was a reduction in the % fall in FEV1 on the
      clemastine day only after hypertonic challenge (p less than 0.04). The protective
      effect afforded by clemastine was unrelated to change in baseline lung function.
      We conclude that histamine is an important mediator of the airway response to non
      isotonic aerosols and suggest that the aerosol route of administration may be
      useful for delivering antihistamines.

PMID- 1756848
TI  - Lobar hypoplasia.
AB  - Lung tissue developmental abnormalities are seldom reported. According to the
      classification of Schneider (1900), which was amended by Boyden (1955), they
      include pulmonary agenesis, aplasia and hypoplasia. Due to the early onset of
      symptoms, lung agenesis and aplasia are usually detected soon after birth.
      Conversely, lung or lobar hypoplasia may remain clinically silent for a long
      time. A single case of left lower lobe hypoplasia is reported. A recurring and
      unrelenting septic fever was the presenting symptom, whilst the radiological
      picture showed a left lower lobe consolidation. On the surgical specimen gross
      pathology revealed a lobar hypoplasia. At a short-term follow-up (nine months)
      the patient shows good overall condition, being free from further complications.

PMID- 1756849
TI  - Occupational asthma to spores of Pleurotus cornucopiae.
AB  - We report the case of a young man who developed severe asthma a few months after
      starting work in a factory producing a single type of mushroom: Pleurotus
      cornucopiae (a basidiomycete). Immunological investigations, performed with
      material recovered from the filtering devices of the mushroom's bed, led to
      demonstration of specific IgE and IgG against spore extracts and to isolation of
      one discriminant antigen (molecular weight: 10.5 kd). Current data concerning the
      underestimated role of the basidiomycetes in allergic asthma are reviewed.

PMID- 1756851
TI  - Re. Calibration of peak expiratory flow (PEF) measuring devices.

PMID- 1756850
TI  - The aetiology of bronchial asthma and critical assessment of therapy. An
      international meeting on bronchial asthma Florence (Italy) March 7th-9th 1991.

PMID- 1756852
TI  - Are prions misfolded molecular chaperones?
AB  - A theory has been developed that could explain prion infection. Prions could be
      molecular chaperones that are required for their own assembly. The theory has
      been deduced from an analysis of protein folding and consequences explored by
      computer simulations. Thermo-kinetic analysis of protein folding shows that a
      misfolded chaperone gives rise to new misfolded chaperones. Consequently such a
      protein could behave as a new kind of informative molecule and replicate
      misfolding according to a process similar to infection. A quantitative model has
      been derived from this hypothesis that displays the characteristics of prion
      infections. This hypothesis satisfactorily explains the three manifestations -
      infection, familial and sporadic - that are the characteristic features of all
      prion diseases.

PMID- 1756853
TI  - Fatty acid circuit as a physiological mechanism of uncoupling of oxidative
      phosphorylation.
AB  - Free fatty acids, natural uncouplers of oxidative phosphorylation, are shown to
      differ from artificial ones in that they fail to increase conductance of
      phospholipid bilayers which are permeable for the protonated form of fatty acids
      but impermeable for their anionic form. Recent studies have revealed that
      uncoupling by fatty acids in mitochondria is mediated by the ATP/ADP antiporter
      and, in brown fat, by thermogenin which is structurally very similar to the
      antiporter. It is suggested that both the ATP/ADP antiporter and thermogenin
      facilitate translocation of the fatty anions through the mitochondrial membrane.

PMID- 1756854
TI  - Structure-function relationships of hirulog peptide interactions with thrombin.
AB  - Using hirudin as a model, a novel class of bivalent thrombin inhibitors has been
      designed and characterized (Maraganore et al. (1990) Biochemistry 29, 7095-7101).
      These peptides, designated 'hirulogs', interact with both thrombin's catalytic
      center and its anion-binding exosite for fibrinogen recognition. In order to
      investigate structure-activity relationships in hirulog peptides, a number of
      peptide and peptidomimetic derivatives with alterations in catalytic-site binding
      and anion-binding exosite binding moieties were prepared. Replacements or
      modifications in the catalytic site and exosite binding moieties were achieved
      with the consequences of maintaining or improving antithrombin activity. In
      addition to showing improved affinity for thrombin, some derivatives with Ki's in
      the sub-nanomolar range showed increased anticoagulant activities. These findings
      highlight the versatility of hirulog peptides in their bivalent interactions with
      thrombin.

PMID- 1756855
TI  - Interaction of intact type VI collagen with hyaluronan.
AB  - The capacity of non-pepsinyzed type VI collagen to bind to hyaluronan was
      investigated. Type VI collagen was extracted from bovine meniscal cartilage with
      6 M GuHCl and purified by extraction of PEG precipitates and dissociative
      Sephacryl S-500 HR chromatography. Type VI collagen, detected with a monoclonal
      antibody, bound in 0.5 M NaCl to hyaluronan-coated micro-wells, the degree of
      binding being higher at 37 degrees C than 23 degrees C and 4 degrees C.
      Incubation of type VI collagen in competitive inhibition assays with testicular
      hyaluronidase digests of hyaluronan in liquid phase, reduced binding of the
      protein to hyaluronan-coated microwells to background levels. Thus, non
      pepsinyzed type VI collagen binds to hyaluronan in vitro.

PMID- 1756856
TI  - Receptor-mediated induction of aminopeptidase A (APA) of human glomerular
      epithelial cells (HGEC) by glucocorticoids.
AB  - Membrane-bound peptidases are critical regulators of peptide hormones. We
      therefore characterized aminopeptidase A (APA) activity in human glomerular
      epithelial cells (HGEC) and studied the control of its expression. APA, which
      splits off the N-terminal Asp from angiotensin II (AII), was present at the
      surface of HGECs (55% of the total enzyme). APA activity was calcium-dependent
      and was inhibited by amastatin. Treatment of HGECs by dexamethasone (DEX)
      increased ecto-APA activity in a dose- and time-dependent manner. Maximal
      increase of APA activity (x 2) occurred after treatment with 0.5 microM DEX for 5
      days. HIgher concentrations (1-10 microM) of aldosterone (ALD) stimulated APA
      activity to a lesser extent (x 1.25). Actinomycin D and cycloheximide prevented
      and RU 38486, a glucocorticoid receptor antagonist, suppressed the DEX-induced
      increase in APA activity. These results indicate that AII availability at
      glomerular receptor sites may be reduced by DEX and suggest a role for
      glucocorticoids in AII-dependent changes of glomerular filtration rate.

PMID- 1756857
TI  - Characterization of trypsinogens 1 and 2 in two human pancreatic adenocarcinoma
      cell lines; CFPAC-1 and CAPAN-1.
AB  - Proteins with trypsin-like immunoreactivity (first detected by a specific
      immunoenzymatic assay) were isolated from CAPAN-1 and CFPAC-1 cell culture
      conditioned media by chromatography on an immunoadsorbent prepared with a
      polyclonal antibody directed against trypsin 1. The adsorbed proteins were devoid
      of free trypsin activity but trypsin activity was present after enterokinase
      activation demonstrating that the immunoreactive trypsin present in cell
      supernatants corresponds to trypsinogens. When characterised by Western blotting
      using a monoclonal antibody directed against human trypsin 1 two protein bands
      corresponding to trypsinogen 1 (23 kDa) and trypsinogen 2 (25 kDa) gave a
      positive reaction. These results demonstrate the presence of trypsinogens 1 and 2
      in CAPAN-1 and CFPAC-1 cells and in their culture-conditioned media.

PMID- 1756858
TI  - Determination of the amino acid sequence of an intramolecular disulfide linkage
      containing sperm-activating peptide by tandem mass spectrometry.
AB  - A sperm-activating peptide (SAP) was isolated from the egg jelly of the sea
      urchin Stomopneustes variolaris. The presence of an intramolecular disulfide
      linkage in the peptide was demonstrated by fast atom bombardment (FAB) mass
      spectrometry with the intact and reduced peptides. The amino acid sequence of the
      reduced peptide was determined to be Lys-Phe-Cys-Pro-Glu-Gly-Lys-Cys-Val by
      tandem mass spectrometry from the spectrum produced by a collision-induced
      decomposition method. Furthermore, it was also demonstrated that SAPs obtained
      from sea urchins Arbacia punctulata and Glyptocidaris crenularis are cyclic
      peptides containing one cystine residue by FAB mass spectrometry.

PMID- 1756859
TI  - Structure/function relationships in the inhibition of thimet oligopeptidase by
      carboxyphenylpropyl-peptides.
AB  - Some novel N-[1(RS)-carboxy-3-phenylpropyl]tripeptide p-aminobenzoates have been
      synthesised as inhibitors of thimet oligopeptidase (EC 3.4.24.15). These
      compounds are considered to bind as substrate analogues with the Cpp group in S1
      and the peptide portion in the S' sites. The most potent inhibitor is Cpp-Ala-Pro
      Phe-pAb, which has a Ki = 7 nM. Substitution of Gly for Ala at P1' leads to
      weaker binding which can be ascribed to increased rotational freedom. Good
      substrates often have Pro at P2' and Pro is favoured over Ala at this position in
      the inhibitors, too. When P2' is Pro, Phe is preferred over Tyr and Trp in P3'.
      The p-aminobenzoate group makes an important contribution to the binding,
      probably by forming a salt bridge, and removal of the C-terminal negative charge
      results in much less potent inhibitors.

PMID- 1756860
TI  - Identification of amino acid residues of Ras protein that are essential for
      signal-transducing activity but not for enhancement of GTPase activity by GAP.
AB  - To determine the amino acid residues required for the signal-transducing activity
      of the human c-Ha-Ras protein, we introduced point mutations at residues 45-54
      near the 'effector region' (residues 32-40). We transfected PC12 cells with these
      mutant genes and also micro-injected the mutant proteins, bound with an
      unhydrolyzable GTP analog, into PC12 cells. Both procedures showed that Val45---
      Glu and Gly48----Cys mutations impaired the ability of the Ras protein to induce
      morphological change of PC12 cells. These mutations did not affect the guanine
      nucleotide-binding activity or GTPase activity in the absence or presence of
      bovine GTPase-activating protein (GAP). Therefore, the Val45 and Gly48 residues
      should be included by definition in the effector region responsible for the
      signal transduction, while only a subset of the effector-region residues is
      required for enhancement of the GTPase activity by GAP.

PMID- 1756861
TI  - Functional significance of aromatic amino acids from three peptide loops of the
      alpha 7 neuronal nicotinic receptor site investigated by site-directed
      mutagenesis.
AB  - Three aromatic amino acids, Tyr92, Trp148 and Tyr187 belonging to three separate
      domains of the alpha 7-subunit of neuronal nicotinic acetylcholine receptor were
      mutated to phenylalanine, and the electrophysiological response of the resulting
      mutant receptors analyzed in the Xenopus oocyte expression system. All mutations
      significantly decreased the apparent affinities for acetylcholine and nicotine,
      and to a lesser extent, those for the competitive antagonists dihydro-beta
      erythroidine and alpha-bungarotoxin. Other properties investigated, such as the
      voltage dependency of the ion response as well as its sensitivity to the open
      channel blocker QX222, were not significantly changed, indicating that the
      mutations affected selectively the recognition of cholinergic ligands by the
      receptor protein. The maximal rates for the rapid desensitization process were
      slightly modified, suggesting that the contribution of Tyr92, Trp148 and Tyr187
      to the binding area might differ in the various conformations of the nicotinic
      receptor. Other mutations at nearby positions (S94N, W153F, G151D and G82E) did
      not affect the properties of the electrophysiological response. These data point
      to the functional significance of Tyr92, Trp148 and Tyr187 in the binding of
      cholinergic ligands and ion channel activation of the nicotinic receptor, thus
      supporting a multiple loop model [(1990) J. Biol. Chem. 265, 10430-10437] for the
      ligand binding area.

PMID- 1756862
TI  - Plant basic 7 S globulin-like proteins have insulin and insulin-like growth
      factor binding activity.
AB  - Basic 7 S globulin (Bg) is a cysteine-rich glycoprotein present in soybean seeds.
      Mature Bg is composed of high- and low-kDa subunits linked by disulfide bonding.
      A ligand blotting experiment using [125I]insulin and [125I]insulin-like growth
      factor-I and -II showed that Bg subunits are able to bind not only to insulin but
      to insulin-like growth factors-I and -II. Bg-like proteins from other legume
      species cross-reacted with anti-Bg antibody also bind to insulin and insulin-like
      growth factors. Bg-like protein in carrot cells was found to have insulin binding
      activity. Bg-like proteins may be involved in an insulin-like regulatory
      mechanism in many plant species.

PMID- 1756863
TI  - A Lys27-to-Glu27 mutation in the human insulin-like growth factor-1 prevents
      disulfide linked dimerization and allows secretion of BiP when expressed in
      yeast.
AB  - Recombinant human insulin-like growth factor-1 (IGF1) secreted from yeast
      contains only 10-15% of the active monomer. A majority of the IGF1-like molecules
      are disulfide bonded dimers. These dimers are not formed in an IGF1 mutant where
      Lys27 has been replaced by glutamic acid. However, increased levels of secreted
      BiP (the yeast KAR2 gene product) are seen in cells expressing the mutant. These
      results imply that by preventing ionic interactions between two IGF1 molecules,
      intermolecular disulfide bonds do not form in yeast, and that in the mutant there
      is a structural change which induces BiP, allowing its secretion.

PMID- 1756864
TI  - 2-Deoxy-2-fluoro-D-galactose protein N-glycosylation.
AB  - 2-Deoxy-2-fluoro-D-galactose (dGalF), added to the medium of primary cultured rat
      hepatocytes, inhibited N-glycosylation of membrane (gp 120) and secretory
      glycoproteins (alpha 1-macroglobulin) in a concentration-dependent manner.
      Complete inhibition of N-glycosylation was achieved at concentrations of 1 mM and
      above. At identical concentrations, 2-deoxy-2-fluoro-D-glucose (dGlcF) caused
      only incomplete inhibition of N-glycosylation. dGalF reduced incorporation of D
      [2,6-3H]mannose into lipid-linked oligosaccharides indicating interference with
      their assembly in the dolichol cycle.

PMID- 1756865
TI  - Evidence for a Competitive-Displacement Model for the initiation of protein
      synthesis involving the intermolecular hybridization of 5 S rRNA, 18 S rRNA and
      mRNA.
AB  - We have previously shown that a 5'-terminal region of mouse 5 S rRNA can base
      pair in vitro with two distinct regions of 18 S rRNA. Further analysis reveals
      that these 5 S rRNA-complementary sequences in 18 S rRNA also exhibit
      complementarity to the Kozak consensus sequence surrounding the mRNA
      translational start site. To test the possibility that these 2 regions in 18 S
      rRNA may be involved in mRNA binding and translational initiation, we have
      tested, using an in vitro translation system, the effects of DNA oligonucleotides
      complementary to these 18 S rRNA sequences on protein synthesis. Results show
      that an oligonucleotide complementary to one 18 S rRNA region does inhibit
      translation at the step of initiation. We propose a Competitive-Displacement
      Model for the initiation of translation involving the intermolecular base-pairing
      of 5 S rRNA, 18 S rRNA and mRNA.

PMID- 1756866
TI  - Trimeric G-proteins of the trans-Golgi network are involved in the formation of
      constitutive secretory vesicles and immature secretory granules.
AB  - Non-hydrolysable analogues of GTP, such as GTP gamma S and GMP-PNP, have
      previously been shown to inhibit the formation of constitutive secretory vesicles
      (CSVs) and immature secretory granules (ISGs) from the trans-Golgi network (TGN).
      Using a cell-free system, we show here that the formation of these vesicles is
      also inhibited by [A1F4]-, a compound known to act on trimeric G-proteins.
      Addition of highly purified G-protein beta gamma subunits stimulated, in a
      differential manner, the cell-free formation of both CSVs and ISGs. ADP
      ribosylation experiments revealed the presence of a pertussis toxin-sensitive G
      protein alpha subunit in the TGN. We conclude that trimeric G-proteins regulate
      the formation of secretory vesicles from the TGN.

PMID- 1756867
TI  - Eicosanoid generation from antigen-primed mast cells by extracellular mammalian
      14-kDa group II phospholipase A2.
AB  - The extracellular form of 14-kDa group II phospholipase A2 has been found to
      accumulate at various types of inflammatory sites. In the present paper, we have
      studied the possible role of the extracellular 14-kDa group II phospholipase A2
      in the process of prostaglandin production in activated rat mast cells. When mast
      cells obtained from the peritoneal cavity of rats were sensitized with IgE,
      challenged with antigen and then exposed to extracellular 14-kDa group II
      phospholipase A2, appreciable release of prostaglandin D2 was observed.
      Generation of prostaglandin D2 was dependent on the concentration of the
      phospholipase A2 as well as that of the antigen, while no appreciable
      prostaglandin D2 generation was observed with cells in the absence of the
      antigen. No histamine release was observed under the same conditions.
      Phosphatidylcholine in mast cell membranes was appreciably hydrolyzed to liberate
      free arachidonic acid when mast cells were incubated with 14-kDa group II
      phospholipase A2 added exogenously in the presence of the antigen. Both the
      generation of prostaglandin D2 and the release of arachidonic acid were retarded
      by inhibitors specific to 14-kDa group II phospholipase A2. Thus, 14-kDa group II
      phospholipase A2 may function in the process of inflammation by acting on IgE
      antigen-primed mast cells, which are not fully activated, to generate
      eicosanoids.

PMID- 1756868
TI  - Phorbol ester stimulation of pancreatic beta-cell replication, polyamine content
      and insulin secretion.
AB  - Long-term effects of the protein kinase C activating phorbol ester, TPA, on
      pancreatic beta-cell proliferation and insulin production were investigated. It
      was found that beta-cell replication and long-term insulin secretion were
      enhanced in TPA-treated islets. This was not accompanied by a corresponding
      increase in (pro)insulin biosynthesis, presumably contributing to the lowered
      islet insulin content. TPA also increased islet polyamine content but when this
      increase was prevented by blocking polyamine synthesis, DNA replication and
      insulin secretion remained elevated. These findings indicate that TPA stimulates
      beta-cell replication and insulin secretion and suggest a stimulatory role for
      protein kinase C, but not for polyamines, in these processes.

PMID- 1756869
TI  - Rapid turnover of low density lipoprotein receptor in human monocytic THP-1
      cells.
AB  - We examined whether human monocyte-derived macrophages had low density
      lipoprotein (LDL) receptors with a short life span. The human monocytic leukemia
      cell line, THP-1, was highly differentiated when treated with phorbol ester. LDL
      receptors degraded rapidly with half-lives of 3-4 h in THP-1 cells before phorbol
      ester treatment. During the transition into monocytic cells, expression of the
      LDL receptor gene was not affected. However, relative degradation rates of LDL
      receptors normalized by those of cellular total proteins were about twice as fast
      in phorbol ester-treated THP-1 cells compared to untreated cells.

PMID- 1756870
TI  - Glycinebetaine enhances and stabilizes the evolution of oxygen and the synthesis
      of ATP by cyanobacterial thylakoid membranes.
AB  - Glycinebetaine (betaine), an osmoregulant in halophilic plants, stabilized the
      evolution of oxygen and the synthesis of ATP by thylakoid membranes from the
      cyanobacterium Synechocystis PCC6803 when it was present during the preparation
      and incubation of the thylakoid membranes. Moreover, betaine enhanced the
      evolution of oxygen and the synthesis of ATP when present during assays. When
      betaine at 1.0 M was present during the preparation of thylakoid membranes and
      during the measurement of activity, the rate of evolution of oxygen was
      equivalent to that of intact cells.

PMID- 1756871
TI  - The sexual inducer of Volvox carteri. Its large-scale production and secretion by
      Saccharomyces cerevisiae.
AB  - The DNA sequence coding for the sexual inducer glycoprotein of Volvox carteri and
      its N-terminal signal peptide was placed under the control of the repressible
      acid phosphatase promoter of the yeast Saccharomyces cerevisiae in a yeast-E.
      coli shuttle vector. Yeast transformed by this construct synthesized and secreted
      into the culture medium biologically active inducer in amounts two to three
      orders of magnitude higher than observed in the Volvox system.

PMID- 1756872
TI  - The major endogenous bovine brain protein kinase C inhibitor is a heat-labile
      protein.
AB  - A crude cytosolic fraction prepared from bovine brain contained protein kinase C,
      as shown by immunoblotting, but its activity was undetectable, suggesting the
      presence of interfering factors. Phosphatase, ATPase and protease activities did
      not account for the absence of detectable protein kinase C activity. The major
      contributing factor was found to be a heat-labile protein which was separated
      from the kinase by ion-exchange chromatography. The contribution to the total
      inhibitory activity of heat-stable proteins was relatively minor, suggesting that
      they may not function physiologically as protein kinase C inhibitors.

PMID- 1756873
TI  - Femoro-distal grafts--can the results be improved?

PMID- 1756874
TI  - Selection of amputation level: a review.
AB  - Preservation of the knee joint in a patient undergoing lower limb amputation for
      critical ischaemia is associated with improved postoperative rehabilitation and
      mobility. Yet, for most surgeons the below-knee to above-knee amputation ratio
      remains less than one. Poor wound healing and a high reamputation rate for below
      knee stumps are important factors mitigating against below-knee amputations. Many
      tests (Doppler indices, segmental pressures, skin blood flow, skin perfusion
      pressure, TcpO2, thermography) have been described to predict the likelihood of
      successful healing of an amputation stump but none appears to have gained
      widespread acceptance. Clinical judgement alone is insufficient to predict the
      success or failure of an amputation stump. In this review, we have looked at the
      evidence in support of these tests, particularly those routinely available to
      most surgeons.

PMID- 1756875
TI  - Pedal reconstructions for limb salvage.
AB  - If only one pedal artery is patent the vascular surgeon has to decide between
      primary amputation and a bypass. Between 1980 and 1990, 460 femoro-distal
      bypasses were performed in our clinic and 8% (39 cases) of these received a pedal
      reconstruction. At discharge from the hospital 85% of these grafts were patent.
      The primary goal of treatment, to maintain life and salvage the limb on the basis
      of a functioning bypass, was obtained in 82% of patients. After 1 year the
      secondary patency of our pedal reconstructions was 68%. Taking the mortality of
      amputations into account, vascular surgery to the foot arteries is preferable to
      amputation, whenever possible.

PMID- 1756876
TI  - The clinical use of an antibiotic-bonded graft.
AB  - Attempts to produce an antibiotic-bonded prosthesis have failed owing to poor
      binding, drug toxicity or inadequate antimicrobial activity of the antibiotic
      particularly against Staphylococcus epidermidis. Rifampicin, with an ideal
      spectrum, but untested against slime-forming S. epidermidis has recently been
      shown to bind with carboxyl groups on gelatin-sealed Dacron. We therefore
      investigated rifampicin activity against 30 slime-forming adherent S. epidermidis
      colonies, isolated from 40 consecutive aortic graft recipients, and compared it
      with their methicillin, gentamicin, cefuroxime, tetracycline and vancomycin
      resistance patterns. The S. epidermidis colonies were highly sensitive to very
      low levels of rifampicin. Rifampicin was then bonded to gelatin-sealed Dacron
      aortic prostheses which were inserted in four patients at high risk of developing
      subsequent infection.

PMID- 1756877
TI  - The value of duplex scanning with venous occlusion in the preoperative prediction
      of femoro-distal vein bypass graft diameter.
AB  - The diameter of the long saphenous vein has been shown to affect the outcome of
      femoro-distal bypass. Many surgeons regard a vein with a diameter of less than 3
      mm as being unsuitable. The long saphenous vein was studied in 35 patients
      undergoing femoro-distal bypass. Diameter measurements of the vein were performed
      using an ATL duplex scanner at the groin, mid-thigh and knee. Measurements were
      performed preoperatively both at rest and with a venous occlusion cuff to dilate
      the vein, and subsequently at 7 days and 2 months after implantation. The mean
      diameter of the vein at the mid-thigh was 4.1 mm non-dilated, 5.1 mm with
      occlusion, 5.0 mm 7 days postoperatively and 5.2 mm at 2 months (ANOVA, p less
      than 0.05). The mean diameter of the vein at the knee was 3.9 mm non-dilated, 4.8
      mm with occlusion, 4.8 mm at 7 days and 4.9 mm at 2 months after operation
      (ANOVA, p less than 0.025). In all five patients whose preoperative resting vein
      diameter at the knee or mid-thigh was less than 3 mm, preoperative dilatation
      occurred, such that the diameter became greater than 3 mm. These results suggest
      that by using a technique of venous occlusion at the time of pre-operative vein
      mapping, the functional diameter of the vein can be predicted and vein
      utilisation may be increased.

PMID- 1756878
TI  - Is laser assisted angioplasty a real alternative to surgical treatment of
      occluded peripheral vessels?
AB  - Since 1988 250 patients had occluded peripheral arteries reopened by an Argon
      laser. The mean age of the 110 men and 85 women was 71 years and the mean length
      of all occlusions 13.4 cm. The primary success rate was 81.5% with a perforation
      rate of less than 2%. The patency rate after 96 weeks was 80%.

PMID- 1756879
TI  - C-reactive protein and alpha 1-acid glycoprotein in monitoring of patients with
      acute arterial occlusion.
AB  - C-reactive protein (CRP) and alpha 1-acid glycoprotein (AGP) levels were studied
      in sera of 75 patients with acute arterial occlusion. Depending on the degree of
      ischaemia, patients were divided into two groups: grade I--26 patients--and grade
      II--49 patients. All patients were treated surgically; 42 embolectomies, 17
      endarterectomies and 16 bypasses were performed. After surgery in 19 patients
      various complications were observed. The concentration of both proteins at the
      time of admission was higher in the serum of patients with grade II than with
      grade I ischaemia. Similarly the concentration of both proteins was significantly
      higher in the sera of the patients admitted after 8 h than in patients admitted
      within 8 h of the onset of ischaemia. CRP and AGP levels were significantly
      higher in the serum of patients with ischaemia of the lower limb than in those
      with ischaemia of the upper limb. In all patients 2-3 days after surgery a
      significant increase in serum CRP and AGP was observed. In uncomplicated cases on
      days 7-10 the values of both proteins decreased below the level observed at the
      time of admission. However, in patients who experienced postoperative
      complications high levels of both serum proteins (especially CRP) were found on
      days 7-10. Complications were detected with a sensitivity and specificity of 84
      and 95%, respectively, using a CRP level of 49 mg l-1 as the cut-off point.

PMID- 1756880
TI  - Monitoring of somatosensory evoked potentials during carotid endarterectomy:
      relationship with different haemodynamic parameters and clinical outcome.
AB  - The authors studied the changes of Somatosensory Evoked Potentials (SEPs)
      performed in 241 anaesthetised patients during 264 carotid endarterectomies
      (CEs). SEP responses were considered significantly modified when the central
      conduction time was greater than 1 ms and/or when the amplitude of the complex
      N20-P25 decreased by at least 50%. Both CCT and N20-P25 have been correlated with
      different parameters, including the presence or absence of preoperative
      neurological deficits, the type of general anaesthesia, the status of the
      contralateral and the ipsilateral carotid artery, stump pressure, the use of an
      intraluminal shunt and the perioperative results. After carotid cross-clamping
      SEP responses were within the normal range in 236 CEs (89%), and abnormal in 28
      (11%). A shunt was inserted 23 times in 264 (9%) cases. None of the patients
      operated on in this series experienced a permanent neurological deficit; there
      were three (1.1%) transient deficits (two Rinds and one TIA) and two deaths from
      non-neurological causes. Only one of the transient deficits was present when the
      patient woke from the anaesthetic and this event was predicted by significant
      modification of the SEP which did not reverse after removal of the clamps (a
      shunt was not used). None of the patients in our series who did not present
      significant modifications of SEPs during the operation had any postoperative
      neurological deficit. The authors conclude that SEP recording is a highly
      reliable and objective method for continuous monitoring of brain function during
      CE.

PMID- 1756881
TI  - Transmetatarsal amputation in patients with peripheral vascular disease.
AB  - Transmetatarsal amputation has the reputation of being an operation with a poor
      healing rate, and less than a 50% success rate had recently been reported. The
      outcome of this amputation in patients with peripheral vascular disease has been
      retrospectively studied in this paper by examining 34 transmetatarsal amputations
      performed over a 5-year period. Twelve patients had had previous toe amputations
      and 22 were diabetic with an overall healing rate of 68%. There was no
      significant difference in the success rate between diabetics and non-diabetics.
      One patient died in the postoperative period, giving an early post-operative
      mortality of 3%. Revision of failed transmetatarsal below-knee amputation
      resulted in healing in seven patients out of nine, suggesting that it does not
      compromise later amputation at a higher level. Healing did not appear to be
      influenced by factors such as sympathectomy, previous arterial reconstruction or
      peripheral pulses. Transmetatarsal amputation provides patients who have a short
      life expectancy with a durable functional stump which is prosthesis free.

PMID- 1756882
TI  - Changes in middle cerebral artery flow velocity and pulsatility index after
      carotid endarterectomy.
AB  - Transcranial Doppler sonography (TCD) was used in 33 patients undergoing carotid
      endarterectomy (CEA). Mean flow velocity (MCA MV) and the pulsatility index in
      the middle cerebral artery (MCA PI) were measured pre- and on six occasions
      postoperatively. The MCA MV was reduced by anaesthesia but was increased
      postoperatively (+43%, p less than 0.001) compared to the preoperative value and
      was still increased at late follow-up after several months. The MCA PI, which was
      lower preoperatively than normally reported in this age group, was not changed by
      anaesthesia but then rose and remained elevated, i.e. within normal limits 72 h
      postoperatively (+30%, p less than 0.01) as well as at late follow-up. No
      significant changes in MCA MV or MCA PI were noted on the contralateral side. The
      results from this study support earlier findings from invasive studies showing
      that CEA results in an increased flow in the middle cerebral artery on the
      operated side and an increased MCA PI suggests an increased resistance on the
      operated side. The findings are compatible with an increased cerebral blood flow
      during the first days after CEA and with the operated side supplying a greater
      part of the cerebral blood flow even several months after surgery.

PMID- 1756883
TI  - Intensive care after abdominal aortic surgery.
AB  - This study examined the necessity for an intensive care environment after
      abdominal aortic surgery. The detailed records of 45 consecutive patients were
      reviewed for the first 48 h after operation, recording the occurrence and numbers
      of episodes of defined medical events or prescription of non-routine drugs.
      Medical events were hypertension (greater than 200 mmHg), hypotension (less than
      100 mmHg), obliguria (less than 20 ml/h) and pulmonary problems. Thirty-six
      patients (80%) had medical events (hypertension 20, hypotension 17, oliguria 31,
      hypoxia 10, chest complications 12), and 38 (84%) had medical interventions. Only
      two had no events or interventions. Twenty-seven (59%) had more than one episode
      of a medical event which would not have been predicated from their preoperative
      state. There were three deaths (mortality 6.7%). These results support the case
      for intensive monitoring and immediate access to experienced medical advice for
      these patients. In hospitals where the intensive care unit is the best place to
      provide these facilities, elective operation may need to be deferred if an
      intensive care bed is not available.

PMID- 1756884
TI  - Hyperbaric oxygen therapy for ischaemia of the hand due to intra-arterial
      injection of methadone and flunitrazepam.
AB  - We present a case of accidental injection of oral methadone and flunitrazepam
      into the ulnar artery, with resultant severe ischaemia of the hand. Initial
      therapy consisted of systemic vasodilators, low molecular weight dextran and
      aspirin. When this therapy failed to produce improvement and amputation of the
      involved hand seemed inevitable, the patient was referred for hyperbaric oxygen
      (HBO) therapy. In spite of a 12 day delay in the initiation of HBO, the response
      was dramatic, with almost complete resolution of the ischaemic signs and
      symptoms. Intra-arterial injection, which is only rarely encountered in drug
      addicts, frequently results in severe ischaemia of an extremity, and carries with
      it a poor prognosis with currently accepted therapy. Given the presently reported
      experience and the known physiology of HBO, we conclude that HBO should be
      started early in the treatment of intra-arterial injection of drugs, and should
      also be considered following prolonged delays.

PMID- 1756885
TI  - Tunnelling instruments for vascular grafts: problems and solutions.
AB  - When autologous veins or vascular prostheses are implanted for bypass operations
      or haemodialysis, the use of an appropriate tunnelling device is extremely
      helpful. In order to avoid perigraft haemorrhage and allow undelayed graft
      incorporation, the tunneller should match the diameter of the implant.
      Interchangeable shafts of various lengths and blunt tips of various diameters are
      prerequisites for a versatile instrument. Most instruments on the market have an
      important drawback: the handle is welded to one end of the shaft thus preventing
      "bi-directional" use. We have therefore developed a modified tunneller that can
      be used equally well in either direction. The connection between shaft and handle
      affords torsional rigidity and thus allows precise guidance during insertion. The
      handle can be attached to both ends of the shaft. Thus, for example, in a femoro
      popliteal bypass, the distal anastomosis can be constructed first, followed by
      the introduction of the tunneller from the knee to the groin. As a next step the
      tip and handle are interchanged and the graft is passed from the knee to the
      groin. When a haemodialysis shunt with a PTFE-loop is inserted, the bidirectional
      use of the tunneller makes it possible to insert the graft with a smooth curve
      into the smallest possible cavity. Thus, the new instrument set called the "Bi
      directional Tunneller" is more versatile and easier to use than other tunnellers
      presently available.

PMID- 1756886
TI  - False aneurysm of the abdominal aorta after blunt trauma.
AB  - Injuries of the abdominal aorta due to blunt trauma are rare. So far, 33 cases
      have been reported in the English literature and false aneurysm formation after
      such injuries is even rarer. In this article, a case of false aneurysm of the
      abdominal aorta after blunt trauma in an acrobat which was successfully managed
      is reported, and the English literature for similar cases reviewed.

PMID- 1756887
TI  - Chylous ascites following aneurysm surgery.
AB  - A case of chylous ascites occurring after elective abdominal aortic aneurysm
      repair is described. The patient was initially managed conservatively with
      hyperalimentation and intermittent drainage of the retroperitoneal collection,
      but, this proved inadequate and a peritoneo-venous shunt was inserted. Although
      the shunt appeared to work well the patient finally died of septicaemia.

PMID- 1756889
TI  - Leaking abdominal aortic aneurysm presenting as an inguinal mass.
AB  - Two patients with leaking abdominal aortic aneurysm (AAA) presenting as a tender
      inguinal mass are reported. Unusual presentations such as this often cause delays
      in definitive surgery which result in increased morbidity and mortality. It
      follows that the diagnosis of a leaking AAA should be considered in all patients
      with a tender pulsatile abdominal mass regardless of the presentation.

PMID- 1756888
TI  - Late false aneurysm formation along an axillobifemoral graft.
AB  - False aneurysm formation is a rare complication of prosthetic arterial
      reconstruction other than at the anastamosis. Several aetiological mechanisms
      have been postulated. We report the development of a false aneurysm along the
      course of a prosthetic graft, with local communication between aneurysm and graft
      at more than one site. Possible causes of this type of graft failure are
      discussed.

PMID- 1756890
TI  - Popliteal vein aneurysm.

PMID- 1756891
TI  - Diagnosis and management of sleep disorders.

PMID- 1756892
TI  - Persistent/recurrent pneumonia in infants and children.
AB  - An infant or child with recurrent/persistent pneumonia requires a careful
      evaluation to determine if an underlaying condition may be treatable or
      surgically correctable.

PMID- 1756893
TI  - Brown-Sequard syndrome following cervical spine compression fracture.
AB  - Brown-Sequard Syndrome is most commonly caused by penetrating trauma to the
      spinal cord. The case of a 15-year-old male who developed Brown-Sequard Syndrome
      following blunt cervical spine trauma sustained in an automobile accident is
      presented. Brown-Sequard Syndrome is rarely seen following blunt trauma; however,
      one must be suspicious so as not to overlook this type of lesion.

PMID- 1756894
TI  - The value of cluster and environmentally related cancer studies in Delaware.

PMID- 1756895
TI  - Fraud and abuse safe harbor regulations.

PMID- 1756896
TI  - Help for the busy doctor.

PMID- 1756897
TI  - The pancreatic islet as Rubik's Cube. Is phospholipid hydrolysis a piece of the
      puzzle?
AB  - At least three types of phospholipase exist in the beta-cells of the pancreatic
      islet. Data regarding their physiological activation are incomplete but suggest
      that glucose (or its metabolite glyceraldehyde) either activates or potentiates
      the activation of several phospholipases. At least seven phospholipid hydrolysis
      by-products (diacylglycerol, myo-inositol 1,4,5-trisphosphate, lysophospholipids,
      arachidonic acid and its cyclooxygenase- and lipoxygenase-derived metabolites,
      phosphatidate) have been demonstrated to have effects compatible with their
      postulated roles as mediators or modulators of islet function. Presumptive
      mechanisms of action have been tentatively identified for these metabolites.
      However, key studies in the puzzle are missing, and current methodologies have
      important limitations. Shortcomings include the paucity of measurements of the
      mass of metabolites; the frequent use of static incubations rather than
      perfusions; a lack of complete time- and agonist concentration-dependence curves;
      the equation of metabolite accumulation with rates of metabolite generation
      (which ignores metabolite removal as a key variable); the use of nonspecific,
      insensitive, or ambiguous phospholipase assays; and the need for more studies
      directly correlating lipid metabolism and insulin secretion in physiologically
      functioning preparations. Like Rubik's Cube, the pancreatic islet is a dynamic
      puzzle comprised of many interrelated components requiring proper alignment and
      integration. Phospholipid turnover is one "panel" in the islet; however, an
      obligate role for phospholipase activation in glucose-induced insulin secretion
      is not yet rigorously established, despite tantalizing, inferential evidence. It
      may be that glucose serves principally to potentiate the phospholipase and
      secretory responses to other signals that act by initiating phospholipid
      hydrolysis.

PMID- 1756898
TI  - Effects of insulin and myo-inositol on embryo growth and development during early
      organogenesis in streptozocin-induced diabetic rats.
AB  - We have previously shown that myo-inositol depletion in the embryonic tissue at a
      critical stage of organogenesis has a crucial role in hyperglycemia-induced
      embryopathy. This study tested whether myo-inositol depletion in early
      organogenesis contributes to the pathogenesis of streptozocin-induced diabetic
      embryopathy. Rats were made diabetic by streptozocin administration before
      conception, and the diabetic rats were treated with diet supplemented by 2% myo
      inositol or insulin from 6 to 11 gestational days during the period of maximum
      teratological susceptibility. In each group on the 11th gestational day, growth
      retardation and incidence of malformations were recorded, and myo-inositol and
      sorbitol content in the embryonic and extraembryonic tissues were examined. In
      diabetic rats, the myo-inositol content of the embryos was decreased by 36% (P
      less than 0.01) compared with control rats, and there was growth retardation
      (crown-rump length 3.37 +/- 0.04 vs. 3.87 +/- 0.03 mm, P less than 0.01; somite
      no. 27.5 +/- 0.2 vs. 29.1 +/- 0.2, P less than 0.01) and a significantly
      increased incidence of the neural lesions (17.6 vs. 1.9%, P less than 0.01).
      Insulin treatment resulted in near normalization of maternal serum glucose and
      complete restoration of myo-inositol content in the embryos with significant
      improvement of the growth retardation (crown-rump length 3.55 +/- 0.06 vs. 3.37
      +/- 0.04 mm, P less than 0.05; somite no. 28.2 +/- 0.13 vs. 27.5 +/- 0.2, P less
      than 0.05) and a significantly lowered incidence of neural lesions (2.5 vs.
      17.6%, P less than 0.01) compared with those of the untreated diabetic
      rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756899
TI  - T-lymphocyte-receptor repertoire of infiltrating T lymphocytes into NOD mouse
      pancreas.
AB  - This study analyzed T-lymphocyte-receptor V beta genes of infiltrating
      lymphocytes into the pancreases of 12- to 16-wk-old NOD mice with severe
      insulitis and 5-wk-old mice with mild insulitis by the quantitative polymerase
      chain reaction method. The V beta transcripts on infiltrating T lymphocytes into
      pancreases with severe insulitis in older NOD mice were diverse. In contrast, the
      V beta 11 gene transcript was predominantly expressed on T lymphocytes in the
      pancreas in younger NOD mice with mild insulitis, suggesting the possible role of
      V beta 11+ T lymphocytes in triggering insulitis in this species.

PMID- 1756900
TI  - Effects of tryptophan on depression and aggression in STZ-D mice.
AB  - Streptozocin-induced diabetic (STZ-D) mice have reduced brain concentrations of
      tryptophan, a precursor substance for 5-hydroxytryptamine, and show lengthened
      immobility in Porsolt's swim test, a putative animal model of depression. This
      study investigated whether tryptophan affects behavior in Porsolt's swim test in
      STZ-administered male National Institutes of Health Swiss mice. In addition, the
      effect of tryptophan on behavior in the resident-intruder test of aggression was
      studied. Tryptophan is effective in the treatment of mild depression and may
      reduce aggressive behavior. Diabetes was induced with injection of 200 mg/kg body
      wt i.p. STZ. Two weeks after STZ treatment, the mice received 0, 50, and 100
      mg/kg i.p. tryptophan 60 min before the swim test. The STZ-administered mice
      exhibited lengthened immobility in the swim test, and tryptophan caused a dose
      related shortening in their immobility times. The control and STZ mice, which
      were isolated for 1 wk before the resident-intruder test, did not show any
      difference in the time spent in social investigation or aggressive or defensive
      behaviors. However, 100 mg/kg i.p. tryptophan 60 min before the test reduced the
      social interaction and aggressive behavior of the STZ-D mice but increased these
      behaviors in controls. Results indicate that tryptophan shortens the increased
      immobility time and reduces social and aggressive behavior in STZ-D mice.
      Therefore, the reported reductions in the brain-tryptophan concentrations in STZ
      D mice may participate in regulating their behavior.

PMID- 1756901
TI  - Aggregation of subclinical autonomic nervous system dysfunction and
      autoantibodies in families with type I diabetes.
AB  - The purpose of our study was to evaluate the occurrence of autonomic nervous
      system autoantibodies (ANS) in the nondiabetic family members of insulin
      dependent (type I) diabetic subjects. We studied 24 families, including 45
      nondiabetic parents and 53 nondiabetic siblings of a type I diabetic proband. One
      hundred one nondiabetic population control subjects were also studied. Stored
      sera from nondiabetic family members and control subjects were evaluated for the
      presence of complement-fixing (CF) adrenal medullary antibodies (CF-ADM),
      sympathetic ganglia antibodies (CF-SG), and vagus nerve antibodies (CF-V) by
      indirect immunofluorescence. HLA-DR3 and -DR4 typing was performed on 42
      nondiabetic family members and 104 diabetic subjects. One or more CF-ANS were in
      45 of 93 (40%) nondiabetic family members compared to 2 of 70 (2.8%) control
      subjects. CF-SG were in 28 of 92 (30%) family members compared to 0 of 101
      control subjects (P = 0.0001). CF-V were in 25 of 95 (26%) family members
      compared to 0 of 76 control subjects (P = 0.0001). CF-ADM were in 10 of 83 (12%)
      family members compared to 2 of 70 (2.8%) control subjects (P = 0.056). There was
      no HLA-DR3 or HLA-DR4 association with ANS. Subclinical autonomic dysfunction was
      demonstrated in 3 of 4 family members with autoantibodies compared to 0 of 4
      family members without autoantibodies.

PMID- 1756902
TI  - Decrease of stimulated amylin release precedes impairment of insulin secretion in
      type II diabetes.
AB  - Amylin, a 37-amino acid polypeptide, has been identified as the major protein
      component of pancreatic amyloid deposits in patients with non-insulin-dependent
      (type II) diabetes mellitus. Amylin is stored and released together with insulin
      and has been proposed to play a major role in the pathogenesis of type II
      diabetes. To compare amylin release and its proportion to insulin secretion under
      different metabolic conditions, oral and intravenous glucose tolerance tests
      (OGTT and IVGTT, respectively) were performed in healthy, lean control subjects,
      obese patients with normal and impaired glucose tolerance (NGT and IGT,
      respectively), and obese type II diabetic patients. Compared with control
      subjects, basal and stimulated amylin secretion during OGTT was significantly
      higher in obese patients with NGT and IGT but not in type II diabetic patients.
      The integrated amylin response was significantly higher in obese patients with
      NGT than lean control subjects and type II diabetic patients matched for degree
      of obesity. The amylin-insulin ratio decreased slightly in obese subjects with
      NGT and IGT and significantly in type II diabetic patients. Amylin secretion was
      significantly stimulated during IVGTT in control subjects and obese patients with
      NGT and IGT but not in type II diabetic patients. These findings suggest that
      amylin is physiologically released by pancreatic beta-cells in a constant ratio
      to insulin in nondiabetic subjects. Glucose-stimulated amylin secretion is
      increased in obese subjects with NGT and IGT. In type II diabetes mellitus,
      amylin secretion relative to that of insulin is decreased, and amylin is not
      stimulated by IVGTT.

PMID- 1756903
TI  - Intestinal and hepatic cholesterogenesis in hypercholesterolemic dyslipidemia of
      experimental diabetes in dogs.
AB  - We previously reported that dog diabetes results in hypercholesterolemia and the
      accumulation of a high-density lipoprotein (HDL) subclass, HDL1.
      Hypercholesterolemic diabetic rodents exhibit hyperphagia, intestinal
      hypertrophy, and increased intestinal cholesterol synthesis and absorption;
      intestinal 3-hydroxy-3-methylglutaryl (HMG) CoA reductase activity is increased,
      whereas hepatic activity is unchanged or reduced. To determine whether similar
      mechanisms operate in the hypercholesterolemic diabetic dog, we measured hepatic
      and intestinal cholesterologenesis. Streptozocin-alloxan-induced diabetic dogs
      allowed access to food ad libitum were hyperphagic and hypercholesterolemic (10.1
      vs. 4.47 mM) but normotriglyceridemic. Plasma HDL1 concentrations were markedly
      increased. Differences in renal and hepatic function were not statistically
      significant, except serum alkaline phosphatase, which was elevated 4-fold (P =
      0.0003). Urinary mevalonate, an index of whole-body cholesterol synthesis, was
      increased 6-fold. Intestinal and hepatic weights were both increased, and direct
      measurements showed crypt and villus thickening. The activity of HMG CoA
      reductase per gram organ weight was increased 1.7-fold in liver and 2.1-fold in
      intestine. Calculated whole-organ activity in intestine was nearly twice that in
      liver. These observations provide strong evidence that intestinal
      cholesterogenesis is involved in the pathogenesis of hypercholesterolemia in dog
      diabetes and support the conclusion that increased cholesterol synthesis plays a
      role in the hypercholesterolemia of diabetes.

PMID- 1756904
TI  - HLA-DQB1 alleles and absence of Asp 57 as susceptibility factors of IDDM in
      Finland.
AB  - It has been proposed that negatively charged aspartic acid at position 57 of the
      HLA-DQ beta-chain determines resistance to development of insulin-dependent
      diabetes mellitus (IDDM), whereas genetic susceptibility to IDDM correlates with
      a neutral amino acid residue. The disease rate is very low in Oriental
      populations with high frequencies of Asp 57. This raises a question whether the
      high incidence of IDDM in Finland could be explained by the distribution of this
      disease marker. In this study, the polymerase chain reaction products of 86
      diabetic patients and 115 nondiabetic control subjects were analyzed with seven
      sequence-specific oligonucleotide probes. Only 25.5% of the diabetic subjects
      were phenotyped as Asp 57+ compared to 82% of control subjects, which suggests
      that Asp 57 negativity is a definite risk marker for developing IDDM in Finnish
      patients. However, the susceptibility conferred by various non-Asp and Asp
      haplotypes was not equally strong: DQw8 was the most important risk marker and
      DQw6 the most protective one. The frequency of Asp 57+ DQw4 was similar in
      diabetic patients and control subjects. The highest genotype-associated relative
      risk was defined by DQw2/DQw8 heterozygosity (RR 91), whereas it was 13 for non
      Asp homozygosity. In the control subjects, the frequency of Asp 57+ phenotypes
      was higher than in several white populations with lower IDDM incidence figures.
      We conclude that the disease risk in Finland appears to be most strongly related
      to specific Asp 57- alleles, although other HLA- or non-HLA-associated genes may
      also contribute to IDDM susceptibility in this population.

PMID- 1756905
TI  - Decreased incorporation of long-chain fatty acids into erythrocyte phospholipids
      of STZ-D rats.
AB  - We studied the mechanisms for the altered fatty acid composition in erythrocytes
      (RBCs) derived from streptozocin-induced diabetic (STZ-D) rats. After 3-wk
      duration of diabetes, blood glucose, plasma triglyceride, and plasma free-fatty
      acid levels were all significantly increased. In the diabetic platelet-poor
      plasma (PPP), the most significant increases in free fatty acids were stearate,
      linoleate, eicosatrienoate (n-6), and docosahexaenoate (n-3). Fatty acid
      composition of RBC phospholipids was also altered, with significant decreases in
      arachidonate, docosatetraenoate (n-6), and docosapentaenoate (n-6) and increases
      in linoleate and docosahexaenoate. Insulin treatment of the diabetic rats
      resulted in normalization of docosapentaenoate, arachidonate, and linoleate
      levels in RBC phospholipids but not of docosahexaenoate or docosatetraenoate
      levels. The incorporation of [5,6,8,9,11,12,14,15-3H]arachidonate into diabetic
      RBC phospholipids was significantly decreased compared with the corresponding
      control RBC, regardless of the incubation medium used, which was the PPP derived
      either from the control or diabetic rats. Therefore, the decreased incorporation
      of [5,6,8,9,11,12,14,15-3H]arachidonate into diabetic RBC phospholipids was
      independent of the altered lipid composition of the PPP incubation media.
      Furthermore, the decreased incorporation was not specific for arachidonate,
      because the incorporation of other long-chain fatty acids such as [9,10
      3H]oleate, [1-14C]palmitate, [2-14C]eicosatrienoate (n-6), and [1-14C]linoleate
      into RBC phospholipids was also comparably decreased. More important, the
      decreased fatty acid incorporations were reversed by insulin treatment of the
      diabetic rat.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756906
TI  - Pioglitazone hydrochloride inhibits cholesterol absorption and lowers plasma
      cholesterol concentrations in cholesterol-fed rats.
AB  - Diabetes is associated with altered cholesterol metabolism that may contribute to
      cardiovascular complications. Treatment of rats with pioglitazone hydrochloride,
      a novel antidiabetic compound that improves the general response of target cells
      to insulin, significantly lowered cholesterol levels in rats fed a
      hypercholesterolemic diet and produced a significant reduction in cholesterol
      absorption. Drug treatment was ineffective in rats that were not given dietary
      cholesterol. To determine whether these effects of pioglitazone hydrochloride
      might be related to the known ability of this compound to improve the response to
      circulating insulin, similar studies were conducted in streptozocin-induced
      diabetic rats with and without insulin replacement. Diabetic rats absorbed a
      greater percentage of dietary cholesterol than control rats. Treatment of insulin
      deficient diabetic rats with pioglitazone alone did not affect cholesterol
      absorption; however, the combination of insulin and pioglitazone was synergistic
      to lower absorption of cholesterol and circulating cholesterol and triglycerides.
      Treatment of either normal rats or diabetic rats receiving insulin with
      pioglitazone hydrochloride produced a twofold decrease in the ratio of total
      cholesterol to high-density lipoprotein cholesterol. These results suggest that
      treatments that improve insulin sensitivity may also have a positive impact on
      coronary artery disease associated with diabetes.

PMID- 1756907
TI  - Insulinlike effects of sodium selenate in streptozocin-induced diabetic rats.
AB  - Treatment of streptozocin (STZ)-induced diabetic rats with sodium selenate (10-15
      mumol.kg-1.day-1) for 7 wk resulted in a decrease in plasma glucose, food intake,
      and water intake to control or near control levels. Plasma insulin was reduced in
      control rats given sodium selenate to the level found in the diabetic and treated
      diabetic group. Treatment did not affect control rats with regard to the other
      measurements cited. Sodium selenate enhanced weight gain in responding diabetic
      rats to that seen in controls; sodium selenate's actions thus resembled those of
      insulin. Thus selenate, like vanadium, appears to have insulinlike effects when
      administered in vivo.

PMID- 1756908
TI  - Risk of IDDM in children of diabetic mothers decreases with increasing maternal
      age at pregnancy.
AB  - Offspring of women with insulin-dependent diabetes mellitus (IDDM) have a
      significantly lower risk of IDDM than the offspring of men with IDDM.
      Furthermore, a negative association of the risk of IDDM in the offspring with
      maternal age at delivery has been reported. This study tested the association
      with maternal age in an independent set of families (n = 103) in which the mother
      had at least one pregnancy before and after the onset of IDDM. In the 304
      offspring, the mean +/- SE risk of IDDM by age 20 was 6.0 +/- 2.4% for those born
      at maternal ages less than 25 yr, whereas, the risk was significantly lower (0.7
      +/- 0.7%) for those born at older maternal ages (P = 0.03). These 304 offspring
      were combined with a sample of 1391 offspring previously reported for a
      multivariate analysis of other factors related to pregnancy. In the combined
      analysis, the risk of IDDM in offspring born at maternal ages greater than 25 yr
      was one-fifth that for offspring born to younger mothers. The risk of IDDM in the
      offspring was not significantly related to birth order, mother's age at first
      pregnancy, or the interval between pregnancies for subsequent ones. The risk for
      the children born before the mother's onset of diabetes was higher than that for
      those exposed in utero to her diabetes, but the difference did not reach
      statistical significance. In conclusion, although genetic factors are important
      determinants of susceptibility to IDDM, exposure to maternal diabetes protects
      offspring from IDDM during the first 2 decades of life.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1756909
TI  - Charge selectivity of proteinuria in type I diabetes explored by Ig subclass
      clearance.
AB  - To investigate the role of protein charge in early diabetic proteinuria, the
      clearance of proteins differing in charge and/or size (anionic and cationic Igs,
      albumin) was evaluated in 98 insulin-dependent (type I) diabetic patients
      selected as a representative sample of the 418 patients attending our clinics. Of
      the patients, 12.9% were microalbuminuric and 4.8% were macroalbuminuric. Anionic
      and total IgG clearances were significantly increased in 30.6 and 12.2% of
      patients and were correlated with duration of disease. Anionic IgG4 clearances
      were increased in patients (9.2%) with normal IgG excretion, suggesting that
      charge-selectivity impairment is responsible for protein loss. Anionic Ig
      clearances were also higher in some patients (14.3%) with normal albumin
      clearance, probably as a result of different glomerular filtration and/or tubular
      reabsorption. The anionic-cationic IgG clearance ratio tended to increase in
      parallel with albumin clearance, but once above macroalbuminuric levels, it
      tended to fall again, indicating the concomitant presence of size-selectivity
      loss. The anionic IgG clearance and the anionic-cationic IgG ratio, in addition
      to albumin excretion, may be valuable in assessing early kidney protein charge
      selectivity impairment and better characterizing normoalbuminuric patients and
      those in the preclinical stage of diabetic nephropathy.

PMID- 1756910
TI  - Islet amyloid polypeptide and insulin secretion from isolated perfused pancreas
      of fed, fasted, glucose-treated, and dexamethasone-treated rats.
AB  - Rats from four experimental treatment groups, including fed controls, 24- to 30-h
      fasted, dexamethasone-treated, and intraperitoneal glucose-treated, were used to
      assess the effects of these treatments on the immunohistochemically detectable
      islet amyloid polypeptide (IAPP) content in the pancreatic islets. Isolated
      perfused pancreases from additional animals in these groups were used to assess
      insulin and IAPP secretion and relative amounts of these hormones secreted into
      the perfusate under low-glucose (2.75 mM) and high-glucose (16.7 mM) conditions.
      Insulin and IAPP concentrations in the perfusate were measured by
      radioimmunoassays. Titration of immunohistochemical staining revealed the highest
      levels of IAPP in the dexamethasone- and glucose-treated groups, followed by the
      fed controls; the least amount was observed in the fasted group. In the perfusion
      experiments, the dexamethasone-treated group had significantly higher IAPP
      secretion than did all of the other groups under stimulation with 16.7 mM
      glucose. In addition, both dexamethasone treatment and glucose treatment
      increased the relative amount of IAPP to insulin secretion during 16.7 mM glucose
      stimulation in comparison with fed controls and fasted groups. Fasting tended to
      have the opposite effect and significantly decreased the relative amount of IAPP
      to insulin secreted under stimulation with 16.7 mM glucose. In all groups, IAPP
      and insulin secretion were generally parallel, which is consistent with their
      colocalization in the beta-cell secretory vesicle and co-release after glucose
      stimulation. However, significant differences in the insulin-IAPP ratios between
      experimental groups is consistent with the hypothesis that production of IAPP and
      insulin are regulated differently in the beta-cell.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1756911
TI  - Enhanced stimulation of diacylglycerol and lipid synthesis by insulin in
      denervated muscle. Altered protein kinase C activity and possible link to insulin
      resistance.
AB  - Denervated muscle is generally regarded as insulin resistant because the ability
      of insulin to stimulate glucose transport and glycogen synthesis is impaired.
      Previous studies indicate that insulin resistance in these muscles is likely due
      to a defect at a postreceptor site in the signaling pathway. Because glucose
      transport into cells has been reported to be linked to changes in diacylglycerol
      (DAG) and protein kinase C (PKC), we investigated the effect of denervation on
      the content and synthesis of DAG and the activity and distribution of PKC in the
      soleus muscle. The DAG content in muscles denervated for 24 h was 40% greater
      than in control muscles. This was associated with a two- to threefold increase in
      the percentage of total PKC activity that was membrane associated, with no
      significant change in total PKC activity, suggesting an increase in PKC activity
      in vivo. Studies of glucose disposition confirmed that the stimulation of
      glycogen synthesis by insulin and, to a lesser extent, 2-deoxyglucose uptake were
      impaired by denervation. However, the stimulation by insulin of glucose
      incorporation into DAG and other lipids was two- to threefold greater in
      denervated than in control muscles, and conversion of glucose to lactate and
      pyruvate and glucose oxidation to CO2 were unchanged. The results reveal a
      dichotomy in the effects of denervation on various actions of insulin, with both
      insulin resistance and hyperresponsiveness occurring in different pathways of
      glucose metabolism. They also reveal a potential mechanism for the elevation of
      muscle DAG after denervation. The results do not support a direct link between
      DAG-PKC and glucose transport.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756912
TI  - Molecular scanning of insulin-responsive glucose transporter (GLUT4) gene in
      NIDDM subjects.
AB  - We investigated the prevalence of mutations in the gene encoding the major
      insulin-responsive facilitative glucose transporter (GLUT4) in patients with non
      insulin-dependent diabetes mellitus (NIDDM). All 11 exons of the GLUT4 gene from
      30 British white subjects with NIDDM were amplified using the polymerase chain
      reaction and screened for nucleotide sequence variation using the single-stranded
      conformation polymorphism (SSCP) method. No variation between the study subjects
      was detected in exons 1-3, 4b-8, and 10. Variant SSCP patterns were detected in
      exons 4a and 9. SSCP variation in exon 4a was revealed by direct nucleotide
      sequencing to be due to a common silent polymorphism (AAC----AAT at Asn130). One
      NIDDM patient demonstrated a variant SSCP pattern in exon 9. This was caused by a
      point mutation (GTC----ATC) at codon 383, which leads to the conservative
      substitution of isoleucine for valine in the putative fifth extracellular loop of
      the transporter. Allele-specific oligonucleotide hybridization was used to
      examine the frequency of this mutation in 240 Welsh white subjects (160 with
      NIDDM and 80 controls). The Val----Ile383 mutation was found in the heterozygous
      state in two diabetic subjects and no control subjects. We conclude that
      mutations of the GLUT4 coding sequence are very uncommon in this population of
      subjects with typical NIDDM. Determining whether the Ile383 GLUT4 variant present
      in 3 diabetic subjects contributes in any way to their disease will require
      further study.

PMID- 1756913
TI  - Comparative analysis of potency of splenic dendritic and adherent cells
      (macrophages) as alloantigen presenters in vivo.
AB  - Dendritic cells and macrophages have been attributed with stimulatory capacity
      for in vivo and in vitro immune responses. However, the relative contribution of
      each of these cell types has long been in dispute. Therefore, the differential
      ability of dendritic cells and macrophages (splenic adherent cells [SACs]) to
      stimulate pancreatic islet allograft rejection in reversed alloxan-induced
      diabetic rats was examined. Rats bearing established allografts were challenged
      with various dosages of donor-strain dendritic cells or SACs, and graft rejection
      was assessed by analysis of plasma glucose levels and/or histological criteria.
      Marked differences in the ability to stimulate allograft rejection were observed
      at the 10(5)-cell dosage; 10(5) dendritic cells induced graft rejection in five
      of six rats (1 rat required 2 injections), whereas 10(5) SACs failed to induce
      rejection in four of four rats (P less than 0.10, chi 2 test). Challenge stimuli
      consisting of less than or equal to 10(5) SACs or less than or equal to 10(4)
      dendritic cells failed to induce graft rejection. These findings indicate that
      dendritic cells are potent stimulator cells for in vivo immune responses.
      Previous studies indicated that as few as 10(3) dendritic cells initiate
      allograft rejection in nondiabetic recipients. That more dendritic cells were
      required to stimulate rejection in reversed diabetic recipients compared with
      nondiabetic recipients suggests that other factors, such as the diabetic state
      and the production of a tolerant status achieved by larger amounts of grafted
      tissue, may influence graft survival.

PMID- 1756914
TI  - Association of elevated IGF-I levels with increased retinopathy in late-onset
      diabetes.
AB  - Insulinlike growth factor I (IGF-I) has been suggested to play a role in the
      pathogenesis of proliferative diabetic retinopathy (PDR). We determined IGF-I
      levels in subjects in a large population-based study of 928 people with diabetes
      diagnosed at 30 yr of age or older. PDR was found in 15.7% of the insulin-using
      group (n = 517) and in 2.8% of those not using insulin (n = 397). The mean serum
      level of IGF-I was 208 micrograms/L in individuals using insulin and 222
      micrograms/L in those not using insulin, both significantly lower than in a
      nondiabetic comparison group (278 micrograms/L, P less than 0.0001). Logistic
      regression analysis was used to examine the relationship between IGF-I and PDR
      while controlling for other factors associated with the presence of PDR. After
      controlling for duration of diabetes, glycosylated hemoglobin, systolic blood
      pressure, presence of proteinuria, and age at diagnosis, higher levels of IGF-I
      were significantly associated with an increased frequency of PDR (P = 0.025) in
      the group using insulin. In individuals not using insulin, higher levels of IGF-I
      were associated with an increased frequency of PDR or moderate non-PDR (P =
      0.08). These data suggest that higher IGF-I levels may be a risk factor for the
      development of severe retinopathy in people with diabetes diagnosed at 30 yr of
      age or older.

PMID- 1756915
TI  - Impaired expression of glycogen synthase mRNA in skeletal muscle of NIDDM
      patients.
AB  - Based on recent studies of the abnormal physiology and biochemistry of the
      glycogen synthesis in skeletal muscle of non-insulin-dependent diabetes mellitus
      (NIDDM) patients and their first-degree relatives, the key enzyme of this
      pathway, glycogen synthase (GS), is considered a candidate gene in the
      pathogenesis of insulin resistance. Comparing matched groups of 14 NIDDM patients
      with 14 control subjects, we found that impaired insulin-stimulated nonoxidative
      glucose metabolism of peripheral tissue (P less than 0.02) and reduced total GS
      activity (P less than 0.05) of vastus lateralis muscle from patients with NIDDM
      were accompanied by a 39% reduction (P less than 0.02) in the steady state level
      of GS mRNA per microgram DNA of muscle. In both diabetic and control subjects,
      the mRNA expression of GS was unaffected after euglycemic-hyperinsulinemic clamp
      for 4 h. With single-stranded conformation polymorphism analysis of the entire
      coding sequence of the GS gene, we were unable to detect any genetic variants in
      a subset of eight NIDDM patients. We conclude that abnormal pretranslational
      regulation of the GS gene may contribute to impaired glycogen synthesis of muscle
      in NIDDM. Our studies give no evidence for structural changes in the coding
      region of the GS gene, and it is unknown if the decreased mRNA expression is due
      to impaired transcription or accelerated degradation of the transcript.

PMID- 1756916
TI  - Improved patient care using the A/S/G/E guidelines on quality assurance: a
      prospective comparative study.
AB  - The American Society for Gastrointestinal Endoscopy has promulgated guidelines on
      quality assurance in gastrointestinal endoscopy. Thorough documentation of
      endoscopy reports and a peer review process were strongly recommended. We
      evaluated 1408 dictated endoscopy and colonoscopy reports for deficiency in
      reference to the guidelines during three periods: 6 months before (group 1), 6
      months after the application of the guidelines (group 2), and 5 months of
      intensive peer review process (group 3). Deficiency was defined as lack of
      documentation of at least 1 of the 10 parameters that should be included in
      endoscopy reports according to the guidelines. There was a significant decrease
      in deficiency rates in groups 2 (91.6%) and 3 (32.7%) compared with group 1
      (99.8%) (p less than 0.01). Peer review and direct confrontation of the
      endoscopists with their deficiencies significantly reduced the use of
      inappropriate indication for endoscopy (1.5%/group 3 vs. 5.2%/group 1, p less
      than 0.01). Adherence to the A/S/G/E guidelines on quality assurance improved
      documentation, decreased inappropriate use of endoscopy, and may thus improve
      quality of care.

PMID- 1756917
TI  - Herpes esophagitis: clinical syndrome, endoscopic appearance, and diagnosis in 23
      patients.
AB  - The unexpected diagnosis of herpetic esophagitis in a patient with nausea led us
      to review our experience with this disease. Review of our records from 1979 to
      1989 produced 23 cases proven by endoscopic culture or microscopic examination
      (Cowdry-type A inclusions), the largest such series reported to date. Twenty-two
      of the 23 patients were immunocompromised. Odynophagia and chest pain were each
      present in half of the cases, but 26% of patients had neither. Gastrointestinal
      bleeding was attributable to herpetic esophagitis in 30%. Thirty percent of
      patients had disseminated herpes simplex infection and 70% had simultaneous
      infections with other organisms. Endoscopic findings included nonspecific
      inflammation, discrete ulcers, coalescent ulcers, and pseudomembranous
      esophagitis. Herpes virus was not suspected endoscopically as the cause of
      esophagitis in 30% of cases. Culture was slightly more sensitive than microscopic
      examination for diagnosis (89% vs. 76%), but both methods should be employed in
      any immunocompromised patient with esophagitis.

PMID- 1756918
TI  - Follow-up of hot biopsy forceps treatment of diminutive colonic polyps.
AB  - Although the hot biopsy technique is widely used to treat diminutive colon
      polyps, there is concern over its efficacy and safety. Our study involved 39
      patients undergoing routine colonoscopy in whom 62 diminutive polyps were found
      in the rectosigmoid. These lesions were treated with hot biopsy forceps in the
      standard manner. Flexible sigmoidoscopy was repeated 1 and 2 weeks later with the
      original treatment sites being identified. Eleven of the 62 sites (17%) revealed
      persistent viable polyp remnants, indicating incomplete treatment. In terms of
      safety, there were no clinical complications in this small study and most post
      biopsy ulcers were healed by 2 weeks. This study shows that the hot biopsy
      technique may be unreliable in eradicating diminutive colon polyps.

PMID- 1756919
TI  - Randomized comparison of endoscopic microwave coagulation and endoscopic
      sclerosis in the treatment of bleeding peptic ulcers.
AB  - We conducted a prospective randomized trial to evaluate the effectiveness and
      safety of endoscopic microwave coagulation in comparison to endoscopic sclerosis
      in the treatment of peptic ulcer bleeding. Over 15 months 127 ulcer-bleeding
      patients with an actively bleeding vessel (N = 21), a non-bleeding vessel (N =
      53), oozing hemorrhage (N = 25), or an adherent clot (N = 28) in the ulcer base
      were randomly assigned during endoscopy to receive treatment with endoscopic
      sclerosis or with microwave coagulation. There were no significant differences in
      effectiveness between endoscopic sclerosis and microwave coagulation in any of
      the assessed parameters: the percentage of patients with major recurrent
      hemorrhage (5 vs. 12), the percentage who needed emergency surgery (5 vs. 9), the
      mean (+/- SD) transfusion requirements (0.32 +/- 0.89 vs. 0.78 +/- 1.65), the
      mean number of hospital days (10.3 +/- 3.5 vs. 10.7 +/- 4.1), and the number of
      deaths due to bleeding (0 vs. 2) were similar in both groups. No case of
      perforation occurred in either group. The data suggest that microwave coagulation
      is as effective and safe as endoscopic sclerosis in the treatment of bleeding
      peptic ulcers.

PMID- 1756920
TI  - Evaluation of a voice recognition system for generation of therapeutic ERCP
      reports.
AB  - We evaluated a computerized report-generating system using voice recognition
      technology (EndoSpeak) for producing therapeutic ERCP reports. For 30 consecutive
      ERCP cases, reports using both EndoSpeak and standard dictation were generated at
      the end of the procedure. The cases were scored for overall difficulty and the
      number of component procedures performed. The time to generate a report with
      EndoSpeak was significantly longer than with dictation (10.0 +/- 2.9 (SD) min vs.
      6.5 +/- 1.6 min, p less than 0.0001), and this difference was greater for more
      lengthy reports (r = 0.85, p less than 0.001). The procedure difficulty score and
      the number of component procedures were both significant predictors of the
      physician's report generation time for EndoSpeak and dictation. Dictated reports
      were judged to have a higher information content than EndoSpeak reports for 90%
      of the cases (p less than 0.00001). Several specific difficulties were
      encountered with the EndoSpeak software. Although EndoSpeak offers promise,
      substantial software modifications will be required before this system can become
      competitive with dictation for therapeutic ERCP reports.

PMID- 1756921
TI  - A pure charcoal suspension for colonoscopic tattoo.

PMID- 1756922
TI  - Sclerotherapy using a small size negative pressure-controlled tube.

PMID- 1756923
TI  - Anastomosis at flexible endoscopy: an experimental study of compression button
      gastrojejunostomy.

PMID- 1756924
TI  - Removal of a broken pancreatic stent using a new stent retrieval device.

PMID- 1756925
TI  - Splenic injury complicating therapeutic upper gastrointestinal endoscopy and
      ERCP.

PMID- 1756926
TI  - Endoscopic management of a bleeding duodenal diverticulum.

PMID- 1756927
TI  - Proximal common bile duct obstruction secondary to a periampullary duodenal
      diverticulum: successful treatment with endoscopic stenting.

PMID- 1756928
TI  - Recurrent acute pancreatitis in pancreas divisum secondary to minor papilla
      obstruction from a gastrostomy feeding tube.

PMID- 1756929
TI  - Quality assurance and patient care.

PMID- 1756930
TI  - American gastroscopy--yesterday and today.

PMID- 1756931
TI  - Needle knife sphincterotomy.

PMID- 1756932
TI  - Earlier report of Mallory-Weiss tear with colonic lavage.

PMID- 1756933
TI  - Treatment of achalasia.

PMID- 1756934
TI  - A method to overcome dilator placement failure in achalasia patients with
      markedly dilated esophagus.

PMID- 1756935
TI  - Warm your contrast.

PMID- 1756936
TI  - Condyloma, condylomata, and Latin grammar.

PMID- 1756937
TI  - Patient positioning during colonoscopy.

PMID- 1756938
TI  - Guidelines for establishment of gastrointestinal endoscopy areas.

PMID- 1756939
TI  - Tissue sampling and analysis.

PMID- 1756940
TI  - Proctoring and hospital endoscopy privileges.

PMID- 1756941
TI  - Technology assessment and the A/S/G/E position statement.

PMID- 1756942
TI  - A/S/G/E status evaluations on new or emerging endoscopic technologies.

PMID- 1756943
TI  - Technology assessment status evaluation: endoscopic band ligation of varices.
AB  - On the basis of limited available data, band ligation appears to be effective for
      control of active esophageal variceal bleeding and for prevention of recurrent
      bleeding. It has minimal morbidity and no reported mortality. Preliminary results
      of a randomized-trial comparing this technique to sclerotherapy show comparable
      efficacy but band ligation may carry a lower complication rate. Long-term results
      of ligation are pending.

PMID- 1756944
TI  - Status evaluation: enteroscopy.
AB  - Enteroscopy is a method to examine the small bowel mucosa beyond the reach of
      standard upper endoscopes. In practice it has primarily been used to search for a
      bleeding lesion in patients where one is not detected by conventional means. Such
      patients constitute only a small percentage of those who bleed (15,20).
      Experience is greatest with push enteroscopy. Examination of the distal duodenum
      and proximal jejunum using a standard or pediatric colonoscope is practical,
      appears to be safe and provides a satisfactory diagnostic and therapeutic yield
      in experienced hands. Longer designated push enteroscopes are under
      investigation. Sonde type enteroscopes can be passed to the ileum in most cases.
      A cause for bleeding can be detected in approximately one-quarter to one-third of
      individuals with minimal morbidity. Certain technical problems limit their
      efficacy and their role in the evaluation of patients with bleeding has not yet
      been clearly defined.

PMID- 1756945
TI  - Power of the admixture test to detect genetic heterogeneity.
AB  - Several dominant genetic diseases which appear to be homogeneous are the
      expression of genetic mutations at several loci. The power to detect linkage by
      likelihood methods is diminished for heterogeneous, as compared to genetically
      homogeneous, disorders. Using a simulation approach and two pedigrees typical of
      those available for the study of a dominant disease (with expected lod scores of
      0.43 and 1.00 at theta = 0.05 and PIC = .59), I have evaluated the power to
      detect genetic heterogeneity by using the admixture test. Linkage power was
      determined by varying the number of families available for study, the
      recombination fraction (theta), the informativity of the hypothetical marker, and
      the proportion of linked families, alpha. For moderate and small values of alpha
      it is feasible to detect genetic heterogeneity once linkage has been established;
      rarely will it be possible to detect linkage and heterogeneity simultaneously
      given a limited number of small or moderate pedigrees.

PMID- 1756946
TI  - Informativeness of twin-nuclear family and nuclear family designs for segregation
      analysis.
AB  - This brief note examines the precision of segregation parameter estimates from
      both twin-nuclear family and conventional nuclear family designs. The program
      MENDEL was used to derive expected frequencies of different family patterns of
      affectation (with fixed sibship size) under various single gene models, and then
      to estimate the standard errors (and information) associated with gene frequency
      and penetrance values at given sample sizes. As might be expected, a 2- to 5-fold
      increase in relative efficiency was found for the same family size if families
      included an MZ twin pair among their offspring. The methods used allow convenient
      calculation of expected informativeness of a given study design.

PMID- 1756947
TI  - Inheritance of human plasma dopamine-beta-hydroxylase thermal stability.
AB  - Although the structural gene for human dopamine-beta-hydroxylase (DBH) has been
      cloned, the mechanism by which DBH physical properties and activity are regulated
      is not well understood. Previous reports have suggested that three-allele or two
      locus models may account for the genetic regulation of these traits in human
      blood. It is an interesting challenge to determine the extent to which
      quantitative analyses will complement or guide molecular genetic studies. In this
      study we analyzed data on the physical property of DBH thermal stability and DBH
      activity in 230 individuals in 53 families in an attempt to clarify genetic
      mechanisms for the inheritance of these traits. Commingling and segregation
      analyses of the thermal stability data provided the first clear evidence of a
      major gene polymorphism for DBH thermal stability analyzed as a quantitative
      trait. Major gene transmission was supported within a mixed model (chi 2[3] =
      13.39, P less than .004). In keeping with earlier findings, similar analyses of
      DBH activity provided strong evidence of genetic transmission. However, in our
      data support for a major gene polymorphism was equivocal (chi 2(2) = 2.99, P =
      .22).

PMID- 1756948
TI  - Genetic epidemiology of childhood brain tumors.
AB  - The study goal was to determine the genetic (heritable) contribution to childhood
      brain tumors (CBT) which cause nearly one quarter of all childhood cancer deaths.
      Their etiology remains unknown, but previous studies have suggested a proportion
      of CBT may be heritable. In this study we collected family histories of 243
      confirmed CBT patients referred to The University of Texas M. D. Anderson Cancer
      Center between the years 1944 and 1983, diagnosed before age 15, and residents of
      the United States or Canada. Family histories were obtained for all the probands'
      first degree relatives (parents, siblings, and offspring) and extended to include
      selected second degree relatives (aunts, uncles, grandparents) using sequential
      sampling. To determine if these CBT families exhibited excess cancer, we compared
      their cancer experience to age-, race-, sex-, and calendar-year specific rates
      from the Connecticut Tumor Registry. No cancer excess was observed among 1,099
      first and second degree relatives [39 cancers observed (O) and 44 expected (E)
      for a standardized incidence ratio (SIR) of 0.88]. For colon cancer, although
      small numbers, five cases were observed among the probands' first degree
      relatives with 1.6 expected, for a significant SIR of 3.10. Segregation analysis
      demonstrated that chance alone could not account for the observed cancer
      distribution with a multifactorial model providing the best overall explanation
      of the data. Overall, heredity played a role in the etiology of CBT in 4% of the
      study families: four (1.7%) due to known hereditary syndromes (nevoid basal cell
      carcinoma syndrome and von Recklinghausens neurofibromatosis--NF-1), four (1.7%)
      with multifactorial inheritance, and two additional families with cancers
      aggregating similar to the clinical criteria described for the Li-Fraumeni cancer
      family syndrome.

PMID- 1756949
TI  - Linkage analysis of low-density lipoprotein subclass phenotypes and the
      apolipoprotein B gene.
AB  - A common heritable phenotype has recently been identified which is characterized
      by a relative abundance of small, dense low-density lipoproteins (LDL), and mild
      elevations of plasma triglycerides and reductions in plasma high-density
      lipoproteins (HDL) cholesterol. This phenotype, designated LDL subclass phenotype
      B, has been associated with up to a three-fold increase in coronary disease risk.
      Complex segregation analysis in two large family studies has demonstrated that
      LDL subclass phenotype B is influenced by an allele at a single genetic locus
      with a population frequency of 0.25-0.3, and autosomal dominant inheritance, but
      with full penetrance only in males age 20 and over and in postmenopausal women.
      Since apolipoprotein B (apoB) is the principal protein component of LDL, linkage
      analysis was used to investigate possible linkage between the phenotype B
      phenotype and the apoB gene, using a variable number of tandem repeats site
      located 0.5 kb from the 3' end of the apoB gene. In 6 informative families
      including only family members in the penetrant classes, a total LOD score of 
      7.49 was found at a recombination fraction of 0.001. Thus, under the assumptions
      of the single gene model, it is unlikely that the apoB locus controls LDL
      subclass phenotype B.

PMID- 1756950
TI  - Commentary: the affected sib-pair method in the context of an epidemiologic study
      design.
AB  - The purpose of this commentary is to provide a framework for using the well-known
      sib-pair methodology in the context of epidemiologic study designs. Using
      examples from the Pittsburgh family studies of insulin-dependent diabetes
      mellitus, we illustrate that the sib-pair method can be used in family-based
      epidemiologic studies. In a cohort study, unaffected relatives of probands
      ascertained from well-defined populations are followed for disease development.
      Disease risks are then stratified according to the number of alleles at one or
      more loci (0, 1, 2) that are identical by descent (ibd) with the proband. In the
      absence of linkage between the marker locus and the disease locus, disease risks
      are expected to be identical in the three groups. Measures of relative risk can
      be computed (with share-0 as baseline group). In a case-control study, relatives
      of probands that become affected (cases) are compared to a sample of relatives of
      probands that stay unaffected (controls) with respect to the number of alleles
      ibd with the proband. Measures of odds ratio can be computed (with share-0 as
      baseline group). In both cohort and case-control approaches, covariates including
      other genetic markers and environmental exposures can be evaluated in relation to
      disease risk and also for evidence of interaction with the specific marker of
      interest using stratified and multivariate analyses. Family-based epidemiologic
      studies allow investigators to study, in a single design, the role of
      environmental factors and specific gene loci in the etiology of diseases.

PMID- 1756951
TI  - Biological factors and psychometric intelligence: a review.
AB  - Results from a synthesis of correlations between psychometric intelligence and
      two physical traits, head size and body size, are reported. Within-family studies
      are reviewed for evidence of pleiotropy, the effect of a single genetic factor on
      two traits. Studies are also reviewed to determine whether prenatal effects bias
      twin studies, leading to underestimates of genetic influence. An N-weighted mean
      partial correlation (controlling height) of .10 between intelligence and head
      size was found. Using a method developed by Van Valen (1974), the correlation of
      intelligence and brain size was estimated as .29 based on all the
      intelligence/head-size studies of adults and adolescents, and .44 based on
      studies measuring intelligence with IQ tests. The N-weighted mean partial
      correlations (controlling age) of intelligence and height were .18 for children
      and .22 for adults. The within-family studies indicated that pleiotropy may
      contribute to the correlation of intelligence with head size and to the
      correlation of intelligence with body size. Prenatal effects are not an important
      source of bias in twin studies or for heritability estimates based on them.

PMID- 1756952
TI  - [Effect of ploidy and the status of the MAT locus in Saccharomyces cerevisiae
      yeast cells on the mitotic stability of episomal plasmids and the level of
      expression of the HBsAg gene of hepatitis B virus].
AB  - The frequency of the YEp13, pEF91, YEp13 + HBs, pNMVG3954 plasmids' elimination
      in a series of isogenic strains n. 2n and 3n was studied. Plasmid stability and
      the level of expression of the gene of hepatitis B surface antigen (HBsAg)
      increased in polyploid transformants as a result of increase in plasmid copy
      number. Heterozygotes MATa/MAT differed from the homozygotes in higher stability
      of YEp13, pEF91, and YEp13 + HBs plasmids having the same quantity of the HBsAg
      antigen. The appearance of negative properties--destabilization of episomal
      plasmids or decrease in synthesis of heterologous protein have been discovered in
      certain diploid cell. These results point to limitations in constructing a
      polyploid producer on the basis of the similar type of genome.

PMID- 1756953
TI  - [Expression of the pro-opiomelanocortin gene in rats with inherited arterial
      hypertension].
AB  - Expression of pro-opiomelanocortin (POMC) gene in pituitary of rats from newly
      developed hypertensive strain (ISIAH strain) was studied by dot hybridization.
      The pUC8 plasmid containing 900 base pair (bp) segment or the human POMC gene
      corresponding to the major portion of the 3'-nontranslated mRNA region and 60 bp
      coding for the signal peptide, was used as a probe for hybridization. It was
      found that the expression of the POMC in pituitary of the hypertensive JSJAH rats
      was more than 3-fold gene lower as compared to normotensive Wistar strain. The
      latter is the original strain from which the ISIAH rats were bred. The mechanism
      of this phenomenon and its possible relation to the arterial hypertension are
      discussed.

PMID- 1756954
TI  - [The interrelation of the polytene chromosomes of generative tissues in
      Drosophila melanogaster].
AB  - The principles of three dimensional organization of primary and secondary orders
      polytene chromosomes in ovarian nurse cells of Drosophila melanogaster were
      elucidated. Contrary to somatic tissues, no joining of chromosome arms into local
      chromocentre was discovered. The chromosomes are separated in the nuclear space
      and are attached to the nuclear envelope by the centromeric (and the XL arm--by
      the telomeric) sites, the arms of autosomes (especially primary polytene
      chromosomes) being separated in the area of attachment. Polytenized XR arm of the
      X chromosomes were discovered. The architecture of chromosomes discovered in
      ovarian nurse cells is tissue-specific and differs considerably from the
      organization of polytene chromosomes of somatic tissues.

PMID- 1756955
TI  - [Interspecies differences of co-orientation of primary polytene chromosomes in
      ovarian nurse cells in Drosophila melanogaster, D. simulans and D. mauritiana].
AB  - Essential differences in the architecture of primary polytene chromosomes in
      ovarian nurse cells between Drosophila melanogaster, D. simulans and D.
      mauritiana were discovered. The individual chromosomes of D. melanogaster (as
      well as their arms) are separated significantly from each other and are attached
      to the nuclear envelope by the centromeric (and the XL arm--by the telomeric)
      sites. D. simulans has the combination of the centromeric parts of the
      chromosomes X, 2, 3 into the "elongated" chromocentre, and in addition, the arms
      of chromosomes are also separated and attached to the nuclear envelope. Unlike
      the rest of the chromosomes, D. mauritiana has the chromosome 3 with firm
      combinated arms and the large heterochromatic block in the centromere, without
      being attached to the nuclear envelope.

PMID- 1756956
TI  - [Genetic recombination and steroid metabolism in Drosophila].
AB  - A double-species ecologo-genetical model, including Drosophila and yeast, has
      been used as a new methodological instrument for investigation of the
      physiological mechanism of recombination. Incubation of Drosophila females in the
      medium containing yeast of the strain mutant for ergosterol synthesis leads to
      suppression of temperature-induced crossing over. The mass-spectrum analysis of
      steroid fraction from Drosophila females has shown that incubation of the yeast
      medium without ergosterol results in arrest of ecdysterone synthesis. These data
      are explained by the absence of ecdysterone synthesis precursor in the fly
      organism. The endocrinal control of crossing over is discussed in the light of
      hormonal regulation of meiosis.

PMID- 1756957
TI  - [Genotypic differences in the level of N-acetyltransferase activity in mice of
      inbred lines and their hybrids].
AB  - There are "slow" and "rapid" acetylator phenotypes in mice according to N
      acetyltransferase activity (E.C. 2.3.1.5) (N-AT). The results of direct, back-
      and reciprocal crosses of mice lines with rapid acetylation phenotype (C57BL/He)
      show monogenic autosomic control of acetylation locus (Ac) with rapid allele
      dominance and sex dependence upon N-AT activity in males. So, genetic
      polymorphism according to the Ac locus exists in mice as well as in some other
      animal species and in humans. The results obtained in this study demonstrated the
      correlation between the N-AT level in mice and their predisposition to malignant
      tumors as well as dependence of cyclophosphamide action on the N-AT activity upon
      the genotype of an individual, which suggests a certain role of the Ac locus in
      tumor development.

PMID- 1756958
TI  - [Adaptive norm and stabilizing selection for anthropometric characters at birth].
AB  - Analysis carried out on medical documentation containing data on several thousand
      healthy and affected babies has revealed patterns of differential mortality and
      differential morbidity for newborns and infants which allow to estimate relative
      risk as a function of birth weight and body length. Adaptive norm for
      anthropometric traits at birth was defined as the weight or length interval in
      which mortality/morbidity rates were lower than the overall population level. The
      intensity of stabilizing selection associated with birth weight calculated from
      these data is several times higher in the neonatal period than for the age
      interval 1-12 months. Neonatal mortality in more than 50% cases can be attributed
      to the effects of stabilizing selection associated with birth weight.

PMID- 1756959
TI  - [Empirical, free of genetic model, estimation of recurrence risks in
      multifactorial diseases: conditional probability approach].
AB  - Conditional probability approach in estimation of recurrence risks in sibships of
      different parental phenotypic matings with the different set of affected and
      normal siblings is considered. The formulae are presented for calculation of
      recurrence risks in cases of equal and different susceptibility of two sexes
      under different ways of sampling of family data: direct selection of offsprings
      through the parents; indirect selection of offsprings through affected siblings-
      the probands, under different ascertainment probability--from pi = 1.0
      ("exhaustive selection") up to pi----0 ("single selection"); for the case of
      different susceptibility of the two sexes a possibility of the differences in the
      ascertainment probabilities of men (pi m) and of women (pi w) is allowed, unlike
      "independent ascertainment model", which requires the constancy of pi. The case
      of multiple incompatible subforms is considered for estimation of the recurrence
      risks of the specified subforms. The methods of the risks estimation proposed are
      free of genetic models being universal both for classical mendelian traits (with
      the constant risks) and for multifactorial ones (with variable risks).

PMID- 1756960
TI  - [Excision repair does not protect Bacillus subtilis cells from inactivation by
      sunlight].
AB  - Exponentially growing Bacillus subtilis cells are highly sensitive to
      inactivating action of sunlight, the strain deficient in excision repair being
      every more sensitive than the uvr1 mutant. The inactivating effect is connected
      with the action of irradiation located in the left part of the spectrum (the
      whole UV region and some zones of the visible one). Increased sensitivity to
      sunlight disappeared when cells were exposed to sunlight in a liquid medium with
      casaminoacids (2 g/l). The inactivating effect was probably of photodynamic
      nature and was caused either by DNA lesions that were not removed by excision
      repair or by the damage which arose not in DNA.

PMID- 1756961
TI  - [A new case of a syndrome including marfanoid phenotype and craniostenosis].
AB  - A new case of the syndrome with craniosynostosis and Marfanoid features is
      reported. The data presented and the analysis of relevant literature are
      suggestive of a community of the Marfanoid features with clinical and genetic
      heterogeneity. The possibility to delineate the Marfanoid syndrome with
      craniosynostosis as a nosologic unit and its etiology are discussed.

PMID- 1756962
TI  - Genetic analysis of extra sex combs in the hybrids between Drosophila subobscura
      and D. madeirensis.
AB  - Drosophila subobscura and D. madeirensis are closely related species, the first
      distributed over a large area and the latter restricted to the island of Madeira.
      These species can hybridize in laboratory conditions, yielding fertile females
      and sterile males. Hybrid offspring show several phenotypic anomalies, including
      sex combs on the second and third pairs of legs in males. The extra sex comb
      trait is a homeotic transformation of the mesothoracic and metathoracic legs into
      prothoracic legs. This anomaly is observed almost exclusively in F1 males with
      D.madeirensis mothers. Analysis of backcross males shows that D.subobscura and
      D.madeirensis have diverged at a minimum of four autosomal loci affecting the
      extra sex comb anomaly. In addition, some incompatibility involving the X
      chromosome and/or a maternal effect is also implicated.

PMID- 1756963
TI  - Developmental stability in hybrids between the sibling species pair, Drosophila
      melanogaster and Drosophila simulans.
AB  - Drosophila melanogaster and its sibling species D.simulans were hybridized in the
      laboratory to test the hypothesis that developmental homeostasis in hybrids
      between two species having no prior gene flow would be significantly reduced.
      Developmental stability was assessed by measuring fluctuating asymmetry for three
      bilateral traits: sternopleural chaetae, wing length, and fronto-orbital plus
      frontal chaetae. Male F1 hybrids showed no decrease in developmental stability
      compared to males of parental species. Female hybrids showed significant
      fluctuating asymmetry compared to other flies. The results are discussed with
      respect to ideas about coadaptation and gene flow based upon previous studies of
      hybrid developmental stability.

PMID- 1756964
TI  - Differential flight activity among karyotypes: daily and weather-induced changes
      in chromosomal inversion polymorphism in natural populations of Drosophila
      subobscura.
AB  - The question is posed whether karyotype frequencies in the active fraction of
      Drosophila subobscura populations vary consistently in the course of a day, or in
      accordance with weather changes. Significant daily variation occurred in all
      chromosomes with the exception of the sex chromosome. The proportions of the
      karyotypes Ust/1+2 and Ist/st decreased from early to late morning and increased
      during the evening. Ist/1 displayed a complementary behaviour. The homokaryotypes
      Ost/st and Est/st decreased both during the morning and the evening. Weather
      disturbances caused a remarkable variation in the frequencies of the standard
      gene arrangements.

PMID- 1756965
TI  - Spectrum of mutations that occur under selective and non-selective conditions in
      E. coli.

PMID- 1756966
TI  - Molecular phylogeny of the subgenus Sophophora of Drosophila derived from large
      subunit of ribosomal RNA sequences.
AB  - RNA sequencing has been used to assess the relationships among species of the
      subgenus Sophophora of the genus Drosophila. Two divergent domains, D1 and D2, of
      the large ribosomal RNA (28S), totalling 550 nucleotides have been sequenced
      using the rRNA direct sequencing method. A tree has been reconstructed from the
      neighbor-joining algorithm and the confidence intervals were evaluated by the
      bootstrap procedure. Results have shown that the branching of the willistoni and
      saltans groups of the subgenus Sophophora is very ancient and probably predates
      that of the subgenus Drosophila. The other groups and subgroups of Sophophora are
      clustered in three main lineages: 1) the melanogaster and oriental subgroups; 2)
      the montium subgroup; 3) the ananassae subgroup of the melanogaster group
      clustered with the fima and obscura groups. Thus, in comparison with our results,
      several taxa of various ranks appear paraphyletic (the genus Drosophila, the
      subgenus Sophophora and the melanogaster group). Our biochemical phylogeny is
      only in partial agreement with the pattern of Throckmorton's radiations as well
      as with classical taxonomy, both based on morphological data.

PMID- 1756967
TI  - Tissue specific expression of the Drosophila Adh gene: a comparison of in situ
      hybridization and immunocytochemistry.
AB  - The tissue specific patterns for Drosophila melanogaster alcohol dehydrogenase
      (Adh) mRNA and protein expression were determined using in situ hybridization and
      immunocytochemical techniques. Alcohol dehydrogenase mRNAs were localized in thin
      sections of frozen tissue using the hybridization of single stranded RNA probes.
      Alcohol dehydrogenase protein was identified in frozen tissue samples using ADH
      antisera, a biotinylated secondary antibody, and streptavidin conjugated to
      horseradish peroxidase. In tissues such as fat body, gastric caeca, and adult
      cardiac valve, the patterns of expression for ADH protein and mRNA were
      identical. Other tissues such as oocytes, nurse cells, imaginal disks, and brain
      show levels of Adh mRNA that are lower than or equivalent to those observed in
      the previously mentioned tissues, but they exhibit little or no ADH protein. The
      lack of concordance between Adh mRNA and ADH protein expression in oocytes and
      nurse cells may reflect the packaging of maternal mRNAs (but not ADH protein) for
      use in early development. The reason(s) for the other discrepancies in protein
      and mRNA expression are not known at this time but may be due to post
      transcriptional regulation in these specific tissues.

PMID- 1756968
TI  - Cloning, overexpression and nucleotide sequence of a thermostable DNA ligase
      encoding gene.
AB  - Thermostable DNA ligase has been harnessed for the detection of single-base
      genetic diseases using the ligase chain reaction [Barany, Proc. Natl. Acad. Sci.
      USA 88 (1991) 189-193]. The Thermus thermophilus (Tth) DNA ligase-encoding gene
      (ligT) was cloned in Escherichia coli by genetic complementation of a ligts 7
      defect in an E. coli host. Nucleotide sequence analysis of the gene revealed a
      single chain of 676 amino acid residues with 47% identity to the E. coli ligase.
      Under phoA promoter control, Tth ligase was overproduced to greater than 10% of
      E. coli cellular proteins. Adenylated and deadenylated forms of the purified
      enzyme were distinguished by apparent molecular weights of 81 kDa and 78 kDa,
      respectively, after separation via sodium dodecyl sulfate-polyacrylamide-gel
      electrophoresis.

PMID- 1756969
TI  - Cloning, expression and characterization of a cDNA encoding a lipase from
      Rhizopus delemar.
AB  - A lambda gt11 cDNA library was constructed in Escherichia coli using poly(A)
      selected mRNA from the fungus, Rhizopus (Rp.) delemar. Lipase-producing members
      of the library were identified by means of a phenotypic score wherein the release
      of fatty acids by lipase causes a characteristic color change in the growth
      medium. One such isolate contained a 1287-bp insert (LIP cDNA) which hybridizes
      to 1.25- to 1.35-kb mRNA species from Rp. delemar. The lipase produced in E. coli
      containing the LIP cDNA exhibits the same substrate selectivity as the authentic
      fungal enzyme, hydrolyzing ester bonds at the stereospecific numbering (sn) sn-1
      and sn-3, but not the sn-2, positions of triglycerides. The complete nucleotide
      sequence of the LIP cDNA was determined. By reference to the N-terminal sequence
      of authentic Rp. delemar lipase, the lipase-encoding region was identified within
      this fragment. The LIP cDNA encodes a putative preprolipase consisting of a 26
      amino-acid(aa) signal sequence, a 97-aa propeptide, and a 269-aa mature enzyme.
      The predicted mature lipase has the same molecular weight and aa composition as
      that of Rp. delemar, is highly homologous to that produced by the fungus
      Rhizomucor miehei, and contains the consensus pentapeptide (Gly-Xaa-Ser-Yaa-Gly)
      which is conserved among lipolytic enzymes. It is concluded that the LIP cDNA is
      an essentially full-length analogue of the lipase-encoding gene of Rp. delemar.
      The lipase encoded by the LIP cDNA occupies a cytoplasmic location when
      synthesized in E. coli. Unprocessed forms of the lipase accumulate in E. coli.

PMID- 1756970
TI  - Optimised cDNA size selection and cloning procedure for the construction of
      representative plasmid cDNA libraries.
AB  - Plasmid libraries are more versatile than phage libraries since they allow
      expression cloning in eukaryotic systems. However, high numbers of primary clones
      are sometimes difficult to obtain and more efficient transformation procedures
      are often required. In this paper, a detailed protocol is presented, for the
      construction of large plasmid libraries from ng quantities of cDNA, based on a
      highly efficient transformation step. Drop dialysis and electroporation are
      optimised: complete ligase removal and yeast tRNA addition before dialysis appear
      critical, while exclusive use of double-distilled water as well as rapid
      preparation of fresh cells provide excellent electroporation yields. A novel,
      simple and flexible cDNA size selection procedure is also presented, based on
      sucrose density gradient. Two libraries were constructed using an expression
      vector for mammalian cells (pCDM8) and its Escherichia coli host strain
      (MC1061[p3]). Numbers of 2 to 10 x 10(6) primary transformants were obtained from
      1 microgram of poly(A)+ RNA. Up to 85% of the clones had inserts and half of the
      inserts were larger than 1.5 kb.

PMID- 1756971
TI  - SrfI, a new type-II restriction endonuclease that recognizes the octanucleotide
      sequence, [sequence: see text].
AB  - A new restriction endonuclease, SrfI has been isolated from an unidentified
      species of Streptomyces. SrfI recognizes the 8-bp palindrome, 5'-GCCCGGGC and
      cleaves double-stranded DNA after the third C in the sequence, producing blunt
      ends. SrfI is a rare-cutting enzyme and should therefore be useful for megabase
      mapping.

PMID- 1756972
TI  - The oligopeptide (Gly-Pro)2-Ala-(Gly-Pro)2 increases the internal proline level
      and improves NaCl tolerance when produced in Escherichia coli.
AB  - We have produced various proline-containing peptides as translational fusions
      with beta-glucuronidase (beta Glu) in Escherichia coli. When these linkers were
      introduced in the 5'-end of the beta Glu-encoding gene, the production of the
      enzyme was increased substantially in vivo. The peptides carrying repetitive Gly
      Pro sequences could also stimulate the growth of the transformants in media with
      inhibitory concentrations of NaCl. Furthermore, the freezing tolerance could be
      improved.

PMID- 1756973
TI  - Characterization of melA: a gene encoding melanin biosynthesis from the marine
      bacterium Shewanella colwelliana.
AB  - A recombinant plasmid with the ability to impart melanin synthesis to an
      Escherichia coli host was isolated from a Shewanella colwelliana genomic library.
      The genetic determinant of the Mel+ phenotype is carried on a 1.3-kb DNA fragment
      and sequence analysis of this revealed a single intact open reading frame that
      was sufficient for melanin synthesis (mel). This gene is expressed as a
      monocistronic transcript and a putative transcription start point is located 115
      nucleotides upstream from the translational start codon. The mel gene encoded a
      protein of 39.5 kDa [346 amino acids (aa)] that showed no aa sequence homology
      with other proteins known to mediate melanin synthesis (e.g., tyrosinases).

PMID- 1756974
TI  - A wide-host-range suicide vector for improving reverse genetics in gram-negative
      bacteria: inactivation of the blaA gene of Yersinia enterocolitica.
AB  - A new suicide vector (pKNG101) that facilitates the positive selection of double
      recombination events in Gram-bacteria has been developed. It contains a
      conditional origin of replication (oriR6K), the strAB genes encoding the
      streptomycin phosphotransferase (SmR), an origin of transfer (mobRK2), the sacB
      gene mediating sucrose sensitivity, and multiple cloning sites. It was used to
      mutate the blaA gene of Yersinia enterocolitica, by marker-exchange mutagenesis.
      To do this, we have first cloned into the suicide vector pKNG101, a 2.5-kb
      fragment of Y. enterocolitica chromosomal DNA encoding the 20-kDa beta-lactamase
      A. Gene blaA was then mutated in vitro by insertion of luxAB, which resulted in
      pKNG105. The disrupted blaA gene was then reintroduced into Y. enterocolitica
      chromosome by homologous recombinations in two steps. First, E. coli SM10 lambda
      pir (pKNG105) was mated with strains of Y. enterocolitica. This led to the
      integration of pKNG105 into the chromosome, by a single homologous recombination
      event. The transconjugants, selected for SmR, were sensitive to sucrose due to
      the synthesis of levans (toxic compounds), catalysed by levansucrase, the product
      of sacB. For the second step, a single colony from the first step was grown in
      rich medium deprived of antibiotic, allowing the occurrence of a second crossing
      over that replaced the wild-type allele blaA with the mutant one, and then
      excised the plasmid-borne sacB from the chromosome. Such blaA mutants were
      selected on their ability to grow on TSA medium containing 5% sucrose.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1756975
TI  - The Saccharomyces cerevisiae ADE1 gene: structure, overexpression and possible
      regulation by general amino acid control.
AB  - The ADE1 gene of the yeast Saccharomyces cerevisiae has been cloned by
      complementation of the ade1 mutation. The nucleotide sequence has been determined
      for the 918-bp coding region, 240-bp 5'-noncoding region and 292-bp 3'-noncoding
      region. The sequenced region includes a single large open reading frame coding
      for a protein of 306 amino acid (aa) residues. The promoter of the ADE1 gene
      contains a copy of the 5'-TGACTC hexanucleotide, a feature characteristic of
      promoters under general aa control. Subsequent search of other published purine
      biosynthesis gene sequences revealed that all of them also contain general aa
      control signals in their promoter regions. An expression plasmid containing the
      ADE1 coding region under control of the PHO5 promoter produced N-succinyl-5
      aminoimidazole-4-carboxamide ribotide (SAICAR) synthetase in yeast cells at a
      level of 40% of total cellular protein. One-step purification resulted in an
      almost homogeneous preparation of SAICAR synthetase.

PMID- 1756976
TI  - Cloning and analysis of five mitochondrial tRNA-encoding genes from the fungus
      Beauveria bassiana.
AB  - Five mitochondrial (mt) tRNA genes from the filamentous fungus, Beauveria
      bassiana, were cloned and sequenced. The genes encoding the Val-, Ile-, Ser-, Trp
      and Pro-accepting tRNAs were found clustered in the region 5' to the lrRNA
      encoding gene. The genes were 64-77% homologous with the equivalent genes from
      other filamentous fungi, 49-58% to yeasts with the exception of the Val-accepting
      tRNA-encoding gene which was 76%, and only slightly homologous with Escherichia
      coli. The B. bassiana mt genetic code was found to be similar to that of other
      fungal mitochondria in that the UGA codon is used as a signal for Trp rather than
      as a stop codon. Transcript analysis has revealed that the genes present in tRNA
      cluster are transcribed and processed into tRNA-size products. Secondary
      structure models proposed for the gene products show that conservation of tRNA
      secondary structure also exists. The presence of a GGC sequence rather than a GGU
      sequence in the D-loop of the tRNA(Trp)-encoding gene is a feature unique to the
      B. bassiana mt tRNA. An unconventional G-A base pair present in the D-stem of the
      tRNA(Ser)-encoding gene is a feature conserved in the mt tRNA of other
      filamentous fungi. Comparison of the B. bassiana tRNA-encoding genes with those
      of two other filamentous fungi and two yeasts revealed that the differences
      between closely related species favoured transition-type mutations.

PMID- 1756977
TI  - Heterologous expression of the Aspergillus nidulans regulatory gene nirA in
      Fusarium oxysporum.
AB  - We have isolated strains of Fusarium oxysporum carrying mutations conferring a
      phenotype characteristic of a loss of function in the regulatory gene of nitrate
      assimilation (nirA in Aspergillus nidulans, nit-4 in Neurospora crassa). One of
      these nir- mutants was successfully transformed with a plasmid containing the
      nirA gene of A. nidulans. The nitrate reductase of the transformants is still
      inducible, although the maximum activity is lower than in the wild type. Single
      and multiple integration events were found, as well as a strict correlation
      between the presence of the nirA gene and the Nir+ phenotype of the F. oxysporum
      transformants. We also investigated how the A. nidulans structural gene (niaD) is
      regulated in F. oxysporum. Enzyme assays and Northern experiments show that the
      niaD gene is subject to nitrate induction and that it responds to nitrogen
      metabolite repression in a F. oxysporum genetic background. This indicates that
      both the mechanisms of specific induction, mediated by a gene product
      isofunctional to nirA, and nitrogen metabolite repression, presumably mediated by
      a gene product isofunctional to the homologous gene of A. nidulans, are operative
      in F. oxysporum.

PMID- 1756978
TI  - The TRP1 gene of Phytophthora parasitica encoding indole-3-glycerolphosphate
      synthase-N-(5'-phosphoribosyl)anthranilate isomerase: structure and evolutionary
      distance from homologous fungal genes.
AB  - The TRP1 gene was isolated from the genome of Phytophthora parasitica. It encodes
      bifunctional enzyme of the tryptophan biosynthetic pathway indole-3
      glycerolphosphate synthase-N-(5'-phosphoribosyl)anthranilate isomerase (IGPS
      PRAI). The gene was localized and sequenced using random in vitro insertions of
      omega interposon. The domain structure of the protein product was found to be
      similar to that of enteric bacteria but different from the structure of
      homologous enzymes in fungi. Two introns in the IGPS domain were found. This is
      unique in eukaryotic IGPS-encoding genes so far sequenced. Comparative analysis
      of the primary structure of IGPS and PRAI domains [neighbor-joining method of
      Saitou and Nei, Mol. Biol. Evol. 44 (1987) 406-425] confirmed a large
      phylogenetic distance of TRP1 from corresponding fungal genes. In the resulting
      distance tree Phytophthora sequences are located outside of the cluster which
      encompasses all known homologous proteins from fungi indicating that the lineage
      of oomycetes took a separate course of development before speciation within the
      fungal line of descent began. Two of the oligopeptide insertions engineered into
      the F domain of the protein product did not abolish the enzymatic activity of the
      protein.

PMID- 1756979
TI  - The isolation, cloning and identification of a vegetative catalase gene from
      Bacillus subtilis.
AB  - A Bacillus subtilis library of Tn917::lacZ insertions was screened for mutants
      that were unable to grow in the presence of normally sublethal concentrations of
      hydrogen peroxide. The identification and subsequent analysis of one mutant
      strain, YB2003, which carried the mutation designated kat-19, revealed that this
      strain was deficient in the expression of a vegetative catalase. Regions of the
      chromosome both 5' and 3' to the site of the Tn917 insertion, as well as the gene
      without the insertion (kat-19+) were cloned. The presence of the functional kat
      19+ gene on a high-copy plasmid restored catalase activity to the kat-19::Tn917
      strain as well as to strains of B. subtilis that carried the katA 1 mutation.
      While the katA+ locus is believed to represent the structural gene for the
      vegetative catalase of B. subtilis [Loewen and Switala, J. Bacteriol. 169 (1987)
      5848-5851], the sequence analysis of the cloned kat-19+ DNA fragments revealed an
      open reading frame that showed significant homology between the deduced amino
      acid sequence of this gene product and that of known eukaryotic catalases.

PMID- 1756980
TI  - Sequence and expression of the gene encoding 3-phosphoglycerate kinase from
      Bacillus stearothermophilus.
AB  - The structural gene (pgk) encoding 3-phosphoglycerate (PGK) from Bacillus
      stearothermophilus NCA1503, has been cloned in Escherichia coli and its complete
      nucleotide sequence determined. The gene consists of an open reading frame
      corresponding to a protein of 394 amino acids (aa) (calculated Mr 42,703) and, in
      common with other prokaryotic pgk genes, is preceded by the structural gene
      encoding glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Constructs containing
      the B. stearothermophilus pgk gene and its flanking sequences in the high-copy
      plasmid, pUC9, co-express both PGK and GAPDH at high levels in transformed E.
      coli cells, typically producing PGK at levels of up to 30% of the soluble cell
      protein. The deduced aa sequence of B. stearothermophilus PGK is compared with
      those of the mesophilic (yeast) and extreme thermophilic (Thermus thermophilus)
      enzymes since the crystal structure of these PGKs are known or are in the process
      of being determined. Changes in the sequences of the three enzymes, as they
      appear to relate to the enhancement of thermal stability, are discussed.

PMID- 1756981
TI  - Expression of heterologous genes in Mycobacterium bovis BCG: induction of a
      cellular response against HIV-1 Nef protein.
AB  - Mycobacterium bovis bacillus Calmette-Guerin (BCG) has been used as a live
      bacterial vaccine to immunize more than two billion people against tuberculosis.
      In an attempt to use this vaccinal strain as a vehicle for protective antigens,
      the human immunodeficiency virus type 1 gene encoding the Nef protein was cloned
      in a mycobacteria-Escherichia coli shuttle plasmid and transferred into BCG. The
      nef gene was expressed under the control of an expression cassette carrying the
      promoter of the groES/groEL1 operon from Streptomyces albus and a synthetic
      ribosome-binding site. Lymph node cells from mice immunized with BCG-nef
      proliferated vigorously in response to purified Nef protein. This first report of
      a proliferative response suggests that recombinant BCG strains may be used to
      immunize against pathogens for which T-cell-mediated responses are important for
      protection.

PMID- 1756982
TI  - Molecular analysis of the dmpM gene encoding an O-demethyl puromycin O
      methyltransferase from Streptomyces alboniger.
AB  - The nucleotide (nt) sequence of a 1332-bp fragment of Streptomyces alboniger DNA
      containing the gene (dmpM), which encodes an O-demethyl puromycin O
      methyltransferase (DMPM), has been determined. The dmpM gene contains a 1131-nt
      open reading frame which encodes a polypeptide of Mr 40,303; this is consistent
      with the 44 +/- 2.5- and 160-kDa sizes of the DMPM monomer and its native form,
      respectively. The ATG start codon of dmpM is 50 bp downstream from the coding
      sequence of the gene (pac), which determines a puromycin N-acetyltransferase. S1
      mapping experiments indicate that pac and dmpM are transcribed on a single
      transcript, which ends at least 500 nt downstream from the dmpM stop codon. The
      deduced amino acid sequence of DMPM shows significant similarities to those of a
      hydroxyindole O-methyltransferase, which is involved in the biosynthesis of
      melatonin by bovine pineal glands [Ishida et al., J. Biol. Chem. 262 (1987) 2895
      2899], a hydroxyneurosporene methyltransferase, which is involved in carotenoid
      biosynthesis in the purple nonsulfur bacterium, Rhodobacter capsulatus [Armstrong
      et al., Mol. Gen. Genet. 216 (1989) 254-268] and two O-methyltransferases of the
      tetracenomycin biosynthesis pathway from Streptomyces glaucescens.

PMID- 1756983
TI  - Sequence and linkage analysis of the Coxiella burnetii citrate synthase-encoding
      gene.
AB  - The nucleotide (nt) sequence of the Coxiella burnetii citrate synthase-encoding
      gene (gltA), previously cloned in Escherichia coli, was determined. The nt
      sequence analysis revealed an open reading frame (ORF) of 1290 bp capable of
      coding for a protein of 430 amino acids (aa) with a deduced Mr of 48,633.
      Preceding an ATG start codon, a possible transcription start point (tsp) with
      homology to the E. coli promoter consensus was detected. A poly-purine-rich
      region occurred immediately upstream from the gltA reading frame and potentially
      serves as a ribosome-binding site. Additionally, a G + C-rich region of dyad
      symmetry 3' to the translational stop codon was found that could possibly
      function as a Rho-independent transcriptional termination signal. A large, nearly
      perfect, inverted repeat was identified upstream from the gltA tsp and was shown
      by Southern analysis to be present in multiple copies in the C. burnetii genome.
      The deduced aa sequence of C. burnetii GltA was optimally aligned with enzymes
      from various prokaryotic sources and one eukaryotic source (pig heart). Using
      perfect aa identity, the C. burnetii enzyme demonstrated the greatest homology
      with GltA from Acinetobacter anitratum (65%). Although only 26% aa identity was
      seen with the pig heart enzyme, many of the residues identified in ligand binding
      appear to be conserved. Sequencing studies of a region centered approx. 5.6 kb
      upstream from gltA revealed an ORF read with opposite polarity that encodes a
      peptide highly homologous to the C terminus of the flavoprotein subunit of E.
      coli succinate dehydrogenase. This report represents the first nt sequence
      analysis of a gene of known function from the obligate intracellular parasite, C.
      burnetii.

PMID- 1756984
TI  - Growth-phase-dependent induction of 6-phosphogluconate dehydrogenase and glucose
      6-phosphate dehydrogenase in the cyanobacterium Synechococcus sp. PCC7942.
AB  - In most cyanobacteria, the only known pathway for oxidation of stored
      carbohydrate in the dark or under energy-limiting conditions is the hexose
      monophosphate shunt. To determine whether the increased use of the shunt under
      these conditions derives from an increase in the activity level of the respective
      enzymes, we measured the effect of growth phase during the growth of batch
      cultures of Synechococcus sp. strain PCC7942 on the specific activity of 6
      phosphogluconate dehydrogenase (6PGD) and glucose 6-phosphate dehydrogenase. The
      specific activities were constant during the exponential growth phase of the
      culture, but they increased about fivefold during the transition into stationary
      phase. As an approach to determining the level of expression at which the growth
      phase-dependent regulation of 6PGD level is exerted, we constructed operon and
      gene fusions between the gnd gene, which encodes 6PGD, and the Escherichia coli
      lacZ gene, which encodes beta-galactosidase (beta Gal). Strains harboring the
      fusions integrated into the cyanobacterial chromosome were prepared, and the
      growth-phase dependence of beta Gal level was determined. The specific activity
      of beta Gal in cultures of both types of fusion strains increased during the
      transition into stationary phase, indicating that the growth-phase-dependent
      regulation is on the gnd mRNA level. Characterization of the growth-phase
      dependent induction of 6PGD in strains carrying differing amounts of DNA upstream
      from the gnd structural gene led to the localization of the promoter and the
      regulatory site on the restriction map of the gene, whose sequence has previously
      been determined.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1756985
TI  - The direct cloning of the yeast genome using the gap-filling method and the
      complete physical mapping of Saccharomyces cerevisiae chromosome VI.
AB  - The ordered clone library of chromosome VI of Saccharomyces cerevisiae has been
      constructed by Olson et al. [Proc. Natl. Acad. Sci. USA 83 (1986) 7826-7830, and
      personal communication]. It is composed of four contiguous stretches from the
      chromosome, each of 40-70 kb. There remained three gaps of unknown length between
      these four contigs. We applied the 'gap-repair' method to clone these three gap
      regions directly from the yeast chromosome. All three gap regions, ranging from 7
      to 22 kb, were successfully cloned without any structural changes. Together with
      these gap regions, a precise physical map of EcoRI and HindIII sites was
      constructed over the 230-kb fragment which covers most of chromosome VI except
      for two telomeres.

PMID- 1756986
TI  - Cloning and expression in Saccharomyces cerevisiae of the NAD(P)H-dependent
      xylose reductase-encoding gene (XYL1) from the xylose-assimilating yeast Pichia
      stipitis.
AB  - The XYL1 gene of the yeast Pichia stipitis has been isolated from a genomic
      library using a specific cDNA probe, and its nucleotide (nt) sequence has been
      determined. In the 5' noncoding region of the P. stipitis XYL1 gene a TATAAA
      element (known to be necessary for transcription initiation in most yeast genes)
      is found at nt -81, and two CCAAT recognition motifs (often referred to as the
      CCAAT box) are present at nt -146 and -106. The XYL1 encodes a polypeptide of
      35,927 Da that constitutes a NADH/NADPH-dependent xylose reductase (XR). The
      enzyme is part of the xylose-xylulose pathway that is absent or only weakly
      expressed in Saccharomyces cerevisiae. Extensive homology is found to the N
      terminus of the XR of Pachysolen tannophilus and Candida shehatae. None of the
      known cofactor binding domains found in many NAD-dependent dehydrogenases are
      present in the protein. Transformants of S. cerevisiae containing XYL1 of P.
      stipitis synthesize an active XR. Fusion of XYL1 with the prokaryotic tac
      promoter leads to a gene that can be expressed in S. cerevisiae and Escherichia
      coli.

PMID- 1756987
TI  - Replicative transformation of the filamentous fungus Ashbya gossypii with
      plasmids containing Saccharomyces cerevisiae ARS elements.
AB  - We have developed a transformation system for the filamentous ascomycete fungus
      Ashbya gossypii. Mycelial protoplasts were transformed to geneticin-resistance
      with plasmids containing the Escherichia coli kanamycin-resistance gene as a
      selectable marker and autonomously replicating sequences (ARS) from Saccharomyces
      cerevisiae (ARS1, 2 mu ARS). Transformation frequencies of up to 63 transformants
      per microgram of plasmid DNA were obtained. The transformants were unstable under
      nonselective conditions. Southern analysis of DNA separated by conventional and
      pulsed-field-gel electrophoresis showed that the transforming DNA was present as
      autonomously replicating plasmid. Plasmid integration into chromosomal DNA was
      not detected. We concluded that the S. cerevisiae ARS elements are functional in
      A. gossypii, since vectors lacking such elements did not yield transformants.

PMID- 1756988
TI  - Differences in susceptibility between crystallins and non-lenticular proteins to
      copper and H2O2-mediated peptide bond cleavage.
AB  - The relative susceptibilities of lenticular proteins (alpha, beta and gamma
      crystallins) and a number of proteins of non-lenticular origin, to hydroxyl
      radical-mediated peptide bond cleavage were compared. The non-lenticular proteins
      (bovine serum albumin, ovalbumin, alcohol dehydrogenase, lysozyme, thyroglobulin,
      beta-amylase, haemoglobin and carbonic anhydrase) were readily cleaved into acid
      soluble fragments following 5 hours treatment with copper ions and hydrogen
      peroxide. In contrast the crystallins were almost totally unaffected by similar
      treatment. When alpha-crystallin was pre-treated with acid or cleaved into large
      fragments with cyanogen bromide it became susceptible to hydroxyl radical attack,
      yet heating the protein did not diminish its resistance. It is suggested that the
      resistance of alpha-crystallin to the copper/peroxide-mediated fragmentation may
      be dependent on the conformation of the protein.

PMID- 1756989
TI  - Induction and rejoining of DNA single-strand breaks in relation to cellular
      growth in human cells exposed to three hydroperoxides at 0 degrees C and 37
      degrees C.
AB  - There was a 5-fold increase in cytotoxicity for cumene hydroperoxide, 10-fold for
      tert-butyl hydroperoxide and 25-fold for hydrogen peroxide, under metabolizing
      conditions (37 degrees C) in comparison to nonmetabolizing conditions (0 degrees
      C), when human P31 cells were exposed for 60 min. The induction of DNA single
      strand breaks correlated poorly with cytotoxicity. Hydrogen peroxide was by far
      the most effective agent inducing single-strand breaks irrespective of
      temperature. Cumene hydroperoxide produced fewer strand breaks than tert-butyl
      hydroperoxide despite its greater cytotoxicity at either 37 degrees C or at 0
      degrees C. The pattern of single-strand break induction did not change with
      temperature. The number of breaks, however, increased when the cells were exposed
      at 37 degrees C. The pattern of rejoining was similar for hydrogen peroxide- and
      tert-butyl hydroperoxide-induced breaks at both temperatures whereas the
      rejoining of cumene hydroperoxide-induced breaks deviated somewhat from this
      pattern. The results indicate that there is no clear-cut relationship between
      induction of DNA single-strand breaks and cytotoxicity after hydroperoxide
      exposure.

PMID- 1756990
TI  - Calcium antagonists prevent monocyte and endothelial cell-induced modification of
      low density lipoproteins.
AB  - Low density lipoprotein (LDL) incubated in the presence of the calcium
      antagonists verapamil, nifedipine and flunarizine were more resistant than
      control LDL to human monocyte- or endothelial cell-induced modification, as
      assessed by electrophoretic mobility in agarose gel, thiobarbituric acid reactive
      substance content, and degradation by J774 macrophages. The efficiency of the
      drugs was: flunarizine greater than nifedipine greater than verapamil. Moreover,
      a 24 h preculture with calcium antagonists significantly impaired the ability of
      cells to modify LDL in the absence of the drugs. All the studied drugs also
      inhibited copper-induced autooxidation of LDL. None of the studied calcium
      antagonists, at concentrations up to 10(-4) M, significantly reacted with free
      radicals as assessed by the 1,1-diphenyl-2-picrylhydrazyl test. It is suggested
      that such a protective effect of calcium antagonists against LDL peroxidation
      could play a role in the previously reported antiatherogenic effect of these
      drugs.

PMID- 1756991
TI  - Interruption of pregnancy: motives, attitudes and contraceptive use. Interviews
      before abortion, at a family planning clinic, Rome.
AB  - Since 1978 when the law on legal abortion came into force, approximately 35% of
      all pregnancies in Italy have ended in abortion (illegal abortions excluded).
      Presently about 25% (national average) of the women who interrupt pregnancy get
      their medical certificate at a family planning clinic. The general aim of the
      present study was to describe women's situation on the occasion of their first
      visit to the family planning clinic, their problems and their motives to
      abortion. Over a period of 6 months, 65 women were interviewed during their visit
      to a family planning clinic before interruption of their pregnancy. A
      semistructured questionnaire was used concerning their motives for interruption
      of pregnancy, contraceptive habits, their attitudes to abortion and the male
      partner's participation. The women arrived in an early stage of the pregnancy, 46
      women said that they had considered the possibility to interrupt the pregnancy
      almost at the same time as they got the message that they were pregnant. Twenty
      eight women had already a previous abortion, the use of contraceptives did not
      differ among these women and was generally scarce. Twenty-one women said they had
      been against abortion before their own experience or said they had never believed
      themselves to be in need of an abortion.

PMID- 1756992
TI  - Lipid profiles during and after normal pregnancy.
AB  - Lipid profiles were estimated in two groups of normal healthy women comprising 39
      non-pregnant women and 67 pregnant women at 28 and 32 weeks gestation and 6 weeks
      after delivery. Triglycerides, total, HDL and LDL cholesterols were high during
      pregnancy. Except for LDL cholesterols which remained constant, all the above
      decreased at 6/52 postnatally, but levels were still above those of normal non
      pregnant women. Compared to the later, the atherogenic index, LDL/HDL cholesterol
      ratio was unchanged during pregnancy but significantly increased at 6/52
      postnatally. These results may suggest that while total lipid levels increase
      during pregnancy, this is balanced by an even distribution of the lipoprotein
      fractions. After delivery, though lipid levels had decreased, the decrease in HDL
      cholesterol and increase in LDL cholesterol caused unfavourable changes in lipid
      lipoprotein ratios. These changes may be due to the change in metabolism of the
      pregnant women as well as diet during and after pregnancy.

PMID- 1756993
TI  - Loss of growth hormone responsiveness to normal physiological stimuli during
      pregnancy.
AB  - The response of pituitary GH to acute hyperglycaemia induced by 75 g oral glucose
      load in 73 pregnant women at various stages of gestation was examined. According
      to the age of gestation, patients were grouped into three groups: less than 20
      weeks, between 20-30 and more than 30 weeks. Plasma glucose, GH and C-peptide
      were measured at fasting and then at 30, 60, 120 and 180 min following the
      glucose load. There was a significant increase in plasma GH concentration with
      weeks of gestation. The results also showed a loss of the normal physiological
      suppressive effects of hyperglycaemia on GH secretion in tests performed after 20
      weeks of gestation. Only in tests performed before 20 weeks, there was a
      significant negative correlation between plasma glucose and GH values. These
      findings are consistent with recent reports suggesting an almost complete
      suppression of pituitary GH secretion by a placental variant of GH. These changes
      in the dynamics of GH secretion suggest that, in pregnancy, GH plays a more
      significant role than was previously thought.

PMID- 1756994
TI  - Measurements of the fetal liver size, hormonal level and pregnancy outcome.
AB  - To further deepen the understanding of growth and development of a fetal liver,
      we measured sizes of 108 fetal livers using ultrasound and compared them with
      levels of urinary estriol excretion and human placental lactogen in the sera of
      their mothers. The present data suggested that growth and development of a fetal
      liver correlated with the levels of these hormones. Measurements of the fetal
      liver sizes also possibly indicate the perinatal outcome.

PMID- 1756995
TI  - Tumor necrosis factor alpha is elevated in the peritoneal fluid from women with
      ruptured ectopic pregnancies.
AB  - The purpose of this study was to determine whether exposure of the peritoneum to
      fetal tissue is associated with elevated tumor necrosis factor alpha (TNF alpha)
      levels in the peritoneal cavity. We measured TNF alpha levels in the peritoneal
      fluids and serum from women with ruptured ectopic, unruptured ectopic and
      intrauterine pregnancies, as well as nonpregnant women undergoing tubal ligation.
      The results showed that patients with ruptured ectopic pregnancies were more
      likely to have TNF alpha levels in the peritoneal fluid greater than 40 units/ml
      (68%), compared with women with unruptured ectopic or intrauterine pregnancies
      (21%) (p less than 0.05, Fisher exact test). No elevation of peritoneal fluid TNF
      alpha levels was found in nonpregnant patients. Because TNF alpha is primarily a
      product of activated macrophages, it is likely that elevated TNF alpha levels in
      the peritoneal fluid of women with ruptured ectopic pregnancies reflects
      activation of peritoneal macrophages.

PMID- 1756996
TI  - Antithromboxane drug in the treatment of preeclampsia.
AB  - In this study, we present our initial trials in the treatment of 6 cases of
      severe preeclampsia with thromboxane synthetase inhibitor (OKY-046). Following
      the treatment with OKY-046, maternal systolic blood pressure decreased
      significantly and umbilical artery waveforms were normalized. These data suggest
      that thromboxane synthetase inhibition might have a beneficial effect on
      preeclampsia.

PMID- 1756997
TI  - Perinatal outcome in fetuses with loss of end-diastolic blood flow velocities in
      the descending aorta and/or umbilical arteries.
AB  - Continuous- and pulsed-wave Doppler velocimetry was used as an additional method
      of antenatal surveillance in high-risk pregnancy care. During a 30-month period
      with 4,169 deliveries 226 patients (5.4%) with complicated pregnancies
      (intrauterine growth retardation, diabetes, hypertension) were investigated. The
      results had only marginal influence on obstetrical management. In 38 fetuses
      absence of end-diastolic blood flow velocities (AEDF) was detected in the
      descending fetal aorta and/or umbilical arteries. Mean birth weight of these
      fetuses was 1,441 +/- (SD) 690 g at a mean gestational age of 31.8 +/- 6.8 weeks
      at birth. Twenty fetuses (53%) were growth-retarded (less than 3rd centile). Six
      fetuses died in utero and 7 during the perinatal period (34% mortality). There
      was a significant deterioration of perinatal outcome with AEDF in the umbilical
      arteries at the last antenatal Doppler scan. With AEDF in the descending fetal
      aorta the Doppler parameter Vmean and with AEDF in the umbilical arteries the
      pulsatility index yielded additional prognostic information. Doppler velocimetry
      of the fetal and umbilical vascular system could be of additional value for
      antenatal surveillance in high-risk pregnancies.

PMID- 1756998
TI  - Effect of continuous lumbar epidural anaesthesia during labour on fetal
      transcutaneous carbon dioxide.
AB  - The effect of epidural anaesthesia during labour on fetal transcutaneous carbon
      dioxide (tcPCO2) was observed on 27 fetuses. Our results show that in the course
      of epidural anaesthesia there is an increase in fetal tcPCO2. We can see a slight
      increase even before administering the test dose, while preparatory measures are
      undertaken for the epidural anaesthesia. After administering the test dose and
      after giving the main dose there is a further increase in fetal tcPCO2, which
      continues for up to 30 min after the main dose has been given. The results
      suggest that it is important to consider any pathological conditions in the
      fetus, so as to avoid the possibility of additionally endangering the fetus
      during epidural anaesthesia.

PMID- 1756999
TI  - Perineal ultrasonography in women with stress incontinence and controls: the role
      of the pelvic floor muscles.
AB  - With a curved array real-time ultrasound scanning machine and the probe placed
      sagitally onto the vulva, symphysis, bladder, urethra and the pelvic floor can be
      visualized in one frame. With this technique we studied 10 women with stress
      incontinence and 10 control women. In both groups active contraction of the
      pelvic floor resulted in a similar elevation of the urethrovesical junction
      (UVJ). During Valsalva maneuver an equal descent of the UVJ was found in patients
      and controls. During coughing a significant descent of the UVJ only occurred in
      the patient group. This suggests that women with stress incontinence are capable
      of operating the pelvic floor muscles but do not use them adequately during a
      cough.

PMID- 1757000
TI  - Increased nuclear damage by high linear energy transfer radioisotopes applicable
      for radiodirected therapy against radiologic malignancies.
AB  - High linear energy transfer radioisotopes carried by appropriate agents have been
      proposed for receptor-directed radiotherapy. Two such classes of isotopes are
      Auger electron and alpha-emitting nuclides. To determine the relative
      cytotoxicity and nuclear damage to cells produced by these two classes of
      nuclides, we compared bromine-80m (80mBr), an Auger-electron-emitting
      radionuclide with a 4.4-hour half-life, with bismuth-212 (212Bi), an alpha
      emitter with a 1-hour half-life. Because of the short path length of the Auger
      electrons, 80mBr was radiotoxic only when incorporated into DNA, such as in the
      form of [80mBr]bromodeoxyuridine ([80mBr]BrUdR). Both agents induced linear
      increases in chromosome aberration frequency, however, [80mBr]BrUdR caused
      multiple aberrations including the shattering of parts of the chromosomes. While,
      in contrast, a 2-hour exposure of cells to 212Bi, chelated to DTPA, a form which
      does not enter the cell, induced much less extensive chromosome damage. Exposure
      to equivalent activities of Auger electrons or alpha-particles results in 5 times
      more damage in Auger-electron-exposed cells. However, estimates of dose suggest
      they are equally toxic. Unlike Auger electrons, alpha-particles did not need to
      be in as close proximity to the DNA to have clastogenic and radiotoxic effects.

PMID- 1757001
TI  - Immunohistochemical localization of blood group substances in normal and
      neoplastic endometrial tissues--with special reference to type 1 core chain
      expression.
AB  - Immunohistochemical stainings were performed to observe the expression of the
      blood group antigens (A, B, H, Lewisa, Lewisb) and lactoseries type 1 core chain
      in normal and neoplastic endometrial tissues using a panel of monoclonal
      antibodies. The results indicated that normal endometrium mostly lacked the
      expression of these sugar structures. In endometrial carcinoma, the expression of
      H, Lewisa, Lewisb was evident and type 1 core chain was observed only after
      neuraminidase pretreatment. These data indicated that type 1 core chains were
      newly synthesized according to malignant transformations in endometrial tissues
      and they were partially fucosylated and partially sialylated.

PMID- 1757002
TI  - Pregnancy in cyclic neutropenia.
AB  - We present a patient with cyclic neutropenia who had two successful pregnancies
      during which the disease improved. Following one of the deliveries severe
      endometritis and wound dehiscence of the episiotomy developed and neonatal
      pemphigoid was seen.

PMID- 1757003
TI  - Heterotopic striated muscle in the myometrium in a patient with myoma uteri.
AB  - Heterotopic striated muscle tissue was found in the myometrium of a 50-year-old
      Japanese woman with myoma uteri. It is suggested that the tissue originated in a
      differentiation of stromal cells in the myometrium.

PMID- 1757004
TI  - [A new classification of distal radius fractures and corresponding treatment
      methods].
AB  - Based on previously published reports on fractures of the distal radius and on
      the analysis of 400 fresh fractures treated in two accident hospitals affiliated
      with our university hospital, we propose a new classification as shown in Table
      2. This new classification includes a type of combined Chauffeur-Barton fracture
      which has never been described before. Each type of fracture of the distal radius
      requires a specific treatment as shown in Fig. 1.

PMID- 1757005
TI  - [Diagnosis of torsion malposition of the radius and ulna after healed distal
      fracture].
AB  - Assessing radial and ulnar rotational deformities quantitatively by routine
      diagnosis after healed distal forearm fractures is very difficult. A method to
      obtain information about direction and graduation of malrotation is described.
      This method is based on discovering topographic changes of skeletal points by CT.
      Rotational angles of intact forearm bones are measured on anatomic specimen and
      in vivo using epiphyseal and diaphyseal axes of the radius and the ulna. Normal
      rotation of intact forearm bones varies in a specific manner. The radius presents
      less variations than the ulna. A morphological index of radial and ulnar rotation
      is not given because of the great individuality of diaphyseal rotation. Both
      radii of a single individuum show a very small rotational difference. Therefore a
      verification of malrotation is indicated by comparison to the intact opposite
      radius. Higher rotational graduations on the left side have to be noted.

PMID- 1757006
TI  - [Results and analysis of poor results after conservative therapy of distal radius
      fracture].
AB  - The authors report on the results of a follow-up study of 120 conservatively
      treated distal radius fractures. Follow-up averaged 35 months (25 to 48 months).
      The quality of initial reduction has a crucial impact on the final outcome. 87
      fractures showed nearly perfect anatomical reduction, of these, 48 resulted in
      excellent, 16 in good, 15 in satisfactory, and 8 in poor final anatomical
      outcomes. In comparison, in 33 fractures with unsuccessful initial reduction,
      only two cases gave excellent and 12 cases good results (42%); 11 fractures were
      considered satisfactory and 8 poor. The necessity of a second reduction was
      significantly lower in the first group of initially well-reduced fractures when
      compared to the second group: 8 (9.2%) to 14 (42.4%) respectively. Evaluation of
      the functional outcome according to the Sarmiento scheme showed a strong
      correlation between the AO fracture classification and the final outcome. In
      group A fractures, 78% gave excellent or good, 22% satisfactory or bad results.
      Type B fractures gave 82% excellent or good and 18% satisfactory or poor results.
      In group C, only 50% reached excellent or good results, the C 3 fractures having
      the worst prognosis, achieving excellent or good results in only 20% of the
      cases. Regression analysis demonstrated a significant correlation between
      anatomical and functional outcome.

PMID- 1757007
TI  - [Value of plate osteosynthesis in treatment of radius fractures at a typical
      site].
AB  - In the past, distal radius fractures tended to be treated conservatively.
      Recently, however, unsatisfactory anatomical and functional results have led to
      an increase in their surgical treatment. Our preferred method of treatment has
      been percutaneous pin fixation after closed reduction. In our opinion, open
      reduction and internal fixation with an A0-plate is indicated for Smith fractures
      (B3 A0-classification), and for any fractures which cannot be ideally reduced
      (usually C1 to C3 fractures). From 1972 until 1989, 84 patients with distal
      radius fractures underwent surgical treatment in the Unfallkrankenhaus Salzburg.
      The procedure was usually performed under brachial plexus or Bier block, and we
      preferred a palmarly positioned plate for internal fixation. Follow-up of 42
      patients showed good results, the functional and subjective results earning
      higher marks than the X-ray findings.

PMID- 1757008
TI  - [Secondary arthrosis of the wrist joint in malposition of healed and uncorrected
      distal radius fracture].
AB  - The authors report on long-term results of thirty-five unreduced distal radius
      fractures with malunion. The mean observation period was 11.5 years (5 to 45
      years). It was found malalignment of the carpal articular surface of the radius
      with a resulting decrease in range of motion of the wrist, well tolerated by the
      patients and apparently not very painful. Much more evident was pain and
      decreased motion in the distal radio-ulnar joint for pronation and supination,
      which paralleled the extent of osteoarthrosis of this joint. This reduced forearm
      rotation was due to shortening of the radius, leading to incongruency and even
      dislocation of the distal radio-ulnar joint.

PMID- 1757009
TI  - [Distal radio-ulnar arthrodesis and Kapandji ulna segment resection in treatment
      of limited forearm rotation].
AB  - Between 1986 and 1990 distal radioulnar arthrodesis with segment resection of the
      distal ulna (Sauve-Kapandji Operation) was performed in 31 patients with
      posttraumatic changes of the distal radioulnar joint; 26 patients could be
      examined after 10 to 44 months. At the time of examination, all patients had bony
      fusion between distal radius and ulna; forearm rotation improved by 60.5%, 55% of
      the patients had significant pain relief. Grip strength also improved
      postoperatively, though never reaching values of the healthy hand. Two patients
      developed a bony regeneration, which was successfully reoperated upon in one
      case, 81% of the patients reported an improved wrist function.

PMID- 1757010
TI  - [Experimental studies of forces on the radiocarpal joint in minus deviation of
      the ulna].
AB  - The length of the radius was experimentally altered with respect to the distal
      end of the ulna. Pressure levels at several points in the wrist were measured
      simultaneously. Lengthening of the radius leads to an increased pressure between
      the distal radius and scaphoid and between the distal radius and lunate.

PMID- 1757011
TI  - [Pseudarthrosis of the capitate bone with special reference to ligamentous
      stabilization].
AB  - Non-union of the capitate is rare. So far, six cases of non-union have been
      reported. The authors add a new case report, involving a 29-year old tobacco
      worker with a typical history. The length of the capitate was restored by
      corticocancellous bone grafting. The mechanism by which non-union occurs is
      discussed, showing that the uninjured palmar V ligament in the wrist is
      responsible.

PMID- 1757012
TI  - [Protective microvascular anastomosis in transverse rectus abdominis myocutaneous
      flap for breast reconstruction].
AB  - Given favorable conditions, breast reconstruction with the TRAM-flap yields the
      best results. However, because of limited blood flow in the flap after
      dissection, partial flap necrosis occurs frequently. To avoid this, a bipedicled
      flap has been used. Although complications are substantially fewer, the necessity
      for improvement of flap perfusion still remains. We have carried out breast
      reconstruction using the TRAM-flap in 66 cases to date. In two of these, the
      vascular system of the deep inferior epigastric artery and vein were successfully
      anastomosed (end-to-side) with the thoracodorsal vessels. Although this technique
      was more time consuming and entailed cooling, it has proven to adequately protect
      the flap. Careful dissection and preservation of the deep inferior epigastric
      vessels is mandatory.

PMID- 1757013
TI  - [Results of sex change operations in 30 transsexual patients: psychosocial and
      sexual adaptation--surgical complications].
AB  - Ten male and twenty female transsexual patients who had undergone sex
      reassignment surgery were followed-up with regard to postoperative complications,
      partner and sexual interaction and their overall ability to cope with their new
      situation. Despite unsatisfactory functional results, social and sexual life
      improved after sex reassignment surgery.

PMID- 1757014
TI  - [Periodontal and esthetic aspects of orthodontic frontal space closure--results
      of a long-term study].
AB  - In this study follow-up results of patients are presented, who have been treated
      in cases of missing incisors by orthodontic space closure. The statements of
      clinical examinations, casts, intra- and extraoral photographies, x-rays,
      periodontal examinations and questionnaires pointed out, that the abnormal
      position of the moved teeth do not interfere with the periodontal tissues. Should
      the occasion arise of correction by crowns or by grinding, the patients consider
      the abnormal positioned teeth as esthetical.

PMID- 1757015
TI  - [Long-term results of treatment of distal occlusion with the function regulator].
AB  - 88 children with a class II/1 malocclusion were analyzed cephalometrically
      concerning dental and skeletal changes through a period of approximately 10
      years. 50 patients were treated with function regulators and 38 cases served as a
      control group. At the beginning, there were no significant differences between
      the groups studied but in the end, the patients at the age of approximately 17
      treated with function regulators showed a stronger mandibular advancement of 4
      4.5 mm.

PMID- 1757016
TI  - [The value of electronic axiography in clinical functional diagnosis].
AB  - Recent years have brought an increasing number of electronic jaw-tracking devices
      for instrumental analysis on the market. However sophisticated they may be, their
      diagnostic value for temporomandibular diseases is not well supported by
      scientific evidence. On the other hand, "manual examination"--a very refined
      diagnostic means acknowledged by orthopedians and adapted to the properties of
      the TMJ--yields a more reliable diagnosis which fits well to MRT data. We were
      hereby solicited to compare the information gained by jaw-tracking and manual
      examination. It was found that the recorded condylar movements gave no
      additional, diagnostically relevant insight that went beyond the manual
      examination. Nevertheless, the accuracy of jaw-tracking, with regard to the
      visualisation of internal derangements of the TMJ, was enhanced by the techniques
      of manual examination.

PMID- 1757017
TI  - [Gnathographic study of mandibular borderline movements and chewing patterns
      before and after surgical dysgnathia correction in retrognathism and
      prognathism].
AB  - Chewing patterns and longitudinal border movements of 16 patients with severe
      dysgnathia were examined preoperatively and up to 12 months postoperatively by
      means of sirognathographic records of surgical-orthodontic treatment results.
      Patients with a skeletal class-III malocclusion showed an increased range of
      movement compared to the preoperative situation, after a surgical mandibular
      setback performed by wire osteosynthesis, followed by an intermaxillary
      immobilisation of 6 weeks. Patients with a skeletal class-II malocclusion showed
      a considerably limited range of movement during the first postoperative
      registration after a surgical mandibular advancement. The preoperative situation
      had not been fully achieved even after 12 months. The postoperative
      sirognathographic records present distinct differences in functional adaptation
      between surgical mandibular advancement and mandibular setback.

PMID- 1757018
TI  - [Long-term results after genioplasty].
AB  - The serial records of 21 patients were analyzed to study the stability of
      genioplasty performed in the course of orthognatic surgery and to describe its
      effect on the soft tissue profile. A pre-operative and a post-operative
      cephalogram as well as a cephalogram one year after surgery of each patient were
      available. Sagital correction of the chin from 16.5 mm advancement to 1.1 mm
      reduction and vertical movements between 4.8 mm lengthening and 9.3 mm shortening
      remained nearly unchanged during the control period. No post-operative movements
      of the chin fragment were observed except for minor resorptions that can be
      attributed to an osseous remodelling and rounding of sharp edges. In cases of a
      long face syndrome a bone apposition from 1 mm to 5.5 mm appeared at the lower
      edge of the chin. The average of sagittal soft tissue change in relation to the
      correction of the bony chin was 71%. The individual values ranged from 4% to 145%
      and the standard error of the estimate was 3 mm. Therefore the planning of the
      soft tissue profile is rather unreliable. A genioplasty performed with rigid
      fixation by compression screws or mini plates, preservation of vascular supply
      and re-fixation of the soft tissue of the chin results in accurately predictable
      and stable bony contours. On the other hand, the planning of surgery procedures
      related to the soft tissue profile is--if at all possible--very insecure.

PMID- 1757019
TI  - [Comparative study of the accuracy of localizing cephalometric reference points
      in using digital and conventional imaging technique].
AB  - The purpose of this study was to present possible advantages of digital
      luminescence radiography for cephalometry. Conventional and digitalized lateral
      headfilms were compared and evaluated. The first impression of an improved
      simultaneous presentation of bony structures and soft tissue profile in digital x
      rays was statistically verified. A significant difference in identification of
      several reference points was proven by means of the F-test. The superior results
      of the digital luminescence radiography were evaluated in comparison with
      xeroradiography and experimental postdigitalization of conventional x-rays.

PMID- 1757020
TI  - [The accuracy of soft tissue profile prediction with the "Dentofacial Planner" in
      skeletal prognathism].
AB  - 30 pre- and postoperative lateral cephalograms of patients with mandibular
      prognathism are used to evaluate the soft tissue profile prognosis given by the
      "dentofacial planner". As a result, the horizontal displacement of SLS (sulcus
      labrale superius) and Pg' (soft tissue pogion) in patients with a normal vertical
      dimension and additional LMF (labiomental fold) in persons with a marked overbite
      are calculated well. The horizontal changes of the other points analyzed as well
      as all vertical changes are not predicted satisfactorily in the momentary version
      4.22 A (febr. 1989), which will be improved by the company.

PMID- 1757021
TI  - [Head posture in lateral roentgen image].
AB  - A cervico-cephalometric examination of 61 yet untreated orthodontic patients was
      performed in order to analyze differences in head posture between standardized
      cephalograms and lateral cephalograms taken in natural head position. Additional
      x-rays were taken in extreme flexion and extention of the head in 48 patients
      examining the mobility of the upper cervical spine. Finding partly large
      differences in cranio-vertical and cranio-cervical parameters between the two
      methods of registration it could be shown, that head posture on the average was
      more proclined in natural than in fixed standardized position. Subjects with
      class III malocclusion tended to a more extended head posture relatively to those
      with class I or class II malocclusion. Judging the atlas position with regard to
      the functional mobility of the upper cervical spine, a superior and inferior
      atlas position was not thought to be a pathologic fixed malposition.

PMID- 1757022
TI  - [Bonding strength of brackets with and without silane coating].
AB  - This study was undertaken to show that a silane treated bracket base can provide
      a better bonding to the enamel than conventional bonding bases commercially
      available. Five different types of metal brackets, each with different retentive
      properties, were tested. 20 brackets of each type were used, half of them
      silanated with a special silicoater treatment. The brackets were bonded to the
      surface of the teeth with Concise Enamel Bond and were then tested to failure in
      an Instron testing machine after 28 days. The following conclusions can be drawn
      from the study: 1. Silane-coated bracket bases demonstrated a higher bonding
      strength than the conventional bases, 2. silane treatment of plain bases is an
      effective method for the bonding of brackets to teeth, similiar to non-silane
      boated brackets with additional mechanical retentive devices.

PMID- 1757023
TI  - [Current state of implantation of flexible intraocular lenses].
AB  - Two main arguments have stimulated the development of hydrogel and silicone
      lenses: flexibility allows folding and thus insertion through a small incision,
      and inertness promises excellent biocompatibility, possibly surpassing that of
      PMMA. However, as long-term performance remains to be established, these implants
      cannot yet be considered a routine alternative. Clinical studies are mandatory to
      document their advantages and any disadvantages, especially as few of the reports
      already published on experience with such lenses do not give an objective picture
      of the current status: the surgical techniques used and the observation criteria
      applied differ and were sometimes inappropriate. In addition, the series are too
      small and the follow-up studies too short to allow valid conclusions. In this
      paper, following the description of the materials and designs and of the
      implantation techniques available for flexible lenses, a review of the pertinent
      literature and the author's own experiences is reported. This is based on 800
      implantations performed over a period of 4 years. Monobloc designs with flange
      haptics (IOGEL, STAAR) have been found to perform best. The Faulkner folder has
      proved to be optimal, allowing for easy and atraumatic folding and insertion.
      Within the eye, the lens is safely guided and released. Bag placement of
      appropriately styled lens models is strongly recommended, since sulcus-placed
      lenses have sometimes shown either iris bulging or decentration and windshield
      wiper or propeller phenomena. The capsular edge should be smooth and the capsular
      opening well centered and round in order to guarantee stable fixation and
      symmetrical compression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757024
TI  - [Intraocular antibiotic administration for prevention of fibrin reaction after
      extracapsular cataract extraction? A randomized double-blind study].
AB  - Postoperative fibrinoid reactions are regarded as a localized form of
      endophthalmitis caused by microbial contamination of the capsular bag during
      intraocular lens implantation. The incidence of early fibrinoid reactions within
      the first 6 postoperative days following extracapsular cataract extraction was
      examined after intraocular administration of antibiotics vs placebo. In a double
      blind randomized trial, 2 mg cefamandol or a placebo was administered in a 0.4-ml
      volume at the end of the operation. A group of 28 patients received the
      antibiotic (mean age 74.6 years; 15 f, 13 m), while 33 patients received the
      placebo (mean age 72,1 years; 21 f, 12 m). Fibrinoid reactions were observed in 8
      out of 61 patients during the first 6 postoperative days. There was no
      significant difference between the antibiotic group and the placebo group (P =
      0.31). We were unable to reduce the incidence of fibrinoid reactions although we
      had selected a broad-spectrum cephalosporin for antibiotic treatment. The results
      give rise to the suspicion that most of the early postoperative fibrinoid
      reactions we observed were not caused by contamination with bacteria of low
      pathogenicity.

PMID- 1757025
TI  - [Absence of cataractogenic effect of lovastatin (Mevinacor) so far].
AB  - Lovastatin is an inhibitor of HMG-Co A reductase, a key enzyme in cholesterol
      biosynthesis. It is of therapeutic value in hypercholesterolemia type IIa and
      leads to decreased levels of low-density lipoproteins in serum. Treatment with
      high doses of lovastatin has been reported to induce cataract formation in dogs.
      The goal of the ongoing prospective clinical study is to evaluate whether
      cataract formation is caused in humans by therapeutic doses of lovastatin. So far
      28 patients (average age 44 years) suffering from hypercholsterolemia have
      entered the study. Besides thorough slit-lamp investigations in all patients,
      best corrected visual acuity and contrast sensitivity for five different spatial
      frequencies were measured. A reduction in contrast sensitivity is a sensitive
      indicator for opacities of lens and cornea. During a mean follow-up of 37 weeks
      (range 5-62 weeks) with a mean total dose of 15 g (range 2-26 g), no cataract
      formation or decreased contrast sensitivity has so far been observed.

PMID- 1757026
TI  - [PDGF-induced calcium increase in cultivated epithelial cells in the cattle
      lens].
AB  - Platelet-derived growth factor (PDGF) is one of numerous growth factors
      regulating development of the ocular lens and its component parts. Although
      little is known about its site of action on the cell and the mechanisms of this
      confirmed mitogenic action, a close connection has been assumed between the
      influence of PDGF on both the lens epithelium and intracellular calcium
      homeostasis. The present study therefore examined the influence of PDGF on the
      concentration of intracellular free calcium [( Ca2+]i) in primary cultivated
      bovine epithelial cells. A dose-dependent [Ca2+]i increase of up to 300% followed
      stimulation with PDGF (5-50 ng/ml) in a medium containing Ca2+. [Ca2+]i also rose
      significantly in Ca(2+)-free medium, indicating mobilization from intracellular
      storage.

PMID- 1757027
TI  - [Controlled clinical study of two viscoelastic substances].
AB  - Viscoelastic substances in correlation with intraocular hypotony have gained
      great significance in low-irritation cataract surgery within the last few years.
      The differences in their chemical properties, and thus in their effect on the
      eye, formed the grounds for a controlled clinical study comparing sodium
      hyaluronic acid, representing the group of glucosamine glykanes, and
      hydroxypropylmethyl cellulose (HPMC), representing the group of cellulose ethers.
      Two hundred cataract patients, excluding those suffering from diabetes mellitus,
      glaucoma and severe corneal damage, were examined on the 1st, 2nd and 5th
      postoperative day, as well as 4 weeks postoperatively. Statistically, no
      significant differences were found as regards IOP and postoperative anterior
      chamber irritation. From the economical point of view, methocel (HPMC) should be
      preferred to sodium hyaluronic acid in routine cataract surgery due to the lower
      costs.

PMID- 1757028
TI  - [Retinal lesions after transvitreal use of ultrasound].
AB  - Removal of a dislocated natural lens into the vitreous cavity is now performed
      using vitreous surgery techniques combined with intravitreal phacoemulsification
      via the pars plana. In contrast to the earlier external surgical approach to
      luxated lenses, postoperative complications, particularly retinal detachment, are
      rare. However, retinal damage may occur when ultrasound is used at therapeutic
      intensities. We therefore examined ultrasound-induced retinal lesions produced in
      rabbit eyes by treating the retina directly with ultrasound using the type of tip
      conventionally used for pars plana lensectomy (Fragmatom). Histological
      evaluation showed that acoustic energy at low intensities led primarily to damage
      of photoreceptor cell outer and inner segments, which correlated with a discrete
      pigment reaction visible on ophthalmoscopy. More severe lesions were seen in
      destruction of the inner retina and resulted in retinal blanching or caused a
      small retinal break. High energy led to a full-thickness retinal defect with
      rupture of choroidal vessels and heavy bleeding into the vitreous cavity. Within
      these lesions the retinal pigment epithelium and Bruch's membrane were also
      disturbed. Our ophthalmoscopical and histological findings indicate that the
      mechanism of ultrasound-induced chorio-retinal lesions is not exclusively thermal
      in nature and differs from other coagulation modalities.

PMID- 1757029
TI  - [Bilateral chorioretinitis after infection with Yersinia enterocolitica].
AB  - We report a case of severe, bilateral panuveitis with disseminated chorioretinis.
      With systemic steroid therapy the inflammation resolved within 4 weeks, resulting
      in chorioretinal scarring. Because the agglutination titer against Yersinia
      enterocolitica type 3 was increased to 6 times over normal, we consider Yersinia
      to be the most probable cause of the panuveitis. Concomitantly, serology revealed
      evidence for recent infection with mumps and shigella. Both can cause anterior
      uveitis. Therefore, we cannot exclude interactions, which may influence the
      clinical picture. After reviewing the literature we describe for the first time a
      case of chorioretinits and panuveitis associated with infection by Yersinia.

PMID- 1757030
TI  - [Humoral immune response to retinal S-antigen in patients with uveitis].
AB  - Experimental autoimmune uveoretinitis (EAU) is a predominantly T-cell-mediated
      autoimmune inflammatory disease of the retina and uveal tract of the eye. Retinal
      S-antigen, a protein found in retinal photoreceptor cells, is a potent agent for
      the induction of EAU in susceptible species and strains. Elevated titers of
      antibody to S-antigen have been reported in patients with different forms of
      uveitis. Serum samples from 166 patients and 87 healthy blood donors were tested
      by immunoblotting against human retinal abstract for IgG, IgM and IgA antibodies
      to S-antigen. Compared to the controls the patient sera showed a higher incidence
      of S-specific antibodies (17.5% vs 9.2%). No specific correlation between the
      presence of any type of uveitis and anti-S antibodies has been found (anterior
      uveitis 15.1%, posterior 19.6%, panuveitis 18.9%). There was a higher incidence
      especially with IgG antibodies during active disease (19.7% vs 9.2% in controls).
      The results suggest that since EAU is T-cell mediated, antibodies in humans may
      be most important as indicators of autoimmunity rather than mediators of the
      inflammation. As these anti-S antibodies might be induced by disruption and
      nonspecific inflammation of the retina and uvea alone, an important and difficult
      question in patients is whether or not these secondary autoimmune response can
      contribute to the induction of uveitis.

PMID- 1757031
TI  - [Autosomal dominant hereditary retinopathia pigmentosa with genetic
      heterogeneity].
AB  - There is considerable clinical variability in autosomal dominant retinitis
      pigmentosa (ADRP). The underlying biochemical defect had remained unknown until
      recently, so that it was not possible to determine the primary cause(s) of this
      phenotypic diversity. Recently, different point mutations and base pair deletions
      have been identified in the rhodopsin gene in a proportion of patients with ADRP,
      providing convincing evidence for allelic genetic heterogeneity in this disease.
      We screened a total of 65 patients with ADRP in Germany, Austria, and Switzerland
      for the presence of the point mutations described recently at codons 58 and 347
      in patients in the USA. Our results show that the frequency of point mutations at
      codon 347 in the patients studied here is about 3%, a figure similar to that
      found in the USA. The frequency of the mutation at codon 58 seems to be generally
      low. The identification of patients with point mutations in the rhodopsin gene
      offers the possibility, for the first time, of studying the correlation between
      genotype and disease phenotype.

PMID- 1757032
TI  - [Hemodynamic findings after retinal interventions].
AB  - In this study we tried to find out if the hemodynamic results could help us
      explain why the visual situation after retinal surgery often becomes
      unsatisfactory despite good anatomical results. Using Ulrich's methods (oculo
      oscillodynamography), we measured the hemodynamic parameters-especially ciliary
      perfusion pressure and the volume of blood flow--in 40 patients after retinal
      surgery. One of our results is remarkable: there is a direct relationship between
      the amount of scleral buckling and a disturbance in the hemodynamic parameters.
      Otherwise, we found that hemodynamic disturbances after vitreous surgery
      (vitrectomy, silicone oil implant or gas) are less dramatic than after buckling
      methods or in connection with them. Also, the hemodynamic disturbance begins
      before retinal surgery, obviously according to the stage of ablation: with or
      without macular involvement and irrespective of the time of retinal detachment.
      After all we have demonstrated in this study, we have reason to believe that a
      disharmony in the ocular hemodynamics causes disappointing visual results, often
      seen after retinal surgery.

PMID- 1757033
TI  - [Retinal degeneration and embryonal rhabdomyosarcoma of the thorax].
AB  - We discuss a paraneoplastic retinopathy in a 6-year-old boy who had an embryonal
      rhabdomyosarcoma of the thorax. Opacities of the vitreous body, optical atrophy,
      contracted arteries and changes in the structure of the retina--especially the
      retinal pigment epithelium--characterized the ophthalmological findings. The
      asymmetrical localization of the changes makes the differential diagnosis of
      hereditary retinal dystrophies easier. It is probably an immunological disease
      caused by an antigenic antibody reaction.

PMID- 1757034
TI  - [Retinal nerve fiber layer photography in retinal vein occlusion].
AB  - In six eyes we found typical signs that could serve as criteria for the
      differentiation of ischemic from non-ischemic retinal branch vein occlusion.
      Perimetry showed a mean defect (in the affected area) of more than 10 dB in eyes
      with defects in the retinal nerve fiber layer in contrast with 5 dB on one eye
      without nerve fiber defects. Secondly, fluorescein angiography showed ischemic
      areas in all eyes examined with localized defects in the photographs of the
      retinal nerve fiber layer. Damage of the retinal nerve fiber layer was observed
      before capillary obliteration could be detected by fluorescein angiography.
      Thirdly, semiquantitative optic disc morphometry demonstrated that using the
      difference between pallor and excavation as the only sign in ascending optic
      atrophy is not always useful. Fourthly, photography of the retinal nerve fiber
      layer showed that there is no correlation between the extension of the ischemic
      area and the sector angle of the defect of the retinal nerve fiber layer.
      Photography of the retinal nerve fiber layer can differentiative ischemic from
      non-ischemic retinal branch vein occlusion because of the qualitative detection
      of localized retinal nerve fiber layer defects. Consequently, this method is not
      only of great clinical importance for the diagnosis of different optic lesions,
      but is also useful for the prognosis and management of occlusion of the retinal
      branch vein.

PMID- 1757035
TI  - [Microcoagulation of the fundus. Experimental results of repeated laser pulse
      exposure].
AB  - Angiographically visible lesions were produced in the fundus of rabbit eyes with
      repetitive 5 microseconds pulses and continuous wave exposures with 50-ms to 1-s
      pulse duration from an modified argon laser (514 nm). The ophthalmoscopic and the
      fluorescein angiographic findings showed less damage in the neural retina and the
      choroid after repetitively pulsed irradiation. Light microscopy and transmission
      electron microscopy showed that the neural retina and the choroid can mostly be
      spared by using repetitive 5 microseconds pulses, even though the damage to the
      retinal pigment epithelium is similar to the damage caused by continuous wave
      irradiation. Possible clinical applications, e.g. for macular edema and central
      serous retinopathy, are discussed.

PMID- 1757036
TI  - [Results of surgical therapy of advanced stages of retinopathy of prematurity].
AB  - The results of buckling procedures performed in 15 consecutive cases of severe
      retinopathy of prematurity between 1983 and 1990 are presented and discussed. The
      preoperative status was stage IV in 6.7% und stage V with an open funnel in 93.3%
      of these cases. Anatomical success was found in 53.3% in the early postoperative
      phase, but this had fallen to 33.3% before the long-term follow-up examination.
      Functional success at least with perception of large forms was recorded in 20%.
      The surgical technique and postoperative complications are described. The results
      of closed vitrectomy performed in 104 consecutive cases of severe retinopathy of
      prematurity between 1983 and 1990 are then dealt with. The preoperative status
      was stage IV in 13.5%, stage V with an open funnel in 18.3% and stage V with a
      closed funnel in 68.2%. Anatomical success was achieved in 29.8% in the early
      postoperative phase, but the proportion fell to 13.5% during a long-term follow
      up study. Functional success at least with perception of hand movements was
      recorded in 10.6%. The surgical technique and postoperative complications are
      described.

PMID- 1757037
TI  - [Automated measurement of retinal vascular diameter].
AB  - We describe a new unit of the Jena retinal camera for automatic measurement of
      retinal vessel diameter. The brightness profile perpendicular to the vessel is
      registered by CCD line sensor and the signal is transmitted to the computer. An
      adaptive computer program recognizes the edges of vessels and estimates the
      vessel diameters automatically. Applying several measurements per vessel, the
      intraindividual standard deviation may be smaller than 3%. By using the same
      objective measuring edge criterion, the measuring results are comparable between
      different observers and methods. Error sources are discussed. Measured vessel
      reactions to oxygen breathing and reduced perfusion pressure are presented to
      demonstrate the efficiency of this new method.

PMID- 1757038
TI  - [Effect of prednisolone on the course of optic neuritis. Results of a double
      blind study].
AB  - The treatment of optic neuritis (ON) with corticosteroids has been controversial
      for many years. None of the previous studies with the usual dosage of steroids or
      ACTH has proven that this therapy is beneficial. However, these studies did not
      apply sensitive parameters for assessing the course of ON. The aim of this study
      was to examine the effect of corticosteroids using subtle parameters. The study
      design emphasized: 1. strict criteria for patient selection; 2. frequent controls
      during the initial period of the disease, follow-up for 1 year; 3. double-blind
      conditions with randomized groups; 4. assessment of the course with sensitive
      parameters, including visual acuity, visual evoked potentials (VEP) and the
      Tubingen Flikker Test, also called the Aulhorn Flicker Test, which monitors the
      activity of the ON. These last two tests were used for the first time in a
      controlled treatment study in ON. Thirty-eight patients with acute ON were
      treated orally in a double-blind procedure with either methylprednisolone
      (initially 100 mg daily, reduction every 3 days) or with vitamin B1 (100 mg
      thiamin daily) in the control group. The results of the Flicker Test and VEP
      showed a trend toward faster recovery under prednisolone within the first few
      weeks after onset of the disease. After 1 year none of the parameters examined
      showed any difference between the two groups. Thus, although prednisolone
      treatment in the dosage mentioned above seems to speed up recovery in the initial
      phase in some patients, no long-term benefit could be demonstrated.

PMID- 1757039
TI  - [Neuroretinal rim in eyes with simple optic atrophy].
AB  - In comparison with normal eyes, eyes affected by glaucomatous optic nerve damage
      are characterized by a decreased neuroretinal rim area and an increased optic cup
      size. This study was performed to find whether eyes with nonglaucomatous optic
      nerve atrophy and normal eyes differ with respect to the neuroretinal rim. In
      all, 143 eyes with nonglaucomatous descending optic nerve atrophy and 563 normal
      eyes were biomorphometrically examined. The area and form of the neuroretinal rim
      and optic cup and the horizontal and vertical cup-to-disc ratios did not differ
      significantly between the two groups. These results are in part not supported by
      data in the literature. If they are confirmed by further studies, they will
      indicate that measurement of the neuroretinal rim and estimation of the cup-to
      disc ratios will not be useful for the diagnosis of damage to the descending
      nonglaucomatous optic nerve. It will be helpful for the differentiation of eyes
      with glaucomatous and nonglaucomatous optic nerve atrophy.

PMID- 1757040
TI  - [Mass screening of blue color vision in divers with the desaturated Lanthony-15
      Hue Test].
AB  - We tested 1002 persons, 572 divers (including 38 who had diving accidents) and
      430 nondivers, for defects of the blue-sensitive system during the years 1988 and
      1989. Recent research has shown functional disorders of color vision in divers,
      linked to previously described alterations of the retinal capillary system and
      pigment epithelium. The desaturated Lanthony-15-HUE test was used as a screening
      method. No defect of the blue-sensitive system was found, either in divers or in
      nondivers. Our results are similar to those of other researchers. One exception
      was that we found no correlation between age and error score. We found no
      evidence for retinal damage caused by diving.

PMID- 1757041
TI  - [Relevance of ocular pressure tonometry and classical tonometry with reference to
      prognosis in suspected glaucoma and ocular hypertension].
AB  - A total of 44 eyes of patients with suspected glaucoma or ocular hypertension
      were examined both by ocular pressure tonometry (OPT) according to Ulrich and by
      tonography according to Leydhecker. The visual fields of these eyes were
      prospectively followed up for 3 years to compare the prognostic value of the two
      methods. In 30 of the 44 eyes a worsening visual field loss was observed, while
      in 14 the visual fields showed no change. Much better correlation was noted
      between values obtained by OPT and changes in visual field than between values
      obtained by tonography and visual field loss. Conventional tonography yielded 39%
      of false-negative values, but only 11% were recorded with OPT. Therefore,
      according to results of these and further investigations, OPT appears to be a
      more helpful and reliable method for assessment and decisions on therapy in
      patients with suspected glaucoma or ocular hypertension.

PMID- 1757042
TI  - [MK-507 (L-671 152): local tolerance and effectiveness of a new local carbonic
      anhydrase inhibitor in healthy probands].
AB  - A three-dose, randomized, double-blind parallel, placebo-controlled ocular
      tolerancy study was undertaken in 24 healthy, normal volunteers with two
      formulations of 2% MK-507 (L-671 152), a novel water-soluble, topical carbonic
      anhydrase inhibitor. In this study MK-507 was administered to humans for the
      first time. Subjects received 3 sequential drops of the test drug in one randomly
      selected eye (at 13:00, 14:00, and 14:10 o'clock): ten received 2% MK-507
      formulated with 0.5% hydroxyethylcellulose (HEC); ten, 2% MK-507 with no HEC;
      two, vehicle with HEC; and two, vehicle without HEC. Local tolerance of 2% MK-507
      was good with predominantly mild and transient local symptoms, somewhat fewer for
      the formulation without HEC. Significant lowering of intraocular pressure (IOP)
      by up to 7 mmHg was noted when comparing IOP 4 h and 5 h after the first dose
      with IOP 20 h and 19 h before the first dose in the treated eyes of subjects
      receiving MK-507. Slightly greater activity was noted when MK-507 was formulated
      with HEC.

PMID- 1757043
TI  - [Modification of refraction and visual noise perception by suction cup
      oculocompression].
AB  - In 17 ocularly healthy persons the IOP was artificially raised by suction cup
      oculopression (negative pressure: 65 mmHg [8.67 kPa]) from initially 15.5 +/- 2.2
      mmHg (2.07 +/- 0.29 kPa) to 25.2 +/- 4.0 mm Hg (3.36 +/- 0.53 kPa) (mean +/- SD).
      Continuing the initial refractive correction, visual acuity (Landolt's rings)
      decreased from initially 1.06 +/- 0.13 to 0.39 +/- 0.22 (P less than 0.001* [*t
      test, paired ties each]). A new optical refraction with suction cup in position
      significantly raised the visual acuity to 0.64 +/- 0.24 (P less than 0.002*). The
      suction cup itself induced astigmatism of 2.15 +/- 1.46 dpt (Canon Auto
      Refractometer RK-1), which significantly differed from the initial astigmatism
      (0.32 +/- 0.23 dpt) (P less than 0.001*). The minus cylinder axis initially
      showed no preferential position. During artificial IOP elevation it shifted to 90
      degrees...125 degrees (referred to the right eye) and thus ran about
      perpendicular to the meridian the suction cup was positioned on the eyeball.
      Effects of such refractive changes on differential light threshold and VEP
      amplitude are demonstrated. The results presented allow critical interpretation
      of previous IOP tolerance tests. The influence of suction cup oculopression on
      the perception of the white-noise field is shown in some glaucoma patients: the
      speed of the white-noise campimetry allows the increase in field defects during
      artificial IOP elevation to be followed up directly.

PMID- 1757044
TI  - [Diffuse and localized glaucomatous visual field changes in light sense, flicker
      and visual acuity perimetry. Evidence of pressure damage].
AB  - 75 eyes of 75 patients with different types of glaucoma (21 eyes with normal
      tension glaucoma, 49 eyes with primary open-angle glaucoma and 5 eyes with
      pigmentary glaucoma) were examined by automated light-sense, flicker and
      resolution perimetry. All fields were classified as being "normal" (N) or having
      "diffuse loss" (D), "localized loss" (L) and "diffuse plus localized loss" (DL)
      in masked fashion. The frequency distributions for the various field loss
      categories against the highest intraocular pressure ever reported in the
      patients' records were plotted. The frequency distributions for the purely
      localized defects show a peak at 20 mmHg and are markedly skewed to low pressure
      values, while the diffuse plus localized damage and the purely diffuse loss,
      however, show a peak at about 30 mmHg. The data support the hypothesis that
      diffuse field loss may be an indicator of pressure-induced damage.

PMID- 1757045
TI  - [Sensitivity of noise field campimetry as a screening method for glaucoma].
AB  - The glaucoma patient can perceive his or her visual field loss subjectively with
      snow field campimetry with the Tubingen electronic campimeter (TEC). The
      sensitivity of this new method of examination for glaucoma has not previously
      been evaluated. We were interested in finding whether absolute and relative
      scotomas could be detected with such high probability that snow field campimetry
      could be used as a screening method for the early detection of glaucoma. Analysis
      of the severity of scotoma is not possible, so that snow field perimetry can
      indeed by regarded as a screening procedure. A total of 76 eyes of 76 patients
      with glaucoma and stage I-IV visual field loss and 20 eyes of 20 patients with
      ocular hypertension were examined with threshold determining static perimetry
      (Octopus or Humphrey perimeter) and with the snow field of the TEC in controlled
      conditions. A qualitative comparison was drawn to evaluate how often a pathologic
      or normal finding was confirmed by snow field campimetry: of the 76 eyes affected
      by scotoma, 65 eyes (85.5%) showed pathologic findings consistent with the result
      of snow field campimetry, and 11 eyes showed normal findings. The visual field
      loss was 63.6% for glaucomatous visual field loss stage I: 90.9% for glaucomatous
      visual field loss stage II, and 95% for visual field loss stages III and IV. For
      16 of the 20 eyes with ocular hypertensions normal findings were reported with
      snow field campimetry. Snow field campimetry is suitable for use as a quick
      screening procedure, but only for absolute glaucomatous scotomas.

PMID- 1757046
TI  - [Visually evoked cortical potentials for early detection of optic neuritis in
      ethambutol therapy].
AB  - Ethambutol leads to chronic, severe optic neuritis with sudden onset in
      approximately 5-14% of all patients. Therefore, the ability of visually (pattern)
      evoked potentials for the early diagnosis of ethambutol-induced optic neuritis
      was tested. During ethambutol therapy prolonged latency was documented in 5 of 15
      cases (33%). One of these 5 cases showed a reversible decrease in visual acuity.
      Thus, during treatment with ethambutol visually (pattern) evoked potentials may
      reveal a surprisingly high percentage of subclinical optic neuritis. These
      patients need close supervision in order to facilitate early discontinuation of
      the drug when neuritis develops.

PMID- 1757047
TI  - [Relation of visual acuity of test field luminance in glare sensitivity of
      various origin].
AB  - Intolerance to bright light is a nonspecific ophthalmological symptom,
      originating either in disturbances of the optic apparatus of the eye or caused by
      functional disturbances of the neuronal network of the retina. Disturbances in
      brightness and darkness adaptation can often cause considerable decrease in
      visual acuity, which is not evident in the standardized tests that measure
      photophobia in conjunction with visual function. If the test field is very bright
      and the patient has photophobia, the visual acuity is often reduced considerably.
      The relationship between visual acuity and luminance of the test field was
      determined in glare--sensitive patients using a relatively simple method and a
      large range of luminances (0.1-30,000 cd/m2). In contrast to previously used
      methods, visual acuity was determined in a range where neuronal mechanism can be
      expected to be responsible for adaptation to brightness. We found disturbances in
      the relationship between visual acuity and luminance in several diseases, and it
      was especially pronounced in cone dystrophies. Affections of the optic nerve and
      opacities of the optic media usually did not cause a marked decrease in visual
      acuity at high luminances. As a supplemental investigation to mesoptometry and
      nyctometry, the method described here primarily permits types of photophobia to
      be determined that are not caused by stray light. The dynamic nature of neuronal
      adaptation processes determined by this test has therefore considerable influence
      on visual acuity.

PMID- 1757048
TI  - [Multisubstance analysis. Detection of changes in the optical density in
      individual layers of the optic fundus].
AB  - A promising method for noninvasive objective diagnosis and monitoring of the
      course of a therapy is spectrometric investigation of the human ocular fundus.
      Application of this method in clinical practice depends on the development of
      suitable procedures for deconvolution of the measured spectra. The availability
      of microcomputers permits the performance of complicated calculations directly at
      the measuring device. Based on the two-photon flux theory, the influence of
      absorption and scattering in anatomically determined layers of the fundus will be
      considered. For this reason, an iterative principle for radiation transport into
      the fundus is introduced, allowing derivation of a physical model for calculation
      of the spectral course of the reflected light. In the multisubstance analysis a
      measured spectrum is approximated by the model function. During this analysis the
      optical densities of photosensitive and nonphotosensitive pigments and the
      reflection at intermediate layers can be calculated. As an example of
      multisubstance analysis, the deconvolution of foveal reflection spectra of
      normals and type I diabetics is demonstrated. This method makes it possible to
      show that early diabetic alternations occur in the choroid.

PMID- 1757049
TI  - [Changes in the pattern electroretinogram in glaucoma and ocular hypertension are
      dependent on stimulus frequency].
AB  - A pattern electroretinogram (PERG) was recorded in patients in the initial stages
      of visual field defects resulting from open-angle glaucoma, in patients with
      ocular hypertension (OHT) and in age-matched controls. In both groups the visual
      acuity was above 0.8. Counterphasing checkerboard patterns were used as visual
      stimuli with a check size of 0.8 degrees and a range of reversal rates from 6 to
      36 reversals/s. The most significant reductions of amplitudes due to glaucoma and
      OHT were observed at rates of 18 and 24 reversals/s (glaucoma: P less than 0.005
      at 18 and 24 reversals/s, OHT: P less than 0.0005 at 18 reversals/s and P less
      than 0.0025 at 24 reversals/s). At reversal rates of 6 and 36 reversals/s the
      PERG was either not reduced (glaucoma and OHT: P greater than 0.01 at 36
      reversals/s, OHT: P greater than 0.01 at 6 reversals/s) or reduced only
      marginally (glaucoma: P less than 0.01 at 6 reversals/s). When one takes the 95%
      confidence limits of normals into consideration, it is obvious that patients with
      glaucoma and patients with OHT have pathologic PERGs more often at 18 reversals/s
      than at other temporal frequencies.

PMID- 1757050
TI  - [Chronic lipogranuloma of the eyelids after paranasal sinus operations].
AB  - Over a period of about 1 year we observed five patients who developed tumors of
      their eyelids a few days to 3 weeks after surgery on the paranasal sinuses
      through the nasal passage. One patient noticed a swelling of his ipsilateral
      eyelid during an irrigation procedure for the maxillary sinus, which was also
      followed by endonasal surgery. After surgery each patient developed an
      ipsilateral periorbital hematoma and subsequently solid indolent tumors of the
      eyelid without a tendency to regress over a period of 3 to 14 months. Therefore,
      surgical treatment was necessary. The histological examination showed
      lipogranulomas with giant cells and many lipid vacuoles of different size.
      Exploring the origin of these lipids, we performed a magnetic-resonance-spectrum
      analysis of one tumor sample. We predominantly found signals for linear
      hydrocarbons, which are the main components in paraffin-liquids. We presume that
      our patients developed lipogranulomas of their eyelids due to the paraffin
      introduced into the tissue by the ointment used to tampon the paranasal sinus
      after endonasal surgery.

PMID- 1757051
TI  - [Temporal tarsal strip-plasty for correction of malposition of the lower eyelid].
AB  - The lateral tarsal strip procedure has the combined effect of increasing
      horizontal lid tension and adjusting the level of the lateral canthus. Following
      a lateral canthotomy a tarsal strip is created from the lateral aspect of the
      lower lid and sutured to the periosteum at the lateral orbital wall. Indications
      for this technique include senile and paralytic ectropion, recurrent entropion,
      congenital malpositions, and lid laxity following trauma or enucleation. The
      results yielded by this technique in 148 patients at the University Eye Hospital
      in Munich are presented. These included 53 suffering from paralytic ectropion in
      whom a medial canthoplasty was added to the lateral tarsal strip procedure. The
      two techniques combined provided symmetrical adjustment of the level of both
      lateral and medial canthal angles, a good position of the lacrimal puncta and
      increased lid tension.

PMID- 1757052
TI  - [Double-guided vacuum trephine system "Asmotom"].
AB  - A new, doubly guided cornea suction trephine system is presented. By means of a
      suction rim placed on the limbus corneal and a suction disc in the centre of the
      cornea the vault of the cornea is preserved throughout the trephination
      procedure. Cutting is performed by a motor trephine, which rotates between the
      inner and the outer suction. The system allows creation of an absolutely safe
      perforation in a 360 degrees cut. The cut edges are precise and sharp. Both donor
      and recipient are trephined from the epithelial side. The endothelial cell loss
      is very low, amounting to 0.170 mm. The suction stabilization prevents any
      tilting of the trephine and avoids elliptical forms. Preliminary clinical
      experiences are presented.

PMID- 1757053
TI  - [Anesthesia effects on ocular circulation. Synopsis of a study].
AB  - In a study of 280 patients (265 with cataract, 15 with strabismus), we
      investigated the ocular circulatory effects of 3 methods of anesthesia widely
      used in ophthalmic surgery, retrobulbar, peribulbar and general anesthesia.
      Retrobulbar anesthesia (RETRO) was performed with 2, 5 or 8 ml of a mixture (BLH
      Mix) of bupivacaine 0.75%, lidocaine 2% and hyaluronidase; with 5 ml BLH-Mix and
      addition of adrenaline in a low (1:500,000) or a higher (1:200,000)
      concentration; with 5 ml bupivacaine 0.75% or lidocaine 2% or mepivacaine 2%;
      with 5 ml mepivacaine 2% and addition of 150 units hyaluronidase; or with 5 ml
      BLH-Mix plus adrenaline and additional oculopression. Peribulbar anesthesia
      (PERI) was performed with 8 ml BLH-Mix (5 ml inferotemporally/3 ml superonasally)
      or 10 ml BLH-Mix (8/4) injected outside the muscle cone. General anesthesia was
      performed using halothane (inspiratory concentration 0.5 vol%) and nitrous oxide
      (65 vol%); respiration was adjusted to produce slight hyperventilation (alveolar
      pCO2 33 mmHg) or forced hyperventilation (pCO2 20-25 mmHg), respectively. The
      following variables were measured; systolic ciliary perfusion and blood pressures
      (PPs,cil and Ps,cil, respectively) and ocular pulsation volume (PVoc) using oculo
      oscillodynamography of Ulrich, and the intraocular pressure (IOD) using the
      Draeger handapplanation tonometer. RESULTS: (1) Measured 15 min after injection,
      PVoc was reduced by all local anesthesia (LA) methods by a range of 17-65%. The
      changes were dependent on the following factors: (a) increasing injection volume:
      larger PPs,cil reduction; (b) addition of adrenaline: larger reduction of all
      hemodynamic variables; (c) addition of hyaluronidase: more pronounced PVoc
      reduction; (d) type of local anesthetic: most marked PVoc reduction induced by
      RETRO with mepivacaine and bupivacaine, smallest reduction by lidocaine; (e) site
      of injection: less marked reduction of all hemodynamic variables during PERI than
      during RETRO with equal (8 ml) or equipotent (PERI 10, RETRO 5 ml) injection
      volumes; (f) additional oculopression: more marked Ps,cil reduction. The IOP,
      measured 15 min after injection, was increased by most LA types. The degree of
      IOP elevation was dependent on the following factors: (a) increasing injection
      volume: higher IOP elevation; (b) type of local anesthetic: lowest IOP elevation
      induced by bupivacaine, more marked effect of lidocaine, highest elevation after
      mepivacaine injection. After additional oculopressure, the IOP was reduced as
      expected. (2) During general anesthesia with slight hyperventilation, PPs,cil and
      Ps,cil were reduced by 20.6 and 27.6 mmHg, respectively, measured 15 min after
      intubation. PVoc was decreased by 50.8% and the IOP by 7.6 mmHg. With forced
      hyperventilation, the reduction of PVoc was even more pronounced. CONCLUSIONS:
      The anesthesia-induced lowering of both ocular perfusion and blood pressures as
      well as of the ocular pulsation volume, which is a measure of the pulsatile
      choroidal blood flow, can be interpreted as reflecting an inhibitory influence on
      ocular circulation. We suggest the following mechanisms to account for the
      changes during LA: elevation of IOP, adrenaline-induced retrobulbar
      vasoconstriction, LA-induced retrobulbar vasoconstriction (hypothetical),
      improved penetration of LA brought about by the orbital compression occurring
      during oculopression. The relative significance of the separate mechanisms
      differs, however, between the various LA types. The changes found during general
      anesthesia are attributable to the halothane-induced reduction of systemic blood
      pressure and cardiac stroke volume as well as to a relative hyperventilation
      induced choroidal vasoconstriction. The results are relevant for ophthalmic
      surgery with respect to the prevention of complications and problems depending on
      pathologic or at least unphysiological changes in ocular circulation, e.g...

PMID- 1757054
TI  - [Mydriasis caused by plant contact].
AB  - Uni- or bilateral dilatation of pupils that are not reactive to light and lack
      miosis in response to 1% pilocarpine may be caused by contact with plants
      containing alkaloids such as scopolamine and atropine. Other causes of a non
      light-reactive dilated pupil, such as Adie's tonic pupil, third nerve palsy and
      lesion of the mesencephalic pretectal region, must be excluded before testing the
      iris sphincter reaction to 1% pilocarpine. Among the naturally growing flowers in
      Germany, deadly nightshade (Atropa belladonna), jimson weed (thornapple, Datura
      stramonium) and black henbane (Hyoscyamus niger) contain enough alkaloids to
      cause mydriasis by direct contact. However, in most cases an accidental mydriasis
      by plants in Germany is caused by Datura arborea taxa, e.g. Datura suaveolens, D.
      candida, D. aurea and D. sanguinea. They contain up to 0.6% dry weight
      scopolamine. These plants can grow very large and are often planted in tubs. They
      have to be cut back each year before the winter. This is typically how the eye is
      contaminated by parts of the plants, which can cause dilatation of the pupil
      mimicing a neuroophthalmological disorder.

PMID- 1757055
TI  - [Traveler's diarrhea--prevention, self care].

PMID- 1757056
TI  - [Endoscopic ultrasound in gastroenterologic tumors].
AB  - By means of endoscopic ultrasound (EUS) the visualization of the gastrointestinal
      wall Layers as well as a high-resolution imaging of the pancreas with
      neighbouring large vessels has become possible. EUS is especially sensitive in
      the local tumor staging in esophageal, gastric, pancreatic and ampullary
      carcinoma (accuracy rates 80-90%). Lymph node metastases are correctly identified
      in 70-80%. This also applies to the rectal cancer employing rigid instruments.
      Experience with colonic endosonography is still too limited to permit any
      definitive conclusions. For the primary diagnosis of submucosal tumors of the
      upper GI tract, and for the detection of small pancreatic lesions (e.g. endocrine
      tumors), endosonography is of high diagnostic accuracy.

PMID- 1757058
TI  - [A galenic diclofenac more wisely packaged?. Interview by Dr. T. U. Keil].

PMID- 1757057
TI  - [Human geneticist from Wurzburg discovers a new hereditary disease. Schindler
      disease: an autosome recessive neuro-axonal dystrophy].

PMID- 1757059
TI  - [Psychosis in organic brain syndrome. Melperon eliminates anxiety and
      restlessness].

PMID- 1757060
TI  - Stress echocardiography: an overview.
AB  - Stress echocardiography has come a long way in the past ten to twelve years since
      it first began. There have been many procedural and technical advances. The
      results being obtained by those laboratories with active programs are very
      gratifying. Stress echocardiography is proving to be particularly valuable in
      women and in evaluating coronary angioplasty. Although the comparison between
      stress echocardiography and stress nuclear cardiology is actively being debated,
      the available data would suggest that the results are grossly comparable. There
      are certain subsets of patients which may be identified where one technique might
      excel over the other. The most important factor is undoubtedly the competence of
      the laboratory performing the test. A high quality nuclear study is clearly going
      to be better than a poor quality echocardiogram and vice versa. However, assuming
      a high degree of competence in either technique, stress echocardiography has many
      obvious practical advantages. There is no reperfusion necessary so that the
      patient does not have to return in four hours. There is no radiation involved.
      And the results are available immediately after the examination. For all of these
      reasons it is not surprising that stress echocardiography is gaining in
      popularity and should play an increasingly important role in the management of
      patients with coronary artery disease.

PMID- 1757061
TI  - [Stress echocardiography: a sensitive method in diagnosis of coronary heart
      disease].
AB  - Prevalence of coronary artery disease requires sensitive diagnostic methods for
      screening and follow-up. The sensitivity of stress-ECG is low, 201-thallium
      scintigraphy is more sensitive but has the disadvantages of radiation and costs.
      Improved echocardiographic resolution with better identification of endocardial
      border as well as digital imaging technique have increased the interest in stress
      echocardiography as a diagnostic tool in coronary artery disease since a decade
      ago the clinical usefulness of stress echocardiography has been demonstrated. For
      stress echocardiography a semisupine bicycle position for continuous recording of
      echocardiographic images from the apical position in the two-chamber- and RAO
      view was developed. Echocardiographic images were digitized with a frame rate of
      30/s and stored on optical discs with a storage capacity of 1 Gbyte. Rest and
      exercise images were analysed simultaneously for newly-occurring wall motion
      abnormalities or deterioration of already present hypokinesia or extension of
      existing wall motion abnormalities. Segmental wall motion was scored according to
      the scheme in Figure 2. In addition end-diastolic, end-systolic volume, and
      ejection fraction were calculated. In a patient population of 150, 30 female and
      120 male, age 56.6 +/- 8.3 years, we could confirm the results reported by other
      working groups and demonstrate a high sensitivity in the diagnosis of single
      vessel disease. Our technique with the patient cycling in semi-supine position
      allows continuous echocardiographic registration during exercise and offers
      adequate image quality. The mean workload at peak stress was 127 +/- 30 watts,
      the maximal heart rate 137 +/- 18 bpm. Digital cine-loop imaging allowed
      evaluation of the examinations in about 90% of the cases. The sensitivity in the
      whole study group was 87%, the specificity 80%. Under full antianginal
      medication, 43% of the patients developed angina pectoris during exercise and 58%
      had a positive stress-ECG. The sensitivity in single-vessel coronary artery
      disease was 93% for the left anterior descending, 80% for the left circumflex,
      and 83% for the right coronary artery. These results in single-vessel disease
      were superior compared to findings of other authors using different techniques of
      stress echocardiography. In addition to the qualitative analysis, quantitative
      measurement of end-systolic volume and ejection fraction seems to be important.
      We found a significantly more pronounced decrease of ejection fraction at peak
      exercise in patients with multivessel disease compared to those with single
      vessel disease. In single-vessel disease ejection fraction was 61 +/- 12% at rest
      and 57 +/- 17% during exercise, this difference was not significant.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1757062
TI  - [Transesophageal echocardiography in combination with atrial stimulation for
      detection of ischemia-induced disorders of myocardial wall motion].
AB  - The diagnostic value of exercise echocardiography has been widely reported. In up
      to 20% of patients conventional transthoracic exercise echocardiography however
      is impossible due to impaired image quality related to exercise. In addition some
      patients will not be able to perform a conventional bicycle exercise test due to
      joint disease or peripheral vascular disease or a sufficient stress is not
      possible because of lack of patient motivation. In an attempt to overcome these
      limitations, a system has been developed which combines transesophageal
      echocardiography with simultaneous transesophageal atrial pacing via the same
      probe. Three circular silver pacing electrodes were installed at a distance of
      7,9 and 12 cm from the tip of the echoscope. Square wave pulses of 10 ms and an
      intensity of 7 to 20 mA were delivered. After baseline recording at the patient's
      spontaneous heart rate, atrial pacing was initiated at a rate of 100 beats/min
      and increased stepwise every 2 min by 20 beats/min up to 85% of the age-predicted
      maximal heart rate. Pacing endpoints were designated to be the development of
      angina pectoris or dyspnea, persisting horizontal or downsloping ST-segment
      depression (0.2 mV 80 ms after the J-point in the 12-lead ECG) or the development
      of new segmental wall motion abnormalities. In a group of 50 patients with
      suspected coronary artery disease, coronary artery disease (luminal narrowing of
      more than 70% of at least one major vessel) was detected with high sensitivity
      (greater than 93%) and specificity (greater than 100%).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1757063
TI  - Dobutamine stress echocardiography: diagnostic utility.
AB  - Pharmacologic stress testing is an accepted alternative in those patients unable
      to perform exercise stress testing. The most prevalent form of pharmacologic
      stress testing remains thallium imaging during vasodilator stress with either
      dipyridamole or adenosine infusions. More recently, dobutamine stress
      echocardiography has emerged as a promising new technique for the evaluation of
      patients with known or suspected coronary disease. The rationale for the use of
      dobutamine infusion as a stress agent lies in its ability to simulate physical
      exercise through its beta-receptor agonist activity. This causes a supply-demand
      mismatch which in turn, creates regional myocardial dysfunction which can be
      detected by two-dimensional echocardiography. A major advantage in the use of
      echocardiography over other adjunctive imaging techniques is its ability to
      detect all forms of anatomic heart disease which may be associated with chest
      pain or may mimic ischemic chest pain. Our current dobutamine protocol involves
      stepwise infusion of dobutamine beginning at 5 micrograms/kg/min and increasing
      to 10, 20, and a peak of 30 micrograms/kg/min in three minute stages. Images are
      recorded in standard parasternal long axis and short axis, four chamber and two
      chamber views, digitized and displayed for comparison in a quad screen format. A
      16 segment model is used for scoring wall motion abnormalities. Ischemia is
      considered present when a wall motion abnormality develops in an area with normal
      or only hypokinetic resting wall motion. The overall accuracy is between 85 and
      90% for the detection of patients with coronary disease. In over 600 studies at
      our institution, no major side effects or complications have occurred.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1757064
TI  - Dipyridamole-echocardiography in coronary artery disease.
AB  - Regional wall motion impairment incurred by means of dipyridamole-induced
      ischemia, is regarded with higher sensitivity and specificity than the
      conventional findings in the ECG. Based on the latter considerations, a new test,
      the dipyridamole echocardiogram has been introduced in which the development of
      regional wall motion impairment is designated as the positive diagnostic
      criterion. Dipyridamole is a vasodilator of coronary arterioles. During the
      course of the examination, three consecutively occurring mechanisms are
      considered responsible for the appearance of dipyridamole-induced ischemia in the
      presence of coronary stenosis. The ischemia is initially attributed to a steal
      effect, then to reflex-induced rise in rate-pressure product and, lastly, to a
      vasospastic component. In 680 patients with thoracic pain, on use of 0.84 mg/kg
      over ten minutes, there was a sensitivity of 74% in detection of angiographically
      documented coronary artery disease, defined as greater than 70% stenosis in at
      least one major coronary artery, and a specificity of 95%. The onset of regional
      wall motion impairment after dipyridamole infusion was correlated with the
      severity of the disease, the localization of the wall motion impairment enabled
      delineation of the localization of the stenosis in the coronary vascular system.
      By means of the dipyridamole echocardiogram, the effectiveness of therapeutic
      measures such as PTCA, ACVB, medical antianginal treatment and thrombolysis can
      be assessed. Lastly, the dipyridamole echocardiogram provides important
      information with regard to prognosis.

PMID- 1757065
TI  - Comparison of exercise echocardiography with myocardial perfusion scintigraphy
      for the diagnosis of coronary artery disease.
AB  - The rationale of exercise echocardiography for the diagnosis of coronary artery
      disease is based on the detection of exercise-induced wall motion abnormalities
      by ultrasound. Some of the problems that had previously limited the widespread
      application of the test have been solved by the development of digital recording
      and side by side cine loop display of two-dimensional echocardiograms: thus,
      respiratory artifacts can be eliminated, the examination is faster, and the
      comparison between rest and stress images has become practical and reliable
      improving sensitivity. The sensitivity and specificity of exercise
      echocardiography vary from 70 to 100%, according to patient selection, the
      protocol, and the gold standard used. Few studies studied the value of exercise
      echocardiography as compared to the more established nuclear cardiology imaging.
      Data from these comparative evaluations show a strong correlation between the two
      techniques for identifying and localizing myocardial ischemia. With good
      equipment and after proper training, exercise echocardiography can provide both
      diagnostic and prognostic information for routine clinical care.

PMID- 1757066
TI  - The histiocytoses of childhood.
AB  - The histiocytoses of childhood include Langerhans' cell histiocytosis,
      haemophagocytic syndrome (familial and reactive), sinus histiocytosis with
      massive lymphadenopathy (Rosai-Dorfman disease), juvenile xanthogranuloma and
      malignant histiocytosis. These disorders show wide variation in their clinical
      presentation, prognosis and genetic implications. All are characterized by
      localized or generalized proliferation of histiocytes, but they differ in their
      morphology, histochemical and immunochemical staining patterns and
      electronmicroscopical features. On the basis of a comprehensive clinical history
      and critical interpretation of morphology and immunocytochemistry using an
      appropriately selected panel of antibodies, a diagnosis can be reached in the
      majority of cases.

PMID- 1757067
TI  - KP1 (CD 68) staining of malignant melanomas.
AB  - The monoclonal antibody KP1, which recognizes the CD 68 antigen on macrophages
      and myeloid precursors, was tested on 28 malignant (primary and metastatic)
      melanomas, 28 naevi, and 17 skin biopsies showing either normal (10) or
      hyperplastic melanocytes (7). Sixteen of 20 primary melanomas and six of eight
      metastatic melanomas showed variable numbers of KP1 positive tumour cells. All
      but five benign melanocytic proliferations (two Spitz naevi and three intradermal
      naevi), as well as normal and hyperplastic melanocytes were negative. These
      results indicate that difficulties may occur with the use of KP1 in the
      differential diagnosis between melanomas and neoplasms derived from histiocytes
      macrophages, and that the expression of CD 68 antigen might be related to tumour
      progression in melanocytic cells.

PMID- 1757068
TI  - Lichen planus pemphigoides: a clinicopathological study of nine cases.
AB  - Lichen planus pemphigoides is a rare condition characterized by blisters arising
      on normal or erythematous skin in a patient with concurrent lichen planus. It
      must be distinguished from bullous lichen planus, in which, as a consequence of
      severe basal cell hydropic degeneration, blisters arise within lichenoid papules
      or plaques. We present a clinicopathological study of nine cases of lichen planus
      pemphigoides, and report histological, immunofluorescent, ultrastructural and
      immuno-electronmicroscopical observations. We distinguish lichen planus
      pemphigoides from bullous lichen planus and consider the differential diagnosis.
      We propose that lichen planus pemphigoides does not represent a homogeneous
      condition: it may represent a number of bullous dermatoses that develop as a
      consequence of exposure of different basement membrane antigens following severe
      damage to the epidermal basement membrane as part of the lichenoid inflammatory
      process.

PMID- 1757069
TI  - Lethal arthrogryposis multiplex congenita: a pathological study of 21 cases.
AB  - Twenty-one cases of arthrogryposis multiplex congenita, which had resulted in
      death soon after birth or had been aborted following prenatal diagnosis, were
      studied. Histochemical and histological study of muscle indicated that 11 cases
      were of myogenic origin, including congenital muscular dystrophy in 10 cases from
      six families and nemaline rod myopathy in one. Neurogenic causation was
      established in five cases, including three with intra-uterine anoxic-ischaemic
      damage and two siblings with a severe form of cerebro-ocular-facio-skeletal
      syndrome. Causation remained uncertain in five. Unusual features included atrophy
      or amyoplasia of the diaphragm associated with lung hypoplasia in 10 cases and
      evidence of birth trauma in seven cases. One pair of siblings had subcutaneous
      tissue of doughy consistency and another pair had bladder hypertrophy. Familial
      recurrence was seen most often in cases with evidence of myogenic origin. We
      consider that neuropathology and muscle histochemistry are essential aids in
      determining the risks of recurrence in this group of lethal conditions which defy
      analysis by syndrome recognition techniques.

PMID- 1757070
TI  - Chromosomal translocation detected by bcl-1 and bcl-2 rearrangement in low-grade
      B-cell lymphomas in a European population.
AB  - Twenty-nine cases of non-Hodgkin's lymphoma of low-grade malignancy in a European
      population were investigated for the presence of bcl-2 and bcl-1 gene
      rearrangement. The cases were classified according to the Kiel classification. It
      was shown that bcl-2 gene rearrangements were exclusively confined to
      centroblastic-centrocytic lymphomas. bcl-1 rearrangements were found in two cases
      of chronic lymphocytic leukaemia. As the chromosomal translocation t(14;18) is
      reported to occur in up to 85% of follicular lymphomas, our results provide
      additional evidence that the differentiation of low-grade B-cell lymphomas
      according to the Kiel classification defines biologically distinct entities.

PMID- 1757071
TI  - Dystrophic amyloidosis: a local complication of tissue damage with heterogeneous
      distribution.
AB  - Seventeen consecutive patients with dystrophic amyloidosis are reported here
      (eight Chinese, three Indian, three Iban, two Malay and one Caucasian). Ten were
      females and seven males, with ages ranging from 12 to 80 years (mean of 48
      years). Five instances of dystrophic amyloidosis occurred in areas of tissue
      damage in the cardiovascular system, including fibrotic cardiac valves and an
      atheromatous plaque. Three occurred in osteoarthritic joint tissue. Of note were
      three occurrences in endometriotic cyst walls, four in the fibrotic walls of
      epidermal cysts, one in a hernial sac and one at the edge of a skin ulcer. All
      deposits were congophilic and exhibited green-birefringence and permanganate
      resistance. Immunohistochemistry did not reveal reactivity for AA protein or
      immunoglobulin lambda or kappa light-chains. AP protein was detected in 35% of
      cases. Our results show that, besides the usual sites of osteoarthritic joints
      and damaged heart valves, dystrophic amyloidosis can complicate other areas of
      chronic tissue damage and fibrosis such as walls of cysts and ulcers. While the
      pathogenesis and biochemical nature remain unresolved, immunohistochemistry
      indicates that neither AA nor AL proteins are present in the deposits, and
      suggests that a different amyloid protein is involved.

PMID- 1757072
TI  - Primary squamous cell carcinoma of the endometrium.

PMID- 1757073
TI  - Ductal papilloma of the minor salivary gland.

PMID- 1757074
TI  - Lymphoepithelioma-like carcinoma of the uvula and soft palate: a rare lesion in
      an unusual site.

PMID- 1757075
TI  - Transitional mucosa of the colon associated with sigmoid volvulus.

PMID- 1757076
TI  - Identification of titanium pigment in drug addicts' tissues.

PMID- 1757077
TI  - Rheumatoid nodule in the breast.

PMID- 1757078
TI  - Immunolocalization of tumour necrosis factor alpha in lung tissue from patients
      dying with adult respiratory distress syndrome.
AB  - Using a mouse monoclonal antibody raised against recombinant human tumour
      necrosis factor alpha (TNF alpha), we have studied immunostained paraffin
      embedded autopsy lung tissues from 13 patients dying with adult respiratory
      distress syndrome and 10 control patients dying of unrelated conditions. Material
      from 12 of the 13 cases showed positive staining, strong in six, less strong in
      the remaining six. TNF alpha was located principally within epithelial cells
      resembling type II pneumocytes in both early and late stages of adult respiratory
      distress syndrome. In the early stages the TNF alpha positive cells were
      scattered and appeared disorganized, but in later cases they formed an
      epithelium. The cells were confirmed as epithelial by their staining pattern with
      monoclonal antibodies reactive with epithelial, cytokeratin and macrophage
      antigens, and by double staining for epithelial membrane antigen and TNF alpha.
      In the control group, staining for TNF alpha was confined to very occasional
      plump type II pneumocytes, and a weak reaction in bronchial lining cells.
      Macrophages were only weakly stained in either group. It is suggested that TNF
      alpha is synthesized (or possibly absorbed) by type II pneumocytes and may be
      involved in the production of, or recovery from, adult respiratory distress
      syndrome.

PMID- 1757079
TI  - Pathological prognostic factors in breast cancer. I. The value of histological
      grade in breast cancer: experience from a large study with long-term follow-up.
AB  - Morphological assessment of the degree of differentiation has been shown in
      numerous studies to provide useful prognostic information in breast cancer, but
      until recently histological grading has not been accepted as a routine procedure,
      mainly because of perceived problems with reproducibility and consistency. In the
      Nottingham/Tenovus Primary Breast Cancer Study the most commonly used method,
      described by Bloom & Richardson, has been modified in order to make the criteria
      more objective. The revised technique involves semiquantitative evaluation of
      three morphological features--the percentage of tubule formation, the degree of
      nuclear pleomorphism and an accurate mitotic count using a defined field area. A
      numerical scoring system is used and the overall grade is derived from a
      summation of individual scores for the three variables: three grades of
      differentiation are used. Since 1973, over 2200 patients with primary operable
      breast cancer have been entered into a study of multiple prognostic factors.
      Histological grade, assessed in 1831 patients, shows a very strong correlation
      with prognosis; patients with grade I tumours have a significantly better
      survival than those with grade II and III tumours (P less than 0.0001). These
      results demonstrate that this method for histological grading provides important
      prognostic information and, if the grading protocol is followed consistently,
      reproducible results can be obtained. Histological grade forms part of the
      multifactorial Nottingham prognostic index, together with tumour size and lymph
      node stage, which is used to stratify individual patients for appropriate
      therapy.

PMID- 1757080
TI  - The predictive value of histological classification into degrees of
      differentiation of squamous cell carcinoma of the larynx and hypopharynx compared
      with the survival of patients.
AB  - In the course of running two clinical trials between 1966 and 1985, data became
      available for 1315 patients, 713 in the first trial and 602 patients in the
      second trial, which has allowed comparison between histological findings in
      laryngeal and hypopharyngeal carcinoma, the observed survival and the tumour-free
      rates for these patients who were followed for up to 10 years. Extensive
      histopathology reviews have revealed over 98% agreement on tumour cell type
      between the initial report and that of the reviewer. Highly significant
      differences have been found for squamous cell carcinoma between the observed
      survival and the tumour-free rates for patients with well-differentiated and with
      anaplastic lesions. There was a statistically significant greater proportion of
      patients with well-differentiated tumours at larynx sites and in stage 1 when
      compared with patients with anaplastic tumours, but even when this was taken into
      account, multivariate analyses showed that tumour grading still made an
      independent significant contribution to the prediction of prognosis. For squamous
      cell carcinoma only very simple and rapidly assessed histopathological features
      need to be identified to classify tumours into the two grades employed in this
      study. The analyses have confirmed the prognostic significance of tumour grading
      in squamous cell carcinoma in the larynx and hypopharynx.

PMID- 1757081
TI  - Subungual malignant melanoma: clinicopathological features of 100 cases.
AB  - From the files of the Scottish Melanoma Group, we have identified 100 cases of
      subungual malignant melanoma (melanoma arising in the nailbed), and this
      represents 2.8% of the total melanomas registered during the period 1979-1989.
      Almost equal numbers arose on the foot as on the hand, with the thumb and big toe
      as the commonest digit affected. More than 80% were greater than 1.5 mm, with the
      mean Breslow depth 4.7 mm, and 70% were Clark level IV or V. Approximately half
      of the cases were of acral lentiginous type. At 5-year follow-up (54 cases), 26
      have died of melanoma, six have died of an unrelated disease, four are alive with
      recurrence and 18 are alive and well. Features related to clinical outcome at 3
      years were Breslow depth, mitotic count and the presence of vascular invasion.

PMID- 1757082
TI  - The histogenesis of inflammatory fibroid polyps of the gastrointestinal tract.
AB  - Inflammatory fibroid polyps are lesions occurring in the submucosa of the
      gastrointestinal tract. These lesions have been identified by a variety of names,
      indicative of their uncertain histogenesis. Three cases were studied by light
      microscopy and cytochemistry and, in one case, by electronmicroscopy. The most
      characteristic feature consisted of concentric fibrovascular structures.
      Peroxidase reaction for muscle actin and Ulex europeus agglutinin was positive in
      the two main cellular components. Electronmicroscopy revealed that the two
      principal cell constituents were endothelial and myocytic cells. These
      observations support the conclusion that inflammatory fibroid polyps are lesions
      of vascular origin.

PMID- 1757083
TI  - Effect of chewing Qat on mucosal histology and prevalence of Helicobacter pylori
      in the oesophagus, stomach and duodenum of Yemeni patients.
AB  - This investigation was aimed at assessing whether the Yemeni habit of chewing Qat
      on a regular basis had a significant effect on the upper alimentary tract.
      Seventy patients with dyspepsia attending Al-Thawra Hospital in Taiz, Yemen
      Republic were examined by endoscopy. Biopsies were taken from the oesophagus,
      stomach and duodenum. The patients included 28 who gave a history of daily Qat
      intake, 21 with less frequent intake and 21 who took none. The only statistically
      significant finding associated with daily Qat intake was a higher prevalence of
      duodenal ulcer, particularly in females. However, a strong association was also
      found between heavy smoking and ulcer, with most ulcer patients who chewed Qat
      daily being heavy smokers. Chewing Qat was not associated with a higher
      prevalence of oesophageal dysplasia, making it unlikely to be the cause of the
      perceived high incidence of oesophageal carcinoma in Yemen. There was a high
      prevalence of gastric H. pylori colonization (93%) and columnar-lined lower end
      of oesophagus (18%), as well as low prevalence of intestinal metaplasia of
      stomach (4%); this was not, however, related to chewing Qat. Further
      epidemiological and histological studies are needed to assess the significance of
      these findings in relation to the incidence of oesophageal and gastric carcinoma
      in Yemen.

PMID- 1757084
TI  - Ovarian morphology in long-term androgen-treated female to male transsexuals. A
      human model for the study of polycystic ovarian syndrome?
AB  - Descriptions of the effect of androgens on ovarian human tissues are exceptional.
      This opportunity was provided for us by 17 women with transsexualism--female to
      male transsexuals (TSX)--who had been given androgens for a mean period of 21
      months before hystero-salpingo-oophorectomy took place. Twenty-nine ovaries from
      TSX and 14 control ovaries from 13 regularly cycling women were examined. As
      compared with controls, TSX ovaries were enlarged and displayed a two-fold
      increase in cystic follicles and a 3.5-fold increase in atretic follicles; the
      ovarian cortex was collagenized and three-times thicker. Theca interna
      hyperplasia and luteinization were uniformly observed in TSX cystic follicles.
      Stromal hyperplasia was a constant finding in TSX ovaries, accompanied by
      clusters of luteinized stromal cells in 12 cases. Eventually, these findings met
      the histological criteria for the diagnosis of polycystic ovaries. These
      observations demonstrate that androgens alone may induce polycystic changes. The
      assumption that the role of androgens is pivotal at the follicular level-
      inducing follicle growth arrest and accelerating cystic changes--in the genesis
      of polycystic ovaries is reinforced.

PMID- 1757085
TI  - AgNOR counts in recurrent and non-recurrent meningiomas.

PMID- 1757086
TI  - The testicular 'tumour' of adrenogenital syndrome--a persistent diagnostic
      pitfall.

PMID- 1757087
TI  - Cellular blue naevus associated with osteoma cutis.

PMID- 1757088
TI  - Peripheral T-cell lymphomas.

PMID- 1757089
TI  - APTES, a section adhesive for immunocytochemistry; and experiences of slide
      drying at room temperature.

PMID- 1757090
TI  - Analysis of X-chromosome inactivation in X-linked immunodeficiency with hyper-IgM
      (HIGM1): evidence for involvement of different hematopoietic cell lineages.
AB  - The pattern of X-chromosome inactivation was analyzed, by means of two different
      DNA probes (pSPT-PGK and M27 beta), in several cell lineages derived from females
      belonging to a pedigree with X-linked immunodeficiency with hyper-IgM (HIGM1).
      Non-random X-chromosome inactivation was demonstrated in T cells, B cells, and
      neutrophils, but not in fibroblasts, of obligate carriers, suggesting that
      different hematopoietic cell lineages are primarily involved in HIGM1.
      Preferential inactivation of the paternally derived X-chromosome was demonstrated
      by analysis of segregation of the alleles defined by the pSPT-PGK and M27 beta
      probes. The possibility that the HIGM1 mutation may confer a proliferative and/or
      differential advantage to hematopoietic precursors carrying the mutated allele on
      the active X-chromosome is discussed.

PMID- 1757091
TI  - Normal variants of human mitochondrial DNA and translation products: the building
      of a reference data base.
AB  - A good standard reference for the highly polymorphic human mitochondrial DNA
      (mtDNA) sequence is essential for studies of normal and disease-related
      nucleotide variants in the mitochondrial genome. A consensus sequence for the
      human mitochondrial genome has been derived from thirteen unrelated mtDNA
      sequences. We report 128 nucleotide variants of the human mtDNA sequence, and 62
      amino acid variants of the human mitochondrial translation products, observed in
      the coding region of these mtDNA sequences.

PMID- 1757092
TI  - Fine mapping of a human chromosome 6 ferritin heavy chain pseudogene: relevance
      to haemochromatosis.
AB  - We have used a somatic cell hybrid regional mapping panel for the short arm of
      chromosome 6, linkage analysis and a population study to map in detail a
      previously described ferritin heavy chain pseudogene sequence on chromosome 6.
      Our results show that this sequence maps to the short arm of chromosome 6
      centromeric to the glyoxylase locus. The ferritin pseudogene locus is thus
      distant from the locus for the iron storage disease haemochromatosis, confirming
      previous evidence that this sequence is not a candidate for the haemochromatosis
      gene.

PMID- 1757093
TI  - Recurrence of a nonsense mutation in the NF1 gene causing classical
      neurofibromatosis type 1.
AB  - The gene responsible for von Recklinghausen neurofibromatosis (NF1) has recently
      been identified, and several point mutations and deletions have been described.
      The availability of intron-exon boundaries of several exons of the NF1 gene
      facilitates the search for mutations in affected patients. We have analysed 38
      patients for mutations in exon 4 of the NF1 gene, and found one patient with a C-
      --T transition at base position 1087 of the cDNA, changing an arginine codon to a
      stop codon, at amino acid position 365. Sequencing of other members of the
      family, including both parents, did not show the mutation, confirming that this
      mutation is responsible for this sporadic NF1 case. As the mutation described
      here was previously identified in an independent case by others, this case
      represents a recurrence of this mutation and suggests that codon 365 might be a
      hot spot for mutations in the NF1 gene. Thus, a specific search for this mutation
      should be performed when studying NF1 sporadic or familiar cases for genetic
      analysis.

PMID- 1757094
TI  - Identification of a mutation in the promoter region of the dystrophin gene in a
      patient with atypical Becker muscular dystrophy.
AB  - We have identified 7 patients with Becker muscular dystrophy (BMD) in whom
      analysis of dystrophin by immunoblotting shows a full-sized molecule produced at
      reduced abundance compared with controls. They have no detectable deletion in
      their dystrophin cDNA. One patient presented atypically with unusually severe
      cramps as his only symptom for 25 years. These patients were investigated using
      the polymerase chain reaction (PCR) with 3 sets of primers within the promoter
      region of the dystrophin gene, followed by dot blot and restriction analysis. In
      the patient with the atypical history, one of the expected fragments on PCR
      failed to amplify. A large deletion was excluded by the finding of normally sized
      fragments on amplification with the other primer sets. The mutation was localised
      to the 3' end of the forward primer binding site by dot blot and restriction
      analysis. This result supports the hypothesis that, in patients with a full-sized
      dystrophin molecule produced at reduced abundance, the phenotype may result from
      a mutation in the promoter region of the dystrophin gene. The atypical history of
      the patient in whom this was detected adds to the variety of phenotypes now known
      to exist as BMD.

PMID- 1757095
TI  - Low density lipoprotein receptor founder mutations in Afrikaner familial
      hypercholesterolaemic patients: a comparison of two geographical areas.
AB  - Afrikaners with familial hypercholesterolaemia (FH) were screened for the
      presence of three point mutations in the low density lipoprotein receptor gene
      that were previously described as being relatively common in this population. The
      prevalence and distribution of the mutations were compared in 27 unrelated
      homozygous and 79 unrelated heterozygous FH Afrikaner patients from two regions
      in South Africa, the Transvaal and Cape Provinces. The relative distribution of
      the three mutations was similar in the two regions, with the FH1 mutation being
      the most prevalent (66%), followed by the FH2 mutation (27%) and the FH3 mutation
      (7%). Interestingly, defects other than the three common mutations are more
      common in the Cape than in the Transvaal; thus the three known mutations account
      for 98% of FH alleles in the Transvaal and only 74% in the Cape Province. None of
      the patients carried the recently described familial defective apolipoprotein
      B100 mutation. These results establish that three "founder" mutant genes occur
      amongst the Afrikaner and are responsible for the overall high prevalence of FH
      in this population.

PMID- 1757096
TI  - Detection of hereditary haemochromatosis in an HLA-identical pedigree showing
      discordance between HLA class I genes and the disease locus.
AB  - Hereditary haemochromatosis is a recessive disease in which primary
      hepatocellular carcinoma, complicating cirrhosis, is responsible for about one
      third of deaths in affected homozygotes. We describe a unique HLA haplo-identical
      pedigree showing parent-to-offspring transmission of hereditary haemochromatosis
      in whom HLA typing studies, including class I and class II allogenotype analysis,
      were of no benefit in identifying affected homozygotes. However, affected
      siblings in the pre-cirrhotic stage of haemochromatosis, with apparent
      discordance between the haemochromatosis allele and class I loci on chromosome 6,
      were detected by undertaking a family study, using analysis of serum parameters
      of iron status in combination with magnetic resonance imaging (MRI). This
      pedigree emphasises the critical importance of genetic and non-invasive methods
      for the identification of asymptomatic homozygotes before cirrhosis develops.

PMID- 1757097
TI  - Identification of common variant alleles of the human guanosine monophosphate
      reductase gene.
AB  - Examination of nucleotide sequences of genomic DNA samples obtained from several
      unrelated Caucasians and orientals revealed the existence of four variant alleles
      in the chromosome 6-linked quanosine monophosphate reductase locus. The wild-type
      gene has T at position 42 (counting from A of the chain initiation codon), C at
      630, G at 700, and T at 766, i.e., its structure is T(42)-C(630)-G(700)-T(766).
      The variant gene, T-T-G-T, was found in about 10% of the loci examined. The C-to
      T change at 630 was silent and did not induce any amino acid substitution (His at
      amino acid residue 210), but it created an additional NcoI cleavage site in the
      variant gene. The frequency of another variant, the T-C-G-A gene, was about 30%.
      The T-to-A change at 766 caused an amino acid substitution Phe----Ile at amino
      acid residue 256 in the variant protein. Frequencies of the C-C-G-T variant and
      the T-C-A-T variant were probably lower than 5% in Caucasians and orientals.

PMID- 1757098
TI  - Oto-palato-digital syndrome type I: further evidence for assignment of the locus
      to Xq28.
AB  - The oto-palato-digital syndrome (OPD) is a rare X-linked disease with diagnostic
      skeletal features, conduction deafness, cleft palate and mild mental retardation.
      Differences in clinical presentation between families have led investigators to
      classify OPD into two subtypes: type I and type II. A linkage study performed in
      one family segregating for OPD I has recently suggested linkage to three marker
      loci: DXS15, DXS52 at Xq28, and DXS86 at Xq26. We have investigated an additional
      OPD I family for linkage by using distal chromosome Xq DNA probes. The linkage
      data and the analysis of recombination events that have occurred in this family
      excluded, definitively, the Xq26 region for OPD I, and provide further support
      for mapping the mutant gene close to the cluster of tightly linked markers DXS15,
      DXS52 and DXS305 at Xq28.

PMID- 1757099
TI  - Xeroderma pigmentosum complementation group H is withdrawn and reassigned to
      group D.

PMID- 1757100
TI  - Toxins, cytokines, immunity and pathology.

PMID- 1757101
TI  - The heat shock response in human phagocytes.
AB  - During the last 10 years the intriguing field of the heat-shock response and
      stress proteins has switched from a particular case to a phenomenon of general
      interest. Discovered in Drosophila, these proteins were observed in every living
      organism with a surprisingly high sequence homology. In addition, these proteins
      are not only inducible by stress or pathophysiological situations but are also
      expressed in unstressed cells. These are arguments for crucial roles of heat
      shock proteins. Here we discuss some aspects of the heat shock/stress response
      that we observed in phagocytic cells after phagocytosis with regard to their
      physiologic functions such as oxygen-free radical generation, antigen processing
      and presentation.

PMID- 1757102
TI  - The CNS acute inflammatory response to excitotoxic neuronal cell death.
AB  - Acute inflammation is a stereotyped non-specific response to tissue injury which
      results in the recruitment of neutrophils and monocytes within minutes. In this
      study the myelomonocytic and microglial reaction to neuronal destruction
      following unilateral hippocampal injection of kainic acid neurotoxin was
      investigated. Despite extensive acute neuronal necrosis and notwithstanding a
      leaky blood-brain-barrier, there is no neutrophil recruitment and a 2-day delay
      before any increase in macrophage-microglial cell numbers. Resident microglia are
      capable of reversible upregulation to an activated morphology and the macrophage
      microglial reaction is seen not only at the injection site, but also at distant
      sites related to the axonal pathways and synaptic terminals of the killed
      neurons.

PMID- 1757103
TI  - Imbalanced cytokine production by macrophages from autoimmune-prone mice.
AB  - Peritoneal macrophages from multiple autoimmune-prone strains of mice (MRL/lpr,
      MRL/+, NZB/W, BXSB, and B6/gld) show defective expression of the cytokines IL-1
      and IL-6. Autoimmune mice were all used between 1 and 6 weeks of age, the
      earliest times being well before the onset of overt disease. Northern blot
      analysis reveals a parallel reduction in the levels of IL-1 alpha, IL-1 beta, and
      IL-6 mRNA. In contrast, the production of other proteins, including the cytokine
      TNF-alpha, appears to be normal. These findings imply an imbalance within the
      cytokine network of autoimmune macrophages. Studies on bone marrow-derived
      macrophage precursors, as well as macrophages from chimeric mice, suggest an
      intrinsic macrophage defect as opposed to conditioning by the autoimmune
      environment. This defect appears to be constant throughout the lifespan of
      autoimmune MRL/lpr mice, being equally apparent in 1-week old mice as in fully
      diseased 6-12-month-old mice. Aberrant regulation of IL-1 and IL-6 represents a
      novel defect in the function of autoimmune macrophages that is both intrinsic and
      substantial, and has the potential to contribute to the immune dysregulation that
      characterizes autoimmunity.

PMID- 1757104
TI  - Role of cytokines in killing of intracellular pathogens.

PMID- 1757105
TI  - The role of rIL-2 in the modulation of cellular immunity in resistance to
      infection.

PMID- 1757106
TI  - Mechanisms involved in the evasion of the host defence by Pseudomonas aeruginosa.
AB  - Pseudomonas aeruginosa, an extracellular opportunistic pathogen, utilizes two
      major mechanisms to evade the host defence system. One of these mechanisms is the
      production of a large number of extracellular products, such as proteases,
      toxins, and lipases. The two proteases, alkaline protease and elastase, inhibit
      the function of the cells of the immune system (phagocytes, NK cells, T cells),
      inactivate several cytokines (IL-1, IL-2, IFN-r, TNF), cleave immunoglobulins and
      inactivate complement. Inhibition of the local immune response by bacterial
      proteases provides an environment for the colonization and establishment of
      chronic infection. The other mechanism by which P. aeruginosa evades the host
      defence system is the biofilm mode of growth of the bacteria in chronic
      infections. The biofilm-grown bacteria induce a low phagocyte response, and
      provide a barrier for the bacteria against antibodies, complement, and the cells
      of the immune system. Protection from the host defence system combined with
      increased antibiotic resistance of the bacteria in the biofilm are the major
      reasons for the persistence of P. aeruginosa in chronic infections.

PMID- 1757107
TI  - Inhibition of human immunodeficiency virus infection in monocytes by monoclonal
      antibodies against leukocyte adhesion molecules.
AB  - CD4 is the surface receptor for HIV envelope. Some evidence exists, however, that
      other cell surface receptors may be involved in viral entry subsequent to the
      initial binding of gp120 to CD4. Antibodies to leukocyte integrin LFA-1, a major
      component of intercellular adhesive interactions, have been shown to inhibit HIV
      induced syncytia formation. Using a stringent system for in vitro HIV infection
      of human leukocytes, we examine the ability of some monoclonal antibodies (mAb)
      against various adhesion-related molecules to block or partially inhibit
      productive viral replication. HIV-1 infection of target monocytes or T cells by
      cell-free virus was blocked completely or partially by some mAb that prevent cell
      cell interactions (CD4, HLA-DR, LFA-1, LFA-3), but not by others (ICAM-1, MAC-1,
      gp150.95, CD2, CD3, CD14). The capacity for mAb to block HIV infection appears to
      be epitope-specific, and does not relate to the ability to block homotypic
      adhesion. HIV transmission from infected cells was more difficult to block than
      was infection by cell-free virus. Adhesion molecules may be involved in
      facilitating early stages of HIV infection, following gp120/CD4 binding but prior
      to viral integration, in a manner distinct from cell-cell adhesion.

PMID- 1757108
TI  - In vivo efficacy of virus-derived peptides and virus-specific cytotoxic T
      lymphocytes.
AB  - The in vivo efficacy of virus- and tumor-specific cytotoxic T lymphocytes (CTL)
      is discussed as well as ways to activate these cells in vivo with lymphokines,
      monoclonal antibodies and immunization. In vivo and in vitro peptide immunization
      can induce such virus- and tumor-specific CTL but several questions have to be
      answered before peptide vaccination can be implemented as a novel
      immunotherapeutic or preventive approach in man.

PMID- 1757109
TI  - Protection by alpha-thalassaemia against Plasmodium falciparum malaria: modified
      surface antigen expression rather than impaired growth or cytoadherence.
AB  - We have attempted to determine the cellular mechanism by which alpha-thalassaemia
      may protect against Plasmodium falciparum malaria. Invasion and development of P.
      falciparum in the microcytic red cells of two-gene deletion forms of alpha
      thalassaemia when measured morphologically or by [3H]hypoxanthine incorporation
      were normal compared to controls. Normal invasion rates were also observed
      following schizogony in thalassaemic red cells. Neither the addition of the
      oxidant menadione, 30% oxygen, nor modified medium, produced differential damage
      to parasites within thalassaemic cells. Furthermore, there were no significant
      differences in the binding of P. falciparum-parasitized alpha-thalassaemic and
      normal cells to C32 melanoma cells in vitro. However, when neoantigen expression
      on the surface of infected thalassaemic cells was estimated using a quantitative
      radiometric antiglobulin assay, clear differences were observed. It was found
      that alpha-thalassaemic cells bound higher levels of antibody from serum obtained
      from individuals living in a malaria endemic area than control normal red cells.
      The binding ratio for thalassaemic compared with controls was 1.69 on a cell-for
      cell basis, and 1.97 when related to surface area. The binding of antibody from
      immune serum increased exponentially during parasite maturation. We also found
      increased binding of naturally occurring antibody present in non-immune serum to
      parasitized thalassaemic red cells which also increased during parasite
      maturation. We conclude that the protection afforded by thalassaemia against
      malaria may not reside in the ability of parasites to enter, grow or cytoadhere
      to endothelium in such cells, but may be related to immune recognition and
      subsequent clearance of parasitized red cells.

PMID- 1757110
TI  - Genetic regulation of macrophage priming/activation: the Lsh gene story.
AB  - This paper describes functional and genetic studies on the macrophage resistance
      gene Lsh/Ity/Bcg first described almost two decades ago. Working in vitro with
      resident peritoneal, liver (Kupffer cells) and bone marrow derived macrophages
      from congenic B10 (LshS) and B10.L-LshR mice it has been possible to demonstrate
      that the final effector mechanism for the gene in regulating antileishmanial
      activity involves production of reactive nitrogen rather than reactive oxygen
      intermediates. This in turn is dependent upon priming/activation of macrophages
      for enhanced TNF-alpha release which acts back on the macrophage in an autocrine
      manner to increase nitric oxide production. The precise point at which Lsh acts
      to control macrophage priming/activation has not been identified, but studies of
      early response gene expression show differences in KC mRNA levels at 2 h after
      LPS stimulation, and in c-fos mRNA as early as 20 min after stimulation with PMA
      plus ionophore, in peritoneal macrophages from congenic LshS and LshR mice. Data
      available suggest that both negative and positive signals may be involved in
      macrophage priming/activation, with LshS macrophages down-regulating their
      capacity for continued response to the autocrine loop. Work in progress will
      examine the role of TPA and cAMP response element-binding proteins in regulating
      gene expression in Lsh congenic mice. A major new initiative has also commenced
      to clone the Lsh gene by reverse genetics using yeast artificial chromosomes to
      walk towards Lsh from the closet proximal and distal markers on mouse chromosome
      1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757111
TI  - Immune responses to filarial parasites.
AB  - Filarial nematode parasites are long-lived organisms which are responsible for
      one of the major tropical diseases. Their ability to survive may be related to
      the antigen-specific anergic state observed in carriers of the parasite. Severe
      disease symptoms are associated with the breakdown of anergy. Different stages of
      the parasite life cycle are anti-genetically distinct, and a state of concomitant
      immunity is therefore possible which prevents superinfection. The evidence for
      these conclusions is discussed, in the context of the need for an effective
      vaccine against filarial parasites which will avoid any risk of increasing
      disease severity.

PMID- 1757112
TI  - Enhancement of MHC class II antigen expression by exposure to Candida albicans.
AB  - In oral infections with the yeast Candida albicans, the expression of MHC class
      II antigens on keratinocytes has been reported to be enhanced. In the present
      experiments, exposure to C. albicans or its products in vitro was found to
      increase the expression of class II MHC antigens on thioglycollate-induced mouse
      macrophages, and on LK cells (an antigen-presenting cell line). The implications
      of this finding for the understanding of immunoregulation and susceptibility to
      C. albicans infection are discussed.

PMID- 1757113
TI  - Control of parasitic diseases: a complementary role for vaccines and drugs.
AB  - This paper seeks to substantiate its title by discussion of three key questions:
      why are we attempting to develop parasite vaccines? Will we be successful? If we
      are, will there still be a need for chemotherapy? It concludes that: parasite
      vaccines are likely to be safer, cheaper and more efficacious as prophylactics
      than antiparasite drugs; in time vaccines will be developed for some but not all
      human parasitic diseases; at least in the short and medium term, drugs will be
      needed for those already infected and for those for whom, for whatever reason, a
      vaccination strategy fails.

PMID- 1757114
TI  - Pneumococcal conjugate vaccines.
AB  - We have prepared conjugates of pneumococcal type 4 polysaccharides (PS4) or
      oligosaccharides to tetanus toxoid using the carbodiimide method. The use of a
      spacer, 6-aminohexanoic acid, resulted in higher incorporation of carrier
      protein. Conjugates contained up to 10% free polysaccharide, but no free protein.
      In general, polysaccharide conjugates induced higher anti-PS4 IgG antibody titers
      than oligosaccharide conjugates. Conjugates with the highest amount of
      incorporated protein were the most immunogenic. The response to conjugated PS4
      does show characteristics of a T cell-dependent antibody response, in terms of
      both isotype distribution and induction of immunological memory. Repeated
      immunization with high doses of PS4TT conjugate resulted in a virtually negative
      anti-PS4 IgG response, suggestive of the induction of high dose tolerance.

PMID- 1757115
TI  - In vivo effects of TRH, T3 and cGH on antibody production and T- and B
      lymphocytes proliferation in immature male chickens.
AB  - Newly hatched White Leghorn male chicks were used in this study. Different doses
      of T3 (0.1 or 1 ppm) or TRH (1 or 5 ppm) were administered in the feed for an 8
      week period. Chicken growth hormone (cGH) (10 micrograms/kg BW) was injected
      (i.v.) into a different group of chicks twice daily for 1 week starting at 7
      weeks of age. A different group received both T3 (0.1 and 1 ppm) and cGH. Serum
      concentrations of T4, T3 and GH, antibody production against sheep red blood
      cells (SRBC) and Brucella Abortus (BA), and in vitro proliferative response of
      both T- and B-lymphocytes to mitogenic stimulation were measured. Supplementation
      of T3 (1 ppm) significantly lowered T4 and increased T3 concentrations. No effect
      of any hormone treatment on antibody production was observed. T3 supplementation
      and cGH injection alone or with T3 (0.1 ppm) significantly increased blastogenic
      response of lymphocytes to either Con-A or LPS mitogenic stimulation. It was
      concluded that T3 and GH are involved in lymphocyte activity of chickens.

PMID- 1757116
TI  - Isolation and characterization of anti-H antibody from egg yolk or immunized
      hens.
AB  - An anti-H antibody was demonstrated to be produced in egg yolk as well as in
      serum of hens which were immunized with human type O red blood cells. The
      antibody in egg yolk was isolated with polyethylene glycol and ethanol and was
      purified by affinity chromatography using immunoadsorbant beads immobilized with
      H type 2 hapten (Fuca1----2Gal beta 1----4GlcNAc beta). Hemagglutination reaction
      of the antibody from egg yolk was inhibited by human saliva samples from secretor
      types irrespective of their ABO blood types, and by immunoadsorbant beads which
      contain Fuca1----2Gal beta structures.

PMID- 1757117
TI  - Standardization of ELISA for the detection of anti-cardiolipin antibodies--effect
      of non-specific IgG binding.
AB  - Various frequencies of anti-cardiolipin antibodies reported in patients with
      systemic lupus erythematosus and other autoimmune and infectious diseases
      necessitates the need for standardization of the immunoassay. We report here the
      usefulness of "no-antigen" control for each serum in determining the actual value
      of the anti-phospholipid antibodies. This non-specific "no-antigen" binding was
      quite variable from serum to serum and in general was higher in the patient
      population than in healthy individuals which served as controls. This non
      specific binding may be associated with the increased IgG content of the sera as
      shown by the linear association of the absorbance of the back-ground readings to
      increases in IgG concentration (correlation coefficient 0.98).

PMID- 1757118
TI  - Modulation of T and B cell proliferative responses by factors present in rat
      salivary glands.
AB  - Rat salivary gland culture supernatants (SGSN) were shown to inhibit the
      proliferation of rat spleen cells induced by the mitogens concanavalin A (ConA),
      phytohaemagglutinin (PHA), pokeweed mitogen (PWM), lipopolysaccharide (LPS) and
      S. typhimurium mitogen (STM). The responses of B cells were more markedly
      inhibited than the responses of T cells. Factors contained in SGSN which had a
      molecular weight smaller than 3500 inhibited all responses, whereas factors
      greater than 3500 only inhibited responses induced by PWM, LPS or STM. Factors
      present in SGSN also inhibited the proliferation of two B cell hybridoma cell
      lines, as well as the IL-2-responsive cell line CTLL-2 and the IL-4-responsive
      cell line CT.4S. However, SGSN factors having a molecular weight greater than
      3500 did not inhibit CTLL-2 proliferation. These data indicate that rat salivary
      glands contain factors which differentially regulate T and B cell proliferative
      responses in vitro and which may modulate localized immune responses in the
      salivary gland in vivo.

PMID- 1757119
TI  - IL4, IL5 and IL6-mediated regulation of immunoglobulin (Ig) heavy chain class
      switching and Ig production by gut-associated lymphoid tissue (GALT) B cells from
      athymic nude (nu/nu) mice.
AB  - Gut mucosal immunoglobulin (Ig) isotype expression and secretion are known to be
      regulated by B cell-stimulatory factors (BSF), lymphokines or cytokines from T
      and non-B cells. The class and amount of Ig secreted appear to depend on the
      presence of a combination of these factors. The effects of IL-4 and IL-5 on Ig
      class switching by gut mucosal B cells remain controversial. To shed further
      light on this issue, young (1-2 months old) athymic nu/nu murine GALT B cells
      were chosen, because the possibility of in vivo effects of T cells on B cells (in
      particular at the levels of transcription and translation without changes in
      surface Ig phenotype expression) cannot be excluded. The results are summarized
      below. IL-4, IL-5 and IL-6 alone or in combination do not act as IgA heavy chain
      switch cofactors, but IL-5 and IL-6 do act at least as B cell terminal
      differentiation factors for any isotype-specific gut-associated lymphoid tissue
      (GALT) (mesenteric lymph node) B cells in the presence or absence of LPS. The BSF
      have augmenting effects on class-specific Ig production by GALT sIgM-bearing B
      cells, when these are treated with the BSF alone. IL-4 alone or in combination
      with other BSF prevents LPS-stimulated IgM production. BSF without LPS do not
      evoke production of significant amounts of IgG and IgA by high density (HD) and
      low density (LD) sIgM-bearing B cells; IgM is synthesized only in small amounts
      of LD sIgM-bearing B cells in the presence of IL-5 and/or IL-6. There is no
      difference in the responsiveness of GALT and spleen sIgM-bearing B cells to the
      BSF.

PMID- 1757120
TI  - An improved PVC strip ML-ELISA technique for diagnosis of recent cases of
      amoebiasis.
AB  - Conventional plate ML-ELISA technique for diagnosis of recent cases of amoebiasis
      was converted into a simple polyvinyl chloride strip multilayer-enzyme linked
      immunosorbent assay (PVC strip ML-ELISA). This report details the development and
      preliminary characterization of the PVC strip ML-ELISA method for Entamoeba
      histolytica antigen detection in human fecal samples. In addition, we evaluated
      the relative efficacies of the PVC strip ML-ELISA and the conventional plate ML
      ELISA methods by screening different categories of amoebiasis patients and other
      intestinal parasites. A significant correlation was found (P less than 0.01)
      between the two assay methods with reference to sensitivity and specificity of
      detecting E. histolytica antigens. However, with reference to operational case
      and economy, the PVC strip ML-ELISA may be performed even by paramedical
      technical personnel under field conditions.

PMID- 1757121
TI  - Lymphocyte blastogenic responses in sickle cell disease.
AB  - Cell mediated immunity (CMI) has not been extensively studied in sickle cell
      disease (SCD). In this study, an assessment of lymphocyte blastogenic responses
      was done in 62 SCD patients (62 steady state and 25 in crisis with or without
      documented infection), along with 30 normal controls in good health and 10 with
      various infections. The mitogen phytohemagglutinin (PHA) and two antigens
      (Candida albicans and Tetanus Toxoid) were used as stimuli. An evaluation of
      these results by stimulation index revealed 53/62 (86%) of SCD steady state
      patients, 30/30 (100%) of healthy controls and 7/10 (70%) of normal control
      patients with infection positively responded to all three stimuli. Conversely,
      only 5/25 (20%) of SCD crisis state patients had totally normal blastogenic
      responses. Analysis of the data from SCD crisis patients revealed 14/20 (70%)
      with abnormally depressed proliferation to PHA, 11/20 (55%) to Candida and 6/20
      (30%) to Tetanus. When comparisons were made by mean counts per minute, the most
      striking finding was the PHA response in the SCD crisis state. In this group the
      mean counts per minute were significantly less than the three other groups by
      statistical analysis. This data suggests that the crisis state, especially when
      associated with infection, profoundly effects blastogenic responses to PHA and to
      a lesser degree in vitro antigenic stimulation. The normal group with infection
      showed similar diminished blastogenesis to antigen, but no effect on mitogen
      response.

PMID- 1757122
TI  - PAF induces rat plasma extravasation and releases eicosanoids during anaphylaxis.
AB  - The effects of anaphylaxis on vascular protein extravasation in selected tissues
      and on the release of prostaglandins in the peritoneal cavity were studied in
      sensitized rats. Extravasation of Evans blue dye was used as a measure of
      vascular permeability. Specific antigen challenge increased by 279, 297, 328,
      250, and 192% the protein extravasation in the trachea, upper and lower bronchi,
      pancreas, and duodenum, respectively, but did not modify significantly the
      vascular permeability of the lung parenchyma, heart, liver, and kidney.
      Extravasation of Evans blue dye also was increased by 43-fold in the peritoneal
      cavity. Pretreatment of the animals with indomethacin (10 mg/kg) did not modify
      significantly the protein extravasation of the trachea, upper and lower bronchi,
      pancreas, and duodenum induced by anaphylaxis. Pretreatment with a mixture of
      mepyramine (3 mg/kg) and methysergide (2.5 mg/kg) reduced by 62, 66, and 40% the
      protein extravasation in the trachea, upper bronchi, and peritoneal cavity,
      respectively, in similar conditions. The PAF antagonist BN-52021 (5 mg/kg) very
      strongly reduced the protein extravasation elicited by anaphylaxis in the
      trachea, upper and lower bronchi, pancreas, and duodenum by 72, 87, 82, 67, and
      85%, respectively, and by 53% in the peritoneal cavity. Anaphylaxis also
      increased the concentrations of thromboxane B2 and leukotriene B4 in the
      peritoneal exudates, but prostaglandin E2 levels were not affected. Pretreatment
      with BN-52021 reduced by 29 and 75% the level of thromboxane B2 and leukotriene
      B4 in the exudates. These results suggest that PAF, histamine, and serotonin
      mediate the protein extravasation associated with anaphylaxis, whereas
      prostaglandins are likely to play a minor role in this reaction.

PMID- 1757123
TI  - Circulating phospholipase A2 activity associated with sepsis and septic shock is
      indistinguishable from that associated with rheumatoid arthritis.
AB  - Elevation of circulating phospholipase A2 (PLA2) activity is associated with
      sepsis and septic shock. Elevated levels of PLA2 activity also are seen in
      association with chronic inflammatory disorders such as rheumatoid arthritis. The
      relationship between these phospholipases is unclear. We have developed a highly
      specific enzyme-linked immunosorbent assay (ELISA) capable of measuring human
      synovial PLA2 in plasma, using monoclonal antibodies raised to recombinant
      synovial PLA2. This ELISA has been used to quantitate circulating PLA2 levels in
      patients clinically diagnosed with sepsis. These elevated levels positively
      correlated with the elevation seen in plasma PLA2 enzyme activity. The antibodies
      also have been used to purify immunoreactive PLA2 from plasma of patients with
      sepsis, thus enabling characterization of the purified protein by amino-terminal
      sequence analysis. We conclude from this study that the increase in PLA2 activity
      seen in association with sepsis and septic shock results from a dramatic
      elevation in levels of a circulating PLA2 enzyme. This inflammatory PLA2 is
      indistinguishable, both immunologically and chemically, from that associated with
      rheumatoid arthritis. Therapeutic agents directed towards inhibition of this
      inflammatory PLA2 enzyme may have utility in the treatment of both chronic and
      acute inflammatory disease.

PMID- 1757124
TI  - Extrahepatic expression of plasma protein genes during inflammation.
AB  - The body's protective responses to infection, wounding, trauma, and malignancy
      include the acute-phase reaction, which is modulated by various cytokines and
      their cellular receptors. During the acute-phase reaction, levels of specific
      proteins synthesized by the liver increase in the plasma. Little information is
      available about the extrahepatic synthesis of plasma proteins during the acute
      phase reaction. The study described here analyzes the tissue-specific expression
      of genes encoding the plasma proteins albumin (ALB), alpha 1-antitrypsin (AAT),
      transferrin (TF), haptoglobin (HP), ceruloplasmin (CP), serum amyloid A (SAA),
      alpha 1-acid glycoprotein (AGP) and alpha 2-HS-glycoprotein (AHSG) during the
      acute-phase reaction in C57B1 mice. The acute-phase reaction was induced by
      intraperitoneal injections of bacterial lipopolysaccharide (LPS). During the
      acute-phase reaction, genes encoding CP, SAA, AGP, and HP demonstrate unique
      extrahepatic tissue specific patterns of expression in kidney, spleen, thymus,
      heart, brain, lung, testis, and epididymis. Different temporal patterns of HP
      gene expression also were observed in lung and thymus after induction by LPS. The
      function of extrahepatic synthesis of plasma proteins is not yet understood;
      however, a local provision of specific plasma proteins in mammalian tissues may
      offer the host a source of functionally important proteins during periods of
      stress.

PMID- 1757125
TI  - Generation of xenopsin-related peptides from tissue precursors by media
      conditioned by endotoxin-stimulated rat peritoneal macrophages.
AB  - Incubation of media conditioned by endotoxin-stimulated rat peritoneal
      macrophages generates immunoreactive xenopsin (iXP) when incubated with acid
      extracts of various tissues of the rat. The generation of iXP, as measured by
      specific radioimmunoassay and confirmed by HPLC analysis, increased as the length
      of the incubation period increased and was inhibited by pepstatin, prior boiling
      of the conditioned media, or by omitting either the tissue extract or the
      conditioned media. The pH optimum for the generation of iXP was 3.0. The
      generated iXP showed biological activity in that stimulated histamine secretion
      from isolated rat mast cells and this secretory response was prevented by
      metabolically poisoning the cells. In addition, the generated iXP stimulated
      contraction of the isolated guinea pig ileum. In this regard, it was similar to
      neurotensin (NT). Tissue precursor levels for iXP, as measured by this system of
      generation, were highest in kidney, liver, and skin and lowest in skeletal muscle
      and plasma. These results suggest to us that during the inflammatory response,
      the NT-related peptide, xenopsin, can be generated from tissue precursor(s) by
      enzymes secreted by invading macrophages. The generated XP may then affect the
      participating cells of inflammation.

PMID- 1757126
TI  - Regulation of serum amyloid A gene expression in Syrian hamsters by cytokines.
AB  - Amyloid A (AA) protein is derived from serum amyloid A (SAA) and deposited as
      beta-pleated sheet fibrils in reactive amyloidosis, a disease that occurs
      spontaneously in golden Syrian hamsters. The precursor SAA is an acute-phase
      reactant in many species including hamsters, and in this report we have defined
      the in vivo kinetic and dosage responses for SAA mRNA accumulation in hamsters
      following administration of various cytokines. Elevations in levels of hepatic
      SAA mRNA were documented when the doses of interleukin-1, interleukin-6, and
      tumor necrosis factor were increased. The increase in dosages applied ranged from
      2 1/2-fold for interleukin-6 to 10-fold for interleukin-1. SAA transcript levels
      were highest 8 h following administration of interleukin-6 or tumor necrosis
      factor, whereas maximal amounts of SAA-specific mRNA were found 24 h after
      administration of interleukin-1.

PMID- 1757127
TI  - Role of neutrophils in acetic acid-induced colitis in rats.
AB  - Intrarectal administration of 4% acetic acid produces diffuse inflammation that
      ultimately results in erosions and ulcerations of the rat colon. Although this
      model of colitis has been used extensively over the past several years, there are
      no quantitative data available regarding the relationship between neutrophil
      infiltration and mucosal injury during times of active inflammation. Therefore,
      the objective of this study was to define the role of extravasated neutrophils as
      mediators of mucosal injury and inflammation in acetic acid-induced colitis. We
      found the intrarectal administration of 4% acetic acid produced an 11-fold
      increase in colonic mucosal permeability, a 9-fold increase in colonic MPO
      activity, and a 1.6-fold increase in colon weight at 48 h following
      administration of acetic acid. In addition, we found significant correlations
      between colonic MPO activity and mucosal permeability and between colonic MPO
      activity and colon weight (P less than 0.01 for both). These data suggested that
      inflammatory neutrophils may mediate mucosal injury and inflammation in this
      model of colitis. To assess the role of circulating neutrophils, rats were
      rendered neutropenic for 48 h by the intraperitoneal administration of antiserum
      directed toward rat neutrophils (ANS). Although ANS treatment reduced both the
      number of circulating neutrophils and colonic MPO activity to less than 10% of
      control values, it did not attenuate the increases in colonic mucosal
      permeability nor did it attenuate the increases in colon weight produced by
      acetic acid. Histological inspection confirmed that ANS treatment was not
      effective in attenuating the injury to the epithelial barrier. These data
      demonstrate that infiltrating neutrophils do not mediate the mucosal injury and
      inflammation observed in acetic acid-induced colitis.

PMID- 1757128
TI  - Scavengers of reactive oxygen intermediates do not mediate the depression of
      macrophage hydrogen peroxide production caused by erythrocyte phagocytosis.
AB  - Our previous studies have shown that a phagocytic challenge with IgG-coated
      erythrocytes (EIgG) depressed macrophage triggered H2O2 production in vitro, and
      in vivo there was a decrease in the survival rate following bacteremia. The
      phagocytosis of an equal number of IgG-coated erythrocyte ghosts had none of
      these effects, indicating that the contents of the erythrocytes are important for
      these effects. The present study evaluated the role of the scavengers of reactive
      oxygen intermediates within erythrocytes in the depression of H2O2 production
      triggered with phorbol myristate acetate following a phagocytic challenge with
      EIgG. Elicited rat peritoneal macrophages (PM) were challenged with EIgG prepared
      from normal E or E with inactivated catalase, depleted glutathione, hemoglobin
      converted to methemoglobin, or fixed with formaldehyde. The depression of
      triggered H2O2 production was similar when equal numbers of normal EIgG and EIgG
      with inactivated scavengers were phagocytized. When the phagocytic challenge with
      normal EIgG was carried out in the presence of cytochalasin B, no depression of
      triggered H2O2 production was observed. Cytochalasin B partially blocked the
      phagocytosis of EIgG, so that with larger doses of EIgG there was sufficient
      ingestion of EIgG to depress H2O2 production in untreated PM. These results
      indicate that the scavengers of reactive oxygen intermediates present in
      erythrocytes are neither required nor sufficient to depress H2O2 production by
      macrophages.

PMID- 1757129
TI  - No effect of recombinant human interleukin-1 on numbers of peripheral blood and
      peritoneal leukocytes during acute inflammation.
AB  - Recombinant human interleukin-1 (IL-1) can prolong the survival of mice with
      severe systemic bacterial or fungal infections. In order to assess whether this
      is due to an effect of IL-1 on the production of leukocytes or their migration to
      the site of infection, the influence of IL-1 on the influx of leukocytes to the
      site of an acute inflammation was studied in normal and in granulocytopenic mice.
      The numbers of granulocytes, lymphocytes, and monocytes or macrophages in both
      the circulation and the peritoneal cavity were determined during an acute sterile
      inflammation elicited by intraperitoneal injection of either newborn calf serum
      (NBCS) or heat-killed Candida albicans, and during a peritoneal infection with
      viable C. albicans. After normal mice were injected intraperitoneally with NBCS
      or 10(7) CFU heat-killed or viable C. albicans, the number of peritoneal
      granulocytes rose sharply within 6 h. Pretreatment of mice with a single
      intraperitoneal dose of 80 ng IL-1 24 h before injection of an inflammatory
      stimulus did not influence the course of the numbers of leukocytes in the
      circulation or in the peritoneal cavity. When mice were rendered granulocytopenic
      by cyclophosphamide, both the influx of granulocytes into the peritoneal cavity
      and the concomitant rise in the number of peripheral blood granulocytes after
      injection of NBCS, killed or viable C. albicans was virtually absent.
      Pretreatment of granulocytopenic mice with IL-1 did not influence the course of
      the numbers of leukocytes in either the circulation or the peritoneal cavity.
      These findings show that the beneficial effect of a single dose of IL-1 on the
      course of candidal infections in normal or granulocytopenic mice is not
      attributable to the influx of granulocytes or monocytes.

PMID- 1757130
TI  - Modification of inflammatory processes by phenobarbital in rats.
AB  - Enzyme-inducing drugs such as phenobarbital (PB) increase serum concentrations of
      an acute-phase protein, alpha 1-acid glycoprotein (AGP), in man, dogs, and rats
      via an unknown mechanism. We studied the effects of PB on components of an acute
      inflammatory reaction in rats in order to determine if PB acts only on this
      biological marker of inflammation or is capable of altering the clinical course
      of inflammatory processes. Local carrageenan injection induces a similar time
      dependent plantar edema and increases serum AGP levels in Sprague-Dawley (SD) and
      Dark Agouti (DA) rats. Pretreatment with PB for seven days modified neither
      parameter in SD rats while plantar edema was aggravated and serum AGP levels were
      increased in DA rats. The sedative-hypnotic properties of PB were not involved,
      since a single administration of this drug had no action in DA rats. On the other
      hand, chronic PB administration reduced the severity of an autoimmune disease,
      type II collagen-induced arthritis, in DA rats. These data indicate that PB, a
      potent inducer a cytochrome P-450-dependent enzymes, modifies the course of the
      inflammatory process. Preliminary results with macrophage transfer experiments
      suggest that this response to PB could be mediated by stimulated macrophages.

PMID- 1757132
TI  - Scaphoid fractures and wrist pain--time for new thinking.
AB  - As with the practice of all medicine, an early accurate diagnosis is essential.
      The same applies after injury. The diagnosis should be made at the earliest
      opportunity--this should be done as soon as an appropriate expert is able to
      examine the patient, assess adequate radiographs and, where necessary, order
      special investigations such as a bone scan. By this means, distal radial
      fractures, injuries of the radioulna joint, dislocated lunates, Bennett's
      fractures, dorsal capsular wrist sprains, avulsion fractures etc. can be managed
      accordingly. Those patients in whom clinical examination, plain radiographs
      and/or bone scans show minor injuries can be advised about pain relief whilst
      staying active either at work or in the home using a light supportive removable
      bandage or splint. Where doubt remains and whilst keeping the patient
      comfortable, a bone scan may be requested. Its availability together with updated
      clinical and, if necessary, radiological assessment, will define a further group
      of patients who can be advised definitively either about active treatment or a
      return to normal activity. Only a few wrists will continue to defy definitive
      diagnosis requiring the continuance of expert advice and investigation. When a
      scaphoid fracture is diagnosed, its site, degree of displacement and any
      associated instability should determine the degree of intervention and the length
      of time required in plaster. This again gives the patient more information about
      the long-term future than many have had hitherto. The patient's individual
      requirements may be taken into account; some are happy to tolerate 2-3 months in
      plaster whilst others want the early function which an uncomplicated operation
      might offer.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757131
TI  - Leukocyte elastase-independent proteolysis of gelatin-bound fibronectin by
      inflammatory macrophages.
AB  - Fragmentation of lung matrix fibronectin by proteases released from activated
      phagocytic cells has been implicated in lung vascular injury. We examined whether
      denatured collagen (gelatin)-bound fibronectin can be degraded by peritoneal
      exudate mononuclear phagocytes harvested from rats 96 h after intraperitoneal
      casein injection. Microtiter plates were pretreated with gelatin and then
      supplemented with purified 125I rat plasma fibronectin, which readily bound to
      the gelatin. Stimulated inflammatory exudate cells were added and proteolysis of
      the bound fibronectin was studied by the release of [125I]fibronectin fragments
      into the media. Following 2 h of incubation, peritoneal exudate mononuclear
      macrophages stimulated with opsonized zymosan released three times more
      radiolabeled fibronectin into the medium as compared to background controls, and
      1.5 times more radiolabeled fibronectin as compared to cells not stimulated with
      zymosan. Western blot analysis and autoradiography confirmed the presence of
      fragments of fibronectin in the culture medium. Some of these fragments were
      clearly derived from the radiolabeled matrix, but others that were not labeled
      were potentially released directly from the added stimulated macrophages. The
      release of radiolabeled fibronectin was inhibited by N-p-tosyl-L-lysine
      chloromethyl ketone (TLCK), a trypsin specific inhibitor, but not by
      methoxysuccinyl-alanine-alanine-proline-valine-chloromethyl-ketone (AAPVCK), a
      leukocyte elastase-specific inhibitor. These results suggest that fibronectin
      bound to denatured collagen is susceptible to leukocyte elastase-independent
      enzymatic degradation by stimulated inflammatory exudate mononuclear phagocytic
      cells. Such proteolysis may mimic a pathological process associated with lung
      vascular injury during the sequestration of activated macrophages in the lung
      microcirculation and interstitium.

PMID- 1757133
TI  - Hepatic trauma and its management.
AB  - This review examines the current management of trauma to the liver. The
      incidence, mechanism, classification, diagnosis, treatment and complications of
      hepatic trauma are discussed. Diagnosis of hepatic injury may be difficult and
      specific investigations are suggested. Non-operative treatment and the strict
      criteria necessary to identify suitable patients for this are assessed. The
      recent trend to conservative surgery in hepatic trauma is reviewed. Aggressive
      resuscitation and early control of bleeding are crucial and are emphasized.

PMID- 1757134
TI  - Intracast pressure measurements in Colles' fractures.
AB  - Intracast pressures were recorded in conventional plaster-of-Paris below-elbow
      casts and compared with a new prefabricated brace for the functional treatment of
      Colles' fractures. Interface pressures were consistently higher in the brace than
      in the conventional plaster cast throughout the treatment period, and
      demonstrated more specific loading to the fracture site.

PMID- 1757135
TI  - Flexion supracondylar fractures of the humerus in children: treatment by
      manipulation and extension cast.
AB  - We have reviewed, at an average of 7 years, 14 children with flexion
      supracondylar fractures of the humerus. These fractures accounted for 6 per cent
      of the 288 displaced supracondylar fractures treated from 1981 to 1985. A total
      of 12 patients had typical fractures that were treated by manipulation and
      immobilization in an extension cast. Two patients had atypical fractures with
      anterior displacement and posterior angulation of the distal fragment; they were
      treated by manipulation, but were more stable when immobilized with the elbow
      flexed with strapping and collar and cuff support. Overall, excellent or good
      results were achieved in 10 cases and poor results in four cases. Of the poor
      results, two were due to cubitus varus. These children were the only ones under 2
      years of age, and in each the deformity was due to the persistence of an
      abnormally large Baumann angle. Plaster immobilization was inadequate at this
      stage. The other two poor results were due to mild stiffness of the elbow. For
      typical fractures, we conclude that excellent results can be expected in most
      children over the age of 2 years when treated with manipulation and
      immobilization in extension for 3 weeks. For the rarer atypical fractures, we
      conclude that excellent results can be expected after manipulation and
      immobilization in flexion for 3 weeks.

PMID- 1757136
TI  - Supracondylar fractures of the humerus in childhood: range of movement following
      the posterior approach to open reduction.
AB  - The posterior approach for open reduction of supracondylar fractures of the
      humerus has been condemned for causing decreased elbow movement. This study
      investigates this by comparing the range of movement in children treated by
      posterior open reduction and Kirschner wiring with those treated by closed
      reduction and immobilization. A total of 65 children with severely displaced
      supracondylar humeral fractures have been reviewed. There was some loss of
      movement in 66 per cent of the open reduction group and 42 per cent of the closed
      reduction group. The proportion losing more than 10 degrees of movement was the
      same in both groups. The difference between the two groups was due to the
      increased numbers in the open reduction group who lost less than 10 degrees of
      motion. Posterior open reduction of childhood supracondylar fractures is not
      associated with an important loss of elbow movement and need not be avoided on
      this account.

PMID- 1757137
TI  - Fractures of the body of the hamate.
AB  - Eight cases of fracture of the body of the hamate are presented, with
      descriptions of the injury and management. This fracture may be considerably more
      common than indicated by standard texts and previous published reports.

PMID- 1757138
TI  - High-pressure injection injuries.
AB  - A retrospective review of the 11 patients attending the Hand Unit at the
      Derbyshire Royal Infirmary over the last 5 years with high-pressure injection
      injuries is presented. The machines and materials that cause these injuries are
      outlined and the methods of treatment and rehabilitation are described in detail.
      The study demonstrates the morbidity of high-pressure injection injuries,
      particularly those inflicted by paint spray guns, and highlights a frequent delay
      between injury and decompression of the injured part. We wish to emphasize the
      importance of early diagnosis, referral, exploration and rehabilitation to ensure
      an optimal outcome, and to point out that failure to refer early is becoming an
      increasing focus of negligence claims.

PMID- 1757139
TI  - Urinary tract injuries in multiply-injured patients: a rational guideline for the
      initial assessment.
AB  - In a retrospective study involving 866 multiply-injured patients we demonstrated
      urinary tract injuries in 72 patients (8.3 per cent), 17 (2 per cent) of which
      were serious. Haematuria was a frequent finding in multiply-injured patients. In
      patients with serious lesions of the urinary tract, more than 35 RBCs/HPF in the
      sediment or macroscopic haematuria were found. All major injuries were
      demonstrated by the emergency intravenous urogram. Ultrasonography demonstrated
      contusions of the kidney or bladder and ruptures of the kidneys, but was not
      reliable in diagnosing ruptures of the bladder. Of 155 patients with a pelvic
      fracture 13 (8 per cent) had lower urinary tract injuries. In all these patients
      the fracture was located in the pubic arch. If a retrograde urethrogram was
      performed in these patients all urethral lesions were detected. We propose a
      rational guideline, which guarantees diagnostic accuracy of serious injuries of
      the urinary tract after blunt trauma, while interfering as little as possible
      with the resuscitative and diagnostic procedures in severely injured patients.

PMID- 1757140
TI  - Delayed diagnosis of injuries from the M1 aircraft accident. The Nottingham,
      Leicester, Derby, Belfast Study Group.
AB  - The incidence of a delay in the diagnosis of injuries from the 83 survivors of
      the M1 aircraft accident is described. A total of 32 injuries in 25 patients were
      not initially diagnosed, nine each in the upper and lower limbs and 14 in the
      spine. This was equivalent to 9.6 per cent of all the major injuries suffered by
      the survivors. Five patients required surgery for a late diagnosed injury. The
      incidence of a delayed diagnosis injury (DDI) was not related to the overall
      severity of injury. Delay in diagnosis of injuries after such a major accident
      was attributable to failure of clinical examination, failure to radiograph
      symptomatic areas and failure of radiographic interpretation.

PMID- 1757141
TI  - Proximal radioulnar translocation in association with posterior dislocation of
      the elbow.
AB  - Proximal radioulnar translocation in association with posterior dislocation of
      the elbow in childhood is a very rare injury. The aetiology is considered to be
      iatrogenic, resulting from an inappropriate reduction technique. Two cases are
      described that challenge this view. A mechanism of injury to explain
      translocation at the time of injury is proposed.

PMID- 1757142
TI  - Stress fracture of the first rib without associated injuries.

PMID- 1757143
TI  - Isolated fracture-dislocation of the proximal radius. A previously undescribed
      injury.

PMID- 1757144
TI  - Late carpal instability associated with dorsal distal radial fracture.

PMID- 1757145
TI  - A combined flexion-extension injury of the atlanto-axial complex.

PMID- 1757146
TI  - An unusual fracture of the atlas.

PMID- 1757147
TI  - Compartment syndrome after intramedullary interlocking nailing of a tibial
      fracture.

PMID- 1757148
TI  - Traumatic cerebrospinal fluid rhinorrhoea: a timely reminder.

PMID- 1757149
TI  - Delayed Serratia marcescens osteomyelitis following a gunshot injury.

PMID- 1757150
TI  - An unusual presentation of papillary carcinoma of the thyroid gland.

PMID- 1757151
TI  - A wrench, a crutch and a nail.

PMID- 1757152
TI  - A simple method to improve wound care for a windowed plaster.

PMID- 1757153
TI  - Three simple surgical aids.

PMID- 1757154
TI  - Using ultrapure water in hemodialysis delays carpal tunnel syndrome.
AB  - Since 1977, our patients have undergone chronic HD with ultra-pure dialysate
      (UPD), defined as having endotoxin levels below 0.008 ng/ml and less than 1
      bacteria/ml of dialysate. We evaluated the incidence of carpal tunnel syndrome
      (CTS) in three groups of patients. Group I (GI), 84 patients, dialysed for 6.1 +/
      3.2 years (mean +/- SD) with UPD only; Group II (GII), 39 patients, first
      dialysed for 3.7 +/- 2.3 years with non-UPD and afterwards for 8.4 +/- 2.1 years
      with UPD; Group III (G III), 103 patients treated for 6 +/- 5.9 years exclusively
      with non-UPD. All patients were dialysed with cuprophan or cellulose acetate
      membranes. Results, expressed by Kaplan-Meier actuarial survival curves as the
      percent of patients without CTS, show that CTS occurred significantly less in GI
      than in GIII. This may be due to less stimulation of monocytes resulting from the
      absence of bacteria, endotoxins and pyrogens in the dialysate, which would reduce
      the stimulation of cytokines release, interleukin 1 and 6, and tumor necrosis
      factor, known to stimulate beta 2 microglobulin synthesis.

PMID- 1757155
TI  - Filtration of dialysate using an on-line dialysate filter.
AB  - Increased concerns about pyrogenic contamination of dialysate have led to the
      development of an on-line dialysate filtration system. Bacteriological testing of
      the system was performed (n = 6) by introducing bicarbonate concentrate
      contaminated with E. coli 026:B 6 (3 x 10(9) cfu/ml) into a dialysis machine
      equipped with a two-stage polysulfone filtration system. The bacterial
      concentration of the dialysate entering the filtration system was maintained
      above 10(6) cfu/ml and endotoxin levels ranged from 30-300 ng/ml during the 3
      hour test period. Bacterial and endotoxin levels on the input side of the first
      stage filter reached minimum concentrations of 5.4 x 10(9) cfu/ml and 30,000
      ng/ml respectively. All output samples of filtered dialysate showed no bacterial
      growth and endotoxin levels were below the sensitivity (0.003 ng/ml) of the LAL
      assay. A dialysis machine (QD = 500), equipped with a single stage filtration
      system, was used for 18 months of clinical testing. In order to evaluate the
      system's reliability with regard to membrane failures and reduced dialysate flow,
      filter membrane integrity was verified weekly using a pressure holding test and
      dialysate flow was measured under routine clinical conditions. No membrane
      failures occurred, and dialysate flow was maintained at 511 +/- 17 ml/min (n =
      70) during the test period. IN CONCLUSION: dialysate filtration is an effective
      and practical method for prevention of pyrogenic reactions due to high levels of
      bacteria and endotoxins.

PMID- 1757156
TI  - Adherence of blood cells to dialyzer membranes as a measure of biocompatibility.
AB  - Cell adherence to plate dialyzer membranes was analyzed at the end of 4 hours of
      dialysis. Three types of membranes were examined: Cuprophan Hemophan and
      Gambrane, (a polycarbonate membrane). The membranes were mounted in dialyzers
      that contained 23 layers of one membrane type and one layer of each of the two
      other. Less leukocytes adhered to the Pc than to the Cu and He membranes.
      Transient initial complement activation during dialysis, which was considerably
      lower with dialysers containing mainly Pc membrane, was not correlated to
      adherence of cells to the membranes. Instead flow geometry is proposed as the
      main factor determining the adherence. Contrary to what has been earlier
      suggested, we think that leukocyte adherence is not a very suitable measure of
      membrane biocompatibility. The reason is that the influence of membrane surface
      chemical factors can not be separated from mechanical factors due to the design
      of the device.

PMID- 1757157
TI  - In vivo demonstration of the Haldane effect during extracorporeal gas exchange.
AB  - During the extracorporeal support (LFPPV-ECCO2R) of 11 patients suffering from
      severe lung failure (ARDS), we consistently noticed a higher arterial than mixed
      venous PCO2 in blood samples drawn at the same time. Two explanations are
      possible: a) the Haldane effect (HE), b) CO2 from lung tissue metabolism. In
      order to distinguish changes in PCO2 due to the HE from those due to tissue CO2
      production, CO2 content (CCO2) was calculated. The results were compared to
      animal experiments with hyperoxic apnea, after which arterial and mixed-venous
      samples were drawn simultaneously. All blood gas samples were analyzed for pH,
      PCO2, PO2, and O2-saturation, from which CCO2 was calculated. In both groups,
      PaCO2 was 2.15 mmHg (2.7 mmHg respectively) higher at a lower CaCO2 (-2.87 ml/l, 
      14.9 ml/l). Oxygen saturation increased by 8.1% in the human group and 17.8% in
      the animal group. A significant relationship was found between changes in PCO2
      and changes in O2-saturation. This is a demonstration of the Haldane effect.

PMID- 1757158
TI  - Cardiac output requirements and maximum dimensions for a neonate total artificial
      heart.
AB  - Two equally important issues need to be addressed during the early stages of the
      design of an implantable total artificial heart (TAH): proper anatomical fit and
      cardiac output capacity. As part of a first-time feasibility study to develop a
      neonate-size TAH, two studies were conducted to establish useful anatomical and
      physiological standards. The first (Study A) was conducted to determine the
      maximum dimensions of a neonate-size TAH. Twelve preserved hearts from full-term
      neonates with the hypoplastic left heart syndrome were examined. A second study
      (Study B) was designed to determine the acceptable minimum stroke volume
      compatible with minimum neonate cardiac output requirements. This study was based
      on a combination of: a) reported cardiac output studies in healthy term neonates,
      and term neonates with heart failure, b) body weight range, and c) limiting
      factors of TAH technology, e.g., valvular regurgitation and leveling off of the
      maximum cardiac output value at a specific heart rate and filling pressure. The
      proposed neonatal standards for TAH technology are presented.

PMID- 1757159
TI  - Shear stress related blood damage along the cusp of a tri-leaflet prosthetic
      valve.
AB  - Blood flowing through a prosthetic heart valve can be damaged by flow-induced
      shear forces. Fluid dynamics variables and geometric factors play an important
      role in the evaluation of shear-stress-related blood damage. Central-flow
      prosthetic valves have been considered as an optimal replacement for mechanical
      and biological valves. Recently it was shown that shear stress distribution along
      the surface of a polyurethane cusp reaches values that can damage the blood
      elements. A mathematical model correlating the effects of shear stresses on blood
      corpuscles with clinical findings was employed in vitro. The model can be applied
      to the effects of blood-surface interaction and is of clinical relevance.

PMID- 1757160
TI  - Heparin-coated versus non-coated surfaces for extracorporeal circulation.
AB  - Studies were made to compare completely heparin-bonded (HBS) and conventional
      extracorporeal circulation surfaces using capillary membrane oxygenators (CMO) in
      sheep and dogs for up to five days. The aims were: to investigate the need for
      systemic heparinization in the case of heparin-coated surfaces, to assess blood
      compatibility and gas exchange performance of both systems and the extent of
      complement activation, and to find solutions for plasma leakage by the use of
      CMO. All studies were performed under standardized conditions, such as drugs,
      surgery, priming, blood flow rate etc. For heparin-coated surface studies all
      blood interfaces (CMO, catheters, tubes, etc) were coated. It was possible to
      eliminate systemic heparinization totally when HBS were used. During the five-day
      non-heparin application period blood coagulation parameters were almost unchanged
      and in the physiological range, platelets did not drop below 80%, hemolysis was
      negligible and gas exchange performance was unaffected. Less complement
      activation occurred with HBS than with non-coated surfaces.

PMID- 1757161
TI  - An insulin-releasing system responsive to glucose: thermodynamic evaluation of
      permeability properties.
AB  - Two weak poly(acid)s, poly(acrylic acid) (PAA) and poly(N-acryloyl-glycine) (P1),
      were graft-copolymerized onto porous cellulose membrane and their protonation
      behavior in aqueous media was studied by potentiometric techniques. Comparison
      with the corresponding free polymers in solution showed the same basicity
      constants during the protonation of ionized carboxyl groups, and the large
      potentiometric hysteresis loops observed for the grafts were indicative of
      specific interactions with the cellulose substrate. This was confirmed by FT-IR
      spectroscopic analysis at low pH. The polymeric membrane system, containing
      immobilized glucose oxidase, was synthesized for the purpose of insulin delivery
      in response to glucose concentration. The porosity of the membrane was controlled
      by the charge-state conformations of the grafted chains. The formation of
      gluconic acid in the presence of glucose caused a drop in pH which led to
      neutralization of the negatively charged carboxyl groups. The decrease in
      electrostatic repulsion caused the extended macromolecular chain to assume a coil
      like form and opened the membrane pores to insulin.

PMID- 1757162
TI  - Effect of neo red cells on the canine hemorrhagic shock model.
AB  - This study evaluated the newly developed artificial red blood cells named Neo Red
      Cells (NRC) after hemorrhagic shock in mongrel dogs. NRC is prepared as
      microcapsules by a method in which stroma-free hemoglobin is encapsulated using a
      bimolecular lipid membrane called liposome. The particle size is 0.2 micron,
      methemoglobin content is less than 5% and the hemoglobin concentration is 5.6
      g/dl. We analyzed blood gases and hemodynamics and carried out laboratory
      examinations after 59-88% blood exchange using NRC. The hemodynamic parameters
      returned to the normal range after NRC. Inhaling normal room air, oxygen carried
      by NRC was 60.40% at the exchange rate of 88%. Renal and hepatic function and
      other laboratory findings were normal after administration of NRC. After further
      study and improvement NRC could be considered suitable as artificial blood for
      treatment of hemorrhagic shock.

PMID- 1757163
TI  - OASYS: a computerized auditing system for orthopaedic surgery.
AB  - Medical auditing based on individual diagnoses or specific therapies is well
      established. Auditing of all medical activity has an expanding role in quality
      assurance and research. In an attempt to overcome the limitations of existing
      auditing systems, a fundamentally different, flexible, high quality and easily
      accessible orthopaedic auditing system has been developed. This records a
      description of each component of patients' orthopaedic diagnoses, records
      treatment and complications, produces discharge letters and surgical log books
      and allows flexible and comprehensive audits. It has been in use in an
      orthopaedic service since January 1990 and has been successful in identifying
      problems and monitoring the effectiveness of changes. It is anticipated that the
      system will become more widely used and provide the basis for a 'user group'
      which will share the accumulated data and further development costs.

PMID- 1757164
TI  - Segmentation of brain CT images using the concept of region growing.
AB  - A method is described for extracting and isolating cerebrospinal fluid and tissue
      areas of brain images obtained with computed tomography. The classification of
      the pixels into components is based on region growing and nearest neighbor
      principles. To aid the performance of this method, the algorithm utilizes a
      priori information on the anatomic composition of the brain, and reduces the
      'cupping effect' in the CT image that is attributed to beam hardening artifacts.
      In order to avoid subjectivity, the performance of the algorithm was tested by
      superimposing five computer-simulated circular lesions on different areas of the
      original CT scans, 8 mm thick. These images were taken at different levels in the
      brain, thereby accommodating different anatomy as well as the apical artifact of
      CT scanning. In this exploratory investigation, the false negative error of
      segmentation for lesions having diameter of 20 pixels was found in the order of
      25% at an estimated partial volume (PV) effect of 50% that decrease further to
      about 5% for a PV of 80%. At that point the false positive error becomes the
      dominant error in the analysis.

PMID- 1757165
TI  - Modeling autostimulation of growth in multicellular tumor spheroids.
AB  - We report the development of a growth model that includes the positive regulatory
      feedback by cell-cell interactions. It is based on the model by Wheldon et al. (J
      Theor Biol, 38 (1973) 627) and Cox et al. (Comput Biomed Res, 13 (1980) 445) and
      is characterized by biologically interpretable parameters. We applied the model
      to growth of multicellular spheroids formed by V79 Chinese hamster fibroblasts.
      The new model resulted in a statistically sound fit. We compared the
      applicability of our model, of the model by Wheldon et al. and Cox et al. as well
      as of the related model by Piantadosi (Comput Biomed Res, 18 (1985) 220). We
      affiliated the models with each other within a nesting scheme and compared their
      respective fits to data by the F-test. Our model yielded a fit statistically
      equivalent to the fit by the model of Piantadosi. However, in distinction to
      other models, the estimated cellular doubling time in our model agreed better
      with the respective experimentally determined value.

PMID- 1757166
TI  - Stability and bifurcation of a reaction-diffusion system.
AB  - In this paper we study the stability and bifurcation of partial differential
      equations derived from enzyme immobilisation modelling. Sufficient mathematical
      conditions ensuring stability and bifurcation are obtained.

PMID- 1757167
TI  - A computerized system for measuring time perception in human subjects.
AB  - We describe an integrated computerized approach to the design, execution and
      recording of time perception experiments in human subjects. The program is menu
      driven and runs on an IBM-compatible microcomputer. The method is easy to use,
      non-obtrusive to the subjects, and flexible enough to allow the investigator to
      design studies with a wide range of experimental protocols and study parameters.
      The fact that the results do not depend on proctor bias or subject-proctor
      interactions are additional advantages. The technique was applied to study the
      effects of prompt positive feedback on the time perception of normal human
      subjects who undergo training. The results of this study are reported.

PMID- 1757168
TI  - From Ganja to crack: Caribbean participation in the underground economy in
      Brooklyn, 1976-1986. Part 1. Establishment of the marijuana economy.
AB  - The involvement of Caribbean youth in drug distribution (marijuana from the mid
      1960s to 1981; cocaine hydrochloride powder and crack from 1981 to 1987, the time
      of writing) throughout the Circum-Caribbean area and in North America is
      described. Social, economic, and cultural outcomes of these engagements are
      highlighted, and the relationship between the underground economy of drugs and
      the corporate, capitalist economy is explored. Responding to high rates of
      unemployment and to other problems of migrant adaptation, young Caribbean African
      males established a multimillion dollar marijuana (ganja) trading network which
      linked cultivators on the islands with exporters/importers and street-level
      distributors in North American cities. By 1976, its participants had become
      Rastafarians, or followers of an ideology of self-reliance and indigenous
      development. Following its precepts, they reinvested marijuana revenues to revive
      cottage industry and agriculture. In Caribbean or minority neighborhoods,
      therefore, marijuana was a "positive vibration" and its distributors were
      lionized.

PMID- 1757170
TI  - Psychometric evaluation of the Children of Alcoholics Screening Test (CAST) in a
      psychiatric sample.
AB  - The Children of Alcoholics Screening Test (CAST) is a 30-item screening
      instrument developed to identify children who are either living with or have
      lived with alcoholic parents. In a sample of 250 psychiatric patients, the CAST
      exhibited substantial item-total scale correlations and a high level of internal
      consistency reliability. Total CAST scores discriminated self-identified children
      of problem drinkers from control subjects and were significantly correlated with
      the severity of parental psychological and social complications due to alcohol
      misuse. Factor analysis indicated a unidimensional scale structure. CAST cut-off
      scores produced a low false positive and false negative rate. The psychometric
      properties of the CAST suggest that it is a useful screening instrument for
      identifying the offspring of problem drinkers and alcoholics.

PMID- 1757169
TI  - Outcomes of an AIDS prevention program for methadone patients.
AB  - Methadone maintenance patients are at risk of contracting or transmitting HIV
      through intravenous drug use and/or unsafe sexual practices. An outcome
      evaluation of a voluntary AIDS prevention program for methadone patients in three
      clinics (two experimental, one control) is reported. The prevention program
      included three components: didactic AIDS education, HIV antibody
      counseling/testing, and facilitated peer support groups. Participation in AIDS
      education was associated with increased knowledge of AIDS risks and with improved
      attitudes toward condoms. Peer group participation was associated with improved
      attitudes toward the use of condoms and with increased use of condoms. Learning
      of HIV seronegativity was related to increased self-efficacy and decreased
      intravenous drug use risk behaviors. Rates of participation in the prevention
      program were disappointing, but the program seemed beneficial for those patients
      who did become involved.

PMID- 1757171
TI  - Alcohol, age, and piloting: judgement, mood, and actual performance.
AB  - We have previously described acute and carry-over effects of alcohol on young and
      older pilots' performance. In the present paper we report the effects of alcohol
      and age on self-assessment of performance and mood in the same study. Young and
      older pilots flew in a simulator during an alcohol and placebo condition. In the
      alcohol condition, they flew after reaching .04 g/dL (.04%) BAL, after .10% BAL,
      and then 2, 4, 8, 24, and 48 h after .10% BAL (they flew at the same times in the
      placebo condition). They rated confidence in ability to fly, mood, alertness, and
      intoxication before each flight, and perceived workload and performance after
      each flight. As reported in Morrow et al., alcohol had both acute and carry-over
      effects for 8 h on actual flight performance, with greater acute impairment for
      older pilots. The present study reports that these older pilots tended to be more
      aware than the young pilots of acute and carry-over alcohol impairment out to 4
      h. By 8 h, however, all pilots were unaware of impairment. Alcohol also had a
      biphasic effect on mood, which increased on the ascending limb and decreased on
      the descending limb of the BAL curve.

PMID- 1757172
TI  - A comprehensive worksite smoking control, discouragement, and cessation program.
AB  - The effectiveness of a comprehensive program of worksite smoking control,
      discouragement, and cessation was compared with a program of smoking cessation
      alone. Two comparable oil refineries served as the research sites. Outcome
      variables consisted of employee self-reported smoking rate assessed by the use of
      a smoking questionnaire and unobtrusive observations of smoking behavior before
      and after the intervention. One company was randomly assigned to the
      comprehensive program of smoking control, discouragement, and cessation while the
      other company only received smoking cessation. Humorous antismoking posters
      emphasizing the benefits of quitting smoking were distributed throughout the
      first worksite and changed every 2 weeks. Large banners stating "Go SmokeFree"
      were also placed at all locations to this plant and left up for the duration of
      the study. Three weeks after the initiation of the smoking discouragement program
      at one refinery, a group smoking cessation program was begun at both plants. At a
      5-month follow-up, participants in the smoking cessation treatment at the plant
      receiving the comprehensive program achieved a 5-month abstinence rate of 43% in
      comparison with a rate of 21% at the refinery receiving only smoking cessation.

PMID- 1757173
TI  - An application of mathematical models for decision making to the selection of
      policies on testing for drug use.
AB  - The object of the paper is to provide the basis to decide whether testing for
      drug use should be used, taking into consideration individual and social benefits
      and costs that the results of the tests could originate. In the analysis, special
      attention is paid to the fact that the actual costs of the tests themselves are
      not the most important elements of the social costs of a testing program. The
      most important costs are those generated by the defective results of the tests.
      They can provide false positive results, meaning that a nonuser is identified as
      a user, or false negative results in which a user is not identified as such.
      Social costs of the false positive results range from lowered worker morale to
      legal suits, while the false negative results eliminate any benefit that the
      identification of drug users could have. Combining all these elements, Correa and
      Woods specify a mathematical procedure as a decision tool to be used for
      determining whether a testing program should be implemented in specific
      industries or groups of industries. A complete implementation of the model is not
      carried out due to the lack of the required statistical information. However,
      preliminary trials showed that the conceptual and mathematical framework is
      operational, and that the model prepared could be used as a guideline for
      collecting the most appropriate data for decision making.

PMID- 1757174
TI  - Alcohol and psychiatric illness: longitudinal study of psychiatric admissions in
      a cohort of Swedish conscripts.
AB  - The association between level of alcohol consumption and admission for
      psychiatric care during a 15-year follow-up was studied in a cohort of 49,464
      Swedish conscripts. The relative risk for psychiatric admission among high
      consumers of alcohol (more than 250 g alcohol per week) was 5.3 (95% confidence
      interval 4.7-6.0) compared with moderate consumers (1-100 g alcohol per week).
      After control for social background variables in a multivariate model, the odds
      ratio was 1.8 (1.5-2.1). Abstainers had the same rate of admission as moderate
      consumers. The association with alcohol was positive in all diagnostic categories
      studied. Neurotic depression was found to be a risk factor for admission for
      alcoholism, indicating that a causal association between alcohol and neurotic
      depression may go in both directions.

PMID- 1757175
TI  - Common pathways for epidermal growth and inflammation and their relevance in the
      pathogenesis of psoriasis.

PMID- 1757176
TI  - Pre-emptive diagnosis of leprosy.

PMID- 1757177
TI  - Leprosy in the United States. Just a curiosity?

PMID- 1757178
TI  - To compound or not? That is the question.

PMID- 1757179
TI  - Heat shock proteins in cutaneous disease.

PMID- 1757180
TI  - Characterization of circulating lymphocytes by monoclonal antibodies in childhood
      and adult leprosy.
AB  - Peripheral blood lymphocyte assays using monoclonal antibodies were done in 66
      patients with leprosy, consisting of 25 children and 41 adults. The results were
      statistically analyzed for correlations, if any, among the different age groups
      and matched controls. The results, however, failed to show any significant
      correlation, nor was it possible to draw any conclusion as to why the disease
      spectrum in children tends to be incomplete (ie, there is a low incidence of the
      highly bacilliferous form of disease expression).

PMID- 1757181
TI  - Cutaneous eruptions in Indian tick typhus.
AB  - Although frequently unrecognized, rickettsial infections may be an important
      cause for fever and exanthem in persons presenting to physicians in South India.
      Most often these patients are referred to dermatology departments with a
      diagnosis of "drug eruption." In the current study the authors analyzed 12 cases
      of rickettsial fever that were seen in the dermatology department of St. John's
      Medical College Hospital, Bangalore, between 1985 and 1989. The distinctive
      cutaneous eruption was found to be an important clue to an early clinical
      diagnosis. Specific serodiagnosis enabled us to confirm that Indian tick typhus,
      a member of the spotted fever group, was the most frequent cause for rickettsial
      fever presenting at our hospital.

PMID- 1757182
TI  - Nodular secondary syphilis.

PMID- 1757183
TI  - Papular pruritic eruption with human immunodeficiency virus infection.

PMID- 1757184
TI  - Cutaneous nocardiosis and human immunodeficiency virus infection.

PMID- 1757185
TI  - Topical canrenoic acid. Quantification of the antiandrogenic activity in the
      hamster flank organ.
AB  - The topical antiandrogenic activity of potassium canrenoate (CAK), compared with
      that of spironolactone (SP), was assayed in vivo in female golden Syrian hamsters
      whose flank organs were stimulated by subcutaneous administration of testosterone
      propionate. Sebaceous glands and hair were measured by a computerized image
      analyzer. Pigmented spots, sebaceous gland areas, and the diameter of hairs of
      the treated flank organs were smaller in the groups that received CAK (1.6
      mg/day) and SP (0.4 mg/day). The authors' results showed that CAK may act as a
      topical antiandrogen on the hamster flank organ when applied in concentrations
      four times greater than the minimal active dosage of SP. Potassium canrenoate may
      be a useful weak topical antiandrogen, and it could be used in androgen-related
      skin disorders involving both sebaceous glands and hair, especially in men. These
      concentrations could be verified by additional clinical investigations.

PMID- 1757186
TI  - Extracorporeal photochemotherapy in the treatment of cutaneous T-cell lymphoma.
      Complexity of objective evaluation.
AB  - The term cutaneous T-cell lymphoma (CTCL) encompasses the spectrum of diseases
      characterized by a monoclonal proliferation of malignant T lymphocytes
      predominantly of the mature T-helper cell type. These include mycosis fungoides,
      which is usually localized to the skin for many years, and the Sezary syndrome,
      the leukemic variant in which characteristic, bizarre lymphatic cells with deeply
      indented or cerebriform nuclei, the Sezary cells, infiltrate lymph glands and
      internal organs such as the spleen, liver, lungs, heart, and bone marrow. The
      condition is more common in men after their fourth decade. The treatment of CTCL
      varies depending on the stage of the disease. The skin of the patient is the
      primary index of effectiveness of therapy. Options range from topical steroids,
      topical nitrogen mustard, X-irradiation, electron beam irradiation, and 8
      methoxypsoralen (8-MOP) combined with ultraviolet A photochemotherapy (PUVA), to
      leukapheresis and systemic chemotherapy. More recently, extracorporeal
      photochemotherapy (ECPC) has been introduced. The safety and efficacy of this
      modality is further investigated in six patients who fulfilled the criteria of
      diagnosis of CTCL. The problems encountered in objectively evaluating the
      clinical responses in the patients are outlined and improvements in the protocol
      to overcome these are suggested. The proposed mechanism of action is an
      immunostimulatory one and a procedure that is relatively free from side effects;
      it offers promise as a potential treatment for a difficult cancer.

PMID- 1757187
TI  - How leprosy is depicted in Ben-Hur.

PMID- 1757189
TI  - To compound or not depends on.

PMID- 1757188
TI  - Human leukocyte antigen in bullous pemphigoid.

PMID- 1757190
TI  - Stimulated chemotactic response in neutrophils from Trichinella pseudospiralis
      infected mice and the neutrophilotactic potential of Trichinella extracts.
AB  - During infection with Trichinella pseudospiralis a strong neutrophil response is
      evident in the peripheral circulation of the mouse. This study compared the
      chemotactic response of neutrophils from uninfected, T. pseudospiralis-infected
      and Trichinella spiralis-infected mice to extracts from adult worms, newborn
      larvae and muscle-stage larvae of both species of parasite. The chemotactic
      response of neutrophils from T. pseudospiralis-infected mice to Zymosan-activated
      mouse serum (ZAMS) was significantly greater than that seen with neutrophils from
      either uninfected or T. spiralis-infected mice. Unstimulated chemotactic response
      of neutrophils from these three groups of animals to medium alone was similar.
      The chemotactic response of neutrophils from the three groups of animals was
      unaffected by either the concentration or source of serum. The chemotactic
      response of neutrophils from T. pseudospiralis-infected mice was significantly
      greater than that observed with cells from uninfected or T. spiralis-infected
      mice. Among parasite extracts, those from newborn larvae displayed the strongest
      chemotactic potential for neutrophils. Extracts from muscle larvae of T. spiralis
      and T. pseudospiralis and extracts of T. spiralis adult worms showed the weakest
      attraction for neutrophils. Extracts from adult T. pseudospiralis and from
      newborn larvae of both species elevated the chemotactic response of uninfected
      mouse neutrophils to a significantly greater level than that seen with ZAMS
      alone, while a significant reduction in this response was evident only when ZAMS
      was presented to neutrophils with 500 micrograms of extract from muscle larvae of
      T. pseudospiralis or T. spiralis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757191
TI  - Immunity to Haemonchus contortus and the cellular response to helminth antigens
      in the mammary gland of non-lactating sheep.
AB  - Cellular exudates induced by infusion with helminth antigens were examined in non
      lactating mammary glands of ewes immune to infection with the abomasal nematode,
      Haemonchus contortus. Secondary immunological responsiveness was expressed in two
      ways. Firstly, antigens from adult H. contortus elicited larger eosinophil-rich
      cellular exudates in immune compared to non-immune ewes. In this situation,
      secondary responsiveness in the mammary gland must have been generated through
      abomasal infection with the parasite. Secondly, repeated infusion with the
      antigens from adult H. contortus increased the size of cellular exudates in both
      immune and non-immune ewes. Eosinophils predominated but numbers of macrophages
      and lymphocytes were also increased. In this second situation, secondary
      responsiveness must have been either supplemented in immune ewes or derived
      completely in non-immune ewes by contact with helminth antigens through the
      mammary gland. The helminth antigens which induce eosinophil exudates in the
      mammary gland may not be potently protective against H. contortus. Furthermore,
      eosinophil exudation may not be an in vivo correlate of immunity which is
      directly useful for discriminating protective antigens and applicable to vaccine
      development. Infusion with antigens from adult forms of either H. contortus or
      Trichostrongylus colubriformis elicited cellular exudates equally well in immune
      ewes primed by infusion with H. contortus adult antigens 7 days beforehand. In
      addition, antigens from infective larvae of H. contortus elicited cellular
      exudates more potently than antigens from adult worms. However, vaccination with
      irradiated larvae has shown that species-specific protective immunity for H.
      contortus is stronger than cross-protective immunity conferred by T.
      colubriformis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757192
TI  - Pyridoxal 5'-phosphate dependent enzymes in the nematode Nippostrongylus
      brasiliensis.
AB  - Eight classes of pyridoxal 5'-phosphate dependent enzymes have been investigated
      in Nippostrongylus brasiliensis in parallel with rat tissues. The range of
      decarboxylases detected in N. brasiliensis was limited in comparison with rat
      tissues. N. brasiliensis possessed a highly active L-serine
      hydroxymethyltransferase, but in contrast with rat liver, 5-aminolevulinic acid
      synthetase was absent. Similar levels of L-serine and L-threonine dehydratase
      activities were detected in N. brasiliensis and rat liver, and both organisms
      lacked L-alanine racemase, L-tryptophan synthetase and L-methionine gamma-lyase.
      The demonstration of cystathionine beta-synthase and gamma-cystathionase in N.
      brasiliensis suggests the presence of a functional trans-sulphuration sequence.
      The substrate specificities of the nematode cystathionine beta-synthase and gamma
      cystathionase varied significantly from those of the corresponding mammalian
      enzymes. Particularly striking was the ability of N. brasiliensis cystathionine
      beta-synthase to catalyse the non-mammalian 'activated L-serine sulphydrase'
      reaction (L-cysteine + R-SH----cysteine thioether + H2S). N. brasiliensis and rat
      liver exhibited comparable abilities to transaminate amino acids via the 2
      oxoglutarate: glutamate system.

PMID- 1757193
TI  - Development, survival, fecundity and behaviour of Haemaphysalis (Kaiseriana)
      longicornis (Ixodidae) at two locations in southeast Queensland.
AB  - The free-living stages of the tick Haemaphysalis (Kaiseriana) longicornis were
      studied at Mt Tamborine (526 m altitude) and Amberley (25 m altitude) in
      southeast Queensland between 1971 and 1980. Data are presented on the number of
      eggs and larvae produced, the moulting success of engorged larvae and nymphs and
      the survival and behaviour of unfed larvae, nymphs and adult females.
      Temperature, moisture, daylength, grass length and age of unfed ticks were
      investigated as sources of variation in development rates, fecundity or survival.
      At Mt Tamborine the life cycle was well synchronized with the seasons to produce
      one generation per year. At Amberley higher temperatures accelerated development
      rates and would have delayed diapause, so disrupting the life cycle.

PMID- 1757194
TI  - NADH oxidase and fumarate reductase of Ancylostoma ceylanicum.
AB  - Ancylostoma ceylanicum, the hookworm parasite of cat, dog and man, was found to
      contain NADH and/or NADPH oxidase as well as fumarate reductase activities. Both
      the enzyme systems were predominantly located in the membranes of mitochondrial
      rich preparations. The membranes also exhibited the presence of a reduced
      pyridine nucleotide transhydrogenase activity which transferred hydrogen from
      NADPH to NAD. Amongst respiratory inhibitors, rotenone (Site I inhibitor)
      markedly depressed both NADH oxidase and fumarate reductase while others, namely
      antimycin-A, KCN and azide, had a lesser effect.

PMID- 1757195
TI  - Purification of Gnathostoma spinigerum specific antigen and immunodiagnosis of
      human gnathostomiasis.
AB  - Specific antigen of G. spinigerum which has been shown to be a protein with a
      relative mol. wt of 24,000 (24K) was prepared from the advanced third-stage
      larvae (L3) obtained from the livers of naturally infected eels. The L3 were
      ground and extracted with water. Purification procedures involved gel filtration,
      chromatofocussing and anion exchange column chromatographies, while
      characterization of the specific antigen was performed by sodium dodecyl sulphate
      polyacrylamide gel electrophoresis (SDS-PAGE) and staining, Western blot analysis
      and isoelectric focussing. The specific antigen which has a pI of 8.5 was used as
      antigen in the indirect enzyme-linked immunosorbent assay (ELISA) to detect
      specific antibody in four groups of individuals, namely five parasitologically
      diagnosed gnathostomiasis patients (group 1); 15 clinically diagnosed
      gnathostomiasis patients (group 2); 136 patients with other parasitic infections
      (group 3); and 25 normal healthy parasite-free controls. Sensitivity, specificity
      and predictive values (positive and negative) of the assay were 100%.

PMID- 1757196
TI  - Effects of cholinergic drugs on longitudinal contraction in levamisole
      susceptible and -resistant Haemonchus contortus.
AB  - A novel force transducer was used to measure the effects of cholinergic agonists
      on longitudinal contraction in Haemonchus contortus. Drugs were applied to whole
      worms or injected via a cannula in the pseudocoelomic cavity. A number of
      agonists, including nicotine and the anthelmintics m-aminolevamisole, levamisole
      and morantel, caused contractions in whole worms. Four- to 25-fold increases in
      concentration of the active compounds were required to cause contractions in each
      of two levamisole-resistant strains of H. contortus. Of the other compounds
      tested, bephenium had equivalent activity against susceptible and resistant
      strains. Anticholinesterase compounds caused contractions after a slight delay in
      susceptible, but not resistant worms. Numerous cholinergic agonists and other
      compounds did not cause contraction when applied to whole worms. One of these,
      acetylcholine, caused contractions in cannulated worms. Compared with the
      susceptible strain, five- to six-fold higher concentrations of acetylcholine were
      required to cause equivalent contractions in the resistant strains. Levamisole
      resistance in adult H. contortus is likely to be due to a change in the
      characteristics of the cholinergic receptor(s).

PMID- 1757197
TI  - Response of pre-adult and adult stages of Trichuris muris to common anthelmintics
      in mice.
AB  - The common anthelmintics, oxantel, mebendazole, albendazole and pyrantel were
      assessed for their comparative activity against Trichuris muris in mice. Mice
      were infected with T. muris and the infection was maintained by a brief cortisone
      administration during the second week of infection. Mice carrying the infection
      with different life cycle stages, viz. fourth stage larvae (L4), pre-adult and
      adult stages were dosed with anthelminitics. The worm burdens in control
      infection groups varied although infection dose and other conditions were
      uniformly followed. With various dose regimens tested, oxantel was highly potent;
      it eliminated completely pre-adult and adult stages, respectively at 25 and 12.5
      mg kg-1 dose levels with significant activity also against adult worms at a 1.56
      mg kg-1 dose level and against pre-adults at a 6.25 mg kg-1 level. Pre-adults
      required twice the dose given to that of adults for complete (100%) activity.
      Mebendazole was the next most active; a dosage of 37.5 mg kg-1 was completely
      active against pre-adults whereas a dosage of 2 x 50 mg kg-1 was required for
      complete elimination of adult worms. In addition, about 90% of the worms were
      eliminated with a single dose of 150 mg kg-1. However, a significant activity was
      seen against adults at a 25 mg kg-1 level and pre-adults at 37.5 mg kg-1, the
      lowest level tested. In comparison, albendazole did not induce complete clearance
      of pre-adult and adult stages even when tested at dose levels as high as 150 and
      2 x 75 mg kg-1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757198
TI  - Ultrastructural observations on the tegument and associated structures of the
      monogenean Cichlidogyrus halli typicus (Price & Kirk, 1967) Paperna, 1979.
AB  - The tegument of the ancyrocephaline monogenean gill parasite Cichlidogyrus halli
      typicus is basically similar to that of other monogeneans. However, there are
      some tegumental features shared with relatively few other monogeneans, namely the
      presence in the surface tegument of extensive regions of homogeneous granular
      cytoplasm, a close association between myofibres and the basal region of the
      tegument and the production of two different tegumental secretory bodies by the
      same cyton. It is suggested that the regions of homogeneous granular cytoplasm
      found in the troughs between the circular muscle fibres provide some kind of
      support for the tegument, perhaps related to contraction of the tegumental
      circular muscle fibres and body shape changes. Three kinds of transtegumental
      sensory structures are recognized, namely a uniciliated bulb, a bulb bearing a
      non-ciliary process and a non-ciliated bulb. The latter two kinds are reported
      for the first time in monogenans. Possible functions of these sensory structures
      are discussed.

PMID- 1757199
TI  - Concurrent infections of Echinostoma caproni and Echinostoma trivolvis in ICR
      mice.
AB  - ICR female mice, 6- to 8-weeks old, were exposed concurrently to 25 metacercarial
      cysts of Echinostoma caproni and 25 metacercarial cysts of Echinostoma trivolvis
      and necropsied 10 and 14 days post-infection. Controls consisted of mice exposed
      singly to either 25 or 50 E. caproni or E. trivolvis cysts. All 23 mice exposed
      to E. caproni cysts were infected with a total of 331 worms (37.8%), whereas only
      11 (37.9%) of 29 mice exposed to E. trivolvis cysts were infected with a total of
      77 (6.4%) worms. In the concurrent infections, 13 (59.1%) of 22 mice were
      infected with both species and the percentage of worm recovery was 72.6% for E.
      caproni and 14.2% for E. trivolvis. There was no difference in worm distribution
      of either species in single vs concurrent infections. In concurrent infections at
      14 days PI, there was a significant decrease in the body area of worms of both
      species, when compared to single worm species.

PMID- 1757200
TI  - Molecular analysis of T and B cell repertoires in mice immunized with
      Opisthorchis viverrini antigens.
AB  - B10 mice were immunized with an Opisthorchis viverrini somatic extract and then
      their responses were analyzed. The antigenic fractions of the extract were
      separated by SDS-polyacrylamide gel electrophoresis, electroblotted to
      nitrocellulose membranes and solubilized for use in lymphocyte culture. Antibody
      specificity was also visualized by immunoblotting using immunized mouse sera. The
      Mr of the main immunogenic fractions for T cells ranged from 28 to 46 kDa,
      whereas those recognized by antibodies were 45, 52, 56, 59, 65, 69, 75 and 81
      kDa. The results indicate a striking difference in the antigenic recognition
      pattern of T and B cells which may be important for selecting antigen molecules
      for immunological studies of this trematode infection in man.

PMID- 1757201
TI  - A Blastocystis species from the sea-snake, Lapemis hardwickii (Serpentes:
      Hydrophiidae).
AB  - Observations were made on Blastocystis isolated from the sea-snake, Lapemis
      hardwickii. Exponential growth of the organism was observed between 2 and 4 days
      of culture. Vacuolated, amoeboid and granular forms were observed in cultures,
      similar to B. hominis. The optimal growth temperature for the sea-snake
      Blastocystis was 24 degrees C compared with 37 degrees C for B. hominis. The
      karyotypic patterns of B. hominis and the sea-snake Blastocystis were studied in
      the clamped homogeneous electric field (CHEF) technique and found to be
      different. Based on the above differences, the sea-snake Blastocystis was
      designated as Blastocystis lapemi sp. nov.

PMID- 1757202
TI  - Purification, quantification and mechanical hatching of eggs of the tapeworm,
      Hymenolepis diminuta.
AB  - Eggs of Hymenolepis diminuta were separated from host's feces using a combination
      of NaCl flotation, filtration through nylon monofilament screen cloths, and
      centrifugation. The resulting purified egg preparations (PEPs) were verified
      microscopically to be virtually free of contaminating debris. The relationship of
      absorbance (500 nm) of PEPs and 'number of eggs per unit volume' was linear, and
      such measurements provided a rapid, reproducible method for quantifying PEPs. The
      average wet and dry weights of individual eggs were 2.86 x 10(-7) and 0.458 x 10(
      7) g, respectively. Eggs were mechanically hatched using a Dounce homogenizer
      with pestle 'A'. This technique caused no detectable damage to larvae and
      resulted in a high percentage of 'activated' (i.e. motile) larvae.

PMID- 1757203
TI  - Biochemical changes during the development of the miracidium of Gigantocotyle
      explanatum.
AB  - Analysis of various biochemical components during the development of the
      miracidium of G. explanatum showed marked changes, particularly in glycogen,
      protein and DNA levels. Though the total lipids remained more or less unchanged,
      alterations in the levels of cholesterol, triglycerides, free fatty acids,
      phospholipids and phospholipid fractions were also recorded. Such changes could
      be intrinsically programmed for the cellular differentiation and organogenesis in
      larval amphistomes.

PMID- 1757204
TI  - Monoclonal antibody to a diagnostic Mr 24,000 antigen of Gnathostoma spinigerum.
AB  - Crude water extract (CA) was prepared from the advanced third-stage larvae of
      Gnathostoma spinigerum collected from livers of naturally infected eels. The
      extract was partially purified by chromatofocussing column chromatography and the
      fraction which contained specific antigen of G. spinigerum which was an Mr 24,000
      glycoprotein was used to immunize five Balb/c mice for preparing immune
      splenocytes. Spleen cells were collected from one mouse which showed high serum
      titre by indirect enzyme-linked immunosorbent assay and contained specific
      antibody to the Mr 24,000 antigen as checked by Western blot analysis. The spleen
      cells were fused with myeloma Sp2/0 cells at a ratio of 10 spleen cells per one
      myeloma cell using polyethylene glycol 3350 as a fusogen. Thirteen out of 174
      growing polyclones (7.5%) produced antibodies to the partially purified CA
      fraction. Among them, two polyclones produced antibody directed to the Mr 24,000
      protein. These two polyclones were subjected to monocloning by limiting dilution
      and a monoclone GN6/24 which produced monoclonal antibody to the specific Mr
      24,000 protein of G. spinigerum was obtained.

PMID- 1757205
TI  - Swimming in a sub-adult monogenean of the genus Entobdella.
AB  - Swimming in a sub-adult monogenean parasite is reported for the first time. When
      detached from the substrate, a specimen of an undescribed species of Entobdella
      from the ventral skin surface of the cow-tailed ray, Dasyatis sephen, was found
      to propel itself vigorously through the water, head-first, by rapid dorso-ventral
      body undulations travelling in an antero-posterior direction. These waves pass in
      the opposite direction to the slower breathing (?) undulations exhibited by the
      attached parasite. Benedeniella macrocolpa from another elasmobranch host and
      benedeniines from teleost fishes merely made uncoordinated wriggling movements
      when detached from the substrate. The possible function of swimming in
      monogeneans is discussed.

PMID- 1757206
TI  - Metalloproteinases in the larvae of Echinococcus granulosus.
AB  - Proteolytic activity in hydatid cyst fluid, cyst membranes and protoscoleces of
      E. granulosus was analyzed by electrophoresis in gelatin-containing
      polyacrylamide gels, including characterization with a set of protease
      inhibitors. All contained metalloproteinases in the range 60-120 kDa, with
      neutral/alkaline pH optima. Major activity was observed in hydatid fluid and the
      membranes (five bands) with both exhibiting similar electrophoretic patterns. The
      samples prepared from protoscoleces shared only some of these bands.

PMID- 1757207
TI  - The toxicity of adenosine analogues against Babesia bovis in vitro.
AB  - The toxicities of 20 analogues of deoxyadenosine or adenosine were tested in
      vitro against the intraerythrocytic parasite Babesia bovis. IC37 values (the
      concentration of compound required to reduce cell survival to 37%) were
      determined for each compound. Tubercidin (7-deaza-adenosine), 2-bromo-adenosine,
      8-bromo-3-ribosyl adenine and 6-phenylamino-deoxyadenosine were shown to be the
      most toxic towards B. bovis. Comparison of the toxicity results for these
      compounds in B. bovis with those in human melanoma cell lines indicated a
      differential toxicity, in that many of the compounds were toxic towards B. bovis
      but were relatively non-toxic towards human melanoma cell lines and vice versa.
      These results suggest that the mechanism of toxicity of the deoxyadenosine and
      adenosine analogues, whose normal metabolism involves transport, metabolism and
      incorporation into nucleic acids, may vary significantly between B. bovis and
      mammalian cells, allowing such drugs to be considered for parasite chemotherapy.

PMID- 1757208
TI  - Trypanosoma cf. carassii: the combination of malic enzyme patterns supports the
      theory of diploidy in trypanosomes.
AB  - Electrophoretic analysis of Trypanosoma cf. carassii strains from cyprinid fish
      revealed three basic types of enzyme patterns of malic enzyme (ME) in forms from
      culture. Two enzyme patterns were one-banded and differed only slightly in
      electrophoretic mobility. The third pattern consisted of three bands, the two
      marginals corresponding to respective bands of one-banded patterns and the third
      located in the middle. ME is thought to be dimeric in trypanosomes and therefore
      the triple-banded pattern may be regarded as the hybrid from combination of the
      former two. This fact supports the concept of diploidy in fish trypanosomes.

PMID- 1757209
TI  - The stability of the fetal oxygen environment.

PMID- 1757210
TI  - Pancreatic insulinoma localised by intra-operative ultrasound.

PMID- 1757211
TI  - A role for a non-androgenic anovulant in the management of hirsutism.
AB  - Sixty-nine patients who had Ferriman/Gallwey hirsutism scores (FG) of greater
      than or equal to 8 were treated with Diane, an anovulant containing cyproterone
      acetate, 2 mg, an anti-androgenic progesterone and ethinyl oestradiol, 5.0
      micrograms. Twenty-one of these had been previously treated with dexamethasone
      (DEX) and did not respond, i.e. FG greater than 50% of pre-treatment value. Prior
      to Diane treatment, plasma total testosterone (T) values, 1.4 +/- 0.5 nmol/l,
      mean +/- S.D., were similar to those in 43 normal women, 1.23 +/- 0.3 nmol/l, as
      were plasma androstenedione levels, 6.8 +/- 2.5 and 6.0 +/- 1.7 nmol/l
      respectively. However, plasma sex hormone-binding globulin (SHBG) values were
      suppressed being 36.2 +/- 16 nmol/l in hirsute women and 45.8 +/- 15 nmol/l in
      normal women, p less than 0.01. The T/SHBG ratio, an index of free testosterone,
      was elevated in hirsute women, 4.8 +/- 4.1, compared to values in normal women,
      2.9 +/- 1.0, p less than 0.001. Following Diane therapy (2-24 months), 73% of
      patients responded clinically. There was no change in T, but SHBG was increased
      to 181 +/- 54 nmol/l, p less than 0.001 and T/SHBG was decreased markedly to 0.9
      +/- 0.4, p less than 0.001. Androstenedione fell also to 4.8 +/- 1.7 nmol/l, p
      less than 0.001. The clinical and hormone response to Diane was similar in both
      DEX-resistant and previously untreated groups. We conclude that Diane is an
      effective agent in the treatment of hirsutism while it avoids the adverse effects
      of androgenic progesterone and of high dose cyproterone acetate therapy.

PMID- 1757212
TI  - Experience with a juvenile rheumatology clinic.
AB  - A dedicated monthly clinic for children with rheumatic diseases was established
      in order to cater for the increasing number of referrals to a rheumatology
      department for assessment and management. The clinic was staffed by a consultant
      rheumatologist, registrar, nurse, physiotherapist and occupational therapist.
      Seventy-four children, 44 girls and 30 boys, were assessed during the first 32
      months. The mean age at referral was 10 years (range 2-15). Thirty-three had
      juvenile chronic arthritis. Other disease categories included dermatomyositis,
      systemic lupus erythematosus and reactive arthritis. Twenty-eight children were
      referred by general practitioners and 26 by paediatricians. Hospital admission
      was required by 24. These observations suggest the need in Ireland for a
      coordinated service for children with rheumatic diseases.

PMID- 1757213
TI  - Immunosuppressive therapy in autoimmune disease--a review.

PMID- 1757214
TI  - Home environmental temperatures in an Irish infant population.
AB  - In this study the ambient temperature in which thirty-three Irish infants, within
      six weeks of birth, were nursed was documented. The study was conducted from
      October to March and a total of 1,250 individual room temperatures were recorded
      with a mean of 19.3 degrees C and a range of 8 degrees C, to 28 degrees C. The
      highest ambient temperature occurred from 1800 to 2100 hours and the lowest from
      midnight to 0300 hours. There was no central heating in 60% of the homes in this
      study. Comparing the various methods of home heating we found that houses with a
      coal fire and back boiler had the greatest range of temperatures recorded (from
      10 degrees C to 23.5 degrees C) and also the lowest mean temperature recorded
      (17.14 degrees C). There was little relationship found between the ambient
      temperature and the amount of clothing and bedding used and some infants were
      heavily clothed despite a high ambient temperature. The purpose of this paper is
      to provide background data on which to base future studies examining the effects
      of varying ambient temperatures and amounts of clothing on an infant's
      physiological homeostasis.

PMID- 1757215
TI  - Effects of monosialoganglioside GM1 in experimental models of ischemic brain
      damage.
AB  - Systemic administration of monosialoganglioside GM1 is efficacious in reducing
      excitatory amino acid (EAA)-related neurotoxicity in vivo following
      intracerebroventricular injection of N-methyl-D-aspartate (NMDA) in 7-day-old
      rats. Five days later, NMDA-treated animals showed extensive brain damage which
      was accompanied by significant decreases in brain weight, choline
      acetyltransferase activity and 3H-ouabain binding. All these neurotoxic effects
      were significantly reduced with ganglioside treatment. Since excessive activation
      of EAAS is implicated in hypoxic-ischemic brain damage, these results favor the
      hypothesis that a similar effect is involved in the ability of ganglioside to
      ameliorate outcome following cerebral ischemia.

PMID- 1757216
TI  - Neuropathological evaluation of brain damage in a rabbit model of focal cerebral
      ischaemia.
AB  - In the present paper we studied different methods for a qualitative and
      quantitative morphologic assessment of the focal brain damage in rabbits after
      occlusion of the middle cerebral artery with vaseline microspheres. The study of
      the early brain ischaemic damage (4 to 12 hours after embolisation) was performed
      on serial coronal cryostat sections of hemispheres frozen in liquid nitrogen and
      processed for NADH enzyme-histochemical method. In the ischaemic area the
      necrotic cells were pale or negative after enzyme-histochemical reaction, but a
      quantitative assessment of the ischaemic area was approximative. The Evans blue
      method for the identification of the region of the edema at 24 hours after
      embolisation showed inconstant results. A reproducible method for a quantitative
      assessment of the ischaemic area up to the 24th hour after embolisation was
      proposed by Osborne and utilised in the present experimental conditions. The
      volumetric assessment of the ischaemic area was obtained after delineation of
      brain damage areas at 8 preselected coronal levels with a computerized automatic
      image analyzer and by integration of areas with the distance between each level.
      In treated animals, the measures of the volume of cerebral infarction were
      accurate and reproducible, and were suitable for neurophysiologic correlations.

PMID- 1757217
TI  - Evoked potentials monitoring of a cerebral focal ischemia model.
AB  - A model of cerebral ischemia by microsphere embolization in the rabbit was
      monitored with somatosensory evoked potentials by median nerve stimulation (SEPs)
      and by flash visual evoked potential (VEPs). The degree of SEP alterations
      paralleled the type of lesions (focal or multifocal ischemia or diffuse oedema).
      Alterations present at the first hour after ischemia were generally unchanged
      during the follow-up, which ended at the 24th hour. The prevalence of VEP
      alterations was low (only 16% in focal ischemia). These results are compared to
      EEG modifications performed in the same animals.

PMID- 1757218
TI  - Hemodilution and revascularization for early treatment of stroke: an experimental
      trial.
AB  - A new experimental trial to investigate the usefulness of early therapeutic
      measures in case of acute I.V.D. has been performed, on the basis of a previous
      already reported experience. A combined treatment consisting of hemodilution and
      revascularization starting 16 hours after the onset of cerebral ischemia was
      tested. The study was performed in a population of 20 New Zealand male rabbits in
      which an acute cerebral ischemia was achieved by means of extracranial ligation
      of both common carotid artery and of one vertebral artery. The animals were
      divided into two groups. 1st group: no treatment; 2nd group: revascularization +
      hemodilution. Better results were observed in treated group considering either
      CBF rates or histological changes.

PMID- 1757219
TI  - Vascular microsurgical anastomosis in hypercholesterolemic rats: an experimental
      study.
AB  - Patency of vascular microanastomosis was examined in aging (6 months) and
      hypercholesterolemic rats, reproducing conditions similar to those occurring in
      human pathology. Results have been compared with those achieved in
      normocholesterolemic, younger (aging less than 8 weeks) rats.

PMID- 1757220
TI  - Arterial micro-prosthesis with polytetrafluoroethylene in rabbits.
AB  - An experimental trial has been realized in rabbits interposing a polytetra
      fluoroethylene (PTFE) graft through the left carotid artery. Patency has been
      compared to one obtained by utilization of vein grafts in identical conditions.

PMID- 1757221
TI  - Transient cerebral ischemia in the rat: a study by nuclear magnetic resonance
      spectroscopy.
AB  - The energy state and the levels of metabolites involved in the phospholipid
      turnover during and following a transient cerebral ischemia have been evaluated
      with the aids of 31P and 1H nuclear magnetic resonance spectroscopy. Ischemia was
      induced by electrocoagulation of vertebral arteries in combination with transient
      occlusion of both common carotid arteries. After 10-min ischemia, the brain
      energy charge and the levels of high-energy phosphates were reduced, whereas
      lactic acid levels had undergone an 8-fold increase. Sixty minutes after cerebral
      blood flow recovery, brain energy charge and levels of high-energy phosphates
      returned to basal values, whereas lactic acid levels remained persistingly
      elevated; an increase in phosphocreatine was also observed. At this same time,
      glycerolphosphorylcholine levels were found to be significantly reduced.

PMID- 1757222
TI  - The brain-heart syndrome: remarks on early ecgraphic changes following focal
      cerebral ischemia in healthy and in experimentally hyperdyslipidemic rabbits.
AB  - Early cardiac effects of focal cerebral ischemia in two groups of rabbit, one of
      which made hyperdyslipidemic with an atherogenic diet, were detected in several
      experiments. In the group of 62 animals fed on a standard diet, primary CVT
      alterations and arrhythmias occurred in 4 rabbits (6.4%), in the group of 15
      animals fed on an atherogenic diet the same cardiac alterations occurred in 6
      rabbits (40%). A marked statistically significant prevalence of ECGraphic changes
      was observed in hyperdyslipidemic group. These results and the data coming out of
      other experiments and literature suggest that the pathogenesis of the "cerebro
      cardiac syndrome" is linked to several biohumoral alterations occurring after the
      stroke. If these events affect functionally damaged endothelia, or occur in the
      presence of atherosclerotic plaques, cardiac alterations occurring after the
      stroke are greater than cardiac alterations observed in the same condition when
      coronary are intact or little damaged.

PMID- 1757223
TI  - A new model of focal brain ischemia based on the intracerebral injection of
      endothelin-1.
AB  - Endothelin-1 and its receptors are widely distributed in the brain of rodents and
      humans. In view of its potent and long-lasting vasoconstrictor activity, a role
      of endothelin-1 has been proposed in brain ischemia. In the present paper, the
      local injection of endothelin-1 was utilized to induce ischemia in rat striatum.
      An evaluation of the rostrocaudal extension of the lesion is reported. By using
      intracerebral microdialysis, a marked increase of lactate and dopamine, but not
      glutamate, was observed in this region upon endothelin-1 administration.
      Moreover, preliminary data reported show a protective effect of ganglioside
      treatment on endothelin-1 lesion of rat striatum. The characteristics of the
      present model of brain ischemia are discussed in comparison with well
      characterized models, such as the Pulsinelli's four vessel occlusion and the
      middle cerebral artery occlusion.

PMID- 1757224
TI  - Endothelin: an endothelium-derived vasoactive peptide and its possible role in
      the pathogenesis of cerebral vasospasm.
AB  - The contractile response to endothelin has been examined in cerebral arteries
      from rats subjected to a prior subarachnoid haemorrhage (SAH) and compared with
      saline injected controls. Endothelin elicited strong concentration-dependent
      contraction of rat basilar artery segments. The response was slow in onset and
      long lasting. The endothelin-induced contraction was much stronger in the SAH
      compared to control animals. Our findings suggest a role of the peptide in the
      pathophysiology of cerebral vasospasm.

PMID- 1757225
TI  - Protective effect of cyproheptadine in a gerbil model of cerebral ischemia.
AB  - The efficacy of Cyproheptadine, a serotonin antagonist, in preventing the
      cerebral ischemic damage was tested on experimental model of transient global
      cerebral ischemia in Mongolian Gerbil. The semi-quantitative histological
      evaluation of the severity of ischemic damage showed a protective effect of
      Cyproheptadine, mainly in the anterior cortical areas.

PMID- 1757226
TI  - Changes in infratentorial blood flow following experimental cerebellar
      haemorrhage. A preliminary report.
AB  - The temporal progression of changes in blood flow within the hemispheric
      cerebellar cortex, following an experimental cerebellar ipsilateral haemorrhage,
      was investigated in rats by using the hydrogen clearance technique.
      Stereotactical injection of 50 microliters of fresh autologous blood into the
      paramedian white matter was found to produce an early drop of cerebellar blood
      flow, with subsequent rise toward higher values. An increase of the intracranial
      pressure only occurred at the time of injection of blood. Arterial blood gases,
      mean arterial blood pressure and blood glucose levels did not exhibit significant
      changes. Histochemical evaluations of glycogen phosphorylase showed a
      posthaemorrhagic pattern of enzyme depletion, consistent with the occurrence of
      an ischaemic damage in both the cerebellum and the brain stem.

PMID- 1757227
TI  - Bilateral carotid occlusion in normotensive rats: olds facts and new
      observations.
AB  - This work describes that prolonged mild cerebral ischemia may lead to either
      general or regional derangement of brain morphofunctional integrity. Normotensive
      adult Wistar rats were used. Under anesthesia with volatile agents or thiopental,
      the common carotid arteries were ligated permanently. In one group of animals
      local cerebral blood flow (1CBF) was measured two hours after carotid occlusion
      using the [14C]iodoantipyrine method. The other carotid-occluded animals were
      used for clinical rating and histological evaluation, which was performed two
      days to 4 weeks after surgical operation. The [14C]iodoantipyrine method showed
      widespread reduction in the cerebral circulation of carotid-occluded animals.
      Several hours after carotid occlusion, 40% of the animals showed dramatic
      neurological signs and died on the day of operation. In 35% of surviving animals,
      brain infarctions were observed in one and exceptionally two areas of the
      sensorimotor cortex, thalamus, hippocampus or cerebellum. The evolutionary
      sequence of the histopathological changes seems to date the induction of the
      infarcts to the early period of carotid occlusion. In conclusion, reduction of
      cerebral blood flow causes, in a high percentage of animals, various degrees of
      acute brain damage after an apparent symptom-free interval.

PMID- 1757228
TI  - Israeli medical lessons from the Gulf war: an overview.

PMID- 1757229
TI  - The Persian Gulf War: Israeli medical experience and perspectives.

PMID- 1757230
TI  - Medical aspects of the Iraqi missile attacks on Israel.
AB  - During the period 18 January-28 February 1991, a total of 39 Iraqi modified Scud
      missiles landed in Israel, most of them in the densely populated Tel Aviv area.
      There were 23 missile attack alerts. These attacks caused 1,059 cases of injury;
      there were two deaths and 232 patients were admitted to emergency rooms for
      injuries directly related to the explosions, only one of which was severe. A
      survey among 91 of the injured showed that 46.6% of the wounds were caused by
      glass splinters, 31.1% were blunt contusions, and 22.2% were acute psychological
      reactions. No case of blast injury was reported. Inappropriate injection of
      atropine was reported in 230 cases. Acute anxiety was the reason for admission of
      544 patients to emergency rooms. Another 40 patients sustained various traumas
      while rushing to the sealed room. The relatively low number of injured people is
      striking in view of the density of population in the areas hit. Various
      explanations are discussed.

PMID- 1757231
TI  - Eighty years of the threat and use of chemical warfare: the medical
      organizational challenge.
AB  - The threat of using chemical warfare (CW) by countries ruled by dictators and
      totalitarian governments still exists despite the Geneva Convention of 1925 that
      prohibited the use of CW. This situation forces nations and their armed forces to
      be in a state of preparedness in the event of a CW attack. A CW attack on an
      unprotected civilian population in a dense urban area can cause numerous
      casualities and become a mass disaster. However, this danger may be significantly
      reduced by: a) providing collective and individual protective measures, b)
      training the population in the use of protective measures, and c) early warning
      to provide sufficient lead time to use the various components of protection.
      Coping with a nonconventional warfare threat requires an innovative approach in
      the organization of the health care delivery system so as to maximize the number
      of survivors. The fact that the population is protected may deter the enemy from
      using CW since the potential destructive impact of CW is neutralized or at least
      reduced.

PMID- 1757232
TI  - Civilian-military health services contingency program for a mass casualty
      situation and wartime in Israel.
AB  - The Israeli civilian-military health services contingency program for mass and
      wartime casualties has more than four decades of experience. The contingency
      program includes key civilian and military organizations that are involved in the
      planning, policy making and delivery of health care and support services to the
      wounded. During the Persian Gulf war the unified civilian and military command-
      the supreme hospitalization authority--implemented a national hospital and
      emergency medical services preparedness system designed to treat the victims of
      chemical warfare attacks.

PMID- 1757233
TI  - Outline of hospital organization for a chemical warfare attack.
AB  - A plan for hospital organization in the event of chemical warfare is described.
      The basic principles are: a) isolation of the hospital receiving the casualties,
      b) several levels of triage, and c) treatment according to simple therapeutic
      protocols using appropriate treatment sites. Triage is based upon walking
      feasibility, respiratory status, age, and additional conventional injuries. The
      nurse's diagnostic and treatment authority is extended. Auxiliary staff
      (numbering hundreds of people) are needed for decontamination, stretcher bearing,
      artificial ventilation, etc. A nation-wide educational program on the prevention,
      decontamination and treatment of chemical warfare casualties is conducted in
      Israeli hospitals and drills are exercised frequently. This scheme is suitable
      for nerve gas poisoning, but can be easily modified for other chemical agents.

PMID- 1757234
TI  - Combined chemical and conventional injuries--pathophysiological, diagnostic and
      therapeutic aspects.
AB  - Chemical warfare (CW) agents may cause both conventional and chemical injuries.
      The effects of the two types of injuries may be reciprocal, leading to
      difficulties in assessing and treating such patients. Several aspects of the
      combined injury are discussed: increased exposure to CW agents following
      conventional trauma, owing to skin laceration or inability to use a gas mask
      (head, face or chest trauma); pathophysiological interactions between the two
      types of injuries; protection of medical personnel against CW intoxication;
      treatment limitations of personnel caused by their CW protection gear, when
      treating patients requiring urgent decontamination; and the influence of
      conventional trauma on the management of CW casualties. The Israel Defense
      Forces' recommendations for the treatment of combined injuries in a contaminated
      area include: a) airway maintenance, b) securing breathing and ventilation, c)
      circulation and hemorrhage control, d) antidote administration, e)
      decontamination with fuller's earth, f) dressing the wound, and g) evacuation to
      a noncontaminated area.

PMID- 1757235
TI  - Mortality in Israel during the Persian Gulf war--initial observations.
AB  - During the 6-week-long 1991 Persian Gulf war, in which the civilian population
      was subjected to 18 separate missile attacks and the constant threat of
      nonconventional warfare, crude mortality rates in Israel were no higher than in
      the previous decade. Although the results are preliminary and need to undergo
      more sophisticated epidemiologic analysis, it appears that our population was
      able to tolerate the subacute period of psychological stress without excess
      mortality.

PMID- 1757236
TI  - Fewer injuries but more deaths from road accidents during the Persian Gulf war.
AB  - During the period 13 January to 28 February 1991, traffic accidents were the
      cause of death in 45 persons (31 vehicle and cycle occupants and 14 pedestrians)
      and of injuries in 2,769 persons (2,309 occupants and 460 pedestrians) in Israel.
      During the same period 18 persons (13 occupants and 5 pedestrians) died as the
      result of traffic accidents in the Territories (Judea/Samaria and the Gaza
      Strip). The decline in the number of injuries among occupants and pedestrians was
      offset by the increase in the case fatality rate (CFR), particularly among
      occupants, compared with: a) the previous 6 months, b) the same period of the
      previous year, a) the ratio of the reduced CFR in January-February in relation to
      the previous 6 months, and d) the CFR predicted by the declining CFR in January
      February of the previous 5 years. Compared with 1990, in 1991 during the Persian
      Gulf war the roads were less crowded and crash occurrences were less frequent,
      but travel speeds, crash impacts and kinetic energy delivered to victims
      (especially occupants on inter-urban roads) were greater. Daytime running lights
      on two-lane roads; temporary lower speed limits; the use of new roadside
      monitoring methods for detecting and deterring speeding, tailgating and
      speedgating; the collection of tachygraph data; and implementation of the
      requirement for a rear seat belt are measures suggested to have been effective in
      swiftly reducing the toll of dead and injured, not only during but after the Gulf
      war as well.

PMID- 1757237
TI  - Principles of respiratory protection.
AB  - This review describes the various types of respiratory protective devices used in
      Israel during the Persian Gulf war, and summarizes the relevant physiological
      concepts of respiratory protection. Physiological principles of modern devices
      with powered air supply are discussed in detail. Our experience may be useful in
      the evaluation of new respirators and in finding solutions for problematic
      subpopulations.

PMID- 1757238
TI  - Physiological assessment of the passive children's hood.
AB  - The physiological effect of the "passive children's hood" (PCH) was studied in 24
      children: 8 toddlers (3-4.5 years old), 8 pre-school pupils (4.5-6 years) and 8
      first- and second-grade pupils (6-8 years). This device consists of a children's
      gas mask and a transparent PVC (polyvinyl chloride plastic) covering (hood).
      Inspiratory CO2 and O2 (FiCO2 and FiO2, respectively), temperature and humidity
      were monitored at 10-min intervals while the children were occupied with
      sedentary activities (playing and watching TV) in a sealed room. Ambient
      temperature and relative humidity were approximately 27 degrees C and 75%
      respectively. In the PCH space the temperature was 2 degrees C higher and
      humidity was near saturation at the end of exposure. FiCO2 in 12 children
      exceeded 2%, which is the upper acceptable limit according to industrial
      standards. In four of them FiCO2 was greater than 4% and FiO2 less than 16%.
      Twenty-two children tolerated the PCH for 92 +/- 35 min (range 24-133 min) with
      no physiological complications. A significant correlation was found between
      childrens' age and tolerance time (r = 0.47, P less than 0.025). We conclude that
      children whose masks are not well adjusted may be exposed to rebreathing CO2
      enriched air.

PMID- 1757239
TI  - The incubator as a chemical warfare protective device in neonatal intensive care
      units.
AB  - During the Persian Gulf war chemical warfare (CW) protective devices were
      distributed to the entire population of Israel. Neonates were to be placed in a
      protective infant carrier (PIC) or an improved PIC ("active PIC") to which
      filtered air was actively introduced by a blower. The specific needs of low
      birthweight babies hospitalized in intensive care units and treated in incubators
      were not adequately addressed. Transfer to a PIC meant disconnecting the infants
      from life-supporting systems and monitoring devices and exposing them to changes
      in ambient temperature. To overcome this difficulty the original incubator was
      used as a CW protective device. Its ports were sealed and low-grade positive
      pressure was created. This avoided transfer of the neonates from their controlled
      environment, reduced physiological stress, and improved medical supervision.

PMID- 1757240
TI  - An argument for equipping civilian hospitals with a multiple respirator system
      for a chemical warfare mass casualty situation.
AB  - During the Persian Gulf war, the entire Israeli population was under the threat
      of chemical missiles. One of the main effects of chemical agents (e.g.,
      organophosphorus) is respiratory distress, which requires treatment with
      mechanical ventilation and oxygen enrichment. In the event of a chemical missile
      attack, the civilian hospitals may enter a state of insufficiency for treating
      such victims due to the limited amount of equipment, staff and oxygen/air
      sources. A possible technological solution is a multiple respirator system (MRS)
      with a multiple oxygen enrichment system designed for use in the battlefield. The
      advantages of these technologies in the civilian hospital setting during a
      chemical mass casualty situation are: (a) rapid deployment, (b) high
      transportability, (c) capability of operation in any location, (d) modularity,
      and (e) less medical staff for operation. Two types of MRS are described and
      issues concerning their selection are discussed. The authorities responsible for
      national health policy may wish to adopt and incorporate these technologies into
      their hospital and emergency services preparedness system.

PMID- 1757241
TI  - Survey of symptoms following intake of pyridostigmine during the Persian Gulf
      war.
AB  - Pyridostigmine bromide, a reversible inhibitor of acetylcholinesterase (AChE), is
      effectively used as a pre-treatment to organophosphate intoxication. Previous
      studies have shown that an oral dose of 30 mg twice a day produces a sufficient
      inhibition of the enzyme activity (20-40%) without causing any significant
      adverse effect. During the Persian Gulf war pyridostigmine was taken for the
      first time under a chemical warfare threat. We searched for symptoms and
      complaints that may be related to the medication. Our survey included 213
      soldiers who completed a questionnaire regarding possible symptoms and their
      severity. AChE inhibition level was compared between groups of soldiers with and
      without complaints. The most frequent symptoms were nonspecific and included dry
      mouth, general malaise, fatigue and weakness. Typical effects, such as nausea,
      abdominal pain, frequent urination and rhinorrhea, were infrequent. The severity
      of the symptoms was generally mild. The symptoms appeared around 1.6 h after
      taking the medication and recurred after each intake. No correlation was found
      between levels of cholinesterase and type or severity of complaints. Anxiety,
      which accompanies wartime, may have contributed to the appearance of significant
      symptoms. Further investigations concerning the effects of pyridostigmine
      ingestion under stressful conditions are warranted.

PMID- 1757242
TI  - Acute pyridostigmine overdose: a report of nine cases.
AB  - Pyridostigmine is known as a pre-treatment drug against intoxication with
      organophosphorus nerve agents. During the Persian Gulf war, we encountered a
      cluster of nine cases of pyridostigmine self-poisoning, of which three presented
      with mixed drug poisoning. The clinical and laboratory features of pyridostigmine
      toxicity are presented. Doses ranged between 390 and 900 mg. Pyridostigmine
      ingestion resulted in mild to moderate cholinergic symptoms such as abdominal
      cramps, diarrhea, emesis, nausea, hypersalivation, urinary incontinence,
      fasciculations, muscle weakness and blurred vision. No central nervous system
      manifestations were evident. The symptoms developed within several minutes and
      lasted up to 24 h. All patients underwent gastric emptying followed by
      administration of activated charcoal. Atropine (1-8 mg) was required in only
      three patients. Measurement of serum cholinesterase inhibition was found to be a
      reliable and sensitive diagnostic tool in pyridostigmine poisoning. No clear
      correlation was found between the extent of cholinesterase inhibition and the
      incidence or severity of the cholinergic signs. The clinical recovery was faster
      than the spontaneous recovery of the enzyme. Pyridostigmine intoxication is self
      limited and well tolerated by young healthy adults.

PMID- 1757243
TI  - The effect of pyridostigmine on respiratory function in healthy and asthmatic
      volunteers.
AB  - Respiratory function was evaluated in 12 healthy and 13 asthmatic volunteers
      following a single oral dose of pyridostigmine in a double-blind, placebo
      controlled cross-over study. Respiratory function tests were performed at rest
      and after submaximal exercise at the time corresponding to the expected peak
      cholinesterase inhibition by pyridostigmine. A single dose of 60 mg
      pyridostigmine given to nonasthmatic subjects led to a decrease of 28.4% in
      cholinesterase activity when compared to the baseline and a statistically (but
      not physiologically) significant decrease in FEV1 (forced expiratory volume in 1
      sec) both at rest (P less than 0.015) and after exercise (P less than 0.05). This
      effect showed a strong correlation to the degree of cholinesterase inhibition (r
      = -0.936, P less than 0.0001). According to these findings, a smaller dose of
      pyridostigmine (30 mg) was given to subjects with mild bronchial asthma. At that
      dose, pyridostigmine resulted in a similar inhibition of cholinesterase activity
      to a mean of 76.7% of the baseline. A significant decrease in the pulse rate was
      also found (P less than 0.005). However, no changes in respiratory function were
      observed when compared with the effects of placebo. The effect of post-exertion
      atropine inhalation on respiratory function was also unchanged with
      pyridostigmine at that dose. We conclude that, in general, at this dose
      pyridostigmine is a safe drug for asthmatics; however, the distribution of
      individual results in this group cannot preclude the existence of a subpopulation
      of asthmatic patients who are more vulnerable to the effects of pyridostigmine.

PMID- 1757244
TI  - Hyperbaric oxygen treatment for carbon monoxide intoxication acquired in the
      sealed room during the Persian Gulf war.
AB  - During the recent Persian Gulf war, the civilian population in Israel was
      frequently instructed to stay in sealed rooms in preparation for a possible
      chemical missile attack. The war broke out in mid-winter, and in many instances
      it was necessary to heat the rooms. The use of open fires or malfunctioning
      heating appliances inside sealed rooms could create ideal conditions for carbon
      monoxide (CO) poisoning. Six patients with CO intoxication resulting from
      confinement inside sealed rooms were referred for hyperbaric oxygen (HBO)
      treatment. Indications for HBO therapy were loss of consciousness and metabolic
      acidosis. The treatment protocol consisted of 90-min exposure to 100% oxygen at
      2.5 atmospheres absolute (ATA), with repeated exposures when required. All
      patients made a full recovery. The risk of CO poisoning should be taken into
      consideration and should determine the selection of heating devices for future
      use in similar circumstances.

PMID- 1757245
TI  - Israeli psychological casualties of the Persian Gulf war: characteristics,
      therapy, and selected issues.
AB  - The Persian Gulf war in 1991 presented Israel with its first experience of a
      threat of chemical attack on the home front. Ground-to-ground missiles were aimed
      directly at civilian populations, threatening death and destruction over a period
      of several weeks. Uncertainty as to time, place, and nature of the missile
      attacks affected the civilian population psychologically. The psychological
      responses of the population were the result of the continuous nature of the
      emergency which affected the entire population, and the destruction, injury, and
      displacement which affected those who were the targets of the attacks. The
      primary psychological effects of the emergency were investigated in several ways:
      surveys of samples of civilian and rear-echelon military populations, studies of
      the military personnel who asked for ambulatory psychological treatment as a
      result of the war, and studies of the specific populations that bore the brunt of
      the actual physical attacks were conducted. These studies show a high level of
      distress in the samples, with considerable differentiation between the
      populations. Levels of functioning generally remained intact even among the
      displaced or injured. Interventions were based on experience gained in the
      treatment of combat stress reaction. The issues of evacuation of psychological
      casualties to hospitals, psychiatric aspects of chemical attacks, and secondary
      traumatization of therapeutic and other staff are emphasized.

PMID- 1757246
TI  - Anxiety-related somatic reactions during missile attacks.
AB  - During the Persian Gulf war the Israeli civilian population was the target of
      missile attacks that could have carried poison gas warheads. During the attacks
      all civilians were ordered to wear gas masks and move into sealed rooms. Four
      telephone surveys studied the somatic reactions to this anxiety-arousing
      situation. The percent of subjects reporting the somatic reactions declined from
      38% after the first attack to 20% 12 days later. Somatic reactions were more
      prevalent among females than males, and among those who completed elementary
      school only compared to those with an academic education. A complex pattern of
      relationships between expectancies about chemical warfare attacks and somatic
      reactions is discussed.

PMID- 1757247
TI  - Sleeping under the threat of the Scud: war-related environmental insomnia.
AB  - The influence of the Scud missile attacks during the Persian Gulf war on the
      sleep of the Israeli population is described. Our study group comprised a random
      sample of 200 people (mean age 41.13 +/- 15.32) who were contacted by telephone
      during the third week of the war and interviewed about their sleep. Overall, 28%
      of the entire sample complained about sleep: 10% complained about mid-sleep
      awakenings, 4.5% on difficulties falling asleep, and 13.5% about the combination
      of the two. People living in the Tel Aviv and Haifa areas complained
      significantly more than those in the rest of the country. Women complained
      significantly more than men, and people with lower education complained
      significantly more than people with higher education. Only 3% of the sample
      reported using sleeping pills. During the war actigraphic sleep recordings in 19
      adults living in the Tel Aviv and Haifa areas did not reveal any measurable
      decrease in sleep quality in comparison with pre-war recordings. Possible
      explanations for the discrepancy between the subjective and objective assessments
      are discussed.

PMID- 1757248
TI  - In the shadow of the Gulf war: psychological distress, social support and coping
      among Israeli soldiers in a high risk area.
AB  - This study assessed the sense of safety, psychiatric symptomatology, coping and
      sources of support among eight groups of soldiers stationed in the region at
      highest risk for missile attacks during the Persian Gulf war. The sample
      consisted of 659 regular, reserve, and career soldiers, both male and female.
      Findings show that elevated levels of distress were associated with a high level
      of perceived threat, a low level of perceived self-efficacy, a low level of trust
      in army authorities, and a low level of support from the social network,
      particularly from commanding officers. Practical implications are discussed.

PMID- 1757249
TI  - Community coordination and information centers during the Persian Gulf war.
AB  - During a time of crisis, community information centers provide valuable data to
      the public and help to avoid confusion and misinformation. During the Persian
      Gulf war, Kupat Holim (sick fund of the General Federation of Labor) established
      a national casualty information center in Tel Aviv as well as numerous
      coordination and information centers throughout the country, which included
      district, geriatric, psychological and emergency centers, as well as one for new
      immigrants. These centers had not been planned in advance, but because of the
      obvious need, they were established in the few months prior to the outbreak of
      the war and during the war itself. The locations of the centers were publicized
      through the media. In this article we report on the different centers and their
      activities, and additional community measures are described. The plan of
      establishing information centers throughout the country proved itself a vital
      necessity and will be incorporated in future Kupat Holim plans for war or any
      other emergency situation.

PMID- 1757250
TI  - Role of the Tel Aviv-Jaffa municipal workers in the treatment of survivors of
      missile blasts.
AB  - Of the nine missiles that landed on the city of Tel Aviv-Jaffa during the Persian
      Gulf war, three fell in heavily populated areas. As a result 192 people were sent
      to hospital and 1,663 (520 families) were left homeless. These were seen and
      evaluated near the site of the blast by a municipal multidisciplinary team and
      then sent to one of 15 hotels in and outside the city. There they were treated
      for acute post-traumatic stress disorder by a municipal health care team (general
      physicians, nurses, social workers and psychologists) and by psychiatrists from a
      local sick fund. Many acute and chronic medical problems, including attempted
      suicide, were also encountered. Community outreach programs aimed at high risk
      groups and several telephone counselling services were also instituted. We
      believe that it is crucial to train and provide a multidisciplinary team for
      handling the survivors of major disasters.

PMID- 1757251
TI  - Willingness of staff to report to their hospital duties following an
      unconventional missile attack: a state-wide survey.
AB  - Adequate staffing of hospitals during a prolonged, potentially unconventional war
      is a key component in the disaster plan of institutions. In an attempt to
      determine policy regarding hospital staffing, a state-wide survey was conducted
      in Israel among hospital personnel during the recent Persian Gulf war. This
      survey aimed to explore the willingness of staff to report to their duties (WTR)
      following an unconventional missile attack described in a hypothetical scenario.
      Of the 2,650 questionnaires distributed among all categories of staff in 10
      hospitals (42%) across the country, 51% were returned. Overall, 42% of the
      responding staff were WTR under the presented scenario. However, WTR would
      increase to 86% if safety measures were provided. Males, personnel with
      headquarter duty of hospital site managers, and parents of children older than 14
      years of age, were the most WTR. The finding of extensive interhospital variation
      in WTR indicates the need for evaluating WTR on an institutional basis when
      establishing both the hospital and the regional disaster plan. Data are presented
      on the extent of WTR, the factors inhibiting WTR, and possible measures to
      improve WTR.

PMID- 1757252
TI  - [Immunoglobulin therapy in IgE-mediated allergic diseases].

PMID- 1757253
TI  - [The significance of protein C deficiency in dermatology].
AB  - The protein C system is a physiological inhibitor of coagulation and is important
      for the regulation of hemostasis. Protein C deficiencies can be inherited or
      acquired, and they lead to enhanced thrombophilia. A number of clinical entities
      that are also of interest to dermatologists have been related to protein C
      deficiency. Inherited protein C deficiency can become manifest in various ways,
      e.g. as purpura fulminans neonatalis, as recurrent episodes of thrombosis and as
      coumarin necrosis. Acquired protein C deficiency can be observed in the course of
      purpura fulminans, disseminated intravascular coagulation, hepatic failure or in
      the presence of antiphospholipid antibodies. The clinical features, the possible
      pathogenesis and the therapy of these manifestations are briefly discussed.

PMID- 1757254
TI  - [Chronic actinic dermatitis. Concept and case examples].
AB  - Two women patients with chronic eczematous dermatitis, who also developed
      extremely severe, persistent photosensitivity during a course of 10 and over 40
      years, are presented. Both patients had an atopic history with positive immediate
      skin reactions. Patch and photopatch tests revealed sensitization to several
      contact allergens, and in one case also a photocontact allergy. The action
      spectrum of the photosensitivity was confined to UV-B; it was possible to provoke
      eczematous skin reactions with doses smaller than 1 mJ/cm2 UV-B. Both patients
      were successfully treated with PUVA therapy. These case reports demonstrate the
      difficulty of nosological classification of chronic eczematous photosensitive
      dermatoses under the traditional terms persistent light reaction, photosensitive
      eczema, photosensitivity dermatitis, and actinic reticuloid. Chronic actinic
      dermatitis is defined clinically by chronic dermatitis on skin exposed to sun,
      histologically by spongiotic dermatitis, and photobiologically by experimental
      provocation of spongiotic dermatitis with UV-B and often also longer wavelengths
      in the absence of a photoallergen. Chronic actinic dermatitis should be used as a
      general term in addition to the more specific terms listed above.

PMID- 1757255
TI  - [Isolated pemphigus vulgaris of the mouth mucosa--pemphigus test: diagnostic
      confirmation using direct immunofluorescence study of normal skin].
AB  - The diagnosis of oral pemphigus vulgaris (PV) without concomitant cutaneous
      manifestations is often complicated by difficulties in obtaining a biopsy
      specimen allowing histological examination and direct immunofluorescence (IF)
      microscopy. In this clinical study five of our patients with oral PV were
      investigated: biopsies were taken both from lesional oral mucous membranes and
      from unaffected gluteal skin for IF analysis. Identical IF results, with
      intercellular epidermal deposition of IgG in all and of C3 in two of the five
      cases, were obtained in lesional and nonlesional biopsies. Therefore, it is
      concluded that with current IF techniques examination of the normal skin is
      sufficient for the diagnosis of oral PV; thus, the often painful and difficult
      removal of biopsy specimens from within the affected oral cavity can be avoided.
      Further studies are needed to confirm the sensitivity of this method.

PMID- 1757256
TI  - [Eccrine angiomatous nevus].
AB  - A case of eccrine angiomatous nevus in a 46-year-old woman is described. The
      histological examination revealed convolutions of eccrine sweat glands with no
      major structural abnormalities, and a closely related angiomatous component. Two
      components of this tumour are of special interest: the bone formation and a
      medium-sized artery with pathologic wall structure.

PMID- 1757257
TI  - [Oligosymptomatic Bourneville-Pringle tuberous sclerosis of the brain with giant
      cell astrocytoma].
AB  - We report on a 9-year-old boy who developed subependymal giant-cell astrocytoma
      associated with tuberous sclerosis. Apart from a few hypopigmented skin patches,
      the boy's clinical picture was completely unremarkable until the onset of
      diplopia and vertigo reflecting increased intracranial pressure. Magnetic
      resonance imaging of the brain revealed subcortical hamartomas in addition to the
      intraventricular tumour. Seizures and mental retardation were absent. The boy's
      mother had suffered from seizures during childhood and presented with typical
      skin lesions. The importance of thorough examination and regular follow-up even
      in patients with oligosymptomatic variants of tuberous sclerosis is emphasized.

PMID- 1757258
TI  - [Pomade crust of the scalp simulating cornu cutaneum].
AB  - A 63-year-old woman with a history of exaggerated use of topical skin care
      products of post-traumatic scarring alopecia presented with a monstrous cutaneous
      horn-like pomade crust of the scalp hidden beneath a wig. The crust consisted of
      corneocytes and bacterial debris. Pomade crusts have not been described
      previously in this localization. They are usually found in the inguinal or
      gluteal folds of infants, and occasionally in other body regions, e.g., on the
      face of adults.

PMID- 1757259
TI  - [Multiple sebaceous gland hyperplasias in X chromosome hypohidrotic ectodermal
      dysplasia].
AB  - We report on a 46-year-old man with X-linked hypohidrotic ectodermal dysplasia,
      who presented with large skin areas covered with aggregated sebaceous gland
      papules on the face and neck. This is rare, but has been observed in very similar
      form in association with this disorder in a not insubstantial proportion of
      cases.

PMID- 1757260
TI  - [Tinea corporis caused by Microsporum gypseum].
AB  - Human infections due to microsporum gypseum are rare. We report on a female
      patient who had tinea corporis caused by M. gypseum after a cutaneous wound. The
      numerous lesions located on the borders of the wound had an eczematous
      appearance.

PMID- 1757261
TI  - [Methotrexate--indications and adverse effects].

PMID- 1757262
TI  - [Limits of hyposensitization in bronchial asthma].

PMID- 1757263
TI  - [14th Annual Congress of the Society of Surgical and Oncologic Dermatology 10-12
      May 1991 in Wurzburg].

PMID- 1757264
TI  - [First International Symposium for Andrology in Graz 10-11 May 1991].

PMID- 1757265
TI  - Etiology of drinking and driving among adolescents: implications for primary
      prevention.
AB  - A prospective study was conducted to investigate what factors are predictive of
      self-reported drinking and driving (DD) among adolescents. The study employs a
      theoretical framework taken from Problem Behavior Theory; environmental,
      personality, and behavioral factors are explored for their predictability of DD.
      A cohort of 1482 high school students completed a written survey in spring of
      1986 and again in fall of 1986. The findings confirm that Problem Behavior Theory
      provides a useful theoretical framework with which to identify etiological
      factors predictive of DD among adolescents. Identified personality, perceived
      environmental, behavioral, and demographic factors accounted for approximately
      50% of the reported variance in DD at baseline. The same factors accounted for
      approximately 40% percent of the variance in follow-up DD and were predictive
      both among the students who did not drink and drive at baseline (incidence
      cases), and among those students who did drink and drive at baseline
      (continuation versus discontinuation of the behavior). Based on these etiological
      data, we recommend that school-based, peer-led educational prevention programs be
      designed to reach young adolescents prior to the age at which a driver's license
      is obtained. We further recommend that the programs be broad-based and consider
      DD within the larger context of drinking and driving related behaviors and
      traffic safety in general.

PMID- 1757266
TI  - Development of a health education program to promote the self-management of
      cystic fibrosis.
AB  - The creative challenge of health education for chronic illnesses is the
      translation of theory-based intervention methods into practical strategies that
      can be organized into a logical series of learning activities to influence
      changes in environmental, cognitive, or behavioral factors. A case example
      describing the development and implementation of a comprehensive health-education
      intervention for the self-management of cystic fibrosis (CF) is presented. The
      design of intervention strategies began with an assessment of the educational
      needs for self-management of CF, followed by specification and validation of
      particular self-management behaviors. Behavioral and learning objectives then
      were formulated for each of the self-management behaviors. Constructs from social
      learning theory considered to be important influences on specified self
      management behaviors in CF were identified. Taking into consideration the
      learning needs of the target population and the practical constraints of the
      system for providing health care, various intervention methods then were devised
      based on social learning theory. Lastly, the intervention methods chosen were
      translated into strategies organized into a series of practical learning
      activities for CF patients and their families. The process described here should
      prove useful to others who are planning and developing comprehensive health
      education programs for self-management of chronic illnesses.

PMID- 1757267
TI  - Psychosocial factors and enrollment in a televised smoking cessation program.
AB  - Registrants for a smoking cessation program on the evening television news in the
      Chicago metropolitan area were compared with other smokers in the population to
      identify psychosocial factors that distinguished registrants. Telephone
      interviews were conducted before the intervention with random samples of 641
      registrants and 2,398 smokers who regularly viewed the evening news. A nested
      series of three contrasts compared registrants with (1) smokers who regularly
      viewed the evening television news on any channel, (2) smokers who were regular
      viewers of the evening news on the intervention channel, and (3) smokers who were
      regular viewers of the evening news on the intervention channel and were planning
      to quit smoking. Registration was associated with a smoker's cognitive appraisal
      of the quitting process, with registrants distinguished by (1) recognition of a
      need to act (perceived severity of and susceptibility to lung cancer), (2) high
      outcome expectancies for quitting as an effective means for health promotion, (3)
      realistic expectations about the effort required to quit, (4) concern about the
      burden of lung cancer on significant others and related social influence factors,
      and (5) motivation to quit smoking. The findings suggest that the effectiveness
      of minimal-contact intervention programs may be enhanced by targeting smokers
      according to their psychosocial characteristics and by cognitively preparing
      smokers to attempt to quit.

PMID- 1757268
TI  - Using the health belief model to predict safer sex intentions among adolescents.
AB  - The purpose of this study was to use Health Belief Model (HBM) concepts to
      predict adolescents intentions to adopt safer sex behaviors. A stratified, random
      sampling technique was used to generate a sample of seventh-, ninth-, and
      eleventh-grade students representative of a southeastern state. A predictive
      model was constructed of the HBM variables. The model accounted for 43% of the
      variance in safer sex intentions among the seventh grade, 27% of the variance for
      the ninth grade and 17% of the variance for the eleventh grade. For the eleventh
      grade sample gender was the only significant predictor. The results of this study
      suggest that educational programs to promote safer sex intentions should focus on
      health related motivations among younger students. With older adolescents it may
      be more effective to expand education efforts to address factors directly
      relevant to their motivational schema and social environment. This study
      underscores the importance of using theory-based models in conducting health
      education research.

PMID- 1757269
TI  - Enhancing social support at the workplace: assessing the effects of the caregiver
      support program.
AB  - Although the health-enhancing effects of social support have been well
      documented, little is known about how to increase the flow of social support
      among network members. This article describes and evaluates the Caregiver Support
      Program, a worksite program that attempts to improve the quality of work
      relationships among house managers and direct care staff who work in group homes
      for the developmentally disabled. The program incorporates three strategies for
      increasing social support: (1) adding a new person or group of persons to the
      employee's social network, (2) enhancing existing relationships by improving the
      focal employee's skills for maintaining strong networks and mobilizing support,
      and (3) enhancing existing relationships by training members of the employee's
      social network in ways to be more supportive. The Caregiver Support Program was
      evaluated in a randomized field trial. Results indicate that the program was
      effective in improving the relationships between direct care staff participants
      and their house managers. However, other work relationships remained unaffected.
      The relationship between direct care staff and their house managers was the only
      work relationship for which both members of the interpersonal dyad participated
      in the program. The implications of these findings for health education practice
      and future research are discussed.

PMID- 1757271
TI  - The credentialing process.

PMID- 1757270
TI  - Training breast self-examination: a research review and critique.
AB  - Despite an increase in knowledge about breast cancer, a relatively low percentage
      of women practice breast self-examination (BSE) regularly and competently. This
      article reviews the BSE literature with a focus on training of BSE components,
      discrimination training, and the effectiveness of training procedures.
      Methodological issues such as the absence of control groups, lack of criteria for
      termination of training and reliance on self-reports of BSE frequency are
      identified weaknesses of BSE training studies. A theoretical analysis of BSE
      highlights potential difficulties in maintaining regular practice of BSE.
      Recommendations regarding training of proficient BSE skills and promoting regular
      practice of BSE are offered, and suggestions for further refinement of BSE
      training and directions for future research are discussed. Promising avenues of
      research in BSE training technology include discrimination training (on real or
      simulated breast tissue) together with computerized assessment of skill
      proficiency.

PMID- 1757272
TI  - Population genetics of human glyoxalases.
AB  - The gene for glyoxalase I (E.C. 4.4.1.5), Glo, has two alleles, Glo1 and Glo2,
      which are autosomally inherited in a co-dominant manner. Glo1 allele-frequency is
      highest in native Alaskan-Eskimo and Indian populations and decreases
      geographically south and east, to minimum levels in Aboriginal-Australian
      populations and native tribes in Papua New Guinea. There was no correlation
      between Glo1 frequency and incidence of insulin-dependent diabetes mellitus
      (IDDM). The frequencies of GLO phenotypes, Glo 1-1, Glo 1-2 and Glo 2-2, are
      disturbed in IDDM and there is a suggestion that IDDM patients with or without
      chronic, clinical complications have characteristic phenotype frequencies.

PMID- 1757273
TI  - Studies of the species barrier between Drosophila subobscura and D. madeirensis.
      I. The genetics of male hybrid sterility.
AB  - The genetics of hybrid male sterility between Drosophila subobscura and D.
      madeirensis were studied with the help of 20 markers in backcross males. A major
      effect resides in the sex chromosomes: backcross males with the X and Y of
      different origin (mad X-sub Y or sub X-mad Y) have very small and empty testes.
      In compatible combinations testes are of normal size but males may be sterile or
      fertile depending on the genetic constitution of their autosomes. Six autosomal
      factors affecting hybrid male fertility could be postulated. This estimation is
      based on the assumption of the absence of interaction between viability and
      fertility. The presence and the mode of such interaction may modify the number of
      sterility factors.

PMID- 1757274
TI  - Correlated variation of chromosomal inversion (3R)C and extra bristles in
      Drosophila melanogaster.
AB  - Chromosomal inversion In(3R)C and extra dorsocentral and scutellar macrochaetae
      are correlated in Asturian natural populations of Drosophila melanogaster in that
      selection for extra bristles produced an increase in In(3R)C frequency. In the
      present work two populations with significantly different frequencies of the
      In(3R)C inversion were created and a significant positive correlation between
      In(3R)C frequency and frequency of individuals carrying extra bristles was found.
      This result confirms the correlation between bristles and In(3R)C. In addition,
      the correlation between the two characters is also demonstrated at the individual
      level.

PMID- 1757276
TI  - Stop, look, and listen when your patients 'complain'.

PMID- 1757275
TI  - Transferrin polymorphism and genetic differentiation in Cervus elaphus L.
      (European red deer) populations.
AB  - A study of transferrin in 11 different European populations of Cervus elaphus as
      well as in one Cervus elephus x Cervus nippon hybrid population has revealed a
      polymorphism of this protein. Genetic analysis suggests that it is controlled by
      one gene locus with three codominant alleles. The allele frequencies allow a
      clear discrimination not only between the hybrid population and pure red deer but
      also between different Continental red deer populations. Comparison of the
      genotypic structures with the Hardy-Weinberg structure shows no significant
      deviation. Genetic variation within and differentiation between populations is
      evaluated for the transferrin gene locus using different measures. Average
      heterozygosities have been calculated for five populations including the results
      of previous studies on 14 other protein systems. Some management implications of
      the present results are discussed.

PMID- 1757277
TI  - PEF flow meter plays important role in asthma therapy.

PMID- 1757278
TI  - The efficacy of an endocervical brush in obtaining adequate Papanicolaou smears.
AB  - A total of 249 consecutive women attending a family planning clinic were entered
      in a study to determine the efficacy of the endocervical brush versus the cotton
      swab in obtaining routine Papanicolaou smears. Also investigated were whether the
      experience level of the smear taker contributed to the adequacy of the sample and
      whether simultaneous sampling by means of the spatula (an ectocervical sampling
      method) was justified. The use of the endocervical brush in place of the swab was
      found to improve cell collection by reducing the frequency of inadequate smears.
      The experience of the sample taker appeared not to be a factor in obtaining
      adequate smears. In 9% of the samples, only the ectocervical specimen was found
      to be satisfactory, indicating that use of the spatula should not be abandoned.

PMID- 1757279
TI  - Laboratory instruments for the physician's office laboratory: technology and cost
      benefits.
AB  - During the past two decades, medicine has witnessed the decentralization of
      laboratory testing from the hospital into the physician's office. This article
      focuses on the technical aspects of the instruments now available for laboratory
      testing in the physician's office. Consideration is given to specific
      instruments, methods, and cost-benefit.

PMID- 1757280
TI  - A proposal to modify research and scholarly activities during osteopathic
      residency training.

PMID- 1757281
TI  - Testicular metastasis from adenocarcinoma of the prostate.
AB  - Reported are two cases of prostate cancer metastatic to the testicle. Both
      patients underwent bilateral orchiectomies for treatment of symptomatic
      metastatic prostate cancer. Testicular metastasis was found incidentally in one
      patient and was suspected in the other. This site of spread is rare. The clinical
      significance and prognosis are discussed and the pertinent literature reviewed.

PMID- 1757282
TI  - Multiple aneurysms of the anterior communicating artery.
AB  - Multiple aneurysms of the anterior communicating artery are rare. The authors
      describe a patient who was admitted with a sudden, severe headache with radiation
      to the neck. Angiograms demonstrated filling of both anterior cerebral arteries
      and bilateral aneurysms arising from the origin of the anterior communicating
      artery. Both aneurysms were surgically verified and clipped.

PMID- 1757283
TI  - First order temporal properties of spontaneous and tone-evoked activity of
      auditory afferent neurones in the cochlear ganglion of the pigeon.
AB  - Spontaneous and tone-evoked single-unit activity was recorded from afferent
      neurones in the cochlear ganglion of the anaesthetized pigeon, and the data
      analysed in a way that allowed the physics of underlying mechanisms to be
      described. The periodicity of neural activity was quantified by Fourier analysis
      of the histogram of successive spike intervals. Spontaneous activity was
      quasiperiodic for 57% of neurones (average rate: 74 s-1); it was irregular for
      the remainder of neurones (average rate: 55 s-1). The preferred frequency (PF) of
      the quasiperiodic spontaneous activity was, on average, equal to the
      characteristic frequency (CF) of the neurone (70% of cases) or CF/2 (30%). This
      observation can be explained by supposing that preferred intervals of spontaneous
      activity are generated by noise passing through a filter tuned to the CF of the
      neurone; in most cases (70%) discharge was synchronized to CF, but in the others
      the neurone fired to every second cycle of the filtered signal. Consistent with
      this interpretation, for 79% of neurones, the modal interval of spontaneous
      activity was, on average, directly proportional to the CF-period, irrespective of
      whether preferred intervals were detected. The synchronization index at the PF
      was inversely related to the PF, and was quantified by the amplitude response of
      a first-order low-pass filter with cutoff frequency of 48 +/- 18 Hz. The
      spontaneous activity of 9% of neurones exhibited a second-harmonic component of
      the PF. For both tone-evoked and spontaneous activity, the observed
      synchronization indices of harmonics of the stimulus frequency or of the PF were
      consistent with an underlying exponential spike-generator function. If such a
      function does indeed govern spike generation, then it implies that the Shannon
      entropy of the probability density function of the instantaneous firing rate is
      near its maximum value and suggests that the system is close to statistical
      equilibrium. Single-tone rate-suppression was detected for 53% of those neurones
      that exhibited multiple preferred intervals of spontaneous activity. It is
      conjectured that the phenomena of quasiperiodic spontaneous activity and single
      tone rate-suppression are different aspects of a single presynaptic process.
      According to this model, we would expect to find these two phenomena in animals
      that have auditory fibres innervating electrically tuned hair cells, and that
      have stereocilia firmly coupled to a tectorial membrane.

PMID- 1757284
TI  - Time course of rate responses to two-tone stimuli in auditory nerve fibres in the
      guinea pig.
AB  - Peri-stimulus time histograms (PSTHs) were constructed from responses of auditory
      nerve fibres in anaesthetized guinea pigs. Acoustic stimuli consisted of pure
      tones, presented either as tone bursts, or in two-tone combinations in which a
      gated test tone was superimposed on a continuous excitatory tone at
      characteristic frequency (CF). The majority of the sample of fibres displayed two
      tone rate suppression (2TRS). The suppression was either a monotonic or a non
      monotonic function of the level of the superimposed test tone. Monotonic
      suppression of CF-driven rate occurred only for test tones at frequencies higher
      than CF, presented at levels up to the maximum available (approx. 100 dB SPL).
      For test tones below CF, 2TRS initially increased, then reverted towards
      excitation for higher levels of the test tone. Three levels were identified in
      non-monotonic, two-tone rate functions; (1) the threshold for rate suppression,
      (2) the maximally suppressing level and (3) the level (referred to as the balance
      point) at which average firing rate was restored to the background, CF-driven
      rate. PSTHs for two-tone responses obtained for test tone levels between the
      maximally-suppressing level and the balance point typically showed brief
      decrements (notches) in spike rate, at the onset and following the offset of the
      test tone. The latency, depth and duration of notches, however, depended on the
      level of the test tone, in a different manner for onset and offset. In some
      cases, without overt rate excitation above the probe-driven rate, the offset
      notch became more pronounced and of extended duration with increased level of the
      test tone, suggestive of adaptation to the test tone. Two-tone responses, in
      which rate exceeded the background, CF-driven rate, in general were preceded by a
      reduced onset notch and were followed by a longer-lasting depression of the
      background spike rate, typical of post-excitatory depression. Relative to
      responses obtained to the test tones presented alone, excitatory two-tone
      responses were of lower rate and were delayed by the onset notch. Onset notches
      sometimes preceded rate excitation in responses to single tones. Some features of
      the time course of rate suppression and excitation displayed in PSTHs for
      responses to one and two-tone stimuli seem inconsistent with current models of
      2TRS.

PMID- 1757285
TI  - Masking and suppression in auditory nerve fibers of the goldfish, Carassius
      auratus.
AB  - The responses of single fibers of the auditory nerve of the goldfish (Carassius
      auratus) were recorded in response to two tones of different duration (20 ms
      'signals' and 200 ms 'maskers') presented simultaneously or non-simultaneously. A
      single tone may produce excitation, adaptation, and suppression in auditory nerve
      fibers. For fibers with characteristic frequencies (CF) in the 200 to 400 Hz
      range, frequencies well above CF tend to produce suppression. If the net response
      to the masker tone is excitation, an added excitatory signal tone tends to
      increment the response in a way predictable from the rate-level function for the
      masker. A masker can attenuate the response to a signal as a result of a
      compressive and saturating response to the masker, and as a result of a low
      signal-to-masker ratio. If the net response to a masker tone is suppression, it
      effectively subtracts from signal excitation, causing 'suppressive masking.' In
      non-spontaneous fibers, suppression, additive excitatory effects, and adaptation
      can be revealed by responses to the signal in the absence of spike responses to
      the masker. In general, the ability of one tone (the masker) to reduce the
      response to a second tone (the signal) is greater in non-spontaneous fibers than
      in spontaneous fibers. These results also show that estimates of the frequency
      selectivity of many goldfish auditory nerve fibers will depend on whether the
      response of the fiber is defined by excitation, suppression, or both. The
      response of many fibers with CF in the 200-400 Hz region, as defined by
      excitation, can be masked or suppressed by a broad range of frequencies covering
      the effective hearing range of the goldfish.

PMID- 1757286
TI  - Binaural amplitude discrimination and the binaural masking-level difference.
AB  - Under certain conditions, amplitude discrimination is not a monotonic increasing
      function of signal-to-noise ratio. The non-monotonicity arises when the tones to
      be discriminated are presented 180 degrees out-of-phase at the observer's ears
      and just above their detection 'threshold' in noise that is in-phase at the
      observer's ears, and with 2-6-dB differences in amplitude.

PMID- 1757287
TI  - The effect of 'conditioning' exposures on hearing loss from traumatic exposure.
AB  - The role of 'conditioning' exposures as moderators of hearing loss produced by
      exposure to a higher level noise was explored using chinchillas. Monaural
      chinchillas were exposed to an octave band of noise centered at 0.5 kHz at 95 dB
      for six hours/day for ten days. The subjects were allowed to recover to pre
      exposure sensitivity and at five days after the last exposure they were re
      exposed to the same noise at 106 dB. Thresholds recorded at various time
      intervals following the second exposure were compared with those recorded in a
      control group exposed only to the higher level noise. The experimental animals
      were found to have less threshold shift at all stages of recovery. Results are
      discussed in the light of results of other related studies and possible
      mechanisms involved are hypothesized.

PMID- 1757288
TI  - Alternating current induced otoacoustic emissions in the guinea pig.
AB  - Injection of alternating current (AC) into the scala media of the guinea pig
      cochlea induced otoacoustic emissions (OAEs) at the frequency of the AC
      fundamental, together with harmonic and intermodulation distortion products.
      Although the waveform of the injected ACs was distorted, probably due to
      nonlinear polarization of the metal electrodes, and was composed of the
      fundamental plus distortion products of every order, only a few of the lowest
      order distortion products were selectively emitted with the fundamental. AC
      injection at a basal site extended the high frequency limit of OAEs. Electrical
      stimulation of the crossed olivocochlear bundle inhibited the sideband emissions
      with little change in the fundamental. OAE was reduced reversibly by temporary
      impairment of the cochlea due to exposure to fatiguing sound, by intravenous
      application of furosemide and by temporary anoxia. Irreversible reduction
      resulted from intracochlear perfusion with excess K+ solution, acoustic trauma
      and cardiac arrest. These facts imply that AC-induced OAE is not an artifact
      generated electrically; rather, such emissions originate in the cochlea and
      normal metabolic activity in the cochlea is essential. A proposed mechanism of
      generation includes two components: 1) electromechanical transduction from AC to
      mechanical vibration in the cochlea and 2) a distortion-producing process; the
      contribution of each component to the receptor mechanism is discussed.

PMID- 1757289
TI  - Recovery from prior stimulation. I: Relationship to spontaneous firing rates of
      primary auditory neurons.
AB  - Recovery of neural thresholds following a forward masker was measured for
      auditory neurons in anesthetized chinchillas. We find that recovery of forward
      masked thresholds is slower for low spontaneous-rate neurons compared to high
      spontaneous-rate neurons. In addition, we studied the dependence of the shape of
      PST histograms on the time between repetitions of a tone-burst. We find that for
      low spontaneous-rate neurons, peak onset responses increase in magnitude over a
      longer range of interstimulus intervals compared to high spontaneous-rate
      neurons. Both results are consistent with the conclusion that low spontaneous
      rate neurons take longer to recover from prior stimulation compared to high
      spontaneous-rate neurons. We suggest applications of this finding in
      psychophysical experiments to investigate the role of low spontaneous-rate
      neurons in intensity coding.

PMID- 1757290
TI  - Recovery from prior stimulation. II: Effects upon intensity discrimination.
AB  - We obtained just-noticeable differences (jnds) for the intensity of pure tones
      following a forward masker. The masker was a 100-ms burst of narrow-band noise
      centered at 1000 Hz presented at 90 dB SPL; the pure-tone signal was at 1000 Hz
      and was 25 ms in duration. The masker-signal delay was 100 ms. Under these
      conditions, there is no threshold shift for the detection of the pure-tone signal
      following the forward masker. In contrast with the absence of a forward-masker
      effect upon detection thresholds, unusually large midlevel (40-60 dB SPL) jnds
      were observed. These large midlevel jnds were measured as a function of signal
      delay, revealing that they are not completely recovered to the normal (unmasked)
      values by 400 ms. We interpret these data as a consequence of the slower recovery
      of low-spontaneous rate, high-threshold neurons following prior stimulation
      (Relkin and Doucet, 1990). These experiments may therefore provide psychophysical
      evidence that the low-spontaneous rate, high-threshold neurons are a necessary
      physiological component in the coding of the large dynamic range for intensity.
      In addition, the present data provide evidence that the assumption that the
      effect of forward masking is limited to 100-200 ms is inappropriate, as this
      recovery time does not necessarily apply to suprathreshold tasks.

PMID- 1757291
TI  - Postsynaptic inhibition can explain the concentration of short inter-spike
      intervals in avian auditory nerve fibres.
AB  - Spontaneous and sound-evoked single-unit activity was recorded from afferent
      neurones in the cochlear ganglion of the anaesthetized pigeon. The histogram of
      successive intervals of spontaneous activity of 51% of neurones exhibited more
      short intervals than expected from a Poisson point-process description of spike
      times; for another 43% of neurones the point-process was Poisson. A model of
      spike generation was developed to account for the concentration of short spike
      intervals. The proposed model contains inhibitory postsynaptic potentials at the
      afferent dendrite, in addition to the excitatory postsynaptic potentials. Not
      only does the model reproduce the first-order interval statistics of neural
      activity, but it provides a mechanism for improving phase-locking to the
      fundamental frequency of a sinusoid, and also offers an explanation for the
      presence of reciprocal synapses in the human cochlea.

PMID- 1757292
TI  - Effects of streptomycin on development of the apical structures of hair cells in
      the chick basilar papilla.
AB  - A single dose of streptomycin (166 mg/kg egg weight) was given to chick embryos 7
      15 days after the beginning of incubation. Embryos were fixed 4-12 days later,
      and the hair cells examined by scanning and transmission electron microscopy. The
      highest proportion of abnormalities was produced by injections on or before the
      11th day of incubation, later injections affecting a substantially smaller
      proportion of embryos. This suggests the possibility of a critical period for
      streptomycin ototoxicity in the chick. In addition to the normal signs of
      cellular degeneration, the most striking abnormality was a massive expansion in
      the apical surface, sometimes by a factor of 20, in area. The organisation of
      stereocilia was also commonly affected. The stereocilia could be broken up into
      multiple small separate bundles, and often there was a wide separation between
      the kinocilium and the stereocilia. Stereocilia tended to be reduced in number,
      fused, and either of abnormally large, small, or irregular diameters. Structures
      with the appearance of stereociliar cores often lay horizontally within the
      surface of the cuticular plate, sometimes running for 15 microns or more.
      Sometimes abnormal 'stereocilia' were expressed around the extreme margins of the
      cuticular plate. In addition, adjacent hair cells could show very different
      developmental stages, as though the development of some cells had been arrested.
      With all these changes, the short hair cells in the centre of a papillar cross
      section tended to be the most affected, with the tall hair cells and the short
      hair cells on the extreme inferior (i.e. abneural) edge being least affected. It
      is suggested that the streptomycin alters the balance of the different aspects of
      development of the hair cells. It might therefore be possible to use ototoxicity
      as a way of analysing hair-cell development.

PMID- 1757293
TI  - The effect of CO2- and O2-gas mixtures on laser Doppler measured cochlear and
      skin blood flow in guinea pigs.
AB  - The effects of carbogen (5% CO2: 95% O2) 10% CO2-in-air and 100% O2 on cochlear
      blood flow (CBF), skin blood flow (SBP), blood pressure (BP) and arterial blood
      gases were investigated in the anesthetized, respired or self-respiring guinea
      pig. In respired animals, CBF and SBF were increased with carbogen and 10% CO2-in
      air and decreased with O2. BP was elevated with each gas. In freely breathing
      animals, only 10% CO2-in-air caused a small increase in CBF; both carbogen and O2
      caused CBF to decrease. SPF changes were similar in form, but larger than those
      seen in respirated subjects. No consistent change in BP was seen during breathing
      of these mixtures. Arterial PO2 was increased by carbogen and 10% CO2-in-air for
      both groups. PCO2 increased for both CO2 gas mixtures during forced respiration;
      but in free-breathing animals PCO2 only increased for 10% CO2-in-air (normal PCO2
      values were maintained with carbogen thorough increased breathing rate). The
      observed changes in CBF were consistent with a balance between a combined
      vasoconstrictive effect of PO2 and vasodilation effect of PCO2 on cochlear
      vessels. Analysis of cochlear vascular conductivity (CBF/BP) indicated that
      vasodilation was significant only with 10% CO2-in-air in respirated animals. In
      all other conditions the increased CBF apparently reflects the increase profusion
      pressure associated with respiration of each gas. For clinical purposes, while
      carbogen does not appear to directly cause vasodilation of cochlear vessels it
      does lead to an increased oxygenation of the cochlea blood and would appear to
      avoid the cochlear vasoconstriction caused by 100% O2.

PMID- 1757294
TI  - Histochemical analysis of glycoconjugates in gelatinous membranes of the gerbil's
      inner ear.
AB  - The gelatinous membranes of the gerbil inner ear were analyzed histochemically
      for glycoconjugates with a battery of twenty horseradish peroxidase-conjugated
      lectins. Glycoconjugates with mannose (Man) and/or glucose (Glc), galactose
      (Gal), fucose (Fuc), N-acetylglucosamine (GlcNAc), N-acetylgalactosamine (GalNAc)
      and N-acetylneuraminic acid (NeuAc) were detected in the tectorial and otolithic
      membranes and cupula. Differences in lectin reactivity were observed between
      tectorial and vestibular membranes and also among zones and between the medial
      and lateral regions of the middle zone of the tectorial membrane. The
      distribution of staining differed markedly for several lectins that bind
      specifically to GalNAc or to GlcNAc but vary in affinity for oligosaccharides
      containing these sugars in different sequences or linkages. The findings suggest
      presence of the terminal disaccharides GalNAc alpha 1,3Gal in tectorial membrane
      and Gal beta 1,3GalNAc in vestibular membranes. Lectin binding profiles provided
      evidence that the limbal zone's fibrous and attachment layers contain mainly O
      glycosidically linked oligosaccharides whereas the middle zone's medial fibrous
      layer contains both O- and N-linked chains. The remaining regions of the
      tectorial membrane contain mainly N-linked oligosaccharides with bisected
      biantennary type chains predominating. Additionally, the marginal band and the
      middle zone's basal layer contain abundant N-linked oligosaccharides with a
      triantennary structure.

PMID- 1757295
TI  - Influences of chemical sympathectomy and simulated weightlessness on male and
      female rats.
AB  - Maximum oxygen consumption (VO2max) has been shown to be reduced after periods of
      simulated weightlessness. To assess the role of the sympathetic nervous system in
      these reductions, Sprague-Dawley rats were either chemically sympathectomized
      (SYMX) or injected with saline (SHAM) and assigned to head-down suspension (HDS),
      horizontal restraint with the hindlimbs weight bearing (HWB), or cage-control
      (CC) conditions. VO2max, run time (RT), and mechanical efficiency (ME) were
      measured before suspension and on days 7 and 14. Male and female SHAM HDS groups
      exhibited reduced measures of VO2max (12-13%) after 7 and 14 days, and this
      decrease was attenuated in the SYMX and HWB rats. HDS resulted in a significant
      reduction in RT (9-15%) in both the male and female rats, and ME was
      significantly reduced after HDS in male and female SYMX and male SHAM rats (23
      33%) but not in the female SHAM rats. Lesser reductions in ME were observed in
      the HWB rats. HDS and HWB were associated with lower body, fat-free, and fat
      masses, which were similar in male and female rats as well as for the SHAM and
      SYMX conditions. In a related HDS experiment with normal rats, plasma
      norepinephrine and epinephrine were increased by 53 and 42% after 7 days, but
      only epinephrine returned to baseline after 14 days. It was concluded that
      chemical sympathectomy and/or a weight-bearing stimulus will attenuate the loss
      in VO2max associated with simulated weightlessness in rats despite similar
      changes in body mass and composition. The mechanism(s) remains unclear at this
      time.

PMID- 1757296
TI  - Effects of maternal exercise on liver and skeletal muscle glycogen storage in
      pregnant rats.
AB  - To examine the effects of maternal exercise on liver and skeletal muscle glycogen
      storage, female Sprague-Dawley rats were randomly divided into control,
      nonpregnant runner, pregnant nonrunning control, pregnant runner, and prepregnant
      exercised control groups. The exercise consisted of treadmill running at 30 m/min
      on a 10 degree incline for 60 min, 5 days/wk. Pregnancy alone, on day 20 of
      gestation, decreased maternal liver glycogen content and increased red and white
      gastrocnemius muscle glycogen storage above control values (P less than 0.05). In
      contrast, exercise in nonpregnant animals augmented liver glycogen storage and
      also increased red and white gastrocnemius glycogen content (P less than 0.05).
      By combining exercise and pregnancy, the decrease in liver glycogen storage in
      the pregnant nonexercised condition was prevented in the pregnant runner group
      and more glycogen was stored in both the red and white portions of the
      gastrocnemius than all other groups (P less than 0.05). Fetal body weight was
      greatest (P less than 0.05) in the pregnant runner group and lowest (P less than
      0.05) in the prepregnant exercise control group. These results demonstrate that
      chronic maternal exercise may change maternal glycogen storage patterns in the
      liver and skeletal muscle with some alteration in fetal outcome.

PMID- 1757297
TI  - Origin of cardiac-related thoracic electrical impedance variations in lambs.
AB  - Cardiac-related deflections in thoracic electrical impedance have been thought to
      correlate sufficiently well with cardiac stroke volume to be used as the basis
      for a noninvasive estimation of cardiac output. To determine more precisely the
      physiological origin of the impedance deflection (DZ), we regarded right
      ventricular stroke volume (SVa) as the sum of two components: 1) that part of SVa
      responsible for the transient increment in pulmonary blood volume within a
      cardiac cycle, SVa-v and 2) the remaining part of SVa, (SVa-SVa-v). SVa-v was
      measured in lambs by integration of the difference between pulmonary arterial and
      pulmonary venous flow. SVa and its components were varied experimentally by
      opening and closing an aorticocaval shunt or by inflating and deflating a cuff
      implanted around the pulmonary artery. DZ was measured using a tetrapolar disk
      electrode system. Multivariate linear regression analysis revealed that SVa-v had
      a significant positive effect on DZ, and, at the same time, (SVa-SVa-v) had a
      significant negative effect on DZ. In the pulmonary artery occluder model, the
      positive effect of SVa-v dominated the opposing negative effect of (SVa - SVa-v)
      so that the net effect of SVa on DZ was positive and significant. In the
      aorticocaval shunt model, these effects opposed each other to the extent that
      there was no significant correlation between SVa and DZ. These results shed new
      light on the physiological origin of DZ. They also demonstrate that use of DZ to
      measure acute changes in cardiac output may yield misleading results. Changes or
      the lack of changes in thoracic electrical impedance do not necessarily reflect
      cardiac output status.

PMID- 1757298
TI  - Hypoxia potentiates exercise-induced sympathetic neural activation in humans.
AB  - Our purpose was to test the hypothesis that hypoxia potentiates exercise-induced
      sympathetic neural activation in humans. In 15 young (20-30 yr) healthy subjects,
      lower leg muscle sympathetic nerve activity (MSNA, peroneal nerve;
      microneurography), venous plasma norepinephrine (PNE) concentrations, heart rate,
      and arterial blood pressure were measured at rest and in response to rhythmic
      handgrip exercise performed during normoxia or isocapnic hypoxia (inspired O2
      concn of 10%). Study I (n = 7): Brief (3-4 min) hypoxia at rest did not alter
      MSNA, PNE, or arterial pressure but did induce tachycardia [17 +/- 3 (SE)
      beats/min; P less than 0.05]. During exercise at 50% of maximum, the increases in
      MSNA (346 +/- 81 vs. 207 +/- 14% of control), PNE (175 +/- 25 vs. 120 +/- 11% of
      control), and heart rate (36 +/- 2 vs. 20 +/- 2 beats/min) were greater during
      hypoxia than during normoxia (P less than 0.05), whereas the arterial pressure
      response was not different (26 +/- 4 vs. 25 +/- 4 mmHg). The increase in MSNA
      during hypoxic exercise also was greater than the simple sum of the separate
      responses to hypoxia and normoxic exercise (P less than 0.05). Study II (n = 8):
      In contrast to study I, during 2 min of exercise (30% max) performed under
      conditions of circulatory arrest and 2 min of postexercise circulatory arrest
      (local ischemia), the MSNA and PNE responses were similar during systemic hypoxia
      and normoxia. Arm ischemia without exercise had no influence on any variable
      during hypoxia or normoxia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757299
TI  - Maximum oxygen uptake and arterial blood oxygenation during hypoxic exercise in
      rats.
AB  - The objectives of these experiments were 1) to describe the effect of maximum
      treadmill exercise on gas exchange, arterial blood gases, and arterial blood
      oxygenation in rats acclimated for 3 wk to simulated altitude (SA, barometric
      pressure 370-380 Torr) and 2) to determine the contribution of acid-base changes
      to the changes in arterial blood oxygenation of hypoxic exercise. Maximum O2
      uptake (VO2max) was measured in four groups of rats: 1) normoxic controls run in
      normoxia (Nx), 2) normoxic controls run in acute hypoxia [AHx inspiratory PO2
      (PIO2) approximately 70 Torr], 3) SA rats run in hypoxia (3WHx, PIO2
      approximately 70 Torr), and 4) SA rats run in normoxia (ANx). VO2max (ml STPD.min
      1.kg-1) was 70.8 +/- 0.9 in Nx, 46.4 +/- 1.9 in AHx, 52.6 +/- 1.1 in 3WHx, and
      70.0 +/- 2.4 in ANx. Exercise resulted in acidosis, hypocapnia, and elevated
      blood lactate in all groups. Although blood lactate increased less in 3WHx and
      ANx, pH was the same or lower than in Nx and AHx, reflecting the low buffer
      capacity of SA. In AHx and 3WHx, arterial PO2 increased with exercise; however,
      O2 saturation of hemoglobin in arterial blood (SaO2) decreased. In vitro
      measurements of the Bohr shift suggest that SaO2 decreased as a result of a
      decrease in hemoglobin O2 affinity. The data indicate that several features of
      hypoxic exercise in this model are similar to those seen in humans, with the
      exception of the mechanism of decrease in SaO2, which, in humans, appears to be
      due to incomplete alveolar-capillary equilibration.

PMID- 1757300
TI  - Effect of alkalosis on maximum oxygen uptake in rats acclimated to simulated
      altitude.
AB  - The objective of the present experiments was to determine whether prevention or
      moderation of exercise acidosis would influence arterial blood oxygenation and
      exercise capacity in hypoxia. The effect of administration of 0.3 M NaHCO3 (3
      ml/100 g) on maximum O2 uptake (VO2max) and arterial blood oxygenation was
      determined in rats acclimated to simulated altitude (370-380 Torr barometric
      pressure) for 3 wk (HxBic) and in normoxic littermates (NxBic). Controls were
      simulated-altitude (HxNaCl) and normoxic rats (NxNaCl) given 0.3 M NaCl.
      Inspiratory PO2 during treadmill exercise was approximately 70 Torr for hypoxic
      rats and 140-145 Torr for normoxic rats. VO2max was 18% higher in HxBic than in
      HxNaCl (62.8 + 1.6 vs. 53.1 + 1.0 ml STPD.min-1.kg-1, respectively, P less than
      0.05) and only 8% higher in NxBic than in NxNaCl (74.0 + 1.1 vs. 68.7 + 1.5 ml
      STPD.min-1.kg-1, respectively, P less than 0.05). Exercise in HxNaCl resulted in
      a decrease in arterial O2 concentration (CaO2), which was largely due to a pH
      induced decrease in O2 saturation of arterial blood, and occurred despite an
      increase in arterial PO2. NaHCO3 moderated the acidosis of exercise and largely
      attenuated the decrease in CaO2. The effects of acidosis and bicarbonate on CaO2
      were much less evident in the normoxic controls. There was an almost linear
      relationship between VO2max and the corresponding CaO2 for all four groups,
      suggesting that the effect of NaHCO3 on VO2max may be related to moderation of
      the decrease in CaO2.

PMID- 1757301
TI  - Prevention of H2O2 generation by monoamine oxidase protects against CNS O2
      toxicity.
AB  - Toxicity to the central nervous system (CNS) by hyperbaric oxygen (HBO)
      presumably relates to increased production of reactive oxygen species. The sites
      of generation of reactive oxygen species during HBO, however, have not been fully
      characterized in the brain. We investigated the relationship between regional
      generation of hydrogen peroxide (H2O2) in the brain in the presence of an
      irreversible inhibitor of catalase, aminotriazole (ATZ), and protection from CNS
      O2 toxicity by a monoamine oxidase (MAO) inhibitor, pargyline. At 6 ATA of
      oxygen, pargyline significantly protected rats from CNS O2 toxicity whereas ATZ
      enhanced O2 toxicity. In animals pretreated with ATZ, HBO inactivated 21-40% more
      catalase than air exposure in the six brain regions studied. Because ATZ-mediated
      inactivation of catalase was H2O2 dependent, the decrease in catalase activity
      during hyperoxia was proportional to the intracellular production of H2O2.
      Pargyline, administered 30 min before HBO, inhibited MAO by greater than 90%,
      prevented ATZ inhibition of catalase activity during HBO, and reversed the
      augmentation of CNS O2 toxicity by ATZ. These findings indicate that H2O2
      generated by MAO during hyperoxia is important to the pathogenesis of CNS O2
      toxicity in rats.

PMID- 1757302
TI  - Dynamic regulation of leg vasomotor tone in patients with chronic heart failure.
AB  - We examined the central hemodynamic (n = 5) and leg blood flow (n = 9) responses
      to one- and two-leg bicycle exercise in nine ambulatory patients with chronic
      heart failure due to left ventricular systolic dysfunction (ejection fraction 17
      +/- 9%). During peak one- vs. two-leg exercise, leg blood flow (thermodilution)
      tended to be higher (1.99 +/- 0.91 vs. 1.67 +/- 0.91 l/min, P = 0.07), whereas
      femoral arteriovenous oxygen difference was lower (13.6 +/- 3.1 vs. 15.0 +/- 2.9
      ml/dl, P less than 0.01). Comparison of data from exercise stages matched for
      single-leg work rate during one- vs. two-leg exercise demonstrated that cardiac
      output was similar while both oxygen consumption and central arteriovenous oxygen
      differences were lower, indicating relative improvement in the cardiac output
      response at a given single-leg work rate during one-leg exercise. This was
      accompanied by higher leg blood flow (1.56 +/- 0.76 vs. 1.83 +/- 0.72 l/min, P =
      0.02) and a tendency for leg vascular resistance to be lower (92 +/- 54 vs. 80 +/
      48 Torr.l-1.min, P = 0.08) without any change in blood lactate. These data
      indicate that, in patients with chronic heart failure, leg vasomotor tone is
      dynamically regulated, independent of skeletal muscle metabolism, and is not
      determined solely by intrinsic abnormalities in skeletal muscle vasodilator
      capacity. Our results suggest that relative improvements in central cardiac
      function may lead to a reflex release of skeletal muscle vasoconstrictor tone in
      this disorder.

PMID- 1757303
TI  - Coincident thresholds in intracellular phosphorylation potential and pH during
      progressive exercise.
AB  - Dynamic changes in intracellular phosphocreatine (PCr), inorganic phosphate (Pi),
      and pH in human forearm muscle were studied from rest through heavy exercise by
      means of a ramp exercise protocol and 31P nuclear magnetic resonance
      spectroscopy. Eighteen healthy volunteers performed an isotonic wrist flexion
      exercise of repeated contractions at a frequency of 0.5 Hz. Work rate was
      increased continuously (ramped) at approximately 0.13 W each minute from 0.34 to
      1.5 W or until fatigue. Pi/PCr was used as an estimate of the cellular
      phosphorylation potential of the muscle. Exercise caused a progressive increase
      in Pi/PCr with an initial slow and later fast component. The transition between
      these components was distinct and corresponded to the onset of pH decline in all
      subjects. These changes in Pi/PCr and pH were best fit (P less than 0.05) by a
      piecewise linear regression model with a break point or threshold. Repeated ramp
      testing of six subjects showed that the threshold was reproducible (r = 0.98).
      The results of this study demonstrate the existence of an intracellular metabolic
      threshold and suggest that indirect threshold measures (lactate and ventilatory
      thresholds) may reflect events at the cellular level.

PMID- 1757304
TI  - Carbohydrate feedings before, during, or in combination improve cycling endurance
      performance.
AB  - This study examined the effects of no carbohydrate (PP), preexercise carbohydrate
      feeding (CP), carbohydrate feedings during exercise (PC), and the combination of
      carbohydrate feedings before and during exercise (CC) on the metabolic responses
      during exercise and on exercise performance. Nine well-trained cyclists exercised
      at 70% of maximal O2 uptake until exhaustion. Blood glucose peaked 30 min after
      the preexercise carbohydrate feeding and at the start of exercise was 25% below
      the prefeeding concentration (4.76 mM). At exhaustion, glucose had declined to
      3.8 (PP), 4.0 (CP), 4.6 (PC), and 5.0 mM (CC). Insulin was 300% above basal (7
      microU/ml) at the start of exercise for CC and CP and returned to baseline by 120
      min of exercise. When carbohydrates were consumed, the rate of carbohydrate
      oxidation was significantly higher throughout exercise than during PP. Total work
      produced during exercise was 19-46% (P less than 0.05) higher when carbohydrates
      were consumed. Time to exhaustion was 44% (CC), 32% (PC), and 18% (CP) greater
      than PP (201 min; P less than 0.05). Performance was improved by ingestion of
      carbohydrates before and/or during exercise; performance was further improved by
      their combination. This is probably the result of enhanced carbohydrate
      oxidation, especially during the later stages of exercise.

PMID- 1757305
TI  - Mechanism of failure of recovery from hypoxic apnea by gasping in 17- to 23-day
      old mice.
AB  - The mechanism of failure of autoresuscitation from hypoxic apnea in 17- to 23-day
      old (weanling) Swiss Webster related/J mice was investigated by recording
      electrocardiogram (ECG) and ventilation in adult, weanling, and 11-day-old mice.
      Hypoxic apnea was induced with 97% N2-3% CO2. O2 (21% or 50% O2) or 97% N2-3% CO2
      was given at the onset of apnea. The ECG showed no arrhythmias predictive of
      failure of autoresuscitation. The first indication of failure was a progressive
      fall in gasp volume ("run down"). This pattern also occurred in animals given
      continuous 97% N2-3% CO2 and was significantly different from that in mice that
      survived. Gasping duration in 97% N2 was longer in weanlings than adults but
      shorter than in 11 day olds. Respiratory and heart rate recovery were more rapid
      in adults than in weanlings. Although recovery in high O2 was more rapid, the
      survival rate was not increased. The lack of effect of high O2 on survival and
      the virtually identical pattern of gasping in mice dying in 97% N2 and air leads
      us to conclude that in mice that fail to autoresuscitate little or no O2 reaches
      the medullary respiratory centers. We speculate that this may be due to increased
      vulnerability of cardiac muscle to anoxia in 17- to 23-day-old mice, resulting in
      early and severe heart failure.

PMID- 1757306
TI  - Metabolism during normal, fragmented, and recovery sleep.
AB  - Average metabolic data (O2 uptake and CO2 output) were obtained for each 3-min
      period during consecutive nights of normal, experimentally fragmented, and
      recovery sleep in a group of 12 normal young adult males. Naturally occurring
      arousals and awakenings resulted in a characteristic increase in metabolism on
      the baseline night. The placement of brief frequent experimental arousals on the
      following night resulted in significantly increased metabolism throughout the
      night and significantly decreased sleep restoration as measured by morning
      performance, mood, and alertness tests, even though total sleep time was
      minimally reduced. Metabolic variables were significantly decreased compared with
      baseline on the nondisturbed recovery night that followed the sleep fragmentation
      night. The data cannot be used to infer that increased metabolism during sleep
      causes nonrestorative sleep, but the direction and time course of metabolic
      change accompanying arousal are consistent with that hypothesis.

PMID- 1757307
TI  - Carrying loads with springy poles.
AB  - People throughout Asia use springy bamboo poles to carry the loads of everyday
      life. These poles are a very compliant suspension system that allows the load to
      move along a nearly horizontal path while the person bounces up and down with
      each step. Could this be an economical way to carry loads inasmuch as no
      gravitational work has to be done to lift the load repeatedly? To find out, an
      experiment was conducted in which four male subjects ran at 3.0 m/s on a
      motorized treadmill with no load and while carrying a load equal to 19% body wt
      with compliant poles. Oxygen consumption rate, vertical ground reaction force,
      and the force exerted by the load on the shoulders were measured. Oxygen
      consumption rate increased by 22%. The same increase has previously been observed
      when loads are carried with a backpack. Thus compliant poles are not a
      particularly economical method of load carriage. However, pole suspension systems
      offer important advantages: they minimize peak shoulder forces and loading rates.
      In addition, the peak vertical ground reaction force is only slightly increased
      above unloaded levels when loads are carried with poles.

PMID- 1757308
TI  - Dynamic response of the peripheral chemoreflex loop to changes in end-tidal O2.
AB  - We studied the peripheral ventilatory response dynamics to changes in end-tidal
      O2 tension (PETO2) in 13 cats anesthetized with alpha-chloralose-urethan. The
      arterial O2 tension in the medulla oblongata was kept constant using the
      technique of artificial perfusion of the brain stem. At constant end-tidal CO2
      tension, 72 ventilatory on-responses due to stepwise changes in PETO2 from
      hyperoxia (45-55 kPa) to hypoxia (4.7-9.0 kPa) and 62 ventilatory off-responses
      due to changes from hypoxia to hyperoxia were assessed. We fitted two exponential
      functions with the same time delay to the breath-by-breath ventilation and found
      a fast and a slow component in 85% of the ventilatory on-responses and in 76% of
      the off-responses. The time constant of the fast component of the ventilatory on
      response was 1.6 +/- 1.5 (SD) s, and that of the off-response was 2.4 +/- 1.3 s;
      the gain of the on-response was smaller than that of the off-response (P =
      0.020). For the slow component, the time constant of the on-response (72.6 +/-
      36.4 s) was larger (P = 0.028) than that of the off-response (43.7 +/- 28.3 s),
      whereas the gain of the on-response exceeded that of the off-response (P =
      0.031). We conclude that the ventilatory response of the peripheral chemoreflex
      loop to stepwise changes in PETO2 contains a fast and a slow component.

PMID- 1757309
TI  - Pulmonary vascular smooth muscle: biochemical and mechanical developmental
      changes.
AB  - To evaluate the developmental changes in pulmonary vascular smooth muscle
      contractile protein content, mechanical properties, and their contribution to the
      high resistance characteristic of the fetal and immediate neonatal period, we
      studied pulmonary vessels of fetal, newborn, and adult sheep, as well as newborn
      and adult pigs. Strips of the second- through fifth-generation vessels were
      dissected, and their content of tissue total smooth muscle cell protein, myosin,
      and actin-to-myosin ratio were measured; the mechanical properties of the second
      generation vascular strips were also studied. For all ages the smooth muscle
      protein and myosin content of the second-generation vessels were significantly
      greater than for the lower pulmonary vascular orders (P less than 0.05). The
      myosin content in fetal sheep (0.77 +/- 0.03 micrograms/mg wet tissue) was
      similar to that of the newborn (0.79 +/- 0.04) and adult (0.86 +/- 0.05).
      However, the smooth muscle protein content (7.94 +/- 0.21 micrograms/mg wet
      tissue) and the actin-to-myosin ratio of the pulmonary vascular tissue of the
      fetus (1.00 +/- 0.04) were lower (P less than 0.01) in the fetal than in the
      newborn (9.16 +/- 0.26 and 1.60 +/- 0.12) and adult (9.38 +/- 0.3 and 1.60 +/-
      0.11, respectively). No differences were observed for these parameters between
      the newborn and adult pig. Stress (16.5 +/- 1.7 mN/mm2) and the maximum
      shortening capacity (13.0 +/- 1.5% of optimal length) in the newborn pulmonary
      vascular strips were significantly greater than for the fetus (6.8 +/- 1.4 and
      5.9 +/- 1.0, respectively) but similar to those of the adult sheep.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1757310
TI  - Autonomic control of heart rate during exercise studied by heart rate variability
      spectral analysis.
AB  - Spectral analysis of heart rate variability (HRV) might provide an index of
      relative sympathetic (SNS) and parasympathetic nervous system (PNS) activity
      during exercise. Eight subjects completed six 17-min submaximal exercise tests
      and one resting measurement in the upright sitting position. During submaximal
      tests, work rate (WR) was increased for the initial 3 min in a ramp fashion until
      it reached constant WRs of 20 W, or 30, 60, 90, 100, and 110% of the
      predetermined ventilatory threshold (Tvent). Ventilatory profile and alveolar gas
      exchange were monitored breath by breath, and beat-to-beat HRV was measured as R
      R intervals of an electrocardiogram. Spectral analysis was applied to the HRV
      from 7 to 17 min. Low-frequency (0-0.15 Hz) and high-frequency (0.15-1.0 Hz)
      areas under power spectra (LO and HI, respectively) were calculated. The
      indicator of PNS activity (HI) decreased dramatically (P less than 0.05) when the
      subjects exercised compared with rest and continued to decrease until the
      intensity reached 60% Tvent. The indicator of SNS activity (LO/HI) remained
      unchanged up to 100% Tvent, whereas it increased abruptly (P less than 0.05) at
      110% Tvent. The results suggested that (cardiac) PNS activity decreased
      progressively from rest to a WR equivalent to 60% Tvent, and SNS activity
      increased only when exercise intensity exceeded Tvent.

PMID- 1757311
TI  - Coarse-graining spectral analysis: new method for studying heart rate
      variability.
AB  - Heart rate variability (HRV) spectra are typically analyzed for the components
      related to low- (less than 0.15 Hz) and high- (greater than 0.15 Hz) frequency
      variations. However, there are very-low-frequency components with periods up to
      hours in HRV signals, which might smear short-term spectra. We developed a method
      of spectral analysis suitable for selectively extracting very-low-frequency
      components, leaving intact the low- and high-frequency components of interest in
      HRV spectral analysis. Computer simulations showed that those low-frequency
      components were well characterized by fractional Brownian motions (FBMs). If the
      scale invariant, or self-similar, property of FBMs is considered a new time
      series (x') was constructed by sampling only every other point (course graining)
      of the original time series (x). Evaluation of the cross-power spectra between
      these two (Sxx') showed that the power of the FBM components was preserved,
      whereas that of the harmonic components vanished. Subtraction of magnitude of Sxx
      from the autopower spectra of the original sequence emphasized only the harmonic
      components. Application of this method to HRV spectral analyses indicated that it
      might enable one to observe more clearly the low- and high-frequency components
      characteristic of autonomic control of heart rate.

PMID- 1757312
TI  - Optimizing athletic performance by influence curves.
AB  - Recent application of modeling techniques to physical training has opened the
      possibility for prediction from training. Solution of the inverse problem,
      determining a training program to produce a desired performance at a specific
      time, is also possible and may yield strategies for achieving better training and
      tapering (complete or relative rest for a period before competition) regimens for
      competitive athletes. A mathematical technique derived from model theory is
      described in this paper that allows the design of an optimal strategy of physical
      preparation for an individual to do well in a single future competitive event or
      cluster of events. Simulation results, using default parameters of a training
      model, suggest that presently accepted forms of taper for competition may remain
      too rigorous and short in duration to achieve the best result possible from the
      training undertaken.

PMID- 1757313
TI  - Estimation of time-varying respiratory mechanical parameters by recursive least
      squares.
AB  - Continuous estimation of time-varying respiratory mechanical parameters is
      required to fully characterize the time course of bronchoconstriction. To achieve
      such estimation, we developed an estimator that uses the recursive linear least
      squares algorithm to fit the equation Ptr = RV + EV + K to measurements of
      tracheal pressure (Ptr) and flow (V). The volume (V) is obtained by numerical
      integration of V. The estimator has a finite memory with length into the past at
      each point in time that varies inversely with the difference between the current
      measurement of Ptr and that predicted by the model, to allow the algorithm to
      track rapidly varying parameters (R, E, and K). V usually exhibits significant
      drift and must be corrected. Of the several correction methods investigated,
      subtraction of the recursively weighted average of V before integration to V was
      found to perform best. The estimator was tested on simulated noisy data where it
      successfully followed a fivefold increase in R and a twofold increase in E
      occurring over 10 s. Three dogs and two cats were anesthetized, paralyzed,
      tracheostomized, and challenged with a bolus of methacholine (approximately 13
      mg/kg iv). Increases of 3- to 10-fold were observed in R and 2- to 3-fold in E,
      beginning within 10-40 s after the bolus injection. In some animals we found that
      the increase in E occurred more slowly than that in R, which the V signal
      suggested was due to dynamic hyperinflation of the lungs. These results
      demonstrate that our recursive estimator is able to track rapid changes in
      respiratory mechanical parameters during bronchoconstrictor challenge.

PMID- 1757314
TI  - Hemodynamic basis for cocaine-induced pulmonary edema in dogs.
AB  - We tested the hypothesis that cocaine-induced impairment of left ventricular
      function results in cardiogenic pulmonary edema. Mongrel dogs, anesthetized with
      alpha-chloralose, were injected with two doses of cocaine (5 mg/kg iv) 27 min
      apart. Cocaine produced transient decreases in aortic and left ventricular
      systolic pressures that were followed by increases exceeding control. As aortic
      pressure recovered, left ventricular end-diastolic, left atrial (Pla), pulmonary
      arterial (Ppa), and central venous pressures rose. Cardiac output and stroke
      volume were reduced when measured 4-5 min after cocaine administration. Peak Ppa
      and Pla were 31 +/- 5 (SE) mmHg (range 17-51 mmHg) and 26 +/- 5 mmHg (range 12-47
      mmHg), respectively. Increases in extravascular lung water content (4.10 to 6.24
      g H2O/g dry lung wt) developed in four animals in which Pla exceeded 30 mmHg.
      Analysis of left ventricular function curves revealed that cocaine depressed the
      inotropic state of the left ventricle. Cocaine-induced changes in hemodynamics
      spontaneously recovered and could be elicited again by the second dose of the
      drug. Our results show that cocaine-induced pulmonary hypertension, associated
      with decreased left ventricular function, produces pulmonary edema if pulmonary
      vascular pressures rise sufficiently.

PMID- 1757315
TI  - Role of NaCl cotransport in cerebrospinal fluid production: effects of loop
      diuretics.
AB  - Cerebrospinal fluid (CSF) is secreted primarily by the choroid plexus (CP)
      located in the cerebral ventricles. Although much is known about ionic
      composition of cisternal CSF, the mechanisms involved in secretion of CSF in
      mammals are still not understood. The main aim of this report is to critically
      review the role of NaCl cotransport carrier in CSF production. On the basis of
      the studies in the literature, a model for CSF production by the CP is proposed.
      In this model, CP cells are assumed to be equipped with an NaCl cotransport
      carrier located on the basolateral (blood-facing) membrane. Because Na+ and Cl-
      are the two principal ions in CSF, their continued secretions into cerebral
      ventricles by CP cells require an adequate intracellular supply, which may be
      guaranteed by the NaCl cotransport carrier. Although this appears to be a
      reasonable assumption, making the processes involved in CSF production similar to
      those of other secretory epithelial cells, the presence of such a carrier in
      mammalian CP remains controversial. The reasons for this controversy are
      critically reviewed, and some suggestions for further studies are made.

PMID- 1757316
TI  - Effect of dietary restriction and/or exercise on 23-h metabolic rate and body
      composition in female rats.
AB  - This study examined the effects of three levels of dietary intake [ad libitum fed
      (AL), moderately severe (MSR), and severe restriction (SR)] and two levels of
      exercise [cage confinement (CC) and exercise training (E)] on 23-h resting
      metabolic rate (RMR) and body composition in 47 female Sprague-Dawley rats. At
      the end of the 9-wk study, the MSR and SR groups weighed approximately 81 and
      61%, respectively, of the AL-CC group. RMR was depressed for the MSR and SR
      groups compared with the AL-CC group. This was true whether expressed on an
      absolute (ml/min) or relative (ml.min-1.kg-0.75) basis. On a relative basis,
      which accounts for changes caused by weight loss alone, the RMR decreased by
      approximately 12 and 19%, respectively, for the MSR and SR groups compared with
      the AL-CC group. Although E resulted in significant differences in fat mass,
      percent fat, percent water, and heart mass between the AL groups, there were no
      significant differences between E and CC groups at either the MSR or SR level of
      dietary intake for any of the variables measured (i.e., body composition, muscle
      mass, RMR). Thus E does not appear to affect the composition of lost weight or
      RMR during diet-induced weight loss for female rats of normal weight.

PMID- 1757317
TI  - Effect of free radicals on pulmonary vascular response to acetylcholine.
AB  - We describe a model of pulmonary endothelial injury caused by electrolysis
      generated free radicals. Rabbit lungs were perfused in situ with Krebs solution
      at 37 degrees C containing 30 microM indomethacin. Electrolysis of this solution
      for 2 min, with a constant DC current of 20 mA, caused pulmonary vasoconstriction
      during the passage of current and converted subsequent acetylcholine-induced
      vasodilation to vasoconstriction. Electrolysis also inhibited endothelial
      dependent vasodilation due to the calcium ionophore A23187 but not that due to
      sodium nitroprusside, suggesting that smooth muscle function was unaltered, while
      that of the endothelium of the lung is specifically modified by the stimulus.
      These effects were prevented by a mixture of superoxide dismutase and catalase or
      by sodium salicylate, which removes hydroxyl radicals from solution after
      electrolysis. Electrolysis-induced endothelial damage was less functionally
      obvious when electrolysis was applied during recirculation of Krebs solution,
      perhaps because recirculating perfusion may trigger release of either free
      radical scavengers or other protective substances. This technique offers a simple
      reproducible model to study free radical-related damage of endothelium in the
      intact lung.

PMID- 1757318
TI  - A nonlinear viscoelastic model of lung tissue mechanics.
AB  - There have been a number of attempts recently to use linear models to describe
      the low-frequency (0-2 Hz) dependence of lung tissue resistance (Rti) and
      elastance (Eti). Only a few attempts, however, have been made to account for the
      volume dependence of these quantities, all of which require the tissues to be
      plastoelastic. In this paper we specifically avoid invoking plastoelasticity and
      develop a nonlinear viscoelastic model that is also capable of accounting for the
      nonlinear and frequency-dependent features of lung tissue mechanics. The model
      parameters were identified by fitting the model to data obtained in a previous
      study from dogs during sinusoidal ventilation. The model was then used to
      simulate pressure and flow data by use of various types of ventilation patterns
      similar to those that have been employed experimentally. Rti and Eti were
      estimated from the simulated data by use of four different estimation techniques
      commonly applied in respiratory mechanics studies. We found that the estimated
      volume dependence of Rti and Eti is sensitive to both the ventilation pattern and
      the estimation technique, being in error by as much as 217 and 22%, respectively.

PMID- 1757319
TI  - How is maximal expiratory flow reduced in canine postpneumonectomy lung growth?
AB  - Six dogs underwent left pneumonectomy (P) at 10 wk of age, while four littermates
      had a sham operation (C). All dogs were studied at 26 wk of age. Pressure
      capsules were placed on the right lung to measure lobar alveolar pressures and
      flows, and a Pitot-static tube was used to measure dynamic intrabronchial
      pressures. Vital capacity and lung elastic recoil did not differ between P and C.
      At all lung volumes studied, maximum expiratory flows (Vmax) in P were
      substantially lower than in C. Choke points in P were located more peripherally
      than in C. In central airways subjected to the same distending pressure,
      calculated cross-sectional area was significantly lower in P than in C,
      indicating different bronchial area-pressure behavior. In P, frictional
      resistances of the right lower, middle, and cardiac lobes were significantly
      higher than those in C. These results indicate that the reduction in Vmax in P
      was greater than would have been expected on the basis of reductions in central
      airway diameter alone. We calculated that, in the middle vital capacity range,
      approximately 60% of the decrease in Vmax was due to changes in dynamic central
      airways properties, and approximately 40% was due to increased lobar frictional
      resistance related to compensatory growth.

PMID- 1757320
TI  - Multiple-breath washout experiments in rat lungs.
AB  - Multiple-breath washouts were performed on 30 Wistar rats postmortem in a study
      in which breaths of 90% O2-5% He-5% SF6 were given. Preliminary comparison of
      alveolar plateau slopes obtained from anesthetized rats in vivo and postmortem
      showed that ventilation distribution remains the same within 1 h after the
      animals were killed. For maneuvers with different preinspiratory lung volumes and
      end-inspiratory breathholding, we computed the normalized N2 slope (Sn) and
      Fowler and Bohr dead spaces [VDF(n) and VDB(n), respectively] as a function of
      breath number (n). For all maneuvers analyzed, Sn of all gases increased in the
      first two or three breaths and reached a horizontal asymptote thereafter. The
      value of Sn decreased, both with increasing preinspiratory lung volume and breath
      hold of 4 s. The fact that the horizontal Sn asymptote is reached after only two
      or three breaths suggests the absence of convection-dependent inhomogeneities
      (CDI) in rat lungs. This contrasts with multiple-breath washout experiments in
      humans, where interregional (gravity-dependent CDI) and intraregional CDI
      generate a marked increase in Sn throughout the entire washout. Also, in contrast
      with results in humans, VDF and VDB were independent of n. The present work
      suggests that rats may be used to study diffusion- and convection-dependent
      inhomogeneities without the influence of CDI or gas exchange.

PMID- 1757321
TI  - Single-breath washout experiments in rat lungs.
AB  - Single-breath washouts were performed on 30 Wistar rats postmortem in studies in
      which breaths of 90% O2-5% He-5% SF6 were given. We investigated the effects of
      variations in preinspiratory lung volume, inspired volume, end-inspiratory breath
      hold time, and inspiratory and expiratory flows on the alveolar plateau slopes
      for N2, He, and SF6. The main result is that the slope for He was always larger
      than the slope for SF6, except for large breath-hold times (approximately 15 s),
      contrary to previous findings in other species. Slopes for the three gases
      decreased with increasing inspiratory and expiratory flows when flows were
      greater than 1 ml/s. There was a strong correlation between the magnitude of a
      slope and its curvilinearity, suggesting that the concentration heterogeneity in
      the lung that causes the slope is due to interaction between diffusion and
      convection. The results seem incompatible with heterogeneities of parenchymal
      elasticity, which have been said to contribute to alveolar slopes in dog lungs
      but appear to be completely explainable as the result of diffusion-convection
      interaction in an asymmetric lung structure that has acini widely spread along
      the tracheobronchial tree.

PMID- 1757322
TI  - Mechanics of running under simulated low gravity.
AB  - Using a linear mass-spring model of the body and leg (T. A. McMahon and G. C.
      Cheng. J. Biomech. 23: 65-78, 1990), we present experimental observations of
      human running under simulated low gravity and an analysis of these experiments.
      The purpose of the study was to investigate how the spring properties of the leg
      are adjusted to different levels of gravity. We hypothesized that leg spring
      stiffness would not change under simulated low-gravity conditions. To simulate
      low gravity, a nearly constant vertical force was applied to human subjects via a
      bicycle seat. The force was obtained by stretching long steel springs via a hand
      operated winch. Subjects ran on a motorized treadmill that had been modified to
      include a force platform under the tread. Four subjects ran at one speed (3.0
      m/s) under conditions of normal gravity and six simulated fractions of normal
      gravity from 0.2 to 0.7 G. For comparison, subjects also ran under normal gravity
      at five speeds from 2.0 to 6.0 m/s. Two basic principles emerged from all
      comparisons: both the stiffness of the leg, considered as a linear spring, and
      the vertical excursion of the center of mass during the flight phase did not
      change with forward speed or gravity. With these results as inputs, the
      mathematical model is able to account correctly for many of the changes in
      dynamic parameters that do take place, including the increasing vertical
      stiffness with speed at normal gravity and the decreasing peak force observed
      under conditions simulating low gravity.

PMID- 1757323
TI  - Fluid replacement and glucose infusion during exercise prevent cardiovascular
      drift.
AB  - This study examined the influence of both hydration and blood glucose
      concentration on cardiovascular drift during exercise. We first determined if the
      prevention of dehydration during exercise by full fluid replacement prevents the
      decline in stroke volume (SV) and cardiac output (CO) during prolonged exercise.
      On two occasions, 10 endurance-trained subjects cycled an ergometer in a 22
      degrees C room for 2 h, beginning at 70 +/- 1% maximal O2 uptake (VO2max) and in
      a euhydrated state. During one trial, no fluid (NF) replacement was provided and
      the subject's body weight declined 2.09 +/- 0.19 kg or 2.9%. During the fluid
      replacement trial (FR), water was ingested at a rate that prevented body weight
      from declining after 2 h of exercise (i.e., 2.34 +/- 0.17 1/2 h). SV declined 15%
      and CO declined 7% during the 20- to 120-min period of the NF trial while heart
      rate (HR) increased 10% and O2 uptake (VO2) increased 6% (all P less than 0.05).
      In contrast, SV was maintained during the 20- to 120-min period of FR while HR
      increased 5% and thus CO actually increased 7% (all P less than 0.05). Rectal
      temperature, SV, and HR were similar during the 1st h of exercise during NF and
      FR. However, after 2 h of exercise, rectal temperature was 0.6 degree C higher (P
      less than 0.05) and SV and CO were 11-16% lower (P less than 0.05) during NF
      compared with FR.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757324
TI  - Pulmonary function in men after oxygen breathing at 3.0 ATA for 3.5 h.
AB  - As a pulmonary component of Predictive Studies V, designed to determine O2
      tolerance of multiple organs and systems in humans at 3.0-1.5 ATA, pulmonary
      function was evaluated at 1.0 ATA in 13 healthy men before and after O2 exposure
      at 3.0 ATA for 3.5 h. Measurements included flow-volume loops, spirometry, and
      airway resistance (Raw) (n = 12); CO diffusing capacity (n = 11); closing volumes
      (n = 6); and air vs. HeO2 forced vital capacity maneuvers (n = 5). Chest
      discomfort, cough, and dyspnea were experienced during exposure in mild degree by
      most subjects. Mean forced expiratory volume in 1 s (FEV1) and forced expiratory
      flow at 25-75% of vital capacity (FEF25-75) were significantly reduced
      postexposure by 5.9 and 11.8%, respectively, whereas forced vital capacity was
      not significantly changed. The average difference in maximum midexpiratory flow
      rates at 50% vital capacity on air and HeO2 was significantly reduced
      postexposure by 18%. Raw and CO diffusing capacity were not changed postexposure.
      The relatively large change in FEF25-75 compared with FEV1, the reduction in
      density dependence of flow, and the normal Raw postexposure are all consistent
      with flow limitation in peripheral airways as a major cause of the observed
      reduction in expiratory flow. Postexposure pulmonary function changes in one
      subject who convulsed at 3.0 h of exposure are compared with corresponding
      average changes in 12 subjects who did not convulse.

PMID- 1757325
TI  - Partitioning of pulmonary responses to inhaled methacholine in puppies.
AB  - Twelve open-chest mongrel puppies, 8-10 wk old, were studied to localize the site
      of action of inhaled methacholine within the lungs. Six puppies were challenged
      with methacholine aerosols and six were challenged with an equal number of
      nebulizations of normal saline (control group). Pulmonary mechanics were measured
      during mechanical ventilation and after midexpiratory flow interruptions.
      Alveolar pressure was measured to allow the partitioning of pulmonary mechanics
      into airway and tissue components. Good matching between airway opening and
      alveolar pressures was seen throughout the study. After methacholine challenge,
      lung resistance increased fivefold. Increases in airway resistance and in the
      parameters reflecting tissue viscoelastic properties contributed to this increase
      in lung resistance. Dynamic lung elastance also increased threefold. The response
      of the methacholine group was statistically different from that of the control
      group. These data indicate that both the airways and pulmonary parenchyma
      contribute to the response to inhaled methacholine in 8- to 10-wk-old puppies.

PMID- 1757326
TI  - Short-term potentiation of breathing in humans.
AB  - The purpose of this study was to determine if the increase in ventilation induced
      by hypoxic stimulation of the carotid bodies (CB) persists after cessation of the
      stimulus in humans. I reasoned that a short-term potentiation (STP) of breathing,
      sometimes called an "afterdischarge," could be unmasked by combining hypoxia with
      exercise, because ventilation increases synergistically under these conditions.
      Seven young healthy men performed mild bicycle exercise (30% peak power) while
      breathing O2 for 1.5 min ("control" state), and their CB were then stimulated by
      1.5 min of hypoxic exercise (10% O2--balance N2). CB stimulation was then
      terminated by changing the inspirate back to O2 as exercise continued.
      Inspiratory and expiratory duration (TI and TE) and inspiratory flow and its time
      integral [tidal volume (VT)] were measured with a pneumotachometer. Inspired
      minute ventilation (VI) and mean inspiratory flow (VT/TI) declined exponentially
      after the cessation of CB stimulation, with first-order time constants of 28.6 +/
      6.7 and 24.6 +/- 1.6 (SD) s, respectively. The slow decay of VI was due
      primarily to potentiation of both TI and TE, although the effect on the latter
      predominated. Additional experiments in six subjects showed that brief intense CB
      stimulation with four to five breaths of N2 during mild exercise induced STP of
      similar magnitude to that observed in the hypoxic exercise experiments. Finally,
      the imposition of hyperoxia during air breathing exercise at a level of
      respiratory drive similar to that induced by the hypoxic exercise did not change
      VI significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757327
TI  - Cigarette smoke in lungs evokes reflex increase in tracheal submucosal gland
      secretion in dogs.
AB  - Stimulation of pulmonary C-fibers (PCs) by capsaicin and of rapidly adapting
      receptors (RARs) by reduced lung compliance reflexly increases airway submucosal
      gland secretion in dogs. Because both PCs and RARs are stimulated by cigarette
      smoke (nicotine being the primary stimulus), we performed experiments in
      anesthetized open-chest artificially ventilated dogs (with aortic nerves cut) to
      determine whether cigarette smoke reflexly stimulates airway secretion. We
      measured submucosal gland secretion by counting the hillocks in a 1.2-cm2 field
      of tracheal epithelium coated with tantalum dust. Secretion was stimulated by
      delivery of 40-320 ml smoke from high-nicotine cigarettes to the lower trachea,
      secretion rate increasing from 7.4 +/- 1.3 to 48.1 +/- 5.1 hillocks.cm-2.min-1.
      Results of cutting the pulmonary vagal branches or carotid sinus nerves or both
      indicated that the secretory response was initiated by stimulation of lower
      respiratory vagal afferents and augmented several seconds later by stimulation of
      carotid chemoreceptors. Results of cooling the cervical vagus nerves to 7 and 0
      degrees C indicated that most of the vagally mediated increase in secretion was
      due to stimulation of afferent lung C-fibers.

PMID- 1757328
TI  - Elevated interstitial fluid volume in rat soleus muscles by hindlimb unweighting.
AB  - Hindlimb unweighting is a commonly used model to study skeletal muscle atrophy
      associated with disuse and exposure to microgravity. However, a discrepancy in
      findings between single fibers and whole muscle has been observed. In unweighted
      solei, specific tension deficits are greater in whole muscle than in single
      fibers. Also, metabolic enzyme activity when normalized per gram of mass is
      depressed in whole muscle but not in single fibers. These observations suggest
      that soleus muscle interstitial fluid volume may be elevated with atrophy caused
      by unweighting in rats. The purpose of this study was to determine if soleus
      muscle atrophy induced by unweighting is accompanied by alterations in muscle
      interstitial fluid volume and to calculate the effect of any such alterations on
      the muscle specific tension (N/cm2 muscle cross-sectional area). Nine female
      Wistar rats (200 g) were hindlimb unweighted (HU) by tail suspension. Soleus
      muscles were studied after 28 days and compared with those from five age-matched
      control (C) rats. Interstitial fluid volume ([3H]inulin space) and maximum
      tetanic tension (Po) were measured in vitro at 25 degrees C. Soleus muscles
      atrophied 58% because of unweighting (C = 147.8 +/- 2.3 mg; HU = 62.3 +/- 3.6 mg,
      P less than 0.001). Relative muscle interstitial fluid volume increased 107% in
      HU rats (35.5 +/- 2.8 microliters/100 mg wet mass) compared with the control
      value of 17.2 +/- 0.5 microliters/100 mg (P less than 0.001); however, absolute
      interstitial fluid volume (microliters) was unchanged.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1757329
TI  - Ibuprofen attenuates plasma tumor necrosis factor activity during sepsis-induced
      acute lung injury.
AB  - Plasma tumor necrosis factor (TNF) activity, cardiac index, extravascular lung
      water, systemic and pulmonary arterial pressures, pulmonary vascular resistance
      index, and arterial PO2 were monitored for 300 min in four groups of anesthetized
      pigs: saline-infused animals (n = 5), saline-infused animals given ibuprofen
      (12.5 mg/kg iv) at 0 and 120 min (n = 4), animals infused for 60 min with live
      Pseudomonas aeruginosa (Ps, 5 x 10(8) organisms/ml at 0.3 ml.20 kg-1.min-1, n =
      6), and animals infused for 60 min with Ps plus ibuprofen administered at 0 and
      120 min (n = 4). Infusion of Ps induced significant elevations (greater than 4
      fold increase in units/ml of TNF by 60 min, P less than 0.05) in plasma TNF
      activity (L929 cytolysis assay) and alterations (P less than 0.05) in all
      hemodynamic and pulmonary parameters within 30-60 min. Ibuprofen administration
      in sepsis significantly decreased peak TNF activity by 2 units/ml and attenuated
      many of the physiological alterations due to sepsis. These results show that
      ibuprofen attenuates sepsis-induced injury and that alterations of acute septic
      insult are correlated with reduced plasma TNF activity in septic animals given
      ibuprofen.

PMID- 1757330
TI  - Glucoregulatory and hormonal responses to repeated bouts of intense exercise in
      normal male subjects.
AB  - Glucose turnover and its regulation were studied during and after two identical
      bouts of intense exhaustive exercise separated by 1 h to define differences in
      response. Six lean young postabsorptive male subjects exercised at approximately
      100% maximal O2 uptake (3.7 +/- 0.3 l/min) for 13.0 +/- 0.7 min for the first
      (EX1) and 13.2 +/- 0.8 min for the second (EX2) bout. Plasma glucose increased
      during EX1 and peaked at 7.0 +/- 0.6 mmol/l in early recovery but to 5.8 +/- 0.5
      mmol/l (P less than 0.05) after EX2, and both the hyperglycemic and the
      hyperinsulinemic responses were less after EX2 (P less than 0.015, analysis of
      variance). The hyperglycemia was due to lesser increments in glucose utilization
      (Rd) (3-fold resting) than glucose production (Ra) (7-fold) toward exhaustion and
      for 7 min of recovery. The rise in Rd was more rapid (P less than 0.05) and
      metabolic clearance rate was greater during (P = 0.015) and from 9 to 60 min
      after EX2, and Ra also remained higher during recovery (P less than 0.05). Marked
      and similar increments in plasma norepinephrine (18-fold) and epinephrine (14
      fold) occurred with both bouts. Plasma glucagon increments were small and not
      different. Therefore, 1) more circulating glucose was used with EX2, 2) greater
      metabolic clearance rate during and after EX2 suggests local muscle adaptations
      due to EX1, and 3) significant correlations (P less than 0.002) between plasma
      norepinephrine and Ra (r = 0.82) and Ra - Rd (r = 0.52) and between epinephrine
      and Ra (r = 0.71) and Ra - Rd (r = 0.48) suggest a major regulatory role for the
      catecholamine responses.

PMID- 1757331
TI  - Blood rheology in acute mountain sickness and high-altitude pulmonary edema.
AB  - The role of blood rheology in the pathogenesis of acute mountain sickness and
      high-altitude pulmonary edema was investigated. Twenty-three volunteers, 12 with
      a history of high-altitude pulmonary edema, were studied at low altitude (490 m)
      and at 2 h and 18 h after arrival at 4,559 m. Eight subjects remained healthy,
      seven developed acute mountain sickness, and eight developed high-altitude
      pulmonary edema. Hematocrit, whole blood viscosity, plasma viscosity, erythrocyte
      aggregation, and erythrocyte deformability (filtration) were measured. Plasma
      viscosity and erythrocyte deformability remained unaffected. The hematocrit level
      was lower 2 h after the arrival at high altitude and higher after 18 h compared
      with low altitude. The whole blood viscosity changed accordingly. The erythrocyte
      aggregation was about doubled 18 h after the arrival compared with low-altitude
      values, which reflects the acute phase reaction. There were, however, no
      significant differences in any rheological parameters between healthy individuals
      and subjects with acute mountain sickness or high-altitude pulmonary edema,
      either before or during the illness. We conclude that rheological abnormalities
      can be excluded as an initiating event in the development of acute mountain
      sickness and high-altitude pulmonary edema.

PMID- 1757332
TI  - Inspiratory timing of heart-lung transplant recipients during progressive
      hypercapnia.
AB  - The relationship between tidal volume (VT) and inspiratory duration (TI) displays
      biphasic characteristics during progressive hypercapnia in humans: an initial
      phase in which VT increases while TI remains constant (region I) and a subsequent
      phase with reciprocal decreases of TI as VT continues to increase (region II).
      Region II behavior is generally attributed, albeit inferentially, to lung volume
      mediated inflation inhibition (Breuer-Hering reflex). To investigate this
      phenomenon, we compared CO2 responses of 10 heart-lung transplant recipients (HL)
      with normal pulmonary function tests and 13 normal controls. Despite pulmonary
      denervation, the HL exhibited region II behavior identical to controls. In four
      additional HL with pulmonary restriction, there were comparative decreases of the
      region II slope (P less than 0.05), but the absolute VT where the phase change
      between regions occurred was indistinguishable from the other groups. We conclude
      that TI shortening in humans during progressive hypercapnia occurs in the absence
      of pulmonary reflexes. The consistency of the VT associated with phase changes,
      despite pulmonary denervation, suggests that the stimulus for this behavior is
      volume displacement of extra-pulmonary respiratory structures.

PMID- 1757333
TI  - Calcium channel blockers inhibit endogenous pyrogen fever in rats and rabbits.
AB  - We have previously shown that febrile responses in both rats and rabbits are
      elicited by the intravenous injection of a semipurified endogenous pyrogen (EP)
      prepared from human monocytes. We are now presenting evidence that these febrile
      responses are mediated via activation of Ca2+ channels by EP. The febrile
      responses of male New Zealand White rabbits and Sprague-Dawley rats to a standard
      dose of EP were determined at their respective thermoneutral ambient
      temperatures. The animals were then treated with Ca2+ channel blocker verapamil
      (7.5 mg/kg iv) 30-60 min before the EP challenge. In every case the febrile
      response to EP was markedly attenuated after verapamil pretreatment, while
      administration of verapamil by itself had no detectable effect on body
      temperature. Another Ca2+ channel blocker, nifedipine (5 mg/kg iv), was shown to
      possess antipyretic activity in rats also. To localize where in the fever pathway
      these Ca2+ channel blockers were acting, we investigated the effect of verapamil
      at the same dose on fevers that were produced by microinjection of prostaglandin
      E (PGE) directly into the brain. These PGE fevers were unaffected by verapamil
      pretreatment, indicating that the antipyretic action of Ca2+ channel blockers
      occurs before the formation of PGE in response to EP stimulation. The most likely
      locus of action is the activation of the enzyme phospholipase A2, which regulates
      the production of arachidonic acid from cellular phospholipids in the prostanoid
      cascade.

PMID- 1757334
TI  - Site of action of calcium channel blockers in inhibiting endogenous pyrogen fever
      in rats.
AB  - We have demonstrated that the Ca2+ channel blocker verapamil, administered
      intravenously, exerts an antipyretic effect on the febrile responses of rats to
      intravenously injected endogenous pyrogen (EP). We have also shown that the same
      intravenous dose of verapamil is ineffective in blocking fevers induced by the
      microinjection of exogenous prostaglandin E (PGE) into the organum vasculosum
      laminae terminalis (OVLT) of rats. Experiments were conducted to determine
      whether the site of this verapamil antipyresis was in the OVLT itself. The
      febrile responses of six male Sprague-Dawley rats to EP were determined at
      thermoneutrality. Verapamil (10 micrograms/rat) was microinjected directly into
      the OVLT, and the febrile responses to the EP dose were redetermined 15-30 min
      later. In every case the EP fevers were attenuated after verapamil pretreatment.
      Intra-OVLT injections of verapamil alone were without effect on body temperature.
      When the same dose of verapamil was injected into the OVLT 15 min before the
      injection of PGE into the same site, it had no effect on the ensuing PGE-induced
      fever. In view of the fact that less than 1/250th of the effective systemic dose
      of verapamil, when injected into the OVLT, was equally effective in blocking the
      EP fevers, we conclude that verapamil acts within the OVLT to block fever rather
      than peripherally. Furthermore, because verapamil administered into the OVLT does
      not block PGE fevers, it is unlikely that PGE produces fever by acting as a Ca2+
      ionophore on hypothalamic neurons.

PMID- 1757335
TI  - Absence of exercise-induced MRI enhancement of skeletal muscle in McArdle's
      disease.
AB  - To assess the role of glycogenolysis in mediating exercise-induced increases in
      muscle water as monitored by changes in muscle proton relaxation times on
      magnetic resonance imaging (MRI) and cross-sectional area (CSA), five patients
      with myophosphorylase deficiency (MPD) were compared with seven controls.
      Absolute and relative work loads were matched during ischemic handgrip and graded
      cycling, respectively. Relaxation times of active muscle did not increase after
      handgrip in MPD (T1: 1 +/- 14%, P greater than 0.1; T2: 4 +/- 4%, P greater than
      0.1) but did in controls (T1: 59 +/- 30%, P less than 0.005; T2: 26 +/- 9%, P
      less than 0.005). The volume of exercised muscles, estimated by CSA, increased in
      both groups after handgrip (controls: 13.8 +/- 3.5%, n = 7, P less than 0.0001;
      MPD: 7.5 +/- 1.5%, n = 4, P less than 0.005), but the change was greater in
      controls (P less than 0.02). Ischemic handgrip in controls resulted in a large
      increase in finger flexor signal intensity (SI) on short tau-inversion recovery
      images (25 +/- 7%, n = 3; P less than 0.005 compared with preexercise) and a
      further increase with subsequent reflow (43 +/- 11%, n = 3; P less than 0.001
      compared with rest); in MPD, SI did not increase. The ratio of active to inactive
      muscle SI did not increase from rest to maximal cycle exercise in MPD (0 +/- 20%,
      n = 2, P greater than 0.1) but did in normals (73 +/- 36%, n = 3; P less than
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757336
TI  - Posterior cricoarytenoid activity and glottic size during hyperpnea in humans.
AB  - We measured the electromyographic activity of the posterior cricoarytenoid (PCA)
      muscle simultaneously with glottic width (dg) in five normal human subjects
      during hyperpnea induced by hypoxia (7% CO2 in N2) or hypercapnia (9% CO2 in 50%
      O2). The glottic aperture was measured during inspiration at the time
      corresponding to peak inspiratory PCA activity and during expiration at the time
      corresponding to the minimum tonic activity. During hyperpnea, peak and tonic PCA
      activity increased simultaneously with widening of the vocal cords in both phases
      of the respiratory cycle. The PCA activity during both inspiration and expiration
      showed a single curvilinear relationship with dg of the form dg = A - Be-k.PCA
      (where A, B, and k are constants) in three of the five subjects. At 50% of
      maximum PCA activity, dg already reached 95% of its maximum value, which was less
      than that recorded during a voluntary forced expiratory maneuver. The single
      curvilinear relationship between PCA activity and dg could be due to the length
      tension relationship of the PCA muscle and/or changes in its mechanical coupling,
      as well as simultaneous agonist and antagonist laryngeal muscle activity during
      progressive chemical stimulation. Also, further widening of the glottis during
      forced expiration suggests recruitment of additional muscles, e.g., the
      arytenoideus.

PMID- 1757337
TI  - Steady and oscillatory transnasal pressure-flow relationships in healthy adults.
AB  - The influence of flow characteristics and gas physical properties on nasal
      resistance (NR) is difficult to ascertain with traditional rhinomanometric
      methods because the respiratory airflows used in these methods are largely
      uncontrolled. As an alternative, we used a novel method of rhinomanometry in
      which an externally generated flow is passed through the nasal passage via a
      mouthpiece. The transnasal pressure-flow relationships for both quasi-steady and
      oscillating flows and with different gases were obtained in five healthy adults
      with this method. For quasi-steady nasal flows the dimensionless pressure losses
      were largely independent of physical properties of the gas and a function of the
      Reynolds number (Re) of the flow. Values of NR for quasi-steady flows were
      largely independent of flow direction for Re up to roughly 3,000 in all five
      subjects and for Re up to roughly 19,000 in two of the five subjects. Airway
      collapse occurred in two subjects at Re greater than 3,000, suggesting that the
      nonrigid segments of the nasal passage contribute to the intersubject variations
      in NR at high flow rates. Pressure losses associated with oscillating flows
      measured at frequencies between 1 and 16 Hz were similar to steady flow losses
      provided that Re was less than roughly 3,000. For Re greater than 3,000 the
      oscillating flow resistances were affected by the phasic redistribution of flow
      into compliant segments of the nasal passage. These results indicate that, for
      flow rates and harmonic frequencies associated with breathing at rest, the nasal
      passage behaves as a rigid rough-walled pipe in which pressure losses are largely
      determined by forces relating to viscous friction and convective accelerations.

PMID- 1757338
TI  - Oxygen cost and oxygen uptake dynamics and recovery with 1 min of exercise in
      children and adults.
AB  - To test the hypothesis that O2 uptake (VO2) dynamics are different in adults and
      children, we examined the response to and recovery from short bursts of exercise
      in 10 children (7-11 yr) and 13 adults (26-42 yr). Each subject performed 1 min
      of cycle ergometer exercise at 50% of the anaerobic threshold (AT), 80% AT, and
      50% of the difference between the AT and the maximal O2 uptake (VO2max) and 100
      and 125% VO2max. Gas exchange was measured breath by breath. The cumulative O2
      cost [the integral of VO2 (over baseline) through exercise and 10 min of recovery
      (ml O2/J)] was independent of work intensity in both children and adults. In
      above-AT exercise, O2 cost was significantly higher in children [0.25 +/- 0.05
      (SD) ml/J] than in adults (0.18 +/- 0.02 ml/J, P less than 0.01). Recovery
      dynamics of VO2 in above-AT exercise [measured as the time constant (tau VO2) of
      the best-fit single exponential] were independent of work intensity in children
      and adults. Recovery tau VO2 was the same in both groups except at 125% VO2max,
      where tau VO2 was significantly smaller in children (35.5 +/- 5.9 s) than in
      adults (46.3 +/- 4 s, P less than 0.001). VO2 responses (i.e., time course,
      kinetics) to short bursts of exercise are, surprisingly, largely independent of
      work rate (power output) in both adults and children. In children, certain
      features of the VO2 response to high-intensity exercise are, to a small but
      significant degree, different from those in adults, indicating an underlying
      process of physiological maturation.

PMID- 1757339
TI  - Relationship between exercise-induced muscle damage and enzyme release in rats.
AB  - The relationship between the amount of exercise-induced muscle damage and the
      release of creatine kinase (CK), aspartate aminotransferase (AST), and lactate
      dehydrogenase (LD) was studied. Gender differences in enzyme release and
      histological damage were also studied. Serial pre- and postexercise blood samples
      were drawn from untrained male and female catheterized Wistar rats that ran 1.5
      or 2.5 h on a treadmill (incline 10 degrees). Three days postexercise, muscle
      damage was quantified morphometrically in five different hindlimb and forearm
      muscles. The 1.5 and 2.5 h of exercise elicited histological damage only in the
      soleus muscle. Significant plasma CK, AST, and LD elevations were found
      immediately postexercise both in male and female rats. However, the enzyme
      release was significantly greater in males than in females. Part of this could be
      explained by differences in clearance rates between males and females. No gender
      difference in amount of histological damage was found. The actual volume of
      histological muscle damage was significantly less than the calculated muscle
      damage based on enzyme release. An increase in the exercise duration from 1.5 to
      2.5 h resulted in a disproportional increase in both histological muscle damage
      and muscle enzyme release. From the present study it is concluded that muscle
      enzyme release is not clearly reflected in histological muscle damage.

PMID- 1757340
TI  - Oxygen radical mechanisms of brain injury following ischemia and reperfusion.
AB  - This review addresses current understanding of oxygen radical mechanisms as they
      relate to the brain during ischemia and reperfusion. The mechanism for radical
      production remains speculative in large part because of the difficulty of
      measuring radical species in vivo. Breakdown of lipid membranes during ischemia
      leads to accumulation of free fatty acids. Decreased energy stores during
      ischemia result in the accumulation of adenine nucleotides. During reperfusion,
      metabolism of free fatty acids via the cyclooxygenase pathway and metabolism of
      adenine nucleotides via the xanthine oxidase pathway are the most likely sources
      of oxygen radicals. Although leukocytes have been found to accumulate in some
      models of ischemia and reperfusion, their mechanistic role remains in question.
      Therapeutic strategies aimed at decreasing brain injury have included
      administration of radical scavengers at the time of reperfusion. Efficacy of
      traditional oxygen radical scavengers such as superoxide dismutase and catalase
      may be limited by their inability to cross the blood-brain barrier. Lipid-soluble
      antioxidants appear more efficacious because of their ability to cross the blood
      brain barrier and because of their presence in membrane structures where
      peroxidative reactions can be halted.

PMID- 1757341
TI  - Cerebral regional capillary perfusion and blood flow after carbon monoxide
      exposure.
AB  - Alterations in regional cerebral blood flow (rCBF) and percent perfused
      capillaries (indicative of functional intercapillary distance) were determined in
      conscious male Long-Evans rats after reducing their blood O2-carrying capacity by
      exposing them to 1% CO for 12 min. rCBF was determined by the iodoantipyrine
      method. rCBF increased from a mean of 106 +/- 8 (SE) ml.min-1.100 g-1 before CO
      exposure to 173 +/- 14 ml.min-1.100 g-1 after CO exposure. There was a greater
      flow increase (126%) in the cerebral cortex than in the lower brain stem [pons
      (45%), medulla (39%)]. Presence of fluorescein isothiocyanate-labeled dextran
      identified the perfused capillaries before and after CO exposure. The volume
      fraction (Vv) and number/mm2 (Na) of all capillaries (perfused and nonperfused)
      in a given area of brain were determined after staining for alkaline phosphatase.
      The percent Vv and percent Na of perfused capillaries increased uniformly (from
      approximately 50% to approximately 80%) in all parts of the brain after CO
      exposure. In the presence of tissue hypoxia with undiminished plasma PO2, the
      brain vasculature allowed greater flow of blood while the microvasculature
      adjusted to reduce the diffusion distance for O2.

PMID- 1757342
TI  - Ventilation during early and late rapid-eye-movement sleep in normal humans.
AB  - Because successive rapid-eye-movement (REM) sleep periods in the night are longer
      in duration and have more phasic events, ventilation during late REM sleep might
      be more affected than in earlier episodes. Despite the increase in eye movement
      density (EMD) in late REM sleep, average minute ventilation was, however, not
      reduced compared with that in early REM sleep. Decreases in rib cage motion (mean
      inspiratory flow of the rib cage) in association with increasing EMD were offset
      by increments in respiratory frequency. Apart from expiratory time, there were no
      significant changes in the slopes of the relationships between EMD and specific
      ventilatory components, from early to late REM sleep periods. However, there was
      an increase in the number of episodes when ventilation was reduced during late
      REM sleep. Changes in ventilatory pattern during late REM sleep are due to
      changes in the underlying nature of REM sleep. The ventilatory response during
      eye movements is, however, subject specific. Some subjects exhibit large
      decrements in mean inspiratory flow of the rib cage and increments in respiratory
      frequency during bursts of eye movement, whereas other individuals demonstrate
      only small changes in these ventilatory parameters.

PMID- 1757343
TI  - Aerosol-derived lung morphometry: comparisons with a lung model and lung function
      indexes.
AB  - This study evaluated the ability of aerosol-derived lung morphometry to
      noninvasively probe airway and acinar dimensions. Effective air-space diameters
      (EAD) were calculated from the time-dependent gravitational losses of 1-microns
      particles from inhaled aerosol boluses during breath holding. In 17 males [33 +/-
      7 (SD) yr] the relationship between EAD and volumetric penetration of the bolus
      into the lungs (Vp) could be expressed by the linear power-law function, log
      (EAD) alpha beta log (Vp). Our EAD values were consistent with Weibel's symmetric
      lung model A for small airways and more distal air spaces. As lung volume
      increased from 57 to 87% of total lung capacity (TLC), EAD at Vp of 160 and 550
      cm3 increased 70 and 41%, respectively. At 57% TLC, log (EAD) at 160 cm3 was
      significantly correlated with airway resistance (r = -0.57, P less than 0.0204)
      but not with forced expired flow between 25 and 75% of vital capacity. Log (EAD)
      at 400 cm3 was correlated with deposition of 1-micron particles (r = -0.73, P
      less than 0.0009). We conclude that aerosol-derived lung morphometry is a
      responsive noninvasive probe of peripheral air-space diameters.

PMID- 1757344
TI  - Effect of oxygenation on breath-by-breath response of the genioglossus muscle
      during occlusion.
AB  - We investigated the effect of different levels of O2 tension (hypoxia, normoxia,
      and hyperoxia) on the breath-by-breath onset and peak electromyographic (EMG)
      activity of the genioglossus (GG) muscle during a five-breath end-expiratory
      tracheal occlusion of 20- to 30-s duration. GG and diaphragmatic (DIA) EMG
      activity were measured with needle electrodes in eight anesthetized
      tracheotomized adult cats. In response to occlusion, the increase in the number
      of animals with GG EMG activity was different during hypoxia, normoxia, and
      hyperoxia (P = 0.003, Friedman). During hypoxia, eight of eight of the animals
      had GG EMG activity by the third occluded effort. In contrast, during normoxia,
      only four of eight and, during hyperoxia, only three of eight animals had GG EMG
      activity throughout the entire five-breath occlusion. Similarly, at release of
      the occlusion, more animals had persistent GG EMG activity on the postocclusion
      breaths during hypoxia than during normoxia or hyperoxia. Breath-by-breath
      augmentation of peak amplitude of the GG and DIA EMGs on each occluded effort was
      accentuated during hypoxia (P less than 0.01) and abolished during hyperoxia (P =
      0.10). These results suggest that hypoxemia is a major determinant of the
      rapidity of onset, magnitude, and sustained activity of upper airway muscles
      during airway occlusion.

PMID- 1757345
TI  - Effects of load on oxygen intake in trained boys and men during treadmill
      running.
AB  - This investigation examines the effects of vertical and horizontal loading on the
      O2 intake (VO2) response of children (n = 8) and adults (n = 8) to treadmill
      running. In unloaded running, the children required a significantly greater VO2
      (P less than 0.001) than the adults [mean difference 7 ml.kg-1.min-1 (18.5%)].
      There was no significant difference in the VO2 response of the children and the
      adults to either vertical or horizontal loading. Vertical loading with 5 and 10%
      of body mass did not produce a significant increase in the VO2 response of either
      group. In contrast, horizontal loading produced a significant increase (P less
      than 0.001) in both groups. The consistent response to the two forms of loading
      suggests that there is no difference between children and adults in the apparent
      efficiency of running with an external load. Stride frequency showed a
      significant increase with vertical loading (P less than 0.001) and a significant
      decrease with horizontal loading (P less than 0.001) in both groups.

PMID- 1757346
TI  - Contribution of exercising legs to the slow component of oxygen uptake kinetics
      in humans.
AB  - Rates of performing work that engender a sustained lactic acidosis evidence a
      slow component of pulmonary O2 uptake (VO2) kinetics. This slow component delays
      or obviates the attainment of a stable VO2 and elevates VO2 above that predicted
      from considerations of work rate. The mechanistic basis for this slow component
      is obscure. Competing hypotheses depend on its origin within either the
      exercising limbs or the rest of the body. To resolve this question, six healthy
      males performed light nonfatiguing [approximately 50% maximal O2 uptake (VO2max)]
      and severe fatiguing cycle ergometry, and simultaneous measurements were made of
      pulmonary VO2 and leg blood flow by thermodilution. Blood was sampled 1) from the
      femoral vein for O2 and CO2 pressures and O2 content, lactate, pH, epinephrine,
      norepinephrine, and potassium concentrations, and temperature and 2) from the
      radial artery for O2 and CO2 pressures, O2 content, lactate concentration, and
      pH. Two-leg VO2 was thus calculated as the product of 2 X blood flow and
      arteriovenous O2 difference. Blood pressure was measured in the radial artery and
      femoral vein. During light exercise, both pulmonary and leg VO2 remained stable
      from minute 3 to the end of exercise (26 min). In contrast, during severe
      exercise [295 +/- 10 (SE) W], pulmonary VO2 increased 19.8 +/- 2.4% (P less than
      0.05) from minute 3 to fatigue (occurring on average at 20.8 min). Over the same
      period, leg VO2 increased by 24.2 +/- 5.2% (P less than 0.05). Increases of leg
      and pulmonary VO2 were highly correlated (r = 0.911), and augmented leg VO2 could
      account for 86% of the rise in pulmonary VO2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757347
TI  - Ventilatory effects and interactions with change in PaO2 in awake goats.
AB  - We utilized selective carotid body (CB) perfusion while changing inspired O2
      fraction in arterial isocapnia to characterize the non-CB chemoreceptor
      ventilatory response to changes in arterial PO2 (PaO2) in awake goats and to
      define the effect of varying levels of CB PO2 on this response. Systemic
      hyperoxia (PaO2 greater than 400 Torr) significantly increased inspired
      ventilation (VI) and tidal volume (VT) in goats during CB normoxia, and systemic
      hypoxia (PaO2 = 29 Torr) significantly increased VI and respiratory frequency in
      these goats. CB hypoxia (CB PO2 = 34 Torr) in systemic normoxia significantly
      increased VI, VT, and VT/TI; the ventilatory effects of CB hypoxia were not
      significantly altered by varying systemic PaO2. We conclude that ventilation is
      stimulated by systemic hypoxia and hyperoxia in CB normoxia and that this
      ventilatory response to changes in systemic O2 affects the CB O2 response in an
      additive manner.

PMID- 1757348
TI  - Nebulized vs. instilled exogenous surfactant in an adult lung injury model.
AB  - Three days after subcutaneous injection of N-nitroso-N-methylurethane (NNNMU) to
      induce lung injury, adult rabbits were mechanically ventilated and lung function
      was evaluated. Each animal then received either nebulized Survanta (Neb Surv),
      nebulized saline (Neb Saline), nebulized gas alone (Neb Gas), or tracheally
      instilled Survanta (Inst Surv). The ventilation efficiency index (VEI) value
      increased significantly compared with pretreatment values (P less than 0.01) over
      a 3-h treatment period for the Neb Surv animals, whereas VEI values for the other
      three groups decreased after treatment (P less than 0.05). Arterial PO2-to
      fraction of inspired O2 ratios and dynamic compliance values significantly
      decreased after treatment for the Inst Surv group (P less than 0.05). Pressure
      volume curves demonstrated a significantly greater volume at maximal pressure for
      the Neb Surv group compared with each of the other groups studied (P less than
      0.01). The calculated quantity of surfactant recovered in lung tissue for the Neb
      Surv group was only 4.9 +/- 1.0 mg lipid/kg compared with 100 mg lipid/kg
      delivered to the Inst Surv group. Surfactant administered as an aerosol resulted
      in modest physiological improvements in this model of lung injury and was
      superior to the tracheal instillation technique.

PMID- 1757349
TI  - Effect of aging on human adductor pollicis muscle function.
AB  - The effect of aging on the voluntary and electrically evoked contractile
      properties of the human adductor pollicis muscle was investigated in 70 healthy
      male subjects aged 20-91 yr, 10 subjects for each decade. Maximum isometric
      voluntary force declined significantly (range of P values less than 0.001-0.05)
      after the age of 59 yr, dropping by the eighth decade to 57.6% of the level
      recorded in the second decade. A significant shift (P range less than 0.001-0.05)
      to the left of the frequency-force curve after ulnar nerve supramaximal
      stimulation at 1, 10, 20, 30, and 50 Hz was observed in the most elderly group
      (greater than 80 yr) compared with the youngest group (20-29 yr). Maximum
      relaxation rate dropped by 48.7% from the second to the eighth decade. The
      decrease became significant (P range less than 0.05-0.001) with the sixth decade.
      Isometric endurance, evaluated during 30 s of stimulation at 30 Hz, showed a
      linear (P less than 0.001) increase with age. Aged muscle is thus weaker, slower,
      and tetanized at lower fusion frequencies but, paradoxically, more resistant to
      static fatigue.

PMID- 1757350
TI  - Changes in tracheal mucosal thickness and blood flow in sheep.
AB  - Airway narrowing may be produced by increasing the blood volume of the airway
      mucosa. Here changes in tracheal mucosal thickness (MTtr) were measured in 10
      anesthetized sheep. Arteries to the cervical trachea were isolated, and blood
      flow (Qtr) was measured with an electromagnetic flow probe. Simultaneous changes
      in MTtr were measured with a mechanical probe over a fixed cartilage. Arterial
      injections of phenylephrine produced dose-related falls in Qtr and MTtr with a
      maximum peak fall in MTtr of -104 +/- 18 (SE) microns. Methacholine, bradykinin,
      albuterol, and histamine produced dose-related increases in Qtr. The largest peak
      increase in MTtr of 308 +/- 121 microns was seen with bradykinin. For
      methacholine, albuterol, and histamine the largest increases in MTtr were 154 +/-
      47, 45 +/- 10, and 153 +/- 31 microns, respectively. The increases in MTtr were
      not always closely dose related. The peak changes in MTtr occurred substantially
      later than those in Qtr for all the drugs and up to 120 s later for methacholine
      and bradykinin. Generally, changes in MTtr and Qtr persisted for less than 10
      min; at the higher doses of bradykinin increases in MTtr lasted for up to 15 min.
      Changes in MTtr were most closely associated in time with changes in Qtr for the
      vasoconstrictor phenylephrine. These changes in MTtr would alter airway
      resistance little in the normal trachea and by substantially more in smaller
      airways such as the bronchi or in the narrowed trachea. Changes in mucosal
      thickness may be due not only to changes in tracheal blood volume but may also
      reflect the effects of tissue edema and mucus secretion.

PMID- 1757351
TI  - Core temperature "null zone".
AB  - An experimental protocol was designed to investigate whether human core
      temperature is regulated at a "set point" or whether there is a neutral zone
      between the core thresholds for shivering thermogenesis and sweating. Nine male
      subjects exercised on an underwater cycle ergometer at a work rate equivalent to
      50% of their maximum work rate. Throughout an initial 2-min rest period, the 20
      min exercise protocol, and the 100-min recovery period, subjects remained
      immersed to the chin in water maintained at 28 degrees C. On completion of the
      exercise, the rate of forehead sweating (Esw) decayed from a mean peak value of
      7.7 +/- 4.2 (SD) to 0.6 +/- 0.3 g.m-2.min-1, which corresponds to the rate of
      passive transpiration, at core temperatures of 37.42 +/- 0.29 and 37.39 +/- 0.48
      degrees C, as measured in the esophagus (Tes) and rectum (Tre), respectively.
      Oxygen uptake (VO2) decreased rapidly from an exercising level of 2.11 +/- 0.25
      to 0.46 +/- 0.09 l/min within 4 min of the recovery period. Thereafter, VO2
      remained stable for approximately 20 min, eventually increased with progressive
      cooling of the core region, and was elevated above the median resting values
      determined between 15 and 20 min at Tes = 36.84 +/- 0.38 degrees C and Tre =
      36.80 +/- 0.39 degrees C. These results indicate that the core temperatures at
      which sweating ceases and shivering commences are significantly different (P less
      than 0.001) regardless of whether core temperature is measured within the
      esophagus or rectum.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757352
TI  - Effect of catheter size on pressures recorded in small pulmonary veins in dog
      lung.
AB  - Controversy continues about the contribution of the veins to pulmonary vascular
      resistance. From data obtained in studies using intravascular catheters, it
      appears that a major fraction (up to 44%) of the total pulmonary vascular
      pressure drop resides in larger (greater than 1.0 mm diam) veins, whereas
      micropuncture data and various models give much less pressure drop.
      Theoretically, artifactual pressure drops can be obtained if an intravascular
      catheter partly obstructs the vessel. We made measurements of pressure in the
      same lung vein with two different-sized catheters (1.2 and 0.6 mm OD,
      respectively). In paired experiments the larger catheter always measured a higher
      pressure than the smaller one, except close to the large lobar vein outlet. In
      some of the experiments we measured the diameter of the vessel containing the
      indwelling catheter by freezing the lung and then serial-sectioned the frozen
      lung. From these data we could infer that the range of vein diameter in the which
      the smaller catheter measured a lower pressure was 1.5-4 mm. We conclude that the
      larger catheter overestimated the pressure because of greater obstruction. The
      pressures obtained with the smaller catheter suggest that little (less than 10%)
      of the total pulmonary vascular resistance resides in veins larger than
      approximately 1 mm diam under zone 3 baseline conditions.

PMID- 1757353
TI  - Myocardial function and energy substrate metabolism in the insulin-resistant
      JCR:LA corpulent rat.
AB  - Alterations in myocardial energy substrate utilization contribute to the
      development of cardiomyopathic changes in insulin-dependent and non-insulin
      dependent diabetic rats. Energy substrate utilization and contractile function,
      however, have not been characterized in insulin-resistant diabetes. In this
      study, we studied these parameters in the insulin-resistant obese JCR:LA-cp rat
      homozygous for the corpulent gene (cp/cp). Homozygous (+/+) or heterozygous
      (+/cp) lean non-insulin-resistant rats were used as controls. Isolated working
      hearts from cp/cp and lean control rats were perfused with Krebs-Henseleit buffer
      containing either 11 mM [U-14C]glucose and 0.4 mM palmitate or 11 mM glucose and
      0.4 mM [1-14C]palmitate. Unlike control hearts, hearts from cp/cp rats were found
      to require high doses of insulin and Ca2+ concentrations of less than or equal to
      1.75 mM to maintain mechanical function. In the presence of 2,000 microU/ml
      insulin, contractile function from cp/cp rat hearts was not depressed in the
      presence of either 1.25 or 1.75 mM Ca2+. Steady-state glucose oxidation rates in
      hearts perfused with 1.25 mM Ca2+ and 2,000 microU/ml insulin were 811 +/- 86
      (SE) and 612 +/- 51 nmol.min-1.g dry wt-1 in cp/cp and control rats,
      respectively. Palmitate oxidation was 307 +/- 47 and 307 +/- 47 nmol.min-1.g dry
      wt-1 in cp/cp and lean control hearts, respectively. Under these perfusion
      conditions, 40% of myocardial ATP production was derived from glucose, whereas
      60% was derived from palmitate in both cp/cp and control rats.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1757354
TI  - Thiol modification in H2O2- and thromboxane-induced vaso- and bronchoconstriction
      in rat perfused lung.
AB  - Hydrogen peroxide (H2O2), arachidonic acid (AA), and U-44069, a thromboxane
      analogue, all induced vaso- and bronchoconstriction in the isolated perfused rat
      lung. The role of protein sulfhydryl modifications in these processes was
      investigated. The thiol oxidizing agent diamide inhibited both vaso- and
      bronchoconstriction induced by H2O2, AA, or U-44069. Diamide had only a marginal
      effect on glutathione and protein thiol levels and no effect on lung mechanics.
      The diamide inhibition was reversible, and H2O2-induced vaso- and
      bronchoconstriction was almost maximal after 10 min of perfusion with buffer. The
      recovery was more rapid if dithiothreitol, a thiol reducing agent, was used in
      the buffer. H2O2- and AA-induced vaso- and bronchoconstriction is caused by
      thromboxane release. Diamide did not influence H2O2- or AA-dependent thromboxane
      formation, indicating that neither AA release nor AA metabolism to thromboxane is
      sensitive to thiol oxidation. Thus our results indicate that the site of diamide
      induced thiol oxidation is the thromboxane receptor or its signal transduction.

PMID- 1757355
TI  - Site of action of hypertonic saline in the canine lung.
AB  - The site of action of inhaled hypertonic saline was determined in 8- to 10-wk-old
      puppies by combining measurements of respiratory mechanics, made during
      mechanical ventilation and after midexpiratory flow interruptions, with direct
      measurements of alveolar pressure. Under both control conditions and after
      inhalation of 10% saline, we were able to partition lung mechanics into
      components representing the airways and tissue viscoelastic properties.
      Hypertonic saline challenge altered lung mechanics by increasing airway
      resistance and did not have any effect on elastic or viscoelastic properties of
      the lung.

PMID- 1757356
TI  - Effects of muscle glycogen and plasma FFA availability on human metabolic
      responses in cold water.
AB  - The purpose of this study was to investigate whether simultaneous alterations in
      the availability of plasma free fatty acids and muscle glycogen would impair the
      maintenance of thermal balance during cold water immersion in humans. Eight
      seminude subjects were immersed on two occasions in 18 degrees C water for 90 min
      or until rectal temperature (Tre) decreased to 35.5 degrees C. Each immersion
      followed 2.5 days of a specific dietary and exercise regimen designed to elicit
      low (LOW) or high glycogen levels (HIGH) in large skeletal muscle groups.
      Nicotinic acid (1.6 mg/kg) was administered for 2 h before and during immersion
      to inhibit white adipose tissue lipolysis. Biopsies from the vastus lateralis
      showed that the glycogen concentration before the immersion was significantly
      lower in LOW than in HIGH (223 +/- 19 vs. 473 +/- 24 mmol glucose units/kg dry
      muscle). However, the mean rates of glycogen utilization were not significantly
      different between trials (LOW 0.62 +/- 0.14 vs. HIGH 0.88 +/- 0.15 mmol glucose
      units.kg-1.min-1). Nicotinic acid dramatically reduced plasma free fatty acid
      levels in both trials, averaging 127 +/- 21 mumol/l immediately before the
      immersion. Cold water immersion did not significantly alter those levels. Plasma
      glucose levels were significantly reduced after cold water immersion to a similar
      extent in both trials (18 +/- 4%). Mean respiratory exchange ratio at rest and
      during immersion was greater in HIGH than LOW, whereas there were no intertrial
      differences in O2 uptake. The calculated average metabolic heat production during
      immersion tended to be lower (P = 0.054) in LOW than in HIGH (15.3 +/- 1.9 vs.
      17.5 +/- 1.9 kJ/min).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757357
TI  - Effect of geniohyoid and sternohyoid muscle contraction on upper airway
      resistance in the cat.
AB  - Previous investigators (van Lunteren et al. J. Appl. Physiol. 62: 582-590, 1987)
      have suggested that the geniohyoid and sternohyoid muscles may act as upper
      airway dilators in the cat. To investigate the effect of geniohyoid and
      sternohyoid contraction on inspiratory upper airway resistance (UAR), we studied
      five adult male cats anesthetized with ketamine and xylazine during spontaneous
      room-air breathing. Inspiratory nasal airflow was measured by sealing the lips
      and constructing a nose mask. Supraglottic pressure was measured using a
      transpharyngeal catheter placed above the larynx. Mask pressure was measured
      using a separate catheter. Geniohyoid and sternohyoid lengths were determined by
      sonomicrometry. Geniohyoid and sternohyoid contraction was stimulated by direct
      muscle electrical stimulation with implanted wire electrodes. Mean inspiratory
      UAR was determined for spontaneous breaths under three conditions: 1) baseline
      (no muscle stimulation), 2) geniohyoid contraction alone, and 3) sternohyoid
      contraction alone. Geniohyoid contraction alone produced no significant reduction
      in inspiratory UAR [unstimulated, 17.75 +/- 0.86 (SE) cmH2O.l-1.s; geniohyoid
      contraction, 19.24 +/- 1.10]. Sternohyoid contraction alone also produced no
      significant reduction in inspiratory UAR (unstimulated, 15.74 +/- 0.92 cmH2O.l
      1.s; sternohyoid contraction, 14.78 +/- 0.78). Simultaneous contraction of the
      geniohyoid and sternohyoid muscles over a wide range of muscle lengths produced
      no consistent change in inspiratory UAR. The geniohyoid and sternohyoid muscles
      do not appear to function consistently as upper airway dilator muscles when UAR
      is used as an index of upper airway patency in the cat.

PMID- 1757358
TI  - Effects of hypoxia and cold acclimation on thermoregulation in the rat.
AB  - The effects of hypoxia (inspired O2 fraction = 0.12) on thermoregulation and on
      the different sources of thermogenesis were studied in rats before and after
      periods of 1-4 wk of cold acclimation. Measurements of metabolic rate (VO2) and
      body temperature (Tb) were made at 5-min intervals, and shivering activity was
      recorded continuously in groups of rats subjected to three protocols. In protocol
      1, rats were exposed to normoxia to an ambient temperature (Ta) of 5 degrees C
      for 2 h. In protocol 2, at Ta of 5 degrees C, rats were exposed for 30 min to
      normoxia, then for 45 min to hypoxia, and finally for 30 min to normoxia. In
      protocol 3, in the non-cold-acclimated (NCA) rats, Ta was decreased from 30 to 5
      degrees C in steps of 5 degrees C and of 30-min duration while in cold-acclimated
      (CA) rats at 5 degrees C for 4-wk, Ta was increased from 5 to 30 degrees C in
      steps of 5 degrees C and of 30-min duration. Recordings were made in normoxia and
      in hypoxia on different days in the same animals. The results showed that 1) in
      NCA rats, cold exposure in normoxia induced increases in VO2 and shivering that
      were proportional to the decrease in Ta; 2) in CA rats in normoxia, for a given
      Ta, VO2 and Tb were higher than in NCA rats, whereas shivering was generally
      lower; and 3) in both NCA and CA rats, hypoxia induced a transient decrease in
      shivering and a sustained decrease in nonshivering thermogenesis associated with
      a marked decrease in Tb that was about the same in NCA and CA rats. We speculate
      that hypoxia acts on Tb control to produce a general inhibition of thermogenesis.
      Nonshivering thermogenesis is markedly sensitive to hypoxia, especially
      demonstrable in CA rats; a recovery or even an increase in shivering can
      compensate for the decrease in nonshivering thermogenesis.

PMID- 1757359
TI  - Lesions in retrotrapezoid nucleus decrease ventilatory output in anesthetized or
      decerebrate cats.
AB  - Kainic acid (KA) injections into the retrotrapezoid nucleus (RTN) of anesthetized
      deafferented cats profoundly decreased phrenic activity (PA) and CO2 sensitivity
      (J. Appl. Physiol. 68: 1157-1166, 1990). In this study small electrolytic lesions
      of the RTN produced the same results, indicating that the KA destroyed cells. We
      then asked whether anesthetic depression or the absence of peripheral
      chemoreceptors could explain the degree of respiratory depression observed. In
      decerebrate cats electrolytic lesions of the RTN resulted in a decrease in PA
      similar to that seen under anesthesia. CO2 sensitivity was decreased by RTN
      lesions that extended into the caudal RTN but less so than under anesthesia. KA
      injections resulted in an initial increase in PA followed by a continuous
      decrease, a pattern similar to that seen under anesthesia but with a slower time
      course. CO2 sensitivity was essentially absent. Peripheral chemodenervation
      produced a small further decrease in PA and a downward shift of the CO2 response
      without change in slope. Blood pressure was unaffected by RTN lesions but was
      decreased by more-caudal lesions without respiratory effects. The RTN appears to
      be necessary for the maintenance of eupneic phrenic activity and CO2 sensitivity
      even in decerebrate cats with intact peripheral chemoreceptors.

PMID- 1757360
TI  - Thromboxane synthase inhibition and cardiopulmonary function during endotoxemia
      in sheep.
AB  - We studied the cardiopulmonary response to endotoxin (lipopolysaccharide, LPS) in
      sheep with and without the administration of a thromboxane synthase inhibitor,
      OKY-046. The animals were instrumented for crystalographic dimension analysis of
      the left ventricle (LV) and for measurement of LV, aortic, left atrial, and
      pulmonary arterial pressures and cardiac index, as well as lung lymph flow. They
      received 1.0 micrograms/kg of Escherichia coli LPS with (n = 8) and without (n =
      8) OKY-046 (10 mg/kg bolus, then 10 micrograms.kg-1.min-1). OKY-046 prevented the
      increase of pulmonary arterial pressure and the decrease of cardiac index that
      occurred during the early phase of endotoxemia. Between 8 and 12 h after LPS,
      cardiac index increased from 6.8 +/- 0.7 to 8.9 +/- 0.51.min-1.m-2.
      Concomitantly, the end-systolic pressure-diameter relationship (ESPDR, sensitive
      myocardial contractility index) significantly decreased from 14.7 +/- 0.6 to 7.7
      +/- 0.7. Other indexes of the LV contractility (+dP/dtmax) were also reduced. OKY
      046 prevented the decreases of ESPDR and +dP/dtmax. OKY-046 also attenuated the
      increased lung lymph flow changes seen with LPS.

PMID- 1757361
TI  - Effect of hypovolemia on forearm vascular resistance control during exercise in
      the heat.
AB  - To determine the influence of hypovolemia on the control of forearm vascular
      resistance (FVR) during dynamic exercise, we studied five physically active men
      during 60 min of supine cycle ergometer exercise bouts at 35 degrees C in control
      (normovolemic) and hypovolemic conditions. Hypovolemia was achieved by 3 days of
      diuretic administration and resulted in an average decrease in plasma volume of
      15.9%. Relative to normovolemia, hypovolemia caused an attenuation of the
      progressive rise in forearm blood flow (P less than 0.05) and an increase in
      heart rate (P less than 0.05) during exercise. Because mean arterial blood
      pressure during hypovolemic exercise was well maintained, the attenuation of
      forearm blood flow was due entirely to a relative increase in FVR. At the onset
      of dynamic exercise, FVR was increased significantly in control and hypovolemic
      conditions by 13.2 and 27.1 units, respectively. The increase in FVR was
      significantly different between control and hypovolemic conditions as well. We
      attributed the increased vasoconstrictor bias during hypovolemia to
      cardiopulmonary baroreceptor unloading and/or an increased sensitivity to
      cardiopulmonary baroreceptor unloading. We concluded that reduced blood flow to
      the periphery during exercise in the hypovolemic condition was caused entirely by
      an increase in vascular resistance, thereby preserving arterial blood pressure
      and adequate perfusion to the organs requiring increased flow.

PMID- 1757362
TI  - Effects of high-intensity sprint training on skeletal muscle blood flow in rats.
AB  - The regional blood flow response (via radioactive microspheres) was determined
      for female rats after 6 wk of high-intensity sprint training (HIST) or limited
      cage activity as the animals exercised at work loads that would elicit maximal O2
      uptake. Blood flow to the different organs of the abdominal region was greatly
      reduced during maximal exercise conditions, and the magnitude of the reduction
      appeared to be similar for both the HIST group of rats and their sedentary (SED)
      control counterparts. Of the 20 different hindlimb muscles examined in the
      present study, blood flow to the soleus, plantaris, gastrocnemius, flexor
      hallicus longus, vastus lateralis, rectus femoris, biceps femoris, and adductor
      magnus and brevis muscles was significantly greater (P less than 0.05) in the
      HIST rats during maximal exercise conditions than in the SED control rats.
      Correspondingly, blood flow to the total hindlimb during maximal exercise was
      also significantly greater in the HIST rats than in the SED control rats [240 +/-
      18 vs. 192 +/- 15 (SE) ml.min-1.100 g-1]. These results support the contention
      that the increase in maximal cardiac output that is produced by HIST in the rat
      is primarily directed toward the working skeletal muscle and not toward the
      organs found in the abdominal region. We conclude from these experiments that
      HIST will produce significant adaptations in central cardiac function and
      skeletal muscle blood flow in the rat.

PMID- 1757363
TI  - Analysis of pulmonary microvascular permeability after smoke inhalation.
AB  - We estimated the reflection (sigma) and filtration coefficients (Kf) in a chronic
      sheep lung lymphatic preparation after smoke inhalation. Group I (n = 7) sheep
      were insufflated with cotton smoke and group II animals (n = 5) with room air.
      After inhalation injury, the lung lymph flow increased nearly four times the
      baseline value by 24 h after injury. There was a concomitant reduction of sigma
      (0.81 +/- 0.02 to 0.64 +/- 0.02) and elevation of Kf (0.020 +/- 0.002 to 0.042 +/
      0.009 ml.min-1.mmHg-1); pulmonary capillary pressure was also elevated (13 +/- 1
      to 17 +/- 1 mmHg). By 48 h postinjury, sigma and Kf returned toward baseline but
      pulmonary capillary pressure was still elevated. We determined that 34% of the
      increase in capillary filtration was attributable to increased capillary pressure
      and 66% to increased permeability 24 h after inhalation, but 48 h after injury,
      75% of the increase in capillary filtration was attributable to increased
      capillary pressure and 25% to increased permeability. We conclude that the lung
      edema formation following smoke inhalation is the result of marked increases in
      both capillary pressure and permeability.

PMID- 1757364
TI  - Heparin reversal by protamine in humans--complement, prostaglandins, blood cells,
      and hemodynamics.
AB  - Fourteen noncardiac surgical patients received heparin (10,000 IU), which was
      neutralized by 100 mg protamine injected within 2 min during steady-state
      anesthesia. After protamine application, plasma complement C3a, thromboxane B2
      (TxB2), prostaglandin F2 alpha (PGF2 alpha) and KH2PGF2 alpha increased
      significantly, whereas prostacyclin (6-keto-PGF2 alpha) levels did not change.
      This mediator response was associated with transient leukopenia and
      thrombocytopenia. Arterial pressure, pulmonary arterial pressure, and
      transpulmonary pressure gradient increased significantly. Heart rate, cardiac
      output, pulmonary capillary wedge pressure, and arterial PO2 remained constant.
      Positive correlations of plasma C3a were observed with pulmonary
      leukosequestration and plasma TxB2. Inverse correlations of C3a were noted with
      the counts of leukocytes and of platelets. A positive correlation was found
      between TxB2 and pulmonary arterial pressure. Our results indicate that marked
      activation of the complement system and the cyclooxygenase pathway is common
      after heparin reversal by protamine in anesthetized patients. This is in contrast
      to previous human studies performed after cardiopulmonary bypass but agrees well
      with results obtained in animal experiments. The mediator response in our
      patients, however, was not accompanied by hemodynamic instability, suggesting
      appropriate compensatory mechanisms.

PMID- 1757365
TI  - Acoustic myography for investigating human skeletal muscle fatigue.
AB  - Sounds produced during voluntary isometric contractions of the quadriceps muscle
      were studied by acoustic myography (AMG) in five healthy adults. With the subject
      seated, isometric force, surface electromyography (EMG), and AMG were recorded
      over rectus femoris, and the EMG and AMG signals were integrated (IEMG and IAMG).
      Contractions lasting 5 s each were performed at 10, 25, 50, 60, 75, and 100% of
      maximum voluntary contraction (MVC) force. Fatigue was then induced by repeated
      voluntary contractions (10 s on, 10 s off) at 75% MVC until only 40% MVC could be
      sustained. After 15 min of rest, the different force levels were again tested in
      relation to the fresh MVC. Both before and after fatiguing activity the
      relationships between force and IEMG [r = 0.99 +/- 0.01 (SD), n = 10] and force
      and IAMG (r = 0.98 +/- 0.02) were linear. After activity, however, the slopes of
      the regression lines for force and IEMG increased (P less than 0.01) but those
      for force and IAMG remained the same (P greater than 0.05). The present results
      clarify the relationship between AMG and isometric force in fatigued muscle
      without the problem of fatigue-induced tremor, which hampered previous studies of
      prolonged activity. This study contributes to the validation of AMG and shows
      that it is a potentially useful method for noninvasive assessment of force
      production and fatigue. Further studies to establish the origin of AMG activity
      are required before AMG can be accepted for use in neuromuscular physiology or
      rehabilitation.

PMID- 1757366
TI  - Plasma catecholamine and lactate response during graded exercise with varied
      glycogen conditions.
AB  - The relationships between the lactate threshold (TLa), plasma catecholamines, and
      ventilatory threshold (TVE) were examined under normal and glycogen-depleted
      conditions. Nine male subjects performed a graded exercise test on a bicycle
      ergometer in a normal glycogen (NG) state and in a glycogen-depleted (GD) state
      to determine if manipulation of muscle glycogen content would affect their
      ventilatory, lactate, and catecholamine responses. High correlations were found
      between plasma lactate and the two catecholamines, epinephrine (r = 0.964) and
      norepinephrine (r = 0.965) under both conditions. The GD protocol resulted in a
      shift in the TLa to a later work rate; inflections in epinephrine and
      norepinephrine shifted in a coordinated manner. TVE and TLa occurred at similar
      work loads under NG conditions [67.2 +/- 1.5 and 65.6 +/- 2.3% maximal oxygen
      consumption (VO2max), respectively], but TLa occurred at a later work load (75.3
      +/- 1.9% VO2max) compared with TVE (68.3 +/- 1.6% VO2max) under GD conditions.
      These results suggest a causal relationship between plasma lactate and
      epinephrine during a graded exercise test under the glycogen conditions studied.
      Although an association existed between ventilation and lactate, this
      relationship was not as strong.

PMID- 1757367
TI  - Role of the epithelium in airway smooth muscle responses to relaxant agonists.
AB  - We studied the role of the guinea pig tracheal epithelium in modulating tracheal
      smooth muscle responses to the relaxant agonists albuterol, sodium nitroprusside,
      and theophylline. We used an in vitro preparation that allowed separation of the
      fluids bathing the luminal (internal) and serosal (external) surfaces of the
      trachea, and bronchodilators were administered to either surface of carbachol
      contracted tracheae. All three drugs produced dose-dependent relaxation. However,
      albuterol and nitroprusside were less potent (concentration that produced half
      maximal effect increased by 100- and 32-fold, respectively) when given to the
      epithelial side with the epithelium intact compared with the epithelium denuded
      or compared with serosal administration with the epithelium intact. These
      differences were not observed for theophylline, where smooth muscle responses
      were independent of either the side of stimulation or of the presence or absence
      of the epithelium. Direct measurements of the diffusion of theophylline across
      the tracheal wall in the presence or absence of epithelium showed that after 5 h
      of incubation with a fixed luminal concentration of theophylline, only 1.7% had
      diffused across the tracheal wall with the epithelium intact. This increased to
      only approximately 3.3% when the epithelium was denuded. These results suggest
      that the epithelial is a relatively weak barrier for lipophilic agents but has a
      major role as a diffusion barrier to hydrophilic substances.

PMID- 1757368
TI  - Effects of flow on recombinant tissue plasminogen activator-induced pulmonary
      thrombolysis.
AB  - We employed a canine model of pulmonary embolism induced by injection of
      radioactive blood clots to investigate effects of changes in cardiac output (CO)
      on recombinant tissue plasminogen activator- (rtPA) induced pulmonary
      thrombolysis. Rate and extent of thrombolysis were assessed with a gamma camera.
      Eighteen dogs were studied. Emboli increased mean pulmonary arterial pressure and
      decreased CO from 2.6 to 1.9 l/min (P less than 0.001). Subsequently, dogs were
      randomly divided into three groups: group 1 received 0.5 mg/kg of rtPA over 30
      min; 30 min before the same dose regimen of rtPA, in the six group 2 dogs, mean
      CO was increased to approximately 3.25 l/min by opening one systemic
      arteriovenous fistula; in the six group 3 dogs, before rtPA, mean CO was
      increased to approximately 4.5 l/min by opening two or three fistulas. After
      embolization, CO remained low in group 1; the mean 2-h time-averaged CO was 1.8
      l/min. CO was much higher in groups 2 and 3 (3.3 and 4.6 l/min, respectively;
      both P less than 0.001 compared with group 1; and P less than 0.001, group 2 vs.
      group 3). Compared with group 1, corresponding to the increased flow in groups 2
      and 3, rate and extent of pulmonary thrombolysis significantly increased. These
      results indicate that an increase in flow per se augments rtPA-induced pulmonary
      thrombolysis. Also, because thrombolysis was similar between groups 2 and 3,
      these results define an upper limit to the flow-thrombolytic relationship with
      rtPA.

PMID- 1757369
TI  - Cerebral metabolic and pressure-flow responses during sustained hypoxia in awake
      sheep.
AB  - Conscious sheep (n = 6), exposed to 3.5 h of normobaric hypoxia (arterial PO2 =
      40 Torr) while allowed varying arterial PCO2, showed striking early increments of
      cerebral blood flow (CBF; +200-250%, by radiolabeled microspheres) and decrements
      of cerebral vascular resistance (CVR) in association with an early temporary
      elevation of cerebral O2 consumption (CMRO2; +25-60%). After 2 h, CMRO2 returned
      to normoxic levels, while CBF declined to a lower but still elevated level
      (+150%). CBF/CMRO2 increased twofold, while cerebral fractional extraction of O2
      was unchanged. Mean arterial pressure was unchanged, but cerebral venous pressure
      rose (+11 mmHg) in a stable fashion such that cerebral perfusion pressure
      declined by 13%. Cerebral venous hematocrit and hemoglobin concentration were
      both elevated (+2.2-2.7% Hct units; +1.0-1.3 g/dl, respectively) above the
      corresponding arterial values between 150 and 210 min of hypoxia, suggesting
      venous hemoconcentration in possible association with a transcapillary fluid
      shift. CBF, and especially CVR, were well correlated with arterial O2 content.

PMID- 1757370
TI  - Pregnancy-induced changes in the maximal physiological responses during swimming.
AB  - The effect of pregnancy on peak O2 uptake (VO2 peak) during tethered swimming was
      evaluated in 10 women during their 25th and 35th wk of pregnancy, as well as 9-11
      wk postpartum. The swim results were compared with cycle ergometry results
      obtained at similar times. The results indicated that exercise-induced maximal
      heart rates remained the same and were similar for the swim and cycle trials,
      approximately 184 +/- 4 beats/min. Cycling VO2 peak was not affected by
      pregnancy, averaging 1.94 +/- 0.11 l/min. Postpartum swim VO2 peak was similar to
      the cycle results; however, during pregnancy it was significantly lower than
      cycling VO2 peak (P less than 0.05; postpartum, 1.78 +/- 0.14 l/min; 25th wk,
      1.64 +/- 0.12; 35th wk, 1.48 +/- 0.11). Hemoglobin concentrations and hematocrits
      were lower during pregnancy; however, changes in plasma volume (based on
      hematocrit and hemoglobin) were found to be significantly greater during cycling
      than during swimming and also greater during pregnancy for both modes of
      exercise. It was concluded that, unlike cycling, the VO2 peak of pregnant women
      during swimming is reduced. This reduction in VO2 peak was associated with a
      decreased peak ventilation (r = 0.864) but was not correlated to exercise-induced
      hemoconcentration (r = -0.29). Furthermore, pregnancy results in a greater-than
      normal exercise-induced hemoconcentration, which may be related to pregnancy
      induced changes in capillary dynamics.

PMID- 1757371
TI  - Effects of perfusate buffer capacity on capillary CO2-HCO3(-)-H+ reactions:
      theory.
AB  - The importance of perfusate nonbicarbonate buffer capacity (beta nonHCO3) to
      intracapillary CO2-HCO3(-)-H+ reactions was assessed by theoretical analysis of
      CO2 exchange in saline-perfused pulmonary capillaries. Time courses for perfusate
      PCO2, [HCO3-], and [H+] were computed for capillaries containing different
      activities of luminal vascular carbonic anhydrase and different amounts of
      perfusate nonbicarbonate buffers. Mobilization of perfusate HCO3- toward CO2
      during capillary transit is determined by the availability of HCO3- and H+. A
      supply of protons from the nonbicarbonate buffer pool is necessary to maintain a
      high rate of HCO3- dehydration. The analyses indicate that beta nonHCO3 has
      marked nonlinear effects on transcapillary CO2 exchange and intravascular pH
      equilibration. These nonlinear effects differ from those previously computed for
      CO2 reactions in an open system because the present model system consists of a
      sequential combination of open (within capillary proper) and closed (within
      postcapillary vasculature) systems. The role of luminal vascular carbonic
      anhydrase in capillary CO2 reactions is strongly dependent on beta nonHCO3.
      Perfusate nonbicarbonate buffer capacity must be considered when the results of
      experimental studies of transcapillary CO2 exchange and/or intravascular pH
      equilibration are interpreted.

PMID- 1757372
TI  - Internal carotid flow velocity with exercise before and after acclimatization to
      4,300 m.
AB  - Cerebral blood flow and O2 delivery during exercise are important for well-being
      at altitude but have not been studied. We expected flow to increase on arrival at
      altitude and then to fall as O2 saturation and hemoglobin increased, thereby
      maintaining cerebral O2 delivery. We used Doppler ultrasound to measure internal
      carotid artery flow velocity at sea level and on Pikes Peak, CO (4,300 m). In an
      initial study (1987, n = 7 men) done to determine the effect of brief (5-min)
      exercises of increasing intensity, we found at sea level that velocity [24.8 +/-
      1.4 (SE) cm/s rest] increased by 15 +/- 7, 30 +/- 6, and 22 +/- 8% for cycle
      exercises at 33, 71, and 96% of maximal O2 uptake, respectively. During acute
      hypobaric hypoxia in a decompression chamber (inspired PO2 = 83 Torr), velocity
      (23.2 +/- 1.4 cm/s rest) increased by 33 +/- 6, 20 +/- 5, and 17 +/- 9% for
      exercises at 45, 72, and 98% of maximal O2 uptake, respectively. After 18 days on
      Pikes Peak (inspired PO2 = 87 Torr), velocity (26.6 +/- 1.5 cm/s rest) did not
      increase with exercise. A subsequent study (1988, n = 7 men) of the effect of
      prolonged exercise (45 min at approximately 100 W) found at sea level that
      velocity (24.8 +/- 1.7 cm/s rest) increased by 22 +/- 6, 13 +/- 5, 17 +/- 4, and
      12 +/- 3% at 5, 15, 30, and 45 min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757373
TI  - Effect of lung volume and positional changes on pulmonary diffusing capacity and
      its components.
AB  - Normal subjects have a larger diffusing capacity normalized per liter alveolar
      volume (DL/VA) in the supine than in the sitting position. Body position changes
      total lung diffusing capacity (DL), DL/VA, membrane conductance (Dm), and
      effective pulmonary capillary blood volume (Qc) as a function of alveolar volume
      (VA). These functions were studied in 37 healthy volunteers. DL/VA vs. VA yields
      a linear relationship in sitting as well as in supine position. Both have a
      negative slope but usually do not run parallel. In normal subjects up to 50 yr
      old DL/VA and DL increased significantly when subjects moved from a sitting to a
      supine posture at volumes between 50 and 100% of total lung capacity (TLC). In
      subjects greater than 50 yr old the responses of DL/VA and DL to change in body
      position were not significant at TLC. Functional residual capacity (FRC)
      decreases and DL/VA increases in all normal subjects when they change position
      from sitting to supine. When DL/VA increases more than predicted from the DL/VA
      vs. VA relationship in a sitting position, we may infer an increase in effective
      Qc in the supine position. In 56% of the volunteers, supine DL was smaller than
      sitting DL despite a higher DL/VA at FRC in the supine position because of the
      relatively larger decrease in FRC. When the positional response at TLC is
      studied, an estimation obtained accidentally at a volume lower than TLC may
      influence results. Above 80% of TLC, Dm decreased significantly from sitting to
      supine. Below this lung volume the decrease was not significant. The relationship
      between Qc and VA was best described by a second-order polynomial characterized
      by a maximum Qc at a VA greater than 60% of TLC. Qc was significantly higher in
      the supine position than in the sitting position, but the difference became
      smaller with increasing age. In observing the sitting and supine positions, we
      saw a decrease in maximum Qc normalized per square meter of body surface area
      with age.

PMID- 1757374
TI  - Extracellular Ca2+ mobilization in potential-dependent contraction of trachealis
      of maturing swine.
AB  - We studied the effect of maturation on potassium-induced parasympathetic
      activation and Ca2+ entry in tracheal smooth muscle (TSM) from fifteen 2-wk-old
      (2ws) and sixteen 10-wk-old (10ws) male domestic farm swine. Atropine (10(-7) M)
      caused inhibition of the maximal contraction elicited by potassium to 50.3 +/-
      2.6% maximum of control response (P less than 0.001) in TSM from 2ws but had no
      significant effect in TSM from 10ws (94.6 +/- 4.2% maximum; P = NS vs. control).
      Verapamil (10(-7) M) plus 10(-7) M atropine reduced contraction elicited by
      potassium in both 2ws (23.7 +/- 5.8% maximum; P less than 0.001 vs. control) and
      10ws (50.6 +/- 6.3% maximum; P less than 0.001 vs. control, P less than 0.05 vs.
      2ws); 10(-6)M verapamil caused greater than 95% blockade of contraction caused by
      potassium in both 2ws and 10ws. In separate studies, atropine-treated strips were
      equilibrated with extracellular Ca2+ concentrations ([Ca2+]o) ranging from normal
      (1X [Ca2+]o) to four times normal (4x [Ca2+]o). Increasing [Ca2+]o increased
      maximal contractile response in atropine-treated TSM strips from 68.7 +/- 3.8%
      maximum for 1x [Ca2+]o to 100.8 +/- 4.8% maximum for 4x [Ca2+]o (P less than
      0.001) in 2ws. Neither atropine nor [Ca2+]o affected maximal responses of TSM in
      10ws (103.5 +/- 3.0% maximum for 1x [Ca2+]o; P = NS vs. control). However, in the
      presence of atropine and verapamil, 4x [Ca2+]o augmented KCl-elicited contraction
      of TSM from both 2ws (46.9 +/- 6.3% maximum; P less than 0.01 vs. control) and
      10ws (78.6 +/- 2.3% maximum; P less than 0.005 vs. control).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1757375
TI  - Does the pressor response to ischemic exercise improve blood flow to contracting
      muscles in humans?
AB  - The purpose of this study was to determine in humans 1) the gain for the reflex
      pressor response that occurs when perfusion pressure to rhythmically contracting
      muscles is reduced and 2) whether the pressor response improves blood flow to the
      contracting muscles. Six normal subjects performed light, moderate, and heavy
      rhythmic forearm contractions (30/min) with the forearm enclosed in a Plexiglas
      box. Pressure in the box was increased 10 mmHg each minute up to 50 mmHg to
      reduce transmural pressure in the arterial system of the forearm. Mean arterial
      pressure (MAP) was measured continuously. During light exercise no reflex
      increase in MAP occurred until box pressure was 50 mmHg. During moderate and
      heavy exercise MAP began to increase with only 10- to 20-mmHg increases in box
      pressure. The slope of this increase was 3.5-3.9 mmHg per 10 mmHg of box pressure
      (approximately 60% of that in dogs). In a further study on six subjects a deep
      vein draining the active forearm muscles was cannulated and deep venous O2
      saturation measured to assess how a 50-mmHg increase in box pressure and
      subsequent reflex increase in MAP altered blood flow to the contracting muscles
      during heavy rhythmic exercise. The increase in box pressure reduced blood flow
      to contracting forearm muscles by 20-25% and was followed by a 19-mmHg increase
      in MAP that did not appear to improve perfusion of the active muscles. This
      finding was unexpected, because studies in dogs suggest that the pressor response
      to rhythmic exercise with restricted muscle blood flow can improve perfusion of
      the active muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757376
TI  - Interfacial transfer kinetics of NO2 into pulmonary epithelial lining fluid.
AB  - Previous studies, both in intact lungs and epithelial lining fluid (ELF) (J.
      Appl. Physiol. 68: 594-603, 1990 and J. Appl: Physiol. 69: 523-531, 1990), have
      suggested that the steady-state absorption of inhaled NO2 is mediated by chemical
      reaction(s) between NO2 and ELF solute reactants. To characterize the kinetics of
      NO2 absorption into aqueous biological substrates across a gas-liquid interface,
      we utilized a closed system of known geometry and initial gas phase [NO2]
      [([NO2]g)0] to expose ELF (as bronchoalveolar lavage; BAL) and a biochemical
      model system (glutathione, GSH). Assessments of NO2 reactive uptake, into both
      GSH and ELF, indicated first-order NO2 kinetics [([NO2]g)0 less than or equal to
      10.5 ppm] with effective rate constants of (kNO2)GSH = 4.8 and (kNO2)BAL = 2.9
      ml.min-1.cm-2 (stirred). Above 10.5 ppm (1 mM GSH), zero-order kinetics were
      observed. Both (kNO2)GSH and (kNO2)BAL showed aqueous reactant dependence. The
      reaction order with respect to GSH and BAL was 0.47 and 0.64, respectively. We
      found no effect of interfacial surface area or bulk phase volume on kNO2. In
      unstirred systems, significant interfacial resistance was observed and was
      related to reactant concentration. These results indicate that NO2 reactive
      uptake follows first-order kinetics with respect to NO2 ([NO2]g less than or
      equal to 10.5 ppm) and displays aqueous substrate dependence. Furthermore the
      site of reactive absorption appears to be limited to near the aqueous surface
      interface. Unstirred conditions confine interfacial mass transfer kinetics in a
      dose-dependent manner. These phenomenological coefficients may provide the basis
      for direct extrapolation to environmentally relevant exposure concentrations.

PMID- 1757377
TI  - Ventilatory afterdischarge in the awake goat.
AB  - Ventilatory afterdischarge (VAD) has been defined as a persistent gradually
      diminishing elevation of ventilatory activity that occurs after withdrawal of a
      variety of respiratory stimuli. The phenomenon has been well documented in the
      anesthetized cat, piglet, and lamb in response to electrical stimulation of the
      carotid sinus nerve. We sought to determine whether VAD could be demonstrated in
      the standing awake goat (n = 7) by use of an extracorporeal circuit to provide
      square-wave physiological stimulation of the carotid chemoreceptor (carotid body
      PO2 40 Torr). After 5 min of isolated carotid body stimulation, the mean time
      constants for diminishing inspired minute ventilation, tidal volume, and
      respiratory frequency were 27.7, 34.5, and 25.5 s, respectively. These results
      indicate that VAD does exist in the awake goat model. A critical factor for the
      demonstration of VAD is the maintenance of systemic arterial PCO2 (isocapnia)
      during the period of increased ventilatory activity. If arterial PCO2 is allowed
      to decrease even slightly during the hyperventilation, the magnitude and duration
      of VAD are greatly attenuated.

PMID- 1757378
TI  - Protection of the reperfused heart by L-propionylcarnitine.
AB  - The effects of L-propionylcarnitine on mechanical function, creatine phosphate
      and ATP content, and lactate dehydrogenase leakage were studied in isolated
      perfused rat hearts exposed to global no-flow ischemia for 30 min followed by
      reperfusion for 20 min. Five and 10 mM L-propionylcarnitine resulted in a 100%
      recovery of left ventricular-developed pressure, whereas the recovery was only
      40% in the hearts perfused without this agent. Ischemia-reperfusion caused a 85%
      loss of creatine phosphate and a 77% loss of ATP, which was prevented by 10 mM L
      propionylcarnitine. Five millimolar L-propionylcarnitine protected the heart from
      the loss of creatine phosphate but not from the loss of ATP. Ten millimolar L
      propionylcarnitine failed to improve the postischemic left ventricular-developed
      pressure, when it was added to the perfusate only after ischemia. L
      propionylcarnitine alleviated the decrease of coronary flow in the reperfused
      hearts. Lactate dehydrogenase leakage was aggravated in the beginning of the
      reperfusion period by 10 mM L-propionylcarnitine. This adverse effect was,
      however, transient. L-Propionylcarnitine provides protection for the postischemic
      reperfused heart in a dose-dependent manner. The optimal time for administration
      is before the ischemic insult. High doses of this compound may perturb cell
      membrane integrity. Moreover, the present data point to an intracellular,
      metabolic, and perhaps anaplerotic mechanism of action of L-propionylcarnitine in
      cardiac ischemia-reperfusion injury.

PMID- 1757379
TI  - Design and implementation of a new computerized system for intraoperative cardiac
      mapping.
AB  - A rapid, portable, yet inexpensive and expandable computer-based system utilizing
      current technology has been developed from experience in the operating room. An
      efficient operating system well suited for surgery is defined. New technology
      recording arrays fabricated from multielectrode flexible Kapton strips were
      developed and found to be easy to use and highly reliable. Novel arrays are
      created easily for research or special clinical applications. The system displays
      all incoming data in real time and transfers 16-s epochs to disk on command.
      After the user defines a beat for analysis, the computer determines the
      activation time for each channel, rejects unsatisfactory channels, and displays
      the results for review and modification before plotting the isochronal map on the
      monitor. The average time to recall data and produce a map is 16 s; if manual
      review of 120 channels is included, mapping time is less than 4 min. Clinical
      data recorded during surgery are discussed. The speed and operational ease
      demonstrated in the operating room make this computer/electrode system valuable
      both for surgery and for elucidating basic mechanisms of arrhythmias.

PMID- 1757380
TI  - Contributions of diffusion jet flow and cardiac activity to regional ventilation
      in CFV.
AB  - The magnitude and regional distribution of local gas transport during constant
      flow ventilation (CFV) were quantified by imaging the washout of nitrogen 13
      (13NN) from anesthetized and paralyzed mongrel dogs with positron emission
      tomography. Equal jet flows, through two 2-mm-ID bronchial catheters 1 cm distal
      to the carina, were adjusted to provide eucapnic CFV (total flow = 57.6 ml.s-1.kg
      1). Basal, midheart, and apical transverse sections were studied in supine and
      prone anesthetized dogs. The ventilation per unit volume (sV) of selected areas
      was computed from local 13NN concentration vs. time curves during washout. To
      separate the regional contributions of CFV and cardiogenic oscillation to
      enhanced molecular diffusion, additional supine dogs were also studied during
      unilateral CFV. In this protocol the CFV jet flow was delivered to a single lung
      while the contralateral lung was left apneic. For each lung, washout data were
      obtained under CFV and apnea both living and postmortem animals. The local
      contributions of diffusion, CFV jet effects, and cardiac activity to gas
      transport were evaluated and tested for additive and multiplicative synergistic
      interactions. The regional distribution of gas transport during CFV was found to
      be highly nonuniform and characterized by higher ventilation to regions located
      close to the main bronchi and those located in the direction in which the CFV jet
      pointed. No major differences were observed between supine and prone positions.
      This regional pattern of ventilation distribution was found to be the result of
      complementary and nearly multiplicative interaction between the regional effects
      of the CFV jet, concentrated in the central airways, and the preferential
      cardiogenic gas transport enhancement in ventral regions close to the heart. The
      data were also analyzed with a model that divides the regional diffusive gas
      transport resistance into a central component, affected by the CFV jet, and a
      peripheral component, affected only by cardiac activity. This analysis showed
      substantial regional heterogeneities in the effects of the different gas
      transport mechanisms, which are consistent with the geometry of the bronchial
      tree and the location of the heart in the dog. The results indicate that regional
      nonuniformities must be considered when modeling gas transport in CFV.

PMID- 1757381
TI  - Lung ischemia-reperfusion injury in awake sheep: protection with verapamil.
AB  - We caused unilateral lung ischemia-reperfusion injury in awake sheep by
      simultaneously occluding the left pulmonary artery and left main stem bronchus
      for 12 h. The occluded left lung was inflated with nitrogen. Reperfusion resulted
      in an elevation of lung lymph flow from 1.3 to 5.0 ml/15 min and an increase in
      lymph-to-plsma protein concentration ratios. Reperfusion, but not ischemia alone,
      caused an increase in wet-to-dry weight ratios in both the reperfused left lung
      and the contralateral right lung. Granulocytes increased in both lungs during the
      ischemic period and after reperfusion, and hypoxemia developed after reperfusion.
      The calcium channel antagonist, verapamil, given just before reperfusion, caused
      a marked attenuation in the reperfusion-induced changes in the lung lymph
      variables and wet-to-dry weight ratio. However, verapamil did not affect the
      hypoxemia or granulocyte sequestration seen after reperfusion. We conclude that
      reperfusion of ischemic sheep lung results in increased microvascular
      permeability that can be partially prevented by verapamil.

PMID- 1757382
TI  - Pharmacological dissection of components of the Valsalva maneuver in adrenergic
      failure.
AB  - The arterial blood pressure (BP) components of the Valsalva maneuver (VM) were
      analyzed to ascertain whether they could be used as an index of adrenergic
      regulation of the circulation. We studied a control and three age- and sex
      matched patient groups. Sympathetic adrenergic failure was graded on the basis of
      the degree of systolic BP (SBP) reduction during tilt: orthostatic hypotension
      (OH; SBP greater than 30 mmHg), borderline OH (BOH; 30 less than SBP greater than
      10 mmHg), and sympathetic sudomotor failure (SSF). Controls exhibited a biphasic
      phase II, consisting of a modest decrement (early phase II) followed by a rise in
      BP (late phase II; II1) above resting values. All the patient groups including
      SSF exhibited a significant reduction in II1. An excessive BP fall in phase II
      and an absent phase IV overshoot were observed in the OH group. BOH and, to a
      lesser extent, SSF groups showed a significant reduction in phase IV overshoot.
      We conclude that BP changes during VM will detect adrenergic vasoconstrictor
      failure with greater sensitivity than orthostatic BP recordings.

PMID- 1757383
TI  - Leg exercise conditioning increases peak forearm blood flow.
AB  - To examine whether forearm vascular adaptations could occur after upright-leg
      exercise training, the reactive hyperemic blood flow after 10 min of forearm
      circulatory arrest (RHBF10) was studied. RHBF10 was examined in seven subjects
      before, at 2 wk, and after the completion of 4 wk of bicycle ergometer training.
      Maximal O2 consumption (VO2max) for leg ergometer work increased 13% (P less than
      0.05) over 4 wk. Over that period of time RHBF10 in the forearm increased 50% (P
      less than 0.05), with a reciprocal drop in minimum vascular resistance. Resting
      heart rate decreased 15% (P less than 0.05) during the same period. Changes in
      RHBF10 and VO2max were noted after 2 wk of training. Mean arterial pressure did
      not change. We conclude that vascular adaptations can occur in the forearm muscle
      beds, even though the training regimen is designed to condition the lower
      extremities.

PMID- 1757384
TI  - Initiation of oral breathing in lambs in response to airway obstruction:
      mechanisms.
AB  - Our aim was to assess the mechanisms determining the reflex formation of an oral
      airway in response to nasal obstruction (NO) and tracheal obstruction (TO). In
      nine conscious lambs (14-37 days old) NO was effected by blockade of nasal tubes;
      TO was later effected by blockade of an endotracheal tube. We measured arterial
      O2 saturation, PO2, PCO2, and pH and the depth and duration of inspiratory
      efforts when mouth opening (MO) occurred. Responses were compared when NO and TO
      followed breathing of room air, rebreathed air, and 100% O2. After both NO and
      TO, MO was initiated most rapidly after lambs rebreathed air and least rapidly
      after they breathed 100% O2. Similar changes in blood gases and pH were measured
      when MO occurred after air breathing and rebreathing; however, the extent of
      these changes was greater during TO than during NO. After 100% O2 was breathed,
      MO occurred when lambs were still hyperoxic, but they were more hypercapnic and
      acidemic than after breathing air or rebreathed air. There were no differences,
      related to prebreathed gases or site of airway occlusion, in the depth of
      inspiratory efforts at the time of MO. We conclude that the formation of an oral
      airway requires a critical level of inspiratory drive in the presence of airway
      obstruction. After the prebreathing of different gases, differences in response
      latency and blood gases at the time of MO can be attributed to the attainment of
      this threshold level of inspiratory drive. The formation of an oral airway is
      facilitated by, but not dependent on, receptors in the upper airway.

PMID- 1757385
TI  - Regional deformation of the canine diaphragm.
AB  - To follow regional deformation of the diaphragm in dogs, radiopaque markers were
      implanted under surgical anesthesia into different anatomic regions of the muscle
      in triangular arrays (approximately 1 cm to a side). After recovery from surgery,
      changes in area and shape of the triangles were followed with biplane
      cinefluorography during quiet breathing and during inspiratory efforts against an
      occluded airway (Mueller maneuvers). From changes in shape of the triangles
      during contraction, area changes were decomposed into a major direction and
      magnitude of shortening (Eg1) and a minor length change (Eg2) perpendicular to
      Eg1, both expressed as a fraction of initial length at end expiration. With the
      use of these techniques, systematic differences in regional area change were
      observed in different parts of the diaphragm during inspiratory efforts at
      different lung volumes. Regional area always decreased during contraction in the
      crural and midcostal zones of apposition to the rib cage. Area decreased less and
      often increased during inspiratory efforts in the costal dome near the central
      tendon and in the costal region near its rib cage insertion. Differences in
      regional area change were not due to differences in the Eg1 in different parts of
      the diaphragm but were a consequence of differences in widening of the muscle
      along Eg2 perpendicular to the direction of Eg1. As lung volume was passively
      increased above functional residual capacity, regional area decreased in all
      parts of the diaphragm except in the costal regions near rib cage insertion,
      where area increased.

PMID- 1757386
TI  - Motoneuron and muscle fiber succinate dehydrogenase activity in control and
      overloaded plantaris.
AB  - To determine the level of coordination in succinate dehydrogenase (SDH) activity
      between plantaris motoneurons and muscle fibers, the soleus and gastrocnemius
      muscles were bilaterally excised in four cats to subject the plantaris to
      functional overload (FO). Five normal cats served as controls. Twelve weeks after
      surgery the right plantaris in each cat was injected with horseradish peroxidase
      to identify plantaris motoneurons. SDH activity then was measured in a population
      of plantaris motoneurons and muscle fibers in each cat. Control motoneurons and
      muscle fibers had similar mean SDH activities and a similar relationship between
      cell size and SDH activity. After FO, muscle fiber size doubled and mean muscle
      fiber SDH activity halved. Motoneuron mean SDH activity and size were unaffected
      by FO. Total SDH activity was unchanged in both the motoneurons and muscle fibers
      after FO. These changes suggest a selective increase in contractile proteins with
      little or no modulation of mitochondrial proteins in the muscle fibers, because
      total SDH activity was unchanged in muscle fibers after FO. These data
      demonstrate that although mean SDH activities were similar in control motoneurons
      and muscle fibers, mean SDH activities in these two cell types can change
      independently.

PMID- 1757387
TI  - Intracranial self-stimulation motivates treadmill running in rats.
AB  - Most animal running models have traditionally used aversive motivators to induce
      exercise tasks. This study demonstrates treadmill running motivated by
      reinforcement of intracranial self-stimulation (ICSS), providing an alternative
      model with which to study physiological responses to exercise. Twenty-nine male
      Sprague-Dawley rats were stereotaxically implanted with bipolar electrodes aimed
      at the ventral tegmental area of the brain. After 7 days of operant lever-press
      training for ICSS, rats that pressed at least 50 presses/min were randomly
      divided into three conditions: exercise-reinforcing brain stimulation (Ex-St),
      exercise-aversive shock (Ex-Sh), and sedentary controls (C). Ex-St and Ex-Sh ran
      for 30 min at 25 m/min at 5% grade for 2 wk with ICSS and electric shock as the
      motivator, respectively, while C did not run. At the end of 2 wk, Ex-St and Ex-Sh
      performed an endurance run. Results show that Ex-St ran longer than Ex-Sh [63 +/-
      10 vs. 42 +/- 10 (SD) min; P less than 0.05]. HR was higher in Ex-St than in C (P
      less than 0.05). Rectal temperature increased similarly in both exercise groups.
      This model provides a highly effective method to motivate treadmill running in
      rats and as such can be used to characterize physiological responses to exercise
      without the potentially confounding influence of stress associated with an
      aversive shock motivator.

PMID- 1757388
TI  - Circadian rhythm in airway responsiveness and airway tone in patients with mild
      asthma.
AB  - To determine the characteristics and reproducibility of circadian rhythms of
      airway responsiveness to histamine and methacholine and their relationship to
      airway tone in patients with mild asthma, we studied nine subjects with
      complaints of nighttime awakening due to dyspnea and/or cough at least once a
      week. Their mean age was 31.4 yr (range 17-65) and their mean daytime FEV1 was 99
      +/- 14 (SD) % predicted. Forced expiratory volume in 1 s (FEV1) and the
      provocative concentrations of histamine and methacholine necessary to decrease
      FEV1 by 20% (PC20FEV1) were determined every 4 h for 13 consecutive measurements.
      Three subjects were measured with histamine, three with methacholine, and three
      with both histamine and methacholine. Data were evaluated on an individual basis.
      PC20FEV1 to histamine and methacholine showed significant and reproducible
      circadian variations in all cases (P less than 0.01 each) with a mean amplitude
      of 1.00 +/- 0.17 (SD) doubling concentrations for histamine and 1.35 +/- 0.29
      doubling concentrations for methacholine. The amplitude of PC20FEV1 was
      significantly larger (P less than 0.05) and the time of maximum responsiveness
      was significantly earlier (P less than 0.05) with methacholine compared with
      histamine. FEV1 showed significant (P less than 0.05) circadian variations in
      three of nine subjects, and peak expiratory flow rate showed variations in two
      subjects. Correlation between the variations of FEV1 and PC20FEV1 was significant
      (P less than 0.05) in 5 of 12 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757389
TI  - Extra-alveolar veins are contiguous with, and leak fluid into, periarterial cuffs
      in rabbit lungs.
AB  - We previously observed physiological evidence that arterial and venous extra
      alveolar vessels shared a common interstitial space. The purpose of the present
      investigation was to determine the site of this continuity to improve our
      understanding of interstitial fluid movement in the lung. Orange G and Evans blue
      dyes were added to the arterial and venous reservoirs, respectively, of excised
      rabbit lungs as they were placed 20 cmH2O into zone 1 (pulmonary arterial and
      venous pressures = 5 cmH2O, alveolar pressure = 25 cmH2O). After 10 s or 4 h the
      lungs were fixed by immersion in liquid N2, freeze-dried, cut into 5-mm serial
      slices, and examined by light macroscopy. Serial sections of 0.25-0.5 mm were
      subsequently examined by scanning electron microscopy. In the animals subjected
      to the zone 1 stress for 4 h, arterial and venous extra-alveolar vessels were
      surrounded by cuffs of edema. The edema ratio (cuff area divided by vessel lumen
      area) was greater around arteries than veins and decreased with increasing vessel
      size. Periarterial cuffs usually contained orange dye and frequently contained
      both orange and blue dye. Lymphatics containing orange or blue dye were
      frequently seen in periarterial cuffs. Scanning electron microscopy demonstrated
      that extra-alveolar veins of approximately 100 microns diameter were anatomically
      contiguous with arterial extra-alveolar vessel cuffs. In rabbit lungs, both
      arterial and venous extra-alveolar vessels (and/or alveolar corner vessels) leak
      fluid into perivascular cuffs surrounding arterial extra-alveolar vessels, and
      lymphatics located in the periarterial cuff contain fluid that originates from
      both the arterial and venous extra-alveolar vessels.

PMID- 1757390
TI  - Effect of work load on cutaneous vascular response to exercise.
AB  - The purpose of the present study was to examine whether intensity of exercise
      affects skin blood flow response to exercise. For this purpose, six healthy men
      cycled, in a random order on different days, for 15 min at 50, 60, 70, 80, and
      90% of their maximum oxygen consumption (VO2max) at a room temperature of 25
      degrees C. At the end of exercise, esophageal temperature (Tes) averaged 37.4 +/-
      0.2, 37.7 +/- 0.2, 37.9 +/- 0.2, 38.6 +/- 0.3, and 38.9 +/- 0.4 degrees C (SE) at
      the 50, 60, 70, 80, and 90% work loads, respectively. At the two highest work
      loads, no steady state was observed in Tes. Skin blood flow was estimated by
      measuring forearm blood flow (FBF) with strain-gauge plethysmography and by laser
      Doppler flowmetry on the upper back. Both techniques showed that skin blood flow
      response to rising Tes was markedly reduced at the 90% work load compared with
      other work loads. At the end of exercise, FBF averaged 7.5 +/- 1.7, 10.7 +/- 3.1,
      9.6 +/- 2.1, 11.3 +/- 2.6, and 5.4 +/- 1.3 (SE) ml.min-1.100 ml-1 (P less than
      0.01) at the 50, 60, 70, 80, and 90% VO2max work loads, respectively. The
      corresponding values for Tes threshold for cutaneous vasodilation (FBF) were
      37.42 +/- 0.16, 37.48 +/- 0.13, 37.59 +/- 0.13, 37.79 +/- 0.19, and 38.20 +/-
      0.22 degrees C (P less than 0.05) at 50, 60, 70, 80, and 90% VO2max,
      respectively. In two subjects, no cutaneous vasodilation was observed at the 90%
      work load.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757391
TI  - Time domain analysis of oxygen uptake during pseudorandom binary sequence
      exercise tests.
AB  - Pseudorandom binary sequence (PRBS) exercise tests involve repeated switching
      between two work rates (WR) according to a computer-generated pattern. This paper
      presents an approach to analysis of O2 uptake (VO2) in the time domain. First,
      the autocorrelation function (ACF) of the input WR was recognized to be a
      triangular-shaped pulse that can be taken to be equivalent to a ramp increase
      followed by a ramp decrease in WR. Then the cross-correlation function of the
      input (WR) and the output (VO2) was treated as if it were the response to a
      triangular-shaped pulse. The cross-correlation function was analyzed by fitting a
      linear summation of the ramp form of a two-component exponential function to this
      triangular pulse. VO2 responses of eight subjects were obtained from two
      different PRBS tests, as well as step changes in WR. The first PRBS test
      consisted of 15 units, each 30 s in duration. Its ACF had a base width of 60 s.
      The ramp increase-ramp decrease model fit the data throughout the range of
      response. The second PRBS test had 63 units, each 5 s in duration; thus its ACF
      base width was 10 s. Again, the ramp model fit adequately. The data from the
      second PRBS test could be fit by the impulse form of the two-component
      exponential equation, although the fit in the first 30 s tended to be poorer. The
      time constants of VO2 dynamics estimated from step and PRBS tests were not
      significantly different. PRBS tests can be analyzed in the time domain, and the
      indicators of system dynamics reflect physiological properties similar to those
      investigated during step changes in WR.

PMID- 1757392
TI  - Intracranial self-stimulation motivates weight-lifting exercise in rats.
AB  - The purpose of this study was to determine the feasibility of using a positive
      reinforcement protocol to motivate weight-lifting exercise in rats. Intracranial
      self-stimulation was used to induce weight-lifting exercise. Bipolar electrodes
      were implanted in the ventral tegmental area of rats, and the animals were
      trained to bar press on a continuous reinforcement schedule for electrical brain
      stimulation. Animals with response rates of 1,200-1,500 presses/h were then
      trained with a discriminative light stimulus to alternate between a normally
      positioned bar and an elevated bar that could be reached only by standing on the
      hindlimbs. The animals were fitted with a weighted jacket at a starting
      resistance of 5-10% of their body weight. Weight-training sessions were conducted
      5 days/wk for 10 wk. Training consisted of 600 presses/session, alternating every
      15 presses between the low and high bars. At the beginning of each subsequent
      week, the resistance was progressively increased, with some animals eventually
      training at resistances greater than 50% of their body weight. At the end of the
      training period, the rats were lifting over 550% of the starting weight.
      Gastrocnemius size and mean fiber diameter were increased in the weight-lifting
      animals. This model combines exercise with positive incentive and has the
      advantages of being relatively easy to implement and not producing any apparent
      physical or mental trauma in the animal.

PMID- 1757393
TI  - In vivo growth patterns of human lung tumors in three-dimensional histoculture.

PMID- 1757394
TI  - Heterogeneity in antigenic expression and radiosensitivity in human colon
      carcinoma cell lines.
AB  - A panel of human colon carcinoma cell lines were characterized regarding both
      antigenic heterogeneity and variations in radiosensitivity. Monoclonal antibodies
      were used to study the expression of carcinoembryonic antigen (CEA),
      gastrointestinal cancer antigen (GICA or CA 19-9) and carcinoma-associated
      antigen (CA-50). Radiosensitivity was studied with the clonogenic survival
      technique. Three cell lines, LS 174T, HCTC, and SW 1116 stained positive for all
      three antigens. HT-29 was positive for CA 19-9 and CA-50 whereas Caco-2 was
      positive for CEA and CA 19-9. The cell lines SW 620 and LIM 1215 only stained
      positive for one of the antigens, CA-50 and CEA, respectively. In nearly all
      positive cases the stainings were very heterogeneous with mixtures of positive
      and negative cells. One exception was the HCTC cells which stained homogeneously
      for the CA 19-9 and CA-50 antigens. The neuroendocrinelike COLO 320 cells were
      negative in all cases. The radiosensitivity varied strongly between the cell
      lines with Dq-values between 0.8 and 1.9, extrapolation numbers between 2.0 and
      4.7, Do-values between 1.1 and 2.8. The surviving fraction at 2 Gy varied between
      0.3 and 0.7 with HCTC as the most radiosensitive and HT-29 as the most
      radioresistant cell line. Thus, there were differences in antigenic expression
      and intrinsic radiosensitivity between the cell-lines and antigenic
      heterogeneities within each cell line. The analyzed panel of cell lines will be
      valuable in studies of dose-effect relations for monoclonal antibodies labeled
      with toxic radionuclides simulating both antigenic heterogeneity and variations
      in radiosensitivity.

PMID- 1757395
TI  - Proliferation and differentiation of mouse uterine epithelial cells in primary
      serum-free culture: estradiol-17 beta suppresses uterine epithelial proliferation
      cultured on a basement membrane-like substratum.
AB  - The effects of different substrata and estradiol-17 beta (E2) on proliferation
      and differentiation of mouse uterine epithelial cells was examined in a serum
      free primary culture system. When cultured on rat-tail collagen gels, the
      epithelial cells rapidly increased in number to form a simple squamous cell layer
      that exhibited a relatively undifferentiated state (a few short microvilli, no
      secretory granules, and poorly developed endoplasmic reticulum). Addition of E2
      into the culture medium did not affect the proliferation of epithelial cells on
      collagen gel. Uterine epithelial cells grown on a reconstituted basement membrane
      like substratum (Matrigel) formed a simple columnar/cuboidal cell layer
      exhibiting fully developed characteristics (many long microvilli, many secretory
      granules, and fully developed endoplasmic reticulum). Examination of epithelial
      proliferation by counting substratum-attached cell number revealed only a slow
      increase in cell growth on Matrigel, and E2 did not significantly affect it.
      However, measurement of proliferating cells by labeling cells with 5-bromo-2'
      deoxyuridine revealed that cells on Matrigel were replicating and that E2 (10(-7)
      to 10(-11) M) actually significantly suppressed epithelial proliferation.
      However, there was not an effect of E2 on total cell number, indicating that the
      cells in control medium replicate faster and detach more readily from the
      substratum than those in E2-supplemented medium on Matrigel. Thus, it is probable
      that E2 significantly reduces the rate of cell detachment from the substratum,
      which may mimic the in vivo condition where significant decrease in apoptosis or
      cell death is induced by E2.

PMID- 1757396
TI  - A method for the harvest, culture, and characterization of human adult atrial
      myocardial cells: correlation with age of donor.
AB  - Myocardial cell culture methods are now well established for animal and fetal
      human tissue. We present here a method for harvesting and culturing adult human
      atrial myocardiocytes. Cells are obtained from fresh atrial tissue normally
      discarded after being removed to cannulate the right atrium during open heart
      surgery. The atrial tissue is minced and then digested using collagenase. The
      single cell suspension is initially cultured in serum-containing growth medium,
      then transferred to defined medium, selective for myocardial cell growth. The
      cells are characterized by immunoperoxidase stains and transmission electron
      microscopy. The cultured cells stain positive for myoglobin, whereas control
      cultured fibroblasts and endothelial cells do not. Electron microscopy shows the
      presence of numerous myofibrils, Z-bodies, pleomorphic mitochondria, and
      secretory granules. The chronological age of the donor was an important factor in
      culturing the adult tissue, the younger tissue correlated with a higher success
      rate. This method provides a means for in vitro study of human adult myocardial
      cells and provides guidelines for appropriate atrial tissue to use.

PMID- 1757397
TI  - A primary culture system of adult rat heart cells for the study of toxicologic
      agents.
AB  - Tricyclic antidepressants (TCAs) are currently used in the treatment of mental
      depression and nocturnal enuresis. Clinically, these drugs are useful; however,
      cardiotoxicity can occur even with therapeutic dosages. For example, TCAs are
      known to alter myocardial function, induce arrhythmias, and produce heart block
      in individuals with a normal cardiovascular history. The present study was
      undertaken to establish a culture system of spontaneously contracting adult
      primary myocardial cells for toxicologic testing and to examine their
      contractility, morphology, and lactate dehydrogenase release (LDH) after
      treatment with one of the most cardiotoxic TCAs, amitriptyline. Primary
      myocardial cell cultures were obtained from approximately 60- to 90-day-old
      Sprague-Dawley rats. After the cells had been grown in culture for 11 days, they
      were treated with amitriptyline (1 x 10(-3), 1 x 10(-4), and 1 x 10(-5) M) for 2
      to 24 h. The highest concentration of amitriptyline (1 x 10(-3) M) completely
      destroyed the cardiac muscle cells. In addition to moderate and severe vacuole,
      granule, and pseudopodia formation, all contractile activity was inhibited as
      early as 2 h after exposure to the intermediate concentration of 1 x 10(-4) M
      amitriptyline. Significant LDH release did not occur until 8 h after treatment
      with this intermediate concentration. Even though there was no significant LDH
      release at all 3 time points tested, there was a 50% decrease in beating activity
      (154 +/- 9 to 77 +/- 5 beats/min) and initiation of vacuole formation by 2 h with
      the lowest concentration of amitriptyline (1 x 10(-5) M). This study presents a
      new apparatus for the isolation of adult cardiac myocytes for the establishment
      of primary cell cultures for toxicologic testing. Furthermore, these data
      demonstrate that amitriptyline induces a concentration- and time-dependent
      cardiotoxic profile in a model of spontaneously contracting adult cardiac muscle
      cells in culture.

PMID- 1757398
TI  - Epithelial differentiation in the absence of extracellular matrix.
AB  - To investigate the regulation of epithelial differentiation, normal human
      epidermal keratinocytes were cultured floating on the surface of culture medium
      without attachment to a solid substrate. Keratinocytes spread out on the surface
      of the medium, proliferated and differentiated either into several flat lacy
      sheets 1 to 3 cells thick (on medium containing 0.15 mM calcium) or formed one
      single aggregate of cells from 5 to 15 cells in thickness on medium containing
      1.15 mM calcium. The cell aggregates demonstrated a pattern of ordered epithelial
      differentiation. Levels of progressive differentiation resembling the structure
      of normal human epidermis were identified by light microscopy,
      immunohistochemistry, and electron microscopy. Differentiation proceeded from
      cells at the air side toward cells at the medium side with basal appearing cells
      on the air side and keratinocytes expressing filaggrin and involucrin on the side
      toward the medium. These results demonstrate that organized epithelial
      differentiation can occur in the absence of extracellular matrix. In contrast
      with other air-liquid interface cultures, epithelial differentiation in the
      absence of extracellular matrix progresses from air towards medium.

PMID- 1757399
TI  - Reduction of proliferative heterogeneity of CHEF18 Chinese hamster cell line
      during the progression toward tumorigenicity.
AB  - Doubling time and generation time represent two parameters by which the
      proliferation of cultured mammalian cells can be monitored. In this study we
      report the characterization of CHEF18 Chinese hamster cell line during the
      progression toward tumorigenicity by analysis of doubling time and generation
      time. The two parameters reveal that the proliferation was initially different,
      indicating the presence of a proliferative heterogeneity among the cycling cells.
      The progressive reduction up to the disappearance of this discrepancy suggests
      that a modification of the length of some phases of the cell cycle may have
      occurred during the progression toward tumorigenicity. However, the hypothesis
      that the shortening of doubling time might be due to a continuous coming out of
      cells from the cell cycle rather than to a shortening of the cell cycle is
      presented.

PMID- 1757400
TI  - Sulfation and glucuronidation of acetaminophen by cultured hepatocytes
      reproducing in vivo sex-differences in conjugation on Matrigel and type 1
      collagen.
AB  - The sulfate and glucuronide conjugation of acetaminophen (APAP) by hepatocytes
      cultured on Matrigel or type 1 collagen was compared to APAP metabolism in vivo.
      The metabolic fate of low (15 mg/kg), medium (125 mg/kg), and high (300 mg/kg)
      doses of APAP injected intraperitoneally were determined in male and female rats.
      Males excreted more APAP as the sulfate conjugate than females, which correlated
      with the twofold greater APAP sulfotransferase activity in the male vs. females
      (301 +/- 24 vs. 156 +/- 18 pmol.mg-1 protein.min-1). Also, as sulfate conjugation
      became saturated, there was a dose-related shift in APAP metabolism from sulfate
      to glucuronide conjugation in both sexes. After death, the livers of the same
      animals were perfused with collagenase and the hepatocytes cultured in modified
      Waymouth's medium on either Matrigel or rat-tail collagen, with various doses of
      APAP (0, 0.125, 0.25, 0.5, and 1.0 mM). Sex differences in APAP sulfation and
      glucuronidation persisted in culture for up to 4 days, with sulfation
      predominating in the male similar to in vivo. With increasing APAP concentration
      (dose), there was a saturation of sulfate conjugation and a shift to
      glucuronidation as observed in vivo. Sex differences in APAP sulfation and
      glucuronidation were no longer significant by Day 4 in culture. Sulfation, and to
      a lesser extent, glucuronidation, were more stable on Matrigel than collagen. We
      concluded that APAP metabolism of freshly isolated hepatocytes could replicate in
      vivo sex differences in conjugation, and that Matrigel was superior to collagen
      as substrate.

PMID- 1757401
TI  - The social dimension of health status measures in rheumatoid arthritis.
AB  - Fifty-six patients with rheumatoid arthritis (RA) were assessed on two occasions
      three months apart. They completed two health status instruments--the Arthritis
      Impact Measurement Scales (AIMS) and the Nottingham Health Profile (NHP)--and the
      Beck Depression Inventory. In addition, clinical and serological data were
      gathered in order to calculate severity of disease according to the Mallya and
      Mace index. Health status instruments and the severity of disease index showed
      agreement in the assessment of mobility; similar agreement was found for
      different assessments of emotions. However, the two instruments provided social
      interaction scores with little agreement either cross-sectionally or in terms of
      change over time. It is argued that the generic NHP may be a valid instrument as
      an outcome measure in RA but the NHP and AIMS assess different aspects of social
      interaction. Care is needed in the selection of outcome measures to evaluate
      interventions.

PMID- 1757402
TI  - Provision of physiotherapy and occupational therapy in outpatient departments and
      day hospitals for stroke patients in Nottingham.
AB  - The provision of rehabilitation for stroke patients discharged from hospital in
      Nottingham was determined in three ways: a longitudinal study of consecutive
      stroke patients discharged from hospital, a cross-sectional survey of stroke
      patients attending physiotherapy (PT) and occupational therapy (OT) outpatient
      departments (OPDs), and an observational study of patients attending for
      rehabilitation at day hospitals (DHs) and PT and OT OPDs. In the longitudinal
      study 17% of patients went to DHs and 20% to OPDs. During the cross-sectional
      study patients most commonly attended twice weekly. Twenty-four per cent of DH
      attenders were 18 months post-stroke. In the observational study, the proportion
      of time spent in therapy was 22% in DHs, 38% in PT OPDs, 48% in OPD OT, and 51%
      in those attending both PT and OT OPDs. Day hospitals are now a major facility
      for the rehabilitation of stroke outpatients. OPDs may deliver rehabilitation
      more efficiently than DHs, and both OPDs and DHs compare favourably when compared
      to inpatient rehabilitation in this respect.

PMID- 1757403
TI  - Posturographic evaluation of the proprioceptive effect of ankle orthoses in
      healthy volunteers.
AB  - This study analyses the proprioceptive effect of wearing a unilateral and then
      bilateral ankle orthosis on 34 healthy volunteer subjects by posturography. An
      elastic orthosis with a ligamentous support band was used, and evaluation was
      performed by a posturographic statokinesimetric platform. Three tests, one
      without an orthosis, one with one orthosis, and one with two orthoses, were
      recorded for each volunteer. The results and statistical analyses demonstrated a
      significant difference in the antero-posterior measurement between the test
      without ankle orthosis and the tests with one and with two orthoses. This study
      provides information about the prophylactic effect of wearing a flexible support;
      it appears that there are important inter-individual variations in postural
      equilibrium, and the wearing of prophylactic ankle orthoses should be reserved
      for subjects after a posturographic examination.

PMID- 1757404
TI  - Electromyographic study of sternocleidomastoid and scalene muscles in tetraplegic
      subjects during respiration.
AB  - An electromyographic investigation of inspiratory respiratory muscles was carried
      out in six tetraplegic and two normal subjects using needle electrodes. When the
      normal subjects were using tidal breathing there was no activity present. In the
      majority of tetraplegic subjects, activity was present in the scalene muscle
      during tidal breathing. This activity became more marked during deep inspiration.
      The muscles were hypertrophied and these muscles filled an important respiratory
      role.

PMID- 1757405
TI  - Trend line influence on visual analysis of single-subject data in rehabilitation
      research.
AB  - Single-subject design and n of 1 randomized clinical trials are being advocated
      as methods of conducting clinical research in rehabilitation environments. The
      traditional procedure for interpreting data from such designs is visual analysis.
      This study examined the effect of including trend lines on the visual judgements
      made from single-subject data. Twenty-four hypothetical single-subject A-B
      designs were presented to 20 rehabilitation therapists for visual interpretation.
      The graphs represented traditional single-subject designs, including a baseline
      and treatment phase. Trend lines were computed and included in both phases of the
      design as an adjunct to visual analysis. The interrater reliability of the visual
      judgements was calculated using the intraclass correlation coefficient and ranged
      from 0.54 to 0.90. The results suggest that adding trend lines to graphed data
      presented in single-subject designs can improve the consistency of visual
      judgements. Implications for using adjuncts to graphing data points in single
      subject rehabilitation research are discussed.

PMID- 1757406
TI  - Experience of a self-care unit as part of a hospital-based rehabilitation
      service.
AB  - The nature, advantages and disadvantages, and cost of a hospital-based self-care
      unit as part of a rehabilitation service are described. The unit's operational
      policy is critically examined after analysing the records of 40 patients admitted
      consecutively over a 2-year period and conducting interviews with 27 patients
      between 4 and 48 weeks after discharge. It is concluded that, compared with a
      hospital ward, a self-care unit is inexpensive to run and helps to prevent
      patients from giving up their homes and being admitted to residential homes
      prematurely. In addition to an assessment and confidence-building role, the unit
      provides a more appropriate and acceptable environment for patients waiting
      housing alteration or rehousing than a hospital ward.

PMID- 1757407
TI  - Liquid chromatographic determination of the processing aid 4-hexylresorcinol in
      shrimp.
AB  - A rapid, sensitive, liquid chromatographic (LC) method has been developed for
      determination of residuals of the processing aid, 4-hexylresorcinol, on shrimp
      meat. An aqueous homogenate of shrimp meat is extracted with ethyl acetate
      followed by precolumn preparation on a silica Sep-Pak cartridge. LC determination
      is preformed with a Nova-Pak C18 column, with UV detection at 214 nm. Sensitivity
      was 0.006 micrograms, and recovery from shrimp meat samples of known 4
      hexylresorcinol addition was 94%. Shrimp treated with 4-hexylresorcinol under the
      recommended dip protocol had mean residuals of 1.18 ppm, with a standard
      deviation of 0.13 ppm.

PMID- 1757408
TI  - Supercritical fluid extraction/enzyme assay: a novel technique to screen for
      pesticide residues in meat products.
AB  - The novel combination of supercritical fluid extraction (SFE) with an enzyme
      assay system has been used to screen meat products to detect the presence of
      pesticides. Analytes are collected in water by expanding supercritical carbon
      dioxide to atmospheric pressure through a restrictor and into an aqueous phase.
      The solution is then tested for the presence of pesticide residues by enzyme
      assay. Two experimental approaches have been used. Alachlor-fortified lard and
      bovine liver were monitored by static SFE coupled with an enzyme immunoassay. SFE
      of carbofuran-fortified frankfurters was coupled with an enzyme assay based on
      cholinesterase inhibition. A major benefit of the SFE/enzyme assay technique over
      conventional screening techniques is that the analyst is not exposed to organic
      solvents.

PMID- 1757409
TI  - Limited survey of residual tetracyclines in tissues collected from diseased
      animals in Aichi Prefecture, Japan.
AB  - Tissues were collected to survey the actual conditions of tetracycline
      antibiotics (TCs) residues in slaughtered animals that did not pass inspection at
      slaughterhouses in Aichi Prefecture, Japan, because of the presence of disease
      symptoms. Tissues were analyzed by liquid chromatography. Among 271 samples, 49
      (18.1%) were positive for oxytetracycline (OTC), 5 (1.8%) for chlortetracycline
      (CTC), and 5 (1.8%) for doxycycline (DC), respectively. One sample (cattle
      kidney) was positive for both OTC and DC. However, tetracycline was not detected
      in any samples. Percentage frequencies of TCs residues were 29.1% (37/127) and
      15.2% (22/144) for cattle and hogs, respectively. Kidney samples showed higher
      incidence of TCs residues and 1.5-7 times higher residual concentrations than
      liver and miscellaneous samples.

PMID- 1757410
TI  - An analytical survey of aflatoxins in tissues from swine grown in regions
      reporting 1988 aflatoxin-contaminated corn.
AB  - A joint project was undertaken by the Food Safety and Inspection Service (FSIS)
      and the Agriculture Research Service branches of the U.S. Department of
      Agriculture to determine the presence of aflatoxins in the U.S. meat supply
      during a drought year. In 1988, high incidences of aflatoxins occurred in corn
      grown in regions of the Midwest, Southeast, and South. Six states were identified
      as having serious aflatoxin contamination in their corn crop: Virginia, North and
      South Carolina, Texas, Iowa, and Illinois. Swine liver and pillars of diaphragm
      (muscle) tissues were sampled by federal FSIS Inspectors in plants located in
      these states. A worstcase sampling plan was conducted. Samples were taken in
      January 1989 from hogs fed corn soon after harvest and in April 1989 from hogs
      fed corn originally stored and then fed in the spring. A modification of the
      official AOAC method for the thin-layer chromatography (TLC) determination of
      aflatoxins in animal tissue was used to permit quantitation by LC with
      fluorescence detection. The official AOAC TLC confirmation of identity method was
      used to confirm all positive samples with B1 concentrations greater than 0.04 ppb
      and M1 concentrations greater than 0.1 ppb. Sixty samples in the January group
      and 100 samples in the April group were assayed. Concentrations of aflatoxins B1
      and M1 in the first group of pig livers ranged from 0.04 to 0.06 ppb. The
      identity of aflatoxin B1 was confirmed in all positive samples. Aflatoxin M1
      could not be confirmed in any of the positive liver samples because the method
      was insufficiently sensitive for this aflatoxin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757411
TI  - Polyvinyl chloride matrix membrane electrodes for manual and flow injection
      analysis of chloroquine in pharmaceutical preparations.
AB  - Two types of polyvinyl chloride (PVC) matrix membrane electrodes responsive to
      the antimalarial drug chloroquine have been constructed, electrochemically
      evaluated, compared and used in pharmaceutical analysis. Type 1 is the classic
      PVC model with chloroquine-tetraphenylborate (TPB) sensor; Type 2 is a coated
      silver disk without internal filling solution. Both electrode types exhibited
      rapid linear potentiometric response to the logarithmic concentration of
      diprotonated chloroquine cation in the 10(-1) - 10(-6)M range with calibration
      slopes 28-30 mV/concentration decade over the pH range 1.8-6.2. These electrodes
      were sensitive enough to permit determination of chloroquine phosphate at
      concentrations as low as 5 microgram/mL with good accuracy and precision.
      Determination of chloroquine in various pharmaceutical preparations using direct
      potentiometry and potentiometric titration with NaTPB gave an average recovery of
      98.8% of the nominal values (SD 0.5%). The Type 2 electrode was also assessed in
      a flow-through sandwich cell for flow injection analysis. Results were compared
      with data obtained by the U.S. Pharmacopeia method.

PMID- 1757412
TI  - Assay of oxolinic acid residues in salmon muscle by liquid chromatography with
      fluorescence detection: interlaboratory study.
AB  - A previously developed method that uses a simplified sample preparation and
      fluorometric detection of liquid chromatographic eluates for the determination of
      oxolinic acid in salmon muscle has been collaboratively studied. Five
      laboratories participated in the study to analyze, in quintuplicate, blank salmon
      muscle fortified at 10, 20, 50, and 100 micrograms/kg (ppb), and 2 incurred
      samples from salmon given feed with medicated oxolinic acid. The tissue, 2 g
      mixed with 2 g Na2SO4, is extracted with ethyl acetate and centrifuged, and the
      solvent is evaporated. The residue is partitioned in a mixture of hexane and 0.01
      M oxalic acid, and the aqueous phase is chromatographed using fluorescence
      detection at 327 nm excitation and 369 nm emission. Mean recoveries ranged from
      77.2 to 84.5% in spiked samples with reproducibility relative standard deviation
      (RSDR) ranging from 11.5 to 18.3%. Treated salmon were found to contain 8.71 and
      53.8 micrograms/kg with RSDR of 18.6 and 16.7%, respectively. The corresponding
      repeatability relative standard deviations (RSDR) were 5.8-12.2%, and 7.7 and
      6.2%. The method is recommended for regulatory purposes in Canada.

PMID- 1757413
TI  - Bacillus stearothermophilus disk assay for determining ampicillin residues in
      fish muscle.
AB  - The Bacillus stearothermophilus disk assay for penicillin in milk (AOAC official
      method) was adapted for the determination of ampicillin in fish muscle. The
      method was evaluated in 2 species of cultured fish: channel catfish and striped
      bass. Recoveries of ampicillin ranged from 99 to 104% when muscle specimens from
      both species were spiked at concentrations of 0.025-1.00 micrograms/g. The lower
      limit of determination (LOD) was 0.025 micrograms/g. The assay was applied to
      monitor the elimination of ampicillin from the muscle of striped bass after
      intravascular administration (dosage of 10 mg/kg body weight). The mean
      concentrations in the muscle declined from 1.160 micrograms/g at 2 h to 0.063
      micrograms/g at 18 h. The half-life of ampicillin in the muscle was 3.6 h.
      Ampicillin concentrations were below LOD at 24 h. No inhibitory activity was
      observed in the muscle of control fish.

PMID- 1757414
TI  - Comparison of automated liquid chromatographic and bioassay methods for
      determining spiramycin concentration in bovine plasma.
AB  - The performance of a liquid chromatographic (LC) method for spiramycin
      measurement in bovine plasma has been compared with that of a microbiological
      method. Plasma samples were obtained from cattle administered spiramycin
      intravenously. Comparison tests used were intraclass correlation (r1),
      correlation (r), and Student's paired t-test. For concentrations lower than 2.5
      IU/mL, microbiological values were higher than LC values. This difference in
      results modified pharmacokinetic interpretation and might be explained by the
      presence of microbiologically active metabolites.

PMID- 1757415
TI  - Sensitive and rapid reversed-phase liquid chromatography-fluorescence method for
      determining bisphenol A diglycidyl ether in aqueous-based food simulants.
AB  - A method has been developed for determination of bisphenol A diglycidyl ether
      (BADGE) in 3 aqueous-based food simulants: water, 15% (v/v) ethanol, and 3% (w/v)
      acetic acid. BADGE is extracted with C18 cartridges and the extract is
      concentrated under a stream of nitrogen. BADGE is quantitated by reversed-phase
      liquid chromatography with fluorescence detection. Relative precision at 200
      micrograms/L was 3.4%, the detection limit of the method was 0.1 micrograms/L,
      and recoveries of spiking concentrations from 1 to 8 micrograms/L were nearly
      100%. Relative standard deviations for the method ranged from 3.5 to 5.9%,
      depending on the identity of the spiked aqueous-based food simulant.

PMID- 1757416
TI  - Potassium as an index of fruit content in baby food products. Part I. Banana
      containing and apricot-containing products.
AB  - Percentage ingredient labeling has been proposed for baby foods. We determined
      whether or not the potassium content of baby foods could be used to verify the
      quantity of fruit when the characterizing ingredients were apricots or bananas,
      fruits rich in potassium. Official values for potassium in fruit (USDA Handbook
      No. 8-9) did not agree well with actual analyses. The potassium levels of
      products of known composition were accurately predicted from analyses of the
      actual ingredients used to make the foods. For banana-containing monofruit
      products of variable or unknown composition, potassium analysis led to fruit
      level estimates consistent with either the known composition or the label
      declaration. For products of unknown composition made with apricot concentrate,
      however, potassium analysis led to fruit level estimates lower than the probable
      fruit content. The quantity of fruit in baby foods made with potassium-rich
      fruits can be estimated from the potassium content if the potassium value for the
      fruit is representative of the actual ingredients used to make the product. If
      potassium analysis is to be used to verify compliance with percentage ingredient
      labeling, there must be statutory specification of the single-strength fruit
      level for fruit reconstituted from concentrate.

PMID- 1757417
TI  - A new approach to the study of glucosinolates by isocratic liquid chromatography.
      Part I. Rapid determination of desulfated derivatives of rapeseed glucosinolates.
AB  - Liquid chromatographic (LC) analysis of desulfated derivatives of rapeseed
      glucosinolates has been carried out under isocratic elution conditions with
      different CN-bonded stationary phases. The effects of the eluant composition
      (water, acetonitrile, and methanol) with the stationary phase (Zorbax CN,
      Lichrospher CN, and Ultrasphere CN) and temperature (20 and 50 degrees C) are
      described. An isocratic LC method performed at room temperature using a
      Lichrospher CN column and water as mobile phase is proposed. The chromatographic
      analysis can be done in less than 12 min, and it is easier and less expensive
      than the traditional gradient mode. Four commercial samples of rapeseed
      containing various quantities of other cruciferous seeds (wild mustard and
      stinkweed) as an admixture have been analyzed to determine the total
      glucosinolate content. Relative standard deviations of repeatability of the
      isocratic and gradient LC methods ranged from 0.4 to 1.7% and from 2.7 to 4.7%,
      respectively. Comparison of the results showed good agreement between the 2
      methods (beter than 98%).

PMID- 1757418
TI  - Analysis of trypsin inhibitors and lectins in white kidney beans (Phaseolus
      vulgaris, var. Processor) in a combined method.
AB  - Buffered saline extraction, affinity chromatography, and Folin-BSA protein assay
      were used consecutively to provide a combined method for analysis of trypsin
      inhibitors and lectins in white kidney beans (Phaseolus vulgaris, var.
      Processor). The method was tested by following the decrease of both
      antinutritional factors by germination of the beans for 7 days at 20 degrees C.
      Repeatability coefficients of variation were 2-7.4% for the trypsin inhibitors
      and 2.2-10% for the lectins. After 7 days of germination, trypsin inhibitors and
      lectins were reduced by 72 and 92%, respectively.

PMID- 1757419
TI  - Identification of whale species by thin-layer isoelectric focusing of
      sarcoplasmic proteins.
AB  - Thin-layer isoelectric focusing was applied to the identification of whale
      (Cetacea) species by using water-soluble sarcoplasmic proteins of skeletal
      muscles. Twenty-eight samples consisting of 4 species (10 samples) of baleen
      whales (Mysticeti) and 8 species (18 samples) of toothed whales (Odontoceti) were
      analyzed. Each sample (approximately 1 g) was electrophoresed with Ampholine
      PAGplate, pH 3.5-9.5. The electrophoretic profiles were species-specific on the 4
      toothed whale species that did not have a marked intra-species difference, and
      all 4 baleen whale species. However, the profiles were not specific on the 4
      other dolphin species, even though they were discriminable from the other 4
      toothed whale species. Numerical values of pIs and relative peak heights were
      obtained by densitometric analysis of the isoelectro-focused protein bands. The
      bands were also species-specific for the 8 toothed whale species mentioned. The
      values may be applicable to species identification without the need for a
      standard sample, which may not be readily obtainable. Experiments on test samples
      of minke and sel whales showed that bloodletting with ice water made the
      densities of isoelectro-focused bands thinner, although species identification
      was still possible by using the inside part of muscles. Heat treatment at below
      60 degrees C for 10 min caused little denaturation; at higher temperatures the
      protein bands were diminished in a temperature-dependent fashion. Therefore, the
      present isoelectric focusing analysis should be applicable to small samples of
      whale meat, excluding several species of dolphins.

PMID- 1757420
TI  - Use of the Mycosep multifunctional cleanup column for liquid chromatographic
      determination of aflatoxins in agricultural products.
AB  - A liquid chromatographic (LC) technique has been developed that uses the Mycosep
      multifunctional cleanup (MFC) column. MFC columns provide a rapid 1-step extract
      purification. They are designed to retain particular groups of compounds that may
      create interferences in analytical methods. At the same time, MFC columns allow
      compounds of interest to pass through. In the method presented, test samples are
      extracted in a blender with acetonitrile-water (9 + 1). A portion of the extract
      is forced through an MFC column designed especially for analysis of numerous
      mycotoxins. Analytical interferences are retained, while aflatoxins pass through
      the column. Aflatoxins B1 and G1 are converted to their hemiacetals by heating a
      mixture of purified extract and water-trifluoroacetic acid-acetic acid (7 + 2 +
      1) at 65 degrees C for 8.5 min. An aliquot of this mixture is analyzed by
      isocratic LC with acetonitrile-water mobile phase and fluorescence detection. A
      detection limit of less than 0.5 ng/g for aflatoxin B1 was obtained. Average
      recoveries greater than 95% total aflatoxins (B1, B2, G1, and G2) and
      coefficients of variation of less than 3% were obtained. The method was
      successfully applied to the following commodities: corn, almonds, pista-chios,
      walnuts, peanuts, Brazil nuts, milo, rice, cottonseed, corn meal, corn gluten
      meal, fig paste, and mixed feeds.

PMID- 1757421
TI  - Monitoring aldehyde production during frying by reversed-phase liquid
      chromatography.
AB  - Acrolein (2-propenal) and other low molecular weight aldehydes (LMWAs) formed by
      degradation of the frying medium (triglycerides) were monitored by liquid
      chromatography (LC) during preparation of fried items. LMWA contents of coatings
      from codfish and of doughnuts and their volatiles that codistill with steam are
      monitored by trapping the vapors and distillate from the food matrix in a 2,4
      dinitrophenylhydrazine solution. The resulting hydrazones are partitioned from
      the aqueous phase, first into isooctane and then into acetonitrile for LC
      analysis. The hydrazones are separated and quantified on a C18 reversed-phase
      column with acetonitrile-water as the mobile phase. LMWAs are confirmed by gas
      chromatography/mass spectrometry. No difference was found in LMWA content in
      coatings from fish fillets fried at 182 or 204 degrees C. Cake doughnuts were
      higher in acrolein content than yeast-raised doughnuts prepared under similar
      conditions. Freshness of the frying medium, frying time, and batch size did not
      seem to influence LMWA production from doughnuts. Results indicated that most of
      the LMWAs formed codistilled with steam during frying rather than remaining with
      the food item.

PMID- 1757422
TI  - Improved method for determination of polynuclear aromatic hydrocarbons in
      pharmacopoeial paraffin and mineral oils.
AB  - An improved method has been developed for quantitative determination of
      polynuclear aromatic hydrocarbons (PAHs) in pharmacopoeial paraffin and medicinal
      white oil samples. This new method combines 2 liquid-liquid partition and
      adsorption chromatography procedures with a 2-step purification on Sephadex LH 20
      and liquid chromatography with fluorometric determination. Selective elution of
      PAHs results in absence of background fluorescence. The minimum detectable level
      ranges from 0.2 ppt for benzofluoranthene isomers to 200 ppt for acenaphthene.
      Recoveries of PAHs added at 7 ppm varied from 92.1 to 111.4%. When a variety of
      medicinal white oil samples were analyzed by this improved method, 27 PAHs were
      identified, including 11 suspected carcinogens. Their identities were confirmed
      by capillary gas chromatography.

PMID- 1757423
TI  - Analysis of organochlorine pesticide residues using simultaneous injection of two
      capillary columns with electron capture and electrolytic conductivity detectors.
AB  - A system has been developed that will allow low level screening of 31
      organochlorine pesticide residues using simultaneous injection on 2 dissimilar
      capillary columns. An electron capture detector was attached to a DB-1701 column,
      and an electrolytic conductivity detector in the halogen mode was attached to a
      DB-5 column. Chlorinated pesticide amounts ranging from 0.05 ng for gamma-BHC to
      1.5 ng for decamethrin can easily be quantitated and confirmed. The system can be
      used in either the column programmed mode or the isothermal column mode. Good
      reproducibility was obtained for injections in both modes. This system can easily
      be retrofitted to any gas chromatograph using on column or split/splitless
      injectors.

PMID- 1757424
TI  - Separation and determination of diesel contaminants in various fish products by
      capillary gas chromatography.
AB  - A semiquantitative capillary column gas chromatographic method is described for
      the determination of diesel fuel contamination in various canned seafood
      products. The diesel contaminants are separated from the fish sample by steam
      distillation, with little carry-over of interfering intrinsic materials such as
      fish oils. The diesel fuel is extracted from the condensate with n-hexane, and
      the extract is analyzed on an SPB-1 fused silica capillary column. The efficiency
      of recovery of diesel fuel added to canned seafood at levels of 40-400 ppt ranged
      from 72 to 102%. With the additional step of concentrating the hexane extract,
      the sensitivity of this procedure may be increased at least 10-fold. This
      procedure can detect the differences among diesel fuel grades No. 1, 2, and 5,
      and variations within diesel grade No. 2, and thus may be useful in determining
      the type of petroleum contaminants present in various canned fish products.

PMID- 1757425
TI  - GC/MIP/AED method for pesticide residue determination in fruits and vegetables.
AB  - This research describes the results of a gas chromatography/microwave induced
      plasma/atomic emission detection (GC/MIP/AED) method performed on a Hewlett
      Packard 5921A system for pesticide residue analysis in fruits and vegetables. A
      total of 6 experiments were conducted: (1) sensitivity and linearity studies for
      elements S, P, Cl, and N by analyzing dursban; (2) a study of instrument response
      to Cl concentration in pesticide molecules; (3) organochlorinated pesticide
      recoveries; (4) organophosphate pesticide recoveries; (5) carbamate pesticide
      recoveries; and (6) investigation of metallic pesticides with plictran and vendex
      as standards. The rank according to sensitivity and linearity was found to be as
      follows: S-181 greater than P-178 greater than Cl-479 greater than N-174.
      Instrument response to the concentration of chlorine atoms in the pesticide
      molecule was linear, with a correlation coefficient of 0.89. Recoveries of
      organochlorinated pesticides were 91.7-109.3%, with the exception of citrus,
      whose recovery was affected by coeluting interferences. Organophosphate
      recoveries were 73.2% or higher, except for the cygon oxygen analog, which
      degraded in the GC system under all circumstances. Carbamate recoveries were
      inconsistent quantitatively; however, the information generated from elements N
      and S were useful for qualitative confirmation of other methods, such as LC
      postcolumn derivatization analysis. Overall, the GC/MIP/AED method is powerful
      for qualitative confirmation in pesticide residue analysis. The instrument's
      capability of acquiring multi-elements (Cl and P) selectively and accurately is
      an alternative method for organochlorinated and organophosphate pesticide residue
      analyses. In addition, the GC/MIP/AED system is easy to use, simple to maintain,
      and its chromatograms can be interpreted by any chromatography analyst without
      much prior training.

PMID- 1757426
TI  - Current status of research activity in American child and adolescent psychiatry:
      II. A developmental analysis by age cohorts.
AB  - A survey designed to assess research activity was sent to 622 full-time child and
      adolescent psychiatric faculty at 127 academic programs. A 78.5% response rate
      was achieved. An examination of the responses of three age cohorts was conducted.
      Only about 10% of the respondents met the empirical definition of a researcher
      based on percentage of effort, publication, and funding. No increase in research
      activity was found for the youngest cohort, although significantly more younger
      women were holding academic appointments. Younger researchers identified
      psychobiological studies as a particular interest. Researchers at all ages
      identified a mentor program as a critical aspect of their training.

PMID- 1757427
TI  - The development of the woman child psychiatry researcher--a review.
AB  - Greater efforts should be made to recruit women into child psychiatry research.
      Women's tendencies to minimize their creativity and to avoid competition and
      criticism and women's underrepresentation and isolation in research and academia
      should be addressed. Nontraditional lateral tracks should be developed for women
      during phases of intense professional and personal demands. Mentorships,
      stimulating collegial relationships, and open forums at local and national levels
      to address these issues may encourage women's growth as child psychiatry
      researchers. In addition, changes for improving hiring, promoting, and
      facilitating career development for women are mandated.

PMID- 1757428
TI  - A 3-year-old boy's chronic diarrhea and unexplained death.
AB  - The fatal case of a three year-old boy hospitalized for chronic diarrhea is
      described. The diagnosis of Munchausen's by Proxy is discussed, and the approach
      to such cases is explored.

PMID- 1757429
TI  - Is divorce a major trauma?

PMID- 1757430
TI  - Ritual abuse of children.

PMID- 1757431
TI  - Will they grow out of it?

PMID- 1757432
TI  - Buspirone for aggression.

PMID- 1757433
TI  - Desipramine side-effect.

PMID- 1757434
TI  - Current developments in the understanding of mental retardation. Part II:
      Psychopathology.
AB  - During recent years there has been greater recognition of the impressive degree
      of psychiatric disturbance that affects those with mental retardation. An
      increasing number of systematic studies are focusing on the prevalence, risk
      factors, and clinical characteristics of psychiatric disturbance within this
      population. In addition, traditional neuropsychiatric assessment and treatment
      approaches are being evaluated, and new approaches are being developed. Such
      efforts will undoubtedly improve the ability to effectively diagnose and treat
      mentally retarded individuals suffering from psychiatric disorders. This paper is
      the second of two reviews that explore several recent developments in biological,
      phenomenological, and psychopathological aspects of mental retardation.

PMID- 1757435
TI  - Psychiatric aspects of epileptic children and adolescents.
AB  - Epilepsy is the most prevalent neurological disorder of childhood and adolescence
      and a very heterogenous disease with a diverse course of illness. It may be a
      benign disease for the majority of children and adolescents, who recover
      spontaneously or are managed well medically; however, a sizeable group of
      children and adolescents with epilepsy, at least one-third, do manifest various
      difficulties--seizure control, academic, emotional, behavioral, and family
      problems. As a group, they have a much higher rate of psychiatric disorder than
      healthy children and children with other chronic illnesses. This review is
      undertaken to summarize the literature on epilepsy in children and adolescents,
      especially with respect to epidemiology, developmental and psychiatric problems,
      and psychiatric treatment issues.

PMID- 1757436
TI  - Behavioral profile and social competence in temporal lobe epilepsy of
      adolescence.
AB  - A group of 26 adolescents with temporal lobe epilepsy was compared with a matched
      control group of 26 adolescents with chronic bronchial asthma as well as with a
      group of 90 healthy adolescents, using the social competence measure and the
      behavior profile of the Child Behavior Checklist. Both chronically ill groups
      exhibited more social and behavioral problems than the healthy adolescents but
      were similar to each other on the social and behavioral profiles. The one area in
      which the temporal lobe epilepsy and asthmatic groups differed from one another
      was that of "schizoid" psychopathology in male subjects.

PMID- 1757437
TI  - Middle childhood onset of interictal psychosis.
AB  - The authors describe three children (mean age = 7.8 years) with complex partial
      epilepsy, left temporal lobe involvement, and interictal schizophrenia-like
      psychosis. As described in adults with complex partial epilepsy, these children
      met DSM-III criteria for schizophrenia, their affect was intact, and they
      demonstrated no negative signs of schizophrenia. Unlike adult epileptic patients,
      these children demonstrated psychotic symptomatology despite inadequate seizure
      control and after a short latency period. The possible role of early onset
      seizures, temporal lobe lesions, and kindling on the developing brain are
      discussed.

PMID- 1757438
TI  - Disturbances of affect expression in failure-to-thrive.
AB  - Positive and negative affects were assessed in 28 6- to 36-month-old children
      with failure-to-thrive and 14 normally growing children in feeding and nonfeeding
      situations. The roles of malnutrition and severity of organic effects also were
      examined. Failure-to-thrive children expressed less positive affect in the
      feeding and nonfeeding situations and more negative affect in feeding than
      normally growing children. Among failure-to-thrive children, the presence of both
      acute and chronic malnutrition was associated with heightened negative affect
      during feeding, whereas the degree of organic contribution had no effect. These
      results, if replicated, may have implications for clinical assessment and are
      discussed in terms of current theories of failure-to-thrive.

PMID- 1757439
TI  - Parental distress and social interaction in families with children with
      inflammatory bowel disease.
AB  - Twenty families who had children with inflammatory bowel disease (IBD) and 20
      comparison families with healthy children were studied concerning parental
      distress and social interaction. The mothers in the IBD group scored very high on
      parental distress, whereas the fathers did not differ from the comparison group.
      Both parents in the IBD group reported significantly lower scores on a social
      support scale. The dimension of social integration was normal, but deeper
      relations and attachment were negatively affected among parents in the IBD group.
      The mental health of the children with IBD correlated with the social support,
      especially the qualitative aspects.

PMID- 1757440
TI  - Family interaction and locus of control in children and adolescents with
      inflammatory bowel disease.
AB  - This study showed that children and adolescents with inflammatory bowel disease
      (IBD) had a more external locus of control than did matched diabetic and healthy
      children. An external locus of control correlated with severity of physical
      illness and presence of psychiatric disorders. It also correlated significantly
      with family dysfunction, which was found to be more common in the IBD group than
      in the groups compared. Tendencies toward a tense and negative family climate
      were observed in the IBD families. Awareness of the interaction between physical
      and psychosocial factors in IBD is essential in the management of therapy.

PMID- 1757441
TI  - Internalizing and externalizing symptoms and attributional style in youth with
      diabetes.
AB  - The psychiatric functioning of 28 youths with insulin-dependent diabetes mellitus
      was examined. Measures of psychological functioning were related to age at onset,
      duration of diabetes, and metabolic control, as assessed by HgbAlC. Children
      diagnosed with insulin-dependent diabetes mellitus at a later age were considered
      by teachers to have more behavioral problems. Children who had better metabolic
      control tended to hold themselves responsible for negative events. It is
      worthwhile to develop interventions to teach diabetic children a realistic
      balance between taking appropriate responsibility for controllable negative
      events without taking undue blame for uncontrollable negative events associated
      with the disease.

PMID- 1757442
TI  - A controlled study of psychoanalytic treatment of brittle diabetes.
AB  - The study compared two equivalent groups of 11 diabetic children with grossly
      abnormal blood glucose profiles necessitating repeated admissions to a hospital.
      Patients in the treatment group were offered an intensive inpatient treatment
      program including psychoanalytic psychotherapy three to four times a week, which
      took place on the hospital ward and lasted an average of 15 weeks. The
      intervention was highly effective in improving the diabetic control of the
      children, and this was maintained at a 1 year follow-up. Patients in the
      comparison group, who were offered only inpatient medical intervention, returned
      to their prehospitalization level of metabolic control within a period of 3
      months from discharge.

PMID- 1757443
TI  - Malignant memories: PTSD in children and adults after a school shooting.
AB  - Sixty-four children and 66 adults were screened for post-traumatic stress
      disorder 6 to 14 months after a school shooting. Although there were no
      differences in overall frequencies of DSM-III-R diagnoses or cluster
      endorsements, there were developmental influences. Post-traumatic stress disorder
      was associated more with emotional states recalled from the disaster than with
      proximity. Emotional states mediated the formation of malignant memories leading
      to symptomatology, suggesting that postdisaster intervention be offered on the
      basis of degree of emotional reaction as well as proximity.

PMID- 1757444
TI  - Children and disaster: age, gender, and parental effects on PTSD symptoms.
AB  - Psychiatric reports of 179 children aged 2 to 15 who were exposed to the Buffalo
      Creek dam collapse in 1972 were rated for post-traumatic stress disorder (PTSD)
      symptoms 2 years after the disaster. Age and gender effects and the impact of the
      level of exposure and parental functioning were examined according to a
      conceptual model addressing factors contributing to adaptation to a traumatic
      event. Results showed fewer PTSD symptoms in the youngest age group and higher
      symptom levels for girls than boys. Approximately 37% of the children were given
      a "probable" diagnosis of PTSD. Multiple regression analysis showed that life
      threat, gender, parental psychopathology, and an irritable and/or depressed
      family atmosphere all contributed to the prediction of PTSD symptomatology in the
      children.

PMID- 1757445
TI  - Stress responses after pediatric bone marrow transplantation: preliminary results
      of a prospective longitudinal study.
AB  - This paper reports the preliminary findings of a longitudinal prospective study
      of young children undergoing bone marrow transplantation. Symptoms of post
      traumatic stress were seen in these children up to 12 months after transplant.
      The bone marrow transplantation survivors demonstrated more denial and avoidance
      and fewer arousal symptoms than has been noted in children traumatized by a
      violent life threat, such as a sniper attack. These data suggest the use of post
      traumatic stress as a model in understanding some of the symptoms of pediatric
      bone marrow transplantation survivors and may be applicable to other children
      exposed to the double life threat of serious illness and intensive medical
      intervention.

PMID- 1757446
TI  - Family dysfunction and alcohol and drug use in adolescent psychiatric inpatients.
AB  - This report examines the relationship between family functioning and substance
      abuse in adolescent psychiatric inpatients. The adolescents, who had been
      hospitalized after acute psychiatric crises, provided reports of drug and alcohol
      use, intoxication-related problems, and family functioning during the 4 months
      preceding hospitalization. Greater degrees of family dysfunction in the areas of
      affective responsiveness and role functioning were associated with higher levels
      of substance abuse. When age, sex, and diagnosis were controlled for, family
      dysfunction in these areas was still significantly associated with alcohol
      consumption but not with drug use or intoxication-related problems. Implications
      for treatment are discussed.

PMID- 1757447
TI  - Characteristics and outcome of hospitalized adolescent girls with conduct
      disorder.
AB  - Fifty-five adolescent girls with conduct disorder from a psychiatric hospital
      were examined with a structured interview schedule and then reevaluated 2 to 4
      years later. The majority also had depressive or anxiety disorders. The criteria
      used for conduct disorder were less weighted toward violent crime and differed
      from the criteria in DSM-III-R. Their outcome was poor; 6% had died a violent
      death, the majority had dropped out of school, one-third were pregnant before the
      age of 17, half were rearrested, and many suffered traumatic injuries. Diagnoses
      of depression or anxiety disorders at the index admission were not associated
      with a better outcome.

PMID- 1757448
TI  - Aggressive behavior in youth: characteristics, outcome, and psychiatric
      diagnoses.
AB  - This study evaluated the characteristics and outcome of a group of children and
      adolescents treated in day hospital and inpatient settings. Severe
      aggressive/destructive behavior was present in about one-third of the sample and
      was more common in boys, in children and adolescents with history of parental
      substance abuse, and in those with a concurrent diagnosis of conduct disorder.
      Although both an admission diagnosis of conduct disorder and
      aggressive/destructive behavior as a preadmission variable predicted poor
      outcome, aggressive/destructive behavior was the more important of the two.
      Aggressive/destructive behavior in association with conduct disorder seems to
      confer an especially poor prognosis in hospital-treated youth.

PMID- 1757449
TI  - Diagnostic predictors of treatment patterns in a cohort of adolescents.
AB  - Data on 776 American adolescents studied longitudinally were used to show
      treatment patterns related to psychiatric disorders. When DSM-III-R diagnoses
      based on mother and youth Diagnostic Interview Schedule for Children interviews
      were used prospectively to determine subsequent treatment seeking, it was found
      that consultation with mental health specialists, but not with pediatricians or
      general practitioners, was elevated in those with disorders. The specific
      diagnoses most associated with treatment seeking were conduct disorder and
      oppositional/defiant disorder. No compensation for differences in mental health
      service usage between children with internalizing disorders and those with
      externalizing disorders in the form of help from informal or other professional
      sources was present.

PMID- 1757450
TI  - Predictors of length of stay of psychiatric adolescent inpatients.
AB  - This study reviewed 158 consecutive admissions to an inpatient adolescent
      psychiatric service for factors that determine length of hospitalization.
      Variables associated with length of stay included diagnostic category and the
      treatment variables of number and type of psychotropic medications prescribed.
      Patients with disruptive behavior disorders had the shortest hospitalizations,
      those with anxiety and affective disorders had stays of intermediate length, and
      patients with psychotic/organic disorders had the longest hospitalizations.
      Treatment with lithium, neuroleptics, or tricyclic antidepressants was associated
      with longer stays. Demographic variables and variables describing the social and
      family situation or level of dangerousness were not significantly associated with
      length of hospitalization.

PMID- 1757451
TI  - Paranoid and aggressive behavior in two obsessive-compulsive adolescents treated
      with clomipramine.
AB  - Obsessive-compulsive disorder is increasingly recognized in patients of different
      age groups. Serotonergic agents, such as clomipramine, have been recently found
      to be useful in the management of this condition. However, unexpected side
      effects, such as dysphoria, aggressiveness, and paranoid ideation, may occur with
      therapeutic doses of this compound, as evidenced in the cases of two male
      adolescents presented here. Possible pathogenetic factors, involving serotonin
      and serotonin-receptor abnormalities are discussed. Management of these side
      effects is based on adequate dose reduction and monitorization.

PMID- 1757452
TI  - Treatment of social phobia with drugs other than benzodiazepines.
AB  - Social phobia is emerging as an important cause of psychiatric morbidity. Reasons
      for this are described, as are clinical issues of importance to social phobia,
      including the extensive associated distress and disability. The use of
      phenelzine, atenolol, buspirone, fluoxetine, and moclobemide are described.
      Diagnostic and transcultural aspects of social phobia are described.

PMID- 1757453
TI  - Long-term treatment of social phobia with clonazepam.
AB  - Twenty-six socially phobic outpatients were treated with clonazepam for the
      relief of symptoms. At evaluation, which took place after an average of 11.3
      months of continuous treatment, 22 (84.6%) patients showed good improvement and 4
      (14.4%) showed no improvement or were not recovered. The dose declined over time,
      from a peak mean of 2.1 mg/day to a mean of 0.94 mg/day at follow-up. Side
      effects are described, along with individual case descriptions that illustrate
      important aspects of the use of benzodiazepines for the treatment of social
      phobia.

PMID- 1757454
TI  - Phenomenology and neurobiology of social phobia: comparison with panic disorder.
AB  - Like panic disorder, social phobia is a common, frequently severe, anxiety
      disorder that can cause significant work and social impairment. Unlike panic
      disorder, social phobia has only recently begun to undergo neurobiologic study
      and to receive pharmacotherapeutic attention. There is a high comorbidity between
      social phobia and panic disorder; however, many differences exist--including age
      at onset, gender distribution, contextual framework of anxiety, help-seeking and
      help-avoidance behavior, quality of sleep and sleep patterns, caffeine and
      lactate sensitivity, and, most probably, pharmacologic responses. Social phobia
      can now be included among the growing number of anxiety disorders that respond to
      pharmacotherapy.

PMID- 1757455
TI  - Levels of urinary free cortisol in social phobia.
AB  - Levels of urinary free cortisol were measured in 10 patients with social phobias
      and in 15 age- and sex-matched normal controls. No differences were found either
      in cortisol levels or in the ratio of free cortisol to creatinine. These
      nonsignificant differences between groups do not necessarily rule out the
      possibility that the hypothalamic-pituitary-adrenal axis may be altered in
      individuals with social phobia.

PMID- 1757456
TI  - Social phobia: the Anxiety Disorders Associated of America helps raise the veil
      of ignorance.
AB  - Social phobias affect some 2.4 million American adults, and more than 5 million
      can expect to develop a social phobia during their lifetime. Despite their
      prevalence, social phobias have been virtually ignored until this past decade.
      The Anxiety Disorders Association of America (ADAA) was founded in 1980 to
      promote awareness among professionals and the public of anxiety disorders. This
      paper outlines the objectives of ADAA and its programs, including the Self-Help
      Group Network, helpful publications, and its partnership with psychiatrists and
      patients. The benefits of self-help programs to persons with social phobias are
      illustrated, including the role played by the clinician in evaluation and
      referral. The ADAA program for the 1990s focuses on the education of all health
      professionals and the creation of awareness of economic costs of undiagnosed
      anxiety disorders.

PMID- 1757457
TI  - The Brief Social Phobia Scale.
AB  - An observer measure of social phobic symptoms, referred to as the Brief Social
      Phobia Scale, consists of 11 items, 7 evaluating commonly feared or avoided
      situations and 4 additional items measuring autonomic distress. Symptoms
      represented by the scale items are found frequently in social phobia, and the
      instrument demonstrates acceptable interrater and test-retest reliability,
      internal consistency, concurrent validity against other measures of social
      phobia, and the ability of patients to change as a result of treatment. It can
      also detect differences between active treatment and placebo treatment. A
      comparison of the sensitivity of this scale with other scales in detection of
      size of effect also is presented.

PMID- 1757458
TI  - Behavioral inhibition in children: a possible precursor to panic disorder or
      social phobia.
AB  - A biological-environmental interaction currently provides the best explanation of
      an anxiety disorder's evolution. In this sense, anxiety disorders are like other
      medical disorders for which a person may have a predisposition. Our knowledge of
      the evolution of anxiety disorders would be enhanced by the ability to identify
      those persons predisposed to anxiety and to identify such "proneness" before an
      anxiety disorder emerges in adulthood. We discuss the developmental aspects of
      panic disorder and social phobia, in particular findings suggesting that
      behavioral inhibition in children may be a precursor to phobic disorders in
      adults. Only longitudinal studies will resolve whether childhood response
      patterns are specifically linked to the risk of developing anxiety disorders or
      other psychopathology across the life cycle. In the interim, we suggest some
      guidelines for parents and clinicians to meet the unique needs of the inhibited
      child.

PMID- 1757459
TI  - Characterization of the immature secretory granule, an intermediate in granule
      biogenesis.
AB  - The events in the biogenesis of secretory granules after the budding of a dense
      cored vesicle from the trans-Golgi network (TGN) were investigated in the
      neuroendocrine cell line PC12, using sulfate-labeled secretogranin II as a
      marker. The TGN-derived dense-cored vesicles, which we refer to as immature
      secretory granules, were found to be obligatory organellar intermediates in the
      biogenesis of the mature secretory granules which accumulate in the cell.
      Immature secretory granules were converted to mature secretory granules with a
      half-time of approximately 45 min. This conversion entailed an increase in their
      size, implying that the maturation of secretory granules includes a fusion event
      involving immature secretory granules. Pulse-chase labelling of PC12 cells
      followed by stimulation with high K+, which causes the release of secretogranin
      II, showed that not only mature, but also immature secretory granules were
      capable of undergoing regulated exocytosis. The kinetics of secretion of
      secretogranin II, as well as those of a constitutively secreted heparan sulfate
      proteoglycan, were reduced by treatment of PC12 cells with nocodazole, suggesting
      that both secretory granules and constitutive secretory vesicles are transported
      to the plasma membrane along microtubules. Our results imply that certain
      membrane proteins, e.g., those involved in the fusion of post-TGN vesicles with
      the plasma membrane, are sorted upon exit from the TGN, whereas other membrane
      proteins, e.g., those involved in the interaction of post-TGN vesicles with the
      cytoskeleton, may not be sorted.

PMID- 1757460
TI  - Milieu-induced, selective aggregation of regulated secretory proteins in the
      trans-Golgi network.
AB  - Regulated secretory proteins are thought to be sorted in the trans-Golgi network
      (TGN) via selective aggregation. The factors responsible for this aggregation are
      unknown. We show here that two widespread regulated secretory proteins,
      chromogranin B and secretogranin II (granins), remain in an aggregated state when
      TGN vesicles from neuroendocrine cells (PC12) are permeabilized at pH 6.4 in 1-10
      mM calcium, conditions believed to exist in this compartment. Permeabilization of
      immature secretory granules under these conditions allowed the recovery of
      electron dense cores. The granin aggregates in the TGN largely excluded
      glycosaminoglycan chains which served as constitutively secreted bulk flow
      markers. The low pH, high calcium milieu was sufficient to induce granin
      aggregation in the RER. In the TGN of pituitary GH4C1 cells, the proportion of
      granins conserved as aggregates was higher upon hormonal treatment known to
      increase secretory granule formation. Our data suggest that a decrease in pH and
      an increase in calcium are sufficient to trigger the selective aggregation of the
      granins in the TGN, segregating them from constitutive secretory proteins.

PMID- 1757461
TI  - Isolation, characterization, and expression of cDNAs encoding murine alpha
      mannosidase II, a Golgi enzyme that controls conversion of high mannose to
      complex N-glycans.
AB  - Golgi alpha-mannosidase II (GlcNAc transferase I-dependent alpha 1,3[alpha 1,6]
      mannosidase, EC 3.2.1.114) catalyzes the final hydrolytic step in the N-glycan
      maturation pathway acting as the committed step in the conversion of high mannose
      to complex type structures. We have isolated overlapping clones from a murine
      cDNA library encoding the full length alpha-mannosidase II open reading frame and
      most of the 5' and 3' untranslated region. The coding sequence predicts a type II
      transmembrane protein with a short cytoplasmic tail (five amino acids), a single
      transmembrane domain (21 amino acids), and a large COOH-terminal catalytic domain
      (1,124 amino acids). This domain organization which is shared with the Golgi
      glycosyl-transferases suggests that the common structural motifs may have a
      functional role in Golgi enzyme function or localization. Three sets of
      polyadenylated clones were isolated extending 3' beyond the open reading frame by
      as much as 2,543 bp. Northern blots suggest that these polyadenylated clones
      totaling 6.1 kb in length correspond to minor message species smaller than the
      full length message. The largest and predominant message on Northern blots (7.5
      kb) presumably extends another approximately 1.4-kb downstream beyond the longest
      of the isolated clones. Transient expression of the alpha-mannosidase II cDNA in
      COS cells resulted in 8-12-fold overexpression of enzyme activity, and the
      appearance of cross-reactive material in a perinuclear membrane array consistent
      with a Golgi localization. A region within the catalytic domain of the alpha
      mannosidase II open reading frame bears a strong similarity to a corresponding
      sequence in the rat liver endoplasmic reticulum alpha-mannosidase and the
      vacuolar alpha-mannosidase of Saccharomyces cerevisiae. Partial human alpha
      mannosidase II cDNA clones were also isolated and the gene was localized to human
      chromosome 5.

PMID- 1757462
TI  - Insulin receptors internalize by a rapid, saturable pathway requiring receptor
      autophosphorylation and an intact juxtamembrane region.
AB  - The effect of receptor occupancy on insulin receptor endocytosis was examined in
      CHO cells expressing normal human insulin receptors (CHO/IR), autophosphorylation
      and internalization-deficient receptors (CHO/IRA1018), and receptors which
      undergo autophosphorylation but lack a sequence required for internalization
      (CHO/IR delta 960). The rate of [125I]insulin internalization in CHO/IR cells at
      37 degrees C was rapid at physiological concentrations, but decreased markedly in
      the presence of increasing unlabeled insulin (ED50 = 1-3 nM insulin, or 75,000
      occupied receptors/cell). In contrast, [125I]insulin internalization by
      CHO/IRA1018 and CHO/IR delta 960 cells was slow and was not inhibited by
      unlabeled insulin. At saturating insulin concentrations, the rate of
      internalization by wild-type and mutant receptors was similar. Moreover,
      depletion of intracellular potassium, which has been shown to disrupt coated pit
      formation, inhibited the rapid internalization of [125I]insulin at physiological
      insulin concentrations by CHO/IR cells, but had little or no effect on
      [125I]insulin uptake by CHO/IR delta 960 and CHO/IRA1018 cells or wild-type cells
      at high insulin concentrations. These data suggest that the insulin-stimulated
      entry of the insulin receptor into a rapid, coated pit-mediated internalization
      pathway is saturable and requires receptor autophosphorylation and an intact
      juxtamembrane region. Furthermore, CHO cells also contain a constitutive
      nonsaturable pathway which does not require receptor autophosphorylation or an
      intact juxtamembrane region; this second pathway is unaffected by depletion of
      intracellular potassium, and therefore may be independent of coated pits. Our
      data suggest that the ligand-stimulated internalization of the insulin receptor
      may require specific saturable interactions between the receptor and components
      of the endocytic system.

PMID- 1757463
TI  - An endogenous MDCK lysosomal membrane glycoprotein is targeted basolaterally
      before delivery to lysosomes.
AB  - Using surface immunoprecipitation at 37 degrees C to "catch" the transient apical
      or basolateral appearance of an endogenous MDCK lysosomal membrane glycoprotein,
      the AC17 antigen, we demonstrate that the bulk of newly synthesized AC17 antigen
      is polarly targeted from the Golgi apparatus to the basolateral plasma membrane
      or early endosomes and is then transported to lysosomes via the endocytic
      pathway. The AC17 antigen exhibits very similar properties to members of the
      family of lysosomal-associated membrane glycoproteins (LAMPs). Parallel studies
      of an avian LAMP, LEP100, transfected into MDCK cells revealed colocalization of
      the two proteins to lysosomes, identical biosynthetic and degradation rates, and
      similar low levels of steady-state expression on both the apical (0.8%) and
      basolateral (2.1%) membranes. After treatment of the cells with chloroquine,
      newly synthesized AC17 antigen, while still initially targeted basolaterally,
      appears stably in both the apical and basolateral domains, consistent with the
      depletion of the AC17 antigen from lysosomes and its recycling in a nonpolar
      fashion to the cell surface.

PMID- 1757464
TI  - Protein folding causes an arrest of preprotein translocation into mitochondria in
      vivo.
AB  - With vital yeast cells, a hybrid protein consisting of the amino-terminal third
      of the precursor to cytochrome b2 and of the entire dihydrofolate reductase was
      arrested on the import pathway into mitochondria. Accumulation of the protein in
      the mitochondrial membranes was achieved by inducing a stable tertiary structure
      of the dihydrofolate reductase domain. Thereby, three salient features of
      mitochondrial protein uptake in vivo were demonstrated: its posttranslational
      character; the requirement for unfolding of precursors; and import through
      translocation contact sites. The permanent occupation of translocation sites by
      the fusion protein inhibited the import of other precursors; it did, however, not
      lead to leakage of mitochondrial ions, implying the existence of a channel that
      is sealed around the membrane spanning polypeptide segment.

PMID- 1757465
TI  - Characterization of actin filament severing by actophorin from Acanthamoeba
      castellanii.
AB  - Actophorin is an abundant 15-kD actinbinding protein from Acanthamoeba that is
      thought to form a nonpolymerizable complex with actin monomers and also to reduce
      the viscosity of polymerized actin by severing filaments (Cooper et al., 1986. J.
      Biol. Chem. 261:477-485). Homologous proteins have been identified in sea urchin,
      chicken, and mammalian tissues. Chemical crosslinking produces a 1:1 covalent
      complex of actin and actophorin. Actophorin and profilin compete for crosslinking
      to actin monomers. The influence of actophorin on the steady-state actin polymer
      concentration gave a Kd of 0.2 microM for the complex of actophorin with actin
      monomers. Several new lines of evidence, including assays for actin filament ends
      by elongation rate and depolymerization rate, show that actophorin severs actin
      filaments both at steady state and during spontaneous polymerization. This is
      confirmed by direct observation in the light microscope and by showing that the
      effects of actophorin on the low shear viscosity of polymerized actin cannot be
      explained by monomer sequestration. The severing activity of actophorin is
      strongly inhibited by stoichiometric concentrations of phalloidin or millimolar
      concentrations of inorganic phosphate.

PMID- 1757466
TI  - The actin filament severing protein actophorin promotes the formation of rigid
      bundles of actin filaments crosslinked with alpha-actinin.
AB  - The actin filament severing protein, Acanthamoeba actophorin, decreases the
      viscosity of actin filaments, but increases the stiffness and viscosity of
      mixtures of actin filaments and the crosslinking protein alpha-actinin. The
      explanation of this paradox is that in the presence of both the severing protein
      and crosslinker the actin filaments aggregate into an interlocking meshwork of
      bundles large enough to be visualized by light microscopy. The size of these
      bundles depends on the size of the containing vessel. The actin filaments in
      these bundles are tightly packed in some areas while in others they are more
      disperse. The bundles form a continuous reticulum that fills the container, since
      the filaments from a particular bundle may interdigitate with filaments from
      other bundles at points where they intersect. The same phenomena are seen when
      rabbit muscle aldolase rather than alpha-actinin is used as the crosslinker. We
      propose that actophorin promotes bundling by shortening the actin filaments
      enough to allow them to rotate into positions favorable for lateral interactions
      with each other via alpha-actinin. The network of bundles is more rigid and less
      thixotropic than the corresponding network of single actin filaments linked by
      alpha-actinin. One explanation may be that alpha-actinin (or aldolase) normally
      in rapid equilibria with actin filaments may become trapped between the filaments
      increasing the effective concentration of the crosslinker.

PMID- 1757467
TI  - Uncoupling of Chlamydomonas flagellar gene expression and outgrowth from
      flagellar excision by manipulation of Ca2+.
AB  - Chlamydomonas cells respond to certain environmental stimuli by shedding their
      flagella. Flagellar loss induces a rapid, transient increase in expression of a
      specific set of genes encoding flagellar proteins, and assembly of a new
      flagellar pair. While flagellar gene expression and initiation of flagellar
      outgrowth are normally tightly coupled to flagellar excision, our results
      demonstrate that these processes can be uncoupled by manipulating Ca2+ levels or
      calmodulin activity. In our experiments, wild-type cells were stimulated to
      excise their flagella using mechanical shearing, and at times after
      deflagellation, flagellar lengths were measured and flagellar mRNA abundance
      changes were determined by S1 nuclease protection analysis. When extracellular
      Ca2+ was lowered by addition of EGTA to cultures before excision, flagellar mRNA
      abundance changes and flagellar outgrowth were temporally uncoupled from
      flagellar excision. When extracellular Ca2+ was lowered immediately after
      excision or when calmodulin activity was inhibited with W-7, flagellar outgrowth
      was uncoupled from flagellar excision and flagellar mRNA abundance changes.
      Whenever events in the process of flagellar regeneration were temporally
      uncoupled, the magnitude of the flagellar mRNA abundance change was reduced.
      These results suggest that flagellar gene expression may be regulated by multiple
      signals generated from these events, and implicate Ca2+ as a factor in the
      mechanisms controlling flagellar regeneration.

PMID- 1757468
TI  - Dystrophin-associated proteins are greatly reduced in skeletal muscle from mdx
      mice.
AB  - Dystrophin, the protein product of the human Duchenne muscular dystrophy gene,
      exists in skeletal muscle as a large oligomeric complex that contains four
      glycoproteins of 156, 50, 43, and 35 kD and a protein of 59 kD. Here, we
      investigated the relative abundance of each of the components of the dystrophin
      glycoprotein complex in skeletal muscle from normal and mdx mice, which are
      missing dystrophin. Immunoblot analysis using total muscle membranes from control
      and mdx mice of ages 1 d to 30 wk found that all of the dystrophin-associated
      proteins were greatly reduced (80-90%) in mdx mouse skeletal muscle. The
      specificity of the loss of the dystrophin-associated glycoproteins was
      demonstrated by the finding that the major glycoprotein composition of skeletal
      muscle membranes from normal and mdx mice was identical. Furthermore, skeletal
      muscle membranes from the dystrophic dy/dy mouse exhibited a normal density of
      dystrophin and dystrophin-associated proteins. Immunofluorescence microscopy
      confirmed the results from the immunoblot analysis and showed a drastically
      reduced density of dystrophin-associated proteins in mdx muscle cryosections
      compared with normal and dy/dy mouse muscle. Therefore, our results demonstrate
      that all of the dystrophin-associated proteins are significantly reduced in mdx
      skeletal muscle and suggest that the loss of dystrophin-associated proteins is
      due to the absence of dystrophin and not due to secondary effects of muscle fiber
      degradation.

PMID- 1757469
TI  - Localization of the DMDL gene-encoded dystrophin-related protein using a panel of
      nineteen monoclonal antibodies: presence at neuromuscular junctions, in the
      sarcolemma of dystrophic skeletal muscle, in vascular and other smooth muscles,
      and in proliferating brain cell lines.
AB  - mAbs have been raised against different epitopes on the protein product of the
      DMDL gene, which is an autosomal homologue of the X-linked DMD gene for
      dystrophin. These antibodies provide direct evidence that DMDL protein is
      localized near acetylcholine receptors at neuromuscular junctions in normal and
      mdx mouse intercostal muscle. The primary location in tissues other than skeletal
      muscle is smooth muscle, especially in the vascular system, which may account for
      the wide tissue distribution previously demonstrated by Western blotting. The
      DMDL protein was undetectable in the nonjunctional sarcolemma of normal human
      muscle, but was observed in nonjunctional sarcolemma of Duchenne muscular
      dystrophy patients, where dystrophin itself is absent or greatly reduced. The
      expression of DMDL protein is not restricted to smooth and skeletal muscle,
      however, since relatively large amounts are present in transformed brain cell
      lines of both glial and Schwann cell origin. This contrasts with the low levels
      of DMDL protein in adult brain tissue.

PMID- 1757470
TI  - Mutagenesis of the 43-kD postsynaptic protein defines domains involved in plasma
      membrane targeting and AChR clustering.
AB  - The postsynaptic membrane of the neuromuscular junction contains a myristoylated
      43-kD protein (43k) that is closely associated with the cytoplasmic face of the
      nicotinic acetylcholine receptor (AChR)-rich plasma membrane. Previously, we
      described fibroblast cell lines expressing recombinant AChRs. Transfection of
      these cell lines with 43k was necessary and sufficient for reorganization of AChR
      into discrete 43k-rich plasma membrane domains (Phillips, W. D., C. Kopta, P.
      Blount, P. D. Gardner, J. H. Steinbach, and J. P. Merlie. 1991. Science (Wash.
      DC). 251:568-570). Here we demonstrate the utility of this expression system for
      the study of 43k function by site-directed mutagenesis. Substitution of a
      termination codon for Asp254 produced a truncated (28-kD) protein that associated
      poorly with the cell membrane. The conversion of Gly2 to Ala2, to preclude NH2
      terminal myristoylation, reduced the frequency with which 43k formed plasma
      membrane domains by threefold, but did not eliminate the aggregation of AChRs at
      these domains. Since both NH2 and COOH-termini seemed important for association
      of 43k with the plasma membrane, a deletion mutant was constructed in which the
      codon Gln15 was fused in-frame to Ile255 to create a 19-kD protein. This mutated
      protein formed 43k-rich plasma membrane domains at wild-type frequency, but the
      domains failed to aggregate AChRs, suggesting that the central part of the 43k
      polypeptide may be involved in AChR aggregation. Our results suggest that
      membrane association and AChR interactions are separable functions of the 43k
      molecule.

PMID- 1757471
TI  - Surface relocation of alpha 6 beta 4 integrins and assembly of hemidesmosomes in
      an in vitro model of wound healing.
AB  - A transmembrane extracellular matrix receptor of the integrin family, alpha 6
      beta 4, is a component of the hemidesmosome, an adhesion complex of importance in
      epithelial cell-connective tissue attachment (Stepp, M. A., S. Spurr-Michaud, A.
      Tisdale, J. Elwell, and I. K. Gipson. 1990. Proc. Natl. Acad. Sci. USA. 87:8970
      8974; Jones, J. C. R., M. A. Kurpakus, H. M. Cooper, and V. Quaranta. 1991. Cell
      Regulation. 2:427-438). Cytosolic components of hemidesmosomes include bullous
      pemphigoid (BP) antigens while extracellular components include a 125-kD
      component of anchoring filaments (CAF) and collagen type VII-containing anchoring
      fibrils. We have monitored the incorporation of the alpha 6 beta 4 integrins into
      forming hemidesmosomes in an in vitro wound-healing explant model. In epithelial
      cells recently migrated from the edges of unwounded sites over bare connective
      tissue, alpha 6 beta 4 first appears along the entire cell surface. At this
      stage, these cells contain little or no cytosolic hemidesmosomal components, at
      least as detectable by immunofluorescence using BP autoantibodies, whereas they
      are already positive for laminin and CAF. At a later stage, as cells become
      positive for cytosolic hemidesmosome components such as BP antigens as well as
      collagen type VII, alpha 6 beta 4 becomes concentrated along the basal pole of
      the epithelial cell where it abuts the connective tissue of the explant.
      Polyclonal antibodies to beta 4 do not interfere with the migration of epithelial
      cells in the explant. However, they prevent assembly of hemidesmosomal complexes
      and inhibit expression of collagen type VII in cells that have migrated over
      wound areas. In addition, they induce disruption of established hemidesmosomes in
      nonmigrating cells of the unwounded area of the explant. Monoclonal antibodies to
      alpha 6 have a more dramatic effect, since they completely detach epithelial
      cells in the unwounded area of the explant. Antibodies to CAF also detach
      epithelial cells in unwounded areas, apparently by inducing separation between
      epithelium and connective tissue at the lamina lucida of the basement membrane
      zone. These results suggest a model whereby polarization of alpha 6 beta 4 to the
      basal surface of the cells, perhaps induced by a putative anchoring filament
      associated ligand, triggers assembly of hemidesmosome plaques.

PMID- 1757472
TI  - Neural cell adhesion molecule mediates contact-dependent inhibition of growth of
      near-diploid mouse fibroblast cell line m5S/1M.
AB  - A near-diploid mouse fibroblast cell line m5S/1M used in this study shows a high
      sensitivity to contact-dependent inhibition of growth, and the addition of EGF
      causes both morphological change and loss of contact-dependent inhibition of
      growth. The m5S/1M cell and its transformants obtained by x-ray irradiation have
      been used to search for the cell surface glycoproteins that are responsible for
      the growth regulation via cell-cell interactions. Lectin blotting analyses showed
      that the expression of the cell surface glycoprotein of 140 kD (140KGP) is highly
      sensitive to the transformation induced either by x-ray irradiation or by the EGF
      stimulation. We purified the 140KGP and found that it was composed of two
      glycoproteins. The major component of 140KGP was identified as neural cell
      adhesion molecule (NCAM) by amino acid sequence analyses of the peptide fragments
      and by the cross-reactivity with anti-NCAM mAb, clone H28.1.2.3. Monoclonal
      antibody against 140KGP (clone LN-10) recognizes all three isoforms of NCAM
      expressed on m5S/1M cell and showed that the expression of NCAM was highly
      sensitive to the transformation. Furthermore, the immobilized LN-10 strongly
      inhibited the growth of actively proliferating m5S/1M cells and the LN-10 in a
      soluble form showed a significant growth-stimulating effect on the confluent
      quiescent cultures of m5S/1M cells. The results show that NCAM plays a major role
      in the contact-dependent inhibition of growth of m5S/1M, and that NCAM might be
      involved in the regulation of cell growth during embryogenesis and formation of
      nervous systems.

PMID- 1757473
TI  - Quantitative variations in gene expression: possible role in cellular
      diversification and tumor progression.
AB  - Changes in the quantitative expression of certain genes or in the amounts of
      their products can quickly stimulate progression to the metastatic phenotype.
      This has been done experimentally by transferring dominantly acting oncogenes
      such as c-H-rasEJ into susceptible cells or more recently by interfering with
      metastasis suppressor genes. In vivo such rapid qualitative changes in dominantly
      acting oncogenes or suppressor genes occur only rarely, and progression to highly
      metastatic phenotypes is thought to occur through a process involving the slow
      stepwise progression of a subpopulation of neoplastic cells to more malignant
      states. Such slow changes can be reversible and need not involve known dominantly
      acting oncogenes or metastatic suppressor genes, consistent with clinical and
      experimental observations on naturally occurring, highly advanced metastatic
      tumors. An important element in the natural progression of tumors to more
      malignant states may be their ability to circumvent host environmental controls
      that regulate growth and cellular diversity. They also evolve into heterogeneous
      cellular phenotypes, a process that appears to mainly involve quantitative
      changes in gene expression but can be rapidly stimulated in cell culture by the
      introduction of a dominantly acting oncogene or inhibited by the introduction of
      a suppressor gene. The oncogenes and suppressor genes that affect malignancy may
      control important steps in the quantitative regulation of sets of genes that are
      ultimately responsible for the cellular alterations seen in adhesion receptors,
      cell motility responses, cell-cell communication components, degradative enzymes
      and their inhibitors, growth factor receptors, components that aid in escape from
      host surveillance mechanisms and others that are important in
      malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757474
TI  - Cytokine induction in HTLV-I associated myelopathy and adult T-cell leukemia:
      alternate molecular mechanisms underlying retroviral pathogenesis.
AB  - The human T-cell lymphotropic virus type I (HTLV-I) is capable of inducing a
      variety of host cellular genes including many of the cytokines responsible for
      immune regulation and osteoclast activation. This derangement in cytokine
      expression may contribute to the panoply of disease states associated with HTLV-I
      infection such as the adult T-cell leukemia (ATL) and HTLV-I associated
      myelopathy/tropical spastic paraparesis (HAM/TSP). We wished to determine if
      there was a correlation between the expression of an array of cytokines and the
      diverse clinical manifestations of ATL and HAM/TSP. Utilizing the techniques of
      specific mRNA amplification by the polymerase chain reaction (PCR) as well as
      Northern blotting, we analyzed the ex vivo mRNA expression of gamma-interferon
      (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1
      beta), and transforming growth factor-beta 1 (TGF-beta 1) in the peripheral blood
      of HAM/TSP and ATL patients as well as asymptomatic seropositive carriers. IFN
      gamma, TNF-alpha, and IL-1 beta transcripts were up-regulated in patients with
      HAM/TSP and seropositive carriers when compared to their levels in ATL and normal
      controls. In contrast, the ATL patients constitutively expressed higher levels of
      TGF-beta 1 mRNA than HAM/TSP and seropositive carriers. In addition, TNF-alpha
      and IL-1 beta serum levels were elevated in HAM/TSP, but not in ATL patients nor
      seropositive carriers. However, the circulating leukemic cells from ATL patients
      secreted increased levels of TGF-beta 1 protein into the culture medium than T
      cells derived from HAM/TSP patients. Collectively these results suggest that
      induction of IFN-gamma, TNF-alpha, and IL-1 beta in HAM/TSP may initiate an
      inflammatory cascade with subsequent events leading to immune mediated
      destruction of the central nervous system in these patients. Expression of
      osteoclast activators such as TNF-alpha and IL-1 beta is not associated with
      hypercalcemia in ATL. Finally, impaired cellular and humoral immune responses
      present in ATL, but not in HAM/TSP, may be related to elevated levels of TGF-beta
      1 produced by the leukemic cells. These differences in retroviral-induced host
      cytokine expression in ATL and HAM/TSP suggest alternate roles in disease
      pathogenesis.

PMID- 1757475
TI  - Secretion of mutant leucine-specific binding proteins with internal deletions in
      Escherichia coli.
AB  - The leucine-specific binding protein, encoded by the livK gene, is located in the
      periplasm of E. coli. The present study is an attempt to identify intragenic
      regions that determine the efficiency of its secretion into the periplasm. C
      terminal deletions or fusions of the livK gene to trpA (encoding the alpha
      subunit of tryptophan synthetase) were secreted with little loss of efficiency
      [1]. A series of deletions was constructed at the unique Sphl site within livK,
      near the 5' end of the region coding for the mature protein. Between 16 and 113
      amino acids were deleted in the amino-terminal one-third of the protein. A few of
      these deletions were located within a few amino acids of the signal sequence
      processing site. Deletions extending within thirteen residues of the processing
      site were processed and secreted more slowly than normal. Secondary structure
      predictions suggested that the alpha-helical core region of the signal sequence
      extends into the mature protein in the case of the slow processing mutants,
      perhaps interfering with the recognition site for leader peptidase or other
      secretory components. These results suggest that the conformation around the
      signal processing site may be a critical factor in determining the efficiency of
      secretion. During the course of this study, it was found that the difference in
      molecular weight between precursor and mature forms of some binding protein
      mutants, as judged by SDS-PAGE, was much greater than could be accounted for by
      processing of the signal sequence. This anomalous mobility on gels, however,
      could be eliminated by performing SDS-PAGE in the presence of 6 M urea.

PMID- 1757476
TI  - Evidence for an immunological and functional relationship between superoxide
      dismutase and a high molecular weight osteoclast plasma membrane glycoprotein.
AB  - Large multinucleated osteoclasts are the major cells responsible for bone
      breakdown and have been reported to produce high levels of superoxides which may
      contribute to the process of bone resorption (Key et al.: J Bone and Mineral Res
      4 [suppl. 1]:S206, 1989). Osteoclasts also possess high levels of superoxide
      dismutase, a protective enzyme capable of converting toxic superoxides to less
      dtoxic H2O2 (Fridovich: J Biol Chem 264:7761-7764, 1989). The amino acid sequence
      of manganese and/or iron superoxide dismutase has a conserved region which
      exhibits substantial homology with a fragment obtained from a high molecular
      weight osteoclast surface marker glycoprotein which is reactive with monoclonal
      antibody 121F. In this report, evidence is presented substantiating
      immunological, biochemical, and functional similarities between the osteoclast
      membrane antigen recognized by the 121F monoclonal antibody and superoxide
      dismutase. Western blot and immunoprecipitation studies show that a monospecific
      polyclonal antibody generated against immunoaffinity purified antigen is cross
      reactive with superoxide dismutase. Both the antigen and a high molecular weight
      superoxide dismutase activity have been detected in osteoclast plasma membrane
      preparations. The levels of superoxide dismutase activity and the membrane
      antigen have been found to correlate in antigen depletion studies and in western
      blots probing osteoclasts and closely related marrow-derived giant cells.
      Moreover, regions of osteoclast superoxide dismutase activity identified by
      electrophoretic zymogram analysis have been shown by gel electrophoresis and
      western blots to contain the high molecular weight antigen, or complexes of the
      antigen with the 121F monoclonal antibody when these were premixed prior to
      nondenaturing electrophoresis. It is proposed that the osteoclast plasma membrane
      possesses a high molecular weight superoxide dismutase activity. Furthermore, it
      appears that this activity is associated with the osteoclast antigen recognized
      by the 121F monoclonal antibody.

PMID- 1757477
TI  - Regulation of expression of the growth-state-related genes 2F1 and 2A9 during
      entry of quiescent smooth muscle cells into the cell cycle.
AB  - Vascular smooth muscle cells (SMCs) play a key role in the development of major
      arteries. Furthermore, abnormal growth of vascular smooth muscle cells has been
      implicated in the progression of major diseases of the cardiovascular system.
      Here, we report detection in primary cultures of bovine vascular smooth muscle
      cells of mRNA for two growth-state-related genes, 2F1 and 2A9, which code for a
      mitochondrial ADP/ATP carrier and calcyclin, respectively, and on the
      characterization of their cell cycle expression. Cultures of exponentially
      growing smooth muscle cells were made quiescent by serum deprivation. Upon
      readdition of serum, cells entered the cell cycle synchronously; DNA synthesis
      began 12 h post-serum addition. Levels of 2F1 and 2A9 RNA were low in quiescent
      cells and increased between 2 and 4 h post-serum addition. No changes in the
      rates of transcription of the 2F1 or 2A9 genes were detected by nuclear run-off
      assays during the time course. Thus the regulation of changes in expression of
      2F1 and 2A9 in early G1 is mediated post-transcriptionally.

PMID- 1757478
TI  - Developmental expression and hormonal regulation of the rat matrix Gla protein
      (MGP) gene in chondrogenesis and osteogenesis.
AB  - Matrix Gla protein (MGP), a vitamin K dependent protein, has recently been
      identified in many tissues. However, it is accumulated only in bone and cartilage
      suggesting that the expression of MGP may be related to the development and/or
      maintenance of the phenotypic properties of these tissues. We systematically
      evaluated MGP mRNA expression as a function of bone and cartilage development and
      also as regulated by vitamin D during growth and cellular differentiation. Three
      experimental models of cartilage and bone development were employed: an in vivo
      model for endochondral bone formation, as well as in primary cells of normal
      diploid rat chondrocyte and osteoblast cultures. MGP was expressed at the highest
      level during cartilage formation and calcification in vivo during endochondral
      bone formation. In chondrocyte cultures, MGP mRNA was present throughout the
      culture period but increased only after 3 weeks concomitantly with type I
      collagen mRNA. In osteoblast cultures, MGP mRNA was expressed during the
      proliferative period and exhibited increased expression during the period of
      matrix development. In contrast to osteocalcin (bone Gla protein), this increase
      was not dependent on mineralization but was related to the extent of
      differentiation associated with and potentially induced by extracellular matrix
      formation. During the proliferative period, type I collagen mRNA peaked and
      thereafter declined, while type I collagen protein steadily accumulated in the
      extracellular matrix. Constant MGP levels were maintained in the mineralization
      period of osteoblast differentiation in vitro which is consistent with the
      constant levels found during the osteogenic period of the in vivo system. MGP
      mRNA levels in both osteoblasts and chondrocytes in culture were significantly
      elevated by 1,25-(OH)2D3 (10(-8) M, 48 h) throughout the time course of cellular
      growth and differentiation. Interestingly, when MGP mRNA transcripts from vitamin
      D treated and untreated chondrocytes and osteoblasts were analyzed by high
      resolution Northern blot analysis, we observed two distinct species of MGP mRNA
      in the vitamin D treated chondrocyte cultures while all other cultures examined
      exhibited only a single MGP mRNA transcript. Primer extension analysis indicated
      a single transcription start site in both osteoblasts and chondrocytes with or
      without vitamin D treatment, suggesting that the lower molecular weight MGP
      message in vitamin D treated chondrocytes may be related to a modification in
      post-transcriptional processing. In conclusion, these results show that the
      selective accumulation of MGP in bone and cartilage tissues in vitro may be
      related to the development and/or maintenance of a collagenous matrix as
      reflected by increases in MGP mRNA during these periods.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1757479
TI  - The nuclear matrix: a heuristic model for investigating genomic organization and
      function in the cell nucleus.
AB  - Despite significant advances in deciphering the molecular events underlying
      genomic function, our understanding of these integrated processes inside the
      functioning cell nucleus has, until recently, met with only very limited success.
      A major conundrum has been the "layers of complexity" characteristic of all cell
      structure and function. To understand how the cell nucleus functions, we must
      also understand how the cell nucleus is put together and functions as a whole.
      The value of this neo-holistic approach is demonstrated by the enormous progress
      made in recent years in identifying a wide variety of nuclear functions
      associated with the nuclear matrix. In this article we summarize basic properties
      of in situ nuclear structure, isolated nuclear matrix systems, nuclear matrix
      associated functions, and DNA replication in particular. Emphasis is placed on
      identifying current problems and directions of research in this field and
      illustrating the intrinsic heuristic value of this global approach to genomic
      organization and function.

PMID- 1757480
TI  - Transcriptional regulation of basic fibroblast growth factor gene expression in
      capillary endothelial cells.
AB  - The growth of capillary endothelial cells (BCE) is an important regulatory step
      in the formation of capillary blood vessels. In vivo, the proliferation of these
      cells is stringently controlled. In vitro they can be stimulated by polypeptide
      growth factors, such as acidic fibroblast growth factor (aFGF) and basic
      fibroblast growth factor (bFGF). Since bFGF is synthesized and stored by vascular
      endothelial cells, this mitogen may play an important role in an autocrine growth
      regulation during angiogenesis. Here, evidence is presented for induction of the
      mRNA of bFGF by bFGF itself. A similar increase of bFGF mRNA was observed in
      response to thrombin and after treatment with phorbol ester. These results
      suggest that an autocrine loop may exist that may serve to modulate the mitogenic
      response in BCE under various physiological conditions, (e.g., wound healing and
      new capillary formation).

PMID- 1757481
TI  - Influence of dexamethasone on the vitamin D-mediated regulation of osteocalcin
      gene expression.
AB  - The influence of dexamethasone on expression of the osteocalcin gene which
      encodes the most abundant non-collagenous and only reported bone-specific protein
      was examined in ROS 17/2.8 osteosarcoma cells which express a broad spectrum of
      genes related to bone formation. Consistent with previous reports, quantitation
      of cellular osteocalcin mRNA levels by Northern blot analysis, osteocalcin gene
      transcription by activity of the osteocalcin gene promoter fused to a
      chloramphenicol acetyl-transferase (CAT) mRNA coding sequence following
      transfection into ROS 17/2.8 cells, and osteocalcin biosynthesis by
      radioimmunoassay indicate that dexamethasone in a concentration range of 10(-6)
      to 10(-9) M only modestly modifies basal levels of osteocalcin gene expression.
      However, dexamethasone significantly inhibits these parameters of the vitamin D
      induced upregulation of osteocalcin gene expression in both proliferating and in
      confluent ROS 17/2.8 cells. In this study, we observed that the extent to which
      abrogation of the vitamin D response occurs is dependent on basal levels of
      osteocalcin gene expression as reflected by a complete inhibition of the vitamin
      D-induced upregulation in a ROS 17/2.8K subline with low basal expression and
      only a partial reduction of the vitamin D stimulation in a ROS 17/2.8C subline
      with eightfold higher levels of basal expression. This effect of glucocorticoid
      appears to be at the transcriptional and post-transcriptional levels as
      demonstrated by a parallel decline in the cellular representation of osteocalcin
      mRNA, osteocalcin gene promoter activity, and osteocalcin biosynthesis. The
      complexity of the glucocorticoid effect on vitamin D-mediated transcriptional
      properties of the osteocalcin gene is indicated by persistence of sequence
      specific protein-DNA interactions at two principal osteocalcin gene promoter
      regulatory elements, the osteocalcin (CCAAT) box which modulates basal level of
      transcription, and the vitamin D responsive element, where vitamin D-mediated
      enhancement of osteocalcin gene transcription is controlled.

PMID- 1757482
TI  - If genes just make proteins and our proteins are the same, then why are we so
      different?

PMID- 1757483
TI  - Dynamic chromatin: the regulatory domain organization of eukaryotic gene loci.
AB  - It is hypothesized that nuclear DNA is organized in topologically constrained
      loop domains defining basic units of higher order chromatin structure. Our
      studies are performed in order to investigate the functional relevance of this
      structural subdivision of eukaryotic chromatin for the control of gene
      expression. We used the chicken lysozyme gene locus as a model to examine the
      relation between chromatin structure and gene function. Several structural
      features of the lysozyme locus are known: the extension of the region of general
      DNAasel sensitivity of the active gene, the location of DNA-sequences with high
      affinity for the nuclear matrix in vitro, and the position of DNAasel
      hypersensitive chromatin sites (DHSs). The pattern of DHSs changes depending on
      the transcriptional status of the gene. Functional studies demonstrated that DHSs
      mark the position of cis-acting regulatory elements. Additionally, we discovered
      a novel cis-activity of the border regions of the DNAasel sensitive domain (A
      elements). By eliminating the position effect on gene expression usually observed
      when genes are randomly integrated into the genome after transfection, A-elements
      possibly serve as punctuation marks for a regulatory chromatin domain.
      Experiments using transgenic mice confirmed that the complete structurally
      defined lysozyme gene domain behaves as an independent regulatory unit,
      expressing the gene in a tissue specific and position independent manner. These
      expression features were lost in transgenic mice carrying a construct, in which
      the A-elements as well as an upstream enhancer region were deleted, indicating
      the lack of a locus activation function on this construct. Experiments are
      designed in order to uncover possible hierarchical relationships between the
      different cis-acting regulatory elements for stepwise gene activation during cell
      differentiation. We are aiming at the definition of the basic structural and
      functional requirements for position independent and high level gene expression.
      The result of these experiments will have important consequences for random gene
      transfer with predictable and reproducible expression of transgenes.

PMID- 1757484
TI  - Modulation of chondrogenesis by the cytoskeleton and extracellular matrix.

PMID- 1757485
TI  - Tissue culture of human epidermal keratinocytes: a differentiating model system
      for gene testing and somatic gene therapy.

PMID- 1757486
TI  - Kinetochore function can be altered by ultraviolet microbeam irradiation without
      loss of the associated birefringent spindle fibre.
AB  - We have irradiated kinetochores of chromosomes in spermatocytes of crane flies
      (Nephrotoma abbreviata (Loew)) and Nephrotoma suturalis (Loew), while observing
      the cells using polarization microscopy. Irradiation of a kinetochore of one sex
      chromosome with 0.106 ergs microns-2, the minimum dose needed to stop movement,
      had no effect on the birefringence of the irradiated kinetochore's spindle fibre.
      Irradiation of the kinetochore of an autosomal half-bivalent in anaphase, with
      the same dose, had no effect on the birefringence of the irradiated kinetochore's
      spindle fibre, but nonetheless the anaphase movements of all six autosomal half
      bivalents were stopped, temporarily, for up to 20 min. Irradiations of the
      kinetochores of an autosomal half-bivalent with higher doses (0.301 ergs microns
      2) caused loss of birefringence of the irradiated kinetochore's spindle fibre,
      and the movements of all six autosomal half-bivalents were stopped permanently.
      We argue that the ultraviolet microbeam differentially affects two functions of
      the kinetochore: (1) a 'signalling' function, and (2) microtubule attachment,
      with the signalling function being altered at doses lower than that of
      microtubule attachment.

PMID- 1757487
TI  - Electron-microscopic and immunochemical analysis of kinetochore microtubules
      after ultraviolet microbeam irradiation of kinetochores.
AB  - We used an ultraviolet microbeam to irradiate kinetochores of chromosomes in
      crane-fly spermatocytes. We used one of two doses, low (0.106 erg microns-2) or
      high (0.301 erg microns-2), and then studied the microtubules in those spindles
      using electron microscopy or immunofluorescence microscopy. After irradiation
      with low doses microtubules are present as usual, with normal fluorescence and in
      normal numbers. After irradiation with high doses microtubules are no longer
      associated with the irradiated kinetochore. After irradiation with either dose,
      non-kinetochore microtubules are in smaller numbers in the irradiated half
      spindle than in the non-irradiated half-spindle or in non-irradiated cells. Since
      irradiation with low doses alters interchromosomal 'signals', but microtubules
      remain attached to the kinetochore, we argue that low doses of ultraviolet light
      damage a signal-related function of kinetochores without altering the ability of
      the kinetochores to bind microtubules.

PMID- 1757488
TI  - Direct experimental evidence for the existence, structural basis and function of
      astral forces during anaphase B in vivo.
AB  - The existence, structural basis and function of astral forces that are active
      during anaphase B in the fungus, Nectria haematococca, were revealed by
      experiments performed on living cells. When one of the two asters of a mitotic
      apparatus was damaged, the entire mitotic apparatus migrated rapidly in the
      direction of the opposing astral forces, showing that the force that accelerated
      spindle pole body separation in earlier experiments is located in the asters.
      When a strong solution of the antimicrotubule drug, MBC, was applied at anaphase
      A, tubulin immunocytochemistry showed that both astral and spindle microtubules
      were destroyed completely in less than a minute. As a result, separation of the
      spindle pole bodies during anaphase B almost stopped. By contrast, disrupting
      only the spindle microtubules with a laser microbeam increased the rate of
      spindle pole body separation more than fourfold. Taken together, these two
      experiments show that the astral forces are microtubule-dependent. When only one
      of the two or three bundles of spindle microtubules was broken at very early
      anaphase B, most such diminished spindles elongated at a normal rate, whereas
      others elongated at an increased rate. This result suggests that only a critical
      mass or number of spindle microtubules needs be present for the rate of spindle
      elongation to be fully governed, and that astral forces can accelerate the
      elongation of a weakened or diminished spindle.

PMID- 1757489
TI  - Induction of partial mitosis in BHK cells by 2-aminopurine.
AB  - The protein kinase inhibitor 2-aminopurine (2-AP) inhibits a subset of mitotic
      events in BHK cells. In the presence of the drug, these cells form a bipolar
      spindle in mitosis, but chromatin fails to generate functioning chromosomes.
      Cells in 2-AP progress through a partial mitosis, in which there is no observable
      metaphase, anaphase or telophase events. After 12 h of exposure to 2-AP the
      chromatin in mitotic cells fails to condense into discrete chromosomes, and is
      displaced by the spindle to form 'binucleate' cells and cells containing
      abnormally shaped nuclei in the subsequent interphase. Other mitotic
      modifications of nuclei, such as nucleolar and nuclear lamina disassembly, occur
      normally. Centromeres in these nuclei do not become engaged in the spindle, but
      instead show either no association or a lateral arrangement around the spindle.
      Cells treated with 2-AP are not arrested in mitosis. Therefore, mitotic exit is
      not inhibited by the failure of these cells to progress through the latter stages
      of mitosis. Further, nocodazole-arrested cells quickly exit mitotic arrest when 2
      AP is added. We conclude that 2-AP interferes with a specific subset of mitotic
      events, and that it allows cells to overcome check-points that require spindle
      function for mitotic progression.

PMID- 1757490
TI  - Biosynthesis and transport of lysosomal alpha-glucosidase in the human colon
      carcinoma cell line Caco-2: secretion from the apical surface.
AB  - The human adenocarcinoma cell line Caco-2 was used for studies on the
      biosynthesis and transport of lysosomal acid alpha-glucosidase in polarized
      epithelial cells. Metabolic labelling revealed that in Caco-2 cells alpha
      glucosidase is synthesized as a precursor form of 110 x 10(3) Mr. This form is
      converted into a precursor of slightly higher Mr (112 x 10(3)) by the addition of
      complex oligosaccharide chains. Via an intermediate form of 95 x 10(3) Mr, this
      precursor is processed into a mature form of 76 x 10(3) Mr. Combination of
      metabolic labelling with subcellular fractionation showed that the 112 x 10(3) Mr
      precursor of alpha-glucosidase is transported to the lysosomes. However, the same
      form is secreted into the culture medium (20% of newly synthesized enzyme after 4
      h of chase). Immunoprecipitation of alpha-glucosidase from culture medium derived
      from either the apical or basolateral site of radiolabelled Caco-2 cells, showed
      that 70-80% of the total amount of precursor form present in the medium is
      secreted from the apical membrane. Measurement of enzyme activities also showed
      that alpha-glucosidase, unlike other lysosomal enzymes, is mainly secreted via
      the apical pathway. Furthermore, immunocytochemistry showed the presence of a
      precursor form of alpha-glucosidase on the apical, but not the basolateral,
      membrane of the Caco-2 cells. We conclude that alpha-glucosidase is, unlike all
      other secretory proteins studied so far, secreted preferentially from the apical
      membrane of Caco-2 cells.

PMID- 1757491
TI  - The epidermal growth factor-induced migration of rat liver epithelial cells is
      associated with a transient inhibition of DNA synthesis.
AB  - Epidermal growth factor (EGF) is a potent mitogen for most cultured cells and has
      previously been shown to induce the migration of rat liver epithelial cells. We
      have now demonstrated that under migration-inducing conditions EGF does not
      stimulate cell proliferation, but causes instead a transient inhibition of DNA
      synthesis. Analysis at the single-cell level by [3H]thymidine autoradiography
      indicated that in 40-50% of the EGF-treated cell population the entry into S
      phase is delayed. The simultaneous demonstration of migration tracks by laminin
      immunofluorescence revealed that the transient inhibition of DNA synthesis is not
      restricted to the migratory cells. The effect is also observed with the
      stationary subpopulation and appears, therefore, to be independent of the
      induction of migration. The independence of both processes was further supported
      by showing that induction of migration by EGF proceeds undisturbed in cells
      blocked in S phase by aphidicolin. These results indicated that for rat liver
      epithelial cells the induction of migration by EGF has priority over cell
      proliferation. The data also emphasize the need for a time-course analysis when
      studying factors that stimulate or inhibit DNA synthesis or cell proliferation.

PMID- 1757492
TI  - Production of matrix metalloproteinase 3 (stromelysin) by cultured ovine
      endometrial cells.
AB  - Ovine endometrial cells (stromal plus epithelial) in primary culture release
      matrix metalloproteinase 3 (stromelysin, MMP-3), the enzyme that degrades various
      extracellular components including the basement membrane components collagen IV
      and laminin. The enzyme was detected in tissue culture medium by specific enzyme
      assay. A low level of MMP-3 activity was released from the cells (0.12 +/- 0.02
      unit per 10(6) cells per 48 h; 1 unit degrades 1 microgram of reduced,
      carboxymethylated transferrin min-1 at 37 degrees C), but following stimulation
      by phorbol myristate acetate (PMA) a mean 4.4-fold increase in MMP-3 production
      was observed (to 0.53 +/- 0.13 unit per 10(6) cells per 48 h). The enzyme was
      released primarily in the form of its proenzyme, which could be activated in
      vitro by (4-aminophenyl)mercuric acetate (APMA). Stimulation of enzyme release
      from cells by PMA was not seen before 24 h and required PMA at a dose of 10 nM or
      higher. This finding was substantiated by Western blot analysis.
      Immunocytochemistry of cells that had been treated with PMA for 48 h, and with
      the ionophore, monensin, for 4 h, confirmed the potential of the endometrial
      cells to produce stromelysin. The release of MMP-3 from ovine endometrial cells
      suggests that this enzyme may have a role in assisting the passage of syncytial
      processes through the basement membrane during the process of implantation.

PMID- 1757493
TI  - Enhanced expression of fibronectin by cmd/cmd chondrocytes and its modulation by
      exogenously added proteoglycan.
AB  - Cartilage matrix deficiency (cmd/cmd) in mice is a genetic disorder associated
      with the failure of chondrocytes to synthesize the core protein of cartilage
      proteoglycan monomer (cartilage-PG). Immunohistochemical and biochemical analyses
      revealed enhanced accumulation of fibronectin in culture of cmd/cmd chondrocytes
      as well as in mutant cartilage tissue in vivo. Purified cartilage-PG, when added
      exogenously to a culture of cmd/cmd chondrocytes, caused a reduction in abnormal
      accumulation of fibronectin over several subsequent days of culturing. Using a
      fibronectin cDNA probe, we showed that, on the basis of total RNA, the
      fibronectin mRNA level was four or eight times higher in cmd/cmd chondrocytes
      than in the normal. The level of fibronectin mRNA in cmd/cmd cells was lowered by
      culturing the cells in the presence of added cartilage-PG. These findings suggest
      that the abnormal accumulation of fibronectin in the mutant cell culture is
      primarily due to elevation of fibronectin mRNA level, and that cartilage-PG in
      the extracellular matrix may affect the regulation of fibronectin biosynthesis at
      the steady-state level of mRNA.

PMID- 1757494
TI  - When is a centromere not a kinetochore?

PMID- 1757495
TI  - Ultrastructure of chromatin. II. Three-dimensional reconstruction of isolated
      fibers.
AB  - Electron-microscope tomography has been used to reconstruct isolated, negatively
      stained chromatin fibers from Necturus maculosus erythrocytes. Tilt series
      micrographs from +70 degrees to -70 degrees at 5 degrees intervals were obtained,
      allowing a reconstruction resolution of 3.3 nm for fibers lying parallel to the
      tilt axis. The fibers were found to be flattened in the plane of the carbon
      support, and also stained differentially according to the distance from the
      carbon. A number of methods of presenting the three-dimensional information were
      explored. Especially useful was an automatic peak search method for locating
      putative nucleosome positions coupled with the production of a computer-generated
      model. Other valuable techniques included the generation of projection
      stereograms and construction of solid models. A peripheral location of
      nucleosomes in the chromatin fiber was indicated, and helical arrangements of
      nucleosomes were observed over short regions. However, no long-range ordering of
      nucleosomes was apparent. The extent to which this lack of order may be the
      result of events occurring during the preparation of chromatin for electron
      microscopy is discussed.

PMID- 1757496
TI  - Histone acetylation and control of gene expression.

PMID- 1757497
TI  - Adipocytic cells cultured from marrow have osteogenic potential.
AB  - Stromal colonies with fibroblastic morphology grown from rabbit marrow cells in
      culture supplemented with foetal calf serum. In this study the same marrow cells
      cultured with autologous rabbit plasma and hydrocortisone form colonies of a
      single lineage that express the adipocytic phenotype. A comparison of the
      potential for differentiation of cloned cell populations grown from fibroblastic
      and adipocytic colonies has been made using an in vivo diffusion chamber assay.
      The adipocytic colonies differentiated and grew to a limited size in medium with
      rabbit plasma and hydrocortisone, but attempts to isolate them and expand them in
      this medium failed. When the serum supplement was changed to foetal calf serum at
      day 10 the cells in the adipocytic colonies acquired a less differentiated
      morphology, there was a large increase in colony growth and cells were produced
      in sufficient numbers for the diffusion chamber assay. Thirty one fibroblastic
      colonies and twenty one adipocytic colonies were isolated either by limiting
      dilution or ring cloning and then expanded. Of these, eleven fibroblastic and
      eight adipocytic colonies provided enough cells (2 x 10(5) to 2 x 10(6] for
      implantation and culture in the chambers. Four of the eleven fibroblastic and
      three of the eight adipocytic colonies formed an osteogenic tissue in the
      chambers. It was concluded that cells that have differentiated in an adipocytic
      direction are able to revert to a more proliferative stage and subsequently to
      differentiate along the osteogenic pathway. Adipocytic and fibroblastic cells
      cultured in vitro from marrow have, with osteogenic cells, a common precursor in
      adult marrow.

PMID- 1757498
TI  - Expression of a divalent cation-dependent erythroblast adhesion receptor by
      stromal macrophages from murine bone marrow.
AB  - Stromal macrophages in haemopoietic organs express novel surface receptors that
      are implicated in trophic interactions with developing blood cells. Macrophages
      isolated from foetal liver bind erythroblasts (Eb) by a divalent cation-dependent
      receptor (EbR), whereas stromal macrophages in adult bone marrow and lymphoid
      organs express a lectin-like receptor, sialoadhesin, which interacts with
      sialylated structures on sheep erythrocytes and murine haemopoietic cells. In
      order to learn more about the regulation of these haemagglutinins, we examined
      binding of Eb by stromal macrophages that had been isolated from adult murine
      tissues or generated in Dexter-type cultures of bone marrow. Macrophages were
      purified from bone marrow by collagenase digestion, adherence to a substratum and
      detachment of clustered haemopoietic cells, and tested for their ability to bind
      Eb from foetal liver or anaemic adult spleen. Freshly isolated bone marrow
      macrophages bound Eb mainly by a divalent cation-dependent activity that was not
      inhibited by neuraminidase treatment of Eb or by specific anti-sialoadhesin
      monoclonal antibodies, although these macrophages express sialoadhesin and Eb
      bear a potential ligand for this receptor. Macrophages obtained by digestion from
      other adult lymphoid tissues also bound Eb by a divalent cation-dependent
      activity, whereas blood monocytes and lavaged peritoneal macrophages failed to do
      so. Peritoneal macrophages could be induced to express high levels of
      sialoadhesin by cultivation in homologous mouse serum, but such macrophages did
      not acquire sialoadhesin-independent EbR activity.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1757499
TI  - Production of heparan sulphate proteoglycans by human bone marrow stromal cells.
AB  - Haemopoietic progenitors from human bone marrow bind strongly to human marrow
      stromal cell cultures but the interaction only occurs if the stromal cells are
      maintained in methyl prednisolone. Heparan sulphate has been implicated in this
      interaction and in the binding of haemopoietic cell growth factors. In the
      present study we have compared the molecular structures of the heparan sulphate
      proteoglycans, metabolically labelled with [35S]sulphate, produced by methyl
      prednisolone-treated and untreated human marrow stromal cells in vitro.
      [35S]proteoglycans were examined in the cell layers (extracted with 1% (v/v)
      Triton X-100 in 6 M urea) and in the culture medium. Fractionation of
      proteoglycans by ion-exchange chromatography indicated that the heparan sulphate
      produced by the treated cultures eluted at a higher NaCl concentration than the
      counterpart from untreated cells. The heparan sulphate appeared to be mainly
      expressed on the cell surface, since it was efficiently extracted by treatment
      with dilute trypsin (50 micrograms ml-1 for 10 min). All cultures contained two
      heparan sulphate proteoglycan species, the major component eluted from a
      Sepharose CL-4B column with a median Kav of 0.33 and apparently contained an
      average of only one heparan sulphate chain. Small quantities of a larger
      proteoglycan, which was eluted in the void volume from the CL-4B column, was also
      detected, mainly in the cell layer extracts. The molecular structure of the
      heparan sulphate chains was analysed by oligosaccharide mapping, following
      specific enzymic depolymerisation, and separation of breakdown products by
      gradient PAGE. The maps revealed significant differences in overall enzyme
      susceptibilities and sulphation patterns of polysaccharides produced by methyl
      prednisolone-treated and untreated cultures.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757500
TI  - Low density lipoproteins bound to Schistosoma mansoni do not alter the rapid
      lateral diffusion or shedding of lipids in the outer surface membrane.
AB  - Schistosomula of Schistosoma mansoni bind human low density lipoproteins (LDL) in
      a concentration-dependent and saturable manner. The bound LDL could provide
      phospholipids and sterol to the worm, which cannot synthesize sterol de novo and
      lacks acyl chain-modifying capability. Here we have used three phospholipid
      analogues to explore the effect of LDL binding on the parasite's outer tegumental
      membrane, i.e. the outer of the two membranes that cover its surface syncytium.
      Fluorescein phosphatidylethanolamine (Fl-PE) and rhodamine
      phosphatidylethanolamine (Rh-PE) bound to the parasite in a saturable manner and,
      as shown by fluorescence microscopy, were confined to the surface. Fl-PE
      fluorescence was completely quenched by Trypan Blue and Fl-PE was lost from the
      surface following single exponential decay kinetics (t1/2 = 12 h), further
      suggesting that the probe was confined to the outer membrane. 1,1'-Dioctadecyl
      3,3,3',3'-tetramethyl-indocarbocyanine perchlorate (DiI-C18(3); DiI) did not bind
      saturably and was seen in both the surface and the internal parasite membranes.
      Fluorescence photobleaching recovery was used to measure the lateral mobility of
      Fl-PE in the outer membrane. The lateral diffusion coefficient of Fl-PE was
      approximately 10(-7) cm2s-1. The fractional mobility of Fl-PE was 85% when
      measured using a laser beam of radius 1.8 microns and 45% using a beam of radius
      4.3 microns. These measurements suggest that the outer membrane is composed of
      micron-scale liquid crystalline-phase lipid domains that lack significant amounts
      of transmembrane proteins. LDL binding to the parasite surface did not alter the
      lateral mobility of Fl-PE or the rate of loss of either Fl-PE or Rh-PE.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1757501
TI  - Monoclonal antibodies to Leishmania mexicana promastigote antigens. II. Cellular
      localization of antigens in promastigotes and infected macrophages.
AB  - In the accompanying paper by Ilg et al., it was shown that Leishmania mexicana
      promastigotes covalently modify a secreted acid phosphatase and other proteins by
      carbohydrate epitopes characteristic for lipophosphoglycan (LPG). In this study,
      the reaction of the anti-LPG monoclonal antibodies (mAbs AP3 and L7.25) and of
      mAb L3.13, an antibody directed against an epitope present on the secreted acid
      phosphatase but not on LPG, with promastigotes and infected peritoneal
      macrophages is studied by immunofluorescence and immunoelectron microscopy. AP3
      labels the surface, the flagellar pocket and intracellular structures in
      promastigotes, while L3.13 reacts predominantly with an antigen located in the
      flagellar pocket. Early after infection with promastigotes, but not amastigotes,
      AP3 or L7.25 transiently label epitopes at the surface of live macrophages. No
      L3.13-reactive material is detected at the surface of infected macrophages. In
      permeabilized, infected macrophages, AP3 heavily labels the surface of
      amastigotes and the lumen of the parasitophorous vacuole, while L3.13 reveals
      antigen in the flagellar pocket, intracellular vesicles of amastigotes, and
      components in the lumen of the parasitophorous vacuole. Possible mechanistic
      implications for Leishmania-macrophage interaction raised by these findings are
      discussed.

PMID- 1757502
TI  - Photoreception of Paramecium cilia: localization of photosensitivity and binding
      with anti-frog-rhodopsin IgG.
AB  - Paramecium bursaria is photosensitive and accumulates in a lighted area. The
      cells can be deciliated by a brief suspension in dilute ethanol. Both intact and
      deciliated cells showed depolarization in response to light stimulation by a step
      increase from dark to above 0.7 mW cm-2 (550 nm). On the other hand, after a step
      increase to below 0.4 mW cm-1, intact cells showed hyperpolarization, while the
      deciliated cells showed no change in membrane potential. This difference in
      membrane potential response between ciliated and deciliated cells suggests that
      both somatic and ciliary structures are photosensitive. In our search for the
      photoreceptive molecules, a polyclonal antibody induced in rabbits against frog
      rhodopsin was found to cross-react with a 63x10(3) Mr protein of P. bursaria, by
      immunoelectrophoresis. Immunocytochemical studies showed that the antibody
      labeling was localized on both the ciliary and the somatic membranes. These
      results raise the possibility that P. bursaria may contain a rhodopsin-like
      protein as a photoreceptor molecule.

PMID- 1757503
TI  - Cell guidance by ultrafine topography in vitro.
AB  - Laser holography and microelectronic fabrication techniques have been employed to
      make grating surfaces in fused quartz with ultrafine period (260 nm) in an
      attempt to mimic the topography of aligned fibrillar extracellular matrix (ECM),
      which, in the past, has been shown to affect the behaviour of cells in vitro and
      in vivo. The alignment of BHK cells, MDCK cells and chick embryo cerebral
      neurones on 260 nm period grating surfaces (130 nm grooves separated by 130 nm)
      of various depths (100, 210 and 400 nm) was examined. While all gratings aligned
      BHK cell populations, the degree of alignment was dependent on depth. The
      response of single MDCK cells to the grating patterns was both to align precisely
      to the direction of the gratings, and to elongate; only their elongation was
      depth-dependent. MDCK cells that were part of epithelial cell islands, and the
      outgrowth of neurites from chick embryo neurones, were mainly unaffected by the
      grating surfaces. It is clear that topography on this scale can control cell
      behaviour, but guidance of this type is strongly dependent on cell type and cell
      cell interactions.

PMID- 1757504
TI  - Rapid and transient reorganization of the cytoskeleton in GH3B6 cells during
      short-term exposure to thyroliberin.
AB  - The cytoskeletal organization of the rat pituitary tumor cell line GH3B6 was
      analysed using immunofluorescence, in basal conditions and after stimulation by
      thyroliberin (TRH). Under basal conditions, a dense and entangled cytoplasmic
      microtubule network, a perinuclear cage of cytokeratin fibers, and a diffuse
      distribution of F-actin were revealed. Short-term stimulation of these cells by
      TRH induces a first early phase of PRL release (0-2 min), concomitant with a
      rarefaction of cytoplasmic PRL-containing granules, followed by a second plateau
      phase (5-30 min), concomitant with modifications of the Golgi zone. We show that
      TRH induced early and transient modifications in the cytoskeletal distribution
      during these short periods of stimulation. First, after 2 min of stimulation,
      small fluorescent tubulin blebs appeared under the plasma membrane. Then, after 5
      min they disappeared, and a thin actin network, accentuated by thicker fibers,
      organized transiently in the cytoplasm. After 30 min, the microtubules and
      cytokeratin networks had extended throughout the cytoplasm and the actin
      distribution was diffuse again. So, in this study, we have shown the existence of
      a parallelism between the redistribution of intracellular PRL compartments and
      the reorganization of cytoskeletal elements, during exposure to TRH. We could not
      clearly correlate these modifications with transduction mechanisms involved in
      TRH action.

PMID- 1757505
TI  - Ultrastructure of chromatin. I. Negative staining of isolated fibers.
AB  - The ultrastructure of chromatin fibers isolated from erythrocyte nuclei of
      Necturus maculosus and contrasted with a number of negative stains is described.
      Long (greater than 1000 nm) fibers are prepared under ionic conditions that
      promote fiber integrity, fixed with glutaraldehyde and negatively stained with
      aurothioglucose, ammonium molybdate, methylamine tungstate, sodium
      phosphotungstate, uranyl acetate and a uranyl acetate-sodium phosphotungstate
      sequence. All stains yield images of '30 nm' chromatin fibers, but
      aurothioglucose gives the most consistent diameter measurements (33 nm, S.D. 3.5
      nm), and provides the clearest images of individual nucleosomes. Regions of fiber
      showing structural order are seen with all stains. The most commonly observed is
      a regular pattern of oblique cross-striations consistent with the visualization
      of the 'top' or 'bottom' of a helical structure. There is a significant
      relationship between fiber diameter and the cross-striation angle, consistent
      with an extensible chromatin fiber. Examination of power spectra prepared from
      selected ordered regions confirms the visual impressions, and indicates a
      striation spacing ranging from 11 nm to 18 nm, and dependent on the stain type.
      Fibers allowed to unfold slightly in a buffer containing 50 mM monovalent ions
      show evidence of a two-stranded helix-like organization. These results are
      discussed in terms of current models for the structure of the chromatin fiber.

PMID- 1757506
TI  - CASPER: a computer program used for structural analysis of carbohydrates.
AB  - The computer program CASPER and its algorithms are described. The program is
      aimed at facilitating the determination of structures of oligosaccharides and
      regular polysaccharides, requiring as input either the one-dimensional 1H or 13C
      NMR spectrum or the 2D C,H-correlation NMR spectrum together with information on
      components and linkages. The databases, the method of simulating spectra, options
      of the program, and techniques for faster calculations are described as well as
      an example of a structural determination.

PMID- 1757507
TI  - A method for automatic generation of novel chemical structures and its potential
      applications to drug discovery.
AB  - A novel method for generation of chemical structures of potential pharmaceutical
      interest is presented. Structures are generated by random combination of known
      fragments and selected by statistical topological techniques. The power of the
      method lies in the great profusion of candidates generated together with the
      extremely high selectivity imposed by the techniques of selection.

PMID- 1757508
TI  - The emperor's new clothes.

PMID- 1757509
TI  - Inhibin and gonadotrophin secretion in physically active males after acute
      exercise.
AB  - Serum concentrations of luteinizing hormone (LH) follicle stimulating hormone
      (FSH), testosterone and inhibin were measured in six physically active male
      volunteers after heavy exercise on a treadmill. Hormone measurements were made
      before exercise, immediately after exercise and at 30-min intervals for 3 h after
      exercise. Serum concentrations of LH fell after exercise reaching nadir values
      between 60 and 180 min post-exercise. The nadir value of LH for the group as a
      whole occurred 90 min after exercise. Serum testosterone concentrations
      paralleled the changes in LH concentrations. Serum FSH and inhibin concentrations
      did not show any appreciable change from baseline values. The data suggest that
      acute exercise does not significantly lower serum concentrations of FSH or
      inhibin. Whether repetitive and prolonged heavy exercise, as in competitive
      runners, produces alterations in serum inhibin concentrations remains to be
      determined.

PMID- 1757510
TI  - Effects of stage of the bovine oestrous cycle on in-vitro characteristics of
      uterine and oviductal epithelial cells.
AB  - The objective of this experiment was to evaluate the effects of stage of the
      bovine oestrous cycle on in-vitro morphology, growth and monolayer foundation of
      uterine and oviductal epithelial cells. Epithelial cells were isolated from the
      uterus and oviducts collected from cyclic cattle on the day of oestrus (Treatment
      A), and between days 4 to 6 (Treatment B), days 8 to 10 (Treatment C) and days 14
      to 16 (Treatment D) of the oestrous cycle. The morphological development, per
      cent cell viability and cell attachment were evaluated during primary culture and
      after the first and third subpassages. The highest per cent cell viability and
      cell attachment during primary culture, respectively, were noted in Treatment B
      for both uterine (87.7 and 87.5%) and oviductal (88.4 and 87.2%) cell
      populations. Uterine epithelial cell populations in Treatments C and D,
      respectively, had the lowest viability (76.5 and 68.8%) and attachment (10.8 and
      10.5%) during primary culture. There were marked improvements in cell viability
      and cell attachment following the first subpassage (P less than 0.001) compared
      with primary cultures for both uterine and oviductal cells. These results
      indicate that the stage of the oestrous cycle has dramatic effects on uterine and
      oviductal epithelial cell morphology and developmental patterns during primary in
      vitro cultures. The stage of the oestrous cycle when cells are collected may be
      more important than was once realized when culturing early stage embryos in
      vitro.

PMID- 1757511
TI  - The role of measurement of progestagen-associated endometrial protein in
      predicting adequate endometrial differentiation.
AB  - Late secretory endometrium synthesizes and secretes progestagen-associated
      endometrial protein (PEP), which is measurable in the serum of cycling women, and
      has been shown to increase in concentration during the luteal phase of the normal
      menstrual cycle. The purpose of this study was to determine the utility of serum
      PEP as a predictor of normal or inadequate luteal phase endometrial
      differentiation. One-hundred-and-twenty-five endometrial biopsies were taken
      within 4 days of a subsequent menstrual period, during the course of evaluation
      of infertility or recurrent abortion. Twenty-one of these biopsies demonstrated
      glandular/stromal asynchrony. Thirteen patients exhibited 'out-of-phase'
      endometrial biopsies and 91 patients had 'in-phase' biopsies. Mean PEP values
      significantly increased from the mid-luteal phase to the late luteal phase. Mean
      PEP values for patients with in-phase biopsies (43.92 units/ml) were not
      significantly different from those with out-of-phase biopsies (25.24 units/ml, P
      = 0.0942). PEP values for patients with asynchronous biopsies were intermediate.
      Use of clomiphene citrate did not affect these results.

PMID- 1757512
TI  - Stress-related hormones affect human chorionic gonadotrophin secretion from the
      early human placenta in vitro.
AB  - The effect of a physiological range of concentrations of three stress-related
      hormones, oxytocin (OT), arginine-vasopressin (AVP) and prolactin (PRL) was
      tested upon human chorionic gonadotrophin (HCG) secretion by placental explants
      from early pregnancy in static and superfusion cultures. In static cultures, OT
      and AVP significantly increased HCG secretion, whereas PRL had no effect. In
      superfusion, 1-min pulses of OT induced a significant (two- to 10-fold) rise in
      HCG pulse amplitude compared to the control. This effect of this neuropeptide was
      blocked by coadministration of a specific receptor antagonist. AVP also increased
      the glycoprotein pulse amplitude by two- to five-fold, but only with every second
      pulse administered. PRL pulses caused a progressive inhibition of spontaneous HCG
      pulsatility. In conclusion, stress-related hormones affect placental HCG
      secretion in vitro. The involvement of these factors in impairing early pregnancy
      development is suggested.

PMID- 1757513
TI  - The effect of oxytocin on oestradiol-17 beta and testosterone secretion by
      cultured human granulosa cells.
AB  - The effect of oxytocin at different concentrations was tested on the secretion of
      oestradiol-17 beta and testosterone by cultured human granulosa cells obtained by
      follicular punctures during in-vitro fertilization (IVF) attempts. Oxytocin had
      no effect on testosterone secretion, either in the absence or the presence of
      follicle stimulating hormone (FSH). It had no effect on oestradiol-17 beta in the
      absence of FSH. However, it decreased the FSH-stimulated secretion of oestradiol
      17 beta in a certain number of cases. This inhibitory effect appears to be
      associated with cells more responsive to FSH and was identified in women found to
      be successful in achieving pregnancy during IVF attempts.

PMID- 1757514
TI  - Preincubation of human granulosa cells with gonadotrophin prevents the
      cloprostenol-induced inhibition of progesterone production.
AB  - Human granulosa cells, from women undergoing ovum collection for in-vitro
      fertilization (IVF), will luteinize in vitro and provide a model for
      investigating the antigonadotrophic action of a prostaglandin F2 alpha (PGF2
      alpha) analogue, cloprostenol, on granulosa-derived luteal cells. The granulosa
      cells were cultured in a defined medium and exposed to treatments during a
      preincubation period of 0 to 3 days and a final incubation with low density
      lipoprotein (LDL) from days 3 to 4. In the absence of human chorionic
      gonadotrophin (HCG), progesterone production was low, whereas exposure to HCG in
      the final incubation resulted in a 10-fold increase in progesterone
      concentrations. The inclusion of cloprostenol with HCG in the final incubation
      significantly (P less than 0.05) inhibited HCG-stimulated progesterone
      production. Exposure to HCG during the preincubation prevented the
      antigonadotrophic action of cloprostenol in the final incubation. The
      antigonadotrophic action of cloprostenol was retained when the granulosa cells
      were exposed to cloprostenol during the preincubation. Omission of LDL from the
      final incubation lowered the production of progesterone but the pattern of
      responses to HCG and cloprostenol were similar. Prevention of the
      antigonadotrophic action of cloprostenol after exposure to HCG may be a mechanism
      through which chorionic gonadotrophin can prevent regression of the corpus luteum
      in early pregnancy. Cloprostenol does not appear to inhibit LDL-stimulated
      steroidogenesis in human granulosa cells.

PMID- 1757515
TI  - Effect of clomiphene citrate on the synthesis and release of the human beta
      lactoglobulin homologue, pregnancy associated endometrial alpha 2-globulin, by
      the uterine endometrium.
AB  - As an extension to a previous study to examine the effects of clomiphene citrate
      (CC) on human chorionic gonadotrophin/luteinizing hormone (LH) receptors in human
      corpora lutea, we sought to determine the effect of CC on the synthesis of the
      beta-lactoglobulin homologue, pregnancy associated endometrial alpha 2-globulin
      (alpha 2-PEG) by the luteal phase human endometrium. Seventeen normally-cycling
      women aged 25.9 +/- 2.1 years (mean +/- SE), undergoing elective tubal ligation,
      were divided into four groups consisting of controls (n = 2) and three treatment
      groups. Each of the treatment groups (n = 5/group) was treated with either 50 mg
      (group 1), 100 mg (group 2) or 150 mg (group 3) of CC daily on days 5 to 9 of the
      cycle. Portions of endometrial tissue were obtained by curettage 7 to 9 days
      following the urinary LH surge and were either fixed for histological analyses or
      cultured in vitro in the presence of [35S]methionine. Tissue media (TCM) that
      were analysed by two-dimensional gel electrophoresis followed by fluorography
      indicated that the synthesis of alpha 2-PEG was most markedly reduced in groups 2
      and 3. Densitometric scans of TCM Western blots and radioimmunoassay (RIA) of TCM
      showed that the overall synthesis of alpha 2-PEG decreased from 5.8 +/- 1.9
      arbitrary units (AU) and 371.2 +/- 239.3 ng/ml in group 1 to 3.1 +/- 0.8 AU and
      69.4 +/- 24.9 ng/ml, and 2.7 +/- 1.1 AU and 52.4 +/- 19.8 ng/ml in groups 2 and 3
      respectively. On cycle days 20-22, control values were 5.8 AU and 498.1 ng/ml
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757516
TI  - Granulated lymphocytes in human endometrium: histochemical and
      immunohistochemical studies.
AB  - Granulated lymphocytes with an unusual antigenic phenotype (CD56+ CD38+ CD2 +/-
      CD3- CD16-) form a substantial proportion of leukocytes in human endometrial
      stroma. The purpose of this study was to examine morphological and antigenic
      heterogeneity in endometrial granulated lymphocytes (eGL) in imprint
      preparations, paraffin-embedded sections and frozen sections. eGL in decidual
      imprints showed variations in cell size, nuclear size, shape and chromatin
      content and the number and size of cytoplasmic granules. eGL were detected in
      paraffin-embedded sections using phloxine tartrazine, alcian blue and toluidine
      blue stains. There was no difference in the number of eGL among the three stains
      but the granules appeared smaller and more regular when stained with toluidine
      blue. The proportion of stromal cells which were leukocytes increased from 8.2%
      in proliferative endometrium to 31.7% in early pregnancy decidua. The number of
      CD56+ and CD38+ cells increased in late secretory endometrium; CD56+ cells formed
      greater than 75% of the leukocytes in first trimester decidua. The increased
      number of CD2+ cells in decidua was not comparable with CD56+ and CD38+ cells
      suggesting that a lower proportion of CD56+ cells in first trimester decidua
      coexpress CD2, an observation which was supported by double labelling studies.
      eGL therefore show morphological and antigenic heterogeneity and the study of
      granulated lymphocytes in pathological endometrium and decidua will require
      careful phenotypic and morphological analysis of accurately dated samples.

PMID- 1757517
TI  - Pregnancy rates after transfer of embryos obtained from different stimulation
      protocols and frozen at either pronucleate or multicellular stages.
AB  - After in-vitro fertilization, 2161 supernumerary embryos were frozen with 1,2
      propanediol and sucrose as cryoprotectants at either pronucleate or multicellular
      (2-6 blastomeres) stages. By the end of March 1990, 494 pronucleate stage embryos
      and 492 multicellular stage embryos had been thawed and 54 and 47% of them,
      respectively were considered suitable for transfer. Ongoing pregnancy and
      implantation rates were 17.9 and 10.7%, respectively for embryos frozen at the
      pronucleate stage and 5.5 and 4.7% for embryos frozen at the multicellular stage.
      Ovarian stimulation with human menopausal gonadotrophin (HMG) after
      pharmacological hypophysectomy with a gonadotrophin releasing hormone agonistic
      analogue (GnRHa) using a long protocol permitted us to freeze significantly more
      embryos per cycle (7.2 +/- 4.1) than stimulation with HMG and GnRHa in a short
      protocol (4.7 +/- 3.4) or stimulation with clomiphene citrate (CC) and HMG (2.7
      +/- 1.9). Ongoing pregnancy rates after transfer during the stimulated cycles
      were similar for the three types of treatment (27.1, 27.3 and 32.1%,
      respectively). However, ongoing pregnancy rates after frozen-thawed embryo
      transfers were significantly higher when originating from GnRHa + HMG treatments
      (14.3 and 14.8%, respectively for long and short protocols) than when originating
      from CC + HMG treatment (5.6%). Embryo cryopreservation has permitted the ongoing
      pregnancy rate to increase from 28.4 to 36.9% (P less than 0.01) even though more
      than half of the embryos have not been thawed. We conclude that embryos obtained
      after stimulation with GnRHa + HMG and frozen at the pronucleate stage are more
      likely to result in a pregnancy.

PMID- 1757518
TI  - Results of IVF from a prospective multicentre study.
AB  - Part of a cost-effectiveness study of in-vitro fertilization was the evaluation
      of the medical results of this fertility treatment. Data were prospectively
      collected from greater than 3000 IVF treatments in five Dutch hospitals during a
      2-year period. The average 'take-at-least-one-healthy-baby-home-rate' per started
      treatment was 10% (the average clinical pregnancy rate per embryo transfer was
      20%). After more IVF treatments, about one in three to four couples were
      successful. Differences in results were mainly caused by patient characteristics,
      the treatment episode and the treating hospital. These differences remained in a
      multivariate logistic regression analysis.

PMID- 1757519
TI  - Incidence and main causes of infertility in a resident population (1,850,000) of
      three French regions (1988-1989).
AB  - To estimate the prevalence and main causes of infertility, a multicentre survey
      was conducted over 1 year (July 1988-June 1989) in three regions of France. All
      the 1686 couples in these regions, who consulted a practitioner for primary or
      secondary infertility during this period, were included in the investigation. The
      prevalence rate of infertility was found to be 14.1%, indicating that one woman
      out of seven in France will consult a doctor for an infertility problem during
      her reproductive life. The main causes of female infertility were ovulation
      disorders (32%) and tubal damage (26%), and of male infertility oligo-terato
      asthenozoospermia (21%), asthenozoospermia (17%), teratozoospermia (10%) and
      azoospermia (9%). Infertility was also found to be caused by disorders in both
      the male and female partners together; thus in 39% of cases both the man and
      woman presented with disorders. The woman alone was responsible for infertility
      in one-third of cases and the man alone in one-fifth. Unexplained infertility was
      found in 8% of the couples surveyed.

PMID- 1757520
TI  - The leuprolide flare regime for in-vitro fertilization/gamete intra-fallopian
      transfer and embryo cryopreservation.
AB  - Gonadotrophin releasing hormone agonists (GnRHa) are now well established as
      adjuvant agents for in-vitro fertilization (IVF)/gamete intra-Fallopian transfer
      (GIFT) but several different modes of usage have been proposed. Our experience
      with 328 cycles of leuprolide used in a flare regime is reviewed. An
      endocrinologically proven flare effect was associated with a reduction of human
      menopausal gonadotrophin (HMG) usage (10 versus 16 ampoules) and a lower cycle
      cancellation/conversion rate (7.4 versus 11.3%). Overall, satisfactory rates of
      oocyte recovery (93%, mean number of oocytes 7.0), clinical pregnancy (24.4% per
      oocyte recovery) and pregnancy from frozen/thawed embryo transfers (14%) were
      achieved. The flare protocol appears to be a satisfactory choice for the majority
      of subjects but careful monitoring is required to avoid the potential for ovarian
      hyperstimulation.

PMID- 1757521
TI  - Contribution of preovulatory-phase small follicles to the ovarian response in
      stimulated cycles.
AB  - The usual criteria for ovulation induction in stimulated cycles take into account
      the number of follicles greater than 14-16 mm in diameter. We have
      retrospectively investigated how the presence of small (8-12 mm) follicles at the
      time of the last scan influences the ovarian response for in-vitro fertilization
      (IVF). The mean number of small follicles was nearly constant (3.8 to 5.9) and
      did not correlate with the number of large (greater than 12 mm) follicles in
      various protocols for ovarian stimulation. In patients stimulated under the
      influence of a gonadotrophin releasing hormone (GnRH) agonist, the number of
      small follicles was correlated with the oestradiol (E2) peak level and with the
      number of recovered oocytes. Our data demonstrate a significant contribution of
      follicles less than or equal to 12 mm to peripheral E2 levels and oocyte
      production for IVF.

PMID- 1757522
TI  - Salpingitis isthmica nodosa in female infertility and tubal diseases.
AB  - Salpingitis isthmica nodosa (SIN) is a condition of nodular thickening of the
      proximal Fallopian tube. The purpose of this study was to investigate the
      occurrence, distribution and frequency of SIN in Danish women salpingectomized
      because of tubal pregnancy or salpingitis and to correlate SIN with infertility,
      pregnancies, outcome of pregnancies, births, pelvic inflammatory disease and
      salpingitis. Sections from the isthmus were present in the specimens from 223
      tubes from 193 patients and were analysed by the same pathologist. Originally,
      SIN was found in 12 patients but on re-examination, it was found in 24 patients.
      Ten women with SIN were bilaterally salpingectomized. Only one woman had SIN in
      both tubes. Women with SIN gave birth to as many children as women without SIN.
      After SIN had been diagnosed, no children were born, but this was not
      statistically different from the frequency of births in the non-SIN group after
      salpingectomy. Women with SIN had histological signs of salpingitis more often
      than women without SIN, but SIN complicated with salpingitis did not influence
      the number of children or tubal pregnancies. Women with SIN had a greater risk of
      two or more tubal pregnancies than women without SIN.

PMID- 1757523
TI  - The effects of cryopreservation and thawing on the development in vitro and in
      vivo of biopsied 8-cell mouse embryos.
AB  - The possible impact of cryopreservation on biopsied 8-cell mouse embryos was
      investigated. Biopsied and control 8-cell embryos were cryopreserved using a slow
      freezing and quick thawing protocol with 1,2-propanediol as a cryoprotectant. The
      cryopreservation process did not affect either the recovery or the survival of
      biopsied embryos, when compared with intact controls; however, sham controls
      survived significantly better than biopsied 8-cell embryos (88.6 versus 74.2%, P
      less than 0.001). When fully and partially intact surviving embryos were cultured
      in vitro to the blastocyst stage, there was no difference in the proportions of
      embryos which formed blastocysts (biopsy 97.2%, intact control 98.4% and sham
      control 93.7%). The developmental potential and fetal development in vivo
      following embryo transfer were not impaired when assessed on day 17 of pregnancy.
      Cryopreservation of biopsied 8-cell mouse embryos is therefore a feasible
      approach to storing embryos while analysis of the biopsied material is carried
      out.

PMID- 1757524
TI  - Using PCR in preimplantation genetic disease diagnosis.
AB  - Preimplantation diagnosis of genetic disease can be accomplished by embryo biopsy
      or polar body analysis using in-vitro gene amplification (PCR). PCR analysis of
      single cells is subject to a number of errors which decrease the reliability of
      the diagnosis. Using realistic assumptions about error rates based on
      experimental data, we analyse some of the practical consequences to be faced by
      whose wishing to use this diagnostic procedure. We considered both autosomal
      dominant and recessive diseases. We calculate the probability of making mistakes
      in the diagnosis, assuming a realistic range in the magnitude of PCR efficiency,
      cell transfer, and contamination errors. We conclude that, in general, analysing
      blastomeres is subject to less mis-diagnosis than polar body analysis, except in
      the case of dominant diseases which are caused by genes which lie extremely close
      to the centromere. We also show that typing multiple blastomeres from a single
      embryo or combining polar body typing with blastomere analysis results in
      significantly lower levels of mis-diagnosis with unacceptable consequences. The
      preimplantation diagnosis of X-linked diseases based upon Y chromosome sequence
      analysis is also discussed.

PMID- 1757525
TI  - Epididymal secretory function in men with asthenoteratozoospermia.
AB  - Epididymal function was evaluated in normozoospermic men and men with
      asthenoteratozoospermia using alpha-glucosidase as a secretory parameter. No
      difference was observed in the total quantity of the enzyme secreted into the
      ejaculate in spite of major differences between the two groups in the proportion
      of spermatozoa exhibiting progressive motility and normal morphology. In general,
      the secretion of alpha-glucosidase was positively correlated with the sperm
      concentration in the normozoospermic group, but not in asthenozoospermic
      subjects. The total enzyme contents of the ejaculate were significantly greater
      in men with asthenoteratozoospermia (sperm concentrations, greater than 35 x
      10(6)/ml) than in subjects with severe oligoasthenoteratozoospermia (sperm
      concentrations less than 10 x 10(6)/ml, P less than 0.01) indicating a higher
      incidence of epididymal occlusion and/or dysfunction in the latter group. Within
      normozoospermic individuals, extremes in progressive motility or abnormal
      morphology could not be related to the quantities of enzyme when expressed per
      million sperm cells. It is concluded that if alpha-glucosidase is a reliable
      parameter of human epididymal secretory function, variation in the secretory
      function of the epididymis cannot explain the poor sperm quality observed in
      asthenoteratozoospermic individuals.

PMID- 1757526
TI  - Variations in semen parameters from fathers.
AB  - Semen volume, pH, sperm characteristics and the ejaculate content of six
      compounds secreted by the epididymides, prostate and seminal vesicles are
      presented for several semen samples from 25 men (mean age 31 years) who, without
      clinical assistance, had fathered children within the previous 29 months. There
      was a large variation both within and between individual's samples for
      concentrations and amounts per ejaculate of all parameters except pH. The range
      including 96% of all values from these fertile men are presented as standards
      against which samples from infertile men could be compared. Lower limits
      (combined arithmetic means minus twice the combined within- and between-father
      standard deviation) were: for semen volume, 1.9 ml; for semen pH, 7.4; for total
      sperm count, 39 X 10(6); for normal morphological forms, 42%; for motility (WHO
      grades) a, 4%; b, 19%; c, 1%; d, 19%; for curvilinear velocity, 27 microns/s; for
      total glucosidase, 27 mU/ejaculate; for neutral alpha-glucosidase, 17
      mU/ejaculate; for L-carnitine, 0.4 mumol/ejaculate; for glycerophosphocholine,
      2.4 mumol/ejaculate; for fructose, 15 mumol/ejaculate; for citrate, 30
      mumol/ejaculate; for zinc, 2.8 mumol/ejaculate.

PMID- 1757527
TI  - Free radical scavengers ameliorate the 2-cell block in mouse embryo culture.
AB  - Mouse zygotes from a strain combination which fails to undergo cleavage in vitro
      (the 2-cell block) were cultured in a variety of media, using either low (5%) or
      normal (20%) oxygen tension in the gas phase. Development beyond the 4-cell stage
      was only achieved in medium containing serum and with normal oxygen tension. When
      serum-free medium was supplemented with free radical scavengers, reduced
      glutathione (1 mM), but not histidine, catalase or superoxide dismutase,
      development to the morula or blastocyst stage was promoted in 50% of zygotes
      cultured with normal oxygen tension. These data suggest that the 2-cell block is
      a consequence, at least in part, of free radical damage incurred by embryos
      during collection and culture, and that medium supplementation with the radical
      scavenger, reduced glutathione, can improve embryo development in vitro.

PMID- 1757528
TI  - Comparison of a radioimmunoassay and bioassay for embryo-derived platelet
      activating factor.
AB  - The pre-embryos of a number of species produce platelet-activating factor (PAF).
      This study compared the sensitivity, reproducibility and cross-reactivity of a
      radioimmunoassay (RIA) for PAF with a quantitative PAF bioassay and assessed the
      use of both assays for the measurement of murine and human embryo-derived PAF.
      PAF was extracted and partially purified by thin-layer chromatography (TLC) from
      medium in which mouse (30 x 2-cell) or individual human embryos [produced by in
      vitro fertilization (IVF)] had been cultured for 24 h. Dose-response curves were
      generated with synthetic PAF standards over a concentration range of 0.3-30
      ng/ml. The RIA was slightly more sensitive than the bioassay since the
      concentration which gave 50% response in the RIA was 3 ng/ml compared to 6 ng/ml
      in the bioassay. The RIA showed greater reproducibility than the bioassay, since
      at these concentrations the coefficients of variation were 1.97 and 6.77% intra
      assay and 4.96 and 10.93% inter-assay, respectively. Both assays had a detection
      limit of 0.3 ng/ml. C-PAF, a non-metabolizable bioactive analogue of PAF, showed
      5.16 and 0.85% cross-reactivity in the bioassay and RIA, respectively, while lyso
      PAF and phosphatidylcholine had no effect. Following extraction and TLC, the
      average PAF concentration was 14.52 ng/ml (range 0.10-141.09) and 20.06 ng/ml
      (range 0.07-106.15) for mouse embryos, and 16.15 ng/ml (range 0.40-78.31) and
      23.70 ng/ml (range 2.00-119.10) for human embryos, as measured by bioassay and
      RIA respectively. Therefore, both the bioassay and RIA were capable of the
      sensitive quantitative measurement of embryo-derived PAF.

PMID- 1757529
TI  - Fertilization and ageing processes in non-divided human oocytes after GnRHa
      treatment: an analysis of individual oocytes.
AB  - Some human oocytes cultured together with spermatozoa for in-vitro fertilization
      (IVF) do not subsequently divide. The arrest of the fertilization process at
      different moments during development may provide information about the cause of
      fertilization failure. Oocytes which subsequently divide are transferred 48 h
      after insemination; when oocytes do not divide, ageing processes can be observed.
      Therefore these oocytes are interesting material in which to observe both
      fertilization and ageing. Our study concerns 72 undivided human oocytes 0, 48 or
      72 h post-insemination. DNA of the oocyte and spermatozoa was visualized by the
      DNA fluorescent dye Hoechst 33342. Living oocytes were observed in toto by
      fluorescence and bright field microscopy which allowed nuclear and pronuclear
      membranes to be discerned. Oocytes were subsequently fixed and sectioned for
      bright field microscopy. Both techniques allowed parallel observations. Oocytes
      at various stages of fertilization are described: sperm penetration in both
      mature and immature oocytes, decondensation of sperm-heads, premature
      condensation of male chromatin, polyspermy and pronucleus formation. Typical
      ageing processes such as the centripetal migration of the metaphase II
      chromosomes, the formation of a restitution nucleus and the lagging of
      chromosomes within a metaphase spindle are observed. DNA fluorescence appears to
      be a quick, easy and valuable means to analyse fertilization and its failure.

PMID- 1757530
TI  - Secretory endometrial protein PP14 in women with early pregnancy bleeding.
AB  - The decidualized endometrium produces secretory proteins of which secretory
      endometrial protein PP14 is the major product during the first trimester of
      pregnancy. The protein is secreted into the uterine lumen as well as into the
      peripheral blood. The purpose of this study was to examine whether decidual
      function, evaluated by the serum concentration of PP14, was different in women
      with early pregnancy bleeding compared to normal pregnant women. A reference
      range for serum PP14 was established on the basis of single samples from 236
      normal pregnant women with ultrasonically confirmed gestational age. All the
      women were delivered of a normal child at term. The study comprised 128 pregnant
      women admitted because of vaginal bleeding between 6 and 18 weeks gestation. At
      ultrasonography, intrauterine fetal heart activity was either present or was
      confirmed at a subsequent examination. No difference was found in the serum level
      of PP14 compared to that in normal pregnancies, but women with vaginal bleeding
      and depressed PP14 levels appeared to have a 5-fold higher risk of preterm
      delivery than women with bleeding and normal PP14 levels.

PMID- 1757531
TI  - Anti-phospholipid antibodies and pregnancy loss.
AB  - Anti-phospholipid antibodies such as the lupus anticoagulant and anti-cardiolipin
      antibodies, are antibodies directed at negatively charged phospholipids and have
      received much attention in the last decade. Their presence has been associated
      with a thrombotic tendency, leading to a variety of clinical symptoms. In the
      pregnant woman, the presence of these antibodies may have consequences for
      management, since retrospective reports have established a correlation between
      the lupus anticoagulant or anti-cardiolipin antibodies with intrauterine fetal
      death, probably due to placental thrombosis. This article reviews current
      knowledge on anti-phospholipid antibodies in relation to pregnancy loss, focusing
      on clinical aspects.

PMID- 1757532
TI  - Maternal death associated with ovum donation twin pregnancy.
AB  - A case of maternal death due to sub-arachnoid haemorrhage in an ovum donation
      twin pregnancy complicated by hypertension is described. Attention is drawn to a
      forecasted increase in maternal morbidity and mortality in in-vitro fertilization
      (IVF) pregnancies, which occur in older women and are often multiple.

PMID- 1757533
TI  - Performance of a nonisotopic DNA probe for detection of Chlamydia trachomatis in
      urogenital specimens.
AB  - The Gen-Probe PACE 2 assay (GP), a nonisotopic DNA probe, was evaluated by using
      cell culture as the method of reference. Specimens were collected from 260 men
      and 482 women visiting the outpatient department for sexually transmitted
      diseases at the University Hospital in Rotterdam, The Netherlands. The
      prevalences of Chlamydia culture-positive men and women were 13.2 and 8.6%,
      respectively. Sensitivity values for the male and female patients were 70.6 and
      92.7%, respectively. Specificity values for these groups were 98.2 and 97.7%,
      respectively. Sensitivity was significantly lower when the number of inclusions
      in cell culture was low. Samples which showed a discordance between cell culture
      and GP results were retested by the polymerase chain reaction. If the results of
      the polymerase chain reaction were considered as the points of reference, the
      sensitivity and specificity of both GP and cell culture could be calculated. The
      performance of GP for females was comparable to that of cell culture. In males,
      the sensitivity of GP was considerably lower than that of cell culture (77.2
      versus 91.4%), while specificity was somewhat higher (99.6 versus 99.1%).
      Compared with cell culture, the GP is a relatively simple and rapid test that is
      suitable for diagnosing Chlamydia infections in urogenital specimens.

PMID- 1757534
TI  - Genomic DNA fingerprinting by pulsed-field gel electrophoresis as an
      epidemiological marker for study of nosocomial infections caused by methicillin
      resistant Staphylococcus aureus.
AB  - In this study, we have compared genomic DNA fingerprintings among isolates of
      methicillin-resistant Staphylococcus aureus (MRSA) by using pulsed-field gel
      electrophoresis (PFGE). Chromosomal fragments digested with SmaI were most
      suitable for the PFGE separation. SmaI cut genomic DNA into 15 to 20 fragments
      whose sizes ranged from about 30 to 1,500 kb. Thirty-one distinctive fragment
      patterns were identified in 111 infecting and colonizing MRSA isolates from six
      different hospitals in Japan. On the basis of the genomic typing by PFGE, we
      performed an epidemiological investigation of an outbreak of nosocomial MRSA
      infections among inpatients in Nagoya University Hospital. Ten types of
      chromosomal digestion were identified in the 20 strains isolated from 18 infected
      patients and 1 from colonized hospital personnel. According to the restriction
      patterns, we found that four types of these strains had caused epidemic
      infections among 13 patients in the outbreak. Two types (types 1 and 4) of the
      strains were involved in the death of five patients. The other infections were
      sporadic. The clarity and polymorphism of the chromosomal digestion patterns
      enabled us to discriminate between isolates which could not be differentiated by
      antibiogram or plasmid analysis. Classification of the genomic DNA fingerprinting
      patterns by PFGE is therefore proposed as a useful method for investigating the
      source, transmission, and spread of nosocomial MRSA infections.

PMID- 1757535
TI  - Rhodococcus equi plasmids: isolation and partial characterization.
AB  - Fifty-four strains of Rhodococcus equi from different clinical sources (mainly
      horses and pigs) were examined for their plasmid content by two screening
      methods. Plasmids were detected in 49 of 54 strains. A plasmid of approximately
      80 kb was isolated from 21 of 22 isolates from horses and 20 of 28 isolates from
      pigs, and a 105-kb plasmid was isolated from 7 of 28 isolates from pigs. The 80
      kb plasmid was significantly associated with strains of equine rather than
      porcine origin, and the 105-kb plasmid was significantly associated with strains
      of porcine origin. The type strain, ATCC 6939, consistently failed to yield a
      plasmid. Restriction enzyme analysis of purified plasmid DNA confirmed the
      relatedness of the 80-kb plasmids isolated from strains of equine and porcine
      origin. More differences between the restriction patterns of plasmids from
      strains isolated from horses and from pigs than among strains from either species
      were observed. Restriction enzyme analysis also showed relatedness of the 105-kb
      plasmid to the 80-kb plasmid. Three strains shown by others to be virulent in
      horses or mice possessed the 80-kb plasmid, whereas three other strains not
      virulent for horses or mice lacked the plasmid, although one had the 105-kb
      plasmid. There was a significant but not perfect association between the presence
      of the 80-kb plasmid and production of a diffuse 17.5-kDa thermoregulated,
      virulence-associated protein. Further study is needed to determine whether this
      plasmid is associated with virulence in R. equi.

PMID- 1757536
TI  - Development of verotoxin 2- and verotoxin 2 variant (VT2v)-specific
      oligonucleotide probes on the basis of the nucleotide sequence of the B cistron
      of VT2v from Escherichia coli E32511 and B2F1.
AB  - We and others have noted that there are serological differences between verotoxin
      2 (VT2) (also known as Shiga-like toxin II) produced by Escherichia coli
      C600(933W) and the VT2 variant (VT2v) produced by strain E32511. Recent reports
      have described nucleotide sequence differences between the VT2v B subunit cistron
      of E32511 and B2F1 and that of VT2. We have confirmed the sequence differences
      and have used them to design oligonucleotide probes which differentiate the B
      subunit cistron of VT2v from that of VT2. Isolates of VT-producing E. coli
      obtained from human as well as food and veterinary sources were classified
      according to the toxin phenotype by using a toxin neutralization assay with VT2
      specific monoclonal antibody and VT2v-specific polyclonal antisera. Using the
      oligonucleotide probes in colony hybridization, we detected 35 of 35 VT2
      producers and 16 of 16 VT2v producers. One VT2 producer was falsely identified as
      containing the VT2v gene. The E32511 strain in our collection hybridized only
      with the VT2-specific probe. Southern hybridization of radiolabeled
      oligonucleotide probes showed that strains carried zero to one copy of the VT2
      gene and zero to two copies of the VT2v gene. We conclude that colony
      hybridization with the VT2- and VT2-specific probes is highly predictive of the
      toxin phenotypes in the clinical isolates described in this study.

PMID- 1757537
TI  - Immunoglobulin binding by Tritrichomonas foetus.
AB  - A better method for diagnosis of bovine trichomoniasis is needed because culture
      is slow and somewhat lacking in sensitivity. Immunodiagnosis of Tritrichomonas
      foetus infection usually involves detection of antigen-antibody reactions with an
      anti-immunoglobulin conjugate. However, nonspecific immunoglobulin (Ig), bound to
      the surface of T. foetus, would also be detected by an anti-Ig conjugate and thus
      would interfere with the specificity of the immunoassay. The goals of this study
      were to define the binding of bovine immunoglobulins to T. foetus. To determine
      whether nonimmune binding of Ig to T. foetus occurs, we immunized rabbits with
      organisms that had been grown in medium containing normal bovine serum and
      vigorously washed three times with phosphate-buffered saline. The rabbit
      antiserum had similar titers to T. foetus and to normal bovine serum by enzyme
      linked immunosorbent assay (ELISA). Furthermore, two bovine serum proteins were
      immunoprecipitated by the rabbit antiserum in an immunoelectrophoretogram. One of
      the serum proteins had a distribution characteristic of IgG2. The rabbit
      antiserum was then shown to react with purified bovine IgG and IgM by ELISA.
      Reactivity to IgG was greater. To identify the IgG subisotypes bound and to
      confirm nonimmune binding of Ig, we grew T. foetus in agammaglobulinemic fetal
      calf serum and reacted it with IgG1, IgG2, and IgM specific for dinitrophenol
      (DNP) in ELISA. The binding of IgG2 was greatest, that of IgG1 was next, and that
      of IgM was least. Little competitive inhibition by DNP was detected, indicating
      that binding of DNP-specific antibodies was predominantly nonimmune rather than
      antigen-specific Ig binding. We also demonstrated that T. foetus grew well in
      medium containing agammaglobulinemic fetal calf serum or serum made
      agammaglobulinemic by ammonium sulfate precipitation of Igs. This may overcome
      the problem of low specificity in diagnostic assays as a result of antigen with
      Ig bound by nonimmune mechanisms.

PMID- 1757538
TI  - Mycobacterium avium complex disease in patients with AIDS: seroreactivity to
      native and recombinant mycobacterial antigens.
AB  - Antibodies to Mycobacterium avium complex (MAC) antigens were measured by enzyme
      linked immunosorbent assays and immunoblot analyses in sera from 20 patients with
      AIDS and disseminated MAC disease, 5 human immunodeficiency virus-seronegative
      patients with pulmonary MAC infections, and 20 healthy controls. Whereas enzyme
      linked immunosorbent assay titers for healthy controls and patients with AIDS and
      MAC disease were comparable, human immunodeficiency virus-seronegative patients
      with MAC disease had higher anti-MAC antibody titers (P less than 0.01).
      Immunoblot analysis with the same sonic extracts indicated that each of the three
      groups had a limited heterogeneous response to M. avium antigens. No significant
      differences in immunoblot reactivities were detected. However, immunoblot studies
      with recombinant nontuberculous mycobacterial antigens revealed that sera from
      over 90% of the patients with MAC disease and only 25% of controls recognized a
      recombinant protein derived from a 35-kDa mycobacterial antigen. Although sonic
      extracts did not permit adequate discrimination of antibody reactivity in
      patients with MAC disease, recombinant antigens may be useful as indicators of
      disease.

PMID- 1757539
TI  - Group G streptococcal lymphadenitis in rats.
AB  - Group G streptococci which have been isolated from the oral flora of rats are
      also normal inhabitants of the human skin, oropharynx, gastrointestinal tract,
      and female genital tract. This group of streptococci can cause a wide variety of
      clinical diseases in humans, including septicemia, pharyngitis, endocarditis,
      pneumonia, and meningitis. Ten days after oral gavage with 7,12
      dimethylbenz[a]anthracene, 12 of 22 two-month-old, female, outbred, viral
      antibody-free rats presented with red ocular and nasal discharges and marked
      swelling of the cervical region. Various degrees of firm, nonpitting edema in the
      region of the cervical lymph nodes and salivary glands as well as pale mucous
      membranes and dehydration were observed. Pure cultures of beta-hemolytic
      streptococci were obtained from the cervical lymph nodes of three rats that were
      necropsied. A rapid latex test system identified the isolates to have group G
      specific antigen. These streptococcal isolates fermented trehalose and lactose
      but not sorbitol and inulin and did not hydrolize sodium hippurate or bile
      esculin. A Voges-Proskauer test was negative for all six isolates. Serologic
      tests to detect the presence of immunoglobulin G antibody to rat viral pathogens
      and Mycoplasma pulmonis were negative. Histopathologic changes included acute
      necrotizing inflammation of the cervical lymph nodes with multiple large colonies
      of coccoid bacteria at the perimeter of the necrotiz zone. To our knowledge, this
      is the first report of naturally occurring disease attributed to group G
      streptococci in rats.

PMID- 1757540
TI  - Development of a rapid enzyme immunoassay for Clostridium difficile toxin A and
      its use in the diagnosis of C. difficile-associated disease.
AB  - A rapid (2.5 h) direct enzyme immunoassay (EIA) for Clostridium difficile toxin A
      was developed for clinical use. Specimen centrifugation and filtration were not
      required. The EIA detected toxin A levels in patient stool as low as 20 pg (2
      ng/ml of stool). The test was 5,000 times more sensitive for toxin A than it was
      for toxin B and did not react with a panel of other bacterial species with the
      exception of one highly toxigenic strain of Clostridium sordellii. The EIA was
      compared with the cytotoxin assay, culture of toxigenic C. difficile (toxigenic
      culture), and latex agglutination by using 313 fresh stool specimens submitted
      from patients with suspected C. difficile-associated disease. Results read
      visually and with a plate reader were similar. Sixty-two specimens were positive
      by one or more tests, but only 22 (35%) were positive by all four laboratory
      methods. The EIA was 84.1% sensitive and 98.9% specific when it was compared with
      the cytotoxin assay. The use of toxigenic culture to referee discrepant results
      (EIA versus cytotoxin assay) showed the EIA sensitivity and specificity to be
      95.1 and 99.3%, respectively, with respect to other laboratory methods. Patient
      charts were reviewed for antibiotic-associated diarrhea on 108 specimens,
      including all those that were positive by at least one test method. Of 34
      patients determined to have C. difficile-associated disease, 29 (85.3%) were
      positive by EIA, 32 (94.1%) were positive by the cytotoxin assay, 27 (79.4%) were
      positive by toxigenic culture, and 20 (58.8%) were positive by latex
      agglutination. Seven patients with antibiotic-associated diarrhea had a positive
      latex result, but results were negative by EIA, the cytotoxin assay, and
      toxigenic culture. The EIA demonstrated high specificity and good sensitivity for
      C. difficile-associated disease cases. The test can be used alone or in
      combination with the cytotoxin assay or toxigenic culture to provide rapid and
      sensitive results.

PMID- 1757541
TI  - Differentiation of Lactococcus lactis and Lactococcus garvieae from humans by
      comparison of whole-cell protein patterns.
AB  - We tested 12 reference and 24 clinical strains of lactococci for physiologic
      characteristics using a conventional test system, the Gen-Probe Enterococcus 2
      chemiluminescence assay (Gen-Probe Inc., San Diego, Calif.), the Rapid Strep
      identification system (Analytab Products, Plainview, N.Y.), and whole-cell
      protein analysis. The Gen-Probe Enterococcus 2 chemiluminescence assay for
      Enterococcus identification was negative with all strains. Neither the
      conventional test nor the Rapid Strep identification system could differentiate
      between the two Lactococcus spp. most commonly isolated from humans. A simple
      procedure, based on sodium dodecyl sulfate-polyacrylamide gel electrophoresis,
      was developed for comparing the whole-cell protein patterns of Lactococcus spp.
      L. lactis and L. garvieae were differentiated by unique protein patterns.

PMID- 1757542
TI  - Quantitative microculture system with standardized inocula for strain typing,
      susceptibility testing, and other physiologic measurements with Candida albicans
      and other yeasts.
AB  - A method for physiologic testing of Candida albicans and other yeasts is
      described in which inocula with reproducible cell concentrations are prepared
      from cultures in a glucose-limited medium and growth turbidities of test cultures
      in microplates are expressed quantitatively as a percentage of control growth.
      The method gave good within-plate and run-to-run reproducibilities and was
      applicable both to strain phenotype discrimination in C. albicans and to
      susceptibility tests of yeasts with azole antifungal agents.

PMID- 1757543
TI  - Isolation and characterization of an Ehrlichia sp. from a patient diagnosed with
      human ehrlichiosis.
AB  - A new disease was recognized in the United States in 1986. The etiologic agent,
      although not previously isolated from a human, appeared to be serologically
      related to Ehrlichia canis, a canine leukotropic rickettsia. We obtained blood
      specimens from 27 febrile patients with a history of tick exposure. Leukocytes
      from 24 patients not treated with tetracycline were placed onto a monolayer of
      DH82 cells. We performed indirect immunofluorescence on sera from all 27 febrile
      patients as well as sera from 12 patients with previously diagnosed ehrlichiosis.
      Intractoplasmic inclusions were first observed in culture 35 days after the
      addition of infected blood from one patient. Partial sequencing of the rRNAs from
      the human isolate and E. canis indicated that they are 98.7% related. Positive
      indirect immunofluorescence reactions to the human isolate were obtained for all
      12 previously diagnosed patients and for 33% of the 27 febrile patients. Two
      patients were seropositive for the human isolate but not for E. canis. No sera
      were positive for E. canis and negative for the human isolate. We report the
      isolation of a previously unrecognized Ehrlichia sp. that appears to be the
      etiologic agent of human ehrlichiosis. Serologic data (range of antibody titers,
      256 to 32,768) in combination with rRNA sequencing indicated that the newly
      isolated Ehrlichia sp. is similar, but not identical, to E. canis.

PMID- 1757544
TI  - Detection of variable DNA repeats in diverse eukaryotic microorganisms by a
      single set of polymerase chain reaction primers.
AB  - We cloned and sequenced a variable DNA repeat from Trichomonas vaginalis, a
      flagellated protozoan parasite. Targeting of this repeat in the polymerase chain
      reaction resulted in complex and intense product patterns for a wide variety of
      eukaryotic microorganisms, including the pathogenic protozoan parasites T.
      vaginalis, Giardia lamblia, Leishmania donovani, three species of Trypanosoma,
      and four species of Acanthamoeba; the nonpathogenic protozoans, Paramecium
      tetraurelia and Tetrahymena thermophilia; and a yeast, Saccharomyces cerevisiae.
      Each microorganism exhibited a distinctive pattern of repeats. For example, a
      characteristic pattern was exhibited by six clinical T. vaginalis isolates. Eight
      G. lamblia isolates exhibited either one of two characteristic pattern types.
      There was no reaction with human DNA or DNA from the prokaryotes Ureaplasma
      urealyticum and Mycoplasma hominis. This approach may facilitate detection of a
      wide variety of eukaryotic microorganisms by use of a single primer set and holds
      promise for the development of typing schemes for both T. vaginalis and G.
      lamblia.

PMID- 1757545
TI  - DNA fingerprinting of Enterococcus faecium by pulsed-field gel electrophoresis
      may be a useful epidemiologic tool.
AB  - Pulsed-field gel electrophoresis was used to compare 34 isolates of Enterococcus
      faecium from six different geographic locations. This procedure generated an
      average of 13 discernible fragment bands per isolate (range, 10 to 19 fragment
      bands) of 34 to 485 kb. The resulting restriction endonuclease digestion patterns
      were quite heterogeneous and were able to differentiate 27 of 34 isolates from
      each other, as defined by one or more mismatched fragment bands. Five patterns
      were shared by two or more isolates, and each set of isolates with matching
      patterns (shared pattern) originated in the same medical center, suggesting a
      common epidemiologic background, including highly penicillin resistant isolates
      in Richmond and Philadelphia. We conclude that pulsed-field gel electrophoresis
      of DNA digested with low-frequency-cleavage restriction enzymes offers a
      relatively simple method of comparing E. faecium for the purpose of epidemiologic
      study.

PMID- 1757546
TI  - Ability of National Committee for Clinical Laboratory Standards-recommended
      quality control strains from the American Type Culture Collection to detect
      errors in disk diffusion susceptibility tests.
AB  - The National Committee for Clinical Laboratory Standards (NCCLS) recommends, as a
      quality control for the disk diffusion susceptibility test, the use of three
      strains from the American Type Culture Collection: Staphylococcus aureus ATCC
      25923, Pseudomonas aeruginosa ATCC 27853, and Escherichia coli ATCC 25922. This
      study assesses the capacity of these strains to detect errors in the overall
      method. ATCC strains were tested by comparing testing by the standard NCCLS
      recommended procedure (ST) with testing under the following conditions:
      incubation at 25 degrees C, Mueller-Hinton agar depths of 2 mm (AD2) and 8 mm
      (AD8), agar pHs of 6.5 and 8, inocula with McFarland standards of 0.25 (0.25M)
      and 4.0 McFarland (4.0M), direct inoculation without preincubation of inoculum
      (DI), and a 2-h delay between inoculation and disk application (2HR). The
      frequency of zone measurements outside the NCCLS-recommended control zone limits
      were as follows: ST, 0%; AD2, 18%; AD8, 9.6%; pH 6.5, 7.9%; pH 8, 5.3%; 0.25M,
      3.5%; 4.0M, 24%; DI, 3.4%; 2HR, 1.8%; 25 degrees C (only E. coli and P.
      aeruginosa were evaluable), 28%. These results suggest that the quality control
      strains are only partially effective in detecting single extreme laboratory
      errors and that careful laboratory supervision is necessary even in the setting
      of properly monitored quality control strains.

PMID- 1757547
TI  - Comparison of the Vitek Immunodiagnostic Assay System with an indirect
      immunoassay (Toxostat Test Kit) for detection of immunoglobulin G antibodies to
      Toxoplasma gondii in clinical specimens.
AB  - The value and convenience of testing for specific anti-Toxoplasma gondii
      antibodies have led to the development of various antibody detection methods,
      such as the enzyme immunoassay. Two enzyme immunoassays, the Vitek Immuno
      Diagnostic Assay System (VIDAS; Vitek Systems, Hazelwood, Mo.) and the Toxostat
      Test Kit (TST; Whittaker Bioproducts, Walkersville, Md.), were compared for their
      ability to detect T. gondii immunoglobulin G antibodies in fresh human sera.
      Specimens were tested according to the instructions of each manufacturer. Of 304
      serum specimens tested, the results for 282 (93%) agreed in both assays (77 were
      positive and 205 were negative). The results for the remaining 22 (7%) specimens
      were discrepant; 20 of the 22 specimens tested low positive or equivocal by
      Toxostat and negative by VIDAS. Upon retesting, 8 of these 22 specimens were in
      concordance, increasing the level of agreement to 95.3%. Intra-assay
      reproducibility was tested with four to nine replicates of each of seven samples
      (four positive, one negative, and two equivocal) by both tests and six replicates
      of one standard by VIDAS. Coefficients of variation (CVs) for VIDAS were 6, 8,
      10, 15, 18, 19, and 23% for the samples and 14% for the standard. For Toxostat
      the CVs were 2, 8, 10, 10, 13, and 16%. In general, CVs for VIDAS were slightly
      larger than the CVs for Toxostat. Day-to-day variability over 3 days was tested
      by VIDAS for only six samples (three positive, two negative, and one equivocal)
      and four standards; CVs ranged from 2 to 15% for the samples and from 6 to 13%
      for the standards. In conclusions, VIDAS is a rapid, convenient, non-labor
      intensive, and easily performed test for the detection of immunoglobulin G
      antibodies to T. gondii in serum specimens.

PMID- 1757548
TI  - Babesia microti, human babesiosis, and Borrelia burgdorferi in Connecticut.
AB  - Babesia microti was isolated from a white-footed mouse (Peromyscus leucopus) that
      was captured in southeastern Connecticut in 1988, when the first human case of
      babesiosis acquired in Connecticut was recognized. To date, 13 cases of
      babesiosis have been reported in Connecticut, the largest number of human cases
      reported on the mainland United States. Two of nine patients quiried remembered a
      prior tick bite. Since Babesia parasites are known to be vectored only by ticks,
      we surmise that 12 of these infections were acquired via tick bites; 1 was
      obtained by blood transfusion (the patient was 46 years of age) from an
      endemically infected donor. The ages of the patients with tick-acquired
      babesiosis ranged from 61 to 95 years. Two patients died with active infections,
      and one patient died from chronic obstructive pulmonary disease soon after
      treatment with clindamycin and quinine. Indirect fluorescent-antibody titers of
      blood samples drawn at the time of hospitalization for 11 patients and at the
      time of active infection for 1 asymptomatic person ranged from 1:1,024 to
      1:4,096. Five of eight patients with babesiosis also had significant
      immunoglobulin G or immunoglobulin M titers (1:640 to 1:5,120) to Borrelia
      burgdorferi. B. microti was isolated in Syrian hamsters inoculated with blood
      from 7 of 12 patients tested and was also isolated from mice captured in six
      towns. The peridomestic nature of the disease was demonstrated by isolating the
      parasite from white-footed mice captured in or near the yards of eight different
      patients. Of 59 mice tested, 27 were positive and 25 were coinfected with B.
      burgdorferi. The isolation of B. microti from a white-footed mouse captured in
      north-central Connecticut (West Hartford), away from the focus of human
      infections in southeastern Connecticut, suggests that this pathogen may spread
      into other areas where Ixodes dammini, the tick vector, becomes established.

PMID- 1757549
TI  - Yersinia enterocolitica isolated from two cohorts of young children in Santiago,
      Chile: incidence of and lack of correlation between illness and proposed
      virulence factors.
AB  - Yersinia enterocolitica was isolated from children in two cohorts in Santiago,
      Chile. In a cohort containing a cross section of children aged 0 to 4 years, Y.
      enterocolitica was isolated from stool samples of 1.1% of children with diarrhea
      and 0.2% of age-matched control children. In a subgroup of this cohort from which
      weekly stool samples were obtained from all children irrespective of clinical
      status, 6% of children had asymptomatic Yersinia infections. In a birth cohort
      (with a greater representation of children less than 1 year of age and a
      significantly higher rate of diarrhea), Y. enterocolitica was isolated from 1.9%
      of children with diarrhea and 0.6% of controls (P = 0.05). Biogroup 1A strains
      (which lacked traditional phenotypic and molecular markers for pathogenicity)
      were isolated from seven children with diarrhea but from no control children in
      the birth cohort (P = 0.02). All other isolates, including all isolates from
      asymptomatic children, were "pathogenic" strains in biogroup 4, serogroup O3; no
      association between these isolates and occurrence of disease was found. Y.
      enterocolitica is found among young children in Santiago, with asymptomatic
      infections not uncommon occurrences. However, questions about the association
      between previously described virulence factors and diarrheal illness remain.

PMID- 1757550
TI  - Serotyping of Canadian isolates of Treponema hyodysenteriae and description of
      two new serotypes.
AB  - A total of 30 isolates of Treponema hyodysenteriae collected in the Saint
      Hyacinthe (Quebec, Canada) area were serotyped by agar gel double immunodiffusion
      by using extracted lipopolysaccharide and hyperimmune rabbit antisera. Only 17%
      (5 of 30) of the isolates were typed with antisera specific for each of the seven
      known serotypes of T. hyodysenteriae. Antisera raised against 11 untypeable local
      isolates were then produced and tested against each lipopolysaccharide extract.
      Results showed two serologically distinct groups among 21 of the 25 untypeable
      isolates. The isolates in each group shared identical antigens. No detectable
      reactions could be observed between antisera raised against these 11 isolates and
      the antigens extracted from 7 reference serotype strains. On the basis of these
      results, two new serotypes of T. hyodysenteriae, serotypes 8 and 9, are proposed.
      We also propose isolate FM 88-90 as the reference strain for serotype 8 and
      isolate FMV 89-3323 as the reference strain for serotype 9. These two new
      serotypes, which represented 70% of the isolates tested, seem to be the major
      serotypes found in the province of Quebec.

PMID- 1757551
TI  - Rickettsiae and Borrelia burgdorferi in ixodid ticks.
AB  - Nymphs and adults of hard-bodied ticks were collected in Connecticut and tested
      by direct and indirect immunofluorescence staining methods for rickettsiae and
      Borrelia burgdorferi. Of the 609 Ixodes dammini ticks examined, 59 (9.7%)
      harbored rickettsialike microorganisms in hemocytes (blood cells). These bacteria
      reacted with fluorescein-conjugated antiserum to Ehrlichia canis, the etiologic
      agent of with fluorescein-conjugated antiserum to Ehrlichia canis, the etiologic
      agent of canine ehrlichiosis. Prevalence of infection ranged from 6.8 to 12.7%
      for males and females, respectively. Although the specific identities of the
      hemocytic rickettsialike organisms are unknown, they share antigens with
      ehrlichiae. Electron microscopy revealed rickettsiae in ovarian tissues of I.
      dammini that also had infected hemocytes. Rickettsialike organisms were also
      observed in the hemocytes of 5 (6.9%) of 73 Dermacentor variabilis ticks. In
      analyses for B. burgdorferi, 146 (23.7%) of 617 I. dammini ticks harbored these
      spirochetes in midguts. Hemocytic rickettsialike microorganisms coexisted with B.
      burgdorferi in 36 (6.7%) of the 537 nymphs and adults of I. dammini examined. I.
      dammini, with its broad host range, has the potential to acquire multiple
      microorganisms.

PMID- 1757552
TI  - Sample preparation method for polymerase chain reaction-based semiquantitative
      detection of Leptospira interrogans serovar hardjo subtype hardjobovis in bovine
      urine.
AB  - An improved method of preparing bovine urine samples was developed for the rapid,
      specific, and sensitive detection of Leptospira interrogans serovar hardjo
      (subtype hardjobovis) DNA by the polymerase chain reaction (PCR). A total of 100
      leptospire-free cows, 4 experimentally infected cows, and 2 negative control cows
      were used. PCR results were improved by (i) using 10-ml urine samples instead of
      1-ml samples, (ii) adding 10(7) to 10(8) Leptospira biflexa serovar patoc cells
      as a carrier to each treated sample, (iii) preventing the loss of pelleted
      leptospires, and (iv) minimizing the presence of PCR-inhibiting factors in the
      samples. The preparation method enabled us to use the PCR to reproducibly detect
      as few as 5 to 10 leptospires per ml of urine without the need for dot blot
      hybridization. In addition, we were able to estimate the number of leptospires
      shed by experimentally infected cows.

PMID- 1757553
TI  - Use of monoclonal antibodies with neutralizing effects on toxic antigens from
      human bacterial plaque to detect specific bacteria by colony blotting.
AB  - Inflammatory periodontal diseases are provoked by bacteria which adhere to teeth
      at the gingival margin and form plaques containing toxins detectable by their
      effect on mammalian cells in culture. The aim of this study was to make toxin
      neutralizing monoclonal antibodies and determine whether they detect antigen in
      specific oral bacteria. Bacterial plaque was collected from teeth and
      homogenized, and the fluid phase (plaque extract) was boiled or first
      fractionated over Sephacryl S-300. Hybridomas from immunized mice secreted
      immunoglobulin M (IgM) antibodies which reacted to plaque antigens.
      Neutralization was detected by an increase in the growth of HL60 cells which were
      exposed to plaque toxins in the presence of IgM from hybridoma culture or ascitic
      fluids. However, the neutralization was obvious only when the plaque toxins
      reduced growth by 50% or less. Plaque toxin preparations were found to contain
      proteases which hydrolyzed all of the IgM in ascitic fluids within 24 h.
      Replenishing the IgM daily preserved protection compared with protection from IgM
      from other hybridomas or saline only. The decrease in the specific activity of
      plaque proteins caused by replenishing one such antibody (3hE5) was 2.5-fold
      compared with activity with unreplenished 3hE5, 3.8-fold compared with activity
      with saline only, and 10.7-fold compared with activity with replenished,
      unrelated antibody. The neutralizing IgM detected an array of 14,000- to 22,000
      molecular-weight antigens. The native toxins may be aggregates of these antigens,
      or the array may indicate fragments of an undetected, larger antigen or a common,
      nonpeptide adduct. Only 0.5 to 0.8% of the bacteria from sites with periodontitis
      and grown on blood agar contained antigen. One group of reactive bacteria was
      identified as Actinomyces odontolyticus serotype I. Other isolates were
      identified as Staphylococcus epidermidis, but antigen disappeared from the these
      isolates within 6 weeks of subculture. Epitope-containing antigens were also
      found in streptococcal and Eikenella isolates, and it is likely that the antigens
      from only some of these bacteria are toxic.

PMID- 1757554
TI  - Phage typing of Salmonella enteritidis in the United States.
AB  - The number of reported isolates of Salmonella enteritidis has increased
      dramatically in the last 10 years. For many years phage typing has been a useful
      epidemiologic tool for studying outbreaks of S. typhi and S. typhimurium. In
      1987, Ward et al. (L. R. Ward, J. De Sa, and B. Rowe, Epidemiol. Infect. 99:291
      294, 1987) described a phage typing scheme for S. enteritidis. This system
      differentiated 27 phage types by use of 10 typing phages. With these phages, we
      typed 573 strains of S. enteritidis from humans (42 outbreaks), animals, food,
      and the environment. Ninety-six percent of the strains were typeable. The most
      common phage types were 8 (48.2%), 13a (20.1%), 13 (7.8%), and 14b (7.8%). Most
      of the strains were specifically collected from egg-related outbreaks in the
      northeastern United States in 1988 and 1989, probably accounting for the
      distribution of the four most common types in this sample. This system was
      particularly useful for differentiating a group of animal strains that had a
      number of diverse phage types. For 49 animal strains typed, 16 different patterns
      were obtained. Phage type 8 represented 32% of these strains, but no other phage
      type represented more than 8% of these strains. One-half of the 16 animal strains
      that were phage type 8 were from poultry. This phage typing system will be useful
      for comparing phage types found in the United States with those types encountered
      worldwide and for determining whether virulent strains of phage type 4 are
      entering the United States. Additional phage typing systems as well as molecular
      techniques are being studied to determine whether they can differentiate strains
      of phage types 8 and 13a.

PMID- 1757555
TI  - Fibronectin binding by Salmonella strains: evaluation of a particle agglutination
      assay.
AB  - Thirty-five Salmonella strains isolated from human cases of salmonellosis were
      tested and compared for their fibronectin (fn) binding capacities by using two fn
      particle agglutination assays (fn-PAAs) prepared by coating with human fn either
      (i) latex beads (Difco; 0.81-micron diameter) (L-fn-PAA) or (ii) heat-killed
      formalin-treated Staphylococcus aureus Cowan 1 cells (C-fn-PAA). Six S. aureus
      strains were also included in this study as controls. The strains were cultured
      on colonization factor antigen agar and blood agar and in tryptic soy broth and
      brain heart infusion broth. The Salmonella and S. aureus strains were cultured at
      33 and 37 degrees C, respectively, for optimal expression of fn-binding proteins.
      Bacterial cells (approximately 10(10) cells per ml) harvested from growth in
      various culture media and suspended in 0.02 M potassium phosphate buffer (pH 6.8)
      agglutinated the fn-PAA reagents. These reactions were scored semiquantitatively
      from + to + depending on the speed or intensity of the reactions within 2 min.
      Maximum agglutination in fn-PAA systems was observed when the cells were grown in
      brain heart infusion broth, while tryptic soy broth proved to be least suitable
      media for culturing cells for fn-PAAS. Although a statistically highly
      significant correlation was obtained between results of assays of radiolabeled fn
      and 29-kDa fragment binding, no significant correlation was observed (i) between
      the results of strains cultured in different media or (ii) when semiquantitative
      score results of the two fn-PAA systems were compared with those of the
      conventional radiolabeled fn assay. To enhance the efficiency of the test system,
      the C-fn-PAA reagent was stained with methylene blue (2% in 0.17 M glycine-NaOH
      buffer [pH 6.8]). This facilitated easy interpretation of results, which could be
      performed on hydrophobic paper instead of glass slides. The results obtained with
      both unstained C-fn-PAA and stained C-fn-PAA were comparable to each other and
      reproducible. Although the fn-PAAs are simple and easy to perform, the results
      did not differentiate between negative, low, moderate, and high binding abilities
      when Salmonella strains were evaluated for fn binding, and the results were not
      comparable to those obtained by the conventional radiolabeling method.

PMID- 1757556
TI  - Evaluation of liquid media for growth of Helicobacter pylori.
AB  - Helicobacter pylori has routinely been isolated and grown on solid media.
      Recently, we have succeeded in obtaining growth of this organism in several
      liquid media in large volumes, including tryptic soy broth, Mueller-Hinton broth,
      brucella broth, brain heart infusion broth, and Columbia broth. Growth was tested
      in the media with and without supplementation. Growth was obtained after
      incubation under microaerobic conditions and with CO2 enrichment. Growth in a
      stationary system versus that in an agitated system was evaluated. Results from
      these experiments show that H. pylori can be grown in any of the liquid media
      tested except buffered yeast extract-alpha-ketoglutarate if serum is added. No
      growth was observed on buffered yeast extract-alpha-ketoglutarate even with serum
      and other supplementation. Growth of H. pylori in most of the liquid media with
      supplements was improved if the culture was incubated in a CO2 atmosphere. The
      findings reported here may be useful in clinical, industrial, and research
      laboratories that require harvests of large quantities of H. pylori cells.

PMID- 1757557
TI  - Ehrlichia chaffeensis, a new species associated with human ehrlichiosis.
AB  - The bacterial 16S rRNA genes from blood samples of two patients with human
      ehrlichiosis and from an isolate recovered from one of the patients were
      amplified by using the polymerase chain reaction. The amplimers were then cloned
      and sequenced. The 16S rRNA gene sequence was also determined for Ehrlichia canis
      (two strains), E. equi, E. phagocytophila (two strains), and E. sennetsu (two
      strains). These sequences, along with a previously published 16S rRNA gene
      sequence of E. risticii, were compared. The 16S rRNA gene sequences were
      identical for all three sources of the human ehrlichiosis agent. The sequence
      comparisons indicate that the human ehrlichiosis agent is a new species most
      closely related to E. canis (98.2%) and more distantly related to other Ehrlichia
      spp. We propose that this species be named Ehrlichia chaffeensis sp. nov., with
      the Arkansas strain as the type strain.

PMID- 1757558
TI  - Aerokey II: a flexible key for identifying clinical Aeromonas species.
AB  - A small subset (n = 18) of highly discriminatory tests was derived from the
      feature frequency of 50 tests used in the study of 167 predominantly clinical
      Aeromonas strains. Seven of these eighteen tests were used to construct a
      flexible, dichotomous key, Aerokey II, for identifying clinical aerontonads:
      esculin hydrolysis, gas from glucose, acid from arabinose, indole production,
      acid from sucrose, Voges-Proskauer reaction, and resistance to cephalothin (30
      micrograms). This schema was initially evaluated in a single-blind trial of 60
      well-characterized clinical Aeromonas hydrophila (n = 21), A. caviae (n = 19),
      and A. veronii bv. sobria (n = 20) strains from an independent laboratory. Of the
      60 strains tested, 58 (97%) were accurately identified to the species level.
      Aerokey II was further evaluated with 18 additional American Type Culture
      Collection and reference strains representing the more recently proposed taxa A.
      veronii bv. veronii, A. schubertii, A. jandaei, and A. trota and accurately
      identified all of these strains.

PMID- 1757559
TI  - Use of multiple markers for investigation of an epidemic of Shigella sonnei
      infections in Monroe County, New York.
AB  - Antibiotic susceptibility patterns, plasmid profiles, and endonuclease
      restriction analysis of plasmid DNA were used in the investigation of an epidemic
      of Shigella sonnei infections in Monroe County, New York, in 1988 and 1989. The
      epidemic peaked during the winter, included the simultaneous transmission of the
      disease from person to person and from common food sources, and especially
      affected inhabitants of the poor, inner-city neighborhoods, young children of
      both sexes, and women. Resistance to ampicillin, tetracycline, or trimethoprim
      sulfamethoxazole, encoded in a 70-MDa plasmid, was found in most of the examined
      isolates. Unexpectedly, isolates from patients involved in a food-borne outbreak
      exhibited three different antibiotic susceptibility patterns, suggesting deletion
      of antibiotic resistance determinants in some strains. Antibiograms clearly
      separated food-borne outbreak-related and non-foodborne outbreak-related strains,
      distinguished more strains than did the plasmid profiles, and were useful in
      tracing the dissemination of individual isolates in the community. Restriction
      endonuclease analysis substantially increased the discriminatory value of plasmid
      profiles and validated the antibiogram results. The present study illustrates the
      complexity of epidemics of S. sonnei infections and shows the value of combining
      different biological markers in the investigation.

PMID- 1757560
TI  - Evaluation of a commercial measles virus immunoglobulin M enzyme immunoassay.
AB  - Paired serum samples from 93 patients suspected of having measles were assayed
      for measles virus-specific immunoglobulin M (IgM) antibodies by an enzyme
      immunoassay (EIA), and the results were compared with results from a complement
      fixation assay and an EIA for measles virus IgG. By using significant serologic
      rises as the standard for comparison, the IgM EIA assay had a sensitivity of
      85.7%, a specificity of 81.3%, a positive predictive value of 95.7%, and a
      negative predictive value of 54.2%. This assay can be expected to perform well in
      outbreak situations.

PMID- 1757561
TI  - Yersinia enterocolitica: a frequent seasonal stool isolate from children at an
      urban hospital in the southeast United States.
AB  - From 1 December 1988 through 28 February 1991, 7,290 rectal swab specimens
      received in our laboratory were screened for Yersinia enterocolitica. A total of
      76 patients had Y. enterocolitica isolated from their stool samples. Of these
      patients, 59 (77.6%) were 12 months old or younger. Y. enterocolitica was second
      only to Salmonella spp. in this age group. Routine screening for Y.
      enterocolitica may be warranted in hospitals serving large pediatric populations.

PMID- 1757562
TI  - Evaluation of the Vitek GPS-TA card for laboratory detection of high-level
      gentamicin and streptomycin resistance in enterococci.
AB  - The Vitek GPS-TA card (Vitek Systems, Hazelwood, Mo.) was compared with single
      concentration broth microdilution and disk diffusion methods using high-content
      disks for the detection of high-level resistance to gentamicin and streptomycin
      in 99 isolates of enterococci (81 Enterococcus faecalis isolates and 18
      Enterococcus faecium isolates). The GPS-TA card accurately detected high-level
      resistance to gentamicin, but not streptomycin, in E. faecalis. When streptomycin
      is being considered for therapy, either disk diffusion or time-kill studies
      should be used to confirm susceptible results obtained by Vitek testing.
      Additional studies are needed to determine the best method for testing E. faecium
      isolates.

PMID- 1757563
TI  - Evaluation of a new method for identification of Cryptococcus neoformans which
      uses serologic tests aided by selected biological tests.
AB  - A new method for identifying Cryptococcus neoformans isolates and their serotypes
      by the slide agglutination test using five kinds of factor sera, with the aid of
      nitrate reduction, phenol oxidase, and growth at 37 degrees C tests was evaluated
      by using 36 reference strains and 75 clinical isolates of C. neoformans. The
      results showed that the reference strains were identified exactly as they were
      labeled, and clinical isolates were identified as C. neoformans serotypes A, D,
      and AD. C. neoformans could be distinguished from other Cryptococcus species that
      cross-reacted with factor sera by their ability to grow at 37 degrees C. These
      results indicate that the slide agglutination test combined the use of factor
      sera for isolates which grow at 37 degrees C is a useful method for
      identification of C. neoformans and their serotypes and that the nitrate
      reduction test (negative in 100% of the isolates) and the phenol oxidase test
      (positive in approximately 95% of the isolates) can be used to confirm that the
      species is C. neoformans.

PMID- 1757564
TI  - Glycosidase profiles of members of the family Enterobacteriaceae.
AB  - A total of 712 strains representing 47 taxa of the family Enterobacteriaceae were
      tested for the ability to hydrolyze 14 4-methylumbelliferyl (4-MU)-linked
      substrates within 3 h of incubation. In addition to the well-known
      differentiation potential of the hydrolysis of 4-MU-beta-D-galactopyranoside, 4
      MU-beta-D-glucuronide, and 4-MU-beta-D-xylopyranoside, the hydrolysis of some
      other fluorogenic substrates (e.g., 4-MU-beta-D-fucopyranoside, 4-MU-N-acetyl
      beta-D-galactosaminide, and 4-MU-alpha-D-galactopyranoside) can also be used for
      species differentiation within the family Enterobacteriaceae.

PMID- 1757565
TI  - Emergence of homogeneously methicillin-resistant Staphylococcus aureus.
AB  - Forty-seven clinical isolates of methicillin-resistant Staphylococcus aureus
      (MRSA), collected between 1986 and 1990 from 29 institutions, were analyzed for
      susceptibility to various antibiotics. Twenty-six strains were homogeneously
      methicillin resistant (i.e., greater than or equal to 10% of the cells in these
      strains were able to grow on Mueller-Hinton agar containing 50 micrograms of
      methicillin per ml). The MICs of gentamicin, clindamycin,
      trimethoprimsulfamethoxazole, methicillin, and imipenem for homogeneous MRSA
      strains were higher than those for heterogeneously resistant strains. Both types
      of strains were, for the most part, susceptible to vancomycin and trimethoprim
      sulfamethoxazole. Ciprofloxacin-resistant MRSA strains were not isolated prior to
      1988 but made up 40% of the post-1987 strains. The level of methicillin
      resistance correlated well with the imipenem MIC, suggesting that susceptibility
      to imipenem may serve as a marker to identify and monitor the prevalence of
      homogeneous MRSA strains.

PMID- 1757566
TI  - Characterization of yellow-pigmented enterococci from severe human infections.
AB  - Four strains of yellow-pigmented enterococci that resembled the species
      Enterococcus casseliflavus were isolated from patients who had undergone surgical
      treatment. They were substantially homologous in terms of biochemical properties,
      antibiotic susceptibilities, and plasmid DNA profiles. Yellow-pigmented
      enterococci could be another potentially important cause of nosocomial infection
      in surgical units.

PMID- 1757567
TI  - Prevalence of virulent Rhodococcus equi in isolates from soil and feces of horses
      from horse-breeding farms with and without endemic infections.
AB  - The prevalence of virulent Rhodococcus equi in isolates from soil and feces of
      foals on a farm with endemic R. equi infections was significantly higher than
      that of a farm with no history of the disease. Foals bred on a farm with the
      endemic disease might be constantly exposed to virulent R. equi in their
      environment.

PMID- 1757568
TI  - Disk diffusion susceptibility test interpretive criteria for GR69153, a new
      catechol-substituted cephalosporin.
AB  - GR69153 disk diffusion tests with 10- and 30-micrograms disks were evaluated
      against 383 rapidly growing aerobic pathogens. Very high absolute agreement (96.1
      to 98.1%) was observed between the MICs and disk zone diameters, and no false
      susceptible results were encountered with the proposed criteria. The 30
      micrograms GR69153 disk with a susceptible-zone diameter of greater than or equal
      to 17 mm (MIC correlate, less than or equal to 8 micrograms/ml) and a resistant
      zone diameter of less than or equal to 13 mm (MIC correlate, greater than 16
      micrograms/ml) is recommended. GR69153 had a spectrum of activity slightly wider
      than that of ceftazidime against the species tested.

PMID- 1757569
TI  - Diagnosis of Legionnaires' disease by radioimmunoassay of Legionella antigen in
      pleural fluid.
AB  - We describe a case of culture-proven Legionnaires' disease (serogroup 1) in which
      a rapid diagnosis was made by detection of Legionella antigen in pleural fluid by
      use of the Binax radioimmunoassay for urine.

PMID- 1757570
TI  - Comparison of commercially available group B streptococcal latex agglutination
      assays.
AB  - Detection of group B streptococcus (GBS) antigen in urine by latex particle
      agglutination (LPA) may facilitate the rapid diagnosis of GBS sepsis. We sought
      to compare three commercial LPA assays with specimens that were spiked with type
      specific antigen, group-specific antigen, or type III organisms. There were
      sensitivity differences between the assays, but the Bactigen assay performed
      best, detecting as little as 1 ng of GBS group-specific antigen per ml in urine
      and as few as 10(5) CFU of GBS type III organisms per ml in urine, serum, and
      cerebrospinal fluid.

PMID- 1757571
TI  - Detection of antibodies to Mycoplasma gallisepticum in egg yolk versus serum
      samples.
AB  - Serum (n = 1,636) and egg yolk (n = 802) samples collected from hens on four
      commercial egg farms in Florida were tested for the presence of specific
      antibodies to Mycoplasma gallisepticum in a commercially available enzyme-linked
      immunosorbent assay. No significant differences were noted between serum and egg
      yolk samples with respect to distribution of positive, suspect, and negative test
      results or for the mean sample/positive control ratio values of positive,
      suspect, and negative test results. A linear relationship between the
      distribution of positive and negative results and the age of the birds was
      observed for results obtained with both serum and egg yolk samples. On the basis
      of the results of this study, egg yolk samples can be used in lieu of serum
      samples to screen flocks for antibodies to Mycoplasma gallisepticum.

PMID- 1757572
TI  - Isoprenoid quinones of "Afipia" spp.
AB  - The isoprenoid quinone contents of seven strains of "Afipia felis," the type
      strains of "A. clevelandensis" and "A. broomeae," and reference strains of three
      unnamed "Afipia" genospecies were determined by reverse-phase high-performance
      liquid chromatography. The quinone profiles of all "Afipia" strains were
      essentially identical, with ubiquinone 10 as the major component. The identity of
      ubiquinone 10 was confirmed by mass spectrometry.

PMID- 1757573
TI  - Evaluation of the Roche Septi-Chek AFB system for recovery of mycobacteria.
AB  - The Septi-Chek AFB system for the recovery of mycobacteria from clinical
      specimens was compared with a conventional approach using Lowenstein-Jensen and
      Middlebrook 7H11 agars. A total of 1,532 clinical specimens were analyzed; 132
      yielded mycobacteria. Mycobacterium tuberculosis and Mycobacterium avium
      complexes were the predominant isolates. With the conventional combination of
      Lowenstein-Jensen and 7H11 agars, 75.8% of the isolates were recovered; the Septi
      Chek AFB allowed recovery of 100% of the isolates. Septi-Chek AFB required less
      time for the detection of mycobacteria than did the conventional media.

PMID- 1757574
TI  - Diagnosis of Chlamydia trachomatis cervical infection by detection of amplified
      DNA with an enzyme immunoassay.

PMID- 1757575
TI  - Thought disorder and verbal recall in acutely psychotic patients.
AB  - This study examined the relationship between thought disorder and verbal recall
      in schizophrenic, manic, and schizoaffective inpatients. Based on previous
      research, it was predicted that subjects who demonstrated only positive thought
      disorder would differ from those with positive and negative thought-disorder in
      terms of their ability to encode short descriptive passages. Unlike controls, who
      were able to encode organized material better than unorganized material, neither
      thought-disorder group improved its encoding when the material to be remembered
      was more organized. Both thought-disorder groups remembered more when the
      material was less organized. These findings raise a number of issues with regard
      to the interrelationship among thought disorders, psychiatric diagnoses, and
      information-processing deficits.

PMID- 1757576
TI  - The perception of attractiveness: what about the beholders?
AB  - This study asked whether there is a relationship between heterosexually relevant
      dimensions and perception of female attractiveness and femininity. Two hundred
      and forty-nine undergraduate males rated 22 photographs of young women on these
      two dimensions. Seventy-nine of these subjects also took the Macho Scale, the
      Survey of Heterosexual Interactions, and the Bem Sex Role Inventory. Results
      showed that high Macho subjects viewed most of the photographed women as less
      attractive than low Macho subjects did. Masculinity/femininity and heterosexual
      anxiety showed less of a relationship. As predicted, moderately attractive women
      were described most differently by the high Macho/low Macho raters.

PMID- 1757577
TI  - Comparison of factor-analyzed Adolescent Reinforcement Survey Schedule (ARSS)
      responses from Japanese and American adolescents.
AB  - The Adolescent Reinforcement Survey Schedule (ARSS) was administered to a sample
      of male and female late adolescent college students from Japan (N = 500). The
      responses to the ARSS are factor analyzed using a principal component method. The
      results of the factor-analyzed ARSS from the Japanese sample are compared and
      contrasted with the results from a previous study (Holmes et al., 1987) in which
      ARSS was administered to a sample of American male and female college students (N
      = 231). Both the American and Japanese samples produced 10 interpretable factors.
      A recommendation is made to replicate the present study with groups of early and
      mid-adolescents in each culture in order to study shifts in reinforcers during
      different periods of adolescent development.

PMID- 1757578
TI  - The Multidimensional Scale of Perceived Social Support: a confirmation study.
AB  - This study examined the psychometric properties of the Multidimensional Scale of
      Perceived Social Support (MSPSS; Zimet, Dahlem, Zimet, & Farley, 1988) with a
      diverse group of 154 students at an urban college. The following areas were
      investigated: internal reliability, factorial validity, social desirability bias,
      and the moderating effect of social support between stressful life events and
      depression (i.e., the buffering hypothesis). The MSPSS had good internal
      reliability, and the factor analysis confirmed the subscale structure of the
      measure: family, friends, and significant other. There was no indication that
      social desirability bias influenced subjects' responses. Finally, social support
      was related to depression only for those subjects who were experiencing high
      levels of life stress, which lends support for the buffering hypothesis.

PMID- 1757579
TI  - Prediction of intention to exercise of individuals who have suffered from
      coronary heart disease.
AB  - The aim of the study was to understand the intention to exercise of individuals
      who suffer from CHD. A group of 161 cardiac patients completed a questionnaire
      that investigated intentions, attitudes, subjective norms, perceived barriers,
      habits, perceived difficulties, and personal normative beliefs with respect to
      exercising, as well as perceived severity of and perceived vulnerability to re
      infarction. Regression of intention yielded an R2 of .41 (p less than .0001),
      with perceived barriers, habits, and perceived difficulties as the significant
      predictors. MANOVA indicated that high and low intenders differed (p less than
      .01) according to their perception of three barriers: difficulties in time
      management, difficulties in psychological adaptation, and laziness. These results
      suggest that new guidelines should be adopted for the development of cardiac
      rehabilitation exercise programs.

PMID- 1757580
TI  - An investigation of the relationship between self-report of memory functioning
      and memory test performance.
AB  - Memory complaints are some of the most common cognitive problems presented to
      clinical psychologists and neuropsychologists. However, the probable validity of
      memory complaints presented to a psychologist rarely has been validated by
      objective memory tests. Using the Memory Functioning Questionnaire (MFQ; Gilewski
      et al., 1983), 62 relatively young adults reported the extent to which they were
      experiencing various types of memory problems. These data were compared with
      findings of memory and non-memory tests on an expanded Halstead-Reitan test
      battery and with the MMPI/MMPI-2. Results showed that with the exception of
      persons with more than one MMPI/MMPI-2 evaluation, memory complaints were not
      related more to memory than to non-memory tests.

PMID- 1757581
TI  - Mothers of sexually abused children: an MMPI study.
AB  - Thirty-seven mothers of sexually abused children were contrasted with 41 mothers
      who were receiving outpatient psychotherapy and with 76 women with no history of
      psychiatric disturbance on the MMPI. The groups were matched on age and
      socioeconomic status, and significant between-group differences were noted.
      Outpatients and mothers of sexually abused children were significantly more
      elevated than the normal comparison group on the majority of the scales. Mothers
      of sexually abused children differed from psychiatric outpatient mothers on
      several scales. The 4-3 and spike 4 MMPI code-types were significantly more
      common in mothers of sexually abused children than in outpatient mothers.
      Differences in the child's sexual abuse characteristics were related to MMPI
      scales of the mother.

PMID- 1757582
TI  - Borderline, depressive, and schizophrenic discrimination by MMPI.
AB  - This study intended to differentiate among borderline personality disorder (BPD),
      schizophrenic, and depressed patients on the basis of their MMPI profiles. MMPI
      profiles of 237 psychiatric inpatients were selected on the basis of their
      primary DSM-III admission diagnoses. Analysis of MMPI mean scores and
      discriminant function analysis supports previous literature in describing
      borderline patients as having a broad spectrum of psychopathology typified by an
      attitude of alienation and rebelliousness, atypical thought content and/or
      process, and eccentric behavior. Schizophrenic patients are differentiated from
      BPD patients by the presence of thought disorder and psychotic-like
      manifestations. The depressed patients did not show the aforementioned extreme
      characteristics of the other two groups.

PMID- 1757583
TI  - Effect of repeated administration of a neuropsychological battery in the elderly.
AB  - Our study explored the magnitude of practice effect in repeated administration of
      NP measures that tap different cognitive domains in normal elderly subjects (N =
      122) between ages 57 and 85, who were evaluated over three annual testing probes.
      Results revealed that WAIS-R PIQ, serial recall of words, WMS visual memory, and
      memory for logical passages (immediate and delayed) are likely to improve on the
      retest due to practice effect in individuals below age 75, whereas test-retest
      changes in older people show a different pattern. Implications of age-specific
      changes on retest for differential diagnosis of dementia in clinical practice
      were considered.

PMID- 1757584
TI  - Is the pattern of intellectual growth and decline across the adult life span
      different for men and women?
AB  - Gender comparisons on the WAIS-R were made for 1,480 adults from the
      standardization sample, ages 20-74 years, to determine whether men and women
      differ in their age-related patterns of change on tests of fluid and crystallized
      abilities. Multivariate analyses of covariance and univariate analyses of
      covariance were conducted, covarying education, to examine the age + gender
      interactions. These interactions tended to be nonsignificant and trivial for the
      WAIS-R Verbal and Performance scales and the 11 subtests, which suggests that
      both men and women maintain their crystallized abilities through old age, but
      show early, rapid declines in fluid ability. These results were interpreted in
      terms of the literature on aging and intelligence, gender differences in
      cognitive abilities, and gender differences in V-P patterns for patients with
      unilateral brain damage.

PMID- 1757585
TI  - Subliminal psychodynamic activation, food consumption, and self-confidence.
AB  - The subliminal psychodynamic activation (SPA) method was used to study the
      effects of a message related to loss and separation on the behavior of anaclitic
      and control subjects in a sample of male college students (N = 148). In the
      subliminal condition (4 ms exposure time), subjects shown the experimental
      message "Mommy is Leaving Me" ate significantly fewer crackers than those exposed
      to the neutral message "Mona is Loaning It" (p = .04). Subjects subliminally
      exposed to the experimental message reported less confidence in their
      interpersonal attractiveness than those subliminally shown the neutral stimulus
      (p = .05). These findings, which support the hypothesis that semantic analyses
      are performed unconsciously, are discussed in the context of recent research on
      both the SPA paradigm and the anaclitic personality.

PMID- 1757586
TI  - Evaluation of a predoctoral clinical psychology internship program by intern
      graduates.
AB  - This investigation is a replication and extension of an earlier study by Stout,
      Holmes, and Rothstein (1977) of the predoctoral clinical psychology intern
      graduates at the William S. Hall Psychiatric Institute. The interns were surveyed
      (N = 63) with regard to how adequately their internship experience prepared them
      for their current professional work as practicing clinical psychologists.
      Questionnaire data (n = 44) from graduates are analyzed in terms of the
      demographics of each intern's work situation, ratings of how well their
      internship prepared them in the areas of interprofessional relationships,
      teaching psychodiagnostic evaluations, psychological treatment, administration,
      consultation, and research. Several recommendations are offered by the intern
      graduates for refinement of the clinical psychology internship.

PMID- 1757587
TI  - Characteristics common to females who exhibit anorexic or bulimic behavior: a
      review of current literature.
AB  - This paper reviews recent literature on the characteristics of females who
      exhibit anorexic or bulimic symptoms. Although researchers categorize bulimics as
      either binge/restrictors or binge/purgers, this paper does not distinguish
      between the two with regard to characteristics. Personal, cognitive, and physical
      characteristics, as well as external influences, are examined for each. An
      additional purpose of the paper is to provide an overview of risk factors that
      may predispose an individual to bulimia nervosa or anorexia nervosa.

PMID- 1757588
TI  - A self-discrepancy reduction model of religious coping.
AB  - It was proposed that effectiveness of a religious response to personal crisis is
      related to type and amount of self-discrepancy. Fifty subjects were administered
      a questionnaire to assess the following two types of self-discrepancies: (1)
      discrepancy between perceived actual self and perceived ideal self and (2)
      discrepancy between perceived actual self and perceived ought-to-be self.
      Subjects also were asked to choose types of religious responses to a personal
      crisis. Religious responses were behaviorally, cognitively, and affectively
      loaded. Subjects with an actual/ought discrepancy chose behavioral and affective
      religious responses more frequently than did those without this discrepancy. No
      effects were found for the actual/ideal discrepancy. Implications of these
      results for revision and extension of the model are discussed.

PMID- 1757589
TI  - Enhancement of physicians' treatment of illness by behavior therapy.
AB  - The author criticizes physicians who cling to the conventional belief that
      successful diagnosis and treatment of physical symptoms can only be handled by
      medical interventions. He describes the behavioral treatment of three patients
      who had been treated for almost two years unsuccessfully by medical specialists
      and who improved significantly with behavioral interventions. A physician who
      lacks the psychological information that illuminates the environmental and
      personal contingencies that help to initiate, support, and maintain a patient's
      symptoms--information such as that obtained by a behavioral analysis--risks
      deriving a deceptive image of the illness, extends treatment time, prolongs
      suffering, augments the risk of iatrogenic complications, and increases treatment
      costs.

PMID- 1757590
TI  - Cognitive-behavior therapy with nighttime fearful children.
AB  - In this study, the nighttime problems of two girls diagnosed as having separation
      anxiety disorder were treated with cognitive-behavioral procedures. Through the
      use of a multiple baseline design across subjects, the additive effects of self
      control training and self-control training plus contingent reinforcement were
      determined. For both girls, self-report of anxiety and behavioral avoidance of
      sleeping in their own beds was reduced significantly only when to the self
      control training the reinforcement condition was added. Resolution of these
      nighttime problems also appeared to generalize to other features of separation
      anxiety disorder. The clinical and theoretical significance of these findings is
      discussed.

PMID- 1757591
TI  - Phone phobia, phact or phantasy? An operant approach to a child's disruptive
      behavior induced by telephone usage.
AB  - The clinical efficacy of a contingency management program for treating a
      developmentally disabled girl referred for telephone phobia was evaluated using
      both a multiple baseline across settings design and a reversal design. A
      descriptive analysis indicated that the 'phobia' was in all probability an
      operant, rather than a respondent. The treatment, consisting of differential
      reinforcement, extinction and time-out, was effective in reducing the frequency
      and intensity of disruptive behaviors in response to telephone usage. Follow-up
      assessments at 1, 3, and 6 months revealed that treatment gains were maintained.

PMID- 1757592
TI  - Intervention package for treating sleep disorders in a four-year-old girl.
AB  - The study describes an intervention package for the treatment of sleep disorders
      in a 4-year-old girl, using a multiple-baseline design. The subject's sleep
      disorders included several undesirable habits: never going to sleep in her own
      bed; waking up several times during the night, screaming and shouting for hours;
      and entering her parents' bed and insisting on staying there. The intervention
      package was carried out with the parents, the child, and her sister. It was based
      on the disconnection of the contingencies between behavior and outcome; rewards;
      praise; and time-out. The whole process was terminated in 8 weeks, and
      maintenance levels were assessed via follow-up after three and six months.

PMID- 1757593
TI  - The practice of behavior therapy among clinical psychologists in Hong Kong.
AB  - A survey was conducted to assess the extent to which behavior therapy techniques
      were employed by clinical psychologists in Hong Kong. The most popular techniques
      included those that could be grouped under the self-management package and the
      least popular techniques generally involved an aversive element, or were in vivo.
      The use of behavior therapy was correlated with the younger age range of the
      treatment clientele. The results and the future development of behavior therapy
      were discussed in terms of cultural issues, training and the theoretical
      orientations of the respondents.

PMID- 1757594
TI  - Managed mental health care and effective psychotherapy: a step in the right
      direction?
AB  - Although a substantial body of literature indicates that specialized treatments,
      usually of a behavioral nature, are available with comparatively superior
      outcome, much of this information is clinically under-utilized across a wide
      range of disorders. Until recently, there were few incentives for clinicians to
      apply state-of-the-art procedures to their clients' problems. Sweeping changes in
      the health insurance industry, however, are leading to a proliferation of managed
      mental health care companies driven by economic forces to deliver the most
      effective and efficient (and therefore most profitable) forms of care. The
      present paper discusses the history and development of these insurance changes
      and their implications for the future utilization of behavior therapy.

PMID- 1757595
TI  - The long-term habituation of sexual arousal in the human male.
AB  - Long-term habituation of male sexual arousal occurs when (a) short-term
      (intrasession) habituation occurs; (b) habituated arousal spontaneously recovers;
      (c) the magnitude of spontaneous remission decreases across habituation sessions;
      and (d) the number of trials to habituation decreases across sessions. Five
      undergraduate volunteers each had six sessions at one week intervals of 15
      presentations of erotic audiotapes. For three weeks, the same audiotape was
      presented, and for each of the other three sessions a different audiotape was
      presented at every stimulus trial. As indicated by penile plethysmography and
      self-report, in the constant stimulus conditions the criteria for long-term
      habituation generally were met. By contrast, responses to variable stimuli
      remained consistently high. Theoretical and clinical implications of the
      habituation process are discussed.

PMID- 1757596
TI  - EMG biofeedback treatment of pediatric hyperfunctional dysphonia.
AB  - A 9-year-old boy with a long history of impaired communication resulting from
      hyperfunctional dysphonia and vocal nodules had proven to be unresponsive to
      traditional voice therapy. In this study, he engaged in biweekly visual EMG
      biofeedback training to reduce laryngeal muscle tension. In a multiple baseline
      design across two responses with changing criteria, results demonstrated
      sequential stepwise reductions in muscle tension with each new criterion.
      Concomitant improvements were found in laryngeal aerodynamic functioning and in
      voice quality. The treatment also resulted in the elimination of the vocal
      nodules without surgical intervention. These effects were maintained at 6 month
      follow-up.

PMID- 1757597
TI  - Architecture of superior and mesial area 6 and the adjacent cingulate cortex in
      the macaque monkey.
AB  - The agranular frontal cortex is formed by several distinct functional areas.
      There is no agreement, however, on its cytoarchitectonic organization. The aim of
      this study was to redefine the cytoarchitectonic organization of superior and
      mesial area 6 and the adjacent cingulate cortex in the macaque monkey. A
      particular goal was to find out whether the so-called supplementary motor area
      (SMA) is cytoarchitectonically different from the rest of area 6 and whether it
      can be considered as a single, independent cytoarchitectonic area. The results
      showed that, rostral to F1 (area 4), four architectonic areas can be recognized
      in the superior (dorsal) and mesial area 6. Two fo them are located on mesial
      cortical surface (F3 caudally and F6 rostrally) and two on superior cortical
      convexity (F2 caudally and F7 rostrally). The main cytoarchitectonic features of
      the five identified areas can be summarized as follows. F1: (1) giant pyramidal
      cells organized in multiple rows, (2) columnar pattern extending from the white
      matter to the superficial layers, (3) low cellular density in the lower part of
      layer III. F3: (1) high cellular density in the lower part of layer III, which
      fuses with a dense Va, (2) columnar pattern present only in the deepest layer,
      (3) occasional presence of giant pyramidal cells in layer Vb. F6: (1) prominent
      layer V, (2) absence of sublayer Vb, (3) homogeneous cell density in superficial
      layers. F2: (1) thin row of medium-size pyramids in the lowest part of layer III,
      (2) columnar pattern extending to the superficial layers, (3) dense layer Va, (4)
      few, scattered giant pyramids in layer Vb. F7: (1) prominent layer V, (2)
      bipartite layer VI. Areas F1, F2, and F3, as defined cytoarchitectonically,
      coincided with the homonymous histochemical areas. The present data showed also
      that area 24 is formed by four subareas: 24a, b, c and d. Areas 24a and b occupy
      the ventral part of area 24, whereas its dorsal part is formed by area 24c,
      located rostrally, and area 24d, located caudally. The following features
      distinguish area 24d from area 24c: (1) larger pyramidal cells in layer V, (2)
      presence of medium-size pyramidal cells in the lower part of layer III, (3) more
      prominent columnar pattern, (4) higher myelinization with the presence of an
      evident horizontal plexus. Mesial area 6 is usually considered as a single
      functional entity (SMA). Our findings show that this cortical region is formed by
      two distinct cytoarchitectonic areas.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1757598
TI  - Multiple representations of body movements in mesial area 6 and the adjacent
      cingulate cortex: an intracortical microstimulation study in the macaque monkey.
AB  - The mesial agranular frontal cortex that lies rostral to area 4 (F1) is formed by
      two distinct cytoarchitectonic areas: F3, located caudally, and F6, located
      rostrally. In the present experiments we investigated the organization of F3 and
      F6 by observing the motor responses evoked by their intracortical electrical
      microstimulation. Our main purpose was to find out whether the cytoarchitectonic
      subdivision of the mesial agranular frontal cortex into two areas has a
      physiological counterpart. The result showed that F3 (the caudal area) contains a
      complete motor representation with hindlimb movements located caudally, forelimb
      movements located centrally, and orofacial movements located rostrally. The great
      majority of limb movements involved proximal joints. With respect to F1, F3
      showed the following functional characteristics: (1) lack of segregation between
      proximal and distal movements, (2) larger percentage of complex movements, and
      (3) higher excitability threshold. Movements were more difficult to elicit from
      F6 (the rostral area) than from F3. However, by using a longer stimulus train
      duration (100 ms) 39.3% of tested sites produced body movements. This percentage
      increased (50.5%) when the electrical stimulation was applied during monkey
      natural movements instead of when the monkey was still in its chair. Most of the
      evoked movements concerned the forelimb. More rarely, neck and upper face
      movements were observed. Unlike F1 and F3 where most movements were fast, slow
      movements were frequently observed with stimulation of F6. Many of them mimicked
      natural movements of the animal. Eye movements were evoked from F7 (superior area
      6) but not from F6. An additional motor representation was found in the
      dorsocaudal part of area 24 (24d). This area is topographically organized with a
      forelimb representation located caudally and ventrally and a hindlimb
      representation located rostrally and dorsally. The excitability threshold of area
      24d is higher than that of F1 and F3. Evoked movements were occasionally observed
      also after stimulation of area 24c. In conclusion, on the mesial cortical wall
      rostral to F1, there are at least three independent motor representations. On the
      basis of somatotopic organization and excitability properties, we propose that
      the term supplementary motor area (SMA-proper) should be reserved to F3.

PMID- 1757599
TI  - Projections from the posteroventral cochlear nucleus to the superior olivary
      complex in guinea pig: light and EM observations with the PHA-L method.
AB  - The efferent neural projections from posteroventral cochlear nucleus to the
      superior olivary complex in guinea pig were examined with the Phaseolus vulgaris
      leucoagglutinin anterograde tract-tracing method. Light microscopic analysis
      demonstrated that the posteroventral cochlear nucleus of guinea pig bilaterally
      projects to the superior para-olivary nucleus and the rostral, medioventral, and
      lateroventral peri-olivary regions. Ipsilaterally, the posteroventral cochlear
      nucleus projects to the lateral superior olive, the caudal peri-olivary region,
      and areas immediately surrounding the capsule of the lateral superior olive.
      Contralaterally, the posteroventral cochlear nucleus projects to the medial
      nucleus of the trapezoid body. All of these projection axons travel in the
      trapezoid body and their terminals make, primarily, en passant endings upon their
      targets. Exclusively within the contralateral medial nucleus of the trapezoid
      body, some neurons terminate also in calyceal endings. The assumption that
      immunolabeled structures observed with light microscopy made actual synaptic
      contact in their respective target areas was confirmed with electron microscopy.
      With postembedding immunocytochemical procedures applied to thin sections, the
      electron microscope revealed labeled synaptic vesicles and pre- and postsynaptic
      membrane specializations. The projection pattern from posteroventral cochlear
      nucleus was found to be topographically organized in three distinct regions. The
      more dorsally located neurons of the posteroventral cochlear nucleus terminated
      dorsomedially in the ipsilateral lateral superior olive, ventromedially in the
      contralateral superior para-olivary nucleus, and medially in the contralateral
      medioventral peri-olivary region. The more ventrally located neurons of the
      posteroventral cochlear nucleus terminated dorsolaterally in the ipsilateral
      lateral superior olive, dorsolaterally in the contralateral superior para-olivary
      nucleus, and laterally in the contralateral medioventral peri-olivary region.

PMID- 1757600
TI  - Generation patterns of immunocytochemically identified cholinergic neurons at
      autonomic levels of the rat spinal cord.
AB  - The time at which a neuron is "born" appears to have significant consequences for
      the cell's subsequent differentiation. As part of a continuing investigation of
      cholinergic neuronal development, we have combined ChAT immunocytochemistry and
      [3H]thymidine autoradiography to determine the generation patterns of somatic and
      autonomic motor neurons at upper thoracic (T1-3), upper lumbar (L1-3), and
      lumbosacral (L6-S1) levels of the rat spinal cord. Additionally, the generation
      patterns of two subsets of cholinergic interneurons (partition cells and central
      canal cluster cells) were compared with those of somatic and autonomic motor
      neurons. Embryonic day 11 (E11) was the first day of cholinergic neuronal
      generation at each of the three spinal levels studied, and it also was the peak
      generation day for somatic and autonomic neurons in the upper thoracic spinal
      cord. The peak generation of homologous neurons at upper lumbar and lumbosacral
      spinal levels occurred at E12 and E13, respectively. Somatic and autonomic motor
      neurons were generated synchronously, and their production at each rostrocaudal
      level was virtually completed within a 2-day period. Cholinergic interneurons
      were generated 1 or 2 days later than motor neurons at the same rostrocaudal
      level. In summary, the birthdays of all spinal cholinergic neurons studied
      followed the general rostrocaudal spatiotemporal gradient of spinal neurogenesis.
      In addition, the generation of cholinergic interneurons also followed the general
      ventrodorsal gradient. In contrast, however, autonomic motor neurons disobeyed
      the rule of a ventral-to-dorsal progression of spinal neuronal generation, thus
      adding another example in which autonomic motor neurons display unusual
      developmental patterns.

PMID- 1757601
TI  - Afferent and efferent projections of the glossopharyngeal-vagal nerve in the
      hagfish.
AB  - Anterograde and retrograde transport of horseradish peroxidase was used to
      examine the afferent and efferent projections of the glossopharyngeal-vagal nerve
      in the hagfish Eptatretus burgeri. Anterogradely labeled ganglion cells are
      scattered in the glossopharyngeal-vagal nerve trunk, in the saccular ganglion,
      and in the brainstem. Afferent fibers of the glossopharyngeal-vagal nerve
      terminate in both the vagal lobe and the fasciculus communis. Close observation
      showed no morphological differentiation between these two structures, indicating
      that they are not separate entities, but a single, continuous structure that is
      homologous with the nucleus and tractus solitarius of other vertebrates. The
      median part of this structure (the commissura infima) is displaced more rostrally
      than the same part of the solitary nucleus in many other vertebrates. Some of the
      afferent fibers invade the ventral portion of the trigeminal sensory nucleus,
      which receives the maxillo-mandibular nerve fibers, and terminate there. Our
      study showed that the hagfish has only one nucleus in the vagal motor system,
      i.e., the vagal motor nucleus, which contains both parasympathetic and
      branchiomotor neurons. The dendrites of the vagal motor neurons in the hagfish
      are more highly developed than those in other vertebrates. This suggests that the
      motor reflex arc of the glossopharyngeal-vagal nerve in hagfishes may be simpler
      than in other vertebrates.

PMID- 1757602
TI  - The size and dendritic structure of HRP-labeled gamma motoneurons in the cat
      spinal cord.
AB  - We report quantitative data obtained from 60 fully reconstructed dendritic trees
      belonging to eight gamma-motoneurons (gamma-MNs) and six additional gamma-MNs
      that were not completely reconstructed. The cells were labeled intracellularly
      with horseradish peroxidase (HRP). These data are compared to measurements from
      79 reconstructed dendrites belonging to seven documented alpha-motoneurons (alpha
      MNs), supplemented by a larger sample of alpha-MNs labeled intracellularly or by
      retrograde transport with HRP. As expected from earlier studies, the soma
      dimensions and total membrane area of gamma-MNs were smaller than those of alpha
      MNs. Although gamma-MN dendrites were, on average, slightly but significantly
      longer than those of alpha-MNs, the former had, on average, smaller diameter stem
      dendrites, less membrane area, and less profuse branching, and they tended to
      branch closer to the soma and to terminate farther from the soma. These
      differences were evident even when subsets of dendrites with similar stem
      diameters were compared. Some of the anatomical distinctions suggest that gamma
      MNs are qualitatively as well as quantitatively different from alpha-MNs, even
      though the distributions of many of the morphological variables examined showed
      no abrupt discontinuities between the two motoneuron groups.

PMID- 1757603
TI  - Dermatopharmacologic investigations of halobetasol propionate in comparison with
      clobetasol 17-propionate.
AB  - Both halobetasol propionate and clobetasol 17-propionate exerted very marked
      antiinflammatory, antiproliferative, and vasoconstrictive effects during
      evaluation in a range of dermatopharmacologic models. Halobetasol propionate was
      distinctly more potent than clobetasol 17-propionate in the ultraviolet-induced
      dermatitis inhibition assay in guinea pigs and in the rat model of oxazolone
      induced late inflammatory reaction. Halobetasol propionate was slightly more
      potent than clobetasol 17-propionate in inhibiting croton oil-induced ear edema
      in rats and mice and in the mouse model of oxazolone-induced early inflammatory
      reaction. In the cotton-pellet granuloma assay in rats and the epidermal
      hyperplasia inhibition assay in guinea pigs, halobetasol propionate was
      distinctly superior to clobetasol 17-propionate. There was a trend in favor of
      halobetasol propionate in the cutaneous vasoconstriction assay performed in
      volunteers with ethanol solutions of halobetasol propionate and clobetasol 17
      propionate. In a further vasoconstriction assay, performed with a 0.05%
      concentration of both halobetasol propionate and clobetasol 17-propionate in
      cream and ointment formulations, halobetasol propionate ointment yielded the
      highest blanching score. In a hypothalamic-pituitary-adrenal axis study in
      volunteers, effects of 0.05% halobetasol propionate ointment and 0.05% clobetasol
      17-propionate ointment on serum cortisol levels were similar. The overall
      efficacy trends demonstrated in these dermatopharmacologic studies are in
      agreement with predictions made from corticosteroid structure and activity
      relationships and the results of two clinical trials comparing halobetasol
      propionate and clobetasol 17-propionate ointments in the treatment of plaque
      psoriasis.

PMID- 1757604
TI  - Halobetasol propionate: a trihalogenated ultrapotent topical corticosteroid.

PMID- 1757605
TI  - A double-blind, multicenter comparison of 0.05% halobetasol propionate ointment
      and 0.05% clobetasol propionate ointment in patients with chronic, localized
      plaque psoriasis.
AB  - In a double-blind, parallel-group, multicenter trial in 134 patients with severe,
      localized, plaque psoriasis, the success rate (described as "healed" or "marked
      improvement") at the end of the study was 96% in the halobetasol propionate group
      and 91% in the clobetasol propionate group. A significantly larger proportion of
      patients treated with halobetasol had no disease or mild disease after 14 days
      compared with those treated with clobetasol (86% versus 70%, p = 0.023). Healing
      within 24 days of starting treatment was noted in 69% and 56% of patients treated
      with halobetasol and clobetasol, respectively. Adverse effects were reported in a
      smaller percentage of patients treated with halobetasol propionate ointment than
      in those treated with clobetasol propionate ointment (7% versus 12%). Cosmetic
      acceptability and ease of application were recorded as "very good" in a larger
      percentage of patients treated with halobetasol propionate ointment than in the
      group treated with clobetasol propionate (90% versus 80%).

PMID- 1757606
TI  - A double-blind, multicenter comparison between 0.05% halobetasol propionate
      ointment and 0.05% betamethasone dipropionate ointment in chronic plaque
      psoriasis.
AB  - In a double-blind, parallel-group, multicenter comparative trial on 104 evaluable
      patients with severe, localized plaque psoriasis, 0.05% halobetasol propionate
      ointment demonstrated an 88.7% success rate assessed as "healed" or "marked
      improvement" compared with 78.5% for 0.05% betamethasone dipropionate ointment.
      Healing was observed within 24 days of the start of treatment in 40% and 25% of
      the patients who received halobetasol propionate and betamethasone dipropionate
      ointments, respectively. After 4 weeks' treatment, tolerability of both ointments
      was good. Neither skin atrophy nor systemic adverse effects were observed.
      Patient acceptance of halobetasol propionate ointment, based on cosmetic
      acceptability and ease of application, was significantly better (p = 0.02) than
      that of betamethasone dipropionate ointment.

PMID- 1757607
TI  - A comparative, multicenter, double blind trial of 0.05% halobetasol propionate
      ointment and 0.1% betamethasone valerate ointment in the treatment of patients
      with chronic, localized plaque psoriasis.
AB  - In a double-blind, parallel-group, multicenter comparative trial in 84 evaluable
      patients with severe, localized plaque psoriasis, 0.05% halobetasol propionate
      ointment proved significantly superior (p = 0.02) to 0.1% betamethasone valerate
      ointment with respect to the success rate, as indicated by ratings of "healed" or
      "marked improvement" (88.1% versus 64.3%). The therapeutic effect was observed
      within 5 days of the start of treatment in 76% and 67% of the patients treated
      with halobetasol propionate and betamethasone valerate ointments, respectively.
      Both preparations were well tolerated. Minor adverse effects at the site of
      application were reported in only 2% of the patients in each treatment group.
      Neither skin atrophy nor systemic adverse effects were observed.

PMID- 1757608
TI  - A double-blind, multicenter trial of 0.05% halobetasol propionate ointment and
      0.05% clobetasol 17-propionate ointment in the treatment of patients with
      chronic, localized atopic dermatitis or lichen simplex chronicus.
AB  - In a double-blind, parallel-group, multicenter comparative trial in 127 evaluable
      patients with chronic, localized atopic dermatitis or lichen simplex chronicus,
      healing was reported in a higher percentage of patients treated with halobetasol
      propionate ointment than in those in the clobetasol propionate treatment group
      (65.1% versus 54.7%). The success rates (described as "healed" and "marked
      improvement") were practically identical in the two treatment groups (93.7%
      versus 92.2%). Early onset of therapeutic effect, that is, within 3 days of the
      start of treatment, was similar in the two treatment groups (24% versus 28%).
      Both preparations were well tolerated. Adverse effects were reported in 5% and 2%
      of the patients treated with halobetasol propionate and clobetasol propionate
      ointments, respectively.

PMID- 1757609
TI  - A double-blind, multicenter, parallel-group trial with 0.05% halobetasol
      propionate ointment versus 0.1% diflucortolone valerate ointment in patients with
      severe, chronic atopic dermatitis or lichen simplex chronicus.
AB  - In a double-blind, parallel-group, multicenter, comparative trial in 120
      evaluable patients with chronic, localized atopic dermatitis or lichen simplex
      chronicus, the success rate (described as "healed" and "marked improvement") was
      91.5% in patients treated with halobetasol propionate ointment and 83.6% in those
      in the diflucortolone valerate treatment group. Of patients treated with
      halobetasol propionate ointment, 40.7% reported healing within 17 days, whereas
      of those in the diflucortolone valerate treatment group, 32.8% reported healing
      within that time. Early onset of therapeutic effect, that is, within 3 days of
      the start of treatment, was reported in a higher percentage of patients treated
      with halobetasol propionate ointment than in those treated with diflucortolone
      valerate ointment (70% versus 59%). Adverse effects at the site of application
      were less frequently reported in patients belonging to the halobetasol propionate
      treatment group than in those treated with diflucortolone valerate ointment (3%
      versus 8%).

PMID- 1757610
TI  - Double-blind, comparative clinical trials with halobetasol propionate cream in
      patients with atopic dermatitis.
AB  - In two double-blind, parallel-group, multicenter trials, 0.05% halobetasol
      propionate cream was compared with 0.05% clobetasol 17-propionate cream and 0.05%
      betamethasone dipropionate cream in 264 patients with acute, severe exacerbations
      of atopic dermatitis. The efficacy of halobetasol propionate cream and
      betamethasone dipropionate cream was similar with regard to the success rate, as
      indicated by ratings of "healed" and "marked improvement" (88% versus 90%) and by
      an onset of therapeutic effect within 3 days of the start of treatment (40%
      versus 39%). The efficacy of halobetasol propionate cream and clobetasol 17
      propionate cream was also similar with regard to success rates (89% versus 93%)
      and an onset of therapeutic effect within 3 days of the start of treatment (41%
      versus 38%). All three creams were well tolerated. Dryness of the skin and
      itching at the site of application were the reported adverse effects. Treatment
      was discontinued because of severe dryness of the skin in 1 of the 121 patients
      treated with halobetasol propionate cream and in 1 of the 59 patients treated
      with betamethasone dipropionate cream.

PMID- 1757611
TI  - Halobetasol propionate cream by day and halobetasol propionate ointment at night
      for the treatment of pediatric patients with chronic, localized plaque psoriasis
      and atopic dermatitis.
AB  - In a multicenter, 14-day pediatric study in 81 evaluable patients with severe,
      localized corticosteroid-susceptible dermatoses, the combined treatment with
      halobetasol propionate cream once during the day and halobetasol propionate
      ointment once at night produced a very satisfactory therapeutic effect. The
      success rates, as indicated by ratings of "healed" and "marked improvement," were
      100% and 90.9% in patients with atopic dermatitis and psoriasis vulgaris,
      respectively. Healing was reported in 86.8% and 72.7% of patients treated for
      atopic dermatitis and psoriasis, respectively. Both the cream and ointment
      preparations were well tolerated. Adverse effects at the site of application were
      reported in only 3 of 81 patients. Mild skin atrophy was observed in one patient.
      No systemic adverse effects were observed.

PMID- 1757612
TI  - Evaluation of halobetasol propionate ointment in the treatment of plaque
      psoriasis: report on two double-blind, vehicle-controlled studies.
AB  - The results of two studies are presented that reveal the efficacy and safety of
      0.05% halobetasol ointment in the treatment of patients with plaque psoriasis of
      at least moderate severity. Both multicenter studies were randomized, double
      blind, and vehicle controlled, and study medications were applied twice daily for
      2 weeks. One study was a paired-comparison (PC); the other study was of parallel
      group (PG) design. Both studies called for evaluations at entry (week 0) and
      after 1 and 2 weeks of treatment. The PC study enrolled 100 patients; the PG
      study enrolled 110 patients; 204 patients provided efficacy data over both
      studies. In the PC study, plaque elevation, erythema, and scaling, at least
      moderately severe at entry, showed at the end of treatment both statistical (p
      less than or equal to 0.0003) and clinical significance (all greater than 1-unit
      difference on the rating scale) favoring 0.05% halobetasol ointment over vehicle.
      Pruritus (initially mild) and total score also showed statistically significant
      treatment differences favoring halobetasol at the final evaluation. Patient
      global responses for "effectiveness" and "overall rating" favored 0.05%
      halobetasol ointment over vehicle. In the PG study, induration, erythema, and
      scaling, at least moderately severe at entry, showed at the end of treatment both
      statistically and clinically significant differences favoring 0.05% halobetasol
      ointment over vehicle. Physician's global evaluation favored 0.05% halobetasol
      ointment over vehicle after 2 weeks of use. No patients were released from either
      study because of adverse events. No systemic adverse events or findings of skin
      atrophy were reported in these studies. Reports of "stings" or "burns" were
      equally divided between halobetasol and its vehicle.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1757613
TI  - A double-blind, vehicle-controlled paired comparison of halobetasol propionate
      cream on patients with plaque psoriasis.
AB  - The efficacy and safety of halobetasol propionate 0.05% cream, an ultra high
      potency corticosteroid preparation, was evaluated in a double-blind, vehicle
      controlled, paired comparison study. Patients' psoriatic lesions were evaluated
      before treatment and after 1 and 2 weeks of twice-daily treatment with
      halobetasol propionate and vehicle. Response measures (plaque elevation,
      erythema, scaling, and pruritus) were evaluated with a 4-point severity scale
      whereby the sum provided a total score. Patient self-assessment measures were
      obtained at the 2-week visit by categorizing his or her global responses to
      queries about each treatment's "effectiveness" and "overall rating." All efficacy
      parameters, as judged by the physician, showed statistically significant (p =
      0.0001) treatment differences favoring halobetasol propionate at both week 1 and
      week 2 evaluations. Patient global responses for "effectiveness" and "overall
      rating" favored halobetasol propionate 0.05% cream over vehicle after 2 weeks of
      use. No systemic adverse drug effects were reported during the study. No patient
      was discontinued from the study because of an adverse event, and there was no
      evidence of skin atrophy after 2 weeks of treatment with either agent. Patient
      reports of "stings" or "burns" were equally distributed between the active and
      vehicle treatment groups. This trial demonstrates that halobetasol propionate
      0.05% cream is clinically beneficial and without evidence of significant risk in
      the treatment of plaque psoriasis.

PMID- 1757614
TI  - A review of two controlled multicenter trials comparing 0.05% halobetasol
      propionate ointment to its vehicle in the treatment of chronic eczematous
      dermatoses.
AB  - The efficacy and safety of 0.05% halobetasol propionate ointment were evaluated
      in patients with chronic atopic or other eczematous dermatoses in two vehicle
      controlled, double-blind studies: a paired-comparison study in 124 patients
      (study A) and a parallel-group study in 100 patients (study B). In study A,
      patients applied both treatments twice daily for 2 weeks and were evaluated by
      investigators on days 0, 7, and 14 with 0 to 3 severity scales and by self
      assessment with two 5-step end-of-treatment rating scales. In study B, patients
      applied treatments twice daily for 2 weeks, and investigators made evaluations on
      days 0, 3, 7, and 14 with 0 to 6 scales and also made a 5-step end-of-treatment
      physician's global assessment. In study A, both severity scores and patient
      ratings favored halobetasol propionate significantly on days 7 (p less than or
      equal to 0.0013) and 14 (p less than 0.0001); in study B, severity scores on days
      3 (p less than or equal to 0.045, pruritus, erythema, and overall lesion
      severity), 7, and 14 (p less than 0.001, all comparisons) also favored
      halobetasol propionate significantly, and global assessments showed complete
      resolution or marked improvement for 83% of patients using halobetasol propionate
      versus 28% of those using vehicle (p less than 0.0001). No instances of systemic
      effects or skin atrophy were reported in either study. We conclude that 0.05%
      halobetasol propionate ointment is highly effective and well tolerated in the
      treatment of the conditions studied, with the rapid action and high degree of
      clearing associated with superpotent corticosteroid formulations.

PMID- 1757616
TI  - Potent bactericidal activity of bovine lactoferrin hydrolysate produced by heat
      treatment at acidic pH.
AB  - A hydrolysate of bovine lactoferrin produced by heat treatment under acidic
      conditions had antibacterial activity at concentrations of 10 micrograms/ml in
      the culture medium. The optimal degree of hydrolysis for this activity was about
      10%. Heat-treated lactoferrin, treated at pH 2.0 and 120 degrees C for 15 min and
      degree of hydrolysis of about 10%, had no Fe-binding capacity (0%) and less
      antigenicity (about 10(-6) than untreated lactoferrin. Heat-treated lactoferrin
      increased in antibacterial activity, and the activity was maintained in an Fe
      rich medium. After fractionation of heat-treated lactoferrin by reverse-phase
      HPLC, several peptide fractions were found that had strong antibacterial
      activity. It was suggested that lactoferrin latently contains at least one
      bactericidal domain that is activated upon release by limited acid hydrolysis of
      the protein. The bactericidal activity of the peptide fragments of lactoferrin
      was shown to have no relation to Fe chelation, in contrast with the antibacterial
      mechanism of native lactoferrin.

PMID- 1757615
TI  - Double-blind bilateral paired comparison of 0.05% halobetasol propionate cream
      and its vehicle in patients with chronic atopic dermatitis and other eczematous
      dermatoses.
AB  - Six investigators evaluated 0.05% halobetasol propionate cream and its vehicle in
      111 patients with chronic atopic dermatitis and several other eczematous
      dermatoses. Patients applied treatment twice daily to bilateral lesions for 14
      days. Investigators graded pruritus, erythema, scaling, papulation, and
      lichenification using 4-point severity scales on days 0, 7, and 14. On day 14
      patients provided an assessment of efficacy for both treatments. Statistically
      significant differences favoring halobetasol propionate over the vehicle were
      seen for all signs and symptoms (p less than 0.001). Substantial improvements
      were achieved by the active treatment by day 7 (p less than 0.001). Patients
      assessments of efficacy were significantly higher for halobetasol cream than for
      vehicle (p less than 0.001). No instances of systemic effects or skin atrophy
      were reported and adverse experiences were limited to burning or stinging and
      other minor, nonspecific complaints distributed uniformly between active
      treatment and vehicle. These results demonstrate that 0.05% halobetasol
      propionate cream is highly effective in the treatment of atopic dermatitis and
      other eczematous dermatoses.

PMID- 1757617
TI  - The binding ability of alpha-lactalbumin and beta-lactoglobulin to mutagenic
      heterocyclic amines.
AB  - The binding ability of bovine milk proteins with mutagenic heterocyclic amines
      was investigated. Binding was determined with 2 mg of beta-lactoglobulin and 20
      micrograms of heterocyclic amine in .4 ml of pH 7.4, 50 mM phosphate buffer, at
      37 degrees C, in a shaker for 10 min. The unbound heterocyclic amine in protein
      free ultrafiltrate was analyzed by HPLC method. The binding of alpha-lactalbumin,
      beta-lactoglobulin A and beta-lactoglobulin B were 90.44, 81.38, and 89.18%,
      respectively, with 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole; 37.85, 34.04, and
      43.90%, respectively, with 3-amino-1-methyl-5H-pyrido[4,3-b]indole; and 49.11,
      43.25, and 57.44%, respectively, with 2-amino-6-methyldipyrido[1,2-a:3',2'-d]
      imidazole. Binding of beta-lactoglobulin and alpha-lactalbumin to 3-amino-1,4
      dimethyl-5H-pyrido[4,3-b]indole and 3-amino-1-methyl-5H-pyrido [4,3-b]-indole was
      higher at pH conditions above 7.4, and binding was lost at pH less than 5.5.
      Maximum binding of both proteins to 2-amino-6-methyl-dipyrido[1,2-a:3',2'
      d]imidazole was at pH 7.4, and binding was inhibited at pH conditions above 8.5
      and less than 6.5.

PMID- 1757618
TI  - Suppression of milk production during endotoxin-induced mastitis.
AB  - Healthy, midlactation cows were given intramammary infusions of 10 micrograms of
      endotoxin in two homolateral quarters. Productive, inflammatory, and systemic
      responses were studied to investigate the pathophysiological effects of mastitis
      on lactational performance. Endotoxin suppressed milk yield in all quarters of
      treated cows. A more severe and prolonged suppression occurred in infused
      quarters compared with uninfused quarters. The fat percentage of milk from all
      quarters was increased with a greater increase occurring in infused quarters. The
      protein composition of milk was elevated, and the lactose concentration was
      depressed in infused quarters. Mammary inflammation--as measured by milk SCC,
      NAGase, serum albumin, and lactoferrin--was limited to infused quarters. Changes
      in milk NAGase closely paralleled changes in milk SCC. Daily feed intake was
      unaffected, and serum glucose levels did not decline following infusion. The
      lactose concentration of urine increased rapidly after infusion. Reduction in
      milk yield in all quarters, but varying changes in milk composition in infused
      versus uninfused quarters suggest that mastitic hypogalactia is mediated by
      multiple pathophysiological events and is not solely due to inflammatory damage
      to the mammary epithelium. Part of the reduced lactational performance may result
      from escape of milk components from the udder into the circulation.

PMID- 1757619
TI  - Effects of supplemental vitamin A or beta-carotene during the dry period and
      early lactation on udder health.
AB  - Effects of vitamin A or beta-carotene supplementation during the dry period and
      early lactation on the frequency of new intramammary infection and clinical
      mastitis and on SCC and milk yield were examined. Eighty-two Holstein cows were
      randomly assigned to one of three groups: 1) 50,000 IU/d of vitamin A per cow
      (approximately equivalent to 1978 NRC recommended daily intake for dairy cows);
      2) 170,000 IU/d of vitamin A per cow; or 3) 50,000 IU/d of vitamin A plus 300 mg
      of beta-carotene per cow. Cows were supplemented during the 2 wk before drying
      off, throughout the dry period, and for the first 6 wk of lactation.
      Concentrations of serum vitamin A did not differ among treatment groups but
      tended to decrease for all treatment groups from 14 d before drying off to
      calving. After calving, serum vitamin A tended to increase in all groups through
      wk 6 of lactation. Serum beta-carotene tended to be higher in beta-carotene
      supplemented cows at dry-off, in the early dry period, and again during
      lactation. Serum beta-carotene decreased sharply in all groups during the
      prepartum period. The frequency of clinical mastitis and of new intramammary
      infection during the dry period, near parturition, and for the first 6 wk of
      lactation did not differ among treatment groups. The percentage of quarters newly
      infected over the entire trial was 26.8 in the control, 25.0 in the high vitamin
      A, and 30.6 in the beta-carotene group. Pathogens isolated most frequently were
      coagulase-negative staphylococci, streptococci other than Streptococcus
      agalactiae, and coliforms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757620
TI  - Variation in milk somatic cells of heifers at first calving.
AB  - To evaluate variation in milk somatic cells, 24 primiparous cows (paired by
      calving date) were sampled during the first 75 d of lactation. Milk somatic cell
      counts were lowest at 9 to 10 wk. For differential cell counts in milk, only
      percentage of macrophages changed significantly during first 75 d (33% at 1 wk,
      25% at 6 wk, and 34% at 11 wk). Epithelial cells were identified and ranged from
      11 to 20% of total. For milk somatic cell count, variation between cows within
      pairs sampled contemporaneously was small (3 to 24%). However, variation between
      cows was much greater for the differential cell counts (46% of total for
      lymphocytes and 34% for epithelial cells). Of 1021 quarter foremilk samples, 26
      were positive for major pathogens, but 326 were positive for various species.
      Prevalence of bacteria was significantly higher during first 10 d after calving.
      Rear quarters had significantly higher bacterial presence: 47% for left rear
      versus 21% for left front and 37% for right rear versus 24% for right front.
      Total milk somatic cell count after first calving appears to depend primarily on
      differences in temporary factors and is not a stable characteristic of individual
      cows. Proportions of the different somatic cell types in milk may vary
      consistently by cow in early first lactation.

PMID- 1757621
TI  - Patterns of nutrient uptake by the mammary glands of lactating dairy cows.
AB  - Twenty-one multiparous lactating dairy cows with previous 305-d milk production
      records varying from 5900 to 13,600 kg were used to examine patterns of nutrient
      uptake by the mammary glands. On d 71 and continuing until d 126 of lactation,
      animals were injected daily with 40 mg of sometribove (bST group) or bicarbonate
      buffer (control group). Arterial and venous blood plasma samples were collected
      over a 12-h period on d 35, 70, 105, and 126 of lactation. Regression equations
      developed to evaluate linear effects of plasma arterial concentrations on net
      arterial-venous difference across the mammary glands demonstrated that, for
      acetate, NEFA, and D-beta-hydroxybutyrate, plasma arterial concentration
      accounted for over 50% of variation in uptake by the mammary glands.
      Additionally, a sigmoidal equation fitted the relationship between D-beta
      hydroxybutyrate plasma arterial concentration and mammary gland uptake (r2 =
      .70). Triacylglyceride concentration was less effective in predicting uptake (r2
      = .25). Administration of bST did not alter patterns of nutrient uptake, but a
      fourfold increase in NEFA uptake was predicted for bST-treated cows from this
      study, using NEFA concentrations from the literature. These observations indicate
      that plasma concentrations of acetate, NEFA, D-beta-hydroxybutyrate, and
      triacylglyceride are major determinants of uptake by the mammary glands. Factors
      other than plasma concentration, such as mammary gland biosynthetic capacity,
      availability of other nutrients, and blood flow, determine uptakes of glucose,
      lactate, and total and free cholesterol (r2 less than or equal to .03).

PMID- 1757622
TI  - Relationship of early lactation and bovine somatotropin on nutrient uptake by cow
      mammary glands.
AB  - Twenty-one multiparous lactating dairy cows with previous 305-d milk production
      records varying from 5900 to 13,600 kg were used to investigate effects of bST
      administration and stage of lactation on nutrient plasma arterial concentrations
      and arterial-venous differences across the mammary glands (uptake). On d 71 and
      continuing until d 126 of lactation, cows were injected with 40 mg of sometribove
      (bST group) or bicarbonate buffer (placebo group). Arterial and venous blood
      plasma samples were collected over a 12-h period on d 35, 70, 105, and 126 of
      lactation. Plasma concentration of glucose was 7% higher in midlactation compared
      with early lactation cows. Plasma concentration of acetate decreased from 2.11 to
      1.87 mM in placebo versus bST-treated cows. Plasma arterial concentration and
      uptake of D-beta-hydroxybutyrate were .52 and .18 mM higher, respectively, in
      early versus midlactation cows. Concentration and uptake of NEFA were elevated in
      both early lactation and bST-treated cows. Triacylglyceride concentrations were
      24 and 19% lower in early lactation and bST-treated cows compared with
      midlactation cows receiving placebo. Likewise, uptake of triacylglyceride was
      reduced in early lactation and with bST treatment compared with midlactation. The
      mediation of nutrient delivery and uptake by the mammary gland appears to be
      markedly similar between early lactation and bST-treated cows, suggesting a
      similarity between these physiological states and the homeostatic and homeorhetic
      mechanisms regulating nutrient partitioning in the lactating dairy cow. In early
      compared with midlactation cows receiving placebo, uptakes of D-beta
      hydroxybutyrate and NEFA were reduced, and triacylglyceride uptake increased.

PMID- 1757623
TI  - Response of dairy cows to high doses of a sustained-release bovine somatotropin
      administered during two lactations. 1. Production response.
AB  - This study evaluated the effect of sometribove (zinc methionyl bST) in a
      sustained-release formulation administered to lactating cows at concentrations up
      to 3.0 g every 14 d over two lactations. Eighty-two lactating Holstein cows in
      their first, second, or third lactation were assigned to the study. Cows received
      .6, 1.8, or 3.0 g of bST in one, three, or five intramuscular injections of a
      unit dose (.6 g) every 2 wk. Controls received five injections of the vehicle
      (equivalent volume to the 3.0-g treatment) every 2 wk. Injections were
      administered from 60 +/- 3 d postpartum until dry-off or necropsy. Thirty-eight
      animals were continued on treatment for a second consecutive lactation. During
      the 1st yr of treatment, bST increased mean 3.5% FCM by 7.2, 9.4, and 8.4 kg/d
      over control production (21.1 kg/d). During the 2nd yr, milk response to .6, 1.8,
      and 3.0 g of bST averaged 10.6, 3.6, and 4.9 kg/d over controls (24.8 kg/d). The
      incidence of clinical mastitis increased in the 3.0-g group relative to controls
      during the 2nd yr. Thus, salable FCM averaged 8.1, 9.1, and 6.2 kg/d above
      controls (yr 1) and 12.1, 4.7, and -2.8 kg/d (yr 2) for the .6-, 1.8-, and 3.0-g
      groups. Salable FCM was unaffected by mastitis at a proposed commercial dose (.6
      g). Milk fat, protein, lactose, calcium, phosphorus, zinc, magnesium, and ash
      concentrations were unaffected by bST treatment. Calculated energy, calcium,
      phosphorus, and protein balances also were unaffected except for early decreases
      of up to 5 Mcal/d, and 40, 20, and 600 g/d, respectively, until feed intake
      increased. Milk serum bST concentrations greater than the assay limit of
      sensitivity (1 ng/ml) were routinely measurable only at doses of 1.8 and 3.0 g.
      Results confirmed that bST concentrations in milk serum are exceedingly small.
      Overall, supraphysiological doses of sometribove increased milk production with
      little effect on composition. No toxic effects of bST were observed.

PMID- 1757624
TI  - Effects of scrotal insulation on viability characteristics of cryopreserved
      bovine semen.
AB  - The effect of a 48-h scrotal insulation on spermatozoal viability (motility and
      acrosomal integrity), before and after semen cryopreservation, was studied in six
      young Holstein bulls whose semen was collected twice in succession at 3-d
      intervals. Motility and acrosomal integrity were measured before and after
      incubation of semen at 37 degrees C for 3 h. For assessment of results,
      collection days were grouped: period 1 (control) = d -6, -3, and 0, where d 0 =
      initiation of scrotal insulation after semen collection; period 2 = d 3, 6, and 9
      (sperm presumed in the epididymis or rete testis during scrotal insulation);
      period 3 = d 12, 15, ... 39 (sperm presumed in spermatogenesis during scrotal
      insulation). Semen was cryopreserved each collection day until morphologically
      abnormal cells exceeded 50% of the ejaculate (d 12 to 21). Semen viability before
      and after freezing was lower in period 3 than in period 1 (P less than .05).
      These differences coincided with the appearance in period 3 of abnormal sperm
      morphology and depressed undiluted semen motility, which began on d 12 (P less
      than .01). Semen collected during period 2 that was extended but unfrozen did not
      differ from that collected during period 1 in morphology or viability. However,
      for frozen semen, period 2 was significantly poorer than period 1 for both
      viability measurements, but only after incubation for 3 h at 37 degrees C
      postthaw (P less than .05). We conclude that epididymal sperm are adversely
      affected by elevated testicular temperatures, as noted by their decreased ability
      to maintain motility and acrosomal integrity following cryopreservation.

PMID- 1757625
TI  - Pregnancy rates of Holstein cows after postinsemination treatment with a
      progesterone-releasing intravaginal device.
AB  - Our objective was to determine whether pregnancy rates following first services
      would be improved by supplementing lactating dairy cows with exogenous
      progesterone via a progesterone-releasing intravaginal device. Estrus was induced
      in cows with PGF2 alpha (3-wk clusters of cows ranging from 42 to 63 d
      postpartum) following a positive milk test for high progesterone. Cows were
      inseminated at estrus (d 0), and progesterone was administered via the device
      from d 5 to 13 or d 13 to 21 following estrus; untreated inseminated cows served
      as controls. Blood was collected from each cow on d 5, 13, and 21 to determine
      concentrations of progesterone in blood serum. A fourth group of inseminated cows
      not receiving PGF2 alpha served as an additional untreated, and nonbled, control
      group. Pregnancy rates at first services, which were followed by insertion of the
      device, were unaffected by treatments. Concentrations of progesterone in serum
      were higher in pregnant than nonpregnant cows on d 13 but similar in cows
      regardless of postinsemination treatment. By d 21, when concentrations of
      progesterone remained consistently higher as a result of pregnancy, cows given
      progesterone from d 13 to 21 had higher progesterone in their blood serum,
      regardless of pregnancy status, than cows receiving progesterone from d 5 to 13.
      Only serum progesterone in nonpregnant controls on d 21 was less than that of
      nonpregnant cows given progesterone on d 13 to 21. Pregnancy rates of cows
      returning to estrus 21 to 27 d after their first service tended to be higher (60
      versus 39%) in those cows previously treated with exogenous progesterone than in
      controls. Furthermore, the proportion returning to estrus 17 to 27 d after first
      service was reduced in cows previously supplemented with exogenous progesterone
      (27 versus 49%). Days from calving to conception were 19 d fewer in cows
      previously treated with progesterone than controls, because average intervals to
      first service were decreased by 13 d relative to controls. We conclude that
      supplementing cows with progesterone after insemination initially failed to
      improve pregnancy rates but appeared to increase pregnancy rate at the subsequent
      service.

PMID- 1757626
TI  - Activity monitoring and an enzyme immunoassay for milk progesterone to aid in the
      detection of estrus.
AB  - The accuracy and efficiency of estrus detection using an electronic activity
      monitor tag in conjunction with an enzyme immunoassay for milk progesterone were
      studied during 55 observed estrous periods in 37 cows. At approximately 30 d
      postpartum, cows were equipped with an activity tag and visually observed for
      estrus, an activity tag with a flashing light-emitting diode, or both twice
      daily. Milk progesterone concentrations were determined from cows observed in
      estrus or with an activated tag. Mean daily activity was greater on the day of
      estrus than during any of the 3 d preceding or 3 d following estrus. Functioning
      activity tags correctly identified 55% of all visually observed estrous periods
      that coincided with low milk progesterone levels. The overall accuracy of a flag
      by the tag for identifying true estrus was 21%. The enzyme immunoassay for milk
      progesterone was in agreement with 98% of all visually observed estrous periods
      and false flags committed by the tags. Although the activity tags detected some
      cows in estrus, a more durable and reliable tag must be developed before it is of
      practical value to dairy producers.

PMID- 1757627
TI  - Addition of chloride to a prepartal diet high in cations increases 1,25
      dihydroxyvitamin D response to hypocalcemia preventing milk fever.
AB  - In this study, we present evidence that cows fed highly cationic diets are less
      responsive to parathyroid hormone than those fed a highly anionic diet. Forty
      seven Jersey cows (55 mo of age) were fed an alfalfa haylage-based diet
      supplemented with either anions (Cl-) or cations (Na+). Cows fed the high
      cationic diet suffered significantly more cases of milk fever (6 out of 23) than
      those fed the high anionic diet (1 out of 24). Concentrations of Ca at
      parturition and the first 2 d of lactation were significantly higher in cows fed
      the anionic diet. Secretion of parathyroid hormone in response to developing
      hypocalcemia was similar in cows fed either diet. Plasma hydroxyproline
      concentration (an index of bone Ca resorption activity) was greater in cows fed
      the anionic diet, suggesting better utilization of bone Ca. Plasma 1,25
      dihydroxyvitamin D concentration was correlated inversely with plasma Ca and
      related directly to plasma parathyroid hormone in both groups of cows. However,
      the magnitude of the response (the amount of 1,25-dihydroxyvitamin D produced per
      unit increase in parathyroid hormone) was reduced greatly in cows fed the high
      cation diet. Because parathyroid hormone regulates both bone Ca resorption and
      renal 1,25-dihydroxyvitamin D production, these data suggest that prepartal diets
      high in cations decrease the ability of bone and renal tissues to respond to
      parathyroid hormone. Addition of anions to prepartal diets can reduce the excess
      cation balance of diets, increasing tissue response to parathyroid hormone and
      enabling the cow to better adapt to the Ca demands of lactation.

PMID- 1757628
TI  - Effects of varying dietary undegradable protein on dry matter intake, growth, and
      carcass composition of Holstein calves.
AB  - The objective was to study the effect of feeding diets varying in rumen
      undegradable protein on DMI, growth, feed efficiency, and carcass composition in
      Holstein calves from birth to 25 wk of age. Sixty Holstein calves were assigned
      in a randomized complete block design to one of three dietary treatment groups
      that differed in rumen undegradable protein as a percentage of total protein.
      Protein undegradabilities of the TMR fed for ad libitum intake for period 1 (wk 1
      to 12 of age) were 33, 37, and 46% and for period 2 (wk 14 to 25 of age) were 30,
      34, and 38%. Intake was not different among diets during period 1. During period
      2, animals fed the highest and lowest levels of undegradable protein diet
      consumed less DM, and those animals on the highest undegradable diet had the
      least amount of crude protein intake. Feed efficiency was increased with
      increasing rumen undegradable protein for period 2. Carcass composition was not
      affected by dietary treatment for either 9-10-11 rib section or the half carcass.
      Prediction equations for carcass protein and fat were calculated for 25-wk
      Holstein calves using urea space and live weight. These results indicate that the
      amount of undegradable intake protein currently recommended for growing dairy
      replacements may not be justified when intake is ad libitum. In the present
      study, urea space was not found to be beneficial over live weight for predicting
      carcass protein and fat in intact male or female Holstein calves.

PMID- 1757629
TI  - Lactational response of dairy cows to increased dietary crude protein with added
      fat.
AB  - Thirty-six Holstein cows were assigned to one of three diets containing soybean
      meal (16% CP), added fat from extruded soybeans (16% CP), and added fat and
      protein from extruded soybeans plus soybean meal (18% CP) to determine whether
      feeding additional protein would prevent the depression in milk protein
      percentages usually experienced when cows are fed additional fat. Total mixed
      diets containing 25% corn silage, 25% alfalfa hay, and 50% of respective
      concentrate mixtures were fed individually wk 4 through 16 postpartum;
      pretreatment (wk 3 postpartum), milk production, and composition data were used
      as covariates. Milk production (33.0, 35.8, and 34.2 kg/d) was higher for cows
      fed added fat. Milk protein (2.92, 2.88, and 2.83%) and casein (2.16, 2.13, and
      2.09%) tended to decrease for cows fed added fat and did not increase with higher
      dietary protein. Dry matter intakes (20.9, 20.7, and 19.8 kg/d) and BW were
      similar for all diets. Supplementing additional CP to a diet containing added fat
      did not prevent depression in milk protein percentage.

PMID- 1757630
TI  - Effects of sometribove on performance, carcass composition, and chemical blood
      characteristics of dairy calves.
AB  - Ten intact male Holstein calves averaging 75 kg of BW and 59 d of age were used
      to study the effects of daily injections of 0 (control) or 10 mg of sometribove
      (recombinant methionyl bST) for 6 wk on performance, health, carcass composition,
      N metabolism, chemical blood characteristics, and hormone profiles. Average daily
      gain, feed intake, feed:gain ratio, and height at withers, hip, and hock were not
      influenced by bST. Carcasses from bST-treated calves contained 5% more protein
      and 36% less lipid than controls. Circulating concentrations of Ca, P, glucose,
      urea N, alkaline phosphatase, creatine phosphokinase, insulin-like growth factor
      I, and insulin were not affected by bST. Packed cell volume was decreased about
      7% (29.9 vs. 32.4%) in the bST calves. Hormone injection did not adversely affect
      health of the calves as measured by body temperature and by pulse and respiration
      rates. The most profound effects of sometribove were a reduction in carcass lipid
      and an increase in body proteins. These effects may be of some practical
      importance when leanness of carcass is desirable.

PMID- 1757631
TI  - Effect of temperature on colostrometer readings for estimation of immunoglobulin
      concentration in bovine colostrum.
AB  - Effect of temperature on colostrometer readings for estimation of immunoglobulin
      concentration in bovine colostrum was investigated. Twenty-five colostrum samples
      were collected within 24 h postpartum from Holstein cows. Immunoglobulin
      concentration of colostrum was measured using a colostrometer through 5 degrees C
      increments from 0 to 40 degrees C. Two technicians measured independently a total
      of 225 samples. The agreement between technicians' readings was high (r = .98);
      thus, readings were averaged and used in regression analysis. A final regression
      model explained 92.5% of the total variation: corrected reading at 20 degrees C =
      uncorrected reading - 13.2 + .8 x temperature (degrees C). The regression
      equation was used to develop a conversion chart for practical field use.

PMID- 1757632
TI  - Effect of excess dietary manganese on lipid composition of calf blood plasma,
      heart, and liver.
AB  - Preruminant calves were fed milk replacer containing control (40 ppm) or two high
      concentrations (200 and 1000 ppm) of Mn to assess the effect of excessive Mn
      intakes on plasma, heart, and liver lipids. The two higher Mn intakes had no
      effect on lipid classes in liver and heart, except for elevated triglycerides in
      liver and lower sphingomyelin in heart (for 1000 ppm of Mn). At 1000 ppm of Mn
      intake, but not at 200 ppm, marked increases occurred in plasma total lipids,
      phosphatidylcholine, cholesterol, cholesterol esters, sphingomyelin, and
      triglycerides. The highest intake altered the essential fatty acid composition of
      liver phosphatidylcholine. Linoleic and linolenic acids were increased, but
      arachidonic and eicosapentaenoic acids were decreased, suggesting that very high
      excess of Mn interfered with hepatic desaturation and elongation of the essential
      fatty acids. Thus, high Mn intake (200 ppm) caused relatively few tissue lipid
      changes, whereas very high intake (1000 ppm) markedly increased plasma lipid
      classes and apparently interfered with essential fatty acid metabolism in liver.

PMID- 1757633
TI  - Evaluation of starter diet crude protein level and feeding regimen for calves
      weaned at 26 days of age.
AB  - The objectives of this study were to evaluate two levels of CP in starter diets
      offered to calves weaned on d 26 and to compare postweaning intake of starter
      diets and performance of calves weaned at 26 or 42 d. Forty Holstein calves were
      housed in individual outdoor hutches and assigned to one of four treatments.
      Treatments consisted of weaning on d 26 after offering a 20% CP starter diet from
      d 1, or d 21, or after offering a 25% CP starter diet from d 21, or weaning on d
      42 after offering a 20% CP starter diet from d 1 (control). Between d 42 and 84,
      calves were commingled in outdoor group pens. On d 42, BW of control calves was
      heavier than that of early weaned calves. On d 84, BW did not differ among
      treatments. Consumption of starter diet was not affected by the age at which it
      was first offered. Weaned calves consumed more starter diet than controls from d
      29 to 42. Postweaning performance was not affected by increasing CP in the
      starter diet. Weaning treatment did not affect the incidence of scours.
      Comparison of CP intakes with current NRC recommendations suggests that CP
      requirements for young milk-fed calves are adequate.

PMID- 1757634
TI  - Suppressing immature house and stable flies in outdoor calf hutches with sand,
      gravel, and sawdust bedding.
AB  - Sand, gravel, sawdust, and pine shavings were used as bedding in outdoor calf
      hutches and compared with straw relative to the density of immature (maggot)
      house flies, Musca domestica, and stable flies, Stomoxys calcitrans. In 6-wk
      field trials, average densities of house and stable fly maggots in concrete mix
      sand ranged from only .3 to 1.6 and 0 to .1 maggots/L, respectively; pea size
      gravel bedding also strongly suppressed densities from less than .1 to .3 and
      less than .1 to .1 maggots/L, respectively. These densities represent reductions
      of 76 to greater than 99% relative to straw bedding, but both sand and gravel
      compacted and became soiled with calf feces, which resulted in unacceptable
      bedding sanitation and foul odors. Densities of house and stable fly maggots in
      pine shavings did not differ from those in straw bedding. Nevertheless, in
      sawdust bedding, maggot density was limited to averages of 1.4 to 8.3 house and
      9.8 to 11.8 stable fly maggots/L; this represented reductions of 45 to 91%
      relative to straw. In a follow-up trial, house and stable fly maggot densities in
      sawdust averaged 11.3 and 43.9 maggots/L, respectively, reductions of 77 and 46%.
      These findings suggest that bedding calf hutches with sawdust during warm weather
      can be useful as an ecologically sound approach to controlling muscoid fly
      populations on dairy farms.

PMID- 1757635
TI  - Effects of sire fertility and daughter stayability on profitability of sire
      selection.
AB  - Holstein sires (n = 340) with milk, milk fat, semen unit fertility, daughter
      stayability evaluations, and semen price for 1986 were studied. Effects of
      variation in sire fertility and daughter stayability on profitability of sire
      selection using the net present value criterion were estimated. The model
      estimated expected profit from a cow bred to pregnancy from future production and
      from cattle disposal and replacement after discounting costs and returns to the
      time of insemination. Effects of semen sexing and semen unit dilution on
      profitability to determine optimal breeding strategies for dairy herds were
      examined. Sire profitability increased with herd average conception rate and sire
      selection intensity. Daughter stayability had a greater impact on profitability
      than semen unit fertility when profit maximization was computed under the
      criterion of breeding a cow to pregnancy. Genetic progress for production was
      compromised when selecting to maximize profit. Dilution of semen units seems
      profitable only when semen availability is limited for high demand sires. The use
      of sexed female semen may only be appropriate when it can generate additional
      income from the sale of surplus heifers.

PMID- 1757636
TI  - Using embryo sexing within closed mixed multiple ovulation and embryo transfer
      schemes for selection on dairy cattle.
AB  - Two types of multiple ovulation and embryo transfer schemes that included bull
      progeny testing were compared. In the juvenile schemes, embryos were collected at
      16 to 18 mo of age without sexing, whereas, in the adult schemes, donors were
      chosen based on their first lactation record, and their embryos were
      systematically sexed. With the latter schemes, natural calves obtained at the
      first two calvings could compete with embryo transfer calves to be replacements.
      The optimal structure of this scheme was derived algebraically for the same
      number of transferred embryos as in the juvenile schemes. Predicted asymptotic
      annual genetic gains, after stabilization of genetic parameters taking into
      account the Bulmer effect, were found to be slightly in favor of the adult
      schemes for a given set of parameters (overall number of transferred embryos,
      number of embryos per collection, and embryo survival rate). In the adult
      schemes, the nucleus sizes were much larger than in the juvenile schemes, which
      allowed a higher selection differential on male paths, thus compensating for the
      longer generation interval. Asymptotic rate of genetic gain for Monte Carlo
      simulations were about 10 and 7% lower for juvenile and adult schemes,
      respectively, but still higher (20%) than the predicted value for the
      corresponding conventional scheme. Consequently, adult schemes with embryo sexing
      can be an efficient alternative to juvenile schemes without embryo sexing.

PMID- 1757637
TI  - Clinical ketosis: phenotypic and genetic correlations between occurrences and
      with milk yield.
AB  - The repeatability and heritability of ketosis were estimated using data from
      28,277 Finnish Ayrshire cows. A four-trait linear model including community-year,
      calving age and month, genetic group, and random sire effects was used to
      describe first and second lactation milk yields and veterinary diagnoses of
      ketosis. Variance components were estimated using REML. The disease traits were
      also analyzed with a categorical model including the same effects except that
      community and year were separate factors. Variance components were estimated with
      marginal maximum likelihood. Genetic relationships between 339 sires analyzed
      were included in models. The phenotypic correlation between the first and second
      lactation was defined as a repeatability of trait. The lactational incidence risk
      of ketosis was .05 in both the first and the second lactation. Average milk
      production was 4956 and 5547 kg in the first and second lactations, respectively.
      Estimates of heritabilities were .09 and .07 for ketosis and .23 and .19 for milk
      in the first and second lactations, respectively. Genetic correlations between
      first and second lactation recordings were .64 for ketosis and .93 for milk.
      Repeatabilities between subsequent lactations were .36 (.13 in linear analysis)
      for ketosis and .68 for milk. In the first lactation, genetic relationship
      between milk yield and ketosis was unfavorable, but in the second lactation
      ketosis and milk yield were genetically and phenotypically unrelated.

PMID- 1757638
TI  - Sire selection decisions and farm profitability relationships for Ontario dairy
      farmers.
AB  - The relationship between the relative emphasis of type and production in the sire
      selection decision and net farm income per cow are examined for a sample of
      Ontario dairy farmers. A significant positive correlation between farm profits
      and the genetic indices for type and production traits of selected bulls exists,
      but the direction of causality cannot be determined. Net farm income per cow was
      found to have a significant inverse association with the relative weighting
      between type and production in the average sire selected. In contrast, the
      emphasis on type relative to production was found to increase with an increase in
      milk yield and herd size. The results of this study show that there may be
      benefits to collecting the breeding, production, and economic information of
      selected herds. The information gathered over time would be useful for
      determining what factors influence breeding decisions and for determining the
      causality in those relationships.

PMID- 1757639
TI  - Potential for enhancing the nutritional properties of milk fat.
AB  - Milk fat has been identified as a hypercholesterolemic fat because it contains
      cholesterol and is primarily saturated. However, different types of dietary
      saturated fats do not have equivalent effects on plasma cholesterol levels
      relevant to ingestion of polyunsaturated fats. Research suggests that the
      hypercholesterolemic effect of saturated fats in human diets is largely due to
      12, 14, and 16 carbon chain length fatty acids. Evidence also suggests that
      stearic acid (C18:0) is as effective as oleic acid (C18:ln-9) in lowering plasma
      cholesterol levels when either replaces palmitic acid (C16:0) in the diet of men.
      Milk fat has a unique fatty acid profile with approximately 10% short- and medium
      chain length saturated fatty acids (less than 12 carbons) and 35% of total fatty
      acids from stearic and oleic acids. The contribution of milk products to fat and
      cholesterol intake in the typical American diet is less than that provided by
      other animal products. This paper will review the recommendations of the National
      Cholesterol Education Program, the effects of milk fat ingestion on blood
      cholesterol, and the rationale and feasibility of three approaches to modifying
      the lipid composition of milk fat.

PMID- 1757640
TI  - Enzymes and factors controlling vitamin D metabolism and action in normal and
      milk fever cows.
AB  - In milk fever (parturient paresis), calcium homeostatic mechanisms, regulated by
      parathyroid hormone and 1,25-dihydroxyvitamin D, fail to maintain normal blood
      calcium concentrations, resulting in severe hypocalcemia. The precise nature of
      the endocrine defect is unknown. Secretion of parathyroid hormone and production
      of 1,25-dihydroxyvitamin D is similar in most cows with milk fever or without.
      However, there are some cows that fail to produce adequate 1,25-dihydroxyvitamin
      D at the onset of lactation. These tend to be cows that will suffer prolonged
      hypocalcemia and relapse after treatment. Assuming that most cows produce
      adequate amounts of both hormones, the next logical cause of milk fever might be
      a failure of tissues to respond to calcium-regulating hormones. Older cows are
      more likely to develop milk fever than younger ones. We have found that tissue
      1,25-dihydroxyvitamin D receptor concentrations decline with age, leaving the
      tissues less able to respond to 1,25-dihydroxyvitamin D. We also have found that
      tissue 1,25-dihydroxyvitamin D receptor concentrations increase during pregnancy
      and lactation in the cow. Intestinal 1,25-dihydroxyvitamin D receptor
      concentration does not appear to be different in cows with or without milk fever
      in cows of similar ages. However, intestinal 1,25-dihydroxyvitamin D receptor
      numbers decrease precipitously at parturition, which may in part be responsible
      for the development of hypocalcemia in dairy cattle.

PMID- 1757641
TI  - C. R. Henderson, the statistician; and his contributions to variance components
      estimation.
AB  - C. R. Henderson's 1953 Biometrics paper "Estimation of Variance and Covariance
      Components" is an outstanding landmark in the discipline of statistics. It sets
      out the very first ideas of how to estimate variance components from unbalanced
      (unequal subclass numbers) data in situations more complicated than the one-way
      classification (completely randomized design). As such it had three important,
      long-lasting impacts. First, it provided methods for actually using unbalanced
      data, even in large quantity, for estimating variance components. And this has
      played a tremendous role in population genetics and in animal breeding where the
      use of estimated variance components is vital to the application of selection
      theory and selection index techniques. Second, that 1953 paper stimulated
      numerous statisticians to become interested in random effects, mixed models, and
      variance components estimation, with such statistical greats as H. O. Hartley and
      C. R. Rao making contributions in the late 1960s and early 1970s. By then,
      improved methods of estimating variance components from unbalanced data had been
      developed, namely maximum likelihood (ML) and restricted maximum likelihood
      (REML). Once computing power had expanded to the point where these methods became
      feasible, Henderson made notable contributions to these methods, allied to his
      two great interests: animal breeding and feasible computing procedures. For both
      of these, his mixed model equations were a salient feature. Third, these methods
      reached a wide audience of geneticists and statisticians.

PMID- 1757642
TI  - C. R. Henderson: contributions to the dairy industry.
AB  - Through C. R. Henderson's position and the application of his knowledge, he had a
      major influence on genetic improvement in dairy cattle beginning in the 1950s. He
      developed herdmate comparisons in the United States. The first extensive program
      using pedigree selection and progeny testing of sires for use in AI was because
      of his suggestion. This program established the direction of dairy cattle
      improvement that still continues. He developed BLUP and discovered how to write
      the inverse of an additive genetic relationship matrix, A-1, without inverting
      the matrix. These accomplishments had a major impact on evaluation methods of
      dairy cattle and other livestock species. Use of BLUP and A-1 are standards for
      evaluation of breeding values all over the world. His pioneering work in
      estimation of components of variance and analyses of unbalanced data were also of
      primary importance for animal evaluation and many other applications. Henderson
      made a major contribution to mankind.

PMID- 1757643
TI  - C. R. Henderson: contributions to predicting genetic merit.
AB  - The contributions of C. R. Henderson to the genetic evaluation of livestock have
      been widely accepted, utilized, and enhanced by animal breeders and
      statisticians. Not well known are the possible alternatives to BLUP that have
      been suggested by Henderson, such as biased predictors and Bayesian methodology
      to incorporate prior information. A search for rapid methods of inverting
      dominance and additive by additive genetic relationship matrices has taken place
      since Henderson first described his method for computing the inverse of the
      additive genetic relationship matrix. Accounting for inbreeding and selected base
      populations continues to be a problem. There is a need to derive accurate
      descriptions of selection processes and the appropriate selection model in order
      to solve the problems of cow culling, nonrandom association of sires with herd
      year-seasons, and preferential treatment. Henderson solved many animal breeding
      problems and left hints for solving others, but there are still many difficult
      problems to be tackled that will have to be resolved without the availability of
      his generous advice.

PMID- 1757644
TI  - C. R. Henderson: the unfinished legacy.
AB  - Ideas and methods developed by Henderson have been applied widely to BLUP of
      additive genetic merit of animals and estimation of components of variance.
      However, a number of other contributions of Henderson to theory and application
      of animal breeding and statistics have not been as fully examined and exploited.
      Some of these contributions are complete in their own right and others lay the
      groundwork to help resolve remaining problems. Henderson had insight and made
      contributions to the areas of analysis of line and breed cross data, hypothesis
      testing under mixed linear models, prediction of breeding values with unknown
      variances, and selection models. The general flexibility of Henderson's mixed
      model methods to quantify a large variety of biological effects is also
      illustrated and discussed in light of new technologies in genetics and biology.

PMID- 1757645
TI  - C. R. Henderson: farm boy, athlete, and scientist.
AB  - Charles R. Henderson was proud to be a product of a farm in Page County, Iowa. He
      was a one man track team in Coin, Iowa, and a brilliant student. He became a
      world class competitor in track at Iowa State College and, at the same time,
      compiled a top academic record. His early experiences set the stage for the
      exceptional contributions of his animal breeding career, which did not begin
      until he was nearly 40 yr of age, but which spanned 40 yr when he was the
      acknowledged leader in development of statistical methodology applied to animal
      breeding. His career goals were to find the best possible ways to analyze data
      and to provide the best genetic evaluations to the livestock industry. If the
      best could not be done because of computational limitations, then he would
      pragmatically work to find the best way that was possible. Only his interest in
      Cornell hockey overshadowed his enjoyment in listening to classical music. He was
      an avid sports fan, especially for the St. Louis Cardinals or any midwestern team
      against the New York Yankees. Midwestern trips during the weeks when the Drake
      Relays were held were as often as possible. Henderson's acknowledged scientific
      hero was Jay L. Lush, with whom he studied during his Ph.D. program at Iowa State
      College and with whom he shared similar talents and the intuition that made both
      of them leaders in the field of animal breeding.

PMID- 1757646
TI  - Rapid skin edge elevation using the OCT compound droplet technique to obtain
      horizontal microsections in Mohs micrographic surgery.
AB  - We describe a technique to quickly raise the skin edges when mounting flat tissue
      specimens on cryostat discs used in Mohs micrographic surgery. The technique
      consists of placing a drop of OCT compound on the superficial surface of the
      tissue before the specimen is mounted bottom-side-up on the cryostat object disc.
      When the Mohs tissue layer is transferred to the disc, the droplet spreads out
      underneath the tissue to support the bottom and to prevent the skin edges from
      dropping below the horizontal plane of the tissue. This technique assures that
      the skin edge and bottom surface of the tissue are on the same plane so that a
      complete section of the undersurface of the flat specimen is taken when the
      tissue is cut with the microtome. The technique is relatively simple to perform,
      requires no special instrumentation, and provides consistent microsections with
      complete skin edge.

PMID- 1757647
TI  - Chondrodermatitis nodularis chronica helicis. Successful treatment with the
      carbon dioxide laser.
AB  - Chondrodermatitis nodularis chronica helicis is a painful, persistent, or
      recurrent inflammatory lesion involving the cartilage and skin of the external
      ear. These lesions are resistant to many therapeutic modalities and often recur
      even after surgical excision. The CO2 laser was used to vaporize the cutaneous
      nodules and involved cartilage. The wounds were allowed to heal with only minimal
      care using hydrogen peroxide cleansing and applications of topical antibiotic
      ointment. Twelve lesions have been treated with no recurrences after 2 to 15
      months. There have been no complications or infections following laser surgery.
      The pain from these lesions is gone immediately following laser surgery. Healing
      with excellent cosmetic results is complete usually within 3 to 4 weeks.

PMID- 1757648
TI  - Mapping and orienting tissue during Mohs micrographic surgery. An alternate
      approach.
AB  - An alternate method for mapping and orienting tissue during Mohs micrographic
      surgery is described. This quick and simple technique eliminates the application
      of indelible dyes to the tissue margins.

PMID- 1757649
TI  - The treatment of benign sebaceous hyperplasia with the topical application of
      bichloracetic acid.
AB  - Sebaceous hyperplasia is a benign lesion that occurs commonly on the face of
      older individuals. A variety of treatment options have been described, including
      oral isotretinoin, electrodesiccation, CO2 laser surgery, cryosurgery, and shave
      excision with curettage. Problems have been noted with these approaches. These
      techniques are more complex, less effective, require more time, or are more
      likely to scar than the procedure we describe. The treatment of sebaceous
      hyperplasia with bichloracetic acid is described with results presented after
      treatment of our first 20 patients.

PMID- 1757650
TI  - Regional anesthesia of the hand for dermatologic surgery.
AB  - The basic principles of regional and local anesthesia of the hand are reviewed,
      and safe and effective methods for outpatient dermatologic procedures and three
      representative cases are discussed with respect to anatomy, local anesthetic
      agents, and techniques. Block techniques are preferred to local infiltration
      because they provide complete and long-lasting anesthesia more comfortably.

PMID- 1757651
TI  - Unusual auricular complications in cutaneous oncology.
AB  - The anatomic complexity of the pinna predisposes that structure to a variety of
      unique, site specific postoperative complications following management of skin
      cancer. We describe four unusual auricular complications: 1)
      radiochondronecrosis; 2) autonecrosis of skin during second intention healing; 3)
      hearing loss secondary to tragal retraction over the external auditory canal; and
      4) extension of tumor through fenestrated cartilage. Well-known postoperative
      auricular complications are reviewed and anticipation and recognition of these
      unusual complications are emphasized.

PMID- 1757652
TI  - The surgical management of chondrodermatitis nodularis chronica helicis.
AB  - Surgical management of chondrodermatitis nodularis chronica helicis by curettage
      is described. The curet directs the dissection. The necrotic cartilage is soft
      and is removed easily. The endpoint is reached when the curet is repelled by
      firm, elastic cartilage. Contours remain normal because the skin is tented over
      the defect supported by the remaining cartilage.

PMID- 1757653
TI  - Postoperative elevation of eyeglasses from the nasal bridge.
AB  - After surgery on the proximal nose, wearing eyeglasses can be difficult and
      uncomfortable. In addition, pressure on the skin underneath the eyeglass nose
      pads may modify wound healing. We describe simple techniques using readily
      available materials and optical devices that either reduce or remove pressure on
      the nose from eyeglasses.

PMID- 1757654
TI  - Re: Microliposuction and autologous fat transplantation for aesthetic enhancement
      of the aging face.

PMID- 1757656
TI  - The analgesia we've been waiting for?

PMID- 1757655
TI  - More on telescopic loupes.

PMID- 1757657
TI  - Characteristics of children of alcoholics: putative risk factors, substance use
      and abuse, and psychopathology.
AB  - A sample of 253 children of alcoholics (COAs) and 237 children of nonalcoholics
      (non-COAs) were compared on alcohol and drug use, psychopathology, cognitive
      ability, and personality. COAs reported more alcohol and drug problems, stronger
      alcohol expectancies, higher levels of behavioral undercontrol and neuroticism,
      and more psychiatric distress in relation to non-COAs. They also evidenced lower
      academic achievement and less verbal ability than non-COAs. COAs were given
      Diagnostic Interview Schedule alcohol diagnoses more frequently than non-COAs.
      The relation between paternal alcoholism and offspring alcohol involvement was
      mediated by behavioral undercontrol and alcohol expectancies. Although gender
      differences were found, there were few Gender X Family History interactions; the
      effects of family history of alcoholism were similar for men and women. When
      gender effects were found, they showed greater family history effects for women.

PMID- 1757658
TI  - Substance use and symptomatology among adolescent children of alcoholics.
AB  - This study assessed the magnitude and specificity of parental alcoholism as a
      risk factor for internalizing symptomatology, externalizing symptomatology, and
      alcohol and drug use in adolescence. We evaluated parents' and children's reports
      of symptomatology and children's reports of alcohol and drug use in a community
      sample of 454 adolescents. The results showed that parental alcoholism was a
      moderate to strong risk factor, with stronger risk associated with recent (rather
      than remitted) parental alcoholism. Multivariate analyses showed that the
      specificity of risk varied with the outcome measure. In predicting externalizing
      symptomatology, the risk associated with parental alcoholism was mediated by co
      occurring parental psychopathology and environmental stress. However, in
      predicting alcohol use, the father's alcoholism was a specific risk factor above
      and beyond the more generalized effects of stress and family disruption.

PMID- 1757659
TI  - Trance logic in hypnosis and imagination.
AB  - In 2 experiments we investigated trance logic, or the tolerance of logical
      incongruity, in age regression and hallucination. Experiment 1 tested 21
      hypnotizable and 19 unhypnotizable subjects in an application of the real
      simulating model of hypnosis. Experiment 2 tested 26 high and 19 low imagery
      ability subjects in an adaptation of the model to the imagination context.
      Subjects' experiences were investigated through the experiential analysis
      technique. More real than simulating subjects displayed trance logic during age
      regression, but they did not differ on the major measures of trance logic during
      hallucination. This pattern of responding occurred in both the hypnosis and the
      imagination contexts. Subjects' comments suggested that completeness of and
      belief in age regression or hallucination may play some role in trance logic. The
      importance of understanding trance logic from the subject's point of view is
      discussed.

PMID- 1757660
TI  - Adjustment of children of depressed mothers: a 10-month follow-up.
AB  - There is considerable concern about the adjustment of children of depressed
      mothers. Earlier we studied the specificity of these difficulties to maternal
      depression. Child adjustment difficulties were evident in 7- to 13-year-old
      children of both depressed and nondepressed psychiatric patient mothers but not
      in the children of community mothers or nondepressed medical patient mothers (Lee
      & Gotlib, 1989a). This report describes a 10-month follow-up of 44 of these
      subjects. Despite the alleviation of maternal depressive symptomatology, children
      in the 2 psychiatric groups continued to manifest adjustment difficulties that
      were evident to both clinicians and mothers. These findings suggest that the
      adjustment difficulties found in the children of psychologically distressed
      mothers do not abate within the 1st year after the mothers' recovery.

PMID- 1757661
TI  - Worry is reasonable: the role of explanations in pessimism about future personal
      events.
AB  - This experiment examines one component of worry, elevated subjective
      probabilities of negative events, and attempts to elucidate the cognitive
      processes on which this is based. The results suggest that the pessimistic
      subjective probabilities shown by chronic worriers can be understood using
      general theories of judgment, specifically, by the use of the availability
      heuristic (Tversky & Kahneman, 1973). However, it is the availability of a
      particular pattern of cognitions--an increased accessibility of explanations for
      why a negative event would occur, combined with a reduced accessibility of
      explanations for why it would not--that is important. The results are integrated
      within a description of the worry process, and possible clinical applications
      through the use of reason-generation techniques are discussed.

PMID- 1757662
TI  - Dream of absent-minded transgression: an empirical study of a cognitive
      withdrawal symptom.
AB  - Among 293 smokers abstinent for between 1 and 4 weeks, 33% reported having at
      least 1 dream about smoking. In most dreams, subjects caught themselves smoking
      and felt strong negative emotions, such as panic and guilt. Dreams about smoking
      were the result of tobacco withdrawal, as 97% of subjects did not have them while
      smoking, and their occurrence was significantly related to the duration of
      abstinence. They were rated as more vivid than the usual dreams and were as
      common as most major tobacco withdrawal symptoms. In subjects abstinent for 1
      year, 63% recalled having dreams about smoking. They had on average 5 of them,
      and about a quarter occurred after the 6th month of abstinence. Having dreams
      about smoking was prospectively positively related to maintenance of abstinence.
      An explanation of this finding based on the association of smoking in dreams with
      aversive emotions is offered.

PMID- 1757663
TI  - Parental affective style risk and the family system: a social relations model
      analysis.
AB  - Social relations model analysis was used to clarify family dynamics associated
      with parental affective style, an index of parent-to-child behavior associated
      with severe psychopathology in the child. Results from 70 families who had sought
      clinical services for an adolescent family member (39 girls and 31 boys) suggest
      (a) that adolescents elicit the negative parental affective style that puts them
      at risk and (b) that elicitation of negative parental affect is strongly tied to
      adolescents' expression of negative affect toward their parents (i.e., a
      reciprocity effect). The findings support the views that children contribute to
      their own risk of psychopathology and that parent-child behavior ought to be
      interpreted in the broader context of the family system.

PMID- 1757664
TI  - Cognitive motivation and drug use: a 9-year longitudinal study.
AB  - The predictive precedence of expectancy constructs, operationally defined as
      cognitive motivations, and drug use was investigated over a 9-year period from
      adolescence to adulthood. Alternative predictions from three different classes of
      theories of expectancy-behavior relations, including expectancy theory, a
      Skinnerian approach, and a reciprocal determinism perspective, were evaluated.
      The results are most consistent with the notion based in expectancy theory that
      cognitive motivations are nonspurious and possibly functionally autonomous
      influences on the use and abuse of drugs. More limited support is found for the
      view that drug use leads to cognitive motivations, as postulated in other
      theoretical perspectives. Other findings reveal the presence of expectancy
      generalization processes consistent with Rotter's (1954) expectancy theory, as
      well as the unique status of cognitive motivations for alcohol as an independent
      predictor of problem drug use.

PMID- 1757665
TI  - Do confidants of depressed women provide less social support than confidants of
      nondepressed women?
AB  - The prediction was tested that during a simulated telephone conversation, the
      confidants of depressed women would provide less social support than the
      confidants of nondepressed psychiatric and nonpsychiatric control women. The
      coded speech of subjects and their confidants indicated that (a) confidants
      echoed the positive or negative valence of the statements made by subjects; (b)
      depressed women exhibited more depressotypic speech than women in both control
      groups; (c) confidants of depressed women also made more depressotypic
      statements, possibly due to the echoing phenomenon; (d) contrary to prediction,
      there were no significant group differences in the sequential dependencies of
      responses that confidants made to depressotypic or antidepressotypic subject
      statements; (e) contrary to prediction, the affect of depressed women's
      confidants was not more negative.

PMID- 1757666
TI  - Clinical, neuropsychological, and brain structural correlates of smooth-pursuit
      eye tracking performance in chronic schizophrenia.
AB  - The relation of smooth-pursuit eye tracking dysfunction to neuropsychological
      performance, brain structural anomalies, and clinical state was examined in a
      sample of 61 patients with chronic schizophrenia. No association was found
      between impaired pursuit oculomotion and measures of chronicity or clinical
      state. Likewise, no association emerged between eye-tracking integrity and brain
      structural anomalies. Patients with dysfunctional eye tracking were more likely
      to have impaired performance on tests that assess frontal lobe functioning. In
      addition, negative symptoms and a relative absence of positive symptoms. Because
      negative symptoms are often found among patients with frontal lobe impairment,
      their association with abnormal eye tracking provides converging support for the
      hypothesis that the cortical locus of deviant smooth-pursuit eye tracking is in
      the frontal lobes.

PMID- 1757667
TI  - Left frontal hypoactivation in depression.
AB  - Baseline resting electroencephalogram activity was recorded with 3 different
      reference montages from 15 clinically depressed and 13 control subjects. Power in
      all frequency bands was extracted by fast Fourier transformation. There was a
      significant Group X Hemisphere interaction in the mid-frontal region, for the
      alpha band power only. Depressed subjects had less left-sided activation (i.e.,
      more alpha activity) than did normal control subjects. This pattern of diminished
      left-sided frontal activation is interpreted as indicating a deficit in approach
      mechanisms in depressed subjects.

PMID- 1757668
TI  - Attribution and expressed emotion in the relatives of patients with
      schizophrenia.
AB  - Indexes of expressed emotion (EE) in 58 relatives of patients with schizophrenia
      were related to those relatives' spontaneously expressed causal beliefs about the
      illness and about related symptoms and behaviors. Relatives made attributions
      predominantly to factors external, universal, and uncontrollable from their own
      perspective, and to factors internal, universal, and uncontrollable from the
      patient's perspective. Low-EE relatives were similar in their attributions to
      emotionally overinvolved relatives. Compared with these two groups, critical
      and/or hostile relatives made more attributions to factors personal to and
      controllable by the patient. Subsequent analyses suggested that hostile relatives
      were further characterized by making more attributions to factors internal to the
      patient and by making attributions with fewer causal elements.

PMID- 1757669
TI  - Generation of stress in the course of unipolar depression.
AB  - The effect of stressful events on depression has been amply demonstrated, but the
      opposite relation is also important. I examined event occurrence over 1 year in
      14 women with unipolar depression who were compared with demographically matched
      groups of women with bipolar disorder (n = 11), chronic medical illness (n = 13),
      or no illness or disorder (n = 22). Interview assessments of life events,
      severity, and independence of occurrence confirmed the hypothesis that unipolar
      women were exposed to more stress than the normal women, had significantly more
      interpersonal event stress than all others, and tended to have more dependent
      events than the others. The implication is that unipolar women by their symptoms,
      behaviors, characteristics, and social context generate stressful conditions,
      primarily interpersonal, that have the potential for contributing to the cycle of
      symptoms and stress that create chronic or intermittent depression.

PMID- 1757670
TI  - (Hu)man versus mean revisited: MMPI group data and psychiatric diagnosis.
AB  - A meta-analysis of Minnesota Multiphasic Personality Inventory (MMPI) data from
      403 control and psychiatric samples was used to (a) examine demographics
      associated with previously published MMPI studies, (b) test Goldberg's (1972)
      indexes for predicting normal versus deviant and neurotic versus psychotic group
      membership, (c) compare multiple regression, discriminant function, and logistic
      regression analyses commonly used to study the relation between the MMPI and
      diagnostic group membership, and (d) examine the signal within the MMPI as it
      relates to current psychiatric diagnosis. Group data were found to be efficient
      indicators of the relation between the MMPI and diagnosis, although efficiency is
      compromised by within-sample heterogeneity. The 3 statistical methods examined
      obtained equivalent results. Regression models related to group prediction are
      presented.

PMID- 1757671
TI  - Responses to depression and their effects on the duration of depressive episodes.
AB  - I propose that the ways people respond to their own symptoms of depression
      influence the duration of these symptoms. People who engage in ruminative
      responses to depression, focusing on their symptoms and the possible causes and
      consequences of their symptoms, will show longer depressions than people who take
      action to distract themselves from their symptoms. Ruminative responses prolong
      depression because they allow the depressed mood to negatively bias thinking and
      interfere with instrumental behavior and problem-solving. Laboratory and field
      studies directly testing this theory have supported its predictions. I discuss
      how response styles can explain the greater likelihood of depression in women
      than men. Then I intergrate this response styles theory with studies of coping
      with discrete events. The response styles theory is compared to other theories of
      the duration of depression. Finally, I suggest what may help a depressed person
      to stop engaging in ruminative responses and how response styles for depression
      may develop.

PMID- 1757672
TI  - Maintenance of grip-induced muscle tension: a behavioral marker of schizophrenia.
AB  - A grip-induced muscle tension maintenance task distinguished between
      schizophrenic patients, regardless of medication or hospitalization status, and
      both normals and controls with affective (unipolar and bipolar) disorders.
      Unaffected first-degree relatives of schizophrenic patients also showed a grip
      deficit. Coupling the grip task with a visual discrimination task that divided
      attention through instruction or reinforcement contingency, increased grip error
      times for all groups. No group differences appeared on the discrimination task,
      regardless of difficulty level, and the tone used to provide corrective feedback
      was not implicated in the grip deficit. The results suggest that the grip task is
      tapping, in a systematic and reliable manner, a motor-control abnormality that
      may be useful as a behavioral marker of schizophrenia.

PMID- 1757673
TI  - Prevalence and correlates of postpartum depression in first-time mothers.
AB  - The prevalence and correlates of postpartum depression were examined in a large
      (N = 1,033) sample of married, primiparous, middle-class mothers of full-term,
      healthy infants; 9.3% met modified Research Diagnostic Criteria for depression.
      However, 39% of the nondepressed women also reported at least 1 somatic symptom.
      Depressed women whose symptoms were current obtained elevated scores on the
      Center for Epidemiological Studies-Depression scale, as did some women who did
      not meet depression criteria. Depressed women different from nondepressed women
      on several socioeconomic status indicators and the occurrence of obstetric
      complications, even in this low-risk sample. These data have implications for the
      assessment of depression in postpartum women.

PMID- 1757674
TI  - Early longitudinal course of acute-chronic and paranoid--undifferentiated
      schizophrenia subtypes and schizophreniform disorder.
AB  - This prospective longitudinal study examined symptoms and adjustment at 2 and 4
      years posthospital discharge in Research Diagnostic Criteria (RDC) and Diagnostic
      and Statistical Manual (DSM-III) schizophrenia subtypes and in DSM-III
      schizophreniform disorder. Delusions, hallucinations, thought disorder, anxiety,
      depression, and specific areas of community adjustment were assessed at each
      follow-up. RDC acute and subacute schizophrenia and DSM-III schizophreniform
      disorder were associated with more satisfactory overall adjustment and lower
      frequencies of psychotic symptoms over time. No significant differences in the
      course of symptoms or adjustment were found between paranoid and undifferentiated
      schizophrenia subtypes. Schizophrenia subtyping schemes based on length of
      illness features appear more prognostically viable than do symptom-based
      approaches.

PMID- 1757675
TI  - Completed suicide in the gifted: a late comment on "suicide among gifted women".
AB  - A recent study by Tomlinson-Keasey, Warren, and Elliott (1986) found differences
      between completed suicides in Terman's sample of gifted children and comparison
      subjects. The present article suggests that the differences identified in
      Tomlinson-Keasey et al. may have been confounded by the fact that completed
      suicides are typically found to have higher levels of psychiatric disturbance
      than nonsuicides. Data are presented to illustrate that when the completed
      suicides in Terman's sample are matched for psychiatric disturbance with the
      comparison subjects, few differences are found.

PMID- 1757676
TI  - Psychometric detection of schizotypy: perceptual aberration and physical
      anhedonia in relatives of schizophrenics.
AB  - We administered scales of Perceptual Aberration (PERAB) and Physical Anhedonia
      (PHYSAN), traits that may be related to risk for schizophrenia, to 54
      schizophrenics, 146 of their first-degree relatives (evaluated for schizophrenia
      related disorders), and 178 normal subjects (screened for psychotic disorders in
      them or their relatives). For both scales, there was a significant effect of
      group membership. For the PERAB scale, the schizophrenics had higher scores than
      the normal subjects, who had higher scores than the relatives. For the PHYSAN
      scale, schizophrenics had higher scores than their relatives, who had higher
      scores than the normal subjects. Patterns of familial correlations also suggested
      that physical anhedonia, but not perceptual aberration, may be familial among
      schizophrenics and their relatives. The PHYSAN scale, but not the PERAB one, may
      be a useful indicator of liability for schizophrenia among the relatives of
      affected probands.

PMID- 1757677
TI  - Reduction of perseverative errors in patients with schizophrenia using monetary
      feedback.
AB  - The influence of monetary feedback on Wisconsin Card Sort Test (WCST) performance
      of 14 male schizophrenics was investigated. Patients were administered the test
      under standard instructions and with monetary feedback in counterbalanced order.
      Monetary reinforcement reduced perseverative errors and increased correct
      responses (p less than .05). These findings suggest that the WCST perseverative
      errors of schizophrenics reflect motivational as well as cognitive factors.

PMID- 1757678
TI  - Inequalities in health and primary health care nursing.

PMID- 1757679
TI  - Self-activeness and the need for help in domiciliary care.
AB  - The data in this paper are based on interviews of domiciliary care patients in
      Helsinki, Finland. The aim of the study was to compare self-active patients' (65)
      and non-self-active patients' (61) need for help and the help they received. The
      findings demonstrated that patients who had, to some extent, a 'better'
      background, received support from their relatives, assessed themselves as
      physically and especially mentally healthier and were socially stronger, were
      also more often self-active than patients, who had a 'poorer' background,
      received little support and felt more ill. The non-self-active patients received
      help with some physical activities more often but not with mental and social
      problems. The self-active patients co-operated better with the care providers and
      considered the quality of care to be higher than did the non-self-active
      patients.

PMID- 1757680
TI  - A case study: perspectives on a self-care deficit nursing theory-based
      curriculum.
AB  - This case study provides a descriptive analysis of administrative, faculty and
      student perspectives on use of and satisfaction with Orem's Self-Care Deficit
      Nursing Theory (SCDNT) in one baccalaureate nursing programme's curriculum
      elements of (a) goals and objectives, (b) materials, (c) content, (d) nursing
      foci, and (e) evaluation. The need for such an analysis is indicated by the wide
      acceptance and use of the SCDNT in education and the absence of any similar
      study. Curriculum is conceptualized in the context of the Curriculum Model for
      the Study of Schooling, USA. Administrative representatives included the dean of
      nursing, the director of the nursing programme, the two curriculum chairpersons
      and the programme co-ordinator. The faculty and students from two specific
      courses provided the instructional and experiential perspectives. Data collection
      included structured personal interviews and document review. The investigator
      developed from the ideal perspective of the literature (Orem and related
      scholars) criteria for judging if the SCDNT indeed was implemented in the
      curriculum elements and the satisfaction with the theory. The faculty perspective
      was the most similar to the ideal, and the administration's was the least
      similar. Student and faculty perceptions were extremely similar. All three
      perspectives were in near agreement with the ideal on the use of the SCDNT in:
      goals and objectives, content and evaluation. A major inconsistency was found.
      Each perspective expressed varying interpretations of the nursing process.
      Pronounced patterns were examined, and implications for nursing education were
      stated.

PMID- 1757681
TI  - Psychosocial predictors of healthy behaviours in women.
AB  - The link between psychosocial factors and various health problems may be
      partially explained by the relationships of these factors to healthy behaviours.
      The relationships of anger experience, anger expression, hostility and hardiness
      to healthy behaviours was investigated in 97 healthy women. In multiple
      regression analysis, 25% of the variance in healthy behaviour was accounted for
      by hostility (12.5%), education (added 7.5%), and the combination of high anger
      experience/high anger-out (added an additional 5%). This was especially
      significant in view of the significant relationship of hostility to both anger
      experience and anger out. Although hardiness showed a significant positive
      correlation (r = 0.23 P less than 0.05) with healthy behaviours, it did not enter
      the multiple regression equation. The negative effects of hostility and chronic
      experience and overt expression of anger emerged as stronger than any positive
      association between hardiness and healthy behaviours. Implications for nursing
      include anger recognition and constructive management as areas of education and
      support. These interventions should assist women in managing their health better
      and will provide fruitful areas for further study.

PMID- 1757682
TI  - The effect of an intervention programme on interactions on a continuing care ward
      for older people.
AB  - This study describes a project designed to enhance the quality of life of older
      people on a continuing care ward. The aim of the interventions used was to
      increase staff/resident interaction levels. The programme interventions focused
      on staff education and extra ward activities. Interaction levels were measured
      using a previously published observation schedule which was adapted for use with
      this client group. Inter-rater reliability measures indicated that the adapted
      measure was still reliable. The patients on the ward were also assessed to
      establish their level of dependency. The findings indicated that, for the
      majority of observational categories, there were no significant differences, but
      those that were found were in the opposite direction to that predicted and
      indicated a reduction in interaction levels. Possible explanations for this
      finding are discussed.

PMID- 1757683
TI  - Nurses as role models and health educators.
AB  - This paper focuses on the role of the nurse as both a role model and as a health
      educator and examines some key areas where tension between these two appear to
      exist. The context is the changing British National Health Service and the
      expectations of both the providers of the care and the consumers. The concept of
      the nurse as a role model for health is explored: the use of the term 'role' and
      its implications for nurses; what being a role model might mean for nurses and
      some of the stresses which living up to these role models might impose; the extra
      burden of an implied healthy role model and the expectations which are placed on
      nurses from both within and outwith the profession. Communication theory and the
      view of the nurse as a 'credible source' may add to these pressures and this
      paper tries to offer to nurses an alternative standpoint from which they may
      begin to tackle their health promotion/education activities. The traditional role
      of the nurse as a health educator is examined and a variety of options are
      offered to encourage nurses to consider their approach to dealing with clients
      within the context of health education. Some different models of education which
      are more suitable for the flexible approach which is required for health
      education are outlined. The paper closes with some discussion points which
      suggest that self-awareness and personal developments may be among the most
      important qualities which nurses need to be effective health educators.

PMID- 1757684
TI  - Are nurses good patient educators?
AB  - Health care demands are rising rapidly as we move towards the year 2000 and
      effective health education is essential if increasing numbers of patients are to
      be nursed in the community and the effects of preventable illnesses are to be
      minimized. It is therefore extremely pertinent to discuss how well nurses are
      educating their patients at present and what strategies the profession may need
      to consider in order to meet educational needs of the future. It seems clear that
      nurses have a responsibility to provide the information that their patients
      require, although there remains some debate regarding whether they are the most
      appropriate member of the health care team to do so. Recent studies show that
      nurses can be effective educators. However, although many recognize the
      importance of this role, they still often lack the skills, knowledge, motivation
      and support required to organize and implement an adequate programme of patient
      education.

PMID- 1757685
TI  - Older adults: factors that predict the use of over-the-counter medication.
AB  - Previous research has found over-the-counter (OTC) medication use not easily
      predicted from physical symptom experience. The purpose of this study was to
      examine the relationship between older adults' use of OTC medications and mood,
      social, health and demographic variables. Interviews were conducted with 186
      adults aged 65 to 99 years. The mood variables of anxiety and depression were
      measured by the Profile of Mood States. The quality and degree of intimacy in a
      social relationship was measured by the Emotional Bondedness Scale. OTC
      medication use was measured by assessing frequency of OTC medication use, the
      total number of categories of OTC medication used, and the use of OTC medications
      in response to symptoms. Subjective health appraisal, number of chronic
      illnesses, number of prescriptive medications, the number of symptoms experienced
      in the previous month, and physician-office visit frequency were recorded. OTC
      medication use was predicted by the total number of symptoms experienced,
      emotional bondedness, age, anxiety, income, cohabitation status, and the
      frequency of physician-office visits. The total number of symptoms experienced
      accounted for more variance in OTC medication use than any other variable.

PMID- 1757686
TI  - Ageist attitudes among young adults: implications for a caring profession.
AB  - It is frequently suggested that younger adults are negative in their attitudes
      toward elderly people. There are also claims that such attitudes develop as a
      result of the socially constructed phenomenon of ageism. This paper briefly
      addresses the concept as it is presented in the literature and goes on to
      describe an attitudinal study which supports the existence of ageism. An
      Attitudes Toward the Elderly inventory was administered to secondary school
      pupils during their final 2 years of schooling, to student nurses at the very
      beginning of their training and to qualified nurses. It was found that the
      subjects did demonstrate negative attitudes and that there appeared to be a
      definite gender socialization influence, with females demonstrating less negative
      attitudes than males. Contrary to expectations, entry into nursing did not lead
      to more positive attitudes but had the converse effect. The influence of ageism
      and more specific professional socialization processes are suggested as
      explanations for these patterns. Implications for nursing and other occupational
      groups involved in caring for the elderly are discussed.

PMID- 1757687
TI  - A quality of life study of discharged long-term psychiatric patients.
AB  - A survey of 48 discharged long-stay patients was carried out. The purpose of the
      survey was to identify the patients' perceptions of: (a) the preparation given to
      them in the rehabilitation wards prior to discharge; (b) the quality of their
      life in the community; (c) the care given by the community psychiatric nurses. A
      structured interview was conducted in the ex-patient's own home and objective
      measures of quality of life were also used. Most patients felt that they were
      well prepared for discharge. More received skills training then received health
      education. Every respondent (48, 100%) preferred living in the community to being
      in a psychiatric hospital. Most respondents (46, 95%) were satisfied with life in
      general. Twenty-eight were visited by community psychiatric nurses and 24 (85%)
      were satisfied with the care given.

PMID- 1757688
TI  - Nurses' hands as vectors of hospital-acquired infection: a review.
AB  - Hospital-acquired infections (HAI) are notorious for the manner in which they
      complicate the course of the original illness, increase costs of hospital stay
      and delay recovery. This review will briefly outline the problems presented by
      HAI in developed countries and present evidence that Staphylococcus aureus and
      gram negative bacilli, the main causative agents, reach susceptible patients via
      the contact rather than airborne route, predominantly on the hands of hospital
      staff. Good hand hygiene could help reduce the economic burden and patient
      distress caused by HAI, but there is evidence that it is infrequently and poorly
      performed by nurses, the health care staff most frequently in continuous contact
      with patients. Possible reasons are explored in an attempt to identify strategies
      to improve hand hygiene.

PMID- 1757689
TI  - The outcome and experiences of first pregnancy in relation to the mother's
      childbirth knowledge: the Finnish Family Competence Study.
AB  - The possible influence of the expectant mother's knowledge of childbirth on the
      outcome and experience of pregnancy and labour was investigated by means of a
      postpartum questionnaire in 1238 primiparae. The mothers were divided into two
      groups according to their basic childbirth knowledge. At birth, the conditions of
      newborns were equal in both groups when judged by Apgar scores. The low knowledge
      level group had small-for-gestational-age babies more frequently and these babies
      were also treated in the paediatric ward more frequently than those in the high
      knowledge group. The latter group was significantly more critical towards the
      staff of the delivery room and the postnatal ward; the fathers of this group were
      also present at delivery significantly more frequently. The low knowledge level
      group was significantly more unwilling to have another pregnancy in the near
      future or ever. The results indicate that low childbirth knowledge is associated
      with a poorer pregnancy outcome. It is a message to antenatal care staff of the
      need for support, supplementary education and careful obstetric surveillance. Low
      childbirth knowledge may imply a set of problems, including those in
      interparental relationship, socio-economic situation and need for close
      surveillance and improved education.

PMID- 1757690
TI  - Continuing nursing education: some issues.
AB  - In nursing, a commitment to continuing education appears to be a relatively new
      concept. There have always been nurses who are continuing learners throughout
      their professional lives. Too often, this is incidental, rather than planned.
      There appears to be a need to re-examine current approach in continuing nursing
      education.

PMID- 1757691
TI  - Teaching activities of clinical instructors during the direct client care period:
      a qualitative investigation.
AB  - The lack of substantial research in the area of clinical teaching would suggest
      that this 'heart' of the nursing student's professional education has long been
      neglected. Employing a qualitative descriptive methodology, this study explored
      the teaching activities that nine clinical instructors said they implemented
      during the direct client care period and the teaching activities that these nine
      clinical instructors said they would implement in response to a specific scenario
      of a clinical teaching event. The unstructured interviews revealed that clinical
      instructors: (a) noted role modelling the greatest number of times as a teaching
      activity but implemented it less frequently; (b) used verbalizations in the form
      of telling, asking, saying, discussing or talking as the primary teaching
      activity in the clinical area and in response to the specific scenario; (c) do
      not have opportunities to see other clinical instructors teaching in the clinical
      area; (d) have difficulty separating teaching activities and evaluation
      activities; (e) are eclectic in their use of learning theories; and (f) find
      articulating teaching activities that they implement during the direct client
      care period to be a complex task.

PMID- 1757692
TI  - First-line nurse managers: issues in the literature.
AB  - The purpose of this paper is to describe the major issues from the literature
      which confront first-line nurse managers. The increasingly complex environment in
      which these managers function has, at the very least, significantly altered their
      role. However, there are other issues confronting those in first-line positions
      and these are discussed under four broad headings: the role of first-line nurse
      managers; role conflict and confusion; management skills and functions; and
      education for first-line nurse managers.

PMID- 1757693
TI  - The conflict management style of staff nurses and nurse managers.
AB  - Conflict is recognized as being a common occurrence in both everyday personal and
      professional nursing life, and it is now generally agreed that conflict can be
      both problematic and potentially beneficial to both individuals and
      organizations. There is a large amount of anecdotal and narrative literature
      about the nature and sources of conflict which fails to reflect upon the
      complexities and theoretical perspectives that exist. There are also few research
      studies which examine the nature of nursing conflict and how conflict is managed
      by nurses in the workplace. This study presents a review of some aspects of
      conflict and its management and specifically investigates the conflict management
      style of staff nurses and nurse managers in the hospital setting. The results
      suggest that avoidance is the most commonly used conflict management strategy,
      with competition being the least favoured.

PMID- 1757694
TI  - Regulation of temporary nursing services--what does it mean?

PMID- 1757695
TI  - Interfacing nursing and biologic science.

PMID- 1757696
TI  - Undoing the habit of hostility.

PMID- 1757697
TI  - The Midwest Nursing History Resource Center.

PMID- 1757698
TI  - Health promotion--a cultural affair.

PMID- 1757699
TI  - Substitute decision makers in health care treatment decisions.

PMID- 1757700
TI  - Accountability for quality improvement--patients' right to assess the plan of
      care.

PMID- 1757701
TI  - The hospital admitting process--a practice perspective.

PMID- 1757702
TI  - Policy at the grassroots: community-based participation in health care policy.
AB  - American Health Decisions is a developing social movement that aims to work at
      the grassroots level to educate people about issues and problems in health care
      and to promote public involvement in decision making about health policy. The
      movement offers nurses opportunities to expand their traditional commitment to
      involving people in decisions about their health. By promoting the development of
      the movement, nurses can contribute to the creation of a structured process of
      direct public participation in policy decisions related to health care. Nurses
      may have a special role to play in the movement by promoting the participation of
      low-income people.

PMID- 1757703
TI  - The concept of integration: a foundation for evaluating outcomes of nursing care.
AB  - Changes in the health care environment, an aging population, and an increase in
      chronic health conditions require consideration of the adequacy of concepts
      available for demonstrating the effectiveness of nursing care. One concept that
      has potential utility for nursing in this regard is the concept of integration.
      Analysis of the concept of integration was conducted to alleviate existing
      ambiguity and to explore ways in which this concept has been employed in diverse
      disciplines. The concept of integration is characterized primarily as a process
      of combination: two or more elements are merged with sufficient interaction so
      that unity of the newly formed entity is achieved. The attributes of the concept
      of integration, therefore, include process, combination, interaction, and unity.
      The concept of integration is useful in evaluation of reconciliation of past and
      present identities and altered role relationships within the environment.

PMID- 1757704
TI  - Radical reflection as a theoretical framework in nursing using acquired
      immunodeficiency syndrome as example.
AB  - The purpose of this article is to present a critical theoretical analysis of
      society's view of the acquired immunodeficiency syndrome (AIDS) epidemic. The
      method of radical reflection that was developed by Jan Thompson in 1983 is used
      as the framework of analysis. Through the five steps of Thompson's method
      (bracketing, historical recovery, critique, dialectical imagination, and
      negotiation), the dominant societal ideology of AIDS is identified, placed in an
      historical context, and examined through the process of Habermasian critique.
      From this knowledge, a more liberating type of social reality can be envisioned,
      allowing for the forging of a more egalitarian health care system. Radical
      reflection can be used by both professional and student nurses to explore and
      evaluate other health issues. Illness must not be approached and thought of
      outside of and detached from the major problems of society.

PMID- 1757705
TI  - Validation of defining characteristics of four nursing diagnoses using a
      computerized data base.
AB  - As the use of nursing diagnoses in clinical practice increases, systematic
      research is necessary to appropriately validate them. Validity studies could be
      expedited by the use of information technology and computerized clinical data
      bases. The purpose of the following descriptive study was to validate the
      defining characteristics (risk factors for potential diagnoses) of the four
      nursing diagnoses related to alterations in fluid volume proposed by the North
      American Nursing Diagnosis Association using a nursing minimum data set (NMDS)
      collected from a computerized nursing data base. A sensitivity measure, the
      proportion of subjects with specific defining characteristics for a given
      diagnosis among the total number of subjects with the respective diagnosis, was
      used to estimate validity. The study was conducted in a 265-bed, mid-western,
      community hospital in which computerized nursing diagnosis care planning is used.
      The elements of the NMDS and defining characteristics were collected from a
      systematic sample (N = 191). The sample consisted of a proportion of about half
      of computerized discharge patient care plan summaries from each of the four
      diagnostic labels related to alteration in fluid volume obtained from medical
      records during the 1987 calendar year. Discharge patient care plan summaries
      contained at least one of four nursing diagnoses related to alteration in fluid
      volume. The results show the existence of individual defining characteristics as
      well as combinations of defining characteristics meeting validation criteria for
      each diagnostic label. Never-documented defining characteristics also were
      identified.

PMID- 1757706
TI  - Developing faculty expertise in culturally focused care and research.
AB  - The faculty development program was designed to extend expertise in culturally
      focused nursing care and research. Its main purposes were to operationalize the
      concept of culture in clinical practice settings and to stimulate culturally
      focused nursing research. The program was an interdisciplinary collaborative
      effort with content grounded in anthropological concepts and research methods.
      Content was divided into four phases: concepts basic to culturally focused care;
      use of research findings in the clinical area; methodological issues in
      culturally focused research; and analysis of culturally focused research
      proposals. The program resulted in greater integration of the concept of culture
      into theory and practice and in the development of several funded research
      proposals.

PMID- 1757707
TI  - Education-practice partnerships: faculty practice as faculty development.
AB  - The importance of establishing service-education partnerships in nursing is well
      recognized. Many such associations will include provisions for faculty practice,
      ideally occurring within the context of a comprehensive program that advances
      clearly stated goals put forth by all participants. We describe the continuing
      clinical education component of faculty practice, and discuss its place within a
      hypothetical, broader program. Faculty practice is conceptualized as one aspect
      of ongoing faculty development.

PMID- 1757708
TI  - Somatization symptoms in pediatric abdominal pain patients: relation to
      chronicity of abdominal pain and parent somatization.
AB  - Symptoms of somatization were investigated in pediatric patients with recurrent
      abdominal pain (RAP) and comparison groups of patients with organic etiology for
      abdominal pain and well patients. Somatization scores were higher in RAP patients
      than well patients at the clinic visit, and higher than in either well patients
      or organic patients at a 3-month followup. Higher somatization scores in mothers
      and fathers were associated with higher somatization scores in RAP patients, but
      not in organic or well patients. Contrary to the findings of Ernst, Routh, and
      Harper (1984), chronicity of abdominal pain in RAP patients was not significantly
      associated with their level of somatization symptoms. Psychometric information
      about the Children's Somatization Inventory is presented.

PMID- 1757709
TI  - Popular and aggressive boys' initial social interaction patterns in cooperative
      and competitive settings.
AB  - Thirty-two third- and fourth-grade popular and aggressive boys were observed
      individually attempting to enter a game being played by a mixed-status unfamiliar
      peer dyad in both competitive and cooperative game settings. Consistent with
      previous findings, popular entry children were accepted more readily into the
      game situation than were aggressive children. Popular children tended to approach
      the situations using more prosocial questions while their aggressive peers tended
      to use demands. More differences in entry strategies were noted in the
      competitive than in the cooperative game setting. While most entry children
      directed their first entry bid toward the aggressive game host, they reported
      having liked the popular game host best when the game was finished. Additionally,
      the quality of game interactions was observed to become more positive following a
      popular child's entry, while becoming more negative following an aggressive
      child's entry. The results are discussed in terms of leadership roles and
      implications for both assessment and intervention settings and strategies.

PMID- 1757710
TI  - Effects of background anger, provocation, and methylphenidate on emotional
      arousal and aggressive responding in attention-deficit hyperactivity disordered
      boys with and without concurrent aggressiveness.
AB  - We investigated the effects of background anger, provocation, and methylphenidate
      on emotional, physiological, and behavioral responding in children with attention
      deficit hyperactivity disorder (ADHD) with and without concurrent aggression. Our
      study revealed that ADHD boys showed more emotional and physiological distress
      when exposed to an interaction in which an administrator chastised each boy's
      favorite counselor, compared to a friendly interaction between the two adults.
      The background anger manipulation did not affect the aggressive behavior of the
      boys against an opponent in an aggressive game. High-aggressive (HA) ADHD boys
      were more likely to respond to provocation with aggression than low-aggressive
      (LA) ADHD boys, but only LA boys showed increased physiological reactivity with
      increasing provocation. Methylphenidate resulted in increased heart rates under
      all conditions and did not interact with any of the other findings.

PMID- 1757711
TI  - Childhood peer rejection, aggression, withdrawal, and perceived competence as
      predictors of self-reported behavior problems in preadolescence.
AB  - Childhood peer rejection, aggression, withdrawal, and perceived competence were
      compared as predictors of self-reported behavior problems. Peer sociometric
      status (Coie, Dodge, and Coppotelli, 1982), teacher ratings of behavior problems
      (Lorion, Cowen, & Caldwell, 1975), and perceived competence ratings (Harter,
      1982) were obtained for 613 second- through fourth-grade children. Two years
      later, these students completed a modified version of the Youth Self-Report from
      (Achenbach & Edelbrock, 1987). Rejected children and neglected girls were more
      likely to have a self-reported nonspecific negative outcome than others.
      Neglected girls were at heightened risk for depression. A varied set of
      predictors obtained from different informants emerged for each sex for each of
      the specific self-reported outcomes of depression, unpopularity, delinquency,
      aggression, and self-destructive/identity problems. Results are discussed in
      terms of future directions for longitudinal research on the consequences of poor
      peer relationships in childhood.

PMID- 1757712
TI  - Salivary testosterone and cortisol among late adolescent male offenders.
AB  - The relationship of salivary testosterone and cortisol concentrations to
      personality, criminal violence, prison behavior, and parole board decisions was
      examined among 113 late-adolescent male offenders. Offenders high in testosterone
      committed more violent crimes, were judged more harshly by the parole board, and
      violated prison rules more often than those low in testosterone. No main effects
      for cortisol emerged. However, as expected, a significant interaction between
      testosterone and cortisol was found, in which cortisol moderated the correlation
      between testosterone and violence of crime. Cortisol may be a biological
      indicator of psychological variables (e.g., social withdrawal) that moderate the
      testosterone-behavior relationship. Paper and pencil measures of personality and
      behavior showed little relationship to hormones.

PMID- 1757713
TI  - Auditory attention switching in hyperactive children.
AB  - The ability to rapidly reorient attention in the auditory modality was studied in
      hyperactive children. Hyperactive and nonhyperactive subjects matched on age,
      sex, and IQ listened to dichotically presented lists for prespecified targets.
      Reorientation was studied by comparing performance on trials requiring subjects
      to reorient their attention during a list to performance on trials requiring no
      switching of attention. The results indicate that although nonhyperactive
      children were temporarily disrupted by the switch, they eventually reoriented to
      the cued ear. In contrast, once hyperactive children were disrupted by the
      switch, they did not reorient to the cued ear. As the pattern in performance
      comparing hyperactive and nonhyperactive subjects resembles the pattern
      previously found in comparing younger and older subjects, these results are
      consistent with the hypothesis that the auditory reorientation skills of
      hyperactive children are developmentally immature.

PMID- 1757714
TI  - Assessment of peer rejection and externalizing behavior problems in preschool
      boys: a short-term longitudinal study.
AB  - We examined the longitudinal stability of measures of negative peer status and
      aggressive-disruptive behavior in preschool boys. Subjects were 53 white 4- to 5
      year-old boys from low-income family backgrounds. Peer sociometric measures of
      rejection and behavioral deviance were assessed in the fall and spring of the
      preschool year. Complementary measures were also obtained from teachers at both
      assessment points. Half of the boys designated as rejected on the basis of peer
      nominations maintained this status at the end of the preschool year. Teachers and
      peers did not agree on their selections of socially rejected children, but had
      good agreement concerning the identification of children with externalizing-type
      behavior problems. Finally, teacher and peer classifications of aggressive
      disruptive children were highly stable throughout the preschool year. These
      findings indicate that peer-rejected children can be identified at very young
      ages, and that preschoolers can be reliable informants about the social
      maladjustment of peers.

PMID- 1757715
TI  - Epidemiology, demography and definitions.

PMID- 1757716
TI  - Pharmacological and biochemical aspects of therapy-resistant depression.

PMID- 1757717
TI  - Treatment resistant or irresolutely treated?

PMID- 1757718
TI  - Prediction, treatment and prognosis of chronic primary major depression.

PMID- 1757719
TI  - Practical issues in managing bipolar depression.

PMID- 1757720
TI  - Psychosurgery for resistant depression: progress and problems.

PMID- 1757721
TI  - Factors distinguishing samples of lesbian and heterosexual women.
AB  - This study utilized non-clinical samples of women and examined historical,
      familial, sexual, and attitudinal variables to assess differences between groups
      endorsing heterosexual or homosexual orientations. Drawing from social learning
      theory, researchers expected the lesbian group to report more negative childhood
      sexual experiences with males, more positive childhood sexual experiences with
      females, more accepting parental attitudes toward sexuality and sexual
      experimentation, and more distant relationships with parents. Results indicate
      that, rather than childhood sexual experiences distinguishing groups,
      respondents' current attitudes are significant between-group discriminators.
      These findings are consistent with the recent body of literature that suggests
      that sexual orientation cannot be explained in terms of early sexual trauma or
      negative heterosexual experiences.

PMID- 1757722
TI  - AIDS and homophobia among nurses.
AB  - The purpose of this research was to study nurses' attitudes toward homosexuality
      and caring for homosexual patients. The results reported in this article are a
      component of a larger study of nurses' knowledge about and attitudes toward
      caring for patients with AIDS. The sample comprised 581 Registered Nurses
      residing in Erie County, New York. Data were gathered by mailed questionnaires.
      Results of the study indicate that issues concerning the care of patients with
      AIDS may be complicated by the fact that many of these individuals are
      homosexuals. The results of this research provide data for developing
      intervention strategies to help nurses cope with their concerns about caring for
      homosexual patients with AIDS.

PMID- 1757723
TI  - A survey of gay/lesbian Catholics concerning attitudes toward sexual orientation
      and religious beliefs.
AB  - The negative assessment of lesbian/gay relationships in Catholic circles is most
      often based on scanty information gathered from folklore, the commercial media,
      and a narrow, literal reading of Biblical texts. Assumptions are made about the
      personal adjustment of individual gay/lesbian persons and the quality of their
      relationships without recourse to actual lived experience. This survey of 263
      gay/lesbian Catholics and 20 controls was designed to receive direct feedback
      from lesbian/gay persons concerning their religious attitudes, personal
      adjustment, and relational quality. The results contradict many preconceptions,
      and a remarkable similarity is demonstrated between the gay/lesbian responses and
      those of the control group.

PMID- 1757724
TI  - Homosexuality, class and the church in nineteenth century England: two case
      studies.
AB  - This article seeks to reconstruct and contrast two episodes in the nineteenth
      century Church. Both involved churchmen, Bishop Percy Jocelyn and Dean Charles
      Vaughan, in homosexual incidents. The second episode, that of Dean Vaughan, has
      been reconstructed for the first time using the Broadlands Manuscripts of Lord
      Palmerston. The most interesting aspect of these events is the response of the
      "establishment" to homosexuality. There seems little doubt that attitudes of the
      "establishment" were determined largely by class. The "establishment" would not
      officially condone homosexual behaviour, but in both cases (to varying degrees)
      it seems to have acted toward these men with latitude. One was able to evade
      justice, the other denied a mitre but otherwise allowed advancement in the
      Church. Both incidents provide evidence that persecution of homosexuals was
      something confined to the lower orders; and that the discreet middle class or
      aristocratic homosexual could rely on his class for protection. Perhaps integral
      to this tolerance was a Victorian taste for self-denial. The homosexual who
      treated his sexuality as a curse and a source of tragedy was more likely to
      attract the tolerance of his peers than the homosexual who acknowledged his
      sexuality to the full.

PMID- 1757725
TI  - "Homosexual occupations" in Mesoamerica?
AB  - Data gathered among self-identified homosexual men in Guatemala City and Mexico
      City call into question the intrinsic connection between homosexuality and
      occupational choice posited by Whitam and Mathy (1986). Concentrations of
      homosexual men in some occupations can be explained as effects of discrimination
      and of the normal transmission through personal networks of information about job
      opportunities, and does not require recourse to any innate drive for homosexual
      men to be actors, hairdressers or interior decorators.

PMID- 1757726
TI  - Military policies regarding homosexual behavior: an international survey.
AB  - The military attaches of 110 non-Communist embassies in Washington, DC, were
      surveyed from 1982-1984 regarding their countries' military policies about
      homosexuality. Of the 57 that responded, 37% reported policies excluding persons
      who engage in homosexual behavior from military service, 14% reported policies
      that accept homosexual and bisexual persons, and 49% reported having no policies
      about homosexual behavior. Cultural factors appear to be related to the military
      policies.

PMID- 1757727
TI  - Perspectives of CCK antagonists in pancreatic research. Part II. Experimental
      studies.
AB  - In this article, the effects of different classes of cholecystokinin (CCK)
      receptor antagonists in CCK-related physiological processes of the pancreas have
      been discussed. Both glutaramic acid derivatives and natural (benzodiazepine)
      analogs are potent, competitive antagonists of peripheral CCK receptors. These
      compounds thus provide a powerful tool for investigating the physiological and
      pharmacological actions of CCK in the gastrointestinal system, and have already
      clarified the role of CCK in pancreatic secretion and trophism or growth.

PMID- 1757728
TI  - Quantitative measurement of fibrosis in pancreatic tissue. Evaluation of a
      colorimetric method.
AB  - A colorimetric method has been used to quantify the collagen contained in 23
      specimens of pancreatic tissue (11 controls and 12 chronic pancreatitis). The
      method takes advantage of the selective capacity of Sirius red to stain collagen
      protein and of rapid green to stain noncollagen protein. The results obtained by
      this method were compared with those of standard morphometry to determine tissue
      fibrosis. With the morphometric method, the values of the control group were 6.6
      +/- 4.0% (fiber area/total area), and those of chronic pancreatitis 66.0 +/-
      19.0% (difference 59.4, 95% confidence interval for difference: 47.2-71.6, P less
      than 0.001). The values obtained with the colorimetric method were 89.1 +/- 11.6
      micrograms collagen/mg total protein in the control group, and 132.7 +/- 25.3
      micrograms collagen/mg total protein in the chronic pancreatitis group
      (difference 43.6, 95% confidence interval for difference: 26.3-61.0, P less than
      0.001). A highly significant correlation (r = 0.847; p less than 0.001) was
      observed between the amount of collagen measured colorimetrically and the degree
      of fibrosis determined morphometrically. These results demonstrate that the
      colorimetric method is a reproducible, simple, and rapid technique to quantitate
      fibrosis in histological preparations of pancreatic tissue.

PMID- 1757729
TI  - Independence of GIP-induced insulin secretion from sympathetic and
      parasympathetic innervation in the isolated perfused rat pancreas.
AB  - The incretin candidate GIP (gastric inhibitory polypeptide) is released from the
      gut by nutrients and can stimulate insulin secretion. Metabolic and hormonal
      factors have been shown to modulate insulin response to GIP. It is unknown,
      however, whether the autonomic nervous system, which itself controls insulin
      secretion, can modulate the insulinotropic effect of GIP. In the isolated
      perfused rat pancreas, we therefore investigated the influence of sympathetic and
      parasympathetic agonists and antagonists on the insulin response to GIP. As
      compared to control (6990 +/- 890 microU/10 min), the effect of either
      acetylcholine (29030 +/- 4600 microU/10 min), atropine (5880 +/- 1740 microU/10
      min), norepinephrine (2520 +/- 750 microU/10 min), phentolamine (11380 +/- 1910
      microU/10 min), isoproterenol (12740 +/- 2090 microU/10 min), propranolol (5600
      +/- 880 microU/10 min), or GIP (29660 +/- 4490 microU/10 min) on insulin
      secretion was consistent with previous reports. The effects of the combined
      administration of GIP and either acetylcholine (48140 +/- 7540 microU/10 min),
      phentolamine (43930 +/- 4490 microU/10 min), norepinephrine (9000 +/- 1740
      microU/10 min), or isoproterenol (36280 +/- 5210 microU/10 min) on insulin
      release were additive. Insulin response to GIP was resistant to atropine (24210
      +/- 9470 microU/10 min) and propranolol (26450 +/- 4930 mu/10 min). We conclude
      that both GIP and the autonomic nervous system influence insulin secretion, but
      that they do so independently from each other.

PMID- 1757730
TI  - Influence of anoxia, reoxygenation, and uncoupling on survival, respiration, and
      trypsin-inhibiting capacity of isolated pancreatic acinar cells.
AB  - In the pathogenesis of acute pancreatitis, the events and mechanisms increasing
      the digestibility of the pancreatic acinar cells are widely unknown. Therefore,
      the possible contribution of a disturbed energy supply (provoked by anoxia or
      partial uncoupling) to the induction of autodigestion was studied in experiments
      on acinar cells isolated from the pancreas. During incubation viability,
      respiration under normal and maximally stimulated conditions, and trypsin
      inhibiting capacity (TIC) of these cells were determined. With increasing
      duration of anoxia, the portion of surviving cells was strongly diminished, and
      the number of cells with blebs and vesicularly transformed endoplasmic reticulum
      was increased. Although the endogenous respiration was not influenced up to 1.5 h
      of anoxia, 30 min of anoxia substantially decreased the capacity of oxidative
      energy production. The survival curves were characterized by a self-accelerating
      course of cell destruction. The alteration of the cellular energy metabolism
      found its reflection in the decreased TIC of the cells.

PMID- 1757731
TI  - Cystic endocrine tumor of the pancreas.
AB  - A large cystic tumor in the pancreatic body was found incidentally in an 85-yr
      old male. A distal pancreatectomy was performed after a diagnosis of
      cystadenocarcinoma. Microscopic examination of the resected specimen revealed a
      pancreatic cystic endocrine tumor; however, this tumor produced no symptoms.
      Immunohistochemical studies of the tumor cells showed positivity for gastrin,
      neuron-specific enolase, chromogranin A, and synaptophysin, and two cell types of
      neurosecretory granules were recognized in electron-microscopic studies. Although
      endocrine tumors of the pancreas are usually solid and cystic change occurs only
      rarely, such tumors should be considered in the differential diagnosis of
      patients who have a cystic lesion in the pancreas.

PMID- 1757732
TI  - Influence of the CCK-antagonist loxiglumide on bile-induced experimental
      pancreatitis.
AB  - The present study investigates the effect of CCK-receptor blockade on
      taurocholate-induced pancreatitis in rats using the potent antagonist
      loxiglumide. Intraperitoneal administration (50 mg/kg) of loxiglumide began 3 h
      before, or 10 min or 3 h after induction of pancreatitis. Mean survival times of
      the experimental groups were 31.2, 23.6, and 20.5 h, respectively, compared to
      18.2 h for controls. Survival for 24 h after induction of pancreatitis was
      significantly improved when the antagonist was given 3 h before, but not in the
      time periods after induction. After 72 h, survival time was not significantly
      altered in any of the groups. Furthermore, amylase and lipase levels quantified
      10 h after induction of pancreatitis in ascites, blood, or tissue did not
      indicate a significant difference, nor was improvement in survival seen when the
      CCK-antagonist was tested in rats receiving a basal treatment with intravenous
      volume substitution, peritoneal lavage, and protease inhibition. We conclude that
      CCK-receptor blockade does not improve the final outcome of bile-induced
      pancreatitis in the rat, even if treatment is started before induction of
      pancreatitis.

PMID- 1757733
TI  - Creatine phosphate as energy source in the cerulein-stimulated rat pancreas study
      by 31P nuclear magnetic resonance.
AB  - Stimulation of the rat exocrine pancreas by cerulein induces a variety of
      cellular processes, some of which require the expenditure of energy. In this
      study, changes in the amounts of various energy metabolites, including creatine
      phosphate (PCr), ATP, and ADP were determined by high-resolution 31P NMR
      spectroscopy. The spectrum of a perchloric acid extract of pancreas from the 48 h
      fasted rat was taken as a reference for comparison of 31P NMR spectra recorded
      after stimulation by cerulein. The NMR results obtained from rat pancreas
      stimulated in vivo by cerulein (3, 5, 10, 20, 40 min) were compared to those
      determined by HPLC. We show that during hormonal stimulation, the relative
      concentrations of PCr in the pancreas of the fasted rat rise significantly (p
      less than 0.02), reach a maximum at 10 min, fall between the 10th and 20th min,
      and then return to the relatively low levels observed in controls. On the other
      hand, the relative concentrations of ATP fall during the first 10 min after
      stimulation by cerulein, then rise significantly between the 10th and 20th min,
      whereas the levels of ADP rise during the first 10 min and fall between the 10th
      and 20th min. The energy required for exocytosis was assumed to be supplied by
      ATP synthesized in acinar cells. The 31P NMR results indicated that this ATP was
      derived from phosphorylation of ADP by PCr, and that large amounts of PCr are
      synthesized during the first minutes after cerulein stimulation. In addition, a
      significant rise in glycerophosphocholine was observed after cerulein
      stimulation, which was attributed to an enhanced catabolism of membranes and an
      increase in phospholipid turnover. Injection of cerulein antagonists, such as
      asperlicin or lorglumide, inhibited the effects of cerulein stimulation on energy
      metabolites. Furthermore, no changes were observed after injection of secretin, a
      hormone that stimulates secretion of bicarbonate. However, the analog of
      cerulein, pentagastrin, produced the same effects as cerulein, although to a
      lesser extent.

PMID- 1757734
TI  - The activation of beta-substituted nitrosamines that are carcinogenic to the
      pancreas.

PMID- 1757735
TI  - Do gallstones cause chronic pancreatitis?
AB  - Gallstones are well known to cause acute pancreatitis. However, the role of
      gallstone disease in the causation of chronic pancreatitis is still
      controversial. Abnormalities of the pancreatic duct have been noted in about one
      half of patients with calculous biliary disease undergoing endoscopic retrograde
      cholangiopancreatography (ERCP), but despite this, it is generally believed that
      gallstones rarely, if ever, cause chronic pancreatitis. The clinical significance
      and the natural history of the pancreatographic changes seen in patients with
      gallstone disease is not known. Studies of the pancreatic functions and long-term
      follow-up of patients with calculous biliary disease, especially those who have
      abnormal pancreatograms, and the effect of removal of the gallstone on the
      pancreatographic abnormalities and pancreatic functions are needed to clarify the
      issue.

PMID- 1757736
TI  - Developmental potentiality of embryos cultured under low oxygen tension with
      superoxide dismutase.
AB  - A low-oxygen culture of preimplantation embryos with superoxide dismutase (SOD)
      has been demonstrated to produce a marked increase in the blastocyst formation.
      In this study, we examined the effects of low oxygen-SOD cultures of embryos on
      the potentiality of embryonic development after intrauterine transplantation and
      the reproductive ability of the offspring. Mouse pronuclear embryos were cultured
      in Biggers-Whitten-Whittingham's solution containing 0.3% bovine serum albumin
      and 500 micrograms/ml SOD under a low-oxygen condition (5% O2, 5% CO2, 90% N2),
      and 37.2% (110/296) of the embryos developed to blastocysts, with a significant
      difference from the 1.3% (3/231) under an atmospheric oxygen condition without
      SOD (P less than 0.01). The blastocysts obtained under a low oxygen-SOD culture
      condition were transplanted by direct insertion into the uterus of pseudopregnant
      females 3 days after infertile coitus. The implantation rate was 65.0% (65/100),
      and the embryo viability rate was 46.0% (46/100). In the control group, in which
      in vivo developed blastocysts were transplanted into 3-day pseudopregnant
      females, the implantation rate was 72.5% (81/112), and the embryo viability rate
      was 51.8% (58/112). The differences between the two groups were not significant.
      Significant differences also were not observed in either the body weight of pups
      at birth and 35 days after birth or the mean number of pups delivered by
      successive mating of the offspring between the two groups.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1757737
TI  - Very early pregnancy wastage in in vitro fertilization and embryo transfer (IVF
      ET).
AB  - The occurrence and incidence of early pregnancy wastage in an in vitro
      fertilization and embryo transfer (IVF-ET) program have been studied in 750
      patients. In 297 (39.6%) a pregnancy was diagnosed; of these, 14.8% were
      biochemical and 24.8% clinical pregnancies. In the latter group 23.6% aborted,
      while 75.8% had clinical ongoing pregnancies. The mean embryo quality score of
      the biochemical pregnancy group was similar to that of the clinical ongoing
      pregnancy group but statistically different from that of the clinical abortion
      group (P less than 0.005). Furthermore, the clinical ongoing pregnancy rate in
      women with previous biochemical pregnancy was 24.7%, a significantly higher
      percentage compared to clinical ongoing pregnancies achieved in IVF-ET cycles (P
      less than 0.05). It is possible that biochemical pregnancy does not represent an
      index for infertility but rather an intact stage of reproduction leading toward
      implantation. The high clinical pregnancy rate in subsequent cycles may probably
      serve as an encouraging sign or a marker for future clinical pregnancy.

PMID- 1757738
TI  - Microbial flora in semen during in vitro fertilization.
AB  - Semen samples from 183 consecutive unselected men participating in an in vitro
      fertilization program were retrospectively studied to determine the bacterial and
      fungal contamination rate before and after antibiotic treatment. To ascertain the
      influence of semen preparation (wash and swim-up method) on the incidence of
      microorganisms, semen from 102 male patients was studied before and after swimup.
      Antimicrobial treatment by prescription of antibiotics decreased the incidence of
      pathogens by 16.3% (P less than 0.0001). Semen processing was more effective by
      ridding 57.4% of semen samples of microbial contaminants (P less than 0.0001).
      When infection of culture media was observed during routine microscopy, all
      infected oocytes were degenerated, without evidence of fertilization or
      pronuclei.

PMID- 1757739
TI  - Intrauterine capsules for incubation of gametes and subsequent release of
      embryos.
AB  - In order to obtain incubation in uteri of spermatozoa, oocytes, and embryos, for
      treatment of patients referred for in vitro fertilization, a capsule was produced
      which could contain the human gametes and allow human fertilization and embryo
      growth after intrauterine introduction. Agar was chosen for capsule material and
      a mold was constructed for the production of capsules. The material was tested in
      vitro using mouse embryos and human oocytes and sperm. Intrauterine resolution
      was tested on mice and by insertion on 11 women. Empty capsules were inserted
      into the uterine cavity in 15 cycles the day after the luteinizing hormone peak
      and followed by daily ultrasound examinations. The resolution time was adjusted
      by changing the wall thickness of the capsules. The final type was dissolved
      after 3 to 4 days. No complications were observed and capsules could be inserted
      on all occasions. The major problem was expelling of capsules, which occurred in
      seven cycles. The problem seemed to be solved by the administration of
      indomethacin at the day of insertion.

PMID- 1757740
TI  - Intrauterine fertilization capsules--a clinical trial.
AB  - Treatment of 26 women with tubal infertility was attempted using intrauterine
      capsules loaded with oocytes and spermatozoa. The stimulation protocol was as
      used for in vitro fertilization and embryo transfer and consisted of short-term
      use of Buserelin, human menopausal gonadotropin, and human chorionic
      gonadotropin. Oocytes were collected by ultrasonically guided transvaginal
      aspiration, and spermatozoa were prepared by swim-up technique. The gametes were
      placed in agar capsules 4 hr after oocyte collection, and the capsules were
      introduced to the uterine fundus using an insertion tube and piston from an
      intrauterine device. Six complete capsules and parts of two other capsules were
      expelled. None of the women became pregnant, compared with a pregnancy rate of
      21% per aspiration following in vitro fertilization and embryo transfer during
      the same period.

PMID- 1757741
TI  - Comparison of unilateral and bilateral tubal transfer in gamete intrafallopian
      transfer (GIFT).
AB  - Gamete intrafallopian transfer (GIFT) is traditionally performed by delivering
      gametes into the ampullary region of either one or two fallopian tubes. The
      choice is made by the surgeon at the time of laparoscopy based upon the patient's
      anatomy, the number of oocytes available, and clinical judgment. In this
      nonrandomized, retrospective review, 399 tubal gamete transfers were performed
      over a period of 18 months, 133 to a single tube and 266 to both tubes. A
      clinical pregnancy rate of approximately 24% was observed in each modality. The
      multiple pregnancy rate of 31.3% for one tube was not significantly different
      from the 25% seen for two tubes. Unilateral tubal transfer offers the distinct
      advantages of less gamete and tissue handling. This, along with the apparent same
      outcome parameters, makes unilateral tubal transfer the preferred method of
      returning gametes at GIFT.

PMID- 1757742
TI  - Scanning electron microscope (SEM) study of mouse embryos obtained from isolated
      blastomeres.
AB  - Preimplantation diagnosis and embryo sexing offer great possibilities in the
      prevention of human diseases and in the field of animal production. These
      techniques involve blastomere isolation. Isolated blastomeres can grow in culture
      and develop as whole embryos. In this paper we describe, at the scanning electron
      microscope level, the characteristics of the plasma membrane surface of isolated
      blastomeres obtained from mouse embryos at the two-cell stage and of embryos
      grown to the 2/4- and 4/8-cell stages and compare them to control embryos grown
      in vitro. According to our results the in vitro manipulation of these embryos
      does not affect the surface characteristics of the plasma membrane in the early
      cleavage stages.

PMID- 1757743
TI  - Transvaginal ultrasonic needle-guided aspiration of endometriotic cysts before
      ovulation induction for in vitro fertilization.
AB  - Controversy still exists concerning the optimal treatment of endometriomata in
      endometriosis and its related infertility. Forty-one women with endometriomata
      who failed to conceive during previous in vitro fertilization and embryo transfer
      (IVF-ET) cycles (protocol A) were readmitted for ovum pickup following
      transvaginal ultrasonic needle-guided aspiration of the endometriomata (protocol
      B). Following aspiration a significantly higher number of oocytes was recovered
      (P less than 0.0006); subsequently, more embryos were transferred, and
      significantly higher clinical pregnancy rates per cycle (P less than 0.0001) were
      achieved. This difference may be directly related to the reduction of extensive
      ectopic endometrial tissue (endometriomata) with improved ovarian response,
      follicular accessibility, and, most probably, improved oocyte quality.

PMID- 1757744
TI  - The effect of chemiluminescent light exposure on the in vitro development of
      mouse embryos.

PMID- 1757745
TI  - Bilateral tubal ectopic pregnancy after in vitro fertilization and embryo
      transfer.

PMID- 1757746
TI  - Delivered twins from electroejaculation and tubal embryo transfer.

PMID- 1757747
TI  - Long-term infertility in late-onset 3 beta-ol-dehydrogenase deficiency:
      successful pregnancy following dexamethasone and in vitro fertilization (IVF)
      therapy.

PMID- 1757748
TI  - Successful management and outcome of heterotopic triplet in vitro fertilization
      (IVF) gestation: twin tubal and surviving intrauterine pregnancy.

PMID- 1757749
TI  - CD4/immunoglobulin interaction: implications for immune physiology and
      autoimmunity.
AB  - CD4 has an important role in T cell activation events that depend on its binding
      to non-polymorphic MHC class II determinants on antigen-presenting cells. Here,
      we provide evidence that CD4 also interacts with immunoglobulins (Ig). The Ig
      binding region lies within residues 21-49 of V1 domain of CD4. Immunochemical
      studies suggest that this property of CD4 does not depend on the three
      dimensional folding of the CD4 molecule. Synthetic peptides (p) encompassing
      amino acid residues 16-49 and 21-49 of CD4 bind immunoglobulins in comparable way
      to the intact molecule. In vitro p 16-49 enhances significantly idiotype/anti
      idiotype and some weak antigen-antibody interactions. Antigen antibody complexes
      formed in antigen excess bind CD4 peptides with much higher avidity then non
      complexed antibodies. The possible role of the CD4/Ig interaction in T-B cell
      cooperation is discussed.

PMID- 1757750
TI  - MDA-image: an environment of networked desktop computers for
      teleradiology/pathology.
AB  - MDA-Image, a project of The University of Texas M. D. Anderson Cancer Center, is
      an environment of networked desktop computers for teleradiology/pathology.
      Radiographic film is digitized with a film scanner and histopathologic slides are
      digitized using a red, green, and blue (RGB) video camera connected to a
      microscope. Digitized images are stored on a data server connected to the
      institution's computer communication network (Ethernet) and can be displayed from
      authorized desktop computers connected to Ethernet. Images are digitized for
      cases presented at the Bone Tumor Management Conference, a multidisciplinary
      conference in which treatment options are discussed among clinicians, surgeons,
      radiologists, pathologists, radiotherapists, and medical oncologists. These
      radiographic and histologic images are shown on a large screen computer monitor
      during the conference. They are available for later review for follow-up or
      representation.

PMID- 1757752
TI  - A very large PC LAN as the basis for a hospital information system.
AB  - Brigham and Women's Hospital is converting its financial, administrative and
      clinical information systems from a mini-computer environment to a platform based
      on MUMPS and a network of several thousand personal computers. This article
      describes the project rationale and status and provides an overview of the
      architecture of the new system. The initial results of the project indicate that
      the personal computer network can provide large amounts of processor power and
      storage at costs per unit of power and storage that are several times less
      expensive than the minicomputer environment. The performance of the converted
      Accounts Payable system indicates that the architecture can deliver acceptable
      performance.

PMID- 1757751
TI  - Significant efficiency findings while controlling for the frequent confounders of
      CAI research in the PlanAlyzer project's computer-based, self-paced, case-based
      programs in anemia and chest pain diagnosis.
AB  - Richard E. Clark in his widely published comprehensive studies and meta-analyses
      of the literature on computer assisted instruction (CAI) has decried the lack of
      carefully controlled research, challenging almost every study which shows the
      computer-based intervention to result in significant post-test proficiency gains
      over a non-computer-based intervention. We report on a randomized study in a
      medical school setting where the usual confounders found by Clark to plague most
      research, were carefully controlled. PlanAlyzer is a microcomputer-based, self
      paced, case-based, event-driven system for medical education which was developed
      and used in carefully controlled trials in a second year medical school
      curriculum to test the hypothesis that students with access to the interactive
      programs could integrate their didactic knowledge more effectively and/or
      efficiently than with access only to traditional textual "nonintelligent"
      materials. PlanAlyzer presents cases, elicits and critiques a student's approach
      to the diagnosis of two common medical disorders: anemias and chest pain.
      PlanAlyzer uses text, hypertext, images and critiquing theory. Students were
      randomized, one half becoming the experimental group who received the interactive
      PlanAlyzer cases in anemia, the other half becoming the controls who received the
      exact same content material in a text format. Later in each year there was a
      crossover, the controls becoming the experimentals for a similar intervention
      with the cardiology PlanAlyzer cases. Preliminary results at the end of the first
      two full trials shows that the programs have achieved most of the proposed
      instructional objectives, plus some significant efficiency and economy gains. 96
      faculty hours of classroom time were saved by using PlanAlyzer in their place,
      while maintaining high student achievement. In terms of student proficiency and
      efficiency, the 328 students in the trials over two years were able to accomplish
      the project's instructional objectives, and the experimentals accomplished this
      in 43% less time than the controls, achieving the same level of mastery. However,
      in spite of these significant efficiency findings, there have been no significant
      proficiency differences (as measured by current factual and higher order multiple
      choice post-tests) between the experimental and control groups. Very careful
      controls were used to avoid what Clark has found to be the most common
      confounders of CAI research. Accordingly, this research proved Clark's rival
      hypothesis, that the computer, in itself, does not appear to contribute to
      proficiency gains, at least as measured by our limited post-testing. Clark's
      position is that the computer is primarily a vehicle--as is either a pill or a
      hypodermic needle for delivering a drug.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1757753
TI  - The use of graphic design in an interactive computer teaching program.
AB  - The widespread diffusion of affordable computers into the scientific and
      educational community has provided the opportunity to design medical and
      scientific teaching programs illustrated either by hand or by utilizing
      commercially available software and manipulating existing computer generated
      images. The medical illustrator can provide the ideal aesthetic link between text
      format information and the visual representation of such knowledge in a concise
      presentation format. The availability of interactive multimedia programs has
      given the medical illustrator an environment to create and enhance Hypermedia
      designed specifically for the purpose of medical education. This paper will focus
      on the incorporation of illustration and screen design into "CT The Game," an
      experimental medical teaching program currently being developed in the Johns
      Hopkins Body CT Imaging Laboratory. The program is designed to provide an
      enjoyable approach to learning Computed Tomography (CT), and is directed toward
      an audience of medical students, residents, and fellows.

PMID- 1757754
TI  - An inventory model for optimizing purchasing of intravenous fluids for hospitals:
      a case study.
AB  - This paper deals with determining the optimal level of purchase of intravenous
      fluids for hospitals by utilizing inventory control concepts. Using the
      conceptual framework of the economic order quantity (EOQ) model, the hospital
      administrators can elicit the efficient materials management, thus reducing both
      the space and capital requirements without compromising the quality of services
      rendered.

PMID- 1757755
TI  - Quality assurance tracking or "finding the needle in a haystack".
AB  - This paper will present a picture of the steps required from conception, through
      development, and leading to implementation of an automated Quality Assurance
      Incident Tracking System within in a multihospital system utilizing general
      purpose software (WordPerfect and Lotus Agenda). This automated tracking system
      provides the manager with an effective and efficient method to control multiple
      staff assignments, tasks, and manage multiple objectives over the resolution
      cycle associated with hospital incident reporting in the Quality Assurance arena.
      It also provides the QA managers and hospital executives with an individualized
      record of the Incident's progress and helps identify useful and dysfunctional
      patterns in the resolution of the Incident. The identification of these patterns
      can assist hospital management in revising and developing protocols and
      procedures that minimize hospital exposure to state sanctions and provide a
      mechanism to improve the quality of care in the institution: QA Tracking, Quality
      Assurance, Incident, Automated Tracking.

PMID- 1757756
TI  - Should we be screening for early diabetic renal disease?

PMID- 1757757
TI  - The measurement of morbidity in general practice.
AB  - (1) The need for morbidity data based on general practice arises because: (a) the
      consultation in general practice is the entry point into the health care system;
      (b) among the health problems brought to the attention of doctors, most are dealt
      with completely in general practice; (c) general practice records can provide a
      comprehensive database for health care. (2) The routine measurement of morbidity
      has to be based on "working diagnostic terms" derived by consensus amongst
      recorders because: (a) many episodes of illness involve only one consultation and
      the doctor is required to make the most of the information available to him at
      the time; (b) the specification of criteria would require validating evidence of
      conformity and this is not a realistic option on a wide scale; (c) health care
      data which include the opinion of the general practitioner are more valuable than
      data based on patient perceptions of illness. (3) The analysis and interpretation
      of data from general practice: (a) should preferably be based on persons as the
      unit of analysis; (b) when based on consultations, may be useful for examining
      workload, but has limited epidemiological value; (c) can, by person linkage,
      facilitate the study of disease concurrence; and (d) is essential for managing
      the health care system and monitoring the public health.

PMID- 1757758
TI  - Chronic leg ulcers: an underestimated problem in primary health care among
      elderly patients.
AB  - STUDY OBJECTIVE: The aim was to establish leg ulcer point prevalence, basal
      patient characteristics, and level of caretaking. DESIGN: The study was a postal
      cross sectional survey. The validity was ensured by examining a randomly selected
      sample of reported patients. Responding health care officials were asked to
      report all patients with an open wound below knee (including foot ulcer) which
      did not heal or was supposed to heal within a six week period after onset of
      ulceration. Response rate was 92%. SETTING: Inpatient and outpatient care in
      hospitals, community health care, and private nursing homes within Skaraborg
      county, with a population of 270,800. PARTICIPANTS: 827 individual patients were
      found with active leg ulcers, 526 women and 301 men. MEASUREMENTS AND MAIN
      RESULTS: Age adjusted sex ratio of ulcer patients was 1:1.4 (M:F). The median age
      was 78 years for women and 76 for men; 700 patients (85%) were older than 64
      years. The point prevalence for active leg ulcers was 3.0/1000 total population.
      District nurses provided care for 680 patients (82%), 106 (13%) were in hospital
      care, and 41 (5%) were managed by outpatient departments. CONCLUSIONS: There has
      been an underestimation of the leg ulcer problem among elderly patients,
      especially men. With an expected increasing number of elderly people it is
      important that this problem is recognised and measures taken to improve the
      primary care of these patients.

PMID- 1757759
TI  - Quantifying health aspects of passive smoking in British children aged 5-11
      years.
AB  - STUDY OBJECTIVE: The aim was to estimate the dose-response relations of height
      and respiratory symptoms to passive smoking in children aged 5-11 years. DESIGN:
      The study was an analysis of existing observational studies, comprising three
      samples: English representative; English inner city; Scottish representative.
      SETTING: Primary schools (children aged 5-11 years). PARTICIPANTS: The study
      population included 5002 English children from the representative sample (69.1%
      of total eligible), 2903 English inner city children (42.0%), and 3319
      representative Scottish children (75.6%). MEASUREMENTS AND MAIN RESULTS: No
      significant relation was found between child's height and total parental smoking
      in the home. Relative risk for persistent wheeze on exposure to 20 cigarettes per
      day was 1.35, compared to no exposure. Risk of at least one respiratory condition
      attributable to passive smoking reached 8.1% in white English inner city
      children. CONCLUSIONS: The relation of child's height to passive smoking was not
      substantiated. The risk of respiratory conditions resulting from passive smoking,
      although small, is not negligible.

PMID- 1757760
TI  - Association of age and social class with suicide among men in Great Britain.
AB  - STUDY OBJECTIVE: The aim was to investigate suicide and "undetermined" deaths by
      age, economic activity status, and social class in Great Britain among males of
      working age. DESIGN: The study was a cross sectional analysis of Registrar
      General's data for England and Wales around 1981, repeated for around 1971, and
      for Scotland around 1971 and 1981. MEASUREMENTS AND MAIN RESULTS: For England and
      Wales around 1971, suicide and undetermined death rates showed a progressive
      increase with age and a markedly higher rate in the lower social classes. A
      significant interaction effect was identified in the central age groups of the
      lower occupational categories. This interaction was confirmed in the remaining
      three data sets, notwithstanding some differences in the profile of age specific
      mortality. Other findings included a higher standardised mortality ratio for the
      economically inactive, who also showed an earlier peak in age specific mortality,
      and a relative concentration of undetermined as compared to suicide deaths in the
      lower social classes, but not all these further results were fully replicated.
      CONCLUSIONS: There is a concentration of suicide and undetermined deaths in the
      middle age groups of the lower social classes. Plausible explanations include
      both the social drift and the social genesis hypotheses, the latter including the
      effects of long term unemployment.

PMID- 1757761
TI  - Mortality from dementia among gastroduodenal ulcer patients.
AB  - STUDY OBJECTIVE: The aim was to examine whether a high intake of aluminium
      containing antacids is a risk for Alzheimer's disease. DESIGN: The mortality from
      dementia (1970-87), coded from death certificates as underlying or contributory
      cause of death, was compared with national rates in a cohort of patients who had
      surgery for gastroduodenal ulcer disease between 1911 and 1978. SETTING: Patient
      data were obtained from patient records from major hospitals in western Norway.
      PARTICIPANTS: 4179 patients were identified who met the study criteria, which
      included having had a documented stomach operation, having a reliably
      identifiable personal number, and being alive on Jan 1, 1970. MEASUREMENTS AND
      MAIN RESULTS: The standardised mortality ratio for dementia was 1.10 (95% CI 0.85
      1.40, n = 64) for all patients, while for patients operated on in the period 1967
      78 it was 1.25 (95% CI 0.66-2.13, n = 13). CONCLUSIONS: As the majority of
      patients operated on after 1963 have probably been heavy consumers of aluminium
      containing antacids, the study provides meager evidence that a high intake of
      aluminium is an important risk factor for Alzheimer's disease, the major cause of
      dementia. However, the possibility of a raised mortality from Alzheimer's disease
      cannot be ruled out due to probable misclassification both in diagnosis and
      exposure. In addition, the observation period may have been too short to detect
      an effect since the latent period for Alzheimer's disease may be very long.

PMID- 1757762
TI  - Low birthweight, preterm, and small for gestational age babies in Scotland, 1981
      1984.
AB  - STUDY OBJECTIVE: The aim was to examine the effect of maternal age, gravidity,
      marital status, previous perinatal deaths, and parental social class on babies
      born low birthweight, preterm, and small for gestational age. DESIGN: The study
      used data on discharge summaries from all maternity hospitals in Scotland.
      SETTING: The study was based on all singleton deliveries in Scotland.
      PARTICIPANTS: The analysis involved information on 259,462 singleton babies born
      during the four years 1981-84 in Scotland. MEASUREMENTS AND MAIN RESULTS:
      Previous perinatal death was found to be the strongest predictor for both preterm
      and low birthweight. Single mothers were at particularly high risk of having a
      small for gestational age baby and those who were previously married of having a
      preterm baby. Women aged less than 20 years old, those over 34 years old,
      nulligravidae, and those of parity 3 or more were also at increased risk of
      adverse pregnancy outcome. Mothers and fathers in manual social classes and those
      who could not be assigned a social class on the basis of their occupation were at
      increased risk for all three adverse outcomes studied. The babies of parents who
      were in manual occupations were twice as likely as those of parents in non-manual
      occupations to be small for gestational age and almost twice as likely to be low
      birthweight. CONCLUSIONS: Mother's social class is a risk factor for adverse
      pregnancy outcome independent of maternal age, parity, and adverse reproductive
      history, and also independent of father's social class. Information on both
      parents' occupations should be collected in maternity discharge systems.

PMID- 1757763
TI  - An indicator of adverse pregnancy outcome in France: not receiving maternity
      benefits.
AB  - STUDY OBJECTIVE: The aim was to compare the social characteristics, the pregnancy
      outcome, and the antenatal care of women in France who did not receive maternity
      benefits to women who did. These benefits (860 FF, approx 86 pounds per month)
      are given to every pregnant woman, starting in the second trimester. Payments are
      made on the condition that at least three antenatal visits are made, the first
      being before the end of the first trimester. DESIGN: The study involved a random
      sample of women who were interviewed after delivery during their stay in
      hospital. Data on pregnancy outcome were collected from medical records. SETTING:
      The study was carried out in four public maternity units in different regions of
      France. PARTICIPANTS: 1692 women were included in the analysis (86.8% of the
      selected sample). Of 257 exclusions, 40 had multiple pregnancies, 189 had missing
      data, and 28 did not answer the question concerning maternity benefits.
      MEASUREMENTS AND MAIN RESULTS: 4.3% of the women did not receive any maternity
      benefits. These women lived in poorer social conditions than the women who
      received the benefits. They had a higher preterm delivery rate, after controlling
      for risk factors in a logistic regression. Women without maternity benefits were
      characterised by a lower level of care, yet the majority began their antenatal
      care during the first trimester or had more than six visits. CONCLUSIONS: Not
      receiving maternity benefits during pregnancy is an index of an underprivileged
      situation and a risk factor for pregnancy outcome.

PMID- 1757764
TI  - Socioeconomic differences in cancer survival.
AB  - STUDY OBJECTIVE: The aim was to investigate the relationship between
      socioeconomic status and cancer survival. DESIGN: This was a prospective study,
      linking census and vital registration records for an approximate 1%
      representative sample of those enumerated in England and Wales in the 1971
      census. SETTING: The study population is nationwide. PARTICIPANTS: The study
      sample consists of 250,588 men and 262,484 women. During 1971-81, 17,844 cases of
      cancer were registered, and of those registered, 13,532 died during 1971-1983.
      MEASUREMENTS AND MAIN RESULTS: Socioeconomic status was assessed in terms of
      housing tenure. Council tenants, the low socioeconomic group, had poorer survival
      than owner occupiers, the high socioeconomic group, for the combined group of all
      neoplasms, and for 11 out of 13 neoplasms examined in males, and 12 out of 15
      neoplasms examined in females. Differences were found irrespective of age, cause
      of death and prognosis of the cancer. Survival analysis by length of follow up
      indicated that council tenants were more likely to present at a later stage than
      owner occupiers. CONCLUSIONS: Wide survival differentials were observed between
      socioeconomic groups. Differences in survival for cancers of poor prognosis (eg,
      oesophagus, pancreas, lung) where treatment has little effect, cannot be
      attributed to socioeconomic differences in treatment. The survival differences
      for cancers of good prognosis (eg, corpus uteri, bladder, skin) could, in part,
      be due to differences in treatment. It is probable that delay in seeking care is
      one of the major contributing causes.

PMID- 1757765
TI  - The cost of screening for colorectal cancer.
AB  - STUDY OBJECTIVE: The aim was to make projections of the likely costs and yield
      resulting from the implementation of a faecal occult blood screening programme
      for colorectal cancer. DESIGN: Cost and clinical data were derived from the MRC
      colorectal screening trial currently in progress in Nottingham, UK. SETTING: The
      above data were used as the basis for modelling the likely implications were the
      trial to be reproduced as a screening programme within a "typical" family
      practitioner committee area. MAIN RESULTS: For an average family practitioner
      committee area with a target population of 75,000 subjects aged 50-74 years, the
      initial screening round might be expected to detect 85 cancers at a total cost of
      approximately 250,000 pounds. This represents a cost per cancer detected of 2700
      pounds and a cost per person screened of approximately 5 pounds. For subsequent
      screening rounds, total costs might be expected to fall although average costs
      are likely to remain approximately constant. CONCLUSIONS: The model is successful
      in generating "order of magnitude" estimates for the costs of implementation of a
      screening programme for colorectal cancer. As benefit estimates are not yet
      available, however, no cost-effectiveness analysis can be undertaken at this
      stage. In general, sensitivity analyses reveal that programme costs are more
      sensitive to changes in clinical variables, especially detection and compliance
      rates, than they are to variations in the costs of resource inputs. A screening
      programme with a more elaborate protocol than that currently employed in the
      Nottingham trial will entail considerable cost increases.

PMID- 1757766
TI  - Influence of "diagnostic delay" upon cancer survival: an analysis of five tumour
      sites.
AB  - STUDY OBJECTIVE: The aim was to assess the relationship between survival, tumour
      stage, and the interval from first symptom to diagnosis (SDI, or duration of
      symptoms). DESIGN: This was a retrospective follow up study of a cohort of
      patients registered in the tumour registry of the Hospital del Mar (Barcelona).
      SETTING: Hospital based tumour registry, with patients derived mainly from the
      City of Barcelona. PARTICIPANTS: 1247 cases of lung, breast, stomach, colon, or
      rectal cancer were analysed using survival curves and Cox proportional hazards
      regression. Subjects (mean age 63.6 years) were followed for a median length of
      12.9 months after diagnosis. At the time of diagnosis one fourth of patients had
      disseminated disease. MEASUREMENTS AND MAIN RESULTS: Based on clinical records, a
      physician registered the onset time of the first symptom attributable to cancer
      (from which the SDI is computed), as well as the tumour stage at diagnosis. Other
      measurements followed standard tumour registry procedures. Overall, the crude
      mean SDI was 5.15 months (SD 8.03, median 2.03); only 24.5% of cases had an SDI
      less than a month. Crude mean SDIs by anatomical site were as follows: lung
      cancer 3.07 months; breast 7.44; stomach 5.34; colon 5.74; rectum 5.03. Tumour
      extension did not appear to be significantly influenced by SDI, only breast
      cancer showing a distinct pattern of increased extension with increasing SDI. As
      expected, the probability of survival decreased monotonically with increasing
      stage in all sites. Tumour site was also a significant predictor of survival,
      which at one year ranged from 93% for breast cancer to 28% for lung cancer.
      However, a longer SDI tended sometimes to be associated with a better chance of
      survival, a fact that was most apparent in colon cancer. All Cox proportional
      hazards models showed a consistent picture: SDI was not a significant predictor
      of survival (age and sex adjusted hazard ratios ranging from 0.97 to 1.01),
      neither was sex; age did predict survival, and so did site and stage.
      CONCLUSIONS: The results provide further evidence of a very weak relationship
      between SDI and tumour stage at diagnosis (except for breast cancer), and between
      SDI and survival, thus emphasising some limitations within which early clinical
      detection operates. They also suggest that in addition to reflecting patient and
      physician behaviour, as well as the functioning of the health system, SDI may be
      influenced by the biological behaviour of the tumour.

PMID- 1757767
TI  - Cultural and economic determinants of geographical mortality patterns in The
      Netherlands.
AB  - STUDY OBJECTIVE: The geographical pattern of mortality in The Netherlands is
      dominated by an area of relatively high mortality in the southern part of the
      country. The aim was to analyse the background of this geographical mortality
      pattern in the early 1980s, and its evolution over time since the early 1950s.
      DESIGN: Mortality data by district (n = 39), cause of death (13 large causes,
      "symptoms and ill defined conditions", all other causes), and time period (1950
      54, 1960-64, 1970-74, 1980-84) were available from the Netherlands Central Bureau
      of Statistics. Standardised mortality ratios were calculated, and the logarithms
      of these were related to three sociodemographic characteristics using multiple,
      ordinary least squares regression analysis. SETTING: This study used data for the
      whole Dutch population. MAIN RESULTS: Although the geographical mortality pattern
      has been rather stable over the last decades, a clear tendency towards
      convergence is also apparent. Approximately 90% of the current excess mortality
      in the southern part of the country is due to cardiovascular diseases. The
      results of regression analysis show that the excess mortality is primarily
      related to the high percentage of Roman Catholics in this part of the country,
      and additionally to a slightly lower average income. In The Netherlands, a higher
      percentage of Roman Catholics in the population is linked with higher all cause
      mortality rates, as well as with higher mortality rates for lung cancer,
      ischaemic heart disease, cerebrovascular disease, arterial disease, and chronic
      non-specific lung disease. Survey data show that these associations are partly
      due to a higher prevalence of smoking among Roman Catholics. As in many other
      countries, a lower average income is linked with high all cause mortality rates
      in The Netherlands. Cause specific data show negative associations for stomach
      cancer, ischaemic heart disease, cerebrovascular disease, chronic non-specific
      lung disease, and traffic accidents. Since the early 1950s the association
      between geographical mortality patterns and the percentage of Roman Catholics in
      the population has gradually become less strongly positive. This suggests that
      the convergence of the mortality rates in the South towards the national average
      may be related to a gradual lessening of differences in lifestyle between
      population groups. CONCLUSIONS: Both cultural and economic factors are important
      in the explanation of geographical mortality patterns in The Netherlands.

PMID- 1757768
TI  - Value of mortality data and necropsy records in monitoring morbidity in a
      population.
AB  - STUDY OBJECTIVE: The aim was to compare the value of four sources of data in
      assessing morbidity in a population: (1) data from a screening programme
      including follow up records, (2) death certifications by attending physicians,
      (3) death certifications by doctor-coroners, and (4) necropsy reports. DESIGN:
      The study was a cohort analysis of health and mortality in a sample of
      agricultural workers first examined in 1964-66 when they were aged 60 years or
      older. Follow up examinations enabled morbidity assessment to be made and ICD
      diagnostic categories to be compared with data available on persons in the cohort
      who had died. SETTING: Hajduszoboszlo, a small town in eastern Hungary.
      PARTICIPANTS: 1412 persons (96.1% of those aged greater than or equal to 60
      years) were examined in 1964-6. Those still alive and available in 1989 were
      examined again. Necropsy records were available for 144 persons from the cohort
      in 1989 and were extensively reviewed in comparison with data available from
      other sources. MEASUREMENTS AND MAIN RESULTS: Comparison of causes of death
      established at necropsy showed marked differences from those registered by
      attending physicians and doctor-coroners, deviations ranging from -91.6% to
      +74.8%; 19.4% of underlying causes of death occurred exclusively in the necropsy
      group. Major divergencies in diagnostic classification occurred in the three data
      sources, particularly for diseases of the circulatory system, where hypertensive
      renal disease, old myocardial infarction, acute cerebrovascular disease, and
      venous thrombosis were rarely documented by physicians/coroners. When necropsy
      data were used the number of diagnostic categories increased strikingly over the
      other sources of information. Necropsy records revealed quantitatively similar
      information on morbidity to follow up examination though there were qualitative
      differences, necropsy being less likely to document diagnoses of endocrine
      disorders, mental and neurological diseases, digestive disorders, and
      musculosketal disorders. CONCLUSIONS: Necropsy records contain much valuable
      material not available from other sources, exceeding by ninefold the amount of
      information reported at present. A way should be found to make use of this large
      data pool.

PMID- 1757769
TI  - Housing and appendicitis in Anglesey.
AB  - STUDY OBJECTIVE: The aim was to test the hypothesis that provision of household
      amenities such as domestic hot water systems and bathrooms changed hygiene which
      thereby triggered the epidemic of appendicitis in Anglesey after the second world
      war. DESIGN: The study was a cross sectional survey with histories of housing and
      appendicectomy obtained from Anglesey residents by postal questionnaire. The main
      outcome measure was reported appendicectomy. SETTING: Four general practices in
      Anglesey. SUBJECTS: 2531 men and women born during 1923-62 and randomly selected
      from age-sex registers. Overall response rate was 73.7%. MAIN RESULTS: Subjects
      born into households with amenities--piped water, hot water systems, and
      bathrooms had, if anything, a reduced risk of appendicectomy. However, those who
      subsequently moved to houses that lacked amenities were at significantly higher
      risk than people born into houses without amenities who later acquired them.
      CONCLUSIONS: Provision of household amenities was not the important trigger to
      the epidemic of appendicitis which occurred in Anglesey after the second world
      war. Rather, the trigger may have been reduction in domestic crowding caused by
      the falling birth rate. Findings among those who moved house support other
      evidence that after infancy household amenities protect against appendicitis and
      contributed to the fall in appendicitis rates in Anglesey after 1965.

PMID- 1757770
TI  - The food pattern in geographical relation to the risk of multiple sclerosis in
      the Mediterranean and Near East region.

PMID- 1757771
TI  - An identifiable molluscan neuron responds to changes in earth-strength magnetic
      fields.
AB  - Diverse animals can orient using geomagnetic cues, but little is known about the
      neurophysiological mechanisms that underlie magnetic field detection. The marine
      mollusc Tritonia diomedea (Bergh) has a magnetic sense and its nervous system is
      amenable to cellular-level electrophysiological analysis. In a semi-intact whole
      animal preparation, intracellular recordings from the large, visually
      identifiable neurons left pedal 5 (LPe5) and right pedal 5 (RPe5) in the brain of
      Tritonia revealed enhanced electrical activity in response to changes in ambient
      earth-strength magnetic fields. No such changes in activity were observed in
      approximately 50 other neurons subjected to identical magnetic stimuli. The
      responses of LPe5 were characterized by increases in spiking frequency occurring
      about 6-16 min after the ambient magnetic field had been rotated to a new
      position. The response was abolished when the brain had been isolated from the
      periphery of the animal by severing nerves, a procedure that also transected
      prominent neurites of LPe5. We hypothesize that LPe5 is one component of a neural
      circuit mediating detection of the earth's magnetic field or orientation to it.

PMID- 1757772
TI  - Activities of key metabolic enzymes in the heater organs of scombroid fishes.
AB  - Maximal in vitro activities of key metabolic enzymes were measured in brain and
      eye heaters of five species of scombroid fishes. Istiophorid billfishes (blue
      marlin, striped marlin and Mediterranean spearfish), xiphiid billfishes (Pacific
      and Mediterranean stocks) and a scombrid fish (butterfly mackerel) were included
      in the analysis. Our main objectives were (1) to assess the maximum possible
      substrate flux in heater tissue, and (2) to determine what metabolic substrates
      could fuel heat production. Heater tissue of all scombroids examined showed
      extremely high oxidative capacity. Activities of citrate synthase, a commonly
      measured index of oxidative metabolism, included the highest value ever reported
      for vertebrate tissue. In most billfishes, citrate synthase activities were
      similar to or higher than those found for mammalian cardiac and avian flight
      muscle. Marker enzymes for aerobic carbohydrate metabolism (hexokinase) and fatty
      acid metabolism (carnitine palmitoyltransferase and 3-hydroxyacyl-CoA
      dehydrogenase) also displayed extraordinarily high activities. Activities of
      carnitine palmitoyltransferase measured in heater organs were among the highest
      reported for vertebrates. These results indicate that heat production could be
      fueled aerobically by either lipid or carbohydrate metabolism. Inter- and
      intraspecifically, heater organs of fishes from the colder Mediterranean waters
      had a higher aerobic capacity and, hence, a greater heat-generating potential,
      than fishes from the warmer waters of the Pacific. This difference may be
      attributed to different thermal environments or it may result from allometry,
      since fishes caught in the Mediterranean were considerably smaller than those
      caught in the Pacific.

PMID- 1757773
TI  - The dopamine and 5-hydroxytryptamine content of locust and cockroach salivary
      neurones.
AB  - The salivary glands of the cockroach and locust are innervated primarily from two
      pairs of motoneurones, designated SN1 and SN2, in the suboesophageal ganglion.
      Intracellular cobalt fills and subsequent silver intensification were used to
      reveal the morphology of these cells in both species. Fluorescent microscopy,
      following treatment of the ganglion with glyoxylic acid, showed that in both
      species only the SN1 neurones contained catecholamines. A radioenzymatic assay
      for dopamine, performed on the locust SN1 neurones, confirmed that this
      catecholamine was present. A radioenzymatic assay for 5-hydroxytryptamine (5-HT),
      performed on both pairs of salivary neurones in the locust, revealed small
      quantities of this amine in the SN2 neurones, but no significant amount in the
      SN1 neurones. In the cockroach, 5-HT was assayed in the SN2 neurones only. In
      contrast to the locust, however, the 5-HT content of these cells was not
      significantly above that of control cells taken from other ganglia. These
      observations demonstrate that only the SN1 neurones are the source of the
      catecholaminergic fibres investing the locust and cockroach salivary glands. The
      difference in neurotransmitter content between the SN1 and SN2 neurones suggests
      that these neurones have separate functions in the control of salivary secretion.

PMID- 1757774
TI  - Intracellular pH in the toad Bufo marinus following hypercapnia.
AB  - We investigated the effects of hypercapnia on intracellular acid-base regulation
      in brain and liver of the toad Bufo marinus L. After 1 h at 5% CO2, arterial PCO2
      increased significantly, from 1.6 +/- 0.04 to 5.7 +/- 0.23 kPa, while brain and
      liver intracellular pH (pHi) decreased significantly. Reductions in pHi of both
      tissues were partially compensated by increased levels of bicarbonate.
      Surprisingly, however, compensation was lower than expected in brain and higher
      than expected in liver. We suggest that compensation in brain may be limited by
      secondary effects of bicarbonate loading in this tissue.

PMID- 1757775
TI  - How stimulus direction determines the trajectory of the Mauthner-initiated escape
      response in a teleost fish.
AB  - Fishes use the Mauthner-initiated C-start for short-latency evasion of predators.
      C-starts consist of a sudden turn (stage 1) and a rapid acceleration (stage 2).
      We analyzed high-speed cine films of goldfish C-starts elicited by dropping a
      ball into the water. It was previously thought that stage 1 angle does not vary
      concomitantly with the angle of the threatening stimulus relative to the position
      of the fish. We found, however, a significant inverse relationship between the
      direction of the impact of the ball and the angle turned by the end of stage 1.
      When starting near a wall, or when its usual trajectory was blocked by a wall,
      the fish used an escape route that was not predictable from the stimulus angle.
      The fish did not appear to correct its trajectory if it began to turn towards the
      ball. This behavioral evidence supports the previous notion that the underlying
      neural command is ballistic and does not use sensory information from the
      stimulus once the movement begins. If this is so, the fish probably utilizes
      information on obstacle location in the interval leading up to the trigger
      stimulus.

PMID- 1757776
TI  - The role of blood glucose in the restoration of muscle glycogen during recovery
      from exhaustive exercise in rainbow trout (Oncorhynchus mykiss) and winter
      flounder (Pseudopleuronectes americanus).
AB  - The role of blood-borne glucose in the restoration of white muscle glycogen
      following exhaustive exercise in the active, pelagic rainbow trout (Oncorhynchus
      mykiss) and the more sluggish, benthic winter flounder (Pseudopleuronectes
      americanus) were examined. During recovery from exhaustive exercise, the animals
      were injected with a bolus of universally labelled [14C]glucose via dorsal aortic
      (trout) or caudal artery (flounder) catheters. The bulk of the injected label (50
      70%) remained as glucose in the extracellular fluid in both species. The major
      metabolic fates of the injected glucose were oxidation to CO2 (6-8%) and
      production of lactate (6-8%), the latter indicative of continued anaerobic
      metabolism post-exercise. Oxidation of labelled glucose could account for up to
      40% and 15% of the post-exercise MO2 in trout and flounder, respectively.
      Exhaustive exercise resulted in a reduction of muscle glycogen stores and
      accumulation of muscle lactate. Glycogen restoration in trout began 2-4h after
      exercise, whereas in flounder, glycogen restoration began within 2h. Despite a
      significant labelling of the intramuscular glucose pool, less than 1% of the
      infused labelled glucose was incorporated into muscle glycogen. This suggests
      that blood-borne glucose does not contribute significantly to the restoration of
      muscle glycogen following exhaustive exercise in either trout or flounder and
      provides further evidence against a prominent role for the Cori cycle in these
      species.

PMID- 1757777
TI  - The action of acetylcholine on the locomotor central pattern generator for
      swimming in Xenopus embryos.

PMID- 1757778
TI  - The relationship between body mass and ventilation rate in mammals.

PMID- 1757779
TI  - Double-focal videomicroscopy: a simple video system for analyzing the dynamics of
      cell motility.

PMID- 1757780
TI  - Presleep suggestion related to a phobic object: successful manipulation of
      reported dream affect.
AB  - Twenty-four female subjects with a strong dislike of snakes slept for four
      nonconsecutive nights in the laboratory. They were divided into four groups of
      six, each group receiving a different presleep suggestion on Nights 3 and 4. On
      Nights 2, 3, and 4, before sleep, the subjects saw but did not have to touch a
      live snake and their dreams were collected for each REM period. The results
      showed that, when compared with the subjects who received the negative affect
      suggestions, subjects who received positive affect suggestions had significantly
      higher levels of positive emotions in their dreams, rated their own dreams as
      more pleasant, and had significantly lower levels of anxiety, sadness, and
      aggression. These results support the hypothesis that presleep suggestion can be
      an effective technique in influencing the affective dimension of the dream.

PMID- 1757781
TI  - The relationship between trauma and financial and physical well-being among
      Cambodians in the United States.
AB  - This study focused on the relationship between trauma and financial and physical
      well-being of Cambodian refugees in the United States. Trauma was defined by
      three variables: whether or not trauma had been experienced in Cambodia, the
      number of traumas experienced, and the number of years spent in refugee camps. It
      was hypothesized that these trauma variables would predict financial and physical
      health among Cambodians in the United States. A discriminant analysis showed
      significant relationships between the trauma variables and current employment
      status, and multiple regression analyses showed that trauma predicted income and
      physical health.

PMID- 1757782
TI  - Motion thresholds in infants to sinusoidal gratings.
AB  - Motion thresholds were determined at 9 degrees eccentricity in infants (mean = 14
      weeks old). The stimuli used were computer-generated sinusoidal gratings
      presented through a 7.45 degrees aperture at a contrast ratio of .83. The range
      of velocities (.5, 1, 2, 4, and 6 degrees per s) was examined at only one spatial
      frequency (1 cycle per degree). At low velocities (less than 2 degrees per s),
      the infants showed no clear preference for the moving stimulus over the
      stationary stimulus. At faster velocities (2-6 degrees per s), the infants
      exhibited a clear preference for the moving stimulus. The results were
      interpreted as indicating that infants at 3 months of age are relatively
      insensitive to slow motions for low spatial frequency stimuli.

PMID- 1757783
TI  - Recovery of susceptibility following audiogenic seizure in mice.
AB  - The rate at which SJL/J mice recover susceptibility following an initial sound
      induced seizure was examined. Fewer than 15% of the subjects seized when retested
      after a 2-min delay, and only 50% reseized after a 10-min delay. The likelihood
      of a second seizure was enhanced if the initial seizure exhibited a rapid
      progression to clonus. During the retest, seizures progressed more slowly than
      during the initial test, which indicates that recovery was not complete even if a
      second seizure was induced. Finally, recovery of seizure susceptibility was
      prevented as long as the subject continued to be exposed to intense auditory
      stimulation following the initial convulsion, an effect previously noted by
      Alexander and Kopeloff (1980). The findings are discussed in terms of a recently
      proposed central inhibitory model of the recovery of audiogenic seizure
      susceptibility.

PMID- 1757784
TI  - Factor structure of temperament in the third year of life.
AB  - The hypothesis that the nine dimensions of temperament defined by Chess and
      Thomas (1984) would emerge in a principal components analysis of maternal
      descriptions of 763 two-year-olds in a longitudinal study was not confirmed. The
      only component that bore any resemblance to the a priori dimensions of
      temperament proposed by Chess and Thomas was the sixth component--defining
      rhythmicity--in a Promax rotation. A higher order rotation to a two-factor
      solution produced components representing sociability and difficult behavior,
      respectively. It is argued that in the long term, these dimensions of temperament
      will, through the process of interaction with others, provide dimensions of
      personality identified by Hans Eysenck and his colleagues (1985).

PMID- 1757785
TI  - Protection against cadmium toxicity in yeast by alcohol dehydrogenase.
AB  - A cDNA expression library from Schizosaccharomyces pombe was transformed into
      Saccharomyces cerevisiae to screen for genes capable of conferring cadmium
      resistance to S. cerevisiae cells. The cDNA library was cloned into the S.
      cerevisiae expression vector pDB20 which is designed to express cDNAs via the
      constitutively-expressed promoter of the gene for alcohol dehydrogenase I (ADH1).
      Terminator and polyadenylation signals are also provided by the ADH1 gene.
      Cadmium resistant colonies were shown to arise by a recombination event leading
      to the exchange of the S. pombe DNA with the chromosomal ADH1 gene and a
      consequent dramatic increase in the ADH1 gene expression due to the high copy
      number of the plasmid. The overexpression of ADH1 effectively buffered the cells
      for cadmium ions by formation of Cd-ADH.

PMID- 1757786
TI  - Copper in biological systems. A report from the 6th Manziana Conference,
      September 23-27, 1990.
AB  - Enzymes and proteins: AO, amine oxidase; and as proposed in reference 3, BSAO,
      bovine serum AO; SSAO, swine serum AO; SKDAO, swine kidney AO; PSAO, pea seedling
      AO; APAO, arthrobacter P1AO; MADH, methylamine dehydrogenase; AAO, ascorbic acid
      oxidase; alpha-AE, alpha-amidating enzyme; Az, azurin; COX, cytochrome c oxidase;
      CP, ceruloplasmin; DBH, dopamine beta-hydroxylase; GO, galactose oxidase; Hc,
      hemocyanin; MT, metallotheonein; NIR, nitrite reductase; SOD, superoxide
      dismutase. Cofactors: Dopa, 3,4 dihydroxyphenylalanine; Topa, 3,4,6
      trihydroxyphenyl-alanine; PLP, pyridoxal-phosphate; PQQ, pyrroloquinolinequinone.
      Reagents: DDC, diethyldithiocarbamate; DMG, diaminoguanidine; DMSA,
      dimercaptosuccinic acid; NTA, nitrilotriacetic acid. Technique-related: XANES, x
      ray absorption near edge spectroscopy; EXAFS, extended x-ray absorption fine
      structure; ENDOR, electron-nuclear double resonance; ESEEM, electron spin echo
      envelope modulation; CD, circular dichroism; MCD, magnetic circular dichroism;
      NMRD, nuclear magnetic resonance dispersion; nqi, nuclear quadrupole interaction;
      DSC, differential scanning calorimetry.

PMID- 1757787
TI  - The effect of trithiomolybdate and some selenium compounds upon 109Cd labeled rat
      metallothionein in vitro: the possibilities for cadmium chelation therapy.
AB  - The main binding protein for 109Cd was metallothionein after in vitro incubation
      of various tissue cytosol preparations obtained from rats supplemented with zinc.
      The exception was heart cytosol where the label was associated with higher
      molecular weight proteins. The metallothionein-bound 109Cd was sensitive to
      trithiomolybdate and moved too higher molecular weight proteins, presumably
      because of the creation of new stronger ligands by the association of
      thiomolybdate with these proteins. The 109Cd binding was affected by selenate,
      selenite, and selenide while molybdate, sulphate, and thiosulphate were
      ineffective. It is proposed that thiomolybdates should be investigated for use in
      the therapy of in vivo cadmium toxicity because they can remove the accumulated
      metal from metallothionein.

PMID- 1757788
TI  - Astrogliosis in von Economo's and postencephalitic Parkinson's diseases supports
      probable viral etiology.
AB  - A marked generalized astrogliosis was observed in the frontal and temporal white
      matter from a case of von Economo's disease and another of postencephalitic
      Parkinson's disease, which areas were otherwise devoid of any other demonstrable
      microscopic lesions. No similar astrocytic reaction of any severity was observed
      in the same areas in a number of other brain diseases or controls, except when
      other kinds of lesions were present in the same section, with reactive astrocytes
      being present within the primary or defining lesion or immediately close by. The
      marked astrogliosis in von Economo's and postencephalitic Parkinson's diseases in
      areas "distant" from the primary lesions seeming to indicate extensive
      pathological involvement, added to the strong qualitative and quantitative
      similarity of this reaction to that observed in concurrently studied cases of
      encephalitides caused by the human immunodeficiency virus, lend further factual
      support to the hypothesis of a viral etiology, albeit unspecified, in both von
      Economo's and postencephalitic Parkinson's diseases.

PMID- 1757789
TI  - Mast cells in brains during experimental allergic encephalomyelitis in Lewis
      rats.
AB  - We studied the number of mast cells and their extent of degranulation in brains
      of Lewis rats with acute experimental allergic encephalomyelitis (EAE), activity
      induced with guinea pig spinal cord and Freund's complete adjuvant. Non-immunized
      controls and EAE rats were killed on days 10, 11, 12, and 16 post-immunization
      (p.i.). The percentage of degranulated mast cells was significantly increased in
      EAE brains. Signs of degranulation were observed as early as day 10 p.i. Clinical
      EAE signs appeared from day 10 p.i. A significant change in mast cell number was
      not observed. The percentage of degranulated cells was largest at day 16 p.i., at
      a time when the inflammation had reached the thalamus. This indicates that mast
      cell degranulation may occur as a result of the inflammation. Collectively, the
      data suggest that mast cells may play a role in the pathogenesis of EAE.

PMID- 1757790
TI  - Discrete lesions in the sensorimotor control system. A clinical-topographical
      study of lacunar infarcts.
AB  - In 50 patients with computed tomography-verified small, deep, lacunar, infarcts
      from a prospective stroke registry, we studied the lesion site in relationship
      with the clinical syndromes pure motor stroke, sensorimotor stroke and ataxic
      hemiparesis. Seventy per cent (95% confidence interval: 57-83%) of the lesions
      were located in the posterior limb of the internal capsule or adjacent
      paraventricular region, affecting the corticospinal tract in pure motor stroke,
      as well as the thalamocortical tract in sensorimotor stroke, and the cerebellar
      (dentato(rubro)thalamocortical and corticopontocerebellar) pathways in ataxic
      hemiparesis. This most frequently involved area is supplied by the anterior
      choroidal artery, indicating that this artery is the predominant deep,
      penetrating artery involved in small vessel disease causing lacunar stroke
      syndromes.

PMID- 1757792
TI  - Upbeat nystagmus: clinicopathological and pathophysiological considerations.
AB  - We describe an electro-oculographic study of upbeat nystagmus in 4 patients, with
      neuropathological correlation in one. All patients had lesions in the pontine
      tegmentum. The electro-oculographic data may be explained by imbalanced vertical
      vestibular or smooth pursuit eye movement control. The nystagmus stopped or
      reversed direction during convergence or in supine head positions. We propose
      that changes in the intensity or direction of upbeat nystagmus that are induced
      by convergence or changes in head position, are caused by vertical imbalance in
      the otolithic-ocular reflex, when superimposed on an imbalanced vestibulo-ocular
      reflex (VOR). Imbalance of the otolithic-ocular reflex and the vertical VOR are
      caused by damage in the pontomedullary tegmentum.

PMID- 1757791
TI  - Influence of age, gender, height and education on vibration sense. A study by
      tuning fork in 192 normal subjects.
AB  - We measured perception time of the vibratory stimulus from a 128 cps tuning fork
      in 96 male and 96 female normal subjects equally subdivided into 8 age decades.
      The following sites were examined: clavicula, olecranon, styloid apophysis of
      ulna and radius, anterosuperior spina of ilium, rotula (patella), internal and
      external malleolus. Reproducibility between different examiners and between tests
      by the same examiner on different days was good. There was a marked regional
      variation with longer perception times at the distal regions of upper limbs. A
      non linear age-related decrease in vibration sense was found in all regions.
      Males had longer perception times at clavicula, females at distal limbs; the
      latter finding might be explained by shorter stature in females. Perception times
      at distal limbs were longer in subjects with higher education levels. The study
      provides normative data for vibration sense in different regions and defines the
      effects on it of age, gender, height and education.

PMID- 1757793
TI  - The effect of pancreatic islet transplantation on experimental diabetic
      neuropathy.
AB  - Quantitative light and electronmicroscopical morphometric techniques were used to
      determine the effect of pancreatic islet transplantation on experimental diabetic
      neuropathy. Groups of STZ-diabetic rats were given islet transplants at 3 weeks
      after diabetes onset (prevention) and at 6 months after diabetes onset
      (reversal). Comparisons were made with onset controls, age-matched non-diabetic
      controls and untreated diabetic controls 6 months later (n = 8 for all groups).
      Euglycaemia and normal levels of glycosylated haemoglobin were achieved in both
      groups of diabetics after islet transplantation. Loss of body weight in diabetic
      animals was prevented by early islet transplantation, but was only partially
      reversed following delayed islet transplantation. Normal growth of myelinated
      fibres and axons during development was retarded in untreated diabetics, but was
      normal in rats given islet transplants soon after the onset of diabetes (cross
      sectional perimeter and area). Diabetics transplanted with islets after a delay
      had myelinated fibres and axons with diminished calibre. Teased fibre
      preparations of nerves from diabetics which had received islet transplants showed
      no excess of abnormalities. This study has shown that the development of certain
      structural abnormalities of peripheral nerve fibres is prevented in diabetic rats
      which receive transplants of islets of Langerhans soon after the onset of
      diabetes. However, once established abnormal fibre morphology can not be
      completely ameliorated merely by achieving and sustaining euglycaemia through
      delayed islet transplantation.

PMID- 1757794
TI  - Effects of 4-aminopyridine on protein phosphorylation in heat-blocked peripheral
      nerve.
AB  - The topical application of 4-aminopyridine (4-AP) reverses within 1-3 min the
      partial conduction block that results from heating 5-mm segments of rat posterior
      tibial, peroneal and sural nerves to 45 degrees C for several minutes. Nerves
      previously blocked in vitro or in vivo were incubated in vitro in the presence of
      [gamma-32P]ATP. The rate of phosphorylation of soluble nerve proteins that had
      entered the media was determined. Labeled proteins were separated
      electrophoretically and autoradiograms prepared. We found that 5 mM 4-AP
      increases the phosphorylation rate in heat-blocked nerve by approximately 50
      fold. The process is calcium-dependent and is heat-labile. Soluble proteins with
      a molecular weight in the 53-55 kDa range are preferentially but not exclusively
      phosphorylated in the presence of 4-AP at levels effective in restoring
      conduction. The results suggest that the potassium channel blocker 4-AP may
      restore conduction by inducing changes in channel proteins.

PMID- 1757795
TI  - Increased growth of myoblasts from hypertrophic muscles in syringomyelia.
AB  - Proliferation and differentiation of myoblasts from hypertrophic muscles were
      studied "in vitro" in two cases of syringomyelia with muscle hypertrophy (MH).
      Their myoblast growth was compared with that of muscle cells sampled on the
      contralateral side in the same patients and in control subjects. The effect of a
      circulating factor was tested using patient sera in place of fetal calf and horse
      sera. The results showed that MH cells were morphologically abnormal (giant and
      granular). MH myoblasts proliferated more rapidly than contralateral and normal
      myoblasts, their fusion was accelerated and the resulting myotubes synthesized
      higher levels of protein. MH sera increased these effects. Serum factors are
      therefore likely to be involved in "in vivo" muscle hypertrophy. These findings
      suggest that the pathogenesis of muscle hypertrophy in syringomyelia involves
      acquired abnormalities due to molecules released in response to neural lesions.

PMID- 1757797
TI  - Distribution of calcium in central nervous system tissues and bones of rats
      maintained on calcium-deficient diets.
AB  - Current changing epidemiological pattern in the Western Pacific area suggests a
      contribution of the environmental factors to the pathogenetic process of
      amyotrophic lateral sclerosis (ALS). The condition of unbalanced mineral levels
      found in the soil and drinking water samples from the ALS foci showing low
      content of calcium (Ca) and magnesium (Mg) plus high content of aluminum (Al) was
      experimentally mimicked in this study using rats. In the groups fed low Ca, low
      Ca-Mg, and low Ca-Mg plus high Al diets, serum Ca levels were lower than that in
      the group fed the standard diet. Ca content of CNS tissues showed higher values
      in the unbalanced diet groups, especially in the spinal cord of low Ca-Mg plus
      high Al diet group, than those in the standard diet group, determined by
      inductively-coupled plasma emission spectrometry (ICP). Ca content in heart,
      liver, kidney, and abdominal aorta in groups fed low Ca-Mg, and low Ca-Mg plus
      high Al diets was higher than that in low Ca, and standard group. Ca content in
      muscle in the three unbalanced diet groups was significantly higher than in the
      standard diet group. Ca and Mg contents in lumbar spine and cortical bone showed
      lower values in the unbalanced diet groups than those values in the standard diet
      group. These findings suggest that under the condition of derangement of bone
      mineralization induced by unbalanced mineral diets fed to the experimental rats,
      Ca and Mg may be mobilized from bone, keeping their content in soft tissues,
      including CNS tissue, for utilization of vital activities, thereby resulting in a
      deposition of Ca while maintaining an almost normal value of magnesium in the CNS
      tissues.

PMID- 1757796
TI  - Fibronectin in plasma and CSF: evidence for its intrathecal synthesis.
AB  - A new methodology, using electroimmunodiffusion, has been described for the
      determination of fibronectin (Fn) in plasma and CSF. Fn was determined in the
      plasma of 35 normal subjects, and in the plasma and the CSF of 86 patients: 10
      controls, 17 definite MS, 15 other inflammatory processes, 11 degenerative
      diseases, 13 peripheral neuropathies and 20 other neurological diseases. The
      normal mean was 354 +/- 53 micrograms/ml in plasma, not influenced by sex or age,
      and in the CSF 2.3 +/- 0.85 micrograms/ml. A significant increase of plasma Fn
      was observed in each of the patients-group. In the CSF an increase of Fn was
      observed predominantly in inflammatory processes but not in MS. An intrathecal
      synthesis of Fn was established in 24/76 patients, most often in inflammatory
      (9/15) processes but rarely (3/17) in MS. The intrathecal synthesis was suspected
      from the CSF Fn/CSF Albumin ratio and calculated using a formula derived from the
      principles previously described for IgG intrathecal synthesis. It represents the
      principal source of Fn increase in the CSF. In all inflammatory processes
      (including MS) the eventual influence of corticoids, immunosuppressive or anti
      inflammatory drugs has not been established. The significance of the CSF Fn level
      in MS is discussed with regard to the recent demonstration of its presence within
      MS lesions and on macrophages in plaques.

PMID- 1757798
TI  - Enhanced proteolytic activities in cultured fibroblasts of Alzheimer patients are
      revealed by peculiar transketolase alterations.
AB  - Characteristic alterations of transketolase (TK) in extracts from cultured
      Alzheimer fibroblasts have previously been reported (Paoletti et al. (1990)
      Biochem. Biophys. Res. Commun., 172: 396-401). These abnormalities, encountered
      in 9 out of 13 Alzheimer patients, were revealed following isoelectric focusing
      and consisted of enzyme forms having unusually high alkaline pI values (alkaline
      bands). The present work has shown that immunologically detected alkaline bands
      were progressively expressed when Alzheimer fibroblasts were incubated for three
      weeks without medium changes. Full expression of the altered enzyme pattern was
      not linked to relative cell density in the petri dish; rather, it appeared to be
      dependent directly on the time elapsed since cell confluence was reached.
      Alkaline bands could artificially be induced also in both crude and pure TK
      preparations from normal cells by a treatment with commercial proteases,
      particularly chymotrypsin. Moreover, specific inhibitors of endogenous cysteine
      proteases were capable of abolishing TK alkaline bands in Alzheimer fibroblasts
      thus turning a pathological into a normal enzyme pattern. Results obtained
      suggest that Alzheimer fibroblasts contain enhanced Ca(2+)-independent cysteine
      proteolytic activities as compared to normal and other pathological cells. These
      enzymes, exhibiting chymotrypsin-like activity, might exert their degradative
      effects at the time of cell extraction using TK and probably other cell
      components as potential substrates. However, peculiar TK abnormalities represent
      so far an useful biochemical marker detectable in fibroblasts of living Alzheimer
      patients and closely associated to this neurological disorder.

PMID- 1757799
TI  - Arabinitol enantiomers in cerebrospinal fluid.
AB  - D-Arabinitol is a metabolite of Candida species, and its presence in serum above
      endogenous concentration may indicate disseminated candidiasis. The o
      trifluoroacetylated derivatives of arabinitol enantiomers in cerebrospinal fluid
      (CSF) were separated using perpentylated cyclodextrin capillary columns and
      measured by selected ion monitoring using negative chemical ionization mass
      spectrometry. The presence of D-arabinitol was confirmed using highly specific D
      arabinitol dehydrogenase. The mean D/L-arabinitol ratio, 16.7 +/- 4.8 (range: 8.6
      22.8), in CSF of the "controls" is approximately 10-fold higher than the ratio
      previously found in normal serum and urine. At the same time, the mean L
      arabinitol concentration, 0.13 +/- 0.05 (range: 0.09-0.2), is virtually identical
      to that in serum. Therefore, the high D/L-arabinitol ratio in CSF is attributed
      to D-arabinitol. Persistently high D/L ratios were found in a variety of diseases
      (without Candida infection). The finding of D-arabinitol in CSF suggests that
      serum D-arabinitol may originate from the brain or the spinal cord, rather than
      from resident Candida species in the gut, and that the accumulation of D
      arabinitol in CSF may be caused by non-consumption or, conversely, the high
      concentration may be maintained in order to have it readily available for
      metabolism in the brain.

PMID- 1757800
TI  - The molecular genetics of familial Creutzfeldt-Jakob disease in France.
AB  - Five French families with Creutzfeldt-Jakob disease (CJD) were found to have
      either of 2 different point mutations (at codons 178 and 200) in the amyloid
      precursor gene (PRNP) on chromosome 20. The ancestry of these and other CJD
      families outside of France suggests that the codon 178 mutation had a northern
      European origin, while the codon 200 mutation originated in central Europe and
      the Mediterranean basin. Evidence is presented that the mutations either cause or
      predispose to familial forms of CJD, and also influence their phenotypic
      expression, although considerable clinical and neuropathological heterogeneity
      may occur between and even within families having the same mutation. Experimental
      transmission of disease was successful in 4 of 5 inoculated cases, comparable to
      the transmission rate in sporadic CJD.

PMID- 1757801
TI  - A case of intracranial chordoma associated with pituitary adenoma.
AB  - We report a patient who had pituitary adenoma and parasellar chordoma
      coincidentally, with neither irradiation nor a history of head injury.
      Preoperative computed tomographic (CT) scan had shown an intrasellar mass that
      infiltrated into the right cavernous sinus. Histopathologically the intrasellar
      mass was diagnosed as pituitary adenoma and the other mass as chordoma. We
      present clinical, radiological and histopathological findings, and discuss
      previously reported cases with multiple intracranial tumours.

PMID- 1757802
TI  - Contralateral extradural hematoma following craniotomy for traumatic intracranial
      lesion. Case report.
AB  - The authors report the case of a patient in whom a contralateral extradural
      hematoma developed immediately after craniotomy for a traumatic intracranial
      lesion. Contrary to other reported cases but one, intraoperative brain bulging
      was not observed in this case. The pathophysiology of this complication is
      discussed. Immediate postoperative CT scan in patients who do not improve as
      expected is recommended for the early detection of this complication.

PMID- 1757803
TI  - A cervico-dorsal intramedullary epidermoid cyst. Case report and review of the
      literature.
AB  - Intramedullary epidermoid cysts are rarely observed. Only a little more than 30
      cases have been reported in the literature. The authors have treated a 51 year
      old woman with a cervico-dorsal intramedullary epidermoid tumor associated with a
      syringomyelia. The frequency of this lesion, its CT and MRI appearance and the
      possibility of a preoperative diagnosis are discussed.

PMID- 1757804
TI  - Aspergillosis of spine. A case report.
AB  - Aspergillosis of spine is a very rare entity generally seen secondary to a
      primary focus in the lung with or without immune suppression. The authors report
      one case of aspergillosis of spine without evidence of a primary elsewhere or a
      predisposing cause.

PMID- 1757805
TI  - Posttraumatic diffuse cerebral lesions. Relationship between clinical course, CT
      findings and ICP.
AB  - One hundred and fifty patients with posttraumatic diffuse cerebral lesions were
      reviewed. Criteria of inclusion were immediate coma and CT appearance of diffuse
      lesions, that were classified as follows: (a) Diffuse axonal injury (70 cases):
      patients with normal CT scan (50 cases) and patients with shearing injury (focal
      hemorrhages in corpus callosum, basal ganglia and brain stem; gliding contusions)
      (20 cases); (b) Diffuse brain swelling (80 cases): reduced or absent lateral
      ventricles, absence of 3rd ventricle and basal cisterns. Many of these patients
      had either subarachnoid haemorrhage or subdural blood effusion. Clinical course
      and mortality rate were in a ranking order in the considered groups. Patients
      with normal CT had a less severe coma and a better outcome than patients with
      shearing injury and diffuse brain swelling. There was evidence of high
      intracranial pressure in 75% of the patients with brain swelling, whereas no
      patient with normal CT had ICP elevation. Diffuse axonal injury represents a
      primary posttraumatic diffuse lesion. Secondary vascular involvement, due to
      hypoxia, shock and other unknown causes, is responsible for the appearance of
      vasoparesis, hyperemia and diffuse brain swelling.

PMID- 1757806
TI  - Validation of a prognostic system in severe brain-injured patients.
AB  - Seventy-six patients with severe isolated head trauma (GCS score of 7 or less)
      were prospectively studied in order to valuate the prognostic power of the APACHE
      II system. In nonsurvivor patients the APACHE II score was higher than in
      survivor patients (24.7 +/- 3.2 (SD) vs 18.7 +/- 3.1; p less than .001). With an
      APACHE II cut-off point of 20 the sensitivity was 100% and the specificity was
      70% while a cut-off point of 21 the sensibility decreased to 97.2% but the
      specificity increased to 72.5%. We conclude that the APACHE II is an effective
      mean to predict the prognosis of severe brain-injured patients.

PMID- 1757807
TI  - Nonsuture closure of arterial defect by vein graft using isobutyl-2-cyanoacrylate
      as a tissue adhesive.
AB  - Nonsuture repair of intracranial blood vessel is still a challenging issue in
      neurosurgery. In this experimental study isobutyl-2-cyanoacrylate was used for
      nonsuture repairing of carotid artery to observe its histotoxicity. Isobutyl-2
      cyanoacrylate was dropped over the edge of defect on carotid artery of rat under
      the surgical microscope and jugular vein was placed to cover the defect. Rats
      were divided in 6 group according to postoperative survival period (2, 5, 7, 14,
      21, 28 days respectively). The carotid arteries were patent of all rats according
      to angiography and autopsy specimen. Histopathological results showed that: the
      changes are mainly inflammatory respons +, there was no necrotic tissue at any
      time the healing progress and no significant differences in the vein graft.
      Therefore isobutyl-2-cyanoacrylate is considered helpful and safe adhesive
      material for the nonsuture repair of blood vessel.

PMID- 1757808
TI  - Laser therapy for the treatment of brain tumors.
AB  - The author examine the specific cases where laser therapy may be indicated for
      the treatment of brain tumors. The different types of lasers currently available
      are described and the effects on the tissue, at different powers and with
      different modalities of use, are reported. On the basis of experience reported in
      literature, the Author describes the characteristics and the fields of
      application of the 1.32 nm Nd:YAG laser, the superpulse CO2 and the Nd:YAG with
      sapphire tips for contact laser surgery. The advantages of laser surgery as
      opposed to the traditional techniques in the most frequently observed tumors, are
      also described.

PMID- 1757809
TI  - Postoperative CSF problems after spinal and lumbar surgery. General review.
AB  - Although the dura is frequently traumatized in surgery, and during lumbar
      punctures, it is surprising that the "CSF problem" is a rare complication in the
      surgical treatment for herniated intervertebral disc (0.1%); and exceptionally
      rare at cervical or dorsal level. In the upright position the CSF pressure at the
      site of the potential leak is greater in the lumbar region, lumbar operations are
      more frequently performed than cervical, and, perhaps, also because cervical
      operations are performed by fewer surgeons with greater specific experience. The
      purpose of this work is to describe the etiopathology, the symptomatology, the
      diagnosis and treatment of early and delayed CSF problems.

PMID- 1757810
TI  - Acute spontaneous subdural haematoma. Description of four clinical cases.
AB  - Four cases of acute spontaneous subdural haematoma are described. A review of the
      literature reveals the rarity of this pathology. The several etiological
      possibilities are discussed. The clinical onset may simulate other
      cerebrovascular diseases. The prognosis is correlate to the neurological findings
      at the operations.

PMID- 1757811
TI  - A window of opportunity.

PMID- 1757812
TI  - Phases of second stage labor. Four descriptive case studies.
AB  - In recent years, the second stage of labor has become an area of interest to a
      number of observers who have described divisions or phases with behavioral
      characteristics. Using a descriptive case study design, four normal nulliparous
      women in spontaneous second stage labor were videotaped from the occurrence of
      involuntary bearing-down efforts or the recognition of complete cervical dilation
      until birth. Analysis of these videotapes, the accompanying narrative
      transcripts, and uterine monitor tracings provided evidence that some behaviors
      changed over the progression of the second stage. These changes could be divided
      into three behavioral phases that the nurse/midwife can identify in order to
      recognize the typical pattern of progression and possible deviations from normal.

PMID- 1757813
TI  - Certified nurse-midwifery care of the postpartum client. A descriptive study.
AB  - This article presents the findings of a small, descriptive, exploratory study
      aimed at identifying the content and process components of certified nurse
      midwifery care in the postpartum period. The conceptual framework, methods, and
      analysis were derived from the research of E.J. Lehrman, who identified
      components of CNM antepartum care. Lehrman's components of prenatal care were all
      found to be present in the postpartum period, but new data emerged. These data
      generated three distinctively new categories, ie, therapeutic techniques, lateral
      relationship, and empowerment. Albeit from a small study, our findings support
      previous research suggesting aspects of CNM care that might be partially
      responsible for improved perinatal outcome documented in various populations
      where CNM care has been established. The article concludes with a discussion of
      these implications for practice and the need for further definition of the
      profession of nurse-midwifery.

PMID- 1757814
TI  - Bacterial vaginosis and its implication in preterm labor and premature rupture of
      membranes. A review of the literature.
AB  - Preterm delivery continues to occur in 5% to 10% of all births, with a perinatal
      mortality rate between 50% and 80%. In recent years, the role of infection with
      lower genital tract organisms in precipitating preterm labor/delivery and
      premature rupture of membranes has come under considerable study. This article
      reviews the mechanisms by which infection may play a role in these problems, with
      a specific focus on bacterial vaginosis. Clinical management issues are
      addressed, including screening of prenatal patients, diagnostic criteria, and
      treatment possibilities.

PMID- 1757815
TI  - Laryngeal papillomas in infants and children. Relationship to maternal venereal
      warts.
AB  - A variety of studies has been directed at establishing the association between
      human papillomavirus (HPV), as manifested in the adult as a sexually transmitted
      disease, and laryngeal papillomas found in infants and children. In spite of
      substantial evidence for the transmission of HPV from women to their infants
      during childbirth, this association remains unknown to most clinicians in the
      specialty areas of childbearing and pediatrics. Nurse-midwives find evidence of
      venereal warts in 1% to 35% (1) of their pregnant clients, depending upon the
      subpopulation under consideration. A potential sequela of this common gynecologic
      finding is the growth of papillomas in the larynx of infants who are born to
      these women. Such growths are not immediately apparent and may be quite difficult
      to diagnose when they usually become symptomatic, between the ages of two and
      five years. Clinical symptoms are similar to pediatric findings in croup, asthma,
      and common upper airway infections. Education of both clinicians and patients
      regarding potential risks to progeny of infected adults will serve to guide
      diagnostic attempts in the pediatric population.

PMID- 1757816
TI  - Fatigue in early pregnancy. An exploratory study.
AB  - The experience of fatigue in early pregnancy was studied, using a general model
      of fatigue as the conceptual framework. A convenience sample of 30 women, age 20
      35 years, who were at less than 20 weeks' gestation and without health problems
      were included in the study. Physiologic, psychological, and environmental factors
      were measured and related to the occurrence and intensity of fatigue. Pearson
      correlations and content analysis were used to analyze the data. Results showed
      that a large portion of the sample (90%) experienced fatigue and that this
      fatigue had a significant impact on their ability to maintain personal and social
      activities. Significant correlations were observed between fatigue and the
      physiologic variables of nausea and feeling tired upon awakening from sleep.
      There was no significant relationship between fatigue and environmental variables
      such as number of hours worked or the number of children living in the home. In
      addition, significant correlations were observed between fatigue and
      psychological variables that included depression, anger, anxiety, and confusion.
      These data suggest that fatigue is a significant problem for pregnant women and
      is not relieved by rest. These data further suggest that the fatigue may be
      related to other physiologic changes, perhaps hormonal, that mediate physiologic
      and psychological variables, including fatigue.

PMID- 1757817
TI  - The importance of non-master's degree options in nurse-midwifery education.

PMID- 1757818
TI  - Hospital setting for birth and use of medical procedures in low-risk women.
AB  - This study examined the use of selected medical procedures in low-risk women
      during childbirth. Data from the 1980 National Natality Survey merged with an
      American Hospital Association annual survey for the same year were used to assess
      the frequency with which low-risk women in the United States received certain
      childbirth procedures and to determine whether their use varied by the hospital
      setting for birth. Stratified analysis was used to assess the relation of
      hospital level for delivery with the use of electronic fetal monitoring, labor
      induction, and primary cesarean delivery in low-risk women, with control for
      potential confounding factors. As the level of available perinatal technology
      increased, the use of these procedures increased. Results of the study suggest
      that low-risk women may have received excess interventions and confirm the need
      for further examination of care procedures for this group.

PMID- 1757819
TI  - Early maternal attachment behaviors of adolescent and adult mothers.
AB  - This comparison of observed attachment behaviors of 184 medically indigent, low
      risk, inner-city adolescent and adult mothers addresses three critical questions
      unanswered by current research regarding the maternal attachments behaviors of
      adolescents. The 69 mothers aged 14 to 17 and the 36 mothers aged 18 to 19
      exhibited significantly fewer maternal attachment behaviors during in-hospital
      infant feedings than a control group of 79 mothers aged 20 to 24. Verbal reports
      of adolescent and adult mothers were not reliable indicators of actual attachment
      behaviors. Two-way analyses of variance, statistically controlling for other
      background factors and amount of infant contact, did not diminish the impact of
      maternal age. However, rooming-in and educational levels appropriate for age both
      had additional independent impacts on maternal attachment scores.

PMID- 1757820
TI  - Prevention of infant mortality. An agenda for nurse-midwifery.
AB  - A major health objective of the United States government and the World Health
      Organization is the reduction of infant mortality by the year 2000. Significant
      progress in the reduction of infant mortality has been made internationally
      simply as a consequence of general improvements in public health and nationally
      as a consequence of increased technological sophistication. Recently, however,
      there has been an attenuation in the rate of decline, and it becomes necessary to
      address the unsolved issues that continue to affect morbidity and mortality in
      the first year of life. Year 2000 objectives related to infant mortality include
      the reduction of low birth weight and increasing access to prenatal care.
      Socioeconomic, behavioral, medical, and obstetric factors associated with low
      birth weight and lack of prenatal care are cited. Personal and political agenda
      targeted to the achievement of the public health goals are proposed.

PMID- 1757821
TI  - Postpartum patients' knowledge, risk perceptions, and behaviors pertaining to
      childhood injuries.
AB  - The purpose of this study was to assess postpartum patients' knowledge, risk
      perceptions, and behaviors pertaining to a variety of childhood injuries.
      Although the respondents did demonstrate some knowledge of injury prevention
      strategies, deficits were noted in the areas of burns, motor vehicle injuries,
      drownings, and falls, as well as in the concept that injuries, in some children,
      are unavoidable. Results showed that greater than 50% of mothers did not know the
      temperature of their hot water tank, 22.4% who had other children under the age
      of four did not use car safety seats with them, and only 43% of the mothers knew
      how to perform infant cardiopulmonary resuscitation. Recommendations for program
      development in parenting classes are included in addition to the roles of nurses
      and nurse-midwives in injury prevention program activities.

PMID- 1757822
TI  - Maternal-fetal conflicts. Ethical and legal implications for nurse-midwives.
AB  - The problem of maternal-fetal conflict presents both ethical and legal challenges
      to birth attendants as well as to policymakers. This essay suggests that a crisis
      intervention approach to such conflicts fosters an adversarial view of the
      relationship between the pregnant woman and her fetus, which can be divisive and
      counterproductive. A better approach to maternal-fetal conflicts emphasizes
      mutually held goals rather than countervailing rights and uses the doctrine of
      informed consent to enhance the pregnant woman's ability to make responsible
      choices for both herself and her fetus. Nonphysician birth attendants can take a
      leading role by employing client-centered professional values to develop and
      extend this cooperative approach to maternal-fetal conflicts.

PMID- 1757823
TI  - Midwives' role in safe motherhood.

PMID- 1757824
TI  - An overview of nurse-midwifery education and accreditation.

PMID- 1757825
TI  - Management of the nuchal cord in relation to vaginal delivery.

PMID- 1757826
TI  - One out of every nine women ...

PMID- 1757827
TI  - Rationale for the revision of oxytocin administration protocols.
AB  - A physiologic rationale, based on a review of the literature, is provided for
      implementing a protocol for labor induction or augmentation with intravenous
      oxytocin infusion. Oxytocin dosage should simulate the amount normally released
      endogenously during labor. Recent studies suggest that smaller dose regimens are
      as effective as previous larger dose regimens and that adverse effects of
      oxytocin are dose related. Nurses must know the relationship between the
      physiology of normal labor and the pharmacokinetics and safe administration of
      oxytocin during labor.

PMID- 1757828
TI  - HIV-seropositive childbearing women. Nursing management.
AB  - With the implementation of the recommendation of the American College of
      Obstetricians and Gynecologists to screen all women who are at increased risk for
      HIV infection, more asymptomatic infected women will be identified. Obstetric and
      neonatal nurses who learn more about maternal and infant HIV infection can
      determine effective nursing interventions. Early planning is necessary to ensure
      that individualized, comprehensive care is available upon discharge.

PMID- 1757829
TI  - Creating a unit-specific charging system.
AB  - A totally nurse-dependent charging system developed specifically for the labor
      and delivery suite at the University of Maryland Medical System is described in
      the article. This easy and effective method of charging was incorporated into an
      already existing patient census and classification system. The number of relative
      value units has increased by more than 30%, and the amount of revenue billed has
      increased by more than $800,000 in the first 10 months after implementation.

PMID- 1757830
TI  - Maternal confidence in coping with labor. A self-efficacy concept.
AB  - The clinical study of labor pain suggests that a woman's confidence in her
      ability to cope with labor contributes significantly to her perception of pain
      during labor. Self-efficacy theory is examined as a framework for evaluating
      women's confidence in their ability to cope with labor. The major propositions of
      self-efficacy theory are described and related to the experience of women
      approaching labor. The implications for nursing practice are presented, and
      directions for the study of maternal confidence are proposed.

PMID- 1757831
TI  - Infant responses to saline instillations and endotracheal suctioning.
AB  - The study examined the effects of endotracheal suction with and without saline
      instillation on neonates with respiratory distress. In a completely
      counterbalanced factorial-within-subjects design, 27 intubated neonates were
      randomly assigned to two orders of presentation of treatment conditions. Heart
      rate and blood pressure were continuously recorded throughout both treatment
      conditions. The ratio of arterial oxygen tension to alveolar oxygen tension was
      used to assess oxygenation. Results indicated that clinically stable newborns
      tolerated instillations of 0.25-0.5 ml. The suctioning protocol used in this
      study minimized changes in infants' heart rates and blood pressures.

PMID- 1757832
TI  - Breastfeeding and employment.
AB  - Breastfeeding problems, outcomes, and satisfaction of married, well-educated
      first-time mothers who returned to work within six months postpartum were
      compared to those of mothers with the same characteristics who stayed at home.
      Mothers who planned to work after giving birth anticipated and experienced
      shorter durations of breastfeeding than did those who planned to remain at home.
      Breastfeeding experiences and satisfaction among working mothers differed little
      from the experiences and satisfaction of their nonworking counterparts; however,
      employment prior to two months postpartum exerted some negative effects on
      breastfeeding outcomes.

PMID- 1757833
TI  - The role of nursing in preventing violence against women.
AB  - Violence against women is a significant problem at every age. While nurses have
      increased their role in identifying and managing cases of women who have
      experienced physical and sexual abuse, they have been less active in preventing
      violence. Effective prevention requires an understanding of the prevalence and
      seriousness of the problem, awareness of the societal forces that foster and
      sustain it, and application of feminist principles to counteract those forces.
      The incidence of rape and battery in contemporary society is highlighted, and the
      societal forces of devaluation of women, power inequity, and treatment of women
      as property that maintain this destructive behavior are outlined. Preventive
      nursing actions derived from feminist philosophy that are applicable in clinical
      practice are discussed.

PMID- 1757834
TI  - The gastrointestinal management of patients undergoing heart transplantation.
AB  - Between March 1985 and December 1989, 86 patients underwent heart (80) or heart
      lung (6) transplantation. Thirty-seven (43%) developed one or more significant
      gastrointestinal problems. Dyspepsia and gallbladder disease were common, but
      easily managed. Cytomegalovirus disease occurred in 25 patients (29%) and
      required aggressive investigation and early therapy with ganciclovir; all
      patients so treated responded satisfactorily. Features of acute peritonitis were
      seen in 6 patients and required exploratory laparotomy in 4. Non-Hodgkin's
      lymphoma of the stomach in one patient has regressed following a combination of
      reduction in immunosuppressive therapy and a course of chemotherapy. The
      development of hepatitis or severe liver dysfunction of unknown cause has been
      associated with significant morbidity and mortality. Since this study was
      undertaken, the incidence of gastrointestinal complications has been greatly
      reduced by modifications to our immunosuppressive and anti-infection prophylactic
      drug protocols. Nevertheless, such complications still occur and it is important
      that the gastroenterologist should understand the need for urgent and intensive
      investigation and therapy.

PMID- 1757835
TI  - Comparison of antimicrobial susceptibilities among hospitalized and nursing home
      patients from Oklahoma.
AB  - Antimicrobial susceptibility results were compared for 13,090 isolates recovered
      from patients of Oklahoma hospitals and nursing homes. The most striking results
      confirm earlier suspicions that nursing home patients represent the largest pool
      of methicillin-resistant (greater than 60%) Staphylococcus aureus.

PMID- 1757836
TI  - HIV seroprevalence in Oklahoma childbearing women.
AB  - From October 1989 through September 1990, we conducted an unlinked seroprevalence
      survey in Oklahoma to determine the prevalence of human immunodeficiency virus,
      type 1 (HIV) in women at the time of childbirth. Blood specimens obtained from
      41,809 newborns in conjunction with the state's newborn metabolic screening
      program were tested for HIV after personal identifiers were removed. The overall
      HIV seroprevalence rate was 0.02% (10/41,809). Rates were highest for mothers
      aged 30 to 39 years (0.06%, 3/5,158). No difference was found between the HIV
      seroprevalence rates for women residing in standard metropolitan areas (MSAs) of
      the state (0.03%, 6/21,105) and women residing in non-metropolitan areas (0.03%,
      3/11,904). When compared to other states where surveys have been done, Oklahoma's
      rate of HIV infection in childbearing women was low.

PMID- 1757837
TI  - Endometrioid carcinoma arising in endometriosis after 21 years: a case report.
AB  - Endometriosis is an odd disease that is at times devastating in the destruction
      of surrounding tissue. Yet, in contradiction, other cases are widespread,
      longstanding, benign, and totally asymptomatic. It has been reported throughout
      the body.

PMID- 1757838
TI  - On a wrong right.

PMID- 1757839
TI  - Principles of oncology: how radiation therapy works.
AB  - Radiation therapy remains the primary mode of treatment for many types and stages
      of cancer as well as playing an extremely important adjunct role in the treatment
      of many other malignancies, often in combination with medical and surgical
      oncology. The combination treatments often yield cure and long-term control rates
      far in excess of single modality treatment.

PMID- 1757840
TI  - The failed appointment.
AB  - OBJECTIVE: To determine reasons for failed internal medicine clinic appointments.
      DESIGN: A retrospective telephone survey of patients within one month of a failed
      appointment. SETTING: An ambulatory teaching clinic for indigent patients staffed
      by 30 internal medicine residents where patients have scheduled visits every 30
      minutes. PATIENTS/PARTICIPANTS: From the 1,622 scheduled patient visits, the
      names of 405 patients who failed their appointments were selected for further
      contact. Successful contact was established with 100 patients. MEASUREMENTS AND
      MAIN RESULTS: The patients completed a telephone survey administered by residents
      and students regarding demographics, general health, reasons for failed
      appointment, and satisfaction with the clinic. Transportation problems accounted
      for 13% of missed visits, forgetfulness accounted for 11%, personal or family
      illness and rescheduling problems accounted for 8% each. Miscellaneous reasons
      accounted for the remainder. Seventeen percent of patients who missed their
      appointments feared the encounter, but none volunteered this as a reason for
      their no-show. Fifty-one percent of patients felt that the failed appointments
      could not have been prevented. Ninety percent of those surveyed were satisfied
      with their clinic physician, and 82% were seen on-time when appointments were
      kept. CONCLUSIONS: Lack of transportation appeared to be the most prohibitive
      factor in continuity of care among this indigent population. Patients are
      generally seen on-time and are satisfied with their care. Financial pressure does
      not appear to keep people away. Fear of the physician encounter and forgetfulness
      may be areas for improved patient education.

PMID- 1757841
TI  - [A case report of lymphoepithelial cyst in the parotid gland].
AB  - A 57 year-old Japanese male was seen with the chief complaints of left parotid
      gland swelling, pain, trismus. At the initial visit, a subcutaneous mass,
      measuring 50 x 70mm, was seen in the left parotid region. The mass was moderately
      tender and the consistency was soft anteriorly and elastic firm posteriorly. The
      mobility was restricted with no change in the skin covering the mass. The saliva
      from the left parotid gland was normal in colour and contents. Various imaging
      modalities were done preoperatively including CT, MRI, ultrasonography and
      aspiration biopsy under the ultrasonographic guide. None was thus conclusive for
      the differential diagnosis and our tentative diagnosis was a cystic lesion in the
      parotid gland. A partial parotidectomy was performed under general anesthesia and
      the cystic lesion, measuring 20mm in diameter, was found in the deep lobe. The
      cyst showed no connection to the external ear canal, and tracts and fistulae were
      absent. Histopathological report lead to the definite diagnosis of
      lymphoepithelial cyst. A mild and incomplete facial palsy on the left had been
      noted for more than 10 years and this, however, improved after the surgery.

PMID- 1757842
TI  - [Application of fuzzy theory for optokinetic pattern test].
AB  - The optokinetic pattern test for optokinetic nystagmus is performed to diagnose
      equilibrium disorders on clinical examination. We constructed computer assisted
      instruction (CAI) algorithm based on knowledge of expert for optokinetic pattern
      (OKP) diagnosis theoretically based Fuzzy reasoning derived from Fuzzy theory to
      ascertain the possible application of CAI to OKP and to develop a useful
      diagnostic tool. The algorithm was constructed by rules of fuzzy reasoning using
      analysed data of diagnostic modes of one expert, consisting of six variables, and
      of 30 normal and 22 abnormal patterns of optokinetic nystagmus which were
      diagnosed by the expert. The results derived from the fuzzy reasoning and those
      obtained by expert agreed with 96% in this test battery. In addition, a
      consistency of 87.3% was obtained after comparison with another 251 OKP patterns
      which diagnosed by the same expert and estimated by this algorithm. This
      algorithm incorporating fuzzy theory is concluded to be useful in obtaining
      results of the same as those of an expert for diagnosing the equilibrium
      disorders. Furthermore, CAI using Fuzzy theory is confirmed to have good
      potential as a diagnostic tools.

PMID- 1757843
TI  - [Effects of frequent antral lavage on chronic sinusitis in children].
AB  - Eighty cases of pediatric sinusitis (4 to 15 years old, averaged 8 years old)
      were treated with frequent antral irrigations. Antral puncture was made through
      the inferior meatus with a Kyoto University needle under topical or general
      anesthesia. Then a plastic tube of 14G Medicut intravenous cannula was left in
      place to serve as an indwelling catheter. Antral lavages were performed through
      this tube 3 times daily for 7 to 10 days. The opacity of the maxillary sinus at
      post-treatment was improved significantly compared with that at pre-treatment in
      Waters view. This improvement was continued even at about 5.7 months after
      treatment. The opacity of the ethmoid sinus was also improved significantly after
      the treatment in occipito-frontal view. Our results suggest that the frequent
      antral lavage is an useful therapeutic modality for pediatric sinusitis.

PMID- 1757844
TI  - [A comparative study between the clinical and autoptic findings in cases with
      malignant tumor in the head and neck].
AB  - In 106 autopsies of patients in Kitasato University Hospital from 1974 to 1989,
      who had died of malignant tumor in the head and neck, the relationship between
      the clinical diagnosis and its autoptic finding was retrospectively investigated.
      The result was summarized as follows. 1. Characteristics in 98 cases other than
      malignant lymphoma: 1) Local recurrence was detected by autopsy in 60 cases (61%)
      among 98. Discrepancy between clinical diagnosis and autoptic findings was
      recognized in 10 cases (10%), in whom 4 false positive cases by clinical
      diagnosis were included and it was considered that the rate was relatively high.
      2) The metastatic lymph nodes were demonstrated by autopsy in 50 cases (51%).
      Discrepancy between clinical diagnosis and autoptic findings was found in 37
      (38%), 35 of them were clinically diagnosed to be negative. However, in 35 of
      them it was considered that the discrepancy had not influenced their fatal
      courses. 3) Metastases to distant organs were demonstrated by autopsy in 49
      (50%). Discrepancy between clinical diagnosis and autoptic findings was found in
      39 (40%). 33 of them were clinically diagnosed to be negative. The discrepancy
      concerned with the causes of death was shown in 5 cases. 2. Characteristics in 8
      cases of malignant lymphoma: Discrepancy between clinical diagnosis and autoptic
      findings of distant metastases was frequently observed but the discrepancy
      concerned with the causes of death was not shown. There were 2 cases in which
      side effect of chemotherapy may cause poor prognosis.

PMID- 1757845
TI  - [Effects of intravenous injection of salicylate on the spontaneous discharge rate
      of the cochlear nerve].
AB  - This study was aimed to elucidate the effects of salicylate on the cochlear nerve
      by recording the spontaneous activity in guinea pigs. After guinea pigs were
      given salicylate (200 mg/kg) intravenously, the transient reduction in cochlear
      spontaneous activity and the elevation over the subsequent 10-20 minutes were
      observed in three of four fibers recorded for more than 30 minutes. The mean
      spontaneous discharge rate of 102 fibers after administration of salicylate (200
      mg/kg) was not significantly higher than the control values from 30 to 120
      minutes after salicylate administration, while that rate of 112 fibers after
      administration of salicylate (400 mg/kg) was significantly higher. The observed
      changes in spontaneous activity due to salicylate administration may represent
      the evidence of a tinnituslike phenomenon in guinea pigs.

PMID- 1757846
TI  - [Neuro-otological study on Behcet disease].
AB  - It seems acceptable that pathological brain stem lesions exist in the patient
      with Neuro-Behcet disease (NB). However, only few reports have been published in
      this field. We report the neuro-otological findings in 33 patients who fulfilled
      the diagnostic criteria of Behcet disease completely or incompletely. The
      patients were classified into 2 groups: one is group of NB and the other is a
      group of Behcet disease without NB (non-NB). Furthermore, the latter was divided
      into 2 subgroups of patients with dysequilibrium and patients with normal
      equilibrium. They underwent equilibrium function tests, such as body balance
      test, gaze test, spontaneous and positional nystagmus test, eye tracking test
      (ETT) and optokinetic pattern test (OKP) by using electro-nystagmography (ENG).
      The following results were obtained. 1. Cerebellar and brain stem lesions were
      confirmed in all cases of NB group. 2. Most cases (6 of 8 cases) in the subgroup
      of dysequilibrium of the non-NB group showed peripheral vestibular disturbance.
      The other two patients were diagnosed to be vertebro-basilar insufficiency (VBI)
      and vascular Behcet disease with CNS disorder, respectively. 3. Nine of 13
      patients in the normal equilibrium subgroup of the non-NB group were diagnosed to
      be neuro-otologically normal. However, we found two patients with peripheral
      vestibular disturbance and CNS disorder associated with hearing disturbance of
      the retrocochlear origin, respectively. 4. The neuro-otological examination is
      assumed to be useful to diagnose neuro-Behcet disease, to reveal the lesion site
      and the state of dysequilibrium in patients with Behcet disease.

PMID- 1757847
TI  - [Articulatory evaluation after mesopharyngeal reconstruction with the radial
      forearm flap].
AB  - Soft palate and tonsil (mesopharynx) play an important role on articulation and
      swallowing. We must take care not to restrict these physiological function when
      we reconstruct the mesopharyngeal defect after cancer ablation. In order not to
      restrict the postoperative function of mesopharynx, we take it the more important
      to preserve the function of the residual tissue rather than to rebuild the lost
      function. We took notice of pliable nature of the radial forearm flap and tried
      to reconstruct mesopharyngeal defect in five cases with this flap. We analyzed
      articulatory function and velopharyngeal closure in these cases, postoperatively.
      Articulatory function was assessed on the results of intelligibility test with
      100 Japanese monosyllables. In four cases out of five, about 70% of syllables
      were accurately heard. According to the Hirose's standard of speech function
      after the operation of oral and/or oropharyngeal cancer, those four cases were
      evaluated also to be excellent. Whether the resection was done beyond the uvula
      or not, proved not to have anything to do with the postoperative speech
      intelligibility. Although speech intelligibility once went down immediately after
      the operation, it improved around six months later. The improvement might be due
      to the following facts; The forearm flap was cicatrized postoperatively,
      disturbing the mobility. After the softening of the cicatrix began, the flap
      gradually recovered flexibility, which enabled surrounding structure to move more
      smoothly. Articulatory dysfunction was characterized as plosives tend to be
      misunderstood as nasals or affricates. Concerning nasality, the velopharyngeal
      closure was examined by fiberscope. Perfect closure was seen in two cases, near
      perfect in two cases, and insufficient in one case.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1757848
TI  - [Detection of RS viral sequences in otitis media effusion from children].
AB  - The role of respiratory syncytial virus (RS virus) in otitis media with effusion
      was studied. Reverse transcriptase-polymerase chain reaction (RT-PCR) and nested
      polymerase chain reaction (Nested PCR) were used to provide accurate methods for
      detection of RS viral sequences in the otitis media effusion from children. We
      could find RS viral sequences in 10/12 samples tested which had been collected
      during and even after natural outbreak of RSV in the community. These
      observations suggest RS virus as an important factor in the pathogenesis of
      otitis media with effusion. The disturbance of the local humoral and cell
      mediated immune response in the middle ear accompanied with RS virus infection
      may lead to the development of infection-induced inflammation and ventilatory
      compromise, development of suppurative and effusion, multiplication of low
      virulence pathogens and subsequent development of mucosal damage.

PMID- 1757849
TI  - [Clinical studies on attic retraction].
AB  - Attic retraction was studied in 327 ears of 264 patients in whom photographs of
      the tympanic membrane were taken from 1983 to 1989. Attic retraction was
      investigated clinically on the basis of findings of the tympanic membrane in
      reference to the photographs and ear X-ray findings, including CT. Attic
      retraction was also observed in 4.5% of cases without inflammation, but its
      severity was mild. The incidence of attic retraction in cases of adhesive otitis
      media was 42.7% in mild adhesive otitis media (adhesive grade I) and 60.8% in
      severe adhesive otitis media (adhesive grade II), both incidences were
      significantly higher than the incidence of 23.8% in cases of otitis media with
      effusion. Thus, the incidence of attic retraction increased as the grade of
      adhesion became severer. In cases of otitis media with effusion, the incidence
      was significantly higher in the adult group (32.3%) than in the child group
      (17.4%). In many of the ears with otitis media with effusion, adhesive grade I
      and chronic otitis media, the severity of attic retraction was mild. There were
      more cases of milder retraction in the child group than in the adult group. Attic
      retraction underwent change with time in 2.8% of cases, and cholesteatoma
      occurred in 1.8% of cases. No improvement in attic retraction was achieved by
      insertion of a ventilation tube. Bilateral attic retraction was observed in 56.9%
      of the child group and 30.2% of the adult group, and the difference was
      statistically significant. Ear X-ray findings by Schuller's method revealed many
      ears with poorly developed mastoid cells and poor pneumatization.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1757850
TI  - [Effect of inner ear immune response on vestibular function in guinea pigs].
AB  - We examined vestibular dysfunction and histological damage caused by direct
      antigen challenge to the endolymphatic sac in guinea pigs. We observed
      spontaneous nystagmus every eight hours and performed caloric testing every week
      following endolymphatic sac secondary KLH challenge. Spontaneous nystagmus was
      seen in 12 of 18 animals, and nystagmus in all directed toward the unchallenged
      ear (paralytic). The caloric response time courses were classified into two
      types, which were irreversible type and reversible type after endolymphatic sac
      KLH challenge. The immune injury of animals with irreversible type was thought to
      be stronger than that of these with reversible type. The spontaneous nystagmus of
      irreversible type animals was longer than that of reversible type animals. The
      temporary vestibular dysfunction was thought to be similar to that observed in
      Meniere's disease.

PMID- 1757851
TI  - The eye of the beholder.

PMID- 1757852
TI  - The fluorescein disappearance test (FDT): an evaluation of its use in infants.
AB  - We report a prospective evaluation of the fluorescein disappearance test (FDT) in
      the diagnosis of lacrimal outflow obstruction in infants under 1 year of age. In
      a preliminary study of 80 lacrimal systems, we showed that the FDT is a sensitive
      (90%) and specific (100%) test in aiding the diagnosis of nasolacrimal
      obstruction in infants. In the main study, we examined 288 eyes of 232 children
      with epiphora. The FDT was abnormal in 237 (82%). Of the remaining 51 eyes, there
      was a clinical explanation for this in 33 cases (epiblepharon, conjunctivitis,
      etc). We have found that this simple and reliable test taken in conjunction with
      clinical examination provides an objective assessment of the lacrimal outflow
      status of young children.

PMID- 1757853
TI  - Bilateral Brown syndrome in three siblings.
AB  - The vast majority of cases of Brown syndrome are considered to be of a
      nonfamilial, sporadic nature. Documented instances of familial transmission are
      rare. All three siblings in one family pedigree showed bilateral Brown syndrome.
      Other family members were reportedly unaffected. The current cases, along with
      previous reports, support the concept that a subset of congenital Brown syndrome
      may have a strong hereditary basis, being transmitted either as an autosomal
      recessive genetic trait or an autosomal dominant disorder with decreased
      penetrance.

PMID- 1757854
TI  - Brown syndrome associated with contralateral superior oblique palsy: a case
      report.

PMID- 1757855
TI  - Visual fields in 4- to 10-year-old children using Goldmann and double-arc
      perimeters.
AB  - We report the comparison of field extent measured using two kinetic perimeters:
      1) a double-arc perimeter developed by van Hof-van Duin for use in infants and
      young children, and 2) the standard Goldmann apparatus. Targets used were the V-4
      e target on the Goldmann and both 2- and 6-degree targets on the double-arc
      perimeter. Visual fields were measured by assessing looking responses toward
      targets presented in a pseudorandom order at 45 degrees, 135 degrees, 225
      degrees, and 315 degrees. Fifty-six children (mean age: 6.8 years, range: 4 to 10
      years) were tested, with retests undertaken in 20%. The extent of total field
      size was highly correlated among the three tests (P less than .001) and test
      retest reliability was high for all three targets (P less than .001). Our
      previous observation of continued growth with age in visual field extent using
      the 6-degree target in 4- to 10-year-old children was confirmed and also seen
      with the 2-degree target in arc perimetry and with the V-4-e in the Goldmann
      apparatus. Kinetic perimetry using a double-arc perimeter with 2- and 6-degree
      target sizes appears reliable and comparable, in the four meridia tested, to
      conventional kinetic perimetry techniques in 4- to 10-year-old children.

PMID- 1757856
TI  - Combined hamartoma of the retina and retinal pigment epithelium in a patient with
      neurofibromatosis type 2.
AB  - We describe a young patient with combined hamartoma of the retina and retinal
      pigment epithelium who developed bilateral acoustic neuromas and meningiomas of
      the cervical-medullary junction and fifth cranial nerve. This case illustrates
      the association between combined hamartoma of the retina and retinal pigment
      epithelium and neurofibromatosis type 2. The authors recommend that children with
      a combined hamartoma of the retina and retinal pigment epithelium be screened for
      neurofibromatosis type 2.

PMID- 1757857
TI  - Preferential looking and recognition acuities in clinical amblyopia.
AB  - Although others have noted a correlation between grating and recognition acuities
      (RA) when both tests are performed on the same day, the value of preferential
      looking (PL) in predicting eventual visual outcome has not been studied. PL
      acuities of 64 preverbal patients considered at risk of amblyopia were measured.
      When these children became verbal, their visual acuities were determined using
      standard recognition acuity tests. Based on intervening amblyopia treatment
      between PL and RA measures, 40 patients were designated the minimal treatment
      group (MTG) and 24 the intensive treatment group (ITG). Chi-square analysis for
      the MTG showed agreement (P less than .005) between PL and RA in identifying
      better, equal, and worse eyes. Interocular ratios of PL and RA were significantly
      correlated for the MTG (P less than .001), but not for the ITG. Monocularly, a
      consistent correlation between PL and RA was not found. Our data suggest that PL
      is predictive of recognition acuity in patients whose visual acuity was expected
      to remain stable.

PMID- 1757858
TI  - Occult Duane syndrome: co-contraction revealed following strabismus surgery.
AB  - Three patients presented in infancy with large angle esotropia and limited
      abduction. Narrowing of the lid fissures with globe retraction on horizontal gaze
      became apparent only after recession of the medial recti. Abduction remained
      limited. Two of the three exhibited dissociated vertical deviations, and seemed
      to have both congenital esotropia and Duane syndrome. The third had an unusual
      pattern of apparent co-contraction in which the eye attempting abduction actually
      adducted. Although rare, Duane syndrome may occur in children with large angle
      esotropia, and its presence may not be revealed until after strabismus surgery.

PMID- 1757859
TI  - Laser treatment of eye disorders in children.
AB  - The increasing range of indications for laser treatment and the development of
      new modalities of lasering have led to a growing tendency to extend this type of
      treatment to the pediatric population. Problems of compliance in this age group
      often necessitate the use of general anesthesia. This report describes the
      operative technique used in 11 children (13 eyes) under the age of 13 years, all
      of whom underwent laser treatment under general anesthesia for a variety of
      ocular conditions. Argon or krypton laser photocoagulation was performed in eight
      children (10 eyes), seven of whom were treated for various retinal pathologies
      and one for an iris cyst. The other three children underwent Nd:YAG posterior
      capsulotomy for secondary cataract.

PMID- 1757860
TI  - Lesions simulating retinoblastoma.
AB  - Of 500 consecutive patients referred to the Ocular Oncology Service at Wills Eye
      Hospital with the diagnosis of possible retinoblastoma, 288 (58%) were found on
      clinical evaluation to have retinoblastoma and 212 (42%) had lesions that
      simulated retinoblastoma. A total of 23 different conditions accounted for the
      212 pseudoretinoblastomas. Three most common pseudoretinoblastomas were:
      persistent hyperplastic primary vitreous (28%), Coats' disease (16%), and
      presumed ocular toxocariasis (16%). Congenital cataract and retinopathy of
      prematurity accounted for a much lower percent of pseudoretinoblastomas in this
      series as compared to a previously reported series. The pertinent clinical
      features that serve to differentiate these simulating lesions from retinoblastoma
      are reviewed.

PMID- 1757861
TI  - Treatment of acute dacryocystitis in neonates.
AB  - Twenty-five newborns with acute dacryocystitis underwent probing of the
      nasolacrimal duct. All had a resolution of the acute dacryocystitis. Only one
      continued to have epiphora and had to undergo a subsequent probing with silicone
      intubation at 9 months of age. All were probed without anesthesia, being
      mummified and held by nurses while the author performed the probing. Only five
      were treated with parenteral and topical antibiotics for a week prior to probing
      while 20 were probed without any prior antibiotic therapy. Additionally, five of
      six mucoceles of the lacrimal sac which did not resolve in the 1st 2 weeks of
      life with massage were successfully probed without anesthesia. Four of the five
      mucoceles had developed an acute dacryocystitis on conservative management.
      Probing of the nasolacrimal duct in the newborn period is a safe and successful
      approach for acute dacryocystitis. It is a highly successful procedure for the
      treatment of acute dacryocystitis with a very low morbidity rate.

PMID- 1757862
TI  - Visual loss in patients with craniofacial synostosis.
AB  - We reviewed the ocular findings in patients with cranial stenosis, who were seen
      in the Craniofacial Clinic at The Children's Hospital of Philadelphia, to
      determine the prevalence, pattern, and etiology of visual loss. There were 15
      patients with Apert syndrome, 25 patients with Crouzon syndrome, and 18 patients
      with other forms of craniofacial synostoses. Visual loss occurred in 17 eyes of
      11 patients with Apert syndrome, 14 eyes of 11 patients with Crouzon syndrome,
      and 12 eyes of 8 patients with other craniofacial synostosis syndromes.
      Refractive errors and strabismus were present in the majority of these patients.
      Amblyopia due to strabismus, ametropia, or ptosis was the major reason for visual
      loss in all three groups of patients. Structural abnormalities contributed to
      loss of vision in six eyes.

PMID- 1757863
TI  - Epibulbar squamous cell carcinomas in brothers with Xeroderma pigmentosa.
AB  - We report two brothers aged 6.6 and 5 years old with the De Sanctis-Cacchione
      variant of Xeroderma Pigmentosa. They had typically severe skin, and ocular and
      neurologic involvement. Both had epibulbar squamous cell carcinomas. The oldest
      presented with a large, invasive, epibulbar mass of the left eye which required
      enucleation. He also had an invasive squamous cell carcinoma of the right lower
      lid. The younger brother presented with a smaller papillomatous lesion at the
      medial limbus of the right eye. After removal, this was found to be squamous cell
      carcinoma in-situ. Flow cytometry done on the tumors revealed diploidy. The case
      descriptions, histopathology, and discussion of ocular manifestations are
      presented.

PMID- 1757864
TI  - Ocular fireworks injuries in children.
AB  - Fourteen children and six adults presented in 1987 with firework-induced ocular
      injuries following celebrations of the Prophet Muhammad's birthday in Tripoli,
      Libya. The children's injuries were, typically, much more severe than those of
      the adults. Indigenous modifications to the fireworks, which are intended for
      children's use, render the devices into very dangerous missiles that, in the
      cases presented, resulted in the loss of one eye and serious damage to another.
      Educating children of the proper use of legal fireworks, and parents discouraging
      their children from modifying fireworks should help reduce the incidence of these
      severe ocular injuries.

PMID- 1757865
TI  - Rat bite--an unusual cause of direct trauma to the globe.

PMID- 1757866
TI  - Relationship between ocular functions and reading achievement.

PMID- 1757867
TI  - Clinical use of the five-factor model: an introduction.
AB  - In the past decade, clinical psychologists have developed a renewed appreciation
      of the value of assessment. At the same time, personality psychologists have come
      to agree on a fundamental taxonomy of personality traits, the five-factor model.
      Articles in this special series describe the model and its measurement and
      discuss applications in three different settings: general clinical practice, a
      sexual behaviors consultation unit, and a behavioral medicine clinic. This
      introduction raises questions about the use of personality profiles in
      psychodiagnosis, the range of applicability of the five-factor model, the utility
      of personality feedback in psychotherapy, the stability of personality scores
      among psychotherapy patients, and the feasibility of using personality scores to
      select optimal forms of treatment. This special series is intended to stimulate
      research on such topics.

PMID- 1757868
TI  - The five-factor model and its assessment in clinical settings.
AB  - Personality researchers have recently converged on the five-factor model as an
      adequate representation of the structure of personality traits. This article
      introduces the factors and the NEO Personality Inventory (NEO-PI), a
      questionnaire designed to measure the factors and some of the traits that define
      them. Data on the comprehensiveness of the model and on the reliability,
      validity, and stability of measures of the factors are reviewed, and correlations
      between scales from the NEO-PI and two instruments widely used in clinical
      practice (the Minnesota Multiphasic Personality Inventory [MMPI] and the Millon
      Clinical Multiaxial Inventory [MCMI]) are used to illustrate similarities and
      differences between normal and clinical assessment. Some issues regarding the
      clinical use of the five-factor model are discussed.

PMID- 1757869
TI  - The psychotherapeutic utility of the five-factor model of personality: a
      clinician's experience.
AB  - This article summarizes experience using the five-factor model of personality,
      operationalized by the NEO Personality Inventory (NEO-PI), to facilitate
      psychotherapy treatment with 119 private-practice, outpatient, psychotherapy
      patients and their family members over a period of 2 years. Trait theories such
      as the five-factor model implicitly challenge the premises of much clinical
      theory, yet they can be useful to clinicians, as they provide a detailed,
      accurate portrait of the client's needs, feelings, proximate motives, and
      interpersonal style. I suggest that: Neuroticism (N) influences the intensity and
      duration of the patient's distress, Extraversion (E) influences the patient's
      enthusiasm for treatment, Openness (O) influences the patient's reactions to the
      therapist's interventions, Agreeableness (A) influences the patient's reaction to
      the person of the therapist, and Conscientiousness (C) influences the patient's
      willingness to do the work of psychotherapy. Fundamental questions raised by the
      five-factor model about the nature of psychopathology and psychotherapy are
      discussed.

PMID- 1757870
TI  - A comparison of five-factor personality dimensions in males with sexual
      dysfunction and males with paraphilia.
AB  - We compared personality profiles of men with sexual dysfunction (n = 51) to those
      of age-matched men with a primary diagnosis of paraphilia (n = 51) employing the
      NEO Personality Inventory (NEO-PI), a measure of the five-factor model.
      Preliminary analyses in a large sample of patients in a sexual behaviors
      consultation unit supported the reliability and factorial validity of the NEO-PI
      for this population. Analysis of variance showed significant differences between
      the dysfunctional and the paraphilic groups on two of the five NEO-PI domains,
      Neuroticism (N) and Agreeableness (A). The group personality profile of the
      sexually dysfunctional men was comparable to the normative sample of the NEO-PI,
      except for a slight elevation in N. By contrast, men with paraphilia had a
      personality profile marked by high N, low A, and low Conscientiousness (C).
      Treatment implications of the average personality profile of the sexual
      dysfunction group and the distinctive personality profile of paraphilic men are
      discussed.

PMID- 1757871
TI  - Self-reports, spouse ratings, and psychophysiological assessment in a behavioral
      medicine program: an application of the five-factor model.
AB  - This article describes the integration of the five-factor model into assessment
      procedures used with 109 patients in an outpatient behavioral medicine program.
      The population, program, assessment techniques, and general findings are
      explored. A case history involving a psychophysiological disorder is utilized to
      demonstrate the utility of a taxonomy of personality traits. The NEO-PI, a five
      factor instrument, is integrated with other assessment techniques to assist in
      diagnosis, rapport building with the patient, tailoring treatment techniques and
      goals to the individual's intrapersonal and interpersonal dynamics, and
      predicting relative success and compliance with noninvasive self-regulation
      procedures and psychotherapy.

PMID- 1757872
TI  - Rorschach Depression indices with children and adolescents: concurrent validity
      findings.
AB  - Exner (1983, 1986) developed and recently revised (1990b) a Rorschach Depression
      Index based on scores from variables in the Comprehensive System. This study
      evaluated both the original and the revised DEPIs for child and adolescent
      outpatient (n = 67) and inpatient (n = 99) samples in order to assess the
      diagnostic utility of these indices. There were no significant relationships
      between the original form and the revised form of the DEPI and clinical
      elevations on the Depression scale of the Personality Inventory for Children in
      the outpatient sample or treatment team diagnostic judgments in the inpatient
      sample. These findings sound a strong cautionary note for using only Rorschach
      Depression indices to diagnose depression in children and adolescents.

PMID- 1757873
TI  - Changes in human figure drawings during intensive treatment.
AB  - This article examines change in the human figure drawings (HFDs) of 32 seriously
      disturbed young adults during the course of intensive inpatient treatment. HFDs
      drawn at the time of admission were compared with HFDs obtained more than 1 year
      after intensive treatment began; both sets were scored on the Goodenough-Harris
      Scale (GH) and the Robins Balance-Tilt Scale (RBT). The findings indicate that
      the HFDs significantly improved over the course of treatment, but only for those
      patients judged introjective, not anaclitic. These findings are consistent with
      prior research on the same population that were based on analyses of clinical
      case records and Rorschach protocols (Blatt, Ford, Berman, Cook, & Meyer, 1988).
      Significant change in the HFDs over the course of treatment suggests that the
      HFDs provide a unique and independent dimension for assessing therapeutic change.

PMID- 1757874
TI  - Hopelessness in community-residing aged persons: a viable construct?
AB  - Previous work with the Geriatric Hopelessness Scale (GHS; Fry, 1984, 1986)
      suggests that it may be a useful measure of pessimism for a variety of domains
      among elderly persons. One hundred seven community-residing aged persons were
      individually administered the GHS and a variety of personality and cognitive
      functioning measures in an effort to further refine and validate the GHS. Results
      suggest very modest internal consistency and a poorly defined factor structure
      for the GHS, in contrast to earlier findings. Although the GHS failed to
      differentiate elderly persons by age, it was nonetheless related to self-esteem,
      depression, self-rated health, internality, morale, and life satisfaction. Taken
      together, these data indicate that the research and clinical utility of the GHS
      with community-residing aged persons may be more limited than previously
      believed.

PMID- 1757875
TI  - An inventory of social skills.
AB  - A social skills inventory of 128 true-false items was constructed to assess eight
      hypothesized bipolar dimensions. In a series of principal component analyses,
      seven of the constructs plus an added concept were isolated in both college and
      high school men and women. Some of the factors isolated were Social
      Assertiveness, Directiveness, Defense of Rights, Confidence, and Empathy. Two
      higher order factors-Social Skill and Empathy-were also identified in several
      samples. Validity studies revealed strong commonalities with Riggio's (1986)
      Social Skills Inventory, the Horowitz Inventory of Interpersonal Problems, the
      Watson and Friend (1969) Social Avoidance and Distress Scale, and a set of self
      ratings. These findings suggest that the Social Relations Survey (SRS) is a
      useful device for clinical and research application to problems involving social
      skills.

PMID- 1757876
TI  - Development of a self-theory and measurement scale.
AB  - In this study, we examined a theoretical model of self-development and a scale to
      measure 12 aspects of the self. The theory, called developmental self-theory,
      proposes a hierarchical arrangement of dimensions of the self. The 12 scales are
      collectively called the Omnibus Self-Test and measure Self-Esteem, Positive Self
      Regard, Moral Self-Concept, Self-Confidence, Self-Reliance, Self-Control,
      Selfishness, Self-Disclosure, Self-as-Agent, Self-Critical, Self-Identity, and
      Self-Reflection. Preliminary data on the reliability and validity of the Omnibus
      Self-Test is reported along with intercorrelations among the scales.

PMID- 1757877
TI  - [The contribution of hydrophobic parameter to the study of structure activity
      relationships. II. Antifungal activity of benzylidene-pyrrols].
AB  - The purpose of the present work is the contribution of hydrophobic fragmental
      constant, molecular connectivity and parachor in the study of the relationship
      between chemical structure and biological activity. The results obtained in this
      series of benzylidenes-pyrrols have shown high correlation between these
      parameters and the antifungal activity of these compounds.

PMID- 1757879
TI  - [Detoxification of aflatoxin B1 by different chemical methods and evaluation of
      the effectiveness of the treatments applied].
AB  - Different chemical treatments were applied to solutions of Aflatoxin B1 in order
      to compare their efficacy for the detoxification of AfB1: sodium sulfite, sodium
      hydrogen sulfate, sodium hydroxide, ammonia, sodium hypochlorite, hydrogen
      peroxide. The rate of the detoxification of AfB1 has been followed by three
      experimental approaches: 1. Quantitative estimation of the unmodified AfB1 by
      HPLC chromatography. 2. Quantitative estimation of the most toxic metabolite.
      AfB1-epoxide by chemical transformation into the trishydroxy AfB1 derivative
      followed by HPLC analysis. 3. Determination of the bacterial mutagenic activity,
      following the Ames' test. Among the different detoxification methods that were
      compared, the treatment with sodium sulfite proved to be the most efficient and
      seems thus to be recommended for foods contaminated by AfB1.

PMID- 1757878
TI  - [Valeriana officinalis and Crataegus oxyacantha: toxicity from repeated
      administration and pharmacologic investigations].
AB  - The aim of this work is to study the toxicity of Valeriana officinalis and
      Crataegus oxyacantha after reiterated administrations. The study has been carried
      on the rat which received 300 and 600 mg/kg/24 h of the drugs for 30 days. During
      the period of the treatment, animals weight and blood pressure have been
      measured. On the end of the treatment the animals have been sacrificed. The
      principal organs have been weighed and in blood samples collected hematological
      and biochemical parameters have been determined. This work is concerned by
      pharmacological properties which are related to the two plants. The influence of
      the drugs on the behaviour, the pain, the intestinal peristalsis and strychnine
      convulsions are reported.

PMID- 1757880
TI  - [The nutritional importance and physiopathology of molybdenum in man].
AB  - Molybdenum is an essential trace element taking part in the active site of three
      human enzymes: xanthine oxidase, aldehyde oxidase and sulfite oxidase, playing a
      role in the detoxification of the organism and/or the production of important
      intermediary products. The perturbation of the first two enzymes has no
      established clinical consequence, but a decrease in activity of the third one is
      harmful for the organism, particularly the nervous system during pre- or post
      natal development. The anomalies in the function of these enzymes are generally
      inherited and linked to the impaired production of the molybdenum cofactor, an
      organic molecule complexed to the element in the active site. However, several
      pathological cases in animals and one case in man have been clearly attributed to
      molybdenum deficiency. It is the reason why molybdenum supplementation has been
      recommended in long term total parenteral nutrition in infants and adults.

PMID- 1757881
TI  - [Cell cultures. Complementary or alternative methods to animal experimentation].
AB  - In vitro methods, which appeared at the beginning of the century, have had
      exponential development since one decade for ethical and technological reasons.
      They can be used for studies concerning intracellular, intercellular or
      environmental activities. Despite of limiting factors, these techniques offer
      certain advantages which have to be optimized in order to be validated. They are
      actually complementary, used for exploratory purposes. In the future, they could
      replace partially but not completely some in vivo experiments.

PMID- 1757882
TI  - [Collagen and its technological possibilities].
AB  - Collagen enjoys a privileged position as a biomaterial in its cosmetic
      applications. It exists under different forms and is more particularly able to
      reticulate. The process which is used allows a modulated reticulation. This means
      that a collagenous matrix having a varying degree of solubility can be obtained,
      which can lend itself to different applications. The prilling technique consists
      in producing microspheres consisting of a more or less reticulated collagenous
      matrix being able or not to imprison an insoluble or lipophilic active substance
      having previously been incorporated in the original solution. In this way, it is
      possible to obtain either strongly reticulated and mechanically resistant
      microspheres of particles which dissolve when crushed. The cosmetic significance
      of these new products is connected with the biocompatibility characteristics of
      the collagenous material and with the characteristics relating to the modulated
      reticulation of the obtained product.

PMID- 1757883
TI  - [Reactions and interactions of drugs].

PMID- 1757884
TI  - Photoreceptor cell specific proteins of snake pineal.
AB  - The pineal body of lower vertebrates is saccular and directly photoreceptive. The
      pineal gland of mammals is parenchymal and not directly photoreceptive. The
      parenchymal morphology of snake pineal raises questions of direct
      photoreceptivity of snake pineal and of correspondence of molecular homology with
      morphological homology. S-antigen and rhodopsin are highly conserved
      photoreceptor cell specific proteins. We used site-specific monoclonal antibodies
      (MAb) to study S-antigen and rhodopsin of snake pineal. Immunohistochemical
      reactivity of snake retina and pineal was compared to that of trout, guinea pig,
      and rat. MAb's to S-antigen reacted with each pineal and retina tested, but
      reactivity of individual MAb's with snake tissue was more similar to that with
      trout than with rat or guinea pig tissue. MAb's to rhodopsin did not react with
      snake pineal, although they did react with the photoreceptive trout pineal body.
      MAb's to rhodopsin reacted with retina of each species. These results suggest
      that although snake pineal is morphologically similar to mammalian pineal, and
      like mammalian pineal is probably not directly photoreceptive, it does have S
      antigen homology with lower vertebrates such as trout.

PMID- 1757885
TI  - Circadian patterns of melatonin, corticosterone, and progesterone in male rats
      subjected to chronic stress: effect of constant illumination.
AB  - Plasma and pineal melatonin and plasma corticosterone and progesterone
      concentrations have been shown to be altered by several types of stressors. This
      study was designed to define the circadian patterns of the hormones mentioned
      above in rats subjected to chronic stress and to investigate the influence of
      constant illumination. The results revealed that melatonin and corticosterone
      circadian patterns deteriorated and their plasma concentrations were
      significantly elevated. The constant illumination (2,500 lux) during the dark
      period (from 2000 to 0600) was not able to suppress melatonin production in
      stressed animals, while the plasma content of corticosterone was decreased at the
      end of experimental period compared to control rats. Plasma levels of
      progesterone were increased in stressed animals as well. Constant illumination,
      however, provoked also an increase of progesterone secretion in controls.
      Statistical comparisons between hormonal secretory patterns showed that melatonin
      and corticosterone correlated negatively in controls (r = -0.58, P less than
      0.05) during the nighttime. However, in stressed animals correlation was observed
      only between melatonin and progesterone secretion during the light and dark
      period (r = -0.43, P less than 0.05). Surprisingly, the correlation during the
      nighttime in rats subjected to constant illumination was negative (r = -0.60, P
      less than 0.02) compared to positive correlation (r = 0.60, P less than 0.02) in
      rats kept under normal lighting regimen. These results suggest that melatonin
      release is affected by stress and, possibly, under these circumstances, interacts
      with adrenal steroid secretion.

PMID- 1757886
TI  - Circadian rhythms of plasma melatonin in the Adelie penguin (Pygoscelis adeliae)
      in constant dim light and artificial photoperiods.
AB  - The response of plasma melatonin in Adelie penguins (Pygoscelis adeliae) to
      constant dim light and to light/dark cycles was measured to determine the
      capacity of the pineal gland to secrete melatonin after exposure to continuous
      daylight for 2 months. Penguins were moved in mid-summer from the natural
      photoperiod to either constant dim light (n = 10), to a 12L:12D light/dark cycle
      (n = 5), or to a 12L:12D light/dark cycle with a 30 min light pulse (50-155 lux)
      on the third (n = 4) or sixth (n = 5) "night." Blood samples were collected
      regularly through cannulae for up to 33 h. The birds in dim light were sampled
      after 2 days, with samples obtained over at least 24 h from 7 birds. Three of
      these birds had melatonin rhythms (peak levels 66.7-130.2 pg/ml) whereas the
      other 4 birds had constant low levels (less than 44 pg/ml). The phase of the
      rhythm was similar for all 3 birds. This is consistent with the pacemaker that
      regulates the circadian rhythm of melatonin secretion being entrained to a period
      of 24 h when the penguins were exposed to the natural photoperiod. Mean melatonin
      levels (42.7 +/- 2.5 pg/ml) were elevated compared to those previously reported
      in penguins under natural daylight. All penguins held under a 12L:12D light/dark
      cycle had melatonin rhythms. The phase and form of these rhythms were similar to
      those reported for other birds, and they appeared to be circadian rhythms
      entrained by the light/dark cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757887
TI  - No difference in day-night serum melatonin concentration after pineal grafting
      into the third cerebral ventricle of pinealectomized rats.
AB  - Serum melatonin concentration and its day-night difference in pinealectomized,
      stereotaxically grafted rats with pineal transplants was examined. The nighttime
      serum melatonin concentration increased significantly only in pinealectomized
      rats that received two pineal transplants. In neither pinealectomized rats
      receiving two pineal glands and one cotransplant of superior cervical sympathetic
      ganglion nor pinealectomized-ganglionectomized rats receiving two pineal
      transplants was there a demonstrable increased in serum melatonin concentration.
      Although some pineal transplanted hosts demonstrated increases in serum melatonin
      concentration, there was no day-night variation in serum melatonin concentration.
      This may be due to a number of mitigating factors. Pineal grafts may not receive
      the appropriate functional reinnervation from the host brain due to the location
      of the transplantation in the cerebral ventricle or due to lack of sufficient
      time for the growth of invading host neurites.

PMID- 1757888
TI  - Pineal rhythm of N-acetyltransferase activity and melatonin in the male badger,
      Meles meles L, under natural daylight: relationship with the photoperiod.
AB  - The rhythmicity of melatonin secretion and of pineal NAT activity was compared in
      male badger kept in natural daylight during two distinctly different photoperiods
      (January and June). The hormone and its enzyme follow the same pattern with a
      nighttime elevation and a low level during the day, demonstrating the presence of
      a nyctohemeral rhythm. The high correlation found between the NAT activity and
      the melatonin concentration suggests that NAT is the rate-limiting enzyme in
      melatonin synthesis in the badger. Peak amplitudes were similar under the two
      photoperiods. Melatonin secretion occurred in the first part of the night
      irrespective of the photoperiod. The rhythm of melatonin secretion is modified by
      the photoperiod. The duration of high nighttime levels varies; it is longer (8 h)
      when the night is long (16 h) in January, and shorter (6 h) when the night is
      short (8 h) in June. In the badger, differences in the duration of high level
      melatonin at night may reflect variations in day length and convey to the animal
      the photoperiodic information.

PMID- 1757889
TI  - Daily cycles of putrescine, spermidine, and spermine in the liver, pineal gland,
      harderian gland, anterior pituitary, and testes of rats kept in LD 12:12.
AB  - A circadian rhythm in cellular polyamine levels was detected in the liver, pineal
      gland, anterior pituitary gland, Harderian gland, and testicular seminiferous
      tubules of male rats fed ad libitum and maintained in a light:dark cycle of LD
      12:12 (lights on at 07:00). Liver putrescine content was highest at 24:00,
      showing a sixfold increase over 12:00 levels. Pineal spermidine and spermine
      contents reached a maximum at 06:00, late in the dark phase. A similar pattern
      was also detected in the Harderian gland. In the anterior pituitary, the
      polyamines putrescine, spermidine and spermine were highest at 18:00, late in the
      light phase. However, the increase in putrescine was not statistically
      significant. The three polyamine contents decreased late in the dark phase. In
      testicular seminiferous tubules putrescine, on the contrary, was highest (about a
      twofold increase) late in the dark phase.

PMID- 1757890
TI  - Pineal melatonin concentrations during day and night in the adult hedgehog:
      effect of a light pulse at night and superior cervical ganglionectomy.
AB  - The European hedgehog (Erinaceus europaeus L.) is a hibernating mammal and
      seasonal breeder in which numerous circadian and circannual rhythms are entrained
      and synchronized by photoperiod. The present study was undertaken in order to
      establish the involvement of the pineal gland in transducing the photoperiodic
      message in this species. Pineal melatonin concentrations were determined by
      radioimmunoassay in female hedgehogs kept under natural climatic conditions and
      killed during the light:dark (L:D) cycle in spring and autumn, after the
      interruption of darkness by a 45 min light pulse, and after bilateral superior
      cervical ganglionectomy (SCGx). Absolute melatonin concentrations were low (less
      than 100 pg/pineal) in the pineal gland. Under natural climatic conditions, in
      spring and in autumn, pineal melatonin concentrations exhibited a marked diurnal
      rhythmicity, with very low levels in the day (1200: less than 10 pg/pineal) and
      high levels during the night (2200: 71.9 +/- 18.6 pg/pineal; 0200: 42.5 +/- 15.6
      pg/pineal). The 45 min light pulse during darkness depressed rapidly and
      significantly the melatonin content (dark + light [D + L]: less than 10
      pg/pineal), but a subsequent return to darkness restored high melatonin content
      after approximately 2 h (D + L + D: 65.4 +/- 20.2 pg/pineal). After bilateral
      SCGx, melatonin concentrations were reduced and no increase during night could be
      observed, either in animals sacrificed 42 days after SCGx or in animals killed 2
      years after SCGx. In the hedgehog, as in other mammals, pineal melatonin
      concentrations are related to the light:dark cycle. Such data indicate that
      during the year, in this species, the effects of light on seasonal endocrine
      rhythms may be mediated by the pineal gland.

PMID- 1757891
TI  - Central pattern generators: some principles learned from invertebrate model
      systems.
AB  - 1. Central pattern generators (CPGs) underlie a wide variety of rhythmic
      behaviours such as locomotion and respiration in most multi-cellular organisms.
      2. The CPG's are capable of generating a patterned output without phasic sensory
      input. 3. The organization of the CPG is due to both intrinsic properties of the
      individual neurons and their network interactions. 4. To gain an understanding of
      the mechanisms which underlie rhythmicity a CPG has been reconstructed in
      culture. This will allow investigators to test directly the mechanisms underlying
      the generation of rhythmic output and will allow the direct testing of the
      mechanisms by which various modulators affect the CPG.

PMID- 1757892
TI  - Repetitive impulse activity potentiates spontaneous acetylcholine secretion at
      developing neuromuscular synapses.
AB  - The effects of presynaptic impulse activity on the transmitter secretion at
      developing neuromuscular junctions were examined in Xenopus nerve-muscle
      cultures. Repetitive suprathreshold stimulation of the presynaptic neuron results
      in marked potentiation of spontaneous synaptic activity, as shown by whole-cell
      voltage-clamp recording of synaptic currents in the postsynaptic muscle cell. Our
      results are consistent with the notion that synaptic efficacy of the developing
      synapse is potentiated by the presence of electrical activity. Such activity
      dependent synaptic modulation enables the early neuronal activity to play a
      regulatory role during the maturation of synaptic connections.

PMID- 1757893
TI  - Endocytosis of the synaptic vesicle protein, synaptophysin, requires the COOH
      terminal tail.
AB  - Synaptic vesicles participate in a cycle of fusion with the plasma membrane and
      reformation by endocytosis. Endocytosis of membrane proteins by the well studied
      clathrin-coated vesicle pathway has been shown to involve specific sequences
      within the cytoplasmic tail domain. Proteins taken up by clathrin-coated vesicles
      are directed to early endosomes from which they may return to plasma membrane.
      Recent evidence suggests that the synaptic vesicle protein synaptophysin is
      targeted to early endosomes in transfected fibroblasts and in neuroendocrine
      cells. To begin to test whether sequences within the COOH-cytoplasmic domain are
      required for internalization we have expressed a synaptophysin molecule lacking
      this domain in 3T3 cells and measured its rate of internalization. While a full
      length synaptophysin was internalized efficiently, we could not detect
      internalization of the mutant construct. These data are consistent with a model
      in which the COOH-terminal tail is required for coated-pit localization and hence
      targeting of synaptophysin to early endosomes.

PMID- 1757894
TI  - Examining personal control beliefs as a mediating variable in the health-damaging
      behavior of substance use: an alternative approach.
AB  - Substance use continues to be a concern for researchers and health professionals
      alike. One of the most extensive areas of research on health-related behaviors
      such as smoking and drug use has been on personal control beliefs. Since many
      health actions (both facilitative and deleterious) depend on voluntary behaviors,
      and many health-related prevention and intervention programs are predicted on an
      assumption of controllability, this is an important area to consider. This
      article is a review of some of the literature and presents an alternative
      approach that entails using area-specific and domain-specific methods to examine
      the role that control beliefs play in the health-damaging behavior of substance
      use.

PMID- 1757895
TI  - Perceptions of submissiveness: implications for victimization.
AB  - Some researchers have suggested that a precondition of affective submissiveness
      may increase the likelihood of female victimization in sexual assault, whereas
      others have suggested that criminal offenders use perceptions of vulnerability
      when selecting a victim. In this study, based on American college students, men
      (decoders) rated videotaped women (encoders) dominant versus submissive using a
      semantic differential instrument. Cue evaluators analyzed the body language and
      appearance of the videotaped women using a Likert instrument. The results suggest
      that (a) men form differentiated perceptions of dominant versus submissive women,
      (b) such perceptions substantially rely on nonverbal cues, (c) dominant and
      submissive women display visually different behaviors and appearances, and (d)
      men tend to select submissive females for exploitation.

PMID- 1757896
TI  - Stress and context in auditory word recognition.
AB  - Recent work in psycholinguistics has revealed that the role of lexical stress in
      auditory word recognition may be a complex one involving other potential sources
      of information. In the present investigation, the nature of lexical stress
      effects on auditory word recognition in context is examined. The ability of
      subjects to identify words based on the prosodic pattern of the word is examined
      for the words in isolation and in a sentence context. The results revealed a
      small influence of stress on the identification of the stimulus waveforms
      relative to a large effect of context. The data indicate that lexical stress is
      used in the identification of the words; however, its role is minor compared to
      the importance of contextual information.

PMID- 1757897
TI  - Promoting public/academic linkage.
AB  - 1. Collaborative linkages between public mental health/mental retardation service
      systems and academic institutions have evolved in response to several problems:
      increasing numbers of individuals requiring long-term mental health care; the
      nursing shortage; and a decline in enrollment and students graduating from
      psychiatric mental health nursing programs. 2. Evidence suggests that a
      public/academic linkage in the form of a multidisciplinary training course in the
      care of seriously mentally ill patients promotes a recruitment of mental health
      professionals to work with these patients. 3. The establishment of
      academic/health care system linkages can enhance client care, expand and improve
      clinical experiences and education for students, and provide opportunities for
      collaborative research among clinical staff, faculty members, and graduate
      students.

PMID- 1757898
TI  - Assaultive behavior: know the risks.
AB  - 1. Violence in our society is an increasing national concern, and violence in
      health-care settings reflects this trend. Assaultive episodes continue to
      increase in health-care settings due to various cultural, sociological, and
      political factors. 2. Present administrative and educational solutions to the
      problems of assault have failed to decrease the incidence and, in fact, may
      contribute to the increasing number of assaultive episodes. 3. Psychiatric staff
      can reduce incidence of assault by recognizing the risk factors and designing
      styles and interventions with these factors in mind. 4. Risks most often
      associated with assault are history of assault, diagnosis of dementia or organic
      brain disorder, intoxication from drugs or alcohol, and from the characteristics
      of the milieu and treatment itself.

PMID- 1757899
TI  - Psychiatric consultation. Improving the work environment.
AB  - 1. The consultant initially must negotiate with the leader to clarify the need
      for and purpose of consultation. 2. Confidentiality is maintained by sharing
      group data without revealing identities of individual nurses. 3. Recommendations
      can be given as options from which the group can choose. 4. Consultation is a
      process using skills of establishing rapport, interviewing, extrapolating themes,
      and giving feedback.

PMID- 1757900
TI  - How can we become more aware of culturally specific body language and use this
      awareness therapeutically?

PMID- 1757901
TI  - Assault's other side.

PMID- 1757902
TI  - Target weight procedure: preventing water intoxication.
AB  - 1. Prevention of water intoxication depends on early intervention for polydipsic
      patients who seem to be retaining fluid. The Target Weight Procedure is designed
      to detect early signs of fluid retention by means of weight gain and low sodium
      levels. 2. The use of this protocol, in addition to successfully decreasing the
      number of acute water intoxication episodes, has also led to increased awareness
      of the meaning of patient behavior, an increased sense of control of patients
      with water intoxication over their behavior, and an increased feeling of
      competence among the staff. 3. The success of the protocol seems to be based on
      its purpose of identifying patients at risk and those with an impending episode,
      as well as secondary advantages, for example, giving the patients the option to
      alter their behavior to be removed from the protocol.

PMID- 1757903
TI  - Aspiration cytology of the breast with immediate reporting: initial experience
      with 1000 patients in a district general hospital.
AB  - A total of 1000 patients with a palpable localized breast mass were assessed
      clinically at a surgical breast outpatient clinic and fine needle aspiration
      cytology was performed and immediately reported. This large series was undertaken
      by one surgeon and one pathologist, neither of whom had any previous experience
      with such a combined clinic, and the pathologist initially had only minimal
      experience of breast aspiration cytology. The results show a diagnostic accuracy
      of 96.9%, a positive predictive value of 98.4%, and a negative predictive value
      of 95.7%, and indicate that the provision of such a facility in a district
      general hospital is of benefit in the diagnosis of palpable localized breast
      lesions.

PMID- 1757904
TI  - Increasing infantile hypertrophic pyloric stenosis? Experience in an overseas
      military hospital.
AB  - Fifty-four children with proven infantile hypertrophic pyloric stenosis (IHPS)
      were treated by Ramstedt's pyloromyotomy during a 14-year period. Between the
      years 1986 and 1989 the mean incidence of the disease was noted to have risen by
      2.72 per 1000 live births over the preceding 10 years. Statistical analysis
      confirmed a significant upward trend between the years 1976 and 1989. Analysis of
      the majority of the cases revealed comparable perioperative morbidity rates with
      other UK district general hospitals. There was no operative mortality. The
      character of IHPS in military personnel overseas has more in common with UK than
      international trends. The incidence in this subgroup may be rising.

PMID- 1757905
TI  - Partial cholecystectomy in the emergency treatment of acute cholecystitis in the
      compromised patient.
AB  - Emergency cholecystectomy in the high-risk patient still results in a substantial
      mortality and morbidity rate. A prospective experience is presented with partial
      cholecystectomy in 16 high-risk patients (APACHE II greater than 10) undergoing
      emergency surgery for perforation, empyema or failure to respond to conservative
      treatment. Excessive bleeding tendency was present in three patients. One patient
      died (6%). Mean operative time was 40 min. One patient developed an intra
      abdominal bile leak due to a retained common bile stone 8 months after operation.
      Partial cholecystectomy has the advantages of both cholecystectomy and
      cholecystostomy. It is a fast and safe procedure and should be considered as an
      option in the emergency situation in the high-risk patient.

PMID- 1757906
TI  - Curative resection: the major determinant of survival in patients with large
      bowel cancer.
AB  - Data collected prospectively from 578 patients with colorectal cancer managed by
      12 Manchester surgeons were analysed to evaluate the effects on survival of
      prognostic, clinical and pathological factors. Available preoperative and
      perioperative factors were included in a stepwise regression analysis and
      curative resection was found to be most strongly associated with patient
      survival. Other variables ranked according to their relative importance were
      performance status, weight loss and sex. The finding of the study supports the
      need to establish an early diagnosis if long-term survival results are to
      improve.

PMID- 1757907
TI  - Prevention of postoperative renal dysfunction in patients with obstructive
      jaundice: a comparison of mannitol-induced diuresis and oral sodium taurocholate.
AB  - The effect of oral sodium taurocholate was compared with that of intravenous
      mannitol when used independently to determine their relative effect on protecting
      postoperative renal function in patients with obstructive jaundice. A total of 20
      patients with obstructive jaundice were randomized to receive either mannitol or
      sodium taurocholate before surgery. Their preoperative and postoperative renal
      function was monitored using serum creatinine and predicted creatinine clearance
      over a 4-day period. There was no difference in postoperative renal function
      between the two groups and no patient from either group suffered significant
      renal dysfunction.

PMID- 1757908
TI  - Cancer of the ureter in a Negro population.
AB  - A 13-year retrospective study of ureteric tumours in an African Negro population
      is reviewed. The tumour is rare. Seven cases were reported, six of them admitting
      to smoking over 50 packets of cigarettes per year. All the tumours were of the
      transitional cell type and prognosis is related to grade and staging.
      Nephroureterectomy with excision of a cuff of bladder was the treatment given.
      Follow-up was poor owing to illiteracy.

PMID- 1757909
TI  - Fine needle aspiration biopsy of pulmonary lesions: a 2-year experience in a
      district general hospital with a literature review.
AB  - During the 2 years of 1987 and 1988, 74 patients with suspected malignant lung
      lesions underwent fine needle aspiration biopsy at the Bradford Royal Infirmary.
      Using a 20Fr needle, sufficient specimen (smear and clot) was obtained in 70
      (95%) patients for histological examination. The indications for the procedure
      were: failure to make a diagnosis at bronchoscopy and bronchial lavage in 32
      (43%) patients, peripherally located lesion in 28 (38%) patients, poor
      anaesthetic risk in 20 (27%) patients, negative bronchoscopy and mediastinostomy
      in five (7%) patients and three (4%) patients refused operative intervention.
      There were no deaths and complications were few. Seven patients developed
      pneumothorax, three of whom required intercostal drainage. Transient haemorrhage
      as shown by haemoptysis occurred in one patient and one patient complained of
      pleuritic chest pain. Of the 60 patients with malignant disease eventually
      proven, 50 were diagnosed correctly. The overall sensitivity and specificity of
      the test were 81 and 100% respectively based on histological and/or clinical
      outcome of the lung lesion. The test was cost-effective, diagnostic yield was
      high and complications were few. The use of fine needle aspiration biopsy as part
      of the management policy in peripheral lung lesions is realistic in a district
      general hospital.

PMID- 1757910
TI  - General surgery with a special interest in vascular surgery: is the tail starting
      to wag the dog?
AB  - Most general surgeons are expected to develop an interest in a surgical specialty
      in addition to their general surgical workload. Over a 2-year period we have
      prospectively analysed the type of patient admitted to a general surgical unit
      with a special interest in vascular surgery. Half of the admissions were
      emergencies, over which we had no control. Of the elective admissions, there was
      a steady increase in the proportion of patients with a vascular diagnosis. This
      was due to increasing numbers of arterial reconstructions and interventional
      radiological procedures being undertaken. As cutbacks are made in the numbers of
      available beds and operating sessions, the increasing number of patients
      requiring admission for the management of arterial disease can only be achieved
      at the cost of patients awaiting routine general surgical procedures.

PMID- 1757911
TI  - Epidemiology of sharps accidents in general surgery.
AB  - A prospective study was carried out of all general surgical operations in one
      theatre of a teaching hospital over a 6-week period to identify the predisposing
      factors involved in the occurrence of sharps accidents and their relative
      importance. Although various predisposing factors have been intimated, the
      relative importance has never been ascertained. Glove puncture was used as an
      objective measure of a sharps accident and this was compared with subjective
      reporting of needlestick injury. The overall rate of sharps accidents per surgeon
      per operation was 23%. The position at the operating table and medical rank of
      operator affected the rate of accidents more than duration of operation. The
      group at most risk of sharps accidents was junior surgeons acting as the
      principal operator. It is important to recommend inoculation against hepatitis B
      in this group before starting surgical training. Another method of minimizing the
      risk to junior surgeons would be compulsory training on surgical rigs. Operations
      on patients with AIDS or hepatitis B should be carried out by the most senior
      surgeon available to reduce the risk of sharps injury and disease transmission.

PMID- 1757912
TI  - Needlestick injury in surgeons: what is the incidence?
AB  - A prospective study by questionnaire was carried out to investigate the incidence
      of needlestick injury in the operating theatre staff of a teaching hospital and
      to calculate the individual risk of acquiring blood-borne virus infection in the
      UK from this source. The individual rate of needlestick injury in operating
      theatre staff was 1.55% per surgeon per operation (confidence interval (Cl) 0.6
      2.5%). The calculated rate of clinical hepatitis B in surgeons compared with the
      observed rate suggests that needlestick in theatre is the main mode of
      transmission.

PMID- 1757913
TI  - Bath scalds in children in the south-east of Scotland.
AB  - Scalds caused by domestic hot tap water constitute a significant but preventable
      hazard in childhood. We have reviewed some of the factors contributing to such
      injuries, and the experience of a regional paediatric burn unit in their
      treatment. There were 91 children with bath water scalds and 667 children with
      thermal injuries from other sources included in this study. In the former group,
      scalds were more common on the limbs, including the hands and feet. Scalds
      involving over 40% of body surface area were more common in children with bath
      water injuries; however, there was no difference between the groups with regard
      to hospital stay or requirement for skin grafting. Parents ran the bath
      responsible for scald production in most cases, but single parenthood did not
      appear to be a risk factor. First aid application made no significant difference
      to eventual burn area or hospital stay. It appears from this study that reduction
      of domestic hot water temperature is necessary. Statutory control is likely to
      offer the best solution to the problem of domestic hot tap water scalds in
      childhood.

PMID- 1757914
TI  - Methicillin-resistant Staphylococcus aureus in surgical patients: Malaysian
      experience.
AB  - Methicillin-resistant Staphylococcus aureus has emerged as an important cause of
      nosocomial infections in recent years. During 1988 in the Department of Surgery
      of the University Hospital in Kuala Lumpur, Malaysia, 148 patients were shown to
      be infected or colonized with these organisms. The patients at risk were those
      who stay in hospital for greater than 14 days, those over 50 years of age,
      patients who underwent neurosurgery, cardiothoracic surgery, or were admitted
      with major burns. Of the 148 patients, 78 (52.7%) were clinically infected, the
      remaining 70 being colonized. A total of 28 patients died (18.9%) but only five
      (3.4%) as a direct result of this infection. The estimated annual cost of
      controlling the organism was found to be approximately MR$250,000. (50,000
      pounds). This nosocomial infection therefore represents a serious problem,
      especially in developing countries where health funding and health facilities are
      limited.

PMID- 1757915
TI  - Controlled-tension suture-tying forceps.
AB  - Suture-tying forceps have been designed to enable surgeons to tie consecutive
      sutures to the same tension to create an evenly compressed wound. The tensioning
      effect of the forceps was tested by tying a suture to the end of a cantilever
      beam strain-gauge device. Three sutures were used: 10/0 nylon, 8/0 polyglactin
      (Vicryl) and 8/0 virgin silk. The tests were repeated, coating the tips with
      citrated blood, sodium hyaluronate and saline. Adjustment of the forceps altered
      the suture tension in 0.015-N steps. Sterilization of the forceps by ethylene
      oxide or by an autoclave caused no obvious regression in the forceps performance.
      When the suture and surface lubricant remain constant, there is a linear
      relationship between forceps setting and the tension induced in the suture.

PMID- 1757916
TI  - Obscure gastrointestinal bleeding: idiopathic aortoduodenal fistula.

PMID- 1757917
TI  - Anal leukoplakia: management using a staged plastic procedure.

PMID- 1757918
TI  - Surgery to the great toe.

PMID- 1757919
TI  - 'Z' metatarsal osteotomy: modified Mitchell's osteotomy for hallux valgus.
AB  - The Mitchell's osteotomy is an established and successful operation for hallux
      valgus. We report a previously undescribed procedure comprising a step or 'Z'
      osteotomy that is a simplified version of the Mitchell's osteotomy which involves
      less extensive soft tissue dissection and avoids opening the first
      metatarsophalangeal (MTP) joint. In total, 51 operations in 40 patients were
      reviewed with a mean follow-up of 4.7 years. The results were compared with those
      reported by Mitchell in his paper of 1958, using the same criteria. The mean age
      was 24 years and 82% of patients were women. In 88% of patients the results were
      rated excellent or good and there were no serious complications. These results
      suggest that this procedure is as successful as the Mitchell osteotomy in young
      patients, and it may have long-term benefits.

PMID- 1757920
TI  - Surgical decompression of the carpal tunnel using infiltrative anaesthesia:
      description of technique.

PMID- 1757921
TI  - Closed rupture of the distal transverse arch of the hand.

PMID- 1757922
TI  - Rhys-Davies exsanguinator: a previously unreported complication.

PMID- 1757923
TI  - Prognosis in rheumatoid arthritis.

PMID- 1757924
TI  - Rheumatoid factors as predictors of rheumatoid arthritis.

PMID- 1757925
TI  - Rheumatoid factors antedating clinical rheumatoid arthritis.
AB  - The relationship between rheumatoid factors (RF) and rheumatoid arthritis (RA)
      was studied in the Mini-Finland Health Survey. This covered a representative
      sample of the Finnish population over 30 years of age, initially comprising 8,000
      persons, of whom 7,217 participated in the field survey carried out in 1978-80.
      The participants were followed using record linkage with the Social Insurance
      Institution's population register to identify patients entitled to free
      medication. Until the end of 1988, 21 persons had developed new seropositive RA.
      In 15 cases, preillness specimens contained elevated levels (greater than or
      equal to 20 IU/ml) of RF. In the remaining 6 cases with RF negative preillness
      specimens, the interval from taking the blood specimen to the onset of disease
      was 4 years or more. RF represent a key element in the rheumatoid inflammatory
      process. Their occurrence in preillness specimens suggests that they may have a
      primary role in the pathogenesis of the disease.

PMID- 1757926
TI  - Older versus younger onset rheumatoid arthritis: results at onset and after 2
      years of a prospective followup study of early rheumatoid arthritis.
AB  - The influence of age at onset was studied in a prospective followup of early
      rheumatoid arthritis (RA). Patients greater than or equal to 60 years (n = 71)
      showed significantly more often an onset in both large and small joints and
      higher disease activity at the start compared with patients less than 60 years (n
      = 142). The higher disease activity was still present after 2 years of followup
      (greater than or equal to 60 years, n = 46, less than 60 years, n = 101); as
      well, there was a tendency towards more radiographic damage. Rheumatoid factor
      (RF) and DR4 were comparable in both age groups. Our data show a more severe
      course in older age RA. This disagreement with the literature is probably due to
      the fact that many studies are cross sectional with unbalance of RF in the 2 age
      groups.

PMID- 1757927
TI  - Clinical and health status measures over time: prognosis and outcome assessment
      in rheumatoid arthritis.
AB  - We studied clinical and health status measures in 561 patients with rheumatoid
      arthritis (RA). Two hundred sixty-four patients were seen within 2 years of
      disease onset and followed for an additional 2 years. Four other groups were each
      followed for 5 years, and had disease durations of 2-7, 7-12, 12-17, and 17-22
      years, respectively, at the first clinic visit. Functional disability developed
      very early in the course of RA and continued to worsen at about an equal rate
      over 22 years. Anxiety, pain scores, and self-assessed severity also increased
      with time, but erythrocyte sedimentation rate (ESR), morning stiffness, and joint
      counts were unchanged. Treatment resulted in reduction in joint counts and in
      nonsignificant improvements in ESR, stiffness, and psychological scores. But
      functional loss increased in each time period in spite of treatment. Variables
      most effective in controlled clinical trials are not effective as longterm
      measures of RA outcome.

PMID- 1757928
TI  - The assessment and prediction of functional disability in rheumatoid arthritis.
AB  - We assessed functional disability with the Stanford Health Assessment
      Questionnaire Functional Disability Index (FDI) in 1,274 patients with rheumatoid
      arthritis (RA) followed longitudinally for up to 12 years. The rate of functional
      loss increased sharply after the first clinic visit. Half of patients with RA
      (median survival time) will reach FDI scores of about 1 in 2 years, 2 in 6 years,
      and 2.5 in 10 years after the first clinic visit, levels that correspond to
      moderate, severe and very severe loss of functional ability. Functional outcomes
      may be predicted by simple demographic and clinical assessments, the best of
      which are self-assessed measures of global severity, pain and function.

PMID- 1757929
TI  - Mortality predictors among 263 patients with rheumatoid arthritis.
AB  - A cohort of 263 patients who completed Health Assessment Questionnaires (HAQ)
      each year from 1981 to 1989 is examined. Forty-three (43) possible covariates
      measured in 1981 are considered that might help predict mortality over the 8
      years of the study. We use univariate correlation coefficients, stepwise
      regressions, and survival functions to identify a number of covariates that
      appear useful for predicting survival: age (-), prednisone use (-), disability
      index (-), male sex (-), never married (-), penicillamine use (+), divorced (+),
      and no occupation (-). Our results confirm studies suggesting that the HAQ
      disability index is a useful prognosticator of length of survival.

PMID- 1757930
TI  - Strength and function in the normal and rheumatoid hand.
AB  - We have reevaluated the Martin vigorimeter to measure grip strength in healthy
      subjects, and patients with rheumatoid arthritis (RA), and investigated the
      correlation of grip strength and hand function using the Jebsen hand function
      tests and Purdue pegboard test before and after treatment. The vigorimeter showed
      good test-retest reliability (r greater than 0.911) and interrater reliability (r
      greater than 0.915). Test-retest reliability was greater than 0.97 for the Jebsen
      test, and greater than 0.94 for the Purdue test in healthy individuals. Seventeen
      patients with RA were studied at intervals of 1 to 16 weeks. Active joint count
      and grip strength both improved significantly. Improvement in grip strength
      correlated with improvement in active joint count. Hand function tests were
      significantly impaired in the patients with RA.

PMID- 1757931
TI  - "Pseudoseptic" arthritis complicating rheumatoid arthritis: a report of six
      cases.
AB  - Six cases of a severe, sterile, inflammatory arthritis mimicking septic arthritis
      occurred in 328 patients with rheumatoid arthritis (RA) over a 4-year period.
      Four patients were poorly controlled by or had recently discontinued a disease
      modifying antirheumatic drug. Five improved after receiving increased
      glucocorticoid therapy. Radiographs showed no accelerated joint destruction after
      a mean followup of 29.5 months (range 8-49). Recognition of "pseudoseptic"
      arthritis occurring in the course of RA permits appropriate therapy and avoids
      extended antibiotic treatment.

PMID- 1757932
TI  - Treatment of rheumatoid arthritis with methotrexate: a prospective open longterm
      study of 191 cases.
AB  - One hundred and ninety-one patients with severe rheumatoid arthritis (RA) were
      included in a prospective open longterm study of the safety, efficacy and
      maintenance of methotrexate (MTX) treatment. The mean duration of MTX treatment
      was 19 +/- 13.2 (3-58) months; the mean weekly dose of MTX was 10.2 +/- 0.2 mg.
      Analysis of the 191 patients in an intent-to-treat manner showed a significant
      improvement of all the clinical variables and a decrease of erythrocyte
      sedimentation rate with a steroid sparing effect. The probability of continuing
      MTX therapy for up to 2 years was 65% and for up to 5 years was 46%. Adverse
      effects of MTX occurred in 37.1% of the patients, but only 15.7% discontinued MTX
      permanently.

PMID- 1757933
TI  - Salmonella arizona arthritis and septicemia associated with rattlesnake ingestion
      by patients with connective tissue diseases. A dangerous complication of folk
      medicine.
AB  - Snakes constitute the main reservoir of Salmonella arizona, which are
      opportunistic pathogens in patients with serious underlying diseases. The 2 may
      meet when such patients ingest uncooked snake flesh, most often as a folk remedy
      for arthritis or other conditions. We have seen 11 patients in whom Salmonella
      arizona infection was documented. Six had systemic lupus erythematosus and
      another had dermatomyositis and are described in detail. All 7 had received
      prednisone, which was combined with azathioprine in 3. Five developed septic
      arthritis, including the site of a hip prosthesis in one patient. A history of
      dessicated rattlesnake ingestion as a "natural" remedy in either capsule or
      powder form was obtained in all but one of the 7 patients. Patients often think
      that if natural or folk remedies are not helpful they also are not harmful and,
      therefore, safe and worth trying. We disprove that belief and call attention to
      the perils of one such remedy: dessicated rattlesnake, particularly when ingested
      by patients with connective tissue diseases who may be immunocompromised.

PMID- 1757934
TI  - Early undifferentiated connective tissue disease. I. Early clinical manifestation
      in a large cohort of patients with undifferentiated connective tissue diseases
      compared with cohorts of well established connective tissue disease.
AB  - We identified a cohort of 410 patients with connective tissue disorders (CTD) of
      less than or equal to 1 year duration among the participating clinics of the
      Cooperative Systematic Studies of the Rheumatic Diseases Program. Fifty-seven had
      rheumatic arthritis (RA), 57 systemic lupus erythematosus, 37
      poly/dermatomyositis, 46 scleroderma, and 213 early undifferentiated CTD,
      including patients with Raynaud's phenomenon, unexplained polyarthritis or at
      least 3 CTD manifestations such as rashes, myalgias, etc. Baseline clinical data
      are now being reported. The followup of these patients may prove to be valuable
      in understanding these diseases. To our knowledge no similar cohort of patients
      is available for further investigation.

PMID- 1757935
TI  - Early undifferentiated connective tissue disease. II. The frequency of
      circulating antinuclear antibodies in patients with early rheumatic diseases.
AB  - The presence of antinuclear antibodies (ANA) in the serum is a common finding in
      various connective tissue disorders, but usefulness of these antibodies in making
      diagnoses or prognoses is not known. We report the results of a panel of ANA
      determinations including ANA, anti-dsDNA, Sm, RNP, SSA, SSB, Jo-1, Scl-70 and PM
      1 in 410 patients in a 5-year descriptive study of 410 patients with rheumatic
      disease symptoms of less than one year's duration. While some patients met
      diagnostic criteria for a specific rheumatologic diagnosis, others were
      classified as undifferentiated connective tissue disease (UCTD) and were
      subclassified by a constellation of symptoms. Our results show that ANA is
      sensitive in systemic lupus erythematosus (SLE) and progressive systemic
      sclerosis even in early disease but is not specific. Other "specific"
      autoantibodies were seen most frequently in SLE but were relatively insensitive
      and were seen in low frequency in UCTD. ANA have limited diagnostic value in
      patients with early disease. The prognostic value of these tests will be assessed
      as the prospective study of these cohorts progresses.

PMID- 1757936
TI  - Role of lymphocytes in collagen induced arthritis.
AB  - We investigated the time related changes of lymphocyte subsets in the blood,
      regional lymph node and thymus during the development of collagen induced
      arthritis in mice. Flow cytometric analysis showed that Lyt2+ T, but not L3T4+ T
      cells in the blood or regional lymph node, was significantly reduced throughout
      the observation. The number of Lyt2+ T cells was decreased in lymph nodes of
      collagen immunized vs adjuvant controls while B cells were increased and L3T4+ T
      cells were not different. These might act as a potential factor for the onset of
      collagen induced arthritis. The reduction of Lyt2+ cells was not influenced by
      thymic T cell maturation; it is conceivable that the main immune organ is the
      regional lymph node.

PMID- 1757937
TI  - Major histocompatibility complex (MHC) complement deficiency, ancestral
      haplotypes and systemic lupus erythematosus (SLE): C4 deficiency explains some
      but not all of the influence of the MHC.
AB  - In 1982 we reported that among Caucasians with systemic lupus erythematosus (SLE)
      there is an increased frequency of C4A null. As this allele occurs on the HLA
      A1,B8,BfS, C4AQO,B1,DR3 (8.1) supratype, we suggested this accounted for the
      reported association of B8 and DR3. Since then we have shown that many supratypes
      including 8.1 identify unique segments of DNA conserved from a common but remote
      ancestor. Many of these ancestral haplotypes (AH), including 8.1, carry disease
      genes and some bear C4 null. We have therefore tested the hypothesis that in SLE
      C4 null alleles are directly involved by examining (1) whether all or only some
      AH bearing C4 null alleles are increased, (2) whether C4 null is increased in all
      racial groups examined, and (3) whether C4 null is associated with the presence
      of antinuclear antibodies (ANA) in the absence of SLE. We performed HLA and
      complement allotyping on 62 Australian Caucasians and 9 Australian aborigines
      with SLE and on the 10 out of 133 healthy individuals with 7 or more
      international units of ANA. Our data confirm an association of C4A null in
      Australian Caucasians (gene frequency 0.30 versus 0.15 in controls) and show an
      increased frequency of C4B null in Australian aborigines (gene frequency 0.33
      versus 0.22). A review of an extensive literature shows C4A and/or C4B null are
      increased in all racial groups examined. On the other hand, the HLA
      A3,B7,BfS,C4A3,B1,DR2 (7.1) AH rather than C4 null is associated with ANA in
      health. Our data indicate that while C4 nulls contribute to MHC susceptibility,
      other genes are likely to be involved.

PMID- 1757938
TI  - Muscular weakness in systemic lupus erythematosus.
AB  - We systematically evaluated muscular weakness in a series of patients with
      systemic lupus erythematosus (SLE) using standardized neurological scoring
      systems, namely Neuropathy Symptom Score for symptoms, and Neurological
      Disability Score for signs. Symptoms of weakness were statistically associated
      with clinical and electrophysiological evidence of nerve and muscle disease.
      Signs of weakness were statistically associated with malaise, disease activity,
      anemia, age, and raised erythrocyte sedimentation rate. Various disease
      associated variables influenced symptoms and signs differently. It is important
      to define a baseline characterizing muscular weakness in SLE before conclusions
      are drawn regarding its significance and prevalence.

PMID- 1757939
TI  - Muscle pathology in ankylosing spondylitis: clinical, enzymatic,
      electromyographic and histologic correlation.
AB  - We assessed muscle pathology in 30 patients with ankylosing spondylitis (AS) and
      22 controls to assess if skeletal muscle is affected primarily by the
      inflammatory process of the disease. Investigations included a questionnaire on
      musculoskeletal discomfort, physical exercises, dynamometric measurements, EMG,
      and biopsy of the quadriceps muscle. Symptoms of muscular weakness were related
      with enthesopathic activity index. Plasma CK was higher in patients than in
      controls. A myopathic EMG pattern was found in 46.4% patients. Histological
      changes were found in 66% and did not correlate with symptomatology. Patients
      with AS with clinical muscular manifestations probably have intense enthesopathic
      inflammatory activity. It is suggested that muscles are secondarily affected as a
      consequence of pain inhibition and reduced activity.

PMID- 1757940
TI  - Magnetic resonance imaging of the parotid gland in patients with Sjogren's
      syndrome.
AB  - To detect structure and size abnormalities, magnetic resonance imaging (MRI) of
      the parotid gland was performed on 36 patients with sicca complaints. Twenty-four
      patients had primary Sjogren's syndrome (SS) without rheumatoid arthritis (RA) or
      connective tissue disease; 6 had secondary SS associated with RA, whereas in
      another 6 cases the related disease could not be classified. Characteristic gland
      size and structural abnormalities were identified in patients with SS and various
      stages could be established, compared to patients with other parotid gland
      disorders, as well as healthy persons. MRI provides an accurate noninvasive
      technique for assessment of xerostomia in patients with SS.

PMID- 1757941
TI  - Electrodermal and microcirculatory activity in patients with fibromyalgia during
      baseline, acoustic stimulation and cold pressor tests.
AB  - The peripheral sympathetic activity was studied in 27 patients with fibromyalgia
      and 29 healthy controls through simultaneous measurements of electrodermal
      variables and blood flow at palmar skin sites during baseline, acoustic
      stimulation, and cold pressor tests. Compared to the controls, the patient group
      showed a significantly larger overall increase in the skin electrical conductance
      and less vasoconstriction during acoustic stimulation and cold pressor tests.
      These findings imply an increased activity of cholinergic and decreased activity
      of adrenergic components of the peripheral sympathetic nervous system in patients
      with fibromyalgia.

PMID- 1757942
TI  - Isokinetic and isometric muscle strength combined with transcutaneous electrical
      muscle stimulation in primary fibromyalgia syndrome.
AB  - Twenty women with primary fibromyalgia syndrome and 20 age matched healthy women
      were investigated. The subjects performed maximum voluntary isokinetic
      contractions of the right quadriceps in an isokinetic dynamometer. Maximum
      voluntary isometric contractions of the right quadriceps were performed with
      superimposed transcutaneous electrical stimulation. The examination protocol was
      repeated after 1 h of resting. Isokinetic and isometric muscle strength was found
      to be, respectively, 45% (p = 0.0001) and 44% (p = 0.0001) lower in the patient
      group compared to the healthy subjects. The frequency of superimposed twitches
      was 65% in the patient group and 15% in the control group (p = 0.003). Patients
      with primary fibromyalgia have a lower maximum voluntary muscle strength than
      expected. The increased presence of superimposed electrically elicited twitches
      during maximum voluntary contraction indicates submaximal force application in
      primary fibromyalgia syndrome.

PMID- 1757943
TI  - Longitudinal analysis of HLA associated risks for iridocyclitis in juvenile
      rheumatoid arthritis.
AB  - The risk of iridocyclitis in children with early onset pauciarticular juvenile
      rheumatoid arthritis (EOPA-JRA) has been shown to be associated with certain HLA
      haplotypes. Our report contains an actuarial analysis, using one-year intervals,
      of 161 subjects and estimates haplotype specific risks. Individuals who possess
      the major susceptibility haplotype HLA-DR5 (11) developed eye disease earlier and
      with a greater frequency than did those with the protective HLA-DR1 haplotype.
      Highly significant differences were found between the resulting life-table curves
      for HLA-DR5 and HLA-DR1 positive subjects (p = 0.00003). These time oriented risk
      estimates may aid clinicians in determining more precisely the probability of
      iridocyclitis throughout the course of the disease in children with EOPA-JRA.

PMID- 1757944
TI  - Soluble interleukin-2 receptor in juvenile rheumatoid arthritis.
AB  - Juvenile rheumatoid arthritis (JRA) is a chronic, relapsing, inflammatory
      childhood disease characterized by arthritis and systemic inflammation. At
      present there is no rapid, efficient laboratory method of assessing disease
      activity and degree of immune activation. We measured serum soluble interleukin 2
      receptor (sIL-2R) levels in 85 samples from 72 patients (22 samples from patients
      with systemic JRA, 34 from polyarticular patients, 29 from pauciarticular
      patients, of which 10 were HLA-B27 positive). The mean sIL-2R level from patients
      was 1565 U/ml, which is significantly elevated compared to control values of 594
      U/ml (p less than or equal to 0.005). The highest levels were seen in patients
      with systemic JRA (mean value 2121 U/ml) while the lowest values were seen in HLA
      B27 positive (+) patients (mean value 899 U/ml). Patients with clinically active
      disease had significantly elevated levels (mean value 1745 U/ml) compared to
      patients with inactive disease (mean value 846 U/ml, p less than or equal to
      0.01). Highest levels were seen in patients with active systemic JRA (mean value
      2419 U/ml) while patients with pauciarticular JRA and B27 + JRA had the lowest
      sIL-2R levels (1167 and 1045 U/ml, respectively). sIL-2R levels were elevated in
      all subgroups of clinically active patients compared to controls (p less than or
      equal to 0.0005). Three of the 4 patients with serial sIL-2R measurements showed
      falling values during the period of clinical remission. Using regression analysis
      and likelihood ratio tests, we found a significant correlation between sIL-2R
      levels and both disease activity and joint count (p less than or equal to
      0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1757945
TI  - Syringomyelia in a patient with rheumatoid subluxation of the cervical spine.
AB  - A patient with rheumatoid damage of the cervical spine with cervical cord
      compression, complaining of a typical syringomyelic syndrome is described.
      Magnetic resonance imaging revealed cord compression due to an upward
      displacement of the odontoid peg with a mass of pannus behind the dens, and a
      syrinx cavity extending from C1 to T1. We postulate that this patient's
      syringomyelia probably represents a complication of cervical rheumatoid arthritis
      that has not been described.

PMID- 1757946
TI  - Herpes simplex hepatitis in a patient with psoriatic arthritis taking prednisone
      and methotrexate. Report and review of the literature.
AB  - Herpes simplex hepatitis is a rare disease in adults and with high mortality
      (81%). Most cases are seen in immunocompromised hosts or in the third trimester
      of pregnancy. A 43-year-old woman with psoriatic arthritis, treated with
      prednisone and methotrexate (MTX), presented with an acute abdomen and elevated
      liver enzymes. The diagnosis was made by liver biopsy. MTX was stopped and
      acyclovir was started. The patient survived. The diagnosis of Herpes simplex
      should be suspected in immunocompromised hosts and established by liver biopsy
      and viral cultures. Treatment includes parenteral acyclovir and discontinuation
      or reduction of immunosuppressive therapy.

PMID- 1757947
TI  - Hypertension, renal artery stenosis and the "primary" antiphospholipid syndrome.
AB  - We describe a 35-year-old man with a history of previous deep vein thrombosis who
      presented with hypertension. Renal investigations revealed failure to excrete
      contrast medium by the right kidney on intravenous pyelography. Digital
      subtraction angiography showed an 80% stenosis of the left renal artery. He was
      antinuclear antibody negative, as well as negative for antibodies to double
      stranded deoxyribonucleic acid and extractable nuclear antigens. The lupus
      anticoagulant test and antibodies to cardiolipin were positive. He conforms to a
      diagnosis of "primary" antiphospholipid syndrome.

PMID- 1757948
TI  - Avascular necrosis associated with anticardiolipin antibodies.
AB  - The association between antiphospholipid antibodies (aPL) and venous and arterial
      thromboses has been well described. However the association between aPL and
      avascular necrosis has not been widely reported. We report the association of
      avascular necrosis with the primary anticardiolipin antibody syndrome in a
      patient with a history of hemiplegic migraine and cerebrovascular infarcts. This
      phenomenon appears to be secondary to hemostatic abnormalities associated with
      the presence of aPL.

PMID- 1757949
TI  - Immunohistological characterization of lymph nodes in two cases of adult onset
      Still's disease.
AB  - Although lymphadenopathy occurs in 60% of patients with adult Still's disease,
      its histopathological pattern has only recently been described. We report on the
      immunohistological study of a lymph node biopsy and the clinical course of 2
      patients with adult Still's disease. The lymph node histology was characterized
      by a diffuse paracortical expansion with a high content of immunoblasts and plump
      endothelium venules. Immunohistochemistry using the alkaline phosphatase,
      antialkaline phosphatase technique showed the mixed B and T cell nature both of
      proliferating cells and immunoblasts. When antiheavy and light chain reagents
      were applied, the B cell component became polytypic. Our report stresses the
      relevance of immunohistological investigation in the diagnostic approach to
      Still's disease in which histological findings, if taken alone, might be
      misleading.

PMID- 1757950
TI  - An unusual case of factitious arthritis.
AB  - Factitious arthritis is an unusual manifestation of a factitious illness. We
      report a case of factitious arthritis after the self insertion of needles and
      fragments of metallic paper clips into the knee joint area. The case illustrates
      an unusual presentation of Munchausen's syndrome.

PMID- 1757951
TI  - Colonic ulcerations in Wegener's granulomatosis.

PMID- 1757953
TI  - The fragile X syndrome.

PMID- 1757952
TI  - Osteitis condensans ilii and sacroiliitis.

PMID- 1757954
TI  - Cloning of the gene for the fragile X syndrome: implications for the clinical
      geneticist.

PMID- 1757955
TI  - Molecular genetics of fragile X: a cytogenetics viewpoint. Report of the Fifth
      International Symposium on X Linked Mental Retardation, Strasbourg, France, 12 to
      16 August 1991 (organiser Dr J-L Mandel).

PMID- 1757956
TI  - Fragile X syndrome: genetic localisation by linkage mapping of two microsatellite
      repeats FRAXAC1 and FRAXAC2 which immediately flank the fragile site.
AB  - We report the genetic localisation of the fragile site at Xq27.3 associated with
      fragile X syndrome. The position of the fragile site within the multipoint
      linkage map was determined using two polymorphic microsatellite AC repeat markers
      FRAXAC1 and FRAXAC2. These markers were physically located within 10 kilobases
      and on either side of the p(CCG)n repeat responsible for the fragile site.
      FRAXAC1 has five alleles with heterozygosity of 44% and is in strong linkage
      disequilibrium with FRAXAC2 which has eight alleles and a heterozygosity of 71%.
      No recombination was observed either between these markers in 40 normal CEPH
      pedigrees or with the fragile X in affected pedigrees. These markers provide the
      means for accurate diagnosis of the fragile X genotype in families by rapid
      polymerase chain reaction analysis and were used to position the fragile X within
      the multipoint map of the X chromosome to a position 3.7 cM distal to DXS297 and
      1.2 cM proximal to DXS296.

PMID- 1757957
TI  - Genotype prediction in the fragile X syndrome.
AB  - Fragile X positive, mentally retarded males have been shown to have an insertion
      or amplification of DNA sequences at, or close to, the site of expression of the
      fragile site. We show here the application of the detection of such changes to
      the diagnosis of affected males and female carriers and the identification of
      normal transmitting males. One fragile X negative male with the clinical features
      of the Martin-Bell syndrome also possesses an inserted/amplified DNA sequence.
      The implications of these results for screening for the fragile X syndrome are
      discussed.

PMID- 1757958
TI  - Selection in blood cells from female carriers of the fragile X syndrome: inverse
      correlation between age and proportion of active X chromosomes carrying the full
      mutation.
AB  - We have studied the patterns of mutation and X inactivation in female carriers of
      a fragile X mutation, to try to correlate them with various phenotypic features.
      We used a simple assay, which shows simultaneously the size of the mutation, its
      methylation status, and DNA fragments that represent the normal active and
      inactive X chromosomes. We have observed an age dependent process, whereby the
      'full' fragile X mutation is found preferentially on the inactive X in leucocytes
      in adult females, but not in younger ones. This phenomenon was not observed in
      female carriers of a 'premutation', who have little phenotypic expression.
      Preliminary data suggest that young females who show preferential presence of a
      full mutation on the active X in leucocytes may be at increased risk for mental
      retardation. We have also obtained preliminary evidence for an age dependent
      decrease in the somatic heterogeneity of full mutations, possibly owing to
      selection for smaller mutated fragments. If confirmed, the latter phenomenon
      might account for the known decrease with age of the expression of the fragile
      site. Our observations suggest that a gene whose expression is affected by the
      presence of a full mutation (possibly the FMR-1 gene) has a cell autonomous
      function in leucocytes, leading to a slowly progressive selection for cells where
      the mutation is on the inactive X chromosome.

PMID- 1757959
TI  - A single lymphocyte culture for fragile X induction and prometaphase chromosome
      analysis.
AB  - A single lymphocyte culture system is described which produces both reliable
      fragile X expression and elongated chromosomes for prometaphase analysis. This
      system, which is based on that described by Wheater and Roberts in 1987, involves
      the deoxycytidine release of a thymidine block. Eight fragile X positive subjects
      had an average expression level of 26%, with a range of 12% to 45%, using the
      thymidine/deoxycytidine protocol. This was comparable to the levels obtained in
      parallel cultures treated with thymidine alone or fluorodeoxyuridine.

PMID- 1757960
TI  - Ehlers-Danlos syndrome type IV: phenotypic consequences of a splicing mutation in
      one COL3A1 allele.
AB  - The features of a child with Ehlers-Danlos syndrome type IV (EDS IV) resulting
      from a mutation in one COL3A1 allele were studied. The child was heterozygous for
      a G- to A-transition at the splice donor site of intron 41. It resulted in the
      splicing out of the exon 41 encoded sequence from alpha 1(III) mRNA and the
      deletion of 36 amino acids from glycine775 to lysine810 of the triple helical
      domain of alpha 1(III) chains of type III collagen. The amount of type III
      collagen in the dermis was only about 11% of normal. The child had the acrogeric
      form of EDS IV. He had the characteristic facies with a pinched nose, thin lips,
      and prominent eyes. These facial features, his aesthenic build, thin skin,
      prominent subcutaneous veins, and aged hands produced a 'cachectic' appearance.
      These features were evident in early childhood and worsened up to 12 1/2 years
      when he was last reviewed. Spontaneous bruising, bleeding from the large bowel,
      constipation, and delayed gastric emptying were other features. In cross section,
      the dermal collagen fibrils were round and measured 93.3 +/- 11.5 nm in diameter
      which was not significantly different from control values of 102.5 +/- 13.4 nm.
      The serum type III procollagen amino-terminal propeptide level of 25.5 ng/ml was
      within the normal age matched values of 15.5 +/- 7.7 ng/ml despite the low
      production of type III collagen by cultured fibroblasts. The child probably had a
      spontaneous new mutation in one COL3A1 allele as only normal sequences were
      obtained from the corresponding amplified region of the parent's leucocyte DNA.

PMID- 1757961
TI  - The midline craniofacial skeleton in holoprosencephalic fetuses.
AB  - Craniofacial skeletal development in eight human holoprosencephalic fetuses from
      second trimester abortions were examined by radiography and histology. The whole
      spectrum of associated facial malformations from anophthalmia through cyclopia,
      ethmocephaly, cebocephaly, and median cleft lip to short philtrum was
      represented. Cases with the most severe facial malformations also had the most
      severely affected facial skeleton. In the facial skeleton, the premaxilla was
      most often affected; it was absent in seven cases and malformed in the one with
      only a short philtrum. This and other facial skeletal malformations can be
      explained as abnormal fusion of the facial bones because of defective development
      of the nasal cartilage. The occipital bones were normal, but the basicranial
      skeleton anterior to the spheno-occipital junction was affected in all cases. The
      findings support the hypothesis that the facial malformations in
      holoprosencephaly result from disturbance in embryonal life of the mesoderm at
      the rostral end of the notochord.

PMID- 1757962
TI  - Determination of Duchenne muscular dystrophy carrier status by single strand
      conformation polymorphism analysis of deleted regions of the dystrophin locus.
AB  - The molecular characterisation of the dystrophin gene, mutations in which are
      responsible for X linked Duchenne and Becker muscular dystrophies, has led to an
      array of strategies for the diagnosis of affected subjects and carriers.
      Initially these were based on blotting and hybridisation technologies but have
      recently been largely superseded by PCR based techniques which afford greater
      speed and sensitivity. We describe the use of single strand conformation
      polymorphism to detect heterozygosity in regions of the dystrophin locus which
      are deleted in affected males, to determine the carrier status of their female
      relatives.

PMID- 1757963
TI  - Becker muscular dystrophy patient with a large intragenic dystrophin deletion:
      implications for functional minigenes and gene therapy.
AB  - The genetic defects responsible for the allelic disorders of BMD and the more
      severe DMD have been shown to be mutations within the dystrophin gene, which
      encodes a 14 kb transcript. We describe here a BMD patient who belongs to a small
      class of subjects with large in frame deletions of the dystrophin gene that
      remove apparently dispensable coding sequence, thereby producing functional
      truncated dystrophin. The in vitro reconstruction of these deletion derivatives
      of full length dystrophin transcripts should enable higher efficiency
      transfection of human muscle or murine germline cells using retroviral based
      vectors, compared with the full length transcript. This capability offers a means
      of examining retroviral mediated transfer as a potential therapeutic strategy in
      severely affected DMD patients.

PMID- 1757964
TI  - Arginine 109 to glutamine mutation in a girl with ornithine carbamoyl transferase
      deficiency.
AB  - We studied DNA from 29 families with at least one member with ornithine carbamoyl
      transferase (OCT) deficiency and have found a mutation in the TaqI site within
      exon 5 of the OCT gene in a female presenting at the age of 21 months.
      Hybridisation with site specific oligonucleotides shows that the mutation is a C
      to T substitution resulting in a glutamine for arginine substitution at amino
      acid 109.

PMID- 1757965
TI  - A cystic fibrosis patient who is homozygous for the G85E mutation has very mild
      disease.

PMID- 1757966
TI  - A cystic fibrosis patient with the nonsense mutation G542X and the splice site
      mutation 1717-1.
AB  - A cystic fibrosis patient with the genotype G542X/1717-1 (G----A) was identified
      by DNA sequencing of exon 11 of the CFTR gene. The available molecular and
      clinical data are presented. This is the first report of a patient with this rare
      genotype and may serve to improve our understanding of allele interactions.

PMID- 1757967
TI  - Multiple exostoses in a patient with t(8;11)(q24.11;p15.5).
AB  - The occurrence of multiple exostoses in a carrier of a balanced translocation
      t(8;11) (q24.11;p15.5) is described. The breakpoint on chromosome 8 is at
      proximal q24.1 within the critical region reported for Langer-Giedion syndrome.

PMID- 1757968
TI  - Phenotypic expression of the first liveborn 68,XX triploid newborn.

PMID- 1757969
TI  - Effects of an intrauterine copper device on serum copper, endometrial histology,
      and ovarian, hepatic, and renal functions in the Japanese monkey (Macaca fuscata
      fuscata).
AB  - A copper intrauterine device (Cu-IUD) was inserted transabdominally into the
      uterine cavity of eight Japanese monkeys (Macaca fuscata fuscata) for 4 to 6
      months, and effects on various organ functions were examined. Results showed no
      significant effects on the menstrual cycle length, serum levels of LH, estradiol
      17 beta, progesterone or clinical biochemical data such as serum copper, glutamic
      oxaloacetic transaminase, glutamic pyruvic transaminase, lactic dehydrogenase,
      and blood urea nitrogen. Histology revealed edema and infiltration of
      eosinophilic leukocytes in the endometrium treated with a Cu-IUD.

PMID- 1757970
TI  - Auditory evoked potentials in the Japanese monkey.
AB  - Auditory sensitivity based on auditory brain stem response (ABR), whole nerve
      action potential (AP), and cochlear microphonics (CM) to tone bursts of 0.5-8 kHz
      were compared with behavioral audiometry in the Japanese monkeys. Although
      sensitivity loss at 4-6 kHz was observed in these potentials, an increase in
      sensitivity at 8 kHz was obtained only in the ABR. Thus the sensitivity loss at 4
      6 kHz originates at the peripheral system and the increased sensitivity at 8 kHz
      originates at the central.

PMID- 1757971
TI  - Total serum creatine kinase and isozyme concentrations in the owl monkey.
AB  - Serum samples from 62 owl monkeys were analyzed to determine concentrations of
      creatine kinase activity and isozymes. Fifty monkeys were determined to be
      clinically normal, while twelve had cardiac disease. Findings showed that the
      data had a non-normal distribution. Based on nonparametric tests, significant
      differences were not observed between sexes or animals with and without cardiac
      disease, indicating that CK activity and isozymes are not reliable indicators of
      myocardial disease in the owl monkey. Reference values presented are only
      intended as a guide. Each laboratory should determine its own reference values.

PMID- 1757972
TI  - Altered lymphocyte phenotypes and proliferative responses in chimpanzees infected
      with hepatitis C virus.
AB  - Peripheral blood mononuclear cells (MNC) from three chimpanzees infected with
      hepatitis C virus (HCV) and from two uninfected animals were analyzed by
      monoclonal antibody phenotyping using flow cytometry. Significant differences in
      numbers of MNC's expressing cluster designation (CD) phenotypes CD4, CD14, CD19,
      and CD45RA were found. Additionally, significant differences in MNC proliferation
      in response to mitogens were also found. This altered proliferative capacity and
      cellular phenotype profile may be important markers in studying the pathogenesis
      of chronic HCV disease.

PMID- 1757973
TI  - Lymphocyte and neutrophil dysfunction associated with hepatitis B virus and
      hepatitis non-A, non-B virus infection in the chimpanzee.
AB  - Chimpanzees were examined for the effect of viral hepatitis infections on
      specific and nonspecific immune response mechanisms. The data suggest that
      infection with either hepatitis B virus or hepatitis non-A, non-B virus may
      result in suppression of cellular immune response components. Mitogen-induced
      lymphocyte proliferation was lower in virus-infected chimpanzees than in naive
      animals. Neutrophils from virus infected animals exhibited decreased or altered
      chemiluminescence kinetics.

PMID- 1757974
TI  - Induction of multiple follicular development and superovulation in the olive
      baboon, Papio anubis.
AB  - The objective of this study was to induce multiple follicular development and
      superovulation in the olive baboon. Beginning at menses, adult female baboons
      were treated with hMG for 10 days followed by hCG on day 11. Multiple follicular
      development was seen in all 19 animals; superovulation occurred in 11 of these.
      Serum E2 and P levels were consistent with multiple follicular and corpora lutea
      development, respectively. Ovulated ova were able to be fertilized. These results
      indicate that olive baboons can be superovulated using a regimen of hMG and hCG,
      however, development of antibodies against the human hormones precludes
      restimulation.

PMID- 1757975
TI  - Osmotic fragility of erythrocytes in Bolivian and Brazilian squirrel monkeys
      (Saimiri sciureus).
AB  - Median corpuscular fragility of erythrocytes does not differ significantly
      between fed and fasted Bolivian and Brazilian squirrel monkeys and are similar to
      values reported in humans and rhesus monkeys. This report further confirms that
      the fasting hyperbilirubinemia present only in Bolivian squirrel monkeys with a
      Gilbert-like syndrome is not due to an increased fragility of erythrocytes and
      should be classified as a nonhemolytic hyperbilirubinemia.

PMID- 1757976
TI  - Postnatal change in lipid composition and nerve conduction of peripheral nerves
      of young rhesus monkeys.
AB  - Body weight, motor and sensory nerve conduction velocities of fore and hind
      limbs, and lipid composition were measured sequentially in peripheral nerves of
      15 rhesus monkeys. Initially measurements were made with monkeys six to eight
      months of age. There were significant increases in body weight, motor, and
      sensory nerve conduction and myelin marker lipids over a five months period, but
      no change was observed in free fatty acids, triglycerides, and esterified
      cholesterol. These results indicate that myelination continues at least for 11 to
      13 months of postnatal age in rhesus monkeys.

PMID- 1757977
TI  - Exogenous progesterone recycling and early detection of pregnancy in rhesus
      monkeys.

PMID- 1757978
TI  - Sleep problems in children with mental handicap.
AB  - This paper reports on a longitudinal study of sleep problems in 200 children with
      severe mental handicap. Sleep problems were extremely common: 51% of children had
      settling problems, 67% of children had waking problems, and 32% of parents said
      they rarely got enough sleep. Sleep problems were also very persistent: between a
      half and two-thirds of children who exhibited sleep problems at Time 1 still had
      them 3 years later. Sleep problems were associated with a number of child
      characteristics: poor communication skills, poor academic skills, poor self-help
      skills, incontinence, daytime behaviour problems and epilepsy. There were no
      relationships with family variables such as social class, income, family
      composition or housing tenure. However, maternal stress, maternal irritability
      and perceived impact on the family were related to sleep problems. A Sleep Index
      was constructed, and path analysis was used to trace the main causal pathways of
      the child, family and social characteristics. Ten variables explained 50% of the
      variance in the Sleep Problems Index. Communication skills played a pivotal role.
      The implications of the findings for intervention strategies are discussed.

PMID- 1757979
TI  - Psychosocial effects on siblings of children with autism and mental retardation:
      a population-based study.
AB  - The probands of this study were 60 children and young adults between 5 and 20
      years of age, 20 of whom had siblings with autism, 20 of whom had siblings with
      mental retardation, and 20 of whom had siblings who were free of handicap. The
      three proband groups were matched for gender, birth order and socioeconomic
      status. The children were questioned about their sibling relationships and about
      particular problems they faced concerning their handicapped brothers or sisters
      and about problems concerning themselves. Parents were interviewed about the
      healthy child's behaviour and social adjustment. Mothers completed the Eysenck
      Personality Inventory concerning themselves. Siblings of handicapped children and
      especially siblings of children with autism were more concerned about the future.
      They also felt lonely more often and many of them had peer problems. They often
      regarded their handicapped siblings as a burden. They tended to have only one
      sibling. Siblings often did not know why their handicapped brother or sister was
      different from other children. There were more behaviour disturbances in the
      siblings of handicapped children and mothers with a child with autism reported
      more 'stressful events'. There were no differences as regards the personality of
      the mothers and the self-concept of the children between the three groups.

PMID- 1757980
TI  - Clients' community and social contacts: results of a 5-year longitudinal study.
AB  - Clients' contacts with a range of community amenities and with their friends and
      relatives were examined to assess the impact of a new community-based service.
      Results over a 5-year period were compared for clients in different residential
      settings: supported ordinary housing, mental handicap hospital and private family
      homes. Findings indicated increased use of community amenities for those in
      supported housing and in their family homes. Little change was noted in clients'
      contact with relatives, and the paucity of social contact with friends was
      highlighted. Use of community amenities in relation to the development of social
      networks is discussed.

PMID- 1757981
TI  - The effect of social contact on college students' attitudes toward severely
      handicapped students and their educational integration.
AB  - Research on integration suggests that the major benefit of educational integrated
      programmes is the facilitation of intergroup contact between mentally handicapped
      and non-handicapped students. The present study was designed to investigate the
      effect of different amounts of social contact with severely handicapped students
      on attitudes and emotional reactions of college students towards such students
      and their integration into mainstream education. The study was carried out in a
      tertiary college which has a link programme with a local school for pupils with
      severe learning difficulties. The results indicated that those participants who
      had social contact with severely handicapped students held more favourable
      attitudes and emotional reactions toward such students than did those who had no
      social contact with this group. The study concludes that the educational
      integration programmes can positively modify attitudes and emotional reactions of
      college students towards severely handicapped students. However, in order to
      implement an effective link or integration programme and to foster attitudes more
      favourable towards severely handicapped students, the study recommends that more
      opportunities for intergroup contact and social interaction between non
      handicapped and handicapped students need to be provided.

PMID- 1757982
TI  - The sterilization of people with a mental handicap: the views of parents.
AB  - The issue of sterilization in people with mental handicap has re-emerged in
      recent years. Historical aspects are briefly reviewed, and attention is drawn to
      the different context in which this issue has been revived. A postal survey of
      parental views was undertaken. Fifty-three per cent of the respondents indicated
      that they had or would consider sterilization for their child with mental
      handicap, and a large majority of the parents felt that they alone, or in
      conjunction with a doctor, should be able to consent on behalf of the person with
      mental handicap. Consideration needs to be given to parental anxieties with
      regard to sexual and reproductive health issues which are surfacing with the
      current emphasis on community care and the philosophy of normalization.

PMID- 1757983
TI  - Musical aptitudes, musical interests and mental retardation.
AB  - A modified version of the Bentley scales of musical aptitude was given to a
      sample of mild and moderately retarded adults chosen on the basis of alleged
      musical interest or experience. Several comparison groups were also given the
      assessment battery. The musical nominees generally performed more accurately than
      both matched retarded subjects with no particular musical interests and a group
      of normal children matched on (Wechsler) vocabulary scores. The musical nominees
      showed especially high performance on the subtest assessing voice analysis in
      chords.

PMID- 1757984
TI  - Paradox, reprimand and extinction in adults with mental handicap.
AB  - To assess the efficacy of paradoxical directives, levels of challenging behaviour
      during 2 weeks of paradox, reprimand and extinction were compared with baseline
      levels in four adults with mental handicaps attending a day centre. Paradox was
      the most effective procedure for reducing the frequency and severity of
      challenging behaviour by an average of over 70% by the end of 2 weeks and up to
      90% in certain subjects; extinction was least effective. Paradox was most
      effective with more defiant subjects, when staff rated treatment success as low,
      when improvement using extinction and reprimand was poorest, and in reducing
      aggressive behaviour. The present authors suggest the overjustification effect
      offers an explanation for the effects of paradox.

PMID- 1757985
TI  - Kensington & Chelsea and Westminster Planning Register for People with Severe
      Learning Difficulties.

PMID- 1757986
TI  - A strategy for the reconstruction of structures possessing axial symmetry:
      sectioned axonemes in sperm flagella.
AB  - The images of complex biological structures seen in the electron microscope,
      possessing an n-fold rotational symmetry, can be enhanced by averaging the
      axially repeating motif in order to improve their signal-to-noise ratio; this
      requires that the slices with n-fold symmetry do not exhibit distortions relative
      to one another. A strategy is proposed to detect the relative distortions and to
      remove them in order to obtain reliable results from the averaging process.
      Extensive use is made of cross-correlation analysis and of interpolation; because
      the procedure involves iterated resampling of the image, it is essential to adopt
      interpolation algorithms which preserve the spectral power. The procedure is
      illustrated by the analysis of transverse sections of the sperm flagellum axoneme
      of a stick insect; it might be used for the reconstruction of microtubules,
      nuclear pore complexes, virus capsids, and other supramolecular aggregates. The
      reconstructed images of axoneme sections reveal new information about the
      interactions between adjacent doublets; in particular, a double conjunction
      connecting the inner dynein arm with the nearest B-tubule has been consistently
      observed.

PMID- 1757987
TI  - Axial resolution of confocal microscopes with parallel-beam detection.
AB  - We present a simple theory for the evaluation of the axial resolution of a
      confocal scanning microscope with parallel-beam detection. The results
      demonstrate that, in certain cases, the collection efficiency is low compared
      with a conventional confocal microscope, but the axial resolution may be further
      improved.

PMID- 1757988
TI  - A note on stereological estimation of the volume-weighted second moment of
      particle volume.
AB  - It is shown that for a variety of biological particle shapes, the volume-weighted
      second moment of particle volume can be estimated stereologically using only the
      areas of particle transects, which can be estimated manually by point-counting.

PMID- 1757989
TI  - A preparation method of specimens of the fungus Penicillium chrysogenum for
      ultrastructural and immuno-electron microscopical studies.
AB  - A combination of cryofixation without pre-treatment, freeze-substitution and low
      temperature embedding was used to prepare specimens of Penicillium chrysogenum
      for electron microscopy. To produce specimens which are thin enough for
      appropriate cryofixation, the P.chrysogenum colonies were grown between dissected
      dialysis tubing on an agar plate, which in addition allowed longitudinal
      sectioning. In contrast to classical chemical fixation, this preparation
      procedure resulted in excellent preservation of ultrastructure. Furthermore, the
      penicillin biosynthetic enzyme acyltransferase could be unequivocally located by
      immunogold labelling, indicating a preservation of antigenic properties of the
      specimen. Labelling density was not conspicuously affected when using different
      freeze-substitution media, but it was reduced after embedding in Epon 812.

PMID- 1757990
TI  - Application of scanning electron microscopy (SEM) and microbead techniques to
      study the localization of p24 and p18 antigens of HIV-1 on the surface of HIV-1
      infected H9-lymphocytes.
AB  - Immunofluorescence staining techniques at present, when applied to follow the
      expression of HIV-1-specific antigens on infected cells, only give the
      information that the antigens detected are localized in the outer region of the
      membrane of the infected cell. We therefore set up a procedure using magnetic
      polystyrol particles coated with antibodies specific for the HIV-1 antigens under
      study, in combination with scanning electron microscopy. We were able to
      demonstrate that p24 and p18 structural antigens are clearly expressed on the
      surface of HIV-1-infected H9 lymphocytes. This means that there was no steric
      hindrance for structures of cell-like size specific for HIV-1 antigens to
      interact with their target antigens. Other antigens may be hidden in membrane
      structures and are therefore inaccessible, for example, to the beads used here,
      which were of a similar size to antigen-specific cells in vivo. The results of
      this model system must be seen with respect to the interaction of antigen
      specific cell-mediated immunity with full antibody-dependent cellular
      cytotoxicity, or without cytotoxic T lymphocytes, the mediator function of
      antibodies.

PMID- 1757991
TI  - Suggestions for the quantitative X-ray microanalysis of thin sections of frozen
      dried and embedded biological tissues.
AB  - When a microregion in a thin section of frozen-dried and embedded tissue is
      analysed by the conventional electron-probe X-ray continuum-normalization method,
      the measured quantity is in mmol of element per kg of embedded specimen. As each
      microregion contains an unknown amount of embedding medium, this quantity
      generally lies indeterminately somewhere within the wide range between mmol of
      element per kg of hydrated tissue and mmol of element per kg of dehydrated
      tissue. However, if a 'tag' element is incorporated in the embedding medium, the
      contribution of the medium to the local continuum count in each probed field
      should be measureable, and the X-ray data may then unambiguously yield mmol of
      element per kg of dehydrated tissue. This result should not be affected by
      shrinkage on freeze-drying or by incomplete replacement of water by embedding
      medium. The same X-ray data can additionally provide estimates of mmol of element
      per unit volume, mmol of element per kg of hydrated tissue and local dry-mass
      fraction. However, these estimates are subject to errors due to tissue shrinkage,
      incomplete replacement of water and beam damage.

PMID- 1757992
TI  - Different rates of substitution may produce different phylogenies of the
      eutherian mammals.
AB  - In an attempt to resolve some points of branching order in the phylogeny of the
      eutherian mammals, a phylogenetic analysis of 26 nuclear and 6 mitochondrial
      genes was undertaken using a maximum likelihood method on a constant rate
      stochastic model of molecular evolution. Seventeen of the nuclear genes gave a
      primates/artiodactyls grouping highest support whereas three of the mitochondrial
      genes found a rodents/artiodactyls grouping to be best supported. The
      primates/rodents grouping was never the best supported. On the assumption that
      rodents are indeed an outgroup to primates and artiodactyls and that the latter
      taxa diverged 70 million years ago, an estimation was made, for each gene, of the
      time of divergence of the rodent lineage. In most cases such estimates were
      beyond the limits set by present interpretations of the paleontological record as
      were many estimates of the divergence time of mouse and rat. These results
      suggest that, although there is locus variation, the divergent position of the
      rodent lineage may be an artifact of an elevated rate of nucleotide substitution
      in this order.

PMID- 1757993
TI  - Genes encoding the small subunit of RUBISCO belong to two highly conserved
      subfamilies in Nicotianeae.
AB  - The sequences of seven complementary DNAs or genes encoding the small subunit
      (SSU) of ribulose-1,5-bisphosphate carboxylase oxygenase (RUBISCO) in several
      Nicotianeae were examined. Two new SSU genes isolated from Nicotiana sylvestris
      were included. Both sequence comparisons and Southern analyses with specific
      probes reveal that SSU genes fall into two homogeneous subfamilies that are
      highly conserved in Nicotianeae and are also present in other Solanaceae.
      Additional criteria such as number of introns and level of expression fitted to
      this classification. Homogeneity must have been maintained by gene conversion
      and/or an unusually high fidelity of DNA replication, whereas traces of slippage
      stranded DNA mispairing and/or transposition probably explain local changes.
      Taken as a whole, these results show that the divergence between the two
      subfamilies predated the divergence between genera inside the Solanaceae, but
      that Nicotianeae retained the most simple SSU gene family structure.

PMID- 1757994
TI  - Nonrandom CpG mutations affect the synonymous codon usage of moderately GC-rich
      single copy actin genes.
AB  - In species where actin genes exist as single copies, analysis of their synonymous
      codon usage and of the substitutions occurring between the genes of closely
      related species shows that there is a positive selection for codons that do not
      have highly mutable CpG dinucleotides in codon positions 2 and 3 when the GC
      content of these genes is less than 57%.

PMID- 1757996
TI  - Distinct patterns in the dinucleotide nearest neighbors to G/C and A/T oligomers
      in eukaryotic sequences.
AB  - The eukaryotic and prokaryotic databases are scanned for potential nearest
      neighbor doublet preferences at the 5' and 3' flanks of some oligomers. Here we
      focus on oligomers containing alternating nucleotides, i.e., UV, UVUV, and UUVV
      where U not equal to V. Strong, consistent trends are observed in eukaryotic
      sequences. A/T alternation oligomers are preferentially flanked by A/T. G/C
      flanks are disfavored. G/C alternation oligomers are preferentially flanked by
      G/C. A/T flanks are disfavored. These trends are consistent with those observed
      previously for homooligomer tracts (Nussinov et al. 1989a,b). G/C tracts are
      preferentially flanked by G/C. A/T nearest neighbors are disfavored. The reverse
      holds for A/T tracts. Additional patterns are described here as well. The
      possible origin of these DNA composition and sequence trends is discussed. These
      trends are suggested to stem from protein-DNA interaction constraints.

PMID- 1757995
TI  - Molecular considerations in the evolution of bacterial genes.
AB  - Synonymous and nonsynonymous substitution rates at the loci encoding
      glyceraldehyde-3-phosphate dehydrogenase (gap) and outer membrane protein 3A
      (ompA) were examined in 12 species of enteric bacteria. By examining homologous
      sequences in species of varying degrees of relatedness and of known phylogenetic
      relationships, we analyzed the patterns of synonymous and nonsynonymous
      substitutions within and among these genes. Although both loci accumulate
      synonymous substitutions at reduced rates due to codon usage bias, portions of
      the gap and ompA reading frames show significant deviation in synonymous
      substitution rates not attributable to local codon bias. A paucity of synonymous
      substitutions in portions of the ompA gene may reflect selection for a novel mRNA
      secondary structure. In addition, these studies allow comparisons of homologous
      protein-coding sequences (gap) in plants, animals, and bacteria, revealing
      differences in evolutionary constraints on this glycolytic enzyme in these
      lineages.

PMID- 1757997
TI  - Molecular evidence for the origin of plastids from a cyanobacterium-like
      ancestor.
AB  - The origin of plastids by either a single or multiple endosymbiotic event(s) and
      the nature of the progenitor(s) of plastids have been the subjects of much
      controversy. The sequence of the small subunit rRNA (Ssu rRNA) from the plastid
      of the chlorophyll c-containing alga Cryptomonas phi is presented, allowing for
      the first time a comparison of this molecule from all of the major land plant and
      algal lineages. Using a distance matrix method, the phylogenetic relationships
      among representatives of these lineages have been inferred and the results
      indicate a common origin of plastids from a cyanobacterium-like ancestor. Within
      the plastid line of descent, there is a deep dichotomy between the
      chlorophyte/land plant lineage and the rhodophyte/chromophyte lineage, with the
      cyanelle of Cyanophora paradoxa forming the deepest branch in the latter group.
      Interestingly, Euglena gracilis and its colorless relative Astasia longa are more
      related to the chromophytes than to the chlorophytes, raising once again the
      question of the origin of the euglenoid plastids.

PMID- 1757998
TI  - A comparison of 18s ribosomal RNA and rubisco large subunit sequences for
      studying angiosperm phylogeny.
AB  - Partial sequences of 18s rRNA were obtained for 2 gymnosperms and 12 angiosperms
      from a wide range of families and these were analyzed with 5 other published
      sequences to form a phylogenetic tree. Using 16 published sequences of the large
      subunit of rubisco (rbcL), also from a wide range of angiosperm families, another
      phylogenetic tree was derived and the two approaches were compared. Both
      phylogenetic trees gave good grouping within families but in neither case was
      there resolution of the branching order of major taxa. Superficially the long
      rbcL sequences (whose base composition was homogeneous among all species) seemed
      very promising, but analysis showed that a large proportion of the variation did
      not affect the amino acid sequence. Although silent substitution contained some
      phylogenetic information, at the level required to order major taxa, much of it
      was random and obfuscating. It was concluded that neither macromolecule alone was
      likely to yield a solution to the problem of angiosperm phylogeny and therefore
      that studies of both, at least, will be required. For this reason, a method was
      described for obtaining both DNA and RNA of good quality from the same
      preparation and which had been used successfully with a wide range of species
      including many with pungent leaves.

PMID- 1757999
TI  - Evolution of a family of N-acetylglucosamine binding proteins containing the
      disulfide-rich domain of wheat germ agglutinin.
AB  - A disulfide-rich domain, first identified in wheat germ agglutinin, has now been
      identified in the amino acid and DNA sequences of a large number of other chitin
      binding proteins. This 43-residue domain includes eight disulfide-linked
      cysteines and has been implicated in the binding of N-acetylglucosamine and its
      polymers. This study used 12 complementary DNA sequences and 1 amino acid
      sequence of proteins with one, two, and four copies of this domain to infer a 44
      amino acid residue ancestor sequence for this domain, and to derive an
      evolutionary tree relating these domains in the different proteins. The tree
      relating these single-domain sequences is divided into two major branches, one
      consisting of the multidomain dimeric lectins, which we have earlier suggested
      arose by duplication of a single copy of the disulfide-rich domain, and the other
      branch consisting of the monomeric chitinases and wound-inducible proteins, which
      have a single copy of the domain fused to a larger polypeptide. Reference to the
      three-dimensional structure of WGA and its saccharide complexes shows that the
      saccharide-binding residues as well as cysteine and glycine residues are
      conserved among all available sequences. In contrast, many residues at the dimer
      interface of the domains of WGA are not conserved in those proteins with a single
      domain, implying that the aggregation state of the domains in these proteins
      differs from that of the gras lectins. Also, the base compositions of the four
      domain and one-domain branches of the tree differ, indicating distinct selective
      pressures at the level of both protein structure and the gene or its transcript.

PMID- 1758000
TI  - Reclaiming sexuality in female incest survivors.
AB  - This paper presents a comparison of female incest survivor sex therapy patients
      and other sex therapy patients. The focus is on family-of-origin dynamics and
      processes of teaching about sexuality, self-image and resulting interpersonal
      issues. The study also discusses nonincest survivor and incest survivor sex
      therapy clients with low sexual desire, their evaluation and treatment.

PMID- 1758001
TI  - The role of assertiveness in female sexuality: a comparative study between
      sexually assertive and sexually nonassertive women.
AB  - To examine the role of assertiveness in female sexuality, a nonclinical
      population of married women (ages 18-31 years) were stratified as above or below
      the median score (73) on sexual assertiveness, as measured by the Hurlbert Index
      of Sexual Assertiveness (HISA), and matched accordingly for demographics,
      resulting in two samples: sexually assertive and sexually nonassertive, each
      group consisting of 50 women. Comparative assessments were made between the two
      matched samples on frequency of sexual activity, number of orgasms, subjective
      sexual desire, and both marital and sexual satisfaction. The t-test was used to
      test the equality of means between samples. Pearson's r was used for
      correlational data. ANOVA methods were employed to examine race, religion, and
      employment status. Using t-test, significant differences between the two groups
      appeared on all five measures. Sexually assertive women reported higher
      frequencies of sexual activity and orgasms, rated themselves as having greater
      subjective sexual desire, and reported greater marital and sexual satisfaction.

PMID- 1758002
TI  - Assessment of erectile dysfunction in diabetic men: the clinical relevance of
      self-reported sexual functioning.
AB  - Diabetes mellitus is commonly associated with erectile dysfunction (ED). Fifty
      three diabetic male veterans presenting with ED underwent an extensive medical
      examination, psychological evaluation, and a detailed assessment of sexual
      functioning. They then underwent two consecutive nights of inhospital Rigiscan
      monitoring to assess erectile capacity. Multivariate analyses indicated that
      patient reports of a.m. erections and erectile quality were highly predictive of
      Rigiscan measures of penile tip and base rigidity and duration of erectile
      episodes. These results highlight the importance of attending to patient reports
      of specific sexual symptomatology in the evaluation of diabetic patients
      presenting with ED.

PMID- 1758003
TI  - Western and non-western human sexuality: implications for clinical practice.
AB  - The emergence of the "new sex therapies" in the early 1970s has brought more
      people, from more diverse cultural groups, to seek help for sexual problems.
      However, the directive approach in sex therapy seems be deemphasize cultural
      differences by offering a set of procedures and techniques that clearly are
      grounded in Western sexual values. Based on existing literature concerning
      cultural values and clinical observations, the idea that the commonly practiced
      sex therapy is useful for everybody is challenged. Four culturally determined
      factors are discussed: 1) the meaning of sexuality; 2) the definition of normal
      sexual relationship; 3) the perception and meaning of sexual dysfunctions; and 4)
      the role of the therapist and therapist-client relations. Finally, implications
      for practice are presented.

PMID- 1758004
TI  - Enriching the sexual experience of couples: the Asian traditions and sexual
      counseling.
AB  - Drawing from Hindu and Buddhist Tantric traditions, central themes reflecting
      Asian approaches to sexuality are described and contrasted with contemporary
      values, assumptions, and objectives implicit in both sexual experience and in the
      clinical practice of sexual counseling. The Tantric ceremonial sex ritual
      provides a fertile source for several innovative behavioral assignments useful in
      sexual counseling. Five exercises in intimacy derived from the ancient Tantric
      sex ritual are presented and suggested as home assignments for couples: the
      creation of a ritual, synchronized breathing, sustained eye contact, motionless
      intercourse, and sexual exchange without orgasm. Applications to intimacy
      development, sexual enhancement, and sexual counseling for couples are described,
      creating a broad and meaningful context for responding to clients' sexual
      concerns.

PMID- 1758005
TI  - Multiple severe sexual dysfunctions resolved in brief sex therapy.
AB  - The following case illustrates the use of integrative sex therapy techniques in
      treating a couple with numerous sexual dysfunctions. The integrative method
      enables the therapist to address sexual difficulties in both partners
      simultaneously and significantly reduce the time of treatment.

PMID- 1758006
TI  - Late seroconversion to hepatitis B in a Somali village indicates the important
      role of venereal transmission.
AB  - Hepatitis B virus (HBV) markers were investigated in a cross-sectional study in
      1985 on sera from 84% of the 648 inhabitants in a rural Somali village. The
      prevalence of HBV markers increased with age, from 9.7% in subjects less than 12
      years old, to 38% in the age group 12-19 years, and to 68% in adults. HBV markers
      were more common in boys less than 12 years old, 13%, than in girls of the same
      age group, 5.8% (P less than 0.05). A rapid increase of HBV markers started at
      adolescence in both sexes. The female cohort showed their highest seroconversion
      rate during their second decade of life, while the male cohort seroconverted more
      rapidly in the third decade. Thus, an initially more rapid seroconversion among
      boys was reversed when the females reached reproductive age, and no sex
      difference in marker frequencies was observed in the age group 12-19 years. There
      was a steady increase of HBV markers during the reproductive years in both sexes.
      The frequencies of HBsAg, as well as total markers, were significantly higher in
      adult males than females, 14 vs 5.6%, and 77 vs 62%, respectively. HBV markers
      were more frequent in wives of HBV positive husbands than in those married to HBV
      negative husbands. No increased marker prevalence was observed among siblings of
      HBV positive children, nor among their mothers, which disproved the role of
      vertical and early horizontal transmission. In 1989 the four-year rate of
      seroconversion was investigated in villagers who were seronegative in 1985. On
      testing 158 sera from 319 individuals, the seroconversion rate was significantly
      lower among those younger than 12 years in 1985 compared to those in the older
      age group, 5 vs 17%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758007
TI  - Paradoxical response to chemotherapy for intracranial tuberculoma: two case
      reports from Saudi Arabia.
AB  - Two patients with tuberculous meningitis are described, who developed
      intracranial tuberculoma while receiving antituberculous therapy. The tuberculoma
      responded to the same regimen of treatment and small dose of corticosteroids.
      Such paradoxical reaction should be looked for if the patient develops new
      neurological signs during the course of the disease.

PMID- 1758008
TI  - Beliefs about the prevention of dengue and other febrile illnesses in Merida,
      Mexico.
AB  - A series of open interviews and a survey were conducted in several neighbourhoods
      in the city of Merida, Mexico to find out whether poor response to government
      dengue control programmes might be related to the explanatory models about dengue
      and its prevention held by community members. Dengue was grouped by informants
      with other mild febrile illnesses, all of which were thought to be inevitable and
      capable of converting into more serious illnesses. Although vector control
      personnel think of prevention in terms of eliminating the larval habitats of
      mosquito vectors, the form of prevention most commonly described involved looking
      after oneself once sick, so that mild fevers do not evolve into serious fevers.
      Due to the prevalence of this different model of prevention, it is argued that
      simple messages about dengue may be misinterpreted. Vector control programmes
      need to take into account local models of febrile illnesses and their prevention
      in order to be effective.

PMID- 1758009
TI  - Potential sources of Campylobacter species in the homes of farmworkers in
      Zimbabwe.
AB  - Chicken faeces, houseflies, household stored drinking water, cooked or prepared
      foods and handwashings of people of all age groups and hands of children under 5
      years old were examined as potential sources and transmission routes of
      Campylobacter species in a farmworker community. Campylobacter species were found
      to be common in chicken faeces collected from the homesteads of the farmworkers
      but were rarely isolated from houseflies or household stored drinking water. They
      were not isolated from foods and hands of people of all ages. A comparison of
      Campylobacter species isolated from humans and chickens showed Campylobacter
      jejuni to be more common than Campylobacter coli in human isolates while the two
      species were evenly distributed in chickens. Most of the C. jejuni isolates from
      humans and chickens belonged to biotype II and none belonged to biotype III.
      There was some similarity in some C. jejuni serotypes isolated from humans and
      chickens. Chickens were therefore found to be the main potential source of
      Campylobacter species in the homes of farmworkers.

PMID- 1758010
TI  - Cryptogenic chorea.
AB  - A total of 40 cases of cryptogenic chorea were studied over a period of 4 years
      in JIPMER Hospital which serves the population of Pondicherry and adjoining
      regions of South India. Analysis of our cases showed the highest incidence for
      the 10-15 year age group with no sex predilection. Arthralgia and non-specific
      fever preceded the onset of chorea in most patients. The majority had generalized
      chorea of variable severity. Laboratory evidence of rheumatic fever was absent in
      all cases. The socioeconomic, environmental and cultural factors contributing to
      persistently high rate of infections together with the absence of evidence of a
      rheumatic process indicate a non-rheumatic aetiology.

PMID- 1758011
TI  - The occurrence and driver characteristics associated with motor vehicle injuries
      in Addis Ababa, Ethiopia.
AB  - Ethiopian documentation of the occurrence and determinants of motor vehicle
      related morbidity and mortality is sparse. The purpose of this investigation was
      to determine the incidence of hospital treated motor vehicle injuries (MVI) in
      Addis Ababa and driver characteristics associated with involvement in a MVI. The
      study was conducted over a 12-week period in the autumn of 1988. Over 91% of MVI
      involved pedestrians. The overall MVI incidence density rate was 279.4 per
      100,000 person years and the mortality rate was 17.6 per 100,000 population per
      year. Road accident injury and fatality rates were 946 and 59.5 respectively per
      10,000 registered vehicles. Overall years of person life lost was 595 per 100,000
      person-years exposure. Significantly increased odds of exposure among drivers
      inflicting a MVI were found for younger age, fewer years driving experience, male
      gender, and those driving newer, government owned, and mass transit vehicles.

PMID- 1758012
TI  - The usefulness of urinalysis reagent strips in selecting Schistosoma haematobium
      egg positives before and after treatment with praziquantel.
AB  - The effectiveness of urinalysis reagent strips for haematuria and proteinuria in
      selecting Schistosoma haematobium egg-positive persons was studied on 426
      subjects of all ages in a Kenyan community before and 3 months after treatment
      with praziquantel. Before and after treatment, the degree of urinary blood or
      protein and prevalence of egg positives were closely associated. Haematuria and
      proteinuria were positively correlated with urinary egg counts. For selecting egg
      positive persons with reagent strips, a combined criterion 'haematuria trace up
      or proteinuria 1 + up' was considered the best in this area. With this criterion,
      sensitivity and specificity before treatment were 69.6 and 84.4 respectively.
      These values remained at the same level (70.7 and 81.2%) even after treatment
      with praziquantel reduced prevalence from 59.4 to 13.6% (77% reduction) and
      intensity of infection from 57.2 to 11.3 eggs 10 ml-1 of urine (80% reduction).
      Although the sensitivity was not very high, heavy infections were not missed. If
      all those selected with reagent strips were treated and cured, a 98% reduction in
      total egg excretion by the community would be expected in both our first and
      second urine examinations.

PMID- 1758013
TI  - Antimicrobial resistance trends of shigellae isolates from Calabar, Nigeria.
AB  - During a 3-year study (January 1986-December 1988), stools of 2200 diarrhoeal or
      dysenteric patients were examined by culturing and 108 (4.9%) were found positive
      for shigellae. Shigella flexneri was the commonest species isolated (54.6%),
      followed by Sh. dysenteriae (24.1%). Patients aged less than or equal to 15 years
      accounted for 51.4% of cases. Shigellae over the 3 years showed high and
      sometimes rising resistance to ampicillin, chloramphenicol, streptomycin and
      cotrimoxazole and complete resistance to tetracyclines and sulphonamides. Sh.
      sonnei strains isolated in 1986 and 1987 were almost invariably sensitive to all
      antimicrobial agents except ampicillin, while in 1988 strains were resistant to
      all. The isolation rate was higher (74.1%) during the dry season than in the
      rainy season (25.9%) (P less than 0.01). Low standards of community and personal
      hygiene and improper sewage disposal are the prevailing epidemiological factors
      identified.

PMID- 1758014
TI  - Gastrointestinal parasitic infection in healthy Jamaican carriers of HTLV-I.
AB  - A subsample (1.6%; n = 13,260) of a healthy Jamaican population of food-handlers,
      studied by Murphy et al. (1991), who were serologically positive (n = 99) or
      negative (n = 113) for HTLV-I was investigated for intestinal parasitic infection
      using coprological methods. Helminth infection included Ascaris lumbricoides
      (2.8%), Trichuris trichiura (7.1%) and hookworms (6.1%). Entamoeba coli was found
      in 21.8% of samples, while E. hartmanni, Giardia lamblia, Endolimax nana,
      Iodamoeba butschlii and Chilomastix mesnili each occurred in less than 10% of
      responders. T. trichiura displayed a higher prevalence (10.6 vs 3%) (chi 2 =
      4.623; P = 0.03) in the HTLV-I negative group. G. lamblia was detected more
      frequently among HTLV-I carriers compared to controls (9.1 and 3.5%,
      respectively), but the association was not statistically significant (chi 2 =
      2.825; P = 0.09). Infection with intestinal parasites is likely to occur
      independent of HTLV-I status: however, possible HTLV-I-induced immunosuppression
      may lead to higher intensity infections of certain organisms thus facilitating
      easier detection using parasitological methods. The immunomodulatory potential of
      HTLV-I infection in the aetiology of non-malignant diseases requires further
      investigation.

PMID- 1758015
TI  - The epidemiology of human brucellosis in a well defined urban population in Saudi
      Arabia.
AB  - A retrospective survey was undertaken to provide the first reported estimate of
      the incidence of human brucellosis in Saudi Arabia. The study population was
      unusually well defined and consisted of all individuals resident in the Riyadh
      and Al Kharj regions and registered for treatment in the Riyadh-Al Kharj Hospital
      Program. Cases satisfying predetermined case criteria were identified initially
      from a retrospective review of hospital laboratory records, and this was
      supported by a review of individual medical case-notes. Brucellosis was found to
      be much more common in Saudi nationals than expatriate nationals. Among Saudi
      nationals the study demonstrated a remarkable increase in brucellosis with
      increasing age, and a higher incidence amongst women than men in some age groups.
      This was felt to have been due either to an increased exposure to infected
      livestock, or to an increased susceptibility to the disease in women, and with
      increasing age. There was a seasonal fluctuation in the occurrence of brucellosis
      with the largest number of cases occurring in spring and summer.

PMID- 1758016
TI  - Human hydatidosis in Niger.
AB  - Thirty-two cases of hydatidosis were collected in two Nigerian hospitals during a
      5-year period; 81% of these had extra-hepatic localizations. Human hydatidosis
      has been considered as exceptional in West Africa but seems to be an
      underestimated disease in Niger. Studies in slaughtered animals from Niger show a
      high prevalence of hydatidosis in camels while no infection was found among
      sheep.

PMID- 1758017
TI  - Yersiniosis in free-ranging muskoxen on Banks Island, Northwest Territories,
      Canada.
AB  - Sixty-seven muskox (Ovibos moschatus) carcasses, 53 skeletal remains and two sick
      muskoxen were seen during an aerial survey of the Thomsen River region, northern
      Banks Island, Northwest Territories, Canada in late July 1986. Complete
      necropsies were performed on 29 muskoxen estimated to have died within the
      previous 3 to 5 days. Twenty were diagnosed with acute yersiniosis due to
      Yersinia pseudotuberculosis serotype 1B and were in excellent body condition. A
      diagnosis could not be made on seven animals due to marked autolysis; however,
      these muskoxen also were in excellent body condition. The remaining two were
      aged, emaciated muskoxen. This report describes the first occurrence of
      yersiniosis in free-ranging muskoxen and the first documentation of large scale
      mortality due to this disease in a free-ranging population of wild ungulates.

PMID- 1758018
TI  - Spontaneous pasteurellosis in captive Rocky Mountain bighorn sheep (Ovis
      canadensis canadensis): clinical, laboratory, and epizootiological observations.
AB  - We observed clinical signs, compared adrenal responses, and performed diagnostic
      tests on 12 captive Rocky Mountain bighorn sheep (Ovis canadensis canadensis)
      during a spontaneous outbreak of pasteurellosis. Cortisol in urine and feces was
      measured for bighorns sampled three times between 20 October and 1 November 1986.
      By 6 November, four of these had developed pneumonia, four showed only mild
      rhinitis, and four remained clinically normal. Bighorns that ultimately developed
      pneumonia showed elevated mean urinary (P = 0.003) and fecal (P = 0.046) cortisol
      excretion over the 12-day sampling period. Twenty-four hour mean urine cortisol:
      creatinine ratios ranged from 10 to 57 ng/mg dry matter for affected and 5 to 22
      ng/mg for healthy individuals; 24 hr mean fecal cortisol concentrations ranged
      from 7.2 to 20 ng/g dry matter for affected and 3.6 to 9.1 ng/g dry matter for
      healthy individuals. Elevated cortisol excretion preceded clinical pneumonia in
      affected bighorns by less than or equal to 16 days. Beta-hemolytic Pasteurella
      haemolytica biotype T, serotype 3 or 4, was isolated from nasal and pharyngeal
      swabs from all eight bighorns with pneumonia or mild rhinitis. We detected no
      evidence of parainfluenza 3, bovine respiratory syncytial virus, or Chlamydia
      psittaci using fluorescent antibody and/or serologic tests. Although elevated
      cortisol excretion was associated with pneumonia, we also believe age,
      reproductive physiology, and/or prior recovery from clinical pasteurellosis may
      have influenced individual susceptibility to pneumonia during this epizootic.

PMID- 1758019
TI  - Correlations of daily activity with avian cholera mortality among wildfowl.
AB  - We tested the hypothesis that wildfowl activities can influence the risk of avian
      cholera (Pasteurella multocida infection) for susceptible birds at Centerville,
      Humboldt County, California (USA). Avian cholera mortality characteristics from
      past epizootics were correlated with variations in flock size, habitat use and 11
      feeding and nonfeeding behaviors among six empirically defined groups of
      wildfowl: American coots (Fulica americana), tundra swans (Cygnus columbianus),
      American wigeon (Anas americana), northern pintails (A. acuta), northern
      shovelers (A. clypeata)/mallards (A. platyrhynchos), and teal (A. discors, A.
      crecca, A. cyanoptera). The position of these wildfowl groups in past mortality
      sequences was directly correlated with mean flock size, time spent on land, and
      time spent grazing on land or in shallow water. We propose that variations in
      bird density, habitat use and frequency of grazing may serve as predisposing
      factors to avian cholera among wildfowl.

PMID- 1758020
TI  - Salmonellosis in laboratory-housed iguanid lizards (Sceloporus spp.).
AB  - Fifteen wild-caught iguanid lizards (14 Sceloporus variabilis and one S.
      malachiticus) were used in a 3 mo study on thermal acclimation. Over a 2 mo
      period, five of the lizards showed decreased activity, anorexia and enlarged
      joints, and were either found moribund or were euthanatized due to their poor
      condition. Specimens taken from lesions in four of the five lizards were cultured
      and were infected with Salmonella spp. Salmonella spp. was cultured from cloacal
      swabs in six of the 10 surviving lizards. Standard metabolic rates of those that
      were infected did not differ significantly from those that were not infected. We
      postulate that the lizards were inapparent carriers of Salmonella spp. at the
      time of capture and, as a result of stress, five developed active overwhelming
      systemic infections.

PMID- 1758021
TI  - S-layer positive motile aeromonads isolated from channel catfish.
AB  - Motile aeromonads are ubiquitous aquatic bacteria that can cause motile aeromonad
      septicemia (MAS), a disease which affects channel catfish and can produce
      significant economic loss. Motile aeromonads isolated from commercially-raised
      channel catfish were screened for production of S-layer protein in order to
      evaluate its potential role in natural epizootics. The S-layer protein was
      produced by 14 of 24 (58%) isolates from epizootics evaluated in this study.
      Concomitant infections with other internal pathogens were detected in 10 of the
      24 cases used in this study, and only one of those 10 isolates (10%) produced the
      S-layer protein. When Aeromonas sp. was the only internal pathogen diagnosed, 13
      of 14 (93%) isolates produced the S-layer protein.

PMID- 1758022
TI  - Antibodies to Borrelia burgdorferi in deer and raccoons.
AB  - An enzyme-linked immunosorbent assay (ELISA) was developed to detect serum
      antibodies to Borrelia burgdorferi, the causative agent of Lyme borreliosis, in
      deer (Odocoileus virginianus) and raccoons (Procyon lotor). Blood samples were
      collected from these mammals in Connecticut, Maryland, North Carolina, Georgia
      and Florida. Seropositivity for deer was highest in Connecticut (56% of 353 sera)
      and Maryland (51% of 35 sera). Raccoons in Connecticut, Maryland, North Carolina,
      and Florida also had antibodies to B. burgdorferi, but prevalence of positive
      sera was highest in Maryland (79% of 14 samples). Based on adsorption tests, the
      immunoglobulins detected in these mammals were probably specific to B.
      burgdorferi. The ELISA was more sensitive than an indirect fluorescent antibody
      staining method and was more suitable for analyzing large numbers of serum
      samples.

PMID- 1758023
TI  - Influence of habitat modification on the community of gastrointestinal helminths
      of cotton rats.
AB  - Dynamics of communities of gastrointestinal helminths of cotton rats (Sigmodon
      hispidus) were monitored in response to five experimental brush management
      treatments using herbicide applications with and without prescribed burning on
      the Cross Timbers Experimental Range in Payne County, Oklahoma (USA). A total of
      113 adult cotton rats (68 male and 45 female) was collected from experimental
      pastures in winter and summer 1986 resulting in the recovery of five species of
      helminths: Longistriata adunca, Syphacia sigmodontis, Strongyloides sp.,
      Protospirura muris, and Raillietina sp. Prevalences of Raillietina sp. and S.
      sigmodontis were greater on control than herbicide-treated pastures. Prevalence
      and abundance of Raillietina sp. and prevalence of S. sigmodontis were
      significantly lower on annually burned, herbicide-treated pastures compared to
      unburned herbicide-treated pastures. Triclopyr-treated pastures had greater
      abundances of L. adunca and lower abundances of Raillietina sp. than those
      treated with tebuthiuron. Abundances of L. adunca also decreased from winter to
      summer on annually burned, herbicide-treated pastures while increasing on other
      pastures. Distribution of all helminths was overdispersed, but distribution of L.
      adunca showed a significant brush treatment by season interaction as a result of
      greater overdispersion in summer than winter for cotton rats inhabiting brush
      treated pastures. Our results indicate that man-induced habitat modifications can
      alter host-parasite relationships in the community.

PMID- 1758024
TI  - Prevalence of Parelaphostrongylus tenuis in white-tailed deer in northern New
      York.
AB  - The prevalence and distribution of "brainworm" (Parelaphostrongylus tenuis) were
      examined in northern New York (USA) from 1986 to 1989. Sixty nine (46%) of 151
      white-tailed deer (Odocoileus virginianus) heads examined, contained adult P.
      tenuis. The proportion of infected individuals was not significantly different
      between males and females. Prevalence was significantly greater in the adult age
      class as compared to the juvenile age class (P less than 0.01). Deer pellet
      samples were examined for prevalence of P. tenuis-like larvae. Pellet samples in
      New York had an overall prevalence of 60%. The effects of precipitation and host
      density on prevalence of P. tenuis in deer was not significant.

PMID- 1758025
TI  - Efficacy of triclabendazole against natural infections of Fascioloides magna in
      wapiti.
AB  - Fourteen free-ranging adult wapiti (Cervus elaphus nelsoni) were captured in
      Banff National Park, Alberta (Canada) and held in captivity near Edmonton. A 24%
      suspension of triclabendazole at doses of 30 to 100 mg/kg body weight was
      drenched into the rumen of eight females and four males. Two male wapiti were
      used as untreated controls. Animals were killed and examined at 4 (n = 3), 6 (n =
      4), or 8 (n = 4) wk after treatment. Efficacy was 90% against immature
      Fascioloides magna collected 4 wk after treatment and 98% against adult flukes
      collected 4, 6 or 8 wk after treatment. All 32 flukes recovered from control
      wapiti were active and apparently healthy. Treatment at 50 to 60 mg/kg is
      recommended against F. magna in wapiti. A protocol for treating infected wapiti
      is outlined.

PMID- 1758026
TI  - Tick infestations of white-tailed deer in Alabama.
AB  - Four species of ticks were collected from 537 white-tailed deer (Odocoileus
      virginianus), examined during the hunting seasons (November to January) of 1988
      89 and 1989-90 at selected locations in Alabama (USA). Ixodes scapularis was the
      most common tick recovered (2,060 specimens) and infested 54% of the deer.
      Dermacentor albipictus was the second most frequent tick (1,253 specimens) and
      infested 15% of the deer. Amblyomma americanum was the third most frequent tick
      (315 specimens) and infested 24% of the deer; this was the only species of tick
      collected from deer at all sampling locations. Amblyomma maculatum was an
      infrequent parasite (five specimens) and infested only 1% of the deer; this tick
      species was only recorded during the 1989-90 season. Year-to-year and
      geographical differences in tick infestation parameters were noted. The data are
      compared with those reported for previous surveys of ticks infesting white-tailed
      deer in Alabama and adjacent states.

PMID- 1758027
TI  - Coccidiosis as a cause of transmural lymphocytic enteritis and mortality in
      captive Nashville warblers (Vermivora ruficapilla).
AB  - Transmural lymphocytic enteritis was diagnosed in thirteen Nashville warblers
      (Vermivora ruficapilla) during an epornitic with high mortality. In the
      intestinal lesions, asexual stages of coccidia were present within lymphocytes
      and asexual and sexual stages of coccidia were present within intestinal villar
      epithelium. Ultrastructurally, the infiltrating lymphocytes resembled granular
      ("intraepithelial") lymphocytes, a cell known to be important in the life cycle
      of some avian coccidia. Gross and histopathologic features of this enteritis
      resemble intestinal changes described for Isospora/Atoxoplasma spp. in other
      passeriformes and lymphoproliferative disease in gold-finches.

PMID- 1758028
TI  - Gray wolf density and its association with weights and hematology of pups from
      1970 to 1988.
AB  - We examined weights and hematologic profiles of gray wolf (Canis lupus) pups and
      the associated wolf density in the east-central Superior National Forest of
      northeastern Minnesota (USA) during 1970 to 1988. We collected weight and
      hematologic data from 117 pups (57 females, 60 males) during 1 September to 22
      November each year. The wolf density (wolves/800 km2) trend was divided into
      three phases: high (72 +/- 7), 1970 to 1975; medium (44 +/- 2), 1976 to 1983; and
      low (27 +/- 2), 1984 to 1988. Wolf numbers declined (P = 0.0001) 39 and 63% from
      1970 to 1975 to 1976 to 1983 and from 1970 to 1975 to 1984 to 1988, respectively.
      Weight was similar between male and female pups and did not vary as wolf density
      changed. Mean hemoglobin (P = 0.04), red (P = 0.0001) and white blood cells (P =
      0.002), mean corpuscular volume, mean corpuscular hemoglobin concentration and
      mean corpuscular hemoglobin (P = 0.0001) did differ among the multi-annual phases
      of changing wolf density. Weight and hematologic data also were compared to
      values from captive wolf pups. The high, but declining wolf density was
      associated with macrocytic, normochromic anemia in wolf pups, whereas the lowest
      density coincided with a hypochromic anemia. Although hematologic values show
      promise for assessing wolf pup condition and wolf population status, they must be
      used cautiously until data are available from other populations.

PMID- 1758029
TI  - Weights and hematology of wild black bears during hibernation.
AB  - We compared weights and hematological profiles of adult (greater than 3-yr-old)
      female black bears (Ursus americanus) during hibernation (after 8 January). We
      handled 28 bears one to four times (total of 47) over 4 yr of varying mast and
      berry production. Mean weight of lactating bears was greater (P less than 0.0001)
      than that of non-lactating females. White blood cells (P less than 0.05) and mean
      corpuscular volume (P = 0.005) also differed between lactating and non-lactating
      bears. Hemoglobin (P = 0.006) and mean corpuscular hemoglobin concentration (P =
      0.02) varied among years; values were lowest during 1975, following decreased
      precipitation and the occurrence of a second year of mast and berry crop
      shortages in a three-year period. Significant (P less than 0.05) interaction
      between reproductive status (lactating versus non-lactating) and study year for
      hemoglobin, red blood cells, and packed cell volume, and increased mean
      corpuscular volume, suggested a greater nutritional challenge for lactating
      females compared to non-lactating females during the 1975 denning season. Our
      data suggest that hematological characteristics of denning bears may be more
      sensitive than weights as indicators of annual changes in nutritional status;
      however, other influential factors, in addition to mast and berry crop
      production, remain to be examined.

PMID- 1758030
TI  - Hematology and serum chemistry of cottontail rabbits of southern Illinois.
AB  - In 1983 and 1984 blood was collected from 79 cottontail rabbits (Sylvilagus
      floridanus) confined to an outdoor enclosure in southern Illinois to establish
      reference values for hematology and serum chemistry. Packed cell volume, sodium,
      potassium, chloride, glucose, calcium, carbon dioxide, blood urea nitrogen,
      creatinine, uric acid, cholesterol, albumin, bilirubin, alkaline phosphatase,
      aspartate transaminase, alanine aminotransaminase, total protein,
      albumin/globulin ratio, and osmolality were measured. Sex and age (adult versus
      juvenile) of rabbit as well as season (June to September versus October to May)
      and method of capture (trap versus shot) variously affected most hematology and
      serum chemistry variables.

PMID- 1758031
TI  - Potential natural exposure of Mississippi sandhill cranes to aflatoxin B1.
AB  - A survey was conducted to determine if carcinogenic mycotoxins were present in
      foods consumed by Mississippi sandhill cranes (Grus canadensis pulla). Samples of
      field corn (Zea mays) (n = 111) and chufa (Cyperus esculentus) (n = 20), obtained
      in 1987, 1988 and 1989 on the Mississippi Sandhill Crane National Wildlife Refuge
      (MSCNWR) and nearby private lands were analyzed for aflatoxin B1(AB1), ochratoxin
      A and sterigmatocystin using thin layer chromatography. Chufa samples were
      negative for all three mycotoxins. Aflatoxin B1 was found in corn at
      concentrations from 5 to 5,000 ppb; the other mycotoxins were not found in corn.
      Contaminated corn was found in 72% of all corn fields, but the proportion of
      contaminated fields was 57 to 100% for the 3-yr period. Contamination with AB1
      was greatest in corn obtained from the ground post-harvest. Overall, 32% of corn
      samples from the ground had levels greater than or equal to 200 ppb with a mean
      of 427 ppb (range = 5 to 5,000 ppb) in contaminated fields. In 1989, mean AB1
      concentration in corn on the ground was 5 to 1138 ppb for individual fields. The
      concentration of AB1 was less than or equal to 200 ppb in all corn samples from
      upright stalks. The study demonstrated that AB1 is available to sandhill cranes
      and at levels that may pose a serious health threat.

PMID- 1758032
TI  - A survey of koala road kills in New South Wales.
AB  - Between 1984 and 1990, 75 koalas (Phascolarctos cinereus) from the central
      northern coast of New South Wales (Australia) were presented for necropsy due to
      motor vehicle accidents. The koalas consisted of 44 males and 31 females. Fifty
      one of these were between 2 and 7 yr (39 males and 12 females). The greater
      proportion of koalas, especially males, were struck by vehicles between June and
      December. The main injuries detected were head injuries (44), hemoperitoneum
      (16), limb injuries (16), hemothorax (15) and spinal injuries (7). Nine koalas
      were not dead at the time of the accident but died later following complications
      from the trauma. Twelve koalas had evidence of underlying disease at the time of
      accident. Ten of these had either conjunctivitis, cystitis, prostatitis,
      periovarian cysts, endometritis or a combination of the diseases. All 10 koalas
      still had good body condition. It is suggested that healthy young to middle-aged
      males are particularly prone to vehicular accidents during the mating period.
      This has implications for the management of local koala populations.

PMID- 1758033
TI  - A review of diseases of parasites of the Kafue lechwe (Kobus leche kafuensis).
AB  - The diseases of the Kafue lechwe (Kobus leche kafuensis) are reviewed in this
      paper. Kafue lechwe are an important natural resource for Zambia. Bovine
      tuberculosis is widespread within the lechwe population and they are host to many
      parasites, especially the warble Strobiloestrous vanzyli.

PMID- 1758034
TI  - Oral vaccination of skunks with raccoon poxvirus recombinants expressing the
      rabies glycoprotein or the nucleoprotein.
AB  - Twenty nine skunks (Mephitis mephitis) were vaccinated orally with raccoon
      poxvirus (RCN) recombinants: 10 with a recombinant expressing the rabies virus
      glycoprotein (RCNRG), 10 with RCNRG mixed with a recombinant expressing the
      rabies virus nucleoprotein (RCNRN) and nine with RCN alone. Rabies virus
      neutralizing antibodies were detected in six of the 20 skunks; five skunks (three
      given RCNRG, two given a mixture of recombinants) survived a rabies challenge
      that was lethal for nine skunks vaccinated with RCN alone.

PMID- 1758035
TI  - Taxon 20 (Fam. Pasteurellaceae) infections in European brown hares (Lepus
      europaeus).
AB  - Hemolytic bacteria, phenotypically related to organisms previously identified as
      Pasteurella haemolytica and tentatively named Taxon 20, were isolated from cases
      of purulent bronchopneumonia and from conjunctivitis in European brown hares
      (Lepus europaeus). The bronchopneumonia, sometimes accompanied by lesions in
      other organs, occurred without other concomitant disease. The conjunctivitis was
      found mainly in animals suffering from the European brown hare syndrome.

PMID- 1758036
TI  - A Sarcocystis sp.-like protozoan and concurrent canine distemper virus infection
      associated with encephalitis in a raccoon (Procyon lotor).
AB  - A raccoon (Procyon lotor) with signs of weakness was captured in upstate New York
      (USA). Despite attempted care in a rehabilitation facility, the animal died and
      was examined because of suspected infectious neurologic disease. The cerebrum had
      a marked, locally extensive, neutrophilic, necrotizing encephalitis with numerous
      associated intralesional protozoal organisms, and a moderate to marked multifocal
      perivascular nonsuppurative meningoencephalitis. Based on morphology and
      immunohistochemical staining, the organism was a Sarcocystis sp.-like protozoan.
      Rabies antigen and canine distemper virus (CDV) inclusions were not detected.
      However, the animal was positive for canine distemper virus based on peroxidase
      anti-peroxidase staining.

PMID- 1758037
TI  - Some viral and protozool diseases in the European wildcat (Felis silvestris).
AB  - Ten European wildcats (Felis silvestris) were examined at necropsy and an
      additional 23 were examined clinically for evidence of viral diseases in
      Scotland. Two plasma samples taken from live free-living wildcats showed positive
      ELISA reactions to feline leukemia antigen. A feline leukemia virus of subgroup A
      was isolated from one of these samples, taken from a wildcat in north-western
      Scotland. No antibodies to feline coronavirus or feline immunodeficiency virus
      were detected in any sample. Three of the live wildcats and one of the dead had
      chronic mucopurulent rhinotracheitis suggestive of "cat flu." One other dead
      wildcat had diffuse enlargement of anterior lymph nodes. The findings indicated
      that feline leukemia virus infection can occur in free-living Felis silvestris.
      It is possible that the disease exists as a sustained infection in some wildcat
      populations, although the close interaction between wildcat and the domestic cat
      means that the latter could act as a continual source of infection.

PMID- 1758038
TI  - Coccidiosis in common wombats (Vombatus ursinus).
AB  - Eimeria arundeli is a widespread coccidian parasite of the common wombat
      (Vombatus ursinus), and has been considered to be nonpathogenic. We describe
      disease in two captive juvenile wombats ascribed to infection with E. arundeli.
      One animal had diarrhea, the second had mucoid soft feces and lost weight over
      several weeks prior to death. Masses of coccidial gametocytes in hypertrophic
      cells in the lamina propria distended villi, causing grossly visible raised pale
      thickened regions over extensive areas of the mucosa of the small intestine in
      both animals. Neutrophils infiltrated affected mucosa, and there was an
      inflammatory exudate into the intestinal lumen in case one. In case two,
      neutrophils infiltrated the lamina propria of villi focally, crypts were
      distended by necrotic debris, and epithelium on villi was extremely attenuated.
      No bacterial pathogens were isolated from lung and intestine in case one; case
      two was not cultured. Oocysts consistent with E. arundeli were present in large
      numbers in floatations of diarrheic feces in both cases.

PMID- 1758039
TI  - Haematozoa of fishes in Humboldt Bay, California.
AB  - Five hundred seven fish representing 45 species from Humboldt Bay, California
      (USA) were examined for blood parasites. Four fish (less than 1%) from two
      species were infected. Haemogregarina leptocotti sp. n. is described from one of
      33 staghorn sculpin (Leptocottus armatus). Haemogregarina roelofsi sp. n. is
      described from three of 15 black rockfish (Sebastes melanops). Gametocytes of H.
      leptocotti sp. n. averaged 6.1 x 2.1 microns with a 2.7 x 1.7 microns oval
      nucleus; those of H. roelofsi sp. n. averaged 5.5 x 2.7 microns with a 2.5 x 2.2
      microns rectangular nucleus. Neither species of parasite had distinct chromatin
      granules, a polar cap, or more than one gametocyte in an infected cell.
      Haematozoa are relatively rare in fishes of the northeastern Pacific Ocean.

PMID- 1758040
TI  - Nasitrema sp.-associated encephalitis in a striped dolphin (Stenella
      coeruleoalba) stranded in the Gulf of Mexico.
AB  - An immature female striped dolphin (Stenella coeruleoalba) found dead on a
      northwestern Florida beach in 1988 exhibited severe inflammation bilaterally in
      the dorsal and mid-thalamus in association with adult trematodes (Nasitrema sp.)
      and trematode eggs. Numerous specimens of Nasitrema sp. also were present in the
      pterygoid sinuses. Pneumonia in association with a heavy growth of Vibrio damsela
      was observed also. This report confirms the occurrence of Nasitrema sp.
      associated encephalitis in striped dolphins and in small cetaceans from the Gulf
      of Mexico.

PMID- 1758041
TI  - Monthly prevalences of Physaloptera retusa in naturally infected Yarrow's spiny
      lizard.
AB  - The gastrointestinal tracts of 167 of 489 (34%) Yarrow's spiny lizards
      (Sceloporus jarrovii jarrovii) collected in Pima County, Arizona (USA) from
      October 1967 through January 1970 were infected with Physaloptera retusa. Of the
      infected lizards, 88 (18%) had only larvae, 45 (9%) had larvae and adults and 32
      (7%) had only adult nematodes. The ratio of larval nematodes to adults was
      approximately 8:1. Monthly prevalences varied from 71% in April 1969 to 10% in
      July 1969; seasonal patterns of infection were not observed.

PMID- 1758042
TI  - Survey for meningeal worm (Parelaphostrongylus tenuis) and ear mites in white
      tailed deer from northern Idaho.
AB  - During the fall hunting season of 1990, 95 white-tailed deer (Odocoileus
      virginianus) heads were collected from hunters in Boundary and Bonner Counties in
      northern Idaho (USA), an area currently occupied by woodland caribou (Rangifer
      tarandus caribou). The heads were examined for adult and larval meningeal worms
      (Parelaphostrongylus tenuis) by physical examination of the brain surfaces, and
      the Baermann technique, respectively, and for ear mites by examination of ear
      scrapings. Meningeal worms or mites were not detected.

PMID- 1758043
TI  - Duration of attachment by mites and ticks on the iguanid lizards Sceloporus
      graciosus and Uta stansburiana.
AB  - Duration of attachment was determined for the mites Neotrombicula californica and
      Geckobiella texana and the tick Ixodes pacificus on the iguanid lizards
      Sceloporus graciosus and Uta stansburiana from southern California. Neotrombicula
      californica infestations lasted approximately 1 wk. Attachment of Ixodes
      pacificus larvae and nymphs lasted approximately 8 days on S. graciosus and 16
      days on U. stansburiana. Geckobiella texana remained attached to S. graciosus for
      5 days and to U. stansburiana for 28 days.

PMID- 1758044
TI  - Notoedric acariasis in the porcupine (Erethizon dorsatum).
AB  - Six of 16 porcupines (Erethizon dorsatum) live-trapped in Sullivan County,
      Pennsylvania were infested with the mite Notoedres douglasi. Alopecia was evident
      in the ventral inguinal area and the infested skin was thickened, wrinkled and
      had multifocal areas of extensive hyperkeratosis. Microscopically the skin
      lesions consisted of extensive acanthosis and hyperkeratosis with variable
      cellular infiltrate in the dermis. Mites were seen in tunnels in the
      hyperkeratotic skin sections. This is the first report of notoedric acariasis in
      the porcupine.

PMID- 1758045
TI  - First record of Ixodes brunneus in Kansas.
AB  - A single specimen, a partially engorged female, of Ixodes brunneus was recovered
      from a common grackle (Quiscalus quiscula) in Butler County, near El Dorado,
      Kansas (USA). The discovery of this tick in Kansas represents a new state record.

PMID- 1758046
TI  - On the use of xylazine for field immobilization of bighorn sheep.

PMID- 1758047
TI  - [Effects of erythroid differentiation factor on inhibition of erythroid colony
      formation (CFU-E and BFU-E) by the sera and on BPA secretion by peripheral
      mononuclear cells in patients with chronic renal failure].
AB  - The effect of erythroid differentiation factor (EDF) on the colony formation of
      erythroid cells (CFU-E and BFU-E) inhibited by the sera from the patients with
      chronic renal failure (CRF) was evaluated by methylcellulose assay. EDF restored
      the inhibited formation of CFU-E colony irrespective of the absence or presence
      of the accessory cells. In addition, EDF was considered to recover BFU-E colony
      formation through the burst promoting activity (BPA) secreted by the adherent
      cells. A suicide experiment using 3H-thymidine revealed that EDF acted to induce
      BFU-E from resting phase to S phase of the cell cycle. Moreover, the number of
      circulating BFU-E and the secretion of BPA by the mononuclear cells, both of
      which were significantly low in CRF patients, were also moderately increased by
      the addition of EDF. These data suggest that EDF could be utilized as a
      therapeutic agent for pathogenetic factors except hypoproduction of
      erythropoietin on the anemia of the patients with CRF.

PMID- 1758048
TI  - [Combination chemotherapy of advanced Hodgkin's disease with vincristine,
      cyclophosphamide, procarbazine, and prednisolone].
AB  - Thirty-three patients with advanced Hodgkin's disease were treated with a
      combination chemotherapy consisting of vincristine 1 mg/m2 iv on day 1, 8,
      cyclophosphamide 500 mg/m2 iv on day 1, procarbazine 100 mg/m2 p.o. day 1-7, and
      prednisolone 40 mg/m2 p.o. day 1-7. Twenty patients received this regimen every 4
      weeks (VCPP II regimen). Furthermore, we conducted higher dose intensive VCPP II
      2 regimen which was repeated every two weeks for thirteen patients. Complete
      response rate of both regimens was 63% (VCPP II 45%, VCPP II-2 85%). The median
      duration of CR was 37 + months. Leukopenia, neurotoxicity and gastrointestinal
      toxicity were commonly observed but were clinically manageable. These results
      indicate that high dose intensive chemotherapy is effective for achieving high CR
      rate for advanced Hodgkin's disease.

PMID- 1758049
TI  - [Peripheral blood stem cell autografts (PBSCT) in the treatment of 30 children
      with acute leukemias and lymphoma].
AB  - Thirty children (1-16 y.o.; median, 10 y.o.) with acute leukemia or non-Hodgkin's
      lymphoma (NHL) associated with high-risk features underwent high-dose
      chemotherapy without total body irradiation and peripheral blood stem cell
      autografts (PBSCT). Eighteen patients had acute lymphoblastic leukemia (ALL), 6
      had acute non-lymphoblastic leukemia (ANLL), 2 had mixed-lineage leukemia and 4
      had NHL. Twelve patients with two or more high-risk features (WBC greater than 10
      x 10(4)/microliter, T- or B-phenotypes, infancy, massive organ infiltration, or
      induction failure) underwent PBSCT in 1st CR. Twelve patients underwent PBSCT in
      2nd CR, and 4 in the subsequent remission greater than or equal to 3rd CR). Two
      patients were treated at refractory relapse. After PBSCT the number of days
      required to achieve a granulocyte count of 0.5 x 10(9)/l and a platelet count of
      50 x 10(9)/l was 6.39 (median, 13) and 9-427 (median, 16), respectively. The
      disease-free survival rate was 6/12 in 1st CR group (6-41 mo) and 6/16 in the
      patients who underwent PBSCT in 2nd or subsequent remission (2-35 mo). The data
      justify the incorporation of PBSCT in the design of salvage protocol for children
      with leukemias or NHL. However, the application of the procedure as part of
      initial therapy in patients still remaining in 1st CR should be regarded as
      highly experimental and deserve further clarification.

PMID- 1758050
TI  - [The analysis of leukemic relapse after allogeneic bone marrow transplantation].
AB  - This report presents the analysis of leukemic relapse of 52 patients who received
      allogeneic bone marrow transplantation between July 1984 and May 1990.
      Conditioning regimen consisted of TBI + CY and GVHD prophylaxis consisted of
      cyclosporin-A and methotrexate. The relapse ratios of chronic myelogenous
      leukemia (CML) (21 in chronic phase, 1 in accelerated phase, 1 in blastic
      crisis), acute nonlymphocytic leukemia (ANLL) (all 17 in 1st CR), acute
      lymphocytic leukemia (ALL) (all 12 in 1st CR) were 13%, 18%, 25%, respectively,
      and 3 year disease free survival (DFS) was as follows, CML 68%, ANLL 72%, ALL
      49%. Regarding acute GVHD grading and chronic GVHD presence, 3 year DFS was as
      follows, acute GVHD 0 degree: 59%, I degree: 78%, II degree-IV degree: 53%,
      chronic GVHD (+): 82% GVHD (-): 77%. In our center leukemic relapse has been the
      major cause of death after BMT since 1984. Among 9 relapsed cases, one recurred
      more than 3 years after BMT, and another one got recurrent leukemia of donor
      origin.

PMID- 1758051
TI  - [Requirements of diagnostic criteria for aplastic anemia in children].
AB  - As a general rule, diagnostic criteria of aplastic anemia in children are the
      same as adult criteria. However, blood counts of normal children show wide age
      related variation, therefore we must establish a system of adjustment for
      diagnosis of aplastic anemia in children. The data of children with aplastic
      anemia visiting our institutes from 1966 to 1990 were evaluated for this study.
      RBC below 350 x 10(4)/microliters, WBC below 4,000/microliters or neutrophils
      below 1,500/microliters, platelets below 8 x 10(4)/microliters, reticulocytes
      below 4 x 10(4)/microliters and lymphocytes over 60% were seemed to satisfy the
      diagnostic criteria of aplastic anemia proposed by the Study Group of hemopoietic
      Disorders sponsored by the Ministry of Health and Welfare of Japan. Fifteen
      children (4.6%) did not meet these criteria and as such were diagnosed as
      atypical aplastic anemia. Thirteen of them were in a pre-aplastic state and
      developed typical aplastic anemia within 6 months to 8 years after the initial
      diagnosis. Clinical findings of these patients showed the decrease in number of
      megakaryocytes and committed stem cells in bone marrow. Three of these patients
      developed acute non-lymphocytic leukemia, and 2 of them were diagnosed as
      Fanconi's anemias.

PMID- 1758052
TI  - [Myelodysplastic syndrome in a patient with familial Pelger-Huet anomaly].
AB  - This paper reports on a patients with congenital Pelger-Huet anomaly who
      developed myelodysplastic syndrome (MDS). A 45-year-old female was referred for
      investigation of pancytopenia of 6 months' duration. Hereditary Pelger-Huet
      anomaly was diagnosed by family study 7 years prior to admission. On admission,
      Hb was 6.5 g/dl, Ht 19.9%, Platelets 1.8 x 10(4)/microliters, and WBC
      1,200/microliters with 2% myelocytes, 9% metamyelocytes, 14% bands, 2% segmented
      neutrophils, 58% lymphocytes and 5% monocytes. Most of the granulocytes were
      Pelger-Huet type with strikingly clumped nuclear chromatin. Bone marrow aspirate
      demonstrated 3.6% blasts and dysplastic changes including megaloblastoid features
      in erythroid series and micro-megakaryocytes compatible with refractory anemia, a
      subtype of MDS. The association of hereditary Pelger-Huet anomaly and MDS is
      discussed.

PMID- 1758053
TI  - [A high serum level of interleukin-6 in a patient with aggressive multiple
      myeloma].
AB  - A 58-year-old female was admitted to our hospital because of anemia in March
      1987. Monoclonal protein (IgA, kappa) was detected and a diagnosis of multiple
      myeloma was made. Partial remission was obtained after VAD therapy with alpha
      interferon. In December 1989, she was readmitted because of a pathological
      fracture of the left humerus. A white blood cell count was 4400/microliters with
      30% myeloma cells and the urine protein (Bence Jones protein) was 26 g/day.
      Systemic chemotherapy was not effective. She developed pleural and pericardial
      effusions, bone mass, disturbance of consciousness and died of respiratory
      failure only 3 months after readmission. The pleural and pericardial fluids
      contained many myeloma cells. c-myc gene rearrangement was detected in myeloma
      cells obtained from the pleural fluid using c-myc exon1 and exon2 probes. The
      levels of interleukin-6 (IL-6) measured by ELISA was 107.4 pg/ml in serum, 56.2
      pg/ml in pleural fluid and 780.0 pg/ml in pericardial fluid. Because of the lack
      of any overt infectious focus, the level of IL-6 appears to have been related to
      aggressive proliferation of myeloma cells. It was of interest that C-reactive
      protein, induced by IL-6, was a good marker reflecting disease activity.

PMID- 1758054
TI  - [Temporary spontaneous remission in Ki-1 (CD30) lymphoma with gastric lesion].
AB  - A case of 56 year-old man with Ki-1 (CD30) lymphoma is reported. He noticed
      cervical lymph node swelling and was admitted with temporary diagnosis of gastric
      adenocarcinoma in February 1986. His physical examination showed several from 1
      to 4 cm size enlarged cervical and axillary lymph nodes. His first lymph node
      biopsy demonstrated the histological picture of malignant lymphoma. After 20 days
      his second lymph node biopsy demonstrated the picture of necrosis. Second gastric
      biopsy showed the picture of neither gastric cancer nor malignant lymphoma, in
      spite of his first gastric biopsy finding with adenocarcinoma that turned out to
      be malignant lymphoma by later reinvestigation. After word those lymph nodes
      disappeared and have not been palpable for about ten months. In October 1987,
      elevated LDH value, lymph node swelling and gastric lesion were again observed
      and sixth gastric biopsy demonstrated the picture of malignant lymphoma. He was
      treated with anti-lymphoma drugs. After his partial remission, he died of
      gastrointestinal bleeding in April 1988. Specimens of both first lymph node
      biopsy and sixth gastric biopsy were examined with cell markers for infiltrated
      cells and were positive for Ki-1/Ber-2H. His final diagnosis was Ki-1 lymphoma.

PMID- 1758055
TI  - [Application of Y-chromosome specific DNA analysis for detection of mixed
      hematopoietic chimerism after allogeneic bone marrow transplantation].
AB  - We report a case involving mixed hematopoietic chimerism after an allogeneic bone
      marrow transplantation (BMT) from a sex mismatched donor. A 31 year-old-man who
      was diagnosed as having chronic myelogenous leukemia in the accelerated phase
      received an allogenic BMT from his HLA-identical sister in March, 1989. To
      determine the mixed chimerism we used the Y-chromosome specific repeated sequence
      of DNA using a specific probe (PHY 10). The donor's DNA 3.5 kb band appeared in 1
      10% of male DNA by Southern blot hybridization in the peripheral blood 21 days
      after BMT. The Y-chromosome DNA band decreased day by day, and disappeared 110
      days after BMT. The Y-chromosome DNA band could be detected, even though few
      metaphases were obtained immediately after BMT. Thus this method is very
      sensitive for determining which cells contain the Y-chromosome, and is therefore
      useful for detecting mixed chimerism after sex-mismatched BMT. Using this method
      the clinical significance of mixed chimerism can be assessed.

PMID- 1758056
TI  - [Acute megakaryoblastic leukemia with leukemia cutis, meningeal leukemia, and
      myelofibrosis].
AB  - A 64-year-old man was admitted to our hospital with leukopenia. On admission,
      leukocyte count in the peripheral blood was 1,600/microliters, containing 24.5%
      blasts of lymphoid appearance, which were negative for myeloperoxidase. A bone
      marrow aspiration showed hypoplasia with increased blasts (31.6%). The blasts
      were ultrastructurally positive for platelet peroxidase (PPO) and positive for
      platelet membrane glycoprotein IIb/IIIa complex. A diagnosis of acute
      megakaryoblastic leukemia was made. Chemotherapy with behenoyl-ara C (BH-AC) (150
      mg/day) was transiently effective. However, after three months, numerous nodules
      without itching appeared over the entire body, particularly on the anterior
      chest. A biopsy of the skin lesion revealed a diffuse fibrosis with infiltrations
      of the blasts. Bone marrow aspirations were dry tap, and a bone marrow biopsy
      showed marked myelofibrosis. Then, severe headache, vomiting, and loss of
      consciousness developed, and a lumbar puncture revealed infiltrations of blasts.
      Although methotrexate was intrathecally injected, he died due to the respiratory
      failure. As far as we know, a case of acute megakaryoblastic leukemia with
      leukemia cutis and meningeal leukemia is quite rare. In addition, it is
      interesting that megakaryoblastic leukemia was accompanied with both the fibrosis
      of skin and the myelofibrosis.

PMID- 1758057
TI  - [Primary myelofibrosis transforming into multiple subcutaneous monoblastoma--a
      case report].
AB  - A 83-year-old man was diagnosed with primary myelofibrosis based on the presence
      of leukoerythroblastosis, splenomegaly, chromosome 46 XY, a dry tap bone marrow
      aspiration and fibrosis on bone marrow biopsy, when he was admitted for herpes
      zoster in June 1987. He was admitted for a second time with multiple subcutaneous
      tumors over his entire body in July, 1989. He had mild splenomegaly, but no
      hepatomegaly nor lymphadenopathy. Laboratory tests were as follows: RBC 214 x
      10(4)/microliters, Hb 5.1 g/dl, Ht 17.7%, WBC 3,200/microliters with
      leukoerythroblastosis, platelets 11.6 x 10(4)/microliters, s-lysozyme 251
      micrograms/ml, u-lysozyme 770 micrograms/ml, NAP ratio 98%, score 278. Bone
      marrow aspiration resulted in a dry tap. Bone marrow biopsy showed marked
      fibrosis. Histologic examination of subcutaneous tumor biopsy specimens revealed
      a diffuse infiltration of monocytes with flexuous nuclei. These cells were
      positive for alpha-naphtyl butyrate esterase stain, and negative for peroxidase,
      alpha-naphtol ASD chloroacetate esterase stain and platelet glycoprotein IIb/IIIa
      stain (APAAP). Ultrastructurally, these cells were mostly monocytes and
      promonocytes, while phenotypically, CD11b, CD13, CD14, CD33 and HLA-DR were
      positive. These date indicated that the subcutaneous tumors originated from
      monocytes.

PMID- 1758058
TI  - [Blastic form of acute erythremia: report of an autopsy case].
AB  - We report an autopsy case of acute erythremia which terminated in generalized
      infiltration of immature blasts similar to proerythroblasts. A 61-year-old man
      was admitted because of general fatigue and fever in June, 1990. Mild anemia and
      severe thrombocytopenia were noted. The bone marrow was hypocellular with 25.5%
      blasts similar to proerythroblasts and 36.5% erythroblasts, many of which were
      polynuclear and megaloblastoid. The blasts were cytochemically negative for POX,
      but positive for PAS staining. Therefore he was diagnosed as having acute
      erythremia. Partial remission was achieved by BHAC-EV therapy. But three months
      later, his marrow was replaced by 52.7% blasts as seen in admission. Those blasts
      were negative for lymphoid, myelocytic, megakaryocytic markers and
      antiglycophorin A, but positive for OKT 9. Electron microscopy revealed that some
      of blasts had characteristics of immature erythroblasts. In spite of low dose Ara
      C therapy, he died of sudden gastrointestinal bleeding in December, 1990. The
      autopsy disclosed widespread infiltration of blasts, involving liver, spleen,
      lung, kidney and stomach. It was interesting that dysplasia had been confined to
      erythroid lineage throughout his clinical course. He seemed to be a rare case of
      blastic form of acute erythremia which should be distinguished from
      erythroleukemia.

PMID- 1758059
TI  - [Primary bilateral adrenal lymphomas in 3 cases].
AB  - This report describes three of primary bilateral adrenal lymphoma. Case 1 was an
      87-year-old female. She was admitted to our hospital because of anemia. Masses in
      the bilateral adrenal glands were noted on abdominal computed tomography (CT).
      After combination chemotherapy, bilateral adrenal masses transiently showed a
      remarkable reduction, but they soon enlarged and she died. The pathological
      diagnosis at autopsy was non-Hodgkin lymphoma (diffuse medium sized cell type).
      Case 2 was a 77-year-old male. He visited our hospital complaining of general
      malaise. Masses in the bilateral adrenal glands were noted on abdominal CT and he
      was admitted. The left adrenal was biopsied under echo guidance. The pathological
      diagnosis was non-Hodgkin lymphoma (diffuse medium sized cell type). The
      bilateral adrenal masses transiently responded to combination chemotherapy, but
      soon enlarged again and he died. Case 3 was a 75-year-old male. He visited our
      hospital complaining of general malaise. Masses in the bilateral adrenal glands
      was noted on abdominal CT and he was admitted. The left adrenal was biopsied
      under echo guidance. The pathological diagnosis was non-Hodgkin lymphoma (diffuse
      medium sized cell type). Combination chemotherapy was followed by a complete
      remission and discharge of the patient.

PMID- 1758060
TI  - [Adult type of idiopathic paroxysmal cold hemoglobinuria].
AB  - A 78-year-old female suffered from idiopathic paroxysmal cold hemoglobinuria
      (PCH). Her symptom occurred immediately after she worked outside in the cold
      early morning. This case is characterized by the eldest case with non-syphilitic
      PCH reported in Japan and by the most advanced anemia (Hb 4.2 g/dl) possibly due
      to prolonged hemolysis after cold exposure. Analysis of the serum revealed
      positive Donath-Landsteiner antibody of IgG type, which could react to hemolysis
      not only below 15 degrees C but also at 15-20 degrees C in vitro.

PMID- 1758061
TI  - [Clinical evaluation of severe toxicity in two patients with acute lymphoblastic
      leukemia receiving outpatient methotrexate therapy].
AB  - Methotrexate (MTX) is now widely used for the treatment of acute leukemia and non
      Hodgkin lymphoma in the pediatric oncology field and is thought to be one of the
      key drugs for this treatment. A regimen utilizing high dose MTX (HD-MTX) with
      leucovorin rescue is being investigated as effective chemotherapy in the patients
      with these kinds of cancer. Relatively large amounts of MTX (225 mg/m2) are given
      to such outpatients by intravenous push as a course of maintenance therapy. It is
      said that those amounts will infuse safely. However, we experienced two serious
      cases-patients T.H. and M.Y.--which developed into severe side effects after this
      treatment. Both patients showed acute renal failure, severe myelosuppression,
      erosion around the oral and anal region, and continuous diarrhea. Judging from
      the serum concentration of MTX, patient T. H. was exposed to more than the
      maximum allowance serum MTX level for 9.6 days, patient M. Y. for 6.5 days. This
      suggests physicians must pay attention to the clinical symptoms even after
      treatment using MTX without HD-MTX.

PMID- 1758062
TI  - [Myelodysplastic syndrome with neoplastic angioendotheliosis: report of a case].
AB  - A 62-year-old woman was admitted to our hospital because of general malaise in
      May, 1987. No hepatosplenomegary, skin eruption or lymphadenopathy was detected.
      Laboratory examinations showed mild anemia, thrombocytopenia, normal leukocyte
      count with no lymphocyte abnormality, hypogranular neutrophils, elevated serum
      lactic dehydrogenase, increased C-reactive protein and hypoxia. Bone marrow
      aspirate was normocellular with dysplastic changes in erythroid and
      megakaryocytic lines which agree with a diagnosis of myelodysplastic syndrome
      (MDS). She was treated with prednisolone which relieved her symptom but she
      developed high fever, hemiplegia and disturbance of consciousness and died in
      August, 1987. Necropsy of the kidney revealed large mononuclear cells within the
      lumen of small blood vessels. Immunohistochemical study of these malignant cells
      showed positive reaction to the anti-LCA and anti-L26 antibodies. And electron
      microscopy showed no azure granules in these cells. Then we diagnosed as
      neoplastic angioendotheliosis (NAE). To our knowledge, this is the first report
      of NAE with abnormalities in myeloid, erythroid and megakaryocytic lineages.
      These results suggest that NAE with MDS originate from a multipotent stem cell.

PMID- 1758063
TI  - [Successful cholecystectomy in a patient with paroxysmal nocturnal
      hemoglobinuria].
AB  - We report a case of paroxysmal nocturnal hemoglobinuria (PNH) and review the
      literature regarding transfusion of red blood cells in PNH patients. A 42-year
      old woman with myelodysplastic syndrome (MDS) complaining of right
      hypochondralgia and high fever was admitted to the hospital for acute
      cholecystitis with gall stone. Blood examination revealed bicytopenia
      (leukocytes, 1,700/microliters and hemoglobin, 8.5 g/dl) and bone marrow
      examination showed normocellular but hypererythroid bone marrow and
      dyshematopoiesis, which suggested MDS. Laboratory data revealed obstructive
      jaundice and hemolytic anemia. Positive sucrose and Ham tests, which were
      compatible with the diagnosis of PNH. Cholecystectomy was successful, and the
      patient showed no postoperative complications of increased hemolysis or
      thrombosis. As hemoglobin level gradually decreased for the first two
      postoperative weeks, filtrated white cell-depleted red blood cells (total, 1,000
      ml) were transfused instead of washed red blood cells. No side effects of the
      transfusion were noted. On the basis of findings in this case and those reported
      in the literature, it is concluded that in some case of PNH, the use of washed
      red blood cells is unnecessary, and that the use of white cell-depleted red blood
      cells is indicated.

PMID- 1758064
TI  - [Hodgkin's disease associated with LDH-M subunit deficiency].
AB  - The patient was a 60-year-old man who had complained of left cervical swelling
      from the end of June, 1984. He was diagnosed as having Hodgkin's disease (mixed
      cell type) by lymph node biopsy, and was admitted to our hospital for thorough
      examination and treatment on July 23rd. Diagnosis of stage IA Hodgkin's disease
      involving only the left cervical lymph node was made. On admission, laboratory
      data revealed that the LDH activity in his serum and erythrocytes consisted of
      only type 1 (LDH-H4), hence LDH-M subunit deficiency (homogeneous type) was
      diagnosed. However, the muscle rigidity, myoglobinuria, and skin lesions that are
      usually seen in this abnormality were not observed. After two course of C-MOPP
      therapy, beginning on August 1st. complete remission was obtained. He was
      subsequently given a total of 6 courses of C-MOPP therapy and 40 Gy of
      irradiation on an outpatient basis. He eventually died of heart failure on
      November 3rd, 1986. Only five families with LDH-M subunit deficiency have been
      reported to date in Japan. This is the first report in Japan of the condition
      being complicated by Hodgkin's disease.

PMID- 1758066
TI  - [Biological membranes and blood cells].

PMID- 1758065
TI  - [Dynamic structure and function of biological membranes].

PMID- 1758067
TI  - [Functional role of cell surface glycoconjugates in leukemic cell
      differentiation: a specific type of sialoglycosphingolipids (gangliosides) as
      potent differentiation-inducers for human myelogenous leukemia cells].

PMID- 1758068
TI  - [Ultrastructure of the plasma membrane of blood cells].

PMID- 1758069
TI  - [Function and pathophysiology of platelet membrane glycoproteins].

PMID- 1758070
TI  - [Lipid metabolism of platelet membrane].

PMID- 1758071
TI  - [Surface antigens of megakaryocytes].

PMID- 1758072
TI  - [The interaction of platelet and vascular endothelial cell].

PMID- 1758073
TI  - [Liposomal membrane].

PMID- 1758074
TI  - [Medical application of liposomes].

PMID- 1758075
TI  - [Development of a new diagnostic assay system using liposomes].

PMID- 1758076
TI  - [Peripheral blood film evaluation for the diagnosis of a patient with red cell
      membrane disorder].

PMID- 1758077
TI  - [Changes in erythrocyte membrane fluidity and function in diseases].

PMID- 1758078
TI  - [Rheology of blood].

PMID- 1758079
TI  - [Inhibition of the cysteamine-induced gastric ulcer by the sympathoadrenal
      medullary system in spontaneously hypertensive rats (SHR) and normotensive Wistar
      Kyoto rats (WKY)].
AB  - We previously reported that cysteamine induces severe gastric ulcers in WKY, but
      very mild in SHR. The aim of this study is to elucidate the role on the
      sympathoadrenal medullary system in the pathogenesis of the cysteamine-induced
      gastric ulcer. Catecholamine (CA) contents in the stomach and adrenal gland were
      significantly higher in the non-treated SHR than in the non-treated WKY,
      suggesting that the sympathetic nervous system is more facilitated in SHR.
      Cysteamine decreased the noradrenaline and adrenaline contents in these tissues
      in both strains, however the values of CA was still higher in the treated SHR
      than the non-treated WKY. Histologically the adrenal medulla was severely damaged
      by cysteamine administration in WKY than in SHR. In contrast an
      immunohistological study revealed that chromogranin reactivity of the adrenal
      medulla was significantly stronger in the treated SHR than in the treated WKY.
      The celiac plexus was well preserved morphologically even in the cysteamine
      treatment in both strains. These results suggest that the capacity of the
      sympathetic nervous system in both the adrenal medulla and the stomach plays an
      important role in preventing the cysteamine-induced gastric ulcer in SHR.

PMID- 1758080
TI  - [A study on the mechanism of indomethacin induced intestinal ulcer--from a
      viewpoint of unstirred water layer].
AB  - We subcutaneously injected indomethacin (IDM) to rats and evaluated its effects
      on the unstirred water layer (UWL) of the small intestine. One hour after IDM
      administration at a dose of 4, 10, 20 and 50 mg/kg, the thickness of UWL
      decreased dose-dependently. Serial measurement of UWL 1, 3, 6, 12 and 24 hours
      after the administration showed early thinning of UWL after 1-3 hours. Many IDM
      induced ulcers were shown 24 hours after the injection of IDM at a dose of 10
      mg/kg. However, in the group given food during the latter 3 hours between 12 and
      15 hours after the drug administration, the number of ulcers was significantly
      decreased compared with those in the group given food ad libitum or in the group
      given food during the early 3 hours. When pectin, a soluble dietary fiber, was
      given together with solid stock food, ulcer formation was significantly
      inhibited. Synthesis of mucus glycoprotein by tissue organ culture was also
      decreased in the jejunum in the IDM-treated group. These results suggest that the
      formation of IDM-induced intestinal ulcer is related to the thing of intestinal
      UWL and the decrease of the synthesis of intestinal mucus glycoprotein.

PMID- 1758081
TI  - [Diagnosis of protein-losing gastroenteropathy by 111In-transferrin scanning and
      fecal excretion test].
AB  - A total of twelve patients with gastroenteropathy were studied for possible
      protein loss. The underlying diseases were intestinal lymphangiectasia,
      ulcerative colitis and Crohn's disease in 2 patients each; and Menetrier's
      disease, Cronkhite-Canada syndrome, postgastrectomy syndrome, severe atrophic
      gastritis, gastric cancer and gastroenteropathy of unknown origin in 1 patient
      each. The controls used in this study were four healthy volunteer and 9 patients
      with benign disease not accompanied by lesions in the digestive tract and protein
      loss, 111In-transferrin (Tf) was prepared by incubating 2-3 mCi of 111In-chloride
      with 15-20 ml of each patient's plasma in a sterilized vial at room temperature
      for 1 hour. After i.v. injection of 111In-Tf, the patients were scanned at given
      intervals of time for 72 hours to localize protein loss. 72-hour fecal 111In-Tf
      excretion was also measured. The following results were obtained: (1) 111In-Tf
      was detected in the feces of all patients. The recovery rate in the patient group
      was 7.95 +/- 3.65%, which was significantly higher than 0.48 +/- 0.26% in the
      control group (p less than 0.01). (2) However, 111In-Tf scanning showed the site
      of protein loss only in 6 patients. Negative scan in six other patients was
      thought to be associated with extensive inflammation and severe diarrhea. (3)
      Five of the twelve patients were observed before and after treatment.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1758082
TI  - [Induction of experimental splenomegaly with portal hypertension in rats with
      liver cirrhosis].
AB  - Liver cirrhosis was induced in rats by administering thioacetamide (TAA), and
      portal hypertension was maintained for at most 35 weeks to study the influence of
      portal hypertension on the weight of spleen and splenic tissues. TAA was
      intraperitoneally injected at dose of 200 mg/kg three times a week. The portal
      pressure was elevated and the weight of the spleen increased with the progression
      of hepatic fibrosis due to TAA. Liver cirrhosis was obviously observed after TAA
      was administered 60 times. The maximum ratio of the weight of the spleen to body
      weight in the group administered TAA was higher by 4.08 times than that in the
      control group. In all 49 rats used in the experiment there was a high correlation
      (r = 0.930, p less than 0.01) between the portal pressure and the ratio of spleen
      to body weight. Histological observation revealed that the red pulp tended to be
      enlarged, while the white pulp tended to be reduced, with increases in portal
      pressure and weight of the spleen. It also histologically revealed an increase in
      the splenic sinus-like structure, narrowing of the splenic cords, fibrosis due to
      reticular cell proliferation in the red pulp and fibrosis around the central
      artery in the white pulp. These histological changes in rats were similar to the
      histological findings of splenomegaly accompanying portal hypertension in humans.
      This suggests that the animal model prepared in the present experiment is useful
      as a model of splenomegaly due to portal hypertension.

PMID- 1758083
TI  - [Effect of synthetic protease inhibitor on the sphincter of Oddi function in
      dogs].
AB  - Fundamental study in dogs have shown that the synthetic protease inhibitor has
      pharmaceutical properties characterized by effect on motility of the sphincter of
      Oddi. Synthetic protease inhibitors, gabexate mesilate and nafamostat mesilate
      have effects on motility of the sphincter of Oddi in dogs. The motor effect of
      synthetic protease inhibitor on the sphincter of Oddi has been investigated by
      manometric evaluation. Immediately after intravenous administration of gabexate
      mesilate (5, 10, 50, and 100 mg/kg/h) the motility of the sphincter of Oddi was
      inhibited dose-dependently, on the other hand after intravenous administration of
      nafamostat mesilate (0.5, 1, and 5 mg/kg/h) motility of the sphincter of Oddi was
      accelerated. Therefore it was suggested that these results shown some
      considerable problems in clinical use.

PMID- 1758084
TI  - [Study of patency of minor duodenal papilla--comparison between pigment method
      combined with pH sensor and pancreatographic method].
AB  - We investigated the patency of minor duodenal papilla in 25 cases that had
      presented normal pancreatogram by using the endoscopic retrograde
      pancreatographic (ERP) method and a pH sensor-combined indigo carmine pigment
      method. The pigment method allowed us to classify the function of minor papilla
      into three types according to pancreatic juice excretion pre- and post-secretin
      administration (Type I), excretion after secretin administration (Type II), and
      no excretion even after secretin administration (Type III). Twelve cases belonged
      to Type I, 4 cases to Type II and 9 cases to Type III. By ERP method, terminal
      shapes of the Santorini's duct were classified as stick type, cystic type and
      branch type. 19 cases were considered stick type, 2 cases cystic type and 4 cases
      branch type. Eighteen cases were identified as patent minor papilla under ERP
      method. There were two cases alleged to be patent under the ERP but without
      pancreatic juice excretion. Therefore, the necessity of pigment method was
      confirmed for investigation of the function of minor papilla.

PMID- 1758085
TI  - [Three cases of gastric malignant lymphoma with a characteristic endoscopic
      ultrasonographic appearance].

PMID- 1758086
TI  - [A case of "dry form" tuberculous peritonitis with difficult differential
      diagnosis from pseudomyxoma peritonei].

PMID- 1758087
TI  - [A case of primary biliary cirrhosis accompanied by uveitis].

PMID- 1758088
TI  - [Two cases of gas-containing liver abscess--review of Japanese literature].

PMID- 1758089
TI  - [A case of visceral larva migrans by Toxocara cati infection with multiple liver
      granuloma].

PMID- 1758090
TI  - [A case of inflammatory pseudotumor of the liver].

PMID- 1758091
TI  - [Primary early carcinoma of the cystic duct--a case report and review of the
      literature].

PMID- 1758092
TI  - [A case of lipase-secreting acinar cell carcinoma with subcutaneous fat
      necrosis].

PMID- 1758093
TI  - [Hepatic metastasis of serous cystadenocarcinoma resected 4 years after operation
      of primary tumors--a case report].

PMID- 1758094
TI  - [Effect of free radical and experimental study on development mechanism of
      gastric rupture in newborn].

PMID- 1758095
TI  - [Ultrasound image of muscularis mucosae of the stomach].

PMID- 1758096
TI  - [Inhibition of gastric acid secretion by protein kinase C in isolated rat
      parietal cells].

PMID- 1758097
TI  - [Effects of protease inhibitors on the motor activity of canine sphincter of
      Oddi].

PMID- 1758098
TI  - [Pancreatic lysosomal enzyme secretion into pancreatic juice stimulated by
      secretin and caerulein in rabbit].

PMID- 1758099
TI  - [Acute pulmonary thromboembolism after coronary artery bypass grafting].
AB  - The cases of acute pulmonary thromboembolism after coronary artery bypass surgery
      have been rarely reported in Japan. We, however, experienced 2 cases of them and
      lost them against intensive therapy. In Mitsui Memorial Hospital, 6 cases of
      pulmonary thromboembolism had been diagnosed in 1990 (0.074% in admission
      patients), four of the cases had occurred following surgical procedures. Its
      manifestations are deceivingly nonspecific and are difficult to distinguish
      perioperative myocardial infarction, pericardial tamponade, and pneumothorax,
      especially in postoperative states. We would like to emphasize that acute
      pulmonary thromboembolism is getting important problems also in Japan.

PMID- 1758100
TI  - [The influence of left atrial cuff rejection on pulmonary hemodynamics after
      canine lung allotransplantation].
AB  - Several factors influence pulmonary hemodynamics after lung transplantation:
      reimplantation response, lung rejection reaction and imperfect anastomosis
      technique. In this experiment, five cases presented marked elevation of mean
      pulmonary artery pressure at the time or right pulmonary artery occlusion test
      performed two weeks postoperatively. Left atrial cuff rejection reaction arose in
      one case in which edema and stenosis of the pulmonary vein outflow tract were
      evidenced. This finding demonstrated that the changes in pulmonary hemodynamics
      after transplant suggest the possibility of inducement by left atrial cuff
      rejection reaction.

PMID- 1758101
TI  - [Operative management of the calcified patent ductus arteriosus in the elderly].
AB  - Two cases of the calcified PDA were experienced in subjects aged more than 50
      years. A 63-year-old woman was successfully operated upon. A Fogarty's balloon
      catheter was wedged into the PDA through the ductus after a pulmonary arteriotomy
      under cardiopulmonary (CP) bypass. A 57-year-old woman was safely operated. PDA
      was repaired under partial CP bypass with Bio-pump. Postoperative courses of
      these cases were uneventful. Brief review of surgical treatment for PDA was
      given.

PMID- 1758102
TI  - [Postoperative brain metastasis from esophageal carcinomas: report of 4 cases].
AB  - Out of 83 cases received resection of primary esophageal lesion, 4 patients were
      affected by metastatic brain tumor which was reported to rarely occur. All 4
      patients had symptoms of central nervous system. Three of them were diagnosed by
      CT and the other one at autopsy. All of the primary esophageal tumors were
      advanced and of histological stage III or IV. They located in the middle or lower
      thoracic esophagus. Brain tumor of one case was removed and this case was of
      progression free at the last presentation. The other 3 cases were not received
      resection of metastatic brain tumors and died. All of 3 were autopsied and two of
      them had no metastasis in the lung. Therefore, it was considered that these
      hematogenic metastases were not through lung filtrations but through other
      routes, which Batson O. V. experimentally proved and designated as vertebral vein
      system in 1940. It is concluded that aggressive surgical intervention to
      metastatic brain tumors was beneficial with regard to prognosis for cases without
      other metastatic lesions.

PMID- 1758103
TI  - [Aortitis syndrome associated with aortic regurgitation and coronary ostial
      stenosis: a case of successful surgical treatment at the active stage].
AB  - A 24-year-old woman with aortic regurgitation and ostial stenosis of coronary
      artery due to aortitis syndrome was reported. She was admitted to the hospital
      with anterior chest pain. Retrograde aortogram showed aortic regurgitation and
      selective coronary angiogram revealed severe ostial stenosis. In spite of steroid
      therapy, chest pain was not controlled. In spite of the active stage, she
      underwent aorto-coronary bypass and aortic valve replacement. Intra-aortic
      balloon pumping (IABP) was necessary to wean from cardio-pulmonary bypass, but
      she recovered well and no complication was recognized after operation.

PMID- 1758104
TI  - [A case report of cavernostomy for lung aspergilloma].
AB  - A 65-year-old male patient with right upper lobe aspergilloma treated surgically
      due to continuation of hemoptysis was reported. Cavernostomy was indicated in
      this patient, since he had a low respiratory function. After cavernostomy,
      cavitry infection with MRSA occurred and additional operation was necessary. We
      should gave great care to intra-cavitary infection. Loss of lung function after
      the operation seemed to be minimal.

PMID- 1758105
TI  - [A case of mediastinal cavernous hemangioma].
AB  - A case of mediastinal cavernous hemangioma was reported. An asymptomatic 6-year
      old girl was discovered to have a mass in the left anterior superior mediastinum
      on a routine chest x-ray film. Computed tomograms demonstrated a mediastinal mass
      with calcification. Under a median sternotomy, a 10 x 9 x 5 cm mass was resected
      after dissecting the connections to the pericardium. As the mass surrounded the
      left phrenic nerve, the nerve was resected with the tumor. The histopathology was
      cavernous hemangioma. The calcification was not found in the vessels as the
      phleboliths but was showed in the interstitial tissues.

PMID- 1758106
TI  - [Sudden onset of systemic hypoxia associated with both tricuspid regurgitation
      and persistent foramen ovale: a case report].
AB  - A 33-year-old female who had undergone closure of VSD 20 years before, was
      hospitalized for sudden onset of dyspnea without history of febrile or traumatic
      disorder. On admission, she had cyanotic lips and nailbeds but no clubbed finger.
      Chest x-ray film showed neither lung congestion nor cardiomegaly. Arterial blood
      gas analysis revealed deep hypoxia (PaO2 = 49.6 mmHg). Echocardiogram clarified
      massive tricuspid regurgitation (TR) due to chordal rupture of anterior leaflet,
      small VSD jet stream through the membranous aneurysm and a great deal of R-L
      shunt on the atrial level through a persistent foramen ovale. Cardiac
      catheterization data confirmed 35% of R-L shunt. At operation, a torn chordal
      tendon of anterior leaflet and an adhered septal leaflet to aneurysm of
      membranous portion of ventricular septum were seen. There were two pledgets, used
      at the first surgery, at the base of the aneurysm and a couple of tiny holes
      (VSDs) above and below the pledgets were recognized. Following resection of
      anterior and posterior leaflet, plication of septal leaflet and closure of VSD, a
      Xenograft valve (Carpentier-Edwards 29-M) was implanted. Then persistent foramen
      ovale, 20 x 20 mm in large, was closed directly. Her postoperative course was
      excellent with disappearance of cyanosis, normalized oxygen saturation in
      arterial blood and improved activity without dyspnea.

PMID- 1758107
TI  - [A case of surgical repair of aortic dissection associated with tear of the right
      coronary artery].
AB  - A 39-year-old female with dissecting aortic aneurysm of DeBakey type I, underwent
      replacement of the ascending aorta. We found that the right coronary artery
      originated just distally from the left sinus of Valsalva, run transversally in
      the aortic wall. Because the entry of dissection occurred at the right coronary
      artery, it was torn longitudinally. Aorto (graft)-rt. coronary bypass grafting
      was performed. She had no ischemic heart symptoms postoperatively. It is supposed
      that the dissecting aortic aneurysm was caused by the anomalous origin of the
      right coronary artery.

PMID- 1758108
TI  - [Malfunction of the Omniscience valve in mitral position: a case report].
AB  - A 55-year-old woman who underwent implantation of a 27 mm Omniscience valve in
      mitral position 5 and a half years ago, consulted our institution complaining
      reappearance of signs of mitral stenosis. In preoperative examinations, the
      maximal opening angle of the Omniscience valve was only 32 degrees and PCWP was
      elevated to 20 mmHg. Her symptoms disappeared after mitral valve re-replacement
      with a Medtronic Hall 27 mm prosthesis. The important point is that no foreign
      body such as thrombus or overgrown pannus interfering motion of the Omniscience
      valve was observed at the time of reoperation. The cause of insufficient opening
      seemed to be valve mechanism itself.

PMID- 1758109
TI  - [A case of cystic mediastinal lymphangioma].
AB  - A 41-year-old man was admitted to our hospital because of an abnormal shadow
      which was pointed out on the chest x-ray film in mass screening. The operation
      was performed through left thoracotomy. The cyst was unilobular and 43 x 36 x 36
      mm in size, located in the middle position of upper mediastinum. This
      localization has not been reported among 46 cases of the mediastinal
      lymphangiomas in Japan. Preoperative diagnosis is very difficult since
      roentogenographic feature is few for ruling out other mediastinal tumors. The
      complete resection of the cyst is recommended.

PMID- 1758110
TI  - [A case of an aberrant subclavian artery-esophageal fistula due to prolonged
      nasogastric intubation].
AB  - A case of fatal hematemesis due to an aberrant right subclavian artery-esophageal
      fistula is presented. The patient was a 9-year-old male child with complex
      congenital heart disease and developed the fistula by prolonged tracheal and
      nasogastric intubation after Fontan type operation. To avoid this unusual but
      serious complication, aberrant subclavian artery should be treated surgically
      before repair of complex cardiac anomaly.

PMID- 1758111
TI  - [Methicillin-cephem-resistant Staphylococcus aureus (MRSA) mediastinitis
      following open heart surgery].
AB  - Mediastinitis following cardiac surgery occurs frequently in association with
      high mortality and morbidity. Patient was a 6-year-old boy suffering from Sotos
      syndrome with secundum type of ASD. He was operated upon to repair ASD. Following
      the surgery, he suffered from MRSA mediastinitis and osteomyelitis of the
      sternum. Routine method of closed irrigation after reopening of the sternal wound
      was ineffective. Patient recovered following aggressive debridement repeatedly,
      open drainage and topical irrigation with vancomycin. This appears to be a useful
      method to treat MRSA mediastinitis of the sternum.

PMID- 1758112
TI  - [A successful correction of common atrium with left atrial isomerism].
AB  - A successfully treated case of one-year-old girl of common atrium associated with
      bilateral superior vena cava and an interrupted inferior vena cava with
      hemiazygos continuation is reported. In addition to these anomalies of systemic
      venous connection, both atrial appendages show morphological characteristics of
      left type, and the final diagnosis of left atrial isomerism was made. In the
      corrective surgery, atrial septation was reconstructed using trimmed autogenous
      pericardial patch to allow the left superior vena cava to drain into the right
      side of the common atrium. The patient had been pointed out bradycardia (50
      100/min) since her birth. Postoperative electrocardiogram also showed bradycardia
      (78-100/min). Especially in sleeping, her heart rate was 50-60/min, resulting in
      A-V junctional escaped rhythm and A-V dissociation. This fact suggests that her
      sinus node is absent or hypoplastic, one of the characteristics of left atrial
      isomerism. Since left atrial isomerism is reported to cause a decrease of atrial
      rhythm with aging, careful postoperative observation on specific arrhythmia is
      necessary.

PMID- 1758113
TI  - [A case report of surgical treatment of acute aortic dissection (DeBakey III B)
      in association with thoracic aortic aneurysm].
AB  - This is a case report of 63-year-old man suffering from DeBakey III B acute
      dissection in association with thoracic aortic aneurysm. He had been following up
      for hypertension and thoracic aortic aneurysm. He was brought to the hospital by
      city ambulance complaining of sudden onset of severe back pain. Emergency
      operation was carried out. It revealed aneurysm of 90 mm in diameter located just
      distal to the aortic arch and an intimal tear or entry of the dissection located
      distal to the left subclavian artery. A low porosity Dacron graft was interposed
      between the distal aortic arch and middle portion of the thoracic descending
      aorta using inclusion technique. Systemic circulation was bypassing external
      iliac vein to artery using pump-oxygenator during aortic clamping. His
      postoperative course was uneventful. In review of the literature, association of
      the atherosclerotic aneurysm and acute dissection occurred approximately 5% in
      the cases of aortic dissection with increasing risk of aneurysmal rupture.

PMID- 1758114
TI  - [Serious complication of retrograde perfusion during repair of dissecting
      aneurysm: compression of the true lumen].
AB  - Between 1982 and 1990, 61 patients underwent the repair of dissecting aneurysm.
      Retrograde perfusion from the unilateral femoral artery were performed for 56
      patients and the selective false lumen perfusion occurred in 3 patients. As for
      those 3 patients, compression of the true lumen and insufficient cerebral
      perfusion were suspected. Selective cerebral perfusion and antegrade systemic
      perfusion from the ascending aortic graft were performed. Although 2 patients
      took uneventful postoperative courses, 1 patient died of massive brain damage. It
      is very important to accomplish the means to maintain adequate cerebral
      circulation as soon as possible toward this fetal complication.

PMID- 1758115
TI  - [Fontan type procedure in patient with borderline hemodynamics: using a temporary
      R-L shunt in early postoperative period].
AB  - Fontan type procedure was successfully performed to a 14-year-old patient with
      borderline hemodynamics using a temporary R-L shunt in early post operative
      period. Preoperative diagnosis was DORV (ILD), small RV, PS, ASD, juxtaposition
      of atrial appendages and post bilateral B-T shunts. Preoperative catheterization
      studies showed low PARI but insufficient pulmonary arterial size (PA-index 220).
      In the Fontan procedure, RA was partitioned obliquely with a composite patch of
      xenograft and Dacron velour. A 5.5 mm hole was created only in xenograft to allow
      a temporary R-L shunt. During rewarming period, systemic pressure hovering around
      60 mmHg with 10 micrograms/kg/min of dopamine and dobutamine. Then a R-L shunt
      was created by a side to side anastomosis between the appendages with the orifice
      diameter of 10 mm, followed by a rise in the systemic pressure up to about 80
      mmHg. One post operative day, a readjustable occluder was applied at the site of
      appendage anastomosis to control R-L shunt flow. According as CVP decreased, the
      occluder was tightened up step by step. Finally, the occluder was fully tightened
      up in 10 post operative days. This experience suggests that a temporary R-L shunt
      in early post operative period may be applicable in patient with borderline
      hemodynamics for Fontan type procedure.

PMID- 1758116
TI  - [Surgical repair of ischemic mitral regurgitation].
AB  - We studied surgical results of 14 cases of ischemic mitral regurgitation. There
      was no surgical death in 10 cases with left ventricular aneurysm, and their
      clinical symptoms improved except 3 with the combined operation of left
      ventricular aneurysmectomy, mitral annuloplasty and bypass grafting. The range of
      the abnormal contracting segment significantly decreased after surgery except in
      3 cases in whom clinical status was not improved. Three of 4 cases which
      underwent bypass grafting and mitral annulo-valvuloplasty survived, but one of
      them died of graft-versus-host disease. In the three survived cases, severe
      mitral regurgitation disappeared. We have concluded as follows: In cases of left
      ventricular aneurysm, a sufficient aneurysmal resection is very important to
      control the mitral regurgitation, and the additional procedures of mitral
      annuloplasty and bypass grafting are essential. The mitral valve replacement is
      recommended in case of the complete disruption of the papillary muscle. Mitral
      valvuloplasty combined with annuloplasty is suitable to control the regurgitation
      in the regional mitral prolapse due to the torn chordae.

PMID- 1758117
TI  - [Etiology of left ventricular rupture following mitral valve replacement].
AB  - Two uncommon cases of left ventricular rupture that occurred during cardiac
      surgery were treated successfully. These cases may be useful in understanding the
      etiology of common left ventricular rupture following mitral valve replacement.
      One case occurred during coronary bypass surgery. The myocardium which is already
      abnormal seems to be weak to trauma such as bending, traction and torsion. In the
      other case, who underwent mitral valve replacement with preservation of the
      posterior leaflet with its attached chordae, the disruption was localized in the
      epicardial side of the left ventricular posterior wall, though direct injury by
      some instrument was excluded as a possibility, with a depth of half the thickness
      of the wall. In experiments using dogs, shape and movement of the mitral annulus
      were examined. The length of the annulus attached to the posterior leaflet in end
      systole was shortened to 89.0 +/- 4.6% of that in late diastole. Furthermore, the
      annulus was distorted by the elevation of the heart. We approve of Cobbs'
      "untethered ventricle theory" and consider moreover as follows: In general,
      whether with or without preservation of the mitral loop, the mitral annulus and
      the left ventricular posterior wall after mitral valve replacement are severely
      constricted by the rigid prosthetic ring and become tense, which limits movement
      in both circular and longitudinal directions. Then even slight stress may cause a
      primary tear on the posterior wall of the left ventricle, resulting in rupture.
      In order to treat the rift, the prosthesis must be removed before the apex of the
      heart is lifted, to avoid excessive ventricular wall tension.

PMID- 1758118
TI  - [Recommendation for open heart surgery in infancy].
AB  - Progress in infant open-heart surgery last 10 years was reviewed mainly based on
      the surgical experiences in Fukuoka Children's Hospital. Recent advances and
      present problems in patient's care, cardiopulmonary bypass methods and
      cardioplegia were discussed. Low surgical mortality of 4.8% in 245 infant open
      heart repairs between 1988 and 1990 in Fukuoka is highly suggestive of early
      primary repair for most of congenital heart diseases.

PMID- 1758119
TI  - [Current problems in valvular surgery].
AB  - Based upon our experiences of 661 valvular operations for these 10 years, we
      discussed about three major topics in valvular surgery. The first is the current
      status of valve repair versus replacement. The second is on the changing aspects
      of patients undergoing valvular surgery. Finally difficult problems in the
      treatment of infective endocarditis was discussed.

PMID- 1758120
TI  - [Surgical treatment of coronary artery disease].
AB  - The indication in revascularization surgery is quite complicated, as the
      manifestation of the anatomical disease in the major three coronary arterial
      trees are innumerable and different as the face of each patient. Even though it
      is simply grouped into three categories as single, double and triple vessel
      disease, the combination of the degree and position of the obstructive lesions
      and the status of left ventricular function is varied in each instance. Adding
      further the patient's specific variables and risk factors to the anatomical
      variance, the situation becomes more complex. During the first decade of
      revascularization surgery, several large scale clinical studies were carried out
      in the United States and Europe to define the subsets of patients who were more
      benefited by revascularization surgery than medical treatment. The technique of
      aorto-coronary bypass graft (CABG) surgery also rapidly developed during this
      period and more complete revascularization using more durable conduits such as
      the internal mammary artery grafts with less surgical morbidity and mortality has
      been attained in the second decade. The appearance of PTCA (percutaneous
      transluminal coronary angioplasty) as a new invasive modality of treatment by the
      cardiologist towards the end of 1970's further complicated the indication of
      CABG. The comparative benefit of PTCA & CABG should be searched by the objective
      prospective randomized studies but such studies may be very difficult to be
      conducted in large scale, and meantime the number of PTCA will continue to
      increase. Based on the ACC/AHA Task Force Report, "Guideline and Indication for
      Coronary Artery Bypass Graft Surgery.": JACC Vol. 17, No. 3 March 1, 1991: 543
      89, some of the subjects in surgical treatment of coronary artery disease were
      discussed in this paper.

PMID- 1758121
TI  - [Myocardial protection: some problems and recent progress].
AB  - One of the great advances in cardiac surgery in the past 20 years has been the
      concept of myocardial protection "cardioplegia". But even now, there are some
      controversies about the methods for myocardial protection. In this review,
      controversy between crystalloid and blood cardioplegia, between extracellular and
      intracellular cardioplegic solution are discussed. And then the recent advances
      in cardioplegia, terminal warm blood cardioplegia, retrograde infusion of
      cardioplegic solution and cardioplegia in infants are reviewed.

PMID- 1758122
TI  - [Recent advancement of surgical treatment of aneurysms of the thoracic aorta].
AB  - The recent advancement of surgical treatment for aneurysms of the thoracic aorta
      with special reference to the operative technique and adjunctive methods of
      distal aortic perfusion during aortic cross-clamping were reviewed. Between 1960
      and July, 1991, 415 patients underwent operation for aneurysms of the thoracic
      aorta in our institution. The overall early mortality rates were 7.7% for the
      nonruptured aneurysms and 30.6% for the ruptured aneurysms during the last 10
      years with recent establishment of mechanical adjuncts and refinement of
      operative technique. Composite graft replacement with coronary reimplantation was
      employed in the treatment of annuloaortic ectasia. Selective cerebral perfusion
      (SCP) with an open aortic anastomosis is a useful adjunct in the treatment for
      aneurysms of the aortic arch. Graft inclusion technique (Crawford's method) with
      the aid of a partial bypass is a valid technique for the treatment of
      thoracoabdominal aortic aneurysms involving visceral branches. Emergency
      operation is necessary for acute type A aortic dissection to prevent the sudden
      death due to cardiac tamponade. Acute aortic arch dissection can be treated
      surgically by replacing both the ascending aorta and aortic arch with prosthetic
      graft using SCP and open aortic anastomosis. Because of poor prognosis of the
      aneurysms of the thoracic aorta, and improvement in present surgical results, it
      now seems justifiable to support an aggressive surgical approach to this disease,
      before the fatal rupture occurred.

PMID- 1758123
TI  - [Recent surgical treatment of thoracic esophageal carcinoma].
AB  - Nowadays, surgery for a thoracic esophageal carcinoma is accomplished safely,
      however, there still remain many problems concerning curative resection.
      Cancerous recurrences of the lymph node is still high against to lymph node
      dissection around thoracoabdominal region. Therefore, surgery should endeavour to
      prevent such lymphatic recurrences. In the patients with a carcinoma in the upper
      or middle third of the esophagus, who underwent extended radical esophagectomy, a
      significantly high incidence of metastasis in the recurrent nerve lymphatic chain
      was noted in comparison with that in patients with that in those who underwent
      standard radical resection. Complete resection of the recurrent nerve lymphatic
      chain is generally difficult through the thoracic approach alone, and such
      approach might be the factor causing the poor prognosis after standard radical
      surgery for an upper or middle thoracic esophageal carcinoma. Accordingly,
      extended radical surgery by the cervicothoracoabdominal approach can produced
      improved surgical curability for an upper or middle thoracic esophageal
      carcinoma. On the other hand, pulmonary complications are still a major
      postoperative complication following radical esophagectomy due to extended
      radical lymphadenectomy around the paratracheobronchial region. So, it is now
      clear that we should preserve the right bronchial artery and pulmonary nerves
      branched from the vagus nerve during the thoracic procedure, if these unaffected
      by cancerous invasion. Adopting this procedure resulted in a marked decrease in
      the incidence rate of postoperative severe pulmonary complications. Finally, in
      the near future we expect to develop criteria to select the best treatment for
      each specific individual based on preoperative studies of the biological
      characteristics of the carcinoma.

PMID- 1758124
TI  - [Postoperative complications and treatments after Bentall operation].
AB  - Postoperative complications of Bentall operation for the annuloaortic ectasia
      have frequently occurred, although the mortality has been reduced. To reduce
      complications after Bentall operation we have taken three major treatments since
      1987. The first was reimplantation technique of coronary ostia in replacing the
      ascending aorta and the aortic valve with a tube graft. The second was the
      infusion technique of cardioplegic solution such as retrograde cardioplegia
      infusion. The third method was to save blood and reduce the blood transfusion by
      preserving autoblood preoperatively and using cell saving machine. The purpose of
      this study was to analyse 20 patients who underwent the Bentall procedure and to
      investigate the effect of our treatments in Bentall operation on the operative
      results. We divided our patients into two groups. Fourteen patients in the group
      1 were operated before 1987, when our principles were not performed. Six patients
      in group II were operated under the principles mentioned above. There were no
      differences in cardiopulmonary bypass time and ischemic time between group I and
      II. Transfused blood volume in group II was remarkably less than that of group I.
      Postoperative complications occurred in all patients in group I (100%), while
      three patients in group II (50%) had complications (p less than 0.05). We, hence,
      conclude that our method could be useful for reducing postoperative complication
      rate in Bentall operation.

PMID- 1758125
TI  - [Experience of predeposit autologous blood transfusion and medication of
      recombinant human erythropoietin in pediatric open heart surgery].
AB  - To avoid using the homologous blood, 11 children between the age of 5 and 15
      years donated autologous blood of 10 ml/kg of body weight (upper limit 400 ml)
      once a week for two weeks prior to elective open heart surgery. Five of 11
      children received erythropoietin (100 U/kg of body weight) intravenously three
      times a week for two weeks. Only one patient experienced a mild donor reaction
      but no adverse effects occurred in erythropoietin therapy. In all the patients
      cardiac operations were able to be completed without homologous blood
      transfusion. Patients treated with erythropoietin were not anemic despite of
      preoperative donation although without erythropoietin therapy patients were
      mildly anemic. Our experience documents safety and effectiveness of predeposit
      autologous blood transfusion and erythropoietin therapy in pediatrics.

PMID- 1758126
TI  - [A case of cardiac lipoma in the ventricular septum].
AB  - A 45-year-old man was admitted because of systolic murmur after routine medical
      checking. Echocardiography and cardiac catheterization revealed a large mass in
      the ventricular septum which bulged into right ventricular cavity with pressure
      gradient of 29 mmHg. The diagnosis of cardiac lipoma was made by CT scanning
      which showed the mass with attenuation values of -94 Hounsfield units. MR imaging
      demonstrated the mass with high signal intensity which corresponded to that of
      subcutaneous fatty tissue. The tumor was resected through the right ventricular
      incision with the use of cardiopulmonary bypass. It was yellow, elastic soft,
      sized 6.5 x 4.3 x 3.5 cm, and weighed 44.7 g. On histological examination, the
      tumor was composed of mature fatty tissues contained with myocardial fibers.
      After operation, he had split of the ventricular septum, which was closed
      primarily after removal of the lipoma, and left-to-right shunt. Patch
      reinforcement was performed at the right ventricular side of the septum on the
      postoperative 18th day. Postoperative electrocardiogram showed left axis
      deviation and complete right bundle branch block. This finding seems to be
      resulted from injury to the anterior branch of left bundle. The postoperative
      course was uneventful. This patient is the second case of removal of cardiac
      lipoma in the ventricular septum on review of the literature in Japan.

PMID- 1758127
TI  - [Successful repair of TGA with ventricular septal defect, the outflow tract
      stenosis of the left ventricle and coarctation of the aortic arch].
AB  - A 9-month-old boy after the coarctectomy at 5 months old was successfully
      repaired by Senning procedure with closure of ventricular septal defect and
      resection of the membranous septal aneurysm causing the outflow tract stenosis of
      the left ventricle. Retrospectively, this case might have been possible to do
      Jatene procedure, however, attempts to resect the left ventricular outflow tract
      stenosis often failed to relieve stenosis completely. Therefore, the intraatrial
      switch operation seems to be better than the arterial switch operation when there
      is a possibility to remain left ventricular outflow tract stenosis. True
      estimation for these cases must await more case studies.

PMID- 1758128
TI  - Great expectations.

PMID- 1758129
TI  - With privilege comes responsibility.

PMID- 1758130
TI  - Peer review revisited.

PMID- 1758131
TI  - The EACH concept. Part II: A physician's perspective.

PMID- 1758132
TI  - Ventricular tachycardia in a newborn of a mother with scleroderma.

PMID- 1758133
TI  - Physician to rancher (and back again). Part Three.

PMID- 1758134
TI  - Managing survivors of ventricular fibrillation.

PMID- 1758135
TI  - [Therapy of acute myeloid leukemia in children--results of the AML II/87
      multicenter study].
AB  - Fifty seven patients entered the cooperative study AML II/87 of the working group
      "Pediatric Hematology and Oncology" of East Germany. Two patients with initial
      hyperleukocytosis died prior therapy. 13 patients died within the first 4 weeks
      of therapy, 3 patients did not respond to therapy, and one patient is not yet in
      remission. 38 patients (70%) attained a complete remission. 15 patients get a
      bone marrow transplantation in first CR (10 autologous BMT without purging, 5
      allogenous BMT). 12 of them are living and well 3 to 34 months after BMT. 9 of
      the 23 patients under chemotherapy relapsed, one patient is lost to follow up. 13
      patients are living in continuous complete remission. The life table
      probabilities 48 months after the start of the protocol are 0.43 for disease free
      survival (DFS) and 0.60 for event free interval (EFI). The respective results of
      the former protocol AML I/82 were 0.34 for DFS and 0.47 for EFI.

PMID- 1758136
TI  - [Course and prognosis of internal hydrocephalus in children].
AB  - Sixty-two patients with infantile hydrocephalus were reexamined at ages ranging
      from 2-19 years. Operations had been performed in 46 children. The long-term
      intellectual prognosis of hydrocephalus is described. Sex, age and frequency of
      shunt complications are not related to intelligence level. In general,
      hydrocephalus due to spina bifida and aquaeduct stenosis results in a better
      intelligence level than hydrocephalus to other reasons.

PMID- 1758137
TI  - [Long-range intelligence development of children with congenital hypothyroidism].
AB  - The intellectual development of 105 children with congenital hypothyroidism was
      assessed. In 70 children the assessment was repeated in several times.
      Correlations between development of intelligence and influence of biological
      and/or psychosocial risks were verified.

PMID- 1758138
TI  - [Modification of anxiety in children prior to dental treatment using
      premedication with Faustan diazepam)].
AB  - In about 22% of children aged from 7 1/2 to 12 years we established heavy
      reaction of anxiety. To proof the influence of Diazepam to dental treatment we
      carried out clinical investigations in 40 patients. By means of premedication
      with Diazepam we got a positive effect for readiness of treatment.

PMID- 1758139
TI  - [Development of body weight and height of small-for-gestational-age infants in
      relation to the degree of intrauterine retardation].
AB  - The increase of weight of 238 hypotrophic and 31 eutrophic newborns is analyzed
      and assigned to 4 clusters in the course of their first 21 months. It is compared
      with body weight curves by Prader. Cluster 1 Increase in weight about the 50th
      percentile Cluster 2 Increase in weight between the 50th and 3rd percentile
      Cluster 3 Increase in weight just below the 3rd percentile Cluster 4 Increase in
      weight clearly below the 3rd percentile More than a half of all hypotrophic
      newborns had a body weight below the 3rd percentile by Prader (cluster 3 and 4)
      on attaining the age of 21 months. The appearance of hypotrophy in the newborns
      is subdivided into 4 groups by means of gestational age and relative birthweight:
      Group 1 eutrophic and moderate hypotrophic (n = 77) Group 2 premature and
      moderate hypotrophic (n = 46) Group 3 eutrophic and distinct hypotrophic (n = 62)
      Group 4 premature and distinct hypotrophic (n = 53) We found that the increase of
      weight correspond to cluster 4 in 4% of group 1, in 22% of group 2, in 32% of
      group 3, and in 43% of group 4. At last the increase of body weight is hard
      influenced in the first 3 years of life by hypotrophy and degrees of maturity of
      the newborns.

PMID- 1758140
TI  - [Opitz' trigonocephaly syndrome].
AB  - The Opitz' Trigonocephaly Syndrome, also called C-syndrome is an important
      autosomal recessive inherited disorder with characteristic synostosis of metopic
      suture, craniofacial abnormalities and severe mental retardation. Some patients
      show chromosomal aberrations with the possibility of prenatal diagnosis. Are
      reported on three children from two families with typical dysmorphic stigmata of
      the syndrome.

PMID- 1758141
TI  - [Pfeifer type acrocephalosyndactylia (McK 10160, 18075)].

PMID- 1758142
TI  - [Rental contracts in medical practice--what should be considered?].

PMID- 1758143
TI  - [Valproate-associated hepatotoxicity--pathogenesis, clinical aspects, therapy and
      prevention].
AB  - The potential hepatotoxicity resulting in fatal liver failure is of major concern
      in treating patients with valproate (VPA). Until now there is no relevant
      laboratory parameter allowing early detection of impending liver failure. The
      major routes of VPA biotransformation are glucuronidation and beta-oxidation.
      There are several other pathways of degradation with formation of mono- und di
      unsaturated derivates. VPA dose, patients age, co-medication (anticonvulsants,
      aspirin), fasting and glucose supply influence the VPA metabolism. The clinical
      spectrum of VPA-associated hepatotoxicity reaches from slight increases of liver
      enzymes without clinical manifestations over reversible slight to severe liver
      dysfunction to fatal liver failure. With respect to pathogenesis attention has
      focused on depletion of beta-oxidation and change of biotransformation to other
      pathways with increased synthesis of toxic unsaturated VPA derivates. Several
      inborn errors of metabolism, acute infections and status epilepticus seem to
      predispose to liver failure. Another hypothesis lies in the possible VPA-induced
      depression of free radical scavenging enzyme activities. On this basis N
      acetylcysteine has been used successfully in treating children with severe
      hepatotoxicity. In the presence of certain risk factors VPA should be avoided.

PMID- 1758144
TI  - [Treatment of obstruction and thrombosis due to central venous catheterization].
AB  - Thrombolytic treatment with urokinase (5000 U/ml) or streptokinase can restore
      patency in central venous catheters occluded by thrombosis. In pediatric patients
      preferable urokinase should be used. The therapy in case of catheter-induced
      central venous thrombosis is a continuous urokinase infusion (125,000
      U/1.73(2)/h) for about 3 to 8 days, followed by a long-term heparinization. The
      treatment in persistent withdrawal occlusion is significantly shorter, a few
      hours of systemic lysis are sufficient. The treatment of choice in case of
      chemical obstructions in patients with long-term parenteral nutrition is the
      injection of 0.1 N HCl in combination with Heparin. By these procedures most of
      obstructed central venous catheters can be reopened and maintained in place. This
      preserves the count of possible catheter implantation sites.

PMID- 1758145
TI  - [Hemostatic changes in idiopathic venous thrombosis in childhood and
      adolescence].
AB  - The prevalence of inherited thrombotic syndrome in the general population appears
      to be higher than that of inherited bleeding disorders. The most important
      candidates for screening are patients with unexplained venous thromboembolism at
      ages of less than 40 years: In 18 children and adolescents suffering from
      "idiopathic" vein thrombosis laboratory screening has been performed: PT, PTT,
      TT, platelet count, spontaneous platelet aggregation, von Willebrand factor,
      fibrinogen, plasminogen, antithrombin III, protein C, C1-inactivator, alpha-1
      antitrypsin, alpha-1-antichymotrypsin, alpha-2-antiplasmin and alpha-2
      macroglobulin. Compared to an age matched healthy control group in children with
      idiopathic vein thrombosis we could demonstrate in vitro platelet activation with
      significant enhanced platelet aggregation and elevated levels of von Willebrand
      factor in the onset of the disease. Antithrombin III, protein C, alpha-2
      antiplasmin and alpha-2-macroglobulin were significantly decreased. These changes
      turned to be normal in the following 6 to 9 months. PT, PTT, TT, platelet count,
      plasminogen, alpha-1-antitrypsin, alpha-1-antichymotrypsin and c1-inactivator
      showed no alterations compared to the control. Platelet activation and alteration
      of platelet function in vivo and in vitro is established to initiate thrombosis.
      The von Willebrand's VIII molecule is involved in this step. The decreased
      inhibitors of the hemostatic system antithrombin III and protein C in the onset
      period of thrombotic diseases are discussed to be an increased turnover, whereas
      the decreased levels of alpha-2-antiplasmin and alpha-2-macroglobulin might be a
      counter-regulation to the thrombotic event, showing an "activated" fibrinolytic
      system.

PMID- 1758146
TI  - [Epidemiology of infectious diseases in children in the old states of the Federal
      Republic of Germany].
AB  - This study was done to describe the epidemiology of infectious diseases in
      children living in the old countries of the Federal Republic of Germany. After an
      intensive search for literature, data about notifiable diseases, data from
      insurance agencies and a random test from 700 charts of a general pediatrician
      were reviewed and analysed in a standardized way for their validity. No single
      review article on this topic was found. Estimates about the frequency of some
      specific infectious diseases as well as data about notifiable diseases proved to
      be unreliable and not useful from a scientific point of view. Published insurance
      data suggested, that infectious diseases may contribute comparatively little to
      the morbidity of the population. In contrast, chart analysis revealed that every
      second visit at a pediatrician's office was prompted by an infectious disease. It
      is concluded, that there are only insufficient and unreliable data about the
      epidemiology of infectious diseases in children in the western part of the FRG
      and that this unsatisfying situation could be changed by using the technique of
      representative evaluation.

PMID- 1758147
TI  - [Gelastic epilepsy and precocious puberty in hamartoma of the hypothalamus].
AB  - Four cases of hypothalamic hamartoma leading to gelastic epilepsy, precocious
      puberty and behavioural disorders are reported. Cerebral neuroradiologic
      examinations revealed a tumor-like mass attached to the hypothalamus in the
      region of the mamillary bodies in all cases. Precocious puberty developed in the
      two girls at 4 and 13 months but in neither of the two boys, who both suffered
      behaviour disturbances in the form of aggressive outbursts. A total resection of
      the tumors of both boys led to histologic confirmation of hamartoma. One boy was
      free of seizures upon follow-up, whereas seizure frequency in the other boy was
      reduced, while his aggressivity increased. The cases are discussed in context of
      current therapeutic conceptions of gelastic epilepsy and central precocious
      puberty.

PMID- 1758148
TI  - [Diagnosis of coxitis fugax, the most frequent hip disease in childhood].
AB  - After a review of the history, clinical features, laboratory findings, imaging
      techniques and the treatment of coxitis fugax, the authors inform about 131 own
      cases. In this disease of the hip joint, which is most commonly encountered in
      childhood, differential diagnosis is of the utmost importance. In the present
      study, the initial diagnosis had to be changed in eleven cases affected with this
      condition, which is also referred to as "observation hip". The patients
      ultimately contracted severe diseases such as leukaemia, juvenile polyarthritis
      or Perthes' disease.

PMID- 1758149
TI  - [Comparative determination of microalbuminuria using radioimmunoassay and kinetic
      nephelometry in children and adolescent with and without Type-I diabetes mellitus
      (IDDM)].
AB  - In 73 healthy (group I) and 32 children and juveniles with insulin dependent
      diabetes mellitus (IDDM, group II) urinary albumin excretion is determined by
      radioimmunoassay (RIA) and kinetic nephelometry. Intention of the study is to
      examine, if the kinetic nephelometry is--as observed in adults--a suitable method
      also in children and juveniles to detect microalbuminuria (greater than 30 mg/d).
      In both groups albumin excretion is observed in every urine sample when measured
      by RIA. Because of it's higher threshold kinetic nephelometry detects albumin
      excretion only in a part of the urine samples. The correlation between the two
      methods is very high (r = 0.905, p less than 0.001, n = 174). So kinetic
      nephelometry is not suitable to determine reference values. But as a faster and
      possibly more specific method than RIA nephelometry is a very effective way for a
      screening of microalbuminuria also in children and juveniles.

PMID- 1758150
TI  - [Neonatal form of a nonketotic hyperglycinemia in consanguinous parents].
AB  - This is a report of the neonatal form of nonketotic hyperglycinemia with rapid
      progressing neurological symptoms, respiratory distress and seizures. The EEG
      pattern is characteristic, the ratio of cerebrospinal fluid to plasma glycine
      abnormally high. The result of cranial computerized tomography demonstrates also
      in our patient that nonketotic hyperglycinemia joins a growing list of inborn
      errors of metabolism associated with brain malformations. The consanguinity of
      parents supports the known autosomal recessive form of inheritance.

PMID- 1758151
TI  - [Familial Mediterranean fever].
AB  - Familial Mediterranean Fever is a genetically determined disease occurring
      predominantly in Arabs, Armenians, Jews and very rarely in Turks. It is
      characterized by moderately elevated body temperature and by abdominal, pulmonary
      or arthritic complaints. These symptoms are recurrent appearing at short
      intervals and persisting for not more than two days. Renal amyloidosis may be a
      complication. Thus, treatment should be continued for life. The pathomechanism of
      the disease is not clear. Colchicine has been shown to give good symptomatic
      relief. Surprisingly, the prolonged use of this mitotic poison is virtually
      devoid of untoward side effects, even in pregnancy and childhood.

PMID- 1758152
TI  - [Adrenocortical nodular hyperplasia as a cause of Cushing syndrome in the
      neonatal period].
AB  - The case report of a female child born preterm (30th wk of gestation) who
      developed symptoms of Cushing's syndrome beginning in the neonatal phase is
      presented. The disease was caused by a unilateral adreno-cortical nodular
      hyperplasia and was successfully treated by unilateral adrenalectomy.
      Preoperative treatment with ketoconazole and metyrapone proved to be effective.
      Symptoms of Cushing's disease including hypertrophic cardiomyopathy were
      completely reversible within one month after surgery.

PMID- 1758153
TI  - [Employment situation in Swiss hospitals. Personnel shortage is decreasing].

PMID- 1758154
TI  - [When children cannot sleep].

PMID- 1758155
TI  - [From swaddling clothes to disposable diapers].

PMID- 1758156
TI  - [Pathways out of the torture chamber].

PMID- 1758157
TI  - ["There is no escape--not for one second". Interview by Martin Glauert].

PMID- 1758158
TI  - [Strategy of the European Council--and what the Swiss Nursing Society is already
      doing].

PMID- 1758159
TI  - [A meaningful task for a nurse].

PMID- 1758160
TI  - [A challenge to civilization: the accumulating trash].

PMID- 1758161
TI  - [Experiences of the Fribourg Hospital].

PMID- 1758162
TI  - [Patient controlled analgesia: a useful instrument].

PMID- 1758163
TI  - [The relational dimension in public health].

PMID- 1758164
TI  - [Towards recognition of the nursing effort. 2].

PMID- 1758165
TI  - [Higher studies in nursing: a new university program].

PMID- 1758166
TI  - [Behind the technique there is always a person].

PMID- 1758167
TI  - [What does the Swiss Nursing Association offer you?].

PMID- 1758168
TI  - Oxygen radicals alter LDL permeability and uptake by an endothelial-smooth muscle
      cell bilayer.
AB  - There is evidence to suggest that the deposition of lipid within the arterial
      wall, which is characteristic of atherosclerosis, involves a break in the
      integrity of the endothelial barrier. Oxidative modification of low density
      lipoproteins by reactive oxygen species may enhance this process. In this study,
      an aortic endothelial (EC) smooth muscle cell (SMC) bilayer was briefly exposed
      to a free-radical generating system to determine the effect of superoxides on
      lipid permeability and uptake. 125I-LDL (10 micrograms/ml) was added to the EC
      medium at various time intervals (3, 24, and 48 hr and 9 days). The amount of
      lipid reaching the subendothelial space was measured. Measurements of EC and SMC
      binding and uptake of LDL were also obtained and compared with those of untreated
      cells. The results demonstrate a significant increase in the permeability of the
      treated EC layer to LDL (P less than 10(-6)), which was sustained over time.
      Superoxide exposure led to a limited initial increase in EC binding and uptake of
      LDL, which later returned to control values. In contrast, SMC uptake of LDL was
      significantly (P less than 10(-3)) and persistently increased over control values
      and disproportionately increased over cellular binding. Such results suggest that
      superoxides can increase LDL permeability of the EC barrier. Because this was not
      associated with a comparable increase in EC binding and uptake, it is unlikely to
      be due to changes in receptor-mediated, transcellular transport.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1758169
TI  - Stress-induced gastric lesions and the synthesis of prostaglandins and
      leukotrienes.
AB  - Prostaglandin E2 renders the mucosa of the GI tract more resistant to acute
      injury by aspirin, acid, bile salts, and stress, whereas leukotrienes promote
      inflammation and retard healing of ulcers. The relationship of stress ulcer
      formation to changes in the activities of prostaglandin synthetase and
      lipoxygenase was evaluated in this study. After a 24 hr fast, 10 rats were
      stressed by the cold-restraint method for 4 hr and 10 rats were not stressed.
      Rats were terminated, stomachs were excised, the number of lesions were counted,
      and the nonulcerated mucosa was assayed for prostaglandin E2 and leukotriene
      synthesis. The mucosa was minced, washed in buffered saline, and then incubated
      for 10 min in a 1.3 mM sodium arachidonate solution containing a nonionic
      detergent (poloxamer 188), NaCl, KCl, KPO4, glutathione, hemin, MgSO4 and Hepes
      at pH 8.0. An ANOVA was used to compare the groups. Following stress the number
      of gastric lesions increased from 0.7 +/- 0.6 to 13.5 +/- 2.6, while leukotriene
      synthesis increased from 173 +/- 20 to 2170 +/- 187 pg/mg/min. A shift in
      synthesis from prostaglandins to leukotrienes in the mucosa appears to be
      detrimental to cytoprotection.

PMID- 1758170
TI  - Cross-species bone marrow transplantation: evidence for recognition of skin
      specific antigens across a species barrier (rat----mouse).
AB  - We have developed a model to study cross-species bone marrow transplantation and
      the associated donor-specific transplantation tolerance induced using fully
      xenogeneic chimeras. Reconstitution of lethally irradiated B10 mice with
      untreated F344 rat bone marrow cells results in fully xenogeneic chimerism (F344
      rat----B10 mouse). Survival of recipients is excellent (greater than 80% at 100
      days) and stable rat lymphoid and multilineage chimerism are present throughout
      the life of the chimeras. Recipients are specifically tolerant to donor-type skin
      xenografts yet are competent to reject major histocompatibility complex (MHC)-
      disparate third party strain rat xenografts. Although prolonged, donor-specific
      skin xenografts underwent chronic rejection which had its onset at approximately
      40 days following skin graft placement. We have now examined these chimeras by
      serial flow cytometry typing to determine whether this is due to skin-specific
      antigens expressed on skin, but not on the bone marrow elements to which the
      chimeras were rendered tolerant. In all animals examined, lymphopoietic chimerism
      persisted unchanged even after the onset of inflammation in the grafts,
      suggesting the presence of skin specific antigens. This model may provide a
      method to study tissue and organ specific antigens recognized across a species
      barrier.

PMID- 1758171
TI  - A case-control comparison of durability and cost between implanted reservoir and
      percutaneous catheters in cancer patients.
AB  - A case-control study was performed to compare the durability and cost of
      implanted reservoir catheter systems with percutaneous central venous catheters.
      Twenty cancer patients had reservoir systems placed in 1985 for chemotherapy
      delivery. The control group consisted of 60 cancer patients, matched according to
      age, sex, and diagnosis who were part of a group of more than 700 patients with
      percutaneous catheters inserted during the same period. The reservoir catheters
      were found to function for a significantly (P less than 0.0001) longer time (495
      +/- 54 days) compared to the percutaneous catheters (197 +/- 22 days). The total
      cost for each system was calculated by adding the charges for an average
      insertion (reservoir = $1738, percutaneous = $562) to the maintenance charges
      accumulated over the catheters' lifespan. Reservoir catheters were associated
      with a significantly greater total cost than percutaneous catheters ($2233 +/-
      54, $1453 +/- 102, respectively) but, if the total cost was spread out over the
      lifespan of the catheter by dividing the total cost by duration of use, reservoir
      catheters can be less expensive on a per diem basis. The break point occurs at
      approximately 6 months. For use less than 6 months, percutaneous catheters are
      cheaper primarily because of their lower insertion costs, but, for longer
      periods, reservoir catheters become cheaper because of lower maintenance costs
      and because a second percutaneous catheterization would likely be necessary.

PMID- 1758172
TI  - Reduction of experimental neuroma formation with ricin.
AB  - Twenty rat sciatic nerves were bilaterally transected, one as control, and one
      intraneurally injected with ricin. At 11 weeks, all controls demonstrated large
      neuromas. Ten injected nerves had no neuroma or a significantly smaller one,
      while the other 10 had neuroma formation similar to controls. No effect on
      distant dorsal root ganglia or spinal cord was seen. Thirteen additional rats
      underwent nerve injection with I125-labeled ricin. At one week, most
      radioactivity was localized to sciatic nerve, surrounding muscle, and thyroid,
      with trace amounts in dorsal root ganglia and spinal cord. Intraneural ricin can
      inhibit neuroma formation in transected nerve, but results in unpredictable
      uptake of ricin by nerve and excess spillage into surrounding tissues.

PMID- 1758173
TI  - Perfusion parameters and pressure at zero flow in canine gracilis muscle flaps.
AB  - The perfusion parameters and pressure at zero flow were examined in island
      gracilis muscle flaps in dogs under sodium pentobarbital anesthesia. Complete
      surgical isolation of the muscle preparation was obtained. Normal blood flow in
      denervated muscle in situ was 8.0 +/- 0.8 ml/min/100 g tissue as measured by
      electromagnetic blood flowmetry. The artery supplying each flap was occluded with
      a microclip and the drop in pressure distal to the clip was observed. The lowest
      pressure obtained following occlusion was the pressure at zero flow. A positive
      pressure at zero flow in the vascular bed was thereby identified at a pressure of
      10.3 +/- 1.2 mm Hg.

PMID- 1758174
TI  - Chylomicrons can inhibit endotoxin activity in vitro.
AB  - Trauma, thermal injury, and nonlethal doses of endotoxin can promote the
      translocation of endotoxin across the mucosal barrier of the colon into the
      mesenteric lymphatics and systemic circulation. Bacterial endotoxemia induces
      changes in lipid metabolism, including an increase in circulating triglyceride
      rich lipoproteins. Because cholesterol-rich lipoproteins can neutralize the toxic
      activity of endotoxin, both in vitro and in vivo, we asked whether triglyceride
      rich chylomicrons can inhibit endotoxin activity in vitro as measured by a
      chromogenic Limulus assay. We tested the effect of intact versus heat-denatured
      chylomicrons on the in vitro activity of increasing concentrations of Escherichia
      coli (055:B5) endotoxin. Intact chylomicrons inhibited up to 12-fold the
      detection of as much as 1 microgram of endotoxin/mg of chylomicron triglyceride,
      compared to denatured chylomicrons (P less than 0.001). This study shows that
      chylomicrons are potent inhibitors of endotoxin activity in vitro. Because
      translocated endotoxin from the colon associates with gut-derived chylomicrons in
      the mesenteric lymphatics, this may represent a natural defensive mechanism
      against endotoxemia of enteric origin.

PMID- 1758175
TI  - Fluid percussion barotrauma chamber: a new in vitro model for traumatic brain
      injury.
AB  - Advances in the understanding of the pathophysiology of traumatic brain injury
      have implicated a number of cellular events as fundamental to the evolution of
      neurologic dysfunction in this process. Following the primary biomechanical
      insult, a highly complex series of biochemical changes occur, some of which are
      reversible. The development of fluid percussion injury as an in vivo model for
      traumatic brain injury has greatly improved our ability to study this disease.
      However, a comparable in vitro model of biomechanical injury which would enable
      investigators to study the response to injury in isolated cell types has not been
      described. We have developed a model of transient barotrauma in cell culture to
      examine the effects of this form of injury on cell metabolism. This model employs
      the same fluid percussion device commonly used in in vivo brain injury studies.
      The effect of this injury was evaluated in monolayers of human glial cells. Cell
      viability by trypan blue exclusion and the production of leukotrienes following
      increasing barotrauma was investigated. This model provided a reproducible method
      of subjecting cells in culture to forces similar to those currently used in
      animal experimental head injury.

PMID- 1758176
TI  - Low oxygen delivery produced by anemia, hypoxia, and low cardiac output.
AB  - In pentobarbital-anesthetized dogs, oxygen delivery (DO2) was measured by
      thermodilution cardiac output and cooximeter determined oxygen content, while
      oxygen consumption (VO2) was measured independently by spirometry. Oxygen
      delivery was decreased by isovolemic dilutional anemia, breathing hypoxic gas
      mixtures, or cardiac tamponade to reduce cardiac output. Baseline VO2 (cc/kg/min)
      for the three groups was 5.9 +/- 0.7 (anemia), 5.4 +/- 0.4 (hypoxia), and 5.6 +/-
      0.1 (low C.O.) (NS). A critical level of oxygen delivery (DO2crit) was found at 9
      10 cc/kg/min (anemia), 10-11 cc/kg/min (hypoxia), and 9-10 cc/kg/min (low C.O.)
      (NS.). Below this level, VO2 fell (became supply dependent) and lactic acidosis
      occurred, regardless of the mechanism of impaired oxygen delivery.

PMID- 1758177
TI  - Ventricular septal defect caused by nonpenetrating trauma in a 3-year-old child:
      use of extracorporeal membrane oxygenation in preoperative stabilization.

PMID- 1758178
TI  - A case of hives and hip pain following steroid injection.

PMID- 1758179
TI  - Endobronchial tuberculosis mimicking lung cancer.

PMID- 1758180
TI  - Radiology case of the month. Carbon monoxide poisoning.

PMID- 1758181
TI  - OBRA 1987 and the role of the physician in long-term care.

PMID- 1758182
TI  - Safety belts.

PMID- 1758183
TI  - Advertising and alcohol sales: a legal impact study.
AB  - According to the single distribution theory increases in the availability of
      alcoholic beverages in the general population are associated with increases in
      average consumption and increases in alcohol-related damage. If it can be
      demonstrated that advertising contributes to availability, perhaps in the form of
      what has been called social or subjective availability, then advertising could be
      considered an appropriate target of prevention. A 58-year ban on advertising of
      alcoholic beverages was lifted in Saskatchewan in 1983. Data on monthly sales of
      beer, wine and distilled spirits were examined for the years 1981 to 1987. Box
      Jenkins time series techniques were used to estimate the statistical relationship
      between the policy change and volume of sales of alcoholic beverages. The results
      revealed that sales of beer increased and sales of spirits decreased following
      the change in legislation that permitted alcohol advertising in Saskatchewan. The
      main finding is that there was no impact on wine and total alcohol sales from the
      introduction of alcohol advertising. Alcohol advertising may have produced a
      substitution effect with respect to beer and spirits, but this was not predicted.
      This evaluation suggests that alcohol advertising is not a contributory force
      that influences the overall level of alcohol consumption. The place of
      advertising in the single distribution theory remains not proven, and the place
      of advertising as an instrument of public policy with respect to the prevention
      of alcohol-related damage remains in question.

PMID- 1758184
TI  - Program integrity as a moderator of prevention program effectiveness: results for
      fifth-grade students in the adolescent alcohol prevention trial.
AB  - This study reports the results of a test of the quality of program delivery
      (program integrity) as a variable that may moderate the effectiveness of alcohol
      prevention programs. Two theory-based programs, Resistance Training and Normative
      Education, were delivered to fifth-grade students who were then tested on program
      relevant mediating variables. Resistance Training was found to improve students'
      knowledge of peer pressure resistance strategies, their performance on a
      behavioral assessment of peer pressure resistance skills and the manifestation of
      their future intentions to drink alcohol. Normative Education was found to
      improve students' perceptions of a conservative norm regarding alcohol use,
      facilitated their belief that refusing unwanted offers to drink alcohol could be
      easily accomplished and reduced their perceptions of the prevalence of alcohol
      use. Program integrity was measured by program specialists who taught the
      programs to students and by trained observers. Ratings of program integrity were
      found to significantly moderate outcomes for three of seven mediating variables.
      Affected were knowledge of peer pressure resistance strategies, behavioral
      pressure resistance skills and perceived self-efficacy. These results suggest
      that the quality of program delivery and reception may play an important
      moderating function on prevention program effectiveness.

PMID- 1758185
TI  - Biases in the perception of drinking norms among college students.
AB  - Individual drinking patterns and the perceived typical drinking patterns of close
      friends and reference groups were assessed in two different studies with college
      students. In both studies virtually all students reported that their friends
      drank more than they did. These effects were found across different levels of
      individual drinking, within different types of samples, across gender of subjects
      and with different types of questionnaire assessment. In addition, students'
      estimates of typical or average drinking within their own social living groups
      were significantly higher than average drinking within the group estimated from
      self-reports. Because of the consistent, asymmetrical pattern of reports of self
      and other drinking, it was interpreted that reports of others' drinking were
      exaggerated. These biases were particularly evident within organized social
      groups (i.e., fraternities and sororities) but were minimal in reference to
      "students in general" or "people in general." Results are discussed in terms of
      cognitive and motivational factors that potentially could promote or excuse
      excessive drinking practices among college students.

PMID- 1758186
TI  - Use of the CAGE scale in a population survey of drinking.
AB  - This article examines the use of the CAGE scale, a 4-item self-report screening
      test designed to identify problem drinkers, among 703 drinkers aged 18 and over
      interviewed in a general population survey. The results showed that 10.9% of
      drinkers reported two or more items affirmatively, the suggested cut-off
      indicative of problem drinking. This rate is similar to the percentage of
      drinkers who consume four or more standard drinks daily, derived from aggregate
      per capita consumption estimates. Factor analysis of the items showed a
      unidimensional scale with good psychometric properties. Other cut-offs are also
      compared with other alcoholism estimates. In general, the results indicated some
      utility of the CAGE in general population surveys.

PMID- 1758187
TI  - Sedative effects of ethanol at night.
AB  - The sedative effect of 0.7 g/kg of 100% ethanol, ingested at 9:30 PM, was
      investigated to examine the combined effects of ethanol and circadian
      sleepiness/alertness levels. Fourteen healthy young adults participated in a
      placebo-controlled, double-blind crossover design. Each subject, on two separate
      occasions (placebo or ethanol), completed multiple sleep latency testing and the
      repeated test of sustained wakefulness as objective measures of physiological
      sleep tendency, and completed the Stanford Sleepiness Scale as a measure of
      subjective sleepiness. The results indicate that a moderate dose of ethanol
      significantly increases physiological sleepiness during early morning hours even
      in individuals that are relatively alert at these times. Therefore, the marked
      reduction in alertness and related performance deficits that normally occur at
      night are worsened by ethanol ingestion. Sleepiness, due to any cause, and
      ethanol may well be a dangerous combination.

PMID- 1758188
TI  - Subjective feelings and changes in body sway following diazepam in sons of
      alcoholics and control subjects.
AB  - The possible generalization to diazepam of the dampened response to ethanol in
      sons of alcoholic fathers was evaluated in 62 sons of alcoholics (family history
      positive [FHP] subjects) and 62 family history negative (FHN) controls (124 men).
      Following challenges with placebo, .12 and .2 mg/kg of diazepam in three separate
      sessions, evaluation of subjective feelings and increases in body sway revealed
      no decreased reaction for FHPs.

PMID- 1758189
TI  - Close linkage of esterase-D to unipolar depression and alcoholism is ruled out in
      eight pedigrees.
AB  - Unipolar depression and alcoholism were tested for genetic linkage to esterase-D
      at 13q14.1. Tight linkage to esterase-D was ruled out for three phenotypes using
      three models of penetrance: (1) unipolar depression and alcoholism taken together
      as affected, (2) unipolar depression alone as affected with alcoholism considered
      unaffected and (3) alcoholism alone as affected with unipolar depression
      considered unaffected. This study does not support an earlier finding of possible
      linkage between the esterase-D locus at 13q14.1 and alcoholism.

PMID- 1758190
TI  - Effect of ethanol on insulin-stimulated glucose uptake in the isolated rat
      diaphragm.
AB  - Insulin-stimulated (0.16 and 2.56 nM) glucose uptake (GU) was studied in isolated
      rat diaphragms in the presence of ethanol (EtOH) 21, 42 and 84 mM as well as in
      diaphragms removed from rats orally treated with the drug (1.5 or 4.5 g/kg/day)
      for 10 or 30 days. In spite of inhibiting the base-line GU, the addition of EtOH
      to the incubation medium gave rise to a potentiation of the insulin effect. In
      the orally intoxicated series, the low-dose EtOH increased the response to 0.16
      nM insulin after 10 or 30 days, no changes being observed in that induced by 2.56
      nM insulin. On the other hand, the high-dose EtOH caused an increase of the base
      line GU which remained practically unmodified in the presence of insulin. The
      precise molecular basis for these phenomena is unknown.

PMID- 1758191
TI  - A method for maintaining and protecting chronic arterial and venous catheters in
      conscious rats.
AB  - The ability to monitor arterial blood pressure and heart rate directly, as well
      as to sample venous blood, or inject pharmaceutical agents intravenously is
      important in pharmacological studies of the cardiovascular system. The rat is a
      frequently used and accepted animal model for cardiovascular investigations,
      especially those relating to hypertension. Even though the rat is a major model
      for these studies, the size of the rat has made it difficult to maintain
      catheters for a long period of time. Although there have been previous methods
      available, the authors report on an improved method to implant, maintain, and
      protect arterial and venous catheters in conscious rats for extended periods of
      time. A Silastic/Tygon catheter is implanted intraarterially and intravenously,
      exteriorized, and protected with a spring device. Catheters remained patent
      throughout a 5-week period during which time direct blood pressure recordings
      were obtained and baroreflexes were evaluated in conscious, unrestrained rats.
      The described design and methods provide an inexpensive means to maintain
      chronically implanted venous and arterial catheters in the conscious rat.
      Furthermore, rats may be gang housed.

PMID- 1758192
TI  - Validation of a human atrial trabecular preparation for evaluation of inotropic
      substances.
AB  - Assessment of cardioactive substances is usually performed using animal tissue,
      with the effects being extrapolated to humans, thereby potentially introducing
      errors due to species differences. In order to validate the use of human atrial
      tissue, known positive and negative inotropic agents were tested on trabeculae
      obtained from patients' atrial appendages at the time of cardiac surgery
      requiring, cardiopulmonary bypass. Trabeculae were selected according to strict
      criteria: cross-sectional area less than 1.0 mm2, resting force (RF) less than
      0.7 g, and developed force (DF) greater than 0.8 g. Each trabecula received only
      one drug in a cumulative dose manner. Where necessary, the vehicle used to
      dissolve or stabilize the drug solution was also tested. In addition, the
      relative DF of "no-drug," "time-only" controls were measured during the same time
      period. After adjusting for the effect of time on the preparation, relative DF
      was increased to 157% by dobutamine (1.5 x 10(-5) M), to 136% by amrinone (5.6 x
      10(-4) M), and to 117% by ouabain (2 x 10(-7) M). The relative DF decreased with
      nifedipine and propranolol, with 50% inhibition for both drugs being 1.5 x 10(-7)
      M. Although human ventricular muscles might be more appropriate to use in order
      to determine the effects observed with the whole heart, they are extremely
      difficult to obtain on a regular basis. The results of this study show that the
      atrial trabecular preparation offers an acceptable alternative.

PMID- 1758193
TI  - Enhanced detection of hyperactivity after drug withdrawal with a simple
      modification of the open-field apparatus.
AB  - The open-field apparatus has been used to study withdrawal reactions from chronic
      treatments with central nervous system depressant drugs. To study the behavior of
      the same animal after drug withdrawal, the rats are introduced into the open
      field on consecutive days. Because the open field is a novel environment, the
      repetition could lead to false-negative results with regard to drug withdrawal.
      To overcome this problem, we sought a modification of the open field, using
      different floor-painting patterns every time the animal is observed. The most
      frequently observed withdrawal manifestation was hyperactivity. We verified that
      long-term treatment withdrawal reactions from barbital, clonazepam, and ethanol
      were seen more often if the rats were introduced in the modified open field. In
      addition, fewer animals were used here than in other trials and hyperactivity was
      detected more frequently in the modified open field than was sound-induced
      convulsions. We propose that the modified open field is more useful than the
      classic one for screening of drug withdrawal reactions.

PMID- 1758194
TI  - A connectionist model of development.
AB  - We present a phenomenological modeling framework for development. Our purpose is
      to provide a systematic method for discovering and expressing correlations in
      experimental data on gene expression and other developmental processes. The
      modeling framework is based on a connectionist or "neural net" dynamics for
      biochemical regulators, coupled to "grammatical rules" which describe certain
      features of the birth, growth, and death of cells, synapses and other biological
      entities. We outline how spatial geometry can be included, although this part of
      the model is not complete. As an example of the application of our results to a
      specific biological system, we show in detail how to derive a rigorously testable
      model of the network of segmentation genes operating in the blastoderm of
      Drosophila. To further illustrate our methods, we sketch how they could be
      applied to two other important developmental processes: cell cycle control and
      cell-cell induction. We also present a simple biochemical model leading to our
      assumed connectionist dynamics which shows that the dynamics used is at least
      compatible with known chemical mechanisms.

PMID- 1758195
TI  - Generative rules for the morphogenesis of epithelial tubes.
AB  - A finite elements model imitating the morphogenesis of smoothly curved tubular
      epithelial rudiments is suggested. It is based upon the experimentally proved
      assumption of the lateral (tangential) pressure between adjacent epithelial
      cells. The main idea of the model is that under a non-zero local curvature the
      lateral cell-cell pressure acquires the radial components which are absent under
      zero curvature. In the framework of the model we investigate the roles of initial
      geometry, the different coefficients relating the local curvatures and radial
      cell shifts, and of visco-elastical cell-cell linkages in the shaping process. We
      also employ the different temporal regimes (both periodical and constant) of the
      lateral pressure exerted and the different overall durations of the modelling. As
      a result, we get a set of biologically realistical shapes, almost all of them
      belonging to the same basical "trefoiled" archetype. Among the variables
      explored, shaping was most affected by the changes in visco-elastical
      coefficients, in the temporal regimes and in the overall duration of the
      modelling. The model shows that rather complicated and realistical shapes of
      epithelial rudiments can be obtained without assuming any initial regional
      differences inside cell layers. The model may be useful for understanding the
      principles underlying both genetical and epigenetical regulation of the
      morphogenesis.

PMID- 1758196
TI  - Feedback theory and Darwinian evolution.
AB  - Feedback loops can have a significant impact on biological systems that are
      evolving under Darwinian natural selection. Many of the striking and sometimes
      bizarre patterns that characterize the evolution of such systems have simple,
      natural explanations that involve the effects of feedback loops. The two
      fundamental types of feedback loops, positive and negative, have effects that are
      radically different: negative feedback tends to produce stability and resistance
      to change; positive feedback produces instability and even catastrophe. Both
      types of feedback loops are important in biological systems, and both can produce
      chaos, whose mathematical complexity often produces strange, beautiful and
      totally unexpected patterns that have only begun to be explored using the
      computational capabilities of modern electronic computers. An understanding of
      the patterns that can result from the effects of feedback loops can produce
      important new insights into the patterns that mark the evolutionary development
      of biological systems.

PMID- 1758197
TI  - Stochastic resonance in a single neuron model: theory and analog simulation.
AB  - Here, we consider a noisy, bistable, single neuron model in the presence of
      periodic external modulation. The modulation induces a correlated switching
      between states driven by the noise. The information flow through the system, from
      the modulation, or signal, to the output switching events, leads to a succession
      of strong peaks in the power spectrum. The signal-to-noise ratio (SNR) obtained
      from this power spectrum is a measure of the information content in the neuron
      response. With increasing noise intensity, the SNR passes through a maximum: an
      effect which has been called stochastic resonance, and which was first advanced
      as a possible explanation of the observed periodicity in the recurrences of the
      Earth's ice ages. We treat the problem within the framework of a recently
      developed approximate theory, valid in the limits of weak noise intensity, weak
      periodic forcing and low forcing frequency, for both additive and multiplicative
      noise. Moreover, we have constructed an analog simulator of the neuron which
      demonstrates the stochastic resonance effect, and with which we have measured the
      SNRs for comparison with the theoretical results. Our model should be of interest
      in situations where a single inherently noisy neuron is the receptor of a
      periodic signal, which is itself noisy, either from the network or from an
      external source.

PMID- 1758198
TI  - Evolution of discriminatory aggression in marine invertebrates.
AB  - Many species of sessile marine organisms show allotype-conditional aggression
      towards conspecifics. However, a recent theoretical analysis (Grosberg & Quinn,
      1989, Evolution 43, 504-515.) was unable to find conditions permitting a
      discriminatory ESS against unconditionally aggressive or non-aggressive
      strategies. This study shows that discrimination can be an ESS if animals
      interact with clonemates more frequently than randomly as occurs when animals
      reproduce by budding of fission. This agrees well with the observation that
      clonal sea anemones are usually discriminators and solitary species usually non
      aggressive to conspecifics (Francis, 1988, Biol. Bull. 174, 241-253.) In
      addition, discrimination can be an ESS if discriminators retaliate against
      unconditionally aggressive conspecifics of the same allotype, or if the payoff to
      two sharers of a resource is greater than the payoff to both when sharing does
      not occur.

PMID- 1758199
TI  - The combinations of the sexes of mammalian sibs and littermates: and the
      possibility of adaptive control.

PMID- 1758200
TI  - Value of CD-1-positive cells in bronchoalveolar lavage fluid for the diagnosis of
      pulmonary histiocytosis X.
AB  - Pulmonary histiocytosis X is characterized by an accumulation of CD-1-positive
      histiocytosis X cells in the lung, which also can be found in the bronchoalveolar
      lavage fluid (BALF). However, it has recently been demonstrated that CD-1
      positive cells can also be detected in BALF of patients with other interstitial
      lung diseases and in healthy smokers. We therefore examined the frequency of CD-1
      positive cells in a pool of patients with different pulmonary disorders,
      according to their smoking habits and diagnoses. We have studied the
      bronchoalveolar lavage in patients with pulmonary histiocytosis X (n = 6),
      sarcoidosis (n = 88), and in 97 patients with other miscellaneous lung disorders
      by using the immunoperoxidase method to detect CD-1-positive cells on glass
      slides. All patients with histologically proven histiocytosis X displayed more
      than 5% CD-1-positive cells, whereas patients with other pulmonary disorders
      showed no more than 3.6% CD-1-positive BAL cells. The dividing line of 5% CD-1
      positive cells was not influenced by patients' smoking habits. The identification
      of CD-1-positive cells in BALF appears to be useful in diagnosing pulmonary
      histiocytosis X.

PMID- 1758201
TI  - Treatment of chronic bronchitis with terbutaline inhaled from a cone spacer with
      and without positive expiratory pressure.
AB  - Patients with chronic bronchitis were randomly allocated to 4 weeks treatment
      with terbutaline 0.5 mg inhaled through a cone spacer with an expiratory
      resistance creating a positive expiratory pressure (+PEP group) or without (-PEP
      group). The patients recorded their symptoms in a diary and peak expiratory flow
      (PEFR) was measured before and after each inhalation. PEFR increased
      significantly after inhaled terbutaline both with and without PEP. The mean
      increase in PEFR after terbutaline inhalations was significantly greater (p less
      than 0.0001) in the +PEP group (24 L/min) compared to the -PEP group (17 L/min).
      The +PEP group had less sputum and less difficulty with coughing up sputum
      compared to the -PEP group. This study showed a small but significant enhancement
      of the bronchodilation and a beneficial effect on symptoms when inhalation of
      beta-2-agonist was combined with PEP in patients with chronic bronchitis.

PMID- 1758202
TI  - Computerized detection of respiratory events during sleep from rapid increases in
      oxyhemoglobin saturation.
AB  - A computerized search for rapid resaturation (RES)--defined as increases in
      oxyhemoglobin saturation (SaO2) of 3% or more within 10 s--was used to detect
      apneas and hypopneas during sleep by the episodes of compensatory
      hyperventilation following them. Results were compared to those from computerized
      search for desaturations (DESAT)--defined as decreases in SaO2 of 4% or more
      within 40 s--and to simultaneous polysomnography. We studied 30 patients with
      obstructive sleep apnea (OSA) with an apnea plus hypopnea index (AHI) of 30.8 +/-
      6.9 (median +/- SEM) and 23 habitual snorers (HSN) with an AHI of 7 +/- 1.5.
      Manual scoring of polysomnography revealed 7965 respiratory events (6192 apneas,
      1773 hypopneas) in OSA patients and 940 events (411 apneas, 529 hypopneas) in the
      HSN group. In OSA patients, the computer found 96% of events by searching for RES
      and 87% by searching for DESAT. The percentage of computer-found events in OSA
      classified as true positive was 91% for RES and 97% for DESAT. In the HSN group,
      83% of polysomnographically scored events were found by RES and 55% by DESAT,
      with 72% of RES and 84% of DESAT being true positive. The correlation of the
      number of computer-found RES with the number of events from polysomnography was
      better in OSA (r = 0.862, p less than 0.0001) than in HSN (r = 0.722, p less than
      0.001). The same was true for DESAT (OSA: r = 0.896, p less than 0.0001; HSN: r =
      0.637, p less than 0.01). In conclusion, computer-found rapid resaturations are
      more sensitive than desaturations for the detection of respiratory events during
      sleep from oximetry.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758203
TI  - Nicardipine suppresses bronchoconstrictor actions of pharmacologic agents in
      guinea pigs.
AB  - We investigated the inhibitory effects of nicardipine on airway smooth muscle
      constriction in the guinea pig via both in vitro and in vivo preparations. In the
      in vitro studies, we created dose-response curves of the excised tracheal strip.
      The increase in respiratory overflow produced by leukotriene (LT) D4 was measured
      in the in vivo preparation. In the organ bath, nicardipine (1-12 micrograms/ml)
      significantly inhibited constriction of the isolated tracheal spiral strip
      induced by 7 different agonists, acetylcholine (Ach), histamine (HA), serotonin
      (5-HT), prostaglandin F2 alpha (PGF2 alpha), slow-reacting substance of
      anaphylaxis (SRS-A), and LTC4 and LTD4. Compared to nifedipine and verapamil
      (data in the literature), the inhibitory potency of nicardipine on the
      constriction of the isolated guinea pig tracheal strip is 100-1,000 times
      greater. In the in vivo studies, nicardipine (50 and 100 micrograms/kg)
      significantly attenuated the LTD4-induced increase in respiratory overflow. These
      results suggest that nicardipine inhibits bronchoconstrictor-induced constriction
      of airway smooth muscle both in vitro and in vivo, and that it is a potent
      bronchodilator. The inhibitory characteristics of nicardipine may prove to be
      applicable clinically.

PMID- 1758204
TI  - [The hepatotoxicity of tuberculosis treatment].
AB  - BACKGROUND: The hepatic toxicity of antituberculous drugs used for the therapy of
      initial cases was evaluated, assessing the incidence and severity and its
      relation with each drug, age, other associated hepatic risks and the
      chronological time of therapy. METHODS: 1235 patients with tuberculosis were
      prospectively assessed with a protocol including periodical clinical and
      laboratory controls. RESULTS: Hepatic toxicity was found in overall 16.5%, with
      3.5% of severe forms and need for a definitive change in therapy in 1.5%.
      Differences in toxicity between the 6-month and the 9-month schedules were not
      found. The most commonly incriminated drugs was isoniazid followed by
      pyrazinamide. All severe forms presented with symptoms, although some were
      nonspecific and insidious. Other associated hepatic risks implied an increased
      frequency of iatrogenic reactions. Age did not have a determining influence in
      severe forms, which predominantly developed within the first two months of
      therapy. CONCLUSIONS: Moderate, transient and asymptomatic increase in
      transaminase activity not requiring a change a therapy is common. Severe and
      dangerous forms are uncommon and predominate at the beginning of therapy and in
      persons with associated hepatic risk factors. Therefore, although the clinical
      controls should be maintained throughout treatment, laboratory controls should
      only be carried out during the first two months, except when symptoms are present
      or in patients with associated hepatic risk factors, where they should be more
      frequent and carried out throughout treatment.

PMID- 1758205
TI  - [The investigation of the contacts of the tuberculous pediatric patient].
AB  - BACKGROUND: Results of contacts investigation of tuberculous pediatric patients,
      usually non-infectious, are shown. Their relationship to the clinical situation
      on index case and the intimacy of exposure is analyzed. METHODS: 714 contacts of
      111 pediatric cases (53 category II and 58 category III, according to the
      American Thoracic Society classification). The tuberculin skin test with 2 units
      of PPD-RT23 was used to identify the infected persons. Chest radiography, sputum
      smear and culture examination were used to diagnose current pulmonary disease.
      According to the intimacy of exposure to index case, contacts were defined as
      household, close or sporadic contacts. The possible association with clinical
      situation of index case and intimacy of exposure was analyzed. RESULTS: 41 new
      cases of tuberculosis were detected, 7 of them were infectious. Prevalence of
      tuberculous infection among contacts was 44%. Quimioprofilaxis was indicated to
      126 contacts. The prevalences of infection and disease according to clinical
      situation and degree of contact did not differ significantly. CONCLUSIONS: it is
      advisable to investigate the contacts of tuberculous pediatric patients, even in
      cases of tuberculous infection without disease; the investigation must include
      close and sporadic contacts.

PMID- 1758206
TI  - [Vaccination in immunodepressed patients].

PMID- 1758207
TI  - [Meningeal myelomatosis as an exclusive form of recurrence in a case of IgA
      lambda myeloma in complete systemic remission].
AB  - Meningeal myelomatosis is an extremely rare clinical presentation generally
      associated to terminal states of the disease and is more frequent in the presence
      of peripheric plasmocytosis or leukemia of the plasmatic cells. Diagnosis
      requires its demonstration in the cephalorhachidian liquid and its monoclonal
      secretion. A case of relapse of meningeal myelomatosis in a patient with multiple
      IgA-lambda myeloma is presented in which the systemic disease fulfilled the
      criteria for complete remission.

PMID- 1758208
TI  - [The diagnosis and treatment of catheter-produced sepsis].

PMID- 1758209
TI  - [Primary lymphoma of the thyroid].

PMID- 1758210
TI  - [The management of a hospital crisis].

PMID- 1758211
TI  - [Ibuprofen and antihypertensive drugs].

PMID- 1758212
TI  - [A high-grade T-cell non-Hodgkin's lymphoma in a patients with tuberous sclerosis
      treated with hydantoins].

PMID- 1758213
TI  - [Diabetic dorsal radiculopathy].

PMID- 1758214
TI  - ADL: an integrated database for filing and study of malignant lymphoma patients.
AB  - The filing of clinical data must comply with purposes of logical organization for
      comparisons and evaluations. ADL (Archives of Data on Lymphomas) is an
      application program of dBASE III plus (Ashton-Tate) for personal computers,
      especially suitable for filing and studying patients afflicted with malignant
      lymphoma. It is subdivided into four data files: general data (private data,
      stage, therapy); disease data (sites of disease by tests and body area);
      immunological data (lymphocyte subpopulations, globulin and immunoglobulin
      dosage, delayed hypersensitivity skin tests); lost patients (register of patients
      not seen for at least 1 year). It has many utilities (descriptive statistics,
      clinical report, export service). Congruence checks and verification of names and
      dates input are included. This program stands as a valuable alternative to more
      traditional filing systems.

PMID- 1758215
TI  - Development and validation of HEPAR, an expert system for the diagnosis of
      disorders of the liver and biliary tract.
AB  - HEPAR is an expert system in the field of hepatology which can be used as a
      supportive tool in the diagnosis of disorders of the liver and biliary tract. The
      representation language employed in HEPAR consists of production rules with
      object-attribute-value triples. In the system, medical diagnosis is modelled
      according to the strategy which is clinically used in this field. The patient's
      disorder is assessed in two stages. In the first stage, available data from
      medical interview, physical examination and simple laboratory tests are used to
      determine whether the disorder is hepatocellular or biliary obstructive in
      nature, and whether benign or malignant features are present. In the second stage
      the system produces a subset of possible diagnoses out of a set of more than 80
      disease categories, using additional data from supplementary tests. The results
      of the first stage classification cause considerable pruning of the search space.
      In this paper the structure, development process and approach followed in the
      validation of the HEPAR system are described. The results of a recent performance
      validation study using data from 181 consecutive patient cases are discussed.

PMID- 1758216
TI  - The wavelet transform and its applications to phonocardiogram signal analysis.
AB  - The wavelet transform, which is the decomposition of a signal into a set of
      independent frequency channels, is shown to be a useful diagnostic tool in the
      analysis of heartbeat sounds. In particular, the wavelet transform enables the
      experimentalist to obtain qualitative and quantitative measurements of time
      frequency characteristics of phonocardiogram (PCG) signals.

PMID- 1758217
TI  - Computerized medical records: defining a standard without the computer.
AB  - The inevitable computerization of medical records may be a boon or a hindrance to
      the practice of medicine. A comprehensive view of the project is essential for
      its success. Definite goals for the computerized medical record are stated to
      this end. An argument is presented for keeping the structure of the medical
      record separate from any specific requirements of technology. An elegant
      structure for medical records is proposed, independent of any computer system and
      requiring a minimum of definitions or special characters. The roles of clinical
      specialists (such as physicians and nurses), medical records specialists,
      administrators, accountants, and computer architects (hardware and software) are
      defined. In particular, the tasks of lexicon and template creation are defined
      and emphasized as urgent and ongoing challenges for specialty organizations.

PMID- 1758218
TI  - How to approach a hospital information system as sampling frame. Selection of
      patients with a percutaneous renal biopsy.
AB  - The paper describes the four steps that have to be taken in the process of using
      a hospital information system as sampling frame: step 1, description of the
      medical routine and registrations related to the study population; step 2,
      defining the design and criteria for selection; step 3, creating the datafile and
      step 4, validating the datafile. To illustrate these four steps a detailed
      description of the selection of patients with a percutaneous renal biopsy is
      given, using the central database of Leiden University Hospital. All
      registrations relating to patients undergoing a percutaneous renal biopsy in 1985
      and 1986 were taken into account and combined in defining the design and criteria
      for selection. The selection resulted in 182 patient-records, of which 177 were
      compared with the medical file. Overall 150 percutaneous biopsies were confirmed.
      Hospital Information Systems are in principle useful as sampling frames for
      clinical research. However, to use these systems successfully in selecting a
      study population intensive mutual consultation between clinicians, clinical
      epidemiologists, database experts and administrative personnel is required.

PMID- 1758219
TI  - A personal computer network system for equitable allocation of cadaver organs.
AB  - We developed a personal computer network system for the equitable allocation of
      cadaveric organs. This network consists of a host computer (IBM PS55 model 5570
      T) and various kinds of personal computers manufactured by many different
      computer makers in Japan. The merits of our personal computer network include
      lower cost and an easy access to the host computer from all the centres
      participating in this network while using their own favourite personal computers.
      Among the programs made for allocating cadaveric organs, we present in this paper
      the program for livers. This program was developed with a modified version of the
      logic developed by Starzl et al. The grade modification for the United Network
      for Organ Sharing (UNOS) in the United States was used as the basis for
      classification of medical urgency. Our program weighed the factors of medical
      urgency, compatibility of blood group and waiting time. Distance factors were
      omitted because of the smaller area of the network compared to that of UNOS. This
      computer network would be linked to other computer networks in creating a
      national organ procurement and transplant network in Japan, in order to help them
      to catch up with other advanced transplant countries. Such an equal and objective
      computer system should allow organ transplantation to become more widely
      accepted.

PMID- 1758220
TI  - Construction of diagnostic rules based on assessments of subjects.
AB  - This paper is based on assessments of subjects which are not defined by formal
      procedures. Logically structured assignment rules are constructed which are
      stable over time and which have a low number of disagreements with the
      assessments of the subjects. Recent results obtained from a computational
      learning theory show that the proposed construction of rules leads with high
      probability to rules with similar performances on large enough learning and
      validation sets of subjects. The construction of a set of stable rules is
      illustrated by using as a case study the psychophysiological, personality and
      speech behaviour data of a repeated-measures Type A behaviour study. This case
      study is also used for a discussion of the issue of biased ratings in the
      presence of assessments which are not defined by formal procedures.

PMID- 1758221
TI  - Integrating a medical database and advisory system.
AB  - A system is described which incorporates the use of a diagnostic and treatment
      advice expert system into the routine information-handling functions of a
      surgical breast clinic. The main focus of the system is on identification and
      management of non-malignant breast disease. The advisor is linked with a clinical
      database which is used to hold summary case notes, and from which reports forming
      the basis for audit of case-mix and resource utilization can be produced. The
      system uses backward chaining of extended production rules and a relational
      database, and runs on a desktop microcomputer.

PMID- 1758222
TI  - [A comparison of 2 curricula: clinical skills during the year of clinical
      medicine studies].

PMID- 1758223
TI  - [Antihypertensive treatment reduces the risk of stroke even in elderly
      hypertensive patients].

PMID- 1758224
TI  - [Asymptomatic primary hyperparathyroidism: surgery or follow-up?].

PMID- 1758225
TI  - [Can we believe children?].

PMID- 1758226
TI  - [Cannulas and gloves reduce the risk of blood contamination].

PMID- 1758227
TI  - [Arthroscopy--a diagnostic technique with increasing therapeutic use].

PMID- 1758228
TI  - [Fine needle renal biopsy is less informative than biopsy using thicker needles].

PMID- 1758229
TI  - [Erythropoietin made surgery for aortic coarctation possible in a Jehovah's
      witness patient].

PMID- 1758230
TI  - [Wolfgang Amadeus Mozart. Medical and musical reflections on the 200th
      anniversary of his death].

PMID- 1758231
TI  - [Wide cooperation is necessary for diagnosis and treatment of torture injuries].

PMID- 1758232
TI  - [Biosensors--future analytical technology?].

PMID- 1758233
TI  - [Mikhail Bulgakov, physician and writer--a year of centenaries. Manuscripts do
      not burn].

PMID- 1758234
TI  - [Current state of treatment and prevention of gastroduodenal side effects of non
      steroidal antirheumatic drugs].
AB  - In spite of optimized antirheumatic treatment, NSAID-related mucosal lesions
      ranging to bleeding ulcers occur mainly in the stomach and less frequently in the
      duodenum. With continued NSAID therapy, overt mucosal lesions can be treated with
      Omeprazol or H2 blockers. The efficacy of these medications may be correlated
      with their acid-inhibiting potency. Antacids have not as yet been sufficiently
      tested for this indication. Although prostaglandin derivatives are effective, in
      high doses they may cause diarrhea. Despite their good efficacy, they should
      therefore not be employed as a first choice for this indication. NSAID-induced
      mucosal lesions "owe" their development to local iatrogenic prostaglandin
      deficiency. Through co-medication with Misoprostol in low dosage, NSAID mucosal
      lesions and ulcers are prevented without the occurrence of significant
      undesirable Misoprostol effects. H2 antagonists and Omeprazol have a protective
      effect on the mucosa solely in the duodenum. Antacids have not as yet been tested
      successfully for this indication either. Elderly patients with a medical history
      of ulcers frequently develop silent NSAID ulcers. Any NSAID therapy necessary for
      these high-risk patients should therefore always be accompanied by at least a
      sufficient mucosal protection therapy.

PMID- 1758235
TI  - [Circulating "tumor markers" in gastrointestinal tumors].
AB  - Tumor markers (TM) of the neoplastic cell can be divided into non-shedded
      substances and antigens shedded in blood, urine or other body fluids. For
      clinicians circulating TM are more important. All relevant circulating TM are not
      useful in screening of asymptomatic patients because of insufficient sensitivity
      and specificity. With caution they are useful in the observation of risk groups.
      Circulating TM have their main significance as additional parameters in
      monitoring symptomatic patients with malignancies. Several follow up
      determinations are more important than one single measurement. During follow up
      of tumor patients TM should not be checked automatically if there are no
      diagnostic or therapeutical consequences. The clinically most important
      circulating TM in non-hormone secreting tumors of the gastrointestinal tract are
      the oncofetal antigens CEA and AFP and antigens defined by monoclonal antibodies
      e. g. CA 19-9 and CA 72-4. AFP is the primary TM in hepatocellular carcinoma,
      often elevated in hepatoblastoma and always normal in cholangiocellular
      carcinoma. CEA is the TM of first choice in patients with colorectal carcinomas
      and liver metastasis. CA 19-9 is TM of first choice in pancreatic carcinoma and
      additionally of diagnostic value in cholangiocellular carcinoma and tumors of the
      bile ducts. In cancer of the stomach CA 19-9 and CEA are secondary TM in
      combination with CA 72-4 as primary TM. Care should be taken that slight and
      moderate elevations of TM can be observed in benign diseases of liver, pancreas
      and bowel.

PMID- 1758236
TI  - [Extra-gastric non-Hodgkin's lymphomas of the abdomen--the role of surgical
      treatment].
AB  - A multimodality approach offers the best chance for treatment of Non-Hodgkin
      lymphoma. Surgery, radiation therapy, and/or chemotherapy when used in
      combination offer better response and longterm survival rates. Surgical therapy
      offers good results in stage I and II according to the Ann Arbor classification.
      Aim is the excision of the tumor with the removal of lymph nodes. The best
      treatment in stage III and IV is chemotherapy and radiation followed by surgical
      tumor reduction. Complications like perforation or bleeding occurred while the
      patients received either chemotherapy or radiotherapy. Resection of the Non
      Hodgkin lymphoma prevented the complications of hemorrhage and perforation
      associated with chemotherapy and radiation.

PMID- 1758237
TI  - [Neurotensin liberation during the consumption of mineral water from Bad
      Mergentheimer Karlsquelle].
AB  - The contraction of the gallbladder mainly mediated by CCK after oral
      administration of pharmacological doses of magnesium sulfate is familiar. The
      same applies to the cholekinetic action of courses of sulfatic mineral water
      treatment. It was demonstrated in 12 patients in a controlled study that besides
      other known secretions of gastrointestinal hormones, there is also a significant
      rise of the plasma level of neurotensin when Bad Mergentheimer Karlsquelle
      mineral water containing sulfate (3.7 g SO4/l) is drunk on an empty stomach (300
      ml, 26 degrees C). This was significantly greater (basal values 6.8 +/- 4.1 pg/ml
      and a maximum of 15.7 +/- 8.1 pg/ml after 40 min) than in a control group
      consisting of the same patients who had drunk tapwater. Whereas the involvement
      of the neuropeptide neurotensin in the regulation of the exocrine functions of
      the pancreas has been established, its effect in the regulation of gallbladder
      contraction is probably of rather minor significance compared to CCK.

PMID- 1758238
TI  - [Goblet cell carcinoid of the vermiform appendix].
AB  - The goblet-cell-carcinoid of the appendix vermiformis lies somewhat between the
      carcinoid and the adenocarcinoma of the appendix concerning the biological
      behaviour and the histological characteristics. Referring an own well documented
      case (76 are well known in the available literature) the importance of the very
      conscientiously managed histological examination of each appendix specimen is
      emphasized with regard to the 5-year-survival of 73%.

PMID- 1758239
TI  - [Collagenous duodenitis and ileitis in a patient with collagenous colitis].
AB  - Collagenous colitis is a disease accompanied by chronic watery diarrhea, of which
      the etiology is unknown. Sporadic cases of collagen deposits in the upper
      gastrointestinal tract are meanwhile reported. We here report the case of a 53
      year-old female patient suffering from collagenous colitis with additional
      collagen deposits in the duodenum and ileum. The favourable effect of a
      therapeutical trial with bismuth nitrate is described.

PMID- 1758240
TI  - [Effect of succinylcholine on recovery of atracurium-induced neuromuscular
      blockade].
AB  - If muscle relaxation is inadequate at the end of surgery, a transient increase in
      neuromuscular (NM) blockade should be needed to facilitate closure.
      Succinylcholine is the only agent of short duration available currently and could
      be used in the just mentioned circumstance. Therefore, the study was designed to
      investigate the effects of succinylcholine on the recovery of atracurium-induced
      NM blockade. Sixty-four female patients who underwent elective surgery under
      general anesthesia were allocated into 6 groups. Before anesthesia, no patient
      had received drugs which affect NM transmission. In all patients anesthesia was
      induced with thiopental, diazepam and fentanyl and maintained with 50% nitrous
      oxide in oxygen and 0.5-1.5% isoflurane. During anesthesia, blood pressure and
      electrocardiogram were monitored and end-tidal CO2 was maintained at 30-40 mmHg.
      Control records of the integrated electromyography responded to train-of-four
      supramaximal stimulation using a Datex Relaxograph were obtained after induction
      of anesthesia before a block was produced with an initial dose of succinylcholine
      1.0 mg in group I (n = 8) or atracurium 0.4 mg/kg in groups II-VI. On first
      twitch (T1) recovering to 50% of control, 0.4 mg/kg, 0.6 mg/kg, 0.8 mg/kg, 1.0
      mg/kg and 1.2 mg/kg of succinylcholine were given in groups II (n = 11), III (n =
      14), IV (n = 11), V (n = 10), VI (n = 10) respectively. It was seen that
      succinylcholine 0.4 mg/kg antagonized NM blockade by atracurium but at 0.6 mg/kg,
      0.8 mg/kg, 1.0 mg/kg, 1.2 mg/kg it enhanced that.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1758241
TI  - [The effect of succinylcholine on the recovery of atracurium-induced
      neuromuscular blockade].
AB  - At the end of abdominal surgery, a brief but profound neuromuscular blockade may
      be needed to facilitate closure of abdominal wall. Succinylcholine (Sch) was the
      agent used in this regard before. This study was undertaken to observe the effect
      after administration of Sch (1 mg/kg) at various levels of recovery from
      atracurium. 40 ASA I or II patients undergoing elective surgery were randomly
      assigned to one of four groups with 10 in each. Anesthesia was induced with
      thiopental 5 mg/kg and Sch 1.5 mg/kg i.v., and maintained with 0.7% isoflurane
      (end-tidal concentration) and 50% N2O in O2 The electromyographic response of the
      hypothenar muscle was recorded in response to supramaximal train-of-four stimuli
      delivered to the ulnar nerve at 20 s intervals using a relaxograph (Datex).
      Control records were obtained after induction of anesthesia. When the first
      twitch (T1) had recovered above 50% from the intubating dose of Sch, atracurium
      0.5 mg/kg was administered. Spontaneous recovery of T1 was observed. Patients in
      group I received 1 mg/kg of Sch, when T1 returned to 20% and those in groups II,
      III, and IV received the same dose of Sch when T1 returned to 40%, 60% or 80% of
      control respectively. The response was observed at 20s intervals for at least 5
      min after the administration of Sch. It was regarded as effective response if the
      T1 returned to less than 5% of control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758242
TI  - [Initial washout time of inhaled anesthetic agents].
AB  - Recovery of inhalation anesthesia is generally considered the inverse of
      induction. While other factors remain unchanged, the rate of elimination of an
      inhaled anesthetic agent with a lower solubility such as nitrous oxide (N2O) is
      faster than one with a high solubility. Therefore, at the end of surgery it is a
      common practice to discontinue the volatile agent prior to discontinuing N2O.
      However, the results of our routine monitoring of end-tidal concentrations of
      anesthetics and physiological gases by employing a mass spectrometer lead us to
      question the practice. We studied 24 non-premedicated ASA I/II patients requiring
      endotracheal intubation with an anesthesia time over 2 h. All patients were
      mechanically ventilated at an appropriate tidal volume and respiratory rate to
      maintain an ETCO2 of 35-38 mmHg with an anesthetic mixture of 40% O2 and 60% N2O
      and isoflurane (Forane). At the end of surgery, both N2O and isoflurane were
      discontinued simultaneously and total oxygen flow was increased to 6 or 10 l/min
      by random. The exhaled partial pressure of both inhaled anesthetic agents were
      assessed at the time of anesthetic termination, after 1, 2 min, and then every 2
      min up to 20 min or at the time of extubation. The results obtained were plotted
      against real time using two different scales. Despite the marked difference in
      their plasma solubilities, these two inhaled anesthetic agents reached to low
      exhaled partial pressure that had no clinical significance about ten minutes
      after discontinuation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758243
TI  - [Intravenous propofol as a supplement in epidural anesthesia].
AB  - Under study were thirty patients of ASA class I-II scheduled for lower abdominal
      and lower extremities surgery. Premedication included intramuscular injection of
      pethidine, atropine and prochlorperazine. Epidural anesthesia was accomplished
      with 12-15 ml 2% lidocaine with epinephrine (1:80,000). Thirty minutes later,
      when blood pressure returned to control value, patients were put to sleep by 2
      mg/kg propofol and the sleep was maintained with continuous infusion of propofol
      at a rate of 6 mg/kg/h. Infusion rate was adjusted when necessary. Patients
      breathed room air spontaneously through the whole course of anesthesia. The
      results showed that all patients fell to sleep within 28.3 +/- 2.7 s after
      intravenous injection of propofol 2 mg/kg. Sleeping dose was satisfactorily
      achieved using a mean infusion rate of 6.1 +/- 1.7 mg/kg/h. The mean time from
      the end of the infusion of propofol to opening of the eyes on command and telling
      the correct date of birth were 7.9 +/- 2.8 min and 9.9 +/- 3.8 min respectively.
      Two minutes after injection, there were significant decrease in systolic
      pressure, diastolic pressure, cardiac output, and stroke volume with a mean of
      17.9 +/- 3.8%, 18.8 +/- 3.3%, 7.6 +/- 0.5% and 11.1 +/- 1.9% respectively. Two
      patients (7%) developed apnea after 2 mg/kg propofol which was considered to be
      the most serious side effect. Propofol infusion had to be stopped in 13% patients
      due to a 30% fall of arterial blood pressure during maintenance. In the recovery
      stage, no other complications were noted except one patient who felt dizziness.
      Propofol, used as the supplementary sedative, provides satisfactory result for
      surgery under epidural anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758244
TI  - [Prolongation of hyperbaric bupivacaine spinal anesthesia with clonidine].
AB  - Recent reports showed that spinal clonidine might provide satisfactory analgesia
      via a nonopioid mechanism. In this study we tried to evaluate the prolongation of
      analgesic effect of the hyperbaric bupivacaine spinal anesthesia with clonidine.
      40 ASA class I-II patients scheduled for TURP were randomly classified into two
      groups of 20 each. In saline group, 3 ml 0.5% hyperbaric bupivacaine plus 1 ml
      normal saline was given. In clonidine group, 1 ml (0.15 mg) clonidine in addition
      to 3 ml 0.5% bupivacaine was given. All the patients were placed in lateral
      position and dural puncture was made at the L3-4 interspace using a 25G spinal
      needle. Assessment of the sensory blockade by "pinprick" and motor blockade by
      Bromage scale and measurement of blood pressure and heart rate were performed
      after injection. All data were analyzed by Student's t-test. A p value less than
      0.05 was considered statistically significant. Our results showed that the
      highest sensory blockade level and the time required for maximal spread of the
      sensory blockade were of no significant difference between groups. The mean time
      for two segments regression and mean time for regression to L2 were significantly
      greater in the clonidine group than in the saline group (p less than 0.001).
      Motor blockade was also prolonged in the clonidine group than the clonidine
      group. Side effects such as hypotension (10 in clonidine gp vs 4 in saline gp)
      and bradycardia (4 clonidine gp vs 2 in saline gp) commonly occurred in the
      clonidine group, but all patients could be effectively treated with ephedrine and
      atropine respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758245
TI  - Incidence of post-dural puncture headache with 25-gauge Quincke spinal needle.
AB  - A retrospective study was undertaken in patients who received spinal anesthesia
      in past two years in order to find out the incidence of post-spinal headache.
      There were 3729 cases, 1997 males and 1732 females. Seventy-two patients were
      noted to have post-spinal headache of whom twelve were male and sixty were
      female. The overall incidence was 1.93%. Incidence was 0.6% and 3.5% in male and
      female groups respectively. With respect to the type of surgical procedures in
      female group, patients undergoing Cesarean section had a higher incidence than
      those who received other surgical procedures, being 4.8% and 1.5% respectively.
      In conclusion, female patients were noted to have higher incidence of post-spinal
      headache, particularly in patients undergoing Cesarean section.

PMID- 1758246
TI  - [The possible mechanism of fentanyl-induced muscle rigidity].

PMID- 1758247
TI  - [Intraoperative evoked potentials monitoring during spine surgery].

PMID- 1758248
TI  - [Seizure induced by small dose of fentanyl].

PMID- 1758249
TI  - [Can diclofenac sodium control the pain associated with uterine contraction after
      cesarean section?].

PMID- 1758250
TI  - Comparison of inguinal nerve block and intravenous fentanyl in relieving
      postinguinal herniorrhaphy pain for pediatric outpatients.
AB  - The purpose of this study was to compare the effects of
      ilioinguinal/iliohypogastric (IG/IH) nerve block and intravenous fentanyl for
      pain control following inguinal herniorrhaphy in pediatric outpatients. Seventy
      five ASA physical status I and II children (aged 1 to 10 yr) with unilateral
      inguinal herniorrhaphy under general anesthesia were randomly divided into three
      groups. Group A received IG/IH nerve block, using 0.25% bupivacaine (1 mg/kg)
      immediately after induction. Group B received intravenous fentanyl (1
      microgram/kg) immediately after induction. Group C received only general
      anesthesia as control. At postanesthetic care unit (PACU), we recorded the degree
      of pain/or discomfort at 5, 15, 30, 45 and 60 min using modified Hannallah's
      scoring system after the patient was fully awake. The degree of recovery was also
      evaluated using Steward's scoring system. After discharge, the parents were
      interrogated about the condition of child within 24 h by telephone. Follow-up
      items raised included vomiting, drowsiness, pain and shivering. Our results
      showed that children in both study groups had lower pain score than those in the
      control group, and in the fentanyl group children had lower pain score than in
      the nerve block group during the first 30 min at PACU. The recovery time was also
      longer in the fentanyl group. There was no significant difference among the three
      groups regarding the raised items over telephone interrogation. In sum, inguinal
      nerve block was effective for postoperative pain relief in children undergoing
      inguinal herniorraphy. We also suggested that small dose of intravenous fentanyl
      would serve as an easy, simple and effective means for relieving postinguinal
      herniorrhaphy pain during the first 30 min of the initial postoperative period.

PMID- 1758251
TI  - Acute normovolemic hemodilution in coronary artery bypass graft surgery.
AB  - Twenty patients undergoing coronary artery bypass graft (CABG) surgery in April
      through May, 1990 in our hospital were included in this study to evaluate the
      merits and practicability of autologous blood transfusion. About 1,000 ml of
      arterial blood were collected via a radial arterial line and stored in a plastic
      bag containing CPD solution immediately after induction of anesthesia. Colloid or
      crystalloid solution was used to replace the volume deficit after the blood
      sampling. At the end of cardiopulmonary bypass and after adequate reversal of
      heparinization by protamine, the blood previously sampled was re-transfused to
      the patient via a peripheral venous line. Thirty patients undergoing CABG
      surgery, who did not receive autologous blood transfusion from February to June,
      1990 save April and May were assigned as control. Comparison of the data between
      the two groups was made using the Student's t-test. It was found that the
      intraoperative acute normovolemic hemodilution could lower the hematocrit by
      approximately 12%. Packed red blood cells (PRBC) given intraoperatively in the
      autologous group was only 2.0 +/- 0.4 units whereas it was 5.3 +/- 0.7 units in
      the control group (p less than 0.001). Fresh frozen plasma (FFP) given
      intraoperatively in the autologous group was only 1.8 +/- 0.5 units whereas it
      was 6.6 +/- 0.7 units in the control group (p less than 0.001). The amount of
      platelets given intraoperatively in the autologous group was 1.9 +/- 1.0 units
      against 9.3 +/- 1.4 units in the control group (p less than 0.001). Thus, acute
      normovolemic hemodilution in CABG surgery decreased intraoperative requirement of
      bank blood components including PRBC, FFP and platelets.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1758252
TI  - [Clinical assessment of laryngeal mask airway in general anesthesia with
      spontaneous breathing].
AB  - The laryngeal mask airway (LMA) is a new form of oropharyngeal airway that
      provides an alternative to endotracheal intubation and face mask anesthesia in
      certain cases. Once the patient is adequately anesthetised, it can be inserted
      blindly without recourse to laryngoscopy. The advantages over standard mask
      anesthesia are: better airway control, minimal leakage of anesthetic gases, and
      it frees the anesthetist's hands, as no mandibular support is needed. LMA does
      not guarantee against the risk of aspiration and it is not recommended for use in
      patients who may have risk of gastric regurgitation. Our preliminary study
      revealed that a clear and clinical satisfactory airway was obtained in 98.2% of
      patients. According to the intraoperative respiratory minute volume and arterial
      blood gases, the patency of the airway did not deteriorate during the course of
      the anesthesia. Blood pressure and heart rate were compared on induction in group
      I and II. Succinylcholine 1 mg/kg, thiopentone 4-6 mg/kg and fentanyl 2
      micrograms/kg were used in group I while using the same dosage of succinylcholine
      and thiopentone without fentanyl for group II. We found no significant
      differences in vital signs between the two groups.

PMID- 1758253
TI  - [Efficiency of patient-controlled analgesia versus conventional analgesia in
      patients after thoracotomy].
AB  - The patients received thoracotomy usually suffered from significant severe pain
      postoperatively, which accompanied with impaired pulmonary function or increased
      incidences of atelectasis and pneumonia. So adequate analgesia for those patients
      is indicated. The purpose of this study is to investigate the efficiency of
      patient-controlled analgesia (PCA) and determine whether it is better than
      conventional analgesia or not. Twenty-six patients, ASA physical status class I
      and II, were randomized into two groups: PCA and intramuscular (IM). The effect
      on pain relief was assessed by a visual analogue pain scale (VAPS) q 4 h
      postoperatively for two days. Forced vital capacity (FVC) and the questionnaire
      of nocturnal sleep disturbance by pain were evaluated preoperatively, the first,
      second postoperative mornings. As result of this study, the patients of PCA group
      get less pain than IM group after the first and second days of surgery. VAPS
      values are 3.7 +/- 1.1, 2.8 +/- 0.8 and 6.1 +/- 0.9, 5.3 +/- 1.1 respectively
      pertaining to PCA and IM groups (p less than 0.05). The patients of IM group get
      more disturbance of nocturnal sleep than PCA group at initial two nights of
      postoperation as well (p less than 0.05). It is manifest to look out the
      significant difference between these two groups in accordance with FVC ratio
      records of post-surgery vs presurgery at initial two days after surgery on the
      subject of respiratory function recovery. PCA group are 46.46 +/- 7.29%, 52.25 +/
      8.32% in a condition of more progress on lung function recovery than IM group of
      38.13 +/- 10.25%, 42.15 +/- 7.82% (p less than 0.05).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1758254
TI  - [A comparison of patient-controlled analgesia with traditional intramuscular
      administration for postoperative pain relief].
AB  - The use of a disposable non-electronic patient-controlled analgesia (PCA) device
      (Baxter) was evaluated in this study. Every patient under trial was instructed
      thoroughly how to use the PCA device before operation. The PCA device delivers a
      25 mg IV injection of pethidine upon patient demand with a delay of 15 min
      between allowable administrations. The degree of patient satisfaction, the drug
      consumption, and the duration of using analgesia were compared with those in IM
      pethidine group. The results showed that, in the PCA group, the duration of using
      analgesic was longer; the drug consumption was greater (especially during the
      first 20 h after operation); and the degree of patient satisfaction was higher.
      The series comprised a total of 54 patients, 14 of whom complained of mild
      dizziness or nausea which did not require specific treatment. In sum, giving
      analgesic by the Baxter PCA device was a safe and effective alternative for IM
      analgesic in postoperative pain control.

PMID- 1758255
TI  - [One lung anesthesia].

PMID- 1758256
TI  - [Initial airway management of laryngotracheal trauma].

PMID- 1758257
TI  - [Succinylcholine-induced prolonged apnea and hyperthermia in a patient with
      organophosphate insecticide poisoning].

PMID- 1758258
TI  - [Anaphylaxis induced by electrodes of electrocardiogram].

PMID- 1758259
TI  - [Effects of drug dose on spinal anesthesia with isobaric tetracaine].
AB  - A protocol similar to that established in our previous reports was used in the
      current study. A total of 128 demographically compatible patients were studied
      using various tetracaine dosages in 2 ml isobaric solution; fifty patients (group
      I) received 10 mg, 46 patients (group II) received 15 mg, and 32 patients (group
      III) received 20 mg. Except for the drug dosage, an identical technique was
      employed for every patient in the study. The highest sensory levels were T7
      (median, range T5-12) for group I, T5 (median, range T3-8) for group II, and T4
      (median, range C8-T5) for group III, with an onset time of 7.08 +/- 1.16, 10.37
      +/- 1.69 and 11.14 +/- 1.85 min respectively. The above differences are
      statistically significant (p less than 0.05). However the differences between
      their onset times to the T10 level were not statistically significant (p greater
      than 0.05). The 2-segment regression times were 180.5 +/- 53.44 min for group I,
      216.4 +/- 37.3 min for group II and 248.7 +/- 38.6 min for group III. The
      difference between group I and group II as well as group I and group III were
      statistically significant (p less than 0.01) but not significant between group II
      and group III (p greater than 0.05). The onset times of maximum motor blockade
      assessed by modified Bromage scale were 5.42 +/- 1.59, 5.28 +/- 1.36 and 5.37 +/-
      1.42 min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758261
TI  - Epidural tramadol for postoperative pain relief.
AB  - Forty-two surgical patients were given epidural tramadol for control of
      postoperative pain. They were randomly assigned to three groups: group 1 (n =
      15), in which 25 mg of tramadol were given; group 2 (n = 13), in which 50 mg of
      tramadol were given; and group 3 (n = 14), in which 75 mg of tramadol were given.
      When the patients complained of wound pain, epidural tramadol was given. Heart
      rate, blood pressure, respiratory rate, oxygen saturation (SpO2), sedation scale,
      motor blockade, verbal rating scale, subjective grading, and visual analogue pain
      scale (VAPS) were measured and recorded before the tramadol administration, at 5
      and 15 min, and at 1, 2, 4, and 8 h after the tramadol administration. Only 26.6%
      of the patients in group 1 had significant relief of pain. The rest of them
      needed at least one incremental dose of 25 mg of tramadol. The baseline VAPS of
      the patients in group 2 was 8.9 +/- 2.0. It became 5.46 +/- 3.0 (p greater than
      0.05) 15 min after tramadol was given, and dropped further to 1.9 +/- 1.8 (p
      greater than 0.05) 2 h later. The average duration of pain relief was 12.0 +/-
      5.9 h. In group 3, the initial VAPS was 8.14 +/- 1.9. It decreased to 4.28 +/-
      1.8 (p greater than 0.05) 15 min, and further dropped to 1.7 +/- 0.9 (p greater
      than 0.05) 2 h following tramadol administration. The average duration of pain
      relief was 11.3 +/- 4.8 h. The common side effects of tramadol such as dizziness,
      nausea, and dry mouth, were most frequently found in group 3.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1758260
TI  - Effect of physostigmine on the loss of consciousness induced by midazolam,
      etomidate and althesin.
AB  - The effect of physostigmine, a cholinesterase inhibitor, on the loss of
      consciousness induced by three different intravenous induction anesthetics,
      namely midazolam, etomidate and althesin at ED50, was studied in three comparable
      groups of patients. Ten min before induction, the first and second groups
      received physostigmine 8 micrograms/kg and 16 micrograms/kg, respectively, and
      the third group received 2 ml of saline solution. Physostigmine 16 micrograms/kg
      resulted in a significant decrease in the percentage of unconscious patients with
      midazolam (from 50% to 10%), but it did not modify the incidence with etomidate
      or althesin. Physostigmine at doses of 8 micrograms/kg and 16 micrograms/kg could
      cause 6.7% and 10% nausea, respectively. Although the mechanism of the drug
      interaction of physostigmine and midazolam is unclear, physostigmine could be
      used clinically to reverse post-anesthetic somnolence induced by midazolam.

PMID- 1758262
TI  - [The study of cancer pain and its correlates].
AB  - From August 1989 to December 1990, we collected 1523 cases of malignancy at Tri
      service General Hospital (TSGH), and 470 cases (30.9%) of these malignancy had
      pain complaint. Moreover, we found that 68.1% (79/116 cases) of malignancy with
      bony metastasis had pain complaint. These informations were obtained from medical
      records. By counting the site of these 1523 cases, the leading sites in sequence
      were lung (207 cases), stomach (164 cases), cervix uteri (132 cases), breast (117
      cases) and colon (91 cases). Regarding the incidence of cancer pain among these
      malignancy, bone cancer had the highest incidence (75.0%), followed by tongue
      (66.7%), brain (65.7%), liver (62.3%) and pancreas (60.0%). There was no
      difference of the incidence of cancer pain between male and female. The
      incidences of cancer pain in different age groups were different; the young
      patients had higher incidence than elderly patients. The analgesics for cancer
      pain used most frequently by physicians at TSGH were nonsteroid anti-inflammatory
      drugs and meperidine. Although the therapeutic management of cancer pain has been
      advancedly developed, we found that the treatments of cancer pain by physicians
      at TSGH were not aggressive enough. Therefore, promotion of the concept in
      advanced pain control and techniques is our important task in the near future.

PMID- 1758263
TI  - A comparison of umbilical venous blood levels of neuropeptide Y and
      catecholamines between cesarean section and normal spontaneous delivery.
AB  - This study was designed to determine the presence and different levels of
      placental neuropeptide Y (NPY) in women at parturition between normal spontaneous
      delivery (NSD) and cesarean section (C/S) under spinal anesthesia and to compare
      it with the level of catecholamines. Umbilical vein plasma levels of neuropeptide
      Y and catecholamines of the placental cord were measured at delivery in 40
      parturient women who were divided into two groups, with 20 patients in each. NSD
      group underwent vaginal delivery without the presence of intrapartum fetal
      distress. C/S group received elective cesarean section (C/S) under spinal
      anesthesia. The results showed that umbilical vein level of NPY in NSD patients
      was significantly less than C/S patients (160.32 pg/ml vs 346.25 pg/ml, p less
      than 0.01). But for catecholamines levels, C/S group were significantly less than
      that of NSD group.

PMID- 1758264
TI  - [Low-flow anesthesia].
AB  - Low-flow anesthesia provides benefits of ecologic advantages, reduction of
      pollution of operating room, increased economy and prevention of airway
      dessication. It is worthy to gain popularity of application. In this review
      article, certain aspects of low-flow anesthesia are included: 1) how to avoid
      hypoxemia, 2) how to prevent carbon dioxide retention, 3) how to use Lin's method
      in calculating the metered concentration of inhalational anesthetics during
      maintenance period, 4) how the time constant to affect the time to surgical level
      of anesthesia, and 5) the indications of low-flow anesthesia for surgery.
      Finally, clinical experience in low-flow anesthesia will be discussed in terms of
      halothane, enflurane or isoflurane with or without nitrous oxide.

PMID- 1758265
TI  - [The occupational hazards of anesthetic personnel].

PMID- 1758266
TI  - Anesthetic management of a patient with epidermolysis bullosa.

PMID- 1758267
TI  - Lessons of the heart: expanding practice.

PMID- 1758268
TI  - Holding back: maternal readiness to give birth.

PMID- 1758269
TI  - Living with an irritable infant: maternal perspectives.

PMID- 1758270
TI  - Teaching children who are learning disabled about illness and hospitalization.

PMID- 1758271
TI  - Assessing postpartum fatigue.

PMID- 1758272
TI  - Making the most of the R.N. in a pediatric outpatient setting.

PMID- 1758273
TI  - Pregnancy over 35: special needs.

PMID- 1758274
TI  - Content analysis: steps to a more precise coding procedure.

PMID- 1758275
TI  - Norplant and the 'coerced conception' controversy.

PMID- 1758276
TI  - [The organization of medical care in enterprises].

PMID- 1758277
TI  - [Methodological recommendations on the organization of centralized sterilization
      departments in hospitals. Appendix 1].

PMID- 1758278
TI  - [The prevention of patient traumatism and asepsis in the nurse's work].

PMID- 1758279
TI  - [The perinatal prevention of allergy in young infants].

PMID- 1758280
TI  - [The physiotherapy of obliterating vascular diseases of the lower extremities].

PMID- 1758281
TI  - [The rules of caring for hospital patients].

PMID- 1758282
TI  - [The characteristics of tooth and jaw diseases in middle-aged and elderly
      patients].

PMID- 1758283
TI  - [Rubella in adults].

PMID- 1758285
TI  - [Adaptogens of plant origin].

PMID- 1758284
TI  - [The basic gastroenterological diet].

PMID- 1758286
TI  - [The abuse of Soviet psychiatry: facts and conjectures].

PMID- 1758287
TI  - Cerebral stroke in a semi-pro football player: a case report.
AB  - Cervical spine trauma can clearly result in neurologic injury. An unusual
      traumatic event is a vascular insult of the vertebral arteries, potentially
      leading to stroke. The vertebral arteries are vulnerable to compression at
      several sites in the cervical spine. The high degree of physiologic rotation at
      the atlanto-axial joint places the vertebral artery at risk through normal daily
      activities as well as following forceful trauma, including manipulative
      treatment. Cerebrovascular insufficiency is an uncommon but serious complication
      of cervical spinal manipulation, which can lead to posterior circulatory
      impairment. Comprehensive diagnostic studies may be required to differentiate
      primary intracranial pathology from cerebral symptoms secondary to vascular
      compromise.

PMID- 1758288
TI  - Patellar location changes following EMG biofeedback or progressive resistive
      exercises.
AB  - Changes in the patellofemoral congruence (PFC) angle, the patellar rotation (PR)
      angle, and the sulcus angle following EMG biofeedback training that emphasized
      vastus medialis obliquus strengthening, the Daily Adjustable Progressive
      Resistive Exercise (DAPRE) technique, or no exercise were studied. Subjects were
      30 normal, college females. The EMG biofeedback group and the DAPRE group
      followed established protocols for a 3-wk training period. The control group
      refrained from exercise. Patellar angles were determined with x-rays both pre-
      and posttest with the quadriceps relaxed and contracted. Reliability of the x
      rays was determined with a correlation matrix of pre- and posttest sulcus angle
      measurements (P less than 0.001). EMG biofeedback training resulted in
      significant changes in the PFC angle with the quadriceps contracted (P less than
      0.05). DAPRE resulted in significant changes in the PR angle with the quadriceps
      contracted (P less than 0.05). The results of this study suggest that quadriceps
      group strength changes are not enough to fully rehabilitate patellar tracking
      dysfunctions. The use of EMG biofeedback training to selectively strengthen the
      vastus medialis obliquus appears to be essential in correcting faulty patellar
      tracking.

PMID- 1758289
TI  - The VO2max of recreational athletes before and after pregnancy.
AB  - This study was designed to test the hypothesis that pregnancy has an added
      training effect (increases "absolute" VO2max) in well-conditioned, recreational
      athletes. VO2max was measured serially in 20 nonpregnant recreational athletes
      who maintained their exercise within +/- 10% of initial levels over a 15-month
      period and 20 similar women who conceived and continued exercise at a reduced
      level during pregnancy with a return to within 20% of initial levels by 12 wk
      postpartum. Initially the two groups were similar in terms of age (30 +/- 1 vs 30
      +/- 2 yr), weight 57.6 +/- 7.2 vs 59.7 +/- 7.5 kg), max pulse rate (189 +/- 8 vs
      187 +/- 10 bpm), and absolute (3083 +/- 469 vs 3138 +/- 464 ml.min-1) VO2max. In
      the nonpregnant group the values obtained 15 months later were unchanged (weight
      = 57.8 +/- 6.6 kg, max pulse = 191 +/- 7 bpm, VO2max = 2977 +/- 397 ml.min-1)
      while those who conceived had a significant increase in absolute VO2max that was
      evident 12-20 wk postpartum and was maintained at the time of final testing 36-44
      wk postpartum (3368 +/- 435 ml.min-1). Both weight (60.1 +/- 8.1 kg) and maximum
      pulse rate (185 +/- 12 bpm) were unchanged. These data indicate that pregnancy is
      followed by a small but significant increase in VO2max in recreational athletes
      who maintain a moderate to high level of exercise performance during and after
      pregnancy.

PMID- 1758290
TI  - Strength training does not improve lipoprotein-lipid profiles in men at risk for
      CHD.
AB  - Sixteen untrained males, age 46 +/- 11 yr (mean +/- SD), were studied to
      determine the effects of 20 wk of strength training on lipoprotein-lipid profiles
      and post-heparin lipase activities. All subjects had abnormal lipoprotein-lipid
      profiles and at least two other risk factors for coronary heart disease (CHD). To
      control for day-to-day variations in blood lipoprotein levels, baseline values
      were established by taking at least two blood samples on separate days from the
      training and control groups. The training program resulted in a 50% increase in
      upper body strength (P less than 0.001) and a 37% increase in lower body strength
      (P less than 0.001) as measured by the one repetition maximum test (1-RM). No
      changes in the 1-RM test were observed in the control group. There were no
      significant changes in VO2max (34.5 +/- 6.4 vs 36.2 +/- 7.4 ml.kg-1.min-1 or
      percent fat (25.4 +/- 4.2 vs 24.9 +/- 4.1%) with training. There were also no
      significant changes in plasma concentrations of triglyceride (193 +/- 96 vs 171
      +/- 101 mg.dl-1), total cholesterol (231 +/- 22 vs 210 +/- 22 mg.dl-1), and HDL-C
      (35 +/- 6 vs 36 +/- 8 mg.dl-1), or LDL-C (139 +/- 16 vs 139 +/- 21 mg.dl-1).
      Furthermore, the activities of post-heparin lipoprotein lipase (9 +/- 4 vs 13 +/-
      5 moles.ml-1.h-1) and hepatic lipase (35 +/- 10 vs 35 +/- 9 moles.ml-1.h-1) did
      not change with training.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758291
TI  - Regulation of Ca(2+)-signaling in cardiac myofilaments.
AB  - The contraction and relaxation of heart muscle cells is associated with a
      transient change in the intracellular level of free Ca2+. This transient reflects
      a release from the sarcoplasmic reticulum of Ca2+ ions that turn on the reaction
      of myosin cross-bridges of the thick filaments with actin of the thin filaments.
      Without this transient no contraction occurs. The first part of this paper is
      concerned with the molecular processes by which Ca2+ signals the actin-myosin
      reaction. It will show that the activation in reality involves release of the
      thin filaments from a prevailing inhibited state. The inhibited state depends on
      the activity of the troponin (TN) complex and tropomyosin (TM); disinhibition
      requires Ca(2+)-binding to TN. The second part of the paper describes evidence
      that the signaling process is itself modulated by the mechanical and chemical
      state of the myofilaments in the short term and by altered gene expression in the
      long term.

PMID- 1758292
TI  - Modulation of cardiac contractility by myosin light chain phosphorylation.
AB  - Cytosolic free [Ca2+] ([Ca2+]c) mediates primary regulation of cardiac
      contractility. Both the magnitude and time-course of [Ca2+]c transient that is
      elicited by a sarcolemmal action potential play central roles in defining the
      characteristics of the mechanical response that occurs during a single excitation
      contraction coupling cycle. Numerous modulators of cardiac contractility, both
      hormonal and autoregulatory, act to influence contractile function via direct
      effects on various cellular processes that govern [Ca2+]c dynamics. Cardiac
      contractility can also be influenced by mechanisms that alter the responsiveness
      of the contractile element to activation by Ca2+ (see preceding paper). There is
      growing interest in the possibility that the phosphorylation of the P-light chain
      subunit of cardiac myosin by a Ca(2+)-calmodulin-dependent myosin light chain
      kinase may modulate cardiac muscle contractility by increasing the sensitivity of
      the contractile element to activation by Ca2+. The types of experimental data
      that have led to the development of this hypothesis and the unique aspects of
      cardiac P-light chain phosphate content regulation will be briefly addressed in
      this paper. Furthermore, several unresolved issues regarding the functional
      significance of cardiac P-light chain phosphorylation in intact myocardium are
      identified.

PMID- 1758293
TI  - Leisure physical activity and age at menarche.
AB  - Early menarche has been associated with higher risk of breast cancer. A
      prospective study of 2487 girls, has been conducted in Quebec City, Canada, to
      evaluate the relationship of exercise to menarche, taking personal and family
      characteristics into account. Weight, height, body mass index, and abdominal and
      supra-iliac skinfolds were inversely associated with age of menstruation.
      Mother's age at menarche was positively associated with age of menstruation. Age,
      mother's age at menarche, and weight-adjusted incidence density ratios (IDR)
      showed no association between energy expenditure and onset of menstruation. Girls
      who participated in dance, gymnastic figure skating, synchronized swimming, or
      diving competitions had a lower risk of reaching menarche at an early age (IDR =
      0.71 (0.51-0.97)).

PMID- 1758294
TI  - Potential misclassification in studies of physical activity.
AB  - Regular physical activity is associated with a reduced risk of coronary heart
      disease, although debate still occurs over the level of intensity required for
      cardioprotection. The use in epidemiological studies of the arbitrarily defined
      categories of light, moderate, and hard, as proxy measures of relative intensity
      has administrative merit but risks potential misclassification, particularly in
      women and the elderly. This potential misclassification is the result of the
      inappropriate categorizing of activity based upon absolute intensity values
      regardless of age or gender. Coronary heart disease is more common in the elderly
      and recent activity more important than remote for cardiac benefit. It is thus
      essential to resolve the issue of the level(s) of exercise intensity needed to
      provide health benefits. Only when this information is available will it be
      possible to give rational and safe public health advice.

PMID- 1758295
TI  - Lumbar spine loads during the lifting of extremely heavy weights.
AB  - The reaction moments at the knee, hip, and L4/L5 joints, and the compressive and
      shearing forces on L4/L5 are documented in powerlifters competing in a national
      powerlifting championship. Analyses were made of 13 female and 44 male
      competitors. The joint moments and forces were estimated from a linked segment
      model (WATBAK) that incorporated functional low back extensor musculature with a
      moment arm of 6 cm and a line action that was oriented 5 degrees posteriorly to
      the L4/L5 compression axis. This oblique orientation of the extensor muscles
      reduced the anterior shearing load on the vertebral motion unit. Average
      compressive loads on L4/L5 were estimated up to 17,192 N while the highest
      average L4/L5 and hip moments were 988 and 1047 N.m, respectively. The sumo
      deadlift style resulted in a 10% reduction in the joint moment and 8% reduction
      in the load shear force at the L4/L5 level when compared with the conventional
      lifting style. Formulation of linear regression equations to predict the load
      lifted using reaction joint moments yielded substantial unexplained variability,
      though significant relationships were found. This analysis suggested that there
      is large variability in the pattern of loading joints among national class
      powerlifters.

PMID- 1758296
TI  - Electromechanical delay during knee extensor contractions.
AB  - The purpose of this study was to investigate the magnitude of electromechanical
      delay (EMD) and its possible dependence on muscle type, type of contraction,
      fatigue, level of force, initial muscle length, and muscle contraction velocity.
      This was achieved using an experiment that measured voluntary knee extensor
      torques and surface EMG activity for a variety of different contractile
      conditions in seven male subjects. EMD values were obtained using a cross
      correlation technique in three experimental KIN-COM dynamometer conditions of
      vastus medialis, rectus femoris, and vastus lateralis. In the first condition, a
      series of 10 repetitive submaximal (50% and 70% MVC) isometric knee extensor
      contractions were performed at knee angles of 90 degrees and 130 degrees
      extension. In the second condition, 10 maximal isokinetic knee extensor
      contractions were performed during passive shortening and lengthening. As such,
      the dynamometer was used to passively move the knee joint at 30 degrees.s-1 and
      60 degrees.s-1. Both during lengthening and shortening, the contractions occurred
      at an angular position of 110 degrees. In the last condition, a repetitive
      submaximal isometric knee extensor fatigue test was performed for 100 s (150
      contractions). At 10, 40, and 90 s during the time course of this fatigue test, a
      series of 10 contractions were recorded. To avoid a phase lag, which is
      introduced with one-way filtering, the EMG was processed with a bidirectional low
      pass filter application. A significant main effect in EMD for the factor level of
      force was found. The EMD values obtained at a force level of 50% MVC were longer
      than at 70% MVC (107 vs 98 ms).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758297
TI  - Injuries and adherence to walk/jog and resistance training programs in the
      elderly.
AB  - To evaluate the effects of 26 wk of aerobic and resistance training on the
      incidence of injury and program adherence in 70- to 79-yr-old men and women, 57
      healthy volunteers (25 males, 32 females) were randomly assigned to a walk/jog
      (W/J, N = 21), strength (STREN, N = 23), or control (CONT, N = 13) group.
      Walk/jog training was for 30-45 min, 3 d.wk-1 with intensity equal to 40-70%
      heart rate max reserve (HRmax reserve) during the first 13 wk, and 75-85% HRmax
      reserve for weeks 14-26. STREN training consisted of one set (10-12 repetitions)
      each of 10 variable resistance exercises performed to volitional fatigue. Forty
      nine of the original participants completed the training program. Walk/jog
      training increased VO2max from 22.5 to 27.1 ml.kg-1.min-1 (P less than or equal
      to 0.05) while STREN and CONT showed no change. STREN improved significantly in
      chest press and leg extension strength (P less than or equal to 0.05) while W/J
      and CONT showed no change. Adherence to training was 20/23 (87%) and 17/21 (81%)
      in STREN and W/J, respectively. One repetition maximum (1-RM) strength testing
      resulted in 11 injuries in the 57 subjects (19.3%) while STREN training resulted
      in only two injuries in 23 subjects (8.7%). Walk training during weeks 1-13
      resulted in one injury in 21 subjects (4.8%). Eight of 14 subjects (57%) who
      began jogging intervals at week 14 incurred an injury: two of eight (25%) of the
      men and all of the women (6 of 6). All W/J training injuries were to the lower
      extremity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758298
TI  - Daily variation in gastric emptying when using the double sampling technique.
AB  - The purpose of this study was to establish the intra-individual variation in the
      rate of gastric emptying (GE) by using the double sampling technique of George.
      Eight healthy male volunteers, all familiar with gastric intubation and testing,
      participated in four GE tests, using an isotonic fluid as a test meal. Conditions
      were kept constant during all four tests, and each test was separated by at least
      48 h. The within-subjects coefficient of variation proved to be 29%. The findings
      demonstrate that, given standard conditions, GE is reproducible from day to day.

PMID- 1758299
TI  - Effect of phonophoresis on serum salicylate levels.

PMID- 1758300
TI  - Can we have a distinctive theory of memory?
AB  - The current status of the concept of distinctiveness an applied to memory
      research is discussed. In spite of the fact that distinctiveness is difficult to
      define, an increasing number of memory phenomena have been explained in terms of
      distinctiveness. These phenomena are grouped into four classes, which vary in how
      distinctiveness is operationalized. Distinctiveness has different effects on
      memory performance, depending on how it is defined, suggesting that the concept
      of distinctiveness has been overapplied. In addition, current theoretical
      explanations of the effects of distinctiveness on memory fail to specify what the
      different definitions of distinctiveness have in common, and fail to encompass
      adequately the broad range of phenomena to be explained. A limited theory of
      distinctiveness is proposed, in order to explain why conceptually incongruent
      material is remembered well.

PMID- 1758301
TI  - Problem-oriented training promotes spontaneous analogical transfer: memory
      oriented training promotes memory for training.
AB  - Spontaneous analogical transfer is the use of information from one problem to
      solve another problem, without an explicit hint to use the previous information.
      The results of five experiments were that if subjects tried to solve a training
      problem before hearing its solution, or tried to explain a training story's
      solution before hearing the correct explanation, spontaneous transfer was more
      likely than it was if subjects had studied the same training passage for memory
      before hearing its solution or explanation. The advantage of problem-oriented
      processing over memory-oriented processing occurred even though solution attempts
      nearly always failed, and the advantage was not reduced if the target problem was
      tested 15 min later rather than immediately after training. We propose that
      problem-oriented processes performed at study are appropriate processes to use at
      test. Further support for the account comes from subjects' memory for the
      training passages; the advantage for problem-oriented processing on solution
      tasks was mirrored by an equally substantial advantage for the memory-oriented
      subjects on a recall task.

PMID- 1758302
TI  - Mental rotation of compound stimuli: the effects of task demands, practice, and
      figural goodness.
AB  - Four experiments examined whether or not mental rotation of compound stimuli is a
      holistic process. Large letters (global aspect) composed of small letters (local
      aspect) were presented, and the format (normal vs. reflected) of each aspect was
      manipulated independently. In Experiment 1, the rate of mental rotation was
      compared under divided- and focused-attention instructions. The overall rate of
      mental rotation was faster under focused-attention instructions than under
      divided-attention instructions. Also, contrary to previous findings, in the
      divided-attention task, the slope of the rotation function was smaller when the
      stimulus configurations contained aspects with congruent formats (both aspects
      were normal or mirror-reversed letters) than when they contained aspects with
      incongruent formats (one normal and one mirror-reversed letter). This pattern of
      results is unlikely to be caused by the subjects' level of familiarity with the
      divided-attention task (Experiment 2), by postrotation processes (Experiment 3),
      or by stimulus attributes (figural goodness) confounded with the format
      congruency variable (Experiment 4). The implications of these results for models
      of mental rotation of compound stimuli are discussed.

PMID- 1758303
TI  - Phonological assembly in reading: lexical contribution leads to violation of
      graphophonological rules.
AB  - According to current models of reading, the phonological representation of a
      letter string could be generated by means of two different procedures. The first
      consists in the looking up or addressing of the phonological representation of
      the appropriate word in the mental lexicon. The second consists in the assignment
      of a phonological code to the various orthographic units that occur in the letter
      string and the assembly of them into a unitary phonological representation.
      However, the various models of phonological assembly differ in the nature of the
      knowledge that such assembly requires. On the one hand, dual-route theories
      assert that the assembly process operates by means of extralexical
      graphophonological rules and, therefore, without reference to lexical knowledge.
      On the other hand, in analogy theories and interactive models of phonological
      assembly, the lexical phonological representations of words orthographically
      close to the letter string (the orthographic neighborhood) are supposed to
      contribute to the translation process. The aim of the experiments reported here
      was to empirically distinguish between these two categories of models. In
      Experiment 1, subjects were asked to pronounce pseudowords containing the letter
      g. Results indicate that the phonological representation assigned to the letter g
      depends on the pronunciation favored by the lexical neighbors. Experiment 2 shows
      that lexical contribution to phonological assembly also takes place in lexical
      decision.

PMID- 1758304
TI  - Spacing judgments as an index of integration from context-induced relational
      processing: implications for the free recall of ambiguous prose passages.
AB  - The effect of information integration on the recall of ambiguous prose passages
      was investigated. In Experiment 1, subjects read ambiguous passages that were
      difficult to comprehend without titles. In judging the relative positions in the
      passages of pairs of test sentences, subjects performed better when they read
      passages headed by a suitable title than when they read untitled passages or
      received a title at the time of testing. In Experiment 2, subjects provided with
      a title at encoding also better discriminated complete old sentences from foils
      composed of fragments of two different old sentences than did subjects provided
      with no titles or with titles at the time of testing. These two tests index the
      degree of inter- and intrasentence information integration, respectively. Two
      findings indicated that integration affected free recall of an ambiguous passage.
      First, when the degree of integration of the passage's propositions was
      controlled, free recall of the passage was no different for subjects who did or
      did not know the passage's title at encoding. Second, inducing subjects to
      comprehend the passage's sentences individually, without relating them to one
      another, reduced free recall of the passage.

PMID- 1758305
TI  - A bias in favor of the positive response to high-frequency words in recognition
      memory.
AB  - A relatively liberal response bias for high-frequency words and a violation of
      the mirror effect for hit and false-alarm rates were found in a yes-no
      recognition-memory test. Subjects more frequently responded "old" to high
      frequency words than to low-frequency words. Four experiments were conducted to
      determine the causes of the different response biases and of the violation of the
      mirror effect. The word-frequency effect on hit rates did not appear, whereas the
      false-alarm rate for low-frequency words was lower than that for high-frequency
      words. When low- or high-frequency words were presented separately in distinct
      halves of a recognition-memory test, the relatively liberal response bias for
      high-frequency words was diminished. A model for recognition judgment is proposed
      that assumes the use of a common criterion for low- and high-frequency words.

PMID- 1758306
TI  - Forgetting in recognition memory with and without recollective experience.
AB  - Retention interval was manipulated in two recognition-memory experiments in which
      subjects indicated when recognizing a word whether its recognition was
      accompanied by some recollective experience ("remember") or whether it was
      recognized on the basis of familiarity without any recollective experience
      ("know"). Experiment 1 showed that between 10 min and 1 week, "remember"
      responses declined sharply from an initially higher level, whereas "know"
      responses remained relatively unchanged. Experiment 2 showed that between 1 week
      and 6 months, both kinds of responses declined at a similar, gradual rate and
      that despite quite low levels of performance after 6 months, both kinds of
      responses still gave rise to accurate discrimination between target words and
      lures. These findings are discussed in relationship to current ideas about
      multiple memory systems and processing accounts of explicit and implicit measures
      of retention.

PMID- 1758307
TI  - Investigation of osmotically stable spheroplasts from two strains of Escherichia
      coli ML-35, W7-M5.
AB  - Osmotically stable spheroplasts were produced from Escherichia coli ML-35 and W7
      M5 using either 1 min exposure to polymyxin B or 10 min exposure to Tris/EDTA,
      followed by 1 to 3 h incubation with lysozyme. Spheroplast membrane permeability
      studies were conducted using paired radioactive probes with E. coli ML-35.
      Experiments with 14C-sucrose-16 kD 3H-dextran indicated that the outer membrane
      had lost its barrier to 16 kD dextran. Parallel experiments with 81 kD 3H-dextran
      indicated that the outer membrane was impermeable to the larger dextran. EDTA
      treated cells also showed outer membrane permeability to 16 kD dextran.
      Cytoplasmic membrane integrity was confirmed using 14C-sucrose and 3H2O before
      and after exposure to polymyxin B and EDTA. Scanning electron microscopy showed
      that a rough surface on polymyxin B produced spheroplasts while Tris/EDTA
      spheroplasts showed the same smooth surface as control cells.

PMID- 1758308
TI  - Haemagglutination inhibition antibody levels one year after natural measles
      infection and vaccination.
AB  - An assessment of haemagglutination inhibition antibody (HAI) titres of 1,163
      children, comprising 739 recipients of live measles vaccines and 424 patients
      with natural measles infection after 1 year was made in this investigation.
      Statistical analysis revealed a significant difference in the levels of HAI
      antibodies. Of the vaccinated children a significant 67.45% showed antibody
      titres of less than or equal to 1:16, while only 23.48% of children with natural
      measles showed these antibody titres. The importance and implication of such HAI
      antibody titres is discussed.

PMID- 1758309
TI  - Effect of Cd2+ on phosphate uptake by cadmium-resistant and cadmium-sensitive
      Staphylococcus aureus.
AB  - The effect of Cd2+ on phosphate (Pi) uptake was investigated in the growing cells
      of Cd(2+)-resistant Staphylococcus aureus 1781OR and Cd(2+)-sensitive S. aureus
      17810S. Inhibitor and ionophore studies showed that 32Pi uptake in the two
      strains occurred via the Pi porter down pH gradient (delta pH) generated by the
      respiratory chain. Cd2+ inhibited 32Pi uptake in the cadmium-sensitive strain
      1781OS at all concentrations used (10 microM-1 mM). In strain 1781OR, possessing
      the plasmid-coded Cd2+ efflux system, 10-100 microM Cd2+ did not inhibit 32Pi
      uptake. Even at 1 mM Cd2+, inhibition of 32Pi uptake in strain 1781OR was
      reversed when the external Cd2+ was chelated with cysteine and activity of Cd2+
      efflux system was restored. Cd2+ efflux induced by cysteine was energized either
      by membrane potential (delta psi) or by delta pH, which indicated that
      electrochemical gradient of protons (delta mu H+) was required for this efflux.

PMID- 1758310
TI  - Changes in cell envelope glycoproteins during germ-tube formation of Candida
      albicans.
AB  - Germ-tube formation by Candida albicans induced by N-acetylglucosamine resulted
      in the appearance of a 43 kD protein in a cell envelope fraction. The protein
      increased quantitatively in the cell envelope during the emergence of the germ
      tube and the amount in the envelope fraction reflected the efficiency of the
      morphogenesis. The 43 kD protein was labelled by the lactoperoxidase catalysed
      iodination procedure confirming a surface location for the antigen. Concanavalin
      A binding to the 43 kD protein demonstrated that this protein contained
      carbohydrate. Tunicamycin inhibited both germ-tube formation in C. albicans and
      the appearance of the 43 kD protein in the cell envelope fraction. Instead the
      presence of tunicamycin resulted in the appearance of a new protein of 39 kD
      molecular weight in the cell envelope which did not bind concanavalin A.
      Endoglycosidase H digestion of the 43 kD protein produced a 39 kD protein.
      Peptide mapping of the 43 kD protein from germ-tube cells and the 39 kD protein
      from tunicamycin-treated cells indicated that these proteins are homologous.

PMID- 1758311
TI  - Training young doctors: everybody's problem.

PMID- 1758312
TI  - The observed long-case in clinical assessment.
AB  - The University of Adelaide has developed a comprehensive approach to final-year
      clinical assessment through the use of ward ratings during student internships
      and the administration of an objective examination of clinical competence at the
      end of the year. The traditional clinical viva has been retained only to make
      pass-fail decisions on borderline students. Problems in making these decisions
      prompted a modification of the viva so that each student undertook two long
      cases, each being observed by a pair of examiners. Better agreement among
      examiners and more effective decision-making seemed to ensue. The success of this
      approach led to the introduction of observed long-cases into the ward setting.
      This move has been strongly supported by staff and students. The opportunities
      for remedial action during the course were regarded as particularly valuable.
      This approach may offer a practical alternative to more sophisticated assessment
      techniques, such as those involving standardized patients, without the need for
      additional resources. However, psychometric studies will have to be performed
      before the approach can be fully recommended.

PMID- 1758313
TI  - Parental problems influencing the academic achievement of medical students: a
      prospective study.
AB  - The 227 students offered places in the 1988 medical student intake at the
      University of Queensland were surveyed regarding their demographic
      characteristics. This was correlated with the students' subsequent performance
      and persistence during the first year of the medical course. Coming from a lower
      socioeconomic background and having family problems were both associated with
      either a decreased academic performance or an increased attrition rate. The
      results are discussed, relevant literature is reviewed and suggestions for
      further research are made.

PMID- 1758314
TI  - Changes in students' attitudes and values during medicine versus surgery
      clerkships.
AB  - A prospective study of students' attitudes and values was conducted during
      medicine and surgery clerkships over the first clinical year. Students who
      finished the surgery clerkship first were more cynical and intolerant of
      ambiguity than the medicine students. Surgery students also felt they lacked self
      confidence and had stronger feelings of being victimized. Cynicism and attitudes
      towards ambiguous situations improved during the medicine clerkship. Feeling
      victimized was strongly correlated with their problems with self-confidence, with
      cynicism, and a feeling of having to submit to authority figures. The findings of
      this study suggest that the clerkship order significantly affects the development
      of students' attitudes. Students also became more punitive and less confident as
      the first clinical year progressed. The implications of these changes in attitude
      on educational planning are discussed.

PMID- 1758315
TI  - A comparison of computer-assisted instruction and small-group teaching of cardiac
      auscultation to medical students.
AB  - Cardiac auscultation is suffering from declining interest, caused by competing
      diagnostic technology and inadequate training of doctors. Computer-assisted
      instruction (CAI) supporting graphics and digitized sound could be ideally suited
      for teaching and sharpening this skill. To evaluate this premise we randomized 35
      third-year medical students to 3 hours of seminar teaching plus the use of
      audiotapes (group 1), the self-use of a MacIntosh-based CAI (group 2), or both
      (group 3). All students took a pre- and post-test consisting of eight pre
      recorded cardiac events and were also assessed for computer anxiety. Although
      there were no significant differences between pre- and post-tests for each group
      and among groups, group 1 had a 4.5% deterioration in its diagnostic score
      compared to the 7.2% and 3.2% improvements of groups 2 and 3 respectively. Group
      2 used the CAI significantly more than group 3. We conclude that CAI is at least
      as effective as seminars in teaching cardiac auscultation to third-year medical
      students.

PMID- 1758316
TI  - Student characteristics as predictors of drop-out from medical school: admissions
      to Beer-Sheva over a decade.
AB  - The study sought to identify variables from the demographic, socio-economic,
      academic and personal background of medical students in order to reveal possible
      predictors of drop-out from medical school. The research included 443 students
      who were admitted to Ben Gurion University (BGU) Medical School during its first
      10 years, 1974-1983. It was found that the permanent drop-out rate in BGU Medical
      School (12.6%) is relatively high and mainly due to academic failures. Of all
      admitted students 11.3% do not graduate on time due to academic reasons. The
      findings are discussed and suggestions for changes in admissions policy are
      provided.

PMID- 1758317
TI  - The construction of a 'topic tree': a way of familiarizing a teaching staff to
      problem-oriented learning in a master's programme in public health.
AB  - At the planning stage of a community-oriented and problem-based learning master's
      programme in public health it is indispensable to build a network of teachers,
      experts in specific fields, willing to guide the students in acquiring new
      competencies and ready to facilitate the experimental learning process. We
      discuss in this paper the construction and the utilisation of the 'topic tree'.
      In addition we show how the teaching staff get acquainted with that educational
      methodology by experimenting with it themselves (prior to the students). About 10
      experts, each one a specialist in a given field, have conceptualized their
      approach in building a topic tree (concept tree); such a tree makes it possible
      to schematize the topics to be understood in order to solve a given problem and
      the relationship existing between actions to be undertaken. The experiment, meant
      to initiate the teaching staff in experimental learning procedures, was
      appreciated by all the experts, who considered it a creative and stimulating
      method. It also permitted the construction of a bibliography including key
      documents concerning each identified priority health problem. We discuss the
      utility and the relevance of our approach in the perspective of initiating
      teachers in experiential learning based on problem-solving.

PMID- 1758318
TI  - Continuing medical education and career choice among graduates of problem-based
      and traditional curricula.
AB  - A survey was conducted among graduates of two Canadian medical schools who have
      been in practice for more than 9 years. The purpose of the study was to test the
      hypothesis that graduates of a problem-based curriculum differ from graduates of
      a traditional curriculum in their attitude to and participation in continuing
      medical education (CME) activities. Differences were noted in the rate of
      participation in certain CME activities (attendance at national and international
      conferences and meetings) between specialists and family doctors in both groups
      of alumni. However, the data indicate that the differences in learning-teaching
      methods employed in the course of the undergraduate medical curriculum do not
      exert a decisive influence upon the learning habits of the graduates.

PMID- 1758319
TI  - Student-directed problem-based learning in general practice and public health
      medicine.
AB  - The development and implementation are described of a new 6-week course in
      general practice and public health medicine for final-year medical students. This
      course is based on the principles of student-directed problem-based learning in
      small groups and makes substantial use of student attachments to local general
      practices which act as learning resources. Student assessment is by profiles.
      Course evaluation is by qualitative feedback, and the results of this are
      presented. The course offers a flexible learning environment in which the aims of
      its designers and the goals of their students can be achieved.

PMID- 1758320
TI  - Profile of doctors who participate in continuing medical education in Malaysia.
AB  - A random survey of 400 doctors was carried out over a period of 3 months to
      determine the factors that would facilitate or inhibit the participation of
      doctors in continuing medical education (CME) in Malaysia. Regular participation
      in CME was defined as participation in any activity (self-directed reading or
      attending organized activities) at least once a month during the past year. It
      was found that 78% of doctors regularly participated in CME. Working in a
      hospital environment and being members of the Malaysian Medical Association and
      at least one specialty organization appeared to be important facilitatory factors
      in CME participation. These doctors also read the local medical journals
      regularly and subscribed to other journals. In addition, they were more likely to
      possess postgraduate qualifications and would have teaching, research, diagnostic
      or clinical responsibilities as major components of their work. They were more
      likely to practise in the big cities and would tend to be active in at least one
      voluntary or social organization. If they were in the Government sector, they
      were more likely to work in the Universities or in the Hospital Division of the
      Ministry of Health. The 22% who were less likely to participate in CME were
      general practitioners in the private sector. They worked long hours with day,
      evening and/or night shifts every day. If the doctors were in the Government
      sector, they were more likely to be in the Health Division, working in
      administration and public health, or they were in the armed forces and other
      organizations such as local councils. They worked in the smaller towns or in the
      districts.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758321
TI  - Clinical information in psychiatric practice: what do doctors know, what do they
      think is known and what do they record?
AB  - Deficiencies in recording clinical information are a widespread problem in both
      psychiatry and medicine. Previous studies have not established whether
      information not recorded in the notes is nonetheless known to clinicians. This
      study compared both the information known to individual clinicians and that
      recorded in the notes with previously established criteria. Overall, individual
      clinicians recalled more information than was recorded in the notes (median
      values: clinicians 47-63% of criteria; notes 42%) and when all this individual
      knowledge was pooled, 88% of the preset criteria were satisfied. Consultants, but
      not more junior staff, recalled significantly more about subsections of the
      history which they considered to be especially relevant to the management plan
      for a given patient. Only a third of data not known to clinicians, but thought by
      them to be recorded in the notes, was actually present. The implications of these
      findings for clinical audit and medical education are discussed.

PMID- 1758322
TI  - Training general practitioners to teach psychiatric interviewing skills: an
      evaluation of group training.
AB  - Group teaching in problem-based interviewing based on video and audiotape
      feedback of the doctor's own consultations significantly improved the ability of
      experienced general practitioners to teach psychiatric skills to their trainees.
      When the GPs were randomly allocated to one of three further training experiences
      -video feedback of their tutorial sessions, discussion about how to teach and no
      further teaching, there were very few differences between the groups. The
      greatest impact on improving teaching skills was brought about by watching their
      own consultations in a group feedback setting.

PMID- 1758324
TI  - Postgraduate medical examinations.

PMID- 1758323
TI  - Proposed changes in medical education in Czechoslovakia.

PMID- 1758325
TI  - Permanent Working Group of European Junior Hospital Doctors. Policy statement on
      postgraduate medical education in general practice. Prepared by the Subcommittee
      on Postgraduate Medical Training.
AB  - The Permanent Working Group of European Junior Hospital Doctors' Policy Statement
      on Postgraduate Medical Education reviewed the regulations governing postgraduate
      training in the European Communities and set out educational principles which the
      Group believed were applicable in all medical disciplines. Recognizing that the
      training of general practitioners poses some specific problems, the PWG has
      adopted this further statement on training in general practice. It reaffirms the
      need for trainees to have a model of good practice, extensive experience,
      theoretical teaching, critical scrutiny and regular, unambiguous feedback
      regarding progress. In addition, it argues for the availability of an appropriate
      number of posts for GP trainees both in hospitals and in practices and an
      awareness among hospital-based trainers of the educational needs of trainees who
      intend a career in general practice.

PMID- 1758326
TI  - Approaches to learning of students in an Indonesian medical school.
AB  - This paper reports on a study of approaches to learning of undergraduate medical
      students in the University of Gadjah Mada, Indonesia. The Lancaster Approaches to
      Studying Inventory was translated into Indonesian and the translated form pilot
      tested. The instrument was then completed by 90 students, 30 each in first,
      second and fifth year in the Faculty of Medicine. It was found that Indonesian
      students generally gave higher rates than previous studies have reported. Factor
      analysis of their responses showed strong resemblances to other groups in the
      factors of meaning and reproducing orientation. Differences found in Indonesian
      students' responses were in strategic and non-academic orientations. There were
      differences between the response patterns of first-, third- and fifth-year
      students. It is concluded that the instrument is valid for use in Indonesia.

PMID- 1758327
TI  - Complementary value of traditional bedside teaching and structured clinical
      teaching in introductory surgical studies.
AB  - A prospective randomized trial was conducted to see if student performance in a
      combined multiple choice and objective structured clinical examination was better
      following a period of structured clinical teaching compared with traditional
      bedside teaching. Student groups were crossed over in a second phase of the
      experiment to allow the two teaching techniques to be compared sequentially in
      the same group. There was no significant difference between the two teaching
      techniques as measured by performance in a criterion-referenced examination. The
      results of the study led to modification of the curriculum for third-year
      introductory surgical studies to incorporate both teaching strategies, which are
      regarded as complementary in value.

PMID- 1758328
TI  - Self-assessment and learning through GOSCE (group objective structured clinical
      examination).
AB  - The objective structured clinical examination (OSCE) was modified to serve as a
      means of self-assessment and learning, rather than as an examination. The main
      modifications were to adapt it for use by small groups instead of individuals,
      and to provide a correct answer or other feedback at each station. The resulting
      group OSCE (GOSCE) was used as an introductory session in two residential
      refresher courses for general practitioners. The 300 participants rated it highly
      as a method of self-assessment and as an enjoyable social event. Four potential
      applications of the GOSCE are suggested: as an assessment instrument for
      formative and informal summative assessment, as a resource for learning about
      interpersonal and interprofessional relationships, and as a framework for problem
      based short courses.

PMID- 1758329
TI  - The cognitive context of examinations in psychiatry using Bloom's taxonomy.
AB  - Psychiatric practice involves complex thinking patterns. In addition to
      commanding a huge number of facts, the student must learn to manipulate factual
      knowledge to solve diagnostic problems, develop treatment plans, and critically
      evaluate those plans. This study demonstrates an empirical method for evaluating
      the level of cognitive processes tested in multiple choice examinations. Use of
      Bloom's taxonomy in evaluating test items demonstrated the majority of test items
      on a psychiatry clerkship examination and a resident in-training examination fell
      into the most basic cognitive level, that of simple recall. The utility of
      Bloom's taxonomy is discussed along with implications for medical education.

PMID- 1758330
TI  - Supervised role-play in the teaching of the process of consultation.
AB  - Supervised role-play is presented as a method for teaching the process of the
      medical consultation. The process of the consultation is reviewed and a brief
      description of supervised role-play is given with some of its advantages and
      disadvantages. Some simple devices used in the method are explained with
      examples. The 'living' nature of the consultation is emphasized and an active
      method of teaching is advocated.

PMID- 1758331
TI  - Death, dying and the medical student.
AB  - The objective of this study was to determine the extent of medical students'
      experience of death and dying. A questionnaire was given to two groups of
      Birmingham medical students at the beginning of clinical studies (third year) and
      in the final year which was designed to estimate their experience of death and of
      dying people. The questionnaire also explored the students' attitudes to their
      own future deaths. Questionnaires were returned by 119 third-year and 143 final
      year students. Students had little experience of death and what they did have was
      largely acquired before entry to medical school or in their social rather than
      medical lives. Where they did have experience of death this was often traumatic
      and there was little chance for them to have counselling about it. There is need
      for increased teaching about death and dying particularly before clinical
      training and at the time of graduation. Another time may be at the beginning of
      human dissection.

PMID- 1758332
TI  - Study approaches of nursing students: effects of an extended clinical context.
AB  - In the first part of this study a comparison is made between the approaches to
      studying adopted by failing and achieving nursing college students. It is
      concluded that failing students manifest approaches to studying that are, in some
      respects, conceptually difficult to interpret. This conclusion is presented
      against a background of similar findings that have emanated from other recent
      studies on student learning. The second part of this study investigates the
      influence of contextual perceptions on the manifestation of the approaches to
      studying adopted by achieving students. In thus exploring the manifestation of
      different forms of contextualized approaches to studying (which are referred to
      as study orchestrations) a distinction is made between the influences
      attributable to 'conventional' and 'clinical' sets of contextual variables. In an
      extension of previously reported studies, it is concluded that the combined set
      of these contextual variables explains significantly more of the variation in
      study approaches than the set of 'conventional' variables. It is further
      concluded that, under the influence of an extended set of contextual variables,
      conceptually related, but differing forms, of study orchestration may be
      manifested; a general form which is readily interpretable in terms associated
      with 'conventional' academic contextual variables and a clinical form which, in
      the present study, is associated specifically with a nursing academic
      environment. The implications of these conclusions for nursing education are
      discussed and areas for future research are indicated.

PMID- 1758333
TI  - Effects of communication skills training on students' diagnostic efficiency.
AB  - This study evaluates the impact of a training programme in communications skills
      on subsequent diagnostic efficiency. Videotaped history-taking interviews
      conducted by groups of specially trained and control groups of students were
      rated for their diagnostic efficiency by two medical practitioners. Students in
      the trained group had shown greatly increased skills in interviewing and
      interpersonal effectiveness as a result of their training. A comparison of
      ratings given by the two experimentally naive, independent observers revealed
      that trained students were significantly better at eliciting full, relevant data
      from patients--they were diagnostically more efficient, but took no longer than
      their control group counterparts to elicit the information. Further research with
      the medical interview rating scale will clarify the skills required of medical
      students in interviewing and diagnosis and facilitate remedial training for
      students who show poor interview skills.

PMID- 1758334
TI  - Developmental accounts of the transition from medical student to doctor: some
      problems and suggestions.
AB  - This paper is concerned with the difficulties in integrating the results of
      recent cognitive research on expert-novice in clinical reasoning. The focus is on
      the issue of stage theories as a means of achieving such integration. Objections
      to the use of such theories in developmental psychology are reviewed. In light of
      these objections, it is argued that it is important to distinguish between stage
      theories and stage-like phenomena. It is concluded that a stage theory is not
      likely to provide adequate integration. Some alternative explanations, which
      include both cognitive and non-cognitive factors, are discussed.

PMID- 1758335
TI  - Awareness of drug costs among general practitioner trainees.

PMID- 1758336
TI  - Non-cognitive components in the selection and training of medical students.

PMID- 1758337
TI  - Problem-based learning and community-oriented medical education.

PMID- 1758338
TI  - Content validity of objectified tests.

PMID- 1758339
TI  - [How to identify an aspecific association? Epidemiological considerations on the
      study of health of office workers].
AB  - An epidemiological approach to the study of health conditions of office workers.
      Nowadays the work-relatedness of the majority of diseases occurring at the
      workplace is by no means obvious. The relationship to work environment and
      performance of work is one of several causative factors. However, the
      multifactorial origin of diseases is not at all a new concept since principles
      and methods for the study of the numerous factors playing a role in any
      association between exposure and disease are already available. The model of
      causal constellations developed by Rothman can be particularly useful for the
      investigation of "non-specific" associations, like those commonly occurring in
      office work. The study of the health conditions of office workers is faced with
      many difficulties, including the identification, measurement and classification
      of exposure variables and health outcomes. In designing these studies, particular
      attention should be devoted to aspects regarding sample size, length of
      observation and referent population.

PMID- 1758340
TI  - [Health risks for waste disposal industry workers].
AB  - Waste disposal currently constitutes a major public health problem in Italy and
      other industrialized countries. In view of the increasing volume of waste
      accumulated and disposed of without control, there is now an ever pressing need
      for regulated disposal that involves minimum risk for the environment and the
      community. Hence a new industrial sector has emerged that is highly specialized
      and varied, on account of the wide field of activity and technology, from
      collection and storage of refuse, processing and definitive disposal, to
      reclamation and improvement of illegal dumps. The industrial waste sector has not
      been fully developed and it is currently believed that most disposal is performed
      without sanitary control. Little attention has been given to the environmental
      impact of these operations and similarly little is known of the possible health
      effects for the operators. Acquisition of toxicological and health data is
      therefore essential to establish correct and appropriate regulations for the
      development of this industrial sector. An objective risk evaluation will require
      filling in many information gaps, which are partly the results of a natural
      uncertainty surrounding any innovative process, but are above all due to the
      vastness of the problem that is not easily defined in concrete terms as regards
      types of waste and number of operators involved.

PMID- 1758341
TI  - [Problems and perspectives of occupational carcinogenesis].
AB  - Epidemiologic research has played an important role in identifying and confirming
      the carcinogenicity of chemicals. This was facilitated in the past by the high
      levels of exposure and by the simple correspondence between one exposure and one
      or few job titles. Today we are faced with a different picture: workers are
      exposed to complex mixtures, exposure levels have decreased while mobility of the
      work-force has increased. In this changing context, epidemiology needs new
      methodological tools to improve the validity of risk assessment. The most
      promising of these seem to be the new techniques of biochemical epidemiology and
      the development of job-exposure matrices. Among the more traditional tools,
      record-linkage studies may be relevant in identifying long-term occupational
      hazards. The methodological problems and the ethical and operative implications
      of these trends in research are discussed.

PMID- 1758342
TI  - Blood lead and erythrocyte protoporphyrin levels in the general population of an
      area in southern Italy.
AB  - Seven hundred and twenty subjects not occupationally exposed to lead were
      examined, among blood donors from a Bari hospital. Short case-histories were
      taken including personal data, residence, occupation, habits. The parameters
      considered were blood lead and protoporphyrin levels. The mean values found in
      Bari were respectively, 8.4 micrograms/100 ml, S.D. = 4.5 and 11.3 micrograms/100
      ml, S.D. = 10.9. The results show that, at present, reference values for blood
      lead levels in the population are lower than the limits set by D.P.R. No. 496/82
      which incorporates EEC directive No. 77/312 concerning biological monitoring of
      lead exposed populations.

PMID- 1758343
TI  - [Degenerative changes in the coxofemoral articulation due to occupational causes.
      I. Radiological description of a control population].
AB  - With a view to initiating epidemiological studies aimed at demonstrating the
      causal or concausal role of certain working activities in degenerative diseases
      of the coxo-femoral articulations, the authors report data from a radiological
      study of a reference population and the necessary conditions for their correct
      use. Statistical analysis of the descriptive features leads to some interesting
      observations on the evolution with age of the radiological picture of the coxo
      femoral joints (and on the aging of these joints). There was an increase with
      advancing age of some of the alterations that are characteristic of degenerative
      articular processes, such as sclerosis and osteophytosis. Reduction of articular
      "rima", however, occurs suddenly between the ages of 36 and 45 and does not seem
      to subsequently undergo any statistically significant evolution.

PMID- 1758344
TI  - [Sensitivity, precision and resolution of the optical microscope in the study of
      environmental pollution by asbestos fibers].
AB  - The authors comment on the methods and equipment used in two Italian laboratories
      for sampling and microscopic phase contrast analysis of asbestos and other
      respirable fibres in the air of the general environment, i.e., the Dust Analysis
      Laboratory, Industrial Hygiene and Toxicology Department of the Institute of
      Occupational Health (Clinica del Lavoro), University of Milan and the Technical
      Microscopy Laboratory, Ground Resources and Land Control (Georisorse e
      Territorio) Department of Turin Polytechnic, which use identical methods.
      Airborne dust samples are taken with personal samplers, 1 l/min air flow (sample
      duration 4-8 h), filtering air on 25 mm diameter, 0.8 micropore cellulose filters
      (about 300 mm total net surface of dust deposit). The following equipment is used
      for counting and analysis of fibres: a) Clinica del Lavoro, Milan: Polyvar
      Reichert-Jung microscope, 500 magnitudes, Zernike positive phase contrast;
      numerical counting on 100 whole ocular fields, equal to 6.38% of the total net
      surface of dust deposit on the membrane; b) Turin Polytechnic: Leitz Ortholux
      microscope, 500 magnitudes, Heine and Zernike phase contrast with mean standard
      contrast; numerical counting on square grid, with explored surface total equal to
      1.68% of the total net surface of dust deposit on the membrane. Measurements
      performed: Clinica del Lavoro, Milan: 2,980 since 1960; Turin Polytechnic: 875
      since 1965. The sensitivity of the methods for counting airborne fibres is
      discussed, concluding that the methods used by the two laboratories have a
      sensitivity between 0.05 and 1.6 fibre/litre of air, according to the overall
      dustiness of the environment under study. Analysis of the accuracy of the optic
      determinations, based on the repeated counts, shows a repeatability of 0.4 (40%)
      within 95% confidence limits. A resolution power of 0.35 microns is reported;
      however, the possibility exists (and is normally achieved in analytical practice
      in both laboratories) of identifying and counting fibrous elements up to 0.1-0.3
      microns in diameter; this is possible in particular conditions, i.e., when there
      is a marked difference between the "mean" refraction index of the fibres and that
      of the diaphanizing liquid. For qualitative determinations of the various types
      of asbestos, however, analyses are limited to diameters greater than 0.5-0.8
      microns, since it is necessary to be able to assess optical properties
      (refraction indices, basically). In the concluding discussion, comments and
      bibliographic references are also given concerning the comparisons with
      possibilities of studying fibrous particulate matter via electron microscopy.

PMID- 1758345
TI  - [Psychosocial factors and myocardial infarct].

PMID- 1758346
TI  - 'The creation of unimaginably large amounts of radioactivity'.

PMID- 1758347
TI  - The medical effects of postulated accidental release of radioactive material from
      Heysham Nuclear Power Station.
AB  - The effects of a postulated reactor accident at one of the four AGRs at Heysham,
      NW England, have been studied, assuming a 10% release of the radioactive core.
      Methods used are a computer program TIRION, analysis of the radiation doses from
      the Chernobyl release of 1986 and the Windscale fire of 1957. Fatal cases
      predicted are 200 on-site, 3000 within 30 km and 250,000 in the cloud paths over
      Northern England. The results would suggest the incidence of fatal cancer would
      increase from roughly 20% to 27% in the postulated exposed population of 3.6
      million.

PMID- 1758349
TI  - The effect of war on personal aggression.
AB  - The effect of war on the suicide rate and on the relative likelihood of suicide
      as a proportion of total personal aggression was examined in the United States
      for the time period from 1933 to 1986. Once unemployment was controlled for, no
      effect of war was detected.

PMID- 1758348
TI  - Chernobyl, four years on.
AB  - It is still too soon to make a full assessment of the Chernobyl disaster, but one
      should be begun, and practical inferences, with particular reference to the
      prevention of radiation-induced cancers, may be drawn.

PMID- 1758350
TI  - Iraq-occupied Kuwait: the health care situation. Conclusions. Physicians for
      human rights (Denmark and USA).

PMID- 1758351
TI  - [Treatment in the rupture of suppurating hepatic echinococcosis into the
      abdominal cavity].
AB  - The rational surgical methods of treatment in 85 patients with suppurative
      hepatic echinococcosis penetrating into the abdomen cavity are presented. The own
      author's techniques strictly individualized in each case are described in
      details. The classification of the variants of the complications and their
      clinical features are given. The advantage of the presented surgical methods has
      been proved by a reduction in the period of treatment, the number of
      intraabdominal complications and mortality rate.

PMID- 1758352
TI  - [The clinico-epidemiological characteristics of opisthorchiasis foci in the
      Yamalo-Nenets Autonomous Okrug and the treatment results with praziquantel].
AB  - A clinical and epidemiological study of opisthorchiasis foci in the Yamalo-Nenets
      Autonomous Okrug was carried out. 764 people were surveyed, including 473
      aborigines of the north, 207 denizens, and 84 migrants. Opisthorchiasis infection
      rate in villages was 40.5-45.7%. The intensity of infection was lower than 200
      eggs per g faeces. The modelling of opisthorchiasis prevalence performed after
      Muench showed the highest correlation with the "simple" and "reversible" models.
      Factors determining the infection spread and limiting its intensity and those
      influencing the effect of chemotherapy were defined. Theoretically determined
      radical suppressive low-dose praziquantel chemotherapy was carried out. The
      efficacy of the drug, 25, 30, 40 and 50 mg/kg, varied from 76.5 to 92.0% (mean
      88.1%), and the decrease of the egg density was more than 60%. The incidence of
      side effects of the therapy averaged 45.3%.

PMID- 1758353
TI  - [The function of the hypophyseal-thyroid system in chronic opisthorchiasis and
      its combination with the Salmonella typhi carrier state].
AB  - The hormonal function of the hypophysis and thyroid (TTG, T3, T4) and its
      dependence on hepatobiliary function, examined by hepatobiliscintigraphy, were
      studied by radioimmunoassay in 71 patients with chronic opisthorchiasis and in 18
      chronic carriers of Salmonella typhi. in both groups. The decrease of T3 and T4
      in the presence of normal TTG level was found. The imbalance of thyroid hormones
      activity is likely to be associated with hepatobiliary dysfunction. In chronic
      opisthorchiasis the hormonal disturbance may be one of the factors favouring the
      S. typhi carriership.

PMID- 1758354
TI  - [The interferon status in helminthiases. 3. Opisthorchiasis].
AB  - In 23 patients with Opisthorchis felineus infection, 4 in subacute and 19 in
      chronic stages of the disease (7 subclinical, 8 with cholepathy and 4 with
      gastroduodenitis) the blood levels of alpha-interferon (IF-alpha) and IF-gamma
      were measured using vesical stomatitis virus culture. In patients with subacute
      opisthorchiasis the blood contents of IF-alpha and IF-gamma were the same as in
      control-30 practically healthy people (640-1280, log2 9.73 +/- 0.19, and 128-256,
      log2 7.75 +/- 0.25 against 640-1280, log2 10.04 +/- 0.12 and 128-256, log2 7.47
      +/- 0.13 respectively). In patients with chronic opisthorchiasis the levels of IF
      alpha and IF-gamma were lower than in control (320-640, log2 8.68 +/- 0.28 and 32
      128, log2 6.0 +/- 0.58, p less than 0.01 and p less than 0.01 respectively).
      Among the ones with the subclinical course of the infection the content of IF
      alpha was lower than in control (320-1280, log2 9.31 +/- 0.27, p less than 0.05).
      Patients with cholepathy had lower levels of IF-alpha and IF-gamma than those
      with subclinical course of the infection (160-640, log2 8.55 +/- 0.24 and 16-64,
      log2 5.0 +/- 0.26, p less than 0.01, p less than 0.01 respectively). That seemed
      to be a sign of immunodepression in the chronic stage of the disease some way
      more prominent in cases with cholepathy. Immediately after praziquantel therapy
      interferon levels remained unchanged.

PMID- 1758355
TI  - [Heterologous immunity in opisthorchiasis at different stages of the development
      of the invasion (experimental research)].

PMID- 1758356
TI  - [The pathogenesis of stomach and duodenal involvement in chronic opisthorchiasis.
      1. The urease test].
AB  - The study using the urease test on mucous biopsies from the antral gastric part
      and from the duodenum of patients with chronic opisthorchiasis with endoscopic
      evidence of antral gastritis and gastroduodenitis, and from noninvaded patients
      with gastritis and duodenitis, some of them with the gastric or duodenal ulcers
      showed that the test was positive. The test was negative in both groups of
      patients when the mucosa of the gastric body was examined as well as in those
      without gastroduodenal pathology. It is supposed that in the both groups of
      patients gastroduodenal pathology was provoked by the colonization of the gastric
      and duodenal mucosa by gastric campylobacteria.

PMID- 1758357
TI  - [The characteristics of gastroduodenal pathology in patients with chronic
      opisthorchiasis as a criterion for the clinical diagnosis of the invasion].
AB  - Using a syndrome approach the clinical pattern has been studied in 269 patients
      with chronic gastritis and duodenitis. 55 of patients had gastric ulcer, 105
      patients had duodenal ulcer. In 130 patients chronic opisthorchiasis was
      diagnosed 8.9 +/- 1.9 years after the disease onset. The following syndromes are
      believed to be diagnostically valuable, enabling one to suspect chronic
      opisthorchiasis in patients with gastroduodenal pathology from the endemic foci:
      "low eosinophilia syndrome", "right hypochondrium" syndrome, "fever and
      enterocolitic syndrome" with the special consideration of the nature of
      dysbacteriosis of the small bowel.

PMID- 1758358
TI  - [A combined method for the laboratory diagnosis of opisthorchiasis].
AB  - A combined method of coproovoscopy using potassium iodide (density 1.71) or zinc
      chloride (1.78) solutions is used for the diagnosis of opisthorchiasis in man,
      dogs and cats. The method is also useful for diagnosing ascaridiasis,
      ankylostomiasis, trichocephaliasis, and taeniasis.

PMID- 1758359
TI  - [Population migration and the epidemic process in opisthorchiasis].
AB  - A correlation between opisthorchiasis epidemic process and population migration
      is reviewed at the third stage of the migration process (the formation of the
      migration flow, resettlement as such, and settlement of migrants in a new place)
      in view of the prevention of infection in conditions of the population migration.
      The endemic situation in the areas between which there is population migration is
      considered as the initial point. A simplified method for the calculation of the
      number of infected persons among the migrants from the endemic territories is
      described.

PMID- 1758360
TI  - [The significance of parasitic diseases in human pathology].

PMID- 1758361
TI  - [An electron microscopic study of the cuticle, hypodermis and somatic musculature
      of the nematode Trichocephalus muris after exposure to anthelmintic
      preparations].

PMID- 1758362
TI  - [The clinico-immunological characteristics and treatment of ankylostomiasis
      patients from tropical countries].

PMID- 1758363
TI  - [Morphological changes in the mucosa of the stomach and the small intestine of
      rats under the action of mebendazole].
AB  - The effect of mebendazole on the gastric and intestinal mucosa was studied in 52
      intact white rats. It was shown that the drug caused a significant damage to the
      mucosa, especially of goblet cells of villi and crypts and interfere with the
      mucoid secretion. The alterations after mebendazole administration were more
      severe than those caused by naphthamon. On the 13-15th day after the treatment
      the complete restoration of the damage was not seen.

PMID- 1758365
TI  - [The effect of toluene and ammonia on the invasive process and immunological
      indices in experimental trichinelliasis in mice].
AB  - Rap mice were exposed to toluene (T) inhalation for 10 days before invasion with
      20 Trichinella spiralis larvae per g body weight (moderate infection). This
      resulted in diminished number of intestinal parasites in the presence of greater
      number of mast cells in the peritoneal exudate, higher IgE production, enhanced
      cell adhesion to trichinella larvae and of migration of splenic lymphocytes.
      Simultaneous inhalation of T and ammonia diminished the immune stimulating effect
      of the former. The number of intestinal trichinella was 1.5 times more but still
      twice less than in controls. Inhalation of T during the first 10 days of
      infection stimulated the immune response only in mice given 5 larvae per g. In
      those given 20 or 60 larvae per g, the immune response was suppressed and 40 and
      100% of mice perished respectively. The exposure to T during 30-39 days of
      infection of mice given 35 larvae per g (the intensive infection) resulted in 50%
      death of the animals without significant changes in immune response. Simultaneous
      therapy with mebendazole (75 mg/kg) provided 100% survival in the presence of
      suppressed immune response. 100% of mice of the same group not exposed to T but
      treated with mebendazole died. The toxic and immunomodulating effects of T differ
      in intact and infected mice due to the dense, the stage of infection and to
      chemotherapy.

PMID- 1758364
TI  - [A comparative study of the efficacy of Vermox, albendazole and medamine in an
      experimental model of trichocephaliasis in mice].
AB  - A comparison of the efficacy of albendazole, medamine, and Vermox using an
      experimental model of Trichocephalus muris in DBA-2 mice showed that Vermox was
      most effective at all stages of the parasite development. The therapeutic
      activity of albendazole and medamine depends on daily dose, its dividing through
      the day and the duration of the treatment. At larval stages of T. muris complete
      recovery might be achieved using a daily dose of 25 mg/kg for albendazole and 150
      mg/kg for medamine, but at the adult stage the doses of the drugs should be 3-4
      times higher to achieve 100% effect. The resistance of T. muris to the drugs
      especially increases at the beginning of egg production.

PMID- 1758366
TI  - [The anticestodal activity of preparations made from the breadfruit].
AB  - Breadfruit tree (Artocarpus tonkinensis) is used in Laotian folk medicine for the
      treatment of taeniasis. Breadfruit tree preparations impair in vitro the motility
      of the cestodes Hymenolepis nana causing their motor excitation, contracture and
      death. The latter is observed when fairly high concentrations of the preparations
      (10(-2) = 2.10(-3)) are used. In mice experimentally invaded by H. nana it was
      shown that the water extraction of breadfruit tree substance is rather less
      effective than its ethanol extraction and has some purgative action, which
      increases the therapeutic effect.

PMID- 1758367
TI  - [The search for new antiparasitic agents. 7. A study of the relationship between
      the structure and the anthelmintic activity of new halogen-containing
      benzamides].
AB  - Anthelminthic properties of new series of haloid-containing benzamides have been
      studied. The anthelminthic activity-structure relationships of the compounds
      under study has been examined. A number of highly active compounds promising for
      further investigations have been identified.

PMID- 1758368
TI  - [The search for new antiparasitic agents. 8. The synthesis and study of the acute
      toxicity, anti-alveolar hydatid and antihymenolepiasis activity of 1-alkyl-4[4
      (heterylamino)phenyl]piperazines].
AB  - The synthesis and the acute toxicity and anticestodal activity of l-alkyl-4-[
      (heterylamino)phenyl]-piperazines are presented. These compounds were found to be
      able to suppress the growth of larvocysts of Echinococcus multilocularis in
      cotton rats when injected intraperitoneally in a single dose of 0.25 g/kg, close
      to capacity of mebendazole. The tested compounds were also highly effective
      against the adult stage of Hymenolepis nana. Experimentally infected mice given
      an oral single dose of 0.2-0.5 g/kg of the drug were radically cured.

PMID- 1758369
TI  - [The assessment of the clinical status of patients with alveolar hydatid disease
      by using statistical processing methods. 2. The correlation of laboratory tests
      at different disease stages and their clinical interpretation].
AB  - In 44 patients with alveolar echinococcosis, the correlation between the results
      of main laboratory tests were studied and their clinical interpretation was
      given. It was shown that at an uncomplicated stage of the disease, the immune
      response suppressing the helminth growth plays the main role; at the stage of
      complications the pathogenetic significance of non-specific inflammatory
      responses caused by destructive processes increases; at a stage of decompensation
      the correlation reflects severe immunological abnormalities and progressive
      immunodepression. The obtained correlations might be used as a measure for
      determining the stage of the disease in the algorithmic method for the
      classification of alveolar echinococcosis.

PMID- 1758370
TI  - [Alpha-1-acid glycoprotein in differential diagnosis of rheumatic diseases].
AB  - In recent years, the investigation of acute-phase proteins with the aid of
      affinity electrophoresis employing lectins as carrier substance, has become ever
      more important, in particular in the diagnosis of inflammatory rheumatic
      diseases. In order to investigate the usefulness of a determination of alpha-1
      glycoprotein microheterogeneity in the sera as a diagnostic parameter, we
      evaluated, on a prospective basis, the sera of 85 consecutive patients presenting
      at our department with various inflammatory rheumatic diseases (chronic
      rheumatoid arthritis [RA] [n = 22], seronegative spondarthropathies [SpA] [n =
      15], polymyalgia rheumatica [PMR] [n = 10], polymyositis dermatomyositis [PM/DM]
      [n = 8], osteoarthritis [n = 18], and infectious diseases [n = 12]). The results
      were expressed as reactivity coefficient of the alpha-1 acid glycoproteins
      (AGP/RC). A significant increase in the AGP/RC was observed in patients with
      various infections, and in those with RA or SpA with intercurrent infection, as
      compared with patients with RA or SpA with no intercurrent infection, or in
      healthy controls. It also proved possible to differentiate between PM/DM and PMR.
      Determination of the erythrocyte sedimentation rate, and quantification of the C
      reactive protein and of alpha-1 glycoprotein, permitted no discrimination between
      an increase in inflammatory activity related to the basic disease, and an
      intercurrent bacterial infection. The results show that the determination of
      qualitative changes in the acute phase proteins, in particular alpha-1 acid
      glycoproteins, may make it possible to differentiate between inflammatory and
      infectious diseases. This examination technique may be of future clinical
      importance.

PMID- 1758371
TI  - [Idiopathic hemochromatosis: association with antigens of the HLA system].
AB  - HLA-A3 and HLA-B7 antigens were detected significantly more frequently in a group
      of 59 patients with idiopathic hemochromatosis than in a general population. The
      haplotype most commonly associated with the disease was A3B7. No differences in
      disease severity were to be found between homozygotic and heterozygotic carriers
      of this haplotype and patients with other haplotypes. An increased prevalence was
      also found for the HLA-A9 antigen. The haplotypes A9B7 and A9B27 were
      significantly more common among the patients investigated than among the general
      population.

PMID- 1758372
TI  - [Fluconazole in therapy of candidiasis of the oropharyngeal space in patients
      with HIV infection. Results of an open multicenter study of assessing the
      effectiveness and tolerance of fluconazole].
AB  - 50 HIV-positive patients (CDC stage III to VI) with oral candidiasis proven by
      culture and typical clinical findings were treated with fluconazole (50 to 100
      mg/day) over a period of eight to 22 days. After completion of treatment,
      clinical signs of oral candidiasis had disappeared in 45/50 patients. In 10/50
      patients, however, increased concentrations of candida both in pharyngeal washes
      (greater than 10(2) PFU/ml) and throat swabs (greater than 20 colonies/culture)
      persisted. Four weeks later, clinical candidiasis had reappeared in 22/42
      patients and another 14/42 patients without clinical symptoms had pathological
      concentrations of candida in culture. In no case did treatment with fluconazole
      itself have to be aborted because of adverse reactions. Most of the patients had
      multiple concomitant bacterial and/or viral infections requiring comprehensive
      medication. The side effects observed (nausea, headache, changes in the blood
      picture, etc.) were due to the concomitant infections and their specific therapy.

PMID- 1758373
TI  - [Experiences with a modified implantation technique of Port-A-Cath systems as
      continuous venous access in infants and children].
AB  - Since April 1987 we implanted the Port-A-Cath infusion system in 60 children in
      the age of 2 months to 16 years (median: 4.3 years). We only used the adult
      system (Pharmacia). By one right side infraclavicular incision the silicon
      catheter was implanted into the jugular vein and also the port was fixed on the
      pectoral fascia. We saw one severe complication as a port perforation through the
      skin. 1.6% was the very low rate of complications which appeared in the median of
      the port using time of 168.5 days.

PMID- 1758374
TI  - [Jaundice and pancreatitis in a 50-year-old patient (Leptospirosis
      icterohaemorrhagica)].

PMID- 1758375
TI  - [Differential therapy with oral antidiabetic drugs].

PMID- 1758376
TI  - [Acute septic cardiomyopathy: a manifestation in multi-organ failure in
      infection?].

PMID- 1758377
TI  - [Focal liver changes in the sonogram. Recommendations for further diagnosis].

PMID- 1758378
TI  - [Fibromyalgia syndrome with IgA and IgG subclass deficiency].

PMID- 1758379
TI  - [Integrated psychosomatic medicine].

PMID- 1758380
TI  - [Pentamidine protecting from the complications of AIDS].

PMID- 1758381
TI  - [Recent findings on infantile autism].

PMID- 1758382
TI  - [Effect of pre-treatment with pyridostigmine on the stimulation of growth hormone
      by clonidine and GRF].
AB  - The large availability of biosynthetic GH suggested the need to define the more
      accurate way to make diagnosis of GH deficit. Only one stimulation test by
      clonidine or insulin is not enough to define a GH deficit, and this because often
      it's possible to get "false negative" tests. The GH is regulated by the influence
      of GRF and somatostatin that respectively are under the adrenergic and
      cholinergic control, for this reason we studied how and in which measure a
      cholinergic agonist (pyridostigmine) acts on GH release during the clonidine and
      GRF stimulation tests. We studied the area under the curve (AUC), the peak and
      the mean of the value of GH after clonidine or clonidine and pyridostigmine, and
      after GRF or GRF and pyridostigmine: we got the following results: 191 +/- 71.33
      (AUC), 5.42 +/- 1.68 (peak), 2.44 +/- 0.54 (mean) after clonidine stimulation
      test; 1048 +/- 442.37 (AUC), 19.5 +/- 10.15 (peak) and 7.96 +/- 3.2 (mean) after
      clonidine and pyridostigmine (p less than 0.01); 1499 +/- 887 (AUC), 21.1 +/-
      11.8 (peak) and 11.11 +/- 6.6 (mean) after GRF test and 2370 +/- 332 (AUC), 31.4
      +/- 3.49 (peak) and 18.22 +/- 3.27 (mean) after GRF and pyridostigmine. The
      pyridostigmine effect on the simulation by clonidine and GRF is able to
      potentiate the stimulation of GH and allowed a more accurate diagnosis of GH
      deficit.

PMID- 1758383
TI  - [Infantile dermatomyositis. Clinical aspects and prospective treatments].
AB  - Juvenile dermatomyositis (DMI) is a rare illness of multisystem inflammatory
      disease of unknown etiology. It is usually considered as a part of the spectrum
      of polymyositis/dermatomyositis (PM/DM), and is distinguished from the adult form
      in having a number of different clinical features as well as distinctive
      pathologic findings. Although the clinical findings and course of the disease,
      laboratory evaluation and therapy have been reviewed, many of these studies are
      old and may not accurately reflect the current status of the disease as it is now
      defined and treated. Generally it is first diagnosed by the appearance of typical
      signs in both the skin and muscles. The clinical picture shows early signs of
      heterogeneity and is confirmed by these latter developments. Its classification
      falls into three groups: acute single cycle, chronic polycycle and continued
      chronic; this sickness invariably evolves into one or another of these three. Our
      current work involves 15 cases of DMI; 8 have acute monocycle, 4 chronic
      polycycle and 3 continued chronic. This illustrates the clinical and biological
      heterogenousness of this illness which in itself presents extreme difficulties
      when considering possible treatment. From our experience, high dose of
      corticosteroida intraveins have had the best result. Where cases have been acute
      at the beginning of the sickness and where there has been complications,
      particularly those of a bronco-pulmonary nature (we treated 3 such cases) it has
      proven to be beneficial to use corticosteroid together with the immunosuppresant:
      ciclofosfamide. The use of ciclosporina in one case who had resisted other forms
      of therapy has appeared to be effective, though this has yet to be verified.

PMID- 1758384
TI  - [Neuropsychiatric approach to a child with spinal muscular atrophy. A study of
      relational problems].
AB  - Various years' experience of an extensive series of children suffering from
      progressive chronic spinal muscular atrophy have made it possible to elaborate a
      neuropsychiatric approach model conducted on the basis of a viewpoint capable of
      integrating the clinico-medical aspect and aptitude to empathic listening aimed
      at establishing a therapeutic alliance with the patient. With advancing age and
      the course of the disease, in most cases very different difficulties and problems
      are encountered. These change continuously in relation to the stage reached in
      emotional development. Entry to school and socialisation mark a particular moment
      in the confrontation with peers and present the ill child with his diversity.
      With the emergence of adolescent problems, there is also a dramatic new impact
      between the body image of a wounded, deteriorated self and the evolutionary
      effort aimed at identifying with the peer group, the autonomisation of parental
      figures, the integration of a sexed image of the self. Room can be found in this
      framework for the child neuropsychiatrist who is able to offer himself as a point
      of reference and set himself up as a model for elaborating disease anxieties.
      From personal experience it also emerges that in children suffering from a
      chronic, often fatal disease there is often the need for a physician to
      coordinate and integrate needs of both a clinical and sociorelational nature for
      the purpose of allowing the family to get closer to the needs of their child and
      prevent him from falling prey to destructive type anxieties.

PMID- 1758385
TI  - [Serum levels of IgG subclasses in critically ill premature infants treated with
      intravenous immunoglobulins].
AB  - Fifty eight premature infants, all needing intensive care and mechanical
      ventilation, were randomly allocated to two groups. Intravenous immunoglobulins
      (IVIG, 500 mg/kg Sandoglobulin) were administered to Group 1 while Group 2
      received saline as placebo. IgG subclass serum levels were evaluated in both
      groups on admission, after two hours from the end of IVIG or saline infusion and
      from day 3 to 7 from birth. IgG subclasses were also measured in 10 healthy term
      neonates during the first day of life. Results show that after 2 hours from the
      end of IVIG administration all IgG subclasses reach levels comparable to term
      neonates. Comparing IgG values between treated and untreated preterm neonates it
      was observed that on day 3 only IgG1 and IgG3 subclasses were significantly
      higher in Group 1 than in Group 2. At day 5 no differences were observed between
      the two groups. IgG2 subclass rose reaching a significant difference between the
      two groups ad day 5 and 7. Our data show that IVIG single dose (500 mg/kg)
      administration doesn't produce a constant elevation in all IgG subclasses during
      the first week of life in the critically ill preterm infant.

PMID- 1758386
TI  - [Hypothyroidism, transitory or congenital. Reflections on a clinical case].
AB  - We report one case of congenital hypothyroidism with thyroid agenesis wrongly
      considered as a transient form of hypothyroidism. The patient came to our
      attention at 9 months of age, showing an important delay in neuromotor
      development. Transient hypothyroidism is a situation of brief hormonal deficit
      with spontaneous resolution in the first weeks of life. We consider it very
      important to differentiate this transient condition from a permanent form of
      thyroid dysgenesis.

PMID- 1758387
TI  - [Intrahepatic gallbladder. Particulars of a case].
AB  - The Authors report a rare case of abnormal position of the gallbladder; the major
      therapeutical and diagnostic problems are pointed out.

PMID- 1758388
TI  - [Freeman-Sheldon syndrome. Case contribution and review of the literature].
AB  - The paper reports a case of Freeman-Sheldon's syndrome in which a medium-slight
      degree of mental retardation which was not associated to malformations of the CNS
      was observed in addition to other typical symptoms. The presence of an hiatal
      hernia and vesico-ureteral reflow was also noted; to date it is still not
      possible to establish whether these visceral anomalies are chance findings or
      whether they are the result of a genetic defect involving tissues of different
      embryonal origin. Further studies are required to increase our knowledge of
      Freeman-Sheldon's syndrome and other nosologically related pathologies.

PMID- 1758389
TI  - [Autoimmune hemolytic anemia in the course of Kawasaki disease. A case
      presentation].
AB  - Kawasaki disease can be characterized by rare complications or by unusual
      associations. One of these is autoimmune hemolytic anaemia that has been observed
      seldom up to now. The Authors report a case with this rare association, compare
      it with cases observed before, and put forth the hypothesis that autoimmune
      anaemia during Kawasaki disease can be linked to numerous immunological
      alterations present in mucocutaneous lymph node syndrome. They moreover advise to
      abstain in these cases from corticosteroid therapy, both to avoid complications,
      and because, as happened in their patient, this kind of autoimmune hemolytic
      anaemia can regress spontaneously.

PMID- 1758390
TI  - [The correlation between blood concentrations of somatomedin C and the
      auxological characteristics in short-stature subjects].
AB  - In this study the authors evaluated the correlation between plasma somatomedin C
      (SmC) levels and auxological features in 129 short children, who have been
      subdivided into four groups: classical growth hormone (GH) deficiency (14
      prepubertal subjects), normal responses to provocative stimuli tests, but
      diminished spontaneous GH secretion (40 prepubertal subjects), normal responses
      to provocative stimuli tests and normal spontaneous GH secretion (45 prepubertal
      subjects and 30 subjects at stage G2/B2-Ph2 of puberty). The following
      correlations with SmC are resulted, when all the subjects were considered:
      chronological age (r = 0.415, p = 0.0002), bone age (r = 0.557, p less than
      0.0001), bone age/chronological age ratio (r = 0.493, p less than 0.0001), height
      SDs (r = 0.574, p less than 0.0001), height velocity SDs (r = 0.599, p less than
      0.0001), but not weight variation % (r = -0.020, p: ns). In conclusion, the
      results of the study demonstrate a high correlation between SmC levels and
      auxological features, with the exception of weight.

PMID- 1758391
TI  - [Local immunotherapy prevention of recurrent respiratory infections in children].
AB  - A group of 20 children aged between 2.5 and 10 years with recurrent respiratory
      infections (greater than 6/year) was treated with local immunotherapy (Biomunil
      spray) for a six-month period (October-March 1988/89). Referring to the same
      period on last year, a statistically significant decrease of upper respiratory
      infections was observed (p less than 0.001) as well as an increase of S-IgA rate
      (p less than 0.001) and less of serum IgA and IgG. The compliance and the
      tolerance of the drug was good.

PMID- 1758392
TI  - [A comparison between antigliadin antibodies and blood xylose in celiac disease].
AB  - We have compared serum antigliadin antibodies (AGA) with xylose absorption test
      in diagnosis and follow-up of pediatric celiac disease. Three groups of children
      were investigated: celiacs, affected by other gastrointestinal disease, healthy
      controls. On gluten diet AGA IgA, IgG and xylose test were abnormal in all celiac
      children. After only three months of gluten-free diet, abnormal AGA IgA values
      were found in 3%, AGA IgG in 63%, xylose test in 28% of children. Normal values
      for AGA IgA and IgG and for xylose test were found between 7 and 20 months. On
      challenge, after 1-4 months of gluten diet, abnormal AGA IgA and IgG values were
      found in 90% of cases, xylose test only in 27%. As far as the children with other
      gastrointestinal disease are concerned, 2% had abnormal values for AGA IgA, 22%
      for AGA IgG and 42% for xylose test. All healthy children had normal AGA IgA, IgG
      values and xylose test. Our date show AGA IgA the most specific laboratory test,
      among these investigated, for diagnosis and follow-up of celiac disease.

PMID- 1758393
TI  - [Phakomatosis in childhood. Clinical and instrumental observations of 11 cases].
AB  - Taking the institution of the Italian Neuroectodermosis Register (Fois, April
      1987) as a starting point, the Authors reviewed their own case-records, including
      six cases of neurofibromatosis and five cases of tuberous sclerosis, observed
      during the period 1982/88, and stress the need for early diagnosis (unfortunately
      often neglected), indispensable both for an effective prevention of any
      pathological involvement and for precise genetic counselling, susceptible of
      further improvements thanks to more and more advanced diagnostic techniques.

PMID- 1758394
TI  - [The efficacy of cyclophosphamide bolus therapy in a girl with SLE with a
      nephritic onset].
AB  - A case of glomerulonephritis as the initial clinical manifestation of SLE in a
      child is reported. Treatment with oral prednisone did not produce beneficial
      results either worth respect to the symptoms or the laboratory data. The
      association with intravenous Cyclophosphamide led to rapid improvement in
      clinical and serological patterns. Moreover this association has reduced the risk
      of end-stage renal failure with few serious complications, and no other side
      effects.

PMID- 1758395
TI  - [The treatment of nocturnal enuresis. A comparative study between desmopressin
      and acupuncture used alone or in combination].
AB  - During the period from March to September 1989, 40 children suffering from
      primary nocturnal enuresis, aged between 5 and 14 years, were included in a study
      to assess the comparative therapeutical efficacy of DDAVP and acupuncture.
      Children were divided into four groups of 10: group A was treated with DDAVP,
      group B was treated with acupuncture, group C was treated with DDAVP and
      acupuncture and group D was treated with placebo (control). The trial design
      included 3 periods: observation (2 weeks), treatment (8 weeks) and follow-up (4
      weeks). Nineteen children completed the study. The efficacy of treatment, which
      was expressed as a percentage of dry nights, was high in both the DDAVP and
      acupuncture groups, when used separately. The combined treatment of DDAVP and
      acupuncture appeared to be the most efficacious both in terms of the percentage
      of dry nights at the end of treatment and in relation to the stability of
      results, even after the end of the study. The paper gives a detailed analysis of
      correlations between type of treatment and urinary osmolarity.

PMID- 1758396
TI  - [Hydrocarbon poisoning in childhood].
AB  - The authors report the experience of a pediatric clinic on hydrocarbon poisoning.
      Among the reported cases was that of a girl showing a serious pneumonitis.

PMID- 1758397
TI  - [Endocrine study in the Prader-Willi syndrome. Apropos of 5 cases].
AB  - Five children (3 boys and 2 girls) ranging in age form 5-12 years and suffering
      from Prader-Willi syndrome have been evaluated. In each subject the Authors have
      examined auxological parameters and the following hormonal values: GH after two
      pharmacological stimuli tests, gonadotropins after LHRH, TSH and prolactin after
      TRH, cortisol rhythm, testosterone after hCG in males, thyroid hormones and
      steroids. The results have shown a height less than 3 degrees centile only in a
      subjects and ranging from 10 degrees-50 degrees in the others, a weight greater
      than 97 degrees centile for the height age in all, a low response in GH to both
      stimuli in two subjects, an increased response to LHRH in FSH in two subjects.
      All other endocrine evaluations were in the normal range with the exception of
      insulin that resulted augmented in spite of normal glycaemic values. In
      conclusion, our data would suggest the existence of an eventual alteration of the
      hypothalamus-pituitary structures.

PMID- 1758398
TI  - [Perinatal listeriosis. A report of a case with a hydrocephalus outcome].
AB  - Perinatal listeriosis is a disease whose incidence has increased constantly in
      recent years. Like neonatal infection determined by B hemolyticus streptococcus,
      the disease appears in two forms: the first is the septicaemic form with early
      onset, the second form is meningoencephalitic with late onset. We describe a case
      of listeriosis with immediate onset in which, in spite of the prompt therapy and
      the normality of rachiocentesis, developed a purulent ventriculitis with outcome
      in hydrocephalus.

PMID- 1758399
TI  - [A report of 2 cases of Turner's syndrome with a ring X chromosome].
AB  - The authors report two cases of Turner syndrome with clinical evidence of only
      primitive hypogonadism and short stature. Karyotype analysis showed X ring
      mosaicism which is present only in 5% of cases of Turner syndrome. The authors
      agree with the hypothesis suggesting no relationship between break points on the
      X chromosome and phenotypical aspect. An earlier diagnosis is auspicious so that,
      using correct therapy, final height should be improved.

PMID- 1758400
TI  - Long-term effects of toluene inhalation on rat behavior.
AB  - The effect of inhalation exposure to toluene (3700 mg/m3, 1000 ppm, 21 h/day, 5
      days/week, during 4 weeks) on male Sprague-Dawley rats was tested. A wide range
      of test situations was used, including an operant test with baseline performance
      and extinction, motor coordination, and exploratory activity. All tests were made
      11 to 35 days after the end of the exposure. The results indicate that toluene
      exposure causes a long-lasting impairment on the extinction process and reduction
      in the variability of the baseline response in the operant behavior situation.
      Toluene also had an effect on the water regulation.

PMID- 1758401
TI  - Behavioral effects of acute exposure to tributyltin chloride in rats.
AB  - The behavioral effects of a single acute exposure to nonlethal doses of
      tributyltin chloride (TBTCl) were studied in male Wistar rats. The rats were
      given TBTCl by oral gavage at doses of 0, 6.3, 12.5, 25.0 or 50.0 mg/kg, and
      spontaneous motor activity (SMA) and acquisition of conditioned avoidance
      responses in a shuttle box were monitored. Body weight gain in the 50.0-mg/kg
      group was significantly lowered, but weight gain in the 6.3-, 12.5- and 25.0
      mg/kg groups was comparable to that in the control group. TBTCl caused a dose
      related decrease in SMA during the dark phase. The 24-h total daily and 12-h
      nocturnal activity was decreased at doses of 12.5 mg/kg and above. The
      acquisition of shock avoidance responses was inhibited in all TBTCl-treated
      groups in a dose-dependent manner, and the difference was significant for rats
      given TBTCl at doses of 25.0 mg/kg and above. The data indicate that an acute
      exposure to TBTCl can cause significant changes in rat behavior and suggest that
      SMA can serve as a sensitive index for detecting its toxicity.

PMID- 1758402
TI  - Assessment of the acute acrylonitrile-induced neurotoxicity in rats.
AB  - Acrylonitrile (VCN) is an aliphatic nitrile which is used extensively in
      manufacturing of synthetic fibers, plastics, and rubber. Although the
      neurotoxicity of VCN is recognized, no thorough characterization of this effect
      has been reported. Current studies were designed to quantitatively characterize
      the acute phase of VCN-induced cholinomimetic neurotoxicity, and to determine the
      effects of dose, route of administration, and atropine on such toxicity.
      Administration of a single gavage or subcutaneous doses of 20, 40, or 80 mg
      VCN/kg to male Sprague-Dawley rats causes two distinctive phases of acute
      neurotoxic effects. Signs observed in the early phase had a rapid onset, and were
      cholinomimetic in nature. They included salivation, lacrimation,
      chromodacryorrhea, polyuria, miosis, vasodilatation in face, ears and
      extremities, increased gastric secretion, and diarrhea. A late phase developed
      hours after VCN dosing, and the toxic signs included depression, convulsions, and
      respiratory failure followed by death at high doses. These results revealed that
      the cholinomimetic toxicity induced by VCN was dose related regardless of the
      route of administration. In another study, rats were pretreated with atropine (1
      mg/kg, IP) prior to VCN (40 mg/kg) in order to investigate the role of the
      cholinergic system. Atropine protected rats against VCN-induced cholinomimetic
      neurotoxicity, suggesting possible involvement of the cholinergic system.
      Finally, this work provides essential basic information for studying the
      biochemical, pharmacological, and neurological basis of VCN-induced neurotoxicity
      in the rat.

PMID- 1758404
TI  - The postweaning housing environment determines expression of learning deficit
      associated with neonatal monosodium glutamate (M.S.G.).
AB  - Perinatal M.S.G. treatment causes a syndrome characterized by damage to the
      hypothalamic arcuate nucleus, other circumventricular areas, parts of the visual
      system and the dentate gyrus of the hippocampus. The resulting hormonal
      dysfunction may be responsible for developmental anomalies of organ systems,
      obesity, and alterations in sensory/motor performance. We have shown that some
      behavioral indicators of M.S.G. toxicity in rats can be masked by rearing them in
      enriched housing conditions. Here, we evaluated the impact of six housing
      conditions on M.S.G.-induced alterations of organ systems and behavior. Perinatal
      M.S.G. treatment reduced adrenal, heart and testes weights, as well as total
      white blood cell (WBC) counts, and increased tail flick latencies. These measures
      were unaffected by the housing condition. M.S.G.-induced reductions in body
      weight, grip strength, water maze and dominance task performance varied as a
      function of housing. Deficits in water maze performance were most evident
      following social and isolated single-cage housing. We propose that deficits in
      water maze performance following perinatal M.S.G. may be attributable to
      hippocampal damage that can be alleviated by rearing the rats in stimulating
      environments.

PMID- 1758403
TI  - The effect of prenatal cocaine exposure on umbilical cord length in fetal rats.
AB  - Umbilical cord length has been considered a reliable indicator of fetal movement.
      In this study, the effect of prenatal cocaine exposure on umbilical cord length
      was examined in rats. Pregnant rats were intubated with either 0 or 60 mg/kg
      cocaine hydrochloride daily from gestation day (GD) 14-21. Fetuses were removed
      via Caesarean section on GD 21 and umbilical cord length, placental weight and
      fetal body weight were measured. Fetuses exposed to cocaine in utero had
      significantly shorter umbilical cords than intubated controls, although there
      were no differences in placental or fetal body weights. These data suggest that
      prenatal cocaine exposure suppresses fetal movement, which could contribute to
      some of the long-term effects observed in cocaine-exposed offspring.

PMID- 1758405
TI  - Neonatal exposure to triethyltin disrupts olfactory discrimination learning in
      preweanling rats.
AB  - Triethyltin is an organotin compound that is known to produce neurotoxicity in
      both adult and developing organisms. Although this neurotoxicity has been
      documented with a variety of behavioral and biological measures, the effects of
      this compound on learning during early development have been less extensively
      studied. The present study reports four experiments that examined this question
      with an odor aversion learning paradigm in which pups received presentations of
      one odor paired with footshock and an alternate odor without shock. In Experiment
      1, Long-Evans rat pups were injected IP on postnatal day 5 (PND 5) with either 0,
      3 or 5 mg/kg TET and then tested for olfactory discrimination learning on PND 18.
      Only the 5-mg/kg dose impaired discrimination learning. In Experiment 2, PND 5
      exposure to TET (5 mg/kg) disrupted olfactory learning on PND 18 but not on PND
      12, whereas exposure on PND 10 disrupted learning at both ages of testing. In
      Experiment 3, PND 16 exposure to TET (5 mg/kg) also disrupted acquisition of
      olfactory learning on PND 18 but had no effect on retention of an olfactory
      discrimination that was acquired prior to TET exposure (i.e., on PND 14 and PND
      15). Unconditioned responses to footshock were also unaffected by TET (Experiment
      4). These findings indicate that neonatal exposure to TET impairs associative
      learning in developing rats and are discussed in relation to other studies of the
      developmental neurotoxicity of this compound.

PMID- 1758406
TI  - Neonatal exposure to trimethyltin disrupts spatial delayed alternation learning
      in preweanling rats.
AB  - Trimethyltin is an organotin compound that produces marked neurotoxicity in both
      adult and developing animals. The limbic system is a primary CNS target site for
      this toxicity, and a prominent behavioral effect of TMT is disruption of learning
      and memory. Impairment of cognitive development has also been suggested by
      studies showing that rats neonatally exposed to TMT cannot perform spatial
      working memory tasks during adulthood. However, the question of how early in
      ontogeny such deficits can be detected has not been addressed. The present study
      examined this question with a T-maze delayed alternation learning paradigm. Long
      Evans rat pups, injected IP on Postnatal Day 10 (PND 10) with 6 mg/kg TMT and
      tested on PND 18, were unable to learn delayed alternation in the manner shown by
      vehicle control pups. However, TMT- and vehicle-treated groups were both able to
      learn a simple position discrimination. These findings indicate a selective
      impairment of spatial working memory by neonatal TMT exposure and show that this
      impairment can be demonstrated during the preweanling period in the rat.

PMID- 1758407
TI  - Sexual receptivity of adult female rats prenatally intoxicated with alcohol on
      gestational day 8.
AB  - On gestational day 8 (GD 8), pregnant albino rats received two IP injections,
      spaced by 4 hours, of either ethanol (2.9 g/kg in 24% v/v saline solution) or
      saline. Adult females exposed to ethanol in utero showed greater sensitivity to
      estrogen, but not to estrogen plus progesterone, for induction of lordotic
      response. The 5-HT1 receptor agonist 5-methoxy-N,N-dimethyl-tryptamine (5-MeODMT)
      had a significantly smaller effect in inhibiting lordosis response in
      experimental rats. The greater sensitivity to estrogen and lower sensitivity to
      the receptor agonist could be a consequence of long-term changes in central
      neurotransmitter systems induced by acute intoxication with ethanol on GD 8.

PMID- 1758408
TI  - Maternal recall of alcohol, cocaine, and marijuana use during pregnancy.
AB  - Alcohol, cocaine, and marijuana use during pregnancy was reported antenatally and
      at 13 months postpartum by 361 black inner city mothers. The two reports were
      moderately related for all three substances, but levels reported retrospectively
      were substantially higher. MAST scores did not differ for the two interviews.
      Most of the correlations of the antenatal and retrospective reports with maternal
      and infant characteristics were similar in magnitude; those that differed were
      somewhat stronger for the antenatal measures. Although the retrospective reports
      may provide a better indication of mean levels of fetal exposure, they may be
      less precise in rank ordering among individuals for purposes of correlational
      analysis. Women with higher MAST scores were particularly prone to report higher
      levels of both alcohol and cocaine when interviewed retrospectively, and more
      severely depressed mothers were more likely to report higher levels
      retrospectively for all three substances. These data suggest that women reporting
      more than 1.3 drinks/week antenatally (AA/day greater than 0.1) may actually be
      drinking at levels at risk for alcohol-related birth defects.

PMID- 1758409
TI  - Elicitation and modification of the acoustic startle reflex in animals prenatally
      exposed to cocaine.
AB  - In separate experiments, pregnant Long-Evans rats were administered cocaine
      orally (60 mg/kg/day) on gestation days 14-21, or subcutaneously (40 mg/kg/day)
      on gestational days 8-21. For each route of administration, a vehicle control
      group was pair-fed to the group administered cocaine and another control group
      was left untreated. Throughout pregnancy, the dams that received cocaine gained
      approximately 15% less weight than the untreated controls, but none of the dosage
      procedures affected the size of the litters, or the weight and growth of the
      offspring. When the offspring reached adulthood, various assessments of reflex
      function were made using the acoustic startle reflex and prepulse inhibition of
      startle. There were no effects on startle habituation or reflex modification that
      could be attributed to the prenatal exposure to cocaine.

PMID- 1758410
TI  - Failure of acute cocaine administration to differentially affect acoustic startle
      and activity in rats prenatally exposed to cocaine.
AB  - Pregnant rats were administered 40 mg/kg of cocaine hydrochloride subcutaneously
      on gestation days 14 through 21. Rats in one control group were pair-fed to the
      cocaine group and injected with the saline vehicle during the dosing period,
      while an untreated control group was simply weighed throughout pregnancy.
      Maternal weight gain was reduced 13% in the cocaine group and pair-fed controls,
      but the offspring did not differ in their numbers or growth compared to the
      untreated controls. The offspring were examined between postnatal days 80 and 96
      in tests of the acoustic startle response and open field behavior immediately
      following acute administration of 0, 5, or 10 mg/kg of cocaine. The acute dosages
      of cocaine increased the startle response and increased behavior in the open
      field. There was no evidence that the prenatal treatment altered the baseline in
      either of these tests. Adult rats exposed prenatally to cocaine entered more
      quadrants in the open field and reared more frequently than the other groups
      following the 10 mg/kg dosage of cocaine. However, there was no evidence of an
      effect of prenatal treatment among the groups administered the 5 mg/kg dosage in
      the open field test, nor was there a systematic effect of prenatal treatment on
      the acute effects of cocaine in the acoustic startle test. These data do not
      provide evidence that prenatal exposure to cocaine can produce persistent changes
      in the neural systems with which it interacts in the adult.

PMID- 1758411
TI  - Exploratory behavior and locomotor activity: a failure to find effects in animals
      prenatally exposed to cocaine.
AB  - Pregnant Long-Evans rats were administered cocaine orally (60 mg/kg) on
      gestational days 14-21, or subcutaneously (40 mg/kg) on gestational days 8-21.
      The oral dosage of cocaine produced some maternal lethality and reduced maternal
      weight gain throughout the pregnancy by approximately 12%. The subcutaneous
      dosage regimen reduced the lethality but still caused a decrease in maternal
      weight gain. Neither dosing regimen affected the number of pups in the litter,
      their weight, or growth. The offspring of dams that received the oral dosage were
      examined as adults in an automated holeboard apparatus and were also tested at
      postnatal day 21 and as adults in an open field. Adult animals exposed prenatally
      to cocaine did not differ from untreated controls in any of the automated
      measures of the holeboard apparatus or in the various behaviors, including
      nosepokes, recorded in the open field. Animals in the vehicle control group did
      make fewer nosepokes in the open field than the cocaine group, which did not
      differ from untreated animals. The offspring of dams given the subcutaneous
      dosage regimen were observed in the open field at day 21. In this case, the
      prenatal cocaine group had a tendency to make fewer crosses into adjacent
      quadrants, to rear less often, and to make fewer nosepokes than the control
      groups. Based on these and other data from our lab, it does not appear that in
      the rat, prenatal cocaine exposure has pronounced effects on subsequent
      exploratory behavior and activity in weanling or adult animals.

PMID- 1758412
TI  - The acquisition of passive avoidance, active avoidance, and spatial navigation
      tasks by animals prenatally exposed to cocaine.
AB  - Pregnant Long-Evans rats were administered cocaine orally (60 mg/kg) on
      gestational days 14-21. One control group was administered the vehicle and
      another left untreated. Cocaine treatment produced some maternal lethality, and
      the weight gain of the surviving dams was reduced approximately 15%. Offspring of
      mothers treated with cocaine did not differ from those of untreated mothers in
      their numbers, birth weight, or growth. Weanling offspring were tested in a
      passive avoidance task, and adult offspring were tested for two-way active
      avoidance and in a spatial navigation task. Although a few animals in the cocaine
      group showed poor retention of passive avoidance, the group differences were not
      statistically significant. The adult animals showed normal performance in both
      the active avoidance and spatial navigation tasks.

PMID- 1758413
TI  - [Pentamidine against the complications of AIDS].

PMID- 1758414
TI  - [Guided regeneration of the periodontal tissues with resorbable and nonresorbale
      membranes. I. Clinical evaluation].
AB  - The present experimental study has been undertaken in order to analyse
      clinically, in humans, the regeneration of periodontal tissue following two
      different surgical techniques of guided tissue regeneration therapy using a
      resorbable and a nonresorbable membrane. Clinical results have demonstrated no
      statistically significant difference between the techniques employed, both of the
      showing a favourable outcome if perfect plaque control in the postoperative
      period is performed.

PMID- 1758415
TI  - [Guided regeneration of the periodontal tissues with resorbable and nonresorbable
      membranes. II. Microbiological evaluation].
AB  - The present experimental study has been undertaken in order to analyze the
      influence of bacterial recolonization on periodontal wound healing following
      guided tissue regeneration therapy in humans. Two different surgical techniques
      has been carried out: one using a non absorbable membrane and the other a
      absorbable one. Microbiological data indicate no statistically significant
      difference between the techniques employed. Furthermore our data have confirmed
      the necessity of maintaining the healing sites free from the main periodontal
      pathogens.

PMID- 1758416
TI  - [An assessment of the proliferative activity in oral lichen planus].
AB  - The author's aim was to evaluate the cell proliferation of oral lichen planus, by
      an in vitro labelling technique using tritiated thymidine (TLI). For this purpose
      six patients with oral lichen planus and six control volunteers with oral mucosa
      clinically sound were studied. The cell kinetic parameter was investigated by
      counting cells from autoradiographs on histological sections of the biopsies.
      Significant differences were found between the basal TLI of the two group (p =
      0.002) but no between the epithelial TLI (Wilcoxon test).

PMID- 1758417
TI  - [Lesions of the inferior alveolar nerve due to endodontic cements].
AB  - The authors report several cases of inferior alveolar nerve injuries caused by
      endodontic cements. The surgical treatment which is suggested is the
      decompression of the nerve by microsurgical neurolysis.

PMID- 1758418
TI  - [Melkersson-Rosenthal syndrome. A case treated with clofazimine].
AB  - A 63-year-old woman suffering from scrotal tongue, facial palsy and granulomatous
      cheilitis (Melkersson-Rosenthal syndrome) is described. Treatment with
      clofazimine dramatically improved swelling of the lips.

PMID- 1758419
TI  - [Maxillofacial traumatology in sports practice].
AB  - The importance of maxillofacial traumatology in sporting practice is stressed.
      1094 patients have been treated for eight years, emphasizing in this way the
      continuous and constant increase--the incidence of this kind of trauma.

PMID- 1758420
TI  - [The transmigration of the permanent lower canine].
AB  - A rare dental anomaly--the transmigration--is analysed. This condition, which is
      sparsely recorded in the literature, typically affects the mandibular canine.
      Twelve cases in which an unerupted mandibular canine has crossed the midline, are
      described and discussed. Reference is made to considerations put forward in the
      past by other Authors on this subject, after which personal conclusions are drawn
      on the diagnosis, etiology and therapy of this rare but serious behaviour of the
      mandibular canine. The anomaly can be properly diagnosed only by an attentive
      radiographic evaluation which is primarily based on the orthopantomogram. A
      series of successive panoramic radiographs taken over years documents the
      progressive ectopic movement of an unerupted mandibular canine from its
      developmental site, through the symphysis of the mandible. Lateral, postero
      anterior cephalometric films and periapical radiographs, provide additional
      important information. After having analysed the most frequent etiological
      factors of mandibular canine impaction, the authors present their considerations
      concerning the probable pathogenetic mechanism of transmigration. In addition to
      the proinclination of the lower incisors and the increasing axial inclination of
      the unerupted canine, already pointed out by other authors, an enlargement of the
      symphyseal cross-sectional area has been observed and documented. In conclusion
      it is important, also from a therapeutical point of view, to keep under control,
      by periodical panoramic radiographs, all those clinical situations considered at
      risk due to their possible evolution in transmigration and which are
      characterized by: 1) an unerupted canine which can be palpated in a mesial
      position in the labial sulcus; 2) an enlarged symphyseal cross-sectional area; 3)
      an obstacle to normal eruption (cysts, odontomas, ecc.); 4) a proinclination of
      the lower incisors. A progressive worsening of the position of the unerupted
      canine should induce to consider the possibility of an early interception of this
      anomalous condition, which, once established, results in the definitive impaction
      of the tooth.

PMID- 1758421
TI  - [Osteomas of the jaws. A clinical and rehabilitative problem].
AB  - The authors study, based on three cases of maxillary osteoma brought to their
      attention, evaluates the most suitable type of operation to perform, and the
      method with which to attention which to approach the problem of postoperative
      functional rehabilitation. This pathological condition is characterized by slow
      developments and the late appearance of symptoms deriving from the invasion of
      surrounding tissues. The chosen technique is surgery, involving the removal of
      the neoplasm. The benign nature of the neoplasm makes conservative surgery
      possible, including the partial removal of the neoplasm, in order to preserve the
      bone tissue indispensable for prosthetic rehabilitation. In cases in which the
      neoplasm spreads to surrounding tissues, in which more destructive surgery is
      required with an attendant loss of considerable portions of bone, we have used
      osteo-muscular pedicle flaps in combination with implantation techniques to
      obtain adequate functional and prosthetic rehabilitation.

PMID- 1758422
TI  - [Implant-prosthetic rehabilitation in posttraumatic maxillomandibular tissue
      losses].
AB  - Trauma in the maxillary-facial region can causes loss of mucous, dental and bone
      tissues, particularly in cases of ballistic trauma in which the explosive force
      disperses the affected tissues to some distance. This circumstance greatly
      complicates functional rehabilitation, a process requiring not only the
      construction of prostheses to replace the lost dental structures, but also the
      reconstruction of the mucous and bone tissues that will support the prostheses.
      Using methods involving the formation of pedicle bone grafts and the use of
      implantation techniques, it has been possible to guarantee a satisfactory
      functional rehabilitation, and in addition good results from the point of view of
      appearance have been obtained.

PMID- 1758423
TI  - [Misoprostol in oral surgery. 112 clinical evaluations].
AB  - The efficacy of misoprostol in protecting gastric mucosa during postoperative
      NSAID therapy was assessed in a sample group of 112 patients of both sexes
      suffering from gastric pathologies for which they had undergone oral surgery. The
      analysis of the results confirms the therapeutic efficacy of misoprostol which
      enabled these patients to conclude the recommended treatment.

PMID- 1758424
TI  - [Anthropometric assessments in dental esthetics].
AB  - Various parameters related to the mobility of the upper lip in a sample of 200
      patients, have been considered in order to establish the correlation these have
      with the extent of lip mobility and the relative visibility of their teeth. From
      this study it was clear that a large number of patients, with a low index of
      tooth visibility, could benefit, from the viewpoint of their periodontal health,
      from the application of prosthetic margins above the gums. This would not damage
      the aesthetic aspect because the margins in question would only be visible with
      the lips contracted or, in certain patients, never.

PMID- 1758425
TI  - Neurologic complications of systemic lymphoma.
AB  - Lymphoma denotes a heterogeneous group of neoplasms derived from lymphoreticular
      tissues. It can cause neurologic symptoms by infiltrating into the meninges or
      brain parenchyma. Alternatively, lymphomas may metastasize to bone or infiltrate
      into the epidural space via intervertebral foramina to cause neurologic
      dysfunction by compressing adjacent CNS structures. These direct effects can
      occur at any time during the disease process; most distressingly, meningeal
      infiltration may be the initial site of relapse after a complete remission.
      Diffuse and more undifferentiated lymphomas are much more likely to be
      responsible for producing either meningeal infiltration or intraparenchymal
      lesions. Direct CNS invasion by lymphoma is associated with significant patient
      morbidity and short survival despite intensive therapy; whether this
      manifestation of lymphoma can be prevented by prophylactic CNS treatment remains
      uncertain. CNS complications may also occur as a result of indirect effects of
      lymphoma. Therefore, CNS dysfunction may develop as a result of infections that
      occur secondary to immunosuppression, as a result of antineoplastic therapies, or
      as a result of true paraneoplastic syndromes. It is important to distinguish
      between these indirect effects and tumor progression because their recognition
      permits frequently available appropriate treatment modalities to be administered.

PMID- 1758426
TI  - Neurologic complications of systemic cancer.

PMID- 1758427
TI  - Brain metastases.
AB  - Brain metastases are the most common intracranial tumors and affect 20% to 30% of
      patients with systemic cancer. Improvements in diagnostic imaging and recent
      advances in treatment have resulted in extension of survival and decreased
      morbidity due to neurologic causes. The overall prognosis, however, remains poor
      because of the presence of systemic cancer.

PMID- 1758428
TI  - Metastatic epidural spinal cord compression.
AB  - It is important to remember that ESCC is a complication of systemic malignancy
      and usually denotes disseminated disease with poor survival rates. Early
      diagnosis is crucial. The initial symptom is almost always back pain, which is
      local, radicular, or both. Following neurologic examination and radiography, MRI
      scanning or myelography/CT is immediately indicated if radiculopathy or
      myelopathy is present or if the radiographs of the spine are abnormal. In cancer
      patients with local back pain and normal findings on neurologic examination and
      radiography of the spine, there is still a probability of 0.1 of significant
      ESCC. Therefore, urgent CT/MRI scanning is justified. At present, the best
      treatment for ESCC remains unknown. In the majority of patients, radiotherapy is
      the most readily available and appropriate option because it is equal in effect
      to posterior decompressive laminectomy in both radiosensitive and radioresistant
      tumors. In patients with posterior epidural disease without tissue diagnosis,
      laminectomy with or without stabilization should be performed. Posterior
      decompressive laminectomy alone is contraindicated in patients with vertebral
      collapse. In selected instances of anterior epidural compression without tissue
      diagnosis or after failure of radiotherapy, an anterior surgical approach or
      synchronous vertebral decompression with posterior stabilization may be
      indicated. In the future, after appropriate clinical trials, vertebral body
      resection may be the optimal approach in de novo selected patients with ESCC with
      radioresistant tumors and limited systemic spread of the disease.

PMID- 1758429
TI  - Central nervous system infections in cancer patients.
AB  - In the immunocompromised patient, even mild forms of any combination of headache,
      meningismus, altered mental status, or focal neurologic signs should initiate an
      evaluation for possible CNS infection. The limited signs and symptoms of acute
      CNS infection are not due to specific organisms but to pathologic changes at the
      neuroanatomic site of infection. The initial clinical history, examination,
      laboratory, and neuroradiographic data will narrow the problem to one of several
      groups of agents, although it may not be possible to specify a single causative
      agent. It should be remembered that several concurrent infections (i.e., CMV and
      toxoplasmosis, aspergillosis, and bacterial sepsis) may be present. Thus, the
      clinician should rely on broad antibiotic coverage appropriate to the suspected
      causative agent or agents at the site of infection. It may be necessary to offer
      broad-spectrum antibiotic coverage for a CSF presentation that is subsequently
      found to result from a viral illness or from a noninfectious cause. However, one
      should avoid undertreating those infections for which specific therapy can be
      offered, and broad-spectrum treatment usually will not be regretted. Uncertainty
      in diagnosis following noninvasive procedures should lead to a brain biopsy.
      Although many of the infections discussed in this article have a poor prognosis,
      some of the most common pathogens, such as Cryptococcus, Listeria, and
      Toxoplasma, have effective specific therapies to which the patient should have
      access as rapidly as possible. The clinician who has successfully treated a
      patient with CNS infection should remain vigilant for late sequelae or recurrence
      of infection. Chronic treatment of some infections, such as toxoplasmosis or
      aspergillosis, may be necessary. The reintroduction of steroids for the treatment
      of an underlying cancer may reactivate previously treated disease, such as
      cryptococcosis, and periodic CSF surveillance is appropriate under these
      circumstances. Recurrence of the symptoms should raise the suspicion of recurrent
      or new infection, and the patient also should be evaluated with CT or MRI for the
      development of hydrocephalus or for new metastatic disease. In patients who have
      had varicella-zoster infection, postherpetic neuralgia and delayed arteritis may
      develop. Seizures, hearing loss, and neuropsychologic sequelae may follow any
      meningoencephalitis. The patient should always be reevaluated for the possibility
      of infection with a different opportunistic organism. CNS infections remain a
      major cause of morbidity and mortality in immunosuppressed patients with
      malignancies. In one series, 60% of such patients died as a result of their CNS
      infection, many at a time when the underlying disease had an otherwise good
      prognosis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1758430
TI  - Cerebrovascular complications in cancer patients.
AB  - The clinician should be alert to the possibility of cerebrovascular disease in
      cancer patients who develop signs of diffuse or focal cerebral dysfunction. The
      cause of cerebrovascular disease can usually be determined by knowing the primary
      tumor type, extent of metastatic disease, and type of antineoplastic treatment.
      Symptomatic infarctions are more common than hemorrhages in patients with
      carcinoma, and NBTE and cerebral intravascular coagulation are the most common
      causes of infarction. Brain hemorrhages in patients with carcinoma are usually
      from hemorrhage into metastatic tumor. Symptomatic hemorrhages are much more
      common than infarction in patients with leukemia, and hemorrhages may be caused
      by coagulopathy or central nervous system infiltration. Infarction in leukemia is
      usually due to septic embolism or intravascular coagulation. By determining the
      cause of cerebrovascular disease in the cancer patient, the clinician can often
      recommend appropriate treatment and predict the clinical outcome.

PMID- 1758431
TI  - Neuromuscular complications of systemic cancer.
AB  - In patients with cancer, neuromuscular dysfunction often develops as a result of
      some combination of direct effects of the cancer, from complications of therapy,
      or from paraneoplastic syndromes. Direct effects include leptomeningeal
      involvement by tumors (most frequently of the breast and lung) causing
      polyradiculopathy and compressive brachial and lumbar plexopathies that produce
      distinctive and typically painful syndromes. The differentiation between
      radiation and tumor-associated brachial plexopathies may be difficult, however.
      Peripheral neuropathy is an important dose-limiting toxic side effect of two
      commonly utilized agents, vincristine and cisplatin. Recent studies have
      suggested that this complication may be ameliorated or even prevented by
      prophylactic administration of protective agents. Finally, cancer can cause
      neuromuscular dysfunction through more remote effects and can produce a variety
      of paraneoplastic syndromes that include subacute sensory neuropathy. Lambert
      Eaton myasthenic syndrome, and the neuropathy associated with paraproteinemia. In
      some syndromes, the presence of specific antibodies that cross-react with both
      neuromuscular tissues and primary tumors strongly suggests an immune-mediated
      pathogenesis. In some patients, immunosuppressive therapies and plasmapheresis
      may relieve symptoms.

PMID- 1758432
TI  - Paraneoplastic syndromes.
AB  - The neuromuscular complications of systemic cancer include direct effects
      (compression or infiltration of peripheral nerve tissues by tumor cells), effects
      of radiation and chemotherapy, and remote effects. Remote effects constitute the
      paraneoplastic syndromes--a heterogeneous group of disorders that include motor
      neuron disease, axon-loss and demyelinating polyneuropathies, Lambert-Eaton
      myasthenic syndrome, and inflammatory myopathies.

PMID- 1758433
TI  - Pain syndromes in the cancer patient.
AB  - Paraneoplastic syndromes affect the nervous system in a very small percentage of
      patients with cancer. In those patients, portions of the nervous system are
      damaged or destroyed, usually in association with a small and often occult
      neoplasm elsewhere in the body. Current evidence suggests that these syndromes
      occur when the body mounts an immune response to an antigen shared between the
      tumor and the nervous system. The immune attack is then misdirected against that
      portion of the nervous system that possesses the "onconeural" antigen.

PMID- 1758434
TI  - Neurologic complications of chemotherapy.
AB  - Neurotoxicity is a common and potential dose-limiting complication of cancer
      chemotherapy. For most agents, high-dose therapy, combination chemotherapy,
      concomitant cranial radiotherapy, and intracarotid or intrathecal injection are
      more likely to produce neurologic complications than standard oral or intravenous
      therapy. Any portion of the nervous system can be damaged. Encephalopathies
      (either focal or diffuse) are produced by BCNU, cisplatin, cytarabine, 5
      fluorouracil, ifosfamide, L-aspariginase, methotrexate, procarbazine,
      corticosteroids, and some biological response modifiers (interferon, interleukin
      2). Cerebellar syndromes may follow the administration of cytarabine, 5
      fluorouracil, and procarbazine. Myelopathy may complicate intrathecal
      methotrexate, cytarabine, thiotepa, and accidental intrathecal vincristine or
      doxorubicin injection. Peripheral neuropathy occurs from cisplatin, vincristine,
      and, sometimes, cytarabine or procarbazine. Myopathy is a common complication of
      corticosteroids. Strokelike syndromes may occur with L-aspariginase, high-dose
      methotrexate, and intracarotid BCNU or cisplatin. Differentiating the neurologic
      complications of chemotherapy from other neurologic complications of cancer is
      often difficult. As cancer patients are treated more aggressively, receive more
      chemotherapy, and live longer, and as new chemotherapeutic agents are developed
      and existing agents are used more intensively or in novel ways, neurologic
      complications of cancer chemotherapy will become more common, serious, and
      complex. The recognition and treatment of chemotherapy-induced neurotoxicity will
      become a frequent and important clinical problem for most neurologists.

PMID- 1758435
TI  - Central nervous system injury by therapeutic irradiation.
AB  - Therapeutic irradiation is the cornerstone of therapy for many neoplastic
      diseases but, at the same time, is capable of causing devastating injury to the
      brain and spinal cord. Thoughtful planning and meticulous execution of
      radiotherapy reduces the risk of neurotoxicity, but there remains a small and
      unavoidable risk of serious injury if an effective radiation dose is to be given.
      It is hoped that better understanding of the mechanisms of radiation injury will
      lead to safer yet equally effective therapies.

PMID- 1758436
TI  - Neurologic complications of leukemia.
AB  - In any patient with leukemia and new neurologic findings, the first entity that
      must be considered is direct invasion of the nervous system. If that is not a
      consideration, one must systematically consider cerebrovascular disorders, CNS
      infections, or metabolic abnormalities as the cause. Finally, one must not
      overlook radiotoxicity, chemotoxicity, or both in the differential diagnosis.
      Although some neurologic disorders are stereotyped in their presentation and are
      relatively easy to recognize, others continue to perplex the physician. Symptoms
      may be multifactorial in origin, compounding the problem. Leukemia is a systemic
      disease that may affect the nervous system at any site and at any time during the
      illness. Now that cure is possible and even to be expected in these diseases, it
      has become even more important to recognize and alleviate any neurologic
      morbidity.

PMID- 1758437
TI  - Molecular mechanics and molecular dynamics studies of the intercalation of
      dynemicin-A with oligonucleotide models of DNA.
AB  - Intermolecular molecular modeling calculations to determine the intercalation
      behavior of dynemicin-A with DNA were performed using both static scanning and
      energy minimization and molecular dynamics relaxation techniques. Two base pair
      sequences, CpApCpGpGpGp-3'/GpTpGpCpCp-5' and ApCpTpApCpTp-3'/TpGpApTpGpAp-5',
      were considered in the calculations. The static scanning and energy minimization
      analyses identified multiple stable intercalation complexes for each base pair
      sequence. These complexes were subsequently used as starting structures in
      molecular dynamics relaxation simulations. Intercalation into the minor groove is
      preferred for both base pair sequences, and intercalation at a central CG site is
      preferred by about 9 kcal/mol over a TA site. However, intercalation at a TA site
      should be more reactive, in terms of chain scission, than that at a CG site,
      because dynemicin-A has more flexibility to achieve an intercalation geometry
      disposed to chemically react toward a base adjacent to the 3' side of a purine.
      This reaction model is consistent with experimental data.

PMID- 1758438
TI  - Effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on 17 beta-estradiol-induced
      glucose metabolism in MCF-7 human breast cancer cells: 13C nuclear magnetic
      resonance spectroscopy studies.
AB  - The effects of 17 beta-estradiol, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), and
      their combination on the metabolism of [1-13C] glucose were determined in cell
      suspensions of wild-type MCF-7 human breast cancer cells, by 13C NMR
      spectroscopy. Preliminary studies showed that, during the 7-hr duration of the
      NMR experiment, the cells maintained their viability and their aryl hydrocarbon
      responsiveness. Lactate was the major glucose metabolite detected in these
      studies, and the rate of lactate formation in the untreated (control) and 17 beta
      estradiol (10(-9) M)-treated cells was 60 and 86 fmol/cell/hr, respectively; this
      represented a 40% increase in lactate formation in the cells treated with 17 beta
      estradiol; comparable results were observed for the percentage of glucose
      converted into lactate. In contrast, TCDD (10(-9) M) did not significantly alter
      the rate of glucose metabolism or lactate formation. Co-treatment of the cells
      with 17 beta-estradiol (10(-9) M) plus TCDD (10(-8) to 10(-10) M) showed that
      TCDD completely inhibited the 17 beta-estradiol-induced metabolism of [13C]
      glucose to lactate in MCF-7 cells. In contrast, 2,8-dichlorodibenzo-p-dioxin (10(
      8) M), a weak aryl hydrocarbon receptor agonist, did not inhibit estrogen-induced
      glucose-to-lactate metabolism in MCF-7 cells. In addition, it was shown that TCDD
      caused a significant decrease in 17 beta-estradiol-induced lactate formation
      within 1 hr after treatment, whereas the induction of monooxygenase activity was
      not observed until 3 hr after exposure of the cells to TCDD. These data indicate
      that TCDD-induced 17 beta-estradiol metabolism is not related to the decrease in
      the rate of conversion of glucose to lactate. These results further define the
      antiestrogenic responses elicited by TCDD and show that 13C NMR spectroscopy
      provides a unique method for measuring, in real time, the effects of TCDD on
      specific metabolic pathways.

PMID- 1758439
TI  - Expression and pharmacological characterization of a canine 5-hydroxytryptamine1D
      receptor subtype.
AB  - RDC4 is a guanine nucleotide-binding protein-coupled receptor clone originally
      isolated from a canine thyroid cDNA library by Libert and colleagues [Science
      (Washington D. C.) 244:569-572 (1989)]. We have isolated the corresponding
      genomic clone for RDC4, have expressed this clone in murine LM (tk-) fibroblasts,
      and have determined that it encodes a serotonin 5-hydroxytryptamine1D (5-HT1D)
      receptor. RDC4 is an intronless gene encoding a protein of 377 amino acids, which
      exhibits greatest sequence identity (43%) to the 5-HT1A receptor and lower
      overall homology to other serotonergic and catecholaminergic receptors. Membranes
      prepared from murine LM (tk-) fibroblasts stably transfected with this clone were
      shown to bind [3H]5-HT in a saturable manner and displayed an apparently
      homogeneous population of high affinity (Kd = 3.6 nM, Bmax = 275 fmol/mg of
      protein) [3H]5-HT binding sites. High affinity [3H] 5-HT binding was unchanged
      using assay conditions [1 microM (+/- )-pindolol and 1 microM (R)-(+/- )-SCH
      23390) to pharmacologically mask 5-HT1A, 5-HT1B, and 5-HT1C receptors.
      Serotonergic ligands displaced specific [3H]5-HT binding with a rank order of
      potency expected of a 5-HT1D receptor subtype, 5-carboxyamidotryptamine greater
      than 5-HT greater than yohimbine greater than 8-hydroxy-2-(di-n
      propylamino)tetralin greater than ketanserin = spiperone greater than zacopride.
      Further, transfected cells responded to addition of 5-HT by decreasing the level
      of forskolin-stimulated cAMP accumulation. These data indicate that the gene RDC4
      encodes a functional 5-HT1D receptor.

PMID- 1758440
TI  - Clonidine-displacing substance from bovine brain binds to imidazoline receptors
      and releases catecholamines in adrenal chromaffin cells.
AB  - Identification of nonadrenergic binding sites for clonidine and related
      imidazolines in brain and peripheral tissues and partial purification of an
      endogenous ligand for these sites have led to the postulation of a novel
      transmitter/receptor system. The receptors seem to be present in adrenal medulla
      and to regulate chromaffin cell function. The present study was undertaken to
      test the ability of the putative endogenous ligand clonidine-displacing substance
      (CDS) to displace [3H]idazoxan binding to adrenal chromaffin cell membranes and
      to release catecholamines from cultured chromaffin cells. CDS potently displaces
      [3H]idazoxan binding to chromaffin cell membranes, with an IC50 of 5 units. The
      displacement of [3H]idazoxan binding by CDS was not modified by guanosine 5'
      (beta, gamma-imido)triphosphate, suggesting that the imidazoline binding sites
      may not be GTP-binding protein-coupled receptors. CDS produced a large release of
      catecholamines from chromaffin cells, and the release was partially blocked by
      cobalt, a calcium channel blocker. The calcium-dependent release reached a
      plateau above 5 units of CDS, with a maximal response at 15 min. It is concluded
      that endogenous CDS, prepared from brain, regulates the secretion of
      catecholamines from adrenal chromaffin cells, probably by activating imidazole
      receptors.

PMID- 1758441
TI  - Subtype-specific antibodies for muscarinic cholinergic receptors. I.
      Characterization using transfected cells and avian and mammalian cardiac
      membranes.
AB  - Polyclonal antibodies to a number of synthetic peptides corresponding to
      sequences of human muscarinic acetylcholine receptor (mAChR) subtypes m1, m2, and
      m4 have been prepared, in order to obtain specific tools with which to study the
      properties of the different receptors. Hydrophilic peptides from each subtype
      were chosen from the large intracellular loop between the fifth and the sixth
      transmembrane domains, because these loops are distinct in each of the mAChR
      subtypes and contain determinants for coupling to different GTP-binding proteins,
      as well as potential sites for phosphorylation. Five different antibodies were
      prepared and tested for their reactivity and specificity toward different mAChR
      subtypes by immunoprecipitation of ligand-binding activity and receptor protein
      and by immunoblot analysis. Each of the antisera immunoprecipitated its
      respective mAChR subtype, as evidenced by precipitation of 50-70% of the ligand
      binding activity from stably transfected cells expressing the respective mAChR
      subtype. Very little cross-reactivity toward other subtypes was observed. We used
      these subtype-specific antibodies to probe the nature of the mAChR subtypes
      naturally expressed in avian and mammalian cardiac membranes. In tests using the
      antibodies with cardiac mAChRs, differences in the avian and mammalian mAChR
      subtypes were detected. Only the anti-m2 antibodies reacted with mAChR from
      porcine heart, confirming previous pharmacological and molecular biological
      studies that suggested that this tissue expressed only the m2 mAChR subtype. In
      contrast, both the anti-m2 and anti-m4 mAChR antibodies immunoprecipitated
      approximately 50% of the mAChRs solubilized from chick heart membranes. The
      combined or successive use of anti-m2 and anti-m4 antisera in immunoprecipitation
      and/or immunoblotting studies with chick heart mAChRs suggested that both
      antibodies appeared to recognize the same population of mAChRs from that tissue.
      Taken together, the results show that the subtype-specific antibodies developed
      in this work are useful in recognizing mAChR subtypes in cells and tissues. These
      antibodies should be valuable tools for further study of the properties and
      regulation of mAChR subtypes in various preparations. Evidence that the
      antibodies can modify mAChR/GTP-binding protein interactions is presented in the
      accompanying paper.

PMID- 1758442
TI  - Subtype-specific antibodies for muscarinic cholinergic receptors. II. Studies
      with reconstituted chick heart receptors and the GTP-binding protein G(o).
AB  - The antibodies described in the accompanying paper were used to probe the
      interactions of the chick heart muscarinic acetylcholine receptors (mAChRs) with
      the GTP-binding protein G(o). The anti-m4b antibodies, which were made against a
      peptide from the amino-terminal portion of the third cytoplasmic loop of the m4
      mAChR subtype, were tested for their abilities to affect the coupling of the
      chick heart mAChR to the GTP-binding protein G(o). The purified chick heart
      mAChRs were reconstituted with purified G(o) in phospholipid vesicles, and their
      interactions were monitored in the presence or absence of the antibodies. The
      anti-m4b antibodies completely inhibited the ability of G(o) to promote high
      affinity agonist binding to the purified receptors. The anti-m4b antibodies also
      completely inhibited the agonist-stimulated binding of guanosine-5'-O-(3
      thio)triphosphate (GTP gamma S) to G(o) and the receptor-stimulated GTPase
      activity of G(o). These findings indicate that the amino-terminal portion of the
      third cytoplasmic loop is an important determinant for G(o) to promote high
      affinity agonist binding to the chick heart mAChR and also for the agonist
      stimulated GTP gamma S binding and GTPase activity. The anti-m4a, anti-m2, and
      anti-m1a antibodies, which were made against centrally located peptides of the
      third cytoplasmic loop of the m4, m2, and m1 mAChR subtypes, respectively, were
      also tested for their effects in the reconstituted receptor/G(o) system. The anti
      m2 and anti-m4a antibodies also significantly reduced agonist-stimulated GTP
      gamma S binding, as well as GTPase activity, but did not completely abolish these
      functions, as was the case with anti-m4b antibodies. However, the anti-m4a and
      anti-m2 antibodies shared with anti-m4b antibodies the ability to markedly
      inhibit the ability of G(o) to promote high affinity agonist binding to the
      purified and reconstituted receptors. In contrast to the results obtained with
      the anti-m2 and anti-m4 antibodies, the anti-m1a antibodies had smaller effects
      on the receptor/G(o) interactions. These results suggested that central portions
      of the loop can also influence mAChR/G(o) interactions. Studies were als
      performed to test the effects of the peptides that were used as antigens on
      receptor-mediated GTP gamma S binding to G(o). Each of the peptides caused
      significant inhibition of this function, but the greatest inhibition was observed
      with the m4b peptide. In sum, the results suggest that multiple domains in the
      third cytoplasmic loop of chick heart mAChR can modulate interactions with G(o).

PMID- 1758443
TI  - Polypeptide toxins from the venoms of Old World and New World scorpions
      preferentially block different potassium channels.
AB  - Venoms from five Old World and two New World scorpions were tested for their
      ability to block various K+ channels in rat brain synaptosomes. A 86Rb efflux
      kinetic assay was used to identify three types of K+ channels, Ca(2+)
      independent, voltage-gated, inactivating (A-type) and noninactivating (delayed
      rectifier) K+ channels and Ca(2+)-activated K+ channels [J. Physiol. (Lond.)
      361:419-440, 441-457 (1985)]. The venoms from the Old World scorpions all blocked
      the A-type K+ channel but not the delayed rectifier K+ channel; only venom from
      the Israeli scorpion, Leiurus quinqestriatus hebraeus (Lqh), blocked the Ca(2+)
      activated K+ channel. In contrast, venoms from the two New World scorpions
      selectively blocked the delayed rectifier K+ channel. Water-soluble components
      from Lqh venom from the Brazillian scorpion, Tityus serrulatus (Ts), were
      separated by ion exchange high performance liquid chromatography (HPLC). Seven
      components that blocked synaptosome K+ channels were isolated from Lqh venom by
      ion exchange HPLC. All seven components blocked the A-type K+ channel; the five
      most potent toxins had IC50 values of 18-40 nM. Two of the components from Lqh
      venom (one identified as charybdotoxin and the other denoted as Lqk4) also
      blocked a Ca(2+)-activated K+ channel (IC50 = 15 and 60 nM for charybdotoxin and
      Lqk4, respectively). Five K+ channel-blocking components were isolated from the
      Ts venom; all five blocked the delayed rectifier channel selectively, and the two
      most potent components had IC50 values of 8 and 30 nM. Several of the more potent
      Lqh and Ts toxins were purified to near-homogeneity by reverse phase HPLC. These
      toxins should be useful as ligands for K+ channel purification, for elucidation
      of K+ channel structure, and for studies of K+ channel function.

PMID- 1758444
TI  - Muscarinic receptors in canine colonic circular smooth muscle. I. Coexistence of
      M2 and M3 subtypes.
AB  - The parasympathetic neurotransmitter acetylcholine, acting postsynaptically at
      the smooth muscle muscarinic receptor, is a principle determinant of colonic
      motility. In order to elucidate the receptor signal-transduction events
      responsible for muscarinic receptor-induced contraction of colonic circular
      smooth muscle, we present here and in the accompanying work studies designed to
      characterize the muscarinic receptors present in colon and to determine their
      biochemical coupling. Muscarinic receptor subtypes in canine colonic circular
      smooth muscle were characterized using radioligand binding techniques. The
      nonselective muscarinic receptor antagonist radioligand [3H]quinuclidinyl
      benzilate ([3H]QNB) binds rapidly and reversibly to a single class of saturable
      sites in colon circular smooth muscle membranes, with an affinity (KD) for the
      antagonist radioligand of 79.8 +/- 12.6 pM and a density of 123.3 +/- 18.7
      fmol/mg of protein. Experiments using membranes prepared from isolated cells
      purified from the circular smooth muscle layer of canine colon (KD = 102.4 +/-
      13.5 pM) confirm the smooth muscle origin of the binding and yield a receptor
      density of 124,340 receptors/cell. The order of potencies of selective muscarinic
      receptor antagonists in competition with [3H]QNB for binding to colonic receptors
      is 4-diphenylacetoxy-N-methylpiperidine methobromide greater than methoctramine
      greater than AF-DX 116 greater than pirenzepine. Unlike other antagonists tested,
      pirenzepine competition of [3H]QNB binding is biphasic. The high and low
      affinities deduced from nonlinear fit of the binding data in colon correlate very
      well with affinities determined for pirenzepine in mixtures of both submandibular
      gland (M3) and atrium (M2), indicating the presence of two muscarinic receptor
      subtypes (82% M2, 18% M3) in colon circular smooth muscle. The muscarinic agonist
      carbachol binds to both high and low affinity sites in colon, and addition of
      guanine nucleotide (100 microM GTP gamma S) shifts the agonist competition curve
      to the right, without eliminating high affinity binding sites. Agonist
      competition studies with a known ratio of M2 and M3 receptors, obtained by mixing
      pure M2 and M3 populations, predict the result obtained in colon. cDNA probes
      specific for each of the muscarinic receptors m1 through m4 were hybridized to
      colon RNA in a Northern blot analysis. Only m2 and m3 probes hybridized to colon
      RNA, suggesting the presence of both M2 and M3 receptors. Our data demonstrate
      that the colon circular smooth muscle contains muscarinic receptors of both the
      M2 and M3 subtypes, which may be coupled to disparate signal transduction
      pathways important in the physiological actions of acetylcholine in this tissue.

PMID- 1758446
TI  - Lesion of the subthalamic nucleus for the alleviation of 1-methyl-4-phenyl
      1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonism in the primate.
AB  - Central to the neural mechanism of MPTP-induced parkinsonism is overactivity of
      the subthalamic nucleus. Lesion of the subthalamic nucleus has therefore been
      performed in two primates with this condition and found to produce a remarkable
      amelioration of the disorder.

PMID- 1758445
TI  - Metal- and photo-induced cleavage of DNA by podophyllotoxin, etoposide, and their
      related compounds.
AB  - Podophyllotoxin (PD) and its derivative etoposide (VP-16), a clinically useful
      anticancer drug, exhibit different mechanisms of action. PD binds specifically to
      tubulin to prevent its polymerization, whereas VP-16 lacks this action. The DNA
      strand breakage caused by VP-16 is thought to be due to its interaction with
      topoisomerase II or to free radical formation by oxidation of its 4'-phenolic
      hydroxyl group to a semiquinone free radical. We have demonstrated that PD, VP
      16, 4'-demethylepipodophyllotoxin (DEPD), and syringic acid (SA) exhibit no DNA
      cleaving activity but, in the presence of metal ions such as Cu2+ and Fe3+, DEPD
      and SA form metal complexes, which in turn show high activity for DNA strand
      scission at pH 7.8 under air. Furthermore, it was found that DNA cleavage was
      greatly promoted by irradiation with UV light. The PD-Fe3+ system at pH 7.8
      showed very low DNA-cleaving activity, but irradiation with UV light in the
      system induced almost complete DNA breakage. DNA cleavages were significantly
      inhibited in the presence of hydroxyl radical scavengers, such as sodium benzoate
      and dimethylurea, in the Cu(2+)-SA and Fe(3+)-PD systems, with or without UV
      irradiation. These reactions were investigated by optical and ESR spectra,
      coupled with ESR spin-trapping techniques, by which the formation of hydroxy
      radicals was clearly detected in all systems. These findings have led us to a new
      proposal of the metal- and photo-induced mechanism for understanding the
      antitumor action of PD, VP-16, and their related compounds.

PMID- 1758447
TI  - Electroconvulsive therapy in Parkinson's disease and other movement disorders.
AB  - Early case reports note marked improvements in the signs of Parkinson's disease
      (PD) in several patients with coexisting psychiatric disorders after treatment
      with electroconvulsive therapy (ECT). Studies since 1959 reveal improvement of
      parkinsonism in over half of PD patients receiving ECT, regardless of the
      presence or absence of psychiatric comorbidity. Drug-induced parkinsonism,
      tardive dystonia, and tardive dyskinesia have also been shown to improve with ECT
      administration; tic syndromes have achieved mixed results. In animals, ECT
      enhances dopamine-mediated effects and increases GABA concentrations in the CNS.
      Optimal parameters relevant to the antiparkinsonism effects of ECT require
      further study.

PMID- 1758448
TI  - A case-control study of idiopathic torsion dystonia.
AB  - A study of 71 patients with idiopathic torsion dystonia (ITD) and 71 matched
      controls was performed to investigate the range of possible clinical expression
      of ITD and the role of environmental factors in the development of the disease. A
      family history of tremor and stuttering were the only factors significantly
      associated with ITD. No associated environmental factor was identified.

PMID- 1758449
TI  - Intrafamilial correlation in idiopathic torsion dystonia.
AB  - Age of onset and severity of idiopathic torsion dystonia (ITD) were studied in
      100 British families containing 107 index cases and 79 secondary cases. Analysis
      of variance of these clinical features did not suggest that ITD is genetically
      heterogenous, and they were similar in Jewish and non-Jewish patients.
      Intrafamilial correlation for age of onset was low, particularly between parents
      and their offspring, suggesting that the ITD phenotype may be determined in part
      by nongenetic factors or an allelic modifying gene.

PMID- 1758450
TI  - Inhibition of forearm EMG by palatal myoclonus.
AB  - The forearm electromyogram (EMG), pharyngeal EMG, and wrist tremor were recorded
      simultaneously from a 74-year-old woman with the syndrome of palatal myoclonus
      and progressive ataxia. Her wrist tremor had the characteristics of enhanced
      physiologic tremor. The enhancement of her tremor was attributable to 50- to 80
      ms silent periods in the forearm EMG that followed the 1.9-Hz bursts of palatal
      myoclonus by 50 to 60 ms. This observation and those of previous authors support
      the notion that rhythmic olivocerebellar discharges can cause tremorogenic
      excitation and inhibition of postural EMG activity in the upper extremities.

PMID- 1758451
TI  - Interobserver reliability between neurologists in training of Parkinson's disease
      rating scales. A multicenter study.
AB  - A multicenter study has been conducted to determine the interobserver
      reproducibility of four of the most frequently used rating scales for Parkinson's
      disease: the Columbia University Rating Scale (CURS) and the Webster Rating Scale
      (WRS), both for assessing clinical signs; the Northwestern University Disability
      Scale (NUDS); and the Hoehn and Yahr staging. Four resident neurologists,
      inexperienced in the use of the four scales, independently examined 48
      parkinsonian patients. The extent to which their assessments agreed was
      determined by calculating the Cohen k index after the scores had been recodified.
      The physicians' scores agreed substantially for the CURS and the Hoehn and Yahr
      scale, while those for the NUDS and the WRS agreed only moderately. Analysis of
      individual item scores within the scales suggests improvements that would offer
      greater interobserver consistency.

PMID- 1758452
TI  - Profile of patients enrolled in a new movement disorder clinic.
AB  - To assess the need for a regional expertise in movement disorders, the numbers of
      patients, clinic visits, and medication changes for a new movement disorder
      clinic were recorded. During 3 1/2 years, 355 patients were seen, with 1,329
      clinic visits. Idiopathic Parkinson's disease was the most common diagnosis,
      comprising 36% of the population, followed by dystonia (17%), tremor (12%),
      parkinsonism (i.e., Parkinson's plus syndromes, drug-induced parkinsonism, etc.)
      (10%), chorea (10%), Tourette's syndrome (6.5%), and tardive dyskinesia (3.4%).
      Distribution of follow-up visits was similar, with Parkinson's disease (52%)
      being most frequent and Tourette's syndrome (3.1%) least frequent. The relative
      utilization of medical care by each patient group was assessed by determining the
      number of medication changes and the number of clinic visits per follow-up year.
      No differences in these measures were found using a one-way analysis of variance.
      Of the Parkinson's disease patients, 67% had Hoehn and Yahr stages III-IV and 77%
      of the clinic visits were made by this subgroup. When considered in light of the
      prevalence of each of the diseases, these data show a need for an expertise in
      movement disorders for a population base of the size we have served.

PMID- 1758453
TI  - Idiopathic Parkinson's disease combined with multiple system atrophy. A
      clinicopathological report.
AB  - The clinical and postmortem findings of a patient with Lewy body pathology
      combined with multiple-system atrophy are described. When alive the patient was
      diagnosed as having Parkinson's disease. Pathological examination found evidence
      of striatonigral and olivopontocerebellar degeneration, together with Lewy bodies
      at a number of sites characteristic for idiopathic Parkinson's disease. Taken
      together, the clinical history and histological findings support the coexistence
      of two disease processes.

PMID- 1758454
TI  - Steroid-responsive chorea in moyamoya disease.
AB  - We report the case of a 13-year-old boy with disabling chorea due to moyamoya
      disease. His chorea seemed to improve with steroid therapy. We conclude that
      steroid therapy may ameliorate moyamoya-associated chorea, and perioperative
      steroids can confound neurosurgical outcome. We are unable to assess the effect
      of cerebrovascular bypass procedures on the outcome of chorea in this patient.

PMID- 1758455
TI  - Segmental ballistic movement overflow myoclonus: a clinical, electromyographic,
      and pharmacologic evaluation.
AB  - A 27-year-old man presented with a sporadic, nonprogressive, right-sided,
      segmental movement disorder that had started at the age of 2 years. Ballistic
      movement overflow myoclonus was diagnosed clinically and by surface
      electromyography. Special investigations did not detect anything except atrophy
      of the left temporal lobe on CT scan. The movement intensity was attenuated by
      alcohol but was minimally affected by high doses of oral propranolol (320 mg
      daily), clonazepam (36 mg daily), or trihexyphenidyl (32 mg daily). High-dose
      intravenous biperidine (10 mg) resulted in dramatic improvement, but with
      unacceptable side effects. The possible role of a cholinergic disturbance in
      generating myoclonus is discussed.

PMID- 1758456
TI  - Extending the concept of ballistic movement overflow myoclonus.

PMID- 1758457
TI  - Complex stereotypies after right putaminal infarction: a case report.
AB  - A 17-year-old boy is described who experienced circling behavior interrupting his
      gait and complex stereotyped movements of the hands after a complicated repair of
      an aortic coarctation. An MRI scan showed a right putaminal infarct. The boy's
      behavior and stereotypies bear a close resemblance to those found in autism.

PMID- 1758458
TI  - What is it? Case 1, 1991: a severe and fatal systemic illness first presenting
      with a movement disorder.

PMID- 1758459
TI  - What is it? Case 2, 1991: unusual tremor, myoclonus, and a limping gait.

PMID- 1758460
TI  - What is it? Case 3, 1991: moaning in a man with parkinsonian signs.

PMID- 1758461
TI  - Blepharospasm associated with pseudohypoparathyroidism and bilateral basal
      ganglia calcifications.

PMID- 1758462
TI  - Thalamic demyelination and paroxysmal dystonia in multiple sclerosis.

PMID- 1758463
TI  - Neuroleptic malignant-like syndrome associated with acute hydrocephalus.

PMID- 1758464
TI  - Levodopa-associated hemifacial dystonia.

PMID- 1758465
TI  - Tourette's syndrome in twins.

PMID- 1758466
TI  - IL-2 gene transfer in immunotherapy of cancer: local administration of IL-2
      activated lymphocytes and X63-m-IL-2 cells constitutively producing IL-2 inhibits
      growth of plasmacytomas in syngeneic mice.
AB  - Peritumoral administration of X63-m-IL-2 cells, transformed by IL-2 cDNA and
      constitutively producing large quantities of IL-2, was effective in mediating
      regression of X63-Ag8.653 plasmacytomas transplanted in syngeneic mice. Injection
      of killer cells with LAK activity substantially enhanced the tumor-inhibitory
      effect of IL-2-producing cells. In vitro activation of murine bone marrow and
      spleen cells with IL-2 produced by the X63-m-IL-2 cell line resulted in
      generation of lymphocytes with oncolytic activity against X63-Ag8.653
      plasmacytomas and a variety of other target cell lines. The cytolytic activity of
      adherent IL-2-activated killer cells (A-LAK) was substantially higher than that
      of a nonadherent subset. Bone marrow and spleen cells from both healthy control
      and tumor-bearing mice contained LAK precursors, but the cytolytic activity
      derived from tumor-bearing mice was lower than that from healthy controls.

PMID- 1758467
TI  - Growth and dissemination of human malignant lymphoblasts in immunosuppressed
      nu/nu mice.
AB  - Athymic nu/nu mice are commonly employed for the heterotransplantation of solid
      human tumors. Leukemias, however, have consistently proved difficult to
      transplant and, to enhance their take, recipient nu/nu mice have been variously
      immunosuppressed. In this study, the natural reactivity against human malignant T
      lymphoblast (PF382) of splenectomized nu/nu mice (S-nu/nu), nu/nu mice
      splenectomized and treated with polyinosinic-polycytidylic acid (SIC-nu/nu), and
      nu/nu mice splenectomized, irradiated and repeatedly injected with antiasialo GM1
      antiserum (SIA-nu/nu) has been correlated with the in vivo growth of subcutaneous
      and intravenous PF382 cell challenges. SIC-nu/nu mice display a marked natural
      killer (NK) activity, quickly clear 125I-Urd-labelled PF382 cells injected
      intravenously and do not allow the growth of subcutaneous nor intravenous PF382
      cell challenges. S-nu/nu mice display a slightly lower NK activity and slower
      clearance of 125I-Urd-labelled PF382 cells. Moreover, an intravenous PF382 cell
      challenge kills 56% of S-nu/nu mice. SIA-nu/nu mice have no NK activity, slowly
      clear 125I-Urd-labelled PF382 cells and always allow the growth of PF382 cells
      injected either subcutaneously or intravenously with a consistent pattern.
      Following the intravenous challenge, PF382 cells first metastasize to liver and
      kideny, then focal or diffuse infiltrations of the bone marrow and menings become
      evident. SIA-nu/nu mice thus offer an interesting experimental model for study of
      the pathogenesis of leukemic infiltration of the meninges, and the exploration of
      possible therapeutic approaches.

PMID- 1758468
TI  - Quantitation of natural killer cell function and risk of metastatic poorly
      differentiated head and neck cancer.
AB  - Previous laboratory studies have suggested that natural immunity is a primordial
      defense mechanism against blood-borne metastatic cancer, its function being most
      effective against dedifferentiated, low-major-histocompatibility-complex-class-I
      antigen-expressing tumors. In this clinical study, 263 previously untreated
      patients with squamous cell carcinoma of the upper aerodigestive tract were
      evaluated for natural killer (NK) cell cytotoxicity mediated by peripheral blood
      lymphocytes against K562 target cells. All patients were evaluated before
      treatment, underwent subsequent attempts at curative therapy in which they were
      initially rendered disease-free, and then followed longitudinally for clinical
      outcome. Using a Cox proportional hazards model, quantitated NK cell cytotoxicity
      was inversely related to subsequent death with disease (p = 0.05), regional
      metastases (p = 0.008) and distant metastases (p = 0.03). No relationship between
      NK cell function and local recurrence could be identified (p = 0.81). Patients
      were further stratified by degree of differentiation of their respective primary
      cancer. The prognostic implication provided as to risk of death with disease and
      progressive metastatic growth was confined to the population with moderate-to
      poorly differentiated cancers. Conversely, its function was nonpredictive in
      patients with well-differentiated cancers; the latter cancers were observed to
      express higher levels of major histocompatibility complex-class I framework
      antigens. Results of this clinical study are consistent with previous laboratory
      investigations and suggest that, within humans, the NK cell functions in
      metastatic sites against more primitive cancers. Such findings may have
      implications in designing therapeutic strategies.

PMID- 1758469
TI  - [Design of a species-specific DNA probe based on the pFra plasmid of the plague
      pathogen].
AB  - The recombinant plasmid pBS1 carrying a 2 kb SalGI fragment of Yersinia pestis
      pFra plasmid was constructed by insertion of the fragment into a vector plasmid
      pBR327. SalGI-BspRI 400 bp subfragment was recloned into a pBR322 vector plasmid.
      Open reading frame was found in the fragment by DNA sequencing technique. The
      subfragment designated F1-probe permits one to identify specifically the Yersinia
      pestis strains harbouring pFra plasmid, thus, differing them from closely related
      Yersiniea and other representatives of Enterobacteriaceae family.

PMID- 1758470
TI  - [Mutagenesis, induced by phosphotriester analogs of oligonucleotides and directed
      to the cleavage site of double-spiral DNA].
AB  - The mutagenic properties of phosphotriester analogues revealed in course of
      interaction with linearized plasmid DNA were studied. The plasmid-based model
      system permitting one to test reliably the induced mutations is proposed. The
      efficiency of mutagenesis was shown to depend on the length of the
      oligonucleotide-mutagen and the genotype of the transformed Escherichia coli
      strain. The possible mechanisms involved in mutagenesis are discussed.

PMID- 1758471
TI  - [Assessment of the genotoxicity of the "Binase" enzyme preparation].
AB  - "Binase" enzyme sample (a microbial ribonuclease) has been tested for
      mutagenicity in a set of tests. The set included Ames test Salmonella/microsome,
      Escherichia coli Rec-test, bacteriophage induction assay, DNA-repair synthesis in
      lymphoid cells. "Binase" is shown to possess a small genotoxic effect at high
      concentrations. Both animal and plant S-9 fractions eliminated the effect.

PMID- 1758472
TI  - [Transfer of transformation and conjugation plasmids from Escherichia coli to
      Bacillus subtilis and Azospirillum brasilense].
AB  - The conjugative transfer of RP4 plasmid from Escherichia coli to Azospirillum
      brasilense was detected after introduction and subsequent incubation of these
      microorganisms in soil. The plasmid transfer via transformation from Escherichia
      coli to Bacillus subtilis was observed in case both bacteria were growing
      together in sand containing sucrose solution. The possible reason for low
      frequency interspecies plasmid transformation under conditions close to natural
      habitats is poor survival of "domesticated" rather than wild type Bacillus
      subtilis strains and lack of competence state in this case.

PMID- 1758473
TI  - [Study of Brevibacterium flavum phage PhiBSh6].
AB  - Properties of a virulent Brevibacterium flavum bacteriophage phi BSh6 were
      studied. The phage was placed in morphological group B1 according to Ackerman
      classification, head diameter being 74-3 nm, tail length being 337 +/- 15 nm. The
      phage was shown to have double stranded DNA as a genetic material. The chromosome
      is linear having cohesive ends. Chromosome length was estimated to be about 71
      kbp by restriction analysis and electron microscopy. A unique EcoRI-EcoRI
      fragment of bacteriophage DNA (0.8 kbp) was cloned in Escherichia coli.
      Restriction chart of cos region was determined, the dyad symmetry being absent
      from cos sequence. Deletion mutant of the phage was obtained and restriction map
      of the corresponding genome region was constructed. The phage phi BSh6 was shown
      to be a close relative to phages phi B and BB14 described earlier.

PMID- 1758474
TI  - Determination of Cd, Co, Cu, Fe, Pb, Mn, Ni and Zn in diets: development of a
      method.
AB  - A method useful for the determination of cadmium, cobalt, copper, iron, lead,
      manganese, nickel and zinc in diets is described. Organic matter is destroyed
      applying a wet procedure, and element content is measured by flame atomic
      absorption spectroscopy (FAAS) in the case of copper, iron, manganese, nickel and
      zinc, and by graphite furnace (GF-AAS) in the case of cadmium, cobalt and lead.
      The matrix interference study is carried out. Values found for linearity,
      detection and quantitation limits as well as accuracy show that the described
      method is useful to determine the elements taken into account at usual levels in
      diets.

PMID- 1758475
TI  - Determination of carotenoids in foods by high-performance liquid chromatography.
AB  - The mean values of alpha and beta-carotene of 10 fruits and vegetables from
      supermarkets in Cairo and Alexandria have been determined using HPLC method, and
      the average vitamin A activities (in retinol equivalents) calculated. Carrots,
      spinach and sweet potatoes were the best sources of provitamin A activity. Beta
      carotene was the more prevalent carotenoid compared with alpha-carotene. An
      analysis of variance including all foods investigated demonstrated that there
      were no significant differences among either locations or times of analysis.
      There was no difference between the analysed values of vitamin A activity and the
      USDA Handbook No. 8 values.

PMID- 1758476
TI  - [The preparation of food and environmental samples for residue analysis of
      pesticides and PCBs by continuous steam distillation].
AB  - The treatment of water, soil and food samples was tested with a modified
      equipment of glass for simultaneous steam distillation/solvent extraction. Spiked
      samples with 22 pesticides (most of them contained halogen) and PCB yielded good
      or very good recoveries after 1.5 h for water samples and after 5 h for soil and
      plant food samples, respectively. This method is ecologically beneficial, and
      because it needs only a small amount of solvent (less than 10 ml) it is not
      expensive and may be used as a quick screening in several fields.

PMID- 1758477
TI  - [The determination of protein content of milk, cheese, and meat with the use of
      the biuret reaction].
AB  - A review is given of the different composition of biuret test solutions and
      experiments with the estimation of protein content of milk, cheese and meat by
      means of the biuret method are reported. The pure protein and the casein content
      of skimmed milk and the protein content of whole milk could be determined with
      biuret test solutions containing potassium hydroxide and a detergent. The use of
      the biuret method is advantageous in the case of cheese and meat, which are
      dissolved in potash lye or alkaline detergent solutions. Disturbances of the
      biuret method caused by lactose, fat or turbidity were eliminated after addition
      of hydrogen peroxide, by means of extraction or of additional measurements with a
      copper-free, zinc-containing biuret reagent. Deviations of the color intensity of
      biuret complexes were compensated by inclusion of standards in the measurement
      series.

PMID- 1758479
TI  - [Obstructive cholangiopathy and isothiocyanate].

PMID- 1758478
TI  - [Determination of aflatoxin M1 level in milk in the production of baby and
      children's food using immunoassay].
AB  - Using commercial immunokits the concentration of aflatoxin M1 was measured in 376
      samples of raw milk from farms in the area of a new dairy plant producing milk
      baby foods. 87.8% of the samples contained no aflatoxin M1 (detection limit 0.025
      micrograms/l) and only 2 samples (0.5%) possessed higher concentration than 0.1
      microgram/l, which represents the tolerance limit for aflatoxin M1 in baby milk
      foods admitted in Czechoslovakia.

PMID- 1758480
TI  - Neurotoxicity of methamphetamine: mechanisms of action and issues related to
      aging.

PMID- 1758481
TI  - The environmental impact and adverse health effects of the clandestine
      manufacture of methamphetamine.

PMID- 1758482
TI  - Heavy metal and organic contaminants associated with illicit methamphetamine
      production.

PMID- 1758483
TI  - Pyrolytic characteristics, pharmacokinetics, and bioavailability of smoked
      heroin, cocaine, phencyclidine, and methamphetamine.

PMID- 1758484
TI  - Methamphetamine abuse in California.

PMID- 1758485
TI  - Trends and patterns of methamphetamine smoking in Hawaii.

PMID- 1758486
TI  - Methamphetamine abuse in Japan.

PMID- 1758487
TI  - Trends and patterns of methamphetamine abuse in the Republic of Korea.

PMID- 1758488
TI  - The Party's dead, but the party goes on.

PMID- 1758489
TI  - DNA fingerprinting discord.

PMID- 1758490
TI  - Electronic arts imitate life.

PMID- 1758491
TI  - Rabies. Immunization in the field.

PMID- 1758492
TI  - Oligonucleotide drugs. A change of backbone.

PMID- 1758493
TI  - Formation and resolution of recombination intermediates by E. coli RecA and RuvC
      proteins.
AB  - The recombination of DNA molecules has been reconstituted in vitro using two
      purified enzymes from Escherichia coli. RecA protein catalyses homologous pairing
      and strand exchange reactions to form intermediate DNA structures that are acted
      upon by RuvC. The newly identified RuvC protein resolves the intermediates by
      specific endonucleolytic cleavage to produce recombinant DNA molecules.

PMID- 1758494
TI  - Large-scale eradication of rabies using recombinant vaccinia-rabies vaccine.
AB  - Rabies infection of domestic and wild animals is a serious problem throughout the
      world. The major disease vector in Europe is the red fox (Vulpes vulpes) and
      rabies control has focused on vaccinating and/or culling foxes. Culling has not
      been effective, and the distribution of five vaccine baits is the only
      appropriate method for the vaccination of wild foxes. Although some European
      countries have conducted field vaccination campaigns using attenuated rabies
      virus strains, their use has not been extensively approved because they retain
      pathogenicity for rodents and can revert to virulence. These strains cannot be
      used in North America because they are pathogenic for the striped skunk (Mephitis
      mephitis) and are ineffective in the raccoon (Procyon lotor). We have constructed
      a recombinant vaccinia virus, VVTGgRAB, expressing the surface glycoprotein (G)
      of rabies virus (ERA strain). The recombinant was a highly effective vaccine in
      experimental animals, in captive foxes and in raccoons. We report here the
      results of a large-scale campaign of fox vaccination in a 2,200 km2 region of
      southern Belgium, an area in which rabies is prevalent. After distribution, 81%
      of foxes inspected were positive for tetracycline, a biomarker included in the
      vaccine bait and, other than one rabid fox detected close to the periphery of the
      treated area, no case of rabies, either in foxes or in domestic livestock, has
      been reported in the area.

PMID- 1758495
TI  - Restoration of antigen presentation to the mutant cell line RMA-S by an MHC
      linked transporter.
AB  - In mammalian cells, short peptides derived from intracellular proteins are
      displayed on the cell membrane associated with class I molecules of the major
      histocompatibility complex (MHC). The surface presentation of class I-peptide
      complexes presumably alerts the immune system to intracellular viral protein
      synthesis. Peptides derived from the cytosol must reach the cisternae of the
      endoplasmic reticulum where they are required for the assembly of stable class I
      molecules, and it has been proposed that the products of the two MHC-encoded ATP
      binding cassette (ABC) transporter genes function to deliver the peptides across
      the membrane of the endoplasmic reticulum. This idea is supported by experiments
      in which transfection of a human cell line defective in class I expression with a
      complementary DNA of one of these genes restored cell surface expression levels.
      Here we show that the complete phenotype of the mouse mutant cell line RMA-S, in
      which lack of surface expression of stable class I molecules correlates with an
      inability to present viral peptides originating in the cytosol, is repaired by
      the cDNA of the other transporter gene. These results are consistent with the
      possibility that the two transporter polypeptides form a heterodimer.

PMID- 1758496
TI  - [Algorithms, brains, computers. What they know and what they do not. I].
AB  - Our concern for machines and for their abilities, though quite ancient, has
      increased with the outstanding achievements of modern computers. What, then, is
      typical of a machine? Is its output really limited by our input? For questions
      like these, an appropriate tool is the concept of algorithm. Algorithms are best
      characterized as mental tools ("Denkzeuge").

PMID- 1758497
TI  - Unusually high levels of thyroid hormones in isolated and/or monolayer-cultured
      pig thyroid epithelial cells.

PMID- 1758498
TI  - [Of what benefit is a research internship in the tropics for Dutch medical
      students?].

PMID- 1758499
TI  - [DNA duplication in hereditary type Ia motor and sensory neuropathy (Charcot
      Marie-Tooth disease)].

PMID- 1758500
TI  - [There is no such thing as the CVA].

PMID- 1758501
TI  - [Injuries due to fireworks at the turn of the year 1990/'91].
AB  - During the festivities at the turn of the year 1990, 58 patients with firework
      related injuries were seen. A 200% increase in relation to previous years was
      observed. Minor blast injuries of the hand were the most frequent. Many children
      of Turkish and Moroccan nationality were involved. It was surmised that illegal
      and unsafe fireworks in combination with careless behaviour were causative
      factors. Prevention should be achieved through amending the law on use and
      distribution of fireworks and through intensifying and fine-tuning the annual
      information campaigns.

PMID- 1758502
TI  - [Accidents a matter of chance? The significance of lunar phases and biorhythms in
      trauma patients].
AB  - The belief that supernatural forces influence man's fate appears to be
      increasing. Many people are convinced that unknown forces can cause injuries.
      From a multitude of proposed possibilities, we selected two factors that are
      claimed to affect the incidence of accidents. The first theory holds that more
      accidents occur at the time of full moon. The second theory concerns the three so
      called biorhythms with their supposedly critical days (physical, emotional,
      intellectual). The effect of the lunar phase and the three biorhythms on
      accidents was determined from the dates of accident and birth of trauma patients
      admitted to the University Hospital in Groningen. We analysed data on all 29085
      patients who were seen at the outpatient department in the years 1981-1983 and on
      930 severely injury patients admitted in the years 1985-1989. At full moon even
      slightly fewer patients than expected (24 percent vs 25 percent) were seen at the
      emergency department. The number of severely injured patients was the same during
      the four moon phases. The 'critical' biorhythm days were not associated with
      increased number of accidents, neither for the patients seen at the emergency
      department, nor for the severely injured patients.

PMID- 1758503
TI  - [150 years of life expectancy of Dutch members of parliament; 1848-1989].
AB  - To determinate whether the stressful lifestyle of members of parliament (MP)
      might lead to excess mortality, as suggested in British Medical Journal in 1989,
      we investigated the mortality and life expectancy of 1589 members of the Dutch
      parliament over the period 1848-1989. Total mortality (all causes) for members of
      parliament who had been in function for at least one year (n = 1472) was compared
      to that of the general population of the Netherlands, adjusted for age, sex and
      calendar period. We calculated a standardized mortality ratio (SMR) from
      beginning of exposure as well as from ten years after entry in order to correct
      for a healthy cohort effect. The total number of deaths was 986 (863 with follow
      up after 10 years after entry) and did not exceed the expected number of deaths
      based on population mortality rates. We conclude that MPs have no higher death
      risk than those who elected them, although one might have expected a lower death
      risk because of their social background.

PMID- 1758504
TI  - [A tuberculosis project in Ecuador].
AB  - OBJECTIVE: Determination of the frequency of pulmonary tuberculosis in an Indian
      community in Ecuador among symptomatic patients and contacts of patients with
      tuberculosis. Pulmonary tuberculosis was defined as the presence of acid fast
      rods in sputum. SETTING: Pontificia Universidad Catolica del Ecuador, Quito,
      Ecuador. DESIGN: Sputum samples were collected with the aid of an educational
      drama. About 5000 persons were informed on tuberculosis by this performance. The
      sputum samples from 241 persons were examined for presence of acid-fast rods with
      a direct Ziehl-Neelsen (ZN) stain and a ZN stain after concentration of the
      sputum. If ZN stain was negative, the sputum was cultured on Lowenstein-Jensen
      medium or on Coletsos medium. The Lowenstein-Jensen medium was past the
      expiration date. RESULTS: Bacteriological examination of the sputum samples from
      241 patients and controls brought to light 65 (26.9%) individuals with acid-fast
      rods in the sputum. Forty per cent of the affected patients were between the ages
      of 20 and 34. Investigation of 82 contact persons revealed 19 (23.2%) positive
      cases. The results of culturing of the sputum samples were disappointing: only 6
      of 152 (3.9%) samples showed growth of acid-fast rods. CONCLUSIONS: The frequency
      of pulmonary tuberculosis (as defined by the presence of acid fast rods in
      sputum) is high in the community investigated, much higher than the official data
      on the prevalence of tuberculosis indicate. It is important to investigate
      contacts of patients with pulmonary tuberculosis to trace a source and to trace
      new cases.

PMID- 1758505
TI  - [Dutchmen and the development of the microscope].

PMID- 1758506
TI  - [A monograph by K.F.H. Marx from 1838; possibly the first clinicopathological
      description of multiple sclerosis].

PMID- 1758507
TI  - [The short extensor muscle of the hand, an 'old' muscle, as the cause of pain in
      the hand].

PMID- 1758508
TI  - [Desmopressin and nocturnal enuresis].

PMID- 1758509
TI  - [Diabetic retinopathy: agreement of funduscopic assessment by the family
      physician and the ophthalmologist].

PMID- 1758510
TI  - [Gynecomastia; the patient's fate is in your hand].

PMID- 1758511
TI  - [Halcion: requiem for a kingfisher?].

PMID- 1758512
TI  - [Cell biology from a medical perspective. IX. Cell-cell and cell-matrix
      interactions].

PMID- 1758513
TI  - [Myelodysplastic syndrome].

PMID- 1758514
TI  - [Surgical treatment of hip fractures in 90-year-olds].
AB  - During 1973-1987 178 patients of 90 years and over were operated for a fracture
      of the hip in the Diaconesseninrichting 'Bronovo', The Hague. Fifty patients were
      suffering of senile dementia which made reactivation difficult and contributed to
      43% of the mortality. The overall in-hospital mortality was 18% and the survivors
      were discharged after 35 days on average. Patients with lateral and
      pertrochanteric fractures were treated according to McLaughlin (6), to Ender (74)
      and with a dynamic hip screw (17) and medial fractures with a dynamic hip screw
      (54) or a prosthesis (27). The in-hospital mortality rates were 16, 28, 6, 11 en
      11% respectively. Postoperatively 7 Ender pins sagged out and 6 patients treated
      with a dynamic hip screw secondarily needed a prosthesis, 3 of them after
      discharge. It is advised to use Ender pins in lateral or pertrochanteric
      fractures in inactive patients only, and a dynamic hip screw in active patients;
      in medial fractures a dynamic hip screw only in inactive patients and in others a
      prosthesis. An increase in the number of very old people with hip fractures is to
      be expected in the near future.

PMID- 1758515
TI  - [Epidemiological surveillance of antibiotic resistance in a general hospital for
      the assessment of 'blind' antibiotics policy].
AB  - A study was made of the epidemiology of gentamicin-resistant Gram-negative rods
      in a large general hospital over the last 12 years, and of the consequences of
      the presence of these bacteria for antibiotics policies, especially the use of
      gentamicin. Resistant bacteria were endemic at a low level: of the clinical
      isolates, 670 from 488 patients contained resistant bacteria, 2% of all Gram
      negative rod isolates. Sporadically there were minor epidemics. Especially
      seriously ill, elderly patients became infected. Every year multiresistant
      bacteria contributed to a number of deaths. The choice of gentamicin as a drug of
      first, blind, choice in life-threatening infections remained justified.
      Continuous monitoring of Gram-negative rods is an important instrument for a
      preventive policy.

PMID- 1758516
TI  - [Mycobacterium avium disease in AIDS patients; diagnosis and therapy].
AB  - In eight (25%) of 32 consecutive AIDS patients between 1986 and 1989,
      Mycobacterium avium infection was diagnosed: in seven disseminated, in one as a
      local lymph node process. Six patients were treated as consistently as possible
      with a combination of ethambutol, rifabutine, clofazimine and protionamide (or
      cycloserine) in relatively large dosages. Median survival of treated patients was
      15.5 (4-22) months. Protionamide inhibited most M. avium strains (7 of 8) in
      vitro, but often caused intolerance (nausea). Treatment of disseminated
      cytomegalovirus infection in our opinion was necessary in 5 of 6 patients during
      longterm M. avium therapy. HIV therapy (Zidovudine) during M. avium treatment was
      not possible due to bone marrow depression. A low maintenance dose of
      corticosteroids was necessary in 3 of 6 patients (one with adrenal insufficiency)
      to suppress symptoms such as fever and malaise.

PMID- 1758517
TI  - [Chronic conjunctivitis caused by oral anaerobic germs].
AB  - A patient with chronic, unilateral conjunctivitis is presented. The predominant
      bacterial flora consisted mainly of Prevotella intermedia (formerly Bacteroides
      intermedius) and Peptostreptococcus micros. Restriction endonuclease
      fingerprinting of genomic DNA demonstrated that P. intermedia most probably
      originated from the oral cavity. In the oral cavity this species was recovered
      from the dorsum of the tongue, the tonsillar area and the periodontal pockets.
      Topical treatment with various antibiotics had failed to cure the infection in
      the past. The condition was cured after systemic therapy with metronidazole and
      amoxicillin.

PMID- 1758518
TI  - [Angiotensin converting enzyme inhibitors in the treatment of proteinuria].

PMID- 1758519
TI  - [Blisters in pregnancy: herpes gestationis].

PMID- 1758520
TI  - [Reduction of the thyroid gland by radioactive iodine in patients with a large
      struma].

PMID- 1758521
TI  - Survival and adequacy in long-term hemodialysis.

PMID- 1758522
TI  - Accuracy of hemodialysis urea kinetic modeling. Comparison of different models.
AB  - To test the accuracy of urea kinetic modeling (UKM), the classic fixed-volume
      model UKMf, two variable-volume models (UKMvb and UKMvd), direct dialysis
      quantification (DDQ) and a partial dialysate collection method (PDC) were
      evaluated in 15 stable, high-hematocrit patients. Urea generation rate (G) was
      also determined from a 1-week collection of total dialysate and urine (OWC). The
      results, except distribution volumes, were highly correlated. However, Kt/V, the
      normalized whole-body urea clearance, was about 8% higher with UKMvb and UKMvd.
      Two of three simple equations for Kt/V rendered grossly deviating, but highly
      correlating, results. The normalized protein catabolic rate was 8% higher with
      UKMvd. With OWC as reference, UKMvb and UKMvd overestimated G by 19 and 15%,
      respectively. All results of PDC closely followed those of DDQ. This method may
      be an alternative for exact quantification. Before using a new UKM method it
      should be compared to an established reference method.

PMID- 1758523
TI  - Evaluation of renal handling of uric acid in essential hypertension:
      hyperuricemia related to decreased urate secretion.
AB  - The tubular transport of urate was studied in 40 hypertensive patients and in 20
      normal subjects by means of pyrazinamide and benzbromarone tests. There was a
      marked decrease in urate excretion per nephron in hyperuricemic patients with
      essential hypertension. Serum uric acid correlated inversely with fractional
      excretion of urate (r = -0.7450, p less than 0.001). Presecretory and
      postsecretory reabsorption of urate did not significantly differ between
      hypertensive patients with high uric acid levels and control subjects. Urate
      secretion was significantly reduced in hypertensive patients and in those with
      hyperuricemia showed a twofold decrease. Serum uric acid correlated inversely
      with tubular secretion of urate (r = -0.7091, p less than 0.001) in hypertensive
      patients. These findings indicate that impaired tubular secretion of urate is a
      potential mechanism of hyperuricemia in essential hypertension.

PMID- 1758524
TI  - Acute effects of ciclosporin on renal hemodynamics and urinary protein excretion
      in patients with the nephrotic syndrome.
AB  - The possibility that the renal hemodynamic abnormalities associated with
      ciclosporin (CS) administration are enhanced in nephrotic patients (NP), leading
      to severe impairment of renal function and/or to modifications in proteinuria,
      has not hitherto been tested. Ten NP and 8 healthy subjects (NC) were examined
      before and after oral CS administration (10 mg/kg body weight in NP and 12 mg/kg
      body weight in NC: a lower dosage was adopted in NP because of edema
      overestimating the actual body weight) under water diuresis by standard renal
      clearance methods. Basal blood volume was lower in NP. Blood CS levels were not
      significantly different in the two groups. Basal glomerular filtration rate (GFR)
      was similar in NP and NC, while renal plasma flow (RPF) was lower in NP. After
      CS, both GFR and RPF significantly decreased in the two groups, but the percent
      decrease in inulin clearance was greater in NP. Filtration fraction increased
      only in NC. Basal renal vascular resistances were greater in NP, and
      significantly increased after CS in both groups. Basal fractional sodium
      excretion (FENa) was lower in NP: after CS FENa decreased only in NC. Neither
      plasma renin activity, nor plasma aldosterone changed after CS. When urinary
      protein excretion (UP) was corrected by GFR, no change was observed after CS; by
      contrast, selectivity of proteinuria (as assessed by the CIgG/CTransferrin ratio)
      markedly increased. Our data indicate that CS induces a greater fall in the GFR
      in hypovolemic NP than in healthy subjects, probably because in the former GFR
      becomes extremely plasma flow dependent.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758525
TI  - Urinary detected renal antigens in the early diagnosis of kidney graft rejection.
AB  - The determination of renal antigens in the urine with an immunoassay, based on
      monoclonal antibodies (moabs), is a noninvasive test system for the analysis and
      monitoring of renal injury. New moabs allowing an immunohistologic dissection of
      the human nephron were generated by a direct intrasplenic immunization of mice
      with pathologic urine samples. A sandwich enzyme immunoassay was developed to
      quantitate renal cell membrane antigens in the urine samples. A sandwich enzyme
      immunoassay was developed to quantitate renal cell membrane antigens in the
      urine. While antigen excretion in healthy individuals is low, preliminary data of
      a clinical investigation suggest the usefulness of these assay systems in
      diagnosis of tubular injury in human kidney transplant recipients. The
      immunoassay can provide very early hints of renal graft rejection prior to the
      appearance of clinical symptoms or the detection by routine clinical laboratory
      investigations.

PMID- 1758526
TI  - Serum erythropoietin and erythropoiesis in primary and secondary
      hyperparathyroidism: effect of parathyroidectomy.
AB  - Primary as well as secondary hyperparathyroidism may be associated with anemia,
      and parathyroidectomy (PTx) may improve or even heal it. The precise link between
      the two conditions is still matter of discussion. The purpose of the present
      study was to investigate possible effects of PTx on serum immunoreactive
      erythropoietin (iEPO) in secondary (group I, n = 23), and primary (group II, n =
      16) hyperparathyroidism patients, and in 3 patients undergoing cervicotomy for
      thyroid mass removal (group III). In group I patients, circulating iEPO levels
      rose from 23.1 +/- 4.8 mU/ml before PTx to 28.2 +/- 5.0 and 245 +/- 125 mU/ml
      (mean +/- SEM) at day 7 (p = NS) and 14 after PTx (p less than 0.003),
      respectively. Reticulocyte count increased 2 weeks after PTx: from 61,000 +/-
      13,317 to 86,533 +/- 13,462/mm3 (p less than 0.05, n = 23). In 4 of these
      patients serum iEPO levels could be measured again 12-24 months after PTx. They
      were slightly higher than those determined before PTx: 37.0 +/- 8.4 versus 31.8
      +/- 13.5 mU/ml. Their hematocrits were also higher than before PTx: 12.8 +/- 0.9
      versus 11.0 +/- 0.9 g/dl. In group II patients, serum iEPO levels remained
      unchanged after PTx: 17.5 +/- 2.0 mU/ml before PTx and 20.0 +/- 3.0 mU/ml 14 days
      PTx. The reticulocyte count, however, increased significantly 2 weeks after PTx:
      from 25,103 +/- 3,000 to 40,827 +/- 4,080/mm3 (p less than 0.01). In group III
      patients, serum iEPO, reticulocyte count, and hemoglobin remained stable after
      surgery. Since all group I patients had received vitamin D supplementation after
      PTx, we studied an additional group of 14 chronic dialysis patients (group IV)
      who received either calcitriol (1 micrograms/day, n = 7) or placebo (n = 7)
      during 14 days. The patients on calcitriol treatment, but not those on placebo,
      had a significant decrease of serum iEPO: 18.6 +/- 4.9 versus 16.0 +/- 4.2 mU/ml
      (p less than 0.03). In conclusion, PTx led to a striking increase of serum iEPO
      and blood reticulocytes in uremic patients with secondary hyperparathyroidism,
      and an increase of reticulocyte count, but not of iEPO, in patients with primary
      hyperparathyroidism. Marked changes of circulating PTH, extra-or intracellular
      calcium and phosphorus concentrations as well as of tissue sensitivity to EPO
      after PTx could all be responsible. In contrast, the surgical procedure and the
      therapeutic increase in plasma calcitriol do not appear to be involved.

PMID- 1758527
TI  - Treatment of azotemic, nonoliguric, anemic patients with human recombinant
      erythropoietin raises whole-blood viscosity proportional to hematocrit.
AB  - It has been reported that patients with azotemia have reduced red blood cell
      (RBC) deformability. Since this is a major determinant of whole-blood viscosity
      (WBV) and rigid RBCs increase WBV disproportionately relative to the level of
      hematocrit, it is conceivable that sustained improvement of hematocrit with
      recombinant human erythropoietin (rhEPO) therapy in azotemic patients might
      result in abnormally raised WBV. To address this concern, WBV and plasma
      viscosity (PV) were measured in 9 adult patients (4 men, 5 women) with anemia
      (mean hematocrit 29.2 +/- 2.7%) and azotemia [mean serum creatinine concentration
      339.85 +/- 102.44 mumol/l (3.8 +/- 1.1 mg/dl)] before and after 6 months of
      treatment with rhEPO (50-175 U/kg given intravenously thrice weekly). Baseline
      and post-treatment hematocrit, WBV and PV were compared to values derived in 50
      normal adult subjects with normal renal function [25 women, 25 men; mean serum
      creatinine concentration 79.56 +/- 8.84 mumol/l (0.9 +/- 0.1 mg/dl), mean
      hematocrit 42.4 +/- 3.7%]. To compare rheologic factors at subnormal hematocrits,
      blood from subjects with normal renal function was diluted with autologous plasma
      to achieve a range of hematocrits from 20 to 50%.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1758528
TI  - Pharmacokinetics and dose response after intravenous and subcutaneous
      administration of recombinant erythropoietin in patients on regular haemodialysis
      treatment or continuous ambulatory peritoneal dialysis.
AB  - The pharmacokinetics and dose response of recombinant human erythropoietin
      (rhEPO), administered intravenously and subcutaneously, were studied in chronic
      haemodialysis (HD) patients and in patients on chronic ambulatory peritoneal
      dialysis (CAPD). Furthermore, two products differing in the presence of albumin
      as preservative were compared. Although the pharmacokinetics differed after
      intravenous and subcutaneous administration, the dose response was the same.
      There is no statistically significant difference in the pharmacokinetics between
      the rhEPO in HD and CAPD, nor had the presence of albumin as preservative an
      influence on the pharmacokinetics.

PMID- 1758529
TI  - Ultrastructural studies of the reaction of urate crystals with a cultured renal
      tubular cell line.
AB  - Hypotheses concerning the development of uric acid and gouty nephropathy suggest
      that the initiating disease mechanism involves an interaction between uric acid
      or monosodium urate monohydrate (MSUM) crystals and renal tubular epithelial
      cells. We have studied the interaction of these crystals with Madin-Darby canine
      kidney (MDCK) cells, which exhibit many of the characteristics of cells of the
      collecting duct epithelium. Addition of MSUM crystals to monolayer cultures of
      MDCK cells leads to the formation of reaction sites, localised areas which are
      raised above the monolayer forming a 3-dimensional structure. These reaction
      sites are evident within 4-8 h and appear to be initiated by the interaction of a
      single crystal or small number of crystals with a single cell. With time, both
      cells and crystals accumulate at the site. By 24 h most reaction sites involve 6
      12 cells and numerous crystals. Interaction of MSUM crystals and MDCK cells not
      only involves the attachment of crystals to cells but, by 8 h, some crystals
      appear to be completely or partially covered by the cell membrane, and MDCK cells
      appear to react by growing around the crystals. Transmission electron microscopy
      shows that crystals are found not only within cells, but also within the
      intercellular spaces. Within the cells, crystals have been shown in vacuoles
      containing lysosomal enzymes, indicating the formation of a phagolysosome.
      Ultimately, enzyme release occurs. These studies support the hypothesis that some
      interstitial deposits of urate and uric acid in the kidney may be derived from
      intratubular deposits that react with the tubular epithelium and pass into the
      interstitium; loss of tubular integrity may not be a prerequisite for crystal
      migration.

PMID- 1758530
TI  - Deterioration of immune complex solubilization activity of serum by increased
      concentration of factor D.
AB  - We investigated the effect of excess complement factor D on the immune complex
      solubilization activity (ICSA) of serum. First, we estimated the concentration of
      factor D, ICSA and the hemolytic activity via the classical complement pathway
      (CH50) in the sera of 16 healthy individuals and 36 patients on hemodialysis for
      end-stage renal failure. The serum concentration of factor D in these patients
      (mean +/- SD: 12.12 +/- 2.38 micrograms/ml) was significantly higher (p less than
      0.001) than that in the healthy subjects (1.02 +/- 0.11 micrograms/ml). In this
      study, peroxidase and antiperoxidase rabbit IgG were used as immune precipitates
      for ICSA. The ICSA in patients (45.8 +/- 7.4 normal human serum %, NHS%) was
      significantly lower (p less than 0.001) than that in the healthy subjects (100.2
      +/- 12.5 NHS%). There was no difference in CH50 between the sera of the patients
      (31.8 +/- 2.5) and that of the healthy group (32.4 +/- 2.6). Second, we
      determined that increasing amounts of purified factor D added to fresh serum
      resulted in a decrease in ICSA. This occurred in the serum of a healthy
      individual as well as in that of a patient. CH50 did not change regardless of the
      concentration of factor D used. There was an increase in C3 conversion in the
      sera to which purified factor D had been added, as observed by crossed
      immunoelectrophoresis. It is suggested that ICSA had deteriorated due to the
      excess of factor D, which had activated the alternative pathway of complement.

PMID- 1758531
TI  - Urinary albumin excretion in normal pregnancy and pregnancy-induced hypertension.
AB  - We measured the urinary excretion of albumin in 67 healthy primigravidae, at
      monthly intervals, from 16 to 36 weeks of gestation and 12 weeks postpartum. Of
      the 67 primigravidae, 55 completed a normal pregnancy and 12 developed pregnancy
      induced hypertension. In the latter group, an additional measurement of urinary
      albumin excretion was performed at 24 weeks postpartum. The aims of the study
      were: to look for changes of urinary albumin excretion during the progression of
      normal pregnancy; to assess if microalbuminuria could be an early feature of
      pregnancy-induced hypertension; to evaluate the effects of physical activity on
      the excretion of albumin in normal pregnancy and pregnancy-induced hypertension.
      In contrast with glomerular hyperfiltration and increased urinary total protein,
      two recognized characteristics of the pregnant state, we found that normal
      primigravidae, during the day, excrete significantly less albumin (p between less
      than 0.01 and less than 0.001) in comparison with the postpartum period and
      nonpregnant women. Normal primigravidae, as a group, showed parallel changes of
      urinary albumin excretion and diastolic blood pressure throughout pregnancy and
      postpartum, suggesting an important physiologic role of hemodynamic factors in
      regulating glomerular permeability to albumin. The daytime urinary albumin
      excretion in patients developing pregnancy-induced hypertension was significantly
      higher (p between less than 0.005 and less than 0.001) than in normal pregnancy
      from the 28th gestational week onwards. The increased urinary albumin excretion
      preceded the onset of hypertension and tended to persist long after blood
      pressure had returned to normal levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758532
TI  - Hyperlipidemia in stable renal transplant recipients.
AB  - Hyperlipidemia is a major risk factor for atherosclerosis and probably
      contributes to the increased cardiovascular mortality following renal
      transplantation. We studied the lipid profiles of 62 adults (29 males) with
      stable renal function (mean plasma creatinine 0.14 mmol/l, SD 0.07), 7 months to
      21 years after renal transplantation. Fifteen patients (24%) were above the age-
      and sex-adjusted 95th percentile for total triglyceride and 10 (16%) for total
      cholesterol concentrations when compared with a local reference population. The
      most common lipoprotein abnormalities were type IIa (19%) and type IIb (13%).
      Multiple regression analysis demonstrated that the use of diuretics and
      angiotensin-converting enzyme inhibitors were significant factors determining
      plasma triglyceride concentrations. There were significant bivariate associations
      between plasma triglyceride concentration and duration since transplantation,
      plasma creatinine concentration and the use of ciclosporin and diuretics.
      Duration since transplantation and ciclosporin use were significant factors
      determining lower plasma cholesterol concentrations. The use of ciclosporin and
      diuretics was associated with a significantly higher apolipoprotein (apo) B
      concentration. The cholesterol/HDL cholesterol risk ratio correlated poorly with
      the apo B/apo A-1 ratio. The value of these ratios as predictors of coronary
      artery disease need to be established in renal transplant recipients.

PMID- 1758533
TI  - Osteocalcin levels in uremic patients: influence of calcitriol treatment through
      two different routes and type of dialysis.
AB  - Osteocalcin, the most abundant non-collagen protein of bone, is synthesized by
      the osteoblast. Serum osteocalcin concentration depends primarily on new cellular
      synthesis, and is a sensitive marker of bone turnover reflecting osteoblastic
      function. In uremic and hemodialysis (HD) patients, a direct relationship between
      serum osteocalcin and histological parameters of bone formation has been
      observed. The modality of dialysis may influence serum osteocalcin levels though
      the available data are controversial. The aim of this study is to assess the
      acute and chronic effects of calcitriol and the influence of modality of dialysis
      on serum osteocalcin levels. Twelve patients on continuous ambulatory peritoneal
      dialysis (CAPD) were treated with calcitriol. For control purposes, 24 patients,
      12 on CAPD and 12 on HD, not treated with calcitriol serum osteocalcin levels
      were included. In CAPD patients previously treated with calcitriol, serum
      osteocalcin levels were higher than in nontreated patients. The higher levels
      occur independent of serum levels of parathyroid hormone (PTH), Ca and P.
      Hemodialysis patients had osteocalcin levels similar to those of CAPD patients
      under calcitriol treatment. However, the levels of HD patients were higher than
      CAPD nontreated patients. Serum ionized Ca was similar in CAPD and HD nontreated
      patients; however, total Ca was significantly higher in HD than in CAPD patients,
      both with and without calcitriol. After the intravenous administration of
      calcitriol, serum osteocalcin levels increased from 9.2 + 2.5 to 13.5 + 5.4 ng/ml
      (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758534
TI  - 1,25-Dihydroxycholecalciferol and peritoneal macrophage chemotaxis in patients on
      continuous ambulatory peritoneal dialysis.
AB  - Single graded doses of 1,25-dihydroxycholecalciferol of 2 and 4 micrograms were
      added intraperitoneally into the overnight 1.5% glucose dialysate of 6 patients
      on continuous ambulatory peritoneal dialysis. The effect on peritoneal macrophage
      chemotaxis and random migration was studied and compared with the baseline when
      no 1,25-(OH)2D3 was added. No consistent effect on peritoneal macrophage
      chemotaxis was observed. Random migration was significantly depressed at 4
      micrograms when compared with baseline (5.4 +/- 1.9 vs. 12.2 +/- 3.7 cells/high
      power field, p less than 0.05). The potential clinical role of 1,25-(OH)2D3 as an
      immune modulator requires further study.

PMID- 1758535
TI  - Serum Tamm-Horsfall glycoprotein level in children with various renal diseases.
AB  - Serum Tamm-Horsfall glycoprotein (THGP) concentrations were measured by a
      competitive enzyme-linked immunosorbent assay using peroxidase-labeled THGP in
      168 patients, aged 10.5 +/- 4.6 years, with various renal diseases. Using this
      method, THGP was determined in the concentration range of 10-10(3) micrograms/l.
      Serum THGP levels ranged from 130 to 350 micrograms/l in 32 control subjects,
      aged 1-16 years with normal renal function. In most patients with renal disease,
      the serum THGP levels were lower than those in control subjects. In particular,
      the serum THGP levels were more reduced according to the decrease in the
      clearance values of endogenous creatinine (CCR). These findings suggested that
      the measurement of serum THGP levels is helpful in the evaluation of renal
      function. On the other hand, 3 patients with vesicoureteric reflux showed higher
      serum THGP levels than control subjects, though the CCR values in 1 of these
      patients was lower. These high serum THGP levels may be the result of urinary
      backflow into circulation.

PMID- 1758536
TI  - Adverse effects on cerebral perfusion of prostacyclin administered directly into
      patients with fulminant hepatic failure and acute renal failure.
AB  - Prior to commencing renal replacement therapy, 8 patients with fulminant hepatic
      failure and acute renal failure were treated with an infusion of prostacyclin, 5
      ng/kg/min, for 30 min, administered directly into the femoral vein. During this
      period, several adverse effects were noted. There was a reduction in mean
      arterial blood pressure from a median of 82 (range 65-93) to 67 mm Hg (55-80), p
      less than 0.01; and an increase in intracranial pressure from a median of 14 (6
      33) to 17 mm Hg (6-42), p less than 0.05; with a consequent reduction in cerebral
      perfusion pressure from a median of 63 (43-77) to 43 mm Hg (15-74), p less than
      0.05. There was a reduction in arterial oxygen tension from a median of 19 (13
      28) to 16 kPa (12-27), p less than 0.05; and no change in cardiac output, from a
      median of 6.7 (4.9-11.2) to 6.5 l/min/m2 (3.8-11.0), p greater than 0.05). The
      administration of prostacyclin into this group of critically ill patients, at
      risk of death due to cerebral oedema/hypoxia, produced both a reduction in
      cerebral perfusion pressure and a reduction in total cerebral oxygen delivery.

PMID- 1758537
TI  - Increases in circulating level of platelet-activating factor lag behind transient
      neutropenia during hemodialysis with cuprophane membranes.
AB  - The significance of the level of circulating 1-O-hexadecyl-2-acetyl-sn-glycero-3
      phosphorylcholine (C16-PAF, platelet-activating factor) in relation to transient
      neutropenia during hemodialysis with cuprophane membranes was examined. The
      neutrophil count was transiently and significantly decreased at 30 min after the
      start of hemodialysis, and it then gradually recovered during the period from 60
      to 240 min after the start. Mirror image changes were observed in the circulating
      levels of C3a and C5a, suggesting that the decrease in the neutrophil count was
      triggered by activation of the complement factors. The circulating level of C16
      PAF, although being similar to the basal level after 30 min of hemodialysis, was
      significantly increased after 60 and 120 min of hemodialysis. These data indicate
      that the increase in the circulating PAF level is not a direct cause of the
      transient decrease in the neutrophil count, but may be the result of activated
      neutrophils during hemodialysis with cuprophane membranes.

PMID- 1758538
TI  - Hyperlactataemia and metabolic acidosis during haemofiltration using lactate
      buffered fluids.
AB  - We have investigated the effect of an exogenous lactate load given during machine
      haemofiltration treatment in 22 patients with acute renal failure and 12 patients
      with chronic renal failure, without any overt evidence of liver disease.
      Hyperlactataemia occurred in all patients, but the expected changes in acid base
      status, an increase in bicarbonate and a reduction in arterial hydrogen ions were
      observed in less than 40% of the treatments in the acute renal failure group.
      Ultrafiltrate losses of lactate and bicarbonate could not alone explain the
      changes in acid-base status. There was a positive correlation between the
      increase in arterial lactate and hydrogen ion concentrations, r = 0.52, p less
      than 0.01. Lactate accumulation in patients at, or close to, their threshold for
      lactate utilisation may result in further depression of cardiac function and
      peripheral lactate utilisation. Hyperlactataemia due to use of lactate-based
      dialysis/haemofiltration solutions in critically ill patients may result in a
      worsening of the acid-base status, and arterial pH should be monitored so that
      bicarbonate solutions can be substituted if the changes are progressive.

PMID- 1758539
TI  - Selective hypoaldosteronism in a patient with Sjogren's syndrome: insensitivity
      to angiotensin II.
AB  - A 51-year-old Japanese woman with hypokalemia due to distal renal tubular
      acidosis associated with Sjogren's syndrome exhibited a decreased plasma
      aldosterone level despite elevated plasma renin activity. Our studies revealed
      selective hypoaldosteronism with normal adrenoglucocorticoid function. In the
      presence of a low level of serum potassium (3.6 mEq/l), plasma levels of
      deoxycorticosterone and corticosterone were normal, while plasma aldosterone was
      very low. The levels of these three mineralocorticoids showed only minor changes
      during infusion of angiotensin II. Furosemide administration under almost the
      same level of serum potassium (3.7 mEq/l) resulted in only a slight increase of
      plasma aldosterone. Since hypokalemia might possibly suppress the synthesis of
      aldosterone in the zona glomerulosa, angiotensin II was also infused under a
      normal level of potassium (4.3 mEq/l). However, angiotensin II also failed to
      stimulate any secretion of aldosterone, despite a progressive rise in blood
      pressure and sufficient suppression of plasma renin activity. On the other hand,
      rapid ACTH administration in the presence of 4.4 mEq/l of serum potassium
      increased both plasma aldosterone and cortisol. These results suggest that
      adrenal insensitivity to angiotensin II was the cause of the selective
      hypoaldosteronism in our patient, possibly due to a dysfunction of adrenal
      angiotensin II receptors, a disorder of postreceptors or both.

PMID- 1758540
TI  - Renal lesions of hyperlipidemic Imai rats: a spontaneous animal model of focal
      glomerulosclerosis.
AB  - The hyperlipidemic Imai rat was originally developed as an animal model of
      spontaneous hyperlipidemia. We report the natural course of the Imai rat up to 32
      weeks of age focusing on renal pathology. The degree of proteinuria, which first
      appeared at 8 weeks, increased with age, and all Imai rats developed heavy
      proteinuria (mean, 228 mg/24 h) with impaired renal function (mean BUN, 78.7
      mg/dl) at 32 weeks. Histologic changes of the glomeruli were characterized by
      focal and segmental sclerosis and hyalinosis. Both the percentage of affected
      glomeruli and the severity of each affected glomerulus were progressively
      increased with age. The immunofluorescence and electron-microscopic findings were
      also comparable to those of focal glomerulosclerosis (FGS) in humans. The serum
      levels of total cholesterol, triglyceride, and phospholipid in Imai rats were
      significantly higher than those in normal Sprague-Dawley rats at 8 weeks of age,
      and progressively increased thereafter. The proteinuria, glomerular involvements,
      and hyperlipidemia were generally less severe in the females than in the males.
      We conclude that the hyperlipidemic Imai rat, a naturally occurring animal model
      of FGS, is useful in studying the pathogenesis of FGS and the renal effects of
      hyperlipidemia in humans.

PMID- 1758541
TI  - Effects of defibrotide on renal function and urinary prostanoid excretion in
      ciclosporin-treated rats.
AB  - Defibrotide (DF) has been proposed as a new antithrombotic agent in renal
      transplantation. Because it was also found to increase prostacyclin synthesis, a
      reduction in ciclosporin (CS) nephrotoxicity could be supposed. To ascertain this
      hypothesis, renal function and urinary prostanoids were evaluated in four groups
      of rats after 10 days of oral treatment (doses in mg/kg/day): CS 50 (group A), CS
      50 + DF 400 (group B), DF 400 (group C) and controls (group D). Compared to
      controls, creatinine clearance (CCR) was significantly lower in groups A and B
      (In CCr: A = 6.62 +/- 0.28, B = 6.83 +/- 0.24 vs. 8.17 +/- 0.13 microliters/min,
      p less than 0.01), whereas it did not change in group C (8.03 +/- 0.24
      microliters/min). The urinary excretion of prostaglandin E2 (PGE2) was
      significantly (p less than 0.05) higher in group A (In PGE2: 3.98 +/- 0.98
      nmol/mol Cr) and more evidently in groups B and C (6.89 +/- 0.38 and 6.01 +/-
      0.32 nmol/mol Cr, respectively) compared to controls (1.43 +/- 0.45 nmol/mol Cr).
      The urinary excretion of 6-keto-PGF1 alpha and of thromboxane B2 (TxB2) were
      higher only in groups A and B (ln 6-keto-PGF1 alpha and ln TxB2: A = 6.45 +/-
      0.22 and 4.97 +/- 0.20, B = 7.06 +/- 0.31 and 5.43 +/- 0.41 vs. group D = 5.53 +/
      0.22 and 3.79 +/- 0.42 nmol/mol Cr; p less than 0.05). The 6-keto-PGF1 alpha/Tx
      molar ratio was not significantly affected, although a trend for a reduction in
      the ratio was found in the treated rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758542
TI  - Renal allograft arteriovenous fistula due to needle biopsy with late onset of
      symptoms--diagnosis and treatment.
AB  - A post-biopsy arteriovenous (AV) fistula in a renal allograft was diagnosed using
      color-coded Doppler sonography. Because the patient was asymptomatic, no specific
      treatment was initiated. 15 months after the diagnosis was established, severe
      hematuria with obstruction of the bladder occurred. Angiography revealed a
      connection of the fistula to the renal pelvis. The patient was treated
      successfully by transarterial embolization of the fistula. As a conclusion, we
      suggest periodical follow-up examinations of asymptomatic AV fistulas in renal
      allografts using color-coded Doppler sonography during 3-6 months. When no
      spontaneous regression of the fistula can be observed, embolization therapy
      should be performed even when the fistula is asymptomatic, in order to prevent
      late onset of complications.

PMID- 1758543
TI  - Recurrence of IgA nephropathy with nephrotic syndrome after kidney
      transplantation.
AB  - Two patients on maintenance hemodialysis after terminal renal failure due to
      mesangial glomerulonephritis with IgA deposits and the nephrotic syndrome,
      received cadaver renal allografts. After several years of functioning
      transplants, both patients developed slowly progressive proteinuria and finally
      the nephrotic syndrome, 1 of them with renal function deterioration. Renal
      biopsies revealed findings indicating recurrence of the original disease.

PMID- 1758544
TI  - Sudden blindness associated with central nervous symptoms in a hemodialysis
      patient.
AB  - Purtscher's-like retinopathy as a cause of sudden blindness in hemodialysis
      patients is not widely known. This is believed to occur secondary to
      leukoembolization to retinal arterioles following complement activation. We
      describe a patient who developed sudden but reversible loss of vision on
      hemodialysis associated with varying reversible neurological signs and symptoms
      which we felt may have been a manifestation of leukoembolic aggregates lodging in
      the arterioles of the retina and central nervous system circulations.

PMID- 1758545
TI  - Hemolytic-uremic syndrome with anticardiolipin antibodies revealing
      paraneoplastic systemic scleroderma.
AB  - Lupus anticoagulant was present in this case of paraneoplastic scleroderma
      revealed by hemolytic-uremic syndrome, suggesting that the autoantibody played a
      significant role in the sequence of events leading to anuria. Reviewing the
      literature we found several observations of paraneoplastic scleroderma, and in
      other series cases of scleroderma-linked (and in rare instances cancer-linked)
      antiphospholipid autoantibodies. Search for antiphospholipid antibodies should be
      considered in patients with systemic scleroderma as well as in patients with
      metastatic cancer. Presence of such procoagulant autoantibodies might predict
      future complications and should influence treatment strategy.

PMID- 1758546
TI  - Anaphylaxis following intravenous methylprednisolone sodium succinate in a renal
      transplant recipient.

PMID- 1758547
TI  - Lymphocytotoxic panel reactive antibodies in hemodialyzed patients treated with
      recombinant human erythropoietin.

PMID- 1758548
TI  - Recovery of anionic sites of the glomerular basement membrane after their
      disappearance by the cationic probe molecule.

PMID- 1758549
TI  - Aluminum and parathyroid hormone concentrations in insulin-dependent diabetics on
      long-term hemodialysis.

PMID- 1758550
TI  - Prostatic cancer in a patient on long-term hemodialysis.

PMID- 1758551
TI  - Peritoneal dialysis induces a local sterile inflammatory state and the
      mesothelial cells in the effluent are related to the bacterial peritonitis
      incidence.

PMID- 1758553
TI  - False positive auto-antibodies in HIV infection.

PMID- 1758552
TI  - Systemic amyloidosis (type AA) in end-stage renal failure patients due to chronic
      pyelonephritis.

PMID- 1758554
TI  - Thrombolysis of blocked hemodialysis catheter using recombinant tissue-type
      plasminogen activator.

PMID- 1758555
TI  - Absence of anaphylactoid reactions with the combined use of ACE inhibitors and
      AN69 hemodialysis membranes.

PMID- 1758556
TI  - Elevated plasma concentration of arginine-vasopressin in renal insufficiency is
      not caused by nonspecific binding of metabolic breakdown products.

PMID- 1758557
TI  - Relating change to initial value.

PMID- 1758558
TI  - Aluminum toxicity from oral sucralfate therapy.

PMID- 1758559
TI  - Systemic amyloidosis secondary to tumoral calcinosis.

PMID- 1758560
TI  - Incidence of atopy in IgA nephropathy.

PMID- 1758561
TI  - Review of experimental spinal cord injury with emphasis on the local and systemic
      circulatory effects.
AB  - Studies of experimental spinal cord injury began approximately 100 years ago, and
      since then many useful models of acute experimental spinal cord injury have been
      developed which stimulate many of the common types injuries in man. This review
      will describe some of these models and the information they have provided about
      the acute pathophysiological mechanisms in the injured spinal cord. There is good
      experimental evidence that the spinal cord suffers both a primary or mechanical
      injury and then a secondary injury which may worsen the prognosis for recovery.
      This review will emphasize the concept of the secondary injury, especially with
      respect to the vascular mechanisms. There is evidence from our laboratory and
      others to support the concept of the secondary injury and that the chief
      mechanism of the secondary injury is posttraumatic ischemia and infarction of the
      spinal cord. We have found evidence for the role of vascular mechanisms in three
      different injury models of acute spinal cord injury (A.S.C.I.) in three species
      of experimental animals. This review will describe the microangiographic and
      blood flow methods for assessing the microcirculation of the spinal cord after
      trauma. In addition, to these local vascular effects, this review will also
      describe the systemic vascular effects of A.S.C.I. which cause the neurogenic
      shock in this condition. It is our hypothesis that these local and systemic
      vascular effects are principal causes of the secondary injury leading to
      posttraumatic ischemia and infarction of the spinal cord after A.S.C.I.
      Furthermore, it is our hypothesis that early treatment of these microcirculatory
      changes and neurogenic shock can lead to improved recovery after A.S.C.I.

PMID- 1758562
TI  - [Reconstruction of the spinal cord and its motor connections using embryonal
      nervous tissue transplantation and peripheral nerve autotransplantation. A study
      in the adult rat].
AB  - Our research group is studying, in the adult rat, the conditions of an anatomical
      and functional reconstruction of the spinal cord and of its motor connections,
      following a spinal lesion that is either small (focal) or large (depletive). In
      this attempt to repair the damaged neuronal circuitry, we use, alone on in
      combination, two transplantation techniques, namely that of embryonic neural
      tissue, to replace the lost neurons, and that of long segments of autologous
      peripheral nerves to stimulate and guide either the axonal regrowth from injured
      host spinal neurons or the axogenesis of transplanted embryonic neurons. The
      common denominator to the whole experimentation is the setting up of a "nerve
      bridge" (peroneal nerve autograft) joining the injured cervical spinal cord an
      aneural region of a nearby denervated skeletal muscle. In a first experimental
      model (focal lesion), in which only a peripheral nerve autograft is used, it can
      be observed that local injured (or uninjured?) motoneurons have the actual
      capacity to extend axons throughout the nerve bridge and, thus, to reach the
      muscle and reform functional and stable, mainly ectopic, neuromuscular
      connections. In a second experimental model (depletion lesion) a cavity is made,
      by suction, in the cervical spinal cord, thus causing a damage which resembles,
      in some respects, certain types of neurodegenerative spinal lesions. This cavity
      is filled with different kinds of embryonic neural transplants. The surviving
      transplanted neurons differentiate axonal projections, some of them extending
      into the peripheral nerve bridge. Studies aimed at determining the capacities of
      motor endplate formation by the axons that have grown from these neurons of
      substitution throughout the nerve bridge, as well as the possibilities of
      reafferentiation of the transplanted tissues by regenerating host "central" nerve
      fibres, are in progress.

PMID- 1758563
TI  - [Traumatic atlanto-occipital dislocation].
AB  - Traumatic atloido-occipital dislocation is usually fatal with immediate cardio
      respiratory arrest. The authors report 3 cases of children who survived such a
      spine injury despite neurological impairment. Clinical and radiological data
      including Magnetic Resonance Imaging are compared with 18 other cases reported in
      the literature.

PMID- 1758564
TI  - [Value of the measurement of cerebral blood flow before and after diamox
      injection in predicting clinical vasospasm and final outcome in aneurysmal
      subarachnoid hemorrhage].
AB  - The timing for surgery on ruptured intracranial aneurysms remains a difficult
      question and the choice of the day of operation depends greatly from the
      occurrence of a vasospasm. On a previous paper, the value of the cerebral blood
      flow (CBF) measurement by intravenous injection of Xenon 133 was demonstrated to
      be efficient for the prediction of vasospasm only when done between day 4 and day
      8 after bleeding. Moreover the efficiency of the measurement was much greater if
      the evolution of the CBF values between D0 and D8 was considered, but this method
      was incompatible with early surgery. It suggested the interest of a dynamic study
      of the CBF by the same method. On a series of 43 patients, the comparison between
      basal CBF values and reactivity of CBF values to intravenous injection of 1 gram
      of acetazolamide for the prediction of clinical vasospasm is presented. The
      series comprises 32 early admitted patients (74%) and 31 operated patients (16 of
      them between D0 and D3 after bleeding, 15 others after D4). The efficiency of the
      CBF reactivity study for the prediction of the clinical vasospasm appears much
      greater than that of the basal CBF value, even during the first three days after
      bleeding, but not for the prediction of the final clinical outcome. The method is
      immediate and compatible with early surgery. What precisely is evaluated by this
      method on the physiopathology of the vasospasm remains disputable, but the
      operability of the patients seems to be explored.

PMID- 1758565
TI  - [Peroperative monitoring of early auditory evoked potentials in microsurgical
      vascular decompression for trigeminal neuralgia or hemifacial spasm].
AB  - Intra-operative B.A.E.P. monitoring have been performed in two series of patients
      who underwent Microsurgical Vascular Decompression (M.V.D.) of the Vth and VIIth
      cranial nerves in the posterior fossa. The first series consisted of 17 patients
      among the 400 operated on for Trigeminal Neuralgia (T.N.), the second one also of
      17 patients among the 25 treated for Hemifacial spasm (H.S.), over the last four
      years. The equal number of recorded patients in the two groups is totally
      fortuitous. The aim of the work was to correlate the electrophysiological
      changes: 1) to the surgical manoeuvres potentially responsible for B.A.E.P.
      alterations, in order to modify the M.V.D. technique, so as to minimize the risks
      of hearing loss, 2) to the eventual post-operative auditory disturbances, in
      order to define prognostic criteria from B.A.E.P. monitoring. I. Intra-operative
      B.A.E.P. modifications were graded into 4 categories, according to their degree
      of severity (table II): minimal changes (category 1), increase in latency
      returning to normal (2) or without normalization (2a) before end of surgery,
      abolition or partial decrease of responses returning to normal (3) or without
      complete normalization (3a) before end of surgery, total B.A.E.P. loss lasting
      through the entire procedure (4). Patients operated on for H.S. had more often
      significant B.A.E.P. changes than those with T.N., respectively 10 and 6 for
      categories 3a and 4 together. Auditory function was at risk mainly during
      cerebellar retraction (especially if cerebello-pontine angle was approached
      laterally) and during vascular manipulation of the labyrinthine artery (which can
      generat vasospasm).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758566
TI  - [Suprasellar tumors in patients over 70 years of age. Value of limited
      frontotemporal craniotomy. Visual results. Apropos of 5 cases].
AB  - The authors report their experience of the surgical approach for suprasellar
      tumors (Jugum or tuberculum sellae meningiomas, 3 cases, and suprasellar
      craniopharyngiomas, 2 cases) in over than seventy years old patients (71-78 y). A
      limited craniectomy was performed at the fronto-temporal junction using three
      adjacent burr-holes. The duramater was cut with an Y-shaped incision.
      Cerebrospinal fluid was sucked out through a lateral subfrontal route, allowing
      an easy cerebral collapse in elderly patients, which can sometimes avoid even
      retraction. Such an supra-orbital craniectomy allowed a subfrontal approach,
      opening of the sylvian fissure and control of the inter optic, inter carotido
      optic and latero-carotidian spaces as well as a good access to the inter
      pedoncular cistern. In 4 cases the craniectomy was performed after fronto
      temporal skin incision, but a trans eyebrow skin incision was used in 1 case. All
      patients had uneventful postoperative course. Follow-up was from 3 to 5 years. A
      visual improvement occurred in all cases. Benefits of this surgical method are
      discussed and compared with use of a bone flap in patients over than 70 years.

PMID- 1758567
TI  - [Paraganglioma of the cranial vault. Apropos of a case].
AB  - The authors report the case of a 40 years old woman with a fronto parietal
      tumefaction and intracranial hypertension caused by a paraganglioma of the
      cranial vault. The clinical follow up is marked by rapid local recurrence of the
      tumor after complete excision. Usually paragangliomas arise in any area of the
      body where paraganglionar structures are situated (glomus jugulare, carotid
      glomus, vagus nerve). Other rare locations have been reported and remain
      difficult to be explained. The location at the cranial vault is exceptional. this
      tumor would probably arise from the paraganglionar cells which migrate from the
      neural crest following the trigeminal branches particularly the ophtalmic
      division.

PMID- 1758568
TI  - Animal models of muscular dystrophy--what can they teach us?
AB  - The discovery and characterization of the X-linked gene which is defective in
      Duchenne muscular dystrophy (DMD) and of its protein product, dystrophin, has led
      to the identification of biochemical homologues of this disease in the mouse, the
      dog and the cat. All three animal models resemble DMD in that they lack
      dystrophin and that their skeletal muscle fibres undergo spontaneous necrosis and
      regeneration. In the dog and man, the degenerative and fibrotic aspects
      predominate, leading to a progressive loss of muscle structure and function, and
      to severe clinical disability. By contrast, in the mouse and the cat there is
      little fibrosis and the regenerative process seems to overcompensate, producing a
      true muscle hypertrophy and little or no clinical deficit. This interspecies
      variation in pathological response limits the usefulness of these animals as
      models for therapeutic testing, calling into question the strength of linkage
      between a given biochemical lesion and a particular pattern of pathology.
      However, these differences do give a valuable perspective to the pathology of the
      dystrophin-deficiency diseases, permitting identification of the immediate and
      secondary consequences of the lack of dystrophin. Moreover, the dystrophic mouse
      and dog are readily bred as colonies, thus providing consistent material for
      investigating the function of dystrophin and for testing methods of replacing its
      function or compensating for the absence of this function in the muscles of DMD
      patients. The fact that a lack of dystrophin is compatible, in some species, with
      only minor muscle dysfunction, raises hopes for an effective therapy in man.

PMID- 1758569
TI  - Demonstration of beta amyloid protein-containing neurofibrillary tangles in
      parkinsonism-dementia complex on Guam.
AB  - This report concerns the immunohistochemical demonstration of beta amyloid
      protein-containing neurofibrillary tangles (beta-NFTs) from patients with
      parkinsonism-dementia complex on Guam (PDC). Formalin-fixed paraffin-embedded
      tissue sections from the temporal lobe of nine PDC cases and the spinal cord of
      three were examined. An affinity-purified antibody to the N-terminal peptide
      sequence of beta amyloid protein was used. beta-NFTs were demonstrated in the
      temporal lobes of the three oldest individuals. Some senile plaques, probably a
      manifestation of ageing, were also seen. The beta-NFTs were most frequent in the
      entorhinal cortex. Senile plaques were invariably present in the vicinity of the
      beta-NFTs. Conversely, in the regions without senile plaques, even though
      numerous neurofibrillary tangles were identifiable with the modified Bielschowsky
      method, no beta-NFTs were seen. The density of beta-NFTs appeared to be
      proportional to that of senile plaques, none was seen in cases lacking senile
      plaques. No beta-NFTs were detected in the spinal cords. Our data suggest that
      beta-NFTs result from secondary beta amyloid deposition on certain
      neurofibrillary tangles.

PMID- 1758570
TI  - An immunohistological study of macrophages in the human fetal brain.
AB  - Brains from human fetuses of 13 to 27 weeks gestation have been examined
      immunohistologically for the presence of macrophages using the marker alpha-1
      anti-chymotrypsin. A preliminary study demonstrated this to be a satisfactory
      marker of brain macrophages, although macrophages were also weakly positive for
      the more specific marker MAC-387. Macrophages were widely present within the
      cerebral hemispheres following their rapid accumulation between 14 and 16 weeks
      of gestation. They were identified in characteristic locations which, in the
      earliest gestation brains examined at 13 weeks, included the mid-line of the
      corpus callosum, around the optic tract and at the junction of the external and
      internal capsules near the apex of the putamen. Subsequently, macrophages were
      identified in abundance in the internal and external capsules and, by 22 weeks
      gestation, in the periventricular tissues. Their consistent presence and
      distribution indicate that at least the majority of these macrophages are a
      normal feature of the developing brain possibly related to remodelling processes.

PMID- 1758571
TI  - The glial reaction in closed head injuries.
AB  - The development of the glial reaction in human closed head injury has been
      investigated using morphometry and statistical analysis. The brains of eight
      individuals that survived less than 48 h following closed head injury were
      analysed using immunoperoxidase for glial fibrillary acidic protein (GFAP).
      Controls were eight patients without neurological disease. The density of
      reactive astrocytes was estimated in 25 fields in each of 10 different areas
      sampled bilaterally avoiding the subpial and subependymal zones, and the
      perivascular white matter. There was great variation between the zones within and
      between groups, and considerable variation between individuals. The raw data were
      expressed as logarithms averaged and analysed using the median and non-parametric
      statistics. The corpus callosum in the head injury group showed the highest
      densities of reactive astrocytes, particularly in the splenium which achieved
      statistical significance using the non-parametric tests. This pattern was not
      reproduced in the control group. Although there was overlap between the head
      injured and control individuals, the head injury group had relatively higher
      densities in all zones, and showed an overall increase in the density of reactive
      astrocytes. This achieved statistical significance in the corpus callosum, the
      occipital subcortical white matter, and the cerebellum. This study has shown that
      the glial reaction is often prominent in the corpus callosum irrespective of the
      presence of a primary lesion although the pattern varies from case to case.

PMID- 1758572
TI  - A method to quantitate axonal injury.
AB  - The quantitation of diffuse axonal injury provides a more objective approach to
      the assessment of tissue damage in head injuries. The method designed in this
      study takes into account the anisotropy and structural inhomogeneity of the
      brain, and the distribution of lesions in diffuse axonal injury. The number of
      counts required for the statistical analysis is inversely proportional to the
      square of the desired accuracy, specified as the percentage of the mean value of
      the axonal balloons since the true mean is unknown from the outset. The number of
      fields are examined using an indexed-squares graticule in 10 different areas of
      the brain. Silver-stained sections from the brains of head injured patients that
      survived longer than 12 h must be used with this method. Difficulties may arise
      when patients of different survival times are compared since it takes some time
      for the axonal balloons to develop. A correlation with the survival time can be
      established with the quantitative data collected. The morphometric principles and
      the statistical rationale on which this methodology is based are briefly
      presented.

PMID- 1758573
TI  - Acute inhibition of pituitary LH release in the male rat by the glucocorticoid
      agonist decadron phosphate.
AB  - The present study was carried out to investigate the effects of acute
      administration of the soluble glucocorticoid receptor agonist, decadron phosphate
      (DEC, dexamethasone sodium phosphate), on pituitary luteinizing hormone (LH)
      release in intact adult male rats. DEC was administered intravenously to
      individual groups of animals at a dose of either 0.05 or 0.5 mg DEC/kg, and the
      magnitude and time course of drug-induced alterations in plasma LH concentrations
      were evaluated. DEC was observed to elicit a dose-proportionate decrease in
      plasma LH within hours after systemic injection. Both doses of DEC significantly
      reduced the magnitude of exogenous LH-releasing hormone (RH; 10 ng/100 g b.w.)
      induced increases in plasma LH at time points coincident with drug-induced
      decreases in basal LH release. During in vitro perifusion of isolated anterior
      pituitary tissue fragments, the administration of DEC, via the perifusate, at a
      concentration of 1.0 microgram/ml had no impact upon basal LH release, but did
      effectively diminish LHRH-stimulated hormone release from perifused tissues.
      Intracerebroventricular injection of DEC also resulted in a decline in
      circulating LH. While intracerebroventricular (ICV) administration of 10 ng of
      DEC had no impact upon circulating LH, higher doses of 100 ng and 1.0 micrograms
      significantly depressed circulating LH levels in a dose-related manner. Both of
      these ICV doses were also found to diminish pituitary responsiveness to LHRH.
      Lastly, DEC was intravenously administered at a dose of 0.5 mg/kg to groups of
      orchidectomized and orchidectomized, testosterone (T)-treated male rats.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1758574
TI  - Interactions between the noradrenergic and opioid peptidergic systems in
      controlling the electrical activity of luteinizing hormone-releasing hormone
      pulse generator in ovariectomized rats.
AB  - The effects of noradrenergic and opioid peptidergic receptor blockade, either
      alone or in combination, on the electrical activity of luteinizing hormone
      releasing hormone (LHRH) pulse generator were studied in ovariectomized rats
      fitted with chronically implanted electrode arrays in the medial basal
      hypothalamus. Both alpha- and beta-adrenergic receptor antagonists, i.e.
      phenoxybenzamine (5 mg/kg i.v.) and propranolol (5 mg/kg i.v.), respectively,
      significantly increased the intervals between characteristic increases (volleys)
      in hypothalamic multiunit activity (MUA), which were associated with the
      initiation of LH pulses. In contrast to this, an opioid receptor antagonist
      naloxone (2 mg/kg i.v.) significantly decreased the intervals between the MUA
      volleys. Naloxone given after the injection of propranolol induced MUA volleys
      with a latency of a few minutes. However, when given after the injection of
      phenoxybenzamine, naloxone failed to induce such immediate MUA volleys. These
      changes in the intervals between the MUA volleys were faithfully reflected by the
      pulsatile LH secretion. These results suggest that norepinephrine facilitates
      LHRH pulse generator activity through both alpha- and beta-adrenergic-receptors,
      and that the action of opioid peptides on it requires an alpha-adrenergic
      receptor-mediated mechanism.

PMID- 1758575
TI  - Maintenance of LHRH and oxytocin neurons in slice explants cultured in serum-free
      media: effects of tetrodotoxin on gene expression.
AB  - A variety of neuroendocrine cells survive and express specific neuropeptide genes
      for long periods of time in slice explant cultures in the presence of serum.
      However, before use of these slice explant cultures as experimental models for
      physiological and pharmacological studies on the regulation of neuropeptide gene
      expression, it is first necessary to evaluate their characteristics in defined
      (e.g. serum free) media and to control for the spontaneous electrical and
      synaptic activity of neurons in these cultures. In this study, brain slices from
      postnatal day 4 rats were cultured in serum-containing media (SCM) for 12 days to
      allow thinning, and then maintained in a serum-free, defined media (SFM) for 6
      days. Culture slices transferred to SFM appeared healthy and numerous
      neuroendocrine neurons containing messenger RNA (mRNA) encoding for LHRH and
      magnocellular neurons containing mRNA encoding for oxytocin (OT) were detected
      using in situ hybridization histochemistry (ISHH). Each of these neuronal
      subtypes robustly produced their appropriate gene products as determined by
      immunocytochemical analysis. Abundant magnocellular OT neurons were found in
      cultures grown in either SCM or SFM. In contrast, magnocellular vasopressin (VP)
      neurons were rarely detected under these conditions. Inhibition of spontaneous
      electrical and synaptic activity in these slice explant cultures was effectively
      achieved by incubation for the last 2.5 days of culture in the presence of
      tetrodotoxin (TTX; 10(-6) M). Densitometric single cell analyses after ISHH was
      performed on both LHRH and OT cells. Comparisons of the density values
      (corresponding to mRNA levels), from these slice explants, found that: (1)
      cellular LHRH mRNA levels decreased in the absence of serum, whereas cellular OT
      mRNA levels did not significantly change under these conditions; (2) the presence
      of TTX in the media resulted in an overall decrease in cellular LHRH mRNA values
      in both SCM and SFM, and (3) the OT neurons in these slice cultures appear to be
      composed of a heterogeneous population, with one cell subtype responding to TTX
      with an increase in cellular OT mRNA levels. These data show that factors in
      serum and spontaneous electrical activity can differentially influence mRNA
      levels of LHRH cells and magnocellular OT neurons in culture.

PMID- 1758576
TI  - Anterograde nerve degeneration after superior cervical ganglionectomy coexists
      with a decrease in arginine vasopressin release in rats.
AB  - After bilateral superior cervical ganglionectomy (SCGx) in adult male rats,
      norepinephrine content of the pituitary neurointermediate lobe (NIL) decreased at
      12-24 h after surgery to attain concentrations 40-60% of controls between 24 and
      60 h after surgery. To assess arginine vasopressin (AVP) secretion during this
      time, plasma and NIL-AVP levels were measured by radioimmunoassay. In sham SCGx
      controls, plasma AVP increased about 2-fold within 6 h after surgery and
      decreased thereafter, to attain presurgical values by 60 h after surgery. In SCGx
      rats, a significant increase in plasma AVP concentration was observed at the 6th
      h after surgery, as compared to presurgical concentrations, with a decrease to
      values significantly lower than those of presurgical controls at 16-18 h after
      SCGx. As compared to sham-operated rats, significantly higher plasma AVP levels 6
      h after surgery and significantly lower plasma AVP levels 16-24 h after surgery
      were found. NIL-AVP concentration in SCGx and sham-operated ras were
      significantly lower than presurgical levels at 6 h after surgery. SCGx rats had
      significantly higher amounts of AVP in NIL at 16-24 h after surgery. The changes
      in plasma and NIL-AVP levels found 6 or 16 h after SCGx or sham SCGx were
      unaffected by a prior pinealectomy. Two injections of the alpha 1-adrenoceptor
      blocker prazosin 45 and 90 min before sacrifice, alone or together with the beta
      blocker propranolol, prevented the increase in plasma AVP found in SCGx rats 6 h
      after surgery, and the decrease in plasma AVP and the increase of NIL-AVP found
      16 h after SCGx.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758577
TI  - Regulation of hypothalamic gonadotropin-releasing hormone secretion in
      experimental uremia: in vitro studies.
AB  - Defective regulation of hypothalamic gonadotropin-releasing hormone (GnRH)
      secretion is the primary defect leading to the inhibition of pituitary
      gonadotropin secretion and its consequences such as androgen deficiency and
      infertility in experimental uremia. Previous studies using indirect methods to
      study presumptive GnRH release and the function of GnRH-secreting neurons have
      suggested functional disturbances of GnRH neurosecretion; however, the precise
      biochemical mechanisms involved were not defined. Therefore, in order to clarify
      the mechanisms of aberrant regulation of hypothalamic GnRH secretion in
      experimental uremia, we examined basal secretion of GnRH from mediobasal
      hypothalamus (MBH) in vitro and the GnRH-secretory responses to naloxone, an
      opiate receptor antagonist in experimental uremia. Using a static incubation
      system, adult male rats, either intact or castrate, with subtotal nephrectomy
      demonstrated a significant reduction of GnRH secretion by 25% in intact and by
      40% in castrate uremic male rats compared with their nonuremic controls. In
      contrast, hypothalamic GnRH content of uremic animals was increased significantly
      (6% in intact and 14% in castrate uremic rats). Despite the fall in basal GnRH
      release from MBH, the MBH GnRH release response to in vitro stimulation by an
      opioid blocker (naloxone) and a membrane-depolarizing agent (veratrine) were not
      diminished in uremic male rats. These findings suggest that the inhibition of
      pituitary gonadotropin secretion in experimental uremia is likely to be due to a
      functional defect in suprahypothalamic regulation of GnRH secretion rather than
      an intrinsic defect in the GnRH-secreting neurons. Further studies are required
      to clarify the nature of the neuromodulator interactions involved.

PMID- 1758578
TI  - Estrogen increases spine density in ventromedial hypothalamic neurons of
      peripubertal rats.
AB  - Using the single-section Golgi impregnation technique, sex differences in
      hypothalamic ventromedial (VMN) neurons of gonadectomized juvenile and
      peripubertal rats were assessed. The effect of estrogen treatment on VMN neurons
      was also investigated. Juvenile rats were gonadectomized at 16 days of age and
      peripubertal rats at 36 days. At 5 days after surgery, the rats were injected
      with estradiol benzoate (20 micrograms/kg) or sesame oil for 2 days after which
      they were perfused and the brains processed for Golgi impregnation. Estradiol
      benzoate treatment significantly increased dendritic and soma spine density in
      juvenile and peripubertal male and female rats. A sex difference was observed in
      oil- and in estradiol-treated rats, with females exhibiting higher dendritic
      spine density and a greater response to estrogen priming. Moreover, dendritic and
      soma spine density was significantly higher in juvenile versus peripubertal rats.
      It is possible that the sex difference observed in dendritic and soma spine
      density and in the response to estradiol benzoate treatment is due to an
      organizational effect of sex steroids.

PMID- 1758579
TI  - Activin-A modulates gonadotropin-releasing hormone secretion from a gonadotropin
      releasing hormone-secreting neuronal cell line.
AB  - The recent development of GnRH-secreting neuronal cell lines (GT1-1, GT1-3 and
      GT1-7 clones) has provided a model system for the study of the neural regulation
      of GnRH expression and secretion. We report here that activin-A stimulates GnRH
      secretion by GT1-7 cells in a dose-dependent manner, with an EC50 of
      approximately 2.5 ng/ml. The maximal response (50% stimulation) was achieved
      after 2 days of incubation with 20 ng/ml activin-A. Activin-A treatment increased
      total GnRH (secreted + cellular) in GT1-7 cells, possibly reflecting a
      stimulation of GnRH biosynthetic rates. The secretory effect of activin-A was
      also accompanied by a change in the cellular morphology to a more neuronal
      phenotype. The addition of TGF-beta (10 ng/ml), which is structurally related to
      activins, did not significantly increase secretion of GnRH by GT1-7 cells
      illustrating the specificity of the activin effect on this cell line. Although
      inhibin (20 ng/ml) alone did not directly affect the spontaneous secretion of
      GnRH, it was able to partially block the stimulatory effect of activin. The
      present study with the GT1-7 clonal cell line suggests that activin, and perhaps
      inhibin, might act at hypothalamic sites to regulate reproduction through the
      control of GnRH production and/or secretion.

PMID- 1758580
TI  - Septal and hippocampal release of vasopressin and oxytocin during late pregnancy
      and parturition in the rat.
AB  - The push-pull perfusion technique, in conjunction with specific
      radioimmunoassays, was used to monitor the release of both arginine vasopressin
      (AVP) and oxytocin (OXT) within distinct limbic brain areas of conscious female
      rats. In pregnant rats near term, the release of AVP was greater than that of
      virgin rats in both the ventral (p less than 0.001) and mediolateral (p less than
      0.001) septal areas; similarly, release of OXT increased in the ventral septal
      area (p less than 0.01) at this time. In contrast, no changes in the levels of
      either peptide occurred in the dorsal hippocampus. In parturient rats, AVP
      release tended to decrease in the septal areas but increased fivefold in the
      dorsal hippocampus (p less than 0.001) compared to pregnant animals. In contrast,
      OXT levels assayed in the same perfusates did not differ from those observed in
      pregnant animals. Plasma levels of AVP in pregnant rats (p less than 0.05) and of
      OXT in parturient animals (p less than 0.01) were found to be increased over
      levels in virgin rats. The regionally different and peptide-specific changes in
      release pattern of AVP and OXT in virgin, pregnant and parturient rats may be of
      physiological significance in antipyresis and behaviors accompanying parturition.

PMID- 1758581
TI  - Stimulation of hypothalamic prolactin release by veratridine and angiotensin II
      in the female rat: effect of ovariectomy and estradiol administration.
AB  - In the female rat immunoreactive prolactin (IR-PRL) has been identified in the
      hypothalamus and in other brain regions. Brain IR-PRL is not of pituitary origin
      and, based on polyacrylamide gel electrophoresis and peptide mapping, shares a
      high degree of sequence homology with its pituitary counterpart. We have
      previously shown that hypothalamic tissue can release IR-PRL in vitro when
      depolarized by potassium. In this study, we examined the release of IR-PRL from
      hypothalami obtained from intact and ovariectomized rats and incubated in the
      presence of veratridine (an alkaloid which depolarizes excitable membranes),
      angiotensin II, or thyrotropin-releasing hormone. Hypothalamic tissue
      spontaneously released IR-PRL, and this release was significantly increased by
      veratridine or angiotensin II in a dose-dependent manner. The specificity of the
      angiotensin-II-evoked IR-PRL release was demonstrated by the inhibitory effect of
      saralasin, an angiotensin II receptor antagonist, on hypothalamic IR-PRL release.
      Thyrotropin-releasing hormone (100 microM) had no effect on hypothalamic IR-PRL
      release. Ovariectomy decreased hypothalamic IR-PRL content and IR-PRL release in
      response to veratridine and angiotensin II. The effect of estradiol on
      hypothalamic IR-PRL content and release was also examined by obtaining
      hypothalami from ovariectomized rats injected with estradiol (1 microgram/day) or
      vehicle for 5 days. When compared with vehicle injected rats, administration of
      estradiol significantly increased the hypothalamic IR-PRL content (46 +/- 4 vs.
      81 +/- 16 ng/mg protein).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758582
TI  - Modulation of the effects of N-methyl-D,L-aspartate on luteinizing hormone by the
      ovarian steroids in the adult rhesus monkey.
AB  - Although the excitatory amino acid, N-methyl-D,L-aspartate (NMA), is generally
      thought to stimulate LH release, we have previously reported that NMA inhibits LH
      secretion in the adult ovariectomized (OVX) rhesus monkey. The objectives of this
      study were: (1) to compare the effect of NMA on LH in the OVX monkey before and
      after replacement with ovarian steroids, and (2) to evaluate the LH response to
      NMA in the intact female monkey during three phases of the menstrual cycle. Three
      hourly injections of NMA (45 mg i.v.) were given to OVX monkeys (OVX; n = 12) and
      to OVX animals treated for 4 days with estradiol alone (OVX + E; n = 4) or with
      estradiol plus progesterone (OVX + E/P; n = 5). Replacement with ovarian steroids
      prevented the NMA-induced decrease in LH: mean (+/- SE) areas under the LH curve
      (expressed as a percentage of the 3-hour baseline preinjection control) during
      the 3-hour NMA treatment period were as follows: OVX, -26.6% +/- 2.4; OVX + E,
      +69.6% +/- 33.9; OVX + E/P, + 161.5% +/- 59.3 (p less than 0.001 vs. OVX). Three
      hourly NMA (45 mg i.v.) injections were also given to monkeys in the early to mid
      follicular phase (n = 5), the late follicular phase (n = 6) and the luteal phase
      (n = 11). NMA significantly increased LH in the luteal phase: control, 11.5 +/-
      2.1; peak LH response, 19.8 +/- 2.1 (p less than 0.005).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1758583
TI  - Sleep-related growth hormone secretion in human obesity: effect of dietary
      treatment.
AB  - Eight obese patients (4 male, 4 female; mean age = 35.9 years) before [mean body
      mass index (BMI) = 37.1] and after (mean BMI = 31.4) weight loss by means of a
      mixed hypocaloric diet were compared with 8 lean subjects (4 male, 4 female; mean
      age = 37.1 years, mean BMI = 22.3) in a study of their nocturnal sleep patterns
      and sleep-related growth hormone (GH) secretions. Although no sleep disorders (in
      particular, sleep apnea and hypersomnia) were observed, GH secretion was markedly
      altered in obese patients that showed no sleep-related GH peaks. After weight
      loss, the sleep architecture in obese subjects was unchanged. On the contrary, GH
      peak appeared to be only partially restored and delayed until after stage III-IV
      of non-REM sleep. Our study on obese subjects suggests that the altered nocturnal
      GH secretion, probably related to a hypothalamic dysfunction, may be the result
      of the obesity per se.

PMID- 1758584
TI  - Ultrastructural evidence of a sexual dimorphism in the neuropil of the medial
      preoptic nucleus of the rat: a quantitative study.
AB  - In the rat, a new structural sex difference of the nervous system was found: the
      density of axodendritic synapses (ADS) is larger in the male central component of
      the medial preoptic nucleus (MPNc), as proven by quantitative electron
      microscopy. The study included 24 animals divided into four groups (n = 6):
      control males (CM), control females (CF), males castrated as newborn (MGx) and
      males castrated as newborn and treated 10 days with daily injections of
      testosterone. No significant differences were found in the number of axospinous
      synapses among all groups; however, the number of ADS was significantly larger in
      CM when compared to that of the CF. This difference was abrogated by castration
      of the newborn male and restored by perinatal treatment with testosterone.
      Further, no difference in ADS was encountered between CF and MGx. The present
      data, together with previous studies which indicate that sex steroids do modify
      the number of synapses in other nuclei of the brain, led us to conclude that the
      sex difference in the number of ADS within the MPNc is determined by the
      organizational effect(s) of testosterone.

PMID- 1758585
TI  - Insulin-like growth factor I: a possible metabolic signal involved in the
      regulation of female puberty.
AB  - In both rats and primates, including humans, serum levels of insulin-like growth
      factor I (IGF-I) increase during the onset of puberty, suggesting a role for IGF
      I in this process. We examined the ability of IGF-I to affect the release of
      hypothalamic luteinizing hormone releasing hormone (LHRH) in prepubertal female
      rats. Our results indicate that IGF-I acts on the median eminence, which contains
      the highest density of type 1 IGF receptors in the brain, to elicit a dose
      related increase in LHRH release. In this regard, a minimal effective dose of 10
      ng/ml (p less than 0.05) and a maximal effective dose of 100 ng/ml (p less than
      0.01) was observed. IGF-II and insulin were one order of magnitude less
      effective. The results demonstrate that IGF-I has the capability to act directly
      upon the median eminence to effect release of LHRH, thereby suggesting a role for
      IGF-I in facilitating peripubertal changes in LHRH release. Thus, IGF-I may
      represent one of the 'metabolic signals' thought to be involved in the initiation
      of puberty.

PMID- 1758586
TI  - Antagonism of morphine-induced respiratory depression by novel anticholinesterase
      agents.
AB  - This study compared the effects of 3 novel antiAChE agents (derivatives of
      dimethylaminoethyl-phenyl carbamate) with that of physostigmine on the
      respiratory depression induced by morphine in rabbits. Each drug, RA6, (1 mg
      i.v., 2 mg s.c.) RA7 (1 or 2 mg i.v.); RA15 (0.25 or 0.5 mg i.v.), physostigmine
      (0.05 or 0.1 mg i.v.) or saline (1 ml), was injected simultaneously with morphine
      (8 mg i.v.) to groups of 6-10 rabbits. Respiration rate, blood gases and pH were
      monitored for 3 hr. Plasma ChE was measured before and at 15 min intervals after
      injection. The 4 antiAChE's were given to 40 other rabbits, which were sacrificed
      at the time of maximal antagonism of the respiratory depressant effect of
      morphine, in order to measure the activity of AChE in the medulla, cortex and
      hippocampus. Physostigmine (0.1 mg) only antagonized the increase in paCO2
      induced by morphine at 15 and 30 min. The drugs RA15 (0.5 mg), RA6 (2.5 mg) and
      RA7 (2 mg) almost completely prevented the respiratory depression, without
      obvious signs of peripheral cholinergic hyperactivity, for at least 3 hr. There
      was no relationship between the degree of antagonism of the effects of morphine
      with any drug and that of inhibition of ChE in plasma. In contrast, a highly
      significant correlation (P less than 0.01) was found between the former and the
      amount of inhibition of AChE in the medulla. It is suggested that the novel
      carbamates may have potential therapeutic application in reducing the respiratory
      depression of opiates, without impairing analgesia.

PMID- 1758587
TI  - Effect of dietary protein on striatal dopamine formation following L-dopa
      administration: an in vivo study.
AB  - We varied the diet of rats and monitored extracellular levels of dopamine in the
      striatum. Following L-dopa administration, the increase in striatal dopamine
      levels was attenuated by 78% in rats that had consumed a high protein diet as
      opposed to a low protein diet. Similarly, the increase in striatal dopamine
      levels was attenuated by 61% in rats that had just eaten a protein-containing
      meal as compared to fasting animals. These findings demonstrate that dietary
      protein strongly affects brain dopamine formation from exogenous L-dopa.

PMID- 1758588
TI  - Hyperglycemia induced by hippocampal administration of neostigmine is suppressed
      by intrahypothalamic atropine.
AB  - We investigated the relationship between the hyperglycemia induced by the
      administration of neostigmine into the hippocampus and the hypothalamus. Prior to
      the injection of neostigmine (5 x 10(-8) mol) into the hippocampus, 1 microliter
      each of atropine or hexamethonium (5 x 10(-11)-5 x 10(-8) mol) was injected into
      the bilateral ventromedial hypothalamus (VMH). Atropine suppressed in a dose
      dependent manner the hyperglycemia induced by hippocampal administration of
      neostigmine, whereas hexamethonium had no significant effect. These observations
      suggest that the pathway for this experimental hyperglycemia involves, at least
      in part, the muscarinic cholinergic neurons in the VMH.

PMID- 1758589
TI  - Systemic morphine simultaneously decreases extracellular acetylcholine and
      increases dopamine in the nucleus accumbens of freely moving rats.
AB  - Microdialysis was used to measure extracellular levels of acetylcholine (ACh) and
      dopamine (DA) simultaneously in the nucleus accumbens (NAC) of freely moving
      rats. Systemic injection of morphine (20 mg/kg) significantly decreased ACh (30%,
      p less than .01) while it increased DA (55%, p less than .01). The effects of
      morphine were eliminated by naloxone. The results confirm that morphine increases
      DA and in addition, demonstrate an inhibitory influence of this opiate on
      extracellular levels of ACh in the NAC.

PMID- 1758590
TI  - The dorsolateral, suboccipital, transcondylar approach to the lower clivus and
      anterior portion of the craniocervical junction.
AB  - The authors review their experience with a dorsolateral approach to the anterior
      rim of the foramen magnum and adjacent region. The operative technique includes
      exposure of the vertebral artery at C1, partial resection of the occipital
      condyle and lateral atlantal mass, and extradural drilling of the jugular
      tubercle. This approach has been applied in six patients who harbored intradural
      space-occupying lesions located ventral to the lower brain stem. Excision of the
      neoplasm was virtually total in all but one patient, in whom biopsy was the
      primary goal of the intervention. No morbidity and no mortality were associated
      with this approach. The main advantage of the dorsolateral, suboccipital,
      transcondylar route is the direct view it offers to the anterior rim of the
      foramen magnum without requiring brain stem retraction.

PMID- 1758591
TI  - Cerebrospinal fluid shunting for hydrocephalus in the adult: factors related to
      shunt revision.
AB  - Cerebrospinal fluid shunting procedures are widely employed in the treatment of
      hydrocephalus and other disturbances of the dynamics of cerebrospinal fluid. In
      spite of its popularity, this operation frequently requires surgical revision. A
      retrospective analysis of a series of 356 adults who underwent the insertion of a
      cerebrospinal fluid shunt between January 1970 and December 1988 was performed.
      The incidence of revision was analyzed, and an attempt was made to identify
      possible causal factors. The overall incidence of surgical revisions was 28.65%;
      the number of revisions in the same patient ranged between one and eight. The
      most frequent causes of revision were distal malposition, obstruction, and
      infection. A statistically significant difference (P less than 0.05) was found in
      both the risk of revision in patients who had undergone previous operations and
      those who had not and in the incidence of revision before and after January 1985.
      Meticulous surgical technique as well as perioperative antibiotic prophylaxis
      appear responsible for the latter. The differences in the incidence of revision
      among patients treated with different types of shunts and valves, though
      remarkable, is not statistically significant.

PMID- 1758592
TI  - Pregnancy in patients with cerebrospinal fluid shunts: report of a series and
      review of the literature.
AB  - Hydrocephalic women with cerebrospinal fluid shunts are now surviving to
      reproductive age. Twenty-one pregnancies in 18 patients with shunts, including 11
      from the present series and 10 from previous series, were analyzed for
      neurological, obstetrical, and perinatal outcome. Fourteen women had preexisting
      shunts, and 4 had the onset of symptomatic hydrocephalus and the placement of
      shunts during pregnancy. Neurological complications occurred in 13 of 17 (76%)
      pregnancies in patients with preexisting shunts, including symptoms of increased
      intracranial pressure (ICP) in 10 of 17 (59%) pregnancies, exacerbation of
      seizure disorder in 2 of 17 (12%) pregnancies, and severe headaches without
      increased ICD in 1 patient. In 7 of 11 (66%) of the symptomatic patients,
      symptoms spontaneously resolved postpartum. Four of 17 (23%) of these pregnancies
      were associated with shunt obstruction requiring antepartum or postpartum
      surgery. Four patients had a primary shunt placement, and one had a shunt
      revision during pregnancy without complications. There were no unusual
      obstetrical or perinatal complications in the series. The clinical management of
      pregnant patients with hydrocephalus should include preconception counseling and
      magnetic resonance imaging, as well as the use of serial antenatal magnetic
      resonance images, ICP monitoring, or the judicious use of radioisotope studies of
      shunt patency if signs of increased ICP appear. A cesarean section is recommended
      for the delivery of the neurologically unstable patient. For asymptomatic
      mothers, a vaginal delivery with a shortened second stage and prophylactic
      antibiotics are advised.

PMID- 1758593
TI  - A ventricular infusion technique for the evaluation of treated and untreated
      hydrocephalus.
AB  - Patients considered to have a possible disorder of the circulation of the
      cerebrospinal fluid (CSF) were prospectively randomized on clinical and computed
      tomographic grounds into one of four categories: low probability of a disorder of
      circulation of the CSF (n = 14); high probability of a disorder of the
      circulation of the CSF (n = 10); low probability of shunt malfunction (n = 10);
      and high probability of shunt malfunction (n = 9). Patients with possible
      disorders of the circulation of the CSF who did not meet the entry criteria for
      each of these categories were excluded from this study. A ventricular catheter
      connected to a subgaleal Rickham reservoir not in continuity with a shunt system
      (if this was present) either was inserted into each patient or was in place from
      previous surgery. Infusion studies were conducted by the infusion of 1 ml/min of
      normal saline through a 25-gauge needle inserted through the skin into the
      Rickham reservoir. A separate 25-gage needle was inserted into the Rickham
      reservoir for continuous recording of intracranial pressure. There were 43
      infusion studies that were included in the four categories. Recordings of
      baseline intracranial pressure for a high probability of a disorder of the
      circulation of the CSF did not differ significantly from a low probability of a
      disorder of the circulation of the CSF. Baseline intracranial pressure for a high
      probability of shunt malfunction was significantly higher than the low
      probability of a disorder of the circulation of the CSF group and the low
      probability of shunt malfunction group; there was, however, marked overlap in
      values between these groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758594
TI  - Anatomy of the sympathetic pathways in the carotid canal.
AB  - The sympathetic fibers in the carotid canal were studied in 30 unfixed specimens
      from human cadavers. Thirty petrous internal carotid arteries were injected with
      red silicone rubber, and the course of the sympathetic fibers was examined after
      removal of the inferior and superior wall of the carotid canal. The internal
      carotid artery was removed completely, leaving the sympathetic fibers intact as
      much as possible. Instead of a plexus-like configuration of the sympathetic
      fibers around the petrous carotid artery in all specimens, an anterosuperior
      group and a posteroinferior group of sympathetic fibers were found together, and
      both closed on the inferior-anterior side of the terminal portion of the
      horizontal part of the carotid canal. Seventy-three percent of the anterosuperior
      group of sympathetic fibers consisted of one large bundle, and 27% consisted of
      two smaller bundles. The majority of the posteroinferior group of sympathetic
      fibers consisted only of one bundle (93%). In 60% of the specimens, the majority
      of sympathetic fibers in the carotid canal were found in the anterosuperior
      group, 20% were found in the posteroinferior group, and in 20%, there was an
      equal distribution. The formation of the petrous bone and the related structures
      of the skull base play an important role in the configuration of these groups of
      sympathetic fibers. This study shows that, in cases of operative intervention in
      the carotid canal, the anterosuperior group of sympathetic fibers may be
      encountered. Damage to this bundle may result in sympathicoparesis, as it often
      contains the most sympathetic fibers. This group of sympathetic fibers can be
      easily separated from the internal carotid artery.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1758595
TI  - The acoustic detection of intracranial aneurysms: a clinical study.
AB  - A new recording method for the acoustical detection of intracranial aneurysms is
      presented. A study examining the capability of the method to discriminate between
      patients with an aneurysm and control patients by a simple, objective parameter
      is reported. Sound signals were recorded over the eyes, and a real-time spectral
      analysis was performed on these signals. For this study, recordings performed on
      26 patients with an aneurysm were compared with recordings on 26 age- and sex
      matched control patients without intracerebral abnormalities. As a result of
      measures taken to reduce artifacts and to improve the signal-to-noise ratio, the
      measurements were performed reliably, with little inconvenience for the patients;
      all measurements could be used for analysis. The power spectra measured in the
      control patients showed a typical, smoothly descending pattern; those measured in
      the aneurysm patients clearly differed from this pattern, showing peaks of
      varying width, height, and dominant frequency. For the objective judgment of the
      power spectra, the power median is introduced. The sensitivity and specificity of
      this parameter were determined. Possible methods to improve the results will be
      discussed.

PMID- 1758596
TI  - Inhibition of subintimal hyperplasia of autologous vein bypass grafts by
      nimodipine in rats: a placebo-controlled study.
AB  - An arterial bypass may be required for the management of neoplastic or
      cerebrovascular disease. When an arterial graft is not suitable, autologous vein
      grafts are the most commonly used conduits; however, as many as 20% of the vein
      grafts used in vascular surgery may occlude as a result of subintimal
      hyperplasia. Although the mechanism initiating subintimal hyperplasia remains
      unclear, it is known that subintimal hyperplasia is dependent upon smooth muscle
      cell proliferation and migration from the media to the intimal layer. The present
      study focused on the prevention of smooth muscle cell proliferation using a
      calcium antagonist. Forty rats received an autologous vein bypass graft from the
      jugular vein to reconstruct the abdominal aorta. They were randomly divided into
      two groups of 20 rats each. Animals in the treated group received a calcium
      antagonist (nimodipine), and those in the control group received a placebo. Nine
      months after grafting, the group receiving the calcium antagonist presented no or
      only slight sub intimal hyperplasia as compared with the placebo-treated group (P
      less than 0.001). These data suggest that a calcium antagonist could be used for
      the prevention of venous graft disease.

PMID- 1758597
TI  - Cerebral arteriovenous malformations: factors influencing the surgical difficulty
      and outcome.
AB  - The outcomes of 151 patients with arteriovenous malformations (AVMs) treated
      either surgically or conservatively are presented. In terms of long-term survival
      rate and follow-up results, the patients who underwent total excision had more
      favorable results than did those treated conservatively. Patient age was the most
      important clinical factors, with the preoperative level of consciousness being
      the second most important. A grading system was formulated on the basis of the
      angiographical factors by using multiregression analysis; the size of the AVM
      influenced the surgical outcome twice as much as did the location and the pattern
      of arterial feeding. Thus, a large AVM (greater than or equal to 4 cm) was given
      2 points; a small AVM (less than 4 cm) was given 0 points; a deep AVM was given 1
      point; a superficial AVM was given 0 points; an AVM supplied by three of more
      artery systems was given 1 point; and an AVM supplied by one or two artery
      systems was given 0 points. AVMs were categorized into 5 grades from Grade 0 to 4
      by the summation of these points. Predicted Karnofsky scale after surgery was
      calculated by this grading system and the following equation: predicted Karnofsky
      scale = 87.2 - 5.6 x Grade. Grade 0 and 1 AVMs showed high rates of total
      excision (Grade 0, 94%; Grade 1, 82%) and of satisfactory outcome (Grade 0, 90%;
      Grade 1, 82%) and were classified as "easy" lesions. Grade 2 AVMs are lesions
      classified as "moderate" and had a total excision rate of 76% and a satisfactory
      outcome rate of 71%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758598
TI  - Intracranial infection after missile injuries to the brain: report of 30 cases
      from the Lebanese conflict.
AB  - This study reviews the features of 30 intracranial infections complicating 600
      penetrating head injuries from missiles in patients treated at the American
      University of Beirut Medical Center between 1981 and 1988. The follow-up period
      ranged from 1 month to 7 years (mean, 2.5 years). Sixteen patients had a brain
      abscess, 9 had cerebritis, 2 had an infected intracerebral hematoma, and 5 had
      meningitis. Infection developed 4 days to 7 years after the initial debridement.
      The infecting organisms were Gram positive in 11 patients (36%), Gram negative in
      12 (40%), and a combination of Gram positive and Gram negative in 2 (7%). Twenty
      four patients (80%) had wound dehiscence or cerebrospinal fluid leakage at the
      time the infection appeared. There was a 76% correlation between the organisms
      cultured from the dehiscent scalp wound and the brain. Twenty-three patients had
      intracranial retention of bone. Infection developed in 16 of the 30 patients
      (70%) around bone fragments, in 4 around a metallic fragment, in 2 around
      absorbable gelatin sponge, and in 3 along the missile tract; 2 had an infected
      intracerebral hematoma, and 3 had meningitis. At least one of the following risk
      factors was present in each patient: extensive brain injury, coma, trajectory
      through an air sinus, cerebrospinal fluid fistula, inadequate initial
      debridement, or incomplete dural closure. The incidence of intracranial infection
      in patients with postoperative retention of bone was 4% in the absence of scalp
      wound dehiscence, compared with 84.6% when wound dehiscence was present. Ten
      patients (43%) still retained a bone fragment measuring less than 1 cm after
      excision of a brain abscess or treatment of cerebritis or meningitis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1758599
TI  - The use of stable xenon-enhanced computed tomographic studies of cerebral blood
      flow to define changes in cerebral carbon dioxide vasoresponsivity caused by a
      severe head injury.
AB  - Previous studies using the xenon-133 cerebral blood flow (CBF) method have
      documented the impairment of CO2 vasoresponsivity after a severe head injury, but
      only global values can be obtained reliably with this technique. We studied CO2
      vasoresponsivity using the stable xenon-enhanced computed tomographic CBF method,
      which provided information about well-defined cortical regions and deep brain
      structures not available with the xenon-133 method. In 17 patients with admission
      Glasgow Coma Scale scores of 8 or less, hemispheric CO2 vasoresponsivity ranged
      from 1.3 to 8.5% per mm Hg change in partial CO2 pressure. Lobar, cerebellar,
      basal ganglia, and brain stem CO2 vasoresponsivity frequently varied from the
      mean global value by more than 25%. In all but one patient, local CO2
      vasoresponsivity in one or more of these areas differed from the mean global
      value by more than 50%. The greatest variability occurred in patients with acute
      subdural hematomas and diffuse (bihemispheric) injuries. This variability in CO2
      vasoresponsivity has important implications for the effective and safe management
      of intracranial hypertension that frequently accompanies severe head injury.

PMID- 1758600
TI  - Effects of sympathectomy on skin and muscle microcirculation during dorsal column
      stimulation: animal studies.
AB  - Electric stimulation of the dorsal spinal cord (DCS) in the treatment of pain in
      peripheral vascular disease is known to enhance peripheral circulation, but the
      mechanisms are still obscure. An earlier study has provided indirect evidence
      that the vasodilator effect is dependent upon alteration of sympathetic vasomotor
      activity. In the present study, surgical interruption of sympathetic pathways was
      performed to define the role of the sympathetic system for the stimulation
      induced vasodilation. Three groups of normal rats were used: one group subjected
      to lumbar sympathectomy, one group sham-operated about 1 week before performing
      spinal cord stimulation, and a third group, without pretreatment, serving as a
      second control. Stimulation was applied to one dorsal column at the thoracolumbar
      junction, and peripheral microcirculation was recorded in hind limb skin and
      muscle by laser Doppler technique. The stimulation parameters were chosen to
      correspond with those used clinically in man. A cold test with monitoring of cold
      induced changes in peripheral blood flow was used to assess the completeness of
      the sympathectomy. The preoperative cold test induced a reciprocal response,
      vasoconstriction in the skin and vasodilation in muscle. DCS with clinical
      parameters did not produce this reciprocity in the control and sham-operated
      rats, but induced a vasodilation in both skin and muscle. After complete
      sympathectomy, defined as postoperative disappearance of the vasomotor responses
      to cold, the vasodilation in skin and muscle in response to DCS was abolished;
      however, the vasodilatory response to high-intensity stimulation (approximately
      10 times the motor threshold) was not affected. Incomplete sympathetic
      denervation in some animals resulted in partial preservation of a vasodilatory
      response to DCS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758601
TI  - Enhanced protein kinase C activity correlates with the growth rate of malignant
      gliomas in vitro.
AB  - Direct measurement of protein kinase C (PKC) activity in vitro revealed a
      significant increase in the activity of the enzyme in all human malignant glioma
      lines examined and the rat C6 tumor in comparison with control nonneoplastic
      astrocyte and mixed glial cultures. The total and particulate PKC activity in
      these cell types correlated strongly [r = 0.98 (P less than 0.001) and 0.94 (P =
      0.002), respectively] with the maximal growth rates as measured by 3H-thymidine
      incorporation in each of the samples. An alteration in the growth rate of an
      individual glioma line (A172) by varying the serum concentration in the growth
      medium produced comparative changes in the measured PKC activity. The addition of
      the phorbol ester phorbol-12-myristate-13-acetate to this tumor line under high
      serum conditions produced down-regulation of the enzyme, which was accompanied by
      a corresponding reduction in thymidine incorporation. The administration of the
      PKC inhibitor staurosporine produced a dose-related decrease in the basal
      proliferation rate of glioma lines A172 and C6, as measured by 3H-thymidine
      uptake and confirmed by flow cytometry, indicating that the high intrinsic PKC
      activity is amenable to pharmacological manipulation. Cytofluorometric
      deoxyribonucleic acid cell cycle analysis of the tumors treated with PKC
      modulators demonstrated that reduced proliferation rates were caused by an
      inhibition of entrance into the deoxyribonucleic acid synthesis (S) phase
      (decrease in proliferative index), supporting the evidence that these modulators
      are not slowing the tumor growth in a nonspecific cytotoxic manner.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1758602
TI  - Blood-brain barrier permeability in an experimental model of bacterial
      cerebritis.
AB  - The mechanisms affecting blood-brain barrier (BBB) permeability in a brain
      abscess are not well defined. We sought to determine whether one bacterial
      species, Staphylococcus aureus, when inoculated into the brain, can cause the BBB
      to become abnormally permeable before leukocytes begin migrating into the brain.
      Cerebritis was induced by inoculating a suspension of S. aureus into the brain of
      the rat. The extent of leukocyte migration into the brain was assessed from
      histological sections at sequential times after the injection. BBB permeability
      was assessed by 1) detecting the presence of serum albumin leakage into the brain
      with a fluorescein-labeled antibody to rat albumin, and 2) detecting evidence of
      staining of the brain parenchyma with Evans blue dye. The fluorescein labelled
      anti-rat albumin antibody studies showed that the BBB was immediately damaged in
      experimental and control animals by the process of inoculation, but remained open
      to a greater extent in subjects inoculated with bacteria. Within 6 hours after
      inoculation, neutrophils began migrating into bacteria-inoculated brains. Evans
      blue dye, however, did not become detectable in the surrounding parenchyma until
      72 hours later, long after leukocyte migration had occurred. The findings
      indicate that an acute disruption of the BBB in the needle track precedes
      leukocyte influx, but a more widespread increase in regional BBB permeability
      does not occur until 3 days after the bacterial inoculation. The time course for
      the development of increased vascular permeability suggests that a delayed
      product of the inoculation caused impairment of the regional BBB.

PMID- 1758603
TI  - Neurenteric cysts of the posterior fossa: recognition, management, and
      embryogenesis.
AB  - Neurenteric cysts are endothelium-lined structures most commonly encountered in
      the lower cervical or upper thoracic spinal cord. The occurrence of neurenteric
      cysts within the cranial vault is unusual. We present three patients with
      neurenteric cysts located within the posterior fossa: one near the jugular
      foramen deforming the 4th ventricle, a second in the cerebellopontine angle, and
      a third in the prepontine cistern. Several different theories have been advanced
      to explain the embryogenesis of neurenteric cysts. We review these theories and
      conclude that cranial neurenteric cysts may arise from a disturbance of early
      gastrulation, shortly after the onset of primitive streak regression.

PMID- 1758604
TI  - Neurological features of cranial vault lymphomas: report of two cases.
AB  - Two patients who had focal neurological deficits as the initial manifestation of
      a malignant non-Hodgkin's lymphoma involving the skull are described. Soft-tissue
      masses and variable bone destruction were the predominant computed tomographic
      findings, and magnetic resonance imaging studies revealed meningeal involvement
      in one case and sinus thrombosis in the other. Malignant non-Hodgkin's lymphomas
      initially appearing in the skull are rare, but these lesions should be considered
      in patients with a palpable scalp mass who have focal neurological signs.

PMID- 1758605
TI  - Plasmacytoma of the skull: case reports.
AB  - Two cases of solitary plasmacytoma of the skull are presented. Both patients
      underwent surgery, and the tumors were removed completely. The patients did not
      receive postoperative radiotherapy. After a follow-up period of 18 months,
      neither patients had a local recurrence, but one developed disseminated systemic
      myeloma.

PMID- 1758606
TI  - Cerebral metastasis from an epithelioid malignant schwannoma: case report.
AB  - The authors present a case of brain metastasis from an epithelioid malignant
      schwannoma. The patient previously had undergone a surgical resection of the
      primary tumor in the right forearm. The neoplasm was composed of nests of cells
      with an entirely epithelioid appearance without spindle cell areas.
      Immunohistochemically, the tumor cells stained positive for S100 protein and
      negative for cytokeratin, neuron-specific enolase, and anti-melanoma antiserum.
      To our knowledge, this is the first reported case of cerebral metastasis from an
      epithelioid malignant tumor of the peripheral nerve sheath.

PMID- 1758607
TI  - Cystic falcine chondroma: case report and review of the literature.
AB  - A rare case of falcine chondroma in a 25-year-old woman with an 8-year history of
      headache and a recent generalized seizure is presented. Microscopic examination
      of the resected tumor revealed that it was a falcine chondroma with chondrocytes
      and central cystic degeneration.

PMID- 1758608
TI  - Subintimal dissection of the vertebral artery in subluxation of the cervical
      spine.
AB  - The vertebral arteries appear to be particularly susceptible to injury in trauma
      of the cervical spine because of their close anatomical relationship to the
      spine; however, traumatic subintimal dissection of the vertebral artery is rare
      judging from the paucity of cases reported in the literature. The case of a
      patient who developed a visual field defect secondary to a fracture-subluxation
      of the cervical spine is reported. Angiography demonstrated an intimal dissection
      of the vertebral artery at the site of the fracture-subluxation resulting in
      thrombus formation and subsequently in emboli occluding the posterior temporal
      branch of the posterior cerebral artery. Early angiography is recommended if
      extracranial injury of the vertebral artery is suspected, and the institution of
      heparin therapy is necessary if a subintimal dissection is demonstrated.

PMID- 1758609
TI  - Hernia of the spinal cord: case report and review of the literature.
AB  - A rare case of a true hernia of the spinal cord through a dural defect without
      evidence of acute trauma is presented. The cause and the differentiation from
      other congenital and traumatic spinal cord lesions, especially arachnoid cysts,
      are discussed.

PMID- 1758610
TI  - Marked growth of a cerebral arteriovenous malformation: case report and review of
      the literature.
AB  - A case demonstrating the marked growth of an angiographically occult
      arteriovenous malformation is presented. A review of 58 cases in which an
      increase in the size of an arteriovenous malformation occurred suggested that the
      patient's initial age may have had an important role in such growth and that both
      the age and the duration of follow-up were related to the extent of growth.
      Follow-up neuroradiological examinations are thought to be necessary for patients
      who have had an episode of intracranial hemorrhage of unknown cause during
      childhood, even if the initial angiograms revealed no vascular lesion.

PMID- 1758611
TI  - A "PICA communicating artery" aneurysm: case report.
AB  - We present an unusual case of an aneurysm of the distal posterior inferior
      cerebellar artery (PICA). The aneurysm was associated with a unilateral PICA that
      supplied both cerebellar hemispheres and arose from an anastomotic vessel to the
      contralateral circulation, a branch of the contralateral PICA. Such an aneurysm
      has not been reported previously. The associated of vascular anomalies with
      aneurysms of the PICA is discussed.

PMID- 1758612
TI  - Extramedullary subdural meningioma after trauma.
AB  - A 61-year-old man had an extramedullary subdural meningioma occurring close to
      the site of an old vertebral traumatic fracture and spinal cord injury. The tumor
      was discovered 3 years after the spinal trauma. This finding supports the
      existence of a causal relationship between trauma and subsequent tumor
      development. A review of the literature disclosed only one other case of
      intraspinal meningioma after the traumatic fracture of the spine with spinal cord
      compression.

PMID- 1758613
TI  - Oscillopsia and primary cerebellar ectopia: case report and review of the
      literature.
AB  - Oscillopsia, the visual sensation of stationary objects swaying back and forth or
      vibrating, has been described in association with downbeat nystagmus in patients
      with primary cerebellar ectopia (Chiari I malformation). A patient with
      symptomatic oscillopsia without downbeat nystagmus, who was diagnosed by magnetic
      resonance imaging to have displaced cerebellar tonsils below the foramen magnum,
      is presented here. Suboccipital craniectomy and upper cervical laminectomy
      completely relieved the visual disturbance of the patient. The pathogenesis and
      surgical management of oscillopsia are discussed with respect to the current
      literature. Early recognition and surgical management of oscillopsia are lead to
      complete recovery in patients with minimal symptomatology.

PMID- 1758614
TI  - Posterior spinal osteosynthesis for cervical fracture/dislocation using a
      flexible multistrand cable system: technical note.
AB  - Cervical instability secondary to fracture/dislocation or traumatic subluxation
      involving the posterior elements may be treated by a variety of fusion
      techniques. The rigidity of the stainless steel wires used in posterior cervical
      fusions often leads to difficulty with insertion, adequate tension, and
      conformation of the graft construct. This report describes a technique of
      posterior cervical fusion employing a wire system using flexible stainless steel
      cables. The wire consists of a flexible, 49-strand, stainless steel cable
      connected on one end to a short, malleable, blunt leader with the opposite end
      connected to a small islet. The cable may be used in occipitocervical,
      atlantoaxial, facet-to-spinous process, and interspinous fusion techniques. The
      cable loop is secured by using a tension/crimper device that sets the desired
      tension in the cable. In addition to superior biomechanical strength, the
      flexibility of the cable allows greater ease of insertion and tension adjustment.
      In terms of direct operative instrumentation in posterior cervical arthrodesis,
      involving both the upper and lower cervical spine, the cable system appears to be
      a safe and efficient alternative to monofilament wires.

PMID- 1758615
TI  - Intrathecal morphine for postoperative analgesia in children after selective
      dorsal rhizotomy.

PMID- 1758616
TI  - Receptor binding of corticosterone in monoaminergic structures of the brain of
      rats after neonatal blockade of the hypophyseoadrenal system.

PMID- 1758617
TI  - Role of testosterone metabolism in the hypothalamus in the regulation of the
      gonadotropic function of the hypophysis in pre- and postpubertal male rats.

PMID- 1758618
TI  - Influence of biologically active substances of the spleen on the content of
      somatotropic hormone in the hypophysis of rats.

PMID- 1758619
TI  - Functional-statistical analysis of action potentials in the multineuronal
      activity of the brain of awake cats.

PMID- 1758620
TI  - Reaction of cats to species-specific acoustic signals during electrical
      stimulation of the hypothalamus before and after ablation of the sensorimotor
      region of the cortex.
AB  - The possibility of the formation under chronic experimental conditions of a
      reaction of a selective character to species-specific acoustic signals (SAS) of
      the agonistic type, presented to cats against the background of subthreshold
      electrical stimulation of hypothalamic divisions, was demonstrated. Reactions
      appropriate to the SAS presented appeared only in those animals in which
      threshold electrical stimulation evoked directed aggressive reactions. Partial
      bilateral ablation of the sensorimotor region of the cortex (SMC) did not
      influence the selective character of the reaction to the SAS, but led to a change
      by comparison with the preoperative period in the relationship of the motoric and
      acoustic reactions of the agonist type to conjoint acoustic and electrical
      stimulation.

PMID- 1758621
TI  - Dynamics of synchronization in the functioning of neurons of the new cortex and
      hippocampus during learning before and after the administration of nootropic
      agents and narcotics.
AB  - The principal difference in the effect of the preparations investigated resided
      in the fact that the nootropic agents did not change the effect of painful
      reinforcement on the synchronicity of neurons of the cerebral cortex of rabbits
      of the inhibitory type (coincidence of both the presence and absence of impulse
      activity), and of the activational type (the time of coincidence of only the
      presence of impulse activity). Both preparations mainly attenuated the initial
      influences of both the inhibitory and reinforced conditional stimuli on the
      synchronicity in the activity of the cortical neurons of both the activational
      and the inhibitory types.

PMID- 1758622
TI  - Neuronal correlates of the serotonin-dependent behavior of the pteropod mollusc
      Clione limacina.
AB  - A pharmacological model of hunting behavior, previously developed by the authors
      on the basis of the utilization of 5-hydroxytryptophan (5-HTP), a precursor of
      serotonin synthesis (5-HT), was employed in order to determine its cytochemical
      and neurophysiological correlates. In the presence of baseline behavior, 5-HT
      containing neurons were not detected by the glyoxylate method, but they were
      readily identified in the buccal, cerebral, and pedal (the greatest number)
      ganglia of the CNS and in the peripheral organs during hunting behavior induced
      by an injection of 5-HTP (100-200 micrograms/g). The disappearance of pauses in
      the initial unsustained fictive swimming, an increase in the frequency of the
      rhythm of swimming and in the generation of spikes in each cycle, as well as a
      change in the phasing of the locomotor cycle, the neurophysiological correlates
      of "fast" locomotion in the presence of 5-HTP-induced hunting behavior, were
      recorded in isolated pedal ganglia in the presence of 5-HTP (100-200
      micrograms/ml). The activity of 5-HT-neurons of the pedal ganglia, which was
      initially synchronized with the episodes of swimming, increases against the
      background of 5-HTP and becomes continuous. The effects of exogenous and
      endogenous 5-HT on the generator of locomotion are identical, and are induced by
      the direct action of the mediator on the membrane of the locomotor neurons. The
      hypothesis of the participation of 5-HT in the monoaminergic control of behavior
      is discussed.

PMID- 1758623
TI  - Some neurophysiological mechanisms of the perception of interoceptive signals.
AB  - The principal objective of this study consisted in the identification of some
      basic mechanisms of the perception of the interoceptive signal. The EEG
      activation reaction through mechanoreceptive stimulation of the stomach served as
      the indicator. A positive relationship was found between the intensity of the
      activation reaction and the intensity of the stimulus employed; the
      extinguishability of the reaction in response to repeatedly acting interoceptive
      stimuli was also found. The characteristic features of the EEG activation
      reaction during an interoceptive effect and the characteristic on- and off
      responses (the development of the reaction at the beginning and ending of the
      action of the stimulus) were identified. The data presented are aimed at the
      disclosure of the interaction of the elements of the dual function of the
      interoceptive analyzer: as a feedback signal for the central apparatus subserving
      the control of visceral functions and as an important element of the nonspecific
      activation of the brain.

PMID- 1758624
TI  - Patterns of the functioning of the hypophyseoadrenocortical system in the
      presence of repeated stressful stimulations.
AB  - The relationship of the magnitude of the response of the hypophyseoadrenocortical
      system (HACS) to the strength of the stimulus in the presence of isolated or
      repeated stressor influences was determined in experiments on awake rats.
      Electrical stimulation of 0.1-0.9 mA of the skin of the paws for 3 min served as
      the stimulus. The reaction of HACS was judged on the basis of the determination
      of blood corticosteroids. Changes take place in the physiological characteristics
      of the system 30 mins after the termination of the stressor activation of the
      HACS. These changes do not depend on the strength of the initial stressor, and
      consist of a decrease in the threshold of excitability and a reduction in the
      maximum of the reaction to stressors of greater strength. The reaction to
      repeated stimulation at small strengths of the initial stressor proved to be
      larger or equal to the response of the system to the initial stimulation. At
      greater strengths of the stressor the reaction to repeated stimulation is
      significantly less than to the initial stimulation.

PMID- 1758625
TI  - Participation of beta-endorphin in the regulation of conditioned reflex activity
      of cats.
AB  - The role of beta-endorphin in the regulation of conditioned instrumental food
      procuring reactions and more complex forms of nervous activity such as reflexes
      of choice of the side of reinforcement was studied in cats. It was established
      that the subcutaneous injection of small doses of beta-endorphin (10
      micrograms/kg, 15 x 10(-6) micrograms/kg) exerts a facilitatory nonspecialized
      effect on positive and negative food-procuring conditioned reflexes that has an
      overall adaptive character overall. The influence of the same doses of beta
      endorphin on conditioned reflexes of choice is more complex in character,
      depending upon the initial level of conditioned reflex activity and on the
      typological features of the experimental animals. A possible mechanism of the
      influence of beta-endorphin on higher nervous activity is discussed.

PMID- 1758626
TI  - Comparative assessment of the disorders of higher brain functions in various
      types of cerebral atrophy.

PMID- 1758627
TI  - Clinical heterogeneity of dementias of the Alzheimer's type.

PMID- 1758628
TI  - Clinico-genealogical study of Alzheimer's disease.

PMID- 1758629
TI  - Ultrastructure of the neuromuscular synapses of three types of muscle fibers of
      the rat diaphragm in acute chlorophos poisoning.

PMID- 1758630
TI  - Morphofunctional characterization of the neurosecretory cells of the supraoptic
      nucleus in rats with parathyroprival hypocalcemia.

PMID- 1758631
TI  - [Postoperative mortality and morbidity of patients in their late eighties].
AB  - During the 12 year period, 1978-1989, 555 operations were performed at the
      Department of Clinica Chirurgica III of the University of Bologna, on 530
      patients greater than 80 years old at the time of surgery. These were the
      indications for surgical procedure in these patients: malignant neoplasm of
      digestive system (243), other diseases of the digestive system (111), abdominal
      wall hernia (74), biliary disease (77), miscellaneous (50). The purpose of this
      paper is to define the role of surgery in patients over 80 years old. An acute
      complication required an emergency operation in 295 cases (53%). In all the other
      cases (260, 47%) an elective operation was performed. There were 63 deaths with
      an operative mortality rate of 11%. Among the patients who underwent elective
      surgery there were 11 deaths (4%); in the emergency group there were 52 deaths
      (17.6%). These rates were found to be statistically significant. The overall
      morbidity rate was 37.6% in the elective group and 49% in the emergency group.
      Also these rates were found to have a statistic significance. Then we have
      compared morbidity and operative mortality of over-eighty years old patients with
      the ones of two younger groups of patients: I group (age greater than 80 years),
      II group (age 65-80 years), III group (age less than 65 years). Patients of the
      three groups had undergone identical surgical operations for the same pathology.
      The operative mortality was 11% in the I group, 5.2% in the II group and 1.4% in
      the III group. The morbidity was 46%, 30% and 17% respectively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1758632
TI  - [Lung surgery in patients over 70 years].
AB  - The Authors according to their previous experience, report on the possibility of
      thoracic surgery in patients older than 70 with lung cancer. Fourty-seven
      patients older than 70 have been operated in the period 1984-1988 for lung
      cancer. The Authors performed 34 lobectomy, 11 pneumonectomy, and 4 wedge
      resection. The mortality rate was 4.25% (2 patients). Thirty-four patients are
      still living (follow-up range 12-60 months). Ten patients died. The Authors
      report a diagnostic and therapeutic guideline for this kind of pathology.

PMID- 1758633
TI  - [Reconstruction of the digestive tract after total gastrectomy. A comparison of
      Roux anastomosis with Nakayama's beta-anastomosis].
AB  - Digestive tract reconstruction following total gastrectomy can be classified into
      two types according to whether the duodenal tract is excluded or preserved. Two
      groups of patients who underwent digestive tract reconstruction excluding the
      duodenal tract following total gastrectomy due to cancer were compared
      retrospectively: Nakayama's anastomosis was used in 20 patients (57%), and a Roux
      en-Y anastomosis was performed in 15 (43%). The main technical difference between
      the two groups consists in the distance between esophagojejunostomy and
      jejunojejuno anastomosis: 20 cm in the case of Nakayama's technique and 50 cm in
      the case of the Roux-en-Y reconstruction. Results showed that 40% of patients
      with Roux-en-Y anastomoses were asymptomatic compared to 60% of patients with
      Nakayama's beta-anastomosis (chi-square test, p = 0.36). The most frequent
      symptom in patients with Roux-en-Y reconstructions was a feeling of postprandial
      fullness (33%), whereas pyrosis (25%) was the most common compliant in patients
      with Nakayama's reconstruction. Endoscopy revealed the presence of esophagitis in
      35% of patients with Nakayam's beta-anastomosis compared to 6.5% in patients with
      Roux-en-Y anastomosis (chi-square test, p = 0.012). Results confirm that a
      minimum distance of at least 50 cm between the esophagojejunal and jejunojejunal
      anastomoses is decisive in reducing the frequency of reflux esophagitis after
      total gastrectomy.

PMID- 1758634
TI  - [Circumscribed peritonitis of colonic origin].
AB  - The Authors present their personal experience of circumscribed peritonitis of
      colic origin. They review some physiopathological aspects of these peritonitis
      and then emphasize the new therapeutic possibilities offered by percutaneous
      prick echo or TC guided.

PMID- 1758635
TI  - [Creation of a colostomy using a circular mechanical stapler].
AB  - The paper describes the method used to create a preternatural anus in terminal
      stomas using a mechanical circular stapler (Model EEA-31). Two methods are put
      forward: Chung's and Burke's methods (the latter of which was used by our
      department). A mechanical circular stapler has been used several times (13) to
      perform this type of stoma, with excellent esthetic and functional results, both
      immediate and long-term. It was only necessary to reoperate in one case in order
      to suspend the affected colic loop.

PMID- 1758636
TI  - [The role of angiography in cryptogenic submesocolic digestive tract bleeding].
AB  - Three cases of chronic gastrointestinal bleeding are described; the Authors
      emphasize the important role of mesenteric arteriography in establishing site and
      nature of bleeding. The review of international literature shows a success rate
      between 41 and 73% of cases studied with this method after negativity of other
      diagnostic procedures.

PMID- 1758637
TI  - [Observations on cancer metastasis from an unknown primary location].
AB  - Following a short introduction in which the criteria used to classify patients
      suffering from cancer metastasis from an occult primary location are defined, the
      paper reports two cases of this type: an omental metastasis occluding the upper
      colon and an inguinal lymph node metastasis. Referring to the international
      literature, the Authors then analyse the reasons for the inability to recognise
      the neoplasm, its incidence, patients survival, the most appropriate diagnostic
      course and possible treatment of these cases. In conclusion, over and above the
      definition of a truly autonomous nosological status of metastasis of unknown
      origin, it is important to follow a correct diagnostic procedure in order to
      establish the most appropriate form of therapy.

PMID- 1758638
TI  - [Intestinal malrotations in the adult].
AB  - The paper reports a case of intestinal malrotation in an adult patient with an
      anomalous location in the left hypochondrium of the cecum and vermiform appendix.
      The patient underwent explorative laparotomy for peritonitis due to acute
      appendicitis. Following a review of the literature, the anomaly was classified in
      embryological terms as a union defect during the third developmental stage of the
      umbilical loop. Attention is focused on the importance of an exact knowledge of
      the embryology of intestinal rotation in order to avoid technical surgical
      errors. In conclusion, the value of giving the patient precise iconographic
      documents is stressed in order to inform the surgeon who may have to operate on
      the patient's abdomen in the future.

PMID- 1758639
TI  - [Primary torsion of the omentum].
AB  - The paper reports a case of spontaneous torsion of the omentum. Following a
      review of the international literature on the topic, the Authors discuss the
      pathogenesis, clinical symptoms and surgical therapy of this pathology.

PMID- 1758640
TI  - [Lesions of the duodenum from closed abdominal injury. A case report].
AB  - Following a review of the literature, the paper reports a case of duodenal
      injury. This rare pathology most frequently affects the second half of the organ
      and may cause damage ranging from a simple hematoma to parietal laceration with
      peritonitis and/or retroperitonitis. Symptoms are often confusing and delayed,
      and together with chemical and instrumental tests do not always allow an early
      diagnosis to be made. Treatment varies according to the type of lesion and its
      location, and is often secondary to the general condition of the patient.
      Postoperative mortality appears to be limited to 11% if laparatomy is performed
      early (within 24 hours).

PMID- 1758641
TI  - [Efferent loop syndrome in gastric stump carcinoma. A clinical case].
AB  - The Authors describe a case of efferent loop syndrome in a patient with
      inoperable gastric stump cancer. The resolution of the symptomatology by an
      anastomosis between afferent and efferent loop in a tract without neoplastic
      infiltration, permitted a six month good life period to the patient.

PMID- 1758642
TI  - [Parathyroid cysts].
AB  - The Authors review the world literature on parathyroid cysts and report a case of
      this uncommon disease. The importance of an early pre-operative diagnosis by
      ultrasound, blood calcium level and parathyroid hormone assay with fine needle
      aspiration biopsy is pointed out. According to several surgeons, only the
      functioning parathyroid cysts require operation; needle aspiration may be
      appropriate therapy for the nonfunctioning ones.

PMID- 1758643
TI  - [Popliteal artery entrapment syndrome. Discussion of a case].
AB  - The paper reports a case of popliteal artery entrapment syndrome (3rd type)
      associated with poststenotic aneurysm with a single painful ischemic attack.
      Diagnosis was made following an accurate anamnesis and clinical examination using
      invasive and non-invasive instruments. Surgical therapy consisted of resection of
      the gastrocnemius muscle followed by a graft to the self inverted saphena vein.

PMID- 1758644
TI  - Knowledge of HIV.

PMID- 1758645
TI  - Diltiazem and the elderly.

PMID- 1758646
TI  - Epidural trial in implantation of intrathecal morphine infusion pumps.
AB  - This retrospective review permits limited conclusions due to the small sample
      size and the limited control of variables. The temporary prepump, percutaneous
      epidural catheter trial is a useful component of our protocol. This period
      provides important information relative to possible side effects and efficacy of
      pain. The trial does give an estimation for the starting point of the intrathecal
      dosage but, as we have demonstrated, this is, at times, at a greater dosage than
      previously had been predicted. We feel that this retrospective review supports
      the continued use of a prepump trial of epidural morphine prior to permanent
      intrathecal pump implantation.

PMID- 1758647
TI  - Position paper: health access New Jersey. Medical Society of New Jersey.
AB  - The health care system in New Jersey is among the finest in the nation. This MSNJ
      position paper offers proposals to strengthen the system and to give the best
      care to all the citizens of New Jersey. The paper encourages a close relationship
      between government and physicians.

PMID- 1758648
TI  - Chronic steroid dependent asthma and pulmonary function.
AB  - The authors followed 84 asthma clinic patients, with an average age of 49 years,
      for 12 years. Pulmonary function studies consisting of forced expiratory volume
      in one second and forced vital capacity were performed upon initial evaluation
      and quarterly re-evaluation.

PMID- 1758649
TI  - Dentistry's role in treating sleep apnea and snoring.
AB  - Dental appliances have a place in the treatment of loud snoring and obstructive
      sleep apnea (OSA), and may be indicated for those patients who cannot tolerate
      continuous positive air pressure ventilation. Physicians and dentists must work
      together for the health, comfort, and well-being of patients.

PMID- 1758650
TI  - Urinalysis for the private office laboratory.
AB  - Urinalysis is the most frequently ordered test performed in the physician office
      laboratory. Quality control programs must be a part of every urinalysis ordered
      in the office laboratory. Quality control will assure the test will yield
      reliable information.

PMID- 1758651
TI  - Medical history: health care crusader, Florence C. Child.
AB  - In January 1924, Florence Chapman Child, MD, was elected to membership in the
      Mercer County Medical Society. Against great odds, she made her mark in medicine
      as one of the first women members of the County Society. Dr. Child will be
      remembered for her dedication to public health.

PMID- 1758652
TI  - Frustrated clinicians must seek out sources of support.

PMID- 1758653
TI  - New York State Coalition urges establishment of effective NP organization.

PMID- 1758654
TI  - Residencies are one option for apprehensive new practitioners.

PMID- 1758655
TI  - Development of an exercise program for older adults: pre-exercise testing,
      exercise prescription and program maintenance.
AB  - Health care practitioners have the technical skills, frequency of contact and
      credibility with older adults to use exercise as a health-promoting and disease
      preventing intervention. This article acquaints the clinician with how to develop
      an exercise program specifically for older adults. The health-promotion and
      disease-prevention outcomes of exercise in older adults, including an explanation
      of the three stages of exercise programming for older adults, are also reviewed.
      Stage one is labeled pre-exercise testing and discusses assessment protocols for
      aerobic capacity, body composition, flexibility and strength. Guidelines for who
      should and should not exercise are also explored. The second stage of exercise
      programming is exercise prescription. An explanation of how to develop a
      beginning level of training and guidelines for how to set goals based on the
      initial pre-exercise testing are presented. Program maintenance is the third
      stage; this includes suggestions for designing an exercise program that increases
      program compliance, reduces attrition and prevents relapses to non-exercise
      behaviors.

PMID- 1758656
TI  - Causes and treatment options for women with dyspareunia.
AB  - The incidence of dyspareunia, defined as difficult and painful intercourse,
      appears to be increasing. A symptom not a disease, dyspareunia is rarely reported
      by patients, even though it may be the actual reason why they seek health care.
      Often, patients will only discuss their concerns after questioning. Health care
      professionals who provide primary care to women must understand the various
      etiologies of dyspareunia. Possible causes of dyspareunia as well as current
      treatment modalities are identified. Sex education, counseling, vaginal
      dilatation and pelvic-relaxation exercises may be needed to restore the woman's
      confidence and decrease anxiety. Not until all organic causes of dyspareunia are
      ruled out, should the option of psychiatric intervention be suggested.

PMID- 1758657
TI  - Parallels between research and diagnosis: the reliability and validity issues of
      clinical practice.
AB  - There are many similarities between the methods used to conduct research and the
      strategies clinicians utilize to improve the quality of the data collected for
      diagnostic purposes. This article reviews basic reliability and validity issues
      as they relate to clinical practice.

PMID- 1758658
TI  - Screening for psychiatric morbidity in men and women.
AB  - This paper describes the use of the general health questionnaire (GHQ) to screen
      a random sample of men for psychiatric morbidity. The results are contrasted with
      those from the earlier Otago Women's Health Survey, an investigation into the
      sociodemographic determinants of psychiatric morbidity in Otago women. The level
      of psychiatric morbidity found in the men was equal to that found in the women
      which is in contrast to most overseas studies where men have been found to have
      lower levels of psychiatric morbidity to women. Significant differences were
      found in male and female demographic subgroups. High GHQ scores were found in
      separated, widowed and divorced men, men in higher socioeconomic status groups
      and those unemployed. High GHQ scores were found among the women aged 18-34,
      women who had never married, those in lower socioeconomic status groups and those
      unemployed. This study illustrates that gender needs to be considered alongside
      traditional sociodemographic factors when studying psychiatric morbidity and
      symptomatology.

PMID- 1758659
TI  - No evidence for social class inequalities in intervention for coronary heart
      disease in Otago 1987-9.
AB  - OBJECTS: to investigate whether social class differences in access to cardiac
      surgical interventions (angioplasties and coronary artery bypass grafting) could
      explain social class inequalities in mortality from coronary heart disease.
      METHODS: rates of therapeutic interventions to treat coronary heart disease were
      calculated for male patients aged less than 65 years admitted for the first time
      to Dunedin Hospital with a principal diagnosis of ischaemic heart disease (ICD
      codes 410-414) during the three year period from 1 January 1987 to 31 December
      1989. Patients were categorised into different socioeconomic groups using the
      Elley-Irving social class scale. RESULTS: no statistically significant trend
      across social class was observed in the cumulative incidence of cardiac surgical
      interventions (angioplasties, coronary artery bypass grafts). Similarly there was
      no statistically significant trend across social class in the incidence rates of
      cardiac surgical interventions, even after adjustment for age. CONCLUSIONS:
      social class inequalities in access to cardiac surgical intervention do not
      appear to explain the observed inequalities in mortality from coronary heart
      disease.

PMID- 1758660
TI  - Regression of atherosclerosis: fact or fiction?

PMID- 1758661
TI  - Forensic psychiatry in New Zealand: a Canterbury perspective.

PMID- 1758662
TI  - Quadruple immunosuppression in renal allografts--the Auckland experience.
AB  - Recipients of live related and first cadaveric renal allografts were
      retrospectively reviewed before and after institution of a standardized regimen
      incorporating greater immunosuppression, (by the addition of antilymphocyte
      preparations). The two review groups were comparable with 11 live related and 27
      first cadaver grafts in each. Despite a small advantage in terms of graft
      survival and diminished rejection, this was at the expense of septic morbidity.
      The implications of this are discussed.

PMID- 1758663
TI  - General practice--survival in the nineties.

PMID- 1758664
TI  - Opioids in the treatment of chronic pain of nonmalignant origin.

PMID- 1758665
TI  - Health reforms.

PMID- 1758666
TI  - Medical residency in the USA.

PMID- 1758667
TI  - Angina bullosa haemorrhagica: associated steroid inhaler use.

PMID- 1758668
TI  - Antibiotics for otitis media.

PMID- 1758669
TI  - Patients' addresses.

PMID- 1758670
TI  - Homoeopathy.

PMID- 1758671
TI  - AIDS.

PMID- 1758672
TI  - Whose quality of care is it, anyway?

PMID- 1758673
TI  - AMA sets policy on infectious disease and health-care workers.

PMID- 1758674
TI  - Renoir's maladies: the medical tribulations of an impressionist.

PMID- 1758676
TI  - Who do you influence?

PMID- 1758675
TI  - Ohio Cancer Information Service: a decade of experience.

PMID- 1758677
TI  - An accessory gluteus maximus muscle.

PMID- 1758678
TI  - Seasonal variations in the corpuscles of stannius in Notopterus notopterus
      (Pallas).
AB  - Seasonal changes in the corpuscles of stannius of Notopterus notopterus (Pallas)
      have been studied during various stages of reproductive cycle. During the pre
      spawning period, corpuscles of stannius are found as enlarged, oval or elongated
      in shape, lobes are clear and show cellular and nuclear hypertrophy while
      spawning phase shows atrophy in the corpuscles of stannius, their cells and
      nuclei. During post-spawning period corpuscles of stannius are more active than
      spawning phase and showed high physiological activity. Two corpuscles of stannius
      are also observed during this phase. This study shows that corpuscles of stannius
      are more active during late prespawning phase. During such period, animals are
      sexually mature and an increased estrogen secretion by the ovaries is naturally
      expected. This study suggests a correlation with the gonadal maturation and
      structural changes in the corpuscles of stannius during seasonal variations.

PMID- 1758679
TI  - A Golgi study on the neuronal organization of the habenular ganglion in the red
      stingray, Dasyatis akajei.
AB  - The neuronal organization of the habenular ganglion (HG) was studied in the red
      stingray using the rapid Golgi method. The HG was made up of the medial (MH) and
      lateral habenular nucleus (LH), and the former nucleus was further divided into a
      dorsal, intermediate and ventral subnucleus. Only one type of neurons were
      observed in the MH, while the LH was composed of two types of neurons. In the
      left HG cut at the rostrocaudal middle of the ganglion, the LH was located in the
      dorsolateral region, while the dorsal, intermediate and ventral subnuclei of the
      MH occupied the dorsomedial, intermediate and ventral portions of the ganglion,
      respectively. In contrast, the right ganglion seen at this level was composed
      exclusively of the MH, with the dorsal, intermediate and ventral subnuclei
      located in the dorsomedial, intermediate and ventral portions, respectively. In
      the caudal level of the left ganglion, each nucleus was seen almost in the same
      region as in the level of the rostrocaudal middle, however, three subnuclei of
      the MH fused with the same subnuclei of the opposite side. In the right ganglion
      at the caudal level, the LH appeared in the intermediate area. The right LH was
      far smaller and was located more ventrocaudally than the left LH. On account of
      the LH, the intermediate subnucleus of the MH was divided into a dorsal and
      ventral part. The dorsal and ventral subnuclei of the MH remained in the same
      region as in the rostral level. Thus, the HG of the red stingray exhibited a
      striking left-right asymmetry, the most remarkable aspect of which was considered
      to be differences of the size, form and location of the LH between the left and
      right HG.

PMID- 1758680
TI  - A Golgi study on the afferent fibers to the habenular ganglion in the red
      stingray, Dasyatis akajei.
AB  - Afferent fibers to the habenular ganglion (HG) were derived mainly from the stria
      medullaris thalami (SM), which was roughly divided into a dorsal and ventral
      bundle. In the left ganglion seen at the level of the rostrocaudal middle, the
      dorsal bundle gave off collaterals to the lateral habenular nucleus (LH) and
      dorsal subnucleus of the medial habenular nucleus (MH), while the ventral bundle
      innervated the intermediate and ventral subnuclei of the MH. On the other hand,
      in the right ganglion at the level of the rostrocaudal middle, the dorsal
      subnucleus of the MH was innervated by collaterals from the dorsal bundle of the
      SM, whereas in the intermediate and ventral subnucleus fibers from the ventral
      bundle were seen. In the left ganglion at the caudal level, the dorsal and
      ventral bundle extended medially and joined the same bundle of the opposite side
      to constitute a dorsal and intermediate component of the habenular commissure,
      respectively. A third component of the HC, a ventral component, was seen to run
      between the fasciculus retroflexus of both sides. As in the case of the rostral
      level, the dorsal bundle of the SM emitted collaterals to the LH and dorsal
      subnucleus of the MH, while the intermediate and ventral subnuclei of the MH were
      projected upon by collaterals from the ventral bundle of the SM. At the caudal
      level of the right ganglion, the dorsal bundle gave off collaterals to the dorsal
      subnucleus of the MH. In contrast, the LH and the intermediate and ventral
      subnuclei of the MH were innervated by fibers from the ventral bundle. With
      regard to terminal patterns of the SM, fibers to the MH gave off many short fine
      branchlets forming the glomerular structures, whereas those to the LH branched
      out into numerous terminals to form a dense fiber plexus. Thus, the afferent
      fibers to the HG in the red stingray exhibited a striking left-right asymmetry.

PMID- 1758681
TI  - Differential lectin binding on walls of thoraco-cervical blood vessels and
      lymphatics in rats.
AB  - Lectin binding in the walls of large to medium-sized blood vessels and lymphatics
      in the rat thoraco-cervical region was examined histochemically. The tunica
      intima of the aorta and superficial cervical artery showed positive reactions
      with wheat germ agglutinin (WGA) and Concanavalin A (ConA) but not with Dolichus
      biflorus agglutinin (DBA). The tunica media of the aorta exhibited intense WGA
      binding, especially on the smooth muscle cells, but the tunica media of the
      superficial cervical artery did not react with the lectin. Neither ConA nor DBA
      bound to the tunica media of the aorta and superficial cervical artery. The
      tunica adventitia of both arteries contained sites binding the three lectins,
      although DBA reactivity declined as the vascular diameter decreased. The tunica
      intima of the superior vena cava and azygos vein exhibited positive WGA and ConA
      binding, whereas DBA binding was noted on only part of the tunica intima of the
      superior vena cava and not on that of the azygos vein. The tunica media and
      tunica adventitia were reactive for all three lectins. The WGA and ConA binding
      sites in the tunica adventitia showed loose networks, suggesting lectin binding
      on connective tissue elements interlacing among smooth muscle bundles. Lectin
      binding sites in the walls of lymphatics exhibited an arrangement similar to
      those in the walls of the veins. Moreover valves protruding into the lumen showed
      intense WGA and ConA binding and scattered DBA binding. Three other lectins (Ulex
      europaeus agglutinin, peanut agglutinin, Maclura pomifera) were examined, but
      they showed no reactions with the vessels. Thus, the differential binding of
      lectins on the walls of blood vessels and lymphatics of various sizes suggests
      the functional complexity of monosaccharide residues in the vascular walls.

PMID- 1758682
TI  - Study on the subclavian artery and its branches in Japanese adults.
AB  - We examined the entire array of branches and the state of ramification of each
      branch of 144 subclavian arteries (Su) in 72 Japanese adults, and obtained the
      following findings. (1) The incidence of Type I -A(1) was 13.2%, the highest
      among the entire Su ramification. This was followed by Type I -B(1) at 9.0%, then
      Type I -A(2) at 6.9%, indicating considerable variation in the morphology of Su
      ramification. (2) Ontogenetic factors were implicated because of the existence of
      cases in which Su traversed the scalenus anterior muscle anteriorly (Type III:
      0.7%), or was transfixed (0.7%). (3) Type 1-c was the form of thyrocervical trunk
      (Ttc) observed with the highest incidence of 31.3%. In addition, we propose that
      Types a-j (that were formed from a common trunk consisting only of the ascending
      cervical artery and inferior thyroid artery, and those in which another branch
      was included in this common trunk: 88.9%) be called Ttc. (4) The most common type
      of transverse cervical artery (Tc), which is formed from a common trunk
      consisting of superficial and deep branches, was found to be Type 1-a that
      branches from the first part of Ttc. It was observed with the highest incidence
      of 61.8%. Some of the superficial branches to the upper portion of the trapezius
      muscle that were independent and branched from Ttc (Types e, f: 2.8%), we called
      upper superficial branches. (5) The most frequently observed type of
      suprascapular artery (Ss) was Type b (38.2%), followed by Type a (25.7%), which
      branches independently from Su. We concluded that the sites at which Tc and Ss
      originate are the positions at which they traverse the brachial plexus (superior,
      transfixed to the plexus). (6) In cases in which the supreme intercostal artery
      (Is) and the deep cervical artery (Cp) were separate, (Types d-i excluding Type
      g: 31.9%), Is branched from a more proximal position than Cp.

PMID- 1758683
TI  - Microvascular architecture of the palatine mucosa in the common squirrel monkey
      (Saimiri sciureus).
AB  - Detailed observations were made of the structure and microvasculature of the
      palatine mucous membrane of the common squirrel monkey (Saimiri sciureus) by
      means of the plastic injection method under a scanning electron microscope. The
      findings obtained were compared with those of the Japanese monkey and other
      mammals. The osseous palate was flat horizontally and a pair of incisive foramina
      were apparently open at the anterior end of the hard palate. At the posterior end
      of the osseous palate, the pterygopalatine incisurae were found bilaterally. The
      incisive papilla was not obvious in form and size, and a pair of openings of the
      incisive canal were always situated on both sides of the papilla. The transverse
      palatine plicae or ridges numbered 7 or 8 symmetrically. They arched
      posterolaterally with an anterior protrusion near each median end. Posterior
      plicae were underdeveloped. Numerous openings of the palatine glands were found
      in the soft palatine mucosa. The arteries supplying the palate were the major
      palatine artery passing through the major palatine foramen and the soft palatine
      artery passing through the pterygopalatine incisura. The major palatine artery
      extended forwards giving off numerous medial and lateral branches, and its end on
      the respective side entered a small foramen located lateral to the incisive
      foramen. Medial and lateral branches formed the submucous arterial network.
      Arterioles diverging from this network were directed to the epithelial surface
      and formed an arterial network in the lamina propria. Further, capillaries
      diverging from the latter network built up the subepithelial capillary network
      immediately beneath the epithelium. Capillary loops sprouting from the capillary
      network were found in the form of a simple hair-pin without locational
      differences in their heights. The microvascular architecture thus displayed some
      similarity with that of the Japanese monkey. However, the vascular networks in
      the lamina propria and submucous layer were not distinct in size and scale as
      compared to those of the Japanese monkey. These differences may be related to the
      stature, living environment and food habits of this species.

PMID- 1758684
TI  - Tridimensional architecture of the lamina propria in the mouse soft palate, with
      special reference to the connective tissue papilla of the palatal papilla.
AB  - The NaOH cell-maceration method was applied to the oral surface of the mouse soft
      palate to demonstrate the tridimensional architecture of the connective tissue
      papillae (CTP) of the "palatal papillae", and of the openings of the glandular
      ducts. The CTP of the palatal papillae extremely differed from those of any types
      of the lingual papillae, and appeared as elliptical wall. Within the elliptical
      wall, there existed the semicircular or circular internal ridge which surrounded
      the round depression corresponding to the taste bud. The openings of the
      glandular ducts were rimmed by the collagen fibers running concentrically. Many
      fibrils derived from the concentrical fibers, turned to the sagittal direction
      and then concentrated into the sagittal fibers in the vicinity of the openings.

PMID- 1758685
TI  - Distribution of argininosuccinate synthetase-like immunoreactive neurons in the
      rat myenteric plexus: a whole mount study.
AB  - The distribution of argininosuccinate synthetase (ASS)-like immunoreactive
      neurons in the myenteric plexus of the rat alimentary tract were
      immunocytochemically studied using whole-mount tissues. The present study
      revealed ASS-like immunoreactive meshworks of ganglia and interconnecting nerve
      strands in the myenteric plexus of almost all parts of the alimentary tract. ASS
      like immunoreactive neurons constituted about 11% of the myenteric cell.

PMID- 1758686
TI  - On the facial artery of the raccoon dog (Nyctereutes procyonoides viverrinus
      Temminck).
AB  - Detailed observations were made of the facial artery in 20 raccoon dogs
      (Nyctereutes procyonoides viverrinus Temminck) utilizing the plastic injection
      method. The findings obtained were discussed in comparison with the facial artery
      of carnivorae. The facial artery diverged anterolaterally from the external
      carotid artery independently at a position between the origins of the lingual and
      the posterior auricular arteries when the external carotid bent laterally in
      front of the tympanic bulla. This artery, immediately after giving off the
      styloglossal branch, passed forwards superomedial to the digastricus muscle and
      medial to the insertion of the pterygoideus medialis muscle up to the
      posterolateral end of the mylohyoideus muscle, where the submental artery was
      derived. The submental ran forwards, giving off the digastric, the mylohyoid, the
      sublingual and the cutaneous branches, down to the posterolateral end of the
      intermandibular symphysis, where it anastomosed with the opposite fellow. The
      facial artery bent inferolaterally and passed laterally giving off the pterygoid
      and the inferior masseteric branches, and then emerged out onto the face through
      the facial vascular notch located inferoanterior to the angular process, which
      was extremely well developed in this species. The main stream of the artery ran
      anterosuperiorly at about 40 degrees to the horizontal plane along the anterior
      margin of the masseter muscle, since the notch was located on a projected level
      posterior to the middle of the zygomatic arch, giving rise en route to the
      anterior masseteric, the mandibular marginal, the buccal and the cutaneous
      branches. The artery finally divided into the inferior and superior labial
      arteries at the inferior margin of the mandibular origin of the buccalis muscle
      in the angle of the mouth. The facial artery of the raccoon dog was thus similar
      in its origin to that in the dog, cat and lion, but notably different in the
      short course of its submandibular region, and the nearly horizontal passage of
      the main route in the face, without the mandibular glandular branch. Additionally
      an extremely well developed angular process, a submandibular lobe and fairly
      posterior position of the vascular notch were found.

PMID- 1758687
TI  - On the laminar formation of the masseter muscle in the lion (Panthera leo).
AB  - An investigation was made of the laminar structure of the masseter muscle in 3
      lions (Panthera leo s. Felis leo), and the findings obtained were evaluated in
      comparison with those in some other carnivora. Although the general aspect of the
      masseter of the lion resembled that of the cat, there was no close similarity or
      analogy between them. The construction of the masseter in the lion was as
      follows. The superficial layer consisted of primary and secondary sublayers, the
      intermediate layer was composed of anterior and posterior portions, and the deep
      layer also had anterior and posterior portions. Among these three layers (the
      masseter proper muscle), the superficial layer was extremely well developed as a
      characteristic feature of this species. The maxillomandibularis muscle was
      developed in a muscular element of its origin and had its tendinous insertion on
      the anteroinferior margin of the masseteric fossa. The zygomaticomandibularis
      muscle was also fairly well developed in the form of two muscular bundles which
      originated from the temporal crest, a shelf forming a lateral protrusion on the
      basis of the zygomatic process, and its posterior surface. Both muscles were also
      well developed as the masseter improper. Such a huge and complicated laminar
      pattern of the masseter muscle in the lion should be sufficient to exert a strong
      force as a predatory animal.

PMID- 1758689
TI  - [Experience with the management of pyogenic liver abscesses by percutaneous
      transhepatic puncture and drainage].
AB  - The authors treated forty-two patients with liver abscesses guided by computer
      tomography or ultrasound percutaneous transhepatic puncture or drainage from
      January 1 1983, to 1989 December 31. Closed aspiration or drainage was done in 42
      patients altogether 56 times. Three patients died (3/42 = 7.2%), postdrainage
      complications happened in 9 cases (9/42 = 21.4). Operative intervention was
      necessary in 11 patient after the percutaneous procedure (11/42 = 26.2%). The
      authors wrote about the technics particularly of the percutaneous puncture or
      drainage. The authors are considering the method as an effective treatment for
      pyogenic liver abscesses if the personal and technical circumstances are given.

PMID- 1758690
TI  - [Clavicle fracture in the newborn].
AB  - The authors have found 244 clavicle fractures during 4131 vaginal delivery
      (5.91%). Both clavicles of three newborns have fractured. The incidence of
      fracture had relation to weight of newborns, to weakness of pains and to vacuum
      extraction. The Apgar score of the newborns with fractured clavicle was not less,
      than one of newborns with unbroken clavicle. None of 704 newborns from cesarean
      section, and none of 52 newborns, who was born out of the hospital had fracture
      of the clavicle. The cause of fracture is the violent hurry of delivery, the
      drawing of the head before birth of shoulders. One of 244 injured newborns had
      permanent brachial plexus palsy. Late complication was not found. Between the
      injured newborns was more frequent the jaundice requiring phototherapy.

PMID- 1758688
TI  - The origin and amplification of biomolecular chirality.

PMID- 1758691
TI  - [The effect of two different methods of jejunal feeding on pancreatic function].
AB  - Pancreatic juice was continuously diverted from the Wirsungial duct by
      nasopancreatic drainage of the remnant of the gland after pylorus preserving
      partial pancreato-duodenectomy in 14 patients. On the 7th postoperative day with
      stabilized pancreatic secretion the juice was collected in 10 min fractions,
      while interdigestive secretory phases of the parenchyma were established by
      volume changes. At the beginning of a phase 100 ml slightly hyperosmolar (400
      mosmol/L) oligopeptide diet with 90 kcal was given as a bolus injection for 7
      patients or 60 min infusion into the second jejunal loop by fine needle catheter
      jejunostomy for 7 patients also. Pancreatic water, bicarbonate, protein,
      chymotrypsin, amylase levels peak, and integrated secretory responses were
      measured. It was observed, that infusion of the diet did not disturb cycling
      interdigestive phases and did not increase peak and integrated outputs. Bolus
      administration interrupted interdigestive phases and stimulated pancreatic water,
      bicarbonate, protein, chymotrypsin and amylase outputs nonparallelly. On the
      basis of their data authors concluded, that pancreatic secretion seems to be well
      preserved without duodenalregulatory mechanisms; and continuous jejunal infusion
      feeding seems to be useful in pancreatic disease and in other postoperative
      states when pancreas has to be put into rest.

PMID- 1758692
TI  - [CO2-laser surgery of rhinophyma].
AB  - Authors are the first in Hungary to report on a CO2-laser dermabration performed
      for the treatment of rhinophyma. They describe the mode and results of the laser
      intervention justifying the application of the CO2-laser.

PMID- 1758693
TI  - [Sideroblastic anemias].
AB  - The sideroblastic anaemias form a group of disorders of varying aetiology. They
      are being recognized with increasing frequency, especially as routine staining of
      bone marrow films for iron is now standard practice in most foreign laboratories.
      The sideroblastic anaemias have as a common feature the presence of large numbers
      of pathologic (ringed) sideroblasts in the bone marrow, ineffective
      erythropoiesis, a high degree of saturation of serum transferrin, increased
      levels of tissue iron and varying proportions of hypochromic erythrocytes in the
      peripheral blood. The marrow structure often exhibits dyserythropoietic features.
      Special attention has been focused by the authors upon the diagnostic and
      differential diagnostic problems, the ferrokinetics, the preleukemic condition
      and the therapeutics measures now available. There is also possible to draw some
      utilizable conclusions from the experiences of the authors.

PMID- 1758694
TI  - [Primary malignant pericardial mesothelioma].
AB  - The case-history of a 41-year-old man is reported. He was admitted because of the
      sudden development of left hemiparesis, loss of consciousness and increasingly
      deeper coma. The ECG demonstrated second-degree AV block with Wenkebach
      conduction or episodes with complete AV block. The colour Doppler ultrasound and
      cranial CT examination revealed occlusion of the right internal carotid artery
      and a cerebral infarct of the right hemisphere. Within 24 hours patient died from
      herniation of the brainstem. Postmortem examination revealed a pericardial
      neoplasm infiltrating both left and right atrium, AV junctional area,
      interventricular septum and right ventricle. The tumor tissue grew transmurally
      and protruded into the cavities of the heart. The right internal carotid artery
      was occluded by a tumor embolism. The histochemical and immunohistochemical
      results proved that the tumor was a primary malignant pericardial mesothelioma.
      This kind of cardiac tumor involving the AV node and mimicking stroke is very
      rare.

PMID- 1758695
TI  - [Historical reflections on health protection and the condom].

PMID- 1758696
TI  - [Principles and pathogenesis of post-traumatic axial malalignment in the growth
      years].
AB  - Deviations of the axis or leg-length discrepancies after fractures in children
      and adolescents can be due to growth disturbances or can be the result of
      incomplete reduction of the fracture. We distinguish between four types of growth
      disturbances. In type I, the overall growth activity of the cartilage is
      increased; growth is then enhanced, which results in the affected bone being too
      long without deviation; this usually occurs after fractures of the metaphysis or
      diaphysis. In type II, activity, the epiphyseal cartilage is severely impaired or
      completely arrested. The direction of growth is unchanged. This results in
      shortening of the bone, usually due to severe damage to the germination zone of
      the growth cartilage after destruction of the vessels or infection. In type III,
      growth of the epiphyseal plate is partially stimulated. The consequence of this
      disturbance is deviation of the axis with overgrowth (this is in fractures of the
      proximal tibia). Type IV is characterized by an asymmetric arrest of growth. This
      results in deviation of the axis and shortening. The cause of such growth arrest
      can be epiphyseolysis or epiphyseal fracture. The defect in growth cartilage
      heals with a bone bridge. This is a very serious kind of growth disturbance, and
      it occurs in only 1% of all fractures before skeletal maturity. Correction after
      incomplete reduction of fractures during growth can be direct or indirect and
      specific or nonspecific. Direct corrections occur in combination with fracture
      healing; indirect corrections occur with physiological changes of the growing
      skeleton without association with the healing process.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1758697
TI  - [Malunited supracondylar and condylar humeral fractures].
AB  - We present three important types of posttraumatic deformity of the distal
      humerus: varus deformity, valgus deformity and complex deformity. Their primary
      causes are discussed. Slight varus deformities are the result of purely lateral
      slip of supracondylar fractures or radial overgrowth after a lateral condylar
      fracture. Severe varus deformities occur after ulnar slip of the distal fragment
      following supracondylar fracture caused by a rotational deformity. The results
      after correlation of varus deformities with a rotational deformity are poor. The
      only way of obviating this problem is to recognize a rotational deformity as soon
      as possible before adaptation of the elbow occurs, and also to correct it early,
      if necessary. Valgus deformities occur mostly after radial malunion. Depending on
      the size of the fragment and the disability of the patient, the fragment should
      be stabilized-but the potential involvement of the malunion in the elbow function
      must be borne in mind. Complex deformities and their unknown origins are also
      discussed. The correction of such deformities depends exclusively on the elbow
      function. More aggressive primary regimens are urgently needed to prevent the
      necessity for such secondary corrections, which are very demanding and, depending
      on the type, have a high failure rate.

PMID- 1758698
TI  - [The malunited juvenile fracture--Monteggia defect].
AB  - Late reconstruction after neglected Monteggia lesions in children is discussed.
      On the basis of the literature (20 cases) and 2 personal cases it is deduced that
      open reduction of the radial head should be combined with osteotomy of the ulna
      according to the pathophysiology of the lesion. Details of the operative
      procedure are given. Reconstruction of the annular ligament is the least
      important part. Reconstruction is indicated in children under the age of 10-12
      years even if the dislocation has been present for years. Unfavorable conditions
      for operative reconstruction are long-lasting dislocations in older children,
      deformation of the radial head, and imminent skeletal maturity.

PMID- 1758699
TI  - [Malunited juvenile fractures in pelvic and hip area].
AB  - Fractures of the hip and pelvis are rare in the growing skeleton. Conversely,
      they are complicated by morphological and functional abnormalities in a
      particularly high percentage of cases. We present a review of posttraumatic
      structural abnormalities and their consequences. In addition to the common
      presentations, less well-known abnormalities and their possible treatments are
      discussed.

PMID- 1758700
TI  - [Malunited juvenile upper and lower leg fractures. Spontaneous correction,
      complications, indication for corrective intervention].
AB  - If malunion occurs after shaft fractures of the femur or tibia, it often corrects
      itself spontaneously. If the remaining growth period is +/- 2 years, side to side
      dislocations, shortening and varus deformities (up to 15 degrees) are equalized.
      Valgus, recurvation and antecurvation equalize much more slowly and rotation
      deformities only at the femur. The indication to perform a corrective osteotomy
      before the end of growth is therefore rare, and the remaining axis deviations
      have a good long-term prognosis as far as arthritic changes are concerned.
      Exceptions of this rule are rotation deformities in the lower leg and progressive
      valgus after high tibial fractures. Contractures instabilities and overuse of
      neighbouring joints represent another indication for early correction
      osteotomies. Risk of damage to the growth plate limits the possibilities for
      performing corrective osteotomies in young children. On the other hand, stable
      fixation is of less importance. At the end of growth, the procedures are the same
      as for adults.

PMID- 1758701
TI  - [Malunited juvenile fractures in the knee joint region].
AB  - There is a tendency for malunion to occur in fractures of the knee region in
      children because the growth plates are often affected. Leg length discrepancies
      are reported in more than 50% of the children and axis deviations in 20-40%. The
      prognostic significance of epiphyseal lesions is described (not always
      accurately) by the classifications of Salter and Harris or Aitken. Treatment is
      mostly directed at leg-length discrepancies and axis deviations by resection of
      callus formations, epiphysiodeses and osteotomies. A complete bone growth history
      is necessary to plan the operative procedure.

PMID- 1758702
TI  - [Malalignment following injuries of the distal tibia and epiphysis of the
      fibula].
AB  - If the correct treatment is applied, growth disturbances following epiphyseal
      fractures of the distal tibia are rare. Even if the prognosis is good after the
      correct treatment of epiphyseal fractures of the distal tibia, the parents and
      child may have to be informed about growth disturbances. Most frequent is a varus
      deformity after asymmetric closure of the medial growth plate. If at least 2
      years of growth can be expected, a callus resection according to Langenskjold is
      indicated. If this procedure fails, the ideal timing for a correction is the end
      of the growth. Imminent contractures can be an indication for early correction
      even if a recurrent deformity can be expected. An open-wedge osteotomy permits
      all three procedures to be carried out: callus resection, axis correction and leg
      length correction. If an incongruence of the joint is present, the closed wedge
      technique using an external fixator is indicated; correction of the leg length
      can be postponed. Joint incongruence reacts well to axis alignment. The pre
      arthrotic joint can remain free of symptoms for years. We never encountered
      epiphyseal fractures of the distal fibula, but we did see one case of deformity
      of the ankle joint as a result of closure of the proximal fibular growth plate.

PMID- 1758703
TI  - Perinatal events and further developmental outcome--assessment of a newborn's
      individual prognosis. 1. Neonatal period and results of an eight years' follow
      up.
AB  - The aim of the prospective study described in this paper was to develop a
      prognostic screening method which permits to give an individual prognostic
      estimate for every newborn, with an accuracy acceptable for clinical purposes. In
      the following, the condensed data of the case histories as well as of the
      clinical and laboratory findings in 47 of initially 60 preterm and term newborns
      with and without cardiorespiratory distress were analyzed under two different
      aspects. In the first part, the general statistical relationships are presented
      in the followed up children, who were classified under various groups according
      to the clinical course during the first two years of life and to the
      developmental stage reached at the age of two and six years. It was shown that
      such a procedure will not suffice in clinical practice for the purpose of
      individual prognostic estimates. The analysis of the clinical classifications of
      the six-year-old children in comparison with their school performance at the age
      of eight years yielded a high accuracy of the previous clinical estimation.

PMID- 1758704
TI  - Perinatal events and future developmental outcome--assessment of a newborn's
      individual prognosis. 2. Prediction of outcome on the basis of perinatological
      data--results of multivariate discriminant analysis.
AB  - The aim of the prospective study described in this paper was to elaborate a
      prognostic screening method which allows to give an individual prognostic
      estimate for every newborn, with an accuracy acceptable for clinical purposes.
      This second part informs about the results of multivariate discriminant analysis,
      using the data from case histories as well as from the clinical and laboratory
      findings in the neonates (including "criteria of hypoxia"). According to the kind
      and number of abnormalities found on the occasion of out-patient consultations
      during the course of the first two years of life, and according to the
      developmental status reached at the age of two and six years, the children were
      classified under two alternative groups. Satisfying results were achieved in the
      discrimination between the groups of six-year-old children. As compared with the
      literature, the prognostic method proposed in this paper yields a relatively high
      accuracy of individual predictions, and therefore promises to become a good tool
      for clinical practice.

PMID- 1758705
TI  - [Symptoms of tic in childhood].
AB  - Literature at the tic phenomen of the last 100 years is reviewed. Phenomenology,
      incidence, etiology, differential diagnosis and therapy are exhibited.

PMID- 1758706
TI  - [The diagnosis of appendicitis in childhood].
AB  - 89 preschool children, 2-4 years old, treated under the diagnosis of appendicitis
      were analyzed. 46 of them were operated. In 39% of those children the diagnosis
      of an acute nonperforated appendicitis could have been ensured, in 39% the
      diagnosis of a perforated appendicitis was found, in 22% the was found, in 22%
      the laparotomy was negative. In cases of an acute perforated appendicitis typical
      symptoms were vomiting (100%), general stomach-ache (89%) and fever (61%). In
      most cases of an perforated appendicitis the state of patients was reduced
      drastically (80%), in 50% an ileus could be observed. Half a children with an
      acute nonperforated appendicitis as well as an perforated appendicitis had got a
      respiratory disease additionally. This fact was the main reason for the to late
      diagnosis particularly in the age up to 3. In all cases being not sure a
      consequent control at a ward is necessary; an important fact for this
      recommendation is the shortness of the acute perforated appendicitis in early
      childhood.

PMID- 1758707
TI  - [Causes, mechanisms and therapy of functional fecal incontinence in children].
AB  - 1. In case of encopresis in childhood about 50% are caused by disorders of
      perceiving the need to relieve the bowels and bowel movement, about 30% are
      caused by disorders of controlling the adaptation mechanism of the rectum or the
      defecation reflex and about 15% are caused by disorders of the sphincter
      apparatus. 2. A nonsurgical therapy must be a complex one. Its effect has to aim
      at concerning the psychoneurologic state, conalizing the reflexes, bettering the
      conductivity of the nerves as well as enhancing the sphincter-tonus. In addition
      to psychotherapy, gymnastics and sphincter-training the transrectal and
      intrarectal electrostimulation is of great importance. 3. To form an estimate of
      the mechanism of encopresis-pathogenesis many different methods are necessary and
      possible; these are the precondition for an effective differentiated therapy.

PMID- 1758708
TI  - Experimental approach to reflex sympathetic dystrophy and related syndromes.

PMID- 1758709
TI  - The epidemiology of pain in children and adolescents: a review.

PMID- 1758710
TI  - Adolescents use patient-controlled analgesia effectively for relief from
      prolonged oropharyngeal mucositis pain.
AB  - We compared patient-controlled analgesia (PCA) and continuous infusion (CI)
      morphine delivery in a randomized controlled trial in adolescents during
      oropharyngeal mucositis pain after bone marrow transplantation. Results from 20
      patients who completed 7 or more days on study (10 PCA, 10 CI) were evaluated.
      The group means for age, weight and height were comparable. Daily measures were
      morphine intake, self-report of pain intensity and side effect scores. Over 10
      study days, the mean cumulative morphine dose to subjects in each group was 4.94
      mg/kg (PCA) vs. 12.17 mg/kg (CI); the difference is significant (P less than
      0.01). No significant differences were found between the groups for patient
      ratings of pain intensity or side effect scores despite the large difference in
      mean morphine intake, but the PCA group tended to report less intense sedation
      and less difficulty concentrating. Adolescents can use PCA effectively and safely
      for 1-3 weeks. Morphine intake of adolescent patients using PCA morphine intake
      is significantly lower than that of similar patients receiving staff-controlled
      CI.

PMID- 1758711
TI  - Epidural opiates and local anesthetics for the management of cancer pain.
AB  - The role of epidural morphine in chronic cancer pain treatment is unresolved. In
      a population of 1205 cancer patients, the aggressive use of systemic opiates
      limited the trial of epidural analgesia to 16 cases. Successful analgesia was
      achieved with epidural morphine alone in 6 of these 16 cases following systemic
      opiate failure. The addition of bupivacaine produced analgesia in all of the 10
      remaining cases and was successful chronically in 6 cases. Complications occurred
      in 11 of the 16 cases of epidural analgesia and included dislodged or broken
      catheters, pain on injection, hyperesthesia from epidural morphine and bleeding
      or infection related to the epidural catheter. Epidural morphine is indicated
      only in selected cancer pain patients and, although bupivacaine extends the
      efficacy of epidural analgesia, these methods are accompanied by problems and
      limitations.

PMID- 1758712
TI  - The role of injury discharge in the induction of neuropathic pain behavior in
      rats.
AB  - When sensory fibers are damaged, a discharge of impulses is emitted, which can
      last up to a few minutes. In the present study, we examined whether this injury
      discharge plays a role in triggering 'autotomy'--a behavior involving self-injury
      in animals that is induced by total denervation of a hind paw. Sensory input from
      the sciatic and saphenous neuroma is thought to elicit chronic pain sensations
      which cause the rat to injure the hind paw. In the present experiments: (1)
      injury discharge was prevented by using a local anesthetic block and (2) injury
      discharge was artificially prolonged by delivering 150 electrical pulses to the
      nerve just prior to transection, at a strength sufficient to drive A- and C
      fibers. In one group of animals, the nerve was stimulated at 0.5 Hz at which
      frequency a synchronous, repetitive activity in C-fibers augments the response of
      some nociceptive dorsal horn neurons by temporal summation ('wind-up'). In 2
      other groups, the sciatic nerve was stimulated at 0.1 Hz and 10 Hz. The results
      show that blocking injury discharge significantly delayed the average time of
      onset of autotomy and suppressed it in magnitude compared to control rats. In
      contrast, electrical stimulation, especially at the 'wind-up' frequency,
      significantly shortened the onset of autotomy and enhanced its severity. Thus, in
      spite of its short duration, injury discharge affects the subsequent development
      of neuropathic pain related behavior.

PMID- 1758714
TI  - Improvement to the Hargreaves paw flick method.

PMID- 1758713
TI  - The effects of auricular transcutaneous electrical nerve stimulation (TENS) on
      experimental pain threshold and autonomic function in healthy subjects.
AB  - The present study examines the effects of auricular transcutaneous electrical
      nerve stimulation (TENS) on electrical pain threshold measured at the ipsilateral
      wrist and autonomic functions including skin temperature, blood pressure and
      pulse rate in 24 healthy subjects. TENS was administered as low frequency trains
      of pulses delivered at a 'strong but comfortable' intensity to 1 of 3 auricular
      points to be examined: (i) autonomic effects (autonomic point), (ii) pain
      threshold effects (wrist point), and (iii) placebo effects at an unrelated point
      (face point). A fourth untreated group was designated as a situation control. The
      main finding of the study was that auricular TENS produced no significant overall
      effects on experimental pain threshold or autonomic functions recorded under the
      present conditions. However, pain threshold was found to increase by over 50% of
      its pretreatment baseline in 4 subjects and by 30% in 6 subjects. This rise was
      not dependent upon the site of auricular TENS. The possible mechanisms of such
      changes are discussed.

PMID- 1758715
TI  - [Polymorphism, competition and evolution of spermatozoides].

PMID- 1758716
TI  - [Bactericide activity of cefadroxil comparated with amoxicillin-clavulanic acid,
      cefaclor and josamycin].
AB  - Betalactamase-producing organisms are responsible for an increasing number of ENT
      and lower respiratory tract infections. Or cephalosporins and the combination of
      amoxicillin with the beta-lactamase inhibitor clavulanic acid are alternatives to
      ampicillin therapy. The killing activity of cefadroxil on the organisms most
      often responsible for ENT and respiratory infections was evaluated in vitro using
      a viable bacteria count method, comparatively with cefaclor, josamycin, and
      amoxicillin-clavulanic acid. Killing activity was found to be time-dependent for
      all the antimicrobial agents studied. Cefadroxil exhibited the same bactericidal
      effect on Streptococcus pyogenes and S. pneumoniae than the other agents.
      Haemophilus influenzae and an increasing number of Pneumococcus strains were
      resistant to josamycin which is therefore not appropriate for first-line therapy.
      As compared with amoxicillin and amoxicillin-clavulanic acid, cefadroxil was less
      active on H. influenzae and more active on Staphylococcus aureus. Production of
      beta-lactamase failed to influence the killing activity of cefadroxil. These
      bacteriologic data, together with results of pharmacologic studies (long half
      life and good penetration within tissues) can explain the clinical successes
      obtained with cefadroxil in ENT and lower respiratory tract infections.

PMID- 1758717
TI  - [Polyurethane versus polyethylene: in vivo randomized study of infectious
      complications of central catheterization].
AB  - Polyurethane (PU) and polyethylene (PE) catheters were distributed by
      randomization among adult ICU patients to evaluate the impact of the catheter
      polymer on the rate of catheter-related sepsis (CRS). The two catheters were
      otherwise strictly identical. Three hundred central venous catheters were
      randomized and inserted in the subclavian or internal jugular vein, at the
      discretion of the clinician. Mean duration of insertion was 9.2 (+/- 3) days for
      both catheter types and mean number of line openings was 159 (+/- 60). A
      bacteriologic culture using a variant of Maki's technique was performed on the
      205 catheters removed before patient discharge. No significant differences were
      found between the two catheters. Total number of tip infections was 33 and
      polyurethane and polyethylene prevalence ratio was 0.7. A clinical evaluation was
      performed for the 183 catheters inserted for a least 48 hours (in 142 patients).
      Patients were divided into four clinical categories according to previously
      reported definitions (Brun-Buisson et al., 1987). Clinical tip-infection rate was
      4.4% and polyurethane and polyethylene ratio was 0.7. For three additional
      catheters (1.6%), only the Luer-lock was infected. These three catheters were
      made of polyethylene and were inserted into the internal jugular vein. The Luer
      lock was made of polypropylene.

PMID- 1758718
TI  - [Cardiovascular responses to passive and active orthostatism in healthy subjects,
      in relation to age].
AB  - Changes in heart rate induced by inclining an orthostatic table to 30 degrees and
      60 degrees and by standing was studied in 200/healthy volunteers of either sex.
      Study subjects were divided in eight ten-year age groups, from 16 to 97 years.
      The 56-65 year age group was the youngest group to develop systolic orthostatic
      hypotension. This response occurred in 4% of subjects aged 56-65 years and became
      increasingly prevalent from one age group to the next (25%, 36% and 44%). In some
      patient, the fall in systolic BP reached 70 mmHg. Systolic hypotension occurred
      in some patients at 30 degrees but in most cases developed only at 60 degrees. No
      significant difference was found between the falls in SBP seen at 60 degrees and
      during active standing (90 degrees), indicating that muscular activity does not
      play a major role in BP regulation. Diastolic hypotension was less common and was
      mainly seen in patients above 75 (20%) who also had systolic hypotension.
      Orthostatism was responsible for tachycardia but this response became
      increasingly less common beyond 55 years of age (60, 60, 52 and 36% in the four
      age groups above 55). This reflects increasing loss of sensitivity of the
      baroreflex with advancing age. These date are useful for comparing the age
      specific effects of disease states (e.g. diabetes mellius, alcohol abuse) or
      treatments (psychoactive drugs, antihypertensive agents).

PMID- 1758719
TI  - [Role of Schistosoma mansoni bilharziasis in male hypogonadism].
AB  - In tropical and subtropical areas, schistosomiasis may cause anatomic anomalies
      of the genital organs responsible for permanent or reversible infertility.
      Furthermore, it has been suggested that this parasitic infection may have adverse
      consequences on the endocrine system. To specify the effects of schistosomiasis
      on endocrine function, production of pituitary gonadotropins and testosterone in
      rats and hamsters experimentally infected with Schistosoma mansoni was studied.
      Prior to infection, hormone levels were within the normal range for our
      laboratory in all animals studied. Hormone levels (FSH, LH and testosterone) fell
      significantly in all experimentally infected animals, as compared with uninfected
      controls. These data suggest that the inhibitory effect (documented by the fall
      in all the hormone parameters studied) of Schistosoma mansoni on gonadal function
      is due to an action at the hypothalamic or pituitary level. The potential role of
      parasite ecdysteroids in the mechanism of action of schistosomes deserves to be
      studied.

PMID- 1758720
TI  - [Vaccination against hepatitis B virus at the Lyon Pasteur Institute. A seven
      year evaluation].
AB  - Results of immunization against hepatitis B among Pasteur Institute staff members
      are reported. Prior to immunization, 439 subjects were tested for hepatitis B
      virus (HBV) markers, including HBs antigen, anti-HBs antibody, and anti-HBc
      antibody (Ausria, Ausab, Corab assays; Abbott). Forty-seven subjects tested
      positive for anti-HBs antibody. 317 subjects negative for all the HBs markers
      studied were given three intramuscular doses of Hevac B (Pasteur vaccins) at one
      month intervals. Anti-HBs antibodies were assayed after the third injection with
      the following results: mean titer, 1,454 mIU/ml, standard deviation, 5,349
      mIU/ml, and range, 4 to 41,100 mIU/ml. Anti-HBs titers above 10 mIU/ml were found
      in 879.4% of subjects. Non-responders and weak responders (anti-HBs titer under
      10 mIU/ml) were given a fourth dose of vaccine. Ultimately, after the last (third
      of fourth) injection 97.6% of subjects had protective antibody titers. No case of
      HBV infection was seen during the seven-year follow-up period.

PMID- 1758721
TI  - Histological evolution of peripheral T-cell lymphomas. Study of six cases.
AB  - The authors report 6 cases of histological transformation in peripheral T-cell
      lymphomas of low grade of malignancy. The transformation occurs in 75% of the
      cases, in extra-nodal sites and corresponds to a monomorphic of pleiomorphic
      large cell type. There is no discordance in the immunologic results between the
      two phases. The transformation seems to occur earlier than in B lymphomas, with a
      relative frequency of hematological manifestations and no therapeutic response.

PMID- 1758722
TI  - [Characteristics of the first penicillinase-producing strains of Neisseria
      gonorrhoeae isolated in Tunisia].
AB  - The first penicillinase-producing strain of Neisseria gonorrhoeae was recently
      isolated in Tunisia (1989). Betalactamase production was detected by the
      iodometric agar test. Minimal inhibitory concentrations (MICs) in agar medium
      were 128 micrograms/ml for penicillin, ampicillin and amoxycillin. With the
      amoxycillin-clavulanic acid combination, MIC fell to 0.25 microgram/ml. An Asian
      type plasmid pattern was evidenced in this strain, with presence of the 2.6 Mdal
      cryptic plasmid and of a 4.5 Mdal plasmid.

PMID- 1758723
TI  - [Vancomycin in 1991: current status and perspectives].
AB  - Vancomycin is a narrow-spectrum glycopeptide antibiotic which is primarily active
      against Gram-positive organisms. Bacterial resistance develops rarely due to its
      numerous modes of action. The mode of action of vancomycin involves the
      inhibition of peptidoglycan synthesis. Vancomycin forms a stoichiometric complex
      with the peptidoglycan precursor UDP-N-acetylmuramyl pentapeptide by forming
      hydrogen bonds. In patients with renal insufficiency vancomycin clearance is
      reduced and elimination half-life prolonged. Vancomycin is the drug of choice in
      the treatment of methicillin-resistant staphylococcal infections and in the
      treatment of Gram-positive endocarditis and has been used as alternative therapy
      in the treatment or prophylaxis of Gram-positive infections in penicillin
      allergic patients.

PMID- 1758724
TI  - [Antiphospholipid antibodies--antiphospholipid syndrome. Cause or consequence of
      thrombosis].
AB  - Antiphospholipid antibodies (APA) are heterogeneous immunoglobulines of G, M or A
      classes with specificity directed towards anionic phospholipids. The APA are
      associated with a wide variety of diseases. They have been found to represent
      risk factor for development of arterial and/or veinous thrombosis. The APA would
      perturbed the biological activities of anionic phospholipid surface in a manner
      that could decrease the natural anti-coagulant pathway in order to lead to
      thrombosis. In the latter hypothesis APA would appear as a secondary response to
      the exposure of phospholipid "self antigens" by activated or damaged blood
      vascular cells by known stimuli able to induce thrombosis. In these cases APA
      would therefore constitute a marker of risk of thrombosis. The question which
      remains to be solved is if APA possess their own pathogenic potential or if they
      appear as the result of an up-stream pathological event known to be favourable to
      the development of thrombosis or if both mechanism are involved.

PMID- 1758725
TI  - [Lipid peroxidation].
AB  - After a brief review of the concepts of free radical and enzymatic lipid
      peroxidation, spontaneous peroxidation (initiation, propagation, termination, end
      products) is described in detail on the basis of the latest published studies
      shedding new light on the role of this process in a wide variety of disease
      states. Toxic effects of lipid peroxidation and physiologic protective mechanisms
      are described. Currently available routine methods for evaluating lipid
      peroxidation, particularly in plasma, although imperfect, are nevertheless
      valuable in clinical practice in view of the many human disease states involving
      lipid peroxidation.

PMID- 1758726
TI  - Effect of positive end-expiratory pressure on respiratory compliance in children
      with acute respiratory failure.
AB  - We studied the effect of positive end-expiratory pressure (PEEP) on the
      compliance of the respiratory system (Crs) in 25 children (age, 3 weeks to 10
      years) requiring mechanical ventilation. Functional residual capacity (FRC)
      measurements were performed at 2 cm H2O increments, from 0 to 18 cm H2O of PEEP,
      and the FRC values were regressed versus PEEP. Static Crs, Crs/kg, and specific
      compliance (Crs/FRC) were calculated for each PEEP level. When FRC normality was
      reached Crs/kg improved in 15/25 (60%) patients but decreased in 2/25 (8%).
      Overall, Crs/kg increased from a mean +/- SE of 0.94 +/- 0.09 to 1.35 +/- 0.13
      mL/cm H2O/kg (P = 0.003) and Crs/FRC from a mean +/- SE of 0.067 +/- 0.006 to
      0.077 +/- 0.007 mL/cm H2O/mL (P = 0.057). The maximum compliance (mean Max
      Crs/kg, 1.56 +/- 0.12 mL/cm H2O/kg, and mean Max Crs/FRC, 0.089 +/- 0.005 mL/cm
      H2O/mL) was significantly higher than the compliance at the clinically chosen
      PEEP level and the compliance at the PEEP that normalized FRC. Maximum compliance
      was achieved within 4 cm H2O of the PEEP that normalized FRC. In 14/25 (60%) of
      cases the PEEP at maximum compliance coincided with the PEEP that resulted in FRC
      normalization. We concluded that static respiratory compliance improves in most
      (but not all) children with acute respiratory failure when FRC is normalized.
      Static respiratory compliance reaches maximum levels at PEEP values that are
      close (but not equal) to those that result in FRC normalization. Thus, assessment
      of the effect of PEEP on compliance is required in individual patients.

PMID- 1758727
TI  - Pulmonary mechanics and outcome of neonates on ECMO.
AB  - Deciding when to wean neonates from extracorporal membrane oxygenation (ECMO) can
      be difficult. The usefulness of simple measurements of pulmonary mechanics e.g.,
      dynamic compliance (Cdyn) has been questioned. We investigated the pulmonary
      mechanics of eight neonates using the interrupter technique, which allows the
      partitioning of pulmonary mechanics into compartments representing the conducting
      airways and more peripheral phenomena (viscoelastic properties and "pendelluft").
      Three neonates required ECMO for a congenital diaphragmatic hernia (CDH), two for
      hyaline membrane disease (HMO), two for meconium aspiration syndrome (MAS), and
      one for pneumonia. All neonates with MAS, HMD, and pneumonia were successfully
      weaned from ECMO when their Cdyn was 0.3 mL/cmH2O/kg or greater [mean 0.34 +/-
      0.06 (SEM)]. All three neonates with CDH died and their highest Cdyn was 0.21,
      0.19, and 0.09 mL/cmH2O/kg respectively (mean, 0.16 +/- 0.037). The airway
      resistance (Raw) and the slower component of pressure change after interruption
      (delta Pdiff), a measure of the more peripheral phenomena of the lung, were not
      significantly different in those neonates who survived and those who did not. The
      values for delta Pdiff in all patients were higher than those in healthy
      neonates. However, the Raw was not different. This suggests that the major
      disturbance in pulmonary mechanics was distal to the conducting airways. Those
      neonates who were successfully weaned from ECMO had a significantly higher Cdyn
      24-48 hours prior to decannulation. Considering the lung as a two-compartment
      model offers no advantages when compared to the one-compartment model for the
      prediction of the outcome of a neonate on ECMO.

PMID- 1758728
TI  - Respiratory responses of piglets to hypercapnia during postnatal development:
      effects of opioids.
AB  - Resting respiratory and cardiovascular functions and the response to CO2
      rebreathing were compared between 2.5 +/- 0.7 (mean +/- SE) and 34.1 +/- 1.9 day
      old piglets, before and after the opioid antagonist naltrexone (1 mg/kg IV). At
      rest, tidal volume, both absolute and per m2, inspiratory and expiratory time,
      absolute minute ventilation, and mean arterial pressure increased with age, and
      breathing frequency, minute ventilation per m2, and heart rate decreased, all of
      these with as well as without naltrexone. During hypercapnia, the pattern, but
      not the quantitative aspects of breathing changed with age. At rest, naltrexone
      produced hyperventilation in the young, but not in the older group. During
      hypercapnia, naltrexone had a sparse effect in both ages. We conclude that, in
      the anesthetized piglet, ventilatory functions at rest undergo change with
      postnatal age, but breathing responses to hypercapnia exhibit maturation in
      pattern only and not in magnitude. Whereas resting ventilation of young piglets
      is modulated by endogenous opioids, hypercapnia may activate opioids to a limited
      extent and in a manner unrelated to age.

PMID- 1758729
TI  - Efficacy, results, and complications of mechanical ventilation in children with
      status asthmaticus.
AB  - We have conducted a retrospective survey of 79 children out of a total hospital
      asthmatic patient population of 2,412, admitted over a 32 month period to the ICU
      for the management of severe status asthmaticus. All patients were in severe
      respiratory distress with CO2 retention; 19 required mechanical ventilation due
      to increasing fatigue and worsening bronchospasm, having failed to respond to
      either inhaled or IV bronchodilator therapy. All patients were ventilated at slow
      rates (less than 12 min) and their airway pressure (Paw) was deliberately kept
      below 45 cmH2O, while accepting a PaCO2 in the 45-60 mmHg range, as long as the
      pH was compensated. Although two patients developed pneumothoraces while on
      positive pressure ventilation, these were resolved without incidents. Five
      patients who had mediastinal or subcutaneous air leaks prior to intubation did
      not develop pneumothoraces. Following the initiation of mechanical ventilation,
      IV beta-agonist therapy was increased in order to reverse the bronchospasm and
      reduce the duration of mechanical ventilation. Mean duration of intubation was 42
      hours. Fourteen of the 19 patients were weaned and extubated within 48 hours. All
      patients survived without sequelae. We conclude that a degree of controlled
      "hypoventilation" by deliberately choosing Paw less than 45 cmH2O can be
      successfully used to ventilate children with severe status asthmaticus with a
      reduced rate of pressure-related complications.

PMID- 1758730
TI  - Asthma in the vicinity of power stations: I. A prevalence study.
AB  - Respiratory symptoms, atopy, and bronchial reactivity were measured in primary
      school children living in Lake Munmorah (LM), a coastal town near two power
      stations, and in Nelson Bay (NB), a coastal town free from any possible major
      sources of outdoor air pollution. A prevalence survey and longitudinal follow-up
      study were performed 1 year apart. In both studies, the prevalence of ever
      wheezed, current wheezing, breathlessness, wheezing with exercise, diagnosed
      asthma, and use of drugs for asthma at LM were all approximately double the
      prevalence at NB (all P values less than 0.01). The prevalence of bronchial
      reactivity was significantly greater at LM than NB (P less than 0.01) at the
      first but not the second survey. By contrast, no significant differences were
      found between the two areas for skin test atopy or for parental history of
      allergic disease. Multivariate analysis supported the conclusion from the
      univariate analysis that there was more wheezing at LM compared to NB at both
      studies, when adjusted for atopy, smoking in the home, age, and sex. As expected,
      a positive skin test reaction to house dust mite was the predominant explanatory
      variable. Asthma was more common in the community near power stations (LM) than
      in the NB area. The absence of significant differences in skin test atopy and
      parental history of allergic disease argued against major genetic differences
      between the two groups. By contrast, the more common reporting of siblings' chest
      disease and asthma in Lake Munmorah supported an environmental cause.

PMID- 1758731
TI  - Asthma in the vicinity of power stations: II. Outdoor air quality and symptoms.
AB  - To assess longitudinally the effect of living in the vicinity of coal-fired power
      stations on children with asthma, 99 schoolchildren with a history of wheezing in
      the previous 12 months were studied for 1 year, using daily diaries and
      measurements of air quality. The children had been identified in a cross
      sectional survey of two coastal areas: Lake Munmorah (LM), within 5 km of two
      power stations, and Nelson Bay (NB), free from major industry. Daily air quality
      [sulphur dioxide (SO2) and nitrogen oxides (NOx)], respiratory symptoms, and
      treatment for asthma were recorded throughout the year. Measurements of SO2 and
      NOx at LM were well within recommended guidelines although they were several
      times higher than at NB: maximum daily levels in SO2 (micrograms/m3) were 26 at
      LM, 11 at NB (standard, 365); yearly average SO2 was 2 at LM, 0.3 at NB
      (standard, 60); yearly average NOx (micrograms/m3) was 2 at LM, 0.4 at NB
      (standard, 94). Marked weekly fluctuations occurred in the prevalence of cough,
      wheezing, and breathlessness, without any substantial differences between LM and
      NB. Overall, the prevalence of symptoms was low (10% for wheezing, 20% for any
      symptom). Whether the daily SO2 and NOx levels affected the occurrence of
      respiratory symptoms was investigated in children at LM using a logistic
      regression (Korn and Whittemore technique). For these children as a group, air
      quality measurements were not associated with the occurrence of symptoms.

PMID- 1758732
TI  - Effect of airway inertance on linear regression estimates of resistance and
      compliance in mechanically ventilated infants: a computer model study.
AB  - Respiratory inertance (I) is usually ignored when resistance (R) and compliance
      (C) of mechanically ventilated infants are estimated by least squares linear
      regression. Values of I that have been reported for these patients can cause
      impedances whose magnitudes approximate respiratory resistance. We show
      theoretically that if inertance is neglected no error is expected in resistance
      estimates, but a positive bias in compliance can be, proportional to the
      inertance, the compliance, and the sinusoidal frequency at which the measurements
      are made. To determine the errors in parameter estimates when the pressure
      waveform is non-sinusoidal, we simulated linear regression based on non-inertive
      and inertive models. R, C, and I of the simulated lung were varied over the range
      expected in an infant intensive care unit. The ventilator was simulated as a
      critically damped second order system with a square pulse input. The rise time
      (TR) of the pressure pulse was varied over the range reported in infant ICUs.
      Simulated measurements confirmed that resistance is correctly estimated if
      inertance is neglected. Maximum error in compliance estimates (13%) occurred when
      TR and R were low, and C and I were high. The variation in the error in estimated
      compliance was consistent with the theory. Coefficients of variation of the
      parameters, the standard errors, and R2 of the regressions tended to deteriorate
      with increasing compliance error, but the relationships were not single valued.
      These statistics may alert investigators to possible bias in compliance caused by
      neglected inertance, but cannot be used to correct any bias.

PMID- 1758733
TI  - Regional cycles of perfusion and non-perfusion in the lung of the term fetal
      rabbit.
AB  - The spatial distribution of pulmonary blood flow and its change over time was
      investigated in term fetal rabbits, using the plasma tracer fluorescein
      isothiocyanate-labeled bovine serum albumin (FITC-BSA). A tracer bolus was
      injected intravenously and allowed to circulate in vivo for increasing periods of
      time (2-30 minutes) prior to arrest of the circulation and tissue preparation.
      Initially, fluorescence was present in the vasculature of 43% of lung parenchymal
      tissue, disposed as discrete regions or "lobules." Interspersed regions of lung
      tissue received no tracer inflow. With increasing tracer circulation times (10,
      20, and 30 minutes), a greater percentage of lung cross-sectional area contained
      vessels exhibiting tracer fluorescence (64, 96, and 100%, respectively). In the
      fetal lung, a high pulmonary vascular resistance (PVR) is maintained. Our studies
      indicate that, at any given moment, fetal pulmonary blood flow is distributed
      only to a proportion of discrete lung "lobules," while interspersed "lobules"
      receive no flow at all. The "lobules" alternate between these "high" and "low"
      vascular resistance states with a periodicity of approximately 35 minutes,
      comprising 22 minutes of non-perfusion followed by 13 minutes of perfusion. This
      circulatory pattern permits both the maintenance of high PVR and uniform lung
      development. Further, by directing flow to only a portion of the vasculature,
      greater microvascular flow rates are achieved and hence the risk of blood
      sludging and stasis is reduced. Recruitment of these "non-perfused" regions at
      birth could thus produce a significant reduction in PVR.

PMID- 1758734
TI  - Effects of a clinically detectable PDA on pulmonary mechanics measures in VLBW
      infants with RDS.
AB  - We examined the effect of a clinically detectable patent ductus arteriosus (PDA)
      and its successful treatment with indomethacin on serial measures of pulmonary
      mechanics in 10 very-low-birthweight (VLBW) intubated infants with respiratory
      distress syndrome (RDS). Pulmonary mechanics were measured by the passive
      expiratory flow technique. Total respiratory system compliance (Crs) gradually
      improved as RDS resolved. However, a significant decrease in mean Crs was
      associated with the development of a clinically detectable PDA, ranging from 1.51
      +/- 0.21 to 0.90 +/- 0.08 mL/cmH2O/m (P less than 0.05). We also noted an
      increase in mean Crs, from 0.90 +/- 0.08 to 1.49 +/- 0.21 mL/cmH2O/m (P less than
      0.05), after successful treatment of a PDA with indomethacin. Total respiratory
      system resistance (Rrs) did not change. We conclude that a clinically significant
      PDA is associated with a decreased Crs and that successful treatment of a PDA
      with indomethacin is associated with an improvement in lung compliance. These
      findings imply that the development of a clinically detectable PDA and its
      subsequent treatment complicates the interpretation of pulmonary mechanics data
      in VLBW infants with RDS.

PMID- 1758735
TI  - The use of peak expiratory flow rate measurements in respiratory disease.

PMID- 1758736
TI  - Retrosternal density: pulmonary underdevelopment or accessory hemidiaphragm.
AB  - Vertical retrosternal density paralleling the sternum, with haziness of a
      hemithorax on chest roentgenogram, often challenges the clinical acumen of
      pediatricians, chest physicians, and pediatric radiologists alike. Its presence
      has been historically linked to either pulmonary underdevelopment and/or
      accessory hemidiaphragm. The surgical and radiological pediatric literature has
      long debated this topic, but unfortunately, it has not received much attention in
      the general pediatric or in pediatric pulmonology literature. The similar
      radiologic appearance of these two entities can cause confusion both in
      diagnostic and the therapeutic approach. Many authors advocate an invasive
      modality, including thoracotomy, as the only definitive way to differentiate
      between them. We present two similar cases with retrosternal densities, review
      the pertinent literature, and propose a rational approach to diagnosis and
      treatment.

PMID- 1758737
TI  - Occurrence of respiratory syncytial virus subtypes in hospitalized children in
      Cleveland, Ohio from 1985 to 1988.
AB  - In order to determine the frequency of occurrence of the two respiratory
      syncytial virus (RSV) subtypes in hospitalized children in Cleveland, Ohio, we
      analyzed clinical isolates obtained during three consecutive winter epidemic
      seasons between 1985 and 1988. RSV was recovered from the frozen clinical
      specimens of 197 patients: 176 subtype A, and 21 subtype B. Subtype A
      predominated during all three epidemic seasons, ranging from 83 to 94% of
      isolates. We surveyed the clinical records of 16 children with subtype B, and 101
      children with subtype A infections, hospitalized at the University Hospitals of
      Cleveland during these winter epidemics and found no differences in age, sex,
      race, or clinical spectrum of severity of disease caused by the two subtypes. In
      contrast to previously reported data, subtype A predominated in each of the
      winter seasons studied within this community. We conclude that both subtypes
      circulate concurrently within the community during the winter. In hospitalized
      children both subtypes appear to cause a similar spectrum of disease. Both the
      concurrent circulation of RSV subtypes and the similar spectrum of illness pose
      for important considerations in the development of effective vaccines against
      this common respiratory agent in children.

PMID- 1758738
TI  - Undetected apnea and bradycardia in infants.
AB  - Despite routine monitoring, a number of prolonged apneic and bradycardic episodes
      were undetected in a group of infants in the neonatal intensive care unit (NICU).
      Sixty-one infants were evaluated by 12-hour pneumocardiograms at a post
      conceptional age of 35 +/- 3 (SD) weeks. Nursing documentation failed to detect
      11 infants with prolonged apnea and bradycardia. Three of these infants were not
      detected in spite of increased awareness following in-service education. Such a
      lack of documentation may lead to improper medical management of infants at risk
      for pathologic apnea and suggests the need for more accurate documentation at the
      time of discharge.

PMID- 1758739
TI  - Inspiratory time and pulmonary function in mechanically ventilated babies with
      chronic lung disease.
AB  - To learn if increasing inspiratory time would improve pulmonary function in
      mechanically ventilated babies with chronic lung disease, we measured lung
      mechanics and alveolar ventilation at three inspiratory times: 0.4, 0.6, and 0.8
      s. Nine babies were studied. Their mean birth weight was 875 g (range, 570-1,100
      g), gestational age 27 (24-34) weeks, and age 7 (4-12) weeks. Their mean oxygen
      requirement was 40% (29-53), ventilator rate 33/min (20-40), and mean airway
      pressure 8 (5-10) cmH2O. Ventilator rate was kept constant; therefore expiratory
      time decreased and mean airway pressure and I:E ratio increased at longer
      inspiratory times. At 0.6 s and 0.8 s, when compared to 0.4 s, significant
      increases occurred in tidal volume (10.4, 10.1, and 8.4 mL/kg, respectively),
      dynamic lung compliance (0.68, 0.68, and 0.53 mL/cmH2O/kg, respectively), and
      alveolar ventilation (6.0, 6.3, and 4.7 mL/kg/breath, respectively). Airway
      resistance, anatomical dead space to tidal volume ratio, and functional residual
      capacity were similar at the three inspiratory times. Our findings suggest that
      an inspiratory time greater than or equal to 0.6 s (compared to 0.4 s) increases
      the effectiveness of mechanical ventilation for babies with chronic lung disease.

PMID- 1758740
TI  - Relationship of symptoms to lung function abnormalities in preterm infants at
      follow-up.
AB  - Recurrent respiratory symptoms are common in preterm infants in the first 2 years
      of life. The aim of this study was to determine the lung function abnormalities
      associated with such symptoms. Forty preterm infants, with a median gestational
      age of 29 weeks were studied at a median postnatal age of 12 months. Twenty-two
      suffered from recurrent symptoms, defined as wheezing and/or coughing on at least
      4 days per week over the previous month. Lung function was assessed by
      measurement of functional residual capacity (FRC), using a helium gas dilution
      technique, and airway resistance (Raw) and thoracic gas volume (TGV)
      plethysmographically. No significant difference was found in TGV between
      symptomatic and asymptomatic infants, but the median FRC was lower (P less than
      0.01), Raw higher (P less than 0.01), and FRC:TGV ratio lower (P less than 0.001)
      in the symptomatic infants. These lung function abnormalities in the symptomatic
      infants are suggestive of gas trapping.

PMID- 1758741
TI  - Importance of using lung function regression equations appropriate for ethnic
      origin.
AB  - Functional residual capacity (FRC) can be assessed reliably in young children
      using a helium gas dilution technique. The aim of the present study was to
      determine if differences in lung volume are found in asthmatic children of
      different ethnic origins. Eighty-eight children were studied, 53 of Caucasian
      origin and 35 of Afro-Caribbean origin. Their median age was 6.1 years (range,
      5.3-9.0 years). FRC measured by helium gas dilution is reported as a percentage
      of predicted for height, using a published regression equation as well as
      regression equations appropriate for the ethnic origin of the child. In the
      majority of both groups FRC was elevated above the ethnically appropriate
      regression equation for healthy children. The Caucasian children apparently had
      higher FRCs than the Afro-Caribbean children if comparing the absolute lung
      volume, and if lung volume was expressed as percent of predicted for height, by a
      regression equation uncorrected for ethnic origin (P less than 0.02). This
      difference disappeared when ethnically appropriate regression equations were
      used. We conclude that lung volumes are similar in asthmatic children of
      different ethnic origin and that it is important to use ethnically appropriate
      regression equations.

PMID- 1758742
TI  - Hyperinflation in children with liver disease due to alpha-1-antitrypsin
      deficiency.
AB  - Fifty-nine patients (median age 6.0 years) with liver disease and ten healthy
      children without liver disease (median age 7.5 years) had serial measurements of
      functional residual capacity (FRC) over a period of at least 6 months. Twenty
      eight children with alpha-1-antitrypsin deficiency (A1ATD) tended to have higher
      lung volumes than 26 with extrahepatic biliary atresia (EHBA). Fifteen children
      had persistent hyperinflation (FRC greater than 120% predicted for height; 2 SD
      above the mean of controls); in five children (four with A1ATD) this was
      unresponsive to bronchodilator therapy. Two of the children with A1ATD who had
      persistent unresponsive hyperinflation on three serial measurements were only 3
      and 4 years of age. No healthy child without liver disease was hyperinflated.
      These results suggest that A1ATD may be associated with lung function
      abnormalities even in very young children.

PMID- 1758743
TI  - Influence of sedation on the Hering-Breuer inflation reflex in healthy infants.
AB  - The airway occlusion technique for measuring passive respiratory mechanics in
      infants relies on an ability to evoke the Hering-Breuer inflation reflex (HBR).
      However, the persistence of this reflex beyond the early newborn period remains
      controversial. We have recently demonstrated that there is no change in the
      strength of this reflex during the first two months of life in healthy infants
      during natural sleep. Measurements beyond this immediate newborn period are
      difficult without sedation, but it is unclear whether sedation itself may
      influence this reflex. To investigate the influence of sedation, the HBR was
      measured in 66 healthy, full-term infants aged 4-8 weeks. Thirty-three infants
      were measured during natural sleep, and 33 after triclofos sodium sedation (75
      mg.kg-1). The strength of the HBR was assessed from the change in expiratory time
      (TE) following brief end-inspiratory airway occlusion, as compared to TE during
      spontaneous breathing. The mean increase in TE following occlusion was 89.45%
      (SD, 29.8; range, 44-175) in infants sleeping naturally, and 92.42% (SD, 31.2;
      range, 34-179) in sedated infants. Using unpaired t tests, no statistically
      significant difference was found between groups (P = 0.7516). We conclude that
      the strength of the HBR in healthy infants is not influenced by sedation with
      triclofos sodium, in doses normally used for lung function testing.

PMID- 1758744
TI  - Comparison of six ECMO selection criteria and analysis of factors influencing
      their accuracy.
AB  - This study compared six extracorporeal membrane oxygenation (ECMO) selection
      criteria in 42 neonates and analyzed factors influencing the accuracy of outcome
      predictions. The sensitivity of the criteria in identifying fatal cases varied
      from 0.44 to 0.94 and the specificity of predictions of survival ranged from 0.42
      to 0.69. The criterion having the highest sensitivity had the lowest specificity
      and conversely the criterion with the lowest sensitivity had the highest
      specificity. Overall accuracy of the criteria, as measured by the total number of
      correct outcome predictions, differed little among the criteria (23/42 to 27/42
      correct predictions). Three factors influenced predictive accuracy: 1) a primary
      diagnosis of congenital diaphragmatic hernia (CDH) was associated with a greater
      mortality (P less than 0.001) and a significantly higher positive predictive
      value (PPV) for all criteria (P = 0.0009-0.012) than that seen in patients with
      other primary diagnoses; 2) calculating the alveolar-arterial oxygen gradient
      using an assumed, rather than measured barometric pressure, or estimating
      oxygenation index using a calculated, rather than a measured, mean airway
      pressure, increased false positive mortality predictions in non-CDH patients; and
      3) requiring a peak inspiratory pressure (PIP) of at least 50 cm H2O in the
      definition of maximal medical management, rather than a PIP of 20-49 cm H2O,
      significantly increased the PPV for three of four criteria examined (P = 0.02
      0.04). Awareness of these factors may facilitate the identification of neonates
      who need ECMO to survive.

PMID- 1758745
TI  - Psychological change associated with theophylline treatment of asthmatic
      children: a 6-month study.
AB  - Theophylline has been associated with a variety of behavioral side effects in
      asthmatic children. This study was a 6-month investigation of the relationship
      between theophylline treatment and psychological changes in 8 to 16 year old
      asthmatic children. Included were a group receiving theophylline (n = 19), a
      control group not receiving theophylline (n = 44), and a nonasthmatic control
      group (n = 24). The three groups had similar age, socioeconomic status, and IQ.
      The two groups of children with asthma demonstrated greater emotional
      dysfunction, characterized by tendency toward withdrawal and depression, than the
      nonasthmatic control group. Each of five assessment appointments (baseline and 1
      week, 1 month, 3 months, and 6 months after beginning theophylline treatment)
      included measures of pulmonary function, attention, impulsivity, memory, fine
      motor control, activity level, self-reported mood, and parental observation of
      difficult behavior. Pulmonary functions were lower in the theophylline group at
      baseline but improved significantly after commencement of theophylline therapy.
      Over the 6-month interval, children in the theophylline group demonstrated
      improved scores on a laboratory measure of attention, while their parents
      reported increased conduct problems and hyperactivity. On the whole,
      psychological score changes were subtle, and no other between-group differences
      emerged in the remaining laboratory measures.

PMID- 1758746
TI  - Antineutrophil elastase activity in cystic fibrosis serum.
AB  - The antigenic concentrations of alpha-1-antitrypsin (alpha 1AT) were measured in
      13 patients with cystic fibrosis (CF) and in 11 healthy subjects. Serum alpha 1AT
      was purified by immunoaffinity chromatography and the antielastase activity of
      the purified alpha 1AT was determined by measuring the molar ratio necessary to
      inhibit human neutrophil elastase (HNE). The association rate constant of alpha
      1AT with HNE was determined in a timed assay. The capacity of CF serum alpha 1AT
      to form complexes with porcine pancreatic elastase was studied by polyacrylamide
      gel electrophoresis. Antigenic concentrations of alpha 1AT mumol/L were markedly
      increased in the serum of all patients with CF (61.9 +/- 4.3 mumol/L) in
      comparison to a reference standard (36.7 +/- 1.8 mumol/L; P less than 0.0001). CF
      serum alpha 1AT was fully active against HNE, and its association rate constant
      in the presence of HNE was similar to that of healthy subjects. In addition, CF
      serum alpha 1AT formed complexes with porcine pancreatic elastase that were
      electrophoretically indistinguishable from those of normal serum alpha 1AT. These
      results indicate that patients with CF have increased serum alpha 1AT
      concentrations and that this antiprotease, when purified from serum, functions
      normally.

PMID- 1758747
TI  - Comparison of FEV1 and transcutaneous oxygen tension in the measurement of airway
      responsiveness to methacholine.
AB  - The measurement of airway responsiveness in preschool children is hampered by the
      fact that most tests of airway caliber are difficult to carry out at a young age.
      Patient cooperation is only needed to a limited extent when transcutaneous oxygen
      tension (PtcO2) is used as an indicator of airway obstruction following bronchial
      provocation. In 51 children, aged 6-14 years with asthma we have measured PtcO2
      and forced expiratory volume in 1 second (FEV1) concurrently after bronchial
      provocation, using increasing doses of methacholine administered with a De
      Villbiss 646 nebulizer and a French-Rosenthal dosimeter. The shapes of the dose
      response curves to PtcO2 and FEV1 show a close similarity. After methacholine
      challenge, the decrease in PtcO2 correlates highly with the decrease in FEV1. We
      conclude that in children a 20% decrease in PtcO2 can be used as a sensitive
      indicator of airway narrowing after methacholine challenge.

PMID- 1758748
TI  - Effect of nasal CPAP on thoracoabdominal motion in neonates with respiratory
      insufficiency.
AB  - Thoracoabdominal motion (TAM) profiles were determined in ten infants requiring
      nasal continuous positive airway pressure (CPAP) and supplemental oxygen, in
      order to assess the influence of CPAP on chest wall function in infants with
      respiratory insufficiency. (TAM) was quantitated by respiratory inductive
      plethysmography, measuring relative motion of the rib cage and abdomen. Baseline
      pulmonary function (without CPAP support) was assessed from simultaneous
      measurements of transpulmonary pressure, air flow, and tidal volume. Measurements
      of (TAM) were acquired at baseline and at nasal CPAP levels of 0, 3, 5, and 8 cm
      H2O, in randomized order. Without CPAP, relative paradoxical motion occurred,
      i.e., the rib cage collapsed inward instead of expanding outward early in
      inspiration. With CPAP, TAM resembled the pattern in preterm infants, without
      lung disease. We found that nasal CPAP lowers the phase angle in infants with
      respiratory insufficiency (P less than 0.003), indicating improved synchrony of
      TAM. In addition, the improvement with nasal CPAP was related to the severity of
      pulmonary compromise at baseline. We speculate that changes in TAM associated
      with nasal CPAP arise from an interaction between pulmonary mechanics and an
      enhanced stability of the chest wall. In this context, the greater synchrony of
      TAM is suggestive of an improved breathing strategy. This may be a noninvasively
      obtainable marker of an effective nasal CPAP level in infants with altered
      pulmonary and chest wall mechanics.

PMID- 1758749
TI  - The long-term effect of high-frequency chest compression therapy on pulmonary
      complications of cystic fibrosis.
AB  - A high-frequency chest compression (HFCC) device for clearance of mucous
      secretions from airways was tested in 16 cystic fibrosis (CF) patients with
      significant improvement in pulmonary function for the HFCC period, which averaged
      22 months per patient. The device consists of a variable air pulse delivery
      system and a non-stretch inflatable vest worn by the patient to cover the entire
      torso. The patients perform 30 minute therapy sessions divided into 5 minute
      periods at each of six frequencies. Individual patient therapy time per day
      ranged from 30 to 240 minutes. Frequencies used by each patient were determined
      by measuring air flow at the mouth and calculated volume expired per chest
      compression during tidal breathing while receiving HFCC at frequencies between 5
      and 22 Hz at 1 Hz increments. The frequencies that produced the three highest
      flows and the three largest volumes were selected for each patient's therapy.
      Ninety-four percent of patients' regression line slopes for percent predicted
      forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1)
      became more positive during self-administered HFCC therapy as compared to slopes
      before HFCC therapy, when manual chest physical therapy was used. Two-sided t
      test showed that the mean slopes were more positive for FVC and FEV1 during HFCC
      therapy than for the manual chest physical therapy period before HFCC therapy.
      The significance level for both FVC and FEV1 was at P less than 0.001.

PMID- 1758750
TI  - Pilot study for the development of a monitoring device for ventilated children.
AB  - Airway pressure and air flow were measured at the endotracheal tube in 13
      children on a variety of ventilators. These signals were stored for analysis on a
      computer. Further data sets were obtained after 24 hours or following major
      interventions. Air flow rate was integrated to give volume. Pulmonary resistance
      and elastance were obtained by multiple linear regression. Pressure-volume,
      pressure-flow and flow-volume loops were plotted. "Closed" pressure-volume and
      pressure-flow loops (by subtraction of the resistive or elastic pressure
      components, respectively) were also displayed, giving compliance and resistance
      loops. The loops from the initial data set were taken as the baseline, and loops
      from later data sets were superimposed to provide visual comparisons. Change in
      clinical status was reflected by the change in slope of compliance and resistance
      loops. A 30% change in compliance or resistance was easily observed. There was
      minimal interference with patient care. This pilot study demonstrates that
      changes in respiratory mechanics can be displayed safely and easily in ventilated
      patients using resistance and compliance loops. Further work is necessary to
      confirm the usefulness of real time of these displays.

PMID- 1758751
TI  - Endoscopic diagnosis and closure of a bronchopleural fistula.

PMID- 1758752
TI  - Was it just our problem, or yours too? Errors in body plethysmography, in
      infants, children, and adults.

PMID- 1758753
TI  - Respiratory mechanics of the piglet during the first month of life.
AB  - Piglets at 3, 14, and 30 days of age were studied to assess the postnatal changes
      in lung, chestwall, and total respiratory system compliance associated with
      normal growth. Static deflation compliance of the lung and total respiratory
      system increased significantly with age; there was no change in chestwall
      compliance. When normalized for body weight or lung volume, all measures of
      compliance tended to decrease with postnatal age. Measures of lung and chestwall
      compliance obtained with an end-inspiratory occlusion technique were less than
      the static compliance measures, but demonstrated the same relative changes with
      postnatal maturation. Chestwall compliance at 3 days of age was only 1.3 times
      greater than lung compliance and there was no significant change in this ratio
      with postnatal age. In contrast to the trend for the human infant, the piglet's
      chestwall at 3 days of age is stiff relative to the lung and does not become
      stiffer with age over the first 4 weeks of life.

PMID- 1758754
TI  - The effect of intravascular complement activation and brief episodes of hypoxia
      on protein in bronchoalveolar lavage fluid in C5 sufficient and deficient mice.
AB  - Our earlier investigations indicated that systemic complement activation with iv
      cobra venom factor (CVF) or infused zymosan-activated rabbit plasma or rabbit C5a
      does not significantly increase bronchoalveolar lavage albumin in rabbits (Am Rev
      Respir Dis 1982; 125:335-340); but that complement activation due to CVF combined
      with a brief episode of hypoxia increases lavage albumin and is associated with
      the presence of neutrophils for its expression (J Clin Invest 1985; 75:902-910).
      In order to determine if intravenous CVF and hypoxia cause similar alterations in
      mice, and to investigate the time course of the response as well as the
      importance of C5 fragments to the process, we challenged the B10.D2/nSn strain of
      C5 sufficient mice (C5+) and the congenic B10.D2/oSn strain of C5 deficient mice
      (C5-) with intravenous CVF, 15 min of 12% oxygen, or CVF followed by hypoxia.
      Neither C5+ nor C5- mice had significant increases in lavage protein after either
      CVF or hypoxia. However, the combined insults significantly increased lavage
      protein in C5+ but not C5- mice; polyacrylamide gel electrophoresis showed
      increased amounts of proteins of low and high molecular weights in lavage fluid
      from the C5+ strain. While the time course of abnormalities in mice was different
      from that in rabbits, both meclofenamate pretreatment and neutrophil depletion
      attenuated the increases in lavage protein after the combined insults in both
      animal species. Infusion of prostaglandin E2 (PGE2) with CVF in the C5+ mice also
      led to significant increases in lavage protein. We conclude that in mice,
      intravenous complement activation, as an isolated event, does not cause a
      significant increase in lavage protein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758755
TI  - Outcome of home care for technology-dependent children: success of an
      independent, community-based case management model.
AB  - Case management is important for successful home care of technology-dependent,
      respiratory-disabled children. Traditionally, the medical model of hospital-based
      home care and case management has been used for these children. The outcome may
      be different from when using independent, community-based home care and case
      management. We evaluated the results of 28 technology-dependent children [23
      receiving mechanical ventilation and 5 receiving continuous positive airway
      pressure (CPAP)] from 8 hospitals, who utilized an independent, community-based,
      case management group to coordinate home care. After 26.3 +/- 20.6 months of
      follow-up, 13 children (46%) remained technology-dependent, 10 (36%) were
      technology-independent, and 5 (18%), all with neurologic dysfunction, had died.
      Only one death was caused by a complication of technology. All children with
      congenital anomalies (n = 4), primary pulmonary disease (n = 8), and
      neuromuscular disease (n = 4) survived, and 9 (56%) were weaned from
      technological support. Children with chronic respiratory failure secondary to
      central neurologic dysfunction (n = 12) did poorly: 5 died, 6 remained technology
      dependent, and only 1 became independent of technology. Children with
      neuromuscular diseases tended to use less home care nursing at a lower home care
      cost. Parent satisfaction was high among those who responded (82%), indicating
      that the child, siblings, and family were better off with the child at home.
      These outcomes suggest that community-based home care and case management is a
      reasonable alternative to the hospital-based model.

PMID- 1758756
TI  - Prevention of chronic pulmonary oxygen toxicity in young rats with liposome
      encapsulated catalase administered intratracheally.
AB  - The lungs and hearts of young rats exposed to 100% oxygen (O2) for 8 days (27 to
      35 days of age) were studied following recovery in room air at 60 days of age
      using morphometric, biochemical, and physiological techniques. In an attempt to
      prevent chronic oxygen toxicity 153 rats had transtracheal catheters surgically
      implanted and were treated during the O2 exposure with daily intratracheal
      injections of liposome-encapsulated superoxide dismutase (SOD) and/or catalase
      (CAT). Oxygen exposure in this model results in chronic cardiopulmonary
      alterations which include pulmonary hypertension, right ventricular hypertrophy,
      and a decrease in number of pulmonary arterioles 25 to 50 microns in diameter
      with increased muscularization of their walls. The volume densities of the
      parenchyma, parenchymal air space, and the alveolar space are increased, while
      that of the combined alveolar ductal and respiratory bronchiolar space is
      decreased. Daily intratracheal administration of liposome-encapsulated CAT (160
      U) during the O2 exposure prevented these chronic changes. Liposome-encapsulated
      SOD (110 U) or SOD (50 U) + CAT (70 U) did not appear to have a preventive
      effect. During the first 3 to 5 days following oxygen exposure the lung tissue
      enzymes SOD, CAT, and glutathione peroxidase markedly increased. We conclude that
      in the young rat animal model liposome-encapsulated CAT (160 U) given
      intratracheally during the period of O2 exposure is safe and will prevent the
      chronic vascular and parenchymal damage due to oxygen toxicity.

PMID- 1758757
TI  - Effect of prenatal cocaine on respiration, heart rate, and sudden infant death
      syndrome.
AB  - We studied 114 neonates by pneumocardiogram recordings in order to examine the
      effects of cocaine with and without opiate exposure on neonatal respiration,
      heart rate, apparent life threatening events (ALTE), and sudden infant death
      syndrome (SIDS). In full-term infants exposed to cocaine without opiates we found
      increased longest apnea duration and more episodes of bradycardia, but decreased
      periodic breathing and average heart rate than in control full-term infants. Term
      infants prenatally exposed to cocaine with opiates also had less periodic
      breathing. Preterm infants exposed to cocaine with and without opiates had
      decreased apnea density and periodic breathing compared with preterm controls.
      Discriminant analysis to determine whether perinatal asphyxia or exposure to
      other drugs could predict cardiorespiratory abnormalities showed no consistent
      relationship. In 72 of 114 infants available for follow-up, no ALTE occurred but
      two were lost to SIDS. Our data support the hypothesis that prenatal cocaine
      exposure may perturb, albeit subtly, the maturation of respiratory control,
      resulting in disruption of postnatal respiration.

PMID- 1758758
TI  - The effect of lung mechanics on gas transport during high-frequency oscillation.
AB  - With the general aim of obtaining clinically relevant information on the use of
      high-frequency oscillation (HFO), we examined the effects of altering oscillatory
      frequency (f), tidal volume (VT), and mean airway pressure (Paw) on gas exchange
      in rabbits, both before and after altering the animal's pulmonary mechanics by
      saline induced lung injury. Twenty-seven combinations of f (5, 8, 12 Hz), VT
      (0.5, 1, 2 mL/kg), and Paw (5, 10, 13 cm H2O) were used. Acute pulmonary injury
      was induced by instilling 10 mL/kg of warm saline into the lung. Gas exchange was
      assessed by steady-state levels of arterial oxygen tension (PaO2) and carbon
      dioxide tension (PaCO2). Arterial PaO2 was independent of f or VT before or after
      lung injury; it was independent of Paw before injury but highly dependent on Paw
      after lavage. The difference was presumably related to lung volume recruitment.
      Arterial PaCO2 was dependent on f and VT but independent of Paw at any time. The
      relationship was modeled by the equation PaCO2 alpha fa. VTb where the exponents
      a = -0.4 and b = -0.6. Our technique of a standardized saline instillation gave a
      reproducible and stable model of lung injury. In damaged rabbit lungs the
      principles of HFO appear to be similar to conventional mechanical ventilation;
      oxygenation depends on Paw and inspired oxygen concentration, while CO2 removal
      is determined by f and VT.

PMID- 1758759
TI  - The effects of diuresis and transfusion on pulmonary function in children with
      thalassemia major.
AB  - Previous pulmonary function studies in subjects with thalassemia major (TM) who
      were on regular transfusion programs have demonstrated results ranging from small
      airway obstruction to a restrictive pattern. Ten subjects with TM were studied
      pre- and postdiuresis, and again 24 hr after transfusion, in order to evaluate
      the role of possible fluid overload in altering pulmonary function. Subjects
      underwent spirometry and had lung volume and flow volume curves (MEFVC) measured
      in a volume displacement plethysmograph while breathing air and a mixture of 80%
      helium and 20% oxygen (HeO2). Six patients had pulmonary mechanics measured with
      esophageal balloons in place. Baseline function was normal and no change occurred
      following diuresis. Following transfusion, the volume of isoflow (VisoV)
      decreased, but other parameters did not change. Subsequent analysis revealed 5
      subjects with an initial VisoV greater than 20 (% FVC) but, paradoxically, less
      evidence of flow limitation in the small airways than those with a VisoV less
      than 20 (% FVC). Posttransfusion, in those subjects with an initially high VisoV,
      the Vmax25(air) tended to fall without a change of MEFVC in HeO2, resulting in a
      decreased VisoV. This was interpreted as evidence of subtle abnormalities in the
      small airways caused by volume expansion, raising doubts about the value of the
      VisoV as a measure of small airway disease. As a group, our subjects did not
      demonstrate any abnormalities in baseline function. Some subjects had mild flow
      limitation in small airway while other developed comparable levels of flow
      limitation following the volume expansion associated with transfusion.

PMID- 1758760
TI  - Hering-Breuer reflex in young asthmatic children.
AB  - The aim of this study was to assess if the Hering-Breuer reflex could be provoked
      in young children. Thirty asthmatic children with a mean age of 5.3 years and 18
      healthy children with a mean age of 7.0 years were studied. The presence of the
      reflex was indicated by prolongation of the spontaneous expiratory time following
      application of continuous positive airways pressure (CPAP). The occurrence of the
      reflex was then related to age, compliance of the respiratory system (Crs)
      measured by weighted spirometry, functional residual capacity (FRC) determined by
      helium gas dilution, and the change in lung volume resulting from the application
      of CPAP. The asthmatic children in whom the Hering-Breuer reflex was observed
      tended to be younger (P less than 0.01) and the reflex was present in those
      children of both groups who had more compliant lungs (P less than 0.05). The FRC
      was not different in asthmatic children with and without the Hering-Breuer
      reflex, but healthy children in whom the reflex was present tended to have
      smaller lung volumes. The change in lung volume resulting from application of
      CPAP was significantly greater in those children of both groups in whom the
      reflex was present (P less than 0.01 asthmatics, P less than 0.02 healthy
      children). We conclude that the Hering-Breuer reflex may be provoked in young
      children.

PMID- 1758761
TI  - Esophageal pressure manometry in human infants.

PMID- 1758762
TI  - Tonal strength and melody recognition after long and short delays.
AB  - In a continuous-running-memory task, subjects heard novel seven-note melodies
      that were tested after delays of 11 sec (empty) or 39 sec (filled). Test items
      were transposed to new pitch levels (to moderately distant keys in the musical
      sense) and included exact transpositions (targets), same-contour lures with
      altered pitch intervals, and new-contour lures. Melodies differed in tonal
      strength (degree of conformity to a musical key) and were tonally strong, tonally
      weak, or atonal. False alarms to same-contour lures decreased over the longer
      delay period, but only for tonal stimuli. In agreement with previous studies,
      discrimination of detailed changes in pitch intervals improved with increased
      delay, whereas discrimination of more global contour information declined, again
      only for tonal stimuli. These results suggest that poor short-delay performance
      in rejecting same-contour lures arises from confusion that is based on the
      similarity of tonality between standard stimuli and lures. If a test item has the
      same contour and a similar tonality to a just-presented item, subjects tend to
      accept it. After a delay filled with melodies in other tonalities, the salience
      of key information recedes, and subjects base their judgments on more detailed
      pattern information (namely, exact pitch intervals). The fact that tonality
      affects judgments of melodic contour indicates that contour is not an entirely
      separable feature of melodies but rather that a melody with its contour
      constitutes an integrated perceptual whole.

PMID- 1758763
TI  - Auditory temporal summation in infants and adults: effects of stimulus bandwidth
      and masking noise.
AB  - A visually reinforced operant procedure was employed to determine the behavioral
      thresholds of 6- to 7-month-old infants and adults for stimuli of various
      bandwidths and durations. Experiment 1 compared absolute thresholds for broadband
      and 1/3-octave filtered clicks and 300-msec noise bursts. For adult subjects, the
      difference in threshold for clicks and noise bursts was quite comparable in the
      two bandwidth conditions, but infants' click-noise threshold differences were
      significantly larger for broadband than for 1/3-octave stimuli. In Experiment 2,
      2-point threshold-duration functions were compared for 4-kHz tones and octave
      band noise bursts presented in backgrounds of quiet and continuous noise.
      Infants' threshold-duration function for octave-band noise bursts was
      significantly steeper than the comparable adult function in quiet, but not in
      masking noise. These results suggest that young infants may have particular
      difficulty detecting low-intensity broadband sounds when durations are very
      short.

PMID- 1758764
TI  - Local and global mechanisms of one- and two-dimensional orientation illusions.
AB  - One-dimensional (1-D) orientation illusions induced on a test grating by a tilted
      and surrounding 1-D inducing grating have a well-known angular function that
      exhibits both repulsion and attraction effects. Two-dimensional (2-D) orientation
      illusions are those induced on a test grating by 2-D image modulation, such as a
      pair of superimposed inducing gratings at different orientations, usually
      orthogonal (a plaid). Given the known angular functions induced by the plaid
      component gratings, two hypotheses were developed that predicted different plaid
      induced illusion functions. Hypothesis 1 states that the 1-D component-induced
      effects simply add linearly; Hypothesis 2 states that there is an additional
      mechanism that responds to the virtual axes of mirror symmetry of the plaid and
      adds to the effect. The data of two experiments were consistent with the
      predictions from the second hypothesis but not the first. Possible neural
      substrates of mechanisms that extract axes of symmetry are discussed; it is
      suggested that such global symmetry axes may underlie the perceived orientation
      of complex shapes.

PMID- 1758765
TI  - Partial information or facilitation? Different interpretations of results from
      speed-accuracy decomposition.
AB  - The speed-accuracy decomposition technique was developed by Meyer, Irwin, Osman,
      and Kounios (1988) to examine the time course of information processing. The
      technique allows for the estimation of the accuracy of guesses that are induced
      by the presentation of a response signal on a proportion of trials. Estimated
      guessing accuracy has been found to be above chance and to increase as time of
      guessing increases, suggesting that guesses are based on partial information that
      has accumulated prior to a response decision (sophisticated guesses). In this
      paper, a different interpretation of these data is presented. Results suggest
      that response signals may enhance the speed of regular processes, thereby
      violating the temporal-independence assumption that underlies the decomposition
      technique. As shown by Monte Carlo simulations, such facilitating effects of
      response signals can explain the results from the decomposition technique at
      least in part and possibly in full, even when guesses are actually at chance
      accuracy (pure guesses). The pure-guess model was supported by the results from
      an experiment designed to test between the alternative interpretations. These
      results point to the need for great caution in the attempt to infer the time
      course of information processing from guessing accuracies as estimated by the
      speed-accuracy decomposition technique.

PMID- 1758766
TI  - Subcategorical phonetic mismatches and lexical access.
AB  - The place of phonetic analysis in the perception of words is unclear. While some
      theories assume fully specified phonemic strings as input, other theories assume
      that little analysis occurs. An earlier experiment by Streeter and Nigro (1979)
      produced evidence, based on auditorily presented words with misleading acoustic
      cues, that lexical decisions were based on mostly unanalyzed patterns, since word
      judgments were delayed by misleading information whereas nonword judgments were
      not. The present studies expand that work to a different set of cues, and to
      cases in which the overriding cue came first. An additional task, auditory
      naming, was used to examine the effects when the decision stage is less
      demanding. For the lexical decision task, misleading information slowed the
      responses, for both words and nonwords. In the auditory naming task, only the
      slower responses were affected. These results suggest that phonetic conflicts are
      resolved prior to lexical access.

PMID- 1758767
TI  - Spatial judgments of exocentric extents in an open-field situation: familiar
      versus unfamiliar size.
AB  - Carlson and Tassone (1971) found that an object of familiar size presented in an
      outdoor setting and viewed at an appreciable distance is judged to be more
      distant than an unfamiliar object. Three experiments examined whether object
      familiarity also affects spatial judgments of exocentric extents presented under
      conditions comparable to those of Carlson and Tassone's experiments. The markers
      of the extents were either familiar or unfamiliar objects. In Experiment 1,
      subjects reproduced the perceived extents of depth intervals by adjusting a
      comparison egocentric extent, and in Experiment 2, subjects also compared the
      relative depths of two equally long extents. In Experiment 3, the two equally
      long extents were presented in the subjects' frontoparallel plane, and the
      subjects reported which of these two extents appeared longer and farther away.
      The results of these experiments indicate that familiar size does not affect the
      perceived depths or lengths of exocentric extents viewed under naturalistic
      conditions.

PMID- 1758768
TI  - Second-order relational properties and the inversion effect: testing a theory of
      face perception.
AB  - Recognition of faces is more severely impaired by inversion than is recognition
      of other types of objects. This was originally interpreted as evidence for the
      existence of special face-recognition mechanisms. Recently, Diamond and Carey
      (1986) attributed the inversion effect to the use of second-order relational
      properties that are important for, but not unique to, face recognition. According
      to their hypothesis, face recognition differs from the recognition of most other
      objects in its dependence on second-order relational properties. This hypothesis
      was tested in two experiments by comparing the effects of inversion on the
      identification of dot patterns that differed in the extent to which they required
      the encoding of second-order relational properties. Identification of the second
      order relational patterns was not more disrupted by inversion than was
      identification of first-order patterns. These results fail to support the
      hypothesis that second-order relational properties are responsible for the
      inversion effect.

PMID- 1758769
TI  - The relationship between eye position and egocentric visual direction.
AB  - Hering's model of egocentric visual direction assumes implicitly that the effect
      of eye position on direction is both linear and equal for the two eyes; these two
      assumptions were evaluated in the present experiment. Five subjects pointed (open
      loop) to the apparent direction of a target seen under conditions in which the
      position of one eye was systematically varied while the position of the other eye
      was held constant. The data were analyzed through examination of the relationship
      between the variations in perceived egocentric direction and variations in
      expected egocentric direction based on the positions of the varying eye. The data
      revealed that the relationship between eye position and egocentric direction is
      indeed linear. Further, the data showed that, for some subjects, variations in
      the positions of the two eyes do not have equal effects on egocentric direction.
      Both the between-eye differences and the linear relationship may be understood in
      terms of individual differences in the location of the cyclopean eye, an unequal
      weighting of the positions of the eyes in the processing of egocentric direction,
      or some combination of these two factors.

PMID- 1758770
TI  - Fixation-point offsets reduce the latency of saccades to acoustic targets.
AB  - If an observer's fixation point is extinguished just prior to the onset of a
      peripheral target, the latency to saccade to that target is reduced. We show that
      this "gap effect" is not specific to visual targets. Observers made saccades to a
      light flash or to a white-noise burst. A warning tone was presented on every
      trial to control for the possible warning effect of the fixation-point offset.
      For both target modalities, saccade latencies were significantly reduced when the
      fixation point was extinguished 200 msec prior to the target onset. Implications
      of this outcome for interpretations of the gap effect are considered. It is
      argued that the presence of a gap effect for tones, in conjunction with previous
      findings, is consistent with the hypothesis that the gap effect is produced by a
      facilitation of premotor processes in the superior colliculus.

PMID- 1758772
TI  - Arabic children's pain descriptions.
AB  - A convenience sample of 60 children, aged five to 12 years, reporting to Kuwait
      government hospital emergency departments was studied. All were native Arabic
      speakers. Our aim was to compare the diagnostic usefulness of the pain
      information provided by children and by accompanying adults when interviewed
      under standard emergency department conditions. Children were asked to describe
      their current pain and how it had changed and to signify pain intensity using a
      10-point visual analog scale (VAS). Comparable data were then collected from the
      accompanying adult. Senior clinicians rated these verbal and VAS descriptions for
      their usefulness in arriving at a diagnosis. Most children provided useful pain
      information. Mothers received consistently higher scores for their VAS
      descriptions than their children did; otherwise, the pain data provided by adults
      were not judged to be significantly more useful. When clinicians and teachers
      were asked to differentiate which data they thought had been provided by a child
      and which by the accompanying adult, nearly half of their decisions were wrong.

PMID- 1758771
TI  - Visual search, visual streams, and visual architectures.
AB  - Most psychological, physiological, and computational models of early vision
      suggest that retinal information is divided into a parallel set of feature
      modules. The dominant theories of visual search assume that these modules form a
      "blackboard" architecture: a set of independent representations that communicate
      only through a central processor. A review of research shows that blackboard
      based theories, such as feature-integration theory, cannot easily explain the
      existing data. The experimental evidence is more consistent with a "network"
      architecture, which stresses that: (1) feature modules are directly connected to
      one another, (2) features and their locations are represented together, (3)
      feature detection and integration are not distinct processing stages, and (4) no
      executive control process, such as focal attention, is needed to integrate
      features. Attention is not a spotlight that synthesizes objects from raw
      features. Instead, it is better to conceptualize attention as an aperture which
      masks irrelevant visual information.

PMID- 1758773
TI  - Are parents accurate in their assessment of fluid volumes?
AB  - Ingestions constitute a common problem in pediatric emergency medicine.
      Management decisions are frequently based on parental assessments of the amount
      of the ingested material. The purpose of this study was to examine the accuracy
      of parental estimates of fluid volumes. One hundred parents of children seen in
      an outpatient clinic and emergency department were asked to estimate fluid
      volumes in four containers. There were no significant differences (P greater than
      0.05) in the accuracy of fluid volume assessment between younger and older
      parents, between participants with and without high school education, or between
      parents with one or more children. While most parents are accurate in their fluid
      volume estimates, 14.5% of the assessments were overestimates of over 300% of the
      actual volume. In view of our findings, caution should be used when management
      decisions are being based on parental fluid volume estimates.

PMID- 1758774
TI  - Extreme leukocytosis in patients presenting to a pediatric emergency department.
AB  - We determined the frequency and clinical significance of white blood cell (WBC)
      counts greater than or equal to 25,000/microliters in children presenting to an
      emergency department (ED) and defined a degree of leukocytosis which might be
      considered extreme in this setting. Records of all patients seen in the ED
      between February 1985 and December 1986 with WBC counts greater than or equal to
      25,000/microliters were identified. Each patient was paired with the
      chronologically nearest patient with a WBC count between 15,000 and
      25,000/microliters. Of the total WBCs obtained, 5.8% were greater than or equal
      to 25,000/microliters; only 1% were greater than or equal to 35,000/microliters.
      Eighteen percent of patients with counts greater than or equal to
      25,000/microliters had a serious disease, and 6% had bacteremia. Twenty-six
      percent of patients with counts greater than or equal to 35,000/microliters had a
      serious disease, and 10% had bacteremia. On the basis of infrequency and severity
      of illness, we suggest that, in children presenting to a pediatric emergency
      department, WBC counts greater than or equal to 35,000/microliters be considered
      extreme leukocytosis.

PMID- 1758775
TI  - Adenosine in the emergency management of supraventricular tachycardia.
AB  - In summary, adenosine is highly effective in terminating paroxysmal
      supraventricular tachycardia, and its very short half-life and benign side
      effects make it a promising alternative to other modes of therapy presently used.
      Further controlled prospective studies are needed before adenosine can become the
      drug of choice in the management of paroxysmal supraventricular tachycardia in
      children.

PMID- 1758776
TI  - The radiolucent wooden foreign body.
AB  - Wooden foreign bodies in the extremities are frequently not suspected at initial
      presentation. Most often, these foreign bodies are not visualized
      radiographically. Xeroradiography, ultrasound, computed tomography, and MRI have
      been described as useful adjuncts in foreign body detection and localization. In
      our case, a truly radiolucent wooden foreign body was well visualized on plain
      radiographs. The atypical appearance resulted in misinterpretation, and proper
      diagnosis and treatment were delayed.

PMID- 1758777
TI  - Reye's syndrome associated with acute myocarditis and fatal circulatory failure.
AB  - We describe an eight-month-old infant who had an unusually fulminant and fatal
      course of Reye's syndrome. The patient died 36 hours after admission because of
      irreversible circulatory failure not associated with clinical symptoms of
      increased intracranial pressure or cerebral herniation. Autopsy revealed the
      pathognomonic fatty degeneration of the liver and heart of Reye's syndrome, but
      the brain was normal. In addition, a marked inflammatory infiltration of the
      myocardium was also observed, which indicated that acute myocarditis had been the
      preceding underlying disease. This case report emphasizes the fact that the viral
      prodrome preceding Reye's syndrome may not be as benign as often observed with
      influenza and varicella. Acute myocarditis and Reye's syndrome are also a
      combination which may result in fatal cardiovascular collapse.

PMID- 1758778
TI  - Centipede ingestion by a six-month-old infant: toxic side effects.
AB  - Centipedes are a common household arthropod whose bite usually causes only local
      reactions. Ingestion of centipedes has not been previously reported. This article
      reports the case of a six-month-old infant who ingested a centipede of the
      Scutigera morpha species and had systemic side effects probably due to systemic
      absorption of its venom. The child recovered spontaneously after 48 hours. This
      case illustrates that toxic effects may be noted after ingestion of arthropods
      and that in this type of centipede no active intervention may be necessary.

PMID- 1758779
TI  - Intraspinal hemorrhage in a child with factor XIII deficiency.
AB  - The rarity of spinal cord injuries and hemorrhages and of fibrin-stabilizing
      factor XIII deficiency during childhood has induced us to report the case of this
      two-year-old boy with factor XIII deficiency who presented with cervical
      intraspinal hemorrhage between the C4 and C7 levels as well as paraplegia
      presumably following a minor trauma. The findings in this patient, who was
      brought in two weeks after the appearance of the first symptoms, indicate the
      importance of early diagnosis and early intervention to minimize the extent of
      the damage from the injury in such cases. The case also points to the need for
      close follow-up of patients with factor XIII deficiency for CNS bleeding.

PMID- 1758780
TI  - Should corticosteroids be used in the treatment of bacterial meningitis? Pro and
      con.

PMID- 1758781
TI  - Infusion pumps.

PMID- 1758782
TI  - Life-threatening infections.

PMID- 1758783
TI  - Acute respiratory distress in a young infant.

PMID- 1758784
TI  - The use of slap wrist ("snap-wrap") bracelets by young school-aged and preteen
      children.

PMID- 1758785
TI  - The cultural context of polio biographies.
AB  - Cultural contexts influence the ways individuals interpret and experience
      functional losses associated with post-polio sequelae. Using in-depth multiple
      interview case studies from two National Institute on Aging projects, the concept
      of "biographies" is presented to place the individuals' polio-related experiences
      within the context of their lives. Two major cultural contexts shape the
      construction of polio biographies: normative life course expectations and
      developmental tasks; and traditions associated with polio recovery and
      rehabilitation. The authors identify key dimensions of personal concern among
      polio survivors that can be used as entrance points for effective clinical
      intervention and to promote treatment compliance.

PMID- 1758786
TI  - The psychology of polio as prelude to post-polio sequelae: behavior modification
      and psychotherapy.
AB  - Even as the physical causes and treatments for post-polio sequelae (PPS) are
      being identified, psychological symptoms--chronic stress, anxiety, depression,
      and compulsive, Type A behavior--are becoming evident in polio survivors.
      Importantly, these symptoms are not only causing marked distress but are
      preventing patients from making the lifestyle changes necessary to treat their
      PPS. Neither clinicians nor polio survivors have paid sufficient attention to the
      acute polio experience, its conditioning of life-long patterns of behavior, its
      relationship to the development of PPS, and its effect on the ability of
      individuals to cope with and treat their new symptoms. We describe the acute
      polio and post-polio experiences on the basis of patient histories, relate the
      experience of polio to the development of compulsive, Type A behavior, link these
      behaviors to the physical and psychological symptoms reported in the National
      Post-Polio Surveys, and present a multimodal behavioral approach to treatment.

PMID- 1758787
TI  - Effect of treatment and noncompliance on post-polio sequelae.
AB  - In this study of 77 patients with post-polio sequelae (PPS), symptoms and manual
      test scores on initial evaluation were compared with those at subsequent follow
      up evaluations. Patients were divided into three groups based on the degree to
      which they had complied with clinically recommended interventions: compliers,
      partial compliers, and noncompliers. At the end of the follow-up period (2.2 +/-
      1.2 years), the mean muscle function scores of the entire study group had
      declined -1.5%, which represented a decline of -0.7% annually. On follow-up
      evaluations, the complier group had realized an improvement or resolution of post
      polio symptoms, and also an improvement in muscle function of +0.6% annually. The
      partial complier group had realized either no improvement, or improvement in post
      polio symptoms, but showed a further decline in muscle function of -3.0%, or an
      annual decline of -1.3%. The noncomplier group showed either no change, or a
      worsening of post-polio symptoms, and also showed a further decline in muscle
      function of -4.1%, which represented an annual decline of -2.0%.

PMID- 1758788
TI  - Assessment and differential diagnosis for post-polio syndrome.

PMID- 1758789
TI  - Activity and post-polio fatigue.
AB  - Fatigue was studied in 12 subjects with post-polio sequelae (PPS). Results of the
      Fatigue Severity Scale (FSS) demonstrated a mean score of 4.8 +/- 1.6 (non
      disabled scores = 2.3 +/- 0.7). The Human Activity Profile (HAP) was not
      sensitive enough to measure fatigue. Fifty percent of subjects scored below the
      first percentile based on age and sex matched norms. The Activity Record (ACTRE)
      results revealed that subjects spent 5% of their time resting and 1% in planning
      or preparation activities. Fatigue peaked in the late morning or early afternoon
      and was relieved by rest periods. Use of energy conservation and work
      simplification skills along with frequent rest periods was suggested as a
      possible method for managing PPS fatigue.

PMID- 1758790
TI  - Energy conservation, occupational therapy, and the treatment of post-polio
      sequelae.
AB  - Individuals experiencing post-polio sequelae (PPS) are usually advised to make
      significant lifestyle changes to lessen symptoms and prevent further decline in
      function. These individuals have spent most of their lives equating success with
      over-achievement and find it difficult to implement such recommendations. As
      specialists in energy conservation and work simplification, occupational
      therapyists increasingly are being called on to evaluate and treat these
      patients. Over the past 2 years, an occupational therapy educational program has
      been developed to educate patients about their condition and about ways to
      implement lifestyle changes while preserving the ability to do valued activities.
      This article describes the components of a thorough occupational therapy
      evaluation and the design and functional outcomes of a successful occupational
      therapy educational program to treat PPS.

PMID- 1758791
TI  - Effect of modified aerobic training on movement energetics in polio survivors.
AB  - Given that individuals with disabilities may be unable to achieve maximal oxygen
      uptake in an exercise test and that maximal exercise testing may cause increased
      fatigue, pain, and muscle weakness, we examined the role of submaximal exercise
      testing and training based on objective as well as subjective parameters in polio
      survivors. Experimental (N = 7) and control subjects (N = 13) were tested before
      and after a 6-week period. The experimental subjects participated in a 6-week
      exercise training program for 30 to 40 minutes, three times a week. The program
      consisted of treadmill walking at 55% to 70% of age-predicted maximum heart
      rates; however, exercise intensity was modified to minimize discomfort/pain and
      fatigue. Neither objective nor subjective exercise responses were significantly
      different in the control group over the 6 weeks. No change was observed in
      cardiorespiratory conditioning in the experimental group. However, movement
      economy, which is related to the energy cost of walking, was significantly
      improved; and walking duration was significantly increased at the end of
      training. Modified aerobic training may have a role in enhancing endurance and
      reducing fatigue during activities of daily living in polio survivors.

PMID- 1758792
TI  - The effects of long-term non-fatiguing resistance exercise in subjects with post
      polio syndrome.
AB  - Measures of torque were used to evaluate changes in muscle strength and endurance
      in 17 patients with post-polio syndrome who did prescribed resistance exercise
      for up to 2 years. Exercise compliance averaged 75%, with 16 subjects increasing
      the weight lifted in training. Maximum torque was significantly increased in the
      exercised muscle compared to the control muscle; no difference was seen in muscle
      endurance. Individuals with post-polio syndrome can increase muscle strength by
      doing non-fatiguing resistance exercise, but they should undergo quantitative
      testing of muscle strength a minimum of every 3 months to guard against overwork
      weakness.

PMID- 1758793
TI  - Post-polio fatigue: a 31P magnetic resonance spectroscopy investigation.
AB  - Changes in high energy phosphates (HEP) and intramuscular pH during exercise were
      measured in 17 patients with post-polio fatigue and in 28 healthy controls using
      31P magnetic resonance spectroscopy (MRS). Subjects performed a dynamic hand grip
      exercise at low and high intensity. Mean changes in the HEP and pH showed no
      significant differences between the groups, although the post-polio group's
      response was highly variable. Six patients showed evidence of a lower lactate
      accumulation during the high intensity exercise when compared with controls.
      These data suggest that the whole body fatigue experienced by polio survivors is
      not related to any systemic metabolic abnormality.

PMID- 1758794
TI  - Polioencephalitis, stress, and the etiology of post-polio sequelae.
AB  - Post-mortem neurohistopathologies that document polio virus-induced lesions in
      reticular formation and hypothalamic, thalamic, peptidergic, and monoaminergic
      neurons in the brain are reviewed from 158 individuals who contracted polio
      before 1950. This polioencephalitis was found to occur in every case of
      poliomyelitis, even those without evidence of damage to spinal motor neurons.
      These findings, in combination with data from the 1990 National Post-Polio Survey
      and new magnetic resonance imaging studies documenting post-encephalitis-like
      lesions in the brains of polio survivors, are used to present two hypotheses: 1)
      polioencephalitic damage to aging reticular activating system and monoaminergic
      neurons is responsible for post-polio fatigue, and 2) polioencephalitic damage to
      enkephalin-producing neurons is responsible for hypersensitivity to pain in polio
      survivors. In addition, the antimetabolic action of glucocorticoids on polio
      damaged, metabolically vulnerable neurons may be responsible for the fatigue and
      muscle weakness reported by polio survivors during emotional stress.

PMID- 1758795
TI  - The link between rehabilitation and orthopedics.

PMID- 1758796
TI  - Insulin resistance and hypertension--implications for treatment.

PMID- 1758798
TI  - Infection in exacerbations of asthma: views of different groups of practitioners.
AB  - A questionnaire designed to elucidate views on the frequency of infection in
      asthma and its management was circulated to general practitioners, general
      physicians, paediatricians and respiratory physicians in the north of England. On
      the whole, general practitioners agreed with the general physicians and
      paediatricians with respiratory physicians. The generalists, and to a lesser
      extent the specialists, tended to overestimate the risk of bacterial infection,
      which was perceived to be a particular risk following viral infection in
      intrinsic asthma. This resulted in more frequent prescription of antibiotics than
      is justified by the published evidence. There was a tendency for frequent
      prescribers of antibiotics to withhold corticosteroids. If prescribing habits are
      to be altered, education will have to be directed at those responsible for acute
      admissions to hospital as well as at general practitioners.

PMID- 1758799
TI  - Asian endoscopies: is there a difference?
AB  - In 1988 2062 adults had their first oesophagogastroduodenoscopy at Leicester
      General Hospital, of whom 224 (10.9%) were Asian. A greater proportion of the
      Asian patients were less than 45 years old (46% vs 24%), which reflects the age
      distribution of the local population. When the findings at
      oesophagogastroduodenoscopy were analysed in two age groups (less than or older
      than 45) there were no differences between the races in the younger group.
      However, in the older group duodenal disease was significantly more common in the
      Asians (P less than 0.001) whereas gastric disease was more common in Caucasians
      (P less than 0.05). The incidence of cancer was much lower in the Asians.

PMID- 1758797
TI  - General surgery.

PMID- 1758800
TI  - The practice of rectal examination.
AB  - Rectal (both digital and rigid sigmoidoscopic) examination is an important part
      of the clinical examination. The aim of this study was to find out the opinions
      of the patients to this routine examination at the time of referral by their
      general practitioner and during their first hospital interview. Assessment of the
      value for the rectal examination was also examined. We questioned 103 patients
      attending their second out-patient interview through a simple questionnaire. We
      discovered that patients considered awareness and explanation important: patients
      preferred to be told of the possibility of rectal examination prior to hospital
      consultation. Explanation of the method and reason was expected from hospital
      doctors. Formal consent was expected; informed verbal consent should be
      sufficient. Where logistically possible, a chaperone should always be present.
      Rectal examination would have facilitated the diagnosis in 47% of the patients
      examined. Thus, rectal examination should be performed on all patients where
      symptoms are referable to the lower gastrointestinal tract and where a possible
      diagnosis may be made or facilitated.

PMID- 1758801
TI  - Fatal splenic sequestration crisis in adult sickle cell-beta thalassaemia.
AB  - Fatal acute splenic sequestration crisis in an adult patient with sickle cell
      beta+ thalassaemia is described. To our knowledge fatal splenic sequestration in
      adult sickle cell-beta thalassaemia has not been previously reported.

PMID- 1758802
TI  - Rapid onset of blindness due to meningeal carcinomatosis from an oesophageal
      adenocarcinoma.
AB  - We report a 49 year old man who presented with left leg weakness, frontal
      headache, impaired concentration and dysphagia. He was thought to have a benign
      oesophageal stricture on barium swallow and oesophagoscopy though this was not
      initially biopsied. During admission his vision deteriorated so that he could
      only recognize bright light. Repeat oesophagoscopy demonstrated an oesophageal
      adenocarcinoma. The diagnosis of meningeal carcinomatosis was confirmed at post
      mortem. Sudden bilateral blindness is a common feature of meningeal
      carcinomatosis but, as this is rare, it is not commonly considered in the
      differential diagnosis of visual loss. The visual loss can be explained by
      vascular insufficiency in association with tumour cuffing of the subarachnoid
      space of the optic nerve sheath, by neuronal toxins, or other, as yet unknown,
      mechanisms.

PMID- 1758803
TI  - Rhabdomyolysis associated with cranial diabetes insipidus.
AB  - Rhabdomyolysis has been reported to be associated with hyperosmolality in
      diabetic ketoacidosis and non-ketotic hyperosmolal state. Whether the
      rhabdomyolysis was due to hyperosmolality per se or whether hyperglycaemia also
      played a role is not clear. We hereby report a case of cranial diabetes insipidus
      with hypernatraemia and hyperosmolality complicated by rhabdomyolysis. None of
      the known risk factors, such as coma, hypokalaemia, hypophosphataemia, diabetic
      ketoacidosis or non-ketotic hyperosmolality, were present in this patient. We
      believe that severe hyperosmolality per se is an important predisposing factor
      for non-traumatic rhabdomyolysis, and serum muscle enzymes should be closely
      monitored in the management of patients with diabetes insipidus.

PMID- 1758804
TI  - Coronary heart disease in diabetes mellitus--antecedents and associations.

PMID- 1758805
TI  - The chronic cardiovascular risk factor syndrome (syndrome X): mechanisms and
      implications for atherogenesis.

PMID- 1758806
TI  - The smoker with diabetes: a difficult challenge.

PMID- 1758808
TI  - Hypertension in non-insulin dependent diabetes mellitus and its management.

PMID- 1758807
TI  - Treatment of diabetes: the effect on serum lipids and lipoproteins.

PMID- 1758809
TI  - Specific lipid lowering therapy in the management of diabetes.

PMID- 1758810
TI  - Profound prolonged hypotension following captopril overdose.

PMID- 1758811
TI  - Percutaneous endoscopic gastrostomy in elderly patients.

PMID- 1758812
TI  - Clinical tutors and surgical tutors.

PMID- 1758813
TI  - Morphine myths: sedation, tolerance, addiction.
AB  - Morphine and other strong opioids are still, more than 180 years after the
      syntheses of morphine, not adequately used in clinical practice and many patients
      suffer unnecessarily severe pain in consequence. Governments limit morphine usage
      by legal restrictions. The underuse of morphine and its restriction in many
      countries is mostly due to prejudice and myths which clinical experience does not
      show to be true. Morphine is a very safe drug, correctly prescribed in chronic
      pain therapy, the only severe side effect being constipation.

PMID- 1758814
TI  - The incidence of cancer pain and improvement of pain management in Japan.
AB  - A nation-wide survey (1987) of cancer pain and analgesic methods showed that the
      incidence of pain in the terminal stage was in the range of 68 to 72% without any
      significant difference between hospital groups. Irrespective of the stage of
      illness, a certain analgesic effect was obtainable with oral/parenteral use of
      opioids. As a result of a year-to-year comparison of pain in cancer clinics, it
      was found that the rate of complete pain relief has increased for all stages of
      illness, especially in the terminal stage. Here the rate of complete pain relief
      steadily increased from 37.8% in 1986 to 42.7% in 1987 and 48.6% in 1988.
      Propagation of WHO-advocated cancer pain therapeutics has led to an improvement
      of the rate of pain relief in the terminal stage. Marketing of MS Contin tablets
      resulted in a dramatic increase in the consumption of morphine, but there was no
      increase in the rate of pain relief due to poor measures to counter adverse
      reactions, and to administration of morphine in insufficient doses. The
      consumption of morphine for medical use increased year by year, but a greater
      number of doctors experienced in the use of opioids would further improve the
      management of pain. To realize that, it would be necessary to incorporate
      terminal care into medical education programmes as soon as possible. Further
      efforts will be required for extensive research and propagation of analgesic
      methods in various fields including education in medicine, science of nursing and
      postgraduate education.

PMID- 1758815
TI  - Pain treatment in gynaecological cancer.
AB  - Women suffering from gynaecological malignancies are highly represented in
      patients with cancer pain: 19.3% of tumour related deaths in females are caused
      by breast carcinoma, 7.1% by carcinoma of the uterus, 6.7% by ovarian carcinoma
      and 2.3% by other malignant gynaecological tumours. These tumours may give rise
      to severe pain due to osseous metastases, nerve or plexus infiltration, soft
      tissue infiltration and (in the case of ovarian carcinoma) obstruction of the
      gastrointestinal tract. The experience represented in the literature and our own
      experience demonstrate that there are very effective measurements of symptom
      control in cancer pain. Based on the results of a specialized cancer pain control
      clinic at the University of Dusseldorf, Germany, recommendations will be given
      for the treatment of cancer pain. The use of nonsteroidal anti-inflammatory
      drugs, weak and strong acting opioids and co-analgesics in relation to the
      different sites of metastases as well as neurosurgical and anaesthetic manoeuvres
      are the subject of the presentation. Furthermore an overview of the psycho-social
      care of cancer patients by the social worker and the priest will be given.

PMID- 1758816
TI  - Relationship between plasma concentration of morphine and analgesic
      effectiveness.
AB  - Morphine is a key drug for cancer pain management. In this study, we analyzed
      plasma morphine concentration in cancer patients who received continuous morphine
      drip and/or oral administrations of morphine: (1) The plasma concentration of
      morphine varied widely in patients whose pain was satisfactorily controlled at a
      constant dosage of morphine. The absolute value of the plasma concentration of
      morphine necessary for effective pain control could not be estimated; (2) When MS
      Contin was given at the doses 20 mg, 30 mg, 40 mg, the plasma concentration of
      morphine increased with increasing dose. Thus, when the dose was increased
      according to the severity of pain, the plasma concentration of morphine increased
      and in turn an analgesic effect was obtained; (3) In those patients who had
      difficulty in taking oral preparations and/or blocked intestines, plasma
      concentration of morphine following oral administration was relatively low
      causing an unsatisfactory analgesic effect. However, by changing from oral
      administration to continuous drip infusion, the plasma concentration of morphine
      became higher and pain relief was obtained; (4) Continuous drip infusion of
      morphine progressively increased plasma concentration of morphine in parallel
      with the increase in the dose of morphine if the patients had no pleural
      effusion, ascites, and/or oedema. In contrast, plasma morphine concentration in
      patients with pleural effusion, ascites, and/or oedema was about half of that
      observed in patients who have normal distribution area. The rapid development of
      pleural effusion and ascites lowers the blood level of morphine; (5) To use the
      plasma concentration of morphine as an index for the analgesic effect, it is
      essential to develop a method to measure the plasma concentration of morphine
      rapidly.

PMID- 1758817
TI  - Morphine at gramme doses: kinetics, dynamics and clinical need.
AB  - The MS Contin tablet 200 mg (controlled release morphine sulphate) provides an
      equivalent rate and extent of absorption to two MS Contin tablets 100 mg. The
      characteristics of controlled release from this higher strength formulation are
      also consistent with those of the 100 mg tablet. The level of analgesia provided
      during the early post-dosing period, at the end of the dosing period and overall
      over the twelve hour interval were also equivalent between the preparations. The
      addition of the MS Contin tablet 200 mg to the existing range will facilitate
      oral dosing in patients requiring large doses of morphine. This extension to the
      range will increase the choice available to the clinician and provide a natural
      progression for those patients requiring a step-up in the dose titration
      procedure.

PMID- 1758818
TI  - Morphine pharmacokinetics and analgesia after oral administration.
AB  - The well established use of oral morphine in the treatment of chronic cancer pain
      has developed empirically and a knowledge of its pharmacokinetics is not
      necessary in order to use the drug effectively. However recent information about
      the pharmacokinetics of morphine may help resolve the controversy about oral to
      parenteral relative potency ratios, and may also in the future shed some light on
      the problem of patients whose pain does not respond to morphine.

PMID- 1758819
TI  - Family factors influencing cancer pain management.
AB  - The purpose of this study was to describe family factors which influence cancer
      pain. Previous research has focused on the patients' and professional caregivers'
      perspective of pain. Cancer pain is an intense burden on the entire family as
      well as on the patient. Findings of the study demonstrate family perceptions of
      pain, caregiver burden associated with pain, caregiver moods and differences in
      caregiver experiences of pain between three sites of care including a hospice, a
      community hospital and a cancer centre. Understanding the perspective of the
      family caregivers and their role in pain management can assist health care
      providers in management of the patient's pain.

PMID- 1758820
TI  - Morphine: myths, morality and economics.
AB  - It is a tragedy that morphine is scarcely available for between 1.3 and 2.5
      billion people whilst 3.5 million cancer patients suffer needlessly. In only 10
      countries is its consumption rising, in many more only codeine consumption shows
      an increase, and in many areas even in the Western world prescribing is grossly
      limited, fears of psychological addiction persist, professional education of
      doctors and nurses in analgesia remains minimal and too much importance is
      attached to expensive sophisticated methods of administration. Doctors have a
      professional and a moral responsibility to press for improved morphine
      availability in the most useful and economical forms worldwide.

PMID- 1758821
TI  - Morphine sulphate tablets in hospice practice.
AB  - Sustained release morphine sulphate tablets (MST Continus), have been available
      for use in New Zealand since 1984. They have become the major opioid in use for
      palliative and terminal care. The Mary Potter Hospice was founded in 1978 and is
      New Zealand's largest hospice. The records of 100 consecutive patients admitted
      to the Mary Potter Hospice Programme who were prescribed morphine sulphate
      tablets (MST) were collected prospectively in order to document current hospice
      usage of MST. It was found that MST was widely tolerated and was highly
      successful in controlling pain in the majority of patients. There was a wide
      dosage range and the dose required appears independent of pathology, age of
      patient or previous analgesic exposure. It was rapidly apparent when MST had been
      employed inappropriately. The commonest reasons for cessation of medication were
      death of the patient or their moribund state. Contrary to expectations nausea and
      vomiting were not frequent causes of stopping medication, neither were confusion
      nor altered states of consciousness. The advantages of MST were demonstrated
      giving evidence for the reasons this agent is now the principle opioid employed
      in palliative and terminal care in the Mary Potter Hospice.

PMID- 1758822
TI  - A clinical survey of controlled-release morphine sulphate for cancer pain relief
      in a Japanese hospice.
AB  - Seventy-six cancer patients were studied on the use of controlled-release
      morphine sulphate (MS Contin) for cancer pain relief in the hospice of Yodogama
      Christian Hospital in Japan. The mean initial and maximum dosages were 81.4 mg
      and 178.6 mg respectively. While 46 patients (61%) did not need an increase in
      the initial dosage, 26 patients (34%) needed an increase ranging between 8 and
      125%. Four patients (5%) required an increment of more than 500% of the initial
      dosage, because of apparent nerve involvement. This clinical survey showed that
      the total effectiveness was 92% and that 90% of the patients could experience
      control of pain with a daily dosage of 240 mg or less of MS Contin. Side effects
      observed were as follows: drowsiness 21%, nausea 11%, vomiting 8%, constipation
      8%, confusion 7%, hallucination 3%. In conclusion, MS Contin offers effective
      cancer pain relief with minimal side effects in the majority of patients.

PMID- 1758823
TI  - Experience with a controlled-release oral morphine for cancer pain management.
AB  - An open pilot study was performed to assess the analgesic efficacy and
      acceptability of a controlled-release oral morphine preparation. Between March
      1989 and August 1990, 50 patients were treated with MS Contin (morphine sulphate
      tablets-MS Continus) for the pain caused by advanced cancer. The participants
      consisted of 28 males and 22 females ranging in age from 8 to 78 years (median 52
      years). Twenty-two patients were actively receiving either cancer chemotherapy
      (15 patients), radiotherapy (2 patients), combined chemoradiotherapy (3 patients)
      or hormonal treatment (2 patients). Most of the subjects had pain caused by
      visceral disease and bone metastasis. A combination of causes was also present in
      19 patients. The patients had a wide variety of cancers the most common being
      stomach cancer. In 24 patients, concomitant non-opioid or non-morphine opioid
      analgesics were combined with MS Contin. The median duration between cancer
      diagnosis and MS Contin initiation was 11.0 months. MS Contin was given on
      average for 1.5 months. The median survival after study enrollment was 1.8
      months. Of the 50 enrolled patients, three left the study in the early phase due
      to drug-related adverse effects. In almost all the patients the effective dose
      was 60 mg/day with 45 days of response duration. The required duration for dose
      adjustment was nine days. The most common side effects were constipation and
      vomiting, which were controlled with conservative care. Two patients withdrew
      because of intractable vomiting and one because of mental drowsiness. In
      conclusion, twice-a-day moderate dose oral MS Contin therapy for cancer pain
      offers effective pain relief with minimal, tolerable side effects in the majority
      of patients in Korea.

PMID- 1758824
TI  - Cost considerations of analgesic therapy: an analysis of the effects of dosing
      frequency and route of administration.
AB  - Using work sampling methodologies, we compared both acquisition and
      administration costs of equivalent daily doses of controlled-release morphine
      tablets and morphine sulphate solution. A total cost for each drug therapy was
      derived by summing: (i) the acquisition cost of the medication, (ii) the cost of
      drug administration supplies, (iii) the cost of pharmacy time required for
      packaging and distribution of doses to nursing units, (iv) the cost of nursing
      time required to administer the medication, (v) the cost of nursing time required
      to complete the requisite narcotic records. Acquisition costs for controlled
      release morphine tablets, morphine sulphate solution and ancillary materials
      required for dosing were those actually paid by the hospital pharmacy at the time
      of the study. Costs for nursing and pharmacy time for administration of doses
      were based on our analysis of the time required to perform each step of the
      procedure and the median hourly wage for the corresponding position from the
      British Columbia collective agreement. Assuming a mean total daily morphine dose
      of 120 mg, administered as one 60 mg controlled-release morphine tablet 12 hourly
      or 20 mg (4 ml of 5 mg/ml) morphine sulphate solution 4 hourly, morphine solution
      had a lower acquisition cost than controlled-release tablets ($0.48 vs. $2.32 per
      day; respectively). However, the saving in acquisition costs was offset by a
      higher administration cost ($10.20 vs. $2.86 per day). These figures indicate
      that administration of 120 mg morphine per day to hospitalized patients for 30
      days would have a total cost of $155.40 using a regimen to 60 mg controlled
      release morphine 12 hourly. In contrast, total cost for a 30 day regimen of 20 mg
      morphine solution 4 hourly would be $320.40. Thus, an analysis which considers
      both acquisition and administration costs reveals that the frequency of
      administration is an important factor in the overall cost of drug therapy and
      that controlled-release formulations may ultimately be less costly to administer
      than their immediate release counterparts. A separate analysis of costs
      associated with the administration of morphine by continuous subcutaneous
      infusion demonstrated that providing analgesia by this route was significantly
      more costly than via the oral route.

PMID- 1758825
TI  - Guidelines for the use of MS Contin tablets in the management of cancer pain.
AB  - MS Contin (controlled-release oral morphine) has been successfully used to treat
      moderate to severe pain associated with cancer. The indication for administering
      MS Contin is not a poor prognosis, but rather pain requiring repeated dosing with
      potent opioids over periods of more than a few days. Individualization of
      analgesic dosage to each patient's needs can provide excellent relief of pain in
      most patients but require selection of the right analgesic in the right dose at
      the right intervals.

PMID- 1758826
TI  - AIDS and cancer pain treated with slow release morphine.
AB  - The use of slow release morphine was compared between those with cancer and those
      with advanced HIV disease in two retrospective studies covering a total of 512
      patients at home. Pain was found to be less severe in HIV/AIDS but still
      requiring opioid use in over a third of patients of which 14% needed subcutaneous
      diamorphine infusion when seriously ill at home. Slow release morphine was used
      by 45% of those with cancer and 17% of those with HIV/AIDS. It was found to be a
      simple and convenient preparation for use at home with most patients never
      needing more than 30 mg twice daily. Half the cancer patients prescribed slow
      release morphine were able to take it until the day of death.

PMID- 1758827
TI  - Hospice care in Japan.
AB  - In 1990 hospice care services in Japan entered a new era when the national
      government authorized medical insurance coverage for hospice care. Within the
      last decade in Japan, gradual yet remarkable progress has taken place in a
      perception of the need for hospice care services. It was in 1981 that the first
      hospice opened in Japan, followed by five other hospices in a 9 year period.
      These have been well received both by public and medical professionals, although
      many difficulties have been encountered in establishing them. It is hoped that
      further development will include an increase in the number of hospices, a growing
      awareness within general hospitals of hospice style approach to care, and
      additionally, an expansion in home care services.

PMID- 1758828
TI  - Angina clinical trial methodology.
AB  - This paper reviews the general structure of clinical trials with special
      reference to those in the area of angina. In particular, aspects of experimental
      design in exercise testing, ambulatory monitoring and mortality studies are
      examined critically. Parallel group and crossover studies are compared and
      contrasted. Sensitivity analysis of the power of any proposed trial is
      recommended, and problems that can arise in the area of event rate estimation are
      illustrated. Additional problems associated with trials involving combination
      therapies, trials with no placebo group and regression to the mean are discussed.

PMID- 1758829
TI  - Progression and regression of atheroma.
AB  - Normal human arteries accumulate lipid in the intima with increasing age. These
      lipids are laid down in proportion to their distribution in low-density
      lipoprotein, suggesting that they are derived from this source. With their
      accretion, the amount of cholesterol and its esters in the subintimal space
      increases significantly, leading to the development of insoluble crystals which
      are difficult to remove by any therapeutic intervention. It has been shown that
      treatment with a low-cholesterol diet combined with lipid-lowering drug treatment
      can halt progression of atherosclerotic lesions, but as yet ther is no conclusive
      evidence that consistent lesion regression is possible.

PMID- 1758830
TI  - Circadian rhythms in cardiovascular function.
AB  - This short overview discusses circadian rhythms observed in cardiovascular events
      such as myocardial ischaemia and myocardial infarction, which occur most
      frequently in the morning. Changes in the frequency of occurrence seem to be
      related to, and may result from, circadian rhythms in factors such as heart rate,
      blood pressure, coronary artery tone, platelet adhesiveness and blood
      fibrinolytic activity, which could be involved in triggering myocardial ischaemia
      or infarction. Consideration of the circadian rhythm of myocardial ischaemia and
      serious cardiovascular events may be important when medical therapy is selected.

PMID- 1758831
TI  - Nocturnal asthma: mechanisms and the role of theophylline in treatment.
AB  - Asthma is characterized by airway inflammation and hyper-responsiveness.
      Clinically, these features are manifested by attacks of cough, wheezing, and
      dyspnoea. Nocturnal asthma symptoms are frequent; 39% of asthmatics awaken
      nightly, and 94% have nocturnal awakenings at least once a month. A number of
      mechanisms have been hypothesized to explain the phenomenon of nocturnal asthma,
      including exposure to dust mite allergen, late-phase allergic reactions, effects
      of posture and sleep stage on airway tone, gastro-oesophageal reflex, impaired
      mucociliary clearance, airway cooling, and changes in circadian rhythms of
      circulating hormones. While no single mechanism can explain these changes,
      circadian rhythms may be particularly relevant. Normal airway tone increases
      during sleep and is magnified in asthmatics. Bronchial responsiveness to
      histamine and allergen challenge increases during sleep and mast cell mediator
      release is enhanced. Circulating eosinophils increase, which may allow their
      ingress into pulmonary tissue. Decreases in plasma catecholamine and cortisol
      levels have also been observed. All of these may influence airway tone,
      inflammation, and responsiveness during sleep and produce the observed clinical
      picture. Inhaled sympathomimetics are frequently ineffective in preventing
      nocturnal symptoms due to their short duration of action. While corticosteroids,
      cromoglycate, and anticholinergics are effective, sustained-release theophylline
      is particularly advantageous for controlling nocturnal symptoms. Once-daily
      theophylline when dosed in the evening not only controls nocturnal symptoms and
      improves airflow during the early morning hours, but decreases airway
      responsiveness to histamine as well. The close association between airway
      inflammation, airway hyper-responsiveness, and nocturnal asthma symptoms makes
      further studies of the mechanism of action of theophylline especially
      interesting.

PMID- 1758832
TI  - Role of theophyllines in severe chronic obstructive pulmonary disease.
AB  - Theophyllines are effective bronchodilators, but have other respiratory effects
      which may be beneficial in patients with chronic obstructive pulmonary disease.
      These effects include increased diaphragmatic contractility, central respiratory
      stimulation and anti-inflammatory actions. Some controversy exists however on the
      precise role of these effects in the clinical setting. We examined the effects of
      a long-acting theophylline preparation (Uniphyllin Continus) on pulmonary
      function, and on ventilation and gas exchange during rest, sleep and exercise in
      a group of 12 patients with severe (FEV1 32 +/- 8.3% predicted), but stable
      chronic obstructive pulmonary disease. The study was randomised, placebo
      controlled, and double-blind in nature. Preliminary analysis of the data
      indicates a significant improvement in the degree of hyperinflation and gas
      trapping with theophylline, and oxygen levels were improved during rest, sleep
      and exercise while on theophylline. These findings confirm a beneficial effect of
      theophylline in such patients.

PMID- 1758833
TI  - What use is steady-state theophylline in severe chronic obstructive pulmonary
      disease? A preliminary report.

PMID- 1758834
TI  - [Therapy of severely mentally-retarded patients with depressive symptoms in long
      term inpatient facilities].
AB  - Early childhood communication and interaction often can be found in the severely
      mentally retarded. Adequate responding to this kind of behaviour plays a crucial
      role in the therapy of symptoms of depression.

PMID- 1758835
TI  - [Stress and coping with stress by mothers of children with mild cerebral
      dysfunctions].
AB  - Adapting the paradigm developed by Richard Lazarus, parenting stress and coping
      were studied among mothers of children (n = 42) with Minimal Brain Dysfunction
      (MBD) and mothers with non-disabled children (n = 42), aged 6 to 9. The children
      of control mothers were matched by age, sex, social status, and maternal marital
      status with the MBD children. The mothers of MBD children were found to
      experience more parenting difficulties, more negatively toned cognitive
      appraisals of their stakes in parenting and less positive adaptational outcomes
      than their controls. The mothers of MBD children appraised their mastery lower
      than their controls. However, family well-being, or self-esteem did not differ
      between the mothers of MBD children and their controls.

PMID- 1758836
TI  - [Report on the International Congress of Child and Adolescent Psychiatry in Bad
      Homburg].

PMID- 1758837
TI  - Cigarette smoking in the Multiple Risk Factor Intervention Trial (MRFIT).
      Introduction, overview, method, and conclusions.

PMID- 1758838
TI  - Comparison of smoking behavior change for SI and UC study groups. MRFIT Research
      Group.
AB  - BACKGROUND: The results of MRFIT smoking intervention program are presented for
      the 4,103 special intervention and 4,091 usual care men who reported smoking
      cigarettes at the first screening visit. RESULTS: Among the special intervention
      men, the reported cessation rate increased from 43.1% at 12 months to 48.9% at 72
      months. The reported cessation rate among the usual care men increased from 13.5%
      at 12 months to 28.8% at 72 months. Among smokers who reported cessation at 72
      months, 51.3% of special intervention men and 22.7% of usual care men had quit
      smoking within the first year and remained abstinent thereafter. Average
      thiocyanate and expired-air carbon monoxide served as objective measures of
      smoking and were significantly lower among the special intervention men than
      among the usual care men over the entire follow-up period. The reported cessation
      rates at 72 months varied according to initial levels of smoking. Smokers
      reporting 1-19 cigarettes per day at entry were more likely to quit than heavier
      smokers. For each category of smoking at entry (1-19, 20-39, and 40 or more
      cigarettes per day) significantly more special intervention than usual care
      smokers reported cessation. CONCLUSION: These results indicate that the MRFIT
      smoking intervention program was successful in promoting early cigarette smoking
      cessation and maintaining cessation over the entire trial for a large percentage
      of cigarette smokers.

PMID- 1758839
TI  - Evaluation of two biological markers of tobacco exposure. MRFIT Research Group.
AB  - This study assesses serum thiocyanate and expired-air carbon monoxide based on
      findings for 8,895 participants in the Multiple Risk Factor Intervention Trial.
      For each marker and combination of markers, a logistic probability model was used
      to generate a plot of true positive vs false positive rates (an operating
      characteristic curve), an optimal cutpoint, and the positive predictive value for
      discriminating tobacco smokers (cigarettes, pipes, cigars, or cigarillos) from
      non-tobacco smokers. Optimal cutpoints were 83 mumols/liter for thiocyanate and
      10 ppm for carbon monoxide. These cutpoints were applied to the entire group to
      evaluate accuracy. Specificity was higher for carbon monoxide than for
      thiocyanate (91.8 vs 87.3%) and sensitivity was lower (85.7% for carbon monoxide
      vs 88.8% for thiocyanate). When carbon monoxide and thiocyanate were both used,
      specificity was 92.7% and sensitivity was 89.1%. The estimated cutpoints derived
      from the Multiple Risk Factor Intervention Trial result in predictive values
      greater than 87% when the prevalence of smokers is greater than 50%. Cutpoints
      should be modified to maximize the predictive value when the prevalence of
      smokers is less than 50%. Both serum thiocyanate and carbon monoxide are good
      markers of smoking exposure. Serum thiocyanate may be preferable to carbon
      monoxide because of its longer half-life.

PMID- 1758840
TI  - Baseline factors associated with smoking cessation and relapse. MRFIT Research
      Group.
AB  - BACKGROUND: Data on smoking cessation and relapse for 6 yers of the Multiple Risk
      Factor Intervention Trial were evaluated in univariate and multivariate analyses
      to determine the relationship between variables measured at the beginning of the
      trial and smoking cessation and relapse for special intervention and usual care
      participants. RESULTS: The variables positively associated with smoking cessation
      in both the SI and the UC groups included age, education, and past success in
      quitting; there was a negative association with the number of cigarettes smoked
      per day. The expectation of quitting was positively associated with cessation in
      the special intervention group only, while life events, alcohol, and the presence
      of a wife who smokes were significant predictors of reduced cessation for the
      usual care group. The special intervention program may have overcome obstacles
      which interfered with cessation among the usual care participants. Associations
      with relapse were generally stronger in the usual care group than in the special
      intervention group. For usual care participants, multivariate analyses showed
      that education, past success in quitting smoking, alcohol, and life events were
      associated with relapse rates. For special intervention participants, only
      alcohol emerged as a significant predictor. Conclusion. The data are relevant in
      terms of factors that govern smoking cessation and relapse for adult smokers who
      take part in formal intervention programs and for those who are left to modify
      their behavior on their own.

PMID- 1758841
TI  - Smoking cessation and change in diastolic blood pressure, body weight, and plasma
      lipids. MRFIT Research Group.
AB  - Cigarette smoking cessation was examined for its impact on diastolic blood
      pressure, weight, and plasma lipids in 3,470 special intervention males in the
      Multiple Risk Factor Intervention Trial. Change in smoking status (quitters vs
      nonquitters) was not independently associated with change in diastolic blood
      pressure or the subsequent use of antihypertensive medication for smokers who
      were normotensive at entry. More quitters (35%) became hypertensive than
      nonquitters (27%, P less than 0.01), although the groups had similar baseline
      diastolic blood pressure levels. Weight gain subsequent to cessation probably
      contributed to this excess incidence of hypertension in quitters. Stepped-care
      antihypertensive therapy lowered diastolic blood pressure similarly for
      hypertensive quitters and nonquitters. Weight increases of 6 lb or more by the 72
      month visit occurred in 47% of quitters vs 25% of nonquitters (P less than 0.01);
      quitters did not differ from nonquitters in their change in total kilocalories
      from baseline to the 72-month visit. Quitters who gained 6 lb or more tended to
      be less obese at baseline, be less physically active, and smoke more cigarettes
      per day than those who did not gain this amount. Finally, quitters relative to
      nonquitters experienced an adjusted increase of 2.4 mg/dl high-density
      lipoprotein cholesterol, but no difference in total or low-density lipoprotein
      cholesterol. The implications for intervention are discussed as they relate to
      the common, but not inevitable, increase in weight subsequent to cessation.

PMID- 1758842
TI  - Pulmonary function in relation to cigarette smoking and smoking cessation. MRFIT
      Research Group.
AB  - BACKGROUND: More than half of the subjects in the MRFIT smoked at baseline and
      10% of the subjects stopped smoking permanently during the first year of the
      trial. In this report, rates of decline in forced expiratory volume in 1 sec
      (FEV1) are compared for early permanent quitters and smokers who continued to
      smoke throughout the trial. METHODS: Since pulmonary function testing was not
      standardized across all centers until the third annual visit cycle, change in
      FEV1 is examined over the latter half of the trial; the level of FEV1 is analyzed
      cross-sectionally at the midpoint of the trial. Analyses are limited to 4,926
      subjects who never used beta-blockers or smoked cigars, cigarillos, or pipes
      during the trial and who had annual FEV1s measured over 2-4 years in the latter
      half of the trial. RESULTS: Quitters during the first 12 months experienced
      smaller declines in FEV1 over the latter half of the trial than continuing
      smokers, with -50.7 ml/year versus -59.0 ml/year, respectively, adjusted for the
      level of FEV1 (P = 0.05). Cross-sectionally, those who had never smoked, former
      smokers, quitters, and continuing smokers showed a gradient of decreasing FEV1,
      and all four smoking groups were significantly different from each other (P less
      than 0.05). CONCLUSIONS: These data suggest that if a middle-aged, healthy smoker
      stopped smoking permanently, he could expect his FEV1 to deteriorate at a more
      gradual rate 3-4 years after stopping smoking than a similar smoker who continued
      to smoke. No information was available for the complete MRFIT cohort on the
      pulmonary function effects immediately following smoking cessation.

PMID- 1758843
TI  - Cigarette smoking and mortality. MRFIT Research Group.
AB  - METHODS: The relationship of cigarette smoking and smoking cessation to mortality
      was investigated among men screened for and also among those randomized to the
      Multiple Risk Factor Intervention Trial (MRFIT). RESULTS: Among the 361,662 men
      screened for the MRFIT, cigarette smoking was an important risk factor for all
      cause, coronary heart disease (CHD), stroke, and cancer mortality. These risks,
      on the log relative scale, were strongest for cancers of the lung, mouth, and
      larynx. The excess risk associated with cigarette smoking was greatest for death
      from CHD. Overall, approximately one-half of all deaths were associated with
      cigarette smoking. Among the 12,866 randomized participants, weak positive
      associations with duration of cigarette smoking habit and tar and nicotine levels
      were found with all-cause mortality. For both SI and UC men, substantial
      differences in subsequent CHD (34-49%) and all-cause (35-47%) mortality were
      evident for men who reported cigarette smoking cessation by the end of the trial
      compared with those continuing to smoke. There was no evidence that lung cancer
      death rates were lower among cigarette smokers who quite compared with those who
      continued to smoke in this 10-year follow-up period. CONCLUSION: The data are
      consistent with results of previous epidemiologic studies indicating that the
      benefits of smoking cessation on CHD are rapid, while for lung cancer, the
      benefit is not evident in a 10-year follow-up period.

PMID- 1758844
TI  - Association between baseline risk factors, cigarette smoking, and CHD mortality
      after 10.5 years. MRFIT Research Group.
AB  - METHODS: The association between baseline risk factors and death from coronary
      heart disease (CHD) after 10.5 years was investigated for cigarette smokers and
      nonsmokers who entered the Multiple Risk Factor Intervention Trial (MRFIT).
      RESULTS: Rates per thousand person-years of CHD mortality were higher for smokers
      than for nonsmokers at every level of baseline risk factors examined. There were
      significant associations between CHD mortality and plasma low-density lipoprotein
      and high-density lipoprotein cholesterol for smokers and nonsmokers. The inverse
      association between CHD mortality and high-density lipoprotein cholesterol was
      significantly stronger among nonsmokers compared with that among smokers and was
      attributable to a very strong association for former smokers. An inverse
      relationship between CHD and body mass index was evident for smokers and
      nonsmokers. Rates of CHD death rose sharply when levels of fasting glucose
      exceeded 140 mg/dl, and there was a significant association between CHD mortality
      and blood sugar levels for nonsmokers but not for smokers. For both smokers and
      nonsmokers, an inverse univariate association between alcohol consumption and CHD
      mortality was evident. This association, however, did not persist after
      adjustment for plasma high-density lipoprotein cholesterol. CONCLUSION:
      Intervention on blood pressure and blood lipids is particularly important among
      cigarette smokers because of their increased risk of CHD death. The different
      associations between high-density lipoprotein cholesterol, fasting serum glucose,
      and CHD mortality for smokers and nonsmokers requires further investigation.

PMID- 1758845
TI  - [The history of tuberculin therapy--its discovery by Robert Koch, its forerunners
      and further development].
AB  - Since tuberculosis had not been known either in its nature or in its proper
      therapeutics for thousands of years, Robert Koch (1843-1910) 1882 discovered its
      germs and 1890 recommended its treatment with tuberculin, i.e. an extract of its
      bacterial cultures. During the "Tuberkulin-sturm" which ensued from the
      publication of Koch, the substance was at once proved in numerous clinics in many
      countries. But in spite of sophisticated procedures of production it could not
      become standard therapy because of its considerable side-effects when not being
      applied accurately. In selected cases therapy with tuberculin is still applied
      even today. However, the effort of treating tuberculosis with tuberculin had
      already been made before its propagation by Robert Koch. Yet the forerunners of
      Koch's therapy with tuberculin had not been recognized by scientific medicine at
      the time because of lacking plausibility of its fundamental principles--not
      before Emil von Behring (1854-1917) within his scientific researches came to an
      explicit recognition of the homeo- and isopathetic principle of treatment.

PMID- 1758846
TI  - [Bronchoalveolar lavage in fibrosing alveolitis--a parameter for evaluating
      activity and prognosis?].
AB  - Bronchoalveolar lavages (BAL) were performed in 19 patients in whom fibrotising
      alveolitis had been detected and confirmed. The patients were then followed up
      and controlled clinically for more than 12 months. The courses of the diseases
      did not reveal any group-specific behaviour (taking lymphocytic and granulocytic
      lavages into consideration) and were not predictable on the basis of the lavage
      patterns. With a BAL lymphocytosis, 40% of the patients showed clinical
      improvement and in 30% the disease became stable whereas in another 30% there was
      a deterioration. If more than 10% BAL granulocytes were present, 50% of the
      patients showed clinical deterioration, whereas the course became stable in 37.5%
      and clinical improvements were recorded in 12.5% of the patients.

PMID- 1758847
TI  - [Aspects of mucociliary clearance in mucoviscidosis].
AB  - Very often the respiratory tract of patients suffering from mucoviscidosis is
      infested with Pseudomonas aeruginosa which is accused of forming substances that
      inhibit ciliary motility. It is the aim of the present study to examine the
      influence of an acute and clinically relevant pseudomonas infestation on the
      ciliary beat frequency. The ciliary beat rate was determined in 25 mucoviscidosis
      patients, 13 of them were hospitalised because of acute bronchopulmonary
      infections. 12 of the patients did not show any clinical signs of an acute
      respiratory tract infection. In the group of the 13 hospitalised patients, 10
      patients (77%) showed infestation of the respiratory tract with Pseudomonas
      aeruginosa, the mean ciliary beat frequency being markedly reduced at 8.2 +/- 1.7
      Hz compared to that of a healthy group with 9.9 +/- 1.0 Hz. The 12 outpatients
      without clinical signs of acute respiratory tract infections did not show any
      reduction of the ciliary beat frequency (9.9 +/- 1.4 Hz). Basing on these
      results, determination of the ciliary beat frequency may possibly develop into an
      auxiliary criterion to decide on starting a Pseudomonas-active antibiotic
      therapy.

PMID- 1758848
TI  - [Effects of the PAF antagonist WEB 2086 on hypoxia and angiotensin II-induced
      pulmonary vasoconstriction in the isolated perfused rat lung].
AB  - Using isolated blood-perfused lung preparations of rats, we tested the influence
      of the PAF antagonist WEB 2086 on vasoconstriction triggered by hypoxia or
      angiotensin II (A II). If a constant flow was pre-set, changes in the
      prepulmonarily measured pressure were directly related to the changes of
      resistance in the pulmonary flow. WEB 2086 reduced the hypoxically conditioned
      vasoconstriction (HPV) when using blood as perfusion medium, the effect being
      dependent on the dose (ED50 = 127.3 +/- 21.1 mg/l). HPV was lowered on the
      average by 82% if the full pharmacologic dose of 800 mg/l WEB 2086 was added to
      the perfusate. The A II response was weakened to a lesser degree (by 45%). If
      plasma was used as perfusate, the pressure increase in response to hypoxic
      stimulation or A II was less marked. However, the relative effect of the PAF
      antagonist was analogous (attenuation by 83% or 53%, respectively). In
      chronically hypoxic animals (3 weeks at 10% O2) the relative pressure drop in the
      lesser circulation after application of WEB 2086 (400 mg/l; HPV; blood as
      perfusate) was definitely more pronounced (p less than 0.001). The fact that WEB
      partly antagonises the pulmonary vasoconstriction triggered both by alveolar
      hypoxy and by angiotensin II, seems to indicate that in both constrictive stimuli
      PAF participates in the complex mediator mechanism or that WEB 2086 exercises a
      non-specific vasodilatory effect on the pulmonary flow.

PMID- 1758849
TI  - [Pearl oyster dust as the cause of exogenous allergic alveolitis].
AB  - Many different inhalative substances may cause allergic alveolitis
      (hypersensitivity pneumonitis). We report on a worker who developed lung fibrosis
      due to the sensitization to pearl oyster shell dust. High concentrations of IgG
      antibodies to proteins (conchagens) of the shell which appear to represent the
      relevant antigens were found in the patient's serum.

PMID- 1758850
TI  - [The role of phenotypic factors in predicting the effectiveness of
      pharmacological prevention of tuberculosis in children].
AB  - The role of genetic markers such as dermatoglyphics, sex and INH inactivation in
      predicting the efficiency of tuberculosis chemoprophylaxis has been studied in 76
      children (41 boys and 35 girls) with a tuberculin reaction reversal. The
      dermatoglyphic signs and the type of INH inactivation were found to be related to
      the efficiency of chemoprophylaxis. This makes it possible to use the child's
      phenotype for prognosis and better individual approach to tuberculosis
      chemoprophylaxis. An association has been found between the INH inactivation type
      and dermatoglyphics.

PMID- 1758851
TI  - [Improving ambulatory services for children in the foci of tuberculosis with
      special reference to the factors of increased risk of infection].
AB  - The paper deals with the results of the examination of certain factors that
      increase the risk of children's contamination in tuberculosis infection foci. It
      has been established that primary infection takes place more frequently in
      children under 6 years of age (1.3-fold), in children who do not attend preschool
      establishments (2-fold), in those having inappropriate BCG vaccination and
      revaccination (2.4-fold) and in the foci where patients abuse alcohol (2.2-fold).
      These children comprise a group of especially high contamination risk. It is
      expedient to check up them 3 times a year, performing a tuberculin test in
      children showing an uncertain response, to conduct clinical and X-ray
      examinations in accordance with the indications and to strictly controlled
      chemoprophylaxis. The proposed scheme of children's medical examination is one of
      the pattern to make better therapeutic and preventive measures in tuberculosis
      infection foci.

PMID- 1758852
TI  - [Groups with the risk of tuberculosis].
AB  - A specially developed screening was used to examine 652 workers of an assembly
      shop of a watch plant whose work is characterized by their being in a constrained
      position for hours which leads of general inactivity and hypoventilation.
      Disturbances of external respiratory function were found in 180 (27.6%) subjects,
      which is associated with their working conditions rather than with smoking. These
      subjects deserve special care since the pre-clinical obstructive bronchial
      changes can be the precursors of broncho-pulmonary diseases and later of
      tuberculosis.

PMID- 1758853
TI  - [Differential diagnosis of disseminated processes in the lungs in adolescents].
AB  - The paper deals with the data of follow-up of adolescents with disseminated
      pulmonary processes of different etiology. Among the patients who were treated in
      the department during the last 10 years disseminated processes amounted to 3.3%,
      with disseminated pulmonary tuberculosis being recorded in 1.3% and dissemination
      of the nontuberculous etiology in 2% of the patients. Mucoviscidosis, metastasis,
      of the thyroid cancer, histiocytosis X, toxoplasmosis and echinococcosis were
      among the disseminations of the nontuberculous etiology. Basic diagnostic
      criteria have been determined.

PMID- 1758854
TI  - [Effectiveness of using external laser irradiation in the complex treatment of
      patients with pulmonary tuberculosis with concomitant bronchial obstruction
      syndrome].
AB  - External laser radiation (ELP) (18-20 daily procedures) was used together with
      chemotherapy in the combined treatment of 53 patients with destructive pulmonary
      tuberculosis characterized by delayed dynamics of the process and concurrent
      obstructive bronchial syndrome. ELR promoted acceleration of the process
      dynamics, closure of disintegration cavities and alleviation of bronchial
      obstruction phenomena. The mechanisms of a favourable ELR action were essentially
      due to the reduction of basal oxidative metabolism and enhancement of defensive
      reaction during contact with a specific pathogen in phagocytes, which was
      confirmed by the recorded results of the spontaneous and stimulated by the killed
      BCG culture NST rest in peripheral neutrophils and monocytes.

PMID- 1758855
TI  - [Effectiveness of the treatment of patients with fibrous-cavernous pulmonary
      tuberculosis].
AB  - The follow-up of 301 patients with fibrous-cavernous pulmonary tuberculosis has
      demonstrated that the disease outcome and treatment effectiveness depend on the
      nature of its course. A long-term specific therapy for 9-10 months brings about
      cessation of bacillary excretion in 50-60% of cases even in a progressive course
      of the disease and closure of destruction cavities occurred in 12.5% of cases
      with rapid progression and in 21.7% of cases with slow progression of the
      disease. Despite all measures taken, stabilization of the process fails in one
      fourth of the patients with rapidly progressing fibrous-cavernous tuberculosis
      and in 9% of those with a slowly progressing course. In 90% of cases bacillary
      excretion in patients with stable fibrous-cavernous tuberculosis ceased in 3
      months and in 100% after 6 months of treatment.

PMID- 1758856
TI  - [The hemostatic system in patients with pulmonary tuberculosis during their
      preparation for surgery].
AB  - The basic mechanisms responsible for equilibrium impairment in the hemostatic
      system in pulmonary tuberculosis patients are reduced activity of antithrombin
      III and disturbances of platelet functional capacities. These changes were proved
      to reflect the course of intravascular hemocoagulation whose degree of
      manifestation is related directly to the extent of specific lesions in the lungs
      and intoxication phenomena. The process of intravascular hemocoagulation in
      tuberculosis patients runs in the presence of an increased concentration of
      plasma fibronectin , while major surgery performed in patients with fibrous
      cavernous processes leads to its reduced level. It is pathogenetically proved to
      use antithrombin III concentrate preparations with anti- and dysaggregatory
      properties, fibronectin preparations, trasylol or its analogs during complex
      preoperative preparation of patients.

PMID- 1758857
TI  - [Evaluation of the contractile capacity of the ureter and kidney pelvis in
      tuberculosis by the method of infusion dynamic uretero- scintigraphy].
AB  - The radionuclide method--infusion dynamic ureteroscintigraphy--was used to
      examine 123 patients with tuberculosis of the urinary organs and 51 patients of
      the control group. Contractility parameters of various portions of the ureters
      and pelves in varying urinary tuberculosis were established. The contractility of
      the pelves and ureters was proved to be impaired even prior to the appearance of
      visible X-ray changes in the ureters. A specific increase in contractility in the
      area from the pelvis to the middle third of the ureter and further reduction in
      the lower third were seen.

PMID- 1758858
TI  - [Functional disorders of the central nervous system in patients with pulmonary
      tuberculosis].
AB  - Two groups of pulmonary tuberculosis patients were followed up to reveal the
      relation between the lipid peroxidation (LPO) processes and the function of the
      central nervous system (CNS) in pulmonary tuberculosis. Group 1 (n = 76) included
      subjects with normal baseline electroencephalographic findings; group 2 (n = 41)
      consisted of those with profound changes in the electroencephalogram. The
      findings of LPO processes were assessed by the blood levels of malonic dialdehyde
      and alpha-tocopherol. Group 2 showed a direct relationship between the
      progression of neurotic symptoms and the abnormal changes in the values of LPO
      processes. It is concluded that it is expedient to use antioxidants in the
      combined treatment of pulmonary tuberculosis patients to eliminate the baseline
      CNS changes caused by the specific process.

PMID- 1758859
TI  - [Problem of cutaneous tuberculosis].
AB  - Case histories of 97 patients were analysed to study the diagnosis, differential
      diagnosis and incidence of recurrences of tuberculosis of the skin. A combined
      examination revealed Basin erythema in 57.7% of the patients, lupus vulgaris in
      29.9% and papulonecrotic tuberculosis of the skin in 12.4%. Recurrences were
      recorded in 15.4% of the cases. Our study gives evidence that tuberculosis of the
      skin is diagnosed from the combined examination of the patient in which
      histologic study of a skin biopsy specimen is most essential. The differential
      diagnosis of tuberculosis of the skin makes difficult the distinction between the
      disseminated forms and allergic vasculitis and sarcoidosis of the skin. The
      relapse depends on how adequate the major and antirecurrence courses of
      antibacterial therapy were.

PMID- 1758860
TI  - [Status of the hemostatic system in patients with chronic lung diseases].
AB  - Blood rheologic properties and homeostasis system were comprehensively examined
      in 23 patients with fibrous-cavernous pulmonary tuberculosis and 58 patients with
      various chronic nonspecific pulmonary diseases complicated by respiratory
      failure. The patients were found to have signs of erythrocyte edema, their more
      rapid depletion, lower resistance and higher aggregation which was accompanied by
      increased hematocrit and normal erythrocyte count. The thromboelastograms showed
      that all all phases of blood coagulation were shortened and fibrinolysis was
      deeply depressed. There was an increase in activated partial thromboplastin and
      thrombin time, a reduction in the values of the prothrombin indices and
      antithrombin III activity and higher heparin levels. The fibrinogen level was
      either normal or reduced despite an increase in other acute phase reactants,
      followed by the appearance of large amounts of blocked fibrinogen in the blood.
      Analysis of the findings enabled one to regard a combination of the above changes
      as signs of the latent DIC syndrome. Determination of fibrin and fibrinogen
      degradation products in a deep and long-term inhibition of fibrinolysis loses its
      diagnostic significance.

PMID- 1758861
TI  - [Extra-focal instrumental fixation of the spine in the surgical treatment of
      tuberculous spondylitis].
AB  - The complex procedure for treating tuberculous spondylitis involving a short-term
      (1-2 months) antibacterial therapy and early functional resection of the diseased
      vertebral bodies with defect replacement by an autograft and extra-focal fixation
      of the resected spinal portion by Byzov's apparatus applied in 492 patients
      proved to be highly efficacious. The reliable apparatus fixation of the spinal
      zone operated on allows early (on day 7) activation of patients which promotes
      functional normalization of organs and systems, activation of reparative
      processes, shortening of treatment duration and reduction of disabled cases.
      Clinical and X-ray findings show that a bone block formed 4-6 months after
      surgery and 67% of the patients finished their therapy during a year.
      Introduction of the procedure into the treatment of spinal injuries and diseases
      will be of the socioeconomical value.

PMID- 1758862
TI  - [Tuberculosis of the endocrine system (thyroid, adrenal and pituitary glands)].

PMID- 1758863
TI  - [Detection of antibodies against Mycobacterium tuberculosis in patients with lung
      diseases by immunoenzyme analysis].
AB  - Diagnostic enzyme immunoassay kits were used for the examination of parallel
      tests of venous and capillary blood in 43 patients with nonspecific pulmonary
      diseases for the presence of antibodies to tuberculosis pathogen. The method of
      parallel tests has revealed that disregarding the site of blood collection (vein,
      finger) the EIA results are identical. Analysis sensitivity in tuberculosis
      patients varies within 30 and 86% in relation to the clinical activity of a
      tuberculosis process. Analysis specificity in tuberculosis patients is 3.4%.

PMID- 1758864
TI  - [Use of dimephosphon in pathogenetic therapy of experimental tuberculosis].
AB  - The results of a study of a new synthetic drug dimephosphon used as a
      pathogenetic means in the treatment of experimental tuberculosis are presented.
      Dimephosphon was found to be responsible for both the in vivo and in vitro
      decrease of the degree of MBT resistance to rifampicin. The findings of
      macroscopic, histologic and bacteriologic examinations demonstrated a significant
      increase in the effectiveness of antituberculous therapy. Dimephosphon
      monotherapy in mice elicited manifested stimulation of peritoneal macrophages:
      increase in O2- production, and decline in extracellular 5-nucleotidase activity.
      Nemolysine-synthetic cellular splenic activity in mice rose essentially. No
      direct stimulating influence of dimephosphon on functional macrophage activity in
      vitro was found.

PMID- 1758865
TI  - [Experimental bioplasty of tuberculous caverns of the lung].
AB  - A possibility of using allontransplants of the "Alloplant" series for pulmonary
      cavernoplasty has been developed and substantiated experimentally. Histological
      studies of an experimental pulmonary cavern under conditions of
      allotransplantation revealed the dynamics of the morphological transformation
      typical of human pulmonary cavern healing. A reparative process results in the
      liquidation of the specific changes in the cavern wall followed by the formation
      of a regenerate in the form of a stellate cicatrix.

PMID- 1758866
TI  - [Causes of recurrences of pulmonary tuberculosis].

PMID- 1758867
TI  - [Extended thoracoplasty with extra-pleural embolization in patients with
      disseminated pulmonary tuberculosis].

PMID- 1758868
TI  - [Possibilities of computerized immunodiagnosis of tuberculosis and related lung
      diseases].
AB  - The results of a computer analysis of immunograms for the differential diagnosis
      of tuberculosis, cancer, pneumonia and sarcoidosis are presented. The findings
      indicate that computer immunodiagnosis may be used as a supplementary tool that
      increases the effectiveness of diagnosis in difficult cases. The advantage of the
      elaborated system is to rapidly apply a systemic approach to the assessment of
      the patient's immune status and to objective diagnosis by using computer
      algorithms.

PMID- 1758869
TI  - Comparative studies on the detection of hepatitis B virus DNA in frozen and
      paraffin sections by the polymerase chain reaction.
AB  - The polymerase chain reaction (PCR) is an extremely sensitive technique that has
      been used for detection of DNA sequences in formalin-fixed, paraffin-embedded
      tissues. In order to verify that hepatitis B virus (HBV) DNA sequences are
      adequately preserved in routinely processed liver tissues, we performed PCR with
      five different primer pairs for HBV sequences on DNA extracted by two different
      methods from paraffin and frozen liver sections. The amount of PCR products
      obtained with DNA templates extracted by the proteinase K-SDS method from frozen
      sections was significantly larger than that from paraffin sections. However,
      boiling of deparaffinized sections in water containing Chelex-100 resulted in
      ample amounts of PCR products irrespective of the primers used. On Southern
      blots, the location of the bands of amplified DNA obtained by the different
      methods was consistent with the predicted size, suggesting that the viral
      sequences had not been altered by processing. Although freezing of fresh tissue
      yields quantitatively more HBV DNA, formalin fixation qualitatively preserves the
      viral DNA sequences adequately for detection by PCR. Therefore, formalin-fixed,
      paraffin-embedded tissues may be used for the detection of viral DNA sequences by
      PCR. Application of the described procedure to routinely processed tissues
      significantly broadens the applicability of this powerful diagnostic and
      investigative method.

PMID- 1758870
TI  - Immunohistochemical studies of human immunodeficiency virus-1 in liver tissues of
      patients with AIDS.
AB  - A wide spectrum of hepatic lesions has been reported in AIDS, but it is not known
      whether the changes are related to the presence of human immunodeficiency virus
      type 1 (HIV-1). Therefore, we examined liver sections from 15 consecutively
      autopsied patients with AIDS for the presence of HIV-1 antigens p24 (core) and
      gp41 (envelope) by the avidin-biotin-peroxidase complex method using monoclonal
      antibodies. The most common histologic abnormalities noted were steatosis, portal
      inflammation, Kupffer cell hyperplasia, and focal hepatocellular and bile duct
      damage. Intra-hepatic opportunistic organisms were detected in six of 15 (40%)
      cases, with Mycobacterium avium-intracellulare being the commonest (four cases).
      Immunoreactivity for HIV-1 antigens was demonstrated in 12 of 15 cases (80%),
      with staining limited to Kupffer cells and other mononuclear cells characterized
      by a lymphoid morphology. Approximately the same number and type of cells were
      stained with both monoclonal antibodies and did not bear any relation to the
      degree of histologic abnormalities nor to the presence of opportunistic
      infections. The data suggest that some pathologic changes in AIDS livers are more
      likely the result of an indirect effect mediated by infected resident and
      circulating mononuclear cells than a direct cytopathic effect of HIV-1.

PMID- 1758871
TI  - Immunocytochemical characterization of a monoclonal antibody directed against
      mitochondria reactive in paraffin-embedded sections.
AB  - The monoclonal antibody mES 13 was previously produced against bacterially
      expressed BALB ras p21 and was reported to have both membrane and cytoplasmic
      reactivity in formalin-fixed, paraffin-embedded tissue sections. In the current
      study, the cytoplasmic reactivity of mES 13 is investigated and demonstrated to
      be mitochondrial. Immunoelectron microscopic studies showed specific labeling of
      mitochondria without labeling of other organelles. In normal tissues, the
      antibody strongly labeled tissues known to have large amounts of mitochondria
      such as renal tubules, hepatocytes, and myocardium. The pattern of reactivity of
      tumors generally mimicked that of normal tissues, with carcinomas and melanomas
      usually showing stronger staining than sarcomas and lymphomas. Two granular cell
      tumors were negative. Among renal neoplasms, mES 13 strongly labeled renal
      oncocytomas and granular cell renal cell carcinomas and showed weaker staining of
      clear cell and chromophobe cell tumors. The mES 13 antibody should be useful in
      the characterization and diagnosis of tumors in which oncocytoma is in the
      differential diagnosis, especially when only paraffin-embedded tissue is
      available for study.

PMID- 1758872
TI  - Blood pressure and nephrosclerosis in black and white men and women aged 25 to
      54.
AB  - Kidney samples obtained at autopsy were evaluated for nephrosclerosis by
      quantitatively measuring the severity of intimal fibroplasia in the interlobular
      arteries and counting the number of hyalinized arterioles. Most cases were
      obtained from the coroner and had violent causes of death; subjects with
      cardiovascular diseases were excluded. Blood pressures in Health Survey data were
      obtained from published sources. Measures of nephrosclerosis in 365 black and
      white men and women in age groups 25 to 34, 35 to 44, and 45 to 54 yr were
      examined by three-way Analysis of Variance (ANOVA). Blacks exceeded whites in
      fibroplasia at all ages and in both sexes; this excess was paralleled by mean
      blood pressure in all comparisons. White women were not different from white men
      in fibroplasia; black women significantly exceeded black men at all ages. Women
      had lower blood pressures than men when matched for age, race, and fibroplasia;
      the average magnitude of this difference was 5.5 mm Hg. Since women are known to
      have as much hypertensive disease as men after age 50 yr, it seems possible that
      the arterial fibroplasia seen in young women may represent progression toward the
      hypertensive state, even through blood pressure does not reveal the equality of
      the sexes in this respect until after menopause. Hence, in women arterial
      fibroplasia is seen to precede a later rise in blood pressure. Arteriolar
      hyalinization was greater in men than in women but did not differ significantly
      between races. Hyalinization did not consistently follow blood pressure in
      comparisons between subgroups of subjects.

PMID- 1758873
TI  - Transthyretin immunoreactivity in choroid plexus neoplasms and brain metastases.
AB  - Although choroid plexus papillomas (CPP) and primary choroid plexus carcinomas
      (CPC) are rare neoplasms of the central nervous system, they have been the
      subject of a number of immunohistochemical studies. To date, no unique or
      specific marker for these neoplasms has been found, however. Normal choroid
      plexus is a major site of transthyretin (TTR) synthesis, and recently this
      protein has been proposed as a possible specific marker of choroid plexus
      differentiation in tumors. In this study, we performed immunohistochemistry for
      TTR on 13 choroid plexus tumors (six CPP and seven CPC) and on 23 carcinomas
      metastatic to the brain, four of which had a papillary architecture. We also
      included four ovarian teratomas that contained choroid plexus elements. Two of
      the CPP had diffuse staining for TTR, while the four others stained only focally.
      Five of the CPC stained only focally and less intensely than the control, while
      one case was negative. Only one CPC stained as strongly and diffusely as normal
      choroid plexus. Two of the papillary and six of the nonpapillary metastases had
      focal staining similar to that seen in the five focally positive CPC. The choroid
      plexus elements of the ovarian teratomas stained as strongly as the positive
      control. These findings indicate that TTR immunoreactivity is not restricted to
      primary choroid plexus tumors. Furthermore, most choroid plexus carcinomas stain
      only weakly or not at all. This limits the usefulness of TTR immunohistochemistry
      in the diagnosis of primary choroid plexus neoplasms and in the distinction of
      CPC from metastatic carcinoma.

PMID- 1758874
TI  - Morphometry and the differential diagnosis between peripheral neuroepithelioma
      and neuroblastoma.
AB  - The differential diagnosis based on morphology between neuroblastoma (NB) and
      peripheral neuroepithelioma (PN) is difficult, since these tumors share many
      architectural and cytological features. In this study, a morphometrical approach
      to this diagnosis is made by using nuclear (shape factors) and tissue (volume
      density of nuclei and stroma) parameters. Quantitative morphological analysis
      adds important information, which when used with clinical and biochemical data
      facilitates the distinction. In the majority of cases, nuclei of PN are
      significantly less round than those of NB and their profile is much more
      irregular. The density of neoplastic nuclei is significantly higher in PN.
      However, in a certain number of cases, even the morphometrical study confirms how
      difficult it may be to differentiate these two neoplastic entities, since the
      values of parameters are largely overlapping. This suggests the existence of a
      "continuum" of changing features between NB and PN, which may substantiate the
      hypothesis of a common histogenesis.

PMID- 1758875
TI  - Reliability of 3H-thymidine labeling index: cell proliferation of colorectal
      carcinoma in three different centers.
AB  - Although the 3H-thymidine labeling index (TLI) has been used extensively as a
      biologic marker of increased susceptibility to neoplasms or as a prognostic
      indicator of the clinical outcome in cancer patients, there is still some concern
      regarding its accuracy and reliability as a marker of cell replication. A study
      on the prognostic value of TLI in colorectal cancer gave us the ability to
      evaluate how such a measurement may vary in different laboratories. A total of
      150 malignant tumors of the large bowel were studied in the period from 1988 to
      1989. Microautoradiography was carried out in tumor fragments taken at surgery.
      There were only slight differences among the three centers involved in the
      investigation, mainly as regards the culture medium, exposure time, and the
      addition of O2 + CO2 during the incubation. No significant difference was
      observed among TLI values recorded in the three centers (18.3 +/- 0.9; 17.4 +/-
      0.9; 15.7 +/- 1.0 mean +/- SE), and the ranges of values were almost identical.
      Similarly, the numbers of total and of labeled cells counted for each patient
      were comparable among the three centers. The frequency distribution of TLI showed
      a peak value between 10 and 19.9% in all three centers. Moreover, more than 80%
      of the observed values were within the range of 10 to 29.9%. In addition, the
      neoplastic areas with the highest proliferative activity ("high" TLI) showed a
      frequency distribution once again rather similar among the three
      centers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758876
TI  - Endocervical involvement by endometrial carcinoma on fractional curettage: a
      clinicopathological study of 37 cases.
AB  - This is a retrospective study of 37 patients with endometrial carcinoma and
      presence of tumor on endocervical curettage (clinical Stage II). We intended to
      correlate the presence or absence of endocervical stromal invasion with the
      clinical behavior and other prognostic factors. Based on the endocervical
      curettage, three categories (CAT) were defined: CAT I: tumor fragments only
      (seven cases); CAT II: endocervical tissue and free-floating tumor fragments (13
      cases); and CAT III: endocervical tissue and tumor with evidence of stromal
      invasion (17 cases). Five tumors were partly of clear cell and/or papillary
      serous types and three of them belonged to CAT I. Six of seven tumors with a
      nuclear Grade 3 were in CAT III (p less than 0.05). Nine patients had local
      recurrence, metastases, or died of their disease (median follow-up: 56 mo) and
      seven of them were in the CAT III (p less than 0.05). We conclude that despite
      the presence of tumor on the endocervical curettage, the lack of endocervical
      tissue invasion is associated with a lower nuclear grade and a less aggressive
      behavior. These tumors should be regarded and treated as Stage I disease. Special
      attention must be paid to staging of clear cell and papillary serous
      adenocarcinomas because of the tendency for these tumors to contaminate the
      endocervical curettage.

PMID- 1758877
TI  - Immunohistochemical and ultrastructural spectrum of hepatic sarcomas of
      childhood: evidence for a common histogenesis.
AB  - Hepatic sarcomas of childhood, which appear heterogeneous by standard morphologic
      criteria, pose challenging diagnostic and nosologic problems to the pediatric
      surgical pathologist. To identify features of these tumors that might help to
      clarify their origin and histologic classification, we studied 13
      undifferentiated (embryonal) sarcomas of the liver (UESL) and two intrinsic
      hepatic rhabdomyosarcomas (RMS) using immunohistochemical and electron
      microscopic techniques. Immunohistochemical staining was performed on 14 tumors
      with use of commercially available antibodies against a variety of markers, as
      well as peanut agglutinin lectin; electron microscopy was performed on five UESL
      and both RMS. Desmin was expressed by 6/12 UESL and 2/2 RMS, muscle-specific
      actin by 5/12 UESL and 2/2 RMS, neuron-specific enolase by 1/12 UESL and 1/2 RMS,
      alpha-1-antitrypsin by 8/12 UESL and 1/2 RMS, and alpha-1-antichymotrypsin by
      10/12 UESL and 1/2 RMS. Cytokeratin expression was observed in only four UESL.
      The overlap of immunohistochemical staining patterns and ultrastructural features
      shown by these obstensibly different tumors suggests a common histogenesis,
      perhaps from a multipotential mesenchymal stem cell.

PMID- 1758878
TI  - Immunocytochemical detection of p53 in human gliomas.
AB  - Since previous published studies of astrocytomas have shown alterations in the
      short arm of chromosome 17, and this chromosomal location is that which encodes
      the p53 protein, we used a monoclonal antibody and immunocytochemistry to detect
      this protein in a series of brain biopsies. The normal p53 protein has a short
      half-life and is not detectable using this method. Expression of an altered p53
      protein was detected in 29 of 71 brain biopsies, but only in those that showed
      astrocytic features. p53 expression was detected in 20/32 glioblastomas, 5/12
      anaplastic astrocytomas, and 3/5 mixed anaplastic oligo-astrocytomas, but only in
      astrocytic cells. It could not be detected in any other histologic types of
      primary brain neoplasms, either benign or malignant. The protein was detected in
      only 1/11 biopsies interpreted as showing gliosis, but this was in a patient who
      had previously had a resection for glioblastoma, and may have represented
      unrecognized infiltrating astrocytoma cells. The p53 protein was also expressed
      in the nuclei of the two human astrocytoma cell lines examined, U251MG and D54MG.
      These results are in general agreement with previous detailed chromosomal
      analyses that have found loss of heterozygosity in up to 60% of malignant
      astrocytic gliomas.

PMID- 1758879
TI  - In memoriam--Cyrus Levinthal.

PMID- 1758880
TI  - FASTRUN: a special purpose, hardwired computer for molecular simulation.
AB  - We describe the design, construction, and performance of a special purpose,
      hardwired accelerator for molecular mechanical calculations called FASTRUN. The
      processor was designed at Columbia University in 1984, constructed in the
      Instrumentation Division of Brookhaven National Laboratory, and delivered to
      Columbia in final form in 1989. It was rendered functional for molecular
      mechanics in early 1990. Together with its host Star array processor, FASTRUN has
      a measured performance for molecular dynamics simulations which compares
      favorably with present day supercomputers. The hardware replication cost of
      FASTRUN is on the order of $100,000.00.

PMID- 1758881
TI  - Changes in the electron density of the cofactor NADPH on binding to E. coli
      dihydrofolate reductase.
AB  - Quantum-mechanical electron density calculations reveal that a significant
      polarization is induced in the cofactor NADPH (reduced nicotinamide adenine
      dinucleotide phosphate) on binding to the enzyme dihydrofolate reductase. The
      calculations indicate that electron density corresponding to approximately 0.7
      electron charges is shifted within the molecule, extending over more than 20 A.
      Further calculations on proposed enzyme mutants show that the polarization of
      NADPH on binding to DHFR is, in large part, induced by a motif of three
      positively charged residues. This motif was also identified to be directly
      responsible for the positive electrostatic potential surrounding the cofactor
      binding site in the enzyme. The possibility of this long-range polarization of
      NADPH was originally proposed based on a previous study of ligand binding to DHFR
      where a conserved structural motif of three positively charged residues was found
      to play a major role in polarizing the substrate folate over its entire length of
      18 A.

PMID- 1758882
TI  - Protein-protein recognition analyzed by docking simulation.
AB  - Antibody-lysozyme and protease-inhibitor complexes are reconstituted by docking
      lysozyme as a rigid body onto the combining site of the antibodies and the
      inhibitors onto the active site of the proteases. Simplified protein models with
      one sphere per residue are subjected to simulated annealing using a crude energy
      function where the attractive component is proportional to the interface area.
      The procedure finds clusters of orientations in which a steric fit between the
      two protein components is achieved over a large contact surface. With five out of
      six complexes, the native structure of the complexes determined by X-ray
      crystallography is among those retained. Docked complexes are then subjected to
      conformational energy refinement with full atomic detail. With Fab HyHEL 5 and
      lysozyme, a native-like complex has the lowest refined energy. It can also be
      retrieved when starting with the X-ray structure of free lysozyme. However, some
      non-native complexes cannot be rejected: they form large interfaces, have a large
      number of H-bonds, and few unpaired polar groups. While these are necessary
      features of protein-protein recognition, they are not sufficient in determining
      specificity.

PMID- 1758883
TI  - Protein folding and association: insights from the interfacial and thermodynamic
      properties of hydrocarbons.
AB  - We demonstrate in this work that the surface tension, water-organic solvent,
      transfer-free energies and the thermodynamics of melting of linear alkanes
      provide fundamental insights into the nonpolar driving forces for protein folding
      and protein binding reactions. We first develop a model for the curvature
      dependence of the hydrophobic effect and find that the macroscopic concept of
      interfacial free energy is applicable at the molecular level. Application of a
      well-known relationship involving surface tension and adhesion energies reveals
      that dispersion forces play little or no net role in hydrophobic interactions;
      rather, the standard model of disruption of water structure (entropically driven
      at 25 degrees C) is correct. The hydrophobic interaction is found, in agreement
      with the classical picture, to provide a major driving force for protein folding.
      Analysis of the melting behavior of hydrocarbons reveals that close packing of
      the protein interior makes only a small free energy contribution to folding
      because the enthalpic gain resulting from increased dispersion interactions
      (relative to the liquid) is countered by the freezing of side chain motion. The
      identical effect should occur in association reactions, which may provide an
      enormous simplification in the evaluation of binding energies. Protein binding
      reactions, even between nearly planar or concave/convex interfaces, are found to
      have effective hydrophobicities considerably smaller than the prediction based on
      macroscopic surface tension. This is due to the formation of a concave collar
      region that usually accompanies complex formation. This effect may preclude the
      formation of complexes between convex surfaces.

PMID- 1758884
TI  - Information-theoretical entropy as a measure of sequence variability.
AB  - We propose the use of the information-theoretical entrophy, S = -sigman pi log2
      pi, as a measure of variability at a given position in a set of aligned
      sequences. pi stands for the fraction of times the i-th type appears at a
      position. For protein sequences, the sum has up to 20 terms, for nucleotide
      sequences, up to 4 terms, and for codon sequences, up to 61 terms. We compare S
      and Vs, a related measure, in detail with Vk, the traditional measure of
      immunoglobulin sequence variability, both in the abstract and as applied to the
      immunoglobulins. We conclude that S has desirable mathematical properties that Vk
      lacks and has intuitive and statistical meanings that accord well with the notion
      of variability. We find that Vk and the S-based measures are highly correlated
      for the immunoglobulins. We show by analysis of sequence data and by means of a
      mathematical model that this correlation is due to a strong tendency for the
      frequency of occurrence of amino acid types at a given position to be log-linear.
      It is not known whether the immunoglobulins are typical or atypical of protein
      families in this regard, nor is the origin of the observed rank-frequency
      distribution obvious, although we discuss several possible etiologies.

PMID- 1758885
TI  - Computer design of bioactive molecules: a method for receptor-based de novo
      ligand design.
AB  - The design of molecules to bind specifically to protein receptors has long been a
      goal of computer-assisted molecular design. Given detailed structural knowledge
      of the target receptor, it should be possible to construct a model of a potential
      ligand, by algorithmic connection of small molecular fragments, that will exhibit
      the desired structural and electrostatic complementarity with the receptor.
      However, progress in this area of receptor-based, de novo ligand design has been
      hampered by the complexity of the construction process, in which potentially huge
      numbers of structures must be considered. By limiting the scope of the structure
      space examined to one particular class of ligands--namely, peptides and peptide
      like compounds--the problem complexity has been reduced to the point that
      successful, de novo design is now possible. The methodology presented employs a
      large template set of amino acid conformations which are iteratively pieced
      together in a model of the target receptor. Each stage of ligand growth is
      evaluated according to a molecular mechanics-based energy function, which
      considers van der Waals and coulombic interactions, internal strain energy of the
      lengthening ligand, and desolvation of both ligand and receptor. The search space
      is managed by use of a data tree which is kept under control by pruning according
      to the energy evaluation. Ligands grown by this procedure are subjected to follow
      up evaluation in which an approximate binding enthalpy is determined. This
      methodology has proven useful as a precise model-builder and has also shown the
      ability to design bioactive ligands.

PMID- 1758886
TI  - Review on crystal polymorphism of substances in the European pharmacopoeia.
AB  - Substances in the European Pharmacopoeia, reported as having polymorphism are
      reviewed. For these substances the analyst may expect irregular melting behaviour
      and IR spectra.

PMID- 1758887
TI  - Optimization of doxorubicine incorporation and of the yield of
      polybutylcyanacrylate nanoparticles.
AB  - The preparation from w/o microemulsion of polybutylcianacrylate nanocapsules
      incorporating doxorubicine was optimized applying a multivariate experimental
      design. Different variables were investigated; the responses were polymer yield,
      concentration of the drug in the particles and percentage of the drug
      incorporated. A preliminary study was carried out with the strategy of fractional
      factorial design; the following step was a central composite design in order to
      study the most important causal variables. The information collected were treated
      by the response surface method (REGFAC package). The optimization allowed to
      maximize the responses; an incorporation of about 10% of doxorubicine and a yield
      of about 95% were obtained, starting from values notably lower of both
      incorporation and yield.

PMID- 1758888
TI  - Fluor determination in toothpaste-extracts with fluoride-selectrode based on the
      kinetics of hydrolysis of sodiummonofluorophosphate.
AB  - The Sodiummonofluorophosphate is used in a large number of toothpastes, s, while
      clinical research proved that application of fluoride has an important
      contribution in caries prevention. This prevention is almost due to the
      reconstitution of the by acids disappeared hydroxylapatite Ca10 (PO4)6 (OH)2 in
      the toothsurface, which process goes two to three times faster in the presence of
      F- by sedimentation of hydroxyfluorapatite Ca10 (PO4)6 (OH)2-xFx, with a higher
      chemical resistance for acids. Therefore, the F- must been released from the FPO3
      - during the application of the pasta, e.g. by hydrolysis in the mouth. Solutions
      of Na2FPO3 seem to release an important amount of free F- ions, without addition
      of acid, and as a function of concentration, time and temperature. The hydrolysis
      of FPO3-- is pH-dependent and can be studied as a pseudo-first-order reaction.
      The dependence of the pH is found in the kinetic expression: -dC/dt = k. [H2PO3F]
      [H+] = k1.C, where C is the total formal concentration of all monofluorophosphate
      species at time t. The Arrhenius energy of activation is 16.42 +/- 0.1 Kcal/mole.
      The hydrolysis of monofluorophosphoric acid has already been studied before. In
      the present work additional F(-)-determinations are performed with a specific F(
      )-selectrode, without any interference of the monofluorophosphate species, which
      was warned for by other authors. More recent investigation showed that in samples
      of controlled ionic strength little interference occurs, and phosphates in
      particular do not interfere. Fresh prepared solutions of Na2FPO3 were used at
      different pH and different temperature.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1758889
TI  - Comparative microbial contamination levels in wet granulation and direct
      compression methods of tablet production.
AB  - Raw materials used for tablet production were assessed for their microbiological
      quality. Tablets were produced by wet granulation and direct compression methods
      and assessed for compliance with B.P. specifications. Samples from the production
      stages in the two tabletting processes were assessed for microbial levels and for
      absence from designated microbial species- E.coli, Ps.aeruginosa, S.aureus and
      salmonella species. The effect of the microbial levels of the raw materials and
      the formulation technology on the microbial levels of the produced tablets were
      also investigated. Results indicated that the microbial levels of the tablets
      were influenced by the microbial quality of the starting raw materials, the
      production environment and the method of production. Generally, tablets produced
      by direct compression method gave lower microbial levels than those of the wet
      granulation method. The compaction process exert lethal effect on the survival of
      microorganisms.

PMID- 1758890
TI  - Polymorphism of carbamazepine: solid-state studies on carbamazepine dihydrate.
AB  - Carbamazepine dihydrate (CBZ.2H2O) crystallizes in the orthorhombic system, space
      group Cmca or C2ca. The unit-cell constants are: a = 19.834(7), b = 4.945(1), c =
      28.826(9) A. M = 272.27, V = 2827(2) A3, Z = 8, D = 1.280 g.cm-3. Indexed X-ray
      powerder diffraction pattern is given. Dehydration process was studied by means
      of thermogravimetry and differential thermal analysis: the enthalpy of
      dehydration was found at 51 kJ per H2O mole. Thermal dehydration leads to an
      (anhydrous) gamma-form of CBZ when processed in dry atmosphere. The presence of
      water vapour induces the formation of the beta-form of CBZ as well as the
      grinding of CBZ.2H2O at room temperature.

PMID- 1758891
TI  - Influence of different sources on the processing and biopharmaceutical properties
      of high-dose ibuprofen formulations.
AB  - It is known that depending on the manufacturing and synthetic processes, drugs
      may exist as different forms. As a result, physicochemical properties,
      compression characteristics, intrinsic dissolution and bioavailability may vary
      substantially. The purpose of this study was to investigate the effect of
      different sources of ibuprofen on the processing of tablets and on their
      properties. Another emphasis of this work was to rationalize one or several key
      characteristics of the raw material as directly related to wet granulation
      parameters and to the behavior of final tablets. Commercially available ibuprofen
      was obtained from different manufacturers and a preformulation program, including
      X-ray crystallography, differential scanning calorimetry, scanning electron
      microscopy, determination of particle size distribution and flowability, was
      performed to characterize the raw material. Granules were prepared with a
      planetary mixer and liquid requirements for the end point were obtained by
      monitoring power consumption. Tablets were manufactured on Stokes rotary and
      single punch instrumented presses. Data acquisition interfaces produced
      compression data for each formulation. Granules and final tablets were analyzed
      for hardness, dissolution profiles and content uniformity. Statistical
      evaluations using analysis of variance and multiple comparison procedures were
      performed on the results to determine the significance of the variability between
      independent parameters. The ibuprofen tested was found to be a unique polymorphic
      form with some differences in the external crystallinity. The particle size
      characteristics of the material also allowed a differentiation between sources
      and although there was no differences in dissolution patterns or content
      uniformity, particle size was found to account for 50% of the variability in
      tablet hardness. Two sources of ibuprofen with lower mean particle size showed
      significant variations in end point liquid requirements resulting in variable
      tablet crushing strength.

PMID- 1758892
TI  - Long-term stability of diazepam injections.
AB  - Diazepam and its main degradation product 2-methyl-amino-5-chlorobenzophenon
      (MACB) were quantitatively determined by HPLC and spectrophotometry in one- to
      ten-years-old diazepam injections. The content of diazepam was within the
      specifications in all the samples. Not more than 1.5% degradation of diazepam was
      found after ten years.

PMID- 1758893
TI  - Doxorubicine englobed in polybutylcyanoacrylate nanocapsules: behaviour in vitro
      and in vivo.
AB  - Nanocapsules of polybutylcyanoacrylate containing doxorubicine were prepared from
      w/o microemulsion. A concentration of about 10% of the drug was obtained. After
      washing, dispersion and lyophilization of the nanocapsules, some experiments were
      performed in vivo and in vitro. About 1% of doxorubicine was released in vitro in
      48 hours; after injection on the hairless back of rabbits, the nanoparticles
      without the drug gave any inflammatory processes, while the nanocapsules
      containing doxorubicine gave a deeper and more prolonged ulcer than that of the
      same amount of doxorubicine in solution, indicating that practically all the drug
      was inside the nanocapsules.

PMID- 1758894
TI  - [The biodisposition of paracetamol. I. The kinetics of disintegration of some
      dosage forms].
AB  - The in vitro properties of twelve brands of paracetamol (nine tablets and three
      capsules), commercialized in France, are studied. Among the brands tested
      (tablets), Latepyrine and Gynospasmine are characterized by faster and Panasorb
      by slower dissolution rate. Total time of dissolution varies between 7 and 60
      min. In some brands, paracetamol is liberated from the surface of the
      disintegrated particles and in others the active principle is released by
      progressive erosion. The presence of a surface active agent enhances liquid
      penetration in the case of capsules.

PMID- 1758895
TI  - [An antiserum directed against phenobarbital with an organometallic tracer:
      production and characterization].
AB  - In order to develop a new immunoassay procedure based on the use of
      organometallic labels, antisera are raising against sedative-hypnotic drug:
      phenobarbital. Immunization was performed in rabbits with
      parasuccinylamidophenobarbital coupled to bovine-serum-albumin. The evaluation of
      the specificity and the affinity constants of antisera are studied against
      different hypnotic or antiepileptic drugs and the metallotracer (phenobarbital
      labelled with an organometallic fragment derived from cymantrene). The most
      important result of this study indicates that the organometallic moiety of the
      metallotracer did not disturb neither the inhibition (% inhibition = 110) nor the
      affinity constant (Ka = 2.10(8) L/M) of the phenobarbital.

PMID- 1758896
TI  - [Stable copper complexes derived from nitrogen sugars].
AB  - This paper describes the synthesis of six new well-defined, stable cupric
      complexes of the general formula Cu(Ligand)2 in which the organic ligand is a
      nitrogen-bearing sugar derivative. Some of these compounds showed a border-line
      cytotoxic activity.

PMID- 1758897
TI  - Effect of low-molecular casein and gelatin on absorption of ibuprofen after oral
      and rectal administration.
AB  - Kneaded mixture of ibuprofen with low-molecular gelatin or casein (LM gelatin or
      LM casein) was prepared, and their in vitro dissolution, release from suppository
      base and in vivo absorption behaviours were examined. The dissolution rate of
      ibuprofen from the kneaded mixtures was markedly higher than that of the drug
      itself. The LM gelatin and LM casein also enhanced the release rate of ibuprofen
      from suppository base. After oral administration of the kneaded mixture with LM
      gelatin to beagle dogs, the initial serum concentration was higher than that of
      the drug alone. On the other hand, LM casein accelerated the absorption of
      ibuprofen from rectum. However, LM gelatin and LM casein did not affect the
      bioinversion of R(-)- to S(+)-ibuprofen.

PMID- 1758898
TI  - [Magnesium sulfate 4% xylitol infusions solution for the treatment of
      hypertensive disorders in pregnancy].
AB  - A new magnesium sulphate solution with xylitol for the management of hypertensive
      disorders during pregnancy has been described. The solution contains 40 g MgSO4
      and 16 g xylit in 1000 ml and is isoosmotic with blood serum. It can be
      sterilised for 15 min. at 121 degrees C without risk of decomposition of the
      ingredients during and after autoclaving. The solution has been proved in the
      clinical practice.

PMID- 1758899
TI  - [Polyelectrolyte solution for pediatric PN/TPN mixtures].
AB  - Pediatric patients who receive parenteral nutrition (PN) or total parenteral
      nutrition (TPN) have very high calcium and phosphorus requirements for bone
      mineralisation. Providing sufficient quantities of these electrolytes is
      difficult because of calcium and phosphorus solubility limitations in PN-/TPN
      mixtures. The preparation and the analytical procedure of the special
      polyelectrolyte solution containing: 30 mmol Ca2+, 30 mmol P, and 20 mmol Mg2+
      pro litre is described. The solution is compatible with fat emulsions and other
      ingredients of all-in-one-solutions.

PMID- 1758900
TI  - High-pressure liquid chromatographic method for determining adenine arabinoside
      monophosphate coupled to lactosaminated albumin in plasma.
AB  - A simple and sensitive method for determining concentrations, in plasma, of
      adenine arabinoside monophosphate conjugated with lactosaminated albumin is
      described. It permits the measurement of as little as 0.02 micrograms coupled
      drug/ml and has considerable advantages over the radioimmunoassay previously used
      for the same purpose.

PMID- 1758901
TI  - [Parameters for the formulation of physical-technical characteristics of granules
      of theophylline obtained by extrusion-spheronization].
AB  - Spheroids are prepared from microcrystalline cellulose in binary and compound
      combination with lactose and theophylline, in certain fixed conditions of
      extrusion and of spheronisation. The present work envisages the influence of
      combinated raw materials upon the physical-technique characteristic of the made
      spheroids. Besides a variation in the granulometric distribution a statical study
      through analysis of variance brings to the fore that the parameters of
      formulation contribute to modify the properties of hardness and of friability of
      the minigranules.

PMID- 1758902
TI  - [Synthesis, antiparasitic and antifungal activity of aryl-2-thiazolines].

PMID- 1758903
TI  - [A comparative study of properties of paracetamol tablets of the matrix type].
AB  - Our study was to compare the quantitative and qualitative effects of 2 polymeric
      agents (methylcellulose, hydroxypropylmethylcellulose) and of 2 diluants (lactose
      and dicalcic phosphate) on the compression properties and sustained liberation of
      acetaminophen matrixes. Three experimental plans were permitted the
      experimentation; regression equations were used for our analysis of the results.
      The results we obtained show the superiority importance of the effect of the
      diluant/acetaminophen ratio over the liberation of the drug, as well as the
      better efficiency of methylcellulosic matrixes. Thence to its solubility, the
      lactose helps to a faster liberation.

PMID- 1758904
TI  - Effect of surfactants on the antibacterial activity of preservatives.
AB  - Antibacterial activities of methyl-p-hydroxybenzoate, phenoxyethanol and
      chlorocresol against Pseudomonas aeruginosa were evaluated in the presence of
      varying concentrations of Tween 80. Below cmc level, the bactericidal activities
      increased with decrease in the surface tension values of Tween 80 solutions and
      with interfacial tension values of Tween 80 solution/liquid paraffin systems.
      Linear relationships were found to exist between the concentrations of each
      preservative required to reduce the microbial population by a factor 10(3) within
      48 hours and the values of surface tension and interfacial tension respectively.
      Reduction in surface tension and interfacial tension would have increased the
      adsorption and uptake of preservatives by bacterial cells thereby killing the
      cells at a faster rate. Concentrations of Tween 80 above cmc also enhanced the
      antibacterial activities of these preservatives. This was attributed to the
      increase in the permeability of bacterial membranes to preservatives.

PMID- 1758905
TI  - Growth and survival of Pseudomonas aeruginosa in some aromatic waters.
AB  - The ability of some aromatic waters at the in-use concentrations to enhance or
      inhibit the growth of microorganisms was determined by the antimicrobial
      preservative challenge method. Anise, chloroform, cinnamon, clove, dill, lemon,
      peppermint and rose waters were challenged with Ps. aeruginosa. Levels of the
      surviving cells at different times were determined by the pour plate method. The
      antimicrobial effect of the corresponding undiluted aromatic oils against Ps.
      aeruginosa was determined by the cup-plate method. Results showed that cinnamon
      water possesses profound and useful preservative activity against Ps. aeruginosa.
      The inhibitory effect of anise, chloroform and rose waters on Ps. aeruginosa is
      not much pronounced. Similarly, clove, dill and peppermint waters exhibited no
      significant preservative actions. Lemon water was found to enhance the growth of
      Ps. aeruginosa. The survival pattern of Ps. aeruginosa in the majority of the
      aromatic waters conforms with the antimicrobial actions of their undiluted oils.

PMID- 1758906
TI  - [Signs and symbols in early pharmaceutical chemistry. Elements--stars--God].

PMID- 1758907
TI  - [Topical agents with an NSAID-base].

PMID- 1758908
TI  - [Pharmaceutical development and research at the Humbolt University of Berlin].

PMID- 1758909
TI  - [Secondary plant materials as chemical feeding deterrents against herbivorous
      insects].

PMID- 1758910
TI  - [HAMOG. A "new star" in "molecular modeling" programs for the personal
      computer?].

PMID- 1758911
TI  - Methodology and reconstruction.
AB  - The challenges presented in treating patients with so-called borderline and
      narcissistic personality disorders have revived interest in the subject of
      reconstruction, because many analysts believe that these difficulties originate
      in the events of the earliest preverbal phase of development. They feel that
      contributions from direct observation of neonates and knowledge gained from
      "infant psychiatry" may enable analysts to effect reconstructions that previously
      appeared to be only speculative. The methodological problems in applying this
      approach, however, may lead to foisting upon clinical observation preconceived
      paradigms of pathogenesis. Reconstruction depends upon a disciplined
      interpretation of the dynamic record of the patient's associations, which
      demonstrate how the past is embedded in the present. The validity of the
      reconstruction depends upon the application of appropriate and disciplined
      psychoanalytic methodology. Reconstructions constitute a special form of
      interpretation and are part of the psychoanalytic process.

PMID- 1758912
TI  - A reading of Freud's Papers on Technique.
AB  - Freud's Papers on Technique (1911-1915) is the canonical description of the
      psychoanalytic procedure. It is a puzzling work because it is dominated by the
      original paradigm of treatment as memory-retrieval, while at the same time it
      introduces a new picture, more consistent with Freud's emerging theory of
      passions, according to which treatment is the stirring up and integration of
      wishes. I suggest that Papers on Technique becomes less puzzling if we assume
      that, when he wrote it, Freud was mainly concerned not with theory but with a
      crucial problem of practice. In exchange for some theoretical inconsistency Freud
      acquired an important practical advantage, and Papers on Technique uses that
      advantage to teach analysts how to divide the patient's consciousness into a
      passionately committed experience, on the one hand, and a detached contemplation,
      on the other hand, without worrying about the element of manipulation that is
      involved. The lesson is that a theoretical ambivalence of this sort is essential
      to the analytic stance.

PMID- 1758913
TI  - The Biblical Book of Job: advice to clinicians.
AB  - Study of the Book of Job clarifies the particular adaptation to trauma that
      underlies the suffering of certain difficult patients. In addition, the
      misdirected efforts of Job's comforters in the Bible story help us understand
      why, with such patients, an analyst's attempts to address unconscious guilt and
      defenses against it will prove counterproductive. A case example is presented.

PMID- 1758914
TI  - The analysis of an adult with night terror.
AB  - The author discusses the analysis of a woman with night terror, a condition
      rarely seen in adults. The analysis revealed the pathogenicity of splitting
      mechanisms which had developed under the influence of an overstimulating
      environment and exposure to the primal scene, followed by the separation and
      divorce of the patient's parents.

PMID- 1758915
TI  - The "dissolution" of the Oedipus complex: a neglected cognitive factor.

PMID- 1758916
TI  - Reinforcement in applied settings: figuring out ahead of time what will work.
AB  - This article reviews the practical value of conceptual attempts to specify the
      circumstances of reinforcement ahead of time. Improvements are traced from the
      transituational-reinforcer approach of Meehl (1950), through the probability
      differential model of Premack (1959, 1965), to the response deprivation and
      disequilibrium approach (Timberlake, 1980, 1984; Timberlake & Allison, 1974). The
      application value of each approach is evaluated on the grounds of simplicity,
      accuracy, and adaptability. The article shows that the disequilibrium approach
      accounts for and extends current empirically driven techniques of reinforcement
      control and examines some of its limitations. The disequilibrium approach
      clarifies how current knowledge can be used to predict more accurately the
      circumstances of reinforcement and invites the collaboration of applied and basic
      research in its further development.

PMID- 1758917
TI  - Diathesis-stress theories in the context of life stress research: implications
      for the depressive disorders.
AB  - Advances in the conceptualization and measurement of life stress in the past 2
      decades raise several questions concerning traditional diathesis-stress theories
      of psychopathology. First, comprehensive measures of life stress force
      investigators to become more precise about the particular stressful circumstances
      hypothesized to interact with diatheses. Second, the influence of the diathesis
      on a person's life is typically ignored, which results in several types of
      possible bias in the assessment of life stress. Finally, information is available
      on diatheses and stress for specific disorders to provide a foundation for more
      empirically based hypotheses about diathesis-stress interactions. This
      possibility is outlined for depression. Such an approach provides the basis for
      developing broader, yet more specific, frameworks for investigating diathesis
      stress theories of psychopathology in general and of depression in particular.

PMID- 1758918
TI  - Culture and the categorization of emotions.
AB  - Some writers assume--and others deny--that all human beings distinguish emotions
      from nonemotions and divide the emotions into happiness, anger, fear, and so on.
      A review of ethnographic and cross-cultural studies on (a) emotion lexicons, (b)
      the emotions inferred from facial expressions, and (c) dimensions implicit in
      comparative judgments of emotions indicated both similarities and differences in
      how the emotions are categorized in different languages and cultures. Five
      hypotheses are reviewed: (a) Basic categories of emotion are pancultural,
      subordinate categories culture specific; (b) emotional focal points are
      pancultural, boundaries culture specific; (c) emotion categories evolved from a
      single primitive category of physiological arousal; (d) most emotion categories
      are culture specific but can be defined by pancultural semantic primitives; and
      (e) an emotion category is a script with both culture-specific and pancultural
      components.

PMID- 1758919
TI  - Neuropsychological correlates of hypertension: review and methodologic
      considerations.
AB  - Essential hypertension is a chronic disorder having many potential physical and
      behavioral sequelae. This article evaluates the impact of hypertension on
      neuropsychological test performance. First, cross-sectional and longitudinal
      studies that examine the neuropsychological correlates of hypertension are
      reviewed. In general, hypertensives are found to perform more poorly than
      normotensives, particularly on tests of memory, attention, and abstract
      reasoning, and less consistently on tests of perception, constructional ability,
      mental flexibility, and psychomotor speed. Next, the influence of variables that
      may moderate relationships between hypertension and neuropsychological
      performance--such as age, education, and medication usage--are examined. Finally,
      potential mechanisms, both physiological and psychological, underlying
      associations between hypertension and neuropsychological performance are
      discussed.

PMID- 1758920
TI  - Explanation, imagination, and confidence in judgment.
AB  - This article concerns a class of experimental manipulations that require people
      to generate explanations or imagine scenarios. A review of studies using such
      manipulations indicates that people who explain or imagine a possibility then
      express greater confidence in the truth of that possibility. It is argued that
      this effect results from the approach people take in the explanation or
      imagination task: They temporarily assume that the hypothesis is true and assess
      how plausibly it can account for the relevant evidence. From this view, any task
      that requires that a hypothesis be treated as if it were true is sufficient to
      increase confidence in the truth of that hypothesis. Such tasks cause increased
      confidence in the hypothesis at the expense of viable alternatives because of
      changes in problem representation, evidence evaluation, and information search
      that take place when the hypothesis is temporarily treated as if it were true.

PMID- 1758921
TI  - The nature of environmental influences on weight and obesity: a behavior genetic
      analysis.
AB  - The nature of environmental influences on individual differences in weight and
      obesity is presently unclear. To resolve this issue, behavior genetic studies are
      reviewed for their relevance to environmental influences on weight and obesity.
      Results are consistent in suggesting that environmental experiences are important
      for weight and obesity, although they account for much less variation than do the
      effects of genes. Furthermore, only environmental experiences that are not shared
      among family members appear to be important. In contrast, experiences that are
      shared among family members appear largely irrelevant in determining individual
      differences in weight and obesity. These conclusions are consistent with a
      growing body of evidence on the relative unimportance of such shared experiences
      for many psychological characteristics.

PMID- 1758922
TI  - On the relationship between self-focused attention and psychological disorder: a
      critical reappraisal.
AB  - A recent review of the literature on the role of self-focused attention in
      psychological dysfunction (Ingram, 1990) is critically examined. This article (a)
      reexamines the evidence relevant to Ingram's proposal that self-awareness is a
      nonspecific factor involved in virtually all forms of psychopathology and argues
      that this conclusion is not warranted by the existing evidence; (b) takes issue
      with his premise that the fact that self-awareness is associated with a variety
      of psychological dysfunctions poses a conceptual dilemma; (c) corrects several
      important inaccuracies and mischaracterizations in his presentation of Carver and
      Scheier's (1981) cybernetic control theory and Pyszczynski and Greenberg's (1987)
      self-regulatory perseveration theory; and (d) critiques the "self-absorption"
      model that he proposed as an alternative to extant theories and concludes that
      this conceptualization does not add to the understanding of either self-awareness
      processes or psychopathology.

PMID- 1758923
TI  - A framework for the interpretation of first-order interaction in logit modeling.
AB  - Several suggestions have been tendered for interpreting first-order interaction
      in log-linear analysis. Occasionally these methods result either in a loss of
      information or in results that are difficult to grasp on an intuitive level. It
      is argued that interpreting effect parameters in terms of odds ratios provides an
      elegant and intuitively appealing conceptual framework that has great generality
      across models. The interaction term then resembles a cross-product term in linear
      regression. In both forms of analysis, the partial effect of a given predictor on
      the response is composed of a constant and a correction that is a function of the
      other predictor involved in the interaction. This framework is especially
      appealing for models in which the logit is based on a bifurcation of the
      dependent variable. Although odds ratios are still useful for summarizing effects
      on polytomous dependent variables, greater caution must be exercised to avoid
      misleading interpretations.

PMID- 1758924
TI  - Misinterpretation of interaction effects: a reply to Rosnow and Rosenthal.
AB  - The structural model of analysis of variance for multiway tables, with main
      effects and interaction parameters, is overspecified. Only the set of estimable
      functions of the cell means is useful. The individual estimates of the parameters
      are artificial as regards the underlying scientific process. Rosnow and Rosenthal
      (1989a) stated that it is "absolutely necessary" (pg 146) that interactions
      should be interpreted by examining the usual estimates of the interaction
      parameters. This is incorrect.

PMID- 1758925
TI  - Age differences in the recall of actions and cognitive activities: the effects of
      presentation rate and object cues.
AB  - In studies of activity memory, age differences have been found in the recall of
      cognitive activities (sustained mental activities that subjects solve during
      acquisition) but not in recall of Subject-Performed Tasks (one-step actions that
      subjects enact during acquisition). To understand the reasons for the discrepant
      findings, both types of item were included in a study examining the effects of
      object cues, rate of presentation, and aging. Variations in presentation rate or
      use of objects did not account for the different findings on the two item types.
      Even when presentation rate and object cues were matched, larger age differences
      were found for recall of cognitive activities than of SPTs. Age differences were
      also affected by the interaction of item type, presentation rate, and the
      presence of objects during encoding. To identify the variables controlling age
      differences, more analysis is needed of the features of activities to be
      remembered.

PMID- 1758926
TI  - Blood pressure reactivity and perception of pain during the forehead cold pressor
      test.
AB  - The relationship between blood pressure reactivity and the perception of pain was
      examined during a series of three forehead cold pressor tests given every other
      day to a group of 18 male college students. Subjects classified as high reactors
      on the basis of peak increases in mean blood pressure during cold pressor tests
      perceived the cold pressor stimulus as more painful than subjects classified as
      low reactors. The propensity to rate the cold pressor stimulus as painful was
      positively correlated with the individual level of blood pressure reactivity
      (baseline-free partial r = .62). Intra-individual correlations between pain and
      blood pressure responses were unrelated to subjects' reactivity status. Across
      the 3-min test, correlations between pain and blood pressure reactivity (with the
      effects of baseline blood pressure levels partialled out) were significant only
      during periods when levels of responses were relatively high. The heart rate
      responses were unrelated to pain ratings. Generalizability theory was applied to
      the analysis of temporal stability of cold pressor reactions. Both blood pressure
      and pain responses were highly reproducible across three sessions, appearing to
      express stable individual differences. The efficacy of 800 mg oral ibuprofen in
      controlling the cold pressor pain was also tested. Analgesic activity of the drug
      during the cold pressor test could not be demonstrated.

PMID- 1758927
TI  - The effect of repeated testing on ERP components during auditory selective
      attention.
AB  - The present study examined long-term repetition effects on human auditory event
      related potentials (ERPs). ERPs were recorded from subjects performing the same
      multidimensional auditory selective attention task on six separate occasions
      spaced one week apart. The task required subjects to attend to tones that varied
      along the dimensions of location (L), pitch (P), and duration (D) and to detect
      prespecified target (L + P + D +) combinations of these attributes. Processing
      negativity (PN) between 100-400 ms did not change in amplitude or onset latency
      as a function of repeated experience with the task. In contrast, two measures of
      "very late" PN were reduced with practice. Specifically, the location effect
      measured over the 400-700-ms epoch was significant only for Weeks 1 and 2, and
      the separation of the L + P + D- ERP from other D- ERPs, measured over the 700
      1000-ms epoch, was significantly reduced from Week 1 to Week 2. A late negative
      component (700-1000 ms) elicited by correctly identified targets increased
      between Weeks 1 and 2, consistent with subjects adopting the strategy of
      rehearsal of the target itself rather than the L + P + D- standard. P2 amplitude
      increased significantly for all standards, possibly due to decreased latency
      jitter in later weeks. N1 latency became significantly shorter over weeks,
      reflecting either increasing confidence in stimulus discrimination with repeated
      testing or the overlapping of an unchanging N1 with an increasing P2.

PMID- 1758928
TI  - EEG alpha methodologies and hypnotizability: a critical review.
AB  - This paper reviews empirical studies that assessed the relationship between EEG
      alpha indices and measures of hypnotic responding. Although there are
      confirmatory reports of such a relationship, these findings have not been
      corroborated in repeated attempts at replication. The research is characterized
      by poor design and statistical procedures that fail to control for various
      extraneous factors. Although a few positive findings have been tentatively
      identified, they await replication. Taken together, the available evidence
      suggests that hypnotizability is not systematically related to alpha.

PMID- 1758929
TI  - The truth will out: interrogative polygraphy ("lie detection") with event-related
      brain potentials.
AB  - The feasibility of using Event Related Brain Potentials (ERPs) in Interrogative
      Polygraphy ("Lie Detection") was tested by examining the effectiveness of the
      Guilty Knowledge Test designed by Farwell and Donchin (1986, 1988). The subject
      is assigned an arbitrary task requiring discrimination between experimenter
      designated targets and other, irrelevant stimuli. A group of diagnostic items
      ("probes"), which to the unwitting are indistinguishable from the irrelevant
      items, are embedded among the irrelevant. For subjects who possess "guilty
      knowledge" these probes are distinct from the irrelevants and are likely to
      elicit a P300, thus revealing their possessing the special knowledge that allows
      them to differentiate the probes from the irrelevants. We report two experiments
      in which this paradigm was tested. In Experiment 1, 20 subjects participated in
      one of two mock espionage scenarios and were tested for their knowledge of both
      scenarios. All stimuli consisted of short phrases presented for 300 ms each at an
      interstimulus interval of 1550 ms. A set of items were designated as "targets"
      and appeared on 17% of the trials. Probes related to the scenarios also appeared
      on 17% of the trials. The rest of the items were irrelevants. Subjects responded
      by pressing one switch following targets, and the other following irrelevants
      (and, of course, probes). ERPs were recorded from FZ, CZ, and PZ. As predicted,
      targets elicited large P300s in all subjects. Probes associated with a given
      scenario elicited a P300 in subjects who participated in that scenario. A
      bootstrapping method was used to assess the quality of the decision for each
      subject. The algorithm declared the decision indeterminate in 12.5% of the cases.
      In all other cases a decision was made. There were no false positives and no
      false negatives: whenever a determination was made it was accurate. The second
      experiment was virtually identical to the first, with identical results, except
      that this time 4 subjects were tested, each of which had a minor brush with the
      law. Subjects were tested to determine whether they possessed information on
      their own "crimes." The results were as expected; the Guilty Knowledge Test
      determined correctly which subject possessed which information. The implications
      of these data both for the practice of Interrogative Polygraphy and the
      interpretation of the P300 are discussed.

PMID- 1758930
TI  - Neuroanatomical correlates of skin conductance orienting in normal humans: a
      magnetic resonance imaging study.
AB  - Although little is known about the neuroanatomical basis of skin conductance
      orienting in intact normal humans, the limited literature on animals and humans
      with neurological and clinical disorders implicate prefrontal, temporal/amygdala,
      and pons brain areas in mediating skin conductance orienting. This study relates
      area of these structures using magnetic resonance imaging techniques to skin
      conductance orienting responses in 17 normal humans in order to test hypotheses
      that larger area of these excitatory structures will be associated with more
      orienting responses. Left and right hand skin conductance orienting was
      significantly associated with left and right prefrontal area (r = .44-.60), area
      of the pons (r = .43-.54), and left but not right temporal/amygdala area (r = .47
      .53). No relationships were observed with areas thought to be unrelated to skin
      conductance activity (cerebellum, nonfrontal cortical area), medial prefrontal
      cortex, or the third ventricle. This appears to be the first study relating brain
      structure to skin conductance orienting in intact normal humans. Although
      preliminary at the present time, these results implicate prefrontal, pons, and
      temporal/amygdala areas in the mediation of skin conductance orienting in normal
      humans.

PMID- 1758931
TI  - Selective effects of alcohol on electrodermal indices of orienting reflexes to
      signal and nonsignal stimuli.
AB  - Effects of a moderate dose of alcohol on the electrodermal orienting reflexes
      evoked by novel signal, novel nonsignal, and common nonsignal stimuli were
      assessed. Social drinkers were randomly assigned to the four cells of a balanced
      placebo design, with 10 males and 10 females per group. They drank a beverage
      consisting of either tonic water only, or tonic water plus enough vodka to raise
      blood alcohol levels to approximately .05%. Following drinking and absorption
      periods, spontaneous and evoked skin conductance responses (SCRs) were recorded.
      Subjects pressed a footpedal whenever they heard an odd stimulus tone in a
      series. Alcohol increased the frequency of spontaneous SCRs, increased the number
      of incorrect pedal-press responses, and selectively enhanced SCRs evoked by the
      signal tone, p less than .05. Results are interpreted in terms of a hypothesized
      selective effect of alcohol on frontal cortical inhibitory functions.

PMID- 1758932
TI  - Phenotypic correlations between oculomotor functioning and schizophrenia-related
      characteristics in relatives of schizophrenic probands.
AB  - Abnormalities of visual pursuit tracking are frequent in the first-degree
      relatives of probands with schizophrenia. The relationship between oculomotor
      abnormalities and schizophrenia-related characteristics in those family members,
      however, has received little attention. Fifty-three first-degree relatives of 24
      probands with schizophrenia were evaluated for the presence of schizophrenia
      related characteristics using both interview (Schedule for Schizotypal
      Personalities) and questionnaire (Chapman scales). The family members also had
      their eye movements recorded during pursuit tracking tasks and scored for gain in
      both the frequency and time domains, and saccadic intrusions. Social
      interpersonal schizophrenia-related features were significantly related to both
      time- and frequency-domain gain calculations. It appears that abnormalities in
      the smooth-pursuit oculomotor system may be associated with symptoms conjectured
      to be most closely related to a genetic diathesis for schizophrenia. These
      findings provide further evidence that oculomotor abnormalities may be related to
      risk for this disorder.

PMID- 1758933
TI  - Modulatory influence of continuous tone, tone offset, and tone onset on the human
      acoustic startle response.
AB  - Startle modulation in young adult men, by continuous background tone and its
      offset, a 2-s sustained tone and its offset, and the onset of a 25-ms tone pip
      were compared. Tone (75dB 1000 Hz) offset and onset occurred either 2000 ms or
      100-120 ms before the startle stimuli (104dB (SPL), 50-ms white noise bursts).
      Blink amplitude and latency were unaffected by continuous background tone. Blink
      amplitude was reliably inhibited by 100-ms offset of both the continuous
      background tone and the 2-s sustained tone or 120-ms onset of the tone pip,
      whereas effects on latency were more variable. Facilitation of blink amplitude
      and latency was significant but weak and only following the 2-s sustained tone,
      and only with respect to one of two experimental contexts. These findings support
      those of others and suggest that startle inhibition results from activation of
      neurons responding to transient environmental changes. The degree of inhibition
      appears to be related to stimulus value. Startle amplitude facilitation following
      long sustained prestimulation intervals is dependent on experimental context.
      Overall latency and amplitude modulation tend to be concordant, leading to the
      conclusion that the mechanism(s) underlying both are context dependent and linked
      in the adult human.

PMID- 1758934
TI  - Fear-potentiated startle in humans: effects of anticipatory anxiety on the
      acoustic blink reflex.
AB  - The effects of fear/anticipatory anxiety on the acoustic startle reflex were
      investigated in humans using a paradigm involving anticipation of electric
      shocks. The eyeblink component of the startle reflex, elicited by an abrupt
      auditory stimulus, was measured in 9 normal volunteers during either the
      anticipation of electric shocks (anticipatory anxiety) or periods in which no
      shocks were anticipated (safe period). The eyeblink was consistently higher in
      amplitude, and shorter in latency, during periods when the subjects anticipated
      shocks, compared to the safe periods. This effect could not be attributed solely
      to a reduction in habituation and was statistically significant before the
      subjects actually received any shock (a single 30 mA stimulation on the median
      nerve). These results indicate that anticipatory anxiety can be measured
      objectively in humans using the fear-potentiated startle reflex in a paradigm not
      actually requiring any shock. Because a great deal is known about the
      neuroanatomical and pharmacological mechanisms of fear-potentiated startle in
      laboratory animals, this test procedure may be especially useful in humans to
      investigate the neurobiological substrates of anxiety disorders and their
      pharmacological treatments.

PMID- 1758935
TI  - Graphical and statistical techniques for cardiac cycle time (phase) dependent
      changes in interbeat interval.
AB  - Cardiac cycle time effects refer to the relative lengthening or shortening of a
      single cardiac cycle as a function of when in the cycle brief sensorimotor events
      occur. These effects may provide short-latency measures of cardiac sensitivity to
      psychological events. Conventional representations have, however, failed to
      clearly separate changes in interbeat interval due to cycle time--i.e., phase
      dependent changes--from other types of change. This paper advocates a particular
      technique of plotting to solve these representation problems. Heartbeat timing is
      represented in real time and in the context of beats both preceding and following
      the event of interest. The plot, a phase-sensitive plot, conceptualizes phase
      sensitive (cardiac cycle time) effects as a change in linear or higher order
      trend. Thus, an adaptation of trend analysis is proposed as an efficient
      statistical analysis that follows directly from the proposed representational
      technique.

PMID- 1758936
TI  - A/D conversion in DMA-mode: problems and solutions.

PMID- 1758937
TI  - From simplicity to complexity (1950-1990): the case of peptic ulceration--I.
      Human studies.
AB  - The problem of the psychobiology of human peptic ulceration has become very much
      more complicated in the past 20 years, once it was realized that it was not one
      disease but many. It is recognized that 29 different forms exist. Two common but
      distinct forms of the disease are characterized by elevated or normal levels of
      pepsinogen-I. In a third form elevated levels of pepsinogen-II occur; however,
      this particular increase imparts more of a risk by a factor of 3 for gastric than
      for duodenal ulcer. In the light of such facts, all studies on the psychological
      characteristics and social contexts that characterize the onset of the disease
      must be reevaluated. In addition, a number of different pathophysiological
      disturbances of the regulation of gastric acid secretion, motility, and
      bicarbonate secretion characterize patients with the disease, and further
      subdivide patients with increased or normal pepsinogen-I levels.

PMID- 1758938
TI  - From simplicity to complexity (1950-1990): the case of peptic ulceration--II.
      Animal studies.
AB  - Considerable progress has been made in the understanding of the formation of
      gastric erosions in rats. The role of gastric acid secretion in their
      pathogenesis has been clarified. Gastric erosions are also associated with slow
      gastric contractions. With several experimental procedures, the body temperature
      falls; preventing this decrease averts erosions. A fall in body temperature or
      exposure to cold is associated with the secretion of thyrotropin-releasing
      hormone (TRH), and both an increase and decrease in corticotropin-releasing
      factor (CRF) in discrete regions of rat brains. TRH produces gastric erosions,
      increases in acid secretion, and slow contractions, while CRF has the opposite
      effects. One of the major sites of interaction of the two peptides is in the
      dorsal motor complex of the vagus nerve. TRH increases serotonin (5-HT) secretion
      into the stomach. 5-HT counter-regulates acid secretion and slow contractions.
      Many other peptides stimulate or inhibit gastric acid secretion.

PMID- 1758939
TI  - Biobehavioral basis of coronary-prone behavior in middle-age men. Part II: Serum
      cholesterol, the Type A behavior pattern, and hostility as interactive modulators
      of physiological reactivity.
AB  - Prior research suggests that the Type A behavior pattern, Cook and Medley
      Hostility (Ho) scores, and Total Serum Cholesterol (TSC) are positively
      associated with physiological changes to behavioral stressors. The objective of
      the present study was to determine whether TSC interacts with the Type A behavior
      pattern and hostility to affect cardiovascular and neurohormonal responses to a
      mental arithmetic task (MATH). For Type A individuals, elevated TSC was
      associated with larger catecholamine and cortisol responses to MATH. In contrast,
      for Type B subjects, cholesterol was negatively associated with neurohormonal
      responses. The interaction between Ho score and TSC predicted a similar pattern
      of responses whereby, in high hostile men only, TSC was positively associated
      with MATH-induced changes in catecholamines and heart rate. While the mechanisms
      responsible for the differences in the lipid-reactivity association as a function
      of coronary-prone behavior measures remain to be elucidated, this differential
      association may play a role in the heightened risk of coronary disease among
      hostile Type A men.

PMID- 1758940
TI  - Negative affectivity and repressive coping: pervasive influence on self-reported
      mood, health, and coronary-prone behavior.
AB  - Negative affectivity (NA) and repressive coping (REP) are coping styles
      characterized by a disposition to either experience or avoid distress. This study
      investigated the potential influence of NA and REP on self-reported distress and
      coronary-prone behavior among 178 male cardiac patients undergoing
      rehabilitation. Based on their STAI-Trait and Marlowe-Crowne Scale scores,
      subjects were categorized as high NA (N = 72), low NA (N = 44), or REP (N = 62)
      individuals. With respect to subjective distress, high-NA individuals reported
      more negative mood states and health complaints than both low-NA and REP
      individuals (p less than 0.0001). In contrast, no association was found between
      coping style and cardiovascular fitness as measured by exercise stress testing (p
      = 0.87). Hence, it seems that (a) high-NA individuals overreacted to physical
      problems and (b) REP individuals warded off distress. These differences in coping
      style were stable over a period of 3 months. With respect to coronary-prone
      behavior, the current findings were largely inconsistent with previous research.
      NA was associated with Type A interview-rating (p less than 0.001), but not with
      Type A self-rating. REP individuals, however, had a significantly lower score on
      the Jenkins Activity Survey and the Cook-Medley Hostility Scale than both high-NA
      and low-NA individuals (p less than 0.0001). Supposed associations, therefore,
      between NA and self-rated coronary-prone behavior may in fact originate from the
      repressive coping style that characterizes some individuals low in NA. In
      summary, it may be stated that the findings of the current study suggest the use
      of NA and REP markers in research, so that the potential influence of these
      coping styles can be identified in the study of stress-health relationships.

PMID- 1758941
TI  - Prevention of arousal-induced hyperlipidemia by glucose ingestion.
AB  - Thirteen subjects were investigated to compare the effects of pre-event glucose
      (G) and placebo (P) ingestion on plasma free fatty acid (FFA) concentration
      during mental work. Subjects performed two trials of a videogame and received
      money for each point scored. Thirty minutes before commencing each trial,
      subjects ingested either a solution containing 50 g of G or an identically
      sweetened and colored placebo. Order of ingestion was partially counterbalanced.
      Heart rate, the measure of arousal monitored, increased significantly above
      baseline during each trial, but there was no difference in this rise between
      trials. The main finding from this experiment was that after ingesting glucose,
      subjects had a stable blood FFA concentration during the videogame, while after
      the ingestion of placebo subjects had a significantly higher blood FFA during
      videogames than they had at baseline. These data suggest that arousal-induced
      hyperlipidemia can be prevented by pre-event glucose ingestion.

PMID- 1758942
TI  - Coping and extreme response tendency in duodenal ulcer patients.
AB  - In this study we examined problem- and emotion-focused coping in samples of 30
      duodenal ulcer (DU) patients and 30 matched healthy controls. Coping processes
      were assessed for two stressful situations, viz, an interpersonal conflict and a
      difficult task or job. The results indicated that DU patients and controls did
      not differ in terms of preferred coping strategies: irrespective of type of
      stressor, no differences were found between the two samples, neither in terms of
      a more general inclination toward problem- or emotion-focused coping, nor in
      terms of separate, more fine-grained coping mechanisms. Furthermore, rating
      extremity was studied in both samples. It was found that DU patients have a
      tendency to endorse extreme positive responses ("Very characteristic of me") more
      often than controls. The latter finding is discussed in terms of competing
      explanations: (a) higher polarizing tendencies of DU patients vs. (b) higher
      meaningfulness of the questionnaire items for DU patients. Specific directions
      for future research are described.

PMID- 1758943
TI  - A naturalistic study of the relationships among electromyographic activity,
      psychological stress, and pain in ambulatory tension-type headache patients and
      headache-free controls.
AB  - Twelve subjects who met diagnostic criteria for episodic tension-type headache
      and nine subjects who rarely or never suffered from headaches wore a computer
      controlled electromyographic (EMG) activity recorder in their natural environment
      for 48 to 96 consecutive hours. EMG activity of the posterior neck or frontal
      muscles was recorded 24 hr per day. During waking hours, subjects rated their
      perceived levels of stress, pain, and negative affect at 30-min intervals. The
      EMG activity of headache and control subjects did not differ significantly, and
      EMG activity did not covary with stress, pain, or negative affect. Cross
      correlations among EMG activity, pain, and stress revealed little evidence of
      leading, contemporaneous, or lagging relationships. Interrupted time series
      analysis showed no consistent muscle hyperactivity during a headache attack
      compared to a headache-free baseline period.

PMID- 1758944
TI  - Relaxation behavior therapy as sole treatment for mild hypertension.
AB  - This study tested the efficacy of relaxation therapy as sole treatment for mild
      hypertension in 110 men and women recruited from a five-stage worksite blood
      pressure screening program. Participants were randomized to 12-weeks of
      relaxation therapy or support therapy. Outcome blood pressure assessments made by
      assessors who were unaware of group allocation revealed similar decreases in both
      treatment groups at post-treatment and 6-month follow-up. While body weight did
      not change, alcohol consumption decreased similarly in both groups, and alcohol
      consumption was positively correlated with both absolute diastolic blood pressure
      and change in diastolic blood pressure at outcome. In conclusion, a superior
      blood pressure effect was not associated with relaxation therapy; however,
      alcohol consumption decreased in both treatment groups, suggesting that both
      interventions facilitated changes in health risk behaviors and indirectly on
      blood pressure level.

PMID- 1758945
TI  - Social network and blood pressure: a population study.
AB  - The relationship between social network and blood pressure was assessed in a
      cross-sectional, random sample of 1409 white adults aged 20 to 70 years studied
      in Buffalo in 1961. Higher total social network scores were associated with lower
      systolic and diastolic blood pressure in both males and females. Considering the
      components of social network separately, increased size of household and greater
      participation in clubs were associated with lower systolic blood pressure for
      males, with the trend in the same direction for women, though not reaching
      statistical significance. Among females, the only social network component
      showing significant linear trend was the number of siblings, with increased
      number of siblings being associated with lower systolic and diastolic blood
      pressure. Religious service attendance and marital status were not associated
      with blood pressure in this population.

PMID- 1758946
TI  - Social support, lifestyle incongruity, and arterial blood pressure in a southern
      black community.
AB  - Social support is generally thought to modify or "buffer" the impact of stressful
      events and circumstances on health. There has been little exploration of how the
      definition and effect of support is modified by culture. In this paper, the role
      of social support in moderating the effect of a social stressor on arterial blood
      pressure is examined in a southern black community. Traditionally, support was
      available mainly within the extended family in African-American culture. In the
      aftermath of social change, however, younger black people often find their
      experiences to be more consonant with their peers. It was hypothesized that kin
      support would moderate the effect of status incongruence on blood pressure for
      older persons, while nonkin support would moderate the effect for younger
      persons. This hypothesis was confirmed in a community study. Future research on
      social support, therefore, must take into account cultural factors influencing
      the meaning of social support from different sources.

PMID- 1758947
TI  - The effects of masculinity and social support on recovery from myocardial
      infarction.
AB  - Ninety post-myocardial infarction (MI) patients were interviewed to assess
      masculinity/femininity and social support shortly before hospital discharge.
      Patients were contacted 1 year following MI to obtain information about
      rehospitalization and/or death, post-MI chest pain, and perceived health. After
      controlling for traditional coronary risk factors, MI severity, and psychological
      distress, lack of disclosure to one's spouse predicted worse recovery on all
      three indices. Exploratory analyses revealed that males (n = 63) who disclosed to
      their spouses were rehospitalized less often than females (n = 14) who disclosed
      to their spouses, and married patients who engaged in less spouse disclosure (n =
      32) were significantly more likely to be rehospitalized than either unmarried
      patients (n = 14) or married patients who engaged in more spouse disclosure (n =
      41). Masculinity predicted more severe post-MI chest pain but was unrelated to
      rehospitalization and perceived health.

PMID- 1758948
TI  - The effects of fat and cholesterol on social behavior in monkeys.
AB  - We report here on the social behavior of 30 adult male cynomolgus monkeys,
      maintained in social groups of five animals each and assigned for 22 months to
      one of two dietary conditions: a) "luxury"--relatively high fat, high cholesterol
      (43% calories from fat, 0.34 mg cholesterol/Calorie of diet); or b) "prudent"-
      relatively low fat, low cholesterol (30% calories from fat, 0.05 mg
      cholesterol/Calorie of diet). The dietary manipulation resulted in higher total
      serum cholesterol (TSC) and lower high density lipoprotein cholesterol (HDLC)
      concentrations in luxury diet animals than in their prudent diet counterparts
      (p's less than 0.05). Additionally, we monitored the occurrence of 21 behavioral
      acts frequently exhibited by this species in captivity. Of these behaviors, only
      contact aggression differed between dietary conditions (p less than 0.03), with
      prudent diet monkeys initiating more aggression than luxury diet animals. These
      results are consistent with studies linking relatively low serum cholesterol
      concentrations to violent or antisocial behavior in psychiatric and criminal
      populations and could be relevant to understanding the significant increase in
      violence-related mortality observed among people assigned to cholesterol-lowering
      treatment in clinical trials.

PMID- 1758949
TI  - Platelets and coronary heart disease: potential psychophysiologic mechanisms.
AB  - Although there has been extensive research attempting to identify
      psychophysiologic mechanisms linking psychological events and behavior patterns
      with risk for coronary heart disease, these are important potential mechanisms
      that remain largely unexplored. One of these mechanisms is thrombosis, which is
      widely recognized as the precipitant of acute coronary events (myocardial
      infarction and sudden ischemic death). A major element in arterial thrombosis is
      the platelet, and platelet inhibition has been shown to be effective in
      preventing coronary events. In the present paper, platelet physiology and
      pathophysiology are reviewed. Platelet function testing and the clinical role of
      platelet activation in atherosclerosis and acute coronary events are also
      discussed. Because epinephrine and possibly shear stress are clinically important
      activators of platelets, it is proposed that platelet reactivity to psychological
      stress may be a major mechanism in coronary events. The literature to date
      supports the hypothesis that platelet activity is increased by emotional stress.
      Suggestions are made for future research in this area.

PMID- 1758950
TI  - Depression and type A behavior pattern in patients with coronary artery disease:
      relationships to painful versus silent myocardial ischemia and beta-endorphin
      responses during exercise.
AB  - A sample of 45 patients with a history of coronary heart disease and documented
      myocardial ischemia during exercise testing were evaluated in an investigation of
      the possible relationships between psychological factors (depression and Type A
      behavior pattern), plasma beta-endorphin response and pain experience during
      maximal exercise-induced ischemia. Depression was assessed using the MMPI-D
      subscale, while Type A was evaluated using the Structured Interview. All patients
      developed ischemia during exercise as defined by ST-segment depression; however,
      only 18 patients reported anginal pain. Patients with high depression scores
      (MMPI-D greater than or equal to 70; n = 13) showed lesser increases in plasma
      beta-endorphin levels, tended more often to report anginal pain and rated pain as
      more severe during exercise than patients with low depression scores (MMPI-D less
      than 60; n = 18). Hemodynamic responses and severity of ischemia (assessed by
      ejection fraction changes and wall-motion abnormalities) did not differ between
      depression groups. Even after adjustment for group differences in exercise
      duration, depression was significantly associated with a lesser beta-endorphin
      response in the sample as a whole and, among patients reporting angina, with
      earlier pain onset and greater pain duration and severity. In contrast, when Type
      A versus B/X subgroups were compared, no differences in pain experience, beta
      endorphin response or measures of ischemia were obtained. These findings suggest
      that in patients with ischemic heart disease, there may be a relationship between
      depression and anginal pain which may in part involve a blunted or absent beta
      endorphin response.

PMID- 1758951
TI  - Cynical hostility in adult male twins.
AB  - The heritability of hostility as measured by the Cook and Medley Ho scale was
      assessed in an adult male sample of 60 monozygotic and 61 dizygotic twin pairs.
      For the total Ho scale, as well as its health predictive component, the results
      were consistent with a moderate genetic effect. Results are discussed in terms of
      genetic and environmental influences on the development of this trait, and
      possible genetic contributions to the association between hostility and
      subsequent health.

PMID- 1758952
TI  - Quantitative assessment of olfactory experience during pregnancy.
AB  - Results of the National Geographic Smell Survey were used to investigate the
      effects of pregnancy on olfactory perception and odor-related behavior. The
      responses to test odors and survey questions of 13,610 pregnant and 277,228
      nonpregnant U.S. women between 20 and 40 years of age were analyzed. In
      comparison to nonpregnant women, pregnant women rated their own sense of smell
      lower, more often rated the test odors less pleasant smelling, more often
      classified the test odors as inedible, were less likely to report odor-evoked
      memories, and used perfume and cologne less frequently. Differences in odor
      detection and intensity rating did not favor either group.

PMID- 1758953
TI  - The rating form of IBD patient concerns: a new measure of health status.
AB  - Health status assessment for persons with chronic illness includes not only
      symptoms, but also an appraisal of the psychosocial concomitants of illness. In
      this national study of persons with inflammatory bowel disease (IBD), we
      standardized a disease-specific 25-item measure of perceived health status: the
      Rating Form of IBD Patient Concerns (RFIPC). Factor analysis yielded four
      indices: a) impact of disease (e.g., being a burden, loss of energy, loss of
      bowel control); b) sexual intimacy; c) complications of disease (e.g., developing
      cancer, having surgery, dying early); and d) body stigma (e.g., feeling dirty or
      smelly). A higher level of IBD concerns was associated with greater disease
      severity, female gender, and lower educational status. When controlling for these
      factors, as well as disease type and age, we found that concerns about: a) impact
      of disease was positively associated with poorer perception of health and well
      being, greater psychological distress (SCL-90), and poorer daily function
      (Sickness Impact Profile) (p less than 0.0001); b) sexual intimacy was related to
      poorer psychologic function (p less than 0.01); and c) complications of disease
      was related to several measures of poorer daily function (p less than 0.0001 to
      0.01). This standardized measure of the worries and concerns of persons with IBD
      may be used in clinical care and research to evaluate the effects of
      interventions on IBD patient outcomes.

PMID- 1758954
TI  - Affect, emotional conflict, and deficit: an overview.

PMID- 1758955
TI  - Multiple sclerosis: the impact of physical impairment and cognitive dysfunction
      on social and sparetime activities.
AB  - In a cross-sectional investigation of 116 patients with multiple sclerosis, the
      social and sparetime activities of the patient were assessed by both patient and
      his/her family. The assessments were correlated to physical disability which
      showed that particularly those who were moderately disabled suffered from severe
      psychosocial strain. The literature shows that the strain becomes even more
      severe in certain periods of progression of the disease with the result that
      psychosomatic conditions arise.

PMID- 1758956
TI  - Psychodynamic aspects of psychopharmacology in functional somatic complaints.
AB  - Psychiatrists as well as general practitioners frequently prescribe psychotropic
      drugs (tranquilizers such as benzodiazepines and increasingly low-dose long
      acting neuroleptics) to treat functional organic complaints. We are interested in
      finding out the psychodynamics in the doctor-patient relationship that determine
      whether the doctor puts more emphasis on eliminating symptoms by prescribing
      psychotropic drugs or on solving the underlying conflicts by psychotherapy.
      Furthermore we describe some interactions which are of importance for
      illustrating whether drugs are effective or lead to side effects.

PMID- 1758957
TI  - Ego defensive styles and alexithymia: a discriminant validation study.
AB  - Fifty-six mildly depressed psychiatric outpatients were evaluated for alexithymia
      measured by the Toronto Alexithymia Scale. Each subject also completed a
      Defensive Style Questionnaire that assessed the maturity of their ego defenses.
      Alexithymia was strongly associated with immature ego defenses, but not with
      depression. The data suggests that alexithymia and such primitive defensive
      operations are separate phenomena. These findings empirically support earlier
      observations regarding the nature of alexithymia.

PMID- 1758958
TI  - Outcome of gastric surgery for morbid obesity: weight changes and personality
      traits.
AB  - This controlled study explores weight change in relation to certain personality
      and behavioural characteristics in a population of morbidly obese individuals who
      have undergone a gastric procedure to lose weight. In particular, measures of
      alexithymia and symbolic function were used, and the results of the study
      indicate that these concepts are particularly helpful in understanding obese
      individuals, and aetiology and treatment of their condition.

PMID- 1758959
TI  - Group therapy with elderly patients.
AB  - In our research we try to suggest a type of group therapy for elderly patients to
      favor the communication process and to make the patient acquire an active role in
      the group. The group has an open structure with weekly sessions that last one
      hour and a half each. The group is conducted by therapists who coordinate the
      work, acting as stimulus and supporting the relationship between the patients. It
      is composed of 8 patients, some of whom have been inpatients of the department
      while others were sent by territorial social service. Age is not the only
      component for selection; above all, problems regarding loneliness, difficulties
      in interpersonal relationships and consequent loss of contact and interest in the
      other are considered.

PMID- 1758960
TI  - Morbid obesity: effects on the marital system of weight loss after gastric
      restriction.
AB  - Eighty morbidly obese married women and 69 of their husbands completed a self
      report measure of personal and marital adjustment before the women proceeded to
      gastric restriction surgery. Fifty-five women and 41 husbands repeated the
      measure 12 months after surgery, at which time the women had lost a mean of 35.4
      kg. Women rated themselves as significantly more attractive and sociable, and
      rated their husbands as significantly less sociable and interesting, than before
      surgery. Husbands rated their wives as excessively sociable after surgery, the
      reverse of their previous view. The data offered some support for a family
      systems view of morbid obesity, but the systemic effect appeared weak, and is
      probably not a major contributor to wives' morbid obesity in most cases.

PMID- 1758961
TI  - Exploring the doctor-patient relationship reduces staff stress and enhances
      empathy when caring for AIDS patients.
AB  - At our AIDS outpatient clinic we presently care for more than 1,200 HIV-infected
      patients. All physicians in this unit have participated for 1 year in a case work
      group supervised by a liaison psychiatrist. The doctor-patient relationship, the
      assessment in the case work group and the ensuing influence on perception and
      behavior are demonstrated by 3 cases. Different issues challenge the doctor
      patient relationship: the serious prognosis of predominantly young AIDS patients;
      isolation and stigmatization of patients; fear of contagion, and questions of
      confidentiality regarding contact tracing. Reflection upon the doctor-patient
      relationship improves communication skills and increases empathy towards AIDS
      patients.

PMID- 1758962
TI  - Observing countertransference in brief dynamic psychotherapy.
AB  - Six cases treated with Brief Dynamic Psychotherapy were studied. Initial
      countertransferential reactions were identified, and expectations were determined
      concerning the evolution of the patient-therapist relationship. The existence of
      a basic pattern of emotional response to the patient in the therapist throughout
      the treatment was observed, and the authors propose to denominate it
      countertransferential focus. Three clinical vignettes are reported.

PMID- 1758963
TI  - The use of the carp retina in neurobiology: its uniqueness and application for
      neural network analyses of the inner retina.

PMID- 1758964
TI  - Development of the cerebellum and its extracerebellar Purkinje cell projection in
      teleost fishes as determined by zebrin II immunocytochemistry.

PMID- 1758965
TI  - Brain activity patterns: assessment by high resolution autoradiographic imaging
      of radiolabeled 2-deoxyglucose and glucose uptake.

PMID- 1758966
TI  - [The value of the Thematic Apperception Test (TAT) for diagnosis and therapy of
      borderline personality disorders].

PMID- 1758967
TI  - [The finite and infinite development. II. Recent psychoanalytic theory and
      therapeutic considerations].
AB  - Freud's characterization of the manifest dream is typified by an implicit
      appreciation and an explicit devaluation of dream images. According to the
      author, the theoretical-historical motive behind this divergent evaluation is
      already evident in Freud's prepsychoanalytic writings, where he assigns primacy
      to the written word. The author holds that the biographic motive derives from an
      ambivalent internalization of the Mosaic sanction against graven images, conveyed
      to Freud by his father through the spirit of the Phillipson Bible.

PMID- 1758968
TI  - [Importance of regression to dependency].

PMID- 1758969
TI  - [Current aspects of a psychoanalytic culture theory].

PMID- 1758970
TI  - Sprouting of aberrant neuropeptide Y-immunoreactive sympathetic nerves into
      neonatally denervated smooth muscle.
AB  - Sympathetic nerves normally project ipsilaterally to lateral cranial targets.
      Following unilateral superior cervical ganglionectomy in neonatal rats, however,
      neurons from the contralateral superior cervical ganglion sprout into the
      denervated region. In the present study we examined neuropeptide Y
      immunoreactivity (NPY-ir) of neurons comprising ipsilateral (control) and
      denervation-induced contralateral pathways to the superior tarsal smooth muscle
      of the eyelid. Fluoro-Gold injection of the control muscle retrogradely labelled
      133 +/- 18 neurons in the ipsilateral superior cervical ganglion; of these, 21 +/
      3% displayed detectable NPY-ir. Fluoro-Gold injections of the reinnervated
      muscle labelled 20 +/- 4 neurons in the contralateral superior cervical ganglion,
      of which 85 +/- 3% contained detectable NPY-ir. Examination of the control tarsal
      muscle revealed DBH-ir noradrenergic nerves throughout the muscle and
      vasculature, while NPY-ir nerves were present primarily around blood vessels. In
      the reinnervated preparation, NPY-ir fibers innervated both blood vessels and
      tarsal muscle in a pattern similar to that of DBH-ir innervation. Acute excision
      of the remaining superior cervical ganglion eliminated all DBH-ir fibers
      bilaterally; NPY-ir was reduced markedly in the reinnervated preparations, though
      some fibers remained. We conclude that, following neonatal denervation, the
      tarsal muscle is reinnervated by a subpopulation of sympathetic neurons that
      differs in neuropeptide phenotype from that of the normal ipsilateral
      innervation.

PMID- 1758971
TI  - The effect of HP-1 and related neutrophil granule peptides on DNA synthesis in
      HL60 cells.
AB  - The recently isolated cysteine- and arginine-rich peptides of the neutrophil
      primary granule and the murine intestinal Paneth cell, named defensins or
      corticostatins, have a number of distinct biological properties. We report the
      effects of three of these peptides HP-1, HP-1-56 and HP-4 on the incorporation of
      [3H]thymidine into the DNA of the leukemic cell line HL60. HP-1 and HP-1-56, but
      not HP-4, inhibited DNA synthesis at 1-50 nM without causing cell death. At
      higher concentrations the effect was reversed, resulting in a small, but
      statistically significant increase in DNA synthesis at 1 microM. In contrast HP-4
      had no effect on HL60 cells at nanomolar concentrations but was strongly
      cytotoxic at micromolar concentrations.

PMID- 1758972
TI  - Chromatographic characterisation and biological activity of neuropeptides
      immunoreactive to antisera against Met5-enkephalin-Arg6-Phe7 (YGGFMRF) extracted
      from the blowfly Calliphora vomitoria (Diptera).
AB  - Neuropeptides identified with a radioimmunoassay specific for the C-terminus of
      Met5-enkephalin-Arg6-Phe7 (YGGFMRF) have been extracted from nervous tissues of
      the blowfly Calliphora vomitoria and also from whole flies. Chromatographic
      characterisation, based on criteria of molecular weight, charge and
      hydrophobicity, reveals a complex multiplicity of immunoreactive peptides.
      Variations in the amounts and types of peptides found within different nervous
      tissues is evidence that the cellular precursor processing is selective.
      Physiological studies on the isolated blowfly salivary gland show that synthetic
      YGGFMRF is a potent secretagogue with a maximal rate of fluid secretion induced
      at a concentration of between 10(-13) and 10(-12) M. The tetrapeptide comprising
      the last four residues of the C-terminus of YGGFMRF, Phe-Met-Arg-Phe, is equally
      potent. However, the carboxyamidated variants, YGGFMRF-NH2 and the molluscan
      cardioacceleratory peptide FMRF-NH2, as well as the opioid peptides Met5- and
      Leu5-enkephalin, have no activity. Partially purified YGGFMRF-immunoreactive
      peptides from the blowfly have ED50 values in the bioassay approximating to 0.3
      thoracic ganglion, 2.1 hypocerebral ganglion and 3.0 brain equivalents.

PMID- 1758973
TI  - Reduced cholecystokinin in the brain of LEC rats with hepatic encephalopathy.
AB  - Levels of cholecystokinin (CCK) immunoreactivity and distribution of CCK
      immunoreactive cells were studied in the cerebral cortex of LEC (Long Evans
      Cinnamon) rats with hepatic encephalopathy. CCK immunoreactivity in water extract
      of cerebral cortex of LEC rats with hepatic encephalopathy (n = 7) was 41.5 +/-
      2.6 (mean +/- S.E.M. pmol/g wet wt.) and that of LEC rats without encephalopathy
      (n = 8) was 67.1 +/- 6.9, the difference being significant (P less than 0.01).
      CCK immunoreactive cells assessed by immunohistochemistry were also markedly
      decreased in the cortex of LEC rats with hepatic encephalopathy of stage IV.
      Thus, CCK reduction was observed in the cerebral cortex of LEC rats with hepatic
      encephalopathy which are provided as a model for analysis of the pathogenesis of
      acute hepatic encephalopathy.

PMID- 1758974
TI  - Elucidation of the sequence of canine (pro)-calcitonin. A molecular biological
      and protein chemical approach.
AB  - From the canine thyroid gland a calcitonin (CT) immunoreactive peptide was
      purified by successive aqueous acid acetone extraction, gel filtration and HPLC.
      Gas-phase sequencing of the purified peptide showed that the first 25 amino acids
      had 65% sequence homology with the amino-terminus of the human CT prohormone. A
      canine cDNA library was then made from the thyroid gland. A plasmid was isolated
      containing a sequence that is homologous to part of exon 3, and the complete
      sequence of exon 4 of the human mRNA encoding preproCT. From this cDNA the amino
      acid sequence of canine CT is predicted. In comparison with well-known CT
      sequences of other species, the strongest homology exists with bovine, porcine
      and ovine CT.

PMID- 1758975
TI  - Neuromedin-N inhibits migrating myoelectric complex and induces irregular spiking
      in the small intestine of rats; comparison with neurotensin.
AB  - The effects of neuromedin-N on migrating myoelectric complexes in the small
      intestine of rats were studied. As neuromedin-N and neurotensin are structurally
      related peptides a comparison with neurotensin was made. Myoelectric activity was
      recorded by means of three bipolar electrodes implanted into the wall of the
      small intestine at 5, 15 and 25 cm distal to the pylorus. The peptides were
      administered as intravenous infusions to fasted conscious rats. Neuromedin-N at
      doses of 100-800 pmol kg-1 min-1 caused a dose-dependent disruption of the
      migrating myoelectric complexes and induced irregular spiking activity (n = 7, P
      less than 0.05). Neurotensin induced a similar response, but at doses of 1.0-8.0
      pmol kg-1 min-1 (n = 5, P less than 0.05). Thus, on a molar basis, neuromedin-N
      appeared to be about 100-times less potent than neurotensin. Hexamethonium (20 mg
      kg-1 i.v.) inhibited the migrating motor complexes and induced quiescence, but
      did not block the effect of neuromedin-N at a dose of 800 pmol kg-1 min-1.
      Atropine (1 mg kg-1 i.v.) and mepyramine (2 mg kg-1 i.v.) did not affect the
      migrating motor complexes, nor did they block the effect of neuromedin-N.
      Simultaneous infusion of neuromedin-N and neurotensin in a 1:1 molar ratio at
      doses of 2 pmol kg-1 min-1 showed inhibition of the response to neurotensin in
      eight out of ten experiments. In conclusion, neuromedin-N changes the myoelectric
      activity in the small intestine from a fasting to a fed pattern.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1758976
TI  - Bombesin-like immunoreactivity in skates and the in vitro effect of bombesin on
      coronary vessels from the longnose skate, Raja rhina.
AB  - Bombesin-like immunoreactivity is present in nerve fibers projecting to the
      cardiovascular system, including the coronary arteries, and to the
      gastrointestinal canal, and in endocrine cells of the gut of skates belonging to
      the family Rajidae. Synthetic bombesin contracted isolated coronary rings from
      the longnose skate, Raja rhina, in a cumulative fashion. The contractile response
      was 84% of that of 60 mM potassium chloride. The pD2-value for bombesin was 8.83
      (S.E.M. = 0.33; n = 15). Phentolamine, atropine and two substance P-antagonists
      increased the sensitivity to bombesin, while atenolol, sotalol, nifedipine,
      tetrodotoxin and two bombesin antagonists were devoid of significant effects. We
      conclude from this study that a bombesin-like peptide is present in nerves
      innervating the cardiovascular system and the gastrointestinal canal of skates of
      the family Rajidae, and that bombesin contracts coronary vessels in vitro via a
      direct mechanism and/or via mechanisms involving alpha-adrenergic and
      muscarinergic receptors.

PMID- 1758977
TI  - Gastrin/CCK antagonists and their use in gastrointestinal research. Bayliss and
      Starling Society 11th annual meeting. Liverpool, 23-24 September 1991.

PMID- 1758978
TI  - Children of alcoholics.

PMID- 1758979
TI  - A revised estimate of the economic impact of fetal alcohol syndrome.
AB  - A revised estimate of the national economic impact of fetal alcohol syndrome
      (FAS)-related abnormalities was conducted. The present evaluation included
      "corrections" for background rates of low birth weight, and costs normally
      incurred for housing and food regardless of whether an individual requires
      institutionalization or not. Additional anomalies were included along with
      hospital costs provided for in diagnostic-related groups. The current estimate
      for annual costs related to FAS is $249.7 million, which is about $80 million
      less than our previous estimate. This estimate is lower due to a slightly lower
      number of cases with low birth weight, a correction for costs that would
      otherwise have occurred, and exclusion of costs (about $75 million) for annual
      semi-independent support for individuals with IQs in the 70-85 range.
      Nonetheless, mental retardation accounts for almost 60% of the estimated total
      cost. A quarter of a billion dollars per year remains a high economic incremental
      cost by any reasonable standard and represents a benchmark against which costs of
      potential prevention strategies may be judged.

PMID- 1758980
TI  - Clinical correlations between ethanol intake and fetal alcohol syndrome.
AB  - Fetal alcohol syndrome (FAS) is a cluster of features observed in some offspring
      of women who abuse alcohol in pregnancy. The defining features include
      intrauterine growth retardation, specific craniofacial dysmorphology, and central
      nervous system dysfunction. FAS is a full expression of a continuum of fetal
      alcohol effects. The assessment of alcohol abuse is one of several major problems
      in the study of the topic. Research findings are reviewed under a hypothesis of
      increasing effect in ordered categories: lethal effects, adverse obstetrical
      outcomes, malformations, growth retardation, reduced head circumference, and
      neuropsychological effects. Evidence of fetal alcohol effects may be found for
      each outcome category. The evidence across studies is not consistent nor is there
      any clear support for an effect order. The risk for psychological deficit may
      depend on the presence of dysmorphic effects.

PMID- 1758981
TI  - The effects of prenatal alcohol on the central nervous system.
AB  - Prenatal alcohol exposure has a profound effect on the developing brain. In fetal
      alcohol syndrome (FAS), mental retardation and microcephaly are commonly
      observed. A partial syndrome, fetal alcohol effects (FAE) can result in
      neurobehavioral sequelae, which may present at birth or appear later in
      development. This chapter discusses the clinical evidence supporting the concept
      of FAE, the range of cognitive disturbances seen in FAS and FAE children, and
      studies on long-term outcome. We review studies that suggest that even in the
      absence of the stigmata of FAS, neonatal signs of central nervous system
      dysfunction may predict later developmental deviation. However, the clinical
      research on the cognitive and behavioral disorders in the FAE population is
      limited. Examination of electroencephalograms, evoked potentials, and sleep
      pattern provide additional evidence that the functional integrity of the brain
      has been altered. An abbreviated review of behavioral animal studies provides
      additional support for the clinical investigations presented.

PMID- 1758982
TI  - Multilevel intervention for prevention of fetal alcohol syndrome and effects of
      prenatal alcohol exposure.
AB  - The deleterious effects of prenatal alcohol exposure have been the subject of
      numerous research studies since first recognized in the early 1970s. The results
      of these studies have indicated that the dose and patterning of maternal alcohol
      consumption, use of other drugs, as well as other social and environmental
      factors may mediate developmental outcomes in prenatally alcohol-exposed
      children. Although there are still many unanswered questions regarding etiology,
      there is a clearly identified need for effective prevention/intervention programs
      for alcohol-abusing women of childbearing age. Such programs must address the
      multiple factors that may exacerbate alcohol's teratogenic effects. The
      prevention of fetal alcohol syndrome (FAS) and other alcohol-related birth
      defects (ARBD) can only be accomplished through multilevel, multisystem
      intervention strategies, including community education, therapeutic interventions
      with the alcohol-abusing mother, parenting education, and early identification
      and intervention with the alcohol-affected child. A review on the etiology of FAS
      and ARBD is presented with recommended strategies for prevention/intervention.

PMID- 1758983
TI  - Vulnerability to alcoholic liver disease.
AB  - Epidemiological evidence suggests a direct relationship between alcohol
      consumption and the prevalence of cirrhosis. However, the observation that only 8
      30% of alcoholics develop cirrhosis illustrates that individual susceptibility
      mediates the relationship between alcohol consumption and cirrhosis. This chapter
      examines the factors that may influence individual risk for alcoholic liver
      disease. These factors include individual differences in alcohol metabolism and
      consumption patterns, gender, HLA antigens, family alcoholism history, and immune
      responsiveness. Important methodological issues in each of these areas are
      addressed also. From the available evidence, the hypothesis is advanced that
      there is an underlying vulnerability to liver disease in some individuals, and
      that alcohol use, although a necessary condition, is not sufficient to trigger
      disease in all individuals.

PMID- 1758984
TI  - Hepatic encephalopathy coexistent with alcoholism.
AB  - Although it is well established that the majority of alcoholics are
      neurologically compromised, little is known about the etiological factors
      underlying the central nervous system (CNS) disturbances. Without doubt, ethanol
      is a neurotoxin; however, the complex array of factors presaging drinking onset
      and factors concomitant to a lifestyle of alcohol abuse probably also influence
      the risk for neurologic injury. This chapter reviews the emerging evidence
      linking liver disease to the neurologic pathology manifested by chronic
      alcoholics. The observation that the pattern and severity of cognitive deficits
      is similar between alcoholics and nonalcoholics with cirrhosis, combined with the
      demonstration that biochemical indices of liver injury correlate with cognitive
      test performance in alcoholics, illustrates the important role of liver disease
      as a codeterminant of the CNS disturbance. In addition, the findings from
      developing research indicating that liver transplantation can reverse the
      deficits on neuropsychological tests further underscore the importance of
      advanced liver disease as a determinant of the CNS pathology, and the results
      suggest the need for aggressive treatment of alcoholic liver disease for
      restoring the alcoholic's functional cognitive abilities, which, in turn, may
      improve the prognosis for psychosocial adjustment.

PMID- 1758985
TI  - Neuropsychological factors in individuals at high risk for alcoholism.
AB  - It has been postulated that deficits in certain areas of cognitive functioning
      among children of alcoholics may contribute to their increased risk for
      developing alcoholism and other substance abuse disorders. In this chapter, the
      recent evidence for this hypothesis is critically reviewed. Studies citing
      differences in cognitive functioning between persons at high risk versus those at
      low risk for alcoholism are presented as well as those studies that have failed
      to demonstrate differences in cognitive abilities. On balance, the evidence in
      support of variations in cognitive abilities at risk factors for the development
      of alcoholism is not strong. The equivocal nature of the literature may be due to
      a variety of issues related to the design of studies examining risk factors for
      alcoholism, to the variability of definitions of family history positive used, to
      the failure to adequately control potentially confounding subject variables, and
      to the improper analysis of data. Recommendations are made for future studies
      examining neuropsychological functioning in "at risk" samples.

PMID- 1758986
TI  - Vulnerability to cardiac disease.
AB  - Chronic consumption of ethanol has deleterious effects on the cardiovascular
      system, as manifested by an attenuation in myocardial contractility, a reduction
      in cardiac output, and the induction of arrhythmia. The arrhythmogenic effect of
      ethanol is associated with the high incidence of sudden death in alcoholics.
      Further, alcohol was found to potentiate arrhythmias due to nonpenetrating chest
      trauma, a finding of profound clinical significance. In addition, chronic ethanol
      consumption is closely linked to hypertension. Whether modest alcohol consumption
      may protect against coronary artery disease is controversial and not clearly
      established. Cessation of alcohol consumption occasionally results in reversal of
      ethanol-induced myocardial injury. However, the transition from ethanol-induced
      reversible injury to permanent heart damage is not well understood. Finally, the
      combined effects on the myocardium of alcohol and other abused drugs, such as
      cocaine and amphetamines, and the interaction of ethanol with chemicals such as
      nicotine, digitalis, and other medicaments are not well understood and may be
      fatal.

PMID- 1758987
TI  - Adult children of alcoholics. The history of a social movement and its impact on
      clinical theory and practice.
AB  - This chapter proposes that the popular social movement of adult children of
      alcoholics (ACOA) has had a profound impact on theory development and clinical
      practice in the fields of mental health and chemical dependence. The birth of the
      social movement is first traced, looking back to the origins of Alcoholics
      Anonymous in the self-help movement and the corresponding professional
      development of a systems perspective that included the notions of alcoholism as a
      "family disease" and the "alcoholic family," which included young children.
      Extending the idea to adults followed. This chapter examines why this movement
      could not originate in either professional field, accenting narrow theoretical
      base, oversimplification, professional denial, and bias in beliefs and values.
      Implications of the label ACOA are next addressed. Finally, a new integrated
      theory is proposed which bridges mental health, chemical dependence, and self
      help disciplines. This theory includes environmental, systems, and individual
      development perspectives and integration of behavioral, cognitive, and dynamic
      psychotherapies. The chapter concludes with new challenges for diagnosis and
      reimbursement.

PMID- 1758988
TI  - Epidemiological perspectives on children of alcoholics.
AB  - Because alcoholism is a highly heritable condition, children of alcoholics,
      especially sons, are at much higher risk than the general population for
      developing the disorder. Furthermore, secular trends are apparent for both sons
      and daughters of alcoholics, such that alcoholism has become more prevalent over
      time, increasing the morbid risk in offspring of alcoholics. Increases in
      prevalence of disorders known to be associated with alcoholism, such as conduct
      disorder, depression, and drug abuse, have also been found in younger cohorts, as
      well. At the genetic level, alcoholism appears to be heterogeneous, raising the
      possibility that alcoholism may be a product of numerous different kinds of gene
      environment interactions. Further advances in our understanding of alcoholism
      will come from molecular genetic studies and longitudinal studies of high-risk
      populations.

PMID- 1758989
TI  - Psychological characteristics of children of alcoholics. Overview of research
      methods and findings.
AB  - Recent years have witnessed a dramatic interest in the psychological
      characteristics of children of alcoholics (COAs). This chapter provides an
      overview of this research, focusing on (1) studies suggesting genetic
      contributions to the intergenerational transmission of alcoholism, (2) studies
      characterizing the features of an alcoholic rearing environment, and (3)
      empirical studies contrasting COAs and children of nonalcoholics (non-COAs).
      Although it appears that COAs do differ from non-COAs on a number of variables
      that might have etiological significance for the development of alcoholism, the
      pattern and consistency of findings defy a simple integration. Perhaps more
      important, much of the available research is characterized by methodological
      limitations that preclude strong inferences concerning the nature and extent of
      deficits in COAs. Relevant methodological issues such as ascertainment strategy,
      the heterogeneity of parental alcoholism, the specificity of COA deficits, and
      design strategies are described and their possible impact on study outcomes is
      discussed.

PMID- 1758990
TI  - From prevention to treatment. Issues for school-aged children of alcoholics.
AB  - Empirical and anecdotal evidence concerning the variables that mediate and
      moderate the relationship between parental alcoholism and child vulnerability has
      been used as the basis for a growing number of prevention and treatment programs
      for school-aged children of alcoholics. Common intervention foci include
      information on alcohol and alcoholism, the dynamics of alcoholic families, common
      social and emotional reactions (e.g., embarrassment, loneliness, guilt,
      depression, anger), skill building (e.g., problem solving, communication,
      expression of feelings), coping strategies for living in an alcoholic home, and
      general social and emotional support. The primary modality is a small group,
      which is usually time-limited. Groups are conducted in schools, community
      agencies, and mental health or drug treatment centers. Research on the
      effectiveness of several of these programs has yielded positive results with
      respect to a variety of psychosocial measures, although most studies share some
      common methodological shortcomings (e.g., lack of appropriate control groups,
      lack of longitudinal assessments of effects). More rigorous evaluation, as well
      as continued and expanded program development and outreach, is recommended.

PMID- 1758991
TI  - Treating adults raised by alcoholic parents.
AB  - The concept of adult children of alcoholics (ACOAs) is a recent one, yet ACOAs
      have had a formidable influence on the chemical dependence and mental health
      treatment field. Through their sponsorship of workshops and conferences,
      development of specialized inpatient and outpatient treatment programs, and
      generation of publications dedicated to understanding themselves with common
      interpersonal and intrapersonal problems, ACOAs have organized themselves into an
      influential social movement. Most ACOA treatment philosophies and programs are
      derived from the ACOA social movement using the concept of the "inner child" to
      guide the treatment. Unfortunately, few studies of treatment efficacy are
      available in the scientific literature. In this chapter, our discussion
      concentrates on the central treatment theme of the ACOA movement as it influences
      the treatment ideologies that currently guide ACOA treatment programs. We
      conclude by addressing the obvious need for research and the necessity for
      maintaining our ethical responsibility both in scientific inquiry and in the
      treatment of needy individuals.

PMID- 1758992
TI  - Potential biochemical markers for the predisposition toward alcoholism.
AB  - For over two decades, evidence has been accumulating that supports a genetic
      predisposition to alcoholism and the presence of subgroups among alcoholics. With
      this knowledge, searches are underway for biological markers, including
      biochemical trait markers, for predisposition to alcoholism. Most promising
      results to date have been obtained in studies on various enzyme activities in
      lymphocytes, platelets, and fibroblasts. Measurement of monoamine oxidase
      activity in platelets and adenylate cyclase activity in platelets and lymphocytes
      should enable rapid investigation of relatively large groups of subjects at high
      risk to become alcoholics. Such studies could generate a valid biochemical marker
      for vulnerability in alcoholism, which is not available at the present time.

PMID- 1758993
TI  - A longitudinal study of children of alcoholics.
AB  - This chapter reviews the identification, testing, and 8- to 12-year follow-up of
      237 sons of alcoholic fathers and 237 controls (474 men). Subjects were selected
      from respondents to a questionnaire mailed to 18- to 25-year-old students and
      nonacademic staff at a university, with initial evaluations demonstrating few
      differences between sons of alcoholics and controls on quantity and frequency of
      drinking or many major life problems related to alcohol. The subset of 474 men
      actually tested in the laboratory also revealed few family history differences on
      personality attributes, including a lack of differential on the Type 1/Type 2
      alcoholism scheme. Our laboratory has, however, consistently documented less
      intense responses to alcohol for the sons of alcoholics, findings consistent
      across subjective feelings, increases in body sway, and changes in several
      hormones and electrophysiological measures. This dampened response to ethanol for
      men at high future risk for alcoholism was not observed after challenges with two
      different doses of diazepam.

PMID- 1758994
TI  - Neurophysiological factors in individuals at risk for alcoholism.
AB  - The literature dealing with electrophysiological research in individuals at risk
      for alcoholism is reviewed. Event-related potential (ERP) and
      electroencephalographic (EEG) differences between family-history-positive (FHP)
      and family-history-negative (FHN) men have been reported both prior to the
      ingestion of alcohol and following alcohol challenge doses. At present, the most
      robust of these electrophysiological findings is the lower P3 amplitude of the
      ERP, which has now been replicated in several laboratories. This perhaps provides
      a phenotypic marker, distinguishing those at risk for alcoholism. However, its
      specificity for alcoholism and the role of gene-environment interactions in the
      development of alcoholism remain to be determined.

PMID- 1758995
TI  - Developmental behavior-genetic perspective of alcoholism etiology.
AB  - Gene-environment interactions underlying the etiology of alcoholism are amenable
      to investigation from a behavior-genetic perspective. The organismic
      characteristics that most frequently and reliably have been found to predispose
      to alcoholism are behavioral traits. Certain behavioral traits, viz.,
      temperaments, have a substantial heritable contribution and comprise the elements
      from which complex habit patterns and personality traits develop. The unique
      interaction between the individual possessing certain extreme deviations in
      temperament traits with environmental contingencies occurring during the course
      of psychosocial development and throughout adulthood is hypothesized to determine
      the risk during any period of the lifespan for an alcoholism outcome.

PMID- 1758996
TI  - Basic animal research.
AB  - Recent research with animal models of the fetal alcohol syndrome has resulted in
      advances in the areas of prenatal and postnatal growth retardation, facial
      dysmorphology, immune system deficiencies, endocrine dysfunction, and central
      nervous system alterations, including behavior. The rat is the most common
      species used in these studies, although similar experimental changes have been
      produced in a limited number of studies in other species. The specific
      deleterious effects of ethanol on the fetus are dose-related and dependent on the
      stage of gestation, as with other fetotoxic agents. However, the precise timing
      and dose-effect curves have yet to be established for most types of ethanol
      induced damage. Various exposure regimens have been employed, including
      inhalation of ethanol vapor and intraperitoneal injection, as well as oral
      exposure by gavage, diet, or drinking water. In the early postnatal period,
      following gestational exposure, altered function is most marked, with recovery in
      some measurements with postnatal maturation. The present literature clearly
      defines developmental damage from gestational exposure to ethanol as well as
      areas for additional research.

PMID- 1758997
TI  - Genetic basis of atopy.

PMID- 1758998
TI  - Preventative therapy in adults with asthma.

PMID- 1758999
TI  - The dose-response slope: a useful method for expressing the results of
      methacholine provocation tests in healthy subjects?
AB  - In order to study the reproducibility of different indices of airway
      responsiveness, two bronchial provocations with increasing methacholine
      concentrations up to 256 mg ml-1 were performed within 2 weeks on 30 healthy
      volunteers. The dose-response slope [DRS = maximal fall (%) in pulmonary
      function/maximal non-cumulative methacholine dose (mumol)] was calculated from
      forced expiratory volume in 1 s (FEV1) and from area under the expiratory flow
      volume curve (AEFV). DRS reproducibility within 2 weeks in responsive (decline in
      FEV1 greater than 20%) and non-responsive subjects (decline in FEV1 less than
      20%) was assessed. After log-transformation of the data the reproducibility was
      assessed with intraclass correlations (ICC) [with 95% confidence intervals
      (CIicc)], mean difference with limits of agreement (delta +/- SD), 95% confidence
      intervals for a single measurement (CIsm), and the absolute difference of the
      observations of the two days from each other (zero = ideal reproducibility).
      Provocative doses (PD20FEV1) could be calculated for 14 subjects on both
      occasions. In this responsive group the reproducibility of all the parameters
      used (PD20FEV1, DRSFEV1 and DRSAEFV) was high. In the non-responsive group,
      DRSFEV1 demonstrated a slightly, but not clearly, lower ICC than DRSAEFV.
      However, DRSFEV1 had clearly wider limits of agreement and CIsm than DRSAEFV.
      Also, with DRSFEV1 the observations of the two days differed significantly more
      from each other than with DRSAEFV (P less than 0.05).

PMID- 1759000
TI  - Reassessment of asthma management in an accident and emergency department.
AB  - To determine if shortcomings in asthma management in the Accident and Emergency
      (A & E) department identified in a previous (1983) study (Reed et al. Thorax
      1985; 40: 897-902) had been corrected, we retrospectively reviewed the case
      records of patients attending with asthma between December 1987 and November
      1988. There was an increase in the number of patients attending with asthma; 0.73
      per 1000 in 1988 versus 0.57 per 1000 in 1983. Sixty-seven percent of patients
      were self-referred and 80% presented between 1600 h and 0800 h. There was
      inadequate recording of the asthma history and examination findings. Peak
      expiratory flow (PEF) was recorded in 86% before treatment (compared to 11% in
      1983) and 70% after treatment. In addition, a prospective study of 40 patients
      responding to a questionnaire 2 weeks after discharge, revealed persistent
      symptoms of unstable asthma in 50%. Although there has been a marked improvement
      in the use of PEF measurements since the 1983 study, the standards of management
      of asthma patients may still be inadequate as evidence by the presence of
      unstable asthma symptoms in many of those discharged. A standardized management
      protocol which provides guidelines for treatment based on PEF has been introduced
      to the A & E department.

PMID- 1759001
TI  - A 2-year longitudinal study of lung hyperinflation in young asthmatics.
AB  - Functional residual capacity (FRC) was measured at 6-monthly intervals for at
      least 2 years in 42 young asthmatic children. Over the 2-year period FRC
      decreased in the 42 children from a median of 136% to 117% of that predicted for
      height (P less than 0.05). These changes in FRC were associated with a reduction
      in the number of children receiving no regular treatment (ten at recruitment, 0
      at 2 years), P less than 0.05, and an increase in the number of children
      receiving inhaled steroids (ten at recruitment and 29 at 2 years), P less than
      0.01. Twenty-five children were hyperinflated at recruitment (FRC greater than
      120% of that predicted for height) with median FRC 152% compared to only 16
      children at 2 years median FRC 117%, P less than 0.01. We conclude that FRC
      decreases as asthmatic children get older but some children, worryingly and
      despite increased use of prophylactic therapy, remain chronically overdistended
      which may put them at serious risk of chronic obstructive airways disease in
      later life.

PMID- 1759002
TI  - Differences in tonsil core bacteriology in adults and children: a prospective
      study of 262 patients.
AB  - The tonsillar microflora of 262 patients with recurrent acute tonsillitis studied
      in 1989-1990 is presented. The patient population was divided into three age
      groups to determine any age-related features. One-hundred and forty-nine patients
      (57%) were in the 2-7-year-old group, 72 (28%) the 8-14-year-old age group, and
      the remaining 41 (15%) were over 15 years of age. H. influenzae was the single
      most common bacterium isolated from the centre of the tonsil (referred to as
      'tonsil core'), and this was more prevalent in the 2-7-year-old age group. Staph
      aureus was the next most commonly isolated bacterium and was most frequently seen
      in the 8-14-year-old age group (29%). Anaerobic bacteriology was performed in 120
      patients. Strict anaerobic species were isolated in significant numbers from the
      tonsil core in 5% but were present in the superficial culture in all. Anaerobes
      were present in moderate to heavy numbers in 32% of superficial swabs overall and
      this was more frequently seen in the older age groups. Mixed pathogens were found
      throughout all age groups and were most prevalent in the 8-14-year-old age group
      at 46%. The commonest mixture was H. influenzae and Staph aureus. Normal flora
      only was commonly found in the superficial swab and rarely in the tonsil core.
      The number of specimens containing a beta-lactamase producer was assessed for
      each group; this was similar in all of the groups ranging from 43% in the 2-7
      year-old group and 53% in the 8-14-year-old group to 39% in the greater than 15
      year-old group.

PMID- 1759003
TI  - Cystic fibrosis: what do patients know, and what else would they like to know?
AB  - As the survival of patients with cystic fibrosis (CF) improves, it becomes
      increasingly important to address such issues as employment, reproduction, and
      quality of life in adulthood. In this study, 22 patients and 20 parents completed
      a questionnaire about the natural history, treatment and genetics of cystic
      fibrosis. Patients and parents knew as much as each other about the natural
      history of cystic fibrosis. Patients under 13 knew significantly less about the
      genetics and treatment. All found probability questions about heredity difficult.
      All the patients indicated that they would like further information on the future
      and how they would cope, through CF literature, organized patient groups and, in
      adolescence, would prefer to obtain information from medical staff rather than
      parents. Patients had received considerable information about the disease and its
      treatment from parents and clinical staff, but few had discussed the day to day
      problems of living with cystic fibrosis. This study has identified specific areas
      of ignorance in patients with cystic fibrosis, areas that need addressing in view
      of the improved survival associated with this disease.

PMID- 1759004
TI  - The effect of a beta 2-adrenergic agonist and a histamine H1-receptor antagonist
      on the late asthmatic response to inhaled antigen.
AB  - In this double-blind, randomized, cross-over trial, the role of histamine and the
      possible protective effect of a beta 2-adrenergic agonist in the later asthmatic
      response to inhaled antigen was investigated in nine atopic asthmatic patients.
      On four study days, 2-4 weeks apart, patients were given either: placebo;
      salbutamol aerosol 400 micrograms before and 200 micrograms 2-hourly after
      challenge; oral terfenadine 120 mg 2 h before and 10 h after challenge; and, on
      the final day, lung function was monitored without medication or antigen
      challenge. A nebuliser-dosimeter system was used to deliver a predetermined,
      single dose of antigen aerosol. Response was assessed by specific airways
      conductance (SGAW) measured in a body plethysmograph; FEV1 and PEFR were measured
      with a Pocket Spirometer. All measurements were made for 10 h in the clinic and
      then the patients continued to record PEFR and FEV1 at home for at least 2 more
      hours. Similar findings were obtained with all three lung function parameters.
      After challenge, the early response (ER) was small when compared with the late
      response (LR). All patients had a definite LR on the placebo day when FEV1 was
      compared with 'no challenge day'. Neither drugs had much effect on the small ER.
      The LR was not altered by terfenadine but was very significantly attenuated by
      salbutamol; the mean maximum fall in FEV1 during LR being 31, 29 and 12% after
      placebo, terfenadine and salbutamol, respectively. It is unlikely that histamine
      plays an important role in the LR to inhaled antigen but beta 2-adrenergic
      stimulants can attenuate LR, probably by directly preventing bronchial smooth
      muscle constriction and also by stabilising bronchial mast cells.

PMID- 1759005
TI  - Salbutamol plus beclomethasone dipropionate, but not salbutamol alone, completely
      prevent early and late asthmatic responses to allergen.
AB  - The effect of a week treatment with inhaled salbutamol plus placebo (S+P) vs.
      salbutamol combined with beclomethasone dipropionate (S+BDP) on early and late
      asthmatic responses to inhaled allergen was studied in ten atopic patients in a
      randomized, double-blind, cross-over study. All patients had previously shown a
      dual type response to the specific bronchial provocative test (sBPT). Each
      patient performed two periods of treatment for a week, with a 15 day interval
      between them: (a) salbutamol 0.3 mg, tid + placebo; (b) salbutamol 0.3 mg+BDP 0.2
      mg, tid; at the end of each treatment period, sBPT was performed and the last
      treatments were given 1.5-2 h before and 3-4 h after allergen challenge. S + BDP
      completely prevented both early and late responses to allergen, while S + P
      reduced but did not completely inhibit early and late responses. The difference
      between the two treatments was significant for early and late asthmatic
      responses. Non-specific bronchial hyperresponsiveness to methacholine was
      performed before each treatment period, after 6 days of treatment before sBPT and
      the day after sBPT at the end of the treatment period; there was only a mild
      increase in PD15FEV1 methacholine after 6 days of treatment with S + BDP in
      comparison with S + P treatment. These results suggest that salbutamol plus
      beclomethasone may be used effectively in the prophylaxis of early and late
      asthmatic reactions induced by allergen in sensitized subjects.

PMID- 1759006
TI  - Portable oxygen therapy: assessment and usage.
AB  - Fifty portable oxygen assessments, based on 6-min walking tests, were reviewed to
      produce guidelines for assessment and prescription of portable oxygen, and to
      evaluate factors predicting benefit. Patients with a portable cylinder were
      questioned about benefits/difficulties and usage of portable oxygen. A
      significant improvement on the oxygen compared to the air walk was found (median
      9.7%) which correlated with the oxygen desaturation on the baseline walk (r =
      0.51, P less than 0.05). A placebo effect was demonstrated using an air cylinder
      (median improvement 6.1%). There was no correlation between improvement in
      walking distance and decrease in visual analogue scale (VAS) score of
      breathlessness. We recommend standard portable oxygen assessments based on a
      series of 6-min walks. Improvements of 10% in walking distance or VAS score from
      the oxygen to the air walk would lead to the patient being offered a portable
      oxygen cylinder.

PMID- 1759007
TI  - Cardio-respiratory responses to exercise following treatment of acute severe
      asthma.
AB  - Asthmatic patients are encouraged to adopt a normal and active life-style.
      However, following treatment of acute severe asthma, patients may ask for advice
      about taking exercise. Serial measurements of the cardio-respiratory responses to
      continuous work load exercise, were made in asthmatic patients convalescing
      following hospital treatment of an acute exacerbation. Eighteen asymptomatic
      patients, (seven male) aged 18-48 years, were studied. The first test was
      performed within 1 week of admission, when the mean (SD) peak expiratory flow
      rate (PEFR) was 88 (20)% predicted normal and the arterial oxygen tension (PaO2)
      was 13.1 (1.4) kPa. No significant differences in the mean cardio-respiratory
      responses, from the last minute of exercise, were found during the 4-week study.
      There were no significant differences in the four tests, between the resting
      PEFR, lowest post-exercise PEFR or % change in PEFR. Also, there were no
      significant differences in the pre-exercise, end of exercise and recovery (10 min
      after exercise) PaO2, between the four tests. However, taking the four tests as a
      whole, significant relationships were found between the recovery PaO2 and the
      lowest post-exercise PEFR, expressed in absolute terms (r = 0.515, P less than
      0.001), and as a percentage of predicted normal (r = 0.533, P less than 0.001);
      and also between the recovery PaO2 and the % change in PEFR after exercise (r =
      0.299, P less than 0.05). It is suggested that a formal exercise test should be
      performed in convalescent asthmatics wishing to participate in active sports.
      Patients with exercise-induced asthma may then be identified and treated
      appropriately.

PMID- 1759008
TI  - Audit of tuberculosis contact tracing procedures in south Gwent.
AB  - A survey of part of the work of the tuberculosis contact clinic over a 5-yr
      period (1984-1988 inclusive) is presented. There were 106 notified index cases
      and 781 contacts were screened. Following chest radiography, Mantoux tests and
      BCG vaccinations, only four contacts who were tuberculin-positive required
      chemoprophylaxis. One asymptomatic adult casual contact was treated as an active
      case because of shadowing on a chest radiograph. Two other cases of active
      tuberculosis came to light but not through the routine contact tracing
      procedures. All cases given treatment were contacts of a single index case and
      the family case history is described. Because of experience with this family the
      contact tracing procedures will continue locally but will be monitored
      prospectively. In view of different findings in other centres it is suggested a
      further national survey is indicated with special attention to regional
      variations.

PMID- 1759009
TI  - Endobronchial sarcoidosis presenting as severe upper airways narrowing with
      normal chest radiograph.

PMID- 1759010
TI  - Pneumopyopericardium in a Zimbabwean man with Klebsiella pneumonia.

PMID- 1759011
TI  - Occult respiratory failure as a cause of neuropsychiatric symptoms in chest wall
      deformity and neuromuscular disease.

PMID- 1759012
TI  - Giant cell tumour of rib: a case report.

PMID- 1759013
TI  - Evaluation of chest percussion in the treatment of patients with copious sputum
      production.

PMID- 1759014
TI  - Primary pulmonary hypertension and thromboembolic pulmonary hypertension-
      similarities and differences.

PMID- 1759015
TI  - The Living with Asthma Questionnaire.
AB  - The 'Living with Asthma Questionnaire' is an asthma-specific quality of life
      scale for assessing patients' own subjective experiences of asthma. The purpose
      of the questionnaire is to assist individual patient management and to provide an
      outcome measure for use in clinical trials. The scale has 68 items and covers 11
      domains of asthma experience which were derived from focus group discussions
      amongst asthma sufferers. The initial item set was refined through standard
      psychometric techniques using a total of 783 patients and there is no statistical
      evidence for independent, domain-specific subscales. Validation studies are
      described.

PMID- 1759016
TI  - Measuring functional status in chronic lung disease: conclusions from a
      randomized control trial.
AB  - The optimal method of assessing the effect of treatment on the day-to-day
      function of patients with chronic airflow limitation has not yet been
      established. Therefore, we examined the performance of the 6-min walk test, a
      rating of dyspnea following the walk test, and three different questionnaires
      measuring dyspnea in daily activities, in a controlled trial of inhaled
      salbutamol and oral theophylline in 24 patients with primary fixed chronic
      airflow limitation. Clinically important and statistically significant effects of
      salbutamol and theophylline on dyspnea during the day-to-day activities were
      detected by each measure, but the Chronic Respiratory Questionnaire (CRQ) was
      more powerful than the other questionnaires, either the Oxygen Cost Diagram or
      the Medical Research Council Dyspnea Questionnaire as modified by the Rand
      Corporation. Changes in the CRQ dyspnea score showed a higher correlation with
      changes in spirometry, walk test score, dyspnea following the walk test, and
      global ratings of dyspnea than did the other two measures. We conclude that the
      CRQ is a responsive, valid measure of functional status for clinical trials in
      chronic lung disease.

PMID- 1759017
TI  - Experience of using the CRQ (Chronic Respiratory Questionnaire).
AB  - We have examined the role of the Chronic Respiratory Questionnaire in practice.
      The questionnaire covers aspects of disability in patients with chronic lung
      disease in terms of dyspnoea, fatigue, emotional function and mastery. It
      therefore provides a measure of physical disability and quality of life in
      patients with lung disease. The questionnaire was validated in older patients
      with chronic obstructive lung disease and is particularly responsive to changes
      within an individual. Its major disadvantages include the lack of sensitivity in
      patients with minor symptoms or possibly those in a younger age group and that it
      is also not possible to make comparisons between populations with the CRQ. It is,
      however, particularly good at demonstrating changes in disability in older
      patients with chronic airways disease.

PMID- 1759018
TI  - The St George's Respiratory Questionnaire.
AB  - The St George's Respiratory Questionnaire is a standardized self-completed
      questionnaire for measuring impaired health and perceived well-being ('quality of
      life') in airways disease. It has been designed to allow comparative measurements
      of health between patient populations and quantify changes in health following
      therapy. The background and rationale for its development are discussed together
      with an analysis of its performance.

PMID- 1759019
TI  - The role of health economics in clinical decision-making: is it ethical?
AB  - With health care resources inevitably limited, we must ensure that they are used
      where they will do the most good. Doing good means improving people's life
      expectancy and quality of life, two characteristics which are combined in the
      Quality-Adjusted-Life-Year, or QALY. Even with effectiveness measured in this
      humanitarian way some people think it is unethical to let cost-effectiveness
      notions guide health care priorities. But costs represent sacrifices of health
      imposed on others, and it cannot be ethical to ignore such sacrifices. Indeed the
      reverse is true, it is unethical to ignore costs, and not to seek to become more
      efficient.

PMID- 1759020
TI  - Economic evaluation studies in respiratory medicine.
AB  - The need for efficient use of resources in the provision of health care is now an
      accepted reality. Despite its economic significance, respiratory disease has been
      the subject of very few examples of the application of techniques of economic
      evaluation. There are a number of examples of cost-minimization studies, and
      these serve to emphasize that choices based on drug acquisition costs may be
      quite different from those based on the total costs of care. The difficulty of
      defining uni-dimensional measures of health outcome for respiratory disease has
      hampered the development of cost-effectiveness studies, and the future of these
      must lie with the efforts to develop measures of quality of life more appropriate
      to this area of medicine. But the multi-dimensional nature of relevant health
      outcomes suggests that cost-utility approaches are likely to play an important
      future role, as off attempts to directly establish patients' monetary valuations
      of the health benefits offered by new respiratory medicines.

PMID- 1759021
TI  - Audit in respiratory disease.
AB  - Respiratory medical audit is discussed in terms of Structure, Process and Outcome
      with a description of the audit Feedback Loop of monitoring, assessment,
      improvement followed by further monitoring and assessment. Methods of monitoring
      include sentinel case, criterion-based, small group comparison, surveys and peer
      review. There are professional, social and pragmatic reasons for audit which is
      the responsibility of the provider professionals and requires adequate resources.

PMID- 1759022
TI  - The patient's viewpoint.

PMID- 1759023
TI  - [Parathyroid function in hypertrophic myocardiopathy].
AB  - It has been suggested that hypertrophic cardiomyopathy (HCM) may be associated
      with hyperparathyroidism. We evaluated parathyroid function in 15 patients with
      HCM and 14 patients with primary dilated cardiomyopathy (DCM), measuring
      different parameters of calcium metabolism (total serum calcium, ionized calcium,
      PTH, vitamin D metabolites, alkaline phosphatase, osteocalcin). As a group PTH
      levels were normal in HCM (intact PTH 3.9 +/- 1.6 pmol/l, midmolecular PTH 59 +/-
      13 pmol/l and carboxyterminal PTH 0.6 +/- 0.4 ng/ml), but in 3 patients
      carboxyterminal PTH levels were persistently higher than normal, while all other
      parameters of calcium metabolism were normal. We conclude that parathyroid
      function is normal in patients with HCM, although some of them may have an
      abnormal secretion and/or metabolism of carboxyterminal PTH fragments, or a
      circulating substance the interferes with this PTH assay. Parathyroid function in
      DCM patients was normal, except in a patient who had hyperparathyroidism
      secondary to vitamin D deficiency.

PMID- 1759024
TI  - [The efficacy of propafenone in preventing recurrent auricular fibrillation and
      flutter].
AB  - In order to investigate the efficacy of propafenone in the prevention of
      paroxysmal flutter or fibrillation, we treated 21 patients without left
      ventricular disfunction. Age was 60 +/- 14 (mean +/- sd) years, left atrial
      diameter by echocardiography 37 +/- 7 mm, cardiothoracic index 0.48 +/- 0.05
      (0.41-0.57) and P wave duration 100 +/- 17 ms. The frequency of recurrences
      before treatment was: daily in five (23%), weekly or more in eight (38%), monthly
      weekly in seven (33%) and quarterly-monthly in one (5%). Propafenone (671 +/- 187
      mg/24 h) was given after recurrences were demonstrated under treatment with 1-3
      antiarrhythmic drugs per patient. During 8.9 +/- 3.5 months of follow-up (range 6
      19) 5 patients (23%) were completely free of recurrences; in seven (33%) the
      incidence decreased by greater than 50% with a marked decrease in duration. Side
      effects appeared in 12 cases (57%), leading to its discontinuation in four (19%).
      Arrhythmogenic effects were observed in 2 cases (9%). Propafenone is effective in
      greater than 50% of patients with paroxysmal atrial flutter or fibrillation,
      resistant to other antiarrhythmic agents. The incidence of side effects is high,
      but they are usually not severe and reversible.

PMID- 1759025
TI  - [Ambulatory transesophageal echocardiography: 2 years of experience].
AB  - In this report we study the value of ambulatory transesophageal echocardiography
      (TEE) in the clinical setting after a 2-year experience at our department. Since
      December 1988 until February 1991, 470 TEE examinations were indicated in 430
      patients. Excluded were 8 cases, two out of them due to a formal contraindication
      and six who did not tolerate the procedure. The clinical indications for the
      examination, in the 462 studies performed, were as follows: possible cardiac
      source of emboli in 165 (35%); native mitral valve disease in 91 (20%);
      prosthetic valve dysfunction in 54 (12%); diseases of the aorta in 44 (10%);
      suspected infective endocarditis in 41 (9%); study of left ventricular function
      in 26 (6%); congenital heart disease in 18 (4%); tumor or intracardiac mass in 11
      (2%); miscellaneous in 12 (2%). Based on this experience, we can conclude that
      TEE is a clinically useful technique for: 1) the study of mitral regurgitation,
      either native or prosthetic; 2) the detection of vegetations and abscesses in
      infective endocarditis; 3) the evaluation of a possible cardiac source of emboli;
      4) the examination of the aorta in cases of suspected dissection; 5) the
      completion of the anatomic study in some congenital heart diseases, particularly
      after a surgical correction; 6) the study of patients with a technically
      inadequate transthoracic approach.

PMID- 1759026
TI  - [Coronary angioplasty with a rotary atherotome].
AB  - Several new coronary dilatation systems, including those using laser energy,
      atherectomy devices and stent implantation, are being developed as alternative or
      complementary procedures to coronary artery balloon angioplasty. We report our
      initial experience performing coronary angioplasty with a new rotational
      atherectomy device, the transluminal extraction catheter, which simultaneously
      cut and aspirate fragments from the atherosclerotic plaque. The components of the
      whole system are a special guidewire to cross the stenosis, the atherectomy
      catheter and the conduction-control unit. This unit, connected when the
      atherectomy catheter is positioned across the lesion, produces rotation of the
      conical bladder located in the catheter distal tip and simultaneous aspiration of
      residual particles. The procedure was performed in 11 patients in whom 13 lesions
      were dilated. All patients were male (mean age 55 +/- 23 years, range 45-77). The
      reason for the angioplasty was stable angina in 2 patients and unstable angina in
      the remaining seven. Initial success (residual stenosis less than 50% of vessel
      diameter) was obtained in 10 of 13 lesions. In two, conventional balloon
      angioplasty was required to improve atherectomy result. The only unsuccessful
      procedure was in a proximal right coronary artery venous graft, in which a large
      dissection occurred. Patient had angina but no myocardial infarction. Pathologic
      examination of aspirated material revealed fibrous tissue in 12 cases and
      cholesterol crystals in four. We conclude, with the limitation of a preliminary
      study, that rotational atherectomy with the transluminal extraction catheter is a
      useful procedure to relief coronary stenosis of the coronary arteries.

PMID- 1759027
TI  - [The surgical treatment of aneurysms of the ascending aorta with associated
      aortic insufficiency. Total replacement with reimplantation of the coronary
      arteries].
AB  - We reviewed our experience with replacement of the ascending aorta and aortic
      valve with a composite graft and reimplantation of coronary arteries to the tube
      graft during 8 years interval from April, 1982, to April 1990. 24 patients
      underwent repair, the mean age was 49.83 years. Annuloaortic ectasia was the most
      common indication (58.33%), followed by aortic dissection (acute or chronic).
      Emergency operation was carried out in nine patients with aortic dissection
      (37.5%) and elective in 15. The mean duration of cardiopulmonary bypass was 118
      +/- 4 minutes and of aortic clamping 83.85 +/- 2 minutes. Hospital mortality was
      4.17%, reoperation for hemorrhage was 12.5% and perioperative morbidity for other
      causes was 34.7%. There were one late death. 20 patients were follow-up with a
      total of 638 patients-months (two patients excluded with insufficient follow-up
      and one late death). At last follow-up 14 patients were in functional class I.
      Eight year actuarial survival for the 24 patients was 91%. We believe that
      replacement of the ascending aorta and aortic valve with a composite graft and
      coronary arteries reimplantation to the tube graft is more than one satisfactory
      alternative to supracoronary graft replacement and aortic valve replacement. It
      offers the advantage of excluding all abnormal aortic tissue, eliminating the
      risk for later development of complications in the non excluded disease aorta. It
      supposes the method of choice for patients with anuloaortic-ectasia, aneurysms of
      the sinuses of Valsalva with aortic insufficiency, and aortic dissection with
      proximal affectation of coronary arteries and aortic valve.

PMID- 1759028
TI  - [Chronic heart failure (I). The epidemiology of chronic heart failure].

PMID- 1759029
TI  - [Brucellar pericarditis: 2 different forms of presentation for an unusual
      etiology].
AB  - Two cases of Brucella melitensis pericarditis are reported. Pericardial
      involvement was the first and almost only manifestation of brucellosis in the
      first patient while in the second, a significant pericardial effusion was
      discovered on a routine echocardiogram performed in a patient with clinically
      florid brucellosis. Some etiopathogenic aspects of this uncommon etiology are
      discussed.

PMID- 1759030
TI  - [Severe hypoxemia due to a right-left shunt at the level of the foramen ovale. A
      complication of right ventricular infarct].
AB  - A 76-year-old woman with an inferior wall myocardial infarction, with right
      ventricular involvement, developed severe arterial hypoxemia with neurological
      involvement. Pulmonary edema or embolism and chronic obstructive pulmonary
      disease were ruled-out, and a right-to-left shunt was demonstrated by contrast
      echocardiography at the level of the foramen ovale. After inotropic support and
      oxygen supplementation, the patient recovered, although with significant
      neurological sequelae. No focal lesions were detected in the central nervous
      system by computerized tomography. Hypoxemia improved, coinciding with the
      disappearance of right-to-left shunt by contrast echocardiography.

PMID- 1759031
TI  - [The 2-dimensional and Doppler color echocardiographic study of a congenital
      aneurysm of the sinus of Valsalva with a fistula of the right atrium in an
      adult].
AB  - This report describe a 69-year old woman with a congenital aneurysm of the non
      coronary sinus of Valsalva ruptured in the right atrium, causing severe
      hemodynamic derangement of the right ventricle. The site of the communication
      between the aneurysm and the receiving chamber was accurately diagnosed by two
      dimensional color flow Doppler imaging which provided more valuable preoperative
      information than conventional aortography.

PMID- 1759032
TI  - [A superior vena cava syndrome secondary to intracavitary pacemakers. The
      diagnostic and therapeutic aspects].
AB  - Two cases of superior vena cava syndrome secondary to an endocardial pacemaker
      are reported. We discuss diagnosis methods and we point out the use of
      radioisotope cavography in patients with iodate contrast allergy. We suggest
      early administration of thrombolytic therapy besides of anticoagulants and we
      review the literature of previous observation of venous occlusion.

PMID- 1759033
TI  - Comparison between computed tomography and magnetic resonance imaging in the
      postoperative evaluation of acromegalic patients.
AB  - Twelve acromegalic patients who underwent transphenoidal resection of a GH
      secreting pituitary adenoma were evaluated postoperatively by Computed Tomography
      (CT) and Magnetic Resonance (MR). CT and MR findings were compared with surgical
      and clinical results. MR was more accurate than CT in delineating postoperative
      abnormalities of the infundibulum, diaphragma sellae and optic chiasm. In three
      cases MR differentiated packing materials from adenomatous tissue. In cases with
      biochemical evidence of residual or recurrent tumor, MR clearly demonstrated
      intra- or extrasellar adenomatous tissue and the spatial relationship between the
      soft tissue mass and the cavernous sinuses. CT was superior to MR only in
      demonstrating sellar floor disruption. MR imaging detected the anatomical causes
      of clinical abnormalities in almost all acromegalic patients with incomplete
      recovery after surgery. On the basis of MR results it is possible to plan
      additional surgery, radiation therapy or medical treatment. MR may be the
      radiological procedure of choice for both surgical treatment planning and
      postoperative follow-up.

PMID- 1759034
TI  - GH response to GH-releasing factor in dementia and its relation with TSH response
      to TSH-releasing factor.
AB  - We have studied the GH response to GH-releasing factor (GRF) and the TSH response
      to TSH-releasing factor (TRH) in two groups or patients with dementia. A group of
      28 patients with Alzheimer's disease (AD) and another group of 28 patients with
      dementia of vascular origin (VD). The GH response to GRF exhibited no difference
      between AD and VD patients (12.2 +/- 10.85 micrograms/L vs. 9.96 +/- 9.9) and
      there was no correlation with GH response to GRF and sex, stage of the disease
      and cerebral atrophy. The number of cases with exaggerated, normal or without
      response were similar in AD or VD patients. The TSH response to TRH exhibited no
      difference between AD and VD patients (9.18 +/- 4.93 mU/ml vs. 10.35 +/- 8.81).
      There was no correlation with TSH response to TRH and sex, stage of the disease,
      cerebral atrophy and response of GH to GRF. The number of cases with exaggerated,
      normal or without response was similar in AD or VD patients.

PMID- 1759035
TI  - [The measurement of bronchial hyperreactivity for military service fitness].
AB  - The authors discuss the efficacy of methacholine challenge to discriminate fit
      subjects to military service. We evaluated the relation between bronchial
      hyperreactivity and clinical symptoms, airways caliber and atopic status in a
      group of italian conscripts who reported to have bronchial asthma. Five-hundred
      four subjects were studied. Bronchial hyperreactivity was measured by
      methacholine test, and atopic status was assessed by skin-tests. A measurable
      PC20 FEV1 was detected in 424 subjects. On the basis of the methacholine
      threshold concentration the overall sample was divided in four categories. The
      four categories differed as regards onset of disease, lung function and skin
      reactivity towards Dermatophagoides Pter, whereas no difference was found as
      regards skin reactivity towards Grass. In the group evaluated in spring, the four
      categories differed as regards skin reactivity towards Grass. In conclusion we
      found that bronchial hyperreactivity is related to clinical history, lung
      function and atopic status; the measurement of bronchial hyperreactivity is
      important to evaluate conscripts referring bronchial asthma.

PMID- 1759036
TI  - [Osteolysis in an aged woman with recurrent urinary infections].
AB  - Hematogenous osteomyelitis has two incidence peaks; the first in childhood, the
      second in elderly people. The vertebrae are frequently involved in the case of
      elderly people and the diagnosis is difficult to make in as much as the
      radiological control of osteolysis is often attributed to malignant metastasis.
      The Authors describe a case of vertebral osteolysis in an elderly woman with
      relapsing urinary infections. The clinical history of the patient is described
      and the diagnostic procedure is critically discussed. In this way the diagnosis
      of osteomyelitis of the thorax-lumbar tract is reached. The Authors go on to
      consider the possibility of an infectious genesis of isolated osteolytic lesions,
      especially in patients with risk factors and ones prone to certain conditions
      such as urinary infections, above all because the complications of osteomyelitis
      can be extremely serious.

PMID- 1759037
TI  - Septic polyarthritis in chronic tophaceous gout.
AB  - This paper reports the case of a 48 year old patient with chronic tophaceous gout
      who was admitted to the hospital with a pneumococcal polyarthritis affecting the
      same joints previously involved by gout attacks. The authors emphasize that the
      possibility of a septic arthritis should always be considered in the gouty
      patient, and not only in the elderly, as stressed in the literature, but also in
      younger patients.

PMID- 1759038
TI  - [Extramedullary plasmocytoma. Description of 2 cases with localization in the
      vocal cords].
AB  - The authors describe two cases of extramedullary plasmacytoma with localization
      to the vocal cord. They underline: the rarity of the laryngeal involvement, the
      different histogenetic, prognostical and therapeutical aspects as regards
      solitary plasmacytoma and the peculiarity of the second case where after 15 years
      the extramedullary plasmacytoma recurred in the same field without any systemic
      spread.

PMID- 1759039
TI  - [Ridogrel, a new platelet antiaggregant molecule with a double mechanism of
      action. A pharmacological and clinical profile].
AB  - Ridogrel has a double mechanism of action: it is a combined thromboxane A2
      synthetase inhibitor and thromboxane A2/prostaglandin endoperoxide receptor
      blocker, demonstrated in vitro, as well as in vivo in animals and in man. In man,
      ridogrel is quickly absorbed after oral administration (30-60 min). The half-life
      is about 6-9 hours. At the oral dose of 300 mg b.i.d., the steady state has been
      reached at the third day of administration. Pharmacodynamic studies in healthy
      volunteers as well as in patients demonstrate a marked decrease in TXB2 serum
      level and an increase in 6ketoPGF1 alpha level. Moreover ridogrel inhibits the
      human platelet aggregation induced by U46619, collagen and arachidonic acid
      (thromboxane A2/prostaglandin endoperoxide receptor blocker). During the ridogrel
      treatment there have been neither variations of coagulative parameters (PTT,
      APTT, plasmatic fibrinogen) nor variations of other metabolic parameters except
      for those concerning the antiaggregant activity. To conclude, the preliminary
      data on about 100 healthy volunteers and more than 100 patients show that
      pharmacologic combined actions on enzyme and on receptors could be more
      efficacious than one single activity in eliminating circulatory flux resistance,
      in potentiating thrombolysis and in preventing or postponing vessels
      reocclusions. According to the above-mentioned results, ridogrel could have a
      good application in correction of thrombotic disorders due to platelet
      activation.

PMID- 1759040
TI  - [Rheumatic fever, the idea of progress and the circularity of time].
AB  - Rheumatic fever, once virtually "gone" from the western world, has made a come
      back in the mid nineteen-eighties. This is disturbing because the control of
      rheumatic fever was a source of pride to the medical community. Changes in
      medical practice, such as a less compulsive attitude vis-a-vis streptococcal
      infections, and social changes, such as "house starvation", probably conspired to
      bring about the come-back. It's likely that the emergence of more virulent and
      more rheumatogenic streptococcal strains was facilitated by these changes.
      Physicians should once again be alert to the streptococcal threat, and accurately
      diagnose and effectively treat streptococcal pharyngitis.

PMID- 1759041
TI  - [Criteria of radicality in surgical therapy of rectal cancer].
AB  - The Authors discuss on their experience in radical rectal cancer surgery
      critically reviewing results of the current literature. In particular, the
      importance of distal clearance, abdominopelvic lymphadenectomy and total excision
      of the mesorectum is stressed. They conclude that radical surgery, if performed
      according to certain principles, can improve survival without affecting the
      incidence of major complications.

PMID- 1759042
TI  - The clinical features, course, prognosis and treatment of juvenile arthritis.
AB  - The author's classification of juvenile arthritis (JA) differs from most by
      utilizing both the type of onset and the disease course separated into individual
      subgroups. The clinical aspects of each are described in detail, along with the
      special tests and studies to be done to differentiate them. Particular attention
      is given to the differences between the four subgroups of the pauciarticular
      onset group. There are different genetic factors for each subgroup and new data
      on HLA typing utilizing DNA techniques may be helpful in the prognosis of the
      disease course. The therapy of JA begins with non-steroidal anti-inflammatory
      drugs, continues with second-line drugs such as gold and penicillamine, and
      finally leads to the use of immunosuppressive agents. The range of doses, the
      maximal dose, and the frequency of administration is given for each medication.
      The long-term prognosis is generally good, with a low death rate, primarily seen
      in the systemic onset patients. The causes of death vary around the world.
      Prognosis for continued joint activity and joint function is determined
      significantly by the type of onset and is worse in the rheumatoid factor positive
      polyarticular onset group.

PMID- 1759043
TI  - [Immunological implications of surgical intervention in critical and noncritical
      patients].
AB  - Immunological implications are important in every surgical operation, specially
      when it is necessary to remove the spleen. She plays an important role in
      immunological aspecific (filter, phagocytosis) and specific processes (production
      of IgM and regulation of T- and B-lymphocytic system). Splenectomy causes an
      immunodeficiency with frequent post-operative complications (the most important
      is OPSI). Each operated patient is considered generically immunodeficient because
      surgical trauma and anesthesiologic practice are at the base of immunological
      alterations (biological barriers, aspecific immunity, A.P.P., complement,
      specific immunity, NK cells). It's indispensable to know pathological situations
      that make "critical" the immunological state: caloric-proteic malnutrition,
      elderly (greater than 70 years old), immunosuppressive therapy, sepsis, shock,
      neoplasms. I. e.: a patient about seventy years old presents a reduced endocrine
      secretion of thymic hormone and, probably, a low synthesis of immunoglobulins.
      Besides the corticosteroids modify the answer of T-lymphocytes and NK cells.
      Sepsis induces metabolic and immunological alterations after early activation of
      humoral mediators, modified quantity and life of A.P.P., activation of
      complement, inhibition of cell-mediate immunity, modification of number and
      activity of haematic lymphocytes. Trauma induces a hypersecretion of
      corticosteroid, adrenalin, noradrenaline, glucagon with consequent
      hypercatabolism that causes malnutrition. The hormonal hypersecretion is a
      determining factor of reduced phagocytic activity (inhibited migration of
      neutrophils and monocytes), quantitative and qualitative alterations of
      complement, deficit of T-cells, hyporeactivity to skin test, depressed answer of
      antibodies to bacterial and viral antigens. Progressive neoplasms are
      characterized by modification of T-lymphocytes number, depressed macrophagic
      activity, hyporeactivity to skin tests.

PMID- 1759044
TI  - Long-term effects of ovariectomy on pituitary-adrenal axis and specific antibody
      response in rats.
AB  - The effects of ovariectomy on morphologically demonstrable characteristics of
      lymphoid tissue, pituitary, and adrenal glands as well as on plasma ACTH and
      corticosterone levels and humoral immunity of female Lewis rats were
      investigated. The present study establishes ovaries as potential regulatory
      organs upon thymus, pituitary, and adrenal glands in female Lewis rats. In
      addition to the effects on these important lymphoid organs and endocrine glands,
      ovariectomy influenced the time course of serum IgM antibody titres against
      fluorescein isothiocyanate (FITC), but had only moderate effects upon serum IgG
      antibody titres. In conclusion, the present results suggest that ovariectomy
      modifies morphological characteristics of the thymus and pituitary-adrenal axis.
      Furthermore, circulating corticosterone seems to play an important role in
      regulating antibody formation in intact compared to ovariectomized female Lewis
      rats, while the influence of thymic mass is far from clear.

PMID- 1759045
TI  - Use of an artificial oxygen carrier in isolated rat liver perfusion: first
      demonstration of net glucose uptake at physiological portal glucose
      concentrations using a hemoglobin-free perfusate.
AB  - A defect in isolated perfused rat-liver (IPRL) preparations has been proposed to
      explain discrepancies between in vivo and in vitro findings regarding hepatic
      glucose metabolism. The aim of the present study was to investigate whether a
      preparation of IPRL using a synthetic hemoglobin-free perfusate was capable of
      net glucose uptake and glycogen deposition at physiological portal substrate
      concentrations. Livers from fed anaesthetized rats were perfused in a
      recirculating system using a fluorocarbon emulsion as artificial oxygen carrier.
      Depending on the prevailing glucose concentration, livers exhibited net glucose
      uptake or release with a threshold value of 5.5-6.0 mM glucose. Net glucose
      uptake was associated with net glycogen deposition (+0.23 to +0.59 mumol C6 min-1
      g-1). From 5.8 mM (n = 3) and 10.0 mM (n = 8), initial concentration glucose
      levels fell to 5.3 +/- 0.2 mM after 210 min (n = 3) and 6.3 +/- 0.9 mM after 120
      min (n = 8), respectively. This was equivalent to a net glucose uptake of -0.16
      and -0.45 mumol min-1 g-1. Anoxia reversibly switched hepatic glucose balance
      from net uptake (-0.42 mumol min-1 g-1) to release (+0.69 mumol min-1 g-1)
      followed by net uptake (-0.50 mumol min-1 g-1) after reinstitution of aerobic
      conditions. We conclude that the composition of perfusion media might play a
      pivotal role for studies of glucose metabolism in the isolated perfused rat
      liver. In our experimental model, using a hemoglobin-free synthetic medium, net
      glucose uptake was readily demonstrated at physiological portal substrate
      concentrations similar to the in vivo situation.

PMID- 1759046
TI  - Effects of dexamethasone on glutamine metabolism in the isolated vascularly
      perfused rat small intestine.
AB  - Post-stress metabolism is associated with a large glutamine (Gln) efflux from
      muscle and an increased Gln utilization by the small intestine. Both appear to be
      modulated by corticosteroids. The present investigation was performed to better
      characterize the mechanism of corticoid action on Gln metabolism in an isolated
      preparation of vascularly perfused rat small intestine. In all perfusions, a
      synthetic perfusate free from blood components was used with only 0.6 mM Gln and
      10 mM glucose as substrates. Irrespective of dexamethasone concentrations in the
      vascular perfusate (none, 0.25 mg l-1, or 2.5 mg l-1, isolated intestines from
      normal rats exhibited unchanged extraction rates of Gln (-85 +/- 8, -89 +/- 10,
      and -87 +/- 16 nmol min-1 g-1) and unchanged production rates of alanine (43 +/-
      9, 40 +/- 7, and 51 +/- 5 nmol min-1 g-1) and ammonia (49 +/- 15, 45 +/- 13, and
      54 +/- 13 nmol min-1 g-1). Similarly, when intestines were vascularly perfused 2
      or 9 days after dexamethasone injection (0.45 mg kg-1 BW), net Gln uptake also
      remained unchanged (-88 +/- 16 and -84 +/- 11 nmol min-1 g-1). There was,
      however, a shift in nitrogenous products of Gln metabolism from ammonia (-31% and
      -38%) to alanine (+16% and +64%). Thus, the failure of dexamethasone to increase
      Gln uptake in the isolated rat intestine may indicate that rather than acting
      directly on the mucosa, dexamethasone could regulate intestinal Gln consumption
      in vivo by indirect mechanisms possibly involving extramucosal tissues.
      Dexamethasone pretreatment may modulate the pattern of nitrogenous products in
      portal venous blood presented to the liver and thus support enhanced nitrogen
      loss through ureagenesis by metabolic cooperation between gut and liver.

PMID- 1759047
TI  - Total denervation of the pancreas does not alter the pancreatic polypeptide
      induced inhibition of pancreatic exocrine secretion in dogs.
AB  - Pancreatic polypeptide (PP) is a potent inhibitor of pancreatic exocrine
      secretion in vivo. The mechanism of pancreatic inhibition by PP is unknown, but
      the absence of PP receptors on pancreatic exocrine cells makes a direct effect of
      this hormone on the gland unlikely. In this study, we investigated the hypothesis
      that PP exerts its inhibitory effect via extrinsic neural pathways. Ten dogs with
      gastric and pancreatic fistulas were given an intravenous infusion of 250 ng/kg-1
      h-1 secretin and 50 ng/kg-1 h-1 caerulein over 3 h. One hour after starting the
      infusion, 400 pmol kg-1 h-1 porcine PP were administered over 1 h. Pancreatic
      bicarbonate and protein secretions were measured. Later, the pancreas was
      extrinsically denervated. PP infusion decreased bicarbonate secretion in the
      intact gland by 47% and in the denervated pancreas by 57%. Protein secretion was
      diminished by exogenous PP by 31% in the intact and by 44% in the denervated
      pancreas. Despite pancreatic denervation, PP still exerted a significant
      inhibitory effect. Atropine infusion completely blocked the inhibitory effect of
      PP on caerulein-stimulated pancreatic protein secretion both in the intact and
      denervated pancreas and of secretion-evoked bicarbonate output in the denervated
      gland. We conclude that the inhibitory action of the hormone is not mediated via
      extrinsic neural pathways of the pancreas, but PP may exert its effect via
      intrinsic atropine-sensitive mechanisms.

PMID- 1759048
TI  - Metabolism during normoxia, hypoxia and recovery in the newborn kitten.
AB  - We questioned whether the hypoxia-induced drop in aerobic metabolism in newborns
      necessitates an oxygen debt, and whether in such a case the debt is payed upon
      recovery. Aerobic metabolism (VO2 and VCO2) was computed each 30 sec in 15
      newborn kittens (age 2-5 days) using an open flow system during normoxia, 30 min
      of hypoxia, and 30 min of recovery for two levels of hypoxia, 10% and 15%
      inspired O2. On a separate occasion, venous lactate levels were measured in
      normoxia and immediately following hypoxia. As expected, VO2 and VCO2 dropped in
      hypoxia. The decline started within 2 min, and the average decrease during
      hypoxia was -25% in 15% O2 and -36% in 10% O2. During recovery after 15% and 10%
      O2 aerobic metabolism was, respectively, below or equal to the normoxic value,
      whilst lactate was, respectively, the same or above the normoxic value. We
      conclude that in the kitten (1) the hypoxia-induced drop in aerobic metabolism is
      accompanied by no (15% O2) or small (10% O2) anaerobic metabolism, and (2) a post
      hypoxic metabolic depression can persist during recovery.

PMID- 1759049
TI  - Role of leukocyte depletion in noncholinergic bronchoconstriction of guinea pigs.
AB  - To test the role of leukocytes in the activation of afferent C-fibers in the
      lung, 33 guinea pigs, 18 control and 15 experimental or leukocyte depleted, were
      used. The leukocyte depletion was accomplished with an intraperitoneal injection
      of cyclophosphamide (100 mg/kg) 96 h prior to the study. On the day of the study,
      bronchial constriction was produced either by exsanguination (n = 17) or by
      capsaicin injection (16 micrograms/kg, i.v.) (n = 16) in anesthetized-paralyzed
      animals. Venous blood samples were collected for leukocyte counts. At 1-30 min
      following the above treatment, the maximal expiratory flow maneuver was performed
      and a decrease in the maximal expiratory flow at 50% baseline total lung capacity
      (Vmax50) was used as an index of bronchoconstriction. The leukocyte count
      decreased significantly following the pretreatment with cyclophosphamide [an
      average of 6217 +/- 612 (control) vs. 2242 +/- 334/mm3 (experimental)].
      Exsanguination caused a gradual decrease in Vmax50 with time, indicating a
      temporal increase in bronchoconstriction. Capsaicin injection, on the other hand,
      caused an immediate (1 min) marked bronchoconstriction, which attenuated
      gradually with time. At a specific time point, leukocyte depletion did not
      produce any significant change in Vmax50 compared to the control group for both
      types of bronchoconstrictions. Based on these results, we conclude that
      leukocytes may play an insignificant role in the bronchoconstriction caused by
      the activation of afferent C-fibers in guinea pig lungs under our experimental
      conditions.

PMID- 1759050
TI  - Pressure-volume properties of the upper airway in man.
AB  - We report a method of measuring the static pressure-volume properties of the
      upper airway in unanesthetised humans. In 10 normal subjects the pressure in the
      upper airway was measured during aspiration of air in 10 ml decrements from 30-40
      ml above resting volume to 30-40 ml below resting volume, with the glottis closed
      voluntarily and the oro-pharyngeal muscles relaxed. The pressure-volume
      properties of the upper airway were well described by the pressure-volume rate
      upper airway elastance (UAE, cmH2O/ml). The mean (+/- 95% CI) UAE measured at
      near total lung capacity and with the neck in neutral position for all runs in
      all subjects was 0.22 +/- 0.06 cmH2O/ml. When UAE was measured repeatedly on
      different days the greatest change observed was from a mean value of 0.17
      cmH2O/ml on one day to 0.25 cmH2O/ml on another, and the standard deviation of
      the means from different days ranged from 0.01 to 0.04. Neither hypoxia (SaO2 80
      85%) nor hyperoxic hypercapnia (PETCO2 65-75 mmHg) had any influence on UAE.
      Maximal extension of the neck did not affect UAE, but flexion of the neck was
      associated with a rise in UAE from a mean of 0.23 +/- 0.05 cmH2O/ml to a mean of
      0.53 +/- 0.14 cmH2O/ml. UAE was not affected by the lung volume at which
      measurements were made. We conclude that upper airway pressure-volume properties
      can be measured non-invasively in man, and that in their linearity,
      reproducibility and lack of sensitivity to hypoxia and hypercapnia they resemble
      those of experimental animals.

PMID- 1759051
TI  - Regional compliance and bronchial pressure-diameter relationships in excised pig
      lungs.
AB  - We estimated the magnitude of parenchymal interdependence in excised pig lungs by
      measuring small airway diameter during homogeneous and nonhomogeneous lung
      inflation, by comparing the ratio of the specific compliance of the lung (Cl) to
      the specific compliance of a single lung region (Cs) and by using a continuum
      mechanics analysis to estimate the pressure at the interface between a single
      lung region and the surrounding lung. We found that the diameter of airways in a
      single lung region increased when the lung was held at a transpulmonary pressure
      (Ptp) of 5, 10 or 15 cmH2O and pressure in the region was increased by up to Ptp
      + 15 cmH2O, indicating that the surrounding lung offered little resistance to
      expansion of the lung region. The ratio of Cl to Cs averaged 1.22 (n = 5 lungs),
      indicating that the parenchyma surrounding the lung region caused a small
      reduction in its distensibility. When the lung was held at a Ptp of 5 cmH2O,
      pressure at the interface was estimated to be 1.1, 0.8 and -1.9 cmH2O when
      pressure in the single lung region was 15, 10 and O cmH2O, respectively. The
      relatively small change in boundary pressure from pleural pressure as the region
      was inflated or deflated indicated that the mechanical interaction between
      adjacent lung regions was small. Taken together, these results confirm the
      prediction of a small interdependence effect as determined by measurements of the
      distensibility and distortability of the pulmonary parenchyma.

PMID- 1759052
TI  - Mechanical properties of respiratory muscles in primates.
AB  - We examined the in-vitro mechanical characteristics of the diaphragm and
      parasternal intercostal muscles in adult baboons. At optimal length (Lo) the
      parasternal intercostal muscles were consistently faster than the diaphragm as
      judged by a shorter time-to-peak tension and a reduced twitch-to-tetanus ratio.
      However, maximal absolute force at Lo, corrected for cross-sectional area,
      revealed that the inherent strengths of both inspiratory muscles were identical
      (31.5 +/- 3.2 N/cm2 for diaphragm vs 29.5 +/- 1.1 N/cm2 for parasternal
      intercostals). Moreover, at submaximal stimulation rates, the parasternal
      intercostals produced significantly less tension at Lo than the diaphragm. At
      lengths less than Lo, however, the parasternal intercostal muscles generated
      significantly less tetanic tension than the diaphragm. These differences are
      similar to previously reported values in dogs (Farkas et al. (1985) J. Appl.
      Physiol. 59: 528-535). Thus, based on our findings, it appears that within a
      given species, the parasternal intercostals are quite different in mechanical
      terms from the diaphragm. Since both muscles are recruited at all levels of
      ventilation, including quiet breathing, these differences do not appear to be
      related to the activation levels. Moreover, since the present results were
      similar to those in dogs, the differences between both muscles do not appear to
      be affected or altered by body habitus.

PMID- 1759053
TI  - Thermal effects on ventilation in cats: participation of carotid body
      chemoreceptors.
AB  - In pentobarbitone anesthetized cats, raising body temperature from 37 to 40
      degrees C by external heat increased respiratory frequency, tidal volume,
      frequency of spontaneous gasps and mean inspiratory flow. It reduced end-tidal
      CO2 pressure, together with inspiratory and expiratory durations. After bilateral
      section of the carotid nerves, raising body temperature still induced
      hyperventilation, but the increase in gasp frequency was less pronounced and no
      significant change in tidal volume was observed. In comparison to steady
      ventilatory values in the intact condition, significant reductions in tidal
      volume at 38 degrees C and in gasp frequency at 37, 39 and 40 degrees C were
      observed after bilateral carotid neurotomy. Brief hyperoxic tests induced
      transient decreases in tidal volume and increases in end-tidal CO2 pressure which
      were significantly larger at 40 degrees C than at 37 degrees C. These changes
      disappeared after bilateral carotid neurotomy. Anesthetic block of both carotid
      nerves produced transient reductions in tidal volume at any given temperature. We
      conclude that carotid body afferents contribute to the hyperventilation evoked by
      hyperthermia. After their interruption, such contribution is replaceable from
      other thermal afferents.

PMID- 1759054
TI  - A decrease in nasal CO2 stimulates breathing in the tegu lizard.
AB  - Tegu lizards decrease ventilatory frequency (f) when constant CO2, as low as
      0.4%, is delivered to the nasal cavities. In contrast, CO2, as high as 6%, pulsed
      into the nasal cavities during the expiratory phase of the breathing cycle does
      not alter f. The purpose of the present study was to investigate further the
      effect of nasal CO2 pattern on f in tegu lizards. Specifically, we tested: (1)
      whether f was affected by CO2 delivered to the nasal cavities during the
      inspiratory phase of the breathing cycle, and (2) whether pulsed decreases in
      nasal CO2 from 4% to 2% and from 4% to 0% would remove the f inhibition caused by
      constant nasal CO2. Ventilation was measured using a pneumotachograph and
      pressure transducer in-line with an endotracheal T-tube inserted through the
      glottis. CO2 was delivered to the nasal cavities through small tubes inserted
      into the external nares. Ventilatory frequency was not significantly altered when
      4% CO2 was pulsed into the nasal cavities during inspiration. Dropping the CO2 in
      the nasal cavities from 4% to 0% at either 15 cycles/min (0.25 Hz) or for one
      cycle stimulated breathing. There was no significant difference between the f
      response to a drop in CO2 from 4% to 0% and that to a drop in CO2 from 4% to 2%.
      The failure to link the phasic CO2 ventilatory response to a phase in the
      respiratory cycle indicates that the nasal CO2 receptors do not participate in
      the breath-by-breath regulation of breathing in these lizards. The observation
      that small decreases in nasal CO2 abolished the f inhibition caused by constant
      nasal CO2 provides further evidence for the ability of the nasal CO2 receptors to
      distinguish between pulsed and constant CO2.

PMID- 1759055
TI  - Flow-mediated vasodilatation of the main pulmonary artery.
AB  - This study compares the independent effects of flow (Qpa) and transmural pressure
      (Ppa) on the diameter (D) and length of a segment (L) of the main pulmonary
      artery (MPA) in anesthetized open-chested dogs. Qpa was increased by a shunt from
      the left lower lobe pulmonary artery to an external jugular vein. Ppa was
      increased with positive end-expiratory pressure (n = 5), or with a femoral
      arteriovenous shunt (n = 5). Mean Ppa, Qpa, D and L were calculated by averaging
      over a single cardiac cycle selected at end expiration of successive breaths. The
      independent effects of Ppa and Qpa on MPA dimensions were determined by multiple
      linear regression. The effects of Ppa delta D%/delta P% = 0.153 +/- 0.03 SE) and
      Qpa (delta D%/delta Q% = 0.021 +/- 0.004 SE) on D were similar in both groups of
      dogs. Changes of L (delta L%/delta Ppa% = 0.168 +/- 0.042 SE and delta Qpa% =
      0.033 +/- 0.006 SE, n = 5) were similar to the corresponding changes of D. We
      conclude that the effects of flow are small relative to pressure and that flow
      not only causes vasodilatation but also vasoelongation of the MPA.

PMID- 1759056
TI  - Intracellular acid-base responses to environmental hyperoxia and normoxic
      recovery in rainbow trout.
AB  - Exposure of rainbow trout to environmental hyperoxia (PIO2 approximately 530
      Torr) resulted in an extracellular respiratory acidosis which was fully
      compensated by 72 h; return to normoxia (PIO2 approximately 145 Torr) at this
      time induced a metabolic alkalosis which was corrected by 24 h. Intracellular pHi
      ([14C]DMO method), fluid volumes [3H]PEG-4000 method), and electrolytes were
      monitored. Environmental hypercapnia (PICO2 approximately 6.5 Torr) was employed
      to confirm that intracellular responses were specific to respiratory acidosis.
      Gill pHi did not change during respiratory acidosis despite a very low non-HCO3-
      buffer capacity, but gill ICFV decreased markedly. A large loss of gill
      intracellular [Cl-]i in excess of [Na+]i, combined with a substantial gain in
      [K+]i, contributed to gill pHi regulation by raising branchial [SID]i. In weakly
      buffered brain tissue, active adjustment of pHi started within 3 h, but two well
      buffered tissues, RBC and white muscle, exhibited compounding metabolic acidoses
      during the first 12-24 h. The muscle response was associated with small increases
      in ICFV and [Cl-]i, and a large decrease in [K+]i which reduced muscle [SID]i. We
      hypothesize that this initial export of K+ and basic equivalents served to
      regulate pH in more critical compartments (e.g. gills, brain) at the expense of
      muscle acidosis. By 48 h, pHi restoration in all tissues was complete, in advance
      of pHe regulation (72 h). Return to normoxia at 72 h elevated muscle, brain, and
      gill pHi, but there was no evidence of a comparable 'altruistic' role of muscle
      during this metabolic alkalosis. Regulation of pHi was complete by 24 h recovery,
      accompanied by partial or complete restoration of intracellular ions and fluid
      volumes.

PMID- 1759057
TI  - Clinical syndromes associated with tumors of the female genital tract.
AB  - Tumors of the female genital tract may be associated with a variety of unusual
      clinical manifestations. Uncommon endocrine and paraendocrine syndromes include
      production of human chorionic gonadotropin by tumors other than those of germ
      cell origin, hyperthyroidism associated with struma ovarii and gestational
      trophoblastic disease, the carcinoid syndrome, the Zollinger-Ellison syndrome,
      hypercalcemia, Cushing's syndrome, hypoglycemia, hypertension related to renin or
      aldosterone production, hyperprolactinemia, inappropriate secretion of
      antidiuretic hormone, and virilization associated with Nelson's syndrome and
      placental site trophoblastic tumor. Paraneoplastic syndromes associated with
      gynecological tumors include disorders of the nervous system, connective tissue,
      and skin, as well as hematologic abnormalities and the nephrotic syndrome.
      Heritable and other congenital syndromes associated with these tumors are the
      Peutz-Jeghers syndrome, the nevoid basal-cell carcinoma syndrome, Ollier's
      disease and Maffucci's syndrome, hereditary leiomyomatosis, ataxia
      telangiectasia, von Hippel-Lindau's disease, thyroid abnormalities associated
      with Sertoli-Leydig cell tumors, and Carney's complex. Other syndromes associated
      with tumors of the female genital tract include Meigs' syndrome, hyperamylasemia,
      uveal melanocytic lesions, and pyrexia.

PMID- 1759058
TI  - Pseudoneoplastic glandular lesions of the uterine cervix.
AB  - Diverse nonneoplastic glandular lesions of the uterine cervix may occasionally be
      misinterpreted as premalignant or malignant. These processes include papillary
      endocervicitis, tunnel clusters, deep glands and deep nabothian cysts,
      microglandular hyperplasia, mesonephric hyperplasia, diffuse laminar endocervical
      glandular hyperplasia, glandular hyperplasia not otherwise specified, tubal
      metaplasia, intestinal metaplasia, endometriosis, Arias-Stella reaction, changes
      secondary to extravasation of mucin, and various infectious and reactive atypias.
      Although these lesions may have abnormal architectural and/or cytologic features,
      their appearances differ from those of any of the various adenocarcinomas of the
      cervix or their precursors. Familiarity with the histologic features of these
      lesions is essential to avoid a misdiagnosis and potential mismanagement of a
      benign condition.

PMID- 1759059
TI  - Metastatic tumors in the ovary: a problem-oriented approach and review of the
      recent literature.
AB  - Metastatic tumors account for a significant proportion of the ovarian tumors that
      cause major problems in diagnosis for the surgical pathologist. This subject is
      reviewed with a consideration of the various patterns and cell types encountered
      in these tumors. The first two categories considered, tumors with endometrioid
      like and mucinous appearances, include a variety of neoplasms originating in the
      gastrointestinal tract and its appendages that simulate closely primary ovarian
      endometrioid and mucinous tumors. Other important categories reviewed include
      several varieties of metastatic tumors with follicle-like spaces, small cell
      malignant tumors, and tumors characterized by cells with abundant eosinophilic
      cytoplasm. The review also includes a discussion of the general considerations
      that are helpful in the distinction of primary and metastatic ovarian tumors.
      Important recent reports in the literature concerning metastatic tumors are
      additionally summarized.

PMID- 1759060
TI  - Pathology of the peritoneum: a review of selected topics.
AB  - Mesothelial lesions of the peritoneum may pose significant diagnostic problems.
      Accurate identification of these lesions is important because of their
      distinctive behavior and treatment requirements. This review discusses the
      clinical, pathological, and differential diagnosis of a variety of mesothelial
      lesions of the peritoneum, which includes mesothelial hyperplasia, multilocular
      peritoneal inclusion cysts (benign cystic mesothelioma), well-differentiated
      papillary mesotheliomas, and diffuse malignant mesothelioma, and the role of
      immunohistochemistry in the distinction from the more common primary peritoneal
      serous carcinomas. In addition, borderline serous tumors, psammocarcinomas, and
      solitary fibrous tumors of the peritoneum are briefly mentioned.

PMID- 1759061
TI  - [The Nottingham Health Profile as an example of a tool for measuring the quality
      of life in health].

PMID- 1759062
TI  - [Encelopathies caused by prions].

PMID- 1759063
TI  - [For the arterial pressure, the brain: a creed! "The scientific observation is
      always a polemic observation" (G. Bachelard)].

PMID- 1759064
TI  - [False hyperphosphoremia in multiple myeloma. Interference of monoclonal
      immunoglobulin G with the determination of blood phosphorus level].
AB  - A case of pseudohyperphosphataemia detected in a male patient with multiple IgG
      myeloma is reported. Phosphataemia, measured by a technique without previous
      deproteinization, reached 5.66 mM before any treatment and varied with treatment
      induced changes in monoclonal immunoglobulin levels. Conversely, normal
      phosphataemia levels were found in blood samples taken before and after treatment
      when serum was deproteinized. This pseudohyperphosphataemia resulted from an
      increase in optic density due to interference between monoclonal immunoglobulin
      and the molybdic reagent used to determine phosphataemia. A retrospective
      investigation yielded three similar cases: two in patients with myeloma and one
      in a patient with non-myelomatous monoclonal dysglobulinaemia. A brief
      prospective study showed that this phenomenon was relatively frequent, as it was
      found in 2 out of 9 patients with monoclonal immunoglobulin (IgG in all 9 cases).
      These data indicate that the finding of marked hyperphosphataemia in subjects
      with monoclonal dysglobulinaemia should always prompt a control assay performed
      on deproteinized blood.

PMID- 1759065
TI  - [Diagnostic delay in Horton's disease. Analysis of the diagnostic delay based on
      a retrospective study of 130 cases].
AB  - Temporal arteritis (Horton's disease) is a multifocal granulomatous arteritis
      which affects elderly people. Its prognosis depends upon the risk of blindness.
      In a retrospective study of 130 patients we paid special attention to the delay
      in diagnosis and its relation to the occurrence of ophthalmic complications. In
      73 patients (56.2%), this delay exceeded 3 months and reached more than one year
      in 22 of them. It was not influenced by age or sex. In requests for admission,
      the diagnosis of temporal arteritis was suggested in only 28 of the 130 cases;
      17.7% of the patients were blind. There was a significant increase in the
      occurrence of ophthalmic lesions when the diagnosis was delayed by 2 to 6 months.
      In 6 cases, blindness had been preceded by transient amaurosis. These findings
      confirm that temporal arteritis is belatedly diagnosed by practitioners and that
      blindness could be avoided by an earlier diagnosis.

PMID- 1759066
TI  - [Alveolar hemorrhage, glomerulonephritis and anti-cytoplasmic polynuclear
      antibodies].
AB  - The value of antineutrophilic cytoplasmic antibodies (ANCA) was assessed in the
      diagnosis and chronic treatment of 7 patients with microscopic polyarteritis or
      Wegener's granulomatosis. All patients had oligoimmune glomerulonephritis with
      segmental and focal necrosis and presented with anaemia. Five of them had
      alveolar haemorrhage with haemoptysis and infiltrates at radiography. ANCA were
      assayed by indirect immuno-fluorescence on ethanol-fixed neutrophils and were
      strongly positive, with a cycloplasmic aspect in 5 cases and a perinuclear aspect
      in 2 cases. Initial remission with fall in ANCA titres was obtained with
      corticosteroids, cyclophosphamide and sometimes plasmapheresis (5 patients), but
      frequent relapses with re-elevation of ANCA titre occurred when treatment was
      reduced. It is concluded that ANCA are very helpful in the diagnosis of systemic
      vasculitis, notably in cases with first-time alveolar haemorrhage. They also
      facilitate monitoring and therapeutic decisions, since relapses are frequent.

PMID- 1759067
TI  - [Anomalies of lipid metabolism in diabetes mellitus].
AB  - Atheroma is by far the most common cause of mortality in diabetic patients (66 to
      75% of deaths). Several physiopathological mechanisms are suspected to account
      for the greater frequency and severity of atheroma in diabetes. Among these,
      lipid abnormalities hold first rank and include not only quantitative but also
      qualitative abnormalities of lipoproteins altering their kinetics and bindings to
      membrane receptors. The main quantitative abnormalities are an increase of
      triglycerides and very low density lipoproteins (VLDL) and a fall in high density
      lipoproteins (HDL) and their HDL2 subfraction. Qualitative abnormalities include
      non-enzymatic glucosylation of apoproteins, changes in lipoprotein size and
      increase in their triglyceride content, and excessive oxidation of low density
      lipoproteins (LDL). Both quantitative and qualitative abnormalities of
      lipoproteins are present in non-insulin-dependent diabetes, whereas only
      qualitative abnormalities are observed, as a rule, in treated insulin-dependent
      diabetes. The physiopathology of lipid metabolism disorders is complex, possibly
      multifactorial and still imperfectly known. However, such factors as modification
      of insulin status, hyperglycaemia and obesity frequently associated with
      diabetes, are thought to be involved.

PMID- 1759068
TI  - [Classification of malignant non-Hodgkin's lymphoma].
AB  - The authors list the reasons which make it important and useful to classify non
      Hodgkin's malignant lymphomas (ML) and discuss the criteria of a convenient
      classification. They also describe the principles of updated Kiel's
      classification and the various entities recognized. These entities are divided
      into type B and type T ML, each type in turn being divided into low malignancy,
      high malignancy and rare forms.

PMID- 1759069
TI  - [Digestive manifestations of food hypersensitivity in adults].
AB  - Food allergy, synonymous with food hypersensitivity (FHS), is defined as an
      immunologically-mediated adverse reaction to food. Initiation of FHS could result
      from a break in the immune mucosal barrier with abrogation of oral tolerance.
      Food hypersensitivity is mostly due to immediate-type reaction involving IgE
      dependent mastocytes activation. Changes in intestinal function and structure
      have been mainly studies in an animal model of rat sensitized to egg albumin.
      Intraluminal antigen challenge resulted in abnormalities of gut absorption,
      secretion and motility in sensitized rats. In man, experimental data are scarce.
      Gastrointestinal manifestations of immediate FHS are varying and unspecific. A
      role for FHS in irritable bowel syndrome is debated. Participation of delayed
      type FHS to digestive diseases is still questionable, but eosinophilic
      gastroenteritis might be an example. In clinical practice, diagnosis of FHS
      demands rigorous criteria. Double blind placebo-controlled food challenge has
      eventually proved to be the "gold standard" test for FHS diagnosis.

PMID- 1759070
TI  - [Portal hypertension and hypervitaminosis A. Apropos of 2 cases and review of the
      literature].
AB  - Portal hypertension consecutive to hypervitaminosis A has seldom been well
      documented. Two cases are reported here. The first case concerns a 39-year old
      woman who had taken meladinine (8-methoxypsoralen) for the purpose of tanning. In
      the second case, a 43-year old woman had absorbed Plethoryl (a combination of
      tiratricol, cyclovalone and retinol) in order to lose weight. Both patients had
      histological hepatic lesions, such as hypertrophic Ito cells, perisinusoidal
      cirrhosis and spontaneous autofluorescence, suggestive of vitamin A overload,
      associated with a hepatic vein pressure gradient of 10 mmHg or more and high
      liver concentrations of vitamin A. The responsibility of Plethoryl in case 2 is
      beyond any doubt, but the mechanism of hypervitaminosis in case 1 is
      controverted. A review of the literature has provided detailed information on the
      signs of vitamin A overload, the frequency of which is probably underestimated.
      Patients with portal hypertension of unknown origin should be investigated for
      hypervitaminosis A.

PMID- 1759071
TI  - [Type B Niemann-Pick disease and sea-blue histiocytes syndrome].
AB  - We report two new cases, in the same family, of type B Niemann-Pick disease
      associated with sea-blue histiocytes syndrome. In one patient the disease was
      revealed by spontaneous rupture of the spleen. The sea-blue histiocytes syndrome
      is due to the histiocytes being overloaded by ceroids, and it usually occurs in a
      context of blood disease or thesaurismosis. Twenty-five cases of sea-blue
      histiocytes syndrome associated with type B Niemann-Pick disease have been
      reported, with rupture of the spleen in two of them. The link between the two
      conditions is the transformation into ceroids of the sphyngomyelin accumulated in
      histiocytes.

PMID- 1759072
TI  - [Musical hallucinations].
AB  - Musical hallucinations are rarely reported. Acquired deafness play an important
      role in their development. The anatomical and neurophysiological substrates for
      the musical hallucinations are unknown. Most authors related the perceptual
      disturbance to organic origin (central or peripheral).

PMID- 1759073
TI  - [Temporal artery syndrome in amyloidosis AL associated with myeloma].
AB  - The authors report a case of amyloidosis AL associated with light lambda chain
      myeloma, mimicking giant cell temporal arteritis. The normality of inflammatory
      proteins, the primary resistance to corcicosteroids and the results of temporal
      artery biopsy (amyloid deposits without giant cell granuloma) excluded a
      diagnosis of giant cell arteritis associated with amyloidosis. The most probable
      mechanism was infiltration of branches of the external carotid artery. In
      patients with temporal arteritis, amyloidosis must be suspected and sought,
      particularly in case of monoclonal dysglobulinaemia or manifestations that are
      not typical of giant cell temporal arteritis. The prognosis of vascular
      amyloidosis seems to be more favourable than that of the classical visceral
      types. The primary amyloidosis of these patients must be treated with melphalan
      combined with prednisone and colchicine.

PMID- 1759074
TI  - [Hyperthyroidism and immune hemolytic anemia following amiodarone therapy].
AB  - We report the cases of two patients who, after prolonged amiodarone therapy
      developed hyperthyroidism and immune haemolytic anaemia. Antibodies were of the
      IgG type and non-specific at elution. A search for other causes of haemolytic
      anaemia with positive Coombs' test gave negative results. Antiamiodarone
      antibodies have recently been discovered; they reflect an immunological
      disturbance due to this drug and might be responsible for some of the
      undersirable effects of amiodarone. In our patients, hyperthyroidism and
      haemolytic anaemia were induced by a dual mechanism: accumulation of amiodarone
      and induction of an effect of this drug on the immune system.

PMID- 1759075
TI  - [Giant cell arteritis of gynecologic localization. Discussion of a new case].

PMID- 1759076
TI  - [Danger to aquariophils. Apropos of a case of poisoning by Pterois volitans].

PMID- 1759077
TI  - [Importance of rehydration in the treatment of symptomatic hypercalcemia].

PMID- 1759078
TI  - [Lipo-atrophy of the buttocks after intramuscular injection of adrenal cortex
      hormones].

PMID- 1759079
TI  - Developments in the treatment of gastric cancer.

PMID- 1759080
TI  - Prolonged survival of stomach cancer patients after extensive surgery and
      adjuvant treatment: an overview of the Japanese experience.
AB  - The 5-year survival rate of resected stomach cancer patients, which had been
      nearly 20% or less in the 1950s, has now been increased to more than 60%. Such a
      remarkable improvement was analyzed from the data of the National Registry or of
      the nationwide cohort studies. Standardization of the operative method involving
      extensive lymph node dissection, which has prevailed since the mid-1960s, was the
      leading factor in this improvement. Development of improved techniques for early
      diagnosis increased the rate of detection of early cancer and the rate of early
      cancer per resected cases amounts to more than 30% in major institutions as of
      1981. Adjuvant chemo-immunotherapy administered over a long postoperative period
      was confirmed to elevate the cure rate substantially. As new anticancer drugs
      recently developed in Japan, UFT (Uracil/Tegafur mixture) and HCFU (Carmoful)
      were introduced. Optional use of regional therapy such as arterial infusion
      chemotherapy or intracavital biological response modifiers (BRM) injection are
      among the latest treatment possibilities.

PMID- 1759081
TI  - Gastric cancer mass survey in Chile.
AB  - A Chilean publication in 1969 reported the 5-year survival rate of gastric cancer
      to be 12% of operated patients and only 3% of all patients diagnosed with gastric
      cancer. Encouraged by the excellent results obtained in Japan through a massive
      study of the population, Chile initiated in 1978 a program for massive detection
      of gastric cancer. From May 1978 to December 1986, 42,492 persons were screened
      under this system. Gastric cancer was detected in 0.43% in the massive group, and
      in 1.27% in the symptomatic group. The rate of early cancer detected per all
      gastric cancer was 14.69% in the former and 11.02% in the latter group. Gastric
      ulcer was found to be located more in the upper third of the stomach and less in
      the lower third, which may call attention in comparison with the foreign
      literature.

PMID- 1759082
TI  - Recurrence of early gastric cancer.
AB  - We investigated the postoperative deaths and recurrence among 673 patients with
      early gastric cancer who had undergone gastric resection at the National Kyushu
      Cancer Center Hospital from March 1972 to December 1988. The mode and time of
      recurrence were assessed with reference to the clinicopathological findings at
      initial surgery. Fifteen patients (2.2%) died of cancer recurrence, and 18
      patients (2.7%) developed recurrence (3 patients are currently alive after
      reoperation). A comparison of modes of recurrence revealed that the incidence of
      hematogenous recurrence was the highest with nine cases, followed by recurrence
      in the remnant stomach in three cases and by local, lymph node, and peritoneal
      recurrences in two cases each. Twelve patients developed recurrence within 5
      years after operation (early recurrence) and six patients after 5 years (late
      recurrence). Cases positive for cancer cell invasion into intralesional veins at
      initial surgery had a significantly higher recurrence rate than negative cases (P
      less than 0.001). Thus, venous invasion was the most important factor for the
      development of recurrence in the patients with early gastric cancer.

PMID- 1759083
TI  - Endoscopic treatment of early gastric cancer.
AB  - Laser therapy and endoscopic strip biopsy for early gastric cancer are useful
      measures from our experience. It is considered that the larger lesion of early
      cancer should be treated by laser therapy and the smaller lesion by strip biopsy.
      However, endoscopic therapy as a curative treatment still presents problems.
      Clinical trials with laser therapy has to accumulate to ascertain the
      effectiveness of laser on the gastric wall. Also, endoscopic treatment methods
      are limited to patients who cannot be admitted to surgery. Furthermore, it is
      difficult to judge the metastasis to lymph nodes surrounding the stomach with
      present diagnostic capabilities. Wider application of these endoscopic treatment
      methods will follow when these difficulties are overcome.

PMID- 1759084
TI  - Surgical treatment of gastric cancer: retrospective survey of 1,704 operated
      cases with special reference to total gastrectomy as the operation of choice.
AB  - Total gastrectomy is discussed as the operation of choice among different
      surgical approaches for gastric carcinoma. We prefer the performance of an
      elective total gastrectomy with systematic lymphadenectomy (compartments I and
      II) and obligatory splenectomy. A retrospective study of 1,704 consecutive cases
      of gastric carcinomas showed a better outcome following total gastrectomy in
      relationship to distal subtotal gastrectomy, but these results cannot be used as
      evidence because of the lack of a prospective study. Nevertheless, a precise
      analysis of our cases in regard to tumor site and tumor type could show a
      frequency of only 6% to maximally 30%, in which elective total gastrectomy may
      represent a procedure too extensive to justify for an oncological course.

PMID- 1759085
TI  - Improvement in treatment results of gastric cancer with surgery and chemotherapy:
      experience of 9,700 cases in the Cancer Institute Hospital, Tokyo.
AB  - Treatment results of 9,741 cases of gastric cancer treated at the Cancer
      Institute Hospital, Tokyo during the past 42 years were retrospectively analyzed.
      Resectability was 89.6% (94.1% for 1960-1988) and operative mortality was 1.9%
      (1.5% for 1960-1988). Five-year survival rate was 48.5% (54.9% for 1960-1988) for
      all cases, 68.8% (73.1% for 1960-1988) for patients with curative surgery, and
      4.7% (4.9% for 1960-1988) for those with noncurative surgery. Curative rate was
      improved twofold among patients with curative gastrectomy. Postoperative adjuvant
      chemotherapy had a marginal benefit for stage II and III disease. Improvement
      could be attributed mainly to the relative increase in early gastric cancer, and
      partly to the extended surgeries for stage III and IV cases, such as systemic
      lymphadenectomy and combined resection of involved adjacent organs. Multimodality
      therapy is expected to control the relapse of peritoneal dissemination (14.2%)
      and hematogenous metastasis (8.9%).

PMID- 1759086
TI  - Coeliac axis-oriented approach in surgery for advanced gastric cancer.
AB  - To achieve the systemic curative lymph node dissection in gastrectomy for
      advanced gastric cancer, coeliac axis-oriented approach was proposed.
      Mobilization of the spleen as well as the tail and body of the pancreas from the
      left retroperitoneum and Kocher's maneuver lifting up the hepatoduodenal ligament
      and head of pancreas from the right retroperitoneum permits the observation of
      the coeliac axis under direct vision and enables the para-aortic node dissection
      with ease. This approach was applied to 131 cases with advanced gastric cancer
      with neither mortality nor notable complication.

PMID- 1759087
TI  - Type-oriented therapy for gastric cancer effective for lymph node metastasis:
      management of lymph node metastasis using activated carbon particles adsorbing an
      anticancer agent.
AB  - Activated carbon particles are taken selectively up by lymphatics when injected
      into the tissues and visualize regional lymph nodes colored black. Furthermore,
      carbon particles adsorb a large amount of the anticancer agent mitomycin C (MMC)
      on their surface and release the drug reversibly. Using these properties of
      activated carbon particles, we have applied it for lymph node dissection and
      chemotherapy of lymph node metastasis. After injection of carbon particles,
      regional lymph nodes of the stomach were found to be black; blackened lymph nodes
      extending widely from perigastric to para-aortic nodes were identified from other
      structures. Four hundred and twenty-four patients with gastric cancer were
      treated with this method for lymph node metastasis during 1984-1988. Involved
      nodes were generally colored in high incidence, about 70% of involved ones except
      for highly positive nodes, which was the same as noninvolved nodes. In highly
      positive nodes, the colored incidence was decreased to about 48%. The cumulative
      5-year survival rate of the patients treated with this series was 74.6%, which
      was significantly higher than the figures without this method.

PMID- 1759088
TI  - Split-night studies: a new standard? Forcing the examination of outcome.

PMID- 1759089
TI  - Single night studies in obstructive sleep apnea.
AB  - The role of single night studies and the determinants of effective nasal
      continuous positive airway (CPAP) pressures were determined in 412 consecutive
      patients between 1984 and 1989. Patients chosen for analysis had an apnea index
      (AI) of greater than or equal to 20 hr-1 prior to CPAP. The AI was 67 +/- 30 hr
      1, the body mass index (BMI) was 36 +/- 9 kg/m2, the age was 51 +/- 13 yr and the
      lowest oxygen saturation was 72 +/- 14%. Effective CPAP (9 +/- 3 cm H2O) was
      documented in 320 patients on single night studies and resulted in a 99%
      reduction in the frequency of obstructive events and improvement in the lowest O2
      saturation to 94 +/- 5%. Only 18% of the variability in effective CPAP could be
      explained by AI and BMI. Single night studies are sufficient to establish
      effective CPAP in 78% of patients and offer considerable conservation of
      resources compared to routine multiple night studies. Effective CPAP pressures
      are variable and must be determined by incremental CPAP trials.

PMID- 1759090
TI  - Insomnia and use of hypnotics: study of a French population.
AB  - A cross-sectional study of insomnia and hypnotic use was performed in a sample of
      the French population. The quota method was used to select the sample of 1,003
      subjects, with less than 3% substitution. Subjects were 15 years old and older
      and were representative of the French population based on gender, age, marital
      status and living environment. Subjects were asked questions relevant to the
      complaint of insomnia and hypnotic use and filled out questionnaires measuring
      anxiety and depression. The complaint of insomnia is common, even in the 15-24
      year-old group. Overall, more women than men were afflicted. The largest group of
      insomniac subjects, and the group who most often used hypnotics "frequently and
      chronically", were women 45 years and older. Men presented a sharp increase in
      hypnotic use after 65 years of age. Ten percent of the entire sample used
      hypnotics, 8% for more than 6 months and 6.17% on a chronic and frequent basis.
      Retired and unemployed elderly were also chronic and frequent hypnotic users:
      aging and social isolation correlate with chronic and frequent hypnotic usage.
      Higher scores on anxiety and depression scales correlate with more frequent
      complaints of nocturnal sleep disturbances. Young individuals are a significant
      complainer group but use hypnotics rarely. A rural environment was associated,
      overall, with fewer insomnia complaints, but environment had much less impact on
      complaints and hypnotic use in the elderly than in other age groups. One may
      question whether, in the French population, hypnotic prescription and intake are
      not responses to a social rather than a medical problem.

PMID- 1759091
TI  - Prevalence and treatment of insomnia in the community: results from the Upper
      Bavarian Field Study.
AB  - In the Upper Bavarian Field Study a total of 1,536 persons (15 yr of age and
      older) were interviewed by research psychiatrists. The prevalence of insomnia
      (last 7 days) identified with the aid of the Clinical Interview Schedule (CIS)
      was 28.5% (mild: 15.0%; moderate/severe: 13.5%). For both sexes sleep disorders
      increased with age. The female preponderance of insomnia was mainly associated
      with the middle and older age groups. In contrast to other psychiatric disorders,
      sleep disturbances were not associated with social class. Moderate/severe
      insomnia was strongly related to psychiatric diagnoses, the use of psychiatric in
      and outpatient services and general hospitals. It also constituted a significant
      burden for the primary-care physicians, whereby the average annual consultation
      rate among mild (10.61) and moderate/severe insomniacs (12.87) was significantly
      higher compared to that for those without sleep disorders (5.25). A total of
      33.7% of the insomniacs were treated with hypnotic and/or other psychotropic
      drugs during the week prior to the interview, whereby the drug consumption among
      moderate/severe insomniacs (48.5%) was significantly higher than that of mild
      insomniacs (20.4%).

PMID- 1759092
TI  - Subjective versus objective evaluation of hypnotic efficacy: experience with
      zolpidem.
AB  - There is little published literature on the correlation between subjective and
      objective efficacy of hypnotics. We wanted to determine whether there was a
      correlation between the patient's subjective evaluation of the efficacy of the
      hypnotic with the polysomnographic (PSG) findings. We studied 16 patients with
      chronic insomnia (sleep latency, greater than or equal to 30 minutes; total sleep
      time, greater than 240 but less than 420 minutes) for 11 nights who took placebos
      on nights 1 and 2, zolpidem (imidazopyridine) on nights 3-9 and placebo on nights
      10 and 11. Patients completed a questionnaire each morning following PSG, which
      evaluated subjective sleep quality, sleep latency and total sleep time. These
      data were compared to PSG findings to answer specific questions about sleep
      latency reduction, efficacy of the hypnotic after a week's use, sleep quality
      after discontinuing the drug, and any correlation between subjective and
      objective measures. PSG findings indicated a shortened sleep latency, increased
      total sleep time, decreased total wake time and increased sleep efficiency when
      patients ingested zolpidem 30 minutes before bedtime. We found that after 7
      nights (nights 3-9) the drug was still effective in reducing sleep latency and
      increasing total sleep time. Upon withdrawal (nights 10 and 11) sleep returned to
      baseline (nights 1 and 2). Subjectively, the patients confirmed those findings on
      the questionnaire, as well as a subjective reduction in the number of awakenings
      and, interestingly, a subjective increase in the time spent awake after sleep.
      Many of the objective variables we examined correlated highly with the subjective
      variables. While on zolpidem, subjects believed and were objectively shown to
      have a decreased sleep latency, increased total sleep time and decreased time
      awake before persistent sleep, although they tended to overestimate sleep latency
      and time spent awake before persistent sleep and underestimated total sleep time.
      Although the correlation between objective and subjective measures was high for
      the group, in individual patients there was an impressive difference between the
      two, and the highest coefficient of variation between a subjective and objective
      measures was 0.453. No correlations were found with subjective measures of
      refreshing quality of sleep, decrease in number of awakenings, how sleepy
      patients felt in the morning or their ability to concentrate in the morning.
      Thus, we believe the PSG remains the keystone in the evaluation of hypnotic
      efficacy.

PMID- 1759093
TI  - Postmarketing surveillance of zopiclone in insomnia: analysis of 20,513 cases.
AB  - The subjective response to the prescription drug zopiclone, an hypnotic agent
      belonging to the cyclopyrrolone family, was assessed under the usual conditions
      of prescription of an hypnotic in general practice. The study included 20,513
      insomniac outpatients with at least two of the following symptoms: sleep onset
      latency longer than 1 hour, more than two nocturnal awakenings, early morning
      awakening 1 hour or more before scheduled time, total sleep time of less than 6
      hours, complaint of tiredness on awakening. Insomniac patients were treated with
      zopiclone and followed for 21 consecutive days within the context of a follow-up
      surveillance study. The population was predominantly female (62.6%), and the mean
      age was 52.3 years. The dosage of zopiclone prescribed at the inclusion visit was
      7.5 mg per day in 87.5% of the cases and 3.75 mg per day in 10.5%. A total of
      93.8% of the patients completed the survey. Spiegel questionnaire improved during
      the 21-day survey, and 9.2% of the patients reported at least one adverse event
      that led to treatment discontinuation in only 2.8% of the population. No serious
      or unexpected adverse events were reported.

PMID- 1759094
TI  - Treatment of persistent sleep-wake schedule disorders in adolescents with
      methylcobalamin (vitamin B12).
AB  - Two adolescent patients suffering from persistent sleep-wake schedule disorders
      appear to have responded to treatment with vitamin B12 (methylcobalamin). A 15
      year-old girl with delayed sleep phase syndrome (DSPS) and a 17-year-old boy with
      hypernychthemeral syndrome complained of not being able to attend school despite
      many trials of medication. The improvement of the sleep-wake rhythm disorders
      appeared immediately after the administration of high doses (3,000
      micrograms/day) of methylcobalamin. Neither patient showed any laboratory or
      clinical evidence of vitamin B12 deficiency or hypothyroidism (which can cause
      B12 deficiency). Serum concentrations of vitamin B12 during treatment were in the
      high range of normal or above normal. The duration of the sleep period of the
      DSPS patient decreased gradually from 10 hours to 7 hours, and the time of sleep
      onset advanced from 2 a.m. to midnight. The period of the sleep-wake cycle of the
      hypernychthemeral patient was 24.6 hours before treatment and 24.0 hours after
      treatment. The relationship between the circadian basis of these disorders and
      vitamin B12 and its metabolites is discussed.

PMID- 1759095
TI  - Sleep-related eating disorders: polysomnographic correlates of a heterogeneous
      syndrome distinct from daytime eating disorders.
AB  - Over a 5-yr period, 19 adults presented to our sleep disorders center with
      histories of involuntary, nocturnal, sleep-related eating that usually occurred
      with other problematic nocturnal behaviors. Mean age (+/- SD) at presentation was
      37.4 (+/- 9.1) yr (range 18-54); 73.7% of the patients (n = 14) were female. Mean
      age of sleep-related eating onset was 24.7 (+/- 12.9) yr (range 5-44). Eating
      occurred from sleep nightly in 57.9% (n = 11) of patients. Chief complaints
      included excessive weight gain, concerns about choking while eating or about
      starting fires from cooking and sleep disruption. Extensive polysomnographic
      studies, clinical evaluations and treatment outcome data identified three
      etiologic categories for the sleep-related eating: (a) sleepwalking (SW), 84.2%
      (n = 16); (b) periodic movements of sleep (PMS), 10.5% (n = 2) and (c) triazolam
      abuse (0.75 mg hs), 5.3% (n = 1). DSM-III Axis 1 psychiatric disorders
      (affective, anxiety) were present in 47.4% (n = 9) of the patients, and only two
      patients had a daytime eating disorder (anorexia nervosa), each in remission for
      3-7 yr. Nearly half of all patients fulfilled established criteria for being
      overweight, based on the body mass index. Onset of sleep-related eating was
      linked directly to the onset of SW, PMS, triazolam abuse, nicotine abstinence,
      chronic autoimmune hepatitis, narcolepsy, encephalitis or acute stress. In the SW
      group, 72.7% (8/11) of patients had nocturnal eating and other SW behavior
      suppressed by clonazepam (n = 7) and/or bromocriptine (n = 2) treatment. Both
      patients with PMS likewise responded to treatment with combinations of
      carbidopa/L-dopa, codeine and clonazepam. Thus, sleep-related eating disorders
      can generally be controlled with treatment of the underlying sleep disorder.

PMID- 1759096
TI  - Prevention of airway obstructions during sleep in infants with breath-holding
      spells by means of oral belladonna: a prospective double-blind crossover
      evaluation.
AB  - We investigated whether the brief airway obstructions seen during sleep in
      infants with breath-holding spells were controlled by the autonomic nervous
      system. We studied 20 infants, with a history of breath-holding spells and a
      median age of 12 wk (range 4-46 wk). During sleep they had a median of 6 airway
      obstructions per 10-hr recording (range 3-16 events), with a median duration of 8
      sec (range 4-12 sec). No explanation was found for the airway obstructions. In
      every infant, a double-blind crossover challenge was conducted. It included oral
      administration of tincture of belladonna, equivalent to 0.01 mg/kg weight of
      atropine, and placebo syrup containing no belladonna. The belladonna, or the
      placebo, was administered at bedtime for 7 days, followed by a 7-day washout
      period. Another 7-day series of syrup administration was then undertaken. A
      nighttime polygraphic recording was made after each 7-day series. It was the
      belladonna, and not the placebo, that induced the disappearance of the
      obstructions in 10 infants; these were called "drug responsive". In 5 children no
      effect was observed after either the placebo or belladonna; these infants were
      defined as "drug unresponsive". In 4 subjects the obstructions disappeared after
      both belladonna and the placebo; the children were considered to have an
      "inconclusive response". One infant was excluded from the study because he
      developed an airway infection. It is concluded that in some breath-holding
      infants, obstructed breathing episodes during sleep disappear after the
      administration of an atropinic drug. The observation could indicate a role of the
      autonomic nervous system in the control of the upper airways during sleep in
      infants.

PMID- 1759097
TI  - Enforced 24-hour recovery following sleep deprivation.
AB  - The pattern of recovery sleep after sleep deprivation was investigated in healthy
      young adults. Six subjects experienced three experimental conditions (0, 24, and
      48 hr sleep deprivation) in a Latin Square design. The recovery period consisted
      of a 24-hr enforced time in bed during which subjects were polysomnographically
      recorded beginning at 0800. To assess the differential effects of the deprivation
      conditions, the total sleep time on the 24-hr recordings was submitted to a six
      (4-hr block) by three (deprivation condition) multivariate analysis of variance.
      Subjects slept more following the 24- and 48-hr conditions when compared to the 0
      hr condition. Across conditions, subjects slept more during the first 4 hr when
      compared to the remaining five blocks. Importantly, there was a significant
      interaction of sleep deprivation by 4-hr block. In block 1 sleep was
      differentially recovered between each condition with more sleep being recorded
      following longer hours of deprivation. In block 2 subjects in the 24- and 48-hr
      conditions slept comparable amounts and significantly more than those in the 0-hr
      condition. In blocks 3 and 4 only the 48-hr condition exhibited significantly
      more sleep than the 0-hr condition. However, significantly less sleep was found
      in block 6 following the 48-hr condition. Overall, subjects recovered 72% and 42%
      of the total amount of sleep lost during the 24- and 48-hr conditions,
      respectively.

PMID- 1759098
TI  - Middle-ear muscle activity (MEMA) and its association with motor activity in the
      extremities and head in sleep.
AB  - Middle-ear muscle activity (MEMA) in sleep was simultaneously recorded from both
      ears using extratympanic manometry. Head movement, speech movements, ankle
      flexion and wrist movement were monitored by electromyographic recording using
      surface electrodes at the back of the neck, second laryngeal notch, anterior
      tibialis and forearm muscle. Motor events recorded from these electrode
      placements were examined for correlation with MEMA to test the hypothesis that
      the middle-ear muscles are activated in conjunction with other motor activities,
      aside from eye movements, by a central motor command system. Phi coefficients
      were calculated for each subject; all were positive, thus indicating an
      association between MEMA and other noneye movement motor events. These results
      suggest that there is a central phasic motor system responsible for MEMA and
      associated phasic motor activity in sleep.

PMID- 1759099
TI  - Periodic hypersomnia: case report with biochemical and EEG findings.
AB  - We report on a 23-year-old patient with periodic hypersomnia.
      Electroencephalographic (EEG) background activity for this individual was
      slightly slowed in the EEG during an episode of hypersomnia, and intermittent
      slow activity was found in addition. Usual laboratory parameters were normal;
      however, leucine-enkephalin was markedly elevated in the plasma at that time,
      whereas free cysteine could not be demonstrated. Clinical findings were normal in
      the following years, and the EEG background activity returned to normal; leucine
      enkephalin and cysteine also returned to normal values.

PMID- 1759100
TI  - Pharmacological dissociation of EEG and behavior: a basic problem in sleep-wake
      classification.

PMID- 1759101
TI  - [Results of medicosurgical treatments of gastroesophageal reflux in asthma].

PMID- 1759102
TI  - [Lasers and endoprosthesis in bronchopneumology].
AB  - During the past decade lasers, especially the Neodymium: Yttrium-Aluminum-Garnet
      (Nd: YAG), have transformed interventional bronchoscopy. Recent improvements of
      tracheobronchial prostheses have further increased the therapeutic possibilities
      of endoscopy. Tracheobronchial obstruction by intraluminal tumeur, stenosis, or
      extrinsic compression can now be palliated successfully. The future of
      therapeutic bronchoscopy is bright. New techniques of optic spectroscopy will
      allow improved detection of laser induced tissue fluorescence. Refinements of
      laser technology and development of visualisation systems such as endoscopic
      echography and electronic videoendoscopy will lead to improved diagnostic and
      therapeutic capabilities.

PMID- 1759103
TI  - [Isolated cough and bronchial asthma].
AB  - Over an 18-month period 31 patients (27 female and 4 male) were referred to the
      ENT department of our clinic for a 1-month to 14-year history of isolated non
      productive cough. As ENT examination, including posterior rhinoscopy, was normal,
      these patients were sent to the pneumology department. Physical examination and X
      ray films of the chest were negative, and the patients did not take an
      angiotensin converting enzyme inhibitor that could have induced this cough.
      Inhalation of acetylcholine lowered vital capacity by 32 +/- 14% and forced
      expiratory volume by 34 +/- 16%, a test which is the hallmark of bronchial
      hyperreactivity. Three patients were atopic. We believe that this cough can be
      the only manifestation of bronchial asthma. In these patients, cough was
      suppressed or strongly attenuated by the inhalation, 5 times a day, of salbutamol
      200 mg puffs and beclomethasone dipropionate 250 mcg. In addition, the atopic
      patients were prescribed 10 puffs of sodium cromoglycate per day. Complaints of
      isolated non-productive cough must always suggest that possibility of bronchial
      asthma, and a bronchial provocation test must be performed to confirm this
      diagnosis.

PMID- 1759104
TI  - [Peculiar development of a case of pneumothorax].

PMID- 1759105
TI  - [Peculiar bilateral opacities].

PMID- 1759106
TI  - [Access of torsades de pointes in Legionnaires' disease: an uncommon adverse
      effect of erythromycin].
AB  - We report the case of a 77-year-old man with legionnaires's disease who,
      immediately after an intravenous infusion of one gram of erythromycin presented
      with wave burst arrhythmia with widening of the QT space. The blood level of
      erythromycin at the time of this adverse reaction was the same as the peak
      observed in young subjects after intravenous administration of this drug.
      Fourteen similar cases were found in the literature. In vitro and in vivo studies
      have shown that erythromycin may exert on the cardiac muscle fibres an
      electrophysiological effect similar to that of class I antiarrhythmic agents.

PMID- 1759107
TI  - [Eosinophilic lung disease caused by filariasis. Apropos of a case].
AB  - A 23-year-old male Pondichery native consulted for vesperal dispnoea. The main
      abnormalities detected were blood and alveolar eosinophilia and bilateral
      micronodular lesions at radiography. The parasitic origin of these symptoms was
      suspected, then confirmed by serological tests for filaria. The outcome was
      favourable after antiparasitic therapy. The histopathological, clinical and
      evolutionary features of pulmonary eosinophilic filiariasis are described, with
      emphasis on the treatment and on follow-up laboratory tests.

PMID- 1759108
TI  - The mathematical description of structures.
AB  - Any mathematical description of structures should start from a precisely stated
      definition of the concept of "structure". Unfortunately no universally accepted
      definition of this type exists. All that can be said is that the concept of
      "structure" is changing together with the modern physico-mathematical thought, so
      that different 'points of view' on the problem of the mathematical description of
      structures can be distinguished. The aim of this paper is to compare the
      explicative and predictive power of these different 'viewpoints' without entering
      into historical detail, in order to critically examine the limits and powers of
      the mathematical tools available today.

PMID- 1759109
TI  - Evolution in absence of mutation.
AB  - Each part of a living organism contains a concealed totality which can eventually
      express itself partially or totally. The extent of the expression is spatially
      and temporally defined by the morphogenetic field and the environment. Neither
      the field nor the genome are evolving units. Evolution is produced by the
      boundary conditions and results in progressive losses, to which the organisms
      responds. Genetic losses can stabilize the new balance. A living system can be
      fruitfully compared to a semiotic system.

PMID- 1759110
TI  - Behavioral pathway to evolutionary change.
AB  - The extreme malleability or plasticity of cells early in their development is
      mirrored to a certain, if lesser, degree in the psychological, behavioral, and
      neural functioning of developing organisms. The early developmental adaptability
      of organisms has significance for our understanding of evolution. It is the
      purpose of the present article to make a case for the extra-genetic or, better,
      the supra-genetic developmental basis of evolutionary change through the genesis
      of novel behavioral phenotypes. To make things as clear as possible, I contrast
      this developmental approach to evolution with the population-genetic model of the
      modern synthesis. I should say at the outset that the present theory can be
      integrated with the population-genetic model, with the exception of the radically
      different role ascribed to genes in the two viewpoints.

PMID- 1759111
TI  - The influence of inhibitors and other factors on cholinesterases.
AB  - Literature survey dealing with cholinesterases and effects of highly toxic
      organophosphorus compounds suitable for use as chemical weapons is given in
      introductory part of this work. There are nerve paralytical agents (NPA)--sarin,
      soman, VX and a model compound O-ethyl-S-(2-dimethylaminoethyl)-methyl
      phosphonothioate (EDMM). On the base of described scheme of intoxication with
      NPA, inhibition effect on cholinesterases, preferably on AChE as the most
      important factor involved in the mechanism of acute intoxication with NPA was
      studied. Intoxication of mice or rats with sarin and soman (2 x LD50) showed that
      time course of poisoning is faster than that for VX or EDMM. Inhibition of AChE
      in the blood was in good correlation with symptoms of intoxication and also with
      inhibition of AChE in the brain. The differences between inhibition effect of
      soman preferably uniform character of inhibition in the brain parts) and sarin
      (selective inhibition in the brain parts, with maximum in the frontal cortex and
      pontomedullar area) were observed. This selectivity was most marked for VX and
      EDMM intoxication (maximal inhibition in the part of the pontomedullar area
      containing reticular formation). The dose causing inhibition effect in the brain
      was assessed to be about 1% of the dose administered. The study of the effect of
      antidotal therapy (combination of atropine and reactivator) in vivo showed in
      mice and rats intoxicated with sarin non-uniform increase of AChE activity in the
      pontomedullar part depending on the dose and type of reactivator. The most marked
      effect was observed for methoxime. It was demonstrated that there exists good
      correlation between survival of experimental animals and the rest AChE activity
      in the pontomedullar part of the brain. AChE activity level critical for survival
      or death of the organism poisoned with NPA was assessed from these experiments;
      it was about 1-5% of normal values. By means of original method allowing
      continual monitoring of AChE activity in the blood, similar AChE reactivation was
      demonstrated, with highest effect for trimedoxime and methoxime. Using continual
      determination of the blood AChE activity following sarin, soman, VX and EDMM
      intoxication demonstrated that only a part of the dose administered caused
      inhibition effect in the blood; this part was determined to be practically 100%
      (i. v. administration); for other routes of administration this ratio was as
      follows: 50-80% (i. m.), 20-40% (i. p.), 6-16% (p. o.) and 1-5% (p. c.),
      respectively. Using this continual monitoring, the detoxication of sarin and
      soman was demonstrated. Detoxication of VX and EDMM was not observed.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1759112
TI  - Severe limb ischemia syndrome.
AB  - In the course of the study of the syndrome of severe limb ischemia (SLI) in a
      representative clinical material of 300 patients and a number of experimental
      studies, we arrived to the proposal of this optimal methodical procedure for
      acute vascular closures of traumatic and non-traumatic origin in the limbs: a) In
      every injury and sudden pain with a change of the function of the limb, it is
      necessary to think of the SLI syndrome and to search targetedly for it. b) In
      injuries connected with bleeding our first-rate task is the control of this
      bleeding. For a temporary arrest of the bleeding it is necessary to prefer more
      physiological methods sparing collateral circulation to the still most used
      tourniquet. For this purpose a new device for temporary hemostasis called
      Hemostop has proved itself, designed by the author and attested both
      experimentally and clinically, protected as a Czechoslovak patent. From surgical
      measures have acquitted themselves from this viewpoint the insertion of vascular
      clamp, ligature of the vessel or its temporary cannulation. c) To set the
      diagnosis of SLI, it usually suffices a careful anamnesis and clinical
      examination, advantageous is the investigation by ultrasound. The angiography
      because of time consumption should be used only in indicated cases. d) The time
      factor--"race against the time"--has to be always borne on our mind. It is
      necessary to achieve the recovery of blood circulation in the limb up to 6 or at
      the latest up to 10 hours from the onset of injury or closure. e) For shortening
      of the period of tissue hypoxia it is of advantage to use the temporary
      cannulation of injured vessels. This should be used always, whenever because of
      any reasons, it is not possible to execute the final reconstructive operation up
      to 10 hours since the injury, e. g. in polytraumatism, transport difficulties and
      the like. f) In isolated vascular injuries without bleeding (about 45%) and in
      all non-traumatic SLI the patients must be efficiently heparinized (i. v.
      administration, at best by infusion) to prevent the growth of the distal
      thrombus. g) Final vascular reconstruction should be performed only by erudited
      surgeons, always with thromboctomy and in protected coagulum. Optimal
      reconstructive performance should be chosen: for embolism the thromboembolectomy,
      for acute thrombosis usually the bypassing the afflicted vascular portion by the
      graft, in injuries appears as the optimal reconstructive measure the anastomosis
      end to end. At the simultaneous or isolated lesion of the stem vein, we must
      always try to reconstruct it.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1759113
TI  - Gastritis, peptic ulcer and gastric cancer.

PMID- 1759114
TI  - The story of gastritis.

PMID- 1759115
TI  - Dyspeptic complaints, diet, gastric mucosa and Helicobacter pylori among an
      Estonian urban population.
AB  - A representative sample of an adult population, earlier examined by gastroscopic
      biopsy, was subjected to correlation and regression analyses to quantitate the
      influences of different factors on the development of three dyspeptic complaints.
      In this study a large part of the complaints were incriminated by the subjects to
      poor tolerance of certain foods and/or beverages. According to the results of
      formal analysis, the state of the corpus and antral mucosa and the presence of
      Helicobacter pylori play only an accompanying role in some regression models.

PMID- 1759116
TI  - Alpha 1-antitrypsin allo- and phenotypes in gastric and duodenal ulcer.
AB  - Serum alpha 1-antitrypsin (A1AT) allo- and phenotypes (including M1, M2 and M3
      alleles) were studied in 99 patients with gastric ulcer (GU) and 56 patients with
      duodenal ulcer (DU) using agarose isoelectric focusing. The results were compared
      with the A1AT data of a random population sample of similar genetic background
      (1422 persons). An increase in M2 allotype and M1M2 phenotype as well as a
      decrease in Z allotype of A1AT was seen in GU in comparison to DU and the random
      population. There were no particular clinical features which would distinguish
      patients with M2 allotype from the remainder of the GU group. However, a trend
      toward elevated serum pepsinogen I and II levels in patients with M2 allotype was
      seen. When the pepsinogen levels were compared in the GU patient groups with and
      without M2 allotype, matched between themselves by the state of the gastric
      mucosa, a statistically significant difference was revealed between pepsinogen II
      levels in these two groups. No associations were found between DU and any of the
      A1AT phenotypes.

PMID- 1759117
TI  - Serum pepsinogen I and serum gastrin in the screening of severe atrophic corpus
      gastritis.
AB  - The possibilities to screen atrophic corpus gastritis with serum pepsinogen I (S
      PGI) and serum gastrin (S-gastrin) concentrations have been studied in 774
      subjects: 71 index subjects selected from a general population at random, 353 of
      their first-degree relatives, 276 first-degree relatives of patients with gastric
      cancer, 53 patients with pernicious anaemia, and 21 of their relatives.
      Discrimination function analysis was calculated from members of random and
      gastric carcinoma families. S-PGI less than 30 ng/ml had a high sensitivity for
      severe diffuse atrophic corpus gastritis (SDAG) alone (89.5%) and SDAG + severe
      patchy atrophic corpus gastritis (SPAG) (89.1%). Respective figures for
      specificity were 91.5% and 94.8%. The discriminatory power of S-PGI less than 30
      ng/ml and S-PGI less than 25 ng/ml was of the same order. The sensitivity of low
      S-PGI decreased sharply in detection of slighter forms of atrophic corpus
      gastritis. The sensitivity of S-gastrin greater than 100 pmol/l to discriminate
      SDAG was 57.9% and SDAG+SPAG 58.7%. Respective figures for specificity were 90.2%
      and 92.2%. Diffuse and patchy atrophic changes behaved similarly regarding S-PGI
      and S-gastrin mean concentrations. Accordingly, the biopsy specimen with the
      severest atrophic changes indicates the degree of atrophy, which associates
      closely with the changes in S-PGI and S-gastrin. In conclusion, severe atrophic
      (diffuse or patchy) corpus gastritis may be screened from a general population
      with high sensitivity and specificity by low S-PGI less than 30 ng/ml, whereas an
      increased level of S-gastrin is too insensitive for this.

PMID- 1759118
TI  - Autoimmune reactions to gastric mucosa in chronic gastritis: a review.
AB  - The main results of two-decade co-operation between Tartu University, Estonia,
      and the University of Helsinki, Oulu and Tampere in Finland on immunology of
      chronic gastritis are presented. These results include data on cell-mediated and
      humoral immunity to autoantigens from gastric antrum and corpus mucosa in chronic
      gastritis, gastric ulcer, gastric carcinoma and other gastric diseases, as well
      as in random samples from two populations.

PMID- 1759119
TI  - Serum pepsinogen I and serum gastrin in the screening of atrophic pangastritis
      with high risk of gastric cancer.
AB  - Serum pepsinogen I (S-PGI) and serum gastrin (S-gastrin) were examined in the
      screening of three types of atrophic gastritis with inherent high risk of gastric
      cancer: in 102 cases with severe atrophic corpus gastritis (SACG), in 5 cases
      with severe atrophic antrum gastritis (SAAG), and in 15 cases with severe
      atrophic pangastritis (SAPG) (atrophy both in corpus and in antrum) found among
      916 subjects from three family series (265 from gastric cancer families, 425 from
      randomly selected control families and 226 from pernicious anaemia families).
      There is no way to screen directly atrophic gastritis restricted to the antral
      mucosa. In pangastritis atrophy of antral glands causes a failure of the
      hypergastrinemic reaction of achlorhydria. The combination of S-PGI less than 25
      micrograms/l + S-gastrin less than 200 pmol/l detected 80.0% of our cases with
      SAPG, and only 17 subjects of 794 (2.1%) were false positives i.e. who had not
      advanced atrophic gastritis. The risk of gastric cancer may be significantly
      higher in SAPG than in SACG. The estimated prevalence of SAPG was 3% in random
      family members over 60 years. The combination of S-PGI and S-gastrin is
      recommended when the cost/benefit ratio in the screening program of gastric
      cancer is considered and people from a general population are selected for
      endoscopic studies.

PMID- 1759120
TI  - Helicobacter pylori in dyspeptic patients: quantitative association with severity
      of gastritis, intragastric pH, and serum gastrin concentration.
AB  - The relationship between different features of gastric mucosal inflammation,
      intragastric pH and serum gastrin concentration and the distribution and quantity
      of Helicobacter pylori was studied in a series of 107 dyspepsia patients. H.
      pylori was identified in 62 cases (59%), and its presence was associated with
      increased amounts of mononuclear inflammatory cells and neutrophilic and
      eosinophilic leucocytes in both the antrum and the corpus. The number of H.
      pylori in the antral mucosa was significantly associated with the quantity of
      mononuclear inflammatory cells. It was also associated with glandular atrophy in
      antral mucosa, so that slight and moderate glandular atrophy were significantly
      more common in cases with abundant H. pylori. Intragastric pH and serum gastrin
      concentration were inversely related to the number of H. pylori in both the
      antral and corpus mucosa. H. pylori positive patients were also divided into
      groups according to proportions of H. pylori in the antral and corpus mucosa. In
      5 of these patients (8%) the bacteria were present only in the corpus, and this
      group had a significantly more pronounced degree of glandular atrophy in the
      corpus mucosa, higher intragastric pH and a higher serum gastrin concentration
      than the other H. pylori positive patients. The other patients with a higher
      corpus H. pylori than antral H. pylori score (n = 25; 34%) also had a
      significantly higher intragastric pH and serum gastrin concentration than those
      with a corpus H. pylori score lower than or equal to the antral score, while the
      latter had more severe inflammation in the antral mucosa and a lower intragastric
      pH and serum gastrin concentration. The results suggest that inflammation in the
      antrum forms a favourable environment for H. pylori, while atrophy of the corpus
      glands, being connected with increased pH, leads to a diminished amount of H.
      pylori. They thus support the view that proliferation of H. pylori is dependent
      on acid produced by the corpus mucosa.

PMID- 1759121
TI  - Chronic gastritis: progression of inflammation and atrophy in a six-year
      endoscopic follow-up of a random sample of 142 Estonian urban subjects.
AB  - To study the prevalence and course of chronic gastritis (CG), 142 adult subjects
      collected at random from an Estonian urban area were endoscopically and
      bioptically examined at a six-year interval. The histology of the antral and
      corpus mucosae was evaluated by grading gastritis without ("superficial
      gastritis"; SG) and with atrophy ("atrophic gastritis"; AG) into mild, moderate
      and severe categories. A total of 135 (95%) and 139 (98%) subjects showed CG in
      the 1st and 2nd examinations, respectively. The CG healed in one subjects (0.7%),
      and in 5 out of 7 subjects with normal stomach in the 1st examination the CG
      started during the follow-up. No change in the severity of CG was seen in 24% of
      subjects with gastritis in the 1st examination. The main trend of CG was a slow,
      "one-step progression" in severity of inflammation and appearance of atrophy and
      intestinal metaplasia. Inflammation progressed significantly, especially in the
      young age groups and in the antrum in particular. The prevalence of AG increased
      linearly with age in corpus (mean annual risk 1.25%). Parietal cell antibodies
      (PCA) were found in 2 subjects in the 1st examination, and a further 2 subjects
      developed these antibodies later. Three of four PCA-positive subjects belonged to
      a subgroup of 8 elderly subjects who had corpus AG at both examinations and who
      also showed normal or normalizing mucosa in the antrum. It is concluded that CG
      is a slowly progressive disease advancing with time and, once started, rarely
      healing spontaneously.

PMID- 1759122
TI  - Grade of Helicobacter pylori colonisation in relation to gastritis: a six-year
      population-based follow-up study.
AB  - The prevalence and density of Helicobacter pylori (HP) colonisation was assessed
      twice, with an interval of six years from antral and corpus biopsies from a
      randomly collected Estonian urban population sample. Positive HP colonisation was
      found in either at 1st or 2nd or in both examinations in 85 out of 86 subjects in
      whom gastritis without atrophy (chronic inflammation without atrophic changes,
      SG) either developed or remained during the follow-up at the SG level. There was
      a clear intraindividual tendency to keep the grade of HP colonisation at an
      unchanged level during the follow-up: the hypothesis of random variation of HP
      colonisation during follow-up could be statistically rejected. Close to half of
      the subjects had at both examinations an identical grade of HP colonisation in
      the antral or corpus mucosa. Distinct changes in HP colonisation were observed in
      three instances: (1) the appearance of HP colonisation occurred concomitantly
      with appearance of gastritis; (2) the development of antrum atrophic gastritis
      (AG) occurred with concomitant diminution and eventual disappearance of HP in the
      antral side, and (3) normalization of antral mucosa occurred with persistence of
      corpus AG with concomitant disappearance of HP colonisation at both sites of the
      stomach mucosa. The grade of HP colonisation increased with increase in severity
      of SG and decreased with the progression of AG changes. In the antrum at the SG
      level a distinct increase was seen both in the grade of HP colonisation and in
      the severity of SG up to middle age, but in the corpus mucosa only HP
      colonisation but no SG progression was seen in the younger age-groups.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1759123
TI  - Characteristics of gastric mucosa which precede occurrence of gastric malignancy:
      results of long-term follow-up of three family samples.
AB  - The aim of the study was to evaluate what family characteristics and what
      morphological, functional and immunological changes of the gastric mucosa precede
      the development of gastric malignancy in a follow-up of 11-14 years. The material
      consisted of 301 first-degree relatives of gastric carcinoma patients, 183
      relatives of pernicious anaemia patients, and of 358 control relatives of
      probands computer matched from the general population by age and sex for the
      carcinoma probands. All subjects were endoscopically examined in 1973-1976 and
      followed up to the end of 1987. According to cancer registry data, 11 cases of
      malignant gastric tumours (9 carcinomas, one carcinoid tumour and one anaplastic
      tumour with suspicion of Hodgkin's disease) had been diagnosed during the follow
      up: 6 belonged to gastric carcinoma, 2 to pernicious anaemia and 3 to control
      families. The occurrence of malignancy was significantly related to the presence
      of advanced gastritis with atrophy and of intestinal metaplasia before the start
      of the follow-up. In relatives with achlorhydria and low serum pepsinogen I
      levels the incidence of malignancy did not significantly differ from that in
      controls of similar age and sex distribution. The risk of getting malignancy was
      about four-fold in female members of gastric carcinoma and pernicious anaemia
      families but was not increased in control families. The risk was increased only
      in female members and concerned only gastric malignancy being the expected one or
      even lower than the expected in regard to malignancies of other location.

PMID- 1759124
TI  - Enrichment of combined antral and corpus atrophic gastritis ("combined AG") in
      sibs of gastric carcinoma patients.
AB  - The occurrence of different combinations of antral and corpus atrophic gastritis
      (AG) was studied in 127 sibs and 159 children of 73 gastric carcinoma patients.
      Seventy-three control probands, age- and sex-matched for the carcinoma probands,
      and their 379 first-degree relatives were used as controls. Sibs of gastric
      carcinoma patients revealed a significant enrichment of AG affecting
      simultaneously both antrum and corpus (combined AG), while no such enrichment
      could be demonstrated in children, who behaved on the whole similarly to the
      controls. In addition, sibs of gastric carcinoma patients showed a significant
      aggregation of combined AG also when compared with children of similar age. This
      suggests that genetic factors in addition to environmental ones participate in
      the accumulation of combined AG in sibs. The lack of phenotype AB in children
      excludes the possibility of dominant Mendelian inheritance, but leaves the
      possibility of a recessive autosomal or multigenetic inheritance. The enrichment
      of combined AG in sibs of gastric carcinoma patients could be one of the factors
      involved in the increased liability of close relatives of gastric carcinoma
      patients to contract gastric malignancy.

PMID- 1759125
TI  - Chronic gastritis profiles in sibs of probands calculated to carry a highly
      increased risk of gastric carcinoma.
AB  - Of 1161 subjects consisting of 4 family samples (gastric carcinoma patient
      relatives, pernicious anaemia, duodenal ulcer and control families) 18 subjects
      representing 17 families had distinct atrophic changes in the gastric mucosa that
      were considered on the basis of risk calculations to carry an at least 7-fold
      risk to develop gastric carcinoma. Twelve of these 18 subjects could be used as
      probands and their 41 sibs were subjected to a closer statistical analysis. Sibs
      of probands having a very high relative risk of gastric carcinoma (18-fold or
      more) differed markedly from the general population. All sibs had some form of
      atrophic gastritis and there was a significantly higher than expected prevalence
      of subjects with severe corpus mucosal atrophy. It is concluded that sibs of
      subjects with severe atrophic changes may carry an increased risk of gastric
      malignancy.

PMID- 1759126
TI  - Young onset peptic ulcer disease and non-ulcer dyspepsia are separate entities.
AB  - The characteristics of peptic ulcer and non-ulcer dyspepsia in young men were
      studied in 202 consecutive conscripts who attended Central Military Hospital in
      Helsinki because of long-standing upper abdominal complaints. Active peptic
      ulceration (APU) was found in 48 patients, inactive peptic ulcer disease (IPU)
      was diagnosed in 77 patients, non-ulcer dyspepsia (NUD) was diagnosed in 52
      patients. In 25 cases the reason for symptoms was another disease, and these
      patients were excluded from the study. A control series (CON) consisted of 30
      symptomless healthy young male volunteers. The likelihood of discriminating
      between peptic ulcer disease and non-ulcer dyspepsia in a young male patient with
      dyspepsia are indicated by odds ratios (OR) and its 95% confidence limits (CL
      95). Active peptic ulcer disease differs from NUD, e.g., by 1) presence of antrum
      gastritis, OR 41.5 (CL 95: 10.1-171), 2) Helicobacter pylori in the gastric
      mucosa, OR 31.0 (7.4-130), 3) Lewisa+ phenotype, OR 8.9 (1.7-45.4), 4) serum
      pepsinogen I (S-PGI) greater than 100 micrograms/l, OR 4.6 (1.7-12.4), 5) non
      secretor status, OR 4.3 (1.6-11.6), and 6) O-blood group, OR 3.0 (1.2-7.7). In
      conclusion, the status of gastroduodenal mucosa, gastric secretion pattern and
      distribution of some genetic markers in patient series indicate that young onset
      peptic ulcer and non-ulcer dyspepsia are two separate entities. Helicobacter
      positive antrum gastritis is the best determinant of ulcer risk, but also high S
      PGI, Lewisa+ phenotype, non-secretor status and O-blood group are signs of
      increased risk of peptic ulcer.

PMID- 1759127
TI  - Estonian traditions in the study of chronic gastritis.

PMID- 1759128
TI  - Helicobacter pylori and duodenal ulcer. A study of duodenal ulcer patients and
      their first-degree relatives.
AB  - Out of 59 duodenal ulcer (DU) probands and their 199 first-degree relatives
      Giemsa-staining for the determination of Helicobacter pylori (HP) was performed
      in 51 probands and 155 relatives. Controls were matched by age and sex from a
      family sample representing the same geographical area. In all, 155 controls were
      found for the probands and relatives. The occurrence and score of HP density
      showed an excellent correlation with morphology of the mucosa, signs of acute
      inflammation and presence of gastric metaplasia in the duodenal bulb. The
      prevalence of HP was 94% in DU probands and significantly higher than in their
      relatives and controls. In sibs of DU probands the prevalence of HP (64%) was
      also significantly higher than in controls (51%) obviously due to the presence of
      a subgroup of sibs with signs of active or past duodenal ulcer disease, which
      show higher than expected prevalence of HP, and of acid hypersecretion and high
      levels of serum pepsinogen I (PG I). Peak acid output (PAO), serum pepsinogen I
      and II and fasting serum gastrin levels were in relatives without atrophy higher
      in HP positive than negative cases but significant differences were present only
      with regard to the pepsinogens. The occurrence of HP positivity as well as of
      high PAO and pepsinogen levels might be considered risk factors of DU disease in
      close relatives of DU probands. On the other hand, the significance of HP
      positivity as cause of abdominal complaints is doubtful, in view of the complete
      lack of correlation between HP and morphology and complaints in the present
      study.

PMID- 1759129
TI  - Functional characteristics of duodenal ulcer patients and their first-degree
      relatives.
AB  - The behaviour of acid secretion, serum pepsinogen I and II (PG I and PG II) and
      morphology of the gastric mucosa were analyzed in 59 duodenal ulcer probands (DU
      probands), their 199 first-degree relatives and 228 control subjects. DU probands
      had as a rule antral gastritis with normal or slightly altered corpus mucosa, and
      higher mean peak acid output (PAO), PG I and II levels than their relatives and
      controls. Sibs of DU probands differed from their controls mainly with regard to
      morphology which showed features characteristic of DU probands, i.e. antral
      gastritis with normal or slightly altered corpus mucosa. Moreover, high PAO
      levels were found highly significantly more often in sibs of DU probands (13%)
      than in controls (6%). Likewise, the prevalence of endoscopic signs of active or
      past duodenal ulcer were present in sibs highly significantly more often than in
      controls and they accumulated in the subgroup of sibs with high PAO or PG I
      levels. It seems probable that the occurrence of high PAO and PG I levels in sibs
      of DU probands can be considered as signs of increased liability to duodenal
      ulcer. PAO and PG I were as expected significantly higher in male than in female
      probands, relatives and controls. Exclusion of cases of corpus gastritis
      decreased the levels but the sex difference persisted. PAO, PG I and II revealed
      a significant increase of the levels in middle age followed in older age in case
      of PAO and PG I by a significant decrease. The decrease was abolished when the
      cases of corpus gastritis were excluded suggesting an effect of gastritis.
      However, the earlier increase of the levels remained virtually unaffected
      although there was a uniform decrease of the mean values. This suggests the
      participation of factors unrelated to gastritis. The nature of the factors
      remains unknown, but literature data and data derived from our recent study
      suggest involvement of anatomical factors such as an increase in the size of acid
      and PG I secreting area.

PMID- 1759130
TI  - Helicobacter pylori and chronic gastritis: an increased risk of peptic ulcer? A
      review.

PMID- 1759131
TI  - Increase of serum pepsinogen I with age in females with normal gastric mucosa but
      not in males, possibly due to increase in acid-pepsin secreting area.
AB  - The mean pepsinogen I (PG I) level in a Finnish family sample was different in
      males and females and the difference was statistically significant. After
      exclusion of subjects with gastritis there remained 67 females and 68 males with
      morphologically completely normal antral and corpus mucosa. In females there was
      a significant increase of PG I with advancing age, the regression coefficient
      being 0.37 and statistically significant (p less than 0.01). In males no such
      increase was found, and individual cases revealed an almost random distribution
      with age. A similar increase with age has been noted in gastric acid output in
      females but not in males. Assuming that there is a linear relationship between PG
      I levels and the total chief cell mass, the PG I level would be determined by
      three main variables: thickness of the glandular layer, density of chief cells,
      and area occupied by chief cells. Of these variables the thickness and chief cell
      density showed neither in females nor in males any statistically significant
      increase with age, leaving the area as the variable which would account for the
      increase of PG I.

PMID- 1759132
TI  - Grade of Helicobacter pylori colonisation, chronic gastritis and relative risks
      of contracting high gastric ulcers: a seven-year follow-up.
AB  - A series of 38 patients with high gastric ulcer (GU) was examined twice a seven
      year interval. One-third of the patients had an active ulcer at the second
      examination. Chronic gastritis was evaluated, and the level of Helicobacter
      pylori (HP) colonisation assessed semiquantitatively. The results were compared
      with age and sex matched non-ulcer controls. The GU series differed from the
      controls in having a higher degree of HP colonisation in gastric mucosa. The
      relative risks (RR) in predicting high GU connected with high HP colonisation
      were significantly elevated, both in the antrum (RR = 6.0-4.8) and in the corpus
      (RR 5.0-4.4), and still higher when combined HP colonisation values were used (RR
      9.5-7.1). The persistence of active ulcer (GU+) was associated with a very high
      level of HP colonisation, with absence of corpus atrophic gastritis at the first
      examination and with young patients. Half of the GU+ patients had the maximum
      grade of combined HP colonisation in both examinations. The study indicates that
      the presence of HP infection as well as the level of HP colonisation are of
      importance in both the development and chronicity of peptic GU disease.

PMID- 1759133
TI  - What fraction of hospital ulcer patients is eligible for prospective drug trials?
AB  - Data of all 397 gastric ulcer patients diagnosed and treated at Jorvi Hospital,
      Finland, during 1980-1984 were collected and the outcome followed up for 5-7
      years. The commonly used exclusion criteria of prospective drug trials were
      applied to this series. Only 29% of patients would have been eligible for a
      trial. The excluded patients were older, their ulcer was larger and more
      proximally located. Nearly all major complications of gastric ulcer disease
      leading to surgery (bleeding, perforation, obstruction) and deaths due to gastric
      ulcer disease appeared in the excluded group. Exclusion criteria may profoundly
      affect the selection of patients and the results. When many patients are excluded
      the applicability of results to the whole material is questionable.

PMID- 1759134
TI  - Long-term effect of vagotomy on gastric mucosa and Helicobacter pylori in
      duodenal ulcer patients.
AB  - The purpose of the study was to evaluate the long-term effects of vagotomy on the
      morphological status and Helicobacter pylori infestation of the gastric mucosa.
      Endoscopy with biopsies (2 from antrum and 2 from corpus) was performed in 317
      patients on whom vagotomy had been performed on an average 8 years earlier. The
      success of the vagotomy was estimated by the endoscopic Congo Red technique in
      270 cases. Non-operated 187 duodenal ulcer patients were examined endoscopically
      and bioptically in a similar way and used as a reference series. Helicobacter
      pylori (HP) was determined by Giemsa staining of biopsy specimens in both series.
      In non-operated dudoenal ulcer patients, gastritis and HP behaved as expected
      from the data in literature: antral gastritis was present in nearly all cases
      (96%), while the corpus mucosa was normal or the process was retarded at the
      stage of superficial gastritis (76%) and atrophic changes were virtually lacking
      (1%). On the basis of the Congo Red test the vagotomized patients were separated
      into two groups: successfully operated, i.e., complete vagotomy, and incomplete
      vagotomy groups. The results of the examinations were independent of the kind of
      vagotomy performed, but related significantly to its completeness. The incomplete
      and complete groups differed significantly. The prevalence of atrophic changes
      (29%) in the corpus was significantly higher and that of superficial gastritis
      (69%) lower in the complete than in the incomplete vagotomy group, in which the
      prevalences were 12% and 85%, respectively. Likewise the prevalence and density
      of HP was lower in the complete vagotomy group but the difference was not
      statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759135
TI  - Helicobacter pylori: histological and serological study on gastric and duodenal
      ulcer patients in Estonia.
AB  - We have examined the occurrence of Helicobacter pylori (HP) infection in 86
      Estonian gastric ulcer (GU) and 25 duodenal ulcer (DU) patients. Diagnosis of the
      HP infection was made histologically (modified Giemsa) from gastric biopsy
      specimens, and serologically by parallel use of two enzyme-linked immunosorbent
      assays for IgG antibodies to HP in patient sera. The infection was diagnosed
      simultaneously by all three methods in 84% of the GU and 84% of the DU patients.
      The infection was revealed histologically in 88% of the GU and 92% of the DU
      patients, and serologically by either of the two methods in 94% and 92% of the GU
      and DU patients, respectively. HP infection was absent by all three methods in
      one GU patient only, this patient being the only subject who showed normal
      gastric mucosa in conventional histology. These observations show that HP
      infection is very common in patients with peptic ulcer in Estonia. In addition,
      the findings suggest that the serological assays will find a small proportion
      (15%) of ulcer patients with antibodies against HP but no histologically
      detectable bacteria.

PMID- 1759136
TI  - Argyrophil cell hyperplasia associated with chronic corpus gastritis in gastric
      ulcer disease.
AB  - Argyrophil cell (AC) hyperplasia in corpus mucosa was investigated in 53 patients
      with chronic gastric ulcer disease not previously treated with antisecretory
      drugs. Mucosal biopsies were taken stepwise from the posterior wall in the corpus
      area of the stomach. Of 117 biopsy sites, 28 showed gastritis without atrophy, 85
      showed chronic atrophic gastritis of varying degrees while 4 biopsies showed a
      normal mucosa. About one third (38%) showed a normal AC pattern. Of the remaining
      two thirds (62%), 45% had simple AC hyperplasia, 18% had linear and 37% had
      micronodular AC hyperplasia. A strong association was found between focal
      (linear/micronodular) AC hyperplasia and chronic atrophic gastritis. It is
      concluded that focal AC hyperplasia is a common phenomenon in gastric ulcer
      patients and is inherently related to the spontaneous development of atrophy in
      the corpus mucosa of these patients.

PMID- 1759137
TI  - Helicobacter pylori and gastritis in children with abdominal complaints.
AB  - Gastroscopy with biopsies was performed in 178 children with upper abdominal
      pain. Of them 109 (61%) had gastritis and 104 (58%) Helicobacter pylori (HP) in
      antrum and/or corpus. Gastritis consisted in most cases (87% of antral and 86% of
      corpus gastritis) of mild superficial round cell infiltration. Mucosal atrophy
      was not found. Accumulation of granulocytes was present in 43 patients and
      lymphonoduli were found in 33 patients, usually in connection with gastritis.
      Gastritis affected only the antrum in 18%, only the corpus in 5% and both antrum
      and corpus in 62% of the cases of gastritis. There was a good correlation between
      morphology and bacteriology in the antrum and a satisfactory one in the corpus.
      However, in some cases gastritis was present without bacteria and in some cases a
      normal mucosa was associated with bacteria. Gastritis and HP prevalences showed a
      general increasing trend with age, but significances were with one exception
      lacking. It is tentatively concluded that gastritis begins in childhood as a
      slight and chronic superficial infiltration affecting usually antrum and corpus
      simultaneously. In the majority of cases gastritis is associated with HP
      infection, which seems to start the process. It is possible that the HP-related
      gastritis is a common cause of abdominal complaints in children; however,
      convincing evidence is lacking.

PMID- 1759138
TI  - Parental grief following the death of an infant--a follow-up over one year.
AB  - The course of parental bereavement during the first year following an infant's
      death was investigated. Also, the differences in mothers' and fathers' reactions,
      the differences according to the mothers' occupational role, and the similarities
      in couples' reactions were studied. From a total sample of 59 families, 13
      families answered their questionnaires at all three time points (1, 6 and 13
      months), 22 families responded at two time points, and 37 families responded at
      some point following the loss. Measures relating to anxiety, depression, bodily
      discomfort, general well being and impact of event were used at the three time
      points. The results showed that grief, as measured by the different inventories,
      decreased over time. The decrease was most evident from 6 to 13 months, and most
      prominent in women. A considerable number of the parents were still actively
      dealing with the loss all through the first year of bereavement. In most couples
      the mother reported most distress. Mothers were significantly more depressed than
      fathers at all time points, and mothers also had significantly higher anxiety and
      lower general health at 1 and 13 months, and intrusive scores of 1 and 6 months.
      Women at home evidenced more grief at all three time points than women employed
      outside the home. A high or low score in one spouse was more strongly correlated
      with a similar score in the other at 1 and 13 months, than at 6 months. The
      implications for counselling of parents, with special emphasis on the employment
      situation of the mother, is emphasized.

PMID- 1759139
TI  - Parental divorce as a factor in children's perception of human relationships: an
      analysis of human movement responses in the Rorschach test.
AB  - The subjects were 108 Swedish children between 10 and 12 years old, who
      constituted a divorce and a non-divorce group of 27 girls and 27 boys each.
      Rorschach Tests were administered individually and human movement responses were
      analysed. Non-divorce children perceived more cooperative and fewer hostile
      interactions than the divorce children. Responses containing figures engaged in
      hostile interaction were most common among divorce girls, whereas the divorce
      boys had difficulties in perceiving any interaction whatsoever. The different
      effect of parental divorce on the ability of girls and boys to develop
      satisfactory social relationships is discussed.

PMID- 1759140
TI  - Mood change and marathon running: a pilot study using a Swedish version of the
      POMS test.
AB  - Regular exercise is said to have positive effects on mood, especially if the
      exercise intensity is low to moderate. However, the acute effects resulting from
      participation in a strenuous competition, such as a marathon race, have been
      studied less. The present investigation used the Profile of Mood States (POMS)
      test to measure mood, before and after the 1989 Stockholm Marathon. A total of
      106 male runners (mean age 40.0 years), with finishing times between 3h and 3h 45
      min participated as subjects. Results showed great changes between pre- and post
      marathon scores, most of them significant at the p less than 0.001 level.
      Furthermore, differences between a faster and a slower group of runners were
      demonstrated with regard to mood states, even though plasma glucose levels were
      comparable. It is concluded that participation in a marathon race greatly effects
      mood, mainly in a more negative way than low to moderately intense exercise does.

PMID- 1759141
TI  - A methodological note concerning long-term effect of treatment.
AB  - The long-term effect of treatment is defined as the score change produced
      directly and indirectly by the treatment during and after the treatment interval.
      Various instances of combinations of short-term effects, attained during the
      treatment interval, and of long-term effects are presented. Designs for measuring
      the short-term and long-term effects are sketched, and suggestions are given for
      distinguishing between these effects in six representative cases. A multiple
      occasion measurement of the long-term effect is recommended.

PMID- 1759142
TI  - Facial reactions to facial expressions in subjects high and low in public
      speaking fear.
AB  - This study investigated whether subjects high and low in public speaking fear
      react with different facial electromyographic (EMG) activities when exposed to
      negative and positive social stimuli. A High-fear and Low-fear group were
      selected by help of a questionnaire and were exposed to slides of angry and happy
      faces while facial-EMG from the corrugator and zygomatic muscle regions were
      measured. The subjects also rated the stimuli on different emotional dimensions.
      Consistent with earlier research it was found that Low fear subjects reacted with
      increased corrugator activity to angry faces and increased zygomatic activity to
      happy faces. The High fear group, on the other hand, did not distinguish between
      angry and happy faces. Rating data indicated that the High fear group perceived
      angry faces as being emotionally more negative. The present results are
      consistent with earlier studies, indicating that the facial-EMG technique is
      sensitive to detect differential responding among clinical interesting groups,
      such as people suffering from social fears.

PMID- 1759143
TI  - Psychophysiological theories on sympathetic nervous system reactivity in the
      development of essential hypertension.
AB  - Psychophysiological theories on the development of essential hypertension are
      reviewed and evaluated. Two interconnected theories that relate behavior to
      essential hypertension and account for individual differences in susceptibility
      to disease are the "hyperreactivity" theory and "the symptom specificity" theory.
      The "hyperreactivity" theory identifies individual differences in autonomic
      nervous system reactivity as the pathophysiological mechanism and the "symptom
      specificity" theory suggests that inflexible, stereotypical responding increases
      the risk to develop hypertension. Based on a literature review, these theories
      are examined. There exist both case/control and prospective studies on autonomic
      nervous system reactivity and the development of hypertension. It is concluded
      that a neurogenically mediated hyperreactivity to stress is a precursor and not
      an effect of hypertension. Tasks that call for active but not passive coping
      efforts are more efficient elicitors of reactivity differences between those at
      high and low risk to develop hypertension in case/control studies. In prospective
      studies, active tasks may also have a predictive advantage over passive with
      respect to blood pressure development. In the early phase of hypertension, an
      increased cardiovascular reactivity is accompanied by increased neuroendocrine
      activation. In the later phase, heightened reactivity is confined to the
      cardiovascular system. This does not prove but is consistent with the notion that
      transient episodes of increased cardiac output translate into essential
      hypertension by causing vascular hypertrophy. Case/control studies suggest that
      an increased "symptom specificity", with stereotypical responding across multiple
      stressors, is independent of cardiovascular reactivity and a precursor of
      hypertension. The literature lacks prospective studies on the clinical relevance
      of stereotypical responding. It is suggested that the presence of both
      hyperreactivity and symptom specificity in a single individual increases the risk
      to develop essential hypertension.

PMID- 1759144
TI  - [Laboratory medicine in the area of interest between medicine and science].
AB  - The scientific disciplines of laboratory medicine are analyzed from the point of
      view of history and the philosophy of science. The results of this study are the
      following: 1. Laboratory medicine is the name of a group of subjects which exist
      in an interdisciplinary area between medicine and science. 2. Historical
      development shows that these subjects arose in the 19th century when medicine
      adopted the "natural scientific method" and became "scientific medicine". 3.
      Clinical chemistry, as one example of these subjects, is analyzed in detail to
      understand the thinking process and the scientific method. This subject is, on
      the one hand, a "theoretical discipline" (like all of the natural sciences) but,
      on the other hand, it is a typical "practical scientific discipline" (which like
      clinical medicine is aimed at certain decisions and actions). 4. The disciplines
      of laboratory medicine have developed typical "professions" mainly because of
      their application in clinical practice and their commitment to patient care.

PMID- 1759145
TI  - [The use of laboratory data].
AB  - Medical laboratory data are gained by scientific methods. The method-inherent
      uncertainties always produce an "inexactitude" of varying degree. The physician
      who uses these data as a support for his decisions should therefore be able to
      estimate the reliability of the laboratory data; this can be assessed by
      statistical methods. The most fundamental characteristics of all analytical
      methods are analytical inaccuracy and analytical imprecision. The limit of
      detection and the limits of the measuring interval are functions of these
      figures. A number of illustrations demonstrate the interdependence of analytical
      performance and of medical significance of laboratory data. Laboratory data, on
      the other hand, are--to put it simply--used to distinguish diseased from NON
      diseased individuals. The "diagnostic validity" of a certain test for a certain
      medical problem is determined by comparing appropriate collectives. The selection
      of these collectives and the choice of the cut-off value determine diagnostic
      sensitivity and specificity respectively. From these figures and prevalence (or
      "pre-test probability"), the predictive values of a positive (or negative) result
      can be calculated. The significance of the position of the cut-off value and of
      prevalence is demonstrated by a number of examples. If the results are not given
      in a binary form (positive/negative) but in different grades (slightly,
      moderately, strongly elevated/depressed), and if the results of several tests
      must be judged in a multivariate manner, the number of theoretically possible
      patterns can become extremely large. Various approaches designed to overcome
      these problems are discussed.

PMID- 1759146
TI  - [Immediate diagnosis: what makes sense?].
AB  - New techniques for stat-tests (e.g. "dry chemistry") are discussed with respect
      to their reliability, speed and economy. Based on these factors, a list of stat
      tests is proposed which appears to meet the needs of the general practitioner's
      laboratory. The new techniques may also affect hospitals and pharmacies.

PMID- 1759147
TI  - [Chemical sensors in medical use: ion-selective electrodes, limitations and
      potentials].
AB  - The electrolyte concentrations of potassium and sodium, for example, are
      routinely analyzed in diluted serum and plasma. In contrast, electrolyte
      activities are quantified by ISEs directly in undiluted whole blood and plasma
      and promise to be highly informative. Nevertheless, some drawbacks, such as the
      interaction between the biological matrix and the ISE surface, limit the accuracy
      of measurements. A symmetrical measuring arrangement allows one to localize and
      quantify the known sources of errors. These are minimized by adequate techniques.
      The membrane composition for sodium selective electrodes is optimized in
      particular. The interpretation of ISE values as compared to FAES (flame atomic
      emission spectroscopy) is closely related to the water concentration of the
      samples. Comparisons between ISE and FAES results obviously allow one to evaluate
      the water concentration of samples, as is shown by a linear regression plot.

PMID- 1759148
TI  - [Determination of alcohol dehydrogenase genotype: no correlation between
      isoenzyme pattern and liver cirrhosis].
AB  - Mounting evidence from various fields of research links the oxidation product of
      alcohol, acetaldehyde, with the development of alcohol abuse-related pathology.
      One factor governing the production of acetaldehyde is the genetically determined
      pattern of class I alcohol dehydrogenase isoenzymes, consisting of "fast" beta 2
      and gamma 1 and "slow" beta 1 and gamma 2 subunits. Alcoholics carrying the beta
      2 and gamma 1 genes might, therefore, be more susceptible to alcohol-related
      liver disease. To verify this hypothesis we developed a method based on the
      polymerase chain reaction and restriction enzyme digestion in order to genotype
      individuals with respect to their alcohol dehydrogenase isoenzyme pattern. In a
      total of 100 caucasian individuals the following genotypes were determined: beta
      1 beta 1, 92; beta 1 beta 2, 8; beta 2 beta 2 0; gamma 1 gamma 1, 38; gamma 1
      gamma 2, 51; gamma 2 gamma 2, 11. No statistically significant differences in the
      distribution of isoenzymes were detectable between alcoholics with liver disease,
      patients with non-alcohol abuse-related liver disease, patients with rheumatoid
      arthritis and healthy controls.

PMID- 1759149
TI  - [Evaluation of enzymatic methods for the determination of plasma sodium and
      potassium using the Hitachi 747 analytic system].
AB  - In the hospital clinical laboratory, plasma potassium and sodium are usually
      determined by using a flame photometer or ion-selective electrodes, for which
      special equipment is required. The new enzymatic methods of sodium and potassium
      can be used as a routine chemical method. We evaluated the new enzymatic methods
      for the determination of sodium and potassium in human plasma on the Hitachi 747.
      The sodium and potassium assay kits were purchased from Boehringer Mannheim,
      Germany. Precision studies were performed using three levels of pool plasma. The
      coefficients of variation (CV) of sodium and potassium determination were less
      than 1.0% and less than 2.2% by intraassay and interassay respectively. The
      recoveries of the assigned values of the ten control sera were 97-102%.
      Comparisons with results either from flame photometry and from ion-selective
      electrodes showed no clinically relevant differences for 100 patient samples.
      Performance of the enzymatic methods for Na+ and K+ is clinically comparable to
      flame photometry or ion-selective electrodes in the routine clinical chemistry
      laboratory.

PMID- 1759150
TI  - [Detection of lysergic acid diethylamide in human urine: elimination, screening
      and analytical confirmation].
AB  - The Coat-A-Count DPC and Roche Abuscreen RIA for LSD were used to search for LSD
      in urines containing various drugs commonly found in specimens from addicted
      groups. Elimination of LSD in urine of a volunteer after ingestion of 50
      micrograms confirmed that LSD can be detected after 3 days at 0.1 ng/ml cut-off
      level. Chromatographic conditions were restudied and the full spectrum of
      trimethylsilyl LSD at 0.125 ng with ion trap GC-MS (ITS40) was shown.

PMID- 1759151
TI  - [Biliopancreatic bypass and disorders of iron absorption].
AB  - Sideropenic anemia is a common long-term complication of surgical bilio
      pancreatic bypass for morbid obesity, and is frequently resistant to oral iron
      therapy. To study the pathogenesis of this phenomenon we investigated 7 such
      patients clinically and biologically, with special emphasis on iron absorption.
      Our results show that sideropenia, consistently present and frequently
      complicated by anemia, is due to deficient iron absorption and that this
      malabsorption is non-selective. Replacement therapy, when indicated, should
      therefore use the parenteral route.

PMID- 1759152
TI  - [Telephone duty "AIDS Information" at the Vaudois University Hospital Center: who
      calls and why?].
AB  - From January 1989 to December 1990, 7653 phone calls were answered by the AIDS
      Hot Line of the Centre Hospitalier Universitaire Vaudois. Most of the calls were
      from the general public (82%), 12% from health care workers and 6% from HIV
      infected subjects. The main reasons for calling were information regarding the
      HIV test (public), scientific inquiries (health care works) and requests for
      medical or social support (HIV-positive persons). With more than 15 phone calls
      per day, this hot line fulfils a definite need with respect to the various types
      of information required.

PMID- 1759153
TI  - [Nosology and ultrasound findings in porencephaly].
AB  - Congenital cerebral defects can be classified into two groups of porencephaly.
      Agenetic porencephaly results from development disturbances during early neuronal
      migration and can often be observed in the region of the fissura Sylvii.
      Encephaloclastic porencephaly, which is relatively rare, is a late prenatal or
      perinatal vascular lesion due to arterial ischemic stroke or venous thrombosis,
      and is located in the supply areas of the vessels involved. Cerebral defects can
      always be detected by ultrasonography. High resolution ultrasonic instruments or
      magnetic resonance imaging are appropriate means to find out disturbed patterns
      of gyration pointing to early fetal developmental disturbances.

PMID- 1759154
TI  - [Transcranial color-coded real time sonography in adults. Part 2: Cerebral
      hemorrhage and tumors].
AB  - We examined three groups of adult patients to evaluate the clinical application
      of transcranial colour-coded real-time sonography (TCCS): 28 patients suffering
      from intracerebral haemorrhage, 36 patients with subarachnoid haemorrhage and 38
      patients with primary brain tumours. All sonographic examinations were performed
      through the intact skull. Cerebral haemorrhages were visualised via TCCS as
      hyperechogenic areas, which were closely correlated in size and location to CT
      findings. Apart from the imaging of subarachnoid haemorrhages and cerebral
      vasospasms, TCCS permitted the identification of the angiographically confirmed
      aneurysms in 76%. Brain tumours were delineated in the vast majority of the
      patients examined. In this type of pathology TCCS provided additional information
      on tumour extension and macroscopic appearance.

PMID- 1759155
TI  - [The transcranial Doppler ultrasound upright posture test for clinical evaluation
      of cerebral autoregulation].
AB  - Description of a TCD test designed for the clinical investigation of cerebral
      autoregulation. The Doppler shift frequency of the middle cerebral artery is
      recorded using of a transducer fixed to the patient's head by an elastic ribbon
      and a ball joint type probe-holder, and on-line digitally analysed to calculate
      the TCD flow index (signal power times velocity). Blood pressure is measured
      every 30 seconds at the right index hold at the level of the heart, using a
      special sphygmomanometer. The patient sits on a foot-stool. After 1.5 minutes of
      measurement he rises to remain in upright position for another 2 minutes. The
      flow index normalised to its average over the sitting period quantitatively
      indicates the evolution of volume flow brought about by the change of the body
      position. The change in arterial blood pressure is off-line calculated from its
      periodic measurements. In a pilot study this test has been successfully used in
      30 healthy volunteers and 2 patients suffering from orthostatic dysregulation of
      blood pressure.

PMID- 1759156
TI  - [Value of color-coded duplex sonography in diagnosis of acute and chronic venous
      diseases of the lower extremity].
AB  - In a prospective study we compared colour duplex ultrasound to venography in 325
      patients with clinically suspected acute lower extremity deep vein thrombosis. In
      269 cases of proven thrombosis overall sensitivity and specificity of colour
      duplex ultrasound were 98% and in calf vein thrombosis 96%. Investigations by
      both methods after fibrinolytic urokinase therapy of phlebothrombosis in 53
      patients revealed no significant diagnostic differences between the two methods.
      In 115 patients with clinically suspected chronic venous insufficiency colour
      duplex ultrasound allowed to differentiate between occluded, partially
      recanalised or normal deep veins with or without venous valve incompetence and
      superficial venous insufficiency. In this study colour duplex ultrasound in
      diagnosis of acute or chronic lower limb venous disease attained results that
      were comparable to those obtained by phlebography.

PMID- 1759157
TI  - [Routine ultrasound diagnosis of the shoulder. A simplified examination
      procedure].
AB  - With increasing use of ultrasonography at the shoulder, a confusing number of
      transducer positions have been recommended. At the shoulder, however, dynamic
      examination yields more information than fixed transducer orientations. In our
      examination routine, the transducer is guided across the shoulder following the
      shape of a triangle. Orientation is secured by palpable, bony structures. The
      clinically relevant parts of the rotator cuff and the long biceps tendon are
      investigated, first medially and laterally in a transverse projection and then
      longitudinally. Dynamic examination is provided by moving the transducer as well
      as the shoulder joint. In a time-saving examination routine, all important soft
      tissue structures of the shoulder are visualized.

PMID- 1759158
TI  - [Sonographic anatomy of the axilla].
AB  - The axilla represents a region of special interest for small-part sonography. It
      is easy to demonstrate musculocutaneous, osseous, neurovascular and lymphatic
      structures. Especially in the presence of breast malignomas with lymphatic
      drainage to the axillary region sonography of the axillary lymphatic tracts and
      nodes is essential. The examination is performed with a linear 7.5 MHz transducer
      with the patient in supine position and the arm hyperabducted. The transducer is
      directed in transversal and sagittal planes and along the axillary vessels. It is
      of importance to know exactly the complex topographic anatomy of the axilla. The
      very dominant pectoral muscles serve as guiding structures. In their vicinity one
      can find some important groups of lymph nodes. The last station of axillary lymph
      nodes is the apical group situated along the axillary neurovascular bundle. With
      their typical echo, the head of the humerus and the coracoid-process facilitate
      the orientation. Ultrasound is now generally available and should always be used
      as a secondary method of examination, it breast malignomas are present or
      suspected in mammogramms, since it supplies important clinical information.

PMID- 1759159
TI  - [Appearance of the femur head epiphysis in healthy children and in children with
      hip dysplasia].
AB  - In a retrospective study we evaluated 4341 sonographic examinations of 1160
      healthy children and 209 children with congenital hip dysplasia with special
      reference to the appearance of the femoral head epiphysis. In healthy children
      the epiphysis appeared between the first and seventh month. In more than 95% of
      the children, the epiphysis was sonographically present after the seventh month.
      In children with congenital hip dysplasia the first appearance of the femoral hip
      epiphysis had a retardation of one to two months. In most of the healthy children
      the epiphysis appeared in the fourth month, and after the ninth month in almost
      all of the normal hip joints the epiphysis is present. In children with normal
      hip joint configuration and missing femoral head epiphysis at three months, the
      final ultrasound examination should not be done before the seventh month. Thus,
      clinically unnecessary ultrasound examination in 6-week intervals can be reduced.

PMID- 1759160
TI  - [Ultrasound image of the gallbladder fossa after cholecystectomy in the immediate
      postoperative period].
AB  - 70 patients clinically classified as n.a.d. were sonographically examined for
      evaluation of the gallbladder fossa within two weeks after cholecystectomy. Four
      marked signs were noted. In 35 patients (50%) we found homogeneous echogenic
      formations of triangular, band-like, or oval shape in the bed of the gallbladder.
      In 25 cases (35.7%) inhomogeneous structures were seen. In 6 cases (8.5%) cystic
      structures resembling the normal gallbladder were seen which were interpreted as
      representing seromas or liquified haematomas. In 4 patients (5.7%) the bed of the
      gallbladder was entirely normal. Whether the gallbladder bed was closed by
      sutures or not, had no statistically significant effect on ultrasound appearance.

PMID- 1759161
TI  - [Sonographic assessment of gliding characteristics and gliding bed of the
      Achilles tendon following surgery].
AB  - A bilateral comparative ultrasound evaluation of 55 patients 1-10 years after
      unilateral Achilles tendon rupture showed that glide was reduced by varying
      degrees in the tendon in a dynamic evaluation. Disturbed tendon glide was often
      the cause of persistent disability. In the evaluation of the glide
      characteristics it was helpful to allocate patients to three categories,
      structural changes in the tendon bed also being taken into consideration.
      According to this classification, 56% of the Patients had either good or only
      slightly reduced glide characteristics, whilst 42% demonstrated severe
      reductions. It was striking that it was not so much alterations in the tendon
      itself, but rather changes in the tendon bed that had the more deleterious
      effects on glide characteristics.

PMID- 1759162
TI  - [Isolated traumatic dislocation of the fibula head. A rare injury in soccer].
AB  - The case presented of a rare injury of the left knee joint underlines the
      necessity for meticulous examination. We report on isolated dislocation of the
      head of the fibula in a 25-year-old football player; the diagnosis and therapy
      for this rare injury are presented.

PMID- 1759163
TI  - [Is arthroscopy always justified in traumatic hemarthrosis of the knee joint?].
AB  - Analysis of 100 consecutive arthroscopies in patients with traumatic hemarthrosis
      of the knee joint demonstrates the importance of arthroscopy in diagnosis and
      therapy. In 48 cases injuries of the anterior cruciate ligament, isolated and in
      combination with lesions of other structures, were found. In 47 cases an
      operation was necessary. In 21 cases the reason for the hemarthrosis was luxation
      of the patella, in 6 cases with a flake fracture. Isolated lesions of one of the
      menisci were found in 11 cases and treated arthroscopically in all cases (2
      meniscopexies, 1 total meniscectomy , 8 partial meniscectomies). Only in 8 cases
      unimportant injuries or lesions were found to have caused the hemarthrosis.

PMID- 1759164
TI  - [Sinus tarsi and canalis tarsi syndromes. A post-traumatic entity].
AB  - The posttraumatic sinus tarsi syndrome is a clinical entity induced by supination
      trauma of the hindfoot. In pathomorphological terms this is due neither to a
      ligament rupture nor to an osteochondral lesion. Clinically, local pain in the
      sinus tarsi is associated with pain during supination or pronation, pain during
      walking, especially on uneven ground, and "giving way" without signs of
      mechanical instability. A more severe variant of this syndrome, in which the
      patient complains of pain on the medial aspect of the hindfoot in conjunction
      with the typical pain of the sinus tarsi syndrome is described. This medial
      symptom complex has been identified as the "canalis tarsi syndrome". Injection of
      a steroid and local anaesthetic agent into the tarsal sinus or tarsal canal will
      relieve the pain if the underlying pathology is that of a tarsi syndrome,
      depending on which side the injection is given. An arthrogram of the subtalar
      joint in a patient with a confirmed sinus tarsi syndrome demonstrates a sac-like
      anterior bulge of the capsule. Performed on a non-pathologic tarsal sinus, this
      procedure would demonstrate a corrugated appearance of the capsule anteriorly,
      without this anterior protrusion. At the Medical School in Hanover, 95 patients
      with a sinus tarsi syndrome were assessed between 1981 and 1989. In all patients
      a conservative regimen of repeated injections (6 or fewer) of a steroid and local
      anaesthetic agent into the tarsal sinus was instituted. In addition, 3 of these
      patients were identified as having a canalis tarsi syndrome, and injections were
      simultaneously given into their tarsal canals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759165
TI  - [Sonographic versus radiological assessment of chronic outer ligament instability
      of the upper ankle joint].
AB  - Chronic instability of the lateral upper ankle joint ligament is usually
      diagnosed by clinical and radiological examination. For the evaluation of an
      ultrasound method of testing lateral instability of the ankle joint we carried
      out a prospective study. We examined 23 adults who were actively engaged in some
      form of sport (21 male, 2 female, mean age 32 years) and had a preexisting
      lateral instability of the ankle. The instability was measured in the standard
      planes using Scheuba's stress apparatus with simultaneous ultrasound monitoring.
      The ultrasound examination was performed by positioning the 5-MHz applicator on
      the lateral side of the Achilles tendon, thus defining a plane from which the
      instability could be measured in both examination planes by observing the
      deviation between dorsal inferior edge of the tibia and the dorsal border of the
      talar roll. For the two examination planes, Spearman's rank-correlation
      coefficient between the radiological and ultrasound methods was 0.83 and 0.92.
      The sensitivity of the ultrasound method was 0.90, and the specificity was 0.85.
      Our study showed a good correlation between the two methods. A pathological talar
      tilt according to radiological criteria was also revealed by ultrasonography.
      Thus, all the advantages of ultrasound are now available for the evaluation of
      chronic lateral instability of the ankle joint.

PMID- 1759166
TI  - [Organization of a bone bank].
AB  - The transmission of infectious diseases by allografts from bone banks has led to
      considerable restrictions on bone transplantations. HIV and hepatitis are
      considered to be the most dangerous diseases transmitted in this way. To prevent
      the transmission of any infections, extensive precautions have to be applied when
      allografts are taken and during their storage. Donors have been checked for
      infectious diseases at the time of collection and 3 months later. In addition,
      the donated grafts must be cultured for aerobic and anaerobic bacteria. This
      elaborate series of tests can only be mastered if the bone bank is tightly
      organised. The number of available grafts also be increased by sterilisation and
      the use of demineralised bone matrix.

PMID- 1759167
TI  - Introduction: autoimmune myelopathies.

PMID- 1759168
TI  - The biology of pure red cell aplasia.

PMID- 1759169
TI  - Therapy of pure red cell aplasia.

PMID- 1759170
TI  - Pure white cell aplasia.

PMID- 1759171
TI  - Acquired pure amegakaryocytic thrombocytopenic purpura.

PMID- 1759172
TI  - The pathophysiology of aplastic anemia.
AB  - No single cause can explain aplastic anemia. Two major factors are involved: An
      intrinsic derangement of hemopoietic proliferation capacity that is essentially
      compatible with life, but has to be considered a premalignant condition. This
      primarily diseased tissue can be destroyed by immune mechanisms in an attempt to
      achieve self-cure. Therefore, immunosuppressive therapy can mitigate this immune
      reaction but leaves the patient with a poorly proliferating bone marrow that is
      prone to late complications. The clinical presentation and course depend on the
      balance of these two major factors: If the immune reaction is strong, acute
      severe aplasia occurs, whereas in patients with a weak immune reaction the
      disease will present itself rather as chronic pancytopenia with myelodysplastic
      traits. Co-involvement of environmental cells in the disease process is an
      additional factor. Poor production of hemopoietic growth factors may aggravate
      aplasia and poor immune competence may allow abnormal clones to proliferate. All
      these pathophysiological factors are genetically determined.

PMID- 1759173
TI  - Allogeneic bone marrow transplantation for severe aplastic anemia.

PMID- 1759174
TI  - Autoimmune myelodysplasias.

PMID- 1759175
TI  - [Digital projection radiography. 1: Fundamentals of digital image processing].

PMID- 1759176
TI  - [Pneumatosis cystoides intestinalis. A possible complication of acute intestinal
      graft versus host reaction following allogeneic bone marrow transplantation].

PMID- 1759177
TI  - [Myelography today].

PMID- 1759178
TI  - [An improved CT diagnosis of unclear ureteral processes using the application of
      air through a percutaneous kidney stoma].

PMID- 1759179
TI  - [Diagnostic imaging during the extracorporeal shockwave treatment of gallstones].

PMID- 1759180
TI  - Euthanasia: the "good death"!

PMID- 1759181
TI  - One-stage construction of giant experimental aneurysms in dogs.
AB  - In an attempt to find safe and effective methods of treating giant intracranial
      aneurysms, we have developed a one-step construction of giant experimental
      aneurysms in dogs with a yield of 100% patency of the parent artery and the
      experimental aneurysm without intraaneurysmal thrombus. Giant aneurysms were
      produced in the right thrombus. Giant aneurysms were produced in the right common
      carotid artery of nine mongrel dogs. Key features concerning the procedure were:
      (1) proximal placement of the aneurysmal neck, (2) 1 cm length as the aneurysmal
      ostea, and (3) postoperative aspirin therapy. This one-step construction of giant
      experimental aneurysms in dogs should prove helpful in evaluating a wide variety
      of treatment modalities of giant aneurysms in the laboratory. It also may be of
      additional value in investigative studies relative to catheters, balloons, and
      other similar techniques.

PMID- 1759182
TI  - Diagnosis and management of gliomatosis cerebri: recent trends.
AB  - Gliomatosis cerebri (GC) describes a diffuse overgrowth of the neuraxis by
      neoplastic glial cells with relative preservation of the underlying
      cytoarchitecture. Ten cases of GC are presented, followed by discussions of its
      radiological and pathological characteristics. The diagnosis of GC was formerly
      made only at autopsy. However, recent improvements in imaging and biopsy now
      allow for antemortem diagnosis. Immunocytochemistry for S-100 protein and glial
      fibrillary acidic protein (GFAP) in three open biopsies of early primary GC
      revealed diffuse proliferation of S-100 immunoreactive and GFAP-resistant small
      astrocytes. Magnetic resonance imaging appears to be the imaging modality of
      choice. T2-weighted images generally show contiguous high intensity signal in
      affected areas. Biopsy, either open or stereotactic, remains necessary for
      antemortem diagnosis. No treatment has proven effective for GC, the prognosis
      being poor. The authors also review theories of tumorigenesis of GC in an effort
      to explain its biology.

PMID- 1759183
TI  - Coagulation changes after an experimental missile wound to the brain in the cat.
AB  - Platelet studies (total number and platelet aggregation) and coagulation assays
      (fibrinogen, factor VIII, and anti-thrombin III) were performed on systemic
      arterial blood of four control and four experimental adult cats that sustained a
      penetrating missile injury to the brain. Among the brain-wounded, a significant
      decrease in the total number of platelets and aggregates occurred 120 minutes
      after injury. Fibrinogen levels decreased significantly in the brain-wounded
      animals by 240 minutes after injury and continued declining until the end of the
      6-hour experiment. No significant changes occurred in factor VIII and
      antithrombin III levels in wounded as compared with control animals. These
      results indicate that blood coagulation factors are altered following a missile
      wound to the brain. These alterations may, occasionally, lead to clinically
      manifested bleeding disorders, specifically disseminated intravascular
      coagulation. Thus, early analysis and control of the coagulation system in the
      brain-wounded patient should be considered to prevent and treat bleeding
      disorders in the setting of penetrating head injury.

PMID- 1759184
TI  - Association of vascular compression in trigeminal neuralgia versus other "facial
      pain syndromes" by magnetic resonance imaging.
AB  - Magnetic resonance imaging was performed in 13 patients with trigeminal neuralgia
      and 18 control patients with facial pain of other types. Among trigeminal
      neuralgia patients, eight (62%) had vessels seen abutting, or immediately
      adjacent to, the trigeminal nerve on the side of their symptoms. Only three
      control patients (17%) had such vessels. The proportion of patients having a
      trigeminal region vessel associated with their symptoms was significantly higher
      in patients with trigeminal neuralgia than in controls (p = 0.0086). These
      findings provide evidence supporting the theory that trigeminal neuralgia is
      associated with vascular compression of the fifth cranial nerve.

PMID- 1759185
TI  - Limitation of temporary vascular occlusion during aneurysm surgery. Study by
      intraoperative monitoring of cortical blood flow.
AB  - The limitations of temporary vascular occlusion during aneurysm surgery as
      evidenced by the postoperative ischemic symptoms in relation to cerebral blood
      flow were studied. Six of the 39 cases had postoperative ischemic neurological
      deficit. When residual cerebral blood flow was below 15 mL/min/100 g, transient
      symptoms were seen when temporary clipping was for 10-20 minutes. When more than
      20 minutes of clipping was required, irreversible deficits were found.
      Correlations between residual cerebral blood flow, duration of temporary
      clipping, and postoperative ischemic symptoms were found. The monitoring of
      cortical cerebral blood flow is an effective means for determining the limits of
      temporary vascular occlusion.

PMID- 1759186
TI  - Solitary cerebral metastasis from lung cancer with very long survival: report of
      two cases and review of the literature.
AB  - Solitary cerebral metastases from lung cancer are not uncommon clinical events.
      Whatever treatment is adopted, long-term survival is rare. Very rare indeed are
      reports of patients surviving the discovery of lung cancer and brain metastasis
      for 10 years or more. Indeed, only 16 cases have been reported to our knowledge.
      We report two further cases, stressing the importance of correct
      clinicopathological staging so that treatment may be conducted in the way most
      likely to ensure longer and better survival and, pending a therapeutic
      breakthrough, to increase the number of long-term survivors.

PMID- 1759187
TI  - A case of coup and contrecoup extradural hematoma.
AB  - We report an unusual type of a bilateral extradural hematoma: one due to direct
      injury and another due to the contrecoup effect. The second evolved after the
      first hematoma was evacuated.

PMID- 1759188
TI  - Arteriovenous malformations of the vein of Galen: report of three microsurgically
      treated cases.
AB  - Three cases of arteriovenous malformations of the vein of Galen were operated on
      without mortality and morbidity. Postoperative angiography confirmed total
      occlusion of the fistulas in each case. Microsurgical operation in the parieto
      occipital region with interhemispheric approach was performed to cut the numerous
      feeders. The procedure was terminated when the sac was diminished in size with
      bipolar coagulation and clipped with encircling clips to preserve the flow
      through the vein of Galen. In spite of the good surgical results, the long-term
      outcome in the two pediatric patients was discouraging because of mental
      retardation caused by the arteriovenous malformation itself.

PMID- 1759189
TI  - Cerebral aneurysms associated with neurofibromatosis.
AB  - An uncommonly recognized complication of neurofibromatosis (NF) is an angiopathy
      of the intracranial and extracranial arteries. Most of the previously reported
      cases have presented as an occlusive process similar to Moyamoya disease. We
      present our experience over the past 3 years involving three patients with five
      cerebral aneurysms and associated NF. Four of the aneurysms were intracranial,
      two being fusiform in nature. Treatment was surgical occlusion and included
      Selverstone clamping, balloon occlusion, and direct clipping. There appears to be
      an association between the development of cerebral artery aneurysms and NF, but
      the pathophysiology of these vascular changes is not fully understood.

PMID- 1759190
TI  - Proximal clipping and bypass between bilateral vertebral arteries using a radial
      arterial graft for the treatment of a dissecting aneurysm of the vertebral
      artery.
AB  - Proximal clipping has been performed recently as the main surgical treatment for
      a dissecting aneurysm of the vertebral artery. When there is a contralateral
      vertebral artery of a smaller size with arteriosclerotic changes, some form of
      bypass to prevent cerebellar and brain stem infarction is needed in addition to
      proximal clipping. We treated a 50-year-old man with a ruptured dissecting
      aneurysm of the left vertebral artery and stenosis at the V3 segment of the right
      vertebral artery. The caliber of the right vertebral artery was smaller than the
      left. After an anastomosis between bilateral vertebral arteries using a radial
      arterial graft, dissecting aneurysm was clipped at the proximal portion of the
      aneurysm.

PMID- 1759191
TI  - [The clinical value of air sonography in the diagnosis of meniscus lesions. A
      prospective study of 50 knee joints].
AB  - This paper shows the results of using air as a contrast medium in ultrasonography
      of the menisci (aerosonography). 100 menisci (50 knees) were examined with
      aerosonography and in 93 = 93% the findings were proven to be true by subsequent
      arthroscopy. 6% of the findings were false positive (2 medial menisci and 4
      lateral menisci). One false negative finding concerned a lesion at the free inner
      edge of the lateral meniscus. Not one single lesion of the medial meniscus was
      totally missed. The sensitivity of aerosonography is 97.8%, the specificity
      89.1%. The predictive value is 88%, the accuracy is 93%. Considering the medial
      meniscus alone the aerosonographic diagnosis proved to be true in 96%
      (sensitivity for the medial meniscus 100%, specificity 87.5%, predictive value
      94.4%, accuracy 96%). 90% of the aerosonographic diagnosis concerning the lateral
      meniscus were confirmed by arthroscopy (sensitivity for the lateral meniscus
      90.9%, specificity 89.1%, predictive value 71.4%, accuracy 90%).

PMID- 1759192
TI  - [Experience with the management of fresh cruciate ligament rupture in athletes].
AB  - Since 1984 we have done over the top repair of the acutely torn anterior cruciate
      ligament combined with augmentation by McIntosh lateral-substitution over the top
      procedure with iliotibial band in view of frequent instabilities following simple
      reconstruction. After treatment by continuous passive motion and early weight
      bearing is possible. The results at review were good. This method is recommended
      to avoid the risk of rerupture.

PMID- 1759193
TI  - [The significance of the activity score in evaluating knee ligament
      reconstructions].
AB  - In a follow-up study of 156 patients after knee ligament reconstruction for
      chronic instability, the results of subjective Lysholm score grading and of
      Tegner activity grading were compared. The postoperative Lysholm score averaged
      85 +/- 13.2 points, the activity scores 6.9 +/- 0.9 points prior to instability,
      1.7 +/- 0.9 points preoperatively and 5.9 +/- 1.2 points postoperatively. 89
      patients reached their preinjury activity level, the average improvement through
      surgery was 4.2 +/- 1.6 points. Non-active patients regularly returned to their
      original activity-level, competitive athletes were less likely to regain their
      previous activity. The subjective results of athletes and non-athletes showed no
      significant differences. The postoperative activity level clearly correlated to
      subjective grading by the patient. For scoring results after knee ligament
      surgery, we use the subjective Lysholm score and an activity score based on
      average German sports activities.

PMID- 1759194
TI  - [Specific methods of strength training also in rehabilitation].
AB  - Until now only minor attention was given to the importance of strength training
      methods as part of rehabilitation. Even though there are numerous methods in
      physical therapy which can, under certain limitations, be summed up as a type of
      strength training, a differentiated use of training methods which are recognized
      in sport has not been accepted. However, especially the search for a rapid
      rehabilitation of the body's performance capability brings up the question about
      effective training methods. In the following paper the physiological conditions
      are discussed first, on whose basis the motor requirement "strength" has been
      structured. This results in consequences for the practical training. For each
      strength component been introduced, practical suggestions for a strength training
      are given.

PMID- 1759195
TI  - [Treatment of fresh fibular capsular ligament lesion].
AB  - 340 patients with ruptures in the region of the fibular ligaments at the ankle
      joint could be followed up clinically and by x-ray after an average period of 3.4
      years following trauma and treatment. Significantly better treatment results were
      seen in the group of 246 patients who had primarily been treated by surgery (77%
      very good to good) than in the group of 94 patients who had been treated
      conservatively (41.5% very good to good). On the basis of our own follow-up
      results, the international literature and with particular reference to the
      experiences collected in sports orthopedics and sports traumatology, it continues
      to seem imperative to arrive at an individual indication in each case as to
      whether a rupture of the lateral ligaments at the ankle joint should be treated
      by surgery or not; the results we have reviewed point to a generally more
      favorable outcome of surgical treatment than of the conservative approach.

PMID- 1759196
TI  - [The most common tendon injury in sports--hammer finger. Origin, classification,
      diagnosis and rational therapy].
AB  - The closed rupture of the distal digital extensor tendon at its attachment on the
      terminal phalanx the so-called mallet finger - is seen very often in ball games
      ("basketball finger", "baseball finger"). Closed rupture with and without a bony
      fragment can be distinguished. We demonstrate a rational and anatomy related way
      of treatment.

PMID- 1759197
TI  - [Os trigonum syndrome].
AB  - The os trigonum is one of the most frequent accessory bones of the foot. It is
      located dorsal of the talus. Os trigonum syndrome means a typical pain syndrome
      localized in the back-foot caused by this ossicle. This syndrome occurs mostly in
      man with sports activities accompanied with intensive stress to different parts
      of the foot. It can be caused particularly by standing on the toe in the "en
      pointe-position" in ballet dancers when the flexor hallucis tendon is under
      maximal tension or by activities accompanied with maximal plan-tarflexion in
      soccer players for instance. Typical complaints, findings and different
      therapeutic procedures are demonstrated in two cases. Therapy includes different
      non-operative methods. Resistance to non-operative procedures is indication for
      operative therapy. Excision of this ossicle is surgical therapy of first choice.

PMID- 1759198
TI  - [An unusual case].

PMID- 1759199
TI  - [The relationship between the effect of atenolol on the baroreceptor reflex and
      its hypotensive action in hypertension patients].
AB  - A study was made of the influence of atenolol on the sinocarotid and
      cardiopulmonary baroreceptor reflexes (BR) in patients with essential
      hypertension. Sinocarotid mechanoreceptors were activated by means of a cervical
      decompression pressure chamber. The cardiopulmonary BR was tested by changing
      venous return with the aid of local decompression of the lower limbs. The changes
      in the hemodynamic parameters were estimated by continuous recording of the mean
      arterial pressure (AP), tetrapolar rheography, direct manometry arterial pressure
      (AP), tetrapolar rheography, direct manometry (right atrium), and venous
      occlusion plethysmography. The drug hypotensive effect was shown to be related to
      modulation of the sinocarotid BR. It has been demonstrated that there is no
      relationship between atenolol suppression of the vasoconstrictor cardiopulmonary
      BR and the drug ability for AP reduction.

PMID- 1759200
TI  - [Predictors of the efficacy of psychorelaxation therapy in hypertension].
AB  - Results of clinical, psychological and psychophysiological examinations of 136
      patients with mild essential hypertension indicate that psychorelaxation therapy
      is more effective in patients with a higher level of BP response to emotional
      stress and a shorter period of BP recovery after stress. Those patients had a
      moderate level of anxiety and interpersonal conflicts. Predictors of the efficacy
      of autogenic training, breathing relaxation training and biofeedback differed.
      The antihypertensive effect of those methods was associated with various
      personality traits.

PMID- 1759201
TI  - [The clinico-echocardiographic characteristics of commissural mitral stenosis].
AB  - Overall 200 patients with rheumatic valvular heart disease were examined.
      Commissural mitral stenosis (CMS) was revealed in 70 patients (35%). At the
      preliminary examination stage CMS was not detected in 57% of patients, the tone
      of mitral valve opening could not be heard in 40%, normal configuration of the
      heart was preserved in 20% of patients according to the roentgenography data. The
      echocardiographic features of CMS were revealed: the lack of a cupola-shaped
      diastolic curvature of the mitral cusp in part of patients, an insignificant
      narrowing of the left venous opening.

PMID- 1759202
TI  - [The diagnosis of coronary failure in patients with aortic and mitral valve
      defects].
AB  - The incidence of angina pectoris was investigated and the treadmill test was
      carried out to assess the presence of myocardial ischemia and heart pump function
      in 238 patients suffering from mitral and aortal heart disease. Comparison with
      the coronarography readings has demonstrated that the diagnostic value of the
      painful syndrome in the health status and anamnesis does not exceed 24%. The
      appearance of an angina pectoris attack in combination with ischemic alterations
      on the ECG raised the diagnostic value up to 50%. The authors have distinguished
      a symptom-complex including the development of angina pectoris, appearance of the
      ischemic signs on the ECG with the integrity of heart pump function, increasing
      the diagnostic value of the test up to 83-100%. The integrity or insufficiency of
      heart pump function were shown to allow differentiation between atherosclerotic
      and relative coronary insufficiency. The conclusion is drawn about the necessity
      of carrying out the treadmill test according to the program in patients suffering
      from heart disease with suspected coronary insufficiency.

PMID- 1759203
TI  - [Kidney involvement in infectious endocarditis (hematuria)].
AB  - As many as 113 patients suffering from infectious endocarditis (IE) were placed
      under observation. Renal damage was discovered in 28 patients (24.7%). Hematuria
      was the common laboratory sign of renal damage. 15% of patients showed
      microhematuria, 9.7 had macrohematuria. In 15% of patients with IE, hematuria was
      due to diffuse glomerulonephritis, in 5.3% to renal infarction, and in 4.4% to
      focal glomerulonephritis. In 3.5% of patients, the nephrotic syndrome developed
      at the disease onset, it was attended by hematuria and was thus a cause of
      erroneous diagnoses. The appearance of hematuria at the IE onset, attesting to
      involvement of the kidneys into the pathological process, complicates the
      diagnosis and early treatment institution. Detection of the hematuric syndrome in
      patients with a verified diagnosis of IE requires specification of the character
      of renal damage. The latter one contributes to a graver and prognostically
      unfavourable course of IE. In 2 out of 8 patients with associated IE and renal
      damage, the death was caused by progressive chronic renal failure. Postmortem
      examination confirmed mesangioproliferative glomerulonephritis in all the
      subjects; in 4, it was coupled with renal infarction. 14.1% of the patients
      manifested complete and 3.5% partial disappearance of hematuria under the
      influence of adequate antibacterial therapy of IE.

PMID- 1759204
TI  - [The hemodynamic support of physical loading in patients with mitral valve
      prolapse].
AB  - Bicycle ergometry and echocardiographic studies were carried out in 29 patients
      aged 17-29 years with first revealed mitral valve prolapse (MVP) without any
      signs of mitral regurgitation. According to bicycle ergometry, the patients
      manifested changes in hemodynamics pointing to dysfunction of the cardiovascular
      system. Echocardiography discovered a reduction of the mass and a rise of the
      rate of contraction of the circular fibers of the left ventricle, evidence of the
      myocardial genesis of the hemodynamic changes. Comparison of the findings of
      bicycle ergometry and echocardiography allowed a conclusion about the necessity
      of the follow-up of patients with MVP in spite of the high level of threshold
      load and the lack of the clinical signs of heart failure.

PMID- 1759205
TI  - [A morphological analysis of the specimens obtained during endomyocardial
      biopsies in patients with a clinical diagnosis of dilated cardiomyopathy].
AB  - The authors summarize experience gained with a study of biopsy specimens obtained
      on endomyocardial biopsies from 88 patients with a clinical diagnosis of dilated
      cardiomyopathy. The diagnostic value of the study was equal to 70%. Dilated
      cardiomyopathy largely masked myocarditis and alcoholic cardiomyopathy which were
      diagnosed morphologically in 30 and 13% of the patients, respectively. No
      morphological alterations which would allow one to change the clinical diagnosis
      of dilated cardiomyopathy were discovered in 26% of cases. It has been shown that
      endomyocardial biopsy is an important tool of diagnosis. In order to introduce it
      on a broader scale, it is necessary that quantitative uniform criteria for the
      diagnosis of endomyocardial diseases, primarily myocarditis, be elaborated.

PMID- 1759206
TI  - [The clinical importance of the dynamic determination of the serum neopterin
      level in patients with dilated cardiomyopathy].
AB  - Serum neopterin was measured over time (from 3 to 24 months) by RIA in 15
      patients with dilated cardiomyopathy. Comparison with the clinical data revealed
      that the initially normal concentration of neopterin (less than 9 nM/l) was
      associated with a stable disease course on a long-term observation (group I). The
      second group with an initially high neopterin concentration showed an objective
      improvement of the health status together with normalization of the neopterin
      level. The third group of patients were characterized by an increase of the
      neopterin level measured over time, coupled with a disease progress. It should be
      noted that 5 out of 8 patients died. In addition to neopterin measurements, the
      patients with dilated cardiomyopathy were examined for serum beta-2-microglobulin
      (beta-2M). Analysis of the data obtained has demonstrated a similar relationship
      between the level of neopterin and beta-2M and the clinical course of dilated
      cardiomyopathy. Still, neopterin is a more sensitive marker. Therefore, the data
      obtained attest to a possibility of the use of serum neopterin as a prognostic
      marker in patients suffering from dilated cardiomyopathy.

PMID- 1759207
TI  - [Arterial hypertension and its treatment in the aged].
AB  - The rise of arterial pressure in elderly and senile persons reflects
      morphological alterations in the vessels, the development of sympathetic
      hyperactivation and adrenoreceptor dysfunction rather than can be referred to
      compensatory and adaptation reactions of the body. The treatment of patients
      suffering from arterial hypertension should be aimed at preventing the
      development of fibrinoid arterial necrosis which may occur because of regular
      antihypertensive therapy and dyslipidemia correction.

PMID- 1759208
TI  - [The comparative value of myoglobin determination in patients with different
      forms of ischemic heart disease].
AB  - The hemagglutination test was used to measure the content of myoglobin (MG) in
      the blood serum in 92 patients suffering from coronary heart disease (myocardial
      infarction, unstable and stable angina pectoris). The content of MG turned out a
      safe indicator attesting to acute myocardial infarction. In complications and
      spreading of necrosis, the MG level was returning to normal slowly. In patients
      with angina pectoris, the MG level did not on the average differ from control.
      However, in patients with unstable angina pectoris, there was an increase of the
      MG content after long-term attacks and in the development of small-focal necroses
      in the myocardium.

PMID- 1759209
TI  - [The current concepts of the effect of cardiac glycosides on sinus node function
      and atrioventricular conductivity].
AB  - The clinical aspects of the influence of cardiac glycosides on the sinus node and
      atrioventricular junction in health and dysfunction are reviewed. It has been
      shown that digitalis drugs do not produce any effect on sinus node automatism
      including that in dysfunction. Cardiac glycosides suppress enhanced
      atrioventricular conduction and do not affect it provided it remains within
      normal. The mechanisms by which cardiac glycosides may act are discussed:
      extracardiac, cholinomimetic (in the acute test and direct one) and influencing
      heart conduction components (when used continuously).

PMID- 1759210
TI  - [Excessive treatment in the internal disease clinic].

PMID- 1759211
TI  - [Recurrent infectious endocarditis].

PMID- 1759212
TI  - [Suppurative complications of myocardial infarct].

PMID- 1759213
TI  - [A severe course of autoimmune thrombocytopenia and the procedure for its
      treatment in systemic lupus erythematosus].
AB  - The authors describe three comparatively rare cases of extremely severe
      symptomatic autoimmune thrombocytopenia associated with systemic lupus
      erythematosus. The use of glucocorticoids in large doses and in two cases of
      splenectomy turned out ineffective. The next therapeutic measures are suggested
      in the following succession: glucocorticoids----cytostatic drugs (vincristine)---
      splenectomy to be performed only in special cases.

PMID- 1759214
TI  - [The treatment of supraventricular tachyarrhythmias by the transvenous electrical
      destruction of the atrioventricular junction of the heart].

PMID- 1759215
TI  - [Permanent forms of tachyarrhythmia as the possible cause of the development of
      the dilated cardiomyopathy syndrome].
AB  - To specify a possible role played by rhythm disorders in the development of
      dilated cardiomyopathy (DCM), 9 patients showing permanent sinus and/or
      supraventricular tachycardia (since birth or within the first 5 years of life)
      coupled with ventricular rhythm disorders and 11 patients with an assumed
      infectious disease onset were examined. It has been established that in
      supraventricular tachycardia, sinus tachycardia included, patients of the child
      and juvenile age may develop dysfunction of the left ventricle followed by its
      dilatation which manifests clinically by DCM. The use of antiarrhythmic
      (cordarone) in such cases may lead to diminution and even to normalization of the
      heart size and to amelioration of the hemodynamic parameters.

PMID- 1759216
TI  - [The use of the phase-image method for noninvasive topical diagnosis in certain
      forms of heart rhythm disorders].
AB  - The authors describe the results of mapping additional conduction pathways in WPW
      syndrome and ectopic sources of the ventricular rhythm with the aid of phasic
      images (PI). The mapping data were compared to the readings of 12 ECG leads and
      to the electrophysiological findings. The mapping with the aid of PI turned out
      informative in both patients' groups. The PI method demonstrated the possibility
      of Kent's bundle mapping in latent WPW syndrome. The use of the PI method is
      suggested to be the first stage in the mapping of Kent's bundle in WPW patients
      suffering from supraventricular tachycardias as well as of pathological rhythm
      sources in ventricular tachycardias refractory to drug therapy in patients who
      are to undergo surgical treatment.

PMID- 1759217
TI  - [The importance of Holter ECG monitoring in the diagnosis of latent arrhythmias
      in patients with acute respiratory viral infections].
AB  - Altogether 37 patients suffering from influenza and acute respiratory viral
      infections were examined. In 25 patients, acute infections ran their course in
      association with coronary heart disease. According to the ECG readings, 15% of
      the patients had rhythm and conduction disorders. Meanwhile Holter ECG monitoring
      revealed the above disorders in 70% of the patients afflicted with influenza and
      acute respiratory viral infections.

PMID- 1759218
TI  - [Etatsizin efficacy in patients with ventricular tachycardias. The results of
      intracardiac electrophysiological research].
AB  - As many as 30 patients with different pathologies of the cardiovascular system
      and paroxysms of ventricular tachycardias were examined. According to the
      ultrasonography data, an ejection fraction was not lower than 35% in all the
      patients. It has been shown by electrophysiological studies that intravenous
      injection of ethacizine in a dose of 0.6 +/- 0.1 mg/kg prevented induction of
      ventricular tachycardia in 66.7% of patients. In 16.7% of patients, the drug
      exerted an arrhythmogenic effect that showed up by a decrease of the cycle of
      tachycardia. Oral administration of ethacizine in the daily dose 100 or 150 mg
      prevented tachycardia induction by endocardial stimulation in 20.8% of patients.
      The arrhythmogenic effect of the drug was recorded in 12.5% of patients. The
      action of ethacizine when administered by both routes was accompanied by a
      significant elongation of the P--Q interval, QRS complex and of the cycle of
      ventricular tachycardia. Continuous administration of ethacizine in the daily
      dose 150 mg to patients with a positive antiarrhythmic drug action (according to
      the electrophysiological data) prevented paroxysms of ventricular tachycardia,
      with the observation period being 2 to 6.5 years.

PMID- 1759219
TI  - [The diagnosis and possibilities for the anti-arrhythmia treatment of malignant
      ventricular disorders of the heart rhythm].
AB  - Altogether 130 patients with malignant ventricular disorders of cardiac rhythm
      were examined to demonstrate a possibility of obtaining the diagnostically
      significant data with the aid of Holter's monitoring of the ECG in 89.2%, with
      the aid of bicycle ergometry exercise tests in 72.3%, and by means of an
      electrophysiological examination of the heart in 82.5% of the above-indicated
      group of patients. The drug testing with the use of invasive and noninvasive
      techniques of monitoring the action of antiarrhythmic drugs given per os makes it
      possible to choose effective therapy on an individual basis. The long-term use of
      such therapy may prevent ventricular tachycardia relapses and noticeably enhance
      the patients' survival. Severe organic pathology of the heart associated with a
      decrease of its pump function seen in the majority of patients with malignant
      ventricular disorders of cardiac rhythm refractory to pharmacotherapy restricts,
      in a considerable number of cases, the potentialities of drastic surgical
      treatment because of the risk of operative death. To improve the disease
      prognosis of these patients, it is necessary that other methods of
      nonmedicamentous treatment may be used, requiring a less scope of surgical
      intervention, such as implantation of a cardioverter-defibrillator.

PMID- 1759220
TI  - [The outlook for the diagnosis and treatment of cardiovascular diseases].

PMID- 1759221
TI  - [A method of choosing maintenance anti-arrhythmia therapy after sinus rhythm
      restoration in patients with a permanent form of atrial fibrillation].
AB  - The authors suggest a new method of choice of the drug (quinidine or cordarone)
      for the maintenance antiarrhythmic therapy after sinus rhythm recovery in
      patients with permanent atrial fibrillation, in patients with rheumatic heart
      disease and coronary heart disease. The method is based on the formalized
      prediction of the results of cardioversion and on the distinguishing groups with
      a good and bad prognosis. In the former group, both drugs can be administered, in
      the latter group, it is desirable that cordarone may be used.

PMID- 1759222
TI  - [The detection of changes in intra-atrial conductivity (based on enhanced ECG
      data)].
AB  - The 20-fold enhanced ECG (without frequency filtration of the signal) was
      recorded in 30 normal men aged 18 to 36 years. A study was made of the constancy
      of the P wave forms on the ECG. The P wave form underwent changes in 8 test
      subjects: in 5 during breathing retention on expiration and in 3 during
      superficial breathing. The changes indicated are viewed as a manifestation of
      intraatrial conduction disorders. It is assumed that the changes in the tone of
      the autonomic nervous system and myocardial hypoxia may contribute to the
      detection of latent disorders in the cardiac activity.

PMID- 1759223
TI  - [The natural course of a complete atrioventricular block].
AB  - The natural disease course is analyzed in 311 patients with atrioventricular
      blockade admitted for surgical treatment to the Leningrad Center of Arrhythmia
      Surgery and Cardiac Pacing. It has been discovered that, as a rule, Morgagni
      Adams-Stokes (MAS) attacks do not occur for over 2-3 years after their onset,
      which determines to a considerable measure the patients: life expectancy. The
      authors hold that the very first Mas attack which may occur in a patient with
      atrioventricular blockade is an absolute indication for implantation of a
      permanent cardiac pacemaker. If the permanent cardiac pacemaker was established,
      1-, 3-, 5-, 7- and 8-year survival rates were, respectively, 91.1, 85.8, 77.3,
      63.2, and 60.8%.

PMID- 1759224
TI  - [The variability of the myocardial ischemia indices in stenocardia patients
      during repeated exercise tests].

PMID- 1759225
TI  - [The role of a spasm of the coronary arteries in the pathogenesis of acute
      myocardial infarct and in the development of sudden coronary death].
AB  - Based on the clinical experience and clinicoanatomic correlations, the authors
      suggest the role of hemorrhage and rupture of atherosclerotic patches in the
      pathogenesis of sudden coronary death. Proceeding from long-term follow-up
      studies of patients suffering from CHD, the necessity is substantiated of the
      regular use of beta-adrenoblockers which significantly reduce the rate of sudden
      death both in the acute and chronic phases of CHD, particularly in patients with
      a history of myocardial infarction. Taking into consideration the multifactorial
      nature of the pathogenesis of acute occlusion of coronary arteries, it is
      suggested that in addition to the preventive administration of beta
      adrenoblockers, thrombolytic agents in combination with antiaggregation remedies
      and calcium antagonists should be prescribed, especially in cases of arterial
      pressure rises.

PMID- 1759226
TI  - [The cholesterol content in immune complexes as a marker of coronary and
      peripheral atherosclerosis].
AB  - As many as 107 patients with coronary atherosclerosis, 66 with peripheral
      atherosclerosis, 27 with unaltered coronary arteries and 30 healthy blood donors
      were examined. The content of cholesterol in immune complexes was significantly
      higher in patients with coronary and peripheral atherosclerosis as compared to
      patients with intact arteries and healthy subjects. The highest content of
      cholesterol in immune complexes was detected in patients with combined lesions of
      coronary arteries and arteries of the lower limbs. It exceeded 3.5-5.5-fold the
      content of cholesterol in immune complexes in the control groups. The accuracy of
      the diagnosis with the aid of measuring the content of cholesterol in immune
      complexes in atherosclerosis of any sites was equal to 85%, in peripheral
      atherosclerosis to 89%, which slightly exceeded the diagnosis accuracy in
      atherosclerosis of coronary arteries (83%).

PMID- 1759227
TI  - [The dynamics of the concentrations of immunoglobulins and circulating immune
      complexes during low-density lipoprotein apheresis in patients with hereditary
      hypercholesterolemia].
AB  - Sessions of-low density lipoproteins (LDL) apheresis using sorbents with mono-
      and polyclonal antibodies possessing the most selective and specific effect with
      respect to LDL provoked a less marked decrease of the concentrations of
      immunoglobulins and circulating immune complexes. This attests to their high
      selectivity and specificity. Sorbents with dextran sulfate and heparin sepharose
      exerted a more evident influence on the concentrations of these serum components.
      However, that was not accompanied by any clinical manifestations of immune
      deficiency. The use of plasmapheresis brought about a more pronounced lowering of
      the concentrations of the serum components under study.

PMID- 1759228
TI  - [Intravascular blood coagulation in patients with ischemic heart disease].

PMID- 1759229
TI  - [The circadian rhythms of myoglobin concentrations in the blood serum in acute
      myocardial infarct and unstable stenocardia].
AB  - Patients with acute myocardial infarction and unstable angina pectoris do not
      demonstrate circadian time organization of myoglobin concentration rhythms. The
      predominance of ultraradian and infraradian neorhthmostasis is typical of such
      patients. Determination of myoglobin concentration rhythms in the given patients'
      group may be helpful in the measurement of the size of the focus of necrosis and
      prediction of the course and outcome of the diseases under consideration.

PMID- 1759230
TI  - [Occupational therapy in the rehabilitation of myocardial infarct patients in the
      convalescence phase].

PMID- 1759231
TI  - [The factors determining the efficacy of the rehabilitative treatment of patients
      who have had a myocardial infarct].
AB  - Factors responsible for the efficacy of rehabilitative treatment of patients with
      a history of myocardial infarction were defined on the basis of the 2-year follow
      up of 235 patients who suffered myocardial infarction, bicycle ergometry data,
      studies into intracardiac hemodynamics, oxygen supply in exercise tests, and
      criteria for the significance of the tetrachoric indicator with regard to the
      confidence limits. In patients who suffered uncomplicated myocardial infarction,
      prediction of the decreased work fitness in the long-term period is determined by
      the presence of angina pectoris and arterial hypertension. It has been
      established that whether will be lowered in future can be judged from the changes
      seen in the magnitude of the liminal power and the end diastolic volume of the
      left ventricle during the first 6 months following myocardial infarction.

PMID- 1759232
TI  - [The current aspects of the problem of heart rhythm disorders].

PMID- 1759233
TI  - [An epidemiological study of ischemic heart disease, vascular brain diseases and
      their risk factors in an open population of 25- to 64-year olds in Novosibirsk].
AB  - To study the incidence of coronary heart disease (CHD), cerebrovascular diseases
      (CVD), combined pathology (CHD and CVD), and their risk factors such as arterial
      hypertension (AH), overweight (OW), hypercholesterolemia (HC), and tobacco
      smoking in the same population, a random representative sample of male and female
      populations were examined in three districts of Novosibirsk. AH and tobacco
      smoking were found predominant among men, whereas OW and HC among women. It
      turned out that almost every fourth person out of the men and almost every second
      woman suffered from cardiovascular diseases. In the men, the CHD/CVD ratio was
      1:1, that in the women, was 1:7. In the men and women, suffering from combined
      pathology, AH occurred more frequently as compared to those with CHD or CVD
      alone. OW promoted the development of CVD and combined pathology in women to a
      greater degree, whereas HC favoured the development of CHD and CVD in men.

PMID- 1759234
TI  - [The somatotype, blood hormone content and the threshold of taste sensitivity to
      table salt in young people with arterial hypertension].

PMID- 1759236
TI  - The physician's guide to medical waste regulations, Part II.

PMID- 1759235
TI  - [The specificity of the hypotensive effect of calcium antagonists in
      hypertension].
AB  - The purpose of the study was to define prognostic criteria that determine
      individual sensitivity to the hypotensive effect of slow calcium channel
      blockers. After two weeks of placebo therapy 45 patients suffering from essential
      hypertension underwent an acute pharmacological test (APT) with nifedipine in a
      dose of 30 mg. Then the patients received monotherapy with nitrendipine in the
      increasing doses for 12 weeks. The drug effect on the renin-angiotensin
      aldosterone system and the level of ionized calcium in the blood serum was
      estimated. In 17 patients who responded to the APT by a decrease of the mean
      arterial pressure (MAP) by not less than 20%, arterial pressure was corrected
      with nitrendipine administered in a dose not exceeding 20 mg. 28 patients whose
      MAP dropped by 10 to 20% in response to the APT required higher drug doses (40
      mg). 7 patients in whom the MAP dropped less than 10% were practically refractory
      to the monotherapy with nitrendipine. A close negative correlation was found
      between the degree of the MAP lowering in response to the APT during nitrendipine
      monotherapy and plasma renin activity as well as the concentration of ionized
      calcium in the blood serum. The low content (less than 1.0 mmol/l) of ionized
      calcium in the blood serum of patients suffering from essential hypertension
      appeared the most valuable predictor for the hypotensive effect of the slow
      calcium channel blockers.

PMID- 1759237
TI  - Medicaid changes mean higher physician payments.

PMID- 1759239
TI  - TMA, AMA seek legislative fix for Medicare payment schedule.

PMID- 1759238
TI  - Sunset review starting soon for medical examiners board.

PMID- 1759240
TI  - No ifs, ands, or butts. You can help patients quit.

PMID- 1759241
TI  - HIV-I testing not covered.

PMID- 1759242
TI  - Theft, murder, and drug warfare: a novel solution.

PMID- 1759243
TI  - Health risks of adolescent sexual activity are focus of TMA report.

PMID- 1759244
TI  - TDH report updates diagnosing, treating cholera.

PMID- 1759245
TI  - Therapeutic approaches to chronic lymphocytic leukemia.
AB  - Chronic lymphocytic leukemia is the most common leukemia in the Western
      Hemisphere and will increase in prevalence as the population continues to age.
      Partly because of the advanced age of patients and the often prolonged indolent
      course of disease, therapy has changed little over the past several decades. The
      clinical course is highly variable and several clinical features have prognostic
      value. Until recently, therapeutic approaches have ranged from watchful
      observation to palliative treatment with an alkylating agent alone or combined
      with a corticosteroid; however, a number of new chemotherapeutic agents (eg,
      fludarabine, deoxycoformycin, and chloride-oxyadenosine) have been shown to act
      effectively against the disease. The availability of effective new agents
      combined with a better understanding of the biology and prognostic determinants
      in this disease have sparked recent interest in the optimal management of
      patients with this increasingly common malignancy.

PMID- 1759246
TI  - Water fluoridation--more isn't better.

PMID- 1759247
TI  - Predictive value of family history in detecting hypercholesterolemia in
      predominantly Hispanic adolescents.
AB  - Plasma levels of total cholesterol, triglyceride, high-density lipoprotein
      cholesterol, and low-density lipoprotein cholesterol were obtained in 110 senior
      high school students who were predominantly Hispanic. Results were compared with
      family history of premature coronary heart disease or hypercholesterolemia. The
      level of high-density lipoprotein cholesterol was significantly lower in Hispanic
      adolescents than in non-Hispanics (P less than 0.05). A positive family history
      was found in 22% of the subjects. Only 25% of the students with high levels of
      total cholesterol had a positive family history. The positive predictive value of
      family history for a high level of total cholesterol was only 38%. These results
      suggest that adolescents should be screened for hypercholesterolemia regardless
      of a positive family history.

PMID- 1759248
TI  - Blunt rupture of the heart in a child.
AB  - The spectrum of blunt cardiac trauma ranges from injuries with no actual cellular
      damage (myocardial concussion) to cardiac chamber rupture. Although blunt
      injuries to the heart are common and potentially lethal, rupture of a cardiac
      chamber is rare. This injury should be suspected in any patient who presents with
      cardiac tamponade after blunt trauma. A child who sustained blunt rupture of the
      right atrium is presented, and the pathophysiology, diagnosis, and treatment of
      these injuries are discussed.

PMID- 1759249
TI  - Burditt appeal unsuccessful, but transfers continue.

PMID- 1759250
TI  - Bridging troubles. Patient representatives aid physicians, too.

PMID- 1759251
TI  - Fort Worth action stops sale of pound dogs for biomedical research.

PMID- 1759252
TI  - Benzodiazepines and triplicate prescriptions: New York's experience.

PMID- 1759253
TI  - Lyme borreliosis in Texas.
AB  - Lyme borreliosis is a protean infection caused by B burgdorferi, a recently
      recognized arthropod-borne spirochete. The disease is generally acquired during
      warm weather, and its onset is characterized by a skin lesion, EM, and flulike
      symptoms. Neurologic, cardiac, and/or rheumatologic abnormalities may emerge
      weeks, months, or years later. In the absence of the pathognomonic skin lesion,
      determination of antibody response is currently the most practical laboratory aid
      in diagnosis. However, clinical judgement is necessary for the correct
      interpretation of laboratory results because false-positive and false-negative
      results are common. Antibiotics remain the mainstay of therapy. Longer courses of
      antibiotic therapy than those previously recommended may be needed to obtain a
      cure, particularly in later stages of the illness.

PMID- 1759254
TI  - Immediate reconstruction: current status in cancer management.
AB  - Immediate elective repair of various defects caused by ablative surgery for
      treatment of cancer is becoming increasingly common. In comparison with delayed
      reconstruction, immediate reconstruction has the advantage of lower costs and, in
      most cases, reduced anesthesia risks. Immediate repair is also technically easier
      in many cases and may provide better results. Furthermore, it often provides
      patients with a strong psychological boost, allowing them to progress toward
      total recovery and minimizing the time they must live with disability and
      deformity. Experience has shown that immediate reconstruction does not increase
      the risk of cancer recurrence or metastasis. Elective immediate reconstruction
      has proven useful for defects of the breast, chest wall, mandible, nose, oral
      cavity, and extremities. Illustrative examples are provided so that the potential
      benefits of this approach can be more widely appreciated.

PMID- 1759255
TI  - Point prevalence of tuberculosis among central Americans sheltered in Houston.
AB  - A study to determine the point prevalence of tuberculosis, as defined by a
      positive tuberculin skin test, was conducted among the inhabitants of a Central
      American shelter. The point prevalence was found to be 50% (17/34). This high
      point prevalence demonstrates the need to test Hispanics who have recently
      arrived in the United States for tuberculosis. The difficulty in completing
      evaluations of those with positive skin tests makes tuberculin skin testing
      ineffective in controlling tuberculosis in this population and setting. To
      improve control, local, state, and federal health agencies will need to
      coordinate their efforts and increase the accessibility of health care to
      populations at high risk.

PMID- 1759256
TI  - Personal choices--communication among physicians and patients when confronting
      critical illness.
AB  - Communication among physicians and patients when confronting life-threatening or
      terminal illness is often flawed. Medical ethics authorities have suggested the
      physician or the hospital is responsible to determine a patient's wishes for
      ongoing therapy; yet, few pragmatic suggestions have been made as to how to
      fulfill this responsibility. Although advance directives are generally available,
      they are often misunderstood and rarely used. An educational brochure has been
      designed to facilitate communication by exposing patients and others to some of
      the technical and ethical issues that come into focus in the setting of critical
      illness. The brochure includes a living will. Early experience with this device
      has been favorable. The hospital ethics committee that developed this brochure
      believes it can be adapted to other institutions and urges its widespread use.

PMID- 1759257
TI  - [Adaptation disorders in newborn animals: pathogenesis and therapy. Review
      article].
AB  - The sympathoadrenal system of the neonate is stimulated during parturition and
      immediately after birth. Endogenous opioid peptides can be regarded as partial
      catecholamine antagonists. They have an inhibitory action on the respiratory
      center but may also lead to a redistribution of cerebral blood flow in favour of
      certain essential brain areas. The acidosis seen in connection with neonatal
      asphyxia stimulates a further release of catecholamines as well as opioid
      peptides. The therapeutic approach should lead to a rapid normalisation of
      respiration.

PMID- 1759258
TI  - [Clinical case. Young Fleckvieh bull, 6 months old].

PMID- 1759259
TI  - [The significance of sheep and goats as carriers of zoonoses in this country].
AB  - The significance of sheep and goats in this country in connection with the
      zoonoses rabies, tick-borne encephalitis, contagious ecthyma, Q-fever,
      chlamydiosis, brucellosis, campylobacteriosis, echinococcosis and toxoplasmosis
      is discussed.

PMID- 1759260
TI  - [Bacteriologic studies of aborted sheep fetuses with special reference to
      chlamydiae].
AB  - A total of 467 tissue specimens recovered from 165 aborted ovine fetuses were
      examined for chlamydiae microscopically and by means of cell culture. Chlamydiae
      were detected by microscope in 34 fetuses (20.6%) and by cell culture in 60
      fetuses (36.4%). Of the 467 tissue specimens, 51 (10.9%) were microscopically
      positive, whereas chlamydiae were recovered from 181 specimens (38.8%) using the
      routine method of BGM cell culture. A total of 87 specimens of fetal organs was
      tested by the BGM cell culture technique and simultaneously by an enzyme
      amplified immunoassay to detect chlamydial antigen. Although not as sensitive as
      cell culture isolation, the ELISA has the advantage of rapidity and of detecting
      antigen from non-viable chlamydiae in sheep abortion material.

PMID- 1759261
TI  - [Interferon in sheep].
AB  - There is only limited information on sheep interferon available. Recent
      publications have reported on: 1. an interferon (IFN) alpha subtype, which is
      secreted by the fetal trophectoderm into the lumen of the uterus between the 10th
      and 21st day of gestation. It was therefore named ovine trophoblast protein (oTP
      1), and is responsible for signalling pregnancy to the ewe via high affinity
      receptors in the endometrium. It is thought that oTP-1 acts by directly
      influencing prostaglandin metabolism. 2. the role of lentivirus-induced
      interferon (LV-IFN) in the pathogenesis of Maedi/Visna. The results indicate that
      LV-IFN limits viral replication and therefore contributes to virus persistence
      and is also responsible for a chronic inflammatory process. 3. the mitogen- or
      antigen-dependent induction of ovine interferon gamma (IFN gamma) and its
      characterization.

PMID- 1759262
TI  - [Partial aplasia of the right horn of the uterus in a German Schwarzbund cow.
      Case report].

PMID- 1759263
TI  - [Clinical findings in vitamin D poisoning of swine].
AB  - Acute to subacute vitamin D toxicosis is described in two different fattening pig
      herds. A few days after admixing a new batch of vitamin/mineral-premix most of
      the fattening hogs developed anorexia, polydipsia and polyuria. Emesis was seen
      in some of the animals. About two weeks after consumption of the suspected feed
      two thirds of the pigs had a rough hair coat and a very poor weight gain. Because
      of the results of haematological and metabolic findings from blood and urine
      samples of diseased pigs a calcinosis and tubular nephrosis was diagnosed. Patho
      histological findings of the euthanatized morbid pigs included severe chronic
      interstitial nephritis, glomerulonephritis and mineralisation of a number of
      organs. Some of the animals showed degeneration of the myocardium. Feeding two
      healthy pigs with the incriminated feed the disease was reproduced.

PMID- 1759264
TI  - [Pteridine pattern in the urine of swine of different breeds and halothane
      genotypes in relation to nutrition and stress].
AB  - Urinary pteridine patterns and creatinine concentrations were determined in pigs
      of the breeds Pietrain, Deutsche Landrasse and their crossbreds. Also the
      influence of the halothane genotypes, of different feeding and of treadmill
      exercise was examined. We conclude that creatinine concentration in pig urine is
      not a reliable reference parameter for the pteridine excretion. Creatinine values
      were significantly influenced by breed and feeding. The pteridine pattern of
      pigs' urine depends on the breed and correlates with other metabolic parameters.
      Stress is reflected by altered pteridine concentrations.

PMID- 1759265
TI  - [The current status of avian ophthalmology].
AB  - Ocular diseases in birds are very rarely investigated. Increased keeping of often
      very expensive caged birds makes it necessary for veterinarians in practice to
      deal with the problems of ornithoophthalmology. Fundamental physiological and
      anatomic differences between the mammalian and the avian eye, interspecies
      variables and general problems in handling do not allow a simple transfer of
      knowledge of mammal ophthalmology to birds. Therefore, it is necessary to find
      differentiated, species-orientated solutions in investigation as well as suitable
      treatments of ocular diseases in birds. An update on ornithoophthalmology is
      given.

PMID- 1759266
TI  - [Immune intervention in Borna disease].
AB  - Borna disease is a naturally occurring meningoencephalomyelitis of sheep and
      horses. After experimental infection of rats with Borna disease virus a biphasic
      disease with initial gait disturbances and later paresis and paralysis can be
      observed. The disease symptoms in these experimental animals resemble those of
      the natural hosts. The disease is not caused by the infecting virus itself but
      rather by a CD4+ T cell-mediated immune response. After the pathogenesis had been
      elucidated new strategies for the therapy of Borna disease by interfering with
      the immune reaction have been developed. Treatment with immunosuppressive drugs,
      with monoclonal antibodies directed against certain immune cells and with
      mediators of the immune reaction resulted in an inhibition or significant
      reduction of Borna disease symptoms.

PMID- 1759267
TI  - [The effect of nutrition on the origin of colic (digestive disorders) in horses].
AB  - Colics are often initiated by mistakes in feeding inadequate feed quality or
      quantity or poor feeding technique. The consequences are obstruction, impaction
      or dysbiosis with increased production of organic acids, gas or toxins.
      Nutritional anamnesis in patients with colic may give information on the
      pathogenesis of the disease.

PMID- 1759268
TI  - [Neonatal isoerythrolysis in newborn foals].
AB  - Aetiology, pathogenesis, clinical symptoms, diagnosis, prophylaxis and therapy of
      neonatal isoerythrolysis in foals are presented. Neonatal isoerythrolysis is
      caused by isoimmunisation of a brood mare to the Aa and Qa erythrocyte antigens
      of the foal. The disease can develop, when the mare does not possess Aa resp. Qa
      blood group antigens, is sensitized to the Aa or Qa erythrocyte antigens--i.e.
      through pregnancy, parturition, blood resp. plasma transfusions, etc.--and the
      foal suckles colostral antibodies to its own blood cells. Aa and Qa antibodies
      can cause haemagglutination and haemolysis in the foal, with a consequent decline
      in erythrocytes, PCV and haemoglobin resulting in several clinical symptoms. In
      most instances the first signs of the disease are noticed by day 2 and 3, ranging
      from 8 to 96 hours of life. Diagnosis is based upon clinical examination and
      determination of erythrocyte count, PCV and haemoglobin concentration and can be
      further confirmed by immunological tests. Several tests can be used to prevent
      the occurrence of neonatal isoerythrolysis in the newborn foal. Prior to
      parturition, brood mares can be typed for blood groups and tested for antibodies
      to Aa and Qa in order to identify mares at risk for causing neonatal
      isoerythrolysis in the foal. After birth, compatibility of the mare's colostrum
      and the foal's erythrocytes can be checked by the "jaundice foal agglutination"
      test. Some instructions for prophylaxis of neonatal isoerythrolysis and for the
      treatment by red blood cell resp. whole blood transfusions are given.

PMID- 1759269
TI  - [Bilateral ectopic ureter in a Persian cat--a possible cause of urinary
      incontinence].
AB  - A bilateral congenital dislocation of the ureter in a one year old male Persian
      cat is discussed. Diagnostic procedures, operative implantation of both ureters
      into the bladder, postoperative course and therapy are described.

PMID- 1759270
TI  - [Cystocentesis in dogs and cats].
AB  - The technique of cystocentesis in dogs and cats was studied. The indications and
      contraindications of this method are discussed, using illustrations.

PMID- 1759271
TI  - [The diagnosis of nephrogenic diabetes insipidus in the dog].
AB  - Nephrogenic diabetes insipidus is characterized by polyuria, hyposthenuria and
      compensatory polydipsia. With conventional clinical and laboratory examinations
      the diagnosis can be established and the differential diagnostic diseases
      excluded. In order to verify the diagnosis, differentiate the condition from
      central and nephrogenic diabetes insipidus and rule out psychogenic polydipsia,
      additional laboratory studies are required: of these, the concentration test,
      modified Carter-Robbins test and AVP stimulation test are described.

PMID- 1759272
TI  - [Experiences with a sedimentation technique for the enrichment of cerebrospinal
      fluid cells in the dog and cat. Part 1].
AB  - The differentiation of cells of the cerebrospinal fluid (CSF) gives valuable
      information about certain neurologic diseases. The sedimentation technique of
      Sayk modified by Kolmel is introduced and its application described. Cells of 300
      samples of CSF from dogs and cats are evaluated. There were very good to
      reasonable results in 88% (263 of 300) of the samples. A comparison between cell
      number, morphology and protein content in 150 samples was performed. 90 CSF
      samples with normal cell count (less than or equal to 5/mm3, determined in the
      Fuchs-Rosenthal chamber) were compared with the cell yield after sedimentation.
      In 58% (52 of 90) of the samples more than 200 cells were found, in 13% (12 of
      90) more than 800 could be differentiated. The results are compared with those of
      other methods mentioned in the literature.

PMID- 1759273
TI  - [Modification of the global coagulation tests for the dog. Significance for the
      monitoring of heparin therapy].
AB  - When the global coagulation tests Quick's test, aPTT and thrombin time are
      carried out on dogs using reagents from the human medical sector according to the
      manufacturer's instructions, they react insensitively to deficiencies of the
      corresponding coagulation factors or to the presence of fibrin degradation
      products. In the present study it was attempted to develop sensitive global tests
      for the dog by modifying these tests. The Quick's test reacted apparently more
      sensitively after a 1:4 dilution of the test plasma with physiological saline
      solution. The sensitivity of the aPTT was demonstrated by the addition of BaSO4
      adsorbed plasma to normal plasma. It seems to be particularly advantageous to
      combine a 1:3 plasma dilution with a reduction in the CaCl2-concentration to 5
      mmol/l. Likewise, plasma dilution allows the thrombin time to react more
      sensitively in the presence of increased concentrations of fibrin degradation
      products. The aPTT and thrombin time are, as in human beings, suited for the
      control of a heparin therapy. However, since prolongation of the coagulation
      times is considerably dependent on the test chosen, the heparin sensitivity of
      the test should be determined in vitro prior to use.

PMID- 1759274
TI  - Family planning operations research in Africa: reviewing a decade of experience.
AB  - Between 1979 and 1990, Columbia University conducted 26 family planning
      operations research (OR) projects in 13 sub-Saharan African countries. Most of
      these projects were implemented in settings where family planning service
      delivery had not yet been initiated or was new and poorly developed. In keeping
      with program needs in the early stages of development, the majority of the OR
      projects were based on demonstration or diagnostic designs. Only four of the 23
      projects were comparative or quasi-experimental in design. Projects demonstrated
      the growing demand for family planning, and the feasibility and acceptability of
      a range of service delivery models. Sixteen of the projects have been sustained
      or replicated by national or local governments and institutions following the
      initial OR phase, replication of two others is planned, and another four resulted
      in policy formulation or improvements in existing national programs. OR in Africa
      played an important role in generating political and medical support for
      contraceptive services, and served to improve project management. OR proved more
      useful in the implementation and strengthening of individual programs than in
      generating universal lessons regarding service delivery. In order to maximize
      OR's utility in Africa, simple research designs and methods should be adopted.

PMID- 1759275
TI  - Rethinking postpartum family planning.
AB  - This article examines the rationales for commonly advocated postpartum family
      planning services and challenges the behavioral and biological assumptions on
      which they are based. An alternative approach to service delivery is suggested.
      Services should be designed to incorporate breastfeeding and to increase their
      acceptability to postpartum women.

PMID- 1759276
TI  - Fertility and family planning in Vietnam.
AB  - This report provides the first reliable statistical data on fertility patterns
      and the family planning program in the Socialist Republic of Vietnam. Findings
      are from the 1988 Demographic and Health Survey of Vietnam and the 1989 census
      survey. The data show that the total fertility rate has declined from over 6
      children per woman in the early 1970s to under 4 in the later 1980s.
      Contraceptive prevalence for modern methods is estimated at 37 percent among
      married women of reproductive age in 1988. The average duration of breastfeeding
      is over 14 months; marriage is relatively late. The IUD is the most common
      contraceptive method and abortion is widespread. The major factors likely to
      influence fertility and family planning in the future are the government's
      population policy, improved access to modern methods of contraception, and the
      institution of new economic policies that are currently under way in Vietnam.

PMID- 1759277
TI  - Perceptions and practices relating to condom use among urban men in Haiti.
AB  - This report is based on a survey conducted in 1986-87 of sexually active adult
      male residents in a low-income community of Port-au-Prince, Haiti. The objectives
      were to investigate knowledge of and attitudes toward condoms; to evaluate the
      effectiveness of the existing condom distribution program; and to obtain
      information that can be used in the design of strategies to increase condom
      acceptance and use among men throughout Haiti. A final sample of 706 sexually
      active adult male residents in stable unions, including a specially drawn sample
      of male partners of condom acceptors, were interviewed in their homes. Although
      condoms are almost universally known, they are rarely used. The majority felt
      that the responsibility for family planning should be borne by the woman. Whereas
      condoms may be of limited popularity for family planning purposes in Haiti, it
      should be determined whether they might be more acceptable as an effective means
      of controlling the spread of AIDS and other STDs.

PMID- 1759278
TI  - Family planning information sources and media exposure among Zimbabwean men.
AB  - This report describes, for a sample of Zimbabwean men, sources of family planning
      information, media exposure, media preferences, and whether they would like to
      learn more about family planning methods. The data are from the 1988 Zimbabwe
      Male Fertility Survey, a representative sample of 711 currently married men aged
      20 and over. The analysis is restricted to the 512 men whose wives were aged 49
      and under at the time of the survey. The radio and personal communications,
      followed by posters and newspapers, are the most frequently reported sources of
      family planning information. The radio is considered to be the best medium for
      learning about family planning, followed by community-based distributors. Nearly
      85 percent of respondents indicated that they would like to learn more about
      family planning. Information from men should be included in information,
      education, and communication programs in order to enhance male involvement in the
      family planning process.

PMID- 1759279
TI  - What's wrong with CYP?

PMID- 1759280
TI  - Kenya 1989: results from the Demographic and Health Survey.

PMID- 1759281
TI  - [The forensic medical diagnosis of the types of vehicle-caused trauma by using
      mathematical methods and programming systems].
AB  - Urgent problems of scientific research on medicolegal evaluation of vehicle
      trauma were studied. One of perspective ways of increasing scientific control and
      evidential value of expert conclusion is pointed out. Use of mathematical methods
      and personal computers in expert evaluation of vehicle trauma is recommended.
      Expert differential diagnostic system (impact-overrun) developed is described and
      operating condition of personal computer is given.

PMID- 1759282
TI  - [The forensic medical aspects of the biomechanics of the impact interaction of a
      blunt solid object and the human head].
AB  - Issues of distribution of kinetic energy of traumatizing object in direct contact
      interaction with head during impact are discussed from position of biomechanics.
      It was stated that kinetic energy is directed at deformation of head tissues and
      object as well as at head displacement after impact and overcoming neck tissue
      resistance. Experimental studies confirmed theoretical principles. Results
      obtained can be used in expert practice and in scientific research.

PMID- 1759283
TI  - [Mechanical damages to the hair in head trauma from blunt metal objects].

PMID- 1759284
TI  - [The selective spatial filtration of roentgenograms in the forensic medical
      expertise of stab-cutting wounds].
AB  - Investigation of 14 roentgenograms of skin preparations with cut-stab wounds,
      treated by spatial filtration method in medium and high spatial frequency modes
      was performed using material of 13 specific cases. This resulted in detection of
      disturbances of skin pattern left at the area of former skin cone in 7 cases
      while in 2 cases indistinct heel traces were seen. Changes in skin pattern were
      not recorded on roentgenograms of skin preparation of 12 experimental cut-stab
      wounds obtained on cadaveric skin.

PMID- 1759285
TI  - [The expertise of strain disease].
AB  - Overload disease (OD) of human osseous system appears after microtrauma and
      excessive and frequently repeated load. Examination of 260 patients with OD was
      carried out. Radioisotope method revealed disease in all cases while radiological
      method--in 91% of cases. Sudden decrease in growth hormone (HGH) was noted in 95%
      of cases. Classification of 5 stages of OD which can be used for expert practical
      work was developed.

PMID- 1759286
TI  - [The restrictase analysis of human DNA as a method for determining genetic sex in
      forensic biological expertise].
AB  - In this article phenomena related to sex heteromorphism of restrictase
      hydrolysates of DNA, isolated from objects of expert analysis was recommended for
      use. The performed investigations allow one to work out the system of
      discriminating sex of biological objects, based on restrictase analysis of human
      DNA and on registration of sex-specific restrictase fragments. Possibilities of
      method and its value for gene-identification expertise were illustrated using
      certain cases from expert practice.

PMID- 1759287
TI  - [The establishment of the presence of sperm in stains by an agar gel
      electrophoretic method].
AB  - Comparative investigation of seminal stains and other secretions from human body
      and blood as well as objects of plant origin by gel electrophoresis using
      alkaline values of pH buffer solutions and subsequent enzymography for acid
      phosphatase made it possible to develop optimal conditions for detection of
      seminal presence in stains. Good preservation of seminal acid phosphatase in
      stains during several years is shown.

PMID- 1759288
TI  - [The use of personal computers for the mathematical processing of the results of
      chemical-toxicological studies].
AB  - Three programs in BASIC and SUPER BASIC language for personal computer are
      suggested. The first program makes it possible to calculate the degree of
      substance extraction and factor of its distribution between two liquid immiscible
      phases. The second program is designed to make calculations on distribution of
      substance in the organs of experimental animals. The third program is designed to
      determine specific and molar factors of light absorption. Results of calculations
      are presented as tables. Programs can be also used in mathematical processing of
      results obtained in the course of scientific research.

PMID- 1759289
TI  - [The forensic medical expertise of carbon monoxide poisonings in the cases of the
      explosion of methane and coal dust in a mine].

PMID- 1759290
TI  - [The pathogenesis and pathomorphology of diffuse cerebral reactions in closed
      craniocerebral trauma].

PMID- 1759291
TI  - [The significance of physiologically active substances in the forensic medical
      determination of the chronobiological characteristics of injuries].

PMID- 1759292
TI  - [The methodological aspects of establishing the time of death].
AB  - Methodological analysis of essence of problem concerning postmortem interval
      estimation is given. The authors present the most promising ways of scientific
      research on this problem and possibilities of practical use of results of
      scientific research. The general methods of postmortem interval estimation
      including wired-in analogy (criterial) method and methods of modelling postmortal
      processes (mathematical and physical) are analysed. Graph of logical structures
      of modes of postmortem interval estimation and means of their realization is
      given.

PMID- 1759293
TI  - [The dynamics of oligophrenia from the forensic psychiatric aspect].
AB  - Clinical-catamnestic examination of patients with oligophrenia (71 subjects) who
      performed socially dangerous acts and were brought to the Research Institute of
      General and Forensic Psychiatry named after V. P. Serbskii for in-patient
      forensic psychiatric expertise was carried out. All the individuals examined are
      people who at least once were recognized irresponsible with diagnosis
      "oligophrenia at debility level". Presence of dynamic shifts both in main
      symptomatology of illness and in concomitant emotional-volitional manifestations
      were detected; prognostic variants of disease development and social adaptation
      of oligophrenics were noted. Group of patients with mental deficiency, who needs
      introduction of "limited sanity" term was singled out.

PMID- 1759294
TI  - [The forensic medical aspects of using safety belts].

PMID- 1759295
TI  - [The postmortem diagnosis of fatty hepatosis in pregnant women].

PMID- 1759296
TI  - The assessment of suicidal behavior in adolescents.
AB  - All available assessment instruments (N = 29) used to study suicidal behaviors in
      adolescents and young adults (age 12-20) were collected and reviewed. Instruments
      were found to vary substantially in purpose, format, informat, and theoretical
      orientation. The items from these tools (N = 461) were categorized according to
      behavior type (thoughts, feelings, or actions) and content categories (death/life
      related, disease-promoting/preventing, injury-producing/reducing, person
      reducing/enhancing, and factual information). The majority of the items were
      found to assess thoughts and were focused on death-related content.
      Recommendations include the need for more rigorous validation of instruments,
      clearer operational definitions, additional normative information, and expansion
      of the pool of available items to encompass a broader array of self-destructive
      behaviors.

PMID- 1759297
TI  - Clinical psychology graduate education in the study of suicide: availability,
      resources, and importance.
AB  - Psychologists run the risk of losing a patient to suicide and of experiencing the
      traumatic impact of this event. The present study examines current levels of
      training in the study of suicide in the member-departments of the National
      Council of Schools of Professional Psychology (NCSPP--N = 33), comparing these
      findings with the level of training in member-departments (N = 115) of the
      Council of University Directors of Clinical Psychology programs (CUDCP). Eighty
      percent of the CUDCP departments (N = 92) responded, and of these, only 35% offer
      formal training in the study of suicide; whereas in the 76% of the NCSPP programs
      that responded, 56% offer formal training. Although the NCSPP programs seem
      attitudinally more receptive and supportive of formal training (graduate and
      postgraduate) in the study of suicide, the NCSPP programs do not significantly
      differ from their CUDCP counterparts in the actual availability of such formal
      training. Even when all training efforts of the CUDCP and NCSPP programs are
      combined, only 40% of all graduate programs in clinical psychology offer formal
      training in the study of suicide.

PMID- 1759298
TI  - Teen suicide and changing cause-of-death certification, 1953-1987.
AB  - This study examines whether the purported tripling in teenage suicides since the
      1950s represents a real increase or is simply an artifact of the increased skill
      of medical examiners in distinguishing youth suicides from fatal accidents. This
      study examines firearms and poisoning deaths, which together account for 75% of
      all certified youth suicides, from 1953 through 1987, and concludes: (a) a past
      undercount of youth suicides is likely, (b) the increase in youth suicide that
      has occurred is less dramatic than reported and resembles increases in adult
      suicide, and (c) the suicide increase indicated among youths and adults occurred
      from 1964 to 1971 and has since stabilized.

PMID- 1759299
TI  - Suicidal behavior in Italy: data, trends and guidelines for a suicide
      intervention/prevention policy.
AB  - Even though in Italy, as in the majority of Mediterranean countries, the increase
      in suicide rates is not among the highest in Europe, between 1969 and 1989 it
      showed a sharp upswing (+43% among males and +31% among females). In terms of
      geographical differences, the regions with the highest suicide rate are the
      northern ones (up to twice the national average). The age groups with the highest
      suicide risk are those over 74 years (in 1989 the rate among males over 65 was
      the highest of all: 31.3 per 100,000). The differences in the between-sexes
      distribution show that among females over 65 years old the suicide rate rose by
      70% between 1974 and 1989, versus 77% for males of the same age. The preliminary
      epidemiological results of one of two Italian centers are presented. These
      centers are collaborating with the WHO/EURO Multicenter Study on Parasuicide;
      parasuicide rates are higher for females than for males (55.9 per 100,000, as
      against 38.1 for males), while the age group at highest risk is seen to be young
      women (15-24 years), with a specific rate of 115.6.

PMID- 1759300
TI  - Suicides in active-duty enlisted Navy personnel.
AB  - Cases of completed suicide among U.S. Navy enlisted personnel occurring from 1974
      through 1985 were identified and compared with similar rates in the U.S. general
      population and in the U.S. Army. Although the Navy suicide rate was the lowest of
      the three groups, this rate increased between 1976 and 1983. This was in contrast
      to national and Army trends during the same period. Young white males in the
      apprentice/recruit and blue-collar occupations had the highest rates of completed
      suicide in the Navy. Recommendations for prevention and treatment are discussed.

PMID- 1759301
TI  - Suicide prevention in the Pacific War (WW II).
AB  - During the war against Japan, there were two facets of an American program to
      prevent suicide among the Japanese. One was a research component in the Foreign
      Morale Analysis Division (FMAD), a subunit of the Office of War Information. The
      principal FMAD figure who did most of the research on Japanese suicide and ways
      to prevent suicide among the Japanese military was the anthropologist Ruth
      Benedict, assisted by her Japanese-American aide Robert Hashima. The second facet
      was the suicide prevention program itself, which was put into effect toward the
      end of the war in the battles of Saipan and Okinawa. This program of action was
      undertaken by American GIs. These unheralded activities in suicide prevention
      merit a place in the annals of suicide prevention programs.

PMID- 1759302
TI  - Case consultation. David.

PMID- 1759303
TI  - [The Zollinger-Ellison syndrome].

PMID- 1759304
TI  - [Therapeutic aspects of traumatic perforations of the colon. 22 cases].

PMID- 1759305
TI  - [Cancers of the mouth].

PMID- 1759306
TI  - [Spontaneous evolution of ventricular septal defects after the age of 2 years].

PMID- 1759307
TI  - [Left intra-auricular myxoma. 13 cases].

PMID- 1759308
TI  - [Bronchial foreign bodies in the adult. 4 cases].

PMID- 1759309
TI  - [Hormonal parameters and fluid-electrolyte imbalances in primary hypothyroidism].

PMID- 1759310
TI  - [Hypocalcemic cardiac insufficiency in the adult. 2 cases].

PMID- 1759311
TI  - [Suppuration of a ovarian dermoid cyst. Case report and review of the
      literature].

PMID- 1759312
TI  - [Franceschetti-Klein mandibulofacial dysostosis. A case report].

PMID- 1759313
TI  - [Exercise-induced asthma].

PMID- 1759314
TI  - ["Sunday athletes" and lipid evaluation].

PMID- 1759315
TI  - [Biliary enteric fistulas. Report of 11 cases].

PMID- 1759316
TI  - [Infection profile of hospitalized diabetics: study of 135 cases].

PMID- 1759317
TI  - [Gastritis and campylobacter pylori. 85 cases].

PMID- 1759318
TI  - [Cervico-facial cellulitis. 20 cases].

PMID- 1759319
TI  - [Diagnosis and effects of subclinical varicocele on fertility. 6 cases].

PMID- 1759320
TI  - [Primary Budd-Chiari syndrome. Review of the literature and 5 case re ports].

PMID- 1759321
TI  - [Drugs and embryonic-fetal development].

PMID- 1759322
TI  - [Multiple myeloma manifesting as recurrent phlebitis].

PMID- 1759323
TI  - Description of broad-band pulsed Doppler ultrasound processing using the two
      dimensional Fourier transform.
AB  - Considering data from a Doppler sample volume as a two-dimensional function of
      depth and time, the properties of its two-dimensional fast Fourier transform
      (2DFFT) are discussed. It is shown that the 2DFFT of idealized Doppler data from
      moving scatterers is a line whose slope is the velocity of the scatterers.
      Aliasing, finite bandwidth effects, and spectral broadening due to transit time
      effects receive simple descriptions in this scheme. Existing processing schemes
      can be described graphically in this unifying description. Processing of broad
      band pulsed Doppler ultrasound can incorporate a correction for aliasing if based
      on the two-dimensional Fourier transform, and this has been tested using data
      from tissue-mimicking phantom in a tank-based experiment.

PMID- 1759324
TI  - A simulation study of echographic imaging of diffuse and structurally scattering
      media.
AB  - Realistic simulations of echographic image formation were performed. The
      simulations were based on a focussed single element transducer of 3.5 MHz and
      linear scanning. The tissue model scanned was composed of a homogeneous,
      nonattenuating, medium containing point-like scatterers. The scatterers were
      distributed in space in two different arrangements: randomly with a fixed number
      density of 7500 per cubic centimeter and regularly in a cubic matrix with a
      characteristic distance of 1 mm. These two populations of scatterers yielded the
      diffuse and the structural scattering component, respectively. The B-mode texture
      was assessed by first and second order statistical parameters. The effects of
      various modifications of the matrix, i.e., the relative scattering strength, the
      orientation and the position uncertainty of the scatterers, on the statistical
      parameters were systematically investigated. Increasing the relative scattering
      strength yields a monotonic increase of the mean grey level, the ratio of
      structural over diffuse scattering intensity and a decrease of the signal-to
      noise ratio and the autocorrelation lengths. Increasing the position uncertainty
      to 20 percent reduces these effects practically to zero, except for the lateral
      ACF's. Rotation of the matrix with respect to the beam axis induces a periodicity
      in all statistical parameters, which is symmetric around 45 degrees. Again, the
      effects become statistically insignificant at a position uncertainty of 20
      percent, with the exception of length of the lateral ACF. While assuming that in
      a single clinical B-mode echogram of the liver many orientations of the matrix
      will be simultaneously present, the B-mode lines of images obtained for a range
      of orientations were taken together and the overall statistical parameters
      calculated. The mean, the signal-to-noise ratio of the echo amplitude, SNRA, and
      the axial and lateral lengths of the ACF for the multirotation condition are
      significantly different from both the diffuse and the zero degree orientation.
      The structural backscattering intensity cannot be estimated any more with a
      reasonable precision. The structural separation distance, however, can still be
      assessed at a 10 percent level of the position uncertainty, even in the
      multirotation case and is therefore a robust clinical parameter.

PMID- 1759325
TI  - An iterative algorithm for scanning tomographic acoustic microscopy.
AB  - Acoustic microscopy is capable of providing high-resolution images of small
      objects. When such a microscope operates in the transmission mode, it produces
      simply a shadow-graph of all the structures encountered by the acoustic wave
      passing through the object. The resultant images are difficult to comprehend
      because of diffraction and overlapping of complex structures. Scanning
      tomographic acoustic microscopy (STAM) overcomes these difficulties and produces
      unambiguous micrographs of objects of substantial thickness and complexity. STAM
      uses the back-and-forth propagation algorithm to reconstruct tomograms of various
      layers to be imaged. When these layers are physically close to one another,
      ambiguities appear in the reconstructed images. Using an iterative algorithm
      eliminates these ambiguities and resolves layers that are only two wavelengths
      apart.

PMID- 1759326
TI  - Improved resolution backscatter coefficient imaging.
AB  - This paper reports the extension of a method for imaging acoustic backscatter
      coefficients that allows for greater spatial resolution in the resulting images.
      This is done by using a broad-band excitation pulse and short-duration time gates
      in the analysis. The images produced had better spatial resolution than the
      previously reported technique [Ultrasonic Imaging 10, 121-138]. Furthermore, the
      pixel values were based upon quantitatively accurate backscatter coefficients at
      given spatial locations. The paper also discusses the additional computational
      requirements of greater spatial resolution and proposes a least-squares fit to a
      smoothly varying set of sparse data to generate the data points in between.

PMID- 1759327
TI  - The problem of obstruction in prostate cancer.

PMID- 1759328
TI  - Photodynamic therapy of bladder cancer--uptake and phototoxicity of photosan in
      vitro.
AB  - The uptake of photosan and the intracellular sites of photoradiation-induced
      damage were investigated in vitro in bladder carcinoma cells and in normal
      bladder cells. Cells were examined by phase contrast, fluorescence and electron
      microscopy. The concentration of photosan, measured in microgram/10(6) cells,
      showed a good correlation to the incubation time. At all incubation times,
      control cells showed a lower uptake when compared with tumor cells. Following
      photodynamic therapy (PDT), phase-contrast microscopy revealed marked changes in
      tumor cells, whereas only minor effects could be detected at the cell membrane of
      the control cells. Following PDT, most of the investigated cells showed changes
      of the mitochondria and cytoplasma. These changes consisted of dissolution of the
      cristae, predominantly in the central part of the mitochondria. Twenty-four hours
      after PDT the shape of the mitochondria had changed markedly and the cristae were
      found to be completely destroyed. Moreover, the cystoplasma showed numerous
      vacuoles, and the number of mitochondria was decreased compared to non-treated
      cells.

PMID- 1759329
TI  - Determination of DNA ploidy and ABH antigen reactivity in both frozen and
      formalin-fixed bladder tumor tissue.
AB  - In a prospective series of patients with transitional-cell bladder carcinomas,
      DNA ploidy and ABH antigen reactivity were determined in both frozen tissue and
      formalin-fixed paraffin blocks. ABH antigen measurement in frozen tissue was
      hampered by methodological problems, especially insufficient morphology, which
      made quantification difficult. In only 38/55 (69%) cases was the same ABH
      reactivity found. The knowledge of secretor status was not helpful in the
      interpretation of these results. In 53/59 (90%) cases the same DNA ploidy was
      achieved, resulting in good correlation between flow cytometric DNA measurements
      in formalin-fixed and frozen tissue. The deviations occurred mainly in cases
      exhibiting a tetraploid DNA profile. DNA assessments using image cytometry on
      imprints of fresh tissue was a rapid and reliable method in our hands, with
      identical results being obtained in 32/36 (89%) cases.

PMID- 1759330
TI  - Alterations in polymeric immunoglobulin receptor expression and secretory
      component levels in bladder carcinoma.
AB  - To assess the capacity of transitional cells to synthesize the release polymeric
      immunoglobulin receptor (pIg-R) in bladder carcinoma, we studied the localization
      of pIg-R in normal and tumor tissues and measured the levels of secretory
      component (SC) either in the free form or bound to Ig (S-IgA, S-IgM) in the serum
      and urine of 56 patients with transitional-cell carcinoma (TCC) of the bladder.
      In the normal bladder mucosa, pIg-R was localized in the cytoplasm and plasma
      membranes of the superficial cells and on all epithelial cell membranes. In TCC
      cases, 65% of those studied expressed pIg-R. A marked heterogeneity in pIg-R
      staining was observed in some tumors. Although a better expression of pIg-R in
      tumors with a well-preserved epithelial architecture was observed, no correlation
      was found between pIg-R expression and the grade or stage of the tumors in the
      patients under study. Three groups were established: (1) in TCC with no
      complications, serum levels of free SC and S-IgA were significantly increased;
      (2) in TCC with urinary infections (UI), serum levels of free SC and S-IgA were
      significantly higher than control values but lay within the same range observed
      in TCC with no complications and rates of urinary excretion of SC were
      significantly higher than those in normal subjects; (3) in TCC without UI but
      with hepatic disorders [high gamma-glutamyl transferase (GGT) activity], there
      was a correlation between serum S-IgA levels and GGT activity (r = 0.5, P less
      than 0.005) and serum SC levels were significantly higher than those observed in
      the other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759331
TI  - Tumor necrosis factor in benign and malign tissue of the kidney.
AB  - The use of tumor necrosis factor (TNF) in immunotherapy of tumor diseases has
      attracted increasing interest. Since the direct antitumor effect of the TNF is
      mediated by receptor-bound TNF, we immunohistologically stained both benign and
      malignant tissue from 35 tumor-bearing human kidneys for TNF. Using a polyclonal
      anti-TNF-antiserum, paraffin sections were tested in the presence and absence of
      in vitro preincubation with TNF. Furthermore, all specimens were stained
      immunohistologically for Tamm-Horsfall protein (THP) because this renospecific
      glycoprotein can bind TNF in a lectin-like manner. In the absence of TNF
      preincubation, malignant tissue was TNF-positive in 34 specimens, as was benign
      tissue from the same tumor-bearing kidneys in 35 cases. In several specimens the
      staining was so intense that preincubation with TNF did not enhance the reaction.
      Whereas TNF staining in tumor tissue was relatively homogenous, that in benign
      tissue was intensive in distal tubuli, moderate in proximal tubuli, and negative
      in glomeruli. THP staining was negative in malignant kidney tissue but positive
      in the distal tubuli of benign tissue, i.e., in the regions in which TNF staining
      was most intense. These results indicate that TNF binds not only to membrane,
      most likely in a receptor-mediated manner, but also to THP both in vivo and in
      vitro. In vivo binding of TNF to THP was confirmed in animal experiments in which
      pigs were given injections of TNF. Immunohistological staining of the animals'
      kidneys revealed positive reactions for both TNF and THP at the distal tubuli,
      indicating TNF binding to THP after in vivo TNF administration.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1759332
TI  - Glycosaminoglycans, uric acid and calcium oxalate urolithiasis.
AB  - The interaction between calcium and glycosaminoglycans (GAGs) was studied using a
      calcium ion-selective electrode. The Ca-binding capacity of GAGs involved 16% of
      total calcium in the presence of chondroitin sulphate and 28% in the presence of
      pentosan polysulphate. The action of GAGs on the nucleation of uric acid and
      sodium urate was examined and inhibitory effects were observed. The action of
      uric acid as a heterogeneous nucleant of calcium oxalate was studied, and
      considerable promotion of the heterogeneous nucleation of calcium oxalate by uric
      acid was found, which could be inhibited by the action of GAGs. From these
      summarised in vitro results, we conclude that uric can constitute an important
      risk factor for calcium oxalate urolithiasis through heterogeneous nucleation and
      the GAGs can play an important role as preventive agents.

PMID- 1759333
TI  - Rate of urinary bladder blood flow evaluated by 133Xe washout and radioactive
      microspheres in pigs.
AB  - Urinary bladder blood flow as measured by the washout of locally injected 133Xe
      and by the simultaneously performed radioactive microsphere reference-sample
      method was studied in pigs. The washout curves were analyzed according to the
      initial slope, the corrected initial slope and the total curve. The corrected
      initial-slope flow rates were not statistically significantly different from the
      microsphere whole-wall flow rates. The variability between the methods shown by
      the test-retest difference revealed only a minor lack of agreement. The bladder
      blood flow tended to decrease after the intravesical pressure had been increased
      to 20 cmH2O, but the difference was not statistically significant. Washout of
      locally injected 133Xe can be used for the evaluation of urinary bladder blood
      flow in humans and in longitudinal animal studies. The corrected-initial-slope
      method is recommended for the analysis of washout curves.

PMID- 1759334
TI  - The role of oxygen free radicals and prostaglandins in reperfusion injury to warm
      ischemic kidneys.
AB  - The present study was designed to determine whether the administration of
      superoxide dismutase (SOD) can alleviate ischemic kidney damage and whether there
      is a relationship between oxygen free radicals and thromboxane (Tx). In 17 dogs,
      the right kidney was removed and the vascular pedicle of the left kidney was
      clamped for 75 min. Prior to reperfusion, the ischemic kidney was rinsed with 5
      mg SOD and an additional 20 mg SOD was infused systemically. Blood samples were
      drawn from the renal vein before ischemia and after reperfusion to determine
      serum levels of thromboxane B2 (TxB2). All eight untreated dogs died within 1
      week of renal failure, and the nine treated dogs demonstrated transient renal
      failure, with a significant difference (P less than 0.001) being found between
      the two groups. A significant difference (P less than 0.001) in TxB2 levels was
      found in the untreated dogs before and after ischemia and between the two groups
      following reperfusion. Animals that are treated with SOD after the ischemic event
      has occurred but before reperfusion exhibit a favorable clinical course in terms
      of survival and renal function. Tx synthesis in the kidney can be blocked by the
      administration of SOD.

PMID- 1759336
TI  - International disease surveillance. Quarterly report June to September 1991.

PMID- 1759335
TI  - Effects of direct current on renal function. An experimental study in pigs.
AB  - Electric current from an external source was introduced between electrodes
      operatively placed into the ureters and positioned in the renal pelves of 13
      pigs. Urinary excretion via the cathodic kidney showed a marked increase. The
      renal plasma flow and glomerular filtration rate diminished with increasing
      voltage, but no significant difference was found between the cathodic and the
      anodic kidney. The fractional sodium excretion by the cathodic kidney was 80%
      higher, indicating that the electric current mainly affected tubular function. A
      possible clinical application for electric fields in the kidneys is discussed.

PMID- 1759337
TI  - Control of fly strike in sheep by means of a pour-on formulation of cyromazine.
AB  - Cyromazine, a triazine insecticide, was used as a pour-on preparation to prevent
      blowfly myiasis in sheep kept in pairs of neighbouring farms in two locations. In
      1987 one of the farms in each location used conventional dipping with a diazinon
      dip while the other used the pour-on treatment. The results achieved with the
      pour-on preparation compared favourably with the results of conventional dipping
      and the incidence of blowfly strike was substantially lower than the proportion
      affected among the untreated groups on the same farms. The 1988 trial results
      confirmed the efficacy of the pour-on treatment for up to 13 weeks and that
      retreatments at eight-weekly intervals could reduce the incidence of fly strike
      to zero.

PMID- 1759338
TI  - Value of standardised exercise tests and blood biochemistry in the selection and
      training of breeding stallions.
AB  - Stallions selected by the Royal Dutch Warmblood Society were submitted to a
      standardised lungeing test at the beginning and at the end of a 100-day test of
      performance and ability. The heart rate, haematology and biochemistry values
      obtained in the first lungeing test showed no significant differences between the
      15 stallions which were rejected by the Royal Dutch Warmblood Society during the
      first month of the 100-day test, the 15 stallions rejected during the last month
      and the 11 stallions which were approved for registration in the studbook. The 26
      stallions submitted to the second lungeing test had significantly lower heart
      rates and blood lactate concentrations than in the first test. The standardised
      lungeing test had no value in predicting the rejection or approval of the
      stallions, and the fitness of a stallion at the beginning of the 100-day test did
      not influence its chance of being approved as a breeding stallion. The
      differences between the results of the first and the second tests suggest that
      the fitness of the stallions improved during the 100-day test.

PMID- 1759339
TI  - Failure of sheep to respond to repeated inoculations with an alcelaphine
      herpesvirus-1-like virus, isolated from a case of malignant catarrhal fever in
      American cattle.
AB  - The replication of an alcelaphine herpesvirus-1-like virus (707K), isolated from
      a clinical case of malignant catarrhal fever in American cattle, was studied in
      sheep. Viraemia was not observed in any of the six sheep repeatedly inoculated
      with the 707K virus or in four steers susceptible to malignant catarrhal fever
      which were housed together with these sheep for one year. None of the four steers
      seroconverted and only two of the six inoculated sheep showed a negligible and
      short-lived seroconversion. The inability of the sheep to seroconvert adequately
      after repeated inoculations with the 707K virus, and the failure to recover the
      agent from them suggests that this agent does not replicate in sheep.

PMID- 1759340
TI  - Attempt to vaccinate orally harbour seals against phocid distemper.

PMID- 1759341
TI  - Potential danger of avian paramyxovirus type 3 to ornithological collections.

PMID- 1759342
TI  - Cutaneous salmonellosis in veterinarians.

PMID- 1759343
TI  - Policy on farm animal welfare.

PMID- 1759344
TI  - RCVS rules on firing.

PMID- 1759345
TI  - Toxocariasis campaign.

PMID- 1759346
TI  - Porcine reproductive and respiratory syndrome in Quebec.

PMID- 1759347
TI  - Effect of maedi-visna virus infection on lamb growth.

PMID- 1759348
TI  - Red meat refresher course.

PMID- 1759349
TI  - [The organization of therapeutic care in accidents at nuclear power
      installations].

PMID- 1759350
TI  - [The prospects for using radiation study methods in rendering care to the victims
      in areas of accidents and catastrophes].

PMID- 1759351
TI  - [The pathogenesis and early therapy of acute radiation lesions].

PMID- 1759352
TI  - [The biochemical and immunological indices in the rehabilitation period of the
      victims of the accident on the Komsomolets atomic submarine].
AB  - Biochemical and immunological indexes of peripheral blood were compiled in
      military sanatorium "Divnomorskoe" in seamen who have suffered from general
      supercooling in the result of "Komsomolets" atomic submarine breakdown. The
      patients had the symptoms of metabolic disturbance, immunodepression, a great
      concentration of proteins in acute phase and activity of MB-fraction of creatine
      phosphokinase. Immunodepression after the general supercooling was mainly
      conditioned by oppression of differentiation, metabolic changes and functional
      activity of T-lymphocytes. A course of immunocorrective therapy was employed
      using "thymogen"--synthetic peptide of thymus. In the process of rehabilitation
      there was a gradual functional recovery, normalization of metabolism and
      immunological indexes.

PMID- 1759353
TI  - [Mental disorders in officials of the law-and-order service working in the area
      of the accident at the Chernobyl Atomic Electric Power Station].

PMID- 1759354
TI  - [The etiopathogenesis of poisonings by the components of technical fluids].
AB  - The studies of peculiarities of aliphatic alcohol metabolism in etiopathogenesis
      of acute poisoning with methyl alcohol and ethilenglicol have shown that it was
      reasonable to apply the inhibitors of alcoholdehydrogenase as a specific antidote
      in emergency therapy. Inhibitors prevent the formation of toxic products by
      blocking metabolism of these spirits.

PMID- 1759355
TI  - [The system of medical evacuation support for the troops at the present stage of
      development of military medicine].
AB  - The authors analyse the former and actual state of evacuation support of troops.
      Having been finally formed during the Great Patriotic War as the system of
      casualty staging it proved to be correct. At the same time this system has some
      deficiencies, namely: the repeated surgical intervention, multistaged character
      of evacuation, medical care and treatment. In the post-war period the improvement
      of this system is connected with a radical technical re-equipment of medical
      service, including modern evacuation facilities, as well as with rational
      assignment of medical specialists. Actually the assurance of an early (within
      first 6 hours) specialized medical care is considered to be the main task and the
      basic principle in the improvement of medical evacuation in troops.

PMID- 1759356
TI  - [Whole-body rheography in the differential diagnosis of critical states in acute
      poisonings by organophosphorus compounds].

PMID- 1759357
TI  - [The prediction of the toxic effect of chemical substances].
AB  - On the basis of general conception of the toxicity mechanism of chemical
      substances the authors worked out a conceptual and mathematical model of
      intoxication within a range from subtle effects and up to lethal cases. The tests
      of this model were made on the basis of carbon oxide action. The model gives the
      possibility to elaborate practical methods for prognostication and realization of
      health service measures in case of large-scale chemical catastrophes.

PMID- 1759358
TI  - [The experimental validation of associated immunization with paired combinations
      of vaccines].
AB  - Experimental researches were conducted on reactogenicity and immunological
      efficiency of pair associations of 8 commercial drug preparations. The following
      vaccines were used in various pair combinations: typhoid, plague, smallpox,
      typhus, tick-borne encephalitis, yellow-fever, cholera, sextaanatoxine. Pair
      combinations of these drug preparations were proved to be harmless. Their
      reactogenicity was manifested mainly in more or less pronounced vaccination
      reaction which may be considered as tolerable. Immunological efficiency
      practically of all pair combinations of vaccines, which was determined by the
      frequency and intensity of antibody formation, had the same indexes as the
      control one. The immunity expression of a large majority of pair combinations of
      vaccines also was unchanged. The study in vitro of compatibility of pair
      associations of vaccines proves the low stability of yellow-fever vaccine, which
      falls down under the influence of plague and cholera vaccines, or sextaanatoxine.
      On the contrary, smallpox vaccine makes yellow-fever vaccine more active. Plague
      vaccine is stimulated by smallpox vaccine and is oppressed with combined
      application of typhoid vaccine and sextaanatoxine.

PMID- 1759359
TI  - [Radioisotopes devices and the sanitary inspection of their use in units and
      installations of the Army and Navy].

PMID- 1759360
TI  - [A rapid method for predicting physical work capacity].

PMID- 1759361
TI  - [A method for determining the need for medical stores].

PMID- 1759362
TI  - [The UMU-1 and UMU-2 uniform fabric cases for military medical kits].

PMID- 1759363
TI  - [Plastic operations with the tubed pedicle flap in combined defects of the
      perioral area and lower and middle face].

PMID- 1759364
TI  - [Experience with the use of dental implantation in eliminating defects of the
      dental arches].

PMID- 1759365
TI  - [The diagnostic and treatment procedure characteristics in foreign bodies of the
      gastrointestinal tract].

PMID- 1759367
TI  - [A device for determining the mobility of the cervical spine].

PMID- 1759366
TI  - [Extrafocal transosseous osteosynthesis of the long tubular bones in multiple and
      combined trauma].

PMID- 1759368
TI  - [A box for instruction on how to puncture the cubital vein].

PMID- 1759369
TI  - [A combination device for determining convergence and accommodation separately
      for each eye].

PMID- 1759370
TI  - [The pride of Soviet surgery. On the centenary of the birth of S. S. Iudin].

PMID- 1759371
TI  - [The effect of naphthalan on the fast potassium current of pond snail neurons].

PMID- 1759372
TI  - [The action of sanatorium-health resort treatment on autonomic endocrine
      regulation in children with functional changes in cardiac activity].
AB  - During sanatorium treatment children with cardiac disturbances developed
      equilibrium between adrenergic and cholinergic effects on cardiac activity.
      Vegetative dysfunctions declined. There was a positive trend in glucocorticoid
      and thyroid conditions. Individual application regimens of mud and galvanic mud
      therapy have been designed basing on changes in the vegeto-endocrine status.

PMID- 1759373
TI  - [The effect of medical gymnastics on the external respiratory function of
      patients with infectious-allergic bronchial asthma under ambulatory treatment].
AB  - A new treatment of bacterial asthma involving therapeutic exercise, massage and
      using a special respiration regulator improving bronchial permeability is
      proposed. The treatment was conducted in 118 patients aged 22-68 with 1-17-year
      history of asthma. The set of exercises proposed, especially in application of
      the regulator, improves external respiration, bronchial permeability, helps to
      reduce hyperventilation and arterial hypoxemia.

PMID- 1759374
TI  - [The rehabilitative treatment of polyneuropathies in children].
AB  - Two hundred children with hereditary polyneuropathy have been examined. A
      positive time course of clinical manifestations, the status of peripheral blood
      circulation and neuromuscular system after the exposure to sinusoidal modulated
      current and electrical stimulation provides evidence for higher efficacy of this
      method in comparison with inductothermy and local whirlpools.

PMID- 1759375
TI  - [A comparative evaluation of the effect of balneopsychotherapy, balneotherapy and
      psychotherapy on osteoarthrosis patients].
AB  - Osteoarthrosis patients underwent balneotherapy or placebo treatment with
      psychotherapy or without it. The response of the patients favors the addition of
      psychotherapy to osteoarthrosis treatment (clinical differences made up 8-12%).

PMID- 1759376
TI  - [Physical factors in the postoperative rehabilitation of patients with congenital
      deformities of the jaw bones].

PMID- 1759377
TI  - [The action of an alternating magnetic field on the antiviral protection of
      cells].

PMID- 1759378
TI  - [The use of sinusoidal modulated currents in treating patients with the
      neuroreceptor form of impotence].

PMID- 1759379
TI  - [The use of preformed physical factors during the preoperative preparation and
      rehabilitation of rectocele patients].
AB  - A technique of using preformed physical factors for the treatment of rectocele
      patients in pre- and postoperative period has been designed. The technique
      promoted early activation of 36 postoperative females. They recovered functions
      of the fundus of the pelvis and normal defecation.

PMID- 1759380
TI  - [Control over mature therapeutic muds].

PMID- 1759381
TI  - [A comparative evaluation of the body uptake of iodine in ionic and molecular
      forms in vaginal irrigations with iodide-bromide water (experimental research)].

PMID- 1759382
TI  - [The automation of the methods for studying the gastrointestinal tract in health
      resort practice].

PMID- 1759383
TI  - [The current aspects of the postgraduate training of physicians in physiotherapy,
      health resort science and medical rehabilitation].

PMID- 1759384
TI  - [The moderation of the physical loads in therapeutic physical exercise].

PMID- 1759385
TI  - [Cryotherapy].

PMID- 1759386
TI  - [Morphofunctional shifts in the thyroid and liver and a change in the thyroid
      hormone level in the blood with the internal use of iodine-containing waters].
AB  - Assessment of thyroid function and antitoxic protein-synthesizing function of
      hepatocytes at light microscopic and ultrastructural levels revealed differences
      in the effects of natural and prepared iodine water under similar iodine-ion
      concentration (14 mg/l). The varieties seem to result from the presence of ion
      salt base in the natural water.

PMID- 1759387
TI  - [Prevention of post-resuscitation metabolic disorders by the antioxidant
      oxypyridine-6].
AB  - Acute mortal hemorrhage in rats induced excessive activation of lipid
      peroxidation, while accumulated high amounts of lipid hydroperoxides impaired
      energy metabolism in brain and heart tissues. Preadministered antioxidant
      hydroxypyridine-6, which increased the lipids antioxidation activity and reduced
      inhibition of the antioxidative enzymes, limited distinctly the lipid
      peroxidation rate in brain, heart, lung and liver tissues and contributed to
      maintaining energy metabolism. The drug diminished 2-fold the early
      postresuscitation lethality.

PMID- 1759388
TI  - [Change in lipid peroxidation processes and level of individual gangliosides and
      phospholipids in the liver of rats with toxic experimental hepatitis].
AB  - Content of individual phospholipids, gangliosides and lipid peroxidation were
      studied in liver tissue homogenates of rats with hepatitis caused by CCl4 or
      heliotrine. In all the cases studied the rate of lipid peroxidation was
      distinctly increased, while content of sphingomyelin was decreased and that of
      phosphatic acid--increased; concentration of some gangliosides was altered.
      Activation of lipid peroxidation appears to induce the enzymatic systems involved
      in degradation of phospholipids and gangliosides in liver tissue of rats with
      toxic hepatitis.

PMID- 1759389
TI  - [Cytochrome P-450 activity and lipid peroxidation in rat liver and lung
      microsomes during hypoxia and followed by pressure oxygenation].
AB  - Influence of hypoxia (0.029 MPa, I h) followed by hyperoxia (0.2 MPa, I h) on
      microsomal oxidation and lipoperoxidation was studied in rat liver and lungs.
      Distinct increase of cytochrome P-450 catalytic activity with amidopyrine and
      benzo-a-pyrene as substrates of the I type was found after hypoxia, subsequent
      hyperoxia resulted in significant increase of amidopyrine and benzo-a-pyrene
      metabolism in liver and lung tissues and of aniline metabolism in liver tissue.
      Both hypoxia and hyperoxia led to increase in content of diene conjugates and
      Schiff bases in liver and lungs, while the increase of diene conjugates in liver
      and both diene conjugates and Schiff bases in lungs were observed under hyperoxic
      conditions.

PMID- 1759390
TI  - [The role of monoamine oxidase in the regulation of mitochondrial energy
      functions].
AB  - Incubation of aldehyde dehydrogenase-free mitochondrial preparations with
      biogenic amines serotonin, tyramine, 2-phenylethylamine and 5-methoxytryptamine
      resulted in inhibition of enzymes activity of both outer (rotenone-insensitive
      NADH-cytochrome c reductase) and inner (succinate dehydrogenase, succinate
      cytochrome c reductase) mitochondrial membranes. Solubilization of mitochondria
      after the incubation did not influence the amine-induced alteration of succinate
      dehydrogenase activity. Pretreatment of the organelles with a mixture containing
      chlorgyline and deprenyl completely inhibited monoamine oxidase (MAO) activity
      and prevented the effects of all the amines studied on mitochondrial enzymes. MAO
      dependent effects of 5-methoxytryptamine were fully reproduced by 5
      methoxyindolyl-3-acetaldehyde (one of probable products of 5-methoxytryptamine
      deamination). The effect of the aldehyde was not prevented by chlorgyline and
      deprenyl. After selective inhibition of MAO-A by chlorgyline the order of MAO-B
      dependent effects of biogenic amines on mitochondrial enzymes studied was as
      follows: tyramine greater than or equal to 2-phenylethylamine much greater than
      serotonin. In deprenyl pretreated mitochondria the potency of MAO-A-dependent
      effects of these amines was: serotonin greater than tyramine much greater than
      much greater than 2-phenylethylamine. The data obtained suggest that the
      product(s) of oxidative deamination of biogenic amines (probably the aldehydes)
      catalyzed by both types of MAO (MAO-A and MAO-B) are able to regulate the energy
      functions of mitochondria.

PMID- 1759391
TI  - [Antigenic properties of lactate dehydrogenase isoenzymes of various biological
      types using antipeptide antibodies to a fragment of the active center of swine
      lactate dehydrogenase-M4].
AB  - Antigenic properties of human, pig, rabbit and rat lactate dehydrogenase (LDH) M4
      isozyme as well as of human LDH-C4 were studied using antipeptide antibodies
      against pig LDH-M4 fragment (180-214). Amino acid sequence 180-214, containing
      His-195, which is involved in the active site of LDH isozymes, proved to be total
      antigenic determinant only for human and pig M4-isozymes. Amino acid sequence of
      total antigenic determinant did not allow any substitutions of essential amino
      acid residues. His-195, participating in substrate binding, was not involved
      immediately in reactions with antibodies as shown by means of chemical
      modification of pig M4-isozyme with diethyl pyrocarbonate and after production of
      antibodies against the modified isoenzyme.

PMID- 1759392
TI  - [Chemical modification of the functional groups of streptokinase B in the water
      soluble carbodiimide-nucleophile system].
AB  - Specific activity of streptokinase was decreased after incubation in the system
      containing I-ethyl-3(3-dimethyl aminopropyl) carbodiimide (EDC)--ethylene
      diamine. Under these conditions about 8 free amino groups and 38 free carboxylic
      groups were modified in the streptokinase molecule. The protein conformation and
      the state of tryptophane residues were altered. The streptokinase modified by
      means of EDC-ethylene diamine treatment lost its ability to form a stable complex
      with human plasminogen.

PMID- 1759393
TI  - [Irreversible pH-denaturation of tissue thromboplastin].
AB  - Irreversible denaturation of tissue thromboplastin from human brain occurred at
      pH values below 5.0 and above 11.0. Coagulating activity of total phospholipid
      fraction of thromboplastin was decreased after incubation in acid or alkaline
      media.

PMID- 1759394
TI  - [The effect of actinomycin D on lysosomal proteinase activity in murine
      macrophages and spleen during immune response].
AB  - Actinomycin D inhibited activation of lysosomal cathepsins A, B, C, D, H and L in
      peritoneal macrophages, caused by T-dependent antigen (sheep erythrocytes), of
      mice CBA X C57BL/6 strain. At the same time, the antibiotic stimulated activity
      of cathepsins A, C, D and H but decreased content of antibody-producing cells in
      spleen tissue. Inhibition of lysosomal proteinases in macrophages may be
      responsible for immunodepressive effect of actinomycin D.

PMID- 1759395
TI  - [Lysosomal leukocyte glycosidases in childhood bronchial asthma].
AB  - Activity of lysosomal glycosidases beta-galactosidase, N-acetyl-beta-D
      galactosaminidase and N-acetyl-beta-D-glucosaminidase was studied in lymphocytes
      and neutrophils of children with bronchial asthma. Alterations of the enzymatic
      activity were found to depend considerably on the disease stage, form, severity,
      duration and on the sensitization efficiency. Activity of these enzymes was
      markedly decreased after glucocorticoid treatment while clenbuterol did not
      affect their activity. The status of leukocyte lysosomal glycosidases appears to
      be of importance for development of bronchial asthma in children.

PMID- 1759396
TI  - [Isolation and characteristics of fibronectin from fibrinolytically active human
      plasma].
AB  - Properties of fibronectin, isolated by means of affinity chromatography from
      blood plasma of suddenly dead persons, were studied. This blood exhibited high
      fibrinolytic potential and was not capable of clotting due to degradation of
      fibrinogen. At the same time, fibronectin was also isolated from blood plasma of
      healthy volunteers. Properties of these fibronectins of dissimilar origin were
      studied using the following parameters: content of immunoreactive and bioreactive
      fibronectin in blood plasma, affinity towards gelatin, yield of fibronectin from
      blood plasma, molecular mass, heterogeneity. Both these fibronectins from
      different sources of blood plasma were similar in their properties studied, thus
      demonstrating that any significant degradation of fibronectin did not occur in
      hyperfibrinolysis in vivo.

PMID- 1759397
TI  - [Kinetic characteristics of monoamine oxidase in brain regions of animals with
      varying degrees of sensitivity to 1-methyl, 4-phenyl, 1,2,3,6-
      tetrahydropyridine].
AB  - Kinetic parameters of monoamine oxidase (MAO) were studied in synaptosomal
      fraction P2 of brain compartments obtained from mice, rats, rabbits, cats, dogs,
      guinea pigs, macaque rhesus, green and javanese macaques using I-methyl-4-phenyl
      1,2,3,6-tetrahydropyridine (MPTP) as a substrate. Rates of MAO-catalyzed
      reactions were also studied in animals sensitive to the dopaminergic neurotoxin.
      At low concentrations of MPTR (about 1-5 mM) the rate of MAO reaction
      corresponded to the index Vmax/Km. Among the animals studied the highest values
      of the index were found in guinea pigs and macaque rhesus, the lowest values --
      in rabbits. Value of the Vmax/Km index correlated with neurosensitivity to MPTP
      in neuromelanin-positive and neuromelanin-negative animal groups. The biochemical
      index for estimation of MAO-catalyzed reactions rates may be used in evaluation
      of brain compartments neurosensitivity to the dopaminergic neurotoxin and its
      derivatives.

PMID- 1759398
TI  - [Use of chloral hydrate for assessing the detoxifying function of the liver in
      experimental pathology].
AB  - A new procedure, developed for evaluation of the liver tissue detoxicating
      activity in experimental pathology, involved estimation of chloral hydrate
      pharmacological efficiency and registration of animal sleep duration. As activity
      of uridine phosphate glucuronyl transferase, the key enzyme of the second step of
      biotransformation, was found to be inhibited after thermic burns, treatment of
      the disease using phenobarbital appears to correct the enzymatic activity.

PMID- 1759399
TI  - [Importance of studying the level of platelet adenine nucleotide levels in
      various phases of chronic myeloleukoses].
AB  - Content of adenine nucleotides was studied in various compartments of blood
      platelets obtained from donors and patients with chronic myeloleukosis at various
      steps of the disease. Dissimilar biochemical defect was found in content of ATP
      and ADP, which varied in thrombocyte storage granules depending on severity of
      the disease. The data on adenine nucleotides content may be used for diagnosis of
      various steps of chronic myeloleukosis, for detection of thrombocytes anomaly and
      for evaluation of the state of medullary hemopoiesis.

PMID- 1759400
TI  - [Qualitative and quantitative assessment of blood erythrocytes of intact animals
      under the effect of 5-fluorouracil in solution and in microspheres made of
      acetylcellulose combined with short-term gas hypoxia].
AB  - Resistance of erythrocyte membranes, estimated by means of ultrasound hemolysis,
      was altered 7 days before the cells quantitative changes after simultaneous
      treatment of intact animals with 5-fluorouracil, administered as solution or in
      acetate cellulose drug-containing granules, and short-term gas hypoxia.
      Simultaneous effect of 5-fluorouracil and hypoxia was less toxic for
      erythropoiesis, while the long-term form of the drug did not affect considerably
      the liver tissue functions.

PMID- 1759401
TI  - [Behavior of ketoamine in animals].
AB  - A simple ketoamine 14C-fructosoglycine with all the fructose carbon atoms
      labelled was synthesized for studies of possible pathways of the ketoamines
      metabolism in animal body. The ketoamine bond in the fructosoglycine was not
      hydrolyzed during incubation with homogenates of rabbit liver, kidney, spleen and
      testicular tissues within 3 hrs at pH 4.8 and 7.3 as well as after hydrolysis
      with pancreatine (the enzymatic extract from bovine pancreas) at pH 8.4. 14C
      fructosoglycine administered into rabbit circulation was mainly excreted with
      urine (about 70% of the label) within 8-14 days. The main part of the ketoamine
      was excreted as fructosoglycine and the lower amount--as glycated dipeptide; some
      amount of fructosoglycine was hydrolyzed liberating fructose or converted into
      aldimine which was hydrolyzed with formation of glucose. The ketoamine was
      metabolized also into non-reducing isosucrose-like glucofructoside, insensitive
      to acid and enzymatic hydrolysis.

PMID- 1759402
TI  - [Anti-radiation activity of alpha- and beta-globulins in blood plasma].

PMID- 1759403
TI  - [Effect of thyrotoxicosis on lipid fatty acid composition in various subcellular
      fractions of the rat brain].
AB  - Thyrotoxicosis, which developed after subcutaneous administration of L-thyroxin
      at a dose of 400 micrograms/100 g of body mass, was accompanied by distinct
      alteration of fatty acid composition in lipids of adult rat brain myelin,
      synaptosomes, mitochondria and microsomes. The most significant alterations were
      detected in synaptosomes and mitochondria. Under conditions of thyrotoxicosis the
      ratio of polyunsaturated docosahexaenic and docosatetraenic acids was decreased
      in synaptosome lipids, whereas the content of palmitic, oleic and neuronic acids
      was increased. The ratio of unsaturated arachidonic and docosahexaenic fatty
      acids was increased but content of palmitic and linoleic acids was decreased in
      mitochondrial lipids.

PMID- 1759404
TI  - [Prospects for correcting the disrupted status of the cardiovascular system in
      acute myocardial ischemia by combined experimental use of phosphocreatine and
      corinfar].
AB  - Individual and simultaneous influence of phosphocreatine and calcium antagonist
      corinfar on hemodynamics patterns was studied in experimental acute ischemia of
      myocardium. Simultaneous treatment with phosphocreatine and corinfar may be
      effective in ischemic impairment of myocardium.

PMID- 1759405
TI  - [Role of individual phospholipids in the functional activity of human myocardial
      creatine kinase].
AB  - Regulating effect of individual phospholipids on the activity of creatine kinase
      MM from human myocardium was studied. Cardiolipin, phosphatidic acid,
      phosphatidyl serine and phosphatidyl choline (dipalmitoyl) stimulated the
      enzymatic activity, while phosphatidyl inositol and lysophosphatidyl choline
      inhibited the creatine kinase MM activity by 80-100%. When mechanisms of the
      phospholipids inhibitory effects were studied, mixed type of inhibition was
      detected in the presence of phosphatidyl inositol and non-competitive type--in
      presence of lysophosphatidyl choline if guanidine was used as a substrate.
      Phosphatidyl inositol and lysophosphatidyl choline inhibited creatine kinase MM
      by the uncompetitive type if ADP was used as a substrate.

PMID- 1759406
TI  - [Disrupted glycerophosphate metabolism in kidney tissue in an inflammatory
      bronchopulmonary process].
AB  - Specific alterations in glycerokinase and glycolytic pathways of glycerophosphate
      biosynthesis were detected in kidney under conditions of chronic bronchopulmonary
      inflammation. Considerable inhibition of glycerol kinase and glycerophosphate
      dehydrogenase resulted in pronounced decrease in content of glycerophosphate-
      initial metabolite of phosphatide genesis.

PMID- 1759407
TI  - [The effect of selenium on enzymes metabolizing xenobiotics in rat liver].
AB  - Activity of enzymes involved in metabolism of xenobiotics was not altered in
      liver tissue of rats kept on a ration enriched with selenium at a dose of 2.5
      mg/kg. Both organic form of selenium (yeast meal, selenomethionine) and inorganic
      derivatives (sodium selenite) at a dose of 5 mg/kg of ration caused distinct
      activation of epoxide hydrolase, UDP-glucuronosyl transferase and glutathione
      transferase within 6 weeks after the experiment beginning, while content of
      cytochrome P-450, glutathione-SH and glutathione peroxidase activity were not
      significantly altered. Within 9 weeks the enzymatic activity remained at the
      higher rate only in rats kept on the ration with sodium selenite. Relationship
      between toxic effects of selenium high doses and alterations in activity of
      enzymes involved in metabolism of xenobiotics is discussed.

PMID- 1759408
TI  - [Comparison of biochemical criteria for supplying the human body with
      riboflavin].
AB  - Various biochemical procedures were used in evaluation of vitamin B2 occurrence
      in 38 women. Highly specific procedures for evaluation of riboflavin in blood and
      urine (high performance liquid chromatography, titration with riboflavin-binding
      apoprotein, lumiflavin procedure) enabled to detect correlation between values of
      FAD-effect and excretion of riboflavin with urine as well as of total riboflavin
      content in erythrocytes, between concentration of free riboflavin in blood plasma
      and its excretion with urine. All the procedures studied were equally suitable
      for evaluation of vitamin B2 deficiency as shown by the data obtained as well as
      by similarity in values of low concentrations which corresponded to normal
      availability of the vitamin.

PMID- 1759409
TI  - [Effect of alpha-tocopherol and selenium on the activity of antioxidant enzymes
      and level of lipid peroxidation products in erythrocytes of patients with
      cerebral ischemia].
AB  - Antioxidant drugs: alpha-tocopherol acetate and "Selenium" (Finland) were used in
      treatment of patients with small ischemic insult and middle severity ischemic
      insult; the state of endogenous antioxidant system and intensity of lipid
      peroxidation were studied in erythrocytes within various periods of diseases.
      Content of diene conjugates and malonic dialdehyde was decreased, while activity
      of superoxide dismutase, catalase, glutathione peroxidase and reductase was
      increased after administration of both these antioxidants during treatment of the
      brain circulation impairments. Simultaneous use of the drugs caused the highest
      effect which occurred due to their influence on various pathways of the
      endogenous antioxidant system.

PMID- 1759410
TI  - [Effect of a carnitine analog on the level of bile lipids of the enterohepatic
      system in rabbits in cholelithiasis].
AB  - Lipid components were studied in enterohepatic system of rabbits with
      cholelithiasis after administration of plant components contained in meadow hay
      as well as of their mixture with a synthetic analogue of carnitine. Hypothetic
      mechanism of the carnitine derivative effect, contributing to elevation of
      phosphatidyl choline production in hepatocytes and to accumulation of the
      phospholipid in bile, is discussed. During the treatment course the calculous
      form of hepatocholecystitis was not detected in the experimental animals.

PMID- 1759411
TI  - [Analysis of the reasons for insufficient efficacy of treating inflammatory
      diseases of the urogenital system in women].
AB  - Concentration of tetracycline, doxicyclin and tarivide was studied in blood
      serum, urine and immediately in the impaired focus, in uterine tube tissue to
      elucidate the factors responsible for low therapeutic efficiency of drugs
      involved in treatment of inflammatory diseases of women urogenital system.
      Content of tetracycline, detected in the patients blood and urine, varied within
      the limits 0.02-0.12 microgram/ml and 0.003-0.136 microgram/ml, respectively,
      depending on the period of administration of therapeutic doses of the antibiotic.
      At the same time, in uterine tube tissue concentration of tetracycline was only
      slightly increased and constituted 0.014 microgram/ml which was distinctly lower
      than the minimal inhibitory content for the antibiotic. Similar results were
      obtained in studies of tarivide concentrations. Both morphofunctional impairments
      of uterine tubes and deficiency of antibiotics in the impaired focus were
      responsible for inadequate treatment of women with infertility of inflammatory
      genesis.

PMID- 1759412
TI  - [Rapid time-resolved fluoroimmunometric analysis of myoglobin].
AB  - High performance quantitative procedure for evaluation of myoglobin in blood
      serum is developed. The principle of two-site immunometry was used involving
      monoclonal antibodies against nonoverlapping epitopes of myoglobin molecule. The
      fluorescent compound containing europium served as a label of the antibody.
      Modification of the single-step assay enabled to increase the velocity of the
      assay to about 30 min and simplify it. The assay allowed estimation of myoglobin
      over a broad range of concentrations from 2 ng up to 1,000 ng/ml. The assay may
      be recommended for use in clinical practice for express diagnosis of myocardium
      infarction.

PMID- 1759413
TI  - [Cholesterol esterification in tissues and change in the apoprotein spectrum in
      rat blood under the effect of auto-oxidized cholesterol].
AB  - Influence of autooxidized cholesterol (Ch) products on accumulation of
      cholesterol esters (ChE) in liver and aorta tissues as well as alteration of the
      apolipoprotein spectrum in low density and very low density (LDL and VLDL)
      lipoproteins in blood plasma was studied in rats treated with purified Ch (ChP
      rats) and with oxidized Ch containing 5% 25-hydroxyCh and 3% 7-ketoCh (ChO-rats).
      Increase of ChE content in liver tissue of ChO-rats resulted in two-fold
      activation of acyl-CoA-cholesterol-O-acyltransferase (ACAT) in liver microsomes
      as compared with the enzymatic activity rate in ChP-rats. As shown by
      polyacrylamide gel electrophoresis content of apoE in VLDL and LDL of ChO-rats
      was 1,5-fold higher as compared with that of ChP-rats. Content of apoIV was
      increased in LDL and VLDL of ChP-rats as compared with controls; this effect was
      not observed in ChO-rats. LDL and VLDL from ChO-rats stimulated incorporation of
      14C-oleate into ChE of cultivated macrophages. Increase in content of ChE found
      in aorta of ChO-rats appears to occur due to activation of Ch esterification.
      Intensification of ChE synthesis in tissues and alterations in the spectrum of
      LDL and VLDL apolipoproteins caused by oxidized products of cholesterol may be
      one of the mechanisms involved in atherogenesis.

PMID- 1759414
TI  - [Diagnostic difficulties in lung mycoses].

PMID- 1759415
TI  - [Carcinoid of the appendix].

PMID- 1759416
TI  - [An outbreak of legionellosis among the workers of an industrial enterprise].

PMID- 1759417
TI  - [The medico-demographic situation in the Ukrainian SSR at the present stage].

PMID- 1759418
TI  - [The malignant neoplasm morbidity of the population of the Ukraine in 1976-1989].

PMID- 1759419
TI  - [The medical aspects of a systems approach to decreasing morbidity with temporary
      loss of work capacity].

PMID- 1759420
TI  - [The role of expert assessments and pilot observations in social hygiene research
      on life styles].

PMID- 1759421
TI  - [The ethical problems of the rights of unborn children].

PMID- 1759422
TI  - [Ukrainian medicine in the mirror of philately].

PMID- 1759423
TI  - [Enterosorption: achievements, problems, outlook].

PMID- 1759424
TI  - [Functional diseases of the digestive organs].
AB  - In this lecture the authors analyze so-called functional disease of the digestive
      organs, namely disorders of these organs where modern means are unable to reveal
      organic changes. The role of emotional and psychic factors on functions of the
      digestive tract and its blood supply is stressed. From 30 to 50% of
      gastroenterological patients suffer of functional diseases of the digestive
      organs. Women prevailed (3:1, 2:1). The etiology, diagnosis and treatment of this
      condition is described in detail.

PMID- 1759425
TI  - [The methodological characteristics of examining and treating patients with
      borderline mental disorders].
AB  - Discussed are problems of the methodology of diagnosing neuroses, neurosis-like
      and other borderline mental disorders. The necessity is emphasized of complex and
      systemic analysis of general somatic, psychological and psychopathological
      states. An important place is taken by dynamic analysis of the development of
      pathological states. The importance of these methodology problems for
      pathogenetic treatment of patients with borderline mental diseases is discussed.

PMID- 1759426
TI  - [The current concepts of the etiology and pathogenesis of atrial fibrillation].

PMID- 1759427
TI  - [The immune mechanisms of recurrent myocardial infarcts].

PMID- 1759428
TI  - [The level of vasoactive prostanoids in patients with ischemic heart disease in
      the early period following aortocoronary bypass].

PMID- 1759429
TI  - [An evaluation of the kinin and sympathetic-adrenal systems and prostanoids in
      rheumatism with a heart rhythm disorder].
AB  - A comparative study is presented of some components of the kinin, sympathetic
      adrenal system and plasma prostacyclin in 296 patients with active rheumatism of
      different activity grades and disorders of the cardiac rhythm. Data were obtained
      on the activation of the sympathetic-adrenal and kinin system in rheumocarditis
      with disorders of the cardiac rhythm. A relationship was established between the
      components of these systems. The content of prostacyclin in patients with
      rheumatism in the active phase was reduced. The effect of the mentioned
      biologically active substances on the development of arrhythmias is discussed.

PMID- 1759430
TI  - [HLA antigens in patients with different forms of arterial hypertension].
AB  - The authors analyze the frequency of HLA [correction of HIA] antigens in 121 male
      patients with borderline arterial hypertension and in 60 patients with
      hypertensive disease, stage II. The frequency of HLA [correction of HIA] antigens
      in these patients was compared with their frequency in the male population of
      Leningrad inhabitants (858 healthy donors). Patients with borderline arterial
      hypertension showed a characteristic increase of the frequency of B16, B18 CW4
      antigens. The presence of an increase representation of B18 and C4 antigens in
      both groups makes it possible to consider them as immunogenetic markers of the
      development of arterial hypertension.

PMID- 1759431
TI  - [A new approach to assessing the blood biochemical indices in diseases of the
      internal organs].
AB  - The authors propose a new approach to evaluation of biochemical indices in
      internal organ diseases, namely, comparison of factually detectable results with
      individual initial data. It was established that in stenocardia the majority of
      patients showed an increase of activity of cardio-specific enzymes. Patients with
      exacerbation of obstructive bronchitis revealed diverse changes of the content of
      immunoglobulins, complement components and proteinase inhibitors. The authors
      suggest that an individual approach to comparison of laboratory indices reflects
      more precisely the response of the patient's body to the pathological process.

PMID- 1759432
TI  - [Xenogeneic splenic perfusion in the treatment of bronchial asthma patients].
AB  - Blood morphology, external respiratory function, central hemodynamics, cellular
      and humoral immunity, circulating immune complexes, average molecules and
      leucocytic index were examined in 40 patients with a severe and average severe
      course of infection-dependent bronchial asthma before and after
      xenosplenoperfusion. Positive clinical results were noted manifested in an
      increase of the immune reactivity, improvement of external respiratory function.
      The method should be used with care due to additional sensibilization of the
      patient and possible bronchospasm.

PMID- 1759433
TI  - [The correction of disorders in the blood coagulating system during the surgical
      treatment of patients with pulmonary tuberculosis].

PMID- 1759434
TI  - [Changes in the bioenergetic processes and immunoglobulin transport in the
      stomach tissues of rats after vagotomy].
AB  - Data are reported on changes of bioenergetic processes and immunoglobulin
      transport in gastric tissues after bilateral subdiaphragmatic transsection of the
      vagal nerves. It was established that the mucosa and muscle membrane of the
      stomach showed a reduced activity of the glycolysis enzyme. There was also
      abnormal transport of autogenic immunoglobulins, namely increased penetration of
      immunoglobulins into the connective-tissue stroma of the mucosa and the surface
      of epithelium into the gastric cavity. The protein transport into the endomysium
      of the muscle membrane was sharply reduced. It is concluded that the above
      mentioned changes reflect development of neurogenic dystrophy after vagotomy.

PMID- 1759435
TI  - [The beta 2-microglobulin content of the blood serum and urine in patients with
      primary chronic and lupus glomerulonephritis].
AB  - The authors studied the content of beta 2-microglobulin (beta 2-MG) in the blood
      serum and its excretion with the urine in 85 patients with chronic and 35 with
      lupoid glomerulonephritis (CGN and LGN) depending on the activity of the disease
      and state of the renal function. In active CGN and LGN one could observe a
      distinct increase of the content of beta 2-MG in the blood serum and an increase
      of its excretion with the urine that may be related to presence of marked
      dystrophic changes of the canalicular apparatus of the kidneys leading to
      disorders of reabsorption and beta 2-MG catabolism as well as disorders of the
      immune homeostasis revealed in these diseases. Results indicate that the beta 2
      MG levels in the blood serum and urine may be considered as criteria of CGN and
      LGN activity.

PMID- 1759436
TI  - [The dynamics of the psychoemotional state in patients with vibration disease].
AB  - Data are presented on the formation of neuropsychic disorders in mine shaft
      sinkers and drill operators at different stages of vibration disease.
      Neuropsychic disorders in this category of workers should be considered in the
      treatment and expertise examination of working capacity.

PMID- 1759437
TI  - [Infectious-toxic shock in patients with acute pneumonia].
AB  - An analysis of case records, medical documentation of the emergency service and
      out-patient departments of 629 patients with acute pneumonia (AP) showed that
      infectious-toxic shock was an early grave complication of acute pneumonia. It was
      observed in 9.4% of patients with acute pneumonia and resulted in a fatal outcome
      in 5.1%. Infectious-toxic shock developed prevalently in males of young or middle
      age suffering of concomitant diseases in acute pneumonia due to viral-bacterial
      associations. At the pre-hospital period shock was detected only in 5.1% of
      patients due to inadequate examination, underestimation of symptoms and their
      erroneous interpretation. Clinical manifestations of infectious-toxic shock,
      their polymorphism may masquerade acute pneumonia symptoms and lead to diagnostic
      errors.

PMID- 1759438
TI  - [Thermography in assessing the microcirculation of patients with acute and
      chronic viral hepatitis].
AB  - The important role is emphasized of microcirculatory disorders in the
      pathogenesis of viral hepatitis and the necessity of their early diagnosis. For
      this purpose the method of infrared thermography of the upper extremities (hands)
      was used that allowed to reveal pronounced disorders of the peripheral
      hemodynamics in a significant number of patients with acute and chronic viral
      hepatitis, in particular, hepatitis B that promoted a more severe, progressive
      course of the disease. It is concluded that for instituting pathogenetically
      substantiated treatment, prognosis and prevention of unfavourable outcomes it is
      necessary to supplement clinico-laboratory data by instrumental examination of
      the terminal blood flow, in particular, thermography of the extremities.

PMID- 1759439
TI  - [The pathogenetic and prognostic significance of the level of class-E
      immunoglobulins in erysipelas].
AB  - The authors determined the content of total immunoglobulins of the E class in the
      blood plasma: native (IgE) and exhausted by a streptococcal allergen in the
      dynamics of the disease in 145 patients with erysipelas. The level of
      antistreptococcal reagins was evaluated. It was established that at the onset of
      erysipelas the concentration of IgE and a-IgE showed a short-term increase in 52
      +/- 4% and 87 +/- 3% of patients correspondingly. During convalescence the level
      of these antibodies did not differ from that of the normal excluding high risk
      patients for recurrence. The participation of IgE-mediated type of allergic
      reactions in the pathogenesis of erysipelas is suggested. It is recommended to
      use the content of IgE and a-IgE for the prognosis of immediate and remote
      recurrences of erysipelas.

PMID- 1759440
TI  - [The phytotherapy of patients with arterial hypotension].

PMID- 1759441
TI  - [Phytotherapy in digestive organ diseases].

PMID- 1759442
TI  - [Enterosorbent SKN in the combined rehabilitative treatment of patients who have
      had a myocardial infarct].
AB  - A study of 34 patients with 2-3 months history of myocardial infarction revealed
      that 10-day course of treatment with SKN enterosorbent resulted in normalization
      of lipid peroxidation and several indices of lipid metabolism. These changes were
      in a part of the patients accompanied by an increase of tolerance to physical
      load and reduced requirement of the myocardium in oxygen.

PMID- 1759443
TI  - [The significance of the ergometrine test for the diagnosis of ischemic heart
      disease and the choice of antianginal treatment].
AB  - A study of 68 patients showed that the ergometrine test is a rather informative
      method of the diagnosis of ischemic heart disease that supplements essentially
      the results of loading tests. The authors demonstrate the possibility of using
      the ergometrine test with the purpose of evaluating the effect of antianginal
      therapy.

PMID- 1759444
TI  - [The clinical and treatment characteristics of patients with herpes zoster in
      different locations].
AB  - An analysis is presented of the clinical course and results of treatment of 102
      patients with herpes zoster. The spinal ganglia of the thoracic region and
      trigeminal nerve ganglia were most frequently involved. The disease was
      manifested not only in local disorders but also in generalized systemic
      vegetative-trophic and vascular disorders. The authors report a high therapeutic
      efficiency of complex treatment of patients with herpes zoster using antiviral,
      antiherpetic and detoxification agents, immunostimulators, vegetotropic drugs,
      physiotherapy and ointment applications.

PMID- 1759445
TI  - [The activity of superoxide dismutase and of the metabolites of lipid
      peroxidation in an acute inflammatory process].

PMID- 1759446
TI  - [A case of exudative erythema multiforme (a clinico-immunological study)].

PMID- 1759447
TI  - [The intravital diagnosis of a dissecting aneurysm of the ascending aorta
      complicated by hemopericardium].

PMID- 1759448
TI  - An explanatory model of diabetes.

PMID- 1759449
TI  - Preterm infants' physiologic responses to early parent touch.

PMID- 1759450
TI  - The appraisal of pain and coping in cancer patients.

PMID- 1759451
TI  - Nurses' risk taking regarding HIV transmission in the workplace.

PMID- 1759452
TI  - Relationship between head nurse responses to staff nurses and staff nurse
      responses to patients.

PMID- 1759453
TI  - Real and ideal hospital work environments in juxtaposition.

PMID- 1759454
TI  - Predictive validity of examinations for assessing student nurses.

PMID- 1759455
TI  - Use of computers for nursing minimum data set and nursing home cost studies.

PMID- 1759456
TI  - Issues related to reliability of videotaped observational data.

PMID- 1759457
TI  - [Experiences with liver transplantation in hepatitis B antigen positive liver
      cirrhosis].
AB  - From 1982 to January 1991 228 orthotopic liver transplantations (OLT) were
      performed in 213 patients with end-stage disease at the Vienna transplantation
      centre, 1st University Department of Surgery. 14 patients were serum HBV surface
      antigen (HBsAg) positive at the time of transplantation. In the first 4 patients
      only OLT was performed; postoperatively all grafts became reinfected and the
      patients developed chronic hepatitis. In a further series, immunoprophylaxis
      against hepatitis B virus reinfection was carried out with hyperimmuneglobulin.
      In 4 patients short-term immunoprophylaxis was performed; all of them were
      seronegative after OLT, but HBsAg ++reoccurred in the serum within 3-16 weeks
      after transplantation and all patients experienced reinfection of their graft.
      The 2 patients, who had been transplanted in a replicative state (HBeAg positive)
      showed a fatal course of hepatitis in the graft. Out of 6 patients given long
      term immunoprophylaxis 3 cases showed stable liver function, without any signs of
      reinfection, and the HBsAg negative status remained for up to 19 months after
      transplantation. Since two patients displayed a HBV replicate status prior to
      transplantation, alpha interferon was administered preoperatively, which resulted
      in decreased serum HBV-DNA levels.

PMID- 1759458
TI  - [Dysfunction of the sphincter of Oddi as a cause of so-called postcholecystectomy
      syndrome].
AB  - In up to 30% of cases of the so-called postcholecystectomy syndrome functional
      disturbances of the sphincter of Oddi are responsible for the clinical picture.
      These pathological changes in pressure and motility at the sphincter can be
      identified by means of endoscopic manometry. We found dysfunction of the
      sphincter of Oddi in 4 out of 10 patients with so-called postcholecystectomy
      syndrome. In 2 patients in whom the basal pressure was higher than 40 mmHg
      endoscopic papillotomy was performed, after which the patients remained symptom
      free. In one case tachyoddi was diagnosed and in another case the proportion of
      retrograde sphincter contractions exceeded 50%. Endoscopic manometry at the
      sphincter of Oddi enables many of the as yet unclarified postcholecystectomy
      symptoms to be identified.

PMID- 1759459
TI  - [Endocrinologic function following cranial irradiation in acute lymphoblastic
      leukemia in childhood].
AB  - Endocrinological function was evaluated in 31 children after successful treatment
      of acute lymphoblastic leukaemia. All patients had received combination
      chemotherapy and 12-24Gy of cranial irradiation according to the German therapy
      protocols BFM-81, BFM-83 and BFM-86. Height, weight, bone age and pubertal
      development, as well as hypothalamic-pituitary function were measured. Long-term
      linear growth was unaffected in all patients. However, 9 patients showed
      subnormal serum growth hormone levels in response to pharmacological stimulation
      of the pituitary. All patients had normal levels of T3 and T4, but one patient
      showed an increased response of thyrotropin to thyrotropin releasing hormone. All
      prepubertal and postpubertal children demonstrated appropriate secretion of
      follicle-stimulation hormone (FSH) and luteinizing hormone (LH) after stimulation
      with LH-releasing hormone (LH-RH). 3 pubertal girls showed adequate oestradiol
      levels, but abnormally high levels of gonadotropins in response to LH-RH. Sexual
      development was normal in two of them, but the third had a late menarche and
      irregular menses. The significance of these findings is discussed in the context
      of recommendations possibly to further reduce or completely delete prophylactic
      cranial irradiation.

PMID- 1759460
TI  - [Paul de Sorbait (1624-1691): on the 300th anniversary of his death].
AB  - The life of Paul de Sorbait (1624-1691), who was Professor of Medicine, Dean of
      the Medical School, and Rector Magnificus at Vienna University, is reviewed on
      the occasion of the 300th anniversary of his death.

PMID- 1759461
TI  - [Low dosage long-term treatment with recombinant alpha interferon induces in
      hairy cell leukemia continuous complete remission].
AB  - Long-term treatment with recombinant interferon alpha (IFN) leading to complete
      remission in a patient with hairy cell leukaemia is presented. Four months after
      the beginning of treatment with IFN, the parameters of the peripheral blood had
      normalized. In spite of a continuous dose reduction (to a dose of 1 Mio. U/week)
      remission could be maintained during the six years of treatment. Two years after
      the start of treatment with IFN, a metastasizing carcinoma of the prostate was
      diagnosed, leading to death after four years. With regard to the hairy cell
      leukaemia, the patient was free of symptoms and the obduction confirmed the
      complete remission: the histological examination of bone marrow, spleen, liver
      and lymph nodes showed no more signs of hairy cell leukaemia. This case report
      shows that long-term treatment with IFN in some cases is effective to induce and
      to maintain complete remission in hairy cell leukaemia.

PMID- 1759463
TI  - The challenge to health insurers. 'Medicina nusquam non est' (medicine is
      universal): VI.

PMID- 1759462
TI  - [Medicamentous modification of vascular tone in varicose vein patients:
      comparative study of venous compliance technique and digital
      photoplethysmography].

PMID- 1759464
TI  - Where there's smoke, there's fire.

PMID- 1759465
TI  - Factors in the economics of health care.

PMID- 1759466
TI  - But it just looked like an insect bite .... A case of myrasis in Wisconsin.

PMID- 1759467
TI  - Ulnar neuropathy caused by an accessory abductor digiti minimi muscle.
AB  - Peripheral neuropathies of the ulnar nerve at various locations in the upper
      extremity are common, but compression of the ulnar nerve at the level of the
      wrist due to an anomalous muscle is rare, though reported in the literature.
      Three cases of an abnormal abductor digiti minimi origin were first reported by
      Wood in 1868, but no mention was made of an associated ulnar neuropathy. To data,
      there have been 8 reported cases of an anomalous abductor digiti minimi, with
      sensory or motor abnormalities of the ulnar nerve the most common presentation.
      This case report describes a patient who had subjective paresthesiae in the ulnar
      nerve distribution for 2 years. He was found, at exploration, to have an
      anomalous muscle belly originating proximally from the deep forearm fascia with
      insertion into the abductor digiti minimi. We present the case, discuss the
      spectrum of compression neuropathies of the ulnar nerve at the wrist, and a
      review of the occurrence of anomalous muscles responsible.

PMID- 1759468
TI  - Diagnostic dilemma for the 1990s: Lyme disease versus rheumatic fever.
AB  - A 15-year-old boy developed an annular erythematous skin rash, fever, knee pain,
      syncope, and was found to be in complete heart block requiring temporary
      transvenous pacing. His recovery was complete following therapy with high dose
      steroids, aspirin, and IV ceftriaxone followed by oral penicillin. Serologic
      tests documented diagnostic levels of antibodies to Borrelia burgdorferi as well
      as to Group A streptococcal DNase B. Diagnoses of both Lyme disease and rheumatic
      fever are based on clinical presentation and serologic confirmation. Our patient
      had a clinical presentation compatible with either diagnosis and serologic test
      results suggestive of infection by both B burgdorferi and Group A streptococci.
      The patient's management was aimed at preventing complications of both diseases,
      since clinicians involved with the patient's case could not agree on the most
      likely diagnosis. We present this case to emphasize the following: both rheumatic
      fever and Lyme disease should be considered in patients presenting with annular
      skin rashes and complete heart block; serologic studies may be confusing in both
      Lyme disease and rheumatic fever since neither is entirely sensitive nor specific
      and efforts should be made to document the causative organism by appropriate
      cultures, biopsies, and stains when possible; and improved immunoserologic
      testing for Lyme disease, in particular, is highly needed.

PMID- 1759469
TI  - ASSIST Wisconsin.

PMID- 1759470
TI  - News you need on Medicare.

PMID- 1759471
TI  - [Early diagnosis and treatment results in breast carcinoma--a population-based
      analysis].

PMID- 1759472
TI  - [Changes in the surgical therapy of breast carcinoma against the background of a
      changing perspective in oncology].

PMID- 1759473
TI  - [Treatment results in breast carcinoma within the interdisciplinary therapy
      concept of the Charite].

PMID- 1759474
TI  - [Surgical therapy in non-invasive cancer of the breast].

PMID- 1759475
TI  - [Radiotherapy following radical surgery--indications - technique -
      complications].

PMID- 1759476
TI  - [Indications for radiotherapy in metastasizing breast carcinoma].

PMID- 1759477
TI  - [Hormonal and chemotherapy of advanced breast carcinoma].

PMID- 1759478
TI  - [Practical experiences with psychosocial rehabilitation in breast carcinoma].

PMID- 1759479
TI  - [Medical requirements resulting from old military burdens].

PMID- 1759480
TI  - [Dendritic spines and interneuronal integration. The problems and the prospects].

PMID- 1759481
TI  - [The epiphysis and the organization of behavior].

PMID- 1759482
TI  - [Noncontractile energy expenditure by transverse-striated muscle tissue].

PMID- 1759483
TI  - [An analysis of the hypotheses on the mechanisms of the vagus acceleration of
      heart beats].

PMID- 1759484
TI  - [The development of the hypothalamus in ontogeny. The differentiation of the
      neurosecretory neurons].

PMID- 1759485
TI  - [Basal ganglia and sensory systems: the motor-sensory dependence].

PMID- 1759486
TI  - [The reflex arches of the facial nucleus].

PMID- 1759487
TI  - Adverse reactions after injection of adsorbed diphtheria-pertussis-tetanus (DPT)
      vaccine are not due only to pertussis organisms or pertussis components in the
      vaccine.
AB  - Reactions to adsorbed diphtheria-pertussis-tetanus (DPT) vaccine have mostly been
      attributed to the pertussis organisms or pertussis components in the vaccine.
      Nevertheless reactions may also be due to other factors such as sensitization
      induced by aluminium adjuvants and impurities present in crude toxoids that
      cannot be removed by purification of toxoids after formalinization. Aluminium
      compounds such as aluminium phosphate and aluminium hydroxide are the most
      commonly used adjuvants with vaccines for human use. Due to the increasing
      concern about the toxicity of aluminium, other adjuvants like calcium phosphate
      may be evaluated as an alternative to aluminium adjuvants. To minimize reactions
      after immunization with DPT vaccine due to impurities in the toxoids, the use of
      toxoided purified toxins is suggested.

PMID- 1759488
TI  - Final report of the Keystone AIDS vaccine liability project. The Keystone Center.

PMID- 1759489
TI  - Efficacy of a Rift Valley fever virus vaccine against an aerosol infection in
      rats.
AB  - The formalin-inactivated Rift Valley fever virus (RVFV) vaccine, TSI-GSD-200, was
      administered subcutaneously to highly susceptible adult Wistar-Furth rats (LD50-1
      p.f.u., ZH501 strain). Vaccine was administered on days 0, 7 and 28, the same
      time course used for at-risk personnel. Six months postimmunization, when the
      serum plaque-reduction neutralization titre (PRNT)80 had declined to low or
      undetectable levels, rats were challenged with 4.4 log10 p.f.u. of the virulent
      ZH501 strain in a nose-only dynamic aerosol apparatus. Ninety-seven per cent
      (33/34) of the non-vaccinated control rats died. In contrast, only 32% (33/105)
      of the vaccinated animals died. In vaccinated rats that succumbed, there was a
      doubling of the mean time to death and the cause of death shifted from hepatitis
      to encephalitis. Rats with a PRNT80 of greater than or equal to 1:40 were
      protected from clinical disease and histological evidence of hepatic or
      encephalitic lesions. While the precise mechanisms of immunity against aerosol
      challenge remain unresolved, here the serum PRNT titre correlated with
      protection.

PMID- 1759490
TI  - Physicochemical and immunological characterization of recombinant host-protective
      antigen (VP2) of infectious bursal disease virus.
AB  - Small fusions to the N-terminal end of the host-protective antigen (VP2) of
      infectious bursal disease virus lead to stable expression of VP2 in Escherichia
      coli and yeast, and reduce the levels of inclusion body formation in E. coli in
      comparison to VP2 constructs with larger N-terminal fusions. VP2 produced with
      small N-terminal fusions, like native viral VP2, can be fractionated into a high
      molecular weight 'multimeric' form and a monomeric form. A virus-neutralizing
      monoclonal antibody that only recognizes undenatured VP2 preferentially reacts
      with multimeric forms of recombinant VP2. Both native and recombinant monomeric
      forms of VP2 are non-immunogenic. The multimeric forms of viral and yeast-derived
      VP2 are highly immunogenic, while those produced in E. coli are not.

PMID- 1759491
TI  - Safety and immunogenicity of hydrogen peroxide-inactivated pertussis toxoid in 18
      month-old children.
AB  - The immunogenicity and adverse effects of an acellular pertussis vaccine
      consisting of a purified pertussis toxin inactivated with hydrogen peroxide
      (PTxd) was evaluated. Children aged 15 to 30 months were injected with 10 (n =
      33) or 50 micrograms (n = 34) of PTxd or with diphtheria and tetanus toxoids and
      whole cell pertussis vaccine (DTP) (n = 34). All children had previously received
      three doses of DTP during infancy. Both dosages of PTxd induced higher IgG
      antibody (p less than 0.05 for 10 micrograms dose and p less than 0.01 for 50
      micrograms dose) and pertussis antitoxin responses (p less than 0.01 for 50
      micrograms dose) than DTP. The 50 micrograms dose gave slightly higher (though
      not significantly) antibody responses than the 10 micrograms dose of PTxd. None
      of the vaccines induced detectable IgM or IgA antibody responses to pertussis
      toxin. At 24 h, local reactions occurred in none of the children injected with 10
      micrograms PTxd, 12% with 50 micrograms PTxd and 78% with DTP. Fever at 24 h
      occurred in 13% after 10 micrograms PTxd, in none after 50 micrograms PTxd and in
      53% after DTP. Recipients of DTP, but not of PTxd, had significant increases in
      neutrophils and decreases in lymphocytes and haematocrit at 24 h (all p less than
      0.05). None of the groups showed changes in blood glucose at 24 h. PTxd induced
      pertussis toxin antibody levels similar to those observed in patients
      convalescing from natural pertussis. This acellular pertussis vaccine deserves
      further evaluation for safety and immunogenicity in infants and for efficacy in
      preventing pertussis.

PMID- 1759492
TI  - Phase I clinical trial of an acellular pertussis vaccine composed of genetically
      detoxified pertussis toxin combined with FHA and 69 kDa.
AB  - An acellular pertussis vaccine composed of genetically detoxified pertussis toxin
      (PT-9K/129G), filamentous haemagglutinin (FHA) and pertactin (69 kDa protein) was
      evaluated in adult volunteers, in double blind, versus placebo. No fever was
      reported in either group. Mild local reactions were reported after injection of
      both vaccine and placebo. After the first dose a marked increase in antibodies to
      PT, FHA and 69 kDa protein was seen in vaccinated subjects with the exception of
      one who responded well to PT and FHA but did not show a humoral response to the
      69 kDa protein. All vaccinees acquired cellular immunity against the three
      antigens. No significant variation was observed in the humoral or cellular
      responses after the second dose.

PMID- 1759493
TI  - Influenza immunization: intranasal live vaccinia recombinant contrasted with
      parenteral inactivated vaccine.
AB  - To compare the efficacy and duration of the immune response to local and systemic
      vaccination, Balb/c mice were vaccinated either intraperitoneally (i.p.) with an
      inactivated A/PR/8/34 (H1N1) vaccine or intranasally (i.n.) with a vaccinia
      recombinant containing the H1 gene of influenza. The i.p. inactivated vaccine
      stimulated high serum IgG anti-influenza titres and protected the lungs against
      viral challenge for the duration of the experiment (17 months). Little nasal wash
      IgA was induced and the noses were susceptible to challenge. Animals vaccinated
      i.n. with the recombinant had lower serum IgG titres and the lungs showed poor
      protection against challenge. Nasal wash IgA titres were higher, however, and the
      noses were largely protected from viral challenge for 17 months.

PMID- 1759494
TI  - Oral immunization with bacterial polysaccharide and adjuvant enhances antigen
      specific pulmonary secretory antibody response and resistance to pneumonia.
AB  - Nosocomial pneumonia, often due to Pseudomonas aeruginosa, occurs frequently
      after haemorrhage and trauma, and contributes to the increased incidence of
      morbidity and mortality in this clinical setting. In order to determine if
      enhancement of bacterial antigen-specific secretory IgA (sIgA) titres in the
      lungs can increase resistance to P. aeruginosa pneumonia following haemorrhage,
      we investigated oral immunization strategies, using bacterial polysaccharides
      (levan, from Aerobacter levanicum, and P. aeruginosa polysaccharide type I) and
      adjuvant (cholera toxin and the B-subunit of cholera toxin), capable of
      increasing bacterial polysaccharide-specific pulmonary secretory antibody titres.
      Oral co-administration of 1000 micrograms levan and 10 micrograms cholera toxin
      resulted in increased titres of levan-specific sIgA in lung lavages and increased
      numbers of levan-specific pulmonary plasma cells, but no changes in serum anti
      levan titres. Similarly, oral co-administration of 1000 micrograms P. aeruginosa
      polysaccharide and 10 micrograms cholera toxin produced increased anti-P.
      aeruginosa polysaccharide titres in lung lavages. Significant decreases in anti
      levan pulmonary sIgA titres and in numbers of levan-specific pulmonary plasma
      cells were found when oral immunization with levan and cholera toxin was
      performed 4 days following haemorrhage, but not if the mice were immunized 8 h
      after blood loss. Although haemorrhage markedly increased the susceptibility of
      mice to P. aeruginosa pneumonia, significant protection from mortality could be
      achieved through oral immunization with 1000 micrograms P. aeruginosa
      polysaccharide and 10 micrograms cholera toxin 8 h after haemorrhage. These
      results demonstrate that haemorrhage induces marked alterations in bacterial
      antigen-specific pulmonary B-cell responses, which contribute to the increased
      susceptibility to infection in this setting.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759495
TI  - Controlled release microparticles for vaccine development.
AB  - The primary and secondary sera IgG antibody responses to ovalbumin (OVA)
      entrapped in biodegradable poly(lactide-co-glycolide) (PLGA) microparticles were
      compared with the responses obtained with soluble OVA. In addition, OVA in PLGA
      microparticles was also administered after dispersion in an immunostimulatory
      vehicle, Freund's incomplete adjuvant (FIA). The primary IgG responses to OVA in
      microparticles/FIA were significantly greater than the responses to soluble OVA
      from day 14 to day 42, when booster immunizations were administered. From day 49
      to the end of the study at day 84, the responses to OVA, both in microparticles
      alone and in microparticles/FIA, were significantly greater than the responses to
      soluble OVA. Nevertheless, the responses obtained for OVA in microparticles or
      microparticles/FIA were, in general, not as high as those obtained with OVA in
      Freund's complete adjuvant.

PMID- 1759496
TI  - HIV vaccines.

PMID- 1759497
TI  - The quest for vaccines against AIDS: progress and challenges. An overview.

PMID- 1759498
TI  - The challenge of HIV vaccines.
AB  - Immunization of an animal or human being against an infectious agent provides
      levels of protection that are relative only. Protection can be overcome by high
      challenge doses. Even with a low challenge dose, protection can vary from
      absolute to relative. The invading pathogen may be neutralized and eliminated
      from the body before it can multiply; in this case, immunization provides
      protection against infection. More frequently, the infectious agent starts
      multiplying at the site of entry, which triggers an anamnestic immune response of
      the host. Rejection of the invader usually takes place before the appearance of
      overt clinical symptoms; in this case, immunization provides protection against
      disease. Protection against infection implies a strong pre-existing immune
      barrier. Protection against disease mostly relies on immune memory and the
      possibility for the host of mounting a rapid immune response against the
      infectious agent.

PMID- 1759499
TI  - Are we detouring from a direct route to development of HIV vaccines?
AB  - Experiments in animal model systems have demonstrated that it is possible for
      vaccination to elicit immune responses that can prevent or significantly delay
      lentiviral infection and perhaps disease. To facilitate the development of
      effective HIV vaccines, current research and development efforts must utilize the
      appropriate HIV strains. International scientific communities and vaccine
      manufacturers, with the support of governments, should now unite to ensure that
      the most direct route possible will be taken.

PMID- 1759500
TI  - SIV vaccines: current status. The role of the SIV-macaque model in AIDS research.
AB  - SIV vaccines made of inactivated whole virus, modified live virus and native and
      recombinant envelope antigens have protected macaques against experimental
      infection with low doses of cell-free SIV given systemically. The few vaccinated
      monkeys that do become infected have tended to live longer than the infected
      controls. Protection against cell-associated virus has not as yet been tested.
      The recombinant envelope vaccines now on test have generally not been as
      effective as the whole virus vaccines. Post-infectious immunotherapy with SIV
      vaccines has been ineffective. The same whole virus and modified live virus
      vaccines that protect against systemic infection fail to protect against genital
      mucosal challenge with cell-free virus. Since sexual transmission is the major
      route of HIV spread on a global scale, a major effort is now required to develop
      vaccines in this animal model that induce genital mucosal as well as systemic
      immunity against infection with both cell-free and cell-associated SIV.

PMID- 1759501
TI  - Prospects for AIDS vaccines: the need for clinical trials in human populations.

PMID- 1759502
TI  - Internal image (Ab2 beta) anti-idiotype vaccines. Theoretical and practical
      aspects.
AB  - Anti-idiotype antibodies that carry an internal image of an antigen epitope (Ab2
      beta antibodies) can be used in vaccine preparations to favourably manipulate the
      immune network. These vaccines have been shown to induce protective immunity in
      animals that have not been intentionally exposed to the native antigen epitope.
      This review attempts to define certain theoretical and practical aspects of
      immunological network manipulations and their relevance to Ab2 beta internal
      image anti-idiotype antibody vaccine design.

PMID- 1759503
TI  - Construction of genetically defined double aro mutants of Salmonella typhi.
AB  - The construction of genetically defined, double aro mutant strains CVD906 and
      CVD908, which were derived from Salmonella typhi strain ISP1820 (a recent isolate
      of S. typhi from Chile) and from laboratory strain Ty2, respectively, is
      described. Strains CVD906 and CVD908 differ from previously described aro mutants
      of S. typhi as their aro deletion mutations do not extend beyond the limits of
      the mutated aro genes, and no antibiotic-resistance genes, plasmid sequences or
      S. typhimurium DNA sequences remain in the mutant strains. In minimal medium the
      aro mutants of S. typhi are unable to replicate whereas the wild type parent
      strains grow well in minimal medium. Using intraperitoneal inoculation of mice
      with S. typhi strains suspended in hog gastric mucin as a virulence assay, it is
      shown that the single aro mutants and the double aro mutants of Ty2 and ISP1820
      are attenuated in mice. Trans complementation of the aro mutants with the aroC
      gene or aroD gene, or both, results in strains that are phenotypically identical
      to that of the wild type parents indicating that no measurable additional changes
      other than loss of the aro gene function occurred during strain construction.

PMID- 1759504
TI  - The effect of cholera toxin and cholera toxin B subunit on the nasal mucosal
      membrane.
AB  - The effects of the self-adjuvanting substances, cholera toxin (CT) and cholera
      toxin B subunit (CTB), on rabbit nasal mucosal membrane, were investigated by
      using Ussing chambers. The control nasal mucosa (lateral wall), isolated from
      rabbits and mounted in the chamber, showed transepithelial potential difference,
      short-circuit current and conductance of -10 mV, 200 microA cm-2 and 20 mS cm-2,
      respectively. These parameters were compared with mucosa isolated from human
      inferior conchae, showing that rabbit nasal mucosa may be usable to understand
      effects on human mucosa. When the mucosa was exposed to various concentrations of
      CTB and CT, the short-circuit current and conductance of the mucosa increased
      with increasing concentration. CTB showed gradual increase in the short-circuit
      current when added in the same molar concentration as the B subunit contained in
      CT, which caused drastic changes by increasing the current to infinite value.
      Furthermore, the total amount of transepithelially fluxed CTB, which occurred
      rapidly after addition to the mucosal side of the chambers, increased with
      increasing CTB concentration. On the other hand, less flux was observed after
      addition of CT. These changes could be blocked by addition of ganglioside GM1.
      This demonstrates that the effect of CTB on the rabbit mucosal membrane are
      different from those of CT, although both CT and CTB act specifically on the
      membrane via the CTB receptor, ganglioside GM1.

PMID- 1759505
TI  - Pre-exposure rabies prophylaxis for travellers: are the benefits worth the cost?
AB  - Pre-exposure rabies prophylaxis is recommended by the Immunization Practices
      Advisory Committee of the US Public Health Services (PHS) as a safe and effective
      method for reducing the risk of rabies in international travellers. The United
      States Peace Corps provides pre-exposure prophylaxis with human diploid cell
      rabies vaccine (HDCV) to over 2000 new volunteers each year going to rabies
      endemic countries. During the year November 1987 through October 1988, 175 rabies
      exposures (and no deaths) were documented in Peace Corps Volunteers serving in 31
      rabies-endemic countries, for an overall postexposure treatment rate of 43.6/1000
      volunteers per year. Although PHS treatment protocols were strictly followed, the
      postexposure prophylaxis rate for these Peace Corps Volunteers was 550 times
      higher than that for the US general population, and 55 times higher than the
      average rate for 30 developing countries. The use of pre-exposure prophylaxis in
      travellers was not cost-effective and will not become so until the price of a
      dose of vaccine declines substantially to $7.00 for the Peace Corps, and even
      lower for groups with less rabies exposure. However, despite the high vaccine
      cost, pre-exposure prophylaxis continues to be recommended in the Peace Corps for
      important non-economic reasons which may also be applicable to other groups of
      travellers.

PMID- 1759506
TI  - Immunity to diphtheria in the 3-19 year age group in Italy.
AB  - In Italy, immunization with diphtheria toxoid has been compulsory for all
      newborns since 1939. The last two clinical cases of diphtheria were reported in
      1987. During the period 1987-1989, immunity against diphtheria was assessed by
      neutralization test in a random sample of 1740 healthy subjects 3-19 years old,
      from five geographical areas of Italy. Of the total population, 76.5% showed
      antibody levels considered to be protective (greater than or equal to 0.1 IU ml
      1), 17.2% had a relative degree of protection (0.01-0.09 IU ml-1), and 6.3%
      lacked immunity (less than 0.01 IU ml-1). The percentage of unprotected subjects
      increased from 6.1% in the age group of 3-5 years to 11.4% in the age group of 18
      19 years (p less than 0.01). A smaller proportion of males (5.3%) than of females
      (7.2%) was unprotected, but this difference was not statistically significant.
      Subjects residing in the south and the islands were more likely to be unprotected
      than those residing in the north (7.4 versus 4.1%, p less than 0.01). No
      association was found between lack of protective antibodies and family size (odds
      ratio 1.35, confidence interval 95% = 0.77-2.36). However, paternal education of
      less than 12 years was associated with a higher prevalence of non-responders. In
      order to maintain a high degree of immunity in the adult population, a routine
      adult booster dose of diphtheria toxoid is advisable.

PMID- 1759507
TI  - Nucleotide sequence analysis of Urabe mumps vaccine strain that caused meningitis
      in vaccine recipients.
AB  - Mumps virus was isolated from the cerebrospinal fluid of eight patients who
      acquired meningitis within 4 weeks of immunization with live Trivirix vaccine
      that contains mumps (Urabe Am 9), measles (Schwarz), and rubella (RA 27/3)
      viruses. Part of the haemagglutinin-neuraminidase (HN) gene from three
      postvaccination isolates of mumps virus, three wild strains and the Urabe and
      Jeryl Lynn vaccine strains was cloned following polymerase chain reaction (PCR)
      amplification, for the purpose of sequence analysis. A 200-nucleotide portion of
      the cloned HN genes was sequenced and compared to published sequences of two
      other strains (RW and SBL-1). The postvaccination mumps strains were identical in
      sequence to Urabe and were distinguishable from the wild and the Jeryl Lynn
      vaccine strains. Twenty-two out of 200 positions were seen to vary among the
      group of viruses. It was concluded that the Urabe vaccine strain was the cause of
      postvaccination meningitis. Therefore, with effect from 1990, Trivirix measles,
      mumps and rubella vaccine is no longer licensed for sale in Canada.

PMID- 1759508
TI  - Determination of circulating antibodies directed to pertussis toxin and of
      agglutinogens in children vaccinated with either the whole cell or component
      pertussis vaccine in France, Japan and Senegal.
AB  - The antibody response to pertussis toxin (PT) and agglutinogens of children
      vaccinated in Japan, France and Senegal with either whole cell or component
      pertussis vaccine was determined at various times after immunization. Agglutinin
      titres were almost similar in sera of Japanese children vaccinated with either
      whole cell or component pertussis vaccine whereas anti-PT antibody levels were
      found to be higher after vaccination with whole cell vaccine than with component
      vaccine. The geometric mean (GM) agglutinin titres in sera of Japanese children
      amounted to 45.0 and 45.7, respectively, and neutralization GM titres to 71.6 and
      22.6, respectively, following vaccination with the whole cell and component
      pertussis vaccines. Sera of French children receiving three doses of whole cell
      vaccine exhibited a GM agglutinin titre of 17.8, whereas only 16% of sera
      contained neutralizing antibodies against PT. Following the booster dose the GM
      agglutinin titre rose to 213.5 and 68% of the sera contained neutralizing
      antibodies to PT (GM titre 48.0). Sera of Senegalese children receiving three
      doses of whole cell vaccine exhibited a GM agglutinin titre of 18.7, whereas anti
      PT neutralizing antibodies were hardly detected. Agglutinins and anti-PT antibody
      in sera of French and Senegalese children turned out to be lower than were found
      25 years ago in sera of children immunized with the French whole cell pertussis
      vaccine.

PMID- 1759509
TI  - [Selective and routine use of mediastinoscopy for staging of bronchial cancer].
AB  - Because of low rate of mediastinal lymphnode metastases of lung cancer in
      patients who seem to be able to undergo operative treatment, in most clinics
      mediastinoscopy for preoperative assessment is only used selectively when
      lymphnodes were found by CT before. Even though most US- and Canadian clinics use
      mediastinoscopy staging preoperatively because of differing sensitivity in CT.
      Analysis of CT and mediastinoscopy will be made by a special computer-program. It
      is focused that in T1 and T2 lung cancer selective mediastinoscopy is in favour.
      In T3 and T4 cancer mediastinoscopy should still be routine in the evaluation of
      mediastinal nodes for preoperative assessment.

PMID- 1759510
TI  - [Effect of perioperative allogenic blood transfusion on prognosis of colorectal
      cancer].
AB  - In 1973 the observation was published that in patients who had received non
      specific blood transfusions before kidney transplantation graft survival was
      improved. An immunosuppressive effect of blood transfusion was suggested. Indeed,
      modulation on the cellular and humoral immunologic system has been demonstrated
      during the last decade. But this immunomodulation effect might worsen the
      prognosis after cancer surgery. Whereas in several experimental studies in
      animals the negative influence was confirmed, clinical investigations on the
      other hand are contradictive. In our retrospective study we analysed the follow
      up of 273 patients (158 men, 115 women; average age 66 years) on which we had
      performed a curative resection of their colorectal carcinoma. 182 patients had
      received nonspecific random blood transfusions. The survival rate for patients
      with blood transfusions was significantly worse in comparison to the non
      transfused group (43% versus 73%, respectively). Even when we subdivided our
      patients into tumor stage, differentiation and localisation, the negative
      influence of transfused blood was confirmed. We conclude that beside the risk of
      transmitting hepatitis or HIV the immunosuppressive effect is a strong argument
      to restrict the indication for blood transfusion.

PMID- 1759511
TI  - [Diagnosis of leiomyosarcoma of the colon after natural excretion].

PMID- 1759512
TI  - [The cultural properties and virulence of Yersinia].
AB  - Study of the cultivation properties of 82 enterobacterial strains has revealed
      that the colonies of virulent Y. enterocolitica (serovars O3, O9) and Y.
      pseudotuberculosis (serovar I) are temperature-sensitive. This sign, closely
      connected with the presence and expression of the virulence plasmid with a
      molecular weight of 44-48 MD, is not characteristic of other strains. Virulent
      Yersinia grown in nutrient agar for 48 hours at 37 degrees C form colonies which
      are smaller in diameter than those formed during cultivation at 26 degrees C
      (with the significance of differences t greater than or equal to 4), their
      diameter at 37 degrees C not exceeding 1.0 mm. The test for the determination of
      the temperature-sensitive morphology of Yersinia colonies, along with the tests
      for other virulence markers, is probably suitable for the detection of the
      causative agents of yersiniosis or pseudotuberculosis.

PMID- 1759513
TI  - [The development of intestinal dysbacteriosis in sexually mature rats after
      thymectomy].
AB  - Thymectomy in puberal rats resulted in the development of pronounced enteric
      dysbacteriosis, correlating with the degree of T- and B-lymphocyte deficiency in
      the lymphoid organs and the blood stream during the first 2 months.
      Microbiocenosis restores probably due to more intensive functioning of
      alternative regulating mechanisms. A simple and informative characteristic
      indicating the degree of dysbacteriosis developing in the intestine is proposed:
      the index of dysbacteriosis.

PMID- 1759514
TI  - [The possibility of creating a vaccinal strain of Brucella abortus 19-BA with
      multiple antibiotic resistance].
AB  - The possibility of preparing B. abortus vaccine strain 19-BA with multiresistance
      to antibiotics was shown. The strain was obtained by the spontaneous induction of
      resistance to rifampicin with the subsequent transformation of nonconjugative
      hybrid plasmid pOVI which, in addition to rifampicin resistance, governed the
      resistance of brucellae to tetracycline, doxycycline, ampicillin, and
      streptomycin. Experiments on guinea pigs demonstrated the immunization with both
      multiresistant vaccine strain GSA1 and B. abortus initial vaccine strain 19-BA.

PMID- 1759515
TI  - [The effect of leukinferon on the activity of phagocytosing cells in human
      salmonellosis].
AB  - The functional activity of phagocytic cells in 52 salmonellosis patients was
      studied with regard to the following characteristics: percent share of
      phagocytosis, phagocytic index, nitro blue tetrazolium test results, digestive
      activity. In patients with the unfavorable course of salmonellosis (the formation
      of carrier state) disturbances in the bactericidal activity of neutrophils and
      monocytes were established. For 32 patients leukinferon was included in the
      complex of etiotropic and pathogenetic treatment. The preparation was introduced
      in 3 intramuscular injections of 10,000 I. U. at intervals of 48 hours (the
      course of treatment); 10 days after the last injection this course was repeated.
      The use of leukinferon restored the normal functioning of phagocytes and the
      number of T-lymphocytes.

PMID- 1759516
TI  - [The microfloral status of the intestines in people in contact with different
      antimicrobial preparations].
AB  - The state of enteric microbiocenosis in persons having contacts with different
      antimicrobial preparations, depending on the spectrum of such preparations and
      the duration of the contact, has been studied. Dysbiotic disturbances in enteric
      microflora have been detected even in those who have daily short-term contacts
      with antibacterial preparations.

PMID- 1759517
TI  - [Hospital strains of Pseudomonas aeruginosa in the surgical clinic].
AB  - Circulation of different antigenic variants of P. aeruginosa in a surgical
      hospital was studied. In this study the process leading to the formation of
      pathogenic hospital strains, determined by time and location, from some serovars
      is demonstrated. The study also established that the department of the hospital
      where the selection of hospital strains mainly occurred was the resuscitation
      ward. Some pyoseptic infections of P. aeruginosa etiology with fetal outcome were
      found to be caused in most cases by hospital strains characteristic of the
      hospital in the period under study.

PMID- 1759518
TI  - [The use of the cluster selection method for assessing the status of immunity to
      controlled infections (measles, diphtheria and tetanus)].
AB  - The use of the method of cluster selection in mass serological examination makes
      it possible to obtain statistically significant results with very low
      expenditures. The coincidence of the results on the number of seronegative
      children, obtained by the method of cluster selection, with the results of mass
      serological examination of all children aged 6-7 years in the district (children
      found to be seronegative to measles constituted 5.5% and 5.0% respectively) is
      indicative of the statistical significance of the method used in this
      investigation. The results obtained by the method of cluster selection indicate
      that the level of protection among the children of the district was high both
      with respect to measles (94.5 +/- 1.8%) and tetanus (96.5 +/- 1.7%); with respect
      to diphtheria, the immune stratum was found to be less (91.1 +/- 2.3%). These
      data may be helpful in working out scientifically substantiated administrative
      decisions contributing to an increase in the effectiveness of planned mass
      immunization.

PMID- 1759519
TI  - [The use of computers and mathematical methods for optimizing epidemic control
      measures with respect to measles infection].
AB  - The potentialities of computers for the study of the effectiveness of
      immunization have been demonstrated and the mathematical model for the prediction
      of the proportion of children, seronegative to measles, derived on the basis of
      the data on the average measles morbidity in different groups for a given period.
      A multifactor analysis of a large scope of data obtained in seroepidemiological
      survey and a retrospective analysis of measles morbidity on the basis of data
      collected in two districts of Moscow have been carried out with the use of
      computers and mathematical methods.

PMID- 1759520
TI  - [An evaluation of the status of natural foci of Crimean-Congo hemorrhagic fever
      in the Crimea].
AB  - Parasitological data, the results of virological and serological investigations
      of materials, collected in nature and during the study of the immune structure of
      the population and indicative of the circulation of CCHF, virus in the Crimea and
      the possibility of human infection, are presented. The data on the spontaneous
      CCHF virus infection of 4 tick species belonging to the genus Ixodes have been
      confirmed, and evidence on the participation of Dermacentor marginatus in this
      process obtained for the first time in this region. The study has revealed for
      the first time that, besides European brown hares, scilly shrews, common voles
      and field mice may contribute to the maintenance of the natural foci of this
      infection. The low activity of the Crimean focus of CCHF may be the result of the
      intensive use of land, the widely spread stall-feeding of cattle, as well as a
      sharp decrease in the number of hares on the territories of hunting preserves.

PMID- 1759521
TI  - [An experimental study of Yersinia in plants].
AB  - Y. enterocolitica and Y. pseudotuberculosis have been experimentally found to
      penetrate into plants (cabbage, salad, pea, oat) from infected soil and water and
      to remain in different plant organs (roots, seeds, leaves) up to 30 days (the
      term of observation). The processes of S-R dissociation in Yersinia cultures
      isolated from plants, as well as changes in some enzymatic properties, have been
      established. In the test on Infusoria the cytotoxic action of strains isolated
      from plants has been noted. The possible role of plants in carrying pathogenic
      bacteria from the soil to the surface ecological systems and the subsequent
      infection of animals and humans is discussed.

PMID- 1759522
TI  - [A safety and reactogenicity study of experimentally produced batches of the
      brucellosis chemical vaccine with different methods for its application].

PMID- 1759523
TI  - [An experimental study of a lactoglobulin preparation against opportunistic
      bacteria and salmonellae].
AB  - A preclinical study of seven batches of lactoglobulin, a new biological
      preparation against opportunistic bacteria and salmonellae, has been carried out.
      High antibacterial activity of the preparation with respect to the virulent forms
      of Salmonella typhimurium, Salmonella enteritidis, Pseudomonas aeruginosa,
      Klebsiella pneumoniae, Proteus vulgaris, Proteus mirabilis has been established.
      The preparation has been shown to be safe and nontoxic. The 4-year term of its
      storage at a temperature of 6 degrees +/- 4 degrees C has been substantiated.

PMID- 1759524
TI  - [The dynamics of the immunological indices during the treatment of recurrent
      erysipelas with the new immunostimulant bemitil].
AB  - Bemitil, administered orally in a dose of 0.25-0.5 g a day for 5-7 days at the
      acute period of the relapse of erysipelas as an immunostimulant, enhanced the
      effectiveness of the basic therapy including antibiotics, anti-inflammatory and
      antiallergic drugs, vitamins, plasma-substituting fluids and saline solutions, as
      well as ultraviolet irradiation of the focus of lesion. Bemitil therapy was
      associated with an increase in the number of T-lymphocytes, normalization of the
      balance between the peripheral lymphocyte preparations, an increase of blood
      serum levels of IgA and IgM.

PMID- 1759525
TI  - [The production of specific immunoenzyme conjugates to human immunoglobulins by
      the glutaraldehyde method].
AB  - The results of studies aimed at obtaining class-specific conjugates to human
      immunoglobulins to be used in the enzyme immunoassay (EIA) are presented. At the
      first stage of the studies purified IgA, IgM and IgG preparations were obtained.
      These preparations were used for obtaining immunologically active immunosorbents
      on the basis of bromocyanic Sepharose. Specific antibodies to human IgA, IgM and
      IgG were isolated from animal sera by the method of affinity chromatography.
      These antibodies were conjugated with peroxidase by the glutaraldehyde method.
      The specific activity of the conjugates were determined in EIA. The results thus
      obtained revealed that all preparations exhibited high specific activity and gave
      no cross reactions with immunoglobulins of other classes.

PMID- 1759526
TI  - [The characteristics of Staphylococcus aureus peptidoglycan in the spectrum of
      the reactivity of human lymphocytes to bacterial peptidoglycans].
AB  - The sensitivity of lymphocytes of healthy persons to S. aureus peptidoglycan as
      compared with that to the polyclonal stimulator zymosan C3b and peptidoglycans of
      other bacteria (Streptococcus faecalis, Escherichia coli, Bacterium bifidum) was
      analyzed with a test system permitting the determination of specific reactivity
      to peptidoglycans. The analysis showed that at the peak of luminol-dependent
      chemiluminescence (25-30 minutes) individual reactivity to S. aureus
      peptidoglycan varied within wide limits (the coefficient of lymphocyte
      stimulation was 1.4-9.6, 3.5 +/- 0.6), exceeding sensitivity to other bacteria,
      as well as the values obtained in the negative control. The conclusion of the
      wide spread of sensitization to S. aureus peptidoglycan and the possibility of
      using this preparation for the study of cell-mediated immunity reactions was
      made.

PMID- 1759527
TI  - [Multispecific monoclonal antibodies].
AB  - Immunization of BALB/c mice with Rickettsia prowazekii antigens, Bordetella
      pertussis toxin and Legionella pneumophila cytolysin induces the synthesis of IgM
      autoantibodies of different specificity. Among monoclonal antibodies,
      multispecific antibodies with a wide reactivity spectrum have been found to make
      up high percentage (30-80%). Monoclonal antibodies interact with different
      bacterial antigens and tissue substances. A hypothesis has been put forward that
      normally the injection of the antigen is followed by the appearance of antigen
      nonspecific "immunological noise", including the synthesis of both tissue
      specific and multispecific autoantibodies. Such antigen nonspecific
      "immunological noise" must have a certain threshold level which can be determined
      with the use of hybridoma techniques. This problem is particularly topical for
      bacterial antigens, as many of them are used in the development of vaccinal
      preparations, which may lead to an increase in the synthesis of autoantibodies
      and induce different autoimmune disturbances in the body.

PMID- 1759528
TI  - [The course of experimental staphylococcal sepsis in opposite mouse strains and
      first-generation hybrids].
AB  - The survival time and histological lesions of the kidneys, liver, heart, and
      lungs were studied in CBA/Sto, C3HA/Mv and F1 (C3HA/Mv x CBA/Sto) mice for 15
      days after i.v. injections with S. aureus pathogenic strains CFU B-243 in doses
      of 10(9), 10(8) and 2.5 x 10(8) microbial cells. CBA/Sto mice were found
      relatively resistant and C3HA/Mv mice, susceptible to infection caused by
      different doses of S. aureus, this being associated with different morphological
      picture in the viscera. F1 hybrids were at least as susceptible to the infections
      as any of the parent strains, suggesting recessive inheritance of resistance to
      staphylococcal infection.

PMID- 1759529
TI  - [A mathematical model of the growth of a population of Legionella pneumophila in
      the presence of Tetrahymena pyriformis protozoa].
AB  - The mathematical model describing the dynamics of the growth of L. pneumophila in
      aqueous environment in the presence of protozoa has been worked out. The model
      has demonstrated considerable heterogeneity of the initial population of virulent
      L. pneumophila strains. The number of bacteria capable of multiplication in
      Infusoria is no more than 0.1% of the initial population. The time of the
      generation of the infective agent inside Tetrahymena pyriformis is 2.8 hours.

PMID- 1759530
TI  - [The host reaction to the administration of different components of Coxiella
      burnetii].
AB  - After the intraperitoneal injection of corpuscles of C. burnetii antigen (Ag),
      phospholipid (PL), and sediment obtained after the extraction of PL from Ag with
      chloroform-methanol (CM) slight leukocytic reaction developed in the peritoneum
      on day 1, and on day 2 it could be observed in the liver and in the spleen. Ag
      induced the most pronounced morphological changes. In the spleen they were
      manifested by the activation of T- and B-dependent zones of white pulp from day 2
      and by the pronounced hyperplasia of reticular cells and macrophages, leading to
      splenomegaly, by days 7-14. Simultaneously lymphoid-macrophagal granulomas and
      hepatomegaly developed in the liver. By days 7-14 the foci of necrosis in the
      liver were caused by the thrombosis of portal veins and were not registered after
      the injection of PL and CM (and earlier also in experiments with Ag in doses of
      0.1-0.3 mg).

PMID- 1759531
TI  - [The dynamics of the basic factors of nonspecific resistance in North Asian tick
      borne typhus].
AB  - At the acute period of tick-borne typhus an increase in the activities of the
      main nonspecific resistance factors of the body, and particularly lysozyme,
      betalysins, complement and properdin, is observed. During convalescence the
      concentration of lysozyme normalizes and the content of betalysins remains
      sufficiently high, this indicating that, even in the absence of clinical sings of
      the disease, the disturbances in homeostasis persist. A decrease in the levels of
      complement and properdin during convalescence is seemingly linked with their
      consumption for the formation of immune complexes, eliminated from the body.

PMID- 1759532
TI  - [The control of viral diseases in the developing countries with the use of
      existing vaccines].

PMID- 1759533
TI  - [The adhesive and colonizing properties of Aerococcus viridans].
AB  - On the basis of experiments carried out in the course of this study the
      conclusion can be made that one of the mechanisms of the preventive effect of
      aerococci, the representatives of the indigenous microflora of the
      gastrointestinal tract, lies in their capacity for adhesion to and colonization
      of the mucous membrane, this enhancing the resistance of the enteric tract to
      infections. These properties of anterococci substantiate good prospects of using
      M-bacterin (live lyophilized aerococcal culture) for the control of enteric
      infections and dysbacteriosis.

PMID- 1759534
TI  - Long-term growth hormone treatment in growth hormone deficient adults.
AB  - Growth hormone treatment in GH-deficient adults has proved beneficial in recent
      short-term trials, but long-term results have not yet been reported. Thirteen GH
      deficient adults (4 females, 9 males; mean (SEM) age 26.4 (1.7) years), who had
      completed 4 months of GH therapy in a double-blind placebo-controlled cross-over
      study were followed, for further 16.1 (0.8) months of uninterrupted GH therapy in
      an open design. A significant mean increase of 1.3 cm in linear height was
      recorded, whereas body mass index remained unchanged. Mean muscle volume of the
      thigh, estimated by computerised tomography, increased significantly compared
      with that of the initial placebo period (p = 0.01), and a slight decrease was
      recorded in adipose tissue volume of the thigh (p = 0.10) and subscapular
      skinfold thickness (p = 0.10). Still, the muscle to fat ratio of the thigh was
      significantly lower compared with that of normal subjects (72.6/27.4 vs
      77.9/22.1) (p less than 0.01). The mean isometric strength of the quadriceps
      muscles increased significantly during long-term GH therapy (p less than 0.01),
      but remained lower compared with that of normal subjects (1.66 (0.10) vs 2.13
      (0.11) Nm/kg body weight). Exercise capacity performed on a bicycle ergometer
      increased significantly after long-term therapy (p less than 0.05), but still did
      not reach the values seen in normal subjects (22.5 (3.4) vs 37.4 (4.2)
      watt.min.kg-1. No adverse reactions were recorded during long-term therapy and
      hemoglobin A1c remained unchanged. These data suggest that long-term GH
      replacement therapy in GH-deficient adults has beneficial effects on several
      physiological features which are subnormal in these patients.

PMID- 1759535
TI  - The neuropeptide, head activator, in human placenta and serum from pregnant
      women.
AB  - The hydra neuropeptide, head activator, was detected in human placenta using
      radioimmunoassay. The placenta contained 11-68 fmol/g wet weight of head
      activator. The slope of the inhibition curve by placental extract in
      radioimmunoassay was identical to that of synthetic head activator. The molecular
      weight of the major immunoreactive head activator in placental extract
      corresponded to the synthetic head activator after Bio-Gel P-2 column
      chromatography. The peak of immunoreactive head activator in the extract emerged
      at the same retention time as that of the synthetic head activator on reversed
      phase high-performance liquid chromatography. Head activator was localized
      histologically in trophoblasts of placenta by peroxidase-antiperoxidase staining
      techniques. The head activator staining was inhibited by the excessive synthetic
      head activator. The serum head activator level during pregnancy ranged from 9 to
      31 pmol/l. A positive linear correlation was found between serum head activator
      content and gestational weeks.

PMID- 1759536
TI  - Regional stimulation of thyroid epithelial cells in Graves' disease by
      lymphocytic aggregates and plasma cells.
AB  - The significance of intrathyroidal lymphocytic infiltration is not known.
      However, several indirect lines of evidence suggest that interstitial or
      intraepithelial lymphocytes are the effector or thyroid autoantibody-producing
      lymphocytes in Graves' disease. This has not been investigated in vivo. Changes
      of nuclear volume of endocrine cells have previously been shown to be a reliable
      parameter of functional stimulation of endocrine glands. Therefore we
      investigated this parameter near and off lymphocytic aggregates, loosely
      distributed plasma cells and memory T cells in paraffin sections of Graves'
      disease thyroid glands. In 21 Graves' disease thyroid glands we found significant
      increases of thyroid epithelial cell nuclear volume near plasma cells (198.4
      micron3) as well as near lymphocytic aggregates (219.1 micron3) compared with
      thyroid epithelial cell nuclear volume one microscopic field away (160.1 and
      137.7 micron3 respectively). Similar nuclear volume differences were observed
      after propanolol and thiourelene antithyroid drug treatment. These nuclear volume
      differences could not be observed in 10 control thyroid glands and around CD45R0
      positive memory T cells in Graves' disease thyroid glands. These direct in vivo
      investigations of regional functional stimulation of thyroid epithelial cells in
      Graves' disease show local stimulation near lymphocytic aggregates and diffusely
      distributed plasma cells. Therefore our in vivo data do not permit to identify
      stimulatory lymphocytes only interstitially or intraepithelially as previously
      suggested.

PMID- 1759537
TI  - Failure to confirm a growth hormone-releasing activity of corticotropin-releasing
      hormone in acromegaly: comparison with the effects of other hypothalamic
      hormones.
AB  - We re-examined whether CRH stimulates GH secretion in acromegaly. Human CRH (100
      micrograms) was given as an iv bolus to 15 patients with active acromegaly, and
      plasma GH levels were measured before and at intervals up to 120 min after the
      injection. For comparison, we assessed in all the patients the effects of TRH
      (500 micrograms), GnRH (100 micrograms), vasoactive intestinal peptide (100
      micrograms) and peptide histidine methionine (100 micrograms), which are known
      paradoxically to stimulate GH secretion in acromegaly. A paradoxical GH response
      (greater than 50% above the basal) to TRH, GnRH, vasoactive intestinal peptide
      and peptide histidine methionine was observed in 12 (80%), 4 (27%), 5 (33%) and 2
      (13%) patients, respectively. All the patients were responsive to at least one of
      these 4 peptides. However, none of the patients showed a positive GH response to
      hCRH. These results do not support a GH-releasing activity of CRH in acromegaly.
      Even if CRH has such an effect, it does not appear as potent as TRH, GnRH,
      vasoactive intestinal peptide and peptide histidine methionine. However, the
      possibility cannot be excluded that our negative data might have been due to the
      use of hCRH vs ovine CRH in earlier studies.

PMID- 1759538
TI  - Thyrotropin receptor antibodies following treatment with recombinant alpha
      interferon in patients with hepatitis.
AB  - We measured thyrotropin receptor antibodies in serum obtained from 2 groups of
      patients participating in clinical trials of recombinant interferon-alpha 2b for
      viral hepatitis. Group I: Patients with hepatitis B (N = 8), received interferon
      5 x 10(6) units thrice weekly for 4 months. Group II: Patients with non-A, non-B
      hepatitis (N = 16) were randomized to receive interferon in a dose of either 0.25
      x 10(6) or 3 x 10(6) U thrice weekly for 6 months and then crossed over to
      receive the other dosage schedule for a further 6 months. None of the patients
      developed thyrotoxicosis. Thyrotropin receptor antibody activity was detectable
      within the "normal range" (less than 10 U/l) in 6 patients prior to treatment. In
      Group I, thyrotropin receptor antibodies became detectable in 6 patients on
      treatment, in 4 of whom it was 10 U/l. In Group II, thyrotropin receptor antibody
      activity was unchanged on low-dose interferon, but on the higher dose became
      detectable in 9 patients, in 7 of whom it was greater than 10 U/l. We conclude
      that treatment with interferon is associated with the development of thyrotropin
      receptor antibodies in a large proportion of patients. It is possible that in
      some patients treated with higher doses of interferon the increase in thyrotropin
      receptor antibody activity may be sufficient to induce hyperthyroidism.

PMID- 1759539
TI  - Chronic treatment with parlodel LAR of patients with prolactin-secreting tumours.
      Different responsiveness of micro- and macroprolactinomas.
AB  - Forty-one patients with prolactinoma (25 micro-, 16 macroprolactinomas) were
      treated with a long-acting injectable preparation of bromocriptine (Parlodel LAR,
      Sandoz), 25-100 mg (mostly 50 mg) in every 4-8 weeks for as long as 43 months
      (median 19 months). The first injection caused a prompt fall of plasma PRL which
      reached its nadir value after 3 days. Thereafter, hormone levels remained well
      below initial values for 4 weeks or longer, though with the tendency, more
      pronounced in microprolactinoma patients, to rise again toward baseline. The
      prevalence of PRL normalization was greater in the macro- than in the
      microprolactinoma group. By repeated injections plasma PRL could be kept close to
      or within the normal limits in most of the patients. However, the extent of PRL
      inhibition was significantly greater in macro- than in microprolactinoma patients
      (p less than 0.01). Clinical improvement occurred in the majority of the
      patients, shrinkage of the tumour in 50% of them. Adverse reactions were
      generally mild or of moderate severity and subsided spontaneously in 24 h. They
      were less frequent (NS) and less severe (p less than 0.05) in macro- than in
      microprolactinoma patients. IN CONCLUSION: a. injectable bromocriptine (Parlodel
      LAR) is a highly effective preparation particularly suitable for the long-term
      treatment of tumourous hyperprolactinemia; b. patients with macroprolactinoma
      exhibit, compared with microprolactinoma patients, better responsiveness and
      better tolerability to injectable bromocriptine.

PMID- 1759540
TI  - Effects of exogenous growth hormone pretreatment on the pituitary growth hormone
      response to growth hormone-releasing hormone alone or in combination with
      pyridostigmine in type I diabetic patients.
AB  - We evaluated the effects of iv pretreatment with exogenous GH on the GH response
      to GHRH either alone or in combination with pyridostigmine in 14 Type I diabetic
      patients and 6 normal subjects. All the subjects received an iv bolus injection
      of biosynthetic human GH, 2 IU; 2 h later they received either a. pyridostigmine,
      120 mg orally, or b. placebo, 2 tablets orally, followed 1 h later by iv
      injection of GHRH(1-29) NH2, 100 micrograms. In normal subjects the median GH
      peak after GH+ GHRH was 1.8, range 1.2-6.9 micrograms/l. Pyridostigmine enhanced
      the GH response to GHRH in all subjects. The median GH peak after pyridostigmine
      + GH + GHRH was 32.7, range 19.8-42.1 micrograms/l (p less than 0.001 vs GHRH
      alone). Seven diabetic subjects had median GH peaks after GH + GHRH greater than
      6.9 micrograms/l (the maximum GH peak after GH + GHRH in normal subjects) (group
      A: median GH peak 35.7, range 21.7-55 micrograms/l). The other diabetic subjects
      had GH peak lower than 6.9 micrograms/l (group B: median GH peak 4.4, range 2.1
      6.5 micrograms/l). Pyridostigmine significantly increased the GH response to GHRH
      in group B patients (median GH peak 29.3, range 15.7-93.4 micrograms/l, p less
      than 0.001 vs GH + GHRH alone), but not in group A patients (median GH peak 39.9,
      range 21.9-64.9 micrograms/l). Group A diabetic patients were younger and had
      higher HbA1c and blood glucose levels than group B patients. In those diabetic
      patients with an exaggerated GH response to GH + GHRH, pyridostigmine failed to
      cause the increase in GH secretion observed in diabetic and control subjects with
      no responses to GH + GHRH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759541
TI  - Biosynthesis of 16-androstene steroids and testosterone by porcine testis tissue
      in vitro: effect of age and relationships with fat 5 alpha-androstenone levels in
      vivo.
AB  - The relationships between testicular 16-androstene and testosterone formation in
      young pigs and levels of 5 alpha-androstenone in fat exhibited at older ages were
      investigated. Testis tissue samples were taken from Large White male pigs at 75,
      100 and 125 days of age (8 pigs per age group) and incubated with a mixture of
      [3H]progesterone and [14C]pregnenolone. 5 alpha-androstenone levels in fat were
      measured in all 24 pigs at 125, 145 and 170 days of age. Less androstadienone,
      more 3 alpha-androstenol and 11-fold more 3 beta-androstenol + androstadienol
      were synthesized from pregnenolone than from progesterone. 5 alpha-androstenone
      synthesis increased significantly between 100 and 125 days, whereas that of
      androstadienone declined between 75 and 100 days of age. Litter had a significant
      effect on all 16-androstene rates of formation. Fat 5 alpha-androstenone levels
      were positively correlated with 5 alpha-androstenone formation from both
      precursors. They were correlated with 3 beta-androstenol + androstadienol
      (positively) and testosterone (negatively) rates of synthesis from progesterone.
      It is concluded that in vitro measurements of 5 alpha-androstenone formation by
      testis tissue could be used as an early predictor of fat 5 alpha-androstenone
      levels exhibited at older ages.

PMID- 1759542
TI  - Balb/C mice immunized with either xenogeneic or syngeneic TSH produce
      immunoglobulins with anti-TSH and thyroid-stimulating activities.
AB  - Balb/C mice were immunized with bTSH (xenogeneic TSH) or extracts of Balb/C
      pituitaries (containing syngeneic TSH), either intracutaneously with Freund's
      adjuvant or intrasplenically. After bTSH, all blood samples contained anti-TSH
      antibodies. Thyroid-stimulating activity was assayed on FRTL-5 cells. Of 80 sera
      from immunized mice, 33 induced an increase in 99mTcO4 uptake, and 31/79 induced
      an increase in thyroidal 3[H]thymidine uptake by thyrocytes. With syngeneic TSH,
      anti-TSH antibodies were found in 10/19 mice. Immunoglobulins increasing
      thyrocyte technetium uptake were found in 14/19 mice, and immunoglobulins that
      stimulated thymidine uptake in thyrocyte DNA were detected in 12/19 sera. After
      immunization with both types of TSH, sera of some mice showed only one of the two
      bioactivities. Hybridomas were prepared with splenic lymphocytes of the mice
      immunized with either of the TSH preparations. These secreted TSH-binding
      immunoglobulins or immunoglobulins which stimulated thymidine or technetium
      uptake by the thyrocytes. One of the hybridomas from mice immunized with
      pituitary extract secreted a monoclonal antibody which stimulated thyroidal
      thymidine uptake, but inhibited bTSH-induced 99mTcO4 uptake. These findings might
      suggest that the anti-idiotypic network acting on TSH as an antigen could be
      involved in the pathogenesis of stimulatory antibodies in thyroid disease.

PMID- 1759543
TI  - Insulin-like growth factor II and transforming growth factor beta 1 regulate
      insulin-like growth factor I secretion in mouse bone cells.
AB  - Bone cells in culture produce and respond to growth factors, suggesting that
      local as well as systemic factors regulate bone volume. Previous studies have
      shown that IGF-I is the major mitogen produced by mouse bone cells and that its
      production is regulated by systemic agents such as PTH and estrogen. Because IGF
      II and transforming growth factor beta 1 have been shown, respectively, to
      increase and decrease MC3T3-E1 cell proliferation, we tested the hypothesis that
      these two growth factors modulate the production of IGF-I in this cell line. In
      order to eliminate artifacts owing to IGF binding proteins, conditioned media
      samples were pretreated with IGF-II before measurement of IGF-I by RIA. After 24
      h treatment at a density of 2.5 x 10(4) cells/cm2, IGF-II (10 micrograms/l)
      induced a 2.2-fold increase compared with untreated control (9.5 +/- 1.5 vs 4.2
      +/- 0.44 pg/micrograms protein, p less than 0.001), whereas transforming growth
      factor beta 1 (1 microgram/l) caused a 66% decrease in IGF-I production (1.5 +/-
      0.3 vs 4.2 +/- 0.44 pg/micrograms protein, p less than 0.001). Both IGF-II and
      transforming growth factor beta 1 regulated IGF-I production in a dose-, time-
      and cell density-dependent manner. The lowest effective doses for IGF-II and
      transforming growth factor beta 1 were 1 and 0.01 microgram/l, respectively.
      These results support a role for IGF-II and transforming growth factor beta 1 as
      potent modulators of IGF-I secretion in mouse bone cells.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1759544
TI  - Comparative effects of chronic administration of the non-steroidal antiandrogens
      flutamide and Casodex on the reproductive system of the adult male rat.
AB  - The effects of chronic blockade of androgen action by the antiandrogens flutamide
      and Casodex on serum and pituitary concentrations of LH and FSH, serum and
      testicular androgen levels, reproductive organ weights, and on spermatogenesis
      were compared in the adult rat. Animals were treated for 3 and 8 weeks with
      vehicle, Casodex (20 mg.kg-1.(day)-1, flutamide (20 mg.kg-1.(day)-1) and GnRH
      antagonist (150 micrograms/day, Detirelix). Treatment with GnRH antagonist
      suppressed gonadotropin and testosterone production, reduced the weights of
      testes, epididymides and seminal vesicles, and inhibited germ cell development.
      Flutamide administration markedly elevated serum and pituitary levels of
      gonadotropins as well as serum and testicular androgen concentrations. Casodex
      induced elevation of gonadotropin concentrations was less pronounced and serum
      and testicular levels of androgens did not change significantly. The reduction of
      seminal vesicle weights was similar after Casodex and GnRH antagonist treatment,
      whereas flutamide was less effective. Testicular weight and spermatogenesis
      (assessed by light microscopical and flow-cytometric analysis) remained
      unaffected by Casodex and flutamide. It is concluded, that 1. Casodex, in
      contrast to flutamide, is a peripherally selective antiandrogen, and 2. Casodex
      influences release of gonadotropins into circulation less than flutamide.
      Therefore this antiandrogen might be useful clinically for selectively blocking
      androgen actions in the accessory sex glands.

PMID- 1759545
TI  - Dehydration, but not vasopressin infusion, enhances the adrenocortical responses
      of sheep to corticotropin-releasing hormone or restraint.
AB  - Two experiments were carried out using adult castrated sheep prepared with
      jugular vein catheters. In Experiment 1, sheep (N = 8) were injected iv with
      saline vehicle, vehicle + 15 or 30 micrograms oCRH, or subjected to 120 min mild
      physical stress (restraint), following a 48 h period during which water was
      freely available or withheld. Blood samples were taken for 30 min before and 120
      min after oCRH injection, and before and during restraint, and the plasma
      analysed for AVP and cortisol content. Levels of AVP increased by over 500% after
      dehydration, but were unaffected by oCRH or restraint. In contrast, plasma
      cortisol was unchanged after dehydration, but increased after oCRH and restraint.
      Moreover, these cortisol responses were significantly greater when the sheep were
      dehydrated. In Experiment 2, euhydrated sheep (N = 6) were infused iv with saline
      vehicle or vehicle + AVP for a 5-h pretreatment period, followed by a 2-h
      experimental period in which the animals were injected with 15 micrograms oCRH or
      subjected to 120 min restraint, as in Experiment 1. Blood samples were taken
      throughout the experiment from a contralateral catheter and the plasma analysed
      for AVP and cortisol content. The AVP infusion produced plasma levels of the
      hormone approximately twice those seen after 48 h dehydration in Experiment 1,
      but did not affect cortisol secretion. Furthermore, the cortisol response to
      oCRH, or restraint, was not enhanced by the AVP infusion. These results suggest
      that pituitary responsiveness to exogenous or endogenous CRH (restraint stress)
      may be enhanced in sheep by dehydration through a mechanism that does not involve
      an adrenal or pituitary action of circulating AVP.

PMID- 1759546
TI  - Expression of GH receptor mRNA in regenerating skeletal muscle of normal and
      hypophysectomized rats. An in situ hybridization study.
AB  - Expression of growth hormone receptor mRNA was investigated by in situ
      hybridization in skeletal muscle from normal and hypophysectomized rats during
      the first seven days of regeneration after ischemic injury. A digoxigenin
      labelled RNA probe directed against the extracellular part of the rat GH receptor
      was used. In both normal and hypophysectomized rats distinct expression of GH
      receptor mRNA could be demonstrated in the regenerating muscle cells at the
      myoblast/myotube stage. The GH receptor expression appeared to decline with
      increasing maturation of the regenerated muscle fibres. In hypophysectomized
      rats, the regeneration process and the expression of GH receptor mRNA was delayed
      compared with that in normal animals. It is concluded that growth hormone may
      affect also the early phase of muscle regeneration in normal animals. To what
      extent lack of growth hormone contributes to the delayed regeneration observed in
      the hypophysectomized rats remains to be elucidated.

PMID- 1759547
TI  - Evidence for direct non-genomic effects of triiodothyronine on bone rudiments in
      rats: stimulation of the inositol phosphate second messenger system.
AB  - Thyroid hormones increase cytosolic free calcium by binding to plasma membrane
      receptors in several tissues. This calcium increase appears to initiate
      extranuclear effects in these tissues. Increases in cytosolic calcium are often a
      consequence of stimulation of inositol phosphate second messenger pathway.
      Several calcemic hormones act via this signal transduction route. Therefore we
      investigated the effects of the metabolically active T3 and the inactive
      analogues 3,5-diiodotyrosine and rT3 on the inositol phosphate pathway in fetal
      rat limb bone cultures prelabeled with [3H]myoinositol. Labelled inositol and
      inositol phosphates were separated by HPLC. There was a significant increase in
      the radioactivity in inositol bis- and trisphosphates after 1 min of exposure to
      10(-7) mol/l T3. Stimulation was also observed at 10(-6) mol/l T3, but not at 10(
      5) mol/l. Time course studies demonstrated a rapid effect of T3 on inositol
      phosphates within 30 seconds that lasted through 5 min. After 20 min incubation
      with T3, no increase was observed in inositol mono- and bisphosphates, and a
      decrease was seen in inositol trisphosphate. Pretreatment with indomethacin
      prevented these effects of T3. 3,5-diiodotyrosine and rT3 did not affect inositol
      phosphate metabolism. These results suggest the existence of plasma membrane
      associated receptors for T3 in bone, in addition to the nuclear receptors
      demonstrated previously. The role of these receptors in the effects of thyroid
      hormones on bone remains to be established.

PMID- 1759548
TI  - A twin study approach towards understanding genetic contributions to body size
      and metabolic rate.
AB  - The genetic and environmental determinants of a brief assessment of metabolic
      rate at rest and under psychological stress were studied in 40 pairs of
      monozygotic and 40 pairs of dizygotic young adult male twins. Height, weight and
      age were employed as covariates. Univariate analyses showed a high heritability
      for height and weight and moderate heritability for metabolic rate. Classical
      twin analyses and multivariate genetic modeling indicated that genetic influences
      on resting metabolic rate were entirely explained by body weight: there was no
      independent genetic contribution to resting metabolic rate. Metabolic rate under
      psychological stress, on the other hand, showed a significant genetic effect. The
      exponent (3/4) in the power function relating body weight to resting metabolic
      rate was the same as that found in a wide variety of animal species, a value that
      has been proposed as defining a body weight set point. We speculate that an adult
      body weight set point is genetically transmitted. Independent genetic effects on
      resting metabolic rate would be observed only when the normal equilibrium between
      body weight and metabolic rate is unbalanced during development, aging or
      disease. The study illustrates the use of multivariate genetic analyses of twin
      data which may be readily applied to widely used metabolic rate assessments.

PMID- 1759549
TI  - Zygosity, placental membranes and Weinberg's rule in a Danish consecutive twin
      series.
AB  - The usual assumption that monochorionic twins are monozygotic has recently been
      questioned, based on blood group discordance in 3 of 12 monochorionic pairs.
      Therefore, this study evaluates the validity of zygosity diagnosis based on
      examination of placental membranes, and at the same time evaluates Weinberg's
      differential rule in a Danish consecutive twin series. All twin pairs, 265 like
      sexed and 87 unlike-sexed pairs, born at Odense University Hospital, Denmark,
      from 1 January 1980 through 31 August 1988, were ascertained. In 229 like-sexed
      pairs, zygosity was determined by serological methods, and in 190 of these, the
      fetal membranes could be reliably classified. Fifty-nine monochorionic twin pairs
      were identified and none of those pairs were discordant for any genetic markers.
      Therefore, we conclude that monochorionic twins can be considered monozygotic.
      The distribution of monozygotic and dizygotic pairs was in accordance with
      Weinberg's rule.

PMID- 1759550
TI  - Northwestern University Twin Study X: Outcome of twin gestations complicated by
      gestational diabetes mellitus.
AB  - Existing data concerning the effect of gestational diabetes on perinatal outcome
      in twin pregnancies is scant. We hypothesized that altered carbohydrate
      metabolism would worsen perinatal outcome in twin gestation in a manner similar
      to singleton gestation. Thirteen twin pregnancies complicated by gestational
      diabetes mellitus were matched by gestational age at delivery to 13 twin
      pregnancies unaffected by gestational diabetes. Comparing infants of diabetic
      mothers to infants of control mothers, there was a trend of greater likelihood of
      respiratory distress syndrome, hyperbilirubinemia, and prolonged neonatal
      intensive care nursery admissions. Our experience suggests that altered
      carbohydrate metabolism in multiple gestations increases the potential for
      neonatal morbidity.

PMID- 1759551
TI  - Efficient sequential search of genetic systems for diagnosis of twin zygosity.
AB  - Conventionally, the zygosity of twins into monozygotic (MZ) and dizygotic (DZ) is
      determined by utilizing several blood groups or other genetic markers. Existence
      of many blood groups or other genetic markers raises the crucial problem of
      choosing minimum number of blood groups and applying them in a sequence with
      minimum cost offering maximum effectiveness in classifying the twins by zygosity.
      In this note, a statistical approach to this problem is made and a solution
      provided. The efficient sequential search procedure utilizing the gene frequency
      of four blood groups from the German population of Nordrhein-Westfalen province
      and applying the results to a twin set of 72 pairs (32 MZ and 40 DZ) of the same
      population indicates that efficient sequences with 3 and 4 blood groups are AB0--
      -P----Rh and AB0----P----Rh----MNSs, respectively. Further, it is understood that
      the efficient sequence for zygosity determination will be differing from
      population to population. As gene frequencies of blood systems differ in the
      various populations, this will effect the probability that a DZ twin pairs is
      concordant for a specific marker. Moreover, the relative cost may also turn out
      to be a decisive factor in the determination of the best sequence. Hence,
      indiscriminate use of several conventional blood group systems in the
      determination of zygosity of twins from a particular population should be
      discontinued. The formulae developed in this note are quite general and the
      procedure explained can easily be generalized to other situations.

PMID- 1759552
TI  - Iatrogenic influences on the heritability of childhood tonsillectomy: cohort
      differences in twin concordance.
AB  - In 1980-82, a mailed questionnaire was completed by 3,810 pairs of adult twins
      enrolled on the Australian NH&MRC Twin Register. Twins were asked whether they
      had had their tonsils out and, if so, at what age. The sample was divided into
      four birth cohorts of approximately equal size, and only childhood tonsillectomy
      (to the age of 18) was considered. The prevalence of tonsillectomy differed
      markedly between cohorts, being highest in those born in the 1940s and early
      1950s. Within each cohort, the prevalence was very similar in MZ and DZ twins,
      yet concordance was much higher in MZ twins, indicating the importance of genetic
      factors in predisposition to tonsillectomy. However, the proportions of variance
      in liability due to genetic and shared environmental factors differed markedly
      between cohorts. In the 1950s, when tonsillectomy was fashionable, shared
      environment accounted for 60% of variance and genetic factors for only 29%.
      However, by the early 1960s, when tonsillectomy was going out of fashion,
      heritability was up to 0.82 and shared environment accounted for only 10% of
      variance. Our results illustrate, once again, that heritability is not a
      constant, but depends on the precise characteristics of the population and the
      time at which it is studied.

PMID- 1759553
TI  - Influence of clinical variables on triplet birth weight.
AB  - The small size of most reported triplet series has resulted in conflicting
      statements about the influence of several clinical variables on triplet birth
      weight. Therefore, obstetrical and neonatal data were collected on 196 mothers
      and their 580 infants (8 stillbirths excluded). Gestational age was based on the
      date of fertilization in 13 IVF triplets and on the date of ovulation in 90
      medically induced triplets. Obstetrical and ultrasonic criteria were used to
      estimate the date of confinement in 93 spontaneous triplets. Birth weight
      appeared to be higher in males and with higher maternal parity, independent of
      gestational age. The apparent effect of medical technologies such as ovulation
      induction or IVF on combined triplet birth weight disappeared when maternal
      parity and fetal gender were controlled. Preeclampsia, maternal race and zygosity
      were not significantly associated with birth weight. While birth order did not
      significantly effect ultimate birth weight, the heaviest triplet did present
      first more often than would be expected by chance alone. Future evaluation of
      neonatal outcome data in multifetal gestations should control for gestational
      age, fetal gender and maternal parity. It appears that triplet birth weight is
      not affected by etiology, which is important given the significant impact of
      medical technologies.

PMID- 1759554
TI  - Time trends in characteristics and outcome of twin pregnancies.
AB  - This study describes the evolution in fetal and neonatal mortality rates among
      twin pairs born in 22 hospitals located in the eastern regions of the province of
      Quebec in 1976-1978 (n = 776 pairs) and 1982-1985 (n = 712 pairs). It also
      assesses the contribution of maternal factors, obstetrical care and
      characteristics of twins in the variation of the risk of death over time. The
      fetal mortality rate did not improve from 1976-1978 (22.6 per 1000) to 1982-1985
      (28.1 per 1000). However, the neonatal mortality rate declined from 44.7 to 34.7
      per 1000 liveborn first twins and from 56.8 to 36.1 per 1000 liveborn second
      twins. For first twins as for second twins, birthweight-specific neonatal
      mortality rates decreased within birthweight categories under 2500 g. In the
      second period, 96.9% of twin pregnancies were detected before confinement
      compared to 59.6% in the earlier period. The proportion of twins delivered by
      obstetricians, the percentage of twin births occurring in ultraspecialized
      perinatal units and the frequency of caesarean sections increased markedly. The
      proportion of preterm births increased over time (34.5% vs 43.1%) whereas the
      percentage of low birthweight twins decreased but not significantly (54.3%
      51.6%). In this study, changes in maternal age, parity, educational level, sex of
      pairs, qualification of the physician, and level of care available at the
      hospital of birth, did not account for the decrease in neonatal mortality rates
      among twins. The increase in the frequency of caesarean sections seemed to
      explain only a small proportion of the decrease in the neonatal mortality rate
      among second twins. In the second as well as in the first period, the neonatal
      mortality rate for twins was six times higher than that for singletons.

PMID- 1759555
TI  - Factors associated with neonatal problems in twin gestations.
AB  - We examined the neonatal outcome of 644 twins weighing 500 g or more and 656
      singletons, born in the years 1984-1986 in the Soroka Medical Center, Beer-Sheva,
      Israel. There was nearly a four-fold risk of antepartum death in twins vs
      singletons, which disappeared when birth weight was controlled for. The risks for
      intrapartum and early neonatal mortality were not raised in this population. A
      statistically significant relative risk for congenital heart malformations in
      twins vs singletons remained (RR = 5.0, 95% CI = 1.5-16.3), after controlling for
      maternal age. Significantly higher rates of hyalin membrane disease,
      hypoglycemia, hyperbilirubinemia, anemia and septicemia were found in twins.
      Controlling for the confounding of the association between twinning and mortality
      or morbidity caused by differences in distributions of mode of delivery or
      gestational age between twins and singletons, was not as efficient as the
      controlling for birth weight. Thus, adjustment for birth weight removed all the
      excess risks detected except in hypoglycemia. Our findings suggest that the lower
      birth weight of twins, which is so intimately associated with multiple
      gestations, is probably the single most important factor associated with neonatal
      problems found in twin births.

PMID- 1759557
TI  - [Abstracts of the 96th Meeting of the Japanese Association of Anatomists. Kyoto,
      April 2-4, 1991].

PMID- 1759556
TI  - [Osteoclasts in bone metabolism].
AB  - Bone resorption plays an important role in bone modeling and remodeling.
      Osteoclasts are the cells responsible for the bone resorption. Osteoclasts are
      located on endosteal bone surfaces and on the periosteal surface beneath the
      periosteum. They are multinucleated giant cells highly polarized in their
      morphology and function. Among the proximal surface, the membrane and the area of
      the cytoplasm directly oppose to the bone surface, which are specialized into two
      regions. A central region consisting of many irregular cytoplasmic processes and
      infoldings, the ruffled border, is known to be the active site of bone
      resorption. Surrounding the ruffled border, a second region, the clear zone
      provides an area of close attachment to the mineralized bone surface. The
      osteoclasts secrete a large amount of protons by the action of H(+)-pump on the
      ruffled border into the sealed resorption cavity, resulting in the acidified
      microenvironment under which condition the bone matrix is dissolved. Protons are
      provided by the intracellular action of carbonic anhydrase. Following the
      secretion of the protons, several ion-transporting systems, i.e., carbonate
      chloride exchanger, chloride-channel, Ca(2+)-transport systems, Na+/K(+)-ATPase,
      and voltage-dependent Ca(2+)-channel, are sequentially operated on both apical
      and basolateral cytoplasmic membranes. In addition, osteoclasts contain a large
      amount of lysosomal enzymes (cathepsin C, beta-glycerophosphatase, beta
      glucuronidase, etc.), which contribute to degrade the bone organic matrices
      exposed in the resorption cavity. These enzymes bind to the mannose-6-phosphate
      receptor on Golgi apparatus, are transported to the ruffled border and are
      secreted into the extracellular compartment in an exocytotic manner. Osteoclasts
      also have a high tartrate-resistant acid phosphatase activity which is currently
      used as a marker enzyme osteoclastic differentiation. Osteoclasts are considered
      to develop from hematopoietic stem cells. So far, the following four different
      pathways of the differentiation of osteoclast are proposed: The precursors of
      osteoclast develop (1) from multilineage hematopoietic cells via a completely
      separate differentiation line, (2) from granulocyte macrophage-colony forming
      cells, (3) from committed but proliferative monocyte-macrophage, and (4) from
      mature and unproliferative monocyte-macrophage. However, the differentiation line
      of the osteoclasts has still to be elucidated. The formation of osteoclasts as
      well as that of other hematopoietic cells is strongly regulated by many cytokines
      [interleukin (IL)-1,IL-3,IL-6, M-colony stimulating factor (CSF), and GM-CSF].
      1,25-Dihydroxyvitamin D3 and parathyroid hormone also stimulate the
      differentiation of osteoclast precursors. However, the mature osteoclasts do not
      possess the receptors for these hormones.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1759558
TI  - Neuropathological stageing of Alzheimer-related changes.
AB  - Eighty-three brains obtained at autopsy from nondemented and demented individuals
      were examined for extracellular amyloid deposits and intraneuronal
      neurofibrillary changes. The distribution pattern and packing density of amyloid
      deposits turned out to be of limited significance for differentiation of
      neuropathological stages. Neurofibrillary changes occurred in the form of
      neuritic plaques, neurofibrillary tangles and neuropil threads. The distribution
      of neuritic plaques varied widely not only within architectonic units but also
      from one individual to another. Neurofibrillary tangles and neuropil threads, in
      contrast, exhibited a characteristic distribution pattern permitting the
      differentiation of six stages. The first two stages were characterized by an
      either mild or severe alteration of the transentorhinal layer Pre-alpha
      (transentorhinal stages I-II). The two forms of limbic stages (stages III-IV)
      were marked by a conspicuous affection of layer Pre-alpha in both transentorhinal
      region and proper entorhinal cortex. In addition, there was mild involvement of
      the first Ammon's horn sector. The hallmark of the two isocortical stages (stages
      V-VI) was the destruction of virtually all isocortical association areas. The
      investigation showed that recognition of the six stages required qualitative
      evaluation of only a few key preparations.

PMID- 1759559
TI  - Time- and pressure-dependent changes in blood-brain barrier permeability after
      temporary middle cerebral artery occlusion in rats.
AB  - After 180 min of temporary middle cerebral artery occlusion in rats, the affect
      of phenylephrine-induced hypertension on blood-brain barrier permeability was
      assessed. One of the following blood-pressure regimens was maintained during
      either a 30- or 120-min period of reperfusion: (a) 30/Norm, 30 min of
      normotensive reperfusion was allowed; (b) 30/HTN, mean arterial blood pressure
      was increased by 35 mm Hg during 30 min of reperfusion; (c) 120/Norm, 120 min of
      normotensive reperfusion was allowed; or (d) 120/HTN, mean arterial blood
      pressure was increased by 35 mm Hg during 120 min of reperfusion. Evans blue (30
      mg/kg) was given, and brains were analyzed for Evans blue by spectrophotometry.
      Evans blue (microgram/g brain tissue, mean +/- SD) was greater (P less than 0.05)
      in both hypertensive groups versus their time matched normotensive groups
      (30/HTN: 80 +/- 16 versus 18 +/- 6 in the 30/Norm group; 120/HTN: 17 +/- 6 versus
      8 +/- 3 in the 120/Norm group). In addition, Evans blue was greater (P less than
      0.05) in both 30-min groups versus their pressure matched 120-min groups
      (30/Norm: 18 +/- 6 versus 8 +/- 3 in the 120/Norm group; 30/HTN: 80 +/- 16 versus
      17 +/- 6 in the 120/HTN group). The data are consistent with previous studies
      which have demonstrated an opening of the blood-brain barrier at the onset of
      reperfusion. In addition, the data support a hypothesis that changes in blood
      brain barrier permeability are more sensitive to hypertension in the early period
      of reperfusion.

PMID- 1759560
TI  - Re-examination of ex-boxers' brains using immunohistochemistry with antibodies to
      amyloid beta-protein and tau protein.
AB  - A histopathological study was carried out on the brains of eight ex-boxers (ages
      56 to 83) using conventional histological staining methods and
      immunocytochemistry with antibodies to amyloid beta-protein and the PHF-related
      tau protein. All cases showed a large number of tau-immunoreactive
      neurofibrillary tangles and also beta-protein immunoreactive senile plaques in
      the cortex. In the areas with many neurofibrillary tangles, neuropil threads with
      tau-immunoreactivity were also observed, and some of the senile plaque lesions
      were surrounded by abnormal neurites with tau-immunoreactivity. Moreover, three
      cases revealed beta-protein-type cerebrovascular amyloid deposits on both
      leptomeningeal and cortical blood vessels. The present observations indicate that
      the cerebral pathology of dementia pugilistica is very similar to that of
      Alzheimer's disease and suggest that these two disorders share some common
      etiological and pathogenic mechanisms.

PMID- 1759561
TI  - Calcitonin gene-related peptide immunoreactivity in spinal spheroids in motor
      neuron disease.
AB  - The spinal cords from seven autopsy cases of sporadic motor neuron disease (MND)
      and two controls were immunohistochemically examined using antibodies directed to
      calcitonin gene-related peptide (CGRP) and to neurofilament proteins (Nf). CGRP
      immunoreactivity was observed in the posterior horns, especially in the laminae I
      and II, of all the spinal cords examined. In MND cases, in addition, a
      considerable number of spheroids in the anterior horns were labelled with the
      antibody. In some spheroids, their entire area was homogeneously immunostained,
      whereas in others the immunoreactivity was confined to a focal area(s) within the
      profile of the spheroids and between these two forms of staining several
      variations of the staining patterns were seen. The anti-Nf intensely and
      homogeneously labelled all spheroids and there was no appreciable difference in
      the Nf-immunoreactive pattern between CGRP-positive and -negative spheroids. It
      is possible that the accumulation of CGRP in spheroids may result from entrapment
      of CGRP during the anterograde axonal transport, causing loss of CGRP at the
      neuromuscular junction and producing weakness and atrophy of the muscles.

PMID- 1759562
TI  - Senile dementia of the Alzheimer type: is there a correlation between entorhinal
      cortex and dentate gyrus lesions?
AB  - Senile plaques (SP) are one of the neuropathological hallmarks of senile dementia
      of the Alzheimer type (SDAT). In 14 patients affected with SDAT (over 74 years of
      age), thioflavine S, Tau and acetylcholinesterase (AChE) stainings demonstrated
      an increased density of SP in the outer two thirds of the dentate gyrus molecular
      layer. However, a wide range of SP density was observed among the cases. The
      molecular layer of the dentate gyrus is one of the termination site of the
      perforant pathway that originates in layers II and III of the entorhinal cortex.
      We have found that the number of AChE-, thioflavine S- and Tau-positive SP that
      accumulate in the dentate gyrus is positively correlated with the density of
      thioflavine S-stained neurofibrillary tangles in layers II and III of the
      entorhinal cortex. In contrast, a similar correlation is not found when using Tau
      immunolabeling of the entorhinal tangles. These observations show an association
      between the accumulation of AChE-positive SP in the dentate molecular layer and
      the lesions of the perforant pathway. Furthermore, they suggest that the density
      of SP in the dentate gyrus correlates with the late stages of neurofibrillary
      tangles formation (thioflavine S positive), but not with the early stages (Tau
      positive).

PMID- 1759563
TI  - Neuropathological observations in a case of autism presenting with self-injury
      behavior.
AB  - We report the neuropathological evaluation of a 24-year-old autistic woman
      suffering from a residual state of infantile autism and presenting with self
      injury behavior since childhood. Her behavior included head-banging, eye-gouging
      and self-biting. All intended therapeutic measures remained without effect,
      including high doses of psychotropic drugs. At autopsy, numerous neurofibrillary
      tangles were found in the perirhinal and entorhinal cortex where they were
      frequently grouped in nests or clusters. A few neurofibrillary tangles were also
      observed in the amygdala and in the prepiriform and orbito-frontal cortex. In the
      cortex, tangles were located in both layers II and III. There were no neuritic
      plaques or amyloid deposits. Interestingly, neurofibrillary tangles have been
      described in brains of individuals who had experienced repeated head injuries
      such as boxers (dementia pugilistica) and soccer players, suggesting that in our
      case a similar mechanism induced tangle formation and resulted in the loss of
      selective neuronal populations.

PMID- 1759564
TI  - Effect of electric stimulation on vestibular compensation in guinea pigs.
AB  - The effect of electric stimulation on vestibular compensation was studied in
      guinea pigs. Pharmacological labyrinthectomy was performed by injecting
      chloroform into the right middle ear under light ether anesthesia. The guinea
      pigs were divided into four groups: a control group which was not electrically
      stimulated after labyrinthectomy, a group stimulated with 0.6 mA square wave, a
      group stimulated with 0.3 mA square wave, and a group stimulated with 0.6 mA
      pulse wave. Electric stimulation, which started 1 h and 15 min after
      labyrinthectomy, was given through retroauricular electrodes. Nystagmus and head
      deviations were recorded and analyzed to assess the process of compensation at 1,
      2, 3, 4, 5, 8, 12, 18 and 24 h after labyrinthectomy. Electrically stimulated
      groups, especially group 0.6 mA square wave and group 0.6 mA pulse wave, showed
      faster compensation in nystagmus and head-body deviation than the control group.
      Therefore, in this study, electric stimulation seemed to contribute favorably to
      vestibular compensation.

PMID- 1759565
TI  - Visual influence on postural reactions to sudden antero-posterior support surface
      movements.
AB  - Visual influence on force reactions to sudden antero-posterior (AP) translations
      of the support surface in 10 healthy men 23-58 years old (mean 36 years) were
      studied. Displacements ranged between 13 and 127 mm in both backwards and
      forwards directions. The experiment was conducted using a modified EquiTest
      dynamic posturography apparatus. An interactive menu-driven software enabled
      selection of a suitable translation pattern (i.e. square wave) in the AP
      direction. Data from four vertical force transducers were acquired and the
      position of centre of pressure (CP) in the AP direction was computed as function
      of time. The movement of CP in response to AP translation was characterized by
      the amplitude of the maximum CP displacement relative to the platform and the
      latency until maximum CP displacement occurred. The experiment unveiled that the
      latency to maximum CP displacement was larger for conditions with vision present.
      Furthermore, both the amplitude and latency to maximum CP deflection were
      increasing functions of translation amplitude. It is proposed that visual
      feedback influences the neural control on the postural reactions to sudden
      support surface translations. Absence of visual cues seems to cause a more rapid
      correction of the body position.

PMID- 1759566
TI  - Effects of hydrostatic pressure on sensory discharge in frog semicircular canals.
AB  - The effects of endolymphatic and perilymphatic pressure changes on resting and
      mechanically evoked responses were studied in isolated posterior semicircular
      canals of the frog. The results demonstrated that ampullar receptors are
      extremely sensitive to hydrostatic pressure changes (0.25 mm H2O were sufficient
      to produce distinct changes), being inhibited by endolymphatic pressure increases
      and facilitated by perilymphatic ones. Intracellular recordings from single
      afferent axons showed that the effects of hydrostatic pressure result from a
      modified transmitter release from the synaptic pole of the hair cells. Unlike
      resting activity, mechanically evoked activity was always depressed in the
      presence of a hydrostatic pressure. This indicates that the sensitivity of
      ampullar receptors to mechanical stimuli, i.e. the gain of the conversion
      process, is maximal when no pressure is present between the inner and the outer
      fluid. The possible action of hydrostatic pressure on vestibular receptors is
      discussed.

PMID- 1759567
TI  - Age-related loss of auditory sensitivity in two mouse genotypes.
AB  - Frequency-specific auditory brainstem responses (ABR) (frequency range 2-31.5
      kHz) were used to describe age-dependent alterations in frequency sensitivity in
      CBA/ca (to 30 months) and C57BL/6J (to 16 months) mouse genotypes. The two
      strains displayed an age-related loss similar to that of humans, with a primary
      decline in high-frequency sensitivity. CBA mice showed a slow, yet gradual
      decrease in sensitivity to high- followed by low-frequency until 18 months of age
      and a rapid deterioration at all frequencies thereafter. C57 mice demonstrated
      precocious aging in auditory sensitivity in an unsteady rather than gradual
      manner. By testing the same individuals on repeated occasions it was shown that,
      for C57 mice, the degenerative process was more precipitous with three phases,
      and that the individual variability was larger than that of CBA mice. It is
      suggested that the two mouse genotypes can be used to express the different
      aspects of human presbycusis in individual variability and modes of gradual or
      staggered progression.

PMID- 1759568
TI  - Spontaneous otoacoustic emissions and sensori-neural hearing loss.
AB  - This study sought to clarify the clinical relevance of spontaneous otoacoustic
      emissions (SOAEs) and to define the hearing loss level (and frequency) at which
      absence of SOAE is found. Findings from 126 ears of patients with sensori-neural
      hearing loss showed an incidence of SOAEs in 18.25% of the cases (23 out of 126
      ears). SOAEs were never found when hearing loss at 1,000 Hz exceeded 10 dB. The
      presence of SOAE seems to indicate a good cochlear functioning at least in the
      mid-frequencies. Although the incidence of SOAEs is markedly lower than that of
      evoked otoacoustic emissions (EOAEs), SOAE recording is shown to be a good test,
      rapid, non-invasive for audiological screening, the presence of SOAE confirming a
      hearing threshold of less than 10 dB at 1,000 Hz, the absence of SOAE being
      inconclusive.

PMID- 1759569
TI  - Hypothermia differentially affects tuning curves generated by forward and by
      simultaneous masking.
AB  - In the gerbil maintained at euthermic (37.5 degrees C) conditions, forward
      masking produces a compound action potential tuning curve (CAP TC) which is less
      sensitive but more sharply tuned than that which is generated by simultaneous
      masking. These differences between forward- and simultaneously-masked CAP TCs are
      minimized at hypothermic (30 degrees C) conditions. The unmasking effect occurs
      at both temperatures, suggesting that hypothermia does not exert these changes by
      eliminating two-tone suppression.

PMID- 1759570
TI  - Cochlear pathology following chronic electrical stimulation using non charge
      balanced stimuli.
AB  - During the course of a chronic intracochlear electrical stimulation study using
      charge balanced biphasic current pulses, one animal inadvertently received a
      short period of direct current (DC) stimulation at a level of approximately 1
      microA. Subsequent, the animal was chronically stimulated using a poorly charge
      balanced waveform that produced a DC level of approximately 2 microA. Extensive
      pathological changes were observed within the cochlea. These changes included
      widespread spiral ganglion cell loss and new bone growth that extended throughout
      all turns of the cochlea. Significant changes in the morphology of the
      electrically evoked auditory brainstem response (EABR) were associated with these
      pathological changes. EABRs recorded prior to the DC stimulation exhibited a
      normal waveform morphology. However, responses recorded during the course of the
      DC stimulation were dominated by a short latency response believed to be
      vestibular in origin. The response thresholds were also significantly higher than
      levels recorded before the DC stimulation. In contrast, the contralateral
      cochlea, stimulated using charge balanced stimuli, showed no evidence of adverse
      pathological changes. Furthermore, EABRs evoked from this cochlea remained stable
      throughout the chronic stimulation period. Although preliminary, the present
      results illustrate the adverse nature of poorly charge balanced electrical
      stimuli. These results have important implications for both the design of neural
      prostheses and the use of DC stimuli to suppress tinnitus in patients.

PMID- 1759571
TI  - Left-right asymmetry in the human response to experimental noise exposure. II.
      Pre-exposure hearing threshold and temporary threshold shift at 4 kHz frequency.
AB  - The repeatedly noted average inferiority of the left ear (or superiority of the
      right ear) in epidemiological surveys at frequencies most susceptible to noise
      damage has not been experimentally confirmed. Twenty-eight non-shooting young
      adults were exposed binaurally to broad-band noise for a maximum of 8 h in
      strictly symmetrical laboratory conditions. The left and right hearing thresholds
      of each individual were monitored during short interruptions in the exposure. The
      average interaural hearing threshold difference became statistically significant
      during the exposure, the left ear being worse than right. The negative
      correlation found between the pre-exposure threshold level and the temporary
      threshold shift (TTS) was more marked in the left than in the right ear. In
      conclusion a hypothesis is presented: a good hearing threshold level in the right
      ear seems to be better protected from noise-induced temporary threshold shift
      than a good hearing threshold in the left ear.

PMID- 1759572
TI  - Chronological study of recovery of sudden deafness treated with defibrinogenation
      and steroid therapies.
AB  - The time courses of hearing recovery resulting from two types of treatment of
      sudden deafness patients, defibrinogenation (DF) therapy and betamethazone (BM)
      therapy, were analyzed and compared. A paired double-blind comparative study was
      performed on 168 patients. The average hearing level was 79.2 dBHL in the DF
      therapy group (n = 82) and 82.3 dBHL in the BM therapy group (n = 86). The DF
      group showed significantly better hearing 1 week after start of treatment at
      frequencies of 0.25, 0.5 and 1 kHz. After 2 weeks of treatment, the average
      hearing level for the frequency range of 0.25-4 kHz was 47.0 dBHL with DF therapy
      and 55.8 dBHL with BM therapy. Thus, the DF group still showed better hearing
      than the BM group (p less than 0.10, t-test), but not as significantly as after 1
      week. It is concluded that therapy for increasing blood circulation is important
      in the early phase of sudden deafness, especially for hearing loss in the low to
      middle frequency range.

PMID- 1759573
TI  - Transport of HRP through Reissner's membrane in experimental endolymphatic
      hydrops.
AB  - Unilateral endolymphatic hydrops was produced in guinea pigs by cauterization of
      the endolymphatic sac. Measurements of compound action potential (CAP), cochlear
      microphonics (CM) and negative summating potential (-SP) confirmed endolymphatic
      hydrops three months after surgery. In both control and hydropic ears, reaction
      product of HRP was observed only on the perilymphatic surface of the epithelial
      cells of Reissner's membrane after 10 min perfusion, while it was observed on
      both the endolymphatic and perilymphatic surfaces after 30 min perfusion.
      Epithelial tight junctions were not stained and labelled pinocytotic vesicles
      were observed in the epithelial cells. These findings suggest that the transport
      of HRP through Reissner's membrane is unchanged in endolymphatic hydrops and that
      the epithelial junctions are tight regardless of the distension of Reissner's
      membrane.

PMID- 1759574
TI  - Isolation of and calcium kinetics in cochlear inner hair cells of the guinea pig.
AB  - Single inner hair cells of the guinea pig cochlea were isolated using enzymatic
      and mechanical techniques. The intracellular free calcium ion concentrations [(
      Ca2+]i) of the isolated inner hair cells were determined using the Ca2+ sensitive
      dye fura-2 and digital imaging microscopy. In the presence of 1 micron ionomycin,
      a Ca2+ ionophore, there was an irreversible increase in [Ca2+]i. The 150 mM KCl
      stimulation, which induces a depolarization, resulted in a temporary increase in
      [Ca2+]i. This increase in [Ca2+]i was not observed under conditions of
      depolarization, in Ca(2+)-free medium. These observations are interpreted to mean
      that the [Ca2+]i during membrane depolarization mainly originates from an influx
      of extracellular Ca2+ into the cytoplasm.

PMID- 1759575
TI  - Degeneration of the organ of Corti following intravenous administration of
      cisplatin.
AB  - The development of acute morphological changes in the cochlea was studied in
      guinea pigs given one intravenous high-dose injection of cisplatin. In the light
      microscope three major stages of degeneration in the organ of Corti could be
      recognized: 1) an initial swelling of the Hensen's cells and protrusion of the
      Deiters' cells into the space of Nuel enclosing the outer hair cells, 2) a
      gradual degeneration of the outer hair cells together with a vacuolization in the
      region of the base of the inner hair cells, 3) a collapse of the Reissner's
      membrane and the entire organ of Corti with different degrees of damage to the
      inner hair cells. Sporadic bulging of the marginal cells of the stria vascularis
      into the endolymphatic space could be observed 4 days after injection.

PMID- 1759576
TI  - Evaluation of procedures to reduce fluid flow in the fistulized guinea-pig
      cochlea.
AB  - The rate of longitudinal flow of fluid in scala tympani (ST) has been quantified
      under a number of experimental conditions. The method used to measure flow
      involved using a tracer ion (trimethylphenylammonium: TMPA) as a volume flow
      marker. Movement of marked perilymph was monitored by ion-selective
      microelectrodes which were capable of detecting exceedingly low concentrations of
      TMPA. Our results show that when the cochlea is perforated at the apex, flow
      rates of 400-500 nl/min are induced in ST, compared to the normal very slow rate
      of 2 nl/min when the cochlea is sealed. This artifactual flow of CSF through the
      perforated cochlea can be reduced to 6.9 nl/min by releasing the hydrostatic
      pressure of cerebrospinal fluid (CSF) or further reduced to 1.8 nl/min by
      surgically obstructing the cochlear aqueduct. In addition, we observed no basally
      directed flow in ST when the round window (RW) was perforated, demonstrating that
      perilymph is not produced in volume as previously assumed. This study
      demonstrates the importance of separating artifactual flows, induced by the
      experimental procedures required to access the cochlear fluids, from the low flow
      rates which occur in normal, physiologic conditions.

PMID- 1759577
TI  - Feasibility of pulse oxymetry to measure arterial O2 saturation in studies on
      cochlear blood circulation.
AB  - To understand the characteristics of oxygen transport to the inner ear, the
      relationship between arterial O2 saturation and cochlear microcirculation was
      investigated under different respiratory condition in guinea pigs. To monitor
      arterial O2 saturation a pulse oxymeter instead of an arterial blood gas analyzer
      was used. When the arterial O2 saturation was measured in the foot pad by a pulse
      oxymeter under different respiratory conditions, the data showed a close
      correlation with the results of blood gas analysis. For the measurement of
      cochlear microcirculation, a pulse oxymeter was found to be a feasible
      respiratory monitor for animal experiments. With this apparatus our study
      demonstrated a slower reaction in the decrease of perilymphatic oxygen tension
      than of cochlear blood flow during stepwise induction of hypoventilation
      monitored by a pulse oxymeter. Under certain conditions of hyperventilation in
      which arterial O2 saturation and perilymphatic oxygen tension increased
      gradually, cochlear blood flow was found to decrease. This decrease of cochlear
      blood flow could be attributed to chemical controls which are regulated, as in
      the cerebral blood circulation, by the content of CO2 and H+ in the vascular bed
      in the cochlea.

PMID- 1759578
TI  - Computer-aided three-dimensional reconstruction of guinea pig cochlear aqueduct.
AB  - A computer-aided method of three-dimensional reconstruction was applied to the
      determination of the overall spatial configuration of the guinea pig cochlear
      aqueduct. The rotation function of the reconstructed images was useful in showing
      the individual small parts of the duct. A semi-translucent display of the
      segmental reconstruction of the duct demonstrated a difference in the density of
      the cellular components between the opening to the perilymphatic space and the
      duct portion. We propose that the cochlear aqueduct serves as a protective
      mechanism against a sudden change in CSF pressure in the subarachnoid space.

PMID- 1759579
TI  - The effect of acetazolamide on the endolymphatic sac DC potential.
AB  - The effect of acetazolamide known as a potent carbonic anhydrase inhibitor of the
      endolymphatic sac DC potential (ESP) was examined in the guinea pig. Intravenous
      administration of acetazolamide produced a dose-dependent decrease in ESP
      amplitude at doses of less than 10 mg/kg. The effect of acetazolamide on ESP was
      saturated at doses exceeding 10 mg/kg. The maximum reduction of ESP induced by
      acetazolamide was approximately 50% of the original ESP amplitude. The results
      suggest that carbonic anhydrase is involved in the generation of ESP.

PMID- 1759580
TI  - Polyp formation by experimental tubal occlusion in the rat.
AB  - The purpose of this study was to show the early stages of polyp formation, as
      part of our studies on the pathogenesis of nasal polyps. Two and 4 weeks after
      experimental tubal occlusion in 18 Wistar rats, 13 showed signs of bacterial
      infection, respective acute otitis media. In the majority of these rats
      polypouslike protrusions of the middle ear mucosa were found in whole-mount
      specimens. All polypouslike protrusions were investigated by cross sections,
      which revealed localised accumulation of fluid and inflammatory cells in the
      lamina propria. The polyps were covered with a flattened epithelium, compared to
      the epithelium in the surroundings. In some of the bigger polyps the apical part
      was without epithelial covering. The findings suggest that the epithelium by fast
      polyp growth may be distended and may burst, or that a primary epithelial defect
      has not been sufficiently covered.

PMID- 1759581
TI  - Neurophysiology of ischemic facial nerve paralysis in an animal model.
AB  - The establishment of an animal model for facial nerve paralysis is assuming
      increasing importance in clinical medicine and also in basic facial nerve
      research. We previously reported an animal model for ischemic facial nerve
      paralysis using selective vascular embolization through the internal maxillary
      and posterior auricular arteries in cats using Avitene which contains bovine
      microfibril collagen. In this paper, we determined the exact site of the lesion
      in established facial paralysis. A descending signal produced by direct
      stimulation to the contralateral motor cortex was able to elicit firing of the
      motor nucleus of the facial nerve, the extra-temporal portion of the peripheral
      nerve, and the orbicularis oris muscle. After achieving complete facial nerve
      paralysis, this descending signal was completely abolished within the temporal
      bone area, whereas peripheral facial nerve stimulation elicited a normal evoked
      electromyogram of the orbicularis oris muscle. The present results suggest that
      the site of the lesion of ischemic facial nerve paralysis produced by
      embolization in an animal model is within the temporal portion of the seventh
      nerve, and this animal model may lead to the advancement of future facial nerve
      research which cannot be conducted in humans.

PMID- 1759582
TI  - Is Pityrosporum ovale a pathogen of the external auditory meatus?
AB  - Fifteen dry wax samples, 15 wet wax samples and 7 dandruffy skin samples obtained
      from the external auditory meatus (EAM) of 26 individuals (age range from 1 to 76
      years) were examined for the identification of Pityrosporum ovale. After staining
      the samples with Gram's stain, cultures were made on Sabouraud's medium with
      olive oil added. Thirteen of the dry wax samples, 1 of the wet wax samples and 6
      of the dandruffy skin samples harboured P. ovale. Lipophilic yeast is frequently
      present in dry wax in adults and must be considered an aetiological agent of
      dandruff in the EAM.

PMID- 1759583
TI  - Macrophages on the nasal mucosal surface in provoked and naturally occurring
      allergic rhinitis.
AB  - Macrophages are the most common cell type residing in the lumen of the lower
      airways. However, very little is known about the presence and putative pathogenic
      implications of macrophages in the upper airways. Using specific
      immunohistochemical techniques, the presence of and changes in macrophage density
      were studied before and after allergen exposure in the laboratory and during
      natural allergen exposure of subjects with seasonal allergic rhinitis. The
      monoclonal antibody EBM 11 combined with the alkaline phosphatase-anti-alkaline
      phosphatase-technique was applied on cytospin-prepared slides. In the challenge
      experiment, 0.5 +/- 0.2% (mean +/- SEM; n = 10) of the total cell number were
      positive for the EBM 11 marker before challenge, thereby not differing from the
      controls (0.2 +/- 0.2%; mean +/- SEM; n = 3). Local allergen challenge induced an
      increase of these cells to a peak of 1.3 +/- 0.4% after 4 h (p less than 0.05).
      During seasonal exposure there was also a similar increase, from 0.7 +/- 0.2 to
      1.3 +/- 0.3% (p less than 0.05; n = 11) in placebo-treated patients and from 0.7
      +/- 0.2 to 1.6 +/- 0.4% (p less than 0.05; n = 11) in patients treated with
      topical glucocorticoids. There was, however, no direct relationship between nasal
      symptoms and number of macrophages present on the mucosal surface. The study
      indicates that macrophages are involved in the inflammatory processes of allergic
      rhinitis.

PMID- 1759584
TI  - Neutrophil elastase and its complex with alpha 1-antitrypsin in soluble and
      insoluble fractions of nasal secretions of chronic sinusitis.
AB  - Immunoreactive neutrophil elastase (NE) and its complex with alpha 1-antitrypsin
      (AT) was measured by double antibody enzyme linked immunosorbent assay (ELISA) in
      nasal secretions of chronic sinusitis (CS). Nasal secretions were separated into
      two fractions: PBS-soluble and insoluble fractions. Elastolytic activity was also
      examined. Mean value of total NE level was 31.0 micrograms/ml in the soluble
      fraction, which was significantly lower than that in the insoluble fraction (71.9
      micrograms/ml, p less than 0.01). On the other hand, the percentage of complexed
      NE in total NE in the soluble fraction (33.7%) was significantly higher than that
      in the insoluble fraction (12.1%, p less than 0.01). Elastolytic activity in the
      soluble fraction (23.4 RFU) was significantly lower than that in the insoluble
      fraction (170.5 RFU, p less than 0.01). NE with elastolytic activity exists in
      nasal secretions of CS, and active-free NE in the insoluble fraction could be a
      major source of enhancement and continuation of mucosal inflammation.

PMID- 1759585
TI  - The effect of pilocarpine and atropine administration on radiation-induced injury
      of rat submandibular glands.
AB  - In the management of head and neck tumors by radiotherapy, the patients are prone
      to suffer from radiation-induced damage of the salivary glands. This experiment
      was carried out to examine the effect of pilocarpine and atropine on the rat
      submandibular gland and to establish whether it is possible to protect the
      salivary glands from irradiation by altering the amount of secretory granules in
      the serous cells prior to irradiation. The submandibular glands of rats were
      irradiated after pretreatment with or without drugs. Single irradiation of 18 Gy
      caused significant damage to the submandibular glands without pretreatment,
      showing the most severe changes 1 week after irradiation and slowly recovering
      thereafter. Pilocarpine pretreatment was protective against irradiation,
      displaying much less damage after irradiation of the same dosage, and with
      complete recovery after 4 weeks. On the other hand, atropine-pretreated animals
      revealed more extensive damage than the other two groups, possibly due to the
      retention of secretory granules.

PMID- 1759586
TI  - Occurrence of mast cells in relation to the distribution of nerve fibers in the
      rat larynx.
AB  - The distribution of mast cells in the rat larynx was studied at a light
      microscopic level in relation to nerve fibers showing substance P (SP)- and
      calcitonin gene-related peptide (CGRP)-like immunoreactivity (-LI) and
      ultrastructurally in relation to unmyelinated nerve fibers. Connective tissue
      mast cells (CTMC), demonstrated by staining for avidin-peroxidase and
      immunohistochemical staining for 5-hydroxytryptamine (5-HT), were localized in
      the lamina propria. Alcian blue and toluidine blue revealed mast cells in the
      epithelium and the lamina propria. The mast cells showed similar regional
      differences in their distribution as fibers showing SP- and CGRP-LI. A large or
      moderate number of cells was found on the laryngeal side of the epiglottis, in
      the ventral recess and in the aryepiglottic folds. No mast cells were found in
      the vocal cords. In addition, a large number of cells showing 5-HT-LI were
      observed in the subglottic epithelium but not in the supraglottic and the glottic
      epithelia. Ultrastructurally and by use of SP- and CGRP-immunohistochemistry,
      nerve fibers were sometimes observed close to the mast cells. These findings may
      be of importance in the understanding of laryngeal pathophysiological events.

PMID- 1759587
TI  - Laryngeal involvement in rheumatoid arthritis.
AB  - Twenty-nine female patients with definite or classical rheumatoid arthritis (RA)
      and 30 controls were studied in order to assess the prevalence of laryngeal
      involvement in patients with RA and the occurrence of extrathoracic airway
      obstruction. Laryngeal involvement was assessed by physical examination including
      direct fiberoptic laryngoscopy, respiratory function tests and low-voltage
      radiography. Physical examination revealed laryngeal involvement in 17 RA
      patients (59%), extrathoracic airway obstruction was indicated by spirometry in 4
      (14%) and radiography revealed pathological findings in 3 patients (10%). One or
      more signs of laryngeal involvement were found in 20 patients (69%). Symptoms of
      breathing difficulties were common (75%) among patients with laryngeal
      involvement. The erythrocyte sedimentation rate and class-specific rheumatoid
      factors were not correlated to laryngeal involvement.

PMID- 1759588
TI  - Recurrent speech patterns as cues to the segmentation of multisyllabic sequences.
AB  - First and second language acquisition both require that speech be segmented into
      familiar, multiphonemic units (e.g., words and common phrases). The present
      research examines one segmentation cue that is of considerable theoretical
      interest: the repetition of fixed sequences of speech. On each trial, subjects
      heard repetitions ('pre-exposures') of two artificially-constructed,
      multisyllabic patterns that shared an embedded segment 1 or 2 syllables long
      (e.g., 2 shared syllables: [ga-li-SE] and [li-SE-stu]). There were 2 and 6, 4 and
      4, or 6 and 2 repetitions of the two patterns, randomly ordered. Subjects were
      then to indicate the groupings they perceived within a subsequent, longer
      sequence containing both of the pre-exposed patterns (e.g., [ga-li-SE-stu]).
      Responses varied systematically with the size of the embedded segment, the
      repetition frequencies of the two pre-exposed patterns, and the serial position
      of each pre-exposure. The results illustrate how investigations of the processing
      of speech patterns may contribute to an understanding of some elementary aspects
      of language learning.

PMID- 1759589
TI  - Spatial topological constraints in a bimanual task.
AB  - Previous research has shown that the concurrent performance of two manual tasks
      results in a tight temporal coupling of the limbs. The intent of the present
      experiment was to investigate whether a similar coupling exists in the spatial
      domain. Subjects produced continuous drawing of circles and lines, one task at a
      time or bimanually, for a 20 s trial. In bimanual conditions in which subjects
      produced the circle task with one hand and the line task with the other, there
      was a clear tendency for the movement path of the circle task to become more line
      like and the movement path of the line task to become more circle-like, i.e., a
      spatial magnet effect. A bimanual circle task and a bimanual line task did not
      exhibit changes in the movement path when compared to single-hand controls. In
      all bimanual conditions, the hands were tightly temporally locked. The evidence
      of temporal coupling and concomitant accommodation in the movement path for the
      conditions in which the hands were producing different shapes suggests that
      spatial constraints play a role in the governance of bimanual coordinated
      actions.

PMID- 1759590
TI  - Kinematics of aiming in direction and amplitude: a developmental study.
AB  - The patterns of aimed movements to visual targets were analyzed in children aged
      6, 8 and 10. Tasks with direction and/or amplitude requirements were used. The
      tasks were performed both with and without vision. Peak velocity, acceleration
      and deceleration and their relative temporal occurrence were evaluated. Overall,
      the 6- and 10-year-olds exhibited higher peak velocity and acceleration when
      performing the pure directional task than when performing tasks with an amplitude
      or stopping requirement. On the contrary, 8-year-olds showed similar peak
      acceleration and velocity across all three tasks. Similarly, when performing the
      pure directional task, the 6- and 10-year-olds reached their peak velocity and
      acceleration relatively later in time than the 8-year-olds. Vision of movement
      increased the peak velocity in all experimental tasks and peak acceleration was
      increased only in the pure directional task. Thus, movement kinematics varied
      according to the task requirements and age. Eight-year-olds showed greater
      propensity to feedback control in all tasks, suggesting an over-inhibition in
      their approach patterns, whereas 10-year-olds tended to use feedforward
      processes, with a shortened deceleration phase.

PMID- 1759591
TI  - Perceptual processing and speed-accuracy trade-off.
AB  - Three experiments are described on speed-accuracy trade-off during a visual
      fixation. In a typical trial subjects started by fixating a fixed position at
      their left side at which a degraded digit (SL) was presented. At about the same
      time an intact digit (SR) was briefly presented at a fixed right side position.
      SL and SR were separated by a binocular visual angle of 45 degrees. The task was
      to verbally report both digits, which implied that the eyes should be rapidly
      shifted from SL to SR, so as not to miss SR. Under these conditions the
      distribution of the fixation latencies of SL appeared to consist of two parts,
      suggesting the occurrence of either anticipations or reactions. This argues
      against a strategy of optional stopping of information accrual during the
      fixation of SL and is in line with a strategy of either fully neglecting or fully
      encoding SL. However, this interpretation meets the difficulty that, at trials
      where SL is reacted to, subjects showed a shorter fixation latency than in a
      control condition, in which they had ample time to view both SL and SR. The
      results of the second and third study supported the view that, when under time
      stress, subjects can end a fixation as soon as a preliminary code of SL is
      obtained. This code (a) is insensitive to the complexity of SL, (b) cannot be
      elaborated during the saccade to SR, and (c) can be used as a starting point for
      further analysis, as soon as the eyes reach SR.

PMID- 1759592
TI  - Knowledge acquisition and information searching strategies in diagnostic decision
      making.
AB  - The effect of three learning procedures on diagnostic information searching
      strategies was investigated. Undergraduate students acquired an artificial
      knowledge domain through either a Taxonomic-, Inductive-, or Case-oriented
      knowledge acquisition procedure. The use of the competing-hypotheses heuristic as
      a practical strategy to guide decision making in the face of uncertainty, was
      compared among the three learning conditions and between each condition and a non
      learning control group using the method developed by Kern and Doherty (1982) and
      Wolf et al. (1985). The small instruction intervention had an effect on the
      diagnostic nature of subjects' information-searching strategies. Subjects in the
      Inductive-learning condition exhibited a stronger tendency to seek diagnostically
      worthless information than the other learning conditions. The outcomes are
      considered relevant to the nature of expertise in decision making, and to the
      effect of instruction methodologies on the knowledge representations available to
      diagnostic classification and decision-making processes.

PMID- 1759593
TI  - GABA immunocytochemistry reveals five morphologically different nerve cell types
      in the frog stomach.
AB  - GABA (gamma-aminobutyric acid) immunocytochemistry was used on whole mounts of
      the frog stomach muscular layer to identify the GABAergic elements of the
      myenteric plexus. Between the labelled nerve fibres, five morphologically
      different types of neurons were revealed. The same cell types were also observed
      in the NADH-diaphorase-labelled control preparations. The different morphologies
      of the GABA-immunoreactive neurons may reflect the different peptide
      cotransmitter contents and/or different electrophysiological properties of these
      neurons.

PMID- 1759594
TI  - Acetyl-cholinesterase and mono-amine-oxidase activities in the microganglia of
      the thyroid gland in the rat.
AB  - The nervous microganglia of the thyroid gland have been studied in forty adult
      male rats, their morphology being analyzed by the osmium-zinc iodide technique
      their acetyl-cholinesterase activity (AChE) by an histochemical specific
      technique and their mono-amine-oxidase activity (MAO) by a tetrazolium technique.
      Few but constant microganglia were observed in the thyroid glands. These
      microganglia are formed by some 4 to 8 nerve cells. Intense mono-amine-oxidase
      activity (MAO) was found in the nerve cells of these microganglia, being absent
      in the rest of the thyroid gland. Intense specific acetyl-cholinesterase (AChE)
      was observed in the nerve cells scattered along nerve branches located in the
      connective tissue (single nerve cells or small cellular groups). AChE activity
      was not observed in the microganglia of the thyroid gland.

PMID- 1759595
TI  - Liliana Lubinska (1904-1990).

PMID- 1759596
TI  - Generalization of conditioned suppression during salicylate-induced phantom
      auditory perception in rats.
AB  - Tonal frequency generalization was examined in a total of 114 pigmented male
      rats, 60 of which were tested under the influence of salicylate-induced phantom
      auditory perception, introduced before or after lick suppression training. Thirty
      control subjects received saline injections, and the remaining 24 subjects served
      as noninjected controls of tonal background effects on generalization. Rats were
      continuously exposed to background noise alone or with a superimposed tone.
      Offset of background noise alone (Experiment I), or combined with onset or
      continuation of the tone (Experiments II and III) served as the conditioned
      stimulus (CS). In Experiment I, tone presentations were introduced only after
      suppression training. Depending on the time of salicylate introduction, a strong
      and differential influence on generalization gradients was observed, which is
      consistent with subjects' detection of salicylate-induced, high-pitched sound.
      Moreover, when either 12- or 3 kHz tones were introduced before or after
      Pavlovian training to mimic salicylate effects in 24 rats, the distortions in
      generalization gradients resembled trends obtained from respective salicylate
      injected groups. Experiments II and III were aimed at evaluating the masking
      effect of salicylate-induced phantom auditory perception on external sounds, with
      a 5- or a 10-kHz tone imposed continuously on the noise or presented only during
      the CS. Tests of tonal generalization to frequencies ranging from 4- to 11- kHz
      showed that in this experimental context salicylate-induced perception did not
      interfere with the dominant influence of external tones, a result that further
      strengthens the conclusion of Experiment I.

PMID- 1759597
TI  - Scopolamine-induced alterations in predatory behaviour pattern in cats.
AB  - Predatory behaviour in its full pattern (i.e., following the mouse, killing it
      and consuming the carcass) was tested in semi-natural conditions in cats.
      Consumption of minced horse meat was tested as well. Centrally acting scopolamine
      hydrobromide injected i.p. did not suppress predatory motivation, since following
      the prey and killing it were preserved. The executory phase of predation (i.e.,
      the killing grip) was severely disturbed and the consumption of the mouse as well
      as meat was totally inhibited. Peripherally acting scopolamine methylnitrate
      administered into another group of cats under the same conditions generally did
      not affect predatory pattern, though meat and mouse consumption was disturbed to
      some extent. It is concluded that central muscarinic involvement in predatory
      behaviour in cats is limited to sensorimotor control of jaw movements.

PMID- 1759598
TI  - Hippocampal evoked field potentials and interictal spikes in hippocampally
      kindled cats.
AB  - Kindling-related changes of the hippocampal evoked field potentials and patterns
      of the spontaneous interictal spikes were investigated in 10 hippocampally
      kindled cats. A complex potential waveform was recorded by macroelectrodes placed
      in the CA3 region of the hippocampal gyrus and hilus of the gyrus dentatus, close
      to the granule cell layer, after stimulation of the entorhinal cortex. After high
      intensity repetitive (10/s) stimulation a late component could be recorded with
      the latency of about 30-40 ms, in addition to the early response originating in
      the gyrus dentatus. Probably this component developed during kindling into a
      delayed, high amplitude spike. After application of the double shock test, post
      stimulus facilitation of the spike response was observed within time limits of 20
      100 ms. Another observation was a widespread, ipsilateral and bilateral long-term
      enhancement of the amplitudes of field potentials evoked by entorhinal and
      intrahippocampal stimulation. It was the most common effect observed during
      kindling. Widespread synchronized discharges of hippocampal spikes and localized
      clusters of brief irregular spikes were the most significant features of
      spontaneous interictal spikes. The paroxysmal discharges of spikes could be
      evoked by ipsi or by contralateral stimulation of the afferent pathways
      projecting to the kindled hippocampus, rather than by direct electrical
      stimulation of the kindled hippocampal gyrus.

PMID- 1759599
TI  - Cardiac frequency, phase and errors in one-dimensional sensorimotor tracking.
AB  - One dimensional manual tracking was investigated in relation to actual heart rate
      and phase of cardiac cycle. Higher heart rate was combined with increased
      tracking error incidence and decreased successful tracking time (light spot
      inside target). Error incidence was time-locked with respect to the phase of
      cardiac cycle.

PMID- 1759600
TI  - Effects of different intrastimulus interval on learning of the Konorski short
      term memory test in dogs.
AB  - A differentiation of instrumental responses to auditory location stimuli using
      the Konorski Test was investigated. Each stimulus consisted of two components
      separated by intrastimulus interval. The components were click series presented
      from four loudspeakers situated in front of the animal, on horizontal and
      vertical axes. Each correct response, performed to the second component of
      positive stimulus, was rewarded by food. Responses to negative stimuli were not
      reinforced. Solving the test was possible by comparing the memory trace of the
      first component location, with location of actually presented second component.
      Two groups of dogs were trained. In one group positive and negative stimuli were
      presented, in which intrastimulus interval lasted 1 s. In the other group,
      differentiation training included stimuli with intrastimulus interval lasting 3
      s. Unexpectedly, the first group was unable to reach differentiation criterion,
      whereas the second group reached criterion without difficulty. The effect of
      reaching the criterion with longer and not shorter interval between stimulus
      components, may be specifically related to location cues as opposed to reported
      earlier auditory quality stimuli.

PMID- 1759601
TI  - Delayed response learning to visual stimuli in cats.
AB  - Six normally reared cats were trained on a three-choice delayed response task to
      visual stimuli. All cats mastered 1 min delay, three cats 2 min delay and one cat
      6 min delay. Learning was much better than in previously studied cats reared in
      laboratory cages. It was comparable to that known for auditory stimuli in
      normally reared cats.

PMID- 1759602
TI  - Visually guided reaching for food in binocularly deprived cats.
AB  - Four visually deprived cats and four controls were tested in reaching for food
      from a cage. In each trial the animals in the groups responded immediately after
      unscreening the cage. However, in reaction time of forelimb extension the
      deprived group showed proportionally fewer responses with shorter reaction time
      than the control group.

PMID- 1759603
TI  - Formation of inositol polyphosphates in cultured adrenal chromaffin cells.
AB  - Formation of inositol polyphosphates has been characterized in cultured bovine
      adrenal chromaffin cells in terms of calcium dependency and isomers of inositol
      polyphosphates. There are two distinct pathways of generation of InsP3.
      Stimulants such as high K+ induce InsP3 accumulation by a calcium uptake
      dependent mechanism. Stimulants such as Ang II induce InsP3 accumulation by a
      calcium uptake-independent mechanism. Both mechanisms are involved in nicotinic
      stimulation. These results suggest that calcium entry as well as receptor
      mediated mechanisms play a significant role in phosphoinositides hydrolysis
      through phospholipase C in adrenal chromaffin cells. Nicotinic receptor
      stimulation induces a rapid and transient increase in Ins(1,4,5)P3 accumulation
      followed by a slower accumulation of Ins(1,3,4)P3. Moreover, nicotine induces a
      large and rapid increase in Ins(1,3,4,5,6)P5 accumulation with an extent and time
      course similar to Ins(1,4,5)P3, which peaks at 15 sec after stimulation. Nicotine
      also induced Ins(1,3,4,5)P4 and InsP6 accumulation with a slower time course and
      a lesser magnitude than Ins(1,3,4,5,6)P5. These results indicate that adrenal
      chromaffin cells possess fine regulation of inositol polyphosphates metabolism
      and that inositol polyphosphates are involved with the control of cellular
      function in these cells.

PMID- 1759604
TI  - Expression of G-protein alpha-subunit cDNA.

PMID- 1759605
TI  - Serotonin receptor subtypes in brain: ligand binding properties and coupling with
      G proteins.

PMID- 1759606
TI  - A cerebral endogenous factor regulates the activity of the serotonergic receptors
      modulating the neuronal release of acetylcholine.

PMID- 1759607
TI  - Serotonin receptor heterogeneity and the role of potassium channels in neuronal
      excitability.
AB  - Intracellular recordings in vitro from a variety of central neuronal types have
      shown both inhibition and excitation to be modulatory consequences of serotonin
      (5-HT) receptor activation. These responses can be seen in isolation or in some
      cases (e.g. hippocampal pyramidal cells) as a complex biphasic combination of
      hyperpolarisation followed by depolarisation, suggesting overall control of
      neuronal excitability may be dependent on the interaction between activation of
      more than one post-synaptic receptor and/or mechanism. Our studies have confirmed
      the 5-HT evoked depolarisation of rat facial motorneurones (FM's) and the
      hyperpolarisation seen in presumed serotonergic neurones of the dorsal raphe
      nucleus (DRN) to be the result of opposite effects on K+ ion permeability.
      Suppression of a resting K+ conductance leads to depolarisation while activation
      leads to hyperpolarisation. The same mechanisms appear to be responsible for the
      5-HT evoked responses in hippocampal pyramidal cells but in addition there is
      also a suppression of a Ca++ dependent K+ conductance responsible for the long
      spike after hyperpolarisation (AHP). Data from the hippocampus and DRN indicate
      the 5-HT induced hyperpolarisation to be sensitive to Pertussis Toxin (PTX) and
      irreversibly mimicked by GTP gamma S, a non-hydrolysable analogue of GTP,
      suggesting the involvement of a G protein in K+ channel activation. The mechanism
      of K+ channel closure is less clear as it is unaffected by PTX or activation of
      adenylate cyclase, however there is indirect evidence that the phosphoinositide
      pathway may be involved from the cloned 5-HT1C receptor which also closes a K+
      channel in cell lines. The results show that hyperpolarisation evoked by 5-HT in
      the hippocampus and DRN to be mimicked and blocked by 5-HT1A agonists and
      antagonists. However, the depolarisations in the hippocampus and FM's are
      mediated by site-dependent receptors with profiles which do not fit into the
      current 5-HT receptor subtype classification.

PMID- 1759608
TI  - Modulatory actions of norepinephrine on neural circuits.
AB  - A spectrum of studies has been conducted on a single aspect of NE function in
      which, through a beta-one receptor activation, NE appears to mediate a degree of
      physiological control over the gain of GABA mediated inhibition. It is
      significant that this single effect has been observed in numerous interrelated
      preparations ranging from single isolated Purkinje cells from young rats to adult
      Purkinje cells in awake locomoting rats. With respect to the functional conse
      quences of these effects, our best current speculation as to "what NE does" is
      that NE acts to regulate the strength of these tuned gating mechanisms in both
      cerebral and cerebellar cortices. There are numerous unanswered questions raised
      by the past work. One pressing issue is - when and for what reason in normal
      function does the modulation take place? When does NE release normally occur (is
      it phasic or tonic), and which of the demonstrated actions appears and for how
      long in relation to period of receptor activation? Does NE release cause the
      circuit to "react" to conditions which need "improved neurocomputation" or does
      NE stabilize the circuit to react predictably in the face of stress? Finally,
      what is the molecular sequence of events between receptor activation and an
      alteration of GABA receptor channel opening? What additional molecular control
      mechanisms exist and how can the diverse inhibitory and modulatory phenomena be
      reconciled, both short and long term? Issues are defined which need to be
      clarified at all levels of the current skeleton of basic understanding. Our
      prediction is that pursuit of these issues will benefit from an exchange of
      insight gained from investigations at all levels.

PMID- 1759609
TI  - Reversal of nigrostriatal-lesion-induced receptor alterations by grafting of
      fetal mesencephalic dopaminergic neurons.

PMID- 1759610
TI  - Depression of NMDA-evoked acetylcholine release by endogenous adenosine in
      striatum slices.
AB  - The mechanisms of NMDA-evoked transmitter release are still not clear. We
      demonstrate for the first time that NMDA-evoked acetylcholine release is
      depressed by endogenous liberated adenosine in functionally-hypoxic and non
      hypoxic brain slices. Adenosine deaminase potentiates the release of 3H
      acetylcholine from rat striatum slices in response to N-Methyl-D-Aspartate (NMDA)
      stimulation, whereas (-)-R-phenylisopropyl-adenosine (R-PIA) decreases the NMDA
      evoked transmitter release. The NMDA-evoked transmitter release is potentiated by
      8-cyclopentyl-1,3-dipropylxanthine (DPCPX) only in adenosine depleted slices. The
      increase of extraneuronal adenosine by dipyridamole also depresses the
      presynaptic transmitter release. Our results indicate: (i) that stimulation of
      NMDA-receptors induces a complex neuronal response, e.g., release of
      acetylcholine and release of adenosine, (ii) that adenosine induces an agonist
      high affinity conformation of the A1-receptors which apparently are insensitive
      to an A1-adenosine receptor-antagonist (DPCPX) and (iii) that brain slices 0.5 mm
      thick can serve as an experimental model for testing antihypoxic substances.

PMID- 1759611
TI  - The nicotinic acetylcholine receptor gene family: structure of nicotinic
      receptors from muscle and neurons and neuronal alpha-bungarotoxin-binding
      proteins.

PMID- 1759612
TI  - Evidence for cardiovascular roles of tachykinin peptides in the brain of the rat.

PMID- 1759613
TI  - Affinity purification of nicotinic acetylcholine receptor from rat brain.

PMID- 1759614
TI  - Differential coupling of subtypes of the muscarinic receptor to signaling
      mechanisms in brain and peripheral tissues.

PMID- 1759615
TI  - The molecular properties of the M1 muscarinic receptor and its regulation of
      cytosolic calcium in a eukaryotic gene expression system.

PMID- 1759616
TI  - Molecular mechanism underlying the occurrence of supersensitivity at muscarinic
      receptors: analysis using cerebral cortical neurons in primary culture.

PMID- 1759617
TI  - Intramembrane particles in the postsynaptic membranes of the S-, F-, and C-type
      synapses by freeze-fracturing, and deep-etching studies on the Xenopus spinal
      cord.

PMID- 1759618
TI  - 123-I-iomazenil-SPECT in patients with focal epilepsies--a comparative study with
      99mTc-HMPAO-SPECT, CT and MR.

PMID- 1759619
TI  - Comparative transfusion medicine.

PMID- 1759620
TI  - History of transfusion medicine.

PMID- 1759621
TI  - Histocompatibility and bone marrow transplantation.

PMID- 1759622
TI  - Preparation of components.

PMID- 1759623
TI  - Clinical transfusion medicine.

PMID- 1759624
TI  - Neonatal transfusion medicine.

PMID- 1759625
TI  - Autologous transfusion.

PMID- 1759626
TI  - Blood substitutes.

PMID- 1759627
TI  - Colony-stimulating factors: their biological activities and clinical promise.

PMID- 1759628
TI  - Appendix: blood cell values in selected mammals.

PMID- 1759629
TI  - White cells.

PMID- 1759630
TI  - Platelets and coagulation.
AB  - Hemostasis is a multiple-component system. In order to function properly it has
      become highly integrated with several strategies of control. Failure of the
      system or its control can result in life-threatening hemorrhage requiring
      transfusion. It is hoped that the information provided in this article has
      enhanced the reader's understanding of hemostasis in animals, and will enable the
      reader to make a more educated choice concerning transfusion therapy for the
      bleeding patient.

PMID- 1759631
TI  - Erythrocytes.

PMID- 1759632
TI  - [Complex oral rehabilitation of children with cleft lip-jaw-palate].
AB  - The prerequisite for the full oral rehabilitation and social adaptation of cleft
      palate patients is a consistent, comprehensive care system, providing a well
      organised integration of preventive and interceptive measures, as well as close
      cooperation between the various specialised disciplines. Preventive
      stomatological care should begin in infancy.

PMID- 1759633
TI  - [Maxillofacial growth in difficult conditions: on orthodontic rehabilitation of
      patients with cleft lip-jaw-palate].
AB  - The orthodontic treatment of cleft palate patients extends from birth to youth
      and is divided into three phases: pre-operative phase, deciduous dentition, mixed
      and permanent dentition. Therapeutic concepts for each particular phase are
      presented. Information is also provided on research into the growth of the jaw
      and face area in cleft palate patients compared with a control group.

PMID- 1759634
TI  - Prediction of the growth in patients with achondroplasia.

PMID- 1759635
TI  - [Disorders of growth and development in patients with osteogenesis imperfecta and
      their effects on the orofacial system].
AB  - The results of stomatological examinations covering 16 children with osteogenesis
      imperfecta are reported. This disease is accompanied by typical symptoms in the
      oro-facial region. Dentinogenesis imperfecta occurred in 5 patients and can be
      considered an optional symptom of osteogenesis imperfecta.

PMID- 1759636
TI  - [AIDS in children: selected topics for pediatric practice].

PMID- 1759637
TI  - [The practical significance of laterality].
AB  - In the present review the practical relevance and the problems of left-handedness
      have been discussed. Nowadays the diagnosis of the correct hand for writing and
      learning to write are very important for left-handers. Laterality is a hybrid
      phenomenon which concerns not only pedagogics but also many other fields, such as
      medicine, transport, sport and art.

PMID- 1759638
TI  - [Catamnestic study of school children with behavioral disorders].
AB  - A catamnestic study of disturbed pupils, who have been examined by a child
      neuropsychiatrist for admission to a balancing class, revealed that the
      accumulation of biological and psychosocial load factors presents a risk for
      persisting behavioural disturbance. Failure at school was prevented by a
      temporary stay in a balancing class, but psychic maldevelopment indicated by the
      high percentage of odd children in the disturbed population could not be
      precluded. The refore the life-long medical and special pedagogic care for these
      children beyond discharge from the balancing class is considered to be necessary.

PMID- 1759639
TI  - [Analysis of the public health status and assessment of vaccination status in
      maternal health services and child and adolescent preventive health care of a
      district city].
AB  - A total of 23 maternity centres and 8 youth welfare centres in the county town of
      Magdeburg were inspected in 1987 and 1988 to review the condition of buildings
      and layout of rooms. Checks were also made on anti-infectious routines and
      compliance with the vaccination regulations. In all of these areas a number of
      deficiencies were found, and the results of follow-up inspections clearly show
      that the attention being given to public health regulations for sterilization and
      disinfection and to the storage of vaccines, is still inadequate. Urgent action
      is also required to improve conditions which are beyond the control of staff,
      such as buildings in need of repair, lack of space and the installation of
      washbasins, toilets, etc.

PMID- 1759640
TI  - [Primary hypogonadism associated with neuropsychiatric disorders].
AB  - Among 43 female patients aged 17-46 years, most with severe oligophrenia, there
      were 4 with primary hypogonadism (olfactory-genital dysplasia, Smith-Lemli-Opitz
      syndrome and lastly a Kanner syndrome). The incidence of genital underdevelopment
      is assumed to be higher among mentally retarded female patients. In cases of
      hypogonadism and hypogenitalism a search should always be made for possible
      mental and neurological disorders.

PMID- 1759641
TI  - [Accommodation and the pupil].

PMID- 1759642
TI  - [The parasympathetic direct pathway from the midbrain to the ciliary muscle in
      cats and monkeys].
AB  - The visceral, namely the parasympathetic component of the oculomotor complex
      which directly innervates ciliary muscle was investigated using horseradish
      peroxidase (HRP) in three cats and three monkeys. A unilateral total iridectomy
      to abolish innervation to the iris was made in all animals. After 1 month to
      allow fiber degeneration in the iris, HRP was injected into the ciliary muscle of
      ipsilateral eye. Distribution of the labeled cells at the midbrain and at the
      ciliary ganglion was examined. Labeled cells were present in the ciliary ganglion
      and midbrain in all three cats and three monkeys. In the cat, labeled cells were
      distributed in the Edinger-Westphal (EW) nucleus and the Perlia nucleus. In the
      monkey, labeled cells were distributed in the anteromedian (AM) nucleus, the EW
      nucleus and the Perlia nucleus, respectively. Therefore, the existence of a
      direct parasympathetic pathway from the midbrain to the ciliary muscles was
      confirmed in these animals. Based on these observations, it is obvious that
      accommodation of the eye was innervated partly by a direct pathway from the
      midsagittal region of the parasympathetic neuron of the oculomotor nuclear
      complex.

PMID- 1759643
TI  - [Attempt to the measurement of the tension of zonular fibers--influence to the
      lens suspensory apparatus when the lens was vertically displaced by pushing
      posteriorly].
AB  - A new fine pressure gauge was developed to quantitate zonular tension of the
      albino rabbit eye. This apparatus consists of a plastic rod to press the
      crystalline lens, transducer, amplifier, and recorder. The diameter of this
      plastic rod is 8 mm. The cornea and the iris of enucleated eyes were removed by
      excision in the limbus. Afterwards the lens were vertically pressed by the
      plastic rod of the fine pressure transducer. It was necessary to disrupt a part
      of zonules by approximately 106 g (2.11 g/mm2). This result was equivalent to 155
      mmHg. The morphological changes of the anterior part of eye globe which consists
      of lens, zonules, and ciliary process were investigated using scanning electron
      microscopy. In the control eyes, the zonular fibers mostly originated from the
      superior or lateral ciliary processes and inserted straight into the equatorial
      region of the lens. In comparison with control eyes, the zonular fibers which
      were pressed by the plastic rod were almost absent within 1/6 of a circle. This
      disruption occurred at the region adjacent to the ciliary e process, while the
      region of the insertion to the lens demonstrated a normal appearance. In the
      unaffected area zonules were well-preserved morphologically, apart from splits of
      the bundles of zonules. The present study indicated that zonular fibers could
      resist a stretching press up to approximately 8 times normal intraocular
      pressure.

PMID- 1759644
TI  - [Topography of the human ciliary muscle].
AB  - The human ciliary muscle of the eye of a 48-year-old male enucleated at surgery
      for an adenoid cystic carcinoma of the lacrimal gland was studied regarding the
      morphological characteristics of the anterior apical part of the muscle,
      including the three-dimensional microstructure. In the anterior serial transverse
      sections from the most anterior level in which the meridional, radial and
      circular muscle fibers were recognized, the circular muscle layer anteriorly
      decreased, whereas the radial muscle layer increased in ratio. Thick muscle fiber
      bundles immediately below the outermost meridional muscle fiber layer repeated to
      merge and divide with neighbouring bundles on every side and indicating a
      complicated structure. In the scleral spur, the apical part of the muscle fiber
      bundle showed a very thin lamellated layer and terminated between the stromal
      tissue of the scleral spur indicating a strong interconnection with stromal
      tissue by a muscle-tendon junctional structure basically similar to the muscle
      tendon junction in the striated muscle.

PMID- 1759645
TI  - [Observation of cellular communication in the corneal endothelium using a small
      molecular weight fluorescent dye].
AB  - The metabolic and functional connection between corneal endothelial cells is
      thought to depend on the transfer of small molecules via gap junctions, as has
      been reported for other tissues. Cell-to-cell communication in the corneal
      endothelium was studied by monitoring the spread of fluorescence following the
      direct injection of Lucifer Yellow CH into single endothelial cells of the
      excised rabbit cornea. The image of the endothelial cells was observed during the
      injection and post-injection periods using specular microscopy and fluorescence
      microscopy. In the fresh cornea, the dye transferred readily from the injected
      endothelial cell to its neighbors. In damaged cells, dye transfer was slower or
      did not occur. After 5 hours of incubation in tissue culture medium 199, the
      specular microscopic image degraded, lowered cell membrane potential and
      decreased dye transfer rate were measured. This study showed that in normal
      corneal endothelial cells there were efficient cell communication channels
      between neighboring cells, and as the endothelium becomes less viable, cell
      communication is inhibited.

PMID- 1759646
TI  - [Lens crystallin leakage in aqueous humor from human cataractous lenses].
AB  - The amounts of human lens crystallins in the aqueous humor from various types of
      cataract patients were measured by radioimmunoassay. alpha, beta and gamma
      crystallins as antigens for radioimmunoassay were purified from one-year-old
      normal human lens by TSK3000SW gel permeation column using high performance
      liquid chromatography. The amounts of both alpha- and gamma-crystallin in the
      aqueous humor from the patients with cortical and posterior subcapsular cataract
      were relatively low but in the case of mature cataract those of both crystallins
      increased. While the amounts of beta-crystallin in aqueous humor from cortical
      and posterior subcapsular cataract patients were at the same level compared with
      alpha-crystallin, those from mature cataract patients showed extremely high
      values.

PMID- 1759647
TI  - [Participation of sodium iodate in the induction of experimental autoimmune
      uveoretinitis (EAU)].
AB  - It is known that Brown Norway (BN) rats show resistance to the development of
      experimental autoimmune uveoretinitis (EAU). Although BN rats don't develop EAU
      easily when they were immunized with S antigen containing emulsified complete
      Freund's adjuvant, this paper reports on the development of EAU at the rate of 40
      60% in BN rats when immunization is preceded by an injection of more than 0.5 mg
      (1.79 mg/kg of body wt) of sodium iodate which leads to the destruction of
      retinal pigment epithelium (RPE). It was thought that the destruction of RPE
      participated in the induction of EAU. Therefore, it is considered that the
      existence of RPE may play an important role in the induction of EAU.

PMID- 1759648
TI  - [Correction of EOG with eye movement measured by the eye mark recorder system].
AB  - The electrooculogram (EOG) is usually necessary for the subject to fixate two
      targets alternately at a fixed visual angle. However, in the patients with poor
      vision, it can be difficult to fixate exactly. In such case, the results can be
      improved by using both the measurement of real eye position and the measurement
      of EOGs in combination. In this study, we measured subject's eye position
      simultaneously with the potential changes around his eyes as the subject pursued
      alternately two on-and-off visual targets which were horizontally placed on the
      cylindrical screen at a regular visual angle in front of his eyes. The EOG is
      obtained from those potential changes. If the difference between the target
      position and the fixating point can be calculated from the net eye movement
      measured with an eye camera, the error potential can be derived from this
      difference. Therefore, exact potential changes are obtained by correcting the
      measured potentials with the above error potentials. The authors were able to
      confirm that the potential changes were approximately proportional to the
      amplitude of saccadic eye movements within about 30 degrees in front of the eyes.
      Therefore, the simultaneous measurement of the potential changes and the eye
      position enable measurement of EOG without pursuing the targets by transforming
      the measured potentials into the exact values corresponding to the constant
      amplitudes of saccades.

PMID- 1759649
TI  - [Studies on intraocular hydrogen ion concentration. The effect of diathermy
      coagulation for normal albino rabbits' eye].
AB  - The vitreous and intra-retinal pH of anesthetized albino rabbits were measured
      using an antimony pH microelectrode (Micro Antimon pH Electrode No. 801, Diamond
      Electro-Tech Co. Ltd). The effect for the retinal pH was observed after regional
      choroidal circulatory disturbance was synthesized by trans-scleral diathermy. The
      results showed that the arterial blood pH was 7.45 +/- 0.03 (n = 24). The average
      vitreous pH was 7.41 +/- 0.11 (n = 24), which was almost equal to or slightly
      lower than that of the arterial blood. There were no statistical significance
      between the two. The average retinal pH was 7.31 +/- 0.11 (n = 22), which was
      lower statistically than that of the vitreous (p less than 0.01). The retinal pH
      was measured in the same way 3 weeks after the trans-scleral diathermy. Those
      within the coagulation scar showed pH value of 6.87 +/- 0.39 (n = 10). This is
      lower than those in a normal retina (p less than 0.01). This instrument allows
      continuous pH measurements of the intraocular tissue and therefore it is thought
      to be useful for the studies of retinal circulatory disturbances.

PMID- 1759650
TI  - [The effects on accommodative and pupillary responses by topical application of
      cyclopentolate hydrochloride].
AB  - Accommodative and pupillary responses, refractive change, and visual acuity after
      30 microliters instillation of cyclopentolate hydrochloride of various
      concentrations (0.00625-0.1%) in 6 young normal males (27.0 +/- 0.6 yrs) were
      investigated. Both accommodative and pupillary responses were measured by an
      infrared optometer, at pre-instillation and 1, 3, 6, 9 and 24 hours post
      instillation. No significant effects were induced by concentrations of
      cyclopentolate hydrochloride 0.0125% or less. Reduced amplitude of accommodation
      and enlarged pupil were, however, observed by 0.025% and 0.05% of cyclopentolate
      hydrochloride from 1 through 9 hours post-instillation. Miotic response in
      accommodation was also reduced from 1-6 hours at the same concentrations. A
      concentration of 0.1% cyclopentolate hydrochloride showed both reduction of
      accommodation amplitude and enlarged pupil for 24 hours after instillation.
      However, neither refraction nor visual acuity was affected by any concentration
      of cyclopentolate hydrochloride. The results suggest that cyclopentolate
      hydrochloride at concentrations up to 0.05% applied before sleep would not be
      accompanied by inhibitory effects on accommodation during the day.

PMID- 1759651
TI  - [Changes in the dark focus of accommodation in patients with asthenopia].
AB  - The authors studied tonic accommodation in cases of asthenopia. The subjects
      consisted of ten college students, aged 20 to 22 years old as normal control and
      seven patients with asthenopia, aged 20 to 27. The dark focus of accommodation
      was measured with the infrared optometer before and after a 15 min sustained
      visual task. No significant differences were found between the two groups on the
      pre-task dark focus of accommodation. After the task, significant differences
      were found between the pre- and post-task dark focus of accommodation in patients
      with asthenopia. The results suggest that the patients with asthenopia are more
      susceptible to autonomic nervous system imbalance than healthy persons.

PMID- 1759652
TI  - [The aging of accommodative function and its pupillary response in VDT workers
      without subjective complaints].
AB  - Using a computer-assisted infrared optometer with a pupillometer, we measured the
      accommodative function and its pupillary response in 81 female subjects (age: 31
      55 yrs) without visual complaints who worked via visual-display-terminal (VDT).
      From these measurements we analyzed the following 6 parameters regarding
      accommodation, and investigated whether a correlation exists between age and each
      parameter. The six parameters were, (1) the amplitude of objective accommodation,
      (2) the refractive fluctuation at the resting state of accommodation, (3) the
      refractive fluctuation after receiving myopic stimuli, (4) the pupil area prior
      to myopic stimuli, (5) the maximum rate of constriction by accommodation, and (6)
      the rate of pupil area recovery after accommodation. Among these parameters, the
      amplitude of objective accommodation, the refractive fluctuation at the resting
      state of accommodation, the refractive fluctuation after receiving myopic
      stimuli, and the pupil area prior to myopic stimuli were significantly correlated
      with age (all parameters: p less than 0.001). The correlation coefficients (r)
      were -0.810, -0.591, -0.612 and -0.320 respectively. There was also some
      relationship between age and the rate of pupil area recovery after accommodation
      (r = 0.188, p = 0.018), but no statistically significant correlation between age
      and the rate of constriction by accommodation (r = 0.100). These findings suggest
      that the overall functional capability of accommodation decreases constantly with
      age, though the pupillary reaction induced by accommodation is not correlated
      well with age.

PMID- 1759653
TI  - [Pars plana lensectomy preserving a clear anterior capsule in vitreous surgery].
AB  - The anterior capsule was preserved intact in pars plana lensectomy in 14 cases of
      pars plana vitrectomy carried out for proliferative diabetic retinopathy in 9
      cases, sarcoid uveitis in one case, proliferative vitreo-retinopathy in 3 cases
      and retinal detachment with a giant break in one case. Follow-up periods ranged
      from 6 to 17 months, with a mean of 11 months. Simultaneous posterior chamber
      intraocular lens implantation anterior to the anterior capsule was performed in 7
      cases, and in one case secondary implantation was performed 4 months later. In 11
      cases anterior capsules remained clear and in 9 of them lens epithelial cells had
      been thoroughly removed up to the equator using a Terry squeegee. Posterior
      synechia occurred in 4 cases in which air or gas tamponade had been done. This
      method allows complete anterior vitrectomy and is adaptable not only to
      simultaneous but also secondary posterior chamber intraocular lens implantation.

PMID- 1759654
TI  - [Tissue plasminogen activator treatment of postvitrectomy pupillary fibrin
      membrane].
AB  - Twenty-five micrograms of human recombinant tissue plasminogen activator (tPA)
      was injected via the corneoscleral limbus of 14 postvitrectomy aphakic eyes with
      prominent pupillary fibrin membranes. Fibrinolysis by tPA was initiated by thirty
      minutes after the injection, and the fibrin membrane was completely dissolved
      within sixty minutes. No toxicity attributed to tPA was observed clinically.
      Intraocular fluid was obtained during fluid-gas exchange after complete
      dissolution of fibrin and analyzed for decomposed fibrin products (FDP).
      Intraocular FDP was significantly higher (160 +/- 250 micrograms/ml) than normal
      after tPA treatment. Intraocular tPA administration is a potent modality to treat
      postvitrectomy fibrin membrane. Fluid-gas exchange must be performed to eliminate
      as much FDP as possible to reduce postoperative inflammation.

PMID- 1759655
TI  - [Choroidal detachment associated with rhegmatogenous retinal detachment and
      aqueous flare].
AB  - The aqueous protein level (APL) in eyes of rhegmatogenous retinal detachment
      (RRD) combined with or without choroidal detachment (CD) was investigated using a
      laser flare-cell meter. The APL in eyes of RRD with CD was 70 times higher than
      in eyes of simple RRD. The APL increased suddenly with the appearance of CD and
      decreased rapidly in accordance with the disappearance of CD. The longer the CD
      continued, the higher the APL remained preoperatively as well as postoperatively.
      The APL in eyes of RRD with CD was still twice as high as in eyes of simple RRD 6
      months after successful retinal reattachment. This marked and prolonged
      intraocular inflammation in eyes of RRD with CD might result in a poorer visual
      outcome. The extremely high APL might be caused by reflux of suprachoroidal
      protein through the uveoscleral route and/or venous protein through the
      trabecular meshwork due to ocular hypotony and possibly by diffusion of protein
      via posterior chamber and vitreous cavity due to the breakdown of the blood
      ocular barrier.

PMID- 1759656
TI  - [Morphometry of sacral neurons innervating the pelvic muscles. Experimental
      study].
AB  - Sacral motoneurons of the pelvic muscles have been extensively studied in the rat
      (1,2). Few informations occur in the literature on their specific morphology and
      their interconnection. In an experimental study we have differentiated the
      neuronal mapping of the: bulbo-spongiosus (B.S.M.), ischio-cavernosus (I.C.M.),
      levator ani (L.A.M.), sphincter ani (S.A.M.) and sphincter urethrae (S.U.M.)
      muscles. Each different or both sided pelvic muscle of 30 wistar rats have been
      injected by a solution of horse-radish-peroxidase. Using this H.R.P. technique,
      the mapping of the marked neurons and compared to the different muscles has been
      performed on horizontal and transversal spinal cord sections. A statistical study
      using the "T" test compares the maximal and minimal diameters and the surface of
      the neurons. 1. Most of the muscles injected in one side left or right receive
      their innervation from the neurons located in the homolateral side of the spinal
      cord. 2. The B.S.M. and the S.A.M. receive, in part, an innervation from the
      opposite side. 3. The neurons of the B.S.M. and of the S.A.M. are located in the
      D.M. group of L5 - L6 segment of the spinal cord. Their diameters are
      significantly different but not their surfaces (+/- 940 mu 2). 4. The neurons of
      the I.C.M. and of the S.U.M. located in the D.L. group have an equivalent
      diameter and surface. 5. The neurons of the L.A.M. have the largest diameter but
      an equivalent surface to the others. This work on a mammalian model brings
      further informations on the mapping of the sacral innervation of the pelvic
      muscles and offers a comparative reference for Man.

PMID- 1759657
TI  - Primary localized amyloidosis of the urinary bladder.
AB  - A case is presented of a woman aged 78 with a primary location of amyloidosis of
      the bladder. The clinical symptoms and the cystoscopy initially suggested a
      vesical carcinomatous infiltration.

PMID- 1759658
TI  - Primary transitional cell carcinoma of anterior male urethra: a rare case.
AB  - We report a rare case of primary transitional cell carcinoma in a man aged 56
      years old. Approximately 600 cases of primary carcinoma of the male urethra have
      been accumulated until today (1). The 30 to 50 per cent of these neoplasms
      originate in the anterior urethra and only the 15 per cent are of the
      transitional cell type (2).

PMID- 1759659
TI  - Leiomyosarcoma of urinary bladder.
AB  - The authors report one case of a leiomyosarcoma of the urinary bladder in a
      seventy-two-year-old man. The treatment was transurethral resection. There has
      been no evidence of recurrence or metastasis in more than a two-year follow-up.
      The literature is reviewed and the size of the tumor on the prognosis is
      discussed.

PMID- 1759660
TI  - [Ureteroscopic resection of a fibrous polyp of the ureter].
AB  - From a new case of fibroepithelial polyp in a 41 year old woman, we reviewed
      literature on this rare and benign pathology, for which differential diagnosis
      with malignant tumor is most often obtained surgically. We emphasize both
      diagnostic and therapeutic advantages of endoscopic approach of this lesion.

PMID- 1759661
TI  - [Transuretero-pyelostomy for ureteral necrosis following a Mainz continent
      umbilical urinary diversion].
AB  - A female patient, undergoing a radical cystectomy and a continent urinary
      diversion in the umbilicus (after multiple gynecological interventions and 40 Gy
      radiotherapy) presented a stenosis of the left ureter. After 6 months a uretero
      pyelostomy (left-right) was performed mediating a bilateral lumbotomy. This
      approach has prevented a nephrectomy or a laparotomy which could compromise the
      continence mechanism of the pouch.

PMID- 1759662
TI  - [Endovesical antireflux plastic surgery. Original technique].
AB  - The authors present a technique of endovesical transposition of the urethra with
      orthotopic reimplantation of latter. This very effective technique is simple. In
      addition, it allows secondary catheterization and reduces post-operative
      complications.

PMID- 1759663
TI  - [Prosthetic replacement in a case of invasion of the inferior vena cava by a
      recurrent hypernephroma].
AB  - We report a case of inferior vena cava resection and reconstruction for
      recidivant renal cell carcinoma. We describe the collateral circulation of the
      renal veins and its importance in the treatment of inferior vena cava
      involvement. We debate of the indications and of the different surgical
      techniques for reconstruction of the inferior vena cava.

PMID- 1759664
TI  - The role of imaging techniques in diagnostic evaluation of angiomyolipomas.
AB  - Renal AML are rare benign tumors of the kidneys consisting of fat tissue
      intermixed with thick-walled blood vessels and smooth muscle. Due to the easy
      access to modern imaging techniques more and more AML are detected incidentally
      during diagnostic evaluation of common urological disease before getting
      symptomatic (mostly flank pain, hematuria). The presence of a highly echodense
      renal mass on ultrasound and the detection of even small amounts of fat in CT
      usually allows to establish the diagnosis of AML. If these procedures give still
      equivocal results, angiography and MRI may become necessary. When report a case
      of a patient with AML where all the imaging techniques including magnetic
      resonance were nonconclusive. The correct diagnosis could only be established by
      histological examination after surgical resection. Indeed, the presence of a
      large hematoma had masked all the characteristic features of AML in this case.

PMID- 1759665
TI  - The use of prostaglandins for diagnosis and treatment of erectile impotence.
AB  - The authors present their experience in using PGE-1 for the assessment of 77
      impotent patients. This drug can be safely used as a screening test for
      vasculogenic impotence but is also useful in more invasive diagnostic tests. PGE
      1 is probably the only natural product that can be used commonly for the
      treatment of erectile impotence, because it is a safe and effective drug.

PMID- 1759666
TI  - Endopyelotomy. Evaluation of a limited experience.
AB  - Endopyelotomy is a recently developed endo-urological technique which gets to be
      standardised and gradually may replace the open pyeloplasty. Our technique is
      described and the early results are presented.

PMID- 1759667
TI  - [Correction of ureteropelvic junction syndrome: Anderson-Hynes method of
      pyeloplasty with or without nephrostomy].
AB  - We report the last 50 ureteropelvic junction repairs (Anderson-Hynes pyeloplasty)
      with a minimum follow-up of 6 months performed in our department. We describe the
      operative technique without nephrostomy in 40 patients and we look at the results
      in relation to a small group which had a nephrostomy for one or other reason (10
      patients).

PMID- 1759668
TI  - [The treatment of prolonged erections using phenylephrine].
AB  - Phenylephrine was used intracavernously to treat prolonged erections in 38 cases.
      A rapid detumescence was obtained in every case. Phenylephrine seems to be
      superior to all other adrenergic drugs in reason of its rapid action and its lack
      of side effects.

PMID- 1759669
TI  - Adrenal cyst: a case report.
AB  - The authors describe the case of a patient with a large adrenal cyst. They review
      the existing literature and discuss the problem of diagnosis an treatment.

PMID- 1759670
TI  - [Dermoid cyst of the bladder. Case report].
AB  - Dermoid cyst of the bladder is an exceptional pathology. One case of hairy
      bladder tumors is describe with short review of the literature.

PMID- 1759671
TI  - [Observations of a case of sirenomelia in a 37-year-old adult].
AB  - The authors study a case of sirenomelia at a 37 years old adult woman,
      nosographic table presented for the first time by Charles Duhamel in 1959, having
      the denomination of "caudal regression syndrome", similar to Goldenhar syndrome
      cephalic expression of this regression. The malformation is known and well
      presented by Greek mythology in Homer (Odissey), Ovide (The Metamorphosis) etc.
      One presents little enough information, its classification and a few
      etiopathology data.

PMID- 1759672
TI  - [Retroperitoneal fibrosis. Apropos of 3 cases 2 of which were induced by
      bromocriptine].
AB  - The authors present three cases of retroperitoneal fibrosis. Two of which were
      induced by bromocriptine (PARLODEL). These three cases followed up for three
      years without recurrence were treated with corticoids and internal derivations
      (double J catheters) in two of the three cases.

PMID- 1759673
TI  - Drug approval process changing, speakers say.

PMID- 1759674
TI  - Chronotherapeutics: implications for drug therapy.

PMID- 1759675
TI  - Community pharmacy residencies refine career goals.

PMID- 1759676
TI  - Case report: 'pitfalls' associated with multiple NSAID use.

PMID- 1759677
TI  - Chronic complications of diabetes.

PMID- 1759678
TI  - Why APhA should reject its code of ethics.

PMID- 1759679
TI  - Clonal development of interconnected germ cells in the rat and its relationship
      to the segmental and subsegmental organization of spermatogenesis.
AB  - Segments and subsegments are the smallest unit of synchrony thus far described
      within longitudinal sections of seminiferous tubules. It is known that cells in a
      clone joined by intercellular bridges are at the same phase of development and
      are also thought to be units of synchrony. This study was designed to determine
      if it is possible that the synchrony seen in cells joined by intercellular
      bridges is the same as that cataloged along the long axis of the seminiferous
      tubule. In the present study, the maximum number of rat spermatids joined by
      intercellular bridges (a clone) was obtained. It was hypothesized that if the
      clone size were larger than the smallest known units of synchrony (segments or
      subsegments) in the long axis of the seminiferous tubule, then intercellular
      bridges would most likely govern the synchronous development of segments or
      subsegments (or finer subdivisions thereof). If the clone size is smaller than
      the number of cells present in a segment or subsegment, then other factors must
      govern synchrony in the longitudinal aspect of the tubule. In the determination
      of spermatid clone size, rat testes were injected with cytochalasin D which opens
      intercellular bridges of a spermatid clone to produce large symplasts. The number
      of nuclei in the symplasts was determined from serially sectioned tissue, by
      drawing nuclei with a camera-lucida, and by counting nuclei. After extensive
      examination of tubules, the number of spermatids found in the suspected five
      largest clones observed was determined to be 650, 607, 338, 240, and
      177.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759680
TI  - Localization of boar sperm proacrosin during spermatogenesis and during sperm
      maturation in the epididymis.
AB  - The localization of proacrosin was determined by using colloidal gold labeling
      and electron microscopy of boar germ cells during spermiogenesis to post
      ejaculation. Proacrosin was first localized in round spermatids during the Golgi
      phase of spermiogenesis; it was associated with the electron-dense granule, or
      acrosomal granule that was conspicuous within the acrosome. It remained within
      the acrosomal granule during the cap and acrosome phases of spermiogenesis. At
      these stages, there was no apparent association of the proacrosin molecule with
      the acrosomal membranes. During the maturation phase of spermiogenesis,
      proacrosin was seen to become dispersed into all regions of the acrosome except
      the equatorial segment. When sperm from different segments of the epididymis and
      ejaculated sperm were examined, localization was observed throughout the acrosome
      except for the equatorial segment. Here proacrosin appeared to be localized on
      both the inner and outer acrosomal membranes as well as with the acrosomal
      matrix, although further studies are required to verify the membrane
      localization. No labeling was seen on the plasma membrane. These data suggest
      that the synthesis and movement of proacrosin to sites in the acrosome are
      controlled by an as yet unknown process. The absence of proacrosin on the plasma
      membrane of mature ejaculated sperm makes it unlikely that this enzyme plays a
      role in sperm-zona adhesion prior to capacitation.

PMID- 1759681
TI  - Short-term morphological response of the rat testis to administration of five
      chemotherapeutic agents.
AB  - As cancer survival rates improve, there is increasing concern about the adverse
      effects of chemotherapeutic agents on male fertility. Five chemotherapeutic
      agents (amethopterin, AP or methotrexate; doxorubicin, DX; cytoxan or
      cyclophosphamide, CP; cisplatinum, CDDP; and 5-fluorouracil, 5-FU) which belong
      to three different categories of chemotherapeutic agents (antimetabolite,
      antibiotic, alkylating agent, alkylating agent, antimetabolite, respectively)
      were given systemically to adult rats to determine the short-term morphological
      patterns of response in the testis, and the testes were examined by light
      microscopy. Morphological patterns of response were found to be highly
      characteristic for each agent, and some shared morphological responses were
      evident. All except one chemotherapeutic agent (5-FU) caused spermatogonial
      damage. Among the defects seen were probable degenerating meiotic spermatocytes
      (CDDP), presence of micronuclei (DX), "arrested" spermatid development (5-FU),
      and abnormally shaped step 15 spermatids (5-FU). Damage that could be due to the
      effect of an agent on the Sertoli cell was failure of sperm release (5-FU, CDDP,
      DX, and AP), increase in the Sertoli cell lipid (5-FU), and malorientation of
      step 8 spermatids (5-FU, DX). The varied patterns of damage observed are a
      possible explanation of why the reproductive recovery potential in cancer
      patients undergoing chemotherapy is variable and drug-specific.

PMID- 1759682
TI  - Testis structure in the sys (symplastic spermatids) mouse.
AB  - Testes of mice with the recessive insertional mutation termed symplastic
      spermatids (sys) were assessed for structural and developmental abnormalities.
      Homozygous (sys/sys) males are infertile due to an abnormality in spermatogenesis
      leading to azoospermia. The major interruption to spermatogenesis occurs when the
      intercellular bridges that connect round spermatids open prematurely resulting in
      the formation of symplasts. Symplasts contain as many as 285 nuclei. Development
      of spermatids within symplasts is arrested just before, or just after, elongation
      of the spermatid nuclei begins. Symplasts degenerate and appear to be
      phagocytized by Sertoli cells and by intratubular macrophages. In addition,
      degeneration of young round spermatids and also spermatocytes occasionally is
      observed. Spermatocyte degeneration is substantial in some tubules and leaves
      them depleted of cells other than basal compartment cells. Sertoli cell
      abnormalities are prominent and include intracellular vacuolation, absence of
      apical processes surrounding round spermatids, degeneration, and occasional
      sloughing. Although reduplication and infolding of the basal lamina is also seen,
      this does not appear as a common phenomenon. The sys phenotype is first manifest
      in animals between 19 days and 22 days of age. Considerable variability is seen
      in testis histology of prepubertal animals; some display degenerating pachytene
      spermatocytes and virtually no Sertoli cell vacuoles, while others display
      vacuoles without apparent elevated numbers of degenerating spermatocytes.
      Although this study has not revealed the primary cell type(s) affected by the
      insertional inactivation event, it is possible that the abnormalities in the
      Sertoli cells are responsible for germ cell degeneration as it is generally
      recognized that deficits in the Sertoli cell can result in major germ cell
      abnormalities but not vice versa.

PMID- 1759683
TI  - Structural characteristics of immature rat Sertoli cells in vivo and in vitro.
AB  - The structural properties of pelleted prepubertal Sertoli cells (pre-culture
      pelleted cells) from 19-day-old rats and of similar cells cultured for 7 days
      were compared with Sertoli cells from the intact animal (testis tissue from 19-
      and 26-day-old rats, the in vivo groups). Sertoli cells from freshly isolated
      pellets and those cultured for 7 days were similar in cell and nuclear volumes to
      their in vivo counterparts. Cell volumes, organelle volumes, and organelle volume
      densities of newly isolated Sertoli cells were similar to those of sectioned
      cells taken from the 19-day-old in vivo group, indicating that the procedure for
      isolation does not grossly alter Sertoli cells. Mean height of cells cultured for
      7 days was significantly lower than that of cells from intact animals at 19 and
      26 days of age. In vivo, Sertoli cells of 26-day-old animals displayed increased
      organelle volumes and organelle surface areas compared with those from 19-day-old
      animals; volume densities and surface densities remained relatively constant,
      indicating that in vivo, organelle growth is in proportion to growth of the cell.
      Most organelle volume and surface densities were not significantly different when
      19-day-old in vivo cells and pre-culture pelleted cells were compared. Many
      organelle volume and surface density values were significantly less in cells
      grown in culture for 7 days as compared to freshly isolated pelleted cells. After
      7 days of culture, most Sertoli cell organelles were significantly less in both
      volume density and surface density, as compared to the in vivo cell groups (19 or
      26 day). This indicates that in vitro the organelles do not develop in proportion
      to the growth of the cell. After 7 days in culture, the absolute volumes and
      surface areas of the organelles remained generally unchanged as compared to cells
      from 19-day-old animals. The data show that Sertoli cells grow in volume in vitro
      like their in vivo counterparts; however, their subcellular features, although
      well maintained, do not develop in proportion to the cell. This suggests that
      short-term cultures are a more ideal system in which to study biochemical
      responses. Also, cultured prepubertal Sertoli cells are most appropriately used
      to study prepubertal Sertoli cell function. This is the first study to quantify
      developmental changes in Sertoli cell structure in vivo as well as to compare
      them with cellular changes occurring in vitro.

PMID- 1759684
TI  - Reinitiation of spermatogenesis by exogenous gonadotropins in a seasonal breeder,
      the woodchuck (Marmota monax), during gonadal inactivity.
AB  - The present study was undertaken (1) to document structural and functional
      changes in the testes of seasonally breeding woodchuck during active and inactive
      states of spermatogenesis and (2) to evaluate the ability of exogenous
      gonadotropins to reinitiate spermatogenesis outside the breeding season. During
      seasonal gonadal inactivity, there were significant (P less than 0.05) reductions
      in volumes of several testicular features (testis, seminiferous tubules, tubular
      lumen, interstitial tissue, individual Leydig cells, Leydig cell nuclei, and
      Leydig cell cytoplasm) as compared with gonadally active animals. The diameter of
      the seminiferous tubules was decreased by 26%, and Leydig cell numbers also
      declined in the regressed testes. These changes were accompanied by a decline in
      testosterone (T) levels in both plasma and testis, and reduction in epithelial
      height of accessory reproductive organs. A hormonal regimen was developed that
      would reinitiate spermatogenesis in captive, sexually quiescent woodchucks. A
      combination of PMSG and hCG markedly stimulated testicular growth and function
      and restored spermatogenesis qualitatively. Quantitatively normal spermatogenesis
      was restored in 2 of 6 treated males. Morphometric analyses revealed substantial
      increases in seminiferous tubular diameter and in the volume of seminiferous
      tubules, tubular lumen, total Leydig cells, and individual Leydig cells in the
      hormone-treated animals. These increased values corresponded to 99, 75, 68, 51,
      and 200%, respectively, of the values measured in naturally active woodchucks.
      Leydig cell numbers, however, remained unchanged and approximated only 31% of the
      number found in naturally active testes. Hormonal stimulation also resulted in a
      significant rise in serum T as well as in the total content of testicular T, and
      a marked increase in epithelial height in various accessory reproductive glands.
      The most effective hormonal protocol for stimulating spermatogenesis was
      treatment with 12.5 IU of PMSG twice a week for 4 weeks followed by 12.5 IU of
      PMSG + 25 IU of hCG twice a week for 4 weeks.

PMID- 1759685
TI  - Linkage of manchette microtubules to the nuclear envelope and observations of the
      role of the manchette in nuclear shaping during spermiogenesis in rodents.
AB  - Structural features of the mouse and rat manchette and the role of the manchette
      in shaping the spermatid nucleus were investigated. Rod-like elements about 10 nm
      in diameter and 40-70 nm in length were seen linking the innermost microtubules
      of the manchette and the outer leaflet of the nuclear envelope in step 8 through
      step 11 rat and mouse spermatids that either had been routinely fixed for
      electron microscopy or had been isolated and detergent extracted. Rod-like
      linkers were also seen joining the nuclear ring to the plasma membrane and
      nuclear envelope. These linkers may ensure that under normal conditions the
      manchette remains in a defined position relative to these membranous components.
      A variety of compounds (taxol, cytoxan, and 5-fluorouracil) were found to perturb
      the manchette and to affect nuclear shaping. In addition, sys and azh mutant mice
      were used to determine the consequences of defective manchette formation. These
      genetic conditions and chemical treatments either produced manchettes that were
      not in their normal position (azh, sys, and taxol) and/or caused the manchette to
      appear abnormal (azh, sys, cytoxan, 5-fluorouracil, and taxol), and all resulted
      in a deformation of the step 9-11 spermatid nucleus. In all instances where the
      manchette was present, either in normal or ectopic locations, the sectioned
      nuclear envelope was parallel to the long axis of the microtubules of the
      manchette. In general, areas of the nuclear envelope where the manchette was not
      present, or where it was expected to be present but was not, were rounded (normal
      animals, sys, cytoxan). In addition, there are indications using certain
      compounds (cytoxan and 5-fluorouracil) as well as in the azh and sys mouse that
      the manchette may exert pressure to deform the nucleus. It is suggested that the
      rod-like linkages of the manchette ensure that the nuclear envelope remains at a
      constant distance from the manchette microtubules and that this is a major factor
      acting to impart nuclear shape changes on a region of the head caudal to the
      acrosome during the early elongation phase of spermiogenesis. The manchette
      microtubules, which are also known to be linked together, may act as a scaffold
      to deform this part of the nucleus from its spherical shape, perhaps in concert
      with forces initiated by other structural elements. Evidence from sys animals
      indicates that structural elements, such as the acrosomal complex over the
      anterior head (acrosome-actin-nuclear envelope), may affect nuclear shaping over
      the acrosome-covered portion of the spermatid head.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1759686
TI  - Chorioallantoic placenta formation in the rat: I. Luminal epithelial cell death
      and extracellular matrix modifications in the mesometrial region of implantation
      chambers.
AB  - On days 7 and 8 of pregnancy, mesometrial regions of rat gestation sites were
      examined by light microscopy and transmission electron microscopy to determine
      what changes occur before the chorioallantoic placenta forms in that region. By
      day 7, gestation sites contained a uterine lumen mesometrially and an
      antimesometrial extension of the uterine lumen, the implantation chamber. The
      implantation chamber consisted of a mesometrial chamber between the uterine lumen
      and the conceptus, an antimesometrial chamber that contained the conceptus, and a
      decidual crypt antimesometrial to the conceptus. Stromal cells that formed the
      walls of the implantation chamber were closely packed decidual cells, while those
      that surrounded the uterine lumen were loosely arranged. Late on day 7, a portion
      of the epithelium lining the mesometrial chamber was degenerating, but this area
      of initial degeneration was never adjacent to the antimesometrial chamber. By
      early day 8, most of the epithelial cells lining the mesometrial chamber were
      degenerating and were being sloughed into the chamber lumen. Although
      degeneration of these epithelial cells morphologically resembled necrosis, it was
      precisely controlled, since adjacent epithelial cells lining the uterine lumen
      remained healthy. The space that separated the denuded luminal surface of the
      mesometrial chamber from underlying decidual cells became wider and was occupied
      by an extracellular matrix rich in cross-banded collagen fibrils. Decidual cell
      processes, that earlier had penetrated the basal lamina beneath healthy
      epithelial cells, protruded into this matrix and penetrated the basal lamina at
      the luminal surface. By late day 8, large areas of denuded chamber wall were
      covered with decidual cell processes, little remained of the basal lamina, and
      cross-banded collagen fibrils were scarce in the area occupied by decidual cell
      processes. During the times studied, uterine tissues that formed the walls of the
      mesometrial chamber were not in direct contact with the conceptus. This study
      indicates that trophoblast does not play a direct role in epithelial
      degeneration, basal lamina penetration, or extracellular matrix modifications in
      the mesometrial region of implantation chambers where part of the chorioallantoic
      placenta forms, although trophoblast may be required to trigger or modulate some
      of the changes.

PMID- 1759687
TI  - The role of hematogenous and intrinsic precursor cells in lymphocyte production
      in murine bone marrow and thymus.
AB  - It is well recognized that the bone marrow contains cells that can repopulate a
      depleted thymus as well as cells that can be induced to express phenotypic
      markers characteristic of T cells. It is not known, however, to what extent
      thymocytopoiesis in the normal thymus relies on immigrant, bone marrow-derived
      cells, nor whether some T cell precursors have entered the bone marrow from the
      circulation. We used the parabiotic system to test whether thymocytopoiesis
      relies on progenitors intrinsic to the thymus or on cells that enter the organ
      from the circulation. In the same system, we have also investigated whether Thy-1
      bone marrow lymphocytes that respond to phytohemagglutinin (PHA) by
      proliferation and Thy-1 expression are produced by myelogenous or hematogenous
      progenitors. Syngeneic CBA/HT6 and CBA/CaJ mice were joined in parabiotic union
      at 4-6 weeks of age. Cross circulation between the two partners was verified by
      the equilibration of Evans' blue dye injected into one partner and by the
      equilibration of PHA-responsive T cells in the spleen of the parabionts.
      Chromosome spreads were prepared from the PHA-stimulated T cell-depleted bone
      marrow and from spontaneously proliferating thymocytes as well as from thymocytes
      stimulated by PHA or Concanavalin A (Con A). The exchange of spleen colony
      forming units (CFU-S) in the femoral marrow was assessed by karyotyping
      individual spleen colonies. Regardless of the length of parabiotic union, ranging
      from 4 to 20 weeks, Thy-1-, PHA-responsive bond marrow lymphocytes remained
      predominantly of the host type with only 3% being derived from the opposite
      partner.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759688
TI  - Arrangement and innervation of the iliocostalis and longissimus muscles of the
      brown caiman (Caiman crocodilus fuscus: Alligatoridae, Crocodilia).
AB  - The axial musculature of the brown caiman was investigated in detail with
      particular attention to the nerve supply, using a binocular stereomicroscope. Due
      to the prominent development of the longissimus (Lo) and the iliocostalis (IC)
      muscles of the caiman, the pattern of distribution of the spinal nerves in the
      body wall was unique; there also was less differentiation of the external
      intercostalis. There were four primary divisions of the spinal nerves in the
      thoracic region of the caiman, from ventral to dorsal: the intercostal nerve, the
      IC nerve, the Lo nerve, and the dorsal main trunk. Thus, the classic concept of
      the organization of the spinal nerves may not be suitable for the caiman. These
      findings suggest that evolutionary changes in the dorsolateral axial musculature
      have brought about the rearrangement of the organization of the spinal nerves. In
      addition, each clearly segmented myotome of the Lo and IC was innervated by more
      than two segments of the spinal nerves (plurisegmental innervation). The manner
      of formation of the myotome and its innervation is discussed from the viewpoint
      of comparative and developmental anatomy.

PMID- 1759689
TI  - Hypophyseal angioarchitecture of common tree shrew (Tupaia glis) revealed by
      scanning electron microscopy study of vascular corrosion casts.
AB  - The vascular corrosion cast technique in conjunction with scanning electron
      microscopy (SEM) was used for the study of pituitary microvascularization in the
      common tree shrew (Tupaia glis). The pituitary vascular casts were obtained by
      infusion of low viscosity methyl methacrylate plastic (Batson's no.17) mixture.
      It was found that the blood supplies to the pituitary complex were from branches
      of the circle of Willis and could be divided into two groups. The first group
      consisted of two to four superior hypophyseal arteries (SHAs) branching off from
      the internal carotid artery supplying each half of the median eminence (ME),
      infundibular stalk (IS), and pars distalis (PD). The SHAs supplying the ME
      branched into internal and external capillary plexi. The internal plexus had a
      larger capillary size (approximately 15 microns in diameter), was deeper in
      position, and had denser and more complex capillary loops than those in the
      external plexus. The capillaries of the external plexus were approximately 10
      microns in diameter. The two plexi drained into 15-20 hypophyseal portal veins
      (HPVs) which were located mainly along the ventral and ventrolateral surfaces of
      the IS before breaking up into large capillaries (approximately 18 microns in
      diameter) with an anteroposterior arrangement within the PD. The second group
      consisted of one inferior hypophyseal artery (IHA) on each side branching off
      from the internal carotid artery. These arteries gave off branches to pierce the
      dorsolateral and ventrolateral aspects of infundibular process (IP) before
      branching off to form a capillary network. They also gave rise to radiating
      capillaries to supply the pars intermedia (PI) surrounding the cortical area of
      the IP. The hypophyseal cleft separating the PI from the PD was clearly seen with
      very few blood vessels. The capillaries in both PD and IP joined to form
      confluent hypophyseal veins draining the blood into the cavernous sinus.

PMID- 1759690
TI  - Congenitally osteosclerotic (os/os) rabbits are not cured by bone marrow
      transplantation from normal littermates.
AB  - The osteopetrotic (os) rabbit is a lethal mutation of autosomal recessive
      inheritance characterized by hypocalcemia, hypophosphatemia, fibrosis of marrow
      spaces, and ultrastructural abnormalities in both osteoclasts and osteoblasts.
      Procedures involving the transplantation of cells from normal hemopoietic
      tissues, which are sources of osteoclast precursors, are known to cure
      osteopetrosis in several mutations including some children. We tested the ability
      of transplanted bone marrow and/or spleen from normal littermates to reverse the
      skeletal sclerosis in os rabbits. Treatment of 15 neonatal mutants consisted of
      immunosuppression by whole-body irradiation followed by transplantation of normal
      bone marrow and/or spleen cell suspensions. This treatment failed to prolong life
      span or to cure osteopetrosis judged radiographically and histologically for up
      to 3 weeks posttreatment, the longest time of survival. These data indicate that
      transplantation of stem cells from multiple hemopoietic tissues, procedures known
      to cure osteopetrosis in other mutations, is not effective in the os rabbit.
      These results support the hypothesis that the skeletal microenvironment is not
      capable of supporting the development and function of normal osteoclasts in this
      mutation.

PMID- 1759691
TI  - Structure-function relationships during preovulatory development of porcine
      follicles following equine chorionic gonadotropin stimulation.
AB  - Porcine follicular maturation begins by recruitment from a continually
      proliferating pool of small antral follicles; those receiving the appropriate
      stimulus differentiate rapidly through a series of structural and functional
      changes. Such ovarian activity can be induced in prepubertal gilts with a single
      injection of equine chorionic gonadotropin (eCG). Average follicular diameter in
      eCG treated females increased from approximately 2 mm before stimulation to 3.5
      mm by 24 hr after injection, with subsequent growth to ovulatory size (8 or 9 mm)
      by 96 hr. Both theca and granulosa layers increased in thickness and complexity,
      and a prominent capillary bed evolved immediately outside the basement membrane
      separating the two layers. Cytoplasmic organelles associated with increased
      metabolic activity and steroidogenesis proliferated within the first 24 hr.
      Progressive changes included increasing amounts of lipid and rough and smooth
      endoplasmic reticulum, with the latter occurring in vesicular or lamellar forms
      and as lipid-associated whorls. Bizarre mitochondrial forms also appeared, often
      associated with lipids. The amount and proportion of rough and smooth endoplasmic
      reticulum shifted dramatically as follicles matured. By 24 hr, rough endoplasmic
      reticulum in thecal cells increased from 4.2 to 7% of cell volume, while the
      amount in granulosa cells increased from less than 3.5% to more than 10%; the
      quantity remained relatively constant in the theca but declined to prestimulation
      values in the granulosa layer. Rough endoplasmic reticulum predominated over
      smooth in the first 24 hr following stimulation but the proportions were then
      reversed, so that more than 10% of both layers was composed of smooth endoplasmic
      reticulum by the time ovulation was imminent. Some follicles had or were in the
      process of ovulating by 96 hr. Their walls were collapsed into prominent folds
      with the two cell types beginning to mix. Slight undulations and some regions of
      discontinuity were observed in basement membranes of large unovulated follicles
      at this time. In specimens collected at 96 hr poststimulation and processed for
      retention of lipid, lipid-like material was noticeable in the extracellular
      matrix surrounding cells that contained organelle configurations suggestive of
      steroidogenesis.

PMID- 1759692
TI  - Sensory innervation of the canine esophagus, stomach, and duodenum.
AB  - The sensory innervation of the postpharyngeal foregut was investigated by
      injecting the enzyme horseradish peroxidase (HRP) into the walls of the
      esophagus, stomach, or duodenum. The transported HRP was identified
      histochemically, labeled neurons in the spinal and vagal ganglia were counted,
      and the results were plotted using an SAS statistical program. The spinal sensory
      fields of each viscus were defined using three determinations: craniocaudal
      extent, principal innervation field, and peak innervation field. The data
      revealed that innervation fields are craniocaudally extensive, the sensory field
      of each viscus overlaps significantly with its neighbor, yet each viscus can be
      characterized by a field of peak innervation density. Craniocaudal innervation of
      the esophagus spans as many as 22-23 paired spinal ganglia (C1-L2). There are two
      peak innervation fields for the cervical (C2-C6 and T2-T4) and for the thoracic
      (T2-T4 and T8-T12) sectors of the esophagus. The sensory innervation of the
      stomach extends craniocaudally over as many as 25 paired spinal ganglia (C2-L5).
      The peak innervation field of the stomach spans a large area comprising the
      cranial, middle, and the immediately adjoining caudal thoracic ganglia (T2-T10).
      The duodenum is innervated craniocaudally by as many as 15 paired thoracolumbar
      ganglia (T2-L3). Peak innervation originates in the middle and caudal thoracic
      ganglia and cranial lumbar (T6-L1) ganglia. There is a recognizable viscerotopic
      organization in the sensory innervation of the postpharyngeal foregut;
      successively more caudal sectors of this region of the alimentary canal are
      supplied with sensory fibers from successively more caudal spinal dorsal root
      ganglia. Vagal afferent innervation of the esophagus, stomach, and duodenum is
      bilateral and originates predominantly, but not exclusively, from vast numbers of
      neurons in the nodose (distal) ganglia. The esophagus is innervated bilaterally
      and more abundantly by jugular (proximal) ganglia neurons than is either the
      stomach or duodenum. The physiological significance of the findings are discussed
      in relation to the phenomena of visceral pain and referred pain.

PMID- 1759693
TI  - The vasculature of the rat penis: a scanning electron microscopic and histologic
      study.
AB  - As a basis for understanding the mechanism of erection in an animal model
      frequently used in research in reproductive biology, the angioarchitecture of the
      penis of the rat has been described using scanning electron microscopy. Study of
      the penile vasculature of the rat indicates that the corpora cavernosa penis and
      the corpus spongiosum are independent erectile tissues, each with its own
      arterial and venous vessels. The large vascular spaces and abundant smooth muscle
      of the penile crura are compatible with its role in regulating blood flow to more
      distal penile tissues. Helicine arteries of the crura, but not the parent deep
      penile artery or arteries elsewhere, have muscular cushions in their walls. The
      venous drainage of the penile crura is via subtunical veins which are thought to
      be compressed during erection to elevate pressure within the penis. Large, paired
      cavernous veins drain the shaft of the penis. A unique method for inhibiting
      blood flow from the penis is indicated by the division of the cavernous veins
      into smaller channels prior to joining the subtunical venous plexus. Erectile
      tissue in the bifid origins of the corpus spongiosum has abundant cavernous
      muscle, while in the remainder of the corpus spongiosum little smooth muscle
      lines the cavernous spaces. The cavernous spaces on either side of the urethra
      coalesce to form vessels, each of which communicates with cavernous spaces in the
      glans. In addition, a bypass of the glans is effected by communication of these
      vessels directly with the deep dorsal vein. The apparent absence of muscular pads
      in vessels of the spongiosum, the relative paucity of cavernous smooth muscle,
      and the ample venous drainage provided by the deep dorsal vein may account for
      the lack of a venous occlusive mechanism similar to that of the corpora cavernosa
      penis.

PMID- 1759694
TI  - Geographic distribution of xanthine oxidase, free radical scavengers, creatine
      kinase, and lactate dehydrogenase enzyme systems in rat heart and skeletal
      muscle.
AB  - The geographic distribution of the following enzyme systems is described in the
      rat heart (left and right ventricles) and in different skeletal muscles (soleus,
      plantaris, and red and white gastrocnemius): xanthine oxidase and dehydrogenase,
      creatine kinase isoenzymes, lactate dehydrogenase isoenzymes, and the free
      radical scavenger enzymes superoxide dismutase, glutathione reductase, and
      glutathione peroxidase. No substantial difference in enzyme activities was
      observed between the left and right ventricles. Skeletal muscles showed a clear
      distinction between enzyme activities depending on their composition of oxidative
      fibers and glycolytic fibers.

PMID- 1759695
TI  - Learning to reproduce a list and memory for the learning.
AB  - The ability to reproduce from memory a short list of verbal items immediately
      following presentation is known to improve over successive trials on that list,
      even if these trials are embedded in a sequence of trials on other lists of the
      same sort (Hebb, 1961). Less clear is whether this "Hebb effect" arises without
      the list repetition being noticed. This question has long been pondered and has
      recently taken on particular theoretical significance, but the available evidence
      is scant and inconsistent. Two experiments are described in which, in essence, a
      sequence of immediate reproduction trials was followed by tests that called for
      list recognition (Experiments 1 and 2) and/or estimates of list presentation
      frequency (Experiment 1). These tests provided quantitative measures of
      repetition awareness. Typical Hebb effects were found, but there was no evidence
      that the effects occurred without the subjects' being aware of the repetition;
      effect-size analyses indicated that both the recognition and frequency responses
      were more sensitive to repetition than were the reproduction responses.
      Therefore, not only could the recognition and frequency responses not have been
      made solely on the basis of how readily the test lists were reproduced, but the
      Hebb effect could have required an awareness of repetition.

PMID- 1759696
TI  - Cognitive aspects of mental activity during sleep.
AB  - Upon nighttime experimental awakening of 27 subjects in four sleep conditions
      (sleep onset early; sleep onset late; Stage 2; and rapid eye movement, REM,
      sleep), 108 dream reports and their association reports were collected. Dream
      reports were analyzed for length (temporal units) and content categories
      (continuity; implausibility; presence of the dreamer [i.e., "the self"], a
      setting, characters). Associations were classified as episodic, abstract self
      referred, and semantic memories. The two sets of results tend to show a basic
      homogeneity among mentation reports in the four sleep conditions considered.
      These findings are interpreted as supporting the hypothesis that the same
      cognitive mechanisms operate, at different levels of engagement, in dream
      generation rather than the hypothesis of multiple dream-generation systems
      dependent upon the physiological characteristics of the various sleep stages.

PMID- 1759697
TI  - An auditory cue-depreciation effect.
AB  - An experiment is reported in which subjects first heard a list of words and then
      tried to identify these same words from degraded utterances. Paralleling previous
      findings in the visual modality, the probability of identifying a given utterance
      was reduced when the utterance was immediately preceded by other, more degraded,
      utterances of the same word. A second experiment replicated this "cue
      depreciation effect" and in addition found the effect to be weakened, if not
      eliminated, when the target word was not included in the initial list or when the
      test was delayed by two days.

PMID- 1759698
TI  - [Celiac plexus block: value of x-ray computed guidance].
AB  - Celiac plexus block is a good alternative of pain treatment in upper abdominal
      pain. Neurolysis of the celiac plexus by the percutaneous posterior route used CT
      guidance in 8 patients. Pain relief was obtained in 5 of 7 patients (70 per
      cent); no complication occurred.

PMID- 1759699
TI  - [Diagnostic epidural analgesia in patients with chronic pain].

PMID- 1759700
TI  - [Perineal pain and involvement of the internal pudendal nerves].
AB  - A number of chronic pain syndromes in the perineal area can be related to
      pudental nerves suffering. The constancy of symptoms among various patients, and
      in duration for a particular one, alterations revealed by electrophysiologic
      studies, pain relief by diagnostic blocks, data from anatomic studies,
      preliminary results of medical and surgical applied therapies, give consistent
      arguments for possible organic lesions of pudental nerves.

PMID- 1759701
TI  - Prolonged stellate block in treatment of reflex sympathetic dystrophy.
AB  - Prolonged continuous stellate ganglion blockade has been found useful in
      treatment of post-traumatic reflex sympathetic dystrophy under the following
      circumstances: 1) When conservative treatment with outpatient physical therapy,
      tranquilizers and mild analgesics has failed. 2) When conservative therapy plus
      intermittent stellate blocks (q.l to 4 weeks) has failed. A three-year average
      follow-up of a group of 26 unselected patients has shown 25% relapse rate and 75%
      marked to complete improvement.

PMID- 1759702
TI  - [Sympathetic nervous system, pain and epidural administration of morphine].
AB  - There are multilevel intrications between nociceptive afferences and sympathetic
      efferences: anatomical vicinity in visceral innervation; systemic and local
      activation of the sympathetic efferences in response to nociceptive stimulation;
      major role of sympathetic activation in the perpetuation of sympathetic
      dystrophies. The analysis of a retrospective series of 10 patients suffering from
      algodystrophia revealed that epidural morphine administration had a beneficial
      effect only in those which were treated at an early stage of their illness.
      Despite epidural morphine has been claimed to be without effect on the efferent
      sympathetic tone in normal animals and individuals, it seems that in some
      pathologic states, the sympathetic output can be depressed. Recent anatomical and
      neurophysiological evidences argue for such a possibility.

PMID- 1759703
TI  - [Management of pain in the home].
AB  - Since patients treated with analgesics at home exist in ever-increasing numbers,
      and nurses are convinced of the efficacity of the treatment of pain, we are
      confronted with an urgent need for competent training. This is why, for a little
      over a year now, nurses have benefitted from theoretical and practical aids,
      allowing them to work more effectively, be it on the educative, therapeutic,
      technical and human level, so that patients benefit from a better quality of life
      and die in comfort and dignity.

PMID- 1759704
TI  - Hydrodynamic relaxation in flow field-flow fractionation using both split and
      frit inlets.
AB  - Two means are described for achieving hydrodynamic relaxation and thus avoiding
      the stopflow injection procedure in field-flow fractionation (FFF): split flow
      injection and frit inlet injection. The advantages, disadvantages, and the
      theoretical basis of these procedures are discussed. Incremental band broadening
      due to the final relaxation step is examined theoretically and shown to be
      negligible when the flow rate of the sample inlet substream is small compared to
      the total channel flow rate. The optimization of the sample inlet flow rate is
      discussed. Experimental results for both injection procedures are reported for
      flow/steric (or hyperlayer) FFF applied to latex standards, confirming the
      expected trends. However, closer examination shows that the observed incremental
      band broadening associated with hydrodynamic relaxation is somewhat larger than
      the value predicted.

PMID- 1759705
TI  - Surfactant-intercalated clay films for electrochemical catalysis. Reduction of
      trichloroacetic acid.
AB  - Composite films made from insoluble dialkyldimethylammonium surfactants and clay
      colloids were evaluated for electrochemical catalysis. When cast on pyrolytic
      graphite (PG) electrodes from chloroform, the films act as charge-transfer
      barriers toward multivalent electroactive ions in solution. They take up ions
      with hydrophobic ligands, e.g. tris-(2,2'-bipyridyl)cobalt(II). To make catalytic
      electrodes, water-insoluble cobalt and iron phthalocyanines (CoPc and FePc) were
      dissolved in surfactant-clay dispersions in chloroform and cast on PG. Films
      containing CoPc were 35-fold more active than FePc films for catalytic reduction
      of trichloroacetic acid. CoPc films decreased overpotential for reduction of
      trichloroacetic acid by about 0.5 V compared to 0.05 V for FePc. These MPc films
      gave stable catalytic currents for at least 10 days. Catalytic current vs
      temperature plots for reduction of trichloroacetic acid showed linear branches
      with intersection points close to reported gel-to-liquid crystal-phase transition
      temperatures. Charge transport was faster in the liquid crystal than the gel
      phase of the films. Observation of phase transitions suggests a multibilayer
      structure.

PMID- 1759706
TI  - Pulsed rapid heating method for volatilization of biological molecules in
      multiphoton ionization mass spectrometry.

PMID- 1759707
TI  - Determination of aluminum in the human serum of a dialysis patient by ion-pair
      reversed-phase partition high-performance liquid chromatography.
AB  - An ion-pair reversed-phase partition high-performance liquid chromatography
      spectrophotometric method is described for the determination of aluminum in human
      serum, based on its complexation with 2,2'-dihydroxyazobenzene. The chelate is
      separated on C18-bonded silica packing by using an aqueous methanol mobile phase
      containing tetrabutylammonium bromide and is detected with 0.005 AU full-scale at
      510 nm. The proposed system offers a simple, sensitive, and selective method. The
      detection limits defined as twice the standard deviation of the blank signal, are
      0.2 micrograms L-1 in pure solution and 6 micrograms L-1 in serum. The sample
      solution is prepared from 0.4 mL of serum after protein precipitation with
      hydrochloric acid and methanol. There was good agreement between the values
      obtained by this method and graphite furnace atomic absorption spectrophotometry.
      The aluminum concentrations in 121 patients on hemodialysis were 6-201 micrograms
      L-1.

PMID- 1759708
TI  - Collection efficiency of various solid-phase traps for off-line supercritical
      fluid extraction.
AB  - Solid-phase extraction tubes were evaluated as traps for off-line supercritical
      fluid extraction. Normal- and reversed-phase traps were studied with
      hydrocarbons, phenols, and a "test mixture" in order to determine the trapping
      efficiency. These traps were then used for the extraction of PCBs from river
      sediment. Polyethylene frits were also investigated for their use as solid-phase
      traps in SFE.

PMID- 1759709
TI  - Trace element determinations using a 15-keV synchrotron X-ray microprobe.
AB  - At the Synchrotron Radiation Source (SRS), Daresbury, U.K., a synchrotron
      microprobe was constructed, in order to create an instrument capable of analyzing
      at the ppm or in favorite cases sub-ppm level with a lateral resolution of 10 x
      15 microns2. In order to span a wide range of elements to be analyzed, a beam
      energy of 15 keV was chosen. Focusing and monochromation of the white beam was
      done in one single step with a high-precision ellipsoidally concave curved
      Si(111) crystal. Sufficient flux of X-rays in a narrow energy band is available
      in the spot to measure trace elements at the femtogram level. Measurements on
      standard materials, reference standard materials, and biological samples showed
      the lower relative minimum detection limits and higher sensitivity for the higher
      Z-elements obtainable with micro-SXRF (synchrotron X-ray fluorescence) as
      compared with microtechniques using ion accelerators. Moreover, the much lower
      energy deposited in the specimen represents a major argument to prefer X-rays to
      ions for the analysis of radiation-sensitive samples.

PMID- 1759710
TI  - Selective biocoulometry of vitamin C using dithiothreithol, N-ethylmaleimide, and
      ascorbate oxidase.

PMID- 1759711
TI  - Amperometric glucose microelectrodes prepared through immobilization of glucose
      oxidase in redox hydrogels.
AB  - Glucose microelectrodes have been formed with glucose oxidase immobilized in
      poly[(vinylpyridine)Os(bipyridine)2Cl] derivative-based redox hydrogels on
      beveled carbon-fiber microdisk (7 microns diameter) electrodes. In the resulting
      microelectrode, the steady-state glucose electrooxidation current density is 0.3
      mA cm-2 and the sensitivity is 20 mA cm-2 M-1. The current density and
      sensitivity are 10 times higher than in macroelectrodes made with the same
      hydrogel. Furthermore, the current is less affected by a change in the partial
      pressure of oxygen. The higher current density and lower oxygen sensitivity point
      to the efficient collection of electrons through their diffusion in the redox
      hydrogel to the electrode surface. These results contrast with those observed for
      enzyme electrodes based on diffusing mediators, where loss of the enzyme-reduced
      mediator by radial diffusion to the solution decreases the current densities of
      microelectrodes relative to similar macroelectrodes.

PMID- 1759712
TI  - Borate interference in surface-enhanced Raman spectroscopy of amines.
AB  - Interference from borate is observed in surface-enhanced Raman (SER) spectra of
      lysine and propylamine obtained with borohydride-reduced silver colloids. Borate
      bands are also observed in the spectra of other basic analytes, as well as when
      certain variations are made in the silver colloid preparation. The relative
      intensities of the analyte and borate bands depend on the pH of the colloid, the
      extent of oxidation of the colloid surface, and the relative adsorptivities of
      the analyte and borate. Benzylamine adsorbs more readily than propylamine and
      also competes more effectively with borate for adsorption sites. On the other
      hand, borate virtually excludes lysine from the surface when the solution pH is
      greater than or equal to 8. The formation of silver oxide in basified colloids
      may facilitate borate adsorption. For some basic analytes, eliminating the
      adsorption of borate ion and the resulting spectral interference may require
      using alternative SERS substrates.

PMID- 1759713
TI  - Cobalt(II)-catalyzed chemiluminescence in a dioctadecyldimethylammonium chloride
      bilayer membranous medium for the flow injection determination of phenylpyruvic
      acid.
AB  - A novel chemiluminescence system is described for the flow injection
      determination of phenylpyruvic acid (PPA). The presence of both ordered
      surfactant molecular assemblies and a metal ion catalyst in the system is
      essential for the phosphorescence of benzaldehyde (emitter) produced by the
      aerobic oxidation of PPA in alkaline solution. Dioctadecyldimethylammonium
      chloride bilayer aggregates and cobalt (II) allows PPA to be selectively
      determined down to 1 X 10(-7) M. The linearity is 2 orders of magnitude with a
      relative standard deviation 3.1% (n = 10) for 1 X 10(-6) M PPA. Of 28 other
      species (1 X 10(-3) M) tested, only 4-hydroxymanderic acid, 4
      hydroxyphenylpyruvic acid, 2,5-dihydroxyphenylacetic acid, and 4-hydroxy-3
      methoxyphenylpyruvic acid provided signals 2-13 times more intense than that for
      1 X 10(-6) M PPA. PPA present at 10(-3) - 10(-2) M levels in urine from patients
      with phenylketonuria can be determined with no special sample pretreatment by
      using this CL procedure. The mechanistic study of the present luminescent
      reaction are also undertaken in detail. The bilayer aggregates were found to
      contribute favorably both to the production of key intermediates and to the
      efficient phosphorescence emission.

PMID- 1759714
TI  - Determination of site-specific carbon isotope ratios at natural abundance by
      carbon-13 nuclear magnetic resonance spectroscopy.
AB  - Site-specific natural isotope fractionation of hydrogen studied by deuterium NMR
      (SNIF-NMR) spectroscopy is a powerful source of information on hydrogen pathways
      occurring in biosyntheses in natural conditions. The potential of the carbon
      counterpart of this method has been investigated and compared. Three typical
      molecular species, ethanol, acetic acid, and vanillin, have been considered.
      Taking into account the requirements of quantitative 13C NMR, appropriate
      experimental procedures have been defined and the repeatability and
      reproducibility of the isotope ratio determinations have been checked in
      different conditions. It is shown that the carbon version of the SNIF-NMR method
      is capable of detecting small differences in the carbon-13 content of the ethyl
      fragment of ethanols from different botanical or synthetic origins. These results
      are in agreement with mass spectrometry determinations of the overall carbon
      isotope ratios. Deviations with respect to a statistical distribution of 13C have
      been detected in the case of acetic acid and vanillin. However, since the method
      is very sensitive to several kinds of systematic error, only a relative
      significance can be attached at present to the internal parameters directly
      accessible. Isotope dilution experiments have also been carried out in order to
      check the consistency of the results. In the present state of experimental
      accuracy, the 13C NMR method is of more limited potential than 2H SNIF-NMR
      spectroscopy. However it may provide complementary information. Moreover it is
      particularly efficient for detecting and quantifying adulterations that aim to
      mimic the overall carbon-13 content of a natural compound by adding a selectivity
      enriched species to a less expensive substrate from a different origin.

PMID- 1759715
TI  - Fourier transform infrared spectroscopic method for the quantitative trace
      analysis of transition-metal carbonyl-labeled bioligands.
AB  - A quantitative FT-IR spectroscopic method has been developed for the trace
      analysis in chlorinated organic solvents of transition-metal carbonyl-labeled
      bioligands. In order to illustrate the widespread analytical potential of the
      method, three derivatives of the female hormonal steroid 17 beta-estradiol,
      containing Cr(CO)3, Cp2Mo2(CO)4 (Cp = eta 5-C5H5), and Co2(CO)6 as labels, and
      the anticonvulsant drug phenobarbital, labeled with (eta 5-C5H4)Mn(CO)3, were
      examined. The cobalt carbonyl marker proved to be the best sulted for
      quantitative analysis purposes, and the minimum tracer quantity detectable for
      this particular marker (64 scans, 4-cm-1 resolution, 3.5 min) was optimized in
      CCl4 solution at about 300 fmol (or 0.3 pmol, 180 pg) by using an ultralow volume
      (23.0 microL), gold light-pipe IR solution cell and a liquid nitrogen cooled,
      InSb (indium antimonide) IR detector. The repeatability of this radically
      different analytical procedure over the concentration range 1.0 x 10(-6) to 5.0 x
      10(-8) M was good (coefficient of variance less than or equal to 6%) and the
      method provides the basis for a new immunological test-
      carbonylmetalloimmunoassay (CMIA).

PMID- 1759716
TI  - Integrated fluid handling system for biomolecular interaction analysis.
AB  - An integrated fluid handling system used for multichannel biomolecular
      interaction analysis is described. Reactions between biological molecules are
      monitored in real time by measuring changes in the angular position where surface
      plasmon resonance occurs at a biospecific active surface. The adsorption
      efficiency of the analyte onto the biospecific active surface is up to
      approximately 3%, due to the low channel height, 50 microns, in the flow cell.
      When a large part of the total biospecific active surface for surface plasmon
      resonance probing (approximately 0.15 mm2) is used, the sensitivity is high.
      Sample sizes in the order of 1-50 microL can be injected. The sample zone
      dispersion is minimized by the low dead volume in the system (approximately 0.4
      microL) accomplished by using integrated sample loops and thin conduits. An asset
      of this integration is the low reagent consumption. The sensor chip with the
      biospecific active surface is reusable and easily exchanged. Experimental results
      obtained with a theophylline monoclonal antibody as the analyte are compared with
      a theoretical model. The standard deviation for the repeatability is
      approximately 5% typically with 50 microL of 250 pM analyte, and the assay time
      is 10 min. The detection limit is approximately 10 pg of the analyte on the
      probed spot of the surface. Possible improvements of the sensitivity and
      detection limit are discussed.

PMID- 1759717
TI  - Amperometric detection of alcohol in beer using a flow cell and immobilized
      alcohol dehydrogenase.

PMID- 1759718
TI  - On-line immunoaffinity sample pre-treatment for column liquid chromatography:
      evaluation of desorption techniques and operating conditions using an anti
      estrogen immuno-precolumn as a model system.
AB  - An immunoaffinity precolumn (immuno-precolumn) containing an immobilized antibody
      directed against estrogen steroids, was used as a model system for the evaluation
      of different desorbing techniques, suitable for on-line coupling to column liquid
      chromatography (LC). Desorption of estrogen analytes from the immuno-precolumn
      proved to be impossible with the buffers and chaotropic solutions frequently used
      in affinity desorption. Micellar solutions are effective in obstructing the
      antibody-antigen reaction, but their use as desorbing solutions was not found to
      be practical because of the large interferences introduced into the
      chromatograms. Desorption with aqueous solutions at elevated temperature, created
      by microwave action or conventional heating, although effective is not practical
      in this instance, because the agarose used in this study as the stationary phase
      for the immuno-precolumn is prone to heat decomposition. The most effective and
      practical approach is desorption with a methanol-water mixture (95 + 5 v/v). On
      line dilution of the eluate allows the concentration of the desorbed analytes
      using a reversed-phase LC system with subsequent separation and ultraviolet
      detection. The performance of the system with spiked urine and plasma samples,
      which were introduced directly into the system, was evaluated and the results
      were compared with immunoselective desorption.

PMID- 1759719
TI  - Simultaneous determination of toxic metabolites by linear combination derivative
      spectrophotometry.
AB  - A linear combination derivative spectrophotometric method is described. The
      method overcomes the problem of overlapping in derivative spectrophotometry and
      allows the maximum use of quantitative information. In addition, the method can
      be used to increase the selectivity, sensitivity and accuracy of the simultaneous
      analysis of multicomponent mixtures. The application of the method to the
      simultaneous determination of bongkrekic acid and toxoflavin, the toxic
      metabolites produced by Pseudomonas farinofermentans, is described.

PMID- 1759720
TI  - Amperometric monitoring of bacteria-induced milk acidity using a platinum disc
      microelectrode.
AB  - The acidity induced by the action of bacteria in milk samples was monitored
      amperometrically by using a platinum microelectrode. The measurements were
      performed directly on commercial packs of milk, stored at 32 degrees C, and were
      continued for 9-10 d after inoculation. The data were compared with those
      obtained by measuring the pH of the samples and the results are discussed on the
      basis of the metabolism of each bacterial species. The effects of the following
      bacteria were examined: Staphylococcus aureus, Bacillus cereus, Streptococcus
      faecalis, Bacillus subtilis, Aeromonas, and Corynebacterium.

PMID- 1759721
TI  - [The structure of the bovine mammary gland during the dry period with special
      reference to the process of involution. 2. Electron microscopic studies].
AB  - According to the electron microscopic investigations the most evident sign of the
      phase of the active involution of the mammary gland in cattle is the occurrence
      of different great vacuoles with a diffuse content in the cytoplasma of the
      secretory cells till the 30th day after the beginning of the dry period.
      Secretory cells which go over in the rest phase show a great reduction of the
      cell organelles and many filaments and secondary lysosomes or residual bodies.
      One can observe many macrophages and lymphocytes in the partly enlarged
      intercellular rooms between the secretory cells and the myoepithelial cells. The
      myoepithelial cells are adapting to the changing forms of alveoli. The phase of
      the colostrogenesis is characterised by the enlargement of the cell organelles
      and the reappearance of vacuoles.

PMID- 1759722
TI  - Spinal root origin of the radial nerve and nerves innervating shoulder muscles of
      the dog.
AB  - The ventral spinal root origin of the radial nerve, its muscle branches, and
      brachial plexus nerves which supply shoulder and thoracic musculature was
      determined in the dog. Electrophysiological signal averaging techniques measured
      evoked potential from specific ventral spinal roots to individual muscle nerves.
      The entire radial nerve received input from the sixth cervical (C6) through the
      second thoracic (T2) spinal roots. The most significant (p less than .05) input
      to triceps brachii came from C8 while the deep ramus of the radial nerve received
      its largest input from C7. The brachiocephalicus, suprascapular, and subscapular
      nerves all received their most significant (p less than .05) innervation from C6.
      Approximately 90% of the evoked potential to the axillary nerve originated from
      C7. The thoracodorsal nerve received most of its innervation from ventral roots
      C7 and C8. The lateral thoracic nerve which innervates the cutaneous trunci
      muscle was supplied by ventral roots C8-T2. Examination of innervation patterns
      suggests that only modest variation of spinal root input to specific nerves
      occurred between individual dogs.

PMID- 1759723
TI  - The os coxae of a digging form of the northern water vole, Arvicola terrestris
      (Rodentia, Arvicolidae).
AB  - Data on the morphology, relative growth and sexual dimorphism of the os coxae of
      a digging form of the northern water vole Arvicola terrestris (A.t. monticola)
      are given. Two hundred ninety-nine specimens (146 males and 153 females) caught
      in the Aran Valley (Spanish Pyrenees) were analyzed. The specimens were
      distributed into six classes of relative age, according to the skull morphology,
      kind of coat, moulting state, weight and sexual state. The morphological features
      of the os coxae in these specimens are similar to those described in other
      species of Arvicolidae. The hormonal effect upon the pelvis in adult females
      during pregnancy and parturition leads to the appearance of marked intersexual
      differences in the obturator foramen length, the pubis length, the pelvis length
      and, specially, in the pelvis height and the pubis width. By means of Becker's
      and Dunmire's procedures both sexes can be correctly discriminated in a 78.87 and
      a 76.4% respectively. Conjugating the variation patterns obtained with Becker's
      index and the pelvis height, we have obtained a more effective method of sexual
      differentiation (an 85.51% of correct discrimination).

PMID- 1759724
TI  - Scanning electron microscopic observations on the development and structure of
      tooth enamel in Cervidae (Mammalia: Ruminantia).
AB  - Enamel formation and structure were investigated in 102 developing or erupted
      teeth of roe, fallow and red deer. Special attention was given to the topography
      of the forming enamel surface, the form, arrangement and course of enamel rods,
      its relation to interprismatic enamel and the occurrence of Hunter-Schreger-bands
      in the enamel. Discussed are the significance of the enamel pattern for the
      identification of certain taxa and the adaptive value of Cervidean enamel
      structures.

PMID- 1759725
TI  - Dural sinuses in the camel and their extracranial venous connections.
AB  - The dural sinuses of one-humped camel (Camelus dromedarius) and their connections
      with veins of the head and neck were described and, whenever possible, were
      compared with other domestic animals emphasizing species differences. Information
      obtained from gross dissection of embalmed camel heads was correlated with latex
      injected vascular casts, as well as venographs. Although the disposition of the
      dural sinuses, in general, was similar to those of other domestic animals, they
      were somewhat complex in the camel. An important venous flow mechanism which
      functions in the thermoregulation of the brain in the camel was described. The
      venous drainage of the nasal cavity and its surrounding areas had five
      connections with the ophthalmic plexus and the cavernous sinus: (1) the
      infraorbital vein----ophthalmic plexus; (2) the medial superior palpebral vein---
      ophthalmic plexus; (3) the medial inferior palpebral vein----ophthalmic plexus;
      (4) the angularis oculi----frontal----supraorbital----dorsal external ophthalmic-
      --emissary vein of the foramen orbitorotundum----cavernous sinus; and (5) the
      deep facial vein----ventral external ophthalmic----emissary vein of the foramen
      orbitorotundum----cavernous sinus.

PMID- 1759726
TI  - [The wisdom of the animal body].
AB  - In 1932 CANNON described the physiological wisdom of the body. This cannot exist
      without morphological wisdom. Since morphology is a formative process, both kinds
      of wisdom depend on the same formative forces. These forces are the forces of
      consciousness at all levels. Their existence is proved by the fact that they can
      be eliminated by narcosis. The wisdom of these forces is twofold: Firstly, the
      wisdom of need sensation which lasts only until the need is satisfied. This is
      the conscious intelligence of the body which is responsible for restraint in all
      living beings. Secondly, the wisdom, or better, the prudence of need satisfaction
      which requires knowledge and appropriate tools. The organs of the body are these
      tools. Knowledge belongs to the intellect which knows how to handle material.
      This is achieved in all prehuman species subconsciously and is demonstrated in
      all structures built by cells and animals. Only the human mind can be unwise and
      imprudent; but man, being free, is also able to be wise and prudent and so
      prevent the extinction of the earthly creation.

PMID- 1759727
TI  - [Immunosuppressive drugs and autoimmune diseases].
AB  - Only a few immunosuppressive drugs can be used today. These are: corticosteroids,
      azathioprine, cyclophosphamide, ciclosporine A, accessorily chlorambucil and
      methotrexate. They all have different actions on immune responses. The use of
      these drugs has completely changed the prognosis of autoimmune diseases such as
      systematic lupus erythematous, polyartheritis nodosa, Wegener's granulomatosis.
      Nevertheless treatment of other autoimmune diseases, such as type I insulin
      dependent diabetes mellitus or multiple sclerosis, has been inconclusive.

PMID- 1759728
TI  - Oral ecology and its pathogenic relation with the origin of primary periodontitis
      associated with plaque.
AB  - Microbial factors involved in the genesis of periodontitis are related with
      supragingival (coronal) and subgingival plaque. The microorganisms in the
      supragingival plaque reach the gingival sulcus, and are influenced by ecological
      determinants in this zone which condition the establishment of adherent plaque.
      This plaque may subsequently form the substrate for particularly periodon to
      pathogenic bacteria, which may then form plaques adhered to the epithelium, or
      develop as floating (nonadhered) populations. After microbial colonization of the
      gingival sulcus, bacteria or substances they produce may reach the junctional
      epithelium and alveolar bone, leading to direct tissular destruction to an extent
      determined by the host's immune response. Damage may be local or generalized,
      depending on additional factors.

PMID- 1759729
TI  - [Multicenter study on purified protein C concentrates and defined plasma levels].
AB  - A variety of protein C assays are available as commercial kits. A collaborative
      study was undertaken to evaluate the performance of protein C assays. Various
      samples including calibrated plasmas and high purity concentrates destined to
      therapy were distributed among five laboratories. This comparison of protein C
      assays indicates that protein C levels measured by different functional or
      immunological assays and by five laboratories are very close for calibrated
      plasmas but not for high purity concentrates. The selection of the standard and
      the dilution buffer for protein C concentrates have important implications for
      the interpretation of the results. Dilution of purified protein C concentrates in
      protein C deficient plasma which restaure a total protein level similar to that
      of normal plasma improve the accuracy of functional protein C assays.

PMID- 1759730
TI  - Detection of Mycoplasma hominis antibodies by three different techniques,
      application to women with pelvic inflammatory disease.
AB  - Mycoplasma hominis, a mycoplasma potentially isolated from the genital tract of
      healthy women, seems to have some role in pelvic inflammatory diseases (PID).
      Three serologic techniques were developed to detect antibodies to M. hominis:
      ELISA (IgG, IgM), microimmunofluorescence (MIF) and Western blot. Rabbit and
      human control sera were used to establish the standard assay conditions. ELISA
      proved to be more sensitive but less specific than MIF. Cross-reactivity with
      antibodies to M. pneumoniae existed with ELISA but not with MIF. Twenty six and
      60 kDa proteins were responsible for that cross-reactivity, as assessed by
      Western blot analysis. Among 33 patients with PID, 18 to 35 year old, 67% had
      antibodies to M. hominis by ELISA and 33% by MIF. Among 52 age comparable healthy
      women, 44 and 13% were positive for M. hominis by ELISA and MIF respectively. The
      Western blot analysis showed heterogeneity in the antibody response to M.
      hominis, but a 76 kDa protein reacted with half of the tested sera. Our study
      agrees with some role for M. hominis in PID. M. hominis was certainly the primary
      pathogen in one case, played a role that was probable in seven cases, and
      possible in three patients.

PMID- 1759731
TI  - [Glycoforms of serum alpha 1-antichymotrypsin studied by immunoaffino
      electrophoresis. From the fundamental aspect to clinical applications].
AB  - alpha 1-antichymotrypsin, purified or in whole serum, exhibits microheterogeneous
      forms when studied by crossed immunoaffinoelectrophoresis with free concanavalin
      A (Con A) in the first dimension. alpha 1-antichymotrypsin purified from the
      serum of a single healthy donor was separated into three forms by affinity
      chromatography on a Con A-Sepharose 4B column: a Con A non-reactive form, a Con A
      weakly reactive form and a Con A reactive form. Some of their physico-chemical
      properties are compared. The complete primary structure of the glycans of each
      form was determined by high resolution 1H-NMR spectroscopy. The results indicated
      the presence of diantennary and triantennary type glycanic structures which occur
      frequently in serum glycoproteins. From deglycosylation experiments it is
      concluded that alpha 1-antichymotrypsin carries four oligosaccharide side chains.
      The Con A non-reactive form contains four triantennary glycans, the weakly
      reactive form contains three triantennary and one diantennary glycans and the Con
      A reactive form possesses on average one triantennary and three diantennary
      glycans. Significant variations in the relative ratios of the microheterogeneous
      forms were detected in various inflammatory syndromes. There is an increased
      proportion of Con A non-reactive form in patients developing a systemic disease
      (systemic lupus erythematosus, rheumatoid arthritis, temporal arteritis). In
      contrast, the proportion of Con A non-reactive form decreased in patients with
      acute septic inflammation whereas no variation appeared in patients with
      metastatic breast cancer. We also studied the variations of alpha 1
      antichymotrypsin microheterogeneity in sera from patients with giant-cell
      arteritis and/or polymyalgia rheumatica before and during treatment with
      glucocorticoids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759732
TI  - [Multicenter study of 435 yeast strains isolated from 116,000 hemocultures].
AB  - During a multicentric study on the diagnosis of yeast septicemia, 5 blood culture
      media have been compared. 435 yeast strains have been isolated from 116,372 blood
      cultures received during year 1989 in the mycological laboratories of 5
      university hospitals from east of France. The results show that Candida albicans
      is always the first septicemia agent with 52% of yeasts isolation from blood. C.
      parapsilosis comes next with 17%, then C. glabrata, 6.2%. The average delay of
      yeasts isolation is 2.3 days for Bactec NR and Sabouraud media, 3.7 days for
      other bacteriological media. Compared with polyvalent media, Sabouraud diphasic
      medium is significantly the best for yeasts isolation. It is recommended to add
      chloramphenicol in the medium, to culture 10 ml of blood and to keep blood
      cultures for at least 8 days, better 15 days.

PMID- 1759733
TI  - [Epidemiology and prevention of mental disorders].
AB  - From a bibliographic analysis and personal experiences, the authors present the
      advantages of the epidemiologic method in psychiatry. They point out its
      specificity and the methodological difficulties. Since the psychiatric practices
      are being deeply transformed, it becomes essential to know precisely the
      importance and the distribution of mental diseases in the population. It is not
      possible to image changing a care system trend without knowing the real needs of
      the population. The descriptive epidemiologic method contributes to this. The aim
      of analytic epidemiology is ever more important since it allows to spot the
      circumstances in which mental diseases appear and are developed, and to elaborate
      etiological hypotheses. Finally, this favors preventive approaches where
      evaluative epidemiology permits to measure the validity and effectiveness of
      programs which, like those elaborated for other social calamities (transmissible
      diseases, degenerative diseases), take place for studies in the field of mental
      health disorders.

PMID- 1759734
TI  - [Nosological classifications of obsessive-compulsive disorder].
AB  - Obsessive-Compulsive Disorder (O.C.D.) has become of central interest to
      researchers. Conflicting data in neurobiological studies and the diversity of the
      responses to behavioral and pharmacological treatments, have raised the question
      of the homogeneity of O.C.D. Is O.C.D. an heterogeneous diagnosis? Is it one or
      several disorders? if so, how can it be divided into homogeneous subgroups? What
      is the meaning of psychiatric comorbidity with regard to a neuropharmacological
      approach of O.C.D.? Has O.C.D. a large spectrum, which includes other disorders
      like Gilles de la Tourette syndrome, trichotillomania, paraphilia, compulsive
      gambling and other impulse control disorders? Many classifications are
      established within O.C.D. in an attempt to delineate similarities and differences
      among clinical manifestations and to develop more adequate and effective
      treatments. Based on recent literature data and on the experience we have
      accumulated in assessing and treating people presenting O.C.D., we propose a new
      clinical classification of this disorder.

PMID- 1759735
TI  - [Language disorders in schizophrenia].
AB  - Psychiatrists, psycholinguists and linguists have been interested in the language
      disorders of schizophrenia. Physicians have described their semiology.
      Psycholinguists have tried to show their structural alterations, using
      standardized tests in the fields of syntax, semantics and more recently, prosody.
      We try to present Benveniste's and Culioli's Enunciation Theory and Irigaray's
      works. Only a theory which studies the dynamic aspects of language would be of
      some use for the analysis of schizophrenic language.

PMID- 1759736
TI  - [Indications of lithium plasma levels in professional practice. Average of a 7
      year follow-up].
AB  - With a mean follow-up duration of 7 years, the retrospective analysis of 57
      charts of lithiotherapy shows that: Better results are observed when the lithium
      blood level reactus 0.87 mmoles/l. In that case, the best lithiotherapy
      indication is the major recurrent long cycles depression. We also propose as
      lithiotherapy indication in order of efficacy: 1--The maniac-depressive psychosis
      (P.M.D.) in its mixed form. 2--The schizo-affective troubles. The curative and
      preventive lithium efficacy is on favour of the diagnosis of recurrent endogenous
      psychiatric disease.

PMID- 1759737
TI  - [Analysis of dermatoglyphics in a population of female psychiatric patients].

PMID- 1759738
TI  - [Commitment of the psychiatrist in general and in legal psychiatry].

PMID- 1759739
TI  - [Mystical delusion: a disease of faith?].

PMID- 1759740
TI  - [Diagnostic strategy of acoustic neuroma. Evaluation of efficacy of auditory
      evoked potentials. Apropos of a series of 50 neuroma cases].
AB  - The authors carry out a retrospective study of the diagnostic procedures used in
      a series of 50 acoustic neuromas. AEP were performed for thirty-four neuromas at
      some stage of their history. The findings were perfectly normal for eight of
      them, which represents a sensitivity level of 76%. Various elements likely to
      account for this are put forward, then the role of AEP and MRI in the diagnostic
      strategy for neuroma is discussed in the light of this study. Finally, the
      authors emphasize the necessity to regularly evaluate the diagnostic methods in
      order to guarantee their quality and reliability.

PMID- 1759741
TI  - [Comparative study of temporal parameters of alaryngeal voices. Esophageal and
      tracheo-esophageal voices].
AB  - Recent studies have established significant acoustic and phonetic differences
      between tracheo-oesophageal (TE) and conventional esophageal voices (EV). 12
      alaryngeal voices (2 esophageal, 6 myomucosal shunts, 4 tracheoesophageal
      phonatory protheses), and 7 normal laryngeal voices were recorded and analyzed.
      Speech timing including voicing and pauses distribution was evaluated and
      compared to laryngeal voices. Speakers with TE voices using pulmonary air were
      able to preserve the rythm and the syntactico-semantic structure of their
      speeches, as opposed to speakers with EV who often had to insufflate air into the
      esophagus and therefore had a staccato-like speech. The phonation time was quite
      similar in both situations, but the length and the number of pauses made the
      difference.

PMID- 1759742
TI  - [Experimental endolymphatic hydrops. Biochemical data in the guinea pig].
AB  - The electrochemical and osmotic composition of the inner ear fluids has been
      studied during experimental endolymphatic hydrops in guinea pig. The data showed
      that the modifications of the electrochemical composition of endolymph has been
      detected only after more than 2 weeks after the hydrops induction. The
      endocochlear potential, the K and Cl concentrations, and the osmolality
      progressively decreased between 6 and 9 weeks of hydrops. The longitudinal
      gradients disappeared. After 24 weeks of hydrops, the endocochlear potential was
      50% of the initial value whereas the K and Cl concentrations and the osmolality
      were higher than that measured at 9 weeks but remained lower than contralateral,
      normal values. These results suggest that the alterations of the electrochemical
      and osmotic composition of endolymph that were observed during the evolution of
      experimental endolymphatic hydrops in guinea pig are related to an alteration of
      the permeabilities of the Reissner's membrane induced by an increase of
      hydrostatic pressure.

PMID- 1759743
TI  - [Olfactory mucosa and Alzheimer's disease. Technique for biopsy and
      ultrastructural study].
AB  - The discovery of a reliable peripheral marker would be of a great interest for
      the early diagnosis of the Alzheimer's Disease. The olfactory deficit and the
      major histologic changes of the olfactory-related areas of the brain occurring
      during this disease raised the possibility that the olfactory epithelia could be
      one of the way of entry of a possible process that still has to be identified. We
      have developed an instrument and a technique of biopsy of the human olfactory
      mucosa to search for the presence of characteristics lesions on patients
      suffering of an Alzheimer's Disease. These small specimens have been prepared for
      electronic microscopy. The ultrastructural study of a sample of olfactory mucosa
      has been realised in 9 cases (5 Alzheimer's-4 controls) revealing in 4 patients
      suspected of an Alzheimer's Disease a complete architectural disorganisation with
      a destruction of the dendrite of the olfactory cells and a severe degeneration of
      the sustentacular cells. We did not find any characteristic changes such as
      Paired Helicoidal Filaments or amyloid fibrils. These results do not presuppose
      of their eventual presence at a precocious stage of the disease. Further
      ultrastructural and immunochemical studies carried out with patients at various
      stages of the disease are necessary in order to confirm this hypothesis.

PMID- 1759744
TI  - [Pseudotumoral salivary localization of Destombes-Rosai-Dorfman syndrome.
      Hemophagocytic histiocytosis. Diagnosed by bilateral submandibular and parotid
      involvement].
AB  - We report one case of pseudotumoral salivary location of the Rosai-Dorfman
      syndrome, with a favorable outcome, occurring in a 32-year-old man from
      Guadeloupe. The clinical, biological and clinicopathological features of this
      syndrome, as well as the pathogenetic hypotheses, are summed up. In this case, no
      bacterial, fungal, parasitic or viral agent was discovered. The subject presented
      with no immune abnormality likely to account for the persistence and intensity of
      the histiocytic infiltration with lymphophagocytosis associated to the
      lymphoplasmocytic infiltration. The rarity of ENT, and more specifically
      salivary, locations is emphasized. The importance of the detection of possible
      immune abnormalities in such patients is demonstrated by the outcome of the
      syndrome being more often unfavorable when such abnormalities are present.

PMID- 1759745
TI  - [Combined approach to malignant tumors of the ethmoid and other paranasal
      sinuses. Principles and results].
AB  - The authors present their experience concerning combined transfacial and
      neurosurgical procedures in the treatment of carcinomas of the ethmoid sinuses.
      109 ethmoid-spheno-orbital tumors were treated at our department from 1982 to
      1990: 85 were located into the ethmoidal and/or sphenoidal sinuses; 78 of these
      were malignant. Among the 65 ethmoidal carcinomas which were operated through a
      combined route, 48 underwent an induction chemotherapy and 19 a post-operative
      radiotherapy. The surgical technique is detailed, mostly the intra-cranial
      approach and the reconstruction of the cranial basis. Clinical results, and
      particularly the actuarial survival rates are discussed. The 5-year actuarial
      survival rate is 40% for all first hand ethmoidal adenocarcinomas. The figure
      reaches 52% for the patients without intra-cranial extension. At last, the 5-year
      actuarial survival rate is 100% for patients having a complete clinical response
      to induction chemotherapy.

PMID- 1759746
TI  - [Insufficiency of ethmoidectomy in the treatment of nasal polyposis].
AB  - The authors report 100 ethmoidectomies performed on 50 patients between 01/87 and
      09/89. 75% have been treated anteriorly by systemic corticosteroids. 65% have had
      prior sinus surgery. Follow-up time ranged from 12 to 34 months (mean: 18
      months). A regular treatment with intranasal steroid sprays was taken post
      operatively by 96% of patients until three months and 48% until 18 months. 72% of
      patients considered the symptoms relief as satisfactorily (score of satisfaction
      greater than 8/10). Severe nasal obstruction, noted in 88% cases pre-operatively,
      reappeared in 26% 18 months post-operatively. Anosmia, encountered in 72% pre
      operatively, disappeared post-operatively in one half of the cases with a good
      conservation of olfaction 18 months later. Anterior and/or posterior rhinorrhea,
      sneezing were also satisfactorily controlled. Results on facial pain were not
      significant. Endoscopic evaluation was performed by a physician who was not the
      surgeon. A normoplastic mucosa covered the ethmoid cavities in 40%. Localized
      oedema was observed in 38%. An asymptomatic recurrence, discovered on endoscopic
      examination, was present in 11%. The symptomatic recurrence rate was 11%. A
      CTscan control, performed the day of the endoscopic examination and analysed few
      weeks later, reinforced the degree of objectivity. A complete marsupialization of
      the ethmoid labyrinth without any remaining cell was confirmed in only 30%.
      Frequence and aspects of the opacities in the great sinuses were the same pre-
      and post-operatively. So, this study shows that the insufficiencies of the
      ethmoidectomy are 1) the difficulty to perform a complete marsupialization of the
      ethmoid 2) persistent opacities in the great sinuses 3) persistence of the mucosa
      disease after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759747
TI  - [Cholesteatoma of the paranasal sinuses. Apropos of 2 cases].
AB  - Two cases of cholesteatoma of the facial sinuses are presented. One of them was
      located in the maxillary sinus and the other was originally located in the
      ethmoid cells and extended into the maxillary sinus. After reviewing the
      literature on this subject, the authors analyze the pathogenetic theories and the
      clinicoradiological expressions. These raise an obvious diagnostic difficulty:
      the diagnosis is virtually impossible to establish before surgery and a
      clinicopathological study are performed.

PMID- 1759748
TI  - [Clinical polymorphism of lupus erythematosus].

PMID- 1759749
TI  - [Lupus erythematosus and papules. 4 cases].
AB  - Papular skin eruptions are uncommon in lupus erythematosus (LE), and their
      occurrence may suggest several diagnoses. We report four cases of papular
      eruptions in LE patients. Two of these patients had purely lupoid papules on
      acute LE in one and on chronic LE in the other. In the remaining two cases the
      papules were formed by mucinous deposits that were either secondary to LE or
      belonged to an associated primary mucinosis. These four cases prompted us to
      discuss the significance of papular eruptions in lupus erythematosus. LE-specific
      papular manifestations have a purely lupoid histological and immunopathological
      substratum. In systemic LE, the frequency of these manifestations varies from one
      series to another, but they seem to rank fourth after vespertilio, alopecia and
      photosensitivity. The papules vary in size and number, and they usually
      complicate a severe and active systemic LE. In chronic LE, a papulo-nodular
      eruption may be observed, but this is even rarer. Papules occurring in the course
      of LE may suggest a diagnosis of mucinosis, this disease being either secondary
      to, or associated with LE. Secondary mucinosis is intricated with LE-specific
      histological abnormalities. It appears as a symptomatic alcianophilic deposit
      induced by cytological alterations in some dysimmune collagen diseases, such as
      dermatomyositis or LE. In the literature, three cases of mucinosis secondary to
      LE are well documented, and to these we add a fourth case in which the papules
      contained lupoid lesions and a variable amount of dermal mucinous deposit. The
      literature has also yielded sixteen cases of primary papular mucinosis associated
      with systemic LE (12 cases) or chronic LE (4 cases); we add to these a case of
      systemic LE in which the papular eruptions varied in course, density and size of
      the papules. As in isolated papular mucinosis, histology regularly shows a
      copious mucinous deposit. When present, the LE-specific skin manifestations are
      clearly distinct from those of mucinosis (except for the above-mentioned cases of
      papular lupus). The course of papular mucinosis usually runs parallel to that of
      LE which is characterized by its severity and its articular, haematological and
      renal manifestations. Analysis of the literature also provides various anatomico
      clinical elements which help in differentiating between isolated papular
      mucinosis and primary papular mucinosis associated with LE. In the majority of
      cases treatment relies on corticosteroid therapy or synthetic antimalarial
      agents, but the results are irregular since LE seems to be more resistant to
      treatment than mucinosis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1759750
TI  - [Buccal and ocular localizations of pyoderma gangrenosum in Vaquez's disease].

PMID- 1759751
TI  - [Multiple minute hyperkeratoses. Apropos of 2 cases].

PMID- 1759752
TI  - [Vesiculobullous disseminated lupus erythematosus. Apropos of a case].

PMID- 1759753
TI  - [Multiple recurrence of epithelioid sarcoma].

PMID- 1759754
TI  - [Ocular complication disclosing juvenile xanthogranuloma. Apropos of a case].

PMID- 1759755
TI  - [What is your diagnosis? Cervical lymphadenitis].

PMID- 1759756
TI  - [Pharmacological or functional nevi. Cutaneous hamartoma caused by abnormal
      hormonal cell receptors].

PMID- 1759757
TI  - [Management of pruritus in pregnancy].

PMID- 1759758
TI  - [Treatment of keloids].

PMID- 1759759
TI  - Non-steroidal anti-inflammatory drugs and stercoral perforation of the colon.
AB  - Within 6 months, three constipated patients have been seen with stercoral
      perforation of the colon associated with the ingestion of non-steroidal anti
      inflammatory drug medications (NSAIDs). These drugs were taken regularly for
      painful musculoskeletal disorders 6, 8 and 12 months before admission.
      Constipation is thought to be the most significant contributory factor in the
      development of colonic stercoral perforation; however, it is unclear why it
      develops in so few of the many patients with severe constipation. NSAID
      medications have been associated with the perforation of colonic diverticula, but
      there are no reports of an association with stercoral perforations. If our
      finding of the association is substantiated by other reports there may be a need
      for greater awareness of lower gastrointestinal problems when prescribing such
      drugs to constipated patients.

PMID- 1759760
TI  - Are current techniques of inguinal hernia repair optimal? A survey in the United
      Kingdom.
AB  - Data was collected on the techniques currently employed in adult inguinal hernia
      repair by means of a postal questionnaire to consultants in four Regional Health
      Authorities in England. Questionnaires were returned by 240 consultants (85%).
      This identified a considerable range in methods of repair, with a Moloney nylon
      darn being the sole method used by 35% of consultants, and the Shouldice
      technique, either alone or in combination with other methods, being used by 20%.
      Overall, 51% employ a subcuticular suture for skin closure, and traditional skin
      sutures are used by 31%. There was no association between consultant's date of
      qualification or subspecialty and type of repair. Consultants qualifying after
      1969 are most likely to use a subcuticular suture. Some 14% of all consultants
      and 19% of those qualifying since 1969 employ a Shouldice procedure and a
      subcuticular suture.

PMID- 1759761
TI  - Dr Paul Tessier.

PMID- 1759762
TI  - Antibiotic prophylaxis in penetrating injuries of the chest.
AB  - Most prospective studies recommend antibiotic prophylaxis whilst a thoracostomy
      tube is in place or even longer. We conducted a randomised study of 188 patients
      with penetrating chest injuries requiring a chest drain. Of these patients, 95
      received a single dose of ampicillin before insertion of the chest tube, the
      remaining 93 patients received additional antibiotic prophylaxis for as long as
      the drain was in place. The incidence of intrathoracic sepsis (pneumonia or
      empyema) was 3.1% and 3.2%, respectively. It is concluded that single-dose
      prophylaxis in penetrating chest trauma is as effective as prolonged prophylaxis.
      The importance of chest physiotherapy immediately after the drain insertion and
      of early removal of the drain is stressed. The role of various possible risk
      factors in the development of sepsis is discussed.

PMID- 1759763
TI  - Application of the laryngeal mask airway to thyroid surgery and the preservation
      of the recurrent laryngeal nerve.
AB  - We report our experience of using the laryngeal mask airway (LMA) in 13
      consecutive patients undergoing thyroid surgery and discuss the advantages and
      limitations of the technique. We also describe a method, based on the use of the
      LMA, for identifying and preserving the recurrent laryngeal nerve during thyroid
      surgery.

PMID- 1759764
TI  - An objective long-term evaluation of the Angelchik antireflux prosthesis.
AB  - This paper reports the long-term results of the Angelchik antireflux prosthesis
      (ACP) in Nottingham from October 1981 to December 1989 in 42 patients with
      gastrooesophageal reflux disease (GORD). Pre- and postoperative oesophagoscopy,
      pH monitoring, acid reflux provocation test (ARPT), manometry and symptom
      evaluation were documented to assess the benefits of the procedure. There were no
      operative complications, dysphagia was the commonest postoperative problem and
      necessitated the removal of four ACPs. In most patients, dysphagia resolved
      within 1 year of surgery. Recurrence of reflux symptoms resulted in revision
      surgery in two patients. In general, reflux control was good. We believe that the
      ACP is a good antireflux operation which gives good long-term reflux and symptom
      control in the majority of patients. The removal rate of 15% in our series is of
      some concern but may be due in part to operator skills. The long-term objective
      follow-up has shown a trend towards a return of GOR and this and the unknown long
      term effects of implanted silicone may limit the use of this procedure to the
      more elderly patient.

PMID- 1759765
TI  - ERICA predicts response to tamoxifen in elderly women with breast cancer.
AB  - Oestrogen receptor status has been determined by an immunocytochemical assay
      using fine-needle aspiration samples of primary breast cancers in elderly
      patients. In a prospective study 56 patients were treated with tamoxifen only.
      Satisfactory assays were achieved in 49 patients. Disease was controlled by
      tamoxifen in 32 of 35 (91%) patients with oestrogen receptor positive tumours,
      compared with only 1 (7%) of 14 who were receptor negative. Immunocytochemical
      assay on fine-needle aspiration samples is relatively non-invasive and simple to
      perform, it accurately predicts response to tamoxifen in elderly patients and can
      be used to select patients for tamoxifen only therapy.

PMID- 1759766
TI  - Breast cancer data collection for surgical audit.
AB  - Data are available about the mortality, the incidence, the stage, the survival,
      and the treatment of breast cancer. In this country mortality data are published
      by the OPCS and HIPE and evidence exists to show that there is a considerable
      shortfall in both these sources. The incidence of breast cancer is recorded by
      the Regional Cancer Registries and published by OPCS. The registries supply OPCS
      with a minimum data set which does not include the stage of the disease, which is
      important, and does include the quadrant, which is not. Audit shows marked
      regional variations in completeness of registration. International comparisons
      with Scandinavia are unfavourable and show what can be achieved. Patients who
      develop breast cancer but do not die from it may be cured. The discrepancy
      between incidence and mortality, which varies both geographically and
      historically, should therefore provide a valuable insight into changing survival,
      but does not do so because the data are unreliable. Wide variations in survival
      figures in the medical literature are probably due to variations in staging
      conventions rather than different treatments. It is clear that cancer stages
      carry a more favourable prognosis, but it still cannot be proved that earlier
      diagnosis in a particular individual prolongs the life of that individual. This
      unproven hypothesis is the rationale for mammographic screening. Data on
      treatment in hospitals do not link diagnosis to operation, so that it is
      impossible to separate operations for benign breast disease from those for
      cancer. The OPCS classification of operations is complex with many open-ended
      choices. Doctors do not participate in the coding process and clerks cannot make
      up for this. Radiotherapy and chemotherapy data are not collected nationally and
      the four regional registries who do collect it also rely on their clerks'
      interpretation of medical notes. Data on the use of tamoxifen are consistent and
      of high quality.An extensive data gathering mechanism is in place for breast
      cancer. A huge body of information exists about the disease which should form a
      valuable database. The poor quality of this information reduces its usefulness.
      It is the responsibility of doctors to agree on a data set and to ensure its
      collection. They do it in Scandinavia.

PMID- 1759767
TI  - Sedation for day-case urology: an assessment of patient recovery profiles after
      midazolam and flumazenil.
AB  - The specific antagonist flumazenil has been shown to reverse the central actions
      of benzodiazepines. Its use, in day-case procedures performed under
      benzodiazepine sedation, offers the potential for enhanced patient recovery.
      However, concern has been expressed over the possibility of resedation given the
      short elimination half-life of flumazenil. A randomised, double-blind, placebo
      controlled trial was therefore designed to assess patient recovery profiles after
      flumazenil. A total of 44 adults were entered into the trial. Recovery was
      assessed by means of a battery of psychomotor tests performed pre- and
      postoperatively. Psychomotor function in patients receiving flumazenil returned
      to, or near to, baseline levels within 15 min of administration--an improvement
      maintained throughout the 6 h test period. Patients receiving placebo did not
      recover fully until the 2 h test point--significant differences between the two
      groups existing at 15 min and 1 h. In this study, flumazenil effectively reversed
      midazolam-induced sedation without evidence of resedation. The implications for
      day-case surgery are discussed.

PMID- 1759768
TI  - Branchial cysts: congenital or acquired?
AB  - Branchial cysts are one of the commonest causes of neck lumps in the young adult.
      Their aetiology is the subject of some controversy, although available evidence
      suggests that they are derived from lymphoid tissue. We present two cases of
      branchial cysts, and emphasise the importance of excluding more sinister causes
      of neck lumps before excision, even when the clinical features suggest benign
      pathology.

PMID- 1759769
TI  - Postoperative collection and reinfusion of autologous blood in total knee
      arthroplasty.
AB  - A series of 40 patients undergoing primary unilateral total knee arthroplasty
      were entered into a randomised controlled trial to assess the safety and efficacy
      of postoperative autologous blood salvage and reinfusion. The mean volume of
      autologous blood reinfused was 520 ml per patient (51% of the mean total
      drainage). Homologous blood transfusion was required in only 35% of patients in
      the study group compared with 95% of patients in the control group (P less than
      0.001). The mean volume of homologous blood transfused was 0.9 units per patient
      in the study group compared with 2.5 units in the control group (P less than
      0.001), a saving of 64%.

PMID- 1759770
TI  - Proposed definitions for the audit of postoperative infection: a discussion
      paper. Surgical Infection Study Group.
AB  - Infection is an important arbiter of success or failure of surgical practice and
      the incidence of infection is incorporated into all surgical audit systems. If
      audit is to be of value the outcome end points of clinical practice must be
      defined. We have attempted to derive clinical definitions suitable for bedside
      diagnosis of infection and believe that these should bs supported by, but not be
      dependent upon, the results of laboratory or imaging techniques. The proposed
      definitions are intended to form the basis for clinical audit and to allow
      meaningful comparisons to be made on clear clinical criteria.

PMID- 1759771
TI  - Use of operating theatres: the effects of case-mix and training in general
      surgery.
AB  - Details of theatre occupancy times for a surgical unit in a district general
      hospital and associated cottage hospital were recorded over a 4-month period. The
      average time of the procedures individually and reclassified within the BUPA
      schedule showed that both the severity of the procedure and the grade of surgeon
      influenced future theatre needs. For almost every type of procedure, as expected,
      consultants were quicker than registrars, who in turn were faster than SHOs. The
      hidden cost of training surgeons in general surgical operative procedures can be
      estimated as a result. It is concluded that current measures of resource use
      which rely only on the bed use and ignore operating theatre needs and training
      requirements for non-consultant grades will be misleading, particularly in
      relation to the large element of minor or intermediate surgery which constitutes
      the bulk of most district health authorities' workload.

PMID- 1759772
TI  - Surgical options for left-sided large bowel emergencies.
AB  - Current choices of operation for left-sided large bowel emergencies have been
      established by a questionnaire sent to 218 consultant surgeons asking which
      operation they would perform under varying circumstances for obstructing sigmoid
      carcinoma and diverticular disease. A 92% response rate was obtained. Hartmann's
      procedure (with or without a mucus fistula) is the most popular operation for all
      conditions. Sigmoid colectomy with primary anastomosis is performed by 40% of
      surgeons for obstructing carcinomas, but less commonly in other situations. On
      table lavage is rarely used, and the majority of anastomoses are not protected by
      a proximal stoma. Subtotal colectomy is very seldom employed, except when caecal
      perforation results from an obstructing carcinoma. Some surgeons perform a
      defunctioning colostomy alone even in the presence of a perforation.

PMID- 1759773
TI  - Outpatient carpal tunnel decompression without tourniquet: a simple local
      anaesthetic technique.

PMID- 1759774
TI  - Early endoscopic sphincterotomy for retained bile duct stones after gallbladder
      surgery.

PMID- 1759775
TI  - A comparative study between Michel and Proximate clips for closure of neck
      incisions.

PMID- 1759776
TI  - The incidence and value of rectal examination in children with suspected
      appendicitis.

PMID- 1759777
TI  - The management of popliteal aneurysm: the importance of early surgical repair.

PMID- 1759778
TI  - Two kinds of diverticular disease.

PMID- 1759779
TI  - Beds or day case unit: your choice?
AB  - The aim of this study was to assess the amount of day case surgery and potential
      day case surgery being performed in the main theatre block of a District General
      Hospital, which had a thriving Day Case Unit. Our results revealed that as well
      as large numbers of potential day cases being performed as inpatients, many
      patients (both potential day cases and long-stay elective surgery patients) are
      spending a day(s) in hospital prior to the day of surgery. We believe that by
      performing all day case surgery in our Day Case Unit and by using the Day Case
      Unit to perform pre-admission screening on all surgical patients, a large number
      of bed days will become available. These beds may be used for elective or
      emergency admissions. Alternatively, cutting surgical beds will free monies which
      can be spent on the Day Case Unit.

PMID- 1759780
TI  - Comparative audit: a new method of delivering audit.
AB  - A new method of audit delivery is described, based on the first large scale
      comparative audit meeting held at The Royal College of Surgeons of England. The
      concept of comparative audit is introduced and the methods of undertaking such an
      exercise are described. This comparative audit processed the clinical activity of
      45 general surgeons during 1989 amounting to 49,005 patient admissions. As an
      illustration of this technique the comparative analysis of 3,710 inguinal hernia
      procedures accounting for 12,600 total stay days is used in order to illustrate
      data manipulation, ranking and presentation in chart form. Conclusions are drawn
      and suggestions as to the future role of the technique are outlined.

PMID- 1759781
TI  - An audit of hospital mortality: general compared with vascular surgery.
AB  - We have prospectively analysed hospital mortality for general and vascular
      surgical patients on a single surgical unit. During 1990, 1277 patients were
      admitted (836 general, 368 vascular, 73 varicose veins). The mortality for the
      general surgical patients was 1.3 per cent, vascular 6.2 per cent and no varicose
      vein patients died. All of the general surgical deaths and 70 per cent of the
      vascular deaths were in-patients admitted as an emergency. The major causes of
      death in general surgical patients were peritonitis and gastrointestinal
      bleeding, whilst those of the vascular patients were ruptured abdominal aortic
      aneurysms and acutely ischaemic legs. The implications of these findings are
      discussed.

PMID- 1759782
TI  - [Should digitalis preparations be prescribed for patients with cardiac sinus
      rhythm insufficiency?].

PMID- 1759783
TI  - [Comparative study of 4 ultrasonic methods for evaluating the severity of mitral
      valve narrowing. Apropos of 36 cases].
AB  - Four ultrasound methods of estimating the severity of mitral narrowing (MN) were
      investigated in a prospective manner in 36 patients who underwent ultrasound
      Doppler and catheterization (KT) within a space of 24 hours. The correlation of
      the mean Doppler and KT gradients was poor: r = 0.56 (n = 36, p less than 0.001).
      The mitral surface areas (MA), calculated from Gorlin's equation (mean A = 0.98
      +/- 0.26 cm2) were successively compared with those obtained using the Hatle
      equation (A = 220/PHT) and by a planimetric determination. The coefficients of
      correlation were as follows: r = 0.80 (n = 36) and r = 0.70 (n = 32) (p less than
      0.001). There was good correlation between the Hatle equation and the planimetric
      determination: r = 0.80 (n = 32, p less than 0.001). The continuity equation was
      carried out 15 times; the second measurement site was aortic in 8 cases and
      pulmonary in 7 cases. Correlations with the Gorlin equation were scored 0.70 and
      0.80 respectively (p less than 0.05). The MA was best estimated by the Hatle
      equation, which was always technically feasible and not influenced by the
      presence of atrial fibrillation, mitral valve incompetence of previous
      commissurotomy. Planimetric determination, which is hampered in the presence of
      considerable calcification, remains valid after commissurotomy. The ultrasound
      estimation of the MA was very reliable when the planimetric and Hatle estimations
      concurred. The results obtained from the continuity equation were reliable;
      however, this method is slow, unreliable in a context of atrial fibrillation and
      inapplicable in a context of mitral valve incompetence.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1759784
TI  - [Left bifascicular block and percutaneous mitral valvuloplasty].
AB  - In some patients, the inflation of balloons through the mitral orifice during
      percutaneous mitral valvuloplasties may impair intraventricular conduction. In
      some cases, this appears to correspond to a block of the anterior and middle
      network within the left branch of the bundle of His. This left "biblock" is
      characterized by extreme left axial deviation of AQRS, of about -60 to -70
      degrees, with a QS aspect on D2 and D3, RS on V1 and R on V6 with no major
      prolongation of ventricular activation time. If this hypothesis is correct, it
      would support the "trifascicular" concept of the left branch of the bundle of
      His.

PMID- 1759785
TI  - [A consultation service for the correction of risk factors of atherosclerosis in
      hospitals].
AB  - Although the main risk factors for atherosclerosis have been clearly identified
      and their correction has demonstrated its efficacy, many subjects do not receive
      the corrective measures appropriate for their case. The authors describe a
      hospital service for the prevention of atherosclerosis, which is intended for
      both primary and secondary prevention as well as for epidemiological monitoring
      and above all the evaluation of the preventive strategies employed. The results
      after the service has been running for one year are reported. They appear to
      confirm the initial options. Cooperation with other people involved in prevention
      both inside and outside the hospital, is also a fundamental aspect of this task.

PMID- 1759786
TI  - [Sudden syncope and myocardial ischemia. Apropos of a case].
AB  - It is unusual to carry out a systematic search for myocardial ischemia in
      patients who have suffered a sudden syncopy with no known history of angina. We
      report a case involving loss of consciousness (LC) in the context of sub-hissian
      atrioventricular block (AVB) which required the installation of a pacemaker, with
      the detection of angina pectoris immediately after its installation. Coronary
      artery angiography confirmed a diagnosis of severe, multitrunk coronary disease
      characterized by a tight stenosis of the common trunk. If consciousness is lost
      by a patient suffering from baseline conduction impairment with no chest pain,
      the first thought is 3rd degree degenerative paroxysmal AVB but the possibility
      of an ischemic origin of this AVB should not be overlooked.

PMID- 1759787
TI  - [Right arrhythmogenic ventricular dysplasia. A propos of 2 cases].
AB  - The authors report two new case histories of arrhythmogenic ventricular
      dysplasia. The disease was manifest as usual by recurrent ventricular tachycardia
      with apparent left lagging. Follow-up was 10 and 2 years. A review of the
      diagnostic and therapeutic approaches is provided based on this short personal
      series and on data from the literature.

PMID- 1759788
TI  - [Determination of cardiac output by Doppler ultrasonics. Principle, techniques
      and limitations].
AB  - The development of quantitative applications of Doppler ultrasound for the
      measurement of cardiac output was a lengthy and difficult process. These
      applications call for rigor of the part of the ultrasound cardiographer and a
      sufficiently echoic patient. Numerous studies have demonstrated the reliability
      of Doppler ultrasound in determining aortic flow. A high degree of consensus has
      emerged for measuring aortic areas and velocities at the ring. Doppler ultrasound
      quantification of the pulmonary flow has been validated in children. In adults,
      measurement of the pulmonary ring is often difficult and may lead to major errors
      in the estimation of the flow rates. The determination of mitral flow is also
      possible, either at the ring or at the tip of the mitral funnel. A few
      publications highlight the value of Doppler ultrasound in evaluation of tricuspid
      flow, however, these results require confirmation.

PMID- 1759789
TI  - [Comparison of the efficacy and tolerability of sustained-release verapamil and
      captopril in mild to moderate essential arterial hypertension].
AB  - A randomised, double-blind, double-placebo trial compared the efficacy and
      safety/acceptability of sustained release verapamil and of captopril in two
      parallel groups of patients with mild to moderate hypertension. After a 2 week
      placebo period, 45 patients were randomised into 2 groups, the 1st group (n = 22)
      given sustained release verapamil (240 mg/24 h) as a single morning dose and the
      second (n = 23) captopril 25 (50 mg/24 h) as two daily divided doses. Treatment
      was given for 75 days, with the possibility of a combination of sustained release
      verapamil + captopril from day 45 onwards if diastolic blood pressure remained at
      95 mmHg or more. After 45 days of treatment, the reduction in supine diastolic
      blood pressure did not differ significantly in the 2 groups (-10.4 mmHg in the
      sustained release verapamil group and -9.7 mmHg in the captopril), with 68.2 per
      cent responders to sustained release verapamil and 52.2 per cent in the captopril
      group. After 75 days of treatment, once again there was no significant difference
      in efficacy between the two groups: -14 mmHg for diastolic pressure and 80 per
      cent responders in patients treated with sustained release verapamil, -11.3 mmHg
      and 62.5 per cent responders in the captopril group. The percentage of responders
      was 58.3 per cent in the group treated with the combination of sustained release
      verapamil + captopril from day 45 onwards. The number of patients showing
      evidence of clinical or electrocardiographic adverse reactions was not
      significantly different: 20.7 per cent in the sustained release verapamil group
      and 34.8 per cent in the captopril group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759790
TI  - Current clinical use of absorbable fracture fixation devices.

PMID- 1759791
TI  - Ischaemic colitis--a clinical study of seven patients with special emphasis on
      diagnostic problems.
AB  - Ischaemic colitis is a relatively rare but well-defined disease entity. It is
      associated with high mortality rate if early diagnosis and adequate surgical
      treatment is not accomplished. The aim of the present study was a clinical
      analysis of 7 patients with the verified ischaemic colitis. The delay from
      admission to the correct diagnosis was 8 days on the average (range 2-15 days).
      The reasons for delayed diagnosis included suspicion of diverticulitis, Crohn's
      disease and bowel obstruction as well as poor general condition in one case
      because of which early colonoscopy was not done. It is concluded that in patients
      with abdominal pain, rectal bleeding and diarrhoea associated with typical
      clinical findings, ischaemic colitis should be suspected. This suspicion should
      be followed by early colonoscopy to detect the gangrenous form of the disease as
      early as possible. Instant laparotomy and excision of the affected bowel is
      necessary for cure in these patients.

PMID- 1759792
TI  - Primary small intestinal non-Hodgkin's lymphoma in Finland 1972-1977. Clinical
      presentation and results of treatment.
AB  - During the period of 1972-1977, 29 patients were treated for primary non
      Hodgkin's small intestinal lymphoma (PSIL) in different hospitals in Finland.
      Most frequently the disease occurred in patients in middle age and there was a
      male predominance. Clinical symptoms were non-specific. An abdominal mass was
      felt in 31% of the patients. Radiological findings were mostly non-specific, and
      often a stricture was revealed. All patients underwent surgery, ten patients
      curative resection, 15 patients palliative resection and 4 patients exploration
      and biopsy only. Sixty per cent of the patients who underwent curative resection
      survived five years compared with ten per cent who underwent palliative
      resection. The stage of the disease was an important prognostic factor. The five
      year survival was 60% for patients with stage I disease, while all the patients
      with stage IV disease died during the first two years.

PMID- 1759793
TI  - Computed tomography is important in assessing resectability of pancreatic
      carcinoma, even after ultrasonographic demonstration of the tumour.
AB  - In Finland pancreatic tumour is often detected initially on ultrasonography (US),
      which is widely used as a primary examination in patients who have epigastric
      pain or are jaundiced. This retrospective study was performed to investigate
      whether computed tomography (CT) provided any essential substantial staging
      information to US in patients, whose primary tumour was detected in US. Both US
      and CT had been performed in 102 pancreatic carcinoma patients. US, being
      performed always prior to CT, detected the pancreatic tumour in 73 patients
      (sensitivity 72%). CT detected pancreatic tumour in 65 of these 73 patients
      (89%). US demonstrated the tumour to be unresectable in 22 patients (30%). CT
      demonstrated the tumour as unresectable in the same 22 patients, but also in
      additional 20 patients (overall 42 patients = 58%, P less than 0.001 as compared
      to US). Three of these 20 patients underwent biliary bypass, but in 17 patients
      laparotomy was considered unnecessary (including the six patients who underwent
      merely exploratory laparotomy). It was estimated, that the 51 CT examinations,
      performed in patients in whom the pancreatic tumour was detected resectable on
      US, with overall costs of about FIM 137,700, might obviate laparotomy in 17
      patients, with operative costs of about FIM 255,000. Thus, CT appears to provide
      essential substantial information to US about the resectability of pancreatic
      carcinoma, and CT can be considered a very important preoperative examination
      from both medical and economical point of view in the patients whose pancreatic
      tumour has been demonstrated by US.

PMID- 1759794
TI  - Clinical results of abdominal rectopexy for rectal prolapse.
AB  - Abdominal Marlex-mesh rectopexy was used for surgical treatment of rectal
      prolapse in 54 consecutive patients. Anal incontinence was observed in 43
      patients (80%) before surgical treatment. The degree of anal incontinence was
      more severe in women as compared with men. Operative treatment corrected the
      pathologic anatomy effectively as only one recurrent prolapse developed. At the
      follow-up examination three patients had symptomless anal mucosal prolapse during
      maximal straining. 75% of the incontinent patients regained continence for faeces
      and the rest had some improvement in continence. Seventeen patients (31%) had
      postoperative constipation, that required lactulose treatment. In conclusion,
      abdominal Marlex-mesh rectopexy can be recommended as safe and effective
      treatment for rectal prolapse, despite some patients developing constipation and
      some remaining incontinent.

PMID- 1759795
TI  - Pneumatic dilatation in oesophageal achalasia. Factors influencing results.
AB  - Pneumatic dilatation was performed for oesophageal achalasia in 19 consecutive
      patients without previous endoscopic or surgical treatment. There were no
      complications. Relief of symptoms was excellent or good in 11 cases during follow
      up averaging 43 months. The outcome was better in patients older than 45 years
      than in younger patients. More than two repetitions of dilatation did not improve
      the results. Modified Heller's cardiomyotomy was performed on five patients with
      poor result after two to six dilatations. Pneumatic dilatation is safe and
      effective as initial treatment of oesophageal achalasia particularly in older
      patients, with cardiomyotomy reserved for those who do not respond to two
      dilatations.

PMID- 1759796
TI  - The results of completion angiography after acute lower limb thromboembolectomy.
AB  - The results of completion angiography after acute thromboembolectomy with a
      Fogarty balloon catheter were evaluated. There were 62 patients (median age 72
      years, range 44-92 years) and completion angiograms were made in 44 of them
      (71%). Incomplete runoff was demonstrated in 26 patients (59%) and
      rethromboembolectomy or vascular reconstruction was made in 18 cases (41%) under
      the same anaesthesia, while additional vascular surgery was technically
      impossible in 8 patients (18%). Supplementary surgery resulted in radiological
      improvement in 56% of operated cases. Reocclusion rate after 6 months was 50% in
      patients without patent tibials compared to 15% in patients with two or three
      patent tibial arteries (P less than 0.05). Eighteen patients had no completion
      angiograms after thromboembolectomy and 5 (28%) required early reoperation due to
      ischaemia. Completion angiograms are advocated in all cases of acute
      thromboembolectomy before the patient leaves the operating table.

PMID- 1759797
TI  - Fixation of experimental osteotomies with absorbable polylactic acid screws.
AB  - Absorbable screws made of self-reinforced poly-L-lactic acid (SR-PLLA) and poly
      DL/L-lactic acid (SR-PDLLA/PLLA) were used for fixation of cancellous bone
      osteotomies of the distal femur in rabbits. The initial molecular weight of PLLA
      was 260.000 and that of PDLLA 100.000. The follow-up times were from one week to
      96 weeks. Seventy-two rabbits were operated on, 36 in the PLLA group and 36 in
      the PDLLA/PLLA group. After sacrifice, radiographic, micro-radiographic,
      histologic, histo-morphometric, and oxytetracycline-labelling studies were
      performed. In the PLLA group 34/36 (94%) osteotomies and in the PDLLA/PLLA group
      31/36 (86%) osteotomies healed without delay or angular deformity. The present
      investigation shows that absorbable SR-polylactic acid screws are suitable for
      fixation of weight loading cancellous bone osteotomies in rabbits. Based on these
      promising results, a clinical study where cancellous bone fractures are fixed
      with SR-PLLA screws has been started.

PMID- 1759798
TI  - Bone malalignment in acute injuries of the wrist.
AB  - The purpose of this study was to analyze radiographic signs of carpal bone
      instability in patients with an acutely injured wrist. There were 80 patients (52
      women and 28 men) with a fall on the outstretched hand. Fifty patients had a
      fracture of the distal radius, and eight had a scaphoid fracture. The patients
      with a bone fracture showed a larger scapholunate angle than those without a
      fracture (P less than 0.001, t-test). However, only four of them showed true
      carpal bone instability: two patients with a scaphoid fracture and one with a
      radius fracture had dorsiflexion instability of the wrist and one patient with a
      radius fracture had dorsal subluxation of the wrist. In addition, one patient
      without any bone fracture had scapholunate dissociation, one form of carpal bone
      instability. Although carpal bone instability is not frequent in an acutely
      injured wrist, its signs should be remembered in the radiographic analysis of the
      traumatic wrist to prevent subsequent articular disorders.

PMID- 1759799
TI  - Clinical evaluation of fracture healing by serum osteocalcin and alkaline
      phosphatase.
AB  - The serum osteocalcin (BGP) concentration and alkaline phosphatase (AP) activity
      were measured prospectively during the healing phases of crural fractures in 15
      patients. They were divided into two groups, the time of union of the fracture
      being under (group 1) or over 16 weeks (group 2). The mean values of BGP and AP
      were somewhat higher from the outset in the group 1 than in the group 2, but the
      difference was not significant. A significant increase in BGP and AP (P less than
      0.05) was evident in both groups at 6 weeks. In cases with undisturbed healing of
      fractures (group 1) the values of serum BGP and AP then declined towards the
      values at the time of accident. Contrary to this, in group 2 both the values of
      the serum BGP and AP were still at a significantly higher level than those at the
      day of the fracture. However, no significant difference in the serum BGP or AP
      was seen between the two groups at 6 or 12 weeks. The results support some
      earlier ones: the changes in serum BGP and AP may provide a prognostic indicator
      for consolidation of a fracture.

PMID- 1759800
TI  - Conservative treatment of tibial fractures. Results in a series of 163 patients.
AB  - The purpose of this study was to assess the results of conservative treatment of
      tibial fractures. The series consisted of 165 tibial fractures in 163 consecutive
      patients. Over one-fifth (35) were open fractures. The treatment was in the main
      conservative, the primary treatment of only three fractures was operative. Full
      weight-bearing was started after 124 days on average. The average duration of
      primary treatment by plaster immobilization was 99 days. A questionnaire was
      completed and returned by 84% of the patients. Symptomatic, clinically and
      radiologically evident deep venous thrombosis was observed in 0.6%, pulmonary
      embolism in 1.9%, signs of fat embolism in 1.9%, superficial infection in 3.1%,
      osteitis in 0.6% and refracture in 2.5% of fractures. The average time to union
      was about 14 weeks. The incidence of radiological malpositions developing during
      the time of treatment was high. The risk of shortening was associated with
      oblique and severely comminuted fractures and possibly also with severely
      displaced fractures. Subjective sequelae were reported by a large number of
      patients. An optimal result is not guaranteed in all tibial fractures by
      conservative treatment.

PMID- 1759801
TI  - Effect of prolonged experimental distension on the function and ultrastructure of
      the canine urinary bladder.
AB  - Urinary bladder distension was induced for 10 hours in dogs and micturition tests
      were made before over-stretching, immediately afterwards and 5 days later.
      Compliance and residual urine had increased and maximum pressure during voiding
      had decreased immediately after retention, but returned to normal after 5 days.
      Biopses for light microscopic and electronmicroscopic investigation taken from
      the anterior wall of the bladder on the fifth day showed submucosal haemorrhages
      and some necrosis. The consistent finding on electron microscopy was Schwann cell
      oedema, which was seen within the cytoplasm and between the cytoplasmic processes
      of the Schwann cells. Axonal degeneration was also a common finding. These
      anatomical changes, although found at the moment of functional recovery, may be
      linked to impaired conductivity of the nerves in the bladder wall, at least
      partly, causing its impaired function. Recovery of function occurs quite rapidly
      in healthy bladders.

PMID- 1759802
TI  - Fibroepithelial polyps of the ureter.
AB  - Two cases of ureteric fibroepithelial polyps are presented. Macroscopic
      haematuria and flank pain were seen as symptoms in both cases. Intravenous
      urography, retrograde ureteropyelography, computed tomography, and
      ureterorenoscopy with visual biopsies were used as diagnostic methods. As a
      result of the preoperative diagnostics, saving surgical procedures (local
      excision and coagulation of the base of the tumour) were used with good results.
      The therapy of ureteric tumours should always be founded on the preoperative
      histological diagnosis and should be conservative transureteric or open surgical.

PMID- 1759803
TI  - Primary arterioenteric fistula between common iliac artery and ileum with massive
      bleeding.
AB  - Primary iliac artery aneurysms are rare, and a fistula to the terminal ileum with
      bleeding is very uncommon. A case with a primary massively bleeding iliaco-ileal
      fistula is described. In an emergency operation the common iliac artery was
      ligated and the fistula to the small bowel was resected. Arterial reconstruction
      was done by extra-anatomical femoro-femoral suprapubic prosthesis. The immediate
      outcome of the operation was excellent, but the patient died four days later
      because of acute myocardial infarction.

PMID- 1759804
TI  - Traumatic luxation of the heart.
AB  - A case of luxation of the heart resulting from blunt thoracic trauma is
      presented. Pericardial defect with herniation of the heart was discovered
      preoperatively and successfully repaired with a pleural patch. Special attention
      is drawn in the report to the preoperative diagnosis of this life-threatening
      condition.

PMID- 1759805
TI  - Recurrent strangulated obturator hernia.
AB  - A case of recurrent strangulated obturator hernia is presented. The difficulty in
      diagnosing obturator hernia and the high mortality associated with strangulation
      are highlighted from a literature review. A high index of suspicion in older
      patients presenting with intestinal obstruction without an obvious cause,
      possibly combined with CT scanning of the pelvic region, may lead to earlier
      diagnosis and operation and a more favourable outcome in such cases.

PMID- 1759806
TI  - The role of experience, narrative, and community in skilled ethical comportment.
AB  - Two major types of narrative--constitutive or sustaining narratives and
      narratives of learning--are presented to illustrate the functions of narrative in
      everyday ethical expertise and socially embedded caring practices. Four narrative
      themes illustrate constitutive and sustaining narratives: healing and
      transcendence, the heroic saving of a life, fostering care and correction, and
      stories of being present. Five themes illustrate narratives of learning: the
      skill of involvement, being open to experience, disillusionment, facing death and
      suffering, and liberation. Quandary- and rights-based procedural ethics address
      ethical problems and breakdown and overlook everyday ethical comportment. Public
      storytelling is recommended as a way to explore notions of the good and ethical
      concerns.

PMID- 1759807
TI  - Principle-oriented ethics and the ethic of care: a creative tension.
AB  - Research to date in the field of nursing ethics has overlooked the nature of the
      guiding moral framework in nursing practice, while focusing primarily on the
      moral reasoning and moral behaviors among nurses. This research depicts two moral
      frameworks--a principle-oriented ethic and the ethic of care--as they are
      experienced by practicing critical care nurses. The interdependence of these two
      frameworks as they inform the moral experience of the nurse is demonstrated in
      the analysis of a complex nurse narrative that depicts the nurse's moral
      struggle.

PMID- 1759808
TI  - Pain assessment in children: theoretical and empirical validity.
AB  - Valid assessment of pain in children is foundational for both the nursing
      practice and research domains, yet few validated methods of pain measurement are
      currently available for young children. This article describes an innovative
      research approach used in the development of photographic instruments to measure
      pain intensity in young African-American and Hispanic children. The instruments
      were designed to enable children to participate actively in their own care and to
      do so in ways that are congruent with their developmental and cultural heritage.
      Conceptualization of the instruments, methodological development, and validation
      processes grounded in Orem's Self-Care Deficit Theory of Nursing are described.
      The authors discuss the ways in which the gaps between nursing theory, research,
      and practice are narrowed when development of instruments to measure clinical
      nursing phenomena are grounded in nursing theory, validated through research and
      utilized in practice settings.

PMID- 1759809
TI  - The meaning of nursing home friendships.
AB  - This research report on the social networks of institutionalized elderly people
      describes four types of networks and focuses on resident-resident interaction.
      Friendship themes of intimacy, social support, reciprocity, and companionship
      provide a basis for examining similarities in and differences between the network
      types. Discussion draws on the study results through examination of the meaning
      of friendship and interpretation of life-span themes.

PMID- 1759810
TI  - Patient outcomes research: seizing the opportunity.
AB  - Nurses must take a proactive role in patient outcomes research. Because the
      patient, not disease, has always been the focus of nursing, nurses are sensitized
      to the rich but complicated context in which patient outcomes research will be
      conducted. Nurse researchers are experienced in using complex research models,
      dealing with ambiguous concepts, grappling with difficult measurement issues, and
      subscribing to methodological pluralism. These skills are important to success
      with patient outcomes research. In this article, the opportunities and challenges
      posed to nurses by patient outcomes research will be addressed. One of the
      benefits will be a stronger knowledge base for clinical practice and hence
      patient care.

PMID- 1759811
TI  - Studying the human-environment phenomenon using the science of complexity.
AB  - The principal argument of the present article is that a new theoretical paradigm
      capable of facilitating the understanding of complex phenomena is necessary to
      study nursing's claim to its science as the science of unitary human beings, or
      the integrality between humans and the environment. A research study of the
      complex human-environment phenomenon illuminating a four-phase methodology is
      presented. It is argued that much can be learned by the use of the science of
      complexity to integrate data gleaned from different approaches to knowledge
      generation into a comprehensive understanding of the human being in the
      environment as a unified whole.

PMID- 1759812
TI  - Antibiotic tissue penetration and its relevance: models of tissue penetration and
      their meaning.

PMID- 1759813
TI  - Antibiotic tissue penetration and its relevance: impact of tissue penetration on
      infection response.

PMID- 1759814
TI  - In vitro activity of orally administered antimicrobial agents against Haemophilus
      influenzae recovered from children monitored longitudinally in a group day-care
      center.
AB  - To determine whether the prevalence of resistance to commonly used oral
      antimicrobial agents varied over time, we compared the in vitro susceptibilities
      of 217 strains of Haemophilus influenzae recovered from nasopharyngeal secretions
      of children in a day-care center studied longitudinally between 1979 and 1987.
      The overall rate of beta-lactamase production in these strains was 18%, with
      rates of 57% in type b isolates (n = 21) and 14% in non-type b isolates (n =
      196). The percentages of isolates for which MICs were less than or equal to 1.0
      micrograms/ml for amoxicillin alone, amoxicillin in combination with clavulanic
      acid, and cefuroxime alone were 82, 92, and 93%, respectively. The percentage of
      strains for which cefaclor MICs were less than or equal to 1.0 micrograms/ml was
      only 0.5%. Isolates for which chloramphenicol MICs were greater than 2.0
      micrograms/ml or for which trimethoprim-sulfamethoxazole MICs were greater than
      0.5/9.5 micrograms/ml were uncommon: 1 and less than 1%, respectively. High
      concentrations of erythromycin alone and in combination with sulfisoxazole were
      required to inhibit the majority of test strains; there was no evidence of
      erythromycin-sulfisoxazole synergy. In vitro susceptibility to commonly used oral
      antimicrobial agents remained at a constant level when H. influenzae isolates
      collected from children in a day-care center during 1979 through 1983 were
      compared with strains collected during 1984 through 1987.

PMID- 1759815
TI  - Microculture screening assay for primary in vitro evaluation of drugs against
      Pneumocystis carinii.
AB  - Pneumocystis carinii inoculated into 96-well filtration plate assemblies was
      shown to synthesize radiolabeled folates de novo from [para-3H]aminobenzoic acid
      ([3H]pABA). At the end of each incubation with [3H]pABA, a vacuum manifold was
      used to remove the medium and wash P. carinii. The membrane at the base of each
      well was dried and punched out, and the level of 3H retained was determined by
      direct scintillation counting. High-pressure liquid chromatography analysis of
      duplicate filters confirmed that direct counting of 3H retained on membranes
      (after correction for unmetabolized [3H]pABA) was an accurate reflection of total
      [3H]pABA incorporation by P. carinii. Greater than 95% of the 3H recovered was
      shown to be present as polyglutamated species. After digestion with rat plasma
      folic acid gamma-glutamyl hydrolase, para-aminobenzoylglutamate, N10
      formyltetrahydrofolate, and tetrahydrofolate were identified as the major 3H
      labeled components. para-Aminobenzoylglutamate was presumed to have arisen from
      folylpolyglutamates synthesized by P. carinii and was therefore included in the
      calculation of total [3H]pABA incorporation. P. carinii incorporation of [3H]pABA
      under optimal conditions was used as a selective measure of in vitro viability
      against which the inhibitory effects of some antipneumocystis agents
      (pentamidine, sulfamethoxazole, 566C80, and piritrexim) were quantitated. The
      concentrations of pentamidine, sulfamethoxazole, 566C80, and piritrexim required
      for 50% inhibition in this assay were 7.3, 0.1, 1.4, and approximately 100
      microM, respectively. The results suggest that this 96-well [3H]pABA
      incorporation assay has considerable potential for objective in vitro drug
      screening against P. carinii.

PMID- 1759816
TI  - Borderline susceptibility to antistaphylococcal penicillins is not conferred
      exclusively by the hyperproduction of beta-lactamase.
AB  - Staphylococcus aureus strains bearing the 17.2-kb beta-lactamase plasmid pBW15
      and belonging to phage group 94/96 exhibit borderline susceptibility to the
      antistaphylococcal penicillins. Borderline susceptibility within phage group
      94/96 is thought to be mediated by the hyperproduction of type A staphylococcal
      beta-lactamase. Evaluation of 84 non-94/96 phage type S. aureus strains that also
      produced the type A enzyme identified 7 additional hyperproducing strains.
      However, none of these isolates contained pBW15, and only one met the criteria
      for borderline susceptibility. To determine the role of pBW15 and the 94/96 phage
      type in the expression of borderline susceptibility, pBW15 was transformed in two
      plasmid-free, penicillin-susceptible strains, one of which belonged to phage
      group 94/96. Penicillin MICs for both transformants and quantitative beta
      lactamase activity were comparable to those for the parent pBW15-containing
      strain. A fourfold difference in the oxacillin MICs for the 94/96 and non-94/96
      phage type transformants (1.0 and 0.25 microgram/ml, respectively) was
      identified, and only the 94/96 phage type transformant met the criteria for
      borderline susceptibility. Chromosomal DNA from borderline-susceptible phage
      group 94/96 strains did not hybridize with a probe for mecA, and the beta-lactam
      binding affinity of PBPs 1, 2, 3, and 4 from a penicillin-susceptible 94/96 phage
      type strain and a non-94/96 phage type strain were comparable. Although
      hyperproduction of the type A beta-lactamase appears to be necessary for the
      expression of borderline susceptibility within certain phage group 94/96 strains,
      beta-lactamase production of a comparable magnitude by a group of S. aureus
      strains belonging to other phage types does not confer borderline susceptibility.
      These data suggest that borderline susceptibility is not solely due to the
      hyperproduction of beta-lactamase.

PMID- 1759817
TI  - Effect of dexamethasone or HWA-138 in combination with antibiotics in
      experimental Haemophilus influenzae type b infection.
AB  - Modulation of the host's inflammatory response in bacterial meningitis may be
      beneficial. In this study, the effects of dexamethasone and HWA-138, an analog of
      pentoxifylline, on CSF cultures and cochlear inflammation in an infant rat model
      of Haemophilus influenzae type b were studied. Five-day-old infant rats were
      inoculated once intraperitoneally with 1 x 10(4) to 10 x 10(4) CFU of H.
      influenzae type b (strain 1406). Twenty-four hours later, infant rats were
      treated intraperitoneally with one dose of ampicillin (0.1 mg/g of body weight),
      cefotaxime (0.05 mg/g), or cefuroxime (0.05 mg/g) alone or in combination with
      one dose of dexamethasone (0.00015 mg/g) or HWA-138 (0.005 mg/g). Twenty-four
      hours after treatment with cefuroxime plus dexamethasone, animals had a
      significantly (P less than or equal to 0.04) greater incidence of bacteremia and
      meningitis (eight of nine animals) than that in animals of the other treatment
      groups. Overall, dexamethasone was associated with less inflammation (P less than
      0.04) of the cochlear nerve compared with that from antibiotic treatment alone.
      In this model, when suboptimal antimicrobial therapy is administered, anti
      inflammatory agents may be beneficial with respect to reducing cochlear
      inflammation. However, dexamethasone and cefuroxime lead to a higher rate of
      positive blood and cerebral spinal fluid cultures than cefuroxime alone.

PMID- 1759818
TI  - Efficacy of SCH 39304 in treatment of experimental invasive aspergillosis.
AB  - The efficacy of SCH 39304 (SCH) against Aspergillus fumigatus was assessed with
      an immunosuppressed, temporarily leukopenic rabbit model of invasive
      aspergillosis. Therapy with SCH at 10 or 15 mg/kg of body weight per day was
      begun 24 h after lethal challenge and compared with therapy with amphotericin B
      at 1.5 mg/kg/day. Compared with untreated controls, SCH reduced mortality and
      also reduced the tissue burden of A. fumigatus 100- to 1,000-fold in liver,
      kidney, and lung tissues. SCH at 15 mg/kg/day and amphotericin B eliminated A.
      fumigatus in liver, kidney, and lung tissues. In addition, both dosages of SCH
      significantly eliminated the organism from brain tissues, compared with controls.
      Both SCH and amphotericin B decreased or eliminated circulating aspergillus
      antigen. These results show that new azoles can be as effective as amphotericin B
      in eradicating the organism from tissues and offer promise in improving the
      treatment of invasive aspergillosis.

PMID- 1759819
TI  - Characterization of erythromycin resistance in Campylobacter jejuni and
      Campylobacter coli.
AB  - The mechanism of resistance to erythromycin, the drug of choice in the treatment
      of campylobacter gastroenteritis, was investigated. Erythromycin resistance
      (MICs, greater than 1,024 micrograms/ml) in three clinical isolates of
      Campylobacter jejuni and one C. coli isolate was determined to be constitutive
      and chromosomally mediated. In vivo protein synthesis in erythromycin-susceptible
      C. jejuni and C. coli strains was completely inhibited by low levels of
      erythromycin (5 micrograms/ml), whereas a high concentration of the antibiotic
      (100 micrograms/ml) had no effect on protein synthesis in erythromycin-resistant
      strains. Biological assays showed that extracellular degradation of erythromycin
      was not responsible for erythromycin resistance in strains of Campylobacter
      species. The rates and amounts of uptake of [14C]erythromycin by resistant and
      susceptible campylobacter cells were determined to be similar. Binding assays
      with purified campylobacter 70S ribosomes as well as 50S ribosomal subunits
      showed that those from erythromycin-resistant strans bound much less
      [14C]erythromycin than did those from susceptible strains. Genomic DNA from C.
      coli UA585 was used to transform erythromycin resistance to C. coli UA417. The
      erythromycin resistance marker was associated with a 240-kb SmaI fragment of the
      C. coli UA585 genome. Our results rule out erythromycin inactivation or efflux
      and are not consistent with the production of an RNA methylase, although they are
      consistent with a mutational mechanism of resistance due to a change in a
      ribosomal protein gene. This study constitutes a detailed biochemical and genetic
      characterization of erythromycin resistance in Campylobacter species.

PMID- 1759820
TI  - Chlorhexidine resistance in methicillin-resistant Staphylococcus aureus or just
      an elevated MIC? An in vitro and in vivo assessment.
AB  - Chlorhexidine (Hibiscrub; ICI) is generally accepted to be effective as an
      antiseptic hand wash for methicillin-susceptible Staphylococcus aureus (MSSA),
      but there is dispute whether the chlorhexidine MIC for methicillin-resistant S.
      aureus (MRSA) strains is higher than that for MSSA strains and, indeed, whether
      it is relevant. In addition, the link between resistance to chlorhexidine,
      gentamicin, and "nucleic acid-binding" compounds (NAB; which code, in particular,
      for propamidine isethionate and ethidium bromide) requires clarification. We
      performed chlorhexidine MIC and rate of kill tests on a number of MSSA and MRSA
      isolates. Two gentamicin-resistant MRSA isolates without NAB plasmids were more
      susceptible (0.25 and 0.5 microgram/ml) than four of eight MSSA that we tested
      (range, 0.25 to 2 microgram/ml). Chlorhexidine MICs were higher (4 to 8
      micrograms/ml) for seven distinct MRSA isolates with plasmids conveying
      resistance to gentamicin and NAB (GNAB). Curing of the GNAB plasmid from MRSA
      strains resulted in a fall in the MIC (1 to 3.3 micrograms/ml), but no consistent
      fall in killing by chlorhexidine was observed. No effect on the chlorhexidine MIC
      or killing was observed when we cured strains of methicillin resistance. GNAB
      plasmid transfer resulted in a rise in the chlorhexidine MIC for the strains but
      not consistent fall in killing by chlorhexidine. Ethical approval was granted for
      10 volunteers to each have a methicillin-susceptible, GNAB-resistant, derived
      transcipient and its GNAB-susceptible isogenic parent applied to separate sites
      in an in vivo skin test; no significant difference was seen in survival rates
      after the application of chlorhexidine. These results suggest that chlorhexidine
      appears to be as effective as a hand-washing agent for MRSA isolates with or with
      out NAB plasmids as it is for MSSA isolates.

PMID- 1759821
TI  - Novel method for measuring growth of Treponema hyodysenteriae and its application
      for monitoring susceptibility of clinical isolates to antimicrobial agents.
AB  - A microdilution assay method was developed to determine MICs of antibiotics for
      Treponema hyodysenteriae and to estimate the bacterial burden of mice colonized
      by this swine pathogen. Hemolysis of bovine erythrocytes in broth was correlated
      with growth of the spirochete, and growth inhibition by drugs could be determined
      by measuring hemolysis. MICs of 10 antibiotics for eight clinical isolates of T.
      hyodysenteriae measured by this method were similar to values obtained by an agar
      dilution method and to values reported in the literature. This method was also
      used to demonstrate the elimination of T. hyodysenteriae from the ceca of
      infected mice following oral treatment with carbadox. The procedure described in
      this paper provides a rapid and simple method for determining MICs of antibiotics
      for T. hyodysenteriae and may be adapted for the purpose of determining the
      presence of this veterinary pathogen in cecal contents of experimentally infected
      mice.

PMID- 1759822
TI  - Differential modulation of cytokine production by macrolides: interleukin-6
      production is increased by spiramycin and erythromycin.
AB  - Antibiotics do not act alone but act in conjunction with the host defense system.
      In particular, it has been shown that some antibiotics can modify cytokine
      production. We compared the in vitro effects of three macrolides (roxithromycin,
      spiramycin, and erythromycin) actively concentrated by leukocytes on interleukin
      1 alpha, (IL-1 alpha), IL-1 beta, IL-6, and tumor necrosis factor alpha
      production by human monocytes stimulated with lipopolysaccharide. Our results
      show that the three macrolides tested have different effects on production of
      these cytokines. Spiramycin and, to a lesser extent, erythromycin increased total
      IL-6 production without affecting IL-1 alpha, IL-1 beta, or tumor necrosis factor
      alpha production, whereas roxithromycin had no effect. To our knowledge, this is
      the first time that an antibiotic has been shown to increase IL-6 production.

PMID- 1759823
TI  - Use of a broad-host-range gyrA plasmid for genetic characterization of
      fluoroquinolone-resistant gram-negative bacteria.
AB  - The gyrA genotypes of ciprofloxacin-resistant clinical isolates of Escherichia
      coli (n = 3), Klebsiella pneumoniae (n = 4), Providencia stuartii (n = 2),
      Pseudomonas aeruginosa (n = 1), and Acinetobacter calcoaceticus (n = 1) were
      analyzed in a dominance test. This test is based on the dominance of a wild-type
      gyrA gene (gyrA+) over the quinolone resistance allele (gyrA) in a heterodiploid
      strain. Plasmid pBP515, developed to carry the gyrA+ gene of E. coli K-12 on a
      broad-host-range vector derived from pRSF1010, was used to obtain heterodiploid
      strains. Plasmid pBP515 encodes kanamycin and gentamicin resistance and is
      transferable via mobilization by a pRP1-derived helper plasmid (pRP1H) to strains
      of several gram-negative species. After the introduction of pBP515, single-cell
      MICs (as measured by reduction of the viable cell count) of ciprofloxacin and
      nalidixic acid decreased by 4- to greater than 8,000-fold for all strains tested,
      and 8 of the 11 strains regained ciprofloxacin susceptibilities similar to those
      of the respective wild types. The results indicate that (i) high-level
      fluoroquinolone resistance in clinical isolates of E. coli, K. pneumoniae, P.
      aeruginosa, and A. calcoaceticus can result from mutational alteration of the
      gyrA gene, and (ii) gyrA mutations are involved in high levels of fluoroquinolone
      resistance in P. stuartii. Additional mutations outside the gyrA locus may
      contribute to resistance in K. pneumoniae and P. stuartii.

PMID- 1759824
TI  - Use of ampicillin-sulbactam for treatment of experimental meningitis caused by a
      beta-lactamase-producing strain of Escherichia coli K-1.
AB  - We evaluated the pharmacokinetics and therapeutic efficacy of ampicillin combined
      with sulbactam in a rabbit model of meningitis due to a beta-lactamase-producing
      strain of Escherichia coli K-1. Ceftriaxone was used as a comparison drug. The
      MIC and MBC were 32 and greater than 64 micrograms/ml (ampicillin), greater than
      256 and greater than 256 micrograms/ml (sulbactam), 2.0 and 4.0 micrograms/ml
      (ampicillin-sulbactam [2:1 ratio, ampicillin concentration]) and 0.125 and 0.25
      micrograms/ml (ceftriaxone). All antibiotics were given by intravenous bolus
      injection in a number of dosing regimens. Ampicillin and sulbactam achieved high
      concentrations in cerebrospinal fluid (CSF) with higher dose regimens, but only
      moderate bactericidal activity compared with that of ceftriaxone was obtained.
      CSF bacterial titers were reduced by 0.6 +/- 0.3 log10 CFU/ml/h with the highest
      ampicillin-sulbactam dose used (500 and 500 mg/kg of body weight, two doses).
      This was similar to the bactericidal activity achieved by low-dose ceftriaxone
      (10 mg/kg), while a higher ceftriaxone dose (100 mg/kg) produced a significant
      increase in bactericidal activity (1.1 +/- 0.4 log10 CFU/ml/h). It appears that
      ampicillin-sulbactam, despite favorable CSF pharmacokinetics in animals with
      meningitis, may be of limited value in the treatment of difficult-to-treat beta
      lactamase-producing bacteria, against which the combination shows only moderate
      in vitro activity.

PMID- 1759825
TI  - Pharmacokinetics of cefuroxime axetil suspension in infants and children.
AB  - The pharmacokinetics of cefuroxime axetil suspension in 28 infants and children,
      ranging in age from 3 months to 12 years (mean, 23 months), were studied. Mean
      maximum serum cefuroxime concentrations of 3.3, 5.1, and 7.0 micrograms/ml were
      achieved 3.6, 2.7, and 3.1 h after the administration of doses of 10, 15, and 20
      mg, respectively, of cefuroxime axetil suspension per kg of body weight together
      with milk or milk formula. These concentrations exceed the MICs for common
      respiratory tract pathogens, including beta-lactamase-producing strains of
      Haemophilus influenzae and Moraxella (Branhamella) catarrhalis. Following a 10-
      or 15-mg/kg dose, serum cefuroxime concentrations are similar to those achieved
      in adults following the administration of a 250-mg cefuroxime axetil tablet.
      There were linear relationships between dose and both maximum serum cefuroxime
      concentration and area under the serum drug concentration-verus-time curve. The
      mean half-life of cefuroxime in serum was independent of dose and ranged from 1.4
      to 1.9 h. No cefuroxime axetil (intact ester) was detected in the blood. The
      intact ester in the urine of four children was measured; however, the amount
      recovered represented less than 0.1% of the administered dose.

PMID- 1759826
TI  - Antifungal activity of HWA-138 and amphotericin B in experimental systemic
      candidiasis.
AB  - HWA-138, a pentoxifylline analog, has been shown to increase yeast urinary
      clearance and to reduce yeast counts in the kidneys of rats infected with Candida
      albicans. Furthermore, HWA-138 has also been shown to prevent amphotericin B
      induced acute renal failure in rats. We report here on the effects of HWA-138
      alone and in combination with amphotericin B in the treatment of systemic
      candidiasis in mice. When single doses of HWA-138 were administered intravenously
      (10, 25, or 50 mg/kg of body weight) into infected mice, no significant
      improvement in survival was observed. In infected mice treated intravenously with
      multiple doses of HWA-138 (10, 25, or 50 mg/kg once daily for 5 consecutive
      days), a significant increase in survival time was seen only in animals also
      receiving 25 mg of HWA-138 per kg (14 +/- 3 days test versus 9 +/- 1 days
      control; P less than 0.05). The coadministration of subtherapeutic doses of
      amphotericin B and HWA-138 resulted in increased survival time. Combination
      therapy with amphotericin B (0.1-mg/kg single dose) and HWA-138 (10-, 25-, or 50
      mg/kg multiple doses) resulted in a significant increase in survival time over
      controls (19 +/- 4, 19 +/- 5, and 21 +/- 9 days, respectively, versus 9 +/- 3
      days; P less than 0.05). Combination therapy with amphotericin B (0.2-mg/kg
      single dose) and HWA-138 (10-, 25-, or 50-mg/kg multiple doses) also resulted in
      a significant increase in survival time over controls (24 +/- 6, 24 +/- 6, and 24
      +/- 6, respectively, versus 9 +/- 3 days; P less than 0.05). Combination therapy
      with amphotericin B (0.2-mg/kg single dose) and HWA-138 (10-, 25-, or 50-mg/kg
      multiple doses) also resulted in a significant increase in survival time over
      controls (24 +/- 6, 24 +/- 6, and 24 +/- 6, respectively, versus 9 +/- 3 days; P
      < 0.05). Variance analysis of these findings indicate synergistic activity
      between amphotericin B and HWA-138 in the treatment of experimental candidiasis
      in mice.

PMID- 1759827
TI  - Comparative study of pharmacokinetics and serum bactericidal activity of
      ceftizoxime and cefotaxime.
AB  - Single 2-g intravenous doses of ceftizoxime (CZX) and cefotaxime (CTX) were given
      over 30 min to 10 adult volunteers in a crossover manner on two separate
      occasions. Concentrations of CZX, CTX, and the primary metabolite of CTX,
      desacetylcefotaxime (dCTX), in serum, suction-induced-blister fluid, and urine
      were determined by high-pressure liquid chromatography. Pharmacokinetic
      parameters were estimated by using an extended least-squares modeling program
      (MKMODEL). CZX exhibited a half-life in serum (2.05 h) longer than that of CTX
      (1.43 h) but comparable to that of dCTX (2.02 h). The percentage of penetration
      in blister fluid, estimated by area under the curve ratios, was significantly
      higher for CZX (164.4%) than for CTX (60.8%). Serum bactericidal activity,
      determined for volunteer samples at 1, 6, 8, and 12 h after patients were dosed,
      against clinical isolates of the Bacteroides fragilis group, Enterobacter
      cloacae, Escherichia coli, Klebsiella pneumoniae, and Morganella morganii were
      significantly higher for CZX than those for CTX against members of the family
      Enterobacteriaceae at all times. Serum bactericidal titers against B. fragilis
      were also higher for CZX than for CTX at 1 h postinfusion. Neither CZX nor CTX
      exhibited any bactericidal activity at any other time against the B. fragilis
      group. In conclusion, the serum bactericidal activity of CZX was greater and more
      prolonged than that of CTX against tested strains in spite of the in vitro
      synergistic contribution of dCTX to CTX, equal serum elimination half-lives of
      dCTX and CZX, and similar antibacterial activity and similar instability under
      microbiological testing for CZX and CTX.

PMID- 1759828
TI  - Emergence of fluoroquinolone resistance in Campylobacter jejuni and Campylobacter
      coli in subjects from Finland.
AB  - The in vitro susceptibilities of 102 human campylobacter strains isolated between
      1978 and 1980 and 100 strains isolated in 1990 to ciprofloxacin, norfloxacin,
      erythromycin, gentamicin, and doxycycline were examined. The biotypes and heat
      stable serotypes of the strains as well as antimicrobial treatments and travel
      history of the campylobacter-positive patients were also studied. The results
      indicated that susceptibility to erythromycin, gentamicin, and doxycycline has
      remained the same during the past 10 years. No gentamicin-resistant strains were
      found. Resistance to erythromycin was 3% in both groups of strains. However, the
      number of norfloxacin-resistant strains increased from 4 to 11% in the follow-up
      period, and ciprofloxacin-resistant strains, which had not occurred 10 years ago,
      composed 9% of the strains isolated in 1990. Thus, the increase of
      fluoroquinolone resistance in Campylobacter jejuni and Campylobacter coli has
      been significant in Finland in the past 10 years.

PMID- 1759829
TI  - Shell-vial assay: evaluation of a new technique for determining antibiotic
      susceptibility, tested in 13 isolates of Coxiella burnetii.
AB  - Coxiella burnetii is a strictly intracellular bacterium. Bacteriostatic effects
      have been described previously on a few isolates in embryonated eggs (A. J.
      Spicer, M. G. Peacock, and J. C. Williams, p. 375-383, in W. Burgdorfer and R. L.
      Anacker, ed., Rickettsiae and rickettsial diseases, 1981). We used the shell-vial
      technique (D. Raoult, G. Vestris, and M. Enea, J. Clin. Microbiol. 28:2482-2484,
      1990) to determine the susceptibility of C. burnetii to amoxicillin, amikacin,
      erythromycin, co-trimoxazole, pefloxacin, ofloxacin, ciprofloxacin,
      chloramphenicol, tetracycline, doxycycline, minocycline, and rifampin antibiotics
      at a single dilution. Human embryonic lung fibroblast monolayers in shell vials
      were seeded with 13 different C. burnetii isolates, including 3 reference strains
      (Nine Mile, Q212, and Priscilla) and 10 new isolates, in order to obtain 30%
      infected cells 6 days later. After inoculation, antibiotics were added, shell
      vials were incubated for 7 days, and immunofluorescence was revealed and compared
      with that of the positive controls. Strain Nine Mile was more susceptible than
      strains Q212 and Priscilla were. The heterogeneity of susceptibility to
      fluoroquinolones, chloramphenicol, and erythromycin was noted among the strains;
      all were resistant to amoxicillin and amikacin, and all were susceptible to
      rifampin, co-trimoxazole, tetracycline, and tetracycline analogs.

PMID- 1759830
TI  - Single-dose pharmacokinetics of ceftibuten (SCH 39720) in infants and children.
AB  - Ceftibuten (CFB), a new broad-spectrum cephalosporin for oral administration,
      possesses potent activity in vitro against a wide range of gram-negative and
      certain gram-positive pathogens frequently encountered in pediatric patients. Its
      antimicrobial spectrum and dosage formulation suggest a use for CFB in the
      treatment of otitis media and upper and lower respiratory and urinary tract
      infections in infants and children. To assess the pharmacokinetic characteristics
      of CFB in pediatric patients, we completed a multicenter investigation of 49
      children (26 females) between the ages of 6 months and 17 years who had normal
      hepatic and renal functions and no evidence of chronic disease. Pharmacokinetic
      parameters were determined from repeated blood samples (n = 12) and, when
      possible, quantitative urine collections (n = 7) obtained over a 12- to 24-h
      period following a single oral CFB dose of either 4.5 or 9.0 mg/kg of body
      weight. CFB was quantitated from plasma and urine samples by using a sensitive,
      microanalytical high-pressure liquid chromatography method. The drug was rapidly
      absorbed (mean time to maximum concentration in serum = 140 min) and produced
      apparent peak concentrations in plasma (Cmax) ranging from 5.0 to 19.0 mg/liter.
      Average CFB pharmacokinetic parameters (+/- standard deviations) were as follows:
      apparent elimination half-life, 2.0 +/- 0.5 h; mean residence time, 3.9 +/- 1.1
      h; apparent steady-state volume of distribution, 0.4 +/- 0.2 liter/kg; and
      apparent total plasma clearance (CL/F), 2.5 +/- 0.9 ml/min/kg. No significant
      differences in any of the pharmacokinetic parameters were observed between the
      two dosing groups. Significant (P < 0.05) negative correlations were found
      between patient age and CFB elimination half-life and CL/F and between the
      estimated creatinine clearance and renal clearance and CL/F. Apparent age
      dependence of CFB disposition was also reflected by a greater CL/F in children
      from 0.5 to less than or equal 5 years of age (3.1 +/- 1.1 ml/min/kg) than in
      children > 10 years of age (2.0 +/- 0.6 ml/min/kg; P < 0.005). The increased CL/f
      for CFB (3.0 +/- 0.5 ml/min/kg) was corroborated by a validation study performed
      with 11 infants (1.0 +/- 0.5 ml/min/kg) with CL/F for 19 subjects suggested that
      appreciable nonrenal clearance (1.3 +/- 0.6 ml/min/kg) of CFB occurred in
      children, a finding different from preliminary data for adults.

PMID- 1759831
TI  - Single daily dosing of antibiotics: importance of in vitro killing rate, serum
      half-life, and protein binding.
AB  - The relative importance of pharmacokinetic and pharmacodynamic parameters for the
      feasibility of a single daily dose (SDD) of antibiotics remains to be
      established. Therefore, we studied the relationship between in vitro
      bacteriological parameters (MIC, MBC, and killing rate [KR], defined as the
      reduction in the inoculum within 3 h), pharmacokinetic parameters (t1/2 and
      protein binding [PB], and in vivo antibacterial effect of a single antibiotic
      dose in an experimental rabbit model of Escherichia coli endocarditis. Nine
      antibiotics were investigated: two aminoglycosides, two quinolones, and five beta
      lactams. For each drug, the minimal effective dose (MED) (in milligrams per
      kilogram) was defined as the lowest dose able to achieve a significant difference
      (P less than 0.05) of CFU in the vegetations in comparison with controls 24 h
      after a single intravenous injection. Aminoglycosides and quinolones had the
      lowest MEDs, followed by beta-lactams. Univariate regression analysis showed that
      KR was the major determinant of MED. A stepwise regression analysis showed that
      t1/2 significantly improved the predictive value of KR, while PB, MIC, and MBC
      did not. The final equation was MED = 1,586-238 KR-297 t1/2 (r = 0.90, P = 0.01).
      We concluded that the pharmacodynamic parameters (especially the high KR) of
      aminoglycosides and quinolones explained their low MEDs and might allow SDD. In
      contrast, the low KR of beta-lactams emphasized the critical importance of a long
      t1/2, as for ceftriaxone, allowing the use of this beta-lactam alone in SDD.

PMID- 1759832
TI  - Pharmacokinetics of ampicillin-sulbactam in healthy elderly and young volunteers.
AB  - The pharmacokinetics of ampicillin-sulbactam in elderly subjects (65 to 85 years;
      group 3, n = 8), compared with those in middle-aged (41 to 64 years; group 2, n =
      8) and younger (20 to 40 years; group 1, n = 8) subjects, were investigated. A
      single 2-g dose of ampicillin combined with 1 g of sulbactam in 60 ml of
      intravenous solution was administered to each subject over a 30-min period. Blood
      and urine samples were taken at baseline and serially over an 8.5-h period
      following the infusion. Ampicillin and sulbactam concentrations were assayed by
      high-performance liquid chromatography on a reversed-phase C-8 column. The mean
      levels in serum of both ampicillin and sulbactam were significantly higher for
      samples from group 3: for ampicillin from 1 through 8.5 h, and for sulbactam for
      the same time interval except at 5.5 h (P less than or equal to 0.05). The mean
      urinary excretion of both ampicillin and sulbactam was lowest, and urinary
      concentrations were highest in group 3. The areas under the serum drug
      concentration-time curve, the half-lives, and the maximum concentrations in serum
      were greatest, while the total clearance was lowest, for group 3 for both
      ampicillin and sulbactam. These results are consistent with a prolongation of
      antimicrobial activity of ampicillin-sulbactam in the elderly compared with that
      in younger subjects.

PMID- 1759833
TI  - Effects of two cations on gastrointestinal absorption of ofloxacin.
AB  - A study was performed to establish the effect of Al3+ and Fe2+ cations on the
      absorption of ofloxacin when it is administered orally at a dose of 200 mg. The
      study was carried out with nine volunteers, who each received three treatments (A
      [200 mg of ofloxacin], B [200 mg of ofloxacin plus 11 g of colloidal aluminum
      phosphate], and C [200 mg of ofloxacin plus 1,050 mg of FeSO4]) according to a
      Latin square design; the washout period was 1 week. The analytical technique was
      a microbiological diffusion method. The pharmacokinetic parameters were
      calculated from the cumulative urinary excretion data and from a sigma-minus
      plot. The total amount of ofloxacin excreted in urine had a mean value of 163.59
      +/- 22.13 mg when ofloxacin was administered alone, 152.41 +/- 18.76 mg when it
      was administered with Al3+, and 146.49 +/- 14.85 mg when it was administered with
      Fe2+. No statistically significant differences were found in the F values
      (fractions of dose absorbed) obtained with ofloxacin alone and ofloxacin plus
      Al3+ (P = 0.341). When ofloxacin alone was compared with joint administration
      with Fe2+ the value of F decreased 10.85%; this difference is statistically
      significant (P = 2.623 x 10(-2)).

PMID- 1759834
TI  - Enantioselective disposition of ofloxacin in humans.
AB  - The enantioselective disposition of ofloxacin (OFLX) was studied in healthy
      subjects after oral administration of (+/-)-OFLX at a dose of 200 mg. S-(-)-OFLX
      and R-(+)-OFLX concentrations in serum and urine were measured separately by high
      performance liquid chromatography, and various pharmacokinetic parameters were
      calculated from the data. The ratio of S-(-) to R-(+) enantiomer concentrations
      in serum showed a increase with time, with S/R ratios of 1.01 at 2 h and 1.31 at
      24 h. The terminal elimination half-life of S-(-)-OFLX was 6.9 h, which was
      significantly greater (P less than 0.05) than that of the R-(+) enantiomer (6.3
      h). S-(-)-OFLX also revealed a significantly greater area under the concentration
      time curve in serum, mean residence time, and total body clearance than the R-(+)
      enantiomer did. The renal clearance of S-(-)-OFLX (7.14 liters/h/1.73 m2) was
      significantly lower than that of the R-(+) enantiomer (7.53 liters/h/1.73 m2).
      Although the difference in the pharmacokinetic parameters of the enantiomers was
      small, their disposition in humans was found to be stereoselective. The
      difference between the enantiomers may be explained by the difference in their
      renal excretion.

PMID- 1759835
TI  - Studies of interaction of a low-molecular-weight heparinoid (Org 10172) with
      cloxacillin and ticarcillin in healthy male volunteers.
AB  - Pharmacokinetic and pharmacodynamic interactions between Org 10172 (intravenous
      bolus injection of 3,250 anti-Xa units), which is a low-molecular-weight
      heparinoid, cloxacillin (500 mg orally four times daily for 3 days), and
      ticarcillin (4,000 mg intravenously four times daily for 2 days) were evaluated
      in two separate studies with healthy male volunteers (n = 18). Both cloxacillin
      and ticarcillin caused a significant increase in elimination half-life of anti-Xa
      activity, i.e., from 31 +/- 10 to 54 +/- 23 h and from 27 +/- 6 to 42 +/- 13 h,
      respectively (P less than 0.05). Ticarcillin decreased clearance (11%) and
      increased apparent volume of distribution (35%) (P less than 0.05), while for
      cloxacillin, these differences did not reach statistical significance. These
      changes in disposition of Org 10172 by the penicillins were not accompanied by
      important pharmacodynamic changes as evaluated by coagulation tests, platelet
      aggregation, and bleeding time. Cloxacillin appeared to influence blood
      coagulation (prolongation of the activated partial thromboplastin time and
      shortening of thrombin time; P less than 0.05) and facilitated thrombin-induced
      platelet aggregation, which coincided with a shorter bleeding time during the
      combined treatment in comparison with the time during treatment with Org 10172
      alone (P less than 0.05). In conclusion, the disposition of Org 10172 was
      slightly changed by cloxacillin and ticarcillin, and, unexpectedly, cloxacillin
      appeared to have mild procoagulant effects.

PMID- 1759836
TI  - Treatment of murine invasive candidiasis with amphotericin B and cilofungin:
      evidence for enhanced activity with combination therapy.
AB  - The in vivo interactions of cilofungin, an echinocandin antifungal agent, and
      amphotericin B, a polyene derivative, in a murine model of disseminated
      candidiasis have been investigated. While single therapy with either drug alone
      prolonged survival of infected mice, kidney colony counts were not appreciably
      reduced. In contrast, combination therapy, especially at higher doses of both
      drugs, resulted in significant prolongation of survival and suppression of growth
      of yeast cells in the kidneys. Combination therapy of experimental candidiasis
      with cilofungin and amphotericin B did not result in antagonism; rather, additive
      or synergistic effects were seen. Future preclinical work with other echinocandin
      and polyene derivatives should include studies evaluating the in vivo
      interactions of both classes of compounds.

PMID- 1759837
TI  - Bacterial and fungal killing by iontophoresis with long-lived electrodes.
AB  - Iontophoresis with gold, carbon, and platinum electrodes was shown to effectively
      reduce or eliminate gram-positive, gram-negative, and Candida albicans inocula in
      synthetic urine. Platinum and gold electrodes were more effective than carbon
      electrodes, but platinum showed the best longevity and may reduce or eliminate
      microbial colonization of catheters.

PMID- 1759838
TI  - Susceptibility of Staphylococcus species and subspecies to fleroxacin.
AB  - Twenty-four Staphylococcus species or subspecies were examined for their
      susceptibilities to the fluoroquinolone fleroxacin (Ro 23-6240) by disk diffusion
      (5-micrograms disk) and by agar dilution for the determination of MICs. Resistant
      strains were further tested for their susceptibilities to oxacillin and the
      fluoroquinolone ciprofloxacin. Reference strains of the novobiocin-resistant
      species (Staphylococcus saprophyticus, Staphylococcus cohnii, Staphylococcus
      xylosus, Staphylococcus arlettae, and Staphylococcus gallinarum) had an intrinsic
      intermediate susceptibility (MIC, 4 micrograms/ml) to fleroxacin. Fleroxacin
      resistance was not observed in the reference strains of the novobiocin
      susceptible species (MIC, 0.5 to 2.0 micrograms/ml). Clinical isolates of
      coagulase-negative species were generally less susceptible to fleroxacin than
      were reference strains. Seven percent of the Staphylococcus epidermidis clinical
      strains were resistant (MIC, greater than or equal to 8 micrograms/ml) to
      fleroxacin. Of these strains, 77% were resistant to oxacillin and 50% were
      resistant to ciprofloxacin. Thirty-four percent of the Staphylococcus
      haemolyticus clinical strains were resistant to fleroxacin, and 9% had
      intermediate susceptibility. Of the resistant strains, 95% were resistant to
      oxacillin and 77% were resistant to ciprofloxacin, while 23% had intermediate
      susceptibility to ciprofloxacin. Fleroxacin is an effective antimicrobial agent
      against most staphylococci.

PMID- 1759839
TI  - In vitro activity of 79 antimicrobial agents against Corynebacterium group D2.
AB  - Corynebacterium group D2 (CGD2) is involved in urinary tract infections in
      patients with underlying predisposing factors. This microorganism is highly
      resistant to a number of antimicrobial agents. We tested the activities of 79
      antimicrobial agents against CGD2. beta-Lactams, aminoglycosides, and macrolides
      were ineffective. Fluorinated quinolones showed irregular activities, ofloxacin
      being the most active one. Doxycycline, rifampin, and mainly glycopeptides
      (vancomycin and teicoplanin) were the most active antibiotics against CGD2.

PMID- 1759840
TI  - Comparative efficacies of amphotericin B lipid complex and amphotericin B
      deoxycholate suspension against murine blastomycosis.
AB  - Amphotericin B as a lipid complex and as a deoxycholate suspension (Fungizone)
      was tested against murine blastomycosis. All doses of each form prolonged
      survival (P less than 0.05 to 0.001). Fungizone was more effective than lipid
      complex at doses of 0.8 mg/kg of body weight. However, lipid complex at 12.8
      mg/kg was not toxic and superior in efficacy (P less than 0.001) to 2.0 mg of
      Fungizone per kg (a toxic dose), and it cleared all animals of infection. Lipid
      complex is an effective therapy for murine blastomycosis.

PMID- 1759841
TI  - Ofloxacin penetration into tuberculous pleural effusion.
AB  - After 3 days of treatment with ofloxacin (300 mg given orally once daily), the
      drug levels in serum and pleural fluid 2 and 4 h after drug administration in
      patients with tuberculous pleural effusion were assessed by a rapid high
      performance liquid chromatography assay. The levels in serum (mean +/- standard
      error of the mean [SEM]) were 4.70 +/- 0.14 and 4.63 +/- 0.09 mg/liter 2 and 4 h
      after administration, respectively, and the levels in pleural fluid (mean +/-
      SEM) were 3.82 +/- 0.09 and 4.21 +/- 0.08  mg/liter, respectively. The pleural
      fluid-to-serum ofloxacin ratio at 2 h was 0.82 +/- 0.02 (mean +/- SEM), and the
      ratio at 4 h was 0.92 +/- 0.02 (mean +/- SEM). This study demonstrated very good
      penetration of ofloxacin into pleural fluid in tuberculous pleuritis.

PMID- 1759842
TI  - Aminoglycosides modify the in vitro metachromatic reaction and murine generalized
      Shwartzman phenomenon induced by Salmonella minnesota R595 lipopolysaccharide.
AB  - Endotoxin-neutralizing activity may be an important property for antibiotics to
      be used in severe sepsis. Several antibiotics, belonging to different classes,
      were evaluated as to their endotoxin-neutralizing ability, using the inhibition
      of an in vitro metachromatic assay for lipopolysaccharides and a murine
      generalized Shwartzman reaction model. Gentamicin, amikacin, and sisomicin have
      been found to share significant in vitro antiendotoxin activity at an
      antibiotic/endotoxin ratio as low as 1.0/5 (by weight) and to reduce the murine
      generalized Shwartzman reaction at an antibiotic/endotoxin ratio of 3.3/5.

PMID- 1759843
TI  - Role of exposure mode in the bioavailability of triphenyl phosphate to aquatic
      organisms.
AB  - A laboratory study was conducted to investigate the role of the route of
      triphenyl phosphate (TPP) entry on its aquatic bioavailability and acute
      biological effects. Three TPP treatments were used for exposures of fish and
      invertebrates. These consisted of TPP dosed directly into water with and without
      clean sediment and TPP spiked onto sediment prior to aqueous exposures. Results
      of static acute toxicity tests (no sediment) were 0.78 mg/L (96-h LC50) for
      bluegill, 0.36 mg/L (48-h EC50) for midge, and 0.25 mg/L (96-h EC50) for scud. At
      24 h, the sediment (1.1% organic carbon)/water partition coefficient (Kp) for TPP
      was 112. Use of this partition coefficient model to predict the sediment-mediated
      reduction of TPP concentration in water during toxicity tests resulted in a value
      that was only 10% less than the nominal value. However, the required nominal
      concentration of TPP to cause acute toxicity responses in test organisms was
      significantly higher than the predicted value by the model for both clay and soil
      derived sediment. Direct spiking of TPP to soil minimized TPP bioavailability.
      Data from parallel experiments designed to track TPP residues in water through
      time suggest that sorption kinetics control residue bioavailability in the
      initial 24 h of exposure and may account for observed differences in LC50 and
      EC50 values from the sediment treatments.

PMID- 1759844
TI  - Environmental contaminants and biochemical responses in flatfish from the Hvaler
      Archipelago in Norway.
AB  - The levels of several environmental contaminants, including selected polyaromatic
      hydrocarbons (PAH), organochlorines (DDT/DDE, hexachlorobenzene), 15
      polychlorinated biphenyl (PCB) congeners, and polychlorinated dibenzofurans and
      dibenzo-p-dioxins, PCDF/PCDD), and heavy metals (Cd, Hg, Pb, and As) were
      analyzed in muscle and liver of three different flatfish species (dab, Limanda
      limanda; flounder, Platichthys flesus; plaice, Pleuronectes platessa) caught by
      gill netting at different sites in the Hvaler Archipelago. Indices of biochemical
      effects in liver S9-fractions were studied by measuring cytochrome P450-dependent
      monooxygenase and UDP-glucuronyl transferase activities, and by
      immunoquantitating cytochrome P450 1A1 using an indirect enzyme-linked
      immunosorbent assay (ELISA). Only low levels of PCDD/PCDF, Cd, and Pb were
      observed, whereas PCB levels were significantly elevated in fish from the inner
      sites of the Archipelago compared to a reference site. The contaminant gradient
      toward the Glomma estuary was correlated with increased cytochrome P450 1A1
      activity, measured as 7-ethoxyresorufin O-deethylase (EROD), and with
      immunoquantitated P450 1A1. In contrast, fish from the site at Idefjorden,
      although containing elevated contaminant levels, did not show elevated EROD
      activity, but apparently elevated P450 1A1 protein. These findings may reflect
      different pollution histories of the sites, and indicate the applicability of
      biochemical effect indices (i.e., EROD and P450 1A1 immunoquantitation) to
      monitoring studies. The integrated chemical-biochemical approach employed in this
      study can obviously be expanded to give fruitful information about cause-effect
      relationships in other contaminant situations.

PMID- 1759845
TI  - A field study on stress indices in the sea mussel, Mytilus edulis: application of
      the "stress approach" in biomonitoring.
AB  - Sea mussels, Mytilus edulis, collected from a relatively unpolluted area of the
      Eastern Scheldt, were transplanted along contaminated sites of the Western
      Scheldt for 2 1/2 and 5 months. Several established stress indices were
      determined such as accumulation of pollutants, adenylate energy charge (AEC), and
      condition index. Following field exposure, mussels were also subjected to an
      additional lethal or sublethal stress. The data show that environmental exposure
      alters the mussel's response to stress, viz., aerial exposure and increased
      temperature, at the organismal (anoxic survival time), biochemical (AEC), and
      molecular (heat shock protein synthesis) level. The "stress approach" to
      assessment of environmental contamination appears to be a promising method to
      disclose early changes in the organism at a stage when conventional parameters
      (condition index, AEC) remain still unchanged.

PMID- 1759846
TI  - Biochemical alterations in fish fingerlings (Cyprinus carpio) exposed to
      sublethal concentration of linear alkyl benzene sulphonate.
AB  - Fish fingerlings (Cyprinus carpio) were exposed to sublethal concentrations of
      linear alkyl benzene sulphonate (0.005 ppm) for 24, 48, and 96 h under static
      laboratory conditions. Alterations were noted in the levels of glycogen, lactic
      acid, sialic acid, and acid and alkaline phosphatases in the gill, liver, and
      kidney. This chemical may impair metabolic processes in fingerling carp, because
      increased exposure resulted in significant increases in lactic acid and decreases
      in glycogen and sialic acid along with inhibition of acid and alkaline
      phosphatase activity.

PMID- 1759847
TI  - Chronic toxicity of dietary disodium arsenate heptahydrate to juvenile rainbow
      trout (Oncorhynchus mykiss).
AB  - Juvenile rainbow trout were fed semi-purified diets containing graded levels of
      disodium arsenate heptahydrate (DSA) for 12-24 weeks under standard laboratory
      conditions to define the maximum acceptable toxicant concentration (MATC) and to
      correlate signs of toxicity with diet and tissue arsenic concentrations. The MATC
      for DSA was between 13 and 33 micrograms As/g diet or 0.281-0.525 mg As/kg body
      weight/day. The most sensitive and reliable indicator of chronic dietary DSA
      toxicity in rainbow trout was chronic inflammation of the gallbladder wall.
      Chronic inflammatory changes in the sub-epithelial tissues of the gallbladder
      wall were evident in 71% of rainbow trout exposed to 33 micrograms As/g diet for
      24 weeks, and 100% of rainbow trout exposed to 65 micrograms As/g diet for 24
      weeks or 49 micrograms As/g diet for 12 weeks. No fish exposed to 13 micrograms
      As/g diet or less for up to 24 weeks showed any demonstrable gallbladder lesions
      or any other ill effect of arsenic exposure. Other signs of chronic dietary DSA
      toxicity to rainbow trout included decreased growth rate, mild to moderate
      anemia, and, at higher levels of exposure, active feed refusal leading to
      decreased feed consumption. Mild nephrocalcinosis was noted in one experiment
      where kidney arsenic residues exceeded 14 micrograms As/g tissue dry weight.

PMID- 1759848
TI  - Time course reversibility of liver and blood changes induced in weanling rats
      after polychlorinated biphenyl exposure during lactation.
AB  - Phenoclor DP5 (DP5), a mixture of polychlorinated biphenyls (PCBs), was
      administered to lactating rat dams, every two days from postnatal days 2 to 20,
      at 50 mg/kg of body weight. Resulting effects on tissue concentrations of PCBs
      and on liver lipids, nucleic acids (DNA and RNA), proteins and blood lipids of
      offspring, at different times after weaning, until postnatal day 100, were
      studied. On postnatal day 21, DP5 contents found in liver, brain and fat of young
      rats indicated that a great part of the dam's body stores of PCBs was eliminated
      into the milk. These accumulations were related to an increase of relative liver
      weight, a decrease in DNA concentration and a rise in liver RNA, protein and
      phospholipid levels, indicating an inducing effect of DP5 in weanling rat.
      Changes in lipid metabolism were associated with increases of liver
      triacylglycerol and cholesterol and decrease of blood triacylglycerol. Both sexes
      exhibited an identical responsiveness to PCBs. The biochemical alterations
      observed in liver and blood at weaning, disappeared with time and were no longer
      detectable after postnatal day 40 in both sexes. Relative liver weight increase
      persisted until postnatal day 60 in males and postnatal day 100 in females.
      Residual aspects of alterations induced before weaning, by exposure via milk,
      could persist until postnatal day 100. Permanent effects of PCBs, after perinatal
      exposure could be assessed in later life of rats, when PCBs were almost
      completely cleared from body tissues.

PMID- 1759849
TI  - Lead toxicosis in tundra swans near a mining and smelting complex in northern
      Idaho.
AB  - Die-offs of waterfowl have occurred in the Coeur d'Alene River system in northern
      Idaho since at least the early 1900's. We investigated causes of mortality and
      lead and cadmium contamination of 46 tundra swans (Cygnus columbianus) from 1987
      to 1989; an additional 22 swans found dead in 1990 were not examined. We
      necropsied 43 of the 46 birds found from 1987 to 1989; 38 of these were from the
      Coeur d'Alene River system, which has been contaminated with mining and smelting
      wastes for a century, and the other 5 were from a nearby, relatively
      uncontaminated area. Of the 36 livers of swans from the contaminated area that
      were analyzed, 32 contained lethal levels of lead (6 to 40 micrograms/g, wet
      weight) and all birds exhibited several symptoms of lead poisoning, notably
      enlarged gall bladders containing viscous, dark-green bile. Only 13% of the lead
      poisoned birds (10% when data were included from other studies of swans in the
      area) contained shot, compared to 95% of lead-poisoning swans in studies outside
      northern Idaho. Lead concentrations in blood samples from 16 apparently healthy
      swans (0.5 to 2.3 micrograms/g, and 4 lead-poisoned birds found moribund (1.3 to
      9.6 micrograms/g) indicating that tundra swans accumulated high levels of lead
      from ingestion of sediment that contained up to 8,700 micrograms/g of lead and
      plants that contained up to 400 micrograms/g. The swans spend only a few weeks in
      the area staging during the spring migration. The five tundra swans from the
      uncontaminated area had low levels of lead and essentially no symptoms of lead
      poisoning.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759850
TI  - Metal pollution and its impact on algae in flowing waters in India.
AB  - Metal pollution in the river Godavari in India, due to discharges of liquid
      wastes from a paper mill, has been studied for a period of two years. At the
      discharge point and 1 km from the point of discharge, iron, manganese, and zinc
      were recorded in high concentrations, whereas cadmium and chromium were observed
      in low concentrations. No metal was in detectable concentration in water before
      the river receives the effluents. A considerable drop in pH values and an
      appreciable increase in organic matter, hardness, and calcium levels were noticed
      after entry of wastes. Diatoms were more diversified in fresh water, whereas
      cyanobacteria were more prevalent both qualitatively and quantitatively at the
      polluted stations. Mathematical equations involving heavy metals and
      physicochemical factors were drawn for better understanding of the distribution
      of algae.

PMID- 1759851
TI  - Toxicity of oleic acid anilide in rats.
AB  - In the present investigation, we have studied the toxic potential of oleic acid
      anilide (OAA) and heated oleic acid anilide (HOAA) in relation to the toxic oil
      syndrome (TOS). Male Sprague-Dawley rats were given 250 mg/kg of OAA or HOAA in
      mineral oil by gavage, on alternate days for 2 weeks (total 7 doses). The control
      rats received an equal volume of mineral oil only. The animals were sacrificed at
      days 1, 7, and 28 following the last dose. Ratio of organ-to-body weight showed
      increases in spleen and kidney of HOAA and OAA treated rats, respectively, at day
      1 while this ratio for liver in HOAA treated group showed a decrease at day 1.
      Among blood parameters, white blood cells increased in HOAA treated group at day
      1 and in both OAA and HOAA groups at day 28. Mean corpuscular hemoglobin (MCH)
      and mean cell volume (MCV) also showed increases in the HOAA treated rats at days
      7 and 28. Serum lactate dehydrogenase (LDH) decreased in both OAA and HOAA
      treated rats at day 1, while at day 7 the decrease was confined only to the HOAA
      group. Serum glutamic oxalacetic transaminase (GOT) and glutamic pyruvic
      transaminase (GPT) activities also decreased at most of the time points. Liver
      mitochondrial ATPase activity decreased in the HOAA group at day 7 and in the OAA
      group at day 28. Among serum immunoglobulins, IgA levels increased throughout the
      study but the changes were more pronounced in HOAA treated rats.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1759852
TI  - Pesticide and polychlorinated biphenyl residues in waters at the mouth of the
      Grand, Saugeen, and Thames Rivers, Ontario, Canada, 1986-1990.
AB  - Water samples were collected from the mouths of the three major agricultural
      watersheds, the Grand, the Saugeen, and the Thames (Ontario, Canada), between
      January 1986 and December 1990. Analyses were performed for 18 herbicides, 26
      insecticides, and 4 fungicides in use in the basins. A total of between 425 and
      474 samples were analyzed for each of the major groups of pesticides. Six
      herbicides, two insecticides and polychlorinated biphenyls (PCBs) were identified
      in surface water. Atrazine and its metabolite desethylatrazine were the most
      frequently found pesticide present in 340 of 474 samples or 72%; the metabolite
      was not always present with the parent compound. The second most frequently found
      pesticide was metolachlor which was identified in 30 of 474 samples or 6.3%. 2,4
      D and cyanazine were present in 3.3% and 1.5% of the samples, respectively;
      alachlor, mecoprop, and simazine were present in 0.5% of the samples. Dicamba and
      metribuzin were present in single samples (0.2%). DDT, heptachlor epoxide, and
      PCB were identified in only single samples over the 5-year period. Between 342
      and 2959 kg/annum of total atrazine were found passing the mouth of the three
      rivers and entering Lakes Erie or St. Clair between 1986 and 1990. The greatest
      loss was from the Thames River and the least from the Saugeen River. Between 1%
      and 2% of that applied in the watershed was lost at the mouth. Loadings of only
      two other pesticides to the rivers exceeded 5 kg in any one year, namely,
      metolachlor and 2,4-D. In the case of metolachlor, loadings ranged from less than
      5 to 1,726 kg/annum, the highest being in the Thames and the lowest in the
      Saugeen River. 2,4-D exceeded a loading of 5 kg/annum in 1988 in the Grand River.
      Atrazine, cyanazine, and metolachlor were tracked across Lake St. Clair from the
      mouth of the Thames to the mouth of the Detroit River in 1987.

PMID- 1759853
TI  - Residues of pentachlorophenol and other chlorinated contaminants in human
      tissues: analysis by electron capture gas chromatography and electron capture
      negative ion mass spectrometry.
AB  - Samples of human tissues including testes, kidneys, prostate glands, livers, and
      adipose tissues removed at autopsy were analyzed for pentachlorophenol (PCP) and
      nonachloro-2-phenoxyphenol (NCPP); the fat samples were also analyzed for other
      chlorinated contaminants. Electron capture gas chromatography was used to
      quantitate the residues after isolation and cleanup. Identity of the residues was
      confirmed by electron capture negative ion mass spectrometry. All tissues
      analyzed for PCP tested positive with a range from 0.007 ppm (microgram/g) in
      subcutaneous fat to 4.14 ppm in testis. Residues of NCPP were much lower, ranging
      from levels below the detection limit to 0.59 ppm in testis. The highest average
      residues, based on the lipid content of the tissue, of PCP (1.09 ppm) and of NCPP
      (0.19 ppm) were found in testis followed by kidney (0.95 ppm PCP), prostate (0.84
      ppm PCP), and liver (0.59 ppm PCP). Residues of these chemicals in the adipose
      tissues were on the average about 40 times lower than the residues in the non
      fatty tissues. Other chlorinated contaminants found in the subcutaneous fat
      included hexa-, hepta-, and octa-chlorodibenzo-p-dioxins at sub-ppb levels and
      DDE averaging 2.47 ppm.

PMID- 1759854
TI  - Evaluation of the effects of chelation therapy with time following strontium
      exposure to mice.
AB  - The effect of increasing the time interval between strontium exposure and
      chelation therapy was studied in male Swiss mice. Diethylenetriaminepentaacetic
      acid (DTPA), ethyleneglycol-bis-(beta-amino-ethylether)-N,N'-tetraacetic acid
      (EGTA), 4,7,13,16,21,24-hexaoxa-1,10-diazabycyclo[8.8.8]-hexacosane (Kryptofix
      222), tartaric acid, and 1,13-bis(8-chinolyl)-1,4,7,10,13-pentaoxatridecan
      (Kryptofix 5) were administered intraperitoneally at 0, 6, 12, and 24 h after
      subcutaneous injection of 1,139 mg/kg of strontium nitrate. Chelating agents were
      given at doses equal to one-fourth of their respective LD50 values. Daily
      elimination of strontium into urine and feces was determined for five days after
      which time the animals were killed, and the concentration of strontium was
      determined in various tissues. Only Kryptofix 222 was capable of increasing the
      total urinary elimination of strontium when given immediately after strontium
      exposure, whereas the amount of total strontium excreted into the feces was
      significantly enhanced by treatment with EGTA at 0 or 24 h after strontium
      injection, or with Kryptofix 222 at 6 h after strontium exposure. However,
      Kryptofix 222, tartaric acid, and Kryptofix 5 reduced the concentration of
      strontium in bone at 0, 6, or 12 h after strontium injection, whereas at 24 h
      only Kryptofix 5 significantly lowered the concentration of the metal in bone.
      The results of this study indicate that the length of time before initiating
      chelation therapy for strontium removal may influence remarkably the
      effectiveness of this therapy.

PMID- 1759855
TI  - Evaluation of potential interactions involving trichothecene mycotoxins using the
      chick embryotoxicity bioassay.
AB  - The Chick Embryotoxicity Screening Test (CHEST) was used to examine possible
      interactions between different trichothecenes. Combinations of deoxynivalenol
      (DON), 15-acetyldeoxynivalenol (15-ADON) and HT-2 toxin were tested at various
      concentrations and the effects were determined based on percent mortality. The
      combined toxicity of any two trichothecenes was found to be additive.
      Discrepancies between observed and expected mortality values seldom differed by
      more than 10%, well within sampling error for the binomial distribution. Several
      limitations of the CHEST assay are discussed.

PMID- 1759856
TI  - On partnerships.

PMID- 1759857
TI  - Institutionalization of an elderly family member: reactions of spouse and
      nonspouse caregivers.
AB  - Although a prevalent clinical assumption is that the caregiver well-being
      improves following patient institutionalization, recent research challenges this
      assumption. In this article, the impact of patient institutionalization on the
      well-being of family caregivers is examined. Caregiver reaction, sense of general
      well-being and level of depression are compared pre- and postinstitutionalization
      and differences between spouse, adult child, and other caregivers are
      investigated.

PMID- 1759858
TI  - A comparative study among college students of sexual abuse in childhood.
AB  - A disproportionate random sample (200 women, 400 men) of students attending a
      major university was invited to participate in a mailed survey to study
      differences in self-efficacy, coping, and well-being between men and women who
      were sexually abused in childhood and those who were not. A total of 271 students
      (111 women, 160 men) responded by returning the completed survey. Fifty percent
      of the women and 22% of the men in the sample reported one or more unwanted
      sexual experiences in childhood. Multivariate analysis of variance (MANOVA)
      techniques to analyze differences in self-efficacy, coping (confrontive, emotive,
      palliative), and well-being between women and men who reported childhood sexual
      abuse and those who did not showed significant interaction effects by sex for
      abuse (F = 2.609, P = .025, df 5,263) and significant effects by sex (F = 3.356,
      P = .006), but no significant differences for abuse alone. Univariate F tests
      were significant (F = 5.386, P = .021) for palliative coping with abused men
      reporting the highest scores, abused and nonabused women having the highest
      scores on emotive coping (F = 9.049, P = .003), and nonabused men and women
      having highest scores on well-being (F = 7.276, P = .007). A second MANOVA was
      performed on data from 245 students (nonabused and those who reported contact
      sexual abuse). Significant interaction effects by sex for abuse (F = 2.259, P =
      0.49, df 5,237) and main effects for abuse (F = 3.225, P = .008) were found.
      Although abused men scored lowest on well-being, both abused men and abused women
      scored higher on emotive coping and lower on well-being than nonabused subjects.
      These are new findings with implications for developing and testing nursing
      interventions for this vulnerable group of young adults.

PMID- 1759859
TI  - Suicide: a conceptual model for an avoidable death.
AB  - Suicide as a premature exit from life is confusing not only for family and
      friends of the individual who shows suicidal behavior but also for many
      professionals. This article defines the concept of suicide, clarifies terms
      associated with suicide, reviews current clinical and research literature on
      suicide, and proposes a conceptual model that describes suicide as both an event
      and a process.

PMID- 1759860
TI  - Hiding and healing: resolving the suicide of a parent or sibling.
AB  - The purpose of this study was to describe the long-term effects of suicide of a
      parent or sibling during childhood or young adulthood. A grounded theory approach
      was used to discover the respondents' perceptions of the meaning of the event and
      the effects that it had on them. The themes that emerged from the data were
      experiencing the pain, hiding the pain, and healing the pain. The need to hide
      the pain often interfered with the process of healing the pain. Findings indicate
      that many survivors of suicide during childhood experience painful, unresolved
      grief that affects their well-being in adulthood.

PMID- 1759861
TI  - Seasonal affective disorder, Part I: A review of the neural mechanisms for
      psychosocial nurses.
AB  - This article is the first of a two-part series on Seasonal Affective Disorder
      (SAD). Mental health and nursing researchers are beginning to investigate the
      implications of seasons on mood and mood states. Delineation of SAD and its
      treatment by phototherapy is an example. This article reviews the pertinent
      research regarding the hypothesized neural mechanisms of SAD. Three competing
      hypothesis are contrasted and compared: the melatonin hypothesis, the phase delay
      hypothesis, and the photon counting hypothesis. Although no one theory is
      universally accepted, current data supports the phase delay hypothesis and
      suggests that morning phototherapy is the most effective treatment.

PMID- 1759862
TI  - Seasonal affective disorder, Part II: Phototherapy, an expanded role of the
      psychosocial nurse.
AB  - The integration of neurobiology into the research and practice of psychosocial
      nursing is an imperative for the decade of the 1990s. This substantial goal
      probably will be achieved through the completion of smaller endeavors. This
      article is intended to be one such contribution. The purpose of this article are
      threefold. First, it will introduce the psychosocial nurse to the characteristics
      of Seasonal Affective Disorder (SAD). This article also will provide the
      psychosocial nurse with the putative biological basis of SAD and phototherapy.
      Finally, specific information regarding the therapeutic application of bright
      light is provided.

PMID- 1759863
TI  - Biological correlates of panic disorder with agoraphobia: practice perspectives
      for nurses.
AB  - The literature on panic disorder is summarized with regard to epidemiological,
      environmental, cultural, psychological, family, and genetic factors. Laboratory
      provocation of anxiety is reviewed with emphasis on the noradrenergic model of
      panic from a biological perspective. Positron emission tomography results
      involving brain asymmetries in lactate-sensitive panic patients are discussed, as
      are the psychopharmacological agents currently effective in the treatment of
      panic disorder. It is suggested that psychiatric nurses base their clinical
      practice on a holistic understanding of treatment implications as they relate to
      an individual's broader functioning. Areas for future nursing research are also
      identified.

PMID- 1759864
TI  - A nursing challenge: adult-onset Tay-Sachs disease.
AB  - Adult-onset GM2 gangliosidosis (AOG), also labelled Adult-Onset Tay-Sachs
      disease, is a slowly progressing disease caused by a gradual accumulation of the
      GM2 ganglioside in neurons due to defective hexosaminidase A. Recent research
      findings and clinical experiences suggest that AOG may be more widespread than
      previously believed. Moreover, the diagnosis of AOG is often delayed because
      patients present with psychotic symptoms that mimic dementia, schizophrenia,
      mania, and depression. Because AOG patients typically respond poorly to
      psychiatric drug therapy and the symptomatology is so diverse, nurses must design
      and implement nursing care that ensures safety, structure, and comfort.

PMID- 1759865
TI  - [Minimally invasive surgery].

PMID- 1759866
TI  - [Minimally invasive surgery].

PMID- 1759867
TI  - [Pyelo-ureteral syndrome: the impact of endo-urological techniques].
AB  - The present article reports our experience with endopyelotomy, a technique we
      have performed at our hospital since 1985. Sixty-two patients comprise this
      series. Of these, 57 were evaluated more than 6 months after treatment (65 cases
      of ureteropelvic junction syndrome (UPJS); 26 were primary UPJS (success rate
      81%) and 39 secondary UPJS (success rate 84.5%). The complication rate was low.
      Patients in whom endoscopic treatment had failed were submitted to open surgery
      with no particular difficulty. A comprehensive review of the literature
      highlighting the indications, techniques and results achieved with this procedure
      is performed.

PMID- 1759868
TI  - [Percutaneous surgery in renal lithiasis. Current indications].
AB  - The indiscriminate use of extracorporeal shock waves in the treatment of urinary
      calculi has changed the place of percutaneous surgery in the treatment of renal
      lithiasis. The authors analyse current indications of PCN highlighting stone
      size. In their view, calculi greater than 2 cm warrant treatment by PCN since
      only 15-20% of patients are completely stone-free following a single session of
      ESWL. Attention is focussed on the staghorn calculus and the percutaneous
      approach. They describe the difficulty encountered in the fragmentation of the
      cystine calculus owing to its hardness and discuss the difficulties that may
      arise when using the percutaneous approach in patients with coexisting
      renoureteral conditions, in the treatment of lithiasis in children and in the
      obese patients.

PMID- 1759869
TI  - [Serous renal cysts: translumbar percutaneous resection].
AB  - Twelve patients with giant renal serous cyst located superiorly, inferiorly or in
      the central zone underwent percutaneous resection. The symptoms that had prompted
      the operative procedure disappeared immediately post-operatively in all patients.
      To evaluate the efficacy of resection, a CT scan was obtained pre-operatively and
      at 3 months post-operatively. All 9 patients in whom complete removal of the cyst
      wall had been achieved revealed a completely normal renal morphology on the post
      operative scan with no evidence of cyst. In the remaining 3 patients in whom the
      cyst could only be partially resected, the postoperative scan revealed residual
      cystic cavity, although its size had markedly diminished. The technique utilized
      and the maneuvers that permit removal of the cyst wall without risk are
      described. The indications and the therapeutic alternatives are discussed.

PMID- 1759870
TI  - [Exploration of the intra-renal collecting system using flexible fibroscopy].
AB  - 23 cases of flexible retrograde nephroscopy system for undiagnosed hematuria or
      filling defect are reviewed. The introduction was carried out by combining
      hydraulic dilation, rigid ureterorenoscopy and a working sheath. The indications
      were merely diagnostic (filling defects and/or haematuria). The success rate was
      very high (22 of 23). 9 cases of papillary tumors, 4 cases of small radiolucent
      stones and 1 case of papillary necrosis were diagnosed. In 8 cases no pathology
      was found. The complication rate was extremely low and the postoperative course
      was uneventful. Flexible instruments offer a very good chance to explore the
      intrarenal collecting system and transureteral nephroscopy through a 10.8 F
      flexible scope is a feasible and effective procedure.

PMID- 1759871
TI  - [Conservative endoscopic treatment of urothelial cystic dysplasia of the upper
      urinary tract].
AB  - We highlight the importance of the new diagnostic possibilities afforded by
      ureterorenoscopy and nephroscopy in the differential diagnosis of single or
      multiple cystic dysplasia of the upper excretory tract. Moreover, endoscopic
      treatment was performed in the two cases reported herein. In the first case the
      biopsy procedure was also therapeutic and in the second case cyst removal
      resolved the ureteral obstruction. Because the disease is detected infrequently
      and because treatment may be required even less frequently, several technical
      solutions have been applied to assess efficacy and reliability. Diathermy
      coagulation has proved to be the safest, fastest and the most effective. Follow
      up has documented the absence of recurrence and good reepithelialization of the
      ureteral wall without progression to stricture. In those cases with single cyst,
      one-stage diathermy loop resection permits obtaining biopsy material and radical
      removal of the neoformation.

PMID- 1759872
TI  - [Ureteral stenosis. Endo-urologic treatment (dilatation). Experience with 43
      cases].
AB  - Stricture of the ureter has been traditionally treated by open surgical
      techniques that occasionally had to be performed not without risk to the patient
      owing to the presence of septic and associated uremic conditions that invariably
      had a negative influence on the outcome. With the advent of endourological
      techniques in the last decade, much has been published on endoscopic treatment of
      the different areas of the urinary tract. One of the fields where important
      developments have taken place is that relative to endourological treatment of
      ureteric strictures. Since we started our therapeutic protocol for our patients
      in 1983 to date, we have treated 43 patients by dilatation. Patient follow up
      ranging from 6 months to 6 1/2 years (mean follow up greater than 30 months)
      revealed good results were achieved in 76.74%. The complications have been scant,
      mortality nil, and patients have been able to resume social and occupational
      activities early. All the foregoing prompt us to consider this therapeutic
      modality as the treatment of choice.

PMID- 1759873
TI  - [Endoscopic ureterectomy].
AB  - Endoscopic ureterectomy is a minimally invasive surgical technique indicated in
      cases warranting ureterectomy to complement extended nephrectomy for
      pyelocaliceal urothelial carcinoma. The results achieved are identical to those
      of conventional ureterectomy (open surgery) without the inconvenience or sequelae
      that usually present with the latter procedure. In 1982, the authors developed
      the modified Dell'Adami and Breda endoscopic ureterectomy technique. To date,
      they have performed their modified technique in 10 cases: 9 with infiltrating
      urothelial or highly malignant pyelic or caliceal tumor and 1 with diffuse
      leukoplasia and cholesteatoma of renal pelvis. The technique described herein
      permits intussusception of the ureter into the bladder by transurethral traction
      of a Chevassu ureteral catheter to which that cephalad end of the ureter is
      attached during the extended nephrectomy procedure. Once intussusception of the
      ureter has been achieved, a resectoscope is used to cut the ureter at the level
      of the ureteral meatus. Thereafter the mucosa of the corresponding trigonal horn
      is completely resected. The results are highly satisfactory in patients whose
      ureter has not previously been submitted to open surgery and is not compromised
      by tumor spread.

PMID- 1759874
TI  - [Endoscopic surgery of bladder diverticula].
AB  - The most frequent method utilized in the treatment of bladder diverticula is by
      open surgery using the extravesical, transvesical or combined approach. The
      endoscopic techniques consisting of electrocoagulation of the diverticular mucosa
      alone (Orandi) or opening the diverticular neck by electroresection (Post-Vitale)
      constitute a therapeutic alternative not widely used to date. We have attempted
      to combine both techniques and, since 1985, we have treated 21 patients with
      bladder diverticula via the transurethral approach using the following technique:
      1. The diverticular neck is opened wide by incision or electroresection. 2.
      Complete electrocoagulation of the diverticular mucosa. 3. Resolution of cervico
      urethral obstruction by cervico-prostatic incision or electroresection of the
      prostate. We have achieved good results and no complications have been observed.
      Reduction of the diverticulum was not achieved in only one case. In our view,
      failure was due to the fact that treatment of the diverticulum had not been
      combined with prostate resection which the patient refused. The technique is
      described and the indications and possible complications are discussed. The
      results achieved by the authors indicate that this technique should be used more
      widely.

PMID- 1759875
TI  - [Percutaneous endoscopic urethrocervicopexy].
AB  - A minimally invasive surgical technique that remarkably simplifies the Stamey
      procedure is described herein. The technique shortens the operating time and
      achieves a success rate of over 80%. Thus, we believe this technique should be
      considered in the treatment of stress urinary incontinence in females.

PMID- 1759876
TI  - [Treatment of urinary stress incontinence using paraurethral injection of
      autologous fat].
AB  - The authors present the late results (greater than 1 year) in the treatment of
      urinary incontinence in 15 women with stress urinary incontinence and 5 men with
      post-adenomectomy incontinence using endoscopic injection of autologous fat
      tissue obtained by microliposuction. Good results were achieved in 23% of the
      cases with stress urinary incontinence and in 0% of those with post-adenomectomy
      incontinence. Although the results are disappointing, they are not very different
      from those obtained with teflon injection. Furthermore, the technique is simple,
      has no complications and it costs very little to obtain the autologous graft
      material. A historical review of free fat grafting and injection of liposuction
      fatty tissue is performed and the hypotheses that have been put forward recently
      relative to the fate of the fat graft are discussed.

PMID- 1759877
TI  - [Total transurethral electroresection of carcinoma of the prostate].
AB  - Transurethral resection of the prostatic carcinoma was performed here most
      completely at a time already when radical surgical prostatectomy was not a rather
      new procedure. The preliminary evaluation of 150 cases of all stages (T1-4)
      showed a 5 year survival rate of almost 80% with post-operative complications
      comparable to transurethral prostatectomy of the adenoma.

PMID- 1759878
TI  - [Acquired hydrocele in the adult: sclerotherapy].
AB  - We report our experience in the treatment of hydrocele using sclerosant therapy
      in 50 patients with adult acquired hydrocele (AAH) or cord cyst (CC). The
      sclerosing agent utilized in all of the patients was quinacrine dihydrochloride
      (quinacrine) at a dose of 13.3 mg 50 cc aspirated volume. The results were
      assessed clinically, ultrasonographically and thermographically. The presence of
      multilocular cysts or incomplete aspiration of the liquid was the most frequent
      cause of failure. The results show a success rate of 85%; however, 18% required
      more than one treatment.

PMID- 1759879
TI  - [Transperitoneal percutaneous cholecystolithotomy].
AB  - Transperitoneal percutaneous cholecystolithotomy is a surgical technique for
      gallstone removal in the otherwise healthy gallbladder. It is a one-stage,
      alternative surgical procedure to extracorporeal lithotripsy. ESWL treatment of
      gallstones permits preservation of the compromised organ but has not been
      reported to achieve the potential good results. We describe the principles of the
      technique--similar to that of percutaneous renal surgery--and highlight specific
      aspects in this condition.

PMID- 1759880
TI  - Hypoosmotic swelling test in patients with varicocele.
AB  - The hypoosmotic swelling test is a simple test for measuring the functional
      competence of human sperm membrane. Thirty-five patients with varicocele were
      assessed by hypoosmotic swelling test and the results were compared with those in
      patients with idiopathic infertility. Percentage of swollen sperm in varicocele
      tended to be lower than that in idiopathic infertility, especially in sperm
      concentration between 30 x 10(6)/mL and 40 x 10(6)/mL. Varicocele with sperm
      motility of 40% or more revealed lower percentage of swollen sperm than
      idiopathic infertility did. The results indicate that varicocele may particularly
      injure sperm membrane function because hypoosmotic swelling test is a test for
      measuring functional ability of human sperm membrane. The percentage of swollen
      sperm recovered after the operation earlier than did the other sperm parameters
      such as sperm concentration or motility, which indicates that impaired sperm
      membrane injury by varicocele is reversible.

PMID- 1759881
TI  - Detrimental effects of cryopreservation on the structural and functional
      integrity of the sperm membrane.
AB  - Many centers have been disappointed with the pregnancy rate following the
      insemination of cryopreserved-thawed sperm, despite the maintenance of an
      adequate motile density. The possibility exists that damage to the sperm membrane
      might occur despite preservation of other semen parameters. Simple measurements
      of structural integrity (viability) and functional integrity (hypoosmotic
      swelling test) were performed on thawed specimens. In each instance, both the
      viability and HOS scores were less than the critical 50% level. Specimens from
      three different commercial centers had very poor HOS and viability scores from
      two of the centers, and, though the scores were generally greater than or equal
      to 50% from the third center, this was achieved by eliminating 11 of 12 donors.
      Reducing the glycerol concentration from 12 to 7% and switching from Nunc vials
      to plastic embryo straws did not improve the poor sperm membrane tests. The
      possibility exists that if modification of the cryopreservation technique leads
      to improved HOS and viability scores, perhaps improved pregnancy results will be
      realized.

PMID- 1759882
TI  - Anomalies of centriolar derivatives manifest in spermatic flagella and
      respiratory cilia of the stallion.
AB  - Anomalies of centriolar derivatives were identified in ejaculates and testicular
      and tracheal biopsies of a sterile stallion, using light, scanning, and
      transmission electron microscopy. LM revealed that over half the sperm population
      had only a vestigial or no tail, while the rest had tails of variable length and
      shape. The vestigial tail was represented by its anlage, which was implanted on
      the nucleus and differentiated up to capitulum and collum stage. The stunted tail
      had an axoneme and its derivatives, but was short in all tail segments.
      Regardless of the tail length or shape, virtually all axonemes were devoid of the
      central tubular complex ("9 + 0" defect). Abnormal tail segmentation was
      associated with missing or defective flagellar sheaths and a profusion of
      extraneous dense fibers, which contributed to the knobby, bulbous, or lobuliform
      tail configurations. The gradient of flagellar anomalies seems associated with
      the inability of the distal centriole to implant on the plasmalemma, to produce
      the axoneme, or maintain its growth, and to induce the normal differentiation of
      periaxonemal structures. In contrast to sperm, the tracheal epithelium displayed
      moderate changes, which are manifest in circumscribed rarefaction of cilia,
      increased incidence of compound cilia, and disturbed orientation of cilia
      regarding the plane of central tubular complex. The tracheal cilia were free of
      "9 + 0" defect.

PMID- 1759883
TI  - Recovery of motile sperm using the osmolality-gradient technique.
AB  - A simple, effective method for collecting motile sperm from ejaculates is
      developed. One hundred semen samples were obtained from both fertile and
      infertile men. Following initial semen dilution (1: 1) to 4 mL in a hypoosmotic
      medium (210 mOsm/kg), the mixture was layered into the specially designed tube
      filled with 1 mL recovery medium in the bottom and 1 mL isolation medium in the
      second layer to form three discrete layers. During the next hour the highly
      motile sperm out-distanced the other seminal contents to reach the bottom of the
      tube. Compared with the parent ejaculates, the recovered specimens exhibited an
      increased percentage of motile sperm with significantly enhanced sperm velocity
      and linearity (p less than .001). This method isolated motile sperm with higher
      velocity than those obtained using the swim-up technique.

PMID- 1759884
TI  - Basic arginine esterase from human seminal plasma: purification and some
      properties.
AB  - Basic arginine esterase (amidase) with a specific activity of 3.2 mumol N-alpha
      tosyl-L-arginine methyl ester (Tos-Arg-Me) esterolysis per A280 was purified
      about 230-fold from a CM-cellulose absorbed preparation of human seminal plasma.
      The purified enzyme was a single band with an apparent molecular weight of 3.4
      4.1 x 10(4). The amidolytic activity of this enzyme was suppressed by aprotinin,
      soybean trypsin inhibitor (SBTI), leupeptin, and antipain, while alpha 1
      antitrypsin, ovomucoid trypsin inhibitor (OTI), EDTA, and chymostatin had no or
      weak effect. This enzyme hydrolyzed synthetic basic amino acid derivatives and N
      alpha-tosyl-glycyl-L-prolyl-arginine-p-nitroanilide (Tos-Gly-Pro-Arg-pNA) and N
      alpha-tert-butyloxycarbonyl-L-leucyl-L-prolyl-L-arginine-p-nitroanilid e (Boc-Leu
      Pro-Arg-pNA) were the best substrates. The enzymatic characteristics of present
      enzyme were clearly different from tissue kallikrein, acrosin, and seminin in
      human semen.

PMID- 1759885
TI  - [Value of medical expert assessment in legal decisions in the city of Ulm in the
      18th century].

PMID- 1759886
TI  - [Secondary combined suicide viewed by the wife].
AB  - A 47-year-old man was found dead at the bottom of a wall outward the door of the
      cellar of his house. Preliminary physical examination at the scene of the death
      revealed a laceration of the scalp, an incised wound in front of the neck and
      several stab wounds in the left chest penetrating through the clothing.
      Questioned by the police his wife told that her husband who suffered from severe
      depression had inflicted the incised and the stab wounds himself, had made an
      unsuccessful attempt at self-strangulation and had finally jumped down from the
      wall beside the stairs declining to the cellar of their house. As the
      circumstances of the scenario were suspicious and as the pattern of injuries
      arose doubts concerning self-infliction homicide was taken into consideration as
      well. Autopsy showed additional hesitation marks adjacent to the left end of the
      incised wound in front of the neck. The stab wounds of the chest were restricted
      to the region of the heart and displayed only minimal penetration of the chest
      wall, findings characteristic of self-infliction. As a consequence the manner of
      death could be determined as prolonged suicide, and exact reconstruction was
      possible with the help of the wife's testimony.

PMID- 1759887
TI  - [3 fatalities after communal use of methamphetamine].
AB  - Two young men and a 17-year-old girl gathered in order to take methamphetamine,
      the quantity of which remained unknown. After a short time one of the men died on
      the scene; the other man, who was alcoholized in addition to having taken
      methamphetamine, fell over a railing from a height of several metres and suffered
      severe injuries before dying. The girl, who left for home by taxi, collapsed and
      died in a hospital about 2 hours later. Methamphetamine was detected in the blood
      of all three people. The autopsy results and the toxicological findings are
      reported and discussed with reference to the literature data.

PMID- 1759888
TI  - [Smoking trials with mercury contaminated cigarettes. Studies of attempted
      poisoning].
AB  - In the context with an attempted poisoning it was investigated, to which extent
      an intoxication can be caused by smoking cigarettes, which contain elementary
      mercury. With a smoking apparatus the effect of the amount (9 mg to 1.4 g) and of
      the distribution of the Hg within the cigarette on its concentration in the
      mainstream and sidestream smoke as well as in the ash and the filter was
      analytically determined. It follows from these experiments, that at a good
      distribution almost independently of the amount involved only up to 2 mg Hg per
      cigarette are inhalated with the mainstream smoke, whereas up to 97% are found in
      the sidestream smoke. In the ash and the filter only small amounts are detected.
      By comparison with cases described in literature it is shown, that a poisoning by
      such cigarettes is possible only after frequent smoking or by passive smoking via
      the sidestream smoke in small and badly aerated rooms.

PMID- 1759889
TI  - [Cocaine profiling. A method of comparative substance studies of illegal cocaine
      samples].
AB  - Illegal cocaine were extracted in acidic medium. The extracts contain significant
      amounts of truxinic and truxillic acids. Successful comparism of cocaine out of
      different sources can be achieved by chromatographing trimethylsilyl- or dimethyl
      t.-butylsilyderivates. The application of the method Ist limited by the purity of
      the samples.

PMID- 1759890
TI  - [Postinfarction segmental asynergy: correction after angioplasty. Predictive
      value of exercise thallium scintigraphy].
AB  - The aim of this study was twofold: to evaluate the frequency of reversibility of
      segmental post-subendocardial infarction asynergy after coronary angioplasty, and
      to test the predictive value of the redistribution phenomenon during stress
      Thallium scintigraphy with respect to the reversibility of segmental asynergy.
      The inclusion criteria for this study were: previous postsubendocardial
      myocardial ischaemia with residual resting or effort ischaemia documented with or
      without the Thallium test, segmented asynergy documented by quantitative analysis
      of the ventriculography, complete correction of coronary angioplasty of stenotic
      single or double vessel disease, a balanced coronary distribution or dominant
      left coronary in cases of lesion of the circumflex artery. Out of 254 consecutive
      angioplasty procedures 39 patients met these inclusion criteria. The location of
      the subendocardial infarct (SEI) was anterior in 17 cases and inferior in 22
      cases. The study protocol included a Thallium scintigraphy from the 10th day
      after SEI, ventriculography 24 hours later, angioplasty and control
      ventriculography 24 hours after angioplasty. Comparison of the two
      ventriculographies opposed Group A (reversible asynergy) and Group B
      (irreversible asynergy) according to criteria defined in 15 normal subjects whose
      average regional ejection fraction (REF) was 0.53 +/- 0.11. This result enables
      definition of normal segmental motion if the REF greater than 0.30 (mean--2 SD);
      hypokinetic if the REF greater than 0.30 or akinetic if the REF less than 0.10
      (mean--4 SD). An increase of REF of 0.15 (50% of the minimal normal value)
      allowed definition of reversibility of asynergy. By these criteria, 19 patients
      (48.7%) had reversible asynergy after PTCA; 20 had definitive asynergy
      (51.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759891
TI  - [Effect of subvalvular disease on results of percutaneous mitral valvotomy].
AB  - In order to study the results of percutaneous mitral valvuloplasty (PMV),
      subvalvular mitral disease was classified using: 1) the transthoracic echo score
      (0-4), 2) an index derived from left ventricular angiography defined as the ratio
      of the distance from the extremity of the papillary muscle and the mitral valve
      in systole and the distance between the beginning of the aortic root and the apex
      of the left ventricle in diastole. This index of subvalvular fibrosis could be
      measured in 80 out of our first 103 PMV performed without complication; the
      mitral surface are a increased from 1.1 +/- 0.4 to 2.2 +/- 0.8 cm2 (p less than
      0.0001). After PMV, mitral regurgitation was observed or was aggravated in 28
      patients (35%), by one grade in 25 and by more than one grade in 3. The overall
      echo score was 8.3 +/- 1.5 and that of subvalvular fibrosis was 2 +/- 0.6. The
      angiographic index of subvalvular fibrosis was 0.18 +/- 0.04. No correlation was
      observed between echo and angiographic appreciation of subvalvular fibrosis.
      Multivariate analyses were selected: 1) the overall echocardiographic score (r = 
      0.45, p less than 0.0001), but not the angiographic index of subvalvular fibrosis
      or echocardiographic score of subvalvular fibrosis, was predictive of increase of
      valve surface area; 2) the absence of mitral regurgitation before PMV (p less
      than 0.01) and an angiographic index of subvalvular fibrosis less than or equal
      to 0.15 (p less than 0.03) were predictive of increased mitral
      regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759892
TI  - [Silent ischemic heart diseases in patients with peripheral arterial diseases.
      Screening and 5-year prognosis in a population of 418 patients].
AB  - Silent ischaemic heart disease was looked for by exercise stress testing in 418
      patients with chronic obliterative arterial disease of the lower limbs with no
      clinical or electrocardiographic signs of myocardial ischaemia. In the initial
      work-up, 6.2% of patients had a positive exercise test and the results were
      suspect in 9.2% of patients. These patients were followed up for 5 years. There
      were 42 deaths (10%). The cause of death was cardiovascular in 53.7% of cases
      (myocardial infarction 40.4%) and malignant disease in 35.7%. During the 5 year
      follow-up, ischaemic heart disease present as angina pectoris or myocardial
      infarction in 115 cases (27.5%). Patients who had a positive exercise stress test
      initially had a particularly high death rate (23%) and developed clinical signs
      of coronary insufficiency in 57.5% of cases. On the other hand, the peripheral
      vascular complications were relatively rare in this series: cerebrovascular
      accidents: 1.4%; retinal vascular accident: 1.1%; carotid surgery: 1.6%; lower
      limb amputation: 1.9%; lower limb vascular surgery: 17.7%. Silent ischaemic heart
      disease is very prevalent in patients with obliterative arterial disease of the
      lower limbs and is a main vital prognostic factor in these patients. These
      results confirm the need for a complete cardiovascular check-up in all patients
      with peripheral arterial disease.

PMID- 1759893
TI  - [Value of a new fast CK-MB determination for the diagnosis of myocardial
      infarction during the 1st hours. Preliminary study].
AB  - This study evaluated the time for a new, rapid and reliable CK-MB analysis to
      become positive in myocardial infarction and compared it with classical total CK
      analyses. Serial analyses of total CK and CK-MB were performed in 49 consecutive
      patients referred to the Coronary Care Unit for suspected acute myocardial
      infarction. Twenty of these patients had myocardial infarction with rising enzyme
      levels, which enabled comparison of the precocity of one analysis compared to
      another. In these patients, the CK-MB analysis became positive on average 85 to
      110 minutes before that of total CK. This result shows that CK-MB analysis can be
      a diagnostic sign of acute myocardial infarction at an earlier stage than the
      total CK analysis. The authors discuss the clinical value of this test in
      difficult indications of fibrinolytic therapy and underline that it enables a
      more objective assessment of the time of onset of necrosis than clinical data
      alone.

PMID- 1759894
TI  - [Mitral valve replacement in postinfarction mitral insufficiency. Immediate and
      long-term results apropos of a series of 39 surgically-treated patients].
AB  - Thirty nine patients, mainly males (84.6%) with an average age of 66 years
      underwent mitral valve replacement for postinfarction mitral regurtation between
      March 1971 and December 1987. Twenty four were in Class IV of the NYHA
      Classification, 9 in Class III and 6 in Class II. All had a history of myocardial
      infarction predominantly of the inferior wall. The 33 preoperative coronary
      angiogrammes showed 13 patients with triple vessel disease, 15 with double vessel
      disease and 5 with single vessel disease. At operation, 13 patients had ruptured
      papillary muscles; acute dysfunction was observed in 16 and chronic in 10
      patients. The hospital mortality was 36%; over three quarters of deaths were due
      to myocardial dysfunction. Twenty two patients had an associated myocardial
      revascularisation procedure with mitral valve replacement. All 25 survivors were
      followed up for an average of 2.3 years (94 patient-years). The 5 year actuarial
      survival (operative mortality included) was 55% and 77% of the 17 survivors are
      in Stages I or II of the NYHA Classification. The quality of these long-term
      results justifies surgery despite the high operative risk.

PMID- 1759895
TI  - [Programmed ventricular stimulation in unexplained syncope: risk factors for
      induction of ventricular tachycardia].
AB  - The aim of this study was to identify the factors associated with the induction
      of ventricular tachycardia (TV) by programmed ventricular stimulation in patients
      with unexplained syncope. Sustained VT was induced in 71 out of 619 patients
      (11.5%) with syncope. A comparison of subjects with inducible VT and those
      without inducible VT showed underlying cardiac disease to be more common (89%
      versus 16%), more Holter abnormalities (Grade IVa ventricular extrasystoles)
      (60.5% versus 10%) in the first group but that signal-averaged ECG, recorded in
      51 cases, was not sufficiently specific to differentiate the two groups (delayed
      potentials in 57% versus 43%). When syncope occurred in a subject without
      apparent cardiac disease with a normal Holter recording, inducible VT was rare
      (1%). On the other hand, when syncope was associated with cardiac disease and/or
      an abnormal Holter recording, VT could be induced in 45 to 64% of cases. In
      addition, as inducible VT was associated with severe infrahisian conduction
      defects in 3 cases, the following strategy is suggested in patients with
      unexplained syncope: programmed ventricular stimulation should be performed
      systematically during endocavitary electrophysiological investigation of AV
      conduction in patients with cardiac disease and if the non-invasive
      investigations, Holter monitoring or echocardiography, are abnormal.

PMID- 1759896
TI  - [Holter electrocardiography before and after coronary angioplasty. Angiographic
      correlation after 24 hours and 6 months].
AB  - Myocardial ischaemia was searched for by Holter monitoring before and after
      coronary angioplasty with primary success in 31 patients. Control angiography was
      performed at 24 hours and 6 months after angioplasty. Twelve patients had signs
      of myocardial ischaemia before angioplasty (cumulated ischaemia: 743 minutes).
      The degree of coronary stenosis was 92 +/- 6% before angioplasty, 25 +/- 17%
      immediately after the dilatation increasing to 34 +/- 25% at the 24th hour (p
      less than 0.002). Despite successful angioplasty myocardial ischaemia persisted
      in 6 patients (cumulated ischaemia: 184 minutes) and was silent in 5 of the 6
      cases. In these 6 cases, control angiography at 24 hours showed either a
      dissection (n = 4) or a filling defect (n = 2). The angiographic outcome of the
      postangioplasty stenosis and at 24 hours was the same in Group I without
      restenosis (25 +/- 14% versus 33 +/- 22%) as in Group II with restenosis (25 +/-
      22% versus 37 +/- 30%). In Group I, the degradation of the result at 24 hours was
      reversible at 6 months (33 +/- 22% vs 23 +/- 14%). After angiographic success,
      postangioplasty ischaemia present in 20% of cases was frequently silent. No
      correlation was observed with restenosis at 6 months which raises the possibility
      of a reversible microthrombotic etiology. These results justify antiaggregant and
      anticoagulant therapy in the 48 hours following angioplasty.

PMID- 1759897
TI  - [Advantages and limits of programmed autologous transfusion in cardiovascular
      surgery. Apropos of 524 patients].
AB  - Between October 1987 and July 1989, 544 patients, candidates for cardiovascular
      surgery, were included in a trial of programmed autologous autotransfusion. Five
      hundred and twenty four patients underwent one or several (maximum 4) blood
      donation sessions in the 3 weeks before surgery with no complications. Overall,
      57% of patients benefited from homologous blood transfusion, thereby avoiding all
      risk of contamination. It was in the group of patients able to undergo 3 or 4
      preoperative blood donations that we observed the smallest number of homologous
      transfusions (30%). Programmed autologous transfusion would seem to be a very
      useful technique for cardiac surgery, allowing a reduction in health care costs
      without additional patient risk. In order to improve on this method, it may be
      useful to associate a peroperative technique of blood recuperation in patients in
      whom the transfusion needs are likely to exceed the possibilities of preoperative
      blood donation alone.

PMID- 1759898
TI  - [Structure of arterial intima in children and adolescents. A pathological study
      of 101 cases].
AB  - This was a macroscopic and histological study of the arteries of 101 unselected
      subjects from 0 to 20 years of age without cardiovascular pathology, autopsied to
      determine the cause of death at the medico-legal Institute of Paris. Stary's
      classification was used as a reference. Multiple Biopsies were taken from
      throughout the arterial system: initial aorta, carotid artery and its
      bifurcation, descending supra and infra renal aorta, iliac artery and left
      anterior descending artery. In this population, we found arterial lesions in 63%
      of subjects in the 15 to 20 year age range and this confirms previously reported
      data, especially by Stary. The lesions were identical irrespective of the site of
      biopsy and predominated at the bifurcations. No difference was observed with
      regards to sex and the lesions progressed after puberty.

PMID- 1759899
TI  - [Percutaneous transluminal angioplasty of the common trunk during the acute phase
      of myocardial infarction].
AB  - The prognosis of cardiogenic shock in the acute phase of myocardial infarction
      has been transformed since the introduction of techniques of myocardial
      revascularisation. We report the case of a patient in cardiogenic shock after a
      large anterior myocardial infarct in whom failure of early thrombolytic therapy
      led to referral for emergency percutaneous transluminal coronary angioplasty. The
      success of the procedure on the patient's haemodynamic condition was life-saving.
      The originality of this case resides in the fact that revascularisation concerned
      the left main coronary stem.

PMID- 1759900
TI  - [Fortuitous discovery of the association of true and false aneurysm of the left
      ventricle after cardiogenic shock].
AB  - The authors report the fortuitous diagnosis of a true and a false left
      ventricular aneurysm in a 77 year old man with severe ischaemic heart disease and
      calcific aortic stenosis, admitted for cardiogenic shock. The association of
      these two forms of aneurysm is very rare. Clinical and paraclinical diagnosis is
      difficult. Conventional left ventriculography is the investigation of reference
      but the diagnosis has been facilitated by Technetium 99 cardiac scintigraphy and
      color Doppler echocardiography. Surgery may be considered in cases of true
      aneurysm especially in patients with left ventricular failure, but the indication
      is formal in cases of false aneurysm.

PMID- 1759901
TI  - [Leiomyosarcoma of the right ventricle. Report of a case and review of the
      literature].
AB  - Primary cardiac leiomyosarcoma is a very rare condition. Only 15 cases have been
      reported in the literature. We report the case of a 27 year old man admitted to
      hospital for chest pain in March 1985. Echocardiography showed a right
      ventricular tumour which was completely resected at surgery. The diagnosis of
      leiomyosarcoma was confirmed by histological examination. After 22 months follow
      up, the patient was still alive despite pulmonary metastases. The diagnosis of
      cardiac tumour used to be made post-mortem but since the introduction of new
      methods of investigation, especially 2D echocardiography, the diagnosis can be
      made at an early stage and allows rapid surgical resection, the only means of
      obtaining the histological diagnosis and of completely curing benign tumours.

PMID- 1759902
TI  - [Does corticosteroid therapy favor the development of ventricular aneurysm in
      myocardial sarcoidosis?].

PMID- 1759903
TI  - Correlation between humoral immune responses and presence of virus in the CNS in
      dogs experimentally infected with canine distemper virus.
AB  - The role of the humoral immune response in clearance or prevention of canine
      distemper viral encephalitis of dogs infected with a virulent strain of canine
      distemper virus has been evaluated. Dogs that have demyelinating lesions, CDV
      proteins and infectious virus in their brains demonstrate an impaired humoral
      immune response. In dogs that recover from infection and contain no demyelinating
      lesions, viral proteins or infectious virus in the brain, antibodies to the
      internal proteins of CDV are observed early after infection. Later antibodies to
      primarily the H protein are detectable in sera of these dogs and the appearance
      of antibodies against the surface glycoprotein (H) correlates with the absence of
      lesions, CDV antigen and infectious virus in the brains of these dogs. Very late
      after infection immunoprecipitating antibody to all CDV antigens diminished
      rapidly so that at about ten weeks post infection antibodies that precipitate CDV
      antigens are barely detectable.

PMID- 1759904
TI  - Antigenic relationships among the 47 human adenoviruses determined in reference
      horse antisera.
AB  - Reference equine antisera to all 47 serotypes of human adenoviruses presently
      described have been prepared and evaluated by reciprocal neutralization and
      hemagglutination-inhibition tests. All tests were carried to endpoint dilutions a
      minimum of five times in each direction to give accurate values for homologous
      and heterologous antibody titers. Significant cross-reactions in the horse
      antisera were compared to similar data obtained from rabbit antisera. Using this
      analysis, major antigenic relationships exist among types 12-18-31 of subgenus A,
      types 7-11-14 and 34-35 of subgenus B, types 8-9-10, 10-19-37, 13-38-39, 15-22
      42, 20-47, 24-32-33-46, and 29-45 of subgenus D, types 16-4 between subgenera B
      and E, and types 40-41 of subgenus F. Across all subgenera, types 8, 10, 13, 15,
      17, 19, 26, 29, 39, 40, and 43 have antigenic moieties found most frequently in
      other types, averaging 12 heterologous reactions per type when summing both tests
      in both directions. Types 20, 30, 32, and 45 exhibit shared determinants slightly
      less often, with a mean of 8 heterologous reactions per type.

PMID- 1759905
TI  - Effect of polyions on the early events of Sindbis virus infection of Vero cells.
AB  - To clarify the role of electrostatic interactions in the binding of Sindbis virus
      (SNV) to cell membrane receptors, we investigated the effect of different
      polyions on the initial steps of infection of Vero cells by the virus. Several
      polyanions (mucin, heparin, polygalacturonic acid) and polycations (polylysine,
      protamine, polybrene) were able to reduce the replication of SNV when present in
      the viral adsorption period, whereas others (chondroitin sulfate, polymyxin B
      sulfate, histone) were devoid of any activity. Therefore the electric charge
      alone is not sufficient to explain the action of compounds. The effects of
      polyions on receptor binding, on bound virus, and on internalized virus have been
      examined. All the drugs inhibited SNV infection by affecting its binding to the
      cellular receptor. The results indicated that heparin and mucin act directly on
      the virus particle while polycations bind to the cell membrane receptor for the
      virus, protamine being effective on both targets. Since among polyanions
      glycosaminoglycans showed a strong inhibiting activity, the involvement of these
      molecules in the virus surface receptor was assessed by enzyme digestion of cell
      membrane with heparinase and chondroitin ABC lyase.

PMID- 1759906
TI  - Interleukin-2 enhances production in 24 hours of infectious human
      immunodeficiency virus type 1 in vitro by naturally infected mononuclear cells
      from seropositive donors.
AB  - When peripheral blood mononuclear cells from HIV-1 seropositive patients were
      treated with rIL-2 in vitro a rapid increase of 2-12 fold in production of
      extracellular infectious HIV-1 occurred, in 6 of 9 experiments. Overall, the
      increase in the 9 experiments was significant (p less than 0.01) and provides
      more direct evidence for an enhancing role of IL-2 in naturally infected cells.

PMID- 1759907
TI  - VP2 is the major exposed protein on orbiviruses.

PMID- 1759908
TI  - In memory of Victor Zhdanov.

PMID- 1759909
TI  - Synthesis and immunogenicity of hepatitis B virus envelope antigen expressed by
      recombinant vaccinia virus. Finding of retention signal in the C-terminal portion
      of the preS1 domain of subtype adyw.
AB  - Five different recombinant vaccinia viruses expressing the envelope antigen of
      hepatitis B virus (HBsAg) under the control of the P7.5 promoter were
      constructed. Cell cultures infected with some of the recombinant viruses
      synthesized both middle (M) and major surface (S) protein of HBsAg. It was shown
      that the length of the nontranslated sequence preceding preS2-ATG influenced the
      extracellular or intracellular HBV antigen distribution and the preS2:S antigen
      ratio. Some recombinants synthesized an M protein that was enlarged by additional
      35 amino acids of preS1 domain and was entirely retained within the infected
      cells. Antibody responses to the S and preS2 antigens in mice revealed
      significant differences in the immunogenicity of individual recombinants.

PMID- 1759910
TI  - Transcriptional analysis of the bovine herpesvirus 1 Cooper isolate. Temporal
      analysis and characterization of immediate-early, early, and late RNA.
AB  - Blot hybridization analysis of infected bovine herpesvirus 1 (BHV-1) cellular RNA
      isolated at various times post infection and after treatment with specific
      metabolic inhibitors was used to characterize transcription of the BHV-1 Cooper
      isolate. Synthesis of BHV-1 RNA was detected as early as 3 h post infection and
      reached a maximum at six to eight hours post infection. The most
      transcriptionally active area of the genome was between map units 0.110 to 0.195,
      within the HindIII I fragment. From the entire genome a total of 59 transcripts
      ranging in size from approximately 0.6 to 10 kilobases were characterized as
      belonging to one of three distinct classes. Using the protein synthesis inhibitor
      cycloheximide, three immediate-early transcripts were identified as originating
      from the internal inverted repeat region between map units 0.734 and 0.842,
      corresponding to the HindIII D fragment. Using phosphonoacetic acid to prevent
      virus DNA synthesis by inhibition of the BHV-1 DNA polymerase, 28 early
      transcripts were recognized. The remaining 28 transcripts, classified as late
      RNA, were detected without the use of metabolic inhibitors at 6 to 8 h post
      infection. Transcription of early and late RNA was not restricted to any specific
      area of the genome. Eighty percent of the transcripts from both the HindIII A
      fragment, between map units 0.381 to 0.537 within the unique long segment, and
      the HindIII K fragment, between map units 0.840 to 0.907 of the unique short
      segment, were designated as belonging to the early class.

PMID- 1759911
TI  - Effect of an Autographa californica nuclear polyhedrosis virion component(s) on
      DNA synthesis and growth in several insect cell lines.
AB  - Thirteen different insect cell lines representing three different orders were
      infected with Autographa californica nuclear polyhedrosis virus (AcMNPV) whose
      genome had been inactivated in situ by photochemical means or by short wave UV
      irradiation. Changes in rates of cellular DNA synthesis, as measured by
      [3H]thymidine incorporation, and cell growth were subsequently measured at
      various times post infection. Seven cell lines exhibited a significant decline in
      [3H]thymidine incorporation (compared to control levels) during an initial 12 h
      period post infection, while three cell lines showed substantial declines in
      [3H]thymidine incorporation over a 4 day period post infection. All cell lines
      which showed a significant decline in [3H]thymidine over the duration of the
      experiment (4 days) also exhibited reduced cell growth rates. The role of a
      putative AcMNPV virion associated factor(s) in influencing these cellular events
      is discussed.

PMID- 1759912
TI  - Studies on the regulation of influenza virus RNA replication: a differential
      inhibition of the synthesis of vRNA segments in shift-up experiments with ts
      mutants.
AB  - The regulation of influenza virus vRNA synthesis in the course of the
      reproduction cycle was studied with the use of a series of ts mutants in shift-up
      experiments. The synthesis of vRNA segments was registered by means of
      polyacrylamide gel electrophoresis of nucleocapsid-associated RNA isolated from
      the infected cells labelled with [3H]uridine after the shift-up to a semi
      permissive temperature. Each mutant exhibited a specific differential pattern of
      vRNA synthesis inhibition after the shift-up. The most affected segments were
      either vRNA 4, vRNAs 4 and 7, or vRNAs 4, 6, and 7 in cells infected,
      respectively, with ts mutants C15 (ts lesion in PB1 gene), C45 (ts lesion in PA
      gene) and CmN3 (ts lesion in NS gene). The synthesis of vRNAs 1, 2, and 3 was
      relatively resistant to the shift-up in the cells infected with C15 or C45 and
      more sensitive in the cells infected with C44 (ts lesion in PB2 gene) or CmN3.
      The replication of the "early" genes (vRNAs 5 and 8) was generally least affected
      by the shift-up. The results are discussed in connection with the "early-late"
      transition of vRNA synthesis pattern in the course of infection.

PMID- 1759913
TI  - Lithium and hypercalcaemia.

PMID- 1759914
TI  - Asthma deaths: where are we now?

PMID- 1759915
TI  - Risk factors for death in patients admitted to hospital with asthma: a follow-up
      study.
AB  - Hospital records of patients with asthma admitted to teaching hospitals in Perth,
      Western Australia between 1976 and 1980 were examined retrospectively to identify
      characteristics of the illness which were associated with subsequent death. From
      5722 admissions there were 195 deaths to December 1982, 186 of whom had records
      available (cases); 452 of the surviving subjects were used for comparison
      (controls). There was no difference in age of onset of asthma or cigarette
      smoking habits between the two groups, but ischaemic heart disease as an
      associated condition was significantly more frequent in cases. On admission to
      hospital an arterial PCO2 less than 45 mmHg was more frequent in those who died,
      but there were no differences in arterial PO2, lowest pH, highest or lowest FEV1
      and FVC. Cases more frequently used home nebulisers and were more frequently
      prescribed corticosteroids, antibiotics and sedatives or tranquilizers prior to
      admission, corticosteroids and sedatives or tranquilisers during admission and
      sedatives or tranquilisers on discharge. These results suggest that cases had
      more severe asthma in that they were more often treated with home nebulisers,
      corticosteroids and antibiotics, but with the exception of PaCO2 the commonly
      used measurements of severity of asthma did not identify those at risk of death.
      The prescription of sedatives or tranquillisers appears to be associated with an
      increased risk of death in subjects with asthma.

PMID- 1759916
TI  - GM-CSF after allogeneic bone marrow transplantation: accelerated recovery of
      neutrophils, monocytes and lymphocytes.
AB  - Ten patients given HLA-identical sibling marrow transplants for lymphoid
      malignancy received recombinant human granulocyte macrophage-colony stimulating
      factor (GM-CSF) from day 7 to day 13 inclusive post transplant. Patients were
      prepared for transplantation with busulphan 16 mg/kg and cyclophosphamide 120
      mg/kg. Immunosuppression to minimise the risk of graft-versus-host disease (GVHD)
      was cyclosporin/short methotrexate. Results were compared with a historical
      control group of patients (n = 16) given matched sibling transplants for acute
      leukaemia and receiving the same immune suppressive regime but not given GM-CSF.
      Recovery of total white cells, neutrophils, monocytes and lymphocytes was more
      rapid in the GM-CSF recipients (p less than 0.02). There was a suggestion of a
      decrease in non-viral infections in the first 30 days in the GM-CSF recipients (p
      = 0.09). There was, however, no significant difference in the severity of
      oropharyngeal mucositis nor in the duration of the transplant hospitalisation.
      Surprisingly, the severity of acute GVHD was higher in the GM-CSF recipients with
      six of eight evaluable patients having grade II-IV acute GVHD (p = 0.003). Two GM
      CSF recipients developed a fluid retention/capillary leak syndrome. These
      findings indicate a need for caution in the use of GM-CSF after allogeneic marrow
      transplantation.

PMID- 1759917
TI  - Low dose erythropoietin in maintenance haemodialysis: improvement in quality of
      life and reduction in true cost of haemodialysis.
AB  - Human recombinant erythropoietin (r-HuEPO) improves quality of life in patients
      on maintenance haemodialysis, but the haemoglobin (Hb) level necessary to achieve
      this improvement is unknown. In this study, quality of life, functional capacity
      and symptoms of 28 haemodialysis patients with an initial Hb of 67 +/- 2 (mean +/
      SEM) g/L were assessed after 0, 6 and 12 months of r-HuEPO, the dose of which
      was titrated to achieve a stable Hb of between 90 and 100 g/L. At six and 12
      months Hb was 97 +/- 2 and 93 +/- 2 g/L, and mean r-HuEPO dose between three and
      six, and between nine and 12 months was 88 +/- 6 and 62 +/- 9 U/kg/week
      intravenously respectively. There was a significant improvement in level of
      activity and satisfaction with various aspects of life, and a reduction in
      fatigue, weakness, dyspnoea, angina and restless legs. Patients were able to walk
      50% further in six minutes. The improvement in quality of life and function was
      similar to that reported from other centres whose target Hb was between 100 and
      120 g/L, and where the r-HuEPO dose was 75% higher than in this study. Costs of r
      HuEPO therapy were assessed. The drug itself costs +A3681/yr/patient, to which
      was added the estimated cost of additional dialyses and medications, bringing the
      total to +A5177/yr/patient. There was, however, a reduction in both
      hospitalisation by 8.3 days/yr/patient and medical consultation by 3.9
      hours/yr/patient. Five patients commenced full-time work, one took up full-time
      study aimed at finding work, three transferred to home haemodialysis and six
      fewer patients drew social security benefits. The net cost saving from using low
      dose r-HuEPO was more than +A1,000/yr/patient.

PMID- 1759918
TI  - Dubbo study of the elderly: sociological and cardiovascular risk factors at
      entry.
AB  - A prospective study of elderly Australians commenced in 1988 in Dubbo, NSW. Its
      goals are to identify predictors of mortality, hospitalisation and placement in
      long-term care, with special focus on risk factors for cardiovascular disease.
      The study population were non-institutionalised subjects, comprising 1237 males
      and 1568 females 60 years and over. This report describes the baseline findings:
      demographic, educational and economic data; tobacco and alcohol usage, self
      medication and other habits; medical contacts and past diagnosis; prescribed
      medication and in study diagnosis; psychosocial variables, functional health and
      social support; blood lipid and lipoprotein data; blood pressure, spirometry and
      glucose data; heights and weights. Where comparison has been feasible, the
      findings in Dubbo closely resemble those obtained from the rest of Australia. The
      findings presented provide the basis for aetiological studies of future outcomes.

PMID- 1759919
TI  - Reproducibility of synovial fluid examination for crystals.
AB  - A quality assurance survey of synovial fluid examination for crystals was
      performed at six teaching hospitals. Aliquots of 12 different fluids (three with
      no crystals, one with betamethasone crystals, four with calcium pyrophosphate
      dihydrate (CPPD) crystals and four with monosodium urate monohydrate [urate]
      crystals) were examined by all six laboratories. Four laboratories performed well
      (10 or more correct out of 12) but two did poorly (50% or less correct). False
      positive crystal identification occurred in eight of 72 samples, but all false
      positive reports were from two laboratories. CPPD and urate crystals were missed
      in seven of 24 (29%) and five of 24 (21%) samples respectively. The standard of
      synovial fluid examination for crystals in Sydney teaching hospitals is not
      uniform and in some cases appears unsatisfactory.

PMID- 1759920
TI  - Metformin increases insulin sensitivity and basal glucose clearance in type 2
      (non-insulin dependent) diabetes mellitus.
AB  - The effects of metformin on glycaemia, insulin and c-peptide levels, hepatic
      glucose production and insulin sensitivity (using the euglycaemic,
      hyperinsulinaemic clamp) were evaluated at fortnightly intervals in 9 Type 2
      diabetic patients using a stepwise dosing protocol: Stage 1--no metformin for
      four weeks; stage 2--metformin 500mg mane; stage 3--metformin 500mg thrice daily;
      stage 4--metformin 1000mg thrice daily. Results are expressed as Mean +/- SEM.
      Fasting blood glucose decreased from basal values (9.7 +/- 1.0 mmol/L) by 13% at
      stage 2, 34% at stage 3 and 41% at stage 4 (p less than 0.02 vs basal for all
      stages; p less than 0.02 stage 2 vs stage 3). Post-prandial glycaemia was
      significantly improved only with metformin 3000mg/day (p less than 0.05).
      Fasting, meal-stimulated and total insulin and c-peptide levels showed no change.
      Hepatic glucose output did not change significantly with metformin. Insulin
      sensitivity, measured as total glucose utilisation during hyperinsulinaemia,
      increased from stage 1 (10.3 +/- 2.1 mumoL/kg/min) by 23% at stage 3 (p less than
      0.05) and by 29% at stage 4 (p less than 0.02). Basal metabolic clearance of
      glucose increased compared to stage 1 (1.69 +/- 0.16 mL/kg/min) by 30% at stage
      2, 53% at stage 3 and 44% at stage 4 (all p less than 0.02). This study
      demonstrates that improved efficiency of glucose utilisation, both basally and
      under conditions of euglycaemic hyperinsulinaemia, is the basis of metformin's
      antihyperglycaemic action.

PMID- 1759921
TI  - A reliable screening test for coeliac disease: enzyme-linked immunosorbent assay
      to detect anti-gliadin antibodies in serum.
AB  - A simple, rapid, highly reproducible enzyme-linked immunosorbent assay detecting
      anti-gliadin antibodies in serum to screen for coeliac disease (CD) is described.
      By combining the results of anti-gliadin IgA and IgG determinations the overall
      sensitivity of the assay was found to be 100% and the specificity 96% for
      children and 99% for adults. Significantly elevated antigliadin IgA and IgG
      antibodies were detected in all 20 children and all 25 adults with untreated CD.
      False positive results were found in 1/79 histologically normal control and 5/86
      disease control children, while for adults false positive rates were 0/74 and
      1/34 for the healthy and disease control groups, respectively. Anti-gliadin IgA
      and IgG was measured in serum samples from 52 coeliac patients (11 children and
      41 adults) treated with a gluten-free diet (GFD). Each of the children and 28 of
      the adults who followed a strict GFD had significantly lower IgA and IgG levels
      than untreated CD patients. The serum anti-gliadin IgA and IgG levels of the 13
      adults not complying with a GFD were similar to those found for untreated CD
      patients. This assay is recommended as a screening test for CD as well as a tool
      for follow-up of treated patients.

PMID- 1759922
TI  - Acute Barmah Forest polyarthritis.
AB  - More than 60 arboviruses have been isolated in Australia with the human
      pathogenicity of the majority yet to be determined. Recent reports outline
      extensive clinical and sub-clinical infection occurring in Eastern Australia by
      such agents as Ross River and Barmah Forest viruses. We describe the clinical
      features of two patients with an acute polyarthritis associated with serological
      evidence of acute Barmah Forest virus infection to alert physicians to this form
      of viral polyarthritis and highlight the need to consider this agent when
      confronted with patients with an acute 'viral-type' polyarthritis in whom
      serology for Ross River virus is negative.

PMID- 1759923
TI  - Adult T-cell leukaemia lymphoma in an aborigine.
AB  - A 44-year-old Aborigine with Adult T-cell Leukaemia/Lymphoma (ATLL) due to HTLV-I
      is reported. He presented with transverse myelitis of subacute onset, and
      subsequently developed frank T-cell leukaemia complicated by splenomegaly and
      hypercalcaemia. Cell surface marker studies showed a phenotype of CD3+ CD4+ CD8-
      CD25+, and serological and molecular studies confirmed HTLV-I infection. This is
      the first report of ATLL in an Australian Aborigine.

PMID- 1759924
TI  - Fulminant metoclopramide induced neuroleptic malignant syndrome rapidly
      responsive to intravenous dantrolene.
AB  - We report a case of fulminant neuroleptic malignant syndrome in a man aged 70
      developing within 12 hours of starting six-hourly intravenous metoclopramide. The
      muscle rigidity and hyperpyrexia were unresponsive to intravenous benztropine but
      resolved within one hour of intravenous dantrolene 2 mg/kg. Within six hours the
      patient had a partial relapse which resolved completely following further
      intravenous dantrolene 2 mg/kg. This case demonstrates that the rapid effect of
      intravenous dantrolene can be life saving in fulminant neuroleptic malignant
      syndrome.

PMID- 1759925
TI  - Multiple cardiac papillary fibroelastomas and rheumatic heart disease.
AB  - A case of severe rheumatic mitral stenosis was found to have multiple echodense
      masses attached to the ventricular surface of the mitral valve and papillary
      muscle at preoperative 2-dimensional echocardiography. Subsequent surgery
      involved mitral valve replacement and excision of the masses. Complete excision
      was confirmed by intraoperative transoesophageal echocardiography. Histologic
      examination of the surgical specimens showed typical papillary fibroelastomas.
      This is the first case report of multiple papillary fibroelastomas in association
      with rheumatic valvular disease demonstrated by 2-dimensional echocardiography.

PMID- 1759926
TI  - Invasive aspergillosis in AIDS.
AB  - Invasive aspergillosis (IA) is a rare infection in patients with the Acquired
      Immune Deficiency Syndrome (AIDS). We report the first Australian cases of
      histologically and microbiologically proven IA diagnosed antemortem in AIDS
      patients. We also describe the first case of laryngeal involvement and the
      unusual case of a pneumothorax due to IA. These three cases illustrate the varied
      clinical and pathological features of IA in AIDS and highlight some of the
      difficulties in diagnosis and treatment. The infections occurred in the setting
      of advanced immunodeficiency and multiple opportunistic infections and responded
      poorly to treatment.

PMID- 1759927
TI  - Giant cell arteritis in two Chinese patients.
AB  - Giant cell arteritis is virtually unknown in Orientals. We report two cases of
      histologically proven giant cell arteritis in two elderly Chinese men, one of
      whom presented with typical symptoms and the other with occult features of the
      disease.

PMID- 1759928
TI  - A randomised blinded study in colonic lavage for colonoscopy.

PMID- 1759929
TI  - Cerebral venous thrombosis associated with antithrombin III deficiency.

PMID- 1759930
TI  - The Arthur E. Mills Oration. Self-regulation and the professions: continuing
      legal education and regulating the regulators.

PMID- 1759931
TI  - An unusual case of chronic cough.

PMID- 1759932
TI  - 'Medical informatics'--a bridge between the clinician and the computer scientist.

PMID- 1759933
TI  - More complications of coeliac plexus blockade.

PMID- 1759934
TI  - One swallow doth not summer make.

PMID- 1759935
TI  - Cyclosporin A and mefenamic acid in a renal transplant patient.

PMID- 1759936
TI  - Septal lesions lower responding under fixed-ratio schedules of reinforcement.
AB  - Albino Sprague-Dawley rats with complete septal lesions and rats with control
      operations were studied under fixed-ratio (FR) schedules of reinforcement. Both
      groups were trained for 10 sessions each under FR 10, 20, 40, 60, 80, and 100. In
      contrast to findings from progressive FR studies and some simple FR studies,
      septal lesions resulted in lower overall and local response rates along with
      longer postreinforcement pauses. These effects were especially evident during the
      FR 100 schedule of reinforcement. A comparison of reinforcement rate as a
      function of FR size within the context of behavioral economics (i.e., a demand
      function) indicated that septal lesions did not alter the reward value of food.
      These findings suggest that responding on FR schedules of reinforcement can be
      altered by the various procedures used to train rats to reach the terminal value
      of a reinforcement schedule.

PMID- 1759937
TI  - Selectivity in paternal and infanticidal responses by male mice: effects of
      relatedness, location, and previous sexual partners.
AB  - Male mice tend to be infanticidal to unrelated infants but parental to their own
      offspring. The present study examines three hypotheses that might explain this
      apparent discrimination. There was no evidence of selective infanticide toward
      infants encountered for the first time on the basis of kinship, location, or cues
      associated with previous sexual partners. However, males tended to direct more
      paternal responses toward their own unfamiliar infants than toward unrelated
      infants, infants encountered in the male's home cage than those in the cage of
      another male, and when cues associated with a previous sexual partner were
      present. Data suggested that the responses of females to male intruders might
      influence the responses of those males. It was concluded that the infanticidal
      responses of male mice are mediated by a particular state of the male but that
      males in a noninfanticidal state may vary their paternal responsiveness on the
      basis of direct and indirect cues concerning relatedness.

PMID- 1759938
TI  - Sequencing of behaviors in Aplysia fasciata: integration of feeding,
      reproduction, and locomotion.
AB  - To begin studying the neural basis of higher-order decision-making in Aplysia
      fasciata, we examined individual bouts of behavior in various conditions of
      access to food and/or mates. We then determined rules governing transitions
      between bouts. The data indicate that a single intermediate condition, moving in
      place, may be centrally related to transitions between behaviors. In all
      conditions, over 85% of all transitions between behaviors were via moving in
      place. Moving in place tended to precede and follow other categories of activity
      (crawling, swimming, immobile), and feeding. Also, moving in place apparently
      represents a fixed proportion of all bouts of behavior. In each condition, moving
      in place represented approximately 40% of all bouts, while the number of bouts of
      other behaviors varied markedly. After a bout of moving in place there was a
      strong tendency for the animal to return to the behavior performed before moving
      in place. Additional preferred sequences of behavior were also seen. Courtship
      tended to precede mating, and crawling preceded swimming.

PMID- 1759939
TI  - Sensitization of amphetamine-stereotypy reduces plasma corticosterone:
      implications for stereotypy as a coping response.
AB  - The potential coping functions of amphetamine-induced stereotypy were
      investigated using a physiological index of stress or arousal, plasma
      corticosterone level. A series of five injections of d-amphetamine was used to
      enhance stereotyped behavior in control animals as well as in rats with bilateral
      dopamine-depleting lesions of the caudate-putamen. This regimen of amphetamine
      injections significantly increased stereotyped behavior and also reduced the
      normal elevation in corticosterone produced by treatment with d-amphetamine. This
      effect was apparent in both control and lesioned animals. These results support
      the hypothesis that amphetamine-induced stereotyped behavior functions to reduce
      stress or arousal and additionally suggest that this effect is largely
      independent of underlying dopaminergic mechanisms.

PMID- 1759940
TI  - The enhancement of retention induced by vasopressin in mice may be mediated by an
      activation of central nicotinic cholinergic mechanisms.
AB  - Immediate post-training subcutaneous administration of lysine vasopressin (LVP,
      0.003-1.00 microgram/kg) enhanced retention, whereas the vasopressin antagonist
      AAVP (0.01-0.30 microgram/kg) impaired it, in male Swiss mice tested 48 h after
      training in an inhibitory avoidance task. Both effects were dose-dependent.
      Neither LVP nor AAVP affected response latencies in mice not given the footshock
      on the training trial. The simultaneous administration of AAVP at a dose (0.01
      microgram/kg) which had no effect on retention shifted the dose-response curve of
      LVP to the right. Nicotine (1.0-30.0 micrograms/kg, sc), a central nicotinic
      cholinergic agonist, also facilitated retention in a dose-related manner without
      affecting the retention performance of unshocked mice. The effect of nicotine was
      prevented by the central acting nicotinic cholinergic receptor antagonist
      mecamylamine (5 mg/kg, sc.). In contrast, neither hexamethonium (5 mg/kg, sc), a
      peripheral acting nicotinic receptor blocker, nor atropine (0.5 mg/kg, sc) or
      methylatropine (0.5 mg/kg, sc), two anticholinergic drugs which are known to act
      on muscarinic cholinergic receptors, prevented the effect of post-training
      nicotine. The effects of LVP and nicotine were time-dependent, suggesting that
      both treatments enhanced retention by influencing post-training processes
      involved in memory storage. Low doses of nicotine (1.50 microgram/kg, sc) or the
      central anticholinesterase physostigmine (35 micrograms/kg, sc) and LVP (0.003
      microgram/kg, sc), which had no effect on retention when administered alone,
      produced a synergistic interaction when given together following training. The
      influence of LVP (0.03 microgram/kg, sc) on retention was prevented not only by
      AAVP (0.01 microgram/kg, sc) but also by mecamylamine (5 mg/kg, sc), whereas the
      effects of nicotine (10.0 micrograms/kg, sc) were prevented only by mecamylamine.
      These results suggest that the enhancement of retention induced by vasopressin is
      probably due to an activation of central nicotinic cholinergic mechanisms which
      are critical for memory formation.

PMID- 1759941
TI  - Dose- and delay-dependent working/episodic memory impairments following
      intraventricular administration of ethylcholine aziridinium ion (AF64A).
AB  - The present study examined the effects of intraventricular administration of the
      cholinergic neurotoxin ethylcholine aziridinium ion (AF64A) on performance of a
      radial arm maze task. Male Sprague-Dawley rats were trained to perform a delayed
      nonmatch to sample radial arm maze task in which a 1-h delay was imposed between
      the fourth and fifth arm selections. Following acquisition, animals were injected
      bilaterally with AF64A (1.5 or 0.75 nmol/side) or artificial cerebrospinal fluid
      into the lateral cerebral ventricles and allowed 7 days to recover before
      behavioral testing resumed. Significant dose- and delay-dependent impairments in
      the radial maze performance were observed in AF64A-treated rats as evidenced by
      fewer correct choices following the delay and by more errors to complete the
      task. Long-term testing in this task revealed significant recovery of memory
      performance. These findings indicate dose-dependent impairments in memory
      following intraventricular administration of AF64A and spontaneous behavioral
      recovery following such insult.

PMID- 1759942
TI  - Increased generalization between drug-related interoceptive stimuli with delayed
      testing.
AB  - Although the flattening of generalization gradients over time has been widely
      investigated using exteroceptive stimuli, little attention has been given to
      generalization involving interoceptive stimuli. To investigate generalization
      between internal states, Sprague-Dawley rats were given either 0.835 ml/kg
      chloropent or 15 mg/kg sodium pentobarbital. Both drugs produced asymmetrical
      state-dependent retention of a passive avoidance response, that is, good
      retention in the "same state" conditions (i.e., the drug-drug and no drug-no drug
      conditions) as well as in the no drug-drug conditions but poor retention in the
      drug-no drug conditions, at both 1- and 7-day retention intervals. Furthermore,
      subjects trained in one drug state (pentobarbital or chloropent) demonstrated
      disrupted performance when tested 1 day later in another drug state, but good
      performance when tested 7 days later in the other drug state, indicating a
      decrement in the discriminability of the two drug states after 7 days. This
      outcome demonstrates that generalization gradients between drug states flatten
      over time. Moreover, these results suggest that memory for attributes of internal
      stimuli undergoes changes similar to those found for exteroceptive stimuli.
      Implications for contextual cues models of forgetting are considered.

PMID- 1759943
TI  - Selective fimbria and thalamic lesions differentially impair forms of working
      memory in rats.
AB  - Several series of experiments were designed to compare the effects of selective
      lesions of the fimbria or of thalamic nuclei on three different tasks involving
      working memory in rats: object recognition, place recognition, and the radial arm
      maze test. The main effects of fimbria lesions were as follows: they produced
      deficits in the radial maze; object recognition was spared or even facilitated,
      whereas place recognition was impaired. Electrolytic lesions of either
      centromedian-parafascicularis (CM-Pf) or dorsomedialis (DM) nuclei produced
      highly significant deficits in the radial maze test but spared object and place
      recognition. Ibotenate lesions of the CM-Pf had no effect on any test, which
      means that the critical structure in the effects of the electrolytic lesions of
      the CM-Pf was the fasciculus retroflexus (FR). These data may contribute two main
      points to animal models of hippocampal and thalamic amnesia: (1) different forms
      of working memory in rats might have different neural bases and (2) the FR may be
      involved in learning and memory processes.

PMID- 1759944
TI  - Altered daylength affects dendritic structure in a song-related brain region in
      red-winged blackbirds.
AB  - Substantial neural and behavioral plasticity occurs in the avian song system in
      adulthood. Changes in the volume of one of the song control nuclei, robustus
      archistriatalis (RA), have been associated with seasonal changes in singing
      behavior in adult canaries (Serinus canarius) and red-winged blackbirds (Agelaius
      phoeniceus). The present work assessed the effects of changed daylength on
      dendritic morphology in RA in adult male red-winged blackbirds. Brains from hand
      reared red-winged blackbirds maintained on long days or long days followed by
      short days were stained with a Golgi-Cox procedure. Dendritic morphology and
      spine density of type IV neurons from nucleus RA were compared between long and
      short day birds. Neurons from short day birds have smaller dendritic fields than
      neurons from long day birds, with the difference greatest for distal dendrites.
      In addition, the density of dendritic spines is significantly smaller for neurons
      from short day birds. Together, these changes result in the loss of approximately
      40% of the spines on this neuron class. In previous work in adult female
      canaries, external testosterone administration has been shown to be associated
      with increases in dendritic field size and synapse number. The similarity of the
      neuronal changes in RA that are associated with the two sorts of manipulations
      suggest that some consequences of altered daylength are mediated by changes in
      the levels of gonadal steroids.

PMID- 1759945
TI  - Common regulation of feeding and mating in Aplysia fasciata: pheromones released
      by mating and by egg cordons increase feeding behavior.
AB  - We examined whether pheromones released by reproductive behaviors (mating and egg
      laying) affect feeding behavior. A preliminary experiment demonstrated that the
      quantity of food eaten can be used to measure the effects of pheromones on
      feeding. Using this measure, we then showed that Aplysia that were prevented from
      mating, but that were in the same aquarium as mating conspecifics, eat more food
      than do Aplysia in a medium lacking mating animals. Mating and feeding were not
      temporally correlated, indicating that pheromones released by mating probably do
      not initiate feeding, but rather modulate feeding after it has begun. Aplysia
      that were in the same aquarium as freshly deposited egg cordons also ate more
      than did animals in a medium lacking eggs.

PMID- 1759946
TI  - Adult blood pressure reduction in spontaneously hypertensive rats reared by
      normotensive Sprague-Dawley mothers.
AB  - Spontaneously hypertensive (SHR), Wistar-Kyoto (WKY) normotensive, and Sprague
      Dawley (SD) normotensive rats were either reared by their natural mothers
      (controls) or fostered to a mother of one of the other strains. The effects of
      rearing environment were assessed by measures of body weight at weaning and adult
      resting mean arterial blood pressure (MAP) and heart rate (HR). At weaning, SHR
      control rats weighed less than WKY controls which in turn weighed less than SD
      controls. SHR and WKY rats reared by SD mothers weighed significantly more than
      their respective controls, whereas SD rats reared by either SHR or WKY mothers
      weighed less than SD control rats. Manipulation of the maternal environment was
      attended by a change in adult resting MAP in only one group. SHR rats reared by
      SD mothers had MAPs which were significantly lower than SHRs reared by their
      natural mothers. No within-strain adult HR differences were observed between
      control and cross-fostered groups. These data indicate that the effects of cross
      fostering on adult resting MAP previously reported for SHR and WKY animals are
      generalizable to another normotensive strain. That is, genetically hypertensive
      (SHR) animals exposed to a normotensive (WKY or SD) maternal environment display
      a reduction in adult resting MAP, whereas hypertension or an increase in adult
      MAP is not induced in normotensive rats (WKY or SD) as a consequence of exposure
      to a hypertensive maternal environment.

PMID- 1759947
TI  - Glucose effects on mecamylamine-induced memory deficits and decreases in
      locomotor activity in mice.
AB  - Peripheral glucose administration attenuates the effects of muscarinic
      cholinergic antagonists on several measures, including spontaneous alternation,
      inhibitory avoidance, and locomotor activity. The present study examined glucose
      interactions with mecamylamine, a nicotinic cholinergic antagonist, on these
      measures. Mecamylamine (5 mg/kg, sc) significantly impaired spontaneous
      alternation performance. Glucose (100 mg/kg, ip) administered with mecamylamine
      attenuated the impairment. Treatment with hexamethonium (5 and 10 mg/kg, sc), a
      peripheral nicotinic blocker, did not impair performance. Pretraining treatment
      with mecamylamine, but not hexamethonium, significantly reduced later retention
      latencies on inhibitory avoidance tests. Glucose, administered with mecamylamine
      prior to training, significantly attenuated the impaired test performance.
      Mecamylamine, but not hexamethonium, significantly decreased locomotor activity.
      In contrast to the attenuating effects of glucose on the other measures above,
      glucose administered with mecamylamine potentiated the decreased locomotor
      activity. These findings demonstrate that glucose influences the behavioral
      effects of a nicotinic cholinergic antagonist in a manner generally similar to
      that of muscarinic cholinergic antagonists, and supports previous evidence that
      circulating glucose interacts with central cholinergic functions.

PMID- 1759948
TI  - Scratching as a behavioral index of anxiety in macaque mothers.
AB  - The aim of this study was to assess the validity of the notion that anxiety
      influences maternal style in monkeys. To this end, we investigated the
      correlations between measures of the quality of mother-infant relationship and
      scratching, a behavior pattern that reflects a state of anxiety. The subjects
      were seven group-living macaque mothers and their infants observed during the
      first 12 weeks postpartum. Postpartum scratching by the mothers was positively
      correlated with both maternal possessiveness and maternal warmth, two composite
      measures of the quality of mother-infant relationship that reflect a possessive
      and attentive maternal style. Evaluation of the correlations between maternal
      rank and scratching before and after parturition indicated that interactions with
      their infants, not those with other group companions, were the main source of
      anxiety for the mothers. These results support the notion that anxiety influences
      maternal style in monkeys and suggest that studies aimed at investigating
      physiological and social correlates of maternal emotionality in nonhuman primates
      could use scratching as a useful and simple behavioral measure.

PMID- 1759949
TI  - Effects of systemic glucose injection on the development of amygdala kindling in
      rats.
AB  - The effects of systemic glucose administration on the development of electric
      amygdaloid kindling seizures were examined in Wistar rats. Daily intraperitoneal
      injections of glucose 100 mg/kg, 20 min prior to each amygdaloid stimulation did
      affect the rate of kindling development in comparison with the saline-injected
      group. The number of stimulations required to reach stage 5 was lower in animals
      treated with glucose. The facilitation of kindling development found in glucose
      treated rats is related to a specific decrease in the number of stimulations
      needed to evolve from stage 2 to stage 3. These results indicate that systemic
      glucose administration facilitates amygdaloid kindling in rats.

PMID- 1759950
TI  - The effect of flumazenil on acquisition, retention, and retrieval of spatial
      information.
AB  - The effect of flumazenil, a benzodiazepine-receptor antagonist, was evaluated in
      a spatial-reference memory procedure in a water maze. Flumazenil (1.0, 3.0, and
      10.0 mg/kg, ip) did not modify acquisition of spatial information. Retention was
      similar between control and experimental rats 24 h after the training phase, as
      all groups showed bias to the target quadrant in a free swim trial. However, 10
      days later, only flumazenil-injected rats (3.0 mg/kg) showed bias to the target
      quadrant. Flumazenil did not affect retrieval of spatial information in a group
      of well-trained rats. These results suggest that a benzodiazepine-receptor
      mediated endogenous mechanism is activated during learning of spatial tasks and
      that its blockade facilitates retention of spatial information.

PMID- 1759951
TI  - The factorial structure of sleep dissatisfaction.
AB  - Research into sleep problems has been dominated by a number of theoretical
      perspectives from each of which useful treatment applications have been derived.
      However, the rich diversity of problems that are subsumed under insomnia or sleep
      disturbance often remain unappreciated. This paper reports the results of a
      factor analysis performed on the combined items of two questionnaires designed to
      assess sleep disturbance. Six factors are described, two of which relate to
      cognitive aspects of sleep disturbance; two which map onto sleep onset and sleep
      maintenance problems; and two which are drawn from dissatisfaction with poor
      sleep. Correlations of factor scores with measures of neuroticism, worry and
      various sleep history variables provide a strong level of construct validity. The
      results are discussed in terms of their treatment implications.

PMID- 1759952
TI  - Time series analysis of obsessional behavior and mood during self-imposed delay
      and response prevention.
AB  - Time series analysis of more than a year of daily self-report of three subjects
      showed that self-imposed delay and response prevention was effective in
      decreasing obsessions and compulsions. The subject-controlled treatment had a
      varied effect on mood-anxiety decreased in two subjects, but depression increased
      in one. (A similar worsening of mood after elimination of obsessional behavior
      was found in a previous case study.) Apparently, successful treatment of
      obsessional behavior will not necessarily lead to an improvement in mood.
      Concurrent mood symptoms need to be targeted separately; and, plans should be
      made to deal with mood symptoms that may occur once obsessional behavior is
      removed.

PMID- 1759953
TI  - Responses to novelty in phobic and non-phobic cynomolgus monkeys: the role of
      subject characteristics and object features.
AB  - In two previous studies it has been shown that most surrogate-reared cynomolgus
      monkeys became phobic of a harmless object (a big paper bag) while most mother
      reared monkeys approached that object. Results of the first study seemed to
      indicate that the phobic reaction was restricted to the bag. Barnett and Cowan
      (Interdisciplinary Science Review, 1, 43-62, 1976) and Suomi (Anxiety disorder in
      childhood, pp. 1-23, 1986), however, reported that subjects (respectively rats
      and monkeys) that avoided a first novel object also avoided subsequent novel
      objects. In the present study we exposed phobic (bag-avoiding) and non-phobic
      (bag-approaching) monkeys from the study by Roder, Timmermans and Vossen
      (Behaviour Research and Therapy, 27, 221-231, 1989) to several big and small
      novel objects. Our results show that, irrespective of their rearing conditions,
      subjects that were phobic also avoided big novel objects while subjects that were
      non-phobic approached big novel objects. The reaction to small novel objects was
      independent of the previous reaction to the bag.

PMID- 1759954
TI  - Cognitive bias in symptomatic and recovered agoraphobics.
AB  - Symptomatic agoraphobics, recovered agoraphobics, and normal control subjects
      completed a series of sentence stems that had either ambiguous or unambiguous
      meanings, and had either a potentially threatening or a nonthreatening
      connotation. The written completions made by subjects to these stems were
      classified as indicating either a biased (i.e. threat-related) or unbiased
      interpretation of the meaning of the stem, and if a biased interpretation was
      made, whether the subject indicated efforts at adaptive coping with the perceived
      threat. Results indicated that symptomatic agoraphobics exhibited strong biases
      for interpreting information as threatening, relative to normal control subjects.
      Moreover, recovered agoraphobics resembled symptomatic agoraphobics more than
      normal control subjects, thus indicating that cognitive biases may persist
      following cessation of panic attacks and reductions in avoidance behavior.
      However, recovered agoraphobics also exhibited tendencies to cope adaptively with
      perceived threats whereas symptomatic agoraphobics did not.

PMID- 1759955
TI  - The effects of incorrect pain expectations on acquired fear and pain responses.
AB  - Previous experimental research on the effects of incorrect intensity expectations
      of aversive events can be criticized because intensity expectations were not
      manipulated independently from changes in objective intensity. The present study
      aims at investigating the effects of incorrect intensity expectations on the
      immediate and later responses to a painful stimulus, and on the acquisition of
      anticipatory responses, with proper experimental control. Subjects (n = 62)
      received 20 painful stimuli of varying intensity. In the control group
      intensities were correctly signalled on all trials by an analogue signal. On 3
      trials the signal was too large in the overprediction condition, and too small in
      the underestimation condition. Underpredicted painful experiences were related to
      subsequent higher pain responses on the physiological level, but not on the
      subjective level; and to increased anticipatory responses (increased pain
      expectations, uncertainty, subjective fear, skin conductance responses). Skin
      conductance level also indicated increased fear after underpredicted experiences.
      Overpredicted painful experiences were related to a faster decrease in subjective
      fear compared to the control group, but did not influence other variables. The
      findings support the notion that underpredictions contribute to the acquisition
      of fear and disrupt habituation processes. The asymmetrical processing of the two
      kinds of incorrectly predicted experiences is discussed.

PMID- 1759956
TI  - Cognitive-behavioral treatment with and without response prevention for bulimia.
AB  - We compared cognitive-behavior therapy (CBT) with and without exposure and
      response prevention (ERP) in the treatment of eating disorder patients who both
      binged and purged, and reported abnormal attitudes concerning body weight and
      shape. Both treatments produced significant and comparable reductions in binge
      eating and purging, eating patterns, and attitudes about weight and shape at
      posttreatment. Treatment effects were generalized to improvements in different
      measures of general psychopathology, and were maintained over follow-ups of 3 and
      12 months. The findings are consistent with prior research showing that CBT is an
      effective treatment for patients with the core features of bulimia nervosa.
      Furthermore, the data suggest that the addition of in-session exposure and
      response prevention does not enhance the effectiveness of the basic CBT program.

PMID- 1759957
TI  - Cognitive intrusions in a non-clinical population. I. Response style, subjective
      experience, and appraisal.
AB  - The present study identified distinctive response styles to unpleasant cognitive
      intrusions to further understanding of intrusive phenomena similar to those
      observed in obsessive-compulsive disorder and other anxiety disorders. Response
      styles were studied among 125 university students who completed a questionnaire
      describing and evaluating seven cognitive intrusions and inventories of
      depressive, anxious, and compulsive symptoms. Almost all subjects (99%) reported
      intrusions and 92% included effortful strategies in response to intrusions in
      their repertoire. Large differences were observed in the dominant strategy used.
      Three distinctive dominant response styles were identified including no effortful
      response (26%) and two effortful styles, attentive thinking (34%), and
      escape/avoidance (40%). The two groups using effortful strategies were more
      anxious and reported more difficulty removing intrusions. The group using
      escape/avoidance strategies reported more sadness, worry, guilt, and disapproval
      than subjects reporting no effortful response. The attentive thinking group
      reported more varied forms and more frequently triggered intrusions then the no
      effortful response group. Within subject analyses support the group comparisons
      and showed that intrusions eliciting escape/avoidance strategies were evaluated
      more disapprovingly than thoughts eliciting attentive thinking. The results are
      discussed in terms of Salkovskis' (Behavior Research and Therapy, 27, 677-682,
      1985) formulation of obsessive-compulsive disorder and Borkovec's (Journal of
      Consulting and Clinical Psychology, 23, 481-482, 1985) and Barlow's (Anxiety and
      its disorders: The nature and treatment of anxiety and panic, 1988) discussions
      of worry and generalized anxiety.

PMID- 1759958
TI  - Biased cognitive operations in anxiety: accessibility of information or
      assignment of processing priorities?
AB  - There is considerable evidence that anxiety is associated with a cognitive bias
      favouring the processing of threat-related information. Bower's (1981) network
      model attributes this bias to the enhanced availability of mood congruent
      information from memory. However, certain experimental tasks do not reveal such a
      bias, when this effect is strongly predicted by the model. We note that all tasks
      which have demonstrated such mood congruent processing effects in anxious
      subjects share the requirement that these subjects must assign priorities to
      simultaneously available, and differentially valenced, alternative processing
      options. This feature has been consistently lacking in those paradigms we have
      found insensitive to the influence of anxiety. It is therefore suggested that
      anxiety is associated with the assignment of high processing priorities to threat
      related options, rather than with the facilitated availability of threat-related
      information from memory. This proposal was experimentally tested using a lexical
      decision task, which is sensitive to the accessibility of information from
      memory, under conditions which either do or do not introduce the requirement to
      assign priorities to alternative processing options. The results indicate that
      the facilitated processing of threat related stimulus words, shown by generalised
      anxiety patients, does indeed appear to reflect a bias in the assignment of
      processing priorities, rather than the enhanced availability of this information
      from memory.

PMID- 1759959
TI  - The effects of voluntary hyperventilation on patients with chest pain without
      coronary artery disease.
AB  - The present investigation was designed to examine panic symptom experience in
      patients with chest pain of nonorganic etiology, using a hyperventilation
      provocation procedure. Given the recent focus on panic disorder in patients with
      nonorganic chest pain, we assessed three indices of physiological arousal,
      subjective anxiety, and endorsement of DSM-III-R panic symptomatology in response
      to 3 min of voluntary hyperventilation. Subjects included 23 patients with
      nonorganic chest pain (CP sample) and matched normal controls (NC sample). The
      results indicate that hyperventilation produced significant increases in skin
      conductance, heart rate, and upper trapezious EMG in both CP and NC samples.
      Despite equivalent levels of physiological arousal and subjective anxiety, the CP
      sample endorsed a greater number of DSM-III-R panic symptoms relative to the NC
      sample. Examination of post-hyperventilation symptoms indicated that a greater
      percentage of the CP sample reported palpitations, nausea, and chest pain when
      compared with normals. Comparison of CP patients with and without Panic Disorder
      revealed no significant differences on any measure. The results suggests that
      hyperventilation plays a role in symptom experience in patients with nonorganic
      chest pain, although anxiety does not appear central in moderating this effect.

PMID- 1759960
TI  - The contribution of music vs instructions in the Musical Mood Induction
      Procedure.
AB  - The relative contribution of the instructions and the music to the effects of the
      Musical Mood Induction Procedure (MMIP) were investigated. Using an experimental
      procedure which minimised covert experimenter bias, subjects performed under both
      elation and depression mood inductions in one of four conditions: music present
      or absent by mood change instructions present or absent, using a crossover
      design. Results indicated that instructions were both necessary and sufficient to
      produce change on mood sensitive measures. Mood change effects were reduced by
      controlling for the effect of subjects who responded so as not to 'louse-up' the
      experiment. The MMIP seems to be much less musical than the name implies. Further
      research is needed to determine which aspects of the instructions contribute most
      to the changes on mood sensitive measures.

PMID- 1759961
TI  - A standardized behavioral group treatment program for obsessive-compulsive
      disorder: preliminary outcomes.
AB  - This paper provides outcome data about the efficacy of a behavioral group therapy
      program for obsessive-compulsive disorder (OCD). Thirty-six patients completed a
      7-week outpatient treatment program which provides: (1) education about OCD and
      its treatment, (2) instruction in a cognitive and behavioral approach to the self
      treatment of OCD and (3) guided behavioral treatment. Significant improvement in
      obsession, compulsion, and depression scores were observed at completion of the
      group and at 3 month follow-up. Significant improvement in obsessions and
      compulsions was observed for both patients taking anti-obsessional medications
      and those who did not.

PMID- 1759962
TI  - Inactivation of 15-lipoxygenases by acetylenic fatty acids.
AB  - The inactivation of soybean lipoxygenase-1 and of rabbit reticulocyte
      lipoxygenase by five selected acetylenic fatty acids was studied. In all cases
      the inactivation was time-consuming and depended on the concentration of the
      inactivator. The inactivation kinetics was measured and the data were fitted to a
      kinetic model based on the assumption of catalytic self-inactivation. The kinetic
      constants (Km-value and inactivation rate k2) calculated indicated that 7,10,13
      eicosatrienoic acid was the most powerful inactivator for the soybean enzyme
      followed by 8,11,14-eicosatrienoic acid. The occurrence of an additional triple
      bond between C-4 and C-5 or between C-5 and C-6 strongly reduced the suicidal
      rate. With the reticulocyte enzyme, only small differences in the reactivities
      towards various acetylenic fatty acids have been observed.

PMID- 1759963
TI  - Intramitochondrial fatty acid activation enhances control strength of adenine
      nucleotide translocase.
AB  - In incubations with isolated rat liver mitochondria we studied the fuel
      properties of octanoate as medium-chain fatty acid and respiratory substrate and
      the extent of control exerted by adenine nucleotide translocase on mitochondrial
      respiration. While, compared with pyruvate, octanoate improved the hydrogen
      supply in the active state to be seen from a high reduction of the mitochondrial
      NAD(P) system and an increased delta psi, it also decreased the efficiency of
      energy transduction indicated by a low ADP/O ratio. Based on measurements of the
      dependence of respiration on the extramitochondrial ATP/ADP ratio, we conclude
      that a switch-over from pyruvate to fatty acid oxidation does not change the
      kinetic parameters which make respiration respond to the ATP/ADP ratio. It is
      shown that the decrease of the exchangeable intramitochondrial adenine nucleotide
      pool due to the activation of octanoate results in a decrease of the activity of
      the adenine nucleotide translocase and an increase of its flux control
      coefficient.

PMID- 1759964
TI  - Multiple forms of N-acetyl-beta-D-glucosaminidase of human urine: isolation,
      properties and the development of a practical approach of differentiation.
AB  - The two major tissue forms of N-acetyl-beta-D-glucosaminidase, A and B, and a
      minor form M were isolated from human urine by chromatography on DEAE-Trisacryl M
      and Con A-Sepharose. Forms A and B have a Km-value of about 0.75 mM for 4
      nitrophenyl-beta-2-acetamido-2-deoxy-D-glucopyranoside, form M a corresponding
      value of 1.57 mM. The pH optimum was for all forms between pH 4.0 and 4.8. Forms
      A and M were heat labile, while form B was relatively heat stable. Using
      different binding properties of forms A and B on Trisacryl, a batch method was
      developed to differentiate both forms in human urine. This method can be easily
      performed and gives reproducible results. The intra-run and between-run precision
      for the separation of the two forms were below 10%.

PMID- 1759965
TI  - The influence of valinomycin induced membrane potential on erythrocyte shape.
AB  - In addition to previous observations indicating that membrane potential changes
      generated by various Donnan- and Nernst-potentials lead to erythrocyte shape
      transformations, we show in this paper that diffusion potential change, induced
      by valinomycin, governs erythrocyte shape transformations. In low KCl-medium
      valinomycin, transferring the positive Nernst-potential into a negative diffusion
      potential, transforms stomatocytes into echinocytes. Using modified erythrocytes
      with a reversed K/Na ratio, even positive diffusion potentials can be induced by
      valinomycin. In these cases, stomatocytes can be generated by valinomycin. It is
      shown that, additionally, valinomycin in large concentrations is itself
      stomatocytogenic, and that the fluorescent dye diS-C3-(5) also induces
      stomatocytes. This, however, is a side effect which does not contradict the
      potential dependence of shape transformation. Using non washed erythrocytes,
      resuspended in plasma, valinomycin, inducing negative diffusion potential,
      transforms most erythrocytes to echinocytes despite the stomatocytogenic effect
      of albumin.

PMID- 1759966
TI  - Effect of ethanol on epidermal growth factor receptor in buccal mucosa.
AB  - The effect of ethanol on buccal mucosal epidermal growth factor receptors was
      investigated. The buccal mucosal cells from adult rats were incubated in DMEM at
      4 degrees C and 37 degrees C in the presence of various concentrations (0-5%) of
      ethanol and then assayed for EGF receptor binding using [125I]-EGF. The results
      of binding analysis showed that the cells incubated in the presence of ethanol
      displayed diminished [125I]-EGF binding. The receptor binding capacity was
      dependent upon ethanol concentration and was more pronounced at 4 degrees C. A
      30% decrease in receptor binding occurred with 1% ethanol, 34% with 2.5% ethanol,
      while 5% ethanol caused a 42% decrease in binding. Scatchard analysis suggested
      that the decrease of [125I]-EGF binding to the buccal mucosal cells pre-incubated
      with ethanol was due to a decrease of the high affinity binding site (Bmax). The
      association constant of the high affinity EGF receptor remained unchanged. The
      results suggest that ethanol due to its untoward effect on the receptor binding
      of salivary GF interferes with the process of epithelial renewal, thus leading to
      weakening of the mucosal defense perimeter of soft oral tissue and the onset of
      dysplasia.

PMID- 1759967
TI  - Influence of urea on the glucose measurement by electrocatalytic sensor in the
      extracorporeal blood circulation of a sheep.
AB  - In an animal experiment with the electrocatalytic glucose sensor, measurements
      were carried out over one week in the extracorporeal circulation of a sheep.
      Glucose tolerance tests were performed, and the influence of increased urea
      concentrations in the blood on the glucose determination was investigated. The
      sensor constructed as a flow-through cell was integrated via a vascular graft
      outside the body into the carotid artery of the animal and activated by an
      external electronic unit of measurement. The glucose concentration was determined
      by measuring the impedance of the electrode/membrane system at various
      potentials. By means of a subsequent correlation analysis of the measured values
      obtained over one week, a calibration valid for the entire measurement period was
      established. After a zero adjustment, it was even possible to adopt the
      calibration from the glucose measurement of the preceding animal experiment. The
      investigations of the influence of urea on the glucose measurement showed that
      the error in measurement of the sensor, which is 20% on average, is only
      insignificantly increased when the urea level is raised beyond the maximum
      physiological concentration.

PMID- 1759968
TI  - Changes in the hemostatic system and compensatory responses during alimentary
      hyperlipidemia.
AB  - Compensatory responses tending to prevent a thrombotic state in rats fed a high
      lipid diet have been investigated. Platelet membranes from these animals had an
      increased cholesterol content but the membrane fluidity was found to be within
      values nearly normal. A decrease in phosphatidylethanolamine was noted. These
      changes may maintain normal platelet sensitivity to aggregating agents. In fact,
      platelets from hyperlipidemic rats were hypersensitive to thrombin, but not to
      adenosine diphosphate. In addition, platelets were apparently able to correct, at
      least in part, the stated hyperactivity of hyperlipidemic plasma to coagulate, as
      shown by thrombelastographic tests in both platelet-rich plasma and plasma from
      hyperlipidemic rats. Finally, thrombelastographic features of whole blood from
      these animals were found to be normal. This suggests an important role of blood
      cells in compensating plasma hyperactivity to coagulate during hyperlipidemia.

PMID- 1759969
TI  - [The postnatal development of EMG reactions of limb muscles to free fall
      stimulation. I. Studies in normal rabbits].
AB  - The ontogenetic development of the vestibulospinal reaction following the free
      fall was studied in 11 rabbits ("Deutscher Riese") 8 to 20 days old by means of
      myographical recordings (EMG) synchronously derived from 3 muscles (M. triceps
      brachii caput lateralis, M. brachialis, M. quadriceps femoris vastus lateralis)
      by chronically implanted steel wire electrodes. With increasing age, rabbits show
      a sustained rise of EMG activity during fall and develop the ability to change
      the generated EMG activity under the condition of repeated stimulation. It is
      concluded, firstly, that more typical EMG reactions are produced with growing
      age, and secondly, that the ability to modify the intensity of the response to
      repeated free falls increases during postnatal development.

PMID- 1759970
TI  - [The postnatal development of EMG reactions of limb muscles to free fall
      stimulation. II. Studies of early postnatal hypoxic-burdoned rabbits].
AB  - 12 rabbits ("Deutscher Riese") were exposed to a hypoxic atmosphere (FiO2 = 0.05)
      for 3 h at their 1st day of life. At the 7th or 13th day of life, steel wire
      electrodes were chronically implanted into 3 leg muscles in order to record the
      electromyograms (EMG). The myographic activity was derived during free fall
      (height of drop = 0.5 m) until the age of 20 days. The quantitatively analysed
      EMG data were compared with corresponding data of undisturbed growing control
      animals. Using various EMG parameters, a quantitative separation of hypoxic
      animals from the controls was successfully done by a discriminant analysis, the
      animals being 8 and 20 days of age, respectively. It can be concluded that 1.
      already a single perinatal hypoxic load influences the supraspinal motor system
      permanently at least up to the age of 20 days, and that 2. this supraspinal
      influence on the investigated vestibulospinal reaction changes with increasing
      age of the rabbits.

PMID- 1759971
TI  - Effects of salicylate on hepatocyte lactate metabolism.
AB  - We have examined the effects of salicylate on fluxes of lactate metabolism in rat
      hepatocytes using a steady state model. Salicylate produces an uncoupling effect,
      an inhibition of gluconeogenesis, a marked activation of pyruvate dehydrogenase
      flux, and an inhibition of endogenous fatty acid oxidation. Agents with known
      functions such as dinitrophenol and dichloroacetate were also compared in this
      system. The in vitro inhibition of gluconeogenesis caused by salicylate is not
      primarily related to the uncoupling effect. The fact that octanoate, but not
      palmitate, overcomes the salicylate inhibition of gluconeogenesis suggests that
      salicylyl CoA is involved in the inhibition. To relate in vitro studies to Reye's
      syndrome in vivo, in which medium chain dicarboxylic acids accumulate, we have
      also examined the effects of monomethyl suberate on liver lactate metabolism.
      This half ester is taken up by the hepatocytes, and causes inhibition of lactate
      gluconeogenesis, and uncoupling. Both salicylate and monomethyl suberate inhibit
      the oxidation of 0.2 mM octanoate by hepatocytes.

PMID- 1759972
TI  - Changes of brain gangliosides in the frontal cortex of rats chronically treated
      with amphetamine, clozapine, haloperidol and ethanol.
AB  - Rats were injected intraperitoneally daily for 20 days with amphetamine,
      haloperidol, clozapine and ethanol to investigate the participation of
      gangliosides in the reactivity of the brain to these drugs. All of these
      substances are able to modulate the ganglioside pattern of the frontal cortex.
      The major changes were observed after amphetamine and clozapine treatment. In
      both cases, GQ1b was significantly increased, whereas GM2 and GM3 were
      significantly diminished. Moreover, GD1a (after amphetamine) and GM1 (after
      clozapine) were decreased with respect to the controls. After haloperidol
      treatment both GQ1b and GT1b augmented, while after ethanol, only GM3 was
      increased.

PMID- 1759973
TI  - Thromboxane plasma level in kappa-carrageenin-induced acronecrosis of the tail in
      rats.
AB  - The thromboxane A2 (TXA2) plasma level in kappa-carrageenin (KC)-induced
      acronecrosis in the rat tail has been studied. TXB2 as stable metabolite of TXA2
      was determined by a radioimmunoassay (RIA). 30 min after KC i.v. injection, the
      increase in the plasma TXB2 level was highest in Barby:Wistar rats but not in
      Halle:Wistar rats. Lambda-carrageenin (LC) increased the TXB2 levels in both
      strains of Wistar rats, although it did not induce acronecrosis. Drugs inhibiting
      TXB2 formation, namely dexamethasone, acetylsalicylic acid, Hoe 944, R 68070 or
      chlorpromazine, had only a small effect on acronecrosis frequency. Heparin
      inhibited TXB2 formation and acronecrosis frequency while the serotonin
      antagonist cyproheptadine decreased only the acronecrosis frequency but caused no
      change in TXB2 plasma level. These data demonstrate that the kappa-carrageenin
      induced acronecrosis is followed by an increased formation of TXA2 in rats.

PMID- 1759974
TI  - Mapping replication origins in yeast chromosomes.
AB  - The replicon hypothesis, first proposed in 1963 by Jacob and Brenner, states that
      DNA replication is controlled at sites called origins. Replication origins have
      been well studied in prokaryotes. However, the study of eukaryotic chromosomal
      origins has lagged behind, because until recently there has been no method for
      reliably determining the identity and location of origins from eukaryotic
      chromosomes. Here, we review a technique we developed with the yeast
      Saccharomyces cerevisiae that allows both the mapping of replication origins and
      an assessment of their activity. Two-dimensional agarose gel electrophoresis and
      Southern hybridization with total genomic DNA are used to determine whether a
      particular restriction fragment acquires the branched structure diagnostic of
      replication initiation. The technique has been used to localize origins in yeast
      chromosomes and assess their initiation efficiency. In some cases, origin
      activation is dependent upon the surrounding context. The technique is also being
      applied to a variety of eukaryotic organisms.

PMID- 1759975
TI  - Gene expression, cellular diversification and tumor progression to the metastatic
      phenotype.
AB  - Alterations in the expression of certain genes or in their products can render
      benign tumor cells metastatic. Experimentally this has been quickly performed by
      transferring dominantly acting oncogenes such as c-H-rasEJ into susceptible
      cells, but in vivo such a rapid qualitative change in a dominantly acting
      oncogene occurs only rarely, and progression to highly metastatic phenotypes is
      thought to occur through a slow stepwise process. Such slow changes can be
      reversible and need not involve known dominantly acting oncogenes, consistent
      with clinical observations. An important element of the natural progression of
      tumors to malignancy may be their ability to circumvent microenvironmental
      controls that regulate growth and cellular diversity and to evolve into
      heterogeneous phenotypes, a process that appears to involve mainly quantitative
      changes in gene expression but which can be rapidly stimulated in cell culture by
      the introduction of a dominantly acting oncogene. It is proposed that the highly
      malignant cells that have slowly evolved in vivo with only a few qualitative gene
      changes have undergone extensive cycles of diversification and accumulation of
      quantitative changes in the expression of genes that encode products that are
      related to malignancy and metastasis. Thus, highly malignant cellular phenotypes
      can arise quickly through specific qualitative changes in critical controlling
      genes or more slowly by less critical qualitative genetic changes, coupled with
      cellular diversification and accumulation of quantitative changes in gene
      expression.

PMID- 1759976
TI  - Discovery of the 9 + 2 subfibrillar structure of flagella/cilia.

PMID- 1759977
TI  - Cancer promotion in a mouse-skin model by a 60-Hz magnetic field: I. Experimental
      design and exposure system.
AB  - The rationale for selection of an animal model, the experimental design, and the
      design and evaluation of an exposure system used in studies of 60-Hz magnetic
      fields are described. The studies were conceived to assay development of cancer
      and immune responsiveness in mice exposed to magnetic fields. The exposure system
      utilized a quadrupole-coil configuration to minimize stray magnetic fields. Four
      square-wound coil provided a uniform field within a volume occupied by 16 animal
      cages. The magnetic field had a mean flux density of 2 mT that varied less than
      +/- 10% within the volume occupied by animals' cages. The flux density decreased
      to less than 0.1 microT at a distance of 2 m from the coils. In each exposure
      system 32 animals could be housed in plastic cages.

PMID- 1759978
TI  - Cancer promotion in a mouse-skin model by a 60-Hz magnetic field: II. Tumor
      development and immune response.
AB  - This paper describes preliminary findings on the influence of 60-Hz (2-mT)
      magnetic fields on tumor promotion and co-promotion in the skins of mice. The
      effect of magnetic fields on natural killer (NK) cell activity in spleen and
      blood was also examined. Groups of 32 juvenile female mice were exposed to the
      magnetic field as described in part I. The dorsal skin of all animals was treated
      with a subthreshold dose of the carcinogen 7,12-dimethyl-benz(a)anthracene
      (DMBA). One week after the treatment, two groups were sham exposed (group A) or
      field exposed at 2 mT (group B) 6 h/day for 21 weeks, to test whether the field
      would act as a tumor promoter. No tumors developed in these two groups of mice.
      To test whether the magnetic field would modify tumor development by directly
      affecting tumor growth or by suppressing immune surveillance, two additional
      groups of mice were treated weekly with the tumor promoter 12-0
      tetradecanoylphorbol-13-acetate (TPA) and then either sham exposed (group C) or
      field exposed (group D). The time to appearance of tumors was shorter (but not
      statistically so) in the group exposed to magnetic fields and TPA. Some
      differences in NK cell activity and spleen size were observed between the sham-
      and field-exposed groups.

PMID- 1759979
TI  - Absence of a synergistic effect between moderate-power radio-frequency
      electromagnetic radiation and adriamycin on cell-cycle progression and sister
      chromatid exchange.
AB  - In our laboratories we are conducting investigations of potential interactions
      between radio-frequency electromagnetic radiation (RFR) and chemicals that are
      toxic by different mechanisms to mammalian cells. The RFR is being tested at
      frequencies in the microwave range and at different power levels. We report here
      on the 1) ability of simultaneous RFR exposures to alter the distribution of
      cells in first and second mitoses from that after treatment by adriamycin alone,
      and 2) on the ability of simultaneous RFR exposure to alter the extent of sister
      chromatid exchanges (SCEs) induced by adriamycin alone. This chemical was
      selected because of its reported mechanism of action and because it is of
      interest in the treatment of cancer. In our studies, Chinese hamster ovary (CHO)
      cells were exposed for 2 h simultaneously to adriamycin and pulsed RFR at a
      frequency of 2,450 MHz and a specific absorption rate of 33.8 W/Kg. The maximal
      temperature (in the tissue-culture medium) was 39.7 +/- 0.2 degrees C. The
      experiments were controlled for chemical and RFR exposures, as well as for
      temperature. Verified statistically, the data indicate that the RFR did not
      affect changes in cell progression caused by adriamycin, and the RFR did not
      change the number of SCEs that were induced by the adriamycin, which adriamycin
      is known to affect cells by damaging their membranes and DNA.

PMID- 1759980
TI  - Morphological and electrophysiological changes produced by electrical stimulation
      in cultured neuroblastoma cells.
AB  - Electric fields, which were equivalent to those generated by medical devices,
      were applied to cultured neuroblastoma cells (mouse and human) to test for
      morphological damage and to establish damage thresholds. Each of two methods of
      applying fields permitted flow of electrical current and minimized exposure of
      cells to electrode-breakdown products. One method consisted of a pair of parallel
      wires in a Petri dish by which current was delivered within a fixed volume of
      flowing tissue-culture media. With the other method, the cells were held in a
      confined geometrical chamber and current was applied via agar bridges. Under a
      given set of stimulation parameters, damage was found to be variable from cell to
      cell. By changing the strength of the electric field (frequency and duration of
      stimulation held constant), thresholds of several V/cm were found above which
      cell damage could be reliably produced. Depending on the intensity of the field,
      damage took the form of cell lysis or damage to neurites. Intracellular
      recordings from the mouse neuroblastoma cells revealed a correlation between a
      decline in resting transmembrane potential and stimulus intensity. Human
      neuroblastoma cells were less susceptible to damage than were the mouse
      neuroblastoma cells, given the same strength of applied electric fields.

PMID- 1759981
TI  - Modification of the 1979 "Denver wire code" for different wire or plumbing types.
AB  - This article examines "wire configuration coding" as used to estimate relative
      residential AC magnetic field exposure in epidemiological studies--and the need
      to alter such coding for time or locations other than those in which the code was
      developed. Effects of different secondary wire practices are particularly
      examined.

PMID- 1759982
TI  - Vascular smooth muscle cells from genetically hyperlipidemic rabbit (WHHL rabbit)
      exhibit decreased growth response.
AB  - The Watanabe Heritable Hyperlipidemic (WHHL) rabbit is a widely studied animal
      model for the human genetic disorder familial hypercholesterolemia, and
      spontaneously develops atherosclerotic disease. We studied the growth
      characteristics of cultured vascular smooth muscle cells (VSMC) from WHHL rabbits
      compared with VSMC from Japanese white rabbits. We measured cell proliferation,
      DNA synthesis, and c-myc proto-oncogene expression, in response to growth stimuli
      such as fetal bovine serum (FBS) and platelet-derived growth factor (PDGF). VSMC
      from Japanese white rabbits exhibited a 4-fold increase in cell numbers during a
      5-day incubation period compared with those from WHHL rabbits. FBS and PDGF
      stimulated DNA synthesis, as measured by thymidine incorporation into VSMC, in
      both Japanese white rabbits and WHHL rabbits, however the response was
      significantly higher in the former strain. The intracellular pH value of VSMC
      determined using the pH-sensitive fluorescence dye 2',7'-bis-carboxyethyl
      carboxyfluorescein was significantly higher in WHHL rabbits than in Japanese
      white rabbits. Proto-oncogene c-myc was induced by exposure of VSMC to FBS,
      however there was no significant difference in c-myc mRNA levels between the two
      strains. These results suggest that VSMC from WHHL rabbits are not genetically
      growth accelerated, but show decreased growth response to growth stimuli.

PMID- 1759983
TI  - The PLAT Study: a multidisciplinary study of hemostatic function and conventional
      risk factors in vascular disease patients.
AB  - In this paper are reported the basal results of a multidisciplinary, multicenter
      study designed to explore in a population with ischemic disease the relation
      between hemostatic variables, conventional risk factors and atherothrombotic
      sequelae. 953 patients less than or equal to 69 yrs with documented coronary,
      cerebral or peripheral atherosclerotic disease were studied and followed-up for
      24 months. Examinations included hemostatic and lipid laboratory assays, arterial
      Doppler examination, cerebral computerized tomography and nuclear magnetic
      resonance, exercise electrocardiogram and coronary angiography. Fibrinogen (301.4
      +/- 71.52 mg/dl) correlated positively with antithrombin III (r = 0.27) and
      leukocytes (r = 0.25), negatively with HDL-cholesterol (r = 0.18) and tended to
      increase with smoking. Heavy smokers had higher leukocyte counts than non-smokers
      (8.0 +/- 2.0 vs. 7.2 +/- 2.1 x 10(3)/microliters), higher triglycerides (1.87 +/-
      1.12 vs. 1.53 +/- 1.35 mmol/l) and lower HDL-cholesterol (0.93 +/- 0.27 vs. 1.00
      +/- 0.25 mmol/l). FVII correlated positively with triglycerides (r = 0.16) and
      protein C (r = 0.45). vWF:Ag (145.4 +/- 70.58%) ad FVII:C (139.7 +/- 59.10%) were
      positively correlated (r = 0.44). FVIII:C correlated positively with fibrinogen
      (r = 0.21). Myocardial infarction survivors with associated cerebral and
      peripheral vascular lesions had higher FVIII:C, FVII, fibronogen and vWF:Ag.
      These findings suggest that hemostatic factors may enhance and/or mediate the
      effects of conventional risk factors in atherothrombotic ischemic events.

PMID- 1759984
TI  - Fish oil ingestion in smokers and nonsmokers enhances peroxidation of plasma
      lipoproteins.
AB  - The effect of fish oil ingestion (10 g MaxEPA/day) on the susceptibility of
      plasma lipoproteins to peroxidation was examined in 20 smokers (study A and B)
      and 22 nonsmokers (study C). The subjects were examined at the onset of each
      study (baseline values), divided into control and experimental groups and
      reexamined 4 weeks later. Smokers were examined 40 h after abstention from
      smoking (0 time) and 90 min after acute smoking (4-6 cigarettes). The parameters
      studied were TBARS, which provide an indication of peroxidative injury, and
      metabolism of conditioned LDL by macrophages as a biological indicator. These
      parameters were significantly higher (P less than 0.05-0.001) when the 90 min
      values of smokers were compared to time 0. After 4 weeks of fish oil ingestion, a
      significant rise above baseline values (33-50%) in plasma and LDL TBARS was found
      in smokers examined at time 0 and after acute smoking. Peroxidative modification
      of LDL isolated from smokers fed fish oil resulted in significantly higher TBARS
      (34-41%) and its metabolism by macrophages was higher (65-139%) compared to
      baseline values. In nonsmokers, the baseline values of the above parameters were
      lower than in smokers. Ingestion of fish oil resulted in a significant rise in
      TBARS in plasma (33%), LDL (137%), conditioned LDL (36-40%) and metabolism of
      conditioned LDL (70%) by macrophages. In 6 nonsmokers and 4 smokers, 400 mg of
      vitamin E/day were given with the fish oil. In the nonsmokers, vitamin E
      counteracted the effect of fish oil more effectively than in the smokers. In the
      light of the present results, indiscriminate recommendation of fish oil
      supplementation to the population at large should be cautioned.

PMID- 1759985
TI  - Effect of clentiazem on lipid profile, lipoprotein composition and aortic fatty
      streaks in cholesterol-fed rabbits.
AB  - Numerous experimental studies have reported that common antihypertensive drugs
      such as diuretics, beta-blockers, and methyldopa have adverse effects on plasma
      lipids and lipoproteins. The present study was designed to define the effect of
      clentiazem (10 mg/kg/day) an antihypertensive drug, on hyperlipidemia in rabbits
      on a cholesterol-rich diet (1%) for 12 weeks. Compared with controls, clentiazem
      treated rabbits had lower plasma concentrations of triglycerides (55%), total
      cholesterol (24%), free cholesterol (27%), esterified cholesterol (23%) and
      phospholipids (24%). The decrease in cholesterol was accounted for by a reduction
      of VLDL-cholesterol (13%), IDL-cholesterol (24%) and primarily LDL-cholesterol
      (45%). Neither HDL-cholesterol nor chemical composition of VLDL, IDL, LDL and HDL
      was altered. When the aortic atherosclerotic involvement was evaluated by
      computerized planimetry, a 24% reduction of lesions was noted in clentiazem
      treated animals (P less than 0.05). Similarly, cholesterol content extracted from
      aortic wall was decreased. Our data therefore demonstrated that clentiazem is a
      potential antiatherosclerotic agent capable of decreasing plasma lipids and
      atherogenic lipoproteins as well as aortic fatty streaks.

PMID- 1759986
TI  - Different locations of cholesteryl ester transfer protein and phospholipid
      transfer protein activities in plasma.
AB  - Activities of cholesteryl ester transfer protein (CETP) and phospholipid transfer
      protein (PLTP) were measured in plasma of four vertebrate species: man, rabbit,
      pig, and rat. The activities were measured in the absence and presence of
      antibodies raised against purified human CETP. PLTP activities were present in
      all four species with highest values in pig (11.7 +/- 1.2 U/ml) and human plasma
      (9.2 +/- 1.6 U/ml). Considerable lower activities were found in rabbit (3.5 +/-
      0.6 U/ml) and rat plasma (1.6 +/- 0.7 U/ml). These activities were not affected
      significantly by antibody against human CETP. CETP activities could be measured
      in human (0.23 +/- 0.05 U/ml) and in rabbit plasma (0.19 +/- 0.03 U/ml). CETP
      activity in human plasma was inhibited over 97% by antibody against human CETP.
      Plasma was chromatographed on a Superose 6 gel filtration column. Average HDL
      particle sizes in the four species differed notably and decreased in the order:
      rat HDL greater than rabbit HDL greater than human HDL greater than pig HDL. A
      separation of the two lipid transfer activities was evident after gel filtration
      chromatography. The peak of the PLTP activity coeluted with a fraction of HDL
      particles with the size of human HDL2 (particle weights 300-375 kDa). CETP
      activity in human and rabbit plasma coeluted largely with relatively small HDL
      particles (particle weights 140-180 kDa). These results show that CETP and PLTP
      activities are located in different macromolecular complexes.

PMID- 1759987
TI  - Human monocyte characteristics are altered in hypercholesterolaemia.
AB  - Peripheral blood monocytes are involved during atherogenesis in adhering to
      endothelium, migrating into the subendothelial space and taking-up lipoproteins
      to become macrophage/foam cells. We have assessed whether peripheral blood
      monocyte characteristics are altered in human hyperlipidaemia in age/sex/smoking
      status matched pairs of patients and controls. Monocytes from the
      hypercholesterolaemic patients, as opposed to the controls, were more sensitive
      to stimulation by the agonist, N-formyl-methionyl-leucyl-phenylalanine, with
      respect to chemokinesis (stimulation index 1.48 +/- 0.17 vs. 1.10 +/- 0.14),
      chemotaxis (4.05 +/- 0.55 vs. 2.72 +/- 0.24) and adhesion to porcine aortic
      endothelial monolayers (1.26 +/- 0.05 vs. 1.17 +/- 0.06). The patients' monocyte
      total surface expression of the adhesion glycoprotein CD11b/CD18 (37.5 +/- 7.1
      vs. 36.0 +/- 7.1), but not CD11c/CD18 (31.6 +/- 7.2 vs. 31.4 +/- 6.8), was
      increased; however, the monocytes in hyperlipidaemia were larger (9.15 +/- 0.11
      microns vs. 8.98 +/- 0.11 microns) such that the surface density of CD11b/CD18
      was not altered (0.144 +/- 0.029 vs. 0.142 +/- 0.029). The data suggest that
      circulating monocytes are functionally different in hypercholesterolaemia. This
      may explain the increased involvement by monocytes in hypercholesterolaemia
      related atherogenesis.

PMID- 1759988
TI  - Effects of sympathetic nerves on collateral vessels in the limb of
      atherosclerotic primates.
AB  - This study was performed to examine effects of sympathetic nerves on collateral
      vessels in the limb. We studied normal (N) and atherosclerotic (AS) cynomolgus
      monkeys that were fed atherogenic diet for 21 months. A common iliac artery was
      ligated 13 months before hemodynamic measurements. Using histofluorescence
      microscopy, a plexus of noradrenergic nerves was identified in the adventitia of
      collateral vessels. We measured blood flow to the limb with microspheres, and the
      pressure gradient from aorta to the iliac artery beyond the occlusion. The lumbar
      sympathetic chain was stimulated electrically at 3 Hz (SNS-3) and 15 Hz (SNS-15).
      In normal monkeys, conductance of collateral vessels (in ml/min per 100 g per 100
      mm Hg) was 19 +/- 3.6 (mean +/- SE) during control, 14 +/- 1.6 during SNS-3, and
      9.8 +/- 0.9 during SNS-15 (P less than 0.05 vs control). In AS monkeys,
      collateral conductance was 12 +/- 2.9 during control, 7.5 +/- 1.7 during SNS-3
      and 3.9 +/- 1.8 during SNS-15 (P less than 0.05). In summary, collateral vessels
      in the limb are innervated and sympathetic stimulation produces pronounced
      constriction of collateral vessels in both normal and atherosclerotic monkeys.
      Thus, the effectiveness of collateral vessels in maintaining blood flow to the
      limb may be compromised by increased activity of sympathetic nerves.

PMID- 1759989
TI  - Serum lipoprotein lipid concentration and composition in homozygous and
      heterozygous patients with cholesteryl ester transfer protein deficiency.
AB  - Six homozygous, 10 heterozygous and 8 unaffected subjects in a CETP deficient
      family confirmed by CETP gene analysis were studied to characterize serum
      lipoproteins separated by ultracentrifugation, and to examine the relations
      between CETP levels and lipoprotein lipid concentration and composition. The
      serum CETP levels were measured by radioimmunoassay using 125I-labeled monoclonal
      antibodies (TP2). The serum CETP levels in the homozygotes were undetectable and
      those in the heterozygotes were significantly lower than those in the unaffected
      subjects (1.5 +/- 0.1 vs. 2.2 +/- 0.5 microgram/ml, P less than 0.01). In the HDL
      fraction, esterified cholesterol (EC) levels in the homozygotes were
      significantly increased (P less than 0.01), and those in the heterozygotes were
      slightly increased (n.s.), in comparison with those in the unaffected and the
      normolipidemic controls. The EC levels in the IDL fractions were lower in the
      homozygotes than in the normolipidemic controls. The EC/triglyceride (TG) molar
      ratios in IDL, the fraction obtained from the homo- and heterozygotes, were lower
      than those from the unaffected subjects (P less than 0.01 and less than 0.01,
      respectively), and the EC/TG ratios in the HDL fraction obtained from the homo-
      and heterozygotes were higher than those from the unaffected subjects (P less
      than 0.01 and n.s., respectively). Linear regression analysis showed that
      positive correlates of the serum CETP levels in all subjects were: IDL-EC (r =
      0.463), HDL-TG (r = 0.603) and VLDL- and IDL-EC/TG ratio (r = 0.698 and
      0.843).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1759990
TI  - A 21-aminosteroid inhibits oxidation of human low density lipoprotein by human
      monocytes and copper.
AB  - Oxidation of low density lipoprotein (LDL) leads to more rapid uptake by arterial
      wall macrophages and foam cell formation. Inhibiting LDL oxidation may impede
      these processes and offers a new mechanism to retard atherogenesis. The 21
      aminosteroids, derived from methylprednisolone, are potent inhibitors of free
      radical production by stimulated monocytes and also are scavengers of lipid
      peroxyl radicals. The 21-aminosteroid, U74500A, was added to a mixture of low
      density lipoprotein cholesterol and human monocytes to which lipopolysaccharide
      was add to stimulate the monocytes. At a final concentration of 10 microM,
      U74500A reduced the production of lipid peroxidation from 6.10 +/- 1.11 to 0.84
      +/- 0.16 nmol (mean +/- SEM) MDA equivalent/1 x 10(6) monocytes, as measured by a
      thiobarbituric acid reacting substance (TBARS) assay. Similarly 10 microns
      U74500A reduced Cu2+ induced LDL oxidation from 12.28 +/- 0.10 (in vehicle) to
      0.49 +/- 0.12. These observations suggest that the 21-aminosteroids should be
      evaluated in animal models as a potential therapy to retard atherogenesis,
      especially considering their apparent lack of mineralocorticoid and
      glucocorticoid side-effects.

PMID- 1759991
TI  - Chemotaxis of the monocyte cell line U937: dependence on cholesterol and early
      mevalonate pathway products.
AB  - In the present study we investigated the influence of cholesterol depletion and
      hydroxymethylglutaryl-coenzyme A reductase (HMG-CoA reductase) inhibition on
      chemotaxis of the human monocytic cell line U937. Chemotaxis was nearly
      completely depressed after incubation for 24 h in the absence of lipoproteins.
      This was accompanied by a significant decrease in cellular cholesterol. Addition
      of 10 micrograms/ml low density lipoprotein (LDL) for 2 h to the cholesterol
      depleted cells restored chemotaxis. Free cholesterol had no effect under these
      conditions. Inhibition of HMG-CoA reductase by pravastatin (0.01-1.0 mM) for 20
      or 72 h also reduced chemotaxis. However, this effect was not accompanied by a
      decrease in cellular cholesterol when cells were grown in the presence of
      lipoproteins. The effect of pravastatin could be reversed by the addition of
      mevalonate. Addition of LDL did not change the response to pravastatin. We
      propose that the availability of cholesterol plays an important role in cellular
      chemotaxis. Furthermore, it can be suggested that other products of the
      mevalonate pathway apart from cholesterol may contribute to the regulation of
      chemotaxis.

PMID- 1759992
TI  - Pathology of atherosclerosis in cholesterol-fed, susceptible mice.
AB  - In recent years the C57BL/6J mouse has gained popularity as a model for studying
      the genetics of diet-induced atherosclerosis. After 10-20 weeks of consuming a
      diet enriched with saturated fat and cholesterol, it develops fatty streak-like
      lesions in the valve sinus region of the ascending aorta. The current study shows
      that continuing the atherogenic diet for a further 15 weeks leads to the
      development of fibro-fatty lesions which have many of the characteristics of
      human atheromatous plaques. This finding lends credence to the use of C57BL/6J
      mice for studying the pathogenesis of atherosclerosis.

PMID- 1759993
TI  - Isolated muscular sarcoidosis causing fever of unknown origin: the value of
      gallium-67 imaging.
AB  - An unusual case of a patient with a long-standing fever of unknown origin (FUO)
      is presented whose gallium-67 (67Ga) images revealed increased activity only in
      the calf muscles bilaterally. Other imaging modalities also failed to show chest
      or other abnormal findings. Subsequent biopsy of the right gastrocnemius muscle
      revealed noncaseating granulomas consistent with the diagnosis of sarcoidosis.
      When using 67Ga to evaluate a patient with a FUO, imaging of the extremities
      should always be included. Also, when abnormal Ga-67 uptake is present in the
      extremities, sarcoidosis should be included in the differential diagnosis.

PMID- 1759994
TI  - A hypothesis: nonsteroidal anti-inflammatory drugs reduce the incidence of large
      bowel cancer.
AB  - Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit prostaglandin synthesis and
      tumor growth in the rodent colon. We assessed NSAID use in relation to risk of
      human large-bowel cancer in a hospital-based, case-control study of 1326 patients
      with colorectal cancer and 4891 control patients. For regular NSAID use that
      continued into the year before interview, the multivariate relative risk estimate
      was 0.5 (95% confidence interval, 0.4 to 0.8); the estimate decreased as the
      duration of use increased, but the trend was not statistically significant.
      Similar results were obtained whether cancer or non-cancer controls were used,
      and the inverse association was apparent for both colon cancer and rectal cancer
      in men and women and in subjects younger and older than 60 years. Regular NSAID
      use that had been discontinued at least 1 year previously and non-regular use
      were not associated with risk. Almost all regular NSAID use was of aspirin
      containing drugs. The present data suggest that the sustained use of NSAIDs
      reduces the incidence of human large-bowel cancer.

PMID- 1759995
TI  - Travel in eastern Europe. Guidelines for patients.
AB  - Some patients need medical preparation and physician counseling before traveling
      to eastern European countries. In addition to baseline immunizations, a measles
      booster, a polio booster, typhoid vaccination, and immune globulin prophylaxis
      against hepatitis A may be indicated. Advice should also be given regarding air
      pollution, contaminated food and water, civil unrest, motor vehicle mishaps, and
      each country's policy on HIV screening. Because the level of healthcare may be
      poor, contact with American or British embassies or consulates is recommended in
      an emergency.

PMID- 1759996
TI  - A review of child psychotherapy research since 1963.
AB  - Reports on individual nonbehavioral child and adolescent psychotherapy since 1963
      are reviewed. Inclusion criteria required some minimal contrasting group. Forty
      three studies were assessed for basic methodological adequacy and main findings.
      The authors conclude that summary impressions from this body of literature cannot
      be made due to the magnitude of the flaws in basic psychotherapy research
      methodology. Suggestions are made regarding the future of child and adolescent
      psychotherapy research.

PMID- 1759997
TI  - Association of the renin-sodium profile with the risk of myocardial infarction in
      patients with hypertension.
AB  - BACKGROUND: To test the prognostic value of plasma renin activity prospectively,
      we determined the pretreatment renin-sodium profile of 1717 subjects with mild-to
      moderate hypertension (mean age, 53 years; 36 percent white; 67 percent men) in a
      systematic work-site treatment program. METHODS: Renin profiles, obtained by
      plotting plasma renin activity against the urinary excretion of sodium, were
      classified as high (12 percent of the subjects), normal (56 percent), and low (32
      percent), and there were expected variations according to age, sex, and race.
      Modified stepped-care treatment for hypertension, prescribed without reference to
      the renin profile, was similar in the three renin groups. RESULTS: Mean (+/- SD)
      blood pressure at entry was 151 +/- 19/100 +/- 10 mm Hg in the subjects with a
      high renin profile, 151 +/- 19/97 +/- 10 mm Hg in those with a normal profile,
      and 151 +/- 20/96 +/- 11 mm Hg in those with a low profile. During 8.3 years of
      follow-up, there were 27 myocardial infarctions. As adjusted for age, sex, and
      race, the incidence of myocardial infarction per 1000 person-years was 14.7 among
      the subjects with a high renin profile, 5.6 among those with a normal profile,
      and 2.8 among those with a low profile (rate ratio for high vs. low, 5.3; 95
      percent confidence interval, 3.4 to 8.3). The rate of mortality from all causes
      was 9.3 in the high-profile group, 5.3 in the normal-profile group, and 3.9 in
      the low-profile group. The independent association of a high renin profile with
      myocardial infarction (but not with stroke or noncardiovascular events) was
      affirmed by Cox analyses (rate ratio for high vs. normal plus low, 3.2; 95
      percent confidence interval, 1.2 to 8.4) after adjustment for race, sex, age at
      entry, serum cholesterol level, smoking status, electrocardiographic evidence of
      left ventricular hypertrophy, blood glucose level, body-mass index, history of
      cardiovascular disease or treatment, blood pressure, and use of beta-blockers.
      CONCLUSIONS: In the study population, whose blood pressure before and during
      treatment was in a narrow range, and after other cardiovascular risk factors had
      been considered, the renin profile before treatment remained independently
      associated with the subsequent risk of myocardial infarction.

PMID- 1759998
TI  - A management informatics rotation for pathology residents.
AB  - A formal, core, two-month rotation incorporating management concepts and computer
      usage has been instituted for residents in clinical pathology at Rush Medical
      Center. In this rotation, emphasis is placed on the pathologist's role as a
      laboratory director and decision maker and in the necessary computer skills and
      managerial background that must be acquired to make this role most effective.
      Specific behavioral goals and objectives were formulated for this rotation. The
      goals served as a guideline for the resident while involving each resident in the
      decision making process and in problem solving in day-to-day laboratory
      activities. The resident was encouraged to become familiar with the laboratory
      computer system, its operation, access, and reporting. Computer fundamentals were
      taught in instances where there was little or no prior computer experience.
      Management activities in which the resident was involved dealt with affirmative
      action, position searches, hiring and firing, laboratory accreditation, licensure
      laws, and decision making. This paper describes the rotation in detail and
      discusses each objective while incorporating both the resident's and laboratory
      director's perspectives.

PMID- 1759999
TI  - Erythropoietin for anemia of renal failure in sickle cell disease.

PMID- 1760000
TI  - Research on DNA typing catching up with courtroom application.

PMID- 1760001
TI  - Spiritual dimensions of health care. Nursing's mission.

PMID- 1760002
TI  - Improvement of functional sitting position for children with cerebral palsy.
AB  - Twenty-three children with cerebral palsy were photographed and video-filmed in
      six different sitting positions--including a hypothetical functional position-
      and the video-films and photographs were analysed. It was found that pathological
      movements were minimised and postural control and arm and hand function best when
      the child was sitting in a forward-tipped seat, with a firm backrest supporting
      the pelvis, arms supported against a table and feet permitted to move backward.

PMID- 1760003
TI  - Chronic-pain patients must cope with chronic lack of physician understanding.

PMID- 1760004
TI  - Sudden death in the young.
AB  - Sudden cardiovascular death in children and adolescents may occur without
      premonitory symptoms. Awareness of risk patterns can provide effective prevention
      in some cases. Antiarrhythmic therapy aimed at both atrial and ventricular
      tachyarrhythmias can reduce unexpected mortality. A major focus is curbing the
      risks faced by young athletes. Another is risk management after cardiac surgery.

PMID- 1760005
TI  - Hemoglobinopathies affect hemoglobin A1C measurement.

PMID- 1760006
TI  - Barriers to the treatment of obesity.

PMID- 1760007
TI  - Sickness dismissals--a management perspective.

PMID- 1760008
TI  - Use of enrofloxacin in laying birds.

PMID- 1760009
TI  - The war against drugs.

PMID- 1760010
TI  - Brittle diabetes.

PMID- 1760011
TI  - Non-operative management of blunt splenic injury.

PMID- 1760012
TI  - Essential hypertension: a sign in search of a disease.

PMID- 1760013
TI  - Lichen planus and liver disease.

PMID- 1760014
TI  - Acute intermittent porphyria in Bikaner.

PMID- 1760015
TI  - Pseudosickness and red cell casts.

PMID- 1760016
TI  - Treatment of abdominal aortic aneurysm by occlusion and bypass: an analysis of
      outcome.

PMID- 1760017
TI  - An excess of information.

PMID- 1760018
TI  - Surgeons who undertake surgery for colorectal cancer.

PMID- 1760019
TI  - Pethidine for painful crises in sickle cell disease.

PMID- 1760020
TI  - The long QT interval syndrome. A Rosetta stone for sympathetic related
      ventricular tachyarrhythmias.

PMID- 1760021
TI  - Crafting a viable health insurance system.

PMID- 1760022
TI  - Renal biopsy in nephrotic syndrome.

PMID- 1760023
TI  - PCR test for Chlamydia psittaci.

PMID- 1760024
TI  - 'The 5-year results of a clinical trial comparing a glass polyalkenoate (ionomer)
      cement restoration with an amalgam restoration'.

PMID- 1760025
TI  - Problems with the two stage analysis of crossover trials.

PMID- 1760026
TI  - Violence and sudden death.

PMID- 1760027
TI  - Psychotherapy research.

PMID- 1760028
TI  - Controversy in automated record keeping.

PMID- 1760029
TI  - Changes come to radiation regs; how will your facility be affected?

PMID- 1760030
TI  - Native Americans and the constant death instinct hypothesis.
AB  - To test Tabachnick and Klugman's hypothesis that the amount of death instinct per
      capita in different regions is constant, 1975-1977 death rates for motor vehicle
      accidents, cirrhosis, and suicide were obtained from the US Indian Health Service
      for all 11 health service areas. In contrast to predictions derived from the
      hypothesis that the death instinct is constant, no negative correlations were
      found among these three variables. Although an analysis of other behaviors might
      yield different findings, these results do not support an hypothesis of a
      constant death instinct among Indian Health Service regions.

PMID- 1760031
TI  - Cerebrospinal fluid rhinorrhea in patients with untreated pituitary adenoma:
      report of two cases.

PMID- 1760032
TI  - Easily avoidable hemolytic transfusion reactions after transfusion of frozen and
      washed autologous red cells.

PMID- 1760033
TI  - Diagnosing and differentiating a doubly committed ventricular septal defect from
      obstruction in the outflow tract of the right ventricle.

PMID- 1760034
TI  - A new pericardiocentesis set.

PMID- 1760035
TI  - Right bundle branch block induced by right ventricular involvement in inferior
      wall left ventricular acute myocardial infarction.

PMID- 1760036
TI  - Sensitivity and specificity of clinical tests.

PMID- 1760037
TI  - Delayed diagnosis of HIV-related tuberculosis.

PMID- 1760038
TI  - Why pediatric otolaryngology?

PMID- 1760039
TI  - Intragastric pH monitoring is unsuitable for diagnosis of duodenogastric reflux.

PMID- 1760040
TI  - Existence of bluish-white fluorescing age-pigment--"pre-lipofuscin".

PMID- 1760041
TI  - A response to Gostin, "The HIV-infected health care professional: public policy,
      discrimination, and patient safety".

PMID- 1760042
TI  - Haematological effects of reinfused mediastinal blood after cardiac surgery.

PMID- 1760043
TI  - Kidney transplantation from second-degree relatives.

PMID- 1760044
TI  - Craniosynostosis in the Ullrich-Turner syndrome.

PMID- 1760045
TI  - Composite multivariate quality control using a system of univariate, bivariate,
      and multivariate quality control rules.
AB  - We propose a composite multivariate quality control (CMQC) system to control
      simultaneously measured variables. This system is designed to detect unacceptable
      trends and systematic error in one or more variables, unacceptable random error
      in one or more variables, and unacceptable changes in the correlation structure
      in any pair of variables. It is also designed to be tolerant of missing data, to
      be capable of rejecting as few as one or as many as all variables in a run, and
      to provide the analyst with control statistics and graphics that logically relate
      to sources of analytical error. Quality control rules for univariate,
      multivariate, and correlation conditions are incorporated in the system, as are
      plots displaying CMQC statistic values and control limits for univariate,
      multivariate, and correlation parameters. We also discuss advantages of the CMQC
      over the T2 and principal component multivariate quality control methods. We
      demonstrate the CMQC procedure using data from a laboratory process in which 40
      variables were measured during 40 characterization runs and 23 runs analyzing
      unknowns.

PMID- 1760046
TI  - N-demethylation activity of renal and hepatic subcellular fractions: an
      interspecies comparison.
AB  - The enzymatic activity of the mixed-function oxidase system in the kidney and
      liver was evaluated by means of an in vitro N-demethylation activity assay with
      aminopyrine as the substrate. Renal and hepatic demethylation activity of 9000 x
      g supernatant fraction was determined in the rat, rabbit, and guinea-pig. In
      terms of interspecies comparison, the renal tissue demethylation activities were
      on a similar level with a slight increase in the order guinea-pig, rabbit and
      rat. In relation to hepatic activity, these relative demethylation activities of
      renal tissue had the same values in the rat and rabbit, whereas that in the
      guinea pig was significantly lower. The distribution of demethylation activity in
      the kidney was determined by comparing the cortex and medullary activity in
      relation to the total kidney tissue activity in the rabbit and guinea-pig.
      Although the higher demethylation activities were obtained in rabbit renal
      preparations and low demethylation activity was detected in the guinea-pig renal
      medulla only, no significant interspecies differences were found by the
      statistical evaluation. It may be concluded that the mixed-function oxidase
      system responsible for renal demethylation activity seems to be concentrated in
      the renal cortex and its distribution coincides in the rabbit and guinea-pig
      kidney.

PMID- 1760047
TI  - Colposcopes: a critical review.
AB  - A multidimensional professional team consisting of a practicing colposcopist, a
      mechanical engineer, and a medical photographer independently critically
      evaluated the features of selected colposcopes. Qualitative observations and
      quantitative measurements were performed on 13 colposcopes representing eight
      manufacturers and distributors. Optical characteristics, ocular system operation,
      mobility and stability, relative ease of use, component characteristics, space
      for instrumentation, and visual illumination, uniformity, and color were
      comparatively assessed. The specific colposcope information provided may benefit
      practicing physicians or novice colposcopists who are contemplating purchasing a
      colposcope. The presented framework of critical feature evaluation may also
      facilitate the informed selection of other colposcopes not included in this
      selective, critical, comprehensive review.

PMID- 1760048
TI  - Interpersonal aggressive behaviour and alcohol consumption among young urban
      adolescents in France.
AB  - In order to supplement existing studies of deviant populations (alcoholics, drug
      addicts, jailed delinquents) and to bring to light the existence of early
      relationships between aggressiveness and alcohol consumption, an epidemiological
      survey was carried out among 1601 adolescents (aged 13-16) from a suburban area
      of Paris. Some types of the aggressive behaviour studied were more socially
      acceptable--breaking objects, hitting people, fighting--than others--threatening
      to use or using physical violence to obtain money or objects from people. A
      majority of the adolescents had already demonstrated violent behaviour, 41%
      showed repetitive delinquent behaviour, and 12% cumulated several types of such
      behaviour. The aggressive teenagers differed from the non-aggressive subjects
      firstly in their alcohol, tobacco and illicit drug consumption, and secondly with
      respect to other deviant behaviour, such as stealing, running away from home or
      violent victimization. A logistic regression analysis highlighted the relative
      importance of each type of delinquent behaviour and of the early onset of regular
      alcohol consumption. The discussion focuses on the complex relationship between
      violence and alcohol consumption.

PMID- 1760049
TI  - The frequency of alcoholisation among young people injured in accidents in
      France.
AB  - In a nation-wide epidemiological survey carried out in France in 1982-1983, blood
      alcohol concentration was systematically measured in 1423 young casualties (aged
      15-24 years) on their arrival in the emergency room. Traffic accidents accounted
      for almost half of the admissions, and they were the most severe, with over 10%
      requiring hospitalisation with vital risk. A quarter of the admissions was
      female; on average, their blood alcohol concentration was low and not
      statistically related to age. Conversely, among young male casualties, 1 out of 5
      had a blood alcohol concentration of at least 0.50 g/l (11 mmol/l) and 1 out of
      15 was classified as a chronic heavy drinker. It is of note that alcohol was
      implicated in 43% of the car/truck accidents of the young men and that blood
      alcohol concentration as well as the proportion of chronic drinkers were strongly
      related to age. Alcohol consumption may begin as early as 15 years; in the young
      men 15-24 years, only 7% were chronic drinkers whereas in men over 24, 37% were
      chronic drinkers. On this basis, it is appropriate to focus education about
      alcohol consumption on adolescents, particularly men.

PMID- 1760050
TI  - The 'topping-up' effect: differences between low- and non-alcoholic lager on
      blood ethanol.
AB  - The peak blood alcohol levels attained in male and female subjects after
      consumption of 3 pints of regular lager (4.2%) over a 30 min period was 73.5 +/-
      6.9 mg% in males and 113 +/- 17 mg% in females. Peak values occurred at 60 and 90
      min post-ingestion in males and females, respectively. Consumption of 3 pints of
      low-alcohol lager gave a maximum blood alcohol level of 13 mg% while there was no
      measurable blood alcohol content after three pints of non-alcohol lager. 'Topping
      up' with a non-alcohol lager after 2 pints of regular lager leads to
      significantly lower blood alcohol levels when compared with 'topping-up' with low
      alcohol lager over a comparable time in males but not in females.

PMID- 1760051
TI  - Evidence that gonadal hormone levels in amniotic fluid are decreased in males
      born to alcohol users in humans.
AB  - Biochemical evaluation of amniotic fluid content is often used to monitor fetal
      secretory and excretory functions. It is known that alcohol freely passes through
      the placenta and enters the fetal tissues. The study was designed to investigate
      whether alcohol use during pregnancy affects amniotic fluid steroid and peptide
      hormone levels. Five alcohol users who drank between 40 and 45 drinks per month
      and consumed approximately 1 oz. of alcohol per day from beer drinking
      participated in the study. Thirteen controls with no history of alcohol use
      including essential and non-essential drugs were selected for the study. The
      final selection of participants was made among those who delivered male
      offsprings. Amniotic fluid was aspirated between 16 and 20 weeks of gestation by
      amniocentesis and an aliquot was used to assay steroid hormones (4
      androstenedione [-4-AD], testosterone [T], estradiol [E2], dehydroepiandrosterone
      sulfate [DHEA-S]), and peptide hormones (FSH and LH). Birth weights, placental
      weights and gestation age were recorded at birth. The results showed that -4-AD,
      T and E2 levels were significantly decreased (P less than 0.01) in alcohol users;
      DHEA-S, FSH and LH levels were unaffected. Birth weights were significantly
      decreased (P less than 0.05) in alcohol users, the placental weights and
      gestation age were not affected. We conclude that alcohol passes through the
      placenta and affects fetal testes, capacity to synthesize steroids and the effect
      appears to be direct and not via the hypothalamic-hypophyseal axis.

PMID- 1760052
TI  - Platelet monoamine oxidase activity in type 1 and type 2 alcoholism.
AB  - Earlier studies have identified at least two distinct subtypes of alcoholism.
      Type 2 is characterised by high heritability, early onset, frequent social
      complications and mixed misuse. With regard to temperament, the type 2 alcoholics
      score high in impulsiveness and sensation-seeking behaviour. Type 1 alcoholics
      have a later onset, lower degree of heritability and rarely there is misuse of
      illegal drugs. In the present study, 37 type 1 and 62 type 2 male alcoholics were
      compared with 36 male controls with regard to platelet monoamine oxidase (MAO)
      activity, which is a stable biological marker, inversely correlated to
      personality traits such as impulsiveness and sensation seeking. The platelet MAO
      activity was found to be lower in type 2 alcoholics when compared both with
      healthy controls and with type 1 alcoholics. Also, the type 1 alcoholics had
      lower platelet MAO activity than the controls. The result confirms a previous
      study and validates the subclassification of alcoholism according to the type 1
      and 2 concept. This should be of value for future studies concerning etiology,
      epidemiology, treatment and prevention of alcoholism.

PMID- 1760053
TI  - HLA Gm systems and susceptibility to alcoholic cirrhosis: a study of mixed-race
      subjects.
AB  - The fact that only a small percentage of excessive drinkers develop cirrhosis may
      be due to a genetic susceptibility to the disease. In order to identify possible
      genetic risk factors for cirrhosis, we studied mixed-race (Negroid-Caucasian)
      inhabitants of the French West Indies and compared: (1) the frequency of 51 HLA
      A, -B, -C and -DR antigens in 41 subjects with alcoholic cirrhosis and in two
      control groups consisting of 41 excessive drinkers free of liver disease and 51
      healthy non-drinkers; and (2) the frequency of Gm and Km haplotypes in the same
      groups. Analysis of the Gm system also determined the patients' ethnic origins.
      The frequency of the HLA-A2 antigen was significantly higher in the cirrhotic
      patients than in the control group of excessive drinkers (chi 2 = 4.47; P less
      than 0.05), while that of the HLA-B15 antigen was significantly lower (chi 2 =
      5.14; P less than 0.05). The frequency of the Cw4 antigen was significantly
      higher in the cirrhotics than in the non-drinkers (chi 2 = 5.59; P less than
      0.05). However, these differences did not persist when the number of comparisons
      was taken into account. The frequency of Gm and Km haplotypes was not
      significantly different in the three groups. In conclusion, complementary studies
      are required to determine the value of the Gm-Km system as a marker of
      susceptibility to alcoholic cirrhosis. Our results do not identify an association
      between HLA antigens and cirrhosis specific to a negroid ethnic group and support
      the notion that such an association is weak.

PMID- 1760054
TI  - Effect of heavy drinking and alcohol withdrawal on markers of carbohydrate
      metabolism.
AB  - A number of biochemical markers were monitored in 38 male alcoholic patients at
      admittance and one week later. In patients with a drinking period of greater than
      3 weeks the median fasting B-glucose decreased significantly as well as S
      fructosamine concentrations. The ability of S-fructosamine to identify patients
      with a diabetic glucose tolerance test, expressed in terms of sensitivity and
      specificity, was 12 and 47%, respectively; that of HbA1c was still lower.

PMID- 1760055
TI  - Detection of stable acetaldehyde-modified proteins in the livers of ethanol-fed
      rats.
AB  - Liver cytosolic fractions, obtained from rats pair-fed diets supplemented with
      either ethanol or an isocaloric amount of sucrose for periods from 3 weeks to 27
      months, were tested for the presence of acetaldehyde-modified proteins by
      immunoblotting, using a partially purified antiserum raised in rabbits against
      proteins modified by acetaldehyde in vitro. The antiserum reacted with a large
      number of proteins in cytosolic fractions from ethanol-fed rats but did not react
      with any proteins in the same fraction from control animals. The duration of the
      ethanol-containing diet did not appear to influence the number of proteins
      modified or the total amount of modification within the time range tested. These
      results indicate that many proteins in rat liver cytosol are targets for
      modification by acetaldehyde in vivo.

PMID- 1760056
TI  - Pattern of the adaptive response of erythrocyte glycerolipid acylation processes
      during chronic alcoholism.
AB  - Challenging intact erythrocytes from normal human subjects with ethanol resulted
      in dose-dependent decreases in rates of acylation of phosphatidylcholine (PC) and
      phosphatidylethanolamine (PE) while triacylglycerol (TAG) acylation was
      stimulated. In erythrocytes from alcoholic subjects, the responses were of lesser
      magnitude, indicating a lower sensitivity to ethanol. This in vitro resistance,
      typical of the state of tolerance, was associated in erythrocytes from alcoholic
      subjects with increased baseline rates of acylation of PC, PE and TAG, suggesting
      high levels of glycerolipid fatty acid turnover. These results suggest that (1)
      intact human erythrocytes are qualitatively and quantitatively valid for studying
      the adaptive response to ethanol; and (2) chronic alcoholism is associated with
      increases in turnover rates of the acyl moieties of lipid membrane components
      regardless of the pattern of initial sensitivity to ethanol. Increased acylation
      rates during chronic alcoholism might modify the remodeling of the lipid matrix
      and thereby the membrane function.

PMID- 1760057
TI  - The effects of chronic ethanol administration on rat liver and erythrocyte lipid
      composition: modulatory role of 'evening primrose oil'.
AB  - The effects of chronic administration of ethanol on the lipid composition of
      erythrocytes and liver of rats were investigated. Ethanol was chronically
      administered alone or in combination with Evening Primrose Oil (containing 10%
      v/v gamma-linolenic acid) in a nutritionally balanced milk diet. Chronic
      administration of ethanol alone significantly decreased the content of
      arachidonic acid in erythrocyte membranes, whereas the concomitant administration
      of Evening Primrose Oil reversed this effect. The triacylglycerol content was
      significantly increased in the microsomal fraction of the liver after chronic
      ethanol administration. Ethanol also significantly increased the ratio of
      cholesterol:cholesteryl esters in the microsomal fraction. The arachidonic acid
      content of the whole liver fraction was significantly reduced after chronic
      administration of ethanol, whereas concomitant administration of Evening Primrose
      Oil did not reverse this effect. The administration of Evening Primrose Oil
      during chronic ethanol intake may have beneficial effects, as it reverses some of
      the effects of ethanol on erythrocyte and hepatocyte membrane lipids which may be
      detrimental to health.

PMID- 1760058
TI  - The effects of dietary lead on ethanol-reinforced responding.
AB  - Sixteen adult male rats were presented with a diet containing no added lead
      (Group Control) or a diet containing 500 ppm inorganic lead (Group Lead) for 60
      days. Subsequently, all animals were trained to lever press on an FR 1
      reinforcement schedule for an ethanol reinforcer using a food-induction procedure
      where 20 g of food were presented to deprived animals 1 hr prior to the training
      session. Gradually, the daily food allotment was shifted to 15 min post-session
      and the ethanol concentration maintained at 6% (v/v). On a subsequent
      dose/response test, serial presentations of 1, 2, 4, 8, 16, and 32% ethanol
      reinforcement (v/v) were presented to both groups of animals. The results from
      the initial self-administration test using 6% ethanol as the reward outcome
      showed that Group Lead lever pressed at a significantly lower rate than Group
      Control. In addition, on the dose/response test control animals increased
      responding at a lower concentration, and then as dose levels continued to
      increase, began to decrease responding earlier than lead-treated animals.
      Apparently, sensitivity to ethanol effects is decreased by lead toxicity. The
      importance of these data for understanding other metal/alcohol interactions is
      discussed.

PMID- 1760059
TI  - Comments on Tittmar's 'limits of confidence in statistics'.

PMID- 1760060
TI  - Misdiagnosis of a normal fetal platelet count after coagulation of intrapartum
      scalp samples in autoimmune thrombocytopenic purpura.
AB  - Intrapartum fetal scalp sampling for platelet counts in maternal autoimmune
      thrombocytopenia has been advocated for determining route of delivery. We report
      a case in which two coagulated scalp samples were believed to indicate a normal
      fetal platelet count. As a result, vaginal delivery of a severely
      thrombocytopenic fetus was allowed.

PMID- 1760061
TI  - Evaluation of phenazopyridine hydrochloride as a tool in the diagnosis of
      premature rupture of the membranes.
AB  - This is a prospective study to determine whether a maternal orally administered
      azo dye, phenazopyridine hydrochloride, would cross into amniotic fluid, and thus
      be of potential aid in the diagnosis of rupture of the membranes. Based on
      anecdotal experience, we hypothesized that this compound would cross the placenta
      and be excreted in the fetal urine, causing discoloration of the amniotic fluid.
      Ten patients with uncomplicated pregnancies undergoing elective amniocentesis for
      obstetric indications received an oral dose of 400 mg of phenazopyridine
      hydrochloride 4 hours prior to the procedure. Amniotic fluid was also available
      from five control patients who did not receive phenazopyridine hydrochloride. The
      typical orange-to-red discoloration of the urine was seen in all study patients,
      indicating ingestion of the dye. None of the ten patients had evidence of the azo
      dye in their amniotic fluid by visual inspection or by spectrophotometric
      absorbance. After the amniotic fluid samples were acidified, the presence of the
      azo dye was visually demonstrable, and spectrophotometry confirmed measurable
      concentrations (mean +/- SE: 13.08 +/- 0.72 micrograms/ml). We conclude that
      although phenazopyridine hydrochloride does cross the placenta into the fetal
      compartment, its presence causes a visual and spectrophotometric change in the
      color of amniotic fluid only when the normal basic pH of amniotic fluid is
      acidified.

PMID- 1760062
TI  - Hypoxic pulmonary hypertension: changes in platelet size and number.
AB  - Circulating platelets have been implicated in the hypoxic pulmonary pressor
      response. This study was undertaken to assess the effects of acute hypoxia
      induced pulmonary hypertension on platelet volume and number across the pulmonary
      circulation in anesthetized newborn lambs. Seven animals were instrumented for
      measurement of pulmonary vascular resistance. All measurements were made during
      normoxia and after 5 and 30 minutes of hypoxia (10 to 12% oxygen breathing).
      Hypoxia caused a doubling of the pulmonary vascular resistance. During hypoxic
      vasoconstriction, platelet volume decreased rapidly while traversing the lung but
      was not affected on return to the lung after traversing the systemic circulation.
      Platelet numbers were unchanged on leaving the lung but were decreased on
      entering the lung during hypoxia. Our data are consistent with the release of
      platelet contents in the lung during hypoxic pulmonary hypertension.

PMID- 1760063
TI  - Hyperstimulation contraction stress tests: an evaluation of outcome by test
      pattern.
AB  - Contraction stress tests (CSTs) interpreted as equivocal, with hyperstimulated
      contractions accompanied by late decelerations (hyperstimulation CSTs), were
      analyzed by test pattern and outcome and compared to a control group with
      negative CSTs. Outcome was evaluated for subsequent abnormal CST, low Apgar
      score, the presence of meconium, and cesarean section for fetal distress.
      Patients with hyperstimulation CSTs and solitary late decelerations, and the
      remainder of the test interpretable as a negative CST, had the least morbidity.
      In both the presence and absence of 10-minute negative windows, patients with
      more than one late deceleration were at significantly higher risk for cesarean
      section for fetal distress than controls. It would seem warranted in the presence
      of hyperstimulation CSTs, therefore, to repeat the CST within 24 hours regardless
      of the presence of a negative window.

PMID- 1760064
TI  - A review of newborn medicine in America: European past and guiding ideology.
AB  - The beginnings of newborn medicine and its rapid advance in America since the
      early twentieth century are reviewed through presentation of ideas that have
      influenced the givers of care. Newly born infants attained patient status at the
      end of the 19th century when Budin gave them hospital charts and Ballantyne
      designed the blueprint for continuity of maternal-infant care. These achievements
      gave impetus to the task of preserving infant life. In 1915, the United States
      established a birth registration area permitting calculation of infant mortality
      rates. These rates became the guide and yardstick for measuring progress in
      newborn care. Since 1915 infant mortality has decreased tenfold as survival
      increased successively in the postnatal infant, the neonate, and recently in the
      premature. Pediatricians began to supervise newborn nurseries after World War I.
      During depression years, national efforts were expended for the premature. After
      World War II, pediatricians moved close to birth, assessing and treating in the
      delivery room. Special care and intensive care nurseries sprang up in the 1960s.
      In the past 25 years, improvements in ventilation and life support systems have
      enhanced survival of compromised and immature infants. Today, newborn medicine is
      spectacularly successful in lowering neonatal mortality but is beset by costs,
      ethics, legal concerns, and the burden of survival morbidity. Controversy such as
      exists today is not new to newborn medicine; it has been its constant companion
      throughout history.

PMID- 1760065
TI  - Noninvasive medical management of fungus ball uropathy in a premature infant.
AB  - Unilateral renal obstruction secondary to fungus balls is described in a
      premature infant. Noninvasive medical management, which included amphotericin B
      and 5-flucytosine therapy and forced diuresis, resulted in disappearance of
      fungus balls and resolution of the obstruction.

PMID- 1760066
TI  - Management of triplet pregnancies in the 1980s--are we doing better?
AB  - The incidence of triplet pregnancies has increased with the introduction of
      ovulation induction agents and is expected to further increase with the
      implementation of multiple embryo transfer in the in vitro fertilization
      programs. We review our experience with 29 triplet pregnancies in the last 10
      years. Despite early sonographic diagnosis, close follow-up, increased use of
      tocolytics, and prophylactic cervical suture, we could not document prolongation
      of pregnancy, increased infants' weight, or a significantly decreased perinatal
      mortality, which still remains about 14%. Furthermore, the use of cesarean
      section as the delivery method of choice did not change the well-documented
      unfavorable relationship between birth order and fetal outcome. There is an
      urgent need for prospective assessment of the value of different treatment
      modalities, which nowadays becomes possible with the increasing incidence of
      triplet pregnancies. The prevention of triplet pregnancies or treatment by
      selective fetal reduction deserves a second thought.

PMID- 1760067
TI  - Anaerobic coverage for intra-amnionic infection: maternal and perinatal impact.
AB  - Although intrapartum antibiotics are beneficial to both the mother and newborn,
      there is no consensus as to the most efficacious antibiotic regimen in the
      treatment of intra-amnionic infection, especially with regard to anaerobic
      coverage. We randomized pregnant women with intra-amnionic infection to receive
      either dual agent therapy (ampicillin and gentamicin) or triple agent therapy
      (ampicillin, gentamicin, and clindamycin). The frequency of vaginal and cesarean
      delivery was similar in both groups. There was no significant difference in the
      incidence of endometritis between the two groups (10 of 69 versus 5 of 64; p =
      NS). There were no significant differences in either neonatal morbidity or
      mortality. The addition of clindamycin to provide anaerobic coverage for intra
      amnionic infection does not significantly alter the incidence of endometritis in
      women delivered by cesarean section, although it may have an impact on women
      delivering vaginally.

PMID- 1760068
TI  - Sonographic evaluation of growth discordance and chorionicity in twin gestation.
AB  - Ninety-four twin gestations had serial ultrasound examinations for evaluation of
      fetal growth, with special attention to prediction of weight discordance and
      chorionicity. Fetal weight estimations were made a mean of 3.2 days before birth
      and then compared to actual birthweights. The average error in intertwin
      discordance prediction was 1 +/- 9%. In 56 patients ultrasonic detection of
      membrane thickness was compared with placental pathologic conditions. If a
      membrane was seen between twins, it was confirmed by placental pathologic study
      in all cases. No membrane was seen in four twin pairs, but only one of these
      actually had monochorionic monoamniotic membranes. The three cases with false
      positive diagnoses of monoamniotic twin gestation were initially seen late in
      pregnancy. If clinical decisions in twin gestations are based on ultrasound
      determination of discordance and chorionicity, the level of accuracy demonstrated
      by these data must be considered.

PMID- 1760069
TI  - Sonographic verification of a nuchal cord following a vibratory acoustic
      stimulation-induced severe variable fetal heart rate deceleration with expedient
      abdominal delivery.
AB  - A case is presented in which external vibratory acoustic stimulation performed
      following a nonreactive nonstress test produced a severe variable deceleration of
      the fetal heart rate. A clinically suspected nuchal cord was confirmed by
      ultrasound. This rapid precise antepartum diagnosis of cord compression prevented
      untimely delay and led to immediate abdominal delivery of a nonacidotic, yet
      hypoxic, infant. This report suggests care be taken when fetal vibratory acoustic
      stimulation is applied in cases of oligohydramnios and a known existing nuchal
      cord.

PMID- 1760070
TI  - Risk factors associated with preterm deliveries among racial groups in a national
      sample of married mothers.
AB  - Seven sociodemographic and behavioral factors that may explain the increased risk
      of preterm deliveries among black women were examined using data from a national
      sample of 5823 married mothers who responded to the 1980 National Natality Survey
      (NNS) Questionnaire. There was a twofold increase in the rate of preterm
      deliveries among black women. Additionally, there was a significant decrease (by
      1 week) in the mean gestational age in black mothers (p less than 0.0001)
      compared with white mothers. The two groups were similar with respect to smoking
      and age; however, there were significant differences between the two groups with
      respect to other risk factors. Black women had a higher rate of heavy alcohol
      use, significantly fewer prenatal visits, prenatal care was started later during
      pregnancy (p less than 0.0001) and were less educated compared with white women.
      The odds ratio (OR) for race adjusted for the risk factors was 1.56 (95%
      confidence interval (CI) equals 1.21, 2.01). All other risk factors except
      education had adjusted ORs greater than 1. Those risk factors that were more
      strongly associated with the risk of preterm births included weight gain (OR,
      2.10; 95%, 1.79, 2.47), number of prenatal visits (OR, 3.37; 95% CI, 2.87, 3.95)
      and smoking (OR, 1.34; 95% CI, 1.13, 1.59). We conclude that race is an
      independent risk factor for preterm deliveries. Additionally, it is shown here
      that the risk of preterm deliveries is attributable to health behaviors that are
      amendable to change.

PMID- 1760071
TI  - Imaging case of the month: I. Teratoma of the newborn.

PMID- 1760072
TI  - Imaging case of the month: II. Central diaphragmatic hernia with herniation of
      the liver into the pericardial sac.

PMID- 1760073
TI  - The circumpolar community.

PMID- 1760074
TI  - Local cold injuries sustained during military service in the Norwegian Army.
AB  - The series comprises 40 soldiers who sustained 49 local cold injuries during
      their service in The Norwegian Army. Twenty-one cold injuries were classified as
      first degree, 15 as second degree and 13 as third degree. No difference in
      ambient temperature at the time of injury was observed between the three
      categories of injuries, but the duration of cold exposure was significantly
      longer in those suffering third degree injury. Thirty-eight of the 40 soldiers
      experienced sequelae. The trend was that the severity of sequelae was most
      pronounced in third degree injuries. However, soldiers with first degree injury
      may suffer from significant sequelae, while those with third degree injury may
      exhibit a more benign clinical course. Overall degree of distress from sequelae
      was mild to moderate with exacerbation of symptoms and signs upon cold exposure.
      Although the influence on civilian occupational activity was minor, a substantial
      negative impact on performance in the field or combat setting may be anticipated.
      Soldiers as well as commanders must be thoroughly informed about prophylactic
      measures, symptoms and signs of an impending cold injury. Rewarming of the skin
      must be initiated without delay.

PMID- 1760075
TI  - Haptoglobin levels among alcoholics in Alaska.
AB  - The levels of haptoglobin, plasma proteins and amino acids were studied in a non
      fasting population of alcoholics. In 25 subjects, only small differences were
      seen between the means when Native subjects were compared to non-Native. There
      did not appear to be any acute phase response differences between these two
      groups. This study did not substantiate other reports on the correlation of the
      severity of alcoholism with glycoprotein synthesis.

PMID- 1760076
TI  - Conception of man and the preservation of his health in circumpolar regions.
AB  - The preservation of human health in polar and circumpolar regions depends mainly
      on the strategy for future development of these regions. The consequences of
      human intervention into northern ecology are irreversible, as in the case of the
      greenhouse effect, the industrial and atomic pollution of polar nature, the
      tundra devastation, the destruction of northern flora and fauna etc. The ongoing
      creation of large industrial population centres in the North by means of
      newcomers is to be stopped. Polar regions are to be used for biospheric
      reservation and tourist sanitary zones, to preserve specific flora and fauna, to
      provide the rhythms and customs necessary to survive in extreme climatic and
      geophysical conditions of high latitudes. The program for securing man's survival
      in circumpolar regions should comprise several stages of practical measures to
      provide necessary resources and to combine international efforts. The
      preservation of man's health must be based on the understanding of the
      interrelation between health and biospheric processes and the assessment of the
      role of human intervention into polar ecology. A program facilitating the
      preservation of human health and survival in the North and in the Antarctic
      should be initiated.

PMID- 1760077
TI  - The epidemiology of viral hepatitis.

PMID- 1760078
TI  - Epidemiology of viral hepatitis in circumpolar populations.

PMID- 1760079
TI  - Treatment of viral hepatitis.

PMID- 1760080
TI  - Prevention of viral hepatitis--immunoprophylaxis.

PMID- 1760081
TI  - Prevention of viral hepatitis in circumpolar populations.

PMID- 1760082
TI  - The neurophysiological basis of epileptic activity: a condensed overview.

PMID- 1760083
TI  - Circadian distribution of generalized spike-wave activity in relation to sleep.

PMID- 1760084
TI  - Nocturnal paroxysmal dystonia.

PMID- 1760085
TI  - Sleep polygraphic findings in epileptic encephalopathies from infancy to
      adolescence.

PMID- 1760086
TI  - Sleep and prolonged epileptic activity (status epilepticus).
AB  - The correlations between sleep and prolonged epileptic activity are discussed on
      the basis of the status classification of Gastaut (1983). Little information is
      available on the interrelation of sleep and the status of tonic-clonic seizures
      (grand mal status). Most important is the therapeutical management of these
      cases. Tonic seizures have been reported to occur in large numbers during NREM
      sleep in patients with Lennox-Gastaut syndrome. A status-like increase is
      possible. Tonic seizures occur almost exclusively during sleep. Myoclonic status
      epilepticus arising (a) in the course of primary generalized epilepsy and (b) in
      the course of encephalopathies, are usually markedly attenuated during sleep. In
      absence status (petit mal status) synchronized sleep generally fragments the
      continuous discharge which is replaced by isolated bursts of polyspikes, or
      polyspike and wave complexes. The absence status can recur upon awaking during
      the night or in the morning. The abnormal EEG activity of a petit mal status can,
      however, occasionally persist during the whole night. Improvement as well as
      activation during sleep have been observed in elementary (= simple) partial
      status epilepticus; improvement seems to be more frequent. Epilepsia partialis
      continua may persist or decrease during sleep. An increase as well as decrease of
      motor phenomena has been observed during the REM stages. 'Epileptic aphasia' of
      childhood is associated with subclinical bioelectric status epilepticus during
      sleep. The electrical status epilepticus must be delineated as a separate group.
      The term encephalopathy related to electrical status epilepticus during slow
      sleep (ESES) has been proposed on the basis of associated psychic syndromes. This
      form of status epilepticus disappears during the waking state and during REM
      sleep. Cases with hypsarrhythmia without clinical signs may also be classified
      under the group of electrical or bioelectrical status. In some cases, a
      continuous hypsarrhythmia is observed only during sleep. In this context, one
      must also mention those patients who demonstrate continuous activation of spikes,
      or spike and wave potentials (without clinical seizures) during eye closure.

PMID- 1760087
TI  - Integrated sleep analysis, with emphasis on automatic methods.

PMID- 1760088
TI  - Historical aspects of sleep and epilepsy.

PMID- 1760089
TI  - General considerations of sleep and sleep deprivation.
AB  - The state of affairs in the field of sleep deprivation has been discussed in this
      chapter. Special emphasis was placed on total sleep deprivation, a domain in
      which the most important work has been done since the dawning of this century,
      and especially during the 'golden years' between 1955 and 1975. After a
      discussion of the biorhythmical aspects, the general condition of sleep deprived
      subjects was pointed out. Psychological-psychiatric changes and impairment of
      performance were further topics of discussion, followed by sections on EEG,
      neurological, autonomic and metabolic changes. The relationship of SD to
      epileptic phenomena and endogenous depression has been considered. The
      characteristics of recovery sleep have also been presented. Most of the author's
      impressions are based on personal data, and especially on 2 subjects who
      underwent most elaborate testing. A discussion of partial sleep deprivation and
      selective sleep deprivation is also included.

PMID- 1760090
TI  - Short-term sleep EEG recordings after partial sleep deprivation as a routine
      procedure in order to uncover epileptic phenomena: an evaluation of 719 EEG
      recordings.
AB  - All night sleep deprivation prior to an EEG registration causes some
      inconvenience not only to the organization of the EEG department but presents a
      burden on the patients as well as their family members, and for these reasons is
      not suitable to be frequently employed as a routine procedure. As an alternative,
      we performed short-term sleep recordings in the early afternoon following a
      partial sleep deprivation of the patients during the preceding night. This method
      was well accepted by the patients and their family. Our only goal was to shorten
      the total time of night sleep using the following guideline: for very small
      children 22.00-06.00; for 4-14-year-old patients 24.00-06.00; and for patients
      older than that 01.00-06.00. 79.9%, out of 719 patients (573) who had been given
      the above instructions subsequently showed sleep patterns in their EEG.
      Additionally we had to administer an oral dose of promazine to only 67 patients.
      However, for the most part, patients showed only light sleep stages: 114 patients
      only reached sleep stage 1; 323 patients sleep stage 2; 88 patients sleep stage
      3; and 48 patients sleep stage 4. As expected, REM sleep was never recorded.
      Nonetheless, in 32 out of 146 patients who were tired but unable to fall asleep,
      epileptic patterns could be provoked. In 636 patients, the EEG-recording after
      sleep reduction was ordered because of a suspected seizure disorder; in the
      remaining patients it was initiated solely because of sharp components in the
      routine-EEG. In 341 (53.6%) of the patients with suspected epilepsy,
      electroencephalographic activity indicative of a seizure disorder was activated.
      Such epileptic patterns were recorded almost exclusively in stages of waking, 1
      and 2. Only in one out of the 124 patients who reached sleep stages 3 and 4
      epileptic patterns were not seen until deep sleep was entered. We observed 2/s,
      3/s and 6/s spike-and-wave complexes, sharp waves, spikes, polyspikes, groups
      containing remarkably sharp components and so called sharp vertex grapho
      elements. Patients with suspected seizure disorders frequently show grapho
      elements which can be interpreted as the expression of a disposition for
      epilepsy. These sharp vertex elements were evident in 54 out of 719 short term
      sleep recordings, more often in children than in adults. 49 times they coincided
      with typical epileptic discharges such as sharp waves, spikes or spike-and-waves
      in the same recording.

PMID- 1760091
TI  - Sleep and epileptic activity.
AB  - Thirteen patients suffering from severe partial epilepsy and potential candidates
      for surgical treatment were investigated with stereotactically implanted
      intracerebral electrodes during nocturnal physiological sleep. The recorded
      electrocerebral activity was automatically analyzed to gain information on
      interictal epileptic events during wakefulness and the phases of sleep. The
      interictal epileptic activity shows: (1) great variability in the different
      subjects, and intra-individually, variability according to the explored cerebral
      regions; (2) is not influenced by the location of the recorded epileptic events;
      and (3) is affected by the local level of epileptogenicity. The latter was
      determined by the assessment of the capacity to give origin to ictal discharges
      and the disappearance of seizures following surgical removal. The interictal rate
      of spiking from the most epileptogenic cerebral zone is characterized by a
      relative stability during the night and by a relatively high degree during REM
      sleep.

PMID- 1760092
TI  - The nature of the influence of sleep deprivation on the EEG.

PMID- 1760093
TI  - Sleep and sleep deprivation in epileptology.

PMID- 1760094
TI  - Sleep deprivation, epilepsy and the ability to operate a motor vehicle.
AB  - This study is based upon 207 examinations for the evaluation of the ability to
      operate a motor vehicle in persons with transient disturbances of the cerebral
      function. In 26 persons, the EEG was repeated after sleep deprivation. There was
      EEG activation with transient disturbances in seven cases (not present in the
      routine EEG). In five individuals, there were transient disturbances in the
      routine EEG as well as after sleep deprivation. No abnormalities were recorded in
      14 persons. No driver's license could be granted in five patients with
      unequivocal spike wave complexes or spike wave paroxysms following sleep
      deprivation. In two patients, however, the permission to drive could be granted.
      These patients showed spike wave patterns in the routine EEG, but no seizures had
      occurred for several years and their performance in the experimental
      psychological evaluation (with simulator) were superior. In persons with
      suspected and clinically obscure cerebral attacks, as well as in persons with
      known seizure disorder but seizure-free for several years, the EEG after sleep
      deprivation must be regarded as a highly informative test which may crucially
      influence the decision. The method of activation corresponds with a type of
      stress with which the motorist must deal frequently. This test can be carried out
      on an outpatient basis and with negligible iatrogenic damage.

PMID- 1760095
TI  - Sleep deprivation and epileptological implications.

PMID- 1760096
TI  - Suppressive effects of enkephalins and REM sleep deprivation on seizures.

PMID- 1760097
TI  - The enforced nap: a simple effective method of inducing sleep activation in
      epileptics.
AB  - The authors routinely carry out sleep activation in suspected cases of epilepsy
      when the EEG performed in the waking state gives insufficient data. The technique
      used, referred to as 'the forced nap', allows the induction of 60 min sleep in
      80% of all subjects and 90% of those under 16 years of age. This method gives
      results comparable with (and probably better than) those obtained by EEG
      recording after 24 h sleep deprivation, but is much simpler to carry out and can
      be used by all hospital-based EEG laboratories. The widespread use of this method
      should allow to change the current situation. It was found that more than 50% of
      hospital-based EEG laboratories do not perform sleep activation, and the
      remaining centers restrict this technique to a very limited number of patients,
      thus depriving almost all epileptics of an effective diagnostic tool.

PMID- 1760098
TI  - Awakening epilepsy ('Aufwach-Epilepsie') revisited.
AB  - The concept of 'awakening epilepsy' (introduced by Janz, 1953) occupies a crucial
      position for the comprehension of primary generalized epilepsy. The associated
      electroencephalographic manifestations are discussed and the role of abnormal
      (paroxysmal) arousal responses ('dyshormia') is stressed. The origin of these
      bilateral-synchronous discharges appears to be located below the frontal midline
      scalp region in mesial portions of the supplementary motor region. 'Awakening
      epilepsy' is also interesting from the viewpoint of sleep research. There is also
      an important age factor; these seizures (mostly grand mal and classical petit mal
      absences) are most common in older children, adolescents and young adults. The
      general management of these patients has to take into account the patient's
      special vulnerability after a night of poor sleep.

PMID- 1760099
TI  - Sleep organization and epilepsy.
AB  - Sleep is known to facilitate epileptic manifestations but can also protect the
      sleeper against the recurrence of seizures. This has been demonstrated in studies
      on sleep deprivation, and is particularly evident in alcoholic epilepsy and
      matutinal myoclonus epilepsy. Sleep organization in the epileptic patient is
      permanently altered by frequent awakenings and stage shifts. Nocturnal grand mal
      and repetitive partial seizures worsen the sleep disorder by reducing total sleep
      time and decreasing REM percentage by half. The cumulative effect of these sleep
      disorders may act on day-time vigilance in epileptics, and may even exert an
      influence on the recurrence of seizures.

PMID- 1760100
TI  - Sleep and benign partial epilepsies of childhood: EEG and evoked potentials
      study.
AB  - The electroclinical picture and nosological limits of benign partial epilepsy of
      childhood with rolandic spikes (BERS) have been better defined by nocturnal sleep
      records. In all stages of sleep, there is a significant increase in frequency and
      amplitude of rolandic spikes (RS) without change of their morphology. Another
      interesting observation is the appearance of independent spike foci in sleep, or
      brief subclinical spike wave discharges which are limited to the state of
      drowsiness. More recently, other types of partial epilepsy of childhood with
      benign evolution have been identified: (a) partial epilepsy with induced spike
      representing somatosensory evoked potentials; (b) benign psychomotor epilepsy;
      (c) partial epilepsy with occipital spike waves. In all these forms, the sleep
      records are essentially similar to those in BERS and have been very helpful in
      the nosological identification of these forms of epilepsy. For this reason, the
      sleep records of these special forms are truly informative for the clinician from
      the diagnostic and prognostic viewpoint. On the other hand, some investigators,
      have pointed out that, in the initial stage of these benign forms of partial
      epilepsy, there may be more or less significant intellectual impairment and
      behavioral disorder, sometimes accompanied by frequent brief absences. From the
      EEG viewpoint, this condition is characterized by brief discharges of slow spike
      wave complexes amounting to a pattern of "electrical status epilepticus". This
      special electroclinical condition mimics the Lennox-Gastaut syndrome but is
      generally self-limited. Thus, a correct differential diagnosis is very important
      from the diagnostic viewpoint. There is good evidence that sleep records permit
      an earlier identification of these conditions and strongly contribute to a
      correct differential diagnosis. In the benign partial epilepsy the SEPs, during
      awake and sleep, morphology and latency are normal, while the N60 amplitude is
      increased. A group of children with benign partial epilepsy shows EEG spikes
      evoked by tapping, and giant N60 component. This giant component persists during
      sleep and is not specific for any type of benign partial epilepsy. In conclusion,
      the results of sleep recordings are conducive to a correct diagnosis and better
      definition of the nosological delineation of partial epilepsies in childhood;
      they also provide a better comprehension of their evolution, and thus of their
      prognosis. The Evoked Potentials seem be a useful tool in the study of benign
      partial epilepsy.

PMID- 1760101
TI  - Epileptic manifestations and influence on sleep in the baboon Papio papio.

PMID- 1760102
TI  - Temporal lobe epilepsy, sleep and arousal: stereo-EEG findings.
AB  - By means of combined surface and depth EEG recordings (32 channels) and split
      screen video-monitoring (infra red light), complete all-night sleep studies were
      carried out in drug-resistant epileptics suffering from complex partial seizures.
      These data were supplemented by (1) all-night sleep recordings from three
      patients who had chronically implanted electrodes in the periaqueductal grey
      matter because of severe pain problems, and (2) incomplete sleep recordings (day
      time or only partial night) from other drug-resistant epileptics, who underwent
      chronic stereo-electroencephalographic (SEEG) examination in view of the surgical
      therapy. The following questions of importance were studied and the results were
      compared between different patient groups. 1. Relationship between overt clinical
      seizures or subclinical seizure discharges and the time course of night sleep. 2.
      Topic behavior of the epileptogenic area and different propagation phenomena of
      interictal spikes and ictal seizure discharges in different sleep stages. 3.
      Influence of arousal on the average spike incidence of any location with special
      attention to the different (slow and fast) components of the K-complex and their
      association with spiky elements, thus testing the hypothesis that the K-complex
      might serve as a vehicle for the seizure discharge. 4. Incidence and time
      relationship of seizure discharges with clinical overt awakenings.

PMID- 1760103
TI  - Incidence of medically treated burns in The Netherlands.
AB  - During the period January 1988 to December 1989, medically treated burn injuries
      in The Netherlands were recorded prospectively by three registration systems.
      These systems cover patients treated in burn units, in general and university
      hospitals, and by general practitioners. Incidence rates and 95 per cent
      confidence intervals were calculated, and basic epidemiological data about
      severity and localization of the burns and about accident circumstances were
      collected. The overall incidence rate of medically treated burns over all levels
      of medical care is estimated to be about 280 per 100,000 persons per year. This
      overall incidence figure appeared to be about three times as high for 0-4-year
      old children: 775 per 100,000 per year. At all levels of medical care, scalds are
      the most frequent type of burn, resulting in an overall incidence rate among 0-4
      year-old children of 430 per 100,000 per year. Incidence rates are lowest among
      the elderly (55 years and over), but this age group suffers a higher mortality
      from burns. Furthermore, it appeared that males are more prone to serious burns
      than females, whereas female are more often treated for less severe burns. Most
      of the accident circumstances for serious burns were related to professions,
      whereas most of the circumstances for less severe burns were related to household
      activities.

PMID- 1760104
TI  - Determinants of behavioural risk factors for burn injuries.
AB  - Systematically developed health education should be based on a thorough knowledge
      of the determinants of the behavioural risk factors. Compared to other health
      related behaviours, safety behaviour has some specific characteristics, which
      complicate studying its determinants. First, there is a multitude of
      circumstances leading to injuries, which means that it is not possible to
      pinpoint one desired behaviour to be linked with the prevention of injuries.
      Secondly, people are often not familiar with (the advantages and disadvantages
      of) all the possible preventive measures. Thirdly, the usefulness of preventive
      measures may depend on housing situations. So far, no elegant way of coping with
      these problems in examining the determinants of safety behaviour seems to have
      been suggested in the literature. In this article an approach to the study of
      determinants of safety behaviour is presented. The general description of this
      approach is illustrated by a study on the determinants of the behavioural risk
      factors for burn injuries in young children, which was conducted among Dutch and
      Turkish parents of children aged 0-4 years. The results indicate, for instance,
      that parents who implemented the safety behaviour reported that safety behaviour
      had become habitual to them.

PMID- 1760105
TI  - Gastrocnemius acetylcholinesterase activity in response to burn trauma in the
      mouse.
AB  - In this study we examined the effect of increasing size of body surface area
      (BSA, 20, 30 and 50 per cent) burn on distally located gastrocnemius
      acetylcholinesterase (AChE) activity. Burn injury was applied to predefined areas
      of the dorsal and ventral skin surfaces of mice. AChE activity at 3 weeks
      postburn was measured by differential extraction and velocity sedimentation on
      sucrose gradients. Analysis of variance was used for all statistical evaluation.
      Within the sham-treated controls most of the AChE activity consisted entirely (92
      per cent) of the globular forms (S1 and S2). Asymmetric (S3 and S4) and non
      extractable (H5) forms were 2 and 5 per cent, respectively. The total globular,
      asymmetric and non-extractable forms were not significantly different in
      gastrocnemius among the burn groups. However, individual forms (6.5S, 10S) of the
      soluble globular group (S1) were decreased (P less than 0.05) by half for all
      burn groups. Some molecular forms (4S, 10S) of residual globular group (S2) were
      decreased (P less than 0.05) in the 20 per cent and 50 per cent burn groups. In
      the asymmetric group (S3) the molecular forms (4S, 10S, 12S and 16S) were
      increased (P less than 0.001) for the 20 and 30 per cent groups. Within and
      between extraction groups interrelationships of the molecular forms were
      apparent. These data provide evidence that in response to burn trauma AChE
      activity of the gastrocnemius showed a decrease in soluble globular and an
      increase in asymmetric forms with multimeric dependence.

PMID- 1760106
TI  - Cryopreservation of cultured skin cells.
AB  - Cryopreservation of human skin keratinocytes and fibroblast cells has been
      evaluated using three cryoprotectants at various concentrations, three cooling
      rates and two warming rates. Optimal combinations of factors were determined.
      Selection for tolerance to cryopreservation was not detected after repeated
      freeze/thaw cycles. A beneficial effect of serum was shown to be cooling rate
      dependent.

PMID- 1760107
TI  - Methylprednisolone does not protect the lung from inhalation injury.
AB  - Most clinical studies suggest that corticosteroids are contraindicated in the
      treatment of acute smoke inhalation. However, they are still used in critical
      situations with the hope that they might reverse the acute pathophysiological
      responses to smoke inhalation and thus reduce the severity of the illness or make
      survival possible. These experiments were done to study the effect of
      methylprednisolone on the response to smoke inhalation in anaesthetized mongrel
      dogs. Three experimental protocols were followed: (I) haemodynamics, gas
      exchange, lung compliance, and lung water were evaluated; (II) pulmonary vascular
      permeability was assessed by cannulating the afferent tracheobronchial lymphatic
      and calculating the osmotic reflection coefficient (sigma d) at high lung lymph
      flows; (III) pulmonary surfactant function was studied using a Wilhelmy balance.
      Methylprednisolone alone did not alter any measured values compared with those
      seen in control animals. Treatment with methylprednisolone (30 mg/kg) prior to
      smoke exposure did not attenuate any of the adverse responses typically seen
      after smoke inhalation. These data indicate that methylprednisolone does not
      protect the lung from the acute physiological consequences of inhalation injury.

PMID- 1760108
TI  - Pain relief in burns: James Laing memorial essay 1990.

PMID- 1760109
TI  - Pain control in paediatric burns--the use of patient-controlled analgesia.
AB  - Eleven children received patient-controlled analgesia (PCA) for the management of
      severe burn pain, their ages ranged from 4.75 to 14 years. Periods of PCA ranged
      from 2 to 131 days. Three patients developed evidence of tolerance as shown by
      high dose requirements, but the patients weaned themselves rapidly when pain
      levels fell. We conclude that PCA provides good quality analgesia to school-age
      children requiring debridement and grafting for burns. Its use simplified one
      major aspect of the management of these children.

PMID- 1760110
TI  - Contact burns due to thermoplastic road paint.
AB  - Thermoplastic road markings are used at similar temperatures to tar and bitumen
      and spillage onto skin causes similar contact burns. Most of these occupational
      burn injuries can be avoided by adherence to the manufacturer's recommendations
      about the wearing of protective clothing. Management and foremen of contractors
      using these materials need to ensure that their workers comply with safe
      procedures and wear the specified protective clothing.

PMID- 1760111
TI  - An analysis of mortality in patients with burns covering 40 per cent BSA or more:
      a retrospective review covering 24 years (1964-88).
AB  - The charts of patients with burns covering more than 40 per cent of the body
      surface area (BSA) who were admitted to the Burn Unit of the Soroka Medical
      Center, Beersheva, Israel, between the years 1964 and 1988 were reviewed for
      mortality rate and causes of deaths. The factors affecting survival are reviewed
      and analysed.

PMID- 1760112
TI  - Audit of thermally injured children under 5 years of age.
AB  - One-third of all admissions to the Wessex Regional Burns Unit (WRBU) are children
      under 5 years of age. These patients constitute a disproportionately large part
      of the workload in terms of nursing and medical care. A review of children
      admitted to the WRBU over a 5-year period was undertaken. Information was stored
      in a computer database (dBASE-IV) to simplify data analysis and to develop a
      system of data collection which can be used for audit. Eighty-one per cent of
      injuries were due to scalds. The mean burn surface area (BSA) was 8 per cent, and
      78 per cent of injuries were smaller than 10 per cent BSA. Skin grafting was
      required in 44 per cent of patients. The mean time to operation was 13 days after
      injury. Significant hypertrophic scarring occurred in 60 per cent of patients and
      12 per cent of patients were readmitted for further surgical procedures. There
      was one death. In an extension to the main database, associations between
      clinical and physiological observations and morbidity were sought. The data
      suggest that behavioural changes, 'shock', profound lymphocytopenia and pyrexia
      greater than 39.5 degrees C should be treated as strongly suggestive of the
      development of complications in the early stages after injury.

PMID- 1760113
TI  - High-tension electrical-arc-induced thermal burns caused by railway overhead
      cables.
AB  - Eleven patients with high-tension electrical-arc-induced thermal burns due to
      railway overhead cables were treated at the Bratislava Burn Department during a
      relatively short period of 18 months. All the injuries occurred by the same
      mechanism, that is persons climbing on top of railway carriages and approaching
      the 25,000 V a.c. overhead cables. All the burns were the result of an electrical
      arc passing externally to the body, with subsequent ignition of the victim's
      clothes. The cutaneous burns, ranging from 24 to 79 per cent of the BSA, were
      mostly deep partial to full skin thickness injuries. One patient died on day 5
      postburn, the other survived. In spite of high-tension aetiology, no true
      electrical injuries appear to have occurred and no amputations were necessary.
      The pathophysiology and possible preventive measures are discussed. It must be
      stressed that arcing can be induced by an earthed object approaching, but not
      touching, a cable carrying a high voltage.

PMID- 1760114
TI  - 'Is all that's blistered burned?' ... A case of kerosene contact burns.
AB  - A case of chemical burns following prolonged exposure to kerosene in the home is
      presented. The appearance are discussed together with the possible systemic
      effects which have been reported. Early treatment to remove the agent followed by
      observation and dressing in a burns unit is recommended.

PMID- 1760115
TI  - The prevention of hot tap water burns--a study of electric immersion heater
      safety.
AB  - A household survey conducted in 1986 as part of a study into the prevention of
      hot tap water burns found that 50 per cent of the immersion heater installations
      visited produced hot water at temperatures of 60 degrees C or greater. The
      Electricity Research and Development Centre has carried out a new detailed survey
      of over 200 electric immersion heater installations to ascertain the
      effectiveness of thermostats in controlling hot water temperatures. This survey
      found that immersion heater thermostats were effective and reliable devices, but
      it was disturbing to record the 71 per cent of the thermostats inspected were set
      at temperatures greater than 65 degrees C. Hot water temperature measurements
      showed that only 20 per cent of the homes had hot water with a temperature
      greater than 65 degrees C at the tap. One possible reason for this may have been
      the use of hot water by the residents before the temperature measurements were
      made because, while conducting the survey, it was not possible to have the
      immersion heater switched on in every apartment due to the time switching
      arrangements. For the age group surveyed, with an average age of 72 years, the
      provision of a device to indicate the remaining hot water in a storage cylinder
      was thought to be helpful but more than half the respondents indicated that they
      did not want new kinds of remote temperature control.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1760116
TI  - Bilateral visual loss after severe burns in a child.
AB  - A girl who sustained severe burns was admitted to the hospital 16 h postburn. The
      patient developed sudden visual loss on day 15 postburn. She responded to
      treatment with significant return of visual acuity by 5 weeks after injury at the
      time of discharge from hospital.

PMID- 1760117
TI  - Parascapular fasciocutaneous flap for covering an above-elbow amputation stump.
AB  - The successful use of a parascapular fasciocutaneous flap to cover an above-elbow
      amputation stump with exposed bone is described. Better stability of the stump to
      pressure (or manipulations), a relatively early one-stage surgical procedure and
      diminished possibility of later contracture leads to a better long-term outcome.

PMID- 1760118
TI  - Rupture of the heart in a burn patient: a case report of free wall rupture of the
      left ventricle.
AB  - A 63-year-old male was burned when in a state of alcoholic intoxication, he fell
      head first into a bathtub filled with hot water and received burns covering 40
      per cent BSA. Despite surgical wound debridement, a severe sepsis continued and a
      sudden cardiac arrest occurred. Autopsy revealed a large volume of blood in the
      pericardial space. The heart was ruptured through a myocardial abscess in the
      posterior wall of the left ventricle. The principle cause of his death was
      attributed to acute cardiac tamponade following cardiac rupture through a
      myocardial abscess.

PMID- 1760119
TI  - Silver sulphadiazine-induced haemolytic anaemia in a glucose-6-phosphate
      dehydrogenase-deficient burn patient.
AB  - A 20-year-old soldier sustained 35 per cent body surface area burns by open
      flames. He was treated with topical application of 1 per cent silver
      sulphadiazine (SSD) twice daily. Four days postburn he developed acute haemolytic
      anaemia. Withdrawal of SSD was followed by complete recovery. A glucose-6
      phosphate dehydrogenase (G6PD) deficiency was proven by pathological Motulski
      tests. Although the hazards of SSD are well indicated by the manufacturers, there
      appear to be no written reports of haemolysis induced by this drug in G6PD
      deficient patients.

PMID- 1760120
TI  - Natural history of 'deep dermal' burns in domestic pigs.

PMID- 1760121
TI  - Standards of care for hospice patients with pressure ulcers.
AB  - Pressure ulcers are a major concern of hospice nurses. A recent survey of hospice
      agencies in an area of the southwest indicated a lack of specific standards of
      care for patients with pressure ulcers and no systematic method to identify
      patients at risk. Standards of care were subsequently developed to identify
      patients at risk and to manage pressure ulcers of hospice patients.

PMID- 1760122
TI  - Assessment of epithelial thickness by ultrasonic imaging.
AB  - Moisturizing creams and lotions are an important aspect of preventing pressure
      ulcers. This study reports the increased thickening of the epithelium on 11
      subjects who used a moisturizing cream (treatment) for 20 days. The thickening of
      the epithelium was measured before use of the moisturizing cream, on day 1, day
      8, and day 20 of the treatment, and 12 days after the treatment. The ultrasound
      measurements were similar before the treatment and 12 days post treatment; the
      measurements increased for the days of treatment. Current research would lead us
      to believe that short-term increase in epithelial thickness as produced by a
      moisturizer is a result of increased water content. Ultrasound imaging may be the
      new standard for comparing the effects of moisturing products.

PMID- 1760123
TI  - Silicone injection management of diabetic foot ulcers: a possible model for
      prevention of pressure ulcers.
AB  - Long-term clinical and histologic findings with injectable fluid silicone to
      reduce mechanical forces over plantar skin are described. The fluid induces a
      relatively stable soft tissue prosthesis between skin and bone, reducing the
      frequency of insensitive ulcer recurrence in the foot. On the basis of these
      favorable findings, studies are warranted to determine the fluid's efficacy in
      prevention of pressure ulcers.

PMID- 1760124
TI  - Comparisons of heel pressure-reducing devices.

PMID- 1760125
TI  - Prevention of pressure ulcers in elderly nursing home residents: are special
      support surfaces the answer?
AB  - This article describes a research study that compared the effectiveness of two
      pressure-reducing devices in a group of elderly nursing home residents. The
      results obtained revealed no significant differences between the two devices--an
      air-filled overlay and a gel mattress--in terms of pressure ulcer incidence,
      severity, and healing. Several factors contributed to these results and
      illustrate the problems encountered when preventing pressure ulcer development in
      a group of elderly, debilitated nursing home residents. These factors include
      ease of use of the pressure-reducing device, caregiver and facility
      characteristics, and critical patient variables. Until these variables are
      addressed, it is impossible for any device to be effective in preventing pressure
      ulcer development in nursing homes.

PMID- 1760126
TI  - Outcomes and critical thinking.

PMID- 1760127
TI  - Biosensors for the determination of drug substances.
AB  - A review of the use of biosensors for the determination of drug substances is
      presented. Although primary emphasis is placed on drugs of abuse, for example,
      cocaine, heroine, and morphine, other pharmaceutically important drugs, such as
      theophylline, Inderal, codeine, lidocaine, and the phenothiazines, are also
      discussed. Applications in both the liquid phase and the gas phase are presented.

PMID- 1760128
TI  - Immobilization of perfluoroalkylated enzymes in a biologically active state onto
      Perflex support.
AB  - Perflex has been introduced by E. I. du Pont de Nemours and Co., Inc., as a new
      fluorocarbon-based technology for protein immobilization. Due to the hydrophobic
      character of the support, however, significant loss of enzymatic activity may
      occur upon immobilization of certain enzymes, which appears to be due to a large
      conformational change of the protein ("inversion"). Pretreatment of the Perflex
      support with a neutral fluorosurfactant lessened the surface hydrophobicity, thus
      decreasing the hydrophobic interaction between the support and the protein.
      Modification of enzymes with a high number of fluorocarbon residues, which forms
      a hydrophobic "envelope" around the protein, also appears to prevent enzyme
      inactivation upon immobilization on Perflex support. Moreover, preactivation of
      the support with either perfluorooctylpropylisocyanate or reactive
      poly(fluoroalkyl) sugar reagents greatly improves the enzyme particle activity by
      increasing the amount of immobilized enzyme. Fluorosurfactant treatment of the
      support activated with perfluorooctylpropylisocyanate improves the retention of
      activity for sensitive enzymes such as alpha-chymotrypsin and increases the
      wetability and ease of handling of the Perflex particles.

PMID- 1760129
TI  - Cell-culturing characteristics of newly developed PHEMA microcarriers: their use
      with BHK21 cells.
AB  - Baby hamster kidney (BHK) fibroblasts, as model cells, have been proliferated on
      acrylic based microcarriers. Microcarriers were prepared by a novel suspension
      polymerization of acrylic monomers. Hydroxyethyl methacrylate was the basic
      monomer. Ethylene glycol dimethacrylate was used as the cross-linker. A
      hydrophobic comonomer, namely, methyl methacrylate, was included in order to
      adjust the hydrophilicity of the resultant matrix. An acrylic comonomer with
      positively charged tertiary amine groups, i.e., dimethylaminoethyl methacrylate,
      was also added in order to optimize the surface charge of the carriers. The
      adhesion, spreading, and growth characteristics of BHK cells on these novel beads
      were studied either in stationary or in submerged culture conditions. The results
      demonstrate that the cell attachment and growth can be controlled by changing the
      degree of charge and the hydrophilicity of the poly(hydroxyethyl methacrylate)
      matrix.

PMID- 1760130
TI  - Kinetically controlled synthesis of dipeptides using ficin as biocatalyst.
AB  - The application of the sulfhydryl protease ficin as biocatalyst is proposed as a
      novel method for enzyme-catalyzed synthesis of dipeptides. The negligible
      peptidase but considerable esterase activity at alkaline pH facilitated the
      kinetically controlled formation of peptide bonds by coupling the ester
      substrates Z-Ala-OMe and Z-Gly-OMe with L-alanine, D-alanine, L-glutamine, D
      glutamine and L-Cys(acetamidomethyl) respectively. The reaction is accomplished
      without the occurrence of secondary peptide hydrolysis. Under optimum reaction
      conditions (pH 9.2, high ratio nucleophile/carboxyl component, 4.8% ethanol, 40
      degrees C), the peptide yields ranged from 5 to 91%, depending on the structure
      of the amino and/or carboxyl component. No racemization was observed in the
      enzymatic reaction. Application of short-chain peptides has been advocated
      recently in clinical nutrition. Ficin-catalyzed peptide synthesis might be an
      attractive biotechnological approach for the synthesis of suitable dipeptides in
      this respect.

PMID- 1760131
TI  - Mutual recognition between polymerized liposomes. III. Association processes
      between avidin and biotin on polymerized liposome surfaces.
AB  - Association processes between avidin and biotin in various liposome systems were
      studied. By incorporating biotin onto the polymerized liposome surface,
      association processes with free avidin were largely decelerated. When the number
      of binding sites on the liposome surface was taken into account, the corrected
      association rate constant was 4.3% of the theoretical value for binary collision.
      The association rate constant between avidin- and biotin-carrying polymerized
      liposomes was much smaller than those for both the free avidin-free biotin system
      and the free avidin/biotin-liposome system, probably due to the repulsive
      hydration phenomenon. The results are discussed both in terms of our
      understanding of cell-cell recognition phenomena and for the development of drug
      delivery systems.

PMID- 1760132
TI  - Thermostabilization of carboxypeptidase A by interaction with its monoclonal
      antibodies.
AB  - The effect of interaction of carboxypeptidase A (CPA) with three monoclonal
      antibodies, each with a different epitope (CP 10, CP 9, and CP 8), on the heat
      stabilization of enzymes is described. These monoclonal antibodies bind to CPA
      with a relatively high binding constant (approximately 10(8) M-1) and do not
      affect its catalytic properties. Intact carboxypeptidase A lost more than 95 and
      90% of its esterase and peptidase activities within 120 min at 50 degrees C. The
      monoclonal antibodies increased the thermal stability of the enzyme by 90 and
      60%, as compared with the peptidase and esterase initial activities,
      respectively. Binding of these monoclonal antibodies, alone or in pairs, to the
      enzyme epitopes that are supposedly involved in heat denaturation of CPA result
      in stabilization of the conformation of the enzyme. The effect of
      thermostabilization by monoclonal antibodies was more pronounced with respect to
      peptidase activity than to esterase activity, indicating that these activities
      follow different reaction mechanisms. Since properly selected monoclonal
      antibodies can be prepared against virtually any enzyme, their immunocomplexation
      may provide a general and convenient method for stabilization of the enzyme
      conformation to heat denaturation, without affecting the catalytic properties.

PMID- 1760133
TI  - alpha-Chymotrypsin in plastein synthesis: influence of substrate concentration on
      enzyme activity.
AB  - The role of alpha-chymotrypsin in the plastein reaction was studied using a
      peptic hydrolysate of albumin as substrate. Study of this reaction simultaneously
      by different methods showed that the plastein reaction is enzyme catalyzed and is
      highly dependent on environmental conditions. A gel permeation chromatography
      study of the plastein reaction showed simultaneous increases in the high- and low
      molecular-weight oligopeptide fractions; a transpeptidation mechanism may be
      involved in the reaction. A study of the effect of substrate concentration on the
      plastein reaction catalyzed by alpha-chymotrypsin showed a profile with both
      hydrolytic and synthetic activities. This effect was also observed when the
      reaction course was followed by quantification of the free amino groups at
      different substrate concentrations, showing that a condensation mechanism is
      responsible for the synthetic activity when the substrate concentration is very
      high. These results have led us to conclude that the plastein reaction involves a
      transpeptidation and/or condensation mechanism, which is a function of the
      substrate concentration.

PMID- 1760134
TI  - Isolation and fundamental characteristics of a phospholipase B inhibitor from
      autolyzed Torulaspora delbrueckii.
AB  - Phospholipase B inhibitor was found in the autolyzate of yeast cells, Torulaspora
      delbrueckii. The inhibitor was purified to homogeneity by ethanol precipitation,
      gel filtration with Sephadex G-10, ion-exchange chromatography with DEAE
      Sephacel, and gel filtration with Asahipak GS-320. On thin-layer chromatography
      the purified inhibitor was detected with the Hanes-Isherwood reagent, which is
      used to detect phosphorus. The activity of the inhibitor was not affected by heat
      treatment at 100 degrees C for 1 h. Heating at 100 degrees C for 1 h in 1 M HCl
      and 1 M NaOH lowered activity to 76 and 80% of the original values, respectively,
      but heating at 110 degrees C for 24 h in 6 M HCl completely abolished activity.
      The inhibitor was highly soluble in water, but practically insoluble in alcohol,
      acetone, ether, and chloroform. The degree of inhibition of enzyme activity was
      not proportional to the concentration of inhibitor. The inhibitor inhibited both
      membrane-bound and water-soluble phospholipase B activity from T. delbrueckii at
      the same level; however, the inhibitor did not inhibit the activity of
      phospholipase A2 from snake venom (Naja naja).

PMID- 1760135
TI  - An automated RNA extraction procedure and application for 16S rRNA sequencing of
      Leuconostoc amelobiosum.
AB  - The determination of 16S ribosomal ribonucleic acid (16S rRNA) primary structures
      by in vitro reverse transcription requires the extraction of rRNA in pure form.
      Although a number of high reliable techniques have been developed for the purpose
      most are fairly complex, involving numerous steps and the wasting of large
      volumes. It describes here a RNA extraction and purification method, suitable for
      automatic extractors, which consistently yields reasonable amounts of pure total
      RNA from prokaryotes, free of DNA and RNases. The rRNA from the type strain
      Leuconostoc amelobiosum was isolated using this procedure. Its 16S rRNA sequence
      was determined and a comparative analysis with those from all currently described
      leuconostocs, including several atypical lactobacilli, revealed very high
      sequence homology with Leuconostoc citreum confirming Leuconostoc amelobiosum is
      phylogenetically a member of the genus Leuconostoc sensu stricto.

PMID- 1760136
TI  - [ Taxonomic study of the yeast flora of musts and wines from "Madrid wines"].
AB  - The natural yeast flora of musts and wines elaborated in wineries of the three
      Madrid viticultural areas, has been taxonomically analyzed. Two hundred and
      seventy yeast strains belonging to eighteen species, have been isolated, and
      Sacch. cerevisiae strains are the most frequent. The chemical characterization of
      samples with enological parameters defines the yeast fermentative ecosystem.

PMID- 1760137
TI  - Increase of hemolysin expression in Escherichia coli by cloned DNA sequences of
      Serratia marcescens.
AB  - A genomic library of Sau 3AI-generated Serratia marcescens DNA fragments was
      constructed in Escherichia coli 5K harbouring plasmid pANN202-312. Two clones
      capable of increasing the external hemolytic activity of the parental strain were
      isolated and characterized. The recombinant plasmids purified from these clones
      (designated pPSF29 and pPSH18) contained approximately 30 and 20 Kb,
      respectively, of Serratia DNA. Introduction of either plasmid in Escherichia coli
      caused a marked increase in hemolysin production and a concomitant decrease in
      cell viability.

PMID- 1760138
TI  - Distribution of oxidizing bacterial activities and characterization of
      bioleaching-related microorganisms in a uranium mineral heap.
AB  - The occurrence and activity of bioleaching-related microorganisms are highest at
      0.25 m under the surface of a uranium mineral heap, and decrease at points deeper
      than 1 m inside the heap. Thiobacillus ferrooxidans, Th. acidophilus, Th.
      thiooxidans and Leptospirillum ferrooxidans have been found and isolated from
      different sites inside the heap. Other mesophilic iron- or sulphur-oxidizing
      bacteria and some moderate thermophile have also been isolated from deep (1 m and
      4 m) sites and characterized. Several fungi and some yeasts are present in this
      bioleaching habitat.

PMID- 1760139
TI  - Methodology employed for the structure determination of tumour necrosis factor, a
      case of high non-crystallographic symmetry.
AB  - The structure of the protein tumour necrosis factor (TNF) was determined from
      crystals of space group P3(1)21 which contain six copies of the TNF monomer per
      crystallographic asymmetric unit [Jones, Stuart & Walker (1989). Nature (London),
      338, 225-228]. The nature of these crystals (relatively high crystallographic
      symmetry coupled with multiple copies of the protein in the asymmetric unit) led
      to some peculiarly challenging problems at several points in the structure
      determination. In particular, (1) self-rotation function calculations failed to
      yield clearly interpretable solutions, (2) the analysis of difference Patterson
      maps for heavy-atom derivatives required the development of a Patterson search
      program suite GROPAT. The redundancy in the asymmetric unit allowed refinement of
      poor-quality isomorphous phases at 4 A resolution and phase extension from 4 to
      2.9 A resolution using real-space symmetry averaging and solvent flattening in
      the absence of any isomorphous phase information. Despite further difficulties
      caused by structural differences between the six independent copies of the
      monomer the resultant electron density map was of high quality and proved to be
      easily interpretable.

PMID- 1760140
TI  - A multisolution method of phase determination by combined maximization of entropy
      and likelihood. V. The use of likelihood as a discriminator of phase sets
      produced by the SAYTAN program for a small protein.
AB  - The use of a likelihood criterion associated with maximum-entropy (ME)
      extrapolation for selecting phase sets as part of a new multisolution phasing
      strategy, already applied to solving small crystal structures from single-crystal
      data [Gilmore, Bricogne & Bannister (1990). Acta Cryst. A46, 297-308] and X-ray
      powder diffraction data [Gilmore, Henderson & Bricogne (1991). Acta Cryst. A47,
      830-841], has been tested on the small protein avian pancreatic polypeptide (APP)
      with 301 non-H atoms in the asymmetric unit in space group C2. A collection of 50
      phase sets for APP were provided by Woolfson & Yao. They had been generated from
      random starting phases by the SAYTAN procedure [Woolfson & Yao (1990). Acta
      Cryst. A46, 409-413] using data to a resolution of 0.98 A. Six of these had an
      unweighted mean absolute phase error, mean value of magnitude of delta phi, of
      less than 50 degrees, the remainder having phase errors of 60 degrees or more.
      However, none of the conventional figures of merit were able to identify these
      preferred sets. Each phase set was subjected to our standard procedure of entropy
      maximization and of evaluation of the log-likelihood gain resulting from the
      associated ME extrapolation. With only a small subset of data (to 2 A
      resolution), the likelihood criterion identified unambiguously the phase sets
      with mean value of magnitude of delta phi less than 50 degrees. In contrast,
      conventional figures of merit showed no such ability.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1760141
TI  - In vitro studies on the microbicidal effectiveness of a xenon-based ultraviolet
      light device for continuous ambulatory peritoneal dialysis connections.
AB  - Mercury vapor sourced ultraviolet light has been used for several years to
      disinfect connections that are integral to peritoneal dialysis solution delivery
      systems. This in vitro study evaluated the suitability of xenon flash sourced
      ultraviolet light as an effective alternative disinfecting agent. Candida
      albicans was determined to be at least four times more resistant than
      Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus mitis, and
      Pseudomonas aeruginosa to ultraviolet radiation generated by both mercury vapor
      and xenon flash devices. Both ultraviolet devices effectively disinfected
      transfer set spikes that were inoculated intraluminally with each of these five
      test microorganisms suspended in a pool of patient dialysis effluent. However,
      ultraviolet (254 nm) absorbance values of dialysis effluent was found to vary
      greatly between patients, with the most ultraviolet-opaque effluent significantly
      reducing the microbicidal effectiveness of the mercury vapor, but not the xenon
      flash system.

PMID- 1760142
TI  - Hypoventilation in a dialysis patient with severe metabolic alkalosis: treatment
      by hemodialysis.
AB  - A patient with end-stage renal disease (ESRD) developed metabolic alkalosis and
      alkalemia from protracted vomiting. As a result of the absence of the alkali
      excretory capacity in this patient with ESRD, the alkaline load accumulated
      rapidly. Once the amount of acid lost from vomiting exceeded the amount of acid
      gained from metabolism, alkalemia supervened. The initial arterial blood gas on
      room air revealed hypercarbia, hypoxia and alkalemia. Her serum bicarbonate was
      greater than 50 mEq/l. Compensatory hypoventilation occurred. In this report, the
      extent of compensatory hypoventilation in the setting of metabolic alkalosis in
      patients treated for ESRD and therapeutic approaches to this problem will be
      discussed. Treatment was aimed at correcting the primary disorder, namely
      metabolic alkalosis. Conventional bicarbonate dialysis was shown to be effective
      in improving acid-base homeostasis in this patient.

PMID- 1760143
TI  - Diagnostic approaches to AB-amyloidosis.
AB  - AB-amyloidosis, characterized by the presence of beta 2-microglobulin in the
      amyloid fibrils, has become an important complication of long-term renal
      replacement therapy. Due to the mainly musculoskeletal manifestation of the
      disease, standard approaches to obtain the diagnosis of amyloidosis, such as
      rectal biopsy or fat aspiration, often yield negative results. Currently,
      definitive diagnosis relies on biopsies, usually of synovial membranes or bone
      cystic radiolucencies. The serum level of beta 2-microglobulin, though markedly
      elevated, does not distinguish between patients with and without amyloid
      deposition. Measurements of altered, circulating beta 2-microglobulin species
      have not yet been evaluated in this regard. Recently, two radiopharmaceuticals,
      namely radiolabelled serum amyloid P component and radiolabelled beta 2
      microglobulin, have been shown to be able to detect amyloid deposits in vivo in a
      noninvasive manner. At least in the case of labelled beta 2-microglobulin it
      enables the specific detection of clinically and radiologically unrecognizable AB
      amyloid deposits. These tests therefore may have the potential to alleviate the
      need for biopsy confirmation in the diagnostic workup of a suspected AB
      amyloidosis.

PMID- 1760144
TI  - Bronchial reactivity in patients undergoing long-term haemodialysis for chronic
      renal failure.
AB  - Trapping of neutrophils within the lung occurs in patients undergoing
      haemodialysis and is also a possible mechanism in the pathogenesis of bronchial
      hyper-responsiveness. Falls in peak expiratory flow rate occur in most dialysis
      patients, and some develop overt asthmatic symptoms. To see whether these changes
      in airway function are secondary to increases in bronchial reactivity during
      haemodialysis, we therefore performed histamine challenge testing in 6 non
      asthmatic patients before and after haemodialysis. No change in reactivity was
      observed, suggesting that haemodialysis does not commonly result in bronchial
      hyper-reactivity in non-asthmatic individuals.

PMID- 1760145
TI  - Measurement of backfiltration rates during hemodialysis with highly permeable
      membranes.
AB  - A method for determining local transmembrane fluid movement in a commercial
      hemodialyzer at low dialysate flow rates by measuring changes along the dialyzer
      length in the local concentration of a marker macromolecule added to the dialysis
      solution has been developed. The method was evaluated in vitro at zero net
      ultrafiltration using dialyzers containing polysulfone (n = 4) and cuprophane (n
      = 3) membranes. The local concentration of the marker macromolecule along the
      dialyzer length was higher than the input dialysate concentration only during
      experiments with dialyzers containing polysulfone membranes. These observations
      provide direct empirical evidence that fluid movement in the dialysate to blood
      direction, i.e., backfiltration, occurs during hemodialysis with this highly
      permeable membrane. Net rates of backfiltration for the dialyzer containing
      polysulfone membrane were also calculated from changes in the local concentration
      of the marker macromolecule and mass balance considerations. The calculated
      backfiltration rates increased with increasing blood flow rate and trended upward
      with increasing dialysate flow rate. The described methodology provides a novel
      approach for the further characterization of fluid and solute transport during
      hemodialysis with highly permeable membranes.

PMID- 1760146
TI  - Plasmapheresis in conjunction with the dextran sulfate cellulose column for
      hypertriglyceridemic patient: a comparison with familial hypercholesterolemia.
AB  - For assessment of the usefulness of a dextran sulfate cellulose (DSC) column in
      the conduct of plasmapheresis (DSC lipoprotein adsorption, DSC-LA) for patients
      with hypertriglyceridemia on hemodialysis, a study was conducted to determine
      whether the adsorption of lipoproteins on a column varies in response to a
      variation in the lipoprotein composition. A patient with type V
      hyperlipoproteinemia on hemodialysis, a patient with type IIa homozygous, and a
      patient with type IIa heterozygous familial hypercholesterolemia were used in
      this study. In all patients, apolipoprotein B- and E-containing lipoproteins were
      removed preferentially by a DSC column. Following DSC-LA, abdominal pain before
      DSC-LA in a patient with type V hyperlipoproteinemia subsided, and regression of
      tuberous and tendinous xanthomas was induced in familial hypercholesterolemia. In
      cases of hyperlipoproteinemia, this column thus appears to exert a therapeutic
      effect regardless of the type of disease.

PMID- 1760147
TI  - In vitro study of the transfer of cytokine-inducing substances across selected
      high-flux hemodialysis membranes.
AB  - The in vitro transfer of cytokine-inducing substances (CIS) across cellulose
      triacetate and polyacrylonitrile hollow-fiber high-flux hemodialyzers was studied
      using culture filtrates of gram-negative bacteria isolated from hemodialysis
      center environments. With Enterobacter cloacae, no transfer of CIS was seen
      despite the potent cytokine inducibility and endotoxin content of the challenge
      solution. In contrast, interleukins 1 and 6 and tumor necrosis factor inducing
      substances did penetrate both dialyzer types challenged with Pseudomonas
      aeruginosa culture filtrates containing a high endotoxin content. Transfer was
      not seen, however, upon dilution of the challenge solution to lower, yet
      clinically very high levels of endotoxin. These results show that, in vitro, the
      transfer of CIS across high-flux membranes is critically dependent upon the
      quality and the quantity of the challenge material employed.

PMID- 1760148
TI  - Colorimetric assay of methyldopa bulk drug and tablets as its Fe(III) complex.
AB  - A new colorimetric method for the determination of methyldopa is described. The
      method is based on the reaction of methyldopa with ferric chloride in the pH
      range of 3.0-3.5 and producing a water soluble (1:2) brown complex with maximum
      absorbance at 423 nm. The conditional stability constant of the complex at the
      optimum pH 3.0 and ionic strength 0.4 M, is found to be 10(7.5). Beer's low is
      obeyed up to 6 mmol/l methyldopa concentration. The RSD of the method is 0.708
      1.226%. The proposed method was found to be suitable for the accurate and
      reproducible analysis of methyldopa bulk drug and tablets which is pointed by
      high recovery values 99.20-99.79%.

PMID- 1760149
TI  - In vitro activity of phenyl-O,N,N-azoxycyanide towards Candida spp. and
      Torulopsis spp.
AB  - Antifungal activity in vitro of phenyl-0,N,N-azoxycyanide has been tested against
      some strains of Candida spp. and Torulopsis spp. freshly isolated from humans.
      The results indicate good activity versus all yeasts tested. These data suggest
      that the azoxycyanide function could be used to obtain derivatives with potent
      anticandidal action, if conveniently vehicled by lypophylic compounds.

PMID- 1760150
TI  - Computation of release kinetics of isoniazid microcapsules.
AB  - Isoniazid is a drug of choice for intermittent chemotherapy of tuberculosis. It
      has been microencapsulated by emulsification followed by solvent evaporation
      technique using Eudragit RS 100 as polymer where free flowing, spherical and
      discrete microcapsules have been formed as obtained by SEM. The drug release data
      have been computed in the light of various kinetic models, where it is found that
      the matrix release mechanism predominates over the first and zero order mechanism
      for isoniazid microcapsules, even if the sizes and drug polymer ratio of the
      microcapsules were varied.

PMID- 1760151
TI  - Biotransformation kinetic of binifibrate and identification of its metabolites.
AB  - The metabolism of binifibrate was studied in 10,000 g supernatant fractions from
      rat liver. Binifibrate was found to be completely biotransformed into clofibric
      acid and nicotinic acid at 60 min from the start of incubation through a series
      of intermediate products among which glycerol dinicotinate was identified. The
      biotransformation constant of binifibrate into its different metabolites proved
      to be 0.11 +/- 0.025 min-1. The formation of clofibric acid follows a first-order
      kinetic process characterized by its corresponding rate constant (kc), proving to
      be 0.043 +/- 0.017 min-1. The amount of clofibrate was 0.78 +/- 0.16 mumol/ml,
      showing that it is not biotransformed later in the incubation mixture. The
      formation constant of nicotinic acid (kn) was 0.067 +/- 0.020 min-1 and the
      amount of substance contained in the incubation mixture (0.94 +/- 0.25 mumol/ml
      shows that it is later biotransformed in the incubation mixture through the
      previously described metabolic processes.

PMID- 1760152
TI  - [Biotechnology and diagnosis: the molecular DNA probe].

PMID- 1760153
TI  - New process for the anaerobic treatment of industrial wastes with high organic
      content.

PMID- 1760154
TI  - Characterization of the integral membrane polypeptides of rat liver peroxisomes
      isolated from untreated and clofibrate-treated rats.
AB  - We have characterized the integral membrane polypeptides of liver peroxisomes
      from untreated rats and rats treated with clofibrate, a peroxisome proliferator.
      Membranes, prepared by treatment of purified peroxisomes with sodium carbonate,
      were used to raise an antiserum in rabbits. Immunoblot analysis demonstrated the
      reaction of this antiserum with six peroxisomal integral membrane polypeptides
      (molecular masses, 140, 69, 50, 36, 22, and 15 kDa). Treatment of rats with the
      hypolipidemic drug clofibrate caused a 4- to 10-fold induction in the 69-kDa
      integral membrane polypeptide, while the other integral membrane polypeptides
      remained unchanged or varied to a lesser extent. The anti-peroxisomal membrane
      serum reacted with two integral membrane polypeptides of the endoplasmic
      reticulum which co-migrated with the 50- and 36-kDa integral membrane
      polypeptides of the peroxisome. Biochemical and immunoblot analyses indicated
      that these integral membrane polypeptides were co-localized to peroxisomes and
      endoplasmic reticulum. Immunoprecipitation of in vitro translation products of
      RNA isolated from free and membrane-bound polysomes indicated that the 22-, 36-,
      and 69-kDa integral membrane polypeptides were synthesized on free polysomes,
      while the 50-kDa integral membrane polypeptide was predominantly synthesized on
      membrane-bound polysomes. The predominant synthesis of the 50-kDa integral
      membrane polypeptide on membrane-bound polysomes raises interesting possibilities
      concerning its biosynthesis.

PMID- 1760155
TI  - In vitro formation of retinoic acid from retinal in rat liver.
AB  - Enzymatic conversion of retinal to retinoic acid in rat liver cytosol was
      detected using a rapid and sensitive assay based on high pressure liquid
      chromatography (HPLC). This retinal oxidase assay system did not require
      extraction steps or any other manipulation of the sample mixture once the sample
      vial was sealed for incubation. The product (retinoic acid) and the reactant
      (retinal) were separated by HPLC in 14.0 min with a sensitivity of 15 and 40 pmol
      per injection for retinoic acid and retinal, respectively. Enzymatic activity was
      observed to be linear with protein concentration (0-2.4 mg/mL) and time (0-30
      min) and displayed a broad pH maximum of 7.7-9.7. The enzyme exhibited Michaelis
      Menten single-substrate kinetics with an apparent Km of 0.25 mM. The average
      specific activity in nine normal rats was 35.6 +/- 3.3 nmol retinoic acid
      formed/h per mg protein. Incubation of the enzyme with zinc did not affect the
      rate of retinoic acid synthesis. Dithiothreitol inhibited the reaction. Both NAD
      and NADH stimulated retinoic acid formation. Formation of retinol was also
      observed when these pyridine nucleotides were added to the reaction mixture,
      indicating the presence of retinal reductase activity. The results of kinetic
      studies suggest that NADH may act indirectly to stimulate retinoic acid
      formation.

PMID- 1760156
TI  - Further purification and characterization of newly synthesized anionic
      glycoconjugates secreted by cultured UMR-106 cells: evidence that the major
      anionic glycoconjugate secreted by these cells is similar to bone sialoprotein
      II.
AB  - Following incubation of UMR-106 cells for 48 h in the presence of [3H]glucosamine
      and [35S]sulfate, the newly synthesized anionic glycoconjugates were isolated
      from the culture medium by cetylpyridinium chloride/ethanol precipitation and
      further separated by DEAE-Sephacel chromatography into two radiolabelled
      fractions, a major component, UM I, and a minor component, UM II. UM I appeared
      to be homogeneous as shown by Sepharose CL-4B chromatography under dissociative
      conditions, and SDS-polyacrylamide gel electrophoresis. It showed a molecular
      mass of approximately 93 kDa on 4-15% gels. UM I was partially degraded by brief
      treatment with trypsin, releasing a small, terminal peptide that contained 47.6%
      of 35S but no 3H. Treatment of UM I with neuraminidase and 0.1 N H2SO4 (1 h at 80
      degrees C), respectively, released 27% 3H and 38.4% 3H plus 41% 35S, suggesting
      the presence of a significant number of sialic acid residues, as shown by
      Sephadex G-50 chromatography of the digests. Amino acid analysis showed that the
      UM I glycoconjugate was rich in acidic amino acids (12.6% aspartic acid and 21.2%
      glutamic acid residues) and its N-terminal sequence was Phe-Ser-Met-Lys-Asn-Phe-,
      which is identical to the published N-terminal amino acid sequence of rat bone
      sialoprotein II. Keratanase treatment of UM I released 26% of the incorporated
      radioactivity, suggesting the presence of keratan sulfate chains. UM II contained
      a chondroitinase ABC-sensitive proteoglycan.

PMID- 1760157
TI  - Isolation, ultrastructure, and partial characterization of collagen from the
      perineurium of the Florida lobster, Panulirus argus.
AB  - Highly concentrated extracellular filaments in the perineurium of the Florida
      spiny lobster, Panulirus argus, were isolated using ultracentrifugation and
      linear sucrose gradients. The pellet obtained was highly enriched for the
      filaments as observed by transmission electron microscopy. Fibril diameter and
      axial periodicity measurements were obtained from filaments positively and
      negatively stained with uranyl acetate. A period between 14.0 and 25.0 nm and an
      average fibril diameter of 15.0 nm were observed. The filaments proved resistant
      to solubilization by most conventional agents and by several collagenases. NaOH
      (0.1 M at 100 degrees C) safely dissolved the filaments for measurements of
      protein content by the Lowry method and carbohydrate content with anthrone
      reagent. These tests revealed a protein content of approximately 84% and a high
      carbohydrate content of approximately 15%. Polyacrylamide electrophoresis of an
      acid-pepsin filament extract revealed a highly concentrated band (approximately
      100,000) corresponding to the alpha-1 and alpha-2 bands of vertebrate type I
      collagen. Wide angle X-ray diffraction yielded meridional reflections that
      confirmed the filaments as collagen when compared with mammalian collagen X-ray
      diffraction. The amino acid composition was determined with a computer-assisted
      Beckman amino acid analyzer, which showed a glycine content of 279 residues/1000.
      Hydroxylysine and hydroxyproline were present in lower concentrations than
      expected.

PMID- 1760158
TI  - Purification and the effect of peptide N-glycosidase F on lysosomal membrane
      bound glucocerebrosidase from human cultured fibroblasts.
AB  - Glucocerebrosidase was purified from human cultured dermal fibroblasts more than
      2200-fold to apparent homogeneity using high performance Alkyl-Superose HR 5/5
      hydrophobic interaction and Bio-Sil TSK-250 gel permeation column chromatography.
      Sodium dodecyl sulfate--polyacrylamide gel electrophoresis and protein staining
      of the catalytically active and concentrated enzyme fractions from the gel
      permeation columns revealed the presence of one band of Mr 64,000. The
      glucocerebrosidase preparation purified to homogeneity was digested with peptide
      N-glycosidase F that cleaves N-linked oligosaccharide structures from
      glycoproteins. The molecular weight of glucocerebrosidase after digestion with
      peptide N-glycosidase F was reduced to Mr 57,000, suggesting that the mature
      enzyme is a glycoprotein and that N-linked oligosaccharide constitutes a minimum
      of about 10% of the total molecular weight of the polypeptide. These findings are
      compatible with the hypothesis that glucocerebrosidase was initially synthesized
      as a precursor polypeptide which was subsequently glycosylated to become the
      mature enzyme.

PMID- 1760159
TI  - Folylpolyglutamate synthetase from beef liver: purification and some properties.
AB  - The polypeptide chain of folylpolyglutamate synthetase from beef liver has been
      isolated and partially characterized. This polypeptide has an apparent molecular
      weight of 73,000. Its amino-terminal residue is blocked. Amino acid analysis
      agrees with the hydrophobic properties and the pI (6.0) of this cytosolic enzyme.
      Polyclonal antibodies to the denatured enzyme have been prepared.

PMID- 1760160
TI  - Isolation and partial characterization of a soluble mucin in human pancreatic
      juice.
AB  - Morphological and histochemical abnormalities in pancreatic mucin occur in many
      pancreatic disorders. However, the composition of pancreatic mucin is poorly
      understood. Purified mucin was isolated from pure pancreatic juice by sequential
      chromatography on Sepharose CL-2B and CL-4B followed by CsCl density gradient
      ultracentrifugation. The mucin preparation consists of 24% protein and 73%
      carbohydrate. Reduction of the macromolecule (greater than 2 x 10(6)) by
      mercaptoethanol resulted in the formation of subunits of molecular weight 500,000
      and released several small molecular weight proteins, including a glycoprotein of
      an average molecular weight of 116,000. Cellulose acetate electrophoresis
      separated the mucin into three species of different staining properties for
      periodic acid-Schiff reagent and Alcian blue, suggesting the presence of
      microheterogeneity with respect to sulphation and sialation. Threonine, serine,
      and proline composed 48% of the total amino acids, while the oligosaccharide
      moiety contained N-acetylglucosamine, N-acetylgalactosamine, fucose, galactose,
      sialic acid, and sulphate. We also detected the presence of C16:0 and C18:0 fatty
      acids which were probably noncovalently bound to the pancreatic mucin.

PMID- 1760161
TI  - Analysis of the activation of poly(ADP-ribose) polymerase by various types of
      DNA.
AB  - In this work, we examined the activation of poly(ADP-ribose) polymerase by
      various types of DNA. We have found that the best activator for poly(ADP-ribose)
      polymerase is an octanucleotide. However, the use of a defined activated DNA is
      also suitable.

PMID- 1760162
TI  - Frequency of anesthetic cardiac arrest in infants: effect of pediatric
      anesthesiologists.

PMID- 1760163
TI  - Frequency of anesthetic cardiac arrests in infants: effect of pediatric
      anesthesiologists.
AB  - STUDY OBJECTIVE: To determine whether the presence of pediatric anesthesiologists
      decreases the frequency of anesthetic-related cardiac arrests in infants
      (children who are 1 year of age or younger). DESIGN: A comparative retrospective
      study of anesthetics and cardiac arrests during a 7-year period. SETTING: The
      main operating room (OR) suite of a large university hospital. PATIENTS: All
      patients age 1 year or less undergoing surgical anesthesia from July 1983 through
      March 1990. INTERVENTIONS: Computerized anesthetic and operative patients records
      were queried for patient age, ASA physical status, body weight, surgical
      procedure, intraoperative complications, and the identity of the attending
      anesthesiologist. In each case, it was determined whether a pediatric
      anesthesiologist was in attendance and whether a cardiac arrest due to anesthesia
      occurred. Pediatric anesthesiologists were identified as those with pediatric
      fellowship training or the equivalent. The study population was divided into two
      groups: (1) the pediatric anesthesiologist group, with 2,310 patients whose
      anesthetics were supervised by pediatric anesthesiologists; (2) the nonpediatric
      anesthesiologist group, with 2,033 patients. MEASUREMENTS AND MAIN RESULTS: Mean
      age and weight were comparable in the two groups, and the distribution of
      physical status did not differ. No anesthesia-related cardiac arrests occurred in
      the pediatric anesthesiologist group; four anesthetic cardiac arrests occurred in
      the nonpediatric anesthesiologist group, for a frequency of 19.7 per 10,000
      anesthetics. This difference between provider groups is significant (Fisher's
      exact probability test, p = 0.048). CONCLUSIONS: The results suggest that the use
      of pediatric anesthesiologists for all infants 1 year of age or younger might
      decrease anesthetic morbidity in this age-group.

PMID- 1760164
TI  - Comparison of train-of-four and posttetanic response as guides for endotracheal
      intubation in children.
AB  - STUDY OBJECTIVE: To evaluate and compare the predictive values of the absence of
      train-of-four (TOF) or posttetanic response as guides for endotracheal intubation
      in children. DESIGN: Prospective controlled study in children. SETTING: Induction
      of anesthesia and endotracheal intubation at a university-affiliated hospital.
      PATIENTS: Thirty pediatric patients age 1 to 10 years, ASA physical status I, who
      were undergoing elective surgery were divided into two equal groups.
      INTERVENTIONS: Anesthesia was induced with halothane and maintained at 1%
      inspired concentration. Fifteen children were stimulated with the TOF (2 Hz for 2
      seconds) technique and 15 with the twitch-tetanus-twitch sequence. All the
      patients received atracurium 0.4 mg/kg. Upon abolishment of the TOF or tetanus
      twitch sequence, endotracheal intubation was performed and the conditions for
      intubation were evaluated. MEASUREMENTS AND MAIN RESULTS: In the group of
      patients stimulated by the TOF technique, the neuromuscular response was ablated
      in 1.7 +/- 0.1 minutes, a significantly shorter time than in those stimulated by
      the tetanus-twitch sequence (4.0 +/- 0.4 minutes; p less than 0.0001). Conditions
      for intubation did not differ between the two groups. CONCLUSIONS: Good
      intubating conditions can generally be counted on when the TOF has disappeared;
      additional waiting for the disappearance of posttetanic response is unnecessary.
      The observation that the disappearance of the tetanus-twitch sequence is a good
      indicator of deep neuromuscular blockade during recovery from atracurium in
      children cannot be extrapolated to the induction period.

PMID- 1760165
TI  - Nasal continuous positive airway pressure: an alternative method for respiratory
      assistance.
AB  - STUDY OBJECTIVE: To examine the efficacy of a nasal continuous positive airway
      pressure (CPAP) system for respiratory support in patients who have respiratory
      insufficiency but are able to maintain spontaneous breathing without hypercapnia,
      respiratory acidosis, or deteriorated mental status. DESIGN: Prospective study.
      SETTING: Medical and surgical patients admitted to the intensive care unit (ICU)
      at the Hillel Yaffe Medical Center. PATIENTS: Nineteen patients with acute
      respiratory insufficiency and intact mental status who were able to maintain
      spontaneous breathing without hypercapnia or respiratory acidosis. Additional
      entry criteria were as follows: arterial oxygen tension (PaO2) less than 65 mmHg
      on inspired oxygen tension (FIO2) greater than or equal to 0.45, PaO2/FIO2 less
      than 150, respiratory rate greater than 35 breaths/minute, and inability to
      tolerate mask CPAP. INTERVENTIONS: Nasal CPAP (10 cmH2O) was applied to patients
      through two nasopharyngeal airways with an internal diameter (ID) of 8 mm each,
      inserted in both nostrils. During CPAP application, the patients were requested
      to breathe through their nose with their mouth closed. Even if they breathed
      through their open mouth, however, CPAP was maintained despite an observed
      pressure decrease of 4 cmH2O. MEASUREMENTS AND MAIN RESULTS: All patients showed
      a constant improvement in arterial blood gases, PaO2/FIO2, and respiratory signs
      during nasal CPAP of 10 cmH2O. PaO2 increased from 52 +/- 5.3 mmHg to 131 +/- 20
      mmHg with CPAP administration (p less than 0.05), while arterial carbon dioxide
      tension (PaCO2) increased from 32 +/- 2 mmHg to 36 +/- 2 mmHg (p less than 0.05)
      and respiratory rate decreased from 39 +/- 2.3 breaths/minute to 31 +/- 1.6
      breaths/minute (p less than 0.05). CONCLUSIONS: Nasal CPAP (10 cmH2O) is a
      reliable alternative to support arterial oxygenation in patients with respiratory
      failure who are alert and vigorous enough to avoid hypercapnia and respiratory
      acidosis while breathing spontaneously. In addition, since the patients are able
      to speak and thus are capable of expressing their feelings, the anxiety observed
      during respiratory support can be reduced.

PMID- 1760166
TI  - Pulse oximetry from the nasal septum.
AB  - STUDY OBJECTIVE: To evaluate the accuracy of the nasal septum site for pulse
      oximetry measurement of arterial oxyhemoglobin saturation (SpO2) in hypothermic
      patients. DESIGN: Prospective study. SETTING: Operating theater of a public
      hospital. PATIENTS: Fourteen hypothermic (temperature 34.6 degrees C to 36
      degrees C) patients (eight males and six females) undergoing a major surgical
      abdominal procedure. INTERVENTIONS: Fifty estimations of SpO2 were simultaneously
      made by a flex sensor probe applied at the nasal septum site and by a finger
      sensor probe using a pulse oximeter. The results were compared with arterial
      oxygen saturation (SaO2) as measured by arterial blood gas sampling. MEASUREMENTS
      AND MAIN RESULTS: In 18% of the estimations, the finger probe produced
      unmeasurable results. The nasal septum probe did not produce any unmeasurable
      results (p = 0.0055). In the remaining 41 estimations, a comparison of the
      measurements from the nasal septum versus the controls showed a mean difference
      of 0.15 and a limit of agreement of -0.106 to +0.398. A comparison difference of
      2.27 and a limit of agreement of 1.986 to 2.551. CONCLUSION: Monitoring SpO2 at
      the nasal septum site is more reliable than monitoring it at the finger site in
      hypothermic patients.

PMID- 1760167
TI  - Effect of preanesthetic intramuscular ranitidine on gastric acidity and volume in
      children.
AB  - STUDY OBJECTIVE: To evaluate the effects of preanesthetic administration of
      intramuscular (IM) ranitidine on pH and volume of gastric contents in children.
      DESIGN: Three randomized treatment groups. SETTING: Central operating rooms at a
      university hospital. PATIENTS: Forty children age 1 to 10 years undergoing a
      variety of elective surgical procedures requiring general anesthesia with
      endotracheal intubation. INTERVENTIONS: IM ranitidine 1 mg/kg (n = 15) or 2 mg/kg
      (n = 15) was administered 2 hours prior to induction of anesthesia. Ten patients
      without ranitidine served as the control group. An orogastric tube was inserted
      into each patient. MEASUREMENTS AND MAIN RESULTS: Gastric fluid pH and volume
      were measured every hour in the three groups. Plasma ranitidine concentrations
      were measured in ten patients of the ranitidine-treated groups. The mean volume
      of gastric fluid at induction of anesthesia was significantly lower in the
      ranitidine-treated patients (2.4 ml for ranitidine 1 mg/kg, 3.2 ml for ranitidine
      2 mg/kg) than in the controls (8.6 ml; p less than 0.05). The mean pH values at
      induction of anesthesia were significantly higher in the ranitidine-treated
      patients (4.6 for 1 mg/kg, 6.7 for 2 mg/kg) than in the controls (2.1; p less
      than 0.05). Dose-dependent plasma ranitidine concentrations were obtained.
      CONCLUSIONS: Preanesthetic IM ranitidine 1 to 2 mg/kg resulted in a higher pH and
      lower volume of gastric fluid at the time of induction and in a higher pH during
      3 hours of anesthesia. This therapy may be a useful adjunct to premedication for
      children who have a greater than normal risk of pulmonary aspiration during
      anesthesia.

PMID- 1760168
TI  - Weaning with end-tidal CO2 and pulse oximetry.
AB  - STUDY OBJECTIVE: To determine whether continuous measurement of arterial
      oxyhemoglobin saturation (SpO2) and end-tidal carbon dioxide (P(ET)CO2) can be
      used to wean patients safely and efficiently from postoperative mechanical
      ventilation after cardiac surgery. DESIGN: Prospective study comparing SpO2 and
      P(ET)CO2 to calculated arterial oxygen saturation (SaO2) and arterial carbon
      dioxide tension (PaCO2) obtained from blood gas analysis. SETTING: Cardiac
      surgical intensive care unit at a university-affiliated hospital. PATIENTS: Ten
      patients requiring elective coronary artery bypass grafting (CABG) were studied
      in the postoperative period during weaning from mechanical ventilation.
      INTERVENTIONS: Continuous monitoring of SpO2 and P(ET)CO2 was used to wean
      patients from mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: The patients
      were weaned from mechanical ventilation in an average time of 6.5 +/- 1.5 hours
      (mean +/- SD). A plot of SaO2 versus SpO2 indicated a high correlation (r = 0.84)
      with sensitivity (100%) for hypoxemia (SaO2 less than 90%). P(ET)CO2 was a good
      indicator of PaCO2 (r = 0.76); its sensitivity to detect hypercarbia (PaCO2 less
      than 45 mmHg) was 95%. The gradient between SpO2 and SaO2 was not significantly
      affected by the weaning process, but the PaCO2-P(ET)CO2 gradient decreased
      significantly as the ventilator rate was decreased (p less than 0.001). The
      weaning process was discontinued on four separate occasions because of metabolic
      acidosis. Ninety-five percent of arterial blood samples confirmed the weaning
      recommendations based on the continuous monitoring of SpO2 and P(ET)CO2.
      CONCLUSIONS: Continuous monitorin of SpO2 and P(ET)CO2 can be used to wean
      patients safely and effectively after CABG when adjustment of minute ventilation
      compensates for an increased PaCO2-P(ET)CO2 gradient during controlled
      ventilation.

PMID- 1760169
TI  - Anesthetic management of obstructive sleep apnea patients.
AB  - Presented in an illustrative case report and a review of the anesthetic
      management of obstructive sleep apnea patients. Preoperative evaluation should
      include a thorough airway evaluation and a comprehensive cardiovascular and
      pulmonary evaluation. With polysomnography, identification of the severity of
      sleep apnea can be idenified. Although sleep centers vary in their definitions,
      severe obstructive sleep apnea is diagnosed if the patient demonstrates an apnea
      index greater than 70 and an oxygen (O2) desaturation less than 80% with
      cardiovascular sequelae. Severe sleep apnea patients are at extreme risk for
      general anesthesia. These risks should be discussed preoperatively with the
      patient. Unsupervised preoperative sedation should be avoided because of the
      extreme sensitivity of these patients to sedatives and airway obstruction.
      Intraoperative management of the obstructive sleep apnea patient varies depending
      on the severity of the sleep apnea. Invasive monitoring may be necessary if the
      patient demonstrates evidence of cardiopulmonary dysfunction. With the assistance
      of the otolaryngologist, the anesthesiologist can formulate an approach to
      establishing an airway. Intraoperative opioids and sedatives should be limited.
      The recovery of the sleep apnea patient is extremely important and is the time
      when most airway emergencies occur. Extubation of the patient should occur when
      appropriate surgical personnel and equipment are available in case of an airway
      emergency. Steroids may be used to decrease the amount of airway swelling.
      Supplemental O2 should be used in patients who demonstrate desaturation. Opioids
      and sedatives should be avoided, as should other drugs that have central and
      sedating effects. Postoperative pain is effectively controlled with acetaminophen
      and topical anesthetic sprays. Postoperative monitoring for apnea, desaturation,
      and dysrhythmias is a necessity in sleep apnea patients.

PMID- 1760170
TI  - Unusual etiology of hyperkalemia in an immunocompromised patient.
AB  - Hyperkalemia was found in an immunocompromised patient undergoing emergency
      cystoscopy. The cause of the hyperkalemia was an intraperitoneal rupture of the
      bladder. This case report discusses conditions that predispose patients to
      bladder rupture and anesthetic management of hyperkalemia.

PMID- 1760171
TI  - Management of the challenging airway with the Bullard laryngoscope.
AB  - The Bullard laryngoscope is a rigid fiber-optic device that offers a new approach
      to oral laryngoscopy. In this report, I present five cases illustrative of the
      use of the Bullard laryngoscope in patients with demonstrated or suspected
      difficult laryngoscopy and intubation.

PMID- 1760172
TI  - Operation Desert Shield sequel: experience aboard the USNS Comfort during the
      Persian Gulf conflict.

PMID- 1760173
TI  - History of anesthesiology in Germany.

PMID- 1760174
TI  - Effects of instrument adjustments on quantitative echocardiographic gray level
      texture measures.
AB  - Quantitative echocardiographic gray level texture measures have proved useful in
      characterizing a variety of cardiac abnormalities, including contusion, ischemia,
      and cardiomyopathies. However, alterations of echocardiographic signal processing
      controls could potentially affect the resulting data. The purpose of this study
      was to assess the effect of common echocardiographic instrument adjustments on
      texture data. We imaged a graphite-in-gel phantom on five separate occasions,
      each time using 12 combinations of adjustments of transmit power, compression,
      and postprocessing curves over a clinically applicable range. Image texture was
      assessed using gray level run length and gray level difference texture measures;
      42 individual measures were calculated. Significance of texture measure
      variations was assessed by analysis of variance. Changes in all three controls
      were associated with significant alterations in texture measures. Adjustments of
      transmit power and compression produced larger changes in texture measures than
      did adjustments of postprocessing curves. There were significant transmission
      compression-postprocessing interaction effects (p less than 0.05) for all but
      eight of the texture measures. For each texture measure, there were significant
      transmission-compression interaction effects (p less than 0.05). In summary,
      instrument adjustments had significant effects on quantitative texture measures,
      and these effects should be considered when evaluating quantitative
      echocardiographic gray level texture measures.

PMID- 1760175
TI  - Ultrasonic myocardial tissue characterization in the operating room: initial
      results using transesophageal echocardiography.
AB  - Ultrasonic tissue characterization provides quantitative assessment of myocardial
      function and viability. We have previously reported that normal myocardium is
      characterized by a diastolic-to-systolic cyclic variation of integrated
      backscatter (IB), whereas ischemic myocardium exhibits blunting of this pattern.
      To define the applicability of this measurement to characterize the left
      ventricular myocardium in the operating room, we studied 26 consecutive patients
      undergoing open heart surgery (12 coronary artery bypass graft, 13 valvular, 1
      other) with 5 MHz transesophageal echocardiography. Images of the left ventricle
      were obtained in the short-axis plane (papillary muscle level) before
      cardiopulmonary bypass. M-mode acquisition of myocardial IB was attempted from
      the anterior and inferior segments in each patient. The cyclic variation of IB
      was measured in at least two consecutive cycles in addition to a qualitative
      assessment of wall motion. Quantitative measurement of IB was possible in 39/52
      (75%) myocardial segments. Cyclic variation of IB averaged 5.7 +/- 1.4 dB (SD) in
      segments with normal wall motion (n = 25); no difference was noted in the cyclic
      variation of IB among anterior or inferior walls. Hypokinetic segments
      demonstrated significant reduction of the cyclic variation (3.8 +/- 1.8 dB; p
      less than 0.001). Difficulty with obtaining myocardial IB was related to near
      field artifact or lateral displacement of the left ventricular wall during
      systole. Transesophageal echocardiography holds promise for the evaluation of
      myocardial function and its preservation during cardiac surgery.

PMID- 1760176
TI  - Pulmonary venous flow velocity: relation to hemodynamics, mitral flow velocity
      and left atrial volume, and ejection fraction.
AB  - Abnormal pulmonary venous flow velocity patterns are present in multiple cardiac
      disease states, but the determinants of pulmonary venous flow velocity have not
      been fully elucidated. To determine the relative importance of several proposed
      factors that could influence pulmonary venous flow, anatomic, hemodynamic, and
      Doppler mitral and pulmonary venous flow velocity data were compared in 50
      consecutive patients undergoing cardiac catheterization for clinical reasons.
      Pulmonary venous diastolic flow velocity was most strongly related to left
      ventricular isovolumetric relaxation time (r = -0.59), left ventricular end
      diastolic pressure (LVEDP, r = 0.50), left atrial minimum volume (r = 0.50),
      mitral deceleration time (r = -0.50), and early diastolic mitral flow velocity (r
      = 0.45). Pulmonary venous systolic flow velocity related best with left atrial
      minimum volume (r = -0.45) and left atrial ejection fraction (r = 0.44).
      Pulmonary venous systolic flow velocity integral also showed the strongest
      relation with left atrial minimum volume (r = -0.48). Relations between pulmonary
      venous flow velocity and velocity time integrals and other variables were
      sometimes significantly different, apparently caused in part to differences in
      heart rate. These results suggest that pulmonary venous diastolic flow velocity
      is influenced by the same factors that influence early left ventricular diastolic
      filling; pulmonary venous systolic flow velocity relates best to left atrial
      volume and atrial ejection fraction and does not relate to left ventricular
      ejection fraction. Future studies analyzing pulmonary venous flow velocity
      variables should include data on both peak velocities and velocity time integrals
      as well as left atrial size and function.

PMID- 1760177
TI  - Pulmonary venous flow in cardiac tamponade: influence of left ventricular
      dysfunction and the relation to pulsus paradoxus.
AB  - The pattern of left atrial filling was studied in nine closed-chest dogs during
      cardiac tamponade before and after production of microembolic left ventricular
      dysfunction produced by intracoronary injection of 54 +/- 4 microns (SD)
      microspheres. With cardiac tamponade, a significant increase in the ratio of
      systolic/diastolic pulmonary venous flow velocity integral both before (1.65 +/-
      0.24 versus 2.77 +/- 0.43 [SE], p less than 0.05) and after production of left
      ventricular dysfunction (0.57 +/- 0.12 versus 1.77 +/- 0.44, p less than 0.05)
      was seen. Compared with baseline, cardiac tamponade caused a significant
      inspiratory decrease in systolic pulmonary venous velocity both before (7.3 +/-
      2.0 versus 1.2 +/- 1.4 cm/sec) and after left ventricular dysfunction (3.4 +/-
      0.4 versus 1.0 +/- 0.9 cm/sec, both p less than 0.05). The magnitude of
      respiratory variation (expiration-inspiration) of the pulmonary venous flow
      velocity integral with tamponade was significantly greater before than after left
      ventricular dysfunction (1.6 +/- 0.2 cm versus 0.8 +/- 0.2 cm, p less than 0.05).
      A significant correlation was found between the inspiratory fall in aortic
      systolic pressure and the flow velocity integral of pulmonary venous flow before
      left ventricular dysfunction (r = 0.58, p less than 0.05). After coronary
      embolization, neither pulsus paradoxus nor significant respiratory variation
      (expiration-inspiration) of the pulmonary venous flow integral was observed with
      cardiac tamponade. In this model of cardiac tamponade and left ventricular
      dysfunction, left atrial filling occurs predominantly during ventricular systole.
      These changes may be helpful in recognizing hemodynamically significant
      pericardial effusion and have implications for the pathophysiology of cardiac
      tamponade.

PMID- 1760178
TI  - Intracardiac two-dimensional echocardiography in patients with pericardial
      effusion and cardiac tamponade.
AB  - The utility of intracardiac two-dimensional echocardiography in the
      identification of pericardial effusion was assessed in five patients with
      pericardial effusion and cardiac tamponade. A 20 MHz, mechanically rotating
      ultrasound catheter was used for intracardiac imaging. In all five patients,
      intracardiac echocardiography yielded high resolution of images of the right
      atrial cavity, the right atrial wall, and the pericardial effusion. In two
      patients, right atrial collapse could be identified during real-time imaging.
      Although the entire right atrial cavity and the pericardial effusion could not be
      displayed in a single imaging field because of the limited depth of field
      associated with the 20 MHz catheter, manipulation of the catheter allowed
      visualization of the pericardial effusion and the parietal pericardium in each
      patient. The effusion was seen to surround the superior vena cava, as well, in
      all patients. After pericardiocentesis, the reduction in the size of the effusion
      and increase in the right atrial cavity size could be recognized by intracardiac
      echocardiography. The introduction and manipulation of the ultrasound catheter
      was easily performed without any complications. This experience presents one
      clinical application for intracardiac echocardiography and indicates its
      potential value in the invasive cardiac laboratory.

PMID- 1760179
TI  - Complications of transesophageal echocardiography in ambulatory adult patients:
      analysis of 1500 consecutive examinations.
AB  - Transesophageal echocardiography is a new approach that can be used to image
      cardiac structures. It combines two existing technologies: cardiac ultrasound and
      endoscopy. To obtain a cardiac image, the transesophageal probe has to be
      positioned properly within the esophagus. The first 1500 consecutive
      transesophageal echocardiographic examinations in ambulatory adult patients from
      one center were analyzed to identify conditions associated with failed esophageal
      intubation and procedural complications. Esophageal intubation was not achieved
      in 11 patients (0.73%). The reasons for the failure of intubation were operator
      inexperience, hypersensitive pharynx despite topical anesthesia, and cervical
      spondylosis. Six of those patients also had a history of dysphagia. Procedural
      complications were identified in seven patients (0.47%). Tracheal intubation was
      present in four patients, with immediate development of stridor and incessant
      cough in two patients. Atrial fibrillation developed in two patients--one had
      atrial myxoma and one had mitral stenosis. Bronchospasm developed during the
      transesophageal examination in one patient who was receiving long-term treatment
      for bronchial asthma. We conclude that transesophageal echocardiography is
      feasible in most adult patients in the ambulatory setting and that the
      complication rate is very low. Proper patient selection and preparation are
      crucial to the successful performance of this procedure.

PMID- 1760180
TI  - Color flow Doppler mapping studies of "physiologic" pulmonary and tricuspid
      regurgitation: evidence for true regurgitation as opposed to a valve closing
      volume.
AB  - Color flow Doppler mapping using either an Aloka 880 or a Toshiba SSH65A system
      was performed in 39 normal subjects (aged 13 to 45 years) and 43 patients (aged
      13 to 82 years) with pathologic tricuspid or pulmonary regurgitation to evaluate
      the incidence of "physiologic" regurgitation of right heart valves and to
      determine the differentiating characteristics in the spatial distribution and
      velocity encoding of "normal" and "pathologic" regurgitant jets. In the normal
      subjects, tricuspid and pulmonary regurgitation were documented in 32 (83%) and
      36 (93%), respectively, and were unrelated to the system being used. Flow
      acceleration and aliasing were imaged on the right ventricular side of the
      tricuspid regurgitant orifice and on the pulmonary artery side of the pulmonary
      valve (in both normal subjects and patients), and indicated flow convergence for
      true regurgitation through an orifice as opposed to blood being driven
      retrogradely by the closing valve. Such proximal acceleration was documented in
      all patients with pathologic tricuspid regurgitation, in 31/32 of the normal
      subjects with tricuspid regurgitation, and was also observed in 12/15 (80%) of
      the patients and 4/12 (33%) of normal subjects with pulmonary regurgitation who
      were examined with the Toshiba system. The dimensions (mean +/- SD) of tricuspid
      regurgitant jets (length [JL] and area [JA]) were consistently larger in the
      patients than in the normal subjects [JL: 3.4 +/- 0.9 vs 1.2 +/- 0.5 cm, p less
      than 0.001; and JA: 5.7 +/- 2.0 vs 1.4 +/- 0.7 cm2, p less than 0.001) as were
      the pulmonary regurgitation jet dimensions (JL: 1.8 +/- 0.4 vs 0.9 +/- 0.08 cm, p
      less than 0.001; JA: 1.8 +/- 0.7 vs 0.3 +/- 0.08 cm2, p less than
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760181
TI  - Transesophageal color flow Doppler mapping in the assessment of native mitral
      valvular regurgitation: comparison with left ventricular angiography.
AB  - Transesophageal echocardiography (TEE) was performed within 24 hours after
      cardiac catheterization in 45 patients for assessment of native mitral valvular
      regurgitation. Color flow mapping was used in evaluating systolic regurgitant jet
      sizes. A jet demonstrated by TEE was 96% sensitive and 44% specific for
      angiographic mitral regurgitation. The presence of angiographic mitral
      regurgitation was best predicted by (single measurement) (1) a holosystolic jet,
      (2) a jet length greater than 2.5 cm, and (3) a jet area greater than 2 cm2.
      Severe angiographic mitral regurgitation (grades 3 and 4) was best predicted by
      (single measurement) (1) a jet area greater than 5 cm2, and (2) a jet length
      greater than 4 cm. It is concluded that the assessment of angiographic mitral
      regurgitation by TEE is improved by the measurement of these jet parameters,
      which have a high sensitivity and higher specificity than the presence of a jet
      alone. Furthermore, with TEE one is able to differentiate severe (grades 3 and 4)
      from absent or mild mitral regurgitation (grades 0, 1, and 2).

PMID- 1760182
TI  - Comparison of intraoperative transesophageal echocardiography to epicardial
      imaging in children undergoing ventricular septal defect repair.
AB  - Intraoperative transesophageal echocardiography was compared with epicardial
      echocardiography after ventricular septal defect repair. This comparison was made
      in 18 children aged 7 to 137 months (median, 32 months), weighing 6.3 to 49.1 kg
      (median, 10.8 kg) from November 1989 to January 1991. Ventricular septal defect
      types were perimembranous (six), malalignment (seven), supracristal (three),
      midmuscular (one), and inlet (one). Eight children had isolated ventricular
      septal defects, four had tetralogy of Fallot, three had double outlet right
      ventricle, two had double chambered right ventricle, and one had pulmonary
      stenosis. Patch interrogation was complete in 17 of 18 transesophageal
      echocardiography and 16 of 18 epicardial echocardiography studies. Inability to
      fully interrogate the ventricular septal defect patch by epicardial
      echocardiography occurred in two children as a result of anterior ventricular
      septal defect location, limited epicardial exposure, and surgical hardware
      interference. Incomplete transesophageal echocardiography patch interrogation
      occurred in the child with the midmuscular ventricular septal defect. Seven
      residual ventricular septal defects were documented by color flow Doppler in six
      patients. Five of seven residual defects were demonstrated by both real-time
      transesophageal echocardiography and epicardial echocardiography imaging.
      Transesophageal echocardiography and epicardial echocardiography missed 1 and 7
      defects, respectively. The missed defects were different with each technique and
      were confirmed by postoperative surface echocardiography. No residual defects of
      sufficient size to require reoperation were found as determined by combination
      color flow jet analysis and intraoperative oximetry (no pulmonary to systemic
      flow ratio was greater than 1.50). Patches caused two-dimensional and Doppler
      signal masking, but this was not limiting because all residual defects were found
      at the margins of the ventricular septal defect patch.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1760183
TI  - Toxic methemoglobinemia caused by topical anesthetic given before transesophageal
      echocardiography.
AB  - Transesophageal echocardiography was performed on a patient with critical aortic
      stenosis and severe three-vessel coronary artery disease. Immediately after the
      procedure the patient experienced marked cyanosis (oxygen saturation of 53%)
      secondary to methemoglobinemia (methemoglobin saturation of 45%). Toxic
      methemoglobinemia was thought to be caused by topical anesthetic. He responded
      dramatically to treatment with intravenous methylene blue. Toxic
      methemoglobinemia should be suspected in unexplained cyanosis occurring after
      transesophageal echocardiography and other endoscopic procedures during which
      potentially causative agents have been used.

PMID- 1760184
TI  - Left atrial mass produced by extensive mitral annular calcification.
AB  - An unusual case of mitral annular calcification presenting as a left atrial mass
      is discussed. The differential diagnosis of left atrial masses with particular
      reference to their echocardiographic features is reviewed.

PMID- 1760185
TI  - Induction of wide QRS tachycardia during transthoracic echocardiography.
AB  - A wide QRS tachycardia was repeatedly triggered during transthoracic
      echocardiographic examination in a critically ill premature infant with bilateral
      chest tubes. The left-sided tube was anterior to the heart. The arrhythmia was
      not induced after removal of the chest tubes at the follow-up ultrasonographic
      evaluation. Compression of the thoracic wall and chest tube, and subsequently the
      heart, by the ultrasound transducer is postulated as the cause for this wide QRS
      tachycardia.

PMID- 1760186
TI  - Atypical pseudoaneurysm after mitral valve replacement: Doppler echocardiographic
      diagnosis.
AB  - Ventricular pseudoaneurysm is a rare complication of mitral valve replacement or
      myocardial infarction. Typically, a ventricular pseudoaneurysm appears as an
      echocardiographic lucency posterior and lateral to the left ventricle and is best
      seen from the parasternal long axis and apical four-chamber views. We present an
      atypical case of left ventricular pseudoaneurysm that tracts posterior and
      lateral to the right ventricle that was best visualized from the subcostal and
      low parasternal windows with medial angulation. Doppler imaging confirmed the
      diagnosis by demonstrating to-and-fro flow between the left ventricle and the
      cavity located behind the right ventricle. This case emphasizes the importance of
      the use of multiple echocardiographic windows.

PMID- 1760187
TI  - Transesophageal echocardiographic guidance of balloon atrial septostomy.
AB  - Two newborn infants with transposition of the great vessels and an intact
      ventricular septum were cyanotic when they underwent bedside balloon atrial
      septostomy in the neonatal intensive care unit. The procedure was conducted under
      direct transesophageal two-dimensional echocardiographic guidance. Success of the
      procedure was evaluated with color flow Doppler and the two-dimensional
      assessment of the septostomy. This procedure has advantages over catheterization
      and its attendant fluoroscopy, which usually are performed in the catheterization
      laboratory, expose the patient to radiation, and necessitate transportation of a
      patient who is hemodynamically unstable to an often distant catheterization
      laboratory. Transesophageal echocardiography has several advantages over
      transthoracic echocardiography in aiding this procedure. It provides an optimal
      view of the atrial septum, while keeping the chest exposed for observation of
      respiratory effort and for improved thermoregulation.

PMID- 1760188
TI  - Noncommunicating intramural hematoma: an indication of developing aortic
      dissection?
AB  - A 60-year-old patient was referred to the hospital for persisting chest pain. The
      first transesophageal echocardiogram showed localized hematomas without aortic
      dissection. Several days later the patient suffered complete paraplegia after a
      second episode of chest pain. The transesophageal echocardiogram now showed a
      complete aortic dissection. Thus whether intramural hematomas can be regarded as
      an early sign of impending aortic dissection needs to be investigated.

PMID- 1760189
TI  - Left ventricle-to-ascending aorta communication complicating composite graft
      repair undetected by aortography: diagnosis by transesophageal echocardiography.
AB  - A 57-year-old man underwent composite ascending aortic conduit and prosthetic
      aortic valve repair of a sinus of Valsalva aneurysm. The patient's course was
      complicated by recurrent aneurysm formation caused by a communication between the
      left ventricular outflow tract and the ascending aorta outside the conduit.
      Transesophageal echocardiography documented the anatomic and functional
      characteristics of this complication, whereas aortography failed to demonstrate
      them. Findings at surgery confirmed the transesophageal echocardiogram results of
      a left ventricular outflow tract to aorta communication, a normal prosthetic
      aortic valve, and an intact distal anastomosis of the conduit with the aorta.
      Transesophageal echocardiography is a useful modality for the evaluation of
      composite graft repairs of the aortic valve and ascending aorta.

PMID- 1760190
TI  - Thrombotic disc impediment in a Medtronic-Hall aortic valve prosthesis diagnosed
      by Doppler echocardiography followed by successful reoperation.
AB  - A case with impeded disc movement caused by thrombus formation in a Medtronic
      Hall aortic valve prosthesis is reported. A correct diagnosis, including both
      mechanism and severity of the prosthesis failure, was established by Doppler
      echocardiography. The patient was promptly referred for surgery without invasive
      or other supplementary investigations.

PMID- 1760191
TI  - Spontaneous left atrial echocardiographic contrast in mitral stenosis: early
      disappearance after valve replacement.
AB  - We describe a patient with mitral stenosis and severely enlarged left atrium.
      Transthoracic echocardiography showed a false image of intraatrial thrombus,
      whereas transesophageal echocardiography showed massive spontaneous left atrial
      contrast. Intraoperative transesophageal echocardiography was performed. During
      cardioplegic arrest the contrast was enhanced, but it gradually and completely
      cleared 15 minutes after cardiopulmonary by-pass arrest. Transesophageal
      echocardiography is a useful technique for the study of intraatrial masses and
      may bring a new dimension to tissue characterization studies.

PMID- 1760192
TI  - [Analysis of sister-chromatid exchange rate from peripheral lymphocyte of people
      exposed to environmental cadmium].
AB  - Sister-chromatid exchanges (SCEs) were analyzed using peripheral lymphocyte from
      38 persons (20 men and 18 women) who had been exposed to environmental cadmium
      (Cd), and 9 controls (7 men and 2 women). Correlations between SCE rates and
      urinary Cd-concentrations were done. There were no significant differences in SCE
      rates between the Cd-polluted and nonpolluted groups. There were no significant
      correlations between SCE rates and urinary Cd concentrations.

PMID- 1760193
TI  - [Studies of the expression of human interleukin-2 receptor cDNA in mammalian
      cells].
AB  - Human interleukin-2 receptor cDNA was transfected into mouse fibroblast cells
      (L929) by using DNA-calcium phosphate coprecipitation method. Results from RNA
      dot-blot hybri dization, FITC-IL-2 fluorescent staining assay and anti-Tac
      specific rossette test demonstrated that the product of human interleukin-2
      receptor cDNA in L929 cells is able to bind IL-2 and anti-Tac antibody. Moreover,
      the abnormal expression of IL-2R gene in T-cell leukemia cell lines such as Jukat
      cells and Molt-4 cells was analyzed and discussed.

PMID- 1760194
TI  - [A study of aneuploid induction by three mitotic arrestants in mouse bone marrow
      cells].
AB  - Three mitotic arrestants, i.e., colchicine (COL), econazole(EZ) and hydroquinone
      (HQ) have been assayed by means of C-Mitotic (CM) effects, micronucleus (MN) and
      chromosomal aberration (CA) test for their effects of aneuploid induction in
      mouse bone marrow cells COL induced poly/aneuploid in mouse bone marrow cells. EZ
      was weakly positive in CM effects test but it may not induce aneuploid in
      mammalian cells. HQ could not only be a clastogen but also an aneuploid inducer.
      The results indicated that the comparative employment of the three cytogenetic
      criteria could be quite useful for detecting aneuploidy inducers in mammalian
      somatic cells in vivo.

PMID- 1760195
TI  - [Screening and isolation of the cerebellar specific expressed mRNA in mouse:
      subtractive hybridization by phenol emulsion reassociation technique].
AB  - There are extremely complicated and numerous gene expressions in mammalian
      brains. Each region of the brain contains a set of mRNA expressed only in that
      region and these mRNA would be related to presumed region of specific function.
      Genes preferentially expressed in cerebellum (CB) are therefore the reasonable
      candioate genes for site of genetic lesions in CB neurodegenerative disorders. In
      this study, the subtractive hybridization was introduced into screening and
      isolating CB specific mRNA. Testing CB and front cortex (CTX) cDNA libraries were
      built, which covered most low abundantly expressed mRNA. By applying over 100
      fold excessive CTX and liver single strand cDNA to the CB double strand cDNA,
      subtractive hybridization was carried out by phenol-emulsion-reassociation
      technique (PERT), in which the common expressed housekeep genes would be eluted
      by restrict site ligation, and CB specific cDNA flanking with EcoRI site in both
      ds cDNA ends could be cloned into lamda gill phage. PERT subtraction reduced CB
      cDNA libraries from initial 5.15 x 10(6) to remaining 2.5 x 10(3) recombinants,
      which were most likely CB specific expressed cDNA. Random Twenty recombinants
      (over 2 kb inserts) were amplified randomly by polymerase chain reaction (PCR)
      and were hybridized with CB cDNA and liver cDNA probes in dot blot. 14 inserts
      positively hybridized with CB cDNA probe and only 3 inserts showed signals with
      liver cDNA probe. Colony blot presented similar results. 10 cDNA clones which
      affinited to CB cDNA probe were selected for the Northern blot. In five tissures,
      2 cDNA clones binded only in CB mRNA channel, 6 were proved preferential
      expression in CB and low abundant expression in 4 other tissues, 1 clone was a
      housekeep gene and 1 could not be detected in all tissues. The partially
      sequencing of clone PC7 and PD8 were introduced into Computer Gene Bank Data
      Base. No homologous complements were found between these two clones and over ten
      thousands genes that have been sequenced. The two clones were newly reported.
      According to our experiment, we believe that: 1) CB specifically expressed mRNAs
      are much less than expected comparing with other brain regions; 2) most of CB
      mRNA expressions are in a preferential way other than unique expression.

PMID- 1760196
TI  - [Subcloning and sequencing of the Streptomyces griseus DNA fragment with promoter
      activity in E. coli].
AB  - A 410-bp DNA fragment of Streptomyces griseus No.45 with in vivo promoter
      activity in E. coli has been isolated by subcloning the cloning strain E. coli
      No.8-1. The result of sequencing shows that the promoter fragment contains 50.5%
      G + C bases. It has some repeat sequences. It shows good homology to the E. coli
      promoter consensus sequences in -10 and -35 regions. There are 18 bp between the
      two regions. It has two regions that are similar to SD sequence in E. coli and
      consensus sequence in SEP (Streptomyces-E.coli-type promoter) of Streptomyces
      lividans respectively. There is 1 Alu I site, 1 Cla I site, 2 Mbo I sites, 3
      NlaIII sites and 1 PvuII site in the promoter fragment.

PMID- 1760197
TI  - [Studies of mtDNA of Ustilago maydis. I. Cloning and gene mapping].
AB  - This paper covers the following studies of mtDNA of Ustilago maydis. (1) By
      inserting the Bam HI and Pst I fragments of the mtDNA into the corresponding
      sites of pBR322, we cloned a unique sequence of 49.6 kb, accounting for 89.3% of
      the mitochondrial genome (60.7 kb). (2) With heterogenous genes from plants or
      fungi as probes, we identified seven genes, and mapped them onto the restriction
      map of the mt DNA. The genes were arranged in such an order: -UmCOB-UmOXII-S-rR
      NA-UmOXIII-L-rRNA-UmATPase6-UmOXI-. (3) We tried to express the three cloned
      genes, UmOXII, UmOXIII, and Um-ATPase 6, in E. coli maxcel expression system, but
      no specific protein was observed.

PMID- 1760198
TI  - [Long-term follow-up of neonatal hyperbilirubinemia when phototherapy was
      withheld because of low bilirubin levels in the spinal fluid--growth,
      intelligence and soft neurological signs in school children].
AB  - The significance of cerebrospinal fluid (CSF) bilirubin levels on the outcome of
      neonatal jaundice has been investigated by correlations between kernicterus or
      brain damage and CSF bilirubin levels (Torii 1974, 1981, Meisels 1984), This
      study is designed to clarify the significance of CSF bilirubin levels in the long
      term prognosis of neonatal hyperbilirubinemia. Sixteen full-term newborn babies
      with hyperbilirubinemia (serum bilirubin level 20.0-30.0 mg/dl) who did not
      receive phototherapy because of low bilirubin in their spinal fluid (usually
      under 0.5 mg/dl in normal neonates) were followed in this study of growth,
      intelligence and neurobehavior. The subjects' neurobehavior was compared with
      that of a matched control group. The physical growth of the children with a
      history of hyperbilirubinemia was within normal limits except for one girl whose
      weight was less than-2 SD from the average. Verbal IQ's were lower than
      performance IQ's in 10 out of 14 children with a history of hyperbilirubinemia.
      However, no mental retardation was noted. No significant difference was found
      between the two groups in mean positive scores on the Garfield test. In the
      Prechtl test, mean score of the finger-touching test was significantly higher in
      the children with a history of hyperbilirubinemia than in the control group. The
      soft sign coefficient and the occurrence of attention deficit hyperactivity
      disorder were not significantly different in the two groups. In summary, a low
      bilirubin level (less than 0.5 mg/dl) in the spinal fluid seems to be a good
      prognostic sign in infants with neonatal bilirubinemia.

PMID- 1760199
TI  - [A study of functional plasticity of the brain in childhood. I. Critical period
      dislodging lateralization of language in the brain].
AB  - To investigate the functional plasticity of the brain in childhood, the
      intelligence and language tests, brain CT and dichotic listening test were
      performed on 34 patients with hemiplegia. All 13 patients with left hemiplegia, 8
      to 37 years old, showed a right ear dominance suggesting the lateralization of
      language in the left hemisphere. Among 21 patients with right hemiplegia, 7 to 22
      years old, 16 patients who had suffered from the left hemispheric damage before 6
      years and 1 month of age, showed the left ear dominance suggesting the
      lateralization of language in right hemisphere except 2 patients. On the
      contrary, 3 patients with right hemiplegia who had suffered from the left
      hemispheric damage after 6 years and 6 months of age showed a right ear
      dominance. It was concluded that the critical period for the dislodging of
      language lateralization in the brain from the damaged left hemisphere to the
      intact right hemisphere is the first half of 6 years after birth. Five patients
      out of 8 patients with right hemiplegia showed significantly lower scores in
      performance than in verbal WISC IQ. The compensation of language function rather
      than performance function was considered to be characteristic for the left
      hemispheric damage in childhood.

PMID- 1760200
TI  - [Relationship between electroencephalographic abnormality and late blink reflex
      responses in infantile spasms and EIEE].
AB  - Electrically elicited blink reflex (BR) were analyzed in seven patients with age
      dependent epileptic encephalopathies (5 patients with infantile spasms and 2 with
      EIEE). Four patients with infantile spasms showed prolonged latency of the late
      BR responses (R2). In 2 patients with EIEE showing suppression burst pattern on
      EEG, R2 was not detectable. R2 abnormality in BR might reflect the dysfunction of
      the brainstem reticular formation in age dependent epileptic encephalopathies.

PMID- 1760201
TI  - [Cerebral blood flow velocities in the anterior cerebral arteries and basilar
      artery. III. Investigation in hydrocephalus (Part 2)].
AB  - We made 10 measurements of Pourcelot's index of resistance (RI) in the anterior
      cerebral artery (RI-ACA) and basilar artery (RI-BA), and RI ratio (= RI-ACA/RI
      BA) in seven cases of hydrocephalus before and after treatment. The mean values
      of RI-ACA (0.831 +/- 0.050, mean +/- SD), RI-BA (0.800 +/- 0.053) and RI ratio
      (1.039 +/- 0.030) before treatment were significantly higher than in normal
      infants. Two hours after treatment, the mean RI-ACA (0.654 +/- 0.099) was lower
      than in normal infants, and RI-BA (0.684 +/- 0.101) were normalized. Before
      treatment, the mean value of RI-ACA was higher than that of RI-BA. All RI ratios
      were higher than 1.00. After treatment, the mean RI-ACA was lower than the mean
      RI-BA. All RI ratios were normalized and lower than 1.00 (0.957 +/- 0.024).

PMID- 1760202
TI  - [Quantitative evaluation of pseudohypertrophy in Duchenne muscular dystrophy].
AB  - In order to evaluate pseudohypertrophy of the calves in Duchenne muscular
      dystrophy (DMD) quantitatively, we measured the circumference of the thigh, knee,
      calf, and ankle in total 7 patients with DMD whose ages ranged from 3 to 5 years,
      and 165 healthy boys aged 3 to 6 years. Simple value of the calf circumference
      was not useful to evaluate pseudohypertrophy in DMD, because the circumference
      was variable following to the nutrition (Kaup index) in healthy boys. Various
      ratios were then tested for the calf circumference in relation to the thigh,
      knee, or ankle circumference. Of these, the calf/knee circumference ratio was the
      most informative; the values of 13 out of 14 affected legs were above the mean +
      2SD.

PMID- 1760203
TI  - [The occurrence of destructive hydrocephalus in cases with neonatal
      intraventricular hemorrhage].
AB  - A total of 21 neonates with intraventricular hemorrhage (IVH) were studied; 12
      (57.1%) survived, and 7 (58.3%) of these 12 cases suffered from hydrocephalus.
      Hydrocephalus occurred only in patients with IVH of grades III and IV on Papile's
      classification, and its occurrence rate was 87.5% as the sum total for the two
      groups. Destructive hydrocephalus (DHC) occurred in 5 cases of grade III and
      grade IV, and its occurrence rate was 62.5% as the sum total for the two groups.
      It could be conjectured that the prognosis of the IVH depends upon the extent of
      the primary hemorrhagic lesions. However, in cases with DHC, the resistance of
      the cerebral parenchyma to the hydrodynamic force is decreased, so that secondary
      cerebral destruction yielding rapid and intense ventricular dilatation, which is
      responsible for the development of neurological disorders, might occur more
      easily than in cases with IVH of grades III and IV, and to the secondary
      parenchymal destruction that may arise in association with hydrocephalus. It is
      essential that a shunt operation should be performed as soon as possible after
      the diagnosis of DHC has been established so as to allow repair of the primary
      lesion and to minimize the secondary brain damage.

PMID- 1760204
TI  - [Facilitation and recovery of the H-reflex in children].
AB  - Facilitation and recovery of the H-reflex were studied in 63 children with
      cerebral palsy, and the results were compared with those obtained for 60 normal
      children. H waves were recorded from the gastrocnemius with surface electrodes,
      after applying paired stimulations to the tibial nerve in the midpopliteal
      crease. In normal children, both the facilitation and the recovery showed a
      tendency to decrease with their development, while those for children with
      cerebral palsy were more marked than normal children in all age groups. The
      present study indicated that the excitability of spinal alpha motoneurons and the
      subliminal fringe in the motoneuron pool might change due to the maturation of
      and the damage to the central nervous system in children. We consider that H
      reflex examination provides useful information for the supraspinal control to the
      spinal mechanism to regulate muscle contraction in children as well as in adults.

PMID- 1760205
TI  - [Clinicoencephalographic study of periodic lateralized epileptiform discharges in
      infants].
AB  - The mechanism of periodic lateralized epileptiform discharges (PLEDs) still
      remains unclear, although it has been the subject of a number of theories. We
      investigated the relationship between the level consciousness and PLEDs in order
      to clarify both the clinical significance and the mechanism of PLEDs. We studied
      two neonates and two infants with acute organic lesions of the brain (cerebral
      infarction, meningoencephalitis, cerebral hemorrhage, acute infantile
      hemiplegia), of whom all showing PLEDs in EEG. In each case, we analyzed
      sequential EEG records and the level of consciousness, and measured the
      periodicity, voltage and duration of PLEDs by a computer controlled digitizer. In
      each case, the periodicity and voltage of the discharges were related to the
      level of consciousness. The appearance rate of PLEDs was relatively high at the
      level of consciousness from III-100 to III-200. The inverse correlation between
      the frequency (1/periodicity) and the voltage of PLEDs was significant in 53% of
      the total records of PLEDs; it was also frequently observed at the level of
      consciousness between III-100 and III-200. From above findings we concluded that
      an appropriate degree of damage to produce PLEDs is required in both the cerebral
      cortex and subcortical white matter corresponding to the level of consciousness
      from III-100 to III-200.

PMID- 1760206
TI  - [The clinical effect of mechanical ventilatory assistance with tracheotomy in
      terminal phase muscular dystrophy].
AB  - The clinical effect of mechanical ventilatory assistance with tracheotomy in
      respiratory failure of terminal phase muscular dystrophy was studied. The
      subjects were 6 Duchenne muscular dystrophy cases and 1 Ullrich type congenital
      muscular dystrophy case. Duration of the longest survival case was 4 years and 5
      months. General physical conditions, complications, ADL and muscular atrophy were
      examined. By ventilatory assistance respiratory failure improved, and the
      physical condition stabilized and took good progress. Arterial hemorrhage which
      is lethal complication was observed in 2 cases. Mechanical ventilatory assistance
      with tracheotomy is an effective symptomatic therapy for the improvement of
      respiratory failure that can be applied when life prolongation is wished for by
      the patients or their families.

PMID- 1760207
TI  - [Cerebro-oculo-hepato-renal syndrome (Arima's syndrome) with slowly progressive
      renal insufficiency and epilepsy].
AB  - We reported an additional case of Arima's syndrome with slowly progressive renal
      insufficiency and epilepsy. The patient is a 20-year-old man whose parents are
      consanguineous. He had a history of mild asphyxia at birth, and unexplained
      tachypnea developed during the neonatal period. But it disappeared later, and he
      have had no respiratory problem since then. Physical examination on admission at
      the age of 19 years revealed bilateral blephaloptosis, narrow palate, searching
      nystagmoid movement, absence of light reflex, muscle hypotonia and wasting of
      extremities. Funduscopic study showed optic hypoplasia, choroid coloboma and
      narrowing of vessels. Head CT scan showed agenesis of cerebellar vermis and
      hypoplasia of brainstem. CT scan and echography of the kidney disclosed the
      bilateral multiple cysts. Liver was hyperechoic in echographic study; this
      finding is consistent with fatty change. EEG showed dysrhythmic slow wave
      activity with sporadic spike and wave complex. Compared with previously reported
      cases, the present case has the following features: (1) slowly progressive renal
      insufficiency, (2) generalized tonic clonic convulsion developing from the age of
      11 months, (3) ABR abnormalities including the right-sided shortening of wave I
      II interpeak latency and bilateral ill-defined wave V. Slow progress of renal
      failure in our case may reflect the mild pathological process of the kidney with
      sparing functional nephrons. It shows the diversity of the kidney pathology in
      Arima's syndrome. Epilepsy is a less common association in the syndrome, whereas
      EEG abnormalities were reported. ABR abnormalities may reflect the morphological
      alteration of the brainstem structure including auditory pathway. In our case it
      is uncertain whether the neonatal tachypnea was due to birth asphyxia or
      brainstem malformation responsible for abnormal respiration as suggested in
      Joubert's syndrome.

PMID- 1760208
TI  - [99mTc-HMPAO SPECT in epileptic disorders in childhood].
AB  - Single photon emission tomography (SPECT) using Tc-99m-d,1
      hexamethylpropylenamine oxime (HMPAO) was performed in two children with
      epileptic disorders during both sleeping and waking diurnal stages. Immediate
      postictal and interictal SPECT scans were obtained for a child with partial
      epilepsy. They demonstrated an interictal decrease in the regional cerebral blood
      flow (rCBF) and a more remarkable immediately postictal decrease in rCBF. The
      focus was in the same region of the SPECT for both interictal and postictal
      spikes. Another patient was diagnosed as having continuous spike-waves during
      slow sleep without epileptic seizures. Although SPECT during wakefulness showed
      no asymmetry, SPECT during sleep revealed decreased rCBF at the same location as
      the predominant area of diffuse epileptic discharges. We conclude that HMPAO
      SPECT is useful in investigation of the etiological mechanisms of seizures and
      epileptic discharges in epileptic disorders in childhood.

PMID- 1760209
TI  - [MELAS without ragged-red fibers: a case report].
AB  - A female patient who had clinical characteristics of MELAS but with no apparent
      muscle symptoms was reported. She was in good health until 12 years and 5 months
      of age when she began to have afebrile generalized tonic-clonic convulsions.
      Thereafter, she had repeated stroke-like episodes, including headache, vomiting,
      convulsions, hemiparesis and left ehemianopsia. She had neither muscle weakness,
      fatigability nor atrophy. Laboratory examinations disclosed elevated lactate and
      pyruvate levels in the serum and cerebrospinal fluids, transient focal low
      density areas on brain CT and right sensorineural deafness by audiometry. No
      ragged-red fibers (RRF) were found in the first biopsy at 13 years and 6 months
      of age, and two RRF-like fibers containing red granular materials in the
      subsarcolemnal regions in the second at 15 years and 3 months of age. A
      biochemical assay on the two biopsied muscles demonstrated normal enzyme
      activities in the mitochondrial electron transport system. She was diagnosed as
      having MELAS because of remarkable mitochondrial abnormalities in smooth muscle
      cells in the intramuscular arterioles which were clearly demonstrated by succinic
      dehydrogenase (SDH) stain and on electron microscopy. It was suggested that the
      stroke-like episodes in this patient were induced by a preferential damage to the
      mitochondria in the blood vessel walls. Thus, we conclude that a simple method of
      identifying the strongly SDH-reactive blood vessels (SSV) in frozen sections is
      critical in supporting or making diagnosis of MELAS.

PMID- 1760210
TI  - [A case report of childhood multiple sclerosis with periodic synchronous
      discharge on EEG].
AB  - A 12-year-old girl with multiple sclerosis (MS) with periodic synchronous
      discharge (PSD) on electroencephalogram (EEG) is reported. The patient developed
      clonic seizure of both arms at the age of 10. The muscle strength of left hand
      and both legs were decreased and her school records were declined at the age of
      12. On neurological examination, the patient showed mild intellectual
      disturbance, mild weakness of face and extremities and bilateral decreased DTRs.
      Her gait was slightly ataxic. Cerebrospinal fluid (CSF) revealed an oligoclonal
      band. Serial CT scans disclosed ring enhancements in the regions corresponding to
      clinical symptoms (right central gyrus on Sep. '85, right lower and middle
      temporal gyri, and mesial site of occipital lobe on Oct. '85, right cerebellum on
      Jan. '86). The same lesions were visualized as a high signal intensity on T2
      weight images and as a low signal intensity on T1 weight images on MRI. The
      attack of seizure occurs more frequently in children with than adults with MS.
      However, as far as we know in the cases of children with MS, there were no
      reports of PSD which was usually seen in the cases of subacute sclerosing
      panencephalitis. The pathomechanism of PSD is speculated to be suffered from
      subcortical damage.

PMID- 1760211
TI  - [Pedaling automatism in atypical West syndrome: a case report].
AB  - A seven-month-old girl with atypical West syndrome with pedaling automatism was
      reported. She started to have early infantile epileptic encephalopathy with
      suppression-burst (EIEE) at age 14 days followed by infantile spasms at 3 months
      of age. She began to have spasms with automatism at 4 month, mainly consisting of
      pedaling movements of both feet associated with tonic spasms of upper extremities
      and writhing of trunk. Ictal EEG showed irregular slow waves with occasional
      spikes predominantly over the right hemisphere mixed with artifacts. Interictal
      EEG during sleep showed suppression-burst patterns. Cerebral atrophy and
      microcephaly were revealed on brain CT, immature myelination on MRI and decreased
      blood flow in the frontal, temporal, and parietal lobes on the right on PET scan.
      Pedaling automatism is rare in infancy and its clinical significance was
      discussed in relation to West syndrome and complex partial seizures.

PMID- 1760212
TI  - [A case of alternating hemiplegia in infants with CT abnormalities before onset].

PMID- 1760213
TI  - [Muscle pathology in a girl with Marshall-Smith syndrome].

PMID- 1760214
TI  - [A case of Hallervorden-Spatz syndrome--clinical course and successive findings
      of brain CT].

PMID- 1760215
TI  - The epithelium of the rabbit vagina: a microtopographical study by light,
      transmission and scanning electron microscopy.
AB  - In order to obtain a more precise microtopographical surface map of the
      epithelium of the rabbit vaginal mucosa, investigations by light microscopy (LM),
      transmission electron microscopy (TEM), and scanning electron microscopy (SEM)
      have been systematically correlated. The epithelium was examined from the "portio
      vaginalis cervicis uteri" down to the "vestibulum". This study shows that the
      upper 2/3 of the vagina--which, in this species, is very long, measuring 13-14 cm
      -is lined by a single epithelial layer of tall ciliated and microvillous cells
      closely resembling the endocervical epithelium with which it is continuous.
      Moreover, these ciliated and microvillous cells also cover mucosal infoldings in
      the upper part of the vagina, especially those on the ectocervix and in the
      fornices, and scattered vaginal crypts. In particular, the ciliated elements
      decrease in number below the fornices, so that in large areas of the middle part
      of the vagina only microvillous cells are recognizable. Prior to the squamo
      columnar junction, however, the ciliated cells increase again. This study also
      reveals that in the rabbit the squamo-columnar junction is located at the level
      of the pubic symphysis and that a squamous pluristratified epithelium covers only
      the lower 1/3 of the inner surface of the vaginal wall. In the estrous, i.e.,
      precoital rabbit, the microvillous cells show little sign of secretion, whereas
      after mating they exhibit remarkable secretory features. These seem to increase
      progressively with postcoital stages (5 h, 24 h and 10 days) in the form of
      extensive mucification. These secretions often come in contact with spermatozoa
      retained in the mucosal infoldings and crypts, and are similar to those occurring
      in the endometrium, where they clearly depend upon progesterone activity. These
      epithelial features, different from those of other mammals, including humans,
      suggest that the greater part of the rabbit vagina accomplishes functions other
      than serving for copulation and as a fetal passageway. The present findings
      support the view that the rabbit vagina also plays a role as a reservoir of
      spermatozoa and in maintaining their viability, like the endometrium and
      endocervix.

PMID- 1760216
TI  - Postnatal changes in nerve cells and myelinated fibers in the pineal gland of
      cotton rats (Sigmodon hispidus). A light microscopic study.
AB  - Intrapineal neurons and intracapsular and intrapineal myelinated fibers were
      studied by light microscopy in male cotton rats (Sigmodon hispidus) at various
      postnatal ages. Until 300 days of age, neurons are encountered mainly in the
      distal third of the organ; neuronal nuclei are largest in this region. The
      remaining regions contain only a few neurons with smaller nuclei. In all regions,
      nuclear sizes of the neurons increase, and neuronal numbers reduce by half until
      100-200 days. Neurons thus consist of different populations of cells, and the
      aging changes in neuronal nuclei seem to be related to the differentiation of the
      organ. The disappearance of neurons and the enlargement of the nuclei of
      remaining neurons proceed simultaneously with age. Intracapsular and intrapineal
      myelinated fibers appear at 20 days and their density increases with age. As the
      myelinated fibers are distributed mainly in the distal region and its capsule,
      these fibers are related topographically to intrapineal neurons. The
      intracapsular myelinated fibers continue into bilateral bundles of myelinated
      fibers found under the transverse sinuses, corresponding to the nervi conarii.
      Since the intracapsular fibers and the fibers traced between the capsule and the
      parenchyma bifurcate in a proximal direction, the intracapsular fibers are
      considered to run proximally, some entering the organ.

PMID- 1760217
TI  - Flagellum abnormalities of spermatozoa in seminiferous tubules after a short term
      vasectomy.
AB  - Electron microscopic observation was performed to examine whether spermiogenesis
      in the hamster might be affected by a short term vasectomy. When viewed by light
      microscopy, spermiogenesis was temporarily inhibited at 2 weeks, though to a
      limited extent among individuals, and had apparently recovered to the control
      level at 4 and 8 weeks after vasectomy in all hamsters. It was revealed at the
      electron microscopic level that mature spermatozoa with an abnormal flagellum
      were intermingled among numerous normal spermatozoa. The flagellum of the mature
      spermatozoa was composed of four different components: a mitochondrial sheath,
      outer dense fiber, fibrous sheath and axoneme. Abnormalities of the mitochondrial
      sheath were of three types: its discontinuity, displasia and deformation. The
      appearance of these abnormalities increased with the time after vasectomy and
      finally reached 52% as the highest value at 8 weeks. Additional noteworthy
      findings were the bisectioning of the outer dense fibers 2, 4 and 7, the fusion
      of two or three fibers, and the partial deletion of the fibrous sheath. These
      defects were characteristic in the vasectomized hamsters. Possible correlating
      microenvironmental factors are discussed as to how these abnormalities of the
      four flagellar components occur in the vasectomized hamsters.

PMID- 1760218
TI  - Effects of dietary zinc deficiency on protein secretory functions of the mouse
      testis.
AB  - The effects of dietary zinc deficiency on testicular protein secretion, mainly
      that by Sertoli cells, were examined by electron microscopy and two-dimensional
      polyacrylamide gel electrophoresis of [35S] methionine-labeled secretory proteins
      from mouse testes. Zinc deficiency caused a significant decrease in the
      gonadosomatic index and a distinct increase in deoxyribonucleic acid
      concentration. Sertoli cells maintained normal fine-structural features;
      junctional complexes among Sertoli cells continued to divide seminiferous tubules
      into basal and adluminal compartments in the zinc-deficient mouse testes. Severe
      atrophic changes were observed in spermatogenic cells after meiotic division in
      the adluminal compartment, but not in spermatogonia located in the basal
      compartment. Zinc replacement treatment caused spermatogenesis to recover
      normally. Although total protein secretion was not affected by zinc deficiency,
      one polypeptide spot appeared due mainly to the loss of its target spermatogenic
      cells. The present study indicates that zinc is indispensable for spermatogenic
      cells after meiosis and that testicular protein secretory functions can be
      preserved in the absence of zinc.

PMID- 1760219
TI  - Short-term mineralization of dentin and enamel in the mouse embryonic molars
      cultured in serum-free, chemically-defined medium.
AB  - The present study was designed to demonstrate the short term mineralization of
      dentin and enamel, and to investigate the effects of sodium beta-glycerophosphate
      (Na-beta-GPO4) on calcification in a serum-free, chemically-defined medium. The
      first mandibular molars at the bell stage dissected from 18-day-old mouse embryos
      were used as explants, which were cultured by an improved flotation method.
      Calcification of enamel in the 18-day-old embryonic molars occurred within the
      6th day of culture. In another experiment, the molar germs were cultured in a
      serum-free, chemically-defined medium supplemented with 1, 5 and 10 mM Na-beta
      GPO4. Promotion of tooth mineralization was recognizable at very low
      concentrations, such as 1 mM Na-beta-GPO4, in 18-day-old embryonic tooth germs.
      The culturing system reported here shortens the time required for dentin and
      enamel calcification to one half or one third of that reported previously and
      therefore should prove useful for examining regulations for cytodifferentiation
      and morphogenesis in tooth germs and the mineralization of dentin and enamel.

PMID- 1760220
TI  - A unique fibrillar coat on the surface of migrating human primordial germ cells.
AB  - Primordial germ cells (PGCs) were studied by electron microscopy in human embryos
      at 27 and 30 days of gestation. PGCs were mainly found in the hindgut epithelium,
      some at the stage of separation from the endoderm, and others in migration
      through the mesenchyme of the dorsal mesentery between the primitive intestinal
      wall and the coelomic epithelium, including the coelomic angle. A few PGCs were
      still located in the endodermal epithelium. Before the process of separation and
      migration, PGCs appeared clearly different from neighboring somatic cells
      (endodermal, mesenchymal and epithelial cells of the hindgut and the coelomic
      layer). PGCs located in the endodermal epithelium were large and showed an
      irregular cell body often provided with filopodia-like processes that contacted
      somatic cells to form small areas of focal junctions. As a rule, PGCs possessed a
      large, round nucleus containing one or two conspicuous nucleoli. Lipid droplets,
      abundant glycogen particles, ribosomes and mitochondria were often observed in
      their cytoplasm. A detailed ultrastructural analysis revealed a delicate
      fibrillar coat frequently present on the free surface of PGCs during their
      migratory phase through the mesenchyme of the dorsal mesentery. This surface
      coat, likely corresponding to a glycocalyx, appeared as a particular, conspicuous
      filamentous layer of 30 nm thickness, mainly in the leading pseudopodial
      projections of PGCs migrating toward their target. The surface coat of PGCs can
      be associated with the binding sites of specific macromolecular components of the
      extracellular matrix, including fibronectin, and hence plays a role in PGCs
      recognition and migration during this special embryonic phase.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1760221
TI  - Differential changes in expression of the neurofilament triplet protein
      immunoreactivity in Purkinje cells of the cerebellum during the postnatal
      development of rats.
AB  - By means of peroxidase-anti-peroxidase (PAP) immunohistochemistry with both the
      neurofilament (NF) triplet (small: 68 K, medium: 150 K, high: 200 K) antisera and
      the antiserum against spot 35-calbindin, developmental changes in expression of
      the immunoreactivity for the NF triplet proteins in different domains of the
      Purkinje cells was examined in the cerebella of postnatal rats. From birth till
      the postnatal day 6 (P6) the somata and dendrites exhibited moderately positive
      immunoreaction for small and medium NF subunits. In contrast, the incubation for
      the high NF subunit resulted in a negative immunoreaction for the somata and
      dendrites of the Purkinje cells at those stages. On P8 and P10 they were weakly
      immunoreactive for all NF triplet. Thereafter the intensity of their
      immunoreaction decreased progressively and the Purkinje cell somata and dendrites
      were immunonegative for all NF triplet proteins on P21, when the Purkinje cell
      attained an adult appearance in morphology. On the other hand, the Purkinje cell
      axons, which can be identified selectively by the positive immunoreaction for the
      spot 35-calbindin throughout the course of the postnatal development, exhibited
      positive immunoreactivity for all the NF triplet on the 9th, 21th and 50th
      postnatal days in the cerebellar white matter. The development of the slow
      axoplasmic transport and the posttranslational modification of the NF triplet
      proteins are discussed as possible mechanisms underlying the differential
      expression of the immunoreactivity for the NF triplet proteins in different
      domains of the Purkinje cells during postnatal development.

PMID- 1760222
TI  - Novel honeycomb structures among collagen bundles in the Golgi tendon organs of
      the Chinese hamster.
AB  - A number of novel honeycomb structures were encountered among collagen bundles in
      the capsule lumen of the Golgi tendon organs in the adult Chinese hamster. They
      varied in size and shape and consisted of a hexagonal aggregation of columnar
      components (or units), usually perpendicularly disposed with respect to the long
      axis of the tendon organ. They measured 90-100 nm along their inner diameter and
      less than 1.0 micron in length, separated by partitions of electron dense
      materials about 30 nm wide. Each columnar unit consisted of a central, globular,
      electron dense material (20-30 nm in diameter) with a constant periodicity of 30
      40 nm and many (16-20) radially-arranged filaments (about 6 nm in diameter),
      showing a flower-like pattern. The honeycomb structures were attached to or fused
      with collagen fibrils or fibers at their margins, and were also attached to the
      microfibrils and basal laminae of the sensory endings, Schwann cells, and the
      innermost cell layer of the outer capsule. These findings suggest that the
      honeycomb structures might contribute to a complicated three-dimensional
      connection of collagen bundles as a whole, and that this connection might
      efficiently cause the mechanical deformation of the sensory endings by their
      squeezing in muscular contractions or passive stretching.

PMID- 1760223
TI  - A scanning electron microscopic study of the intercalated portion of the biliary
      system in the rat liver.
AB  - The intercalated portion of the rat liver was studied by scanning electron
      microscopy (SEM) after removal of interlobular connective tissue by acid or
      alkaline hydrolysis. Biliary intercalated portions have generally been regarded
      as short straight links lying between the bile capillary network and the
      interlobular duct. The biliary system as observed by SEM lacked such specialized
      segments for linking. Instead, it contained long intercalated ductules taking
      winding and branching courses. The ductular branches frequently anastomosed with
      each other to form an extensive plexus along the limiting plate. The ductules
      repeatedly connected with the plate on their courses as well as at their
      terminals. This disposition of the ductules probably potentiates their tolerance
      to luminal obstruction. At the junction between the ductule and the limiting
      plate, ductular cells and hepatocytes shared the biliary lumen. The lumen
      sometimes approached the base of the ductule, providing a possible route for bile
      leakage. The intercalated ductule was composed of low fusiform epithelial cells
      throughout its length, meeting its classical criteria by light microscopy. Its
      basal surface was furrowed with narrow grooves along cell boundaries. The
      ductular cells extended numerous microplicae in the basal grooves and on their
      lateral surfaces, suggesting their secretory function.

PMID- 1760224
TI  - Post-embedding immuno-electron microscopy with rapid freezing and freeze
      substitution techniques for the localization of manganese superoxide dismutase.
AB  - Dehydration of specimens with ethanol or acetone makes it impossible to detect
      manganese superoxide dismutase (Mn-SOD) by immunohistochemistry. To circumvent
      obstacles and demonstrate localization by post-embedding immuno-electron
      microscopy, a rapid freezing and freeze-substitution technique was employed using
      Lowicryl K4M embedding medium. This was effective enough to allow the specific
      observation of immunogold particles for Mn-SOD on the mitochondria of cardiac
      muscle cells and WI-38 cells (human normal fetal lung diploid cells). This method
      preserved the antigen-antibody binding activity of Mn-SOD even after dehydration.
      Therefore, rapid freezing and freeze-substitution is useful for post-embedding
      immuno-electron microscopy of Mn-SOD and can further be employed for other
      antigens previously difficult to detect by conventional methods.

PMID- 1760225
TI  - Serine phosphorylation-independent downregulation of cell-surface CD4 by nef.

PMID- 1760226
TI  - Antigenic domains of the HIV-1 vif protein as recognized by human sera and murine
      monoclonal antibodies.
AB  - To analyze the vif antibody response in individuals infected with the human
      immunodeficiency virus type 1 (HIV-1) and to determine antigenic epitopes on the
      vif protein, 104 HIV-1+ sera were screened for reactivity with a recombinant vif
      protein; 30 (28.8%) of these sera recognized the recombinant vif protein in
      immunoblot and were employed, together with 17 HIV-1/vif-negative control sera,
      in an enzyme immunoassay (EIA)-based epitope scanning assay with 183 overlapping
      decapeptides that covered the complete amino acid sequence of the HIV-1 vif
      protein (strain BH10). Of the 30 HIV-1/vif+ sera, 87% reacted with decapeptides
      comprising the two following epitopes: IEWRKKRY (vif amino acids 87-94) or
      DRWNKPQ (vif amino acids 172-178). The two epitopes were 89% and 100% conserved
      among different HIV-1 strains and their antigenicity could be confirmed by
      computer-assisted predictions of vif antigenic determinants. All the sera
      reactive with recombinant vif protein and with vif peptides originated from
      patients in CDC stages III or IV. Two murine anti-vif monoclonal antibodies
      reacted only with the seven C-terminal amino acids of the vif protein (SHTMNGH),
      which were not recognized by any of the human sera. Our results may be useful for
      further studies of vif seroreactivity and for the production of anti-vif mono- or
      polyclonal antibodies using vif peptides.

PMID- 1760227
TI  - In vivo sequence variation of the human immunodeficiency virus type 1 env gene:
      evidence for recombination among variants found in a single individual.
AB  - To assess in vivo sequence heterogeneity of the human immunodeficiency virus type
      1 (HIV-1) env gene, we used the polymerase chain reaction to amplify proviral
      sequences present in peripheral blood mononuclear cell DNA of a patient with
      acquired immunodeficiency syndrome (AIDS). The amplified env gene fragment (575
      bp) contains the first hypervariable region and part of the first conserved
      region. Eleven and twelve clones were sequenced, respectively, from specimens
      collected two months apart. Notable heterogeneity was observed among sequences
      recovered from both specimens. Also, the proviral population recovered from the
      first specimen varied significantly from that found in the second specimen. Both
      specimens contained forms with and without an 18 bp duplication. The presence or
      absence of this duplication, in addition to several point mutations, appear to
      define two molecular groups evolving in parallel within this patient. Several
      genotypes which had sequences characteristic of both groups occurred primarily in
      the second specimen; these can best be explained by multiple recombinational
      events between representatives of the two groups during reverse transcription.
      This study demonstrates that recombination may contribute significantly to the
      generation of diversity among HIV variants within a single individual.

PMID- 1760228
TI  - Human chromosome-dependent and -independent pathways for HIV-2 trans-activation.
AB  - Human immunodeficiency virus (HIV types 1 and 2) replication is controlled by the
      interaction of viral-encoded regulatory proteins and host cellular proteins with
      the viral long terminal repeat (LTR). The presence of HIV-1 and HIV-2 trans
      activator proteins, tat1 and tat2, respectively, greatly increases viral gene
      expression from their homologous LTRs. It is unclear if the cellular factors that
      support tat1-directed trans-activation of the HIV-1 LTR are the same for tat2
      trans-activation of the HIV-2 LTR. Human-Chinese hamster ovary hybrid cell clones
      were used to probe for human chromosomes involved in regulating HIV-1 and HIV-2
      tat-directed transactivation. DNA transfection experiments showed that the
      presence of human chromosome 12 in human-hamster hybrid clones was necessary for
      high-level tat-directed trans-activation of the HIV-1 and -2 LTR. Cross-trans
      activation of the HIV-2 LTR by tat1 was found to be chromosome 12 independent. In
      addition, chromosome 12 did not support trans-activation of another human
      retrovirus (human T-cell leukemia virus type I). Our results suggest that HIV-1
      and -2 have evolved to employ a cellular pathway(s) encoded on human chromosome
      12 for supporting homologous tat-directed trans-activation. Trans-activation of
      the HIV-2 LTR by tat1 in chromosome 12-minus cells suggests that multiple
      cellular pathways can be recruited to trans-activate the HIV-2 LTR and that these
      pathways may have been important in an HIV-like progenitor virus.

PMID- 1760229
TI  - Functional and immunological characterization of SIV envelope glycoprotein
      produced in genetically engineered mammalian cells.
AB  - Retroviral envelope glycoproteins interact with cell receptors and are targets
      for antiviral immune responses in infected hosts. Macaque simian immunodeficiency
      virus (SIVmac) is a T-lymphocytopathic lentivirus which causes an AIDS-like
      disease in rhesus macaques. The envelope gene of SIVmac encodes a precursor
      glycoprotein (gp160) which is cleaved into an external domain (gp130) and a
      transmembrane domain (gp32). To investigate the functional and immunological
      properties of the SIV external envelope glycoprotein, we have used genetically
      engineered mammalian cells to produce recombinant gp130 (rgp130). The rgp130 has
      the appropriate molecular weight, is glycosylated, and has native conformation as
      determined by binding to the cell receptor for SIV, the CD4 antigen. Rhesus
      macaques immunized with purified rgp130 formulated in muramyl dipeptide adjuvant
      generated high titers of antienvelope antibodies. Antibodies from these macaques
      were tested for in vitro virus neutralization; very low or undetectable levels of
      neutralization were observed. In contrast, neutralizing antibodies were readily
      detected in sera from goats immunized with rgp130. With respect to cell-mediated
      immunity, proliferative responses to rgp130 were demonstrated in peripheral blood
      monocyte cells (PBMC) from macaques immunized with the recombinant glycoprotein
      as well as in PBMC from SIV-infected animals. These results show that rgp130 is
      functional and immunogenic; the potential of rgp130 for protective immunization
      remains to be determined.

PMID- 1760230
TI  - Nucleotide sequence analysis of isolates of human T-lymphotropic virus type 1 of
      diverse geographical origins.
AB  - Nucleotide sequences for long terminal repeat (LTR), gag, the protease gene, and
      pol of a human T-lymphotropic virus type 1 (HTLV-1) isolate of probable Caribbean
      origin (HTLV-1CH) and a Zairian isolate (HTLV-1EL) were determined providing
      complete proviral sequences for these isolates. These sequences were compared
      with those available from previously analyzed isolates. Nucleotide sequence
      differences of 1.2-3.3% were identified among isolates for which complete genetic
      information was available. Nucleotide sequence diversity was distributed
      relatively evenly over the genome with 1.3-5.2% differences in the LTR, 1.1-2.9%
      differences in gag, 0.7-2.1% differences in the protease gene, 0.9-2.5%
      differences in pol, 0.9-2.4% differences in env, 0.0-1.4% differences in rex, and
      0.1-2.6% differences in tax. There were 1.2-2.3% amino acid differences overall,
      with 0.8-1.6% nonconservative amino acid alterations. Nucleotide differences were
      not found in regions of the LTR which are important for transcriptional activity
      or Tax response. Within the Rex-response element, nucleotide differences were
      found predominantly in loop rather than stem structures, thus, maintaining the
      overall secondary structure necessary for Rex activity. Evolutionary tree
      analysis of the sequence differences suggests a predominant clustering of
      different HTLV1 strains according to geographical origin. An open reading frame
      was also identified on the minus DNA strand situated between the env and rex/tax
      genes which exhibits 0.1-6.9% nucleotide sequence variation among HTLV1 strains.
      The limited sequence variation among HTLV-1 strains is in striking contrast to
      the extensive heterogeneity seen among human immunodeficiency virus (HIV)
      strains.

PMID- 1760231
TI  - Differential alteration of the anti-HIV-1 effect of phosphorothioate
      oligonucleotide S-dC28 by AZT, interferon-alpha, and dextran sulfate.
AB  - The combination of S-dC28 (a phosphorothioate oligodeoxcytidine 28 mer) with AZT,
      recombinant interferon alpha-A (IFN-alpha A) or dextran sulfate (DS) against
      replication of human immunodeficiency virus type 1 (HIV-1) were studied in MT4
      cells, using both p24 core antigen and reverse transcriptase (RT) assays. Under
      the standardized conditions, the anti-HIV-1 dose-effect relationships of all test
      drugs showed sigmoidal curves with the following EC50 values: for the p24 core
      antigen assay, S-dC28, 0.03 microM; AZT, 0.004 microM; IFN-alpha A, 9.2 U/ml; DS,
      0.26 micrograms/ml; for the RT assay, S-dC28, 0.04 microM; AZT, 0.01 microM; IFN
      alpha A, 11.6 U/ml; and DS, 0.31 micrograms/ml. A computer software based on the
      median-effect principle and isobologram techniques were used to quantitatively
      analyze drug interactions by calculating the combination index (CI) where CI less
      than 1, = 1, and greater than 1 indicates synergism, additive effect and
      antagonism, respectively. For p24-ELISA, the interaction of S-dC28 and AZT in
      combination produced a slight antagonism on HIV-1 replicative inhibition with CI
      values of 1.29-1.10; for RT assays, at EC50-EC95 levels, the CI values are 1.96
      1.11. For p24 core antigen assay, the combination of S-dC28 with IFN-alpha A
      exhibited a dose-dependent anti-HIV synergism with CI values of 1.15-0.87 at EC75
      EC95 levels. The RT assays for the same combination showed a broad synergistic
      effect with CI values of 0.62-0.60, at EC50-EC95 levels. S-dC28 plus DS showed a
      nearly additive effect based on both assay methods.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1760232
TI  - Proliferative response of mononuclear cells from HIV-infected patients to B-cell
      mitogens: effects of lymphocyte subset frequency, T-cell defects and
      prostaglandins.
AB  - Proliferative responses of mononuclear cells from patients seropositive for human
      immunodeficiency virus to B-cell mitogens are severely depressed compared with
      those of controls. The role of several immunoregulatory phenomena was analyzed.
      Experimental results show that addition of exogenous lymphokines to cultures
      increases responses to anti-mu and SAC. Addition of indomethacin to cultures
      greatly increases the SAC response and causes a smaller increase in the pokeweed
      mitogen (PWM) response. When both exogenous lymphokines and indomethacin are
      present in cultures, responses of patients' cells to all three mitogens are
      positively correlated with the percentage of CD4+ T cells and negatively
      correlated with the percentage of CD8+ T cells. Responses to anti-mu and SAC are
      also positively correlated with the percentage of B cells in these cultures. On
      the basis of these correlations between B-cell responses and lymphocyte subset
      frequency, patients' B-cell responses can be mathematically corrected to estimate
      the responsiveness of the B cells in the presence of normal numbers of CD4+ and
      CD8+ cells. These corrected responses for all three mitogens are virtually
      identical to control responses. Furthermore, responses of enriched B-cell
      populations from HIV+ subjects and normal controls to SAC were not significantly
      different when assays were performed in the presence of indomethacin and
      exogenous lymphokines. These results suggest that B cells from HIV+ patients are
      inherently normal in their responsiveness to B-cell mitogens. The depressed
      function is imposed upon them as a result of the abnormal frequency of lymphocyte
      subsets in the blood, by increased prostaglandin production, and deficient
      lymphokine production.

PMID- 1760233
TI  - [Rehabilitation of patients following brain injuries: specialized institution or
      general rehab center?].
AB  - The capacity for the rehabilitation of patients who have been affected by a brain
      injury does not meet the needs. Additional capacities are to be created in
      Switzerland. It is discussed whether it is preferable to create specialised
      institutions for the rehabilitation of the brain injured patient or whether these
      patients should rather be admitted to general rehabilitation centers. The
      advantages and disadvantages of these two options are discussed. The advantages
      of the admission of brain injured patients to general rehabilitation centers is
      stressed and the demand for special strategies and staff is described.

PMID- 1760234
TI  - [Facial injuries in bicyclists: epidemiological analysis and prophylactic
      consequences].
AB  - Bicycle accidents in adults are common and concern frequently injuries to head
      and face. 150 of totally 216 patients with cycle accidents in a six month'
      prospective study at the Basel University Hospital showed face and head trauma.
      85 severe facial injuries treated operatively by the Clinic for Reconstructive
      Surgery between 1985 and 1989 are analysed in detail. These facial injuries are
      rarely life threatening and normally the postoperative outcome is good.
      Nevertheless, usual bicycle helmets cannot avoid facial trauma. Therefore traffic
      educational programs are the most important prophylactic efforts. Technical
      progress and improvement of the bicycles ask for better trained cyclists. Further
      more, the importance of really respecting the traffic rules as well as the
      construction of separate cycle routes is stressed.

PMID- 1760235
TI  - [Simplification of osteosynthesis procedures of the hand bones using newly
      developed mini-osteosynthesis].
AB  - From unsatisfactory results in fractures in the hand treated with K-wires or
      other osteosynthesis we felt the need to develop new material for osteosynthesis.
      Our goal was to simplify the operative procedure, to enable exact anatomical
      reposition to avoid or reduce splinting in order to prevent adhesions and
      secondary operations. Further more to be able to reduce and stabilise small
      fragments. After more than 4 years of experience with our material in more than
      200 osteosynthesis we can conclude, that our goal has been accomplished to a
      great deal. We would like to present this procedure.

PMID- 1760236
TI  - [The treatment of fresh and chronic scapho-lunate tendon ruptures using trans
      osseous reinsertion and capsulodesis].
AB  - Presented here is a surgical method which attempts to reconstruct the dorsal
      scapho-lunate ligaments in a anatomical manner. This is done by using the
      remainders of the ligaments which, in our patients, where still present month
      after the accident. For additional stabilisation a capsulodesis according to
      Blatt is performed. The early results up to 20 month after surgery in 11 patients
      are encouraging, especially according to subjective complaints. However, a
      restriction of movement must be expected. The dorsal subluxation of the lunate
      can only rarely be fully corrected. The more significant long-term results are as
      yet not available.

PMID- 1760237
TI  - [Emergency screw osteosynthesis of femoral neck fractures].
AB  - 27 patients with femoral neck fractures have been treated by ORIF with 3 or 4
      large cancellous bone screws. The operation has been performed as an emergency
      intervention within 5 1/2 hours after accident. Anterior arthrotomy in direction
      of the long axis of the neck for evacuation of the intraarticular hematoma has
      been performed as a routine. Personal follow-up with X-ray documentation after 18
      to 106 months (mean 29.5 months) showed complete rehabilitation in 22 patients
      and 2 femoral head necroses (7.4%). We conclude that these good results are due
      to the short interval between accident and operation as well as to the evacuation
      of the intraarticular hematoma, together with a stable internal fixation and
      functional rehabilitation.

PMID- 1760238
TI  - [The treatment of fresh Lisfranc dislocations and fracture-dislocations].
AB  - Dislocations and fracture dislocations of the tarsometatarsal joint are usually
      the result of a high energy trauma to the forefoot. A missed diagnosis or an
      insufficient treatment or a massive destruction of the tarsometatarsal joint
      result in a high rate of late morbidity. An appropriate radiological assessment,
      open anatomical reduction and temporary K-wire arthrodesis followed by a
      functional after-treatment can improve the long-term results of this severe
      forefoot injuries. The long term results (7 months to 20 years) of 24
      tarsometatarsal injuries are analysed and a concept of their treatment presented.

PMID- 1760239
TI  - [Role of arthroscopy in complex sports injuries].
AB  - Shoulder lesions caused by accident are often of complex nature. In most cases,
      different structures are involved, which cannot be distinguished and
      individualized clinically with certainty. Arthroscopy permits far more
      differentiated diagnosis with systematic revision of traumatized structures.
      Besides the possibility of comprehensive repair (e.g. in part arthroscopic, in
      part open), the faster rehabilitation attained by minimal exposures is also of
      importance.

PMID- 1760240
TI  - [Comparative microstructural studies on collagen and elastic fiber systems of the
      cruciate ligaments].
AB  - The aim of the present study was to compare the collagenous fibre systems of the
      anterior (ACL) with the posterior cruciate ligament (PCL). 22 cruciate ligaments
      were examined by the combined use of light-, transmission- and scanning electron
      microscopy. Characteristic interligamental differences were established. ACL:
      more anchoring type VI collagen, thinner but more branched fibrils, complex
      collagen networks, much more elastic elements. PCL: more type IV collagen, many
      intrinsic vessels, thicker fibrils, parallel fibre arrangement. The results
      indicate that the ACL is exposed at the first line to rotational forces, the PCL
      probably more to tensional forces. The collagen fibre arrangement of the cruciate
      ligaments is to take into consideration by the surgeon.

PMID- 1760241
TI  - [Prevot's method of elastic-stable endomedullary fixation--an ideal method for
      the management of juvenile shaft fractures].
AB  - We report on the experiences on the internal fixations of long bones which has
      replaced the non operative method of extension over the last years in our clinic.
      Although the short-term results of the internal fixations are very convincing the
      follow-up of these patients will give us further informations on its validity.
      The well defined aim is to find the treatment with the best chance of restitution
      combined with the lowest risk-rate.

PMID- 1760242
TI  - [The importance of ADP for medical statistics].
AB  - Recent german articles concerning medical statistics give priority to data
      acquisition. This contribution describe the statistical analysis and presentation
      of the results of the Swiss accident insurance Company (SUVA) with 1.9 million of
      insured workers. This documentation covers per year approximately 450,000
      accidents at work and in free time. The documentation include primarily the
      insurance-data, for medical purposes we use the adjacent diagnoses (up to 20 per
      accident). The new medical statistic (SUMEST) begins with the accidents of the
      year 1984, updated until 1988, this means, that we have a statistic of the
      outcome of accidents. For the analysis we use properties of the personality,
      details of what happened, injury, expenses for healing and results. The primary
      presentation is a collection of tables for every diagnosis (total 417) with the
      most important criteria for the cases. It is provided to publish results of
      special problems like time of disability, influence of algodystrophy etc. The
      possibility to analyse a big documentation (25 MBytes) with a personal computer
      give to the physician the possibility to perform the statistical analysis himself
      and to select the significant results immediately.

PMID- 1760243
TI  - Chromosome 11q13 abnormalities in human cancer.
AB  - Structural abnormalities affecting band q13 of chromosome 11 have been reported
      in a variety of human tumors, particularly multiple endocrine neoplasia type 1
      (MEN1), certain low-grade B-cell neoplasms, and a significant subset of breast
      and squamous cell carcinomas. The perturbations of the region are also varied,
      ranging from allele loss and deletions to specific translocations and DNA
      amplification. Given their clinical relevance in classifying tumors and
      identifying patients at increased risk, it is important to locate and
      characterize the genes on which these aberrations impinge. Here we assess the
      candidate genes identified thus far and the evidence that implicates them in
      tumorigenesis.

PMID- 1760244
TI  - Gene-specific repair of DNA damage induced by UV irradiation and cancer
      chemotherapeutics.
AB  - DNA repair processes are critically important in the prevention of
      carcinogenesis, and currently much research is directed toward elucidation of the
      biochemical mechanisms by which DNA repair occurs. Techniques have been developed
      for examining individual genes to quantitate the lesions induced by various
      chemotherapeutic agents and to measure the rate of gene-specific DNA repair. In
      mammalian cells, the DNA repair response exhibits intragenomic heterogeneity
      active genes are preferentially repaired and the transcribed strand of DNA is
      repaired more rapidly than the nontranscribed strand. These studies have provided
      new insight into the molecular biology of DNA repair and a new perspective on the
      role of repair processes in cellular resistance to DNA damage and malignancy.
      Elucidation of the mechanisms by which gene-specific lesions are formed and
      repaired will be important if we are to understand the fundamental processes of
      malignancy.

PMID- 1760245
TI  - Photodynamic therapy of malignant tumors--recent developments.
AB  - Photodynamic therapy (PDT) is a promising new cancer treatment modality in which
      tumor cells are killed as a result of photoactivation of a tumor-localizing
      photosensitizing agent. Since activating light can be targeted specifically to
      tumors, and tumor-selective photosensitizing agents are being developed, this
      treatment has the potential to induce highly selective destruction of malignant
      cells. To date, PDT has been applied to a large variety of human carcinomas,
      resulting in successful eradication of single tumor nodules and several types of
      superficial tumors. Current research is aimed at improving the efficacy and tumor
      selectivity and tumor destruction. The most immediate benefits of PDT are likely
      to be seen in patients treated with a combination of this and other forms of
      therapy.

PMID- 1760246
TI  - All about B cells.

PMID- 1760247
TI  - Radioprotection with cytokines: a clarification of terminology.

PMID- 1760248
TI  - Serum-free growth and karyotype analyses of cultured normal and tumorous
      (SqCC/Y1) human buccal epithelial cells.
AB  - Epithelial cell cultures were obtained following tryptic digestion of normal
      human buccal mucosa. Primary cultures exhibited markedly higher colony-forming
      efficiencies and growth rates using fibronectin/collagen-coated, as compared to
      non-coated culture dishes and a serum-free MCDB 153 medium developed for
      epidermal epithelial cells than a similar medium previously developed for buccal
      explant outgrowth cultures. At the preferred conditions, the cells could be
      transferred at least 5-fold, divided at about one population doubling per day,
      and commonly underwent 60 population doublings resulting in yields of 10(8) to
      10(11) cells per cm2 mucosal specimen. Moreover, these conditions successfully
      cultivated a buccal carcinoma cell line (SqCC/Y1) for several months. The
      carcinoma cells were resistant to factors that inhibited growth or induced
      differentiation of normal cells, i.e., transforming growth factor type beta 1,
      Ca2+, or serum. Karyotype analyses of SqCC/Y1 cells showed 63 to 83 chromosomes
      per metaphase and consistent occurrences of monosomy 1, tetrasomy 19 and 20, as
      well as trisomy 22, and at least 7 marker chromosomes, whereas cells obtained
      from non-cancerous donors were diploid. It is concluded that the similarly
      defined culture conditions may now be applied to study characteristics of both
      normal and tumorous buccal epithelial cells.

PMID- 1760249
TI  - Cell-cycle associated transcriptional regulation of ribonucleotide reductase in
      L1210 leukemia cells and drug-resistant variants.
AB  - Previous studies from this laboratory have shown that the steady-state levels of
      the mRNA for the non-heme iron (NHI) subunit of ribonucleotide reductase were
      markedly elevated in hydroxyurea-resistant L1210 cell lines with minimal changes
      in the mRNA levels for the effector-binding (EB) subunit. In the present study,
      wild-type L1210 cells and their drug-resistant variants [hydroxyurea-resistant
      (HU-7); deoxyadenosine-resistant (Y-8); and deoxyadenosine/pyrazoloimidazole
      resistant (ED2)] were synchronized by EGTA treatment in the G0/G1-phase of the
      cell cycle. Upon the addition of CaCl2, the cells reentered the cell cycle. The
      steady-state levels and the transcriptional rates of the mRNAs for the EB subunit
      and glyceraldehyde-3-phosphate dehydrogenase were measured and found to be
      similar in the drug-resistant variants compared to the wild-type cells. While the
      steady-state level of the mRNA for the NHI subunit was increased 35-fold in the
      HU-7 cell line, the transcription rate was increased only 7-fold. The increase in
      the transcription rate did not account for the large increase in the steady-state
      level. These data indicate that the increased steady-state level of the mRNA for
      the NHI subunit in the HU-7 L1210 cell line was not due to cell-cycle differences
      and that post-transcriptional processing and/or stability may play a role as
      well.

PMID- 1760250
TI  - Cytotoxicity and DNA crosslinks produced by mitomycin analogs in aerobic and
      hypoxic EMT6 cells.
AB  - Several mitomycin antibiotics were evaluated for their capacities to kill EMT6
      tumor cells and to produce DNA crosslinks under conditions of oxygenation and
      hypoxia. The agents examined included mitomycin C, porfiromycin, and the 7
      aminomethyl dithioacetal derivative of mitomycin C (BMY-43324), all of which
      caused greater kill of hypoxic cells than of their oxygenated counterparts; the
      N,N'-dimethylaminomethylene derivative of mitomycin C (BMY-25282), which was
      considerably more cytotoxic under oxygenated conditions than in hypoxia; and the
      N,N'-dimethylaminomethylene derivative of porfiromycin (BL-6783), which was equal
      in its toxicity to hypoxic and oxygenated cells. All of these agents produced DNA
      crosslinks in EMT6 cells, as measured by alkaline elution. The number of
      crosslinks required to produce a given amount of cell kill was similar,
      regardless of the mitomycin employed or the degree of oxygenation, suggesting
      that the crosslinking of DNA was a major lesion in the cytodestructive action of
      the mitomycins.

PMID- 1760251
TI  - Intracellular mechanisms involved in leukotriene C4-stimulated adhesion of U-937
      cells.
AB  - Leukotrienes C4 and D4 (LTC4 and LTD4) stimulated, 5- to 6-fold, the adhesion of
      the monoblastoid cell line U-937 to plastic. Half-maximal effects were observed
      around 1 nM. Leukotrienes E4 and B4 (LTE4 and LTB4) were less effective. The
      adhesive response to LTC4 was inhibited by pertussis toxin and was completely
      dependent on the presence of extracellular Ca2+. The LTC4-stimulated increases in
      inositol-phosphates and in intracellular Ca(2+)-concentration were insensitive to
      pertussis toxin. Activation of leukocyte adhesion is a novel action of cysteinyl
      leukotrienes and the present study suggests that control of U-937-cell adhesion
      by LTC4 involves two pathways; one pertussis toxin insensitive pathway regulating
      intracellular Ca2+ in a manner partly dependent on extracellular Ca2+ and one
      pertussis toxin sensitive pathway not concerned with Cai(2+)-regulation.

PMID- 1760252
TI  - Effects of homo- and heterodimeric isoforms of PDGF on signalling events in rat
      renal mesangial cells.
AB  - Platelet-derived growth factor (PDGF) exists in three dimeric isoforms, AA, BB
      and AB. Mesangial cells exclusively bound the BB homodimer and responded only to
      the BB isoform in terms of DNA synthesis and phosphoinositide hydrolysis. PDGF-BB
      stimulated a dose-dependent formation of inositol trisphosphate (InsP3). Neither
      pertussis toxin nor short-term (10 min) treatment with 12-O-tetradecanoylphorbol
      13-acetate (TPA) inhibited the PDGF-BB-evoked production of InsP3. In contrast,
      the response to PDGF-BB was attenuated in cells in which protein kinase C has
      been down-regulated by long-term (24 h) treatment with TPA. In parallel to the
      generation of InsP3, there was a biphasic increase in 1,2-diacylglycerol (DAG).
      The second peak of DAG generation was associated with a concomitant 2-fold
      increase in choline formation. In addition, PDGF-BB stimulated the accumulation
      of phosphatidylpropanol, produced by phospholipase D phosphatidyl transferase
      activity, when 1-propanol was added to mesangial cells. Stimulation of mesangial
      cells with PDGF-BB caused a dose-dependent formation of prostaglandin E2.
      Furthermore, mesangial cells secreted PDGF-AA into the culture supernatant.

PMID- 1760253
TI  - Evidence that metabolically active synaptosomes lack functional cyclic AMP
      dependent protein kinase.
AB  - Cyclic adenosine monophosphate (cAMP)-mediated signal transduction was evaluated
      in synaptosomes prepared from rat brain cortex. Adenylate cyclase was responsive
      to known adenylate cyclase stimulators including peptides (CRH and VIP),
      catecholamines (norepinephrine and isoproterenol) and ligands that directly
      stimulate adenylate cyclase (forskolin). Cyclic AMP accumulation also increased
      approximately 2 to 3-fold, but none of the agonists was able significantly to
      activate cyclic AMP-dependent protein kinase (A-kinase) in cortical synaptosomes.
      However, in parallel studies with slices prepared from rat brain cortex,
      adenylate cyclase activity, cAMP accumulation and A-kinase activity were all
      stimulated by CRH, VIP, norepinephrine, isoproterenol and forskolin. These data
      suggest that, in intact synaptosomes, either the cellular machinery which
      facilitates binding of cAMP to the regulatory subunit of A-kinase is missing or
      the cAMP produced by adenylate cyclase is not accessible to A-kinase.

PMID- 1760254
TI  - The proteolysis of membrane-associated protein kinase C as a possible component
      of the signalling pathway leading to c-myc induction in B lymphocytes.
AB  - Occupancy of surface immunoglobulin (sIg) receptor for antigen expressed on
      resting B cells initiates increased turnover of membrane-associated
      phosphatidylinositol (PI), which ultimately leads to the enhanced expression of c
      myc mRNA. The mechanism which links these initial membrane biochemical changes to
      subsequent alterations in c-myc transcription is unclear. The present study
      examines the possible involvement of PKC and its calpain-generated proteolytic
      fragment, protein kinase M (PKM), in conveying the membrane-associated signal to
      the nucleus. Utilizing an in vitro phosphorylation assay, we have shown that a
      calcium-dependent protease, similar to calpain, is involved in the downregulation
      of membrane-associated PKC induced by anti-immunoglobulin or phorbol 12-myristate
      13-acetate (PMA) and ionomycin stimulation of resting B cells. In addition, we
      have confirmed previous studies showing that PMA and ionomycin are both required
      for optimal expression of c-myc mRNA. The enhanced expression of c-myc mRNA is
      sensitive to inhibitors of PKC, such as H-7 and sangavimycin, providing evidence
      for a prominent role of PKC and/or PKM in the receptor-mediated up-regulation of
      c-myc message expression. Finally, a calpain inhibitor interferes with the
      transmission of the membrane-associated signal which induces the increased
      expression of c-myc mRNA. Our results are consistent with the hypothesis that the
      calpain-mediated proteolysis of membrane-associated PKC is involved in the sIg
      mediated signal transduction pathway.

PMID- 1760256
TI  - [The origin of malformations].

PMID- 1760255
TI  - Distribution of arrestin-like protein and beta-subunit of GTP-binding proteins in
      quail choroid plexuses.
AB  - Monoclonal antibodies (Mabs) directed against retinal arrestin (S-antigen) were
      used to detect and characterize this protein in choroid plexus (CP) of quails
      maintained during eight days, either under long-day photoperiods or in constant
      darkness. Immunocytochemistry and Western blotting confirmed the presence and the
      distribution of an arrestin-like protein in quail CP. Arrestin-like
      immunoreactivities in CP were compared with those obtained with Mabs to beta 36
      subunit of G proteins (G beta), alpha-subunit of transducin and rhodopsin.
      Rhodopsin-like and transducin-like proteins could not be detected in choroidal
      cells, whereas intense positive reactions were observed with anti-G beta and anti
      arrestin Mabs. The strongest immunoreactivities were found in choroidal
      ependymocytes of the lateral and IIIrd ventricles. In CP epithelial cells lining
      the IVth ventricle, very weak or no immunoreactivity could be detected with Mabs
      to arrestin, while Mab against G beta subunit always provided a positive
      reaction. In quails maintained in constant darkness, arrestin- and G beta
      immunoreactivities of CP epithelial cells displayed changes in cellular
      distribution and intensity (decrease or disappearance of the immunoreactions).
      The strong arrestin-like immunoreaction located in the apical region of
      ependymocytes suggests the preferential association of the protein with choroidal
      microvilli and a possible role in cerebrospinal fluid production assumed by CP
      cells.

PMID- 1760257
TI  - [The indications, technics and results of the use of tissue expanders in
      pediatric surgery].
AB  - We review our experience in tissue expansion in twenty-four pediatric patients.
      The most frequent indications for the use of tissue expanders included congenital
      nevi and burn scars, they were also used with success in alopecia, congenital
      abdominal wall defects, mammary hypoplasia and microtia. Tissue expanders were
      always placed subcutaneously. Both, surgery and body deformity during expansion,
      were well tolerated. We found complications in five cases, but only in one
      patient treatment was interrupted. Results were considered excellent in nineteen
      cases.

PMID- 1760258
TI  - [Otological assessment in patients operated on for cleft palate].
AB  - Tympanometry and otoscopy has been carried out to determine the presence of
      middle ear disease on patients with cleft palate and the influence of corrective
      surgery. This explorations have been evaluated preoperatively and at one and six
      months postoperative follow-up. There is a high incidence of otitis media with
      effusion in patients with cleft palate, almost 60 per 100 in our study. The
      influence of cleft palate surgery repair has not revealed as a mayor factor on
      its resolution, although a visible benefit has been observed in the long term
      controls. We recommend a otorhinolaryngological follow-up in these patients.

PMID- 1760259
TI  - [Hepatic artery thrombosis in the pediatric liver transplant].
AB  - The hepatic artery thrombosis (HAT) is the most serious complication after
      pediatric liver transplantation. Most of the cases will need a retransplantation.
      Multiple factors are keeping in discussion as causes of this complication:
      Rejection, two or more arteries, complex vascular reconstruction, etc. This
      article describes our experience with this complication and the prophylactic
      treatment. From January 1986 through April 1991, 62 orthotopic liver transplants
      were performed on 48 pediatric patients with a mean age of seven years. The
      incidence of hepatic artery thrombosis was 19 per 100, increasing when recipients
      were less than three years and less than 15 kg (23.8 per 100). Forty six cases
      were rearterialized with end-to-end anastomoses, ten were rearterialized by
      directly anastomosing them to the recipient aorta and six with iliac artery
      graft. We use in the last 38 consecutive patients prophylactic heparin during two
      weeks after transplantation (300 u/kg/d) following with antiaggregants. There
      were eleven patients with hepatic artery thrombosis, one of them had two episodes
      in both grafts. We perform a retransplantation in eight patients, two died
      waiting a new graft and one exceptional patient is out of the clinic with normal
      liver function and without regraft. Seventeen grafts had two or more arteries
      from aorta, ten with branches from superior mesenteric artery and five from
      gastric artery. One graft had a triple hepatic artery and another one was a
      common hepatic artery from superior mesenteric artery.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1760260
TI  - [The surgical treatment of anterior hypospadias. Apropos 590 cases (1966-1988).
      The indications and results. The current trends in surgical treatment].
AB  - The surgical treatment of hypospadias is very complex. The objective is to obtain
      a satisfactory urinary and genital function with an equal morphological,
      anatomical and aesthetic result. Our contribution covers twenty-two years of
      surgical multicentre experience (590 cases). We evaluate the surgical indication,
      results, complications, associated malformations and study protocols. We have
      objectively evaluated the evolution of the indications, as well as the
      application of different techniques depending on the extent of urethral
      malformation.

PMID- 1760261
TI  - [Urologic obstructions due to fungal balls].
AB  - Fungal urologic infections are unusual in children. They are associated with
      chronic uropathies, citostatics and antibiotic treatments and depressed immunity
      which allow the pathologic growth of a saprofitie organism. This infection must
      present special forms when the mycotic development is realized in cavities and
      special advantageous conditions. Then it adopt the form of fungal bezoars, and it
      can mobilize itself and provoke obstructions in the urinary tract. We present two
      cases of urinary obstructions secondary to fugal bezoars. The obstruction was
      localized in the uretero-vesical junction. In both of them the infection was
      associated with long antibiotic treatment, and with severe immunodeficiency only
      in one. The diagnosis was possible by echography and direct determination of
      candida albicans in urine. We proved also temporary ureterovesical stenosis we
      found before a reflux. The treatment included intravenous and local anfotericine
      B with dissolution of the bezoar in three and four days respectively.

PMID- 1760262
TI  - [Fetal urinary dilatation due to vesico-ureteral reflux].
AB  - We have retrospectively studied 163 newborns referred to us between 1986 and 1990
      for sonographic diagnosis of intra-uterine upper urinary tract enlargement. All
      were studied by paediatric radiologists on days 5th or 6th after birth by means
      of sonography and voiding cystourethrogram (VCU). Fifty percent had also IVP. No
      urinary tract disease could be found in 44 children, obstructive uropathy or
      cystic disease were diagnosed in 58 children and 61 patients had vesico-ureteric
      reflux (VUR). They form the basis of the present report. There was a male-to
      female ratio of 3.3 to 1. Neonatal ultrasonography was normal in 11 cases, 42 had
      pyelectasia (bilateral in eight cases) and eight had ureterohydronephrosis
      (bilateral in seven). VUR was bilateral in 28 cases, right in 16 and left in 17.
      Out of the 89 refluxing units, VUR grade was I in 11, II in 16, III in 24, IV in
      14 and V in 23. There was intra-renal reflux in 17 units. Some other form of
      urinary tract disease was detected in 29 babies (47.5 per 100). Twenty-eight
      patients were operated upon and the remaining are under long-term urinary
      antisepsis with only five episodes of infection. The considerable proportion of
      false negatives for VUR in neonatal ultrasonography (30 per 100) and the high
      grade of some of these cases lead us to strongly advise routine VCU for patients
      with intra-uterine urinary tract dilatation.

PMID- 1760263
TI  - [An analysis of the introduction of pediatric surgery in Spain].
AB  - The specialty of paediatric surgery (P.S.) has been officially recognized in
      Spain since 1977 as being independent of other surgical areas, and charged with
      carrying out pathological surgery in paediatric ages. In spite of the
      considerable progress made, it suffers constant threats, which is why we feel it
      is opportune to review various aspects of the problems it is currently facing. If
      we observe how the specialty is distributed, we can see that there are many
      paediatric services and professorships which do not send their patients to a P.S.
      specialist. The child's health may suffer as a result of the Administration's
      decision to allow twenty-two provinces (seven million inhabitants) to go without
      P.S. We know that many specialties carry out surgery on the paediatric
      population, so we may well ask: What use is the P.S. qualification? Information
      was collected from legal sources which indicates the need to hold the
      qualification of "homologated specialist", given that "the doctor who ventures
      into specialties which are not his/her own may add a risk factor, and thereby
      give rise more easily to an offence of negligence". It is time that concepts and
      competences of the specialty were clarified, and to fight to ensure that all
      Spanish children should be operated on by legally qualified specialists.

PMID- 1760264
TI  - [Continuous arteriovenous hemofiltration in the newborn surgical patient].
AB  - Continuous arteriovenous hemofiltration is an extracorporeal technique that uses
      the arterio-venous pressure gradient to remove plasma water and solutes via
      convection through a hemofilter. This therapy is specially indicated in the
      newborn with acute renal failure, hypervolemia and/or metabolic disturbances. The
      technique has good clinical tolerance in the critically ill patient because of
      little hemodynamic repercussion without major osmolar shifts, low anticoagulation
      needed and its simplicity (no need for specialized staff).

PMID- 1760265
TI  - [Ectopic gastric mucosa in the proximal esophagus].
AB  - Gastric mucosa is not found often in the proximal and medial esophagus.
      Hematemesis and dysphagia are the most frequent symptoms. We report a six year
      old child who complained of difficulty in swallowing. A filling defect was detect
      in the esophagogram. We biopsied the suspected area, through an endoscopy and the
      pathological examination informed of ectopic gastric mucosa. We performed a 99Tc
      isotopic study. The child is on ambulatory controls and at the moment is
      asymptomatic.

PMID- 1760266
TI  - [A case of total intestinal aganglionosis. 2 years of survival].
AB  - A two-year-old male is presented. Small bowel aganglionosis was proved to extend
      to 3 cm below ligament of Treitz. Gastrostomy and ileostomy was done. He received
      his caloric intake by cyclic home parenteral nutrition trough implantable venous
      system. At eighteen months of age, intestinal transplantation was refused and
      reoperation was done. The child underwent Ziegler's miotomymiectomy on 60 cm of
      aganglionic jejunum. Now at twenty seven months of age he receives cyclic
      parenteral nutrition, and enteral feedings are being increased slowly. The
      weight/height was at 91 per 100 standard, intestinal motility appears much better
      on contrast study and he is developmentally a normal child.

PMID- 1760268
TI  - Nursing development units: a new hand on the tiller. Interview by Charlotte
      Alderman.

PMID- 1760267
TI  - Update on AIDS.

PMID- 1760269
TI  - Health visiting: working in a divided community.

PMID- 1760270
TI  - Health care assistants: open College?

PMID- 1760271
TI  - Audit commission: lean, mean quality care.

PMID- 1760272
TI  - Computer records in occupational health.

PMID- 1760274
TI  - The extended role of the nurse: a review.

PMID- 1760273
TI  - Psychotherapy: therapeutic use of metaphor.

PMID- 1760275
TI  - Continuing education: community education and practice.

PMID- 1760276
TI  - Nursing: yin and yang.

PMID- 1760277
TI  - Tradimus. Accommodation: living-in fear.

PMID- 1760279
TI  - Tradimus. Mental health nursing: RMNs need counselling.

PMID- 1760278
TI  - Tradimus. Ethics: getting a moral body.

PMID- 1760280
TI  - Tradimus. Health education: not enough cooks?

PMID- 1760281
TI  - Tradimus. Education: degree to disagree.

PMID- 1760282
TI  - Tradimus. International: New York, new work.

PMID- 1760283
TI  - Tradimus. Bereavement support: Students are human, too.

PMID- 1760285
TI  - The Clay column.

PMID- 1760284
TI  - Tradimus. Grieving: confronting death.

PMID- 1760286
TI  - The image of nurses: the times they are a'changing?

PMID- 1760287
TI  - Education. Doctors and nurses: a personal view.

PMID- 1760288
TI  - Personnel: NHS Trusts and equal opportunities.

PMID- 1760289
TI  - Post-traumatic stress management.

PMID- 1760290
TI  - Nursing issues in intravenous therapy.

PMID- 1760292
TI  - Ear, nose and throat nursing: aural hygiene and the use of cotton swabs.

PMID- 1760291
TI  - Uncommon disorders. Malignant hyperpyrexia.

PMID- 1760293
TI  - Pros and cons of working as a bank nurse.

PMID- 1760294
TI  - Scare tactics don't work. Interview by Audrey Thompson.

PMID- 1760295
TI  - Lateral nursing: the Pink revolution.

PMID- 1760296
TI  - AIDS focus. Groups for people with HIV/AIDS.

PMID- 1760297
TI  - AIDS focus. Sexuality, saints and sinners.

PMID- 1760298
TI  - AIDS focus. The challenge of the nineties.

PMID- 1760299
TI  - Quality Assurance Network Newsletter. Hooked on quality.

PMID- 1760300
TI  - Quality Assurance Nursing Newsletter.

PMID- 1760301
TI  - Quality Assurance Network Newsletter. A cycle of quality.

PMID- 1760302
TI  - Quality Assurance Network Newsletter. Hands-on quality.

PMID- 1760303
TI  - Politics. Waldegrave on nursing. Interview by Norah Casey.

PMID- 1760304
TI  - The A-Z Christmas survival guide.

PMID- 1760305
TI  - Homelessness: Christmas in the open air.

PMID- 1760306
TI  - Linking poverty and ill health.

PMID- 1760307
TI  - Continuing education: developing a career through nursing.

PMID- 1760308
TI  - Staff development. Clinical grading: the silver lining?

PMID- 1760310
TI  - On being treated as an ignorant hillbilly when escorting a patient to a London
      hospital.

PMID- 1760309
TI  - Paediatric intensive care: transposition of the great arteries.

PMID- 1760311
TI  - Substance abuse: Christmas cheer or drear?

PMID- 1760312
TI  - Dreams come true in '92?

PMID- 1760313
TI  - Ethnic issues: from plasters to poverty.

PMID- 1760314
TI  - Statutory bodies: proposals for major change.

PMID- 1760315
TI  - Family interventions in schizophrenia.

PMID- 1760316
TI  - Midwifery: an exercise in pregnancy. Interview by Charlotte Alderman.

PMID- 1760317
TI  - Neurology: relating pathology to hand preference.

PMID- 1760318
TI  - Uncommon disorders. Epidermolysis bullosa.

PMID- 1760319
TI  - Continuing education and UK nurses.

PMID- 1760320
TI  - Breastfeeding shame?

PMID- 1760321
TI  - Communication: of verbosity and verbiage.

PMID- 1760323
TI  - Cardiology update. Transplant assessment.

PMID- 1760322
TI  - Cardiology update. No smoke without fire.

PMID- 1760324
TI  - Cardiology update. Surgical aspects of heart transplantation.

PMID- 1760325
TI  - Cardiology update. Endomyocardial biopsy technique.

PMID- 1760326
TI  - Cardiology update. Thoracic sympathectomy for angina.

PMID- 1760327
TI  - Cardiology update. Dorothy: a breath of fresh air.

PMID- 1760328
TI  - Education: No More Nightingales.

PMID- 1760330
TI  - Special hospitals: a better understanding. Interview by Derek Hand.

PMID- 1760329
TI  - Old age is not a reason to fall.

PMID- 1760331
TI  - Continence training programmes: need for standardisation.

PMID- 1760332
TI  - Continuing education: application of CATS in the health service.

PMID- 1760333
TI  - Reviewing trends in nurses' earnings.

PMID- 1760334
TI  - Manipulative and splitting behaviours.

PMID- 1760335
TI  - Developing an NDU: the manager's role.

PMID- 1760336
TI  - Pleasures of returning to the profession.

PMID- 1760337
TI  - Neat work on networks.

PMID- 1760338
TI  - Managing to take the lead.

PMID- 1760339
TI  - No masters without slaves.

PMID- 1760340
TI  - Health promotion: no smoke without ire.

PMID- 1760341
TI  - Community nursing: visitations on the elderly.

PMID- 1760342
TI  - Learning disabilities: qualified in caring.

PMID- 1760343
TI  - General election: a passion for politics.

PMID- 1760344
TI  - Northern Ireland. 'It's the patients who take us through.'.

PMID- 1760345
TI  - Continuing education in an NDU.

PMID- 1760346
TI  - Sports therapy in mental illness.

PMID- 1760347
TI  - Management of fungal infections.

PMID- 1760348
TI  - Downgrading of arts-centered education in state schools.

PMID- 1760350
TI  - The Nat Health files. Welcome to Glandstand.

PMID- 1760349
TI  - There's no Seventh Cavalry.

PMID- 1760351
TI  - John Kelly: an extraordinary man. Interview by Alex Mathieson.

PMID- 1760352
TI  - Car tax: steering through taxation.

PMID- 1760353
TI  - A day in the life ... a nurse of ill repute.

PMID- 1760354
TI  - Essential fatty acids and the skin.

PMID- 1760355
TI  - In-situ hybridization using digoxigenin-labelled probes in human skin.
AB  - This study demonstrated that in-situ hybridization using digoxigenin-labelled
      oligonucleotide poly-T probes and digoxigenin-labelled riboprobes for keratin 14
      is possible on routinely fixed paraffin-embedded sections. The resolution and
      time course of the detection system compared favourably with isotopically
      labelled probes. Major differences were shown in keratinocyte messenger RNA
      content with differentiating cells expressing high levels when compared with the
      basal layers. Previous work on the distribution of keratin 14 messenger RNA was
      confirmed and we were able to show that using non-isotopic in-situ hybridization,
      sensitive and accurate cellular localization was feasible in skin sections.

PMID- 1760356
TI  - The expression of MHC class II (Ia) antigens on mouse keratinocytes following
      epicutaneous application of contact sensitizers and irritants.
AB  - The expression of MHC class II (Ia) antigens on mouse keratinocytes was studied
      following both the induction and elicitation of contact sensitivity, and after
      primary irritant reactions. IA+ and IE+ keratinocytes were detected, using an
      indirect immunofluorescence assay on epidermal sheets, only after the induction
      and elicitation of contact sensitivity with the sensitizers oxazalone, picryl
      chloride and 2,4-dinitrochlorobenzene but not with formaldehyde. Ia+
      keratinocytes were not detected after epicutaneous application of the non
      sensitizing irritants croton oil, SDS and anthralin, or following attempted
      sensitization of nude mice, suggesting that the expression of Ia antigen on
      keratinocytes during contact sensitivity reactions is T-cell mediated. Because Ia
      antigen expression on keratinocytes could be detected only several days after
      induction or elicitation of contact sensitivity, and contact sensitization could
      also be demonstrated to occur independently of aberrant Ia expression, Ia+
      keratinocytes cannot be involved in the initiation of these reactions. However,
      they might be important in exerting an immunomodulatory influence during the
      later stages of the responses to certain sensitizers.

PMID- 1760357
TI  - Profile of prostanoid release following antigen challenge in vivo in the skin of
      man.
AB  - We have previously characterized the kinetics of prostaglandin D2 (PGD2)
      production at cutaneous sites of allergic inflammation employing a blister
      chamber model. In this study, a more complete profile of prostaglandins released
      in vivo was obtained. PGD2 release, as measured by radioimmunoassay and by
      combined gas chromatography-mass spectrometry, was evident within 1 h after
      antigen challenge with maximal levels occurring 3-4 h post-challenge. The 11
      ketoreductase metabolite of PGD2, 9 alpha, 11 beta-prostaglandin F2 was present
      in blister fluid from three of six patients at the time of maximal levels of
      PGD2. The stable non-enzymatic hydrolysis product of prostacyclin, 6-keto
      prostaglandin F1 alpha, was significantly elevated in blister fluid from five of
      six patients following antigen challenge. In these subjects, the levels of 6
      kappa-PGF1 alpha were highest in samples obtained 1 and 2 h after antigen
      challenge and remained significantly elevated until 5 h post-challenge. Levels of
      prostaglandin E2, prostaglandin F2 alpha and thromboxane B2 did not vary
      significantly. These studies suggest that following antigen challenge two fatty
      acid cyclo-oxygenase products of arachidonic acid are released, PGD2 and
      prostacyclin. The 11-ketoreductase metabolism of PGD2 to 9 alpha, 11 beta-PGF2
      could represent a mechanism by which the biological effects of PGD2 are prolonged
      in cutaneous tissue. The presence of 6 kappa-PGF1 alpha in the blister fluid
      suggests that significant prostacyclin release occurs as the result of antigen
      challenge and could represent a mechanism by which the prolonged microvascular
      response in cutaneous tissue may occur.

PMID- 1760358
TI  - Electron microscopic and immunocytochemical studies of the sequence of events in
      psoriatic plaque formation following tape-stripping.
AB  - Electron microscopic and immunocytochemical studies were performed on sequential
      biopsies following the tape-stripping of the uninvolved skin in 12 patients with
      psoriasis. In the biopsies taken after 5 min for up to 7 days during the pre
      psoriatic phase, there were initial lymphocyte-Langerhans cell interactions as
      well as interactions between lymphocytes and keratinocytes. In biopsies taken
      after 6-8 weeks during the proliferative phase there were lymphocyte-macrophage
      interactions. In the 24-h and 7-day biopsies there were close contacts between
      epidermal lymphocytes and keratinocytes via microvilli, with blebbing of the
      keratinocyte plasma membranes and granular cytoplasmic changes around these
      microvilli. Few basal keratinocyte herniations were noted during this phase. The
      6-8-week biopsies of Kobner-positive patients were characterized by a marked
      increase in lymphocyte-macrophage interactions via similar microvillous processes
      with associated electronlucent areas suggestive of cytotoxicity.

PMID- 1760359
TI  - Three-dimensional ultrastructural study of molluscum contagiosum in the skin
      using scanning-electron microscopy.
AB  - The three-dimensional ultrastructure of molluscum contagiosum virus (MCV) in
      human skin was visualized using scanning-electron microscopy with the osmium
      dimethyl sulphoxide-osmium method. There were spherical, ellipsoidal, brick
      shaped, miniature and incomplete forms of MCV. In all the forms the surface had
      densely distributed small protrusions and all had the same ultrastructure. All
      the forms had one or two long cord-like substances that appeared to be linked
      together, but became short, vestigial or absent on the surface of the mature
      virus. The cord-like substances were connected to the core of the MCV. In the
      matrix between the viruses, the cord-like substances formed an intricate fine
      network.

PMID- 1760360
TI  - The clinical expression of bullous pemphigoid is not determined by the
      specificity of the target antigen.
AB  - The major bullous pemphigoid (BP) antigen is a 220-240-kDa polypeptide, although
      some BP sera recognize bands of 180-200 kDa or lower molecular weight. We have
      investigated to what extent this heterogeneity of the target antigen accounts for
      the clinical diversity of BP. Immunoblotting studies against extracts of salt
      separated epidermis were performed on sera from 39 patients with BP. The blotting
      patters obtained were correlated with the clinical findings, with particular
      reference to prodromal itching, lesion morphology and severity, mucosal
      involvement, presence of milia, dapsone responsiveness and disease duration. The
      results confirm that the major BP antigen is a 220-kDa polypeptide, and that the
      180-kDa polypeptide is a second and sometimes the sole BP antigen identified in
      immunoblots. Rarely, multiple bands of lower molecular weight were found. There
      was no correlation between the pattern of BP antigens detected in immunoblots and
      the clinical presentation and course of BP. There was considerable clinical
      diversity even among the nine patients showing specificity for a single 220-kDa
      target antigen. Although two patients with a single 180-kDa antigen specificity
      had a disease of unusually long duration, factors other than antigen specificity
      must determine the clinical expression of BP.

PMID- 1760361
TI  - In-vivo studies of the action spectrum and time course for release of
      transforming growth factor-alpha by ultraviolet irradiation in man.
AB  - Transforming growth factor-alpha (TGF-alpha) is a growth-promoting cytokine which
      enhances epithelial proliferation and is secreted by a wide variety of tumour
      cells. It is also present in normal human epidermis and its overproduction may be
      responsible for epidermal hyperproliferation in psoriasis. Ultraviolet (UV) B
      irradiation of human skin leads to epidermal damage and significant subsequent
      hyperplasia after approximately 24 h, whereas UVA irradiation has little such
      effect and predominantly damages the dermis. The relative efficacies of UVB and
      UVA in releasing TGF-alpha were studied in 10 subjects of skin types I and II
      using a skin-chamber technique and a specific TGF-alpha radioimmunoassay.
      Significantly elevated concentrations of immunoreactive TGF-alpha were detected
      in samples after 24 h in UVB-irradiated compared with unirradiated skin. Samples
      at earlier time points from UVB- and UVA-exposed skin contained measurable levels
      of TGF-alpha but these were not significantly elevated above the levels found in
      samples from unirradiated areas. These results, which suggest the UVB irradiation
      increases release of TGF-alpha from human skin at 24 h, indicate that TGF-alpha
      may be implicated in UVB-induced epidermal hyperplasia.

PMID- 1760362
TI  - UVA solarium versus UVB phototherapy of atopic dermatitis: a paired-comparison
      study.
AB  - In a paired-comparison study, 21 patients suffering from atopic dermatitis were
      treated with fluorescent tubes radiating mainly ultraviolet A (UVA) on one half
      of the body and with tubes radiating mainly UVB on the other. Treatment was given
      three times a week for up to 8 weeks. Eight variables reflecting disease status
      were recorded and the sum of these comprised the total score. The total score and
      the overall evaluation score were better with UVA therapy (P less than 0.02 and P
      = 0.01, respectively). No statistically significant difference for the pruritus
      score was found. The reduction in extent of dermatitis, seen with both therapies,
      was more pronounced with UVA (P less than 0.05). Differences in the healing score
      were not statistically significant. Treatment with UVA resulted in healing or
      considerable improvement in 15 patients and 13 patients showed improvement when
      treated with UVB. A better result was found with UVA in 10 subjects and with UVB
      in two subjects. Equal results occurred with both UVA and UVB in nine of the
      patients although most preferred UVA treatment.

PMID- 1760363
TI  - Loss of lanolin patch-test positivity.
AB  - Thirty-seven patients who had shown a relevant positive patch-test response to
      lanolin within the previous 5 years were retested. Only 41% demonstrated
      persistence of the positive patch test to lanolin. Analysis according to age,
      sex, atopic status, interval between patch testings, strength of the original
      response and the number of concurrent reactions, were not associated with the
      persistence of the lanolin response.

PMID- 1760364
TI  - Cyclo-oxygenase products do not participate in the induction of ornithine
      decarboxylase in human epidermis.
AB  - Extensive animal data suggest that prostaglandins are involved in the epidermal
      induction of ornithine decarboxylase (ODC). We undertook this study to
      investigate their role during induction of hyperproliferation in human skin.
      Topical indomethacin (Elmetacin) or vehicle only were applied under occlusion on
      the backs of healthy volunteers. This was followed 1 h later by Sellotape
      stripping and biopsies were carried out for the estimation of the levels of ODC.
      There was no significant difference in the level of ODC in the indomethacin
      treated and control sites. Also, test sites were irradiated with 3 MEDs of UVB,
      and this was immediately followed by the application of indomethacin or vehicle
      only on the irradiated sites. After 8 h biopsies were taken and the levels of ODC
      were again similar in both sites. The data indicate that the cyclo-oxygenase
      products in human epidermis do not contribute to the induction of ODC.

PMID- 1760365
TI  - Skin cancer as a cause of death in Denmark.
AB  - Denmark has a well-established nation-wide registration system for cancer
      incidence and mortality. In 1984, 2984 new cases of non-melanoma skin cancer were
      notified to the Danish Cancer Registry and 40 deaths were attributed to this
      cause. An evaluation and validation of the death certificates indicate that the
      true number of deaths caused by non-melanoma skin cancer was 18. Basal cell and
      squamous cell carcinoma accounted for three and 15 of the deaths, respectively.
      The estimated lethality is 4.3% for squamous cell carcinoma and 0.12% for basal
      cell carcinoma.

PMID- 1760367
TI  - Atypical facial porokeratosis of Mibelli.

PMID- 1760366
TI  - Relapsing polychondritis: autoimmunity to type II collagen and treatment with
      cyclosporin A.
AB  - A case of relapsing polychondritis (RPC) with strongly positive antibodies to
      both native and denatured type II collagen is reported. This is only the second
      report of the use of cyclosporin A in the treatment of RPC.

PMID- 1760368
TI  - General practitioners and minor surgery.

PMID- 1760369
TI  - Rapid healing of ulcerated necrobiosis lipoidica with optimum glycaemic control
      and seaweed-based dressings.

PMID- 1760370
TI  - 'Wet-wrap' dressings for the treatment of atopic eczema in children.

PMID- 1760371
TI  - Sunscreen protection against UVB, UVA and blue light.

PMID- 1760372
TI  - Enhanced amyloid deposition in Bowen's disease treated with radiotherapy.

PMID- 1760373
TI  - Familial progressive hyperpigmentation: a family study in China.

PMID- 1760374
TI  - Cytoplasmic modification of the nuclear lamina during pronuclear-like
      transformation of mouse blastomere nuclei.
AB  - During the successive interphases of cleaving mouse embryos the nuclear periphery
      diminishes its reactivity to anti-lamin A and C antibodies. This developmentally
      regulated characteristic can be modified by exposure of the blastomere nuclei to
      metaphase II (M II) oocyte cytoplasm followed by activation. In the current study
      we define the cytoplasmic conditions necessary for this modification of 8-cell
      and 16-cell stage nuclei in hybrids obtained by fusion with metaphase II arrested
      oocytes, oocytes at various time points after parthenogenetic activation,
      naturally fertilized eggs (zygotes) and interphase 2-cell embryo blastomeres. The
      intensity of fluorescence obtained with anti-lamins A/C in the blastomere nuclei
      increases as a result of fusion with freshly activated oocytes or early zygotes
      (first 3.0-5.5 h in the case of parthenogenetic activation), and not when eggs or
      2-cell blastomeres advanced in interphase are used as partners for fusion. This
      transformation of the A/C lamin pattern is correlated with the ability to promote
      pronucleus-like growth of blastomere nuclei in hybrids. Blastomere nuclei
      introduced into M II-arrested oocytes undergo premature chromatin condensation
      and dissolution of the nuclear lamina. The results are discussed with regard to
      certain particularities of the first embryonic interphase of the mouse and the
      potential involvement of nuclear lamins in pronuclear growth.

PMID- 1760375
TI  - Some thoughts on the language of cognitive research.

PMID- 1760376
TI  - Chronic effects of high salt intake and conflict stress on blood pressure in
      primates. A progress report.
AB  - The effects of combined behavioral stress and high dietary salt on blood pressure
      were examined in baboons (N = 4) over the course of 1 year. Either high salt diet
      (240 mEq Na+/day) or conflict stress were administered for 8 to 16 weeks,
      followed by high salt intake and stress combined. Mean arterial pressure (MAP)
      increased by 8 mmHg during high dietary salt alone, by 4 mmHg during stress
      alone, and increased further to 14 mmHg above baseline during combined salt and
      stress. Control baboons (N = 2) had no change in MAP across 47 weeks. The data
      indicate additive effects of chronic high dietary salt intake and behavioral
      stress on blood pressure in non-human primates.

PMID- 1760377
TI  - Second-order conditioning of the rabbit's nictitating membrane response.
      Interstimulus interval and frequency of CS-CS pairings.
AB  - Second-order conditioning of the rabbit's nictitating membrane response (NMR) was
      investigated when second-order trials (CS1-CS2) were intermixed with first-order
      trials (CS2-US) from the outset of training. Experiment 1 showed that CR
      acquisition to CS1 was inversely related to the CS1-CS2 interval but nevertheless
      extended to an interval of 8,400 ms. Experiment 2 revealed that CR acquisition of
      CS1 was an inverted-U function of the number of CS1-CS2 trials relative to a
      fixed number of CS2-US trials. Experiment 3 directly contrasted second-order
      conditioning with a reinforced serial compound procedure (CS1-CS2-US) and a mixed
      procedure in which second-order trials were intermixed with the reinforced serial
      compound. Second-order conditioning was about half the strength of either the
      reinforced serial compound or the mixed procedure, which were similar. The
      present results are discussed with respect to the relative strength of excitatory
      and inhibitory processes in second-order conditioning.

PMID- 1760378
TI  - Does anxiety or cardiovascular reactivity have a causal role in hypertension?
AB  - Anxiety, stress, and cardiovascular reactivity (CVR) are variously believed to
      play a role in sustained hypertension. Although acute anxiety or stress elicits
      acute pressor responses, there is little support for their significant role in
      sustained hypertension. Anxiety correlates poorly with CVR, and blood pressure
      levels and anxiolytics do not sustain blood pressure lowering in subjects with
      hypertension-associated anxiety. Chronic anxiety disorders tend to be
      characterized by relatively low blood pressure and prevalence of sustained
      hypertension. Blood Pressure Regulation in hypertension is normal, and normo- and
      hypertensives have similar ambulatory blood pressure variability. Laboratory CVR
      fails to predict variability in natural environments, hyperreactors do not
      exhibit increased variability in natural environments, and the increased
      variability and ambulatory reactivity that is "accounted for" by laboratory
      responses is small. These findings do not support the belief that hypertension is
      related to a summation of heightened pressor responses over time.
      Antihypertensives normalize elevated blood pressures but do not alter CVR in the
      laboratory or variability in natural environments, probably because of a dual
      central regulation of resting and reactive blood pressures. Psychological stress
      responses result from selective neuronal activation rather than from generalized
      sympathetic neural responses or dysregulation. Differences in blood pressure
      responses during various emotions are only quantitative, with no specificity of
      sympathoadrenal or emotional responses to stressors. It may be time to regard
      reactive cardiovascular responses as physiological, rather than as psychological,
      and to require much stronger evidence to confirm causal roles of anxiety, stress,
      and reactivity in sustained hypertension.

PMID- 1760379
TI  - Mental "stress" and hypertension. Evidence from animal and experimental studies.

PMID- 1760381
TI  - People need people. Perspectives on the meaning and measurement of social
      support.

PMID- 1760380
TI  - Personality, stress, smoking, and genetic predisposition as synergistic risk
      factors for cancer and coronary heart disease.
AB  - Risk factors for cancer have been found in the past to act synergistically in a
      number of studies. However, these studies were not always designed to test the
      hypothesis of synergism, and have sometimes failed to equate for important
      variables, which might influence the results. The present study tests the
      hypothesis that psychosocial variables and physical ones (personality/stress,
      smoking, and genetic predisposition) interact in a synergistic fashion in the
      causation of lung cancer and coronary heart disease (CHD).

PMID- 1760382
TI  - Interrupting neural pathways that transduce stressful information into
      physiological responses.
AB  - Stressor-stimuli evoke a noradrenergic process in the frontal lobes, the
      amplitude of which depends on both the individual's experience with the stimulus
      and his or her genetic background. Novel and noxious stimuli evoke large
      frontocortical responses and benign ones evoke relatively larger reactions in
      persons with a family history of cardiovascular disease. Blockade of neural
      projections from the frontal cortex and amygdala to the brainstem cardiovascular
      centers will normalize blood-pressure elevations in experimental hypertension and
      prevent lethal arrhythmias in animals with a myocardial infarction. The anti
      mortality effect of the cardiac drugs known as beta-blockers is exerted by
      inhibition of cerebral beta-receptors, not peripheral ones. A new putative
      neuropeptide, NLX, may have the same desirable cardiovascular effects, but
      without the side-effects that limit clinical usefulness. The neural regulation of
      the heart during stress can be detected by a new deterministic measure of low
      dimensional chaos in heartbeat intervals. In both animals and humans undergoing
      myocardial infarction, this deterministic measure correctly predicts lethal
      arrhythmogenesis, minutes to hours prior to the event. Thus an approach combining
      both brain and heart studies (i.e., "neurocardiology") has led to an
      understanding of how stressor-stimuli evoke autonomic reactions. This, in turn,
      has led to new methods in the diagnosis and treatment of cardiovascular
      disorders.

PMID- 1760383
TI  - On humility in science.

PMID- 1760384
TI  - Schizophrenia: static or progressive pathophysiology?

PMID- 1760385
TI  - Astrocytosis and schizophrenia.

PMID- 1760386
TI  - Evidence for neurodevelopment disturbances in anterior cingulate cortex of post
      mortem schizophrenic brain.

PMID- 1760387
TI  - The age dependencies of MRI abnormalities in schizophrenia suggest early
      ventricular enlargement but later prominence of cortical atrophy.

PMID- 1760388
TI  - Cerebral ventricular abnormalities in schizophrenia: evidence of their early
      origin and stability over time.

PMID- 1760389
TI  - Progressive and static ventriculomegaly in schizophrenia: clinical and
      methodological variables.

PMID- 1760390
TI  - Psychopathology and the question of neurodevelopmental or neurodegenerative
      disorder.

PMID- 1760391
TI  - The age of onset of psychosis as a clue to a defect in the cerebral dominance
      gene.

PMID- 1760392
TI  - Information-processing anomalies in the early course of schizophrenia and bipolar
      disorder.

PMID- 1760393
TI  - Cross-sectional and longitudinal neuropsychological test findings in first
      episode schizophrenic patients.

PMID- 1760394
TI  - Neuropsychological deficits in the early course of first episode schizophrenia.

PMID- 1760395
TI  - Amphetamine response and duration of illness in schizophrenia.

PMID- 1760396
TI  - Brain volume loss in schizophrenia: when does it occur and is it progressive?

PMID- 1760397
TI  - Follow up MRI study in first episode schizophrenia.

PMID- 1760398
TI  - Brain morphological changes in 1st episode cases of schizophrenia: are they
      progressive?

PMID- 1760399
TI  - Evidence against progression of in vivo anatomical abnormalities in
      schizophrenia.

PMID- 1760400
TI  - T1 and T2 relaxation times in schizophrenia as measured with magnetic resonance
      imaging.
AB  - T1 and T2 relaxation times were measured in ten brain regions on the right and
      left side in a sample of 27 schizophrenic patients and 37 normal controls. The
      schizophrenic patients showed a prolongation of T2 relaxation time, and to a
      lesser extent of T1 relaxation time, which was more predominantly localized in
      the right hemisphere and in gray matter structures. These results may indicate
      that metabolic, physiological, or neurochemical brain function in schizophrenia
      is related in some way to a change in tissue fluid in neuronal cell bodies or
      interstitial gray matter.

PMID- 1760401
TI  - ROUNDS, a new time-sampling methodology for the quantitative behavioral
      assessment of schizophrenic withdrawal. Reliability and validity.
AB  - Negative symptoms in schizophrenia have been the subject of much research
      interest. However, there has been a need for a way to measure withdrawal behavior
      quantitatively over time. We have developed a behavioral time-sampling
      methodology performed by nursing staff on a schizophrenia inpatient unit. Called
      ROUNDS, it gathers reliable and valid quantitative data about specific withdrawal
      behaviors such as posture, daytime sleep and levels of social interaction and
      activity. This paper describes the development of the method, its implementation,
      the statistical analysis of its reliability and validity, and the degree to which
      the data can be replicated with different sampling frequencies. We contend that
      this method can be applied to the analysis of a wide variety of questions about
      the nature and treatment response of schizophrenic withdrawal in an inpatient
      setting.

PMID- 1760402
TI  - Stage-specific transcription of germline IgH C gamma and C alpha regions during
      human B cell differentiation.
AB  - Previous studies have suggested that transcription of germline heavy chain
      constant region (CH) genes in murine B cells may determine the potential of their
      different CH regions to undergo isotype switch recombination. We have examined
      the transcriptional activity across the immunoglobulin heavy chain (IgH) locus in
      human B lineage cells. Transcription of germline C gamma and C alpha was observed
      in every surface IgM+ or surface IgM+/IgD+ B cell stage cell line and malignancy.
      In contrast, such transcription could not be detected in pre-B cells and only low
      levels of C alpha but not C gamma transcription were evident in IgM-secreting
      plasmablast cells. Transcriptional activity of germline IgH C epsilon was
      singularly absent at all stages of B cell development. Our results suggest that
      germline transcription of the C gamma and C alpha regions may be a constitutive
      feature of the human B cell differentiation program. Because this transcriptional
      activity is limited primarily to the B cell stage and occurs prior to the actual
      isotype switch, the induction of C gamma and C alpha transcription may represent
      preparation of the downstream IgH chromatin for potential switch recombination.

PMID- 1760403
TI  - Organization and expression of the lambda-like genes that contribute to the mu
      psi light chain complex in human pre-B cells.
AB  - Lambda-like genes encode a polypeptide chain that associates with VpreB and mu
      chain in the so-called mu-psi light chain complex specifically expressed in pre-B
      cells. In humans, the lambda-like gene cluster contains three genes, termed 14.1,
      16.1, and F lambda 1. The 14.1 gene contains three exons and was previously
      sequenced. The 16.1 and F lambda 1 have been isolated from cosmid libraries. They
      both contain only the exons 2 and 3 that appear highly homologous to their 14.1
      counterparts. The lambda-like gene cluster has been mapped on chromosome 22,
      close and distal to the BCR gene, in the order (14.1; F lambda 1) and 16.1.
      Hybridization with the 14.1 exon 1 probe did not detect an equivalent on 16.1 and
      F lambda 1 genes, but instead, only revealed the X6 gene, that was previously
      identified 5 kb upstream of the IGLC locus. It appears, therefore, that the gene
      organization of the lambda and lambda-like loci is strikingly similar, with a
      three-exon-containing gene 5' of a series of J lambda-C lambda or J lambda-C
      lambda-like tandemly organized genes. Analysis of the transcripts in a 8 week old
      human fetal liver clearly indicated that 14.1 was the only functional gene of the
      lambda-like cluster. Various forms of transcripts resulting from alternate
      splicing have been characterized. The major component consisted of a full-length
      (exons 1-2-3) mRNA, whereas a minor (1-3) transcript was identified. Only the
      full-length transcript could encode a functional polypeptide chain corresponding
      to the 22 kDa light chain surrogate.

PMID- 1760404
TI  - Regulation of anti-immunoglobulin-induced B lymphoma growth arrest by
      transforming growth factor beta 1 and dexamethasone.
AB  - Exposure of the murine B lymphoma cell line WEHI-231 to anti-immunoglobulin M
      (anti-IgM) antibodies results in growth arrest in the G1 phase of the cell cycle
      followed by programmed cell death. This response may be analogous to the clonal
      deletion of immature B cells that occurs when the membrane IgM on these cells is
      engaged by self-antigens or by anti-IgM antibodies. Thus the WEHI-231 cell line
      has been a useful in vitro system for identifying factors that modulate anti-Ig
      induced growth inhibition and/or clonal deletion. For example, both antigen
      induced tolerance induction in immature B cells and anti-Ig-induced growth arrest
      of WEHI-231 cells are prevented by bacterial lipopolysaccharide or by the
      products of activated T helper cells. Since negative signaling by membrane Ig may
      also be regulated by additional factors, we asked whether other cytokines or
      hormones would regulate the growth of WEHI-231 cells or its response to anti-IgM
      antibodies. We show here that two compounds that are generally immunosuppressive,
      transforming growth factor beta 1 (TGF-beta 1) and the synthetic corticosteroid,
      dexamethasone, blocked the ability of lipopolysaccharide and T cell-derived
      lymphokines to protect WEHI-231 cells from anti-IgM-induced growth arrest. In
      addition, TGF-beta 1 and dexamethasone slightly inhibited the growth of WEHI-231
      cells by themselves and also potentiated the growth inhibitory effects of anti
      IgM antibodies. Thus for WEHI-231 cells, TGF-beta 1 and dexamethasone are
      inhibitory factors which favor growth arrest.

PMID- 1760405
TI  - TGF-beta 1 induces germ-line transcripts of both IgA subclasses in human B
      lymphocytes.
AB  - Immunoglobulin (Ig) class switching appears to be preceded by induction of germ
      line transcripts. In this report, we demonstrate that transforming growth factor
      beta (TGF-beta) induces germ-line transcripts of both the IgA subclasses (IgA1
      and IgA2) in Branhamella catarrhalis (BC)-activated human spleen B cells. Two
      germ-line bands, one of approximately 1.85 kb and the other of approximately 1.6
      kb, could be seen in cultures treated with TGF-beta. The approximately 1.85 kb
      band contains mRNA for a germ-line transcript of the membrane form. This band co
      migrates with the productive secreted form of alpha mRNA. The other, shorter form
      of approximately 1.6 kb did not correlate in size with any known form of
      productive alpha mRNA and contained the secreted form of germ-line alpha mRNA.
      The induction of alpha germ-line transcripts was accompanied by a concomitant
      suppression of mu and gamma mRNA. We have also identified the location of a
      putative I alpha sequence (designated according to the generally accepted
      nomenclature) within approximately 0.5 kb upstream to the switch alpha (S alpha)
      region. The relative proportions of IgA-subclass-specific mRNA in TGF-beta
      stimulated spleen B cells are concordant with the distribution pattern seen in
      pokeweed mitogen (PWM)-stimulated spleen mononuclear cells (MNC), which was 89
      and 11% for the IgA1 and the IgA2 mRNA respectively. These results suggest a role
      of TGF-beta in regulating IgA class switching in human B lymphocytes.

PMID- 1760406
TI  - Structure of TGF-beta 1-induced human immunoglobulin C alpha 1 and C alpha 2 germ
      line transcripts.
AB  - We have characterized the structure of the human immunoglobulin C alpha 1 and C
      alpha 2 germ-line transcripts that are synthesized upon treatment of human B
      lymphocytes with Branhamella catarrhalis (a B cell mitogen) and transforming
      growth factor beta 1 (TGF-beta 1). These transcripts initiate upstream of the
      switch alpha 1 and switch alpha 2 regions and contain, together with the C alpha
      1 and C alpha 2 sequences, additional exons designated according to the generally
      accepted nomenclature I alpha 1 and I alpha 2 respectively. The I alpha exons are
      spliced directly onto the acceptor splice site of the CH1 domains of the C alpha
      1 and C alpha 2 genes. As in other previously characterized germ-line
      transcripts, stop codons present in all three reading frames prevent translation
      of the C alpha 1 and C alpha 2 heavy-chain coding sequences. The longest open
      reading frame (ORF) present in the I exons can code for a polypeptide of only 26
      amino acids. The human I alpha exons do not show any significant sequence
      homology with the corresponding mouse I alpha exon. However, comparison of
      nucleotide sequences of the genomic mouse and human I alpha regions demonstrated
      the presence of an approximately 300 bp highly conserved element located
      immediately upstream of the transcription initiation sites of the human and mouse
      C alpha germ-line transcripts. The isolation of the C alpha 1 and C alpha 2 germ
      line transcripts will further facilitate the characterization of the molecular
      events responsible for the regulation of the human C alpha heavy chain loci.

PMID- 1760407
TI  - The immunoglobulin light chain related protein lambda 5 is expressed on the
      surface of mouse pre-B cell lines and can function as a signal transducing
      molecule.
AB  - Abelson Leukemia Virus-transformed mouse cell lines with an early pre-B phenotype
      carry partially rearranged or unrearranged Ig-H genes and consequently do not
      express intact IgM-H protein (mu protein). Such early mu- pre-B cells express an
      intracellular protein complex of the pre-B cell specific 22 kDa protein lambda 5
      and a 16 kDa protein designated p16. Late pre-B cell lines which carry a
      rearranged IgM-H chain gene in which a continuous translational reading frame has
      been established in the fused V-D-J element express intact mu-protein, which
      forms an intracellular complex with lambda 5 and p16. We show here that both the
      lambda 5/p16 or the mu/lambda 5/p16 complexes can be immunoprecipitated from
      lysates of cells surface labeled with 125I. Thus early pre-B cells express the
      lambda 5/p16 complex on the cell surface in the absence of mu protein, while mu+
      late pre-B cells express a surface mu/lambda 5/p16 complex. To investigate a
      possible signal transduction function of the lambda 5/p16 and mu/lambda 5/p16
      complexes on the surface of pre-B cell lines we measured the changes in
      intracellular free Ca2+ after treatment of cells with anti-lambda 5 or anti-mu
      antibodies. Two mu- early pre-B cell lines showed a rapid and transient increase
      in intracellular free Ca2+ when incubated with anti-lambda 5 antibodies but not
      when incubated with anti-mu, while the mu+ late pre-B cell line CB32 showed a
      rapid and transient increase in intracellular Ca2+ after incubation with anti
      lambda 5 or anti-mu. These results show that both the lambda 5/p16 and the
      mu/lambda 5/p16 cell surface protein complexes can transduce an external signal
      to the inside of the cell, which implicates these complexes in the regulation of
      pre-B cell physiology.

PMID- 1760408
TI  - Comparison of protein tyrosine phosphorylation and morphological changes induced
      by IL-2 and IL-3.
AB  - We constructed cell lines which can proliferate in response to IL-2 or IL-3 by
      introducing a wild-type and mutant forms of cDNAs encoding the human IL-2R p75
      chain into an IL-3 dependent hematopoietic cell line which expresses the p55
      chain of the IL-2R. We compared early events that were induced in these cells by
      IL-2 and IL-3. Analysis of protein tyrosine phosphorylation showed that two
      common protein bands, pp95 and pp90, were phosphorylated by stimulation of either
      IL-2 or IL-3, suggesting the possible sharing of part of a signal transduction
      pathway between IL-2R and IL-3R. Comparison of protein tyrosine phosphorylation
      profiles induced by IL-2 and IL-3 among a variety of cell lines revealed that the
      pp90 band is the common tyrosine phosphorylation substrate in the cell lines
      examined, although the general tyrosine phosphorylation pattern differed in each
      cell line. Mutant p75 molecules incapable of inducing tyrosine phosphorylation
      could bind and internalize IL-2, but could not support cell growth. We also found
      that swift changes of cytoskeletal protein organization are one of the early
      events caused by signal transduction through either IL-2R and IL-3R.
      Reorganization of cytoskeletal proteins seems to be associated with protein
      phosphorylation, as a significant portion of pp90 was found in a detergent
      soluble fraction in IL-2 or IL-3 treated cells.

PMID- 1760409
TI  - Antigen-specific directional target cell lysis by perforin-negative T lymphocyte
      clones.
AB  - Despite a number of reports indicating that perforin, a pore-forming protein, is
      the primary effector molecule mediating specific target cell lysis by cytotoxic T
      lymphocytes (CTL), several lines of evidence suggest the existence of perforin
      independent mechanisms. We established class II-restricted, soluble protein
      specific CD4+ T cell clones with killing function which do not express a
      detectable amount of perforin and perforin mRNA. Nevertheless, these clones
      induced cytolysis and DNA fragmentation of target cells in a specific and highly
      directional manner which was not inhibitable by antibody against TNF/lymphotoxin.
      These data not only indicate the existence of cytotoxic T cell subsets which do
      not utilize perforin, but also suggest that perforin is not mandatory for
      specific target lysis by T cells.

PMID- 1760410
TI  - Cell adhesion by membrane-bound paf-acether.
AB  - It was recently shown that paf-acether (paf) synthesized in different cell types
      remains partly cell-associated. In the present work, we tested the hypothesis
      that cell-associated paf might in fact remain exposed on the external plasma
      membrane and be able to exert its biological functions. Human polymorphonuclear
      neutrophils (PMN), stimulated with either opsonized zymosan or ionophore A23187
      and then thoroughly washed, induced aggregation of human and rabbit platelets in
      a time- and dose-dependent manner, whereas no aggregation was observed in the
      presence of unstimulated cells. Aggregation was inhibited by the specific paf
      antagonists BN 52021 or WEB 2086. Treatment of stimulated PMN with specific anti
      paf antibody before addition to platelets abolished the PMN--paf-mediated
      aggregation. Microscopic observation of human platelets revealed that aggregates
      formed by platelets were attached to the neutrophil surface. Paf remained
      associated with PMN following human PMN-human platelet interaction, in contrast
      to human PMN-rabbit platelet incubation, where it disappeared from both PMN and
      platelet surfaces. Our results strongly support the hypothesis that a fraction of
      cell-associated paf synthesized in neutrophils is located on and/or in the
      external plasma membrane, where it can act upon other cells by direct cellular
      contact. Such a mechanism of cell adhesion might play a role in cell physiology
      (neutrophils but also monocytes/macrophages, eosinophils, and lymphocytes), as
      well as in the onset and perpetuation of immune and inflammatory reactions.

PMID- 1760411
TI  - Rat thymic epithelial cells in culture constitutively secrete IL-1 and IL-6.
AB  - To study the in vitro interactions between rat thymic non-lymphoid cells and
      thymocytes, we established a system for long-term cultivation of thymic
      epithelial cells (TEC). TEC were cultivated and successfully propagated for over
      8 months in RPMI 1640 medium containing 15% FCS, dexamethasone, insulin,
      epidermal growth factor, and poly-L-lysin as an adhesive matrix. Their epithelial
      nature has been confirmed using monoclonal anti-cytokeratin (CK) antibodies. More
      than 95% of these cells were reactive with K 8.13 and CK 8 mAbs, which are pan
      epithelial markers for rat TEC in situ. An epithelial cell clone (TE-R 2.5)
      established from a long-term TEC culture was 100% reactive with these anti-CK
      antibodies. Phenotypic analysis of TEC cultures was performed by a large panel of
      mAbs reactive with a subset of rat TEC or CK polypeptides as well as UIex
      europaeus agglutinin I using a streptavidin-biotin immunofluorescence assay.
      Although the results obtained demonstrated phenotypic heterogeneity among these
      cells, most cultures, including the TE-R 2.5 clone, were of subcapsular/medullary
      phenotype. Medium conditioned by TEC cultures exhibited IL-1 and IL-6 activities
      when tested on D10S and B9 sensitive cell lines, respectively. Cytokine
      activities were neutralized (IL-1) or significantly inhibited (IL-6) by specific
      polyclonal antibodies. In addition, both anti-IL-1 and anti-IL-6 antibodies
      reacted with TEC in culture and epithelial (CK-positive) cells on thymic cryostat
      sections, indicating that thymic epithelium provides an important intrathymic
      source for molecules contributing to T cell activation.

PMID- 1760412
TI  - Perforin and granzyme B as markers for acute rejection in heart transplantation.
AB  - Histological analysis of endomyocardial biopsies (EMB) is regarded as the most
      satisfactory technique for monitoring crisis of rejection in heart transplanted
      patients. In this study, 42 biopsies from 14 patients who underwent heart
      transplantation were examined. Three patients did not present any rejection
      crisis at the date of the biopsy analysis, six were examined during an early
      rejection crisis (day 7-70 post-graft), and five were examined during a late
      rejection crisis (day 74-960 post-graft). Since granzyme B and perforin are
      proteins associated with cell lysis histological grading and cell phenotype
      analysis, in situ hybridization using granzyme B and perforin [35S]RNA probes was
      performed on 30 EMB to characterize the cytolytic activation of heart
      infiltrating cells. Our data suggest that granzyme B and perforin could be used
      as predictive markers for acute rejection in patients with early rejection
      crisis. Their detection might be an indication to administrate corticoids to
      resolve an acute rejection crisis. In contrast, their absence in patients with
      late rejection crisis appears as a good prognostic factor for the outcome of
      rejection and raises the question of the necessity to treat such patients with
      additional corticoid treatment.

PMID- 1760414
TI  - Audit in obstetrics.

PMID- 1760413
TI  - Infection of human CD4+ rabbit cells with HIV-1: the possibility of the rabbit as
      a model for HIV-1 infection.
AB  - Although human T cell surface glycoprotein CD4 is the cellular receptor for human
      immunodeficiency virus 1 (HIV-1), the introduction of the human CD4 gene into
      murine cells does not render them susceptible to HIV-1 infection. Here we have
      established rabbit transfectant cell lines expressing human CD4 on the cell
      surface and demonstrated that the CD4+ rabbit transfectants could be readily
      infected by HIV-1 by co-cultivating with a HIV-1-infected human MOLT-4 T cell
      line (MOLT-4/HIV). Avid syncytia formation was observed upon co-cultivation and
      the syncytia abundantly produced HIV-1 mature particles, as revealed by electron
      microscopy. A significant increase of HIV-1 p24 antigen was also detected in the
      culture supernatant. The syncytia formation was blocked by pretreating the
      transfectant with anti-human CD4 or by pretreating the MOLT-4/HIV with anti-HIV-1
      serum obtained from an infected individual, indicating that the syncytia formed
      as a result of the interaction of human CD4 on the rabbit transfectant with the
      HIV-1 envelope protein expressed on MOLT-4/HIV. In contrast, only a very small
      proportion of the rabbit transfectants expressed HIV-1-specific antigens upon
      infection with an HIV-1 stock. This may indicate that, although rabbit cells have
      partially acquired susceptibility to HIV-1 by transfection of human CD4 gene,
      rabbit cells may further require such a molecule as might be provided by MOLT-4
      to become fully susceptible to HIV-1 infection. The possibility of the rabbit as
      a model for HIV-1 infection is also discussed.

PMID- 1760415
TI  - The flying squad.

PMID- 1760416
TI  - Criteria for standards of management of women with an abnormal smear.

PMID- 1760417
TI  - Evaluating the quality of the maternity services--a discussion paper.
AB  - OBJECTIVE: A review of the use of computer collected audit data in assessing the
      quality of maternity services. SETTING: All maternity units managed by the North
      West Thames Regional Health Authority. RECOMMENDATIONS: A system of audit must
      supply information that is both credible and of interest to clinicians managers
      and consumers. The information should be adjusted for differences in populations
      to allow valid comparisons between units. It needs to be presented in an easily
      digested form. One way of implementing audit would be to establish a regional
      group representative of clinicians, patients and managers who would initially
      interpret the data and make recommendations. A local group of similar composition
      would be asked to comment on and respond to these with a plan for the following
      year. Changes would be monitored by analysis of the routinely collected data.
      CONCLUSIONS: Medical audit in the maternity services requires new concepts if it
      is to influence the quality of clinical care and the use of resources available
      to provide that care. The appropriate balance needs to be found between the
      perspectives of clinicians, patients and managers. A major challenge is the
      collection of valid data. This has largely been overcome by the St Mary's
      maternity information system. The next stage is to devise a system of audit that
      is epidemiologically sound and is acceptable to those who will be asked to
      implement the lessons that emerge. Only then will it be possible to determine
      whether clinical practice and the use of resources can be altered to the benefit
      of patients.

PMID- 1760418
TI  - Is genetic susceptibility to pre-eclampsia conferred by homozygosity for the same
      single recessive gene in mother and fetus?
AB  - OBJECTIVE: To determine whether any simple, purely genetic mechanism can account
      for susceptibility to pre-eclampsia. DESIGN: Six simple Mendelian models of
      inheritance were considered, and predictions concerning the incidence of pre
      eclampsia in various family members of index cases were calculated for each
      genetic model. Data were then extracted from published family studies in which a
      suitable disease definition had been used, and compared to our theoretical
      expectations. RESULTS: Only one of the genetic models considered, in which both
      mother and fetus must express the same recessive gene to confer susceptibility,
      was consistent with the observed incidence values for relatives of index cases.
      This model was also consistent with the putative association with HLA-DR4, but
      could not account for the comparative rarity of pre-eclampsia in parous women.
      CONCLUSION: Homozygosity for a single recessive gene shared by mother and fetus,
      unlike five other genetic mechanisms tested, is consistent with published family
      studies in pre-eclampsia, and should be considered the best working hypothesis at
      present.

PMID- 1760419
TI  - The obstetric and neonatal outcome of pregnancy in women with a previous history
      of infertility: a prospective study.
AB  - OBJECTIVE: To compare the frequency of common antenatal problems, the amount of
      antenatal surveillance and the obstetric and neonatal outcome in women with and
      without a history of infertility. DESIGN: A prospective cohort study with age and
      parity matched controls. SETTING: A single consultant unit at the Jessop Hospital
      for Women, Sheffield, over a 22-month period. SUBJECTS: 114 women with a history
      of infertility who reached 16 weeks gestation with a singleton live fetus and 114
      control women matched for age and parity. MAIN OUTCOME MEASURES: Frequency of
      antepartum complications, amount of antepartum surveillance, obstetric and
      neonatal outcome. RESULTS: Common antenatal complications were not increased. In
      the infertility compared with the control group, the relative risk of requiring
      an emergency caesarean section was 2.43 (95% CI 1.05-5.63). There was no
      difference in birthweight. CONCLUSION: Many of the previously observed
      differences in outcome of pregnancy in women after infertility compared with
      those without are associated with age and parity but these characteristics do not
      explain the increased frequency of emergency caesarean section.

PMID- 1760420
TI  - The prevalence, aetiology and clinical significance of pseudo-sinusoidal fetal
      heart rate patterns in labour.
AB  - OBJECTIVE: To investigate the prevalence of sinusoidal and pseudo-sinusoidal
      fetal heart rate (FHR) patterns in labour and the relation between the
      characteristics of the FHR pattern and fetal outcome. DESIGN: A prospective
      observational study over a 6-month period in which all women who had continuous
      FHR monitoring in labour had their intrapartum cardiotocographs (CTGs)
      scrutinized for the presence of sinusoidal or pseudo-sinusoidal FHR patterns.
      SETTING: John Radcliffe Hospital, Oxford. SUBJECTS: 1520 women who had fetal
      monitoring during labour for various reasons. MAIN OUTCOME MEASURES: Both
      internal (electrocardiographic) and external (ultrasound) recordings of the FHR
      were analysed. Abnormal FHR patterns were related to obstetric characteristics
      and fetal outcome in terms of Apgar scores, umbilical artery pH and admission to
      the special care unit. RESULTS: No true sinusoidal FHR patterns were observed,
      but pseudo-sinusoidal FHR patterns were found in 230 of the 1520 CTGs examined
      (15%). Of these, 219 were classified as minor (amplitude 5-15 beats/min) and 11
      as intermediate (amplitude 16-24 beats/min). Major pseudo-sinusoidal FHR patterns
      (amplitude greater than 24 beats/min) were not observed. Minor pseudo-sinusoidal
      FHR patterns had a mean duration of 21 (SD 13) min and typically occurred once or
      twice early in labour. Using logistic regression analysis a significant,
      independent relation was demonstrated between the presence of minor pseudo
      sinusoidal FHR patterns and the use of pethidine (RR 1.84, 95% CI 1.3 to 2.59, P
      less than 0.0001) and epidural analgesia (RR 1.85, 95% CI 1.24 to 2.76, P less
      than 0.001). Intermediate pseudo-sinusoidal FHR patterns were found in
      association with both in utero fetal sucking and transient episodes of fetal
      hypoxia such as that caused by periodic umbilical cord compression. CONCLUSION:
      Pseudo-sinusoidal FHR patterns in labour will usually be associated with a normal
      fetal outcome but a careful fetal assessment is mandatory.

PMID- 1760421
TI  - The management of prolonged pregnancy--an analysis of women's attitudes before
      and after term.
AB  - OBJECTIVE: To determine the attitude of pregnant women to a proposal of
      conservative management of prolonged pregnancy. DESIGN: A prospective
      questionnaire-based survey. SETTING-Louise Margaret Maternity Wing, Cambridge
      Military Hospital, Aldershot. SUBJECTS: 500 pregnant women initially at 37 weeks
      gestation considered suitable for the potential conservative management of
      prolonged pregnancy. RESULTS: Despite a stated obstetric preference for
      conservative management, only 45% of the women at 37 weeks gestation were
      agreeable to conservative management; of those undelivered by 41 weeks gestation
      31% still desired conservative management. This significant decrease was
      unaffected by parity or certainty of gestational age. CONCLUSIONS: Most pregnant
      women are unwilling to accept the conservative management of prolonged pregnancy
      and become more reluctant to do so if undelivered by 41 weeks gestation. Women
      are not as favourably disposed towards the conservative management of pregnancy
      as has been suggested previously.

PMID- 1760422
TI  - Gamete intrafallopian transfer (GIFT) compared with intrauterine insemination in
      the treatment of unexplained infertility.
AB  - OBJECTIVE: To compare GIFT, intrauterine insemination (IUI) with, and without,
      ovarian hyperstimulation in the treatment of unexplained infertility. DESIGN:
      Women randomly allocated to one of three treatment protocols. SETTING: Northern
      Regional Fertility Centre. SUBJECTS: 59 couples with unexplained infertility of
      more than 3 years duration. INTERVENTIONS: Three cycles of either GIFT, IUI after
      ovarian hyperstimulation or IUI in a spontaneous cycle. MAIN OUTCOME MEASURES:
      Pregnancy resulting in a live birth. RESULTS: Fecundabilities were 0.12 after
      GIFT, 0.018 after ovarian hyperstimulation and IUI, and 0.018 after IUI in a
      spontaneous cycle. The fecundability after IUI was no different from that which
      would be expected without treatment in these couples but fecundability was
      significantly better (P greater than 0.02) after GIFT. CONCLUSIONS: This trial
      does not support the use of IUI in the treatment of unexplained infertility but
      confirms the value of GIFT.

PMID- 1760423
TI  - United Kingdom colposcopy survey, British Society for Colposcopy and Cervical
      Pathology.
AB  - OBJECTIVE: To audit various aspects of colposcopy practice throughout the United
      Kingdom on behalf of BSCCP. DESIGN: A postal questionnaire was circulated to
      those responsible for colposcopy services in all districts in the United Kingdom
      in 1988, followed by a smaller survey of 40 clinics in 1990 to detect any trends.
      MAIN OUTCOME MEASURES: Information was sought on colposcopy workload, referral
      criteria, treatment method and follow-up, waiting times, staffing and training.
      RESULTS: There was a 71% response to the national survey of 1988 practice which
      alone accounted for 80,000 new referrals for colposcopy. Cytological criteria for
      colposcopy referral were generally liberal. In 1988 laser ablation was the single
      most popular method, and waiting times for colposcopy varied, with 79% of
      patients being seen within 8 weeks of referral. Colposcopy clinics run by non
      gynaecologists, mainly genito-urinary physicians, were reported by 32% of
      districts. Half the respondents did not have accurate statistics, only 17% being
      computerized, and dissatisfaction with clerical support was widespread. Resources
      are required to improve administration and data collection. The principal
      findings from the 1990 data subset were a 10% reduction for new patient referrals
      compared with 1988 and the use of diathermy loop excision by one-third as their
      preferred treatment. CONCLUSIONS: This audit of colposcopy has provided useful
      information as well as a means of monitoring trends in colposcopy activity in the
      future.

PMID- 1760424
TI  - A multicentre study of coagulation and haemostatic variables during oral
      contraception: variations with four formulations. Task Force on Oral
      Contraceptives--WHO Special Programme of Research, Development and Research
      Training in Human Reproduction, World Health Organization, Geneva, Switzerland.
AB  - OBJECTIVE: To explore the extent to which progestogen type and oestrogen and
      progestogen dose may modify the effects of combined oral contraceptives (OC) on
      coagulation and haemostasis. DESIGN: Randomized double-blind clinical trial.
      SETTING: Gynaecological clinics in Salvador (Brazil), Santiago (Chile),
      Singapore, and Dublin (Ireland). SUBJECTS: 622 women aged 18-35 years who had
      opted for oral contraception. A contrast group of 155 women who were not to
      receive OC was also studied. Both groups included approximately equal numbers
      from each of the four centres. INTERVENTIONS: Treatment of approximately equal
      numbers of women at each centre with one of the following OC preparations for at
      least 12 months: Norethisterone acetate (NEA) 1 mg + ethinyl oestradiol (EE) 50
      micrograms; levonorgestrel (LNG) 250 micrograms + EE 50 micrograms; LNG 250
      micrograms + EE 30 micrograms; LNG 150 micrograms + EE 30 micrograms. MAIN
      OUTCOME MEASURES: Changes over 12 months in 12 coagulation and haemostatic
      variables. RESULTS: At 12-month follow-up, the women on each OC preparation
      showed acceleration of prothrombin time and increase in factor X and fibrinogen.
      With the OC containing NEA there was also a persistent rise in factor VIIC, and
      reduction of antithrombin III and alpha 2-antiplasmin. The formulation which
      contained low doses of both LNG and EE showed the least adverse coagulation
      changes. Large increases in fibrinolysis were found in all OC groups.
      CONCLUSIONS: The adverse effects of combined OC on clotting are affected by the
      type and dose of progestogen as well as the dose of oestrogen.

PMID- 1760425
TI  - Self-reported long-term outcomes of hysterectomy.
AB  - OBJECTIVES: To investigate women's perceptions of and satisfaction with the long
      term outcomes from a hysterectomy performed between 2 and 10 years ago and to
      determine whether satisfaction is related to demographic factors, factors
      associated with the hysterectomy, and the number or type of perceived benefits
      and problems associated with the hysterectomy. DESIGN: Retrospective survey by
      telephone interview and postal questionnaire of 236 women who had a hysterectomy
      between 2 and 10 years ago. SETTING: Women who had had a hysterectomy were
      identified from a community survey in the Hunter Region of NSW, Australia.
      SUBJECTS: Two hundred and thirty-six women who self-reported having had a
      hysterectomy between 2 and 10 years ago. MAIN OUTCOME MEASURES: Perceived
      benefits resulting from the hysterectomy; perceived physical and psychological
      problems caused by the hysterectomy; satisfaction with care. RESULTS: Relief from
      heavy bleeding was the most frequent benefit (57%) and the most important benefit
      (32%). Most of the women reported improvements in symptoms experienced before
      hysterectomy but more than half the women had symptoms which they believed had
      been worsened or caused by the hysterectomy. Despite this, high levels of
      satisfaction with the operation were reported. CONCLUSION: The results highlight
      the need to examine more closely decision-making about treatment for menstrual
      symptoms such as heavy bleeding.

PMID- 1760426
TI  - Ureteric obstruction in pregnancy--diagnosis and management.
AB  - OBJECTIVE: To discuss the aetiology, diagnosis and management of ureteric
      obstruction in pregnancy and to describe the use of double-pigtail ureteric
      stents in a series of 10 patients. DESIGN: Retrospective study of women
      presenting to a maternity unit in whom the diagnosis of ureteric obstruction is
      reached. SETTING: Southmead Hospital in Bristol; a large district general
      hospital with a throughput of around 6000 maternity patients per year. SUBJECTS:
      10 women (8 in their first pregnancy, 1 in her second and 1 in her third; mean
      age 29.2 years (range 18-31 years). INTERVENTIONS: Double-pigtail ureteric stents
      were electively passed after a diagnosis of ureteric obstruction. Stents remained
      in situ for a mean 15.5 weeks (range 8-25 weeks) and were electively removed 4-6
      weeks post partum. RESULTS: Nine women progressed uneventfully through the
      remainder of their pregnancy. One developed strangury, haematuria and discomfort
      after stent insertion. Seven women had normal vaginal deliveries, two assisted
      vaginal deliveries and one was delivered by caesarean section. None required to
      have external urinary drainage. CONCLUSIONS: Double-pigtail ureteric stents are
      easy to place and remove and are well tolerated. They provide a simple, safe and
      effective method of internal upper urinary tract drainage in ureteric obstruction
      in pregnancy.

PMID- 1760427
TI  - The Stamey endoscopic bladder neck suspension: a clinical and urodynamic
      investigation, including actuarial follow-up over four years.
AB  - OBJECTIVE: To assess a modified Stamey endoscopic bladder neck suspension as a
      management for genuine stress incontinence in women unsuitable for
      colposuspension because of vaginal narrowing or inefficient voiding. DESIGN:
      Uncontrolled observational study. SETTING: Regional university gynaecological
      urology unit. SUBJECTS: A hundred women, median age 58 years, with genuine stress
      incontinence confirmed by urodynamic investigation; 65 had had previous surgery
      for the same problem. TREATMENT: A Stamey procedure with monofilament nylon and
      short buffers of silastic tubing at each anchor site. MAIN OUTCOME MEASURES:
      Urodynamic reassessment 3 months after surgery and clinical follow-up for up to 4
      years, using life table methods. The median follow-up was 27 months. RESULTS: At
      3 months the objective cure rate was 83%. Subjectively the cure rates at 4 years
      were 53% in patients under 65 years of age and 76% in those who were older.
      Overall mean bladder capacity decreased from 506 to 458 ml after surgery (P less
      than 0.05) and, in those who were cured, mean peak flow rate fell from 25.5 to
      19.6 ml/s (P less than 0.05). The urethral functional length and the pressure
      transmission in the proximal three quarters were increased by successful surgery
      (P less than 0.01) but the resting urethral profile, voiding pressure and the
      frequency of detrusor instability were unchanged. CONCLUSIONS: This modification
      of the Stamey operation has an important role in the management of elderly
      patients those with previous unsuccessful operations, and those with inefficient
      voiding pre-operatively.

PMID- 1760428
TI  - The surgical management of vaginal vault prolapse.
AB  - OBJECTIVE: A review of the results of surgery for vaginal vault prolapse
      following hysterectomy. DESIGN: A retrospective review of all patients treated
      surgically for vaginal vault prolapse between 1981 and 1990 in one hospital.
      SETTING: St George's Hospital, London. SUBJECTS: 28 women. INTERVENTIONS: The 28
      patients underwent 33 operations, either a colposacropexy (23 procedures) or a
      Zacharin procedure (10 procedures). Of the 28 women 25 were seen in the
      gynaecological clinic within the last year. MAIN OUTCOME MEASURES: Pre- and post
      operative data and any interim prolapse surgery was recorded. Success of the
      procedure in terms of cure, urinary complications, infection and sexual function.
      RESULTS: The mean follow-up time was 17.1 months for the colposacropexy and 33
      months for the Zacharin. The cure rate for colposacropexy was 91% and that for
      the Zacharin procedure was 70%. The two commonest complications were development
      of a voiding difficulty and infection. Three women developed voiding difficulty
      following the Zacharin and one following colposacropexy. Two women following
      colposacropexy required removal of the Mersilene mesh due to a persistent
      discharging sinus. CONCLUSION: The colposacropexy had a better success rate and,
      as it is a simpler operation to perform, has become the operation of choice in
      this unit. It is, however, associated with a risk of infection which can
      necessitate removal of the supporting mesh.

PMID- 1760429
TI  - Relations between the fetal circulation and pituitary-thyroid function.
AB  - OBJECTIVE: To study the relation between changes in the fetal thyroid hormone and
      thyroid stimulating hormone (TSH) concentrations and alterations in the fetal
      circulation as assessed by Doppler ultrasound. DESIGN: A cross-sectional study of
      small for gestational age (SGA) and red-cell isoimmunized fetuses undergoing
      cordocentesis and Doppler studies for the assessment and determination of fetal
      karyotype, acid-base balance and haemoglobin concentration. SETTING: Harris
      Birthright Research Centre for Fetal Medicine, King's College, London. SUBJECTS:
      38 growth retarded and 38 red-cell isoimmunised fetuses. INTERVENTIONS:
      Cordocentesis. MAIN OUTCOME MEASURES: Serum TSH total and free thyroxine (T4,
      FT4) and total and free triiodothyronine (T3, FT3) concentrations; middle
      cerebral artery (MCAVm) and descending thoracic aorta (AoVm) mean blood
      velocities; fetal Po2 and haemoglobin concentration (Hb). RESULTS: Delta values
      (delta) calculated as the number of SDs from the respective normal mean for
      gestation were used to compare the results with those from a previous study of
      normal fetuses. Mean AoVm was increased in the isoimmunized fetuses (P less than
      0.001) but decreased in the SGA fetuses (P less than 0.001). Mean MCAVm was
      increased in both groups (P less than 0.01; P less than 0.001). There were
      significant associations between the gestational age adjusted values for TSH and
      MCAVm (r = 0.23, P less than 0.05) and between T4, FT4 or FT3 and AoVm (r = 0.41,
      P less than 0.01; r = 0.50, P less than 0.01; r = 0.36, P less than 0.01
      respectively). In addition, T4 and FT4 were associated with delta Po2 and delta
      Hb. CONCLUSION: In the hypoxaemic hypoxia of growth retardation and the anaemic
      hypoxia of rhesus disease there are significant associations between changes in
      fetal thyroid hormone concentrations and changes in fetal blood flow as assessed
      by Doppler. Irrespective of whether altered blood flow is the cause or effect of
      changes in thyroid hormone concentrations, the observed changes could have
      beneficial effects for fetal survival, in the presence of a hostile intrauterine
      environment.

PMID- 1760430
TI  - Patient acceptability of laser and cold coagulation therapy for pre-malignant
      disease of the uterine cervix.
AB  - OBJECTIVE: To determine patient acceptability of cold coagulation and laser
      treatment for cervical intraepithelial neoplasia (CIN). DESIGN: A prospective
      study with alternate allocation. SETTING: Teaching hospital in London. SUBJECTS:
      155 women requiring treatment for CIN. MAIN OUTCOME MEASURES: Time taken to
      complete the treatment; visual analogue scores for pain experienced, anxiety felt
      and acceptability of the procedure; post treatment bleeding and discharge, and
      follow-up smear. RESULTS: Cold coagulation treatment was found to be quicker and
      less painful than laser treatment, there were no other significant differences
      between the two methods of treatment. CONCLUSION: Cold coagulation is a more
      acceptable form of treatment for CIN than laser.

PMID- 1760431
TI  - Changes in flow velocity waveforms in umbilical and uterine artery following
      haemodialysis. Case report.

PMID- 1760432
TI  - Epidural analgesia--a cause of transient impairment of the utero-placental
      circulation?

PMID- 1760433
TI  - The flying squad--an expensive and potentially dangerous practice in modern
      obstetrics.

PMID- 1760434
TI  - Absence of diurnal variation in urinary chorionic gonadotrophin excretion at 8-13
      weeks gestation.

PMID- 1760435
TI  - The effects of pregnancy on previous incontinence surgery. Case report.

PMID- 1760436
TI  - Colpo-needle suspension for the treatment of urinary stress incontinence--a new
      surgical technique.

PMID- 1760437
TI  - Litigation in obstetrics and gynaecology. Commentary.

PMID- 1760438
TI  - Litigation in obstetrics and gynaecology. Commentary.

PMID- 1760439
TI  - Maternal and fetal haemodynamics in hypertensive pregnancies during maternal
      treatment with intravenous hydralazine or labetalol.

PMID- 1760440
TI  - Contents of essential and toxic mineral elements in Swedish market-basket diets
      in 1987.
AB  - Market baskets containing sixty food items included in the average Swedish diet
      were purchased from three shops in four major Swedish cities during autumn 1987.
      Food items were selected on the basis of food-balance-sheet data. Freeze-dried
      homogenates representative of each city were analysed for twelve essential or
      toxic mineral elements. The energy content of the market baskets (11.5 MJ)
      corresponded to the reference value for male adults. At this energy level the
      contents of calcium (1180 mg), magnesium (300 mg), iron (16 mg), zinc (12 mg) and
      selenium (44 micrograms) were above or close to the Swedish recommended daily
      intakes. The contents of manganese (3.7 mg) and molybdenum (150 micrograms) were
      within and that of copper (1.2 mg) was below the safe and adequate intake values
      given in the US recommended dietary allowance (Food and Nutrition Board, National
      Research Council, 1989). The content of nickel was 82 micrograms. The contents of
      lead (17 micrograms), cadmium (12 micrograms) and mercury (1.8 micrograms) in the
      daily diet were low compared with the provisional tolerable intakes set by the
      Joint Food and Agriculture Organization/World Health Organization Expert
      Committee on Food Additives (World Health Organization, 1972, 1989). The market
      basket contents of Ca, Mg, Fe and Zn calculated from values in the Swedish food
      composition tables were close to the analysed values, indicating that the Swedish
      food tables provide relevant information for the estimation of the dietary supply
      of these elements.

PMID- 1760441
TI  - The effect of energy source and feeding level on the hormones of the entero
      insular axis and plasma glucose in the growing pig.
AB  - The aim of the experiment was to test the theory that accustoming pigs to a high
      fat diet causes exaggerated gastric inhibitory polypeptide (GIP) secretion in
      response to a high-fat meal, and to determine whether hypersecretion of GIP could
      be related to an increase in the GIP content of the small intestine. Twenty-four
      pigs were fed one of three dietary regimens for 11 weeks: a high-carbohydrate
      diet (CL), or a high-fat diet (FL), both fed at 1.46 MJ gross energy (GE)/kg live
      weight0.75 per d, or a high-fat diet (FH) fed at 2.10 MJ GE/kg live weight0.75
      per d. At the end of the period two acute tests were performed. For acute test 1
      the accustomed meal (diets CL, FL and FH) and for acute test 2 a standard high
      fat meal (diet FL) were given; blood samples were taken during the next 5 h and
      analysed for GIP, insulin and glucose. Integrated increases in hormone and
      glucose levels were compared by analysis of variance (0-300 min). In acute test 1
      there were significantly different plasma GIP concentrations between groups (CL
      greater than FH greater than FL; P less than 0.05). Plasma insulin concentrations
      were significantly higher in group CL compared with groups FL and FH (P less than
      0.002). There were no differences in glucose levels. In acute test 2 integrated
      increases in plasma GIP (0-300 min) concentrations were not significantly
      different; however, GIP (0-45 min) concentrations were significantly higher in
      group FH than in groups CL and FL (P less than 0.05). There were no differences
      in plasma insulin concentrations. Plasma glucose (0-300 min) concentrations were
      significantly higher in groups FL and FH compared with group CL (P less than
      0.05). The GIP content of tissue samples taken at the end of the experiment from
      the duodenum, jejunum, upper and lower ileum decreased significantly in a
      proximal to distal direction (P less than 0.001). Diet FH significantly increased
      the average GIP content of the small intestine compared with diets CL and FL (P
      less than 0.05). It is concluded that fat meal-stimulated GIP secretion was
      enhanced by increased feeding level during a pre-treatment phase, possibly due to
      an increase in GIP synthesis in the small intestine. The high-fat diet caused
      glucose intolerance after a high-fat meal. This may be due in part to the action
      of dietary fat on glucose transport and metabolism.

PMID- 1760442
TI  - Urease (EC 3.5.1.5) inhibition in the sheep rumen and its effect on urea and
      nitrogen metabolism.
AB  - The urease (EC 3.5.1.5) inhibitor, phenylphosphoryldiamidate (PPDA), was given by
      continuous infusion into the rumen of two sheep nourished by intragastric
      infusion and into either the rumen or abomasum of four sheep given a pelleted
      diet containing 119 g crude protein (nitrogen x 6.25)/kg dry matter. PPDA was
      given at 1 g/d in infusion sheep and 1.5 g/d in the normally-fed sheep.
      Measurements of urea kinetics were made using single injections of [14C]urea.
      Urease inhibition was complete within 24 h of starting PPDA infusions to the
      rumen; in this time-period, urea concentration in rumen contents reached
      equilibrium with that in plasma and this situation persisted until infusions were
      terminated. Relative to the control periods, plasma urea and rumen ammonia
      concentrations were unchanged but urea irreversible loss rate decreased by 26% in
      infusion sheep and 33% in fed sheep when PPDA was given. Urinary urea excretion
      was not affected, hence urea degradation, measured by difference, decreased by 77
      and 58% respectively in response to urease inhibition. Administration of PPDA to
      the abomasum resulted in a reduction in rumen urease activity to about 40% of
      control values but had no effect on urea metabolism. Differences between
      treatments in daily nitrogen retention were not significant, indicating that
      under the dietary conditions imposed in these experiments, even substantial
      changes in urea recycling had only minor effects on the overall N economy of the
      animal.

PMID- 1760443
TI  - The effect of dietary taurine content on the plasma taurine concentration of the
      cat.
AB  - The essential role of taurine in the diet of the cat has been well documented and
      a deficiency of this nutrient is known to be responsible for a number of clinical
      conditions. At present, the National Research Council (1986) recommendation for
      the minimum dietary requirement of the kitten is 400 mg/kg dry matter and for a
      pregnant cat is 500 mg/kg dry matter. However, these minima were established by
      feeding the animals on semi-purified diets and, therefore, may be inappropriate
      for other dietary regimens. The aim of the present study was to investigate the
      effect of feeding a series of specially prepared diets containing different
      concentrations of taurine (canned diets 1475-5750 mg/kg dry matter, dry diets 811
      1240 mg/kg dry matter) on the plasma taurine concentration of the cat. All diets
      were fed solus for 6 weeks and plasma taurine concentration was measured every 2
      weeks. The results showed that to maintain plasma taurine values in the 'normal'
      range (less than 60 mumol/l), a canned diet must supply at least 39 mg taurine/kg
      body-weight per d and a dry diet at least 19 mg/kg body-weight per d; a cat fed
      on a semi-purified diet need only achieve a daily intake of at least 10 mg
      taurine/kg body-weight to maintain an adequate circulating level of taurine. The
      cause of the reduced availability of taurine from these diets is not yet known.
      Furthermore, repletion of plasma concentration above 60 mumol/l can be achieved
      within 2 weeks of feeding an adequate diet.

PMID- 1760444
TI  - Nitrogen transactions along the digestive tract of lambs concurrently infected
      with Trichostrongylus colubriformis and Ostertagia circumcincta.
AB  - Twelve lambs, paired on the basis of live weight, were cannulated in the
      abomasum, in the proximal jejunum approximately 4 m distal to the pylorus and in
      the terminal ileum. Six were infected with 3000 Trichostrongylus colubriformis
      and 3000 Ostertagia circumcincta larvae each day for 18 weeks and the remainder
      were pair-fed to individual infected lambs. All animals were offered ryegrass
      (Lolium perenne)-white clover (Trifolium repens) pasture, cut daily. Dry matter
      (DM) intake, live weight, faecal egg concentration, plasma pepsinogen and plasma
      protein concentrations were measured weekly. During weeks 7 and 17 after
      commencement of infection, the flow of digesta along the gastrointestinal tract
      was measured together with enteric plasma loss and true digestion and absorption
      of 125I-labelled albumin in the small intestine. DM intake was depressed by
      parasitism, being 1331, (SE 70), 423 (SE 32) and 529 (SE 52) g/d during weeks 3,
      7 and 17 respectively. The flow of nitrogen at the proximal jejunum and in faeces
      was increased by parasitism during week 7 and at the abomasum and ileum during
      week 17. Plasma protein-N loss (g/d) into the gastrointestinal tract was 0.68 (SE
      0.091) and 1.97 (SE 0.139) during week 7, and 0.85 (SE 0.158) and 1.96 (SE 0.396)
      during week 17, in control and infected sheep respectively. True digestion and
      absorption of albumin in the proximal small intestine, the site of infection, was
      very low (mean 0.08) and was not affected by parasitism. Between the abomasum and
      terminal ileum absorption of albumin was high (mean 0.87) and again was not
      affected by parasitism. It was calculated that of the total increase in
      endogenous protein passing from the ileum tract as a result of infection, plasma
      protein comprised only a small percentage (10-36%). The major proportion of
      digestion and absorption of protein occurred in the distal small intestine beyond
      the site of infection and was not affected by infection.

PMID- 1760445
TI  - Effect of refeeding diets containing cottonseed flour with traces of gossypol on
      rat liver and testis.
AB  - The aim of the present work was to show that cottonseed flour introduced into
      rehabilitation diets is not nutritionally harmful. The cottonseed flour obtained
      from glandless seeds contains traces of gossypol. As gossypol is known to have
      pathological hepatic and testicular actions, the effects on hepatic variables and
      on the histological appearance of liver and testis of diets containing cottonseed
      flour were compared with those without cottonseed flour. Seventy growing male
      Wistar rats were divided into two groups. The control group (C) received a
      balanced diet (200 g casein + 3 g methionine/kg) for 78 d and the experimental
      group was fed on a low-protein diet (20 g casein + 3 g methionine/kg) for 29 d.
      After the period of protein deprivation, the depleted rats were divided into four
      groups and each group was refed with a different diet, for 49 d: a balanced diet
      (200 g casein + 3 g methionine/kg; rC), maize-soya-bean flour-milk (60:30:5, by
      wt; MSM), maize-cottonseed flour-milk (60:30:5, by wt; MCM) or rice-cottonseed
      flour-milk (60:30:5, by wt; RCM). Each diet was supplemented with a vitamin
      mixture (10 g/kg) and a salt mixture (40 g/kg). In the liver, protein, total
      lipid, fatty acid composition and nucleic acid contents were determined after 29
      d of protein deprivation and after 2, 14, 29, 49 d of refeeding. The refeeding of
      rats with either diet MSM or RCM promoted a higher growth than that with diet MCM
      or diet rC. In all groups, a progressive decrease in relative liver weights with
      age was observed. The highest values were obtained with diets rC and MSM. After
      49 d of refeeding, the lowest values for lipid, DNA and protein:RNA and the
      highest values for RNA and RNA:DNA were obtained with the cottonseed diets (MCM
      and RCM). Rats fed on the cottonseed-flour diets for a 49 d period after severe
      protein malnutrition showed no change in size or shape of their hepatocytes
      compared with those obtained with the control casein diet, and all stages of
      spermatogenesis occurred normally and spermatozoa were accurately formed.
      Therefore, our findings show that a low level of gossypol administrated during 49
      d, even to an organism weakened by protein malnutrition, does not affect hepatic
      variables and the histological appearance of liver and testis.

PMID- 1760446
TI  - Metabolic effects of coconut, safflower, or menhaden oil feeding in lean and
      obese Zucker rats.
AB  - The aim of the present investigation was to study the effects of fish oil feeding
      in obese Zucker rats to establish its suitability as an animal model of
      hyperlipidaemia, and to understand the possible mechanism of fish oil-induced
      perturbations in cell metabolism. Lean and obese Zucker rats were fed on diets
      containing 180 g coconut, safflower, or menhaden oil/kg for 10 weeks. Body
      weights and food intakes of lean coconut (LC), safflower (LS), and menhaden (LM)
      groups were similar. Obese menhaden (OM) rats had lower food intakes and body
      weights compared with obese coconut (OC) and obese safflower (OS) groups, but
      values for all obese rats were higher than those for lean rats. Liver weights
      were higher in obese compared with lean rats, but on a percentage body-weight
      basis menhaden oil rats had higher values within genotype. Serum cholesterol and
      triacylglycerol levels were lower in the OM group compared with the OC and OS
      groups, and in the LM group compared with the LC group. Glucose and insulin
      levels were highest in OS rats followed by OC and OM rats and then the lean rats.
      Serum triiodothyronine and thyroxine were lower in OM rats compared with OC and
      OS rats. Liver mitochondrial state 3 rates with glutamate-malate and succinate
      were lower; mitochondrial beta-oxidation was unaffected and peroxisomal beta
      oxidation was higher in menhaden oil rats compared with both coconut and
      safflower oil rats. In general, consumption of menhaden oil lowered hepatic malic
      enzyme (EC 1.1.1.38, 1.1.1.40), glucose-6-phosphate dehydrogenase (EC 1.1.1.49)
      and glutathione peroxidase (EC 1.11.1.9) activities and elevated long-chain fatty
      acyl-CoA hydrolase (EC 3.1.2.2) activity when compared with the two other diets.
      It is concluded that obese Zucker rats do respond like human subjects to fish oil
      feeding but not to vegetable oils. The hypolipidaemic effect of fish oil appears
      to be mediated through a lowering of lipogenic enzymes, glucose-6-phosphate
      dehydrogenase and malic enzyme.

PMID- 1760447
TI  - Weaning food mythology.

PMID- 1760448
TI  - Gastroduodenal injury from nonsteroidal anti-inflammatory drugs: risk management
      issues.

PMID- 1760449
TI  - Palatability of colonic lavage solution is improved by the addition of
      artificially sweetened flavored drink mixes.
AB  - A frequent complaint of patients asked to drink polyethylene glycol (PEG) colonic
      lavage solution is the salty flavor. This often results in failure to ingest the
      entire 4 liters of the solution and compromises bowel cleansing. The purpose of
      this study was to determine systematically whether the addition of a flavored
      drink mix sweetened with aspartame to the PEG lavage solution would improve
      palatability without significantly altering the osmolality of the solution.
      Eighty-seven (87) staff volunteers participated in a taste test of PEG lavage
      solutions containing varying amounts of commercially available drink mixes. The
      solution containing two packages of lemon-flavored KoolAid drink mix sweetened
      with aspartame was significantly more palatable than the others (p less than
      0.005), while osmolality remained within the range specified by the manufacturer
      of Colyte.

PMID- 1760450
TI  - Alpha 1-antitrypsin deficiency.
AB  - alpha 1-Antitrypsin (AAT) is a polymorphic protein with many variants
      collectively known as the Pi system. The most common alleles are the M, S and Z,
      which are co-dominantly inherited. Infants with PiZZ have approximately 16% of
      the normal AAT serum concentration. alpha 1-Antitrypsin deficiency (AATD) is an
      inborn error of metabolism which is principally associated with liver disease in
      children and emphysema in young adulthood. Individuals with AATD produce an
      abnormal protein which accumulates in the liver, resulting in decreased serum
      levels. Affected individuals cannot protect their lungs from digestion by
      elastase. Smoking is a significant risk factor for the early development of
      emphysema. Prolastin, human alpha 1-protease inhibitor, is now available as
      replacement therapy. Weekly intravenous administration, with the goal of
      maintaining the serum AAT greater than 80 mg/dl, appears to arrest pulmonary
      damage. Its effect on liver disease is unknown at this time. A recombinant alpha
      1-protease inhibitor is being tested in aerosol form with promising early
      results.

PMID- 1760451
TI  - Dipentum (olsalazine sodium)
AB  - Dipentum (olsalazine sodium), a product by Pharmacia, represents the first oral
      delivery of sulfa-free 5-aminosalicylic acid therapy available for remission
      maintenance in sulfasalazineintolerant patients with ulcerative colitis. It
      provides a safe and well-tolerated treatment regimen that has been shown to be as
      effective as sulfasalazine in maintaining remission of ulcerative colitis.

PMID- 1760452
TI  - Managing patient education: a perspective for the 1990s.
AB  - Changes in the delivery and complexity of health care make it imperative that the
      patient and family are provided with the information needed to make intelligent
      decisions and choices about health care alternatives. The intent of this paper is
      to outline the nurse manager's responsibilities for patient education and to
      provide a practical framework by which to structure patient teaching programs.
      Although the philosophies of self-care and self-determination are outlined and
      provide the primary orientation to the concept of patient education, the
      description of the nurse manager's clinical and aggregate skills provide both the
      training and practice guidelines.

PMID- 1760453
TI  - Standards documentation.

PMID- 1760454
TI  - Hospital marketing: a new frontier.
AB  - Competition is now forcing hospitals to become more efficient and market-wise.
      This article investigates the past, present and future trends in hospital
      marketing. Dramatic changes are taking place at a staggering pace in the health
      care arena. An understanding of the necessity of hospital marketing is essential
      for all health care workers.

PMID- 1760455
TI  - Why an international gastroenterology nursing organization?

PMID- 1760456
TI  - Health care trends for older people.
AB  - Research is showing us a radically different view of aging from the one seen by
      earlier generations. Attitudes, which were based on the myth that physical and
      mental decline are inevitable with age, are beginning to change as a result of
      new scientific information. What we are learning is that aging involves both
      intrinsic and extrinsic factors. The universal phenomena that occur in all of us
      as we advance in age are intrinsic characteristics of aging, while extrinsic
      factors are those characteristics that can be prevented or modified, such as
      lifestyle choices, environmental exposure, and disease.

PMID- 1760457
TI  - Prevalent sleep problems in the aged.
AB  - Quality of sleep influences the level of daytime functioning, including stress
      levels, psychosomatic complaints, general health, and overall well-being. As
      people age, they complain more about disturbed sleep, insomnia, increased time in
      bed, and sleep fragmentation. These complaints can be related to circadian rhythm
      desynchronization, hypnotic or other medication use, chronic bedrest, napping,
      dementia, or to sleep apnea, a disorder of respiratory cessation which is quite
      prevalent in the elderly. We review here the results of 12 years of research on
      sleep in the elderly. In studies of three populations of elderly, it was found
      that between 24% and 42% had five or more apneas per hour of sleep and 4%-14% had
      20 or more apneas per hour of sleep. Since apnea is related to dementia and even
      to mortality, this high prevalence of apnea is of extreme importance.

PMID- 1760458
TI  - Biofeedback-assisted relaxation training for the aging chronic pain patient.
AB  - The older segments of the U.S. population are expanding rapidly and account for a
      disproportionate amount of health care, including treatment for pain-related
      musculoskeletal disorders. In a prospective study with objective measures and one
      year follow-up, Middaugh et al. (1988) found that older patients (55-78 yr; N =
      17, 76% success) treated in a multidisciplinary chronic pain rehabilitation
      program enjoyed a success rate equal to that of younger patients (29-48 yr, N =
      20, 70% success). The current study presents additional data on these two groups
      of patients to compare their ability to learn the physiological self-regulation
      skills taught in the biofeedback/relaxation component of the multimodal program.
      This component included progressive muscle relaxation training, diaphragmatic
      breathing instruction, and EMG biofeedback. Repeated measures ANOVA showed
      significant increases in digital skin temperature (peripheral vasodilation) and
      decreases in respiration rate both within and across training sessions (p values
      = .04 to .0001) with no differences between age groups (p greater than .05). EMG
      measures for the upper trapezius ms in patients with cervical pain showed similar
      deficits in muscle control at evaluation and similar improvements with
      biofeedback training for the two age groups. These findings indicate that older
      pain patients responded well to the biofeedback/relaxation training component of
      the multimodal pain program.

PMID- 1760459
TI  - Electromyographic biofeedback training for tension headache in the elderly: a
      prospective study.
AB  - This study evaluated the effects of a 12-session frontal electromyographic
      biofeedback training regimen on the headache activity of eight tension headache
      sufferers aged 62 and older. The biofeedback sessions were slightly modified for
      a geriatric population, essentially to increase comprehension and retention of
      rationale and instructions. Post-treatment assessment at three months revealed
      significant decreases in overall headache activity (50% or greater) in 50% of the
      subjects, and moderate improvement (35%-45%) in three of the remaining four
      subjects. Significant clinical and/or statistical pre-post differences were also
      found for the number of headache-free days, peak headache activity, and
      medication index. This is the first prospective study of biofeedback training for
      tension headache in an elderly population and, unlike previous retrospective
      studies, suggests that such therapy may be an effective intervention in the
      treatment of tension headaches in the elderly.

PMID- 1760460
TI  - The present and future roles of biofeedback in successful aging.
AB  - Brief descriptions of the applications of biofeedback in normal elderly and in
      diseases occurring during old age are given. An outline for new applications or
      expansion of areas presently under investigation is presented.

PMID- 1760461
TI  - Sustained effects of biofeedback-assisted relaxation therapy in essential
      hypertension.
AB  - The usefulness of biofeedback-assisted relaxation as an adjunct or substitute for
      pharmacotherapy in essential hypertension can be enhanced if the effects are
      shown to persist after formal treatment has ended. Patients with essential
      hypertension successfully treated with biofeedback-assisted relaxation were
      recalled for follow-up yearly after the termination of treatment. Twenty-six of
      40 patients met the BP criterion for success. At one-, two-, and three-year
      follow-up, 31%, 38%, and 27% of the successful completers continued to meet the
      criterion for success. The pretreatment-posttreatment decreases in BP were
      accompanied by decreases in forehead muscle tension and urinary cortisol.
      Forehead muscle tension, urinary cortisol, and anxiety levels were significantly
      lower than pretreatment one year after the end of treatment. Self-report data
      were used to assess continued relaxation practice. No relationship was found
      between practice and any other dependent measure. It appears that some patients
      trained in biofeedback-assisted relaxation can maintain lowered blood pressure,
      muscle tension, anxiety, and cortisol levels over the long term; however, the
      role of relaxation practice in maintaining these lowered levels remains unclear.

PMID- 1760462
TI  - EMG biofeedback treatment of torticollis: a controlled outcome study.
AB  - Successful treatment of torticollis with electromyographic (EMG) biofeedback has
      been reported in a number of single case and single group studies. The present
      investigation represents the first controlled outcome study. Twelve torticollis
      patients were randomly assigned to EMG biofeedback or relaxation training and
      graded neck exercises (RGP). The procedure involved three sessions of baseline
      assessment, 15 sessions of EMG BF or RGP, 6 sessions of EMG BF or RGP plus home
      management, 6 sessions of home-management alone, and follow-up 3 months after the
      end of treatment. A variety of outcome measures were used including physiological
      (EMG from the two sternocleidomastoid muscles, skin conductance level),
      behavioral (angle of head deviation, range of movement of the head), and self
      report (depression, functional disability, body concept), therapist and
      "significant other" reports and independent observer assessment of videos. In
      both groups, neck muscle activity was reduced from pre- to posttreatment. This
      reduction was greater in the EMG biofeedback group. There was evidence of
      feedback-specific neck muscle relaxation in the EMG biofeedback group. Therefore,
      the outcome was not due to nonspecific factors and could be attributed to
      feedback-specific effects. Changes in skin conductance level showed that neck
      muscle relaxation was not simply mediated by a general reduction of "arousal."
      Significant improvements of extent of head deviation, and range of movement of
      the head, as well as reductions of depression were present, which were not
      different in the two groups. At the end of treatment, no patient was
      asymptomatic. Any therapeutic benefit was generally maintained at follow-up. The
      results and the procedural simplicity of RGP make the issue of cost-efficacy of
      EMG biofeedback a pertinent one. Further controlled outcome studies of EMG
      biofeedback treatment of torticollis with larger samples are required.

PMID- 1760463
TI  - The psychophysiology of motor vehicle accident related posttraumatic stress
      disorder.
AB  - Heart rate, BP, and electrodermal responses of four individuals with PTSD
      secondary to motor vehicle accidents (MVAs) were measured while they imagined two
      separate scenes related to their MVA. Results showed reliable HR responses to
      these images. In addition, SBP and DBP also showed some responsivity to the
      images while skin resistance level changed reliably in only 2 of 4 subjects.
      Psychophysiological measurement could play a role in the assessment and treatment
      of MVA-related PTSD.

PMID- 1760464
TI  - Distribution of indole-producing urease-negative pasteurellas in animals.
AB  - Three hundred fifty-six animal isolates of indole-positive urease-negative
      cultures of Pasteurella, which would formerly have been classified as P.
      multocida, were examined with respect to their relationship to the recently
      described P. multocida subspecies (ssp.) multocida, septica, and gallicida and P.
      canis, P. stomatis/Taxon 16, and Pasteurella sp. B. Two hundred sixty-three
      (73.9%) of the cultures could be identified with one of these taxa, and 93
      isolates (26.1%), representing 17 different biotypes, were unassignable.
      Pasteurella multocida ssp. multocida was the predominant taxon throughout and in
      most of the 25 animal species from which isolations were made. In dogs, P. canis
      was the most frequent. Different degrees of host predilection were observed also
      in P. multocida ssp. septica for cats, P. canis for sheep, and 2 of the
      unassignable biotypes for cattle and dogs, respectively. Overall, the respiratory
      tract was the most frequent source of isolates, but a propensity of P. multocida
      ssp. septica for localization in the central nervous system of cats was noted.

PMID- 1760465
TI  - Association of a Pasteurella haemolytica-like organism with enteritis in swine.
AB  - A Pasteurella haemolytica-like organism was isolated from the intestines of 28
      swine with clinical, gross, or microscopic evidence of enteritis. In 15 cases,
      other known enteric pathogens were also demonstrated, and in 13 cases, no other
      pathogens were detected. The mean age of affected animals was 44 days. Most of
      the animals had clinical evidence of diarrhea. Gross enteric lesions were present
      in 17 of 21 cases. Microscopic lesions were present in 24 of 26 cases. A diffuse
      or segmental moderate to severe necrotizing enteritis was the most common lesion
      in cases in which only the Pasteurella haemolytica-like organism was isolated.
      Biochemical tests gave results consistent with Pasteurella haemolytica, and 5 of
      15 isolates met criteria for biotype A. Negative results were found with an
      indirect haemagglutination procedure for P. haemolytica.

PMID- 1760466
TI  - Light and electron microscopic observations of a segmented filamentous bacterium
      attached to the mucosa of the terminal ileum of pigs.
AB  - Segmented filamentous bacteria were seen attached to apical villous enterocytes
      of the terminal ileum in 15 of 2,766 live pigs submitted for necropsy over a 6
      year period. Infected pigs ranged in age from 2 to 13 weeks. All pigs except 2,
      however, were greater than 4 weeks old and had been weaned. All infected pigs
      came from conventional commercial herds with intensive, all-indoor, confinement
      rearing management systems. The bacteria were gram negative or gram variable and
      were not associated with any clinical disease. Bacteria were more commonly
      attached to epithelium on the dome villi in the ileum. Electron microscopic
      examination revealed organisms composed of a cranial segment with a nipple-like
      appendage and several other segments making up elongated filaments of various
      lengths. Each filament was divided into segments by transverse septa. The nipple
      like appendage served as an attachment apparatus by indenting the enterocyte
      surface without physically penetrating it. Occasionally, the colonizing bacterium
      was itself colonized by small rod-shaped bacteria that completely surrounded the
      filament.

PMID- 1760467
TI  - Patterns of bovine dairy submissions to the California Veterinary Diagnostic
      Laboratory System.
AB  - Dairy cattle submissions to the California Veterinary Diagnostic Laboratory
      System (CVDLS) were analyzed to determine submitter statistics. Eligible
      submissions were those received July 1, 1987 through December 31, 1989 for
      reasons other than regulatory brucellosis serology. A comprehensive list frame of
      California dairies was constructed from Brucella Ring Test information and served
      as the comparison population for the study. Analyses were performed based on
      geographic location, herd size, proximity to a CVDLS laboratory, and frequency of
      submission. Thirty-nine percent of the 2,490 California dairies in the reference
      population had submitted specimens greater than or equal to 1 time to the CVDLS
      during the study period. Twenty-three percent of the reference population had
      submitted greater than or equal to 2 times. Specimens were more likely to be
      submitted from larger herds than smaller herds. Larger dairies also submitted
      specimens more frequently. Dairies in the northern part of the state were more
      likely to submit specimens and submitted more frequently than southern herds when
      herd size was accounted for in the analysis. Mean submission rate (+/- SD) for
      the 970 submitting dairies was 1.4 (+/- 1.8) submissions/year. Forty-six percent
      of the dairies accounted for 80% of submissions, whereas only 14% of dairies
      accounted for 50% of all diagnostic dairy submissions.

PMID- 1760468
TI  - Identification of porcine mycoplasmas using commercial enzyme assay systems.

PMID- 1760469
TI  - Pseudospirochetes in animal blood being cultured for Borrelia burgdorferi.

PMID- 1760470
TI  - An Eperythrozoon-like parasite of llamas: attempted transmission to swine, sheep,
      and cats.

PMID- 1760471
TI  - Fatal reactions in bison following systemic organophosphate treatment for the
      control of Hypoderma bovis.

PMID- 1760472
TI  - Analysis of corn and cultured corn for fumonisin B1 by HPLC and GC/MS by four
      laboratories.

PMID- 1760473
TI  - Encephalitis in two porcupines due to Baylisascaris larval migration.

PMID- 1760474
TI  - Epizootics of diaphragmatic hernias in swine.

PMID- 1760475
TI  - Posterior paralysis and electrocution of swine caused by accidental electric
      shock.

PMID- 1760476
TI  - Cultivation of Mycobacterium paratuberculosis from bovine fecal specimens and a
      suggested standardized procedure.

PMID- 1760477
TI  - Ruminant paratuberculosis--a century of progress and frustration.

PMID- 1760478
TI  - [Artificial nutrition in kidney failure].
AB  - Renal failure in itself generates a state of malnutrition, due to three main
      causes: inadequate ingestion (anorexia, vomiting or diet insufficiencies), the
      existence of catabolic factors (proteins, acidosis, PTH) and extrarenal
      depuration (which provokes a lack of amino acids and vitamins). Artificial
      nutrition constitutes a series of measures that can be adopted to act upon each
      of the above causes. Adequate ingestion compared to inadequate ingestion can be
      performed orally (especially in chronic renal failure) by parenteral
      administration (preferable in acute renal failure) and enteral administration
      (complementary in both cases). The quantity and quality of adequate nutrients is
      non-dependent on the method of administration; 500 ml, of water should be
      administered plus diuresis, plus loss from other tracts; the mineral intake of
      sodium, potassium and phosphorus should be restricted; in the case of vitamins,
      these should be administered, especially the B and D complexes; there should be
      sufficient calories to constitute a hypercaloric diet (from 30-50 kg/day), at
      least 50% in the form of carbohydrates (hypertonic glucose, if administered
      intravenously, and dextrinolmaltose or starch if administered through the
      digestive tract) and at least 40% in the form of lipids (preferably of vegetable
      origin, rich in non-saturated fatty acids); proteins are the mainstay of
      nutrition in renal failure; thus, with a normal renal function or in dialysis, a
      dose of 1 g/kg/day is recommended; in chronic renal failure, 0.5 g/kg/day; in
      cases of renal failure not on dialysis, 0.3 g/kg/day, supplemented by essential
      amino acids or cetoacids (the effectiveness of the latter is still in
      dispute).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760479
TI  - [Informatics and parenteral and enteral nutrition: the state of the art].
AB  - A review was performed of the progress made with the assistance of computers in
      the parenteral and enteral nutrition field as one more of the many uses made
      today of the computer industry. Detailed analysis is presented by the authors of
      the different types of hardware used, as well as the main characteristics and
      content of the programmes and applications existing in this field, both
      restricted to small working groups and in management. A comparative study was
      also made of the management programmes distributed free of charge by some
      laboratories. Finally, an evaluation was made of the advantages and disadvantages
      of using computers in parenteral and enteral nutrition at present.

PMID- 1760480
TI  - [A prospective study of the functioning of 2 types of enteral nutrition
      catheters].
AB  - The problems of disintubation and obstruction of nutritional catheters are common
      during treatment with enteral nutrition. This prospective study has been designed
      to evaluate the differences in the frequency of obstruction between two different
      types of enteral nutrition catheter. Catheter A (Silk, Ibys) with one single
      lateral outlet, wide, long and with a curved edge, and Catheter B (Nutrisoft M,
      Kabi-Pfrimmer), with several smaller lateral holes, 46 nutritional periods were
      studied, divided into two groups: first group, n = 32 (catheter A) and second
      group n = 14 (catheter B, Nutrisoft M, Kabi-Pfrimmer). There were no significant
      differences between both groups for the type of diet administered, osmolarity,
      speed, volume administered, number and duration of interruptions, external
      fixation, washing of the catheter and duration of the nutritional period. The
      catheter slipped out in 21 periods (46%). Obstruction of the catheter was the
      cause of disintubation of the catheter in eight cases, five of the cases with
      catheter A (15%) and three cases with catheter B (21%); there were no significant
      differences between the values for both. These results indicate that the
      frequency of obstruction is similar with both catheters; however, the Silk
      catheter may have a better tolerance and be easier to intubate, due to its
      smaller external diameter.

PMID- 1760481
TI  - [The protocolization and follow-up of enteral nutrition. 2 years of experience].
AB  - The Artificial Nutrition Unit was set up in 1980 in the Pharmacy Service, with
      the objective of preparing parenteral nutritional units. Different protocols were
      prepared, approved by the Commission of Pharmacy and Therapeutics. From 1986
      onwards, follow-up was commenced and since March 1988, nutritional evaluation of
      the patients on enteral nutrition has been performed. Encouraged by the results
      obtained, a proposal for protocolizing enteral nutrition was put to the
      Commission of Pharmacy and Therapeutics, which was approved in December 1988. The
      main objective was to select the enteral diets which would be used as a formula
      for existing hospital diets and, after establishing this formula, protocolize the
      indications that would assists in selecting from among the diets available, the
      ones that would best adapt to the individual needs of each patient. As a
      secondary objective, the Artificial Nutrition Unit took on the responsibility of
      processing the medical instructions and dispensing enteral diets using the
      dosage/patient/day distribution system. It also provides information to medical
      and nursing staff on existing diets, as well as on rules for administration and
      storage in nursing units, providing when necessary the most suitable containers,
      equipment and pumps for administering the diets. It also carries out a
      nutritional evaluation of patients exclusively on enteral nutrition, as well as
      follow-up of these. Finally, it prepares the monthly actual cost figures
      generated by each nursing unit, since diets not administered after twenty-four
      hours are returned to the Nutrition Unit. One problem existing is the non
      administration of products or patients who refuse to take their diets.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1760482
TI  - [The quality control of a photoprotector bag against ultraviolet light].
AB  - The action of light on parenteral nutritional solutions may affect the stability
      of many of their ingredients. The aim of this study is to perform quality
      controls on a commercial photoprotective bag by quantifying the degradation of
      riboflavin in isotonic saline solution during forty-eight hours. Thirty solutions
      were prepared using 5 mg of riboflavin in 500 ml of saline solution. These were
      divided into three batches; one not protected from the light, one in a black bag
      and the third in a commercial bag. Samples were taken at 0 and 48 hours, and were
      analyzed by spectrophotometry. Solutions were prepared using 1.75 mg of
      riboflavin in 500 ml of saline solution. The same method was followed, and the
      samples were analyzed by fluorometry. The results were analyzed using the Student
      t test. The black bag was seen to be superior to the other two as a protector
      against ultraviolet light. There were no significant differences between the
      commercial bag and the non-protective bag.

PMID- 1760483
TI  - [The effect of nutrition on bone marrow transplantation].
AB  - Malnutrition alone may provoke considerable immune alterations, mainly in the
      immunocellular function, and in particular in the T lymphocyte and macrophage
      monocytic function. This gives rise to an increase in proneness to infections,
      which in patients subjected to bone marrow transplants, will be increased by the
      intense neutropenia suffered by them. This study shows the greater incidence of
      infection among badly nourished patients compared to nourished patients. It was
      also observed that short bouts of high temperature mainly occurred in a subgroup
      of patients with an acceptable nutritional level, which in our opinion was the
      cause for none of them developing the infectious illness. Finally, one of the
      germs most often found in these patients is Staphylococcus epidermis, and the
      most common method of entry is through the catheters used in the administration
      of medicines and artificial nutrition. Emphasis is placed on the role played by
      nursing in preventing this type of infection.

PMID- 1760484
TI  - High performance liquid chromatography method for rapid and accurate
      determination of homocysteine in plasma and serum.
AB  - Determination of homocysteine in plasma or serum for evaluation of cobalamin and
      folate deficiency is becoming an important diagnostic procedure. Accurate, rapid
      and low cost methods for measuring homocysteine are therefore required. We have
      improved an HPLC method and made it suitable for clinical application. The more
      important changes are the addition of an internal standard,
      mercaptopropionylglycine, and the use of a plasma/serum based calibration
      material. The method consists of the following steps: reduction of the sample
      with tri-n-butylphosphine, precipitation of proteins, derivatisation with
      ammonium 7-fluorobenzo-2-oxa-1,3-diazole-4-sulphonate, and HPLC separation
      followed by fluorescence detection. The linearity of the assays is established
      and the coefficient of variation is 3.0%. Stability studies show that blood
      samples must be cooled or centrifuged immediately after venipuncture. The method
      is useful for evaluation of cobalamin or folate deficiency, especially in
      patients with normal or moderately depressed cobalamin or folate concentrations
      in blood.

PMID- 1760485
TI  - Mathematical modelling of competitive labelled-ligand assay systems. Theoretical
      re-evaluation of optimum assay conditions and precision data for some
      experimentally established radioimmunoassay systems.
AB  - A mathematical theory of competitive labelled-ligand assays was developed with
      the intention of theoretically re-evaluating the optimal assay conditions and
      precision data of assay systems established by experiment. Our theory is based
      upon the assumptions of a simple bimolecular reaction mechanism, homogeneous
      reactants, as well as kinetically indistinguishable labelled and non-labelled
      ligands. The general case of two-step (non-equilibrium) assay was considered
      including the one-step (equilibrium) assay as a special case. The solution of the
      system of corresponding kinetic differential equations was used to mathematically
      construct standard curves. Furthermore, intraassay precision profiles and indices
      as well as detection limits were calculated considering solely the pipetting
      error, epsilon, as a source of experimental error. A procedure was outlined to
      mathematically determine the optimal incubation conditions for any assay system
      targeted to a given analyte concentration, P, at which the standard deviation of
      assay results is to be minimized. Estimates of both the content of binding sites
      and the equilibrium constant, K, of the specific binding agent are necessary, and
      these can be derived from Scatchard plots. For six RIA systems, of which three
      were one-step and three were two-step assays, experimental assay conditions and
      precision data were compared with theoretical predictions. Experimentally
      determined antibody binding site concentrations agreed fairly well with those
      independently evaluated by mathematical optimization. Mean precision indices,
      defined as constituting an average over the complete precision profile, were
      found to be within the theoretically predicted range, i.e. two- to threefold the
      pipetting error.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760486
TI  - A fluorometric enzyme immunoassay for follitropin and lutropin.
AB  - The analytical performance of the Stratus (Baxter) automatic analyser for human
      lutropin and follitropin determination was evaluated and compared with that of an
      immunoradiometric assay. Within-run and between-run imprecision were lower than
      those of the immunoradiometric assay. No significant differences were obtained in
      the parallelism study. A good and significant correlation was obtained between
      both methods. Results obtained for both methods were not interchangeable. The
      Stratus automatic analyser can replace radioisotopic methods, thus eliminating
      radioactive hazards.

PMID- 1760487
TI  - Evaluation of the measurement of prolactin in serum with Enzymun-Test System ES
      600.
AB  - The Enzymun-Test System ES-600 is a fully automated analyser for the Clinical
      Chemistry hormone laboratory. The Enzymun-Test prolactin, an enzyme immunoassay,
      is based on a sandwich technique using two monoclonal antibodies, one coated onto
      tubes and the other labelled with peroxidase. We have studied the measurement of
      prolactin concentration in serum and compared the results obtained with both this
      system and with the manual IRMA used in our laboratory. The within-day
      imprecision gave the following CV (n = 20): 6% at 64 mU/l, 1% at 379 mU/l and 2%
      at 1232.1 mU/l. The CV for between-day imprecision (n = 20) was 10%, 8% and 6%,
      respectively. The detection limit was 4 mU/l and linearity was demonstrated with
      geometric dilutions of a highly concentrated serum. We observed an average
      recovery of 104%, ranging 95.6%-110%. The calculated carryover was of 0.05%, and
      there was no trend in the measurements to indicate the occurrence of long series
      drift. In the study of interchangeability (Passing-Bablok regression test) we
      obtained a linear equation: y (ES-600) = 3.16 mU/l + 0.82 x (IRMA), with the
      confidence intervals (95%) a(-30.69, 21.53); b(0.73, 0.99); and a correlation
      coefficient of r = 0.98.

PMID- 1760488
TI  - International Union of Pure and Applied Chemistry, Commission on Analytical
      Nomenclature and Clinical Chemistry Division. Nomenclature for automated and
      mechanised analysis, (recommendations 1989).

PMID- 1760489
TI  - Gastrointestinal surgery for severe obesity.
AB  - The National Institutes of Health Consensus Development Conference on
      Gastrointestinal Surgery for Severe Obesity brought together surgeons,
      gastroenterologists, endocrinologists, psychiatrists, nutritionists, and other
      health care professionals as well as the public to address: the nonsurgical
      treatment options for severe obesity, the surgical treatments for severe obesity
      and the criteria for selection, the efficacy and risks of surgical treatments for
      severe obesity, and the need for future research on and epidemiological
      evaluation of these therapies. Following 2 days of presentations by experts and
      discussion by the audience, a consensus panel weighed the evidence and prepared
      their consensus statement. Among their findings, the panel recommended that (1)
      patients seeking therapy for severe obesity for the first time should be
      considered for treatment in a nonsurgical program with integrated components of a
      dietary regimen, appropriate exercise, and behavioral modification and support,
      (2) gastric restrictive or bypass procedures could be considered for well
      informed and motivated patients with acceptable operative risks, (3) patients who
      are candidates for surgical procedures should be selected carefully after
      evaluation by a multidisciplinary team with medical, surgical, psychiatric, and
      nutritional expertise, (4) the operation be performed by a surgeon substantially
      experienced with the appropriate procedures and working in a clinical setting
      with adequate support for all aspects of management and assessment, and (5)
      lifelong medical surveillance after surgical therapy is a necessity. The full
      text of the consensus panel's statement follows.

PMID- 1760490
TI  - Assessment of histocompatibility of different hemoglobin solutions using
      mesenteric perfusion on the small bowel of the male Wistar rat.
AB  - Histocompatibility assessment of 70 g/l stroma-free hemoglobin solutions
      pyridoxylated or not, and purified or not, was carried out using vascular
      perfusion of the intestine of rats. Mechanical and ultrastructural changes in the
      organ and the arteriovenous difference of PO2 were compared to those obtained
      with albumin, gelatin and dextran. Overlapping epithelium conserves its structure
      in the presence of hemoglobin, whereas it is partially or totally destroyed with
      the plasma substitutes. Nevertheless, with non pyridoxylated hemoglobin there is
      a strong detachment of the epithelium from the lamina propria. The intestine,
      irrigated by the hemoglobin solutions shows efficient peristalsis, but this
      totally disappears with plasma substitutes. For similar arterial PO2, for all the
      solutions, the arteriovenous difference was of 100 mmHg for the hemoglobin
      solutions, whereas they never exceeded 60 mmHg for the plasma substitutes.
      Hemoglobin pyridoxylation led to an arteriovenous difference significantly
      superior (p less than 0.001) to those obtained using non modified hemoglobin.
      With their O2 supply hemoglobin solutions appear able to limit the development of
      hypoxia in the tissue. The continuation of peristalsis and the weak
      ultrastructural modifications confirm the slight histological improvement gained
      when using pyridoxylated hemoglobin. Nevertheless an extravasation appeared
      constantly, as well as flow reduction during perfusion with the hemoglobin
      solutions.

PMID- 1760491
TI  - Effects of hepatic stimulatory factor released from free or microencapsulated
      hepatocytes on galactosamine induced fulminant hepatic failure animal model.
AB  - This paper describes the presence of a cell free hepatocyte stimulating factor
      secreted by hepatocyte cultures. Hepatocytes were isolated from 70-90 grams
      Wistar-Lewis rats. Free or microencapsulated hepatocytes in alginate matrix were
      cultured separately. Cell free supernatant was collected from the culture medium
      in which was cultured free hepatocytes; microencapsulated hepatocytes or control
      microcapsules containing no microcapsules. This was tested in the galactosamine
      rats. A galactosamine dose of 2.7 g/Kg of body weight given intraperitoneally to
      Wistar-Lewis rats resulted in reproducible hepatic necrosis with 90% mortality.
      Cell free supernatant from one day old free hepatocyte cultures was able to
      increase survival time and incorporation of 3H-thymidine in liver of
      galactosamine induced fulminant hepatic failure rats at the time of maximal liver
      damage. The cell free supernatant of one day old microencapsulated hepatocyte
      cultures did not have the same stimulatory effect either on survival time or
      incorporation of thymidine. Another study was carried out as follows. The
      microcapsules containing hepatocytes were ruptured. The supernatant of the
      microcapsule contents was collected. This was found to have hepatic stimulatory
      effect as shown by survival time and incorporation of thymidine. This suggests
      that hepatocytes are a source of a factor(s) which is capable of stimulating
      liver regeneration in the galactosamine induced fulminant hepatic failure rats at
      the time of maximal liver damage. Since the molecular weight cut off of this
      particular preparation of microcapsule is molecular larger than albumin, this
      suggests that the molecular weight of this factor is in the macromolecular range.

PMID- 1760492
TI  - Physicochemical characteristics of hepatic stimulatory factor prepared from cell
      free supernatant of hepatocyte cultures.
AB  - We previously reported that the cell free supernatant of hepatocyte cultures
      contained a hepatic stimulatory factor, which increases survival time and
      stimulates liver regeneration in the galactosamine induced fulminant hepatic
      failure animal model. When hepatocytes were microencapsulated in an alginate
      matrix, the cell free supernatant outside the microcapsuled lacked the above
      stimulatory effects. However, the cell free content of microcapsules was able to
      increase both survival time and incorporation of 3H-thymidine in our animal
      model. This hepatic stimulatory factor has a molecular weight greater than
      albumin because alginate microcapsules allow the penetration of albumin but not
      the hepatic stimulatory factor. In this paper we report the molecular weight
      study and some other physiochemical characteristics of this factor. Using
      Sephacryl gel chromatography we showed that this factor has a molecular weight of
      over 110,000 D. This factor loses its hepatic stimulatory effect after heat or
      trypsin treatment. Although its elution profile on Sephacryl gel does not change
      after such treatments.

PMID- 1760493
TI  - Surface modification of corneal contact lens with phosphoryl choline by glow
      discharge.
AB  - Polymers like poly(methylmethacrylate) (PMMA) and poly(2
      hydroxyethylmethacrylate) (PHEMA) are widely used in the development of hard and
      soft contact lenses. Cell adhesion and deposition of chemicals such as calcium,
      lipoproteins and mucin on the lens surface cause visual acuity which is the main
      problem in extended uses of contact ocular lenses. In order to minimise the cell
      adhesion and other type of depositions, a method of surface modification of lens
      involving the use of phosphoryl choline, a phospholipid and the glow discharge
      technique has been described. The power variation of the lenses after
      modification has been checked using Topcon lensometer. The possible power changes
      of the modified samples due to the exposure to the normal light in the
      laboratory, darkness, ultraviolet (U.V.) light or saline have been investigated
      by taking the visible and ultra violet spectra using Beckman spectrophotometer.
      Surface energy variations after modifications of the samples have been checked by
      sessile drop water contact angle measurements. Glow discharge treatment increases
      the hydrophilicity of the samples. It seems, the modifications do not affect the
      power of hard contact lens significantly. It is also observed that the exposure
      of samples to the normal light in the laboratory, darkness, U.V. light or saline
      make no significant change in the visible and ultraviolet spectra of the samples
      before and after modification.

PMID- 1760494
TI  - Effect of stabilization temperature on the degradation of adriamycin in albumin
      microspheres.
AB  - The effect of stabilization temperature on the degradation of adriamycin HCl
      during the preparation of albumin microspheres was investigated. The degradation
      of adriamycin HCl by heating at various temperature with different time interval
      in dried adriamycin HCl powder, adriamycin HCl aqueous solution, wetted
      Adriablastina (adriamycin HCl with lactose) powder and Adriablastina aqueous
      solution was also studied. In the presence of water the degradation of adriamycin
      HCl was found; whereas, in the absence of water no degradation occurred. The
      degradation of adriamycin HCl in solution and wetted powder showed a zero order
      reaction. An increase in temperature increased degradation rate. The rate
      constant for adriamycin HCl degradation in Adriablastina solution obtained was in
      good agreement with that in adriamycin HCl solution. It was suggested that the
      presence of lactose had no interference in the degradation of adriamycin HCl. The
      zero-order reaction of degradation was attributed to the drug behaved like a
      suspension. The degradation of adriamycin HCl at various stabilization
      temperature during the preparation of microspheres had the same tendency as those
      of the adriamycin HCl solution and the wetted adriamycin HCl powder that were
      heated by the DSC instrument with the condition similar to the preparation of
      microspheres.

PMID- 1760495
TI  - Antibacterial multifilament nylon sutures.
AB  - Multifilament nylon fibers were made antibacterial by dopping with iodine. Nylon
      fibers were immersed in acetone solution of iodine for 48 hours at room
      temperature for dopping of iodine. It was observed that iodine uptake by the
      nylon fibers increased with the increase in concentration of iodine in the
      solution. Antibacterial activity of these iodine dopped samples was evaluated by
      measuring the zone of inhibition. The bacterial species used for this study were
      Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Klebsiella
      pneumoniae. Iodine dopped fibers exhibited good antibacterial activity against
      these bacterial species. Release of iodine in distilled water is sustained for
      about 30 days. Antibacterial activity of the fibers decreases with the release of
      iodine in water. Ultra-violet and visible spectroscopic studies showed that tri
      iodide ions were released from the dopped samples in the aqueous medium. These I3
      ions might be responsible for the observed antibacterial activity. Fiber shrinks
      on iodine dopping leading to increase in the denier of the fiber. However effect
      of iodine dopping on the breaking load of fibers is not significant.

PMID- 1760496
TI  - Polyether urethane urea membrane for an improved hemodialysis.
AB  - This paper reviews our current activities of developing polyether urethane urea
      membranes for hemodialysis application. It is observed that the processing
      parameters such as precipitation medium, precipitation temperature etc. can
      influence the porosity of the membrane and subsequently the permeability
      property. Polyurethane/poly(methyl methacrylate) blended membranes have also
      shown high permeability. All the membranes are subjected to different
      sterilization processes and the pore sizes before and after sterilization are
      determined. The changes in the pore size due to sterilization seems to effect the
      permeability.

PMID- 1760497
TI  - Endogenous chelation of exogenous aluminum in renal patients--a factor in
      aluminum toxicity?

PMID- 1760498
TI  - Compatibility of biomaterials with blood.

PMID- 1760499
TI  - Gel-liquid crystalline transition of some multilamellar lipid bilayers follows
      classical kinetics with a fractional dimensionality of approximately two.
AB  - The relaxation kinetics of the gel-liquid crystalline transition of
      phosphatidylcholine (DC14PC, DC16PC, and DC18PC) multilamellar vesicles have been
      examined using volume-perturbation calorimetry. The time-dependent temperature
      and pressure changes associated with a periodic volume perturbation are monitored
      in real time. Data collected in the time domain are transformed to the frequency
      domain using Fourier series representations of the perturbation and response
      functions. Because a very small perturbation is imposed during the experiment,
      linear response theory is suitable for analysis of the relaxation process. The
      Laplace transform of the classical Kolmogorov-Avrami relation of transition
      kinetics is used to describe the dynamic response in the frequency domain. For
      DC14PC and DC16PC, the relaxation process is better fit with an effective
      dimensionality of n = 2 rather than n = 1. For DC18PC, we estimate that an
      effective dimensionality of approximately 1.5 will best fit the data. These
      results indicate that the gel-liquid crystalline transition of these lipid
      bilayers follows the classical Kolmogorov-Avrami kinetic model with an effective
      dimensionality greater than 1 and the assumption of simple exponential decay (n =
      1) commonly used in data analysis may not always be valid for lipid transitions.
      Insofar as the dimensionality of the relaxation reflects the geometry of
      fluctuating lipid clusters, this parameter may be useful in connecting
      experimental thermodynamic and kinetic results with those obtained from Monte
      Carlo simulations.

PMID- 1760500
TI  - Kinetic constants of the acetylcholine (ACh) receptor reaction deduced from the
      rise in open probability after steps in ACh concentration.
AB  - Outside-out patches of enzymatically dissociated adult and denervated mouse
      muscle fibers were superfused repetitively by pulses of acetylcholine (ACh)
      containing solution. Up to 300 channels opened simultaneously 300 microseconds
      after the beginning of a 1,000 microM ACh pulse corresponding to a peak current i
      of almost -1 nA. Single responses to ACh were averaged and the concentration
      dependence of i and of the rise time tr from 0.1 i to 0.9 i was measured. In
      adult receptors, i increased proportional to the second to third power of ACh
      concentration, whereas in embryonic-type receptors it was proportional to the
      first to the second power. tr increased from approximately 0.3 ms at 1,000 microM
      ACh to a plateau value of approximately 5 ms for adult and of approximately 10 ms
      for embryoniclike receptors at concentrations less than 10 microM ACh. The
      concentration dependence of i and tr was simulated using the standard model of
      ACh binding with different combinations of rate constants and two and three
      binding sites for ACh. The calculated curves were compared to the measurements
      and a set of well fitting rate constants was determined for adult and
      embryoniclike receptors. Three binding sites for ACh were necessary to fit the
      dose response for i for adult receptors. A method for deriving rate constants in
      a model of ACh-receptor interaction is described that avoids analysis of open
      closed kinetics of single channels, which in rapid systems, as the ones studied
      here, are at the limit of the frequency response of the current measurement.

PMID- 1760501
TI  - Coupling of spectrin and polylysine to phospholipid monolayers studied by
      specular reflection of neutrons.
AB  - The technique of specular reflection of neutrons is applied for the first time to
      study the charge-dependent interaction of the protein spectrin and the
      polypeptide poly-L-lysine with model phospholipid monolayers in the condensed
      phase state. We first established the structure of a pure monolayer of
      dimyristolyphosphatidylcholine (DMPC) in both the expanded and condensed fluid
      phase states without protein in the subphase. The thickness of the hydrocarbon
      chains increases from 11.4 +/- 1.5 A in the expanded state to 15.8 +/- 1.5 A in
      the condensed state, whereas the head group region is approximately 10 A thick
      for both phase states. When spectrin is present in the subphase, the dimensions
      of DMPC in the condensed state are not significantly affected, but there is
      approximately 0.09 volume fraction spectrin in the head group region. Lipid
      spectrin coupling is enhanced by electrostatic interaction, as the volume
      fraction of spectrin in the head group region increases to 0.22 in a mixed
      monolayer of DMPC and negatively charged dimyristolyphosphatidylglycerol in the
      condensed state. In contrast to spectrin, polylysine does not penetrate the head
      group region, but forms a layer electrostatically adsorbed to the charged head
      groups.

PMID- 1760502
TI  - Evidence that the spectrin network and a nonosmotic force control the fusion
      product morphology in electrofused erythrocyte ghosts.
AB  - The conversion of the membrane area in the "contact zones" shared by erythrocyte
      ghosts held in contact by dielectrophoresis into a fusion product by
      electrofusion was studied by both light and electron microscopy. Fusion products
      fell into two categories: (a) those with a freely expanding open lumen which
      ended in the "giant cell morphology" and with considerable internal vesicle
      membrane fragments, and (b) linear chains of polyghosts with long term stability
      but having planar diaphragms at the ghost-ghost junctions. Thin section electron
      microscopy showed each of these planar diaphragms to be a double membrane septum
      multiply-perforated with fusion pores. Heat and low ionic strength treatments
      known to denature or detach spectrin caused the stable planar diaphragms to
      dissolve, thereby quickly converting the polyghost chains to the giant cell
      morphology, thereby suggesting that spectrin restricts fusion zone diameter
      expansion if it is intact. Other indications suggest that the expansion of the
      open lumens appears to take place as a result of one or more membrane-specific
      forces with a nonosmotic origin but this tendency to expansion can be overcome if
      the spectrin network on only one side of a contact zone is intact.

PMID- 1760503
TI  - Unidirectional block between isolated rabbit ventricular cells coupled by a
      variable resistance.
AB  - We have used pairs of electrically coupled cardiac cells to investigate the
      dependence of successful conduction of an action potential on three components of
      the conduction process: (a) the amount of depolarization required to be produced
      in the nonstimulated cell (the "sink" for current flow) to initiate an action
      potential in the nonstimulated cell, (b) the intercellular resistance as the path
      for intercellular current flow, and (c) the ability of the stimulated cell to
      maintain a high membrane potential to serve as the "source" of current during the
      conduction process. We present data from eight pairs of simultaneously recorded
      rabbit ventricular cells, with the two cells of each pair physically separated
      from each other. We used an electronic circuit to pass currents into and out of
      each cell such that these currents produced the effects of any desired level of
      intercellular resistance. The cells of equal size (as assessed by their current
      threshold and their input resistance for small depolarizations) show
      bidirectional failure of conduction at very high values of intercellular
      resistance which then converts to successful bidirectional conduction at lower
      values of intercellular resistance. For cell pairs with asymmetrical cell sizes,
      there is a large range of values of intercellular resistance over which
      unidirectional block occurs with conduction successful from the larger cell to
      the smaller cell but with conduction block from the smaller cell to the larger
      cell. We then further show that one important component which limits the
      conduction process is the large early repolarization which occurs in the
      stimulated cell during the process of conduction, a process that we term "source
      loading."

PMID- 1760504
TI  - Raman microspectroscopic approach to the study of human granulocytes.
AB  - A sensitive confocal Raman microspectrometer was employed to record spectra of
      nuclei and cytoplasmic regions of single living human granulocytes. Conditions
      were used that ensured cell viability and reproducibility of the spectra.
      Identical spectra were obtained from the nuclei of neutrophilic, eosinophilic,
      and basophilic granulocytes, which yield information about DNA and protein
      secondary structure and DNA-protein ratio. The cytoplasmic Raman spectra of the
      three cell types are very different. This was found to be mainly due to the
      abundant presence of peroxidases in the cytoplasmic granules of neutrophilic
      granulocytes (myeloperoxidase) and eosinophilic granulocytes (eosinophil
      peroxidase). Strong signal contributions of the active site heme group(s) of
      these enzymes were found. This paper illustrates the potentials and limitations
      for Raman spectroscopic analysis of cellular constituents and processes.

PMID- 1760505
TI  - Gating current "fractionation" in crayfish giant axons.
AB  - Effects of changes in initial conditions on the magnitude and kinetics of gating
      current and sodium current were studied in voltage-clamped, internally-perfused,
      crayfish giant axons. We examined the effects of changes in holding potential,
      inactivating prepulses, and recovery from inactivation in axons with intact fast
      inactivation. We also studied the effects of brief interpulse intervals in axons
      pretreated with chloramine-T for removal of fast inactivation. We find marked
      effects of gating current kinetics induced by both prepulse inactivation and
      brief interpulse intervals. The apparent changes in gating current relaxation
      rates cannot be explained simply by changes in gating charge magnitude (charge
      immobilization) combined with "Cole-Moore-type" time shifts. Rather they appear
      to indicate selective suppression of kinetically-identifiable components within
      the control gating currents. Our results provide additional support for a model
      involving parallel, nonidentical, gating particles.

PMID- 1760506
TI  - ATP dependence of KATP channel kinetics in isolated membrane patches from rat
      ventricle.
AB  - The dependence of KATP channel activity on [ATP] has been examined in isolated
      membrane patches from rat ventricular myocytes. The steady-state [ATP] dependence
      of channel open probability could be described by a sigmoidal relationship with
      the ki ([ATP] causing half-maximal inhibition of open probability) = 25 microM
      and Hill coefficient of 2. Description of channel open- and closed-time
      distributions required at least 2, and 3, time constants, respectively. Long open
      channel lifetimes decreased with [ATP]; unconditional mean channel closed-times
      increased with [ATP]. Step decrease (jump) in bathing [ATP] resulted in a delay
      (of up to hundreds of milliseconds) followed by a pseudo-exponential rise of
      current (with a time constant of up to hundreds of milliseconds). The time course
      of channel current after changes of [ATP] (or the ATP-analogue AMP-PNP) was shown
      to be predominantly determined by the time course of diffusion into the tip of
      the electrode and to the membrane. This time course of diffusion of ATP into the
      pipette tip had to be taken into account when analyzing the current response to
      [ATP] steps. Several possible kinetic models of the ATP-dependent regulation of
      channel activity were considered. Adequate explanation of the data required a
      model with sequential ATP-binding sites. The model can account for the time
      course of channel opening after steps of [ATP], as well as for the steady-state
      dependence of P0 on [ATP]. The model predicts [ATP]-dependent closed and open
      lifetimes as were observed experimentally.

PMID- 1760507
TI  - pH-dependent structural transitions of Alzheimer amyloid peptides.
AB  - To understand the molecular interactions leading to the assembly of beta/44
      protein into the hallmark fibrils of Alzheimer's disease (AD), we have examined
      the ability of synthetic peptides that correspond to the beta/A4 extracellular
      sequence to form fibrils over the range of pH 3-10. Peptides included the
      sequences 1-28, 19-28, 17-28, 15-28, 13-28, 11-28, and 9-28 of beta/A4. The model
      fibrils were compared with isolated amyloid with respect to morphology,
      conformation, tinctorial properties, and stability under denaturing conditions.
      Electron microscopy, Fourier-transform infrared (FT-IR) spectroscopy, and x-ray
      diffraction revealed that the ionization states of the amino acid sidechains
      appeared to be a crucial feature in fibril formation. This was reflected by the
      ability of several peptides to undergo fibril assembly and disassembly as a
      function of pH. Comparisons between different beta/A4 sequences demonstrated that
      the fibrillar structure representative of AD amyloid was dependent upon
      electrostatic interactions, likely involving His-13 and Asp-23, and hydrophobic
      interactions between uncharged sidechains contained within residues 17-21. The
      results also indicated an exclusively beta-sheet conformation for the synthetic
      (and possibly AD fibrils) in contrast to certain other (e.g., systemic) amyloids.

PMID- 1760508
TI  - The molecular origin of birefringence in skeletal muscle. Contribution of myosin
      subfragment S-1.
AB  - The state of optical polarization of He-Ne laser light diffracted by single
      skinned frog skeletal muscle fibers has been determined after decoration of the
      thin filaments of rigor fibers with exogenous S-1. Light on the first diffraction
      order was analyzed using optical ellipsometry for changes occurring in total
      birefringence (delta nT) and total differential field ratio (rT) and the
      experimental results compared with theoretical predictions. Fibers were examined
      with SDS-gel electrophoresis and electron microscopy as independent assays of S-1
      binding. The binding of S-1 to the thin filaments caused a significant increase
      in rT and a small but significant decrease in delta nT. Release of bound
      exogenous S-1 with magnesium pyrophosphate demonstrated that the effect of S-1 on
      the optical parameters was reversible and both electrophoresis and electron
      microscopy demonstrated the presence of S-1 specifically bound to the thin
      filaments. Model simulations based on the theory of Yeh, Y., and R. Baskin (1988.
      Biophys. J. 54:205-218) showed that the values of delta nT and rT were sensitive
      to the axial bonding angle of exogenous S-1 as well as to the volume fraction of
      added S-1. Analysis of the data in light of the model showed that an average
      axial S-1 binding angle of 68 degrees +/- 7 degrees best fit the data.

PMID- 1760509
TI  - Flow rate measurements in isolated perfused kidney tubules by fluorescence
      photobleaching recovery.
AB  - We have developed a new application of the fluorescence photobleaching recovery
      (FPR) technique for instantaneous measurement of volume flow rates at any axial
      position along isolated perfused kidney tubules. The method requires fast data
      acquisition of emitted fluorescence through a photomultiplier (time resolution,
      0.5 ms) coupled with differential interference contrast microscopy to measure
      luminal diameters accurately. While the tubule is perfused in vitro with an
      impermeant fluorophore (fluorescein sulfonate), a 20-ms bleach pulse reduces the
      fluorescence in the observation region by 20-25%. Fluorescence recovery is a
      direct function of perfusate velocity; diffusion plays no significant role in the
      early phase of recovery. A fluid dynamics approach to data analysis shows that
      fractional recovery increases linearly with time until t = L/2vm, where L is the
      length of the observation window and vm is the mean axial velocity. Practically,
      a linear regression analysis of the early recovery phase allows measurement of vm
      of up to 0.14 cm/s, i.e., a 40-nl/min flow rate in a 25-microns-diameter tubule.
      Calibration experiments in small glass tubes perfused at predetermined flow rates
      demonstrated good accuracy (within 10%) and reproducibility (coefficient of
      variation, 8.7%). In rat inner medullary collecting ducts microperfused at 4-40
      nl/min, the correlation with a standard fluid collection method was excellent (r2
      greater than 0.97). The method should also be suitable for the direct measurement
      of fluid flow rate in kidney tubules or blood vessels microperfused in vivo.

PMID- 1760510
TI  - Temperature dependence of drug blockade of a calcium-dependent potassium channel
      in cultured hippocampal neurons.
AB  - The temperature dependence of drug blockade of a calcium-dependent potassium
      channel K(Ca) has been studied in cultured CA1 hippocampal neurons. Channel
      openings from a 70-pS K+ channel were recorded when inside-out patches were
      exposed to a bath solution containing 140 mM K+ and 0.2 mM Ca2+. The mean open
      times of channel events were not significantly altered when the bath temperature
      was lowered from 24 degrees to 14 degrees C (Q10 = 1.2). Introduction of the drug
      RP-62719 into the bath solution (at 5 microM) resulted in the mean open time of
      the K(Ca) channel to be diminished by 85% (at 24 degrees C) with no change in the
      amplitudes of the unitary currents. Over the same temperature range of 24 degrees
      to 14 degrees C, in the presence of RP-62719, the mean open times were
      significantly prolonged (Q10 = 2.2). A simple open channel block scheme was used
      to determine the temperature dependence of the onward- (blocking) and off-
      (unblocking) rate constants. Thermodynamic analysis, using transition rate
      theory, showed that the blocking rate constant was associated with a large
      increase in entropy. The relatively high temperature dependence for channel
      blockade is not consistent with a rate-limiting process established by simple
      diffusion of the agent to a channel blocking site. Channel block may involve
      conformational changes in the channel protein as a consequence of hydrophobic
      interactions between drug and channel sites.

PMID- 1760511
TI  - Politics of pacemaker dominance.

PMID- 1760512
TI  - 1/f alpha power spectrum of the QRS complex does not imply fractal activation of
      the ventricles.

PMID- 1760513
TI  - Oxidative damage to the myocardium: a fundamental mechanism of myocardial injury.
AB  - Certain pathophysiologic conditions are able to shift normal oxygen metabolism
      towards univalent reduction, resulting in the production of reduced oxygen
      intermediates, including free radicals and their metabolites. Oxygen free
      radicals have been implicated in a number of pathologic conditions, including
      myocardial injury. The possible sources of oxygen free radicals, the detection of
      the radicals during ischemia/reperfusion and possible mechanisms of free radical
      damage are discussed. The clinical implications of free radical damage and the
      experimental drug therapies at present under investigation are also reviewed.

PMID- 1760514
TI  - Heart rate and cardiac energetics.
AB  - The heart and arterial system are matched in the sense that the heart pumps at
      maximal external power. Why external power is optimized and what regulatory
      mechanisms are responsible for this optimization are not known. In the present
      report we will suggest a mechanism of matching on the basis of the following
      arguments. 1) Mean aortic pressure, the perfusion pressure for most organs, most
      notably the cerebral circulation, is similar in mammals. 2) Heart period (T), a
      cardiac parameter, is related to body mass in a similar way as the decay time
      (tau = RpC, where R is peripheral resistance and C is total arterial compliance)
      of aortic pressure in diastole, a vascular parameter. In other words, the ratio
      of T/tau is similar in all mammals and assures a similar aortic pressure in
      diastole so that coronary perfusion, which mainly takes place in diastole, is
      guaranteed. 3) Assuming given mechanical properties of mammalian cardiac muscle,
      optimal power delivery relates to a minimal cardiac size; in other words, during
      evolution total cardiac volume was minimized, resulting in a heart that pumps at
      maximal power.

PMID- 1760515
TI  - The extracellular matrix in human myocardium: Part I: Collagens I, III, IV, and
      VI.
AB  - The composition of the extracellular matrix in normal human myocardium obtained
      at open-heart surgery was investigated using monoclonal antibodies against the
      collagens I, III, IV, and VI, and fluorescence microscopy. The aim of the study
      was to provide information on normal myocardium that could be used in the
      evaluation of pathological changes. Porcine myocardium was used for comparison,
      and both tissues showed a perfect agreement of the results, apart from collagen
      IV. This was negative in pig myocardium, due to the species specificity of the
      antibody. Collagens I and III were localized in the extracellular space as either
      coarse or fine fibrillar structures; the cellular elements of the interstitium,
      except for the endothelial cells, were also stained. Labeling for collagen VI was
      much finer than for the other collagens, and was present throughout the
      interstitium. Collagen IV stained the basement membranes of myocytes and
      capillary endothelial cells, and also labeled the T-tubular system in the
      myocytes. The second part of this communication will describe the localization of
      fibronectin, laminin and vimentin in normal human myocardium.

PMID- 1760516
TI  - Effects of propionyl-L-carnitine in chronically hypoperfused ("hibernating")
      myocardium.
AB  - The purpose of this report was to test the effects of systemic treatment with
      propionyl-L-carnitine in a new model of chronically hypoperfused ("hibernating")
      myocardium. Adolescent swine were instrumented to undergo a period of mild
      partial coronary constriction for 1 week (50% reduction of the maximum phasic
      flow velocity in the anterior descending coronary artery). This reduced regional
      mechanical function by 56%. The system satisfied criteria defining "hibernating"
      myocardium, in that the chronic hypoperfusion did not produce massive tissue
      necrosis and that the reduction in regional contraction remained responsive to
      inotropic stimulation. Treatment with 50 mg/kg propionyl-L-carnitine by mouth
      twice daily for 1 week significantly (p less than 0.0005) increased
      concentrations of free and total carnitine in the myocardial tissue by 39% and
      31%, respectively. Treatment with propionyl-L-carnitine did not alter regional
      systolic shortening in either hibernation or reperfusion for 2 hours, but
      enhanced one estimate of contractility reserve based on the rate of left
      ventricular emptying with occlusion of the inferior vena cava. Propionyl-L
      carnitine did not reverse the observed impairments in mitochondrial respiration
      (diminutions in state 3 respiration and the respiratory control ratio), but
      limited the number of lesions seen on histological examination. Six out of eight
      placebo hearts showed one or more changes of ischemia, infarction or reperfusion
      injury, while the same was true in only two out of eight hearts treated with
      propionyl-L-carnitine (p less than 0.003). Carnitine and various analogues have
      been proposed to benefit ischemic myocardium. The present data suggest that this
      general sparing effect may also occur with the propionyl derivative in
      chronically underperfused myocardium.

PMID- 1760517
TI  - The efferent mechanisms of reflex hemodynamic responses to distension of the
      descending colon in anesthetized dogs.
AB  - We have recently shown that distension of the descending colon in anesthetized
      dogs causes reflex increases in heart rate, aortic blood pressure and the maximal
      rate of rise of left ventricular pressure, involving afferent pathways in the
      hypogastric nerves. In this study we have examined the efferent mechanisms
      involved in those responses. The descending colon was distended using Ringer
      solution at constant pressure in 13 anesthetized dogs. As previously shown,
      distension of the colon caused an increase in aortic blood pressure, heart rate
      and the maximal rate of rise of left ventricular pressure. The increase in the
      aortic blood pressure was abolished by either bretylium tosylate or phentolamine.
      Propranolol or bretylium tosylate abolished the increases in heart rate when
      changes in the aortic blood pressure were prevented, and abolished the increases
      in the maximal rate of rise of left ventricular pressure when the increases in
      heart rate were also prevented. These results indicate that the reflex increases
      in heart rate, arterial blood pressure and the maximal rate of rise of left
      ventricular pressure involved efferent sympathetic pathways.

PMID- 1760518
TI  - Diuretics as initial and sole treatment in chronic cardiac failure.
AB  - Six patients with chronic congestive cardiac failure, who had never received any
      drug treatment, were studied before and after one month of therapy with frusemide
      alone at a dose of 40 mg a day. Measurements were made at rest of plasma
      epinephrine, norepinephrine, renin activity, aldosterone, atrial natriuretic
      peptide, cortisol, growth hormone and prolactin, together with central
      hemodynamics, body fluid volumes and renal function. The initial measurements of
      hemodynamics, body fluid compartments and renal function confirmed the presence
      of the physiopathology typical of congestive cardiac failure. Plasma
      concentrations of norepinephrine, atrial natriuretic peptide, aldosterone and
      growth hormone were significantly increased. The mean value of plasma renin
      activity, although high, was not significantly different from normal. After one
      month of treatment, body weight, body fluid volumes and exchangeable sodium were
      reduced. Hemodynamics and renal plasma flow and glomerular filtration were not
      significantly affected. Plasma norepinephrine fell to within normal limits;
      atrial natriuretic peptide increased significantly; plasma renin activity and
      cortisol increased to levels which were abnormally high; growth hormone increased
      to levels similar to those associated with acromegaly. Increased circulating
      concentrations of atrial natriuretic peptide during treatment by frusemide may
      have an important influence on the kidney, blood vessels and neuro-endocrine
      response.

PMID- 1760519
TI  - Platelet-mediated cytotoxicity and its enhancement by platelet activating factor.
AB  - Platelet cytotoxicity was assessed in 70 cancer patients with various tumor
      localizations and in 30 normal donors. The data presented reveal that the ACL
      cell line displays the highest sensitivity to platelet cytotoxicity. Using the
      ACL cells, we discovered that platelets from oncological patients and normal
      donors display comparable cytotoxicity. The level of platelet lytic activity is
      irrelevant to tumor localisation; however, it appears to be dependent on the
      stage of tumor growth. Incubation of platelets, both from donors and patients,
      with PAF (concentration range 10 pM to 10 nM) results in a significant rise of
      the killing activity of platelets. PAF induces greater cytotoxicity enhancement
      for platelets with lower initial activity, this pattern appearing to be the
      specific feature of the PAF mediated effect. Hence, platelets can be considered
      as effector cells relevant to antitumor immunity; PAF-mediated enhancement of
      platelet cytotoxicity can appear to be useful in the search for new
      immunotherapeutic drugs.

PMID- 1760520
TI  - Monocytic origin of fibroblasts: spontaneous transformation of blood monocytes
      into neo-fibroblastic structures in osteomyelosclerosis and Engelmann's disease.
AB  - We describe here two pathological situations, osteomyelosclerosis and Engelmann's
      disease, in which HLA-DR blood monocytes modulate to the fibroblastic class, in
      long-term culture. Monocytes/macrophages were identified by immunofluorescence,
      using monoclonal antibodies against surface markers (Leu M3, CD 68, and HLA-DR)
      and the neo-fibroblasts by electron microscopy and immunofluorescence using
      monoclonal antibodies against a cytoplasmic enzyme specifically involved in the
      synthesis of collagen (5B5). Macrophages makers were found on the neo
      fibroblasts, whereas HLA-DR macrophages expressed the cytoplasmic marker 5B5.
      Since osteoblasts are classically derived from fibroblasts, the significance of
      the in vitro differentiation of monocytes/macrophages into fibroblasts to the in
      vivo mechanism leading to excessive osteoblastic proliferation in both
      osteomyelosclerosis and Engelmann's disease, is discussed. The possible
      involvement of this pathway leading from monocytes to fibroblasts and osteoblasts
      in the normal process of bone modeling and remodeling in questioned.

PMID- 1760521
TI  - Effect of fusafungine on adherence of Haemophilus influenzae type b to human
      epithelial cells in vitro.
AB  - Haemophilus influenzae, a normal host of the nasopharynx of humans, may become a
      pathogen. The first step of infection is adherence to epithelial cells of the
      nasopharynx through glycopeptidic adhesins, or pili. Adherence to human
      epithelial cells in continuous lines, HeLa and Hep2, of 8 piliated strains of
      Haemophilus influenzae isolated from human infections of the respiratory tract
      was studied in vitro in the presence of fusafungine, a local bacteriostatic
      antibiotic. When the bacteria were grown in the presence of 0.5 x the MIC,
      fusafungine afforded 45-75% of adherence inhibition, but this inhibitory effect
      did not parallel the MICs. In contrast, no significant effect could be observed
      either when epithelial cells were exposed to 0.5 x the MIC before use in the
      adherence assay, or when this assay was performed in the presence of 0.5 x the
      MIC of fusafungine. The partial adherence inhibition observed suggests that
      fusafungine interacts with the bacterial binding sites but that other mechanisms
      may contribute to the inhibitory process. This effect of fusafungine should
      prevent but not eradicate colonization of the nasopharyngeal mucosa by
      Haemophilus influenzae and may account for the therapeutic efficacy reported in
      infections of the respiratory tract due to Haemophilus influenzae.

PMID- 1760522
TI  - Calcitonin and metabolic alkalosis.
AB  - Calcitonin is used in the treatment of osteoporosis and several adverse effects,
      such as rash, antibody presence, hypocalcemia, etc have been reported with the
      therapeutic use of large quantities of this hormone. The results found in this
      paper show that 7 h after administration of large doses of calcitonin to
      osteoporotic patients on hormone treatment, the acid-base status shifts to
      metabolic alkalosis. This represents another adverse effect of the use of
      pharmacological doses of calcitonin.

PMID- 1760523
TI  - Increased level of soluble interleukin-2 receptor in sera of patients with
      Graves' disease.
AB  - Soluble interleukin-2 receptor was studied in 20 patients with Graves' disease
      before and after methimazole treatment. Soluble interleukin-2 receptor level was
      significantly increased in newly diagnosed Graves' disease compared to controls
      (667 +/- 270 vs 205 +/- 45 U/ml) (P less than 0.001). In untreated patients' sera
      the soluble interleukin-2 receptor levels were higher in patients with active
      ophthalmopathy than in those without eye symptoms. Soluble interleukin-2 receptor
      levels were normalized in remission induced by methimazole treatment in the
      majority of patients except those with infiltrative ophthalmopathy. Furthermore,
      a correlation was found at the hyperthyroid stage of the disease between soluble
      interleukin-2 receptor level and titre of anti-TSH-receptor antibodies. However,
      the association with other parameters including anti-eye muscle, anti-thyroid
      peroxidase, anti-thyroglobulin antibodies was not significant.

PMID- 1760524
TI  - Hypocalcemia and hypomagnesemia in cancer patients.
AB  - The aim of this study was to evaluate the incidence of hypocalcemia and
      hypomagnesemia and the relationship between calcium and magnesium serum levels in
      82 hospitalized cancer patients, 61 of whom were in the terminal phase of the
      disease. The frequency of hypocalcemia and hypomagnesemia was 13.4% and 17.1%
      respectively. The incidence of hypocalcemia in patients with hypomagnesemia was
      28.6%, while in those with normal or high magnesium serum levels it was 10.3%.
      The lowest magnesium serum level was observed in hypocalcemic patients. It may
      thus be concluded that hypocalcemia and hypomagnesemia are a frequent
      complication of malignant tumors mostly in the terminal stage of the disease, and
      that even hypomagnesemia could contribute to the development of tumor-associated
      hypocalcemia.

PMID- 1760525
TI  - Activated murine B cells promote CFU-S proliferation through the release of
      soluble factors.

PMID- 1760526
TI  - Detection of barbiturate-induced surface changes in cerebrocortical synaptosomes
      by phase partitioning in an aqueous two-phase system.
AB  - The barbiturates tested in this work (barbital, phenobarbital, thiopental and
      pentobarbital) modify the partition of synaptosomes in a Dextran T500
      poly(ethylene glycol) 4000 two-phase system. Under adequate experimental
      conditions, the drugs increase the partition into the upper phase and this effect
      appears to be due to an action on the biological material and not on the
      interface potential of the system. This conclusion can be drawn from the fact
      that synaptosomes preincubated with low concentrations (0.1 mM) of barbital and
      pentobarbital maintained an increased partition into the upper phase. The extent
      of the effect observed appeared to be inversely proportional to the
      hydrophobicity of the drugs since phenobarbital and barbital showed a higher
      effect than thiopental and pentobarbital. Dithionite-induced anoxia, rotenone and
      ouabain also induced a similar increase of partition of synaptosomes into the
      upper phase, suggesting that the surface changes detected by phase partitioning
      modification of synaptosomes could be somehow related to the bioenergetic
      maintenance of the membrane ATPase.

PMID- 1760527
TI  - Up-modulation of phorbol dibutyrate receptors by carbachol and arachidonic acid
      in rat prostatic epithelial cells.
AB  - Phorbol dibutyrate (PDBu) binding to rat prostatic epithelial cells has been
      measured as an indirect determination of protein kinase C in this cell system.
      Analysis of [3H]PDBu binding using competitive displacement demonstrated a single
      class of PDBu receptors with a Kd = 141 nM and a binding capacity of 4.8 pmol
      PDBu bound/mg cell protein. Raising cytosolic Ca2+ levels by redistribution of
      intracellular Ca2+ after cell treatment with carbachol or arachidonic acid (which
      also affects the bulk biophysical properties of the cell membrane) resulted in up
      regulation of the available number of PDBu receptors. These results appear to be
      a consequence of PKC translocation from the cytosolic compartment to the plasma
      membrane after a cytosolic Ca2+ increase, confirming previous results in other
      cell systems.

PMID- 1760528
TI  - Increased insulin receptor binding in erythrocytes from growth hormone-deficient
      children.
AB  - Erythrocytes from growth hormone-deficient children (GHd-children) (n = 10)
      showed a statistically significant increase in insulin binding at low unlabeled
      insulin concentrations, together with a threefold decrease in apparent receptor
      affinity, as compared to control children (C) (n = 11). Scatchard analysis of the
      binding data using the two-site model revealed that both the receptor
      concentration R1 [GHd-children 0.10 +/- 0.01 ng/ml and C 0.03 +/- 0.002 ng/ml]
      and the dissociation constant KD1 [GHd-children (0.48 +/- 0.05) x 10(-9) M and C
      (0.19 +/- 0.01) x 10(-9) M] for high affinity-low capacity sites were
      significantly increased in erythrocytes from GHd-children, while neither receptor
      concentrations (R2) nor the dissociation constant (KD2) for low affinity-high
      capacity sites proved to be altered. These events were accompanied by a normal
      sensitivity to insulin as well as glucose tolerance in the GHd-group. The meaning
      of the increased insulin binding with normal insulin sensitivity in GH-deficiency
      is discussed.

PMID- 1760529
TI  - The influence of chlorpromazine on the potential-induced shape change of human
      erythrocyte.
AB  - The effect of chlorpromazine (CPZ) on the shape of human erythrocytes with
      different values of transmembrane potential (TMP) was investigated. The shape of
      red blood cells with negative values of the TMP remained unchanged after the
      formation of stomatocytes by chlorpromazine, while cells with positive TMP showed
      a characteristic time course of shape change during the incubation with CPZ.
      Experiments with vanadate show that this might be due to a difference in the
      activity of the phospholipid-translocase at different values of TMP.

PMID- 1760530
TI  - A significant pool of amino acids is adsorbed on blood cell membranes.
AB  - It is well known that the amino acids in the blood are distributed between the
      plasma and inside the cells. This study was conducted to determine whether amino
      acids can be located adsorbed on blood cell membranes. The amino acid
      concentration in the deproteinized haemolysed blood was higher than that in the
      fraction of blood after removal of the blood cell membranes by centrifugation.
      These results showed that a pool of amino acids representing 21.1% of the whole
      blood cell amino acids was adsorbed on the blood cell membranes of adult Wistar
      rats. The non-polar amino acids showed high adsorption on the membrane, whereas
      out of the polar amino acid group, only the non-ionic amino acids did adsorb.

PMID- 1760531
TI  - Dynamics of autocatalytic reaction networks. IV: Inhomogeneous replicator
      networks.
AB  - The inhomogeneous replicator equation is derived as the continuous time model for
      parallel first and second order autocatalytic replication of macromolecules in a
      flow reactor based on mass action kinetics. It is shown that the total
      concentration of replicating material determines the relative importance of the
      first order and the second order mechanism. A complete description of the
      dynamics of the first order model and some special features of the inhomogeneous
      replicator equation are presented. A minimal prebiotic scenario with the
      potentiality to develop cooperation is derived from the inhomogeneous replicator
      equation. In this model cooperation can emerge when the total concentration of
      replication material exceeds a certain threshold. Below this value, a single
      species is selected; which one is determined by the rate constants of the first
      order reaction alone. Above this threshold the second order process becomes
      important and may lead to cooperative behavior such as hypercycles.

PMID- 1760532
TI  - What is the role of predation on stability of natural communities? A theoretical
      investigation.
AB  - A basic question in ecology concerns the role of species interaction on dynamics
      of natural communities. In this framework, ecologists have considered predation,
      competition, mutualism, the three most important interactions, highlighting their
      specific effects on distribution and abundance of species, providing knowledge
      about phenomena like coexistence and extinction. This paper seeks to identify the
      effects of predation on stability of natural communities by mathematical models.
      Simple multispecies community models, organized in trophic levels, are analyzed
      by means of a qualitative technique, loop analysis, combined with a computer
      calculation procedure. Results do not support the hypothesis of predation as a
      stabilizing factor. Rather, the outcomes of the analysis suggest that predation
      may or may not stabilize a community. This depends on the predator's behaviour
      and on the network of the community.

PMID- 1760533
TI  - Modeling of biological and medical systems: a systemic strategy.
AB  - A strategy in the frame of General System Theory is proposed for the study of
      biological systems for medical purposes. Its definition and use requires in each
      experiment the collaboration between physician and system scientists and hence
      the definition of a common language, by which the real system under study is
      described. The strategy is based on three intermingled steps: first an ingenuous
      model is proposed, gathering all the medical knowledge about the studied system,
      organized within an informal frame derived from the state space approach. Next, a
      functional model is derived, enlightening the organization of the relations in
      the medical model. Finally, this organization is formalized by the most suitable
      algebraic tools, which are thereafter translated into APL programs. This last
      version is used for simulation, which is exploited not only as a tool to describe
      and make provisions on the dynamics of the models, but also to deepen and improve
      the knowledge about the observed system.

PMID- 1760534
TI  - A theoretical analysis of the effect of placental metabolism on fetal oxygenation
      under conditions of limited oxygen availability.
AB  - The purpose of this theoretical paper is to examine the effects of placental
      metabolism on fetal oxygenation under conditions of limited oxygen availability.
      Features of the mathematical model used here include: (1) ordinary non-linear
      differential equations defining the oxygen partial pressure profiles in the
      maternal and fetal streams for a concurrent flow pattern; (2) the presence of
      maternal and fetal blood flow shunts; (3) consumption of oxygen by a
      metabolically active placenta; and (4) modification of the fetal input to the
      placenta by changing the rate of fetal oxygen consumption in response to changes
      in the rate of oxygen delivered to the fetus via the umbilical vein. Model
      parameters were chosen to be well within the range of values cited in the
      literature. Based on these calculations, we conclude that: (1) under normal
      conditions, approximately one-half of the fetal uterine-umbilical venous oxygen
      partial pressure difference can be attributed to placental oxygen consumption;
      (2) utilization of fetal oxygen to help maintain the metabolic activities of the
      placenta does not significantly impair fetal oxygenation under normal conditions;
      (3) consumption of oxygen by the placenta will have a significant detrimental
      effect on the rate of oxygen delivered to the fetus if oxygen availability is
      compromised; and (4) for the same rate of maternal oxygen delivered to the
      placenta, maternal hypoxemia has a significantly greater adverse effect on fetal
      oxygenation than does maternal anemia.

PMID- 1760535
TI  - Acute renal tubular and hemodynamic effects of the calcium antagonist felodipine
      in healthy volunteers.
AB  - To evaluate the renal tubular effects of felodipine in a low (1.25-mg) and a high
      (10-mg) dose, lithium clearance was measured and related to renal hemodynamics in
      10 healthy volunteers. After felodipine (1.25 mg), mean blood pressure decreased
      4 mm Hg and heart rate increased 4 beats per minute. GFR and renal hemodynamics
      were unaltered. Natriuresis and diuresis increased and lithium clearance and
      fractional excretion of lithium were unchanged as compared with placebo.
      Felodipine (10 mg) decreased mean blood pressure 8 mm Hg; heart rate increased 16
      beats per minute, and plasma catecholamines were elevated. GFR was unaltered,
      whereas RBF increased and renal vascular resistance decreased. Natriuresis and
      diuresis were further increased, and lithium clearance and fractional excretion
      of lithium were elevated. In conclusion, felodipine in a low dose of 1.25 mg,
      which did not change renal hemodynamics, had natriuretic and diuretic effects at
      a predominantly postproximal tubular site, whereas a high dose of 10 mg, which
      increased RBF and decreased renal vascular resistance, had additional natriuretic
      and diuretic effects in the proximal tubule.

PMID- 1760536
TI  - Lack of plasma interleukin-1 beta or tumor necrosis factor-alpha elevation during
      unfavorable hemodialysis conditions.
AB  - Plasma interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha)
      were determined by ELISA in 17 healthy controls, 23 HD patients, 10 continuous
      ambulatory peritoneal dialysis patients, and 15 chronic renal failure patients,
      as well as in 2 HD patients experiencing pyrogenic reactions. Another group of 10
      chronic HD patients were dialyzed for 2.5 h, 5 with first-use Cuprophan membranes
      and 5 with first-use high-flux cellulose triacetate membranes. The mean bacterial
      and endotoxin concentrations of the dialysate used for HD treatments during the
      study period were 18,440 +/- 530 CFU/mL (mean +/- SEM) and 976 +/- 205 pg/mL,
      respectively. Blood specimens were obtained intradialysis and postdialysis for
      cytokine assay and were incubated to augment cytokine production. There was no
      difference in plasma IL-1 beta or TNF-alpha concentrations among the healthy
      controls, continuous ambulatory peritoneal dialysis patients, chronic renal
      failure patients, or HD patients. Neither cytokine increased significantly during
      or after HD. Two patients experiencing pyrogenic reactions had plasma TNF-alpha
      concentrations of 537 and 413 pg/mL, compared with matched controls of 6 and 0
      pg/mL. Il-1 beta concentration did not differ from controls. We conclude that:
      (1) plasma IL-1 beta and TNF-alpha are not chronically elevated in chronic renal
      failure, continuous ambulatory peritoneal dialysis, or HD patients; (2) HD with
      new Cuprophan or cellulose triacetate membranes and high concentrations of
      dialysate endotoxin and bacteria does not cause elevation of circulating IL-1
      beta or TNF-alpha; and (3) pyrogenic reactions might be mediated by TNF-alpha.

PMID- 1760537
TI  - The effect of long-term intravenous calcitriol administration on parathyroid
      function in hemodialysis patients.
AB  - Secondary hyperparathyroidism is common in dialysis patients. Intravenous
      calcitriol has proven to be an effective therapy for the reduction of parathyroid
      hormone (PTH) levels. However, the effect of i.v. calcitriol on parathyroid
      function, defined as the sigmoidal PTH-calcium curve developed during
      hypocalcemia and hypercalcemia, has not been evaluated during the prolonged
      administration of i.v. calcitriol. Six hemodialysis patients with marked
      secondary hyperparathyroidism, PTH levels greater than 500 pg/mL (normal, 10 to
      65 pg/mL), were treated for 42 wk with 2 micrograms of i.v. calcitriol after each
      hemodialysis. Parathyroid function was evaluated before and after 10 and 42 wk of
      calcitriol therapy. Between baseline and 42 wk, the basal PTH level decreased
      from 890 +/- 107 to 346 +/- 119 pg/mL (P less than 0.02) and the maximally
      stimulated PTH level decreased from 1293 +/- 188 to 600 +/- 140 pg/mL (P less
      than 0.01). In addition, calcitriol administration significantly decreased PTH
      levels throughout the hypocalcemic range of the PTH-calcium curve. Although the
      slope of the PTH-calcium curve (with maximal PTH as 100%) decreased between
      baseline and 42 wk (P less than 0.05), the set point of calcium did not change.
      Two patients with a decrease in both basal and maximally stimulated PTH levels
      after 10 wk of calcitriol, developed marked hyperphosphatemia between 10 and 42
      wk; this resulted in an exacerbation of hyperparathyroidism despite continued
      calcitriol therapy. In conclusion, prolonged i.v. calcitriol administration is an
      effective treatment for secondary hyperparathyroidism in hemodialysis patients
      provided that reasonable control of the serum phosphate is achieved. In addition,
      the slope of the PTH-calcium curve may be a better indicator of parathyroid cell
      sensitivity than the set point of calcium.

PMID- 1760538
TI  - Regulation of taurine transporter activity in LLC-PK1 cells: role of protein
      synthesis and protein kinase C activation.
AB  - Taurine transporter activity increases after exposure of cultured renal
      epithelial cells to taurine-free medium for 24 h and decreases after incubation
      in high (500 microM) taurine. This adaptive response mimics that observed in rat
      kidney after manipulation of dietary taurine. In order to elucidate potential
      mechanisms involved in the regulation of beta-amino acid transporter activity,
      the role of RNA transcription, protein synthesis, and protein import
      (trafficking), as well as protein kinase C activation, on the control of taurine
      transport was examined in the continuous proximally derived LLC-PK1 renal cell
      line. Inhibition of RNA transcription with actinomycin D did not alter the up
      regulatory and down-regulatory adaptive responses. Inhibition of protein
      synthesis with cycloheximide prevented the increased taurine transport in
      response to taurine-free medium as well as the decrease in taurine transport
      after exposure to high taurine. Colchicine prevented the response to taurine-free
      medium but had no effect on the response to high-taurine medium. Exposure of
      confluent cell monolayers to the active phorbol esters, phorbol 12-myristate 13
      acetate and phorbol 12,13 dibutyrate, resulted in a reduction in taurine uptake.
      The effect was seen within minutes of exposure but was not observed in the
      presence of the inactive phorbol 4-alpha. This inhibitory action was blocked by
      staurosporin, an inhibitor of protein kinase C (PKC). Treatment of cells with the
      diacylglycerol kinase inhibitor R59022, which results in increased intracellular
      diacylglycerol, a natural stimulant of PKC, also inhibited taurine uptake,
      providing further evidence for a specific effect of PKC activation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1760539
TI  - Cellular electrolyte and volume changes induced by acidosis in the rabbit
      proximal straight tubule.
AB  - Cellular acidosis induced either by high Pco2 or by low HCO3- concentrations has
      been shown to cause cell swelling in isolated, lumen-collapsed, S2 segments of
      the rabbit proximal tubule (Sullivan et al., Am J Physiol 1990; 258: F831-F839).
      The swelling is not followed by a volume regulatory response. The ionic basis of
      the swelling has been investigated by measurement of the cellular K+, Na+, and Cl
      content (electron probe) and HCO3- concentration (pH-sensitive fluorescent dye).
      Cell content of K+, Na+, and Cl- was expressed as a ratio to P content. Exposure
      to 15% CO2 increased K/P from 0.98 to 1.16, Cl/P from 0.14 to 0.20, and Na/P from
      0.09 to 0.11. Cell (HCO3-) increased from 22 to 32 mM. Reduction in bath (HCO3-)
      from 25 to 5 mM reduced cell (HCO3-) from 24 to 8 mM and increased K/P from 0.75
      to 0.90. Na/P fell from 0.13 to 0.09, and Cl/P fell from 0.15 to 0.12. Thus,
      swelling resulting from acidosis induced by high CO2 was accompanied by an
      accumulation of K+, Cl-, and HCO3-; that resulting from acidosis induced by a
      fall in (HCO3-) was combined with an accumulation of K+ and an unidentified
      anion. To determine if the swelling induced by a fall in pH might be coupled with
      depolarization of the basolateral membrane, the effect of 1 mM barium was tested.
      Barium caused cell volume to increase 10.2%. Cell pH rose from 7.38 to 7.56, K/P
      increased from 0.63 to 0.73, Na/P did not change, and Cl/P rose from 0.17 to
      0.20. Cell (HCO3-) increased 10.4 mM. When the pH of the barium-treated tissue
      was reduced to 7.02 by raising Pco2, additional cell swelling and accumulation of
      K+ occurred. The effect on cell volume of a reduction of bath (HCO3-) from 25 to
      5 mM at constant bath pH was determined. Cell pH was not altered. Cell volume
      decreased 3% initially and then returned to the control level. When the bath
      (HCO3-) was restored to 25 mM, cell volume increased 3.9% and then returned to
      the baseline. Thus, volume regulation was not impaired. It was concluded that a
      fall in cell pH induces swelling, and this is coupled with an accumulation of K+.
      This is probably the result of a pH effect on barium-sensitive and barium
      insensitive K+ conductance pathways. The nature of the anions that balance the
      gain in K+ depends on the means used to induce acidosis.

PMID- 1760540
TI  - Minimizing hemorrhagic complications in dialysis patients.
AB  - Renal failure is associated with an increased incidence of hemorrhage from a
      variety of sites, particularly in patients undergoing surgical procedures. The
      primary factors in the pathogenesis of bleeding in renal failure are platelet
      biochemical abnormalities and alterations in platelet vessel wall interactions.
      Hemodialysis improves hemostatic abnormalities in uremia, but the need for
      heparinization during the procedure may increase the bleeding risk. The risk of
      bleeding may be minimized by using peritoneal dialysis or alternative means to
      routine heparinization to prevent clotting in the extracorporeal circulation
      during hemodialysis. These include use of minimal heparin, prostacyclin, regional
      citrate anticoagulation, and no anticoagulation. Continuous arteriovenous
      hemodialysis may also be performed with regional citrate anticoagulation. There
      are several nondialytic therapies that may be used to prevent or treat hemorrhage
      in renal failure patients. These include administration of cryoprecipitate, 1
      deamino-8-arginine vasopressin, estrogens, red blood cells, and erythropoietin. A
      clinical strategy to minimize bleeding complications in dialysis patients is
      presented.

PMID- 1760541
TI  - Verapamil improves the outcome after cadaver renal transplantation.
AB  - Because of their favorable effects on renal hemodynamics, calcium antagonists may
      have a major role in the prevention and management of certain types of acute
      renal dysfunction. In fact, verapamil (VP) was shown to prevent cyclosporin A
      (CsA)-induced decreases in RBF in mice and in cadaver renal transplant (CRT)
      recipients. The study presented here of 59 cadaver renal transplant patients
      evaluates the outcome from perioperative treatment with VP (N = 30) administered
      intraoperatively into the renal artery (10 mg) followed by oral administration of
      120 mg every 8 to 12 h for 14 days versus no drug (N = 29). Early
      immunosuppression included azathioprine, corticosteroids, and antilymphocyte
      globulin with subsequent overlapping with CsA on days 5 and 6. Actuarial graft
      survival at 1 yr was different when the two groups were compared (P less than
      0.05). Estimated graft survival at 1 yr for VP patients was 93.3 compared with
      72.4% in control patients. The improved graft survival was most striking in
      repeat transplants with 90% graft survival at 1 yr for VP recipients versus 37.5%
      for controls. Compared with controls, VP recipients had significantly improved
      renal parenchymal diastolic blood flow velocities on the first day after surgery
      (7.8 versus 5.8 cm/s). By day 7, GFR were greater with VP (44 +/- 29 mL/min)
      versus controls (28 +/- 22 mL/min). Of VP patients, 67% (18 of 24) had GFR
      greater than 30 mL/min versus 33% (9 of 26) for control patients. Similarly, on
      the seventh day, 77% (21 of 30) of VP patients had serum creatinines less than
      2.0 mg% versus 34% (10 of 29) for controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760542
TI  - Influence of adenosine receptor blockade on renal function and renal
      autoregulation.
AB  - Experiments were conducted in anesthetized dogs to evaluate the effects of
      adenosine receptor blockade on renal function and on autoregulation of total RBF
      and outer cortical blood flow. After control measurements, the adenosine receptor
      antagonist, 1,3-dipropyl-8-p-sulfophenylxanthine (PSPX) was infused intrarenally
      for 45 min at 2 or 6 microM/min. Responses to PSPX were compared with those
      obtained during infusions of either aminophylline or theophylline. PSPX infusion
      led to substantial increases in urine flow and sodium excretion (four- to
      fivefold). RBF increased significantly; however, outer cortical blood flow and
      GFR were not significantly altered. PRA increased twofold during PSPX infusion.
      The vasoconstrictor responses to bolus injections of 2-chloroadenosine (100
      mumol) were attenuated by 58 and 86% during the low and high doses of PSPX and to
      a lesser extent with aminophylline/theophylline infusions. At renal arterial
      pressures above the inflection point, the slope of the average pressure-flow
      relationship during PSPX infusion was close to zero and was not significantly
      different from control. Similarly, autoregulatory capability was not altered
      during infusions of theophylline or aminophylline. These data provide further
      evidence that endogenous adenosine contributes substantially to the control of
      renin release but only modestly to the control of RBF and GFR and to renal
      autoregulatory capability. The natriuretic responses during adenosine blockade,
      which occurred in the face of elevated renin levels, support the hypothesis that
      endogenous adenosine enhances tubular sodium reabsorption rate.

PMID- 1760543
TI  - Implementing a computerized operating room management system.
AB  - The Queen's Medical Center implemented a computerized operating room management
      system in 1987 that includes surgery scheduling, intraoperative recording, and
      resource tracking. In addition to the important functional components, the system
      provides management with a better tool for decision-making. The purpose of this
      article is to describe this implementation. Background is provided to identify
      the manual system's deficiencies followed by the anticipated benefits of the
      computer system. The paper concentrates on Queen's implementation experiences in
      coding the surgical procedure information, confronting staff anxiety, managing
      the changing roles of the staff and providing adequate resources. Minimum
      requirements for a successful implementation include designating an effective
      project leader, assigning system responsibilities to the user, relieving all
      operational responsibilities from key members of the project team and providing
      adequate resources to support the system.

PMID- 1760544
TI  - Resource scheduling: from theory to practice.

PMID- 1760545
TI  - Knowledge-based schedule formulation and maintenance under uncertainty.
AB  - This paper is concerned with the dual sequential problems of (1) determining an
      acceptable personnel schedule over a specified time period, and (2) adjusting
      that schedule during the course of its execution in reaction to daily changes in
      both demand and available personnel. The first problem is schedule formulation;
      the second sequential problem is schedule execution. A rule-based, hierarchical
      system has been developed for first modeling and then solving both the schedule
      formulation and the schedule execution problems as a two-phase dependent process.
      The system is applied to the scheduling and staffing of nurses. A double-blind
      evaluation was conducted, which ascertained the quality of the resultant
      schedules in terms of maintainability, coverage, and personal satisfaction. The
      evaluation indicates that for units on which personnel changes have occurred, the
      prototype appears to perform as well as human schedulers.

PMID- 1760546
TI  - Automated nurse scheduling.
AB  - This article attempts (1) to define the several aspects of scheduling nursing
      personnel within the general context of nursing management, (2) to briefly review
      the history of the application of operations research and computers to scheduling
      nurses, (3) to describe what nursing administration is looking for in an
      automated scheduling system, (4) to review a typical system, and then (5) to
      discuss issues of implementation from the viewpoint of nursing administration,
      including realizable benefits.

PMID- 1760547
TI  - Continuous personnel scheduling algorithms: a literature review.
AB  - Hospitals frequently use personnel scheduling options as recruiting and retention
      instruments. The successful application of these personnel scheduling tools,
      whether developed in-house or purchased from vendors, requires appreciation of
      the interrelationships of three basic manpower decisions--staffing, personnel
      scheduling, and allocation. This article introduces these basic relationships and
      their influence on the development of satisfactory personnel schedules. Next, it
      reviews published personnel scheduling algorithms, applicable to hospital
      operations, within the context of the three manpower decisions. It is proposed
      that scheduling algorithms be classified by type of schedule produced (cyclic or
      noncyclic); and technique used (heuristic, mathematical programming, or self
      scheduling). The characteristics of each classification are discussed.
      Considerations for the development of new personnel scheduling algorithms are
      also presented.

PMID- 1760548
TI  - Computerized clinic scheduling system at the University of Michigan Medical
      Center.
AB  - The University of Michigan Medical Center has a flexible computerized clinic
      scheduling system that handles approximately 750,000 visits per year at the main
      hospital and satellite locations. The system includes a wide variety of fully
      integrated functions, including appointment booking, multiple and series
      scheduling, wait and reschedule lists, routine reminder notices, routine requests
      for medical records and radiology reports, no-show follow-up, and managerial
      reporting at multiple levels of detail. The system is extremely flexible, and
      allows separate scheduling specifications for every physician and all other
      resources within the system. The system is available at any of the approximately
      1,800 computer terminals throughout the Medical Center, and is regularly used at
      approximately 400 terminals.

PMID- 1760549
TI  - Resource and appointment scheduling: closing the information loop.
AB  - Hospital-wide preparation is currently underway for a new patient care
      information system at Baystate Medical Center in Springfield, Massachusetts.
      Integral to this new system are two new products recently developed by the TDS
      Healthcare Systems Corporation: a permanent patient record system and a resource
      and appointment scheduling application. The new patient care information system
      can maintain up to 16 million records on-line and can be used throughout the
      medical center. This article will focus on the resource and appointment
      scheduling application and how it can be used to track resource utilization and
      close the information loop related to patient appointment activities.

PMID- 1760550
TI  - Gay men and HIV/AIDS: understanding the double stigma.
AB  - Many men with HIV/AIDS are and will continue to be homosexual or bisexual.
      Effective care requires understanding the impact of the double stigma of being
      gay and having HIV/AIDS. While providers have traditionally focused on gay men
      with HIV disease as individuals, this article directs providers' attention to the
      importance of social dimensions in creating a plan of care.

PMID- 1760551
TI  - Overcoming methodological barriers to HIV/AIDS nursing research.
AB  - While more than 1,600 articles have been published in the nursing literature
      about HIV infection, only 54 (3%) have been research articles. The sparsity of
      nursing research related to HIV has partially resulted from methodological
      problems inherent in the implementation of research protocols with persons
      infected with HIV. The authors' focus is on methodological and ethical problems
      related to sampling patterns, informed consent, and protection of human subjects
      that have hindered the study of HIV infection. The underlying reasons for these
      problems as well as solutions and approaches to minimize or prevent the problems
      are presented.

PMID- 1760552
TI  - How long can HIV survive on environmental surfaces?

PMID- 1760553
TI  - Association of Nurses in AIDS care. Position paper: duty to care.

PMID- 1760554
TI  - Ten years: looking back, looking forward.

PMID- 1760555
TI  - Tuberculosis: the other epidemic.
AB  - In 1990, the number of cases of tuberculosis (TB) reported in the United States
      rose 6%. This is a noticeable change since, in prior years, TB had been
      declining. The increased incidence of TB is largely related to the HIV epidemic.
      TB is of particular interest in HIV-related illnesses, since it is preventable
      and treatable. The presentation of HIV-associated TB is different from "standard
      TB." Nurses need to be informed about the clinical presentation of the disease,
      the procedures to diagnose it, the treatments, and their potential side effects.

PMID- 1760556
TI  - The effect of flow on the interaction of isolated megakaryocytes with
      subendothelial extracellular matrix.
AB  - We have previously shown that human, guinea pig, or rat megakaryocytes, incubated
      under static conditions on an extracellular matrix (ECM) produced by endothelial
      cells, readily adhered to the matrix and underwent platelet-like shape change and
      thromboxane A2 secretion. We have now exposed megakaryocytes to ECM in a
      perfusion system similar to that used to study platelets circulated over aortic
      subendothelium. We used a continuous flow circuit incorporating a parallel plate
      perfusion chamber. Megakaryocytes were isolated to high purity from guinea pig
      marrow by centrifugal elutriation and velocity sedimentation. The cells were
      introduced into the flowing medium while the surface of an ECM-coated coverslip
      mounted in the chamber was observed continuously by phase-contrast video
      microscopy for up to 18 hours. Megakaryocytes from the flowing suspension started
      to adhere to the ECM within seconds. Significant adhesion occurred over a range
      of shear rates, from 10 to 190 seconds-1, did not appear above 300 seconds-1 and
      was greatest at a shear rate of 60 seconds-1. Adhesion to the ECM was specific,
      since there was no adherence to glass coverslips, glutaraldehyde-fixed ECM-coated
      coverslips, or to endothelial cells cultured on ECM-coated coverslips. At low
      shear rates large aggregates of megakaryocytes formed on the ECM surface; these
      could be detached and washed away by higher shear forces. Megakaryocytes thus
      acquire, even before platelet formation, an adhesive capacity similar to that of
      platelets. In addition, a significant fraction of the adherent megakaryocytes
      underwent elongation and pseudopod formation similar to that seen in marrow
      sinusoids.

PMID- 1760557
TI  - The platelet open canalicular system: a final common pathway.
AB  - Channels of the surface-connected, open canalicular system (OCS) of human
      platelets serve as the pathway for transport of substances into the cells and as
      conduits for the discharge of alpha granule products secreted during the platelet
      release reaction. The purpose of the present study was to determine if both
      functions of the OCS can take place simultaneously. Suspensions of washed
      platelets were exposed to thrombin at 1 U/ml for 5, 60, or 180 seconds in the
      presence of fibrinogen molecules coupled to particles of colloidal gold (Fgn/Au).
      The samples were fixed in a low concentration of glutaraldehyde and embedded in
      L.R. White resin to preserve antigenicity. Thin sections were exposed to a rabbit
      polyclonal antibody to human fibrinogen followed by an anti-rabbit IgG coupled to
      5-nm gold beads. Thrombin caused Fgn/Au particles to bind to platelets and enter
      channels of the surface-connected OCS. Endogenous fibrinogen detected by
      immunogold 5-nm beads were localized to alpha granules in resting platelets and 5
      seconds after thrombin stimulation. At 60 seconds and 3 minutes Fgn/Au particles
      were present in swollen alpha granules, as well as OCS channels. Fibrinogen gold
      beads were evident in alpha granules and OCS channels connected to the platelet
      surface. The 18- to 20-nm Fgn/Au particles were in the same channels of the OCS
      as fibrinogen gold beads. The OCS is a final common pathway for uptake of
      particulates and discharge of secretory products in thrombin-activated human
      platelets.

PMID- 1760558
TI  - Accurate determination of mean cell volume by isotope dilution in erythrocyte
      populations with variable deformability.
AB  - Variations in erythrocyte deformability and morphology lead to artifacts in
      electronic determinations of mean cellular volume (MCV) by the aperture-impedance
      method. The micropipette-aspiration technique loses accuracy when applied to
      severely aberrant cells such as dense sickle cells. A new light-scattering
      technique requires that the cells be capable of undergoing isovolumetric
      sphering. In contrast, the isotope-dilution (ID) method measures absolute mean
      volume and is free of artifacts associated with abnormal deformability or
      morphology. It does not depend on any algorithms or correction factors and does
      not subject the cells to any stringent processing, not even centrifugation. The
      ID method can be used to determine the mean volume of red cells in hypo- or
      hypertonic media or in the presence of pharmacologic agents. It requires no more
      than a 1-ml aliquot of suspended cells at a hematocrit of at least 30%. The cells
      can be readily recovered, washed, and reused. Using EDTA labeled with 57Co as an
      extracellular space marker we have used ID to determine the MCV of fractionated
      normal human red blood cells (RBC), unfractionated RBC containing SS hemoglobin,
      and RBC from four other mammalian species. In the case of human RBC obtained from
      eight normal donors, we obtained mean MCV values (+/- SD) of 83.6 +/- 3.0, 87.5
      +/- 3.9, and 76.5 +/- 5.3 fl for unfractionated and top and bottom 10% density
      fractions, respectively. The value 83.6 is significantly lower than the generally
      accepted range of 89-91 indicated by electronic analyzers calibrated against spun
      microhematocrits. The discrepancy of about 7% can account for the difference
      between mean cell hemoglobin concentration (MCHC) data determined by a calibrated
      Coulter Counter and corresponding data obtained with paired samples using a
      cyanmethemoglobin procedure specified in NCCLS Standard H15-A and corrected for
      trapped plasma.

PMID- 1760559
TI  - Effect of dehydration on the viscoelastic behavior of red cells.
AB  - Dehydration of red cells alters their rheological behavior and may contribute to
      the pathology of disorders such as sickle cell disease. We have measured the
      viscoelastic properties of individual human HbAA red cells after graded
      dehydration induced by incubation with valinomycin at different external K
      levels. With dehydration, the cells underwent progressive reduction in their rate
      of extensional shape recovery (i.e., after elongation by micropipette
      manipulation). Their rigidity remained unaffected until the mean cell hemoglobin
      concentration (MCHC) rose above 50 g/dl, but then increased about 100% as judged
      from the response of membrane tongues drawn into micropipettes. There was also a
      marked reduction in the shape recovery rate at this level of dehydration, and the
      cells no longer behaved elastically but rather showed unrecoverable residual
      deformation. Additionally, the cytoplasm took on solid-like properties. Changes
      in cell rigidity and shape recovery rate have been previously demonstrated for
      dense sickle cells; our results indicate that normal red cells can be induced to
      behave similarly, but that a greater degree of dehydration is required.

PMID- 1760560
TI  - Ultrastructural and morphometric alterations in bone marrow stromal tissue after
      7 Gy irradiation.
AB  - To evaluate the response of marrow stroma to 7 Gy irradiation, femoral bone
      marrow was fixed by vascular perfusion (so as to avoid the artificial destruction
      of sinus endothelia), and was examined using light and electron microscopy with
      morphometric methods. The radiation caused a marked decrease in hematopoietic
      cell number (NHC) within 3 days post-irradiation, followed by total recovery of
      hematopoiesis, which occurred gradually over 28 days. An increased number of fat
      cells was seen by 7 days. During the whole course of hypoplasia and recovery, the
      continuity of sinus wall, three-dimensional reticular mesh work in hematopoietic
      parenchyma, gap junctions (GJ) between stromal cells, the adventitial cell cover
      of sinus wall (ACC), and the stromal cell numbers of reticular cells (RC), sinus
      endothelia (SE), and macrophages (MP) were maintained. The cellularity of stromal
      components of RC, SE, and MP seemed passively increased in contrast to a
      reduction in numbers of NHC. A similar tendency was observed (1) between NHC and
      ACC and (2) between GJ and the cellularity of fat cells, which had a statistical
      significant correlation (p less than 0.05; t-test). The mechanism of radio
      resistance in bone marrow stroma and the possible functional adaptation and
      cellular coordination after irradiation are discussed.

PMID- 1760561
TI  - Response of marrow stroma to ionizing radiation.

PMID- 1760562
TI  - Optimized recirculation survival of mouse carrier erythrocytes.
AB  - Carrier mouse erythrocytes prepared by a hypotonic dialysis technique and
      reinjected into mice have a 24 hour survival of approximately 50%. Twenty-four
      hour survival can be improved substantially to 74% by removing the more fragile
      erythrocytes by a hypotonic wash treatment. The mean cell volume of the carriers
      prepared by this modification is significantly (p less than 0.01) different from
      cells prepared by the standard method with a isotonic wash treatment. Carriers
      prepared by the hypotonic treatment wash modification exhibit a different 50%
      hemolytic value (15% difference) from isotonically prepared carriers, and normal
      erythrocytes. Carrier-erythrocytes removed from mice 24 hour post-injection
      exhibit an osmotic profile that is independent of the treatment. Carriers were
      also prepared by another modification of the encapsulation procedure and held in
      a permeable state overnight before resealing and annealing. Carriers prepared in
      this manner showed a much lower 24 hour survival (13%).

PMID- 1760563
TI  - Epidemiology of inflammatory bowel disease over a 10-year period in Florence
      (1978-1987).
AB  - The epidemiology of inflammatory bowel disease (IBD) in southern Europe is still
      not well-known. Sporadic reports have suggested a lower incidence and a milder
      course of the disease in Italy, but conclusive data are still lacking. To shed
      light on this issue, we conducted a retrospective study of IBD incidence (from
      January 1978 to December 1987) in the metropolitan area of Florence (650,000
      inhabitants). We also estimated IBD prevalence at December 31, 1987. Our study
      included both in-patients and out-patients referred to the Gastroenterological
      and Surgical Departments of the area. The diagnosis was based on well-established
      clinical, endoscopical, radiological, histological and surgical criteria.
      Overall, nine-hundred IBD patients were identified, but only 359 (195 males, 164
      females) met the eligibility criteria for inclusion in the incidence study (area
      of residence and period of diagnosis); of these, 263 had ulcerative colitis (UC),
      96 had Crohn's disease (CD), and 6 had IBD. The average incidence rate of CD was
      1.5/100,000 per year while its prevalence was 17.3/100,000. The average incidence
      rate of UC was 4.0/100,000 per year and the prevalence was 49.6/100,000. Both the
      incidence and the prevalence rates for UC and CD were higher in males than in
      females. This retrospective, hospital-based study shows that, in this area, the
      incidence rate of IBD has steadily increased over the period considered. Further
      studies specifically focused on risk factors are needed.

PMID- 1760564
TI  - Early endoscopic cholangiopancreatography and sphincterotomy in acute biliary
      pancreatitis: report of 50 cases.
AB  - Endoscopic retrograde cholangiopancreatography (ERCP) was successfully performed
      in 49/50 consecutive patients with acute pancreatitis and suspected biliary
      aetiology in the early phases of the disease (24-72 hours from admission). ERCP
      showed common bile duct lithiasis and/or stenosis (25 cholecystectomized
      patients) in 41/49 cases (83.7%). In 38 patients endoscopic sphincterotomy (ES)
      was performed: stone removal was possible in lithiasic patients (36 cases, 13
      previously cholecystectomized); 3 further patients showed a main pancreatic duct
      stenosis (2 of these underwent pancreatic ES). The patients treated with ES
      showed a quick improvement in symptomatology and clinical outcome; no adverse
      effect of ERCP was found; no mortality was registered. Comparison with a previous
      series of 130 cases of acute biliary pancreatitis (ABP) showed a reduction in
      mortality, complications and length of hospitalization. These findings suggest
      that, from a diagnostic and therapeutic point of view, early ERCP is safe and
      useful in ABP.

PMID- 1760565
TI  - Fasting H2 breath values revised.

PMID- 1760566
TI  - Acute biliary pancreatitis.
AB  - Technological innovations in the past decade suggest that their systemic
      utilisation in acute biliary pancreatitis may have a significant impact on
      diagnosis and treatment. Urgent severity assessment resulting in the use of ERCP
      in patients with probable gallstones is essential since early endoscopic
      sphincterotomy may reduce morbidity and mortality. Contrast enhanced CT scanning
      is indispensable to the clinical decision-making process resulting in surgical
      intervention for necrosectomy. A rational application of diagnostic modalities,
      including ERCP, duodenal bile crystal analysis and dynamic biliary scanning, can
      greatly increase the proportion of patients with aetiological diagnosis, thereby
      enabling treatment to prevent further attacks. A fundamental knowledge of the
      patho-biochemical and patho-physiological nature of acute pancreatitis, however,
      is still required for further progress.

PMID- 1760567
TI  - The "stepchild" of gastroenterology?

PMID- 1760568
TI  - Omeprazole in short-term treatment of Helicobacter pylori positive duodenal
      ulcer.

PMID- 1760569
TI  - Evaluation of health and productivity of small ruminants in Africa: the example
      of Senegal.
AB  - The authors describe a system of investigation introduced into Senegal in 1983;
      their purpose is to extend knowledge about the farming of small ruminants and the
      epidemiological relevance of such farming. The investigations are conducted in
      the traditional livestock sector by using a multidisciplinary approach. The
      precision and reliability of the information depend on the recording and
      processing of data on individual animals. The system of investigation has a
      modular structure organised around a central module for demographic surveys. The
      peripheral modules correspond to specific activities: clinical surveillance,
      recording changes in body state, laboratory tests and a study of animal husbandry
      conditions and practices. The authors distinguish four levels of analysis
      depending on the origin of variables under consideration: a single module (level
      1), the demographic module plus the peripheral module (level 2), the demographic
      module plus two or more peripheral modules (level 3) and one or more modules
      derived from experimental modification of certain features of the husbandry
      system (level 4). The constraints and limitations of the procedure are discussed.

PMID- 1760570
TI  - Information systems for animal health: objectives and components.
AB  - As in most other technical and management fields, information management is fast
      becoming the key to effective action in animal health. A modern veterinary
      service requires effective systems for gathering relevant information from the
      field, processing it in ways which provide maximum value, and presenting it in a
      form which is easy for national policy-makers and field staff to use in
      implementing appropriate actions to achieve effective disease control. This paper
      describes seven objectives which should form the basis for developing an
      integrated national animal health information system. It also specifies six
      criteria which any information-gathering activity should be required to meet
      before it is allowed to commence. For each of the seven objectives, a description
      is given of how the particular component of the system can be used, with examples
      of how such information management procedures have been implemented in practice.
      Attention is drawn to other papers in this issue which describe various
      innovative techniques currently used to meet some of the objectives of a modern
      animal health information system.

PMID- 1760571
TI  - Application of ecopathological methods to the investigation of health problems on
      farms.
AB  - Application of the techniques of ecopathology to the investigation of health
      problems on farms has allowed a specific methodology for the study of enzootic
      diseases of multiple aetiology, dominant under intensive husbandry, to be
      developed. New knowledge about such diseases has accumulated for various species
      of animals. Finally, a procedure for regulating and managing the health risks of
      livestock farming is proposed.

PMID- 1760572
TI  - Geographic information systems: their application in animal disease control.
AB  - Geographic information systems (GIS) are computerised information systems that
      allow for the capture, storage, manipulation, analysis, display and reporting of
      geographically referenced data. They have been used in recent years for a wide
      variety of purposes, including town planning and environmental resource
      management. The technology has many features which make it ideal for use in
      animal disease control, including the ability to store information relating to
      demographic and causal factors and disease incidence on a geographical
      background, and a variety of spatial analysis functions. A number of possible
      veterinary applications are suggested, and three examples of the use of GIS in
      New Zealand are discussed.

PMID- 1760573
TI  - Satellite imaging as a technique for obtaining disease-related data.
AB  - Because of its initial expense, remote sensing imagery has been frequently
      ignored in studying the epidemiology and ecology of human and animal diseases.
      However, these digital images have many advantages when the theoretical
      restrictions and constraints on the data are understood. Remote sensing imagery
      has the potential significantly to improve the effectiveness and delivery of
      disease control programmes. As soon as it can be integrated into the operational
      aspects of programmes, remote sensing imagery will pass from being a data-driven
      research tool to being need-driven.

PMID- 1760574
TI  - Epidemiological methods for investigating wild animal reservoirs of animal
      disease.
AB  - The epidemiological and ecological methodologies used to investigate tuberculosis
      in badgers (Meles meles) in Great Britain are reviewed. The objectives of these
      studies have been, on the one hand, to investigate the causal association between
      Mycobacterium bovis infection in badgers and the occurrence of tuberculosis in
      cattle and, on the other, to acquire knowledge of the population biology of
      badgers and the dynamics of infection in order to identify, formulate and assess
      potential strategies. The studies provide examples of the possible approaches and
      the practical difficulties that investigations of wild animal populations
      present; the importance of a multi-disciplinary team which can be maintained for
      the protracted periods necessary for prospective studies is also highlighted. The
      most successful components of the research programme have been specific
      prospective studies of populations, as they provide the only means of
      understanding the dynamic aspects of the population biology and the epidemiology
      of infection and disease. Expedient, cross-sectional studies have, however,
      proved valuable in supplementing the main long-term studies.

PMID- 1760575
TI  - The application of risk assessment methods in making veterinary public health and
      animal health decisions.
AB  - The newly emerging discipline of quantitative risk assessment has wide
      application in the field of veterinary public health and animal health.
      Regulatory authorities are increasingly faced with public policy decisions that
      must assess the risks of new technology or practices relative to the potential
      benefits, thereby establishing a level of acceptable risk. The elements of risk
      are a choice of action, a probability of loss and a magnitude of loss. Perceived
      risk and actual risk are seldom equivalent; adoption of the methodologies used in
      technological and human health risk assessments will allow veterinary regulators
      to make better decisions. Determination of levels of acceptable risk are
      increasingly dependent on quantitative models, and examples are presented for
      evaluation of different post-mortem meat inspection systems, estimating disease
      risks associated with animal embryo transfer and formulating national border
      protection strategies. All models have some degree of subjectivity, and the
      decisions made by regulators and risk managers should incorporate a wide
      knowledge of the risk assessment process, as well as the conditions of use that
      will occur in the real world.

PMID- 1760576
TI  - Steps in the implementation of a micro-computer approach to the management of
      animal disease information.
AB  - The stages in the design, procurement and implementation of a micro-computer
      based animal health information system are described. The scenario presented is
      that of a national Director of Veterinary Services taking his first steps in the
      computerisation of an epidemiology unit, but sub-national and international
      issues are also discussed. The administrative and management aspects are
      considered and the need to incorporate computers into a carefully designed and
      appropriate information system is emphasised. The principles of the specification
      of initial systems and their subsequent development are described; suggestions
      are made for the procurement and continuing support of both hardware and
      software.

PMID- 1760577
TI  - The OIE world animal disease information system.
AB  - The priority task of international collection and dissemination of information
      concerning diseases of animals by the OIE has three purposes: to alert countries
      threatened by an epizootic, to strengthen international cooperation on the
      control of animal diseases, and to facilitate international trade in animals and
      animal products. In order to improve the quantity and quality of information
      received, the OIE has organised seminars on the reporting of diseases of animals
      in most regions of the world. The authors show that these seminars have had very
      positive results. To achieve further progress, it is indispensable for every
      country to have a truly operational national system for animal health
      surveillance. Consequently, some technical assistance projects have been
      undertaken, beginning with Asia and Oceania, to examine the difficulties
      encountered by certain countries and to propose solutions. Activities of the
      various specialist commissions of the OIE have also led to improvement in the
      quality of information, particularly by defining, with greater precision, the
      concepts currently employed in connexion with diseases of animals (e.g.
      infection, disease, infected zone), and by standardising methods of diagnosis and
      of the preparation of biological products for veterinary use. Finally, a concise
      account is given of the development at the OIE Headquarters of an animal disease
      database, its mode of operation and various improvements which could be
      introduced to better satisfy the needs of Member Countries.

PMID- 1760578
TI  - Appropriate animal health information systems for nomadic and transhumant
      livestock populations in Africa.
AB  - Nomadic and transhumant livestock comprise the normative mode of production in
      the arid and semi-arid regions of Africa. By adopting management practices with
      high human labor and informational input, pastoral societies have adapted to
      innately high environmental variability. The Western veterinary model, which
      developed under sedentary conditions of production, has been unable to address
      herd health problems in African pastoral regions. By soliciting the participation
      of pastoral people, however, it is possible to develop an animal health
      information system that is technically appropriate, economically viable and
      socially acceptable. The organizational structure of appropriate information
      systems can furnish the framework for animal health delivery under pastoral
      conditions.

PMID- 1760579
TI  - Hepatitis of viral origin in Leporidae: introduction and aetiological hypotheses.
AB  - In less than ten years, two very serious viral hepatic diseases have spread
      through Leporidae populations (rabbits and hares) in numerous countries. In May
      1989, the Office International des Epizooties designated this new disease of
      rabbits "viral haemorrhagic disease" and entered it as a List B disease in the
      International Animal Health Code. Clinically, the disease is very similar to the
      European brown hare syndrome. However, numerous uncertainties prevail today on
      the true nature of the viruses of the two species. Although they are related, the
      viruses appear to be different and cross infection between species has given
      contradictory results. Hepatitis of Leporidae have probably existed in Europe for
      several years, although their viral aetiology has been demonstrated only
      recently. The acute form has occurred in hares in Northern Europe since
      approximately 1980, while the inapparent (or ignored) form has been present in
      rabbits in Czechoslovakia since 1975. These diseases of Leporidae are true viral
      hepatitis which, in their fulminating forms, bear a remarkable resemblance to
      human viral hepatitis (B and non-A non-B) with regard to clinical symptoms,
      pathological lesions and mode of transmission. The dominant faecal-oral
      transmission observed for types A and E hepatitis would explain the particular
      susceptibility of family-kept rabbits, as they are fed potentially contaminated
      fodder. As the clinically similar fulminating hepatitis in human beings is caused
      by a diversity of viruses (both RNA and DNA), the disease in Leporidae might also
      be caused by different viruses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760580
TI  - Molecular biology of the viral haemorrhagic disease virus of rabbits.
AB  - Viral haemorrhagic disease virus (VHDV) of rabbits is a small, nonenveloped DNA
      virus which contains a linear, single-stranded genome approximately 7,000 bases
      in length. The virions are icosahedral in symmetry, consisting of 180 subunits
      with pentamer-hexamer clustering. The capsid is composed of four structural
      polypeptides: VP1:60-61 kDa, VP2:54.7 kDa, VP3:52 kDa, and VP4:26-28 kDa. VP1 is
      a major structural polypeptide which constitutes approximately 54.7% of the total
      viral proteins. There are extensive antigenic relationships among the
      polypeptides. Haemagglutination activity is associated with the intact virions.
      The genome of the VHDV isolate strain (VHDV-NJ) is partially cloned, and 4.6 kb
      DNA fragment of restriction mapping has been determined, showing that there are
      few common restriction sites compared with the restriction site mapping of the
      parvoviruses. There are five viral-specific mRNA species, each coding for one of
      the five polypeptides identified by in vitro translation. The cDNA library from
      viral mRNA has been established. Southern blot hybridisation shows that, to some
      extent, H-I virus, minute virus of mice, porcine parvovirus and goose parvovirus
      share homology with VHDV. However, to clarify VHDV taxonomy, further efforts must
      be directed towards VHDV genome analysis.

PMID- 1760581
TI  - Adaptation of the viral haemorrhagic disease virus of rabbits to the DJRK cell
      strain.
AB  - Liver emulsion of rabbits which had died of viral haemorrhagic disease (VHD) was
      inoculated onto DJRK cell culture. After two passages, specific cytopathic effect
      was observed. Immunofluorescence was found in the nucleus at the early stage of
      infection and later also in the cytoplasm. The virus propagated in cell culture
      at the fifth, tenth and sixteenth passages was found to cause typical VHD.
      Electron microscopy showed that there were numerous virions in the infected
      cells. The cultured virus, inactivated with formaldehyde, could elicit
      haemagglutination inhibition antibodies in the inoculated rabbits and protect
      them against the challenge of virulent VHD virus.

PMID- 1760582
TI  - Clinical and pathological features of viral haemorrhagic disease of rabbits and
      the European brown hare syndrome.
AB  - The authors review the clinical, macro- and microscopical features, and
      pathogenesis of viral haemorrhagic disease (VHD) of rabbits and the European
      brown hare syndrome (EBHS). The two diseases share similar clinical and
      pathological manifestations involving an acute syndrome, sometimes accompanied by
      nervous and respiratory symptoms and epistaxis, and in all cases by severe
      hepatic damage and multifocal haemorrhages leading to fatal shock. The hepatic
      lesions (necrosis and inflammation) result from direct cytolytic and indirect
      microthrombotic effects of the causal agent. Endothelial lesions and a primary or
      secondary defect of coagulation factors are possible causes of the haemorrhagic
      syndrome. Typical lesions consist of necrotic hepatitis and congestion,
      haemorrhaging and oedema of the lungs and trachea. The histological and
      ultrastructural alterations of the liver are similar to those found in certain
      cases of acute fatal hepatitis in man. The high correlation between
      histologically typical hepatic findings and immunohistochemistry and
      immunoelectron microscopy is of diagnostic value. Both microscopic lesions and
      pathogenesis favour the unifying definition of "infectious necrotic hepatitis of
      Leporids" for the two disease entities.

PMID- 1760583
TI  - Viral haemorrhagic disease of rabbits in the People's Republic of China:
      epidemiology and virus characterisation.
AB  - Viral haemorrhagic disease (VHD) is a new and severe infectious disease of
      rabbits, with a high rate of morbidity and mortality. The disease occurs
      throughout the year, affecting only adult rabbits and not other domestic animals,
      fowls or laboratory rodents. The transmission is horizontal, by direct or
      indirect contact, and through all routes. There is no evidence of congenital
      infection or biological vectors. The causative agent, viral haemorrhagic disease
      virus (VHDV), is present in all tissues, excretions and secretions. It is an
      icosahedral and nonenveloped parvo-like virus. The genome, as determined by
      classical methods, high performance chromatography and in vitro synthesis of
      double-stranded DNA, is linear, single-stranded DNA. VHDV can agglutinate human
      erythrocytes at very high titres, irrespective of blood groups, and has a stable
      reaction to many physical and chemical factors. VHDV has been adapted to grow on
      rabbit kidney cell strain (DJRK) culture and to produce cytopathic effect (CPE).
      Inactivated cell culture can protect inoculated rabbits against virulent VHDV.
      The disease is now effectively controlled in the People's Republic of China, but
      has not yet been completely eradicated.

PMID- 1760584
TI  - Viral haemorrhagic disease of rabbits in Mexico: epidemiology and viral
      characterization.
AB  - A fatal disease of rabbits was first reported in the People's Republic of China
      in 1984. Since 1986, the disease has been reported in most countries of Europe
      and in the Republic of Korea. In 1989 a similar disease, presumably linked to the
      importation of rabbit meat from the People's Republic of China, spread rapidly
      through ten states in Mexico; it was eradicated during the same year by "stamping
      out" measures. In Mexico, as was the case in other outbreaks, morbidity and
      mortality reached 80-90% with few clinical signs. In pathogenesis studies, the
      primary sites of replication were in the small intestinal crypt and villous
      epithelium, hepatocytes and splenic lymphocytes. Many organs, including the lung
      and kidney, contained acutely infarcted tissue and haemorrhages resulting from a
      terminal disseminated intravascular coagulopathy. The disease and the
      characteristics of the virus isolated in Mexico are similar to isolates from
      Europe and the Republic of Korea. The comparative morphologic, from Europe and
      the Republic of Korea. The comparative morphologic, immunologic, and in situ
      nucleic acid hybridization evidence for a parvovirus aetiology are summarized.

PMID- 1760585
TI  - Epidemiology and diagnosis of the European brown hare syndrome in Scandinavian
      countries: a review.
AB  - Outbreaks among European brown hares (Lepus europaeus, Pallas) of a fatal disease
      associated with severe liver damage have occurred in Sweden since the beginning
      of the 1980s. The disease, called the European brown hare syndrome (EBHS), was
      recognised in Denmark in 1982 and is today widespread in Denmark and southern
      Sweden. It has not been reported in Norway or Finland. Two species of hares are
      affected in Sweden, the European brown hare and the varying hare (Lepus timidus,
      Linnaeus). EBHS occurs both in free living and farmed hares. The disease is
      clearly seasonal, occurring most frequently in October, November and December. A
      virus related to the viral haemorrhagic disease of rabbits virus has been shown
      to cause EBHS. All attempts to isolate the virus in cell culture have been
      unsuccessful. Diagnosis can be made by histopathology and detection of the virus
      in organ homogenates by haemagglutination, negative staining electron microscopy
      and enzyme-linked immunosorbent assay (ELISA). Antibodies can be detected early
      by haemagglutination inhibition and ELISA.

PMID- 1760586
TI  - Viral haemorrhagic disease of rabbits: vaccination and immune response.
AB  - Results are presented for the large-scale use of a tissue vaccine, inactivated
      with beta-propiolactone and containing aluminium hydroxide adjuvant, against
      viral haemorrhagic disease of rabbits. The kinetics of haemagglutination
      inhibiting antibodies over eighteen months, the response of vaccinated animals to
      challenge infection with field virus between six and fifteen months after
      vaccination, the serological response to revaccination, and the immunological
      mechanisms involved in primary vaccination and revaccination were investigated.

PMID- 1760587
TI  - Vaccination against and immune response to viral haemorrhagic disease of rabbits:
      a review of research in the People's Republic of China.
AB  - Viral haemorrhagic disease (VHD) of rabbits is an acute entity with high
      mortality which affects adult rabbits. Several vaccines have been developed in
      China and extensive use of these vaccines in the field has controlled the spread
      of the disease. Formalin inactivated tissue vaccine induces solid immunity on the
      third to fourth day post vaccination and immunity lasts for at least six months.
      The oil-emulsion tissue vaccine which has been developed has longer lasting
      potency. Successful adaptation of VHD virus (VHDV) to cultured cells and
      preliminary immunisation will provide the possibility of large-scale production
      of cell-cultured virus vaccine. Passive, emergency immunisation with hyperimmune
      antiserum provides short-term protection of threatened rabbits as well as
      treatment of infected rabbits in the field. Histopathological and
      pathophysiological studies reveal that immune cells and organs are the most
      affected targets in infected rabbits; owing to the damage to the endothelial
      system of blood vessels, extensive disseminated intravascular coagulation (DIC)
      occurs in the parenchymal tissues. Destruction of the immune system and the
      occurrence of DIC lead to acute illness and sudden death post infection.
      Experimental immunological studies demonstrate that the induction of rapid
      immunity is coordinated by macrophages and T and B lymphocytes in the initial,
      post-immunisation stage, whereas humoral immunity plays the main role in long
      term protection against VHDV infection. The positive association of post
      vaccination protection with haemagglutination inhibition antibody can also be
      observed. Interferon probably takes effect as an anti-VHDV agent soon after
      vaccination.

PMID- 1760588
TI  - Systematic morphogenesis of the viral haemorrhagic disease virus in infected
      rabbits and in adapted cell culture.
AB  - The morphogenesis of viral haemorrhagic disease virus (VHDV) of rabbits in
      infected cell cultures and in tissues and cells from infected animals has been
      observed systematically by electron microscopy. Viral particles have been found
      to assemble through a condensation process within the nucleus of infected cells,
      having passed partially into the cytoplasm through disrupted nuclear membranes,
      enlarged nuclear pores or perinuclear space. Late in infection, both mature and
      immature virions are observed in the cytoplasm; these are often aggregated or
      interspersed and remain cell-associated long after infection. Release of the
      virus occurs when the cell finally lyses. In studies of the localisation and
      development of VHDV antigens, the viral antigens have been observed to appear
      first in the nucleus of infected cells and often thereafter in the cytoplasm.
      This finding is very similar to observations made by electron microscopy.

PMID- 1760589
TI  - Application of control measures against viral haemorrhagic disease of rabbits in
      the Czech and Slovak Federal Republic.
AB  - The first outbreaks of viral haemorrhagic disease (VHD) of rabbits were reported
      from eastern Slovakia in 1987. In 1988, the infection spread throughout the Czech
      and Slovak Federal Republic. Electron microscopy was used by the Veterinary
      Research Institute in Brno to diagnose the disease during the early stage of
      infection. At present, the regional laboratories of the veterinary investigation
      services use the haemagglutination and the direct immunofluorescence tests as the
      principal methods to demonstrate the causal agent. Indirect immunofluorescence
      and immunoperoxidase techniques have been developed to demonstrate VHD virus,
      while the enzyme-linked immunosorbent assay (ELISA) has been used to detect
      antibodies. Diagnostic kits, allowing a wide use of these methods, are now
      available commercially. Two types of inactivate vaccines were developed and
      produced in 1988 and 1989. VHD is controlled by vaccination of exposed rabbit
      colonies. This is accompanied by other preventive and protective measures,
      directed by district veterinary officers following instructions from federal
      authorities.

PMID- 1760590
TI  - The measurement of nucleoside deaminases by high performance liquid
      chromatography and their use in clinical chemistry.
AB  - The measurement of the nucleoside deaminases--cytidine deaminase, guanosine
      deaminase and adenosine deaminase--by reversed phase high performance liquid
      chromatography is reviewed. The clinical value of assaying the enzyme activity is
      discussed for each of these enzymes. Both cytidine deaminase and adenosine
      deaminase measurements have proven clinical value, although the use of the assay
      of cytidine deaminase in the diagnosis of pre-eclampsia is probably not helpful.

PMID- 1760591
TI  - A high performance liquid chromatographic method for the quantitation of
      flecainide in plasma.
AB  - A routine high performance liquid chromatographic method for the rapid
      determination of flecainide (Flecaine), using a novel internal standard, N
      methylflecainide, has been developed. After deproteinization of spiked samples,
      flecainide was totally recovered at neutral pH. Flecainide and the internal
      standard were separated on a reversed phase XL 3 microns ODS column using 10 mM
      phosphate buffer, pH 3.0: acetonitrile (70:30) as mobile phase, in less than 10
      min. With spectrofluorometric detection, the limit of quantitation for flecainide
      was 10 ng/mL. Intra- and inter-assay precision variations were 0.24% and 1.4%.

PMID- 1760592
TI  - Study of the solid phase extraction of pentoxifylline and its major metabolite as
      a basis of their rapid low concentration gas chromatographic determination in
      serum.
AB  - A gas-liquid chromatographic method for the determination of pentoxifylline and
      its secondary alcohol metabolite in serum has been developed. The method is based
      on the combination of solid phase extraction, capillary column separation and
      nitrogen-phosphorus detection of the analytes. Optimization of the solid phase
      extraction conditions permitted a low concentration determination, with limits of
      determination of 2 ng/mL and 10 ng/mL for pentoxifylline and its metabolite,
      respectively. The simplicity and rapidity of the extraction step was preserved.

PMID- 1760593
TI  - Disopyramide analysis using REMEDi: comparison with EMIT and conventional high
      performance liquid chromatographic methods.
AB  - REMEDi (Rapid EMErgency Drug identification; Bio-Rad) is an automated high
      performance liquid chromatographic (HPLC) system designed to detect, identify and
      measure a range of basic and neutral drugs in 0.5-1.0 mL of urine or
      plasma/serum. We have evaluated REMEDi in the analysis of the antiarrhythmic drug
      disopyramide in patient samples. The specimens were also analysed by a
      conventional HPLC method, based on solvent extraction and UV detection (254 nm),
      and by EMIT. There were good correlations between the results obtained with each
      method (r = 0.91 or greater). REMEDi gave a lower mean result than EMIT [means +/
      SD (mg/L): REMEDi 2.64 +/- 1.10, EMIT 3.14 +/- 1.51; t = 4.0, p less than 0.01;
      n = 25], but there were no other significant differences in mean results. The
      principal disopyramide metabolite, mono-N-desalkyldisopyramide, did not interfere
      in any method. Clearly REMEDi can be used for therapeutic drug monitoring of
      disopyramide provided enough sample is available.

PMID- 1760594
TI  - Rescuers' psychological responses to disasters.

PMID- 1760595
TI  - Lessons of Chernobyl.

PMID- 1760597
TI  - The health strategy and the hole at the centre.

PMID- 1760596
TI  - Artificial blood.

PMID- 1760598
TI  - German haemophilic patients infected with HIV.

PMID- 1760599
TI  - Prison policies on HIV under review.

PMID- 1760600
TI  - Childhood leukaemia and poliomyelitis in relation to military encampments in
      England and Wales in the period of national military service, 1950-63.
AB  - OBJECTIVE: To determine if any excess of childhood leukaemia was associated with
      the large and increasing numbers of national military servicemen in 1949 and
      1950, particularly in rural districts. This would be a further test of the
      hypothesis that childhood leukaemia can originate in an infection, the
      transmission of which is facilitated by an increased number of unaccustomed
      contacts in the community. DESIGN: Rural and urban districts, aggregated by
      county, were ranked by proportion of servicemen, and five groups containing
      similar numbers of children were created. In addition, individual local authority
      districts were ranked and grouped in tenths. Mortality from childhood leukaemia
      1950-3 was examined in these groups. Data on infectious diseases were also
      examined, as well as data on leukaemia in later periods. SETTING: England and
      Wales. SUBJECTS: Children aged under 15 years. RESULTS: In 1950-3 but not
      subsequently a significant excess of leukaemia in children under 15 was found in
      the fifth of county groupings with the highest proportions of servicemen. This
      was due mainly to a significant excess in children under 2 years (and especially
      in those under 1 year) in rural districts. It was confirmed among the tenth of
      local authority districts with the highest proportion of servicemen. These rural
      areas showed significantly more notifications of, and deaths from, poliomyelitis
      among children than the rural average. CONCLUSIONS: The findings support the
      infection hypothesis. That the excess of leukaemia was greatest in children under
      1 year suggests transmission of infection among adults and thence to the fetus.
      The pattern of spread of poliomyelitis may also have been influenced by the
      presence of large numbers of servicemen.

PMID- 1760601
TI  - A randomised trial comparing endometrial resection and abdominal hysterectomy for
      the treatment of menorrhagia.
AB  - OBJECTIVE: To determine the advantages and disadvantages of endometrial resection
      and abdominal hysterectomy for the surgical treatment of women with menorrhagia.
      DESIGN: Randomised study of two treatment groups with a minimum follow up of nine
      months. SETTING: Royal Berkshire Hospital, Reading. SUBJECTS: 51 of 78
      menorrhagic women without pelvic pathology who were on the waiting list for
      abdominal hysterectomy. TREATMENT: Endometrial resection or abdominal
      hysterectomy (according to randomisation). Endometrial resections were performed
      by an experienced hysteroscopic surgeon; hysterectomies were performed by two
      other gynaecological surgeons. MAIN OUTCOME MEASURES: Length of operating time,
      hospitalisation, recovery; cost of surgery; short term results of endometrial
      resection. RESULTS: Operating time was shorter for endometrial resection (median
      30 (range 20-47) minutes) than for hysterectomy (50 (39-74) minutes). The
      hospital stay for endometrial resection (median 1 (range 1-3) days) was less than
      for hysterectomy (7 (5-12) days). Recovery after endometrial resection (median 16
      (range 5-62) days) was shorter than after hysterectomy (58 (11-125) days). The
      cost was 407 pounds for endometrial resection and 1270 pounds for abdominal
      hysterectomy. Four women (16%) who did not have an acceptable improvement in
      symptoms after endometrial resection had repeat resections. No woman has required
      hysterectomy during a mean follow up of one year. CONCLUSION: For women with
      menorrhagia who have no pelvic pathology endometrial resection is a useful
      alternative to abdominal hysterectomy, with many short term benefits. Larger
      numbers and a longer follow up are needed to estimate the incidence of
      complications and the long term efficacy of endometrial resection.

PMID- 1760602
TI  - How do patients with HIV perceive their general practitioners?
AB  - OBJECTIVE: To study the perceptions of patients with HIV of their general
      practitioners in terms of knowledge, abilities, confidence, and satisfaction.
      DESIGN: Questionnaire survey of inpatients, outpatients, and members of a self
      help group. SETTING: Two city hospitals, three outpatient clinics, and one AIDS
      self help group in Munich and Berlin, Germany. SUBJECTS: All 402 patients
      available between 1 September 1988 and 31 May 1989. MAIN OUTCOME MEASURES:
      General practitioners' attitudes towards the patients' HIV status; patients'
      experience of treatment rejection; reception in the general practitioner's
      office; the doctor's perceived knowledge about HIV and AIDS. RESULTS: 394 of 402
      patients consented to interview; 87% were registered with a general practitioner
      and 91% of those indicated that the doctor was aware of their HIV diagnosis. The
      overwhelming majority of patients (94%) had a friendly or at least neutral
      reception in the general practitioner's surgery and only six patients' general
      practitioner changed his or her behaviour for the worse because of the HIV
      diagnosis. Two thirds of patients said they would consult first with their
      primary care doctor for a physical problem, but only 13% would do so for
      psychological problems. Over a third of the patients did not routinely inform
      other doctors or medical staff about their HIV status, but there was no
      significant correlation between this concealment and ever having been rejected by
      a doctor (7%) or a dentist (12%). CONCLUSION: Most patients expressed a high
      degree of satisfaction with their general practitioners in terms of confidential
      issues, attitudes, knowledge, and management.

PMID- 1760603
TI  - Genitourinary tract infections in pregnancy and low birth weight: case-control
      study in Australian aboriginal women.
AB  - OBJECTIVE: To investigate the association between genital and urinary tract
      infections in pregnant Aboriginal women and low birth weight. DESIGN:
      Retrospective case-control study controlling for potential confounding variables.
      SETTING: Western Australia from 1985 to 1987. SUBJECTS: All Aboriginal women (n =
      269) who had given birth to singleton infants weighing 2250 g or less (cases),
      and 269 randomly selected Aboriginal women who had given birth to singleton
      infants weighing 3000 g or more (controls). MAIN OUTCOME MEASURES: Proportions of
      women in case and control groups who had had genital and urinary tract
      infections; odds ratios for low birth weight when genitourinary tract infection
      was present; population attributable fraction of low birth weight to
      genitourinary tract infection. RESULTS: At the time of delivery 51% of women in
      the case group (109/215) had genitourinary tract infections compared with 13% of
      controls (35/266). After controlling for potential confounding variables the odds
      ratio for giving birth to infants weighing 2250 g or less when genitourinary
      tract infection was present was 4.0 (95% confidence interval 2.3 to 7.0). The
      proportion of infants with low birth weight attributable to genitourinary tract
      infection in the whole population of Aboriginal women was 32% (95% confidence
      interval 17% to 49%). CONCLUSIONS: There was a strong association between low
      birth weight and the presence of genitourinary tract infections in Aboriginal
      women both during pregnancy and at the time of delivery. A community intervention
      trial of screening and treatment of genitourinary infections in this population
      is recommended.

PMID- 1760604
TI  - Risk of epilepsy after febrile convulsions: a national cohort study.
AB  - OBJECTIVE: To identify children with febrile convulsions, classify their febrile
      convulsions into simple and complex, and determine the number and type of
      subsequent afebrile seizures in those children. DESIGN: National population based
      study. SETTING: United Kingdom. SUBJECTS: 16,004 neonatal survivors born during
      one week in April 1970. MAIN OUTCOME MEASURES: Information about febrile and
      afebrile seizures obtained from questionnaires at 5 and 10 years of age and from
      hospital records. RESULTS: Information was available for 14,676 of the cohort
      children. 398 (2.7%) of them had had at least one febrile convulsion. 16 children
      were known to be neurologically or developmentally abnormal before the first
      attack. Of the remaining 382 children, 305 had had a simple first febrile
      convulsion and 77 a complex first febrile convulsion. Thirteen of the 382 had had
      one or more afebrile seizures, nine of whom had developed epilepsy (recurrent
      afebrile seizures). A higher proportion of children with complex febrile
      convulsions (6/95) rather than simple febrile convulsions (3/287) developed
      epilepsy, the risk being highest for those who had had focal febrile convulsions
      (5/17; chi 2 = 39.9, p less than 0.001). Three of the 32 children who had
      prolonged febrile convulsions developed afebrile complex partial seizures.
      CONCLUSIONS: The risk of epilepsy after febrile convulsions is much less than
      reported in many hospital studies, and if febrile convulsions cause brain damage
      that leads to later epilepsy this is a rare occurrence.

PMID- 1760605
TI  - Severe cystitis associated with tiaprofenic acid.

PMID- 1760606
TI  - Does competence of general practitioners predict their performance? Comparison
      between examination setting and actual practice.
AB  - OBJECTIVE: To study the differences and the relation between what a doctor
      actually does in daily practice (performance) and what he or she is capable of
      doing (competence) by using national standards for general practice. DESIGN:
      General practitioners were consulted by four standardised (simulated) patients
      portraying four different cases during normal surgery hours. Later the doctors
      participated in a controlled practice test, for which they were asked to perform
      to the best of their ability. In the test they saw exactly the same standardised
      cases but in different patients. The patients reported on the consultations.
      SETTING: Province of Limburg, the Netherlands. SUBJECTS: 442 general
      practitioners invited by a letter. 137 (31%) agreed to participate, of whom 36
      were selected and visited. MAIN OUTCOME MEASURES: Number of actions taken during
      the consultations across complaints and for each category of complaint: the
      competence and performance total scores. Combination of scores with duration of
      consultations (efficiency-time score). Correlation between scores in the
      competence and performance part. RESULTS: Mean (SD) total score across complaints
      for competence was 49% higher than in the performance test (81.8 (11) compared
      with 54.7 (10.1), p less than 0.0001). The Pearson correlation across complaints
      between the competence total score and the performance total score of the
      participating physicians was -0.04 (not significant). When efficiency and
      consultation time of the consultations were taken into account, the correlation
      was 0.45 (p less than 0.01). CONCLUSIONS: Assessment of competence under
      examination circumstances can have predictive value for performance in actual
      practice only when factors such as efficiency and consultation time are taken
      into account. Below standard performance of physicians does not necessarily
      reflect a lack of competence. Performance and competence should be considered as
      distinct constructs.

PMID- 1760607
TI  - The Hillsborough tragedy.

PMID- 1760609
TI  - ABC of vascular diseases. Convalescent problems in arterial surgery.

PMID- 1760608
TI  - Doctor-patient communication: the Toronto consensus statement.

PMID- 1760610
TI  - Health and the environment. Waste disposal: fresh looks at a rotting problem.

PMID- 1760612
TI  - Doctors convicted of manslaughter.

PMID- 1760611
TI  - Medicine in Europe. European health challenges.

PMID- 1760613
TI  - Glasgow coma scale and gag reflex.

PMID- 1760614
TI  - Rugby injuries.

PMID- 1760615
TI  - Chorionic villus sampling.

PMID- 1760616
TI  - Oral and intravenous rehydration therapy.

PMID- 1760617
TI  - Auditing necropsies.

PMID- 1760618
TI  - Communicating necropsy results.

PMID- 1760619
TI  - Corticosteroids and tuberculosis.

PMID- 1760620
TI  - Health of the nation.

PMID- 1760621
TI  - Zidovudine after occupational exposure to HIV.

PMID- 1760622
TI  - Use of thalidomide in leprosy.

PMID- 1760623
TI  - Animal experimentation.

PMID- 1760624
TI  - Seafarers and HIV infection.

PMID- 1760625
TI  - Growth failure in children after total body irradiation preparative for bone
      marrow transplantation.

PMID- 1760626
TI  - Growth hormone therapy following bone marrow transplantation in childhood.

PMID- 1760627
TI  - Pubertal development and fertility in children after bone marrow transplantation.

PMID- 1760628
TI  - Endocrine problems in children after bone marrow transplant for hematologic
      malignancies. The Long-term Follow-up Team.

PMID- 1760629
TI  - Gonadal function after bone marrow transplantation in adult male and female
      patients.

PMID- 1760630
TI  - Late effects in bone marrow transplanted patients--a multicenter study supported
      by EBMT and EULEP.

PMID- 1760631
TI  - Total body irradiation in the conditioning regimen for hematological
      malignancies.
AB  - The role of Total Body Irradiation (TBI) is well defined in the conditioning
      regimen for BMT, but in pediatric malignancies there are some particular points
      of discussion, due to the side effects of irradiation. As alternative methods
      have been described, as Busulfan based regimens, a critical balance between
      efficacy and toxicities has to be considered in this subset of patients.

PMID- 1760632
TI  - Busulfan as part of conditioning regimen for bone marrow transplantation in
      children.

PMID- 1760633
TI  - Is orchiectomy indicated before BMT in childhood ALL?

PMID- 1760634
TI  - Hormonal and psychologic assessment in LLA patients after bone marrow transplant.
AB  - Four adolescent males were submitted to hormonal and psychological evaluation 3-8
      years after bone marrow transplant. All presented testicular failure, two were
      submitted to orchiectomy. Androgen replacement therapy was begun at 13 yr 7 mo-17
      yr. A psychological evaluation has been performed. Orchiectomy and insertion of
      artificial testicles do not seem to have affected patients' psychological
      situation. Individual differences have been found due to many causes.

PMID- 1760635
TI  - Ethical and legal problems of orchiectomy.

PMID- 1760636
TI  - A proposal for multicentric schedule for follow-up of bone-marrow transplanted
      children.

PMID- 1760637
TI  - Precocious puberty following BMT.

PMID- 1760638
TI  - Evaluation of late side-effects after bone marrow transplantation in children
      with leukemia.

PMID- 1760639
TI  - Cyclic sex hormone replacement therapy in women undergoing allogeneic bone marrow
      transplantation: aims and results.

PMID- 1760640
TI  - Growth pattern in children after allogenic bone marrow transplantation.

PMID- 1760641
TI  - Gonadal function in adolescents receiving different conditioning regimens for
      bone marrow transplantation.

PMID- 1760642
TI  - Pubertal development after bone marrow transplantation in adolescents.

PMID- 1760643
TI  - Prospective study of endocrine side-effects following bone marrow transplantation
      in childhood.

PMID- 1760644
TI  - Prophylactic orchiectomy after bone marrow transplantation for boys with acute
      lymphoblastic leukaemia and previous testicular relapse.

PMID- 1760645
TI  - Approaches to the evaluation of growth and growth disorders in children after
      bone marrow transplantation (BMT).
AB  - Since impaired growth may occur as a long--term consequence in children treated
      with BMT this aspect of development needs particular attention for various
      reasons. Primarily, in each affected child parameters relevant for the evaluation
      of growth need to be documented regularly from the beginning in a prospective
      mode. In addition, treatment protocols should contain elements of a standardized
      follow-up for the documentation and evaluation of the endocrine, the nutritional
      and the emotional situation of the patient. This will eventually allow us to
      define--and hopefully avoid--adverse elements within complex treatment modalities
      -including BMT--for various malignant diseases. Thus it will be possible to
      develop a rational approach for the therapy of persistent adverse events
      following attempts of treatment primarily directed to ensure survival.

PMID- 1760646
TI  - Growth in pubertal children after bone marrow transplantation.

PMID- 1760647
TI  - Growth and endocrine assessment in children undergoing bone marrow transplant:
      the 'G. Gaslini' experience.

PMID- 1760648
TI  - Oral and dental status in leukemic children treated with bone marrow
      transplantation.

PMID- 1760649
TI  - Pancreatic beta cell function in children and adolescents after bone marrow
      transplantation.

PMID- 1760650
TI  - Growth in homozygous beta-thalassemia after bone marrow transplantation.
AB  - In 8 homozygous beta-thalassemic patients, aged between 1.9 and 18 years, that
      received bone marrow transplantation (BMT), a longtidinal study of growth before
      and after BMT and relative Height Standard Deviation Score (SDS), has been
      performed. In all patients, also after BMT, a progressive growth retardation has
      been observed except in a case who presented serum ferritin levels in a normal
      range for age. The study shows that iron depletion must be continued, even after
      BMT, in those subjects that have after bone marrow transplantation high serum
      ferritin levels and short stature.

PMID- 1760651
TI  - Autologous bone marrow transplantation for childhood acute lymphoblastic leukemia
      -a European survey. EBMT Working Party on ABMT.

PMID- 1760652
TI  - Autogous bone marrow transplantation for childhood acute myeloid leukemia--a
      European survey. EBMT Working Party on ABMT.

PMID- 1760653
TI  - Neurochemical mechanisms of recovery from peripheral vestibular lesions
      (vestibular compensation)
AB  - This paper reviews the literature relating to the neurochemical basis of
      vestibular compensation, a process of behavioral recovery which occurs following
      the removal of afferent input from one labyrinth (unilateral labyrinthectomy,
      UL). Although vestibular compensation is known to be correlated with a return of
      resting activity to the vestibular nucleus (VN) ipsilateral to the UL (the
      deafferented VN), the neurochemical mechanisms by which this neuronal recovery
      occurs, are unknown. At present, there is little evidence to support the
      hypothesis that denervation supersensitivity of excitatory amino acid, dopamine,
      norepinephrine or acetylcholine receptors in the deafferented VN, is responsible
      for vestibular compensation: binding studies for glutamate or acetylcholine do
      not support an upregulation of these receptor types. However, changes in the
      affinity or efficacy of these receptor complexes cannot be ruled out. There are
      still many neurotransmitter systems, such as serotonergic and histaminergic
      systems, which have not been investigated in relation to vestibular compensation.
      In several species it has been shown that treatment with adrenocorticotropic
      hormone, fragment 4-10 (ACTH-(4-10], can accelerate vestibular compensation. It
      is not clear how these drugs exert their effects. In vitro electrophysiological
      studies have shown that VN neurons are capable of generating resting activity in
      the absence of their normal afferent inputs and it is possible that these neurons
      have pacemaker-like membrane characteristics which contribute to the regeneration
      of activity following UL. Recent biochemical studies have revealed changes in the
      phosphorylation patterns of a number of proteins during compensation. The
      possible relationship between these phosphorproteins and the synaptic or membrane
      changes which are responsible for vestibular compensation remains to be
      determined.

PMID- 1760654
TI  - The messages in optic nerve fibers and their interpretation.
AB  - Spike discharges are the principal carriers of information in the nervous system.
      Although both the ionic and the molecular mechanisms of spike generation have
      been studied extensively, the methods for analyzing a spike train that are
      currently employed have not changed much from those in use 20 years ago. There is
      an apparent need for a refinement of the methods used to analyze spike trains. We
      present here a summary of our recent results of an analysis of spike trains from
      retinal ganglion cells that is based on Wiener's theory of non-linear analysis or
      white-noise analysis. We found that spike trains carry, at least to a second
      order approximation, as much information as is carried by the ganglion cell's
      postsynaptic potential (PSP). There is no loss of information when an analog
      signal, PSP, is converted into a point process, namely, spike discharges. It is
      indeed possible to predict the cell's PSP from a spike train. This finding has
      two important implications. First, the neuron network in the retina produces a
      PSP, the dynamics of which are optimal for triggering a spike discharge, or
      conversely, the spike-generation mechanism is optimized to match the dynamics of
      the network. The external stimulus that is optimal for production of a ganglion
      cell discharge is represented as the cell's PSP. Second, there is structure
      encoded within the spike train; information on a second-order non-linearity is
      encoded by the relative timing of two consecutive spike discharges. Coding of non
      linearity into a spike train is an efficient means of signal compression and is
      an important aspect of neurophysiology.

PMID- 1760655
TI  - Taurine: retinal function.
AB  - The status and potential functions of taurine in the retina have been reviewed.
      Taurine is present in high concentrations in the retina of all species tested,
      while the retinal concentrations of the enzymes necessary to synthesize taurine
      are presumed to vary among those species. The documented low activity of
      cysteinesulfinic acid decarboxylase, a key enzyme in taurine biosynthesis, in the
      livers of the cat, monkey and human possibly reflect low activity in their
      retinas, indicating reliance on the diet as an important source of taurine. Both
      high- and low-affinity binding proteins and uptake systems have been described
      for taurine in retinal tissue. Evoked release of taurine by light and other
      depolarizing stimuli have been well documented. Retinal pathologies including
      diminished ERGs and morphologic changes have been reported for animals and man
      deficient in taurine. Possible functions for taurine in the retina include: (1)
      protection of the photoreceptor - based on the shielding effects of taurine on
      rod outer segments exposed to light and chemicals; (2), regulation of Ca2+
      transport - based on the modulatory effects of taurine on Ca2+ fluxes in the
      presence and absence of ATP; and (3) regulation of signal transduction - based on
      the inhibitory effects of taurine on protein phosphorylation.

PMID- 1760656
TI  - Learning and memory. FESN Study Group.

PMID- 1760657
TI  - Home care in the 1990s.

PMID- 1760658
TI  - Is the implantable cardioverter-defibrillator cost-effective?

PMID- 1760659
TI  - Growing points in psychiatric genetics.

PMID- 1760660
TI  - The Chest, Heart and Stroke Association.

PMID- 1760661
TI  - Neuroanatomy of the upper limb.

PMID- 1760662
TI  - Risks of unnecessary X-rays are widely understood.

PMID- 1760663
TI  - The changing role of high dependency units.

PMID- 1760664
TI  - Caution urged in the use of DC cardioversion.

PMID- 1760665
TI  - Conduct of the examination in child sexual abuse.

PMID- 1760666
TI  - Need for more training in the use of the ventouse.

PMID- 1760667
TI  - Strange sequela of unexplained failure of a spinal anaesthetic.

PMID- 1760668
TI  - Problems of multiple pregnancy.
AB  - There has been a sharp increase in the number of multiple births, particularly
      triplets and higher order births, in recent years (Botting et al, 1990).
      Perinatal mortality and morbidity are more frequent in multiple pregnancies than
      in singleton pregnancies. Greater understanding of the biological phenomenon of
      multiple pregnancy and perinatal care strategies directed at specific problems
      should improve the outcome.

PMID- 1760669
TI  - Paraphrenia revisited.
AB  - Paranoid disorders of late life, commonly known as paraphrenia, are not uncommon.
      This article reviews the history of the concept, the classification, the possible
      risk factors implicated in causation and the natural history of the disorder.
      Evidence suggests that paraphrenia is distinct from schizophrenia and that an
      organic substrate probably exists in most cases.

PMID- 1760670
TI  - Chronic lymphocytic leukaemia.
AB  - Chronic lymphocytic leukaemia is the commonest of the leukaemias and occurs most
      often in the elderly. The identification of presenting features that correlate
      adversely or favourably with survival has allowed the rational development of new
      treatment strategies.

PMID- 1760671
TI  - How and when to investigate syncope.
AB  - Recurrent syncope is a distressing phenomenon and may be very difficult to treat
      where the cause remains obscure. A methodical approach to investigation will
      often be fruitful when proper emphasis is given to thorough clinical assessment
      and simple investigations. Where these are normal, head-up tilt testing will
      often diagnose 'malignant vasovagal syndrome'.

PMID- 1760672
TI  - A surprising case of hypertension.

PMID- 1760673
TI  - Moral principles in withdrawing basic life support from patients in the
      persistent vegetative state.
AB  - Patients in a state of persistent vegetation or 'cognitive death' are an
      emotional drain on their family, and a financial drain on a society with limited
      resources. In this article, society's responsibility towards these patients and
      the moral and ethical issues involved in the withdrawal of fluid and nutrition
      are discussed.

PMID- 1760674
TI  - Home ventilation.
AB  - Home ventilation has become practical recently because of improvements in the
      equipment available to support respiration in the long term. It is especially
      effective in neuromuscular and skeletal disorders, but may also have a limited
      place in chronic lung diseases. Both positive- and negative-pressure ventilators
      may be suitable for home ventilation.

PMID- 1760675
TI  - Percutaneous insertion of Hickman-type catheters.
AB  - Hickman lines may be used for long-term venous access in patients having
      chemotherapy, bone marrow transplantation, parenteral nutrition, or in others
      needing prolonged venous access. This article describes the technique of
      percutaneous insertion, some of the problems that may be encountered at
      insertion, and ways of minimizing these problems.

PMID- 1760676
TI  - The sail sign.
AB  - Radiological terminology includes a number of interesting and often amusing terms
      intended to help us understand and remember the pathological abnormality being
      described. What radiological sign is illustrated in Fig. 1 and what condition
      does it represent?

PMID- 1760677
TI  - Lateral sinus abscess: the empty delta sign.

PMID- 1760678
TI  - A curious case of catatonia.

PMID- 1760679
TI  - The opiates debate.

PMID- 1760680
TI  - Anticholinergic drugs in anaesthesia.

PMID- 1760681
TI  - Immunotherapy for cancer.

PMID- 1760682
TI  - Use of the appendix in reconstructive surgery: a case against incidental
      appendicectomy.
AB  - Ignored for years, the appendix is once again being promoted as having useful
      surgical potential, notably in the management of incontinence. Incidental and
      prophylactic appendicectomy with their established complications become less easy
      to justify as the incidence of appendicitis declines. The role of the appendix in
      reconstructive surgery is reviewed, with particular reference to urinary
      reconstruction and to the treatment of chronically constipated or faecally
      incontinent children by use of the antegrade continence enema.

PMID- 1760683
TI  - Peptide growth factors and wound healing.
AB  - Growth factors and cytokines are important signal transducers in wound
      microenvironments. Experimental data are accumulating rapidly which demonstrate
      their ability to influence populations of polymorphs and macrophages to migrate
      to the wound, subsequently to be replaced by synthetic cells which produce
      collagen and matrix; these events are controlled sequentially at cell receptor
      level by a variety of locally delivered (paracrine and autocrine) peptides.
      Preliminary results from clinical trials using recombinant human growth factors
      to improve cutaneous healing are encouraging. Current research aims to produce
      growth preparations which can be applied to a wound to accelerate healing.

PMID- 1760684
TI  - Sutureless intestinal anastomoses.
AB  - Sutureless intestinal anastomoses can be achieved either by compression, where
      two inverted rings of bowel are compressed by a hollow circular device that
      subsequently sloughs away and is passed anally, or by the use of tissue glues or
      laser welding. Compression devices used clinically with success are the Valtrac
      biofragmentable anastomotic ring, the polypropylene rings described by Rosati and
      the AKA guns. Glued anastomoses have only been used in animals and seem to be
      unsafe. However, laser-welded intestinal anastomoses appear highly promising in
      experimental studies and further development of this technique is warranted.

PMID- 1760685
TI  - Recurrence of colorectal cancer after sutured and stapled large bowel
      anastomoses.
AB  - The purpose of this study was to compare surgical stapling and manual suturing
      techniques with respect to the incidence of tumour recurrence in patients with
      colorectal cancer: 294 patients undergoing potentially curative resections for
      colorectal cancer were randomly allocated to receive sutured (n = 142) or stapled
      (n = 152) anastomoses. The mean (s.e.m.) incidence of tumour recurrence at the
      end of 24 months was 29.4(4.4) per cent in the sutured group, compared with
      19.1(3.9) per cent in the stapled group (P less than 0.05). The corresponding
      rates for cancer-specific mortality at 24 months were 22.3(4.1) per cent and
      10.9(3.0) per cent respectively (P less than 0.01). A multiple regression
      analysis revealed that the influence of anastomotic technique on recurrence and
      mortality rate was independent of tumour stage. These results suggest that in
      colorectal cancer surgery the use of stapling instruments for anastomotic
      construction could be associated with a reduction in the incidence of recurrence
      and mortality rate by as much as 50 per cent.

PMID- 1760686
TI  - Abdominal injuries in the war wounded of Afghanistan: a report from the
      International Committee of the Red Cross Hospital in Kabul.
AB  - This report is from the hospital opened by the International Committee of the Red
      Cross, in Kabul, which receives acute war-wounded patients from the Afghanistan
      conflict. Of more than 1000 operations carried out by the New Zealand team in a 6
      month period, there were 70 laparotomies for penetrating wounds. These injuries
      were dealt with by established surgical techniques. The main area of controversy
      was the management of colonic wounds where the recent trend away from mandatory
      colostomy was followed by good results. Selective primary repair was achieved in
      16 of 27 patients with colonic injury with no mortality and minimal morbidity.
      The right colon was considered particularly favourable for primary anastomosis.
      The overall mortality rate for all laparotomies was 13 per cent, with injuries to
      the liver, major veins and rectum particularly being fatal. There were eight
      negative laparotomies.

PMID- 1760687
TI  - Glutamine-enhanced enteral diet improves nitrogen balance without increasing
      portal ammonia.
AB  - Following surgical stress the jejunum actively metabolizes endogenous glutamine,
      a non-essential amino acid, to produce alanine and ammonia, which augments
      substrate flow to the liver at a time when oral intake of nutrients is decreased.
      Oral glutamine supplementation theoretically may modify the response to injury.
      This study was designed to demonstrate the role of the jejunum in postinjury
      glutamine metabolism and to evaluate the influence of enteral glutamine
      supplements on nitrogen and ammonia metabolism after laparotomy and bowel
      resection in dogs. Oral glutamine in the presence of an intact small bowel
      significantly improved nitrogen balance (461 mg kg body-weight-1 day-1) compared
      with a control diet (-370 mg kg-1 day-1) (P less than 0.05, analysis of
      variance). Removal of the proximal small bowel prevented this beneficial effect
      of glutamine (-507 mg kg-1 day-1). Glutamine-supplemented and control diets were
      associated with similar portal ammonia concentrations throughout the study.

PMID- 1760688
TI  - Hypoxaemia and postoperative pulmonary complications.

PMID- 1760689
TI  - Mucosal function after ileal mucosal fenestration and colonic
      autotransplantation.
AB  - A method of small bowel mucosal augmentation called ileal mucosal fenestration
      and colonic autotransplantation (IMFCA) was devised and tested in pigs. In this
      technique, a vascularized mucosal graft was harvested from a 12-cm ileal loop,
      fenestrated by serial incision and then expanded to 20 cm. A 20-cm colonic loop
      was isolated and surgical mucosectomy was carried out. The fenestrated ileal
      mucosal graft was then autotransplanted into the prepared colon and the resulting
      composite structure was exteriorized as a Thiry-Vella loop. With this technique,
      ileal mucosal fenestrations healed by lateral epithelial in-growth, giving a new
      mucosal continuum within the recipient colon. At 60 days after surgery, the
      surface area of transplanted mucosa exceeded that within the original ileal loop
      by approximately 85 per cent. At this time, the transplanted mucosa had
      morphology and capacity for Na(+)-dependent glucose transport which were
      indistinguishable from those of control ileal mucosa.

PMID- 1760690
TI  - Secondary surgery for liver trauma.
AB  - Over a 10-year period from 1980, 46 patients with liver injuries were referred
      after primary admission to other hospitals. Previous surgery had been performed
      in 40 cases and the predominant reasons for referral were uncontrollable bleeding
      and postoperative sepsis with biliary leakage. Of 30 such cases, 19 were treated
      by liver resection; all were of a limited nature and no major hepatectomies were
      performed. Only two deaths occurred in these patients and this low mortality rate
      supports our conservative approach to liver trauma. Other reasons for referral
      were late biliary stenosis, complicated penetrating injury and intrahepatic
      haematoma. Three cases were referred with postoperative hepatic failure; two
      responded to resection of infected necrotic tissue and liver transplantation was
      attempted in the third. Injuries to liver segments 6 and 7 were those most
      frequently referred for assistance with bleeding, and all patients were safely
      transferred after intra-abdominal packing. This injury is particularly suitable
      for resection by segmentectomy rather than a formal hepatectomy, which has been
      associated with a high mortality rate in trauma cases. Further patients with
      intractable injuries might be salvaged by liver transplantation.

PMID- 1760691
TI  - Sarcoma induced by radiotherapy after breast conservation surgery.

PMID- 1760692
TI  - A safe new procedure for high-risk patients with symptomatic gallstones.
AB  - Cholecystectomy is associated with an appreciable mortality rate in elderly high
      risk patients. Patients aged over 60 years with symptomatic gallstones, at high
      operative risk, underwent cholecystotomy under local anaesthesia through a 3-cm
      incision. Stones were removed and clearance was demonstrated endoscopically and
      by tube cholecystography. Catheter drainage was continued for 7 days until a
      further cholecystogram confirmed clearance. The procedure was attempted in 26
      patients with concomitant cardiovascular, respiratory or malignant disease.
      Successful removal of all gallbladder stones was possible in 24 patients. Four
      patients had common bile duct stones demonstrated on cholecystography, all of
      which were successfully treated by endoscopic sphincterotomy. All patients are
      symptom-free at a mean follow-up of 36 weeks with no recurrent stones on
      ultrasonography.

PMID- 1760693
TI  - Cystic duct obliteration and gallbladder mucosal destruction: a feasible
      alternative to cholecystectomy.
AB  - 'Chemical cholecystectomy' has been proposed as an alternative to removal of the
      gallbladder. This study assessed cystic duct obliteration using bipolar
      electrocoagulation (with sham cannulation controls) and gallbladder mucosal
      treatment with tetracycline (or saline controls) in 29 mongrel dogs. Cystic duct
      obstruction was assessed by tube cholecystography at day 14, and epithelial
      damage by histology at day 42. Electrocoagulation by duct diathermy effectively
      occluded the cystic duct in 14 of 19 animals; however, this was associated with
      mucocele formation unless mucosal treatment with tetracycline was also performed.
      Immediate instillation of tetracycline after duct electrocoagulation produced
      only partial epithelial damage. The combination of duct electrocoagulation and
      delayed tetracycline instillation at 14 days produced complete destruction of all
      gallbladder epithelium and an effective chemical cholecystectomy.

PMID- 1760694
TI  - For debate: research in surgical training.

PMID- 1760695
TI  - Subtotal cholecystectomy.
AB  - Subtotal cholecystectomy has been carried out on 11 patients during a 5-year
      period, constituting 3.8 per cent of cholecystectomies performed during this
      time. The indications were severe inflammation/fibrosis in six patients, portal
      hypertension in three and the Mirizzi syndrome in two patients. There were no
      deaths and only minor in-hospital morbidity. One patient developed a common bile
      duct stone 21 months after the operation. None of the remaining patients has to
      date developed postcholecystectomy sequelae (mean follow-up period 29 (range 1
      62) months). Subtotal cholecystectomy is a safe, straightforward and definitive
      operation in patients for whom standard cholecystectomy could be dangerous, and
      is a more attractive proposition than cholecystostomy.

PMID- 1760696
TI  - Effect of biliary infection on common bile duct healing in the rat.
AB  - It has been postulated that biliary infection plays a role in bile duct stricture
      formation. The aim of this study was to verify this hypothesis and to evaluate
      the effect of biliary infection on common bile duct healing. A 3-mm longitudinal
      choledochotomy was performed in 120 rats and closed with a continuous 11/0
      Ethilon suture. Common bile duct division with end-to-end anastomosis using
      interrupted 11/0 Ethilon sutures was performed in another 30 rats. Biliary
      infection was achieved in half of the animals with retrograde injection of living
      046:K1:H31 strain Escherichia coli recovered from the rat colonic content. All
      rats with choledochotomy, including those with biliary infection, showed no bile
      leakage at the suture line, and the bursting pressure at the site of
      choledochotomy exceeded 40 mmHg as early as 24 h. Rats with common bile duct
      anastomosis alone showed no stricture formation for up to 6 months after
      operation. All rats with biliary sepsis developed complete occlusion at the
      anastomosis. On scanning electron microscopy, the biliary epithelium was well
      preserved in all rats. The study suggests that in rats with biliary sepsis the
      risk of bile leakage after primary closure of the common bile duct is negligible,
      but biliary infection may play a critical role in common bile duct stricture
      formation.

PMID- 1760697
TI  - Treatment perspectives in locally advanced unresectable pancreatic cancer.
AB  - Locally advanced unresectable pancreatic cancer is sometimes encountered without
      manifest distant metastases. Twenty patients with histologically proven
      unresectable pancreatic cancer without distant metastases were treated with
      radiotherapy and 5-fluorouracil (5-FU). Radiotherapy consisted of 50 Gy external
      upper abdomen radiation in two courses, concomitant with intravenous 5-FU 375
      mg/m2 given as a bolus injection 4-6h before radiation on the first 4 days of
      each treatment course. The treatment protocol was completed in 18 patients
      without complications. The median survival time was 10 months which compares
      favourably with a 3-5 months median survival time when treatment is withheld.
      Nine patients (45 per cent) were alive at 1 year, two patients at 2, 3 and 4
      years. A second-look operation was performed in four patients 6, 11, 12 and 22
      months after completion of radiotherapy. In two patients the tumour could be
      resected. It appears that treatment with radiotherapy and 5-FU may benefit
      patients with locally advanced unresectable pancreatic cancer.

PMID- 1760698
TI  - Treatment of severe postvagotomy/postgastrectomy symptoms with the somatostatin
      analogue octreotide.
AB  - Fourteen patients with severe and persistent postvagotomy/postgastrectomy
      symptoms were entered into a trial of treatment with the somatostatin analogue
      octreotide, 50 micrograms twice daily 30 min before meals being self-administered
      by subcutaneous injection. Six of the seven patients completing the 3-month trial
      showed sustained overall improvement of symptoms. The remaining patients were
      unhelped by treatment or developed unwanted effects. Six of eight patients with
      dumping syndrome showed sustained improvement of dumping symptoms during
      treatment. Bile vomiting was relieved in three of four patients with this
      complaint. Diarrhoea accompanying dumping showed a variable response to
      treatment, with improvement in three patients and no change or worsening of this
      symptom in five. Two patients with severe postvagotomy diarrhoea alone showed no
      improvement. Four patients with unwanted effects and three patients who found no
      benefit stopped the trial medication early. Four further patients reported mild
      or transient side-effects. For patients with severe postvagotomy/postgastrectomy
      symptoms, a trial of octreotide seems justified when significant dumping symptoms
      are present and other treatment options have been exhausted.

PMID- 1760699
TI  - Comparison of minimal and conventional surgery in patients with bleeding peptic
      ulcer: a multicentre trial.
AB  - A multicentre randomized prospective trial compared minimal surgery (under
      running the vessel or ulcer excision and adjuvant ranitidine) with conventional
      ulcer surgery (vagotomy and pyloroplasty or partial gastrectomy) for the
      treatment of bleeding peptic ulcer. This report is based on 137 patients (eight
      withdrawn through misdiagnosis or lost data), of whom 62 received conservative
      surgery and 67 conventional operation. Twenty-nine patients died, 16 (26 per
      cent) after conservative surgery and 13 (19 per cent) after conventional
      operations. The only significant difference between the groups was the incidence
      of fatal rebleeding, which occurred in six patients after conservative surgery
      compared with none after conventional surgery (P less than 0.02, Fisher's exact
      test).

PMID- 1760700
TI  - Transhiatal oesophagectomy for oesophageal carcinoma.
AB  - Between 1979 and 1990 transhiatal oesophagectomy and reconstruction with stomach
      was performed in 148 patients with carcinoma of the oesophagus. Ninety-seven
      patients were men and 51 were women; ages ranged from 21 to 88 years with a mean
      of 57.4 years. Dysphagia and weight loss were the usual clinical symptoms. The
      mean duration of symptoms was 14 weeks. Squamous cell carcinoma was present in
      129 patients (87.2 per cent), 18 patients (12.2 per cent) had adenocarcinoma, and
      one had lymphoma (0.7 per cent). In two-thirds of the patients tumours were
      located in the middle thoracic (50 of 148 patients) or distal thoracic oesophagus
      (59 of 148 patients). Three-quarters of the patients had tumours determined as
      stage III. The mean length of hospital stay after operation was 12.8 days.
      Anastomotic leakage occurred in 15 cases (10.1 per cent). Pulmonary complications
      other than pneumothorax were observed in 36 cases (24.3 per cent). The 30-day
      postoperative mortality rate was 8.1 per cent (12 of 148 patients). Respiratory
      insufficiency was observed as the major cause of death (six of 12 patients).
      Mediastinitis due to necrosis of the transposed stomach in the mediastinum was
      the cause of death in three cases. Two-year actuarial survival rates in patients
      with cervical, upper, middle and lower thoracic tumours were 20, 22, 26 and 30
      per cent respectively. Transhiatal oesophagectomy is safe and offers limited
      morbidity and mortality, although pulmonary complications and anastomotic leakage
      in the early postoperative period still pose a significant risk, especially for
      elderly patients in poor condition.

PMID- 1760701
TI  - Histopathological study of oesophageal mucosa in patients with varices: a
      comparison between bleeders and non-bleeders.
AB  - Thirty-six patients with oesophageal varices underwent a non-shunting operation
      including oesophageal transection. Of these, 16 had an emergency or elective
      operation (bleeders) and the remaining 20 had prophylactic surgery (non
      bleeders). A comparative study was performed between the bleeders and non
      bleeders in terms of preoperative endoscopic findings and histopathology of the
      oesophagus. The severity of red colour sign showed no significant difference
      between the two groups. The venous dilatation in each of the three layers of the
      oesophageal mucosa was demonstrated histologically to be of the same degree in
      bleeders and non-bleeders. In addition, the hepatic venous pressure gradient in
      cirrhotic patients did not differ between the two groups; for bleeders this was a
      mean(s.d.) of 15.2(6.1) mmHg and for non-bleeders 14.4(2.9) mmHg. We were unable
      to find any factors differentiating bleeders from non-bleeders, although these
      results do not justify prophylactic surgery for oesophageal varices.

PMID- 1760702
TI  - Staple-line erosion: a common source of recurrent bleeding following stapled
      oesophageal transection.
AB  - Recurrent bleeding after stapled oesophageal transection was studied in 73
      patients with cirrhosis transected for acute variceal bleeding. The most frequent
      source of bleeding was partial or total circumferential oesophageal erosion at
      the transection: staple-line erosion. This lesion occurred in 36 (49 per cent)
      patients and was the source of rebleeding in 29 (40 per cent) patients with 54
      episodes. Rebleeding in 22 (30 per cent) patients was due to varices in nine (12
      per cent), peptic ulcer in six (8 per cent), gastric erosions in two (3 per cent)
      and unknown sources in five (7 per cent), accounting for 33 episodes. The
      mean(s.e.m.) blood transfusion requirement for bleeding from staple-line erosions
      were 1.5 (0.25) units per bleed versus other sources, 6.5(1.0) units per bleed (P
      less than 0.001). Staple-line erosion was present at the first postoperative
      endoscopy in 11 (15 per cent) patients but the time to appearance varied widely.
      The lesion was more common in patients with Pugh's grade A liver disease at the
      time of transection, reflecting the increased survival rate of these patients.
      Staple-line erosion is a common source of minor recurrent bleeding following
      stapled oesophageal transection.

PMID- 1760703
TI  - Perioperative blood transfusion does not promote recurrence and death after
      mastectomy for breast cancer. The Danish Breast Cancer Cooperative Group.
AB  - Several reports suggest that perioperative blood transfusion promotes recurrence
      and death after cancer surgery. We studied the effect of transfusion in 1599
      patients who had mastectomy for carcinoma of the breast. In 228 transfused
      patients the disease recurred in 110 (48 per cent), compared with 647 (47 per
      cent) of 1371 non-transfused patients (P = 0.85). The 5-year recurrence-free
      survival rate was 0.54 in the transfused patients and 0.60 in the non-transfused
      group (P = 0.44). The transfused patients had a higher prevalence of risk factors
      than the non-transfused patients. Cox's multiple regression analysis confirmed
      that perioperative blood transfusion was of no importance. The study does not
      support the hypothesis that perioperative blood transfusion promotes recurrence
      after operation for breast cancer.

PMID- 1760704
TI  - Trauma audit: experience in north-east Scotland.
AB  - The management of 125 patients with trauma treated at Aberdeen Royal Infirmary
      from 1 January 1988 has been analysed using a microcomputer-based hospital trauma
      registry incorporating trauma and injury severity scores (TRISS) methodology.
      These patients fulfilled the North American Major Trauma Outcome Study (MTOS)
      inclusion criteria and were the first for whom data were available. Sixty-six
      patients had multiple injuries, of whom 52 were suffering from major trauma
      (defined as an injury severity score of 16 or greater). There were 14 deaths in
      the series, three (21 per cent) of which were considered to be preventable.
      Surgery was required in 84 (67.2 per cent) patients, of whom 59 (70 per cent)
      were operated on by a consultant or senior registrar. Five of six critically
      injured patients who died from their injuries were operated on by a consultant.

PMID- 1760705
TI  - Factors influencing local recurrence and survival in patients with soft tissue
      sarcoma of the upper limb.
AB  - Fifty-one patients with soft tissue sarcoma of the upper limb were studied to
      identify risk factors for local recurrence and survival. More than half (53 per
      cent) of the patients referred had locally recurrent disease. The flexor aspect
      of the forearm was the most common site of origin. The majority of patients were
      managed by a combination of conservative surgery and radical radiotherapy. Wide
      or radical excision was achieved in 49 per cent of cases. One-third of patients
      required partial resection of bone or neurovascular structures; 75 per cent of
      them had presented with local recurrence after treatment elsewhere. Skin grafts
      and flap repairs were used more often in patients with local recurrence (P =
      0.013) and 20 (74 per cent) of those referred with locally recurrent disease have
      had no further local relapse. The overall 5-year survival rate of 80 per cent (95
      per cent confidence interval 61-90 per cent) supports a policy of conservative
      surgery. Factors associated with a lower survival rate were deep fixation, origin
      in the flexor aspect of the forearm, and previous local recurrence. Deep fixation
      was also associated with an increased risk of local recurrence. Referral to a
      specialist unit at the time of initial presentation may result in lower rates of
      local recurrence and may improve the survival rate.

PMID- 1760706
TI  - Management of coeliac artery aneurysms.

PMID- 1760707
TI  - In situ femorodistal bypass: novel technique for angioscope-assisted intraluminal
      side-branch occlusion and valvulotomy. A preliminary report.
AB  - To allow and facilitate complete endoluminal vein preparation under angioscopic
      guidance for in situ femorodistal bypass grafting, a novel instrument was
      constructed. In experiments in cadavers we developed the occluder valvulotome,
      consisting of a modified Mills' valvulotome containing a laterally-ending working
      channel, a retrograde cutting blade and an advanceable Teflon tube within the
      working channel. Using this instrument in combination with commercially available
      wire coils, we successfully performed five femorocrural in situ reconstructions
      with endoluminal valvulotomy and embolization of a total of ten thigh
      tributaries. The technique allows angioscope-assisted valvulotomy and
      simultaneous endoluminal tributary occlusion, making long skin incisions and
      extensive vein dissection obsolete.

PMID- 1760708
TI  - Above-knee prosthetic grafts do not compromise the ipsilateral long saphenous
      vein.
AB  - Prosthetic graft materials are used preferentially by a number of surgeons for
      above-knee femoropopliteal bypasses. Using B-mode ultrasonography we have
      assessed the ipsilateral long saphenous vein in patients undergoing such bypasses
      to determine its suitability for future use in more distal bypasses. A total of
      137 above-knee prosthetic grafts were performed over a 10-year period. Of the
      patients, 74 were available for further assessment. Overall, 97 per cent of veins
      were suitable for future bypass surgery if required. Above-knee prosthetic
      bypasses do not appear to jeopardize the ipsilateral long saphenous vein.

PMID- 1760709
TI  - Quantitative measure of small vessel anastomotic contour using corrosion resin
      cast models: an aid to surgical training.
AB  - A surgeon who had not previously carried out a small vessel anastomosis performed
      20 consecutive anastomoses between human long saphenous vein and the left
      anterior descending artery of a pig's heart. Corrosion resin cast models were
      made of the anastomoses and subjected to a quantitative analysis of the
      anastomotic contour. A trend of improvement in contour parameters was found with
      increasing experience. This model may be useful for surgeons in training.

PMID- 1760710
TI  - Effect of weight on claudication distance.
AB  - Conservative measures to improve claudication distance include advice on smoking,
      exercise, diet and weight reduction. Although the effects of smoking, exercise
      and diet are established, the effect of weight is less clear. The aim of this
      study was to investigate the effect of carrying extra weight on the maximum
      walking distance in stable claudicants. Twenty stable claudicants were exercised
      on a treadmill (3.5 km/h, 0 degrees slope) carrying 0, 2.5, 5, 7.5 and 10 kg
      weights in randomized sequence. Maximum claudication distance and ankle: brachial
      pressure indices were recorded. Patients were categorized into mild or severe
      claudicants depending on their ability to walk 200 m. A response index (RI) was
      calculated as the reduction in claudication distance per kilogram load; RI = [CD0
      CD10]/10 m/kg, where CD0 and CD10 represent claudication distance with 0 and 10
      kg weights, respectively. Claudication distance was significantly reduced in
      subjects carrying 5 kg or more (P less than 0.01). A linear relationship was
      demonstrated between the mean claudication distance and the load carried (r =
      0.98, P less than 0.01) with a mean response index of 10.2 m/kg. The mean(s.e.m.)
      RI in mild claudicants (25.9(9.5) m/kg) was greater than the value observed in
      the severe claudicants (3.3(0.8) m/kg; P less than 0.01, Mann-Whitney U test).
      This study demonstrates that weight adversely affects claudication distance and
      suggests that weight reduction may deserve greater emphasis in the management of
      some patients with intermittent claudication.

PMID- 1760711
TI  - Role of splenectomy as a salvage procedure in thrombotic thrombocytopenic
      purpura.
AB  - Thrombotic thrombocytopenic purpura is a rare but serious haematological disease
      for which first-line therapy is medical, but not always successful. The role of
      splenectomy in the management of such patients is unclear. This paper reports
      three patients with the condition who went into remission following splenectomy
      after other forms of therapy had failed. Because thrombotic thrombocytopenic
      purpura is nearly always fatal if a remission is not obtained, splenectomy should
      be considered in patients who prove to be resistant to medical therapy.

PMID- 1760712
TI  - Peripheral parenteral nutrition: effect of a standardized compounded mixture on
      infusion phlebitis.
AB  - The incidence and severity of infusion phlebitis was evaluated prospectively in
      142 surgical patients who received peripheral parenteral nutrition (PPN) for a
      total of 700 days. In a first study phase 83 patients were given PPN for a total
      of 424 days. All nutrient solutions were delivered over a 12-h period from a 3
      litre bag and the infusion sites rotated daily. These methods resulted in an
      incidence of phlebitis of 18 per cent, 75 per cent of the patients being fed
      successfully by PPN until resumption of oral nutrition. In an attempt to assess
      the importance of the method of delivering nutrient solutions, the next 59
      patients were randomized to receive PPN as a compounded mixture or by a
      conventional technique with simultaneous infusion from separate bottles. Infusion
      phlebitis was significantly more frequent (P less than 0.001) in patients infused
      with separate bottles. There was no difference between the groups with regard to
      duration of nutrition or the need to establish central venous access. We conclude
      that PPN is a safe and cost-effective means of providing total parenteral
      nutrition in most surgical patients. The use of compounded mixtures significantly
      reduces the incidence of phlebitis without increasing total costs.

PMID- 1760713
TI  - Effects of different lipid emulsions on lymphocyte function during total
      parenteral nutrition.
AB  - A prospective randomized study of the immunological effects of three total
      parenteral nutrition (TPN) regimens in patients undergoing preoperative
      parenteral nutrition was conducted. In one regimen the calories were derived
      solely from glucose. The others were identical except that 50 per cent of the
      calories were provided as lipid emulsion, in one as long-chain triglycerides
      (LCT) only while the other contained half the fat as medium-chain triglycerides
      (MCT) and half as LCT (MCT/LCT). Natural killer (NK) activity and lymphokine
      activated killer (LAK) activity were significantly higher after TPN with the
      MCT/LCT solution. A significant fall in LAK activity occurred after TPN with the
      LCT solution. The interleukin 2 content in supernatants from activated T
      lymphocytes was significantly higher after TPN with the LCT-containing solution.
      Solutions containing LCT and those containing MCT perturb cytokine interactions,
      but this is less with MCT-containing solutions, which may augment certain
      responses. These observations may have implications for the design of TPN
      regimens.

PMID- 1760714
TI  - Surgical management of primary hyperhidrosis.

PMID- 1760715
TI  - Colon perforation during colonoscopy: surgical versus conservative management.

PMID- 1760716
TI  - Necrotizing fasciitis.

PMID- 1760717
TI  - Infrainguinal bypass surgery.

PMID- 1760718
TI  - Influence of obstructive jaundice on the serum levels of sodium.

PMID- 1760719
TI  - Sources of electrical transients in tectal neuropil of the frog, Rana pipiens.
AB  - We have studied the outer neuropil layers in frog tectum where the unmyelinated
      optic nerve fibers terminate. At any point in the neuropil an extracellular
      microelectrode records several different visually evoked electrical transients,
      distinct by size and shape. When classified by shape alone, each transient falls
      into one of 3 distinct classes. Some of these transients are binocularly driven,
      as originally described by Finch and Collett. The aggregate of the receptive
      fields of all the elements recorded at a single point defines a multiunit
      receptive field (MURF). Each MURF is characteristically oval, and divided into 3
      sections along its long axis. Each section represents the aggregate of the
      receptive fields associated with one class of transient; i.e. transients
      belonging to only one specific class can be evoked by stimulating that part of
      the visual field corresponding to the appropriate section of the MURF. All of the
      MURFs mapped by recording in a single tectum are radially arranged in visual
      space about a central point, or 'visual pole'. Several conclusions are made.
      First, the two larger types of transient are generated postsynaptically by
      electrically active dendritic elements, specifically the beaded dendritic
      appendages of tectal neurons. The smallest type of transient is of presynaptic
      origin. Second, these tectal elements have a local and global anatomical order
      across the tectum, which accounts for both the tripartite structure of the MURFs
      and their radial arrangement about a visual pole. Third, since the large
      transients are of postsynaptic origin, genuine recordings of single retinal
      ganglion cell (RGC) activity can be made only in the optic nerve or retina
      itself. Fourth, information is conveyed over the unmyelinated optic nerve fibers
      at pulse rates as high as 80/s and is transsynaptically effective at such rates.
      Finally, the electrically active tectal dendritic elements, with their highly
      organized spatial arrangement, are an important component of the frog's visual
      processing apparatus, instead of being merely relays or repeaters.

PMID- 1760720
TI  - Phase-shifting effect of triazolam on the hamster's circadian rhythm of activity
      is not mediated by a change in body temperature.
AB  - Treatment with the short-acting benzodiazepine, triazolam (Tz), 6 h before
      activity onset (CT 6) induces large phase advances in the circadian rhythm of
      locomotor activity in golden hamsters free-running in constant lighting
      conditions. These phase shifts are associated with acute increases in locomotor
      activity. The acute increases in activity appear to be necessary for induction of
      phase shifts in the activity rhythm by Tz, since suppression of this activity by
      restraining the animal blocks the phase shifts normally induced by Tz.
      Furthermore, other stimuli which induce an acute increase in locomotor activity
      phase shift the circadian clock in a similar manner as does Tz. Since increased
      locomotor activity is associated with a rise in body temperature in mammals, and
      changes in temperature have been associated with changes in circadian rhythms,
      this study was designed to determine whether the phase-shifting effect of Tz on
      the circadian clock could be mediated by the change in body temperature resulting
      from the induced acute increase in locomotor activity. Hamsters free-running in
      constant light (LL) were implanted with Mini-Mitter biotelemetry devices and
      either injected with Tz at CT 6, injected with Tz at CT 6 and restrained for the
      next 6 h, or restrained for 6 h beginning at CT 6. Treatment with Tz resulted in
      large phase advances in the activity rhythm, while the other two treatments did
      not induce phase advances. Mean body temperature increased over control levels
      for all 3 groups during most of the 6 h following the beginning of treatment, and
      there were no significant differences in body temperature changes between any
      pairs of groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760721
TI  - The influence of long-term potentiation on the spatial relationship between
      astrocyte processes and potentiated synapses in the dentate gyrus neuropil of rat
      brain.
AB  - The influence of long-term potentiation (induced by repeated high-frequency
      stimulation of the perforant pathway) on the distribution pattern of astrocyte
      processes in the neuropil of the hippocampal dentate area containing the
      potentiated synapses was investigated by quantitative electronmicroscopy. It has
      been found that significant changes occurred in the ramification of astrocyte
      processes as well as in their topographic relation to synaptic complexes. When
      comparing the results obtained in LTP animals with active control or sham
      operated animals, we found significant higher numerical density, but smaller
      volume, higher surface density and closer apposition of astrocyte processes to
      the synaptic clefts, boutons terminaux or spines in the potentiated synapses
      containing neuropil. The glial reaction to synaptic activation has been seen most
      pronounced 8 h after the LTP induction. The results are pointing to a
      participation of the glia cells in the maintenance of the LTP effect as well as
      to a metabolic coupling between synaptic transmission and glia function for
      equilibrating the homeostasis by clearing the extracellular space next to the
      transmission zones.

PMID- 1760722
TI  - Expression of ALZ-50 immunoreactivity in the developing principal sensory nucleus
      of the trigeminal nerve: effect of transecting the infraorbital nerve.
AB  - Many neurons in the CNS die as a consequence of normal development. As these
      neurons die, they may be programmed to produce 'death proteins'. We explored the
      possibility that an antigen recognized by ALZ-50, a protein expressed in
      Alzheimer's-type neurofibrillary tangles, is generated during the process of
      neuronal death. The effects of transecting the infraorbital nerve on the
      expression of ALZ-50 immunoreactivity and neuronal death in the principal sensory
      nucleus of the trigeminal nerve (PSN) was examined. In normal rats, a small
      number of PSN neurons was ALZ-50-positive on postnatal day (P) 3. Transections on
      the day of birth (i.e. during the period of naturally occurring neuronal death)
      led to a 5-fold increase in the number of immunoreactive neurons expressing a 56
      kDa protein on P3. In contrast, lesions on P25 (i.e. after the period of
      naturally occurring neuronal death) did not induce any neurons to exhibit ALZ-50
      immunoreactivity. Thus, the 56-kDa protein recognized by ALZ-50 appears to be a
      death protein which is transiently expressed during the period of naturally
      occurring neuronal death. It is appealing to speculate that the pathological
      degeneration described in Alzheimer's brains results from the up-regulation of a
      quiescent developmental program.

PMID- 1760723
TI  - The effects of two 21-aminosteroids on overt infarct size 48 hours after middle
      cerebral artery occlusion in the rat.
AB  - The lipid peroxidation inhibitors U74006F (21-[4-(2,6-di-1-pyrrolidinyl-4
      pyrimidinyl)-1-piperazinyl]-16 alpha-methylpregna-1,4,9]-(11)-triene-3, 20-dione)
      and U74512E (21-[4-(3-ethylamino-2-pyridinyl)-1-piperazinyl]-16 alpha
      methylpregna- 1,4,9]-(11)-triene-3,20-dione) were tested for cerebroprotective
      properties in the rat. Focal cerebral ischemia was induced by irreversible
      occlusion of the middle cerebral artery (MCA-O). The 21-aminosteroids U74006F (1
      mg/kg or 10 mg/kg, i.p.) and U75412E (1 mg/kg or 30 mg/kg, i.p.) were injected 30
      min prior and 2, 6, and 24 h after MCA-O. The higher doses of U74006F or U75412E
      caused reductions in cortical infarct size ranging from 28 to 34%. The data
      suggest the 21-aminosteroids to be mildly effective after irreversible occlusion
      of the MCA but possibly to be more beneficial as part of a combined drug therapy
      in conjunction with Ca2+ or NMDA antagonists.

PMID- 1760724
TI  - The relationship between visual stimulation, behaviour and continuous release of
      protein in the substantia nigra.
AB  - In the substantia nigra, a protein (acetylcholinesterase) is secreted from the
      dendrites of dopaminergic pars compacta neurons, in a noncholinergic capacity.
      This non-classical phenomenon could be influenced by sensory stimulation: the
      effect of light flashing was investigated on the 'on-line' release of
      acetylcholinesterase and concomitant behaviour in the guinea-pig. The stimulus
      induced an increase in release of the protein and the appearance of chewing
      movements. Similarly, chewing could also be elicited by direct local application
      of exogenous acetylcholinesterase. The results suggest that visual stimulation
      causes release of AChE, which in turn facilitates movement. Therefore secretion
      of this protein within the substantia nigra might form an important intermediary
      step in visuo-motor interactions.

PMID- 1760725
TI  - Portacaval anastomosis disrupts circadian locomotor activity and pineal melatonin
      rhythms in rats.
AB  - To determine whether hepatic encephalopathy may be associated with a disruption
      of circadian function, the circadian rhythms of locomotor activity and pineal
      melatonin content were examined in an animal model of complete portal-systemic
      shunting, rats with a portacaval anastomosis (PCA). The locomotor activity rhythm
      of all sham-operated animals entrained normally to a light/dark cycle and
      exhibited a normal free-running period during exposure to constant light. In
      contrast, PCA led to a dampening of the locomotor activity rhythm in all animals
      and the abolishment of a circadian periodicity in the activity rhythm of
      approximately 50% of rats during exposure to either a light/dark cycle or
      constant light. While normal diurnal variations of pineal melatonin content were
      seen in sham-operated rats, the amplitude of this variation appeared to be
      decreased in PCA animals. The similar effects of PCA on both a behavioral and an
      endocrine circadian rhythm, known to be regulated by a common neural pacemaker,
      coupled with studies indicating that a variety of other circadian rhythms may be
      disrupted in both animals and humans with hepatic dysfunction, suggests that this
      circadian disturbance originates within the pacemaker or on one of its
      afferent/efferent pathways.

PMID- 1760726
TI  - Effects of intra-amygdaloid injections of alpha-difluoromethylornithine and
      putrescine on the development of electrical kindling in rats.
AB  - In our previous study, an increase in concentration of putrescine was observed in
      the brain of amygdaloid kindled rats. To clarify the role of putrescine in
      kindling, the effects of intra-amygdaloid injections of alpha
      difluoromethylornithine (DFMO), an inhibitor of polyamine synthesis, or
      putrescine on the development of electrical kindling were examined in rats.
      Kindling stimulations were applied to the left amygdala. Pretreatment with DFMO
      (50 nmol) for 10 days by injection into the ipsilateral amygdala decreased both
      the number of stimulations and total afterdischarge (AD) duration required to
      reach first fully kindled state. Kindling-induced elevation of the putrescine
      concentration was inhibited by pretreatment with this dose of DFMO. On the other
      hand, pretreatment with putrescine (200 nmol) for 10 days into the same site of
      the brain retarded the behavioral and electrographic development of kindling
      seizure during the period of drug administration, although these treatments did
      not produce any changes in the number of stimulations or total AD duration.
      Putrescine (200 nmol) demonstrated no anticonvulsive effects in previously
      kindled animals. These results suggest that putrescine has an inhibitory effect
      on the development of amygdaloid kindling in rats.

PMID- 1760727
TI  - Taurine-like immunoreactivity in photoreceptor cells and mushroom bodies: a
      comparison of the chemical architecture of insect nervous systems.
AB  - Taurine is one of the most abundant amino acids found in the tissues of insect
      nervous systems. The distribution of taurine-like immunoreactivity was
      investigated in compound eyes, ocelli and mushroom bodies of Drosophila and
      Locusta. A comparison to the previously described taurine-like immunoreactivity
      in the brain of worker honeybees (J. Comp. Neurol., 268 (1988) 60-70) showed that
      the photoreceptor cells of all three insect species are immunoreactive.
      Immunoreactive mushroom body intrinsic Kenyon cells were also found in all three
      species. The intensity of the immunoreactivity was however graded, depending on
      the species. While the majority of Kenyon cells were stained in Apis and
      Drosophila, the immunoreactivity of the locust mushroom body was mainly confined
      to the intrinsic neurons originating in the accessory calyx.

PMID- 1760728
TI  - Extracellular space volume changes in the rat spinal cord produced by nerve
      stimulation and peripheral injury.
AB  - Double-barrelled potassium and tetramethylammonium-sensitive microelectrodes were
      used in diffusion studies with tetramethylammonium ions, which remain essentially
      extracellular during the measurements. Activity-related changes in the
      extracellular space (ECS) volume fraction (alpha), ECS tortuosity (lambda) and
      the dynamics of the ECS volume changes were examined in the spinal dorsal horns
      of rats. The alpha and lambda in L4 and L5 segments of unstimulated rats were
      alpha = 0.24 +/- 0.01 (i.e. ECS occupied 24 +/- 1% of the total spinal cord
      volume) and lambda = 1.54 +/- 0.04 (mean +/- S.D. of mean, n = 21). The values
      were not significantly different throughout the dorsal horn. Repetitive
      electrical stimulation of peripheral nerves at 3-100 Hz increased extracellular
      potassium concentration [( K+]e) and ECS volume in Rexed laminae III-V by 15.8 +/
      2.7% (n = 5). After the end of stimulation, when the [K+]e decreased below the
      original baseline (K+ undershoot), the ECS volume decreased by 20-45%. The
      magnitude and duration of ECS volume decrease were positively related to the
      stimulation frequency and duration. The ECS volume decrease was maximal at 2-10
      min after the stimulation had been discontinued, and it returned to the
      prestimulation values in 15-40 min. The ECS volume decreased by 20-50% after
      injury of the ipsilateral hind paw evoked either by subcutaneous injection of
      turpentine (n = 5), or by thermal injury (n = 6). The maximal changes were found
      in Rexed laminae III-V, 5-10 min after injection of turpentine and 10-25 min
      after thermal injury, and persisted for more than 120 min and 30 min,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760729
TI  - Microdialysis of extracellular noradrenaline in the hippocampus of the rat after
      long-term alcohol intake.
AB  - Intracerebral microdialysis combined with high-performance liquid chromatography
      and electrochemical detection was used to study the effect of chronic ethanol
      intake on the release of noradrenaline in the hippocampus of the awake, freely
      moving rat. The hippocampal sites were perfused with an artificial cerebrospinal
      fluid for 30 min at a rate of 2 microliter/min before ethanol intake and after
      one and 3 months of ethanol intake. The animals received a 10% ethanol solution
      as their drinking fluid. The basal release of noradrenaline before ethanol
      drinking varied from no measurable value to 28 pg in 50 microliters perfusate,
      possibly being dependent on the behavioral state of the animal. After one month
      of drinking the release had increased in 4 rats, was lower than before in two
      animals and remained unchanged in 3 rats. After 3 months of ethanol intake the
      release had increased in 7 rats out of the 9 and had remained unchanged in two.
      The mean amount of noradrenaline in 50 microliters perfusate after 3 months of
      drinking was 52 pg. Five rats out of 9 increased their ethanol consumption during
      the last two months. The results suggest that chronic ethanol intake affects the
      release of noradrenaline in the hippocampus, but that the effect is probably
      dependent on the duration of intake.

PMID- 1760730
TI  - Sensitization to noise-mediated induction of seizure susceptibility by MK-801 and
      phencyclidine.
AB  - The effect of single administrations of MK-801 (5-methyl-10,11-dihydro-5H
      dibenzo[a,d]cyclohepten-5,10-imine) or PCP (phencyclidine) on the induction of
      audiogenic seizure susceptibility by noise in immature rats was examined.
      Treatments with these non-competitive N-methyl-D-aspartate (NMDA) receptor
      antagonists resulted in increases in noise exposure-dependent susceptibility. In
      neonatally drug-treated rats, seizures during adulthood were found to occur with
      significantly higher incidence and severity. Furthermore, drug treatments were
      found to lengthen what is normally a restricted developmental period within which
      susceptibility can be induced by noise exposure. The drugs, however, had no
      inherent ability to induce audiogenic seizure susceptibility if given alone.
      Moreover, in already-susceptible rats, MK-801 exhibited predictable
      anticonvulsant effects. These data suggest acute PCP or MK-801 exposures may
      transiently exacerbate risks inherent in certain forms of trauma. The mechanism
      underlying these effects is unknown although certain inferences are possible and
      may reveal much about epileptogenesis in this model.

PMID- 1760731
TI  - Behavioural evidence for a peripheral component in the enhanced antinociceptive
      effect of a low dose of systemic morphine in carrageenin-induced hyperalgesic
      rats.
AB  - This study reinvestigated the possible contribution of a peripheral action of
      systemic morphine in the modulation of the response to noxious pressure on
      inflamed paws, using a supraspinally integrated test and various low doses of
      naloxone. Rats received an injection of carrageenin into the right hindpaw which
      resulted in an ipsilateral inflammatory response and decreased threshold to
      noxious pressure. Four hours post-carrageenin, the injection of 1 mg/kg i.v.
      morphine induced a significantly enhanced antinociceptive effect on the inflamed
      compared to the non-inflamed paws. Intrapantar injection of extremely low doses
      of naloxone (0.5 and 1 micrograms in a volume of 0.1 ml) significantly reduced
      this effect (naloxone being more effective when administered at the same time as
      morphine, compared to 15 min later), while equal doses of naloxone given
      systemically were inactive. These data confirm that synergism of peripheral and
      central actions may result in the augmented analgesic potency of morphine in rats
      subjected to inflammatory conditions. In addition, they provide further evidence
      for the complexity of opioid actions in inflammatory processes. In particular,
      the results are in line with the hypothesis that the paradoxical antinociceptive
      effect of extremely low doses of i.v. naloxone described in several studies is
      due to a central action.

PMID- 1760732
TI  - A study of the hypothalamic pulse-generating mechanism responsible for LH
      release: electrical stimulation of the medial basal hypothalamus in the
      ovariectomized guinea pig.
AB  - In order to examine the neurophysiological properties of the hypothalamus
      responsible for the pulsatile release of luteinizing hormone (LH) the medial
      basal hypothalamus (MBH) of the ovariectomized adult female guinea pig was
      stimulated electrically through an implanted electrode and LH release was
      monitored as an indication of luteinizing hormone-releasing hormone (LHRH)
      release. Electrical stimulation (ES) consisting of monophasic square wave pulses
      with 0.5 ms pulse duration was applied for 2 min at 60, 40, 20, or 10 min
      intervals. Current intensity (80, 200, 500 microA) and frequency (8, 50, 100 Hz)
      were varied to determine the parameters of ES which resulted in an LH pulse with
      amplitude similar to that of a pulse induced by the endogenous pulse-generating
      mechanism. Blood samples were collected at 5 or 10 min intervals through an
      indwelling catheter, and LH was measured by RIA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760733
TI  - Prostaglandin E2 mediates the stimulatory effect of methoxamine on in vivo
      luteinizing hormone-releasing hormone (LH-RH) release in the ovariectomized
      female rhesus monkey.
AB  - Previously, we found that noradrenergic input through alpha 1-receptors modulates
      pulsatile release of luteinizing hormone-releasing hormone (LH-RH) in
      ovariectomized rhesus monkeys in the absence of estrogen. In the present study,
      the role of prostaglandin E2 (PGE2) in mediating alpha-adrenergic stimulation of
      LH-RH release is investigated. In the first experiment the effects of the alpha 1
      adrenergic agonist methoxamine (MTX) on LH-RH and PGE2 release were examined.
      Push-pull perfusion of the stalk-median eminence (S-ME) was performed in
      conscious, ovariectomized monkeys, and perfusate samples were collected on ice.
      MTX (10(-5) M) was infused into the S-ME through the push cannula for 10 min at
      90-min intervals, and LH-RH and PGE2 in aliquots of the same perfusate samples
      were measured by radioimmunoassay. Infusion of MTX significantly stimulated LH-RH
      release (n = 12; P less than 0.01) and PGE2 release (P less than 0.05). In the
      second experiment, the effect of PGE2 infusion on LH-RH release was tested. PGE2
      (10(-7) M) was infused using the same protocol as above, and LH-RH was measured
      in the perfusates. Infusion of PGE2 through the push cannula significantly
      stimulated LH-RH release (n = 23; P less than 0.05). These results suggest that
      the stimulatory effect of MTX on LH-RH release is at least partly mediated by
      PGE2, since MTX stimulated not only LH-RH but also PGE2 release, and since PGE2
      itself stimulated LH-RH release. Therefore, PGE2 may be an important endogenous
      mediator of alpha 1-adrenergic input stimulating pulsatile LH-RH
      release.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760734
TI  - Labeling of human retinohypothalamic tract with the carbocyanine dye, DiI.
AB  - The carbocyanine dye, DiI, was used to demonstrate human retinohypothalamic tract
      (RHT) projections in 6 normal human postmortem brains. In 5 of 6 brains, labeling
      was seen extending from the site of implantation in the distal optic nerve to
      both the ipsilateral and contralateral suprachiasmatic nuclei. This study
      confirms the presence of RHT projections in humans, and demonstrates the
      usefulness of DiI for neuronal tracing in human postmortem tissue.

PMID- 1760735
TI  - Dystrophic neurites infiltrate extracellular neurofibrillary tangles in Alzheimer
      disease.
AB  - The neurotrophic activity of beta-amyloid protein (beta-AP) has been suggested to
      be responsible for the dystrophic neurites that surround beta-AP deposits in
      senile plaques of Alzheimer disease. The recent finding that neurofibrillary
      tangles (NFT) that remain as remnants in the extracellular space (E-NFT) after
      the death of the neuron contain beta-AP, suggested that dystrophic neurites might
      also be associated with E-NFT. In this study, we use a probe for E-NFT, basic
      fibroblast growth factor (bFGF)-binding to show that E-NFT do contain dystrophic
      neurites. Since these neurites contain the amyloid precursor protein whose
      cleavage can lead to beta-AP, they may also play a role in further beta-AP
      deposition in the E-NFT.

PMID- 1760736
TI  - Suppression of 4-aminopyridine-induced paroxysmal depolarizing shift in rat
      amygdaloid neurons by diltiazem.
AB  - The effects of organic Ca2+ channel blocker, diltiazem, on the epileptiform
      activity induced by 4-aminopyridine (4-AP) were studied in rat amygdaloid slices
      using intracellular recording techniques. Application of 4-AP (0.5 mM) resulted
      in spontaneous and evoked epileptiform activity which consisted of an initial
      burst followed by a number of afterdischarges. The initial burst began with
      rapidly rising action potentials superimposed on a large depolarizing wave termed
      paroxysmal depolarizing shift (PDS). Diltiazem reversibly suppressed the
      amplitude and duration of PDS in a concentration-dependent manner. The IC50,
      estimated from the graph of the concentration-response relationship, was
      approximately 60 microM. These results demonstrate that a calcium current
      sensitive to diltiazem is involved in the generation of PDS and suggest that PDS
      is based on giant synaptic conductance as well as endogenous calcium currents.

PMID- 1760737
TI  - Nerve sprouting and endplate growth induced in normal muscle by contralateral
      partial denervation of rat plantaris.
AB  - The incidence of motor nerve and terminal sprouting was quantitatively analyzed
      in normal unoperated muscles, in homologous muscles contralateral to muscles
      which have been partially denervated, in partially denervated muscles, and in
      sham-operated muscles. Muscles were studied by light microscopy after staining
      motor endplates by a combined silver-cholinesterase stain. In addition, the
      incidence of endplates containing terminal sprouts, the number of terminal branch
      points per endplate, and endplate, and endplate size were also assessed in the
      various groups examined. We observed that following section of the L4 spinal
      nerve, the incidence of sprouting (preterminal and intranodal) in the
      contralateral muscle exhibited a 2-fold increase over sham-operated controls. We
      also found a correlation between nerve terminal sprouting, terminal branch point
      number and endplate size. All of these parameters were significantly increased in
      the contralateral muscles as compared to the sham-operated control muscles. These
      findings suggest that normal muscles undergo sprouting which can be enhanced by
      contralateral partial denervation. The possible underlying mechanism may be the
      transneuronal induction of sprouting.

PMID- 1760738
TI  - Trigeminal mediation of the diving response in the muskrat.
AB  - Stimulation of the nasal cavity elicits powerful cardiorespiratory responses
      similar to the diving response. In the present study, bradycardia and apnea were
      elicited in muskrats by stimulation of the nasal cavity with ammonia vapors.
      These responses could be blocked by injections of 2% lidocaine made bilaterally
      into the medullary dorsal horns of the trigeminal sensory complex. However, the
      bradycardia due to activation of the baroreceptor reflex with intravenous
      phenylephrine was retained. These data implicate trigeminal neurons in the
      medullary dorsal horn as modulators of autonomic activity, especially in the
      cardiorespiratory adjustments after nasal stimulation.

PMID- 1760739
TI  - Destruction of different fiber tracts underlies development of lateral
      hypothalamic lesion-induced hyperthermia and loss of bombesin-induced
      hypothermia.
AB  - The relative roles of lateral hypothalamic cell bodies and fibers of passage were
      assessed in the development of lesion-induced hyperthermia and bombesin-induced
      hypothermia. Electrolytic lesions or discrete fiber transections were combined
      with intracisternal bombesin injection to show that each of these two
      thermoregulatory effects involves fibers crossing the borders of the lateral
      hypothalamus; however, the two effects primarily involve fibers crossing
      different borders. Thus, the hyperthermia and the abolition of bombesin-induced
      hypothermia which follow lateral hypothalamic damage appear to result from
      disruption of separate thermoregulatory pathways.

PMID- 1760740
TI  - Axonal regeneration of retinal ganglion cells in the cat geniculocortical
      pathway.
AB  - The optic nerve of anesthetized cats was completely cut and the autologous
      sciatic nerve was transplanted. Sixty days later some populations of retinal
      ganglion cells were shown to regenerate the axon with retrograde HRP labeling. We
      verified that ganglion cells that had projected to the lateral geniculate nucleus
      (LGN) were able to regenerate through the transplant with a double-labeling
      method: diI was injected into the LGN prior to the transplantation, and dextran
      fluorescein was injected into the graft after axonal regeneration. Intracellular
      injection of HRP into regenerating ganglion cells in an in vitro preparation
      revealed that the two major cell types projecting to the LGN, alpha and beta,
      regenerated axons and showed normal dendritic morphology.

PMID- 1760741
TI  - The AT2 angiotensin receptor subtype predominates in the 18 day gestation fetal
      rat brain.
AB  - The angiotensin II receptor subtype-specific antagonists Dup 753 (AT1) and PD
      123177 (AT2) were used to characterize the angiotensin II receptor subtypes
      present in 18 day gestation fetal Wistar-Kyoto (WKY) and spontaneously
      hypertensive (SHR) rat brain using in vitro receptor autoradiography. The AT2
      subtype was predominant in the brain of both rat strains, even in areas that
      display predominantly the AT1 subtype in the adult rat brain.

PMID- 1760742
TI  - c-fos protooncogene expression in rat hippocampus and entorhinal cortex following
      tetanic stimulation of the perforant path.
AB  - The elevated expression of the c-fos protooncogene has been proposed to be a
      marker of cell activation leading to a long term cellular response. In this
      communication we compared the c-fos mRNA accumulation in the hippocampus (i.e.
      postsynaptic cells) and entorhinal cortex (i.e. presynaptic cells) following high
      (tetanic) and low frequency electrical stimulation of the perforant path. Using
      Northern blot analysis we have found that high frequency stimulation elevates c
      fos expression in both hippocampus and entorhinal cortex, and the increase of c
      fos mRNA levels in the entorhinal cortex is less pronounced, but longer lasting,
      than in the hippocampus. Slight increase of c-fos mRNA levels has been also
      observed in low frequency treated animals in the entorhinal cortex, but not in
      the hippocampus. These findings raise the question about differences in
      mechanisms involved in c-fos activation in both parts of the brain after
      stimulation which evokes long term potentiation (LTP) of synaptic efficacy.

PMID- 1760743
TI  - Excitatory and inhibitory amino acid binding sites in human dentate nucleus.
AB  - Autoradiography of excitatory and inhibitory amino acid binding sites in human
      dentate nuclei indicated virtually no binding to N-methyl-D-aspartate (NMDA) or
      gamma-aminobutyric acidB (GABAB) binding sites, and a low density of kainate
      binding sites. alpha-Amino-3-hydroxy-5-methylisoxazole-4-propionic acid,
      metabotropic-quisqualate, benzodiazepine, and gamma-aminobutyric acidA (GABAA)
      binding sites were present in moderate abundance. Our NMDA results differ from
      those found previously in rodents. GABAA receptors are probably the primary
      mediators of inhibitory neurotransmission and alpha-amino-3-hydroxy-5
      methylisoxazole-4-propionic acid and metabotropic-quisqualate receptors are
      probably the primary mediators of excitatory neurotransmission within the human
      deep cerebellar nuclei.

PMID- 1760744
TI  - Temperature dependence of carbachol-induced modulation of miniature end-plate
      potential frequency in rats.
AB  - In the rat soleus, the frequency of miniature end-plate potentials (MEPP) did not
      change after application of 10(-5) M of the cholinomimetic drug carbachol between
      18 degrees C and 34 degrees C but decreased by 40% at physiological temperatures
      of 37-38 degrees C. The carbachol-induced decrease in MEPP frequency was not
      eliminated by 10(-7) to 10(-8) M atropine or 3 x 10(-7) (+)-tubocurarine
      similarly as had been previously found at frog neuromuscular junction.

PMID- 1760745
TI  - Transplantation of microencapsulated bovine chromaffin cells reduces lesion
      induced rotational asymmetry in rats.
AB  - Surrounding bovine chromaffin cells by a semipermeable membrane may protect the
      transplanted cells from a host immune response and shield them from the
      inflammatory process resulting from the surgical trauma. Encapsulation of the
      chromaffin cells was achieved by interfacial adsorption of a polycation on a
      polyanionic colloid matrix in which the chromaffin cells were entrapped. Basal
      and potassium-evoked release of catecholamines from encapsulated bovine
      chromaffin cells was analyzed over a 4-week period in vitro. Norepinephrine and
      dopamine release remained constant over time whereas epinephrine release
      significantly decreased. The chromaffin cells also retained the capacity for
      depolarization-elicited catecholamine release 4 weeks following the encapsulation
      procedure. Morphological analysis revealed the presence of intact chromaffin
      cells with well-preserved secretory granules. Striatal implantation of chromaffin
      cell-loaded capsules significantly reduced apomorphine-induced rotation compared
      to empty polymer capsules in animals lesioned with 6-hydroxydopamine for at least
      4 weeks. Intact chromaffin cells expressing tyrosine hydroxylase and dopamine
      beta-hydroxylase were observed in all capsules implanted in the striatum for 4
      weeks. The assessment of the clinical potential of transplanting encapsulated
      adrenal chromaffin cells of either allo- or xenogeneic origin for Parkinson's
      disease will require long-term behavioral studies. The present study suggests,
      however, that the polymer encapsulation procedure may offer an alternative to
      adrenal autografts as a source of dopaminergic tissue.

PMID- 1760746
TI  - The expression of proteins and activities of metabolic enzymes in transplanted
      brain tissue.
AB  - The middle three-fifths of the forebrains of 14-day-old embryos were obtained and
      transplanted into the cortical cavities of adult rats made 7 days prior to the
      transplantation. The expression of proteins, as revealed by 2-dimensional gel
      electrophoresis studies, and the activities of energy metabolizing enzymes in the
      mature allografts were compared with those in the 14-day-old embryonic forebrains
      and corresponding areas in the contralateral cerebral hemispheres of the hosts.
      They were shown to approach adult pattern and adult values after 10-12 weeks of
      growth. The biochemical findings were discussed and correlated with some of the
      anatomical observations.

PMID- 1760747
TI  - Evaluation of vagal afferent modulation of the digastric reflex in cats.
AB  - In the present study, we have examined the relative ability of cervical,
      thoracic, cardiac and diaphragmatic vagal stimulation to modulate the digastric
      reflex produced by tooth-pulp stimulation in anesthetized cats. The right
      maxillary tooth pulp was stimulated and the digastric reflex was recorded from
      the right digastric muscle. Cervical vagal stimulation produced a biphasic effect
      on the digastric reflex. The reflex was facilitated at conditioning test
      intervals less than 20 ms and inhibited at conditioning test intervals between
      100 ms and 500 ms. Cardiac and thoracic vagal stimulation did not significantly
      facilitate the digastric reflex but inhibited the reflex at conditioning test
      intervals between 50 ms and 500 ms with maximum inhibition observed at 200 ms. In
      contrast, diaphragmatic vagal stimulation produced a weaker inhibition of the
      digastric reflex. The relative ability of different vagal segments to inhibit the
      digastric reflex was: thoracic = cardiac = cervical greater than diaphragmatic.
      The inhibitory effects were not related to cardiovascular responses to vagal
      afferent stimulation. These findings suggest cardiopulmonary vagal afferents
      represent an important source of vagal afferents which modulate the digastric
      reflex in the cat.

PMID- 1760748
TI  - Effects of acute and chronic ethanol treatment on pre- and postsynaptic responses
      to baclofen in rat hippocampus.
AB  - Interactions between the GABAB receptor and acute or chronic ethanol treatment
      were studied using extracellular and intracellular electrophysiological recording
      techniques. Bath application of the GABAB receptor agonist, (-)-baclofen (0.1-100
      microM) induced concentration-dependent inhibition of extracellularly recorded
      dendritic excitatory postsynaptic potentials (EPSPs) in the CA1 region of
      hippocampal slices. Responses to baclofen were unchanged relative to control
      either by simultaneous application of ethanol (10-60 mM) or by previous chronic
      ethanol exposure. The membrane potential of CA1 pyramidal neurons was reversibly
      hyperpolarized an average of 5 mV by pressure ejection of baclofen (1 mM). Bath
      application of ethanol (30 mM) alone occasionally caused a small depolarization
      of resting membrane potentials in CA1 neurons but failed to increase
      hyperpolarizing responses to pressure-ejected baclofen. However, in slices from
      chronic ethanol-treated animals hyperpolarizing responses to bath-applied
      baclofen (10 microM) were reduced by approximately 30% relative to controls.
      These results suggest that GABAB-mediated responses in CA1 hippocampal pyramidal
      neurons are relatively resistant to the acute effects of ethanol, but that
      continuous exposure to ethanol sufficient to induce physical dependence may evoke
      an adaptive reduction in some GABAB receptor mediated responses.

PMID- 1760749
TI  - Exogenous tyrosine potentiates the methylphenidate-induced increase in
      extracellular dopamine in the nucleus accumbens: a microdialysis study.
AB  - Previous work has shown that the synthesis and release of dopamine may, under
      certain conditions, be influenced by an increase in the availability of its amino
      acid precursor, tyrosine. To examine whether exogenous tyrosine could potentiate
      the methylphenidate-induced increase in extracellular dopamine, male rats were
      implanted with microdialysis probes aimed at the right nucleus accumbens. Samples
      were collected from awake animals beginning 22 h after surgery. A repeated
      measures design was used involving the continuous collection of 20-min samples
      for a 4-h period once a day for 3 consecutive days. On a given day, an animal was
      infused with methylphenidate, tyrosine, or methylphenidate plus tyrosine. Periods
      of infusion with the active compounds were preceded and followed by baseline
      conditions, and treatments were counterbalanced to control for possible order
      effects. Methylphenidate plus tyrosine significantly increased extracellular
      levels of dopamine in comparison to drug alone. This effect was long-lasting,
      persisting into the post-treatment sampling period and peaking 40 min after the
      peak induced by methylphenidate alone. Tyrosine alone induced a small but
      significant increase in extracellular dopamine in the absence of any treatment to
      accelerate the firing of dopamine cells. These findings may have implications for
      the treatment of attention deficit hyperactivity disorder.

PMID- 1760750
TI  - [Control with progesterone of intracellular sulfate available in glandular
      epithelial cells of endometrium in culture].
AB  - Sulfate incorporation was measured in subcultured glandular epithelial cells from
      guinea-pig endometrium, treated by estradiol alone or in concert with
      progesterone. Progesterone significantly increased sulfate incorporation in
      cellular and secreted macromolecules. However, the greatest effect of
      progesterone was on the size of the intracellular sulfate pool available for
      sulfation. This effect of progesterone was correlated with the percentage of
      cells exhibiting progesterone receptors in vitro.

PMID- 1760751
TI  - Stability of CD4/CD8 ratios in man: new correlation between CD4/CD8 profiles and
      iron overload in idiopathic haemochromatosis patients.
AB  - The proportions of CD4+, CD8+ cells were determined in peripheral blood samples
      obtained from 27 patients with idiopathic haemochromatosis and 67 healthy
      controls. Samples from the patients were obtained at the start of therapy and at
      intervals during intensive phlebotomy treatment in which 400 ml of blood are
      removed each week for 6 months to 2 years. Patients varied in their CD4/CD8
      ratios from 0.8 to 4.2. An individual's CD4/CD8 ratio, however, remained
      unaffected by the repeated removal of large volumes of blood by phlebotomy
      confirming the existence of a homeostatic regulation of the relative numbers of
      the two major peripheral T cell pools in man. Follow-up of iron reentry into the
      transferrin pool at the end of the intensive phlebotomy treatment indicates that
      the relative proportion of circulating CD4/CD8 cells is critically related to the
      regulation of iron absorption.

PMID- 1760752
TI  - Ruminant pharmacology.
AB  - Aspects of drug disposition, metabolism, and toxicity in the ruminant animal are
      discussed, and illustrative examples are provided. The effects of the reticulo
      rumen on drug disposition in the ruminant are highlighted.

PMID- 1760753
TI  - Food animal practice. Applied pharmacology and therapeutics I.

PMID- 1760754
TI  - The impact of federal drug regulations on food animal practice.
AB  - This article discusses some of the regulations governing the use of drugs in
      ruminants. Because drug disposition is so influenced by dose, duration, and
      disease status, it is difficult to publish specific withdrawal time information.
      A discussion of calculation of withdrawal times is included.

PMID- 1760755
TI  - Problems and practice in mass medication of beef cattle.
AB  - Mass medication is a health management tool that, when used appropriately,
      results in cost savings and sound economic return to the food animal producer.
      Careful planning and consideration should precede the implementation of a mass
      treatment program, clearly defining the goal to be achieved and a detailed plan
      of execution. For economic as well as professional reasons, indiscriminate
      administration of antimicrobials to large groups of food animals should be
      avoided.

PMID- 1760756
TI  - Therapy of bovine bacterial pneumonia.
AB  - Practical strategies for developing rational therapeutic regimens based on in
      vitro sensitivity and pharmacokinetic disposition are presented. Special
      attention is given to Pasteurella haemolytica, which is regarded as the most
      frequent cause of bovine bacterial pneumonia. Bacterial-dependent and host
      dependent causes of therapeutic failure and potentially valuable novel therapies
      and drug combinations are considered.

PMID- 1760757
TI  - Clinical pharmacology of antimicrobial drugs for the treatment of septic neonatal
      calves.
AB  - For a given infection, each antibiotic will have a probability of producing a
      beneficial outcome. Decisions that increase the antibacterial activity of the
      therapeutic regimen against the bacterial infection will increase the probability
      of a beneficial outcome. Unfortunately, such decisions may increase the cost of
      therapy or the risks of toxicity. Finally, neonatal calves presented for therapy
      are not of uniform value. It is logical to employ different antimicrobial drugs
      and ancillary therapies when the value of the individual calf is considered. A
      constructive balance between efficacy, cost, and toxicity establishes the value
      of a therapeutic approach for the client.

PMID- 1760758
TI  - Treatment of diarrhea of neonatal calves.
AB  - Therapeutic strategies for the treatment of diarrhea of neonatal calves should be
      logical and should be targeted at correction of physiologic dysfunction.
      Appropriate, specific antimicrobial or antiprotozoal therapy should be instituted
      when colibacillosis, salmonellosis, or giardiasis is confirmed or suspected. All
      calves with diarrhea should be rehydrated if necessary, and proper nutritional
      support should be provided. Antisecretory agents such as flunixin meglumine and
      bismuth subsalicylate may be beneficial for treatment of calves with
      colibacillosis and salmonellosis. Adsorbants, such as attapulgite and bismuth
      subsalicylate, also may reduce loss of fluids. Perhaps loperamide or a similar
      drug will be proven effective in calves in the future. Potentially harmful drugs
      include several antimicrobial agents when they are administered orally, because
      they result in malabsorption; kaolin and pectin, which increase loss of ions
      during diarrhea; and motility modifiers that cause a decrease in all types of
      intestinal motor function. Finally, success should be measured by indicators of
      production such as survivability, days treated, weight gained, and net profit.
      Our goal should be to restore and maintain the health of the calf, not simply to
      alter the volume and consistency of the feces.

PMID- 1760759
TI  - Treatment of cardiovascular disease in cattle.
AB  - Cardiac diseases of cattle may involve valvular structures, myocardium,
      pericardium, or blood vessels and are manifested by the clinical signs of cardiac
      dysrhythmias, cardiac murmurs, generalized edema, muffled heart sounds, jugular
      venous distention, jugular venous pulsations, pulmonary edema, pleural effusion,
      or ascites. Digoxin, quinidine, and furosemide can be used effectively to control
      signs of CHF and cardiac arrhythmias. Combination antimicrobial therapy can be
      successful for cows with infective endocarditis and thrombophlebitis. Pericardial
      fluid drainage may temporarily improve cattle with traumatic pericarditis or
      lymphosarcoma so that short-term goals may be reached.

PMID- 1760760
TI  - Treatment of infectious arthritis and osteomyelitis.
AB  - Infectious arthritis and osteomyelitis are commonly encountered diseases of the
      skeletal system that can result in premature loss of an affected animal from the
      herd. Selection of the best possible treatment approach for an individual animal
      requires a solid understanding of the pathophysiologic processes involved in the
      infection of bone or joint; recognition of the unique aspects of the anatomy,
      physiology, behavior, management, and economics of the species involved; and a
      broad grasp of the availability and role of various therapeutic options. By
      recognizing the importance of all three of these areas, a clinician not only will
      be able to make realistic and effective judgments about care of commonly
      encountered cases today but also will have a sufficient basis for rational
      variations in therapy as pharmacologic options expand and environmental or
      economic pressures change.

PMID- 1760761
TI  - Ocular pharmacology.
AB  - Application of sound ocular therapeutic principle is more difficult in food
      animals than most other species. Financial or husbandry constraints limit the
      practitioner's ability to use the entire range of ocular drugs available or to
      use them with adequate frequency. These problems may be dealt with by using
      systemically administered drugs when effective or by employing vehicles or
      delivery techniques that necessitate minimal dosing frequency. By far the most
      important medically treatable eye disease encountered in food animal practice is
      IBK. Effective therapies include systemic administration of long-acting
      oxytetracycline, subconjunctival administration of a variety of antibiotics, or
      topical application of benzathine cloxacillin. Infectious conjunctivitis in sheep
      and goats due to a variety of agents may be treated successfully with
      tetracycline in most cases. Conjunctivitis and keratitis secondary to IBR virus
      usually are given supportive therapy only, although specific antiviral drugs have
      been used in the treatment of herpetic eye disease in other species. Anterior
      uveitis is best treated by corticosteroid and mydriatic therapy in addition to
      treatment of the underlying cause, if identified.

PMID- 1760762
TI  - Treatment of Mycobacterium paratuberculosis infection in ruminants.
AB  - Paratuberculosis is a chronic, debilitating, fatal condition that usually is
      clinically undetectable until the onset of copious diarrhea. Paratuberculosis is
      caused by an acid-fast organism, M. paratuberculosis. Successful eradication of
      paratuberculosis depends on the early detection of infected animals, thereby
      allowing removal of carrier animals from the herd. Treatment for paratuberculosis
      is therefore rarely indicated or undertaken; however, treatment may be considered
      for animals of exceptional genetic value or companion animals. Antimicrobials
      reviewed in this article for the treatment of paratuberculosis include isoniazid,
      rifampin, streptomycin, amikacin, clofazimine, and dapsone. Treatment of
      paratuberculosis requires daily medication for extended periods and results in
      palliation of the disease rather than a definitive cure. The treatment for
      paratuberculosis recommended by the authors is isoniazid at 20 mg/kg administered
      orally every 24 hours for the rest of the animal's life. When the animal has
      acute onset of diarrhea, rifampin at 20 mg/kg every 24 hours is also administered
      orally. In severe, imminently life-threatening cases, an aminoglycoside should be
      administered concurrently for 3 to 8 weeks. This protocol (isoniazid, rifampin,
      and an aminoglycoside) will help ensure that Mycobacteria organisms are sensitive
      to at least two of the antibiotics. Rifampin treatment can be discontinued if
      clinical signs of paratuberculosis disappear and the cost of therapy is judged
      excessive. The combined therapeutic approach has been used in three animals, and
      the results are presented in this article. Because isoniazid, rifampin, and some
      aminoglycosides are not approved for use in food animals in the United States of
      America, the meat or milk from treated animals should not be used for human
      consumption.

PMID- 1760763
TI  - Some ABC's of skeletal pathophysiology. 5. Microdamage physiology.

PMID- 1760764
TI  - Cyclosporin A: friend or foe?

PMID- 1760765
TI  - DEXA measurement of spine density in the lateral projection. I: Methodology.
AB  - Bone mineral content and bone mineral density (BMC in g and BMD in g/cm2) were
      measured using dual-energy X-ray absorptiometry (DEXA). DEXA scans in the lateral
      decubitus position required about 12 minutes for the L2-L4 sequence at 0.75 mA
      (dose 5 mrem) and 4 minutes at 4.75 mA (7 mrem). The former scans were done with
      the Lunar DPX densitometer and the latter with the Lunar DPX-L. One test of the
      algorithms used for measurement is the equality of BMC in both AP and lateral
      projections. BMC in the lateral projection averaged about 1% lower than in the AP
      projection in phantoms and for L2 + L3 in 8 subjects, but the difference was not
      significant. Additional tests were done on the effects of tissue thickness and
      position from the tabletop. There was little or no influence of tissue thickness
      from 18 to 30 cm on BMD results, but there was a small influence of thickness
      below 18 cm (0.01 g/cm2; P = 0.01) and of distance from the tabletop at extremes
      of positioning (0.02 g/cm2; P = 0.06). The precision in vivo was similar for both
      4- and 12-minute scans; the standard deviation of repeat measurements was about
      0.02 g/cm2, which was about 2% relative to the mean BMD for a region within the
      vertebral body. The latter region included half the BMC of the body, or 24% of
      the entire vertebra. Results of 4-minute scans on the DPX and 12-minute scans on
      the DPX-L in 9 subjects were highly correlated (r = 0.98; P less than 0.001).

PMID- 1760766
TI  - Calcium absorption in normal and osteoporotic postmenopausal women.
AB  - Hourly fractional absorption of radiocalcium (alpha), serum calcitriol, and a
      number of other variables were measured in 152 normal and 148 osteoporotic
      postmenopausal women. Alpha, body weight, and serum albumin were all
      significantly lower in the osteoporotic than in the normal women, and plasma
      alkaline phosphatase, fasting urinary calcium, sodium, and hydroxyproline were
      all significantly higher in the osteoporotic than in the normal group. The most
      significant determinant of alpha in each group was the serum calcitriol
      concentration, but calcium absorption relative to serum calcitriol was
      significantly lower in the osteoporotic than in the normal women. The serum
      calcitriol level was slightly but not significantly lower in the osteoporotic
      than in the normal group and accounted for only 20% of the difference in alpha
      between them. The implied "resistance" to calcitriol in the osteoporotic group
      was significantly related to serum albumin and body weight but independent of
      age. Urinary hydroxyproline was an inverse function of alpha and a positive
      function of fasting urinary calcium in the osteoporotic group.

PMID- 1760767
TI  - Isotopic exchange of ingested calcium between labeled sources. Evidence that
      ingested calcium does not form a common absorptive pool.
AB  - We studied the extent of salt dissociation during absorption of calcium from
      sources of differing absorbability by measuring fractional absorption from loads
      in the range of 200-300 mg in healthy adult women. Sources were labeled both
      intrinsically and extrinsically with 45Ca and 47Ca, respectively, and were fed
      alone and in combination with one another. We first confirmed our previous
      observation of superior absorbability of calcium oxalate over spinach calcium in
      a randomized cross-over design in 20 women. Spinach calcium exhibited only half
      the absorbability of the same load of calcium presented as the oxalate. Then, in
      14 women fed spinach with both an intrinsic and an extrinsic label, apparent
      absorption of the extrinsic label averaged 0.130 +/- 0.041 and of the intrinsic
      label, 0.029 +/- 0.023. Thus, the extrinsic tag was partially, but not
      completely, bound by the spinach. In the same 14 women, milk absorption averaged
      0.331 +/- 0.092 when ingested alone. However, when co-ingested with spinach,
      apparent milk calcium absorption fell to 0.267 +/- 0.079 and apparent spinach
      calcium absorption rose to 0.111 +/- 0.039. Thus, there was significant but
      incomplete label exchange between the two sources, indicating that at least some
      of the calcium from both sources enters a common preabsorptive, ionic pool. By
      contrast, we had previously shown no tracer exchange when labeled oxalate was co
      fed with labeled milk. We conclude that (1) the presence of calcium as the
      oxalate in spinach is not a sufficient explanation for the poor absorbability of
      spinach calcium; and (2) oxalate calcium and spinach calcium are absorbed by
      different mechanisms, one involving a common preabsorptive pool and the other
      not.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760768
TI  - Changes in apatite crystal size in bones of patients with osteogenesis
      imperfecta.
AB  - Apatite crystal size in compact bone of children (age less than 11 years) and
      adolescents (age greater than 12 years) with osteogenesis imperfecta (OI) was
      analyzed by X-ray diffraction. Eight type I, 4 type II, 11 type III, and 14 type
      IV OI patients were studied along with 9 controls. The crystal size was most
      significantly reduced in type II patients, all of whom had died at birth. Crystal
      size was also diminished in both children and adolescents with types III and IV,
      whereas with type I OI, crystal size was reduced in children only, returning to
      normal in adolescence. There was a trend toward increased bone crystal size with
      age in both OI patients and controls.

PMID- 1760769
TI  - Fourier transform infrared spectroscopic study of the carbonate ions in bone
      mineral during aging.
AB  - The environment of CO3(2-) ions in the bone mineral of chickens of different ages
      and in bone fractions of different density have been investigated by resolution
      enhanced Fourier Transform Infrared (FTIR) Spectroscopy. Three carbonate bands
      appear in the upsilon 2 CO3 domain at 878, 871, and 866 cm-1, which may be
      assigned to three different locations of the ion in the mineral: in monovalent
      anionic sites of the apatitic structure (878 cm-1), in trivalent anionic sites
      (871 cm-1), and in unstable location (866 cm-1) probably in perturbed regions of
      the crystals. The distribution of the carbonate ions among these locations was
      estimated by comparing the intensities of the corresponding FTIR spectral bands.
      The intensity ratio of the 878 and 871 cm-1 bands remains remarkably constant in
      whole bone as well as in the fractions obtained by density centrifugation. On the
      contrary, the intensity ratio of the 866 cm-1 to the 871 cm-1 band was found to
      vary directly and decreased with the age of the animal. In bone of the same age,
      the relative content of the unstable carbonate ion was found to be highest in the
      most abundant density centrifugation fraction. A resolution factor of the CO3(2-)
      band (CO3 RF) was calculated from the FTIR spectra which was shown to be very
      sensitive to the degree of crystallinity of the mineral. The crystallinity was
      found to improve rapidly with the age of the animal. The CO3 RF in the bone
      samples obtained by density centrifugation from bone of the same animal was found
      to be essentially constant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760770
TI  - A resolution-enhanced Fourier transform infrared spectroscopic study of the
      environment of the CO3(2-) ion in the mineral phase of enamel during its
      formation and maturation.
AB  - A resolution-enhanced Fourier Transform Infrared (FTIR) Spectroscopic study of
      the CO3(2-) ion in pig enamel of increasing age and maturity has demonstrated the
      existence of four different, main carbonate locations. The major CO3(2-) site
      arises as a result of the substitution of CO3(2-) ions in the positions occupied
      by PO4(3-) ions in the apatitic lattice. In addition, two minor locations have
      been identified in positions in which the CO3(2-) ions substitute for OH- ions.
      The fourth carbonate group appears to be in an unstable location. Its
      concentration has been found to decrease with aging and maturation, during which
      there is a progressive increase in the amount of mineral deposited in the enamel.
      The distribution of the carbonate ions in the different apatitic sites varies
      randomly during the formation of the mineral phase in enamel and during its
      maturation. Although these changes have been shown to be related to changes in
      the composition of the mineral phase, a comparison of the parameters assessing
      the degree of crystallinity of the mineral phase from upsilon 2CO3(2-) and
      upsilon 4PO4(3-) infrared absorption data reveals a significant discrepancy
      related to the nonhomogeneous partition of the CO3(2-) ion in the mineral phase.
      After maximum mineralization is reached, the composition of the mature mineral
      phase is decidedly different than that of the initial mineral deposited; the
      changes affect principally the concentrations of Ca2+, OH-, and HPO4(2-) ions,
      but not the CO3(2-) ions.

PMID- 1760771
TI  - Carbonate ions in apatites: infrared investigations in the upsilon 4 CO3 domain.
AB  - Fourier transform infrared (IR) spectroscopic investigations of precipitated
      carbonate apatites in the upsilon 4 CO3 domain reveal the existence of five bands
      at 757, 740, 718, 692, 670 cm-1 which can be assigned to several distinct
      environments of the carbonate ion in the apatite structure. In order to identify
      these environments precisely, fluoridated and pure type A carbonate apatites
      (i.e., with carbonate ions in monovalent anionic sites) were examined. The bands
      at 670 and 757 cm-1 were attributed to type A carbonate and their relative
      intensity was found to increase when the carbonate content of the apatite
      diminished or when samples were heated at 400 degrees C. Fluoridated apatites
      show only two bands, close to 718 and 692 cm-1, corresponding to type B carbonate
      ions (carbonate in trivalent anionic sites). The band at 740 cm-1 was revealed by
      heating the samples to 400 degrees C. This is due to OH ions' hydrogen bonded to
      fluoride and to carbonate ions in an undetermined apatite site. Despite the low
      intensity of IR bands, investigations in the upsilon 4 CO3 domain appear
      complementary to those in other carbonate vibrational domains and could be useful
      for a more precise identification of bone mineral.

PMID- 1760772
TI  - Effects of cyclosporine A on chick osteoclasts in vitro.
AB  - We have studied the effects of cyclosporine A (CsA) on basal and bovine
      parathyroid hormone (1-34) (bPTH)-stimulated bone resorption by osteoclasts in 24
      hour cultures of chick long bone cells. At a high concentration (10
      micrograms/ml), CsA had a cytotoxic effect on both osteoclasts and mononuclear
      cells in the culture. At 1 microgram/ml, CsA inhibited basal and bPTH-stimulated
      bone resorption but was not cytotoxic over 24 hours. We also studied the binding
      of bPTH to the osteoblastic cell line, Saos-2, and chick long bone cells in
      suspension culture. CsA inhibited bPTH binding in Saos-2 in a dose-dependent
      manner; inhibition of binding was also observed in chick bone cells. The effects
      of CsA on osteoclast viability and resorptive function may be due to a direct
      effect on the osteoclasts and/or to an interaction with the nonosteoclastic cell
      population in the culture.

PMID- 1760773
TI  - Clinical and laboratory parameters in adult diabetics with and without calcific
      shoulder periarthritis.
AB  - The clinical and laboratory parameters of calcific shoulder periarthritis (CSP)
      were examined in 900 patients with type II diabetes mellitus as well as in 350
      age- and sex-matched control subjects. A threefold increased prevalence of CSP in
      diabetics compared with the control group was associated with the presence of
      longstanding and poorly controlled diabetes, hypercholesterolemia, and
      hypertriglyceridemia suggesting pronounced diabetic angiopathy, as well as with
      minor trauma and hypomagnesemia. Aging and serum calcium concentrations were not
      related to the presence of CSP. Thirty-two percent of diabetics with CSP were
      symptomatic; 15% of them presented with severe pain and restriction of shoulder
      movement. These findings confirm a close pathogenetic interrelation between CSP
      and diabetes mellitus.

PMID- 1760775
TI  - Experience with the novo DPA scanner.

PMID- 1760774
TI  - Correlations between photon absorption properties and failure load of the distal
      radius in vitro.
AB  - The bone mineral content (BMC) and cross-sectional properties of cadaveric radii
      were assessed by single photon absorptiometry (SPA). A new multiple-angle
      scanning technique was used in conjunction with SPA to measure the area and
      moments of inertia of the radial cross section in intact forearms. The radii of
      the same forearms were then broken in a failure test to simulate a fall on the
      outstretched arm. Colles' fracture was produced in 16 of 18 radii tested. The BMC
      divided by the bone width, which is called bone mineral density (BMD) in clinical
      applications, did not correlate with the load at failure in cadaveric forearms.
      The BMC alone did correlate significantly with failure load (r2 = 0.62), and the
      cross-sectional properties gave the best correlation with failure load in a
      sequential multiple regression (r2 = 0.80). We conclude that if SPA is to be used
      in clinical studies to predict risk of radial fracture or of fractures at remote
      skeletal sites, then BMC should be used rather than BMD. An even better indicator
      of radial bone strength than BMC would be a biomechanical parameter derived from
      the cross-sectional area and moments of inertia, which can be obtained from
      multiple-angle SPA.

PMID- 1760776
TI  - "60 minutes--a year later".

PMID- 1760777
TI  - Safety and tooth whiteners.

PMID- 1760778
TI  - Issues in the amalgam debate.
AB  - This paper reviews the facts available on the biological effects of mercury
      released from amalgam restorations in teeth. There seems to be no doubt that
      mercuric vapor is released from restorations, but we do not know how much of this
      mercury is deposited in human tissues. There is no scientific evidence to support
      the belief that vapors from dental restorations either cause or exacerbate human
      diseases. Therefore, there is no clinical justification at present for replacing
      amalgam with other less durable or less predictable restorative materials.

PMID- 1760779
TI  - Comparison of two popular methods for removal and killing of bacteria from
      dentures.
AB  - A study was undertaken to compare the efficacy of a soaking solution (Efferdent
      Extra-Strength Denture Cleanser Tablets) to mechanical cleaning with a denture
      paste (Advanced Formula Dentu-Creme Denture Cleaning Paste) to remove and kill
      plaque bacteria from removable dentures. The study was conducted in a randomized,
      four-way crossover fashion with 18 subjects. At each clinic visit, subjects were
      randomized to one of four treatment regimens: 1) no treatment; 2) brushing with
      denture paste; 3) soaking in Efferdent; 4) brushing followed by soaking in
      Efferdent. Microbiological sampling for plaque bacteria was made before and after
      each treatment. Aliquot samples of 10-fold serial dilutions were plated on
      supplemented Schaedler Agar (for total anaerobes) and on CVE agar (for
      fusobacteria). Analysis of covariance was performed on the log10 transformed
      scores at posttreatment using the pre-treatment scores as covariates. Significant
      treatment effects were: F(3,41) = 81.60, p less than 0.001 for anaerobes and
      F(3,50) = 104.38, p less than 0.001 for fusobacteria. Pairwise comparisons using
      Tukey hsd post hoc tests showed that for total anaerobes, treatments 1 and 2
      yielded higher scores than treatments 3 and 4. For fusobacteria, treatment 1
      greater than 2 greater than 3 or 4; no difference between treatments 3 and 4. The
      results demonstrated the superior performance of Efferdent over Dentu-Creme.

PMID- 1760780
TI  - A useful model for dental practice analysis, budgeting and income projection.
AB  - A versatile dental practice financial model, developed and utilized by the
      author, is presented. The model can be used by the dentist/manager to analyze
      dental practice financial data in order to identify practice inefficiencies and
      determine return on investment. It can also be used as a simple method of
      preparing a dental practice budget and projecting practice profit. Rationale for
      the model is explained and its use is discussed using hypothetical dental
      practice situations.

PMID- 1760781
TI  - Documenting nursing care in the operating room.

PMID- 1760782
TI  - Organ transplants and retrieval.

PMID- 1760783
TI  - The other side of caring.

PMID- 1760784
TI  - Ethical considerations of the extracorporeal membrane oxygenation procedure.

PMID- 1760785
TI  - Geriatric home health care. Conceptual and demographic considerations.
AB  - This article has explored conceptual and demographic aspects of HHC and the
      distinction between formal and informal care. HHC for elderly persons is shown to
      be mainly an informal, familial activity with important formal professional,
      skilled, and unskilled components. Formal home health care in the United States
      has undergone a historic transformation with the rise of third-party payment as a
      principal, defining force and with demographic and epidemiologic transition of
      the general population. Recent national studies demonstrate that the principal
      population group receiving HHC services--the chronically ill, functionally
      limited, noninstitutionalized elderly--is growing in number and as a proportion
      of the group with home and community service needs. Although diverse formal
      service innovations are being explored to meet these growing needs, current
      involvement of medical professionals in formal HHC emphasizes relatively short
      term, post-acute therapeutic and restorative care offered through Medicare
      certified home health agencies.

PMID- 1760786
TI  - Geriatric home care.

PMID- 1760787
TI  - The role of physicians in home health care.
AB  - Physician involvement in home care has declined markedly over the past 50 years.
      By contrast, the renaissance in home care in the US over the last decade has
      created a pressing need for greater physician participation and new roles for
      physicians as members of the home care team. This article reviews these
      developments and identifies the need for improved medical education and physician
      reimbursement if the desired physician involvement in home care is to become a
      reality.

PMID- 1760788
TI  - Geriatric assessment in the home.
AB  - Home assessment of health, environmental, and social factors, and their
      interactions that may impair the patient's functional capabilities and quality of
      life can play a critical role in the care of frail elderly patients. Home
      assessments can reveal important new health and social problems not identified in
      a clinical visit. Recent information suggests that home assessment is identified
      with good patient outcomes. Although this type of assessment is traditionally
      carried out by a nurse in the context of an interdisciplinary team, an individual
      primary care physician can also establish an ad hoc, multidisciplinary team to
      help care for frail elderly patients using principles derived from a
      comprehensive home assessment.

PMID- 1760789
TI  - Multidisciplinary home rehabilitation. A practical model.
AB  - The home is the most natural setting for rehabilitation. At home, the patient and
      family become active team members and the plan of care is created and carried out
      in the environment in which the patient will live. Home rehabilitation enhances
      the patient's autonomy, independence, and community reintegration.

PMID- 1760790
TI  - Home safety and fall prevention.
AB  - In conclusion, the majority, or at least a large proportion, of accidental
      injuries in the elderly are preventable with careful medical and environmental
      evaluation and intervention. A vigorous diagnostic, therapeutic, and preventive
      approach is appropriate in all older patients who fall in addition to those at a
      high risk of falling. Any intervention that can make inroads on this major cause
      of death and disability in the elderly population will clearly have major impact.

PMID- 1760791
TI  - Medication management in the home.
AB  - Medication management in home care patients differs from medication management in
      other settings. Medication choice among home care patients may be improved by a
      comprehensive geriatric assessment in the patient's home. Technological advances
      have improved the choices of drugs, routes of drug administration, and monitoring
      devices available at home. Other special aspects of medication management in the
      home include long-term ambulatory monitoring of complex drug regimens, the
      initiation of high-risk medication therapies, compliance aids for functionally
      impaired patients, and methods for an interdisciplinary team approach to health
      care.

PMID- 1760792
TI  - Home intravenous antibiotic therapy.
AB  - This article examines the development of a home intravenous program, types of
      outpatient intravenous programs, the criteria for patient selection, the
      equipment required, types of infections treated, the use of antimicrobics,
      clinical experience in the elderly, and financial considerations.

PMID- 1760793
TI  - Pain management at home.
AB  - The management of chronic pain should be a priority in geriatric home care. Pain
      is a common problem that has tremendous potential to influence the physical
      function and quality of life of elderly people during their remaining years. The
      experience of pain and its management at home are not analogous to institutional
      settings. Family and caregivers have important influences on pain management and
      may require education and support for the long-term management of chronic pain
      patients. Existing pain management strategies should be tailored to meet the
      special needs of geriatric patients and be sensitive to caregiver concerns.
      Implications, indications, and applications for high-tech pain management
      strategies need to be clarified for the management of older people at home.

PMID- 1760794
TI  - Home care for respiratory problems.
AB  - This article reviews current recommendations for the home care of geriatric
      patients with chronic pulmonary disease. Special attention is given to new
      bronchodilators, indications for home oxygen and ventilator use, as well as the
      use of nasal CPAP in elderly sleep apnea patients. The necessity of do not
      resuscitate (DNR) orders is also discussed.

PMID- 1760795
TI  - Managing the behavioral problems of dementia in the home.
AB  - The majority of persons with dementia are cared for in the home by family and
      friends. The goals of treatment in this setting are to maximize the quality of
      life of the demented person and minimize burdens on the caregiver. Behavioral
      problems are common with dementia and can lead to significant caregiver burden.
      Behaviors that are most common or most serious to caregivers include behaviors
      related to memory disturbances, restlessness and agitation, catastrophic
      reactions, day/night disturbances, delusions, wandering, and physical violence. A
      general method for clinicians to manage these problems involves the
      identification of the behavior and its antecedent and consequent events.
      Stressors that may cause behavioral problems include fatigue, a change of
      routine, excessive demands, overwhelming stimuli, and acute illness or pain.
      Caregivers can be taught to identify these stressors in order to prevent or
      alleviate troublesome behaviors. When behavioral techniques are not successful
      and the behaviors are particularly dangerous or burdensome, therapy with low
      doses of high-potency neuroleptics has been suggested. Measures such as these to
      help caregivers in the management of dementia at home can be instrumental in
      improving the quality of life for the person with dementia.

PMID- 1760796
TI  - Family dynamics and caregiver burden in home health care.
AB  - Planning an intervention involves the assessment of medical needs followed by an
      analysis of the family composition, dynamics, role allocations, coping
      mechanisms, mode of emotional expression, and the point in the family's
      developmental sequence. Therapeutic targets should be identified and prioritized.
      At that point, a behavioral probe or some specific recommendation that the family
      can easily follow should be made. A careful analysis of the response will
      indicate the ease with which more difficult change prescriptions can be
      introduced. Failure of the family to follow even the most simple suggestion may
      indicate that family therapy is needed. If the family is successful at carrying
      out the probe suggestion, however, the home health care team can proceed with
      greater confidence that their efforts will lead to improved patient care and
      healthy family functioning.

PMID- 1760797
TI  - Elder abuse.
AB  - Elder abuse encompasses physical, psychological, and financial abuse and also
      includes the violation of an individual's rights, or social abuse. Detection of
      elder abuse is often obstructed by the denial or shame of the abused older adult
      and the denial or improper assessment by health care professionals. The ethical
      struggle professionals face when they suspect abuse may also impede assessment or
      intervention. Preliminary data on etiologic factors related to elder abuse
      suggest that misinformation, the caregiver's lack of understanding of the needs
      of older adults, social isolation, a history of dysfunctional family
      relationships, and the psychopathologic factors of the caregiver are salient
      factors for understanding elder abuse. In addition, caregiver burden related to
      the care of the impaired elder and other external life events is a risk factor
      for elder abuse. Self-neglect is the type of elder abuse most often reported and
      the most difficult to handle, because older adults have a right to refuse
      services. Home care providers often face practical and ethical dilemmas in cases
      of self-neglect. When making an assessment for elder abuse, it is best to use a
      multidisciplinary approach. In addition to physical indicators (bruises,
      malnutrition, fractures), attention must be paid to the social, family, and
      sexual history of the patient. The psychological history of the patient and
      caregiver is also important. Reporting laws exist in all states, and health care
      practitioners must become familiar with the laws in their states. Awareness of
      elder abuse by professionals working in home care is essential, because the
      failure to detect abuse can interfere with interventions and in some cases lead
      to death.

PMID- 1760798
TI  - Quality assurance in home care.
AB  - The current increasing role of home care in US health care has brought with it
      the need for the development of standards addressing the quality of home care
      services. Home care poses quality assessment difficulties because of the broad
      spectrum of in-home procedures and services now available. Home care
      professionals (including physicians), as well as local, state, and national
      medical organizations all play a significant role in developing and enforcing
      quality assurance standards in home care.

PMID- 1760799
TI  - Cost-effectiveness of home care.
AB  - Home health care is uniformly accepted by patients, caregivers, health
      professionals, policymakers, and the public as a desirable way to provide care to
      disabled individuals and the frail elderly. Given the lack of positive impact of
      home care upon functional status, cost, and nursing home use, as well as
      documented additional cost, future research must focus upon positive aspects from
      past experiences. Careful targeting of patients most likely to benefit from this
      care has produced better results. Satisfaction with care has been shown
      consistently. Managed home health care may have the potential, especially the
      impact of physician involvement with team care on hospital use, to contain costs.
      The intuitive belief that home care is beneficial and a worthwhile expense, held
      by policymakers and health care professionals alike, needs to be fully researched
      by studies that carefully examine the wide spectrum of home care benefits for
      disabled or chronically ill individuals in relation to varying cost levels that
      the population and health care system can absorb. The challenge is here, and
      those who believe in home care need to make use of the results of these previous,
      rather nonsupportive studies. Additional research is needed to measure the impact
      of active physician participation in the team care provision of home care
      services and the impact of managed home care on the cost of hospital care in the
      population most at risk for recurrent hospitalization. This same research must
      document not only more effective targeting of individuals, but also the
      maintenance of increased satisfaction with care--strongest motive for the need to
      prove the cost-effectiveness of home care.

PMID- 1760800
TI  - African-American men. Perceptual determinants of early cancer detection and
      cancer risk reduction.
AB  - Research has shown that African-American men have a higher incidence, a higher
      death rate, and a lower survival rate for most cancers. But currently there are
      few studies addressing factors influencing the health care trends of this high
      risk population. A study focused on identifying factors that contribute to early
      cancer detection and cancer risk-reduction health behavior in African-American
      men was therefore implemented. There is evidence to support the conclusion that
      perceptions do significantly contribute to the health behavior of African
      American men. Those having the greatest impact were related to methods of early
      cancer screening. Clearly, if the National Cancer Institute's goal to reduce the
      mortality from cancer in the general population by 50% from the base rate in 1984
      is to be met by the year 2000, there must be an increase in programs targeting
      African-American men. Every day African-American men can take steps to help
      protect themselves from cancer. Our charge as health care clinicians, educators,
      and researchers is to pinpoint ways to encourage them to do so.

PMID- 1760801
TI  - Clinical decision making and pain.
AB  - Pain management is intimately linked to decision making. Nurses play a key role
      in making decisions regarding pain and its management. This paper presents data
      from a preliminary study (N = 53) extending the investigators' pain research into
      the areas of clinical decision making and ethical dilemmas related to pain
      management. Nurses completed surveys focused on actual experiences of caring for
      patients in pain. The results identify common clinical decisions related to pain,
      barriers to providing optimum pain relief, and ethical/professional conflicts in
      pain management. Decisions related to the amount of pain intensity, when to give
      medications, and choice of analgesics. Nurses identified verbal and nonverbal
      cues central to their decisions regarding pain assessment. Barriers to effective
      pain management included physician knowledge and cooperation, patient/family
      knowledge and cooperation, as well as nursing knowledge and time. Respondents
      identified ethical dilemmas about overmedication or undermedication, conflicts
      with physicians or patients, and concern over opioid side effects. A tentative
      model of decision making related to pain is presented.

PMID- 1760802
TI  - Systematic pain records and their impact on pain control. A pilot study.
AB  - This study examined the impact of a systematic nursing pain assessment tool (PAT)
      and pain flow sheet (PFS) on pain management. A control group (N = 23) was
      compared with a treatment group (N = 20) of hospitalized patients on a medical
      oncology unit. In the control group, "routine" charting of pain was done in the
      nurses' narrative notes. Patients in the treatment group underwent standardized
      pain assessment and documentation using a PAT and PFS. The treatment group
      reported significantly lower average pain intensity ratings (chi 2 = 5.019, p =
      0.02) on day three of follow-up. In addition, a greater number of patients in the
      treatment group (85%) reported decreased pain intensity from day one to day three
      as compared with the control group (57%). This study supports other research and
      recommendations in the literature that use of systematic pain records can improve
      pain management.

PMID- 1760803
TI  - A survey of nursing students' knowledge of cancer pain control.
AB  - The World Health Organization estimates that approximately 3.5 million people
      suffer daily from cancer pain. Recently, a Midwestern state was named by the
      World Health Organization to lead worldwide efforts in controlling the pain
      experienced by cancer patients. As part of this effort, the Nursing Education
      Committee conducted a statewide study of first year and final year nursing
      students from 19 nursing programs. The purpose of this study was to determine
      nursing students' perceptions and knowledge about cancer pain control. After the
      deans and directors of the nursing programs were contacted to obtain their
      agreement to participate, questionnaires composed of 26 items were mailed to each
      nursing school and distributed to students. Nine hundred thirty-eight
      questionnaires were returned to the researchers, realizing a 40% return rate.
      Data analysis reflects poor knowledge about the prevalence of cancer pain and its
      management. Using the student's t-test, significant differences between the
      scores of first year and last year students were found with last year students
      achieving higher mean scores. It was concluded that more information about how to
      manage cancer pain needs to be provided in nursing curricula. It is recommended
      that faculty members frequently update their knowledge and skills about cancer
      pain management.

PMID- 1760804
TI  - Process of dying. Defining characteristics.
AB  - Health professionals should not be forcing the terminal patient into
      preestablished stages, but rather should take into account the actual experiences
      of the individual. The purpose of this study was to identify the defining
      characteristics of the dying process within the terminal phase. A retrospective
      audit of 11 deceased clients' charts from a hospice program was conducted. Each
      client had been diagnosed with terminal cancer. Defining characteristics of the
      process of dying were delineated and organized into groups of subjective and
      objective phenomena. These included anorexia, absence of pain, nausea, vomiting,
      tachycardia, respiratory status, withdrawal of self, secretions, mental status,
      urinary output, restlessness, bowel sounds, blood pressure, internal temperature,
      skin temperature, skin color, edema, and diaphoresis. Although the sample size
      was small, these findings confirmed that the dying process for terminal cancer
      patients was an individualized experience. Additional research is needed to build
      on this framework.

PMID- 1760805
TI  - Determinants of anticipatory nausea and anticipatory vomiting in adults receiving
      cancer chemotherapy.
AB  - There is a need for further empirical investigation of variables that may
      contribute to the occurrence of anticipatory nausea and/or anticipatory vomiting
      (AN/AV) in persons receiving cancer chemotherapy. The purpose of this study was
      to examine the relationship of AN/AV in adults receiving an initial course of
      cancer chemotherapy in an outpatient setting with the following set of variables:
      symptom distress, mood disturbance, stage of disease, sensitivity to conditioning
      cues, emetic potential of antineoplastic drugs, age, psychosocial stress, and
      ability to cope. Thirty-two percent of the sample developed anticipatory nausea.
      Multivariate statistics were used to examine the contribution of the variables to
      the prediction of AN/AV. Analysis of the data revealed that 53% of the variance
      accounted for was contributed by the following combination of variables: emetic
      potential of drug, level of symptom distress, mood disturbance, stress and
      ability to cope (p = .001). The total percentage of cases correctly classified
      was 88.3%. This combination of variables correctly classified 100% of patients
      who experienced anticipatory nausea (n = 15). Eighty-two percent of patients who
      did not experience anticipatory nausea and/or anticipatory vomiting (n = 28) were
      classified correctly.

PMID- 1760807
TI  - Effect of a glucan, sizofiran, on natural-killer activity of 5-fluorouracil
      treated murine bone marrow cells.
AB  - The number of bone marrow cells in C3H/He mice was reduced 3-4 days after
      treatment with 130 mg/kg intraperitoneal 5-fluorouracil (5-FU). Higher rates of
      spontaneous proliferation and natural killer (NK) activity, accompanied by an
      increase in asialoGM1-positive cells, were observed in treated mice. When
      sizofiran at a dose of 200 micrograms/animal was intramuscularly injected after 5
      FU treatment, the rates of proliferation and NK activity of bone marrow cells
      were higher than with 5-FU alone. The cell number was not influenced by sizofiran
      alone. These results indicate that all precursors of the various mature cell
      types (including NK cells) differentiate and regenerate rapidly to replace cells
      damaged by 5-FU treatment, and that sizofiran has the potential to assist this
      recovery. These results suggest that administration of sizofiran after
      chemotherapy may be useful in cancer patients.

PMID- 1760806
TI  - T cell targeting in cancer therapy.
AB  - Targeting of immune cells by bispecific antibodies has proven a powerful tool for
      the investigation of cellular cytotoxicity, lymphocyte activation and induction
      of cytokine production, as well as to represent an innovative form of
      immunotherapy for the treatment of cancer. The hallmark of this approach is the
      use of the specificity of monoclonal antibodies to join target and immune cells
      by virtue of the dual specificity of bispecific antibodies for the two entities.
      More precisely the bispecific antibody has two different binding sites, which are
      capable of recognizing tumor associated antigens on the one hand and lymphocyte
      activation sites on the other. This process of crosslinking results in the
      activation of the lymphocyte and triggering of its lytic machinery, as well as
      lymphokine production. A major advantage of this therapeutic modality is, that
      use is made of the normal cellular immune defence system and therefore is only
      associated with minor toxicity. The distinct lymphocyte populations, which can be
      used for adoptive immunotherapy and the various bispecific antibody preparations,
      as well as the chimeric immunoglobulin/T cell receptor construction are the major
      topics of this review.

PMID- 1760808
TI  - Human lymphokine-activated killer (LAK) cells: III. Effect of L-phenylalanine
      methyl ester on LAK cell activation from human peripheral blood mononuclear
      cells: possible protease involvement of monocytes, natural killer cells and LAK
      cells.
AB  - We have shown that depletion of monocytes from human peripheral blood mononuclear
      cells (PBMC) by L-phenylalanine methyl ester (PheOMe) enhanced lymphokine
      activated killer cell (LAK) generation by recombinant interleukin-2 (rIL-2) at
      high cell density. In this study, we have investigated the mechanism of action of
      PheOMe on LAK activation by using trypsin, chymotrypsin,
      tosylphenylalaninechloromethanol (TPCK, a chymotrypsin inhibitor), tosyl-L
      lysinechloromethane (TLCK, a trypsin inhibitor), phenylalaninol (PheOH), and
      benzamidine. PBMC were treated with 1-5 mM PheOMe for 40 min at room temperature
      in combination with the various agents, washed and assessed for their effects on
      natural killer (NK) activity against K562 cells and monocyte depletion. The
      treated cells were then cultured with or without rIL-2 for 3 days. LAK
      cytotoxicity was assayed against 51Cr-labeled K562 and Raji tumor target cells.
      TPCK at 10 micrograms/ml partially inhibited depletion of monocytes by PheOMe.
      TLCK did not prevent depletion of monocytes nor inhibition of NK activity induced
      by PheOMe. TPCK and TLCK inhibited NK activity by themselves. TPCK but not TLCK
      inhibited rIL-2 induction of LAK cells. On the other hand, PheOH and benzamidine
      (analogs of PheOMe) lacked any effect on monocyte depletion but abrogated the
      inhibitory effect of PheOMe on NK activity. They had no effect on rIL-2
      activation of LAK activity enhanced by PheOMe. Trypsin potentiated the inhibitory
      effect of PheOMe on NK activity and monocyte depletion. Trypsin partially
      inhibited IL-2 activation of LAK activity enhanced by PheOMe. Chymotrypsin had
      little effect on NK activity but prevented the inhibitory effect of PheOMe on NK
      activity. It had little effect on monocyte depletion induced by PheOMe. PheOMe
      was hydrolysed by monocytes and chymotrypsin to Phe and methanol as determined by
      HPLC. TPCK inhibited hydrolysis of PheOMe by monocytes. Our data suggest that the
      effects of PheOMe on monocytes, NK cells and LAK activation involve protease
      activities of monocytes.

PMID- 1760809
TI  - Characterization of a monoclonal antibody directed against the epidermal growth
      factor receptor binding site.
AB  - In this work a new monoclonal antibody (mAb), designated MGR1, which recognizes
      the epidermal growth factor receptor (EGF-R) binding site, is described. The main
      characteristic of this mAb is its ability to discriminate between cells that
      express normal levels of EGF-R from cells with overexpression, the detectability
      threshold by immunocytochemical tests being 5 x 10(4) receptors/cell of 10
      microns diameter. MGR1 was found to inhibit EGF binding on the relevant target
      cells, and vice versa its binding was inhibited by EGF, which indicated that MGR1
      recognizes the EGF receptor binding site. MGR1 exerted an inhibitory effect on
      both the in vitro and in vivo growth of cells with EGF-R overexpression, but had
      no effect on cells with a normal expression of the receptor. Tumour growth
      inhibition in athymic mice was also obtained on already implanted tumours. MGR1
      therefore seems to be an adequate reagent for the development of
      immunotherapeutical approaches suitable for the treatment of tumours with EGF-R
      overexpression.

PMID- 1760810
TI  - Immunotherapy of B lymphoma by anti-idiotype antibodies: characterization of
      variant tumour cells appearing a long time after the initial tumour inoculation.
AB  - Immunotherapy of a murine B-cell lymphoma by antibodies to idiotypic determinants
      of its IgM, resulted in surviving tumour-free mice. Several of these mice,
      however, did develop tumours a long time after the initial inoculation of the
      tumour cells, or upon rechallenge of the survivors with B-lymphoma cells. The
      presence of tumour cells during this long latent period may have been due to the
      development in the host of an anti-idiotype immune response. These late
      developing tumours were detected by a radioimmunoassay and characterized by
      immunofluorescent staining and sodium dodecyl sulphate/polyacrylamide gel
      electrophoresis. Cells of some late-developing tumours lost the idiotype
      recognized by the antibodies used for the immunotherapy. Several of these tumours
      expressed IgM on the cell surface, while others did not, because of the absence
      of light chains. They were identical in the structure of their rearranged mu
      chain genes proving their derivation from the original inoculation. Cell lines
      obtained from the late-developing tumours differed in their tumorigenicity. The
      appearance of idiotype-negative tumour cells as a result of anti-idiotype
      immunotherapy has a great impact in our efforts to cure lymphoma by this
      modality.

PMID- 1760811
TI  - Production of tumor necrosis factor alpha and interferon gamma in interleukin-2
      treated melanoma patients: correlation with clinical toxicity.
AB  - Interleukin-2 (IL-2)-based immunotherapy regimens are accompanied by dose
      limiting toxicity consisting of fever, tachycardia, chills and capillary leak
      syndrome. We hypothesized that the toxicity was caused by the induction and
      release of endogenous cytokines such as tumor necrosis factor alpha (TNF alpha)
      and interferon gamma (IFN gamma). We measured the serum levels of TNF alpha and
      IFN gamma in IL-2-treated melanoma patients and attempted a correlation with
      clinical toxicity. A total of 23 patients received either 6 x 10(6) IU or 12 x
      10(6) IU Cetus IL-2/m2 by i.v. bolus daily for 5 consecutive days on weeks 1, 3
      and 5. Serum TNF alpha and IFN gamma levels were measured by enzyme-linked
      immunosorbent assay. Clinical toxicity was scored each day by objective
      measurements of hypotension, tachycardia, fever and chills/rigors. Clinical
      toxicity and IFN gamma levels correlated nicely, peaking on the 5th day of each
      treatment cycle. The kinetics and magnitude of TNF alpha production, however,
      were not predictable and did not correlate with either IFN gamma or toxicity.
      Some patients had modest increases in TNF alpha production while others had
      markedly increased levels during the second and third treatment weeks.
      Remarkably, these high levels persisted during nontreatment weeks and after
      completion of therapy. This clinical study demonstrates novel kinetics for
      immunoreactive TNF alpha in IL-2 cancer patients, which do not correlate well
      with toxicity.

PMID- 1760812
TI  - Therapeutic use of a long-term cytotoxic T cell line recognizing a common tumour
      associated antigen: the pattern of in vitro reactivity predicts the in vivo
      effect on different tumours.
AB  - A long-term-cultured cytotoxic T lymphocyte (CTL) line (E/88) was obtained from
      splenic lymphocytes of BALB/c (H-2d) mice bearing the weakly immunogenic colonic
      carcinoma C26. This line was shown to be alpha/beta TCR + V beta 6 + CD3 + CD8 +
      CD4- and to recognize a common tumour-associated antigen on syngeneic carcinomas
      and sarcomas in a major-histocompatibility--complex-restricted and T-cell
      receptor(TCR)-mediated fashion. The assessment of cytotoxic activity on a panel
      of 30 normal and neoplastic target cells of differing etiology and histo-type
      showed that E/88 CTL lysed syngeneic colon carcinomas and some fibrosarcomas but
      not leukemias, lymphomas or mammary carcinomas. Clones derived from the E/88 line
      exhibited the same lytic pattern. Moreover, anti-T3, anti-Lyt2.2, anti-alpha/beta
      TCR and anti-V beta 6 mAbs as well as anti-H-2d antisera abolished cytotoxicity
      when used in blocking experiments. The therapeutic activity of E/88 CTL upon in
      vivo transfer was assessed in mice bearing either experimental or spontaneous
      metastases of C26. In both models therapy with E/88 lymphocytes in combination or
      not with interleukin-2 was highly effective. Adoptive immunotherapy carried out
      with two clones obtained from line E/88 showed comparable therapeutic effects. In
      addition, treatment of syngeneic mice bearing experimental metastases of in vitro
      E/88-lysable or E/88-resistant tumours, showed that E/88 CTL can eradicate
      metastases of the former but not of the latter neoplasms. These data indicate
      that long-term CTL lines recognizing common tumour-associated antigens can be
      derived from tumour-bearing animals and used in adoptive immunotherapy of tumours
      previously shown to be lysed in vitro by these effectors.

PMID- 1760813
TI  - Tumour rejection after adoptive transfer of line-10-immune spleen cells is
      mediated by two T cell subpopulations.
AB  - The growth of line-10 tumours in naive guinea pigs is prevented by adoptive
      transfer of spleen cells that are hyperimmune to this hepatocellular carcinoma.
      To study the T cell subpopulations responsible for the adoptive transfer of
      immunity, various cell populations were removed from immune spleen cells using
      monoclonal antibodies (mAbs) and magnetic microspheres. Spleen cell
      subpopulations were identified by mAb after flow cytometry and rosette formation
      with the magnetic microspheres. mAb CT5 was confirmed to be a pan T cell marker,
      while the CT6 (anti-T-suppressor/cytotoxic) and CT7 (anti-T-cell) markers were
      present on two different T cell subpopulations. So our results show that CT7 mAb
      cannot be used as a pan T cell marker as was published previously. Moreover, the
      mAb H155 (anti-T-helper/inducer) reacted with the same T cell subpopulation
      recognized by CT7. So we designated this H155/CT7-positive subpopulation as T
      helper/inducer cells. Removal of the CT6-, CT7-, or the H155-positive T cells
      from the immune spleen cells resulted in loss of the in vitro proliferative
      response to line-10 tumour protein and tuberculin purified protein derivative
      (PPD). The H155/CT7 (anti-T-helper/inducer)-positive spleen cells did not express
      MHC class II antigens as determined by mAb 25E3. In most experiments, elimination
      of MHC-class-II-positive cells did not change the in vitro proliferative response
      to line-10 protein, whereas the response to tuberculin PPD was completely
      abrogated. Immune spleen cells after depletion of CT6-, CT7- or H155-positive
      cells, failed to transfer immunity. However, after depletion of MHC-class-II
      antigen-positive cells the line-10 immunity was still present, whereas the immune
      response to tuberculin PPD was lost. In conclusion, our data indicate that
      immunity to the line-10 tumour is the result of a cooperation between at least
      two different T cell subpopulations, the T helper/inducer (CT7/H155) cells and
      the T suppressor/cytotoxic cells (CT6). If this is a common feature, then the
      therapeutic approach of in vitro expanded TIL cells should take into
      consideration the requirement of two T cell subsets.

PMID- 1760814
TI  - Interleukin-2 dose, blood monocyte and CD25+ lymphocyte counts as predictors of
      clinical response to interleukin-2 therapy in patients with renal cell carcinoma.
AB  - The purpose of this study was to determine immunological parameters in the
      peripheral blood that correlate with the clinical effect of interleukin-2 (IL-2)
      in patients with metastatic renal cell cancer. A group of 26 patients with
      metastatic renal cell cancer underwent IL-2 treatment using a 36-day schedule
      with continuous intravenous IL-2 infusion (3 x 10(6) units m-2 day-1)
      administered from days 1 to 5 and days 12 to 16. The white blood cell count and
      the absolute and relative number of neutrophils, lymphocytes, eosinophils and
      monocytes were recorded six times in peripheral blood during the treatment. Also
      the blood counts of T cell and NK cell subsets and cells expressing the T cell
      activation markers IL-2R alpha and VLA-1 were measured. The lymphokine-activated
      killer (LAK) cell cytotoxicity was measured either with or without additional in
      vitro stimulation by IL-2. Multivariate statistical analysis showed that the
      clinical responses were related to the administered dose of IL-2, to a low number
      of blood cells expressing IL-2 receptors and to a reduction in the blood monocyte
      count (P less than 0.05).

PMID- 1760815
TI  - Biochemical and immunological responses of hairy cell leukemia patients to
      interferon beta.
AB  - Ten hairy-cell leukemia patients were treated with interferon beta (IFN-beta) at
      a dose rate of 2 x 10(6) IU/m2 x 5 days for 4 weeks (induction therapy) and,
      thereafter, at the same dose three times a week for 11 months (maintenance
      therapy). The effect of this treatment on serum neopterin, beta 2-microglobulin,
      (2'-5')oligoadenylate [(2'-5')An] levels, intracellular (2'-5')An values and
      human Mx protein synthesis was analysed. There were significant rises in serum
      neopterin and (2'-5')An levels during both induction and maintenance, whereas
      beta 2-microglobulin levels rose only during induction. Rises in intracellular
      (2'-5')An were documented mainly during induction, but they were not
      significantly higher than pretherapy values. IFN beta provoked an increase in
      human Mx protein synthesis over the entire induction-maintenance period, but was
      only significantly higher than baseline during induction. All markers proved
      useful for monitoring the effects of IFN beta dose schedules, but were not
      predictive of clinical outcome. Natural killer activity and IFN gamma production,
      which were initially defective, followed a different trend from that of the other
      factors studied, in that increases were documented only late in the course of
      therapy when the disease was already in remission.

PMID- 1760816
TI  - Production of interleukin-1 and tumour necrosis factor in non-Hodgkin's lymphoma
      patients.
AB  - Peripheral blood monocytes from non-Hodgkin's lymphoma (NHL) patients were
      assessed for the monocyte functions with respect to their ability to secrete
      interleukin-1 and tumour necrosis factor (TNF) and their cytotoxic potential to
      tumour target WEHI 164 clone 13. Our results indicate comparable levels of
      interleukin-1 and TNF production by NHL patients. The cytotoxic potential by
      monocytes was also not depressed in these patients. The data obtained suggest
      normal monocyte functions in NHL patients.

PMID- 1760817
TI  - Potentiation of T cell immunity against radiation-leukemia-virus-induced lymphoma
      by polysaccharide K.
AB  - C57BL mice inoculated with radiation leukemia virus (RadLV) develop preleukemic
      cells long before the onset of leukemia. These cells are potentially immunogenic
      but fail to elicit an immune response in the host because of the appearance of
      virus-specific suppressor T cells. We have studied the effect of polysaccharide K
      (PSK) on the generation of RadLV-specific cell-mediated immune responses in
      vitro. Long-term exposure to PSK in culture potentiated the ability of immunized
      T cells to respond to a RadLV-induced lymphoma. It also abrogated the suppressive
      activity of suppressor T cells and simultaneously boosted the ability of reactive
      T cells to respond. The dual immunostimulating activity of PSK resulted in the
      generation of T cytotoxic lymphocytes that could lyse lymphoma cells in vitro.
      The results suggest that PSK could be used as a prophylactic immune response
      modifier in preleukemia.

PMID- 1760818
TI  - An overview of radioimmunotherapy.
AB  - In reviewing the current state of affairs in radioimmunotherapy the paper focuses
      on the main difficulties thus far encountered and the procedures designed to
      avoid or circumvent these problems. The long range beta-emitters 90Y and 188Re
      have replaced 131I as the isotopes currently receiving most attention for use in
      radioimmunotherapy, and a range of new chelators are under investigation for in
      vivo stability and immunogenicity. Approaches aimed at improving tumour
      targetting and antigen expression such as two-step pretargetting techniques,
      tumour necrosis treatment and cytokine pretreatment are summarized. Methods
      designed to improve host-Mab interactions are outlined and the need to
      incorporate successful ideas from current cancer therapies is emphasised.

PMID- 1760819
TI  - Importance in timing of cyclophosphamide on the enhancement of interleukin-2
      induced cytolysis.
AB  - We investigated the in vivo effects of cyclophosphamide (CY) on interleukin-2(IL
      2)-induced cytolytic function and spleen cell immunophenotype. Pretreatment of
      A/J mice with CY (25 mg/kg or 75 mg/kg) i.p. on days -10 and -15 followed by IL-2
      (50,000 U i.p. on days 0 to +3) resulted in increased lysis of YAC-1 target cells
      compared to the group receiving IL-2 without previous CY therapy. In contrast,
      when CY was given on day -5, the cytotoxicity against YAC-1 was not enhanced.
      Phenotypic analysis of splenocytes obtained from mice treated with CY on day -10
      or -15 revealed a relative decrease in L3T4- and Lyt2-positive T cells. In vivo
      depletion of natural killer (NK) cells by anti-asialoGM1, prior to IL-2 therapy,
      abrogated the enhancing effect of CY on cytolysis while in vivo elimination of T
      cells by anti-L3T4 and anti-Lyt2 monoclonal antibodies did not, indicating that
      in the absence of T cell antigenic challenge, the increased cytolytic function
      after CY administration is probably mediated through NK cells. These findings
      provide evidence that CY may be used more effectively in IL-2-based immunotherapy
      protocols, if consideration is given to timing of CY and IL-2 administration.

PMID- 1760820
TI  - Enhanced expansion of the thymic CD8+ cell subset as a potential mechanism for
      the generation of enhanced antitumor cytotoxicity by thymocytes from low-dose
      melphalan-treated MOPC-315 tumor bearers.
AB  - We have previously shown that thymocytes from low-dose melphalan (L-phenylalanine
      mustard)-treated MOPC-315-tumor-bearing mice (melphalan TuB) are able to generate
      an enhanced level of anti-MOPC-315 cytotoxicity, as compared to thymocytes from
      untreated MOPC-315-tumor-bearing mice or thymocytes from untreated or low-dose
      melphalan-treated normal mice, upon in vitro stimulation with MOPC-315 tumor
      cells in the presence of a low concentration of recombinant interleukin-2 (rIL
      2). Here we show that the generation of enhanced anti-MOPC-315 cytotoxicity by
      melphalan TuB thymocytes depends on the ability of the thymocytes to proliferate.
      In addition, the ability of melphalan TuB thymocytes to generate an enhanced
      level of anti-MOPC-315 cytotoxicity correlated with their ability to proliferate
      more readily than thymocytes from untreated tumor-bearing mice and thymocytes
      from untreated or melphalan-treated normal mice in response to stimulation with
      MOPC-315 tumor cells plus a low concentration of rIL-2. Moreover, although fresh
      melphalan TuB thymocytes do not contain a higher percentage of phenotypically
      mature cells (i.e., CD4-/CD8+ or CD4+/CD8-) than do thymocytes from normal mice
      or untreated tumor-bearing mice, after a 5-day culture with both MOPC-315 tumor
      cells and a low concentration of rIL-2, cultures of thymocytes from melphalan TuB
      contained a much higher percentage of CD4-/CD8+ (but not CD4+/CD8-) cells than
      did cultures of thymocytes from the other two sources. Since CD4-/CD8+ cells were
      previously shown to be responsible for the exertion of antitumor cytotoxicity by
      thymocytes stimulated with MOPC-315 in vitro, our results indicate that the
      enhanced antitumor cytotoxicity exerted by melphalan TuB thymocytes following in
      vitro stimulation with MOPC-315 tumor cells in the presence of a low
      concentration of rIL-2 is due, at least in part, to an expansion of the pool of
      CD4-/CD8+ effector cells.

PMID- 1760822
TI  - International experience with nitrates.

PMID- 1760821
TI  - Regression of human melanoma xenografts in nude mice injected with methotrexate
      linked to monoclonal antibody 225.28 to human high molecular weight-melanoma
      associated antigen.
AB  - Intravenous injections into nude mice of 5 mg/kg methotrexate (MTX) linked to the
      antibody to human high molecular weight-melanoma associated antigen (HMW-MAA),
      monoclonal antibody (mAb) 225.28, an IgG2a, on days 1, 4, 7, 10 and 14, starting
      24 h after subcutaneous inoculation of 2 x 10(6) cultured human M21 melanoma
      cells inhibited mean tumor volume by 90% on day 14 and by 65% on day 50 after the
      beginning of the treatment. Injections of equimolar amounts of free MTX and MTX
      linked to normal mouse IgG or to an isotype-matched myeloma protein did not
      inhibit tumor growth significantly. MTX linked to mAb 225.28 did not inhibit the
      xenograft of a subline of human melanoma cell line M21 without detectable
      expression of HMW-MAA. In a clonogenic assay, the MTX-225.28 conjugate was three
      times more potent in inhibiting the growth of M21 melanoma cells than free MTX,
      but did not inhibit the growth of kidney carcinoma cells Caki-1, which do not
      express high-Mr MAA. In contrast, MTX linked to the mAb DAL K29, reacting with
      kidney carcinoma cells Caki-1, inhibited their growth but did not affect that of
      melanoma cells. M21 melanoma cells isolated from the residual tumor of a mouse
      treated with the MTX-225.28 conjugate did not differ in their reactivity with mAb
      225.28 and in their sensitivity to MTX when compared with M21 cells from an
      untreated mouse.

PMID- 1760823
TI  - Evaluation of the antianginal and anti-ischemic efficacy of slow-release
      isosorbide-5-mononitrate capsules, bupranolol and their combination, in patients
      with chronic stable angina pectoris.
AB  - The effects of slow-release isosorbide-5-mononitrate (IS-5-MN), 25 mg once daily,
      bupranolol, 50 mg once daily, and their combination on exercise-induced ST
      segment depression at comparable work load, maximal work load, exercise capacity,
      frequency of anginal episodes and sublingual nitroglycerin consumption were
      studied in 30 patients with chronic stable angina pectoris. The patients were
      assigned in a randomized, double blind protocol, to either form of monotherapy,
      for 12 days, and thereafter to combined therapy for 12 days. Exercise stress test
      was performed before treatment and at 2 and 16 h after drug administration on the
      first and 12th day of each treatment period. ST-depression at comparative work
      load at 2 h after dosing was reduced by 49% acutely after administration of IS-5
      MN. This effect was not significantly altered after 12 days of treatment and
      during combined therapy. In those patients treated by bupranolol alone, an effect
      was observed only after 12 days - a 24% reduction in ST depression. At the 12th
      day of combined therapy ST-segment depression was reduced by 65%. At 16 h after
      dosing there was no significant reduction in mean values of ST-segment depression
      in either groups, but some patients in each group showed a sustained effect for
      16 h. Both drugs increased maximal work load and exercise capacity at 2 h after
      administration. This effect was sustained in the IS-5-MN group also at 16 h after
      administration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760824
TI  - Isosorbide-5-mononitrate and atenolol in the treatment of stable exertional
      angina.
AB  - Fourteen men and six women, 48-68 years old, with stable angina and effort
      induced ST-segment depression (ST-D) were treated with isosorbide-5-mononitrate
      (IS-5-MN) 2 x 40 mg/day and/or atenolol (AT) 100 mg/day in a double-blind
      randomized sequence during two 6-week periods. The patients performed ergometer
      tests. AT caused more decrease of heart rate at rest and at comparable work-load
      than IS-5-MN. Blood pressure at rest was in the normal range. Decrease of blood
      pressure at rest and at effort was similar with both agents. Combined
      administration of the two drugs was not more effective than monotherapy with AT
      or IS-5-MN in lowering heart rate and blood pressure. The average ST-D at
      comparable effort was for placebo 2.3 mm, for IS-5-MN after 2, 4, and 6 weeks, 3,
      6, and 12 h, respectively, after medication, 1.4, 1.0, and 1.3 mm, and for AT
      1.2, 1.4, and 1.4 mm, respectively. Administration of the drugs together caused
      additional highly significant reduction of ST-D (0.3-0.9 mm). The results
      indicate that IS-5-MN and AT have a similar beneficial effect on effort-induced
      myocardial ischemia, which is enhanced by their combined administration. The
      drugs alone and in combination are effective for as long as 12 h after
      administration of IS-5-MN, and 24 h after administration of AT. Moderate signs of
      tolerance to IS-5-MN were found after 6 weeks of therapy.

PMID- 1760825
TI  - Nitrates for myocardial salvage in the 1990s.
AB  - Low-dose intravenous nitroglycerin infusion for the first 48 h is becoming
      routine in the management of acute myocardial infarction in North America. It is
      most widely used as primary therapy in patients admitted more than 6 h after
      acute infarction. Such therapy has been shown to limit infarct size, infarct
      complications and remodeling. However, it is being applied increasingly more as
      an adjunct before, during and after thrombolytic therapy. Several trials are
      underway to test the effectiveness of more prolonged therapy, with early
      intravenous nitroglycerin followed by buccal or oral formulations for several
      weeks, in further limitation of ventricular remodeling, dilatation, aneurysm
      formation and in preserving function. Nitrates may prove to be a useful adjunct
      or alternative to angiotensin-converting-enzyme (ACE) inhibitors for long-term
      therapy.

PMID- 1760826
TI  - Evaluation of the antianginal effect of isosorbide-5-mononitrate in patients with
      chronic stable angina pectoris.
AB  - The antianginal and anti-ischemic properties of isosorbide-5-mononitrate (ISMN)
      were evaluated in 40 patients with chronic stable angina pectoris in a randomized
      double-blind parallel-group placebo-controlled study. After 2 weeks' placebo run
      in period the patients were randomized to either ISMN, orally 20 mg 2-3 times
      daily (titrated) or placebo. They underwent bicycle exercise stress test at the
      end of the placebo period and after 4 weeks of treatment. Compared with placebo
      ISMN increased the exercise performance, reduced ST-segment depression, anginal
      frequency and sublingual nitroglycerin consumption. All these changes were
      statistically significant. It may be concluded that ISMN is an effective
      antianginal and anti-ischemic agent in patients with chronic stable angina
      pectoris.

PMID- 1760827
TI  - Randomized double-blind comparison of the effects of isosorbide dinitrate retard,
      verapamil sustained-release, and their combination on myocardial ischemic
      episodes.
AB  - The antianginal and anti-ischemic efficacy of isosorbide dinitrate (ISDN) retard
      120, verapamil 120 sustained-release (s.r.) and their combination was evaluated
      in 30 patients with chronic angina pectoris. The study was a randomized, double
      blind crossover comparison. The evaluation was determined by exercise testing and
      24-hour electrocardiographic ambulatory monitoring. The sum of ST-segment
      depression at comparable exercise levels was reduced by 37% (p less than 0.001)
      after verapamil 120 s.r. and by 45% (p less than 0.001) after combination
      therapy. After ISDN retard 120 the sum of ST-segment depression was also slightly
      reduced by 18% without attaining statistical significance. Total walking time and
      time to angina pectoris during treadmill exercise were significantly prolonged
      after all treatments. The sum of ST-segment depression in the 24-hour Holter ECG
      was reduced by 46% (p less than 0.001) after verapamil and by 39% (p less than
      0.01) after combined therapy. After ISDN retard 120 the mean reduction was 34% (p
      less than 0.01). In conclusion, the result of the study indicated that ISDN
      retard 120, verapamil 120 s.r. and a combination of both drugs are effective in
      reducing the frequency and duration of ischemic episodes in patients with
      ischemic heart disease.

PMID- 1760828
TI  - Treatment of angina pectoris with isosorbide-5-mononitrate. A multicenter study
      in general practice.
AB  - In this multicenter study 191 practitioners treated 532 patients with coronary
      artery disease and chronic stable angina pectoris by isosorbide-5-mononitrate (IS
      5-MN), 20 mg 2-3 times daily. At the end of this period the frequency of anginal
      attacks was reduced by 83% and nitroglycerin consumption by 85.7% (p less than
      0.0001). 40.1% of the patients categorized this treatment as very good, 28.6% as
      excellent and 23% as good. Serious adverse effects were observed in 2% of the
      patients and 6.4% of the patients discontinued treatment during the study because
      of inefficacy, infarction, death, or adverse effects. At the end of the study
      90.2% of the patients were still on IS-5-MN. In conclusion, IS-5-MN is an
      effective treatment for patients with chronic stable angina pectoris. It is well
      tolerated, with minimal side effects.

PMID- 1760829
TI  - Evaluation of effectiveness and tolerability of isosorbide mononitrate during a
      three-year period in patients with angina pectoris.
AB  - The antianginal effect and tolerability of isosorbide mononitrate (ISMN), 20 mg 2
      3 times daily, orally were investigated in an open study in 28 patients,
      suffering from coronary heart disease and stable angina pectoris. Ergometric
      exercise tests were carried out before treatment and 2 h after drug intake, every
      3 months during the first year and at 6-month intervals during the following 2
      years. At the conclusion of the 3-year study the reduction of ST-segment
      depression, which had amounted to 58% after 1 year, could be improved to 78% (p
      less than 0.01). The frequency of angina was markedly reduced during the
      treatment with ISMN. While 14 of the patients had more than 3 episodes per day
      prior to the study, 16 patients were symptom-free at the end of the three years'
      therapy, and none of the patients had more than 1 or 2 attacks per day. The
      consumption of sublingual nitroglycerin diminished by 94% after one year and by
      98% after 3 years of therapy (p less than 0.01). Headache was the only adverse
      effect observed in some of the patients (at the initiation of the treatment
      only). In conclusion this study demonstrated (1) the good tolerability of ISMN,
      at the doses used, and (2) the fact that the antianginal efficacy may be enhanced
      during the course of the therapy.

PMID- 1760830
TI  - Nitrate therapy in heart failure.
AB  - Nitrates are drugs of first choice in patients with acute heart failure. Acute
      pulmonary edema can be successfully treated with single or repeated doses of
      sublingual nitroglycerin. In cases of prolonged acute heart failure, e.g. in the
      setting of acute myocardial infarction, nitroglycerin or isosorbide dinitrate can
      be given by the intravenous route for up to 24 h. Patients with acute myocardial
      infarction usually benefit from nitrate therapy if filling pressures are high
      and/or left ventricular function is compromised. Nitrate therapy can be
      considered safe if arterial blood pressure is maintained above 95 mm Hg. With
      these precautions nitrates can reduce infarct size and the incidence of
      complications as well as improve long-term prognosis. In the chronic treatment
      concern has risen with regard to possible nitrate tolerance. Thus, therapy
      schedules allowing for nitrate-poor phases are generally recommended. Therapy
      schedules with constant-rate delivery of drugs achieved with patches or
      intravenous administration of nitrates should be used with caution.

PMID- 1760831
TI  - Sustained-release IS-5-MN in the treatment of coronary heart disease.
AB  - In a double-blind, randomized cross-over study the antianginal efficacy and
      tolerability of Elantan Long (50 mg sustained-release IS-5-MN) were compared with
      a 80-mg sustained-release (s.r.) IS-5-MN formulation. 28 patients were enrolled
      in the study, which consisted of a 3-day washout period on placebo, an active
      treatment of 14 days (cross-over after 7 days) and a final 3-day withdrawal
      period on placebo. Ergometric exercise tests with simultaneous ECG monitoring
      were carried out 2 and 10 h post administration (p.a.) on the last days of each
      period. Under 50 mg s.r. IS-5-MN the mean ST- segment depression under comparable
      load was reduced by 67% 2 h p.a. and by 70% 10 h p.a. The reduction under the 80
      mg IS-5-MN form was about 76% 2 h p.a. and 78% 10 h p.a. Maximum workload,
      working capacity, duration of exercise, time to angina pectoris and time to ST
      segment depression greater than 0.1 mV were markedly increased under therapy with
      each dosage. Comparisons between the medications revealed significant differences
      only in time to ST-segment depression greater than 0.1 mV and in ST-segment
      depression under maximum workload at 10 h p.a. which were increased more by the
      higher dosage. The incidence of anginal attacks decreased by almost 80% in the
      patients under both treatments. Ten patients under each dosage were completely
      freed from attacks. Adverse drug reactions occurred in 14 patients, 10 times
      under 80 mg s.r. IS-5-MN, 5 times under Elantan Long and twice under
      placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760832
TI  - Hemodynamic effects of transdermal nitroglycerin patches in patients with acute
      myocardial infarction.
AB  - Transdermal nitroglycerin patches are used mainly in the therapy of angina
      pectoris. However, the magnitude and duration of their effects are still
      controversial. In this study, transdermal discs with nitroglycerin were given to
      14 patients with acute myocardial infarction (AMI) and mild hemodynamic
      impairment. Seven patients received Nitroderm TTS, and seven patients Deponit 5
      (in this case 2 patches), the nitroglycerin dose being 10 mg. Hemodynamic
      measurements were made 19-24 h after application of the patch and 1 h after its
      removal. Comparing with the values obtained 1 h after removal of the patch, 19-24
      h after the application of the patch heart rate was significantly higher (90.2 +/
      3.8 vs. 85.6 +/- 4.0 min-1; p less than 0.01), mean right atrial pressure was
      significantly lower (10.8 +/- 1.0 vs. 12.7 +/- 1.3 mm Hg; p less than 0.01), and
      so were the pulmonary artery pressure: systolic (36.9 +/- 3.0 vs. 43.0 +/- 3.1 mm
      Hg; p less than 0.001), mean (26.8 +/- 2.1 vs. 31.4 +/- 2.0 mm Hg; p less than
      0.001) and the capillary wedge pressure (19.2 +/- 1.8 vs. 23.0 +/- 1.9 mm Hg; p
      less than 0.01). These findings revealed that in patients with AMI hemodynamic
      effects persist for at least 19 h after single application of a nitroglycerin
      patch of 10 mg. The therapy is safe and the risk of side effects is small.

PMID- 1760833
TI  - Comparative evaluation of intravenous isosorbide dinitrate and nitroglycerin in
      patients with acute myocardial infarction.
AB  - The efficacy of isosorbide dinitrate (ISDN) and nitroglycerin was studied in 115
      patients with acute transmural myocardial infarction admitted to the Coronary
      Care Unit not later than 12 h after the onset of chest pain: 58 patients not
      later than 2 h after the onset of chest pain, 49 after 3-6 h and 8 patients in
      the period of 6-9 h. There were 69 men and 45 women, mean age 62.4 +/- 0.9 years.
      The duration of the preceding clinically evident coronary artery disease was in
      12 patients 1 year, in 29 2-3, in 22 4-5 and in 16 patients 6 years or more. In
      36 cases the chest pain of acute infarction was the first presentation of
      coronary artery disease. Thirty-seven patients had a previous myocardial
      infarction. Fifty patients had concomitant systemic hypertension. The patients
      were divided into 3 groups depending on the type of therapy received: group I,
      receiving anticoagulants only, served as control; patients of groups II and III
      received, in addition to the anticoagulants, intravenous ISDN or nitroglycerin,
      respectively. The patients were monitored for recurrent chest pain,
      electrocardiographic changes, clinical parameters and cardiac enzyme changes.
      ISDN, at a dose of 10 mg/h over the first 3 days of infarction, had marked
      antianginal effect, limited the dimensions of the necrotic area, reduced the
      number of ischemic relapses and the development of heart failure. Compared to
      nitroglycerin, ISDN exerted a more prolonged action (up to 12 h), did not affect
      heart rate and blood pressure, and had a marked antiarrhythmic effect.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1760834
TI  - Hemodynamic mechanisms of the effect of nitroglycerin in patients with acute
      myocardial infarction.
AB  - We studied the hemodynamic response to intravenous nitroglycerin (NTG) in 40
      patients with and without acute heart failure (hemodynamic subsets I-IV) during
      acute myocardial infarction. Hemodynamic measurements were performed by right
      heart catheterization. The results showed that NTG response influenced mainly the
      preload and to a lesser extent the afterload, however these changes were
      dependent on initial hemodynamic status. The changes in mean arterial pressure
      and cardiac index were predominantly related to pretreatment pulmonary wedge
      pressure and slightly to systemic vascular resistance. Response to NTG could be
      predicted with 85% probability as a decrease of pulmonary wedge pressure, with
      58% probability as a decrease in mean arterial pressure and cardiac index, and
      with 32% probability as an increase in cardiac index and a decrease in systemic
      vascular resistance. These results indicate that NTG therapy could have optimal
      results in patients with elevated pulmonary wedge pressure and normal cardiac
      index, while in the subsets with low mean arterial pressure or low cardiac index
      potentially deleterious decrease in these values could occur. Therefore the
      optimal condition for use of intravenous nitroglycerin in the patients with acute
      heart failure is isolated pulmonary congestion.

PMID- 1760835
TI  - Slow release isosorbide-5-mononitrate therapy in angina pectoris. Effects of
      exercise performance and hemodynamics.
AB  - The possibility of maintaining preload reduction and enhancement of exercise
      tolerance during an interval treatment with 100 mg/day of slow-release isosorbide
      5-mononitrate (IS-5-MN) was investigated in 12 patients (aged 57 +/- 5.0 years)
      with angiographically confirmed coronary artery disease and chronic stable angina
      pectoris. The effects of a single dose (acute test) were compared with those
      following an 8-day (chronic) regimen of mononitrate administration. Two hours
      after administration of 100 mg sustained-release IS-5-MN, mean resting pulmonary
      artery pressure (PAP), measured with a Swan-Ganz catheter, was reduced by 32% (p
      less than 0.001) and at submaximal exercise level (50 W, 3 min) by 37% (p less
      than 0.001). At individually highest comparable work loads mean PAP was reduced
      by 37% (p less than 0.001), and at maximal work load the PAP reduction was 14% (p
      less than 0.05). At the end of 1 week of therapy with sustained-release IS-5-MN a
      slight, clinically irrelevant reduction of hemodynamic effect was recorded. Work
      capacity increased after 1 h by 79% (264 +/- 154 vs. 472 +/- 180 W x min, p less
      than 0.01), still significantly above base-line 10 h after nitrate
      administration. No difference from baseline was demonstrable 24 h after
      medication. During interval therapy the improved work capacity was fully
      maintained (chronic, 1 h: 280 +/- 119 vs. 532 +/- 160 W x min, p less than
      0.001). There was no significant difference between the plasma IS-5-MN levels at
      acute and chronic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1760836
TI  - Leukocyte-endothelial cell recognition: three (or more) steps to specificity and
      diversity.

PMID- 1760837
TI  - Similarity between the DNA-binding domains of IHF protein and TFIID protein.

PMID- 1760838
TI  - Variation of the CGG repeat at the fragile X site results in genetic instability:
      resolution of the Sherman paradox.
AB  - Fragile X syndrome results from mutations in a (CGG)n repeat found in the coding
      sequence of the FMR-1 gene. Analysis of length variation in this region in normal
      individuals shows a range of allele sizes varying from a low of 6 to a high of 54
      repeats. Premutations showing no phenotypic effect in fragile X families range in
      size from 52 to over 200 repeats. All alleles with greater than 52 repeats,
      including those identified in a normal family, are meiotically unstable with a
      mutation frequency of one, while 75 meioses of alleles of 46 repeats and below
      have shown no mutation. Premutation alleles are also mitotically unstable as
      mosaicism is observed. The risk of expansion during oogenesis to the full
      mutation associated with mental retardation increases with the number of repeats,
      and this variation in risk accounts for the Sherman paradox.

PMID- 1760839
TI  - B cell lymphoma-associated chromosomal translocation involves candidate oncogene
      lyt-10, homologous to NF-kappa B p50.
AB  - A B cell lymphoma-associated chromosomal translocation, t(10;14)(q24;q32),
      juxtaposes the immunoglobulin C alpha 1 locus to a novel gene, lyt-10. The normal
      lyt-10 cDNA codes for a 98 kd protein which displays amino-terminal homology with
      the rel (DNA-binding) domain of the NF-kappa B-rel family of transcription
      factors and carboxy-terminal homology with the NF-kappa B p50 precursor protein,
      including the putative proteolytic cleavage domain (poly-G) and the ankyrin-like
      repeat domains. The lyt-10 protein can bind to kappa B sequences in vitro,
      although with different specificity from NF-kappa B p50, and in vitro DNA-binding
      is activated by removal of the ankyrin domain. Chromosomal translocation
      generates an lyt-10-C alpha 1 fusion gene coding for a protein that retains the
      rel effector domain, lacks the ankyrin regulatory domain, and binds kappa B
      sequences in vitro, suggesting its constitutive activation in vivo. Analogous
      rearrangements of the lyt-10 gene have been found in an additional three cases of
      lymphoid neoplasia. The lyt-10 gene defines a new subfamily (rel/poly-G/ankyrin)
      of NF-kappa B-rel transcription factors with potential for oncogenic activation
      in human cancer.

PMID- 1760840
TI  - Maturation of the immune response in germinal centers.
AB  - Germinal centers develop in peripheral lymphatic tissue during the primary immune
      response and may play a crucial role in affinity maturation. We have compared the
      diversification of the antigen-specific repertoire of B cells, both from within
      and from outside the germinal centers, during the murine response to 2
      phenyloxazolone (phOx). By sequencing V kappa Ox1 L-chains characteristic of phOx
      specific antibodies, we show that somatic mutations accumulate in germinal center
      B cells and that a mutation conferring high affinity binding is found with
      increasing frequency. An analysis of V/D/J rearrangements suggests that this
      mutation occurred independently in many B cells, which were then preferentially
      expanded. We conclude that, although the hypermutation mechanism may be activated
      before germinal centers develop, affinity maturation by hypermutation and
      selection takes place in the germinal centers.

PMID- 1760841
TI  - Molecular basis of symbiotic host specificity in Rhizobium meliloti: nodH and
      nodPQ genes encode the sulfation of lipo-oligosaccharide signals.
AB  - The symbiosis between Rhizobium and legumes is highly specific. For example, R.
      meliloti elicits the formation of root nodules on alfalfa and not on vetch. We
      recently reported that R. meliloti nodulation (nod) genes determine the
      production of acylated and sulfated glucosamine oligosaccharide signals. We now
      show that the biochemical function of the major host-range genes, nodH and nodPQ,
      is to specify the 6-O-sulfation of the reducing terminal glucosamine. Purified
      Nod factors (sulfated or not) from nodH+ or nodH- strains exhibited the same
      plant specificity in a variety of bioassays (root hair deformations, nodulation,
      changes in root morphology) as the bacterial cells from which they were purified.
      These results provide strong evidence that the molecular mechanism by which the
      nodH and nodPQ genes mediate host specificity is by determining the sulfation of
      the extracellular Nod signals.

PMID- 1760842
TI  - Induction in the developing compound eye of Drosophila: multiple mechanisms
      restrict R7 induction to a single retinal precursor cell.
AB  - The development of the Drosophila R7 photoreceptor cell is determined by a
      specific inductive interaction between the R8 photoreceptor cell and a single
      neighboring precursor cell. This process is mediated by bride of sevenless
      (boss), a cell-surface bound ligand, and the sevenless (sev) tyrosine kinase
      receptor. The boss ligand is expressed specifically on the surface of the R8
      cell, whereas the sev receptor is expressed on 5 cells contacting the developing
      R8 cell and other cells not in contact with R8. By altering the spatial and
      temporal expression of boss, we demonstrate that sev-expressing cells that do not
      contact R8 can assume an R7 cell fate. By contrast, the sev-expressing precursor
      cells to the R1-R6 photoreceptor cells that do contact R8 are nonresponsive to
      the inductive cue. Using the rough and Nspl mutations, we demonstrate that an
      early commitment to an R1-R6 cell fate blocks the pathway of sev activation in
      these cells.

PMID- 1760843
TI  - The Drosophila single-minded gene encodes a helix-loop-helix protein that acts as
      a master regulator of CNS midline development.
AB  - Development of the Drosophila CNS midline cells is dependent upon the function of
      the single-minded (sim) gene. Sequence analysis shows that sim is a member of the
      basic-helix-loop-helix class of transcription factors. Cell fate experiments
      establish that sim is required for early events in midline cell development,
      including a synchronized cell division, proper formation of nerve cell
      precursors, and positive auto-regulation of its midline expression. Induction of
      ectopic sim protein under the control of the hsp70 promoter shows that sim can
      direct cells of the lateral CNS to exhibit midline cell morphology and patterns
      of gene expression. We propose that sim functions as a master developmental
      regulator of the CNS midline lineage.

PMID- 1760844
TI  - The NPXY internalization signal of the LDL receptor adopts a reverse-turn
      conformation.
AB  - Peptides corresponding to the proposed coated pit internalization signal of the
      native low density lipoprotein receptor, NPVY, take up in aqueous solution a
      reverse-turn conformation with the Asn in position i and the Tyr in position i +
      3. By contrast, peptides derived from receptors that are defective for
      endocytosis do not adopt the reverse turn. These internalization-defective
      receptors include those with a nonaromatic residue substituted for the Tyr and
      those with Asn----Ala or Pro----Ala substitutions. While the tendency of an Asn
      Pro sequence to induce a reverse turn was anticipated, the structural importance
      of an aromatic residue in position i + 3 was not. The sequences associated with
      the internalization signal thus appear to play a critical conformational role
      that is required for endocytosis, probably by enabling binding to adaptor
      molecules. With the results presented in the accompanying paper on lysosomal acid
      phosphatase, we now have direct evidence for previous proposals of a general
      correlation of internalization signals with a turn conformational motif.

PMID- 1760845
TI  - The essential tyrosine of the internalization signal in lysosomal acid
      phosphatase is part of a beta turn.
AB  - For rapid endocytosis lysosomal acid phosphatase requires a Tyr-containing signal
      in its cytoplasmic domain, as do cell surface receptors mediating endocytosis and
      clustering in coated pits. To determine the structure of the internalization
      signal an 18 amino acid peptide representing the cytoplasmic tail of lysosomal
      acid phosphatase was analyzed by two-dimensional nuclear magnetic resonance
      spectroscopy. Part of the peptide, 5-PPGY-8, forms a well-ordered beta turn of
      type I in solution. Our result and data on the structure of the endocytosis
      signal of the low density lipoprotein receptor reported by Bansal and Gierasch in
      the accompanying paper represent experimental determinations of the three
      dimensional structure of protein transport signals and suggest that the essential
      aromatic amino acid of internalization signals is recognized by a putative
      cytoplasmic receptor in the structural context of a tight turn.

PMID- 1760846
TI  - HIV-1 DNA integration: mechanism of viral DNA cleavage and DNA strand transfer.
AB  - Retroviral DNA integration involves a coordinated set of DNA cutting and joining
      reactions. Linear viral DNA is cleaved at each 3' end to generate the precursor
      ends for integration. The resulting recessed 3' ends are inserted into target DNA
      by a subsequent DNA strand transfer reaction. Purified HIV-1 integration protein
      carries out both of these steps in vitro. Two novel forms of the dinucleotide
      cleaved from HIV-1 DNA were identified and one, a cyclic dinucleotide, was used
      to analyze the stereochemical course of viral DNA cleavage. Both viral DNA
      cleavage and DNA strand transfer display inversion at chiral phosphorothioates
      during the course of the reaction. These results suggest that both reactions
      occur by a one-step mechanism without involvement of a covalent protein-DNA
      intermediate.

PMID- 1760847
TI  - TFIID binds in the minor groove of the TATA box.
AB  - We have analyzed the interaction of the general RNA polymerase II transcription
      factor TFIID with its DNA-binding site, the TATA box (consensus sequence
      TATAAAA). We have demonstrated that TFIID, unlike most sequence-specific DNA
      binding proteins, interacts primarily within the minor groove of the DNA helix.
      This was established by a novel approach involving complete replacement of the
      thymines and adenines in the TATA box with cytosines and inosines, respectively.
      This substitution exchanged the major groove of TATAAAA for that of the sequence
      CGCGGGG, without altering the surface of the minor groove. The unusual DNA
      binding properties of TFIID revealed by this study have important implications
      for TFIID specificity and function and, more generally, for sequence-specific
      recognition by DNA-binding proteins.

PMID- 1760848
TI  - Interaction of TFIID in the minor groove of the TATA element.
AB  - TFIID binding in the minor groove of DNA at the TATA element was demonstrated by
      methylation interference and hydroxyl radical footprinting assays, and by binding
      studies with thymine analog substituted oligonucleotides. These results provide
      an explanation for TFIID-dependent DNA bending at the TATA element. TFIID binding
      shows phosphate contacts with the same residues that were found to be essential
      for TFIID interactions by methylation and thymine-specific modification
      interference assays. Based on previous studies implicating residues conserved
      between the direct repeats in DNA binding, as well as models of prokaryotic DNA
      binding proteins, these results also suggest a model in which the direct repeats
      of TFIID form two basic antiparallel beta ribbon arms that could contact DNA
      through the minor groove.

PMID- 1760849
TI  - Detection of novel secondary metabolites.
AB  - The study of antibiotics and other fermentation products has shown that a
      seemingly unlimited number of compounds with diverse structures are produced by
      microorganisms. The continued high rate of discovery of new chemical entities, in
      the light of the abundance of microbial products already described, is due to
      creative screening procedures that incorporate such features as the emphasis on
      unusual microorgnaisms, their special propagation and fermentation requirements,
      supersensitive and highly selective assays, genetic engineering both for the
      biosynthesis of new compounds and in the development of screening systems, early
      in vivo evaluation, improved isolation techniques, modern procedures for
      structure determination, computer-assisted identification, and an efficient
      multidisciplinary approach. This review focuses on the genesis and development of
      the gamut of methodologies that have led to the successful detection of the wide
      variety of novel secondary metabolites that include antibacterial, antigungal,
      antiviral and antitumour antibiotics, enzyme inhibitors, pharmacologically and
      immunologically active agents, products useful in agriculture and animal
      husbandry, microbial regulators, and other compounds for which no bioactive role
      has yet been found.

PMID- 1760850
TI  - Principles and biotechnological applications of bacterial ice nucleation.
AB  - Certain aerobic, Gram-negative bacteria, including the epiphytic plant pathogen,
      Pseudomonas syringae, possess a membrane protein that enables them to nucleate
      crystallization in supercooled water. Currently, these ice-nucleating (IN)
      bacteria are being used in snow making and have potential applications in the
      production and texturing of frozen foods, and as a replacement of silver iodide
      in cloud seeding. A negative aspect of these IN bacteria is frost damage to plant
      surfaces. Thus, of the various types of biological ice nucleators, bacteria have
      been the subject of most research and also appear relevant to the anticipated
      practical uses. The intent of this review is to explain the identification and
      ecology of the ice-nucleating bacteria, as well as to discuss aspects of
      molecular biology related to ice nucleation and consider existing and potential
      applications of this unique phenomenon.

PMID- 1760851
TI  - Reduced cardiotoxicity of doxorubicin given in the form of N-(2
      hydroxypropyl)methacrylamide conjugates: and experimental study in the rat.
AB  - A rat model was used to evaluate the general acute toxicity and the late
      cardiotoxicity of 4 mg/kg doxorubicin (DOX) given either as free drug or in the
      form of three N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer conjugates. In
      these HPMA copolymers, DOX was covalently bound via peptide linkages that were
      either non-biodegradable (Gly-Gly) or degradable by lysosomal proteinases (Gly
      Phe-Leu-Gly). In addition, one biodegradable conjugate containing galactosamine
      was used; this residue was targeted to the liver. Over the first 3 weeks after
      the i.v. administration of free and polymer-bound DOX, all animals showed a
      transient reduction in body weight. However, the maximal reduction in body weight
      seen in animals that received polymer-bound DOX (4 mg/kg) was significantly lower
      than that observed in those that received free DOX (4 mg/kg) or a mixture of the
      unmodified parent HPMA copolymer and free DOX (4 mg/kg; P less than 0.01).
      Throughout the study (20 weeks), deaths related to cardiotoxicity were observed
      only in animals that received either free DOX or the mixture of HPMA copolymer
      and free DOX; in these cases, histological investigations revealed marked changes
      in the heart that were consistent with DOX-induced cardiotoxicity. Sequential
      measurements of cardiac output in surviving animals that received either free DOX
      or the mixture of HPMA copolymer and free DOX showed a reduction of approximately
      30% in function beginning at the 4th week after drug administration. The heart
      rate in these animals was approximately 12% lower than that measured in age
      matched control rats (P less than 0.05). Animals that were given the HPMA
      copolymer conjugates containing DOX exhibited no significant change in cardiac
      output throughout the study (P less than 0.05). In addition, no significant
      histological change was observed in the heart of animals that received DOX in the
      form of HPMA copolymer conjugates and were killed at the end of the study.
      However, these animals had shown a significant increase in heart rate beginning
      at 8 weeks after drug administration (P less than 0.01).(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1760852
TI  - Treatment of DNA with ammonium bicarbonate or thiourea can lead to
      underestimation of platinum-DNA monoadducts.
AB  - Thiourea and NH4HCO3 are widely used to block the conversion of Pt-DNA
      monoadducts to diadducts prior to the enzymatic digestion of DNA and subsequent
      analysis of the relative proportion of the different types of Pt-DNA adducts. Our
      data show that NH4HCO3 (100 mM, 18 h, 25 degrees C) is much less effective than
      thiourea (10 mM, 10 min, 25 degrees C) at blocking monoadducts, apparently
      because considerable monoadduct-to-diadduct conversion occurs during the
      incubation of platinated DNA with NH4HCO3. Under these incubation conditions,
      neither NH4HCO3 nor thiourea treatment causes significant diadduct-to-monoadduct
      conversion. At 25 degrees C, thiourea causes no significant removal of either
      ethylenediamine(en)- or diaminocyclohexane(dach)-Pt monoadducts. However, at 37
      degrees C, both en-Pt and dach-Pt monoadducts are selectively removed. Pt-DNA
      diadducts are stable to 10 mM thiourea at either temperature. These data suggest
      that previous experiments using NH4HCO3-blocked DNA are likely to have
      underestimated Pt-DNA monoadducts and to have overestimated diadducts. As a
      consequence, such studies are likely to produce inaccurate estimates for the
      repair of individual adducts. The data also show that although thiourea treatment
      is suitable for blocking Pt-DNA monoadducts under the conditions generally used
      (10 mM, 10 min, 25 degrees C), it can selectively remove Pt-DNA monoadducts at
      higher temperatures.

PMID- 1760853
TI  - Polymer-coated albumin microspheres as carriers for intravascular tumour
      targeting of cisplatin.
AB  - We used a poly-lactide-co-glycolide polymer (PLAGA 50:50) to formulate cisplatin
      (cDDP) into microspheres designed for intravascular administration. Two systems
      were developed. PLAGA-coated albumin microspheres and microspheres consisting of
      PLAGA only. PLAGA-coated microspheres displayed a mean diameter of 31.8 +/- 0.9
      microns and a payload of 7.5% cDDP (w/w). Solid PLAGA microspheres exhibited a
      mean diameter of 19.4 +/- 0.6 microns and a payload of 20% cDDP. Release
      characteristics and in vitro effects on L1210 leukemia and B16 melanoma cell
      lines were investigated. Both types of microsphere overcame the initial rapid
      release of cDDP (burst effect), and PLAGA-coated albumin microspheres also showed
      a lag phase of approximately 30 min before cDDP release began. PLAGA-coated
      albumin microspheres released most of their payload through diffusion, and the
      coating eventually cracked after 7 days' incubation in saline supplemented with
      0.1% Tween at 37 degrees C, enabling the release of any cDDP remaining. Effects
      of platinum, pre-released from PLAGA-coated albumin microspheres on the in vitro
      growth of L1210 cells were comparable with those of standard formulations
      (dissolved) of cDDP. Material released from non-drug-loaded PLAGA microspheres
      had no effect on L1210 cell growth, suggesting the absence of cytotoxic compounds
      in the matrix. The colony-forming ability of B16 cells was also equally inhibited
      by standard cDDP and pre-released drug. These studies show that formulation of
      cDDP in PLAGA-based microspheres prevents the rapid burst effect of cDDP seen in
      previous preparations and offers an improved system of administration for hepatic
      artery infusion or adjuvant therapy, enabling better clinical handling and the
      promise of a higher ratio of tumour tissue to normal tissue.

PMID- 1760854
TI  - Antitumor activity of FTC-092, a masked 5-trifluoromethyl-2'-deoxyuridine
      derivative.
AB  - 1-(3-O-Benzyl-2-deoxy-beta-D-ribofuranosyl)-5-trifluoromethyl-2,4(1H,3)-
      pyrimidinedione (FTC-092), a fluorinated pyrimidine derivative, appeared to be
      effective against various transplantable tumors in mice following oral
      administration, and its activity was superior to that of several other antitumor
      fluorinated pyrimidines. The ED50 value for FTC-092 the dose effective in
      achieving 50% inhibition of tumor growth against the solid form of sarcoma 180
      was 13.3 mg/kg daily, whereas those for 5-trifluoromethyl-2'-deoxyuridine
      (CF3dUrd), the parent compound of FTC-092, for 1-(2-tetrahydrofuryl)-5
      fluorouracil (Tegafur, FT), the prodrug of 5-fluorouracil (FUra), and for FUra
      were 64.1, 122, and 28 mg/kg daily, respectively. The therapeutic indices
      (LD10/ED50) of FTC-092, CF3dUrd, FT, and FUra were 4.39, 1.7, 1.35, and 1.65,
      respectively. FTC-092 itself is not an active agent. After it has been absorbed
      from the gastrointestinal tract, FTC-092 undergoes a gradual biotransformation,
      mainly via the action of liver microsomes, releasing CF3dUrd over a long period.
      The levels of CF3dUrd in the stomach and small intestine of mice after the oral
      administration of FTC-092 were undetectable, whereas those following the
      administration of CF3dUrd at the same dose were high for a period of several
      hours. In contrast, the CF3dUrd level generated in plasma after the
      administration of FTC-092 remained at a high level for a longer period than did
      that observed on the administration of CF3dUrd. The low levels of CF3dUrd
      measured in stomach and small-intestine tissues and the maintenance of CF3dUrd in
      blood over long periods after the administration of FTC-092 are features that
      favor the possible clinical application of FTC-092.

PMID- 1760855
TI  - Multidrug resistance in MCF-7 human breast cancer cells is associated with
      increased expression of nucleoside transporters and altered uptake of adenosine.
AB  - The rate of adenosine uptake and the corresponding expression of nucleoside
      transporters were studied in several MCF-7 human breast-cancer cell lines that
      express different levels of multidrug resistance (MDR). Kinetic studies of
      adenosine transport in these cell lines revealed that the mean apparent Km and
      Vmax values for the nucleoside transporters increased with increasing MDR. The
      apparent Km and the apparent Vmax of Adriamycin-resistant (ADR10) cell lines were
      respectively 3.2- and 1.8- fold those of Adriamycin-sensitive wild-type (WT)
      cells (P less than 0.001). A partially revertant cell line (ADR10rev) that was
      derived from the ADR10 line and was partially sensitive to Adriamycin exhibited
      apparent Km and Vmax parameters that lay between those of the ADR10 and WT cells
      (P less than 0.001 vs ADR10 cells; P less than 0.05 vs WT cells). ADR10 cell
      membranes bound greater than 4 times more of the nucleoside transporter blockers
      [3H]-nitrobenzylthioinosine [( 3H]-NBI) and [3H]-dipyridamole [( 3H]-DPR) than
      did WT cell membranes per unit protein (P less than 0.0001). Scatchard analysis
      revealed a 2-3 times greater density for nucleoside transporters in ADR10
      membranes as compared with those in WT membranes. ADR10rev membranes bound less
      [3H]-NBI and [3H]-DPR than did ADR10 membranes (P less than 0.001), but they
      bound more of the blockers than did WT membranes (P less than 0.05). A 2.5-h
      exposure to 200 nM phorbol-12,13-dibutyrate (PDBu), which activates protein
      kinase C (PKC) and induces WT cells to exhibit a 4-fold increased transient MDR
      phenotype, increased the apparent Km of WT cells for adenosine transport by
      greater than 2 times (P less than 0.001) to a value close to that found for the
      ADR10 cells. An identical exposure of ADR10 cells to PDBu produced no significant
      effect. The apparent Km of ADR10rev cells was increased 1.4 times by a 2.5-h PDBu
      exposure. None of the cell lines were affected by a 2.5-h exposure to 200 nM
      phorbol-13,10-diacetate (PDA), a much less active phorbol, or vehicle. These
      results suggest that MDR in MCF-7 cells is associated with changes in nucleoside
      transport, including both the number of transporters and their rate of transport,
      and that such changes can be partially mimicked by stimulation of PKC.

PMID- 1760856
TI  - Use of plasma cytotoxic activity to model cytotoxic pharmacodynamics of
      anticancer drugs.
AB  - We have developed a pharmacokinetic/pharmacodynamic approach that integrates the
      disposition, cytotoxic activity and interaction of anticancer drugs. Fundamental
      to this approach is the measurement of the cytotoxicity, against a "target" cell
      line, of patient plasma collected at different times after administration of the
      anticancer agent(s). To illustrate this approach, we have studied the plasma
      cytotoxic activity (PCA), against HL-60 cells, of plasma from 11 acute
      myeloblastic leukemic patients treated with daunorubicin (DNR). Plasma, obtained
      before and serially for 24 h after DNR treatment, was assayed by HPLC for DNR and
      daunorubicinol (DNRol), its active metabolite. The corresponding observed PCA
      values (PCAobs) against HL-60 cells were also measured with a flow-cytometric
      cell-survival assay that we had developed previously. The pharmacodynamics, i.e.
      PCA, were co-modeled (dual Hill equation with an interaction term to allow
      synergism or antagonism) with the pharmacokinetics. The integration of the PCA
      profile provided the area under the observed PCA versus time curve (AUCobs). For
      each patient, we also generated an "interaction panel", by adding known amounts
      of DNR and DNRol to his or her pretreatment plasma. The corresponding
      cytotoxicities were measured, and then applied to the pharmacodynamic model. This
      provided a standard surface from which the PCA of each sample obtained after
      therapy was predicted (PCAprd), on the basis of assayed concentrations of DNR and
      DNRol in that sample. For plasma samples obtained after treatment, the model
      simultaneously fit all three outputs, i.e. PCA and DNR/DNRol concentration, very
      well. We observed substantial interpatient variability in HL-60 growth rate in
      medium containing patient pretreatment plasma, in DNR activity in pretreatment
      plasma, and in the in vitro activity (PCA) of plasma obtained after DNR
      treatment. We also compared the AUCprd to the AUCobs for each patient, and we
      identified a subset of 4/11 acute myeloblastic leukemic patients who had
      developed much more PCA after DNR administration that could be explained by the
      measured concentrations of DNR and DNRol. This may be due to unidentified active
      metabolites or to factors produced in the plasma in response to the treatment.
      This pharmacokinetic/pharmacodynamic model is promising to describe
      pharmacodynamics and interactions of anticancer drugs in cancer patients.

PMID- 1760857
TI  - The effects of doxorubicin and mitoxantrone on wound healing.
AB  - The goal of the present study was to determine whether mitoxantrone would impair
      wound healing to a similar degree as doxorubicin when given in equally cytotoxic
      doses. On day 0, male Fischer rats were wounded and treated with 5% dextrose
      (control), 6 mg/kg doxorubicin, or 1.2 or 2.4 mg/kg mitoxantrone. On day 5, WBCs
      for the doxorubicin group and the group that had been treated with 1.2 mg/kg
      mitoxantrone were 33% and 43% lower than control values, respectively. All rats
      that had been given 2.4 mg/kg mitoxantrone died within 1 week of being wounded
      due to drug toxicity. On day 21, wound-breaking strength (WBS) analysis was
      performed: two skin specimens were taken from each dorsal skin incision
      perpendicular to the scar axis and were subjected to wound disruption (grams of
      force) by uniaxial extension. The WBS analysis indicated significant differences
      between the doxorubicin treated group (1183 +/- 96 g) and the control group (2422
      +/- 247 g). However, no significant difference was found between the group that
      had been given 1.2 mg/kg mitoxantrone (2140 +/- 191 g) and control animals. Thus,
      mitoxantrone seems to exert myelosuppressive effects similar to those displayed
      by doxorubicin, but the former drug results in significantly less impairment of
      wound healing in the rat model.

PMID- 1760858
TI  - Somnolence, hypotension, and metabolic acidosis following high-dose teniposide
      treatment in children with leukemia.
AB  - This report describes an unexpected adverse effect in three children receiving
      teniposide at 3-5 times the conventional dosage (i.e. 200 mg/m2) plus cytarabine
      as part of continuation therapy for acute lymphocytic leukemia. Pharmacokinetic
      studies in each patient had demonstrated high teniposide clearances, and thus the
      increased dosage requirements were necessary to attain plasma concentrations
      similar to those expected for patients with average drug clearance. At 3-4 h
      after the beginning of the 4-h simultaneous infusions of teniposide and
      cytarabine, these patients experienced somnolence, hypotension, and metabolic
      acidosis. The adverse events were associated with elevated teniposide plasma
      concentrations during the infusions compared with those in patients receiving
      similar doses without toxicity, and clinically significant ethanol
      concentrations, presumably from the teniposide formulation. Blood concentrations
      of cremophor and histamine, which are also constituents of the teniposide
      formulation, were not measured. In addition, concomitant therapy with antiemetic
      agents in patients who may have been mildly volume-depleted due to emesis may
      also play a contributory role. Prolonging the infusion time for patients
      receiving teniposide doses above 500 mg/m2 will avoid excessive teniposide and
      ethanol plasma concentrations and minimize the risk of this potentially serious
      side effect.

PMID- 1760859
TI  - Clinical pharmacokinetics of mitoxantrone in hyperthermic, isolated perfusion of
      the leg.
AB  - The clinical pharmacokinetics of mitoxantrone in hyperthermic, isolated perfusion
      of the leg were studied in five patients exhibiting solitary, localized malignant
      melanoma. Mitoxantrone was given as four 1-min infusions at 15-min intervals into
      the arterial line of the perfusion system at a total dose of up to 14 mg/m2. The
      mean half-lives for mitoxantrone in the blood circulation of the leg were: t1/2
      alpha (distribution phase), 25.5 s, and t1/2 beta (elimination phase), 14.9 min.
      The mean volume of distribution at steady state in the leg was 25.6 1. In the
      arterial part of the perfusion, the mean AUC was 155.9 mg min l-1, and that in
      the corresponding venous part was 91.6 mg min l-1. Leakage of the drug from the
      leg into the systemic circulation amounted to 1.2% of the total delivered dose;
      91% of the delivered dose remained in the leg after the perfusion had been
      completed. The mean elimination half-life of mitoxantrone in the systemic
      circulation was 123 min and the corresponding AUC for systemic concentrations was
      8.59 mg min l-1. The present data revealed a high uptake of mitoxantrone into the
      leg and low systemic drug concentrations due to minor leakage, suggesting that
      mitoxantrone might be a good candidate for use in isolated, hyperthermic limb
      perfusion.

PMID- 1760860
TI  - Cancer chemotherapy in the elderly: a series of 51 patients aged greater than 70
      years.
AB  - A total of 2,238 new cancer patients were treated in our institution in 1988;
      among the 423 (18.9%) who were greater than 70 years old, 51 underwent
      chemotherapy. The median age was 75.8 years, and the Karnofsky performance status
      (KPS) was greater than or equal to 70% for 40 patients. Malignancies were
      hematopoietic in 24 cases (47%) and digestive in 15 patients (29%), and 12
      subjects (24%) had other types of cancers. The first chemotherapy course was
      given at the full dose to 23/51 (45.1%) patients. The drug dose was reduced for
      28/51 (54.9%) patients, due in 25 cases to the subjects being greater than 70
      years old. Neither age, KPS, pretreatment assessment, nor cancer extent was
      correlated with the modifications made to the first cycle. An overall toxicity of
      grade 3 + 4 (WHO grading scale) was noted in 10 subjects (19.6%). Although these
      elderly patients were probably selected, analysis of their charts did not
      evidence an increase in chemotherapy toxicity, regardless of the dose they
      received.

PMID- 1760861
TI  - Combined haemoperfusion, haemofiltration and haemodialysis for systemic
      detoxification in locoregional 5-fluorouracil therapy.
AB  - Combined haemoperfusion, haemofiltration and haemodialysis (HPFD) was examined
      for its systemic effect on 5-fluorouracil (5-FU) kinetics after locoregional
      application to one female patient with liver metastases of a colon carcinoma.
      During each HPFD treatment, which lasted 4 h, 5-FU was given via a port-a-cath
      system into the hepatic artery on 4 separate days. The HPFD extraction rate was
      99%. Extracorporal 5-FU clearance (89 ml/min) was 9% of total body clearance
      (1094 ml/min). The fraction eliminated within 4 h was only 6% of the applied dose
      (3500-4000 mg 5-FU). Sufficient extracorporal detoxification during combined HPFD
      can thus not be guaranteed in locoregional chemotherapy with a high dose of 5-FU.

PMID- 1760862
TI  - Local treatment of cutaneous and subcutaneous metastatic malignant melanoma with
      fotemustine.
AB  - Fotemustine is a highly reactive chloroethyl-nitrosourea anti-tumor drug that is
      currently undergoing phase III clinical trials in stage IV metastatic malignant
      melanoma. The drug is a potent alkylating agent and rapidly chloroethylates the
      active sites of the important thioproteins thioredoxin reductase (TR),
      glutathione reductase (GR) and ribonucleotide reductase (RR). These enzymes
      control ribonucleotide reduction and, consequently, DNA synthesis in the S phase
      of the cell cycle. Side effects are minor due to the rapid metabolism of the
      drug. [14C]Fotemustine exhibited a half-life of 90 min in the vascular system
      after the administration of 100 mg/m2. Fotemustine was shown to yield the
      volatile degradation product acetylene (a) in distilled water (4.1%/h), (b) in
      melanoma cell culture medium (MCDB) supplemented with 10% fetal calf serum
      (33%/h) and (c) in fotemustine-sensitive human melanoma cells in culture medium
      (70.5%/h). Due to its rapid metabolism and its low toxicity, high concentrations
      of fotemustine (55 x 10(-3) M) were injected directly into cutaneous and
      subcutaneous melanoma metastases (n = 36) of seven patients, resulting in minor
      necrosis followed by total remission of the metastases. Untreated metastases
      adjacent to the treated tumors were not affected by fotemustine, confirming that
      rapid local metabolism of this drug occurs only in the vicinity of injected
      tumors without producing any systemic effects.

PMID- 1760863
TI  - Affinity of antineoplastic amino acid drugs for the large neutral amino acid
      transporter of the blood-brain barrier.
AB  - The relative affinity of six anticancer amino acid drugs for the neutral amino
      acid carrier of the blood-brain barrier was examined in rats using an in situ
      brain perfusion technique. Affinity was evaluated from the concentration
      dependent inhibition of L-[14C]-leucine uptake into rat brain during perfusion at
      tracer leucine concentrations and in the absence of competing amino acids. Of the
      six drugs tested, five, including melphalan, azaserine, acivicin, 6-diazo-5-oxo-L
      norleucine, and buthionine sulfoximine, exhibited only low affinity for the
      carrier, displaying transport inhibition constants (Ki, concentrations producing
      50% inhibition) ranging from 0.09 to 4.7 mM. However, one agent - D,L-2-amino-7
      bis[(2-chloroethyl)amino]- 1,2,3,4-tetrahydro-2-naphthoic acid (D,L-NAM) -
      demonstrated remarkably high affinity for the carrier, showing a Ki value of
      approximately 0.2 microM. The relative affinity (1/Ki) of D,L-NAM was greater
      than 100-fold that of the other drugs and greater than 10-fold that of any
      compound previously tested. As the blood-brain barrier penetrability of most
      endogenous neutral amino acids is related to their carrier affinity, the results
      suggest that D,L-NAM may be a promising agent which may show enhanced uptake and
      distribution to brain tumors.

PMID- 1760864
TI  - D-3-deoxy-3-substituted myo-inositol analogues as inhibitors of cell growth.
AB  - A number of unnatural D-3-deoxy-3-substituted myo-inositols were synthesized and
      their effects on the growth of wild-type NIH 3T3 cells and oncogene-transformed
      NIH 3T3 cells were studied. The compounds were found to exhibit a diversity of
      growth-inhibitory activities and showed selectivity in inhibiting the growth of
      some transformed cells as compared with wild-type cells. Remarkably, D-3-deoxy-3
      azido-myo-inositol exhibited potent growth-inhibitory effects toward v-sis
      transformed NIH 3T3 cells but had little effect on the growth of wild-type cells.
      The growth-inhibitory effects of the myo-inositol analogues were antagonized by
      myo-inositol. Since [3H]-3-deoxy-3-fluoro-myo-inositol was shown to be taken up
      by cells and incorporated into cellular phospholipids, we suggest that these
      unnatural myo-inositol analogues may act as antimetabolites in the
      phosphatidylinositol intracellular signalling pathways. Because cells transformed
      by oncogenes often exhibit elevated phosphatidylinositol turnover, the inhibition
      of signalling pathways that mediate oncogene action could offer new opportunities
      for controlling the growth of cancer cells.

PMID- 1760865
TI  - Characterization of beta-endorphin-related peptides in the caudal medulla
      oblongata and hypothalamus of the prenatal, postnatal and adult rat.
AB  - A comparison was made of beta-endorphin (B-END) concentrations versus post
      translation products during the perinatal period in the hypothalamus and the
      caudal medulla oblongata. The concentration of B-END-like immunoreactivity did
      not differ statistically between embryonic day 21 (E21) and postnatal day 1 (P1)
      in either area. There were significant differences in forms, with a shift from
      larger precursors at E21 to smaller peptides at P1, with the predominant form of
      B-END being the 31 residue form at E21 in both regions. B-END varied between the
      two regions at P1, the 27-26 residue predominant in the hypothalamus, and the 31
      residue in the caudal medulla.

PMID- 1760866
TI  - Neuromuscular contacts in the developing rat soleus depend on muscle activity.
AB  - Neuromuscular transmission of the rat soleus muscle was interrupted by blocking
      the response of the postsynaptic membrane with alpha-bungarotoxin (alpha-BTX) at
      two different stages of postnatal development, i.e., at birth and at 10 days. The
      effect of this treatment on the maintenance of synaptic contacts was studied
      using histological and electrophysiological criteria. Following treatment at
      birth fewer muscle fibres were polyneuronally innervated 5-7 days later. After
      this initial loss of synaptic contacts, the subsequent rate of synapse
      elimination was slower than in control animals, so that even at 3 weeks muscles
      treated with alpha-BTX at birth had higher levels of polyneuronal innervation
      than their unoperated controls. Thus, interference with the response of the
      postsynaptic membrane at birth has prolonged effects on synaptic development. In
      muscles treated with alpha-BTX at 10 days the elimination of polyneuronal
      innervation was arrested and more neuromuscular contacts preserved.

PMID- 1760867
TI  - The effects of bilateral enucleation in the primate fetus on the parcellation of
      visual cortex.
AB  - Bilateral enucleation in the macaque fetus causes an areal reduction of an
      otherwise normal striate cortex. Here we show that in early operated animals this
      reduction is accompanied by a separation of striate and prostriate cortices which
      are normally contiguous. However this induced separation does not correspond to
      the areal reduction of striate cortex, indicating that extrinsic signals regulate
      either the proliferation and/or survival of striate cortical neurons.

PMID- 1760868
TI  - Effects of dark-rearing on the retinal dopaminergic system in the neonatal and
      postnatal guinea pig.
AB  - To appraise the extent of light responsivity of the retinal dopaminergic system
      in the early postnatal period, dopamine content (DA) of retinas of cycling-light
      reared and dark-reared guinea pigs was determined. DA storage postnatally was
      suppressed in dark-reared animals. Their retinas responded to a brief light
      stimulus by rapidly increasing DOPA synthesis and DA utilization, but not to the
      extent of the response of cycling-light-reared animals. Dopaminergic retinal
      neurones depend on light stimulus for the complete development of some of their
      neurochemical characteristics.

PMID- 1760869
TI  - The intracortical position of pyramidal tract neurons in the motor cortex of the
      reeler changes from postnatal day 10 to adulthood.
AB  - To determine whether or not the intracortical distribution pattern of pyramidal
      tract (PT) neurons in the motor cortex (hindlimb area) of normal and reeler
      mutant mice changes during early postnatal development of the cortex, we injected
      HRP into the pyramidal decussation of postnatal day (P) 8 and adult animals of
      the normal and reeler strains, and killed the animals 2 days later. In the normal
      P10 and adult mice, such an injection resulted in a band of labelled neurons
      confined to the layer of large pyramids (LP), suggesting that the intracortical
      localization of PT neurons does not change from P10 to adulthood in the normal
      strain. In the P10 and adult reeler mice, labelled PT neurons were scattered
      radially from the deepest zone to the superficial zone of the motor cortex.
      However, while the HRP-labelled PT neurons are located bilaminarly in both the
      deepest zone and the superficial zone of the motor cortex of the P10 reeler
      mouse, the majority of PT neurons were found in the upper third of the motor
      cortex of the adult reeler mouse. Thus, the intracortical distribution pattern of
      PT neurons of the reeler mouse changes during the postnatal period.

PMID- 1760870
TI  - Prenatal nicotine exposure selectively affects perinatal forebrain aromatase
      activity and fetal adrenal function in male rats.
AB  - Previous studies have revealed effects of prenatal nicotine treatment on fetal
      plasma testosterone and perinatal sexual brain differentiation in the rat. In an
      attempt to further elucidate the processes underlying this action of nicotine, we
      studied the effect of the drug on brain steroid aromatase which converts
      androgens to estrogens and is known to be important in sexual brain
      differentiation. Aromatase activity (AA) was measured by the conversion of [1
      beta-3H]-androstenedione to estrone in a brain region comprising preoptic,
      hypothalamic and amygdaloid areas. In untreated animals, the development of AA
      between gestational day (GD) 18 and postnatal day (PN) 15 was similar in both
      sexes, except for a significant drop of AA in female brain at PN6, i.e., during
      the later part of the critical period for sexual brain differentiation. When time
      pregnant rats were treated with nicotine delivered by an osmotic minipump for
      either one week (2 mg/kg/d or 6 mg/kg/d from GD12) or two weeks (6 mg/kg/d from
      GD8), their male offspring showed a decrease of AA to female levels at PN6, the
      sex difference existing at this stage thus being abolished. AA of offspring from
      dams bearing tartaric acid-containing minipumps or sham-operated at GD8 or GD12
      was identical to that of untreated controls. No drug effect was seen in female
      fetuses and offspring. Sex differences in the developmental effect of nicotine
      may thus involve brain aromatase. An additional sex-dependent effect of nicotine
      was observed in the male fetal adrenal axis at GD18. Whether the drug effects on
      the two steroid hormone systems are interrelated, remains to be elucidated.

PMID- 1760871
TI  - Ontogeny of proenkephalin gene expression in the rat hypothalamus.
AB  - In the rat hypothalamus, proenkephalin (PE) mRNA synthetizing cells were detected
      by in situ hybridization, using synthetic oligodeoxy-nucleotides, from embryonic
      day 14 (E14) in the presumptive anterior hypothalamic area (AHA) and preoptic
      part of the bed nucleus of the stria terminalis (BST), and from E18 in the
      developing median preoptic area, perifornical area, suprachiasmatic nucleus,
      dorsomedial and ventromedial hypothalamic nuclei. In the paraventricular nucleus,
      cells expressed PE gene in the late prenatal stages; both parvo- and
      magnocellular neurons synthetized PEmRNA in the early postnatal stages. Cells
      expressing PE gene were observed after birth in the lateral preoptic area,
      lateral hypothalamus, medial and lateral parts of the BST. PEmRNA was also found
      from E14 in the striatum, from E18 in the central and medial amygdaloid nuclei,
      the medial group of the thalamic nuclei, and postnatally in a second more
      anterior structure of the thalamus. In the hypothalamus, a clear similarity was
      observed between adult and developmental distributions of PE gene expressing
      cells. The early onset of PE gene expression in the developing rat diencephalon
      suggests an involvement of PE in developmental processes, such as cell
      proliferation and differentiation; the presence of PE during the perinatal period
      may also indicate the appearance of adult neural regulations.

PMID- 1760872
TI  - Developmental expression of the basic fibroblast growth factor gene in rat brain.
AB  - Basic fibroblast growth factor (bFGF) is a trophic factor for a variety of
      neuronal/glial cell populations. The RNase protection assay, with a cRNA
      complementary to the coding region of bFGF mRNA, was used to investigate the
      brain distribution and developmental regulation of bFGF mRNA expression. In adult
      rats bFGF mRNA is distributed throughout the brain, the highest levels being
      observed in cerebral cortex, hippocampus and spinal cord. The levels of bFGF mRNA
      in all the brain structures are low in newborn rats, increase thereafter to reach
      a peak of expression around postnatal day 21. bFGF mRNA levels are significantly
      different between various brain structures during the first and second postnatal
      week. Adult and aged rats (Fisher 344) express the same levels of bFGF mRNA in
      the various brain regions. The onset of bFGF mRNA expression suggests that this
      growth factor is important for the maturation as well as for the maintenance of
      different cell populations of the central nervous system.

PMID- 1760873
TI  - Postnatal development of corticosteroid receptor immunoreactivity in the rat
      hippocampus.
AB  - Postnatal changes in corticosteroid receptor immunoreactivity in the rat
      hippocampus were examined using an antiserum against a fusion protein containing
      an N-terminal peptide of the Type I receptor, and a monoclonal antibody against
      the rat liver Type II-receptor. Age-related regional differences were observed.
      In the pyramidal cell layer of Ammon's horn, and granule cell layer of the
      dentate gyrus (DG), the percentage of Type I receptor immunoreactive (Type I-ir)
      and Type II receptor immunoreactive (Type II-ir) cells was high perinatally,
      declined sharply by postnatal day 10 (P10), and showed a variable increase to
      adult levels subsequently. The pyramidal cells of CA1-CA2, subiculum and DG
      showed a selective increase in Type II-ir in late postnatal life into adulthood,
      while most other regions showed higher Type I-ir in both early and late postnatal
      life, suggesting different roles for these receptors during development. Type II
      ir was predominantly nuclear in most neurons, except for a transient appearance
      of cytoplasmic Type II-ir in neurons of the stratum oriens and molecular layers
      of Ammon's horn and dentate gyrus of P20-P30. Type I-ir was diffusely nuclear and
      cytoplasmic at all developmental ages. This is suggestive of differential genomic
      and extragenomic roles for these receptors during postnatal development of the
      hippocampus.

PMID- 1760874
TI  - Role of laminin in stimulating rapid-onset neurites in NG108-15 cells: relative
      contribution of attachment and motility responses.
AB  - The present paper analyzed how attachment and motility responses contribute to
      the initial formation of rapid-onset neurites in undifferentiated NG108-15 cells.
      Attachment responses played a positive role in stabilizing neurites against
      slippage, but exerted a negative effect upon active motility--which appears to be
      the major rate-determining event in initial outgrowth. The role of laminin in
      this paradigm was elucidated by analyzing the effects of polyglutamate and other
      agents (bovine serum albumin and polyethylene glycol chain derivatives) which
      reduced the number of passive substratum attachment sites, but which did not
      affect cells directly nor affect the binding of laminin to the substratum.
      Polyglutamate decreased attachment and spreading of cells, yet greatly
      accelerated the initial laminin-dependent formation of rapid-onset neurites, and
      greatly enhanced active neurite remodelling and cell translocation as well.
      Together with data presented in previous studies in this series, these findings
      indicate that laminin stimulates rapid-onset neurites primarily by stimulating
      active motility responses. Insofar as rapid-onset neurites appear to provide a
      valid model of how neuronal growth cones are regulated, it is likely that these
      findings will be relevant to developing primary neurons as well.

PMID- 1760875
TI  - Differential hormonal modulation of brain antigens recognized by the AB-2
      monoclonal antibody.
AB  - The expression of monoclonal antibody AB-2 immunoreactivity is age- and sex
      dependent in radial glia of developing rat hypothalamus and is regulated by
      prenatal exposure to gonadal steroids. In the present study, several proteins
      were recognized by AB-2 and were distributed selectively in subcellular fractions
      from neonatal hypothalamus (HYP), remaining forebrain (FB), and brainstem
      regions. Immunoblots revealed polypeptide bands in 3 major molecular weight
      classes: one at approximately 195 kDa in the cytosolic compartment; and two
      doublets at 220 kDa and 340 kDa in both microsomal and crude mitochondrial
      membrane fractions. The 220 kDa and 340 kDa doublets were also Triton-insoluble,
      suggesting a cytoskeletal association. The 195 kDa-AB-2-immunoreactive band was
      present in both Triton-soluble and insoluble fractions. AB-2 also recognized
      several acidic glycolipids extracted from postnatal rat brain regions on
      immunoblots following high performance thin layer chromatography. One of the
      bands from postnatal rat brain extracts migrated similarly to purified bovine
      brain sulfatide, which was also immunoreactive with AB-2. AB-2 immunoreactivity
      with proteins, polar lipids, and sulfatide suggests that the epitope is a
      carbohydrate present in multiple cellular compartments. AB-2 recognized the same
      molecular bands in males and females. Testosterone treatment selectively
      decreased the level of the 195 kDa AB-2-immunoreactive polypeptide. The 195 kDa
      AB-2-immunoreactive polypeptide possibly acts in radial glia in the determination
      of sexually dimorphic neurons in the preoptic area/hypothalamus.

PMID- 1760876
TI  - Establishment of photoreceptor cell polarity in culture revealed by mushroom
      lectin binding.
AB  - Differentiation of photoreceptor cells dissociated from chick embryo was
      investigated in a monolayer culture at low cell density and low serum
      concentration. The precursor cells were initially round and finally adopted the
      elongated and monopolar shape characteristic of such photoreceptor cells in vivo.
      They exhibited the primitive inner segment, and on its distal side showed a crest
      like membrane expansion instead of the developed outer segment. The cell polarity
      of these cultured photoreceptor cells was examined using mushroom lectin, which
      has specific affinity for the D-galactose-beta(1,3)-N-acetylgalactosamine moiety.
      Rhodamine-labeled mushroom lectin uniformly initially stained the surface of
      early round photoreceptor cells, but with time the staining became restricted to
      the inner segment and its distal membrane expansion in all elongated
      photoreceptor cells at 12 days from the beginning of development. In semithin
      sections of 12-day-old chick embryo retina, mushroom lectin also stained the
      immature inner segment that had emerged at this stage. After hatching, light and
      electron microscopic observations revealed that the entire scleral surface of
      retinal plasma membranes as far as the outer limiting membrane, i.e. the inner
      and outer segments of all types of photoreceptor cells and also Muller cell
      processes, were stained with the mushroom lectin. These results clearly show that
      all photoreceptor cells can establish their inherent cell polarity even in
      culture, and that mushroom lectin is a valuable marker, for the investigation of
      photoreceptor cell polarity.

PMID- 1760877
TI  - Growth factor and oncogene signalling pathways as targets for rational anticancer
      drug development.
AB  - There is a critical need for new targets, in addition to DNA, for anticancer drug
      development. A recently discovered target is the intracellular signalling
      pathways that mediate the actions of growth factors and oncogenes on cell
      proliferation. Two important pathways, the myo-inositol and protein tyrosine
      kinase signalling pathways are reviewed. Three classes of compounds that modulate
      myo-inositol signalling are discussed. These are: 1) the D-3-substituted-3-deoxy
      myo-inositol analogues that act as antimetabolites of myo-inositol and show
      selective growth inhibition of some transformed cells; 2) the alkaloid
      staurosporine that acts as a potent inhibitor of protein kinase C and of platelet
      derived growth factor (PDGF) receptor protein tyrosine kinase activity; 3) the
      ether lipid analogues that block growth factor signalling at several points by
      acting as inhibitors of protein kinase C, phosphoinositide specific phospholipase
      C and inositol(1,4,5)trisphosphate-induced Ca2+ release. It is suggested that
      inhibition of signalling pathways may explain the growth inhibitory effects of
      these compounds. Other potential signalling target sites for anticancer drug
      development are discussed.

PMID- 1760878
TI  - Purification and biochemical characterization of xanthopterin from patients with
      chronic renal failure. I. Isolation, purification and preliminary
      characterization.
AB  - We describe the purification and initial characterization of a hitherto
      unrecognized fluorescence (excitation/emission maxima at 380/440 nm and 400/460
      nm) reported from this laboratory in patients with chronic renal failure (Clin
      Chem 31: 1988, 1985). Purification was achieved using Sephadex G-10 gel
      chromatography combined with reverse phase and ion exchange high-performance
      liquid chromatography (HPLC). Purity of the "blue-green" fluorescent compound was
      determined to be greater than 99% by HPLC, and two-dimensional thin layer
      chromatography using an acidic and basic solvent system. The excitation/emission
      maxima were shown to be 390 nm/456 nm, and ultraviolet scans, at pH 1.0, 7.0, and
      13.0, gave absorbance optima at 261 nm/356 nm, 278 nm/390 nm, and 255 nm/394 nm,
      respectively. The isoelectric point of 4.05 in conjunction with the fluorescent
      and ultraviolet spectra suggests that the fluorophore belongs to the class of
      compounds known as pteridines.

PMID- 1760879
TI  - Purification and biochemical characterization of xanthopterin from patients with
      chronic renal failure. II. Biochemical elucidation and structural analysis.
AB  - We have identified the primary endogenous fluorescent substance, which has
      characteristic excitation/emission maxima at 380/440 nm and 400/460 nm, found in
      the sera of patients with chronic renal failure (Clin Chem 32: 1276, 1988).
      Preliminary studies, using thin layer chromatography (with cellulose) in
      conjunction with pteridine standards, indicated that the compound is an
      unconjugated pteridine. Characterization by gas chromatography-mass spectrometry
      (electron impact), direct probe-mass spectrometry (electron impact/chemical
      ionization), and Fourier Transform Infrared analysis showed this compound to be
      xanthopterin (2-amino 4,6 pteridinedione), an unconjugated pteridine known to be
      present in man in trace quantities. An authentic sample of this compound had a
      retention time with high-performance liquid chromatography (HPLC) identical to
      that of the purified fluorophore. The physiological role of xanthopterin in the
      pathogenesis of uremia has yet to be elucidated.

PMID- 1760880
TI  - Precipitation method for separating and quantifying bone and liver alkaline
      phosphatase isoenzymes.
AB  - We evaluated a method for quantifying bone isoenzyme of alkaline phosphatase
      (ALP) which utilizes wheat-germ lectin to precipitate this fraction. In precision
      studies, CVs ranged from 3.2 to 11.4% (within-day) and from 3.7 to 11.5% (day-to
      day). The assay procedure was linear to 1100 U/L and was easily adapted to
      automated kinetic measurement. Comparison of the precipitation method with an
      affinity electrophoretic method, which utilizes cellulose acetate as a support,
      demonstrated a satisfactory coefficient of correlation (r = 0.886). The reference
      range was determined in sera from 188 healthy adult subjects. The distribution of
      bone ALP values was also studied in 73 healthy children and in 30 healthy
      adolescents. To evaluate the clinical applicability of the method, the bone
      isoenzyme was determined in samples from several groups of subjects (pregnant
      women, patients with hepatobiliary diseases, patients with hepatocellular
      carcinoma without skeletal involvement, and patients with bone, liver or lymph
      node metastases). We found the method suitable for routine determination of bone
      alkaline phosphatase and for the screening of bone metastases. Because of its
      technical simplicity and satisfactory analytical performance, it can be used
      instead of the heat-inactivation procedure.

PMID- 1760881
TI  - A fast high-performance liquid chromatographic method for the measurement of
      plasma concentration and specific activity of phenylalanine.
AB  - A fast high-performance liquid chromatographic (HPLC) method for the measurement
      in plasma of phenylalanine concentration and specific activity is reported. One
      to-two mL of acidified plasma are applied to an ion-exchange resin. The eluted
      amino acids are enzymatically converted into the corresponding alpha-ketoacids,
      i.e. phenylalanine is converted into phenylpyruvic acid. After a two-step
      extraction, phenylpyruvic acid is separated by reverse phase chromatography
      within 8-10 min. The use of an internal standard allows precise quantitation of
      plasma concentrations. The radioactivity eluted from the HPLC is divided by the
      amount injected to yield the specific activity. Concentration and rate of
      appearance of phenylalanine in man, calculated with the L-[2,6-3H]-phenylalanine
      tracer, are in the range of published data.

PMID- 1760882
TI  - Heterogeneity of HDL in crossed immunoelectrophoresis with continuous gradient
      polyacrylamide gel in the first dimension and one or two antibody layers in the
      second dimension.
AB  - We describe a new method of immunoelectrophoresis with a continuous gradient
      polyacrylamide gel in the first dimension and an agarose-dextran gel in the
      second dimension with one or two layers of antibody. The use of a polyacrylamide
      gel in the first dimension allows better resolution of lipoproteins than with
      crossed immunoelectrophoresis using agarose gel in both dimensions. The use of
      two layers of antibody in the second dimension also enhances the specificity of
      characterization and the resolution of the separation. Thus, using a layer of
      anti-apo A-I combined with a layer of anti-apo A-II, three particles containing
      only apo A-I and three containing both apo A-I and A-II could be separated.

PMID- 1760883
TI  - Serum total free radical trapping ability in acute myocardial infarction.
AB  - Serum total free radical trapping abilities (TRAP experimental) were measured in
      15 patients with acute myocardial infarction (AMI) and compared to sex- and age
      matched controls. TRAP experimental values were significantly lower (p less than
      0.01) in the AMI group. Theoretical trapping abilities were also calculated and
      compared with experimentally derived values. In the AMI group there was no
      significant difference between the experimental and calculated TRAP, but in the
      control group experimental values were significantly higher (p less than 0.01)
      than calculated values. In the control group regression analysis revealed that
      alpha-tocopherol and ascorbate taken together most closely explained the radical
      trapping ability of sera, with a regression equation: TRAP experimental = 562.9 +
      2.082 (alpha-tocopherol + ascorbate). In the AMI group no relationship between
      the serum antioxidants and TRAP experimental was observed.

PMID- 1760884
TI  - Phosphatase isoenzymes as bone metastasis markers in prostatic carcinoma.
AB  - Bone alkaline phosphatase (b-ALP) and tartrate resistant acid phosphatase (tr
      ACP) are markers of the activity of osteoblasts and osteoclasts, respectively. We
      have already shown that the serum activity of these isoenzymes was elevated in
      breast cancer patients with bone metastasis (BM); we show here that the serum
      activity of b-ALP and tr-ACP were also elevated in prostate cancer patients with
      BM. Specificity and sensitivity of b-ALP for BM were 0.90 and 0.75, respectively;
      and for tr-ACP, 0.60 and 0.60, respectively. The accuracy of b-ALP as a BM marker
      was higher than the accuracy of usual markers of prostatic carcinoma (tartrate
      labile ACP [tl-ACP], prostatic acid phosphatase [PAP] and prostate specific
      antigen [PSA]). The highest value predictive of a positive bone scan was obtained
      with b-ALP (0.88); this increased to 0.97 when b-ALP was coupled with PAP.

PMID- 1760885
TI  - Role of endogenous dopamine in the natriuretic response to various degrees of iso
      osmotic volume expansion in rats.
AB  - It is recognized that endogenous dopamine (DA) plays an important role in
      regulation of sodium excretion under certain physiological and experimental
      conditions. However, the relative contribution of intrarenally produced DA to
      natriuresis accompanying various degrees of acute volume expansion (VE) still
      remains to be clarified. In the present study, acute iso-osmotic VEs were
      performed in pentobarbital-anesthetized rats over a 60 min period. The rats were
      divided into 3 groups, each received either modest (2.5% body weight), moderate
      (5% body weight), or large degree of VE (10% body weight), respectively. Acute VE
      in these three groups evoked pronounced increases in urine output (UV) and
      urinary sodium excretion (UNaV), which were associated with significant increase
      in urinary DA excretion (UDAV). Compared to the modest VE (2.5% body weight),
      moderate VE (5% body weight) produced larger increases in UV (43 +/- 4.7 vs 29.0
      +/- 4.7 microliters/min, p less than 0.05) and UNaV (7.8 +/- 0.7 vs 4.7 +/- 1.0
      microEq/min, p less than 0.05) with slight but significantly greater increase in
      UDAV (1.38 +/- 0.06 vs 1.23 +/- 0.02 ng/min, p less than 0.05). Compared to
      moderate VE (5% body weight), large VE (10% body weight) produced more pronounced
      increases in UV (91 +/- 14 vs 43 +/- 4.7 microliters/min, p less than 0.01) and
      UNaV (16 +/- 2.3 vs 7.8 +/- 0.7 microEq/min, p less than 0.01), however the
      increase in UDAV was similar to that seen during moderate VE. These results
      suggest that endogenous DA is involved in natriuretic response to various degrees
      of acute VE. Furthermore, it was discovered that the relative contribution of
      endogenous DA to overall VE-induced natriuresis is related to some extent to the
      degree of VE, inasmuch as DA appears to play a greater role in the overall
      natriuretic response seen during modest to moderate degree of VE.

PMID- 1760886
TI  - Long term follow-up after surgical removal of pheochromocytoma--observations in
      61 patients.
AB  - 89 patients were operated on for pheochromocytoma. 61 patients (37 women and 24
      men) were available for extended follow-up. The final survey, performed 79.1 +/-
      66.9 months postoperatively, provided data on survival, blood pressure tumor
      recurrence, malignant metastatic lesions, cardiovascular complications and
      coexisting diseases. There were 4 deaths during the follow-up period, including 2
      instances of malignant pheochromocytoma. Permanent normalization of blood
      pressure was achieved in 38 patients (62.3%). This hypotensive effect was noted
      in 79.2% of patients with preoperative paroxysmal hypertension and in 40.8% of
      those with sustained hypertension. Permanent or re-developing postoperative
      hypertension was noted in 23 (37.7%) patients. This includes 4 cases of malignant
      pheochromocytoma, 4 cases of recurrent benign pheochromocytoma and 15 cases of
      essential hypertension. Cardiovascular complications during follow-up were rare
      and concerned the patients with essential hypertension diagnosed postoperatively.

PMID- 1760887
TI  - Obstructive sleep apnea syndrome in male hypertensives, refractory to drug
      therapy. Nocturnal automatic blood pressure measurements--an aid to diagnosis?
AB  - Sixteen therapy resistant hypertensive males and 16 responders to
      antihypertensive drug treatment, matched for age, gender and body mass index,
      were examined by means of Static Charge Sensitive Bed (SCSB) and oximetry for the
      presence of obstructive sleep apnea syndrome (OSAS). In borderline cases,
      polysomnography was performed. The prevalence of OSAS among therapy resistant
      patients was 56%, as compared to 19% in the control group (p less than 0.05).
      This higher prevalence of OSAS in a weight-matched group of subjects with severe
      hypertension supports the notion of a causal connexion between hypertension and
      OSAS. In 10 OSAS patients and 10 hypertensives with normal respiration during
      sleep, ambulatory noninvasive monitoring (ABPM) of arterial pressure (AP) and
      heart rate (HR) was also performed. The OSAS patients had a higher nocturnal
      variability of HR, systolic blood pressure (both p less than 0.05), and diastolic
      blood pressure (p less than 0.01) in 8 half-hourly single ABPM measurements.
      Contrary to the non-OSAS subjects they also had a higher HR variability during
      sleep than they had in the waking state (p less than 0.05). For subjects less
      than 60 yrs a range/median value of greater than 0.32 for nocturnal diastolic
      pressure was found to predict OSAS with a sensitivity of 87.5% and a specificity
      of 100%. It is concluded that therapy-resistant male hypertensives have a high
      prevalence of OSAS. As this may be a deleterious combination, screening for OSAS
      is highly indicated in such patients. A high variability of HR and AP in
      nocturnal ABPM suggests OSAS.

PMID- 1760888
TI  - Altered renin release from isolated superfused rat glomeruli in DOCA-salt
      hypertensive rats.
AB  - The present study was designed to clarify the role of calcium in suppressed renin
      release in DOCA-salt hypertension. Rat glomeruli were isolated by the modified
      Beierwaltes' sieving method. The glomeruli were superfused with Krebs-Ringer
      solution. Basal levels of renin release were lower in the DOCA-salt hypertensive
      rats (1.16 +/- 0.27 ng/ATI/hr/hr/10(4) glomeruli, mean +/- SEM, n = 8) than in
      the control rats (1.92 +/- 0.18, p less than 0.01, n = 8). Perfusion with a
      calcium free solution containing EGTA and A23187 stimulated renin release in the
      DOCA-salt hypertensive and control rats. The maximum levels of renin release
      during the perfusion in DOCA-salt hypertensive rats (1.79 +/- 0.17, n = 8) were
      lower than those in control rats (10.60 +/- 1.85, p less than 0.01, n = 8). These
      results suggest that high levels of intracellular calcium might not contribute to
      the suppression of renin release in DOCA-salt hypertension.

PMID- 1760889
TI  - Blood pressure and anthropometric differences in regularly exercising and
      nonexercising black adults.
AB  - Few studies have examined the relationship between exercise and BP in Black
      adults, a population with substantial risk for hypertension. This pilot study was
      undertaken to examine BP, anthropometric characteristics, dietary intake, and
      resting pulse rate by level of exercise participation in a group of Black Seventh
      Day Adventists. Subjects were classified as regular exercisers (n = 54, age =
      54.6 yrs) if they reported at least two exercise sessions per week (x = 4.0 times
      per week) lasting a minimum of 20 minutes each, in which they engaged in vigorous
      exercise. Nonexercisers (n = 60, age = 56.2 yrs) were those who reported
      participation in such exercise no more than once per week (x = 0.1 times per
      week). There were no group differences in dietary intake of any macro or
      micronutrients, but exercisers exhibited significantly lower body mass index,
      waist circumference, triceps skinfold thickness, and resting pulse rate. Forty
      two percent of the nonexercisers were confirmed hypertensives compared to only 20
      percent of the exercisers. Age and gender-adjusted BP was significantly lower in
      the exercisers (BP = 123.8/73.4 mm Hg) compared to the nonexercisers (BP =
      133.5/77.1 mm Hg). After adjustment for anthropometric differences, the systolic
      BP of the exercisers remained approximately 8 mm Hg lower than their
      nonexercising counterparts. These data suggest that participation in vigorous
      exercise is favorably related to blood pressure and may attenuate the risk of
      hypertension in Black Seventh Day Adventists.

PMID- 1760890
TI  - Hypercholesterolemia and changes of vascular contractile responses in
      experimentally uremic rats.
AB  - Arterial contractile responses were studied in experimentally uremic rats. The
      ligation of 75% of the terminal branches of the left renal artery, followed by
      contralateral nephrectomy induced a chronic renal failure, as evidenced by
      significantly higher BUN concentrations and an elevation in blood pressure.
      Uremic rats exhibited elevations in total and HDL cholesterol, increased
      triglyceride levels, and significantly lowered HDL/total cholesterol ratios
      compared to control groups: 1) untreated control, 2) experimental control
      receiving renal infarction without contralateral nephrectomy, and 3) two kidney,
      one clip (2K1C) model of hypertension. Plasma total cholesterol levels in uremic
      rats increased by 50% in the first week following final surgery and plateaued at
      approximately 100% above control levels during postoperative weeks 3 through 10.
      Plasma transaminase levels were similar among all of the groups of rats studied
      indicating no effects of surgery on hepatic function. The contractile responses
      of aortic rings from uremic rats to submaximal concentrations of serotonin and
      clonidine were significantly increased and decreased, respectively, whereas the
      contractile response to norepinephrine was not altered. The enhanced sensitivity
      to serotonin of aortic rings from uremic rats was abolished following disruption
      of the endothelium. Neither the alteration of aortic contractile properties nor
      changes in plasma BUN and cholesterol concentrations were observed in
      hypertensive 2K1C rats. However, there was a tendency for decreased acetylcholine
      induced relaxation in aortic rings of uremic and 2K1C rats. No significant
      histological evidence of atherosclerosis was found in aortic tissues of uremic
      rats during the interval of study. These results indicate that
      hypercholesterolemia, hypertriglyceridemia, and altered vascular sensitivity to
      serotonin and clonidine are likely to be primary changes in the uremic rat and
      are not secondary to the development of blood pressure elevation or overt
      evidence of structural change in the vessels of this model.

PMID- 1760891
TI  - Calcium and the impairment of contractions to norepinephrine in aorta isolated
      from the spontaneously hypertensive rat.
AB  - Helical strip contractility from hypertensive (SHR) and normotensive (WKY) rat
      aortas assessed in the presence of varying calcium concentrations indicated that
      SHR strips exhibit a higher intrinsic myogenic tone and contract less to
      norepinephrine (NE) in a physiological calcium concentration compared to
      controls. Relatively higher isometric tension was developed in the SHR in low
      calcium (0-0. 27 mM). While control responses were blunted by LaCl3, EGTA, and
      nifedipine, the SHR strips were unaffected. Addition of procaine significantly
      enhanced SHR contractility to NE with no effect on control strips. These data
      suggest that abnormal cytosolic calcium provokes an increase in myogenic tone and
      an impaired contractile response of aortic smooth muscle cells to NE.

PMID- 1760892
TI  - Renal dopamine and changes in dopamine receptor ligand binding during high sodium
      intake.
AB  - This study was designed to measure changes in plasma levels of atrial natriuretic
      peptides (ANP), urine volume (UV), urinary excretion of dopamine (UDAV) and
      sodium (UNaV), and dopamine (DA) receptor affinity (Kd) and binding sites (Bmax)
      in kidneys of rats drinking normal saline for a period of 7 days. The saline
      intake significantly increased UV, UNaV, plasma ANP, UDAV, and its primary
      metabolite dihydroxyphenyl acetic acid (DOPAC) for the period of 7 days. Bmax
      increased significantly 1 day after the initiation of saline intake, however, the
      increase appeared to be transient since measurements of Bmax made after 7 days of
      saline intake were not significantly different from the control group. No changes
      in Kd were observed. These results indicate that renal DA contributes to
      maintenance of Na balance during increased Na intake and that renal DA receptors
      undergo transient changes during this period.

PMID- 1760893
TI  - Psychosocial stress elevates blood pressure via an opioid dependent mechanism in
      normotensive rats.
AB  - Stress is an important risk factor in cardiovascular diseases, including
      hypertension. Endogenous opioids are known to be elevated in stress and in
      various models of hypertension with differing etiologies. Blockade of endogenous
      opioids with naloxone has been demonstrated to attenuate or reverse the elevation
      in blood pressure in both renovascular and spontaneous hypertension. In the
      current study, increased blood pressure was induced using a model of psychosocial
      stress. During the first week of stress, systolic blood pressure rose rapidly to
      reach a level that was sustained throughout the remaining period of stress.
      Chronic infusion of the opiate antagonist, naloxone, both prevented and
      completely reversed the elevated blood pressure due to psychosocial stress. These
      data demonstrate that elevated endogenous opioids are important factors in
      cardiovascular regulation and are likely to influence both the development and
      maintenance of stress-induced hypertension.

PMID- 1760894
TI  - Development of a high renin model of hypertension in the cynomolgus monkey.
AB  - Hypertension was produced in cynomolgus monkeys by reducing blood flow to the
      left kidney by 60% via renal artery stenosis (2-kidney, 1-clip). Significant
      increases in mean arterial blood pressure (MABP) were observed within two to
      three weeks. Maximum increase (from 95 +/- 6 mmHg to 130 +/- 7 mmHg) occurred at
      about four to six weeks following renal artery stenosis and was sustained for
      more than 24 weeks. Plasma renin activity (PRA) was elevated concomitantly with
      the increase in MABP. PRA was raised to 42 +/- 3 ng angiotensin I/ml/hr six weeks
      after renal artery stenosis from a control PRA of 3 +/- 0.7 ng angiotensin
      I/ml/hr. At six months post renal artery stenosis, PRA was 33.4 +/- 4.2 ng
      angiotensin I/ml/hr. The angiotensin II (AII) receptor antagonist saralasin, the
      angiotensin I converting enzyme inhibitor captopril, and the renin inhibitor CGP
      38,560 produced sustained reductions in MABP. The antihypertensive response to
      the renin inhibitor CGP 38,560 was associated with a reduction in PRA of greater
      than 99%, and a greater than 90% reduction in immunoreactive AII. These studies
      demonstrate that high-renin hypertension can be induced in the cynomolgus monkey.
      This pathological model provides a useful method for investigating the
      antihypertensive effects of agents which antagonize the renin-angiotensin system
      in a nonhuman primate.

PMID- 1760895
TI  - Mechanisms involved in angiotensin II induced increases in cardiac output in
      pithed rats.
AB  - This study was conducted to determine the mechanisms by which angiotensin II (Ang
      II) acutely increases cardiac output. Pithed Sprague-Dawley rats were prepared
      for continuous measurement of cardiac output by electromagnetic flowmetry. Ang-II
      (31-1000 ng/kg, i.v.) produced dose-related increases in cardiac output, heart
      rate and stroke volume. Although the heart rate increases were abolished by beta
      adrenoceptor blockade, the cardiac output responses were unchanged due to an
      offsetting increase in stroke volume. The constancy of the cardiac output
      response following beta-adrenoceptor blockade suggested that Ang-II increased
      cardiac output by constricting venous smooth muscle and thereby increasing venous
      return. This conclusion is supported by the observation that Ang-II produced
      marked increases in left ventricular end diastolic pressure that paralleled the
      increases in cardiac output. In fact, based on volume loading with Tyrode's
      solution, the changes in left ventricular end diastolic pressure produced by Ang
      II should have resulted in even greater increases in cardiac output. However, it
      appears that the significant rise in peripheral resistance to Ang-II tended to
      counter the effects of increased venous return on cardiac output. In addition,
      the Ang-II-induced elevations in cardiac output were not altered by alpha
      adrenoceptor blockade. Therefore, catecholamines do not play a role in mediating
      the Ang-II effects. The results of this study support the conclusion that Ang-II
      is capable of increasing cardiac output by constriction of venous smooth muscle.

PMID- 1760896
TI  - Hormonal correlates of weight loss associated with blood pressure reduction.
AB  - This study investigated changes in plasma norepinephrine and the renin
      angiotensin-aldosterone system during weight loss. Subjects were maintained on a
      hypocaloric and low sodium diet for 12 weeks. During weight loss statistically
      significant decreases in blood pressure, aldosterone, plasma renin activity, and
      norepinephrine were evident. Plasma renin substrate was suppressed from week one
      to eight and returned to control levels by week twelve. The data indicate that a
      reduction in the activity of the renin-angiotensin-aldosterone system, modulated
      by circulating norepinephrine and plasma renin substrate, may significantly
      contribute to the fall in blood pressure associated with weight loss.

PMID- 1760897
TI  - Interactive video: state of the art.

PMID- 1760898
TI  - The treatment of hypertension in pregnancy. Clinical pharmacokinetic
      considerations.

PMID- 1760899
TI  - Clinical pharmacokinetics of carboplatin.
AB  - Carboplatin [diammine(1,1-cyclobutanedicarboxylato)platinum(II)] is one of the
      most promising second generation platinum compounds. Its greater chemical
      stability in comparison with cisplatin accounts for its lower reactivity with
      nucleophilic sites of DNA, and may therefore be related to the higher dose
      necessary to obtain an antitumour effect similar to that of cisplatin. The lower
      reactivity with proteins may be related to the observed reduction in
      nephrotoxicity. Its dose-limiting toxicity is myelosuppression, especially
      thrombocytopenia. Total and ultrafilterable platinum are detected by flameless
      atomic absorption spectrophotometry, and high performance liquid chromatography
      with either UV or electrochemical detection is used for the quantification of
      carboplatin. These 3 species have been measured as a function of time in
      biological fluids and tissues to determine their pharmacokinetics. Carboplatin
      has high stability in infusion fluids in the absence of chloride, but it is less
      stable in plasma and urine. Protein binding is limited, while the low uptake in
      red blood cells appears to be species dependent. Commonly, carboplatin is
      administered intravenously, and its pharmacokinetics are linear up to a dose of
      2400 mg/m2. In comparison with cisplatin, carboplatin has longer half-lives of
      ultrafilterable platinum (23 and 120 min versus 6 and 36 min for distribution and
      initial elimination half-lives, respectively) and a higher cumulative urinary
      platinum excretion (77 versus 28% of the dose in 24 h), both due to the lower
      protein binding of carboplatin. The terminal half-life of total platinum is
      comparable between the 2 compounds (5.8 versus 5.4 days). This value most
      probably represents the breakdown of proteins to which both compounds are
      irreversibly bound. Relationships between pharmacokinetics (area under the curve)
      and pharmacodynamics (extent of myelosuppression or extent of existing kidney
      failure) have allowed the development of equations for rational dosage reduction.
      Intraperitoneal administration has been used in cases of residual ovarian cancer:
      as a result of its higher hydrophilicity and higher molecular weight, carboplatin
      is cleared more slowly from the peritoneal cavity than cisplatin (6 vs 15
      ml/min). The low bioavailability (4 to 12%) and the gastrointestinal side effects
      observed did not warrant further studies with oral administration. In contrast to
      results from animal studies, the modulation of carboplatin-induced
      myelosuppression by diethyldithiocarbamate (DDTC) was not clinically successful.
      Valuable alternatives may be the combination with WR2721 or colony-stimulating
      factors.

PMID- 1760900
TI  - Interleukins. Clinical pharmacokinetics and practical implications.
AB  - Interleukins and tumour necrosis factor (TNF) are a complex group of proteins and
      glycoproteins able to exert pleiotropic effects with respect to a number of
      different target cells. In physiological conditions, they are induced and
      released in basal amounts only in restricted microenvironments where they have
      paracrine activity. Any small amounts reaching the circulation do not disturb
      homoeostasis. During therapy, particularly when these cytokines are administered
      via conventional routes, it has become apparent that their presence in
      nonphysiological plasma concentrations and their unselective action cause toxic
      effects with small benefits. The pharmacokinetics of interleukins-1, -2, -3 and 
      6 and TNF have been evaluated, and their disappearance from plasma after
      intravenous administration is very rapid (i.e. the distribution half-life is
      measured in minutes; the elimination half-life is several hours). The efficiency
      of catabolic pathways such as renal filtration and/or liver uptake is interpreted
      as a salutary mechanism for extracting proteins that should not be in the
      circulation. However, because these cytokines are very potent immunomodulatory
      agents there is a need to improve their therapeutic index, and to this end a
      number of possible formulations and routes of administration are now available
      and may eventually be of practical use.

PMID- 1760902
TI  - Pharmacokinetic optimisation of oral hypoglycaemic therapy.
AB  - Two main classes of oral hypoglycaemic drugs, the sulphonylureas and the
      biguanides, are currently used in the therapy of type II, non-insulin-dependent
      diabetes mellitus (NIDDM). The basic pharmacokinetic properties of these agents
      are discussed with a view to efficient and safe treatment. Both first- and second
      generation sulphonylureas are rapidly absorbed from the gastrointestinal tract.
      In the plasma compartment, these drugs are strongly bound to serum proteins. All
      sulphonylureas are metabolised in the liver, and the metabolites and the parent
      drugs are eliminated mainly in the urine, but also (second-generation
      derivatives) in the faces. Rapid- and short-acting sulphonylureas may improve
      early insulin release and promote better postprandial glucose control. Long
      acting derivatives may ensure better control of overnight glycaemia. The elderly
      are at risk of developing severe sulphonylurea-induced hypoglycaemia, and in this
      population the agent chosen should have a short or intermediate duration of
      action and no active metabolites. Caution is needed when prescribing any
      sulphonylurea in patients receiving drugs known to affect sulphonylurea action,
      and in those with impaired liver and/or kidney function. The bioavailability of
      the biguanides ranges from 40 to 60%. Binding to plasma proteins is absent or
      very low. Metformin and buformin are not metabolised and are excreted in the
      urine; phenformin undergoes hepatic hydroxylation and is excreted in both urine
      and faeces. Metformin is the only agent of this class currently recommended for
      clinical use. The main indications of metformin treatment are NIDDM associated
      with obesity and/or hyperlipidaemia, and in combination with sulphonylurea both
      as primary treatment and when secondary failure occurs with sulphonylurea alone.
      Lactic acidosis may develop in patients receiving therapy with biguanides,
      especially in the presence of a preexisting contraindication to their use.

PMID- 1760901
TI  - Pharmacokinetic drug interactions in anaesthetic practice.
AB  - Patients receive on average 10 different drugs while in hospital; when fewer than
      6 are administered the probability of an adverse drug interaction is about 5%,
      but when more than 15 are given the probability increases to over 40%. Patients
      presenting for anaesthesia and surgery are likely to receive multiple
      preoperative drug therapy and also many perioperative medications as part of
      their anaesthetic regimen. Thus, there is a considerable potential for
      interactions to occur in anaesthetic practice. Pharmacokinetic interactions occur
      when the administration of 1 drug alters the disposition of another, and hence
      alters the concentration of drug at the receptor site, leading to altered drug
      response. These changes in drug concentration at the receptor site may be
      produced by alteration of (a) drug absorption and uptake into the body, (b) drug
      distribution, (c) drug metabolism and (d) drug elimination or excretion by
      nonmetabolic routes. Interactions affecting the absorption of orally administered
      medications are often due to the indirect effect of 1 drug on gastric motility
      and emptying, which leads to reduced, delayed or variable systemic drug
      availability. Gastric emptying time before elective surgery is normal, but
      premedication with morphine, pethidine (meperidine) and anticholinergics all
      delay gastric emptying and hence drug absorption. Inhalational anaesthesia of
      short duration does not appear to affect drug absorption, although halothane
      anaesthetic used for longer periods produces a slight delay in gastric emptying.
      Volatile anaesthetics have been shown to delay the intramuscular absorption of
      ketamine. Anaesthetic agents may affect drug distribution, and peak
      concentrations of propranolol, for example, are 4 times higher during halothane
      anaesthesia in dogs, accompanied by a marked decrease in volume of distribution.
      This effect has been noted for other drugs, including thiopental and verapamil.
      Volatile anaesthetics also affect plasma protein binding, leading to displacement
      interactions in some cases. Volatile anaesthetics affect the metabolism of
      concomitantly administered drug (a) by altering the rate of delivery to the organ
      of clearance (e.g. decreasing hepatic blood flow) and (b) by altering the
      activity of drug metabolising enzymes. It is now well recognised that all the
      volatile anaesthetics currently in use inhibit the metabolism of a large variety
      of drugs, e.g. propranolol, lidocaine (lignocaine), fentanyl and pethidine. Other
      examples of interactions of clinical importance to anaesthesiologists include
      those between cimetidine and the local anaesthetics and benzodiazepines;
      inhibition of plasma cholinesterase by drugs such as ecothiopate; interactions
      between monoamine oxidase inhibitors and sympathomimetics or pethidine and
      between monoamine oxidase inhibitors and sympathomimetics or pethidine and
      between isoniazid and enflurane.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1760903
TI  - Contrast-enhanced MRI for the staging of bronchogenic carcinoma: comparison with
      CT and histopathologic staging--preliminary results.
AB  - Nineteen patients with potentially operable bronchial carcinoma were included in
      a prospective study to assess the staging capabilities of plain and contrast
      enhanced magnetic resonance imaging (MRI) in comparison with computed tomography
      (CT) and to compare the results to post-operative histopathological staging (HS).
      The evaluation focused on the following T-staging criteria: (i) direct invasion
      of the pleura; (ii) neoplastic invasion of the mediastinum; (iii) differentiation
      of the primary tumour from alterations of the surrounding lung parenchyma such as
      inflammation or atelectasis; and (iv) intrathoracic lymph node involvement by
      tumour. MRI and CT produced similar results for pleural invasion (sensitivity of
      0.4 and 0.75 respectively and a specificity of 0.86 and 0.93 respectively).
      Mediastinal invasion was overdiagnosed in four patients (no false negatives),
      whereas CT had only one false positive result (two false negatives). Our results
      showed CT to be superior to MRI for the preoperative evaluation of patients
      suffering from bronchogenic carcinoma.

PMID- 1760904
TI  - Chronic lung fibrosis following carmustine (BCNU) chemotherapy: radiological
      features.
AB  - Carmustine (BCNU) is a cytotoxic drug which is a recognized cause of acute
      pulmonary fibrosis. We describe the radiological findings in six patients who
      received carmustine in childhood for treatment of central nervous system tumours
      and were subsequently found to have pulmonary fibrosis 13-17 years after
      treatment. Patients were studied by chest radiography and high resolution
      computed tomography. The pattern of disease is novel, involving the upper zones
      in a predominantly peripheral pattern.

PMID- 1760905
TI  - Tumours involving the intrathoracic vagus and phrenic nerves demonstrated by
      computed tomography: anatomical features.
AB  - Four cases of mediastinal tumours involving the intrathoracic vagus and phrenic
      nerves are presented and their computed tomographic (CT) features are described
      with particular attention to the intrathoracic course of these nerves. One case
      of mediastinal plexiform neurofibromatosis appeared as a series of low
      attenuation masses along the intrathoracic course of the nerves. Three examples
      of neurilemmomas of the vagus nerve appeared as masses with central low
      attenuation; one in the retrocaval area, one to the left of the aortic arch, and
      one in the right paraoesophageal area. Familiarity with the CT anatomy of the
      vagus and phrenic nerves will greatly assist in the diagnosis of mediastinal
      tumours.

PMID- 1760906
TI  - Sonographic findings in tuberculous peritonitis of wet-ascitic type.
AB  - Sonograms in 46 patients with tuberculous peritonitis of the wet-ascitic type
      were analysed retrospectively. The ascites was clear in 24 patients (52%). There
      were fixed membranes, septa and debris in eight patients (17%), floating debris
      in six patients (13%), mobile strands or membranes in four patients (9%), and
      fixed septa in four patients (9%). The patients were divided into two groups
      depending on the amount of ascites: small amount of ascites with clear fluid in
      eight patients (17%), and moderate or large amount of ascites with clear or
      complex fluid in 38 patients (83%). Associated findings were omental 'cake'
      (26%), hepatomegaly (24%), thickened mesentery with adherent small bowel loop
      (22%), splenomegaly (20%), pleural effusion (17%), lymphadenopathy (13%), and
      thickening of the ileal wall (7%). The sonographic findings are not specific for
      tuberculous peritonitis, but may give valuable information to prevent unnecessary
      laparotomy.

PMID- 1760907
TI  - Barium meal or endoscopy? A prospective randomized study of patient preference
      and physician decision making.
AB  - This study examines the preference of 64 out-patients for either a barium meal or
      an upper gastrointestinal endoscopy. The sequence of the examinations was
      randomized to avoid order bias. An initial preference for a barium meal of almost
      two-to-one, with 53% having no preference, was changed after the investigations
      to a preference for endoscopy of two-to-one with 5% having no preference. The use
      of mild sedation and the skill of the endoscopist had a major impact on the
      patients' opinion of the endoscopic procedure, and on their choice of examination
      for any repeat study. There was little agreement between clinical diagnosis and
      the result of investigation, but clinicians tended to accept the reported result
      of the investigation, especially if the result was abnormal. Despite a change in
      diagnosis in 34 of 49 patients there was little change in management as a result
      of the investigations, supporting the view that young patients with dyspepsia may
      be managed with symptomatic treatment initially, and without investigation. This
      study lends further support to the view that endoscopy should be the
      investigation of choice in patients with persistent dyspepsia, especially those
      whose age or infirmity may make barium examination suboptimal.

PMID- 1760908
TI  - Double-contrast radiographic features in primary small intestinal lymphoma of the
      'western' type: correlation with pathological findings.
AB  - Eighteen patients with 20 primary lesions of small intestinal lymphoma of the
      'Western' type were examined to determine the double-contrast radiographic
      features of the disease with pathological correlation. The radiographic
      appearances on double-contrast study were divided into five groups: polypoid (3
      lesions), stricturing (6), non-stricturing (3), aneurysmal (3), and
      intussusception (5). In the first four groups, ulceration, signs of submucosal
      tumour, and displacement of adjacent loops were frequent. Two early lesions
      confined to the submucosal layer were also seen. There was a close association
      between the radiographic appearance and macroscopic findings of the resected
      specimens, including the cross section of the tumour, but no correlation with the
      cell type. These results indicate that the double-contrast study accurately
      reflects the morphological changes of primary small intestinal lymphoma.

PMID- 1760909
TI  - Spontaneous intramural haematoma of the oesophagus: appearance on computed
      tomography.

PMID- 1760910
TI  - A trial to assess the effectiveness of bowel preparation prior to intravenous
      urography.
AB  - A randomized prospective trial was undertaken to compare the relative
      effectiveness of two commonly used bowel preparations (senna tablets and sodium
      picosulphate powder) administered to patients before they underwent out-patient
      intravenous urography. Their 'control' films were compared with plain 'kidneys,
      ureters, and bladder' (KUB) radiographs of patients who had had no bowel
      preparation. The results show no significant difference in the degree of faecal
      shadowing between those receiving a bowel preparation and the unprepared
      patients. Nor is there any difference between the two laxatives. We conclude that
      the routine administration of a bowel preparation is unlikely to improve the
      diagnostic quality of out-patient intravenous urograms. In addition, 40% of the
      urogram patients found the effects of the laxatives to be unpleasant or very
      unpleasant.

PMID- 1760911
TI  - The use of a computerized image transfer system linking a regional neuroradiology
      centre to its district hospitals.
AB  - We describe a new personal computer based image transfer and storage system. We
      prospectively assessed the uses and benefits of ImLink (Electronic Imaging Ltd.)
      in a regional neuroradiology department linked by the system to six referring
      district general hospitals. One hundred and fifty consecutive CT scans
      transferred by the system were analysed (142 head, four spine and four body
      scans). Sixty-eight CT scans were of acute neurosurgical cases. A significant
      change in management occurred in 55 of these cases (81%), principally as a result
      of prevention of transfer of head-injured patients when no neurosurgically
      correctable lesion was evident. The high quality of transferred images achieved
      by the system allows the provision of specialist radiological advice to
      colleagues in linked district hospitals. A further 50 non-acute head CT scans
      were transferred by district hospital radiologists seeking the second opinion of
      a neuroradiologist. Twenty-three out-of-hours acute head CT scans were
      transferred from clinicians in our own hospital to the home of the on-call
      neuroradiologist. Overall 63% of the 150 scans were transferred during normal
      working hours. We discuss the multiple uses and future potential for such an
      image transfer and storage system.

PMID- 1760912
TI  - Technical report: wire guided sialography.
AB  - An improved technique for performing sialography in difficult cases is described.
      This is based on the passage of a cannula into the salivary duct ostium over a
      thin, flexible, blunt guide-wire.

PMID- 1760913
TI  - Technical report: oxygen saturation monitoring during sedation for
      chemonucleolysis.
AB  - Pulse oximetry is widely used during anaesthetic practice to monitor heart rate
      and oxygenation and has been recommended as a monitor when sedative techniques
      are used. We monitored 25 patients receiving sedation for chemonucleolysis and
      showed that 17 became hypoxaemic at some stage of the procedure, none of whom had
      clinically detectable signs of respiratory depression. We recommend that
      monitoring with pulse oximetry is used in all patients receiving sedation for
      radiological procedures and that all radiologists administering sedation be
      trained in airway management.

PMID- 1760914
TI  - Case report: hepatobronchial fistula complicating amoebiasis, treated by
      percutaneous catheter drainage.
AB  - We report the case of a 41-year-old man who presented with hepatic amoebiasis 18
      months after visiting the Far East. His progress was initially complicated by a
      bronchohepatic fistula which was further complicated by secondary bacterial
      infection. The fistula persisted and only resolved following percutaneous
      catheter drainage, thereby avoiding open surgery.

PMID- 1760915
TI  - Case report: gastroduodenal intussusception--an unusual cause of pancreatitis.
AB  - Gastroduodenal intussusception is a rare complication of polypoidal gastric
      tumours, and it has not previously been described as a cause of acute
      pancreatitis. We report a case of an endoscopically, radiologically and
      histologically proven intussuscepting gastric leiomyoma presenting with
      biochemical evidence of acute pancreatitis. The radiological appearance is
      illustrated and possible mechanisms for the pancreatitis are discussed.

PMID- 1760916
TI  - Case report: painless thoracic scoliosis due to dumb-bell ganglioneuroma--CT and
      MRI appearances.

PMID- 1760917
TI  - MRI of the spine.

PMID- 1760918
TI  - Persistent colonic spasm.

PMID- 1760919
TI  - Plasma osmolarity, iodine concentration and urographic images.

PMID- 1760920
TI  - Measurement systems calibration: microcomputer implementation.
AB  - Measurement systems used in the collection and processing of laboratory data must
      be calibrated periodically to obtain accurate results. Because calibration
      factors can change over time or may be reset to optimize measurements for
      specific tests, care must be taken to assure that calibration factors and data
      are aligned correctly. Users should be able to process current data or re-process
      older data using appropriate calibration factors. The alignment of calibration
      factors and data should occur in a simple, automatic and transparent way. This
      document describes one approach to calibration procedures and computer programs
      used to collect, process, document, measure and display laboratory data. The
      examples are from our neurophysiology laboratory, where investigators study the
      mammalian spinal cord and peripheral neuromuscular system. Typical calibration
      problems, some workable solutions, and computer programs (described in
      pseudocode) are presented.

PMID- 1760921
TI  - An image-processing system, motion analysis oriented (IPS-100), applied to
      microscopy.
AB  - This paper describes a real-time video image processing system, suitable for
      image analysis of stationary and moving images. It consists of a high-quality
      microscope, a general-purpose personal computer, a commercially available image
      processing hardware module plugged into the computer bus, a b/w TV-camera, video
      monitors and a software package. The structure and the capability of this system
      are explained. The software is menu-driven and performs real-time image
      enhancements, real-time mathematical and morphological filters, image
      segmentation and labelling, real-time identification of moving objects, and real
      time analysis of their movements. The program is available in listing form.

PMID- 1760922
TI  - MRATE: a Pascal program for on-line calculation of metabolic rate using wet
      gases.
AB  - MRATE is a Pascal program designed for on-line calculation of metabolic rate in
      an open circuit system, when outlet gases are not dried. Voltages from O2 and CO2
      analysers, humidity and temperature probes and mass flow meter are digitised and
      used to calculate outlet flow, oxygen consumption, carbon dioxide production,
      respiratory quotient and metabolic rate. The program may be easily modified to
      suit a variety of experimental set-ups.

PMID- 1760923
TI  - A microcomputer-based interactive cough sound analysis system.
AB  - The occurrence and nature of cough sounds, especially those occurring in asthma
      in young children, is of considerable interest to workers in paediatrics and
      general practice. To facilitate our research into the characteristics of such
      sounds, we have developed a microcomputer-based analysis system, which we call
      COFF. In this paper we discuss the design and implementation of the system,
      emphasising its user-friendly, interactive features, and the manner in which it
      efficiently manages the large amounts of data that research into sounds incurs.
      We illustrate the operation of the system with examples of spectrograms computed
      from cough sounds recorded simultaneously at the mouth and through the chest
      wall.

PMID- 1760924
TI  - A microcomputer system for collecting and processing physiological information
      about the masticatory system.
AB  - A software system has been written for IBM PC, XT, AT and compatible computers to
      be used for data collection, analysis and display. The system supports the
      sampling and processing of data for jaw movement tracks, myoelectrical activities
      of masticatory muscles, the temporomandibular joint (TMJ) and occlusal sounds and
      bite force, etc. The package includes the following functions: calculating
      displacement, velocity, curvature, and curvature center of jaw movement trace,
      analyzing myoelectrical signals in amplitude integration, root mean square and
      power spectrum, processing TMJ sounds and occlusal sounds and bite force,
      analysing jaw movement traces and myoelectrical activities during mastication
      simultaneously, determining the maxillomandibular relations, etc. The program
      also provides versatile formatting capability for video, printing and plotting of
      data, and graph creation. The most of the above programs have flexibility and
      adaptability to other physiological signal processes.

PMID- 1760925
TI  - RECPAM: a computer program for recursive partition and amalgamation for survival
      data and other situations frequently occurring in biostatistics. III.
      Classification according to a multivariate construct. Application to data on
      Haemophilus influenzae type b meningitis.
AB  - The methodology of RECursive Partition and AMalgamation (RECPAM) previously
      presented in Parts I and II (A. Ciampi et al., Computer. Methods Progr. Biomed.
      26 (1988) 239-256 and 30 (1989) 283-296) pursues its development with an
      application to predict long-term effects of a disease given a set of clinical
      information measured at the time of illness. This paper illustrates how RECPAM
      deals with a situation typical in Medical Informatics applied to data on
      Haemophilus influenzae type b meningitis.

PMID- 1760926
TI  - MACSPEC--a software system for fully automatic processing and analysis of large
      series of NMR spectra.
AB  - In vivo NMR spectroscopy often accumulates a large number of spectra (typically
      100 individual files or even more) to follow metabolic changes with high time
      resolution. The analysis of these spectra is very time-consuming for the
      spectroscopist and, furthermore, it requires the spectrometer's computer, needed
      for control of experiments. Here we report the software system MACSPEC developed
      for automatic processing and analysis of large series of individual NMR spectra
      on a peripheral personal computer. With this software the spectrometer's computer
      is kept available for experiments, and the necessary interaction of the
      spectroscopist is limited to a definition of the processing conditions at the
      beginning of the data analysis.

PMID- 1760927
TI  - Clinical use of tumor markers in oncology.
AB  - The perfect tumor marker would be one that was produced solely by a tumor and
      secreted in measurable amounts into body fluids, it should be present only in the
      presence of cancer, it should identify cancer before it has spread beyond a
      localized site (i.e., be useful in screening), its quantitative amount in bodily
      fluids should reflect the bulk of tumor, and the level of the marker should
      reflect responses to treatment and progressive disease. Unfortunately, no such
      marker currently exists, although a number of useful but imperfect markers are
      available. The predominant contemporary markers are discussed here by chemical
      class, as follows: glycoprotein markers, including carcinoembryonic antigen
      (CEA), alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-hCG), and
      prostate specific antigen (PSA); mucinous glycoproteins, including CA 15-3, CA 19
      9, mucinous-like cancer antigen and associated antigens, and CA 125; enzymes,
      including prostatic acid phosphatase (PAP), neuron specific enolase (NSE), lactic
      acid dehydrogenase (LDH), and placental alkaline phosphatase (PLAP); hormones and
      related endocrine molecules, including calcitonin, thyroglobulin, and
      catecholamines; and, molecules of the immune system, including immunoglobulins
      and beta-2-microglobulin. The biologic properties of each group of tumor markers
      are discussed, along with our assessment of their role in clinical medicine
      today.

PMID- 1760928
TI  - Mitochondrial protein import.
AB  - A dynamic picture of the mitochondrial protein import pathway is emerging, with
      conformational alteration a critical feature both preceding and following
      membrane translocation. The mediators of these steps of conformational
      alteration, as well as steps of recognition, translocation, and proteolytic
      cleavage, appear to be proteins. Using powerful tools of genetics and
      biochemistry, in years to come it should be possible to determine the precise
      molecular function of these proteins in mediating these novel reactions.

PMID- 1760929
TI  - Transport of membrane proteins to the cell surface.

PMID- 1760930
TI  - Protein sorting in polarized epithelial cells.

PMID- 1760931
TI  - Protein localization and virus assembly at intracellular membranes.

PMID- 1760932
TI  - Condom conundrums: Part II.

PMID- 1760933
TI  - A dermatologic diary. Portrait of a practice.

PMID- 1760934
TI  - Cat scratch disease.

PMID- 1760935
TI  - Chronic tophaceous gout with severely deforming arthritis: a case report with
      emphasis on histopathologic considerations.
AB  - The dramatic clinical presentation of a patient with severe deforming arthritis
      secondary to chronic tophaceous gout is described. Polarization microscopic
      examination and use of the De Galantha stain identified the dermal amorphous
      material as urate crystals. When the possibility of gout is entertained and a
      lesional biopsy specimen is examined to confirm the diagnosis, it is useful to
      fix the fresh tissue in absolute ethanol and process the specimen using an
      anhydrous technique to preserve the crystals.

PMID- 1760936
TI  - Digitate dermatosis.
AB  - Two cases of digitate dermatosis are presented. The clinical and histopathologic
      features of this unique entity are reviewed. We suspect that digitate dermatosis
      may be more prevalent than reported.

PMID- 1760937
TI  - Cutaneous involvement in Wegener's granulomatosis.
AB  - A case of Wegener's granulomatosis is presented. The major features of the
      disease, with special emphasis on the cutaneous findings, are reviewed.

PMID- 1760938
TI  - Evaluation of BRL 42715, a beta-lactamase-inhibiting penem.
AB  - BRL 42715 is a new penem which inhibits a wide range of plasmid as well as
      chromosomally mediated bacterial beta-lactamases. We used a total of 902 recent
      clinical isolates, consisting of 455 Enterobacteriaceae, 247 staphylococci and
      200 other gram-negative bacteria to evaluate its ability for potentiation of
      amoxycillin. MICs for all the 104 strains of methicillin-susceptible
      Staphylococcus aureus were reduced from 8-greater than 32.0 to less than or equal
      to 0.06 micrograms/ml in the presence of 1-5 micrograms/ml of this penem. It was
      also highly effective in inhibiting the beta-lactamase of a wide variety of gram
      negative bacteria, thereby bringing their MIC values for amoxycillin from a
      'resistant' range (greater than 32.0 micrograms/ml) to a 'susceptible' range
      (less than or equal to 8.0 micrograms/ml). Commonly resistant bacteria like
      Klebsiella, Enterobacter, Citrobacter, Morganella, Serratia, Acinetobacter and
      Aeromonas were rendered susceptible to amoxycillin in the presence of 1.0-5.0
      micrograms/ml of BRL 42715.

PMID- 1760939
TI  - Imipenem resistance in Acinetobacter baumanii is due to altered penicillin
      binding proteins.
AB  - The comparison of a clinical Acinetobacter baumanii isolate (strain No. 4852/88)
      and its selected imipenem-resistant (IMR) clone exhibited a complex
      reorganization of the penicillin-binding proteins (PBPs) with diminished
      labelling of all PBPs except the 24-kD PBP which showed an increased binding of
      14C-penicillin. This protein could not be saturated by preincubation of membranes
      with imipenem at 8-fold the MIC of imipenem, thus indicating PBP alterations
      responsible for imipenem resistance. In A. baumanii 4852/88 seven PBPs with the
      apparent molecular weights of 94, 84, 65, 61, 48, 40 and 24 kD could be detected.
      beta-Lactamase production was barely detectable in any case and could not be
      enhanced in the presence of various beta-lactams as the inducer. The outer
      membrane proteins were found identical in both the wild-type strain and the Im
      clone. So far, imipenem-resistant A. baumanii isolates have been isolated twice
      in our diagnostic laboratory; however, no implications on the future relevance of
      the above findings can be made.

PMID- 1760940
TI  - Comparative antibacterial activity of the penem ALP 201.
AB  - The minimum inhibitory concentration (MIC) of the new penem ALP 201 was tested
      against 243 recent clinical isolates of which 95 were from the family
      Enterobacteriaceae, 50 were from the genus Streptococcus, 50 were Staphylococcus
      aureus and 48 were Staphylococcus epidermidis. An agar dilution technique was
      used to determine the MIC50 and MIC90 of ALP 201 in comparison with cefotaxime,
      cefuroxime, clindamycin, imipenem, piperacillin, tobramycin and vancomycin.
      Overnight cultures were suspended to produce inocula of 10(5) colonies from a
      replicator. ALP 201 was shown to have an activity similar to imipenem against
      most species; ALP 201 was less active than imipenem against Serratia spp. and was
      more active against S. epidermidis. beta-Lactamase production did not affect the
      activity of ALP 201. All the other compounds tested were less active than ALP 201
      and imipenem.

PMID- 1760941
TI  - Postantibiotic effect of ciprofloxacin compared with that of five other
      quinolones.
AB  - The antimicrobial activity (minimal inhibitory concentration, MIC, and killing
      kinetics) and postantibiotic effect (PAE) of different concentrations (MIC and 6
      mg/1) of ciprofloxacin, norfloxacin, ofloxacin, pefloxacin, fleroxacin and
      lomefloxacin on pure cultures of Staphylococcus aureus and Escherichia coli were
      compared in vitro. The MIC, killing kinetics and PAE were determined by standard
      methods. Ciprofloxacin displayed the lowest MICs, while the highest were those of
      norfloxacin against S. aureus and lomefloxacin against E. coli. The killing
      curves showed ciprofloxacin to be the most and norfloxacin the least active. The
      bactericidal power was dependent on the concentration. At MIC, the
      fluoroquinolones, with the exception of norfloxacin, induced PAEs of 1-2 h. The
      effect was, in all cases, greater against E. coli. When assayed at 6 mg/l the
      PAEs were increased to 2-5 h, the best results being obtained by ciprofloxacin
      followed by ofloxacin. Norfloxacin produced no PAE on S. aureus and scarcely
      reached 1.3 h against E. coli. There was a close relationship between
      bactericidal power and PAE.

PMID- 1760942
TI  - Virulence of clinical and fecal isolates of Clostridium perfringens type A for
      outbred NMRI mice.
AB  - Twelve clinical and 102 fecal isolates from healthy carriers of Clostridium
      perfringens type A were tested for virulence in juvenile, outbred NMRI mice
      (intramuscular route). There were marked differences (up to 1,000-fold) in
      virulence among strains of both groups of isolates. On average, clinical isolates
      were not more virulent than fecal isolates. Fresh epinephrine (10
      micrograms/mouse and given concurrently with bacterial inocula) significantly
      augmented virulence. The murine model of Hill and Osterhout for experimental gas
      gangrene yielded reproducible results. Myelosuppressed (cyclophosphamide
      pretreated) mice were somewhat more susceptible to C. perfringens as contrasted
      with mice that had been pretreated with either carrageenan type II or with
      zymosan. The murine virulence of C. perfringens was enhanced significantly by
      Escherichia coli.

PMID- 1760943
TI  - Daunorubicin impairs 1-beta-D-arabinofuranosylcytosine uptake.
AB  - Daunorubicin (DNR) and 1-beta-D-arabinofuranosylcytosine (Ara-C) act in a
      schedule-dependent fashion on leukemic cells. The present study was undertaken to
      determine whether the inhibition exerted by DNR on Ara-C cytotoxicity on HL 60
      cells could be accounted for by an impairment of its uptake. After 250 ng/ml DNR
      treatment for 30 min, the time course of Ara-C uptake was measured, up to 128 min
      of incubation at 37 degrees C and at 4 degrees C, compared with controls. We
      found that DNR inhibits Ara-C uptake both at 37 and 4 degrees C, mostly acting on
      passive diffusion.

PMID- 1760944
TI  - Effects of recombinant human cytokines on cytarabine activity in K562 human
      myeloid leukaemia cells.
AB  - The K562 cell line provides a unique population of primitive human myeloid
      leukaemia cells which can be induced to differentiate along the erythroid,
      granulocytic, macrophage and megakaryocytic lineages in response to several
      agents. Cytarabine is not only the most widely used drug in the treatment of
      myeloid leukaemia but also the most effective agent in K562 cells. The effects of
      five recombinant human cytokines - interleukin-3 (IL-3), granulocyte-macrophage
      colony-stimulating factor (GM-CSF), interferon-alpha, interferon-beta and
      interferon-gamma on cytarabine-induced growth inhibition and differentiation of
      K562 cells was studied in liquid suspension cultures. GM-CSF and to a lesser
      extent IL-3 enhanced the antiproliferative effect of cytarabine in K562 cells,
      whereas the three interferons reduced it. The efficacy of cytarabine in
      inhibiting the growth of K562 cells was doubled by its combination with GM-CSF or
      IL-3 but was halved by its combination with interferons. The five cytokines did
      not significantly affect cytarabine-induced erythroid differentiation of K562
      cells. The present results appear to favour the use of GM-CSF and IL-3 but not of
      interferons in future treatment strategies based on a combined cytokine and
      chemotherapy approach for myeloid leukaemia.

PMID- 1760945
TI  - Oral chemotherapy with idarubicin plus cyclophosphamide in advanced breast
      cancer.
AB  - An oral chemotherapy schedule based on idarubicin and cyclophosphamide was
      evaluated in 31 advanced breast cancer patients. Out of 27 patients evaluable for
      response, 1 (3.7%) achieved a complete response and 5 (18.5%) a partial response,
      with an objective response rate of 22.2% (95% confidence limits 8.6-42.3%). The
      median time to progression was 7 months (range 3-12). Fourteen patients (51.9%)
      showed a disease stabilization, and 7 progressed (25.9%). Toxicity was mild.
      Considering the low response rate, but also the advantages of oral chemotherapy
      and the mild toxicity observed, oral idarubicin plus cyclophosphamide can be
      considered as a second-choice regimen in advanced breast cancer.

PMID- 1760946
TI  - [Interprofessional cooperation in surgical medicine. When does the busy surgeon
      have time to reflect on his own problems? Thoughts during handwashing].

PMID- 1760947
TI  - [Evaluation of 17 years' performance as surgical staff physician].

PMID- 1760948
TI  - [Comments by a review expert of the North Wurttenberg health insurance
      organization for surgical claims].

PMID- 1760949
TI  - [Hematogenous liver metastases--human pathologic principles].

PMID- 1760950
TI  - [Diagnosis and spontaneous course of liver metastases].

PMID- 1760951
TI  - [Surgical possibilities and therapeutic chances in liver metastases].

PMID- 1760952
TI  - [Helicobacter pylori colonization in surgical patients].
AB  - The prevalence of Helicobacter pylori (HP) was examined in 387 patients
      undergoing endoscopy of the upper gastrointestinal tract. Of central interest was
      the question to which extent surgical intervention influences the colonisation of
      the gastric mucosa with HP. The bacillic status was appraised using double
      microbiological examinations, histological determination and the CLO-test. In 229
      patients a 13C-urea-breath test was also carried out (sensitivity 98%). HP could
      be detected in 90% of all patients presenting with duodenal ulcers as well as in
      70% of patients with gastric ulcers, whereas in those patients in whom a lesion
      of the upper gastrointestinal tract could be excluded through endoscopy. HP was
      found in only 27%. The prevalence of HP did not increase with age. In patients
      having undergone distal gastric resection due to gastric ulcers, HP was only
      rarely found (19%) in the mucosa in the vicinity of the anastomosis following
      removal of the apparently pathogenetically important antrum mucosa. There was no
      association between anastomosis ulcers and bacillic colonisation. Following
      selective proximal vagotomy in patients with duodenal ulcers, HP was found in 80%
      of all cases. In these patients there was also no association between recurrent
      ulceration and a HP-positive status. Our results describe the postoperative HP
      status after different surgical procedures of ulcer therapy: whereas a distal
      gastric resection removes the antrum mucosa, which provides the necessary
      environmental milieu, the HP-colonisation rate after selective proximal vagotomy
      is similar to that in non-operated ulcer disease.

PMID- 1760953
TI  - [Spontaneous uni- and bilateral Achilles tendon rupture--a frequent complication
      after kidney transplantation].
AB  - In our clinic we observed uni- or bilateral ruptures of the Achilles tendon as a
      complication in 5% of all renal transplant patients. The majority of ruptures
      took place within the first two months following transplantation in a phase of
      increasing physical activity. Besides steroid treatment, elevated uric acid and
      hyperparathyroidism, advanced age at the time of transplantation as well as long
      duration of chronic hemodialysis must be considered as risk factors.

PMID- 1760954
TI  - [Ultrasonic diagnosis in suspected acute appendicitis: probable or certain
      indications for surgery?].
AB  - The diagnostic accuracy and the clinical impact of routine ultrasonography
      performed by 4 surgeons, were prospectively studied in 366 unselected patients
      admitted for suspected acute appendicitis. Clinical and sonographic findings on
      admission were correlated with laparotomy findings, pathological outcome and
      clinical as well as follow-up data. The overall sensitivity, specificity and
      accuracy of the clinical diagnosis of acute appendicitis were 55.3%, 94.6% and
      84.2% respectively (positive predictive value (PPV) 75.8%, negative predictive
      value (NPV) 87.3%). Ultrasound enabled visualization of the disease in 67 of 85
      (prevalence 23.3%) patients with a histologically confirmed acute appendicitis;
      false positive results were recorded in 7 cases (sensitivity 78.8%, specificity
      97.5%, accuracy 93.1%, PPV 90.5%, NPV 93.8%). Ultrasound was particularly useful
      in patients presenting with equivocal or highly unsuspective signs of acute
      appendicitis: of 38 patients with an acute appendicitis in this group
      ultrasonography enabled to make the diagnosis in 26. The combined approach of
      clinical evaluation and routine ultrasonography markedly improved the diagnostic
      accuracy (sensitivity 85.9%, specificity 96.4%, accuracy 94%) and substantially
      reduced the negative laparotomy rate (7.9%) in patients with suspected acute
      appendicitis. It is concluded, that ultrasonographic evaluation of the patient
      with suspected acute appendicitis performed by surgeons is of great assistance in
      surgical practice.

PMID- 1760955
TI  - [Esophageal cancer in myasthenia].

PMID- 1760956
TI  - [Therapy of spontaneous esophageal perforation].

PMID- 1760957
TI  - [Congenital intrathoracic ectopic gallbladder--a currently unreported
      developmental disorder. Attempt at a classification of abnormal gallbladder
      sites].

PMID- 1760958
TI  - [An unusual case of Chilaiditi syndrome--hepatodiaphragmatic interposition of a
      sigma elongatum].

PMID- 1760959
TI  - [Kuntscher femoral nailing. A 74-year follow-up].

PMID- 1760960
TI  - [Guidelines for allogeneic bone transplantation].

PMID- 1760961
TI  - [Comment on the contribution by J. R. Izbicki et al.: Retro- and prospective
      study of the value of clinical and chemical laboratory data in acute
      appendicitis].

PMID- 1760962
TI  - Hufeland's interest in plant movements.
AB  - Christoph Wilhelm Hufeland (1762-1836) was one of the eminent physicians at the
      time of Goethe. When only 21 years old, he followed his father as a medical
      practitioner in Weimar. In 1793 he became Professor of Medicine at the University
      of Jena, from where he moved, in 1801, to Berlin as the physician in ordinary to
      king Friedrich Wilhelm III, council of state, and Professor at the leading
      hospital, the Charite. Hufeland pioneered in what today would be called public
      hygiene. Many of his lectures and publications were addressed to the educated
      laymen. In his most read book, the 'Makrobiotik', he emphasizes the importance of
      the 24-h periodicity as a basic unit of biological chronometry. In view of this,
      Hufeland has become a kind of 'patron saint' to modern chronobiologists.

PMID- 1760963
TI  - A mathematical model for time perception with experimentally obtained subjective
      time scales for humans and rats.
AB  - The concept of sensation measurement with the entailing subjective scales is
      explained. It is shown that linearity between, e.g. sensation halving values and
      standard values implies that subjective sensation (output) grows as a power
      function of the physical measure of the stimulus (input). This outcome can be
      used in the scaling of subjective duration, based on reproduction experiments,
      i.e., experiments in which the participants are required to reproduce given time
      intervals, e.g., indicated by noise. It will be shown that what is reproduction
      for the participant is halving for the experimenter, making it possible to
      determine the parameters of the power function. The model is confirmed
      experimentally for humans and rats, the rats having a lower exponent than adults.
      In a recent experiment it was shown that the reproduced durations differ between
      female and male observers as well as for different sound intensities. These
      differences could be attributed to differences in parameter values. An
      interesting observation is that almost all power functions exhibit a
      discontinuity, possibly indicating a switch between different neural loops as the
      durations become longer.

PMID- 1760964
TI  - A chronobiological approach to the effects of cefodizime on monocytic and
      granulocytic functions of patients with multiple myeloma.

PMID- 1760965
TI  - Chronobiology meets the need for integration in a reductionist climate of biology
      and medicine.
AB  - One of us introduces a chronobiology course to students at the University of
      Milan, Italy, with a succinct statement that may well serve to summarize the
      foregoing 24 points. Its few lines distill the preceding details and formulate
      the raison d'etre of Chronobiology: Chronobiology is: not only a science in its
      own right; not only a methodology; not only a new kind of statistical analysis;
      not just an aspect of biology, but a new way of invariably approaching any
      problem in biology, notably medicine.

PMID- 1760966
TI  - Spatial frequency of the human short-wavelength-sensitive (blue) cone mechanism.
      Psychophysical studies and pattern-reversal visual evoked potentials.
AB  - The interactions of spatial and chromatic processing of the short-wavelength
      sensitive cone mechanism were studied in humans with patterned (checkerboard)
      stimuli of various spatial frequency (10, 22, 44, and 85 min of are
      respectively), under steady exposure to yellow light (575 nm, 390 cd/m2).
      Psychophysical studies and pattern-reversal visual evoked potentials were
      employed. Parameters of the transient pattern-reversal visual evoked potentials
      (pattern reversal rate of 2.4 s-1) especially observed were the latencies of P2
      (P100) and N3 and the amplitude of P2-N3. It was only with the largest applicable
      check size (85 min of arc) that both the psychophysical studies and visual evoked
      potentials could succeed in satisfactorily isolating the short-wavelength
      sensitive cone mechanism. Pattern-reversal visual evoked potential latencies are
      recommended in the evaluation of this cone mechanism because of their smaller
      variance and higher selectivity in isolating the short-wavelength-sensitive cone
      mechanism than the amplitude. The peak sensitivity of this cone mechanism was
      shown to be about 449 nm at the corneal level. The short-wavelength sensitive
      cone mechanism represented the characteristics of low spatial resolution and long
      latencies of the pattern-reversal visual evoked potentials.

PMID- 1760967
TI  - Longitudinal measures in children receiving ENCAD for hereditary retinal
      degeneration.
AB  - A hydrolysate of yeast RNA (ENCAD) is used in the Soviet Union for the treatment
      of hereditary retinal degenerations. We report longitudinal data from three young
      patients who have made at least two visits to the Soviet Union over a five-year
      period to receive treatment with ENCAD. Two children were diagnosed with cone-rod
      degeneration and the third has an isolated (simplex) form of retinitis
      pigmentosa. Visual function measurements were obtained before and after each
      visit to Moscow. In the comparison of previsit and postvisit visual acuity, 30 Hz
      flicker amplitude, and visual fields, ENCAD treatment had no significant short
      term effect. Despite treatment with ENCAD, each patient has shown a significant
      decrease in visual function over the 5-year period. The rate of progression in
      these patients appears similar to previously published data on the natural
      history of their retinal degenerative disorders.

PMID- 1760968
TI  - Color pattern-reversal visual evoked potential in eyes with ocular hypertension
      and primary open-angle glaucoma.
AB  - Color pattern-reversal visual evoked potential testing was performed in 99 normal
      eyes, 27 eyes with ocular hypertension and 30 eyes with primary open-angle
      glaucoma with the use of black-white, black-red and black-blue color checkerboard
      stimuli. The P1 wave peak time and amplitude of the eyes with ocular hypertension
      and glaucoma were significantly different from those of age-similar normal eyes,
      especially on the black-red and black-blue checkerboards (p less than 0.001). The
      differences between the ocular hypertensive and glaucomatous eyes were of less
      significance. The P1 peak time difference between black-white and black-red
      checkerboards may serve as an important parameter in the early diagnosis of
      glaucoma.

PMID- 1760969
TI  - The effects of age on steady-state pattern electroretinograms and visual evoked
      potentials.
AB  - Steady-state pattern-reversal electroretinograms and visual evoked potentials
      were simultaneously recorded in two groups of young and elderly normal
      volunteers. The young group consisted of 23 subjects (13 women and 10 men) aged
      18 to 28 years, and the elderly group consisted of 24 subjects (11 women and 13
      men) aged 58 to 77 years. Stimuli were square-wave gratings ranging in spatial
      frequency from 0.5 to 6 c/deg and phase reversed at a frequency of 4 Hz. Pattern
      reversal electroretinograms and visual evoked potentials consisted of a prominent
      second and a smaller fourth harmonic response. Spatial frequency-amplitude
      functions of the pattern-reversal electroretinogram second and fourth harmonics
      were similar for the young and elderly groups. The mean fourth harmonic phase was
      significantly shifted in elderly subjects compared with young subjects for all
      spatial frequencies tested. Spatial frequency tuning was observed for amplitude
      and phase functions of the visual evoked potential second and fourth harmonic
      responses for both age groups. Age had a significant effect on phase for spatial
      frequencies above 1.5 c/deg. Amplitude of the fourth harmonic was significantly
      lower for the elderly group at 1.5-4 c/deg. Phase was significantly different
      between groups for spatial frequencies below 3 c/deg. Our results suggest that
      aging influences both retinal and central visual pathways. Aging differentially
      affected the visual evoked potential second and fourth harmonic responses,
      suggesting different neuronal origins for these components.

PMID- 1760970
TI  - Influence of a twofold voluntary hyperventilation on visually evoked cortical
      potentials and human pupillogram.
AB  - We studied the direct and aftereffects of twofold hyperventilation (HV) on
      pattern reversing VEPs and pupillograms (PGs) of 19 healthy volunteers. The VEP
      N80 and P100 latencies increased during HV. Both peak times were maintained for a
      longer period, up to 20 minutes after HV-2 ended. In addition, the PG-latency
      time during HV and the PG-construction time during and after HV were increased.
      The results indicated a temporary delay of neural afferent transmission in the
      visual system during and after HV. A similar delay of the nervous transmission
      appeared in the efferent part of the system regulating the pupillary movements
      after HV ended. The observed changes of the VEP and PG parameters most probably
      resulted from the hypocapnia cased by HV and its effect on the brain vessels,
      although other explanations for the changes of the VEP- and PG-parameters may
      have been possible.

PMID- 1760971
TI  - The pattern electroretinogram in retinal and optic nerve disease. A quantitative
      comparison of the pattern of visual dysfunction.
AB  - A retrospective analysis was performed on the transient and steady-state pattern
      electroretinograms recorded from 42 patients with glaucoma, 13 patients with
      senile dementia of the Alzheimer's type, 58 patients with diabetes mellitus, and
      92 control subjects to evaluate the pattern of electroretinographic changes
      associated with retinal and optic nerve disease. The amplitudes of both the
      initial positive component (N1 to P1) and the subsequent negative component (P1
      to N2) of the transient (4 rps) responses were measured. From these measurements
      the (P1 to N2)/(N1 to P1) was derived. The N1 to P1 amplitude of the steady-state
      pattern electroretinogram also was measured. In the glaucoma patients all three
      amplitude measures, as well as the amplitude ratio of the components of the
      transient response, were reduced significantly compared with age-matched controls
      (p less than 0.05). A similar pattern was detected in the patients with
      Alzheimer's disease, but in this case the only statistically significant
      amplitude reduction was in the steady-state pattern electroretinogram. A
      different pattern was observed among the diabetic patients (both with and without
      retinopathy). Only minor reductions in the amplitude of the transient pattern
      electroretinogram, which were not statistically significant, were noted. In
      addition, the ratio of the amplitudes of the components of the transient response
      did not differ from age-matched controls. The amplitude of the steady-state
      pattern electroretinogram was reduced in diabetics, but this was significant only
      for those patients with retinopathy (p less than 0.01). These findings support
      the suggestion that an analysis of both the positive and negative components of
      the pattern electroretinogram may be useful for differentiating the contributions
      of retinal and optic nerve dysfunction to visual impairment. The results also
      indicate that in both retinal and optic nerve disease the steady-state pattern
      electroretinogram can be an earlier sign of dysfunction than the transient
      pattern electroretinogram.

PMID- 1760973
TI  - Detection of hidden visual loss in multiple sclerosis. A comparison of pattern
      reversal visual evoked potentials and contrast sensitivity.
AB  - The detection of hidden visual loss is important in establishing the diagnosis of
      multiple sclerosis, especially in patients who have neurologic symptoms of the
      disease. Both visual evoked potentials and contrast sensitivity have been used
      for this purpose. We compared the sensitivities of pattern-reversal visual evoked
      potentials and contrast sensitivity, measured with the Vistech VCTS 6500 chart,
      in detecting hidden visual loss in 18 patients with multiple sclerosis whose
      visual acuity was correctable to 20/20 (6/6) or better in the examined eye.
      Thirteen patients had delayed visual evoked potential latencies. An additional
      four patients had reduced P100 amplitudes without prolonged latencies. Nine
      patients had abnormal contrast sensitivity. The visual evoked potential was more
      sensitive than contrast sensitivity at detecting hidden visual loss in patients
      with multiple sclerosis (p less than 0.01).

PMID- 1760972
TI  - Selective reduction of oscillatory potentials and pattern electroretinograms
      after retinal ganglion cell damage by disease in humans or by kainic acid
      toxicity in cats.
AB  - We recorded pattern electroretinograms, scotopic threshold responses, oscillatory
      potentials and ganzfeld flash electroretinograms in patients with glaucoma or
      other optic nerve diseases and in cats with inner retinal damage caused by
      intravitreal injections of kainic acid. In both studies, the scotopic b-wave and
      the scotopic threshold responses were normal but the oscillatory potentials and
      pattern electroretinograms were not. The photopic b-wave was also often reduced
      in patients with scotopic oscillatory potential reduction, and the reduction was
      proportionate to the oscillatory potential change. Oscillatory potentials were as
      frequently reduced as pattern electroretinograms in both patient groups, and in
      the few cases where only one response was reduced, there was no bias toward
      either measure. In cats, the effects of intravitreal injection of various doses
      of kainic acid on the retina were evaluated electrophysiologically, and
      structural damage was assessed histologically. After 25 nmol of kainic acid, the
      pattern electroretinograms and oscillatory potentials were reduced but neither
      the b-waves nor the scotopic threshold responses, were affected. Histologic
      studies of retinas after this dose showed swollen dendrites that were restricted
      to the outer part (off-sublamina) of the inner plexiform layer. Serial semithin
      sections indicated that most, if not all, of the swelling was confined to
      dendrites of large ganglion cells. Our results indicate that the size and
      sensitivity of the oscillatory potential response may have a role in the
      diagnosis and management of early glaucoma and optic nerve disease, and that the
      photopic electroretinogram may give similar information.

PMID- 1760974
TI  - [Care and rehabilitation of patients without a larynx].

PMID- 1760975
TI  - [Rehabilitative nursing--a changing professional concept].

PMID- 1760976
TI  - [Rehabilitation instead of taking a cure].

PMID- 1760977
TI  - [Rehabilitation-oriented nursing in a hospital].

PMID- 1760978
TI  - [Positioning techniques for the prevention of shoulder pain in the early phases
      of tetraplegia].

PMID- 1760979
TI  - [Rehabilitation of patients with neurologic disorders].

PMID- 1760980
TI  - [Rehabilitation of patients with cranio-cerebral injuries].

PMID- 1760981
TI  - [Rehabilitation of cancer patients from the viewpoint of the social worker].

PMID- 1760982
TI  - [Continuing education rehabilitation. Nursing specialty rehabilitation?].

PMID- 1760983
TI  - [Long-term care and rehabilitation--a Berlin pilot project].

PMID- 1760984
TI  - [Rehabilitation in pediatric nursing. A curriculum for a minor part of pediatric
      nursing].

PMID- 1760985
TI  - [Early rehabilitation: medical, therapeutic and nursing aspects].

PMID- 1760986
TI  - [The situation of handicapped adolescents in rehabilitation facilities from a
      psychotherapeutic point of view].

PMID- 1760987
TI  - [Society for the encouragement and support of children with neurologic diseases
      and their families].

PMID- 1760988
TI  - [Education in the nursing professions].

PMID- 1760989
TI  - [Memorandum against the new discussion on the non-value of life].

PMID- 1760990
TI  - [A light on the horizon of pragmatic recommendations for disinfection].

PMID- 1760991
TI  - The human placental lactogen genes: structure, function, evolution and
      transcriptional regulation.
AB  - hPL is a member of an evolutionarily related gene family including hGH and hPRL.
      Expression of hPL is limited to the placenta but its physiological actions are
      far reaching. hPL has a direct somatotropic effect on fetal tissues, it alters
      maternal carbohydrate and lipid metabolism to provide for fetal nutrient
      requirements, and aids in stimulation of mammary cell proliferation. Two hPL
      genes (hPL3 and hPL4) encoding identical proteins are responsible for the
      production of up to 1-3 g PL hormone/day. Recent studies have characterized the
      regulatory controls of hPL expression. At the post transcriptional level, RNA
      stability may contribute to variable levels of hPL3 vs. hPL4 production. In
      addition, non-tissue-specific protein-promoter interactions involving the Sp1
      transcription factor are necessary for hPL transcription initiation. A
      transcriptional enhancer located 3' to the hPL3 gene is responsible for the
      placenta-specific expression of this gene, while an additional enhancer may be
      located 3' to the hPl4 gene. The hPL enhancer is bound by multiple proteins
      including at least one placental specific protein that interacts with a TEF-1
      motif. Therefore, enhancer-protein interactions most likely play a large part in
      the high levels of placenta-specific hPL expression.

PMID- 1760992
TI  - Mammosomatotropes: presence and functions in normal and neoplastic pituitary
      tissue.

PMID- 1760993
TI  - Hypoglycemia unawareness.
AB  - Hypoglycemia unawareness can occur in diabetic as well as nondiabetic
      individuals. A single causative mechanism for its occurrence is not yet apparent.
      It is likely to be multifactorial but current evidence favors a major role for
      some type of CNS adaptation. Certainly in some instances, classic autonomic
      neuropathy could be a contributory factor in patients with longstanding diabetes.
      Most, if not all, individuals with this condition have reduced plasma epinephrine
      and/or norepinephrine responses during mild hypoglycemia. Although it may be
      difficult to distinguish between mere reductions in the magnitude of a response
      and a true alteration in the threshold to initiate that response, four studies
      (44, 59, 65, 86) have provided evidence for an increase in the threshold (greater
      hypoglycemia required) for activation of counterregulatory hormone secretion
      associated with reduced awareness of hypoglycemia; in one study (44), diabetic
      patients had developed abnormalities with improved glycemic control after
      intensive insulin therapy; in another study (59), diabetic patients had recurrent
      hypoglycemia but did not differ in glycemic control (as assessed by glycosylated
      hemoglobin values) from subjects aware of hypoglycemia. In the two other studies,
      patients with impaired counterregulatory hormone responses and hypoglycemia
      unawareness had lower glycosylated hemoglobin levels than the other patients (65,
      86). Altered tissue sensitivity to catecholamines seems unlikely to provide a
      primary explanation since not all symptoms are adrenergic and since, as mentioned
      earlier, most patients with this condition have reduced or delayed catecholamine
      responses to hypoglycemia, which in themselves could explain reduced awareness of
      hypoglycemia. Furthermore, patients with diabetic autonomic neuropathy have been
      reported to have increased sensitivity to catecholamines (143). One frequent
      observation, dating back to the early descriptions of hypoglycemia unawareness
      (17-19), is that patients with this condition have had frequent episodes of
      hypoglycemia. Although it is easy to envision how reduced warning symptoms could
      result in development of severe hypoglycemia, it is quite possible that frequent
      episodes of hypoglycemia themselves might initiate the process. For example, as
      depicted in Fig. 4, episodes of mild hypoglycemia occurring in insulinoma
      patients, diabetic patients undergoing intensive insulin therapy, or patients
      with longstanding diabetes complicated by autonomic neuropathy and impaired
      glucagon secretion could lead to CNS adaptation.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1760994
TI  - Recurrent secretion of progesterone in large amounts: an endocrine/metabolic
      disorder unique to young women?

PMID- 1760995
TI  - Pregnancy and the prolactin family of hormones: coordination of anterior
      pituitary, uterine, and placental expression.

PMID- 1760996
TI  - Growth hormone heterogeneity: genes, isohormones, variants, and binding proteins.
AB  - Human GH represents a family of proteins rather than a single hormone. The
      circulation contains a bewildering array of GH forms, including several monomeric
      variants, their homo- and heteropolymers, fragments, and complexes with at least
      two BPs. The net biological activity of this mixture is difficult to predict, as
      the various molecular forms interact as partial agonists and/or antagonists at
      the receptor level. The number of GH forms that can be counted in plasma exceeds
      100. Table 5 attempts to illustrate what is known and provide estimates for
      circulating variants. It does not include GH-V and its variants, which have to be
      added in pregnancy. Of note, what is commonly understood as "plasma GH," i.e.
      free monomeric 22K, represents only 21% of total immunoreactivity in plasma. In
      view of this complicated picture, it should be no surprise that different assays
      of plasma GH yield different results (107, 108, 290). While immunoassays are
      relatively unaffected by the BPs (291), receptor assays are seriously affected by
      the high affinity BP (261). Immunoassays, particularly of the monoclonal variety,
      are vulnerable to differential recognition of molecular variants depending on the
      unique epitope specificity of the antibody used. Polyclonal assays are more
      robust in this regard because of "epitope averaging" among the wide spectrum of
      epitope specificities present in the antibody population. Future work should aim
      at developing antibodies that are specific for individual GH variants. Such
      molecular probes will be helpful not only in standardizing immunoassays, but also
      in delineating the biological role of the various GH forms. The physiological
      significance of the numerous GH forms (or of the BPs) is still largely unknown.
      Progress in this area has been hampered, on the one hand, by the unavailability
      of pure GH variants in quantities sufficient for biological studies, and, on the
      other, by a certain lack of interest stemming from suspicions about artifacts.
      The recent resurgence of interest in GH and in its receptor and BPs should also
      refocus attention on the various molecular forms. Thus far, this interest has
      been largely confined to monomeric 22K, which is certainly effective for its
      original intended purpose, namely growth promotion. Whether 22K is sufficient for
      optimal growth and development, or whether it can fulfill all the functions of
      the GH family is unknown. It can be argued that evolutionarily conserved GH
      variants probably have biological importance.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1760997
TI  - Effects of dietary trans fatty acids on blood pressure in normotensive subjects.
AB  - Consumption of essential fatty acids of the (n-6) series may affect blood
      pressure in man. Trans fatty acids in the diet interfere with the metabolism of
      essential fatty acids in rats. We therefore measured the effect of dietary trans
      fatty acids on blood pressure in 25 men and 34 women. Each subject consumed, in
      random order, three mixed natural diets, each for three weeks. The composition of
      the three diets was similar, except for 10.4 per cent of energy, which was
      provided by either oleic acid, trans fatty acids, or saturated fatty acids. The
      intake from polyunsaturated fatty acids was 3.4 per cent on the saturated-fat
      diet and 4.6 per cent on the other two diets. On the oleic-acid diet systolic
      blood pressure was 113 +/- 12.8 mmHg and diastolic blood pressure 66 +/- 8.3
      mmHg, on the trans-fatty-acid diet 112 +/- 12.2 mmHg and 67 +/- 8.1 mmHg, and on
      the saturated-fat diet 112 +/- 12.6 mmHg and 67 +/- 8.1 mmHg. No significant
      differences were observed in blood pressure levels between the three diets. We
      conclude that neither trans nor saturated fatty acids influence blood pressure
      levels in normotensive subjects relative to oleic acid.

PMID- 1760998
TI  - The effect of dietary energy percentage of fat and its P/S ratio on incorporation
      of n-3 PUFA and leukotriene production during fish oil supplementation in healthy
      volunteers.
AB  - The effect of low (25 per cent of energy) and high (35 per cent of energy) fat
      diets with either low (less than 0.4) or high (greater than 1.0)
      polyunsaturated/saturated fatty acid (P/S) ratios on fatty acid compositions of
      plasma cholesterol esters and neutrophil phospholipids, and leukotriene
      production was studied in four groups of healthy volunteers supplemented with 6 g
      fish oil daily for four weeks. Except for three subjects, eicosapentaenoic acid
      (20:5n-3) content markedly increased from baseline in the plasma cholesterol
      ester fraction and to a lesser extent in the neutrophil phospholipid fraction.
      The increase in the plasma cholesterol ester fraction was inversely, though
      weakly related to the dietary intake of linoleic acid (18:2n-6). At
      supplementation endpoints, the 20:5n-3/20:4n-6 ratio in both plasma cholesterol
      esters and neutrophil phospholipids was highest in the groups consuming diets
      with low P/S ratio. In vitro leukotriene B5 production by neutrophils, did not
      differ between groups and there was no consistent suppression of LTB4 production
      in this four-week study. It is suggested that factors other than the actual
      dietary 18:2n-6 intake additionally influence the accumulation of 20:5n-3 in
      tissue during dietary fish oil supplementation.

PMID- 1760999
TI  - Changes in hedonic responses to sweet and fat in recently diagnosed non-insulin
      dependent diabetic patients during diet therapy.
AB  - A study was undertaken to find out how the hedonic responses to, and reported
      liking and consumption of, sweet and fat foods change during the first months of
      diet therapy of recently diagnosed patients with non-insulin-dependent diabetes
      mellitus. The patients were 12 women and 19 men aged 40-65 years. The methods
      used consisted of hedonic rating tests and summated scales which measured overall
      tendencies to like and consume fatty and sweet foods. These measurements were
      made three times at intervals of six weeks. At the same time clinical
      measurements, weight and glycaemic control were recorded. Hedonic ratings of
      sweet juices decreased during three months of therapy, but hedonic responses to
      fatty food items (cheese, milk) remained practically unchanged. After three
      months of diet therapy the diabetic subjects liked fatty and sweet foods less and
      consumed them less frequently, which was the aim of the diet therapy. At the same
      time their metabolic control improved markedly, too.

PMID- 1761000
TI  - Incidence of premature rupture of membranes in pregnant women with low leukocyte
      levels of vitamin C.
AB  - The present study was undertaken to explore the association between vitamin C
      nutritional status in pregnant women with premature rupture of the chorioamniotic
      membranes (PRM). A case-control cross-sectional study was carried out in 10 women
      with PRM and 19 women without PRM. The women were evaluated in the first hours
      postpartum while hospitalized: 10 ml of blood were obtained from each woman to
      determine vitamin C expressed as micrograms/10(8) leucocytes or microgram/mg of
      leucocyte protein. Data on fruit and vegetable consumption was collected by a
      frequency dietary survey and the hospital clinical records were reviewed to
      obtain their obstetric history and data on the presence of infection during
      pregnancy, in placenta and/or in fetal membranes. Low vitamin C levels were
      considered at a cut-off point equal or less than 26.33 micrograms/10(8)
      leucocytic cells and 3.15 micrograms/mg leucocyte protein. An association was
      found between low vitamin C levels and cases with PRM. No difference was found in
      the frequency of consumption of fruit and vegetables between the two groups.
      Infections were more frequently found in the PRM group, when the women had low
      levels of vitamin C, and when both risk factors were present simultaneously the
      proportion of PRM cases identified was greater than 0.75.

PMID- 1761001
TI  - The reproducibility of the modified relative dose response (MRDR) assay in
      healthy individuals over time and its comparison with conjunctival impression
      cytology (CIC).
AB  - The modified relative dose response (MRDR) assay is a minimally invasive method
      of detecting marginal vitamin A status. In the present study, the MRDR assay was
      performed four times in six well-nourished adults and in one male five-year-old
      child over a seven-month period. In all instances, assay ratios of dehydroretinol
      (DR) to retinol (R) were less than 0.03, the tentative cutoff value of 'normal'
      for the MRDR assay in humans. The mean ratio for all time points for all
      individuals was 0.015 +/- 0.005, with a mean coefficient of variation of 27 +/-
      13%. In a related experiment, both MRDR and conjunctival impression cytology
      (CIC) tests were conducted on nine adults and the same male child. All DR/R
      ratios were less than or equal to 0.021, and all CIC specimens were normal. Thus,
      the DR/R ratio in well-nourished individuals, although showing some variation,
      does not oscillate between abnormal and normal responses. Furthermore, the DR/R
      ratios and CIC patterns were fully concordant.

PMID- 1761002
TI  - Temperature and sweating responses in one-legged and two-legged exercise.
AB  - In looking at the thermoregulatory responses resulting from symmetrical or
      asymmetrical exercise, this paper has focused on the effect of local skin
      temperature (Tsk,local) on local sweat rates (msw,local) during one-legged (W1)
      and two-legged (W2) exercise on an ergocycle. Five subjects underwent four 3-h
      tests at 36 degrees C, each consisting of six 25-min exercise periods alternating
      with 5-min rest periods. The subjects performed W1 and W2 at 45 and 90 W,
      respectively, either dehydrated or rehydrated. Body temperatures and total sweat
      rate were measured as well as four msw,local (on chest and thighs), assessed from
      sweat capsules under which Tsk,local was maintained at predetermined levels (37.0
      degrees C and 35.5 degrees C). The combinations of Tsk,local levels, capsule
      locations, exercise intensity and hydration level chosen in our protocol led to
      the following results. The hydration level affected rectal temperature but not
      total or msw,local. No specific effect of muscle activity was found; msw,local on
      thighs of resting and working legs were similar. The msw,local were only
      influenced by exercise intensity, msw,local being more elevated during the higher
      intensity. No significant effect of Tsk,local on msw,local was found, whatever
      the experimental condition and/or the location. It was concluded that local
      thermal effects on msw,local could have been masked by the strong central drive
      for sweating which has been found to exist in subjects exercising in a warm
      environment.

PMID- 1761003
TI  - Surface electromyogram spectral characterization and motor unit activity during
      voluntary ramp contraction in men.
AB  - The relationships were investigated between the surface electromyographic (SEMG)
      power spectrum analysed by the 20 order autoregressive model (AR spectrum) and
      underlying motor unit (MU) activity during isometric contractions increasing
      linearly from 0% to 80% maximal voluntary contraction. Intramuscular spikes and
      SEMG signals were recorded simultaneously from biceps brachii muscle; the former
      were analysed by a computer-aided intramuscular MU spike amplitude-frequency
      (ISAF) histogram and the latter subjected to AR spectral analysis. Results
      indicated that there was a positive correlation between the force output and the
      mean amplitude of the ISAF histogram but not with the mean frequency. These
      changes were accompanied by changes in relative power of the high frequency (100
      200 Hz) peak (HL) in the AR spectrum. It was also found that there was a positive
      correlation between the mean amplitude of the ISAF histogram and the HL value.
      These data suggested that the power of the high frequency peak in the AR spectrum
      of the SEMG signal preferentially reflected the progressive recruitment of
      underlying MU according to their size. Differences between the AR spectrum and
      the spectrum estimated by fast Fourier transform algorithm have also been
      discussed.

PMID- 1761004
TI  - Influence of the bicarbonate pool and on the occurrence of 13CO2 in exhaled air.
AB  - In 13CO2 breath tests, based on 13C:12C ratio measurements, the appearance of 13C
      in exhaled CO2 was monitored after the administration of a 13C-labelled compound.
      Independently of the substrate used, the existence of a bicarbonate pool into
      which the CO2 produced enters before being exhaled, imposes a delay on the
      appearance of changes in the 13C:12C ratio. To estimate the nature and magnitude
      of this delay, we applied a two-compartment model to describe the kinetics of the
      body bicarbonate pool and we evaluated the 13C:12C ratio of CO2 entering that
      pool from the measured 13C:12C ratio in the exhaled CO2 after an oral intake of
      "naturally labelled" 13C-glucose. Our results demonstrated that discrepancies
      between total and exogenous glucose oxidation in relation to the peak occurrence
      time, as well as the absolute quantities, could be adequately explained by the
      interference of the bicarbonate stores.

PMID- 1761005
TI  - Non-exercise daily energy expenditure and physical activity pattern in male
      endurance athletes.
AB  - The present study was performed to determine whether differences in non-exercise
      daily energy expenditure (Md,ne) exist between trained and untrained individuals.
      The data from seven cross-country skiers were compared with those from eight
      sedentary men. Daily energy expenditure (Md) was determined using the heart rate
      oxygen consumption relationship; resting metabolic rate (Mr) was measured using
      indirect calorimetry. A physical activity questionnaire and ratios of Md or Md,ne
      to Mr were used as indices of physical activity. Md and Mr were significantly
      higher in the trained subjects whereas Md,ne was identical in the two groups. The
      ratio of Md,ne to Mr and the data from the physical activity questionnaire showed
      that there was no significant difference in daily energy expenditure and physical
      activity pattern during the non-exercise time. These results suggest that the
      exercise-induced increase in daily energy requirements is not compensated by a
      more sedentary life during the other daily activities in these trained men.

PMID- 1761006
TI  - Cyclic intramuscular temperature fluctuations in the human forearm during cold
      water immersion.
AB  - The purpose of the present study was to investigate the intramuscular temperature
      fluctuations in the human forearm immersed in water at 15 degrees C. Tissue
      temperature (Tt) was continuously monitored by a calibrated multicouple probe
      during 3 h immersion of the forearm. The probe was implanted approximately 90 mm
      distal from the olecranon process along the ulnar ridge. Tt was measured every 5
      mm, from the longitudinal axis of the forearm (determined from computed
      tomography scanning) to the skin surface. Along with Tt, rectal temperature, skin
      temperature and heat loss of the forearm were measured during the immersions.
      Five of the six subjects tested showed evidence of cyclic temperature
      fluctuations in the forearm limited to the muscle tissue. The first increase of
      the muscle temperature was observed 75 (SE 6) min after the onset of the
      immersion, and the duration of the cycle averaged 36 (SE 3) min. The maximum
      increase of the muscle temperature, which ranged between 0.4 degrees C and 1.0
      degrees C, was measured at the axis of the forearm, and was inversely correlated
      to the circumference of the subject's forearm (P less than 0.05). No
      corresponding increases of the skin temperature and heat loss of the forearm were
      observed for the complete duration of the immersion. These data support the
      hypothesis of a significant contribution of the muscle vessels during cold
      induced vasodilatation in the forearm.

PMID- 1761008
TI  - Validity of heart rate and ratings of perceived exertion as indices of exercise
      intensity in a group of children while swimming.
AB  - The purpose of this study was to investigate the validity of heart rate (fc) and
      ratings of perceived exertion (RPE) as indices of exercise intensity in a group
      of children while swimming. Six healthy male swimmers, aged 10-12, swam tethered
      using the breast-stroke in a flume. The resistance started at 1.0 kg and
      increased in 1.0 kg steps up to the point of their exhaustion. The subjects swam
      for 5 min during each period, with a rest of 10-20 min until they had returned to
      their resting fc level. The last exercise intensity was with the maximal mass the
      subjects could support for 2 min. The last min of oxygen consumption (VO2) and 30
      s of fc were measured during each exercise period. The subjects gave their RPE
      assessment at the end of exercise. The individual relationships between fc and
      VO2, and percentage maximal oxygen consumption (%VO2max) were linear with a high
      correlation r = 0.962-0.996 and r = 0.962-0.996, respectively. Therefore, it was
      concluded that fc was valid as an index of the exercise intensity of children
      while swimming. Compared to the results found in adults using a similar protocol,
      the children's fc were 8.3-26.9 beats.min-1 higher than those of the adults at
      the given %VO2max. The present study showed two different patterns in the
      relationship between VO2 and RPE in individuals. In two subjects the RPE
      increased linearly with VO2 while in the other four subjects the increase was
      discontinuous. If fc and RPE were to be applied to the setting and evaluation of
      exercise intensity during swimming, it would seem that fc would be a more useful
      guide than RPE for some children.

PMID- 1761007
TI  - Serum hormones in male strength athletes during intensive short term strength
      training.
AB  - Training-induced adaptations in the endocrine system and strength development
      were investigated in nine male strength athletes during two separate 3-week
      intensive strength training periods. The overall amount of training in the
      periods was maintained at the same level. In both cases the training in the first
      2 weeks was very intensive: this was followed by a 3rd week when the overall
      amount of training was greatly decreased. The two training periods differed only
      in that training period I included one daily session, while during the first 2
      weeks of period II the same amount of training was divided between two daily
      sessions. In general, only slight and statistically insignificant changes
      occurred during training period I in mean concentrations of serum hormones
      examined or sex hormone-binding globulin as well as in maximal isometric leg
      extensor force. However, during training period II after 2 weeks of intensive
      strength training a significant decrease (P less than 0.05) was observed in serum
      free testosterone concentration [from 98.4 (SD 24.5) to 83.8 (SD 14.7) pmol.l-1]
      during the subsequent week of reduced training. No change in the concentration of
      total testosterone was observed. This training phase was also accompanied by
      significant increases (P less than 0.05) in serum luteinizing hormone (LH) and
      cortisol concentrations. After 2 successive days of rest serum free testosterone
      and LH returned to (P less than 0.05) their basal concentrations. Training period
      II led also to a significant increase (P less than 0.05) [from 3942 (SD 767) to
      4151 (SD 926) N] in maximal force.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761009
TI  - Effects of hypotension on cutaneous and subcutaneous blood flow in anaesthetized
      humans.
AB  - The aim of this study was to determine the effect of controlled hypotension on
      subcutaneous and cutaneous haemodynamics in humans. Moderate hypotension was
      achieved with nitroglycerin (NTG) and sodium nitroprusside (SNP) infusion during
      narconeuroleptanalgesia in seven patients. Subcutaneous and cutaneous blood flow
      were measured by a superficial and deep heat clearance (HC) technique. The mean
      arterial pressure (BPa) decreased by 23%-30% and heart rate (fc) increased but
      only during NTG infusion (+22%; P less than 0.02). Subcutaneous and cutaneous
      blood flows remained unchanged despite a significant decrease in calculated
      cutaneous resistance (NTG: -26%, P less than 0.01; SNP: -34%, P less than 0.02]
      and subcutaneous vascular resistance changed only with SNP (-31%, P less than
      0.02). After hypotension was discontinued the subcutaneous blood flow decreased (
      13%, P = 0.05), whereas subcutaneous vascular resistance returned to its control
      values. An inverse relationship was found between fc and BPa (NTG: r = -0.525, P
      less than 0.01; SNP: r = -0.622, P less than 0.01) as well as with subcutaneous
      blood flow (NTG: r = -0.653, P less than 0.001; SNP: r = -0.573, P less than
      0.01). In addition, we found oscillatory changes in deep HC values which differed
      in magnitudes (NTG 0.22 (SEM 0.09) W.m-1.degree C-1 vs SNP 0.42 (SEM 0.1) W.m
      1.degrees C-1, P less than 0.01) and frequencies (NTG 0.02 (SEM 0.006) Hz vs SNP
      0.01 (SEM 0.002) Hz, P less than 0.01). Despite unchanged blood flow, the effects
      of controlled hypotension on cutaneous and subcutaneous haemodynamics were
      different depending on the type of drug. These differences may have been related
      to counterregulatory responses and/or to direct vascular effects.

PMID- 1761010
TI  - Dietary intervention and training in swimmers.
AB  - To ascertain if muscle damage occurred in swimmers as a result of high-intensity
      training and to find if fluid and dietary manipulation could affect muscle
      damage, we studied 40 members of the University of Florida swimming team using
      creatine kinase (CK) and lactic dehydrogenase (LDH) as markers of muscle damage
      during a 6-month period of intensive training. During this time, training
      intensity, fluid intake during exercise and dietary supplementation were all
      modified one by one to examine their individual effects. During a control period
      of 4 weeks, all swimmers drank water before and during (120 min) workouts. CK in
      men at the end of this period averaged 315, SD 122 (normal less than 170 IU.l-1).
      Half of the swimmers were then given 500 ml of a glucose-electrolyte solution
      (GES) (Na 21 mmol.l-1, Cl 13 mmol.l-1, K 2.5 mmol.l-1, PO4 5 mmol.l-1 and glucose
      6%) before workouts and twice at intervals during the workout, while half
      continued to drink the same volume of water. One week after division into fluid
      groups, the workout intensity was increased by about 10%. Another week later CK
      had increased to 500, SD 180 IU.l-1 in swimmers drinking water, but fell to 280,
      SD 105 IU.l-1 in those drinking GES (P less than 0.05). The second phase of the
      study began after a 4-week control period during which all athletes drank water
      before and during workouts. The swimmers were divided into four matched
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761011
TI  - The electro-mechanical delay of the erector spinae muscle: influence of rate of
      force development, fatigue and electrode location.
AB  - Electro-mechanical delay (EMD) values of the erector spinae muscle were obtained
      using a technique based on the cross-correlation between the force and the
      electromyogram (EMG). Seven subjects performed a series of 20 submaximal dynamic
      isometric contractions in a seated position at two frequencies (0.5 Hz and 1 Hz)
      to study the influence of the rate of force development on EMD. Mean EMD values
      of 125.7 (SD 28.1) ms (1 Hz) and 136.8 (SD 28.6) ms (0.5 Hz) were shown to differ
      significantly (P = 0.02). This finding supports the hypothesis that EMD is
      inversely related to the rate of force development and implies that the time to
      stretch the series elastic component is an important factor determining EMD.
      After performing a series of fatiguing contractions EMD did not differ
      significantly from the control value. Multiple regression analysis showed that
      maximal voluntary contraction force (MVC) and endurance time of the fatiguing
      exercise correlated significantly with EMD. The site from which the EMG signal
      was recorded had no significant influence on EMD. However, the coefficient of
      correlation between force and the EMG-signal differed significantly between
      electrode positions. The magnitude of the EMD values found emphasized the need to
      account for this delay when interpreting temporal patterns of activation of the
      muscles in, for example, lifting tasks.

PMID- 1761012
TI  - Effect of phentolamine on the relationship between O2 consumption and delivery in
      sheep.
AB  - The oxygen flux challenge test (OFT) has recently been used in critically ill
      patients as a dynamic test for assessment of the response in oxygen consumption
      (VO2) to an increase in O2 delivery (QO2). Such a test may indicate whether a
      patient demonstrates delivery-dependent VO2. However, the increase in whole body
      VO2 following an increase of QO2 might be due to the agents used for the OFT. In
      this study, we examined the possibility of obtaining false positive OFT with an
      alpha-adrenergic antagonist. Five normothermic thiopentone-anaesthetised and
      mechanically-ventilated (inspired O2 fraction, 0.3; expired CO2 fraction, 0.045
      0.055) adult sheep (25-31 kg) were investigated. The QO2 was increased in a
      stepwise fashion from 200 to 850 ml.min-1 by vasodilatation with intravenous
      infusion of phentolamine. The VO2 was calculated at each step from the product of
      arteriovenous. O2 content difference (CO2, a-v) and cardiac output (Qc), the
      latter being continuously measured with a transit-time ultrasonic flow probe
      placed around the main pulmonary artery. The VO2 (y) was linearly related to QO2
      (x), y = 0.034 (SD 0.024) x + 29.3 (SD 3.9). The relationship between Qc (y) and
      CO2, a-v (x) was y = 4.6x(-1.12) (n = 69; r2 = 0.75; P = NS compared to the
      expected relationship for isoconsumption conditions, i.e. where Qc = VO2.(CO2, a
      v)(-1). Our data suggested that under stable conditions, an infusion of
      phentolamine did not sufficiently alter the relationship between Qc and CO2, a-v
      to invalidate its use for OFT in normal sheep.

PMID- 1761013
TI  - Monitoring exercise stress by changes in metabolic and hormonal responses over a
      24-h period.
AB  - Metabolic and endocrine responses of 14 subjects of varying levels of fitness to
      an intensive anaerobic interval training session were assessed before exercise
      and at 2 h, 4 h, 8 h and 24 h postexercise. The endocrine response of the same
      subjects to a control day, where they were required not to exercise, was also
      assessed and compared with the values obtained on the interval training day. Uric
      acid, urea, and creatine phosphokinase concentrations still remained elevated
      above pre-exercise values 24 h postexercise. Lactate, creatinine, testosterone
      and cortisol concentrations were significantly elevated above pre-exercise values
      immediately postexercise but these had reversed by 2 h postexercise. Over the
      remainder of the recovery period testosterone concentrations remained
      significantly lower than values measured at similar times on the control day.
      This was shown to be due directly to a change in testosterone as sex hormone
      binding globulin concentration remained constant throughout the recovery period.
      The data indicate that when comparisons of data were made to control (rest) days,
      imbalances in homeostasis, due to intensive training, are not totally reversed
      within the next 24-h. The data also demonstrate that the parameters measured
      undergo the same variations in subjects with a wide range of physical fitness,
      indicating that these parameters could be used to monitor exercise stress and
      recovery in athletes of a wide range of abilities.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1761014
TI  - Influence of anthropometric characteristics on changes in maximal exercise
      ventilation and breathing pattern during growth in boys.
AB  - The aim of this study was to investigate the effect of growth on ventilation and
      breathing pattern during maximal exercise oxygen consumption (VO2max) and their
      relationships with anthropometric characteristics. Seventy six untrained
      schoolboys, aged 10.5-15.5 years, participated in this study. Anthropometric
      measurements made included body mass, height, armspan, lean body mass, and body
      surface area. During an incremental exercise test, maximal ventilation (VEmax),
      tidal volume (VTmax), breathing frequency (fmax), inspiratory and expiratory
      times (tImax and tEmax), total duration of respiratory cycle (tTOTmax), mean
      inspiratory flow (VT/tImax), and inspiration fraction (tI/tTOTmax) were measured
      at VO2max. A power function was calculated between anthropometric characteristics
      and ventilatory variables to determine the allometric constants. The results
      showed firstly, that VEmax, VTmax, tImax, tEmax, tTOTmax, and VT/tImax increased
      with age and anthropometric characteristics (P less than 0.001), fmax decreased
      (P less than 0.001), and tI/tTOTmax remained constant during growth; secondly
      that lean body mass explained the greatest percentage of variance of VEmax
      (62.1%), VTmax (76.8%), and VT/tImax (70.6%), while anthropometric
      characteristics explained a slight percentage of variance of fmax and timing; and
      thirdly that VEmax, VTmax, and VT/tImax normalized by lean body mass did not
      change significantly with age. We concluded that at VO2max there were marked
      changes in ventilation and breathing pattern with growth. The changes in VEmax,
      VTmax, and VT/tImax were strongly related to the changes in lean body mass.

PMID- 1761015
TI  - Effects of muscarinic blockade on the thermic effect of oral or intravenous
      carbohydrate.
AB  - Muscarinic blockade by atropine has been shown to decrease the thermic effect of
      a mixed meal, but not of intravenous glucose. To further delineate the mechanisms
      involved in the atropine-induced inhibition of thermogenesis after a meal, plasma
      substrate and hormone concentrations, energy expenditure (EE) and substrate
      oxidation rates were measured before and during a continuous glucose infusion
      (44.4 mumol.kg-1.min-1) with or without atropine. After 2 h of glucose infusion,
      a 20-g oral fructose load was administered while the glucose infusion was
      continued. Plasma insulin concentrations attained a plateau at 596 (SEM 100)
      pmol.l-1 after 120 min of glucose infusion and were not affected by muscarinic
      blockade; plasma glucose concentrations peaked at 13.3 (SEM 0.5) mmol.l-1 at 90
      min and decreased progressively thereafter; no difference was observed with or
      without atropine. Plasma free fatty acid and glucagon concentrations, with or
      without atropine, were both decreased to 201 (SEM 18) mumol.l-1 and 74 (SEM 4)
      ng.l-1, respectively, after 2 h of glucose infusion, and were not further
      suppressed after oral fructose. Carbohydrate oxidation rates (CHO(ox)) increased
      to 20.8 (SEM 1.4) mumol.kg-1.min-1 and lipid oxidation rates (Lox) decreased to
      1.5 (SEM 0.3) mumol.kg-1.min-1 between 90 and 120 min after the beginning of
      glucose infusion and were not affected by atropine. Glucose-induced thermogenesis
      was similar with [6.5% (SEM 1.4%) of basal EE] or without [6.0% (SEM 1.0%), NS)
      muscarinic blockade during the 30 min preceding fructose ingestion.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1761016
TI  - Measurement of anterior tibial muscle size using real-time ultrasound imaging.
AB  - Cross-sectional images of the anterior tibial muscle group were obtained using
      real-time ultrasound scanning in 17 normal women. From photographs taken of the
      images, the cross-sectional area (CSA) and two linear measurements of muscle
      cross-section were determined. A measurement of the shortest distance of the
      muscle depth was termed DS, and a measurement of the longest distance through the
      muscle group was termed DL. Both linear dimensions showed a positive correlation
      with CSA and the best correlations were obtained when the dimensions were squared
      or combined (DS x DL). The correlation values were: CSA vs DS2, r = 0.9; CSA vs
      DL2, r = 0.75 and CSA vs DS x DL, r = 0.88. An approximate value for CSA could be
      calculated from DS2 by the equation 2 x DS2 + 1. A shape ratio, obtained by
      dividing DL by DS, was consistent within the group [mean 2.1 (SD 0.2)] and
      characterised the muscle geometrically. The CSA of repeated scans was assessed
      for repeatability between-days and between-scans by analysis of variance and the
      coefficient of variation (CV) calculated. Areas were repeatable between-days (CV
      6.5%) and between-scans (CV 3.6%). Linear dimensions of the anterior tibial
      muscle group reflected CSA and their potential for assessing changes in muscle
      size with atrophy and hypertrophy have yet to be established.

PMID- 1761017
TI  - Can cycle power predict sprint running performance?
AB  - A major criticism of present models of the energetics and mechanics of sprint
      running concerns the application of estimates of parameters which seem to be
      adapted from measurements of running during actual competitions. This study
      presents a model which does not perpetuate this solecism. Using data obtained
      during supra-maximal cycle ergometer tests of highly trained athletes, the
      kinetics of the anaerobic and aerobic pathways were modelled. Internal power
      wasted in the acceleration and deceleration of body limbs and the power necessary
      to overcome air friction was calculated from data in the literature. Assuming a
      mechanical efficiency as found during submaximal cycling, a power equation was
      constructed which also included the power necessary to accelerate the body at the
      start of movement. The differential equation thus obtained was solved through
      simulation. The model appeared to predict realistic times at 100 m (10.47 s), 200
      m (19.63 s) and 400 m (42.99 s) distances. By comparison with other methods it is
      argued that power equations of locomotion should include the concept of
      mechanical efficiency.

PMID- 1761018
TI  - Step ergometry: is it task-specific training?
AB  - Maximal exercise responses were measured before and after 10 weeks of training in
      two groups of men, one trained on a treadmill (n = 12) and the other on a step
      ergometer (n = 9); the groups were pre- and post-tested on both machines to
      examine the specificity of the training modes. Training for both groups consisted
      of 3 days week-1, 30 min day-1, progressing to 50 min day-1, at an intensity of
      75%-80% heart rate maximum reserve. Pre-training maximal oxygen uptake (VO2max)
      was significantly higher on the treadmill for both groups (X = 8.5%). VO2max
      increased 6.9% on the treadmill (P less than 0.05) and 6.9% (P greater than 0.05)
      on the step ergometer after treadmill training. The small increases may be
      attributed to the specificity of the testing protocols used to elicit VO2max.
      Significant (P less than 0.01) increases in VO2max were found for both modalities
      after step-ergometry training (treadmill = 11.8%; step ergometer = 23.2%). These
      increases resulted in equal post-test VO2max values (4.05 l min-1; 51 ml kg-1 min
      1) on the step ergometer and treadmill. The significant increases in VO2max found
      for both modalities after step-ergometry training shows that (1) step ergometry
      is an effective training modality, and (2) its effects can be measured on the
      treadmill and therefore it is not task-specific training.

PMID- 1761019
TI  - A simple and disposable sweat collector.
AB  - Apart from in cystic fibrosis, where sweat analysis provides valuable diagnostic
      information, sweat yields remain an overlooked biological fluid. Technical
      problems (dilution, condensation, contamination, evaporation, etc.) linked to
      currently available collection procedures are of concern and thwart their use. To
      overcome some of these technical difficulties, an original sweat-collection
      technique is described. A collection capsule is created inside a flexible,
      adhesive and disposable anchoring membrane pasted onto the skin. A fluid-tight
      window is positioned in the upper part of the pocket and gives access to its
      content. Through the collection window, complete emptying of the sweat collector
      can be achieved repeatedly by suction using a vacutainer tube inserted in a tube
      holder equipped with a long dull needle. With prior addition of a suitable
      marker, fractional samplings can also be performed using a precision
      micropipette. This collecting method allows for kinetic studies on sweat rate and
      sweat content. The limited bias-inducing manipulations linked to the described
      technique, coupled with the ease of performing kinetic studies on sweat volume
      and content, make this original tool a reliable and accurate sweat-collection
      technique.

PMID- 1761020
TI  - Blood lactate concentration following intermittent and continuous cycling tests
      of anaerobic capacity.
AB  - The purpose of this study was to compare the time and the magnitude of peak blood
      lactate concentration [La] following three 90-s cycle-ergometer tests.
      Intermittent all-out, continuous all-out, and continuous constant cycling tests
      were performed by 19 hockey players and 19 physical education students. Eight
      fingertip blood samples were drawn 1-11 min into recovery. [La] was similar
      between 3 min and 8 min of recovery for the three 90-s tests. [La] at the
      individual peak time was similar to that in samples taken at 1-4 min for the
      intermittent all-out test, 2-6 min for the continuous all-out test, and 2-4 min
      for the continuous constant cycling test. The intermittent and continuous all-out
      tests produced higher [La] at the individual peak time than did the continuous
      constant test. The intermittent all-out test produced an earlier peak [La] than
      the continuous tests. Both time and magnitude of peak [La] are dependent on the
      mode of testing.

PMID- 1761021
TI  - Twitch potentiation during fatiguing exercise in the elderly: the effects of
      training.
AB  - Twitch potentiation was studied during a fatigue paradigm involving intermittent
      maximum voluntary contractions (MVCs) of the tibialis anterior muscle in the
      elderly and in young adults. Resting twitch torques were similar between groups,
      but twitch potentiation was significantly greater (241% vs 166%) in the young;
      the recovery of the twitch after fatigue was similar between groups. Contraction
      time, time to peak torque and half-relaxation time were all significantly slower
      in the elderly. Following 12 weeks of resistance training in the elderly, there
      was no significant change in the twitch contractile properties at rest, but there
      was a significant main effect of training on the degree of twitch potentiation
      during the same fatigue protocol (peak potentiation 192% post-training vs 165%
      pretraining). These data suggest that the mechanism(s) responsible for twitch
      potentiation following MVCs may be influenced by both aging and training.

PMID- 1761022
TI  - Predicted sweat rate in fluctuating thermal conditions.
AB  - The ISO 7933 Required Sweat Rate Index is inappropriate under conditions of
      fluctuating exposure. Time weighted average values can introduce large
      underestimations as, for hot conditions, the relationship between physical stress
      and physiological strain is not linear. Mean skin temperature and sweat rate vary
      as a first order system, that is, according to an exponential averaging system,
      in response to a step function of the primary parameters. A very simple algorithm
      has been derived to take into account this exponential averaging and to predict
      the sweat rate at any time, taking into account the past exposure of the subject.
      It is based on time constants of 3 min for the mean skin temperature and of 25
      min (up to a sweat rate of 50 W.m-2) and 10 min for the sweat rate. The
      correlation coefficient is 0.780 between observed and predicted sweat rates in
      independent experiments used for the validation of the model. This emphasises the
      necessity for exponential averaging as differences between individuals are very
      important and the precision of the observed data in these experiments was lower
      than for laboratory experimental data.

PMID- 1761023
TI  - Structural and metabolic properties of rat muscle exposed to weightlessness
      aboard Cosmos 1887.
AB  - Male Wistar rats were subjected to 12.5 days of weightlessness aboard Cosmos
      1887. Histomorphometric and biochemical analyses were investigated in soleus
      (SOL), plantaris (PL) and extensor digitorum longus (EDL) muscles of flight rats
      (group F) and compared with data from two groups of terrestrial controls: one
      group living free in a vivarium (group V) and another subjected to a flight
      simulation except for the state of weightlessness (group S). Relative to groups V
      and S, no alteration in the percentage distribution of fibres had occurred in
      SOL, PL or EDL, after the flight. In SOL muscles from group F animals, cross
      sectional areas of all fibre types were reduced to a greater extent (-40%) than
      capillary to fibre ratio (-24%) leading to a higher capillary density (+33%) than
      in V and S groups. In PL, type I, IIA and IIB fibre cross-sectional areas were
      less decreased (-25%). In EDL, only fast-twitch fibre cross-sectional areas
      showed an average decrease of 30%. Capillary per fibre ratio was reduced by 15%
      and 28% respectively in PT and EDL muscles from group F rats compared to control
      groups V and S. Citrate synthase and 3-hydroxyacyl-coenzyme A dehydrogenase
      activities remained unchanged in SOL, PL and EDL following spaceflight. These
      findings indicate greater atrophy and functional alterations (capillarity)
      compared to those observed after 7 days of microgravity on Cosmos 1667.

PMID- 1761024
TI  - Development of muscle fatigue during intermittent submaximal static contraction
      in an agonist heterogeneous muscle group.
AB  - A comparison of the mean power frequency (MPF) and the root mean square amplitude
      (rms) of the myo-electric signal of two agonist muscles [triceps brachii (fast;
      TB) and anconeus (slow; ANC)] has been made during repeated intermittent static
      contractions. Subjects were asked to maintain different extension torques at 50%
      of maximal voluntary contraction until this could no longer be maintained
      (endurance time). The interval between successive contractions was kept constant
      at 3 min. During the first six successive contractions, a decrease in MPF and an
      increase in rms were most pronounced, ANC and TB MPF recovered with subsequent
      overshoot. A marked decline in endurance time was also seen. The increase in rms
      was greater for TB than for ANC when the decrease in MPF was greater for ANC than
      for TB. The differences in power spectrum density function upper frequencies of
      the two muscles could explain the greater decrease of MPF in ANC. Our data would
      suggest a greater fatigability in TB relative to ANC. On and after the seventh
      contraction, a steady-state in duration, muscle temperature, MPF and rms was
      reached. These results suggested that a slow (ANC) and a fast (TB) muscle acted
      in a similar way during intermittent static contractions, when the intervening
      rest was not long enough to allow full recovery of the muscles.

PMID- 1761025
TI  - Kinetics of ventilation and gas exchange during supine and upright cycle
      exercise.
AB  - The dynamics of ventilation (VE), oxygen uptake (VO2), carbon dioxide output
      (VCO2), and heart rate (fc) were studied in 12 healthy young men during upright
      and supine exercise. Responses to maximal and to two different types of
      submaximal exercise tests were contrasted. During incremental exercise to
      exhaustion, the maximal work rate, VO2max, VEmax, fc,max, and ventilatory
      threshold were all significantly reduced in supine compared to upright exercise
      (P less than 0.01-0.001). Following step increases or decreases in work rate
      between 25 W and 105 W, both VO2 and VCO2 responded more slowly in supine than
      upright exercise. Dynamics were also studied in two different pseudorandom binary
      sequence (PRBS) exercise tests, with the work rate varying between 25 W and 105 W
      with either 5-s or 30-s durations of each PRBS unit. In both of these tests,
      there were no differences caused by body position in the amplitude or phase
      shifts obtained from Fourier analysis for any observed variable. These data show
      that the body position alters the dynamic response to the more traditional step
      increase in work rate, but not during PRBS exercise. It is speculated that the
      elevation of cardiac output observed with supine exercise in combination with the
      continuously varying work-rate pattern of the PRBS exercise allowed adequate,
      perhaps near steady-state, perfusion of the working muscles in these tests,
      whereas at the onset of a step increase in work rate, greater demands were placed
      on the mechanisms of blood flow redistribution.

PMID- 1761026
TI  - Basketball exercise and secretory immunoglobulin A.
AB  - This study examined saliva levels of immunoglobulin A (IgA) before and after
      three games and three practice sessions during the basketball season. Saliva was
      collected from 27 prepubescent boys (10-12 years) in a small Fry league and 23
      postpubescent boys (16-18 years) on a high school varsity team. Saliva samples
      were frozen for later assay using a standard enzyme-linked immunosorbent assay
      technique. IgA levels were significantly increased after games 1 and 3 in both
      age groups and after practice 3 in the high school athletes. Over the 2 months of
      saliva collections the pre-exercise IgA increased significantly with games 2 and
      3 higher than game 1, and practice 3 higher than practices 1 and 2, in both age
      groups. These results indicate that basketball exercise can increase saliva IgA
      levels and that chronic exercise over the basketball season may increase the
      resting levels of IgA. These changes may give athletes more protection against
      respiratory infections both after exercise and in the resting state later in the
      season.

PMID- 1761027
TI  - Sulfur-containing cyclic ketimines and imino acids. A novel family of endogenous
      products in the search for a role.
AB  - Aminoethylcysteine, lanthionine, cystathionine and cystine are mono-deaminated
      either by L-amino-acid oxidase or by a transaminase exhibiting the properties
      described for glutamine transaminase. The deaminated products cyclize producing
      the respective ketimines. Authentic samples of each ketimine were prepared by
      reacting the appropriate aminothiol compound with bromopyruvate, except cystine
      ketimine which required the interaction of thiopyruvate with cystine sulfoxide.
      Reduction of the first three mentioned ketimines with NaBH4 yields the respective
      derivatives with the saturated rings of thiomorpholine and hexahydrothiazepine.
      The same reduction is carried out enzymically by a reductase extracted from
      mammalian tissues. Properties of the members of this family of compounds are
      described. Gas chromatography followed by mass spectrometry permits the
      identification of most of these products. HPLC is very useful for the
      determination of the ketimines by taking advantage of specific absorbance at 380
      nm obtained by prior derivatization with phenylisothiocyanate. Adaptation of
      these and other analytical procedures to biological samples disclosed the
      presence of most of these compounds in bovine brain and in human urine. By using
      [35S]lanthionine ketimine as a representative member of the ketimine group, the
      specific, high-affinity, saturable and reversible binding to bovine brain
      membranes has been demonstrated. The binding is removed by aminoethylcysteine
      ketimine and by cystathionine ketimine indicating the occurrence in bovine brain
      of a common binding site for ketimines. The reduced ketimines are totally
      ineffective in competing with [35S]lanthionine ketimine. Alltogether these
      findings are highly indicative for the existence in mammals of a novel class of
      endogenous sulfur-containing cyclic products provided with a possible
      neurochemical function to be investigated further.

PMID- 1761028
TI  - Structural role of amino acids 99-110 in recombinant human erythropoietin.
AB  - Erythropoietin is the prime regulator of red blood cell production. Previous
      studies demonstrated that antipeptide antibodies to amino acids 99-119 and 111
      129 bind to two non-overlapping domains and inhibit the hormone's action
      (Sytkowski, A.J. & Donahue, K. A. (1987) J. Biol. Chem. 262, 1161-1165).
      Oligonucleotide-directed mutagenesis now shows that amino acids 99-110 (domain 1)
      but not 119-129 (domain 2) are important to erythropoietin's structure and
      function. Mutagenesis of wild-type human erythropoietin cDNA was used to produce
      a series of mutant proteins with sequential deletion of three adjacent amino
      acids and insertion of the sequence Glu-Phe across the two domains. Transient
      expression in COS-7 cells revealed 2.0-kb transcripts encoded by all of the
      cDNAs. Domain 2 mutants exhibited specific biological activities similar to that
      of the wild type. In contrast, domain 1 mutants were not secreted. In vitro
      transcription and translation of the domain 1, domain 2 and wild-type cDNAs
      resulted in the isolation of 23.5-kDa and 32-kDa proteins in the absence or
      presence of pancreatic microsomes, respectively, consistent with efficient
      translation of all of the mutants and equivalent post-translational processing of
      each protein. The data suggest that mutation within domain 1 results in the
      intracellular biosynthesis of erythropoietins with altered structure, rendering
      them subject to rapid degradation. The bioassay of erythropoietins synthesized
      entirely in vitro demonstrated that domain 1 mutants were inactive, whereas both
      wild type and domain 2 mutant hormones exhibited biologic activity. The results
      are consistent with a critical role for amino acids 99-110 in the structure of
      human erythropoietin.

PMID- 1761029
TI  - Self-catalysed affinity labeling of Q beta replicase.
AB  - The spatial neighbourhood of the active center of Q beta replicase can be
      selectively modified by the method of self-catalysed affinity labeling. In the
      template-directed, mainly intramolecular enzymatic catalysis, the product
      [32P]GpG becomes specifically attached to the beta subunit. Using limited
      digestion of the radioactively labeled polypeptide by cyanogen bromide or N
      chlorosuccinimide, we have mapped the attachment site to the region of subunit
      beta between Trp93 and Met130. Under our reaction conditions, Lys95 is the amino
      acid most likely to be modified, suggesting that Lys95 lies near the nucleotide
      binding site in the active center.

PMID- 1761030
TI  - Patchwork-structure serpins from silkworm (Bombyx mori) larval hemolymph.
AB  - A new serpin (serine proteinase inhibitor), having antichymotryptic activity, was
      isolated from silkworm, Bombyx mori, larval hemolymph and was named silkworm
      antichymotrypsin II (sw-AchyII). Amino-acid-sequence analysis of sw-AchyII
      revealed that it consisted of 375 amino acids without cysteine or glycosylated
      residues. sw-AchyII formed an SDS-undissociable complex with alpha-chymotrypsin,
      but this complex was broken down at pH 12.5 into alpha-chymotrypsin and sw-AchyII
      in which the reactive site was cleaved. Amino-acid-sequence analysis after
      cleavage identified in P1-P1' residue at the reactive site of sw-AchyII as Phe340
      Met341. The amino acid sequence from the amino terminus to residue 336 was
      completely identical to the corresponding region of sw-AT [Takagi, H., Narumi,
      H., Nakamura, K. & Sasaki, T. (1990) J. Biochem. (Tokyo) 108, 372-378]. The
      degree of similarity between sw-AchyII and silkworm antitrypsin (sw-AT) from
      residue 337 to the carboxy terminus was only 46%. Reactive sites of both serpins
      were in the variable regions.

PMID- 1761031
TI  - Role of aspartic acid 38 in the cofactor specificity of Drosophila alcohol
      dehydrogenase.
AB  - Drosophila alcohol dehydrogenase (ADH), an NAD(+)-dependent dehydrogenase, shares
      little sequence similarity with horse liver ADH. However, these two enzymes do
      have substantial similarity in their secondary structure at the NAD(+)-binding
      domain [Benyajati, C., Place, A. P., Powers, D. A. & Sofer, W. (1981) Proc. Natl
      Acad. Sci. USA 78, 2717-2721]. Asp38, a conserved residue between Drosophila and
      horse liver ADH, appears to interact with the hydroxyl groups of the ribose
      moiety in the AMP portion of NAD+. A secondary-structure comparison between the
      nucleotide-binding domain of NAD(+)-dependent enzymes and that of NADP(+)
      dependent enzymes also suggests that Asp38 could play an important role in
      cofactor specificity. Mutating Asp38 of Drosophila ADH into Asn38 decreases
      Km(app)NADP 62-fold and increases kcat/Km(app)NADP 590-fold at pH 9.8, when
      compared with wild-type ADH. These results suggest that Asp38 is in the NAD(+)
      binding domain and its substituent, Asn38, allows Drosophila ADH to use both NAD+
      and NADP+ as its cofactor. The observations from the experiments of thermal
      denaturation and kinetic measurement with pH also confirm that the repulsion
      between the negative charges of Asp38 and 2'-phosphate of NADP+ is the major
      energy barrier for NADP+ to serve as a cofactor for Drosophila ADH.

PMID- 1761032
TI  - Specific inhibition of endopeptidase 24.16 by dipeptides.
AB  - The inhibitory effect of various dipeptides on the neurotensin-degrading
      metallopeptidase, endopeptidase 24.16, was examined. These dipeptides mimick the
      Pro10-Tyr11 bond of neurotensin that is hydrolyzed by endopeptidase 24.16. Among
      a series of Pro-Xaa dipeptides, the most potent inhibitory effect was elicited by
      Pro-Ile (Ki approximately 90 microM) with Pro-Ile greater than Pro-Met greater
      than Pro-Phe. All the Xaa-Tyr dipeptides were unable to inhibit endopeptidase
      24.16. The effect of Pro-Ile on several purified peptidases was assessed by means
      of fluorigenic assays and HPLC analysis. A 5 mM concentration of Pro-Ile does not
      inhibit endopeptidase 24.11, endopeptidase 24.15, angiotensin-converting enzyme,
      proline endopeptidase, trypsin, leucine aminopeptidase, pyroglutamyl
      aminopeptidase I and carboxypeptidase B. The only enzyme that was affected by Pro
      Ile was carboxypeptidase A, although it was with a 50-fold lower potency (Ki
      approximately 5 mM) than for endopeptidase 24.16. By means of fluorimetric
      substrates with a series of hydrolysing activities, we demonstrate that Pro-Ile
      can be used as a specific inhibitor of endopeptidase 24.16, even in a complex
      mixture of peptidase activities such as found in whole rat brain homogenate.

PMID- 1761033
TI  - Single amino acid substitutions in the B870 alpha and beta light-harvesting
      polypeptides of Rhodobacter capsulatus. Structural and spectral effects.
AB  - To obtain information on the structural and functional role of highly conserved
      amino acid residues in the B870 alpha and beta light-harvesting polypeptides of
      Rhodobacter capsulatus, site-directed mutagenesis was performed. 18 mutants with
      single amino acid substitutions at nine different positions in the B870 antenna
      polypeptides were prepared in a B800-850-lacking strain. The characterization of
      the resulting phenotypes was based on a quantification of the core-complex
      elements (reaction center, light-harvesting polypeptides, bacteriochlorophyll a
      and carotenoid) and the core-complex spectral characteristics (absorption
      maximum, absorption coefficient and fluorescence intensity). These data generally
      showed that strong structural effects were caused by the amino acid
      substitutions. Thus, the three tryptophan exchanges at the position alpha 8
      resulted in either the absence of a core complex (alpha Trp8----Leu), the absence
      of the core antenna (alpha Trp8----Ala) or a reduction in the carotenoid content
      (alpha Trp8----Tyr). Likewise, the mutants alpha Pro13Gly (i.e. alpha Pro13---
      Gly), beta Gly10Val and alpha Phe23Ala demonstrated an abnormal protein/pigment
      ratio in the core antenna, while a drastically reduced antenna size resulted from
      the amino acid exchange beta Arg45Asp. In contrast to the structural effects, the
      absorption maxima and the fluorescence intensities of the mutant antennae
      differed only slightly from the wild type. The strongest blue shift of the
      bacteriochlorophyll a (8-11 nm) was induced by substitutions of the Trp at
      position alpha 43 (alpha Trp43----Ala, Leu or Tyr). Contrary to the other
      spectral effects, the absorption coefficient of bacteriochlorophyll a was
      strongly influenced by the amino acid substitutions and varied by 1.6-times less
      (beta Arg45Asp) and 1.3-times greater (alpha Phe25Ala) than normal. The antenna
      free mutant, alpha Trp8Ala, yielded a high rate of B800-850 revertants during
      phototrophic growth, indicating a direct energy transfer from the B800-850
      antenna to the reaction center in these strains. Although conditions for growth
      were generally observed to influence phenotypic expression, the structural as
      well as spectral effects were demonstrated to differ to the greatest extent
      between chemotrophically grown and phototrophically grown cells.

PMID- 1761034
TI  - Cloning and expression of the gene encoding the soluble cytochrome b562 of
      Escherichia coli.
AB  - The gene for the soluble cytochrome b562 from Escherichia coli B has been cloned
      on a SalI fragment. The analysis of the gene reveals the presence of a leader
      sequence in front of the sequence encoding the mature protein. Expression of
      cytochrome b562 using the lac-promoter produced the protein to a level of 3-5% of
      total protein. This over-production enables employment of a simple, high-yield
      purification protocol to obtain homogeneous cytochrome b562. Spectroscopic and N
      terminal sequence analyses of the purified protein demonstrate that it is
      identical to the chromosomally expressed cytochrome b562 purified and
      characterized from E. coli B [Itagaki, E. & Hager, L.P. (1966) J. Biol. Chem.
      241, 3687-3695]. It is demonstrated that the genomic sequence codes for a classic
      N-terminal signal sequence and that mature cytochrome b562 is translocated to the
      periplasmic space.

PMID- 1761035
TI  - 1H NMR studies of echistatin in solution. Sequential resonance assignments and
      secondary structure.
AB  - Two-dimensional 1H-NMR methods have been used to obtain complete proton resonance
      assignments for the 49-residue protein echistatin from the viper Echis carinatus.
      The protein in solution contains only a small amount of regular secondary
      structure with four very short beta-strands. These beta-strands form two short
      segments of antiparallel beta-sheet, as evidenced by the observed cross-strand
      NOE. The first two strands are connected with a tight reverse turn, whereas the
      remaining two strands are linked together by an 11-residue loop forming a so
      called hairpin. The tripeptide unit Arg-Gly-Asp, responsible for the binding of
      echistatin to the fibrinogen receptor glycoprotein GPIIb/IIIa, is located at the
      tip of this very hydrophilic loop.

PMID- 1761036
TI  - Nuclear magnetic resonance studies of the snake toxin echistatin. 1H resonance
      assignments and secondary structure.
AB  - The 1H-NMR spectrum of the snake toxin echistatin has been assigned using
      homonuclear two-dimensional methods. Consideration of the NOE patterns, coupling
      constants and putative hydrogen bonds enabled two regular features of secondary
      structure to be deduced: a beta-sheet/turn between residues 8 and 13 and a small
      anti-parallel beta-sheet and bulge linking residues 16-20 with residues 30-33.
      The recognition region of the protein containing the residues RGD lies in a loop
      joining the two strands of the beta-sheet. The beta-bulge and the loop containing
      the RGD sequence undergo pH-dependent conformational interconversion, modulated
      by the side chain of Asp29.

PMID- 1761037
TI  - The secondary structure of echistatin from 1H-NMR, circular-dichroism and Raman
      spectroscopy.
AB  - Detailed biophysical studies have been carried out on echistatin, a member of the
      disintegrin family of small, cysteine-rich, RGD-containing proteins, isolated
      from the venom of the saw-scaled viper Echis carinatus. Analysis of circular
      dichroism spectra indicates that, at 20 degrees C, echistatin contains no alpha
      helix but contains mostly beta-turns and beta-sheet. Two isobestic points are
      observed as the temperature is raised, the conformational changes associated with
      that observed between 40 degrees C and 72 degrees C being irreversible. Raman
      spectra also indicate considerable beta-turn and beta-sheet (20%) structure and
      an absence of alpha-helical structure. Three of the four disulphide bridges are
      shown to be in an all-gauche conformation, while the fourth adopts a trans-gauche
      gauche conformation. The 1H-NMR spectrum of echistatin has been almost fully
      assigned. A single conformation was observed at 27 degrees C with the four
      proline residues adopting only the trans conformation. A large number of backbone
      amide protons were found to exchange slowly, but no segments of the backbone were
      found to be in either alpha-helical or beta-sheet conformation. A number of turns
      could be characterised. An irregular beta-hairpin contains the RGD sequence in a
      mobile loop at its tip. Two of the four disulphide cross-links have been
      identified from the NMR spectra. The data presented in this paper will serve to
      define the structure of echistatin more closely in subsequent studies.

PMID- 1761038
TI  - Sequence-specific 1H-NMR assignment and secondary structure of the Tyr41----His
      mutant of the single-stranded DNA binding protein, gene V protein, encoded by the
      filamentous bacteriophage M13.
AB  - Sequence-specific 1H-NMR assignments are reported for the Tyr41----His (Y41H)
      mutant of the single-stranded DNA binding protein, encoded by gene V of the
      filamentous bacteriophage M13 (GVP). The mutant protein was chosen for this
      purpose because it exhibits significantly improved solubility characteristics
      over wild-type GVP [Folkers et al. (1991) Eur. J. Biochem. 200, 139-148]. The
      secondary structure elements present in the protein are deduced from a
      qualitative interpretation of the nuclear Overhauser enhancement spectra and
      amide exchange data. The protein is entirely composed of antiparallel beta
      structure. It is shown that identical structural elements are present in wild
      type GVP. Previously, we have demonstrated that the secondary structure of the
      beta-loop, encompassing residues 13-31 which is present in GVP in solution,
      deviates from that proposed for the same amino acid sequence on the basis of X
      ray diffraction data [van Duynhoven et al. (1990) FEBS Lett. 261, 1-4]. Now that
      we have arrived at a complete description of the secondary structure of the
      protein in solution, other deviations with respect to the crystallographically
      determined structure became apparent as well. The N-terminal part of the protein
      is, in solution, part of a triple-stranded beta-sheet while, in the crystal, it
      is an extended strand pointing away from the bulk of the protein dimer. One of
      the antiparallel beta-sheets in the protein which had been designated earlier as
      the complex loop has, in the solution structure, a different pairwise arrangement
      of the residues in its respective beta-ladders. Residues 30 and 48 are opposite
      to one another in the solution structure while in the crystal structure residues
      32 and 48 are paired. A similar observation is made for the so-called dyad domain
      of the protein of which the beta-sheet in the solution structure is shifted by
      one residue with respect to that of the crystal structure.

PMID- 1761039
TI  - Structural and functional relationships in two families of beta-1,4-glycanases.
AB  - CenA and Cex are beta-1,4-glycanases produced by the cellulolytic bacterium
      Cellulomonas fimi. Both enzymes are composed of two domains and contain six Cys
      residues. Two disulfide bonds were assigned in both enzymes by peptide analysis
      of the isolated catalytic domains. A further disulfide bond was deduced in both
      cellulose-binding domains from the absence of free thiols under denaturing
      conditions. Corresponding Cys residues are conserved in eight of nine other known
      C. fimi-type cellulose-binding domains. CenA and Cex belong to families B and F,
      respectively, in the classification of beta-1,4-glucanases and beta-1,4-xylanases
      based on similarities in catalytic domain primary structure. Disulfide bonds in
      the CenA catalytic domain correspond to the two disulfide bonds in the catalytic
      domain of Trichoderma reesei cellobiohydrolase II (family B) which stabilize
      loops forming the active-site tunnel. Sequence alignment indicates the probable
      occurrence of disulfides at equivalent positions in the two other family B
      enzymes. Partial resequencing of the gene encoding Streptomyces KSM-9 beta-1,4
      glucanase CasA (family B) revealed five errors in the original nucleotide
      sequence analysis. The corrected amino acid sequence contains an Asp residue
      corresponding to the proposed proton donor in hydrolysis catalysed by
      cellobiohydrolase II. Cys residues which form disulfide bonds in the Cex
      catalytic domain are conserved in XynZ of Clostridium thermocellum and Xyn of
      Cryptococcus albidus but not in the other eight known family F enzymes. Like
      other members of its family, Cex catalyses xylan hydrolysis. The catalytic
      efficiency (kcat/Km) for hydrolysis of the heterosidic bond of p-nitrophenyl-beta
      D-xylobioside is 14,385 min-1.mM-1 at 25 degrees C; the corresponding kcat/Km for
      p-nitrophenyl-beta-D-cellobioside hydrolysis is 296 min-1.mM-1.

PMID- 1761040
TI  - The effect of water content and nature of organic solvent on enzyme activity in
      low-water media. A quantitative description.
AB  - A simple theoretical model was suggested to describe quantitatively the effect of
      water content and nature of organic solvents on catalytic behavior of enzymes
      suspended in low-water media. The model was based on a generally accepted notion
      that the destruction of the protein hydration shell is one of the main reasons
      for protein denaturation by organic solvents. The validity of the model was
      confirmed by the example of catalytic behavior of immobilized laccase suspended
      in water/organic mixtures of different compositions. In addition, the results
      were used to demonstrate that the effect of organic solvents and/or water content
      on catalytic behavior of enzymes in low-water media can be adequately assessed
      only in terms of the full kinetic description based on properly determined Vm and
      Km values.

PMID- 1761041
TI  - Inactivation of pancreatic and gastric lipases by tetrahydrolipstatin and alkyl
      dithio-5-(2-nitrobenzoic acid). A kinetic study with 1,2-didecanoyl-sn-glycerol
      monolayers.
AB  - We studied the covalent inhibition of lipases by the monolayer technique. We
      report the inactivation of porcine pancreatic and human and rabbit gastric
      lipases, acting on mixed monomolecular films of dicaprin containing
      tetrahydrolipstatin or new hydrophobic disulfide compounds, which can be
      described as a 'poisoned-interface' system. A kinetic model is presented for
      depicting the covalent inactivation of lipolytic enzymes at a lipid/water
      interface. The stoichiometry of the interfacial situation can be described as
      follows: one lipase molecule embedded among 10(5) substrate molecules will be
      inactivated to half its initial velocity by the presence of 10
      tetrahydrolipstatin molecules. This inactivation was independent of the surface
      pressure. When tested in the form of mixed films, all the disulfide compounds
      investigated specifically reduced the hydrolysis of 1,2-didecanoyl-sn-glycerol
      films by gastric lipases, but did not affect hydrolysis by pancreatic lipase.
      With this poisoned-interface system, tetrahydrolipstatin was found to be the most
      potent inactivator, whereas disulfide compounds showed a higher degree of
      selectivity than tetrahydrolipstatin.

PMID- 1761042
TI  - A calorimetric study of the Ni(II)-5' AMP system. A base-stacking stabilization.
AB  - The thermodynamic parameters of the interaction between Ni(II) (M) and 5'-AMP in
      aqueous solution were determined calorimetrically (I = 0.1 tetramethylammonium
      bromide, 25 degrees C) at physiological pH. The experimental conditions were
      carefully selected to avoid the polynuclear complex formation. From the Ni(5'AMP)
      complex-formation constant (logK1 = 2.55), the Ni(5'AMP)2(2-)-complex-formation
      constant and the Ni(5'AMP) (ML) and Ni(5'AMP)2(2-) (ML2) complex-formation
      enthalpies were determined (logK2 = 2.34, delta H1 = -10.0 kJ/mol and delta H2 =
      21.6 kJ/mol). These results confirm the formation of the ML2 complex in solution
      and agree very well with the hypothesis of the 'stacking' between the purine
      rings, promoted for metal ions.

PMID- 1761043
TI  - Biochemical and biophysical investigations of the ferrocene-iron-loaded rat. An
      animal model of primary haemochromatosis.
AB  - Male Wistar rats fed with ferrocene had high hepatic iron loading (7.24 +/- 1.97
      mg Fe/g tissue) after 6 weeks, principally located in lysosomes, which was
      comparable to the levels and distribution determined in human haemochromatosis.
      The two iron-storage proteins, ferritin and haemosiderin were isolated from the
      livers of the ferrocene-loaded rats and their iron cores were investigated by
      Mossbauer spectroscopy and inductively coupled plasma-emission spectrometry.
      Ferrihydrite was the predominant form of iron present in both ferritin and
      haemosiderin, while haemosiderin contained higher amounts of phosphorus,
      magnesium, calcium and barium, then either normal or ferrocene-loaded ferritin.
      Free-radical-mediated damage in the iron-loaded livers was inferred by the
      significant depletion of alpha-tocopherol in both the livers and subcellular
      hepatic lysosomal fraction, which inversely correlated with the increasing iron
      content (r = -0.61; P less than 0.05) and was associated with increased fragility
      of the lysosomal membranes.

PMID- 1761044
TI  - The distribution of permeant ions demonstrates the presence of at least two
      distinct electrical gradients in bloodstream forms of Trypanosoma brucei.
AB  - The distribution of 86Rb+ and the radiolabelled lipophilic cation
      [3H]methyltriphenylphosphonium (MePh3P+) was used to investigate the membrane
      potentials that exist in bloodstream forms of Trypanosoma brucei. Even after
      correction for binding to cellular constituents, the accumulation of MePh3P+ was
      approximately tenfold greater than the accumulation of Rb+ under resting
      conditions. The addition of low concentrations of carbonylcyanide p
      trifluoromethoxyphenylhydrazone or valinomycin reduced the accumulation of
      MePh3P+ tenfold without perturbing the accumulation of Rb+. Although selective
      permeabilization of the plasma membrane abolished the accumulation of Rb+ and
      caused a substantial decrease in the accumulation of MePh3P+, a significant
      carbonylcyanide-p-trifluoromethoxyphenylhydrazone-sensitive accumulation of
      MePh3P+ persisted under these conditions. These data were consistent with the
      presence of at least two distinct membrane potentials (delta psi) in bloodstream
      forms of T. brucei; a potential across the plasma membrane (delta psi p) and an
      additional delta psi, generated by the electrogenic movement of H+, across the
      membrane of an intracellular organelle that possesses no electrical permeability
      to Rb+ or K+.

PMID- 1761045
TI  - The solution structure of a monomeric insulin. A two-dimensional 1H-NMR study of
      des-(B26-B30)-insulin in combination with distance geometry and restrained
      molecular dynamics.
AB  - The solution conformation of des-(B26-B30)-insulin (DPI) has been investigated by
      1H-NMR spectroscopy. A set of 250 approximate interproton distance restraints,
      derived from two-dimensional nuclear Overhauser enhancement spectra, were used as
      the basis of a structure determination using distance geometry (DG) and distance
      bound driven dynamics (DDD). Sixteen DG structures were optimized using energy
      minimization (EM) and submitted to short 5-ps restrained molecular dynamics (RMD)
      simulations. A further refinement of the DDD structure with the lowest distance
      errors was done by energy minimization, a prolonged RMD simulation in vacuo and a
      time-averaged RMD simulation. An average structure was obtained from a trajectory
      generated during 20-ps RMD. The final structure was compared with the des-(B26
      B30)-insulin crystal structure refined by molecular dynamics and the 2-Zn crystal
      structure of porcine insulin. This comparison shows that the overall structure of
      des-(B26-B30)-insulin is retained in solution with respect to the crystal
      structures with a high flexibility at the N-terminal part of the A chain and at
      the N-terminal and C-terminal parts of the B chain. In the RMD run a high
      mobility of Gly A1, Asn A21 and of the side chain of Phe B25 is noticed. One of
      the conformations adopted by des-(B26-B30)-insulin in solution is similar to that
      of molecule 1 (Chinese nomenclature) in the crystal structure of porcine insulin.

PMID- 1761046
TI  - Determination of the orientations of tryptophan analogues bound to the trp
      repressor and the relationship to activation.
AB  - The antirepressor indole 3-propanoate has been shown by X-ray crystallography to
      bind in a different orientation compared with the natural corepressor for the
      tryp repressor, L-tryptophan (Lawson, C.L. & Sigler, P. B. (1988) Nature 333, 869
      871). This suggests a simple difference between what constitutes a corepressor
      versus an antirepressor. We have used visible absorption and 1H-NMR spectroscopy
      to characterise the nature of several ligand-repressor complexes and DNA-binding
      assays to assess the relative operator binding affinities. 5-Fluorotryptophan
      binds with similar affinity and in the same orientation as L-tryptophan, and is
      an equally effective corepressor. In contrast, the tight-binding antirepressor
      indole 3-acrylate binds in the same orientation as indole 3-propanoate. Indole,
      also an antirepressor, also binds in the indole-3-propanoate orientation. 5
      Methyltryptamine, a corepressor, shows spectroscopic characteristics of both
      tryptophan and indoleacrylate, though NOEs indicate that the tryptophan
      orientation is preferred. These results indicate that the ammonium group in the
      side chain is essential both for activation and binding in the L-tryptophan
      orientation. Antirepressors, lacking the ammonium group, bind in the more
      favourable indole-3-propanoate orientation. Differences in the NMR signatures of
      the different repressor-ligand complexes indicate that the details of the
      conformations depend on the nature of the ligands and their orientation within
      the binding site. Despite any conformational rearrangement of the protein on
      binding, dissociation of ligands is facile: 5-fluorotryptophan dissociates
      rapidly at 313 K. These findings complement and extend the X-ray and
      thermodynamic analyses of ligand binding.

PMID- 1761047
TI  - Mechanism of action of deoxyribonuclease II from human lymphoblasts.
AB  - Deoxyribonuclease II has been purified through five fractionation steps from the
      human lymphoblast cell line K562. Isolation included DEAE-cellulose and heparin
      agarose chromatography followed by fractionation on Mono-S, Mono-Q and Superose
      12 FPLC columns. In an extension of previous studies, deoxyribonuclease II was
      found to introduce a much higher proportion of single-strand nicks relative to
      double-strand breaks into supercoiled DNA than has been reported for linear DNA.
      Application of DNA sequencing techniques has further revealed a unique resistance
      of 3' termini to hydrolysis by this enzyme. Deoxyribonuclease II cleaves at every
      available site along the duplexed portion of a paired oligonucleotide substrate
      with the exception of the last four nucleotides. Consistent with previous
      results, this deoxyribonuclease II is active at low pH in the absence of Mg2+ and
      is not inhibited by EDTA, but complete inhibition is observed with 100 microM
      Fe3+. Likewise we confirmed the presence of 3'-phosphoryl termini on the DNA
      cleavage products since they failed to function as primers for DNA synthesis
      catalyzed by Escherichia coli DNA polymerase I.

PMID- 1761048
TI  - Geotrichum candidum produces several lipases with markedly different substrate
      specificities.
AB  - We have purified and examined the substrate specificity of four lipases from two
      strains of the mould Geotrichum candidum, ATCC 34614 and CMICC 335426. We have
      designated the lipases I and II (ATCC 34614), and A and B (CMICC 335426). The
      enzymes are monomeric and have similar molecular masses and pI. Thus, lipases I
      and II have native molecular masses of 50.1 kDa and 55.5 kDa, and pI of 4.61 and
      4.47, respectively. Lipases A and B are very similar to lipases I and II with
      native molecular masses of 53.7 kDa and 48.9 kDa, and pI of 4.71 and 4.50,
      respectively. Treatment with endo-beta-N-acetylglucosaminidase caused a reduction
      in molecular mass of approximately 4.5 kDa for all four lipases, indicating that
      these enzymes are glycosylated. Western blotting shows that the lipases are
      related. However, lipase B from CMICC 335426 shows a remarkable specificity for
      unsaturated substrates with a double bond at position 9 (cis configuration), and
      this specificity is not exhibited by the other three lipases. No lipase of this
      unique specificity has previously been purified to homogeneity. Structural
      studies using these four lipases should allow insight into the molecular basis of
      this remarkable specificity.

PMID- 1761049
TI  - Notechis 11'2, a non-toxic phospholipase A2 from the venom of Notechis scutatus
      scutatus.
AB  - Previously, we deduced the amino acid sequence of a novel phospholipase-A2-like
      protein (PLA2) from the nucleotide sequence of a cDNA isolated from a library
      prepared from the venom gland of the Australian elapid Notechis scutatus
      scutatus. The corresponding protein has now been identified, purified from the
      venom and named Notechis 11'2. Its complete amino acid sequence has been
      determined by automated Edman degradation of both the whole protein and peptides
      generated by Staphylococcus aureus protease digestion and chemical cleavage at a
      tryptophan residue. As predicted from its sequence which contains all the
      residues putatively required for PLA2 activity, Notechis 11'2 exhibits an
      esterase activity, preferentially against neutral phospholipids. However, despite
      its sequence homology with other highly toxic PLA2 present in the venom of
      Notechis scutatus scutatus, notechis 11'2 has no lethal activity. This
      observation further supports the view that the lethal activity of PLA2 from
      Notechis scutatus scutatus is not due to the esterasic activity only.

PMID- 1761050
TI  - Effect of N-glycan removal on the enzymatic activity of porcine thyroid
      peroxidase.
AB  - Active porcine thyroid peroxidase (pTPO) has been purified either by deoxycholate
      extraction followed by immunoaffinity purification (pTPO A) or by
      trypsin/digitonin extraction followed by ion-exchange and gelfiltration
      chromatography (pTPO B); pTPO A appeared as a full-length molecule, while pTPO B
      appeared as peptide fragments. Purified pTPO were deglycosylated either by
      peptide N-glycosidase F (PNGase F) or by endo-beta-N-acetylglucosaminidase H
      (endo H) treatment. Electrophoretic controls and affinity blotting with
      concanavalin A indicated that deglycosylation was not total and that pTPO was
      more efficiently deglycosylated by endo H than by PNGase F. The enzymatic
      activity of pTPO A, checked by guaiacol and iodide oxidation, was inhibited by
      PNGase F and endo H deglycosylation, while that of pTPO B was not. After
      deglycosylation, the apparent Km of pTPO A for guaiacol and iodide increased,
      while the Vmax for both substrates decreased. The state of aggregation of pTPO A
      before and after deglycosylation was checked by sucrose density-gradient
      centrifugation. Results indicated that this inhibition was not due to a loss of
      pTPO A solubility. These observations suggest that deglycosylation induced a
      modification of the tertiary structure of pTPO A which affected the active-site
      domain of the enzyme.

PMID- 1761051
TI  - Synthesis of dinucleoside polyphosphates catalyzed by firefly luciferase.
AB  - In the presence of ATP, luciferin (LH2), Mg2+ and pyrophosphatase, the firefly
      (Photinus pyralis) luciferase synthesizes diadenosine 5',5"'-P1,P4-tetraphosphate
      (Ap4A) through formation of the E-LH2-AMP complex and transfer of AMP to ATP. The
      maximum rate of the synthesis is observed at pH 5.7. The Km values for luciferin
      and ATP are 2-3 microM and 4 mM, respectively. The synthesis is strictly
      dependent upon luciferin and a divalent metal cation. Mg2+ can be substituted
      with Zn2+, Co2+ or Mn2+, which are about half as active as Mg2+, as well as with
      Ni2+, Cd2+ or Ca2+, which, at 5 mM concentration, are 12-20-fold less effective
      than Mg2+. ATP is the best substrate of the above reaction, but it can be
      substituted with adenosine 5'-tetraphosphate (p4A), dATP, and GTP, and thus the
      luciferase synthesizes the corresponding homo-dinucleoside
      polyphosphates:diadenosine 5',5"'-P1,P5-pentaphosphate (Ap5A), dideoxyadenosine
      5',5"'-P1,P4-tetraphosphate (dAp4dA) and diguanosine 5',5"'-P1,P4-tetraphosphate
      (Gp4G). In standard reaction mixtures containing ATP and a different nucleotide
      (p4A, dATP, adenosine 5'-[alpha,beta-methylene]-triphosphate, (Ap[CH2]pp), (S')
      adenosine-5'-[alpha-thio]triphosphate [Sp)ATP[alpha S]) and GTP], luciferase
      synthesizes, in addition to Ap4A, the corresponding hetero-dinucleoside
      polyphosphates, Ap5A, adenosine 5',5"'-P1,P4-tetraphosphodeoxyadenosine (Ap4dA),
      diadenosine 5',5"'-P1,P4-[alpha,beta-methylene] tetraphosphate (Ap[CH2]pppA), (Sp
      diadenosine 5',5"'-P1,P4-[alpha-thio]tetraphosphate [Sp)Ap4A[alpha S]) and
      adenosine-5',5"'-P1,P4-tetraphosphoguanosine (Ap4G), respectively. Adenine
      nucleotides, with at least a 3-phosphate chain and with an intact alpha
      phosphate, are the preferred substrates for the formation of the enzyme
      nucleotidyl complex. Nucleotides best accepting AMP from the E-LH2-AMP complex
      are those which contain at least a 3-phosphate chain and an intact terminal
      pyrophosphate moiety. ADP or other NDP are poor adenylate acceptors as very
      little diadenosine 5',5"'-P1,P3-triphosphate (Ap3A) or adenosine-5',5"'-P1,P3
      triphosphonucleosides (Ap3N) are formed. In the presence of NTP (excepting ATP),
      luciferase is able to split Ap4A, transferring the resulting adenylate to NTP, to
      form hetero-dinucleoside polyphosphates. In the presence of PPi, luciferase is
      also able to split Ap4A, yielding ATP. The cleavage of Ap4A in the presence of Pi
      or ADP takes place at a very low rate. The synthesis of dinucleoside
      polyphosphates, catalyzed by firefly luciferase, is compared with that catalyzed
      by aminoacyl-tRNA synthetases and Ap4A phosphorylase.

PMID- 1761052
TI  - Isolation of a novel type-I fatty-acid synthetase from Euglena gracilis. Specific
      derepression in streptomycin-bleached cells.
AB  - A novel, high-molecular-mass fatty-acid synthetase (FAS) complex has been
      isolated from streptomycin-bleached Euglena gracilis cells. The enzyme was
      purified 250-fold from the crude cell homogenate and subsequently migrated upon
      SDS/PAGE as a single band of molecular mass 270 kDa. This apparent subunit size
      of the purified protein contrasted with a smaller size of only 200 kDa which was
      exhibited by the same protein upon immunoblotting of the crude cell extract. The
      purified Euglena FAS complex cosediments in a sucrose density gradient with yeast
      FAS and, from this, both enzymes were concluded to have the same overall
      molecular mass of 2.3 MDa. The enzyme described in this paper appears to be a
      typical type-I FAS multienzyme which clearly differs from the E. gracilis FAS so
      far described. Instead, it appears to be organized structurally similar to the
      type-I FAS multienzymes of lower fungi. In vitro, the purified Euglena FAS
      complex synthesizes mainly palmitic acid, or its CoA ester, from acetyl CoA and
      malonyl CoA as substrates. The Km values for acetyl CoA and malonyl CoA are 20
      microM and 31 microM, respectively. Similar to the FAS enzymes of other lower
      eucaryotes, the Euglena type-I FAS is a flavoprotein. In contrast to yeast FAS,
      however, the flavin cofactor appears to be covalently attached to the enzyme
      protein. By immunological techniques, the enzyme was shown to be absent in green
      as well as in etiolated E. gracilis cells, while being rapidly induced upon
      streptomycin bleaching of heterotrophically growing green cells. The data suggest
      an inverse correlation between organellar development and derepression of this
      FAS complex.

PMID- 1761053
TI  - Purification and characterization of two xylanases from Trichoderma
      longibrachiatum.
AB  - Two endoxylanases were purified from the culture medium of Trichoderma
      longibrachiatum. Both enzymes were highly basic, and lacked activity on
      carboxymethyl-cellulose. An enzyme of 21.5 kDa (xylanase A) had a specific
      activity of 510 U/mg protein, a Km of 0.15 mg soluble xylan/ml, possessed
      transglycosidase activity and generated xylobiose and xylotriose as the major
      endproducts from xylan or xylose oligomers. A larger enzyme of 33 kDa (xylanase
      B) had a specific activity of 131 U/mg protein, a Km of 0.19 mg soluble xylan/ml,
      lacked detectable transglycosidase activity and generated xylobiose and xylose as
      major endproducts from xylan and xylose oligomers. Xylotriose was the smallest
      oligomer attacked by both enzymes. In addition, xylotriose inhibited hydrolysis
      of xylopentanose by both enzymes, while xylobiose appeared to inhibit xylanase B,
      but not xylanase A.

PMID- 1761054
TI  - Heparinase II from Flavobacterium heparinum. HPLC analysis of the saccharides
      generated from chemically modified heparins.
AB  - Saccharides produced by the action of heparinase II on native pig mucosal heparin
      (heparin IS), de-N-sulphated heparin (heparin IH), N-acetylheparin (heparin IA),
      de-N/O-sulphated heparin (heparin IVH), de-O-sulphated heparin (heparin IVS) and
      de-O-sulphated N-acetylheparin (heparin IVA) were analysed by reversed-phase HPLC
      using Spherisorb ODS2. Fractions obtained by gel filtration with Bio-Gel P-4 were
      similarly examined. Heparin IS gave delta UA-2S----GlcNS-6S (IS) as the major
      unsaturated disaccharide and lesser amounts of delta UA----GlcNS-6S (IIS), delta
      UA-2S----GlcNS (IIIS), delta UA----GlcNS (IVS), delta UA-2S----GlcNAc-6S (IA),
      delta UA----GlcNAc-6S (IIA), delta UA-2S----GlcNAc (IIIA) and delta UA----GlcNAc
      (IVA). Heparins IA, IVA and IVS gave as the predominant unsaturated disaccharide
      that corresponding to the major repeat structure of the polymer. These were
      respectively delta UA-2S----GlcNAc-6S (IA), delta UA-GlcNAc (IVA) and delta UA---
      GlcNS (IVS). Minor disaccharides from the heterogeneous structure in native pig
      heparin and from residual O-sulphates after the de-O-sulphating process were
      detected. Heparin IH was degraded more slowly than any of the N-substituted
      heparins. The predominant unsaturated disaccharide was IH, which was derived from
      the major repeating unit. In addition, disaccharides IIH, IIIH, IA, IIA and IVA
      were detected. Heparin IVH showed little degradation, the unsaturated
      disaccharide IVH not being detected after 24 h. Disaccharide IVA was obtained
      from the heterogeneous sequence in heparin IVH. Several higher oligosaccharides
      were identified in the gel-filtration fractions including saccharides from the
      linkage region (for heparin IS and IVA) and the anti-thrombin binding site (for
      heparin IS only). A tetrasaccharide and hexasaccharide, with the structures delta
      UA----GlcNAc----UA----GlcNAc and delta UA----GlcNAc----UA----GlcNAc----UA---
      GlcNAc, were present in the HPLC profiles of heparins IA and IVA.

PMID- 1761055
TI  - Volume changes in high-affinity calcium binding of the sarcoplasmic reticulum
      calcium-transport enzyme.
AB  - The effect which hydrostatic pressure exerts on the hydrolysis of dinitrophenyl
      phosphate and nitrophenyl phosphate by the sarcoplasmic reticulum calcium
      transport enzyme was determined. Activation volumes for substrate hydrolysis at
      saturating and non-saturating concentrations of calcium were determined and used
      to evaluate volume increments for initial calcium binding. A reaction scheme in
      which two unidirectional substrate-driven reactions transfer high-affinity into
      low-affinity calcium-binding sites was applied to determine binding-volume
      increments. It has been inferred from the pressure dependence of the volume
      generating function, defined as the difference between the reciprocal reaction
      rates of the saturated and the unsaturated enzyme, that calcium binding proceeds
      in two steps. The two associated binding constants are endowed with large binding
      volume increments of opposite signs (+84 to +207 ml/mol and -3 to -136 ml/mol).
      Under different experimental conditions, with respect to the temperature, degree
      of calcium saturation and absence or presence of Me2SO, they add up to the same
      integral volume increment of 73 +/- 3.5 ml/mol for the entry of two calcium ions
      into the reaction cycle. In aqueous media, the two binding constants contribute
      about equally to binding and to the observed binding-volume increment. The
      presence of Me2SO strongly favours the first binding step. The size of the
      integral volume increment is in line with that determined for the interaction of
      calcium with calmodulin [Kupke, D.W. & Dorrier, T.E. (1986) Biochem. Biophys.
      Res. Commun. 38, 199-204].

PMID- 1761056
TI  - The medium chains of the mammalian clathrin-associated proteins have a homolog in
      yeast.
AB  - We have cloned and sequenced mouse brain AP47, the medium chain of the trans
      Golgi network clathrin-associated protein complex AP-1. The predicted protein
      sequence of AP47 is closely related to rat and calf brain AP50, the corresponding
      medium chain of the plasma-membrane clathrin-associated protein complex AP-2. We
      have also identified in the yeast genome an open reading frame encoding a protein
      of previously unknown function. Referred to here as YAP54, its predicted protein
      sequence displays a striking homology to AP47. We therefore propose that Yap54 is
      the medium chain subunit of a putative AP-1 complex in yeast. From the analyses
      of the optimized sequence alignments of AP47, AP50 and Yap54p, we suggest a model
      for the domain organization of the medium chains.

PMID- 1761057
TI  - Expression and post-transcriptional regulation of ornithine decarboxylase during
      early Xenopus development.
AB  - In this paper we show that large changes in ornithine decarboxylase (ODC)
      activity occurred during early Xenopus development. Following fertilization, this
      enzyme activity rises with a quantitatively correlated accumulation of putrescine
      and spermidine. This increase in ODC activity was associated with an increased
      translation of the maternal ODC mRNA, which was stable in the embryo and whose
      polyadenylation increased slightly between fertilization and the mid-blastula
      transition (MBT). ODC activity was stable in cycloheximide-treated embryos,
      indicating that before the MBT this enzyme was not degraded. After the MBT, ODC
      activity fell, but no decrease in this mRNA was observed. In gastrulae, ODC mRNA
      was both increased in amount and polyadenylated. The reduced ODC activity at this
      stage of development was not associated with a fall in ribosome loading of the
      mRNA. Treatment of post-MBT embryos with cycloheximide lead to an accentuation of
      the normally observed decrease in ODC activity. Expression of Xenopus ODC in
      mutant ODC-deficient Chinese hamster ovary cells (C 55.7 cells) showed that the
      Xenopus enzyme was rapidly degraded and can be regulated post-translationally by
      polyamines, indicating that the post-MBT fall in ODC activity could be caused by
      a change in protein turnover or by polyamine-mediated regulation.

PMID- 1761058
TI  - Mollusc-specific toxins from the venom of Conus textile neovicarius.
AB  - Three peptide toxins exhibiting strong paralytic activity to molluscs, but with
      no paralytic effects on arthropods or vertebrates, were purified from the venom
      of the molluscivorous snail Conus textile neovicarius from the Red Sea. The amino
      acid sequences of these mollusc specific toxins are: TxIA, WCKQSGEMCNLLDQNCCDGYCI
      VLVCT (identical to the so called 'King Kong peptide'); TxIB,
      WCKQSGEMCNVLDQNCCDGYCIVFVCT; TxIIA, WGGYSTYC gamma VDS gamma CCSDNCVRSYCT (gamma
      = gamma-carboxyglutamate). There is a similarity of the Cys framework of these
      toxins to that of the omega-conotoxins; however, their net negative charges, high
      content of hydrophobic residues and uneven number of Cys residues in TxIIA, are
      highly unusual for conotoxins. When assayed on isolated cultured Aplysia neurons,
      all three toxins induced membrane depolarization and spontaneous repetitive
      firing. The TxI toxins also induce a marked prolongation of the action potential
      duration, which is sodium dependent. These effects differ significantly from the
      blocking activities of piscivorous venom conotoxins. These mollusc specific
      conotoxins may therefore serve as new and selective probes for ion-channel
      functions in molluscan neuronal systems.

PMID- 1761059
TI  - Disulfide-bonded dimerization of fibronectin in vitro.
AB  - Human plasma fibronectin was denatured with 8 M urea and reduced with
      dithiothreitol. Dialysis or dilution of the solution led to formation of
      fibronectin dimers which migrated in non-reducing SDS/PAGE similarly to untreated
      control protein. When the redimerized fibronectin was reduced and re
      electrophoresed it formed a doublet of alpha and beta chains of equal intensity
      indicating that it was a heterodimer. Low concentrations (less than 1 mM) of Fe3+
      enhanced the redimerization of fibronectin, suggesting that metal ions may
      mediate oxidative reactions in the formation of the disulfides. Consequently,
      redimerization of fibronectin was completely prevented by deferoxamine, an iron
      chelator. Dimerization of fibronectin took place most effectively at pH greater
      than or equal to 8.8 but decreased strongly at lower pH, representing more
      unfavourable conditions for the action of the thiolate anion in the
      thiol/disulfide exchange reaction. Redimerized fibronectin, however, lost many of
      its binding properties to macromolecular ligands, suggesting that the disulfide
      bonding did not entirely regenerate the proper conformation of the protein.
      Pulse/chase experiments of fibroblast cultures showed that the initially
      monomeric fibronectin was rapidly and quantitatively dimerized under conditions
      representing natural pH and environment. SDS/PAGE analysis of the dialyzed urea
      denatured/reduced thrombin and plasmin digests of fibronectin revealed that the
      NH2-terminal 30-kDa fragment and other fragments that contained intrachain
      disulfides quantitatively regained their non-reduced electrophoretic mobility.
      The results show that the dimerization and formation of intrachain disulfides of
      fibronectin may occur, in part, spontaneously, based on the amino acid sequence
      information of the protein. However, complete disulfide formation may also need
      other factors, present only in living cells, as suggested by pulse/chase
      experiments in fibroblasts.

PMID- 1761060
TI  - Temperature dependence of charge recombination from the P+QA- and P+QB- states in
      photosynthetic reaction centers isolated from the thermophilic bacterium
      Chloroflexus aurantiacus.
AB  - The temperature dependence of charge recombination from the P+QA- and from the
      P+QB- states produced by a flash was studied in reaction centers isolated from
      the photosynthetic thermophilic bacterium Chloroflexus aurantiacus. P designates
      the primary electron donor; QA and QB the primary and secondary quinone electron
      acceptors respectively. In QB-depleted reaction centers the rate constant (kAP)
      for P+QA- recombination was temperature independent between 0-50 degrees C (17.6
      +/- 0.7 s-1 at pH 8 and pH 10). The same value was obtained in intact membranes
      in the presence of o-phenanthroline. Upon lowering the temperature from 250 K to
      160 K, kAP increased by a factor of two and remained constant down to 80 K. The
      overall temperature dependence of kAP was consistent with an activationless
      process. Ubiquinone (UQ-3) and different types of menaquinone were used for QB
      reconstitution. In UQ-3 reconstituted reaction centers charge recombination was
      monoexponential (rate constant k = 0.18 +/- 0.03 s-1) and temperature independent
      between 5-40 degrees C. In contrast, in menaquinone-3- and menaquinone-4
      reconstituted reaction centers P+ rereduction following a flash was markedly
      biphasic and temperature dependent. In menaquinone-6-reconstituted reaction
      centers a minor contribution from a third kinetic phase corresponding to P+QA-
      charge recombination was detected. Analysis of these kinetics and of the effects
      of the inhibitor o-phenanthroline at high temperature suggest that in detergent
      suspensions of menaquinone-reconstituted reaction centers a redox reaction
      removing electrons from the quinone acceptor complex competes with charge
      recombination. Instability of the semiquinone anions is more pronounced when QB
      is a short-chain menaquinone. From the temperature dependence of P+ decay the
      activation parameters for the P+QB- recombination and for the competing side
      oxidation of the reduced menaquinone acceptor have been derived. For both
      reactions the activation enthalpies and entropies change markedly with
      menaquinone chain length but counterbalance each other, resulting in activation
      free energies at ambient temperature independent of the menaquinone tail. When
      reaction centers are incorporated into phospholipid vesicles containing
      menaquinone-8 a temperature-dependent, monophasic, o-phenanthroline-sensitive
      recombination from the P+QB- state is observed, which is consistent with the
      formation of stable semiquinone anions. This result seems to indicate a proper QB
      functioning in the two-subunit reaction center isolated from Chlorflexus
      aurantiacus when the complex is inserted into a lipid bilayer.

PMID- 1761061
TI  - Primary structure and processing of the Candida tsukubaensis alpha-glucosidase.
      Homology with the rabbit intestinal sucrase-isomaltase complex and human
      lysosomal alpha-glucosidase.
AB  - The nucleotide sequence of a 4.39-kb DNA fragment encoding the alpha-glucosidase
      gene of Candida tsukubaensis is reported. The cloned gene contains a major open
      reading frame (ORF 1) which encodes the alpha-glucosidase as a single precursor
      polypeptide of 1070 amino acids with a predicted molecular mass of 119 kDa. N
      terminal amino acid sequence analysis of the individual subunits of the purified
      enzyme, expressed in the recombinant host Saccharomyces cerevisiae, confirmed
      that the alpha-glucosidase precursor is proteolytically processed by removal of
      an N-terminal signal peptide to yield the two peptide subunits 1 and 2, of
      molecular masses 63-65 kDa and 50-52 kDa, respectively. Both subunits are
      secreted by the heterologous host S. cerevisiae in a glycosylated form.
      Coincident with its efficient expression in the heterologous host, the C.
      tsukubaensis alpha-glucosidase gene contains many of the canonical features of
      highly expressed S. cerevisiae genes. There is considerable sequence similarity
      between C. tsukubaensis alpha-glucosidase, the rabbit sucrase-isomaltase complex
      (proSI) and human lysosomal acid alpha-glucosidase. The cloned DNA fragment from
      C. tsukubaensis contains a second open reading frame (ORF 2) which has the
      capacity to encode a polypeptide of 170 amino acids. The function and identity of
      the polypeptide encoded by ORF 2 is not known.

PMID- 1761062
TI  - Sequence-specific complex formation of DNA and a eukaryotic sequence-specific
      endonuclease, SceI.
AB  - Endo.SceI is a eukaryotic sequence-specific endonuclease of 120 kDa that causes
      sequence-specific double-stranded scission of DNA. Unlike results with
      restriction enzymes, we found a consensus sequence around the cleavage sites for
      Endo.SceI instead of a common sequence. We searched for conditions for studying
      the binding of Endo.SceI to DNA other than cutting. Under optimized conditions
      including gel mobility shift assay, Endo.SceI exhibited sequence-specific binding
      to a short double-stranded DNA (41 base pairs) containing a cleavage site and the
      DNA reisolated from the protein-DNA complex was not cleaved. The analysis of the
      complex of Endo.SceI and DNA isolated by the gel mobility shift experiments
      showed that the DNA-binding entity in the Endo.SceI preparation does have
      Endo.SceI activity and consists of an equal amount of 75-kDa and 50-kDa
      polypeptides. Based on this observation and those from previous studies, we
      conclude that Endo.SceI is a heterodimer of the 75-kDa and 50-kDa subunits. Under
      the present assay conditions, Endo.SceI did not show binding to single-stranded
      DNA having the same sequence of either plus or minus strand of the double
      stranded DNA containing the cleavage site (the 41-bp DNA). Endo.SceI showed
      significantly higher affinity for the consensus sequence than the major cleavage
      site in pBR322 DNA. Unlike the cleavage of DNA by Endo.SceI which requires Mg2+,
      this sequence-specific binding is independent of but stimulated by Mg2+.

PMID- 1761063
TI  - Purification and characterization of the cytosolic NADP(+)-dependent malic enzyme
      from human breast cancer cell line.
AB  - Cytosolic NADP(+)-dependent malic enzyme from a cultured human breast cancer cell
      line was purified to near homogeneity by two highly efficient chromatography
      systems: Pharmacia-LKB Q-Sepharose anion-exchange chromatography and adenosine
      2',5'-bisphosphate-agarose affinity chromatography. The overall yield was 27%.
      The enzyme is presumably a tetramer composed of four probably identical subunits
      of Mr 65,000, which is similar to the enzyme from other sources. The pI and
      optimum reaction pH values for the tumor malic enzyme are 5.5 and 7.2,
      respectively. At pH 6.9, most of the enzyme exists as monomers. Activation energy
      for the enzyme-catalyzed oxidative-decarboxylation reaction is 57.4 kJ/mol. The
      enzyme is strictly NADP+ dependent, as NAD+ cannot support the oxidative
      decarboxylation reaction. ATP at low concentration inhibits the enzyme activity.
      Fumarate at concentrations up to 5 mM does not affect the enzymatic reaction
      rate. Therefore the tumor cytosolic malic enzyme, unlike the mitochondrial malic
      enzyme, is not an allosteric regulatory enzyme.

PMID- 1761064
TI  - The pharmaceutical physician--requirements for the position.
AB  - Physicians looking for a position as pharmaceutical physician are usually
      uncertain whether they are suitable for this activity by training and personal
      abilities. The main requirements are a major interest in therapeutics and
      research as well as the ability to treat a disease as an entity instead of the
      individual patient. The pharmaceutical physician is a specialist in the area of
      drug development. Even by treating populations and diseases his ultimate goal is
      to contribute to better care for the individual patient. Requirements for
      training and the personal abilities necessary for the position of a
      pharmaceutical physician are described and recommendations given for applicants.

PMID- 1761065
TI  - Influence of short term verapamil treatment on glucose metabolism in patients
      with non-insulin dependent diabetes mellitus.
AB  - The effect of a sustained-release verapamil preparation on glucose metabolism was
      investigated in 10 patients with non-insulin dependent diabetes mellitus. In a
      single blind cross-over study verapamil 240 mg b.d. for 1 week lowered fasting
      plasma glucose from a mean value of 11.6 mmol/l to 10.3 mmol.l-1, and the fasting
      glucose appearance rate was decreased from 1.5 to 1.2 mmol.min-1. The decrease in
      fasting plasma glucose and glucose appearance rate was not related to the steady
      state plasma concentration of verapamil, nor-verapamil and the metabolites D.617
      and D.620. After oral glucose administration a tendency to lower plasma glucose
      values was found after verapamil administration. Plasma insulin, C-peptide, total
      and C-terminal glucagon were not significantly different in the placebo and the
      verapamil studies, neither in the fasting state nor after glucose. It is
      concluded that brief verapamil treatment decreases fasting plasma glucose and
      glucose turn-over in non-insulin dependent diabetics, possibly by inhibition of
      gluconeogenesis.

PMID- 1761066
TI  - Effects of captopril on diabetic nephropathy in hypertensive women.
AB  - The effects of the angiotensin converting enzyme inhibitor captopril on blood
      pressure, proteinuria, creatinine clearance and metabolic control in diabetic
      nephropathy have been evaluated. Captopril 144 mg per day was given to 8
      longstanding, insulin-dependent, diabetic females with nephropathy. The blood
      pressure was significantly reduced (systolic 45.4, diastolic pressure 30.6 and
      mean arterial pressure 33.8 mm Hg after 24 weeks of treatment). Plasma renin
      activity rose significantly from a basal value of 1.60 to 6.71 ng.ml-1.h-1, and
      so did serum potassium (from 4.57 to 4.83 mEq.1-1). Serum aldosterone fell from
      161 to 70.9 pgm.ml-1 and from 27.3 to 15.3 micrograms.24 h-1 in plasma and urine,
      respectively, after 6 months on captopril therapy. Urinary protein excretion was
      decreased by about 48% and creatinine clearance remained unchanged throughout the
      study. Plasma triglycerides and cholesterol also remained unchanged, and
      glycosylated haemoglobin was significantly reduced from 13.8 to 10.2% after
      captopril. The results suggest that captopril is a useful drug to treat
      hypertension in patients suffering from diabetic nephropathy, as the decline in
      kidney function can be reduced without impairing glucose tolerance or the lipid
      profile.

PMID- 1761067
TI  - Effect of nifedipine on glucose potentiation of the acute insulin response to
      arginine in non-insulin-dependent diabetics.
AB  - The effect of 7-days of nifedipine treatment on insulin secretion has been
      analyzed in hypertensive patients with non-insulin-dependent mellitus (NIDDM).
      Pancreatic beta-cell function was assessed as insulin release following
      stimulation with arginine after potentiation by hyperglycaemia. Two groups of 5
      patients with NIDDM (fasting blood glucose 139.2 mg.dl-1), on the same controlled
      diet, were compared; one was treated with nifedipine 30 mg per d and the other
      was the control. The mean blood pressure in the nifedipine group decreased (110
      vs 102 mm Hg). Fasting blood glucose and basal plasma insulin were not affected
      by nifedipine. The acute insulin response (AIR) to 5 g arginine after
      potentiation by hyperglycaemia (clamped at 240 and 350 mg/dl for 30 min) was
      significantly (P less than 0.05) decreased, as well as the potentiation slope
      (line relating AIR and plasma glucose level) in those patients, and were
      unchanged in the control group. Thus, nifedipine may impair insulin secretion at
      high glucose levels in patients with NiDDM.

PMID- 1761068
TI  - Role of altered prednisolone-specific lymphocyte sensitivity in chronic renal
      failure as a pharmacodynamic marker of acute allograft rejection after kidney
      transplantation.
AB  - The effects of four immunosuppressive agents on the in vitro blastogenesis of
      peripheral blood lymphocytes activated by concanavalin A have been studied using
      cells from 26 healthy subjects, 34 patients with chronic renal failure (CRF) and
      30 kidney transplant recipients. Differences in lymphocyte sensitivity to
      prednisolone between the healthy subjects and the CRF patients were statistically
      significant (P less than 0.0002), with impaired sensitivity in CRF. Impaired
      lymphocyte sensitivity occurred in 3.8% and 52.9% of the healthy and CRF
      subjects, respectively. Lymphocyte sensitivity to prednisolone, both
      preoperatively and 3 months post-operatively, was strongly correlated with early
      allograft rejection during co-administration of prednisolone with cyclosporin or
      azathioprine. Lymphocyte sensitivity to cyclosporin, azathioprine, and mizoribine
      in CRF was not significantly less than that in healthy subjects. Since the
      pharmacokinetics of prednisolone are little altered in renal transplantation, it
      is concluded that lymphocyte sensitivity specific to prednisolone may be a
      pharmacodynamic marker characteristic of successful graft survival in patients
      with histo-incompatibility and/or drug resistance.

PMID- 1761069
TI  - Diurnal variation of methotrexate disposition in children with acute leukaemia.
AB  - There is recent evidence that survival is improved when maintenance therapy for
      acute lymphocytic leukaemia in children is given at night. We have examined the
      possibility that diurnal variation in methotrexate pharmacokinetics may
      contribute to this improvement. In 6 children with leukaemia there was a
      significant fall in methotrexate plasma clearance at night (from 5.6 to 4.7 ml.kg
      1.min-1). Renal clearance of methotrexate tended to fall at night and unbound
      renal clearance fell significantly (from 17.5 to 8.5 ml.min-1.kg-1 P less than
      0.05). Creatinine clearance did not exhibit diurnal variation, whereas there was
      a significant fall in the non-glomerular clearance of methotrexate (from 14.8 to
      6 ml.min-1.kg-1). Since methotrexate is a weak organic acid, its tubular
      secretion depends on urinary pH. At night urinary pH is more acidic, and this may
      result in more reabsorption and hence reduced renal clearance.

PMID- 1761070
TI  - Pharmacodynamics of ticlopidine in man in relation to plasma and blood cell
      concentration.
AB  - In 6 normal volunteers given single oral doses of 250,500 and 1000 mg ticlopidine
      (T), the peak plasma level of unchanged drug was reached after about 2 h. There
      was no correlation between the plasma T level and its inhibitory effect on
      platelet function, expressed as % inhibition of ADP-induced aggregation. By means
      of HPLC and GC/MS significant concentrations of T were demonstrated in washed red
      cells, platelets and neutrophils, with a marked difference in the time course of
      the appearance of cell-associated drug. The time course of platelet-associated T
      very accurately fitted that of the antiaggregatory activity. After subacute oral
      administration (250 mg b.d. for 7 days), the maximum effect on platelet function
      was observed after 3 to 4 days, when a significant concentration of platelet
      associated T had been reached. The pharmacological effect persisted as long as
      drug was detectable in platelet. An in vitro study strongly suggested that the
      antiaggregating effect was retained by treated washed platelets but not by
      treated plasma. It is suggested that the platelet compartment represents the
      pharmacological target of T via a specific uptake system.

PMID- 1761071
TI  - Drug-prescribing patterns in old age. A study of the impact of hospitalization on
      drug prescriptions and follow-up survey in patients 75 years and older.
AB  - A prospective drug surveillance study was undertaken in 300 elderly patients
      admitted to a geriatric clinic. Prescribing patterns were determined on
      admission, at discharge and 3.6 and 18 months after discharge. Patients referred
      from long-term care institutions were on significantly more drugs than non
      institutionalized subjects. A 34% reduction in the number of medicines prescribed
      at discharge was accompanied by a significant decrease in the mean number of
      prescriptions per patient, from 4.3 to 2.8, irrespective of whether the patient
      was institutionalized. Polypharmacy, defined by 5 or more concomitant drugs,
      declined from 43 to 17%. Dosage schedules were simplified in the majority of
      patients, as expressed by a significant decrease in the mean number of daily
      doses to be taken from 6.7 on admission to 4.4 at discharge. Cardiovascular
      drugs, diuretics and psychotropic drugs accounted for 64% of all drug
      prescriptions. At discharge, prescription frequencies were reduced for most
      medication categories, except diuretics and gastrointestinal drugs, which were
      being taken more often. The prescribing frequency of cardiac glycosides, the
      single most frequently prescribed drug class, decreased from 60 to 33% of the
      patients. Three months after discharge, prescribing patterns and frequencies were
      found to be very similar to the pre-admission situation. Eighteen months after
      discharge, overall drug use had increased by 15% compared to admission, and
      polypharmacy was recorded in 54% of patients. It is concluded that a substantial
      reduction in drug prescriptions was possible in the majority of elderly patients,
      particularly if they are institutionalized, on admission to a geriatric
      clinic.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761072
TI  - Pharmacokinetics of caffeine in patients with decompensated type I and type II
      diabetes mellitus.
AB  - Diabetes may alter the pharmacokinetics of aminopyrine and antipyrine, which are
      used to assess liver function. Caffeine has recently been used to test liver
      function, but the effect of diabetes on caffeine kinetics is not known. The
      kinetics of caffeine has been examined in patients with decompensated Type I and
      Type II diabetes and in two age- and sex-matched control groups. In both types of
      diabetes the apparent caffeine clearance, half-life, and apparent volume of
      distribution were similar to controls. It is concluded that decompensated
      diabetes does not influence the cytochrome P-448 mono-oxygenase system
      responsible for caffeine metabolism.

PMID- 1761073
TI  - Clinical and pharmacokinetic comparison of oral and duodenal delivery of
      levodopa/carbidopa in patients with Parkinson's disease with a fluctuating
      response to levodopa.
AB  - The clinical effects and pharmacokinetics of orally and intraduodenally
      administered levodopa, in four patients with Parkinson's disease have been
      compared. The patients had unpredictable fluctuations in motor function and
      episodic unresponsiveness to single doses of levodopa. The pharmacokinetic and
      clinical data of these patients were compared retrospectively with those of
      Parkinsonian patients with fluctuations in motor performance but with preserved
      clinical responses to single oral doses of levodopa. There was a threshold plasma
      concentration of levodopa associated with the "switch on or off" effect. In
      addition, rapid attainment of this critical plasma concentration was associated
      with a quicker onset of action and a more prolonged clinical response. All the
      patients had delayed absorption of levodopa related to delayed and erratic
      gastric emptying, which contributed to the fluctuation in motor response. In
      contrast, the patients with fluctuating motor effects but a preserved clinical
      response after levodopa showed an absorption pattern comparable to that of four
      patients studied after duodenal delivery of levodopa. It is suggested that there
      is a subgroup of patients with fluctuating responses due mainly to altered
      peripheral pharmacokinetics of levodopa. The findings demonstrate the relevance
      of routine measurements of plasma levodopa in patients with Parkinson's disease
      in whom there are fluctuations in motor performance.

PMID- 1761074
TI  - Effect of duration of levodopa/decarboxylase inhibitor therapy on the
      pharmacokinetic handling of levodopa in elderly patients with idiopathic
      Parkinson's disease.
AB  - We address, from a pharmacokinetic viewpoint, the important question of why some
      patients with clinical idiopathic Parkinson's disease experience a fall off in
      benefit from levodopa maintenance therapy. Thirteen such patients, of mean age 78
      y, without overt fluctuations in motor control in temporal relation to dosing
      with a levodopa/decarboxylase inhibitor combination, were studied. Levodopa
      (currently 400 to 800 mg daily) had been started at between 61 and 81 y of age,
      the mean duration of therapy being 54 months. Plasma concentrations of levodopa
      and its peripheral metabolite, 3-0-methyldopa, were measured before a morning
      dose of levodopa (100 mg)/carbidopa (25 mg) and at hourly intervals for 6 h
      after. There was a significant negative regression between duration of levodopa
      therapy (but not age or severity of disease) and the area under the plasma
      concentration/time curve (AUC) for levodopa attributed to the test dose. A
      significant negative regression was also seen of duration of therapy on the dose
      absorbed per unit distribution volume, but not on the elimination rate constant,
      indicating a decrease in bioavailability and/or an increase in distribution
      volume with duration. There was a tendency for the plasma 3-0-methyldopa
      concentration, standardised for daily dose, [30MD], to increase with duration of
      therapy. Although, the regression of duration on [30MD] did not reach statistical
      significance, that on the ratio, [30 MD]/AUC, did so at the 0.01 level. The
      amount by, and time for which, the plasma levodopa concentration exceeds any
      critical threshold for the competitive active uptake process into the brain may
      thus decrease with duration of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761075
TI  - Effect of age on the pharmacokinetics of oral levodopa in patients with
      Parkinson's disease.
AB  - The influence of age on the kinetics of a standard oral dose of levodopa
      administered with an inhibitor of peripheral dopa decarboxylase enzymes
      (benserazide) has been evaluated in 40 patients with Parkinson's disease (age 34
      78 y) on chronic therapy. They were divided into 2 groups, on the basis of age
      below (21 patients, Group A) or above (19 patients, Group B) 65 y. The area under
      the plasma concentration-time curve (AUC) of levodopa was significantly greater
      in the older group (547 versus 428 mumol.l-1.min in Group B), coupled with a
      reduced apparent oral clearance (8.1 versus 10.7 ml.min-1.kg-1) and a longer
      plasma elimination half-life (67.6 versus 54.6 min). The age of the patients was
      positively correlated with the AUC of levodopa (r = 0.474) and its plasma
      elimination half-life (r = 0.391), and was negatively correlated with clearance
      (r = -0.489). The findings confirm previous data on volunteers that showed a
      reduction in the systemic clearance of levodopa due to age, which would probably
      account for the finding of a greater AUC of levodopa in older patients. The
      observed, age-mediated differences in levodopa pharmacokinetics, albeit
      statistically significant, were moderate and were likely to be of only minor
      importance for the dosing schedule.

PMID- 1761076
TI  - Quinidine but not quinine inhibits in man the oxidative metabolic routes of
      methoxyphenamine which involve debrisoquine 4-hydroxylase.
AB  - Healthy male volunteers (n = 13) took a single oral dose of 60.3 mg of
      methoxyphenamine HCl with and without prior administration of either quinidine
      (250 mg as bisulphate salt) or its diastereomer quinine (300 mg as sulphate
      salt). Methoxyphenamine and its N-desmethyl, O-desmethyl and aromatic 5-hydroxy
      metabolites were quantified in the 0-32 h urine. The oxidative routes of
      methoxyphenamine metabolisms which had been previously shown to involve
      debrisoquine 4-hydroxylase, namely O-demethylation and 5-hydroxylation were both
      significantly inhibited by quinidine in the 12 extensive metabolizers. The
      inhibition was selective in that N-demethylation which does not involve this
      isozyme was not affected by quinidine. In all but one of these volunteers the
      methoxyphenamine/O-desmethylmethoxyphenamine ratio changed such that extensive
      metabolizers could be classified as poor metabolizers due to quinidine
      pretreatment. No marked change occurred in the renal excretion of
      methoxyphenamine and its three metabolites either in the extensive metabolizers
      because of quinine pretreatment or in the poor metabolizer because of treatment
      with either quinidine or quinine. Thus in the extensive metabolizer phenotype it
      was demonstrated in one study that enzyme inhibition of quinidine was selective
      in terms of the metabolic pathways inhibited as well as stereoselective with
      respect to the inhibitor.

PMID- 1761077
TI  - Comparison of in vitro and in vivo biotransformation in patients with liver
      disease of differing severity.
AB  - The activity of 7-ethoxycoumarin O-deethylase (ECOD) has been measured in liver
      biopsy samples from 23 patients (smokers and non-smokers) with different degrees
      of structural liver damage. The results, which reflect in vitro cytochrome P450
      dependent biotransformation, were correlated with various measures of the P450
      dependent in vivo elimination of caffeine and metamizol. The relatively non
      specific, low affinity component of ECOD activity was significantly correlated
      with the kinetics of metamizol (mean residence time, apparent clearance, half
      life, area under the concentration-time curve, and metabolite excretion in the
      urine). Thus, metamizol elimination, which is mainly due to P450 IIB, and the low
      affinity component of ECOD both reflect, at least in part, the activity of the
      same form of P450. In contrast, caffeine biotransformation, which is via P450 IA,
      was not correlated with ECOD activity. There was no relation between the kinetics
      of metamizol and caffeine, perhaps because of the inducing effect that smoking
      has on caffeine elimination. In patients with liver disease, smoking appears to
      alter the elimination of caffeine more than the degree of liver disease.

PMID- 1761078
TI  - Enantioselective steady-state kinetics of unbound disopyramide and its
      dealkylated metabolite in man.
AB  - Disopyramide is provided as a racemic mixture of R and S enantiomers, which have
      different pharmacodynamic and pharmacokinetic characteristics. Five volunteers
      were given racemic disopyramide 100 mg and 200 mg t.d.s. in a cross-over design.
      Plasma and urine concentrations of disopyramide and its active metabolite
      monodesisopropyl-disopyramide (MND) were determined at steady state by an
      enantioselective HPLC method. Unbound drug in plasma was measured after
      ultrafiltration. There was enantioselective clearance of unbound disopyramide
      (0.39 l.h-1.kg-1 for R-disopyramide and 0.58 l.h-1.kg-1 for S-disopyramide after
      100 mg t.d.s.). The enantioselectivity was due to differences in the metabolism
      of disopyramide to MND and in further non-renal clearance, and the renal
      clearance of disopyramide was not enantioselective. The in vivo protein binding
      of disopyramide, which was saturable for both enantiomers, was also
      enantioselective. The difference in binding of the two enantiomers was explained
      by a difference in apparent binding capacity rather than in apparent binding
      affinity. The renal clearance of S-MND was significantly higher than R-MND (0.29
      and 0.19 l.h-1.kg-1, respectively, after 100 mg t.d.s.). The renal clearance of
      MND also showed a tendency to saturation at higher concentrations.

PMID- 1761079
TI  - Dose-proportionality of eltoprazine. Pharmacokinetics of single oral doses in
      healthy subjects.
AB  - Eltoprazine. HCl belongs to a new class of psychotropic drug, the serenics. The
      dose-proportionality and pharmacokinetics of eltoprazine HCl has been
      investigated after single oral doses of 5, 10, 20 mg (18 subjects) and 30 mg (12
      subjects) in a partly randomized, cross-over design. Eltoprazine was well
      tolerated and there were no relevant changes in safety parameters. All subjects
      showed irregular plasma-concentration-time profiles, some subjects demonstrating
      secondary peaks. The mean half-life was calculated to be about 6.5 h. The renal
      excretion of eltoprazine was characterized by net tubular secretion. AUC, peak
      plasma concentrations and the amount excreted unchanged in the urine were
      linearly related to the dose. Renal clearance and t1/2 were independent of dose.
      Thus, eltoprazine HCl was well tolerated orally and exhibited a linear
      pharmacokinetic profile.

PMID- 1761080
TI  - Drug prescription in young children: results of a survey in France. Epicreche
      Research Group.
AB  - A 8.5-month prospective study was performed in the Rhone area of France to study
      the incidence of infectious diseases in children in day care, and the qualitative
      and quantitative aspects of drug prescriptions for young children. The families
      of 1.359 children agreed to participate (98.5% of those selected). During the
      follow-up period 3.605 infections episodes were reported and 10.706 medications
      were used, an average of 3.0 medications per episode. Antibiotics were used in
      the treatment of 2.333 infectious episodes (65%) amoxycillin (36%), cephalosporin
      (23%), macrolide (17%) and trimethoprim-sulphamethoxazole (9%). Acetylsalicylic
      acid and paracetamol were used 865- and 1.568-times, respectively. Drugs with
      multi-active components represented 11.3% of the total number of systemic
      medicines reported. Paracetamol was prescribed in 59% of cases in a multi-active
      component drug, whereas this type of product accounted for 83.5% of the
      antihistamines (used 932-times). The rationale behind the paediatric prescribing
      habits of French medical doctors is discussed in relation to results previously
      obtained in other European countries.

PMID- 1761081
TI  - Relation between plasma concentration and clinical efficacy after sublingual
      single dose apomorphine in Parkinson's disease.
AB  - Five patients with Parkinson's disease were given a single sublingual dose of
      apomorphine in 3 mg tablets (2 patients received 18 mg and 3 patients took 39
      mg). The therapeutic effect appeared within 33.0 min and lasted 137 min. There
      was a significant correlation between peak concentration, area under the curve,
      dose (mg/kg) and the duration of the therapeutic effect.

PMID- 1761082
TI  - Pharmacokinetics of oral salbutamol controlled-release in Asian patients with
      asthma.
AB  - Using a double blind, double dummy crossover design, single dose and steady state
      pharmacokinetics of oral controlled release (SCR) salbutamol 4 mg and 8 mg
      tablets b.d. has been studied in 8 Asian patients. Plasma salbutamol was measured
      over 12 h. In 8 patients the single dose mean Cmax was 4.2 ng.ml-1 and 7.7 ng.ml
      1 after 4 and 8 mg, respectively. In 5 patients the steady state mean Cmax, Cmin
      and tmax were 8.1 ng.ml-1 and 4.7 ng.ml-1 and 6 h for the 4 mg tablets and 14.1
      ng.ml-1 and 7.1 ng.ml-1 and 4 h for the 8 mg tablets. It is concluded that both
      doses of SCR show features of controlled release and that they produced a
      relatively constant plasma level of salbutamol in Asian patients.

PMID- 1761083
TI  - Effects of parenteral diclofenac sodium on upper gastrointestinal motility after
      food in man.
AB  - In experimental animal models nonsteroidal anti-inflammatory drugs may influence
      gastrointestinal motility, but as evidence is lacking in man. The effect of
      diclofenac sodium 75 mg i.m. on the motor response of the upper gastrointestinal
      tract to food has been studied by manometry in 9 healthy volunteers. Diclofenac
      had no effect on the motor activity of the stomach, duodenum, or jejunum after a
      605 kcal meal.

PMID- 1761084
TI  - Pharmacokinetics of flumazenil in fulminant hepatic failure.

PMID- 1761085
TI  - Effect of flomoxef on human platelet aggregation.

PMID- 1761086
TI  - Inhibitory substantia nigra inputs to the pedunculopontine neurons.
AB  - Responses of 43 pedunculopontine area (PPN area) neurons to electrical
      stimulation of the substantia nigra (SN) were studied in anesthetized rats. An
      intracellular recording technique was used to demonstrate that SN stimulation
      evoked hyperpolarizing potentials, which were identified by intracellular
      injections as inhibitory postsynaptic potentials (IPSPs). These IPSPs were often
      followed by a rebound depolarization that originates several spike potentials.
      These IPSPs were characterized as monosynaptic, with latencies varying from 1.0
      to 8.5 ms. Similar results were observed in some animals with chronic unilateral
      coronal lesion just rostral to subthalamic nucleus (STH), which severed the
      rostral afferents. PPN are neurons were also antidromically activated by SN
      stimulation. Two PPN area projection neurons were clearly identified. Mean
      latency of one group was 0.71 ms; mean latency of the second group was 5.16 ms.
      The morphological analysis of a neuron inhibited by SN stimulation and labeled
      with horseradish peroxidase (HRP) demonstrated that the soma was fusiform in
      shape, with the axon originating in the soma and collaterals and a large
      dendritic field extending in the ventrodorsalis direction. The results indicate
      that the PPN area is reciprocally connected with the SN, which elicits an
      inhibitory effect on PPN area neurons.

PMID- 1761087
TI  - Binocular neuronal responsiveness in Clare-Bishop cortex of Siamese cats.
AB  - Retinotopy and binocular responsiveness were studied extracellularly in a total
      of 278, 61, 110 and 275 cells sampled in areas 17, 18, 19 and Clare-Bishop (CB)
      of Siamese cats. The misalignment of the visual axes of the two eyes was
      determined by the pupil reflex method in the behaving animal. The recording
      sessions were conducted under N2O anesthesia, supplemented with continuous
      infusion of short-lasting anesthetics (Saffan, Glaxo) and muscle relaxants
      (Gallamine triethiodide) using two types of visual stimulators presenting two
      dimensional (2D) motion stimuli and the visual cues for three-dimensional (3D)
      motion. All of the nine Siamese cats demonstrated Boston type retinotopic
      abnormalities in all of cortical areas 17-19 and CB. Very few binocular cells
      were present in areas 17-19 and the posterior (A1-P2) CB but they were numerous
      in most of CB (A9-4). A significant fraction (36/78) of binocular cells in the
      major CB of the Siamese cats demonstrated similar response selectivity to that
      reported in normal CB cortex for stimulation with the 3D motion cues under both
      null disparity and strabismic conditions (binocular receptive fields for two eyes
      were optically superposed or separated by the strabismic angles estimated in the
      individual animals). These findings indicate that the binocular signals
      converging to the CB cells through different pathways (signals coming from the
      contralateral eye via the ipsilateral hemisphere including the interlaminar
      nucleus and areas 17-19, and commissural signals from the ipsilateral eye via the
      contralateral areas 17-19 and CB) were integrated to yield useful information for
      the recognition of 3D motion, and that the major CB is an actual site of
      binocular integration at least in Siamese cats, rather than being merely a
      reflection of the information processing before the CB cortex.

PMID- 1761088
TI  - Corticofugal modulation of the information processing in the auditory thalamus of
      the cat.
AB  - Single unit activity of 355 cells was recorded in the auditory thalamus of
      anesthetized cats before, during, and after the inactivation by cooling of the
      ipsilateral primary auditory cortex (AI). Most of the units (n = 288) showed
      similar functional characteristics of firing before and after the cryogenic
      blockade of AI. The spontaneous firing rate remained unchanged by cooling in 20%
      of the units and decreased in the majority of them (60%). In some regions, i.e.
      dorsal division of the medial geniculate body (MGB), lateral part of the
      posterior group of the thalamus, and auditory sector of the reticular nucleus of
      the thalamus, the maximum firing rate evoked by white noise bursts was generally
      affected by cooling in the same direction and to the same extent as the
      spontaneous activity. Units in the ventral division of MGB showed a
      characteristic increase of signal-to-noise ratio during cortical cooling. The
      corticofugal modulation led to the appearance or disappearance of the best
      frequency of tuning in 51 units and changed it by more than 0.5 octave in 34
      units. The bandwidths of different response patterns to pure tones stimulation
      were used to define a set of functional properties. During cryogenic blockade of
      AI, two cortically modulated sub-populations of units were usually distinguished
      that exhibited changes for a given functional property. The complexity and
      diversity of the effects of cortical inactivation suggest that the
      corticothalamic projection may be the support for selective operations such as an
      adaptive filtering of the incoming acoustic signal at the thalamic level adjusted
      as a function of cortical activity.

PMID- 1761089
TI  - Intrinsic inter- and intralaminar connections and their relationship to the
      tonotopic map in cat primary auditory cortex.
AB  - Small iontophoretic injections of the lectin, Phaseolus vulgaris leucoagglutinin
      (PHA-L), were made into different layers of the primary auditory cortex (AI) of
      cats. Injections in layer I labeled two types of morphologically distinct fibers
      in layer I as well as a smaller number of axons in layers II and III. Layer II
      injections labeled descending axons that produced a dense plexus of terminal
      fibers in layers I-III of both AI and adjacent auditory fields. Injections in
      layer III also labeled a dense plexus of axon collaterals at the junction of
      layers V and VI and labeled patches of terminal fibers in both AI and adjacent
      auditory fields. These were densest in layers I-III but usually extended into
      layers IV and V as well. The patches were partly formed by axon collaterals of
      layer III pyramidal cells that traveled for over 4 mm in the gray matter.
      Injections confined to layer IV labeled axons in all layers of the cortex but
      none of these axons appeared to reach the white matter. The axons spread
      laterally in layer IV and up into the superficial layers and ramified especially
      layer I. Injections in layers V and VI labeled axons in all layers' of the cortex
      but these were densest in the deep layers where labeling was fairly homogeneous.
      In the upper layers the labeling was arranged in semi-discrete patches. Large
      injections involving layers I-III were studied in tangential sections. Between 3
      and 8 patches of terminal labeling were observed in AI and these were mainly
      arranged in a band with its long axis aligned approximately in the dorsoventral
      direction. However dense patches of terminal labeling also occurred both anterior
      and posterior to the injection site. In selected experiments portions of the
      tonotopic map in AI were mapped by single unit recording and subsequently the map
      was related to patches of anterogradely labeled fibers that surrounded injections
      of PHA-L. Rows of dorsoventrally oriented patches were among cells with a similar
      best frequency to those in the injection site. However patches located anterior
      or posterior to the injection site were among cells with higher or lower best
      frequencies. Two injections of PHA-L close together produce different patterns of
      labeling. One of the injections usually produces one or more patches that has no
      correlate among the patches of fibers labeled by the adjacent injection. This is
      clearest when one of the injections is made with biotinylated PHA-L that can be
      visualized directly without the use of primary antibodies.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1761090
TI  - Adaptation and habituation of the vestibulo-ocular reflex in intact and inferior
      olive-lesioned rats.
AB  - The gain of the vestibulo-ocular reflex (VOR) of intact pigmented rats was
      adaptively modified by training protocols that created a visual-vestibular
      conflict. For training, head restrained animals were oscillated on a turntable in
      front of an optokinetic pattern projected onto a cylindrical wall. The
      optokinetic pattern either moved the same amplitude with the animal ("in-phase":
      0.05 Hz +/- 20 degrees/s) or opposite in direction ("out-of-phase": turntable and
      pattern 0.05 Hz +/- 10 degrees/s each). VOR responses were tested in darkness
      before and after each 8 min training period for a duration of 40 min. During "out
      of-phase" training the gain of compensatory eye movements measured in light was
      close to 2 from the beginning on and the VOR tested in darkness increased in gain
      progressively from 0.48 (+/- 0.12) to 0.9 (+/- 0.3; P less than 0.05) in 5 out of
      7 rats. Two rats did not adapt their VOR gain. Phase values decreased slightly by
      about 10 degrees. During "in-phase" stimulation compensatory eye movements were
      almost completely suppressed (gain close to 0) from the beginning on and the VOR
      tested in darkness decreased gradually in gain from 0.62 (+/- 0.17) to 0.13 (+/-
      0.1; P less than 0.001) in all 6 trained rats. Phase values decreased in parallel
      from 151 degrees to 119 degrees (P less than 0.01). The effectiveness of the "in
      phase" training paradigm in the absence of compensatory eye movements indicates
      that retinal image slip is the relevant signal for adaptation. In seven rats with
      histologically verified almost complete inferior olive (IO) lesions (chemically
      induced at least 45 days prior to training), "out-of-phase" and "in-phase"
      stimulation evoked compensatory eye movements with gains comparable to those in
      intact rats. VOR parameters measured in darkness were altered with respect to
      those of control rats. Gain differed extremely between individuals and phase lag
      re acceleration was in all IO-lesioned rats larger than in intact rats. The time
      constant of the VOR in response to table velocity steps was significantly longer
      (17 s +/- 4) than in intact rats (11 s +/- 3). Training did not alter the gain of
      the VOR in 5 out of 7 IO-lesioned rats. One rat increased its gain during "out-of
      phase" training in the first, but not during a second training session (and not
      during "in-phase" training) and another rat decreased its gain during "in-phase"
      training (but not during "out-of-phase" training).(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1761091
TI  - Different effects of intracranial and intraorbital section of the optic nerve on
      the functional responses of rat retinal ganglion cells.
AB  - A lesion to the optic nerve of adult mammals leads to the retrograde degeneration
      and finally to the death of injured retinal ganglion cells. In this study, we
      have evaluated the effects induced by different sites of axotomy on the
      functional changes occurring in the retinal ganglion cells after optic nerve
      section. We have investigated the functional properties of retinal ganglion cells
      of adult rats by recording the retinal responses to patterned stimuli (pattern
      electroretinogram) after unilateral section of the optic nerve at two different
      levels: intraorbital and intracranial. The results show that the site of lesion
      of the optic nerve affects the time of disappearance of the pattern
      electroretinogram. The pattern electroretinogram takes longer to be degraded
      after an intracranial section than an intraorbital section.

PMID- 1761092
TI  - Effects of cingulate cortical lesions on avoidance learning and training-induced
      unit activity in rabbits.
AB  - This study extends an ongoing analysis of the neural mediation of discriminative
      avoidance learning in rabbits. Electrolytic lesions encompassing anterior and
      posterior cingulate cortex (area 24 and 29) or ibotenic acid lesions in area 24
      only were made prior to avoidance conditioning wherein rabbits learned to step in
      response to a tone conditional stimulus (CS+) in order to avoid a brief, response
      terminated 1.5 mA. foot-shock unconditional stimulus (US). The US was presented 5
      s after CS+ onset, in the absence of a prior stepping response. The rabbits also
      learned to ignore a different tone (CS-) not followed by the US. Multi-unit
      activity of the caudate and medial dorsal (MD) thalamic nuclei, projection
      targets of the cingulate cortex, was recorded during learning in all rabbits.
      Activity was also recorded in area 29 in the rabbits with area 24 lesions.
      Learning in rabbits with combined lesions was severely impaired and it was
      moderately retarded after lesions in area 24. MD thalamic and caudate training
      induced neuronal discharge increments elicited by the CS+ were enhanced in
      rabbits with lesions, suggesting a suppressive influence of cingulate cortical
      projections on this activity. Early-, but not late-developing training-induced
      unit activity in area 29c/d was absent in rabbits with area 24 lesions,
      indicating that area 24 is a source of early-developing area 29 plasticity. These
      results are consistent with hypotheses of a theoretical working model, stating
      that: a) learning depends on the integrity of two functional systems, a mnemonic
      recency system comprised by circuitry involving area 24 and the MD nucleus and a
      mnemonic primacy system comprised by circuitry involving area 29 and the anterior
      thalamic nuclei; b) corticothalamic information flow in these systems suppresses
      thalamic CS elicited activity in trained rabbits; c) corticostriatal information
      flow is involved in avoidance response initiation. An absence of rhythmic theta
      like neuronal bursts in area 29b in rabbits with area 24 lesions is attributable
      to passing fiber damage.

PMID- 1761093
TI  - Role of the nucleus geniculatus lateralis ventralis (GLv) in the optokinetic
      reflex: a lesion study in the pigeon.
AB  - Several functions have been proposed for the avian GLv (color vision, pupillary
      reflex, optomotor mechanisms). In the present paper we have examined the role of
      the GLv in optomotor responses. For this purpose, horizontal and vertical
      optokinetic nystagmus (OKN) were quantified in response to different stimulation
      velocities, before and after chemical (kainic acid) lesions. Unilateral lesion of
      the GLv produced a marked increase of the horizontal OKN gain when the eye
      contralateral to the lesion was stimulated in the temporonasal (T-N) direction
      and, to a lesser extent, when the ipsilateral eye was stimulated in the naso
      temporal (N-T) direction. Biocular integration was reduced after the lesion,
      since the biocular stimulation corresponding to these two monocular stimulations
      (ipsiversive to the lesion) produced only a moderate gain increase. When
      stimulations were delivered in the opposite direction (contraversive to the
      lesion), the horizontal OKN gain was slightly increased for the N-T monocular
      stimulation of the eye contralateral to the lesion, but was unchanged for other
      stimulations. A bilateral lesion of the GLv provoked only a slight increase of
      the horizontal OKN gain. The vertical OKN was not affected by the GLv lesions.
      Thus, the GLv system is probably involved in the modulation of optomotor
      responses and could mediate visuo-optokinetic interactions, each nucleus (and its
      associated system) exerting an inhibitory (or disfacilitatory) effect on the
      horizontal OKN in one direction.

PMID- 1761094
TI  - A neuronal correlate of spatial stability during periods of self-induced visual
      motion.
AB  - Motion of background visual images across the retina during slow tracking eye
      movements is usually not consciously perceived so long as the retinal image
      motion results entirely from the voluntary slow eye movement (otherwise the
      surround would appear to move during pursuit eye movements). To address the
      question of where in the brain such filtering might occur, the responses of cells
      in 3 visuo-cortical areas of macaque monkeys were compared when retinal image
      motion of background images was caused by object motion as opposed to a pursuit
      eye movement. While almost all cells in areas V4 and MT responded
      indiscriminately to retinal image motion arising from any source, most of those
      recorded in the dorsal zone of area MST (MSTd), as well as a smaller proportion
      in lateral MST (MST1), responded preferentially to externally-induced motion and
      only weakly or not at all to self-induced visual motion. Such cells preserve
      visuo-spatial stability during low-velocity voluntary eye movements and could
      contribute to the process of providing consistent spatial orientation regardless
      of whether the eyes are moving or stationary.

PMID- 1761095
TI  - Amygdalectomy and ventromedial prefrontal ablation produce similar deficits in
      food choice and in simple object discrimination learning for an unseen reward.
AB  - Cynomolgus monkeys (Macaca fascicularis) with either bilateral amygdalectomy or
      bilateral ventromedial prefrontal cortical ablations showed abnormal choices
      between apple, lemon, olive, and meat. Not only did they choose meat or olive
      more often than normal animals, but also their choices were less consistent from
      trial to trial than the normal animals' choices were. The same animals were
      subsequently tested for their ability to learn 2-choice simultaneous visual
      discriminations between objects which they could suck. The positive object
      yielded fruit juice, which entered the mouth directly without being seen. Both
      groups of animals with lesions were severely impaired in this discrimination
      learning task. The reason why amygdalectomy has little effect on simple object
      discrimination learning in the Wisconsin General Test Apparatus, we suggest, is
      that the animal can there associate the visual discriminanda with the visual
      properties of the food reward, a mechanism which is not available when the reward
      is unseen. These results add to existing evidence of a close functional
      relationship between the amygdala and the ventromedial prefrontal cortex, and
      they support the proposal, derived from previous work, that the amygdala is
      important for associating visual stimuli with the incentive value of reinforcers.

PMID- 1761096
TI  - A quantitative analysis of pallidal discharge during targeted reaching movement
      in the monkey.
AB  - Neurons in the globus pallidus have been studied during reaching movements of the
      arm made at varying speeds. The reaching task is similar to one used in earlier
      experiments, in which disruption of normal pallidal output caused changes in
      movement time. The pallidal cells studied were those that showed task-related
      changes in activity and a modification of discharge when the arm was manipulated
      outside of the task. Neuronal discharge was assessed to evaluate two possible
      models, one in which the timing of task-related discharge varied as a function of
      movement time and the other in which the amplitude (mean firing rate) of the
      change in discharge varied as movement time varied. The relation between neuronal
      discharge and movement time was examined quantitatively on a trial-by-trial basis
      using a statistical algorithm that identified each phase of the change in
      neuronal discharge on each trial. A non-parametric statistic was used to
      determine the correlation between movement time and the duration or latency of
      changes in neural firing or the mean discharge during each phase of the cell's
      response. For fifty-five percent of the 40 neurons studied, the timing of the
      cell's response (duration or latency) varied as a function of movement time. For
      only 10 cells (25%) was there a significant correlation between movement time and
      the mean firing rate during one or more phases of the cell's response. Both
      timing and frequency modulation with movement time were limited to cells
      responsive to manipulation at the wrist or the shoulder.

PMID- 1761097
TI  - The role of the subthalamic nucleus in the response of globus pallidus neurons to
      stimulation of the prelimbic and agranular frontal cortices in rats.
AB  - We investigated how the cerebral cortex can influence the globus pallidus by two
      routes: the larger, net inhibitory route through the neostriatum and the
      separate, smaller, net excitatory route through the subthalamic nucleus.
      Stimulation (0.3 and 0.7 mA) of two regions of frontal agranular (motor) cortex
      and of the medial orbitofrontal cortex centered in the prelimbic cortex typically
      elicited one or more of the following extracellularly recorded responses in over
      50% of tested cells: an initial excitation (approximately 6 ms latency), a short
      inhibition (15 ms latency) and a late excitation (29 ms latency). Some other
      cells responded with an excitatory response only (18 ms latency). The excitatory
      responses largely arise from the subthalamic route. Kainic acid or electrolytic
      lesion of the subthalamic nucleus eliminated most excitatory responses and
      greatly prolonged the duration (16 vs 50 ms) of the inhibition. Subthalamic
      neurons typically showed one or more of the following responses to cortical
      stimulation: an early excitatory response (4 ms latency), an inhibitory period (9
      ms) and a late excitatory response (16 ms). The early response was seen after
      motor cortex but not prelimbic stimulation. The timing of the globus pallidus and
      subthalamic responses suggest the operation of a reciprocal inhibitory/excitatory
      pathway. Two reciprocal interactions were indicated. First, pallidal inhibition
      may disinhibit the subthalamus and, via a feedback pathway onto the same pallidal
      cells, act to terminate the neostriatal-induced inhibition. Second, there may be
      a feedforward pathway from pallidal cells to subthalamic neurons to a different
      group of pallidal cells. This pathway could act to suppress competing responses.
      Thus the subthalamus may have three actions: 1) an early direct cortical and 2,3)
      later reciprocal feedforward and feedback excitatory antagonism of the
      neostriatal mediated inhibition of globus pallidus.

PMID- 1761098
TI  - Tactile discrimination of curvature by humans using only cutaneous information
      from the fingerpads.
AB  - Spherically curved surfaces were applied, with controlled force, to the
      fingerpads of human subjects; their fingers were immobilized. The curvature of
      the surfaces was characterised by the reciprocal of the radius of curvature. In
      scaling experiments, the subjects' perceived magnitude of curvature increased
      markedly with an increase in the curvature of the stimulus. An increase in
      contact force resulted in a slight decrease in perceived curvature. Four
      discrimination experiments were performed using a forced choice paradigm.
      Subjects could discriminate, at the 75% level, a flat surface (zero curvature)
      from a convex curvature of 4.9 m-1 (radius of curvature 204 mm) and from a
      concave curvature of 5.4 m-1 (radius 185 mm). When discriminating 2 convex
      spherical surfaces, subjects could discriminate a curvature of 144 m-1 from a
      curvature of 158 m-1 (radii 6.95 and 6.33 mm respectively), and could
      discriminate a curvature of 287 m-1 from one of 319 m-1 (radii 3.48 and 3.13 mm
      respectively); the Weber fraction is about 0.1. Contact areas between the curved
      surfaces and the fingerpad skin were estimated. There was approximate
      correspondence between contact areas and the scaling functions.

PMID- 1761099
TI  - Comments to: S.D. Newlands and A.A. Perachio: Neuronal activity in the medial
      vestibular nuclei following unilateral labyrinthectomy.

PMID- 1761100
TI  - Some new aspects of CJD epidemiology in Slovakia.
AB  - Descriptive epidemiological and genealogical data obtained by prospective and
      retrospective studies on CJD in Slovakia and in patients emigrating from CJD
      clusters were analysed. Observations contradictory to an exclusively genetic
      etiology of temporo-spatial accumulation of CJD are presented. Data indicating a
      genetically increased susceptibility to the disease and its coincidence with
      environmental risk in clustering patients are discussed.

PMID- 1761101
TI  - "Clusters" of CJD in Slovakia: the first statistically significant temporo
      spatial accumulations of rural cases.
AB  - A space-time analysis of clustering among 78 definite CJD cases who died in
      Slovakia (75) and an adjacent part of Hungary (3) during 1972-1991 is presented.
      Two geographical rural accumulations of sporadic and familial CJD patients in the
      north and south of Central Slovakia were found. There was evidence of two
      significant clusters when spatial and temporal neighborhoods were defined by
      distances of 2,4,5 and 7 km within 1.5 and 2 years. Involvement of genetic
      mechanisms in the clusters was demonstrated, and the possible role of
      environmental (zoonotic) risk factors are considered.

PMID- 1761102
TI  - Creutzfeldt-Jakob disease in the last 5 years in Hungary.

PMID- 1761103
TI  - Epidemiological surveillance of Creutzfeldt-Jakob disease in the United Kingdom.
AB  - Systematic epidemiological surveillance of Creutzfeldt-Jakob disease was carried
      out in England and Wales covering the years 1970-1984. The results of this work
      provide a basis from which to assess any change in the pattern of Creutzfeldt
      Jakob disease following the occurrence of Bovine Spongiform Encephalopathy. The
      methodology, early results and problems of the current systematic national survey
      of CJD, initiated in May 1990, are discussed.

PMID- 1761104
TI  - Risk of Creutzfeldt-Jakob disease in relation to animal spongiform
      encephalopathies: a collaborative study in Europe.
AB  - This paper describes a study of the risk of Creutzfeldt-Jakob disease in various
      European countries. The objectives of the study are to investigate the frequency
      of Creutzfeldt-Jakob disease and other human spongiform encephalopathies in
      Europe in relation to animal spongiform encephalopathies, and to assess the risk
      of Creutzfeldt-Jakob disease in relation to genetic, occupational and nutritional
      factors. The study will consist of three parts: the establishment of registries
      of Creutzfeldt-Jakob disease on the basis of cases in the registries, and
      molecular genetic studies with material collected in the registries.

PMID- 1761105
TI  - Focal accumulation of CJD in Slovakia: retrospective investigation of a new rural
      familial cluster.

PMID- 1761106
TI  - Creutzfeldt-Jakob disease among Libyan Jews.
AB  - The focus of CJD among Jews of Libyan origin has been recognized for two decades,
      but the reasons underlying it were unknown. Prevailing views suggested
      transmission from sheep infected with scrapie. However, recent data show that in
      fact CJD in this ethnic group is a genetically determined disease due to a point
      mutation on the codon 200 of the prion protein gene. The clinical characteristics
      of CJD in this group, and particularly the less common periodic activity in the
      EEG, are reviewed. New findings include peripheral neuropathy of the
      demyelinating type in two cases, presumably due to involvement of Schwann cells.
      The pathophysiology of the disease includes, presumably, a focal post
      translational modification of the prior protein, (predisposed by the mutation).
      Later, the disease progresses through cell-to-cell transmission.

PMID- 1761107
TI  - Creutzfeldt-Jakob disease in young people.
AB  - Three neuropathologically confirmed cases of Creutzfeldt-Jakob disease in young
      people (19, 23, and 27 years of age) are described. None had received pituitary
      hormone therapy. At the onset of illness all patients were suspected of having
      SSPE or other viral encephalitis, because of the similarity of clinical
      symptomatology and the shift towards older age of SSPE onsets observed in Poland
      in recent years.

PMID- 1761108
TI  - Creutzfeldt-Jakob disease--clinical picture analysis.
AB  - The early, late, and terminal features of (CJD) were analyzed, based on the
      clinical histories and picture evolution of 12 histologically-confirmed cases of
      CJD. The most essential features observed were sensorimotor disintegration, and
      impairment of both mental and higher cortical functions, occurring in various
      combinations. On the basis of a sampling of early symptoms and signs we were able
      to make an early differential diagnosis.

PMID- 1761109
TI  - "Clusters" of CJD in Slovakia: the first laboratory evidence of scrapie.
AB  - Epidemic-like occurrence of Creutzfeldt-Jakob disease was observed in 1987 in
      Slovakia (Orava). Search for the cause of CJD focus indicated a coincidence of
      genetic and environmental risks in clustering patients. Since Spongiform
      Encephalopathies might be transmitted orally, (Bovine Spongiform Encephalopathy),
      the possibility of zoonotic source of CJD cases in Orava was also considered. A
      deficient knowledge about the occurrence of scrapie in Slovakia stimulated an
      examination of sheep with signs of CNS disorders in two flocks of Valasky breed
      in Orava. In one flock, neurohistopathological examination revealed in sheep
      brains lesions characteristic for scrapie. Frozen brain tissue of these animals
      were used for the detection of scrapie associated fibrils. They were found in 2
      animals from the same flock. This is the first laboratory confirmation of scrapie
      in Czecho-Slovakia. The possible epidemiological and economical implications are
      emphasized.

PMID- 1761110
TI  - Slow neurological diseases (scrapie and visna) of the sheep in the USSR.

PMID- 1761111
TI  - Some problems of diagnosis of the spongiform encephalopathies in ruminants.
AB  - The difficulties of a positive diagnosis in the spongiform encephalopathies based
      only on epidemiological and clinical data are briefly reviewed. However, in
      B.S.E. as in scrapie, the epidemiology and the clinical data may frequently
      suggest these diseases. The main diseases which must be taken into account in the
      differential diagnosis of both spongiform encephalopathies are discussed and the
      criteria of the differential diagnosis are tabulated.

PMID- 1761112
TI  - Bovine spongiform encephalopathy (BSE): the current situation and research.
AB  - Bovine spongiform encephalopathy (BSE), discovered in Great Britain in 1986, was
      to pose one of the most serious threats to the well-being of the British cattle
      industry this century. The disease is now established as a member of the group of
      diseases known as the sub-acute spongiform encephalopathies caused by
      unconventional, transmissible agents and which includes scrapie of sheep. It is
      from scrapie of sheep that it appears BSE has resulted though it is possible BSE
      may have existed in a sub-clinical form in cattle. The vehicle of transmission is
      meat and bone meal prepared from infected ruminant carcases and included in the
      protein concentrate rations of cattle, especially dairy cattle in which the
      disease predominates. Most animals become exposed as calves and the incubation
      period is typically 4-5 years with most cases occurring at this age. The increase
      in exposure of cattle to infection that resulted in disease in 1985/1986 was
      1981/1982. The factors that contributed to this increase were an increasing sheep
      population, possibly an increase in the prevalence of scrapie and changes in the
      industrial processing of animal waste to prepare meat and bone meal. The clinical
      signs of BSE include abnormal behaviour, posture, gait and an increased
      sensitivity to visual and aural stimuli. There is loss of condition and milk
      yield. In only one of 28,197 cases of BSE confirmed by 10 May 1991 can feed be
      almost certainly ruled out as a source of infection. This therefore may be a
      singleton case of maternal transmission though we cannot be certain. Every other
      case so far has been exposed to meat and bone meal in the diet and thus resulted
      in an extended common source epidemic. A large research programme is underway to
      investigate the epidemiology, clinicopathology, transmission and molecular
      biological/genetic aspects of the disease. Much is collaborative between
      Institutes and Member States of the European Community, in which the disease, as
      in Britain, is notifiable. In Britain the lynch pin of control for animal health
      has been the ban established in July 1988 on feeling of ruminant protein to
      ruminant animals. Though there is no evidence that either BSE or scrapie is a
      hazard to humans, as a precautionary measure, suspect animals are compulsorily
      slaughtered and destroyed (except all brains are taken for diagnosis) with
      compensation being paid at 100% of value. Milk from such animals is also
      destroyed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761113
TI  - Mechanism of the damage to myelinated axons in experimental Creutzfeldt-Jakob
      disease in mice: an ultrastructural study.
AB  - We report the ultrastructural pathology of myelinated axons in mice infected
      experimentally with the Fujisaki strain of Creutzfeldt-Jakob disease (CJD).
      Initially the myelin sheath was separated into several concentric bands, and
      cellular processes penetrated between layers of myelin and lifted away the
      outermost lamella. Then a complicated labyrinth of the concentric cellular
      processes, clearly belonging to either astrocytes or macrophages, invested
      myelinated axons. In terminal stages axons completely denuded of myelin were seen
      in the center of concentric networks of cellular processes. Myelin remnants were
      seen within astrocytes and macrophages. We conclude that the mechanism(s) of
      damage to myelinated axons in CJD may be similar to that operating in
      immunologically mediated demyelinating disorders.

PMID- 1761114
TI  - Tubulovesicular structures in human and experimental Creutzfeldt-Jakob disease.
AB  - Tubulovesicular structures (TVS) have been consistently observed in brain tissue
      of animals with transmissible spongiform encephalopathies such as natural and
      experimental scrapie, bovine spongiform encephalopathy, and experimental
      Creutzfeldt-Jakob disease (CJD). In this communication we demonstrate for the
      first time the presence of TVS in natural CJD. TVS were detected in all 3 CJD
      specimens. However, they were rare and were found only in one or two locations
      per grid. They were seen in distended pre- and postsynaptic terminals and
      measured approximately 35 nm in diameter, and they were smaller and of higher
      electron density than synaptic vesicles. Their occurrence in all types of
      spongiform encephalopathies irrespective of the affected host and the strain of
      infectious agent emphasizes their biological significance.

PMID- 1761115
TI  - Experimental drug treatment of scrapie: a pathogenetic basis for rationale
      therapeutics.
AB  - Pharmacological treatment with polyanions or amphotericin B in hamsters with
      experimental scrapie reveals that it is possible to delay the appearance of the
      disease only when the drug is given before the invasion of the agent into the
      clinical target areas of the brain. We suggest such early treatment may be
      possible for individuals at high risk of acquiring the disease, such as healthy
      mutation-positive relatives of patients with familial Creutzfeldt-Jakob disease
      or Gerstmann-Straussler syndrome, or recipients of potentially contaminated
      pituitary-extracted human growth hormone.

PMID- 1761116
TI  - Transmissible spongiform encephalopathies (TSE) virus-induced amyloidoses of the
      central nervous system (CNS).

PMID- 1761117
TI  - Hemopoietic improvement following fetal liver infusion in aplastic anemia.
AB  - 41 (38 males, 3 females) patients with aplastic anemia received fetal liver
      infusion (FLI) from 74 abortuses with gestation periods of 8-32 (Median(M)-16)
      weeks and cell dose of 0.004-11.1 x 10(8) (M-2.3 x 10(8)) from September, 1976
      until November, 1987. 35 persons received single FLI; those with recurrence or no
      response received two or more FLI. 8 received two; 7, three; 2, four; and 1, six
      FLI. There was a slow and incomplete autologous hematopoietic improvement in 40%
      and expected survival of 52% at 1 year, 45% at 2 yr, and 37% at 5 yr (Kaplan
      Meier estimate). There was rise in fetal hemoglobin (Hb), 0-15.7%, (M-3.5) among
      responders in 3-20 (M-6) months. Patients who survived for more than 12 months
      had, on average, a longer duration of disease (4 months or more), and higher
      granulocyte and platelet counts. Statistically, however, these differences were
      not significant. Reticulocyte count was significantly lower in those who survived
      beyond 12 months. 1 patient developed acute undifferentiated leukemia 3 yr post
      FLI. The study indicates that fetal liver infusion is likely to benefit about 40%
      of individuals suffering from severe aplastic anemia. Longer surviving patients,
      however, may be at risk of developing clonal diseases.

PMID- 1761118
TI  - Has the incidence of multiple myeloma in old age been underestimated? The myeloma
      project of health region I in Norway. I.
AB  - All patients in the region with newly discovered M components were registered
      from 15 Aug. 1984-31 Dec. 1986. Among a total of 393 patients enrolled, 162 had
      multiple myeloma (MM). The incidence rate was 6.6 per 100,000 population per year
      (age-adjusted to the European standard population), which is somewhat higher than
      previous reports based on hospital and autopsy records. In particular, the
      incidence rate was higher in the greater than 70 age group. Thus, the median age
      was 72 yr, which is the highest reported. As many as 71 (44%) of the 162 MM
      patients were asymptomatic; these asymptomatic patients had the same age
      distribution as the symptomatic ones. The stage distribution, occurrence of risk
      factors, response to chemotherapy, response duration and survival were similar in
      the age groups below and above the median and, in multivariate survival analysis,
      age was not an independent risk factor.

PMID- 1761119
TI  - Incidence and follow-up of asymptomatic multiple myeloma. The myeloma project of
      health region I in Norway. II.
AB  - During a general population follow-up study in Health Region I in Norway, 162
      patients with multiple myeloma (MM) were diagnosed. 71 of these (44%) were
      asymptomatic, and were observed without chemotherapy. The great majority (90%)
      were in stage I, and there were only 2 with light chain disease. 45 of the 71
      asymptomatic patients developed progressive disease during the 4-5 year follow-up
      period. Estimated median time to disease progression was 26 months. The presence
      at diagnosis of osteolytic lesions and/or at least 20% plasma cells in the bone
      marrow defined a group with significantly shorter time to progression (median 10
      vs 39 months). Median survival from diagnosis for the asymptomatic patients was
      45 months, which is significantly longer than the 26 months of the symptomatic
      group. However, when estimated from the start of treatment, the survival was
      similar for the two groups.

PMID- 1761120
TI  - An Arg545----Cys545 substitution mutation of the von Willebrand factor in type
      IIB von Willebrand's disease.
AB  - Type IIB is a special variant of von Willebrand's disease, characterized by an
      abnormal von Willebrand factor which shows an increased interaction with
      platelets. This interaction sometimes causes platelet aggregation and
      thrombocytopenia in vivo. It involves the glycoprotein-Ib (GPIb) receptor on
      platelets and corresponding GPIb-binding sites in the von Willebrand factor. We
      here demonstrate a C----T mutation at codon 1308 of the von Willebrand factor
      gene in 2 related patients with IIB von Willebrand's disease. The transition
      gives rise to a substitution of arginine by cysteine at position 545 of the
      mature von Willebrand factor subunit. This position is close to the GPIb- as well
      as the collagen- and heparin-binding domains of the von Willebrand factor. The
      mutation may change the conformation of the molecule in this region and activate
      the GPIb-binding domain, which is normally not exposed in the von Willebrand
      factor of circulating blood.

PMID- 1761121
TI  - Prophylactic heparin does not prevent liver veno-occlusive disease following
      autologous bone marrow transplantation.
AB  - Veno-occlusive disease (VOD) is a major cause of toxic death after autologous
      bone marrow transplantation (ABMT). We studied the potential role of continuous
      administration of low-dose heparin for VOD prevention in 234 consecutive patients
      who underwent ABMT in our institution. The population consisted of 98 patients
      autografted before October 1984 who did not receive heparin, and a series of 136
      patients autografted from October 1984 to March 1989 containing 98 patients
      included in a randomized trial comparing heparin administration (n = 52) vs no
      heparin (n = 46), and an additional group of 38 patients who received non
      randomized heparin in view of high-risk criteria to develop VOD (n = 31) or other
      reasons unrelated to VOD (n = 7). Overall, 90 patients (38%) received heparin and
      144 (62%) did not. The global incidence of VOD was 13/234 (5-5%). Heparin did not
      reduce the risk of VOD in all subgroups studied. In particular, in the randomized
      trial, the incidence of VOD was 2.2% in the group without heparin vs 7-7% in the
      group receiving heparin. We analyzed in depth the 13 patients who developed VOD
      and we compared them to a control group of 13 patients pair-matched for age, sex,
      diagnosis and preparative regimen, who did not develop VOD. We found that
      abnormal LFT before ABMT predisposed patients to VOD; refractoriness to platelet
      transfusion was observed in 85% of the patients in the VOD group vs 15% in the
      control group (p less than 0.05). VOD patients had an increased requirement for
      red cells and platelet transfusions, a lower recovery (R less than 25%) after the
      second and third platelet transfusion, and shorter intervals separating the first
      four platelet transfusions. Further, the platelet reconstitution after ABMT in
      the VOD group was slower in comparison to the control group (p less than 0.01).
      Again, in this pair-matched analysis continuous infusion of low-dose heparin did
      not prevent VOD.

PMID- 1761122
TI  - Treatment of myelodysplastic syndromes with recombinant human erythropoietin.
AB  - 12 patients with myelodysplastic syndromes were treated with recombinant human
      erythropoietin (r-epo). 5 patients had stable anemia, 78-92 g/l, and 7 were
      transfusion-dependent. In 11 patients, r-epo was given intravenously three times
      a week, with dose escalation after 4 and 8 wk if hemoglobin did not increase more
      than 15 g/l. The doses were 600, 1500 and 3000 U/kg bodyweight/wk. The 12th
      patient was treated subcutaneously with a dose of 560 U/kg/wk. 3 patients showed
      a significant response with an increase in hemoglobin of greater than or equal to
      15 g/l. 2 of these had stable anemia before treatment and increased in hemoglobin
      from 87 to 116 g/l and from 80 to 99 g/l, respectively. The 3rd patient was
      transfusion-dependent and rose to a stable hemoglobin level between 76 and 80 g/l
      without transfusions. 2 patients showed a reduction of their transfusion need.
      Mean initial serum erythropoietin in the responding group was 366 U/l compared to
      1049 among the non-responders (p = 0.367). Response was observed in 5/7 patients
      without bone marrow sideroblasts and in 0/5 patients with sideroblasts (p =
      0.027). Erythropoietin seems to be an effective and well-tolerated treatment for
      a certain proportion of patients with MDS. A larger patient material might
      provide a model for predicting responses.

PMID- 1761123
TI  - Diagnostic utility of the pre-incubated acidified glycerol lysis test in
      haemolytic and non-haemolytic anaemias.
AB  - The usefulness of the pre-incubated acidified glycerol lysis test (AGLT), a
      laboratory test for spherocytosis, has been investigated in a selected hospital
      population of 348 patients with haemolytic and non-haemolytic anaemia. The AGLT
      was positive in 58 out of 59 patients with hereditary spherocytosis. In all 32
      patients with other types of hereditary haemolytic anaemia the AGLT was normal or
      equivocal, but clearly different from spherocytosis. Adults with a positive AGLT,
      but without hereditary spherocytosis, had auto-immune haemolytic anaemia,
      myelodysplastic syndrome or were pregnant women. In newborn infants the AGLT was
      positive, in the first week of life, in those babies having hereditary
      spherocytosis or immune haemolysis due to blood group incompatibility; no
      positive AGLT results were seen if no haematological explanation for neonatal
      hyperbilirubinaemia could be found. At the optimal cut-off point the sensitivity
      of the AGLT for hereditary spherocytosis was 98.3% and the specificity 91.1%,
      under the most unfavourable conditions. The AGLT is a very useful and simple test
      for the diagnosis of hereditary spherocytosis.

PMID- 1761124
TI  - Acute lymphoblastic leukaemia relapsing in bowel.

PMID- 1761125
TI  - Signal-averaged electrocardiography.

PMID- 1761126
TI  - The health care gap for women.

PMID- 1761127
TI  - Strategies for developing a family support group.
AB  - Various interventions may be used by nurses to provide social support to critical
      care families. Nurses may support family members in one-to-one relationships, or
      by facilitating the development of supportive relationships in the group setting.
      The steps described here are fundamental in developing a support group for family
      members of adults hospitalized in a surgical ICU to meet their predetermined
      needs. The support needs of family members and the timing of a support group
      during the critical care phase must first be validated. Once this assessment is
      completed, the support group may be based on the educational model, mutual-peer
      support model, educational-mutual support model, or ventilation model. The group
      model selected will provide direction to the structure, membership, and
      leadership of the support group. Regardless of the model considered appropriate
      for the needs of the family population and setting, critical care nurses need to
      evaluate the impact of the support group on the psychologic health of the family.
      The four different group perspectives clearly illustrate the need for nurses to
      determine what types of support are needed or are most beneficial for families
      during various phases of illness. Perhaps family members benefit from sharing and
      camaraderie during the acute or critical care phase, whereas educational support
      groups are more effective in reviewing illness and treatment implications after
      the immediate threat of the illness has passed. Findings from these evaluation
      studies will assist nurses in shaping intervention strategies for critical care
      family members in clinical practice.

PMID- 1761128
TI  - Health care trends: a call for advanced knowledge and skills in baccalaureate
      graduates.

PMID- 1761129
TI  - Denying alcoholism.

PMID- 1761130
TI  - Applying standards of care in legal proceedings.

PMID- 1761131
TI  - From hopeful to hopeless ... when do we write "do not resuscitate"?
AB  - The issue of do not resuscitate (DNR) decisions has been the subject of much
      discussion in the medical literature. To try to understand the factors that may
      be determinants of the timing of DNR decisions, we reviewed the charts of 70
      consecutive burned patients who died between 1986 and 1988. When a DNR decision
      was written, it was within 48 hours of the patient's death (74% of patients). No
      statistical difference was found in the sex distribution or in the percentage of
      body surface area burned in the DNR group and in the resuscitation group.
      Physicians, nurses, social workers, the hospital attorney, the district attorney,
      and the coroner of our county were interviewed. The uncertainty of legal
      guidelines and practical considerations of family expectations preclude a uniform
      approach to this problem.

PMID- 1761132
TI  - Identification and treatment of acute myocardial infarction by
      electrocardiographic site classification.
AB  - The nature and severity of an acute myocardial infarction may be related to the
      region of myocardial involvement. Four possible sites of infarction are inferior,
      anterior, posterior, and lateral. Knowledge of ECG tracings common to each of
      these areas, the coronary artery source of each, clinical complications, and
      signs and symptoms is vital to subsequent nursing management.

PMID- 1761133
TI  - The art and science of weaning from mechanical ventilation.

PMID- 1761134
TI  - Using multiple teaching techniques in a continuing education program.
AB  - The use of Gregorc's mind mediation channel theories as a framework for
      continuing education planning has been successful and well received by
      participants on the basis of evaluation responses received over a 2-year period.
      This framework has been especially applicable in the setting described because
      participants form a heterogeneous audience drawn from registered nurses in
      various practice settings at many different institutions across the country.
      Integration of various techniques designed to meet the needs of participants with
      different mind mediation characteristics assures that participants will find at
      least one technique targeted to their learning needs. In a more homogeneous
      setting with a consistent audience for continuing education (for example, a
      critical care unit with monthly continuing educational offerings), the planner
      may want to consider asking participants (staff nurses) to complete the Gregorc
      Style Delineator so that educational experiences can be planned for congruency
      with participants' learning characteristics.

PMID- 1761135
TI  - Update: are milking and stripping chest tubes necessary?

PMID- 1761136
TI  - Neuromuscular blockade.

PMID- 1761137
TI  - The gift.

PMID- 1761138
TI  - [The effects of body fat distribution on glucose tolerance in overweight
      subjects: glucose intolerance and insulin resistance induced by intra-abdominal
      fat accumulation].
AB  - To evaluate the pathophysiological significance of intra-abdominal fat
      accumulation in Japanese subjects with mild to moderate overweight, 107 subjects
      (56 men and 51 women, aged 16-68 years) with body mass index (BMI, kg/m2) of 17
      39 (mean +/- SD, 25 +/- 4.3) were evaluated. Subjects with disorders which affect
      glucose metabolism, such as thyroid, adrenal, liver, and kidney diseases, were
      excluded. A 75 g oral glucose tolerance test (OGTT) was performed in all
      subjects, and venous samples were obtained before 15, 30, 60, 90 and 120 min
      after the glucose load for plasma glucose (PG), immunoreactive insulin (IRI) and
      C-peptide immunoreactivity (CPR) measurements. In 72 of the subjects, plasma free
      fatty acid (FFA) level at fasting was also determined. The degree of visceral fat
      accumulation was evaluated using a CT-scan by the method reported by Fujioka et
      al. (Metabolism, 36: 54-59, 1987), and intra-abdominal fat area/subcutaneous fat
      area (V/S ratio) was obtained. V/S ratio and BMI correlated positively in
      subjects with BMI less than 25 (17 men and 16 women, aged 28-62 years) but they
      did not correlate at all with each other in those with BMI greater than or equal
      to 25 (39 men and 35 women, aged 16-68 years). Based on this finding, the
      possible adverse effects of increased intra-abdominal fat on glucose metabolism
      were investigated in the subjects with BMI greater than or equal to 25. For this
      purpose, the correlation of V/S ratio with fasting PG (FPG), fasting IRI (FIRI),
      fasting CPR (FCPR), FPG/FIRI, FFA, or PG area (sigma PG) and sigma PG/sigma IRI
      at OGTT was analyzed. V/S ratio positively correlated with FPG, sigma PG,
      FPG/FIRI and sigma PG/sigma IRI but not with FFA. The correlation between V/S
      ratio and FIRI or FCPR was significant in the subjects with V/S ratio greater
      than or equal to 0.8 in men and greater than or equal to 0.4 in women. In sharp
      contrast to V/S ratio, BMI did not correlate at all with any of these metabolic
      indices. We conclude that in Japanese subjects with mild overweight to moderate
      obesity, intra-abdominal fat accumulation, but not the increase in the degree of
      obesity, accompanies worsening of glucose tolerance. Because PG elevation
      relative to IRI secretion is progressively greater with increasing V/S ratio, it
      is suggested that the deleterious effects of intra-abdominal fat accumulation can
      be attributed to increased insulin resistance.

PMID- 1761139
TI  - [The influence of the sympathetic nervous system on brown adipose tissue: an
      experimental and histopathologic study on aging].
AB  - Brown adipose tissue (BAT) is known to be a principal energy source of non
      shivering thermogenesis and related diet-induced thermogenesis. These regulate
      body temperature and body weight and are controlled by the dissipation of
      excessive dietary caloric intake. We carried out histopathologic,
      immunohistochemical and biochemical studies of BAT in rats in relation to aging
      changes. Four groups of Donryu strain male rats (5 each of 1 month, 2 months, 4
      months and 20 months of age) were used. They had been given commercial chow and
      tap water ad libitum and were kept in an air-conditioned room. Body weight (BW),
      interscapular BAT weight (IBATW) and g IBATW/g BW of rats were measured. Nor
      adrenalin (NA), and dopamine-beta-hydroxylase (DBH) of IBAT were determined. To
      evaluate the catecholaminergic effects of BAT, morphometric quantitation of BAT
      was carried out based on the cytoplasmic locularity of fat globules in the BAT
      cells. Distribution of DBH in BAT was assessed immunohistochemically by the
      avidin biotin peroxidase complex method. With the use of statistical analysis of
      variance procedure, there were highly significant decreases in the ratio of g
      IBATW/g BW (p less than 0.0001) and in the concentrations of NA (p less than
      0.0001) and DBH (p less than 0.01) between young (weaning at 1 month old) rats
      and adult (aged from 4 to 20 months) rats. In the morphometric measurement, by
      the statistical analysis system (SAS) Spearman correlation coefficient method,
      there was a significant increase of Type 5 cell (monocular brown adipose tissue
      cell) in 4 month and 20 month rats, compared to 1 month and 2 month rats (p less
      than 0.05). Immunohistochemical study of BAT showed localization of DBH in
      perivascular mesenchymal cells which corresponded with the morphologic
      distribution of catecholamine as reported by Lever. The results suggest that in
      the processes of aging in the rat there are reductions in the ratio of g IBATW/g
      BW, NA and the activity in DBH.

PMID- 1761140
TI  - [Clinical studies on 3 pairs of monozygotic twin sisters affected by Graves'
      disease].
AB  - Clinical studies were undertaken of three pairs of monozygotic twin sisters
      affected by Graves' disease. The evidence that the twins were monozygotic was
      established by similarity in physical appearance, identical blood-group antigens
      and identical HLA types. All pairs were female, and the evidence of Graves'
      disease in both members of the pair was observed in 2 out of 3 pairs. In the
      remaining pair the disease started in the elder sister, but the younger sister
      still remained in euthyroidism in spite of the presence of diffuse goiter. The
      disease occurred in the second decade in all the patients, and the interval
      between the occurrence of the disease in twin sisters was 1 to 4 years. No common
      specific type of HLA was found among all three pairs, but DR4 was common in two
      pairs of twin sisters showing positive MCHA test. Serum TRAb was positive in 2
      pairs of twin sisters but negative in the remaining one. However, it became
      positive in the elder sister of the latter pair during the antithyroid treatment.
      The effect of antithyroid drug treatment was found to be similar in each of the
      twin sisters, and the serum TRAb moved almost in parallel with serum FT4 level.
      These results indicate that a genetic factor may be of great importance in the
      aetiology of Graves' disease, and there was a strong preponderance for it to
      occur in women and the second decade was the peak age for its occurrence. The
      common specific type of HLA for all Graves' patients was not found in this study.
      A strong relationship was observed between Grave's disease and TRAb.

PMID- 1761141
TI  - [The role of the renal dopaminergic and the prostaglandin systems in renal uric
      acid metabolism in patients with essential hypertension].
AB  - The present study aimed to elucidate the role of renal dopaminergic and
      prostaglandin (PG) systems in renal uric acid metabolism in essential
      hypertension. Mean arterial pressure (MAP), heart rate (HR), endogenous
      creatinine clearance (Ccr), serum uric acid (SUA), urinary excretions of uric
      acid (UUAV) and sodium (UNaV), fractional excretions of uric acid (FEUA) and
      sodium (FENa), plasma renin activity (PRA) and plasma aldosterone concentration
      (PAC) were measured before and after intravenous injection of a dopamine receptor
      antagonist, metoclopramide (MCP: 8 mg/m2.BSA), or before and after a single oral
      administration of prostaglandin synthesis inhibitor, indomethacin (IM: 75 mg), in
      34 mild-to-moderate essential hypertensives (EHT). MCP injection or acute oral
      administration of IM caused significant decreases of UNaV and FENa in each group,
      whereas MAP, HR and SUA did not change in either group. Significant decreases in
      Ccr, UUAV and FEUA and increases in PRA and PAC were demonstrated by MCP
      injection, while no significant changes in these parameters were revealed by IM
      administration. There was a significant positive correlation between delta UUAV
      and delta Ccr or delta FEUA in both groups. In addition, a close positive
      correlation between delta UUAV and delta UNaV as well as between delta FEUA and
      delta FENa was found in the MCP group, but not in the IM group. On the other
      hand, no significant correlation was observed between delta UUAV and delta PRA or
      delta PAC in either MCP or IM administration. The decreases of UUAV and FEUA were
      significantly greater in MCP than in IM administration, despite similar changes
      in Ccr, UNaV and FENa between the two procedures. These data suggest that the
      endogenous renal dopaminergic system may contribute to renal uric acid
      metabolism, which is rather closely related to sodium handling in essential
      hypertension than the prostaglandin system. Furthermore, the attenuated renal
      dopaminergic activity may contribute to the elevation of serum uric acid level in
      patients with essential hypertension.

PMID- 1761142
TI  - [Immunohistochemical studies on the thyroid C-cells in primary
      hyperparathyroidism].
AB  - This study was conducted in order to establish whether C cells, which are
      responsible for secretion of calcitonin within the thyroid gland, change either
      in volume or morphology under conditions of chronic hypercalcemia in primary
      hyperparathyroidism. Out of 106 primary hyperparathyroid patients undergoing
      surgery, in 11 cases the thyroids were excised and examined for changes in the C
      cell. As a control group we used thyroids removed in another 14 cases undergoing
      thyroidectomy or laryngectomy. Calcitonin in the C cell was observed by optical
      microscope after immuno staining using the indirect peroxidase-labeled antibody
      technique. C cells are not evenly distributed within the thyroid. However, there
      is excellent positive correlation (p less than 0.001) between the C-cell index,
      which is the average of two tissue samples excised from the area at the border
      between the upper 1/3 and middle 1/3 of the thyroid lobe (the area where most C
      cells are found), and the total number of C cells. The C-cell index can thus be
      used as an indicator of the total number of C cells in the thyroid. The number of
      C cells decreased (p less than 0.01) as the level of calcium in serum increased.
      In patients with primary hyperparathyroidism, this decrease in C cells was
      significantly greater (p less than 0.025) than in the controls. Focal C cell
      hyperplasia and diffuse C cell hyperplasia were present in both the control group
      and primary hyperparathyroid group, but there was no significant difference
      between the two groups as to the frequency of occurrence. For both these
      conditions the rate of occurrence was considered within normal ranges for C cell
      morphology. We concluded that the decrease in C-cell count in primary
      hyperparathyroidism patients with chronic hypercalcemia is due to consumption of
      calcitonin in the C cell.

PMID- 1761143
TI  - Glycogen structure and biogenesis.

PMID- 1761144
TI  - Comparative biochemistry of vitamin B12 (cobalamin) metabolism: biochemical
      diversity in the systems for intracellular cobalamin transfer and synthesis of
      the coenzymes.

PMID- 1761145
TI  - Regulation of neutrophil and macrophage production by growth factors.

PMID- 1761146
TI  - Hepatoprotective agent (+)-cyanidanol increases the synthetic phase of
      hepatocellular regeneration.
AB  - 1. (+)-Cyanidanol (250 mg/kg) administration to male rats resulted in a
      concentration-dependent increase in [3H]-thymidine incorporation into hepatic
      nuclear DNA as well as a corresponding increase in the per cent of labelled
      cells. 2. The increase in [3H]-thymidine incorporation and per cent labelled
      cells was significant by 24 hr, maximal between 48 and 96 hr, and declined very
      slowly to normal by 15 days (360 hr). 3. Administration of (+)-cyanidanol
      resulted in an increase in heptic putrescine levels and ornithine decarboxylase
      activity at 6 hr but not at 24 hr. However, S-adenosylmethionine decarboxylase
      and spermidine acetyltransferase activities were unaltered. 4. Inspite of these
      favorable conditions, for cell division, mitotic index (per cent cells in
      metaphase) was not increased by (+)-cyanidanol. 5. These results along with
      previous findings indicate that (+)-cyanidanol stimulates the S-phase activity of
      hepatocellular regeneration, but the commitment to M-phase depends on the
      occurrence of liver injury.

PMID- 1761147
TI  - Conformational stability of citraconylated ovalbumin.
AB  - The lysine residues were modified to varying degrees (50-91%) with citraconic
      anhydride to determine the extent of conformational change in ovalbumin. Major
      findings included: 1. Sixteen of the 20 lysine residues are located on the
      protein surface, while the remaining four are buried. 2. The tertiary structure
      changed progressively with the degree of modification. 3. However, the secondary
      structure was disrupted only after one or more of the four buried lysines had
      been citraconylated. 4. Although the secondary structure was unaltered, the alpha
      helix was nevertheless progressively destabilized as the surface 16 lysine
      residues were modified. This destabilization was due to electrostatic repulsions
      introduced by the entering citraconyl groups.

PMID- 1761148
TI  - Comparison of the metabolic fate and tissue distribution of B700, an albumin-like
      melanoma-specific antigen with serum albumin in normal and tumor-bearing mice.
AB  - 1. B700, a murine melanoma antigen, is a member of the serum albumin protein
      family, being closely related to murine serum albumin (MSA). 2. We have studied
      and compared the metabolic fate and anatomic distribution of radioiodinated B700
      and MSA administered to semisyngeneic naive and tumor-bearing mice. 3. Labelled
      material from both proteins is excreted primarily into urine. 4. The rate of
      excretion of the two proteins is markedly different, with B700 having a shorter
      half-life in the body. 5. Despite their similar molecular weights, intact B700
      represents approx. 30% of the radioactivity in the urine but only 4% of the MSA
      in the urine is intact. 6. These studies demonstrate that the host can readily
      distinguish between very similar normal (MSA) and tumor-associated (B700)
      molecules and process them differently. 7. Similar findings of differential fate
      and distribution have been reported in comparing other albuminoid molecules
      [Dueland S., Blomhoff R. and Pedersen J. I. (1990) Biochem. J. 267, 721-725].

PMID- 1761149
TI  - Enhancement of immunogenic properties of ovalbumin as a result of its
      chlorination.
AB  - 1. Chlorination of ovalbumin results in its enhanced immunogenic properties. 2.
      This has been evaluated by the interleukin-2 production after incubation of the
      modified protein with antigen presenting cells and T helper cells.

PMID- 1761150
TI  - Characterization of the process of 5-aminolevulinic acid formation from glutamate
      via the C5 pathway in Clostridium thermoaceticum.
AB  - 1. In vitro formation of 5-aminolevulinic acid (ALA) from glutamate required two
      enzyme fractions, separable on Blue Sepharose affinity chromatography, and a tRNA
      fraction, which can be replaced by Escherichia coli tRNA(Glu) in the
      reconstituted assay. 2. Gabaculine was shown to inhibit ALA formation in the
      complete assay as well as in a defined system consisting of only glutamate-1
      semialdehyde and the enzyme fraction not retained on Blue Sepharose. 3. The
      results indicate that the enzyme system supporting ALA formation in Clostridium
      thermoaceticum is very similar to the tRNA(Glu)-dependent C5 pathway in plant
      plastids.

PMID- 1761151
TI  - Inhibition by monochloramine of the transport of glutamine and glucose in HeLa
      cells and lymphocytes.
AB  - 1. Chloramine was previously shown to inhibit glutamine uptake by human
      lymphoblast tumour cells. In the present study, the effect of monochloramine on
      the glutamine and glucose transport systems in HeLa cells and rat mesenteric
      lymphocytes was investigated. 2. Initial exposure to monochloramine slightly
      inhibited both the glutamine and glucose transport systems in HeLa cells.
      However, pre-exposing the cells to monochloramine increased its inhibitory
      action. 3. Similar results were obtained using rat mesenteric lymphocytes, which
      suggests that monochloramine's effects are not cell specific. 4. Only the Na(+)
      independent (system L) component of glutamine transport activity in HeLa cells
      was inhibited by monochloramine. 5. Dithiothreitol protected both the glucose and
      glutamine transport carriers in HeLa cells against monochloramine inhibition. 6.
      Monochloramine did not inhibit HeLa cell metabolism, nor enhance cell lysis,
      which, in conjunction with other experimental data, suggests that monochloramine
      inhibits cellular transport activity by binding to thiol groups present on the
      membrane.

PMID- 1761152
TI  - In vitro metabolism of [14C]4-chlorobiphenyl and [14C]2,2',5,5'
      tetrachlorobiphenyl by hepatic microsomes from rats and pigeons. Evidence against
      an obligatory arene oxide in aromatic hydroxylation reactions.
AB  - 1. The catalytic activities of cytochromes P-450IA1 and P-450IIB1 in control and
      Aroclor 1254 treated rats and pigeons (1 mmol/kg) were assessed using [14C]4
      chloro- and [14C]2,2',5,5'-tetrachlorobiphenyl as substrates. Treatment of rats
      resulted in increases of the total amount of chloroform-extractable metabolites
      of [14C]4-chlorobiphenyl from 37.2 (control) to 199.4 and 221.6 nmol/hr per mg
      microsomal protein at 48 and 120 hr post treatment. The portion of [14C]4-chloro
      3',4'-dihydroxybiphenyl (M4) and of a second unidentified dihydroxylated
      metabolite (M3) increased during these incubations from 13.7% for controls to
      53.5% at 48 hr and 69.12% at 120 hr post treatment. 2. [14C]4-chloro-3'
      hydroxybiphenyl (M1) and [14C]4-chloro-4'-hydroxybiphenyl (M2) were the major
      metabolites formed by pigeon hepatic microsomes; however, the amounts formed were
      38.7- and 29.3-fold less, respectively, than in untreated rats. Treatment of
      pigeons with Aroclor 1254 increased the metabolite formation from 1.0 (control)
      to 13.6 and 22.4 nmol/hr per mg microsomal protein at 48 hr and 120 hr post
      treatment respectively; however, only small amounts of metabolites M3 (0.5
      nmol/hr per mg protein) and M4 (2.0 nmol/hr per mg protein) were detected. 3.
      Treatment of rats with Aroclor 1254 resulted in an approximately two-fold
      increase in the rate of metabolism of [14C]2,2',5,5'-tetrachlorobiphenyl, and the
      ratio of 3- to 4-hydroxylation increased from 0.45 (control) to 0.6 and 0.8 at 48
      hr and 120 hr post treatment respectively. The rate of metabolism of
      [14C]2,2',5,5'-tetrachlorobiphenyl by control and Aroclor 1254 treated pigeons
      was up to 23-fold lower than in rats and there was no evidence for the formation
      of the diol metabolite M3. However, as with rats, the ratio of meta- to para
      carbon atom hydroxylation increased from 0.58 (controls) to 0.72 at 120 hr post
      treatment. 4. From the evidence presented, it is suggested that cytochromes P
      450IA1 and P-450IIB1 may not metabolize PCB-congeneric substrates via an
      obligatory arene oxide intermediate.

PMID- 1761153
TI  - Twenty-four-hour changes of S-adenosylmethionine, S-adenosylhomocysteine
      adenosine and their metabolizing enzymes in rat liver; possible physiological
      significance in phospholipid methylation.
AB  - 1. The metabolic control of adenosine concentration in the rat liver through the
      24-hr cycle is related to the activity of adenosine-metabolizing enzymes [5'
      nucleotidase (5'N), adenosine deaminase (A.D.), adenosine kinase (A.K.) and S
      adenosylhomocysteine hydrolase (SAH-H)]. 2. Two peaks of adenosine were observed,
      one at 12:00 hr caused by high activity of 5'N and SAH-H, and the other at 02:00
      hr, caused by a decrease in purine catabolism and purine utilization, low
      activity of SAH-H and de novo purine formation. 3. The similarity of the
      adenosine and S-adenosylmethionine (SAM) profiles through the 24-hr cycle
      suggests a role of adenosine in transmethylation reactions, because, during the
      night (02:00 hr), the metabolic conditions favor the formation and accumulation
      of S-adenosylhomocysteine (SAH), with consequent inhibition of transmethylation
      reactions. 4. In the 24-hr variation of phosphatidylcholine (PC) and
      phosphatidylethanolamine (PE), the lowest ratio of PC/PE was observed at 24:00
      02:00 hr when SAH concentration is high, whereas the highest PC/PE ratio occurs
      at the same time as one of the SAM/SAH ratio maxima.

PMID- 1761154
TI  - Al-ATP as an intracellular carrier of Al(III) ion.
AB  - 1. Using 27Al and 31P NMR spectroscopy in conjunction with an Al lactate aqueous
      reagent at pH 7.2, Al complexes of ATP and of phospholipids were characterized in
      synthetic-aqueous and organic-phospholipid chemical systems and in the intact
      human red blood cell. 2. The observed 31P NMR chemical shifts of the Al-ATP
      complex in aqueous laboratory preparations or the intact human red blood cell
      were, respectively, alpha phosphate, -11.53 delta; beta phosphate, -22.65 delta;
      and gamma phosphate, -10.95 delta. 3. The observed complexed 27Al chemical shift
      was -2.22 delta. 4. The relative affinities for Al of the phospholipids
      determined from 31P NMR spectroscopic titrations were PA much greater than Cl
      much greater than PS greater than PG approximately equal to PI greater than PE
      plus approximately equal to PE much greater than SPH greater than PC.

PMID- 1761155
TI  - Steroid hormone receptors in the thymus: a site of immunomodulatory action of
      melatonin.
AB  - 1. Melatonin and glucocorticoids are known to affect the immune response in an
      opposite mode. The probability for an interaction between these hormones in the
      thymus gland has been investigated in rats following chronic administration of
      exogenous melatonin and long-term exposure to variable levels of circulating
      glucocorticoids. 2. Daily melatonin administration was shown to affect the
      properties of corticosterone and progestin receptors in the thymus in the
      presence of normal and increased systemic corticosterone concentrations, but not
      in adrenalectomized animals. 3. In intact rats melatonin caused a marked increase
      in the affinity and a decrease in the density of thymic receptors for adrenal
      steroids. Following corticosterone overdosage, simultaneously with melatonin
      treatment, a decrease in receptor affinity and a relative increase in the number
      of binding sites was observed. 4. The results suggest that steroid hormone
      receptors in the thymus might be considered as a target site for the interaction
      between melatonin and adrenal steroids in the modulation of the immune response.

PMID- 1761156
TI  - Melatonin effects on thymus steroid receptors in the course of primary antibody
      responses: significance of circulating glucocorticoid levels.
AB  - 1. The effects of chronic melatonin treatment on antibody production and thymus
      glucocorticoid and progestin binding sites in the course of primary immune
      response were investigated in rats subjected to long-term manipulations of
      circulating glucocorticoid concentrations. 2. The chronic melatonin treatment
      enhanced the PFC-ability in control and ADX animals and decreased it in the
      presence of high circulating corticosterone levels. 3. Melatonin treatment
      increased the affinity and decreased the density of glucocorticoid and progestin
      receptors in non-immunized animals, while in SRBC-primed rats it was ineffective.
      4. The influence of melatonin was apparent when steroid environment was subject
      of variations: it decreased the affinity of both types of receptors in ADX
      animals and increased it in immunized rats which have been subjected
      simultaneously to corticosterone overdose.

PMID- 1761157
TI  - Heterogeneity of synaptosomal membrane preparations from different regions of
      calf brain studied by partitioning and counter-current distribution.
AB  - 1. Membranes obtained by lysis and Yeda-press treatment of synaptosomes (nerve
      endings) from cortex, caudateus nucleus, and hippocampal region of calf brain
      have been studied by partitioning within a liquid-liquid aqueous two-phase system
      consisting of water, dextran, Ficoll, and poly(ethylene glycol). 2. The
      partitioning of membranes was sensitive to the presence of a dextran-bound dye,
      Procion yellow HE-3G, in the lower phase. 3. The two-phase system was used for
      counter-current distribution to study the heterogeneity of the synaptic membranes
      from the three regions of the brain and to separate the membranes into fractions.
      4. The obtained counter-current distribution profiles strongly depended on the
      region of the brain from which the membranes were isolated. 5. The membrane
      fractions obtained showed marked differences in their SDS electrophoresis
      pattern.

PMID- 1761158
TI  - Regulation of basement membrane invasiveness in human breast cancer model
      systems.

PMID- 1761159
TI  - Regulation of thyroid follicular volume by bidirectional transepithelial ion
      transport.
AB  - Previous studies have shown that thyroid cells in monolayer culture exhibit
      bidirectional ion transport comprising apical-to-basal amiloride-sensitive Na+
      transport and oppositely directed bumetanide-sensitive Cl- transport. We have now
      investigated the role of ion transport in the regulation of thyroid follicular
      size using follicular primary porcine thyroid cell cultures. Bumetanide (10
      microM) added at the beginning of culture inhibited the formation of follicular
      lumina and caused a fall in follicle height when added to 3-day-old cultures. In
      contrast, phenamil (1 microM; an amiloride analog) increased follicle size both
      in freshly isolated and 3-day-old cultures. The effect of bumetanide was
      prevented by the prior addition of phenamil. Micropuncture studies showed that
      follicles had a lumen-negative, basal-positive transepithelial potential
      difference which was progressively reduced in magnitude by the serial addition of
      bumetanide (10 microM) and phenamil (1 microM). We conclude that thyroid
      follicles possess a bidirectional ion transport system which transports Na+ in an
      apical-to-basal direction and Cl- in the opposite direction. The balance between
      these two processes determines net solute flux and hence follicular size. A
      physiological role of ion transport in the thyroid may be to regulate follicular
      volume suggesting that abnormalities of ion transport may be responsible for
      disorders of follicular size.

PMID- 1761160
TI  - Sertoli cells are the site of interleukin-1 alpha synthesis in rat testis.
AB  - To elucidate the cellular origin of interleukin-1 (IL-1) in the mammalian testis,
      we assayed IL-1 activity in culture media of Sertoli cells collected from rats at
      20, 35 and 45 days of age as well as in culture media of interstitial,
      peritubular and germ cells from adult rats. IL-1 was detected in Sertoli cell
      culture media isolated from 35- and 45-day-old rats. At 45 days approximately
      twice as much IL-1 was produced than at 35 days. In contrast, IL-1 activity was
      not detected in 20-day-old rat Sertoli cell culture media nor in interstitial,
      peritubular and germ cell culture media. The Sertoli cell IL-1 activity was
      specifically neutralized by an IL-1 alpha antiserum. It is concluded that Sertoli
      cells produce IL-1 alpha and that this production increases during sexual
      maturation.

PMID- 1761161
TI  - Human thyrotropin receptor gene: expression in thyroid tumors and correlation to
      markers of thyroid differentiation and dedifferentiation.
AB  - Human thyrotropin (TSH) receptor steady-state transcript levels were analyzed by
      Northern blot analysis in thyroids of patients with thyroid carcinoma, with
      hyperfunctioning adenoma and in normal controls. In control tissue and benign
      tumors expression levels of TSH receptor mRNA were high whereas in anaplastic
      carcinomas no normal TSH receptor mRNA was detected. In papillary and follicular
      tumors it varied from normal to markedly reduced levels. Thyroid peroxidase (TPO)
      and thyroglobulin (Tg) mRNA were strongly expressed in normal tissue and in
      hyperfunctioning adenomas but were completely lost in all anaplastic tumors. In
      papillary tumors expression of TPO and Tg mRNA varied from normal to a complete
      loss of expression of either TPO, Tg or both. Tg and TPO steady-state expression
      did not correlate to TSH receptor transcript levels. C-myc mRNA was highly
      expressed in anaplastic carcinomas, very variable in normal controls and in
      differentiated thyroid tumors and low in hyperfunctioning adenomas. In summary,
      TSH receptor mRNA is persistently expressed in all differentiated thyroid tissues
      and tumors but lost in undifferentiated carcinomas. Its persistence far along the
      transformation pathway further supports the concept that this gene which inserts
      the thyrocytes in the physiological regulatory network is almost constitutively
      expressed in this cell.

PMID- 1761162
TI  - Inhibitory effects of serum and stimulatory effects of estrogen on prolactin mRNA
      levels in GH3 rat pituitary tumor cells.
AB  - We investigated the effects of serum and estrogen on prolactin (PRL) mRNA
      accumulation in GH3 cells under different cell culture conditions. Hybridization
      analysis of GH3 cellular RNA indicated that PRL mRNA levels decreased more than
      20-fold in cells cultured for 1 week in medium containing dextran-charcoal
      treated serum (stripped serum). No effects on actin mRNA levels were observed
      under these conditions. Furthermore, this inhibition of PRL mRNA accumulation
      depended on the concentration of stripped serum in the medium. Although
      incubation in stripped-serum medium inhibited cell growth, these culture
      conditions did not appear to irreversibly affect the GH3 cell population. These
      data indicate that a potent inhibitor of PRL mRNA accumulation is present in
      stripped serum. GH3 cells grown in stripped-serum medium were shown to be
      responsive to estrogen. Treatment of these cells with 10(-9) M estradiol resulted
      in a 6.6-fold stimulation of PRL gene expression. However, estrogen had no effect
      on cell growth under these conditions, suggesting that estrogen stimulates PRL
      gene expression and cell proliferation by independent mechanisms.

PMID- 1761163
TI  - Growth and cell cycle regulation of mRNA levels in GH3 cells.
AB  - In the rat anterior pituitary gland, estrogen increases both prolactin (PRL) mRNA
      levels and stimulates the proliferation of PRL-producing cells. The temporal
      sequence of these events suggests that PRL gene expression may be coordinated
      with cell proliferation. We investigated the relationship between cell cycle
      progression and the accumulation of the PRL mRNA, as well as several other mRNAs,
      in the rat pituitary tumor GH3 cell line. Serum-deprived cells progressed from G0
      to S phase in 20-24 h following serum stimulation. During this time, beta-actin
      mRNA levels increased 7-fold in 5 h, then returned to basal levels prior to the
      beginning of S phase. Histone H1 mRNA levels increased approximately 3-fold as
      cells entered S phase. These data are consistent with the cell cycle-dependent
      regulation of beta-actin and histone H1 gene expression reported for other cell
      types. Glucocorticoid receptor mRNA levels were barely detectable in serum
      deprived cells but rapidly increased 3- to 5-fold following serum stimulation.
      This increase resulted in glucocorticoid receptor mRNA levels that were
      equivalent to those seen in cells maintained in serum-containing medium,
      suggesting that serum factors regulate glucocorticoid receptor gene expression.
      In contrast to these changes in gene expression, the levels of PRL and growth
      hormone (GH) mRNAs gradually increased 2-fold while the cells progressed through
      G1 phase. Similarly, in cells synchronized to progress through S and G2 phases
      following aphidicolin treatment, histone H1 gene expression showed a specific
      increase in S phase cells, whereas PRL and GH mRNA levels changed little with
      cell cycle progression. These results indicate that the levels of PRL and GH
      mRNAs are not regulated in a cell cycle-dependent manner. When changes in
      estrogen responsiveness were determined during the cell cycle, we found that
      estradiol treatment was capable of increasing PRL mRNA accumulation independent
      of cell cycle progression and cell cycle distribution in synchronized GH3 cells.
      These results support the hypothesis that the hormonal regulation of PRL gene
      expression is not significantly affected by cell growth.

PMID- 1761164
TI  - Potentiation of thyrotropin-releasing hormone-stimulated prolactin mRNA levels in
      GH3 cells by acetylcholine.
AB  - We have examined the effect of acetylcholine (ACh) pretreatment on the
      thyrotropin-releasing hormone (TRH) induced prolactin gene expression in GH3
      cells, a rat pituitary tumor cell line. Prolonged exposure (greater than 6 h) to
      ACh enhanced the TRH-induced prolactin mRNA accumulation in a time- and
      concentration-dependent manner while ACh by itself did not affect the basal
      prolactin mRNA levels appreciably. Maximal augmentation of the TRH-induced
      prolactin mRNA accumulation was obtained when cells were pretreated with 10(-5) M
      ACh for 24 h. The activation was mimicked by carbachol and oxotremorine and was
      blocked by the simultaneous presence of atropine. Preincubation of GH3 cells with
      pertussis toxin abolished the augmenting effect of ACh. These results indicate
      that prolonged exposure to muscarinic receptor agonists may enhance the TRH
      stimulated prolactin mRNA expression and a pertussis toxin sensitive G-protein
      may be involved.

PMID- 1761165
TI  - Crotoxin, a phospholipase A2 neurotoxin from snake venom, interacts with
      epithelial mammary cells, is internalized and induces secretion.
AB  - Prolactin (PRL) induces liberation of arachidonic acid (AA) from phospholipids of
      lactating mammary epithelial cells and stimulates casein secretion. In order to
      investigate the possible involvement of phospholipase A2 (PLA2) activity in the
      hormonal control of casein secretion by PRL, we examined the effects of crotoxin,
      a PLA2 neurotoxin from snake venom, on mammary epithelial cells. Crotoxin is made
      of two subunits: a basic PLA2 with low toxicity (component B, CB) and an acidic,
      non-toxic and enzymatically inactive component A (CA) which enhances the
      pharmacological action of CB. While CA is inactive, the PLA2 subunit (CB) induces
      an accumulation of secretory products in the lumen of mammary acini, an extensive
      development of the Golgi apparatus. The secretion of newly synthesized casein is
      increased in the presence of CB and this effect is inhibited by
      nordihydroguaiaretic acid (NDGA) and caffeic acid, two inhibitors of the
      lipoxygenase pathway which also prevent stimulation of secretion by PRL. Further,
      CB transiently induces the release of radiolabelled AA from mammary tissues
      previously labelled with [14C]AA, the highest release being observed between 15 s
      and 5 min of contact with CB and CA. Immunofluorescence labelling by anti-CB
      antibodies of epithelial mammary tissues previously incubated with CA, CB or a
      combination of CA and CB indicates that CB binds to epithelial cells and is
      internalized, at least in part, and that CA enhances both CB binding and its
      internalization. These observations emphasize the involvement of PLA2 in the
      control of casein secretion and suggest that PLA2 acts intracellularly.

PMID- 1761166
TI  - Processing of pro-CGRP in a rat medullary thyroid carcinoma cell line transfected
      with protease inhibitors.
AB  - A rat medullary thyroid carcinoma cell line, CA77, was used to study the effect
      of a series of biosynthesized protease inhibitors on the proteolytic cleavage of
      the endogenously synthesized pro-CGRP. This cell line efficiently converted the
      pro-CGRP to mature CGRP as assessed by chromatography of cell extracts followed
      by radioimmunoassay for CGRP. CA77 cells were transfected with expression vectors
      encoding protease inhibitors: the Arg-serpins, alpha 1-antitrypsin Pittsburgh
      (358 Met----Arg) and plasminogen activator inhibitor 1, the Kazal type serine
      protease inhibitor, pancreatic secretory trypsin inhibitor, and the general thiol
      protease inhibitor, cystatin C. Only the chromatography of cell extracts from
      CA77 cells transfected with a plasmid encoding cystatin C showed an apparent
      higher content of unprocessed pro-CGRP as compared to non-transfected cells. No
      effect on pro-CGRP processing could be measured in the CA77 cells transfected
      with plasmids encoding the three serine protease inhibitors. CA77 cells were also
      transfected with two constructs encoding chimeric proteins consisting of cystatin
      C and the precursor for neuropeptide Y. Release experiments using 8-bromo cAMP as
      the secretagogue showed that the chimer was co-released with CGRP. However, no
      effect of this chimer upon pro-CGRP processing could be detected. It is concluded
      that the processing of pro-CGRP in the CA77 cell line was very efficient and that
      four different protease inhibitors and two cystatin C/NPY chimers synthesized by
      this neuroendocrine cell line had only minimal effect upon the processing of
      CGRP.

PMID- 1761167
TI  - [Therapy of endometrial cancer].
AB  - Surgical-pathological categorising of endometrial carcinoma makes it possible to
      treat this cancer in a more differentiated way. In clinical stage I, 6% of the
      adnexes, 10% of the pelvic lymph nodes and 5% of the paraaortic lymph nodes are
      affected. There is a direct correlation between depth of invasion and pelvic and
      paraaortic lymph node metastases. The new surgical-pathological categorising of
      endometrial carcinoma requires extensive surgery. Lymphadenectomy, which is
      necessary for categorisation means over-treatment for 2 thirds of all cases.
      Today, low-risk endometrial cancers can be distinguished from high risk ones by
      vaginal sonography as well as NMR permits the detection of invasion
      preoperatively and curettage to determine the unfavorable subtypes
      (seropapillary, clear-cell), hormonal receptors and ploidy. In low-risk cases,
      hysterectomy (with adnexes) and careful revision of the abdomen is sufficient. No
      further adjuvant therapy is necessary. In high-risk cases, an extended pelvic
      and, in the case of metastases, an para-aortic lymphadenectomy is imperative.
      Percutaneous X-ray therapy is not necessary in low-risk cases postoperatively. In
      high-risk cases, its effectiveness is not established and is probably not
      superior to the operative removal of metastases. Radiation of the vaginal cuff is
      necessary and successful in high-risk cases. In low-risk cases, side-effects are
      minimal. Adjuvant therapy with gestagens in low-risk cases is not indicated,
      because of their side-effects and does not reduce recurrence rate. Recurrent and
      metastasizing endometrial carcinomas respond to gestagens in about 15% of cases.
      Response is receptor dependent. High dose is not more effective. Endometrial
      carcinoma responds to chemotherapy. Most effective is adriamycin with a response
      rate of 35%. Combination therapies did not show greater effect in randomized
      studies. Recurrence free interval is only 6 to 8 months, however. An adjuvant
      chemotherapy is only indicated in the case of a serous carcinoma.

PMID- 1761168
TI  - [A risk score for operated endometrial cancer and its importance for adjuvant
      radiotherapy (histopathology and results of treatment based on 208 cases with
      pelvic lymph node excision)].
AB  - In a retrospective study of 208 surgically treated cases of endometrial cancer
      with pelvic lymphadenectomy, histomorphology with subtypes, tumour grading,
      infiltration of the myometrium, blood- and lymphatic vessel invasion and pelvic
      lymph node metastases, were analysed. Typical adenocarcinomas had lymph node
      involvement in 9% of the patients, whereas unfavourable subtypes showed in 27%.
      In patients with tumour grading I, the lymph nodes were involved in only 4.5% and
      with grading 3 in 31.4%, respectively. If the carcinoma was limited to the
      endometrium, no lymph node metastases could be detected. If the inner half of the
      myometrium was involved, pelvic nodes were positive in 9.2% with deeper
      infiltration in 27.3% of the cases. With obvious invasion of blood or lymph
      vessels, lymph nodes were positive in 43.2% of the cases. A simple score for
      these histopathological risk factors is proposed, enabling the allocation to
      patient groups of similar risk on the basis of a point system for individual
      prognostic factors. With a score of 1-2 points (13.5% of the cases) the prognosis
      is good and adjuvant irradiation does not seem necessary. With 3-4 points (34.1%
      of the cases), local vaginal irradiation is recommended. With 5 or more points,
      we recommended, in addition to vaginal irradiation, aggressive irradiation of the
      small pelvis, 52.4% were in this group, from which 85% were symptom-free at the
      critical 5 year point. In case of positive pelvic lymph node, 67% of the patients
      survived after adequate adjuvant follow-up irradiation.

PMID- 1761169
TI  - [Prognostic factors in stage Ia-IIb invasive cervix cancer after radical
      hysterectomy with special reference to stroma reaction].
AB  - 158 cases of invasive carcinoma of the uterine cervix stages Ia to IIb were
      analysed with respect to the following prognostic criteria: histological stage,
      presence of nodal metastases, vascular space invasion and inflammatory stromal
      reaction at the periphery of the tumor. The assessment of these criteria was
      correlated to the prevalence of tumor recurrence. In cases with absent nodal
      metastases, a significant increase of tumor recurrence in stage IIb compared to
      other stages was noted. A constant increase of the recurrence rate was found,
      when nodal metastases were present, although the incidence of positive lymph
      nodes was approximately equal in stages Ic, IIa and IIb. The involvement of the
      parametrium therefore appears to be a significant parameter for the poor
      prognosis in stage IIb. Vascular space invasion proved to be a significant
      parameter with regard to lymph node involvement. When no vascular space invasion
      was obvious, 94% of the cases showed tumor-free lymph nodes. Overall, heavy
      inflammatory infiltration at the tumor periphery correlated with a good
      prognosis. In cases of heavy inflammatory stromal reaction, the risk of nodal
      metastases and tumor recurrence was significantly lower, independent of the
      histological stage. The incidence of heavy inflammatory infiltration was
      significantly higher in microinvasive carcinomas than in clinically invasive
      tumors. Therefore, the extent of inflammation appears to be an additional useful
      prognostic index to identify a group of patients at high risk for recurrence and
      reduced chance of survival.

PMID- 1761170
TI  - [Posterior exenteration with plastic reconstruction in advanced vulvar cancer].
AB  - Between 1984 and 1990, twenty-four patients suffering from advanced primary (7)
      or recurrent (17) valvular carcinoma were treated by posterior exenteration and
      myocutaneous reconstruction of the defect. During a follow-up of 34 months, the
      overall survival was 49%. Eight patients died. Tumour diameter and tumour-free
      margins of the resected specimens were the most important prognostic factors. In
      all cases, an improved quality of life could be achieved by the operation. It is
      concluded that, even in extremely difficult situations, posterior exenteration,
      followed by plastic reconstruction entails an essential benefit for the patient.

PMID- 1761171
TI  - [Reactions to stress during the normal menstrual cycle].
AB  - In the present study, we questioned, whether the variability of physiological
      parameters within a menstrual cycle are connected with psychological variables
      like mood, state of health and positive/negative daily occurrences. We examined
      20 women with normal cycles. The definition of a normal cycle was: 28 (+/- 5)
      days of length, standard weight according to Broca, 3-5 days menstrual bleeding,
      no oral contraceptive during the last 6 months, no IUP, inconspicuous hormones
      (no raised prolactin or testosterone levels), gynecologically unremarkable
      findings. Gynecological and psychological data were gathered daily during one
      menstrual cycle: hormone levels, vaginal ultrasound for detecting follicle
      growth, ovulation, corpus luteum and endometrial development. The psychological
      data on mood, state of health and positive/negative occurrences were recorded in
      parallel in the form of a diary, in which new entries were made daily. The
      results showed, that only 6 out of the 20 women had a normal menstrual cycle as
      defined above. Women with a normal (physiological) cycle, report in their diary:
      less negative bodily tendencies, more positive everyday situations, but the same
      amount of negative situations as women with noticeable cycles. Both the normal
      cycle group and the conspicuous cycle group report more negative body states and
      more negative moods in the premenstruum than the middle phase. The implications
      of these results are discussed.

PMID- 1761172
TI  - [Endoscopic bladder neck suspension--clinical, urodynamic and radiologic
      results].
AB  - 70 women were evaluated clinically and urodynamically both before and, on average
      16 (12-48) months after undergoing endoscopic suspension of the bladder neck,
      following Stamey, for genuine stress urinary incontinence. The average age of the
      patients at surgery was 52 (35-85) years; the average parity was 3 (0-10).
      Preoperative and postoperative lateral colpocystograms were performed on 48
      patients. 40 patients had marked descent of the pelvic organs; 30 patients had
      previously undergone vaginal hysterectomy and anterior colporrhaphia. Overall,
      70% of the patients were postoperatively clinically and urodynamically continent
      at follow-up; however, only 44% of the patients with a preoperative urethra
      closure pressure (UCP) less than 20 cm H2O were continent. The functional
      urethral length was unchanged but the point of maximum closure pressure was
      shifted to the proximal third of the urethra. The UCP at rest decreased
      significantly (p = 0.0277). Radiologically, the bladder neck was elevated further
      and the angle beta decreased more in the patients continent after surgery, than
      in those who remained incontinent. These data suggest that the Stamey operation
      is effective in selected patients with stress incontinence, but not in patients
      with a low UCP at rest.

PMID- 1761173
TI  - [The effectiveness of intravaginal estriol tablet administration in women with
      urge incontinence].
AB  - In postmenopausal patients, stress and urge incontinence often occur as a
      consequence of oestrogen deficiency. We performed a comparative study in a
      prospectively randomised and placebo controlled group of women with urge
      incontinence to investigate different dosages of intravaginally applied oestriol.
      Clinical and urodynamic parameters were also compared. 15 women (Group I)
      received 1 mg oestriol applied daily intravaginally over 3 weeks; 15 women (Group
      II) received a daily dosage of 3 mg and 10 women received a placebo. A complete
      clinical and urodynamic evaluation was carried out twice at a 4-week interval.
      The women receiving a daily dose of 3 mg oestriol applied intravaginally
      demonstrated a significant improvement of the parameters strong desire to void,
      pollakisuria, and nycturia. No improvement was seen in patients with motoric urge
      incontinence.

PMID- 1761174
TI  - [Local administration of metronidazole before hysterectomy--effect on infectious
      morbidity. A prospective study].
AB  - A prospective clinical trial was designed to examine the influence of a local
      application of metronidazole on postoperative infectious morbidity in 134 women
      undergoing vaginal and in 108 women undergoing abdominal hysterectomy. 116
      patients received on the evening before hysterectomy a vaginal suppository of
      metronidazole (500 mg). The control group (126 patients) had no metronidazole
      prophylaxis. All patients, who underwent vaginal hysterectomy, were given
      additionally a single-shot prophylaxis with 1500 mg cefuroxim. With regard to
      febrile morbidity, urinary tract infection and abdominal wound or pelvic
      infection, there was a significant decrease in infectious morbidity. In women
      undergoing vaginal hysterectomy the infectious morbidity was reduced from 35.7%
      to 20.3% (p less than 0.05) in spite of systemic prophylaxis. In cases with
      abdominal hysterectomy, we saw a decrease from 64.3% to 26.9% (p less than
      0.001). There was no effect on the incidence of urinary tract infections. Local
      prophylaxis with metronidazole in abdominal hysterectomy and additional to a
      systemic prophylaxis in vaginal hysterectomy reduces the infectious morbidity in
      our patients.

PMID- 1761175
TI  - [Trends in surgery of gynecologic cancers].

PMID- 1761176
TI  - [Modification of the use of a magnetic device for urethral occlusion in recurrent
      incontinence].
AB  - The magnetic closure device consists of a bow-shaped retropubically implanted
      magnet. Another removable magnet is situated in the vagina, thus gently closing
      the urethra. The modification described herein consists of colposuspension over
      the upper edge of the implanted magnet. Continence was thus achieved. The use of
      the intravaginal magnet was not necessary. The case report deals with the first
      two patients.

PMID- 1761177
TI  - [Reduction-plasty of the breast in symmastia].
AB  - Medial confluence of the breasts, known as symmastia, has received little
      attention in plastic surgery literature. By reporting on one case, we present our
      surgical technique. The chosen method of the reduction mammoplasty is considered
      to be particularly important. Liposuction is integrated into the surgical
      procedure. Suggestions made by other authors are discussed.

PMID- 1761178
TI  - [Recurrent multicystic peritoneal mesothelioma in endometriosis of the pelvis].
AB  - In the case of a 21-year old woman, who complained of chronic pelvic pain and
      where cystic structures in the adnexal region had been diagnosed ultrasonically
      and by laparoscopy, a tumour made up of many small cysts was discovered in the
      pouch of Douglas next to a typical endometrial cyst. Both the endometrial cyst
      and the cystic tumour were excised by laparotomy. Histology established the
      tumour as a multicystic peritoneal mesothelioma. Postoperative recurrence was
      noticed by ultrasound less than one year later. Laparotomy revealed a 5 cm serous
      cyst of the right ovary and again countless liquid-filled grape-like small cysts
      in the pouch of Douglas. Histology revealed a multicystic peritoneal mesothelioma
      identical to the previously excised tumour. Multicystic peritoneal mesothelioma
      is a rare soft tissue tumour noted for its frequent recurrences. Most authors
      agree, that it belongs to the morphological spectrum of reactive mesothelial
      proliferative lesions and not the neoplastic spectrum. It appears mostly in
      women, often concomitant with endometriosis and pelvic inflammatory disease and
      frequently in women, who had previous surgical interventions in the abdominal
      region.

PMID- 1761179
TI  - [Prenatal diagnosis of malignant intracranial teratoma in the fetus].
AB  - At 24 weeks of gestation, an intracranial cystic lesion of 3 cm diameter, without
      further associated foetal malformations, was detected by ultrasound in a 25-year
      old nullipara prima gravida, during routine prenatal care. Within 5 weeks, the
      cystic mass developed into a predominantly solid tumour located at the 3rd
      ventricle, showing patterns of a rapidly growing malignant intracerebral process.
      At 29 weeks of gestation, pregnancy was terminated by sectio parva because of a
      progressive hydrocephalus with a biparietal diameter of 10.2 cm. Autopsy
      confirmed a malignant teratoma. Foetal intracranial teratomas are rare. Diagnosis
      and therapy should be carried out in perinatal centres.

PMID- 1761180
TI  - Effect of repeated administrations upon cathinone discrimination and conditioned
      place preference.
AB  - 1. Eight male rats were trained to discriminate the interoceptive cues produced
      by 0.8 mg/kg l-cathinone in a two-lever, food-motivated operant task and they
      were, subsequently, tested for preference to cathinone in a conditioned place
      preference (CPP)-test. 2. Once trained, the rats were placed on a 10 day regimen
      of twice-a-day non-contingent administrations of saline followed by a similar
      regimen of multiple injections of 0.8 mg/kg cathinone. 3. After each series of
      non-contingent administrations, the rats' ability to discriminate (0.2-0.8 mg/kg)
      cathinone, as well as their preference for it, was determined. 4. Results
      indicate that tolerance tends to develop to the effect of cathinone in its
      ability to control discriminative behavior as indicated by deficits in
      discriminative performance and a two-fold shift of the dose-response curve to the
      right. 5. In contrast, preference for cathinone, in the CPP-tests, was not
      significantly affected by the multiple cathinone administration regimen. 6. The
      possibility that tolerance to some behavioral effects may occur in habitual users
      of the cathinone-containing Khat shrub is discussed.

PMID- 1761181
TI  - Effect of ageing on response to nicotine in rabbit bronchial preparation.
AB  - 1. Effect of ageing on the response to nicotine was tested in the bronchial
      muscle preparations from 5, 13, 100 and 125 week-old rabbits. The pD2 value
      (potency) of nicotine significantly increased in the preparation from the 125
      week-old rabbits. No age-related change was found in the pD2 value of
      carbamylcholine or pA2 value of atropine. 2. No age-related change in
      characteristics of nicotine receptors. Choline acetyltransferase activity, the
      amount of acetylcholine released by nicotine and acetylcholineesterase activity
      decreased in the preparations from the 125 week-old rabbits. 3. Decrease in the
      pD2 value of nicotine in the preparation from the older rabbit is due to a
      decline in choline acetyltransferase activity followed by a reduction in the
      acetylcholine released, and not to a change in characteristics of nicotine
      receptors. 4. These results also suggest that enzymes may be influenced more
      easily with age than drug receptors.

PMID- 1761182
TI  - Ampicillin concentrations in human oral tissues following a single oral
      administration of lenampicillin.
AB  - 1. Ampicillin concentrations in serum (n = 20), gingiva (n = 12), jawbone (n =
      13), dental follicle (n = 12), radicular granuloma (n = 2) and radicular cyst (n
      = 2) were measured in specimens obtained during 0.5-2.5 hr after a single oral
      administration of lenampicillin (equivalent to 500 mg of ampicillin). 2.
      Measurable ampicillin concentrations were found in all serum and tissues. 3.
      Ampicillin concentrations in serum and tissues except for some gingiva and
      jawbone exceeded MIC for 90% of clinically isolated strains of alpha-hemolytic
      Streptococci. 4. Ampicillin concentrations in gingiva and jawbone were below the
      MIC for 90% in 2 out of 12 and 4 out of 13 specimens, respectively.

PMID- 1761183
TI  - Effect of bradykinin antagonists, NG-monomethyl-L-arginine and L-NG-nitro
      arginine on phospholipase A2 induced oedema in rat paw.
AB  - 1. The rat paw oedema produced by a local injection of phospholipase A2 from Naja
      mocambique mocambique has been shown to be mainly driven by the liberation of
      serotonin and kinins. 2. Using specific bradykinin receptor antagonists we have
      shown that kinins are acting through B2 receptors. 3. Using endothelium-derived
      relaxing factor (EDRF) synthesis inhibitors NG-monomethyl-L-arginine and L-NG
      nitro arginine we have tested the possible envolvement of EDRF as mediator. 4.
      Our work supports the view that extracellular phospholipases A2 are involved in
      inflammation, and suggests a role for EDRF as mediator of extravasation in this
      model of inflammation.

PMID- 1761184
TI  - Evaluation of synergism of drugs cis-diamminedichloroplatinum (II) and
      arabinosylcytosine on the level of chemical interaction with DNA and on the
      growth of mouse leukemia.
AB  - 1. Cytotoxic synergism of drugs cis-diamminedichloroplatinum(II) (cis-DDP) and
      arabinosylcytosine (araC) was studied both on the level of interaction with DNA
      in chemically determined conditions and on leukemia L1210 bearing mice. 2. AraC
      and its structural natural precursor cytidine were tested for the modulation of
      kinetics of bifunctional adducts production induced by cis-DDP in DNA. 3. This
      process plays the basic role in cytotoxic mechanism and antitumor activity of cis
      DDP. 4. No interaction was seen between cis-DDP and araC. Further, presence of
      araC in reaction mixture had no effect on cis-DDP-DNA interaction. 5. Therefore,
      cytotoxic synergism does not arise in the araC-cis-DDP-DNA interaction and its
      origin is different. 6. Finding that cytidine has no synergistic effect on life
      span of leukemia L1210 bearing mice when administered together with cis-DDP it
      shows the difference between cytidine and araC. 7. The small structural
      difference between cytidine and araC is very important for synergism of
      cytotoxicity.

PMID- 1761185
TI  - Operant food intake in pigs following intracerebroventricular (i.c.v.)
      administration of prolactin.
AB  - 1. It has previously been shown that systemic administration of prolactin
      stimulates food intake in a number of animal species. 2. In the present study we
      investigated whether central administration of prolactin would increase food
      intake in satiated pigs trained to make operant responses for food and water. 3.
      Prolactin (25-100 U) administered by intracerebroventricular (i.c.v.) injection
      produced no significant effects on food intake during the 60 min measurement
      period after injection. 4. Furthermore, none of these doses of prolactin had any
      effect on the daily (24 hr) consumption of food in these animals. 5. Similarly
      prolactin (25-100 U) i.c.v. had no significant short or long-term effects on
      water intake. 6. These results indicate that prolactin does not stimulate food
      intake in pigs by a central mode of action.

PMID- 1761186
TI  - Lasting impact of a single benzpyrene treatment in pre-natal and growing age on
      the thymic glucocorticoid receptors of rats.
AB  - 1. Rats exposed to benzpyrene in utero at 19 days of pre-natal life showed a
      relative decrease in the number of thymic glucocorticoid receptors at 6 weeks of
      age. 2. Primary exposure to benzpyrene at 6 weeks of age had a similar effect on
      females 4 weeks later, but did not change the glucocorticoid receptor number of
      males. 3. In utero exposure accounted for an increase in the fetal cytochrome
      P450 level within 1 day, whereas exposure at 6 weeks of age did not change it
      within 4 weeks. 4. It appears that exposure to benzpyrene gives rise to a faulty
      imprinting of the thymic glucocorticoid receptor in both fetal and growing age,
      to judge from a lasting change in the receptor number.

PMID- 1761187
TI  - Participation of opioid peptide (beta-endorphin) and norepinephrine in the
      control of compound 48/80-induced hypovolemic thirst in the rats.
AB  - 1. Subcutaneous (s.c.) administration of compound 48/80 elicited the increases of
      water intake, plasma beta-endorphin-like immunoreactivity, hypothalamic 3-methoxy
      4-hydroxyphenylethyleneglycol sulfate and Hct in the rats. 2. The s.c.
      pretreatment of naloxone reduced the compound 48/80-induced water intake but had
      no effects on other variables. 3. Intracerebroventricular (i.c.v.) injection of
      naloxone attenuated the compound 48/80- and i.c.v. injected angiotensin II (ANG
      II)-induced water intake. 4. The hypothalamic norepinephrine metabolism was
      increased by s.c. injection of compound 48/80 but not by i.c.v. ANG II. 5. The
      present data suggest the possible involvement of opioid peptide (beta-endorphin)
      on the compound 48/80- and ANG II-induced thirst. However, it is uncertain
      whether hypothalamic norepinephrine is involved in the hypovolemic thirst
      mediated via stimulation of renin-angiotensin system.

PMID- 1761188
TI  - Influence of diethylcarbamazine and mefloquine on PGI2 synthesis by the rat
      thoracic aorta and myometrial tissues.
AB  - 1. The influence of the antifilarial drug diethylcarbamazine citrate (D) and DL
      erythro mefloquine hydrochloride (Mf) on PGI2 synthesis by the male rat thoracic
      aorta and day-20 pregnant rat myometrium was investigated in vitro using a rat
      platelet antiaggregatory bioassay method. 2. Pretreatment of the tissues with D
      (25.5-204 microM) or Mf (24-192 microM) for 30 min at 37 degrees C significantly
      inhibited PGI2 synthesis in a concentration-dependent manner. 3. D exhibited its
      inhibitory effect even in presence of exogenous arachidonic acid (AA) (16.6
      microM) whereas Mf lost its inhibitory effect in presence of AA. 4. Pretreatment
      of urethane-anaesthetized rats with D (32 mumol kg-1) but not Mf (7.5 mumol kg-1)
      for 30 min significantly antagonized AA (4 nmol kg-1)-induced hypotension. 5.
      Furthermore, D (0.25-0.5 microM) antagonized AA-induced aggregation in rabbit
      platelet-rich plasma without affecting that of ADP. 6. D seemed to interfere with
      the action of the PG endoperoxide synthase (PG cyclooxygenase) whereas Mf seemed
      to interfere with the action of phospholipase A2 (PLA2) enzyme. 7. D may have
      exerted its effect via release of toxic O2 radicals whereas Mf effect may have
      been due to an interaction with PLA2 substrate phospholipids. 8. The demonstrated
      inherent property of these two drugs to inhibit the synthesis of the potent
      vasodilator, platelet antiaggregatory, anticonvulsant and antiinflammatory
      mediator PGI2 may partly contribute towards better understanding of the
      biochemical mechanisms that underly some of the previously known but poorly
      understood actions of these drugs.

PMID- 1761189
TI  - Trichosanthin induces atresia of ovarian follicles and inhibits steroidogenesis
      in gonadotropin-primed immature mice.
AB  - 1. Immature mice were induced to ovulate by injections of pregnant mare serum
      gonadotropin (PMSG) and human chorionic gonadotropin spaced 48 hr apart. 2.
      Trichosanthin (TCS), a protein purified from tubers of Trichosanthes kirilowii
      (Family Cucurbitaceae), was administered respectively 24 hr before, on the same
      day as, 24 hr after and 48 hr after the PMSG injection. 3. The results of TCS
      injections at different times were generally similar. The number of maturing
      follicles, corpora lutea and ovulated oocytes, and the ovarian weight, remained
      unaltered. 4. However, there was an increased incidence of follicular atresia and
      degeneration of ovulated oocytes, and a lowering of serum estradiol-17 beta and
      progesterone levels.

PMID- 1761190
TI  - Characterization of muscarine receptors in rabbit ciliary body smooth muscle
      using propylbenzilylcholine mustard.
AB  - 1. A piece of rabbit ciliary body was mounted in organ bath and used as a test
      organ containing muscarine receptors. 2. A concentration response curve of
      carbachol was completely inhibited by a 50 min treatment of the smooth muscle
      preparation with propylbenzilylcholine mustard(PrBCM; 10(-6) M). This treatment
      was reported to block PrBCM-sensitive muscarine receptors in intestinal smooth
      muscle completely. 3. It is suggested that an existance of only PrBCM-sensitive
      muscarinic receptors, though there are two subtypes of muscarine receptors; PrBCM
      sensitive and -resistant ones in intestinal smooth muscles.

PMID- 1761191
TI  - Inhibition of prostaglandin synthetase alters uterine response to adrenoceptor
      agonists in pregnant and post-partum rats.
AB  - 1. The involvement of intramurally generated prostaglandins in uterine response
      to adrenoceptor agonists has been investigated in rats during late pregnancy and
      post partum. 2. Both adrenaline and salbutamol (10(-9)-3 x 10(-7) M) produced
      concentration-dependent inhibition of acetylcholine-induced tone in preparations
      from 20-day pregnant and 1-day post-partum rats. 3. Inhibition of prostaglandin
      synthetase with flurbiprofen enhanced uterine response to these agonists in late
      pregnancy and post partum. 4. In endometrium-free preparations, flurbiprofen
      treatment had no significant effect on myometrial responses to adrenaline and
      salbutamol, suggesting a role for the endometrium in the interaction between
      adrenoceptor agonists and the prostaglandin synthetase pathway. 5. The above
      results provide pharmacological evidence for the involvement of prostaglandins in
      rat uterine response to adrenoceptor agonists during pregnancy and post partum.

PMID- 1761192
TI  - Effect of RU-38486 on dexamethasone reversal of morphine-induced constipation in
      mice.
AB  - 1. Morphine and dexamethasone significantly reduce gastrointestinal transit in
      mice. The degree of reduction was greater for morphine. 2. Dexamethasone
      pretreatment was found, however, to antagonize morphine-induced constipation. 3.
      Cycloheximide does not modify the dexamethasone effects. 4. RU-38486 reverses
      both the inhibitory action of dexamethasone on gastrointestinal transit and its
      reducing effect on morphine-induced constipation. 5. These results suggest that
      dexamethasone might act through binding to receptors not linked to DNA-responsive
      elements.

PMID- 1761193
TI  - Purinergic modulation of field stimulation responses of rat and human vas
      deferens smooth muscle.
AB  - 1. Guanethidine at 5 x 10(-6) M strongly inhibited rat prostatic but not
      epididymal vas deferens, reflecting differences in innervation and the neurogenic
      field stimulation responses of these tissues. 2. Adenosine and ATP inhibited the
      field stimulation responses of rat prostatic vas deferens by 56 and 50%
      respectively. A 10-min pretreatment with 10(-4) M caffeine partly reversed this
      inhibition, by 55% in the case of adenosine and 60% for ATP. 3. Pretreatment for
      10 min with 5 microM quinidine failed to significantly alter the extent of either
      adenosine or ATP inhibition of the field stimulation responses of rat prostatic
      vas deferens. 4. 8-Phenyltheophylline, the selective blocker of the A1 subtype of
      the P1 receptor, partly reversed adenosine-induced inhibition of the vas deferens
      FS responses. NECA, the selective agonist of the A2 subtype of the P1 receptor,
      very strongly inhibited vas deferens FS responses. 5. Field stimulation responses
      of human vas deferens were also inhibited by both adenosine and ATP but to a
      lesser extent and more variably than in rat tissue. 6. Adenosine and ATP
      inhibition was reversed by caffeine pretreatment, but far more variably than in
      rat tissue, and quinidine was without significant effect on inhibition of the
      responses. 7. It is concluded that in these tissues adenosine and ATP may operate
      via a P1 type receptor of both A1 and A2 subtypes and that a P2 type receptor may
      be lacking.

PMID- 1761194
TI  - Age-related changes of the effects of a group of nootropic drugs on the content
      of rat brain biogenic monoamines.
AB  - 1. The changes in the levels of brain biogenic monoamines (BMAs) after chronic (7
      days) treatment with piracetam, aniracetam and structural analogues of aniracetam
      (p-H, p-F, p-Cl, p-P and m-D) were studied in young and old rats. 2. An age
      related significant decrease in the BMA content was established in old rats. 3.
      Most of the investigated compounds increased the level of one or other BMA in one
      or other of the brain structures studied. This elevation was predominantly
      established in old rats. 4. The present results and those from previous behaviour
      studies show that elevation of one or more of the BMA levels in one or more brain
      regions plays a beneficial role in the realization of their effects on the
      processes of learning and memory.

PMID- 1761195
TI  - Comparative effects of adrenaline and noradrenaline on the synthesis and
      secretion of soluble protein by isolated hepatocytes.
AB  - 1. Adrenaline (A) supplementation of the incubation medium of monolayer cultures
      of hepatocytes at 0.1, 0.2, 0.3, 1 and 10 ng/ml resulted in consistently enhanced
      levels of secreted and newly synthesised non-secreted proteins; supplementation
      with 100 and 1000 ng/ml resulted in lower or unchanged levels. These effects were
      most consistent 6 hr after a medium change. 2. Noradrenaline supplementation of
      the medium resulted in increased levels of secreted and non-secreted proteins at
      low concentrations (less than 2.4 ng/ml) at 6 hr after a medium change, but
      significantly decreased levels of both populations at high concentrations of
      noradrenaline (NA) (2.4 less than NA less than 1000 ng/ml), at 6-9 hr after a
      medium change and sustained to 24 hr, the most significant decrease being at 10
      ng/ml. 3. All combinations of concentrations of A + NA resulted in non-dose
      dependent decreased levels of both the secreted and non-secreted soluble protein
      fractions. The most significant decreases occurred at concentrations of (1 + 5)
      and (10 + 10) ng/ml adrenaline + noradrenaline. 4. Medium supplementation with
      adrenaline, noradrenaline or a combination of the two had no effect on the uptake
      of [3H]leucine by the cells. 5. The results are discussed in relation to receptor
      status on the hepatocyte membranes.

PMID- 1761196
TI  - The effect of cyanide on vitamin C uptake by human polymorphonuclear leukocytes.
AB  - 1. Cyanide inhibited the uptake of vitamin C by human polymorphonuclear
      leukocytes (PMNs). 2. Preincubation of PMNs with cyanide had no effect on
      cytochalasin B-inhibitable uptake of dehydroascorbic acid (DHA) (the reversibly
      oxidized and transportable form of vitamin C). 3. Preincubation of DHA with
      cyanide resulted in inhibition of DHA uptake. 4. Vitamin C uptake was decreased
      by cyanide to the same degree as it was by glutathione (GSH), which effectively
      reduces DHA to ascorbic acid. The effects of cyanide and GSH were not additive.
      5. The data are consistent with the hypothesis that cyanide inhibition of vitamin
      C uptake represents the chemical elimination of extracellular DHA rather than the
      inhibition of active transport in these cells.

PMID- 1761197
TI  - The interaction of peripherally and centrally administered dexamethasone and RU
      38486 on morphine analgesia in mice.
AB  - 1. Dexamethasone or RU 38486 were administered intraperitoneally or
      intracerebroventricularly to mice 10 or 120 min before morphine administration.
      The interaction of these drugs with the analgesic effects of morphine was
      examined using the hot plate test. 2. Dexamethasone i.p. pretreatment reduced
      analgesic responses to morphine injected 120 min but not 10 min after
      dexamethasone; i.c.v. injection of dexamethasone 10 and 120 min before morphine
      administration was effective in reducing morphine analgesia. 3. RU 38486 i.c.v.
      pretreatment (but not i.p. pretreatment) performed 120 (but not 10) min before
      morphine administration enhanced morphine analgesic effects. 4. These results,
      particularly the effects of drug interaction for i.c.v. administration, strongly
      confirm a central site for dexamethasone and RU 38486 action.

PMID- 1761198
TI  - The effect of verapamil on the thermoregulatory responses produced by endotoxin
      or noradrenaline in rabbits.
AB  - 1. Thermal responses to verapamil (5 mg/kg per hr) were investigated in pyrogen
      (lipopolysaccharide Escherichia coli) or noradrenaline (NA) treated rabbits. 2.
      The compound reduced the pyretic, metabolic and vasoconstricting activity of
      pyrogen. 3. On the other hand, verapamil did not significantly affect NA-induced
      hyperthermia. 4. Possible mechanisms responsible for the thermoregulatory
      activity of verapamil are discussed.

PMID- 1761199
TI  - The effects of chronic administration of morphine on the levels of brain and
      adrenal catecholamines and neuropeptide Y in rats.
AB  - 1. Monoamine turnover and neuropeptide Y (NPY) levels were investigated in the
      central and peripheral nervous systems in adult male rats chronically treated
      with morphine. 2. The well-recognized biochemical alterations (serotoninergic
      turnover increased in the hypothalamus, hippocampus and striatum; dopaminergic
      turnover increased in the striatum and cortex; adrenaline levels decreased in the
      adrenal glands) were observed. 3. In addition, we observed a significant decrease
      of the NPY levels in the hypothalamus, the striatum and the adrenal glands. The
      observed changes were not reflected in plasma. 4. Our results contribute to the
      evidence that brain and adrenal monoamines and NPY could be involved in the
      mechanism of morphine tolerance and/or dependence.

PMID- 1761200
TI  - Respiratory and circulatory effects of centrally administered phencyclidine in
      anesthetized dogs.
AB  - 1. Anesthetized dogs were given phencyclidine HCl (PCP) by
      intracerebroventricular (i.c.v.) injection. 2. Physiological parameters were
      monitored after consecutive doses of 0.5, 1.0 and 2.0 mg of PCP. 3. Dose-related
      changes seen, including bradycardia, hypotension and bradypnea, were opposite to
      those produced by i.v. doses. 4. Single doses of 1.0 or 2.0 mg of PCP confirmed
      the prior observations, and the latter provided the baseline for further
      observations on dogs receiving PCP before various i.c.v. pretreatments--atropine,
      haloperidol, phentolamine or propranolol--in efforts to characterize the central
      neurotransmitter system(s) involved in the PCP effects.

PMID- 1761201
TI  - Lipid peroxidation, glutathione and ascorbic acid concentrations in tissues of
      mice treated with oltipraz: influence of cysteine and olive oil pretreatments.
AB  - 1. The effects of treatment with the antischistosomal drug oltipraz on reduced
      glutathione (GSH), lipid peroxide (LP) and ascorbic acid (AA) concentrations in
      the liver, kidney and brain were studied in mice 24 h after drug administration.
      2. The influence of pretreatment with cysteine or olive oil on the above
      variables in oltipraz-treated mice was also investigated. 3. Oltipraz, at single
      oral doses of 25 and 125 mg/kg, did not affect significantly the concentrations
      of GSH, LP or AA in any of the tissues studied. 4. At a dose of 625 mg/kg, the
      drug produced significant increases in GSH concentration in the liver (about
      34%), kidney (38%) and brain (24%). 5. AA concentrations were not significantly
      affected by the drug treatment in any of the organs studied. 6. However lipid
      peroxide formation in the liver of mice treated with oltipraz (625 mg/kg) was
      less than that in control animals by about 45% (P less than 0.05). 7. In other
      organs it was not significantly affected by the treatment. 8. Oltipraz (625
      mg/kg) was given orally to mice which were pretreated with cysteine (25, 50 and
      100 mg/kg for 7 days intramuscularly). 9. The cysteine pretreatments did not
      affect significantly the increases in GSH caused by oltipraz alone, although they
      were effective in significantly increasing GSH concentrations in saline-treated
      mice. 10. The oltipraz-induced increases in the concentrations of GSH in liver
      and kidney was enhanced (by about 16%) by olive oil (0.2, 02 and 0.4 ml/mouse)
      when given 1 h before oltipraz treatment. 11. Concentrations of LP and AA were
      not significantly affected by olive oil pretreatment.

PMID- 1761202
TI  - Lack of evidence for linkage between low-density lipoprotein subclass phenotypes
      and the apolipoprotein B locus in familial combined hyperlipidemia.
AB  - Low-density lipoprotein (LDL) subclass phenotype B, characterized by a
      predominance of small, dense LDL particles, appears to be a genetically
      influenced risk factor for coronary heart disease. Phenotype B, as determined by
      gradient gel electrophoresis, appears to be inherited in a manner consistent with
      the presence of a single major genetic locus, based on complex segregation
      analysis. Familial combined hyperlipidemia (FCHL) is a disorder characterized by
      elevations in total plasma cholesterol and/or triglyceride levels in probands and
      family members, variable lipoprotein phenotypes over time, and elevations in
      apolipoprotein B levels. Because apo B is the primary protein component of LDL
      particles, the present study was undertaken to determine whether LDL subclass
      phenotypes are controlled by the APOB locus in FCHL families. The evidence
      against linkage was very strong based on lod score analyses (total lod = -13.3),
      under assumptions that LDL subclass phenotypes are influenced by a major genetic
      locus and that the mode of inheritance and penetrance functions are known. Other
      methods requiring fewer assumptions also provided evidence against linkage,
      although the strength of this evidence was weaker. Thus the results demonstrate
      that the proposed gene responsible for LDL subclass phenotypes is unlikely to be
      the APOB gene in families with FCHL.

PMID- 1761203
TI  - Multivariate segregation analysis using the mixed model.
AB  - Most major genes involved in the etiology of complex diseases are likely to have
      pleiotropic effects on a number of intervening quantitative traits. Methods of
      segregation analysis that incorporate the additional information from such
      multiple traits will exhibit greater power for detecting the effects of major
      genes and allow explicit tests of major locus pleiotropy hypotheses. In this
      study, we present a new method for multivariate segregation analysis that
      utilizes a multivariate generalization of Hasstedt's [1982] technique for
      calculating approximate mixed model likelihoods on pedigrees. The method is based
      on a simplification of the multivariate conditional likelihood via a
      transformation that simultaneously orthogonalizes the residual additive genetic
      and environmental covariance matrices. This transformation allows the
      multivariate conditional likelihood to be factored into the product of
      independent univariate conditional likelihoods. Resulting computations are
      relatively fast, making it feasible to analyze multiple traits in extended
      pedigrees. We demonstrate our method with a bivariate analysis of high-density
      lipoprotein cholesterol (HDL-C) and apolipoprotein AI (apo AI) serum levels in
      585 pedigreed baboons.

PMID- 1761204
TI  - Affected kin-pair IBD methods: genetic models.
AB  - Cases of interest using affected sib-pair methods to distinguish between
      recessive and additive (dominant) modes of inheritance of a disease-predisposing
      gene involve goodness-of-fit tests with a small expected number in the "share
      zero parental haplotypes" category, as well as an unknown parameter, the
      frequency of the disease-predisposing allele. Our simulations demonstrate that
      the real significance level of the chi-square test using the three-haplotype
      sharing IBD values (share 2, 1, and 0 parental haplotypes) is close to the
      assumed (.05) level in these cases, so that the haplotype-sharing classes do not
      have to be lumped, which would leave no degrees of freedom for a statistical
      test. The validity of the chi-square approximation in cases of small expected
      frequencies has previously been described, but the situations that have been
      considered do not cover the very small values in the share-zero category that are
      often expected in the affected sib-pair analysis, nor do they involve estimation
      of an unknown parameter. Although including IBD values from affected kin pairs
      other than sibs can be a very powerful tool in demonstrating linkage of a marker
      and disease, these pairs do not add power, in fact they reduce the power, of the
      chi-square tests of goodness-of-fit of modes of inheritance.

PMID- 1761205
TI  - Estimating effects of probands' characteristics on familial risk: I. Adjustment
      for censoring and correlated ages at onset.
AB  - Family studies with age at onset of the disease as the endpoint face two
      important problems: censoring and correlation of age at onset among relatives. We
      present a multivariate survival model for ages at onset of relatives which
      incorporates the problems cited above. The interpretations of regression
      coefficients and association parameter in the context of family studies are
      emphasized. The present paper describes a statistical method for estimating these
      parameters. In a companion paper [Pulver and Liang, Genet Epidemiol 8:339-350,
      1991] this model is applied to a genetic epidemiologic study of schizophrenia.

PMID- 1761206
TI  - Estimating effects of proband characteristics on familial risk: II. The
      association between age at onset and familial risk in the Maryland schizophrenia
      sample.
AB  - In this report we apply methods outlined in the companion paper [Liang, Genet
      Epidemiol 8:329-338, 1991] to study the association between proband age at onset
      and familial risk among first-degree relatives of 374 schizophrenic probands. The
      analyses take into consideration the potential problems of censoring and
      correlation of age at onset within families. All analyses were done by gender of
      the proband; age at onset was dichotomized. The results of the analyses of the
      male probands suggest that there is an increased risk of schizophrenia among the
      relatives of male probands who have an onset prior to age 17 when compared to
      relatives of male probands who have an onset later than 16. We did not find an
      association between age at onset and familial risk among the female probands, but
      this may be due to the smaller number of female probands and the lower power
      associated with the analyses.

PMID- 1761207
TI  - Genetics of total serum IgE levels: a regressive model approach to segregation
      analysis.
AB  - The genetics of basal total serum IgE levels was investigated in 278 individuals
      from 42 randomly ascertained nuclear families. The data were analyzed using the
      regressive model approach to segregation analysis with age, sex, and a measure of
      skin test responsiveness as covariates in the Class D models. The best fitting
      model was that of recessive inheritance of high IgE levels with a gene frequency
      of 0.99 for the "high" allele. Only 3 families showed evidence for segregation of
      the rare "low" allele, and, if extended further, these families could be useful
      for molecular genetic linkage studies. These results suggest that there may be a
      rare allele for very low total serum IgE levels that can be detected even after a
      measurement of allergic responsiveness (skin test results) is considered as a
      covariate. Therefore, this major gene for IgE levels appears independent of any
      similar locus controlling atopy.

PMID- 1761208
TI  - [Cloning of segments of the Drosophila melanogaster genome using artificial
      chromosomes of the yeast Saccharomyces cerevisiae].
AB  - A partial genomic library from the Batumi L stock of Drosophila melanogaster was
      constructed using yeast artificial chromosomes as vectors. The DNA was restricted
      by Not1 and large fragments were inserted into the YAC5 vector. The size of
      cloned DNA varied from 90 to 500 kb. 48 random clones were characterized by in
      situ hybridization to the Batumi L polytene salivary gland chromosome. Single
      euchromatic sites of hybridization were detected for 27 clones; 11 clones
      revealed the main euchromatic hybridization site and several additional sites
      scattered along the chromosomes; 8 clones carried repeats which hybridized to
      chromocenter and other chromosomal sites; clones with 500 and 90 kb inserts
      originated from the Y chromosomes and nucleolus, respectively. The library is
      enriched by the repeated sequences related to the b-heterochromatin.

PMID- 1761209
TI  - [Genetic activity of aminofluorene and 2-acetylaminofluorene in strains of
      Saccharomycetes under conditions of in vitro metabolic activation: influence of
      rad 1-5 mutation].
AB  - It has been shown that the rad1-5 mutation which alters excision repair in
      Saccharomyces cerevisiae yeast increased reversion frequency of the ochre
      mutation his7-1 and the frequency of intragenic mitotic recombination in the LYS2
      gene induced by 2-aminofluorene and 2-acetylaminofluorene, as compared with the
      wild type strains activated in vitro by 39 mix from chicken liver.

PMID- 1761210
TI  - [Genetic instability of colonies' morphologic characteristics in the yeast
      Saccharomyces cerevisiae. The influence of mutations of radiosensitivity].
AB  - The exposure to ionizing radiation of radiosensitive mutants of diploid yeast
      Saccharomyces cerevisiae deficient in double-strand break repair results in
      formation of morphologically unstable colonies. Some characteristics of this
      process were studied. The results obtained are consistent with the hypothesis on
      relationship between DNA double-strand breaks or their repair with the formation
      of unstable clones of diploid yeast cells.

PMID- 1761211
TI  - [Analysis of MGE Dm412 localization pattern in Drosophila melanogaster lines
      undergoing long-term selection for a quantitative character].
AB  - The subpopulation composed of the mixture of Drosophila isogenic lines with
      interrupted wing radial vein (mutation radius incompletus, ri) was subjected to
      long-term selection in different directions for increase or decrease in
      expression of the ri gene. As a result, the lines with contrasting different
      values of mean character phenotype were developed. The isogenic lines of mean
      character phenotype were developed. The isogenic lines and F2 from their crosses
      with selected lines were analysed by the pattern of copia-like MGE DM412
      localization. The isogenic lines were shown to have individual pattern, the
      selected lines differing strongly from them. Selection led to the loss of Dm412
      localization sites during negative selection, while positive selection results
      both in loss and acquisition of sites. Correlation between the phenotype of the
      quantitative character and the pattern of MGE Dm412 was revealed.

PMID- 1761212
TI  - [A method of obtaining complementary "deletion-duplication" pairs on the
      posterior arm of Drosophila autosomes].
AB  - A method for selecting pairs of deletion--tandem duplication in an autosome arm
      of Drosophila has been developed. Males containing autosome 2 and the right and
      left free arms of this autosome are producing gametes with metacentric and the
      free arm throughout meiotic nondisjunction. Unequal exchanges induced in such
      gametes give deletions and tandem duplications corresponding to the arm. This
      approach makes it possible to induce deletion without having a marker in the
      region under study.

PMID- 1761213
TI  - [Control of genetic consequences of vaccinations: electron microscopic analysis
      of murine synaptonemal complexes].
AB  - The ability of two inactivated bacterial vaccines, from Proteus vulgaris and
      Klebsiella pneumoniae, to injure synaptonemal complexes (SCs) was studied by
      means of electron microscopy. The preparations were given intraperitoneally to
      C57BL/6J male mice during five successive days and testes were fixed 24 h after
      the last injection. Cyclophosphamide was used for positive control. The vaccine
      from Klebsiella given at subtoxic dose, which was about 200 times higher that
      that given to people during vaccinations, induced the 10-fold rise in the
      frequency of SC abnormalities in murine 1-storger spermatocytes. Breaks of SCs
      and of single lateral elements of SCs predominated over other types of vaccine
      induced anomalies. According to the preliminary data, vaccine from Proteus at
      subtoxic dose showed no damaging SC activity. The results of the given study are
      discussed in connection with the negative data obtained earlier when genotoxicity
      of these two vaccines had been studied in the Ames test, in routine
      investigations of bone marrow metaphases of vaccinated mice as well as under
      light microscopy of their SCs.

PMID- 1761214
TI  - [Verification of the color genotype based on morphological analysis of fur
      pigmentation of brown and black water voles Arvicola terrestris L].
AB  - Qualitative and quantitative analysis of fur pigmentation in brown and black
      water voles (Arvicola terrestris L.) was performed. Morphology of pigment
      granules, their distribution along the hair layers and histology of hair bulbs
      were studied. Morphological data and the results of the analysis of segregation
      in the progeny, when brown voles were self-crossed and crossed with black ones,
      led to conclusion that fur colour of water voles is mediated by genes from the
      agouti series, precisely, black colour is determined by the extreme non-agouti
      allele (aeae genotype), and in brown voles which are homo- or heterozygous the
      colour is determined by the agouti allele (AA or Aae genotypes).

PMID- 1761215
TI  - [Chromosome differentiation of spiny rats of the genus Proechimys (Rodentia,
      Echimyidae)].
AB  - Karyological analysis of spiny rats of the genus Proechimys revealed four
      chromosome forms: 2n = 30; 2n = 29; 2n = 28; 2n = 24. 30-chromosome spiny rats
      are characterized by unique karyotype constitution. 27-chromosome spiny rats from
      the territory near Iquitos differ from the same of Pucalpa (Ucayali Department)
      by Y-chromosome structure and banding of long arms with two pairs of autosomes.
      24-chromosome rats from the regions mentioned above do not differ in G-banded
      chromosomes. Diploid chromosome set equal to 29, has a family originated from the
      parents which had 2n = 30 and 2n = 28 under the laboratory conditions. The
      absence of clear morphological differentiation, similarity of constituent parts
      of the karyotype and hybridization possibility point to relatively recent
      origination of the chromosome forms under study.

PMID- 1761216
TI  - [Component analysis of craniologic characters of silver foxes (Vulpes fulvus
      Desm.) and their changes arising under domestication].
AB  - The data on cranial measurements performed in silver foxes indicate that there
      are differences in sizes measured between the farm foxes--bred population and the
      population selected for domestication. A method of principal components was used
      to analyse the cranial measurements and their changes under domestication. The
      first component covers about 50% of cranial diversity, which is interpreted as
      variation in the total skull size. This component clearly separates the two
      sexes, but not different populations. The second component presumably reflects
      the growth rate allometry between the skull length and width. The third and
      fourth components are measurements of skull width; the fifth one reflects the
      sizes of brain skull. None of these components clearly separate the foxes from
      farm--bred and domesticated populations. However, some differences in
      distribution are observed.

PMID- 1761217
TI  - [Genetics of Caucasian ethnic groups: distribution of some immunologic and
      biochemical markers in the Dagestan ASSR].
AB  - Distribution of the genetic markers of blood groups (AB0, Rhesus, MN, MNSs, P,
      Kell-Cellano); plasma proteins (Hp, C'3, Tf, Gc); red-cell enzymes (AcP, EstD,
      GLO-1) and also ABH-secretion was studied among 6 ethnic groups of Dagesthan.
      Distribution of gene frequencies in Dagesthan populations and other Caucasian
      ethnic groups was comparatively studied.

PMID- 1761218
TI  - High-fidelity amplification using a thermostable DNA polymerase isolated from
      Pyrococcus furiosus.
AB  - A thermostable DNA polymerase which possesses an associated 3'-to-5' exonuclease
      (proofreading) activity has been isolated from the hyperthermophilic
      archaebacterium, Pyrococcus furiosus (Pfu). To test its fidelity, we have
      utilized a genetic assay that directly measures DNA polymerase fidelity in vitro
      during the polymerase chain reaction (PCR). Our results indicate that PCR
      performed with the DNA polymerase purified from P. furiosus yields amplification
      products containing less than 10% of the number of mutations obtained from
      similar amplifications performed with Taq DNA polymerase. The PCR fidelity assay
      is based on the amplification and cloning of lacI, lacO and lacZ alpha gene
      sequences (lacIOZ alpha) using either Pfu or Taq DNA polymerase. Certain
      mutations within the lacI gene inactivate the Lac repressor protein and permit
      the expression of beta Gal. When plated on a chromogenic substrate, these LacI-
      mutants exhibit a blue-plaque phenotype. These studies demonstrate that the error
      rate per nucleotide induced in the 182 known detectable sites of the lacI gene
      was 1.6 x 10(-6) for Pfu DNA polymerase, a greater than tenfold improvement over
      the 2.0 x 10(-5) error rate for Taq DNA polymerase, after approx. 10(5)-fold
      amplification.

PMID- 1761219
TI  - Nonradioactive labeling with chemically modified cytosine tails by the polymerase
      chain reaction.
AB  - We developed a modified nonradioactive method for the detection of DNA. This
      method makes use of the polymerase chain reaction for preparation of probes; that
      is, a DNA fragment inserted in the polylinker region of an M13 or pUC vector is
      amplified with primers that have a modified cytosine tail at the 5' terminus (C
      tailed primers). By this method, large amounts of labeled probes can be obtained
      easily. After hybridization, modified cytosine tails can be detected
      immunologically. DNA labeled by this method could be used in plaque
      hybridization. We could detect 0.05 pg of dot-blotted labeled DNA in 30 min with
      an enzyme-catalyzed chemiluminescence reaction.

PMID- 1761220
TI  - Pseudomonas aeruginosa plasmids as suicide vectors in Escherichia coli:
      resolution of genomic cointegrates through short regions of homology.
AB  - Pseudomonas aeruginosa plasmids which cannot replicate in Escherichia coli have
      been used to introduce specific modifications into the E. coli chromosome by
      homologous recombination ('gene targeting'). The E. coli gene (gpt) encoding
      guanine-xanthine phosphoribosyltransferase (Gpt) was used for initial targeting
      studies owing to the availability of a powerful positive selection for loss of
      the Gpt+ phenotype (6-thioguanine resistance or 6TGR or Gpt-). P. aeruginosa
      plasmids containing selectable markers flanked by gpt sequences were introduced
      as supercoiled DNA into an E. coli strain which contained a normal gpt locus.
      Primary cointegration of such plasmids into the E. coli genome results in a gene
      duplication event which maintains Gpt function; a secondary recombinational event
      which resolves the cointegrate either reverses the primary event or results in
      replacement of the original gpt copy with the modified version. A 316-bp region
      of homology was sufficient for cointegrate formation, and resolution of the
      cointegrates through a shorter (92 bp) homologous flank was selectable through
      loss of Gpt function. The frequency of cointegrate resolution under these
      conditions was significantly above the spontaneous gpt mutational loss rate.

PMID- 1761221
TI  - Bacillus subtilis inositol dehydrogenase-encoding gene (idh): sequence and
      expression in Escherichia coli.
AB  - The Bacillus subtilis inositol dehydrogenase (Idh)-encoding gene (idh) was cloned
      in the B. subtilis temperate phage, rho 11, and then in Escherichia coli plasmids
      (pBR322 and pUC118). The nucleotide sequence of the idh gene, which consists of
      344 codons and whose product has an Mr of 38,351, was determined. E. coli,
      bearing pIOL05d15, in which expression of the idh gene is under the control of
      the lac promoter of pUC118, overproduced an active Idh to approx. 20% of total
      protein upon addition of isopropyl-beta-D-thiogalactopyranoside. This
      overproduced enzyme cross-reacted with an anti-Idh antibody, and exhibited the
      same Mr and substrate specificity as those of the B. subtilis enzyme.

PMID- 1761222
TI  - Nucleotide sequence and transcriptional start point of the kan gene encoding an
      aminoglycoside 3-N-acetyltransferase from Streptomyces griseus SS-1198PR.
AB  - We determined the nucleotide sequence of a 1794-bp BglII-BamHI fragment
      containing the kan gene (KmR) which encodes a novel aminoglycoside 3-N
      acetyltransferase of Streptomyces griseus SS-1198PR. The sequence was found to
      contain four open reading frames (ORF) in the direction of transcription
      determined by low resolution S1 nuclease mapping. Except for the largest one,
      these ORF are unlikely to be the coding sequence of kan, because of their
      inability to confer kanamycin resistance. The largest ORF could encode a 30.8-kDa
      protein consisting of 284 amino acids (aa) with 93.3 mol% G + C in the third
      position of codons, and is preceded by potential ribosome-binding sites. Thus,
      the largest ORF was likely to represent the kan gene. The transcription start
      point of kan was located 84 bp upstream from the start codon. The -10 region
      showed similarity to the Escherichia coli consensus promoter motif, while no
      sequence similarity was found in the -35 region. The deduced aa sequence of kan
      showed 85% similarity with that of the aacC7 gene of Streptomyces rimosus forma
      paromomycinus [Lopez-Cabrera et al., J. Bacteriol. 171 (1989) 321-328] suggesting
      that these genes are derived from a common ancestral gene.

PMID- 1761223
TI  - A dnaK homolog in the archaebacterium Methanosarcina mazei S6.
AB  - A fragment of genomic DNA cloned from the methanogenic archaebacterium,
      Methanosarcina mazei strain S6, was found to contain an 1857-bp open reading
      frame (ORF). A sequence matching the consensus ribosome-binding sequence
      determined for other methanogens was found upstream from the ORF. The amino acid
      (aa) sequence encoded by the ORF was compared with reference sequences and was
      found to be related to six DnaK sequences determined for five species of
      eubacteria (none exist for archaebacteria). The M. mazei S6 aa sequence was over
      61% identical and over 77% similar (identities plus conservative substitutions)
      to the closest four reference sequences, which were all DnaKs. The gene described
      here is therefore proposed to be the first member of the dnaK family sequenced
      from the archaebacterial kingdom (Archaea). This finding confirms that DnaK
      proteins are highly conserved, occurring not only in eubacteria (Bacteria) and
      eukaryotes (Eucaria), but also in archaebacteria (Archaea).

PMID- 1761224
TI  - Nucleotide sequence and expression of the glucoamylase-encoding gene (glaA) from
      Aspergillus oryzae.
AB  - The glucoamylase-encoding gene (glaA) from Aspergillus oryzae was cloned using
      its cDNA as a probe, which had been isolated previously. From comparison of
      nucleotide (nt) sequences of genomic clones with its cDNA, the glaA gene was
      found to contain four short putative introns, 45-56 nt in length. The A. oryzae
      glaA gene shared 62% homology at the nt level with the A. niger glaA gene with
      the four introns located at the same position. The 5'-flanking region contained a
      TATA box at nt-72 from the start codon, and two putative CAAT sequences at nt-87
      and -331. Genomic Southern analysis and physical mapping showed that the glaA
      gene is located on the smallest chromosome (3.4 Mb) of six separated bands of
      chromosomes. Clones containing the glaA gene, when re-introduced intro A. oryzae,
      resulted in a three- to eightfold increase in glucoamylase activity.

PMID- 1761225
TI  - Identification of eleven single-strand initiation sequences (ssi) for priming of
      DNA replication in the F, R6K, R100 and ColE2 plasmids.
AB  - Based on the ability to complement the poor growth of an M13 phage derivative
      lacking the complementary strand origin, eleven single-strand initiation
      sequences (ssi) for DNA replication are identified in the F, R6K, R100 and ColE2
      plasmids. Six of them were from F, two from near the gamma and alpha origins
      (ori) of R6K, two from the vicinity of the basic replicon of R100 and one from
      near the ori of ColE2. They can be classified into two groups based on the
      morphology of the plaques and the length of nucleotide (nt) sequences required
      for ssi activity; one group that gives rise to larger and clearer plaques and can
      be reduced to nearly 100 nt (seven out of eleven), and another that generates
      smaller and less clear plaques and requires more than 200 nt for full activity
      (four out of eleven). Sequence homology is detected among some members from both
      groups. The possible biological roles of the ssi are discussed.

PMID- 1761226
TI  - Isolation and nucleotide sequence of the ribosomal protein S16-encoding gene from
      Aspergillus nidulans.
AB  - A genomic clone has been isolated from Aspergillus nidulans which is homologous
      to the ribosomal (r) protein S16-encoding gene of Saccharomyces cerevisiae (S16A)
      and the r-protein S19-encoding gene of rat (S19). The amino acid (aa) sequences,
      deduced from nucleotide (nt) sequence analysis, show that in both cases more than
      63% of the aa are conserved. The proposed A. nidulans r-protein S16 gene (rps16)
      differs from that of S. cerevisiae in that it occurs as a single copy in the
      haploid genome (rather than two copies as in yeast) and contains two putative
      introns (rather than one). The mRNA leader is long compared to many Aspergillus
      genes, commencing 293 nt upstream from the coding region, and contains an open
      reading frame of 13 codons.

PMID- 1761227
TI  - Evidence for a new Escherichia coli protein resembling a lysyl-tRNA synthetase.
AB  - The amino acid sequence deduced from the nucleotide sequence of an open reading
      frame adjacent to the frdA gene of Escherichia coli shows 30.5% identity with the
      C terminus of Escherichia coli lysyl-tRNA synthetases. The three motifs
      characteristic of aminoacyl-tRNA synthetases of class 2 are recognizable within
      this sequence.

PMID- 1761228
TI  - Genetic analysis of the export of an extracellular DNase of Vibrio cholerae using
      DNase-beta-lactamase fusions.
AB  - A series of C-terminal deletions of the dns-encoded extracellular
      deoxyribonuclease (DNS) of Vibrio cholerae, fused to the mature form TEM beta
      lactamase (Bla) has been used to analyse the export of the DNase in both V.
      cholerae and Escherichia coli. All hybrid proteins were localized to the
      periplasmic space in E. coli and V. cholerae, with specific cleavage of the DNS
      Bla fusion occurring in V. cholerae. Periplasmic accumulation of wt DNS was also
      seen in V. cholerae when present on a multicopy plasmid. DNS fusions retaining
      all six Cys residues of DNS displayed both DNase and Bla enzymatic activity.
      While hybrid proteins were unable to be secreted across the outer membrane in V.
      cholerae, the cleaved (active) DNS portion of these proteins was exported. Taken
      together, these data suggest that the periplasmic form seen in E. coli is a
      normal intermediate also seen in V. cholerae, and that the lack of secretion
      machinery in E. coli prevents further export across the outer membrane. Although
      the DNS portion of the protein fusions must be able to interact with secretion
      genes, the whole fusion proteins are not exported.

PMID- 1761229
TI  - Isolation of Bacillus sphaericus biotin synthesis control mutants: evidence for
      transcriptional regulation of bio genes.
AB  - The genes involved in biotin synthesis have recently been isolated from Bacillus
      sphaericus [Gloeckler et al., Gene 87 (1990) 63-70]. Sequence analysis revealed
      that they are organized into two gene clusters, designated bioXWF and bioDAYB.
      The 5'-noncoding region of the bioD locus fused to the xylE reporter gene was
      inserted into the Gram-positive pUB110 replicon and the resulting plasmid was
      introduced into B. sphaericus IFO3525. Transformants expressed the xylE gene only
      if the biotin concentration in the growth medium remained below 50 ng/ml. After
      mutagenesis, colonies were screened for their ability to express the chromogenic
      marker in the presence of an excess of biotin. Most of these mutants escaped
      biotin repression of xylE gene expression. Classical genetic analysis showed they
      formed two main categories: chromosomal mutations, pleiotropically acting in
      trans on both bioXWF and bioDAYB 5'-noncoding regions, in which a 15-bp region
      common to both promoters represented a hot-spot for the second class of plasmid
      associated mutations. These results, completed by the identification of
      transcription start points for the bioD and bioX genes, strongly suggest that
      this 15-bp sequence overlaps the site of a biotin-mediated negative regulation
      circuit controlling the transcription of the bio genes.

PMID- 1761230
TI  - Identification and characterization of the ribosomal RNA-encoding genes in
      Clavibacter xyli subsp. cynodontis.
AB  - Clavibacter xyli subsp. cynodontis (Cxc) is a xylem-inhabiting bacterial
      endophyte of Bermudagrass. This organism is classified with Gram-positive, high G
      + C content, coryneform-actinomycete bacteria. Southern-blot analysis showed that
      Cxc contains only one copy of the ribosomal RNA-encoding genes (rRNA). A clone
      containing the rRNA genes was isolated from a genomic library of Cxc DNA cloned
      in the lambda EMBL3 vector. The gene cluster was partially sequenced, revealing
      the gene order 5'-16S-23S-5S-3', similar to that found in other prokaryotes. Low
      resolution S1 mapping suggested multiple transcription start points of the rRNA
      operon.

PMID- 1761231
TI  - Cloning and characterization of two genes from Streptomyces lividans that confer
      inducible resistance to lincomycin and macrolide antibiotics.
AB  - Inducible resistance to lincomycin and macrolides in Streptomyces lividans TK21
      results from expression of two linked genes: lrm, encoding a ribosomal RNA
      methyltransferase that confers high-level resistance to lincomycin with lower
      levels of resistance to macrolides, and mgt, encoding a glycosyl transferase that
      specifically inactivates macrolides using UDP-glucose as cofactor. The lrm and
      mgt genes have been cloned and sequenced. The deduced lrm product is a 26-kDa
      protein with much similarity to other ribosomal RNA methyltransferases, such as
      the carB, tlrA and ermE products, whereas the mgt product (predicted to be 42
      kDa) resembles a eukaryotic glycosyl transferase. Macrolides that induce the lrm
      mgt gene pair are substrates for inactivation by the mgt product, and the lrm
      product confers ribosomal resistance to such inducers.

PMID- 1761232
TI  - Analysis of the promoter region of saf, a Streptomyces griseus gene that
      increases production of extracellular enzymes.
AB  - The product of the saf gene of Streptomyces griseus ATCC10137 mediated an
      increase in the production of several extracellular enzymes and retarded the
      formation of pigments and spores in Streptomyces [Daza et al., Mol. Gen. Genet.
      222 (1990) 384-392]. A promoter upstream from saf was identified by subcloning a
      DNA fragment in the promoter probe pIJ486. Using the Escherichia coli
      Brevibacterium lactofermentum promoter-probe shuttle vector, pULMJ51, we
      determined that the saf promoter region is also active in E. coli. The
      transcription start points (tsp) of the saf promoter in Streptomyces and E. coli
      have been determined using high-resolution S1 mapping. The tsp are at the same
      position in both microorganisms. Expression from the saf promoter region was
      negatively regulated by phosphate in Streptomyces, but not in E. coli. The
      amplification of the saf promoter lacking the saf coding region did not increase
      the production of extracellular enzymes and did not reduce sporulation or
      pigmentation in Streptomyces (i.e., it does not titrate out a putative repressor
      of the genes encoding extracellular enzymes). Several structural features of the
      saf promoter region and saf mRNA are studied in relation to the regulation of the
      saf gene expression.

PMID- 1761233
TI  - The broad-host-range plasmid pTF-FC2 requires a primase-like protein for
      autonomous replication in Escherichia coli.
AB  - A 3202-bp fragment of plasmid pTF-FC2, cloned into PUC19, had previously been
      identified as the minimum region required for replication in either Pseudomonas
      aeruginosa or Escherichia coli polA- mutants. During the course of experiments to
      construct broad-host-range cloning vectors based on the pTF-FC2 replicon, it was
      found that the 3202-bp fragment had an absolute requirement for some function of
      the pUC19 vector. This requirement was eliminated in the presence of co-resident
      pTF-FC2 derivatives. An additional 1239-bp fragment from pTF-FC2, immediately
      adjacent to the 3202-bp fragment, was identified which restored the ability of
      the pTF-FC2 replicon to replicate autonomously. Sequence analysis of the region
      revealed a single open reading frame encoding a 40-kDa polypeptide, which was
      synthesised in an in vitro transcription/translation system. A comparison of the
      amino acid sequence of this protein with sequence data banks revealed limited
      homology with the RepB' primase of the IncQ plasmid, RSF1010. An M13 delta lac
      110 replication-deficient phage system was used to demonstrate that the 40-kDa
      protein did function as a primase with respect to replication at the origin of
      replication (vegetative) of pTF-FC2.

PMID- 1761234
TI  - The CYP2 gene of Saccharomyces cerevisiae encodes a cyclosporin A-sensitive
      peptidyl-prolyl cis-trans isomerase with an N-terminal signal sequence.
AB  - Cells of Saccharomyces cerevisiae contain a major cytosolic cyclophilin (Cyp)
      related peptidyl-prolyl cis-trans isomerase (PPIase) which is the target for
      cyclosporin A (CsA) cytotoxicity and which is encoded by the CYP1 gene [Haendler
      et al., Gene 83 (1989) 39-46]. We recently identified a second Cyp-related gene
      in yeast, CYP2 [Koser et al., Nucleic Acids Res. 18 (1990) 1643] which predicts a
      protein with a hydrophobic leader sequence. A sequence lacking 33 codons from the
      5'-end of the CYP2 open reading frame was generated by the polymerase chain
      reaction and engineered for expression in Escherichia coli. The corresponding
      recombinant truncated protein was purified and found to exhibit PPIase activity
      which was inhibited by CsA. The CYP2 gene is genetically unlinked to CYP1. As
      with CYP1, genomic disruption of CYP2 had no effect on haploid cell viability.
      Disruption of all three of the known yeast PPIase-encoding genes [CYP1, CYP2, and
      RBP1 for rapamycin-binding protein; Koltin et al., Mol. Cell. Biol. 11 (1991)
      1718-1723] in the same haploid cell also resulted in no apparent cellular
      phenotype, suggesting either that none of these enzymes have an essential
      function or that additional PPIases can compensate for their specific absence.
      Whereas cells containing a genomic disruption of CYP1 exhibited a CsA-resistant
      phenotype, genomic disruption of CYP2 had no effect on CsA sensitivity. This
      suggests that the CYP1 gene product is the primary cellular target for CsA
      toxicity in yeast. Since both purified Cyps display CsA sensitivity in vitro, our
      data suggest that Cyp1 and Cyp2 differ in terms of their cellular function and/or
      localization.

PMID- 1761235
TI  - Protein disulfide isomerase is essential for viability in Saccharomyces
      cerevisiae.
AB  - Protein disulfide isomerase (PDI) is an enzyme involved in the catalysis of
      disulfide bond formation in secretory and cell-surface proteins. Using an
      oligodeoxyribonucleotide designed to detect the conserved 'thioredoxin-like'
      active site of vertebrate PDIs, we have isolated a gene encoding PDI from the
      lower eukaryote, Saccharomyces cerevisiae. The nucleotide sequence and deduced
      open reading frame of the cloned gene predict a 530-amino-acid (aa) protein of Mr
      59,082 and a pI of 4.1, physical properties characteristic of mammalian PDIs.
      Furthermore, the aa sequence shows 30-32% identity with mammalian and avian PDI
      sequences and has a very similar overall organisation, namely the presence of two
      approx. 100-aa segments, each of which is repeated, with the most significant
      homologies to mammalian and avian PDIs being in the regions (a, a') that contain
      the conserved 'thioredoxin-like' active site. The N-terminal region has the
      characteristics of a cleavable secretory signal sequence and the C-terminal four
      aa (-His-Asp-Glu-Leu) are consistent with the protein being a component of the S.
      cerevisiae endoplasmic reticulum. Transformants carrying multiple copies of this
      gene (designated PDI1) have tenfold higher levels of PDI activity and overproduce
      a protein of the predicted Mr. The PDI1 gene is unique in the yeast genome and
      encodes a single 1.8-kb transcript that is not found in stationary phase cells.
      Disruption of the PDI1 gene is haplo-lethal indicating that the product of this
      gene is essential for viability.

PMID- 1761236
TI  - A single-copy promoter-cloning vector for use in Escherichia coli.
AB  - We have constructed and tested a single-copy-plasmid vector (pEU720) based on the
      IncFII-group plasmid, R100, that is useful for cloning promoters in front of
      lacZ. The vector is 15 kb long and contains a unique XhoI site in front of lacZ.

PMID- 1761237
TI  - [Chorea gravidarum].
AB  - Chorea gravidarum is a rare maternal complication during pregnancy. Like the
      better known chorea minor it shows extrapyramidal symptoms with involuntary
      movements, lack of coordination, slurred speech and psychic disorders. The
      neurological state is normal except for a loss of muscle tone. The symptoms most
      commonly begin in the first trimester of pregnancy and usually resolve
      spontaneously after 2-3 months. The maternal mortality lies below 1%. In the case
      of subjectively disturbing symptoms anticonvulsive and sedative therapy with
      benzodiazepine or neuroleptics may be indicated. Etiological factors including
      rheumatic fever, chorea minor, hormonal, psychic and autoimmune disorders are
      discussed. Elective termination of the pregnancy is not indicated. The presented
      case report shows a chorea-like situation beginning in the ninth week of
      pregnancy.

PMID- 1761238
TI  - [Pregnancy and labor in advanced renal failure due to chronic pyelonephritis].
AB  - The rare completion of a pregnancy in the presence of severe chronic renal
      failure is discussed in 6 cases. In all those cases the renal failure became
      worse, even though the pregnancy and delivery were satisfactory. Shortly after
      delivery, the 6 women underwent hemodialysis or peritoneal-dialysis. One patient
      died several weeks after delivery because of uremia. Our results suggest that for
      their own safety, women with severe renal failure should not become pregnant.

PMID- 1761239
TI  - [Prolonged pregnancy. Risks in pregnancy duration over 294 days and obstetric
      consequences].
AB  - A total of 73 postterm pregnancies (greater than or equal to 294 days gestational
      age) were studied retrospectively and showed the following results: the frequency
      of postterm pregnancies was 1.5%. Compared to a control group of normal
      pregnancies (262-293 days), there was no evidence of a higher risk for infants
      born after term. As far as the different routes of delivery are concerned, there
      was a slightly higher number of cesarean sections and a markedly higher number of
      surgical vaginal deliveries in postterm pregnancies.

PMID- 1761240
TI  - [Vaccination against nonspecific bacterial vaginosis. Double-blind study of
      Gynatren].
AB  - 167 patients suffering from nonspecific bacterial vaginoses were vaccinated in a
      double-blind, randomized, placebo-controlled trial. It appeared, during the study
      period of 14 months, that the vaccination with Gynatren, a lactobacillus vaccine,
      was significantly better than the placebo as concerns its therapeutical effect,
      but mainly as concerns its preventive effect (less reinfections). The vaccine was
      very well tolerated. We conclude that vaccination with Gynatren is an effective
      measure to prevent recurrences of nonspecific vaginosis.

PMID- 1761241
TI  - [Infection screening in pregnancy].
AB  - The aim of screening for infectious diseases in pregnancy is to identify subjects
      who are at risk of a specific infection, which lends itself to effective
      intervention. The value of routine screening is determined by the validity of the
      test and the prevalence of the disorder in the population. During pregnancy,
      serological screening for rubella, syphilis, toxoplasmosis, HIV, hepatitis B and
      bacteriological screening for asymptomatic bacteriuria and gonorrhea is
      recommended. The search for additional infections is reserved for patients
      presenting special risk factors or clinical symptoms.

PMID- 1761242
TI  - [Surgical treatment of male baldness using Juri's crescent flap].
AB  - This is a report on thirty six patients with male pattern baldness, surgically
      treated with one or two parieto-occipital flaps according to Juri. In six
      patients with isolated occipital baldness, specially designed flaps were used.
      Since male baldness usually is genetically determined and hairroots of the
      temporo-occipital scalp remain active throughout life, one can expect that they
      continue growing within the transposed flaps. There are three indications for
      parieto-occipital flaps: 1. psychological burden of the patient, 2. genetic
      background in the family of young patients, and 3. prior punch hair grafts whose
      roots have atrophied.

PMID- 1761243
TI  - [Possibilities in lower eyelid reconstruction].
AB  - Reconstruction of the lower lid is associated with aesthetic and functional
      problems. Different techniques are proposed. From 1985 to 1988, 17 patients have
      been treated by a bridge flap technique from the upper lid combined with a
      composite graft from the septum. In our opinion, this method is indicated in
      smaller through-and-through defects as well as in total lid reconstruction. The
      advantages of the technique are discussed and demonstrated.

PMID- 1761244
TI  - [Concept and technique for closure of septum defects].
AB  - A surgical concept for the closure of perforations of the septum is presented.
      Small and medium-sized defects are closed by a one-step extramucosal technique
      also used in rhinoplasties. Tissue tubes of mucoperichondrium, mucoperiosteum and
      the upper lateral cartilage are mobilized in both nasal lumina. Parts of the
      lamina quadrangularis are dissected and shifted to close the defect. Very large
      defects with a diameter of more than 3 cm are closed in a three-step technique. A
      spoon-shaped flap from the oral vestibule with a piece of ear cartilage attached
      is inserted into the perforation. The cartilage is covered with oral mucosa on
      both sides. These procedures are superior to traditional techniques in terms of
      both blood supply and safe closure.

PMID- 1761245
TI  - [Morphological changes in the healing process of mixed grafts in animal studies
      with reference to the immunological modification processes based on sex-specific
      chromosome analysis. A cytogenetic and histological study in rats].
AB  - In the rat, free skin grafts exchanged between genetically different clones were
      completely rejected after three weeks. These transplants were not rejected when
      island autografts were set into preformed holes in the allografts. A typical
      graft-rejection pattern in the mixed skin transplants showed initial healing of
      the alloepidermis, which was later replaced by outgrowing autoepidermis from the
      interspersed islands. Since the autoepidermis covers the allocorium directly, it
      appears much like normal skin. In a few cases, connective tissue formed between
      the new autoepidermis and the remaining allodermis. Fibrous tissue streaks were
      also found between the otherwise unchanged allodermis layer and the muscle
      fascia. The remaining allocorium could still be found 111 days after
      transplantation using cytogenetic techniques and chromosome analysis. Mixed skin
      grafts consist of cell mosaics including cell lines form the donor and the
      recipient, with the corium structures completely retained. Cellular and humoral
      infiltration was not found to be part of the rejection process.

PMID- 1761246
TI  - [Electromyographic studies of myocutaneous sliding flaps for the covering of
      sacral decubitus ulcer].
AB  - Gluteus maximus myocutaneous sliding flaps from one or both sides are useful in
      covering deep, usually infected sacral pressure sores. Although skin is known to
      tolerate higher pressure in the covered area, muscle offers far better conditions
      for flap healing of infected defects. In spite of excellent early results, the
      long-term fate of the transposed muscle remains uncertain. An electromyography
      study was performed on eleven patients out of 29 with sliding gluteus maximus
      myocutaneous flaps in periods up to seven months after surgery. Our results show
      that signs of denervation parallel reinnervation and functional integrity of the
      transposed muscle.

PMID- 1761247
TI  - [Finger tip amputations in children].
AB  - Among the various alternative forms of treatment of digital tip amputations,
      replantation of the amputated tip as composite graft or conservative treatment
      (healing by secondary intention) are of special interest for the management of
      fingertip injuries in children. From 1986 until 1987, the authors treated
      thirteen fingertip amputations in children between one and eight years of age
      (mean 3.5 years). In twelve cases, the amputated tip was reattached as composite
      graft, one injury healed by secondary intention. Twelve children were reexamined
      according to a prospective protocol after a mean follow-up time of 3.4 years. In
      three cases, primary healing of the replanted tip could be observed, in eight
      cases partial necrosis and superficial mummification preceded complete healing.
      At follow-up, seven cases presented with an anatomical tip, four with a slight
      asymmetry. Distal phalangeal length was identical to the opposite side, but in
      two cases a maximal loss of length of 2 mm was observed. Fingernails showed no
      significant deformities, although nail bed injuries had occurred in 90% of the
      cases. Sensitivity was normal in all cases. Child and parents considered the
      final result excellent in 75% and good in 25%. Reattachment as composite graft or
      conservative treatment for management of fingertip amputations in children (Zone
      I to III according to Rosenthal) is recommended and discussed.

PMID- 1761248
TI  - [Ulnar head resection--indication and treatment results].
AB  - A follow-up of 52 patients with a history of Darrach's procedure between 1961 and
      1989 was carried out 16 years after surgery. 92% of those with trauma of the
      forearm, wrist, and distal radio-ulnar joint reported hardly any pain at all with
      marked improvement of forearm rotation and wrist mobility. The only drawback to
      surgery was an average strength loss of 50%.

PMID- 1761249
TI  - [Basket wires--a percutaneous surgical procedure for the treatment of unstable
      Colles' fractures].
AB  - Colles fractures are usually treated with closed reduction and forearm plaster.
      Even if reduced perfectly, some of these fractures tend to redislocate dorsally
      and radially, requiring repeated reduction maneuvers. Since K-wires cannot be
      firmly anchored in the distal fragment if comminution exists, Kapandji proposed a
      method whereby the distal fragment is not pinned at all. He introduced the pins
      through the fracture itself and into the medullary canal of the proximal
      fragment, anchoring the wires into the opposite cortices of the radius shaft. In
      order to "pre-stress" the K-wires, Bohler and Zifko modified the technique and
      the wires themselves. They inserted the wires through small skin incisions into
      the fracture and into the proximal fragment as medullary pins. The specially bent
      pins glide smoothly into the medullary cavity and snugly fit along the distal
      fragment; thereby minimizing the chance of damaging extensor tendons. One pin is
      inserted proximal to Lister's tubercle and another radially, proximal to the
      radial styloid. Technique, indication, and possible technical errors are
      discussed based on the follow-up of forty one patients.

PMID- 1761250
TI  - [Intraoperative pressure measurement at the median nerve in carpal tunnel
      syndrome and its surgical significance].
AB  - The authors measured the intraoperative pressures on the median nerve in local
      anesthesia in thirty patients. Pressures were recorded at the distal antebrachial
      fascia near the carpal tunnel, at the proximal and distal carpal tunnel and at
      the level of the palmar fascia distal to the carpal tunnel. The two passive and
      three active movements examined generally led to a pressure elevation. Passive
      movements had a greater effect on pressure at the proximal carpal tunnel. Active
      movements led to a high pressure level in the proximal and distal carpal tunnel
      higher than those observed during passive movements. Beneath the distal
      antebrachial fascia near the carpal tunnel, the pressure level was higher than
      beneath the antebrachial fascia at a greater distance from the carpal tunnel.
      Pressure levels beneath the distal antebrachial fascia correlated with the
      patient's age. Pressure values beneath the palmar fascia were low during passive
      and active movements. As a consequence, division of the flexor retinaculum and
      the distal antebrachial fascia up to 3 cm proximal of the carpal tunnel is
      necessary, whereas dissection of the palmar fascia distal to the carpal tunnel is
      not.

PMID- 1761251
TI  - Mean daily intake of volatile N-nitrosamines from foods and beverages in West
      Germany in 1989-1990.
AB  - The levels of volatile N-nitrosamines were determined in 38 alcoholic drinks and
      215 food samples prepared for human consumption using standard culinary
      practices. The analyses used gas chromatography-thermal energy analysis.
      Detectable levels were found in 80 (31.5%) of the individual samples. The average
      daily intake of volatile N-nitrosamines in West Germany in 1989-1990 was found to
      be: 0.28 microgram N-nitrosodimethylamine (NDMA)/day, 0.011 microgram N
      nitrosopyrrolidine (NPYR)/day and 0.015 microgram N-nitrosopiperidine (NPIP)/day
      for men, and 0.17 microgram NDMA/day, 0.011 microgram NPYR/day and 0.015
      microgram/NPIP/day for women. For men, 31% of the daily NDMA exposure results
      from the consumption of beer.

PMID- 1761252
TI  - Mean daily intake of primary and secondary amines from foods and beverages in
      West Germany in 1989-1990.
AB  - 264 samples of foods and beverages from the German market in 1989-1990 were
      analysed for primary and secondary amines. Amines were determined as
      benzenesulphonyl chloride derivatives by gas chromatography with
      chemiluminescense detection. The mean daily intake of primary amines was
      calculated to be 29 mg/day for women and 37 mg/day for men. For secondary amines,
      the mean daily intake was 6 mg/day for women and 8 mg/day for men.

PMID- 1761253
TI  - Safety evaluation of benzophenone.
AB  - Benzophenone (FEMA No. 2134; CAS No. 119-61-9) was administered in the diet to
      rats at target dose levels of 20 mg/kg body weight/day for 90 days and 100 or 500
      mg/kg/day for 28 days. Body weights and food consumption were measured weekly;
      haematology, clinical chemistry and urinalysis values were obtained at 4 wk and
      at the end of the study. Gross and microscopic pathological examinations were
      conducted and organ weights were recorded. Treatment-related changes occurred in
      erythrocyte count, haemoglobin, haematocrit, bilirubin, total protein and albumin
      at the mid- and high-dose levels, although all changes did not occur in both
      groups in both sexes. There were indications of increased absolute and relative
      liver and kidney weights in the mid- and high-dose groups, but this was not
      statistically consistent for absolute kidney weights. Histopathology of the liver
      in the mid- and high-dose groups showed hepatocellular enlargement with an
      associated clumping of cytoplasmic basophilic material around the central vein. A
      no-effect level was demonstrated at 20 mg/kg/day for 90 days of administration.
      This would be equivalent to an intake of 1200 mg/day for a 60-kg human. On the
      basis of the calculated Possible Average Daily Intake of 0.33 mg/day, a safety
      factor of greater than 3600 is demonstrated. The safety factor based on the more
      realistic per capita consumption of 0.32 microgram/day would be approximately 3.7
      million.

PMID- 1761254
TI  - Quantitative relationship between oral nitrate-reducing activity and the
      endogenous formation of N-nitrosoamino acids in humans.
AB  - Salivary nitrate and nitrate concentrations, in vitro kinetics of nitrate
      reduction in saliva, and numbers of salivary nitrate-reducing micro-organisms
      were each compared with N-nitrosoamino acid excretion in 16 humans eating
      controlled diets. N-Nitrosoproline (NPRO) and N-nitrosothiazolidine-4-carboxylic
      acid (NTCA) excretion were measured after intake of nitrate (5.24 mmol) and L
      proline (4.35 mmol) before and after treatment with an oral antiseptic (Peridex,
      0.12% chlorhexidine gluconate). Peridex treatment resulted in a 94% reduction in
      the numbers of salivary nitrate-reducing bacteria, a decline from 17 to 4% in the
      amount of salivary nitrate that was reduced to nitrite in vivo, and an 85%
      reduction in the rate of in vitro nitrate reduction by saliva. Concurrently,
      there were 62 and 74% inhibitions of endogenous NPRO and NTCA formation,
      respectively. Correlations of the numbers of nitrate reductase micro-organisms,
      in vivo oral nitrate reduction and salivary nitrite concentrations, with
      individual NPRO excretion, indicated that individuals with higher oral nitrate
      reducing capacities formed more N-nitrosoamino acid endogenously. These data
      suggest that individual differences in oral nitrate reduction are a significant
      factor in gastric nitrosation and account for a large proportion of the
      interindividual variability in nitrosoamino acid excretion.

PMID- 1761255
TI  - Liver response to low-hexachlorobenzene exposure in protein- or energy-restricted
      rats.
AB  - The individual effects of protein deficiency and energy restriction on liver
      response to low-hexachlorobenzene (HCB) exposure were investigated in adult male
      Wistar rats. In rats fed either the low-protein or control diet, the only effect
      caused by HCB was a decrease in paralysis time following an ip injection of
      zoxazolamine. This decrease was similar for both groups. In the animals subjected
      to energy restriction, HCB induced a greater decrease in paralysis time, an
      increase in the size of centrilobular hepatocytes, a lower liver DNA content and
      an increased concentration of HCB in the adipose tissue, compared with the
      control and protein-deficient groups. Our data suggest that energy restriction
      increases liver response to HCB, while protein deficiency does not impair the
      hepatic reaction to small doses of HCB exposure.

PMID- 1761256
TI  - Effect of emodin on cooked-food mutagen activation.
AB  - The herbs Rheum palmatum B and Polygonum cuspidatum S are frequently used as
      laxatives and anticancer drugs in Chinese medicine. The antimutagenic activity of
      these herbs as well as their active component emodin was examined in Salmonella
      typhimurium TA98. The crude extracts and emodin induced a dose-dependent decrease
      in the mutagenicity of benzo[a]pyrene (B[a]P), 2-amino-3-methylimidazo[4,5
      f]quinoline (IQ) and 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2).
      Furthermore, emodin reduced the mutagenicity of IQ by direct inhibition of the
      hepatic microsomal activation and not by interaction with proximate metabolites
      of IQ and/or by modification of DNA repair processes in the bacterial cell.

PMID- 1761257
TI  - Chronic oral toxicity and carcinogenicity study of thiabendazole in rats.
AB  - The potential toxicity and carcinogenicity of thiabendazole (TBZ) was
      investigated in F344 rats. TBZ was given in pelleted diets at different dietary
      levels (0, 0.05, 0.1, 0.2 or 0.4%) to groups of 30 rats of each sex for 104 wk.
      Throughout the study, a marked decrease in body-weight gain was observed in males
      and females fed 0.4% TBZ. Transitional cell hyperplasia of the renal pelvis
      and/or papilla was observed in dosed groups of each sex with significant positive
      trends. Low incidence of transitional cell papilloma or carcinoma of the urinary
      system was recorded in the dosed groups. Preputial gland adenoma occurred in
      males treated with 0.4% TBZ, and the incidence was significantly higher than in
      controls. There was no clear-cut evidence of the carcinogenic activity of TBZ in
      the urinary system of male and female rats.

PMID- 1761258
TI  - Effect of chlorophyllin on mercuric chloride-induced clastogenicity in mice.
AB  - The effect of chlorophyllin (1.5 mg/kg body weight) on the clastogenicity of
      mercuric chloride (HgCl2) was studied in vivo in mouse bone marrow cells. HgCl2
      (3.0, 6.0 and 12.0 mg/kg body weight) administered by gavage induced chromosomal
      aberrations at frequencies directly proportional to the dose. Chlorophyllin was
      not clastogenic, and significantly reduced the mitotic index when given alone.
      Chlorophyllin administered simultaneously with HgCl2 significantly reduced the
      frequencies of chromosomal aberrations in a dose-dependent manner. When given
      simultaneously with the lowest HgCl2 concentration tested (3.0 mg/kg body
      weight), chlorophyllin provided total protection. A lower degree of protection
      was given by chlorophyllin administered 2 hr before HgCl2. The data demonstrate
      the potential of green plant components to modify the genotoxic activity of HgCl2
      when administered orally.

PMID- 1761259
TI  - Safety evaluation of alkaline cellulase.
AB  - A programme of studies was conducted to establish the safety of alkaline
      cellulase, an enzyme used as a processing aid in the food industry. Laboratory
      animal studies were used to assess general, inhalation and reproduction toxicity,
      eye irritation and skin irritation and sensitization. Mutagenic potential was
      assessed in microbial and animal in vivo studies. The pathogenicity of Humicola
      insolens, the micro-organism used in the production of alkaline cellulase, was
      also assessed in laboratory animals. Basic ecotoxicity in a variety of test
      species was studied. General toxicity by a variety of routes was low; there was
      no evidence of reproductive toxicity. There was evidence of mild skin irritation
      and some eye conjunctival reddening. There was no evidence of skin sensitization,
      mutagenic potential, ecotoxicity or notable pathogenicity. When these results are
      considered along with levels of human exposure and previously published data, it
      appears that alkaline cellulase is safe for consumers in the given applications,
      requires no special occupational health precautions in manufacture, and is of low
      environmental impact. Furthermore, the micro-organism used in production of
      alkaline cellulase has no notable pathogenicity.

PMID- 1761260
TI  - [What is the contribution of PET in tumor diagnosis today?].
AB  - Positron emission tomography (PET) permits qualitative and quantitative
      measurements of tumor metabolism in the patient. In the clinical setting, the
      present studies suggest that tumors with a potential for proliferation can be
      differentiated from scar tissue, soft tissue and benign lesions. Accumulation of
      tracer by lymph nodes identifies them as metastatic. On the basis of a
      quantification of the accumulation of tracer and its metabolites, information can
      be provided about the biological activity of a tumor, and presumably also about
      the prognosis. The response of a tumor to treatment can be monitored, in
      particular in combination with CT. Possible selection of resistant parts of the
      tumor can be determined, so that modification of treatment is possible. Modes of
      application can also be individualized by identifying pre-treatment advantages of
      intraarterial or systemic administration; recurrent tumors can be detected with a
      high degree of accuracy. However, to date, only limited numbers of cases are
      available, so that, in view of the very promising aspects of this modality, more
      widespread application followed by the evaluation of larger numbers of patients
      is needed.

PMID- 1761261
TI  - [Diagnosis of focal liver lesions. The value of imaging systems].
AB  - Selection of the suitable modality for the detection or differential diagnosis of
      focal liver lesions must consider, in addition to its accuracy, such factors as
      on-site availability, the costs involved, and the stress to the patient. The
      preferred screening technique is ultrasonography which, however, has a high
      failure rate, in particular in the case of small lesions. In many cases computed
      tomography (CT) permits the correct diagnosis to be established. Both CT and
      ultrasonography make possible selective percutaneous biopsy. Magnetic resonance
      imaging is one of the most sensitive procedures, but is often not available -
      even in specialized centers. With this technique or blood pool scanning, hepatic
      hemangiomas found incidentally can be diagnosed in 90% of the cases. The
      diagnosis of focal modular hyperplasia continues to be difficult.

PMID- 1761262
TI  - [Diagnosis of gastroenterologic diseases with sonography. Part 1: Principles-
      ultrasound diagnosis of diffuse and local liver damage].
AB  - Ultrasonography has now become an integral part of the gastroenterological
      diagnostic work-up and treatment. In some clinical problems it may be employed as
      the sole procedure, for example in the diagnostic evaluation of gallstones, for
      measuring the size of the liver and spleen, or in the detection of free fluid
      within the peritoneal cavity. Among the diffuse lesions of the liver,
      macronodular cirrhosis and typical forms of fatty liver can be diagnosed
      ultrasonographically, while the majority of such diffuse changes are not
      amendable to ultrasonographic evaluation. Cystic lesions of the liver are often
      diagnosable with ultrasonography, while many circumscribed solid lesions, such as
      metastases or focal-nodular hyperplasia, pose a differential diagnostic problem.

PMID- 1761263
TI  - [Digital luminescence radiography. Part 1: Basic principle, technical execution
      and clinical use].
AB  - Digital luminescence radiography (DLR) is a new technique in projection
      radiography, which enables the production of plain X-ray images and motion
      tomographies with high quality, and is suitable for digital image management.
      With this procedure the X-ray image produced by conventional roentgen devices is
      temporarily stored on a reusable photostimulable storage phosphor screen which is
      characterized by a wide dynamic range. A laser beam scans the exposed phosphor
      screen and recovers the stored X-ray information as photostimulated luminescence
      radiation. A photomultiplier converts the emitted light into electrical signals.
      After normalization and digitization the signals are transmitted to an image
      processor. The stored digital image can be individually processed and displayed,
      digitally archived or transferred to any location. The technique is described in
      two following papers. Part 1 covers the basic principle of the system and the
      technical implementation of the data acquisition with its advantages and
      disadvantages as compared with conventional film/screen radiography.

PMID- 1761264
TI  - ["Excessive" lowering of blood pressure. Are there diastolic blood pressure
      values which should not be breached?].

PMID- 1761265
TI  - [Aquarium--when hobby becomes a danger. A case report].
AB  - In this case report, allergic rhinitis and episodes of asthma triggered by the
      hemoglobin of the red mosquito larva used as fish food are described. After three
      years of contact and an allergic condition persisting for three months, skin
      testing and IgE determination revealed moderate sensitization of the immediate
      reaction type. When contact with the allergen was stopped, the symptoms abated
      immediately.

PMID- 1761266
TI  - [Cytostatic drugs. Part 5 (conclusion): Other cytostatically active drugs].

PMID- 1761267
TI  - [Fixed drug combination of ACE inhibitor plus diuretic. Results of an open
      multicenter study for the treatment of hypertension].
AB  - An open multicenter trial involving 7,232 participating physicians, was performed
      to assess the anti-hypertensive efficacy and tolerance of a fixed combination of
      captopril and hydrochlorothiazide (Capozide) given once daily to 34,976 patients
      (mean age 58.5 +/- 11.4 years) with mild-to-moderate hypertension inadequately
      controlled by previous anti-hypertensive treatment. After 8 weeks, the response
      rate to a daily dose of Capozide 25 or 50 was 87.2%. Within this period, the mean
      systolic/diastolic blood pressure dropped from 175 +/- 16/103 +/- 5 mmHg to 150
      +/- 13/88 +/- 7 mmHg (p less than 0.001). In 81% of the questionnaires, treatment
      with the combination was rated superior to the previous treatment; in only 5% was
      it considered inadequate. Side effects, for the most part mild, were reported by
      7.4% of the patients. Treatment with Capozide was discontinued, or another form
      of treatment substituted in 12.9% of the cases.

PMID- 1761268
TI  - [Formal thought disorders and speech disorders in schizophrenia--new findings
      from empirical studies?].
AB  - The investigation of formal thought and speech disorders in schizophrenia is
      hampered by the missing differentiation of speech and thought. Empirical
      investigations paying attention to this differentiation do not argue for specific
      schizophrenic speech or thought disorders but for a clinically relevant continuum
      of these disorders within the group of endogenous psychoses.

PMID- 1761269
TI  - [Psychobiology of compulsive disease].
AB  - The predominant psychobiological hypotheses regarding the pathophysiology of
      obsessive-compulsive disorder (OCD) are that a selective basal ganglia
      dysfunction and a dysregulation of one or several central serotonin (5-HT)
      subsystem are related to at least some aspects of the syndrome. Recent
      neuroanatomical, -pharmacological, and -ethological studies indicate a complex
      perceptual and cognitive role for the basal ganglia, particularly the striatum
      and the pallidum, in addition to the well-established motor functions. Obsessive
      compulsive symptoms in syndromes with extrapyramidal-motor dysfunction, such as
      Gilles de la Tourette syndrome or Chorea minor (Sydenham), response to specific
      pharmacotherapy, behavioural therapy, and psychosurgery, as well as findings
      derived from brain imaging studies including positron emission tomography (PET)
      support the view of a frontal cortex/basal ganglia dysfunction in OCD. In
      addition, growing evidence suggests that potent inhibitors of 5-HT reuptake and
      other 5-HT subsystem-selective agents, such as the azapirones with partial
      agonist properties at the 5-HT1A receptor, are effective in OCD not only has
      improved the therapeutic perspective but may also reveal clues to the
      aetiopathogenesis of OCD. Much of this evidence has resulted from the discovery
      of multiple receptors and signal transduction pathways for 5-HT and from
      experiments relating the action of 5-HT receptor-selective agents to discrete
      effects in different subsystems. Among these 5-HT subsystems the 5-HT1D and 5
      HT1A receptor-effector system complex appears to play a central role in the
      pathophysiology of OCD symptoms and the mechanism of action of antiobsessional
      drugs. Recent psychoneurobiological findings are reviewed briefly and evaluated
      in the context of the 5-HT and basal ganglia hypothesis of OCD.

PMID- 1761270
TI  - [Neurologic and psychiatric manifestations of lead poisoning in adults (case
      report and review of the literature)].
AB  - A 59-year-old potter presented with lead polyneuropathy after 37 years of
      occupational exposure. There was a 25-year history of normochromic normocytic
      anaemia with moderate basophilic stippling, mild renal failure, hyperuricaemia
      and abnormal porphyrins. Since 1964 three short psychotic episodes were noted.
      Cranial computed tomography showed extensive bilateral symmetrical calcification
      in the cerebellar hemispheres and slight calcification in the subcortical area of
      the cerebral hemispheres and basal ganglia. T2-weighted magnetic resonance
      imaging disclosed high signal intensities in the periventricular white matter,
      basal ganglia, insula, posterior thalamus and pons. Differential diagnostic
      aspects are discussed with special regard to CT and MRI findings. A review of the
      literature on neurological and psychiatric manifestations of lead intoxication in
      adults is given.

PMID- 1761271
TI  - [Flashback following use of cannabis--a review].
AB  - The present study tries to find an answer to the question, whether the
      consumption of cannabis can cause flashbacks, and, if so, under what
      circumstances they occur. This is of interest for the treatment, prognosis and
      also from the legal viewpoint. The definition of a flashback is often unclear.
      Empirical investigations are often not sufficiently comparable, the supplementary
      data are very often missing, making the evaluation of the results difficult. Self
      diagnosis by the consumer is usually unsuitable for estimating the frequency and
      phenomenology of flashbacks. Cannabis may trigger flashbacks after consuming
      hallucinogenes; the probability of the occurrence of a flashback seems to
      increase with the amount of hallucinogenes a person has consumed. A definite
      correlation between the amount of hashish consumed and the occurrence of
      flashback does not exist. Flashbacks have also been reported after consuming
      cannabis alone. However, data vary regarding the frequency of such flashbacks.
      According to the available data they occur rarely and require a thorough
      differential diagnostic evaluation in each individual case. As a rule, the
      occurrence of a flashback may take place in cases where there is an intake of
      hallucinogenic drugs in the recent case history.

PMID- 1761272
TI  - [Mood follow-up over 6 years in a patient with season-dependent form of
      depression (SAD)].
AB  - Since the first description of seasonal affective disorder (SAD), many
      international studies have confirmed the existence of this subgroup of depressive
      patients. Even though the diagnosis of SAD has been incorporated into the DSM-III
      R classification system, many psychiatrists maintain a certain skepsis as to the
      existence of SAD as a separate sub-group of depression. The diagnostic issues are
      important because of the apparent specificity of treatment of SAD with bright
      light. Most diagnoses have relied on retrospective descriptions of the patients'
      depressive and healthy phases with respect to time of year. We present
      prospectively gathered weekly depression self-ratings in a SAD patient over a
      period of six years that may provide valid criteria for diagnostic purposes. This
      is a particularly exemplary case with implications for the relationship between
      light therapy and the course of depressive phases, the possible interaction of
      light treatment with lithium, the relationship between weight-changes and mood
      changes over the year and aspects of family loading of the illness.

PMID- 1761273
TI  - [Lyme borreliosis--epidemiology, etiology, diagnosis and therapy].
AB  - The tick-borne Lyme Borreliosis may lead to a wide variety of sequels. Besides
      symptoms involving skin, joints and heart the infection provokes as a neurologic
      complication a meningopolyneuritis Garin-Bujadoux-Bannwarth in second state and a
      progressive encephalomyelitis in third state. Unexpected widespread--as modern
      laboratory investigations proved--the contamination only occasionally inflicts
      clinical manifestations. Involvement of the nervous system is substantiated by
      the demonstration of endogenous Borrelia antibodies in the cerebrospinal fluid.
      This prove is to claim especially for the assumption of a third state
      neuroborreliosis with progressive encephalomyelitis. Severe damage can be
      prevented by prompt diagnosis, specific treatment and follow-up.

PMID- 1761274
TI  - [The neurologic department of the Neurologic Clinic--establishment of the
      Heidelberg Chair for Neurology 1881-1969].
AB  - During the 20th century clinical neurology developed to a fully established
      discipline being descended from Psychiatry and Internal Medicine. In this paper
      the development of clinical neurology at the University of Heidelberg from a
      Nervenabteilung at the clinic for internal medicine to a chair with separate
      clinic of neurology is outlined as an example for the controversy which
      accompanied the institutionalization of the discipline in Germany. Pointing out
      motives and arguments of the persons involved in this process the specific
      circumstances of the development of neurology in Germany are stated more
      precisely.

PMID- 1761275
TI  - Circadian variations and extraadrenal effect of ACTH on insulinemia in rabbit.
AB  - The present experiment was designed to study the action of ACTH1-24 on insulin
      secretion during the circadian cycle in normal rabbits and to provide evidence
      that ACTH1-24 has an extra-adrenal effect on this secretion. In normal rabbits
      intravenous administration of three doses of ACTH1-24 (1, 10, 100 micrograms/kg)
      at 10 a. m. increased plasma insulin levels. Hyperglycemia only occurred with
      doses of 10 and 100 micrograms/kg. A maximum insulin response was already
      obtained at 1 micrograms/kg. The same experiment performed at 12 p. m. also
      induced hyperinsulinemia which was only noted at 10 and 100 micrograms/kg;
      hyperglycemia was only observed after stimulation by the highest dose (100
      micrograms/kg). ACTH was therefore more effective during the day; however, at 12
      p. m. plasma insulin levels were the highest, but only with the maximum dose of
      ACTH (100 micrograms/kg). The effect of ACTH1-24 was evaluated throughout the day
      on normal and adrenalectomized rabbits. In normal animals injection of ACTH1-24
      increased plasma glucose and insulin levels both together. In the contrary, in
      rabbits deprived of adrenal glands, ACTH1-24 induced high insulinemia along with
      hypoglycemia. We could, therefore, reasonably conclude that ACTH stimulates
      directly the pancreatic secretion of insulin.

PMID- 1761276
TI  - Food intake after hatching inhibits the growth hormone induced stimulation of the
      thyroxine to triiodothyronine conversion in the chicken.
AB  - The effect of a single injection of 10 micrograms chicken GH on circulating
      thyroid hormones as well as in vitro liver 5'-monodeiodination (5'-D) activity
      was studied in posthatch chicks submitted to different feeding conditions. One
      group was normally fed after hatching, a second group was only fed after three
      days and a third group was food deprived after 2 days of feeding. Combination of
      all results indicates that the start of food intake abolishes the stimulatory
      effect of a GH injection on circulating T3 and liver 5'-D activity. Food
      deprivation after a period of food intake restores the GH effect on plasma T3 but
      not on liver 5'-D.

PMID- 1761277
TI  - Failure to demonstrate natriuretic activity in the posterior pituitary after
      immunoneutralization of the vasopressin content.
AB  - The attempt to demonstrate the presence of a natriuretic substance in the
      posterior pituitary after immunoneutralization of the AVP content failed. Rats
      infused i.v. AVP-immunoneutralized posterior pituitary extract did not respond by
      natriuresis to a saline infusion, in contrast to those infused untreated
      posterior pituitary extract. Thus, vasopressin seems to be the natriuretic
      substance in the posterior pituitary extract.

PMID- 1761278
TI  - Transitory coexistence of oxytocin and vasopressin in the hypothalamo
      neurohypophysial system of parturient rats.
AB  - We used in situ hybridization and immunocytochemistry to investigate a possible
      coexistence of vasopressin and oxytocin in hypothalamic neurons of parturient
      rats. We found that a fraction of magnocellular neurons in the paraventricular
      and supraoptic nuclei contained immunostaining for both peptides as well as
      oxytocin and vasopressin mRNA hybridization. Colocalization of immunoreactive
      vasopressin and oxytocin could be observed in some of the Herring bodies in the
      median eminence and the posterior lobe. No coexistence of vasopressin and
      oxytocin was found in pregnant or in lactating animals, indicating that the
      observed coexistence is transitory, perhaps mediated through changing hormonal
      conditions peri partum.

PMID- 1761279
TI  - Does estradiol treatment normalize the hypothalamic-pituitary-adrenal axis in
      streptozotocin-induced ovariectomized diabetic female rats?
AB  - We recently found circulating corticosterone (CS) levels to be significantly
      lower in diabetic female rats as compared with proestrous control animals. This
      reduction in CS was correlated with the hypoestrogenic state of the diabetic
      female. It was the purpose of this study to evaluate basal and corticotropin
      releasing hormone (CRH)-stimulated CS secretion in ovariectomized (OVX) control
      (C) and streptozotocin-induced diabetic (D) rats given blank, 5 mcg and 20 mcg
      estradiol (E2) implants to determine if adrenal CS secretion in the diabetic is
      normalized by E2 treatment. After 3 weeks of diabetes, pituitary-adrenal function
      was assessed in rats from each group with a CRH stimulation test. The remaining
      rats were sacrificed for determination of CS, E2, testosterone and fructosamine
      in serum. Suppressed CS secretion in OVX female diabetic rats was partially
      restored with E2 therapy. Basal CS levels were significantly higher in 20 mcg E2
      treated C and D rats compared with OVX rats. However, C rats had significantly
      higher basal CS compared with D rats in similarly E2 treated groups. The CS
      response to CRH stimulation was not different between OVX female diabetic and
      control rats. Estrogen enhanced the CS response to CRH stimulation in control
      animals but not in diabetic animals suggesting altered estrogen action at the
      pituitary level in diabetic animals.

PMID- 1761280
TI  - The effect of guanidino substances from uremic plasma on insulin binding to
      erythrocyte receptors in uremia.
AB  - We have studied insulin binding to erythrocyte receptors in a group of 25
      nonobese, nondiabetic uremic patients undergoing maintenance hemodialysis for 2
      54 months and 14 healthy controls. Erythrocytes of predialyzed uremics bind
      significantly less insulin than control erythrocytes (p less than 0.01). Dialysis
      resulted in a rapid increase of insulin binding (p less than 0.001). The
      concentrations of plasma insulin and glucose remained essentially unchanged
      during 5-hour hemodialysis and did not significantly differ from the control
      values. The down regulation of insulin receptors in undialyzed patients in the
      presence of normal plasma insulin concentration indicates that factors other than
      insulin itself could be responsible for insulin receptor activity during uremia.
      The results demonstrated that creatinine, creatine and glycocyamine have a direct
      suppressive effect on insulin binding of postdialyzed plasma (p less than 0.05)
      in concentration of 1 mmol/l. This suggested that specific uremic toxins could
      play an important role in the mechanisms of altered insulin binding during
      hemodialysis. Despite the high concentration of these compounds in blood of
      uremics, the only common feature for these compounds is the presence of the
      guanidino group in the molecule.

PMID- 1761281
TI  - Insulin secretion, glycosylated haemoglobin and islet cell antibodies in cystic
      fibrosis children and adolescents with different degrees of glucose tolerance.
AB  - In comparison with 12 weight-matched controls, 39 children and adolescents with
      cystic fibrosis (CF) showed higher fasting glycaemic levels and both delayed and
      enhanced blood glucose responses to OGTT. Glycaemic response was normal in 30/39
      patients (76.9%), impaired in other 7 cases (18%) and diabetic in the remnant two
      (5.1%). Fasting insulin levels and total insulin output during OGTT did not
      differ in patients and controls, but insulin peak in CF group was delayed and
      sustained. In the whole CF series mean HbA1c was higher than in controls but no
      difference was found between patients with normal and those with impaired glucose
      tolerance. Islet cell antibodies were absent in the entire CF group. In
      conclusion, our results confirm the raised prevalence in CF of glucose tolerance
      abnormalities, which do not seem to depend on auto-immune factor involvement.
      Delayed insulin response to OGTT can be considered a very early expression of
      beta cell impairment in the course of CF. In our experience HbA1c assay did not
      constitute a sensitive and specific screening test for detection of the C
      patients with glucose intolerance.

PMID- 1761282
TI  - Studies on facial temperature rise and involvement of serotonin in the
      respiratory stimulation by CRH.
AB  - Following an intravenous injection of 100 micrograms hCRH a facial flushing can
      frequently be observed along with respiratory stimulation. Both effects can be
      mediated by a common transmitter. Serotonin is well known to produce facial flush
      as well as to modulate respiration. In order to clarify is serotonin is a common
      mediator for facial flush and respiratory stimulation after i.v. application of
      hCRH, we studied the time course of facial skin temperatures and respiratory
      stimulation after intravenous injection of 100 micrograms hCRH in 10 healthy
      subjects. Furthermore, we measured respiratory stimulation after i.v.
      administration of 100 micrograms hCRH in 10 healthy subjects pretreated with the
      serotonin antagonist cyproheptadine. Facial skin temperatures reached maximum
      levels 9 min after CRH administration and remained raised for more than 60 min.
      Respiratory stimulation occurred within the first minute after CRH administration
      and reached a maximum during the second minute, but could no longer be observed
      after 10 min. Serum serotonin levels did not change after CRH stimulation in
      doses up to 3 micrograms/kg body weight), and cyproheptadine did not abolish the
      respiratory stimulation effect of hCRH in a dosage sufficient to suppress CRH.
      induced cortisol secretion.

PMID- 1761283
TI  - Blood glucose, serum thyroid hormones, insulin, C-peptide and C-peptide/insulin
      ratio in hyperthyroid patients.

PMID- 1761284
TI  - Acute effect of propranolol on the growth hormone (GH) response to GH-releasing
      hormone in patients with hyperthyroidism.

PMID- 1761285
TI  - Carcinomatous infiltration of the thyroid presenting as thyroiditis and stridor.

PMID- 1761286
TI  - Biological parameters of bone remodelling in chronic adrenal insufficiency.

PMID- 1761287
TI  - Effect of prednisolone on urate and oxypurine excretion.

PMID- 1761288
TI  - Impedance analysis applicable to cardiac muscle and smooth muscle bundles.
AB  - An electrical equivalent circuit was constructed to represent a chain of five
      myocardial cells in a cardiac muscle bundle with various degrees of cell-to-cell
      coupling, and an impedance analysis was performed. The impedance across the
      entire network was measured at frequencies ranging from 10(1) to 10(6) Hz. The
      Bode plots were nearly superimposable for 1, 10, and 100 tunnels; for 10(3),
      10(4), and 10(5) tunnels, the absolute zeta at 10 Hz was lower: e.g., 9.82 M
      omega for 1 tunnel compared to 6.64 M omega for 10(5) tunnels. The delta zeta 1/2
      values were shifted to the left in the well-coupled cases: e.g., for 1 tunnel,
      f1/2 was 37.8 kHz, and for 10(5) tunnels, f1/2 was 1.2 kHz. For high coupling,
      the Bode plots contained a double component due to the end membranes. When Ro was
      increased by eight times, zeta increased by 7.47 fold (for 1 tunnel, 10 Hz), and
      by 3.72 fold (for 10(5) tunnels, 10 Hz). Raising Ro to x 12, x 100, and x 1000
      produced a further and further shift to the left of the Bode plots. The total
      tissue resistivity (Rt) increased as a function Ro. Thus, in low coupling cases,
      almost all of the applied current passes through the interstitial space; e.g., at
      1 tunnel (10 Hz), 1.0% of the current passes through the cell pathway (Rcell).
      The ratio of impedances at 10 kHz to 10 Hz (zeta 10kHz/zeta 10Hz) decreased with
      increasing tunnels (for Ro x 1). The ratio of resistivities at Ro x 8 to Ro x 1
      (Rt'/Rt) was 7.47 for 1 tunnel. In contrast, the ratio at 10(5) tunnels was 3.73.
      It is concluded that it is difficult to determine the degree of cell coupling
      from such impedance analysis, unless the same tissue can be used for its own
      control, i.e., before and after a large change in cell coupling is introduced.

PMID- 1761289
TI  - A reduced sampling schedule for estimating the parameters of the glucose minimal
      model from a labeled IVGTT.
AB  - The minimal model of tracer glucose disappearance allows the measurement in man
      of important metabolic parameters from a labeled IVGTT (intravenous glucose
      tolerance test). Usually 30 blood samples are drawn to measure the insulin and
      the labelled glucose concentration time courses, which provide the data base for
      the model identification. In this paper, we address the problem of reducing the
      number of blood samples withdrawn without, however, deteriorating parameter
      estimation. By using a stepwise approach, largely based on optimal experiment
      design theory, we have derived a reliable reduced sampling schedule, which
      comprises only 14 total samples. The practical application of this reduced
      schedule has been validated by applying it in a new set of human experiments,
      completely independent of the ones used in the design phase.

PMID- 1761290
TI  - A three-dimensional thermal and electromagnetic model of whole limb heating with
      a MAPA.
AB  - Previous studies by the authors have shown that if properly implemented, the
      Pennes assumptions can be applied to quantify bioheat transfer during extremity
      heating. Given its relative numerical simplicity and its ability to predict
      temperatures in thermoregulated tissue, the Pennes model of bioheat transfer was
      utilized in a three-dimensional thermal model of limb heating. While the arterial
      blood temperature was assumed to be radially uniform within a cross section of
      the limb, axial gradients in the arterial and venous blood temperatures were
      computed with this three-dimensional model. A realistically shaped, three
      dimensional finite element model of a tumor-bearing human lower leg was
      constructed and was "attached" mathematically to the whole body thermal model of
      man described in previous studies by the authors. The central as well as local
      thermoregulatory feedback control mechanisms which determine blood perfusion to
      the various tissues and rate of evaporation by sweating were input into the limb
      model. In addition, the temperature of the arterial blood which feeds into the
      most proximal section of the lower leg was computed by the whole body thermal
      model. The variations in the shape of the tissues which comprise the limb were
      obtained from computerized tomography scans. Axial variations in the energy
      deposition patterns along the length of the limb exposed to a miniannular phased
      array (MAPA) applicator were also input into this model of limb heating. Results
      indicate that proper positioning of the limb relative to the MAPA is a
      significant factor in determining the effectiveness of the treatment. A patient
      specific hyperthermia protocol can be designed using this coupled electromagnetic
      and thermal model.

PMID- 1761291
TI  - A device to measure the cross-sectional area of soft connective tissues.
AB  - A device has been designed and fabricated to measure the cross-sectional area of
      soft connective tissues ex vivo. It consists of two displacement transducers; one
      sensing tissue thickness and the other sensing width. Outputs are recorded (via
      an analog to digital interface) using a personal computer. Numerical integration
      of a thickness versus width plot computes cross-sectional area. This plot also
      provides a quality check of acquired data. This device has been successfully used
      in biomechanical studies of rabbit patellar tendons, rat medial collateral
      ligaments, and dissected specimens of human fascia.

PMID- 1761292
TI  - Sound velocity inversion in layered media with band-limited and noise-corrupted
      data.
AB  - With reflection data measured from two different incident angles, it is possible
      to make them "nearly the same" by stretching or contracting the time axis of one
      of them. In this way, a correspondence is built up between the two travel times,
      which can be used to calculate the one-dimensional sound velocity profile of the
      medium. For the special case that the impulse response of the medium consists of
      sparse spikes, a spectral fitting procedure is developed which deconvolves the
      received signal, and gives the exact positions of the spikes. The stepwise sound
      velocity profile can then be calculated from these positions. In experimental
      measurements the plane wave assumption made in the analysis is not true, but this
      can be accommodated with some modifications of the calculation. Results of both
      computer simulation and of measurements are presented, indicating the validity of
      these processings.

PMID- 1761293
TI  - Inspiration produced by bilateral electromagnetic, cervical phrenic nerve
      stimulation in man.
AB  - Eddy-current stimulation of both phrenic nerves at the base of the neck in human
      subjects was carried out to provide inspiration resulting from tetanic diaphragm
      contraction. The inspired volume obtained was in excess of spontaneous tidal
      volume.

PMID- 1761294
TI  - The effect of CO2 laser pulse repetition rate on tissue ablation rate and thermal
      damage.
AB  - The ablation rate and thermal damage in skin produced by a superpulsed CO2 laser
      operating at pulse repetition rates between 1 and 900 Hz was measured. When
      delivering a fixed number of pulses (20 or 30) of equal energy, a 55-60% increase
      in the amount of tissue ablated was observed when the pulse repetition rate rose
      from 10 to 200 Hz. At pulse repetition rates greater than 200 Hz no further
      increase was seen. Under identical conditions, an 80% increase in the zone of
      thermal damage was observed when the pulse repetition rate was increased from 1
      to 60 Hz. The large increases in tissue ablation and tissue damage may indicate
      the existence of a layer of mixed-phase (i.e., liquid and vapor) or metastable
      liquid which can store significant amounts of thermal energy between pulses. The
      data suggest that CO2 lasers should be operated at relatively low repetition
      rates for optimal performance.

PMID- 1761295
TI  - A 16-channel 8-parameter waveform electrotactile stimulation system.
AB  - We have developed a general-purpose electrotactile (electrocutaneous) stimulation
      system as a research tool for studying psychophysiological performance associated
      with various stimulation waveforms. An experimenter-defined command file
      specifies the stimulation current and waveform of each of the 16 channels. The
      system provides burst onset delay of 0-20 ms, phase current of 0-50 mA,
      interphase interval of 0-1000 microseconds, number of pulses per burst from 1
      100, pulse repetition rate of 0.1-25 kHz, phase width of 2-1000 microseconds, and
      functionally-monophasic pulses (with zero dc current) or balanced-biphasic pulses
      (with equal positive and negative phases). The system automatically delivers the
      desired stimulation, prompts the subject for responses, and then logs subject
      responses. Key features of the system are 1) very flexible choice of bursts of
      pulsatile waveforms, 2) real-time control of all of the waveform parameters as
      mathematical functions of external analog inputs, and 3) high-performance
      electrode-driver circuitry.

PMID- 1761296
TI  - Control of end-point forces of a multijoint limb by functional neuromuscular
      stimulation.
AB  - A multivariable feedback controller was designed and tested for regulating the
      magnitude and orientation of the force vector at the end point of a multijoint
      limb in contact with an isometric load. The force vector was produced by
      electrical stimulation of muscles. To achieve arbitrary control of end-point
      force magnitude and orientation, two coupling issues must be dealt with by the
      control system. First, there is a geometric coupling between the end-point force
      vector and joint torques. The amplitude and orientation of the force vector
      depend on the limb geometry. Second, torques at two joints may be coupled due to
      activation of muscles that cross them (biarticular coupling). To eliminate the
      geometric coupling, a transformation of controller error from the Cartesian space
      to the joint space was employed. A multivariable proportional-plus-integral (PI)
      control law was used to calculate muscle activation based on the transformed
      controller error. Centralized and decentralized controls were investigated for
      decoupling the effects of biarticular muscles. The results obtained from cat
      experiments showed that the magnitude and orientation of the end-point forces of
      the cat hindlimb could be regulated by this controller. In the presence of strong
      biarticular coupling, centralized control yielded better performance than
      decentralized control during transient responses. Both control strategies could
      decouple the biarticular muscle at steady state. When no biarticular coupling was
      present, centralized control sometimes performed worse than decentralized
      control. This is the first step in the simultaneous control of multiple joints by
      functional neuromuscular stimulation (FNS). The controller has broad potential
      applications in FNS neural prostheses.

PMID- 1761297
TI  - Tunable diode laser spectroscopy for isotope analysis--detection of isotopic
      carbon monoxide in exhaled breath.
AB  - A high resolution tunable infrared diode laser spectroscopy system was developed
      for isotope analysis with sensitivity at ppb levels. Such a system is ideally
      suited for detection and measurement of minute amounts of infrared active
      compounds present in a huge noninfrared active background such as air. The
      operation and capabilities of the system were demonstrated by measuring
      physiological levels of isotopic carbon monoxide, 12C16O and 13C16O, naturally
      present in exhaled human breath with essentially no sample preparation. The
      simplicity in obtaining such data suggests that fundamental physiological
      information may be derived from noninvasive measurements. This makes the system
      potentially useful for many biomedical applications.

PMID- 1761298
TI  - Development of medical pressure and temperature sensors employing optical
      spectrum modulation.
AB  - Fiber optic Fabry-Perot sensors have been developed whose optical reflectance
      varies with optical cavity depth (pressure) or with change in a material's
      refractive index (temperature). These sensors employ a unique combination of
      features: they are interrogated by an LED; they are designed to operate within a
      single reflectance cycle; and their returned light is analyzed by a dichroic
      ratio technique. The sensors use a step index glass fiber and are relatively
      insensitive to absolute light levels and fiber bending. They have an expanded
      linear operating range and can be built for low cost disposable applications.
      Sensor performance meets or exceeds established medical requirements.

PMID- 1761299
TI  - Computer simulations of activation in an anatomically based model of the human
      ventricular conduction system.
AB  - Simulations of the electrical activity during excitation were performed in an
      anatomically based model of the human ventricular conduction system. Each of the
      33,000 elements of this model represented a unit bundle of Purkinje or
      atrioventricular nodal tissue. The Ebihara-Johnson model for sodium defined the
      active membrane characteristics. Using a combination of new and existing modeling
      techniques, simulations of excitation were completed in approximately 5 min CPU
      time on an IBM 3090 at the Cornell National Supercomputer Facility. Activation
      times at sites in the model were compared to experimental measurements for the
      excitation of the ventricular myocardium on the endocardial surface. These
      "literature-based" times were estimated from a number of reported human heart
      mapping studies. Initially, the times fit poorly. The major factor for the
      discrepancy was the conduction velocities of the elements, which were a result of
      the physical and electrical parameters derived from a review of histologic and
      electrical properties studies. In addition, there was a latency between
      activation of the system in the left ventricle of the model and that in the right
      ventricle when compared to the experimental work. When the times were scaled to
      adjust for the conduction velocity and ventricular latency effects, the match
      between the simulation and literature-based times was much improved. Quantitative
      comparison between normalized times resulted in correlation coefficients CCF =
      0.76 for the right ventricle and CCF = 0.64 for the left ventricle.

PMID- 1761300
TI  - Structural complexity effects on transverse propagation in a two-dimensional
      model of myocardium.
AB  - A thin sheet of cardiac tissue was modeled as a set of resistively coupled
      excitable cables with membrane dynamics described by the modified Beeler Reuter
      model. Transverse connections have a resistance Rn and are regularly distributed
      with a spacing delta on any given cable, to provide alternating input and output
      junctions. Flat wave longitudinal propagation corresponds to propagation along a
      single continuous cable since all units of the network are functionally isolated
      due to the absence of transverse current flow. Events on a given cable during
      flat transverse propagation include electrotonic spread of potential from input
      to output junctions, action potential initiation at input junctions, and
      collision at output junctions. The propagating two-dimensional transverse
      wavefront is an undulating transmembrane potential surface with highs at the
      input junctions and lows at the output junctions. The action potential upstroke
      is also modulated in a periodic manner with minimum and maximum Vmax at the input
      and output junctions respectively. Thus, the network is capable of a diversity of
      dynamic behavior spatially distributed in relation to the specific pattern of
      transverse connections chosen. Overall, the behavior of the network model is in
      good agreement with available structural and electrophysiological data on
      myocardium. In addition, this network topology allows to handle more easily
      parameters governing propagation and to avoid very large matrices which are
      costly in computational effort and overall computer time.

PMID- 1761301
TI  - [Diagnosis of infections with gene technology methods: an increased value of
      miasmata?].

PMID- 1761302
TI  - [The "polymerase chain reaction" (PCR) and its possible applications].
AB  - This review article summarizes the basics of PCR technology. Besides technical
      details PCR as a diagnostic tool for infectious diseases is described. Finally
      problems involved in using this technique for the diagnosis of infectious
      diseases are discussed.

PMID- 1761303
TI  - [Applications of PCR in molecular immunology].
AB  - Since a wide panel of monoclonal antibodies specific for antigen receptor
      variable (V) regions is unavailable, PCR has emerged as the primary analytical
      method for determining the expressed repertoire of T- and B-lymphocyte
      populations. Furthermore, PCR amplification of immunoglobulin V-region genes is
      exploited for the production of monoclonal antibodies by repertoire cloning as a
      replacement of the B-cell-hybridoma technique and for the humanization of murine
      monoclonal antibodies. The heavy and light chains of immunoglobulins as well as
      the transmembrane-protein chains which build the heterodimeric T-cell receptors
      consist of a constant and of an antigen-binding variable segment. Conventional
      PCR makes use of two specific oligonucleotide primers that flank a sequence of
      interest to prime replication of the bracketed DNA. In the case of antigen
      receptor encoding DNA one flanking sequence of the variable region is unknown or
      heterogeneous. Therefore, modifications of the conventional PCR had to be
      developed for the cloning and analysis of antigen-receptor DNA: (1) the usage of
      known V-gene segments by a lymphocyte population can be analyzed by quantitative
      PCR with panels of V-specific primers; (2) since PCR primers do not have to be
      completely complementary to the target DNA, it is possible to amplify a variety
      of different V regions with degenerate primers for relatively conserved sequences
      of the V genes; (3) enzymatic addition of a homopolymeric dG tail to the variable
      end of the antigen receptor DNA makes the amplification completely independent of
      the structure of the variable region because the dG-tailed DNA can be amplified
      with a nonspecific poly-dC oligonucleotide combined with a specific primer for
      the constant gene segment of interest.

PMID- 1761304
TI  - Is it fair?

PMID- 1761305
TI  - Health insurance, 1979-1989: the frayed connection between employment and
      insurance.
AB  - Using data from the Current Population Survey, this article shows that low-income
      workers were much less likely to have employer-sponsored insurance in 1989 than
      they were in 1979. For example, workers earning $6.00 per hour in 1989 were over
      10 percentage points less likely to have employer sponsored health insurance than
      were workers earning $3.51 per hour in 1979 (the constant dollar equivalent of
      $6.00 per hour in 1989). The decline in employer sponsored coverage was confined
      to low income workers; coverage levels did not decline for workers earning
      $30,000 per year and more. The paper explores two types of explanations for the
      decline in coverage among low-income workers. First, the decline might have
      resulted from increases in the price of medical care, the cost of administering
      health insurance, and from a breakdown in the small group insurance market.
      Second, the decline might have resulted from changes in the structure of the
      economy that changed the types of jobs available to low-income workers. Since
      coverage declines among the self-employed parallel coverage declines among the
      employed, it seems likely that increases in the price of health insurance are a
      larger part of the cause for coverage declines than are changes in the structure
      of the economy, but further research on this question is needed.

PMID- 1761306
TI  - A lifetime perspective on proposals for financing nursing home care.
AB  - In this paper data from the National Mortality Followback Survey and the National
      Nursing Home Survey are used to estimate the lifetime cost of nursing home care.
      The expected discounted cost for persons turning 65 in 1990 is $27,600. However,
      variation around this average is high. The 9% of persons expected to use at least
      5 years of nursing home care will account for 64% of aggregate cost for the
      cohort; the 68% using less than 3 months of care will account for only about 1%
      of cost. The percentage of costs covered under alternative financing strategies
      also varies widely. An entitlement covering the first 3 months of care subject to
      30% coinsurance would cover 5% of aggregate cost; an entitlement with a 2-year
      deductible and the same coinsurance would cover 41% of cost.

PMID- 1761307
TI  - Medicare patient access to posthospital skilled nursing facility care.
AB  - The willingness of nursing homes to accept any Medicare admissions (Medicare
      participation) and the number of patients they serve (Medicare utilization)
      affect the access of Medicare SNF patients to posthospital care. Characteristics
      of facilities, their market areas, and state Medicaid reimbursement were found to
      affect both participation and utilization. Most important, when Medicaid and
      private nursing home market conditions support high-intensity care, facilities
      are more likely to serve Medicare patients and admit more of them. SNFs in states
      that require Medicare certification are more likely to accept Medicare
      admissions, suggesting that the cost and effort of achieving certification are a
      barrier to service to Medicare SNF patients. For-profit facilities, hospital
      based SNFs, and larger nursing homes have higher rates of participation and serve
      more Medicare patients when they serve any.

PMID- 1761308
TI  - The resource utilization group system: its effect on nursing home case mix and
      costs.
AB  - Using data from 1985 and 1986, we examine how New York state's prospective
      payment system affected nursing homes. The system, called Resource Utilization
      Group (RUG-II), aimed to limit nursing home cost growth and improve access to
      nursing homes by "heavy-care" patients. As in Medicare's prospective hospital
      reimbursement system, payments to nursing homes were based on a "price," rather
      than facility-specific rates. With respect to cost growth, we observed
      considerable diversity among homes. Specifically, those nursing homes most
      financially constrained by the RUG-II methodology exhibited the slowest rates of
      cost growth; we observed higher cost growth among the homes least constrained.
      This higher rate of cost growth raises a question about the desirability of using
      a pricing methodology to determine nursing home payment rates. In addition to
      moderating cost growth, we also observed a significant change in the mix of
      patients admitted to nursing homes. During the first year of the RUG-II program,
      nursing homes admitted more heavy-care patients and reduced days of care to
      lighter-care patients. Thus, through 1986, the RUG-II program appeared to satisfy
      at least one of its major policy objectives.

PMID- 1761309
TI  - Family structure and physicians' hours in large, multispecialty groups.
AB  - There is a consensus that male physicians work more hours than female physicians,
      but no consensus on how or why female physicians limit hours. Drawing on a new
      national survey of physicians in large, multispecialty groups, we conclude that
      much of the hours differential is due to differences in nonpractice incomes and
      is likely to be permanent. However, due to reductions in family responsibilities
      for women and increases in nonpractice incomes for men, the differential should
      narrow somewhat as the current cohort of physicians ages. We also infer that the
      link between hours and practice choices may well account for much of the
      diversity of the literature.

PMID- 1761310
TI  - Rollover effects in gatekeeper programs: cushioning the impact of restricted
      choice.
AB  - Public and private medical care plans that restrict the beneficiary's choice of
      providers have experienced rapid growth in the past decade as a means to contain
      costs and coordinate care. Such plans have been criticized for engendering
      beneficiary dissatisfaction and potentially impeding access to necessary care.
      Some of the objections to primary care "gatekeeping" may be diminished by
      recruiting the physician who served previously as the beneficiary's "usual source
      of care" to assume the role of formal gatekeeper. This study examines how persons
      whose gatekeepers were their regular source of care before plan implementation
      differed in their use and satisfaction from persons required to change their
      regular source of care. Our findings indicate that satisfaction was significantly
      higher among individuals who experienced no change in usual source of care. These
      individuals also tended to be less likely to use the emergency department as a
      source of care. Although the data are from Medicaid managed care programs, the
      findings may also be applicable to private sector point-of-service plans that
      adopt the primary care gatekeeper model.

PMID- 1761311
TI  - Medicaid shortfalls and total unreimbursed hospital care for the poor, 1980-1989.
AB  - This article examines the relationship between Medicaid payments and hospital
      costs from 1980 through 1989, using data from the American Hospital Association's
      Annual Survey of Hospitals. It finds that payments covered about 90% of Medicaid
      hospital costs until 1985, then declined to 78% in 1989. Together, Medicaid
      shortfalls ($4.2 billion) and unsponsored care ($8.9 billion) accounted for $13.1
      billion in unreimbursed hospital costs in 1989. Most of the recent growth in
      unreimbursed hospital cost incurred in care for the poor is now caused by rising
      Medicaid shortfalls rather than increases in unsponsored care. While Medicaid
      shortfalls accounted for about one-fifth of unreimbursed care for the poor in
      1980, they accounted for a third in 1989.

PMID- 1761312
TI  - Employer-sponsored insurance coverage for alcohol and drug abuse treatment, 1988.
AB  - This paper uses 1988 Bureau of Labor Statistics data to analyze the content of
      insurance coverage for alcohol and drug abuse treatment offered by medium and
      large private sector firms. Ninety percent of workers had medical insurance. Of
      these, 81% had coverage for alcohol abuse treatment and 75.5% had coverage for
      drug abuse treatment. The coverages were almost always offered together, and the
      benefits were generally identical for both. Coverage for inpatient detoxification
      was most common, followed by outpatient care and inpatient rehabilitation. Self
      insured plans, although exempt from state-mandated benefits, were as likely to
      include alcohol and drug abuse coverage as Blue Cross and Blue Shield and
      commercial plans, and their specific benefits were no less generous. Coverage
      limitations tended to be more restrictive for these illnesses than for others.
      The nature of the limitations varied greatly, although day and dollar limits were
      most common for inpatient treatment, and visit limits and higher copayments were
      most common for outpatient treatment.

PMID- 1761313
TI  - Health insurance coverage of the immigrant elderly.
AB  - In this paper, I examine and contrast factors that contribute to whether
      individuals are covered by public health insurance (Medicare, Parts A and B, with
      and without Medicaid benefits) or private insurance. The study, based on data
      from a sample of foreign- and native-born elderly, employs descriptive analysis
      and a multivariate investigation involving logistic regression models. The
      results show that the immigrant population is less likely than native-born
      elderly to be covered by public insurance or to have private insurance. Medicare
      coverage for the immigrant elderly is strongly influenced by their length of stay
      in the United States, employment status, and country of origin, while their
      having private insurance coverage is affected by race, income, and employment
      status. For native-born elderly, race, income, and employment status are
      contributing factors to the type of insurance coverage retained. Policy
      implications are discussed.

PMID- 1761314
TI  - Estimating county percentages of people without health insurance.
AB  - County data on the percentage of people without health insurance are seldom
      available, although state program planning requires such information. As part of
      an evaluation of Washington's Basic Health Plan (BHP), we conducted a telephone
      survey in nine Washington counties to estimate the percentage of people under the
      age of 65 who were uninsured. We used regression analysis to estimate the
      percentage uninsured in a county as a function of the percentage unemployed. Two
      validation approaches yielded very good results, suggesting that the equation
      could be used to estimate the percentage uninsured in unsurveyed counties. The
      variation ranged from 15% to 23% uninsured in the 9 surveyed counties, and was
      estimated to range from 9% to 35% among the state's 39 counties. With proper
      caution, estimates based on this equation can probably be used in other states if
      better data are unavailable.

PMID- 1761315
TI  - Communication with Alzheimer's patients: an analysis of caregiver listening
      patterns.
AB  - Alzheimer's Disease is the leading cause of dementia in today's aging population.
      Behavioral manifestations of this illness have been studied primarily by focusing
      on diagnostic and assessment tests. Communication studies have emphasized
      identification of speech and language deficits, and little attention has been
      given to communication processes that are still in place. This study addresses
      caregiver listening responses as they occur in conversations with an Alzheimer's
      patient. This project videotaped twenty-six episodes of conversations between
      caregivers in an adult day health care setting. The dialogue was transcribed
      (enhanced by the use of video-taped data) and analyzed for caregiver listening
      responses. Frame analysis was used to identify several categories of caregiver's
      responses to the patient's message. In addition, this study found that sensitive
      listening and partial entry into the patient's frame (reality) may be an
      effective response to prevent behavior and anxiety related outbursts. This study
      also found that videotaping of natural conversations and frame analysis can be
      useful tools for continued study in the treatment and care of Alzheimer's
      patients.

PMID- 1761316
TI  - Information-seeking triggered by age.
AB  - Age labels may lead to the seeking of age-stereotypic information from target
      individuals. Using Carver and de la Garza's information-seeking procedure (which
      asked respondents to judge the relative importance of various kinds of
      information they would glean from drivers involved in an automobile accident for
      assigning accident responsibility), but extending it to a wider life span (16 to
      91 years of age) and to both genders, we generalized earlier findings to a
      similar undergraduate sample (n = 437) in another country. Also demonstrated for
      the first time is the fact that ageist information-seeking across the life span
      was independent of the driver's gender, the participant's age, and the
      participant's gender. Specifically, participants wanted to know from younger
      drivers about their driving conduct (whether they had been drunk and speeding),
      and from older drivers about their capacity for driving (mental competence,
      vision, and health). The seeking of environmental information (car safety and
      road conditions) did not vary with the age of driver in any systematic way.

PMID- 1761317
TI  - Throwing patterns of older adults: a follow-up investigation.
AB  - Previous investigations of the movement patterns of older adults have focused on
      functional movements. Performance declines have been reported with increasing
      age. Many investigations, however, do not require older adults to perform
      maximal, force producing actions. Smaller declines might be observed if older
      adults made a maximal effort. This investigation examined changes in a maximal
      skill--the overarm throw for force. Active, older adults were videotaped as they
      threw tennis balls. Thirteen people were filmed for two consecutive years. Gender
      and age differences were examined for movement patterns, ball velocity, and
      selected kinematic measures. Participants threw using patterns and velocities
      generally observed in children in middle elementary-school years. This result
      suggested there was a decline in this force production skill. Some older adults
      regressed in the movement patterns they used over the two years of testing. Older
      males threw faster, using more advanced movement patterns than older females.

PMID- 1761318
TI  - Usefulness of commercial memory aids as a function of age.
AB  - Recent research has produced disagreement about the usage and usefulness of
      external memory aids across age groups. The present study examined the use and
      perceived usefulness of commercial memory aids as a function of the ages of users
      and potential users. Three age groups (ages 20, 45 and 65 years) were asked to
      indicate whether they owned each of thirty different commercial aids and
      regardless of ownership, to rate the degree of usefulness of each of the aids.
      Each age group used certain aids or perceived certain aids as more useful, than
      did other age groups. The pattern of results suggest that memory aid usage
      differs with age partly because the memory tasks required of a person change with
      life stage.

PMID- 1761320
TI  - Can disturbances of the ejaculatory sequence contribute to male infertility?

PMID- 1761319
TI  - Individual differences in reminiscence among older adults: predictors of
      frequency and pleasantness ratings of reminiscence activity.
AB  - Although reminiscence has been recognized as an adaptive coping mechanism and its
      beneficial value is stressed in later life transitions, few studies have examined
      the frequency of self-reported reminiscence in relation to the personality
      traits, psychological well-being, purpose in life, and background characteristics
      of elderly individuals. Nor has there been any previous attempt to study the
      independent contributions of these factors as predictors of the frequency of
      reminiscence activity or the pleasantness ratings of the reminiscence activity. A
      sample of seventy individuals between the ages of sixty-seven and eighty-two
      years was selected from community settings, and an equivalent age sample of
      seventy individuals was selected from nursing home settings. A structured
      interview procedure and questionnaire assessed the frequency of reminiscence
      activity and ratings of pleasantness associated with it. The independent
      contributions of various personality measures, psychological well-being measures,
      and meaning of life measures as predictors of the frequency and pleasantness of
      reminiscence activity were analyzed via multiple regression analyses. The results
      showed that despite wide variability in the use of reminiscence, certain specific
      factors of personality, psychological well-being, will to meaning, and negative
      life events are strong predictors of the frequency and pleasantness of
      reminiscence activity. These results are discussed in terms of mental health
      implications for the identification of individuals with greatest potential for
      engaging frequently in reminiscence as a therapeutic tool and finding it a
      pleasant pursuit.

PMID- 1761321
TI  - Sperm transport in the human female reproductive tract--a dynamic interaction.
AB  - The interaction between sperm and the human female tract has been largely
      ignored. This review summarizes the data available from animal species with
      specific reference to sperm in the oviduct. Our knowledge of sperm transport
      within the human female tract is explored and, using the data available from
      animal species, three lines of future experimental design are suggested. Firstly,
      there is the need to improve and develop techniques to recover sperm successfully
      from the tract. Second, an in-vitro approach which examines the modulation of
      reproductive tract fluids on sperm function is advocated. Third, an in-vitro
      tissue/cell culture system is required to investigate in more detail the
      interaction between the epithelium and sperm. Using such approaches many of the
      questions posed in this review can be addressed confidently in the near future.

PMID- 1761322
TI  - Movement characteristics and hyperactivation of human sperm on different
      epithelial cell monolayers.
AB  - Studies of sperm movement characteristics concern mainly sperm swimming between
      two glass surfaces (as in the Makler chamber). Using automated videomicrography,
      (CellSoft, Cryo Resources, New York, USA), we have analysed the movements of
      human sperm swimming on monolayers of different origins: monkey kidney (Vero)
      cells, bovine oviduct cells, and human endometrial cells. About 10(5) sperm were
      deposited upon preparations consisting of monocellular layers adhering to a
      coverglass, and placed in a deep slide-coverglass system. Experiments were first
      performed at room temperature then at 37 degrees C. At room temperature, motion
      characteristics on Vero cell layers (six samples) were not different from those
      measured in either the conditioned or corresponding non-conditioned media, except
      for the amplitude of lateral head displacement (ALH) which was significantly
      lower. Comparison of the three different cell monolayers showed no difference
      between them for the corresponding motion parameters. The data were dramatically
      different at 37 degrees C: sperm swimming on cell monolayers of genital origin
      (oviduct or endometrium) exhibited high rates of hyperactivation (HA: 36.7% and
      38.6% respectively), which was significantly more than on either Vero cells
      (10.9%) or in a control medium (12.6%). Moreover, HA rates were significantly
      higher on genital cell monolayers than in the corresponding conditioned medium.
      Hyperactivated sperm exhibited lasting 'star-spin' trajectories rather than
      'transitional phases'. It is concluded that passage of sperm on either oviduct or
      endometrial epithelial cell monolayers can induce sperm hyperactivation and
      improve their fertilizing capacity.

PMID- 1761323
TI  - The fertility potential of male cystic fibrosis patients.
AB  - Men suffering from cystic fibrosis (CF) are considered to be infertile because of
      azoospermia. In testicular biopsies from two patients with CF normal
      spermatogenesis was found despite the absence of sperm in the ejaculate. Fructose
      and prostaglandin were not detectable in the semen whereas the levels of acid
      phosphatase and zinc were within normal limits, indicating normal prostatic
      function and absence of seminal vesicles. These findings may improve the
      possibility for male patients with CF to father a child.

PMID- 1761324
TI  - Effects of LHRH-analogue treatment of spermatogenic dysfunction in the dog.
AB  - Three male dogs, aged 2-4 years, which exhibited a high percentage of sperm with
      abnormal tails in their semen and low levels of peripheral plasma LH and
      testosterone were given two injections of 400 micrograms an LHRH analogue (LHRH
      A) 3 h apart. The semen quality of all three dogs and the peripheral plasma
      levels of LH and testosterone were examined in two of the dogs. Plasma levels of
      LH and testosterone in both dogs peaked at 30 and 90 min respectively, after the
      injection of LHRH-A. The semen quality of all three dogs had improved temporarily
      20 days after the injection. To be specific, although the mean percentage of
      sperm with abnormal tails in the three dogs was 19, 26 and 32% respectively
      before injection of LHRH-A, these values had decreased to 10, 16 and 13%,
      respectively, 20-40 days later. Thereafter, however, the percentage sperm
      abnormalities increased again. The testes and epididymides of two of the dogs
      were examined histologically at the end of 90 days. Sloughed germ cells were
      observed in the seminiferous tubules of the testes, and pyknotic epithelial cells
      were noted in some of the epididymal ducts. The other dog, which had a history of
      three unsuccessful matings was treated again with LHRH-A and mated with three
      bitches 30, 75, and 110 days later, respectively. Only the bitch mated with this
      dog 30 days after a second series of injections conceived. It is assumed that the
      semen quality of the three dogs improved because of a temporary rise in plasma LH
      and testosterone levels after the injection of LHRH-A. It is concluded that the
      fertility of dogs with a high percentage of sperm with abnormal tails can be
      improved approximately 30 days after treatment with an LHRH-A.

PMID- 1761325
TI  - Does unilateral orchidectomy influence blood flow, microcirculation and vascular
      morphology in the remaining testis?
AB  - Adult rats were hemi-orchidectomized and various aspects of testicular blood
      flow, microcirculation and vascular morphology were studied in the remaining
      testis after 30 days and compared to that in intact sham-operated animals. Testis
      weight, total testicular blood flow (measured with microspheres), capillary blood
      flow pattern (studied with laser Doppler flowmetry) and the volume of
      interstitial fluid in the testis (index of vascular permeability) were all
      unaffected by hemi-orchidectomy. Morphometric measurements on perfusion-fixed
      testicular tissue showed that the volume densities of Leydig cells, blood vessels
      and small exchange blood vessels were increased by hemi-orchidectomy (by
      approximately 45, 33 and 42%, respectively). The volume density of Leydig cells
      in individual testes was correlated to the volume and surface density of
      capillaries + small postcapillary velules (r = 0.72 and 0.86, respectively). Hemi
      orchidectomy is known to result in a doubling in testosterone secretion per
      Leydig cell. This increased endocrine activity results in moderate increase in
      the vascular exchange area but other aspects of testicular microcirculation and
      blood flow are apparently unaffected.

PMID- 1761326
TI  - Seminal emission by electrical stimulation of the spermatic nerve and epididymis.
AB  - The spermatic nerve and epididymis were stimulated electrically in dogs to
      elucidate the possibility of artificial seminal emission after bilateral
      transection of the hypogastric nerves and sympathetic trunks. Before transection,
      electrical stimulation of a distal end of the severed spermatic nerve caused a
      trace amount of emission in two dogs and no emission in the remaining four. In
      contrast, 1 month after the transection, stimulation of a distal end of the
      severed spermatic nerve caused seminal emission in all six dogs examined, with
      full seminal volume in four dogs and partial volume in the remaining two.
      Anatomically, sympathetic nerves originating from the upper portion of the lumbar
      sympathetic ganglia descended along the spermatic arteries to the testes as
      spermatic nerves. The present results indicate that spermatic nerves have the
      potential to generate seminal emission as a compensatory pathway after bilateral
      transection of the hypogastric nerves. Both direct and percutaneous electrical
      stimulation of epididymal tails resulted in a full volume of seminal emission in
      all dogs with transection of both hypogastric nerves and lumbosacral sympathetic
      trunks as well as in unoperated controls, while high voltage (8 V vs 40-80 V) was
      required to cause seminal emission by electrical stimulation on the skin surface.
      Direct stimulation of epididymal tails in men undergoing orchidectomy as
      treatment for prostatic carcinoma or during biopsy of the contralateral testis in
      a patient with a testicular tumour, resulted in seminal emission in all five
      epididymides examined either from the end of the severed vas deferens or in the
      posterior urethra if the vas deferens was not severed.

PMID- 1761327
TI  - Testicular lesions and lymphocyte subpopulations in rats immunized with a soluble
      fraction of testicular homogenate.
AB  - A soluble fraction obtained from a testicular homogenate by precipitation with
      ammonium sulphate (ASPM) was emulsified with Freund's complete adjuvant (CFA) and
      injected into Wistar rats. At 50 days after the first immunization (total of
      three injections) the animals had developed moderate and multifocal testicular
      damage, characterized mainly by sloughing of the seminiferous epithelium. A
      delayed-type hypersensitivity response and circulating antibodies to ASPM were
      detected at different times with maximum levels at 50 days. The addition of
      Bordetella pertussis to the immunization did not increase the severity of the
      lesion but augmented the cellular and humoral immune response to ASPM. The
      phenotypic characterization of cells present in the lymph nodes draining from the
      site of immunization in animals injected with CFA alone (control group) revealed
      an increase in CD8+ T-cells and a low CD4/CD8 ratio. Conversely, rats immunized
      with CFA plus ASPM (experimental group) exhibited testicular damage and showed a
      significant decrease in CD8+ cells with a normal CD4/CD8 ratio. In conclusion,
      rats immunized with a testicular antigen developed focal aspermatogenic lesions
      and a concomitant specific immune response as well as lymph-node cell variations
      focused apparently on the CD8+ T-cell subpopulation.

PMID- 1761328
TI  - Advances in pacing for bradycardia.

PMID- 1761329
TI  - Clinical cardiac electrophysiology: the last 10 years.

PMID- 1761330
TI  - Parasympathetic overactivity and its evaluation in patients with sinus nodal
      dysfunction.
AB  - In 17 controls, and 17 patients with sinus nodal dysfunction, an
      electrophysiologic study was made of sinus nodal function and atrioventricular
      nodal conduction in the basal state. The study was then repeated in all patients
      after atropine. The heart rate, mean sinus cycle length, variations of sinus
      cycle length, sinus node recovery times, sinuatrial conduction time, AH interval,
      and atrioventricular nodal Wenckebach threshold were significantly different in
      patients from those of controls. All these parameters changed significantly in
      patients after atropine, and were comparable to those of controls except for the
      atrioventricular nodal Wenckebach threshold. Atropine failed to increase the
      heart rate beyond 90 beats per minute in 10 of 17 patients (sensitivity of 59%)
      or by at least 30% above the resting heart rate only in 4 of them (sensitivity of
      24%). The variations of sinus cycle length, and their standardized value, could
      detect sinus nodal dysfunction with sensitivities of 59 and 47%, respectively.
      From our results, we conclude that there is parasympathetic overactivity in
      patients with sinus nodal dysfunction. Because of their very low sensitivities,
      the atropine test and variations of sinus cycle length were not useful in
      identifying sinus nodal dysfunction noninvasively. The normal response of the
      heart rate to atropine does not exclude sinus nodal dysfunction, but atropine may
      help to differentiate abnormalities intrinsic and extrinsic to the sinus node
      during the electrophysiologic study.

PMID- 1761331
TI  - Posture determines the nature of the interaction between angiotensin converting
      enzyme inhibitors and loop diuretics in patients with chronic cardiac failure.
AB  - The effects of inhibition of the renin angiotensin aldosterone system on the
      natriuretic and diuretic actions of an intravenous dose of frusemide 40 mg in
      patients with chronic cardiac failure maintained on oral diuretics were studied
      in the supine and erect positions. In the patients studied in the supine position
      the total 4 hour diuresis was decreased from 995 (92) ml to 668 (66) ml and the
      total 4 hour natriuresis fell from 105 (14) mmol to 67 (14) mmol following the
      administration of captopril. Creatinine clearance fell from 87 (8) ml/minute to
      52 (15) ml/minute. In the patients studied in the erect position the total 4 hour
      diuresis was 596 (87) ml without captopril and 562 (83) ml with captopril. Total
      4 hour natriuresis was 71 (13) mmol without captopril and 65 (9) mmol with
      captopril. Creatinine clearance was reduced by captopril from 82 (7) ml/minute to
      47 (12) ml/minute. The reduction in the diuretic and natriuretic response to
      frusemide caused by captopril in the supine position is mediated through a fall
      in glomerular filtration rate. However, in the erect position, which is
      associated with even further increases in activity of the renin angiotensin
      aldosterone system, the reduction in diuresis and natriuresis that a fall in
      glomerular filtration rate would cause is offset by abolition of the rise in
      sodium retaining hormones, angiotensin II and aldosterone that mediate the
      antinatriuretic effect of the erect position.

PMID- 1761332
TI  - Indirect assessment of acute effects of ethyl alcohol on coronary circulation in
      patients with chronic stable angina.
AB  - Acute effects of ethyl alcohol on left ventricular performance, haemodynamic and
      electrocardiographic response to treadmill exercise test were studied in 20
      patients with chronic stable angina. Following ingestion of 80 ml of whisky (43%
      ethyl alcohol by volume) the mean heart rate and rate-pressure product decreased
      significantly at the end of each stage of exercise compared to corresponding
      prealcohol values. There were also significant derangements in systolic time
      intervals parameters in the form of decrease in left ventricular ejection time I
      and increase in pre-ejection phase I and pre-ejection phase/left ventricular
      ejection time ratio after alcohol intake indicating a depression in left
      ventricular performance. However, following alcohol intake the mean exercise time
      (6.5 +/- 3.8 minutes) until onset of ischaemic ST segment depression decreased
      significantly (P less than 0.01) compared to the corresponding prealcohol
      exercise time (8.6 +/- 3.5 minutes). Interestingly, the mean rate-pressure
      product (an indicator of myocardial oxygen demand) at the onset of ischaemic ST
      segment depression was significantly less (P less than 0.01) when exercise test
      was done after alcohol intake compared to the corresponding pre-alcohol value.
      The data indicated that despite significant decrease in myocardial oxygen demand
      produced by alcohol intake, ST T changes developed early and at a lower rate
      pressure product, indicating decreased blood flow to the ischaemic zones of the
      myocardium. This may be explained by the coronary steal effect produced by
      alcohol.

PMID- 1761333
TI  - Study of some cardiovascular parameters after chronic exposure to noise.
AB  - Research has focussed lately on noise as a risk factor for cardiovascular
      diseases. Recent findings, which have not been well confirmed, indicate that it
      does appear to affect heart rate, blood pressure and the electrocardiogram. This
      study involved two groups of subjects (with 75 and 225 in each, respectively)
      classified on the basis of different intensity of exposure to noise. Non
      occupational risk factors studied (cholesterol, blood glucose, smoking, body mass
      index, family history of cardiovascular problems) revealed no significant
      differences between the two groups. Audiometric deficits and time exposure to
      noise were also studied. Blood pressure was measured at rest, an
      electrocardiogram was taken, and a cycloergometric stress test was made. The
      prevalence of hypertension and electrocardiographic modifications in basal
      conditions and under the stress test differed to a significant extent in relation
      to the different exposures to noise.

PMID- 1761334
TI  - Clinical, psychological and thallium stress studies in patients with chest pain
      and normal coronary arteries.
AB  - The clinical and psychological profiles of 36 consecutive patients with chest
      pain and normal coronary arteries (study group) were compared to those of 34
      patients with chest pain and significant coronary arterial disease (control
      group). All 70 patients were hospitalized for chest pain at least once prior to
      coronary angiography. The features of a typical episode of chest pain were
      similar in the normal coronary arteries and coronary arterial disease groups, but
      the female patients with normal coronary arteries had a shorter duration of a
      typical episode of chest pain, and the male patients with normal coronary
      arteries had a lower frequency of positive effort tests. Psychological testing
      showed the women with normal coronary arteries to have a tendency to increased
      somatization, anxiety, and a lower ability to identify origin of difficulties.
      The patients in the normal coronary and coronary arterial disease groups had
      psychological profiles typical of patients with chronic somatic disease. A
      psychiatric interview demonstrated an increased frequency of depressive trait
      (score 0-2) in the normal women (0.6 +/- 0.8 vs 0, P less than 0.05), and a
      tendency to increased somatization, anxiety, and sleeping disorders. Increased
      somatization was found in the normal coronary men (1.1 +/- 0.7 vs 0.5 +/- 0.7, P
      less than 0.05). Twenty-five patients of the normal coronary group underwent
      quantitative thallium stress studies, and 13 patients (52%) had evidence of
      stress-induced myocardial perfusion defect. There were no differences in the
      clinical and psychological profiles of the patients with normal and those with
      pathological thallium stress tests.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761335
TI  - New onset ventricular tachycardia during pregnancy.
AB  - A previously healthy young woman who developed the new onset of symptomatic
      sustained ventricular tachycardia during pregnancy is described. Evaluation
      revealed mitral valve prolapse with minimal mitral regurgitation, and normal left
      ventricular size and function. The arrhythmia resolved after delivery, but
      recurred nine months later in a nonsustained form. Electrophysiologic study
      revealed only nonsustained ventricular tachycardia, and she was treated with
      propafenone. It is suggested that the pregnant state may have been important in
      the pathogenesis of her arrhythmia.

PMID- 1761336
TI  - Increased occurrence of exercise-induced silent ischemia after treatment with
      aspirin in patients admitted for suspected acute myocardial infarction.
AB  - Patients admitted for suspected acute myocardial infarction within 6 hours (mean
      3 hours 42 minutes) after onset of symptoms were randomised to double-blind
      treatment with low-dose oral aspirin or placebo. Early exercise ischemic
      responses, exercise capacity and resting left ventricular ejection fraction
      (radionuclide ventriculography) were estimated in 77 survivors 2-4 weeks later.
      Exercise performance and ejection fraction in patients with confirmed acute
      myocardial infarction were equal in the two groups. During exercise, patients
      treated with aspirin had significantly more silent ischemia (ST depression
      without chest pain) compared to placebo (28% versus 6%; P = 0.015). The
      occurrence of positive exercise tests (chest pain or ST-segment depression),
      however, was similar in the two groups. The results indicate that the
      administration of aspirin early after acute myocardial infarction increases the
      occurrence of silent ischemia but has no effect on left ventricular function.

PMID- 1761337
TI  - Ventricular septal defects in a family of Yucatan miniature pigs.
AB  - We have studied the hearts from a colony of Yucatan miniature pigs with
      spontaneously occurring congenital defects. Ventricular septal defect was
      encountered in 57 of 81 neonates from 15 consecutive litters. Of 73 hearts
      preserved for morphological assessment, 52 were found to have defects within the
      ventricular septum remarkably similar to those observed in humans with deficient
      ventricular septum. The defects, including 3 which had closed spontaneously, were
      perimembranous in 34, muscular in 12 and doubly committed and juxtaarterial in 6
      hearts. Atrial septal defects were found in 12 of the 52 hearts with deficient
      ventricular septation; only 1 atrial septal defect was seen among 21 hearts with
      an intact ventricular septum. Anomalies of the aortic arch were associated with
      ventricular septal defect in 2 cases; 1 with a solitary arterial trunk and one
      with hypoplasia of the aorta and patent arterial duct. All these findings are
      replicated in human hearts. This strain of pig provides an ideal large animal
      model for morphologic and genetic investigations concerning the details of
      ventricular septation, including potential mechanisms of late spontaneous
      closure.

PMID- 1761338
TI  - Noninvasive preoperative localization of an intracardiac bullet.
AB  - A 40-year-old patient with intracardiac gunshot injury is reported. The bullet
      was localized preoperatively within the pericardium at the junction of the right
      atrium and the inferior caval vein and was removed successfully at surgery. The
      role of various imaging techniques in the preoperative localization of
      intracardiac missiles is discussed.

PMID- 1761339
TI  - Successful cardiopulmonary resuscitation using high doses of epinephrine.
AB  - Cardiac arrest usually carries a bleak prognosis when occurring in patients who
      have undergone open heart surgery. We report two cases where cardiac arrest was
      not responsive to routine therapies. Doses of epinephrine 5-10 times higher than
      recommended were able to provide a resolution, and the patients were discharged
      in a normal neurological state.

PMID- 1761340
TI  - Hydatid disease of the right ventricle and role of tomographic scanning in its
      diagnosis.
AB  - A case of hydatid cyst affecting the right ventricle is described and role of
      tomographic scanning highlighted as it demonstrated a typical multilocular cyst
      arising from the right ventricle in the patient discussed here.

PMID- 1761341
TI  - Recurrence of an atrial myxoma.
AB  - A 22-year-old man had an operation 14 years ago for removal of a left atrial
      myxoma. He was admitted to our hospital because of acute femoral arterial
      embolism. Echocardiographic examination revealed a mobile pedunculated echodense
      atrial mass attached to the atrial septum. At operation, the left atrium was
      found to be occupied with a gelatinous pale mass attached by a stalk to the
      atrial septum. The tumour was extirpated along with a part of atrial septum,
      which was assumed to be involved in the tumour. The atrial septal defect created
      was closed with patch. Histopathological examination of excised material revealed
      typical features of a myxoma.

PMID- 1761342
TI  - Chronic atrial fibrillation and incessant ventricular tachycardia treated with a
      single transcatheter ablation.
AB  - We present a unique patient with a 12-year history of chronic atrial fibrillation
      resistant to external direct current shocks associated with incessant ventricular
      tachycardia. Both arrhythmias were treated with a single shock delivered through
      a catheter at the atrioventricular junction. The other unusual feature is that
      sinus rhythm has been maintained in a follow-up of 6 months after the
      intervention.

PMID- 1761343
TI  - Unusual electrocardiographic response during pulmonary balloon valvoplasty.
AB  - An 18-year-old girl with severe valvar pulmonary stenosis was subjected to
      balloon valvoplasty. During each inflation of the balloon, we observed transient
      electrocardiographic disappearance of 'R' waves in the monitoring lead. The
      possible explanations for this observation include sudden severe right
      ventricular strain and ischemia.

PMID- 1761344
TI  - Clinical validation of four solid state ambulatory monitoring devices in
      detecting shift of the ST segment.
AB  - Continuous monitoring for detection of changes in the ST segment during daily
      life in patients with stable angina has received increasing attention in recent
      years. Various reports testify to its role in the detection of silent ischaemia,
      and its potential usefulness in stratification of risk. Frequency modulated
      recorders, using magnetic tape for recording with subsequent visual analysis,
      have been previously validated for the detection of such changes. Analysis,
      however, is time consuming, and is subject to technical faults due to the
      presence of moving parts. Several new solid state devices have become available
      in recent years which provide real-time automated analysis, and have
      theoretically ideal recording capabilities with frequency response down to 0.05
      Hz and linear phase integrity which may be as good, or better than, tape based
      recorders. We compared each of four solid state devices with a previously
      validated frequency modulated recording device in patients with angina in order
      to assess whether such devices correlate well in detecting changes in the ST
      segment.

PMID- 1761345
TI  - Double outlet left ventricle with intact ventricular septum: a cross-sectional
      and Doppler echocardiographic diagnosis.
AB  - Double outlet left ventricle with intact ventricular septum, valvar pulmonary
      stenosis, an atrial septal defect within the oval fossa, dysplastic tricuspid
      valve and normally related great arteries are described in a four-year old male
      child presenting with cyanosis since birth. The diagnosis was made by cross
      sectional and Doppler echocardiography and confirmed by cineangiocardiography.

PMID- 1761346
TI  - A new peptide analog (RM06) modulates the growth of hematopoietic cells.
AB  - The bombesin carboxy terminal dipeptide Leu-Met, was bound to hypoxanthine with a
      pentoxy-carbonyl chain. The new purine derivative, N-omega-[5(1,6-dihydro-6-oxo-9
      purinyl)] pentoxy-carbonyl-L-leucil-L- methionine-COOH (RM06), significantly
      augmented human bone-marrow derived granulocyte-monocyte colony forming units
      (CFU-GM) when added to the cell-culture medium. Moreover, in vivo hemopoietic
      reconstitution was more rapid in lethally irradiated bone-marrow reconstituted
      BDF-1 mice, treated with RM06. Both in vitro and in vivo effects were similar to
      those exerted by recombinant granulocyte-monocyte colony stimulating factor (GM
      CSF). It is concluded that the new modified dipeptide modulates the growth of
      both human and murine hematopoietic cells in vitro and in vivo.

PMID- 1761347
TI  - Interference with oxidative processes inhibits proliferation of human peripheral
      blood lymphocytes and murine B-lymphocytes.
AB  - A number of agents capable of interfering with oxidative events were found to
      inhibit, in a dose-dependent manner, DNA synthesis in isolated human peripheral
      blood lymphocytes stimulated with phytohaemagglutinin, or phorbol myristate
      acetate plus ionomycin. These inhibitory substances were: the iron chelators
      desferrioxamine and desferrithiocin; the electron acceptor ferricyanide; the anti
      oxidant nordihydroguaiaretic acid; ebselen, an agent with glutathione peroxidase
      like activity; and diphenylene iodonium, an inhibitor of NADPH-oxidase. The
      actions of desferrioxamine and desferrithiocin were abolished by prior saturation
      with iron. Ferrocyanide was much less active in inhibiting human lymphocyte DNA
      synthesis than its redox partner ferricyanide. Desferrioxamine, ferricyanide and
      nordihydroguaiaretic acid also inhibited lipopolysaccharide-initiated DNA
      synthesis in mouse splenocytes in vitro. The common property of these
      structurally dissimilar agents is their ability to prevent formation of, or
      detoxify, reactive oxygen species. Thus, the data are consistent with an
      obligatory role for reactive oxygen formation in human T-cell and mouse B-cell
      activation at a stage prior to DNA synthesis.

PMID- 1761348
TI  - Chai-ling-tang (Japanese name: sairei-to) as an oral adjuvant.
AB  - Immunomodulating and anti-tumor activities of orally administered Chai-Ling-Tang
      (Japanese name: sairei-to, ST) were investigated. The oral administration of ST
      into mice augmented the antibody response to intraperitoneally administered 2, 4,
      6-trinitrophenyl-haptenated sheep red blood cells (TNP-SRBC). Orally administered
      ST showed also an enhancing effect on the antibody response to TNP-SRBC
      administered by the oral route. In addition, orally administered ST markedly
      activated the peritoneal macrophages to enhanced phagocytic and lysosomal enzyme
      activities. A significant inhibition of tumor growth was observed in a syngeneic
      tumor-mouse system when ST was administered orally. These results suggest that ST
      has an efficiency as an oral adjuvant or an oral biological response modifier
      (BRM).

PMID- 1761349
TI  - Spleen cell dialyzable extracts (SCDE) mediated immunotherapy for patients with
      myasthenia gravis.
AB  - We studied 14 cases of myasthenia gravis (MG) with regard to their anti
      acetylcholine receptor antibody (AChR-Ab) production, peripheral blood CD4+/CD8+
      ratio, and responses of peripheral lymphocytes to PHA and PWM stimulations. We
      found that the clinical severity was not proportional to AChR-Ab level in serum
      in terms of whole myasthenic population, whereas in one individual patient there
      was a close correlation between clinical severity and the AChR-Ab level in serum.
      The CD4+/CD8+ ratio in myasthenic patients was significantly higher than that of
      normal controls. The responses of T- and B-cells to mitogenic stimulations were
      impaired in myasthenic patients. The immune abnormalities found in the majority
      of the patients were restored to about normal after spleen cell dialyzable
      extracts (SCDE) therapy was applied to all patients. The results implicated that
      SCDE, working as an immunomodulator, could serve as a promising agent to
      normalize the abnormal immune functions of MG patients or other autoimmune
      diseases.

PMID- 1761350
TI  - Drug-specific F(ab')2 fragment reduces desipramine cardiotoxicity in rats.
AB  - Current therapy for cardiotoxicity due to tricyclic antidepressant (TCA) overdose
      is often ineffective in seriously poisoned patients. We studied the effect of a
      drug-specific antibody fragment on TCA cardiotoxicity in rats. Animals received
      anti-TCA F(ab')2 2.0 g/kg i.v. over 10 min starting 15 min after administration
      of a toxic dose of desipramine (DMI). This anti-TCA F(ab')2 dose was 36.9% of the
      molar DMI dose in terms of binding sites. Anti-TCA F(ab')2 infusion had no
      adverse effects and rapidly reduced DMI induced QRS prolongation compared with
      control F(ab')2 (23 +/- 14 vs 71 +/- 11% QRS prolongation at the end of infusion,
      P less than 0.001). This beneficial effect lasted for the 45 min duration of the
      study. Markedly enhanced DMI binding in serum after anti-TCA F(ab')2 was
      demonstrated by a 48-fold increase in the total DMI concentration over controls
      and a reduction in the fraction of unbound DMI (44.5 +/- 19.4 vs 0.7 +/- 0.2%).
      Anti-TCA F(ab')2 reduced the DMI concentration in brain but not in other organs.
      We conclude that anti-TCA F(ab')2 substantially reduces DMI cardiotoxicity in
      rats, and does so rapidly enough to be of potential clinical benefit for patients
      with DMI overdose. Because only a small fraction of the DMI dose was bound by
      antibody, these data suggest that antibody fragment doses considerably less than
      equimolar to the DMI dose may be effective in treating DMI cardiotoxicity.

PMID- 1761351
TI  - The inhibitory effect of rosmarinic acid on complement involves the C5
      convertase.
AB  - Rosmarinic acid (RA), a naturally occurring extract from Melissa officinalis,
      inhibits several complement-dependent inflammatory processes and may have
      potential as a therapeutic agent for the control of complement activation in
      disease. Rosmarinic acid has been reported to have effects on both the classical
      pathway C3-convertase and on the cobra venom factor-induced, alternative pathway
      convertase. In order to define the mechanism of inhibition, the effect of RA on
      classical and alternative pathway lysis, C1q binding, the classical pathway
      convertase, the alternative pathway convertase, membrane attack pathway lysis and
      the generation of fragments of C3 and C5 during activation, was tested in vitro.
      The results showed that RA inhibited lysis by the classical pathway more than by
      the alternative pathway. This effect was dose-dependent with maximum inhibition
      of classical pathway lysis observed at 2.6 mmoles of RA. There was little effect
      on C1q binding or on the classical and alternative pathway convertases. However,
      there was highly significant inhibition of lysis of pre-formed EA43b cells by
      dilutions of human or rabbit serum in the presence of RA (1 mM); this was
      accompanied by inhibition of C5a generation. We conclude that the inhibitory
      effect of RA involves the C5 convertase. Such inhibition could be advantageous to
      the host in disorders where the terminal attack sequence plays a role in
      pathogenesis.

PMID- 1761352
TI  - Restorative effect of neurotropin on maturation of bone marrow cells to IL-2
      producing T-cells in aging BALB/c mice.
AB  - In a previous paper, we have demonstrated that Neurotropin, a non-protein extract
      isolated from the inflamed skin of rabbits inoculated with vaccinia virus,
      restores decreasing immune responses through the recovery of interleukin-2 (IL-2)
      production in aging BALB/c mice. To clarify the mechanism by which Neurotropin
      restores IL-2 production, its effect on the recruitment of IL-2-producing T-cells
      from bone marrow cells was examined using syngenic radiation bone marrow
      chimeras. Two fundamental lesions in recruiting IL-2-producing T-cells in aging
      BALB/c mice were demonstrated: (1) a drastic decline of the maturation of bone
      marrow cells to IL-2-producing T-cells as demonstrated by old----young chimeras;
      and (2) an environment unable to support bone marrow cell differentiation to IL-2
      producing T-cells by young----old chimeras. Neurotropin clearly restored the
      maturation of bone marrow cells to IL-2-producing T-cells when administered from
      13 to 16 month-old mice, whereas the non-complementing environment was not
      normalized with Neurotropin administration. These results suggest that
      Neurotropin administration restores IL-2 production through the recovery of the
      maturation of bone marrow cells to IL-2-producing T-cells, resulting in
      restoration of in vivo T-cell immune response in aging BALB/c mice.

PMID- 1761353
TI  - Differential staphylococcal protein A-induced enhancement of natural killer cell
      activity of lymphocytes from HIV-seropositive individuals.
AB  - A decrease in Natural Killer (NK) cell activity is a common feature of the immune
      dysfunction found in patients with HIV-induced acquired immune deficiency
      syndrome (AIDS). We and others have shown earlier that staphylococcal protein A
      (SpA) preparations enhance NK cell activity against tumor targets. The present
      study was aimed at exploring whether the decreased NK activity of lymphocytes
      from HIV seropositive subjects could be modulated or restored in vitro by SpA.
      Two types of HIV-seropositive subjects were studied: hemophiliac and non
      hemophiliac; matched controls were chosen among hospital staff and HIV
      seronegative hemophiliac volunteers. In vitro proliferation and interleukin-2(IL
      2)/interferon gamma (IFN gamma) release in response to mitogens were also
      studied. NK cell responses of peripheral blood lymphocytes (PBL) of HIV
      seropositives were lower than those of seronegatives. However, exposure of PBL
      from HIV-seropositive individuals to SpA boosted their NK cell responses against
      NK-resistant target cells of tumor origin. The decrease in NK activity could not
      be attributed to the low number of NK cells, since no significant difference in
      NK cell number was observed between HIV-seropositive individuals and controls.
      Mitogen-induced blastogenic responses were present in all four groups, as was the
      mitogen-induced IFN gamma release. We conclude that impaired NK activity and its
      boosting against NK-resistant targets after SpA induction is an important
      characteristic of lymphocytes of HIV-seropositive individuals regardless of the
      disease state and that this NK defect may not be irreversible.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1761354
TI  - Activated murine natural killer cells control growth of Mycobacterium
      lepraemurium in mouse macrophages; in vitro and in vivo evidence.
AB  - The role of natural killer cells (NK) in murine leprosy was investigated in vivo
      and in vitro. In a first set of experiments, it was found that IL-2 (interleukin
      2) activated NK cells reduced Mycobacterium lepraemurium (MLM) growth in mouse
      C57BL/J peritoneal macrophages which had phagocytosed low numbers (MOI of 10 : 1)
      of MLM (P less than 0.0001 at day 20). There was no cytotoxicity exerted by the
      NK cells against the infected cells in these conditions. Conversely, macrophages
      heavily infected with MLM (multiplicity of infection of 1000 : 1) were found to
      be susceptible to lysis by activated NK cells in vitro. In vivo, progressing
      murine leprosy was associated with a sharp increase in splenic NK cell activity,
      which was abrogated by treatment with a monoclonal antibody against NK cells.
      Administration of this monoclonal antibody against NK cells enhanced C57BL6/J
      mouse susceptibility to mouse leprosy, as seen by a decrease in survival time of
      mice infected with 10(7) MLM i.v. (81 days vs 110 days, P less than 0.0005).
      Overall, these findings suggest that NK cells may play an important role in
      resistance to leprosy, either by reducing MLM growth in macrophages or by lysing
      heavily infected macrophages.

PMID- 1761355
TI  - Cytokine modulation of Mycobacterium lepraemurium infection in mice; important
      involvement of tumor necrosis factor, interleukin-2 and dissociation from
      macrophage activation.
AB  - Susceptible BALB/c and resistant A/J mice were infected by the intravenous route
      with 10(7) Mycobacterium lepraemurium (MLM), and mortality was followed in
      controls and in experimental animals infused i.p. with interleukin-2 (IL-2),
      tumour necrosis factor alpha (TNF alpha) and interferon-gamma (IFN gamma). BALB/c
      mice injected with buffer and 10(7) M. lepraemurium i.v. died significantly
      earlier than A/J mice (111 days vs 158 days, respectively P less than 0.001),
      confirming earlier reports. Infusion of IFN gamma (1 or 2 micrograms every day)
      led to no significant increase in survival of both strains of mice infected with
      M. lepraemurium. Injection of IL-2 (1 microgram/day) led to a moderate increase
      in survival time in both strains of mice (P less than 0.01) although not changing
      the differences between resistant and susceptible strains of mice. Injection of
      tumour necrosis factor (1 microgram/day) significantly enhanced survival time in
      both strains (P less than 0.001), although all infected mice eventually died. The
      beneficial effect of IL-2 and TNF alpha on progression of the disease was seen as
      a modest reduction in bacterial growth in the lymph nodes and livers of BALB/c
      mice injected subcutaneously (approximately a one-log reduction in bacterial
      numbers). There was no evidence that the beneficial effect seen in vivo in mice
      was related to superior macrophage activation, inasmuch as peritoneal macrophages
      from untreated infected mice released similar amounts of superoxide anion, upon
      PMA triggering, as macrophages from infected and cytokine-treated mice. Moreover,
      macrophages from infected mice responded better to IFN gamma than cells from
      uninfected mice, in terms of developing tumour cytotoxicity in vitro.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1761356
TI  - Recombinant interleukin-1 infusion increases resistance of BALB/c mice to murine
      leprosy.
AB  - BALB/c mice were infected by the subcutaneous route with 10(7) Mycobacterium
      lepraemurium (MLM), and the progression of the infection followed in mice
      injected i.p. with diluent or recombinant human recombinant interleukin-1 alpha
      (IL-1 alpha). It was observed that infusion of 1 microgram of IL-1 alpha per day
      led to a reduction of bacterial growth in the livers and popliteal lymph nodes of
      MLM injected mice (2-3-log reduction at 6 months, P less than 0.0001). There was
      no indication that IL-1 alpha infusion was acting by enhancing macrophage
      activation. Indeed, resident peritoneal macrophages from control infected mice
      were as competent as macrophages from infected mice treated with IL-1 alpha in
      generating superoxide anion (O2-) (approximately 400 nM O2-/h/mg at 2 months post
      infection). Moreover, they were no more permissive than those of IL-1 alpha
      infused mice for MLM in vitro as both groups of cells allowed progressive MLM
      growth, i.e. a 20-fold enhancement of intramacrophage MLM growth. Infusion of IL
      1 alpha during MLM infection was not associated with any abrogation of the
      suppression of the T-cell response to T-cell mitogens or specific stimulation
      with antigens which is complete at 1 month post-infection. It is concluded that
      IL-1 alpha has immunotherapeutic potential in leprosy with the mechanism(s) of
      action still unclear.

PMID- 1761357
TI  - The effect of IFN-alpha-Con1 on hepatic cytochrome P-450 and protein synthesis
      and degradation in hepatic microsomes.
AB  - Interferon and its inducers are well known to depress drug biotransformation in
      the liver by decreasing the levels of cytochrome P-450 in that organ. We now
      report that IFN-alpha-Con1, which was constructed from the most frequently
      observed amino acid sequences in human alpha-interferon subtypes, causes a loss
      in cytochrome P-450 which could be prevented by pretreating animals with either
      puromycin or actinomycin D. This suggests that the loss in drug biotransformation
      is mediated via the production of an intermediate protein. When the turnover of
      microsomal protein was examined this interferon appeared to depress the synthesis
      of proteins with molecular weights 46-60 kd and had little effect on the
      synthesis of other proteins. The in vitro translation of proteins of molecular
      weights 45-60 kd was also depressed in an in vitro translation system using mRNA
      isolated from the livers of interferon treated hamsters. Interferon had no effect
      on the degradation of microsomal proteins of all molecular weights. It is
      concluded that interferon probably depresses the levels of cytochrome P-450 in
      the liver by decreasing the synthesis of the apoprotein and that interferon has
      little effect on the degradation of the hemoprotein.

PMID- 1761358
TI  - Suppression of demyelination by mitoxantrone.
AB  - The mode of action of the immunosuppressant mitoxantrone was examined in murine
      models of demyelinating disease. The drug has been shown to block antigen induced
      proliferative activity and to inhibit myelin degradation by leucocytes from
      paralysed mice. Mitoxantrone blocked myelin breakdown by macrophages although
      phagocytosis was not affected. Further evidence was obtained to indicate that
      mitoxantrone acts therapeutically in reducing, or at high dose, preventing signs
      of EAE developing in mice immunized with spinal cord homogenate and Freund's
      complete adjuvant. Mitoxantrone also significantly inhibited the incidence of
      relapse when treatment was initiated during the post-acute remission period.

PMID- 1761359
TI  - Application of purified polysaccharides from cell cultures of the plant Echinacea
      purpurea to test subjects mediates activation of the phagocyte system.
AB  - Polysaccharides purified from large-scale cell cultures of the plant Echinacea
      purpurea were tested for their ability to activate human phagocytes in vitro and
      in vivo. These substances enhanced the spontaneous motility of PMN under soft
      agar and increased the ability of these cells to kill staphylococci. Monocytes
      were activated to secrete TNF-alpha, IL-6 and IL-1 whereas class II expression
      was unaffected. Intravenous application of the polysaccharides to test subjects
      immediately induced a fall in the number of PMN in the peripheral blood,
      indicating activation of adherence to endothelial cells. This fall was followed
      by a leukocytosis due to an increase in the number of PMN and a lesser increase
      of monocytes. The appearance of stab cells and some juvenile forms and even
      myelocytes indicated the migration of cells from the bone marrow into the
      peripheral blood. The acute phase C-reactive protein (CRP) was induced, probably
      due to activation of monocytes and macrophages to produce IL-6. In addition a
      moderate acceleration of the erythrocyte sedimentation rate was observed.
      Altogether, as in mice, the polysaccharides could induce acute phase reactions
      and activation of phagocytes in humans. The possibility of clinical use is
      discussed.

PMID- 1761360
TI  - Growth of murine natural killer cells from bone marrow in vitro: role of TNF
      alpha and IFN gamma.
AB  - It has been previously shown that natural killer (NK) cell growth can be induced
      by interleukin-2 (IL-2) in bone marrow (BM) cultures and that other cytokines
      (CKs), including IL-1 alpha, act synergistically with IL-2. However, as the
      effect of IL-2 and IL-1 alpha could be due to direct stimulation of NK progenitor
      cell growth, as well as to the induction of other factors, we analysed the role
      of the endogenous production of CKs in BM cultures. Results show that mRNAs
      specific for tumour necrosis factor-alpha (TNF alpha) and interferon-gamma (IFN
      gamma) are detectable within hours in BM cultures supplemented with IL-2 and IL-1
      alpha, and that the amount is higher when both IL-2 and IL-1 alpha are present.
      Antibodies directed against TNF alpha and IFN gamma abrogate the NK cell
      development, indicating that these CKs play an essential role. The antibodies,
      however, had no effect on mature NK cells. Furthermore, pretreatment of BM cells
      with TNF alpha or IFN gamma before culturing with IL-2, enhances IL-2
      responsiveness and NK cell growth. These results suggest that induction of
      cytokines production may be important for growth of NK cells from BM precursors
      and that the synergistic effect of IL-1 alpha could be due, at least in part, to
      increased TNF alpha and IFN gamma production.

PMID- 1761361
TI  - Modulation of circulating colony-stimulating activity in mice: combined effects
      of IL-1 and bacterial or indomethacin treatment.
AB  - We have investigated the effects of interleukin 1 (IL-1) administration on
      circulating levels of colony-stimulating activity (CSA) in intact or neutropenic
      mice. Intact or cyclophosphamide-treated mice received human rIL-1 beta according
      to different regimens, and their sera were assayed for CSA at 4, 24 or 48 h. The
      results indicated that (1) cyclophosphamide alone significantly increased the
      level of circulating CSA, (2) administration of IL-1 to intact or neutropenic
      mice resulted in a biphasic pattern of CSA response, an early burst at 4 h being
      followed at 24-48 h by a significant decrease. In nongranulocytopenic mice, the
      combined treatment with IL-1 and bacterial cells also resulted in a biphasic
      pattern of CSA response. However, when IL-1 was administered in concurrence with
      the cyclo-oxygenase inhibitor indomethacin, sustained CSA levels could be
      observed for a prolonged period of time. These data expand upon our previous
      observations on modulation of CSA by IL-1 in granulocytopenic mice, and further
      support the concept that IL-1 may have both positive and negative effects on the
      expression of circulating CSA.

PMID- 1761362
TI  - Effect of sizofiran, a polysaccharide, on interferon gamma, antibody production
      and lymphocyte proliferation specific for hepatitis B virus antigen in patients
      with chronic hepatitis B.
AB  - To examine whether sizofiran (SPG), a polysaccharide isolated from Schizophyllum
      commune Fries, could modulate the immune response of immunocompetent cells to
      hepatitis B virus (HBV) nucleocapsid antigens, we investigated in vitro the
      production of interferon-gamma (IFN-gamma) and antibody (antibody to HB core and
      e antigens; anti-HBc and anti-HBe), and proliferation by peripheral blood
      mononuclear cells (PBMC) from six patients with chronic hepatitis B and four
      control individuals in the presence of recombinant HBcAg and purified HBeAg.
      Sizofiran alone in culture and in combination with HBV Ag was found to enhance
      IFN-gamma production and the proliferative response of PBMC from the patients
      compared with corresponding medium or HBV Ag alone culture. In contrast, antibody
      production was not elicited by SPG alone, but amplified by the drug in HBcAg
      stimulated culture. In vitro leukocyte IFN-alpha addition increased IFN-gamma
      production, but suppressed the proliferation of PBMC from both controls and
      patients in the presence or absence of SPG and HBV Ag. These results indicate
      that SPG is able to modulate both cellular and humoral immune responses specific
      for nucleocapsid antigens in patients with chronic hepatitis B.

PMID- 1761363
TI  - Host resistance to murine malaria in mice exposed to the adenosine deaminase
      inhibitor, 2'-deoxycoformycin.
AB  - Resistance to infection with the nonlethal rodent malaria parasite Plasmodium
      yoelii 17XNL (Py 17XNL) is mediated by humoral, T-cell and accessory cell
      activity. The purpose this study was to profile host resistance to infection with
      this organism in mice exposed to 2'-deoxycoformycin (2dCF), a potent adenosine
      deaminase (ADA) inhibitor. Inhibition of ADA activity by 2dFC results in
      defective T-cell function and either suppression or augmentation of the humoral
      response, depending on whether 2dCF exposure precedes (suppression) or follows
      (augmentation) immunization. In this study, mice injected with 2dCF during the
      first five days of infection cleared the infection at the same time as controls,
      but had lower peak parasitemia than controls. Mice infected with the lethal
      variant of P. yoelii were more susceptible to infection when injected with 2dCF
      after infection, suggesting that 2dCF injection did not directly affect the
      parasite. Rather, suppression of parasitemia in 2dCF-treated mice may have been
      mediated by augmented humoral immunity, since 2dCF injection increases antibody
      responses when 2dCF injection follows antigen (in this case, parasite) injection.
      Conversely, in mice given 2dCF prior to infection, parasitemia peaked 2 days
      later and was eliminated more gradually than in control mice. Exposure to 2dCF
      did not deplete reticulocytes and thus temporarily limit parasitemia. Similarly,
      enrichment of NK cells or augmentation of macrophage phagocytic activity prior to
      infection were not sufficient to alter the pattern of infection. In contrast, the
      pattern of infection in mice treated with tilorone (a macrophage activator which
      also causes suppressed T-cell function) prior to infection was similar to that
      observed in 2dCF-exposed animals. These results indicate that 2dCF, given before
      or after infection, alters the host response to infection with Py17XNL. It
      appears that a combination of increased macrophage activity and altered T-cell
      activity contributed to the delay in peak parasitemia and clearance of infection
      in mice exposed to 2dCF before infection with Py17XNL.

PMID- 1761364
TI  - Clinical benefits and recovery of delayed-type hypersensitivity in patients with
      AIDS-related complex treated with IMREG-1 or placebo.
AB  - IMREG-1, an immunomodulatory biological therapeutic, was studied in a placebo
      controlled, double-blind, six-month trial in 45 anergic patients with AIDS
      related complex (ARC) and 4 with Kaposi's sarcoma, which was followed by
      compassionate IMREG-1 administration to all subjects. The IMREG-1 group had
      significantly less AIDS-defining events compared with the placebo group during
      the randomized trial (6.9 events per 100 person-years vs 43.7 events per 100
      person-years, P = 0.018, relative risk 6.33) and the total observation period.
      Patients receiving IMREG-1 significantly improved their work performance. Nine
      (41%) of 22 patients in the IMREG-1 group, compared with one (14%) of seven in
      the placebo group, recovered cutaneous reactivity to tetanus toxoid. At the end
      of the six-month trial, CD4+ counts were 0.429 x 10(9)/l in the IMREG-1 group and
      0.304 x 10(9)/l in the placebo group (P = 0.04). IMREG-1 is a promising
      therapeutic for HIV-infected patients with symptoms of ARC.

PMID- 1761365
TI  - Primary structure of alpaca growth hormone.
AB  - Reduced and carbamidomethylated alpaca growth hormone was submitted to tryptic
      digestion. Peptides in the mixture were purified by reverse phase HPLC and N
      terminal determination and an amino acid analysis of each was performed. Data
      obtained and the already known primary structure of the equine growth hormone
      allowed the assembly-by homology-of a definite sequence of amino acids for the
      polypeptide chain of the protein. Present data provide further information about
      the relationship between growth factors.

PMID- 1761366
TI  - Vibrational circular dichroism spectra of unblocked proline oligomers.
AB  - Vibrational Circular Dichroism (VCD) spectra of unblocked L-proline
      oligopeptides, (Pro)n n = 3 to 7, dissolved in D2O are reported. For these
      oligomers, the VCD spectra can be attributed to a conformational dominance of the
      trans amide conformation with subunits interrelated by a left-handed twist,
      particularly for the longer oligomers. As a function of oligomer length,
      formation of this conformation starts at n = 3; and by n = 5 a spectrum closely
      resembling that of the poly-L-proline II helix in shape and magnitude is seen.
      The VCD data are compared with previous (Pro)n results using IR, CD, Raman and
      NMR spectroscopies, and reasons for the variations in interpretation are
      discussed.

PMID- 1761367
TI  - Mapping the receptor-recognition site of human transforming growth factor-alpha.
AB  - The receptor-recognition site human transforming growth factor-alpha (TGF alpha),
      a 50-residue tricyclic peptide with three disulfide bonds, was mapped by a set of
      46 peptide analogs consisting of linear, monocyclic, bicyclic, and tricyclic
      structures representing individual and overlapping subdomains of human TGF alpha.
      Linear overlapping fragments ranging from 7 to 18 residues and spanning the
      entire length of TGF alpha as well as monocyclic analogs with one disulfide
      linkage were found to be inactive in both receptor-binding and mitogenic assays.
      Bicyclic analogs with two disulfide linkage and representing either the amino or
      carboxyl two-thirds of TGF alpha showed low activity at 0.1-0.9 mM
      concentrations. Tricyclic analogs containing all three disulfide linkages but
      lacking either the amino or carboxyl terminal heptapeptide was, respectively, 3%
      and 0.1% as active as TGF alpha. These results show that determinants for the
      receptor binding cannot be represented by a short continuous fragment or a single
      subdomain, but are located on a discontinuous surface on a folded structure with
      disulfide restraints. Furthermore, these results when combined with our previous
      results which shows that the middle subdomain (second disulfide loop) is not
      involved in the receptor binding suggest that the receptor-binding residues are
      constituted of three fragments located at the first and third subdomains as well
      as the external carboxyl peptide.

PMID- 1761368
TI  - Molecular properties of poly(RGD) and its binding capacities to metastatic
      melanoma cells.
AB  - We examined the binding capacity of anti-metastatic polypeptide containing
      repetitive Arg-Gly-Asp(RGD) sequence derived from cell binding site of
      fibronectin, poly(RGD), to the surface of tumor cells. Poly(RGD) competitively
      inhibited the binding of radiolabeled fibronectin to the cell surface more
      potently than oligo(RGD) or RGD tripeptide on a molar basis. Compared on a weight
      basis to oligo(RGD) or RGD peptide, poly(RGD) was more active than the oligo- and
      monomeric peptide at inhibiting tumor cell adhesion to immobilized fibronectin.
      The secondary structure of poly(RGD) was predicted to be a beta-turn from the
      data of CD spectra and its amino acid sequence. These findings suggest that
      poly(RGD)-mediated inhibition of cell adhesion is due to its potent binding
      capacity to fibronectin receptors on cell surface probably through its
      conformational properties.

PMID- 1761369
TI  - Stabilities of leucine zipper dimers estimated by an empirical free energy
      method.
AB  - The leucine zipper motif is a characteristic amino acid sequence found in dimeric
      DNA-binding proteins. Computer-generated models for leucine zippers were
      constructed as alpha-helical coiled dimers with leucine repeated every seventh
      residue. An empirical Gibbs free energy, delta G, function which incorporates
      hydrophobic force, electrostatic interactions, and conformational entropy loss as
      the major intermolecular interactions was used to estimate the delta G of dimer
      formation in fos, jun, and GCN4 zipper sequences. The calculations showed that
      complexes known to form stable homo- or heterodimers have favorable (negative)
      delta G, while other less stable complexes have unfavorable (positive) delta G.
      Leucines in position d of the coiled coil contribute large hydrophobic
      stabilization energies while residues in the a position contribute less to dimer
      stability. Hydrophobic contributions show little sequence specificity, however,
      and do not contribute significantly to homo/heterodimer preference. Charged
      residues in the e and g positions, on the other hand, determine homo/heterodimer
      specificity. In GCN4 homodimers, residues GLU el, Glu b2, Lys g2, and Lys e4
      greatly contribute to dimer stability. The preferential stability of fos-jun
      heterodimer over the jun-jun and fos-fos homodimers is primarily due to the side
      chains Asp b1, Glu g1, Asp b2, Glu e2, Glu g2, Glu g3, and Lys a5 of the fos
      helix, and Arg c1, Lys g1, Lys b2, Lys e2, Arg e4, and Glu g4 of the jun helix.

PMID- 1761370
TI  - Stereocontrolled synthesis of psi[CH = CH] dipeptide isosteres.
AB  - A new stereocontrolled synthesis of the psi[CH = CH] dipeptide isostere is
      described. They key step of the sequence relies on the stereospecific alpha
      alkylation of delta-amino-gamma-mesyloxy-alpha,beta-unsaturated esters. The broad
      availability of nucleophilic alpha-side chains by this method allows the
      preparation of a wide variety of psi[CH = CH] isosteres with predictable
      stereochemistry.

PMID- 1761371
TI  - Peptides from chiral C alpha,alpha-disubstituted glycines. Synthesis and
      characterization, conformational energy computations and solution conformational
      analysis of C alpha-methyl, C alpha-isopropylglycine [(alpha Me)Val] derivatives
      and model peptides.
AB  - Conformational energy computations on Ac-L-(alpha Me)Val-NHMe indicate that turns
      and right-handed helical structures are particularly stable conformations for
      this chiral C alpha-methyl, C alpha-alkylglycyl residue. We have synthesized and
      characterized a variety of L-(alpha Me)Val derivatives and peptides (to the
      pentamer level). The results of the solution conformational analysis, performed
      using infrared absorption, 1H nuclear magnetic resonance, and circular dichroism,
      are in general agreement with those obtained from the theoretical investigation,
      in the sense that the L-(alpha Me)Val residue turns out to be a strong beta-turn
      and right-handed helix former. A comparison is also made with the conclusions
      extracted from published work on peptides rich in other C alpha-methyl, C alpha
      alkylglycyl residues.

PMID- 1761372
TI  - Circular dichroic and 1H-NMR studies on the aged form of bovine plasma albumin.
AB  - Bovine plasma albumin (BPA) has 17 disulfide bonds and approximately one SH group
      at Cys-34 which catalyzes the intramolecular SH, S-S exchange reaction in the
      alkaline region at low ionic strength, resulting in the formation of the aged
      form (A-form). 1) Fractions of alpha-helix (f alpha) and beta-form (f beta) of
      iodoacetamide-blocked non-aged BPA (IA-BPA) at pH 6.5 (the N-form) and 9.0 (the B
      form) in the absence of added salt were 0.70, 0.12 and 0.62, 0.18, respectively
      (Era et al. (1990]. However, there were no changes in f alpha and f beta of the
      iodoacetamide-blocked A-form (IA-A-form) over the pH range from 5.5 to 9.1 in the
      absence of added salt or in 0.10 M KCl (f alpha approximately 0.60, f beta
      approximately 0.20), indicating that the secondary structure of the IA-A-form
      might be similar to that of non-aged IA-BPA at pH 9.0 (B-form) in the absence of
      added salt, that is, the frozen B-form, stabilized covalently by the repairing of
      disulfide bonds. 2) The rigidity of the A- and IA-A-forms, as monitored by cross
      relaxation times between irradiated and observed protein protons, was similar to
      or slightly higher than that of non-aged IA-BPA or BMA.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1761374
TI  - 4-Alkyl-5(4H)-oxazolones from mixed anhydrides of N-formylamino acids.

PMID- 1761373
TI  - Enzymatic peptide synthesis in organic solvent mediated by gels of copolymerized
      acrylic derivatives of alpha-chymotrypsin and polyoxyethylene.
AB  - Copolymers of acrylated derivatives of alpha-chymotrypsin and polyethylene glycol
      (PEG) have been prepared and used as biocatalysts for the synthesis of model
      peptides in organic solvent containing a low quantity of water. Other peptide
      couplings have been tried to point out the chemico- and stereoselectivity and
      examples of segment couplings are given.

PMID- 1761375
TI  - Outcomes of nursing care: the case of primary nursing.
AB  - Using primary nursing as a 'case study', this paper reviews research literature
      which attempts to measure the effectiveness of a mode of nursing using outcome
      measures. Previous research, it is argued, is hampered by a lack of
      conceptualization of structure and process and inadequate research design, with
      consequent uncertain findings. A shift in emphasis is suggested from an
      evaluation of global concepts, such as primary nursing, to an identification of
      the features of structures and processes of nursing care which interrelate with
      patient and nurse outcomes. For this purpose, multivariate research design and
      investment in methodological research are recommended.

PMID- 1761376
TI  - From san gu liu po to 'caring scholar': the Chinese nurse in perspective.
AB  - This study presents a re-evaluation of the origins of Chinese nursing from the
      earliest traditional carers to the mature, professionalized institution of the
      republican period. The influence of traditional cultural values on the nature of
      the modern profession is discussed and its emergence considered in historical
      context with particular attention to the role of missionaries, philanthropic
      institutions and other aspects of foreign intervention, both European and
      Japanese. The Chinese anti-imperialist response, as stimulated by the 'May 4th
      Movement' and later the Sino-Japanese war, is shown to be an important ingredient
      in the transition from foreign to national control of the profession and in its
      achieving respect. Some doubt is cast on the assumption that Chinese nursing has
      followed a process of rapid convergence to the Western model.

PMID- 1761377
TI  - The introduction of a new system of care delivery into a surgical ward in Sweden.
AB  - Action research is used to implement a change in the system of care delivery on a
      surgical ward in Sweden. Couched within a Lewinian framework the stages of
      change, the problems faced by staff and their solutions are described. The
      effects of the change to a system of care more closely resembling the Loeb model
      of primary nursing, in which accountability is for the duration of the shift,
      were closely monitored. Observation of registered nurses showed a three-fold
      increase in the time spent giving direct patient care. A significant increase in
      scores on a measure of "Intrinsic Job Satisfaction" was also found (P less than
      0.01) together with increased scores on a measure of "Patient Focus" (P less than
      0.001). These findings were sustained over time. The problems of evaluating a
      system of care which is based on a different philosophy are addressed.

PMID- 1761378
TI  - Patient satisfaction with nursing care in Alexandria, Egypt.
AB  - The study assessed the satisfaction of medical and surgical patients in a
      university hospital in Egypt using the La Monica/Oberst Patient Satisfaction
      Scale. In spite of the nursing shortage in that hospital, the results indicated
      that patient satisfaction was high. The implications for nursing care are
      discussed in terms of the validity of the scale and the objectivity of clients
      when responding to the questionnaire.

PMID- 1761379
TI  - The oral complications of specific anticancer therapy.
AB  - Oral complications commonly affect cancer patients undergoing active treatment.
      These include oral infection, gingival bleeding, stomatitis/mucositis,
      xerostomia, dental caries and periodontal disease. The oral cavity also acts as
      an entry site for systemic infection, particularly in those who are
      myelosuppressed. This paper reviews the structure and function of the oral cavity
      and how this may be affected by anticancer therapy. Oral care procedures are
      discussed and controversial areas highlighted showing that, although it is
      generally agreed that oral care is essential in preventing/minimizing
      complications and maintaining general comfort, there is no general agreement
      about the frequency with which care is required or about the tools and agents to
      be employed. Areas for future research are highlighted.

PMID- 1761380
TI  - Nurses' smoking worldwide. A review of 73 surveys on nurses' tobacco consumption
      in 21 countries in the period 1959-1988.
AB  - Nurses are the largest professional group in health care. Nurses' smoking is not
      only important to their personal health, but also to the public's health.
      Analysis of smoking prevalences found among nurses in 21 countries in the period
      1959-1988 shows that considerable numbers of both female and male nurses are
      smokers. More often than not there are found as many smokers among nurses as
      among the general population, sometimes even more. Only in Canada and Finland
      female nurses smoked clearly less than the population at large. Nurses' smoking
      prevalences decreased slowly in industrialized countries. An exemplary role is
      recognized by many nurses; more so by non-smoking nurses than by their smoking
      colleagues. Factors influencing nurses' smoking are professional socialization,
      duality of roles, workstress, discrepant expectancies about nurses' role and lack
      of social support. Theoretical explanations for nurses smoking by means of the
      theories of strain, of selection, of social control and of professional
      subculture are discussed. Future research should be internationally coordinated
      and aimed at comparability within a cultural and organizational context.

PMID- 1761381
TI  - Social support, participation and collaboration of relatives in domiciliary care.
AB  - This article is based on material from two domiciliary care studies which were
      carried out in two large towns in southern Finland. The patients in domiciliary
      care received a considerable amount of both practical and mental or social
      support from their relatives. Support received from relatives correlated with
      patients' well-being. Patients who had more difficulties with physical daily
      activities received more help from relatives than patients who had less
      difficulties. Therefore, the help from relatives was necessary for continuing
      home care, especially for those whose physical condition was poor. The
      participation of relatives in the patient's care, particularly when they were
      able to collaborate with domiciliary care providers, improved the quality of
      patient care and enhanced the security and satisfaction of the patient.

PMID- 1761382
TI  - On applying psychoanalytic explanation in phenomenological research.
AB  - In this paper I propose to examine the theoretical underpinnings of
      phenomenological research which is plagued with the same methodological problems
      that confronted psychoanalysis at the turn of the century. Some general
      criticisms levelled at both phenomenological and psychoanalytic research, by
      philosophers of science, point to: the absence of falsifiable hypotheses; the
      absence of measurable and observable data; and the absence of an explanatory
      general theory upon which the study of consciousness may be grounded. The primary
      task of the present analysis is to articulate the structural similarities that
      obtain between psychoanalysis and phenomenology in the expectation that the rules
      of evidence governing psychoanalytic research may also apply in the government of
      phenomenological research. Finally, I shall offer some procedural suggestions
      phenomenologists might care to consider.

PMID- 1761383
TI  - Calcium transport across epithelia.

PMID- 1761384
TI  - The Golgi apparatus and membrane trafficking in green algae.

PMID- 1761385
TI  - Cellular and molecular biology of Pneumocystis carinii.

PMID- 1761386
TI  - [Chronic pancreatitis].

PMID- 1761387
TI  - [Pathophysiology and practical diagnostic importance of the IgE system for
      allergies].

PMID- 1761388
TI  - [Epidemiology of allergic diseases].

PMID- 1761389
TI  - [Food allergy].

PMID- 1761390
TI  - [Occupationally-induced respiratory allergies of the immediate type].

PMID- 1761391
TI  - [Allergologic diagnosis of drug hypersensitivity reactions].

PMID- 1761392
TI  - [The environment and allergen expression].

PMID- 1761393
TI  - [Hyposensitization].

PMID- 1761394
TI  - [46-year-old patient with congenital actinic dermatosis and progressive liver
      failure after travel to Southeast Asia].

PMID- 1761395
TI  - [Comment on the contribution by K. Rieke, M. Spranger and W. Hacke: Ischemic
      stroke (focal cerebral ischemia)].

PMID- 1761396
TI  - [Circulatory disorders in the area of the internal carotid artery].

PMID- 1761397
TI  - [Do increased serum bile acids induce pruritus?].

PMID- 1761398
TI  - Human mononuclear cell chemiluminescence and interleukin-1 release induced by
      Staphylococcus aureus protein A.
AB  - Staphylococcus aureus protein A (SpA) is shown to induce a temporary
      chemiluminescence (CL)-response of human peripheral blood mononuclear cells.
      Maximal activity of SpA is observed at 3 micrograms/ml and EC50 is about 1
      microgram/ml. The CL response depends on extracellular calcium, and moreover is
      inhibited by pretreating cells with rabbit-anti-human IgG's. From glass-adhered
      monocytes, SpA alone (3 micrograms/ml) did not consistently affect the generation
      of immunoreactive interleukin-1 (IL-1). However, SpA and endotoxin (1
      micrograms/ml) showed a marked synergistic effect on IL-1 release. The results
      suggest that SpA interacts with membrane-bound Ig molecules endowed with receptor
      functions. The CL response may be envisaged as a result of early transmembrane
      signalling events presumably taking place in monocytes. Apparently, hereby, the
      cells become primed for endotoxin-triggered IL-1 release.

PMID- 1761399
TI  - Epithelial modulation of thromboxane A2 and PAF involvement in IgE- and IgG
      mediated guinea pig anaphylaxis.
AB  - The role of prostanoids and platelet-activating factor (PAF) was studied in the
      in vitro response of guinea pig trachea to immunochallenge according to the
      presence or the absence of the epithelial layer and to the sensitization
      procedure leading to the preferential synthesis of immunoglobulin E (IgE) or
      immunoglobulin G (IgG) antibodies. Indomethacin, a cyclooxygenase inhibitor,
      potentiated the antigen-induced contractions both in IgE and IgG models,
      suggesting the involvement of relaxant prostaglandins (PGs), independently of the
      presence of the airway epithelium. UK-38485, a thromboxane synthetase inhibitor,
      did not modify the tracheal response to antigen in the IgE model. However, this
      compound enhanced the maximum contractile response to antigen of the intact
      tracheal strips of IgG-sensitized guinea pig, but reduced the contractile
      response of the epithelium-free tracheal strips. Two potent non-structurally
      related PAF antagonists, Ro 19-3704 and BN 52021, reduced antigen-induced
      contraction of the epithelium-free tracheal strips in the IgE model. In contrast,
      these compounds did not affect the contractile responses of the preparations in
      the IgG model. These results suggest the selective implication of thromboxane A2
      and PAF, in IgG- and IgE-mediated guinea pig anaphylaxis respectively. Finally,
      these results indicate that thromboxane A2 (TXA2) and PAF are potent inducers of
      epithelium-derived mediators.

PMID- 1761400
TI  - Resistance of C57Bl/6 mice to immunosuppressive effects of aflatoxin B1 and
      relationship with neuroendocrine mechanisms.
AB  - Aflatoxin B1 (AFB1) a secondary metabolite of Aspergillus flavus and A.
      parasiticus, is known for its carcinogenicity and immunosuppressive effects. We
      previously reported on the immunosuppressive effects of AFB1 in Swiss and CD-1
      mice. This study concerned the involvement of the hypothalamus-pituitary-adrenal
      gland axis in the immunosuppressive effects of AFB1 in C57Bl/6 mice. Animals were
      treated orally with 30, 150 or 750 micrograms/kg AFB1 daily for four weeks.
      Splenic lymphocytes were assayed to investigate their phenotyping using flow
      cytometry, proliferative response against mitogens and allogeneic lymphocytes,
      cytolytic cell activity, and IL-2 production. Antibody-mediated immunocompetence
      was checked using sheep red blood cell (SRBC)-challenged animals by plaque
      forming cell assay and enzyme-linked immunosorbent assay. The dose of AFB1 for
      the immunosuppressive effects on blastogenic response, IL-2 production, and
      primary antibody production of splenic cells was much higher than previous
      studies involving other mice strains. AFB1 decreased the amount of circulating
      anti-SRBC antibody, and the helper-T cell and B cell populations in phenotyping
      splenic lymphocytes. There were no significant changes in natural killer cell
      activity, mixed lymphocyte response, hypothalamic biogenic amine concentrations,
      and corticotropin releasing factor, and of adrenocorticotropic hormone and
      corticosterone in plasma. Results were confirmed using adrenalectomized mice. The
      hypothalamic-pituitary-adrenal axis does not appear to have a major role in AFB1
      induced immunotoxicity.

PMID- 1761401
TI  - Immunomodulation by 9-amino-1,2,3,4-tetrahydroacridine (THA): 1. Down-regulation
      of natural cell-mediated cytotoxicity in vitro.
AB  - THA (Tacrine), a drug used in the experimental therapy of dementia of Alzheimer's
      disease type, and whose biochemical site of action is believed to be the neural
      cholinesterase, is shown, for the first time, to be an immunosuppressant in vitro
      on normal human peripheral blood lymphocytes in microgram quantities. THA down
      regulates non-MHC restricted natural killer (NK) cell activity without affecting
      the general viability of cells. This down-regulation can be demonstrated at all
      effector and target (K562) concentrations, in purified resting NK cells as well
      as in lymphokine (interleukin 2) activated killer cells in 3- or 16-h NK assays
      and in all the blood samples tested. Kinetic analysis shows that the Vmax
      (maximal cytotoxic potential) and Km of NK cell-mediated cytolysis are also
      attenuated. Single cell assays using agarose matrix reveal that THA moderately
      interferes with tumor target binding/recognition events and strongly abrogates
      the delivery of lethal hit, thus lowering the frequency of active killer cells
      among THA-treated lymphocytes. THA down-regulates NK cells upon direct
      interaction and does not require the help of non-NK cells. The THA sensitive
      site(s) on NK cells does not appear to be perturbed significantly either by their
      proliferative status or by membrane modulations that may be normally induced by
      interleukin 2. The in vitro immunomodulatory pharmacological properties of THA
      reveal that the biological site of action of THA extends to non-neural cells
      also. Such non-neural models may be helpful in exploring the pathophysiological
      neuroimmunomodulatory properties of THA at cellular and molecular levels.

PMID- 1761402
TI  - Ganglioside (GM1)-treated T cells shed CD4.
AB  - In previous studies (Morrison et al., 1990), we showed that ganglioside (GM1)
      modulation of CD4 was associated with activation of phospholipase C and increased
      production of inositol triphosphate, but not with activation of protein kinase C.
      These results demonstrated a unique signal transduction pathway related to GM1
      modulation of CD4 on T cells and raised the question as to whether intracellular
      Ca2+ levels and related protein kinases would be affected by GM1-induced
      signalling. We now show that GM1 modulation of CD4 from human T cells corresponds
      to decreased cellular Ca2+ without significant changes in cellular protein
      phosphorylation. In the course of this study we discovered that T cells
      challenged with GM1 exhibited new proteins in their surrounding media.
      Fractionation of cellular and supernatant proteins show that cells treated with
      GM1 released proteins with an approximate molecular weight (Mr) of 49,000. This
      was exclusive of GM1 protein association and GM1-induced protein phosphorylation.
      Immunoblots demonstrated the presence of CD4 in GM1-treated cell supernatants.
      Western immunoblots using anti-CD4 antibodies detected a lower Mr form (49,000)
      of CD4 in the supernatants of GM1-treated cells. These studies further define the
      unique nature of GM1 signalling relating to modulation of CD4 and demonstrate
      that the fate of GM1 modulated CD4, in part, involves protein shedding.

PMID- 1761403
TI  - Does verapamil act as an immunomodulatory drug in vivo?
AB  - Based on in vitro data, previous investigators have hypothesized that Ca2+ entry
      blockers might affect lymphocyte activation, proliferation and effector function.
      We have tested this hypothesis by comparing the in vitro and in vivo effects of
      the Ca2+ entry blocker verapamil on human lymphocytes. In vitro high
      concentrations of verapamil (100 microM) inhibited mitogen-stimulated Ca2+
      influx, inositol phosphate generation, and proliferation; similar effects were
      observed with diltiazem and nifedipine. In vivo treatment of healthy volunteers
      with verapamil (2-4 times 240 mg per day for 7 days) did not affect the number of
      circulating lymphocytes or their subset distribution. Moreover, we did not
      observe any effect of in vivo treatment with verapamil on mitogen-stimulated
      lymphocyte proliferation or expression of interleukin-2 receptors in vitro. We
      conclude that the inhibitory effects of verapamil on lymphocyte activation in
      vitro are unlikely to be of therapeutic relevance and may not be related to the
      Ca2+ entry blocking effects of this drug.

PMID- 1761404
TI  - Pathogenesis of limb malformations in mice induced by methoxyacetic acid.
AB  - The present study was performed to reveal the pathogenesis of limb malformations
      induced by methoxyacetic acid (MAA) in developing mouse limbs. Pregnant Jcl:ICR
      mice were orally given at gestational day (gd) 10.5, 11.0, or 11.5 (vaginal plug
      = gd 0) a single dose of MAA 10 mmol/kg of body weight. Various patterns of cell
      death in limb buds were observed by vital dye staining with Nile blue A. Under a
      light microscope and transmission electron microscope, excessive cell death was
      observed in the mesenchyme as well as in the apical ectodermal ridge (AER) 2 hr
      after MAA treatment, reaching a maximum after 6 hr. Scanning electron microscopic
      examinations showed hypoplasia of the AER and small hand plates 24 hr after
      treatment. Small hand plates and delayed digital ray formation were noted at 48
      hr. Neither detachment nor massive necrosis was detected in the periderm covering
      the limb bud. The distribution of cell death 6 hr after treatment was similar in
      limb buds treated either at gd 10.5, 11.0 or 11.5, but the final pattern of limb
      defects was different in fetuses treated at different stages. This study
      indicates that variations in the pattern of limb defects induced by MAA are due
      to differences in the amount and distribution of cell death, together with
      differences in the regenerative capacity of surviving cells.

PMID- 1761405
TI  - Transantral ligation of the maxillary artery for refractory epistaxis. A case
      report.
AB  - A case of severe arterial epistaxis treated by transantral ligation of the
      maxillary artery is reported. A 66-year-old woman had recurrent left sided
      epistaxis from the posterior nasal cavity which was difficult to control by
      conventional nasal packing methods. Selective angiography was performed to
      identify the arterial flow patterns and site of bleeding which was confirmed to
      be the descending palatine artery. Following radiographical examination, ligation
      and clipping of the maxillary artery and its branches was performed with
      transantral approach under general anesthesia. No further epistaxis occurred
      after the ligation. This surgical procedure seems to be relatively simple and
      highly effective in the management of refractory epistaxis.

PMID- 1761406
TI  - Intracavitary drainage procedure for giant bullae in compromised patients.
AB  - Two cases of giant bullae were treated by intracavitary suction and drainage
      procedure under local anesthesia because of the poor pulmonary function. After
      staged bullectomy, the patients returned to normal life. The first case was
      admitted to our intensive care unit (ICU). Tube drainage was performed in the
      giant bulla of the left lung immediately after admission. One month after
      recovery from right heart failure and mediastinal shift to the right side,
      bullectomy was performed using linear stapler. The patient was discharged 20 days
      later. The second case was admitted with severe dyspnea and bilateral giant
      bullae were noticed. We performed tube drainage for larger bulla of the left lung
      under local anesthesia. Two months later, bullectomy was performed on the right
      side, because the bulla on the left side became smaller and the general condition
      of the patient improved. The patient was discharged three months later on foot
      and has since been asymptomatic. Giant bulla is a well-established clinical
      entity which includes abnormal dilatation of various parts of the tracheo
      bronchial tree and other discrete sacs originating from the interstitial portion
      of the lung. Giant bullae are frequently associated with marked dyspnea and
      emphysematous symptoms. However, these symptoms depend upon various factors:
      size, location, valvular mechanism, condition of the contiguous lung parenchyma
      and the changes that may take place in the intrathoracic pressure.

PMID- 1761407
TI  - Pattern of limb malformations in mice induced by methoxyacetic acid.
AB  - The present study investigated the pattern of limb malformations induced in mice
      by methoxyacetic acid (MAA), one of di(2-methoxyethyl) phthalate (DMEP)
      metabolites. Pregnant Jcl:ICR mice were given orally at gestational day (gd)
      10.5, 11.0, or 11.5 (vaginal plug = gd 0) a single dose of MAA 10 mmol/kg of body
      weight. Fetuses were examined at gd 15.5 for external and skeletal malformations.
      Limb defects were maximum in frequency and severity after administration at gd
      11.5. Forelimbs had greater susceptibility than hindlimbs. Treatment at gd 10.5
      produced cutaneous or osseous syndactyly between digits I and II, II and III, and
      ectrodactyly of digit II or digit I. Intercalary defects in the forelimbs were
      also detected. No hindlimb malformations were induced. Treatment at gd 11.0
      induced ectrodactyly of digit II and digit I in the forelimbs, as well as osseous
      syndactyly or intercalary defects of the metacarpals or phalanges, and the
      frequency became increased. Hindlimb malformations were also detected in a small
      number with syndactyly between digits I and II or ectrodactyly in digit I.
      Treatment at gd 11.5 induced ectrodactyly in the forelimbs. Half of the forelimbs
      showed ectrodactyly with four missing digits (digits I, II, III, and V) and the
      remaining limbs showed ectrodactyly with a similar frequency with one, two, or
      three missing digits, either in the pre- or postaxial area. In the hindlimbs
      ectrodactyly with one, two, or three missing digits was the most common
      malformation observed. Syndactyly between digits I and II was also induced in a
      small percentage.

PMID- 1761408
TI  - Credentialing by legislative fiat: implications for the allied health
      professions.

PMID- 1761409
TI  - Legalistic ethics and the lingering doubt about withdrawing life-supports.

PMID- 1761410
TI  - Influencers of career choice among allied health students.
AB  - This study focused on the factors that influence students' choice of an allied
      health profession. A survey of 153 students in three allied health programs at
      the University of Connecticut revealed that "the need to help others,"
      "prestige," "professional autonomy," "opportunities for advancement," "income
      potential," and "the effect of the specialty on family and personal life," were
      the major influencers of career choice among allied health students. Only a few
      students regarded malpractice suits and AIDS as negative influencers. While
      medical laboratory science majors regarded these as important factors, dietetics
      and physical therapy majors did not. The article suggests further use of these
      findings by program directors and career counselors.

PMID- 1761411
TI  - An evaluation of AIDS education: a quasi-experimental exploration.
AB  - This study reports on a quasi-experimental study designed to evaluate the
      relationship between receiving classroom instruction and subsequent AIDS
      knowledge, behavior, and attitudes. Survey information was gathered from 61
      students enrolled in an AIDS course and 68 students enrolled in "control"
      courses. Both groups were pretested at the beginning of the semester and again at
      the end of the semester concerning AIDS knowledge, behavior, and attitudes. The
      results obtained indicated that there was a widespread acceptance of the
      conventional wisdom concerning AIDS in both the experimental and control groups
      prior to the study. Few behavior changes were observed as a result of the AIDS
      curriculum. Three empirically distinct factors, "interaction," "constraint," and
      "testing," emerged from the attitude measures. Respondents were more accepting of
      interacting with persons with AIDS across time. Moreover, respondents in the
      experimental group were more reticent to advocate mandatory AIDS testing vis-a
      vis those in the control group across time.

PMID- 1761412
TI  - An analysis of revised federal budget procedures.

PMID- 1761413
TI  - Advances in health informatics and implications for allied health education.

PMID- 1761414
TI  - Studies on the isotetracenone antibiotics. IV. Hatomarubigins A, B, C and D, new
      isotetracenone antibiotics effective against multidrug-resistant tumor cells.
AB  - A complex of new isotetracenone group antibiotics was isolated from the cultured
      broth of Streptomyces sp. 2238-SVT4. It consisted of four related compounds,
      designated hatomarubigins A, B, C and D, whose structures were elucidated by NMR
      spectral analysis including a variety of 2D techniques. They enhanced the
      cytotoxicity of colchicine against multidrug-resistant tumor cells.

PMID- 1761415
TI  - Structures of aureobasidins B to R.
AB  - Structures of 17 minor forms of aureobasidins (Abs), Abs B-R, were elucidated by
      mass fragmentation and amino acid analysis. The fragmentation patterns by FAB-MS
      spectroscopy of Abs A-E seemed to follow predictable rules, so we used the rules
      to elucidate the 13 other Abs. All Abs consisted of eight amino acids and one
      hydroxy acid.

PMID- 1761416
TI  - NMR studies of aureobasidins A and E.
AB  - The 1H and 13C NMR spectra of aureobasidins A and E were analyzed by a variety of
      2D NMR techniques. Two isomers of aureobasidin A existed as an equilibrium
      mixture in deuteriochloroform. The isomerism was associated with cis-trans
      rotation of the amide bond between N-methylphenylalanine and proline. Almost all
      of the aureobasidin E was found in deuteriochloroform as one conformer; the amide
      bond between beta-hydroxy-N-methylphenylalanine and proline was in the cis
      conformation. Experiments with the NOE made identification of the conformation of
      the amide bonds of aureobasidins A and E possible.

PMID- 1761417
TI  - An NMR study of eremomycin and its derivatives. Full 1H and 13C assignment,
      motional behavior, dimerization and complexation with Ac-D-Ala-D-Ala.
AB  - Complete 1H and 13C NMR assignments are presented for eremomycin (1) and some of
      its desglycosylated derivatives 2, 3 and compared to the structurally closely
      related glycopeptide vancomycin. Primary structure and stereochemistry of
      eremomycin is corroborated by the present high field total correlation
      spectroscopy, NOESY and heteronuclear multiple-bond correlation NMR methods. A
      rough motional characterization of the title compound is attempted by 13C-T1 and
      13C-[1H] NOE measurements. Dimerization of eremomycin is observed both in DMSO-d6
      CCl4 and D2O solutions. Complexation with cell wall analogue dipeptide Ac-D-Ala-D
      Ala is also demonstrated.

PMID- 1761418
TI  - Complete amino acid sequence of phenomycin, an antitumor polypeptide antibiotic.
AB  - The primary structure of phenomycin, an antitumor polypeptide antibiotic isolated
      from the culture broth of Streptomyces fervens var. phenomyceticus, was
      determined. Sequence analysis has revealed that it consists of 89 amino acid
      residues (Mr 9,524) and no disulfide bridge is present. The sequence of
      phenomycin at residues 48-70 was found to be hydrophilic, being surrounded by
      hydrophobic regions at both sides. Furthermore, clustering of half the lysine
      residues in this hydrophilic region and marked basicity of phenomycin imply the
      external disposition of this region. Phenomycin does not show significant
      sequence homology to any known proteins including antitumor polypeptide
      antibiotics.

PMID- 1761419
TI  - Antifungal and antiviral activities of benanomicins and their analogues.
AB  - In vitro activities of benanomicins and their analogues against human
      immunodeficiency virus and fungi including Candida, Cryptococcus and Aspergillus,
      were examined. The free carboxyl group and at least one sugar moiety in the
      benanomicins were essential for their activities. Benanomicin A was most active
      and had low toxicity, and was selected as the best candidate for chemotherapy.

PMID- 1761420
TI  - The nature of in vivo cell-killing of deoxyspergualin, and its implication in
      combination with other antitumor agents.
AB  - The mode of in vivo cell-killing by 15-deoxyspergualin (NKT-01) was assessed by
      measuring change of whole body radioactivity of mice inoculated with 125I
      iododeoxyuridine-labeled P388 leukemia cells. Although NKT-01 showed strong life
      prolonging effect on P388 leukemia-bearing mice, significant excretion of 125I
      was not observed within 4 days after the start of treatment with NKT-01.
      Thereafter, the remaining 125I was reduced gradually and reached about half of
      control level on day 7. Colony forming ability in soft agar media of peritoneal
      tumor cells taken after completion of 5-day treatment with NKT-01 was markedly
      reduced to less than 3%. These results suggested that life prolongation of NKT-01
      was produced both by a cytostatic effect, which lasts for an extraordinarily long
      period, and by a subsequent cytotoxic effect. Cell cycle distribution analysis
      using flow cytometry showed the cytostatic action of NKT-01 caused G0/G1 arrest
      of the tumor cells. Therefore, the drug-sensitive cycling population of the tumor
      cells was reduced, and combination with other antitumor agents was antagonistic,
      if they were administered simultaneously or consecutively with NKT-01. In
      contrast, if the other drugs such as cyclophosphamide, cisplatin and cytosine
      arabinoside, were administered prior to NKT-01, a synergistic combination effect
      was obtained. This synergism might be due to prolongation of the period of cell
      cycle perturbation caused by other drugs (such as G2 arrest by cisplatin) by the
      cytostatic effect of NKT-01. Although the precise mechanisms of the cytostatic
      action of NKT-01 remain unclear, it might play an important role in the
      combination with other antitumor drugs.

PMID- 1761421
TI  - The effect of methylation inhibitors on citreamicin biosynthesis in
      Micromonospora citrea.
AB  - When the citreamicin-producing organism Micromonospora citrea NRRL 189351 was
      incubated in the presence of the methylation inhibitors sinefungin or
      aminopterin, biosynthesis of the zeta component was stimulated approximately 20
      to 200-fold above the level normally produced. Inhibition of a second methylation
      reaction, which is superficially very similar to the first, was not detected.
      Other known methylation inhibitors failed to yield any change in the natural
      pattern of citreamicins produced. This approach is an excellent route for
      preparing citreamicin zeta, which can be used as a substrate for semi-synthesis
      or for further biosynthetic studies.

PMID- 1761422
TI  - "In vitro" synthesis of different naturally-occurring, semisynthetic and
      synthetic penicillins using a new and effective enzymatic coupled system.
AB  - Forty-seven different penicillins, including some of great clinical importance,
      have been synthesized "in vitro" by coupling the newly described enzyme
      phenylacetyl-CoA ligase (PCL) from Pseudomonas putida and acyl-CoA: 6
      aminopenicillanic acid (6-APA) acyltransferase (AT) from Penicillium chrysogenum.
      Incubations were carried out at 30 degrees C in 50 mM HCl-Tris buffer pH 8.0. The
      reaction mixtures contained 6-APA, CoA, ATP, dithiothreitol, Mg2+ and the
      corresponding penicillin side-chain precursor. This is the first description of
      the enzymatic synthesis of all the natural penicillins known, many of the
      semisynthetic until now reported, and some penicillins that could only be
      currently obtained by chemical synthesis. The efficiency of this prokaryotic
      eukaryotic enzymatic-coupled system and its application to the synthesis of
      different beta-lactam antibiotics are discussed.

PMID- 1761424
TI  - Transduction of plasmid DNA containing the ermE gene and expression of
      erythromycin-resistance in streptomycetes.

PMID- 1761423
TI  - Amphidinolide F, a new cytotoxic macrolide from the marine dinoflagellate
      Amphidinium sp.

PMID- 1761425
TI  - Mycinamicins, new macrolide antibiotics. XII. Isolation and structural
      elucidation of mycinamicins X and XI.

PMID- 1761426
TI  - Respinomycin A1, a new anthracycline antibiotic.

PMID- 1761427
TI  - 8-Methoxygriseorhodin C, a new member of griseorhodin antibiotic.

PMID- 1761428
TI  - Isolation and structural elucidation of sekothrixide, a new macrolide effective
      to overcome drug-resistance of cancer cell.

PMID- 1761429
TI  - Isolation and structure determination of a novel phosphatidylinositol turnover
      inhibitor, piericidin B1 N-oxide.

PMID- 1761431
TI  - Stephen P. Lapage.

PMID- 1761430
TI  - Studies on the biosynthesis of fosfomycin. 2. Conversion of 2-hydroxypropyl
      phosphonic acid to fosfomycin by blocked mutants of Streptomyces wedmorensis.

PMID- 1761432
TI  - Bacterial life at low temperature: physiological aspects and biotechnological
      implications.

PMID- 1761433
TI  - Microbiological exploitation of cardiac glycosides and alkaloids from Garcinia
      kola, Borreria ocymoides, Kola nitida and Citrus aurantifolia.
AB  - The four medicinal plants, Garcinia kola (roots), Borreria ocymoides (leaves),
      Kola nitida (bark) and Citrus aurantifolia (roots) were screened for
      phytochemical components. They were found to contain tannins, phlobatannins,
      polyphenols, hydroxymethyl anthraquinones, glucides, saponins, alkaloids, cardiac
      glycosides, flavanoids and reducing compounds. The aqueous and alcoholic extracts
      as well as alkaloids and cardiac glycosides of the medicinal plants were tested
      on various pathogenic bacteria. They were found to inhibit such organisms as
      Staphylococcus aureus, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas
      aeruginosa, beta-haemolytic streptococci, Escherichia coli and Neisseria
      gonorrhoeae. The usefulness of the phytochemical bases of these plants as
      potential sources of pharmaceutical drug preparation is discussed.

PMID- 1761434
TI  - Plasmid profiles and curing of plasmids in Lactobacillus plantarum strains
      isolated from green olive fermentations.
AB  - Plasmid profiles of 35 Lactobacillus plantarum strains isolated from different
      green olive fermentors were obtained. A large number of plasmids in the CCC form
      (from 5 to 16) were present in all the tested strains as confirmed by a second
      dimension electrophoresis of DNA. These plasmids, all of which remain cryptic,
      ranged from 2.0 to 68 kb in size. Novobiocin, sodium dodecyl sulphate and
      ethidium bromide were used as plasmid-curing agents but only novobiocin induced
      loss of extrachromosomal DNA at a high frequency in these strains.

PMID- 1761435
TI  - High frequency transformation of Streptomyces niveus protoplasts by plasmid DNA.
AB  - A procedure has been developed for transforming protoplasts of the novobiocin
      producing strain Streptomyces niveus at high frequency. This required the
      isolation of strains LH13 and LH20 defective in DNA restriction from the wild
      type (ATCC 19793) which is transformed at very low frequencies. The LH13 and LH20
      derivatives were obtained by curing pIJ702 DNA from the few S. niveus transformed
      protoplasts obtained by transformation of the wild type with high concentrations
      of pIJ702 DNA. Protoplasts of S. niveus strains LH13 and LH20 produced about
      10(6) transformants/micrograms DNA with modified pIJ702 DNA derived by
      replication in S. niveus. Unmodified DNA (derived from replication in S:
      lividans) from a series of pIJ101, SCP2 and pSN2-based derivatives, gave
      transformation frequencies in the range of 10(2)-10(3) transformants/micrograms
      DNA. Optimal conditions for the formation and transformation of S. niveus
      protoplasts are described.

PMID- 1761436
TI  - A dot-immunobinding assay for the laboratory diagnosis of tuberculous meningitis
      and its comparison with enzyme-linked immunosorbent assay.
AB  - In an attempt to establish an alternative to standard bacteriological methods in
      the laboratory diagnosis of tuberculous meningitis (TBM), a simple dot
      immunobinding assay (Dot-Iba) was standardized to detect Mycobacterium
      tuberculosis antigen 5 and antimycobacterial antibody in cerebrospinal fluid
      (CSF) specimens of patients with TBM. Sensitivity and specificity of Dot-Iba was
      compared with conventional enzyme-linked immunosorbent assay (ELISA) and standard
      bacteriological techniques. The Dot-Iba showed excellent correlation with
      indirect ELISA for the detection of antimycobacterial antibody in CSF and showed
      60% sensitivity and 100% specificity in culture-negative patients with TBM.
      However Dot-Iba was less sensitive for the detection of antigen 5 in CSFs and
      showed false negative results (60%) in culture-positive patients with TBM.

PMID- 1761437
TI  - Continued successful operation of open-fronted microbiological safety cabinets in
      a force-ventilated laboratory.
AB  - The considerable refinements necessary to enable Class I and II microbiological
      safety cabinets to operate in a force-ventilated laboratory and to meet
      appropriate safety criteria have been reported previously. The continued
      successful operation of such cabinets without a deterioration of operator
      protection is described. The performance of two Class II units, one meeting and
      one failing the current British Standard applied to four head KI-discus testing,
      is compared and discussed. In addition, some further potential difficulties
      within the environment, which could compromise cabinet containment, are
      highlighted.

PMID- 1761438
TI  - Mercuric reductase activity in the adaptation to cationic mercury, phenyl
      mercuric acetate and multiple antibiotics of a gram-negative population isolated
      from an aerobic fixed-bed reactor.
AB  - Eighty-eight strains, isolated from an aerobic fixed-bed reactor and identified
      to the genus level, were examined for resistance to 21 antibiotics, cationic
      mercury and phenylmercuric acetate. All except three were able to grow on Mueller
      Hinton agar plates containing 8 micrograms/ml mercuric chloride, but only 42
      exhibited a mercuric reductase and an organomercurial lyase activity.
      Furthermore, 82 of them were multiply-antibiotic resistant, whereas no positive
      correlation between this property and cationic mercury volatilization capacity
      was found. It was concluded that this bacterial community-adapted response to
      these selective agents, which has been most often shown to be mediated by R
      plasmids, was the result of two independent phenomena. Moreover, the high
      percentage of multiple antibiotic and mercury resistance found in this population
      suggested that simultaneous selections occurred on filters of bacteria which
      exhibited mucoid colonies and tolerance to these two categories of stress agents.

PMID- 1761439
TI  - Analysis of quantal response data from bacterial destruction studies in
      sterilization: the Stumbo estimate is biased.
AB  - Real and simulated experimental data and theoretical data from quantal response
      experiments were used to make a comparison between the analysis of data from a
      quantal response experiment and data from a direct enumeration experiment. The
      method of analysis for each is differentiated, thereby enhancing the utility of
      the quantal response experiment in sterilization studies. From this comparison it
      appears that the Stumbo estimate of the D value is biased. Furthermore, the
      Stumbo estimate depends upon the spore load per replicate in quantal response
      type experiments, which makes experimental comparisons difficult. Another
      estimate of D is demonstrated which overcomes some of these shortcomings.

PMID- 1761440
TI  - Typing of Proteus mirabilis from clinical sources by computerized analysis of
      electrophoretic protein patterns.
AB  - Seventy-five strains of Proteus mirabilis (mainly of human origin) were
      characterized by one-dimensional SDS-PAGE of cellular proteins. The strains came
      from various countries; 24 were from urine, 17 from faeces (including one from a
      dog and one from a monkey), 12 from the respiratory tract (including nine from
      sputum), four from a cerebral abscess, 12 from miscellaneous sources and six from
      unknown sources. The protein patterns, which contained 45 to 50 discrete bands,
      were highly reproducible. The patterns of the 75 P. mirabilis cultures plus those
      of the type strains of six Proteus and Providencia species were used as the basis
      for two numerical analyses. In the first, which included all the protein bands,
      the P. mirabilis cultures formed nine clusters at the 85% S level. In the second
      analysis, in which the principal protein bands (in the 34.0-44.6 kDa range) were
      excluded, 74 of the 75 cultures of P. mirabilis formed a single cluster at the
      77% S level distinct from the six Proteus and Providencia reference strains. The
      P. mirabilis strain which failed to cluster with the others had a background band
      pattern typical of the species in the lower molecular weight region but appeared
      to be less typical in the heavier bands. It is concluded that high resolution
      PAGE combined with computerized analysis of protein patterns provides the basis
      for typing clinical strains of P. mirabilis. Reference strains of each of the
      nine PAGE types identified are available from NCTC for inclusion in future
      studies.

PMID- 1761441
TI  - Detection of glycopeptide resistance in clinical isolates of gram-positive
      bacteria.

PMID- 1761442
TI  - Management of biliary tract infections: potential role of the quinolones.

PMID- 1761443
TI  - Uptake of 3H-norfloxacin in methicillin-resistant Staphylococcus aureus.
AB  - To examine the possibility of a proton-motive efflux pump for quinolones in
      highly quinolone-resistant clinical isolates of methicillin-resistant
      Staphylococcus aureus (MRSA), we studied 3H-norfloxacin uptake in two quinolone
      resistant and two quinolone-sensitive strains of MRSA whose gyrA region
      surrounding amino acid codons 84 and 85 had been sequenced. Two strains were
      related (one sensitive and one resistant) in that both were recovered from a
      single patient, one before (sensitive) and one after (resistant) ciprofloxacin
      therapy. Drug uptake was assessed in four separate experiments running triplicate
      bacterial suspensions with radiolabeled drug added at time = 0. Sampling was
      performed in 10 min increments up to 50 min by a vacuum filtration method. The
      ionic uncoupler, carbonyl cyanide m-chlorophenylhydrazone (CCCPH), was added at
      40 min to test inhibition of a pump mechanism. The results demonstrated no
      statistically significant differences in uptake between the sensitive and
      resistant groups, and the uptake patterns were similar. CCCPH also induced an
      equivalent surge, or enhanced uptake among these strains, rendering an energy
      dependent efflux pump an unlikely contributor to the high levels of resistance
      seen in our strains. Our findings support parallel studies done on these isolates
      that implicate mutational changes at amino acid codon 84 and/or codon 85 in the
      gyrA gene as an explanation for high-level quinolone resistance (MIC to
      ciprofloxacin greater than or equal to 16 mg/L) in MRSA.

PMID- 1761444
TI  - Imipenem resistance associated with the loss of a 40 kDa outer membrane protein
      in Enterobacter aerogenes.
AB  - An imipenem-resistant strain, Enterobacter aerogenes EA-Z, was isolated from a
      blood culture. Outer membrane protein (OMP) profiles indicated the loss of a 40
      kDa OMP, decreased expression of 42 and 44 kDa OMPs, and increased expression of
      a 50 kDa OMP in strain EA-Z when compared with imipenem-susceptible clinical
      isolates of E. aerogenes. The OMP profile of EA-Z was similar to that of strain
      EA-SI16, an imipenem-resistant E. aerogenes second-step mutant selected on
      imipenem-containing media. A single-step imipenem-resistant mutant, EA-SI8, had
      lost expression of only the 40 kDa OMP. No new beta-lactamase could be detected
      by isoelectric focusing, and no increase in imipenem hydrolysis was seen when EA
      Z was compared with imipenem-sensitive controls, even in the presence of added
      zinc. These data suggest that the 40 kDa OMP of E. aerogenes might be required
      for the normal diffusion of imipenem across the outer membrane.

PMID- 1761445
TI  - Quantification of in-vitro post-antibiotic effect based on the mean recovery
      time. I: Theoretical perspectives and a practical procedure.
AB  - An empirical description of the post-antibiotic effect has been previously
      proposed on the basis of the time required for the bacterial density to increase
      by one log10 following antimicrobial exposure. In this study, a set of
      theoretical perspectives are established and the post-antibiotic effect
      quantitatively defined based on the mean-recovery time. The mean recovery-time
      can be determined by measuring the area above the growth curve of a bacterial
      population following antimicrobial exposure. It can be shown that the previously
      proposed description of the post-antibiotic effect may be regarded as a special
      case of the definition based on the mean-recovery. Furthermore, a practical
      procedure is described for the quantitation of the post-antibiotic effect from a
      given set of data in the form of a growth curve.

PMID- 1761446
TI  - Quantification of in-vitro post-antibiotic effect based on the mean recovery
      time. II: A comparison of colony counting versus photometric methods for the
      determination of bacterial growth.
AB  - In the preceding paper, a method for the quantification of the post-antibiotic
      effect (PAE) has been developed based upon the mean recovery-time of an
      antibiotic-treated bacterial population, showing that the mean recovery-time is
      determined by the area above a growth curve of the bacterial population. Such an
      area determination of PAE implies that this method is less likely to be
      influenced by the early portion of a growth curve and therefore less dependent on
      the ability of a technique to detect a minimum bacterial density (sensitivity
      limit). In this study, this implication is further demonstrated in theory and
      through experimentation. As a result, an approach to estimation of contribution
      of the early portion of a growth curve to the quantitation of PAE based on the
      mean recovery-time is derived. The PAE of ciprofloxacin on Escherichia coli ATCC
      25922 was determined under different test conditions using colony count and
      optical density measurements for determining bacterial growth. Differences in
      durations of the PAE quantitated by the mean recovery-time from the colony count
      measured and optical density measured growth curves were not statistically
      significant (P greater than 0.05).

PMID- 1761447
TI  - Synergic post-antibiotic effect of mecillinam, in combination with other beta
      lactam antibiotics in relation to morphology and initial killing.
AB  - The synergic in-vitro post-antibiotic effect (PAE) of mecillinam, in combination
      with either ampicillin, aztreonam, ceftazidime or piperacillin, on a reference
      strain of Escherichia coli was evaluated by bioluminescence assay of bacterial
      ATP. Ampicillin, ceftazidime and mecillinam alone induced a concentration
      dependent PAE (greater than 3 h) on E. coli, whereas aztreonam and piperacillin
      alone induced a short (less than 1 h) non-dose dependent PAE. At most
      concentrations, the combination of mecillinam and ampicillin, aztreonam,
      ceftazidime or piperacillin induced longer PAEs on E. coli than the sum of the
      individual antibiotics' PAEs. Long PAEs were seen concomitantly with the presence
      of spheroplasts. In addition to the synergistic PAE, the decrease in colony
      counts and changes in ATP values after a 2 h exposure to mecillinam, in
      combination with the other beta-lactam antibiotics, were more prominent than the
      respective values after exposure to the individual antibiotics. The change in ATP
      was generally less pronounced than the decrease in colony counts. This could be
      due to lysis of spheroplasts on agar plates, leading to an over-estimation of the
      initial killing when assayed by viable counting. Mecillinam, which induced long
      PAEs on E. coli at almost all concentrations in this study, has a high affinity
      for penicillin binding protein 2 (PBP 2) and induced spheroplast formation at all
      concentrations. However, mechanisms other than the affinity for PBP 2 and
      spheroplast formation are involved in the PAE of beta-lactam antibiotics on Gram
      negative bacteria; since the PAE was prolonged when mecillinam was combined with
      ampicillin, aztreonam, ceftazidime or piperacillin, which bind preferentially to
      PBP 1 and 3.

PMID- 1761448
TI  - Killing kinetics of cefuroxime axetil against Haemophilus influenzae in an in
      vitro model simulating serum concentration profiles after oral administration.
AB  - We have used a dynamic in-vitro model to determine the killing kinetics of two
      formulations of cefuroxime axetil against 18 clinical strains of Haemophilus
      influenzae. The concentration of cefuroxime axetil was adjusted dynamically to
      simulate the mean serum profile in healthy volunteers following the
      administration of a single 250 mg dose in oral suspension or tablet form.
      Bacterial numbers were reduced by 3 log10 cfu/mL during the eight-hour
      experimental period with both dosage form simulations. Our results suggest that
      cefuroxime axetil, 250 mg in oral suspension or tablet form, may protect against
      the dissemination of H. influenzae during episodes of bacteraemia.

PMID- 1761449
TI  - beta-Lactamase produced by a highly beta-lactam-resistant strain of Bacteroides
      fragilis: an obstacle to the chemotherapy of experimental mixed infections.
AB  - A strain of Bacteroides fragilis, which produces a metallo-beta-lactamase, was
      inoculated into pouches on the backs of rats together with a beta-lactamase
      negative Escherichia coli highly sensitive to beta-lactam antibiotics. The mixed
      infection rat pouch model was treated with either flomoxef (susceptible to
      hydrolysis by the beta-lactamase produced by B. fragilis), or cefmetazole
      (relatively resistant to hydrolysis). In this model of mixed infection flomoxef
      showed weak in-vivo activity against E. coli, although showing the same strong
      activity in a model of single infection with E. coli. On the other hand,
      cefmetazole showed strong activity against E. coli, even in the model of mixed
      infection. The concentrations of both drugs in the pouches were decreased in
      infections with the strain of B. fragilis. There was a greater decrease in the
      concentration of flomoxef than of cefmetazole. Flomoxef was unstable whereas
      cefmetazole was relatively stable in the pouch exudates that had been infected
      with B. fragilis. These experimental data suggest that bacteria that produce a
      metallo-beta-lactamase decrease the in-vivo efficacy of beta-lactam antibiotics
      against other co-infecting bacteria. Thus, it is suggested that it is important
      in the chemotherapy of mixed bacterial infections that include these highly
      resistant beta-lactamase-producing bacteria to use antibiotics that are stable to
      hydrolysis by these enzymes.

PMID- 1761450
TI  - Dosage adjustment and clinical outcomes of long-term use of high-dose tobramycin
      in adult cystic fibrosis patients.
AB  - A two-phase study was undertaken designed to investigate the impact of computer
      aided drug monitoring on tobramycin concentrations and clinical outcomes in adult
      patients with cystic fibrosis. In phase one, a baseline (historical control)
      study of drug use patterns was performed. During the second phase, patients
      admitted for intravenous treatment with tobramycin for acute exacerbations of
      pseudomonal pulmonary infections were randomly allocated to one of two schedules.
      Group A patients had tobramycin dosage regimens decided by clinicians based on
      pre-existing protocols using serum tobramycin assay data determined three times
      weekly. Group B patients had dosage regimens determined by a computerized
      pharmacokinetic predictive program using both population-based pharmacokinetic
      parameter estimation and fitting of serum concentration-time data using Bayesian
      regression. The agreed therapeutic target was a peak serum tobramycin
      concentration of 8-10 mg/L and a trough concentration of 1-2 mg/L. There was a
      major difference between the two groups comparing the number of paired trough and
      peak concentrations within the target concentration ranges (group A-14%; group B
      34.7%, chi 2 test, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761451
TI  - A randomized trial of cefepime (BMY-28142) and ceftazidime for the treatment of
      pneumonia.
AB  - Cefepime is a new cephalosporin with a broad antimicrobial spectrum that includes
      Staphylococcus aureus and Pseudomonas aeruginosa. To study the efficacy and
      safety of cefepime for treatment of pneumonia, 65 patients were randomized to
      therapy with either cefepime or ceftazidime at a two to one ratio. Of the 57
      evaluable patients, 89% of the cefepime patients and 84% of the ceftazidime
      patients were cured clinically or improved. Haemophilus spp., Streptococcus
      pneumoniae, and Neisseria spp. were common pathogens. Bacteriological cure was
      achieved in 31 (91%) of cefepime patients and 17 (100%) ceftazidime patients.
      Adverse clinical and laboratory reactions possibly due to study drug occurred in
      9 (21%) cefepime patients and in 1 (5%) ceftazidime patient. Most reactions were
      mild and resolved with discontinuation of study drug. In this study, cefepime
      appeared as effective as ceftazidime for the treatment of pneumonia.

PMID- 1761452
TI  - Ceftibuten versus cefaclor for the treatment of bronchitis.
AB  - Ceftibuten is an oral third generation cephalosporin with potent antimicrobial
      activity against Enterobacteriaceae, beta-lactamase positive Haemophilus
      influenzae, Moraxella catarrhalis, Neisseria meningitidis, Neisseria gonorrheae,
      penicillin-susceptible pneumococci, and beta-hemolytic streptococci. To study the
      efficacy and safety of ceftibuten for treatment of bronchitis, 58 patients were
      randomized to therapy with either ceftibuten 400 mg once a day or cefaclor 250 mg
      every 8 h at a ratio of two to one. Of 45 clinically evaluable patients, 28
      (87.5%) of the 32 ceftibuten patients and 12 (92.3%) of the 13 cefaclor patients
      were clinically improved or cured. Of 33 microbiologically evaluable patients, 21
      (87.5%) of the 24 ceftibuten patients and eight (80%) of the ten cefaclor
      patients were cured. Of 56 patients evaluable for adverse effects, three (7.9%)
      of the 38 ceftibuten patients and one (5.6%) of the 18 cefaclor patients had
      adverse reactions. In this small study, once-daily ceftibuten appeared as safe
      and as effective as cefaclor for the treatment of bronchitis.

PMID- 1761453
TI  - Comparative efficacy and safety of cefprozil and cefaclor in the treatment of
      acute uncomplicated urinary tract infections.
AB  - Cefprozil is a new oral semi-synthetic cephalosporin with broad antibacterial
      spectrum and prolonged serum elimination half-life. In vitro, cefprozil
      demonstrates excellent activity against common urinary tract pathogens such as
      Escherichia coli and Klebsiella pneumoniae. Cefprozil, 500 mg once a day, was
      compared to cefaclor, 250 mg three times a day, in an open, randomized,
      comparative, clinical trial for the treatment of acute, uncomplicated, urinary
      tract infection. One hundred and two adult patients were eligible for safety
      evaluation; four patients were excluded due to side-effects (abdominal
      discomfort, nausea and vomiting). Ninety-eight patients were eligible for
      evaluation of efficacy. Clinical and bacteriological responses were comparable
      for both antibiotics. Leucopenia, nausea, and vaginal yeast infections were
      slightly more common in the cefprozil group. Cefprozil, 500 mg once daily,
      appears to be an appropriate alternative for the treatment of acute,
      uncomplicated urinary tract infections.

PMID- 1761454
TI  - Plasmid-associated resistance to pivmecillinam in Shigella flexneri and Shigella
      boydii.

PMID- 1761455
TI  - Reduced uptake of ciprofloxacin in a resistant strain of Neisseria gonorrhoeae
      and transformation of resistance to other strains.

PMID- 1761456
TI  - Susceptibility testing of cefpodoxime.

PMID- 1761457
TI  - Dependence of the interaction of ceftazidime and gentamicin against Pseudomonas
      aeruginosa on the bacterial growth-rate.

PMID- 1761458
TI  - Imipenem resistance in Proteus mirabilis.

PMID- 1761459
TI  - Activity of free and liposome encapsulated streptomycin against Mycobacterium
      avium complex (MAC) inside peritoneal macrophages.

PMID- 1761460
TI  - Interference of cefpirome with the measurement of plasma creatinine.

PMID- 1761461
TI  - Influence of ventrolateral surface of medulla on tracheal gland secretion.
AB  - Airway secretion can be modified reflexly as well as locally. Previous studies
      indicate that neurons in a circumscribed region near the ventral surface of the
      medulla (VMS) can substantially modify airway tone and reflex responses to vagal
      inputs. In the present studies we assessed the importance of these neurons on
      tracheal gland secretion. We examined the changes in the number of hillocks of
      secretion appearing from submucosal glands in an exposed field of tracheal
      epithelium (1.2 cm2) coated with tantalum dust before and after interventions on
      the VMS. Experiments were performed in alpha-chloralose-anesthetized dogs
      paralyzed and ventilated with 40% O2. Stimulation of nicotinergic receptors by
      application of a pledget containing nicotine in 11 dogs caused a significant
      elevation in tracheal gland secretion in the subsequent 60 s, compared with a
      control period in which buffered saline was applied. Prior application of
      lidocaine or hexamethonium bromide to the VMS blocked the effect of topically
      applied nicotine. The central effects of nicotine were diminished by atropine
      methylnitrate given intravenously. In addition, lidocaine application to the VMS
      or focal cooling of intermediate areas to between 20 and 15 degrees C
      significantly decreased secretion rates reflexly produced by capsaicin-induced
      stimulation of pulmonary C-fiber receptors and by mechanical stimulation of the
      carina and larynx. These findings suggest that the ventral medulla contains cells
      near its surface that influence tracheal fluid secretion and modulate reflex
      responses of airway submucosal glands, probably by altering the level of general
      excitation within the central respiratory integrating circuits.

PMID- 1761462
TI  - Organ blood flow in Fischer-344 rats bearing MCA-induced sarcoma.
AB  - Although blood flow is central to systemic metabolism, little is known about the
      effect of tumor on the perfusion of host tissues. This study evaluated the
      effects of a methylcholanthrene-induced sarcoma on blood flow to intra-abdominal
      organs and skeletal muscle of Fischer-344 rats anesthetized with pentobarbital
      sodium. Animals were studied by aortic injection of radiolabeled microspheres
      when the tumors reached 20% of body weight. Total-organ arterial flows in spleen,
      liver, small intestine, and pancreas were each increased to 50-150% in tumor
      bearers relative to controls (P less than 0.05). Portal venous flow and flow per
      gram to hindlimb muscle were 60 +/- 20 and 300 +/- 100% greater, respectively, in
      tumor-bearing animals (P less than 0.005). This study shows that tumor growth can
      be associated with large changes in organ flow and distribution of cardiac
      output. The increase in skeletal muscle flow in the tumor bearers, which lost
      normal tissue weight relative to pair-fed controls (P less than 0.05), is in
      marked contrast to decreased muscle flow previously observed in simple
      starvation.

PMID- 1761463
TI  - Alveolar and lung liquid clearance in the absence of pulmonary blood flow in
      sheep.
AB  - The effect of removing pulmonary blood flow on the clearance of excess liquid and
      protein from the air spaces and interstitium of the normal lung was studied in
      anesthetized ventilated sheep. To eliminate pulmonary blood flow to one lung, the
      left pulmonary artery was occluded. Autologous serum (3 ml/kg) with 125I-labeled
      albumin was then instilled into the left lower lobe. Hemodynamics and lung lymph
      were measured, and the lungs were removed after 4 h. Alveolar protein
      concentration over 4 h was used as the index of alveolar liquid clearance. Total
      lung liquid clearance was measured by the gravimetric method. The percent
      increase in alveolar protein concentration over baseline was similar between
      sheep without pulmonary blood flow (33.8 +/- 17.4) and with pulmonary blood flow
      (31.1 +/- 14.6); thus, alveolar liquid clearance was not changed by the absence
      of pulmonary blood flow. Also, in the absence of pulmonary blood flow, lung
      liquid clearance (as percent of instilled) over 4 h was 27.1 +/- 3.8 (n = 7),
      which was not significantly different from control experiments with pulmonary
      blood flow (26.4 +/- 7.1, n = 7). In the sheep without pulmonary blood flow,
      bronchopulmonary anastomotic flow was 41.5 +/- 21.3 ml/min. To further reduce
      blood flow to the lung, both the left pulmonary artery and the bronchoesophageal
      artery were occluded, which reduced bronchopulmonary anastomotic flow to the left
      lung to 12.0 +/- 9.3 ml/min. This further reduction in blood flow did not,
      however, change alveolar or lung liquid clearance. Even with this low blood flow
      to the left lung, the removal of 125I-albumin from the lung was not
      altered.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761464
TI  - Determinants of bronchoalveolar lavage cellularity in idiopathic pulmonary
      fibrosis.
AB  - To investigate factors that determine bronchoalveolar lavage (BAL) cellularity in
      patients with idiopathic pulmonary fibrosis (IPF), we compared BAL cells in
      patients with IPF (n = 83) to both nonsmoking (n = 111) and smoking (n = 19)
      normal volunteers. Patients with IPF had higher concentrations of BAL total cells
      and alveolar macrophages than nonsmoking volunteers and more BAL neutrophils and
      eosinophils than normal volunteers regardless of smoking status. Among patients
      with IPF, the numbers of alveolar macrophages, neutrophils, or eosinophils were
      strongly associated with either smoking status or pack-years of cigarette
      smoking. In fact, after accounting for cigarette smoking, using multivariate
      analysis, the only additional factors that were found to be associated with BAL
      cellularity were age (macrophages and eosinophils) and the percent predicted
      forced expired volume in 1 s (neutrophils). Additional multivariate models failed
      to identify a significant relationship between BAL cellularity and either the
      type of immunosuppressive therapy or other physiological measures of lung
      function. We conclude that cigarette smoking strongly influences BAL cellularity
      in patients with IPF. These findings suggest that cigarette smoking may have a
      role in the pathogenesis of IPF or may adversely affect the prognosis in patients
      with IPF.

PMID- 1761465
TI  - Effect of estradiol on tissue glycogen metabolism and lipid availability in
      exercised male rats.
AB  - The effect of 17 beta-estradiol 3-benzoate (10 micrograms.0.1 ml sunflower oil
      1.100 g body wt-1) on exercise performance, tissue glycogen utilization, and
      lipid availability was determined in male rats. In experiment 1, estradiol or oil
      was administered 1 h or 1-6 days before a treadmill run to exhaustion. No
      differences in body weight between oil- and estradiol-administered animals were
      observed during the 6-day treatment. Animals receiving estradiol for 3-6 days ran
      significantly longer and completed more work than oil-administered animals.
      Significant degradation of red and white vastus muscle, myocardial, and liver
      glycogen was observed in all animals run to exhaustion. In experiment 2, animals
      were administered estradiol for 5 days and then run for 2 h. The submaximal run
      for 2 h significantly reduced tissue glycogen content in red and white vastus
      muscle, heart, and liver of oil-administered animals. The latter effect was
      attenuated in both vastus muscles, liver, and myocardial tissues in the estradiol
      administered animals. Estradiol administration significantly increased plasma
      fatty acids and lowered plasma lactate during the submaximal run. These data
      indicate that when body weight remained constant between groups of male rats,
      estradiol administration for 3-6 days increased exercise performance.
      Furthermore, estradiol administration for 5 days resulted in greater lipid
      availability and less tissue glycogen utilization during submaximal running for 2
      h.

PMID- 1761466
TI  - Distensibility of small arteries of the dog lung.
AB  - To obtain in situ measurements of the distensibility of small (100- to 1,000
      microns-diam) pulmonary arterial vessels of the dog lung, X-ray angiograms were
      obtained from isolated lung lobes with the vascular pressure adjusted to various
      levels. The in situ diameter-pressure relationships were compared with the
      diameter-pressure relationships for small arteries that were dissected free from
      the lungs and cannulated with small glass pipettes for the measurement of
      diameter and transmural pressure. The diameter-vascular or diameter-transmural
      pressure curves from both in situ and cannulated vessels were sufficiently linear
      in the pressure range studied (0-30 Torr) that they could be characterized by
      linear regression to obtain estimates of D0, the diameter at zero vascular
      pressure, and beta, the change in diameter (micron) per Torr change in pressure.
      The vessel distensibility coefficient (alpha) was defined as alpha = beta/D0. The
      mean values of alpha were approximately 2.0 +/- 0.8%/Torr (SD) for the in situ
      vessels and 1.7 +/- 0.6%/Torr for the cannulated vessels, with no statistically
      significant difference between the two methods. The influence of vasoconstriction
      elicited by serotonin was evaluated in the in situ vessels. Serotonin-induced
      vasoconstriction caused a decrease in D0 and little change in alpha.

PMID- 1761467
TI  - Inhomogeneous response of expiratory muscle activity to cold block of the ventral
      medullary surface.
AB  - We assessed the effects of cooling the ventral medullary surface (VMS) on the
      activity of chest wall and abdominal expiratory muscles in eight anesthetized
      artificially ventilated dogs after vagotomy and denervation of the carotid sinus
      nerves. Electromyograms (EMGs) of the triangularis sterni, internal intercostal,
      abdominal external oblique, abdominal internal oblique, and transversus abdominis
      muscles were measured with EMG of the diaphragm as an index of inspiratory
      activity. Bilateral localized cooling (2 x 2 mm) in the thermosensitive
      intermediate part of the VMS produced temperature-dependent reduction in the EMG
      of diaphragm and abdominal muscles. The rib cage expiratory EMGs were little
      affected at 25 degrees C; their amplitudes decreased at lower VMS temperatures
      (less than 20 degrees C) but by significantly fewer degrees than the
      diaphragmatic and abdominal expiratory EMGs at a constant VMS temperature. With
      moderate to severe cooling (less than 20 degrees C) diaphragmatic EMG
      disappeared, but rib cage expiratory EMGs became tonic and resumed a phasic
      pattern shortly before the recovery of diaphragmatic EMG during rewarming of the
      VMS. These results indicate that the effects of cooling the VMS differ between
      the activity of rib cage and abdominal expiratory muscles. This variability may
      be due to inhomogeneous inputs from the VMS to expiratory motoneurons or to a
      different responsiveness of various expiratory motoneurons to the same input
      either from the VMS or the inspiratory neurons.

PMID- 1761468
TI  - Sweat lactate in exercising children and adolescents of varying physical
      maturity.
AB  - This study attempts to explain some of the individual variability in sweating
      pattern by comparing prepubescents and pubescents. Sweating rate and muscular
      anaerobic capacity are higher in adults than in children; thus we hypothesized
      that sweat gland anaerobic metabolism, as reflected by lactate excretion, might
      be higher with advanced physical maturity (PM). Lactate concentration in sweat
      ([LAC]sw) was measured at various stages of PM in boys who exercised in the heat.
      The subjects were divided into three groups on the basis of Tanner staging:
      prepubertal (PP, n = 16), midpubertal (MP, n = 15), and late pubertal (LP, n =
      5). Subjects cycled at 50% of maximal O2 uptake for three 20-min bouts, with 10
      min rest periods, in 42 degrees C and 18% relative humidity. Sweat samples were
      harvested, and population density of activated sweat glands was determined after
      each exercise bout. [LAC]sw during bout 1 was higher in PP than in LP [PP = 22.2
      +/- 2.2, MP = 19.5 +/- 1.4, LP = 14.3 +/- 1.3 (SE) mmol/l]. In all groups,
      [LAC]sw decreased during subsequent bouts, and there were no intergroup
      differences in [LAC]sw during bout 3 (PP = 11.2 +/- 0.4, MP = 10.6 +/- 0.5, LP =
      9.7 +/- 0.2 mmol/l). [LAC]sw was inversely related to sweating rate. Lactate
      excretion rate per gland was greater with the increase in PM (PP = 61.0 +/- 8.2,
      MP = 79.1 +/- 11.3, LP = 99.9 +/- 11.0 pmol/min; P = 0.08).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1761469
TI  - Aldosterone and prolactin response to exercise in the heat in circumpubertal
      boys.
AB  - Thermoregulatory responses to exercise in the heat, especially sweating pattern,
      differ between children and adults. To determine whether such differences may be
      related to hormonal responses and to assess the possible association between this
      response and physical maturation, three groups of circumpubertal boys cycled at
      50% of maximal O2 uptake (three 20-min bouts with 10 min of rest between bouts)
      in 42 degrees C at 20% relative humidity. On the basis of Tanner staging, 11 were
      prepubertal (PP), 12 midpubertal (MP), and 7 late pubertal (LP). Water ingestion
      was encouraged to minimize dehydration. Venous blood was sampled before and
      immediately after the session. Changes in heart rate, rectal temperature, and
      percent decrease in plasma volume did not differ among groups. There was no
      change in plasma osmolality in any of the groups. Resting testosterone
      concentrations were higher with increased level of physical maturity (PP = 0.4 +/
      0.1, MP = 8.2 +/- 1.9, LP = 13.8 +/- 1.2 nmol/l; P less than 0.05). In all
      groups, both aldosterone (ALD) and prolactin (PRL) markedly increased after
      exercise in the heat (ALD: PP = 161 +/- 40 vs. 1,289 +/- 263, MP = 173 +/- 47 vs.
      1,245 +/- 153, LP = 250 +/- 76 vs. 1,681 +/- 400 pmol/l; PRL: PP = 8.1 +/- 1.2
      vs. 24.9 +/- 4.2, MP = 8.8 +/- 1.0 vs. 22.0 +/- 8.9, LP = 8.4 +/- 0.8 vs. 39.0 +/
      3.6 micrograms/l; P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761470
TI  - Influences of gender and sex hormones on hypoxic ventilatory response in cats.
AB  - Hypoxic ventilatory response (HVR) is known to be increased by female as well as
      male sex hormones, but whether there are differences in HVR between men and women
      remains unclear. To determine whether gender differences exist in HVR, we
      undertook systematic comparisons of resting ventilation and HVR in awake male and
      female cats. Furthermore to explore the potential contribution of sex hormones to
      gender differences observed, we compared neutered and intact cats of both sexes.
      Resting ventilation differed among the four groups, but differences disappeared
      with correction for body weight. Intact females had a lower end-tidal PCO2 than
      intact male cats (females: 31.6 +/- 0.4 Torr vs. males: 33.6 +/- 0.4 Torr, P less
      than 0.05), indicating an increased alveolar ventilation per unit CO2 production.
      HVR expressed as the shape parameter A was similar among the four groups of
      animals. However, baseline (hyperoxic; end-tidal PO2 greater than 200 Torr)
      minute ventilation [VI(PO2 greater than 200)] differed among the groups.
      Therefore we normalized HVR by dividing the shape parameter A by VI(PO2 greater
      than 200) to compare the relative hypoxic chemosensitivity among the various
      groups of animals. In addition, we further normalized HVR for body weight,
      because body size influences ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761471
TI  - Erythrocyte insufflation-induced protection against oxygen toxicity: role of
      cytokines.
AB  - We studied the pulmonary response of adult rats to erythrocyte (RBC) and RBC
      lysate insufflation to define the mechanism of RBC insufflation-induced
      protection against oxygen toxicity. Tracheal insufflation of 1 ml RBC (75%) or
      RBC lysate induced an intense pulmonary inflammatory response. Within 24 h of
      oxygen exposure, greater than 95% of insufflated RBCs was hemolyzed. The cell
      free fraction of alveolar lavage fluids from RBC- or RBC lysate-insufflated rats
      had similar capacity in protecting endothelial cells against H2O2 cytotoxicity.
      However, RBC insufflation but not RBC lysate insufflation, protected rats against
      oxygen toxicity. There was marked erythrophagocytosis by alveolar macrophages of
      RBC-insufflated rats. Insufflation of RBCs, but not RBC lysate, resulted in
      production of tumor necrosis factor and interleukin 1, which could be recovered
      by bronchoalveolar lavages. When rats were insufflated with a combination of RBC
      lysate and cytokines at dosages within the range of cytokine levels achievable in
      alveolar lavage fluids by RBC insufflation, they became tolerant to oxygen. These
      results suggest that endogenously produced tumor necrosis factor and interleukin
      1 as a result of RBC insufflation may play an important role in RBC insufflation
      induced oxygen tolerance.

PMID- 1761472
TI  - Exercise training depletes sarcoplasmic reticulum calcium in coronary smooth
      muscle.
AB  - We examined the effects of chronic exercise training on sarcoplasmic reticulum
      (SR) Ca uptake, spontaneous SR Ca release, and whole-cell currents in coronary
      smooth muscle cells. Single coronary artery smooth muscle cells demonstrated
      increases in intracellular free Ca (Cai) during depolarization (measured with
      fura-2) that were abolished by diltiazem (10(-4) M). Diltiazem significantly
      inhibited (80%) refilling of the SR Ca store. The SR Ca store of exercise-trained
      pigs was 64% less after 11 min vs. 2 min of recovery, whereas cells from
      sedentary pigs showed no depletion. Exercise-training-induced depletion of the SR
      Ca store was abolished when ryanodine (10(-5) M) was applied during the recovery,
      but depletion was enhanced by low concentrations of ryanodine (10(-8) M). In
      smooth muscle from sedentary pigs, 10(-8) M ryanodine mimicked the effects of
      exercise training by depleting the SR Ca store during 11 min of recovery (54%
      depletion). When allowed a longer recovery without ryanodine (14 min or without
      prior depolarization), the SR Ca store in cells from exercise-trained pigs
      returned toward peak levels. The outward K current vs. voltage relationship did
      not differ in cells from exercise-trained or sedentary pigs. Exercise training
      reduced the number of spontaneous transient outward currents normally found in
      cells from sedentary pigs. We introduce a model that provides a rational basis to
      explain the results obtained in this study.

PMID- 1761473
TI  - Occlusion pressure response to inspiratory flow-resistive loading in anesthetized
      swine.
AB  - Conscious animals subjected to inspiratory flow-resistive loading augment
      respiratory drive [as measured by airway occlusion pressure (P100)] independently
      of changes in chemical drive. Past studies of anesthetized subjects, however,
      have failed to demonstrate this response, and investigators have concluded that
      its presence depends on a state of consciousness. We tested the hypothesis that
      respiratory depression due to anesthesia or endogenous opioids rather than
      unconsciousness per se was responsible for this observation. Miniature piglets
      were anesthetized with ketamine and xylazine and subjected to hyperoxic CO2
      rebreathing trials with and without added inspiratory resistance, before and
      after treatment with the opioid antagonist naltrexone. Before naltrexone there
      was a parallel leftward shift in the occlusion pressure vs. PCO2 relationship
      without a change in slope (delta P100/delta PCO2). After naltrexone there was a
      45.5 +/- 15% increase in slope with loading. Addition of incremental doses of
      pentobarbital markedly reduced this increase in slope. We conclude that
      anesthetized animals can demonstrate flow-resistive load compensation in the form
      of augmented neuromuscular output not due to increased chemical drive. Failure to
      observe this response in past studies may reflect respiratory depression due to
      the anesthetic agents employed.

PMID- 1761474
TI  - Effect of aminophylline on transpulmonary passage of venous air emboli in pigs.
AB  - Aminophylline has been shown to dramatically reduce the filtering capacity of the
      lung in dogs during venous air embolism. Similarities have been pointed out
      between the cardiovascular and respiratory systems of the pig and of humans. We
      therefore wanted to find out whether aminophylline also modifies the
      transpulmonary spillover of microbubbles to the arterial circulation of the pig.
      Twenty-eight pigs were anesthetized with pentobarbital sodium and mechanically
      ventilated. Aminophylline was injected intravenously into 10 of the pigs before
      the introduction of air bubbles into the right ventricle, while the other 18 pigs
      served as controls. A transesophageal echocardiographic probe was used to detect
      eventual air bubbles in the left atrium or in the aorta. Pigs received either air
      infusion, at rates varying from 0.05 to 0.20 ml.kg-1.min-1, or calibrated
      microbubbles, 5-300 microns diam. We found that aminophylline-treated pigs did
      not show any change in spillover incidence compared with controls. Furthermore,
      in both groups the spillover during continuous air infusion seemed to be a
      preterminal event, because the pigs had very low arterial pressure when arterial
      bubbles were observed. Finally, there was an increase in mean pulmonary arterial
      pressure from 18 +/- 3.4 to 26 +/- 2.2 (SD) mmHg (n = 4, P less than 0.01) in
      aminophylline-treated pigs after a bolus injection of microbubbles (less than or
      equal to 50 microns, total volume less than 0.5 ml). Our results suggest that
      aminophylline does not modify the transpulmonary passage of microbubbles in this
      porcine model. In addition, it would seem that the pulmonary circulation of the
      pig is sensitive to very small volumes of air, when injected as microbubbles.

PMID- 1761475
TI  - Decrease in functional residual capacity during inspiratory loading and the
      sensation of dyspnea.
AB  - The purposes of the present study were to determine the changes in functional
      residual capacity (FRC) during inspiratory loading and to examine their
      mechanisms. We studied seven normal subjects seated in a body plethysmograph. In
      both graded inspiratory elastic (35, 48, and 68 cmH2O/l) and resistive (21, 86,
      and 192 cmH2O.l-1.s) loading, FRC invariably decreased from control FRC and
      phasic expiratory activity increased. The reduction in FRC was greater with
      greater loads. A single inspiratory effort against an inspiratory occlusion at
      three different target mouth pressures (-25, -50, and -75 cmH2O) and durations
      (1, 2, and 5 s) also resulted in a decrease in FRC with an increase in expiratory
      electromyogram activity in the following expiration. The decrease in FRC was
      greater with greater target pressure and duration. This decrease in FRC is
      qualitatively similar to that during inspiratory loaded breathing, and we suspect
      that the same mechanisms are at work. Because neither vagal nor chemoreceptor
      reflex can account for these responses, we suspect conscious awareness of
      breathing or behavioral control to be responsible. In an additional study, the
      sensation of discomfort of breathing during elastic loading decreased with a
      decrease in FRC. These results suggest that the reduced FRC may be due to
      behavioral control of breathing to reduce the sensation of dyspnea during
      inspiratory loading.

PMID- 1761476
TI  - Role of vagal afferents in the control of abdominal expiratory muscle activity in
      the dog.
AB  - We examined the contribution of afferent vagal A- and C-fibers on abdominal
      expiratory muscle activity (EMA). In seven spontaneously breathing supine dogs
      anesthetized with alpha-chloralose we recorded the electromyogram of the external
      oblique muscle at various vagal temperatures before and after the induction of a
      pneumothorax. When myelinated fibers were blocked selectively by cooling the
      vagus nerves to 7 degrees C, EMA decreased to 40% of control (EMA at 39 degrees
      C). With further cooling to 0 degrees C, removing afferent vagal C-fiber
      activity, EMA returned to 72% of control. On rewarming the vagus nerves to 39
      degrees C, we then induced a pneumothorax (27 ml/kg) that eliminated the EMA in
      all the dogs studied. Cooling the vagus nerves to 7 degrees C, during the
      pneumothorax, produced a slight though not significant increase in EMA. However,
      further cooling of the vagus nerves to 0 degrees C caused the EMA to return
      vigorously to 116% of control. In three dogs, intravenous infusion of a constant
      incrementally increasing dose of capsaicin, a C-fiber stimulant, decreased EMA in
      proportion to the dose delivered. These results suggest that EMA is modulated by
      a balance between excitatory vagal A-fiber activity, most likely from slowly
      adapting pulmonary stretch receptors, and inhibitory C-fiber activity, most
      likely from lung C-fibers.

PMID- 1761477
TI  - High rates of exogenous carbohydrate oxidation from starch ingested during
      prolonged exercise.
AB  - This study compared the gastric emptying and oxidation of two 15% carbohydrate
      (CHO) solutions: a 22-chain-length glucose polymer (GP) and soluble starch (SS).
      Six endurance-trained subjects ingested 1,200 ml of either GP or SS while cycling
      for 90 min at 70% of maximal oxygen consumption (VO2max). Whereas the calculated
      total CHO oxidation (GP 266.8 +/- 41.9 g; SS 263.6 +/- 28.9 g) and the volume
      emptied from the stomach (GP 813 +/- 130 ml; SS 919 +/- 116 ml) were similar, the
      appearance of the 14C label in plasma occurred more rapidly from ingested SS than
      from GP (P less than 0.001). This resulted in a significantly greater rate of SS
      oxidation than that from GP (SS 105.9 +/- 21.9 g, GP 49.6 +/- 10.2 g; P less than
      0.001). Exogenous CHO oxidation from GP accounted for 19% of total CHO oxidation,
      whereas the corresponding value for SS was 40%. This study suggests that the
      oxidation of SS and GP solutions ingested during exercise at 70% VO2max is not
      limited by gastric emptying. Rather, it appears to be either the rate of
      digestion or absorption of these solutions that determines their utilization.

PMID- 1761478
TI  - Airways impedance during single breaths of foreign gases.
AB  - The changes in airways resistance (Raw) and inertance (Iaw) during single
      inspirations of pure methane, helium, neon, and ethane at a flow of 0.1 l/s were
      measured in six healthy subjects by use of a forced-oscillation technique. Raw
      and Iaw were computed from respiratory transfer impedance obtained at a frequency
      of 20 Hz by applying pressure oscillations at the chest and measuring flow at the
      mouth with a bag-in-box system. Compared with the air data, the changes of Iaw
      after inhalation of 500 ml of gas averaged -41.1% with methane, -82.8% with
      helium, -25.8% with neon, and +4.8% with ethane. These changes were slightly less
      than the changes in gas density (-45%, -86%, -31%, and +5%, respectively). The
      inhaled volumes at which 50% of the changes had occurred (V50) did not differ
      significantly among gases and were approximately 100 ml. For Raw the data were
      more noisy than for Iaw; they were discarded in two subjects because of a strong
      and irreproducible volume dependence in air. Consistent differences were seen
      between the remaining subjects, one of whom exhibited a predominant viscosity
      dependence of Raw, one a predominant density dependence, and two an intermediate
      pattern. V50s were larger for Raw than for Iaw, indicating a more peripheral
      distribution of Raw. For Raw, V50s were lower with helium than with methane, in
      agreement with the notion that density-dependent resistance is located mainly in
      the large airways. The results suggest that some information on the serial
      distribution of Raw and Iaw may be derived from impedance measurements with
      foreign gases.

PMID- 1761479
TI  - Low-intensity training produces muscle adaptations in rats with femoral artery
      stenosis.
AB  - The effectiveness of a mild-intensity exercise program to induce adaptations
      within skeletal muscle of animals with peripheral arterial insufficiency was
      evaluated using an isolated perfused hindlimb preparation at a muscle blood flow
      similar to the peak found in vivo. Adult rats were subjected to bilateral femoral
      artery stenosis sufficient to limit peak blood flow during exercise but not alter
      resting blood flow. Stenosed-trained (Sten-Trained) rats walked on a treadmill at
      an easily achieved speed (20 m/min with a 15% grade) 5 days wk. Exercise
      tolerance improved from 10 min initially to 2 h/day. Non-stenosed-sedentary (Non
      Sten-Sed) and stenosed-sedentary (Sten-Sed) animals were limited to cage
      activity. Oxygen delivery to the contracting muscles was similar among groups
      (7.0 +/- 0.4, 7.3 +/- 0.6, and 6.6 +/- 0.6 mumol.min-1.g-1 in Non-Sten-Sed, Sten
      Sed, and Sten-Trained, respectively; n = 13 each). Force development was better
      maintained by Sten-Trained muscle (P less than 0.001) during a sequence of
      tetanic contraction conditions. Peak oxygen consumption was greater (P less than
      0.05) in the Sten-Trained (5.23 +/- 0.34 mumol.min-1.g-1) than in Non-Sten-Sed
      (4.08 +/- 0.35) and Sten-Sed (4.34 +/- 0.37) rats. The increased peak oxygen
      extraction (P less than 0.05) by the muscle of the Sten-Trained rats (82.5 +/-
      7.1% of oxygen inflow vs. 58.7 +/- 4.7 and 57.4 +/- 5.0%, respectively) was
      probably related to the increased muscle capillarity and mitochondrial enzyme
      activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761480
TI  - Fructose 1,6-diphosphate augments paraquat injury in isolated dog lungs.
AB  - Paraquat (PQ; 1,1'-dimethyl-4,4'-bipyridylium dichloride), a widely used
      herbicide, causes pulmonary edema by a cyclic oxidation and reduction reaction
      with oxygen molecules with the production of oxygen free radicals. Because
      fructose 1,6-diphosphate (FDP) has recently been shown to inhibit the generation
      of oxygen free radicals by activated neutrophils, we determined the effects of
      FDP on PQ-induced increase in microvascular permeability in isolated blood
      perfused dog lungs. Vascular permeability was assessed using the capillary
      filtration coefficient (Kf,c) and isogravimetric capillary pressure (Pc,i). There
      was no change in these variables over 5 h in the control lungs treated with
      saline (n = 5). A significant increase in Kf,c and a decrease in Pc,i, both of
      which indicated increased vascular permeability, were observed at 5 h of
      perfusion with 4 x 10(-3) M PQ (n = 5). Unexpectedly, an increase in
      microvascular permeability occurred within 4 h after administration of PQ in the
      lungs that were pretreated with FDP (2.7-14.2 mM, n = 6). Moreover the increases
      of Kf,c in the FDP-pretreated lungs were significantly greater than those in the
      lungs treated with PQ alone. Also, the final-to-initial lung weight ratio of the
      FDP-pretreated group was greater than those of the other groups. Thus the FDP
      dose used in the present study accentuated rather than prevented the PQ lung
      injury.

PMID- 1761481
TI  - Intramuscular accumulation of prostaglandins during static contraction of the cat
      triceps surae.
AB  - We previously demonstrated that muscle afferent endings are sensitized by
      exogenous prostaglandins during static contraction of skeletal muscle. The
      purpose of this study was to determine whether 30 s of static hindlimb
      contraction, induced by electrical stimulation of the cat sciatic nerve,
      increases the concentration of immunoreactive prostaglandin E2 (iPGE2) and 6
      ketoprostaglandin F1 alpha (i6-keto-PGF1 alpha, the stable metabolite of
      prostaglandin I2) in muscle tissue. In addition, the role of ischemia in
      augmenting prostanoid production was examined. Gastrocnemius muscle was obtained
      by freeze-clamping tissue, and prostaglandins were extracted from muscle
      homogenates and measured by radioimmunoassay. Compared with precontraction
      values, high-intensity (68% of maximal tension) static contraction elevated
      gastrocnemius iPGE2 and i6-keto-PGF1 alpha by 45 and 53%, respectively (P less
      than 0.01). Likewise, when blood flow to the gastrocnemius was attenuated by
      arterial occlusion during and 2 min before low-intensity contraction (29% maximal
      tension), the intramuscular iPGE2 concentration was increased by 71% (P less than
      0.01). Conversely, low-intensity contraction (30% of maximal tension) and
      arterial occlusion without contraction did not alter the concentration of either
      prostanoid. Our findings demonstrate that prostaglandins accumulate in muscle
      during static contraction. We believe that local muscle ischemia may provide a
      stimulus for this phenomenon. These prostaglandins therefore are available to
      sensitize afferent endings responsible for reflex adjustments during static
      muscle contraction.

PMID- 1761482
TI  - Effects of environmental temperature on the venodilatory response to
      nitroglycerin.
AB  - The venodilatory response to nitroglycerin (0.8 mg sublingually) was measured in
      10 healthy young male volunteers in a cool [24.3 +/- 0.6 degrees C skin
      temperature (Tsk)] and a warm environment (34.7 +/- 0.2 degrees C Tsk).
      Nitroglycerin caused mean arterial pressure to fall and heart rate to rise in
      both the cool (105 +/- 2 to 96 +/- 3 mmHg; 55 +/- 3 to 62 +/- 3 beats/min) and
      the warm environment (87 +/- 3 to 81 +/- 3 mmHg; 66 +/- 4 to 75 +/- 3 beats/min),
      but the fall in pressure was greater in the cool than in the warm environment.
      Forearm blood flow was reduced and forearm vascular resistance elevated in the
      cool (117 +/- 19 units; 1.15 +/- 0.08 ml.100 cc arm-1.min-1) compared with the
      warm environment (15 +/- 3 units; 8.60 +/- 1.89 ml.100 cc arm-1.min-1).
      Nitroglycerin caused forearm vascular resistance to fall in the cool but had no
      effect in the warm environment. Venous distensibility (increase in venous volume
      per 30-mmHg increase in venous pressure) was twice as great in the warm as in the
      cool environment (3.90 +/- 0.27 vs. 1.88 +/- 0.23 ml/100 cc arm). However, the
      venodilatory effect of nitroglycerin was similar in the cool and warm
      environments (0.79 +/- 0.10 vs. 0.67 +/- 0.13 ml/100 cc arm, respectively).
      Arterioles are not dilated by nitroglycerin in the warmer environment, but the
      venodilatory effect of nitroglycerin is quantitatively similar in the two
      environments.

PMID- 1761483
TI  - Fetal swallowing: response to graded maternal hypoxemia.
AB  - A computer-based system, incorporating electromyography (EMG) and esophageal
      fluid flow measurement, was used to determine fetal breathing and swallowing
      responses to graded maternal hypoxemia. Five chronically prepared ewes with
      singleton fetuses at a gestational age of 130 +/- 2 (SE) days were subjected to
      successive 30-min periods of mild and moderate hypoxemia (inspired O2 fraction =
      0.16 and 0.13, respectively). Mild and moderate maternal hypoxemia evoked
      significant reductions in fetal arterial PO2 (21 +/- 1 to 17 +/- 1 and 13 +/- 1
      Torr, respectively), while fetal arterial pH, hematocrit, plasma osmolality,
      heart rate, and mean blood pressure did not change. Moderate hypoxemia was
      associated with significant increases in fetal plasma arginine vasopressin and
      renin activity and significant reductions from basal values in percent time
      breathing (53 +/- 4 to 25 +/- 12%), percent time swallowing (11.5 +/- 3.1 to 1.3
      +/- 0.7%), and volume swallowed (21.3 +/- 2.1 to 4.8 +/- 2.7 ml/30 min). Fetal
      swallowing activity was better correlated with arterial PO2 (r = 0.8) than
      breathing activity (r = 0.45). We conclude that fetal swallowing is suppressed
      during mild and moderate hypoxemia. It is suggested that several sites and/or
      mechanisms may account for the hypoxemic inhibition of fetal activities.

PMID- 1761484
TI  - Accuracy of respiratory inductive plethysmograph in measuring tidal volume during
      sleep.
AB  - Respiratory inductance plethysmography (RIP) has been widely used to measure
      ventilation during sleep, but its accuracy in this role has not been adequately
      tested. We have thus examined the accuracy of the RIP by comparing tidal volume
      measured with RIP with that measured by a pneumotachograph in eight unrestrained
      normal subjects during sleep. We have also studied the effect of posture on the
      accuracy of the RIP. In all sleep stages the correlation between RIP tidal volume
      measurements and expired volume showed relatively poor correlations (mean r =
      0.49-0.60), and the bias of the measurements varied widely. Changes in posture
      altered the correlations between the two measurements, with no systematic
      differences between positions. When the subjects resumed a position, the 95%
      confidence intervals of tidal volume measurement did not overlap the original
      confidence limits in that posture on 13 of 25 occasions. This study shows that
      the RIP does not accurately measure tidal volume during sleep in unrestrained
      subjects and should only be used for semiquantitative assessment of ventilation
      during sleep.

PMID- 1761485
TI  - Physiological effects of hydrogen sulfide inhalation during exercise in healthy
      men.
AB  - Occupational exposure to hydrogen sulfide (H2S) is prevalent in a variety of
      industries. H2S when inhaled 1) is oxidized into a sulfate or a thiosulfate by
      oxygen bound to hemoglobin and 2) suppresses aerobic metabolism by inhibiting
      cytochrome oxidase (c and aa3) activity in the electron transport chain. The
      purpose of this study was to examine the acute effects of oral inhalation of H2S
      on the physiological responses during graded cycle exercise performed to
      exhaustion in healthy male subjects. Sixteen volunteers were randomly exposed to
      0 (control), 0.5, 2.0, and 5.0 ppm H2S on four separate occasions. Compared with
      the control values, the results indicated that the heart rate and expired
      ventilation were unaffected as a result of the H2S exposures during submaximal
      and maximal exercise. The oxygen uptake had a tendency to increase, whereas
      carbon dioxide output had a tendency to decrease as a result of the H2S
      exposures, but only the 5.0 ppm exposure resulted in a significantly higher
      maximum oxygen uptake. Blood lactate concentrations increased significantly
      during submaximal and maximal exercise as a result of the 5.0 ppm exposure.
      Despite these large increases in lactate concentration, the maximal power output
      of the subjects was not significantly altered as a result of the 5.0 ppm H2S
      exposure. It was concluded that healthy young male subjects could safely exercise
      at their maximum metabolic rates while breathing 5.0 ppm H2S without experiencing
      a significant reduction in their maximum physical work capacity during short-term
      incremental exercise.

PMID- 1761486
TI  - pH-induced effects on median frequency and conduction velocity of the myoelectric
      signal.
AB  - H+ accumulation at the sarcolemma is believed to play a key role in determining
      the electrophysiological correlates of fatigue. This paper describes an in vitro
      method to externally manipulate muscle pH while measuring the resultant effect on
      surface-detected median frequency (MDF) and conduction velocity (CV) parameters.
      Hamster muscle diaphragm strips (n = 8) were isolated with the phrenic nerve
      intact and placed in an oxygenated Krebs bath (26 degrees C). The muscle was
      clamped to a noncompliant load cell to measure isometric contractile tension.
      Tetanic contraction was developed via 40-Hz supermaximal stimulation of the
      phrenic nerve. Differential signals were recorded from three electromyogram (EMG)
      detection surfaces for computation of CV (via the phase shift in the EMG signals)
      and MDF. Repeated trials were conducted at bath pHs of 7.4, 7.0, and 6.6. Bath pH
      was altered by aerating predetermined concentrations of O2 and CO2 into the bath.
      Decreases in bath pH resulted in decreases in both initial MDF and initial CV.
      The differences in initial MDF and initial CV were significant (P less than
      0.001) for each of the bath pH conditions. In general, the change in bath pH
      resulted in an equal percent change in initial MDF and initial CV. This suggests
      that the change in bath pH caused a decrease in CV without significantly altering
      the fundamental shape of the M wave. In contrast, the EMG was altered differently
      during stimulated contractions. During stimulation, the rate of decay of CV was
      65% of the rate of decay of MDF.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761487
TI  - Hypoxic remodeling of the rat pulmonary arterial microcirculation assessed by
      microdissection.
AB  - Artery segments were microdissected from distal acini of the rat lung and studied
      by light and electron microscopy. Morphometric methods were used to quantify the
      structure of the wall at defined levels within the normal axial pathway and to
      determine the changes after 5 and 7 days of whole-animal exposure to hypobaric
      hypoxia at an inspiratory O2 fraction of 0.1. In the normal lung, at the level of
      the terminal bronchiolus, the artery wall comprised up to six layers of smooth
      muscle cells (SMCs). At the respiratory bronchiolar level, however, the wall
      contained fewer than two layers of SMCs with a consistently circumferential
      orientation. By the second-generation alveolar ducts (AD2), the medial layer was
      lost, replaced by subendothelial precursor smooth muscle cells (PCs) resembling
      intermediate cells. At this and the next level (AD3), the PC layer was often
      circumferentially discontinuous. Regression analysis of the morphometric data
      suggested, however, that the smallest AD3 artery is likely to have a layer of PCs
      but with virtually no measurable separation between them and the endothelium. The
      mean maximum radial diameter of SMCs decreased along the axial pathway with a
      significant difference between diameters at terminal bronchiolus and AD2 levels;
      yet the diameter of endothelial cells remained the same. After 7 days of hypoxia,
      no change was noted in the number of smooth muscle layers, but at the AD2 level
      the relative area of media in the total wall increased. This was due in part to
      hypertrophy of PCs, as evidenced by an increase in their mean maximum radial
      diameter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761488
TI  - Neural control of the forearm cutaneous vasoconstrictor response to dynamic
      exercise.
AB  - This study was designed to evaluate the relative importance of intended effort
      ("central command") and of the absolute intensity of dynamic exercise to the
      cutaneous vasoconstrictor response to the onset of exercise in humans. Skin blood
      flow (laser-Doppler flowmetry) was measured from the forearm in six healthy
      individuals during 3-min periods of high- and low-intensity exercise with and
      without partial neuromuscular blockade. Cutaneous vascular conductance (CVC) was
      calculated from the ratio of skin blood flow to mean arterial pressure and
      expressed as a percent change from rest. A rating of perceived exertion (RPE) was
      expressed as a subjective measure of intended effort. Under control conditions,
      CVC decreased by 22% (median; range 7-42%, P less than 0.05) during high
      intensity exercise [218 (186-268) W; RPE 16 (14-19) exertion units]. In contrast,
      during control low-intensity exercise [106 (88-128) W; RPE 10 (9-14) exertion
      units], during low-level exercise with curare [77 (54-98) W; RPE 13 (11-16)
      exertion units], and during maximal exercise with curare [106 (88-124) W; RPE 19
      (18-20) exertion units], CVC did not change significantly. These results suggest
      that factors related to the activity of the exercising muscle and its metabolism
      rather than intended effort determine the cutaneous vasoconstrictor response to
      the initiation of intense dynamic exercise in humans.

PMID- 1761489
TI  - Relationship between inspiratory effort and breathlessness in pregnancy.
AB  - Using open-magnitude scaling, we compared the relationships between
      breathlessness, inspiratory esophageal pressure swing (delta Pes), and
      ventilation in pregnancy and postpartum. Thirteen healthy women performed
      progressive cycle exercise tests at 33 +/- 2 wk gestation and 12 +/- 3 wk
      postpartum. Pulmonary function and maximal transdiaphragmatic pressure did not
      change. Minute ventilation (VE) was greater in the third trimester. This increase
      was entirely due to the increase in tidal volume (VT; 0.74 +/- 0.18 vs. 0.54 +/-
      0.18 liters at rest, P less than 0.01; 1.56 +/- 0.3 vs. 1.24 +/- 0.24 liters at
      48 W, P less than 0.001). delta Pes (15.3 +/- 3.0 vs. 11.9 +/- 3.5 cmH2O at 48 W,
      P less than 0.01) and breathlessness (1.8 +/- 1.4 vs. 1.0 +/- 0.9 at 48 W, P less
      than 0.05) were greater in the third trimester. However, the relationships
      between VT and delta Pes and between delta Pes and breathlessness were identical
      in the two conditions. The VT-tidal abdominal volume (Vab) and Vab-tidal gastric
      pressure swing (delta Pga) relationships were similar in the two conditions. In
      conclusion, the relationship between delta Pes and breathlessness is the same in
      the third trimester and postpartum. The increased VE is responsible for the
      breathlessness in the third trimester. Despite progressive abdominal distension
      by the gravid uterus, the VT-Vab and Vab-delta Pga relationships were the same in
      the two conditions.

PMID- 1761490
TI  - Human serum catalase decreases endothelial cell injury from hydrogen peroxide.
AB  - Serum from normal human subjects contained variable amounts of catalase activity,
      which was inhibitable by heat, azide, trichloroacetic acid (TCA), or
      aminotriazole treatment. Serum also decreased hydrogen peroxide (H2O2)
      concentrations in vitro and H2O2-mediated injury to cultured endothelial cells.
      By comparison, heat-, azide-, TCA-, or aminotriazole-treated serum neither
      decreased H2O2 concentrations in vitro nor reduced H2O2-mediated damage to
      endothelial cells. We conclude that serum catalase activity can alter H2O2
      dependent reactions. We speculate that variations in serum catalase activity may
      alter individual susceptibility to oxidant-mediated vascular disease or be a
      factor when added to test systems in vitro.

PMID- 1761491
TI  - Plasma volume expansion in humans after a single intense exercise protocol.
AB  - We used intense intermittent exercise to produce a 10% expansion of plasma volume
      (PV) within 24 h and tested the hypothesis that PV expansion is associated with
      an increase in plasma albumin content. The protocol consisted of eight 4-min
      bouts of exercise at 85% maximal O2 uptake with 5-min recovery periods between
      bouts. PV, plasma concentrations of albumin and total protein (TP), and plasma
      osmolality were measured before and during exercise and at 1, 2, and 24 h of
      recovery from exercise. During exercise, PV decreased by 15%, while plasma TP and
      albumin content remained at control levels. At 1 h of recovery, plasma albumin
      content was elevated by 0.17 +/- 0.04 g/kg body wt, accounting for the entire
      increase in plasma TP content. PV returned to control level at 1 h of recovery
      without fluid intake by the subjects, despite a 820 +/- 120-g reduction in body
      weight. At 2 h of recovery, plasma TP content remained significantly elevated,
      and plasma TP and albumin concentration were significantly elevated. At 24 h of
      recovery, PV was expanded by 4.5 +/- 0.7 ml/kg body wt (10 +/- 1%), estimated
      from hematocrit and hemoglobin changes, and by 3.8 +/- 1.3 ml/kg body wt (8 +/-
      3%), measured by Evans blue dye dilution. Plasma albumin content was increased by
      0.19 +/- 0.05 g/kg body wt at 24 h of recovery. If 1 g of albumin holds 18 ml of
      water, this increase in plasma albumin content can account for a 3.4-ml/kg body
      wt expansion of the PV. No significant changes in plasma osmolality occurred
      during recovery, but total plasma osmotic content increased in proportion to
      PV.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761492
TI  - Influence of electrical stimulation on a fast-twitch muscle in aging rats.
AB  - Recently we observed that the flexor digitorum longus muscle of the Fischer 344
      rat, which is comprised primarily of type IIb muscle, does not change in size,
      fiber type, or physiological characteristics during senescence [Am. J. Physiol.
      258 (Cell Physiol. 27): C1031-C1035, 1990]. This muscle was utilized to determine
      whether a predominantly fast-twitch glycolytic muscle would respond to tonic
      electrical stimulation (ES) with the same degree of fiber-type transformation in
      aging and young rats. The extent of transformation was quantified by measuring
      the contractile and metabolic properties, as well as the fiber-type composition,
      of the flexor digitorum longus muscle after ES (10 Hz, 8 h/day) imposed on the
      tibial nerve for periods of 0-90 days in young adult (YG; 6-8 mo), middle-aged
      (MA; 16-18 mo), and senescent (SN; 26-28 mo) male Fischer 344 rats. Although ES
      induced a IIb-to-IIa fiber-type shift in all groups, in the SN rats the shift was
      significantly less pronounced at the intermediate time points and remained
      incomplete after 90 days, compared with YG and MA rats. ES resulted in a
      reduction in tetanic tension (Po), which in the YG and MA rats was due to a
      reduction in muscle cross-sectional area. In the SN rats the reduced Po was due
      to a combined loss of cross-sectional area and specific tension (Po, N/cm2).
      Contraction and half-relaxation times were largely unaffected by ES, and maximal
      velocity of unloaded shortening declined throughout ES in all groups.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1761493
TI  - Shivering and pathological and physiological clonic oscillations of the human
      ankle.
AB  - Shivering and physiological and pathological clonus of the ankle were compared
      using power spectral and cross-correlation analysis of their respective
      electromyographic and acceleration waveforms. The major spectral peaks from each
      type of involuntary oscillation possessed similar frequencies (5-7 Hz). Soleus
      electromyographic activity was significantly correlated with the motion signal,
      whereas no correlation was observed between motion and tibialis anterior
      electromyographic signal. These data suggest that although shivering and
      physiological and pathological clonus are activated by different stimuli, these
      overt ankle oscillations may be an expression of a common spinal neuronal
      network.

PMID- 1761494
TI  - Estimation of regional cutaneous cold sensitivity by analysis of the gasping
      response.
AB  - Regional cutaneous sensitivity to cooling was assessed in males by separately
      immersing four discrete skin regions in cold water (15 degrees C) during head-out
      immersion. The response measured was gasping at the onset of immersion; the
      gasping response appears to be the result of a nonthermoregulatory neurogenic
      drive from cutaneous cold receptors. Subjects of similar body proportions wore a
      neoprene "dry" suit modified to allow exposure to the water of either the arms,
      upper torso, lower torso, or legs, while keeping the unexposed skin regions
      thermoneutral. Each subject was immersed to the sternal notch in all four
      conditions of partial exposure plus one condition of whole body exposure. The
      five cold water conditions were matched by control immersions in lukewarm (34
      degrees C) water, and trials were randomized. The magnitude of the gasping
      response was determined by mouth occlusion pressure (P0.1). For each subject,
      P0.1 values for the 1st min of immersion were integrated, and control trial
      values, although minimal, were subtracted from their cold water counterpart to
      account for any gasping due to the experimental design. Results were averaged and
      showed that the highest P0.1 values were elicited from whole body exposure,
      followed in descending order by exposures of the upper torso, legs, lower torso,
      and arms. Correction of the P0.1 response for differences in exposed surface area
      (A) and cooling stimulus (delta T) between regions gave a cold sensitivity index
      [CSI, P0.1/(A.delta T)] for each region and showed that the index for the upper
      torso was significantly higher than that for the arms or legs; no significant
      difference was observed between the indexes for the upper and lower
      torso.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761495
TI  - Effect of resistive loads on pattern of respiratory muscle recruitment during
      exercise.
AB  - In healthy subjects, we compared the effects of an expiratory (ERL) and an
      inspiratory (IRL) resistive load (6 cmH2O.l-1.s) with no added resistive load on
      the pattern of respiratory muscle recruitment during exercise. Fifteen male
      subjects performed three exercise tests at 40% of maximum O2 uptake: 1) with no
      added-resistive load (control), 2) with ERL, and 3) with IRL. In all subjects, we
      measured breathing pattern and mouth occlusion pressure (P0.1) from the 3rd min
      of exercise, in 10 subjects O2 uptake (VO2), CO2 output (VCO2), and respiratory
      exchange ratio (R), and in 5 subjects we measured gastric (Pga), pleural (Ppl),
      and transdiaphragmatic (Pdi) pressures. Both ERL and IRL induced a high increase
      of P0.1 and a decrease of minute ventilation. ERL induced a prolongation of
      expiratory time with a reduction of inspiratory time (TI), mean expiratory flow,
      and ratio of inspiratory to total time of the respiratory cycle (TI/TT). IRL
      induced a prolongation of TI with a decrease of mean inspiratory flow and an
      increase of tidal volume and TI/TT. With ERL, in two subjects, Pga increased and
      Ppl decreased more during inspiration than during control suggesting that the
      diaphragm was the most active muscle. In one subject, the increases of Ppl and
      Pga were weak; thus Pdi increased very little. In the two other subjects, Ppl
      decreased more during inspiration but Pga also decreased, leading to a decrease
      of Pdi. This suggests a recruitment of abdominal muscles during expiration and of
      accessory and intercostal muscles during inspiration. With IRL, in all subjects,
      Ppl again decreased more, Pga began to decrease until 40% of TI and then
      increased.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761496
TI  - Adenosine prevents phorbol ester injury in rabbit lungs: role of leukotrienes and
      TNF.
AB  - The objective of this study was to determine whether adenosine (ADO) prevents
      phorbol myristate acetate- (PMA) induced lung injury by modulating
      peptidoleukotrienes (LT) and/or tumor necrosis factor (TNF) production. PMA
      significantly increased pulmonary vascular resistance (PVR, 275 +/- 4 to 447 +/-
      30 cmH2O.1-1.min) and microvascular filtration coefficient.(Kf, 0.024 +/- 0.002
      to 0.040 +/- 0.006 g.min-1.cmH2O-1) in isolated blood-perfused rabbit lungs. ADO
      (5 mumol/min) blocked the increases in PVR (257 +/- 9 to 283 +/- 26) and Kf
      (0.028 +/- 0.005 to 0.018 +/- 0.002). After PMA (30 min), perfusate levels of
      LTC4 + LTD4 increased by 15.3 +/- 2.1 pg/ml; LTE4 increased by 15.1 +/- 4.1
      pg/ml. ADO reduced the increase in LTC4 + LTD4 to 2.7 +/- 6.1 pg/ml, but total LT
      increased by 31.9 +/- 16.6 pg/ml, implying that ADO enhanced the conversion of
      LTC4 and LTD4 to LTE4. MK-886 (L663,536), an LT synthesis inhibitor, blocked the
      increase in total LT (6.1 +/- 13.9 pg/ml) but did not reduce the PMA-induced
      increase in Kf (0.022 +/- 0.003 to 0.035 +/- 0.005) or PVR (238 +/- 11 to 495 +/-
      21). After PMA administration, perfusate TNF levels were not different from the
      10-fold increase observed in control experiments and were not reduced by ADO or
      MK-886. TNF production was independent of perfusate blood components and
      presumably due to low levels of endotoxin in the perfusate (70-90 ng/ml). These
      results indicate that ADO does not protect against PMA-induced acute lung injury
      by altering circulating levels of LT or TNF.

PMID- 1761497
TI  - Lung and chest wall mechanics in microgravity.
AB  - We studied the effect of 15-20 s of weightlessness on lung, chest wall, and
      abdominal mechanics in five normal subjects inside an aircraft flying repeated
      parabolic trajectories. We measured flow at the mouth, thoracoabdominal and
      compartmental volume changes, and gastric pressure (Pga). In two subjects,
      esophageal pressures were measured as well, allowing for estimates of
      transdiaphragmatic pressure (Pdi). In all subjects functional residual capacity
      at 0 Gz decreased by 244 +/- 31 ml as a result of the inward displacement of the
      abdomen. End-expiratory Pga decreased from 6.8 +/- 0.8 cmH2O at 1 Gz to 2.5 +/-
      0.3 cmH2O at Gz (P less than 0.005). Abdominal contribution to tidal volume
      increased from 0.33 +/- 0.05 to 0.51 +/- 0.04 at 0 Gz (P less than 0.001) but
      delta Pga showed no consistent change. Hence abdominal compliance increased from
      43 +/- 9 to 70 +/- 10 ml/cmH2O (P less than 0.05). There was no consistent effect
      of Gz on tidal swings of Pdi, on pulmonary resistance and dynamic compliance, or
      on any of the timing parameters determining the temporal pattern of breathing.
      The results indicate that at 0 G respiratory mechanics are intermediate between
      those in the upright and supine postures at 1 G. In addition, analysis of end
      expiratory pressures suggests that during weightlessness intra-abdominal pressure
      is zero, the diaphragm is passively tensed, and a residual small pleural pressure
      gradient may be present.

PMID- 1761498
TI  - Parenchymal stress affects interstitial and pleural pressures in in situ lung.
AB  - After resecting the intercostal muscles and thinning the endothoracic fascia, we
      micropunctured the lung tissue through the intact pleural space at functional
      residual capacity (FRC) and at volumes above FRC to evaluate the effect of
      increasing parenchymal stresses on pulmonary interstitial pressure (Pip). Pip was
      measured at a depth of approximately 230 microns from the pleural surface, at 50%
      lung height, in 12 anesthetized paralyzed rabbits oxygenated via a tracheal tube
      with 50% humidified O2. Pip was -10 +/- 1.5 cmH2O at FRC. At alveolar pressure of
      5 and 10 cmH2O, lung volume increased by 8.5 and 19 ml and Pip decreased to -12.4
      +/- 1.6 and -12.3 +/- 5 cmH2O, respectively. For the same lung volumes held by
      decreasing pleural surface pressure to about -5 and -8.5 cmH2O, Pip decreased to 
      17.4 +/- 1.6 and -23.8 +/- 5 cmH2O, respectively. Because Pip is more negative
      than pleural pressure, the data suggest that in intact pulmonary interstitium the
      pressure of the liquid phase is primarily set by the mechanisms controlling
      interstitial fluid turnover.

PMID- 1761499
TI  - Tissue temperature profile in the human forearm during thermal stress at thermal
      stability.
AB  - The purpose of the present study was to investigate the effect of a range of
      water temperatures (Tw from 15 to 36 degrees C) on the tissue temperature profile
      of the resting human forearm at thermal stability. Tissue temperature (Tti) was
      continuously monitored by a calibrated multicouple probe during 3 h of immersion
      of the forearm. The probe was implanted approximately 9 cm distal from the
      olecranon process along the ulnar ridge. Tti was measured every 5 mm, from the
      longitudinal axis of the forearm (determined from computed tomography scanning)
      to the skin surface. Along with Tti, skin temperature (Tsk), rectal temperature
      (Tre), and blood flow were measured during the immersions. For all temperature
      conditions, the temperature profile inside the limb was linear as a function of
      the radial distance from the forearm axis (P less than 0.001). Temperature
      gradient measured in the forearm ranged from 0.2 +/- 0.1 degrees C C cm (Tw = 36
      degrees C) to 2.3 +/- 0.5 degrees C cm (Tw = 15 degrees C). The maximal Tti was
      measured in all cases at the longitudinal axis of the forearm and was in all
      experimental conditions lower than Tre. On immersion at Tw less than 36 degrees
      C, the whole forearm can be considered to be part of the shell of the body. With
      these experimental data, mathematical equations were developed to predict, with
      an accuracy of at least 0.6 degrees C, the Tti at any depth inside the forearm at
      steady state during thermal stress.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761500
TI  - TNF but not IL-1 in dogs causes lethal lung injury and multiple organ dysfunction
      similar to human sepsis.
AB  - We compared the early and late pulmonary effects of human recombinant tumor
      necrosis factor (TNF) and interleukin 1 (IL-1) challenges in awake dogs with
      chronic tracheostomies. Serial blood gas analysis, bronchoalveolar lavage (BAL)
      with cell and protein analysis, intravascular catheter hemodynamics, and
      radionuclide left ventricular ejection fractions (LVEF) were determined before
      and after infusion of TNF (60 micrograms/kg body wt, n = 8), IL-1 (1,000
      micrograms/kg body wt, n = 6), or heat-inactivated IL-1 (n = 6, controls).
      Controls given heat-inactivated IL-1 had no changes (P = NS) in any pulmonary
      parameter throughout the study. Animals given IL-1 had a transient increase (P
      less than 0.05) in BAL neutrophil concentration 1 day after infusion but no other
      changes (P = NS) in pulmonary function throughout the study. Animals given TNF
      had early (0-4 h) decreases (P less than 0.05) in arterial PO2, increases (P less
      than 0.05) in physiological shunt fraction and alveolar-to-arterial PO2 gradient,
      and a high mortality rate (50%). In TNF animals, volume challenges at 4 h were
      associated (P less than 0.05) with death and noncardiogenic pulmonary edema. In
      TNF survivors, hypoxemia persisted for 2-3 days and was associated with increases
      (P less than 0.05) in alveolar protein and neutrophil concentration on days 1 and
      3, respectively, which in survivors returned to near normal over 6-21 days.
      Animals challenged with TNF and not IL-1 had reversible depression of LVEF
      similar in time course to abnormalities in arterial PO2. In this study, TNF (but
      not IL-1) challenges were lethal and produced acute pulmonary dysfunction
      sustained over days (reversible in survivors) that was similar to that seen in
      human septic shock. The ability of TNF to induce pulmonary injury similar to
      bacterial shock suggests that TNF is a key mediator of sepsis-induced lung
      injury. Furthermore, because TNF challenge induced both sustained pulmonary and
      cardiac injury, TNF may be a common pathway for the multiple organ dysfunction
      that occurs during septic shock.

PMID- 1761501
TI  - Pulmonary hypertension after postlavage lung injury in rabbits: possible role of
      polymorphonuclear leukocytes.
AB  - Previous studies showed that repeated lung lavage leads to a severe lung injury
      with very poor gas exchange, a substantial protein leak into the alveoli with
      hyaline membrane formation, pulmonary hypertension, and migration of granulocytes
      (PMN) into the alveolar spaces. Depletion of PMN leads to a better gas exchange
      and a markedly decreased protein leak with only scanty hyaline membranes. In this
      study we show that there is sustained pulmonary hypertension after the lung
      lavage, but in PMN-depleted rabbits there is no postlavage increase in pulmonary
      arterial pressure. Changing the shunt fraction by manipulating mean airway
      pressure still leads to a hypoxic vasoconstriction with increase of pulmonary
      arterial pressure. Thus, after lung lavage, pulmonary reactivity to hypoxia is
      still preserved. Comparisons between high-frequency ventilation and conventional
      mechanical ventilation at the same mean airway pressures showed that equal mean
      airway pressure in these two very different modes of ventilation do not translate
      into the same mean functional lung volumes.

PMID- 1761502
TI  - In vivo neutrophil sequestration within lungs of humans is determined by in vitro
      "filterability".
AB  - Neutrophils are normally delayed in transit through the lung microcirculation,
      relative to the passage of erythrocytes. This sequestration contributes to a
      pulmonary pool of neutrophils that may relate to the relative inability of
      neutrophils to deform compared with erythrocytes when in transit in the pulmonary
      capillaries. A micropore membrane was used to model the human pulmonary
      microcirculation, in which cell deformability was measured as the pressure
      developed during filtration of the cells through the membrane at a constant flow.
      We demonstrated a significant correlation between in vitro deformability and in
      vivo lung sequestration of indium-111-labeled neutrophils in 10 normal subjects
      (r = 0.69, P less than 0.02). In eight patients with stable chronic obstructive
      pulmonary disease, this relationship was not significant (r = -0.2, P greater
      than 0.05). Furthermore, in a subject with microscopic pulmonary telangiectasia
      known to allow significant passage of 30-microns microspheres, neutrophils passed
      through the lungs without delay. Moreover, neutrophils from patients studied
      acutely with an exacerbation of chronic obstructive pulmonary disease were
      temporarily less deformable (P less than 0.01). These studies confirm that cell
      deformability is an important determinant of the normal neutrophil sequestration
      within the lungs. Changes in cell deformability may alter the extent of this
      sequestration.

PMID- 1761503
TI  - Effects of gender, age, and fitness level on response of VO2max to training in 60
      71 yr olds.
AB  - The adaptive response of maximal aerobic power (VO2max) to endurance exercise
      training was compared in 53 men and 57 women, aged 60-71 yr. The subjects were
      healthy and had been sedentary for at least 2 yr. Pretraining VO2max was measured
      during graded treadmill walking on two occasions. These values were reproducible
      (24.4 +/- 4.7 vs. 24.4 +/- 4.6 (SD) ml.min-l.kg-1; r = 0.96). Subjects trained
      primarily by walking and running for 9-12 mo, averaging 3.9 +/- 0.6 days/wk and
      45 +/- 5 min/day at 80 +/- 5% of maximal heart rate (HRmax). Average improvement
      in VO2max (ml.min-1.kg-1) was 24 +/- 12% (range 0-58%). Relative improvement was
      not significantly different in men and women (26 +/- 12 vs. 23 +/- 12%, ml.min
      1.kg-1; 21 +/- 10 vs 19 +/- 10%, l/min). When subjects were divided into three
      groups by age (60-62, 63-66, 67-71 yr), there were no significant differences
      among the groups in the relative increase in VO2max (21% vs. 19% vs. 18%, 1/min).
      Correlation analysis also yielded a nonsignificant relationship between
      improvement and age (r = -0.13). To examine the effect of initial fitness level
      on the adaptive response to exercise, pretraining VO2max was correlated with the
      absolute improvement in VO2max. This relationship was not significant in either
      men (r = 0.04) or women (r = -0.23). In conclusion, in healthy people aged 60-71
      yr, VO2max adapts to endurance exercise training to the same relative extent as
      in young people, and this adaptation is independent of gender, age, and initial
      level of fitness.

PMID- 1761504
TI  - Analysis of responses to sarafotoxin 6a and sarafotoxin 6c in the pulmonary
      vascular bed of the cat.
AB  - Pulmonary vascular responses to sarafotoxins 6a and 6c (S6a and S6c) were
      investigated in the intact-chest cat under constant flow conditions. Injections
      of S6a and S6c into the perfused lobar artery caused dose-related increases in
      lobar arterial pressure, increased left atrial pressure, and produced biphasic
      changes in systemic arterial (aortic) pressure. When left atrial pressure was
      maintained constant, injections of S6a, S6c, and endothelin 1 (ET-1) caused dose
      related increases in lobar arterial pressure. The increases in lobar arterial
      pressure in response to S6a and S6c were not altered by treatment with a
      cyclooxygenase inhibitor or a thromboxane receptor blocking agent. Increases in
      lobar arterial pressure in response to S6a and S6c were not altered when airflow
      to the left lower lung lobe was interrupted by bronchial occlusion, and pressor
      responses were not diminished when the left lower lobe was perfused with low
      molecular-weight dextran. Under conditions of controlled blood flow and constant
      left atrial pressure, S6a, S6b, S6c, and ET-1 had similar pressor activity,
      whereas the thromboxane A2 mimic, U-46619, had far greater activity when compared
      on a nanomolar basis. The present studies demonstrate that S6a and S6c have
      significant vasoconstrictor activity in the feline pulmonary vascular bed. These
      data suggest that pulmonary vasoconstrictor responses to the endothelin peptides
      are not dependent on release of cyclooxygenase products and the activation of
      thromboxane A2 receptors, alterations in bronchomotor tone, or interaction with
      formed elements in blood.

PMID- 1761505
TI  - Multiple muscarinic receptor subtypes in the canine pulmonary circulation.
AB  - The vascular response to the muscarinic receptor agonist acetylcholine (ACh) in
      the presence of selected antagonists was examined in the isolated blood-perfused
      canine left lower lung lobe under conditions of normal (resting) and elevated
      vascular tone. At normal vascular tone, ACh (1-5 mumol) produced a dose-dependent
      increase in pulmonary arterial pressure (Ppa), total pulmonary vascular
      resistance (PVR), and downstream resistance (Rds) without altering upstream
      resistance (Rus). Pirenzepine (50 and 100 nM), the prototype M1-selective
      antagonist, and gallamine, an M2-selective antagonist, as well as atropine (50
      nM) and secoverine (100 nM), nonselective antagonists, attenuated (P less than
      0.05) the ACh-induced increase in Ppa and Rds. With elevated vascular tone
      induced by serotonin infusion, ACh produced a dose-dependent increase in Ppa in
      19 of 25 lobes, although Rus decreased while Rds increased in all lobes. At high
      vascular tone, pirenzepine or gallamine attenuated the ACh-induced increase in
      Rds, whereas Rus was not affected. Secoverine and atropine antagonized ACh
      induced increases in both Rds and Rus. The pA2 values (i.e., the negative log
      antagonist concentration requiring a doubling of ACh dose for an equivalent
      increase in Rds) for gallamine, pirenzepine, secoverine, and atropine were 6.1 +/
      0.1, 7.4 +/- 0.1, 8.3 +/- 0.2, and 10.2 +/- 0.3, respectively. These results
      suggest that 1) ACh increases PVR in the dog by constricting the venous segments
      (downstream) of the pulmonary circulation via activation of pulmonary vascular
      muscarinic receptors under conditions of both normal and elevated vascular tone,
      2) both M1- and non-M1-muscarinic receptor subtypes appear to participate in
      mediating the ACh-induced increase in Rds, and 3) ACh moderately relaxes the
      upstream (arterial) vessels, especially under conditions of elevated tone.

PMID- 1761506
TI  - Adequacy of a systems structure in the modeling of training effects on
      performance.
AB  - A systems model of training effects on performance was applied to eight initially
      untrained subjects who were volunteers for an endurance training program for the
      purpose of verifying the statistical adequacy of the systems structure. In the
      model initially proposed by T. W. Calvert, E. W. Banister, M. V. Savage, and T.
      Bach (IEEE Trans. Syst. Man Cybern. 6: 94-102, 1976), the performance changes
      were related to the successive training loads by three first-order transfer
      functions. In the present study, the number of first-order components was
      statistically tested. A model including only one component, which had a positive
      effect on the performance, provided a significant fit with the performances in
      every subject. A second component significantly improved the fit in only two
      subjects. This further component, which had a negative effect on performance, was
      identified as fatigue. Nevertheless, a two-antagonistic component model is
      proposed to provide a good representation of the training responses. However, the
      low level of exercise demands and the inaccuracy of the fit could have impaired
      the evidencing of a fatiguing effect during the presently studied training
      protocol.

PMID- 1761507
TI  - An algorithm for angiographic estimation of blood vessel diameter.
AB  - This study was carried out in an attempt to develop an objective and robust
      method for measuring changes in the diameters of small blood vessels from X-ray
      angiographic images. Recognizing potential problems with edge detection methods
      applied to cylindrical vessels in which the contrast diminishes as the boundary
      is approached, we have attempted to utilize the X-ray absorbance data across the
      entire cross section of the vessel. Then, assuming a cylindrical geometry, the
      absorbance data are fit to the cylindrical absorbance function by use of
      nonlinear regression analysis. The method was tested and calibrated using glass
      tubes filled with various concentrations of contrast medium. The diameters of
      small pulmonary arteries were estimated by applying the method of angiograms
      obtained from an isolated dog lung lobe. The structure of the residuals obtained
      after the fitting procedure was analyzed to test the appropriateness of the model
      for use with images of vessels. The results suggest that this approach will have
      utility for systematically quantifying vessel dimensions.

PMID- 1761508
TI  - Use of 13C substrates for metabolic studies in exercise: methodological
      considerations.

PMID- 1761509
TI  - Augmentation of prostaglandin E2 production by mammalian phospholipase A2 added
      exogenously.
AB  - Rat group II phospholipase A2 added exogenously to A23187-activated HL-60
      granulocytes augmented their production of prostaglandin E2. Human group II
      phospholipase A2 and porcine group I phospholipase A2 augmented the prostaglandin
      E2 production in a similar manner. No significant increase in prostaglandin E2
      production was observed when cells were treated with purified phospholipase A2 in
      the absence of A23187. Extracellular phospholipase A2 at inflamed sites may
      contribute to the generation of pro-inflammatory lipid mediators by hydrolyzing
      the cellular phospholipids of activated inflammatory cells.

PMID- 1761510
TI  - A continuous cell-free protein synthesis system for coupled transcription
      translation.
AB  - A continuous cell-free protein synthesis system [Spirin et al. (1988) Science
      242, 1162-1164] was modified so as to be suitable for coupled transcription
      translation, a process useful for obtaining products of cloned genes or cDNAs. A
      reaction chamber equipped with an ultrafiltration membrane was newly designed and
      an HPLC pump was used to supply a low molecular weight substrate solution at a
      constant rate to the viscous reaction mixture in the chamber. By using an
      Escherichia coli S30 extract in this modified flow system (1 ml), coupled
      transcription-translation could be continuously performed for 17 h, the
      synthesized chloramphenicol acetyltransferase (congruent to 0.1 mg) being
      subsequently eluted through the chamber's membrane and then purified.

PMID- 1761511
TI  - A resonance Raman study on a reaction intermediate of Pseudomonas L-phenylalanine
      oxidase (deaminating and decarboxylating).
AB  - Resonance Raman (RR) spectra of purple intermediates of L-phenylalanine oxidase
      (PAO) with non-labeled and isotopically labeled phenylalanines as substrates,
      i.e., [1-13C], [2-13C], [ring-U-13C6], and [15N]phenylalanines, were measured
      with excitation at 632.8 nm within the broad absorption band around 540 nm. The
      spectra obtained resemble those of purple intermediates of D-amino acid oxidase
      (DAO). The isotope effects on the 1,665 cm-1 band with [15N] or [2
      13C]phenylalanine indicate that the band is due to the C = N stretching mode of
      an imino acid derived from phenylalanine, i.e., alpha-imino-beta
      phenylpropionate. The intense band at 1,389 cm-1 is contributed to by the CO2-
      symmetric stretching and C-CO2- stretching modes of alpha-imino-beta
      phenylpropionate. The 1,602 cm-1 band, which does not shift upon isotopic
      substitution of phenylalanine, corresponds to the 1,605 cm-1 band of DAO purple
      intermediates and was assigned to a vibrational mode associated with the C(10a) =
      C(4a) - C(4) = O moiety of reduced flavin. These results confirm that PAO purple
      intermediates consist of the reduced enzyme and an imino acid derived from a
      substrate, and suggest that the plane defined by C(10a) = C(4a) - C(4) = O of
      reduced flavin and the plane containing H2+N = C - CO2- of an imino acid are
      arranged in close contact to each other, generating a charge-transfer
      interaction.

PMID- 1761512
TI  - Ornithine decarboxylase induction in partially hepatectomized rat liver and modes
      of its stimulation by glucagon and insulin.
AB  - Hepatic ornithine decarboxylase (ODC) activity increases after partial
      hepatectomy and this activity is further stimulated by pharmacologic doses of
      glucagon and insulin. We now present data suggesting that glucagon and insulin
      stimulate ODC activity by distinct mechanisms. ODC activity increased
      progressively after partial hepatectomy and reached an initial peak at 4 h.
      Activity decreased to 50% of its peak value at 6 and 8 h and then rose
      progressively to a maximum at 12 h. Enzymatic activity was well correlated with
      the amount of hepatic immunoreactive ODC protein, thus suggesting that increased
      enzyme activity was due to increased amount of enzyme protein. Hepatic ODC mRNA
      increased gradually and continuously, reaching the maximal value by 12 h. In rats
      receiving glucagon after partial hepatectomy, ODC mRNA increased significantly by
      2 h and enzyme immunoreactive protein and activity by 2 to 4 h as compared to
      controls. In contrast, insulin administration only induced a significant increase
      in enzyme immunoreactive protein and activity 10 to 12 h after partial
      hepatectomy. No significant changes in ODC mRNA level were observed. Our data
      suggest that the regulation mechanism of ODC induction following partial
      hepatectomy differs depending on the time after operation. Our data also suggest
      that while glucagon appears to regulate ODC activity by a transcriptional
      mechanism, insulin appears to operate at a post-transcriptional level.

PMID- 1761513
TI  - Multiple proteolytic action of rat liver cathepsin B: specificities and pH
      dependences of the endo- and exopeptidase activities.
AB  - Dipeptidylcarboxypeptidase, endopeptidase, and carboxypeptidase activities of rat
      liver cathepsin B were investigated using soluble denatured protein substrates,
      reduced and S-(3-trimethylammonio)propylated proteins and their derivatives. It
      was found that the soluble denatured proteins were degraded mainly by the
      dipeptidylcarboxypeptidase activity and in a few cases by the endopeptidase and
      carboxypeptidase activities. The eipeptidylcarboxypeptidase activity showed broad
      substrate specificity with broad pH optimum at 4-6. A peptide having the alpha
      carboxyl group amidated with methylamine could also be a good substrate for this
      activity. These results suggest that this activity is dependent not upon the
      dissociated alpha-carboxyl group at the P2' site but upon the hydrogen-bonding
      abilities of the alpha-imino moiety and the protonated or amidated alpha-carboxyl
      moiety at P2'. On the other hand, the endopeptidase and carboxypeptidase
      activities were observed in a few cases, suggesting that special amino acid
      sequences in the substrates are responsible for these activities. These
      activities showed sharp pH optima at 6 and seemed to prefer basic amino acid
      residues at P1 site. Therefore, we suppose that cathepsin B has a carboxyl group
      with a pKa of about 5.5 at the S1 subsite which more effectively interacts with a
      positive charge at the P1 site of the substrate at pH 6 than at pH 5. Based on
      these results, a model of the binding subsites of this enzyme is proposed.

PMID- 1761514
TI  - Composition of long chain bases in ceramide of the guinea pig Harderian gland.
AB  - Ceramide of the guinea pig Harderian gland was isolated and characterized. The
      purified ceramide gave two spots on thin-layer chromatography. Ceramide with the
      higher Rf value (NHCer) contained non-hydroxy fatty acids and that with the lower
      Rf value (HCer) contained 2-hydroxy fatty acids. The ratio of NHCer to HCer was
      6:1. The non-hydroxy fatty acids of NHCer were composed of straight-chain acids
      (94.9%) and branched-chain acids (5.1%). The 2-hydroxy fatty acids were also
      composed of straight-chain acids (94.2%) and branched-chain acids (5.8%). The
      ratio of straight-chain acids to branched-chain acids was similar in NHCer and
      HCer. The long chain bases of NHCer and HCer consisted of straight chain
      sphinganines and sphingenines, and methyl-branched long chain bases. In NHCer,
      59.9% of the total bases were methyl branched, and in HCer, 48.3%. The
      characteristics of ceramide, that is, the large amount of methyl-branched long
      chain bases and relatively small amount of methyl-branched fatty acids, are
      similar to those of cerebroside and sphingomyelin isolated from the same organ,
      although the ratios of constituents are different among these sphingolipids.

PMID- 1761515
TI  - Purification of hepatic N-hydroxyarylamine sulfotransferases and their regulation
      by growth hormone and thyroid hormone in rats.
AB  - From liver cytosols of male Sprague-Dawley rats, two N-hydroxyarylamine
      sulfotransferases (HASTs) which sulfate N-hydroxy-2-acetylaminofluorene and a
      phenolsulfotransferase (PST-I) have been purified about 290-, 690-, and 210-fold,
      respectively, by the use of DEAE-anion exchange, Blue-Sepharose CL-6B, DEAE-HPLC,
      and ATP-agarose affinity chromatography. All three enzymes showed almost the same
      molecular weight of 33 kDa on SDS-polyacrylamide gel electrophoresis. In Western
      blots using antibody raised against HAST I, the two HASTs, but not PST-I, were
      detected. The content of total HAST in male rats was estimated as 4-5
      micrograms/mg cytosolic protein, about 4 times higher than that in female rats.
      Direct comparison of the DEAE-HPLC elution profiles of cytosol showed that HAST I
      and HAST II were male-dominant and male-specific, respectively, in their
      expression in the livers. Hypophysectomy decreased the level of HAST by 60% in
      male rats, but had no obvious effect in female rats. Intermittent injection of
      growth hormone to mimic the male secretory pattern raised the content in
      hypophysectomized rats of both sexes close to that in intact male rats, while the
      continuous infusion of growth hormone to mimic the female secretory pattern
      showed limited effects. In addition, the administration of triiodothyronine
      stimulated HAST in hypophysectomized rats of both sexes, and the extent of
      stimulation was nearly the same as observed in the male-type growth hormone
      treatment. PST-I, in contrast to HAST, showed no clear sex-related difference in
      hepatic content, and was not apparently affected by growth hormone or
      triiodothyronine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761516
TI  - Xenobiotic responsive element in the 5'-upstream region of the human P-450c gene.
AB  - The nucleotide sequence of the 5'-upstream region up to about -4.1 kb of the
      human P-450c gene was determined. Two kinds of repetitive sequences were located;
      one was the Alu sequence which was inserted at three positions (-3127 to -3038, 
      3017 to -2770, and -2167 to -1851), and the other was the SINE-R element located
      just upstream of the most distal Alu sequences. The region other than the two
      repeated sequences showed an overall similarity of 70% to that of the rat P-450c
      gene. Survey of XRE or its homologues, responsible for the inducible expression
      of the rat P-450c gene, revealed eight XRE core sequences in this region of the
      human P-450c gene. Three of them were carried in the Alu sequences. A fusion gene
      which was constructed by ligating the upstream region of the human P-450c gene to
      the chloramphenicol acetyltransferase (CAT) gene expressed the CAT activity in
      response to the inducer, methylcholanthrene, when transfected into Hepa-1 cells.
      Stepwise decrease in CAT activity in three regions was observed as the 5'
      upstream sequence containing XRE motifs was removed. However, the XRE core
      sequence in the Alu sequences seemed inactive, because elimination of the three
      elements in the Alu sequences did not affect the expressed CAT activity. In
      accordance with this observation, competition experiments using gel mobility
      shift assay showed that XRE core sequences in the Alu sequences could not compete
      with the XRE sequence for the inducer-bound receptor.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1761517
TI  - The existence of galactosylceramide I3-sulfate in serums of various mammals and
      its anticoagulant activity.
AB  - Human, porcine, goat, sheep, bovine, horse, canine, rat, mouse, guinea pig, and
      chicken serums were investigated for the existence of sulfatide. Among the ten
      mammal serums, seven were found to be sulfatide positive, and the amounts of
      sulfatide were determined to be: 16.29 nmol/ml serum (porcine), 9.39 (bovine),
      12.71 (goat), 7.75 (horse), 1.21 (sheep), 0.64 (human), and 0.16 (dog). The
      existence of sulfatide in the serums of human, goat, sheep, cow, horse, and dog
      is here reported for the first time. It is suggested that sulfatide is widely
      distributed in the serums of various mammals except for rodents and that it takes
      part in the anticoagulant systems. The fatty acids of those sulfatides comprised
      mainly non-hydroxy fatty acids and a significant amount (18-53% of the total
      fatty acid) of hydroxy fatty acids with chain lengths of C16, C22, C23, and C24.
      The long chain bases comprised sphingenine, sphinganine, and 4-D
      hydroxysphinganine. Experiments to elucidate the mechanism of the anticoagulant
      activity of sulfatide revealed that it was specific to sulfatide and that the
      galactose-bound sulfate group is essential for this activity. The activity of
      clusters of sulfatide molecules was much more pronounced than that of single
      molecules.

PMID- 1761518
TI  - Ribulose bisphosphate-induced, slow conformational changes of spinach ribulose
      bisphosphate carboxylase cause the two types of inflections in the course of its
      carboxylase reaction.
AB  - The cause of the inflection in the course of the carboxylase reaction and the
      changes in the functioning form of spinach ribulose bisphosphate carboxylase
      (RuBisCO) during the reaction were elucidated by relating the activity to the
      protein conformation of RuBisCO using a fluorescence probe, 2-p
      toluidinylnaphthalene sulfonate. The activity of RuBisCO in the linear phase was
      50 to 60% of that in the initial burst at 0.5 to 1.0 mM ribulose bisphosphate
      (RuBP) and 65 to 80% at 2 to 5 mM RuBP. The amount and the progress of the
      decrease in the activity during the reaction had a close relationship to a change
      in the protein conformation of RuBisCO. The enzyme, the substrate binding sites
      of which were masked beforehand with carboxyarabinitol bisphosphate, still showed
      a change of its protein conformation upon addition of RuBP, suggesting that
      RuBisCO has two (substrate and regulatory) RuBP-binding sites per RuBisCO
      promoter. RuBisCO required over 2 mM RuBP for binding on the regulatory sites.
      Both sites also bound 6-phosphogluconate. When both sites were masked with 6
      phosphogluconate beforehand, the course of the subsequent carboxylase reaction
      was linear with time. From these results, I propose that the inflection in the
      course of the reaction of spinach RuBisCO is a hysteretic response of the enzyme
      to RuBP bound to both substrate and regulatory sites.

PMID- 1761519
TI  - Cooperative binding of carboxyarabinitol bisphosphate to the regulatory sites of
      ribulose bisphosphate carboxylase/oxygenase from spinach.
AB  - Ribulose bisphosphate carboxylase (RuBisCO) binds carboxyarabinitol bisphosphate
      (CABP) on its regulatory sites [Yokota, A. (1991) J. Biochem. 110, 246-252]. The
      characteristics of the equilibrium binding of CABP to the sites were examined by
      the gel-filtration method. Since RuBisCO binds CABP on the substrate sites with a
      dissociation constant of less than 10 pM, CABP bound exclusively to the substrate
      sites at less than 5 microM. Plotting the number of CABP bound to the sites other
      than the substrate sites against the concentration of CABP gave a typical "bumpy"
      curve; the binding number in the intermediate plateau at 20 to 40 microM CABP was
      3.7 to 4.4 mol per mol of RuBisCO and that at the saturating concentration of
      CABP was 7.6 to 7.8 mol per mol of RuBisCO. The Hill plot of their relationship
      gave a line which bent strongly at 20 to 40 microM CABP. The best fitting of the
      data to the equations derived from the binding model constructed according to the
      reported model [Teipel, J. & Koshland, D.E., Jr. (1969) Biochemistry 8, 4656
      4663] showed that the binding of CABP to the regulatory sites proceeded with
      positive cooperativity both before and after the plateau. The dissociation
      constant decreased from 31 to 14 microM by the factor of 1/1.3 in the former
      group and 490 to 0.7 microM by the factor of 1/8.9 in the latter with increasing
      binding number of CABP.

PMID- 1761520
TI  - Mechanisms of stimulation of collagen synthesis during chick embryonic skin
      development.
AB  - To study how collagen synthesis is regulated in developing chick embryonic skin,
      hydroxyproline synthesis, incorporation of proline, and translational activity
      and content of collagen mRNA in 12-, 15-, and 18-day skins were determined and
      compared with each other. Hydroxyproline synthesis in the 18-day skins was
      markedly increased over that in the 12-day skins, whereas proline incorporation
      was moderately increased. The increase in collagen synthesis from day 15 to 18
      was accompanied by increases in both the translational activity and the content
      of type I procollagen mRNA, with a selective increase in the lower-molecular
      weight species of pro alpha 1 (I) collagen mRNA. In contrast, the stimulation of
      collagen synthesis from day 12 to day 15 did not parallel the levels of type I
      procollagen mRNA. These results suggest that the stimulation of collagen
      synthesis is regulated by collagen mRNA levels only in the later stage of
      development (from day 15 to day 18). Both the collagen synthesis and type I
      procollagen mRNA levels in the fibroblasts isolated on each corresponding day
      were constant. The difference in collagen synthesis under two different culture
      conditions suggests that cell-matrix interaction and/or some serum factors,
      including several growth factors, are essential for the marked stimulation of
      collagen synthesis observed in 12- to 18-day skin.

PMID- 1761521
TI  - Identification of a cross-linked peptide of a covalent complex between
      adrenodoxin reductase and adrenodoxin.
AB  - A cross-linked complex between bovine NADPH-adrenodoxin reductase (AR) and
      adrenodoxin (AD) was prepared with 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide
      and purified, as described previously [Hara, T. & Kimura, T. (1989) J. Biochem.
      105, 594-600]. The covalent complex was S-pyridylethylated and digested with
      lysylendopeptidase, and the resulting peptides were separated by reversed-phase
      HPLC to identify the cross-linked peptide. Comparison of the HPLC chromatograms
      of the peptides showed that (i) two tandem peptides (K-4 and K-5) from AD and a
      peptide (K-1) from AR were missing in the chromatogram of the peptides of the
      covalent complex and (ii) a single new peak was observed in the chromatogram of
      the peptides from the covalent complex. Amino acid composition and sequence
      analyses showed that the newly observed peptide was a covalently cross-linked
      peptide formed between a peptide K-4-K-5 (Ile-25-Lys-98) derived from AD and a
      peptide K-1 (Ser-1-Lys-27) derived from AR, in which an amide bond had been
      formed between the epsilon-amino group of Lys-66 in AD and the gamma-carboxyl
      group of Glu-4 in AR. These results indicate that the binding site of AR with AD
      is localized in the amino-terminal part of AR and that of AD with AR is localized
      around Lys-66 of AD. The six clustered basic amino acid residues (His-24, Lys-27,
      His-28, His-29, Arg-31, and His-33) present in the amino-terminal portion of AR
      and the eight clustered acidic amino acid residues (Glu-65, Glu-68, Asp-72, Glu
      73, Glu-74, Asp-76, Asp-79, and Asp-86) present in the middle part of AD may play
      an important role in the complex formation.

PMID- 1761522
TI  - A GM1b-derived disialoganglioside GD1c is the predominant ganglioside of rat
      thymocytes.
AB  - The thin-layer chromatographic (TLC) pattern of gangliosides of rat thymocytes
      showed a profile characterized by the occurrence of a predominant ganglioside
      which did not correspond to any reference gangliosides of rat brain. The
      ganglioside was isolated from rat thymus, and characterized by compositional
      analysis, methylation analysis, sialidase treatment, negative-ion fast atom
      bombardment (FAB) mass spectrometry, and proton NMR spectroscopy. The structure
      was elucidated to be NeuGc alpha 2-8NeuGc alpha 2-3Gal beta 1-3GalNac beta 1-4Gal
      beta 1-4Glc beta 1-1Cer. This is the major ganglioside of rat thymus lymphoid
      cells and is one of the GM1b-derived gangliosides, GD1c, having two N
      glycolylneuraminic acids. This is the first report on the occurrence of GD1c in
      normal animal cells.

PMID- 1761523
TI  - Thermostable alanine racemase of Bacillus stearothermophilus: subunit
      dissociation and unfolding.
AB  - The guanidine hydrochloride-induced subunit dissociation and unfolding of
      thermostable alanine racemase from Bacillus stearothermophilus have been studied
      by circular dichroism, fluorescence and absorption spectroscopies, and gel
      filtration. The overall process was found to be reversible: more than 75% of the
      original activity was recovered upon reduction of the denaturant concentration.
      In the range of 0.6 to 1.5 M guanidine hydrochloride, the dimeric enzyme was
      dissociated into a monomeric form, which was catalytically inactive. The
      monomeric enzyme appeared to bind the cofactor pyridoxal phosphate by a non
      covalent linkage, although the native dimeric enzyme binds the cofactor through
      an aldimine Schiff base linkage. The monomer was mostly unfolded, with the
      transition occurring in the range of 1.8 to 2.2 M guanidine hydrochloride.

PMID- 1761524
TI  - Production and characterization of functional domains of human fibronectin
      expressed in Escherichia coli.
AB  - An efficient expression system was constructed in Escherichia coli that produced
      a 33-kDa fragment, C-274, of human fibronectin with a strong cell-adhesive
      activity. The entire sequence of the heparin-binding domain with 271 amino acids,
      H-271, was also expressed. Deletion analysis of the type III repeats showed that
      the heparin-binding site was at type III-13. The cell-adhesive activity of a
      fusion protein, CH-271, containing the cell- and the heparin-binding domains was
      twice that of C-274 when BHK but not B16-F10 melanoma cells were tested; H-271
      alone was inactive. Recombinant proteins containing the CS1 sequence of the IIICS
      region were more active than C-274 and CH-271 with B16-F10. However, H-296, which
      contained both H-271 and CS1, was almost inactive with BHK. CH-296, which
      contained CS1 at the C-terminus of CH-271, was more active with B16-F10 than H
      296 and C-CS1, which was produced by the deletion of H-271 from CH-296. Thus, the
      cell-binding domain was active with both kinds of cells. The heparin-binding
      domain promoted the adhesion of both kinds of cells only when linked to the cell
      binding domain or CS1. CS1 was specific for the adhesion of B16-F10 but was not
      essential.

PMID- 1761525
TI  - Site-specific 13C-labeling of Trp 62 in hen egg-white lysozyme: preparation and
      13C-NMR titration of [delta 1-13C]Trp 62-lysozyme.
AB  - The indole C-2(delta 1) carbon of Trp 62 in hen egg-white lysozyme was
      selectively labeled with 13C through a series of reactions involving N'
      formylkynurenine 62-lysozyme with K13CN, NaBH4-reduction, and acid-catalyzed
      dehydration. [delta 1-13C]Trp 62-lysozyme in which Trp 62 is labeled with 90% 13C
      has the same chemical and enzymatic properties as the native protein. The
      reverted lysozyme gave a single 13C-NMR signal at 125 ppm. pH-titration of the
      13C signal indicated a transition at pH 3.9 for the free enzyme. In the presence
      of (GlcNAc)3, the resonance signals were shifted 0.5-1 ppm upfield, and the
      transitions in the titration curve were observed at pH 3.9 and 6.5. Asp 52 and
      Glu 35 were assigned to the groups with pKas of 3.9 and 6.5, respectively. In [2
      13C]AHT 62-lysozyme, which has 3-(2-amino-3-hydroxy-3H-[2-13C]indol-3-yl)alanine
      (AHT) at position 62, AHT 62 behaved quite differently from Trp 62 on pH
      titration of the 13C-label. These results suggest that a conformational change
      around Trp 62 is induced upon ionization of the catalytic residue and that the
      structural flexibility of the side chain of this aromatic residue in the
      substrate binding site is closely related to the function of lysozyme.

PMID- 1761526
TI  - Localization of beta-actinin in the Z lines of chicken breast muscle, as detected
      with a monoclonal antibody specific to the beta I subunit (Cap Z alpha).
AB  - Immunofluorescence microscopy showed that a monoclonal antibody, 2F3, specific to
      the beta I subunit (Cap Z alpha) of beta-actinin (Cap Z) bound to the Z lines of
      chicken breast muscle. When myofibrils were briefly extracted with 0.6 M KI, the
      reactivity of the Z lines with 2F3 was very weak, but on subsequent treatment
      with purified beta-actinin, the antibody binding recovered. beta-Actinin
      inhibited elongation of the actin filaments of isolated I-Z-I brushes, myosin
      extracted sarcomeres, on the addition of G-actin. However, when an increased
      concentration of G-actin was added, the inhibitory action of beta-actinin became
      negligible, suggesting that beta-actinin did not cap the pointed end of an actin
      filament in a myofibril.

PMID- 1761527
TI  - Molecular structure of a yeast gene, PDI1, encoding protein disulfide isomerase
      that is essential for cell growth.
AB  - A genomic DNA clone for protein disulfide isomerase (PDI) of Saccharomyces
      cerevisiae was isolated by hybridization with synthesized oligonucleotide probes
      based on a partial amino acid sequence of yeast PDI. The introduction of a
      multiple copy plasmid carrying this fragment into yeast caused a tenfold increase
      in PDI specific activity and in the amount of PDI antigen in the extract. The
      gene on this fragment was named PDI1. The nucleotide sequence of the gene
      predicts a polypeptide of 522 amino acids with about 30% identity to mammalian
      PDIs. The predicted amino acid sequence contains an N-terminal signal peptide
      like sequence, the C-terminal putative endoplasmic reticulum retention signal of
      yeast (HDEL), and two putative active site sequences of PDI (WCGHCK). The
      predicted polypeptide is acidic and contains five putative glycosylation sites,
      consistent with the molecular properties of the purified yeast PDI [T. Mizunaga
      et al. (1990) J. Biochem. 108, 846-851]. The PDI1 gene was mapped on chromosome
      III. A gene disruption experiment revealed that the PDI1 gene is essential for
      cell growth.

PMID- 1761528
TI  - Biological role and regulation of the universally conserved heat shock proteins.

PMID- 1761529
TI  - Interferon induces tryptophanyl-tRNA synthetase expression in human fibroblasts.
AB  - A cDNA clone complementary to an interferon (IFN)-induced mRNA was isolated and
      used to characterize the regulation of expression of its RNA by the IFNs and to
      identify the protein its RNA encodes. This cDNA hybridizes to IFN-induced 3.1-
      and 2.3-kilobase mRNAs that are synthesized in response to both IFN-alpha and IFN
      gamma. IFN-gamma induces the sustained accumulation of these mRNAs while IFN
      alpha induces their transient accumulation. Cycloheximide (50 micrograms/ml)
      failed to inhibit the induction of these mRNAs by either IFN-alpha or IFN-gamma,
      suggesting that their induction does not require de novo protein synthesis. DNA
      sequence analysis of this cDNA reveals that it encodes a protein of Mr 53,168
      that has sequence homology with and the biological activity of a tryptophanyl
      tRNA synthetase, an enzymatic activity that has been demonstrated to play a role
      in and be modulated by the growth of cells. Elevated levels of this enzyme may be
      involved in the cell growth inhibitory activity of the IFNs.

PMID- 1761530
TI  - Cell attachment activity of the carboxyl-terminal domain of human thrombospondin
      expressed in Escherichia coli.
AB  - Thrombospondin (TS) is a multidomain, adhesive glycoprotein that associates with
      cells through multiple cell attachment sites. One of these has been located in or
      near the globular COOH-terminal region of TS by the monoclonal antibody (mAb)
      C6.7, which inhibits the attachment of human melanoma cells (G361) to TS. The
      epitope for C6.7 lies within the last 122 residues of the COOH-terminal domain of
      TS. This domain is distant from two known cell attachment sites in TS, namely the
      NH2-terminal heparin-binding domain and the CSVTCG sequences in the type I
      repeats, but is close to the RGDA sequence, an integrin-dependent cell attachment
      site. In order to separate the adhesive activity of the TS COOH-terminal domain
      from that of the RGD sequence, we have expressed the COOH-terminal 212 amino
      acids (residues 941-1152) of TS in Escherichia coli using the expression vector
      pRIT2T. The resultant fusion protein is effective in supporting G361 cell
      attachment even though it lacks the RGD sequence. In addition, the expressed
      protein inhibits adhesion of G361 cells to intact TS. mAb C6.7 blocks adhesion to
      the expressed TS COOH-terminal domain whereas GRGDSP and VTCG peptides are not
      inhibitory. These results show that the TS COOH-terminal domain contains a
      separate cell adhesion site, defined by mAb C6.7, that is distinct from the other
      adhesion sites of TS.

PMID- 1761531
TI  - Chitin utilization by marine bacteria. A physiological function for bacterial
      adhesion to immobilized carbohydrates.
AB  - Chitin turnover is essential for recycling carbon and nitrogen in marine
      ecosystems. A key step in this process is the adhesion of marine bacteria to
      chitin-containing particulates. Vibrio species were therefore surveyed for their
      ability to bind to immobilized carbohydrates, and one, Vibrio furnissii, adhered
      to glycosides of three sugars, N-acetylglucosamine (the preferred ligand), D
      mannose, and D-glucose. A single Ca(2+)-requiring lectin is responsible for
      binding to the three sugars. Cells adhering to the chitin analogue divided at the
      same rate as cells in liquid culture. The first progeny of adherent cells
      continued to bind to the beads, but the population gradually shifted to a large
      fraction of free swimming cells, a process that may be necessary for
      colonization. Metabolic energy is required for cell adhesion to the glycosides,
      and transient (or no) adhesion occurred in incomplete growth media. The results
      were explained by studying met and pro mutants. Both the initiation and
      maintenance of lectin-mediated adhesion requires continuous protein synthesis;
      expression of lectin activity is a major priority of these cells and functions
      under conditions adequate for minimal protein synthesis, but insufficient to
      support cell growth. The adhesion/deadhesion apparatus is apparently used to
      continuously monitor the nutrient status of the environment, i.e. as a nutrient
      sensorium. In incomplete medium, cells deadhere, presumably to migrate to a more
      favorable environment.

PMID- 1761532
TI  - Chitin utilization by marine bacteria. Chemotaxis to chitin oligosaccharides by
      Vibrio furnissii.
AB  - The adhesion/deadhesion apparatus of the marine bacterium Vibrio furnissii (Yu,
      C., Lee, A., Bassler, B. L., and Roseman, S. (1991) J. Biol. Chem. 266, 24260
      24267) probably catalyzes the first step in colonizing chitin. Evidence is
      presented here for a second step, chemotaxis to chitin hydrolysis products. V.
      furnissii swarms toward chitin oligomers (GlcNAc)n, n = 1-6, at initial
      concentrations as low as 10 microM. A modified capillary assay was used for
      quantitation; the cells exhibit low level constitutive taxis to GlcNAc but not to
      the oligosaccharides. A mutant defective in the GlcNAc receptor (IINag of the
      phosphotransferase system) showed inducible taxis to the oligosaccharides. Two
      (or more) independently inducible receptors with overlapping specificities
      recognize (GlcNAc)n, n = 2-4. (GlcNAc)5 and (GlcNAc)6 were inactive in the
      capillary assay; expression of this receptor(s) apparently require special
      induction conditions. The (GlcNAc)n, n = 1-4, chemoreceptors of V. furnissii may
      be the most potent reported for bacteria. L-Amino acids were weak, constitutive
      attractants; glutamine, not known to be an attractant in other bacteria, was the
      most effective amino acid. The most potent receptor in Escherichia coli, Tar
      (aspartate), is not expressed in V. furnissii. The chemotactic responses were
      greatly affected by growth and induction conditions and the presence of nutrients
      in the assay media. Taxis to GlcNAc and GlcNAc oligomers was optimally induced by
      growth in lactate medium containing 0.6 mM sugar, while growth on the sugar per
      se resulted in poor taxis. Chemotaxis to the sugars increased 2- to 3-fold when
      the cells were starved. Nutrients in the assay medium, especially compounds that
      feed into or are part of the Krebs cycle, were potent inhibitors of taxis to the
      sugars and Gln. With the exception of isocitrate, inhibition of taxis correlated
      with the rate of oxidation of these compounds. The results suggest a link between
      catabolism and taxis in this organism, i.e. interactions or "cross-talk" between
      systems that are regulated by protein phosphorylation (Stock, J. A., Ninfa, A.
      J., and Stock, A. M. (1989) Microbiol. Rev. 53, 450-490).

PMID- 1761533
TI  - Chitin utilization by marine bacteria. Degradation and catabolism of chitin
      oligosaccharides by Vibrio furnissii.
AB  - Chemotaxis of the marine bacterium Vibrio furnissii to chitin oligosaccharides
      has been described (Bassler, B. L., Gibbons, P. J., Yu, C., and Roseman, S.
      (1991) J. Biol. Chem. 266, 24268-24275). Some steps in catabolism of the
      oligosaccharides are reported here. GlcNAc, (GlcNAc)2, and (GlcNAc)3 are very
      rapidly consumed by intact cells, about 320 nmol of GlcNAc equivalents/min/mg of
      protein. (GlcNAc)4 is utilized somewhat more slowly. During these processes,
      there is virtually no release of hydrolysis products by the cells. The
      oligosaccharides enter the periplasmic space (via specific porins?) and are
      hydrolyzed by a unique membrane-bound endoenzyme (chitodextrinase) and an
      exoenzyme (N-acetyl-beta-glucosaminidase; beta-Glc-NAcidase). The genes encoding
      these enzymes have been cloned and expressed in Escherichia coli. The
      chitodextrinase cleaves soluble oligomers, but not chitin, to the di- and
      trisaccharides, while the periplasmic beta-GlcNAcidase hydrolyzes the GlcNAc
      termini from the oligomers. The end products in the periplasm, GlcNAc and
      (GlcNAc)2 (possibly (GlcNAc)3) are catabolized as follows. (a) Disaccharide
      pathway, A (GlcNAc)2 permease is apparently expressed by Vibrio furnissii.
      Translocated (GlcNAc)2 is rapidly hydrolyzed by a soluble, cytosolic beta
      GlcNAcidase, and the GlcNAc is phosphorylated by an ATP-dependent, constitutive
      kinase to GlcNAc-6-P. (b) Monosaccharide pathway, Periplasmic GlcNAc is taken up
      by Enzyme IINag of the phosphoenolpyruvate:glycose phosphotransferase system,
      yielding GlcNAc-6-P, the common intermediate for both pathways. Finally, GlcNAc-6
      P----Ac- + GlcNH2-6-P----Fru-6-P + NH3. (GlcNAc)2 is probably the "true" inducer
      of the chitin degradative enzymes described in this report and, depending on its
      concentration in the growth medium, differentially induces the periplasmic and
      cytosolic beta-GlcNAcidases. The disaccharide pathway appears to be the most
      important when the cells are confronted with low concentrations of the oligomers
      (e.g. in chemotaxis swarm plates). The relative activities of the induced enzymes
      suggest that the rate-limiting steps in oligosaccharide catabolism are the
      glycosidase activities in the periplasm.

PMID- 1761534
TI  - Proline residues responsible for thermostability occur with high frequency in the
      loop regions of an extremely thermostable oligo-1,6-glucosidase from Bacillus
      thermoglucosidasius KP1006.
AB  - The gene encoding for an extremely thermostable oligo-1,6-glucosidase from
      Bacillus thermoglucosidasius KP1006 (DSM2542, obligate thermophile) was
      sequenced. The amino acid sequence deduced from the nucleotide sequence of the
      gene (1686 base pairs) corresponded to a protein of 562 amino acid residues with
      a Mr of 66,502. Its predicted amino acid composition, Mr, and N-terminal sequence
      of 12 residues were consistent with those determined for B. thermoglucosidasius
      oligo-1,6-glucosidase. The deduced sequence of the enzyme was 72% homologous to
      that of a thermolabile oligo-1,6-glucosidase (558 residues) from Bacillus cereus
      ATCC7064 (mesophile). B. cereus oligo-1,6-glucosidase contained 19 prolines.
      Eighteen of these were conserved at the equivalent positions of B.
      thermoglucosidasius oligo-1,6-glucosidase. This enzyme contained 14 extra
      prolines besides the conservative prolines. The majority of extra prolines was
      replaced by polar or charged residues (Glu, Thr, or Lys) in B. cereus oligo-1,6
      glucosidase. The extra prolines were responsible for the difference in
      thermostability between these two enzymes. We suggested that 11 of the extra
      prolines in B. thermoglucosidasius oligo-1,6-glucosidase occur in beta-turns or
      in coils within the loops binding adjacent secondary structures.

PMID- 1761535
TI  - Identification of the essential cysteine residue in Klebsiella aerogenes urease.
AB  - During reaction with [14C]iodoacetamide at pH 6.3, radioactivity was incorporated
      primarily into a single Klebsiella aerogenes urease peptide concomitant with
      activity loss. This peptide was protected from modification at pH 6.3 by
      inclusion of phosphate, a competitive inhibitor of urease, which also protected
      the enzyme from inactivation. At pH 8.5, several peptides were alkylated;
      however, modification of one peptide, identical to that modified at pH 6.3,
      paralleled activity loss. The N-terminal amino acid sequence and composition of
      the peptide containing the essential thiol was determined. Previous enzyme
      inactivation studies of K. aerogenes urease could not distinguish whether one or
      two essential thiols were present per active site (Todd, M. J., and Hausinger, R.
      P. (1991) J. Biol. Chem. 266, 10260-10267); we conclude that there is a single
      essential thiol present and identify this residue as Cys319 in the large subunit
      of the heteropolymeric enzyme.

PMID- 1761536
TI  - Effects of MgATP, MgADP, and Pi on actin movement by smooth muscle myosin.
AB  - To test the idea that the in vitro motility assay is a simplified model system
      for muscle contraction, the MgATP-dependent movement of actin filaments by
      thiophosphorylated smooth muscle myosin was characterized in the presence of the
      products MgADP and inorganic phosphate. The dependence of actin filament velocity
      on MgATP concentration was hyperbolic with a maximum velocity of 0.6 micron/s and
      an apparent Km = 40 microM (30 degrees C). MgADP competitively inhibited actin
      movement by MgATP with a Ki = 0.25 mM. Inorganic phosphate did not affect actin
      filament velocity in the presence of 1 mM MgATP, but competitively inhibited
      movement in the presence of 50 microM MgATP with a Ki = 9.5 mM. The effects of
      ADP and Pi on velocity agree with fiber mechanical studies, confirming that the
      motility assay is an excellent system to investigate the molecular mechanisms of
      force generation and shortening in smooth muscle. The rate at which rigor cross
      bridges can be recruited to move actin filaments was observed by initiating cross
      bridge cycling from rigor by flash photolysis of caged MgATP. Following the
      flash, which results in a rapid increase in MgATP concentration, actin filaments
      experienced a MgATP-dependent delay prior to achieving steady state velocity. The
      delay at low MgATP concentrations was interpreted as evidence that motion
      generating cross-bridges are slowed by a load due to a transiently high
      percentage of rigor cross-bridges immediately following MgATP release.

PMID- 1761537
TI  - Thermodynamics of the binding of galactopyranoside derivatives to the basic
      lectin from winged bean (Psophocarpus tetrogonolobus).
AB  - The thermodynamics of the binding of D-galactopyranoside (Gal), 2-acetamido-2
      deoxygalactopyranoside (GalNAc), methyl-alpha-D-galactopyranoside, and methyl
      beta-D-galactopyranoside to the basic agglutinin from winged bean (WBAI) in 0.02
      M sodium phosphate and 0.15 M sodium chloride buffer have been investigated from
      298.15 to 333.15 K by titration calorimetry and at the denaturation temperature
      by differential scanning calorimetry (DSC). WBAI is a dimer with two binding
      sites. The titration calorimetry yielded single-site binding constants ranging
      from 0.56 +/- 0.14 x 10(3) M-1 for Gal at 323.15 K to 7.2 +/- 0.5 x 10(3) M-1 for
      GalNAc at 298.15 K and binding enthalpies ranging from -28.0 +/- 2.0 kJ mol-1 for
      GalNAc at 298.15 K to -14.3 +/- 0.1 kJ mol-1 for methyl-beta-D-galactopyranoside
      at 322.65 K. The denaturation transition consisted of two overlapping peaks over
      the pH range 5.6-7.4. Fits of the differential scanning calorimetry data to a two
      state transition model showed that the low temperature transition (341.6 +/- 0.4
      K at pH 7.4) consisted of two domains unfolding as a single entity while the
      higher temperature transition (347.8 +/- 0.6 K at pH 7.4) is of the remaining
      WBAI dimer unfolding into two monomers. Both transitions shift to higher
      temperatures and higher calorimetric enthalpies with increase in added ligand
      concentration at pH 7.4. Analysis of the temperature increase as a function of
      added ligand concentration suggests that one ligand binds to the two domains
      unfolding at 341.6 +/- 0.6 K and one ligand binds to the domain unfolding at
      347.8 +/- 0.6 K.

PMID- 1761538
TI  - Kinetic studies of human immunodeficiency virus type 1 protease and its active
      site hydrogen bond mutant A28S.
AB  - Human immunodeficiency virus type 1 (HIV-1) protease optimally catalyzes in the
      pH range of 4-6 in contrast to nearly all of the other eukaryotic aspartic
      proteases, which catalyze best in the pH range of 2-4. A possible structural
      reason for the higher optimal pH of HIV-1 protease is the absence of a hydrogen
      bond to the carboxyl group of active-site Asp25, which is nearly universally
      present in others. To investigate this hypothesis, we have mutated residue 28 in
      HIV-1 protease from alanine to serine. Both the wild-type and the mutant A28S
      enzymes have been overexpressed in Escherichia coli using a chemically
      synthesized gene and purified for a comparative study in enzyme kinetics. The
      kcat and Km values were determined by a radiometric assay for the wild-type
      enzyme from pH 3.2 to 7.0, and for the mutant enzyme from pH 3.2 to 6.0. The low
      pK values of the active site of the free enzyme, pKe1, are 3.3 and 3.4 for the
      wild-type and mutant enzymes, respectively. The low pK values of the active site
      of the enzyme bound to substrate, pKes1, are 5.1 and 4.3 for the wild-type and
      mutant enzymes, respectively. The high pK values of the free enzyme, pKe2, are
      6.8 and 5.6, and the corresponding ones for the substrate-bound enzyme, pKes2,
      are 6.9 and 6.0 for the wild-type and mutant enzymes, respectively. The lowering
      of pK values in mutant HIV-1 protease indicates that the hydroxyl group of Ser28
      forms a new hydrogen bond to active-site Asp25 to increase its acidity.

PMID- 1761539
TI  - A nucleolar 2'-O-methyltransferase. Specificity and evidence for its role in the
      methylation of mouse 28 S precursor ribosomal RNA.
AB  - Methylation of ribose moieties appears to be an essential post-transcriptional
      event in ribosomal RNA maturation. Although the sites of ribose methylation have
      been identified, the components involved in the 2'-O-methylation of precursor
      ribosomal RNA in mammalian cells have not yet been elucidated. To investigate the
      involvement of a recently isolated nucleolar 2'-O-methyltransferase in this
      process, an in vitro synthesized 28 S rRNA transcript containing a unique tandem
      triple 2'-O-methylated ribose site was used as a substrate. Activity assays
      demonstrated that this transcript served as a substrate for the nucleolar 2'-O
      methyltransferase. The distribution of incorporated methyl groups was determined
      by hydrolyzing the 2'-O-methylated transcript with RNase followed by
      chromatography of the digested products on an anion-exchange high performance
      liquid chromatography column. Results showed one unique RNase-resistant 2'-O
      methylated product, a tetramer. The position of the tetrameric sequence in the 28
      S rRNA transcript was determined using RNase protection analysis which mapped the
      methylations to a 20-nucleotide region spanning the unique tandem triple 2'-O
      methylated ribose site in 28 S rRNA. To confirm the absolute specificity of
      methylation, direct sequence analysis was carried out on the tandem triple 2'-O
      methylated tetramer. The sequence determined for the tetramer, AmGmCmA,
      corresponded exactly with that reported from in vivo studies. These findings
      demonstrate that the purified nucleolar 2'-O-methyltransferase can accurately
      methylate at a specific site of an in vitro derived preribosomal RNA transcript
      and support the proposed involvement of this nucleolar enzyme in ribosomal RNA
      maturation.

PMID- 1761540
TI  - Mutation of invariant cysteines of mammalian metallothionein alters metal binding
      capacity, cadmium resistance, and 113Cd NMR spectrum.
AB  - Using a yeast expression vector system, we have expressed both wild type and six
      mutated Chinese hamster metallothionein coding sequences in a metal-sensitive
      yeast strain in which the endogenous metallothionein gene has been deleted. The
      mutant proteins have single or double cysteine to tyrosine replacements (C13Y,
      C50Y, and C13,50Y), single cysteine to serine replacements (C13S and C50S), or a
      single cysteine to alanine replacement (C50A). These proteins function in their
      yeast host in cadmium detoxification to differing extents. Metallothioneins which
      contain a cysteine mutation at position 50 (C50Y, C50S, C50A, and C13,50Y)
      conferred markedly less cadmium resistance than wild type metallothionein, or
      metallothionein with a single cysteine mutation at position 13 (C13Y and C13S).
      Wild type and three of the mutant Chinese hamster metallothioneins (C13Y, C50Y,
      and C13,50Y) were purified from yeast grown in subtoxic levels of either CdCl2 or
      113CdCl2. All three of the mutant proteins bound less cadmium than the wild type
      protein when metal-binding stoichiometries were determined. The one-dimensional
      113Cd NMR spectrum of the recombinant wild type Chinese hamster metallothionein
      was compared to the spectra of native rat and rabbit liver metallothioneins. The
      close correspondence between the 113Cd chemical shifts in these metallothioneins
      is consistent with the presence of two separate metal clusters, A and B,
      corresponding, respectively, to the alpha- and beta-domains, in the recombinant
      metallothionein. The one-dimensional 113Cd NMR spectra recorded on each of the
      three mutant metallothioneins, on the other hand, provide some indication as to
      the structural basis for the reduced, by one, metal stoichiometry of each of the
      mutant metallothioneins. For the C13Y mutant, it appears that the beta-domain now
      binds a total of two metal ions whereas with the C50Y mutant, the alpha-domain
      appears metal-deficient. For the double mutant, C13,50Y, the 113Cd resonances are
      indicative of major structural reorganizations in both domains.

PMID- 1761541
TI  - Differential regulation of antioxidant enzymes in response to oxidants.
AB  - We have demonstrated the selective induction of manganese superoxide dismutase
      (MnSOD) or catalase mRNA after exposure of tracheobronchial epithelial cells in
      vitro to different oxidant stresses. Addition of H2O2 caused a dose-dependent
      increase in catalase mRNA in both exponentially growing and confluent cells. A 3
      fold induction of catalase mRNA was seen at a nontoxic dose of 250 microM H2O2.
      Increase in the steady-state mRNA levels of glutathione peroxidase (GPX) and
      MnSOD were less striking. Expression of catalase, MnSOD, and GPX mRNA was highest
      in confluent cells. In contrast, constitutive expression of copper and zinc SOD
      (CuZnSOD) mRNA was greatest in dividing cells and was unaffected by H2O2 in both
      exponentially growing and confluent cells. MnSOD mRNA was selectively induced in
      confluent epithelial cells exposed to the reactive oxygen species-generating
      system, xanthine/xanthine oxidase, while steady-state levels of GPX, catalase,
      and CuZnSOD mRNA remained unchanged. The 3-fold induction of MnSOD mRNA was dose
      dependent, reaching a peak at 0.2 unit/ml xanthine oxidase. MnSOD mRNA increases
      were seen as early as 2 h and reached maximal induction at 24 h. Immunoreactive
      MnSOD protein was produced in a corresponding dose- and time-dependent manner.
      Induction of MnSOD gene expression was prevented by addition of actinomycin D and
      cycloheximide. These data indicate that epithelial cells of the respiratory tract
      respond to different oxidant insults by selective induction of certain
      antioxidant enzymes. Hence, gene expression of antioxidant enzymes does not
      appear to be coordinately regulated in these cell types.

PMID- 1761542
TI  - Alteration of the binding specificity of cellular retinol-binding protein II by
      site-directed mutagenesis.
AB  - Rat cellular retinol-binding protein II (CRBP II) is an abundant 134-residue
      intestinal protein that binds all-trans-retinol and all-trans-retinal. It belongs
      to a family of homologous, 15-kDa cytoplasmic proteins that bind hydrophobic
      ligands in a noncovalent fashion. These binding proteins include a number of
      proteins that bind long chain fatty acids. X-ray analyses of the structure of two
      family members, rat intestinal fatty acid-binding protein and bovine myelin P2
      protein, indicate that they have a high degree of conformational similarity and
      that the carboxylate group of their bound fatty acid interacts with a delta
      guanidium group of at least 1 of 2 "buried" arginine residues. These 2 Arg
      residues are conserved in other family members that bind long chain fatty acids
      and in cellular retinoic acid-binding protein, but are replaced by Gln109 and
      Gln129 in CRBP II. We have genetically engineered two amino acid substitutions in
      CRBP II: 1) Gln109 to Arg and 2) Gln129 to Arg. The purified Escherichia coli
      derived CRBP II mutant proteins were analyzed by fluorescence and nuclear
      magnetic resonance spectroscopy. Both mutants exhibit markedly decreased binding
      of all-trans-retinol and all-trans-retinaldehyde, but no increased binding of all
      trans-retinoic acid. Arg substitution for Gln109 but not for Gln129 produces a
      dramatic increase in palmitate binding activity. Analysis of the endogenous fatty
      acids associated with the purified E. coli-derived proteins revealed that E. coli
      derived intestinal fatty acid binding protein and the Arg109 CRBP II mutant are
      complexed with endogenous fatty acids in a qualitatively and quantitatively
      similar manner. These results provide evidence that this internal Arg may play an
      important role in the binding of long chain fatty acids by members of this
      protein family.

PMID- 1761543
TI  - N-acylation of Aplysia egg-laying hormone with biotin. Characterization of
      bioactive and inactive derivatives.
AB  - Chemical modification of the egg-laying hormone (ELH) of Aplysia by reaction with
      the N-hydroxysuccinimide ester of biotin, which contained 6-aminohexanoic acid as
      spacer, yielded seven distinct derivatives that were readily separated by
      reversed-phase high performance liquid chromatography. The derivatives were
      chemically characterized by amino acid compositional analysis, sequence analysis,
      and mass spectrometry. The seven derivatives resulted from combinations of
      differential modification of the three amino groups in the ELH molecule located
      at Ile1 (alpha-NH2), Lys8, and Lys36. Of the seven derivatives formed, only one,
      monobiotinyl Lys36-ELH, was biologically active in eliciting egg-laying activity
      and altering the electrophysiological activity of the abdominal ganglion neuron
      R15 and LB and LC cluster neurons. In addition, evaluation of the time course of
      biotinylation of ELH revealed that the relative rate of amino group reactivity
      was epsilon-NH2-Lys36 greater than epsilon-NH2-Lys8 much greater than alpha-NH2
      Ile1. The slow rate of reaction of the terminal alpha-amino group suggested that
      it was relatively inaccessible to biotinylation, possibly due to conformational
      factors or to ion-pair formation with an unidentified carboxyl group. Loss of
      bioactivity of ELH monobiotinylated on the alpha-amino group, coupled with the
      unusually low reactivity of the alpha-amino group, provided strong evidence for
      the importance of the alpha-amino group in ELH function. Furthermore, the
      development and availability of a bioactive ELH probe should greatly facilitate
      the isolation, characterization, and localization of the ELH receptor.

PMID- 1761544
TI  - The 5'-flanking region of the human CGL-1/granzyme B gene targets expression of a
      reporter gene to activated T-lymphocytes in transgenic mice.
AB  - The human CSP-B/CGL-1 gene is the homologue of the mouse granzyme B/CCPI gene and
      encodes a cytotoxic T-lymphocyte-specific serine protease. We have used
      regulatory sequences upstream from the CSP-B gene to drive human growth hormone
      gene expression in transgenic mice. Eleven founder mice were screened for
      transgene expression in activated T-cells. Expression was detected in 10 mice;
      levels of expression were integration site-dependent. The transgene was not
      expressed in resting lymphocytes but could be activated by treatment with
      concanavalin A or interleukin-2, indicating that CSP-B regulatory sequences are
      responsive to signals originating at either the T-cell receptor or the
      interleukin-2 receptor. Transgene expression was detected at the whole organ
      level only in lymph nodes and small intestine, where endogenous mouse CCPI mRNA
      was also present. The time course of transgene activation in T-lymphocytes was
      similar to that of the mouse CCPI gene. No differences in levels of expression of
      the transgene were observed in activated lymphocyte populations that had been
      depleted of either CD4+ or CD8+ cells; in contrast, the mouse CCPI gene was
      expressed primarily in CD8+ cells. Six CD4+ T-cell clones with Th0, Th1, or Th2
      phenotypes were generated from a transgenic animal. All clones expressed moderate
      to high levels of the transgene, but only three clones expressed mouse CCPI,
      indicating that the transgene is disregulated in CD4+ T-cell subsets. The CSP-B
      regulatory unit represents a novel reagent for targeting gene expression to
      activated T-lymphocytes.

PMID- 1761545
TI  - Increase in eukaryotic initiation factor 2B activity following fertilization
      reflects changes in redox potential.
AB  - One of the factors involved in the postfertilization activation of protein
      synthesis in the sea urchin, Strongylocentrotus purpuratus, is the activation of
      eIF-2B, the initiation factor responsible for guanine nucleotide exchange on eIF
      2. Cell-free translation systems from unfertilized eggs are stimulated by added
      eIF-2B, although this dependency is rapidly lost in translation systems prepared
      at various times following fertilization. Cell-free translation systems prepared
      from unfertilized eggs show significantly lower eIF-2B activities than those
      prepared from 2-h embryos. However, the provision of an NADPH regeneration system
      significantly stimulates eIF-2B activity in egg extracts and, in addition,
      stimulates both binding of initiator tRNA to the small ribosomal subunit and
      protein synthetic activity. These data suggest that the activation of eIF-2B
      following fertilization reflects the fertilization-induced increase in NADPH
      levels.

PMID- 1761546
TI  - Regulation of the human ApoA-II gene by the synergistic action of factors binding
      to the proximal and distal regulatory elements.
AB  - We have recently shown that the human apoA-II promoter contains a set of 11
      distal regulatory elements between nucleotides -903 and -255 and three proximal
      regulatory elements between nucleotides -126 and -33 that are essential for
      hepatic and intestinal transcription of the apoA-II gene (Chambaz, J., Cardot,
      P., Pastier, D., Zannis, V. I., and Cladaras, C. (1991) J. Biol. Chem. 266, 11676
      11685). Deletion or nucleotide substitution analysis has shown that alterations
      in elements L (nucleotides -803 to -773) and K (nucleotides -760 to -743) reduced
      hepatic transcription to 25 and 20% and intestinal transcription to 8 and 4% of
      control, respectively, as measured by chloramphenicol acetyltransferase assays,
      indicating that these elements play an important regulatory role. Nucleotide
      substitutions in element AB (nucleotides -65 to -33) reduced hepatic and
      intestinal transcription to 60 and 36% of control, respectively. The factors that
      recognize regulatory regions L, K, and AB were analyzed by DNA binding gel
      electrophoretic and competition assays. This analysis has shown that elements AB,
      K, and L bind with different affinities to a newly characterized heat-stable
      factor, CIIIB1, which is a transcriptional activator of the human apoC-III gene
      (Ogami, K., Kardassis, D., Cladaras, C., and Zannis, V. I. (1991) J. Biol. Chem.
      266, 9640-9646). In addition, elements AB and K bind a heat-labile activity,
      designated AIIAB1, and element L binds to several CCAAT box binding activities.
      Mutations in domain L that prevented the binding of CCAAT box binding activities
      reduced both hepatic and intestinal transcription to 30% of control, indicating
      the importance of these factors in transcription. Simultaneous nucleotide
      substitutions that prevented the binding of CIIIB1 activity in elements AB, K,
      and L reduced hepatic and intestinal transcription to 7 and 6% of control,
      respectively, suggesting that the synergistic interaction of CIIIB1 (bound to the
      proximal and distal regulatory elements) with CCAAT box proteins (bound to
      element L) can modulate the level of transcription of the human apoA-II gene.

PMID- 1761547
TI  - Variants of a Leishmania surface antigen derived from a multigenic family.
AB  - The promastigote surface antigen-2 (PSA-2) complex comprises a group of
      immunogenic surface antigens linked to the surface of the Leishmania major
      promastigote with glycosylphosphatidylinositol anchors. The L. major genome
      contains at least 14 PSA-2 genes on a 950-kilobase chromosome and comprising
      approximately 20% of the length of this chromosome. The sequence of three
      independent, but incomplete, PSA-2 cDNAs and one genomic fragment encoding a
      complete PSA-2 coding sequence were compared. PSA-2 genes encode polypeptides
      exhibiting 22-25aa tandem repeat elements, threonine-rich segments which vary
      between genes, a conserved COOH-terminal cysteine-rich region, and a conserved
      GPI anchor signal sequence. PSA-2 genes appear to be transcribed in a complex
      manner with multiple RNAs. The complex genomic organization of PSA-2 genes is
      present in other members of the genus suggesting that PSA-2 function is important
      for the biology of Leishmania.

PMID- 1761548
TI  - Characterization of cross-linking of cell walls of Bacillus subtilis by a
      combination of magic-angle spinning NMR and gas chromatography-mass spectrometry
      of both intact and hydrolyzed 13C- and 15N-labeled cell-wall peptidoglycan.
AB  - Cross-polarization magic-angle spinning 13C and 15N NMR, rotational-echo double
      resonance 13C NMR, and delays alternating with nutation for tailored excitation
      difference 13C NMR spectra have been obtained from lyophilized cell walls of
      Bacillus subtilis grown on a synthetic medium containing D,L-[2-13C,
      15N]aspartate and D-[1-13C]alanine. Label from aspartate is incorporated into D
      glutamic acid and m-diaminopimelic acid of cell-wall peptidoglycan, while label
      from alanine appears in the C-1 positions of both D- and L-alanyl residues. The
      cross-link index (the fraction of peptide stems joined by an isopeptide covalent
      bond) is obtained directly from analysis of the results of the 13C NMR
      experiments. However, specific isotopic enrichments of cell-wall components
      cannot be obtained from NMR data alone. The latter are determined either from a
      gas chromatographic-mass spectrometric analysis of the amino acids derived from
      hydrolysis of cell-wall peptidoglycan, or from a combination of NMR and gas
      chromatographic-mass spectrometric results. The combined analysis is
      overdetermined and so involves the least error for evaluations of both the cross
      link index and the isotopic enrichments. The cross-link index is 0.33 +/- 0.03
      for cell walls of B. subtilis grown in the presence of the antibiotic,
      cephalothin.

PMID- 1761549
TI  - Double-mixing kinetic studies of the reactions of monoliganded species of
      hemoglobin: alpha 2(CO)1 beta 2 and alpha 2 beta 2(CO)1.
AB  - The kinetics of CO association to and dissociation from the two isomers of
      monoliganded species alpha ICO beta I(alpha II beta II) and alpha I beta I (alpha
      II beta COII) has been studied by double-mixing stopped-flow and microperoxidase
      methods. The monoliganded species were generated by hybridization between excess
      ferric Hb and alpha CO2 beta +2 or alpha +2 beta CO2 prepared by high-pressure
      liquid chromatography (HPLC). The results indicated that: 1) there were no
      significant differences in the reactivities of alpha and beta chains in the first
      step of ligation; 2) in the second step of ligation there was significant
      cooperativity in the reaction of deoxyhemoglobin with 0.05 or 0.1 equivalent of
      CO. Diliganded species were therefore formed in significant amounts. The double
      mixing HPLC results suggested that in the second step of ligation alpha chains
      reacted faster than the beta chains, and the main diliganded species formed was
      alpha I beta ICO (alpha IICO beta II) or its isomer alpha ICO I(alpha II beta
      IICO). These results seem to indicate that the reaction of the first CO is mostly
      random and in the second step of ligation CO binds more to the tetramers in which
      one beta chain is already ligated: alpha I beta I (alpha II beta II) + CO---
      alpha ICO beta I (alpha II beta II) and alpha I beta ICO (alpha II beta II) + CO-
      --alpha I beta ICO (alpha IICO beta II).

PMID- 1761550
TI  - How does trp repressor bind to its operator?
AB  - Three explanations have been advanced to account for the unexpected absence of
      direct hydrogen bonds and presence of a buried water layer in the co-crystal-line
      complex of Escherichia coli trp repressor with DNA. We present results of
      physical and biochemical measurements that address the testable predictions of
      each model. We find that the DNA oligomer used for co-crystallization binds to
      the repressor with high affinity and specificity, and 1:1 stoichiometry,
      consistent with other evidence that this sequence represents the true operator
      target for a single repressor dimer. A proposed alternative DNA sequence binds
      weaker and with higher stoichiometry, consistent with a cooperative binding mode.
      The operator DNA in solution has a B-form helical structure in the presence and
      absence of repressor. Affinity of repressor for operator is altered under the
      conditions used for cocrystal growth.

PMID- 1761551
TI  - Identification of a sequence of human activated protein C (residues 390-404)
      essential for its anticoagulant activity.
AB  - Activated protein C (APC) exerts its physiologic anticoagulant role by
      proteolytic inactivation of the blood coagulation cofactors Va and VIIIa. To
      identify the regions on the surface that mediate anticoagulant activity, 26
      synthetic peptides were prepared representing 90% of the human protein C heavy
      chain primary structure and tested for their ability to inhibit APC anticoagulant
      activity. Peptide-(390-404) specifically inhibited APC activity in activated
      partial thromboplastin time and Xa-1-stage coagulation assays in normal, in
      protein S-depleted and Factor VIII-deficient plasma with 50% inhibition at 5
      microM peptide. Polyclonal antibodies raised against this peptide and
      immunoaffinity-purified on a protein C-Sepharose column inhibited APC
      anticoagulant activity in activated partial thromboplastin time and Xa-1-stage
      assays in normal, protein S-depleted, and Factor VIII-deficient plasma with half
      maximal inhibition at 30 nM anti-(390-404) antibody. Neither the peptide-(390
      404) nor the anti-(390-404) antibodies inhibited APC amidolytic activity or the
      reaction of APC with recombinant [Arg358] alpha 1-antitrypsin. Furthermore, in a
      purified system, peptide-(390-404) inhibited APC-catalyzed inactivation of Factor
      Va in the presence as well as in the absence of phospholipids with 50% inhibition
      at 4 microM peptide. These data suggest that the region containing residues 390
      404 in APC is essential for anticoagulant activity and is available to interact
      with antibodies or with other proteins such as the macromolecular substrates
      Factors Va or VIIIa.

PMID- 1761552
TI  - Insect immunity. Isolation from a coleopteran insect of a novel inducible
      antibacterial peptide and of new members of the insect defensin family.
AB  - Injection of heat-killed bacteria into larvae of the large tenebrionid beetle
      Zophobas atratus (Insecta, Endopterygota, Coleoptera) results in the appearance
      in the hemolymph of a potent antibacterial activity as evidenced by a plate
      growth inhibition assay. We have isolated three peptides (A-C) from this immune
      hemolymph which probably account for most of this activity. Their primary
      structures were established by a combination of peptide sequencing and molecular
      mass determination by mass spectrometry. Peptide A, which is bactericidal against
      Gram-negative cells, is a 74-residue glycine-rich molecule with no sequence
      homology to known peptides. We propose the name coleoptericin for this novel
      inducible antibacterial peptide. Peptides B and C are isoforms of a 43-residue
      peptide which contains 6 cysteines and shows significant sequence homology to
      insect defensins, initially reported from dipteran insects. This peptide is
      active against Gram-positive bacteria. The results are discussed in connection
      with recent studies on inducible antibacterial peptides present in the three
      other major orders of the endopterygote clade of insects: the Lepidoptera,
      Diptera, and Hymenoptera.

PMID- 1761553
TI  - Purification and characterization of aginactin, a newly identified agonist
      regulated actin-capping protein from Dictyostelium amoebae.
AB  - Amoeboid chemotaxis involves a regulated increase in actin nucleation activity
      that is correlated with an increase in actin polymerization occurring seconds
      after chemotactic stimulation (Carson, M., Weber, A., and Zigmond, S. H. (1986)
      J. Cell Biol. 103, 2707-2714; Hall, A. L., Warren, V., Dharmawardhane, S., and
      Condeelis, J. (1989) J. Cell Biol. 109, 2207-2213). We report the isolation and
      characterization of an agonist-regulated capping protein, aginactin, from
      Dictyostelium that may regulate these changes in actin nucleation activity.
      Aginactin is isolated from low speed supernatants of starved amoebae by
      sequential anion exchange, hydrophobic interaction, fast protein liquid
      chromatography anion exchange, and hydroxyapatite chromatography. Aginactin
      migrates with an apparent molecular weight of 70,000 on sodium dodecyl sulfate
      polyacrylamide gel electrophoresis gels and gel filtration columns, suggesting
      that it is a globular monomer. Aginactin is a barbed-end capping protein by
      several criteria. It inhibits the rate and final extent of actin polymerization
      and increases the apparent critical concentration at substoichiometric ratios to
      actin. It also inhibits depolymerization of F-actin and inhibits polymerization
      at the barbed end of Limulus acrosomal bundles. Aginactin is unaffected by
      micromolar Ca2+, and it neither severs F-actin nor nucleates actin polymerization
      in either the presence or absence of Ca2+. Aginactin binds to and cosediments
      with F-actin and has an apparent Kd for capping F-actin of 2.7 nM.

PMID- 1761554
TI  - The Saccharomyces cerevisiae TRG1 gene is essential for growth and encodes a
      lumenal endoplasmic reticulum glycoprotein involved in the maturation of vacuolar
      carboxypeptidase.
AB  - We have isolated and mapped to the left end of chromosome III a single-copy gene
      (TRG1) encoding a 72-kDa glycoprotein, by screening a yeast genomic library with
      a DNA probe specifying the catalytic center (APWCGHCK) of thioredoxin-related
      proteins. the TRG1 gene sequence predicts an amino-terminal leader peptide, two
      thioredoxin-like domains, five N-glycosylation sites and a carboxyl-terminal HDEL
      retention signal. The TRG1 protein shows about equal sequence similarity to a
      mammalian multifunctional protein family residing in the lumen of the endoplasmic
      reticulum (ER), and to a putative cytosolic alpha form of phosphoinositide
      specific phospholipase C. Haploid cells do not survive TRG1 gene disruptions,
      unless an additional wild-type copy is generated by interchromosomal
      transposition. Antibodies raised against synthetic amino- and carboxyl-terminal
      epitopes recognize a pair of lumenl ER glycoproteins (gp70/72) and a cytosolic 48
      kDa protein. A 1.8-kilobase TRG1 transcript was translated by a reticulocyte
      lysate into a 60-kDa protein, which was translocated and processed to a 72-kDa
      glycoprotein in the presence of ER membrane vesicles. The TRG1 gene was placed
      under the control of the galactose-inducible and glucose-repressible GAL1
      promoter, leading to growth arrest in glucose media. Glucose repression of the
      TRG1 gene caused the disappearance of gp72 and the accumulation of
      procarboxypeptidase. Our data indicate that the TRG1 gene encodes a growth
      essential lumenal ER glycoprotein involved the maturation of vacuolar
      carboxypeptidase.

PMID- 1761555
TI  - Increase of Cu,Zn-superoxide dismutase activity during differentiation of human
      K562 cells involves activation by copper of a constantly expressed copper
      deficient protein.
AB  - Cu,Zn-superoxide dismutase activity, expressed on the basis of cell number,
      increased by 50% during sodium butyrate-induced differentiation of human K562
      erythroleukemia cells. The increased enzyme activity was found to be concomitant
      with constant Cu,Zn-superoxide dismutase mRNA and immunoreactive protein levels
      and was accompanied by a rise in intracellular copper and glutathione. Incubation
      of K562 cell homogenates with copper caused an increase of Cu,Zn-superoxide
      dismutase activity which reached the levels observed after differentiation in the
      presence of sodium butyrate. The same treatment led to no significant activity
      increase in homogenates derived from differentiated cells. Externally added
      ceruloplasmin increased both intracellular copper levels and Cu,Zn-superoxide
      dismutase activity in undifferentiated cells to a level comparable with that
      observed after induction of differentiation. Both increments were abolished by
      depletion of cell glutathione. Cu,Zn-superoxide dismutase purified from control
      cells had both a lower kcat and a lower copper content than the enzyme purified
      from differentiated cells. From these data we conclude that: 1) Cu,Zn-superoxide
      dismutase is present in K562 cells also under the form of a less active copper
      deficient enzyme, 2) the extent of enzyme activation is regulated post
      translationally by differential delivery of copper as a function of
      differentiation stage, and 3) glutathione is likely to play a role in delivering
      copper to the copper-deficient protein in intact K562 cells.

PMID- 1761556
TI  - Transcription complex formation at the mouse rDNA promoter involves the stepwise
      association of four transcription factors and RNA polymerase I.
AB  - We have used purified transcription factors and RNA polymerase I (pol I) to
      analyze the individual steps involved in the formation of transcription
      initiation complexes at the mouse ribosomal gene promoter in vitro. Complete
      assembly of transcription complexes requires pol I and at least four auxiliary
      factors, termed TIF-IA, TIF-IB, TIF-IC, and UBF. Preincubation and template
      commitment, as well as order of addition protocols, were used to discriminate
      between various intermediate complexes generated during assembly of the
      initiation complex. As a first step, TIF-IB binds to the core promoter, a process
      that is facilitated by the upstream control element and the upstream binding
      factor (UBF). Binding of TIF-IB to the rDNA promoter results in the formation of
      a functional preinitiation complex (complex 1), which is stable for many rounds
      of transcription. UBF, which on its own does not stably associate with the rDNA
      promoter, triggers a 5-10-fold increase in the overall amount of this primary
      complex. Following binding of TIF-IB and UBF to the template DNA, pol I and TIF
      IC successively bind, yielding complexes 2 and 3, respectively. Transcription
      competent initiation complexes are built up by the final association of the
      growth-regulated factor TIF-IA. The various complexes can be distinguished by
      their different sensitivity to Sarkosyl. Only the complete complex consisting of
      all four factors and pol I shows resistance to intermediate concentrations of
      Sarkosyl (0.045%) and is competent to catalyze the formation of the first
      phosphodiester bond. The initiated complex is, on the other hand, resistant to
      high concentrations of Sarkosyl (0.3%). The hierarchical nature of the different
      complexes formed suggests a model for transcription initiation and predicts
      functions for the individual factors.

PMID- 1761557
TI  - Protein components of the nonactivated glucocorticoid receptor.
AB  - The nonactivated glucocorticoid receptor (Mr approximately 350,000) of WEHI-7
      mouse lymphoma cells was investigated with respect to the stoichiometry of
      protein subunits. Cross-linking patterns obtained by affinity labeling and
      denaturing gel electrophoresis revealed a heterotetramer consisting of one
      receptor polypeptide in association with two 90- and one approximately 50-kDa
      subunits. The receptor stabilized by molybdate, disulfide bond formation, or
      chemical cross-linking was purified roughly 6000-fold by immunoaffinity
      chromatography and analyzed by gel electrophoresis and immunoblotting. The 90-kDa
      component was consistently detected in a 2:1 ratio with respect to the receptor
      polypeptide and was identified as the 90-kDa heat shock protein, hsp90. A 70-kDa
      heat shock protein was found in both stabilized and nonstabilized receptors and
      bound to the immunomatrix independent of receptor. The additional receptor
      subunit was unequivocally identified as the 59-kDa protein previously described
      (Tai, P.-K. K., Maeda, Y., Nakao, K., Wakim, N. G., Duhring, J. L., and Faber, L.
      E. (1986) Biochemistry 25, 5269-5275). This component was found only in complexes
      cross-linked via amino groups. It was removed from the molybdate-stabilized
      receptor under our purification conditions, thus leaving behind a trimer composed
      of the receptor polypeptide and two molecules of hsp90. In the absence of
      hormone, the receptor had the same subunit composition as in its presence.

PMID- 1761558
TI  - Structural evolution of an enzyme specificity. The structure of rat
      carboxypeptidase A2 at 1.9-A resolution.
AB  - The structure of rat carboxypeptidase A2 (CPA2), which has a unique specificity
      for tryptophan-containing COOH-terminal peptides, has been determined in an
      unliganded state at 1.9-A resolution and refined to a crystallographic R-factor
      of 18.3%. Comparison of the structure of CPA2 with that of bovine
      carboxypeptidase A (referred to here as CPA1) reveals that the specificity of the
      former for larger amino acids probably arises from two amino acid replacements
      within the binding cavity (Thr268----Ala and Leu203----Met), coupled with
      differences in the positions of conserved residues in a surface loop on one face
      of the specificity pocket. The position of the reactive-site surface loop may be
      affected also by a disulfide bridge between Cys210 and Cys244. In this unliganded
      form of the enzyme, Tyr248 takes up a position interior to the specificity pocket
      and is distinct from that observed in bovine CPA1. The structural differences
      between CPA1 and CPA2 correlate strongly with crystallographically determined
      temperature factors and thus appear to be largest where the enzyme is flexible.

PMID- 1761559
TI  - A novel calcitonin carboxyl-terminal peptide produced in medullary thyroid
      carcinoma by alternative RNA processing of the calcitonin/calcitonin gene-related
      peptide gene.
AB  - The calcitonin/calcitonin gene-related peptide gene expresses two different mRNAs
      by tissue-specific alternative processing. The calcitonin mRNA is produced in
      thyroid C cells by splicing of the first three exons to the fourth polyadenylated
      exon. It encodes a protein precursor containing an amino-terminal peptide,
      calcitonin, and a carboxyl-terminal peptide (CCP I). Calcitonin gene-related
      peptide (CGRP) mRNA is produced in neuronal cells by splicing of the three common
      exons to the fifth exon and the polyadenylated sixth exon, leading to the
      production of a CGRP precursor. Our studies concerning the expression of the
      calcitonin/CGRP gene in human medullary thyroid carcinoma revealed the presence
      of a new RNA transcript. Amplification by polymerase chain reaction and direct
      sequencing showed that the novel transcript is composed of exons 1, 2, and 3,
      part of exon 4, exon 5, and a polyadenylated exon 6. This transcript contains an
      open reading frame coding for the known amino-terminal and calcitonin peptides,
      as well as for a novel calcitonin carboxyl-terminal peptide, CCP II. This third
      alternative pathway utilizes an internal donor site within the exon coding for
      calcitonin. The presence of CCP II was demonstrated in plasma and thyroidal
      tissues of medullary thyroid carcinoma patients, implying that this novel mRNA is
      actively translated in medullary thyroid carcinoma.

PMID- 1761560
TI  - The role of N-glycosylation of GLUT1 for glucose transport activity.
AB  - To elucidate a functional role of N-glycosylation in glucose transporters, we
      introduced oligonucleotide-directed mutagenesis in GLUT1 cDNA to remove the
      possible site for N-linked glycosylation. The wild-type and the mutated GLUT1
      cDNAs which induced a mutation of Asn at residue 45 to Asp, Tyr, or Gln were
      transfected and stably expressed into Chinese hamster ovary cells. The expressed
      wild-type and the mutated GLUT1 was demonstrated to be a broad band of a 45-60
      kDa form and a sharp band of a 38-kDa form on Western blot analysis,
      respectively, indicating no glycosylation in the mutated GLUT1. Although the cell
      surface labeling of the glucose transporters demonstrated the presence of the
      glycosylation-defective glucose transporters on the cells surface, photoaffinity
      labeling of glycosylation-defective GLUT1 with [3H] cytochalasin B and a
      photoreactive mannose derivative, [3H]2-N-4-(1-azi-2,2,2,trifluoroethyl)benzoyl
      1,3-bis(D-mannos+ ++-4-yloxy)-2- propylamine in the membranes was observed to be
      40-70 and 15-30% of that of the wild-type GLUT1, respectively. The kinetic study
      of 2-deoxyglucose uptake revealed that the glycosylation-defective GLUT1 had a 2
      2.5-fold greater Km value for 2-deoxyglucose uptake compared with the wild-type
      GLUT1. These observations strongly suggest that 1) N-glycosylation of GLUT1
      glucose transporter is only on Asn 45 and 2) N-glycosylation plays an important
      role in maintaining a structure of glucose transporter with high affinity for
      glucose, thus, with high transport activity.

PMID- 1761561
TI  - The functional size of ferrochelatase determined in situ by radiation
      inactivation.
AB  - Ferrochelatase (EC 4.99.1.1) catalyzes the final step of heme biosynthesis, the
      insertion of iron(II) into protoporphyrin. It is an integral protein of the inner
      mitochondrial membrane. The functional size of bovine hepatic ferrochelatase has
      been studied in situ using radiation inactivation analysis. The functional unit
      required for enzymic activity in intact mitochondria was found to have a mass of
      82 +/- 13 kDa. In contrast, the structural unit (evaluated in immunoblots
      following sodium dodecyl sulfate-polyacrylamide gel electrophoresis) has a mass
      of 40 +/- 10 kDa. Similar results were obtained when irradiation was performed on
      sodium cholate-solubilized mitochondria. The presence or absence of
      dithiothreitol during irradiation had no effect on target sizes obtained from
      either intact or solubilized mitochondria. Pairwise comparison of the functional
      and structural target sizes from each set of irradiated samples yielded a ratio
      of 2.0 +/- 0.4. Previous studies using sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis and gel filtration chromatography have shown that a Mr 40,000
      peptide is associated with ferrochelatase activity. This study shows that the
      functional size of bovine ferrochelatase is approximately 80 kDa; the data are
      most consistent with a model for active ferrochelatase composed of two structural
      subunits of about 40 kDa each.

PMID- 1761562
TI  - Cryoelectron microscopy of mammalian pyruvate dehydrogenase complex.
AB  - Cryoelectron microscopy has been performed on frozen-hydrated pyruvate
      dehydrogenase complexes from bovine heart and kidney and on various subcomplexes
      consisting of the dihydrolipoyl transacetylase-based (E2) core and
      substoichiometric levels of the other two major components, pyruvate
      dehydrogenase (E1) and dihydrolipoyl dehydrogenase (E3). The diameter of frozen
      hydrated pyruvate dehydrogenase complex (PDC) is 50 nm, which is significantly
      larger than previously reported values. On the basis of micrographs of the
      subcomplexes, it is concluded that the E1 and E3 are attached to the E2-core
      complex by extended (4-6 nm maximally) flexible tethers. PDC constructed in this
      manner would probably collapse and appear smaller than its native size when
      dehydrated, as was the case in previous electron microscopy studies. The tether
      linking E1 to the core involves the hinge sequence located between the E1-binding
      and catalytic domains in the primary sequence of E2, whereas the tether linking
      E3 is probably derived from a similar hinge-type sequence in component X. Tilting
      of the E2-based cores and comparison with model structures confirmed that their
      overall shape is that of a pentagonal dodecahedron. The approximately 6 copies of
      protein X present in PDC do not appear to be clustered in one or two regions of
      the complex and are not likely to be symmetrically distributed.

PMID- 1761563
TI  - Identification and purification of a peroxisomal branched chain fatty acyl-CoA
      oxidase.
AB  - Isoprenoid (branched) fatty acids such as pristanic acid can be degraded via beta
      oxidation in peroxisomes. We synthesized 2-methylpalmitoyl-CoA as a model
      substrate in order to study the first step of the peroxisomal beta-oxidation of
      branched fatty acids, catalyzed by an acyl-CoA oxidase. 2-Methylpalmitoyl-CoA
      oxidase activity was found in rat liver homogenates. Subcellular fractionation
      demonstrated that the oxidase was confined to peroxisomes. 2-Methylpalmitoyl-CoA
      oxidase was also present in kidney and intestine. It was not induced in liver or
      in the extrahepatic tissues by treatment of rats with peroxisome proliferators or
      by feeding diets containing excess isoprenoids. The enzyme was partially purified
      together with palmitoyl-CoA oxidase and trihydroxycoprostanoyl-CoA oxidase by
      heat treatment and ammonium sulfate fractionation of liver extracts. The
      partially purified preparation was chromatographed on various columns. 2
      Methylpalmitoyl-CoA oxidase could be separated from the inducible (by peroxisome
      proliferators) palmitoyl-CoA oxidase and from trihydroxycoprostanoyl-CoA oxidase,
      but it always coeluted with the noninducible palmitoyl-CoA oxidase, recently
      described by us (Schepers, L., Van Veldhoven, P. P., Casteels, M., Eyssen, H. J.,
      and Mannaerts, G. P. (1990) J. Biol. Chem. 265, 5242-5246). 2-Methylpalmitoyl-CoA
      oxidase was purified to near homogeneity in three chromatographic steps (anion
      exchange, hydroxylapatite, and gel filtration). Its apparent molecular mass is
      approximately 415 kDa, and it consists of identical subunits of approximately 70
      kDa. The enzyme oxidized 2-methylpalmitoyl-CoA twice as rapidly as palmitoyl-CoA
      and pristanoyl-CoA as rapidly as palmitoyl-CoA, so that it can be considered as a
      branched fatty acyl-CoA oxidase. Since pristanoyl-CoA is one of its naturally
      occurring substrates we propose to name this enzyme pristanoyl-CoA oxidase.

PMID- 1761564
TI  - Persistent intracellular calcium pool depletion by thapsigargin and its influence
      on cell growth.
AB  - The intracellular Ca2+ pump inhibitor, thapsigargin, added to DDT1MF-2 smooth
      muscle cells in culture, irreversibly inhibited accumulation of Ca2+ within
      cells, permanently emptied the inositol 1,4,5-trisphosphate (InsP3)-sensitive
      Ca2+ pool, and simultaneously induced profound alteration of cell growth. After
      only a brief (30-min) treatment of cultured cells with 3 microM thapsigargin
      followed by extensive washing, the total releasable InsP3-sensitive Ca2+ pool
      remained entirely empty, even after 7 days of culture without thapsigargin. After
      thapsigargin treatment, cells retained viability, usual morphology, and normal
      mitochondrial function. Despite the otherwise normal appearance and function of
      thapsigargin-treated cells, cell division was completely blocked by thapsigargin.
      DNA synthesis was completely inhibited when thapsigargin was added immediately
      after passaging, but was suppressed only slowly (4-6 h) when added to rapidly
      synthesizing cells (24 h after passaging). Protein synthesis was reduced by
      approximately 70% in thapsigargin-treated cells. The sensitivity of thapsigargin
      mediated inhibition of cell division, DNA synthesis, protein synthesis, and
      Ca(2+)-pumping activity were all similar with the EC50 values for thapsigargin in
      each case being close to 10 nM. Upon application to DDT1MF-2 cells, thapsigargin
      transiently increased resting cytosolic Ca2+ (0.15 microM) to a peak of 0.3
      microM within 50 s; thereafter, free Ca2+ declined to 0.2 microM by 150 s and
      continued to slowly decline toward resting levels. Cells treated with
      thapsigargin for 1-72 h in culture displayed normal resting cytosolic Ca2+
      levels. However, application of thapsigargin or epinephrine to such cells
      resulted in no change in the intracellular Ca2+, indicating that the internal
      Ca2+ pool remained completely empty. These results suggest that emptying of Ca2+
      from intracellular thapsigargin-sensitive Ca(2+)-pumping pools induces profound
      alteration of cell proliferation.

PMID- 1761565
TI  - Autoxidation of hemoglobin enhanced by dissociation into dimers.
AB  - Autoxidation as a function of hemoglobin concentration indicates a 17-fold
      increase in the rate of autoxidation from 0.25 (%/h) to 4.3 (%/h) when tetrameric
      oxyhemoglobin dissociates into dimers. As a result of this large enhancement, a
      contribution of dissociation to the autoxidation is evident even at relatively
      high concentrations of hemoglobin for which it is usually considered that
      dissociation can be neglected. The mechanism for this phenomenon is attributed to
      alterations in the ligand pocket which occur when constraints due to subunit
      contacts within the R-state are eliminated.

PMID- 1761566
TI  - Direct analysis of aminoacylation levels of tRNAs in vivo. Application to
      studying recognition of Escherichia coli initiator tRNA mutants by glutaminyl
      tRNA synthetase.
AB  - We describe the use of a gel electrophoretic method for measuring the levels of
      aminoacylation in vivo of mutant Escherichia coli initiator tRNAs, which are
      substrates for E. coli glutaminyl-tRNA synthetase (GlnRS) due to an anticodon
      sequence change. Using this method, we have compared the effects of introducing
      further mutations in the acceptor stem, at base pairs 1:72, 2:71, and 3:70 and
      discriminator base 73, on the recognition of these tRNAs by E. coli GlnRS in
      vitro and in vivo. The effects of the acceptor stem mutations on the kinetic
      parameters for aminoacylation of the mutant tRNAs in vitro are consistent with
      interactions seen between this region of tRNA and GlnRS in the crystal structure
      of tRNA(Gln). GlnRS complex. Except for one mutant, the observed levels of
      aminoacylation of the mutant tRNAs in vivo agree with those expected on the basis
      of the kinetic parameters obtained in vitro. We have also measured the relative
      amounts of aminoacyl-tRNAs for the various mutants and their activities in
      suppression of an amber codon in vivo. We find that there is, in general, a good
      correlation between the relative amounts of aminoacyl-tRNAs and their activities
      in suppression.

PMID- 1761567
TI  - Functional analysis of the putative catalytic bases His-321 and Ser-368 of
      Rhodospirillum rubrum ribulose bisphosphate carboxylase/oxygenase by site
      directed mutagenesis.
AB  - Numerous candidates have been suggested according to chemical and structural
      criteria for the active site base of ribulose bisphosphate carboxylase/oxygenase
      that catalyzes substrate enolization. We evaluate the functional significance of
      two such candidates, His-321 and Ser-368 of the Rhodospirillum rubrum enzyme, by
      site-directed mutagenesis. Position 321 mutants retain 3-12% of wild-type rates
      of both overall carboxylation and the initial enolization, with little effect on
      Km for CO2 or ribulose bisphosphate. Position 368 mutants exhibit approximately
      1% of wild-type carboxylation but 4-9% of enolization, also accompanied by little
      effect on Km values. The modest catalytic facilitations elicited by these
      residues are incompatible with either acting as the crucial base. The enhanced
      efficiency of the position 368 mutants in enolization versus carboxylation
      clearly indicates that Ser-368 effects catalysis preferentially beyond the point
      of proton abstraction. Both sets of mutants bind the reaction intermediate
      analogue, 2-carboxy-D-arabinitol bisphosphate, stoichiometrically. Ligand
      exchange from complexes with position 321 mutants is increased relative to wild
      type, whereas complexes with position 368 mutants are more exchange-inert.
      Therefore, His-321 may assist stabilization of the transition state mimicked by
      the analogue.

PMID- 1761568
TI  - Interleukin-5, interleukin-3, and granulocyte-macrophage colony-stimulating
      factor cross-compete for binding to cell surface receptors on human eosinophils.
AB  - Human interleukin (IL)-5 receptors were characterized by means of binding studies
      using bioactive 125I-labeled IL-5. Of purified primary myeloid cells, eosinophils
      and basophils but not neutrophils or monocytes expressed surface receptors for IL
      5. Binding studies showed that eosinophils expressed a single class of high
      affinity receptors (Ka = 1.2 x 10(10) M-1) with the number of receptors being
      small (less than 1000 receptors/cell) and varying between individuals. Among
      several cell lines examined only HL-60 cells showed detectable IL-5 receptors
      which were small in numbers (200 receptors/cell) and also bound 125I-IL-5 with
      high affinity. The binding of IL-5 was rapid at 37 degrees C while requiring
      several hours to reach equilibrium at 4 degrees C. Specificity studies revealed
      that the two other human eosinophilopoietic cytokines IL-3 and granulocyte
      macrophage colony-stimulating factor (GM-CSF) inhibited the binding of 125I-IL-5
      to eosinophils. No competition was observed by other eosinophil activating or
      nonactivating cytokines. The inhibition of 125I-IL-5 binding by IL-3 and GM-CSF
      was partial up to a concentration of competitor of 10(-7) M with GM-CSF
      consistently being the stronger competitor. Converse experiments using IL-5 as a
      competitor revealed that this cytokine inhibited the binding of 125I-IL-3 and of
      125I-GM-CSF in some but not all the individuals tested, perhaps reflecting
      eosinophil heterogeneity in vivo. Cross-linking experiments on HL-60 cells
      demonstrated two IL-5-containing complexes of Mr 150,000 and Mr 80,000 both of
      which were inhibited by GM-CSF. The competition between IL-5, IL-3, and GM-CSF on
      the surface of mature eosinophils may represent a unifying mechanism that may
      help explain the common biological effects of these three eosinophilopoietic
      cytokines on eosinophil function. This unique pattern of competition may also be
      beneficial to the host by preventing excessive eosinophil stimulation.

PMID- 1761569
TI  - Interaction of the UvrABC endonuclease with DNA containing a psoralen monoadduct
      or cross-link. Differential effects of superhelical density and comparison of
      preincision complexes.
AB  - The effect of negative supercoiling on UvrABC incision of covalently closed
      duplex DNA circles containing either a furan-side monoadduct or a cross-link of
      4'-hydroxymethyl-4,5',8-trimethylpsoralen at a unique site was examined. The rate
      of UvrABC incision of these DNA substrates was measured as a function of
      superhelical density, sigma, for values of sigma between 0 and -0.050. The
      monoadducted DNA substrate was incised at close to the maximum rate at all
      superhelical densities, with only a slight stimulation of activity between sigma
      = 0 and -0.035. In contrast, efficient UvrABC incision of the cross-linked DNA
      substrate required the DNA to be underwound, and activity showed a linear
      dependence on superhelical density up to sigma = -0.035. DNase I protection
      studies show that in the presence of both UvrA and UvrB a protein complex binds
      to the site of a psoralen monoadduct or cross-link in linear DNA. This UvrA-UvrB
      dependent complex binds with similar affinity to both the monoadducted and the
      cross-linked DNA helices. However, differences in the DNase I footprint on these
      two DNA substrates indicate that the interaction of this protein complex is
      different at these two lesions. The addition of UvrC to linear DNA molecules that
      are saturated at the site of the lesion with the UvrA-UvrB-dependent complex
      resulted in efficient nicking of the monoadducted DNA, but not the cross-linked
      DNA. Thus, the properties of a DNA lesion site that lead to UvrAB recognition and
      binding are not necessarily sufficient to allow incision when all three Uvr
      subunits are present. We propose that after recognition and binding of a lesion
      site by the UvrAB complex and prior to incision, the damaged DNA helix undergoes
      a conformational change such as unwinding or melting that is induced by the
      lesion-bound Uvr complex.

PMID- 1761570
TI  - Occurrence of multiple aberrantly spliced mRNAs upon a donor splice site mutation
      that causes familial lipoprotein lipase deficiency.
AB  - A donor splice site mutation was found in the lipoprotein lipase (LPL) gene of a
      patient with familial LPL deficiency. The mutation, a G----A substitution,
      occurred at the first nucleotide of intron 2. Northern blot analysis of total RNA
      from the patient showed strikingly low levels of LPL-specific mRNAs. Using the
      polymerase chain reaction, the LPL mRNA splicing was analyzed in detail. The
      results demonstrated that no normal splicing occurred at the authentic splice
      site; rather a cryptic splice site 18 bases upstream from the mutation site was
      preferentially utilized. Although the resulting alteration in mRNA was a minute
      in-frame 18-base deletion, the amount of the abnormal transcript was only 1/12
      that of the normal. In addition to this major cryptic splice site, we also
      identified multiple minor sites which were utilized at extremely lower
      efficiencies. Unexpectedly, one of these minor sites was also used as an
      alternative splice site in the normal subject at a comparably low efficiency. The
      sequences of these minor cryptic sites possessed many of the characteristics
      common to those of other normal splice sites, indicating that even such minor
      sites should have also been selected according to the general rules for splice
      site selection. These results demonstrate that upon mutation, a broad spectrum of
      cryptic splice sites is activated in vivo at the sites' respective efficiencies.

PMID- 1761571
TI  - Peroxisomal degradation of leukotrienes by beta-oxidation from the omega-end.
AB  - Chain shortening via beta-oxidation from the omega-end has been recognized as the
      major pathway for the degradation of cysteinyl leukotrienes as well as
      leukotriene B4 (LTB4). The metabolic compartmentation of this pathway was studied
      using peroxisomes purified from normal and clofibrate-treated rat liver. beta
      Oxidation products of omega-carboxy-LTB4, including omega-carboxy-dinor-LTB4
      identified by gas chromatography-mass spectrometry, were formed by the isolated
      peroxisomes. The reaction was dependent on CoA, ATP, and NAD and was stimulated
      by FAD. NADPH was necessary for the further metabolism of omega-carboxy-dinor
      LTB4. Together with microsomes a degradation of omega-carboxy-LTB4 also proceeded
      in isolated mitochondria in the presence of CoA, ATP, and carnitine. beta
      Oxidation of the cysteinyl leukotriene omega-carboxy-N-acetyl-leukotriene E4 was
      observed only with isolated peroxisomes in combination with lipid-depleted
      microsomes. Direct photoaffinity labeling using omega-carboxy-[3H] LTB4 and omega
      carboxy-N-[3H]acetyl-LTE4 served to identify peroxisomal leukotriene-binding
      proteins. The bifunctional protein (EC 4.2.1.17 and 1.1.1.35) and 3-ketoacyl-CoA
      thiolase (EC 2.3.1.16) of the peroxisomal beta-oxidation system were the
      predominantly labeled polypeptides as revealed by precipitation with monospecific
      antibodies. In vivo studies with N-acetyl-[3H2]LTE4, N-acetyl-[3H8]LTE4, and N
      [14C]acetyl-LTE4 after treatment with the peroxisome proliferator clofibrate
      indicated formation and biliary excretion of large amounts of metabolites more
      polar than omega-carboxy-tetranor-N-acetyl-LTE3 including omega-carboxy-tetranor
      delta 13-N-acetyl-LTE4 and omega-carboxy-hexanor-N-acetyl-LTE3. Increased
      formation of beta-oxidized catabolites of N-acetyl-LTE4 and LTB4 was also
      observed in hepatocytes isolated after clofibrate treatment. Our results indicate
      that peroxisomes play a major role in the beta-oxidation of leukotrienes from the
      omega-end. Whereas omega-carboxy-LTB4 was beta-oxidized both in isolated
      peroxisomes and mitochondria, the cysteinyl leukotriene omega-carboxy-N-acetyl
      LTE4 was exclusively degraded in peroxisomes.

PMID- 1761572
TI  - Arterial lumican. Properties of a corneal-type keratan sulfate proteoglycan from
      bovine aorta.
AB  - A glycoprotein reactive with antibodies against corneal keratan sulfate
      proteoglycan (KSPG) was purified 300-fold from extracts of bovine aorta using
      DEAE ion-exchange, gel-filtration, hydrophobic interaction, and reverse-phase
      chromatographic separations. The intact glycoprotein was 70-80 kDa on sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis. Deglycosylation with endo
      beta-galactosidase and N-glycanase reduced the size to 48 and 37 kDa,
      respectively, similar to the large isoforms of corneal KSPG. N-terminal amino
      acid sequence of the arterial KSPG was identical with lumican, the 37B isoform of
      corneal KSPG, and the arterial KSPG reacted with an antibody to synthetic peptide
      duplicating this sequence. Arterial KSPG and corneal lumican displayed identical
      tryptic maps. Arterial lumican contains fucose and mannose in amounts similar to
      corneal KSPG, but galactose, glucosamine, and sulfate were reduced compared to
      KSPG from cornea. Treatment of arterial lumican with endo-beta-galactosidase
      released 8-9 mol of glucosamine and galactose per mol of protein as
      oligosaccharides. These eluted as neutral, nonsulfated oligosaccharides on high
      pH anion-exchange chromatography. The size of arterial lumican was not altered by
      glycosidases having specificity for sulfated keratan sulfate, nor was the charge
      of the lumican molecule altered by digestion with endo-beta-galactosidase. These
      data show arterial lumican to be a glycoprotein containing unsulfated
      lactosaminoglycan chains. Abundance of low sulfate lumican in many tissues
      indicates that this protein occurs predominantly as a glycoprotein rather than as
      the more widely studied, highly sulfated proteoglycan present in the cornea.

PMID- 1761573
TI  - Expression of interferon-beta during the triggering phase of macrophage cytocidal
      activation. Evidence for an autocrine/paracrine role in the regulation of this
      state.
AB  - The expression of cytocidal activity is induced by the sequential interaction of
      macrophages with a priming stimulus, such as interferon (IFN)alpha, -beta, or 
      gamma, and a triggering stimulus, such as poly(I.C) or lipopolysaccharide.
      However, most triggering stimuli are also capable of inducing IFN expression.
      This suggested to us the possibility that in addition to its role in initially
      priming macrophages for cytocidal activity, IFN may also be expressed during the
      triggering stage where it may potentially contribute to the regulation of
      cytocidal activity. We have explored this question by (i) attempting to
      dissociate IFN-inducing activity from triggering activity with a variety of
      structurally related and charge-related polyanions; (ii) determining if
      macrophages express IFN during the triggering stage; and (iii) questioning if IFN
      produced during the triggering stage contributes to the regulation of cytocidal
      activation. Exposure of unprimed macrophages to a triggering concentration of
      poly(I.C) alone failed to induce IFN beta expression. However, exposure of IFN
      beta-primed cells to poly(I.C) dramatically increased the expression of IFN beta
      mRNA. Priming with IFN gamma was likewise found to increase the expression of IFN
      beta mRNA in response to a triggering concentration of polyribonucleotides. Three
      approaches were adopted to ascertain if the increased expression of IFN beta
      contributed to cytocidal activation. First, macrophages derived from strains of
      mice which differ in their susceptibility to IFN induction by poly(I.C) were
      primed with IFN beta, washed, and triggered with poly(I.C). Under these
      conditions, macrophages derived from stain B10.A(2R), which are hyporesponsive to
      poly(I.C) in terms of IFN induction, also showed a diminished capacity to express
      Bf, a marker of cytocidal activation. Second, exposure of IFN-primed macrophages
      to poly(I.C) in the presence of anti-IFN alpha/beta antibody was found to reduce
      substantially the synthesis of NO2/NO3, an alternative marker of macrophage
      cytocidal activation. Third, exposure of IFN-primed macrophages to the calcium
      ionophores ionomycin or A23187, which do not induce the production of IFN beta
      during triggering, led to an abbreviated expression of Bf compared with stimuli
      that induce IFN beta expression such as poly(I.C). However, the capacity to
      synthesize Bf in response to A23187 was partially reconstituted when macrophages
      were triggered with the ionophore in the continuous presence of IFN beta.
      Collectively, these data show that IFN beta is expressed during the triggering
      stage of macrophage cytocidal activation and suggest that it plays an important
      and previously unsuspected role in the expression of this state.

PMID- 1761574
TI  - 1,25-Dihydroxyvitamin D3 down-regulates aggrecan proteoglycan expression in
      immortalized rat chondrocytes through a post-transcriptional mechanism.
AB  - We have examined the effects of various analogs of vitamin D on the expression of
      the aggrecan proteoglycan by an immortalized rat chondrocyte cell line. The
      active metabolite of vitamin D, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), produced
      a concentration-dependent reduction in the synthesis of aggrecan as monitored by
      histochemical staining of the matrix, incorporation of [35S]sulfate, and the
      level of aggrecan core protein. Other analogs of vitamin D were much less potent
      or had no activity whatsoever. The reduced expression of aggrecan was caused by a
      dramatic decrease in the steady-state level of the mRNA coding for the aggrecan
      core protein. A nuclear run-off analysis revealed that the rate of transcription
      of the aggrecan gene was not significantly altered by 1,25(OH)2D3 treatment,
      suggesting that the metabolite was acting through a post-transcriptional
      mechanism. Experiments using the transcriptional inhibitor actinomycin D also
      supported a nondirect effect of 1,25(OH)2D3 on the expression of the aggrecan
      gene. These results suggest that the vitamin D metabolite activates a new pattern
      of gene expression which results in a more rapid turnover of the aggrecan mRNA.
      This system should be useful for characterizing the regulation of chondrocyte
      gene expression by vitamin D.

PMID- 1761575
TI  - Purification of the sodium- and chloride-coupled glycine transporter from central
      nervous system.
AB  - We have recently developed a reconstitution assay which allows the rapid
      determination of sodium- and chloride-dependent glycine transport activity of
      many fractions (Lopez-Corcuera, B., and Aragon, C. (1989) Eur. J. Biochem. 181,
      519-524). In this paper we report the purification of the sodium- and chloride
      coupled glycine transporter from pig brain stem. Transporter is solubilized from
      plasma membrane vesicles with 2% cholate and purified by sequential
      chromatography on phenyl-Sepharose, wheat germ agglutinin-Sepharose, and
      hydroxylapatite columns, followed by a 5-20% sucrose density gradient
      fractionation. Taking into account the inactivation suffered by the transporter,
      a final increase in specific activity of about 450-fold is achieved. Although two
      polypeptides with apparent molecular masses of 100 and 37 kDa are progressively
      enriched during the chromatographic steps, only the 100-kDa band comigrates with
      transport activity along the density gradient. This band is finally isolated to
      apparent homogeneity in the active fractions. We conclude that the 100-kDa band
      represents the glycine transporter. Finally, the pure transporter can be
      reconstituted into liposomes, retaining the absolute dependence on sodium and
      chloride gradients, the electrogenicity, the glycine affinity, the substrate
      specificity, and the sensitivity to group-selective modifiers characteristic of
      the native transporter.

PMID- 1761576
TI  - Guanine nucleotide biosynthesis is regulated by the cellular p53 concentration.
AB  - As an approach to defining the role of p53 in cellular proliferation, murine cell
      lines were derived which contain a stably transfected temperature-inducible p53
      expression system. Cell lines derived with the system exhibited a 3-6-fold
      physiologic elevation in the cellular p53 concentration when grown at 32.5
      degrees C. A p53 induction phenotype was defined by examination of the growth
      properties of these lines at 32.5 degrees C. The induction phenotype had three
      main features: 1) a 2-4-fold increase in doubling time and biphasic growth
      kinetics; 2) delayed early S phase transit; and 3) complete reversibility either
      by growth at 37 degrees C or by growth in the presence of added hypoxanthine or
      xanthosine. The reversal of the induction phenotype by these purine salvage
      precursors implicated the purine nucleotide biosynthetic pathway as the cellular
      target for the antiproliferative action of p53. Subsequent genetic and
      biochemical analyses identified a p53 induction-related purine pathway defect
      which was localized to the step of inosine 5'-monophosphate conversion to
      xanthosine 5'-monophosphate. This enzymatic step catalyzed by inosine 5'
      monophosphate dehydrogenase (EC 1.2.1.14) is the rate-limiting step for GTP
      synthesis. Extracts from p53-inducible cells growing at the induction temperature
      show a specific reduction in inosine 5'-monophosphate dehydrogenase enzymatic
      activity. These findings define p53 as a cellular regulator of the synthesis of
      GTP, a key regulatory nucleotide for many important cellular processes. Moreover,
      observations of the growth behavior of p53-inducible cells suggest that by
      regulating the production of GTP, p53 can control cellular quiescence.

PMID- 1761577
TI  - Purification and functional characterization of a DNA-binding protein that
      interacts with a negative element in the mouse alpha 1(I) collagen promoter.
AB  - In an effort to understand the regulation of expression of the mouse type I
      collagen genes, we have purified to homogeneity a transcription factor, called
      inhibitory factor 2 (IF-2), that binds to the mouse alpha 1(I) collagen promoter
      upstream of the proximal CCAAT motif. IF-2 was purified to homogeneity from mouse
      lymphocyte nuclear extracts by ion-exchange chromatography and two different
      steps of DNA affinity chromatography, one using the wild-type IF-2-binding site
      as affinity ligand and one using a mutated IF-2-binding site that has a higher
      affinity for the factor. Renaturation of active DNA-binding proteins purified
      through several chromatography steps from sodium dodecyl sulfate-polyacrylamide
      gels identified two polypeptides of 120 and 100 kDa, respectively, capable of
      binding specifically to an IF-2-binding site. DNA transfection experiments of NIH
      3T3 fibroblasts using an alpha 1(I) promoter-CAT chimeric gene in which mutations
      were introduced that either improved or decreased the binding affinity of IF-2
      for its recognition site, strongly suggest that IF-2 acts as a transcriptional
      inhibitor of the mouse alpha 1(I) collagen gene. DNA-binding studies with similar
      concentrations of purified IF-2 and CBF (CCAAT-binding factor) indicate that CBF
      inhibits binding of IF-2, whereas IF-2 inhibits CBF binding more weakly.

PMID- 1761578
TI  - Sphingomyelinase enhances low density lipoprotein uptake and ability to induce
      cholesteryl ester accumulation in macrophages.
AB  - Cholesteryl ester-loaded macrophages, or foam cells, are a prominent feature of
      atherosclerotic lesions. Low density lipoprotein (LDL) receptor-mediated
      endocytosis of native LDL is a relatively poor inducer of macrophage cholesteryl
      ester accumulation. However, the data herein show that in the presence of a very
      small amount of sphingomyelinase, LDL receptor-mediated endocytosis of 125I-LDL
      was enhanced and led to a 2-6-fold increase in 125I-LDL degradation and up to a
      10-fold increase in cholesteryl ester accumulation in macrophages. The enhanced
      lipoprotein uptake and cholesterol esterification was seen after only
      approximately 12% hydrolysis of LDL phospholipids, was specific for sphingomyelin
      hydrolysis, and appeared to be related to the formation of fused or aggregated
      spherical particles up to 100 nm in diameter. Sphingomyelinase-treated LDL was
      bound by the macrophage LDL receptor. However, when unlabeled acetyl-LDL, a
      scavenger receptor ligand, was present during or after sphingomyelinase treatment
      of 125I-LDL, 125I-LDL binding and degradation were enhanced further through the
      formation of LDL-acetyl-LDL mixed aggregates. Experiments with cytochalasin D
      suggested that endocytosis, not phagocytosis, was involved in internalization of
      sphingomyelinase-treated LDL. Nonetheless, the sphingomyelinase effect on LDL
      uptake was macrophage-specific. These data illustrate that LDL receptor-mediated
      endocytosis of fused LDL particles can lead to foam cell formation in cultured
      macrophages. Furthermore, since both LDL and sphingomyelinase are present in
      atherosclerotic lesions and since some lesion LDL probably is fused or
      aggregated, there is a possibility that sphingomyelinase-treated LDL is a
      physiologically important atherogenic lipoprotein.

PMID- 1761579
TI  - The density and strength of proteoglycan-proteoglycan interaction sites in
      concentrated solutions.
AB  - Rheological flow properties of link-stable and link-free proteoglycan (PG)
      aggregates in concentrated solutions were measured using a cone-on-plate
      viscometer. A second-order constitutive model, based upon the statistical-network
      theories of Lodge, [Rheol. Acta 7, 379-392 (1968)] and De Kee and Carreau [J. Non
      Newtonian Fluid Mech. 6, 127-143 (1979)], was developed to describe the measured
      steady and transient flow responses exhibited by the PG solutions. Our
      measurements confirmed previous experimental findings that the complex shear
      modulus of PG solutions depends on the frequency of the imposed small-amplitude
      oscillatory shear, and the apparent viscosity and primary normal-stress
      difference depend nonlinearly on the shear rate under steady-shear flow
      conditions [Mow et al., J. Biomechanics 17, 325-338 (1984b); Hardingham et al.,
      J. orthop. Res. 5, 36-46 (1987)]. In the present study, we found that PG
      solutions exhibit pronounced stress overshoot responses and large hysteresis loop
      effects. These transient responses were shown to be sensitive to acceleration
      strain (i.e. the second rate of strain) as well as PG structure (i.e. link
      protein stabilization). The model parameters were determined by curvefitting of
      the second-order constitutive model and experimental data from steady,
      oscillatory and transient shear flow measurements. Using this network model, we
      calculated the density of the idealized interaction sites existing in the PG
      network, and the average strength of these interaction sites. The results
      indicate that link-protein stabilization of PG aggregates does not change the
      density of interaction sites formed in the PG network, rather, it increases the
      average strength of these interaction sites.

PMID- 1761580
TI  - Articular contact in a three-dimensional model of the knee.
AB  - This study is aimed at the analysis of articular contact in a three-dimensional
      mathematical model of the human knee-joint. In particular the effect of articular
      contact on the passive motion characteristics is assessed in relation to
      experimentally obtained joint kinematics. Two basically different mathematical
      contact descriptions were compared for this purpose. One description was for
      rigid contact and one for deformable contact. The description of deformable
      contact is based on a simplified theory for contact of a thin elastic layer on a
      rigid foundation. The articular cartilage was described either as a linear
      elastic material or as a non-linear elastic material. The contact descriptions
      were introduced in a mathematical model of the knee. The locations of the
      ligament insertions and the geometry of the articular surfaces were obtained from
      a joint specimen of which experimentally determined kinematic data were
      available, and were used as input for the model. The ligaments were described by
      non-linear elastic line elements. The mechanical properties of the ligaments and
      the articular cartilage were derived from literature data. Parametric model
      evaluations showed that, relative to rigid articular contact, the incorporation
      of deformable contact did not alter the motion characteristics in a qualitative
      sense, and that the quantitative changes were small. Variation of the elasticity
      of the elastic layer revealed that decreasing the surface stiffness caused the
      ligaments to relax and, as a consequence, increased the joint laxity,
      particularly for axial rotation. The difference between the linear and the non
      linear deformable contact in the knee model was very small for moderate loading
      conditions. The motion characteristics simulated with the knee model compared
      very well with the experiments. It is concluded that for simulation of the
      passive motion characteristics of the knee, the simplified description for
      contact of a thin linear elastic layer on a rigid foundation is a valid approach
      when aiming at the study of the motion characteristics for moderate loading
      conditions. With deformable contact in the knee model, geometric conformity
      between the surfaces can be modelled as opposed to rigid contact which assumed
      only point contact.

PMID- 1761581
TI  - A three-dimensional non-linear finite element study of the effect of cement
      prosthesis debonding in cemented femoral total hip components.
AB  - A three-dimensional non-linear finite element analysis of a cemented femoral
      component in which the component was partially debonded from the cement mantle
      was used to assess the effects of debonding on stresses in the cement. Three
      cases of partial cement-metal debonding were modelled with debonding of the
      proximal portion of the implant down to a horizontal plane which was 35, 62.5, or
      82.5 mm below the prosthesis collar. Each situation was studied under loads
      simulating both gait and stairclimbing. Also, complete debonding between the
      implant and the surrounding cement mantle was modeled for loads simulating gait.
      Under stair climbing loads with partial cement-mental debonding, hoop stresses of
      13-18 MPa were observed in the cement at the cement-metal interface at the
      proximal postero-medial corner of the implant. Similarly, in stair climbing, the
      maximum principal stresses in the cement were also adjacent to the proximal
      postero-medial region of the implant. These stresses were compressive and
      increased from 15 MPa with fully bonded interfaces to 48 MPa with debonding down
      to 82.5 mm below the prosthesis collar. Under gait loads, complete debonding
      caused high compressive stresses up to 34.9 MPa in the cement distal to the
      prosthesis tip. Thus, cement failure subsequent to prosthesis debonding is likely
      in the proximal region in a partially debonded implant due to stair climbing
      loads and is likely below the prosthesis tip in a fully debonded implant due to
      gait loading.

PMID- 1761582
TI  - Physical and mechanical properties of calf lumbosacral trabecular bone.
AB  - The physical and mechanical properties of calf lumbar and sacral trabecular bone
      were determined and compared with those of human trabecular bone. The mean tissue
      density (1.66 +/- 0.12 g cm-3), equivalent mineral density (169 +/- 36 mg cm-3),
      apparent density (453 +/- 89 mg cm-3), ash density (194 +/- 59 mg cm-3), ash
      content (0.6 +/- 0.05%), compressive strength (7.1 +/- 3.0 MPa) and compressive
      modulus (173 +/- 97 MPa) of calf trabecular bone are similar to those of young
      human. There were moderate, positive linear correlations between apparent density
      and equivalent mineral density, ash density, and compressive strength; and
      between compressive strength and equivalent mineral density (R2 ranging from 0.35
      to 0.48, p less than 0.001). Apparent density, ash density, and equivalent
      mineral density did not differ significantly in different regions. In contrast to
      humans, the compressive strength increased from posterior, near the facet, to the
      anterior vertebral body. These comparisons of physical and mechanical properties,
      as well as anatomical comparisons by others, indicate that the calf spine is a
      good model of the young non-osteoporotic human spine and thus useful for the
      testing of spinal instrumentation.

PMID- 1761583
TI  - Mathematical modelling of flow through an irregular arterial stenosis.
AB  - A mathematical model of flow through an irregular arterial stenosis is developed.
      The model is two-dimensional and axi-symmetric with the stenosis outline obtained
      from a three-dimensional casting of a mildly stenosed artery. Agreement between
      modelled and experimental pressure drops (obtained from an axi-symmetric machined
      stenosis with the same profile) is excellent. Results are also obtained for a
      smooth stenosis model, similar to that used for most mathematical modelling
      studies. This model overestimates the pressure drop across the stenosis, as well
      as the wall shear stress and separation Reynolds number. Also, the smooth model
      predicts one instead of three recirculation zones present in the irregular model.
      The original stenosis is modified to increase the severity from 48 and 87% areal
      occlusion, while maintaining the same general shape. This has the effect of
      increasing the pressure drop by an order of magnitude and decreasing the number
      of recirculation zones to one, with a lower separation Reynolds number.

PMID- 1761584
TI  - The influence of limb alignment on the gait of above-knee amputees.
AB  - Biomechanical gait tests on above-knee amputees were conducted in which the
      alignment of the prosthesis was changed systematically. An eight-segment
      biomechanical model of the above-knee amputee was developed to analyse and
      present the three-dimensional kinematic and kinetic data obtained. The effects of
      alignment changes on the above-knee amputees' gait were studied in terms of the
      angular displacements of the lower limbs, ground reactions and intersegmental
      moments. It was found that following the alignment changes the angular
      displacement at the hip joint on the prosthetic side showed compensatory actions
      by the amputee. The ground reaction force was sensitive to alignment changes, and
      in particular, the changes in the characteristics of the fore-aft component of
      the ground force could be related to the alignment changes. The antero-posterior
      intersegmental moments at the prosthetic ankle and knee joints were evidently
      influenced by alignment.

PMID- 1761585
TI  - Optimal distance from the implement to the axis of rotation in hammer and discus
      throws.
AB  - It is a well-known fact that a dramatic improvement in the range of any
      projective throw can be achieved by increasing the release velocity. In this
      paper a simple model of a competitor with an implement (hammer or discus) in the
      turns is considered. The thrower is regarded as a rigid body, and the implement
      as a point mass. The transverse velocity component of the implement at the
      release moment is maximized. For finding the optimal distance of the implement
      from the axis of rotation optimal control theory is applied. According to the
      proposed model, the optimal hammer throwing technique requires constant and
      maximal distance of the implement from the axis of rotation, followed by the
      rapid shortening of the distance immediately prior to the release. In the discus
      throw, however, this shortening is useless.

PMID- 1761586
TI  - [Early prognostic factors of the surgery of aneurysms of the abdominal aorta with
      renal artery clamping].
AB  - The aneurysms of the abdominal aorta requiring suprarenal clamping are rare.
      Suprarenal clamping was required for only 43 of 544 aneurysms operated electively
      from 1981 to 1989. Twenty-five patients had a juxtarenal aneurysm, without any
      normal aortic segment under the renal arteries, and suprarenal clamping was
      therefore necessary while the upper anastomosis was being established (group I).
      Eighteen patients had an aneurysm enclosing the root of at least one renal artery
      (group II). Several prognostic factors have been assessed: patient's age,
      presence of preoperative renal insufficiency, of arterial hypertension or of
      coronary insufficiency, and revascularization method. Five patients died. Four of
      them belonged to group II and were over 75 years old. All presented with a
      preoperative renal insufficiency. Two of these deaths were caused by mesenteric
      infarction. Four cases of regressive postoperative renal insufficiency were
      observed in patients for whom renal clamping had lasted longer than 45 minutes.
      This study allowed outlining three prognostic factors: the patient's age,
      preoperative renal insufficiency, a period of renal ischemia exceeding 40
      minutes. On the other hand, the severity of hypertension had no predictive value.
      Coronary insufficiency requires a strict hemodynamic surveillance, but is not a
      contraindication for revascularization.

PMID- 1761587
TI  - [Cholelithiasis in patients over 75 years of age. Apropos of 147 cases].
AB  - The authors perform a retrospective study of a series of 147 patients aged 75 and
      more, who were treated for gallstone. AMong them, 104 had conventional surgery
      and 43 a nonsurgical treatment. The noticeable elements produced by this analysis
      are: the frequency of common bile duct lithiasis and of severe septic
      complication in elderly patients, the frequency of previous gallstone, sometimes
      remote in time, a significantly higher mortality when the treatment is non
      surgical (p less than 0.001), mainly due to the septic complications of the
      lithiasis. the influence of the diathesis on mortality, and finally, the greater
      inocuity of the right infracostal approach in view of respiratory complications.

PMID- 1761588
TI  - [Role of total thyroidectomy in the treatment of multinodular goiter].
AB  - Although it may seem to be excessive, total thyroidectomy has recently been
      advocated by several authors for the treatment of diffuse multiheteronodular
      goiters. As a complement to a recent study on the thyroid function following
      thyroidectomy for benign goiters, the authors specify the role of this surgical
      technique, which had been reserved for the sole thyroid neoplasms for a long
      time. On the occasion of the presentation of a series of 75 cases gathered from
      1989 to 1990, the justification of glandular resection is based on the
      publication of new pathogenetic data and on the absence of any increase in
      morbidity, subject to precise indications and to a strict technique aimed at
      preserving recurrents and locating the parathyroid glands while maintaining their
      vasculature. When aimed at reducing the frequency of recurrence of euthyroid and
      toxic diffuse multinodular goiters, total thyroidectomy might also contribute in
      reducing the morbidity of second surgery, at the expense of a permanent
      substitution therapy. While the choice of its indications must remain eclecty,
      thelong-term consequences of initial surgery with too restricted glandular
      exeresis must be recognized.

PMID- 1761589
TI  - [Pelvic endometriosis with urinary and digestive involvement. Apropos of 7
      cases].
AB  - Seven cases of pelvic endometriosis of the urinary or digestive tracts are
      reported: 4 cases of vesical endometriosis, 1 case of ureteral involvement, 1
      rectal case and 1 sigmoid location. The authors point out the difficulty of the
      clinical preoperative diagnosis--in despite of cyclic troubles--and underline the
      interest of complementary explorations performed at the time of periods:
      ultrasound, cystoscopy, rectosigmoidoscopy and coelioscopy. The MR imaging,
      showing high intensity a T1-weighted images and prominent high intensity on T2
      weighted images, is very suggestive of an endometrial lesions. A joint medical
      and surgical treatment is required. Endoscopic excision, endoprothetic tube,
      excision-suture, resection-anastomosis and a complementary medical treatment
      using Danazol, Decapeptyl or progestational agents have to be proposed. Per
      operative microscopy is advised as routine procedure in order to avoid excessive
      surgery.

PMID- 1761590
TI  - [Sigmoido-uterine fistula of diverticular origin. Review of the literature
      apropos of a case].
AB  - The authors report one case of sigmoid-uterine fistula of diverticular origin
      with a favorable outcome after an ideal colectomy associated with subtotal
      hysterectomy. They emphasize the rarity of this complication, due to the
      resistance of the uterine tissue. Its diagnosis is primarily clinical, and other
      examinations are required only to establish the etiological diagnosis. Surgery
      must be curative, ideally in one stage including the treatment of the
      diverticular disease and that of its gynecological consequences, which may vary
      according to the local conditions.

PMID- 1761591
TI  - [Synovial cyst of the hip with revealing neurologic symptoms].
AB  - The authors report an exceptional case of a ganglion cyst of the hip revelated by
      sciatica. They recall the usual clinical expression of this pathology, her
      diagnostic tests and her treatment. They open the discussion about ganglion cyst
      and mucoid pseudocyts.

PMID- 1761592
TI  - [Protocol for the use of Pavlik harness in the treatment of congenital
      dislocation and dysplasia of the hip].
AB  - The authors wanted to establish a protocol of use of Pavlik's harness and check
      ots efficiency with as few complications as possible for the ambulatory treatment
      of congenital dislocation and dysplasia of the hip. To achieve this, they studied
      41 hips in 37 children. They noted 2 failures of reduction, 2 failures of
      stabilization, 2 cases of osteochondritis and 1 transitory crural paresis. It
      should be noted that reduction failed and osteochondritis and crural paresis
      occurred in one and the same child. The other children, ie. 36 hips, had a quite
      favorable evolution without any stay in hospital, and reduction and stabilization
      were permanent. This confirms the merits of Pavlik's harness and the low rate of
      iatrogenic complications. The authors propose a starting, observation and
      termination procedure for the treatment. However, it still is difficult to define
      how long stabilization will take and to specify the indication for the treatment
      of a possible residual dysplasia.

PMID- 1761593
TI  - [Association of bronchogenic cyst of the pancreas and duplication cyst of the
      stomach].
AB  - One case of bronchogenic cyst of the pancreas associated to a true gastric cyst
      produced by duplication is described. Such congenital neoformations are extremely
      rare. The symptoms are highly variable. The diagnosis can be established only
      through the histopathological study of the surgical specimen.

PMID- 1761594
TI  - [Cutaneous fistula of hydatid cyst of the liver].
AB  - We report a case of liver hydatic cyst fistulised spontaneously at the skin. It
      is an extremely scarce complication.

PMID- 1761595
TI  - [Differentiated thyroid cancer on the thyroglossal duct].
AB  - Over one hundred cases of carcinomas located on the thyroglossal duct have been
      reported worldwide. Most of these tumors originally were differentiated thyroid
      cancers. Their biological behavior is the same as that of tumors of the thyroid
      gland itself. On the basis of one case discovered in an 11-year-old girl, who
      presented with regional and systemic metastases, we discuss the various aspects
      of their origin, diagnosis and treatment. As far as the latter is concerned, we
      think that these tumors can not always be treated by exeresis of the thyroglossal
      duct. On the basis of the analysis of situations in which these tumors may be
      encountered, we propose a carcinological surgery, which might possibly be more
      aggressive, on the thyroid and cervical lymphatic tissues.

PMID- 1761596
TI  - [Gastric villous adenoma. 2 new cases].
AB  - Villous adenomas are extremely rare in the stomach. This type of lesion is
      characterized by its high capacity of malignant degeneration, as well as by its
      association with other tumors of the gastrointestinal tract. In this regard, we
      present two cases of villous adenoma of the stomach observed in our hospital, as
      well as a review of the characteristics of these tumors and of the treatment
      required.

PMID- 1761597
TI  - [Experience with a surgical mesh covering a hepatectomy incision].
AB  - A polyglycolic acid net (Vicryl) has been applied against the hepatectomy section
      of 27 patients (14% of all our liver resections) to complete its hemostasis. The
      indications for the use of this net were: the persistence of blood oozing and/or
      the necessity to shorten the operation. In one patient suffering from severe
      coagulopathy, active bleeding continued until the patient died; another patient
      bled until his blood dyscrasia was corrected. One case of abscess was
      encountered, and treated through a percutaneous approach. Although the
      achievement of perfect hemostasis is usual in surgical exeresis of the liver, a
      minority of patients can present with resistant bleeding of the resection slice,
      for which packing with a net may prove to be useful.

PMID- 1761598
TI  - [Mortality in the surgical unit of a general hospital. Study of 27 postoperative
      deaths among patients operated on during 1990-1492].
AB  - This study takes in account all post operative deaths during the year 1990 in one
      surgical Professorial unit of Lille academic hospital (France). During this year,
      1492 consecutive patients underwent surgery. The mean age of deceased patients
      was 63.7 years. 15 died after emergency procedure and 12 after elective surgery.
      Lastly 2 patients died without any operation. The most common condition
      encountered in those cases was oesophageal carcinoma, thereafter gastric or
      duodenal complicated peptic ulcer, and finally colonic carcinoma and diverticular
      disease. 13 patients had neoplasia (45%). From a critical point of view, 14
      patients died after surgical indication or procedure of questionable legitimacy.
      The comparison with a similar study conducted five years ago and the analysis of
      these charts allow us to reaffirm some basic principles of surgery.

PMID- 1761599
TI  - [Isolated proximal revascularization for double aorto-iliac and femoral lesions].
AB  - From 1980 to 1990, 101 limbs were revascularized at the upper level only in 67
      patients, while they presented with associated aortoiliac and femoral obstructive
      lesions. The symptoms disappeared after aortofemoral revascularization in 94% of
      the limbs operated on for claudication and 80% of those operated on for critic
      ischemia. Surgery of the deep femoral artery was associated in 51% of all cases.
      The average time lapse is 58 months. No complementary revascularization was
      needed in the cases of claudication. Out of the patients operated on for critic
      ischemia, upper revascularization was insufficient in 8 cases. Two of the
      operated patients were cured after secondary downstream revascularization (4%).
      Three operated patients still presented with intermittent claudication (6%), and
      3 were amputed due to acute iliac obstruction seen at an advanced stage. As no
      reliable predictive test is available, we find it justified to carry out only
      upper revascularisation in most cases and to decide on the need for secondary
      downstream extension according to the clinical outcome. However, simultaneous
      revascularization at both levels is required in case of extensive involvement of
      the deep femoral artery, such as observed in only 5 of the patients operated
      during the same period.

PMID- 1761600
TI  - [Rectal cysts and rectal functional disorders after surgical treatment for
      genital prolapse].
AB  - From 1966 to 1984, 417 female patients were operated for genital prolapse in the
      department of surgical gynecology of the Salpetriere Hospital (Pr Blondon's
      department). The results of the surgical treatment were studied in the posterior
      perineum from an anatomical (rectocele) and functional point of view (indiced
      rectal disorders). This study allows drawing several conclusions: when the
      context leads to deciding to operate the prolapse through an abdominal approach,
      it is desirable, in order to reduce the risk of postoperative rectocele, to
      systematically insert a posterior prosthetic band, which will be tethered as low
      as possible on the posterior aspect of the vaginal (after a sufficiently low
      extensive rectovaginal cleaving). The Orr-Loygue rectopexy must remain indicated
      for rectal prolapse, even more so as it is associated with incontinence. Since
      this procedure often causes constipation of even more complex exoneration
      disorders, it must be reserved for prolapse associated to a large rectocele (type
      IV) or an invalidating dyschezia.

PMID- 1761601
TI  - [Sandblaster or alumina-coated 316 L stainless steel for implantable material in
      orthopedic surgery. Study on metacarpal bone of sheep].
AB  - We have carried out a study in sheep of the behavior of bone in the presence of
      two materials, 316 L stainless steel with a surface roughened by sandblasting,
      and the same type of steel, plasma-coated with alumina. Twelve nails of each type
      were implanted into the medullary cavities of previously fractured metacarpal
      bones. The samples were removed after 90 days for six animals and after 180 days
      for six others. The functional study and the radiographic analysis, as well as
      the growth of bone around the implants as assessed with a light microscope and
      with microradiography, did not show any significant difference between both types
      of temporary implants.

PMID- 1761602
TI  - [Synchronous colorectal cancers].
AB  - The frequency of synchronous colorectal cancers ranges from 1.7 to 9.3% according
      to the series. The incidence of these cancers has been appreciated in various
      ways, according to variable diagnostic criteria, especially because some authors
      have included in situ carcinomas developing on degenerated polyps. A
      retrospective study of the synchronous cancers operated in our department from
      January, 1980 to August, 1990 allowed us to assess their frequency and location
      and to discuss the therapeutic choices. Two hundred and forty-nine patients with
      cancers of the colon or of the rectum have been operated during that period.
      Twelve (4.8%) presented with more than one colorectal cancer, all discovered
      simultaneously. The average age of the patients operated for synchronous cancer
      was higher that that of those operated of isolate cancer (68.8 years versus
      63.3). Two thirds of the synchronous cancers were located in the sigmoid loop or
      the colon and, in one third of all cases, on non-adjacent segments of the colon.
      The frequent association of colic adenomatous polyps and of synchronous cancers-
      in one half of the patients in our series--must raise a discussion on the merits
      of systematic subtotal, or even total, colectomy in the treatment of synchronous
      colorectal cancers. This is also true for tumoral sites in 2 different segments
      of the colon. Segmental colectomy may be advocated in the other cases: cancers
      located on one segment, polyps located only on the resected segment of the colon,
      or polyps that can be resected via endoscopy.

PMID- 1761603
TI  - [Prognostic factors for peritonitis in elderly patients. Multifactorial
      statistical analysis apropos of 216 cases].
AB  - The aim of this paper is to analyse retrospectively the data of our patients over
      60 years old who had an acute peritonitis, localized or diffuse, to establish
      prognostic factors. They were 216 patients, who underwent surgical treatment
      between 1971 and 1990. We observed 243 variables and its significance using the
      chi 2 test. We divided our study in two stages: from 1.10.71 to 30.09.80 (group I
      = 93 patients) and from 1.10.80 to 31.01.90 (group II = 123 patients). Group I
      was composed by 51 men and 42 women with a mean age of 71.9 +/- 5.3 years.
      General mortality of this group was 36% (33 patients). Group II corresponded to
      55 men and 68 women with a mean age of 74.26 +/- 7.1 years. Mortality was 23% (28
      patients). Age, sex and associated clinical disorders were not significant on
      prognosis, meanwhile the clinical and biological form of presentation were not
      adequate to establish a severity index. The most common ethiologies were: biliar
      (24 patients = 26%) in group I and appendicular (41 patients = 32.2%) In group
      II. Significant factors on mortality rates in group II were: delay between onset
      of symptoms and surgical treatment (over 96 hs, p less than 0.05), generalized or
      purulent peritonitis operated after 96 hs from onset of the attack (p less than
      0.05) and malignancy (p less than 0.01).

PMID- 1761604
TI  - [Sacrococcygeal cysts. Is Lord Millar's procedure an alternative to exeresis?].
AB  - The benignancy of sacrococcygeal cysts stands in contrast to their morbidity and
      rate of recurrence. Due to the differences in the results found in the literature
      and to the lack of recommendations as to the optimal surgical procedure, the
      authors have reviewed a series of 69 patients with a chronic inflammatory state.
      The procedure was either exeresis up to the sacrum (37 patients) or Lord Millar's
      procedure (32 patients). The latter consisted in a limited exeresis of the
      portals and in the extraction of the hairs with a brush, followed in principle by
      a weekly depilatory treatment until the wound was closed. The results in the 2
      groups have been compared. Sixty-six patients (87%) were controlled after an
      average of 3.7 years. The shorter stay in hospital of the patients operated with
      Lord Millar's procedure (4.9 vs. 7.6 days) and the shorter period of inability to
      work (14 vs. 26 days) demonstrate the socioeconomical advantage of this
      procedure. Recurrence occurred in 5 of the 31 patients controlled after exeresis
      (16%) and in 7 of the 29 patients controlled after a Lord Millar's operation
      (24%), including one in the subgroup of 16 patients who submitted themselves to a
      regular postoperative epilatory treatment (6%) and 6 in the group of 13 who were
      not followed up in our clinic (46%). Thus Lord Millar's procedure represents an
      alternative to exeresis, provided the patient is motivated enough to submit
      himself to regular postoperative controls.

PMID- 1761605
TI  - [Pyloric obstruction. Apropos of a new clinical case with this rare pathology].
AB  - The authors describe a pyloric obstruction due to a mucosal diaphragm in a 16
      months old child. They review the literature, and emphasize on the rare frequency
      on this affection, the steps of its diagnosis, and its surgical removal.

PMID- 1761606
TI  - [Interruption of the inferior vena cava by the DIL filter. Experience apropos of
      34 cases].
AB  - Endocaval filters are often used to prevent pulmonary embolism but they have a
      number of disadvantages. The DIL filter, made of a memory metal wire, is intended
      to male up for some of these disadvantages. It acts by modifying the shape of the
      inferior vena cava, which it filters through its meshed loops. It is inserted
      percutaneously, causes little trauma, and its release is progressive. However, it
      requires measuring the caliber of the inferior vena cava. This filter was
      inserted in thirty-four patients over a period of 13 months. One filter has
      migrated. No recurrence of pulmonary embolism and no thrombosis of the inferior
      vena cave occurred.

PMID- 1761607
TI  - [Intra-abdominal textiloma. Report of a case].

PMID- 1761608
TI  - [Isolated listeria monocytogenes liver abscess: suspect diabetes mellitus].

PMID- 1761609
TI  - [Angiodysplasia of the small intestine. Surgical resection guided by peroperative
      enteroscopy].

PMID- 1761610
TI  - Selective production of vocalization types in different communication contexts.
AB  - This study investigates the production of vocalization in adult-infant-toy
      interactions from 0;4 to 0;11. The hypothesis is that vocalizations are
      selectively uttered in relationship to their production context. Five infants
      (two girls, three boys) were intensively studied. Non-segmental acoustic features
      of vocalizations in four communicative contexts were analysed in relation to the
      individual infants, in order to reveal individual differences. The data were
      submitted to discriminant function analysis. Results show that (a) different
      patterns of non-segmental features characterize sounds produced in different
      contexts; (b) both inter-subject differences and intra-subject consistency are
      observed; (c) 'selective production' disappears after 0;9. These results are
      discussed in relationship to sound-meaning development.

PMID- 1761611
TI  - Intonational differences between the reduplicative babbling of French- and
      English-learning infants.
AB  - The two- and three-syllable reduplicative babbling of five French-learning and
      five English-learning infants (0;5 to 1;1) was examined in two ways for
      intonational differences. The first measure was a categorization into one of five
      categories (RISING, FALLING, RISE-FALL, FALL-RISE, LEVEL) by expert listeners.
      The second was the fundamental frequency (F0) from the early, middle and late
      portion of each syllable. Both measures showed significant differences between
      the two language groups. 65% of the utterances from both groups were classified
      as either rising of falling. For the French children, these were divided equally
      into the rising and the falling categories, while 75% of those utterances for the
      English children were judged to have falling intonation. Proportions of the other
      three categories were not significantly different by language environment. In
      both languages, though, three-syllable utterances were more likely to have a
      complex contour than two-syllable ones. Analysis of the F0 patterns confirmed the
      perceptual assessment. Several aspects of the target languages help explain these
      intonational differences in prelinguistic babbling.

PMID- 1761612
TI  - The mosaic acquisition of grammatical relations.
AB  - The view that grammatical relations have substantial essence, designated as
      'subject' or 'object' has difficulty in accounting for the variety of naturally
      acquirable grammatical relations. The acquisition of grammatical relations is
      examined from a theoretical framework, ROLE AND REFERENCE GRAMMAR, in which
      grammatical relations are decomposed into two separate types of structure:
      logical (semantic) structure and information (pragmatic) structure. The
      acquisition of grammatical relations from four languages is compared: (1) the
      definite accusative suffix and pragmatically motivated word order of Turkish; (2)
      Kaluli verb agreement, case and focus marking postpositions, and pragmatically
      motivated word order; (3) Hungarian definite and indefinite verb conjunction; and
      (4) Italian participial agreement and anaphoric, accusative case pronouns. Two
      conditions on structures are found to cause difficulty: the neutralization of a
      semantic or pragmatic distinction by interfering structures (e.g. Kaluli and
      Italian), and global case marking which forces the child to discover relevant
      semantic characteristics of both the actor and the undergoer (e.g. Hungarian and
      Kaluli). Structures that encode semantic or pragmatic distinctions independently
      are more easily acquired (e.g. Turkish). Piecing together discrete structures in
      a mosaic fashion, the child can acquire the great variety of grammatical
      relations that exist in human languages.

PMID- 1761613
TI  - Mean length of utterance and the acquisition of Irish.
AB  - One of the most widely used indices of language development is a measure of
      utterance length in morphemes (MLUm). This study examines the applicability of
      MLUm to the acquisition of Irish. MLUm was calculated for data from Cian, aged 1;
      11-3; 0. Even when an attempt was made to 'assume the maximum' by counting all
      possible morphemes, the correlation between a morpheme MLU (MLUm) and a word
      count MLU (MLUw) was very high (0.99). This points to MLUw being as effective a
      measure of Irish development as MLUm, as well as being easier to apply and more
      reliable. MLUw was calculated for the two younger children in the study (Eibhlis
      1; 4-2; 1 and Eoin 1; 10-2; 6). An examination of the relationship between the
      three children's MLUw values and their grammatical complexity as measured on
      ILARSP (the Irish adaptation of LARSP) indicates that MLUw is a useful
      preliminary index for early development in Irish. However, further data are
      necessary to check whether MLUw loses its predictive relationship with
      grammatical complexity after a certain point. The study emphasizes the caution
      necessary in applying MLU to languages whose acquisition has not hitherto been
      studied, and underlines the role of MLU as a preliminary measure, which must not
      be overinterpreted.

PMID- 1761614
TI  - The acquisition of gender: what Spanish children tell us.
AB  - Data from an experiment on gender acquisition with 160 Spanish children from four
      to eleven years of age are presented in this paper. In Spanish there are three
      possible clues (semantic, morphophonological and syntactic), that speakers can
      use to determine the gender of a noun and the agreement of other variable
      elements accompanying it. Items where only one of the clues was present, items
      where there was a combined effect of two of them in agreement (both were feminine
      or masculine), and items where clues were in conflict (one masculine and the
      other feminine) were introduced in the experiment. This experimental manipulation
      made it possible to test the relative strength of the different types of
      competing clues. In particular, the aim of the present study was to determine the
      relative importance of intralinguistic and extralinguistic clues, as evidenced by
      the ability of Spanish children to recognize the gender of a noun upon hearing it
      in a particular frame, and consequently, to establish the agreement of other
      variable elements accompanying it. A procedure similar to that used by Karmiloff
      Smith (1979) was employed. The results (which are compared with those obtained in
      other languages) give support to the theoretical view that children pay for more
      attention to syntactic and morphophonological (intralinguistic) information than
      to semantic (extralinguistic) information.

PMID- 1761615
TI  - The status of 'canonical SVO sentences' in French: a developmental study of the
      on-line processing of dislocated sentences.
AB  - This on-line study investigates the processing of word order by 30 French
      children (6;6, 8;6, 10;6) and 10 adults. Its main objective is to show that the
      privileged status granted to 'canonical SVO sentences' is inadequate to account
      for the on-line processing of pronominal utterances in spoken French. Using a
      word monitoring task, we showed that word order (NVN vs NNV): (1) is a
      significant factor in sentences containing no clitic pronoun; (2) stops being
      significant when sentences contain either one or two clitic pronouns. These
      results suggest that processing complexity depends upon co-reference ('linear',
      'crossed' or 'embedding') assignment constraints rather than upon word order per
      se. We conclude that, in French, word-order processing always interacts with
      acceptability considerations provided by cliticization.

PMID- 1761616
TI  - 'Can I put--I want a slippers to put on': young children's development of request
      forms in a code-switching environment.
AB  - This paper concerns the development of semi-modal want/want to, and modals may,
      can and could in two Trinidadian children, whose Verb Phrase development was
      studied in naturalistic settings, between the ages of 2;3 and 4;1, and 2;4 and
      4;9. The similarities and differences in development between the two are
      important for underlining a number of key factors in the acquisition process.
      Accepting the salience of requests/demands in early child language, the study
      draws attention to the child's propensity for using the means most readily
      available to him/her in the input, for expression of this function. Additionally,
      there is evidence of the child's ability to make stylistic discriminations at a
      very early age and of the propensity for making semantic distinctions among
      forms. The study indicates that work on the development of grammatical features
      is incomplete without consideration of sociolinguistic aspects of usage as
      integral to grammatical acquisition from the outset.

PMID- 1761617
TI  - Modified repetition in poems elicited from young children.
AB  - Attempts were made to elicit poems from 133 children between the ages of 2;3 and
      6;11. Seventy-eight of the children produced 606 poems between them. Forty-five
      per cent of the poems contained the syntactic device of modified repetition: a
      substitution exercise where a grammatical frame is repeated and the substitution
      occurs in part of the grammatical frame. This was so despite the fact that
      modified repetition was not present in the examples that were used to elicit
      poems from the children. The frequency and types of modified repetition used by
      the children did not vary much with age. The question of whether children's use
      of modified repetition in their rhythmical poems has the function of helping them
      to practise grammatical forms, or whether it is simply one reflection of a
      general human tendency towards the use of pattern in language, is discussed.

PMID- 1761618
TI  - Simultaneity in children's narratives: the case of when, while and as.
AB  - This study examines the use of the co-temporal connectives when, while and as in
      the elicited narratives of 71 children between 4;10 and 11;11. A group of 26
      adults provided comparison data. Subjects were asked to 'tell a story' about each
      of three sets of story pictures. Analysis of the adult data confirmed a
      preference for preposed over postposed when clauses and supported the notion of a
      continuum of simultaneity for when, while and as. The oldest children (like the
      adults) were more likely to prepose when clauses than were younger children, a
      finding which suggests that with increasing awareness of the information needs of
      the listener, children begin to use preposed adverbial clauses as information
      'guideposts'. Surprisingly, however, children in general were far more likely
      than adults to use durative predicates with when clauses and did not use co
      temporal as - substituting when or while in those contexts in which as appeared
      in the adult protocols. These two findings are shown to be connected, since
      aspect in the adult data is differentially distributed with respect to the three
      connectives. It is hypothesized that for narrative purposes children acquire when
      before while and while before as, in the order of increasing specificity and
      constraint, with the determining factor being a convergence of syntax, semantics
      and information flow.

PMID- 1761619
TI  - Introducing information in dialogues: forms of introduction chosen by young
      speakers and the responses elicited from young listeners.
AB  - Young speakers in dialogue must establish mutual knowledge. Traditionally,
      researchers have focused on how children used indefinite and definite articles to
      signal novel and shared information. In this study of 170 children aged seven to
      thirteen, the form of introduction chosen, whether question or statement, is more
      significant than the type of article used. No developmental effects on article
      use emerge, with statement + indefinite always the least common choice. However,
      young speakers use question introductions significantly less than older children.
      There is also a developmental interaction between speakers' and listeners'
      behaviour. Question introduction elicit effective listener responses at all ages,
      but only twelve-year-olds respond reliably to statements. Unfortunately, young
      speakers prefer just those forms of introduction to which young listeners are
      least likely to provide informative feedback. Thus two separate developmental
      effects appear to combine to hamper young subjects' chances of achieving
      successful communication in dialogues.

PMID- 1761620
TI  - On the ability to provide evaluative comments: further explorations of children's
      narrative competencies.
AB  - This study investigated the changing functions of evaluative devices in
      children's narratives. The evaluative devices included (a) references to 'frames
      of mind', particularly to emotions, (b) character speech, (c) 'hedges', (d)
      negative qualifiers, and (e) causal connectors. Narratives were elicited from a
      24-picture story book. The subjects were three groups of native English-speaking
      Americans (12 per group): five- and nine-year-old children and college
      undergraduate students. A quantitative comparison revealed that (i) adults used
      evaluative devices three times as often as five-year-olds, and two-and-a-half
      times as often as the nine-year-old children; (ii) adults used significantly more
      references to 'frames of mind' and 'hedges' than the children; and (iii) whereas
      five-year-olds used each evaluative type equally often, nine-year-olds and adults
      used references to 'frames of mind' significantly more than the other four
      evaluation types. A second analysis, focusing specifically on the discourse
      functions of references to 'frames of mind' revealed that, early on, this
      particular device is used to express a local evaluative perspective on particular
      events, while with increasing age it is used to signal the hierarchial
      organization of the story events. These findings are discussed with regard to two
      non-linguistic developmental achievements, the formation of event schemas and the
      formation of a theory of mind.

PMID- 1761621
TI  - An historical observation on "why 'mama' and 'papa'?".

PMID- 1761622
TI  - On the acquisition of negation in Tamil and English.

PMID- 1761624
TI  - Separation of fluorescent oligosaccharide derivatives by microcolumn techniques
      based on electrophoresis and liquid chromatography.
AB  - Various aldose oligosaccharides can be quantitatively derivatized into primary
      amines for subsequent reaction with fluorogenic reagents, such as 3-(4
      carboxybenzoyl)-2-quinolinecarboxaldehyde or 3-benzoyl-2-naphthaldehyde.
      Capillary electrophoresis (CE) and microcolumn liquid chromatography (LC),
      coupled with laser-induced fluorescence detection, were evaluated as a means of
      separating complex oligosaccharide mixtures. Whereas microcolumn LC and open
      tubular CE appear confined in their utility to relatively small oligosaccharides,
      unprecedented results were obtained with polyacrylamide gel-filled capillaries on
      hydrolyzed malto-oligosaccharides and enzymatically degraded samples of
      chondroitin sulfate and hyaluronic acid.

PMID- 1761623
TI  - Selected applications of cyclodextrin selectors in capillary electrophoresis.
AB  - Through the use of alpha-, beta-, gamma- and heptakis(2,6-di-O-methyl)-beta
      cyclodextrin as stereospecific selectors or electrolyte modifiers, both in
      capillary zone electrophoresis and isotachophoresis, selected model isomeric
      compounds (including optical isomers) were resolved. Soluble
      alkylhydroxyalkylcellulose derivatives were further added to the cyclodextrin
      modified background electrolytes under study. Their presence was found to be
      essential, as demonstrated by improvements in both enantioselectivity and
      separation efficiency. The results obtained in both electrophoretic modes, under
      optimized conditions, are compared and discussed.

PMID- 1761625
TI  - Low-cost, high-sensitivity laser-induced fluorescence detection for DNA
      sequencing by capillary gel electrophoresis.
AB  - A low cost, 0.75-mW helium neon laser, operating in the green region at 534.5 nm,
      is used to excite fluorescence from tetramethylrhodamine isothiocyanate-labelled
      DNA fragments that have been separated by capillary gel electrophoresis. The
      detection limit (3 sigma) for the dye is 500 ymol [1 yoctomole (1 ymol) = 10(-24)
      mol] or 300 analyte molecules in capillary zone electrophoresis; the detection
      limit for labeled primer separated by capillary gel electrophoresis is 2 zmol [1
      zeptomole (1 zmol) = 10(-21) mol]. The Richardson-Tabor peak-height encoded
      sequencing technique is used to prepare DNA sequencing samples. In 6% T, 5% C
      acrylamide, 7 M urea gels, sequencing rates of 300 bases/hour are produced at an
      electric field strength of 200 V/cm; unfortunately, the data are plagued by
      compressions. These compressions are eliminated with addition of 20% formamide to
      the sequencing gel; the gel runs slowly and sequencing data are generated at a
      rate of about 70 bases/hour.

PMID- 1761626
TI  - Capillary electrophoresis of DNA in entangled polymer solutions.
AB  - Electrophoretic separations of DNA restriction fragments were performed in
      solutions of hydroxyethylcellulose (HEC) using capillary electrophoresis.
      Rheological studies confirmed that the entanglement threshold (phi*) for the
      solution is ca. 0.003 g/ml, in good agreement with theoretical predictions. A
      mesh size an order of magnitude smaller than that found in agarose gels was
      calculated using polymer-entanglement theory and was confirmed by electrophoretic
      measurements. Electrophoretic migration was shown to follow the Ogston regime
      under most conditions. An approach for obtaining smaller mesh sizes is presented.

PMID- 1761627
TI  - Capillary zone electrophoresis studies of motilin peptides. Effects of charge,
      hydrophobicity, secondary structure and length.
AB  - Motilin is a gut hormone, which is involved in gastrointestinal motility.
      Capillary electrophoresis studies were made on 24 peptides that are N-terminal, C
      terminal or internal fragments of motilin. The isoelectric point, total charge
      and hydrophobicity were calculated for all of the peptides. The effects of
      buffers and pH on migration time and resolution were studied. These included
      citrate buffer, pH 2.5; phosphate buffer, pH 7.0 and borate buffer, pH 10.0. A
      capillary zone electrophoresis method was developed to resolve 14 of the motilin
      peptides. Secondary structure predictions were made using the Chou-Fasman method.
      Circular dichroism spectra were collected to confirm presence of alpha-helix in
      several fragments. Effects of charge, hydrophobicity, secondary structure and
      length of the motilin fragments on migration time were studied.

PMID- 1761628
TI  - Fractionation of the human recombinant tissue plasminogen activator (rtPA)
      glycoforms by high-performance capillary zone electrophoresis and capillary
      isoelectric focusing.
AB  - This paper reports the fractionation of recombinant human tissue plasminogen
      activator (rtPA) glycoforms, a complex mixture to demonstrate the high resolving
      power of capillary zone electrophoresis (CZE) and capillary isoelectric focusing
      (cIEF). rtPA is a glycoprotein with a complex carbohydrate structure. The
      electropherograms and IEF patterns have been discussed in light of the known
      carbohydrate structures of rtPA. rtPA was treated with neuraminidase which
      removes the sialic acids from the carbohydrate chains. The desialylated rtPA was
      analyzed by both CZE and IEF and the results were compared to those of untreated
      rtPA. The usefulness of CZE and cIEF in the characterization of glycoproteins
      proteins is also discussed.

PMID- 1761629
TI  - High-performance capillary electrophoresis of histones.
AB  - A high-performance capillary electrophoresis (HPCE) system was developed for the
      fractionation of histones. This system involves electroinjection of the sample
      and electrophoresis in 0.1 M phosphate buffer (pH 2.5) in a 35 cm x 50 micron
      I.D. coated capillary. Electrophoresis was accomplished in 9 min, separating a
      whole histone preparation into its components in the following order of
      decreasing mobility: (MHP) H3, H1 (major variant), H1 (minor variant), (LHP) H3,
      (MHP) H2A (major variant), (LHP) H2A, H4, H2B and (MHP) H2A (minor variant),
      where MHP is the more hydrophobic component and LHP is the less hydrophobic
      component. This order of separation is very different from that found in acid
      urea polyacrylamide gel electrophoresis and in reversed-phase high-performance
      liquid chromatography and, thus, brings the histone biochemist a new dimension
      for the qualitative analysis of histone samples.

PMID- 1761630
TI  - Capillary electrophoresis for diagnosis and studies of human disease,
      particularly metabolic disorders.
AB  - High-performance capillary electrophoresis (HPCE) has been used in a
      multicomponent analytical system designed to diagnose and study human diseases,
      particularly metabolic disorders. Comparative analyses, using HPCE, high
      performance liquid chromatography (HPLC) and an automated amino acid analyser,
      were carried out on urine and blood samples from patients with homocystinuria,
      cystinuria, glutathione synthetase deficiency and adenylosuccinase deficiency.
      HPCE of the sulphur-containing amino compounds, derivatized with monobromobimane
      and detected by fluorescence spectroscopy, was a quick and simple alternative to
      classical amino acid analysis. The detection of the characteristic
      succinylpurines associated with adenylosuccinase defect was equally well achieved
      with HPLC and HPCE (absorbance detector). Owing to the possible connection
      between deficiency of taurine (2-amino-1-ethanesulphonic acid) in the heart and
      the development of cardiomyopathy and heart failure, a simple HPCE method was
      developed for the determination of taurine in sub-milligram samples of biopsies
      of the myocardium. The homologue 3-amino-1-propanesulphonic acid was the internal
      standard, and derivatives of 9-fluorenylmethyl chloroformate and fluorescence
      detection were used. It is suggested that the potential of HPCE to analyse small
      volumes should be exploited in biomedicine and clinical diagnosis to analyse sub
      milligram samples of tissue biopsies and cells.

PMID- 1761631
TI  - Determination of thiopental in human serum and plasma by high-performance
      capillary electrophoresis-micellar electrokinetic chromatography.
AB  - The quantitation of thiopental in human serum and plasma was investigated using
      high-performance capillary electrophoresis (HPCE) in a micellar configuration and
      the results were compared with reversed-phase high-performance liquid
      chromatography (HPLC). Thiopental and an internal standard (carbamazepine for
      HPCE and thiamylal for HPLC) were extracted from serum or plasma using pentane
      and a phosphate buffer (pH 6.4). HPCE analysis took place in a phosphate-borate
      buffer with 50 mM sodium dodecyl sulphate using an automated instrument and HPLC
      was performed with a C8 column and a mobile phase of phosphate buffer
      acetonitrile (65:35, v/v). HPCE and HPLC data from 66 patient samples compared
      well based on linear regression analysis. However, estimates obtained with the
      inclusion of the internal standard were lower than those based on the sample peak
      only. This example allows the elucidation of the advantages of using HPCE as an
      assay methodology for the therapeutic monitoring of thiopental and other drugs.

PMID- 1761632
TI  - Determination of small drug molecules by capillary electrophoresis-atmospheric
      pressure ionization mass spectrometry.
AB  - Capillary electrophoresis (CE) separations are reported for sulfonamides and
      benzodiazepines in an uncoated fused-silica capillary. The capillary column exit
      was connected to a liquid junction-ion spray interface combination coupled to an
      atmospheric pressure ionization (API) triple quadrupole mass spectrometric (MS)
      system. On-line UV detection occurred 20 cm from the inlet of the capillary and
      with the API mass spectrometer (CE-API-MS) after the entire length of the
      capillary (100 cm). The separations were made using volatile buffers composed of
      ammonium acetate (15-20 mM) with 15-20% of methanol to facilitate ionization
      under electrospray conditions. This study showed that the major metabolite of
      flurazepam in man, N-1-hydroxyethylflurazepam, could be detected and
      characterized in human urine by CE-UV-MS following the administration of a single
      oral dose of 30 mg of flurazepam dihydrochloride. The presence of additional
      flurazepam metabolites in human urine was observed by using the system,
      suggesting that a combination of UV with MS detection should be useful for
      metabolic studies. In addition to molecular weight determination of compounds,
      structural information may be obtained by utilizing online tandem mass
      spectrometry (CE-UV-MS-MS). This was demonstrated for sulfamethazine where the
      protonated molecule species was transmitted into the collision cell of the tandem
      triple quadrupole mass spectrometer. Collision-induced dissociation of the
      protonated sulfamethazine molecule yielded structural information characteristic
      of the sulfa drug following the on-column injection of 2 pmol of sulfamethazine.

PMID- 1761633
TI  - Electrochromatographic solid-phase extraction for determination of cimetidine in
      serum by micellar electrokinetic capillary chromatography.
AB  - A highly effective electrochromatographic solid-phase extraction and
      preconcentration method is reported for the determination of cimetidine in serum
      in the concentration range 0.233-11.4 micrograms/ml. Preconcentrated samples were
      determined by micellar electrokinetic capillary chromatography while ranitidine
      was used as an internal standard. Sample preparation included retention of the
      analyte on a C18 solid-phase cartridge, followed by elution assisted by an
      applied voltage of 150 V. From 0.5-ml serum samples, 20-50-microliters aliquots
      were collected for electrophoretic analysis. Within the studied concentration
      range, the method was linear and provided adequate precision.

PMID- 1761635
TI  - LC-MS compatible HPLC separation for xenobiotics and their phase I and phase II
      metabolites: simultaneous anion exchange and reversed-phase chromatography.
AB  - Benzene and five of its mammalian metabolites, phenol, phenyl-beta-D-glucuronide,
      phenylsulfate, phenylmercapturate, and t,t-muconic acid, are separated on a
      methylstyrene-divinylbenzene-based anion exchange--reversed-phase column. The
      retention of the model compounds is manipulated by modifying the type, ionic
      strength, and pH of the mobile phase buffer, and the type and percent of organic
      mobile phase modifier. The separations developed are compatible with both
      particle beam (PB) and thermospray (TSP) interfaces used in liquid chromatography
      mass spectrometry (LC-MS). These separations should be adaptable to the study of
      a wide range of xenobiotics and their phase I and phase II metabolites, and
      provide an LC-MS compatible alternative to the use of iron pairing reagents.

PMID- 1761634
TI  - Influence of operating parameters on reproducibility in capillary
      electrophoresis.
AB  - The reproducibility of two migration parameters (retention time and mobility) of
      a seven-component test mixture was examined under various operating conditions
      using laboratory-built capillary electrophoresis systems. It was found that the
      frequency of rinsing the capillary and the solutions used for rinsing had the
      greatest effect on migration reproducibility. In addition, it was found that the
      migration behavior of solutes that interact with micelles is not repeatable
      unless the proper rinse protocol is applied. Inconsistent migration behavior is
      linked to inconsistent total current of the system. Preliminary investigations
      indicate that the fluctuation in total current were associated with non
      equilibrium conditions between the buffer and the capillary wall.

PMID- 1761636
TI  - The application of solid phase extraction to the analysis of tobacco-specific
      nitrosamines.
AB  - A new isolation and separation method has been developed for the alkaloid-related
      nitrosamines in tobacco, called tobacco-specific nitrosamines (TSNA). The
      improved isolation procedure involves the extraction by sonication of TSNA from
      cured tobacco with toluene and an aqueous citrate buffer solution, while
      purification is achieved by solid phase extraction on small silica cartridges.
      Interfering extract materials are eluted from the silica cartridges with the
      toluene and a chloroform-methylene chloride solvent, while subsequent elution
      with chloroform yields the TSNA in a purified fraction. Gas chromatographic
      analyses on an SE-54-coated glass capillary column and detection by a nitrogen
      phosphorous detector produce very good data on the four TSNAs, which include N
      nitrosanatabine (NATB), N-nitrosoanabasine (NAB), 4-(N-methyl-N-nitrosamino)-1-(3
      pyridyl)-1-butanone (called NNK), and N-nitrosonornicotine (NNN). The method is
      shown to be quantitative, reproducible, and applicable to the determination of
      TSNA in various tobacco samples, such as stems and lamina of cured tobacco
      leaves, as well as to smokeless tobacco.

PMID- 1761637
TI  - Ion chromatographic determination of inositol tris- and tetrakisphosphates in rat
      brain.
AB  - Ion chromatography has been applied to the determination of inositol 2,4,5
      trisphosphate (Ins 2,4,5-P3), inositol 1,3,4-trisphosphate (Ins 1,3,4-P3),
      inositol 1,4,5-trisphosphate (Ins 1,4,5-P3), and inositol 1,3,4,5
      tetrakisphosphate (Ins 1,3,4,5-P4). Other common polyanionic metabolites,
      including ATP and GTP, do not interfere with the determinations even at
      concentrations exceeding those normally found in tissue extracts. Assay of rat
      brain for Ins 1,4,5-P3 and Ins 1,3,4,5-P4 by the method of standard addition
      gives values which are within 10% of the amount calculated by external
      calibration. When rat brain homogenates are spiked with Ins 1,4,5-P3, the
      recoveries are greater than 90%. Treatment of animals with lithium chloride and
      pilocarpine produces increases in total inositol trisphosphates from 14 to 64
      nMol/g wet weight, and increases in Ins 1,3,4,5-P4 from 0.9 to 18 nMol/g wet
      weight in tissue extracts obtained from the cerebral cortex. Using chemically
      suppressed conductivity, detection limits in brain are estimated to be 50 pMol/g
      wet weight for inositol trisphosphates and 22 pMol/g wet weight for inositol
      tetrakisphosphate.

PMID- 1761638
TI  - Effect of column and mobile phase modifications on retention behavior in size
      exclusion chromatography of polycyclic aromatic hydrocarbons on
      poly(divinylbenzene).
AB  - Results are reported from a study, the goal of which was the reduction of the
      nonsize effects that govern the size exclusion chromatography (SEC) of planar
      polycyclic aromatic hydrocarbons (PAHs) on poly(divinylbenzene) (PDVB). Thought
      to arise from electron-pair donor--electron-pair acceptor (EPD-EPA) interactions
      between column packing and PAH eluate, nonsize effects could be substantially
      reduced by the addition of bulky substituents to the PAH, thereby perturbing EPD
      EPA interactions between column and eluate. In this work we study the effect of
      adding a bulky substituent to the column material itself and have selected a
      sulfonated column material for this purpose. The-SO2OH group provides
      considerable steric shielding of the PDVB phenyl groups from the PAH eluates and
      thus its presence could weaken column-eluate interactions, but it is also
      electron-withdrawing and could possibly aggravate nonsize behavior, because the
      electron-pair acceptor strength of PDVB could be increased by electron
      withdrawing substituents. It was found that either an increase or decrease of EPD
      EPA bonding could result with the sulfonated PDVB (S-PDVB) columns, depending on
      the nature of the mobile phase. Size-dependent elution of PAHs could be obtained
      with S-PDVB for two classes of PAH by the inclusion of a small amount of hydrogen
      bonding solvent, i.e. methanol, to the mobile phase. It is thought that the
      methanol additive, by strongly hydrogen bonding with the S-PDVB sulfonic acid
      groups, provides the additional steric shielding necessary to minimize EPD-EPA
      interactions.

PMID- 1761639
TI  - Elevated monocyte interleukin-6 (IL-6) production in immunosppressed trauma
      patients. II. Downregulation by IL-4.
AB  - Aberrant monocyte mediator production is pivotal in the development of posttrauma
      immunosuppression. We have previously shown that immunodepressed trauma patients'
      monocytes produce elevated interleukin-6, suggesting their in vivo preactivation.
      This study confirms that preactivated patients' Mo produce greater levels of IL-6
      than normals' Mo to the same in the in vitro Fc gamma RI stimulation. We also
      demonstrate the capacity of interleukin-4 to downregulate the elevated
      interleukin-6 production of trauma patients' in vivo preactivated monocytes.
      Monocyte interleukin-6 downregulation by interleukin-4 is dose dependent and
      occurs whether Fc gamma RI cross-linking, muramyl dipeptide, indomethacin plus
      muramyl dipeptide, or interferon-gamma plus muramyl dipeptide is the interleukin
      6 inducing stimulus. Furthermore, interleukin-4-dependent downregulation of
      monocyte interleukin-6 expression is confirmed at both the supernatant and the
      mRNA levels. Simultaneous downregulation of posttrauma elevated monokines implies
      a possible therapeutic benefit of interleukin-4 for trauma patients.

PMID- 1761640
TI  - Subset markers of CD8(+) cells and their relation to enhanced cytotoxic T-cell
      activity during human immunodeficiency virus infection.
AB  - Using fresh whole blood or isolated lymphocytes, the activity of in vivo
      generated cytotoxic T-lymphocytes (CTL) was measured as the OKT3-specific lysis
      of HL-60 targets, in a cross-sectional study of 53 HIV (+) patients. CTL activity
      in the entire HIV(+) group was two to three times higher than in HIV(-) controls,
      with WHO stage 3 (=pre-AIDS) patients showing the highest cytolytic function. The
      whole-blood CTL assay was validated and its practical and theoretical advantages
      are discussed. Within the CD8(+) cells, the number and proportion of the
      CD45RO(+) "memory" subset were significantly increased in HIV(+) subjects. The
      HLA-DR(+) subset rose most spectacularly in the asymptomatic stage of the
      infection, while the CD38(+) subset was the only one still significantly rising
      between the pre-AIDS and the AIDS stage. CTL activity was most closely correlated
      with T8 cells expressing the CD38 marker. In the context of CTL, CD38 thus seems
      to reflect activation rather than immaturity. Lymphocytes from HIV(+) subjects
      with a high OKT3-specific lytic capacity also destroyed normal lymphoblasts to a
      significant extent, pointing to their possible involvement in an autodestructive
      process. Our data thus suggest the importance of T8 cytolytic function and/or T8
      subtyping in the immunopathogenesis and the prognosis of HIV infection.

PMID- 1761641
TI  - Indomethacin-sensitive monocyte killing defect in a child with disseminated
      atypical mycobacterial disease.
AB  - A child with disseminated disease due to Mycobacterium avium had progressive
      disease in spite of 4.5 years of therapy with multiple antimicrobial agents
      selected on the basis of in vitro sensitivity testing of her organism. A defect
      in monocyte bactericidal activity was detected which was corrected in vitro by
      exposure of the patient's monocytes to indomethacin and normal serum.
      Indomethacin therapy resulted in normalization of monocyte bactericidal activity
      and striking, albeit temporary, clinical improvement.

PMID- 1761642
TI  - Treatment of septic thrombocytopenia with immune globulin.
AB  - Thrombocytopenia frequently complicates systemic infection and results from
      multiple possible mechanisms. We and others have demonstrated that platelet
      associated IgG (PAIgG) levels are elevated in the majority of patients with
      septic thrombocytopenia. Corticosteroids may be undesirable as a treatment for
      thrombocytopenia for patients with severe infection because of their potential
      for suppressing the immune response. We hypothesized that septic thrombocytopenia
      is, in most cases, an immune disorder analogous to idiopathic thrombocytopenic
      purpura (ITP) which might respond to intravenous gamma-globulin as a treatment
      for increasing the platelet count in this disorder. Intravenous immune globulin
      (IVIG), 400 mg/kg daily for 3 days, was administered in a randomized double-blind
      placebo-controlled trial. Twenty-nine patients who developed thrombocytopenia
      during a documented, septic episode were studied. Patients with disseminated
      intravascular coagulation (DIC), hypersplenism, or drugs known to cause
      thrombocytopenia were excluded. Elevated PAIgG levels were documented in 52% of
      evaluable patients. Mean platelet counts in the IVIG group rose from 43K at study
      entry to 178K (411% rise) by Day 9. In the placebo group platelets rose from 51K
      to 125K (261% rise; P = 0.02). Seventy-seven percent of the IVIG group had a
      minimum peak rise of 35K, vs 56% of the placebo group. Three patients in the
      placebo group had a serious bleeding episode, vs one in the IVIG group. The use
      of IVIG to treat septic thrombocytopenia not associated with DIC leads to a more
      rapid, more sustained, and greater increase in platelet count than placebo. Its
      use is recommended in the septic patient who is bleeding or is likely to need
      invasive or surgical procedures.

PMID- 1761644
TI  - The biological imagination.

PMID- 1761643
TI  - Severe combined immune deficiency presenting with cyclic hematopoiesis.
AB  - At age 2 months a male infant presented with a cyclic clinical syndrome every 14
      21 days that included pharyngeal aphthous ulcers, high fever, lymphadenopathy,
      pallor, and malaise. Serial blood studies indicated cycling of all blood cell
      elements, compatible with a diagnosis of cyclic hematopoiesis (CH). He also
      manifested a progressively severe immune deficiency, not described before in
      human CH. When first studied at age 5 months, he was hypogammaglobulinaemic with
      normal B lymphocyte numbers. By 6.5 months, he was agammaglobulinaemic. At age 8
      months, he developed severe pneumocystis carinii pneumonia, and studies showed a
      state of severe combined immune deficiency. The patient received a bone marrow
      transplant from his HLA-identical sister with no preconditioning therapy.
      Subsequently, normal immune function developed and the cyclic hematopoiesis
      resolved. The majority of lymphocytes is of donor origin. Persistence of
      erythrocytes and neutrophils of recipient origin suggests that the hematopoietic
      stem cells were not abnormal. We speculate that this patient had a primary
      deficiency of a differentiation factor affecting maturation of lymphoid and
      myeloid progenitor cells.

PMID- 1761645
TI  - A quantitative genetic analysis of localized morphology in mandibles of inbred
      mice using finite element scaling analysis.
AB  - We analyzed patterns of mandibular genetic and phenotypic morphological
      integration and the relationship of genealogy to interstrain molecular and
      morphological differences in ten inbred strains of mice. Positions of mandibular
      landmarks in two-dimensional space were used to construct a finite element mesh
      for each individual, then all individuals from the ten strains were compared to
      the average mandible from a standard strain (SEA/GnJ). Measures of size and shape
      associated with finite element scaling analysis were then used in a quantitative
      genetic analysis of mandibular variation. Significant genetic variation for
      mandibular size and shape was uncovered. Patterns of both genetic and phenotypic
      correlation for measures of landmark-specific sizes were consistent with models
      of morphological integration based on the developmental origin of parts of the
      mandible and on the effects of muscle attachment on mandibular morphology. Shape
      differences local to particular landmarks did not show these forms of
      morphological integration. Although interstrain distances based on local shape
      magnitudes were significantly correlated with genealogical relationship,
      distances based on local size differences were not. Even higher than the
      correlation of genealogy with distances based on local shape magnitude was the
      genealogical-molecular distance correlation. Patterns of morphometric mandibular
      variation corresponded to expected effects of epigenetic developmental processes.
      Also, when detailed shape differences were considered, morphology served as a
      rough guide to genealogy, although molecular distances showed a stronger
      relationship.

PMID- 1761646
TI  - Immunohistochemical localization of TGF-B1 during morphogenetic movements of the
      developing mouse palate.
AB  - Transforming growth factor-beta (TGF-B1) may play an important role in
      developmentally active tissues in which it is found in high concentrations. We
      localized TGF-B1 in the developing fetal mouse palate immunohistochemically using
      a polyclonal antibody. Mouse fetal palates at 12-17 days (inclusive) of gestation
      were examined and specific focal concentrations of TGF-B1 identified regions
      undergoing active morphogenesis. The association of TGF-B1 with aggregates of
      mesenchymal cells in the palate and chondroblasts, rhabdomyocytes, and epithelia
      of the craniofacial complex strongly implicates its role in proliferation and
      differentiation in the developing mouse palate. We believe these findings have
      important bearing on the normal development of the palate as well as cleft
      anomalies.

PMID- 1761647
TI  - Does the tongue play a role in the initial development of vertical palatal shelf
      in hamster?
AB  - A study was undertaken to examine whether the tongue plays any role in
      determining the primordial development of palatal shelves in a vertical direction
      in mammals. Control and 6-mercaptopurine-treated embryos from Golden Syrian
      hamsters were examined by scanning electron microscopic and histological
      techniques for the spatio-temporal relationship of primordial development of the
      palate, tongue, and mandible. DNA synthesis, measured by 3H-thymidine
      incorporation, was used as an index of growth. The data indicated that in
      controls, vertical palate development began in the anterior half from the roof of
      the oronasal cavity, whereas the tongue bulges and the mandibular process
      developed in the posterior half of the oronasal cavity. A burst in DNA synthesis
      occurred in the palate and mandible, but not in the tongue. In 6-mercaptopurine
      treated fetuses, although the chronological appearance of primordia of all three
      structures was normal, DNA synthesis was inhibited in all three structures. The
      recovery in DNA synthesis, albeit partial, was faster in the palate and mandible
      than in the tongue. On the basis of observations from the present study, along
      with those from other vertebrates, it is suggested that the developing tongue may
      not play any role in determining the direction of development of the palatal
      primordia.

PMID- 1761648
TI  - Measurement precision and reliability in craniofacial anthropometry: implications
      and suggestions for clinical applications.
AB  - Craniofacial anthropometry has become an important tool used by both clinical
      geneticists and reconstructive surgeons. Yet little attention has been paid to
      the potentially serious problem of measurement error. This paper examines intra
      observer measurement error and precision (also called repeatability or
      reliability) for 52 commonly used anthropometric variables of the head and face.
      Two factors proved critical to reliability: magnitude of the measurement in
      question and the degree to which its constituant landmarks could be readily
      identified. Thus, all of the measurement variables with means above 10 cm proved
      to have good or excellent reliability. In contrast measurement variables with
      means below 10 cm were more likely to have poor reliability. This trend was
      especially evident in variables with means of 6 cm or less where 18 of the 20
      variables in this range had poor reliability. The least reliable variables were
      those like philtrum breadth, columella breadth, and nasal root breadth that
      combine small magnitude with difficult to define landmarks. While these results
      suggest that it may be prudent to avoid using craniofacial variables with small
      dimensions this may be neither practical nor desirable. In such cases repeat
      measurements may be the best means for optimizing reliability.

PMID- 1761649
TI  - Heritability of dental arch dimensions in humans.
AB  - The purposes of this study were to estimate the heritabilities of several human
      dental arch dimensions and compare the hereditary differences among kinships and
      among variables. The sample consisted of 102 Japanese families, each including
      both parents and one of their offspring, and on average all subjects had
      relatively well-aligned permanent dentitions. The heritabilities of all variables
      were estimated from the regression of offspring on parent and on midparent.
      Results showed that genetics played a role regarding dental arch dimensions, and
      arch perimeter (sum of tooth width) was a more definite genetic-related factor
      than other arch dimensions, such as width, length, or size. There were few
      significant hereditary differences between sons and daughters, and between upper
      and lower arches for each variable. Sex chromosomal involvement was not
      confirmed, but maternal effects were found to be more evident in daughters than
      in sons, for both arches. Comparisons among the heritabilities of overall and of
      anterior arch dimensions indicated that size of the anterior part of the dental
      arch might be less resistant to environmental factors, especially in case of the
      lower arch.

PMID- 1761650
TI  - Developmental stage of the dentition and speech sound production in a series of
      first-grade schoolchildren.
AB  - This study was undertaken to investigate the effect of developmental stage of the
      dentition on speech sound production in children with and without articulatory
      speech disorders. In the whole sample, there were 281 subjects, mean age 7.5
      years (SD 0.4). The stage of the eruption of the permanent incisors was
      calculated as the percentage height of each tooth of the mean crown height of the
      corresponding tooth in a group of 252 young adults. Eruptional stage of the first
      permanent molars was classified into three categories. Articulatory disorders
      were diagnosed by one experienced speech therapist and phoniatrician using the
      Remes Articulation Test [Remes, 1975] for the Finnish language. The results
      showed a wide interindividual variation in developmental stage of the dentition
      in a group of 7-year-old children with a tendency of the first permanent molars
      but not the incisors to erupt earlier in girls than in boys. Boys had a higher
      frequency of misarticulations estimated to need treatment than did girls. The
      present results indicate that during eruption of permanent teeth it is more
      important to draw attention to symmetrical eruption and to individual timing
      pattern rather than to the mean values of tooth eruption in subjects of the same
      age. The findings also suggest a decreasing risk of faulty speech sound
      production with advancing eruption of some permanent teeth still present in 7
      year-old children.

PMID- 1761651
TI  - Advanced heterotopic pregnancy after in-vitro fertilization and embryo transfer,
      with survival of both the babies and the mother.
AB  - A combination of an extra-uterine and an intra-uterine pregnancy is defined as
      heterotopic pregnancy. An infertile patient, pregnant at her fourth in-vitro
      fertilization/embryo transfer attempt, was diagnosed at 21 weeks' gestation as
      having simultaneous abdominal and intra-uterine pregnancy. Expectant management
      under strict hospitalization was proposed and accepted by the couple, fetal
      assessment was by serial ultrasound evaluation of growth and amniotic fluid
      volume and by non-stress tests. Planned operative delivery was accomplished at 34
      weeks' gestation. Both the mother and infants are alive and well.

PMID- 1761652
TI  - Micromanipulation of gametes using laser microbeams.
AB  - Various microsurgical procedures at the cellular and subcellular levels using
      laser non-touch techniques are presented and reviewed. In these procedures, the
      beams of light, varying in their wavelength (range: 14 ns to continuous wave),
      were directed via microscopes towards the target area. Micromanipulation of human
      spermatozoa with a laser-generated optical trap enabled the assessment of
      possible effects on sperm motility and measurements of the relative force
      generated by each single spermatozoon. Furthermore, the optical trap also
      provides a new approach to the measurements of intracellular forces without
      physically touching the cell or its organelles, and inducing chromosome movement
      during cell division is also possible. Laser beams in a specific configuration
      are able to induce minimal superficial damage to the zona pellucida of oocytes
      from various species. This manipulation is aimed at increasing the fertilization
      rate following insemination with low-quality spermatozoa. Another intracellular
      application of the laser beams is the destruction of extra pronuclei in
      polyspermic fertilized human oocytes. These procedures require special equipment
      which is not commonly available. However, simpler devices may be developed if the
      advantages of this novel technology are demonstrated.

PMID- 1761653
TI  - Premature chromosome condensation as a sign of oocyte immaturity.
AB  - In this work we report the possibility that oocyte immaturity is associated with
      premature chromosome condensation (PCC) after in-vitro fertilization (IVF). Using
      a murine model, we have related PCC and endoreduplicated-like oocytes to oocyte
      immaturity as a basis for a prognosis in oocyte immaturity problems. The
      cytogenetic analysis was performed in 511 embryos obtained from immature oocytes
      that were directly fertilized in vitro and in 1363 embryos obtained from immature
      oocytes that were matured in vitro with different concentrations of human
      chorionic gonadotrophin (HCG) added to the culture medium. As a control we used
      507 embryos obtained from freshly ovulated oocytes. PCC at the G1-phase-(G1-PCC)
      was observed only when immature oocytes were immediately fertilized in vitro
      (45.4%) and PCC at the S-phase (S-PCC) only when using in-vitro matured oocytes
      with the highest HCG concentration (3.3%). Neither G1-PCC nor S-PCC were found in
      the control group. Endoreduplicated-like oocytes appeared in a significant
      percentage (27.3%) only in the immature group. Immature oocytes yielded a low
      fertilization rate (16.6%) while in-vitro maturation seemed to confer a higher
      fertilization capacity compared to the control group (90.1% versus 78.2%). The
      possible correlation between PCC and oocyte immaturity provides new prospects in
      the determination of human IVF failures of unknown origin. Thus, when a problem
      of oocyte immaturity is diagnosed through the presence of PCC, a special
      programme of in vitro oocyte maturation, such as a longer preincubation time or
      addition of hormones to the media, would be recommended.

PMID- 1761654
TI  - Vagaries of sperm preparation techniques and fertilization failure in assisted
      reproductive technology.

PMID- 1761655
TI  - Ultrasonographic appearance of the endometrium in natural and stimulated in-vitro
      fertilization cycles and its correlation with outcome.
AB  - Ultrasonographic evaluation of the endometrium in 56 IVF patients was performed
      prospectively. Endometrial thickness and pattern were analysed in 18 natural
      cycle and 38 stimulated-cycle patients. Thickness was measured from the echogenic
      interface of the endometrium-myometrium junction on a transverse section at the
      level of the fundus. Patterns were classified as A (homogeneous, hyperechogenic),
      B (mixed, with an outer hyperechogenic and inner hypoechogenic layer) or C (fluid
      filled cavum with ring configuration). The thickness and pattern distributions
      were similar in natural- and stimulated-cycle patients. There was no correlation
      between thickness and serum oestradiol levels, the diameter of the largest
      follicle or the pregnancy outcome in either group. However, the occurrence of
      endometrial pattern A on the day prior to oocyte retrieval had a predictive value
      of 100% for a non-conceptional cycle. In contrast, pattern B occurred in a
      significantly greater proportion of pregnant than non-pregnant patients.

PMID- 1761656
TI  - The effect of progesterone upon first trimester trophoblastic cell
      differentiation and human chorionic gonadotrophin secretion.
AB  - The effect of progesterone (P) upon first trimester placental secretion of human
      chorionic gonadotrophin (HCG) and cellular differentiation was studied using both
      static and kinetic methods. At 1 microM, P inhibited spontaneous episodic
      secretion of HCG when given in short pulses (1-4 min) to placental explants in
      superfusion. Both HCG pulse frequency and amplitude were reduced. At 0.1-0.01
      microM P concentrations, the effect of HCG secretion was milder. P also blocked
      the maximally effective concentration 100 pM of gonadotrophin releasing hormone
      (GnRH) analogue, a known HCG stimulant, when given together with it for 1 min.
      This inhibitory effect lasted for 1 h after P administration. Progesterone at 1
      microM, added daily for 1 week blocked HCG secretion by isolated trophoblastic
      cells in static culture. This inhibitory effect lasted until the fifth day. No
      effect on differentiation and long-term viability was noticed in P-treated cells.
      Incubation with 0.1-1.0 microM P did not affect HCG secretion by explants after
      24 h. In contrast, the effect of 1 microM cortisol or 1 nM oestradiol was
      stimulatory. In conclusion, P exerts both a rapid and delayed inhibitory effect
      upon HCG secretion and production. It may do so by counteracting the stimulatory
      effect of endogenous GnRH on gonadotrophin secretion by the placenta.

PMID- 1761657
TI  - Hormonal and histological evaluation of the luteal phase after combined GnRH
      agonist/gonadotrophin treatment for superovulation and luteal phase support in in
      vitro fertilization.
AB  - A hormonal and histological study of the luteal phase was performed in 21
      stimulated in-vitro fertilization (IVF) patients not undergoing embryo transfer.
      Ovarian stimulation was carried out with gonadotrophins [follicle stimulating
      hormone (FSH) + human menopausal gonadotrophin (HMG)] under pituitary suppression
      with buserelin. Ovulation was induced with 5000 IU human chorionic gonadotrophin
      (HCG) and additional doses of 5000, 2500 and 2500 IU were given on the day of
      follicular aspiration, and 2 and 5 days later respectively, to support the luteal
      phase. Supraphysiological levels of oestradiol (E2) and progesterone in plasma
      were found in the midluteal phase of all women, while prolactin was in the normal
      range. An endometrial biopsy taken in the late luteal phase was normal in 90.5%
      (19/21) of patients, most of them (15/19, 79%) having E2 greater than 1500 pg/ml
      on the day of HCG. Conversely, both patients with defective endometrial biopsies
      had E2 levels less than 1500 pg/ml.

PMID- 1761658
TI  - Comparison of 'poor' responders with 'good' responders using a standard
      buserelin/human menopausal gonadotrophin regime for in-vitro fertilization.
AB  - This study identifies a group of 87 patients, who demonstrated a 'poor' response
      to a standard buserelin/human menopausal gonadotrophin (HMG) regime. The
      subsequent outcome in 61 of these 'poor' responders when treated with a higher
      dose of HMG to achieve a satisfactory response was compared with 250 patients,
      who showed a 'good' response to the standard regime. 'Poor' responders were
      significantly older than 'good' responders (P less than 0.001), but no
      significant difference was demonstrated in the indication for in-vitro
      fertilization (IVF). Even on higher doses of HMG, 'poor' responders took longer
      for their follicles to achieve maturity than the 'good' responders (P less than
      0.01). 'Poor' responders produced 8.9 oocytes per oocyte collection compared to
      11.8 in the 'good' responders (P less than 0.01). The fertilization rate was
      significantly lower in the 'poor' responders compared to the 'good' responders (P
      less than 0.01). Although there was no significant difference in morphometric
      grading between 'poor' responder embryos and 'good' responder embryos, the rate
      of cell division was significantly slower in embryos of the 'poor' responders
      than the 'good' responders (P less than 0.01). The pregnancy rate per oocyte
      retrieval was 9% in the 'poor' responders compared to 29% in the 'good'
      responders (P less than 0.01). The implantation rate in the 'poor' responders was
      4.4% compared to 16.1% in the 'good' responders (P less than 0.001).

PMID- 1761659
TI  - Does ovarian stimulation for in-vitro fertilization induce a hypercoagulable
      state?
AB  - Effects on blood coagulation and fibrinolytic activity during ovarian stimulation
      for in-vitro fertilization (IVF) were examined in 12 women. Blood samples were
      taken prior to hormonal stimulation (days 2-3 of the menstrual cycle, mean serum
      oestradiol concentration 0.16 nmol/l) and the day after ovulation induction with
      human chorionic gonadotrophin (HCG) (days 10-12, mean serum oestradiol
      concentration 5.35 nmol/l). We measured whole blood clotting time, whole blood
      clot lysis time, plasma fibrinogen, factor VII and antithrombin III. The whole
      blood clotting time was slightly, but not significantly shortened after ovarian
      stimulation. A significant rise in plasma fibrinogen (P less than 0.001) and
      reduction in antithrombin III (P less than 0.001) were observed, whereas no
      change in factor VII was found. The blood fibrinolytic activity was significantly
      reduced as evaluated by an increase in the clot lysis time (P less than 0.02).
      These results indicate that ovarian stimulation for IVF may create a state of
      hypercoagulability.

PMID- 1761660
TI  - Use of the hormonal response to clomiphene citrate as an endocrinological
      indicator of ovarian ageing.
AB  - We compared the gonadotrophin and oestradiol responses to clomiphene citrate (CC)
      in women aged 18-25 versus 35-40 years. Despite similar baseline hormone
      concentrations and the attainment of similar concentrations of the E and Z
      isomers of clomiphene, higher follicle stimulating hormone (FSH) concentrations
      were observed in the older women, possibly indicative of their ageing ovaries.
      Furthermore, diminished oestradiol responses occurred in a subgroup of women
      showing FSH hyper-responsiveness to CC. These preliminary results support the
      concept that the hormonal response to CC may be an indicator of approaching
      perimenopause.

PMID- 1761661
TI  - Biochemical monitoring during hormone replacement therapy cycles for transfer of
      cryopreserved embryos in patients with functional ovaries.
AB  - Biochemical monitoring was undertaken in 22 treatment cycles for women with
      normal ovarian function who underwent pituitary suppression with buserelin and
      administration of exogenous oestradiol (E2) and progesterone (P) for
      cryopreserved embryo transfer (ET). Eighteen transfers of 1-4 thawed embryos, on
      the third day of exposure to progesterone, resulted in five clinical pregnancies
      (27.8%) and one biochemical pregnancy. There was no difference between pregnant
      and non-pregnant patients in the number and quality of embryos transferred, age,
      weight or infertility diagnosis. Serum E2 level from days 10-17 (the late
      proliferative phase) of the therapy cycle were significantly higher in the
      pregnant group compared with the non-pregnant group (P less than 0.05--P less
      than 0.005). There were no significant differences in P levels between the two
      groups from the onset of progesterone administration to the end of the cycle.
      However, as might be expected, the mean E2/P molar ratio in the pregnant group
      was significantly higher at the time of ET (P less than 0.02). It is concluded
      that biochemical monitoring during the embryo replacement cycle is necessary to
      tailor drug dosages for individual requirements to achieve adequate E2 levels
      before ET. Alternative routes of oestradiol administration need to be considered
      in patients with poor E2 profiles.

PMID- 1761662
TI  - Selective drop-out in successive in-vitro fertilization attempts: the pendulum
      danger.
AB  - Success rates from in-vitro fertilization (IVF) in the long term are dependent on
      selection procedures with regard to continuation into further IVF episodes.
      Publications on success rates in successive episodes will give incentives to
      adapt selection criteria, but if these publications do not deal explicitly with
      patient selection, the adaptations might change their direction every time: the
      pendulum danger.

PMID- 1761663
TI  - Beneficial effects of a 24 h delay in human chorionic gonadotrophin
      administration during in-vitro fertilization treatment cycles.
AB  - We used a gonadotrophin-releasing hormone agonist (buserelin) and human
      menopausal gonadotrophin (HMG) for superovulation for in-vitro fertilization
      (IVF) in 143 patients. The patients were prospectively allocated to two balanced
      groups. In one group (47 patients) human chorionic gonadotrophin (HCG) was given
      when the three largest follicles were greater than or equal to 17 mm in diameter,
      with consistent levels of plasma oestradiol (standard group). In the second group
      (96 patients), HCG injection was delayed by 24 h (delayed group). In the delayed
      group of patients, proportionately more had clinical pregnancies (52.1% versus
      34.0%). These results suggest that IVF patients will benefit from delayed
      administration of HCG. The traditional criteria for HCG administration should be
      changed when buserelin is used.

PMID- 1761664
TI  - Multiple follicular recruitment and intrauterine insemination outcomes compared
      by age and diagnosis.
AB  - We studied the outcome of our intrauterine insemination (IUI) programme,
      evaluating female age and diagnosis. One-hundred-and-twenty-six patients less
      than 36 years of age (mean 30.91 +/- 3.02 years) completed 306 cycles of multiple
      follicular recruitment (MFR) and timed IUI; 64 patients greater than or equal to
      36 years of age (mean 38.36 +/- 2.08 years) completed 166 cycles (total 190
      patients, 472 cycles). The male partners' semen was prepared for IUI with wash
      and swim-up techniques. Diagnostic groups were: male factor (n = 26), idiopathic
      (n = 33), endometriosis (n = 19), ovulatory disorder (n = 7), other (n = 19) and
      combined factors (n = 86). Pregnancy rates (% per couple, % per cycle) [overall
      (31.58, 12.7)] [less than 36 years (38.10, 15.69)] [greater than 36 years (18.75,
      7.23)] were greater in the less than 36 years group (P less than 0.025). The
      probability of conception after three treatment cycles was 0.402 overall, 0.481
      for age less than 36 years and 0.252 for age greater than or equal to 36 years.
      The probability of conception for male factor and idiopathic infertility patients
      was 0.469 and 0.411 respectively. An age effect was found on pregnancy rates in
      the idiopathic group only. In conclusion, MFR + IUI is a valuable treatment
      especially for male factor patients and patients less than 36 years old, with
      idiopathic infertility.

PMID- 1761665
TI  - The ESHRE multicentre trial on the treatment of unexplained infertility: a
      preliminary report. European Society of Human Reproduction and Embryology.
AB  - Nineteen European fertility centres participated in a controlled randomized trial
      aimed at comparing the effectiveness of five methods for the treatment of
      unexplained infertility. Each centre was invited to employ two of the five
      treatments being investigated, and the treatment allocated to individual patients
      was then decided by randomization. The treatments were superovulation alone, and
      superovulation together with one of the following procedures: intra-uterine
      insemination (IUI), intra-peritoneal insemination (IPI), gamete intra-Fallopian
      transfer (GIFT), in-vitro fertilization (IVF). All the patients admitted to the
      study had experienced greater than 36 months infertility prior to the start of
      the trial, and only patients less than 38 years of age were included in the
      investigation. Further, the study was confined to patients with normal Fallopian
      tubes, and where there was evidence of spontaneous ovulation. Yet another
      prerequisite for inclusion in the study was that the male partner was 'normal' as
      regards fertility. Due to unavoidable practical difficulties, the experimental
      design eventually obtained was severely unbalanced. Nevertheless, objective
      statistical comparisons were possible among the five treatments, using non
      orthogonal analyses of variance. By the completion of the trial 444 patients had
      been treated in a total of 649 cycles. There was some statistical evidence that
      the pregnancy rate obtained from superovulation alone was inferior to that
      obtained by using superovulation together with one of the methods of assisted
      conception.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761666
TI  - Are there predictive criteria of complicated ovarian hyperstimulation in IVF?
AB  - Among 599 trials of in-vitro fertilization (IVF) treatment, complicated ovarian
      hyperstimulation (OHSS) was diagnosed in 14 cases (2.5%) on the basis of heavy
      abdominal discomfort and echographic findings (ascites, ovarian enlargement with
      cysts). Among eight hospitalized patients, four presented with a
      haemoconcentration and/or electrolytic disturbances. OHSS cases were compared
      with two control groups for a series of criteria: age, aetiology of infertility,
      total dose of human menopausal gonadotrophin (HMG), day of oocyte collection,
      oestradiol (E2) peak level, rate of E2 increase, number of oocytes, number of
      embryos transferred and embryonic vitality scores. Comparison with a random group
      of normal IVF trials showed a significant difference for the following
      parameters: E2 peak level and rate of increase, E2/dose of HMG, E2/day of egg
      collection and number of oocytes. When OHSS cases were compared to another
      control group consisting only of high E2 responders (peak E2 greater than 2700
      pg/ml), no significant difference was found for any of the above-mentioned
      criteria. In view of this lack of predictive power of individual criteria,
      stepwise discriminant analysis was applied, showing that this method might
      provide a predictive mathematical function for evaluating the risk of OHSS before
      human chorionic gonadotrophin (HCG) administration. Such a formula, however,
      should be validated by a multicentric study in which a greater number of OHSS
      cases would be tested.

PMID- 1761667
TI  - The history of endometriosis: identifying the disease.
AB  - The history of endometriosis is reviewed in the light of today's clinical and
      pathological knowledge of this disease. Prior to Sampson's report in 1921,
      attention was focused on the enclosed type of endometriosis, sited deep in the
      pelvis and called adenomyosis externa. Sampson's first hypothesis, that rupture
      of an ovarian endometrioma caused superficial peritoneal endometriosis, was
      probably changed after this observation that the free, superficial peritoneal
      implants reacted like eutopic endometrium. These implants were recognized as
      implants from menstrual blood regurgitated into the pelvic cavity. Adenomyosis
      externa, ovarian endometrioma and peritoneal endometriosis then came to be
      regarded as the same disease. In the light of today's knowledge, it may be
      important to remember this progressive understanding in the nosology of what is
      now universally called pelvic endometriosis.

PMID- 1761668
TI  - Some disturbances of acrosomal development and function in human spermatozoa.
AB  - Disturbances of acrosomal development and function significantly impair the
      fertilizing capacity of spermatozoa. Therefore, evaluation of acrosomal
      morphology and function is of particular importance in the diagnostic testing of
      male infertility. Acrosomal disturbances include either specific defects showing
      a complete absence of certain acrosomal structures or various acrosomal
      malformations in combination with nuclear or flagellar defects which indicate
      acquired testicular disorders. As examples of specific acrosomal defects, the
      syndrome of round-headed spermatozoa (globozoospermia), the crater defect
      syndrome and the syndrome of decapitated spermatozoa are discussed. In addition
      to disturbances of acrosomal morphology, the assessment of acrosomal proteinase
      activity and the acrosome reaction as a method of evaluating impaired acrosomal
      functions is discussed. Clinical examples demonstrate the importance of these
      sperm function tests in the fertility testing of infertile men.

PMID- 1761669
TI  - Use of aniline blue to assess chromatin condensation in morphologically normal
      spermatozoa in normal and infertile men.
AB  - Chromatin condensation is vital for the function of the spermatozoon as the
      motile carrier of the paternal genome. The degree of condensation can be shown
      with the aid of acidic aniline blue staining, which is able to discriminate
      between lysine-rich histones and arginine- and cysteine-rich protamines. Using
      this technique and employing the Dusseldorf classification of sperm morphology in
      cases of disturbance of spermatogenesis, it was demonstrated that chromatin
      condensation is impaired not only in malformed but also in morphologically normal
      spermatozoa. Among morphologically normal spermatozoa, the percentages of
      spermatozoa with chromatin condensation disturbances increase in patients with
      different patterns of sperm malformation, if compared with patients with
      normozoospermia.

PMID- 1761670
TI  - Sperm morphological assessment based on strict criteria and in-vitro
      fertilization outcome.
AB  - One-hundred-and-twenty-three in-vitro fertilization (IVF) cycles were analysed in
      order to clarify the influence of strictly normal morphology (SNM) of spermatozoa
      on IVF outcome. SNM was defined using strict criteria according to Kruger with
      our modifications. The IVF cycles studied were divided into three groups: %SNM
      less than 12% (13 cycles), 12 less than 40% (68 cycles), greater than or equal to
      40% (42 cycles). The cleavage rates per oocyte were higher in the groups with 12
      40% and greater than or equal to 40% of %SNM than in the group with %SNM less
      than 12%. The embryo transfer rate per cycle increased with increasing %SNM. The
      overall pregnancy rate per cycle increased with increasing %SNM (7.7% in %SNM
      less than 12%, 22.1% in 12-40% of %SNM, and 40.5% in %SNM greater than or equal
      to 40%). The ongoing pregnancy rate per cycle also increased with increasing %SNM
      (7.7% in %SNM less than 12%, 14.7% in 12-40% of %SNM, and 31.0% in %SNM greater
      than or equal to 40%). The miscarriage rate was lower in %SNM greater than or
      equal to 40% (23.5%) than in 12-40% of %SNM (33.3%). It was suggested that %SNM
      is a good predictor of IVF outcome.

PMID- 1761671
TI  - Protective role of superoxide dismutase in human sperm motility: superoxide
      dismutase activity and lipid peroxide in human seminal plasma and spermatozoa.
AB  - The levels of superoxide dismutase (SOD), a highly specific scavenging enzyme for
      superoxide anion radicals (O2-), and lipid peroxide produced by oxygen free
      radicals were measured in human seminal plasma and spermatozoa. Seminal plasma
      contained 366.8 +/- 20.9 U/ml (mean +/- SE) of SOD activity. SOD activity in
      human spermatozoa showed a significant correlation to the number of motile
      spermatozoa, while the activity in seminal plasma did not relate to the sperm
      concentration or motility. The lipid peroxide concentration in seminal plasma was
      6.22 +/- 0.46 nmol/ml and had no significant relationship to sperm concentration
      or motility. The malondialdehyde (MDA) concentration in spermatozoa was
      significantly related to the number of immotile spermatozoa. A decrease in the
      motility of spermatozoa incubated in medium without seminal plasma was observed
      after 120 min, while the MDA concentration of the spermatozoa increased. Addition
      of exogenous SOD (400 U/ml) to the sperm suspension significantly decreased this
      loss of motility and the increase of the MDA concentration. These data suggest a
      significant role for SOD in sperm motility. It seems that lipid peroxidation of
      human spermatozoa may cause loss of motility and that SOD may inhibit this lipid
      peroxidation. These results suggest that SOD may have a possible clinical
      application in the use of spermatozoa for in-vitro fertilization (IVF) or
      artificial insemination.

PMID- 1761672
TI  - Feasibility of semen collection and cryopreservation during chemotherapy.
AB  - Collection and cryopreservation of semen was undertaken in a 40-year-old man
      undergoing combination cyclophosphamide-doxorubicin-vincristine-prednisone
      chemotherapy for diffuse large cell lymphoma. Semen samples worthy of
      cryopreservation could be obtained through 39 days of therapy, with azoospermia
      observed after 70 days. Although pregnancy has not been attempted in the current
      case, reports by others suggest that normal outcomes can be expected with thawed
      semen collected during chemotherapy.

PMID- 1761673
TI  - The use of a pretherapeutic, predictive score to determine inclusion criteria for
      the non-surgical treatment of ectopic pregnancy.
AB  - Non-surgical management of ectopic pregnancy has recently become an alternative
      to surgery. We have investigated a pretherapeutic score to define the indication
      for non-surgical and surgical treatment in 61 patients with ectopic pregnancy.
      The score was performed before the patients' inclusion in a nonsurgical
      management scheme. The score used six criteria which were evaluated on a scale
      from 1 to 3: gestational age, human chorionic gonadotrophin (HCG) level,
      progesterone level, abdominal pain, haemoperitoneum volume and haematosalpinx
      diameter (estimated by laparoscopy or transvaginal ultrasound). Three scores, 10,
      11 and 12, were studied in order to define a threshold beyond which surgical
      treatment should be performed. For each one, sensitivity, specificity and
      positive and negative predictive values were analysed. The success rate of non
      surgical treatment was 75% (46/61). For patients undergoing medical treatment
      with a score less than or equal to 12, the success rate was significantly higher
      compared with a success rate of 50% when the score was greater than 12. We
      conclude that a score less than or equal to 12 permits non-surgical management
      with a success rate of 82%. A score greater than 12 indicates that laparoscopic
      surgery may be more suitable. The choice between different non-surgical
      approaches, did not influence the success rate. When ultrasound reveals embryo
      heart activity, medical treatment is always possible if the score is less than or
      equal to 12.

PMID- 1761674
TI  - Subsequent fertility for patients presenting with an ectopic pregnancy and having
      an intra-uterine device in situ.
AB  - Of 503 ectopic pregnancies (EP) dealt with surgically using conservative
      laparoscopic techniques, 153 (30.4%) occurred in patients with an intra-uterine
      device (IUD) in situ. Examination of the characteristics of the EP revealed that
      the fimbrial location was more frequent among patients with an IUD whereas a
      significantly higher proportion were located in the isthmus in the group of
      patients without an IUD. Whereas the condition of the tubal wall did not differ
      according to the presence or absence of an IUD, adhesions and obstructed or non
      existent contralateral tubes were significantly less frequent among patients with
      an IUD in situ. Two hundred and twenty three patients desired pregnancy, 30 of
      whom had an IUD in situ when the EP was diagnosed. The subsequent fertility for
      these 30 patients with an IUD was shown by rates for intrauterine pregnancy
      (IUP), recurrent EP and infertility of 96.7, 3.3 and 0% respectively. These
      results were significantly better than those for women who had no IUD, the
      figures for this group being 59, 13.4 and 27.4%, respectively. The favourable
      prognosis was due solely to the fact that women with an IUD had far fewer
      negative antecedents and that the EP probably occurred due to impaired ciliary
      action which is reversible when the IUD is removed.

PMID- 1761675
TI  - Evaluating biochemical identification systems.

PMID- 1761676
TI  - Antigenic properties of Borrelia burgdorferi isolated from Ixodes ovatus and
      Ixodes persulcatus in Hokkaido, Japan.
AB  - Spirochete strains HP3 and HO14, isolated from Ixodes persulcatus and I. ovatus
      in Hokkaido in 1989, were the first isolates of Borrelia burgdorferi, the
      etiological agent of Lyme disease, to be recognized in Japan. Antigenic
      properties of the Japanese strains were compared with those of the strains
      isolated in the United States (B31 and 297) and Europe (IRS, P/Gau, P/Bi, 2/B45,
      and 3/B56) by Western blotting (immunoblotting), by using monoclonal antibodies
      (MAbs) against strains B31 and P/Bi. The Japanese strains reacted with MAb U40
      against the 41-kDa antigen. MAb E34a31 against Osp A reacted with all the strains
      tested except for strain HP3. Furthermore, MAb U31b against Osp A reacted with
      all the American and European strains but did not react with the Japanese
      strains. When MAbs against Osp B were used, MAb E34b reacted only with European
      strains and MAb U34b reacted only with the American strains. However, neither
      showed reactivity to two Japanese strains. MAb E60 against 60-kDa antigen reacted
      with all the U.S. and European strains and strain HP3 but did not react with
      Japanese strain HO14. These results indicate that the antigenicity of the
      Japanese strains isolated from two species of ixodid ticks is different from that
      of the strains isolated in the United States and Europe. It is suggested that the
      Japanese strains are much more suitable than the U.S. or European strains as the
      antigen source for the serodiagnosis of Lyme disease in Japan.

PMID- 1761677
TI  - Identification of genomic clonal types of Actinobacillus actinomycetemcomitans by
      restriction endonuclease analysis.
AB  - To evaluate its utility in discriminating different strains, restriction
      endonuclease analysis was applied to 12 strains of Actinobacillus
      actinomycetemcomitans (3 serotype a, 5 serotype b, and 4 serotype c strains). DNA
      isolated from each strain was digested by 12 different restriction endonucleases,
      and the electrophoretic banding patterns of the resulting DNA fragments were
      compared. The DNA fragment patterns produced by SalI, XhoI, and XbaI for the 12
      A. actinomycetemcomitans strains were simple (less than 30 bands) and allowed us
      to recognize easily 10 distinct genomic clonal types. The three serotype a
      strains exhibited distinctly different clonal types from one another, the five
      serotype b strains exhibited an additional four distinct clonal types, and the
      four serotype c strains showed another three different clonal types. The other
      endonucleases tested were less useful in typing A. actinomycetemcomitans. We
      conclude that restriction endonuclease analysis is a powerful tool for typing and
      discerning genetic heterogeneity and homogeneity among A. actinomycetemcomitans
      strains. It should, therefore, be very useful for epidemiologic studies.

PMID- 1761678
TI  - Clinical and microbiological observations on CDC group DF-3, a gram-negative
      coccobacillus.
AB  - Sequential stool cultures submitted for routine culture were screened for the
      presence of CDC group DF-3. Of 690 specimens, 11 (1.6%) yielded moderate to heavy
      growth of DF-3. Information on the 11 patients from whom these specimens were
      obtained showed that 4 had a history of prolonged diarrheal disease that resolved
      after specific therapy to eradicate DF-3, while for the other 7 patients no clear
      role could be established. Microbiological characterization of the stool isolates
      and 10 CDC strains of DF-3 suggested the presence of two subtypes within the
      group. Antibiotic susceptibility studies showed DF-3 to be relatively resistant
      to a wide variety of antibiotics.

PMID- 1761679
TI  - Longitudinal study of the microbiology of endemic trachoma.
AB  - A longitudinal study of trachoma in 100 members of nine Tanzanian families was
      conducted to assess the sources of variation in the laboratory identification of
      trachoma and the changes that might occur over time. Multiple conjunctival swabs
      were collected every 3 months for 1 year and examined by direct fluorescent
      antibody cytology (DFA), enzyme immunoassay, or microimmunofluorescence serology
      for tear antichlamydial antibodies. DFA specimens collected 5 min apart had a
      discordance rate of 10% and this is attributable to sampling variation. DFA
      specimens collected 2 days or more apart show a 25% discordance rate. This
      suggests a biologic variation in shedding in addition to sampling variation. Good
      correlation existed between the DFA and the enzyme immunoassay. Tear serology was
      quite specific in predicting the presence of clinical disease and correlated with
      the other two antigen detection tests, although it does not seem to offer any
      practical advantages. These studies indicate that there is considerable variation
      in the shedding of chlamydia by people living in trachoma-endemic areas.

PMID- 1761680
TI  - Application of colorimetric microdilution plate hybridization for rapid genetic
      identification of 22 Mycobacterium species.
AB  - Quantitative microdilution plate hybridization was used to identify 22
      Mycobacterium species. DNAs of clinical strains were rapidly extracted and
      labeled with photoreactive biotin. Labeled DNAs were distributed into wells of a
      microdilution plate in which reference DNAs had been immobilized. After 2 h of
      hybridization, hybridized DNAs were quantitatively detected with peroxidase
      conjugated streptavidin and the substrate, tetramethylbenzidine. This method
      could differentiate among 20 of the 22 Mycobacterium species tested. The type
      strains of Mycobacterium tuberculosis and M. bovis were genetically highly
      related and could not be differentiated by this method. Of 194 biochemically
      identified human clinical strains, 178 (90%) were genetically identified within 3
      h of the small-scale DNA extraction.

PMID- 1761681
TI  - Comparison of the PREMIER cryptococcal antigen enzyme immunoassay and the latex
      agglutination assay for detection of cryptococcal antigens.
AB  - A new enzyme immunoassay (EIA), PREMIER Cryptococcal Antigen, was compared with
      latex agglutination (LA) for the detection and quantitation of circulating
      capsular polysaccharide antigen from Cryptococcus neoformans. The clinical
      evaluation of PREMIER EIA as a screening assay, including 475 specimens with 120
      LA and EIA positives, resulted in 99% sensitivity and 97% specificity. The
      clinical specimens included sera and cerebrospinal fluids as well as 10
      rheumatoid factor-positive and 20 anti-nuclear antibody-positive serum samples.
      This monoclonal antibody-based assay detects serotypes A to D at 0.63, 0.63, 7.8,
      and 62 ng/ml, respectively. With three different known positive specimens, the
      assay was found to yield coefficients of variation of 2 to 12% for intra- and
      interassay comparisons of precision and reproducibility. The primary use for
      semiquantitative values derived with the LA or EIA is to follow the course of
      disease and monitor drug therapies. The present data suggest that the PREMIER EIA
      will be a valuable method for this purpose. We conclude that the PREMIER
      Cryptococcal Antigen EIA provides a rapid, convenient, and reliable antigen
      detection method for screening and semiquantitative determination of antigen
      levels.

PMID- 1761682
TI  - Characterization of an immunoreactive species-specific 19-kilodalton outer
      membrane protein from Helicobacter pylori by using a monoclonal antibody.
AB  - Immunoblotting experiments on hyperimmune rabbit serum and sera from patients
      with Helicobacter pylori gastritis showed a consistent antibody response to a 19
      kDa outer membrane protein antigen. A monoclonal antibody, designated HP 40,
      which reacted by Western immunoblotting with this protein was produced. It was
      shared by all H. pylori strains tested (D 273, NCTC 11637, and 24 wild strains)
      but not by the thermophilic Campylobacter species, Campylobacter fetus,
      Helicobacter mustellae, or Helicobacter fennelliae. Immunogold staining suggested
      that the 19-kDa antigen was exposed on the outer surface of the bacteria. Its
      functional role and effectiveness as a serological diagnostic tool are under
      study.

PMID- 1761683
TI  - Application of a monoclonal antibody-based enzyme-linked immunosorbent assay for
      detection of an inflammatory response antigen in subclinical mastitic milk
      samples.
AB  - A monoclonal antibody to a 23.5-kDa bovine inflammatory antigen present in high
      levels in mastitic milk has been used in an antigen-capture enzyme-linked
      immunosorbent assay (ELISA) to screen milk samples from herds of cattle for
      subclinical mastitis. The results from 20 herds with a total of 2,612 quarter
      samples are presented. Good correlation was observed between the ELISA level and
      the milk cell count (MCC). The results demonstrated an average of 5% false
      negatives (1.8% associated with isolates of Staphylococcus aureus and/or
      Streptococcus spp.) and 7.7% false positives for each herd in relation to
      mastitic (greater than 400,000 cells per ml) or nonmastitic (less than 400,000
      cells per ml) MCCs.

PMID- 1761684
TI  - Identification of Plasmodium falciparum histidine-rich protein 2 in the plasma of
      humans with malaria.
AB  - Plasmodium falciparum histidine-rich protein 2 (PfHRP-2) is a water-soluble
      protein released from parasitized erythrocytes into in vitro culture
      supernatants. This study sought to determine whether PfHRP-2 could be detected in
      the plasma of humans with P. falciparum malaria. A monoclonal antibody (1E1) is
      described that binds to PfHRP-2. By using monoclonal antibody 1E1, PfHRP-2 was
      identified by Western blot (immunoblot) analysis in the plasma of 37 of 39 (95%)
      patients experiencing either a first or repeat episodes of P. falciparum malaria
      and by dot blot analysis in the plasma of 40 of 41 patients tested. PfHRP-2 was
      not detected in 30 control, uninfected subjects. The current demonstration of
      PfHRP-2 in plasma, plus the fact that it is a structurally well-characterized
      molecule present in all natural isolates of P. falciparum tested, makes PfHRP-2
      of interest for its potential effects on the host immune system and as an antigen
      for specific diagnosis of malaria.

PMID- 1761685
TI  - Serodiagnosis of Helicobacter pylori: comparison of enzyme-linked immunosorbent
      assays.
AB  - Enzyme-linked immunosorbent assays (ELISAs) have been developed to diagnose
      Helicobacter pylori infection. However, the methods are not standardized. We
      therefore prospectively evaluated the sensitivities and specificities of ELISAs
      developed in the United States and the United Kingdom in a study population
      comprising 41 consecutive symptomatic outpatients and 35 volunteers. At
      endoscopy, multiple biopsies were obtained for histology and culture and stained
      sections were graded for chronic gastritis, active chronic gastritis, and density
      of H. pylori. Serum samples were analyzed for H. pylori by ELISA. The first set
      of assays for immunoglobulin G (IgG) and IgA used a pool of sonicated isolates of
      H. pylori from five patients in the United States (antigen A). The second set of
      assays, developed in the United Kingdom, used three different antigens: antigen
      1, an acid-extractable surface antigen; antigen 2, an acid-extractable antigen
      from an aflagellate variant; and antigen 3, a urease-containing fraction. Cutoff
      scores for positive results were determined a priori on the basis of previous
      serological studies. There was close agreement between histology and culture. In
      the study population, 36% of the individuals were H. pylori positive. The
      diagnostic value of the different ELISAs were highly comparable, and the crude
      antigens performed as well as the more purified antigens. The antigen A IgG had a
      sensitivity and specificity of 96 and 94%, respectively; the values for antigen 1
      were 93 and 96%, respectively. The antigen A IgA and antigen 3 assays were the
      least sensitive tests.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761686
TI  - Fluorescence immunoassay for detecting periodontal bacterial pathogens in plaque.
AB  - A particle concentration fluorescence immunoassay has been modified into a
      bacterial concentration fluorescence immunoassay (BCFIA) to rapidly detect
      periodontopathic bacteria in human plaque samples. The BCFIA utilizes
      fluorescently tagged monoclonal antibodies (MAbs) directed against the
      lipopolysaccharide of selected gram-negative plaque bacteria. Microorganisms
      closely associated with periodontal disease that can be identified in plaque with
      the BCFIA include Porphyromonas gingivalis, Bacteroides intermedius,
      Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, and Eikenella
      corrodens. Briefly, the procedure involved mixing a patient's plaque sample or
      other bacterial preparation with a species-specific fluorescein isothiocyanate
      labeled MAb in a specialized microtiter plate. This mixture was incubated to
      allow binding of the MAb to its homologous bacteria. The bound and unbound
      fluorescent tagged MAbs were separated by filtration in the modified microtiter
      plate, and the total bacterial bound fluorescence was determined with a
      fluorimeter. The number of a specific bacterial species in a given plaque sample
      or other bacterial suspension was estimated by reference to a primary standard
      carried through the BCFIA. The lower detection limit of the BCFIA was 10(3) to
      10(4) bacterial cells from single cultures of bacteria or 10(4) bacterial cells
      in mixed cultures. The coefficient of variation within and between plates for
      each of the five bacterium-specific MAbs in screening plaque for the periodontal
      pathogens was less than 10%. These results demonstrate that microbes in plaque
      can be used as the solid phase in the BCFIA to detect and quantitate MAbs
      associated with specific bacteria quickly and reliably.

PMID- 1761687
TI  - Mycobacterium paratuberculosis antigen D: characterization and evidence that it
      is a bacterioferritin.
AB  - By using a combination of agarose and polyacrylamide gel electrophoresis,
      Mycobacterium paratuberculosis antigen D was resolved from a crude sonicated
      preparation of the organism and characterized as a component with a molecular
      mass of approximately 400,000 Da. While this component was composed mainly of
      protein, with unusually high proportions of glutamic acid and leucine, it was
      resistant to digestion with a number of proteolytic enzymes. Structural detail
      revealed by electron microscopy, amino acid sequence data, and the demonstration
      of a Soret band in its absorption spectrum indicated that antigen D was similar
      to an Escherichia coli bacterioferritin.

PMID- 1761688
TI  - Chromatographic purification and characterization of antigens A and D from
      Mycobacterium paratuberculosis and their use in enzyme-linked immunosorbent
      assays for diagnosis of paratuberculosis in sheep.
AB  - The protein antigens A and D were purified from culture filtrates and sonic
      extracts of laboratory strains of Mycobacterium paratuberculosis by salt
      precipitation and chromatography. The characterization of antigen A is shown
      here, and both antigens were evaluated along with lipoarabinomannan antigen in
      indirect enzyme-linked immunosorbent assays (ELISA) for the serodiagnosis of
      ovine paratuberculosis. After anion-exchange (DEAE-5PW) and hydrophobic (phenyl
      5PW) chromatography using high-performance liquid chromatography, antigen A
      showed a prominant band in sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE) at 31 kDa with small amounts of low-molecular-mass
      proteins but with no evidence of antigen D. A single precipitin arc was evident
      with purified antigen A in crossed immunoelectrophoresis. The determination of
      the N-terminal amino acid sequence showed a high degree of homology between the
      31-kDa component of antigen A and antigens of the BCG85 complex of Mycobacterium
      bovis BCG, a total of 24 of 26 residues being identical to those of BCG85C. A
      prominant SDS-PAGE band at 400 kDa and a single crossed-immunoelectrophoresis arc
      was also evident for antigen D after gel filtration (Sephacryl S-200), anion
      exchange (DEAE-Sephacel), and concanavalin A-Sepharose affinity chromatography.
      By ELISA, purified antigen A detected antibody in the sera of 18 of 22
      paratuberculosis-infected sheep (82% sensitivity), whereas the purified antigen D
      detected antibody in all 22 infected animals (100% sensitivity). Combined ELISA
      results showed increased specificity with some loss in sensitivity.

PMID- 1761689
TI  - Rapid clearance of Candida albicans mannan antigens by liver and spleen in
      contrast to prolonged circulation of Cryptococcus neoformans antigens.
AB  - Clearances of mannan antigen from Candida albicans and glucuronoxylomannan
      antigen from Cryptococcus neoformans were examined in nonimmune rabbits by using
      self-prepared latex agglutination tests. Injected intravenously, 20 mg of Candida
      mannan antigen was cleared from the serum with a half-life of approximately 2 h.
      In contrast, 20 micrograms of Cryptococcus glucuronoxylomannan antigen had a half
      life in serum of approximately 24 h. At the latest, 9 h after injection, both
      antigens were no longer detectable without pretreatment of serum samples with
      protease and heating to 100 degrees C, thus indicating rapid binding by serum
      proteins other than immunoglobulins. Candida mannan antigen clearance was also
      examined in nonimmune mice after intravenous injection of (i) 200 micrograms of
      Candida mannan antigen, which accumulated in the liver and spleen and persisted
      for 97 days; (ii) 2 x 10(7) ethanol-killed Candida blastospores, which was
      accompanied by rapid clearance of mannan from the blood but accumulation of
      mannan in the liver and spleen and slow clearance from these organs; (iii) 6 x
      10(6) viable C. albicans cells (lethal infection), which resulted in a rapid
      decrease of Candida CFU in the blood, liver, and spleen during the first 8 h,
      after which blood cultures were negative on day 2 and viable Candida burdens in
      the liver and spleen persisted at 10(5) CFU/g, whereas Candida mannan antigen
      continued to circulate in the bloodstream and accumulated in the liver and
      spleen.

PMID- 1761690
TI  - Identification of Vibrio vulnificus O serovars with antilipopolysaccharide
      monoclonal antibody.
AB  - A serotyping scheme for Vibrio vulnificus predicated on the detection of
      lipopolysaccharide (LPS) antigens is proposed. The serovar O typing scheme used
      to type V. vulnificus employs polyclonal antisera raised in rabbits immunized
      with heat-killed whole-cell vaccines. Polyclonal typing sera produced in this
      manner cross-react with heterologous strains. Affinity purification of polyclonal
      antisera with LPS affinity columns resolved some of these cross-reactions;
      however, affinity-purified polyclonal antisera still showed cross-reactions that
      were nonreciprocal. On the basis of the serological patterns that were obtained
      with affinity-purified polyclonal antisera, V. vulnificus strains were selected
      as vaccine strains for production of monoclonal antibody. Spleen cells harvested
      from BALB/c mice immunized with formalin-killed V. vulnificus cells were fused
      with SP2/O-Ag 14 myeloma cells. Hybridomas were screened by using LPS and whole
      cell enzyme-linked immunosorbent assay to identify clones secreting LPS-specific
      antibodies. Monoclonal antibodies identified five LPS serological varieties of V.
      vulnificus and a single serovar each for Vibrio damsela and Vibrio hollisae. No
      cross-reactions between V. vulnificus and V. hollisae or V. damsela were
      observed.

PMID- 1761692
TI  - Genetic dissimilarity of commensal strains of Candida spp. carried in different
      anatomical locations of the same healthy women.
AB  - Candida spp. carriage and strain relatedness were assessed in 52 healthy women at
      17 anatomical locations by using an isolation procedure which assesses carriage
      intensity and by using a computer-assisted DNA fingerprinting system which
      computes genetic similarity between strains on the basis of the patterns of
      Southern blots probed with the moderately repetitive sequence Ca3. Candida spp.
      were cultured from 73% of the test individuals, most frequently from the oral
      (56%), vulvovaginal (40%), and anorectal (24%) regions. Half of the test
      individuals with Candida spp. carried the organism simultaneously in more than
      one of the three general areas of carriage. Isolates from different body
      locations of the same individual were either completely unrelated, identical, or
      highly similar but nonidentical. In 11 cases in which Candida spp. were
      simultaneously isolated from the oral cavity and vaginal canal, seven pairs of
      isolates were genetically unrelated and four pairs were similar but nonidentical.
      In the latter cases, the isolate pairs each appear to have arisen by genetic
      divergence from a single progenitor. A comparison of the genetic relatedness of
      isolates from different individuals further uncovered a single strain which was
      vaginospecific in the Iowa City, Iowa area and reduced genetic diversity among
      vulvovaginal strains compared with those isolated from other body locations.
      These results suggest that strains adapt to different anatomical locations and,
      conversely, that in a healthy individual there is anatomical selection of
      vaginotropic, anotropic and orotropic strains of Candida spp.

PMID- 1761691
TI  - Murine intestinal antibody response to heterologous rotavirus infection.
AB  - Rotavirus is the most important worldwide cause of severe gastroenteritis.
      Extensive efforts have been devoted to the design of a vaccine that will prevent
      disease, but development of a more effective vaccine strategy may require
      progress in the understanding of the mucosal immune response to replicating viral
      antigens. In this article, we report the characterization of the intestinal
      antibody response of a murine model to heterologous infection with the rhesus
      rotavirus vaccine strain. We have adapted the enzyme-linked immunospot assay to
      measure this response without the difficulties associated with measurement of
      antibodies in intestinal contents or the artifacts associated with culturing of
      lymphocytes. The predominant response in terms of antibody-secreting cells (ASC)
      is seen in the small intestine lamina propria, which can be measured within 4
      days of infection, peaks 3 weeks after infection, and remains near that level for
      longer than 8 weeks. The magnitude of the immunoglobulin A (IgA) cell response is
      approximately 10 times greater than the intestinal IgG cell response, and IgM
      cells are rare. Virus-specific ASC constitute approximately 50% of all ASC in the
      gut at the peak of the virus-specific response. This response is considerably
      greater than responses to nonreplicating mucosal antigens measured by similar
      techniques. Enteral infection engenders minimal virus-specific ASC response in
      the spleen. Rhesus rotavirus-specific enzyme-linked immunosorbent assay and
      neutralization assays of serum and intestinal contents did not correlate with
      virus-specific ASC response.

PMID- 1761694
TI  - Collaborative feasibility study of a biphasic system (Roche Septi-Chek AFB) for
      rapid detection and isolation of mycobacteria.
AB  - A study to delineate the feasibility of a biphasic-culture approach for detection
      and isolation of mycobacteria from clinical specimens except blood was conducted
      in four medical centers. The biphasic system (Septi-Chek AFB, Roche Diagnostic
      Systems, Nutley, N.J.) was compared with conventional mycobacterial isolation
      media and the BACTEC system. Septi-Chek AFB showed the highest degree of
      mycobacterial recovery. In addition, Septi-Chek AFB consistently shortened the
      time required for recovery of mycobacteria from clinical specimens and supported
      the growth of small inoculum numbers of stock cultures of 14 mycobacterial
      species. The study indicates the feasibility and potential advantages of the
      biphasic approach for detection and isolation of mycobacteria.

PMID- 1761693
TI  - Use of polymerase chain reaction and rabbit infectivity testing to detect
      Treponema pallidum in amniotic fluid, fetal and neonatal sera, and cerebrospinal
      fluid.
AB  - The diagnosis of congenital syphilis continues to pose a difficult clinical
      challenge. Because the serodiagnosis of congenital syphilis has significant
      limitations, the direct detection of Treponema pallidum in suspect neonatal
      tissues or body fluids represents a desirable alternate diagnostic strategy. We
      developed and applied the polymerase chain reaction (PCR) for the detection of T.
      pallidum in clinical material relevant to the diagnosis of congenital syphilis
      but which typically contain factors inhibitory for the PCR. Four methods of
      specimen processing were examined to circumvent PCR inhibition; clinical
      materials included amniotic fluids, neonatal sera, and neonatal cerebrospinal
      fluids. The PCR was 100% specific for T. T. pallidum compared with the sensitive
      rabbit infectivity test (RIT) for all clinical materials tested. For amniotic
      fluids, the PCR was 100% sensitive when correlated with the RIT but had a lesser
      sensitivity when applied to sera or cerebrospinal fluids, which typically contain
      few treponemes. The combined sensitivity of the PCR for all clinical samples was
      78%. Positive PCR results also were obtained among some clinical specimens for
      which RIT was not performed; these results correlated well with either stigmata
      or risk factors for congenital syphilis. The combined results suggest that the
      PCR can be a useful adjunct to the diagnosis and clinical management of
      congenital syphilis and that it will provide a valuable tool for investigations
      of the pathogenesis of the disorder.

PMID- 1761695
TI  - Variability in commercial histoplasma complement fixation antigens.
AB  - Using Immuno-Mycologics (IMMY; Norman, Okla.) histoplasmal yeast (HY) and
      mycelial (HM) antibody complement fixation test antigens, we retested 1,386
      samples that were initially tested with Meridian Diagnostics, Inc. (Cincinnati,
      Ohio), antigens. Histoplasma antibody was identified (greater than or equal to
      1:16) in 20% of HY and 5% of HM samples reported to have titers of less than 1:8
      with Meridian reagents. IMMY titers were at least fourfold higher than Meridian
      titers in 39% of HY and 54% of HM samples that initially had titers of greater
      than or equal to 1:8 with Meridian antigens. Because 30 of 58 (52%) samples from
      confirmed cases of histoplasmosis yielded negative results with Meridian antigens
      and positive results upon retesting with IMMY antigens, we concluded that the
      Meridian antigens had less reactivity with human histoplasmal antibody.

PMID- 1761696
TI  - Use of pooled formalin-preserved fecal specimens to detect Giardia lamblia.
AB  - Three formalin-preserved fecal specimens from the same child attending a child
      care center were pooled and compared with the three separate individual specimens
      by a single microscopic examination of concentration sediment for Giardia
      lamblia. The sensitivity of the pooled system was 100% when two or more
      individual specimens were positive and 88% when only one individual specimen was
      positive. The organism density in a single specimen was not a factor of whether
      the pool of specimens was positive or negative. Nearly half of the pools that
      contained positive specimens had only one of three specimens with positive
      results, reinforcing the need for multiple stool examinations when diagnosing G.
      lamblia infections.

PMID- 1761697
TI  - Evaluation of the An-Ident system and an indole spot test for the rapid
      differentiation of porcine treponemes.
AB  - The An-Ident strip system (Analytab Products Inc., St-Laurent, Quebec, Canada)
      was evaluated for its ability to differentiate Treponema hyodysenteriae from
      Treponema innocens. Of the 20 tests included on this strip, 15 yielded identical
      results for the two species. Among the other five assays, none could be
      considered as a positive discriminator for the two species. However, when an
      indole spot test with 1% p-dimethylaminocinnamaldehyde was used in parallel, all
      reference strains and 97% of the isolates of T. hyodysenteriae were positive,
      whereas all isolates of T. innocens were negative. Our results indicate that An
      Indent is of little value for the differentiation of the two species. Our results
      also suggest that a rapid and simple differentiation between T. hyodysenteriae
      and T. innocens can be achieved by using the hemolysis and ring phenomenon tests
      in conjunction with an indole spot test.

PMID- 1761698
TI  - Isolation and characterization of Borrelia burgdorferi from Illinois Ixodes
      dammini.
AB  - Ixodes dammini ticks from two northwestern Illinois sites were found to be
      infected with Borrelia burgdorferi at rates of 19 and 32%. B. burgdorferi
      isolates, one from each site, had protein and antigenic patterns similar to those
      of the B-31 strain. An indirect immunofluorescence method proved to be more
      sensitive than dark-field microscopy in detection of these spirochetes. A
      modified BSK medium containing rifampin was found to be more efficient for
      spirochete isolation than unsupplemented BSK medium.

PMID- 1761699
TI  - Detection of untreated mycobacteria by using polymerase chain reaction and
      specific DNA probes.
AB  - A method for specific identification of mycobacteria by using the polymerase
      chain reaction on organisms taken from liquid cultures, frozen suspensions, or
      colonies grown on Lowenstein-Jensen slants is presented. This direct detection of
      mycobacterial organisms has important implications for strain typing and
      diagnosis.

PMID- 1761700
TI  - Indirect immunofluorescence assay for detection of Helicobacter pylori in human
      gastric mucosal biopsies.
AB  - To determine sensitivity and specificity of immunofluorescence assay (IFA) for
      detection of Helicobacter pylori, we studied 151 patients. Biopsies of gastric
      mucosae were obtained for culture, histological testing, and IFA. H. pylori serum
      antibodies were tested by enzyme-linked immunosorbent assay. IFA was done on
      Formalin-preserved, paraffin-embedded biopsies by using rabbit anti-H. pylori and
      goat anti-rabbit gamma globulin-fluorescein isothiocyanate conjugate. The
      sensitivity and specificity of IFA compared with culture and Warthin-Starry stain
      were 93 and 95%, respectively. IFA is an accurate method for the diagnosis of H.
      pylori infection.

PMID- 1761701
TI  - Detection of rubella-specific immunoglobulin G: comparison of the enzyme-linked
      immunosorbent assay and an automated microparticle enzyme immunoassay (IMx).
AB  - An automated microparticle enzyme immunoassay (IMx Rubella IgG Antibody Assay;
      Abbott Laboratories, North Chicago, Ill.) was compared with a conventional enzyme
      linked immunosorbent assay (ELISA) for detection of rubella-specific
      immunoglobulin G (IgG) in 400 consecutive antenatal patients. There was complete
      agreement between the two tests in this population, which had a positivity rate
      of 99% for rubella-specific IgG antibodies. The performance of the IMx was also
      evaluated at the cutoff zone by assaying 64 selected antenatal serum samples with
      low or negative rubella antibody titers as determined by ELISA. Overall, the IMx
      was found to be a specific, sensitive assay for the detection of rubella-specific
      IgG and is virtually fully automated for easy performance.

PMID- 1761702
TI  - Isolation of Mycobacterium shimoidei from a patient with cavitary pulmonary
      disease.
AB  - Mycobacterium shimoidei was isolated from the sputum of a man hospitalized for
      cavitary pulmonary disease. This is the fourth isolation of M. shimoidei to be
      reported; the organism has also been isolated in Japan, Australia, and Germany.

PMID- 1761703
TI  - History and evolution of methods for solving the inverse problem.
AB  - This article serves as an introduction to the other articles in this issue
      devoted to the problem of the localization of neural generators. Elements of the
      theory of electric volume conduction are briefly introduced, as far as these
      apply to the interpretation of observed scalp potentials. First, some basic
      methods for display of the different aspects of the spatiotemporal information
      are described. Next, the most prominent source and volume conductor models that
      have been postulated for the involved forward problem are summarized. The
      problems of source identification and source localization, known as the inverse
      problem, are then formulated in terms of a parameter estimation procedure. The
      importance of introducing a priori information in the inverse problem, aimed at
      stabilizing (regularizing) the obtained solution, is emphasized. Methods for
      imposing such constraints are briefly outlined.

PMID- 1761704
TI  - Models of the human brain and the surrounding media: their influence on the
      reliability of source localization.
AB  - This article is a review of the evolution of models of the head as used in dipole
      source localization. Models fall into two classes: those that can be expressed in
      simple analytic form, such as the homogeneous sphere or spherical three-shell
      models, or those that can only be solved by numerical methods, such as the finite
      element approach. The latter models always involve heavy procedural and
      computational burdens. The trend over the last decade has been to use these more
      advanced models to estimate the error that would be incurred if one of the
      simpler spherical models were used instead for dipole source localization. An
      estimate is presented of the magnitudes of the random and systematic errors of
      localization that may be expected when using these methods.

PMID- 1761705
TI  - Principles for transformation of scalp EEG from potential field into source
      distribution.
AB  - Tracings representing simultaneously recorded values of EEG potentials from
      different positions on the scalp surface describe how the instantaneous potential
      field over the scalp surface changes with time. Each instantaneous distribution
      of potential can be seen as resulting from spatial integration of primary
      components into the potential field. These components may be derived by means of
      the reverse procedure: subjecting the data from the potential field to spatial
      differentiation as provided by the Laplacian source operator. The result is a
      "deblurred," i.e., a more differentiated, distribution of source components
      hypothetically associated with the generators of the potential field. The
      Laplacian source operator can be implemented as a linear combination of the
      instantaneous potential values, either by means of very simple electronic
      circuitry or in a computer. The linear combination is a standard operation in
      matrix algebra and is widely applied in signal processing. The formalism of
      matrix algebra simplifies a precise evaluation of the method in relation to
      conventional derivation techniques and provides further methods for analysis of
      the EEG data.

PMID- 1761706
TI  - The spline-Laplacian in clinical neurophysiology: a method to improve EEG spatial
      resolution.
AB  - An important goal of EEG research is to obtain practical methods to improve the
      spatial resolution of scalp-recorded potentials, i.e., to make surface data more
      accurately represent local underlying brain sources. This goal may be somewhat
      different from that of "localizing brain activity with EEG," since the latter
      approach often involves prior assumptions about the nature of sources. In this
      paper, we demonstrate that spline-Laplacian, a relatively new approach that can
      yield dramatic improvement in spatial resolution when average electrode spacing
      is less than about 3 cm. This approach is mostly independent of assumptions about
      sources and models of the head. The demonstration involves computer simulations,
      evoked potentials, normal spontaneous EEG, and epileptic spikes.

PMID- 1761707
TI  - Localization of seizure foci: pitfalls and caveats.
AB  - The pitfalls and difficulties in accurately localizing seizure foci are reviewed.
      Basic issues regarding modeling, volume conduction, inhomogeneities, and
      corticocortical propagation are discussed, and the limitations of scalp and
      intracranial recordings are outlined. The ambiguities in interpreting patterns
      and their significance are highlighted with a concluding commentary on pitfalls
      in defining the epileptogenic region.

PMID- 1761708
TI  - Expanded head surface EEG electrode array: an application to display the voltage
      topography of focal epileptiform discharges of mesiotemporal origin.
AB  - Aided by computerized voltage topographic display, conventional time-series EEG
      display methods were expanded. Representations of both negative and positive ends
      of an equivalent current dipole can be localized in EEG sampled over the head
      surface. Intuitive EEG analysis can be applied to source localization in three
      dimensions of scalp focal epileptiform discharges.

PMID- 1761709
TI  - Technology and equipment review. EEG storage methods.

PMID- 1761710
TI  - Changes in total body water during spaceflight.
AB  - This experiment represents the first time that it has been possible to measure a
      body fluid compartment by direct means during spaceflight. Based on the results
      observed in the five crewmen in this study, it is concluded that TBW decreases by
      3.4% after 1 to 3 days of exposure to microgravity in the Space Shuttle. Some
      individuals appear to undergo this decrease within 24 hours. This effect may be
      enhanced by decreased water intake due to nausea associated with SMS.

PMID- 1761711
TI  - Cardiovascular adaptation to spaceflight.

PMID- 1761712
TI  - Echocardiographic evaluation of the cardiovascular effects of short-duration
      spaceflight.

PMID- 1761713
TI  - Space medicine: answering the challenge.

PMID- 1761714
TI  - Cerebral blood flow: comparison of ground-based and spaceflight data and
      correlation with space adaptation syndrome.

PMID- 1761715
TI  - Blood and urine responses to ingesting fluids of various salt and glucose
      concentrations.
AB  - Several hours before returning to Earth, Space Shuttle astronauts consume fluid
      and salt tablets equivalent to a liter of 0.9% saline as a countermeasure to
      postflight orthostatic intolerance. This countermeasure is not completely
      successful. Therefore, in search of a countermeasure that would protect against
      orthostatic intolerance better and for a longer duration, the authors compared
      the blood and urine responses of five men (21-41 yr) after they drank 1 L of 0.9%
      saline to their responses after drinking five other solutions: distilled water,
      1% glucose, 0.74% saline with 1% glucose, 0.9% saline with 1% glucose, and 1.07%
      saline. Each subject ingested a different solution on 6 different days and
      remained seated for the ensuing 4 hours. Heart rate, blood pressures, and urine
      variables were measured before ingestion of the fluids and every 30 minutes
      thereafter; blood samples were drawn before, immediately after, and every 60
      minutes after ingestion. Change in plasma volume, which was estimated from
      hemoglobin and hematocrit, was considered the most critical variable. Data for
      all solutions were compared by analysis of variance. Since plasma volume was
      increased most after ingestion of 1.07% saline, all variables (at 2 hours, at 3
      hours and at 4 hours) were compared between 1.07% saline and 0.9% saline, the
      current countermeasure. Plasma volume was increased more after 1.07% saline than
      after 0.9% saline, and this difference was most significant at 4 hours after
      ingestion (P = .056). Diuresis occurred promptly after ingestion of the two
      saline-free solutions, water and 1% glucose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761716
TI  - Development of lower body negative pressure as a countermeasure for orthostatic
      intolerance.
AB  - Exposure to prolonged (1-4 hr) lower body negative pressure (LBNP) is a
      countermeasure against postflight orthostatic intolerance which is used in the
      Soviet space program and planned for use in the American space program. LBNP in
      combination with fluid-loading is believed to act by promoting a transient
      positive fluid balance resulting in an increase in vascular, as well as
      extravascular fluid. Inflight LBNP also may provide beneficial orthostatic
      effects by restoring baroreceptor reflex functions and/or lower body venous
      compliance. Current research efforts at the Johnson Space Center are directed
      towards increasing the effectiveness and efficiency of the LBNP and saline
      countermeasure. A promising avenue may involve combining pharmacologic agents,
      such as inhaled anti-diuretic hormone, or mineralocorticoids, with mechanical
      stimuli such as LBNP.

PMID- 1761717
TI  - Orthostatic function during a stand test before and after head-up or head-down
      bedrest.
AB  - Astronauts may exhibit orthostatic dysfunction upon returning to 1 g after space
      flight. Understanding cardiovascular changes at 0 G will provide insights into
      the mechanisms of the loss of orthostatic tolerance, whether due to space flight
      or bedrest. Bedrest is one model used to produce cardiovascular changes that are
      associated with space flight. In the current study, young male adults were placed
      at -5 degrees, +10, +20, or +42 degrees bedrest (0, 1/6, 1/3, and 2/3g,
      respectively) for 6 hours on 4 different days. This was preceded and followed by
      a stand test: 5 minutes in the supine position, and then 5 minutes in the
      standing position, with the feet 9 inches apart and 6 inches from the wall.
      Cardiovascular values were measured at 1-minute intervals. Systolic and diastolic
      pressures were measured using an automated blood pressure device; mean arterial
      pressure (MAP; mm Hg) was calculated. Heart rate (bpm) and cardiac parameters
      were measured with a thoracic impedance device. Minute 3, 4, and 5 values were
      used to determine whether there were time or angle effects. Of six subjects, one
      reported nausea upon 3 minutes of standing after 6 hours of bedrest at -5
      degrees. The same subject was lightheaded in the first minute of standing after 6
      hours of bedrest at +10 degrees. Mean heart rate pre-bedrest in the supine
      position was 63 and increased by 24 bpm on standing. Heart rate post-bedrest in
      the supine position was 65 and increased by 35 bpm on standing; standing heart
      rate increased 11 bpm after -5 degrees bedrest. The increases after +10 degrees,
      +20 degrees, and +42 degrees tilts were 4, 3, and 4 bpm, respectively. Changes in
      the mean arterial blood pressure were minimal. Results from the stand test pre-
      and post- 6 hours of bedrest at -5 degrees but not at +10 degrees, +20 degrees,
      or +42 degrees are similar to those after space flight.

PMID- 1761718
TI  - Human vestibular function and weightlessness.
AB  - This article presents the concept of a spatial orientation/motion perceptual
      system, the contributions of the vestibular receptors to this system, and
      apparatus and training procedures and observations to allow astronauts to
      preadapt to weightlessness. The author also discusses perceptual reactions to
      prolonged weightlessness.

PMID- 1761719
TI  - Cerebral blood flow during +Gz acceleration as measured by transcranial Doppler.

PMID- 1761720
TI  - Cerebral blood flow velocities by transcranial Doppler during parabolic flight.
AB  - Microgravity is produced for 20 to 30 seconds in NASA's KC-135 aircraft at the
      end of a 2 G pullup for each of 40 parabolas per flight. Continuous transcranial
      Doppler ultrasound, arterial blood pressure, and acceleration levels were
      recorded for 12 male and 8 female healthy subjects without known cardiovascular
      or cerebrovascular disease. Recordings were made throughout 10 parabolas per
      subject in each of the supine, sitting, and standing postures. The data were
      digitized for off-line analysis using Fast Fourier Transform and other signal
      processing methods. A phase lag in changes to transcranial Doppler waveforms from
      the onset of acceleration was more pronounced in the standing position than in
      the sitting position. There was less of a phase lag in the supine position. These
      ultrasound changes preceded the more delayed variations in arterial blood
      pressure. The KC-135 provides a unique short-term environment that allows
      measurement of the human response to variations in acceleration but limits
      physiological monitoring of responses to a steady state of microgravity.

PMID- 1761721
TI  - First intramuscular administration in the U.S. Space Program.

PMID- 1761722
TI  - Metabolic changes observed in astronauts.
AB  - Study of metabolic alterations that occur during space flight can provide insight
      into mechanisms of physiologic regulation. Results of medical experiments with
      astronauts reveal rapid loss of volume (2 L) from the legs and a transient early
      increase in left ventricular volume index. These findings indicate that, during
      space flight, fluid is redistributed from the legs toward the head. In about 2
      days, total body water decreases 2 to 3%. Increased levels of plasma renin
      activity and antidiuretic hormone while blood sodium and plasma volume are
      reduced suggest that space flight-associated factors are influencing the
      regulatory systems. In addition to fluid and electrolyte loss. Skylab astronauts
      lost an estimated 0.3 kg of protein. Endocrine factors, including increased
      cortisol and thyroxine and decreased insulin, are favorable for protein
      catabolism. The body appears to adapt to weightlessness at some physiologic cost.
      Readaptation to Earth's gravity at landing becomes another physiologic challenge.

PMID- 1761723
TI  - A biomedical trip to the moon and beyond.

PMID- 1761724
TI  - Pharmacologic considerations for Shuttle astronauts.
AB  - Medication usage by crewmembers in the preflight and inflight mission periods is
      common in the Shuttle Program. The most common medical reports for which
      medication is used are: space motion sickness (SMS), sleeplessness, headache, and
      backache. A number of medications are available in the Shuttle Medical Kit to
      treat these problems. Currently, astronauts test all frequently used medications
      before mission assignment to identify potential side-effects, problems related to
      performance, personal likes/dislikes, and individual therapeutic effect. However,
      microgravity-induced changes in drug pharmacokinetics, in combination with
      multiple operational factors, may significantly alter crew-member responses
      inflight. This article discusses those factors that may impact pharmacologic
      efficacy during Shuttle missions.

PMID- 1761725
TI  - Intraocular pressure in microgravity.

PMID- 1761726
TI  - Human autonomic responses to actual and simulated weightlessness.
AB  - Orthostatic dysfunction occurs after exposure to microgravity, and is not
      completely understood. The authors developed a device for stimulating carotid
      baroreceptors to test the hypothesis that exposure to microgravity leads to
      impairment of arterial baroreflex mechanisms. Data obtained before and after two
      head-down bedrest studies and before and after brief Space Shuttle missions
      indicate that baroreceptor-cardiac reflex control is impaired by simulated or
      actual weightlessness. The authors speculate that arterial baroreflex
      derangements combine with blood volume reductions and increased venous compliance
      to provoke orthostatic hypotension after microgravity exposure. Altered
      baroreflex function after missions may result from autonomic neuronal plasticity
      that develops during missions secondary to changes of cardiopulmonary and
      arterial dimensions and consequent changes of autonomic sensory input profiles.

PMID- 1761727
TI  - Pharmacodynamic aspects of spaceflight.
AB  - Little is known at present about the effects of human exposure to microgravity on
      the pharmacodynamics of medicinal agents. Considering the known physiologic
      perturbations associated with spaceflight and the effects of some of these
      perturbations on the pharmacodynamics of certain medicinals that act on the
      central nervous system, it is likely that the pharmacodynamics of at least some
      of these agents will be altered in individuals who are subjected to microgravity
      and other conditions of spaceflight. It is timely to initiate formal studies,
      initially in ground-based animal models and human volunteers during prolonged,
      head-down bed rest and eventually in animals and human volunteers exposed to
      microgravity, of pharmacodynamics and pharmacokinetics during spaceflight.

PMID- 1761728
TI  - Optimal sampling theory and population modelling: application to determination of
      the influence of the microgravity environment on drug distribution and
      elimination.
AB  - Newer mathematical techniques such as optimal sampling theory and NON-linear
      Mixed Effects Modelling (NONMEM) allow the determination of pharmacokinetics and
      pharmacodynamics in populations of individuals previously believed to be "too
      ill" or "too difficult to study." Optimal sampling determines the most
      information-rich times to sample the system, allowing robust parameter estimates
      to be determined from the minimal number of samples. NONMEM, by taking the
      population as the unit of analysis, allows even fragmentary patient data sets to
      contribute to population parameter estimates. Obviously, the microgravity
      environment presents extreme logistical difficulties to the performance of
      traditional pharmacokinetic and pharmacodynamic studies. Examples of the
      validation of these techniques are presented, which indicates their likely
      utility in the important task of determining the influence of the microgravity
      environment on drug distribution and elimination, even accounting for the
      limitations of support which will be faced in this circumstance.

PMID- 1761729
TI  - Effects of gravity on gastric emptying, intestinal transit, and drug absorption.
AB  - The effects of microgravity on the physiologic response of the human body, the
      physical properties of gastrointestinal contents, and the influence these
      responses have on drug absorption are becoming more and more critical as the
      duration of humans in the hostile space environment dramatically increases. In
      this environment, some conventional oral dosage forms may be severely limited as
      an effective drug regimen. To understand the effects of microgravity, one must
      first understand the basic forces acting on a particle moving through a walled
      tube such as the small intestine: gravity (FG), buoyancy (FB), and drag (FD).
      These forces can be combined and rearranged into a dimensionless ratio of
      gravitational forces to viscous forces. This is the most important dimensionless
      group influencing the motion of a particle relative to the fluid. Gastric
      emptying is highly influenced by several factors: volume, calories, exercise,
      size, density, temperature, viscosity, osmolality as well as those factors
      associated with physiologic responses: splanchnic blood flow, body position, and
      electrolyte balance. This array of factors can lead to variability in drug plasma
      levels. In the absence of gravity, the factors of size and density would appear
      to be most directly altered due to their dependence on the force of gravity.
      Intestinal transit rate in a gravity environment is highly dependent on the
      motility state of the GI tract either fasted or fed partly due to the higher
      viscosities of chyme in the fed state. In space, the absence of gravity may tend
      to increase the transit rate along the small intestine by decreasing the
      dimensionless ratio of gravitational forces to viscous forces. In zero gravity,
      therefore, these alterations in GI emptying and intestinal transit rate could
      lead to erratic plasma levels and inefficient absorption.

PMID- 1761730
TI  - Drug effects on orthostatic intolerance induced by bedrest.
AB  - Effective and practical preventive procedures for postflight orthostatic
      intolerance are highly desirable. The current practice of attempts to expand
      plasma volume by ingestion of salt and fluids before reentry has proven benefits.
      This study evaluated alternative options using fludrocortisone (F) to expand
      plasma volume (PV), dextroamphetamine (Dex) to enhance norepinephrine (NE)
      release and atropine (A) to reduce the effects of vagal stimulation. Seven
      subjects with proven post-bedrest orthostatic intolerance returned for a 7-day 6
      degrees head-down bedrest study. F (0.2 mg) was given at 8:00 AM and 8:00 PM the
      day before and 8:00 AM the day the subjects got out of bed (2 hours before
      standing). PV was measured before and 1 hour after the last dose of F. D (5 mg)
      and A (0.8 mg) were then taken orally 1 hour before the stand test. F expanded PV
      by 16% and caused sodium retention. Four of the 7 subjects stood for 1 hour post
      bedrest and HR, plasma NE and PRA responses to standing were greatly enhanced and
      sustained. Although there was a narrowing of pulse pressure, the ability to
      overcome orthostatic intolerance with these countermeasures was largely due to
      vasoconstriction and sustained high heart rate. The existing literature on
      pharmacologic countermeasures for post-flight and post-bedrest orthostatic
      hypotension is reviewed, and the results are discussed in that context.

PMID- 1761731
TI  - Protein crystal growth in microgravity.
AB  - Protein crystallography is a powerful method for determining the three
      dimensional structures of biological macromolecules. Although new methods, such
      as two-dimensional NMR, have demonstrated promise for determining the structures
      of small proteins and nucleic acids, the complete atomic arrangements within
      large proteins can only be determined at present using crystallographic
      techniques. Such crystallographic studies have been of major importance for
      establishing structure/function relationships that are fundamental to
      understanding how enzymes, nucleic acids, and other macromolecules function in
      biological systems. More recently, crystallographic studies of proteins have
      become of considerable practical interest within the pharmaceutical and
      biotechnology industries, as promising tools in drug design and in protein
      engineering.

PMID- 1761732
TI  - Pharmaceutical R & D in space: an industry perspective.

PMID- 1761733
TI  - Acute hemodynamic responses to weightlessness during parabolic flight.
AB  - Pilots and astronauts experience fluid shifts in variable gravity. Acute effects
      of fluid shifts on the cardiovascular system were monitored on NASA's KC-135
      aircraft during parabolic flight. The variability of R-R intervals in the
      electrocardiogram was measured as an indication of vagal cardiac neural activity.
      R-R intervals were measured during the gravity transition from 2-G to 0-G
      produced by parabolic flight to assess the involvement of the autonomic nervous
      system in regulating the acute effects of fluid shifts. In seven subjects, a
      BoMed noninvasive continuous cardiac output monitor (NCCOM 3) monitored thoracic
      fluid index (TFI, ohms), heart rate (bpm), and cardiac output (1/min). Data were
      stored on a lap-top computer with the subject in one of four postures: sitting,
      standing, supine, and semi-supine, during one of four sets of eight to ten
      parabolas. Five seconds of data were averaged: before parabola onset (1.3-G);
      parabola entry (1.9-G); 0-G; and parabola exit (1.7-G). Three to eight parabolas
      were averaged for subjects in each posture; the mean for each posture was
      calculated. In each of five additional subjects, the coefficient of variation was
      calculated by dividing mean value by the standard deviation of 3 to 15 R-R
      intervals. Eight to ten parabolas were averaged for each postural set. Compared
      with values collected before 0-G, standing values during 0-G showed that the
      thoracic fluid index decreased 2.5 ohms, heart rate decreased 22 bpm, and cardiac
      output increased 1 L/min. During sitting, thoracic fluid index decreased 1.25
      ohms, heart rate decreased 10 bpm, whereas cardiac output increased 0.5
      L/min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761734
TI  - The drug development conundrum.

PMID- 1761735
TI  - Regurgitant valvular disease.

PMID- 1761736
TI  - The effect of diltiazem on hepatic drug oxidation assessed by antipyrine and
      trimethadione.
AB  - The effect of pretreatment for 3 days with diltiazem 60 mg three times a day on
      the pharmacokinetics of 500-mg antipyrine and 250-mg trimethadione was studied in
      six healthy male subjects. Diltiazem decreased the total body clearance from 34.0
      +/- 8.0 to 28.6 +/- 6.1 mL/min (P less than .01), and prolonged the elimination
      half-life from 12.6 +/- 3.0 to 14.3 +/- 2.5 hours (P less than .01) of antipyrine
      without any changes in volume of distribution. The cumulative renal excretion (%
      dose) of antipyrine was significantly increased from 2.23 +/- 0.73 to 2.78 +/-
      0.83% (P less than .05). Clearances of production for three major antipyrine
      metabolites, norantipyrine (4.31 +/- 1.64 to 3.50 +/- 1.28 mL/min, P less than
      .01), 3-hydroxymethylantipyrine (4.67 +/- 1.63 to 3.82 +/- 1.34 mL/min, P less
      than .01) and 4-hydroxyantipyrine (10.47 +/- 3.41 to 8.16 +/- 2.82 mL/min, P less
      than .01) were reduced significantly by diltiazem. On the other hand, diltiazem
      did not produce any significant changes in pharmacokinetic parameters of
      trimethadione and plasma concentration ratio, oxidative major metabolite of
      trimethadione to trimethadione itself. These results suggest that other drugs
      metabolizing the same hepatic oxidative pathways as antipyrine, may be influenced
      by diltiazem.

PMID- 1761737
TI  - Pharmacokinetic and tolerance studies of cefpodoxime after single- and multiple
      dose oral administration of cefpodoxime proxetil.
AB  - Cefpodoxime proxetil, a third generation, broad-spectrum, oral cephalosporin, was
      administered in single doses of 100, 200, 400, 600, and 800 mg (dose expressed as
      cefpodoxime equivalents) and multiple doses of 100, 200, and 400 mg twice daily
      to healthy volunteers. The pharmacokinetics of the active metabolite,
      cefpodoxime, and tolerance of cefpodoxime proxetil were determined. Results from
      the single-dose study indicate that cefpodoxime exhibits nonlinear
      pharmacokinetics over the dose range of 100 to 800 mg. This nonlinearity is
      primarily due to differences in dose-normalized AUC and Cmax, urinary recovery,
      and half-life between one or more of the higher-dose treatment groups and the 100
      mg dosing group. After multiple-dose (twice daily) administration for 15 days,
      steady state is achieved on the second day of dosing, and there is no drug
      accumulation. Cefpodoxime pharmacokinetics are linear with dose over the
      clinically relevant dosing range of 100 to 400 mg. Microbiologic and HPLC plasma
      assay results are highly correlated, with close agreement between HPLC- and
      microbiologic-determined pharmacokinetic parameter estimates. Cefpodoxime
      proxetil was well tolerated in both studies. The most frequent medical events
      were related to gastrointestinal problems and consisted of transient loose stools
      in three subjects in the single-dose study and antibiotic-associated diarrhea in
      one subject in the multiple-dose study.

PMID- 1761738
TI  - Morphology and somatotopic organisation of the central projections of afferents
      from tactile hairs on the hind leg of the locust.
AB  - The morphology and organisation of the central projections of tactile hair
      afferents from the hind leg of the locust, Schistocerca gregaria, were examined
      by staining individual hair afferents. Each tactile hair on the femur, tibia, and
      tarsus is innervated by a single sensory afferent, which projects to the
      ipsilateral half of the metathoracic ganglion. Afferents arborize in the
      ventralmost and lateral ventral association centres (vVAC and lVAC). The
      projections are organised somatotopically in a map with three axes, according to
      the position of the hair on the leg. First, proximo-distal: afferents from hairs
      on the proximal leg segments project more anteriorly than do those from hairs on
      distal leg segments. Moreover, on any given segment the afferents from the more
      proximal hairs project more anteriorly than do the afferents from the distal
      hairs. Second, antero-posterior: afferents from hairs on the posterior surface of
      the leg project more medially than do afferents from anterior hairs. Third, dorso
      ventral: afferents from hairs on ventral parts of the leg project more ventrally
      than do afferents from the dorsal hairs. The afferents from posterior and
      anterior hairs project to an area between the central projections from dorsal
      hairs and ventral hairs. The position of a projection within the map is dependent
      upon the location of the hair on the leg and not the peripheral routes taken by
      the axon of its afferent to reach the ganglion.

PMID- 1761739
TI  - Prefrontal projections to the mediodorsal nucleus of the thalamus in the rhesus
      monkey.
AB  - The corticothalamic projections to the prefrontal cortex have been shown to be
      topographically organized. However, the underlying basis for this topography as
      it relates to the organization of the different architectonically defined areas
      of the prefrontal cortex has not been systematically studied. In the present
      investigation we have reassessed the thalamic projections from the different
      architectonic areas of the prefrontal cortex by using the technique of
      autoradiography in the rhesus monkey. The results show that the prefronto
      mediodorsal projections are organized according to the architectonic
      differentiation of the prefrontal cortices. Thus architectonically less
      differentiated medial and orbital prefrontal regions project to the medial sector
      of the mediodorsal nucleus, the magnocellular subdivision. In contrast, highly
      differentiated prefrontal area 8 projects to the most lateral sector of the
      mediodorsal nucleus, the multiformis subdivision. Lateral prefrontal areas with
      intermediate architectonic features project to the central parvocellular sector
      of the mediodorsal nucleus. Additionally, these projections also reveal a
      dorsoventral topography. Thus areas in the medial and dorsolateral cortices
      project to the dorsal part of the mediodorsal nucleus. In contrast, areas in
      orbital and ventrolateral cortices project to the ventral part of the mediodorsal
      nucleus. The topographic organization of the corticothalamic connections
      described in this study corresponds to the progressive elaboration and
      differentiation of the architectonic features of the different prefrontal areas.
      This successive and dichotomous organization of prefrontothalamic connections may
      provide the basis for the observed differential functions of the prefrontal
      cortex and the mediodorsal nucleus.

PMID- 1761740
TI  - Internuclear neurons in the ocular motor system of frogs.
AB  - Medial and lateral rectus motoneurons of frogs were localized after retrograde
      labeling with horseradish peroxidase (HRP) injected in the medial rectus muscle
      or applied on the cut end of the abducens nerve. Coordinates of these cell
      columns were used as target areas for the injection of small amounts of HRP (20
      60 nl) and [3H]leucine (25-40 nl) and as search areas for retrogradely and
      anterogradely labeled internuclear neurons (INT) in in vivo and in vitro
      experiments. HRP injection in the medial rectus subdivision of the oculomotor
      nucleus (n = 6) resulted in retrograde labeling of cell bodies in the
      contralateral principal abducens nucleus. On the average about 16 cells per
      animal were found. Somatic diameters were about 13.5 +/- 2.8 microns (n = 32).
      The number and the size of these abducens internuclear neurons (AbINT) are
      smaller than those of lateral rectus motoneurons (n = 75; diameter: 19 +/- 3.2
      microns). A crossed projection of AbINT to medial rectus motoneurons in the
      contralateral oculomotor nucleus is further supported by autoradiographic
      results. Following injection of [3H]leucine into the abducens nucleus, a high
      density of silver grains was visible within the contralateral oculomotor nucleus,
      mainly in the caudal part of the oculomotor nucleus, where medial rectus
      motoneurons are located. Injection of [3H]leucine in vivo (n = 4) and in vitro (n
      = 3) resulted in a similar high density of silver grains within the contralateral
      oculomotor nucleus, but the background level of silver grains was significantly
      higher after in vitro (264 +/- 38/2,500 microns2) than after in vivo injections
      (195 +/- 17/2,500 microns2). HRP injection in the principal abducens nucleus (n =
      9) resulted in retrograde labeling of cell bodies in the medial rectus
      subdivisions of the bilateral oculomotor nuclei. Ipsilateral projections
      predominated, with about 10 (+/- 8) labeled cells over contralateral projections
      (about 3 +/- 2). Average diameters of these oculomotor internuclear neurons
      (OcINT) were again smaller (10.8 +/- 2 microns; n = 18) than those of medial
      rectus motoneurons (14.4 +/- 3 microns; n = 52). In addition, retrogradely
      labeled cells were consistently encountered in the bilateral vestibular nuclei,
      the cerebellar nuclei, the dorsal brainstem caudal to the abducens nuclei, and
      ipsilaterally in the pretectum. Most of the vestibular neurons were located in
      the rostral part of the vestibular nuclear complex. These neurons might
      constitute part of the three-neuronal arc of the vestibulo-ocular reflex in the
      frog. Labeled cells in the pretectum were restricted to the ipsilateral posterior
      thalamic nucleus (P).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761741
TI  - Gliosis during optic fiber regeneration in the goldfish: an immunohistochemical
      study.
AB  - Antisera directed against the 48 kDa and 50 kDa cytoskeletal antigens were used
      to examine changes in the astroglial fabric of the goldfish visual pathways
      following optic nerve crush. Several major observations are described. First, an
      optic nerve crush lesion in these animals appears to be devoid of glial cells for
      at least the first month after surgery. As a corollary, regenerating axons that
      grow across the lesion may do so over an aglial substrate. Once the axons cross
      the lesion, their growth is confined to the astroglial domains of the proximal
      nerve stump. In the optic nerve, gliosis comprises hypertrophy of astrocytic
      processes such that the open framework characterizing the normal nerve is
      obscured. In addition, during regeneration, optic nerve glia express large
      amounts of the 50 kDa cytoskeletal protein, which they ordinarily express at only
      minimal levels. In the optic tract, gliosis is reflected in a markedly increased
      expression of the 50 kDa protein as well as an apparent increase in the number
      and complexity of glial processes. In addition, optic tract glia begin to express
      the 48 kDa antigen during regeneration. This protein is ordinarily confined for
      the most part to the optic nerve and is not seen in the tract glia. Finally, no
      obvious changes were seen in the glia of the optic tectum. These results
      demonstrate many points of similarity between gliosis in the goldfish and in
      mammals. However, in some particulars the two responses differ, and it is
      possible that these differences are related to the differing ability of central
      axons to regenerate in the two groups of organisms.

PMID- 1761742
TI  - Organization of callosal connections in the visual cortex of the rabbit following
      neonatal enucleation, dark rearing, and strobe rearing.
AB  - The organization of visual callosal projections was studied in (1) normal adult
      rabbits; (2) adult rabbits which had undergone monocular enucleation (ME) or
      binocular enucleation (BE) at birth; and (3) adult rabbits which had been
      deprived of normal visual experience during development by dark rearing (DR) or
      strobe rearing (SR). Previously published observations (Murphy and Grigonis,
      Behav Brain Res 30:151, 1988) on callosal organization in adult rabbits in which
      retinal ganglion cell activity was eliminated during development by intraocular
      tetrodotoxin (TTX) injections, are also summarized for comparison with these
      data. The tangential extent of the callosal cell zone was significantly larger
      than normal in DR, TTX, and ME rabbits, was unchanged in BE rabbits, and was
      significantly reduced in SR rabbits. An analysis of the laminar distribution of
      the callosal cells revealed a significant increase in the percentage of callosal
      cells in lamina IV in ME, DR, and TTX animals. Measurements of density of
      callosal cells showed a significant increase in the density of the callosal
      projection in ME and SR rabbits and a decrease in density in BE rabbits compared
      with normal. The data suggest that the mechanisms involved in the development of
      the tangential and laminar organization of the callosal cell zone are different.
      In addition, the data suggest that the mechanisms involved in the maintenance of
      callosal projections are different from the mechanisms involved in the
      elimination of callosal projections during development. The effects of these
      developmental manipulations on callosal organization in other mammals are
      reviewed and compared with the effects in rabbits. The data suggest that species
      differences in the degree of maturity of the visual system at birth and in the
      extent of callosal development at the time of eye opening, may underlie species
      differences in the effects of these manipulations on the organization of visual
      callosal projections during development.

PMID- 1761743
TI  - A synaptic antigen (B16) is localized in retinal synaptic ribbons.
AB  - This morphological and biochemical study examines the cytoplasmic synaptic
      determinant recognized by a monoclonal antibody (B16). This antibody was
      generated by using an immunosuppression protocol that generates antibodies to
      relatively rare antigens. The B16 antibody labels structures in the brain that
      are dot-shaped and in the retina that resemble synaptic ribbons in their
      location, size, developmental emergence, and biochemical composition. The antigen
      is apparently conserved across species as it is found in retinas from lizards,
      frogs, fish, birds, mice, rats, rabbits, cats, and monkeys. This paper focuses on
      observations in the murine retina. Labeling in the outer plexiform layer of the
      retina is confined to the margin between the outer plexiform layer (OPL) and the
      outer nuclear layer. The labeled structure resembles a semiellipse or an arc with
      the open end facing the OPL and the top facing the outer nuclear layer. Overall,
      the arc is approximately 1 micron in length and less than 0.5 micron thick.
      Approximately 10% of the labeled arcs occur in a proximal stratum of the OPL and
      form a planar cluster that resembles a flat plaque parallel to the OPL. Five to
      ten arcs are found in each plaque. The arcs found within the plaques are
      approximately 50% smaller than the larger isolated arcs. Counterstaining with
      peanut agglutinin (PNA), a lectin that recognizes cone photoreceptors and their
      associated processes, demonstrates that the plaques are associated with the cone
      pedicles. Animals that have a higher ratio of cones/rods than mice demonstrate a
      much higher ratio of plaques/isolated arcs in the OPL. The structure labeled in
      the inner plexiform layer resembles a short bar (0.8 micron long by less than 0.5
      micron wide) that is confined to the inner half of the inner plexiform layer in
      mice. The relative mobility (Mr) of the B16 antigen obtained from mouse retinal
      and brain tissue is 88 kD, as determined by SDS-PAGE followed by Western
      blotting. The mouse 88 kD protein is relatively soluble (precipitates at 70%
      ammonium sulphate) and elutes at a pH of 7.3 from an isoelectric focusing column.
      It appears that the determinant recognized by the B16 antibody is a previously
      undescribed synaptic protein that is associated with the synaptic ribbons in
      photoreceptor and bipolar terminals of most vertebrate retinas.

PMID- 1761744
TI  - Localization of aspartate-like immunoreactivity in the retina of the turtle
      (Pseudemys scripta).
AB  - Aspartate has been reported to be a putative excitatory neurotransmitter in the
      retina, but little detailed information is available concerning its anatomical
      distribution. We used an antiserum directed against an aspartate-albumin
      conjugate to analyze the anatomy, dendritic stratification, and regional
      distribution of cell types with aspartate-like immunoreactivity in the turtle
      retina. The results showed dramatic differences in immunoreactivity in the
      peripheral versus the central retina. Strong aspartate-like immunoreactivity was
      shown in the peripheral retina, with many well-labeled processes in the inner
      plexiform layer. Many bipolar, horizontal, amacrine, and ganglion cells, some
      photoreceptors, and some unidentified cells were strongly immunoreactive in the
      peripheral retina. In contrast, although the central retina showed well-labeled
      horizontal cells, there was only light labeling in the inner plexiform layer with
      weakly immunoreactive amacrine and ganglion cells and no labeled bipolar cells.
      There were several strongly immunoreactive efferent nerve fibers which left the
      optic nerve head and arborized extensively in the retina. At the electron
      microscopic level, electron-dense reaction product was associated with synaptic
      vesicles at bipolar and amacrine cell synapses in the inner plexiform layer.
      These results suggest that aspartate may be involved in many diverse synaptic
      interactions in both the outer plexiform layer and the inner plexiform layer of
      the turtle retina.

PMID- 1761745
TI  - Post-rolandic cortical projections of the superior temporal sulcus in the rhesus
      monkey.
AB  - The efferent connections of different cytoarchitectonic areas of the superior
      temporal sulcus (STS) in the rhesus monkey with parieto-temporo-occipital cortex
      were investigated using autoradiographic methods. Four rostral-to-caudal
      subdivisions of cortex (area TPO) in the upper bank of the STS have distinct
      projection patterns. Rostral sectors (areas TPO-1 and -2) project to the rostral
      superior temporal gyrus (areas Ts1, Ts2, and Ts3), insula of the Sylvian fissure,
      and parahippocampal gyrus (perirhinal and prorhinal cortexes, areas TF, TH, and
      TL); caudal sectors (TPO-3 and -4) project to the caudal superior temporal gyrus
      (areas paAlt and Tpt), supratemporal plane (area paAc), circular sulcus of the
      Sylvian fissure (area reIt), as well as medial paralimbic (areas 23, 24, and
      retrosplenial cortex) and extrastriate (areas 18 and 19) cortexes. Area TPO-1
      does not project to the parietal lobe; area TPO-2 projects to the inferior
      parietal lobule; area TPO-3 to the lower bank of the intraparietal sulcus (IPS)
      (area POa); and area TPO-4 to medial parietal cortex (area PGm). Vision-related
      cortex (area TEa) in the rostral lower bank of the STS sends fibers to the
      rostral inferotemporal region (areas TE1, -2, and -3) and parahippocampal gyrus
      (perirhinal cortex, areas TF and TL). Visual zones in the caudal lower bank and
      depth of the sulcus (area OAa, or MT and FST) project to the caudal
      inferotemporal region (areas TE3 and TEO), lateral preoccipital region (area V4),
      and lower bank of the IPS (area POa). A zone in the rostral depth of the STS
      (area IPa) projects to the rostral inferotemporal region, parahippocampal gyrus,
      insula of the Sylvian fissure, parietal operculum, and lower rim of the IPS (area
      PG). STS projections to parieto-temporo-occipital cortex have "feedforward,"
      "feedbackward," and "side-to-side" laminar patterns of termination similar to
      those of other cortical sensory systems. The differential connectivity supports
      the cytoarchitectonic parcellation of the STS and suggests functional
      heterogeneity.

PMID- 1761746
TI  - Immunocytochemical localization of argininosuccinate synthetase in the rat brain.
AB  - The neuronal distribution of argininosuccinate synthetase (ASS) was mapped in the
      rat brain. Argininosuccinate synthetase is one of the enzymes of the arginine
      metabolic pathway and catabolizes the synthesis of argininosuccinate from
      aspartate and citrulline. Since arginine is the precursor of nitric oxide,
      argininosuccinate synthetase may act as part of the nitric oxide producing
      pathway. Argininosuccinate is also suggested to have a messenger function in the
      nervous system. Therefore, the localization of ASS is of great interest.
      Polyclonal antisera against purified rat liver argininosuccinate synthetase
      revealed a characteristic distribution pattern of argininosuccinate synthetase
      like immunoreactivity: (1) many neurons with strong argininosuccinate synthetase
      like immunoreactivity were observed in the septal area, basal forebrain, anterior
      medial and premammillary nuclei of the hypothalamus, anterior and midline
      thalamic nuclei, dorsal endopiriform nucleus of the amygdala, basal nucleus of
      Meynert, subthalamic nucleus, laterodorsal tegmental nucleus, raphe nuclei,
      nucleus ambiguus, and the area postrema, (2) neuropile staining was dense in the
      septal areas, hypothalamus, area postrema, nucleus of the solitary tract, and the
      laminae I and II of the caudal subnucleus of the spinal trigeminal nucleus and
      the spinal dorsal horn, (3) relay nuclei of the specific sensory systems such as
      the dorsal lateral geniculate nucleus and the ventral nuclei of the thalamus were
      devoid of argininosuccinate synthetase-like immunoreactivity, (4) no staining was
      seen in the large white matter structures such as the internal capsule, corpus
      callosum, and the anterior commissure, and (5) most of the neurons stained were
      small or medium in size and appeared to be interneurons. The results suggest that
      argininosuccinate synthetase affects the widely distributed, neuromodulatory
      system in the brain.

PMID- 1761748
TI  - Evidence for new growth and regeneration of cut axons in developmental plasticity
      of the rubrospinal tract in the North American opossum.
AB  - We have shown previously that rubral axons can grow around a lesion of their
      spinal pathway in the developing opossum and that a critical period exists for
      that plasticity (Martin and Xu, Dev Brain Res 39:303, 1988). Since most
      rubrospinal neurons degenerate after axotomy during the critical period, we have
      proposed that plasticity results primarily from growth of late arriving axons
      around the lesion rather than regeneration of cut axons (Xu and Martin, J Comp
      Neurol 279:368, 1989). In the present study, we used a double-labeling paradigm
      to test that hypothesis. Four groups of pouch young opossums received bilateral
      or unilateral injections of Fast Blue (FB) into the caudal thoracic or rostral
      lumbar cord (T12-L2) at different ages in order to label rubrospinal neurons.
      Three or 4 days later, the rubrospinal tract was transected unilaterally, four to
      five segments rostral to the injection(s). If the injection was unilateral, the
      lesion was made ipsilateral to it. The animals were maintained for about 1 month
      before a second marker, Diamidino Yellow (DY), was injected, usually bilaterally,
      between the FB injection(s) and the lesion. The animals were maintained for about
      5 days before sacrifice and sections through the red nucleus and spinal cord were
      examined with a fluorescence microscope. During the critical period for
      plasticity, only a few rubral neurons contralateral to the lesion were labeled by
      FB alone, supporting our previous contention that most axotomized neurons
      degenerate. In contrast, many neurons were labeled by DY alone, indicating that
      their axons were not present in the caudal cord at the time of the FB injection
      and that they grew around the lesion during the 1 month survival to incorporate
      DY. A few double-labeled neurons were also found. One interpretation of such
      neurons is that they survived axotomy, as evidenced by the presence of FB, and
      supported axons which grew around the lesion to take up DY. Another
      interpretation is that they supported late growing axons which incorporated
      residual FB as well as DY. In order to choose between these alternatives, a
      similar double-labeling paradigm was carried out, but with removal of FB at the
      time of the lesion. Since a few neurons were still double labeled, we conclude
      that regeneration of cut axons also contributed to rubrospinal plasticity. Our
      results support our previous suggestion that developmental plasticity of the
      rubrospinal tract results primarily from growth of late arriving axons around the
      lesion, but they also suggest that regeneration of cut axons occurs.

PMID- 1761747
TI  - Calbindin-like immunoreactivity in the central auditory system of the mustached
      bat, Pteronotus parnelli.
AB  - With the aid of a polyclonal antibody specific for Calbindin D-28k, we studied
      the distribution of this calcium-binding protein in the central auditory system
      of the mustached bat, Pteronotus parnelli. Components of the cochlear nucleus
      (CN) that were calbindin-positive (cabp(+] included the root of the auditory
      nerve, multipolar and globular bushy cells in the anteroventral CN, multipolar
      and octopus cells in the posteroventral CN, and small and medium-size cells in
      the dorsal CN. Not stained were spherical bushy cells of the anteroventral CN and
      pyramidal/fusiform cells in the dorsal CN. In the superior olivary complex,
      labeled cells were found in the lateral and medial nuclei of the trapezoid body,
      the ventral and ventromedial periolivary nuclei, and the anterolateral
      periolivary nucleus. No cellular labeling was seen in the lateral superior olive.
      In the medial superior olive, only marginal cells were cabp(+). Labeled fibers
      could be seen surrounding the gosts of unlabeled cells in both the latter nuclei.
      Most cells in the intermediate nucleus and the columnar division of the ventral
      nucleus of the lateral lemniscus were cabp(+). However, the dorsal nucleus was
      cabp(-). A group of cabp(+) cells was also seen in the paralemniscal zone. The
      inferior colliculus had a relatively low density of cabp(+) cells. Labeled cells
      were more common in the caudal half of the central nucleus, and in the external
      nucleus and dorsal cortex. In the auditory thalamus, nearly every cell in the
      medial geniculate body was cabp(+), but those in the suprageniculate nucleus and
      in the posterior group did not stain. Small cells in the intermediate layer and
      giant cells in the deep layers of the superior colliculus were densely cabp(+).
      In the pons, cabp(+) cells and neuropil could be seen in the medial and lateral
      pontine nuclei (pontine gray). In conclusion, calbindin-like immunoreactivity was
      found in most of the brainstem auditory system, as well as in regions associated
      with acoustic orientation or control of vocalization. However, except for a
      minority of cells of the medial superior olive, it is conspicuously absent from
      the nuclei receiving binaural input below the level of the inferior colliculus.

PMID- 1761749
TI  - Postnatal development of acetylcholinesterase in, and cholinergic projections to,
      the cat superior colliculus.
AB  - The postnatal development of cholinergic afferents to the superior colliculus in
      neonatal cats was studied by using acetylcholinesterase (AChE) histochemistry,
      choline acetyltransferase (ChAT) immunohistochemistry, and retrograde transport
      of horseradish peroxidase (HRP). In the adult cat, the pattern of AChE staining
      was laminar specific. AChE was distributed continuously in the stratum griseum
      superficiale (SGS) but was organized as patches in the stratum griseum
      intermediate (SGI). Diffuse AChE staining also was present in the stratum griseum
      profundum (SGP) and the dorsolateral periaqueductal gray (PAG). At birth,
      however, AChE staining was barely detectable in the SGS and, aside from a few
      isolated labeled neurons, was absent from the SGI, SGP, and PAG. By 7 days
      postnatal (dpn), staining in the SGS was more apparent but did not change
      appreciably in the deeper laminae. A substantial increase in AChE staining
      occurred in the SGS at 14 dpn (several days after eye opening), at which time
      patches in the SGI first became apparent. By 28 dpn, the complete laminar
      specific adult AChE staining pattern was present, though the staining intensity
      did not reach the adult level until 56 dpn. A protracted maturation of both AChE
      staining and ChAT immunoreactivity also was observed in the sources of
      cholinergic afferents to the superior colliculus, which include the parabigeminal
      nucleus, and the pedunculopontine (PPN) and lateral dorsal tegmental (LDTN)
      nuclei. AChE and ChAT-immunoreactive staining in each nucleus was weak at birth
      but increased during the ensuing 2 weeks. At 21 dpn, however, ChAT
      immunoreactivity virtually disappeared in the parabigeminal nucleus and
      significantly decreased in PPN and LDTN. The ChAT immunoreactivity in these
      nuclei then gradually increased reaching maximum levels by 28 dpn. At 35 dpn,
      AChE staining showed a significant, though temporary (4 weeks), decrease in the
      parabigeminal nucleus, but not in the PPN and LDTN, that subsequently increased
      to the adult level of staining at 70 dpn. The absence of AChE in the SGI in
      neonatal animals was correlated, at least in part, with a paucity of neurons in
      the brainstem cholinergic cell groups labeled by retrograde transport of HRP from
      the superior colliculus. Injections of HRP into the superior colliculus
      retrogradely labeled many neurons in the parabigeminal nucleus, but few, if any,
      neurons in the PPN or LDTN at 1 dpn. Retrogradely labeled neurons also were
      observed in the substantia nigra pars reticulata, albeit fewer in neonates than
      in adults.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761750
TI  - Calcitonin gene-related peptide and corneal innervation: a developmental study in
      the rat.
AB  - The development of calcitonin gene-related peptide-like immunoreactive (CGRP-LI)
      nerves was studied in neonatal and adult rat corneas stained
      immunohistochemically according to an avidin biotin peroxidase procedure. At
      birth, rat corneas already contained dense plexuses of CGRP-LI nerve fibers. Most
      of the nerves entered the cornea in 12-15 prominent stromal nerve bundles located
      at regular intervals around the circumference of the cornea. Fibers in these
      bundles entered the epithelium approximately midway between the limbus and the
      center of the cornea and supplied extensive central and pericentral areas of the
      tissue. In addition, smaller numbers of axons entered the cornea individually and
      in small fascicles located in between the larger bundles and supplied mainly
      peripheral territory. In the epithelium, the CGRP-LI nerves formed a complex,
      highly anastomotic meshwork that ramified uniformly throughout central and
      peripheral areas of the tissues. Fibers in the plexus gave origin to numerous
      short, stout terminal axons that extended into the adjacent epithelium in all
      directions with no preferred orientation. During the first week of neonatal life,
      several changes in CGRP-LI innervation occurred: 1) the innervation density of
      the central and pericentral cornea increased relative to the peripheral cornea;
      2) intraepithelial axons became progressively longer, increased in branching
      complexity, and oriented preferentially towards the center of the cornea; and 3)
      a dense innervation of the corneoscleral limbus and, in particular, the branches
      of the marginal artery, developed. Midway through the second week of life,
      immature versions of corneal epithelial "leashes," the dominant feature of the
      adult corneal innervation, were first observed. Over the next 10 days, the leash
      formations in the central and pericentral cornea gradually became more complex
      and gave rise to greater numbers of terminal axons, compared to developing
      leashes in the peripheral cornea. The mature pattern of corneal CGRP-LI
      innervation was reached on day 21 and remained constant (except for compensatory
      growth-related elongation of axons) for at least the first 6 months of life.
      Transection of the ophthalmomaxillary nerve or neonatal administration of the
      sensory neurotoxin capsaicin resulted in the total loss of CGRP-LI staining from
      the cornea. In contrast, removal of the superior cervical ganglion had no effect
      on corneal CGRP-LI staining. The extraordinary density and complexity of the CGRP
      LI innervation of the rat cornea demonstrated at all stages of development in
      this study suggests that these nerves may play important roles in corneal
      sensory, reflex, and trophic functions.

PMID- 1761751
TI  - Functional regions within the map of a single digit in raccoon primary
      somatosensory cortex.
AB  - Electrophysiological recordings were made at a large number of sites in the
      primary somatosensory cortex of six anesthetized raccoons. A high density of
      penetrations (110-229 per animal), within or near the representation of the
      fourth digit, allowed identification of three cortical regions with different
      physiological properties: a glabrous zone, containing a highly detailed,
      somatotopically ordered representation of the glabrous surface of the digit;
      rostral to this a claw-dominant zone, in which the neurons at most penetrations
      respond to stimulation of the claw of the fourth digit, but may also receive
      input from the hairy skin or surrounding glabrous skin; and a more rostral
      multidigit zone, in which the neurons respond to stimulation of two to five
      digits, with the dominant digit usually being the one represented caudally (i.e.,
      the fourth digit at most of the sites sampled here). Claw-dominant zones with
      receptive fields restricted to digit three or five are also found rostral to the
      representations of the glabrous skin of the corresponding digit. The glabrous and
      claw-dominant zones constitute a complete map of the fourth digit. The multidigit
      region presumably is a separate map, since its neurons have different spatial
      convergence, higher thresholds, and a lower incidence of slowly adapting inputs
      than those in the claw-dominant and glabrous zones. A comparison between animals
      with lesions of the basal forebrain and intact animals found no differences in
      the organization of these zones or in the responses to peripheral input,
      suggesting that cholinergic inputs to the cortex are not essential to these
      properties. The detailed description of these regions and the proposed
      terminology should resolve some inconsistencies in the use of the term
      "heterogeneous zone" in this species.

PMID- 1761752
TI  - Parvalbumin- and calbindin D28k-immunoreactive neurons in the hippocampal
      formation of the macaque monkey.
AB  - Calcium-binding proteins calbindin D28k (CaBP) and parvalbumin (PV) were
      localized in neurons of the monkey hippocampal formation. CaBP immunoreactivity
      is present in all granule cells and in a large proportion of CA1 and CA2
      pyramidal neurons, as well as in a distinct population of local circuit neurons.
      In the dentate gyrus, CaBP-immunoreactive nongranule cells are present in the
      molecular layer and in the hilar region, but they do not include the pyramidal
      basket cells at the hilar border. In the Ammon's horn, CaBP-positive,
      nonpyramidal neurons are more frequent in the CA3 area than in any other parts of
      the hippocampal formation. They are concentrated in the strata oriens and
      pyramidale of areas CA1-3, whereas only a few small neurons were found in the
      strata lucidum and radiatum of CA3 and in the stratum moleculare of the CA1 area.
      PV is exclusively present in local circuit neurons both in the dentate gyrus and
      in Ammon's horn. In the dentate gyrus the presumed basket cells at the hilar
      border exhibit PV immunoreactivity. In the hilar region and molecular layer only
      a relatively small number of cells are immunoreactive for PV. Most of these PV
      positive cell bodies are located in the inner half of the molecular layer, with
      occasional horizontal cells at the hippocampal fissure. In Ammon's horn, strata
      oriens and pyramidale of areas CA1-3 contain a large number of PV-positive cells.
      There are no PV-immunoreactive cells in the strata lucidum, radiatum, or
      lacunosum moleculare. The CaBP- and PV-containing neurons form different
      subpopulations of cells in the monkey hippocampal formation. With the exception
      of a basket cell type in the monkey dentate gyrus, the CaBP- and PV-positive cell
      types were found to be remarkably similar in rodents and primates.

PMID- 1761753
TI  - A light and electron microscopic study of the development of the Mauthner cell
      and vestibular nerve in the axolotl.
AB  - Vestibular axons form synapses on a restricted area of the lateral dendrite of
      the Mauthner cell, a large, identified brainstem neuron found in fish and
      amphibians. The differentiation of the vestibular nerve, medullary neuropil, and
      Mauthner cell of the axolotl (Ambystoma mexicanum) was studied to understand
      better the means by which this synaptic specificity arises. The Mauthner cell
      first extends a medial process and then a lateral dendrite. The latter initially
      elongates as a simple process and later sends out branches. As the lateral
      dendrite grows, vestibular axons enter the brainstem to form one of the earliest
      of several discrete axon fascicles that course longitudinally through the
      neuropil. The fascicles, many of which are identifiable on the basis of their
      location and axonal morphology, are the precursors of the longitudinal tracts of
      the mature salamander. The lateral dendrite grows dorsally over the orthogonally
      oriented fascicles, making contact with each at a characteristic time and place.
      The first afferents to form synapses do so on the soma and proximal lateral
      dendrite; subsequent afferent groups terminate more distally. Axons within a
      given fascicle form synapses with the Mauthner cell in a discrete and initially
      homogeneous domain. As dendritic branches form and the organization of the
      longitudinal fascicles becomes more complex, the homogeneity of axons terminating
      on a given region of the Mauthner cell surface is lost, but no major
      rearrangement or migration of terminals is apparent. These observations are
      consistent with both active recognition and passive spatiotemporal models of
      synaptic site specificity.

PMID- 1761754
TI  - Specific temporal and spatial distribution of JUN, FOS, and KROX-24 proteins in
      spinal neurons following noxious transsynaptic stimulation.
AB  - We present the first comparative investigation of the basal and transsynaptically
      induced expression of c-JUN, JUN B, JUN D, c-FOS, FOS B, and KROX-24 proteins in
      the spinal cord, using immunocytochemistry with specific antibodies. We
      demonstrate that electrical stimulation of the sciatic nerve at A delta/C-fiber
      (not A alpha/beta-fiber) intensity strongly induces the expression of these
      immediate-early gene-encoded proteins. Basal immunoreactivity was found for c-JUN
      in motoneurons, for JUN D in almost every cell of the gray matter, and for KROX
      24 in the superficial dorsal horn. One hour after electrical stimulation of the
      sciatic nerve at A delta/C-fiber intensity, expression of all proteins except JUN
      D reached its maximum. Initially immunoreactivity was restricted to the
      ipsilateral dorsal horn, but after 4 hours appeared contralaterally. Expression
      of JUN D was increased only after 4 hours. Within the dorsal horn, the expression
      of c-JUN, JUN B, FOS B, and KROX-24 was mainly restricted to the superficial
      layers. Immunoreactivity decreased to basal levels between 8 and 16 hours. c-FOS
      and JUN D were expressed in both the superficial and deep dorsal horn; in the
      latter, c-FOS and JUN D persisted longer. Induced JUN D was present the longest
      and was still visible after 32 hours. In motoneurons of the ipsilateral ventral
      horn, c-JUN, JUN D, and c-FOS appeared after 8 hours. Surgical exposure of the
      sciatic nerve evoked a strikingly prolonged expression of all proteins compared
      to that following electrical stimulation of the sciatic nerve. Our results
      demonstrate that stimulation of nociceptive A delta- and C-fibers induces early
      and late expression of proteins encoded by immediate-early genes with a specific
      temporal and spatial distribution of the expression of each protein. Furthermore,
      the extent of protein expression reflects the intensity of noxious stimulation.

PMID- 1761755
TI  - Effect of precocious and delayed afferent arrival on synapse localization on the
      amphibian Mauthner cell.
AB  - Afferents often form synapses on restricted regions of their target cells. The
      connections between vestibular axons and the Mauthner cell are an example of this
      sort of specificity. The Mauthner cells are a pair of identifiable central
      neurons in certain fish and amphibians. In the axolotl (Ambystoma mexicanum), the
      large vestibular axons form club endings on only one portion of one dendrite of
      the Mauthner cell. During development, this specific distribution might result
      from nothing more than when and where the growing axons and dendrite meet
      (spatiotemporal model). Alternatively, the distribution might reflect constraints
      on where the developing axons may grow (axon segregation model) or form synapses
      (active recognition model). As a test of the spatiotemporal model, ears and
      vestibular ganglia from older embryos (Harrison stage 33/34-) were unilaterally
      grafted in place of prospective ear/ganglion placodes of younger embryos (stage
      23). Light and electron microscopic examination revealed that the axons
      precociously entered the brain and formed synapses on the Mauthner cell.
      Similarly, grafts from younger to older embryos resulted in a delay. In both
      situations, mapping the club endings on the mature Mauthner cells of 21-mm larvae
      revealed a distribution similar to that of the contralateral control cells. Thus
      precocious and delayed afferent arrival did not alter the eventual localization
      of the synapses. These results conflict with the spatiotemporal model and imply
      that the vestibular axons are either restricted to a certain region of the
      neuropil or capable of recognizing a specific region of the Mauthner cell
      surface.

PMID- 1761756
TI  - Diverse thalamic projections to the prefrontal cortex in the rhesus monkey.
AB  - We studied the sources of thalamic projections to prefrontal areas of nine rhesus
      monkeys with the aid of retrograde tracers (horseradish peroxidase or fluorescent
      dyes). Our goal was to determine the proportion of labeled neurons contributing
      to this projection system by the mediodorsal (MD) nucleus compared to those
      distributed in other thalamic nuclei, and to investigate the relationship of
      thalamic projections to specific architectonic areas of the prefrontal cortex. We
      selected areas for study within both the basoventral (areas 11, 12, and ventral
      46) and the mediodorsal (areas 32, 14, 46, and 8) prefrontal sectors. This choice
      was based on our previous studies, which indicate differences in cortical
      projections to these two distinct architectonic sectors (Barbas, '88; Barbas and
      Pandya, '89). In addition, for each sector we included areas with different
      architectonic profiles, which is also relevant to the connectional patterns of
      the prefrontal cortices. The results showed that MD included a clear majority
      (over 80%) of all thalamic neurons directed to some prefrontal cortices (areas
      11, 46, and 8); it contributed just over half to some others (areas 12 and 32),
      and less than a third to area 14. Clusters of neurons directed to basoventral and
      mediodorsal prefrontal areas were largely segregated within MD: the former were
      found ventrally, the latter dorsally. However, the most striking findings
      establish a relationship between thalamic origin and laminar definition of the
      prefrontal target areas. Most thalamic neurons directed to lateral prefrontal
      cortices, which are characterized by a high degree of laminar definition (areas
      46 and 8), originated in the parvicellular and multiform subdivisions of MD, and
      only a few were found in other nuclei. In contrast, orbital and medial cortices,
      which have a low degree of laminar differentiation, were targeted by the
      magnocellular subdivision of MD and by numerous other limbic thalamic nuclei,
      including the midline and the anterior. Thus topographic specificity in the
      origin of thalamic projections increased as the laminar definition of the target
      area increased. Moreover, the rostrocaudal distribution of labeled neurons in MD
      and the medial pulvinar also differed depending on the degree of the laminar
      definition of the prefrontal target areas. The rostral parts of MD and the medial
      pulvinar projected to the eulaminate lateral prefrontal cortices, whereas their
      caudal parts projected to orbital and medial limbic cortices. Selective
      destruction of caudal MD is known to disrupt mnemonic processes in both humans
      and monkeys, suggesting that this thalamic-limbic prefrontal loop may constitute
      an important pathway for memory.

PMID- 1761757
TI  - Differential expression of mRNAs for the NGF family of neurotrophic factors in
      the adult rat central olfactory system.
AB  - The cellular localization of mRNAs for nerve growth factor (NGF), brain-derived
      neurotrophic factor (BDNF), and neurotrophin-3 (NT3), in the rat central
      olfactory system was evaluated with in situ hybridization of 35S-labeled cRNA
      probes. In the main olfactory bulb, low levels of NGF and BDNF mRNA expression
      were detected. NGF mRNA was restricted to the glomerular region while BDNF mRNA
      was predominantly localized to the granule cell layer. No cellular hybridization
      to NT3 cRNA was seen. The accessory olfactory bulb did not express detectable
      levels of mRNA for any of the three related neurotrophic factors. Areas which
      receive olfactory bulb afferents expressed comparatively high levels of both NGF
      and BDNF mRNA. Cell labeling with cRNAs for NGF and BDNF occurred throughout the
      cellular layers of the anterior olfactory nucleus and in layers 2 and 3 of
      rostral piriform cortex. BDNF mRNA expression in these areas appeared more robust
      than that of NGF mRNA, while NT3 mRNA was not detectable. In contrast, tenia
      tecta exhibited dense labeling with the cRNAs for all three neurotrophic factors.
      The localization of NGF mRNA to primary target neurons of the olfactory nerve in
      the periglomerular region of the main olfactory bulb suggests that bulb cells may
      influence the ingrowth and continual turnover of olfactory sensory afferents.
      However, as there is a strong correlation between the distribution of
      neurotrophic factor mRNAs within rostral olfactory structures and the
      distribution of centrifugal cholinergic afferents, it is more likely that bulb
      derived NGF, and possibly BDNF, act on the cholinergic neurons of the basal
      forebrain.

PMID- 1761758
TI  - Experimental hypophosphataemia in growing pigs: effects on endochondral
      ossification in comparison to osteochondrosis.
AB  - Hypophosphataemia was induced in growing pigs by dietary supplementation with
      aluminium hydroxide. The effect on endochondral ossification was studied
      morphologically in comparison with normophosphataemic pigs given aluminium
      phosphate or left untreated. The aim of the investigation was to elucidate
      further the role of nutritional factors in the pathogenesis of disturbed
      endochondral ossification, occurring in osteochondrosis. In all pigs, focal
      arrestment of endochondral ossification with subsequent cartilage retention in
      the epiphyseal or metaphyseal growth zones was seen. In normophosphataemic pigs,
      focal degenerative cartilage changes were associated with impairment of vascular
      penetration. The lesions had morphological characteristics of early
      osteochondrosis. In hypophosphataemic pigs, a more generalized disturbance,
      endochondral ossification, was seen with impaired vascular penetration and
      excessive deposition of osteoid in the primary spongiosa. Focal cartilage
      retentions were associated with necrotic changes in the primary spongiosa and not
      with cartilage degeneration. The lesions were similar to rickets and it was
      concluded that hypophosphataemia is not an aetiological factor in the development
      of osteochondrosis. The differentiation between the cartilage retention seen in
      early stages of osteochondrosis and rickets must be based on histological
      examination.

PMID- 1761759
TI  - Hepatic pathology of the colon carcinogen, azoxymethane, in Hanford-Moore
      miniature pigs.
AB  - Azoxymethane (AOM) is commonly used in colon carcinogenesis studies in rodents.
      In an attempt to develop a large animal model of human colon cancer, AOM was
      given to Hanford-Moore miniature pigs. Six pigs were injected intraperitoneally
      with a single dose of AOM of either 5, 10, 20, 40 or 55 mg per kg body weight.
      Within 48 h, severe signs of toxicity and death occurred in animals receiving
      greater than 20 mg per kg AOM. After 30 days, all surviving animals were killed
      and necropsied. Acute hepatic necrosis with haemorrhage was the major toxic
      effect of AOM in all animals receiving doses exceeding 20 mg per kg. In a second,
      longer-term experiment, eight pigs were injected with either 20 mg per kg AOM
      weekly or 10 mg per kg AOM every other week or a combination of both treatments.
      Chronic toxic effects were limited to the liver. No colon tumours were observed.
      It is concluded that this particular species demonstrates marked hepatic
      sensitivity to the toxic effects of AOM.

PMID- 1761760
TI  - Bovine farcy: a clinico-pathological study of the disease and its aetiological
      agent.
AB  - An extensive survey for bovine farcy covering 14,192 animals was conducted in the
      Sudan. The incidence of the disease was 31.9 per cent in Western Sudan which is
      regarded as an endemic area. Animals were examined clinically and at post-mortem.
      The lesions involved the prescapular, femoral, parotid, retropharyngeal,
      submaxillary, inguinal and mediastinal lymph nodes. Some animals had farcy
      lesions in the udder and some developed the pulmonary form of the disease. The
      disease is slow, but progressive in nature and was more prevalent among adult
      cattle than calves. Mycobacterium farcinogenes was found to be the cause of
      bovine farcy in the Sudan. The morphological and biochemical characteristics, and
      the mycolic acid content of the isolated strains were found to be identical to
      the reference strains of M. farcinogenes and were quite different from reference
      strains of Nocardia farcinica from which they were easily distinguished by the
      presence of alpha-mycolate, alpha'-mycolate and epoxymycolate in M. farcinogenes.
      Hydrolysis of mycolic acids with tetrabutylammonium hydroxide and the
      precipitation with toluene and acetonitrile gave good results comparable with
      acid methonalysis and alkaline hydrolysis. Precipitin lines were detected in the
      sera of some farcy-infected cattle. Histopathological examination of farcy
      lesions revealed a severe granulomatous reaction characterized by lymphocyte,
      macrophage, epithelioid and giant cell infiltration as well as marked fibrous
      proliferation. These changes were indicative of a progressive disease of the
      delayed tuberculin hypersensitivity type.

PMID- 1761761
TI  - Chronic lesions of thrombo-embolic meningo-encephalomyelitis in calves.
AB  - Six calves showed neurological signs with recumbency for 5 to 30 days.
      Histologically, they had encephalomyelitis characterized by multiple minute foci
      of malacia and perivascular microgliosis throughout the central nervous system.
      Widespread degeneration of the white matter was also detected mainly in the
      spinal cord. Micro-abscesses and thrombophlebitis, which were occasionally
      observed in the malacic lesions, suggested that the disease was a feature of
      infectious thrombo-embolic meningo-encephalomyelitis modified by various factors,
      including antibiotic therapy.

PMID- 1761762
TI  - Increased susceptibility of aged rats to haemorrhage and intravascular
      hypercoagulation following endotoxin administered in a generalized Shwartzman
      regime.
AB  - Ageing rats are known to have an increased incidence of myocardial fibrosis and
      dyspnoea caused by pulmonary intravascular coagulation. In order to determine
      whether endotoxin can be responsible for such responses in ageing rats we have
      exposed rats of differing ages (2 months, 16 months and 24 months) to single or
      repeated (two doses 24 h apart; generalized Shwartzman regime) intravenous doses
      of endotoxin (E. coli 0111 B4). Only the 2-year-old rats reacted adversely. Two
      doses of endotoxin produced death, with focal myocardial necrosis, haemorrhage
      and pulmonary and hepatic intravascular coagulation. The increased susceptibility
      of aged rats to the toxic effects of endotoxin explains some of the changes found
      in the tissues of old rats. The sporadic nature of both cardiac failure and
      dyspnoea as a cause of morbidity and mortality in ageing rats may be related to
      the need for two endotoxin episodes in a period of 24 h to provoke a generalized
      Shwartzman reaction, an occurrence likely to be relatively uncommon under natural
      conditions.

PMID- 1761763
TI  - AA-like amyloid deposits confined to arthritic joints in two dogs with rheumatoid
      arthritis.
AB  - Two dogs with clinical, serological, radiographic and pathological changes
      similar to those of rheumatoid arthritis of man and a previously undescribed
      pattern of amyloid deposits are described. As revealed by light and electron
      microscopical investigations, amyloid fibrils were found exclusively in articular
      tissue structures of arthritic joints and in one tonsil of one dog. Based on our
      immunohistochemical results, the amyloid protein is believed to be of a local AA
      type.

PMID- 1761764
TI  - Minimal focal dermal hypoplasia in a man: a case of father-to-daughter
      transmission.
AB  - Focal dermal hypoplasia is a rare genetic disorder characterized by diffuse and
      specific cutaneous lesions. Multiple visceral abnormalities are frequently
      associated. A minimal form of the disease (only cutaneous and localized to one
      thigh) is reported in the father of a woman who had typical focal dermal
      hypoplasia.

PMID- 1761765
TI  - Intravascular coagulation necrosis of the skin associated with
      cryofibrinogenemia, diabetes mellitus, and cardiolipin autoantibodies.
AB  - Intravascular coagulation necrosis of the skin is rare and appears as hemorrhagic
      infiltrates that may develop ulcerating necrosis, mainly on the acral areas. The
      face, arms, and legs were severely involved in our patient. In this patient
      intravascular coagulation necrosis was associated with cryofibrinogenemia,
      diabetes mellitus, and IgM cardiolipin autoantibodies. In addition, rheumatoid
      factor, elevated polyclonal IgA, and haptoglobin were present as risk factors for
      the vasculopathy. Skin biopsy specimens showed plugging of dermal venules by
      thrombi formed of fibrin and erythrocytes. Immunohistologic staining revealed a
      strong positive reaction for fibrinogen, with some positivity for C3, C4, IgG,
      IgA, and IgM. Erythrocyte extravasation occurred in late lesions without being
      accompanied by perivascular leukocytic infiltrates. Detailed clinical examination
      failed to identify an underlying malignancy. Treatment with heparin and
      prednisolone produced only a brief remission. However, the combination of
      chlorambucil (7 mg/day orally) with low-dose oral prednisolone (10 mg/day) for
      several weeks controlled the disease and greatly reduced the cryofibrinogen. No
      relapse occurred after discontinuation of treatment.

PMID- 1761766
TI  - Hydroa vacciniforme: an unusual clinical manifestation.
AB  - Hydroa vacciniforme is a rare, chronic photodermatosis with onset in childhood
      that is characterized by recurrent vesiculation, necrosis, and vacciniform
      scarring limited to sun-exposed skin. We report a case of nonvesicular hydroa
      vacciniforme in which only extensive crusting associated with hypertrophic
      scarring on sun-exposed skin was present. Multiple exposures to UVA, however,
      reproduced lesions with the typical clinical and histologic features of hydroa
      vacciniforme. Results of blood, urine, and fecal porphyrin studies were normal.

PMID- 1761767
TI  - Cystic fibrosis presenting with periorificial dermatitis.
AB  - A 2-week-old baby boy had a periorificial dermatitis that progressively worsened,
      as did his failure to thrive. Decreased serum zinc, proteins, and amino acids, as
      well as an increase in fecal fat, were noted. The child's dermatitis responded
      promptly to nutritional therapy. Sweat chloride levels were markedly elevated.
      The dermatitis, occasionally seen as a presenting feature of cystic fibrosis, is
      most likely the result of malabsorption caused by pancreatic exocrine
      dysfunction.

PMID- 1761768
TI  - Alopecia of myxedema: clinical response to levothyroxine sodium.
AB  - Noncicatricial alopecia resulting from myxedema developed in a 58-year-old woman.
      We report the response of her alopecia to treatment with levothyroxine sodium and
      review the literature on the subject.

PMID- 1761769
TI  - Large-cell lymphoma presenting with a distinctive inflammatory dermatosis.
AB  - Severe, progressively enlarging inflammatory plaques of the upper trunk and neck
      developed in a 12-year-old girl. Histologic examination revealed a unique
      inflammatory cell infiltrate that consisted of chronic inflammation in the dermis
      subtending spongiosis with a diffuse neutrophilic epidermal infiltrate. A tumor
      in the right axilla was found by computed tomography. Tissue obtained at open
      biopsy examination demonstrated a large-cell lymphoma of B-cell origin. The tumor
      and dermatosis responded dramatically to chemotherapy. The distinctive histologic
      pattern and clinical course suggest that this dermatosis may represent an unusual
      paraneoplastic presentation of large-cell lymphoma.

PMID- 1761770
TI  - Cutaneous reaction from a broken thermometer.
AB  - A cutaneous and soft tissue reaction that resulted from a broken thermometer
      inside the mouth of a 10-year-old boy is described. Metallic mercury globules and
      glass pieces were identified in the excised tissue. On histologic examination, a
      zone of necrosis, polymorphonuclear leukocytes, macrophages, and multinucleated
      giant cells surrounded metallic mercury that appeared as dark opaque globules.
      Dense fibrosis and reactive lymphoid hyperplasia were also noted in the dermis
      and deeper tissues. The gold lysis test, scanning electron microscopy, and energy
      dispersive x-ray analysis confirmed the presence of mercury in the tissue. A
      literature review on cutaneous mercury granuloma illustrates its unpredictable
      course. The cutaneous reaction may remain localized, but some cases are
      associated with an elevated mercury level in blood and urine, pulmonary embolism,
      mercury poisoning, and even with fatal outcome. Various manifestations of mercury
      poisoning and guidelines for the management of cutaneous mercury granuloma are
      discussed.

PMID- 1761771
TI  - Treatment of necrolytic migratory erythema in glucagonoma syndrome.
AB  - The glucagonoma syndrome is characterized by elevated serum glucagon, a
      pancreatic alpha-cell tumor, anemia, hypoaminoacidemia, and necrolytic migratory
      erythema. Necrolytic migratory erythema may cause marked morbidity and is
      frequently misdiagnosed. A 42-year-old white woman with a 1 1/2-year history of
      refractory dermatitis (most severe on the lower extremities) had the glucagonoma
      syndrome. Her severe morbidity was markedly relieved with the administration of
      intravenous amino acids. This therapy was successful in controlling the
      necrolytic migratory erythema through recurrences after somatostatin (SMS 201
      995), surgical debulking, and chemotherapy proved inadequate.

PMID- 1761772
TI  - An unusual presentation of fixed cutaneous sporotrichosis: a case report and
      review of the literature.
AB  - Sporotrichosis is extremely rare in infants. This report describes an 84-day-old
      girl with fixed cutaneous sporotrichosis, presumably transmitted by a cat. A
      rapid, complete response to a low dose of oral potassium iodide therapy was
      attained. To our knowledge, this is the youngest reported patient with
      sporotrichosis, as well as the lowest effective daily dose of potassium iodide.

PMID- 1761773
TI  - Nodular cutaneous B-cell lymphoma of the scalp in the acquired immunodeficiency
      syndrome.
AB  - Aggressive B-cell non-Hodgkin's lymphoma frequently complicates human
      immunodeficiency virus type 1 infection. Although extranodal disease is an
      important feature of this condition, the incidence of cutaneous involvement has
      not been determined. A review of 754 published cases of B-cell non-Hodgkin's
      lymphoma associated with human immunodeficiency virus type 1 revealed an
      incidence of cutaneous extranodal involvement of 8.2%, approximately equal to
      that seen in non-Hodgkin's lymphoma not associated with human immunodeficiency
      virus. Lymphoma was the initial manifestation of acquired immunodeficiency
      syndrome in two thirds of these cases. In particular, although the head and neck
      are commonly involved in non-Hodgkin's lymphoma not associated with human
      immunodeficiency virus, scalp involvement is uncommon in human immunodeficiency
      virus-associated B-cell non-Hodgkin's lymphoma, and we report the second case.
      The natural history and proposed pathogenesis of human immunodeficiency virus
      associated non-Hodgkin's lymphoma are discussed.

PMID- 1761774
TI  - Linear and punctate porokeratosis associated with end-stage liver disease.
AB  - A periodic eruption of porokeratosis developed in a 31-year-old black woman with
      chronic idiopathic hepatitis requiring liver transplantation. The
      clinicopathologic features were chiefly those of linear and punctate
      porokeratosis but overlapped those of porokeratosis plantaris, palmaris et
      disseminata and hyperkeratotic or verrucous porokeratosis. Typical cornoid
      lamellae were visible on histologic examination. Outbreaks of the lesions
      occurred during exacerbations of the liver disease. The skin condition rapidly
      improved after operation, with concomitant improvement in liver function.

PMID- 1761775
TI  - Eruptive epidermal cysts and multiple squamous cell carcinomas after therapy for
      cutaneous T-cell lymphoma.
AB  - Both topical nitrogen mustard and psoralen photochemotherapy may induce benign
      and malignant alterations in the skin. We describe the explosive appearance of
      multiple epidermal cysts and squamous cell carcinomas in a patient whose
      cutaneous T-cell lymphoma was treated sequentially with these two types of
      therapy. This is the first report of both processes in the same patient with
      cutaneous T-cell lymphoma. It strongly supports the concept of lesion induction,
      while raising the question of an additive or even synergistic effect of these
      types of therapy.

PMID- 1761776
TI  - Role of tumor necrosis factor-alpha in Sneddon-Wilkinson subcorneal pustular
      dermatosis. A model of neutrophil priming in vivo.
AB  - A patient with IgG-kappa-associated subcorneal pustular dermatosis (Sneddon
      Wilkinson disease) refractory to dapsone, etretinate, and plasma exchange was
      successfully treated with corticosteroids. A study of neutrophils from both blood
      and pustules was carried out before and during treatment. Levels of tumor
      necrosis factor-alpha were measured in serum, pustules, content, and supernatant
      of monocytes. The results suggest that a hyperactivation of neutrophils in the
      skin is due at least partly to excessive production of tumor necrosis factor
      alpha.

PMID- 1761777
TI  - Multiple cutaneous reticulohistiocytomas (reticulohistiocytic granulomas).
AB  - Multiple cutaneous reticulohistiocytomas (reticulohistiocytic granulomas)
      represent a unique pattern in the spectrum of the reticulohistiocytoses. Seven
      cases have been reported in the English-language literature. A case of multiple
      cutaneous reticulohistiocytomas observed for 5 years is presented. The spectrum
      of the reticulohistiocytoses is reviewed, and the distinct clinical patterns of
      the disease are compared.

PMID- 1761778
TI  - Evidence for percutaneous inoculation as the mode of transmission for
      chromoblastomycosis.
AB  - The exact pathogenesis of chromoblastomycosis is unknown. Direct percutaneous
      inoculation, inhalation, and hematogenous dissemination have been implicated. We
      report a case of chromoblastomycosis that followed a well-defined episode of
      penetrating trauma. The causative organism, Fonsecaea pedrosi, was cultured from
      the patient's lesion and from the tree branch responsible for the trauma. This
      "natural" experiment supports the contention that one cause of
      chromoblastomycosis is traumatic cutaneous implantation of the fungus.

PMID- 1761779
TI  - Castleman's disease associated with pemphigus vulgaris.
AB  - Castleman's disease is a rare, benign, lymphoproliferative disorder of unknown
      cause. The hyaline-vascular type is frequently associated with a localized
      mediastinal mass. The plasma-cell type is associated with constitutional
      symptoms, multicentric lymph node involvement, lymphoma development, and
      autoimmune disease-like laboratory abnormalities such as elevated erythrocyte
      sedimentation rate, anemia, and thrombocytopenia. We report a case of hyaline
      vascular Castleman's disease associated with a cutaneous autoimmune disease,
      pemphigus vulgaris. We also reviewed the clinicopathologic features of four
      similar cases. Among these five reports of Castleman's disease, five patients had
      severe erosive stomatitis diagnosed as oral pemphigus, three had
      keratoconjunctivitis, and three had circulating pemphigus antibodies. All were
      young, ranging in age from 15 to 21 years, and four of the five were women. Two
      had hyaline-vascular Castleman's disease, whereas three had plasma-cell
      Castleman's disease. All five had surgical resection of the Castleman's disease
      mass. After surgery, remission of pemphigus vulgaris could be achieved with
      reduced dosages of steroids in all cases. In at least two cases steroid treatment
      could be completely discontinued. We postulate that an underlying immune
      dysfunction in Castleman's disease facilitates the expression of pemphigus.

PMID- 1761780
TI  - Are stem cells attacked in graft-versus-host disease?

PMID- 1761781
TI  - HMB-45: a clue to the biology of malignant melanoma?

PMID- 1761782
TI  - Cytotoxic folliculitis in GvHD. Evidence of follicular stem cell injury and
      recovery.
AB  - Recent observations indicate that stem cells of the murine hair follicle exist
      exclusively as a subpopulation of relatively undifferentiated outer root sheath
      cells located in the bulge region at the mid-portion of the follicle. Because it
      has been hypothesized that stem cells of interfollicular epidermis may represent
      targets of cytotoxic responses in acute graft-versus-host disease (AGVHD), we
      studied murine AGVHD and observed sequential skin biopsies for the presence and
      evolutionary pattern of follicular injury. Highly purified subsets of donor T
      cells were used to produce AGVHD to multiple minor histocompatibility (H)
      antigens in two strain combinations of mice matched for the major
      histocompatibility complex (MHC). In the C3H.SW- greater than B6 strain
      combination, only CD8+ effector cells produced histologic evidence in skin of
      AGVHD, which peaked three weeks post-transplant. In the B10.D2- greater than
      DBA/2 strain combination, CD4+ effector cells, and to a lesser extent, CD8+
      cells, mediated disease, which peaked during the fourth week post-transplant.
      Analysis of skin from both strain/effector cell combinations revealed follicular
      infiltrates preferentially involving follicular stem cell (FSC) regions (bulge)
      of anagen follicles between the second and third weeks post-transplant. These
      infiltrates often preceded infiltration of adjacent interfollicular epidermis and
      were associated with follicular involution to telogen (resting) phase. By the
      fourth week post-transplant, greater than 50% of follicles were in telogen phase
      and residual inflammation was minimal. This provided a unique opportunity to
      observe follicular recovery from telogen.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761783
TI  - HMB-45 monoclonal antibody recognizes an inducible and reversible melanocyte
      cytoplasmic protein.
AB  - HMB-45 is a monoclonal antibody directed against human melanoma cells and which
      stains epidermal and dermal melanoma cells, the junctional components of common
      and dysplastic melanocytic nevi, and melanocytes in fetal skin. In addition,
      melanocytes in a variety of reactive conditions have been shown to label with HMB
      45, as have dermal melanocytes within Spitz and dysplastic nevi. No melanocytes
      in normal adult epidermis or in the dermis of common nevi have stained with HMB
      45. In order to better understand the properties of this antibody, and of the
      melanocytes that react with it, we stained cultured human melanocytes grown in a
      variety of conditions. Melanocytes from human foreskins were grown for 2-3 weeks
      in MCDB 153 medium supplemented with insulin, epidermal growth factor, and bovine
      pituitary extract as a mixed population of keratinocytes and melanocytes. Some
      cells were transferred to basal medium MCDB 153 (unsupplemented) for periods
      ranging from 3-5 days, and a subset of these were returned to growth-factor
      supplemented medium. In all cases, S100 staining was used to confirm the presence
      of melanocytes. Melanocytes grown in complete medium showed strong granular
      cytoplasmic staining with HMB-45. Cells transferred to basal medium showed a
      markedly diminished staining intensity which was reversible within 3 days upon
      return of the cells to complete medium. The findings suggest that expression of
      the protein recognized by HMB-45 may be related to a growth factor present in
      complete medium, but missing from basal MCDB 153.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1761784
TI  - Transient bullous dermolysis of the newborn. Case report and review of
      pathogenesis.
AB  - A case of transient bullous dermolysis of the newborn is reported. A healthy
      Hispanic newborn developed bullae during the first two days of life. From age two
      to four weeks, the lesions healed with milia formation. There was no residual
      scarring or hypopigmentation. An induced blister showed dermal-epidermal
      separation with the PAS-positive basement membrane in the epidermal roof. PAS
      positive inclusions were present in the cytoplasm of a few basal cells.
      Examination by electron microscopy showed degeneration of the collagen and
      anchoring fibrils. There were numerous stellate inclusions in the endoplasmic
      reticulum of the cytoplasm of the lesional basal keratinocytes.

PMID- 1761785
TI  - Neonatal lupus erythematosus syndrome.
AB  - Three cases of neonatal lupus erythematosus (NLE) syndrome are described. The key
      diagnostic sign is the erythematous and annular clinical appearance of lesions.
      The histopathologic findings may be subtle in NLE syndrome compared with discoid
      or subacute cutaneous lupus erythematosus. Direct immunofluorescence testing may
      be useful in supplementing the histopathologic evaluation. Detection of
      immunoglobulins, complement, or both at the basement membrane zone in lesional
      skin by immunofluorescence occurs in approximately half of cases; a negative
      study does not preclude the diagnosis of NLE syndrome. Clinical and serologic
      evaluation of both the infant and the mother are important in establishing a
      diagnosis of NLE syndrome, particularly when histopathologic findings are subtle.

PMID- 1761786
TI  - Localized epidermal necrolysis (erythema multiforme-like reaction) following
      intravenous injection of vinblastine.
AB  - We report a case of localized epidermal necrolysis that developed 24 hours after
      an intravenous injection of vinblastine. Clinically, the lesions consisted of
      erythematous macules, vesicles, and bullae with a linear arrangement over the
      injected vein. Histologically, the lesions showed features closely resembling
      erythema multiforme (epidermal necrolysis). We discuss the pathogenesis of this
      curious cutaneous drug reaction and review the literature concerning local
      cutaneous complications associated with intravenously administered
      chemotherapeutic agents.

PMID- 1761787
TI  - Ultrastructural signs of altered intracellular metabolism in acral persistent
      papular mucinosis.
AB  - An asymptomatic 24-year-old woman presented with multiple discrete papules on the
      extensor surfaces of the hands and wrists. Light microscopy revealed focal
      increase in the amount of dermal fibroblasts as well as deposition of
      hyaluronidase-labile mucoid substance. The collagen and elastin were decreased.
      The changes were consistent with acral persistent papular mucinosis (APPM). In
      electron microscopy, the intercellular glycosaminoglycans showed small ruthenium
      red-positive granules and thin filaments indicating normal morphology. The
      fibroblastic cells, however, were conspicuously altered. Endoplasmic reticulum
      was dilated, cytoplasm contained large amounts of osmiophilic, concentric
      lysosomal structures, and there was distinct fibrous lamina in the nuclear
      membrane. It was concluded that the primary event in APPM probably affects the
      intracellular metabolism of the dermal fibroblast. The accumulation of lysosomal
      structures may be a distinct feature of APPM differentiating it from the other
      reactive cutaneous mucinoses, or it may only reflect nonspecific degeneration in
      a long-standing lesion.

PMID- 1761788
TI  - Collagenous and elastotic marginal plaques of the hands (CEMPH)

PMID- 1761789
TI  - Immunological effects of ultraviolet radiation.

PMID- 1761790
TI  - Skin organogenesis in vitro: a new tool for dermatology.

PMID- 1761791
TI  - Dermatophytosis in children and adolescents: epidemiological, clinical, and
      microbiological aspects changing with age.
AB  - During a four year period, a total of 84 cases of dermatophytosis were seen in
      patients from 0 to 17 years of age attending our out-patient department. The sex
      distribution was about equal in preadolescents. Males predominated among
      adolescents. A peak incidence at early school age was due to cases of tinea
      capitis, mainly caused by Microsporum canis. A peak among adolescents was due to
      cases of tinea pedis, mainly caused by Trichophyton rubrum. In general, patients
      with Trichophyton rubrum infections were older than those with other types of
      dermatophytosis (p less than 0.05). Dermatophytosis due to Microsporum canis was
      most frequently seen in January and in September (p less than 0.01). Although
      onychomycosis due to dermatophytes was a comparatively rare disease, it did occur
      within all age subgroups. Entities which were very frequent in former times and
      which have become rare during the last decades, such as tinea capitis due to
      Trichophyton schonleinii, still contribute to the spectrum of dermatophytosis in
      childhood.

PMID- 1761792
TI  - Gangliosides inhibit the proliferation of human T cells stimulated with
      interleukin-4 or interleukin-2.
AB  - T cell growth factors such as interleukin-2 (IL-2) and interleukin-4 (IL-4) act
      as potent comitogenic factors for purified human T cells in the presence of
      phorbol myristate acetate (PMA). We investigated the effects of gangliosides on
      the IL-4-driven or IL-2-driven proliferation of human T cells, using these
      comitogenic assays. Bovine brain gangliosides inhibited the proliferation of
      human T cells activated by PMA + IL-4 or PMA + IL-2. These inhibitory effects
      were dose and time-dependent and were significant at concentrations higher than
      50 microM. PMA + IL-2 stimulation was more sensitive to the inhibitory effects of
      gangliosides (I50 = 77.2 microM) than PMA + IL-4 stimulation (I50 = 105.9
      microM). Differential inhibitory effects were also examined among the panel of
      various gangliosides. GD1b and GT1b showed the most potent inhibitory actions in
      each assay; the inhibitory effect of GD1a was somewhat less potent than GD1b or
      GT1b. GM2 and GD3 were only weakly inhibitory, and the inhibitory effect of GM3
      was almost negligible. These findings suggest that gangliosides may play an
      immunomodulatory role by interfering with IL-4 or IL-2-driven proliferation of
      human T cells.

PMID- 1761793
TI  - Modulation of epidermal terminal differentiation in patients after long-term
      topical corticosteroids.
AB  - The expression of the various markers for terminal epidermal differentiation in
      atrophic skin of patients after long-term topical corticosteroids (TCS) was
      studied by electron microscopy, immunofluorescence using antibody to
      profilaggrin/filaggrin (PF/FG), immunoperoxidase staining using antibody to
      involucrin, and oil red O stain for neural lipids of the stratum corneum. Thirty
      nine patients were subdivided into two groups: (A) 19 patients suffering from
      rebound phenomenon after stopping TCS and (B) 20 patients without rebound
      phenomenon. Biopsy specimens were taken before ending the use of TCS in both
      groups. In group A, both the morphological markers (including the different
      epidermal strata, keratohyalin granules, lamellar granules, and cornified cell
      envelopes) and the molecular markers (including involucrin, PF/FG, and neutral
      lipids) of terminal epidermal differentiation were significantly suppressed. On
      the other hand, the differentiational markers in the atrophic skin of patients
      without rebound phenomena were only slightly altered. These results suggest that
      potent TCS not only has antiproliferative actions but also inhibits the
      differentiation of epidermis, resulting in structural defects in the epidermis,
      especially the stratum corneum.

PMID- 1761794
TI  - Sclerotic fibromas of the skin.
AB  - We report a case of a 34-year-old Japanese woman with a fibrous tumor on the left
      palm that fulfilled the criteria of sclerotic fibroma of the skin.
      Immunohistochemically, the tumor cells were positive for vimentin, but negative
      for S-100 protein and neuron-specific enolase. Ultrastructurally, the cross
      striations of collagen microfibrils were less prominent. Our case supports the
      concept that sclerotic fibroma of the skin is a distinctive lesion which may
      represent a hamartoma of the skin.

PMID- 1761795
TI  - Lichen nitidus: a histologic and electron microscopic study.
AB  - A lesion of lichen nitidus in a 53-year-old man was examined by histology and
      electron microscopy. The histology showed typical features. The electron
      microscopy revealed primary changes in hydropic degeneration of basal cells which
      possibly indicated severe edema between the basal keratinocytes and in the
      subepidermal area. The basal keratinocytes themselves were not particularly
      altered, except for clustered micro-vacuolar structures in a small portion of the
      peripheral cytoplasm. In one of the eight blocks observed, the cytoplasmic
      process of a mast cell was found between the basal keratinocytes, indicating that
      mast cells may possibly infiltrate the epidermis in lichen nitidus. Scattered
      mast cells in the dermis were also noted. Thus primary pathologic changes of
      lichen nitidus may be induced by severe edema, which was accompanied by
      inflammatory cells including mast cells, in the region of the dermal-epidermal
      junction.

PMID- 1761796
TI  - In vitro effects of organophosphorus compounds on calmodulin activity.
AB  - In vitro effects of organophosphorus compounds (OP), such as malathion (M),
      methyl parathion (MP) and ethyl parathion (EP), on calmodulin (CaM) activity and
      its active conformation were studied to understand the mechanism(s) of
      neurotoxicity, since CaM is known to regulate Ca2+ transport and the enzymes
      involved in signal transduction and nucleotide metabolism. The biological
      activity of CaM was assessed as a measure of phosphodiesterase (PDE) stimulation.
      The effect of OP compounds on the active conformation of CaM was determined by
      studying the binding of fluorescence probes, namely N-phenyl-1-naphthylamine
      (NPN), and changes in dansyl-calmodulin fluorescence. Dansylated calmodulin was
      also used to study the effect of OP compounds on complex formation between CaM
      and PDE. All three OP compounds inhibited the CaM activity and its active
      conformation in a concentration-dependent manner. Malathion was less effective in
      comparison to EP and MP, with IC50 values of 37 microM, 34.5 microM and 32
      microM, respectively, for CaM activity. EP and MP significantly altered NPN and
      dansyl-calmodulin fluorescence (50 microM concentrations of OP compounds),
      whereas M did not show any significant effect on NPN fluorescence. All these
      compounds significantly affected complex formation between the dansylated CaM and
      PDE. These results suggest that OP compounds may be interacting with CaM,
      altering its active conformation, and thus may be inhibiting its biological
      activity.

PMID- 1761797
TI  - Immunotoxicity of tri-n-butyltin oxide (TBTO) and tri-n-butyltin chloride (TBTC)
      in the rat.
AB  - In a 1-month feeding trial, pure and commercial tri-n-butyltin oxide (TBTO) and
      tri-n-butyltin chloride (TBTC) were fed to rats at concentrations of 5 ppm and 25
      ppm. At all times, the mean body weight gain and the food consumption was
      significantly less in rats treated with 25 ppm pure TBTO or pure TBTC as compared
      to control rats or rats receiving commercial TBTO. Histological examination of
      the thymus of rats treated for 7 days with TBTO showed atrophy with severe
      lymphocytic depletion in the cortex. After 28 days of exposure, most of the
      lesions reversed and the thymus became markedly smaller than in control rats,
      both in absolute terms and in relation to body weight. Seven days of exposure to
      TBTO increased liver weight but this change was reversed during a further 3-week
      exposure. Tin concentrations were the highest in livers and kidneys.
      Concentrations in the thymus were less than one-fifth of hepatic values. Changes
      in the rats treated with the commercial TBTO were very similar. Rats treated with
      TBTC showed lower tin levels and less immunotoxicity as compared to those treated
      with TBTO.

PMID- 1761798
TI  - Effects of some organophosphorus compounds on the binding of a radioligand (8
      cyclopentyl 1, 3-[3H]dipropylxanthine) to adenosine receptors in ovine cardiac
      membranes.
AB  - 8-Cyclopentyl-1,3-[3H] dipropylxanthine [( 3H]CPX) is a potent radioligand that
      specifically binds to the A1 adenosine receptors. Its high specificity makes it a
      suitable ligand for the characterization of A1 adenosine receptors in tissues
      with low receptor densities. We have demonstrated that the organophosphorus
      compounds soman, tabun and sarin, at relatively high concentrations, all bind to
      the A1 adenosine receptors in ovine cardiac membranes with Ki values of 36.7, 328
      and 175 microM, respectively. The binding of soman to the receptor site was found
      to be totally reversible. We suggested that these organophosphorus compounds
      affect the mechanical responses of the heart through interaction with a potassium
      channel that does not seem to be closely linked to the A1 adenosine receptors.

PMID- 1761799
TI  - Joint toxic action of binary mixtures of osteolathyrogens at malformation
      inducing concentrations for Xenopus embryos.
AB  - The joint action of binary mixtures of the osteolathyrogens semicarbazide (SC),
      beta-aminopropionitrile (beta APN) and penicillamine (PNC) were determined at
      malformation-inducing concentrations for Xenopus embryos. Tests were static with
      renewal every 24 h for the 96-h test period. Simultaneous tests on each
      individual component of the binary mixtures alone gave baseline malformation data
      (EC50) for joint action analyses. Toxic unit analysis and isobole diagrams were
      used to determine the type of joint action for 3:1, 1:1 and 1:3 mixtures of each
      combination. The joint action was concentration additive (strictly additive) for
      SC with beta APN and response additive (less-than-additive) for SC with PNC and
      beta APN with PNC. The joint actions were not changed when only osteolathyrogenic
      lesions, rather than all types of malformations, were considered. The different
      specific location and character of PNC lesions, as opposed to those for SC and
      beta APN, may signify a different type of osteolathyrogenic effect for PNC. The
      mixture testing approach has potential value in determining compounds that act
      similarly.

PMID- 1761800
TI  - Validation of a non-invasive technique to assess immediate or delayed onset of
      airway hypersensitivity in guinea-pigs.
AB  - Conscious Hartley guinea-pigs were sensitized with trimellitic anhydride (TMA) or
      trimeric hexamethylene diisocyanate biuret (Des-N) by repeated intradermal
      injections or by inhalation exposure. Immediate- and delayed-onset pulmonary
      reactions were recorded during/after challenges with the hapten or protein
      conjugate of the hapten, respectively. The positive control was sensitized and
      challenged with ovalbumin (OA) by inhalation. Homocytotropic antibodies of the
      IgG1 type were determined to correlate antibody titres and pulmonary responses.
      Immediate-onset pulmonary reactions were apparent in guinea-pigs sensitized by
      inhalation of TMA and OA. Animals sensitized intradermally with TMA demonstrated
      more vigorous immediate-onset reactions than animals sensitized by inhalation.
      The measurement of breathing parameters demonstrated that the ability to detect
      immediate-onset airway hyperreactivity was best when the breathing rate and tidal
      and minute volumes were measured. None of the measurements for delayed-onset
      reactions presented conclusive results, since sensitized as well as naive guinea
      pigs demonstrated a delayed increase of breathing frequency. Antigen-specific
      IgG1 antibodies were several orders of magnitude higher in intradermally
      sensitized animals compared with animals sensitized by inhalation. Although Des-N
      sensitized guinea-pigs experienced high IgG1-antibody titres, no response of
      pulmonary hypersensitivity could be elicited after hapten or conjugate challenge.
      In summary, it would appear that pulmonary hypersensitivity depends on factors
      other than IgG1 antibody titres. For the screening of chemicals, the dermal
      induction and inhalation challenge protocol was revealed to be more sensitive
      than the inhalation induction and inhalation challenge protocol.

PMID- 1761801
TI  - Biliary excretion of hexachloro-1,3-butadiene and its relevance to tissue uptake
      and renal excretion in male rats.
AB  - Renal, biliary, pulmonary and faecal excretion experiments were carried out with
      labelled hexachloro-1,3-butadiene [( 14C]HCBD) in male Sprague-Dawley rats, given
      orally (p.o.) and intravenously (i.v.) in doses of 1 and 100 mg kg-1 as a
      solution in polyethylene glycol. The radioactivity excreted over 72 h was
      determined in rats fitted with exteriorized biliary cannulae and in rats whose
      bile ducts remained fully functional, respectively. In addition, bile duct
      duodenum cannula-linked rats, of which the donor was given 100 mg kg-1 [14C]HCBD
      orally and the recipient had also a bile fistula, were examined within 30 h for
      radioactivity in the excreta, the kidney, the liver and the plasma. In non
      cannulated rats, fractional urinary excretion decreased when the dosage increased
      and amounted to 23% and 8.6% after i.v. injection or 18.5% and 8.9% after p.o.
      administration of 1 and 100 mg kg-1, respectively. Pulmonary excretion of
      radioactivity was less than 9% and was not affected by the increase in dosage. In
      bile duct-cannulated rats, fractional urinary excretions were similar
      irrespective of the dose and the route of administration and amounted to ca. 7.5%
      of the dose. Decrease in fractional biliary excretion occurred with increase in
      dosage (88.7% vs 72%) after i.v. injection and (66.8% vs 58%) after gavage. In
      cannulated rats, faecal excretion was less than 0.5% after i.v. injection and
      accounted for 3% and 16% of the dose after p.o. administration of 1 and 100 mg kg
      1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761802
TI  - Depression of iron uptake into erythrocytes in mice by treatment with the
      combined benzene metabolites p-benzoquinone, muconaldehyde and hydroquinone.
AB  - Using radio-iron uptake into erythrocytes as a measure of hematopoiesis, it was
      demonstrated that p-benzoquinone (BQ) and muconaldehyde (MUC) are potent
      inhibitors of bone marrow function in female mice. These two benzene metabolites
      reduced iron uptake at dosages of less than 5-6 mg kg-1. The combination of MUC
      and hydroquinone (HQ) (100 mg kg-1) was additive, reducing iron incorporation to
      an extent that was the sum of the effect of each chemical given alone. The
      combined effect of MUC and BQ was significantly less than additive, demonstrating
      antagonism in the response. Multiple regression was used to study the
      contributions of the components of binary mixtures of the benzene metabolites
      (METAB). Data obtained from standard curves of METAB and their mixtures are
      separable in regression analysis. Thus, for zero interaction of METAB, the
      responses would be simply additive, while positive and negative interaction would
      indicate synergy and antagonism, respectively. T-testing of the data resulted in
      non-significant values for the mixture MUC + HQ, indicating zero interaction and
      an additive response. The negative t-values obtained for the mixture MUC + BQ,
      however, indicate negative interaction or an antagonistic response. Since
      mutually exclusive agents share the same binding sites and occupation of a site
      by one agent excludes its occupation by another, they cannot interact in
      producing the effect; combinations of these agents show zero interaction and are
      simply additive. This suggests that HQ and MUC are mutually exclusive and share
      the same binding site.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761803
TI  - Toxicology update.

PMID- 1761804
TI  - Fast thin-layer chromatography systems for fumonisin isolation and
      identification.

PMID- 1761805
TI  - Mycotoxins, porphyrias and the decline of the etruscans.

PMID- 1761806
TI  - Thyroid hormones changes in infants and children with metabolic acidosis.
AB  - The influence of the acidotic state on the thyroxine (T4) peripheral metabolism
      was studied in two different forms of metabolic acidosis, ie infantile diarrhea
      and diabetic ketoacidosis. The serum concentrations of T4, free T4 (FT4),
      triiodothyronine (T3), reverse T3 (rT3), thyrotropin (TSH) and thyroxine-binding
      globulin (TBG) were measured and compared to healthy control groups. Lower T4 and
      T3 and higher rT3 serum concentrations were found in both tested groups of
      patients in relation to the control groups. In infants with severe metabolic
      acidosis FT4 values were lower than those observed in the control group. In
      addition, serum TBG levels were lower in diabetic patients as compared to control
      subjects. Despite the reduced serum T3 and T4 concentrations in both groups of
      patients, TSH concentrations, were within the normal range. Therefore, we
      concluded that acidosis caused either by diarrhea (not so far described) or by
      diabetes mellitus (well documented up to now) affects the thyroid hormones
      metabolism in a similar way, at least as far as the thyroid hormones blood levels
      are concerned.

PMID- 1761808
TI  - Follicular fluid lipoproteins in preovulatory period and their relationship with
      follicular maturation and progesterone production by human granulosa-luteal cells
      in vivo and in vitro.
AB  - Follicular fluid (FF) lipoprotein content was evaluated in an in vitro
      fertilization/embryo transfer and gamete--intrafallopian--transfer program and
      correlated to follicular and oocyte maturation. Moreover, the in vitro
      progesterone response of granulosa-luteal cells from 10 patients to high-density
      lipoprotein (HDL) and to low-density lipoprotein (LDL) was assessed. Most FFs
      contained only HDL. Sixteen out of 97 FFs contained also very low levels of LDL
      and very-low-density lipoprotein (VLDL). The presence of LDL was associated to
      features of follicle and oocyte hypermaturity. LDL alone induced a much more
      potent increase of progesterone (P) release by granulosa-luteal cells than HDL
      alone, and the HDL partially reversed the potent effect of LDL. It is concluded
      that in late follicular phase HDL maintains P release by granulosa cells at a low
      rate and prevents a potent stimulation of P production by LDL which might cross
      the maturating blood-follicle barrier, until increasing passage of LDL in FF
      decreases the HDL:LDL ratio and the action of LDL becomes prominent.

PMID- 1761807
TI  - In vivo insulin action in hepatocellular and cholestatic liver cirrhosis.
AB  - The in vivo dose response curve to insulin were studied, using an euglycemic
      insulin clamp technique, in 13 cirrhotic patients [8 with "hepatocellular" (HC)
      (nonalcoholics) and 5 with "cholestatic" (CHOL) cirrhosis] and 12 healthy
      controls (N). Subjects were studied in the basal state and during infusion of
      insulin at 3 different rates - 1, 3, 10 mU kg-1 min-1. Insulin responsiveness was
      similar in N and in HC, but it was 23% greater in CHOL (p less than 0.001).
      Insulin sensitivity was decreased in cirrhotics as compared with N but this
      difference was only significant (p less than 0.001) in HC. (ED50:62 + 5, 88 + 13
      and 136 + 16 muu ml-1 in N, CHOL and HC respectively). Insulin clearance rate
      (ICR) was significantly (p less than 0.005) decreased in HC (1060 +/- 80, 996 +/-
      95 and 776 +/- 128 ml sq m-1 ml-1 in N, CHOL and HC respectively. Basal hepatic
      glucose production (BHGP) was 39% lower in HC (p less than 0.005) and 24% lower
      in CHOL (p less than 0.05) than in N. Erythrocyte cholesterol phospholipid ratio
      was significantly elevated (p less than 0.001) in both groups of cirrhotic
      patients but was not correlated to specific metabolic changes described. In
      summary: i) intervariations in insulin dependent glucose metabolism were
      described in different cirrhotic groups; ii) basal hepatic glucose production and
      insulin clearance rate impaired in the different groups of cirrhotics; iii) the
      role of decreased cholesterol/phospholipid ratio on tissues glucose metabolism in
      cirrhotic patients should be further studied.

PMID- 1761809
TI  - Increased mean serum thyrotropin in apparently euthyroid hypercholesterolemic
      patients: does it mean occult hypothyroidism?
AB  - Serum thyroid hormones and antithyroid autoantibodies (AAB) were assayed in 87
      randomly selected hypercholesterolemic persons compared to 80 controls with
      normal serum total cholesterol (TC). Of the 87 hypercholesterolemic persons 22
      (25%) had positive AAB compared to 5 (6%) controls. Furthermore, 8 of the
      hypercholesterolemic patients had a serum TSH level above 5 mU/l, i.e. the had
      subclinical hypothyroidism, not diagnosed before, whereas thyroid function was
      normal in all normocholesterolemic persons. The new and unexpected finding was
      that the hypercholesterolemic persons had on average a significantly higher serum
      TSH than the controls, and this was true even when persons with positive AAB were
      excluded. There was a significant correlation between TC and serum TSH. It is
      concluded that hypothyroidism may not be an all-or-none phenomenon, and that many
      hypercholesterolemic persons with thyroid tests within the conventional normal
      range may have a slight impairment of their thyroid function.

PMID- 1761810
TI  - The effect of short-term growth hormone or low-dose oxandrolone treatment in boys
      with constitutional growth delay.
AB  - We evaluated the effect of six-month treatment with growth hormone (GH) or low
      dose oxandrolone in a group of boys with constitutional growth delay (CGD).
      Sixteen boys were randomly assigned to two treatment groups. Group 1 received GH
      (0.6 U/kg/week sc 5-6 times/week) and Group 2 received oxandrolone (0.07 mg/kg
      po). The boys of the two groups were closely matched for age (13.7 +/- 0.5 and
      12.8 +/- 0.4 years) (mean +/- SE), chronologic age/bone age ratio (1.15 +/- 0.04
      and 1.16 +/- 0.02), height standard deviation score (SDS; -2.7 +/- 0.4 and -2.5
      +/- 0.3) and pretreatment height velocity (HV) (3.7 +/- 0.8 and 4.0 +/- 0.4
      cm/year). Other known causes of short stature were excluded in all subjects, and
      none had taken long-term medication prior to the study. After 6 months of
      treatment HV increased to 7.5 +/- 0.4 and to 8.1 +/- 0.5 cm/year in group 1 and
      2, respectively. Plasma IGF-I concentrations rose significantly after treatment
      in both groups. Predicted adult height was not significantly affected by either
      GH or oxandrolone treatment. We conclude that a short-term course of low-dose
      oxandrolone is as effective as GH to accelerate growth in boys with CGD. Low-dose
      oxandrolone represents an effective, cheap, and convenient therapeutic approach
      in boys with CGD.

PMID- 1761811
TI  - Glucose tolerance and insulin release in adolescent female.
AB  - The increase in insulin requirement at the onset of adolescence is compensated by
      an increase of insulin secretion. This metabolic pattern persists during
      adolescence but is no longer present in adults. It is supposed to depend on a
      decrease of insulin sensitivity of uncertain origin. We compared the metabolic
      pattern of late adolescent girls (13-16 year old) with young women (21-30 year
      old) with similar body mass indexes, testing subjects with iv glucose tolerance
      test (IVGTT) (glucose 0.33 g/kg) and arginine test (ATT) (arginine 30 g in 30
      min). In late adolescent vs adult women we observed: i) IVTT: similar k of
      glucose tolerance and higher insulin and C-peptide responses; ii) ATT: unmodified
      plasma glucose, insulin and glucagon values, higher GH plasma levels; iii) in
      adolescent girls GH and CPR incremental areas significantly correlated (r =
      0.755, p less than 0.05). These data show that: i) the adolescent pattern of
      glucose metabolism persists after completion of sexual development and, ii) there
      is a positive correlation between GH response to arginine and beta-cell response
      to glucose. So GH should play a role in the impairment of glucose metabolism
      during adolescence.

PMID- 1761812
TI  - Increased rat femur osteocalcin mRNA concentrations following in vivo
      administration of thyroid hormone.
AB  - Thyroid hormone has a direct resorptive effect on bone. Thyroid hormone therapy
      in doses that suppress pituitary TSH production result in a reduction in bone
      density. Osteocalcin is a bone matrix protein. Serum levels are a sensitive
      marker for bone turnover and are increased in hyperthyroid patients. In order to
      establish an animal model to study the effects of thyroid hormone on bone
      turnover, we measured rat femur osteocalcin mRNA following in vivo administration
      of thyroid hormone. Young CD rats weighing 60-90 g were given daily ip injections
      of T3, T4, or saline (control) for 12 days. Blood was obtained for
      radioimmunoassays, and RNA was extracted from femurs and analyzed by Northern
      blot using a 60-mer synthetic oligonucleotide probe corresponding to bases 360
      420 of rat osteocalcin mRNA, labeled with [32P] ATP by 5'-end-labeling. Serum TSH
      concentrations were suppressed to subnormal levels by the lowest doses of T3 and
      T4, and to undetectable levels by the higher doses. Increases in serum T3 and T4
      concentrations were proportional to the dose of each administered hormone. T3, 5
      and 10 micrograms/100 g body weight, resulted in a 43% and 62% increase in
      osteocalcin mRNA, respectively. T4, 5, 10, and 20 micrograms/100 g body weight,
      resulted in a 35%, 47%, and 135% increase in osteocalcin mRNA, respectively.
      These data demonstrate that in vivo administration of either T4 or T3 to young
      rats results in a significant dose-dependent increase in femur osteocalcin mRNA
      concentrations.

PMID- 1761813
TI  - Riedel's thyroiditis associated with Hashimoto's thyroiditis, hypoparathyroidism,
      and retroperitoneal fibrosis.
AB  - A patient with Riedel's struma (invasive fibrous thyroiditis) with
      hypothyroidism, hypoparathyroidism, and retroperitoneal fibrosis is reported.
      This disorder appeared to emanate from Hashimoto's thyroiditis in this case. The
      possible relationship of the two entities is discussed.

PMID- 1761814
TI  - Circulating soluble interleukin 2 receptor concentration is increased in both
      immunogenic and nonimmunogenic hyperthyroidism.
AB  - High serum concentration of soluble interleukin-2 receptor (sIL-2R) is considered
      a reliable marker of T lymphocyte activation. It has been recently reported that
      sIL-2R levels are increased in untreated Graves' disease. This finding has been
      interpreted as the consequence of an active autoimmune state, but the relevance
      of the thyroid function per se was not investigated. In the present study we
      assayed sIL-2R by ELISA in 20 normal subjects and in a series of patients with
      immunogenic (Graves' disease, GD) or nonimmunogenic (toxic adenoma, TA)
      hyperthyroidism. Significant increased concentrations of sIL-2R were found in 46
      patients with untreated hyperthyroid GD (mean +/- SD: 1,683 +/- 1016 U/ml, vs 461
      +/- 186 U/ml in normal controls, p less than 0.0001) and in 21 with untreated TA
      (1,111 +/- 617 U/ml, p less than 0.0001 vs normals). Restoration of the euthyroid
      state by antithyroid drugs or 131I administration was associated with a
      normalization of sIL-2R (516 +/- 174 U/ml in 38 patients with GD and 365 +/- 90
      U/ml in 12 with TA; p = NS vs normals and p less than 0.001 vs the untreated
      state for both groups). A highly significant positive correlation between serum
      sIL-2R and free triiodothyronine (FT3) (r = 0.724, p less than 0.0001) or free
      thyroxine (FT4) (r = 0.698, p less than 0.0001) concentrations was found in
      combined sera obtained from all untreated and treated patients, irrespectively of
      the autoimmune or nonautoimmune nature of the underlying hyperthyroid
      disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761815
TI  - Thyroid function in systemic sclerosis.

PMID- 1761816
TI  - Hypertension in elders. Clinical diagnosis and treatment considerations.
AB  - Isolated systolic hypertension (ISH) accounts for more than 50% of all
      hypertension in persons over age 65 and is linked to increased morbidity and
      mortality. The various antihypertensive medications have been shown to be
      effective in reducing ISH. However, the efficacy of such treatment in reducing
      morbidity and mortality has been demonstrated in only one study to date and only
      on a selected population. The care provider for an elderly person with ISH must
      therefore weigh the risks of ISH against the risks of treatment of side effects
      and quality of life. Ultimately, the treatment of ISH in those over age 65 must
      be carefully planned on an individual basis.

PMID- 1761817
TI  - Reminiscence behavior: an empirical exploration.
AB  - Engagement in the process of reminiscing involves the use of detail and depth,
      easy access to memories, and requests for feedback from the listener. Engagement
      in reminiscing may be stable during old age or may follow a developmental course.
      Avoidance behaviors, defined as switching to non-reminiscing topics or giving
      neutral/informative responses, were prevalent among non-engaged reminiscers.
      Understanding what a person chooses to avoid reminiscing about is as important as
      what a person chooses to reminisce about. Diversity refers to the degree to which
      engaged reminiscers varied the events they reminisced about. Diversity of
      verbalizing both validating and lamenting reminiscences may related to the
      specific usefulness of reminiscence as an intervention. Two distinct reminiscence
      interventions are currently being used: life review and psychosocial reminiscing.
      Findings regarding engagement and diversity of reminiscing suggest more effort is
      needed in prescribing the appropriate reminiscing intervention.

PMID- 1761818
TI  - Mental dysfunction: a clinical pilot project in the elderly.
AB  - In recognizing that there will be an increase in the number of individuals with
      dementing illnesses well into the next century, the authors show how one
      institution is coping with this problem today. The authors outline an innovative
      approach to admission and discharge planning and monitoring of patients with
      irreversible dementias and behavioral problems. Nurses and other team members
      need a mechanism (ie, a flow chart) to monitor behavior and plot progress within
      an individualized program designed to meet the needs of dementia patients.

PMID- 1761819
TI  - Assessing toileting skills and habits in an adult day care center.
AB  - In a structured assessment of mobility and toileting skills, all the continent
      clients but only 46.2% of incontinent clients were able to toilet themselves,
      even with verbal and physical guidance. Unobtrusive observation of toileting
      habits indicated that incontinent clients used the toilet less often than
      continent clients and used more staff assistance to do so. On mental status
      examination, incontinent clients scored significantly lower than continent
      clients. Incontinence in this population is a multidimensional disorder in which
      physical disability is a predominant factor.

PMID- 1761820
TI  - The Advisory Panel on Alzheimer's Disease second annual report: what's in it for
      gerontological nurses?

PMID- 1761821
TI  - Sharing the legacy. Hospice care principles for terminally ill elders.
AB  - Hospice care is usually chosen as the preferred mode of care when the patient and
      family judge that the burdens of aggressive treatment are greater than the
      benefits that can be expected. Hospice treatment is directed at controlling pain,
      relieving other symptoms, and focusing on the special needs of the hospice
      patient and the patient's family. The objective of hospice care is to prevent
      breakthrough pain while maintaining an acceptable level of consciousness. Family
      teaching in hospices is centered around appropriate responses to physical and
      emotional/spiritual/mental signs and symptoms of approaching death.

PMID- 1761822
TI  - Agitated behavior in the cognitively impaired elderly.
AB  - The study of agitation is of interest to caregivers because of potential nursing
      interventions that could be implemented to prevent or alleviate these behaviors.
      To ensure an effective plan of care for agitated patients, it is essential that
      the assessment be based on an objective measurement of the observed agitated
      behavior. Reliability and validity of the three instruments used to measure
      agitation were supported; however, none were considered an ideal tool for use
      with this population because frequently observed behaviors fell into the
      nonspecific "other" category. Agitated behaviors were highly variable among the
      subjects in this study; thus, no predictable pattern of occurrence could be
      established.

PMID- 1761823
TI  - Controlling large malpractice claims: the unexpected impact of damage caps.
AB  - Indiana's comprehensive malpractice reforms, inaugurated in 1975, include a cap
      on damages, a mandated medical review before trial, and a state insurance fund to
      pay claims equal to or greater than $100,000. We have found that the amount of
      compensation going to claimants with such large malpractice claims in Indiana is,
      on average, substantially higher than in Michigan and Ohio. Indiana's mean claim
      severity between 1977 and 1988 was $404,832, while the means for Michigan and
      Ohio were $290,022 and $303,220, respectively, with the difference between these
      three means being highly significant. Although data on claim and claimant
      characteristics reveal considerable interstate variation, the results of
      regression analyses show that Indiana claim payment amounts are higher than
      Michigan or Ohio payments, independent of the effect of factors such as sex, age,
      severity of injury, allegations of negligence, and year of settlement.

PMID- 1761824
TI  - Lessons for tort reform from Indiana.

PMID- 1761825
TI  - Sources of countervailing power in medicine.
AB  - In recent years a substantial literature has emerged on the alleged
      deprofessionalization and proletarianization of physicians. The contention is
      that corporatization is transforming the practice of medicine, divesting
      physicians of control over many features of their work, consistent with the needs
      of advanced capitalism. I examine the hypothesis skeptically, differentiating
      between the cultural role of medicine, the political and social legitimacy of
      medical concepts, and the personal autonomy of the individual physician. I
      suggest that while physicians are less autonomous than they used to be, the
      constraints imposed on them fall within a medical paradigm. From a cultural or
      social perspective, medicine is more central to the economy and more powerful
      than ever before. As its centrality and importance increase, there is more at
      stake, and interests compete more aggressively. I conclude that there is little
      evidence in support of the hypothesis.

PMID- 1761826
TI  - Professionalism as a countervailing power.

PMID- 1761827
TI  - Administrative and policy issues in reimbursement for nursing home capital
      investment.
AB  - The way in which states reimburse for nursing home capital costs can create
      incentives for nursing home owners to use the home primarily as a vehicle for
      real estate speculation, with potentially adverse consequences for patient care.
      In order to help promote and control the stability, adequacy, and quality of
      capital investment in long-term care, an increasing number of states are using a
      fair-rental approach for calculating capital reimbursement. In this article we
      compare the fair-rental approach with traditional cost-based capital
      reimbursement in terms of administration and policy. We discuss issues of concern
      to the state (cost and reimbursement design options) and the investor (after-tax
      cash flows, rate of return, etc.). Our analysis suggests that fair-rental systems
      may be superior to traditional cost-based reimbursement in promoting and
      controlling industry stability, while at the same time providing an adequate
      return to investors, without incurring long-term increases in the costs of
      administering programs.

PMID- 1761828
TI  - Further issues in small area variations analysis.
AB  - In this article, I examine Wennberg's "practice style" hypothesis and the
      literature on variations among small areas. According to Wennberg, geographic
      variations in rates of per capita use for many clinical procedures arise mainly
      from differences over what constitutes appropriate care. I show, however, that
      the role of practice style in explaining variations among areas has not been
      clearly demonstrated. I also argue that the practice style hypothesis can neither
      be established nor refuted by the methods traditionally used to study small areas
      and, moreover, that inferences about practice style variations cannot be drawn
      from differences among areas in their rates of use. I thus conclude that more
      research at the micro level in the practice patterns of the individual physician
      is needed before major health care initiatives based on small area methodology
      are undertaken.

PMID- 1761829
TI  - Insuring women's health.

PMID- 1761830
TI  - Themes in medical sociology.

PMID- 1761831
TI  - Disease or illness: alcoholism as social metaphor. Review essay.

PMID- 1761832
TI  - Abdominal migraine: does it exist?
AB  - Abdominal migraine is well recognised in children, but in spite of anecdotal
      reports migraine is not well established as a cause of abdominal pain in adults.
      Functional abdominal pain is usually classified as either irritable bowel
      syndrome or nonulcer dyspepsia, but some patients have intermittent abdominal
      pain associated with headache or other migraine accompaniments and, in these, a
      diagnosis of abdominal migraine should be considered. It is possible that some
      patients with functional abdominal pain have migraine presenting with few or even
      no migraine accompaniments. There is no nonclinical objective standard for
      diagnosing migraine, and research in this area is therefore very difficult.
      Nevertheless, some patients with functional abdominal pain may respond to
      antimigraine medication and, if their symptoms are suggestive, a trial of therapy
      may be desirable.

PMID- 1761833
TI  - Structural analysis in medicine--hiatal hernia, heartburn, Hercules, and the
      Hydra.
AB  - In this issue, we report that esophagitis is associated with the presence of a
      hiatal hernia, but not with smoking or the pressure of the lower esophageal
      sphincter. This editorial argues that our sampling and statistical methods were
      appropriate. We discuss how these methods can be employed in future studies.

PMID- 1761834
TI  - The role of educational videos in gastroenterology.
AB  - The potential role for video tape education in gastroenterology is discussed. The
      need for material to inform patients about their diagnoses is widely acknowledged
      and educators need to take advantage of modern techniques. Studies in general
      practice, diabetes care, and asthma care have found that videos have significant
      benefits when compared with conventional techniques. There are few such video
      tapes available to gastroenterologists. It has been shown that patients are keen
      to accept educational material in this form provided it is shown at a suitable
      time and in a suitable venue.

PMID- 1761835
TI  - Significant role of aspirin use in patients with esophagitis.
AB  - This study determines objectively the extent of nonsteroidal anti-inflammatory
      drug (NSAID) use in upper gastrointestinal (GI) mucosal acid-peptic diseases by
      supplementing the conventional interview with two tests of current aspirin (ASA)
      use--high-performance liquid chromatography (HPLC) for the presence of
      salicylates in serum and platelet cyclooxygenase activity, which detects ASA use
      within 5 days of testing. Of 186 consecutive patients undergoing upper endoscopy,
      62% of 55 patients with esophagitis had evidence of current NSAID use, vs. 26% of
      42 control patients with normal endoscopy (p less than 0.001), 12% of 17 patients
      with recently healed peptic ulcer (p less than 0.001), and 36% of 25 patients who
      had an active peptic ulcer (p less than 0.05), five of whom had concomitant
      esophagitis. Another 52 patients were ineligible for this analysis. Testing for
      platelet cyclooxygenase activity uncovered 26% more ASA users than history alone.
      In considering age, sex, smoking and drinking habits, arthritis, and ASA use by
      logistic regression, ASA use was the only factor contributing to esophagitis; ASA
      could not be further associated with severity, stricture or symptoms, however. In
      these patients, 95% of NSAID use was chronic, and 84% of that was ASA. These data
      show a previously unreported, strong association of ASA use with esophagitis,
      which suggests that ASA may be a significant factor in the resistance of
      esophagitis to current therapies as well as the frequently rapid relapse after
      therapy is withdrawn.

PMID- 1761836
TI  - The importance of hiatal hernia in reflux esophagitis compared with lower
      esophageal sphincter pressure or smoking.
AB  - The characteristics of gastroesophageal reflux disease have not been adequately
      defined. To determine the influence on the esophageal mucosa of hiatal hernia,
      lower esophageal sphincter pressure, acid reflux, and cigarettes and alcohol, we
      studied the reflux parameters, smoking habits, and alcohol consumption of 184
      healthy, ambulatory outpatients who received endoscopy as the initial diagnostic
      procedure for workup of gastroesophageal reflux. Patients received endoscopic and
      histologic evaluations of the esophageal mucosa, prolonged ambulatory esophageal
      pH monitoring, and esophageal manometric determinations. Structural analysis was
      used to test the plausibility of various clinical theories concerning the most
      important factors contributing to the development of esophagitis. Statistical
      analyses revealed the following: (a) the lower esophageal sphincter pressure,
      acid contact time, and frequency of reflux episodes were highly associated with
      the presence of a hiatal hernia (p less than 0.003 for all parameters); (b)
      individuals with esophagitis had 16.5 times as many hiatal hernias as found in
      normal, healthy people; (c) cigarette smoking was not correlated with esophagitis
      but was significantly associated with increased lower esophageal sphincter
      pressure (r = 0.18; p less than 0.03); and (d) smoking was also not associated
      with increased acid contact time or increased frequency of reflux episodes. We
      conclude that (a) the presence of a hiatal hernia, not the pressure of the lower
      esophageal sphincter, is the most important predictor of reflux frequency, acid
      contact time, and esophagitis; (b) a decreased lower esophageal sphincter
      pressure, as suggested by structural analysis, is unlikely to be the cause of
      increased reflux episodes or esophagitis; and (c) if smoking and lower esophageal
      sphincter pressure are factors in the development of esophagitis, they damage the
      esophageal mucosa by mechanisms other than increased frequency of reflux episodes
      or increased acid contact time.

PMID- 1761837
TI  - HIV-1 gp41 antigen demonstration in esophageal ulcers with acquired
      immunodeficiency syndrome.
AB  - Esophageal ulcers associated with acquired immunodeficiency syndrome (AIDS) may
      be chronic, debilitating, and resistant to antifungal or antiviral therapy. The
      therapeutic management of these lesions remains controversial due to the
      difficulty in identifying pathogenic agent(s). We review previously published
      cases and describe three AIDS patients with esophageal ulcers that stained by
      immunoperoxidase techniques for human immunodeficiency virus (HIV)-1 surface
      glyloprotein (gp41). All three showed symptomatic resolution and healing of their
      ulcers with corticosteroid therapy. We believe this documentation of HIV-1 gp41
      antigen within mononuclear cells of esophageal ulcers in AIDS supports a role of
      the HIV-1 virus in the pathophysiology of idiopathic esophageal ulcers in
      patients with AIDS. These cases further support a role for corticosteroid therapy
      in the treatment of esophageal ulcers resistant to antifungal and antiviral
      therapy in patients with AIDS.

PMID- 1761838
TI  - Arterial oxygen saturation, blood pressure, and pulse rate during upper
      gastrointestinal endoscopy--influence of sedation and age.
AB  - We studied the effect of sedation by I.V. meperidine on blood pressure, pulse
      rate, and arterial oxygen saturation during upper gastrointestinal endoscopy.
      Meperidine increased the tolerance of the patients and attenuated the endoscopy
      induced rise in blood pressure and pulse rate. Arterial oxygen saturation was
      transiently depressed in the first few minutes of the endoscopic procedure even
      without sedation, and meperidine administration did not aggravate this oxygen
      desaturation. Therefore, meperidine may be a favorable sedative for upper
      gastrointestinal endoscopy because its treatment increases the tolerance of
      patients and decreases cardiac oxygen demand without decreasing arterial oxygen
      saturation.

PMID- 1761839
TI  - Anorectal manometry and defecography in the diagnosis of fecal incontinence.
AB  - We carried out anorectal manometry and defecography prospectively in 43
      consecutive patients with fecal incontinence. A subgroup of 17 patients with
      severe incontinence was identified radiologically by a short and incompletely
      closed anal canal. In these patients, the anal resting pressure was significantly
      lower than in the rest of the group (34.9 +/- 11.4 mm Hg versus 60.0 +/- 25.7 mm
      Hg, respectively; p less than 0.01). The anorectal angle did not change in 24
      patients during squeezing, indicating a dysfunction of the puborectalis muscle.
      Manometric data did not differ between this subgroup and patients with a more
      acute anorectal angle during voluntary sphincter contraction. This indicates that
      the anal pressures recorded manometrically do not reflect the function of a
      muscular component that is important in the maintenance of fecal continence. We
      conclude that anorectal manometry and defecography are complementary diagnostic
      tools in the investigation of patients with fecal incontinence.

PMID- 1761840
TI  - Acute pancreatitis associated with anomalous union of the pancreaticobiliary
      ductal system.
AB  - Between 1978 and 1989, 13 of 48 patients with anomalous union of the
      pancreaticobiliary ductal system (AUPBD) were diagnosed as having acute
      pancreatitis. We have studied the clinical, radiologic, and surgical features of
      these 13 patients. A transient rise in the intraductal pressure of the pancreatic
      duct during an episode of abdominal pain is responsible for pancreatitis in
      patients with AUPBD. This rise in the intraductal pressure must be due to bile
      reflux into the pancreatic duct when an abnormally long common channel is blocked
      by cholelithiasis, protein plug, or dysfunction of the sphincter of Oddi. The
      pancreatitis resolves when the common channel obstruction is removed, and bile
      and pancreatic juice flow easily into the duodenum. We believe that this
      phenomenon is responsible for acute relapsing pancreatitis. It is our belief that
      the pancreas appears almost normal during symptom-free intervals.

PMID- 1761841
TI  - Peptic-ulcer-induced aortoenteric fistula. Report of a case and review of the
      literature.
AB  - A 71-year-old woman with a remote history of esophagogastric resection for
      malignancy developed abdominal pain, nausea and vomiting. She died of shock 15
      days after admission, during which time clinical investigation failed to reveal
      recurrent tumor or an ulcer. The autopsy revealed massive exsanguination
      secondary to a peptic-ulcer-induced aortoenteric fistula (AEF). The ulcer
      involved the third portion of the duodenum, was chronic, and complicated by
      growth of fungus. We review the literature on peptic-ulcer-related AEF.

PMID- 1761842
TI  - Methamphetamine-induced ischemic colitis.
AB  - A 50-year-old woman with acute onset of right lower quadrant pain and
      hematochezia proved to have segmental ischemic colitis associated with
      methamphetamine abuse. The diagnosis was established by colonoscopy with biopsy,
      and abdominal angiography revealed no thrombosis, vasculitis, or vasospasm. The
      condition resolved within 10 days. Since methamphetamine abuse is increasing,
      physicians should be aware of its potential to produce intestinal ischemia.

PMID- 1761843
TI  - Valproic-acid-induced pancreatitis. Case report and review of the literature.
AB  - We report a case of pancreatitis with fatal liver failure, in a 21-year-old,
      mentally retarded patient, taking valproic acid (VPA) therapy, together with a
      review of the literature of this rare side effect. Until March 1991, only 24
      cases of isolated pancreatitis and six cases (including ours) of pancreatitis
      with hepatic failure under VPA treatment have been published. Most of the
      patients were less than 20 years old, and injury to the pancreas developed during
      the first year of therapy in 72% of the patients, approaching a mortality of 21%.
      Pancreatitis associated with liver failure has a poor prognosis mainly because of
      the VPA hepatotoxicity. It seems that the pancreatic side effects fluctuate
      between two extremes: asymptomatic hyperamylasemia and fatal pancreatitis.

PMID- 1761844
TI  - Endogenous septic endophthalmitis in severe acute hepatitis with septicemia.
AB  - Endogenous bacterial endophthalmitis occurred in a hepatitis B virus carrier
      during an episode of severe hepatitis complicated by anaerobic septicemia and
      possible spontaneous bacterial peritonitis. This may well represent another
      complication of severe hepatitis with anaerobic bacteremia.

PMID- 1761845
TI  - Gallbladder abnormalities in acute viral hepatitis: a prospective ultrasound
      evaluation.
AB  - We carried out a prospective case controlled study to evaluate the temporal
      sequence of sonographic abnormalities in acute viral hepatitis (AVH) and their
      resolution patterns. Correlations were established between the sonographic
      abnormalities and the clinical and biochemical profiles. Fifty-six patients
      within 2 weeks of onset of illness (37 within 1 week and 19 between 1 and 2
      weeks) underwent real-time ultrasound at weekly intervals until clinical and
      biochemical resolution. Abnormal sonographic patterns were found in 55 of 56
      (98.2%) patients. The wall thickness was abnormal (6.1 +/- 4.3 mm) in 55 (98.2%)
      cases, luminal abnormalities observed in 33 (58.9%) cases, and alterations in
      volume in 14 (25%) cases. Complete resolution took place in 53 (96.4%) cases by
      12 weeks. A wall thickness of greater than 7 mm and abnormal luminal contents
      were more frequent in patients studied within 1 week of illness than later (p
      less than 0.05). No other correlations could be established between the different
      sonographic patterns and the clinical and biochemical profiles at any stage of
      the illness. We conclude that sonographic abnormalities are common in patients
      with AVH, with resolution as the rule with clinical recovery.

PMID- 1761846
TI  - The role of intrahepatic portal venous stenosis in the formation and progression
      of hepatolithiasis: morphological evaluation of autopsy and surgical series.
AB  - Recently, it has been suspected in animal models that a decrease in portal blood
      flow plays a role in the formation and progression of hepatolithiasis. To find
      whether this hypothesis is applicable to humans, we examined histologically the
      intrahepatic portal venous and arterial systems in normal livers (n = 13),
      extrahepatic biliary obstruction (n = 18), intrahepatic biliary sludge and
      microcalculi (n = 18, most of which were associated with biliary obstruction and
      might represent pathogenesis of an early developmental stage of hepatolithiasis),
      and fully developed hepatolithiasis composed of calcium bilirubinate stones (n =
      30). A scoring method was employed to quantify portal stenosis, portal
      phlebosclerosis, arterial stenosis, and parenchymal atrophy. We found that these
      vascular changes were significantly more severe in hepatolithiasis than in
      biliary sludge and microcalculi, or in extrahepatic biliary obstruction. There
      were no significant differences in the vascular changes except for arterial
      stenosis between the latter two. There is a positive correlation between vascular
      stenosis and parenchymal atrophy. These findings suggest that portal venous
      stenosis deteriorates during the progression of hepatolithiasis. We could not
      find direct evidence that portal venous stenosis is an initial lesion followed by
      the formation of hepatolithiasis. The vascular changes may be caused by an
      inflammatory extension of cholangitis and may deteriorate, causing parenchymal
      atrophy during the progression of hepatolithiasis.

PMID- 1761847
TI  - Acute pancreatitis induced by mesalazine.

PMID- 1761848
TI  - Ectopic pancreas cyst in the mesocolon.

PMID- 1761849
TI  - A case seeking an entity.

PMID- 1761850
TI  - Wide QRS tachycardia.
AB  - Wide QRS tachycardia is a diagnostic challenge when confronted on a 12-lead
      electrocardiogram. The differential diagnosis includes: ventricular tachycardia;
      supraventricular tachycardia with aberration; and Wolff-Parkinson-White syndrome.
      Confronted with a wide QRS tachycardia, one must determine whether the origin is
      ventricular or supraventricular because the therapy will differ. The
      electrocardiographic findings of capture beats, fusion beats and atrioventricular
      dissociation are highly specific for ventricular tachycardia but not very
      sensitive. After careful assessment of the 12-lead electrocardiogram following
      selected diagnostic features, the correct diagnosis of the cause of wide QRS
      tachycardia can be made in about 90 percent of patients. This article contains a
      brief discussion of the diagnostic features of wide QRS tachycardia.

PMID- 1761851
TI  - Thoracolumbar spinal fractures--concepts of treatment.
AB  - The treatment of thoracolumbar spinal fractures has evolved significantly in the
      last 50 years. Clear classification systems now allow physicians to predict which
      fracture patterns will require surgery and which may be adequately treated non
      operatively. These indications, as well as a brief overview of thoracolumbar
      spinal fracture care, are presented.

PMID- 1761852
TI  - Young woman with large chest mass.

PMID- 1761853
TI  - Carpal tunnel syndrome.

PMID- 1761854
TI  - Physicians' attitudes toward hospital ethics committees.

PMID- 1761855
TI  - Doctors, families and difficult decisions: the implications of the Lawrance case.

PMID- 1761856
TI  - Hepatitis C.

PMID- 1761857
TI  - Wittgenstein on Kohler and Gestalt psychology: a critique.
AB  - Wittgenstein's objections to Kohler and gestalt psychology are critically
      examined. Principal features of Kohler's Gestalt Psychology are discussed that
      are relevant to Wittgenstein's views. They include Kohler's concepts of
      "subjective" and "objective" experiences, "sensory organization," and "empiristic
      theory." Wittgenstein's objections, which focus on the concept of sensory
      organization, are examined. Wittgenstein employs the term "aspect," which is
      derived from the findings of gestalt psychology, as a replacement for Kohler's
      term "sensory organization." After tracing his uses of aspect, it is shown that
      aspect is a superordinate entity distinct from 'sensory content' (colors and
      shapes). This dualism of aspect and sensory content is of the same kind that
      prevailed in the empiristic theory of visual perception. Wittgenstein's adherence
      to the empiristic theory is discussed. Finally, the difference between
      Wittgenstein's aspect and Kohler's sensory organization is examined.

PMID- 1761858
TI  - Psychiatry, psychoanalysis, and politics during the First World War.
AB  - This article compares the therapeutic power used by psychiatrists and
      psychoanalysts serving in the German and Austro-Hungarian armies during World War
      I, and the ways in which their therapeutic techniques were related to
      governmental and military authority. When treating "shell shocked" soldiers, army
      psychiatrists were guided by nationalist commitment rather than concern for their
      patients. Whatever theoretical approach they took, they defined their therapeutic
      task as administrative intervention aimed to increase the docility of soldiers to
      the state and its military purposes. But violent means of coercion, designed to
      force neurotic soldiers back into duty, remained inefficient. Drawing from an
      alternative body of knowledge, army physicians influenced by Freud's writings, or
      trained in psychoanalysis, applied cathartic methods to treat the Central Powers'
      soldiers. Their approach was not only more humane, but also proved to be
      therapeutically more efficient.

PMID- 1761859
TI  - Psychoanalytic ethics: Edoardo Weiss, Freud, and Mussolini.
AB  - This paper examines Edoardo Weiss's correspondence with S. Freud regarding
      Concetta Forzano's analysis and Forzano's efforts to intercede with Mussolini on
      Freud's behalf after the Nazis invaded Austria in 1938. Freud's reliance on
      Mussolini can be explained by traditional Viennese attitudes toward Italy, the
      Duce's protectiveness about Austrian independence, and the relatively benign
      attitude of the Fascist regime towards Jews.

PMID- 1761860
TI  - [Continent urinary diversions].
AB  - A series of 200 continent Benchekroun pouchs are presented. This original
      technique, with a hydraulic continence valve, provided a 91.5% continent rate. A
      review of the literature puts this technique into perspective.

PMID- 1761861
TI  - [What may be expected from endorectal ultrasonography and magnetic resonance
      imaging in the assessment of local extension of cancer of the prostate?].
AB  - 30 patients presenting with a clinical stage A or B cancer underwent TRUS and MRI
      with a body coil prior to radical prostatectomy. Imaging and pathology were
      correlated to assess the limits of TRUS and MRI in pre-operative staging of
      prostatic carcinoma. Results showed that TRUS and MRI had a sensitivity of 42 and
      66% and a specificity of 89 and 94% respectively, for the diagnosis of
      macroscopic capsular effraction. Seminal vesicle invasion was diagnosed by TRUS
      with a sensitivity of 16% and a specificity of 81%. With MRI, the sensitivity and
      the specificity were 85 and 94% if only gross infiltration was considered.
      Sensitivity dropped to 45% if microscopic invasion was included. We conclude
      that: (1) postero-lateral venous plexus are more easily delineated by MRI,
      permitting a more accurate diagnosis of capsular penetration. (2) Seminal vesicle
      invasion cannot be diagnosed by TRUS as the echostructure of the cancer and the
      caudal junction of the seminal vesicles and vas deferens are similar. (3) A
      normal caudal junction on TRUS or a normal bilateral hypersignal of the seminal
      vesicles on MRI are associated with seminal vesicle invasion in less than 5% of
      cases. (4) A normal caudal junction on TRUS eliminates false positive cases of
      MRI related to non tumoral hyposignals of the seminal vesicles.

PMID- 1761862
TI  - [Fistulas and ureteral strictures after kidney transplantation. Diagnosis and
      treatment].
AB  - We report our experience of 4 urine fistulas and 4 ureteral strictures after
      renal transplantation. Percutaneous nephrostomy was performed on all patients.
      The diagnosis was established by antegrade pyelography. Nephrectomy was performed
      on 2 patients because of failure of drainage and formation of an infected urine
      collection due to an extended ureteral necrosis. Abstention was elected in one
      case as renal function did not improve due to associated chronic rejection. In 5
      cases, renal function quickly improved with drainage: 2 were operated on
      immediately, and one after failure of endo-urological treatment of a urine
      fistula. Antegrade dilatation has been used successfully in one stenosis. In the
      last case, a double pigtail stent allowed a urine fistula to close. Percutaneous
      nephrostomy seems to be best method of drainage when ureteral obstruction or
      fistula is suspected in renal transplant patients, and permits diagnosis by
      antegrade pyelography. Percutaneous management may be a satisfactory way of
      treatment for limited stenosis or fistulas.

PMID- 1761863
TI  - [Urethral lesion associated with perineal tissue defect: immediate combined
      repair with a musculocutaneous flap from the m. gracilis].
AB  - Facing urethro-perineal lesions with large soft tissue defects, the surgeon has
      to set himself a fourfold target. First, the urethral lesion has to be repaired,
      and second it needs immediate protection. Third, the tissue defect needs to be
      filled up, and forth the skin should be closed. A double team surgery, combining
      the urethral repair and its immediate covering by a gracilis musculo-cutaneous
      flap, has given functional and morphological results. The highly vascularized
      muscular portion of the flap prevents local infection and warrants good wound
      healing in an ischemic region. Its bulk may fill the perineal defect and protect
      a delicate urethroplasty. With the growing collaboration between urologic and
      plastic surgeons, this technique will probably find wider indications, possibly
      when dealing with important perineal trauma.

PMID- 1761865
TI  - [Tumors of the bladder in patients under 40 years of age].
AB  - It is often stated that younger patients have a better prognosis than their older
      counterparts. From the records of 17 men and 2 women, aged 40 years or less it
      appears that bladder carcinoma in patients 30 years-old or less have a favorable
      prognosis. Disease occurring at age 30 to 40 has a much worse prognosis and is no
      different from that affecting the older age groups.

PMID- 1761864
TI  - [Resection of pyelo-ureteral junction without external urinary drainage for
      primary ureteral stenosis].
AB  - During a 3-year period 30 consecutive patients (20 women and 10 men) with primary
      ureteropelvic junction obstruction underwent open dismembered pyeloplasty
      associated with the placement of an indwelling double pigtail stent via antegrade
      approach. Renal stones were removed in 8 cases, multiple nephrotomies being
      necessary in 2 patients. 2 men had temporary urinary leakage. Mean
      hospitalization time after surgical procedure was 9,8 days, but last 18 patients
      were discharged after only 7,3 days, Stents were removed 4 to 5 weeks after
      operation. With 1 to 4 years post-operative follow-up, successful treatment with
      relief of obstruction was achieved in all 38 patients without secondary
      stricture. Open pyeloplasty with double pigtail stenting appears to be a safe and
      successful procedure for the treatment of primary ureteropelvic junction
      obstruction in adults. Comparison with percutaneous endopyelotomy in terms of
      morbidity, duration of hospitalization and success rate appears to be in favor of
      open procedure, although secondary stricture may require endourological
      procedure.

PMID- 1761866
TI  - [Value of a clinical test for the assessment of bladder and sphincter function in
      the management of urinary disorders in the aged].
AB  - The authors report about the merits of a clinical test for the evaluation of
      bladder and sphincter function in the analysis of urinary disorders in the aged.
      This simple and inexpensive bedside test has been carried out in 175 subjects
      whose mean age was 81.2 years, and the majority of whom (66.2%) presented with
      urinary incontinence; 80% of the patients came from longterm-care geriatric
      departments. The most frequent mechanism is bladder instability (41% of all
      patients). The cystomanometric data obtained in 80 subjects were analysed and
      retrospectively compared to the test data: they showed good correlation for the
      study of vesical stability. From the viewpoint of general health care, this test
      is a real diagnostic tool for the practitioners, in particular in geriatric
      departments without further specialised exploration commodities.

PMID- 1761867
TI  - [Epidermoid tumors of the penis. Clinical experience and review of the
      literature].

PMID- 1761868
TI  - [Simplified technique for uretero-ileal anastomosis in ureteral diversion using
      an ileal conduit].
AB  - The authors report a simplified technique for uretero-ileal anastomosis. It
      avoids the opening of the ileal segment, avoids doing a direct anastomosis,
      leaves a 2 cm ureteric segment floating free inside the bowel lumen as a "flap
      valve". An ileal sleeve is made around the ureter, using the ileal wall, to
      prevent ileo-ureteral reflux.

PMID- 1761869
TI  - [A rare complication of extracorporeal shock wave lithotripsy: rupture of the
      kidney. Apropos of a case].
AB  - The authors report one case of renal rupture occurring during an extracorporeal
      shock wave lithotripsy (ESWL). The patient presented with a bilateral
      urolithiasis and ESWL, was performed on a large stone (3 cm x 3.5 cm) located in
      the lower calyx of the right kidney. Ultrasound and CT Scan were used to diagnose
      the renal rupture and a partial nephrectomy was performed.

PMID- 1761870
TI  - [Epididymitis in infants. Apropos of a case and review of the literature].
AB  - Epididymitis is a rare disease in infants, and its symptoms are the same as those
      of torsion of the spermatic cord or of its adnexa. Its diagnosis is often
      surgical, and should lead to suspecting possible associated urogenital
      abnormalities, requiring appropriate urological investigations.

PMID- 1761871
TI  - [Hydatid cyst of the right kidney invading into the duodenum. Apropos of a case].
AB  - The authors report about one case of hydatid cyst of the right kidney with a
      fissure opening into the duodenum. They emphasize the exceptional character of
      this complication, as well as the importance of imaging for its diagnosis.

PMID- 1761872
TI  - [Retroperitoneal fibrosis in a patient treated with bromocriptine for a
      prolactinoma].
AB  - We present one case of retroperitoneal fibrosis occurring in a patient presenting
      with a prolactinoma identified five years previously and treated with
      bromocriptine since then. Bromocriptine, an ergot derivative with a dopaminergic
      action, seems to be the cause of the fibrosis in this patient.

PMID- 1761873
TI  - [Oncocytoma of the kidney. Apropos of a case and review of the literature].
AB  - Renal oncocytoma is an unusual benign tumor, occasionally suspected on
      preoperative clinicoradiological features. Its diagnosis is histopathological. We
      report such a case, in which gross appearance showed renal cell carcinoma signs,
      but oncocytoma was suspected prior to surgery, confirmed by histopathology
      including electron microscopy.

PMID- 1761874
TI  - DNA analysis of oral leukoplakia by flow cytometry.
AB  - DNA ploidy of 19 oral leukoplakias with and without epithelial dysplasia was
      investigated and the results were compared with 11 normal gingival biopsies, 14
      oral benign tumours and 50 oral squamous cell carcinomas. The results suggest a
      possible relationship between DNA aneuploidy and oral leukoplakias or squamous
      cell carcinomas, as 32% of the oral leukoplakias and 48% of the oral squamous
      cell carcinomas were aneuploid although all the normal gingival biopsies and the
      benign oral tumours examined were diploid. No significant relationship was
      observed, however, between DNA ploidy and epithelial dysplasia in the
      leukoplakias.

PMID- 1761875
TI  - Efficacy of oral midazolam prior to intravenous sedation for the removal of third
      molars.
AB  - The combination of oral and intravenous sedation has not been well investigated
      and this study examined the combination's effect on amnesia, anxiety,
      cardiovascular stability and recovery in a double blind, cross-over, placebo
      controlled trial. Patients were given 7.5 mg oral midazolam or placebo 1 h prior
      to intravenous midazolam and surgery. This investigation demonstrated significant
      anxiolysis, amnesia and patient preference for oral midazolam compared to
      placebo. There was no significant effect on cardiovascular stability, the
      intravenous dose of midazolam used or post-operative recovery. Low dose oral
      midazolam prior to intravenous sedation may be beneficial in very anxious
      patients, particularly if surgery is delayed.

PMID- 1761876
TI  - Orbital abscess of odontogenic origin. Case report and review of the literature.
AB  - A case is discussed of a patient with an orbital cellulitis and a post septal
      abscess secondary to infection from an upper molar tooth. Spread of infection was
      to the maxillary sinus and thence to the orbit via a defect in the orbital floor.
      The clinical presentation, differential diagnosis, value of CT scanning,
      treatment and possible complications are reviewed.

PMID- 1761877
TI  - Intravascular papillary endothelial hyperplasia of the mandibular mucosa.
AB  - Intravascular papillary endothelial hyperplasia (IPEH) usually presents as a
      cutaneous lesion consisting of a reactive proliferation of endothelial cells that
      arise in an organizing thrombus. This lesion can easily be mistaken for an
      angiosarcoma. Oral presentations are rare, and when they do occur the most common
      site is the lip. A rare case of IPEH affecting the mandibular buccal mucosa is
      described.

PMID- 1761878
TI  - True lateral dermoid cyst of the neck.
AB  - A case of a lateral dermoid cyst presenting in the submandibular triangle without
      previous intra-oral swelling is reported. Sonography provided the key to
      diagnosis and is the first investigation of choice.

PMID- 1761879
TI  - Traumatic carotid cavernous sinus fistula due to a gun shot injury.
AB  - A case of a traumatic carotid cavernous sinus fistula is presented, the result of
      a bullet passing through both condylar regions of the mandible. The fistula was
      occluded by a detachable balloon brought in place using endovascular techniques.

PMID- 1761880
TI  - Intermaxillary fixation using screws. Report of a technique.
AB  - A technique of intermaxillary fixation using screws anchored in the maxilla and
      mandible has been described. AO (Synthes) screws with a diameter of 3.5 mm and 12
      mm to 16 mm in length were inserted at the antero-lateral surface of the maxilla
      and the buccal surface of the mandible. This technique is particularly suitable
      for mandibular fractures in denture wearing patients.

PMID- 1761881
TI  - Transfacial access for neurosurgical procedures: an extended role for the
      maxillofacial surgeon. I. The upper cervical spine and clivus.
AB  - A variety of osteoplastic flaps have been devised for transoral or extraoral
      access to the base of skull and the upper anterior cervical spine. Part I of this
      two-part review will describe access to the clivus and upper anterior cervical
      spine. Part II will describe access to the middle cranial fossa, the
      infratemporal fossa and the pterygoid (retromaxillary) "space".

PMID- 1761882
TI  - Transfacial access for neurosurgical procedures: an extended role for the
      maxillofacial surgeon. II. Middle cranial fossa, infratemporal fossa and
      pterygoid space.
AB  - A variety of osteoplastic flaps have been devised for transoral or extraoral
      access to the base of skull and the upper anterior cervical spine. Part I of this
      two-part review describes access to the clivus and upper anterior cervical spine.
      Part II will describe access to the middle cranial fossa, the infratemporal fossa
      and the pterygoid (retromaxillary) "space".

PMID- 1761883
TI  - Intravelar veloplasty: surgical modification according to anatomical defect.
AB  - The patient is often left with an oro-nasal fistula after the intravelar
      veloplasty procedure for the primary closure of the hard and soft palate cleft.
      The junction between the hard and soft palate is submitted to maximal tension
      during this procedure and is where the fistula most often occurs. The primary
      intravelar veloplasty procedure is discussed and 7 surgical modifications are
      introduced. The aim of these modifications is the prevention of an oro-nasal
      fistula and each is specifically adapted according to the existing anatomical
      form and defect of the cleft palate. The surgical modifications are divided into
      2 main groups: those based on localised swivel flaps and those based on distant
      flaps.

PMID- 1761884
TI  - Altering the angulation of a curved osteotome--does it have effects on the type
      of pterygomaxillary disjunction in Le Fort I osteotomy? An experimental study.
AB  - A standard Le Fort I osteotomy was performed on 12 cadavers to determine whether
      the incidence of pterygoid plate fractures could be reduced by increasing the
      angle of the curved osteotome relative to the sagittal plane. In the group where
      an osteotome with the usual angulation was employed, fractures occurred on 9 of
      12 sides. In the increased angulation group, 5 of 12 pterygoid plates were
      fractured. All fractures were restricted to the level of the horizontal osteotomy
      cut. It is concluded that increased angulation of a curved osteotome can decrease
      the incidence of fractures of the pterygoid plates. This procedure, however, is
      not recommended because it can cause fracture of the palatine bone or
      displacement of the fractured pterygoid plate fragment posteriorly.

PMID- 1761885
TI  - Resection of endonasal neoplasm by means of modified maxillo-zygomatic cheek
      flap.
AB  - To remove an endonasal tumour an access osteotomy has been designed which can be
      used for tumours of the nasal cavity. This approach allows for a safe and
      adequate tumour resection without appreciable morphological and functional
      consequences for the patient.

PMID- 1761886
TI  - Myxoid liposarcoma of the buccal vestibule. A case report.
AB  - A case of a myxoid liposarcoma in the buccal vestibule of the mandible is
      presented. The patient, an 86-year-old women, had 2 local recurrences after
      initial excision and died several months later. The literature is briefly
      reviewed.

PMID- 1761887
TI  - Penicillin concentration in the compact bone of the mandible.
AB  - During surgical removal of impacted third molars, the concentration of Penicillin
      G was determined in the compact bone of the mandible. Fifteen patients received 5
      million IU and 15 received 10 million IU of Penicillin G intravenously as a
      single dose before surgery began. In both groups concentrations of penicillin
      with a bactericidal effect on most pathogenically relevant oral bacteria were
      detected during osteotomy. Taking into account the considerable interindividual
      variation, the one-shot application of 10 million IU of Penicillin G was more
      effective in certain cases than the 5 million IU dose. The factors influencing
      the decision on the high single-dose application include expected length of
      operation, body weight, kidney function, and infusion period. Assuming that in
      intraoral osteotomies the bone becomes contaminated with bacteria that are highly
      sensitive to penicillins, the results indicate that preoperative infusion of
      Penicillin G could be an effective method of preventing wound infection.

PMID- 1761888
TI  - Report on the 4th International Congress on Preprosthetic Surgery, Palm Springs,
      USA, 18-20 April, 1991.

PMID- 1761889
TI  - [Clinical study on ivermectin against Strongyloides stercoralis].
AB  - We previously reported the efficacy of ivermectin (IVM) for the treatment of 23
      strongyloidiasis patients. We now reported the efficacy and safety of IVM therapy
      on 54 patients. Fifty-four patients, 28 males and 26 females, received a single
      oral dose of IVM one hour before breakfast and this treatment was repeated 2
      weeks later. The following results were obtained: 1) The cure rate at 2 weeks
      after the initial treatment was 92.5% (49 of 53 patients) and 2 weeks after the
      second course was 96.0% (48 of 50 patients). 2) Four patients (7.4%) complained
      of diarrhea (n = 2 patients), constipation (n = 1), borborygmus (n = 1),
      dizziness (n = 1), diplopia (n = 1) and peri-anal itching (n = 1) after the first
      treatment. Three patients (5.6%) complained of borborygmus (n = 1), itching (n =
      1) and exanthema (n = 1) after the second treatment. But all symptoms were mild
      and required no treatment and subsided in a few days. 3) Positive rate of HTLV-1
      antibody was 25.9% in the patients. As described above, although side effects
      occurred in some cases, they were mild and transient. From these results, we
      concluded that IVM is an effective drug for strongyloidiasis.

PMID- 1761890
TI  - [Clinical evaluation of serological antigen detection tests for candidemia].
AB  - The new serological tests for candidemia were evaluated. In nine cases of
      candidemia, fungal index (Endotoxin D-Endospecy) was 146.8 +/- 116.8 pg/ml and D
      arabinitol/creatinine 1.10 +/- 1.04 mumol/mg. Fungal index was significantly (p
      less than 0.01) higher in candidemia than suspected infections. All candidemia
      were positive for Cand-Tec latex agglutination, but twelve of the sixteen cases
      of suspected infections were also positive. Mannan latex agglutination was very
      specific for candidemia. Four cases of candidemia was positive for Mannan latex
      agglutination and only one case was positive in suspected infections. Fungal
      index and D-arabinitol/creatinine was decreased after treatment of antifungal
      agents. In poor clinical efficacy case, these titer remained high even after
      treatment. These data suggested the usefulness of these serological tests for
      candidemia.

PMID- 1761891
TI  - [Clinical features of enterococcal septicemia and antimicrobial susceptibilities
      for clinical isolates of enterococci in Nagoya University Hospital].
AB  - Enterococci are important causative organisms of nosocomial infections as well as
      methicillin resistant Staphylococcus aureus and Pseudomonas aeruginosa.
      Enterococcal bacteremia has been increased in Nagoya University Hospital from
      April 1983 to March 1990. We analyzed the clinical backgrounds, portal of entry
      and mortality for the patients with Enterococcal septicemia. Thirty-four cases
      with enterococcal septicemia (24 Enterococcus faecalis, 10 Enterococcus faecium)
      were subjected in this study. Twenty-seven cases were monomicrobial septicemia
      and 7 cases were polymicrobial septicemia. As to the portal of entry, intra
      abdominal infections in 21 cases, urinary tract infections in 4 cases,
      respiratory tract infections or chest tubes in 2 cases, decbitus infection in 1
      case, intravascular catheter in 1 case, and unknown sources in 5 cases. Total
      mortality of the septicemia was 44.1%. E. faecium and Enterococcus avium were
      much more resistant to antimicrobial agents than E. faecalis. Enterococci with
      high-level resistance to gentamicin (minimal inhibitory concentration, greater
      than 2000 micrograms/ml) accounted for 35% of the 26 clinical isolates of
      enterococci.

PMID- 1761892
TI  - Virulence of Escherichia coli strains with R-plasmid mediated penicillin
      resistance in mice infections.
AB  - Penicillinase I-, II- and III-producing R-plasmid of Escherichia coli were
      transferred to Escherichia coli 177, KC-14, and 444. These strains are highly
      virulent in mice. This study was conducted to investigate the influence of
      conjugative R-plasmid on the virulence of its host strains. Escherichia coli 177
      after penicillinase I- or III-producing R-plasmids transfer retained parental
      levels of virulence. On the other hand, penicillinase II-producing
      transconjugants showed reduced virulence in mice. The virulence of its
      revertants, in which R-plasmid was eliminated by heat, were equivalent to that of
      the host strain. It is suggested that the decrease in the virulence of
      transconjugants was not due to transferred R-plasmid. The reduced virulence of
      the these transconjugants may be due to alterations in their components such as
      the lipopolysaccharides in the cell envelope.

PMID- 1761893
TI  - [Nosocomial infections due to methicillin-resistant S. aureus (MRSA) at the
      Kagoshima University Hospital (1). Coagulase typing of MRSA].
AB  - Nosocomial infection due to MRSA at the Kagoshima University Hospital and their
      coagulase typing were examined using S. aureus (349 strains) clinically isolated
      in 1989. The results were as follows: 1) S. aureus consisted of 43.6% of MRSA and
      56.7% of Methicillin-sensitive S. aureus (MSSA). 2) MRSAs were recovered most
      frequently from the specimens from the respiratory tract (47.8%). 3) The
      isolation of MRSA gradually increased in frequency from January to August;
      however, that of MSSA did not show a similar tendency. 4) The isolation of MRSA
      was higher in frequency in the surgical wards, the ICU and the pediatric ward. 5)
      When classified into 8 coagulase types, MRSAs (133 strains) consisted of only 3
      types (54.1% of type II, 32.3% of type VII, and 12.0% of type IV), whereas MSSAs
      contained all coagulase types. As compared with the results of coagulase typing
      at other institutions, the incidence of type VII was much more frequent at our
      hospital. 6) A few coagulase types of MRSA appeared in each ward. Also, type II
      MRSA strains increased in June and July, and type VII MRSA increased in August.
      However, MSSA strains did not show any similar tendency.

PMID- 1761894
TI  - [Nosocomial infections due to methicillin-resistant S. aureus (MRSA) at the
      Kagoshima University Hospital (2). Susceptibility to antibiotics].
AB  - Susceptibility to antibiotics of 123 MRSA strains isolated at the Kagoshima
      University Hospital in 1989 was examined. The results were as follows: 1)
      Susceptibility of MRSA strains was excellent to VCM, MINO, and RFP, followed by
      IMP, CLDM, and CPFX. However, most strains were resistant to PCG, MPIPC, ABPC,
      CET, CMZ, CZON, GM, and AMK. 2) Five strains highly resistant to RFP were
      isolated. Three of these strains were isolated on the ward for tuberculosis. This
      suggests easy development of resistance to RFP by MRSA. 3) Differences in
      susceptibility to antibiotics between coagulase type II and type VII strains were
      examined. The cumulative percentage of type II strains susceptible to CLDM (MICs
      less than 0.5 microgram/ml) was 15.3%, and that of type VII was 45.2%. Strains
      resistant to CLDM were more frequently isolated among type II than among type VII
      strains (p less than 0.001). A similar relationship between strains and
      antibiotics was also found with EM and CPEX. On the other hand, the cumulative
      percentage of type II strains susceptible to AMK (MICs less than 25
      micrograms/ml) was 89.7%, and that of type VII was 9.7%. Strains resistant to AMK
      were more frequently isolated among type VII than among type II strains (p less
      than 0.001).

PMID- 1761895
TI  - [A clinical experience of rokitamycin on Campylobacter enteritis. Research Group
      of Rokitamycin on Infectious Enteritis].
AB  - Rokitamycin, a newly developed macrolide, was administered to a total of 107
      cases, 16 years old or more, in order to evaluate its clinical efficacy, safety
      and usefulness on Campylobacter enteritis. Daily dosage of 600 mg of rokitamycin
      was administered orally in three divided doses for 5 days. Bacteriological and
      clinical efficacies were judged by the attending doctors from the evaluation
      criteria made by the committee and from the days required for improvement of
      diarrhea, defervescence and so on, respectively. Antibacterial activities against
      the isolates were tested of rokitamycin (RKM), erythromycin (EM), josamycin (JM)
      and ofloxacin (OFLX). The results were as follows; 41 symptomatic patients and 5
      carriers were evaluated. Clinical efficacy (n = 41) was 100% (excellent; 34.1%,
      good; 65.9%). Bacteriological efficacy (n = 41) was 97.6%. Eight of the 9 cases
      with consecutive stool cultures were free of the bacteria on and after one day of
      the drug administration. Clinical usefulness (n = 46) was 97.8%. Slight
      epigastric pain was seen in only one as a side effect. The items of abnormal
      laboratory findings were 4 elevated GPT and/or GOT and one increased number of
      WBC in 4 cases. MIC90 of RKM, EM, JM and OFLX against 41 clinical isolates of C.
      jejuni were 1.56, 3.13, 3.13 and 0.78 micrograms/ml, respectively. Rokitamycin
      was considered clinically useful to treat Campylobacter enteritis.

PMID- 1761896
TI  - [Comparison of clinical efficacy of rokitamycin (RKM) and ofloxacin (OFLX) for
      the treatment of Campylobacter enteritis by a double-blind method. The Research
      Committee for the Effect of Rokitamycin, Research Group for Infectious
      Enteritis].
AB  - The clinical efficacy, safety and usefulness of Rokitamycin (RKM), a new
      macrolide antibiotic, were compared with those of Ofloxacin (OFLX) for the
      treatment of Campylobacter enteritis by a double blind method. The daily dose
      level of RKM or OFLX was 600 mg. They were orally administered in three divided
      doses for 5 days. Of 223 cases studied, 106 cases were diagnosed as Campylobacter
      enteritis. Ninety cases (RKM group: 50, OFLX group: 40) except for 16 excluded or
      drop-out cases were analysed. There was no significant difference between the two
      groups in any background factors. The effectiveness and usefulness was evaluated
      in 88 cases (RKM group: 48, OFLX group: 40). The results obtained were as
      follows: 1. In a total of 82 strains of Campylobacter jejuni/coli (RKM group: 42,
      OFLX group: 40), the bacteriological efficacy rate of RKM (95.2%) was superior to
      that of OFLX (70.0%) with a significant difference (p = 0.006). 2. In 76
      symptomatic patients (RKM group: 42, OFLX group: 34) on the day of the beginning
      of drug administration, the clinical efficacy rate was 97.6% in the RKM group and
      85.3% in the OFLX group with no significant difference between the two groups. 3.
      In 88 evaluable patients, the global clinical efficacy rate of RKM (95.8%) was
      superior to that of OFLX (67.5%) with a significant difference (p = 0.001). 4.
      Side effect was observed in 1 (1.9%) of the 54 patients in the RKM group and none
      of the 44 patients in the OFLX group. Slightly abnormal laboratory findings were
      seen in 4 (10.8%) of the 37 patients treated with RKM and 3 (9.7%) of the 31
      patients treated with OFLX, but there was no significant difference between the
      two groups. 5. In 88 evaluable patients, the clinical usefulness of RKM (91.7%)
      was superior to that of OFLX (67.5%) with a significant difference (p = 0.01).
      From these results, RKM is considered to be a very useful agent for the treatment
      of Campylobacter enteritis.

PMID- 1761897
TI  - [Detection of Chlamydia trachomatis by polymerase chain reaction].
AB  - A polymerase chain reaction (PCR) procedure was developed for detection of
      Chlamydia trachomatis. Two oligonucleotide primers based on sequences within the
      major outer membrane protein gene from C. trachomatis serovar L2 were used. A
      single DNA fragment was amplified, when C. trachomatis DNA was template for the
      PCR. No amplified product was detected in Chlamydia psittaci DNA, Chlamydia
      pneumoniae DNA or other bacterial DNAs. The amplified DNA fragment was detected,
      when DNA of greater than or equal to 10(2) C. trachomatis per reaction was used
      as template for the PCR. Thus, the PCR was shown to be specific for C.
      trachomatis and more sensitive than the enzyme immunoassays for detection of
      chlamydial antigen and the chlamydial rRNA:DNA probe hybridization method.

PMID- 1761898
TI  - [A case report of siblings with hemolytic uremic syndrome from whose stool E.
      coli O157:H7 was isolated].
AB  - We experienced siblings of hemolytic uremic syndrome which occurred following
      diarrhea and bloody stool. They were immediately treated with dipyridamole and
      aspirin, and recovered from hemolytic uremic syndrome in about two weeks. E. coli
      O157:H7 (verotoxin producing E. coli) which is recently thought to be related to
      the pathogenesis of hemolytic uremic syndrome was isolated in their stool
      cultures on admission. As far as we know, this is the first case in Japan from
      which stool E. coli O157:H7 was detected. Moreover, we reported clinical
      effectiveness of genomic investigation utilizing polymerase chain reaction method
      for verotoxin coding region in a rapid diagnosis of this bacterial infection.

PMID- 1761899
TI  - [Hospital spread of scabies from an immunocompromised patient with Norwegian
      scabies].
AB  - Scabies was first found in a 71-year-old female who had been diagnosed as having
      leukemic transformation of primary myelofibrosis and had undergone treatment for
      the disease. She was admitted to the hospital in December 1986, because of
      abdominal fullness and a generalized subcutaneous tumor that proved to be
      myeloblastoma. For treatment of the underlying disease, the regimen of the
      combination of vindesine, cyclophosphamide, 6-mercaptopurine, and prednisolone
      was selected. She developed cardiac failure and fell into a coma one month after
      starting the anticancer therapy. She was put on artificial respiration and on
      additional steroid therapy as well. Dexamethasone was administrated at 16 mg/day.
      Since the myeloblastomas found on admission regressed, the steroid therapy was
      continued. She was in coma for a few days before her skin lesions turned red and
      formed a grayish crust in the lower abdominal region. Several days later, the
      doctor responsible for the treatment of this patient developed pruritus and
      exanthema on both arms, and soon many nurses in the same hospital-ward developed
      similar symptoms. At approximately the same time, the patient with myelofibrosis
      was diagnosed as having Norwegian scabies: the crusted skin lesions revealing
      many Sarcoptes scabiei mites. Two doctors (2/18), 17 nurses (17/19) and 3 other
      patients (3/51) were found to have contracted scabies, and we recognized the
      hospital spread of the infection. The first patient was isolated in a private
      room, and we avoided direct contact with her. The persons with scabies were
      treated with crotamiton liniment. The first scabies patient died of cardiac
      failure 1 month after falling into a coma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1761900
TI  - [Effect of fluconazole on Aspergillus infection associated with chronic
      granulomatous disease].
AB  - Aspergillus infection is the most frequent fungal infection associated with
      chronic granulomatous disease (CGD), and often results in a life-threatening
      situation. This report describes the use of high-dose fluconazole, a new
      antifungal agent, for invasive Aspergillus infection in a patient with CGD. A 27
      month-old boy was sent to our hospital because of unknown fever in October, 1988.
      He was then admitted for pneumonia and pleural effusion of the right lung in
      February, 1989. Treatment with antibiotics was ineffective, and cultures of
      throat and pleural fluid were negative. In May, 1989, Aspergillus fumigatus was
      cultured from a subcutaneous abscess at the point of pleural puncture. Therefore
      we speculated that Aspergillus might have been the cause of pneumonia. The
      patient was diagnosed as having CGD by NBT test. Treatment with miconazole,
      flucitocin and amphotericin-B syrup was ineffective. From July, 1989, he was
      given 100 mg/day fluconazole d.i.v., but the drug did not reach an effective
      serum concentration to combat Aspergillus. However, an effective concentration of
      fluconazole was reached at a dose of 250 mg/day, and the chest X-ray findings
      subsequently improved, despite occasional high fever and continued high CRP. In
      July, 1990, the route of fluconazole administration was changed from d.i.v. to
      p.o. at the same dose, resulting in a serum concentration of fluconazole higher
      than that achieved with d.i.v. treatment. Both the clinical and laboratory
      findings showed improvement thereafter. Therapy for Aspergillus infection
      associated with CGD was found to necessitate high doses of anti-fungal drugs over
      a long period, although treatment with previously employed anti-fungal drugs
      could not be continued due to their adverse side effects.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1761901
TI  - [Hafnia alvei septicemia with shock and DIC in an adult with postoperative lung
      cancer].
AB  - In Japan, we experienced the first case of Hafnia alvei septicemia with shock and
      disseminated intravascular coagulation (DIC) in an adult with postoperative lung
      cancer. A 63 year-old male, who had been followed up in our department since
      1987, was admitted to our hospital with the complaints of fever, hemoptysis and
      dyspnea on June 25, 1989. After admission, he was treated with
      sulbactam/cefoperazone 4 g/day intravenously for suspicion of respiratory-tract
      infection. After antibiotic administration, the fever subsided and the general
      condition became almost good. The patient experienced fever again after the
      antibiotic was stopped. For this reason subsequent Clavulanic acid/Amoxicillin,
      Flomoxef, and Ceftazidime was administered, but was not effective. Therefore
      septicemia was suspected and blood culture was done. The bacteria isolated from
      blood culture was identified as Hafnia alvei. Hafnia alvei is a gram-negative
      organism belonging to the Enterobacteriaceae family and quite rare pathogen in
      human.

PMID- 1761902
TI  - Biomechanical study of Chiba Solid Rod System for scoliosis surgery.
AB  - The Chiba Solid Rod System for three-dimensional correction of scoliosis was
      developed. The system consists of a 7 mm diameter smooth solid rod, closed and
      open hooks, and specially designed conical sleeves. The rod does not have
      ratchets, thus minimizing stress concentrations. The hooks are attached to the
      rod utilizing the conical sleeves. The inner surface of the hooks and the outer
      surface of the conical sleeves have precisely machined tapers of two degrees. The
      sleeves have longitudinal slits permitting compression during insertion. The
      purpose of this study is to evaluate quantitatively the strength and stability of
      the system. Axial compression tests, torsional tests, and cyclic axial
      compression tests up to ten million cycles were performed to evaluate the
      attachment of the hook to the rod. Mechanical testing protocols demonstrated the
      effective attachment of the hook to the rod. Furthermore, simulation tests using
      scoliosis-simulation models were carried out. The single rod system of the Chiba
      Solid Rod System was appropriate for stabilizing a curvature of 30 degrees
      (Cobb). However, the dual rod system of the Chiba Solid Rod System was necessary
      to stabilize a curvature of 50 degrees or more.

PMID- 1761903
TI  - [Periosteal osteosarcoma of the femur: a pathological and ultrastructural study].
AB  - A femoral, diaphyseal tumor was found in a 17-year old male, and the diagnosis of
      periosteal osteosarcoma was made, based on the typical radiological and
      pathological findings. Microscopic observation on a resected specimen revealed
      that the tumor was covered with the intact periosteal fibrous layer and did not
      extend beyond the periosteum. The adjacent cortex was free of tumor. These
      findings indicated that the tumor originated from the periosteal cambium layer,
      which lies between the periosteal fibrous layer and the cortex. For transmission
      electron microscopic examination, the tissue was obtained at open biopsy.
      Ultrastructurally, no specific cell of periosteal osteosarcoma was found.
      Although most types of osteosarcoma cells were identified in the tumor
      (osteoblast-like, chondroblast-like, fibroblast-like, primitive mesenchymal-like,
      osteoclast-like and so on), the ultrastructural characteristics were of wide
      variety and of low malignancy.

PMID- 1761904
TI  - Clinical significance of the straight-leg-raising test.
AB  - The results of conventional sciatic nerve stretching tests are usually evaluated
      regardless of patient age, gender or movements of the hip joint and spine. In
      this study, we correlated data on the leg raising angle and changes in tension
      signs according to age, gender, and movement of the pelvis during the SLR-test
      and Lasegue-test. Results suggest that increased tension in the pelvic and leg
      muscles due to rapid skeletal growth contributes to the limited range of SLR in
      growing persons, while the Lasegue-test is less influenced by age and shows less
      pelvic rotation than the SLR-test.

PMID- 1761905
TI  - [Ferrographic analysis of synovial fluid in total hip replacement].
AB  - A synovial fluid analysis was carried out on 84 patients with total hip
      replacements, 53 of which were revision cases. The analysis was done using
      ferrography. An animal study was carried out whereby alumina ceramic,
      polyethylene and polymethyl methacrylate particles were inserted into the knees
      of rabbits, the synovial fluid of which was analysed. In addition, the synovium
      and surrounding tissues were histologically analysed. One week after insertion of
      the particulate debris only a few particles were noted in the synovial fluid and
      none at two weeks post insertion. However, these particles were noted in the
      synovium and surrounding tissues. Therefore, it was concluded that wear
      particles, following total hip replacement, may be encapsulated in the early
      period by the capsule and synovium, and have no adverse affect on the lubricating
      kinetics of the joint. It is postulated that the difference in tissue reaction to
      each of these particles may be responsible for the subsequent loosening.

PMID- 1761906
TI  - [A study of degenerative changes in the triangular fibrocartilage of the wrist
      joint].
AB  - The present investigator has studied the degenerative changes in the triangular
      fibrocartilage (TFC), the articular cartilage of the wrist joint, and the carpal
      interosseous ligament. Moreover, the possibility of the healing of the TFC was
      examined. The materials were 162 wrist joints obtained from 99 cadavers (5;
      fresh, 94; preserved) and were studied radiographically, anatomically,
      pathologically and immunohistochemically. TFC perforation was correlated with
      ulnar variance. Cartilaginous changes were mainly found around the lunotriquetral
      interosseous ligament. There was a correlation between the TFC perforation and
      degenerative changes of the articular cartilage. The pathological finding showed
      the degenerative changes on the ulnar head side of the TFC, which were much more
      severe than the carpal side of the TFC. On the other hand, the cartilaginous
      changes were more severe in the carpal bones than in the distal ulnar head. The
      finding that central portion of the TFC was found to be avascular, as confirmed
      by the immunohistochemical method would indicate little possibility of healing of
      the central portion of the TFC.

PMID- 1761907
TI  - Mechanical strength of osteochondral junction.
AB  - The junction between articular cartilage and bone in adult humans was tested in
      shear to determine their bonding strength in relation to the tensile strength of
      full thickness articular cartilage and shear strength of underlying subchondral
      bone. The site of failures was also studied under light microscope and scanning
      electron microscope. The junction failed at a shear strength of 7.25 +/- 1.35 MPa
      (n = 18). On the other hand, the tensile strength of cartilage and shear strength
      of subchondral bone were 3.75 +/- 0.75 MPa (n = 17) and 2.45 +/- 0.85 MPa (n =
      15) respectively. Light and scanning electron microscopic examination revealed
      that in fact, failures occurred at the tidemark. The ultrastructure of the
      tidemark suggested that this region might have structural weakness against
      mechanical stresses. The relevance of the results were discussed in relation to
      the osteochondral fractures in adult humans.

PMID- 1761908
TI  - [Pathological studies on the lumbar facet joints].
AB  - Relationship between changes of the bony architecture and remodeling in the facet
      joints of the lumbar spine was studied in cadaveric specimens, using the method
      of microradiography. The facetal angle was 59 degrees at L1-2, 65 degrees at L2
      3, 75 degrees at L3-4 and 92 degrees at L4-5. The subchondral compact bone volume
      was higher at the anterior part in all cases. The greater compact bone volume was
      found in the more sagittally facing facets, asymmetrical facets and facets with
      disc degeneration. Highly mineralized tissues in the trabeculae were observed in
      the degenerative facets. These tissues consisted of old calcified fibrocartilage,
      left alone as the result of continued remodeling. The degenerative changes in the
      lumbar facet joints probably start as calcification of the part where the
      ligamentum flavum attaches, followed by new bone formation and transformation of
      the joints.

PMID- 1761909
TI  - [Histological and mechanical observations of interconnection between sintered
      porous hydroxyapatite and Achilles tendon in rats].
AB  - Sintered porous hydroxyapatite blocks (3 x 3 x 4 and 5 x 5 x 5) were implanted
      into the calcaneal tendons of 64 Wistar rats to observe tissue reaction and
      interconnection. Histological observations and measurements of mechanical
      strength of the interconnection were performed at 1 to 24 weeks after the
      implantation surgery. The implants were found to be surrounded by connective
      tissue consisting of small, round cells which infiltrated into micropores of the
      hydroxyapatite blocks. Neither calcifications nor inflammatory reactions were
      observed. The mechanical strength at the interconnection increased significantly
      from 1 week to 8 weeks after the implantation, which then reached the peak of 1.3
      +/- 0.3 kg/cm2 at 8 weeks.

PMID- 1761910
TI  - [Study on reconstruction of the anterior cruciate ligament in the monkey knee
      using polyester artificial ligament].
AB  - We performed an experimental study of ACL reconstruction utilizing polyester
      artificial ligament(Leeds-Keio). The quality of regenerated ligaments was
      compared between two different procedures; in the one 1 cm wide Leeds-Keio
      ligament was used alone for reconstruction(Group 1) and in the other, Leeds-Keio
      ligament of the same size was augmented with one-third width of free patellar
      tendon (Group 2). Eighteen knees of nine Japanese monkeys were used. The
      specimens were obtained at 2, 6 and 12 months after the operation and
      investigated macroscopically, microscopically and biomechanically. Regenerated
      ligaments in Groups 1 and 2 appeared identical and grossly normal. However, more
      mature and stable ligament was noted in the cylinder of artificial ligaments
      after 2 months after operation in Group 2 than in Group 1 in terms of both
      quality and quantity. Biomechanically, however, the maximum the tension in the
      regenerated ligaments was approximately 1/2-1/3 of that of normal ACL. The
      authors believe that more mature ligament was made in ACL reconstruction when the
      artificial ligament was augmented with autogenous soft tissue.

PMID- 1761911
TI  - [Haematogenous osteomyelitis induced by strain SMU-0611 of Staphylococcus warneri
      in mice].
AB  - Strain SMU-0611 of Staphylococcus warneri isolated from clinical specimens (1.25
      x 10(9) colony forming units) was intravenously administered into mice. Strain
      SMU-0611 caused remarkable inflammation characterized by roentgenographically
      recognizable changes in bone at 14 days after the injection. A number of
      organisms were detected in the bone marrow for as long as 35 days after the
      injection, suggesting specific lodgement of the strain in mouse bone marrow.
      Concerning the X-ray features of the mice, multiple foci of osteolytic changes
      were shown in the metaphysis of the femur and the tibia obtained 14 days after
      the injection. However, these changes did not aggravate at all for 56 days after
      the injection.

PMID- 1761912
TI  - [Roentgenological and pathological studies on the development of discitis in
      canine models].
AB  - Discitis was experimentally induced in 42 dogs by intradiscal injections of
      bacterial suspensions and sequentially studied by X-rays and histopathology up to
      24 weeks. 1. A narrowing of the serpentine intervertebral disc space was seen
      roentgenologically in the Pseudomonas and E. coli groups. 2. Histologically, the
      acute inflammation began to subside in eight weeks, at which time new bone
      formation started to appear, and fusion of the adjacent vertebrae became apparent
      in eight weeks. The degree of the disease process was more advanced in the Staph.
      aureus group and less severe in the Pseudomonas group. The E. coli group lay in
      between. 3. The inflammatory process seemed to be confined in the disc for a week
      after the injection, during which time the cartilagenous cells in the nucleus
      pulposus underwent atrophy and degeneration. This resulted in direct exposure of
      the cartilagenous plate to the infection, causing invasion of the inflammatory
      process into the vertebral body. 4. The presence of the epiphyseal line, however,
      seemed to act as a barrier to hinder the inflammatory process invading the
      vertebral body.

PMID- 1761913
TI  - [Bone lengthening: essential concepts and methodology].

PMID- 1761914
TI  - [Vascularized bone graft].

PMID- 1761915
TI  - [Selection of containment treatment for Legg-Calve-Perthes disease].

PMID- 1761916
TI  - [Alpha 2-plasmin inhibitor].

PMID- 1761917
TI  - [Cytokines and diseases. Clinical applications of RhG-CSF].

PMID- 1761918
TI  - [Cytokines and diseases. Interleukin-2 and its receptor in adult T cell
      leukemia].

PMID- 1761919
TI  - [Cytokines and diseases. Abnormal expression of interleukin 6 and diseases].

PMID- 1761920
TI  - [Cytokines and liver diseases].

PMID- 1761921
TI  - [Diabetes mellitus and its complications in Japan. Clinical profile of diabetic
      retinopathy in Japanese diabetics].

PMID- 1761922
TI  - [Diabetes mellitus and its complications in Japan. Clinical and pathological
      finding and their relationship to prognosis in diabetic nephropathy].

PMID- 1761923
TI  - [Diabetes mellitus and its complications in Japan. Late complications of diabetes
      mellitus--estimation of risk factors in patients on sulfonylureas (Su) more than
      10 years].

PMID- 1761924
TI  - [Diabetes mellitus and its complications in Japan. The determination of glycemic
      threshold for the regression or prevention of diabetic microangiopathies, and
      insulin injection regimen to establish strict glycemic control in NIDDM].

PMID- 1761925
TI  - [Diabetes mellitus and its complications in Japan. The dysfunction of mesangial
      cells on pathogenesis of diabetic nephropathy].

PMID- 1761927
TI  - [Diabetes mellitus and its complications in Japan. Pathogenesis and
      correspondence of diabetic retinopathy--approach from polyol metabolism].

PMID- 1761926
TI  - [Diabetes mellitus and its complications in Japan. The pathophysiology and
      etiology of diabetic osteopenia].

PMID- 1761928
TI  - [Myocarditis, clinical features and management].

PMID- 1761929
TI  - [Recent advances and practice of psychosomatic medicine].

PMID- 1761930
TI  - [Management of chronic respiratory insufficiency].

PMID- 1761931
TI  - [Detoxification function of the liver].

PMID- 1761932
TI  - [Altered vascular reactivity in hypertension].

PMID- 1761933
TI  - [Roles of arachidonic acid cascade and related substances in respiratory
      diseases].

PMID- 1761934
TI  - [Clinical aspects of hyponatremia].

PMID- 1761935
TI  - [The development and clinical application of erythropoietin].

PMID- 1761936
TI  - [Vasculitic syndrome].

PMID- 1761937
TI  - [Secondary cardiomyopathy associated with myopathy].

PMID- 1761938
TI  - Emergency cricothyrotomy.
AB  - The indications for the ruling for the Gulf Forces that emergency cricothyrotomy
      is to be performed where the airway is thought to be compromised are reviewed.
      The advantages of this procedure are outlined and some of the likely consequences
      regarding the incidence of complications and their management predicted.

PMID- 1761939
TI  - Human temporal bone findings in acquired hypothyroidism.
AB  - Histological studies of the auditory organ in patients with acquired
      hypothyroidism are scarce. Thus the aim of the present study was to examine the
      temporal bones and the brain in subjects with hypothyroidism. Four temporal bones
      and two brains from clinically and biochemically hypothyroid subjects were
      removed and evaluated by light microscopy determine to the morphological changes
      and deposition of neutral and acid glycosaminoglycans. An audiogram from one of
      the patients showed a sensorineural hearing loss, which could be ascribed to
      occupational noise exposure. The study revealed histological changes compatible
      with age and infectious disease. No accumulation of neutral or acid
      glycosaminoglycans could be demonstrated in the temporal bones, or in the brains.

PMID- 1761940
TI  - Blast injuries of the ear as a result of the Peterborough lorry explosion: 22
      March 1989.
AB  - The incidence of blast trauma to the ears in significant numbers is relatively
      rare in peace time. This paper outlines the results and management of twenty
      patients injured as a result of the outside explosion of 800 kg of high
      explosives in Peterborough on 22 March 1989.

PMID- 1761941
TI  - A comparison of performance of Shepard and Sheehy collar button ventilation
      tubes.
AB  - This study was designed to confirm the longer in situ life of the Sheehy collar
      button compared with the Shepard tube and to assess the complication rates
      associated with the two tubes. Cases of bilateral otitis media with effusion had
      a Shepard tube inserted in one ear and a Sheehy contralaterally. The insertion
      position was allocated randomly. The patients were then assessed at three-monthly
      intervals for two years. In 71 per cent of those in whom at least one tube had
      extruded, the Sheehy remained in situ longer. The antero-inferior tube remained
      longer than the postero-inferior whichever type was used. There was no
      significant difference between complication rates, or recurrence rates of middle
      ear effusion after tube extrusion, for the two types. We conclude that use of a
      Sheehy rather than a Shepard tube carries no increased risk of complications and
      the patient may require further surgery less often in total.

PMID- 1761942
TI  - Obliterative otosclerosis.
AB  - An analysis of 420 consecutive cases of obliterative otosclerosis seen in the
      Christian Medical College Hospital, Vellore is presented. The proportion of truly
      obliterative otosclerosis is 33.09 per cent (139 ears). Our male to female ratio
      in truly obliterative otosclerosis is 1.48:1, while in the non-obliterative group
      it is 1.34:1. The mean age at onset in the obliterative group was 19.14 while in
      the non-obliterative group it was 25.60. This is statistically significant (P
      less than 0.001). The age at presentation was 25.90 in the obliterative group
      while in non-obliterative group it was 30.86; this is also statistically
      significant (P less than 0.001). However the time interval between the age at
      onset and the age at presentation is not statistically significant.

PMID- 1761943
TI  - Non-ampullary plugging of the posterior semicircular canal for benign paroxysmal
      positional vertigo.
AB  - Benign paroxysmal positional vertigo (BPPV) is a common condition which is
      usually self-limiting. Surgical treatment is rarely required and for many years
      the mainstay of such treatment has been singular neurectomy (posterior ampullary
      nerve section). A new operation has recently been described for the treatment of
      BPPV involving occlusion of the posterior semicircular canal. We have performed
      this operation on five patients with intractable BPPV and report our results with
      follow up of between 12 and 36 months from operation. The excellent results of
      posterior semicircular canal occlusion which have been previously reported in the
      literature are confirmed by our experience. In our opinion the operation is a
      safe and effective alternative to singular neurectomy.

PMID- 1761944
TI  - Role of surgery in tuberculous mastoiditis.
AB  - A study was undertaken in 43 patients to determine the role of surgery in
      tuberculous mastoiditis. Cortical mastoidectomy was performed on five patients
      (Group I). Incision and drainage of a post-auricular abscess, removal of
      sequestrum and meatoplasty in eight (Group II). Thirty patients had no ear
      surgery (Group III). Of the 17 patients with facial palsy, three were in Group I,
      two in Group II, 12 in Group III. The patients in all three groups were treated
      with anti-tuberculous drugs for a period of no less than six months. The average
      time taken for the otorrhoea to subside and granulation tissue to resolve
      completely was two months in all three groups. The facial nerve recovery in the
      non-operated ears (Group III) was 92 per cent and in the operated ears (Group I
      and II) 80 per cent. The conclusion is that chemotherapy is the management of
      choice in tuberculous mastoiditis. The only role of surgery is incision and
      drainage of a post-auricular abscess and removal of sequestrum if present.

PMID- 1761945
TI  - Fronto-ethmoidal mucocoeles: a histopathological analysis.
AB  - From a series of 118 fronto-ethmoidal mucocoeles, 40 specimens have been
      submitted to detailed histological analysis. The frequency of each epithelial and
      sub-epithelial component is considered and reveals features which support a
      dynamic theory of bone resorption and formation rather than that of pressure
      erosion in the pathogenesis of mucocoeles.

PMID- 1761946
TI  - Lymphangioma of the tongue. A review of pathogenesis, treatment and the use of
      surface laser photocoagulation.
AB  - Lymphangiomas of the tongue are rare tumours. Several reports of this interesting
      condition have appeared in the literature with varying modalities of treatment
      being employed to control tongue size. We present here our experience with seven
      children who have lymphangiomas of the head and neck with tongue involvement seen
      over the past eight years. If the tongue is large with protrusion outside the lip
      margins, we advocate early tongue reduction so as to promote proper speech and
      deglutition, reduce orthodontic problems and achieve good cosmesis. However, the
      natural history of these tumours is one of recurrent tongue enlargement secondary
      to infection and trauma, irrespective of surgical reduction. We describe our
      technique of surface CO2 laser photocoagulation which has been successfully
      employed in controlling tongue size and removing superficial lymphangioma in all
      our patients. We propose therefore that this should be the mainstay of follow-up
      therapy in lingual lymphangiomas.

PMID- 1761947
TI  - Laryngeal preservation in cases of advanced laryngeal cancer treated with
      platinum based induction chemotherapy before local treatment.
AB  - In this study we analyse our preliminary results after treating 28 patients with
      locally advanced laryngeal cancer with platinum based induction chemotherapy
      followed by radiation therapy or surgery. The median age of our patients was 60
      (46-75) years and median performance status was 80 (60-100). In 18 of the 28
      patients locoregional treatment was radiation therapy with an overall response of
      94.4 per cent. After a median follow-up of 26 (15-40) months 39.3 per cent of the
      whole group of patients are alive and disease-free and six (21.4 per cent)
      patients are alive and disease-free preserving their larynx. We conclude that
      although more extensive studies with large groups of patients and longer follow
      up is needed to reach definite conclusions, it seems that platinum based
      induction chemotherapy can be used successfully in locally advanced laryngeal
      cancer followed by radiotherapy. In those cases who respond well, the patient's
      larynx is preserved without compromizing the overall survival.

PMID- 1761948
TI  - Laryngectomy: the patient's view.
AB  - The disabilities following laryngectomy are well recognized. The incidence of
      these disabilities and the acceptability of the surgery to the patients were
      assessed by a questionnaire method. Sixty-five patients participated in the
      study. The incidence of disabilities are discussed. Total laryngectomy was felt
      to be a worthwhile operation by most of the patients in the study despite the
      disabilities they experienced afterwards.

PMID- 1761949
TI  - Survey of immunosuppressive acidic protein and other immunological parameters in
      head and neck cancer patients.
AB  - Serum levels of immunosuppressive acidic protein (IAP) and other immunological
      parameters were examined in 95 head and neck cancer patients and 27 control
      patients. The mean values of IAP in patients in the advanced stage were
      significantly higher than in early stage patients. Statistically significant
      increases in the mean concentration of IAP were also observed in patients with a
      recurrence, as compared to findings in those in the advanced stages. The mean
      values of blastogenesis response to PHA and NK cell activity in the cancer
      patients were lower than in disease free individuals, but with no statistical
      differences. In the endstage patients, the IAP concentration was considerably
      elevated and the blastogenesis response showed a statistically significant
      decrease. Thus, the monitoring of serum IAP, in combination with other
      immunological parameters, aids in planning and assessing clinical staging in head
      and neck cancer patients.

PMID- 1761950
TI  - The laryngeal box: an aid to laser microlaryngeal surgery.

PMID- 1761951
TI  - Orf of the pinna.
AB  - A case of orf affecting the pinna is discussed. This is an unusual presentation
      of an infection that is common in farming communities. At the initial
      presentation the diagnosis was not suspected, the management therefore was
      inappropriate and probably gave rise to the secondary infection that ensued. The
      history described is classical. Orf affecting the external auditory canal has
      been reported once, but orf affecting the pinna has not been described before.

PMID- 1761952
TI  - Aggressive papillary middle ear tumour.
AB  - A rare middle ear tumour is reported. The clinical presentation was similar to
      that of a glomus tumour but the pathology that of an aggressive papillary middle
      ear tumour. This is a recently recognized subgroup of middle ear glandular
      tumours. Clinical findings, imaging, pathology and treatment are presented.

PMID- 1761953
TI  - Cutaneous sebaceous gland carcinoma in the postauricular region.
AB  - Carcinomas of the sebaceous glands of the skin are uncommon. These tumours
      metastasize frequently. A case of cutaneous sebaceous carcinoma localized in the
      postauricular region is presented with its exceptional large size and very poor
      prognosis.

PMID- 1761954
TI  - Adenoidectomy in a girl with haemophilia.
AB  - Haemophilia A is a sex-linked inherited disease in which those affected are
      usually males, and females are usually asymptomatic carriers. This paper presents
      a haemophilia A carrier who has a low factor VIII level first, to remind readers
      that females can have low factor VIII levels with consequent increased tendency
      to bleed; second, to stress the importance of routine questioning regarding a
      bleeding tendency in the patient or the patient's family and third, to illustrate
      the importance of pre-operative diagnosis to allow adequate correction of the
      defect so that surgery such as adenoidectomy can be undertaken with safety in
      such a patient.

PMID- 1761955
TI  - Sphenoid sinus mucocoele: a possible late complication of radiotherapy to the
      head and neck.
AB  - A case of sphenoid sinus mucocoele following radiotherapy in a patient with
      nasopharyngeal carcinoma is reported. Diagnosis was made by radiological
      investigation and confirmed at surgery performed via a sublabial transeptal
      approach. Its content was completely removed and continuous drainage of the sinus
      was maintained by an indwelling tube. It is felt that the sphenoid mucocoele
      developed as a result of occlusion of the sinus ostium by scarred mucosa
      following radiotherapy.

PMID- 1761956
TI  - Relapsing polychondritis presenting with stridor from bilateral vocal cord palsy.
AB  - A case of bilateral vocal cord palsy caused by relapsing polychondritis is
      presented. The diagnosis was not suspected preoperatively and was made solely on
      histopathology. A case is made for histological examination of cartilage removed
      during routine tracheostomy.

PMID- 1761957
TI  - Styloid apparatus anomaly causing dysphagia.
AB  - An unusual case of dysphagia due to anomalous styloid apparatus anatomy is
      presented. Clinical and radiological findings are documented. Variations in
      anatomy and clinical syndromes are discussed together with management.

PMID- 1761958
TI  - Salmonella neck abscess associated with jugular vein thrombosis.
AB  - An unusual case of synergistic infection caused by Salmonella paratyphi and
      anaerobic streptococcus resulting in necrotizing cervical infection associated
      with deep neck abscess and internal jugular vein thrombosis, is presented.
      Salmonella acting as an oxygen consumer in the infected tissues, facilitates the
      growth of anaerobic cocci, hence the development of a devastating soft tissue
      infection. The precipitating cause was a tonsillar infection developing due to
      'post-anginal sepsis'. The aetiopathogenesis of the cervical infection is
      discussed.

PMID- 1761959
TI  - Radiological diagnosis of rhinoscleroma--the 'palatal sign'.
AB  - This paper reports a characteristic radiological finding observed in seven cases
      of rhinoscleroma with nasal involvement. The soft palate exhibits a marked
      thickening at its attachment to the hard palate which tapers off towards its free
      edge. This new sign could be of help in the early diagnosis of this condition.

PMID- 1761960
TI  - How to disclose imminent fracture of brazing alloy in a tracheostomy tube.

PMID- 1761961
TI  - The inter- and intraexaminer reliability of the Gonstead pelvic marking system.
AB  - An investigation was undertaken to determine the inter- and intraexaminer
      reliability of the Gonstead pelvic radiographic marking system. This methodology
      analyzes the relative dimensions and spatial positions of the two innominate
      bones and sacrum and measures leg length inequality through an evaluation of
      femur head height. Two examiners marked 71 full spine radiographs twice to
      provide data from 284 analyses. Reliability was ascertained with the Pearson r,
      Spearman, intraclass correlation coefficient (ANOVA) and Kappa statistics. All
      results were statistically significant (less than 0.001) and indicated high
      levels of concordance. In every case, intraexaminer agreement was superior to
      interexaminer concordance.

PMID- 1761962
TI  - A new approach to testing of long-term resistance of the spine to mechanical
      stress.
AB  - This paper studies the movement of the cervical spine from a side-bending to a
      return to the neutral position. The importance of muscular and ligamentous
      elements of the spine are emphasized. Directions for future research are noted.

PMID- 1761963
TI  - The reliability of specific sacro-occipital technique diagnostic tests.
AB  - Four interexaminer and one intraexaminer agreement studies were performed on
      specific diagnostic tests commonly employed within sacro-occipital technique
      (SOT). Ten of the tests were evaluated in more than one interexaminer study. Of
      these, only one test (bilateral supine leg raise with cervical compaction) had at
      least fair reliability more than once. Six of these 10 tests obtained poor
      agreement in more than one study. One examiner out of two had a number of
      excellent and fair intraexaminer values, whereas the other examiner generally had
      poor results. There may have been some treatment effect as a comparison of the
      combined intraexaminer diagnosis for two observers after no treatment and after
      treatment showed that the repeatability diminished from Kappa of 0.36 in
      untreated cases (which were expected to have high agreement of before and after
      treatment findings) to a Kappa of 0.27 for those subjects having received
      treatment (which were expected to have low agreement of before and after
      treatment findings). It appears unlikely that SOT tests can be reproduced to a
      sufficiently high degree to constitute useful clinical procedures.

PMID- 1761964
TI  - The radiology of cervical spine injury.
AB  - Cervical spine injury is a frequent sequelae of accidental trauma. Clinical
      evaluation often fails to raise adequate suspicion of an underlying injury.
      Radiologic assessment frequently reveals recognizable signs of damage ranging
      from fractures to joint and soft tissue injuries. This paper reviews the
      pathomechanics, clinical and radiologic features of the most common patterns of
      cervical spine injury.

PMID- 1761965
TI  - Is there a chiropractic science?

PMID- 1761966
TI  - A retrospective consecutive case analysis of pretreatment and comparative static
      radiological parameters following chiropractic adjustments.

PMID- 1761967
TI  - The physics of spinal manipulation. Part I. The myth of F = ma.

PMID- 1761968
TI  - Statistical methodology for reliability studies.

PMID- 1761969
TI  - Q beta and Q gamma components of intramembranous charge movement in frog cut
      twitch fibers.
AB  - Intramembranous charge movement was measured in frog cut twitch fibers mounted in
      a double Vaseline-gap chamber with a TEA.Cl solution at 13-14 degrees C in the
      central pool. When a fiber was depolarized from a holding potential of -90 mV to
      a potential near -60 mV, the current from intramembranous charge movement was
      outward in direction and had an early, rapid component and a late, more slowly
      developing component, referred to as I beta and I gamma, respectively (1979. J.
      Physiol. [Lond.]. 289:83-97). When the pulse to -60 mV was preceded by a 100-600
      ms pulse to -40 mV, early I beta and late I gamma components were also observed,
      but in the inward direction. The shape of the Q gamma vs. voltage curve can be
      estimated with this two-pulse protocol. The first pulse to voltage V allows the
      amounts of Q beta and Q gamma charge in the active state to change from their
      respective resting levels, Q beta (-90) and Q gamma (-90), to new steady levels,
      Q beta (V) and Q gamma (V). A second 100-120-ms pulse, usually to -60 mV, allows
      the amount of Q beta charge in the active state to change from Q beta (V) to Q
      beta (-60) but is not sufficiently long for the amount of Q gamma charge to
      change completely from Q gamma (V) to Q gamma (-60). The difference between the
      amount of Q gamma charge at the end of the second pulse and Q gamma (-60) is
      estimated from the OFF charge that is observed on repolarization to -90 mV. The
      OFF charge vs. voltage data were fitted, with gap corrections, with a Boltzmann
      distribution function plus a constant. The mean values of V (the potential at
      which, in the steady state, charge is distributed equally between the resting and
      active states) and k (the voltage dependence factor) were -59.2 mV (SEM, 1.1 mV)
      and 1.2 mV (SEM, 0.6 mV), respectively. The one-pulse charge vs. voltage data
      from the same fibers were fitted with a sum of two Boltzmann functions (1990. J.
      Gen. Physiol. 96:257-297). The mean values of V and k for the steeply voltage
      dependent Boltzmann function, which is likely to be associated with the Q gamma
      component of charge, were -55.3 mV (SEM, 1.3 mV) and 3.3 mV (SEM, 0.6 mV),
      respectively, similar to the corresponding values obtained with the two-pulse
      protocol.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761970
TI  - Voltage-dependent slowing of K channel closing kinetics by Rb+.
AB  - We have studied the effect of Rb+ on K channel closing kinetics in toadfish
      pancreatic islet cells. These channels are voltage dependent, activating at
      voltages positive to -10 mV. The channels also inactivate upon prolonged
      depolarizations, and the inactivation time course is best fit by the sum of two
      exponentials. Instantaneous current-voltage relationships show that external Rb+
      enters the channel as easily as K+, but carries less current. In the voltage
      range from -140 to -50 mV, the closing time course of the channels can be fit
      with a single exponential. When Rb+ is present in the external solution the
      channels close more slowly. The magnitude of this Rb+ effect is voltage
      dependent, decreasing at more negative voltages. Similarly, when the internal
      solution contains Rb+ instead of K+ the closing time constants are increased. The
      effect of internal Rb+ is also voltage dependent; at voltages positive to -80 mV
      the closing time constant in internal Rb+ is slower than in K+, whereas at more
      negative voltages the difference is negligible. With internal Rb+, the
      relationship between the closing time constant and voltage is best fit with two
      exponential components, suggesting the presence of two distinct voltage-dependent
      processes. The results are discussed in terms of a model of the K channel with
      two internal binding sites, and we conclude that Rb+ produces its effects on
      channel gating by binding to a site in the pore.

PMID- 1761971
TI  - Changes of myoplasmic calcium concentration during fatigue in single mouse muscle
      fibers.
AB  - Measurements of the intracellular free concentration of Ca2+ ([Ca2+]i) were
      performed during fatiguing stimulation of intact, single muscle fibers, which
      were dissected from a mouse foot muscle and loaded with fura-2. Fatigue, which
      was produced by repeated 100-Hz tetani, generally occurred in three phases.
      Initially, tension declined rapidly to approximately 90% of the original tension
      (0.9 Po) and during this period the tetanic [Ca2+]i increased significantly
      (phase 1). Then followed a lengthy period of almost stable tension production and
      tetanic [Ca2+]i (phase 2). Finally, both the tetanic [Ca2+]i and tension fell
      relatively fast (phase 3). The resting [Ca2+]i rose continuously throughout the
      stimulation period. A 10-s rest period during phase 3 resulted in a significant
      increase of both tetanic [Ca2+]i and tension, whereas a 10-s pause during phase 2
      did not have any marked effect. Application of caffeine under control conditions
      and early during phase 2 resulted in a substantial increase of the tetanic
      [Ca2+]i but no marked tension increase, whereas caffeine applied at the end of
      fatiguing stimulation (tension depressed to approximately 0.3 Po) gave a marked
      increase of both tetanic [Ca2+]i and tension. The tetanic [Ca2+]i for a given
      tension was generally higher during fatiguing stimulation than under control
      conditions. Fatigue developed more rapidly in fibers exposed to cyanide. In these
      fibers there was no increase of tetanic [Ca2+]i during phase 1 and the increase
      of the resting [Ca2+]i during fatiguing stimulation was markedly larger. The
      present results indicate that fatigue produced by repeated tetani is caused by a
      combination of reduced maximum tension-generating capacity, reduced myofibrillar
      Ca2+ sensitivity, and reduced Ca2+ release from the sarcoplasmic reticulum. The
      depression of maximum tension-generating capacity develops early during fatiguing
      stimulation and it is of greatest importance for the force decline at early
      stages of fatigue. As fatigue gets more severe, reduced Ca2+ sensitivity and
      reduced Ca2+ release become quantitatively more important for the tension
      decline.

PMID- 1761972
TI  - Electrogenic sodium-dependent bicarbonate secretion by glial cells of the leech
      central nervous system.
AB  - The ability to move acid/base equivalents across the membrane of identified glial
      cells was investigated in isolated segmental ganglia of the leech Hirudo
      medicinalis. The intracellular pH (pHi) of the glial cells was measured with
      double-barreled, neutral-ligand, ion-sensitive microelectrodes during step
      changes of the external pH (pHo 7.4-7.0). The rate of intracellular acidification
      after the decrease in extracellular pH (pHo) was taken as a measure of the rate
      of acid/base transport across the glial membrane. Taking into account the total
      intracellular buffering power, the maximum rate of acid/base flux was 0.4 mM/min
      in CO2/HCO3-free saline, and 3.92 mM/min in the presence of 5% CO2/10 mM HCO-3,
      suggesting that the acid/base flux was dependent upon HCO3-. The rate of acid
      influx/base efflux increased both with the external HCO3- concentration and with
      increasing pHi (and hence HCO3-i). This suggested that the decrease in pHi was
      due to HCO3- efflux. The rapid decrease of pHi was accompanied by a HCO3-
      dependent depolarization of the glial membrane from -74 +/- 5 mV (n = 20) to -54
      +/- 7 mV (n = 13). Both this depolarization and the rate of intracellular
      acidification were greatly reduced by the anion exchange inhibitor 4,4
      diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS; 0.3-0.5 mM), but were not
      affected by the removal of external Cl-. Reduction of the external Na+
      concentration to one-tenth normal affected the rate of intracellular
      acidification only in the presence of CO2/HCO3-: the rate increased within the
      first 3-5 min after lowering external Na+; after longer exposures in low external
      Na+ the rate decreased, presumably due to depletion of intracellular Na+.
      Amiloride (1 mM), which inhibits the Na+-H+ exchange in these cells, had no
      effect on the rate of intracellular acidification. The intracellular Na activity
      (aNai) of the glial cells was measured to be 5.2 +/- 1.0 mM (n = 8) in CO2/HCO3
      free saline; aNai increased to 7.3 +/- 2.2 mM (n = 8) after the addition of 5%
      CO2/24 mM HCO3-. Upon a change in pHo to 7.0 in the presence of CO2/HCO3-, aNai
      decreased by an average of 2 +/- 1.1 mM (n = 5); in CO2/HCO3--free saline
      external acidification produced a transient increase in aNai. It is concluded
      that, in the presence of CO2/HCO3-, the rate of intracellular acidification in
      glial cells is dominated by an outwardly directed, electrogenic Na+-HCO3
      cotransport. Neurons, which do not possess this cotransporter, acidify at much
      lower rates under similar conditions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761973
TI  - Ultrastructural organization of the interstitial subnucleus of the nucleus of the
      tractus solitarius in the cat: identification of vagal afferents.
AB  - This electron microscopic study, based on serial section analysis, describes the
      synaptic organization of the interstitial subnucleus of the nucleus of the
      solitary tract and identifies the terminals of the vagal primary afferents
      utilizing degeneration and HRP transport. The interstitial subnucleus contains
      sparsely scattered cell bodies, numerous dendrites and axon terminals, and
      bundles of unmyelinated and myelinated axons. The cell bodies which are small in
      diameter have an organelle poor cytoplasm and a large invaginated nucleus. Axon
      terminals can be classified into two main types according to their vesicular
      shape. The first type contains clear, round vesicles and can be further
      subdivided into two subgroups on the basis of their morphology and the size of
      their vesicles. In the first subgroup the terminals are small, contain a few
      mitochondria and their vesicles are densely packed with an homogeneous size. In
      the second subgroup the terminals which vary from small to large, contain many
      mitochondria and contain round vesicles which are heterogeneous in size. The
      second main terminal type consists of axon terminals containing pleomorphic
      vesicles which are associated with asymmetrical or symmetrical synaptic contacts
      on dendrites. Axo-axonic contacts are present in the interstitial subnucleus. In
      general, the presynaptic axon terminals contain pleomorphic vesicles and the
      postsynaptic elements contain round vesicles of varying size. In some dendrites,
      identified by the presence of ribosomes, groups of round and/or pleomorphic
      vesicles are found associated with synaptic contacts. These dendrites are
      presynaptic to conventional dendrites and postsynaptic to axon terminals. After
      removal of the nodose ganglion, degenerative alterations are seen only at the
      caudal and middle levels of the interstitial subnucleus. Degeneration occurs in a
      few myelinated axons and in axon terminals which usually contain a mixture of
      small and larger round, clear vesicles. After HRP injection into the vagus nerve,
      the HRP reaction product is visible in axon terminals filled with clear, round
      vesicles which are heterogeneous in size. The labelled axon terminals establish
      single or multiple synaptic contacts. This study demonstrates that terminals of
      vagal primary afferents consist principally of terminals of the second subgroup.
      The morphology of these terminals are compared to primary afferents in the
      brainstem and spinal cord.

PMID- 1761974
TI  - Patterns of hair cell survival and innervation in the cochlea of the bronx
      waltzer mouse.
AB  - A massive loss of inner hair cells typifies the cochleae of Bronx waltzer mutant
      mice. We have characterized the surviving inner hair cells and their modified
      innervation by immunocytochemistry using antibodies against neuron-specific
      enolase, with additional stains for neural cell adhesion molecule and
      neurofilaments, and by electron microscopy. The surviving inner hair cells vary
      in size, neuron-specific enolase content and innervation. All neuron-specific
      enolase-positive cells are innervated by neuron-specific enolase-positive
      endings. There is apparent correspondence between the neuron-specific enolase
      immunoreactivity of sensory cells and their innervation. Well-stained cells are
      richly innervated (and large) while lightly stained cells received fewer nerve
      endings. Neuron-specific enolase-negative inner hair cells innervated either by
      neuron-specific enolase-positive or -negative nerve endings are very rare.
      Ultrastructurally, the surviving inner hair cells vary from those of a normal
      morphological appearance to underdeveloped or vacuolated. Most of the apparently
      normal inner hair cells are associated with few nerve endings; instead nerve
      growth cones are abundant in the adjacent inner spiral sulcus epithelium. Cells
      forming ribbon synapses with afferent endings are rare. The contingent of
      efferent endings in the inner spiral bundle depends on the presence of afferent
      endings. The absence of inner hair cells and the uneven distribution of nerve
      endings on the surviving cells results in the disruption of normal innervation
      patterns, especially in the thinning out or discontinuation of the inner spiral
      bundle and an uneven distribution of tunnel fibres. We infer that the sprouting
      of nerve endings and their convergence on a selected population of the surviving
      inner hair cells represents a compensatory regenerative phenomenon in response to
      the loss and the genetic defect of the remaining inner hair cells.

PMID- 1761975
TI  - An ultrastructural study of oligodendrocytes in zitter rat: a new animal model
      for hypomyelination in the CNS.
AB  - The ultrastructural alterations in oligodendrocytes in the zitter rat--a newly
      established animal model of CNS hypomyelination--were studied in animals between
      3 and 37 weeks of age. Throughout the observation period, the most characteristic
      alteration was the presence of abnormal structures associated with nuclear
      membranes and resembling split myelin lamellae. The structures consisted of
      stacks of membranes continuous with the inner and outer membranes of the nuclear
      envelope or with plasma membranes. This abnormality was prominent at 3 weeks of
      age, when initial myelination was probably still occurring. It was decreased
      transiently at 12 weeks of age and then again increased slightly with advancing
      age. However, the mean incidence of this abnormality was approximately 5% of the
      oligodendrocyte nuclei in randomly examined electron micrographs. As the small
      membranous abnormalities were observed in a few serial sections, the actual
      incidence is believed to be several times higher than 5%. Such membranous
      abnormalities were also detected in some mitochondria, in some cisternae of rough
      endoplasmic reticulum, and in some lysosomes, all at lower incidence rates. Some
      aberrant or elongated myelin sheath formations, an increased number of radial
      components and intracytoplasmic inclusions in oligodendrocytes were also
      observed. These findings suggest that functional abnormalities in membrane
      biosynthesis including the myelin sheaths and the nuclear membranes in
      oligodendrocytes are closely related to the hypomyelination in the CNS and may be
      related to the genetic abnormality in the zitter rat.

PMID- 1761976
TI  - Motor-unit recruitment in the decerebrate cat: several unit properties are
      equally good predictors of order.
AB  - 1. Recruitment order was studied in pairs of motor units of the medial
      gastrocnemius (MG) muscle of decerebrate cats with the use of dual microelectrode
      recording from intact ventral root filaments. Excitation was provided by stretch
      of MG, stretch of synergists [lateral gastrocnemius (LG), plantaris (PL), and
      soleus (SOL) muscles] or electrical stimulation of the caudal cutaneous sural
      (CCS) nerve. Motor units were characterized by axonal conduction velocity (CV),
      tetanic tension (Pmax), twitch contraction time (CT), and fatigue index (FI). 2.
      Consistent with the recruitment pattern described by others, most often in
      relation to either CV or Pmax, the first unit of a pair to be recruited by MG
      stretch was typically the one with the lower CV and Pmax, and the higher FI and
      CT. The proportion of pairs that agreed in rank order of each property and
      recruitment order was as follows: for CT, 94%; for CV, 87%; for Pmax, 84%; and
      for FI, 75%. With a single marginal exception (CT vs. FI), no motor-unit property
      proved to be significantly better than the others at predicting recruitment (G
      test; P greater than 0.05). 3. In all 11 tested pairs containing one slow (type
      S) and one fast (type F) unit, the S was more easily recruited by stretch. Type F
      units divided into groups with high (type FR), low (type FF), and intermediate
      (type FInt) values for FI were recruited in order from FR to FInt to FF in 8/11
      pairs. Thus our findings were similar to earlier demonstrations that recruitment
      proceeds in order by type. 4. Stretch of MG synergists usually recruited units in
      the same order as MG stretch. In two S-S pairs, recruitment order was switched
      with synergist stretch. 5. Stimulation of the CCS nerve was generally excitatory
      to the MG units sampled. Most unit pairs were recruited by CCS stimulation in the
      same order as by MG stretch, but, for 6 of 39 pairs, CCS stimulation switched the
      order produced by stretch. Thus, whereas sural afferent input can preferentially
      excite some units over others as suggested by Kanda et al., that effect is not
      widespread or selective for unit type under these conditions. 6. Assuming that
      all MG motor units cooperate as a single functional pool in homonymous stretch
      reflexes, we support others in concluding that a motoneuron's recruitment
      threshold is not strictly determined by its size. However, our data do not
      distinguish other schemes that predict recruitment order more accurately than the
      size principle.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761977
TI  - Mechanical analysis of heterogenic inhibition between soleus muscle and the
      pretibial flexors in the cat.
AB  - 1. The role of proprioceptive pathways linking the direct antagonists soleus (S)
      and tibialis anterior (TA) muscles in governing the mechanical properties of the
      ankle joint were studied in the decerebrate cat. Actions of these heterogenic
      pathways were compared with those between S and extensor digitorum longus (EDL),
      a muscle that also acts at the metatarsophalangeal joint. These neurally mediated
      interactions between S and either TA or EDL were studied by applying controlled
      length changes to the isolated tendons of pairs of these muscles and recording
      the resulting changes in force. The muscles were activated with the use of
      electrically evoked crossed-extension reflexes, flexion reflexes, and brain stem
      stimulation. 2. Heterogenic inhibition from TA or EDL onto S was well developed
      whether S was initially quiescent or activated by a crossed-extension reflex. The
      inhibition persisted for the duration of the stretch of TA or EDL. During a
      crossed-extension reflex, TA did not generate background force, but brief stretch
      reflexes could be obtained. During flexion reflexes, stretch reflexes in S were
      usually abolished, and heterogenic inhibition from S to TA was weak or absent. 3.
      The strength of the heterogenic inhibition onto S was dependent on the initial
      length and activation level of TA and EDL. Changes in flexor length or activation
      level per se did not alter the background force or strength of the stretch reflex
      in S. Even taking into account the variation of strength of inhibition with the
      initial state of the muscle of origin, the strength of the inhibition was
      stronger from TA to S than the other way around. 4. The contributions of
      heterogenic inhibition from TA and EDL to S were independent in the sense that
      these components summed linearly with each other and with the autogenic reflex in
      S. In addition, the magnitude of the inhibition from TA to S was proportional to
      the amplitude of stretch for low to intermediate levels of initial force in S.
      The inhibition appeared to affect the mechanical responses of S essentially as
      rapidly as the stretch reflex in this muscle. 5. The heterogenic inhibition from
      TA to S was reduced or abolished by intravenous injections of strychnine but
      unaffected by injections of picrotoxin or bicuculline. These results, together
      with the observation that the inhibition sums linearly with the stretch reflex,
      suggest that the mechanism of this heterogenic inhibition is glycinergic and
      postsynaptic and, therefore, may include Ia-disynaptic reciprocal
      inhibition.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761978
TI  - Gustatory neural coding in the monkey cortex: stimulus quality.
AB  - 1. Extracellular action potentials were recorded from 50 single neurons in the
      insular-opercular cortex of two alert cynomolgus monkeys during gustatory
      stimulation of the tongue and palate. 2. Sixteen stimuli, including salts,
      sugars, acids, alkaloids, monosodium glutamate, and aspartame, were chosen to
      represent a wide range of taste qualities. Concentrations were selected to elicit
      a moderate gustatory response, as determined by reference to previous
      electrophysiological data or to the human psychophysical literature. 3. The
      cortical region over which taste-evoked activity could be recorded included the
      frontal operculum and anterior insula, an area of approximately 75 mm3. Taste
      responsive cells constituted 50 (2.7%) of the 1,863 neurons tested. Nongustatory
      cells responded to mouth movement (20.7%), somatosensory stimulation of the
      tongue (9.6%), stimulus approach or anticipation (1.7%), and tongue extension
      (0.6%). The sensitivities of 64.6% of these cortical neurons could not be
      identified by our stimulation techniques. 4. Taste cells had low spontaneous
      activity levels (3.7 +/- 3.0 spikes/s, mean +/- SD) and showed little inhibition.
      They were moderately broadly tuned, with a mean entropy coefficient of 0.76 +/-
      0.17. Excitatory responses were typically not robust. 5. Hierarchical cluster
      analysis was used to determine whether neurons could be divided into discrete
      types, as defined by their response profiles to the entire stimulus array. There
      was an apparent division of response profiles into four general categories, with
      primary sensitivities to sodium (n = 18), glucose (n = 15), quinine (n = 12), and
      acid (n = 5). However, these categories were not statistically independent.
      Therefore the notion of functionally distinct neuron types was not supported by
      an analysis of the distribution of response profiles. It was the case, however,
      that neurons in the sodium category could be distinguished from other neurons by
      their relative specificity. 6. The similarity among the taste qualities
      represented by this stimulus array was assessed by calculating correlations
      between the activity profiles they elicited from these 50 neurons. The results
      generally confirmed expectations derived from human psychophysical studies. In a
      multidimensional representation of stimulus similarity, there were groups that
      contained acids, sodium salts, and chemicals that humans label bitter and sweet.
      7. The small proportion of insular-opercular neurons that are taste sensitive and
      the low discharge rates that taste stimuli are able to evoke from them suggest a
      wider role for this cortical area than just gustatory coding.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1761979
TI  - Functional properties of a slowly inactivating potassium current in guinea pig
      dorsal lateral geniculate relay neurons.
AB  - 1. The time- and voltage-dependent properties of a slowly inactivating and
      depolarization-activated potassium current and the functional consequences of its
      activation was investigated with current and single-electrode voltage-clamp
      techniques applied to guinea pig dorsal lateral geniculate neurons maintained as
      a slice in vitro. 2. In current clamp, application of a step depolarization to
      near firing threshold resulted in a slowly rising membrane potential that took up
      to 10 s to reach steady state and firing threshold. In voltage clamp, step
      depolarization of the membrane potential to values positive to approximately -65
      mV resulted in the rapid activation followed by slow inactivation of an outward
      current. In both cases the sudden depolarization was associated with a large
      increase in membrane conductance, which gradually lessened in parallel with the
      slow depolarization in current clamp or with the decrease in outward current in
      voltage clamp. 3. The time course of inactivation of the outward current, which
      we refer to as IAs, was well fitted by a two-exponential function with time
      constants of 96 and 2,255 ms, suggesting the presence of a fast and slow phase of
      inactivation. The activation threshold for IAs was about -65 to -60 mV, whereas
      inactivation was incomplete even at -50 mV, suggesting the presence of a
      substantial "window" current. The time course of removal of inactivation of IAs
      at -85 to -100 mV was well fitted by a single exponential function with time
      constant of 91 ms. 4. IAs appears to be mediated by K+. Increasing [K+]o from 2.5
      to 10 mM resulted in a reduction in amplitude of IAs, whereas changing from 10 to
      2.5 mM [K+]o enhanced this current. Intracellular injection of Cs+ resulted in an
      abolition of IAs, whereas extracellular application of Ba2+ resulted in a large
      decrease in the apparent input conductance but relatively little reduction of
      IAs. 5. Both phases of inactivation of the transient outward current were
      completely blocked by low doses (100 microM) of 4-aminopyridine (4-AP), but not
      by extracellular application of Cs+, tetraethylammonium (TEA), tetrodotoxin
      (TTX), or after block of transmembrane Ca2+ currents. Local application of 4-AP
      to neurons depolarized to near firing threshold resulted in depolarization
      associated with a decrease in apparent input conductance, thereby confirming the
      presence of a window current.4+ this bias against depolarizing inputs.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1761980
TI  - Physiological properties of primary sensory neurons appropriately and
      inappropriately innervating skin in the adult rat.
AB  - 1. We have studied the physiology of sensory neurons innervating skin of the rat
      hindlimb, in three groups of animals: 1) normal animals; 2) animals in which the
      sural nerve (Sn) had regenerated to its original cutaneous target; and 3) animals
      in which the gastrocnemius muscle nerve (Gn) had previously been cut and cross
      anastomosed with the distal stump of the cut Sn so that its axons regenerated to
      a foreign target, skin. 2. Single-unit recordings were made from 222 afferents in
      normal, intact animals. They had conduction velocities of 0.5-53.1 m/s. The
      conduction velocity distribution had distinct peaks at approximately 37.5, 2.5,
      and 1.25 m/s, presumably corresponding to A alpha beta-, A delta-, and C-fiber
      populations. Eighty-two percent of the characterized myelinated fibers had low
      threshold mechanosensitive receptive fields, whereas 16% were high threshold, and
      only 2% appeared to have no receptive field. The very large majority of low
      threshold mechanosensitive receptive fields (87%) were rapidly adapting hair
      follicle afferents. 3. In animals with regenerated Sn, 308 afferents were
      recorded with conduction velocities of 0.4-58.8 m/s. However, the mean conduction
      velocity was lower than in control animals (P less than 0.05), and only one peak,
      at 27.5 m/s, was apparent for myelinated fibers. Eighty-six percent of myelinated
      fibers were low-threshold mechanosensitive afferents, 8.5% were high-threshold
      mechanoreceptors (HTMRs), and 5.5% appeared to have no receptive fields. Fewer
      low-threshold mechanoreceptors (LTMRs; compared with controls) were activated by
      hair movement (63 vs. 87%). Most of the remainder appeared to be field receptors
      (which were therefore more commonly observed here than in normal animals). 4. In
      animals in which the Gn had regenerated to skin, 430 afferents were recorded.
      These had conduction velocities ranging from 0.6 to 71.4 m/s, and again only one
      peak was apparent in the myelinated conduction velocity histogram, at
      approximately 17.5 m/s. Of the myelinated fibers, 79% had low-threshold
      mechanosensitive receptive fields in skin and 10% high-threshold mechanosensitive
      receptive fields. The remaining 11% apparently had no receptive field (cf. 5.5%
      in regenerated Sn). In contrast to normal or regrown sural afferents, only 58% of
      low-threshold gastrocnemius afferents in skin were rapidly adapting. Of the 42%
      slowly adapting afferents, many surprisingly responded to hair movement. Thus
      some gastrocnemius afferents seemed to have retained the adaptation properties
      characteristic of muscle afferents. Also surprisingly, given that the Gn contains
      fewer fibers than the Sn, receptive-field areas were not significantly different
      from regrown or normal sural fibers.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761981
TI  - Physiological properties of primary sensory neurons appropriately and
      inappropriately innervating skeletal muscle in adult rats.
AB  - 1. We have studied the physiology of primary sensory neurons innervating rat
      hindlimb muscle in the following: 1) normal control animals; 2) animals in which
      the gastrocnemius nerve (Gn) had regenerated to its original muscle target; and
      3) animals in which the cutaneous sural nerve (Sn) had regenerated to a foreign
      target, muscle. 2. Single-unit recordings were made from 115 afferents in normal,
      intact animals. They had conduction velocities of 0.8-67.2 m/s, which were
      distributed with peaks at approximately 1.25, 17.5, and 47.5 m/s. Of the
      myelinated fibers, 88% had low-threshold mechanosensitive receptive fields and
      responded to ramp-and-hold stretches of the muscle. The large majority of these
      fibers (85%) gave slowly adapting responses to ramp-and-hold stretches or direct
      muscle probing. Stretch-sensitive afferents could be divided (on the basis of
      their responses to active muscle contraction) into in-parallel or in-series
      receptors (presumed muscle spindles and Golgi tendon organs, respectively). The
      in-parallel receptors outnumbered the in-series receptors by approximately 3:2.
      The 12% of fibers that were insensitive to stretches of the muscle in the
      physiological range could be divided into roughly equal groups of totally
      insensitive fibers and high-threshold fibers, which required excessive stretching
      of the muscle. 3. In the animals with regrown Gn, 94 single fibers with
      conduction velocities ranging from 11 to 60.6 m/s were studied. The myelinated
      conduction velocity distribution exhibited only one peak, at approximately 37.5
      m/s. Only 67% of the afferents were stretch sensitive (vs. 88% in normal
      animals), and only about two-thirds of these (vs. 85% in normal animals) gave
      slowly adapting responses to ramp-and-hold stretches or muscle probing. The
      incidence of in-series receptors was also increased among regenerated
      gastrocnemius afferents. The 33% of fibers that were stretch insensitive were
      mostly unresponsive to even extreme forms of mechanical stimuli. This group
      presumably represents afferents that failed to make appropriate endings. 4. In
      the animals with Sn directed to muscle, 460 single afferents were recorded. Their
      conduction velocities ranged from 0.7 to 67.9 m/s, and the distribution exhibited
      only a single peak for myelinated fibers at approximately 22.5 m/s, significantly
      lower than for intact or regrown Gn. Only 41% of the myelinated fibers were
      stretch sensitive. Nearly all of these (98%) were rapidly adapting to ramp-and
      hold stretches or muscle probing, in marked contrast to the other groups. Also,
      unlike other groups, nearly all stretch-sensitive afferents appeared to be in
      series.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761982
TI  - Gustatory responses of neurons in the nucleus of the solitary tract of behaving
      rats.
AB  - 1. The activity of 117 single neurons was recorded in the rostral nucleus of the
      solitary tract (NST) and tested with each of four standard chemical stimuli
      [sucrose, NaCl, citric acid, and quinine HCl (QHCl)] and distilled water in
      awake, behaving rats. In 101 of these neurons, at least one sapid stimulus
      elicited a significant taste response. The mean spontaneous rate of the taste
      neurons was 4.1 +/- 5.8 (SD) spike/s. The mean response magnitudes were as
      follows: sucrose, 10.6 +/- 11.7; NaCl, 8.6 +/- 14.6; citric acid, 6.2 +/- 7.8;
      and QHCl, 2.4 +/- 6.6 spikes/s. 2. On the basis of their largest response, 42
      taste neurons were classified as sucrose-best, 25 as NaCl-best, 30 as citric acid
      best, and 4 as QHCl-best. The mean spontaneous rates for these categories were
      4.9 +/- 6.2 for sucrose-best cells, 5.8 +/- 7.4 for NaCl-best, 1.6 +/- 2.0 for
      citric acid-best, and 5.8 +/- 6.0 spikes/s for QHCl-best. The spontaneous rate of
      the citric acid-best neurons was significantly lower than that of the other
      categories. 3. At the standard concentrations, 45 taste cells (44.6%) responded
      significantly to only one of the gustatory stimuli. Of the 30 acid-best neurons,
      23 (76.7%) responded only to citric acid. For sucrose-best cells, specific
      sensitivity was less common (18/42, 42.9%), and for NaCl-best neurons, it was
      relatively uncommon (3/25, 12%). One of the 4 QHCl-best neurons was specific. In
      a concentration series, more than one-half of the 19 specific neurons tested
      responded to only one chemical at any strength. 4. The mean entropy for the
      excitatory responses of all gustatory neurons was 0.60. Citric acid-best cells
      showed the least breadth of responsiveness (0.49), sucrose-best cells were
      somewhat broader (0.56), but NaCl-best and QHCl-best cells were considerably less
      selective (0.77 and 0.79, respectively). Inhibition was observed infrequently and
      never reached the criterion for significance. 5. In the hierarchical cluster
      analysis, the four largest clusters segregated neurons primarily by best-stimulus
      category. The major exception to this was a group of sucrose-best neurons that
      also responded to NaCl and were grouped with the NaCl-best neurons. In a two
      dimensional space, the specific taste neurons, those that responded to only one
      of the four standard sapid stimuli, remained in well-separated groups. These
      specific groups, however, were joined in a ring-like formation by other neurons
      that responded to more than one of the sapid stimuli.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1761983
TI  - Properties of high-threshold mechanoreceptors in the oral mucosa. I. Responses to
      dynamic and static pressure.
AB  - 1. Mechanical response properties of high-threshold mechanoreceptors (HTMs) of
      the goat oral mucosa were determined by single-unit recording from the palatine
      and alveolar nerves and from the trigeminal ganglion. The following observations
      were made. 2. HTMs of the oral mucosa could be separated into two subgroups on
      the basis of their threshold to mechanical stimulation. Intense pressure
      receptors (IPRs) comprised a group of A-delta afferents with thresholds of 2-16
      g. Mechanonociceptors (MNs) comprised a group of relatively slowly conducting
      afferents (A-delta and C-fibers) with a higher threshold range (16-300 g). 3. In
      most instances, MNs lacked pressure-transducing capacity. Tests of reactivity to
      dynamically or statically applied stimuli revealed that significant functions
      were rarely fit between MN activity and pressure (4/20 cases). 4. IPRs differed
      from MNs by their pressure-transducing properties. The afferent response interval
      was in inverse proportion to the applied pressure. Significant pressure interval
      functions were fit in 16/20 cases. The relationship between pressure and response
      interval was best described by power functions. 5. Tests of reactivity to
      dynamically or statically applied stimuli revealed that IPRs preferred static
      pressure. Tighter fits and steeper slopes were observed in power functions fit to
      data generated by statically applied stimuli (mean fitted function, dynamic test:
      LnISI = -0.97 LnP + 3.4; mean fitted function, static test: LnISI = -1.6 LnP +
      4.71). 6. Pressures-frequency thresholds (PFTs), asymptotes (PFAs), and mean
      response intervals (MRIs) were determined for IPRs from the static test series.
      The first two values are the pressures that produce the lower and upper limits of
      response frequency of mucosal HTMs (mean PFT, 1.48 N/mm2; mean PFA, 3.34 N/mm2).
      The MRI (28 ms) is simply computed from the function. When PFTs and PFAs are
      combined with activation threshold and power functions, they provide a relatively
      complete description of the range and form of reactivity of the IPR of the oral
      mucosa.

PMID- 1761984
TI  - Properties of high-threshold mechanoreceptors in the goat oral mucosa. II.
      Dynamic and static reactivity in carrageenan-inflamed mucosa.
AB  - 1. We have previously described two classes of high-threshold mechanoreceptors
      (HTMs) of the oral mucosa of the goat. Mechanonociceptors (MNs) had very high
      thresholds (16-300 g) and were poor transducers of pressure. Intense pressure
      receptors (IPRs) had thresholds from 2 to 16 g and were good transducers of
      pressure. After carrageenan inflammation (CI) we observed mechanical
      sensitization in both classes of HTMs. The characteristics were as follows. 2.
      Sensitization of MNs was manifested as qualitative shifts in the capacity to
      encode intense pressure. MNs that were unable to code intensity before CI
      acquired pressure coding properties after treatment with carrageenan. Qualitative
      shifts in coding capacity were suggested by the greater proportion of MNs coding
      in preinflamed (10 of 14) compared with noninflamed tissue (8 of 25 cases).
      Improved afferent reactivity was directly observed, in additional experiments, in
      which MNs were characterized in normal tissue before the injection of carrageenan
      into the mucosa. In five of six cases, either qualitative or quantitative
      improvements were observed. In control experiments, improved reactivity was
      observed in one of six cases. 3. Sensitization in IPRs was manifested as both
      qualitative and quantitative improvement in intensity coding properties. Power
      functions fit to individual IPRs indicated sensitization for most mucosal
      afferents after inflammation. Carrageenan induced decreases in the mean response
      interval, pressure-frequency threshold (PFT), and pressure-frequency asymptote
      (PFA), and decreases in variability of functions fit to units sampled from
      preinflamed and noninflamed tissue (n = 23). Experiments were also conducted in
      which units were characterized before and after carrageenan treatment. In 7 of 10
      cases, injection of carrageenan into the oral mucosal led to improved dynamic
      and/or static reactivity. Injection of vehicle led to changes in reactivity in
      one of five cases. 4. Carrageenan induced decreases in activation thresholds only
      when afferent receptive fields fell into restricted tissue zones. Large shifts in
      activation thresholds were observed for five of five (3 MNs and 2 IPRs) units in
      the sulcal zone of the incisal papilla (IP). In contrast, activation thresholds
      increased or remained the same in 11 of 12 units (10 IPRs and 3 MNs) with
      receptive fields in the medial or ventral tissue zones. Changes in activation
      threshold evolved slowly after carrageenan injection and required 1-2 h to
      develop. Rapid changes in activation threshold were also observed in a limited
      number of cases (3). These threshold shifts were unrelated to carrageenan
      inflammation.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761985
TI  - Slow inactivation of a TEA-sensitive K current in acutely isolated rat thalamic
      relay neurons.
AB  - 1. Voltage-gated K currents were studied in relay neurons (RNs) acutely isolated
      from somatosensory (VB) thalamus of 7- to 14-day-old rats. In addition to a
      rapidly activated, transient outward current, IA, depolarizations activated
      slower K+ currents, which were isolated through the use of appropriate ionic and
      pharmacological conditions and measured via whole-cell voltage-clamp. 2. At least
      two slow components of outward current were observed, both of which were
      sensitive to changes in [K+]o, as expected for K conductances. The first, IK1,
      had an amplitude that was insensitive to holding potential and a relatively small
      conductance of 150 pS/pF. It was blocked by submillimolar levels of
      tetraethylammonium [TEA, 50%-inhibitory concentration (IC50 = 30 microM)] and 4
      aminopyridine (4-AP, 40 microM). In the absence of intracellular Ca2+ buffering,
      the amplitude of IK1 was both larger and dependent on holding potential, as
      expected for a Ca(2+)-dependent current. Replacement of [Ca2+]o by Co2+ reduced
      IK1, although the addition of Cd2+ to Ca(2+)-containing solutions had no effect.
      3. The second component, IK2, had a normalized conductance of 2.0 nS/pF and was
      blocked by millimolar concentrations of TEA (IC50 = 4 mM) but not by 4AP. The
      kinetics of IK2 were analogous to (but much slower than) those of IA in that both
      currents displayed voltage-dependent activation and voltage-independent
      inactivation. IK2 was not reduced by the addition of Cd2+ to Ca(2+)-containing
      solutions or by replacement of Ca2+ by Co2+. 4. IK2 had a more depolarized
      activation threshold than IA and attained peak amplitude with a latency of
      approximately 100 ms at room temperature. IK2 decay was nonexponential and could
      be described as the sum of two components with time constants (tau) near 1 and 10
      s. 5. IK2 was one-half steady-state inactivated at a membrane potential of -63
      mV, near the normal resting potential for these cells. The slope factor of the
      Boltzman function describing steady-state inactivation was 13 mV-1, which
      indicates that IK2 varies in availability across a broad voltage range between 
      100 and -20 mV. 6. Activation kinetics of IK2 were voltage dependent, with peak
      latency shifting from 300 to 50 ms in the voltage range -50 to +30 mV.
      Deinactivation and deactivation were also voltage dependent, in contrast to
      inactivation, which showed little dependence on membrane potential. Increase in
      temperature sped the kinetics of IK2, with temperature coefficient (Q10) values
      near 3 for activation and inactivation. Heating increased the amplitude of IK2
      with a Q10 value near 2.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761986
TI  - Neural control of swimming in Aplysia brasiliana. I. Innervation of parapodial
      muscle by pedal ganglion motoneurons.
AB  - 1. Swimming is an oscillatory locomotor behavior in Aplysia accomplished by
      rhythmic undulating movements of the parapodia, winglike flaps that cover the
      dorsum of the body. As part of an analysis of the neural basis of this behavior,
      we have identified and characterized motoneurons in the pedal ganglia that
      directly innervate parapodial muscle and fire phasically during fictive swimming.
      2. Parapodial musculature is organized into at least eight discrete layers.
      Fibers of adjacent layers are directed orthogonally. 3. Motoneurons were
      localized to the middle and rostral portions of the dorsal surface of each pedal
      ganglion by the use of backfill staining and intracellular dyes. These neurons
      were defined as motoneurons on the basis of additional physiological evidence for
      peripheral axons and their ability to cause excitatory junction potentials (EJPs;
      average amplitude, 2-5 mV) in muscle fibers and discrete contractions of
      parapodial muscles. Muscle fibers are polyneuronally innervated. Fibers had an
      average resting potential of -79 mV and no over-shooting action potentials. 4.
      There are probably at least 50 motoneurons. Their average resting potential was 
      48 mV, and they do not appear to be directly connected synaptically to one
      another. One identifiable motoneuron is described in detail. It participates in
      the opener (downstroke) phase of swimming and causes contraction of one of the
      described muscle layers. 5. Divalent ion concentrations were altered centrally
      and peripherally during motoneuron activity to demonstrate that the motoneurons
      directly innervate muscle fibers. Blockage of EJPs by hexamethonium and the
      presence of specific anticholinesterase staining in parapodial nerves and muscle
      fibers strongly suggest that many of the motoneurons are cholinergic. 6. Studies
      of excitation-contraction coupling showed that single or a few spikes in
      motoneurons rarely cause an EJP. Bursts of motoneuron spikes produced
      facilitating EJPs. With approximately 10 spikes in a 1-s motoneuron burst,
      adequate depolarization occurred in muscle fibers to initiate a small, slow
      contraction. Increased spike frequency led to greater depolarization, because of
      EJP summation, and larger contractions. Contraction requires depolarization of
      the muscle above a threshold, beyond which the force of contraction depends on
      both the duration and degree of depolarization. 7. Although dozens of motoneurons
      appear to be involved in the complex control of parapodial movements during
      swimming, preliminary evidence indicates that these neurons are probably not
      participating directly in the circuitry of the central pattern generator for
      swimming, which has been shown by others also to reside in the pedal ganglia.

PMID- 1761987
TI  - Neural control of swimming in Aplysia brasiliana. II. Organization of pedal
      motoneurons and parapodial motor fields.
AB  - 1. We have examined the locations and functional properties of a large number of
      motoneurons in the pedal ganglia of Aplysia brasiliana. These neurons control
      movement of the parapodia and body during swimming. We have grouped the
      motoneurons into classes based on several criteria, including the topology of the
      cells and their axons, the properties of their peripheral motor fields, and their
      phasic activity during an induced swim motor program. 2. A total of 410
      motoneurons were analyzed. There are at least 16 distinguishable motor fields in
      the parapodia, based on the region affected, direction of contraction, and phase
      of neuronal activity during fictive swimming. 3. Motoneurons for each motor field
      tend to appear in the same region of the ganglion in different preparations. 4.
      Most motoneurons have only ipsilateral effects. About 1% cause contralateral
      contraction, and they project directly to the contralateral parapodium. 5. Three
      types of motoneuron are described that cause parapodial expansion. 6. Two other
      groups of motoneurons were found that innervate either the columellar muscle or
      longitudinal foot muscles. 7. Almost all motoneurons fired rhythmically during
      fictive swimming, including those controlling foot and columellar muscle.

PMID- 1761988
TI  - Kinetics and voltage dependence of A-type currents on neonatal rat sensory
      neurons.
AB  - 1. We have characterized three voltage-gated potassium currents on neonatal rat
      nodose neurons: a rapidly inactivating current (IAf), a slowly inactivating
      current (IAs), and a noninactivating current (IK). 2. Most neurons expressed all
      three currents. However, we found that a significant number of neurons had only
      one of the two A-currents. 3. IAf activates rapidly (tau = 1.0-1.5 ms at -10 mV)
      and inactivates in 10-30 ms. The activation and steady-state inactivation curves
      were fit with Boltzmann distributions of V' = -21, k = 12 mV and V' = -73, k = -8
      mV, respectively. 4. IAs activates more slowly than IAf (tau = 5.4-9.2 ms at -10
      mV) and inactivates with two components (150-300 ms; 1-3 s). The activation and
      inactivation curves are shifted approximately 20 mV more positive than those of
      IAf, with Boltzmann coefficients of V' = -2, k = 14 mV and V' = -51, k = -14 mV,
      respectively. 5. Of the three, IK activates most slowly (tau = 29.4-38.3 ms at 
      10 mV) and at more positive potentials than IAf or IAs (V' = 16, k = 12 mV). IK
      does not inactivate over tens of seconds. 6. In addition, we have identified the
      single channels that underlie IAf and IAs. These two channels, Af and As, have
      the same single-channel conductance, 22 pS, but different inactivation kinetics.
      7. Furthermore, we show that there is an inverse relationship between the
      appearance of A-currents (IAf and IAs) and the appearance of IK, suggesting that
      these neurons coordinate the expression of these currents in their membranes.

PMID- 1761989
TI  - Efferent neurons and suspected interneurons in second somatosensory cortex of the
      awake rabbit: receptive fields and axonal properties.
AB  - 1. Receptive-field properties of antidromically identified efferent neurons
      within the representation of vibrissae and sinus hairs above the mouth were
      examined in secondary somatosensory cortex (S-2) of fully awake adult rabbits.
      Efferent neurons studied included callosal neurons (CC neurons, n = 88),
      ipsilateral corticocortical neurons (C-IC neurons, n = 51) that project to
      primary somatosensory cortex (S-1), and corticofugal neurons of layer 5 (CF-5
      neurons, n = 63) and layer 6 (CF-6 neurons, n = 42) that project to and/or beyond
      the thalamus. Appropriate collision tests demonstrated that substantial numbers
      of corticocortical efferent neurons (21 of 113 tested) project an axon to both
      the corpus callosum and to ipsilateral S-1. 2. Suspected interneurons (SINs, n =
      62) were also studied. These neurons were not activated antidromically from any
      stimulus site but did respond synaptically to electrical stimulation of the
      ventrobasal (VB) thalamus with a burst of three or more spikes at frequencies of
      600 to greater than 900 Hz. Most of these neurons also responded synaptically to
      stimulation of S-1 and the corpus callosum. The action potentials of these
      neurons were much shorter (mean, 0.49 ms) than those of efferent neurons (mean,
      1.01 ms). 3. CF-5 neurons differed from CC, C-IC, and CF-6 neurons in their
      spontaneous firing rates, axonal properties, and receptive-field properties.
      Whereas CF-5 neurons had a mean spontaneous firing rate of 5.7 spikes/s, CC, C
      IC, and CF-6 neurons all had mean values of less than 1/s. Axonal conduction
      velocities of CF-5 neurons were much higher (mean, 11.90 m/s) than either CC
      (mean, 2.63 m/s), C-IC (mean, 0.86 m/s), or CF-6 (mean, 1.73 m/s) neurons. A
      decrease in antidromic latency (the "supernormal" period), which was dependent on
      prior impulse activity, was seen in most CC, C-IC, and CF-6 neurons but was
      minimal or absent in CF-5 neurons of comparable conduction velocity. Although all
      CF-5 neurons responded to peripheral sensory stimulation, many CC (52%), C-IC
      (49%), and CF-6 (55%) neurons did not. CC and CF-6 neurons that did not respond
      to sensory stimulation had significantly lower axonal conduction velocities and
      spontaneous firing rates than those that responded to such stimulation. Whereas
      no CC, C-IC, or CF-6 neuron responded synaptically to callosal stimulation, 43%
      of CF-5 neurons (and 78% of SINs) did so respond. Similar differences in synaptic
      responsivity to stimulation of S-1 were seen in these populations.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1761990
TI  - Modeling the spatiotemporal organization of velocity storage in the
      vestibuloocular reflex by optokinetic studies.
AB  - 1. A generalized three-dimensional state space model of visual vestibular
      interaction was developed. Matrix and dynamical system operators associated with
      inputs from the semicircular canals, otolith velocity estimator, and the visual
      system have been incorporated into the model, which focus on their relationship
      to the velocity storage integrator. 2. A relationship was postulated between the
      eigenvalues and the direction of the eigenvectors of the system matrix and the
      orientation of the spatial vertical. It was assumed that the system matrix for a
      tilted position was a composition of two linear transformations of the system
      matrix for the upright position. One transformation modifies the eigenvalues of
      the system matrix, whereas another rotates the eigenvectors of the system matrix.
      The pitch and roll eigenvectors rotate with the head, whereas the yaw axis
      eigenvector remains approximately spatially invariant. 3. Based on the three
      dimensional model, a computational procedure was formulated to identify the
      eigenvalues and eigenvectors of the system matrix with the use of a modification
      of the marquardt algorithm. With the use of data obtained from a monkey, it was
      shown that the three-dimensional behavior of velocity storage cannot be predicted
      solely in terms of its time constants, i.e., the inverse of its eigenvalues. With
      the use of the same eigenvalues the data could either be fit or not fit,
      depending on the eigenvector directions. Therefore, it is necessary to specify
      eigenvector directions when characterizing velocity storage in three dimensions.
      4. Parameters found with the use of the Marquardt algorithm were incorporated
      into the model. Diagonal matrices in a head coordinate frame were introduced for
      coupling the visual system to the integrator and to the direct optokinetic
      pathway. Simulations of optokinetic nystagmus (OKN) and optokinetic after
      nystagmus (OKAN) were run. The model predicted the behavior of yaw and pitch OKN
      and OKAN when the animal is upright. It also predicted the cross-coupling in the
      side down position. The trajectories in velocity space were also accurately
      simulated. 5. One of the predictions of the model is that when the stimulus
      direction is along an eigenvector, the trajectory in velocity space is a straight
      line. Using the "spectral width" of the residuals from a straight line sequence
      during OKAN, we developed a methodology to estimate how close the OKAN decay was
      to an eigenvector trajectory. 6. Thus we have developed a model-based approach
      for studying and interpreting the response characteristics of velocity storage in
      three dimensions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1761991
TI  - Spatial orientation of the vestibular system: dependence of optokinetic after
      nystagmus on gravity.
AB  - 1. Monkeys received optokinetic stimulation at 60 degrees/s about their yaw
      (animal vertical) and pitch (animal horizontal) axes, as well as about other head
      centered axes in the coronal plane. The animals were upright or tilted in right
      side-down positions with regard to gravity. The stimuli induced horizontal,
      vertical, and oblique optokinetic nystagmus (OKN). OKN was followed by
      optokinetic after-nystagmus (OKAN), which was recorded in darkness. 2. When
      monkeys were tilted, stimulation that generated horizontal or yaw axis eye
      velocity during OKN induced a vertical or pitch component of slow phase velocity
      during OKAN. This has been designated as "cross-coupling" of OKAN. Eigenvalues
      and eigenvectors associated with the system generating OKAN were found as a
      function of tilt. They were determined by use of the Levenberg-Marquardt
      algorithm to minimize the mean square error between the output of a model of OKAN
      and the data. 3. The eigenvector associated with yaw OKAN (yaw axis eigenvector)
      was maintained close to the spatial vertical regardless of the angle of tilt. The
      eigenvector associated with pitch OKAN (pitch axis eigenvector) was always
      aligned with the body axis. The data indicate that velocity storage can be
      modeled by a piecewise linear system, the structure of which is dependent on
      gravity and the yaw axis eigenvector, which tends to align with gravity. 4. Yaw
      axis eigenvectors were also determined by giving optokinetic stimulation about
      head-centered axes in the coronal plane with the animal in various angles of
      tilt. A technique using a spectral analysis of residuals was developed to
      estimate whether yaw and pitch OKAN slow phase velocities decayed concurrently at
      the same relative rate and over the same time course. The eigenvectors determined
      by this method were in agreement with those obtained by analyzing OKAN elicited
      by yaw OKN. 5. During yaw OKN with the animal in tilted positions, the mean
      vector of the ensuing nystagmus was closer to the body axis than to the spatial
      vertical. This suggests that there is suppression of the cross-coupled pitch
      component during OKN. The direction of the stimulus may be utilized to suppress
      components of velocity storage not coincident with the direction of stimulus
      motion. 6. There were similarities between the monkey eigenvectors and human
      perception of the spatial vertical, and the mean of eigenvectors for upward and
      downward eye velocities overlay human 1-g perceptual data.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1761992
TI  - The relationship among leadership preferences, head nurse leader style, and job
      satisfaction of staff nurses.
AB  - A better understanding of the effects of the relationships between staff nurses
      and their leaders is needed if retention of vital resources is to occur in this
      age of increasing need and decreasing resources in the health care industry. This
      study investigated the interactions among leadership preferences of staff nurses,
      the perceived leader behavior of their nurse managers, and their job
      satisfaction. Although a "match" or "mismatch" relationship was not found, one
      surprising finding was the high positive relationship between structuring
      behavior of head nurses and job satisfaction of staff nurses. Implications and
      recommendations for training nurse managers are offered.

PMID- 1761993
TI  - Beliefs about mental illness in a culturally diverse nursing student population:
      implications for education and practice.
AB  - The effects of a psychiatric nursing curriculum on a culturally diverse nursing
      student population was investigated using Cohen and Streuning's factor analyzed
      Opinions About Mental Illness questionnaire. Statistical analysis revealed that
      the experimental subjects (N = 118) showed change on four out of five selected
      attitude dimensions. Cultural variables (ethnic group, length of time in the US
      and political affiliations) corresponded with mental illness attitudes. Length of
      time in the US had a significant effect on two factors--Authoritarianism and
      Stereotyping.

PMID- 1761994
TI  - Military nursing bibliography.

PMID- 1761995
TI  - Training in injury prevention for health professionals.
AB  - BACKGROUND: The shortage of health professionals with training in injury
      epidemiology and control is an obstacle to injury prevention. METHODS: Two two
      hour workshops in childhood injury epidemiology and control were provided to
      nurses and physicians in the New York City Department of Health. RESULTS: 101
      nurses and 76 physicians received the training. Workshop I test scores rose from
      60% to 75%. Workshop II test scores rose from 67% to 88%. DISCUSSION: Training in
      injury prevention increases knowledge. Future studies will examine the effect of
      training on practice.

PMID- 1761996
TI  - Chemical impairment in colleagues: perceptions of Western New York nurses.
AB  - The purpose of this study was to determine nurses' perceptions about substance
      abuse in professional colleagues, opinions about strategies for dealing with
      substance abuse, and knowledge about resources available for dealing with the
      problem of chemical impairment. Subjects included a convenience sample of 161
      nurses from Western New York. Data were gathered by a questionnaire that included
      "The Perceptions of Nursing Impairment Inventory" and items regarding
      respondents' background characteristics, suspicions about alcohol and drug abuse
      in nurse colleagues, and knowledge about and use of peer assistance services
      available through District I of the New York State Nurses Association. The major
      outcome of the study was identification of a knowledge deficit on the extent of
      the substance abuse problem in nursing, ability to recognize an impaired
      colleague, and awareness of services available. These data substantiate the need
      for implementing educational programs to increase nurses' basic knowledge of, and
      sensitivity to, the problem of chemical dependency.

PMID- 1761997
TI  - Heparin and graduated compression stockings in patients undergoing fractured hip
      surgery.
AB  - Despite evidence that effective regimens are available for the prevention of
      venous thrombosis in fractured hip patients, many centers do not use prophylaxis.
      In order to evaluate the efficacy and safety of heparin and graduated compression
      stockings, we conducted a cohort study of 55 consecutive fractures hip patients
      treated postoperatively with heparin, 5,000 U every 12 h, and graduated
      compression stockings. The rates of venous thromboembolism and bleeding were
      compared with an historical cohort from Hamilton. Before discharge, 51 patients
      underwent bilateral venography. Deep venous thrombosis (DVT) occurred in 10 of
      the 51 patients (incidence of 20%); three had proximal DVT (incidence of proximal
      DVT was 6%). DVT was seen in 29 of the 63 control patients (incidence 46%); 19
      had proximal DVT (incidence of proximal DVT was 30%). The differences in the
      rates of DVT and proximal DVT are statistically significant (p less than 0.01).
      Bleeding occurred in one patient in the treatment group (incidence 2%) and five
      patients in the control group (incidence 8%). This study confirms that therapy
      with heparin and graduated compression stockings is effective, inexpensive, and
      convenient for the prevention of venous thrombosis in fractured hip patients and
      is associated with a low bleeding risk.

PMID- 1761998
TI  - The abduction lordotic view of the clavicle: a new technique for radiographic
      visualization.
AB  - The abduction lordotic view is a previously unreported radiographic technique for
      visualization of the clavicle. Use of this technique, a simple office procedure,
      combined with a standard anteroposterior view allows almost 90 degrees
      visualization of the clavicle. It is recommended particularly for the assessment
      of clavicular healing.

PMID- 1761999
TI  - The posterior Monteggia lesion.
AB  - Thirteen posterior Monteggia fracture-dislocations in adults were treated
      surgically at the Massachusetts General Hospital from 1980 to 1988. A
      characteristic lesion was observed, consisting of a proximal ulna fracture with a
      triangular or quandrangular fracture at or near the level of the coronoid, a
      posterior or posterolateral radiocapitellar dislocation, and, in 10 cases, a
      radial head fracture. Nine patients were women and four were men, with an average
      age of 56 years. Following reduction of the radiocapitellar dislocation, the
      ulnar fractures were treated with plates in each case. Seven fractured radial
      heads were excised, one replaced with a silicone prosthesis, and three treated by
      open reduction and internal fixation. The 11 surviving patients were observed
      using the performance index of Broberg and Morrey at an average follow-up time of
      38.4 months. The conditions of three were rated excellent, three good, four fair,
      and one poor. Incomplete reduction of the ulnar fracture with residual posterior
      radiocapitellar subluxation was observed in four cases, all leading to loss of
      forearm supination. We believe this lesion to be more common than previously
      reported. Recognition of its specific anatomic features is essential to achieve a
      functional outcome.

PMID- 1762000
TI  - Spinal canal decompression in traumatic thoracolumbar burst fractures: posterior
      distraction rods versus transpedicular screw fixation.
AB  - Although the benefit of spinal canal decompression of traumatic thoracolumbar
      burst fractures is controversial, it remains a desirable procedure, as many
      reports describe improved neurologic outcome with spinal canal reconstruction.
      The optimal type of posterior instrumentation for reconstructing the spinal canal
      is unclear. This study focused on the efficacy of posterior distraction rods
      versus transpedicular screw fixation implants in decompressing the spinal canal
      and on the relationship between the amount of canal decompression and subsequent
      neurologic recovery. A medical records review was conducted to identify all
      patients surgically treated for traumatic burst fractures of the thoracolumbar
      spine from January 1, 1987 to June 30, 1989. Sixty-seven patients were selected
      by this review, and, of these, 30 had had both preoperative and postoperative CT
      scans. We could find no bias among patients who received both preoperative and
      postoperative CT scans as compared to those who did not, therefore the 30
      patients were considered to be a random sample of the total population of 67. A
      retrospective study was then conducted on the 30 patients with surgically treated
      burst fractures--15 treated with posterior distraction rods and 15 treated with
      AO Fixator Interne transpedicular screw fixation implants. Preoperative and
      postoperative spinal canal cross-sectional areas were measured directly from the
      scaled CT scans. The area of most severe compromise was compared with an internal
      standard defined as the next, caudal, uncompromised spinal level, and the
      percentage of preoperative and postoperative canal compromise was
      calculated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762001
TI  - Treatment of posttraumatic reflex sympathetic dystrophy syndrome (RSDS) with
      intravenous blocks of a mixture of corticosteroid and lidocaine: a retrospective
      review of 17 consecutive cases.
AB  - Seventeen consecutive patients with posttraumatic reflex sympathetic dystrophy
      syndrome (RSDS) were treated with one or more regional i.v. blocks of
      methylprednisolone sodium succinate and lidocaine HCL after physical therapy and
      oral medications had failed to produce satisfactory relief of their symptoms. In
      12 of these patients the upper extremity was affected, and in five, it was the
      lower extremity. A fracture of the distal radius was the most frequent
      predisposing event. The average delay between injury and the manifestation of
      RSDS was 2.5 months (range 2 days to almost 6 months). The index treatment in all
      cases started within 3 months of the onset of symptoms. The number of i.v. blocks
      given ranged from one to four (average 2.4). The side effects and complications
      were negligible. The treatment, which in most cases was given exclusively on an
      outpatient basis, was well tolerated by all patients except one. Assessment of 16
      of them at 6 months showed that 11 had total or almost total relief of their
      symptoms. When 15 of the patients were reassessed at an average follow-up of 28
      months (range 12-48 months), it was noted that none of the patients with an early
      satisfactory response experienced recurrence of their symptoms. The condition of
      the symptomatic patients in the interim had improved overall. Analysis of the
      cases with an unsatisfactory outcome suggested that the primary reason for
      failure was inadequate treatment rather than ineffectiveness of the treatment
      used. It was concluded that this method is simple, safe, and well tolerated and
      should be regarded as a first choice for posttraumatic RSDS.

PMID- 1762002
TI  - Three-dimensional load displacement properties of posterior lumbar fixation.
AB  - Pedicular fixation devices for the posterior treatment of segmental spinal
      instability are thought to offer enhanced stabilization compared with sublaminar
      wire systems, while avoiding the immobilization of multiple normal motion
      segments. We compared the performance of three dissimilar stabilization systems:
      the Hartshill rectangle, the Acromed/Steffee interpedicular screw and plate, and
      the Synthes/Dick fixateur interne. Human cadaveric lumbosacral specimens were
      first tested intact, then after a laminectomy and a facetectomy at the L3/L4
      level, and finally after the fixation devices were sequentially attached.
      Constructs spanning two to four vertebral levels were compared for stabilization
      of the resected lumbar spine segments. When tested in compression, the
      Acromed/Steffee system with pedicular screws at L2-L5 allowed significantly less
      intersegmental distraction than the Synthes/Dick construct with screws at L2 and
      L5 only, and less than the intact and the destabilized uninstrumented spine. When
      sagittally rotated, the Acromed/Steffee construct with screws at L2-L5, or at L2
      and L5, allowed significantly less distraction than the intact or destabilized
      segments, and the construct with screws at L2 through L5 allowed less distraction
      than the Synthes/Dick constructs with screws at L3/L4 or L2/L5. With the
      exception of the Acromed/Steffee system with screws at four levels, there were no
      significant differences in distraction allowed between the Synthes/Dick and
      Acromed/Steffee constructs, or between the multisegment and single segment
      constructs. There were no significant differences in stiffness across levels
      L3/L4 with the various implants. Results indicate that the use of posterior spine
      constructs significantly augment the stability of posterior segmental defects.
      Pedicular fixation immediately cephalad and caudad to the defect provided stable
      fixation in this application.

PMID- 1762003
TI  - Fracture patterns in battered children.
AB  - We reviewed cases of 75 battered children with fractures over a 2-year period.
      The average age was 16 months; 57% were boys. There were 154 fractures (2.0 per
      child); 77% were acute and 23% were old. The most common fracture occurred in the
      skull (32%) and the most common long bone fracture occurred in the tibia (16%).
      The most common long bone fracture pattern was transverse (41%); corner fractures
      accounted for 28% of long bone fractures. An isolated acute fracture was the
      orthopaedic injury in 65% of the children, whereas multiple fractures in various
      stages of healing were present in only 13% of children.

PMID- 1762004
TI  - Anatomical and radiological considerations in compressive bar technique for
      posterior pelvic disruptions.
AB  - Sacral bar fixation is a well-recognized technique for the treatment of
      posteriorly unstable pelvic injuries, particularly sacral fractures. The sacral
      bars are placed in the iliac crest posterior to the sacrum. We reviewed 103
      pelvic computed tomography (CT) scans and three cadaver pelves to measure the
      iliac crest prominence and its spatial relationship to the lamina of the sacrum.
      It was found that the best bony purchase for the bars is at the level of the L5
      S1 junction. Lower placement of the bar increases the risk of violating the
      sacral canal and may also decrease the bony purchase of the bars. Some patients
      have an inadequate iliac crest posteriorly for proper placement; therefore, the
      pelvic CT scans should always be carefully evaluated preoperatively. The study
      also includes a description of a technique for percutaneous placement of sacral
      bars using fluoroscopic guidance.

PMID- 1762005
TI  - Open reduction and internal fixation of acetabular fractures: heterotopic
      ossification and other complications of treatment.
AB  - Open reduction and internal fixation was performed on 50 displaced acetabular
      fractures in 49 patients by nine different attending surgeons over a 10-year
      period. At an average follow-up of 38 months, poor results were noted clinically
      in 38% and radiographically in 40%. The incidence of short- and long-term
      complications was greater than in other studies. Particularly distressing was the
      58% incidence of heterotopic ossification (HO). Twenty-four percent had grade III
      or IV; five hips were autofused and the remainder had 40-60% loss of motion.
      There was no correlation of HO with age, sex, fracture type, degree of
      comminution, associated femoral head fracture or dislocation, delay to surgery,
      or operative time. However, 26 of 28 patients who had a trochanteric osteotomy as
      part of the operative exposure developed HO. Other complications included wound
      infection (12%), avascular necrosis of the femoral head (10%), nerve palsy (8%),
      and deep vein thrombosis/pulmonary embolism (8%). The data suggest formulation of
      specific treatment protocols, an awareness of surgical risks, and that staff
      specialization may reduce complications and improve outcome. Avoiding a
      trochanteric osteotomy at surgery and using prophylactic postoperative
      irradiation or indomethacin are suggested to reduce HO.

PMID- 1762006
TI  - Pertrochanteric fractures in the elderly: are there indications for primary
      prosthetic replacement?
AB  - During a 10-year period (1978-1988), 565 patients, aged greater than or equal to
      70 years, who sustained a fresh pertrochanteric fracture, were treated in the
      Department of Traumatology at the University Hospitals of Leuven, Belgium. Three
      hundred eighty-eight fractures were complex and unstable, according to the Evans
      Jensen system and the AO system. Special attention was given to the 324 cases of
      type IC and ID in Evans' system, type A2 in the AO system. The method of
      treatment changed greatly during the period of study. All patients were followed
      prospectively during 1 year. Our study showed that for these unstable fractures,
      fixation with an angled plate or Ender nails should be forsaken. The overall
      results of the compression hip screw treatment were good (reoperation rate 2%,
      good functional results in 64%), but as this treatment has a risk for serious
      collapse and pain in about 80% of all type ID fractures, one could suggest
      treating these complex multifragment fractures primarily with an endoprosthesis.
      This treatment need no longer be considered severe intervention, as the danger of
      mechanical complications is minimal (less than 1%).

PMID- 1762007
TI  - Treatment of intertrochanteric fractures: comparison of Ender nails and sliding
      screw plates.
AB  - The results of two fixation devices for the treatment of intertrochanteric
      fractures were compared in 220 patients--163 women and 57 men with a mean age of
      81 +/- 10 years. One hundred and one patients were randomized to Ender nailing
      and 119 to fixation with a sliding screw plate (SSP). The two treatment groups
      were equal with respect to important preinjury variables. The two methods did not
      differ in operating time or perioperative blood loss. The proportions of good
      reduction of the fractures and of good positioning of the internal fixation
      devices were equal in the two groups. But the complication rate and the
      reoperation rate were more than twice as high in the Ender group than in the SSP
      group. The outcome at 1-year follow-up was approximately equal in the two groups.

PMID- 1762008
TI  - Subtrochanteric femur fractures: a comparison of the Zickel nail, 95 degrees
      blade plate, and interlocking nail.
AB  - Seventy-nine nonconsecutive patients with subtrochanteric femur fractures were
      divided into three groups based on the method of fracture fixation. Group I
      consisted of 21 patients treated with a Zickel nail, Group II comprised 25
      patients treated with a 95 degrees blade plate, and Group III included 33
      patients treated with an interlocking nail. All patients in Group I and Group II
      had open reduction and internal fixation of their fractures. Ninety-four percent
      of the patients in Group III were treated by closed intramedullary nailing. The
      average operating times for Groups I, II, and III were 212, 272, and 181 min,
      respectively, while blood loss averaged 900, 1,500, and 600 ml for each group,
      respectively. Group I had one infection, ten malunions, and one nonunion. Group
      II had one infection, six malunions, and two nonunions. Group III had no
      infections, two malunions, and one nonunion. We conclude that closed interlocking
      nailing is the treatment of choice for acute nonpathologic subtrochanteric femur
      fractures in adults. There is decreased blood loss, reduced operating time, and
      fewer complications than with either the Zickel nail or the 95 degrees blade
      plate regardless of the fracture pattern or the degree of fracture comminution.

PMID- 1762009
TI  - The effect of autogenous bone graft application on wound contamination.
AB  - A rat model was created in which contaminated wounds were closed in either the
      presence or absence of autogenous bone graft. The recipients of bone graft were
      divided into two groups--one receiving autogenous cancellous bone, the other
      receiving nonviable autogenous autoclaved cortical bone. Quantitative bacterial
      cultures were collected both at the time of wound closure and 2 weeks after
      closure. A significantly increased level of soft-tissue contamination was
      associated with wound closure in the presence of either type of bone graft,
      indicating an overall adverse effect on soft tissues. A critical level existed
      such that at initial bacterial contamination levels greater than 10(4)
      organisms/g tissue, final contamination levels were significantly elevated. With
      initial contamination levels less than 10(4) organisms/g tissue, however, final
      bacterial contamination levels were not significantly different. These results
      may help explain the different rates of infection that have been reported when
      delayed primary closure of open fractures is done in conjunction with autogenous
      bone graft.

PMID- 1762010
TI  - Harvesting of autogenous cancellous bone graft from the proximal tibial
      metaphysis. A review of 230 cases.
AB  - A study was undertaken to review the results of donor site morbidity of
      cancellous bone grafts obtained from the proximal tibial metaphysis. Two hundred
      six patients who underwent 230 proximal tibial bone graft harvestings were
      reviewed. Patients with lower-extremity fractures or nonunions who required
      cancellous bone grafts and would be non-weight-bearing for at least 6 weeks were
      selected to undergo the procedure. Minimum length of follow-up was 4 months, with
      an average length of follow up of 20.4 months. The proximal tibial metaphysis was
      found to supply an adequate amount of graft for all procedures involved, with a
      complication rate related to graft donor site of 1.3%. This compares favorably to
      a previously published report on bone grafts taken primarily from the iliac
      crest. The postoperative appearance of the proximal tibia may be permanently
      altered by the procedure, but weight-bearing after 6 weeks appears safe. The
      proximal tibial metaphysis is a useful site for obtaining cancellous bone graft
      and is associated with a low morbidity.

PMID- 1762011
TI  - Type III fractures of the tibial tubercle in adolescents.
AB  - Fifteen patients with Type III avulsion fractures of the tibial tubercle treated
      surgically were reviewed at an average of 9.6 years after injury. Six patients
      had a history of Osgood-Schlatter disease, and two patients had Type I
      osteogenesis imperfecta. Associated injuries to the meniscus were found and
      repaired in three patients. Two of these patients had also avulsed the origin of
      the tibialis anterior muscle, leading to a compartment syndrome in one. All but
      one fracture healed. There was one refracture. Five patients developed bursitis
      over prominent screw heads, which required screw removal. All but two patients
      were asymptomatic and participated in sports. A full range of knee motion without
      instability was present in all patients. Thigh and calf circumferences were equal
      to the opposite side. Radiographs showed normal knee joints in all but one
      asymptomatic patient, who showed signs of an early arthrosis. No patient
      developed angular or recurvatum deformities. However, a leg-length discrepancy of
      1.0-1.8 cm was noted in four patients (two overgrowth, two undergrowth).

PMID- 1762012
TI  - An investigation of the contribution of the extraosseous tissues to the
      diaphyseal fracture callus using a rabbit tibial fracture model.
AB  - The contribution of the extraosseous tissues to diaphyseal fracture healing was
      investigated using a new fracture model. A transverse osteotomy of the tibial
      diaphysis of 18 New Zealand White rabbits was reamed and nailed, and a 2-cm
      length of the periosteum was excised from either side of the osteotomy. Healing
      was studied by radiography and by haematoxylin/eosin histology at intervals over
      2 weeks. None of the osteotomies had united at the end of the observation period.
      Within days, cellular activity was observed in the remnant of the periosteum,
      which subsequently resulted in cartilage and bone formation. The repair tissue
      derived from the periosteum advanced in the direction of the osteotomy site. The
      extraosseous tissues did not appear to contribute significantly to the fracture
      callus.

PMID- 1762013
TI  - Induction and prevention of pin loosening in external fixation: an in vivo study
      on sheep tibiae.
AB  - In external fixation of fractures, pin loosening is a major concern. Preloading
      the pins is generally done to ensure their stability within the bone cortex. The
      effect of radial preload and bending preload in reducing resorption at the
      pin/bone interface was tested. Schanz screws were fixed to live sheep tibiae
      using a pneumatically operated external fixator frame. Evaluation was based on
      radiological observation and fluorochrome histology using sequential labels.
      Though not completely absent, bone resorption was minimal in the radial preload
      group, compared with the two other groups. More important, the bone-to-pin
      contact surface in the radial preload group was found to be almost intact after 5
      weeks. In this study, radial preload appears to be superior to bending preload in
      terms of minimizing the problems of pin loosening.

PMID- 1762014
TI  - External fixation of the sternum for thoracic trauma.
AB  - A flail chest with a manubriosternal separation in a man with multiple injuries
      was treated with an external fixator applied to the sternum and the manubrium.
      Pain and ventilatory function were improved, permitting immediate postoperative
      extubation and prompt patient mobilization. The external fixator was removed
      after fracture union at 2 months. One year after injury, the patient's pulmonary
      function was normal. External fixation is an alternative to other methods of
      sternal fracture stabilization.

PMID- 1762015
TI  - Unilateral lumbosacral facet joint dislocation associated with vertical shear
      sacral fracture.
AB  - An 18-year-old woman involved in a motor vehicle accident sustained a vertical
      shear fracture of the sacrum accompanied by unilateral dislocation of the L5-S1
      joint. Evaluation of the patient's injuries was defined by computed axial
      tomography. Through a posterior midline incision, open reductions of the
      dislocated L5-S1 joint and of the sacral fracture were performed. Reduction was
      followed by anterior stabilization of the symphysis pubis. The patient remained
      neurologically intact after surgery.

PMID- 1762016
TI  - Fixation of a fracture of the femoral head with preservation of remaining soft
      tissue attachments.
AB  - Residual soft-tissue attachments may provide a blood supply to femoral head
      fragments after fractures associated with traumatic dislocation of the hip. Screw
      fixation of these fractures without sacrifice of the attachments can prove to be
      difficult. A case is presented using a method of fixation--not, to my knowledge,
      previously reported--that preserves these attachments and facilitates subsequent
      removal of metalware.

PMID- 1762017
TI  - Technique for treatment of a bent Russell-Taylor femoral nail.
AB  - A case is presented in which a 14-mm Russell-Taylor intramedullary nail, placed
      to secure a right femoral shaft fracture, was deformed 22 months postoperatively
      by subsequent trauma. The nail was straightened in situ, removed, and replaced
      with a larger nail. The femur subsequently healed without complication.

PMID- 1762018
TI  - Migration of a screw from a plated femur into the knee joint 22 years
      postoperatively.

PMID- 1762019
TI  - Open tibia fracture caused by femoral shaft fragment.
AB  - Open tibia fractures and open femoral shaft fractures are commonplace in today's
      motorized society. We report a unique combination of injuries sustained by two
      patients treated at our institution.

PMID- 1762020
TI  - Orofacial functions in patients with congenital and acquired maxillary defects: a
      fluoroscopic study.
AB  - By means of videofluoroscopic recordings, chewing, swallowing and speech were
      monitored in nine patients with congenital and acquired maxillary defects. All of
      them were rehabilitated with a maxillary obturator prosthesis. The defective
      region was seldom used for chewing. No leakage between the obturator and
      surrounding tissue was observed, either for solids or for liquids. All of the
      prosthetic reconstructions were surprisingly stable during function. In the
      phonetic analysis, speech production was judged to be restored almost to normal.
      Videofluoroscopy may be valuable as a complement to other functional diagnostic
      procedures, and for the evaluation and improvement of rehabilitation with an
      obturator prosthesis.

PMID- 1762021
TI  - The relationship between failure and design in conventional bridgework from
      general dental practice.
AB  - A total of 142 failed bridges constructed in general dental practice were
      assessed for design factors that might relate to failure. The overall mean age of
      the bridges at failure was 6.2 years; anterior and complex bridgework had a mean
      age of about 5 years, compared with 7.5 years for posterior bridges. The lifespan
      of the bridgework was significantly correlated with the number of retainers but
      not with the number of units. Bridges with one or two retainers had an average
      lifespan of just over 7 years, whilst those with three or more retainers had been
      in service for, on average, only 4 years. The practical difficulties of
      constructing multi-abutment bridgework could account for this difference. One
      hundred and ninety-one of the 346 retainers were porcelain bonded to semi non
      precious metal crowns, and had a mean lifespan of 3.7 years, whilst those that
      were gold based lasted at least twice as long. Post crowns as retainers survived
      on average for 6.2 years.

PMID- 1762022
TI  - Mandibular manipulation of anterior disc displacement without reduction.
AB  - The history and clinical symptoms of anterior temporomandibular joint disc
      displacement without reduction are characteristic, and include limitation of
      mandibular movement and mandibular deviation on opening of the mouth. Twelve
      consecutive patients attending a clinic with such symptoms were treated by
      mandibular manipulation. An immediate increase in the range of mandibular
      movement was obtained for all patients, with a mean increase in interincisal
      opening of 8 mm. The method of manipulation is described, and the implications of
      the results for the treatment of TMJ patients are discussed.

PMID- 1762023
TI  - Tooth enamel softening with a cola type drink and rehardening with hard cheese or
      stimulated saliva in situ.
AB  - The in-situ remineralization effect of hard cheese was compared with that of
      saliva on tooth enamel in man. The intra-oral test of softening enamel surfaces
      by a cola type drink followed by rehardening by chewing hard cheese and/or
      parafilm was assessed by microhardness and SEM measurements. Cheese consumption
      significantly increased the enamel hardness, whereas stimulated saliva did not
      have this effect. The remineralizing effects are presumably due to uptake of
      calcium and phosphate salts by the surface enamel. Morphologically, the enamel
      surfaces did not return to their original state.

PMID- 1762024
TI  - Effects of phosphoric acid and tannic acid on dentine collagen.
AB  - We examined the effects of phosphoric acid, the most common enamel etchant in
      composite resin therapy, on dentine collagen. Dentine collagen pretreated with 7M
      phosphoric acid was shown to be more susceptible to trypsin digestion than
      untreated collagen. This susceptibility increased with increasing duration of
      exposure to the acid. The results indicate that phosphoric acid induces a
      conformational change in dentine collagen (denaturation or perturbation) similar
      to that observed with 0.39 M HCl, which has a similar pH value (0.65). However,
      phosphoric acid-pretreated dentine collagen, when treated with tannic acid for 2
      h, became as resistant to tryptic digestion as intact dentine collagen. The
      present results suggest that tannic acid may work as a dentine conditioner in
      composite resin therapy, in view of the fact that phosphoric acid etchant is
      applied, either deliberately or inadvertently, to dentine, and would thus induce
      denaturation or perturbation of collagen.

PMID- 1762025
TI  - In-vitro study to compare the efficacy of N-monochloro-D,L-2-aminobutyrate (NMAB,
      GK-101E) and water in caries removal.
AB  - The present in-vitro study was designed to investigate the chemical efficacy of N
      monochloro-D,L,-2-aminobutyrate (NMAB, GK 101E) in removing carious material
      under clinically relevant conditions, using objective methods of measurement.
      Assuming that the chemical effectiveness of water in caries removal is minimal, a
      comparison of the efficacy of GK-101E with that of water was made. The force
      required to achieve complete caries removal from symmetrically separated carious
      lesions was determined with the Caridex system, modified by a force gauge. One
      lesion half was treated with GK-101E, while the corresponding half was treated
      with water. Thus a difference in the chemical potential of the fluids in
      softening carious material should lead to a difference in the force required to
      remove equal quantities of caries. Statistical analysis of the findings of the
      present study revealed no significant difference between GK-101E and water, with
      regard to both the force and the number of excavation strokes and the time needed
      for caries removal. It is concluded that, under the given test conditions, the
      removal of carious dentine is not significantly enhanced by the chemical action
      of GK-101E.

PMID- 1762026
TI  - Orthognathic diagnosis and treatment planning: a cephalometric approach.
AB  - Cephalometric analyses have long been important diagnostic tools for the
      orthodontic specialist. Such analyses, as they pertain to adult skeletal problems
      and their consequent therapy, should also be a valuable adjunct for various
      dental specialties, e.g. the oral surgical clinician. However, because of the
      complexity of most analyses, it is difficult to glean the important values needed
      for most orthognathic cases. In this article an analysis is presented to aid the
      clinician in surgical diagnosis and treatment planning.

PMID- 1762027
TI  - Defects in automixed addition silicone elastomers prepared by putty-wash
      impression technique.
AB  - Voids presenting in impressions of five automixed addition silicone elastomers
      were investigated. Impressions were prepared with the putty-light body impression
      technique on stainless-steel cylinders with acrylic spacers. The number of voids
      was counted at a predetermined site on three separate days using a
      stereomicroscope at x7 magnification. Impression specimens of a hand-mixed
      addition silicone, and from hand-mixing of the automixed materials, were made for
      comparison. Express gave a significantly higher number of voids than other
      automixed materials, with President Jet having the lowest void count. Automixed
      materials generally produced impressions with significantly fewer voids than the
      hand-mixed material. Automixing was effective in reducing void defects in
      elastomeric impressions.

PMID- 1762028
TI  - Activity index and isometric contraction velocity of human jaw muscles.
AB  - To determine the relative contribution of the masseter and anterior temporalis
      muscles to global isometric bite force, activity indices were constructed on the
      basis of the peak mean voltage (microV) and the integrated voltage (microV.s) of
      bipolar surface electromyograms obtained during brief maximum voluntary teeth
      clenching (MVC). The index that was based on integrated myoelectrical activity
      showed that the masseter muscle contributed the major part of the isometric MVC
      force. The index that was based on instantaneous peak myoelectrical activity also
      showed that activity in the masseter muscle predominated over that in the
      anterior temporalis muscle. In addition, the latter index showed a negative
      linear association with the initial (0-50% MVC) isometric contraction velocities
      of the masseter and anterior temporalis muscles. Both indices appear to be
      promising clinical diagnostic tools.

PMID- 1762029
TI  - Palpation as a method for evaluating occlusal discrepancies.
AB  - In this study, 30 dentists were surveyed about their methods of palpating teeth
      for the evaluation of premature contacts. Thirty-eight dentists were then tested
      to determine their ability to discriminate degrees of prematurity using each of
      two different methods of palpation. The degree of digital pressure used by each
      dentist during palpation was also measured. The majority of dentists chose the
      same method for palpation: a single forefinger overlaying the facial surfaces of
      the central incisors being evaluated. In the discrimination test, the majority of
      dentists were able to identify reliably occlusal interference of greater than or
      equal to 50 microns regardless of the palpation method used.

PMID- 1762030
TI  - Prevalence of craniomandibular disorders in adults of Ilala District, Dar-es
      Salaam, Tanzania.
AB  - The prevalence and distribution of signs and symptoms of craniomandibular
      disorders (CMD) were studied in a random sample of 100 adult Tanzanians. The
      associations between subjective and objective findings were analysed. Signs and
      symptoms of CMD were assessed by interview and clinical examination. Twenty-six
      per cent of subjects reported at least one symptom, and in 40% at least one
      clinical sign was present. No significant differences were observed between the
      sexes. Tenderness of the lateral pterygoid area and crepitation of the
      temporomandibular joint increased significantly with age. Several significant
      associations between subjective and objective findings were observed. The
      distribution of the signs and symptoms of CMD in Tanzanians was not dissimilar to
      that observed in the developed countries. The prevalence was not high by
      comparison, but sufficient to lend credence to the general view that CMD is a
      universal problem.

PMID- 1762031
TI  - Oncogenes and anti-oncogenes; the molecular basis of tumour behaviour.

PMID- 1762032
TI  - Apoptosis in cultured rat hepatocytes: the effects of tumour necrosis factor
      alpha and interferon gamma.
AB  - We investigated the cytotoxic effects of tumour necrosis factor alpha (TNF alpha)
      and interferon gamma (IFN gamma) on rat hepatocytes in culture. Under phase
      contrast microscopy, we found a small number of dying hepatocytes in control
      cultures, each having been transformed into a cluster of small spheres. Under
      transmission electron microscopy, these cells showed the characteristics of
      apoptosis. TNF alpha and a combination of TNF alpha and IFN gamma exerted a
      cytotoxic effect, whereas IFN gamma showed no significant cytotoxicity when
      assessed by neutral red assay and by measuring LDH activity in culture medium.
      Under phase contrast microscopy, the number of apoptotic cells increased with the
      addition of either TNF alpha or IFN gamma, and markedly with the addition of
      both. DNA extracted from apoptotic cells cultured with TNF alpha and IFN gamma
      was fragmented, and a set of bands of the '200 bp ladder', which is
      characteristic of the DNA of apoptotic cells, was observed in agarose gel
      electrophoresis. These findings indicate that cultured hepatocytes die from
      apoptosis. TNF alpha killed cultured rat hepatocytes by increasing apoptosis, and
      this effect was potentiated by the addition of IFN gamma, which by itself was
      also weakly cytotoxic.

PMID- 1762033
TI  - Recovery from hepatic necrosis following acute portal vein embolism with special
      reference to reconstruction of occluded vessels.
AB  - We examined the morphological and haemodynamic changes in the livers of rats
      following acute obstruction of portal vein branches by the injection of agar into
      the portal vein. Histological and angiographic examinations of the liver were
      performed after measurements of portal vein pressure in vivo and portal vascular
      resistance by an isolated liver perfusion method. Portal vein embolism induced
      hepatic necrosis in the centrilobular and midzonal areas, which was rapidly
      resorbed and replaced by regenerated liver cells leaving no trace. This recovery
      from hepatic necrosis was closely related to recanalization of obstructed portal
      vein branches, which led to falls in both the elevated portal vein pressure and
      the increased portal vascular resistance following embolization.

PMID- 1762034
TI  - An assessment of MAC 387 antibody as a diagnostically useful marker of L1
      epithelial antigen expression by lung tumours.

PMID- 1762035
TI  - Measurement of Breslow depth.

PMID- 1762036
TI  - Publishing clinical papers.

PMID- 1762037
TI  - Biliary atresia.
AB  - Care of the child with biliary atresia is a challenge for pediatric nurses. The
      cause of the disease is not known, and new diagnostic tests and treatment options
      are continually being developed. This article addresses fundamental issues
      specific to the care of children with biliary atresia. In order to understand the
      clinical manifestations and the treatment rationale, pathophysiology and theories
      of etiology are discussed. Nursing care of the child and issues regarding the
      teaching and support of the family system are addressed, with suggestions for
      independent reading.

PMID- 1762038
TI  - The consequence of maternal depression for early mother-infant interaction: a
      nursing issue.
AB  - Adequate mother-infant interaction during the first year of a child's life is
      critical for secure attachment and basic to development of the child's lifelong
      emotional competence. Maternal depression can have decidedly deleterious effects
      on this delicate process. This article will explore the consequences that
      maternal depression can have for early maternal-child interaction. It will offer
      the nurse clinician specific recommendations for assessment and intervention to
      support the normalization of depressed mothers' parenting.

PMID- 1762039
TI  - Achieving excellence in nursing.
AB  - The critical shortage of nurses has placed a heavy burden on managers. Because
      they are responsible for ensuring that pediatric staff members maintain high
      professional standards, the promotion excellence within the staff remains
      imperative; it is essential that managers assist themselves and others to strive
      for excellence. How do you strive for excellence? A commitment to excellence
      requires a lifelong commitment to nursing, research, learning, scholarship, and
      personal balance and well-being. Pursuit of excellence in nursing is difficult,
      especially in a society marked by its satisfaction with mediocrity. Yet by this
      pursuit, not only will the nurse benefit, but so will the staff, the children,
      and maternal-child nursing.

PMID- 1762040
TI  - Conceptions of health and health behaviors of preschool children.
AB  - A modified version of Flaherty's (1986) Preschool Health Picture Interview was
      administered to 30 preschool children to explore their conceptions of health and
      health behaviors. Health was conceptualized as a positive feeling state and the
      ability to participate in desired activities. Brushing teeth and eating were the
      highest ranked health-promotion behaviors. Behaviors harmful to health were
      explained in terms of immediate physical consequences. Responses to all questions
      were predominantly behavioral. A t test showed that the mean number of moral
      responses given by boys to all questions was significantly greater (p = 0.04)
      than the mean number given by girls although no significant differences between
      boys' and girls' responses were found for any subgroup of questions.

PMID- 1762041
TI  - Pediatric staff nurses' reactions to job characteristics.

PMID- 1762042
TI  - Team research: development of "we" in nursing research.
AB  - Team (tem) n. 1. a. Two or more draft animals harnessed to a vehicle or farm
      implement, b. A vehicle along with the animal or animals harnessed to it. 2. A
      group of animals exhibited or performing together. 3. A group of players on the
      same side in a game. 4. Any group organized to work together.

PMID- 1762043
TI  - Prescriptive authority for nurse practitioners: a strategy for improving access
      to child health care.

PMID- 1762044
TI  - The button: replacement gastrostomy device.

PMID- 1762045
TI  - Battered child syndrome: educating the pediatric nurse.

PMID- 1762046
TI  - Pediatric nursing in Japan.

PMID- 1762047
TI  - "Management of the infant with respiratory syncytial virus".

PMID- 1762048
TI  - Nursing responsibility in the diagnosis, care, and treatment of the child with
      gastroesophageal reflux.
AB  - Gastroesophageal reflux (GER) has been known to occur in infants but was thought
      to be normal. As a result of increased recognition of GER and a clear
      documentation of GER with extended (18 to 24 hour) esophageal pH monitoring,
      several severe complications of GER in children have become apparent. An immature
      cardiorespiratory system is susceptible to some complications of GER such as
      apnea, choking, recurrent cough or wheezing, and recurrent aspiration pneumonia.
      Noncardiorespiratory complications include weight loss, esophagitis, anemia,
      irritability, posturing, malnutrition, and developmental delays. Nursing
      assessment contributes to a complete clinical picture and the subsequent
      treatment choice of the physician. To form an accurate assessment of the child
      with suspected GER, the nurse must be aware of the symptoms and complications of
      this condition and must precisely execute diagnostic studies, particularly
      extended esophageal pH monitoring. Nursing responsibilities also include
      providing a safe yet stimulating environment for the child, teaching parents to
      participate in the child's care, supporting parents through hospitalization, and
      preparing both the parents and child for discharge and follow-up care at home.

PMID- 1762049
TI  - [Research and development of pravastatin].
AB  - The attempts to find a potent inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A
      (HMG-CoA) reductase which catalyzes the rate limiting step of cholesterol
      biosynthesis were started from 1971. The first potent inhibitor, ML-236B
      (compactin), was found from the culture broth of Penicillium citrinum. Among many
      derivatives of ML-236B, pravastatin sodium (hereafter refer to pravastatin) was
      finally selected because of its potency and tissue selectivity. Since pravastatin
      has a hydroxyl group at 6 beta position in the skeleton of decaline of ML-236B,
      the microbial hydroxylation was adopted for the production of pravastatin.
      Streptomyces carbophilus was finally chosen as a potent converter with the
      formation of a lesser amount of by-products. For the sake of industrial
      production of pravastatin, many devices and improvements were performed for
      selecting high potent strains and for culturing conditions both with ML-236B and
      pravastatin. Pravastatin strongly inhibited the sterol synthesis in freshly
      isolated rat hepatocytes, but only weakly inhibited in the cells from nonhepatic
      tissues. This selective inhibition of pravastatin in sterol synthesis was further
      confirmed by ex vivo and in vivo experiments by using rats and mice. Pravastatin
      markedly reduced serum cholesterol levels in dogs, monkeys and rabbits, including
      Watanabe heritable hyperlipidemic (WHHL) rabbits, an animal model for familial
      hypercholesterolemia. Pravastatin showed the preventive effect on the development
      of coronary atherosclerosis and xanthoma in young WHHL rabbits in consequence of
      maintaining the serum cholesterol levels low. In the clinical trials, pravastatin
      significantly reduced serum cholesterol and low density lipoprotein cholesterol
      levels, whereas inversely increased high density lipoprotein cholesterol levels.

PMID- 1762050
TI  - [Mammalian cellular phospholipases A2 and their physiological roles].
AB  - Phospholipase A2 hydrolyzes the ester linkage at sn-2 of glycerophospholipids and
      is thought to function as a key enzyme in generation of variety of bioactive
      mediators, such as prostaglandins and platelet-activating factor. In the present
      review, recent studies on two kinds of cellular phospholipases A2, 14 kDa group
      II phospholipase A2 and arachidonate-preferentially hydrolyzing phospholipase A2,
      will be summarized.

PMID- 1762051
TI  - [Monoamine oxidase inhibitory effects of pentanthrene type heterocyclic
      compounds].
AB  - Pentanthrene type heterocyclic compounds, which contain oxazole, isoxazole,
      oxadiazole, thiazole, isothiazole, thiadiazole or pyrrole ring as C-ring, and
      naphthalene, quinoline, isoquinoline or quinoxaline ring as A.B-ring, were
      prepared, and their monoamine oxidase (MAO) inhibitory activities were examined.
      As expected from our previous investigation on the structure-activity
      relationship of this series, most of them showed strong inhibitory potency to
      both MAO-A and MAO-B. However, a few indicated highly selective inhibition for
      either of MAO subtypes.

PMID- 1762052
TI  - [Physiologically active compounds in the extracts from tochukaso and cultured
      mycelia of Cordyceps and Isaria].
AB  - Tochukaso is a Chinese traditional medicine composed of a fruit body of Cordyceps
      sinensis and its parasitic host larva. Tochukaso (C. sinensis) and the cultured
      mycelia of five species of Cordyceps and four species of Isaria were each
      extracted with hot water and examined for the inotropic effect on guinea-pig
      right atrium in vitro system. The extracts from C. militaris and I. felina showed
      a negative inotropic effect to approximately the same extent as that from
      Tochukaso. These three extracts also showed inhibitory action on twitch response
      of guinea-pig ileum and aggregation of human blood platelet. It is suggested that
      these activities are ascribed to the combination of adenosine, 5'-adenosine
      monophosphate and several other nucleic acid-related compounds, all of which have
      been shown to be present in the extracts.

PMID- 1762053
TI  - [Study on fluidized melt-granulation. I. Examination of the factors on the
      granulation].
AB  - The purpose of this study is to develop a new granulation method by using a
      fluidized-bed granulator, which requires a nucleus with a low melting point as a
      binder. This method was named as fluidized melt-granulation. The technique is
      very simple and useful. In this paper, the granulation mechanism and the effect
      of the physico-chemical properties of raw materials on the growth of the granules
      were investigated. The results were as follows: (1) The mixture of the nucleus
      and the other powder particles was heated up to the melting point of the nucleus
      by hot inlet air, immediately resulting in the generation of the adhesion of the
      powders on the melted nucleus. The granules grew as the melted material immersed
      into the void space among the adhered particles. (2) The lower the viscosity of
      the melted nucleus was, the faster the granule grew. (3) The shape and the size
      of the nucleus affected those of the products. (4) The optimum mixing ratio
      between the nucleus and the granulated materials existed and it depended on the
      ratio between the surface areas of these materials.

PMID- 1762054
TI  - [Studies on the metabolic fate of gomisin A (TJN-101). I. Absorption in rats].
AB  - Gomisin A (TJN-101) is one of the lignan components isolated from Schisandra
      Fruits and expected to have some efficacies in clinical treatment of hepatitis.
      The serum concentrations of TJN-101 and Met. B, which was identified as a
      demethylenated substance and one of the major metabolites of TJN-101 in rats,
      were investigated. After intravenous administration at doses of 1.6, 4.0 and 10
      mg/kg of body weight, the serum concentration of TJN-101 decreased biphasically,
      and the terminal elimination half-life at each dose was about 70 min. Dose
      dependency was observed for the area under the concentration-time curve (AUC). On
      the other hand, the serum concentration of TJN-101 increased rapidly and reached
      maximum within 15 to 30 min when administered orally. This result was supported
      by the in situ roop method. The Cmax and the AUC values were not exactly dose
      dependent, but the values increased with a dose-up of TJN-101. The
      biotransformation of TJN-101 to Met. B, was very rapid in both intravenous and
      oral administrations. The AUC value of Met. B after oral administration of TJN
      101 at a dose of 1.6 mg/kg was relatively larger than any other dosages. It
      suggested that TJN-101 was extensively underwent the first pass effect in rats.
      More than 80% of TJN-101 was bound with rat serum protein in vitro and in vivo.
      Therefore, it seems to be necessary to pay attention when it was administered
      concurrently with high protein binding drugs.

PMID- 1762055
TI  - [Studies on the metabolic fate of gomisin A (TJN-101). II. Absorption and
      excretion in CCl4 treated rats].
AB  - The absorption and excretion of gomisin A (TJN-101) in rats whose livers were
      injured by carbon tetrachloride (CCl4) were investigated. After intravenous
      administration of TJN-101 at a dose of 5 mg/kg, the terminal elimination half
      life was 1.5 h in the CCl4-treated rats, which was two times that in normal rats.
      The mean area under the blood concentration-time curve (AUC) value of TJN-101 in
      the CCl4-treated rats was twice that in normal rats, and this difference was
      significant (p less than 0.05). Therefore, the total body clearance of TJN-101 in
      the CCl4-treated rats decreased less than half of that in normal rats. Similar
      results were observed when it was administered orally. In the CCl4-treated rats,
      the serum concentration of Met. B, which was identified as a demethylenated
      substance and one of major metabolites, tended to decrease more than that in
      normal rats. On the other hand, the cumulative biliary excretion ratio of TJN-101
      in 24 h after dosing in the CCl4-treated rats was 2.5 times that in normal rats.
      The excretion rate of Met. B in the bile in the CCl4-treated rats tended to be
      delayed. However, the quantitative variance of biliary excretion of Met. B was
      not found in both groups. The urinary excretion of TJN-101 or Met. B in 72 h
      after dosing in the CCl4-treated rats was lower than that in normal rats. Similar
      results were also observed in excretion in the feces.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1762056
TI  - [High performance liquid chromatographic analysis of typical ultraviolet
      absorbers in cosmetic products].
AB  - Typical 11 ultraviolet (UV) absorbers in cosmetic products were separated and
      determined by high performance liquid chromatography. The recommended conditions
      for the analysis were as follows: column, 4.6 mm i.d. x 250 mm, Capcell Pak C18
      SG (5 microns); detector, UV spectrophotometer (280 nm); column temperature, 40
      degrees C; mobile phase, H2O-CH3OH (15:85 v/v) containing 3 mM stearyltrimethyl
      ammonium chloride; flow rate, 1.0 ml/min. In the case of the products containing
      2-ethylhexyl p-methoxycinnamate (OMC) and/or 4-tert-butyl-4'
      methoxydibenzoylmethane (BMD), it was necessary to use H2O-1,4-dioxane (34:66
      v/v) containing 6 mM stearyltrimethyl ammonium chloride as the mobile phase in
      order to separate OMC and BMD. Anthracene and 9,10-dimethylanthracene were used
      as an internal standard for the H2O-CH3OH mobile phase and the H2O-1,4-dioxane
      mobile phase, respectively. Calibration curves were linear within a range of 50
      150 micrograms/ml for the 11 UV absorbers. Recoveries and reproducibilities of
      the method were satisfactory. By using this method, typical UV absorbers in
      several commercial cosmetic products such as lip creams, sun oils, lotions and
      emulsions were able to be rapidly determined without any interference.

PMID- 1762057
TI  - SC-46275: a potent, long-acting gastric antisecretory prostaglandin with low oral
      bioavailability in the dog.
AB  - The synthetic prostaglandin, SC-46275, an omega chain cyclopentenyl analog of
      enisoprost, was studied to determine its gastric antisecretory potency and
      duration of action in meal-stimulated innervated (Pavlov) pouch dogs and its p.o.
      bioavailability in unoperated fasted dogs. SC-46275 exhibited potent
      antisecretory activity when administered directly into the gastric pouch, the
      ED50 being 0.01 micrograms/kg. It had a long duration of antisecretory action;
      significant (P less than or equal to .05) inhibition of total acid output was
      observed 16 hr after intrapouch administration of 0.03 micrograms/kg. At this
      dose p.o., neither SC-46275 nor its free acid metabolite was detected in plasma.
      These data indicate that SC-46275 has novel properties: it is a potent, long
      acting gastric antisecretory agent which is not readily available systemically
      after p.o. administration. Thus, potential systemic side effects are expected to
      be absent or minimized at doses of SC-46275 which inhibit gastric acid secretion,
      and therefore it might be useful in peptic ulcer disease.

PMID- 1762058
TI  - Is staurosporine a specific inhibitor of protein kinase C in intact porcine
      coronary arteries?
AB  - We assessed the specificity of staurosporine, a putative protein kinase C
      inhibitor, for the enzyme in intact porcine coronary arteries by examining its
      effects on changes in intracellular free calcium level ([Ca++]i) and force
      induced by a phorbol ester, high KCl and caffeine. [Ca++]i was measured
      simultaneously with force by the fura-2 microfluorimetric method. Phorbol 12,13
      dibutyrate (PDBu, 10(-6) M) produced a slowly developing and sustained
      contraction; however, [Ca++]i only increased slightly and transiently in the
      initial phase and then decreased gradually. On the other hand, 90 mM KCl elicited
      a contraction with a sustained increase in [Ca++]i. Staurosporine (10(-10) to 10(
      7) M) applied 20 min before the addition of PDBu inhibited the PDBu-induced
      changes in [Ca++]i and force in a concentration-dependent manner. In contrast,
      staurosporine only at 10(-7) M reduced an increase in [Ca++]i and contractile
      force produced by 90 mM KCl. The inhibitory effects of staurosporine on PDBu- and
      KCl-induced contractions depended on exposure time. The [Ca++]i-force
      relationship obtained with variable concentrations of KCl was shifted slightly to
      the right by staurosporine at 10(-7) M. Furthermore, staurosporine even at 10(-7)
      M did not affect an increase in [Ca++]i by caffeine (25 mM), although it slightly
      attenuated a caffeine-induced contraction. These results suggest that
      staurosporine is a relatively specific inhibitor of protein kinase C in intact
      arteries at lower concentrations. At higher concentrations it may have actions
      unrelated to its inhibitory effect of protein kinase C, which include the
      inhibition of calcium influx into smooth muscle cells through the voltage
      dependent Ca++ channel.

PMID- 1762059
TI  - Central and peripheral injections of the 5-HT2 agonist, 1-(2,5-dimethoxy-4
      iodophenyl)-2-aminopropane, modify cardiovascular function through different
      mechanisms.
AB  - The mechanisms underlying the cardiovascular effects of central and peripheral
      administration of the 5-HT2 (serotonin) receptor agonist (+-)-1-(2,5-dimethoxy-4
      iodophenyl)-2-aminopropane hydrochloride (DOI) were studied in conscious rats.
      Intravenous (10-1000 nmol/kg) and i.c.v. (3-300 nmol) administration of DOI
      produced dose-related elevations of arterial pressure without altering heart rate
      except after injection of the highest doses. Pretreatment with xylamidine
      tosylate, a 5-HT2 receptor antagonist that does not cross the blood-brain
      barrier, blocked the pressor response to i.v., but not i.c.v., administration of
      equivalent doses of DOI. Pretreatment with the vasopressin receptor antagonist
      d(CH2)5Tyr(Me)AVP significantly reduced the pressor response to i.c.v., but not
      i.v., administration of DOI. Prior ganglionic blockade with chlorisondamine
      amplified the pressor response to both i.v. and i.c.v. administration of DOI.
      Pretreatment with a combination of chlorisondamine, xylamidine and
      d(CH2)5Tyr(Me)AVP abolished the pressor response to i.c.v. administration of DOI.
      Thus, the pressor response to i.v. administration of DOI was mediated at sites
      outside the blood-brain barrier, most likely at vascular 5-HT2 receptors, and was
      not secondary to vasopressin release. Inappropriate heart rate changes attended
      the pressor responses to i.v. administration of DOI, suggesting an action at
      extravascular sites. The pressor response to i.c.v. administration of DOI
      resulted from a combination of vasopressin release, modulation of autonomic
      nervous outflow and some leakage into the periphery.

PMID- 1762060
TI  - Presystemic acetylation of platelets by aspirin: reduction in rate of drug
      delivery to improve biochemical selectivity for thromboxane A2.
AB  - The utility of aspirin in the treatment of vascular occlusive disease has been
      ascribed to its blockade of platelet thromboxane A2 (TxA2), a potent inhibitor of
      vascular smooth muscle contraction and platelet aggregation. Coincident with the
      inhibition of TxA2 by aspirin at currently used dose regimens is a decrease in
      formation of prostacyclin (PGI2), an eicosanoid with opposing effects to TxA2 in
      vivo. The coincident inhibition of PGI2 could potentially limit the therapeutic
      efficacy of aspirin. This study addressed the issue as to whether a reduction in
      the rate of drug delivery could enhance the biochemical selectivity of aspirin
      toward inhibition of TxA2. Intubation studies were performed in parallel groups
      of healthy volunteers in which a 50-mg aspirin dose was administered as either a
      bolus or a 5 or 10 mg/hr infusion via a nasogastric tube. A control group
      received buffer solution. Systemic plasma levels of aspirin, major urinary
      metabolites of TxA2 and PGI2 and serum thromboxane B2 levels ex vivo were
      evaluated. Relative to the group receiving bolus aspirin, the slower rates of
      aspirin delivery increased the effective selectivity of the administered aspirin
      for TxA2. To investigate further this apparent selectivity, controlled release
      (CR) dose forms of aspirin were prepared and evaluated in a preliminary dose
      ranging study in healthy subjects. The doses studied were 50 and 75 mg CR and a
      75-mg aspirin solution. The CR aspirin dose forms decreased the maximal plasma
      concentration of aspirin relative to a bolus dose. The pharmacodynamic effects of
      the CR formulations were assessed via measurement of ex vivo serum thromboxane B2
      formation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762061
TI  - Stimulation of sodium transport by duramycin in cultured human colonic epithelia.
AB  - Effects of two peptide antibiotics, duramycin and Ro 09-0198, on ion transport in
      cultured human colonic epithelia were investigated. Both peptides acted on the
      apical face of epithelial monolayers, causing an increase in ion transport
      measured as short circuit current. Concentration-response relationships were
      complex, because above a concentration of 2 to 5 microM, the peptides caused
      currents either to decline toward zero or become large and unstable. Ion
      substitution experiments showed that the majority of the current response was due
      to electrogenic sodium absorption. An outward chloride current could also be
      induced by duramycin, provided an outwardly directed chloride gradient was
      imposed. It was also shown that the peptides could increase [Ca]i, probably by
      creating entry sites in the apical face. Duramycin was also able to create large
      conductance (2000 pS) channels in "black" lipid bilayers. It is proposed that the
      antibiotics interact with membrane lipids in the apical faces of colonic
      epithelia to create artificial nonspecific ion channels. The prevailing
      electrochemical gradients which exist when the epithelia are bathed symmetrically
      in Krebs-Henseleit solution result in increased electrogenic sodium transport. No
      evidence was found for colonic epithelia that duramycin or Ro 09-0198 interacted
      specifically with either membrane channels or receptors to increase ion
      transport.

PMID- 1762062
TI  - Activities of lung NADPH-cytochrome C-reductase and of cytochrome P-450
      peroxidase during the protection of rat from hyperoxic injury by polyriboinosinic
      acid-polyribocytidilic acid.
AB  - Rats exposed to normobaric oxygen received a single i.p. injection of 2.5 mg/kg
      of poly I: poly C at various times (-120 to +36 h) before and after the beginning
      of oxygen exposure. Hyperoxic lung damage and modifications in cytochrome P-450
      system components were evaluated. Our results confirmed the protective effect of
      poly I: poly C on rats exposed to oxygen, reducing the lung edema and the
      mortality. This effect was only observed when poly I: poly C was injected 48 or
      36 h before the beginning of oxygen exposure. Although oxygen exposure per se
      decreased the total level of lung cytochrome P-450, poly I: poly C per se induced
      a deeper decrease to levels similar in air- or oxygen-exposed rats. Poly I: poly
      C did not modify the NADPH-cytochrome c reductase level nor the cytochrome P-450
      peroxidase activity in air-exposed rats. The oxygen exposure induced a decrease
      of these two enzymes, either in the absence or in the presence of poly I: poly C,
      except when poly I: poly C was injected 48 or 36 h before the beginning of oxygen
      exposure, times at which poly I: poly C restored the enzymatic values measured in
      rats exposed to air. Because the times of injection of poly I: poly C were those
      at which the protective effect was observed, it suggested that the protective
      effect of poly I: poly C against oxygen toxicity was associated with a lack of
      oxygen-induced decrease of both the lung NADPH-cytochrome c reductase level and
      the lung cytochrome P-450 peroxidase activity.

PMID- 1762063
TI  - Imipramine as a discriminative stimulus.
AB  - The tricyclic antidepressant imipramine was established as a discriminative
      stimulus in pigeons at two doses (3.0 or 5.6 mg/kg). Because imipramine has
      multiple effects on different neurotransmitter systems, a range of compounds from
      several pharmacological classes were tested for substitution. The tricyclic
      antidepressants desipramine, amitriptyline and doxepin, all of which block
      serotonin (5-HT) and norepinephrine (NE) reuptake, resulted in imipramine-key
      responding. The psychomotor stimulants cocaine and d-amphetamine also occasioned
      responding on the imipramine key, as did the NE reuptake inhibitor tomoxetine;
      nomifensine, which blocks the reuptake of both NE and dopamine (DA), also
      resulted in responding on the key correlated with imipramine injections.
      Bupropion, a DA reuptake inhibitor, resulted in drug key responding but
      substitution did not occur with another DA uptake inhibitor GBR 12909. The alpha
      2 agonist clonidine, the 5-HT2 antagonist ritanserin or the 5-HT reuptake
      inhibitor fluoxetine also did not occasion drug-key responding. Drug-appropriate
      responding occurred in pigeons trained at the lower dose of imipramine with the 5
      HT1A compounds 8-hydroxy-2-(di-n-propylamino)tetralin hydrobromide and gepirone;
      partial substitution occurred in pigeons trained with the higher dose of
      imipramine. Substitution for the imipramine stimulus by gepirone, an
      antidepressant with actions mediated by the 5-HT1A receptor, as well as with 8
      hydroxy-2-(di-n-propylamino)tetralin hydrobromide, suggests that imipramine may
      have effects at this receptor site and confirms reports that compounds active at
      this receptor may have antidepressant activity. This appears to be the first
      report of the successful, long-term establishment of imipramine as a
      discriminative stimulus without the development of toxicity.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1762064
TI  - Effects of GABA in the morphine-tolerant longitudinal muscle, myenteric plexus
      preparation of the guinea pig.
AB  - The effect of chronic treatment with morphine via pellet implantation on the
      sensitivity of the longitudinal smooth muscle-myenteric plexus of the guinea pig
      ileum to the contractile effects of gamma-aminobutyric acid (GABAA)-receptor
      agonists was assessed. GABA and muscimol elicited concentration-dependent
      contractions of the longitudinal smooth muscle which were due to the release of
      acetylcholine because the contractile effects were markedly attenuated by
      atropine (10 nM). The contractile action of GABA agonists does not involve an
      intermediate step mediated by nicotinic receptors because the concentration
      response curves for GABA were unaffected by hexamethonium (1 mM). Bicuculline (10
      microM) produced nearly equivalent rightward shifts of the concentration-response
      curves for both GABA and muscimol, indicating mediation of the contractile
      effects of these agents by GABAA receptors. Chronic exposure to morphine via
      pellet implantation did not alter the sensitivity of this preparation to either
      GABA or muscimol. This is in contrast to the development of supersensitivity of
      the longitudinal smooth muscle-myenteric plexus to other excitatory agonists
      (nicotine, 5-hydroxytryptamine and potassium), which accompanies the development
      of tolerance to opioids. GABA induces depolarization of myenteric neurons that is
      observed most prominently in AH neurons and rarely in S neurons. The stimulatory
      effects of nicotine and of GABA were inhibited by morphine (a predominantly mu
      opioid agonist) and by U50,488H (a predominantly kappa opioid agonist). The
      results are discussed within the context that supersensitivity to neuronal
      stimulants of the myenteric plexus in morphine-tolerant preparations is limited
      to substances which depolarize S neurons.

PMID- 1762065
TI  - Distribution and analgesia of [3H][D-Pen2, D-Pen5]enkephalin and two halogenated
      analogs after intravenous administration.
AB  - To improve pharmacological characteristics of the delta-selective, cyclic peptide
      [D-Pen2, D-Pen5]enkephalin (DPDPE), modification by halogenation at the Phe4
      residue was undertaken. The present study was to determine the extent [3H]DPDPE,
      [3H][p-Cl-Phe4]DPDPE and [p-125IPhe4]DPDPE crosses the blood-brain barrier,
      elicits analgesia and to characterize selective organ distribution and stability
      after i.v. administration. A significantly greater percentage of total [3H][p-Cl
      Phe4]DPDPE reached the brain after 10, 20 and 40 min as compared to [3H]DPDPE and
      both peptides were significantly displaced by pretreatment with naloxone or
      naltrindole. The amount of [3H]DPDPE detected in the brain was greater than that
      of [p-125IPhe4]DPDPE. Distribution results revealed large amounts of the
      administered peptides were sequestered rapidly in the gall bladder and secreted
      into the small intestine. Hot-plate antinociception tests 5 min after i.v.
      administration (30 and 60 mg/kg) revealed [p-Cl-Phe4]DPDPE to elicit a much
      greater analgesic effect as compared to DPDPE or [p-125IPhe4]DPDPE. These results
      provide evidence that [p-Cl-Phe4]DPDPE has a greater apparent distribution to the
      brain and has a greater effect on the antinociception threshold as tested on the
      hot-plate than DPDPE or [p-125IPhe4]DPDPE. Stability of unlabeled and tritiated
      DPDPE and [p-Cl-Phe4]DPDPE was determined both in vitro and in vivo; both
      unlabeled and tritiated DPDPE and [p-Cl-Phe4]DPDPE remain intact.

PMID- 1762066
TI  - [3H]tetraphenylphosphonium accumulation in cerebral cortical synaptosomes as a
      measure of nicotine-induced changes in membrane potential.
AB  - The effect of nicotine on synaptosomal membrane potential in P2 preparations of
      rat cerebral cortex was investigated using a membrane permeant, lipophilic
      cation, [3H]tetraphenylphosphonium ([3H]TPP+). [3H]TPP+ accumulated in
      synaptosomes in a time-dependent manner and its accumulation was decreased when
      the extracellular potassium concentration was increased and in the presence of
      the sodium channel toxin, veratridine. Nicotine (1-1000 microM) decreased the
      accumulation of [3H]TPP+ in both P2 synaptosomal preparations and in synaptosomes
      purified using Percoll gradients. This effect of nicotine was mimicked by other
      nicotinic agonists (1,1-dimethyl-4-phenylpiperazinium iodide, cytisine,
      suberyldicholine and acetylcholine) and was partially blocked by 10 microM
      mecamylamine and 30 microM hexamethonium. Atropine (1 microM) and the removal of
      calcium from the incubation mixture both enhanced the effect of nicotine while
      the addition of physostigmine (10 microM) reduced the nicotine-induced decrease
      in [3H]TPP+ accumulation, evidence that acetylcholine released from the
      synaptosomes by nicotine may produce hyperpolarization of synaptosomes via
      stimulation of presynaptic muscarinic receptors. It is concluded that the effect
      of nicotine on [3H]TPP+ accumulation is mediated by nicotine stimulation of a
      ganglionic-type nicotinic cholinergic receptor and that this method of
      determining synaptosomal membrane potential will provide a functional measure of
      presynaptic nicotinic receptor activation.

PMID- 1762067
TI  - Stereoselective metabolism of ibuprofen in humans: administration of R-, S- and
      racemic ibuprofen.
AB  - Using stable isotope methodology, we studied the effect of the enantiomeric
      composition of dosage form on ibuprofen metabolism. Eight healthy human subjects
      received racemic ibuprofen (800 mg) plus S-[aromatic-2H4]ibuprofen (10 mg), R
      ibuprofen (600 mg) plus S-[aromatic-2H4]ibuprofen (10 mg) and S-ibuprofen (600
      mg) orally on separate occasions in random order. Stereoselective gas
      chromatography-mass spectrometry was used to quantify deuterated and
      nondeuterated ibuprofen in serum up to 24 h postdose. Urinary excretion of the
      stereoisomeric forms of carboxyibuprofen, hydroxyibuprofen and ibuprofen
      glucuronide were determined up to 24 h postdose by stereoselective high
      performance liquid chromatography. The metabolism of ibuprofen enantiomers was
      not influenced by the enantiomeric composition of the dose. For racemic
      ibuprofen, the mean clearances (+/- S.D.) of S-ibuprofen, R-ibuprofen inversion
      and R-ibuprofen noninversion were 87.4 +/- 25.9, 57.3 +/- 31.0 and 56.3 +/- 29.0
      ml/min, respectively. The fractional inversion of ibuprofen was significantly
      greater (P less than .05) using the stereochemical composition of the urinary
      metabolites (0.63 +/- 0.05) vs. the method using the clearance of deuterated S
      ibuprofen (0.51 +/- 0.08) after the dose of racemate. Unreliable estimates of
      fractional inversion were obtained when the S-ibuprofen and racemic ibuprofen
      doses were combined. Metabolite formation clearances suggested that S-ibuprofen
      is preferred over R-ibuprofen in the formation of hydroxyibuprofen,
      carboxyibuprofen and ibuprofen glucuronide. Product stereoselectivity in the
      formation of the four diastereomers of carboxyibuprofen was modest in favor of SS
      and RR-carboxyibuprofen for S- and R-ibuprofen, respectively.

PMID- 1762068
TI  - The reinforcing and subjective effects of morphine in post-addicts: a dose
      response study.
AB  - The reinforcing and subjective effects of morphine were determined in five human
      volunteers with histories of i.v. heroin abuse. Subjects responded under a second
      order schedule of i.m. injection. Under this schedule, every 100 lever presses
      produced a brief stimulus light [fixed ratio (FR) 100:s]; the 30th completion of
      the FR 100 requirement turned on the light for 15 min and the subject received an
      i.m. injection of morphine [FR 30 (FR 100:s)]. Once each weekday morphine or
      placebo was available under this schedule. Each drug dose was available for 1
      week. Under these conditions placebo did not maintain responding; 3.75 mg of
      morphine maintained responding in four of five subjects, and higher morphine
      doses (7.5, 15 and 30 mg) maintained responding in all five subjects. Subjective
      effects were measured concurrently: these included measures of drug liking, the
      Morphine Benzedrine Group scale of the Addiction Research Center Inventory, drug
      detection and identification. Subjects did not report subjective effects
      different from placebo for the lowest dose of morphine; the intermediate doses of
      morphine produced inconsistent effects, and the highest dose of morphine
      occasioned reports of drug liking and "dope" identifications. These results
      indicate that there can be a significant dissociation of the reinforcing and the
      subjective effects of opioids, which has implications for theories of opioid
      abuse, particularly those assuming that the reinforcing effects are causally
      related to the euphoric effects of opioids. Furthermore, these results confirm
      that measures of reinforcing effects and measures of subjective effects do not
      necessarily lead to identical predictions when used to assess the liability for
      abuse of a substance.

PMID- 1762069
TI  - Evaluation of the central and peripheral components for induction of postural
      hypotension by guanethidine, clonidine, dopamine2 receptor agonists and 5
      hydroxytryptamine1A receptor agonists.
AB  - Previously, it was observed that the severity of postural hypotension in rats
      after i.v. administration is: guanethidine (severe) greater than clonidine
      greater than dopamine2 (DA2) receptor agonists greater than 5-hydroxytryptamine1A
      (5-HT1A) receptor agonists (none). In this paper we investigated central and
      peripheral mechanisms involved in postural hypotension induced by these drugs.
      Intracerebroventricular or intracisternal doses of the above agents produced a
      fall in mean arterial pressure of 32 to 42 mm Hg and were used for evaluation of
      the central component. Intracerebroventricular, but not intracisternal, clonidine
      induced postural hypotension. DA2 or 5-HT1A receptor agonists did not induce
      postural hypotension after either i.c.v. or intracisternal administration.
      Intracerebroventricular guanethidine did not lower arterial pressure dose
      dependently, or did it produce postural hypotension. A peripheral action
      postulated to be involved in the postural hypotension was inhibition of
      sympathetic neurotransmission; to evaluate this inhibition, drug effects on
      pressor and tachycardiac responses elicited by electrical stimulation in pithed
      rats were determined. Inhibition of heart rate changes by each of the drugs was:
      guanethidine, 60 to 100% at 0.1 to 8.0 Hz; clonidine, 20 to 40% at 0.1 to 2.0 Hz;
      DA2 receptor agonists, 10 to 45% at 0.1 to 2.0 Hz; and 5-HT1A receptor agonists,
      20 to 40% at less than or equal to 0.5 Hz. These data indicate that the frequency
      selective inhibition in the peripheral sympathetic nervous system may explain the
      likelihood of postural hypotension for guanethidine, clonidine DA2 and 5-HT1A
      receptor agonists. Clonidine has some central component for induction of postural
      hypotension in addition to the frequency-related peripheral component.

PMID- 1762070
TI  - Characterization of the renal effects and renal elimination of sulotroban in the
      dog.
AB  - The renal effects and renal handling of the nonprostanoid thromboxane receptor
      antagonist, sulotroban (4-[2-(phenylsulfonylamino)ethyl]phenoxyacetic acid), were
      characterized in dogs. Sulotroban was infused i.v. at 0.06, 0.2, 0.6 and 1.0 mg
      kg-1 min-1 (plus prime) for 180 min. Arterial blood pressure was reduced
      significantly during infusion of the 1.0 mg kg-1 min-1 dosage only. Diuresis,
      characterized by increases in both fractional and absolute urinary excretion of
      sodium, potassium, chloride and calcium, and decreases in urine osmolality
      occurred at each of the sulotroban dosages tested. The renal clearance of
      sulotroban exceeded the glomerular filtration rate, suggesting renal secretion of
      sulotroban. The transport maximum for sulotroban secretion was approximately 160
      micrograms kg-1 min-1. Renal cortical slices from naive dogs accumulated
      [14C]sulotroban against a concentration gradient. Sulotroban accumulation was
      blocked by metabolic inhibitors (dinitrophenol and sodium azide) and inhibitors
      of organic anion transport (probenecid and p-aminohippurate), but not by
      inhibitors of organic cation transport (cyanine and tetraethylammonium),
      suggesting that tubular secretion of sulotroban is mediated by an organic anion
      transport system. It was concluded that: 1) decreases in blood pressure occurred
      only after high dosages and were associated with high plasma sulotroban
      concentrations; 2) diuresis occurred at all dosages and may represent a separate
      pharmacological action unrelated to thromboxane receptor antagonism; and 3) renal
      excretion of sulotroban in the dog occurs by both filtration and tubular
      secretion with secretion occurring via an organic acid transporter.

PMID- 1762071
TI  - Expression of monomorphic arylamine N-acetyltransferase (NAT1) in human
      leukocytes.
AB  - The expression of arylamine N-acetyltransferase (NAT) in leukocytes was
      investigated using p-aminobenzoic acid (PABA) and sulfamethazine (SMZ),
      substrates which are preferentially acetylated by the monomorphic NAT1 and
      polymorphic NAT2 enzymes, respectively. Activity towards both substrates was
      detected in mononuclear leukocytes (MNL; preparation containing approximately 80%
      lymphocytes), monocytes and neutrophils. PABA and SMZ acetylation rates were
      highly correlated in each of the isolated cell types. The NAT in leukocytes
      displayed a much higher affinity and turnover rate for the acetylation of PABA
      than for SMZ. These kinetic characteristics suggest that the acetylating activity
      in human leukocytes is predominantly attributable to the monomorphic enzyme NAT1.
      Neutrophils showed evidence of biphasic kinetics for SMZ which would indicate the
      coexpression of NAT1 and low levels of the polymorphic enzyme, NAT2. NAT activity
      in MNL was not influenced by the acetylator phenotype of the individual. There
      was, however, a significant correlation between NAT activity in MNL and the in
      vivo acetylation (urinary metabolite ratio) of p-aminosalicylic acid, which is
      monomorphically acetylated in humans. The expression of NAT1 in leukocytes and
      the virtuall absence of NAT2 may have important toxicological implications. The
      in vitro/in vivo correlation suggests that leukocytes may be a useful marker of
      systemic NAT1 activity.

PMID- 1762072
TI  - Pharmacokinetics and metabolism of nilutamide in the isolated rat lung.
AB  - Nilutamide (N) is a potent antiandrogen used in the treatment of diffuse
      carcinoma of the prostate. The drug has been implicated in a few instances of
      pneumonitis in man. The present studies were carried out to examine N disposition
      in the isolated perfused lung (IPL) from rats. Both recirculating and single-pass
      IPL were used. Recirculation was run for 60 min at concentrations of N ranging
      between 12 and 120 microM (+1 mu Ci [14C]N). Single-pass perfusions were run for
      30 min (uptake, 10 min; efflux, 20 min) at inflowing concentrations ranging from
      12 to 480 microM (+1 mu Ci [14C]N). Nilutamide was concentrated in the
      recirculating IPL, and tissue to medium ratio (T/M) ranged between 6.6 and 4.2,
      depending on the inflowing concentration of N (Cin). High performance liquid
      chromatography analysis of extracts of 60-min lung homogenates demonstrated the
      primary amino metabolite of N in addition to the parent compound. This indicated
      reduction of the nitro moiety of N by lung tissues. At 60 min and Cin = 40
      microM, 17.6 +/- 4.7% of the radioactivity present in lung was accounted for by
      the metabolite. Perfusate samples contained low to undetectable amounts of the
      metabolite. No metabolism of N was detected in single-pass IPL, possibly because
      of the shorter duration of experiments. Amount of N taken up in lung and T/M were
      similar to those found in recirculating preparations. Uptake of N in the single
      pass IPL was proportional to N concentration up to 480 microM.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1762073
TI  - Effects of endothelin-3 on renal functions.
AB  - The effects of L-NGnitroarginine (LNNA), a nitric oxide synthase inhibitor, and
      ibuprofen, a cyclooxygenase inhibitor, on the renal actions induced by endothelin
      (ET)-3 were studied in anesthetized dogs. Continuous infusion of ET-3 in a dose
      of 5 ng/kg/min for 25 min increased both renal blood flow (RBF) and urine flow
      rate. In dogs given LNNA (75 micrograms/kg/min for 25 min), the RBF decreased
      after intrarenal administration of ET-3 (5 ng/kg/min). Glomerular filtration rate
      (GFR) was unchanged throughout the infusion of ET-3, in dogs treated with and
      without LNNA. In dogs given ibuprofen (12.5 mg/kg i.v.), an initial increase in
      RBF was evident after initiating infusion of the peptide, to be followed by a
      gradual reduction in RBF, GFR decreased significantly with ET-3, whereas the
      degree of reduction in RBF was the same in dogs treated with LNNA. Thus, ET-3
      acts as a vasodilatory and diuretic peptide in the dog kidney. Presumably ET-3
      enhances the release of nitric oxide and prostaglandins and then renal
      vasodilation occurs. Although the enhanced production of prostaglandins by ET-3
      may be responsible for maintaining GFR, it is not linked to the initial phase of
      renal vasodilation.

PMID- 1762074
TI  - A nonprimate animal model applicable to zidovudine pharmacokinetics in humans:
      inhibition of glucuronidation and renal excretion of zidovudine by probenecid in
      rats.
AB  - The monkey is considered the best animal model to study the pharmacokinetics of
      zidovudine (azidothymidine, AZT) because humans and monkeys eliminate 60 to 75%
      of AZT by metabolism to the 5'-O-glucuronide (GAZT), in contrast to other
      experimental animals, which excrete most of the drug unchanged in the urine. It
      has become increasingly difficult and costly to use monkeys in research.
      Therefore, we undertook studies to determine the suitability of the rat as an
      alternative animal model to study the pharmacokinetics of AZT. In the initial
      experiments, [3H]AZT was administered i.v. at doses of 19, 60 and 187 mumol/kg to
      male Sprague-Dawley rats with intact bile ducts. The respective values (mean +/-
      S.D.) for total clearance of AZT were 2.4 +/- 0.2, 2.3 +/- 0.3 and 1.8 +/- 0.4
      l/hr/kg and for renal clearance were 1.7 +/- 0.2, 1.8 +/- 0.4 and 1.5 +/- 0.4
      l/hr/kg. The renal clearance of AZT was approximately equal to renal plasma flow
      of rats (1.5 l/hr/kg), suggesting that in addition to filtration, AZT is also
      efficiently secreted in the kidney of the rat. The respective values for volume
      of distribution at steady state were 1.3 +/- 0.2, 1.0 +/- 0.2 and 0.84 +/- 0.19
      l/kg (P less than .05) and elimination half-life were (harmonic mean) 0.55, 0.44
      and 0.46 hr. Urinary excretion of AZT as unchanged drug in intact rats accounted
      for 70 +/- 6, 79 +/- 6, and 83 +/- 12% of the dose, whereas only 0.7 to 0.8% of
      the dose was recovered in the urine as GAZT. Rats with exteriorized bile ducts,
      the proposed alternative animal model, were given an i.v. dose of 60 mumol/kg of
      [3H]AZT. To test the effect of a concurrently administered drug on the
      elimination of AZT in the model, some rats with bile duct cannulas were
      pretreated with probenecid, a known inhibitor of AZT elimination in humans. Urine
      and bile were collected to quantify the formation of GAZT. GAZT was identified by
      fast atom bombardment mass spectrometry as the major metabolite of AZT in the
      rat. GAZT excretion in the bile and urine accounted for 11 +/- 3% of the dose in
      saline-treated rats, compared to only 1.4 +/- 0.3% in rats treated with
      probenecid (P less than .001).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1762075
TI  - Use of an isolated in situ canine lung perfusion model to evaluate dopamine
      clearance by the lung.
AB  - An isolated in situ lung perfusion model was used to assess dopamine clearance by
      the lungs in 12 dogs. The preparation consisted of a closed perfusion system in
      situ, in which systemic arterial blood supply was interrupted. Blood flow to the
      lungs was maintained at presurgery flow rates. The inflow was restricted to the
      lungs by the pulmonary arteries and outflow was limited to the pulmonary veins.
      Pulmonary artery pressure, temperature and pO2 were maintained at physiological
      levels. After confirmation of a stable base line, one of 3 doses (1, 2, or 5
      micrograms/kg/min) of dopamine was infused over 30 min to achieve steady-state
      blood concentrations, then blood samples were drawn at specified times during and
      after the infusion. Dopamine plasma concentrations were analyzed by high
      performance liquid chromatography with electrochemical detection. Dose-dependent
      disposition of dopamine was observed in both plasma concentration-time profiles
      and in clearance (20.3 +/- 9.6 ml/min/kg at 5 micrograms/kg/min vs. 41.6 +/- 19.1
      ml/min/kg at 1 micrograms/kg/min, P = 0.038). A sham experiment revealed that the
      blood in this experimental preparation contributed less than 10% to the total
      clearance of dopamine. This study revealed that our isolated in situ model is an
      excellent method to evaluate the role of the lungs in drug removal. Furthermore,
      it confirmed that the lungs contribute to the clearance of dopamine from the
      body.

PMID- 1762076
TI  - Ethanol potentiates gamma-aminobutyric acid-mediated inhibition in the inferior
      colliculus: evidence for local ethanol/gamma-aminobutyric acid interactions.
AB  - The effect of ethanol on gamma-aminobutyric acid (GABA)-mediated inhibition of
      neurons of the inferior collicular cortex (IC) was investigated. Systemic
      administration of 0.5 g/kg ethanol, but not 0.25 g/kg ethanol, potentiated the
      inhibitory effect of GABA on IC neuronal activity. As with systemic
      administration of ethanol, local application of two concentrations of ethanol
      potentiated, in a dose-dependent and concentration-dependent manner, GABA
      mediated inhibition of IC activity. When utilizing the lower ethanol
      concentration (270 mM), increasing ethanol ejection currents produced a
      correspondingly greater amount of augmentation of GABA inhibition without
      concomitant changes in spontaneous neural activity. At the highest ejection
      current tested (90 nA), ethanol doubled the inhibitory effects of GABA on IC
      neuronal activity. Local application of a higher concentration of ethanol (2.7 M)
      also potentiated GABA-mediated inhibition, with greater ejection currents
      producing greater potentiation of GABA-inhibition. Compared to the lower ethanol
      concentration, the higher ethanol concentration required lower ejection currents
      to produce comparable amounts of potentiation of GABA inhibition. These findings
      demonstrate that ethanol potentiates GABA inhibition of IC activity via a local
      action. In contrast to the effects of ethanol on GABA inhibition, locally applied
      ethanol failed to potentiate the inhibition by glycine of IC activity, indicating
      that ethanol does not indiscriminately potentiate all types of inhibition of IC
      neural activity. Additionally, locally applied ethanol failed to potentiate
      inhibition by GABA in the lateral septum, indicating that ethanol/GABA
      interactions are site specific. These findings indicate that ethanol specifically
      potentiates GABA-mediated inhibition of neural activity, and that this action
      occurs via a local action at specific sites in brain.

PMID- 1762077
TI  - Species variation in pulmonary endothelial aminopeptidase P activity.
AB  - Pulmonary endothelial aminopeptidase P (AmP) may be an important contributor to
      the inactivation of circulating bradykinin in certain species. To examine this
      possibility, we measured AMP activity in vivo and in vitro using Arg-Pro-Pro
      [3H]benzylamide (3H-APPB) as substrate under conditions of first order enzyme
      kinetics. Utilizing multiple indicator dilution techniques, metabolism of 3H-APPB
      to Arg and Pro-Pro-[3H]benzylamide by AmP was not detectable during a single
      transpulmonary passage in anesthetized rabbits (n = 4), cats (n = 3) and pigs (n
      = 4). However, percent metabolism of 3H-APPB ranged from 54 to 63% in
      anesthetized rats (n = 6). In all experiments, the substrate remained within the
      vascular space and was thus accessible to endothelial and blood AmP only. At the
      same time, single-pass transpulmonary percent metabolism of [14C]benzoyl-Ala-Gly
      Pro by endothelial-bound angiotensin converting enzyme was remarkably similar
      among rabbits, cats, rats and pigs (60-65%). In culture, Vmax/Km of AmP was 3 to
      10 x 10(-4) min-1 for human basal arterial and rabbit and bovine pulmonary
      arterial endothelial cell monolayers (2 x 10(5) cells). AmP activity in the
      supernatant of lung and kidney tissue (homogenized in saline containing 1-o-n
      octyl-beta-glucopyranoside) from rabbit, cat, pig and rat expressed as
      Vmax/Km(min-1) per (g wet tissue/ml) was 0.74, 2.25, 3.91 and 185.8 (lung), and
      1.0, 3.7, 8.4 and 438.3 (kidney), respectively. Similarly, Vmax/Km values of AmP
      in plasmas of cat, dog, rabbit, pig, calf (serum), human and rat were 0, 0.016,
      0.025, 0.068, 0.191, 0.237 and 3.53 min-1. These results suggest that 1) there
      are large interspecies variations in AmP activities of plasma, lung and kidney;
      2) of the species studied, the rat contains the largest activities of AmP; and 3)
      AmP appears to be located on the luminal surface of the rat pulmonary
      endothelium.

PMID- 1762078
TI  - Evidence against serotonin-induced endothelium-dependent relaxation in bovine
      coronary artery.
AB  - Bovine coronary artery rings were mounted in tissue baths for the measurement of
      isometric contraction in order to test for serotonin-induced endothelium
      dependent relaxation. A23187 caused a concentration-dependent relaxation in
      precontracted artery rings when the endothelium was intact, but not when it was
      removed. Endothelium removal had no effect on serotonin concentration contractile
      response curves (CRC) in normal Krebs' solution, but enhanced the response to
      serotonin in artery rings precontracted with 25 mM K+ Krebs' solution. In
      endothelium-intact, precontracted artery rings, ketanserin shifted the serotonin
      CRC to the right, but did not convert the contraction to relaxation. 5
      Carboxamidotryptamine caused a weak contraction that was blocked by ketanserin,
      but not converted to relaxation. Inactivation of monoamine oxidase enhanced the
      contractile response to serotonin in precontracted artery rings in a manner
      identical to that caused by endothelium removal. Inactivation of monoamine
      oxidase had no effect in endothelium-denuded artery rings. De-endothelialized
      rabbit aorta strips pretreated with phenoxybenzamine were placed in close
      apposition to endothelium-intact coronary artery strips. Superoxide dismutase,
      acetylcholine and A23187 caused the precontracted rabbit aorta strip to relax,
      whereas serotonin had no effect. These results support the conclusion that the
      endothelium of the bovine coronary artery releases a relaxing factor both
      spontaneously and in response to acetylcholine and A23187. Serotonin appears to
      be incapable of releasing endothelium-derived relaxing factor or causing an
      endothelium-dependent relaxation. However, bovine coronary artery endothelium
      appears to be able to take up and metabolize serotonin.

PMID- 1762079
TI  - Effect of intranasal capsaicin on symptoms and mediator release.
AB  - Differential nasal responsiveness to environmental tobacco smoke (ETS) has been
      documented in humans and we hypothesized that this reflects differential
      responsiveness to c-fiber stimulation. We compared the response to intranasal
      capsaicin in subjects with and without a history of ETS-rhinitis. We challenged
      10 ETS-sensitive and 11 ETS-nonsensitive subjects intranasally with 25 mg of
      lactose powder followed by 25 pg to 25 ng of capsaicin in 25 mg of lactose.
      Subjects rated nasal symptoms and underwent nasal lavage. In each lavage, the
      concentrations of albumin (an index of vascular permeability), kinins and
      histamine (a marker of mast cell activation) were measured. Nasal lavage tosyl-L
      arginine methyl ester (TAME)-esterase activity, which can be a reflection of mast
      cell activation, increased vascular permeability or glandular secretion, was also
      determined. Subjects with a history of ETS-rhinitis reported more rhinorrhea than
      subjects without a history of ETS-rhinitis (P less than .01). No significant
      increase occurred in nasal lavage histamine, albumin or kinins in either subject
      group. TAME-esterase activity (presumably a reflection of increased glandular
      secretion) increased greater than 1000 cpm in 12/21 subjects (designated "TAME
      producers"), but this was unrelated to ETS-sensitivity. TAME producers showed a
      dose-dependent increase in TAME-esterase activity, whereas TAME nonproducers
      showed no change at any capsaicin dose. We conclude that capsaicin causes nasal
      symptoms and glandular stimulation without evidence of increased vascular
      permeability or mast cell activation. ETS-rhinorrhea symptoms in humans appear
      related to c-fiber stimulation. The absence of c-fiber-induced glandular
      secretion, although not related to ETS-sensitivity, was associated with decreased
      sneezing and increased symptoms of capsaicin-induced nasal burning.

PMID- 1762080
TI  - Detection of human hepatitis anti-liver kidney microsomes (LKM2) autoantibodies
      on rat liver sections is predominantly due to reactivity with rat liver P-450
      IIC11.
AB  - Anti-liver kidney microsomes (anti-LKM2) autoantibodies, appearing in patients
      treated with tienilic acid and suffering from hepatitis, react with proteins in
      rat liver sections. The nature of the rat proteins responsible for this
      recognition and detection of anti-LKM2 has been investigated. Immunoblot testing
      of the anti-LKM2 with liver microsomes from diversely treated rats and with
      purified rat liver cytochromes P450 (IA1, IA2, IIB1, IIB2, IIC6, IIC11 and IVA1)
      showed that these antibodies cross-reacted with cytochrome P450IIC11 and also
      with phenobarbital-induced cytochromes P450IIB1 and IIB2. Moreover, metabolic
      activation of tienilic acid and of a tienilic acid isomer by untreated rat liver
      microsomes was partially inhibited by anti-LKM2. On the other hand, monospecific
      polyclonal anti-rat P450IIC11 antibodies cross-reacted with human microsomal
      cytochromes P450 and recognized the same cytochromes P450 as anti-LKM2. This
      antibody also gave an immunofluorescence pattern on rat and mouse liver and
      kidney sections very similar to anti-LKM2. The data presented here show that anti
      LKM2 recognize epitopes shared by rat P450 IIC11, and a human P450 of the family
      IIC. All the results indicate rat P450 IIC11, the major isoenzyme present in
      normal adult male rat liver, as the main antigen recognized by human anti-LKM2
      autoantibodies; this is the basis of the immunofluorescence test for detection of
      these antibodies.

PMID- 1762081
TI  - 5-Hydroxytryptamine1C/2 agonists in the thoracic spinal cord: cardiovascular
      effects and binding sites in the intermediolateral cell column.
AB  - The presence of 5-hydroxytryptamine (5-HT)1C/2 binding sites in autonomic regions
      of the thoracic spinal cord and their role in the regulation of sympathetic
      outflow to the cardiovascular system were examined. Light microscopic receptor
      autoradiography was used to visualize the binding of the 5-HT1C/2 ligand, [125I]
      1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane [( 125I]DOI). In thoracic spinal
      cord, a discrete and preferential localization of specific [125I]DOI binding
      sites was found in the intermediolateral cell column. To determine the mean
      arterial pressure (MAP) and heart rate (HR) effects resulting from activation of
      5-HT1C/2 receptors in spinal cord, DOI and alpha-methyl-5-HT were administered
      intrathecally (i.t.) to anesthetized, artificially ventilated rats. DOI (1-100
      micrograms) caused initial decreases followed by increases in MAP and HR, whereas
      alpha-methyl-5-HT (1-30 micrograms) only decreased MAP and HR. The distribution
      of [125I]DOI after i.t. administration and the effects of a peripherally
      administered 5-HT1C/2 antagonist 6-methyl-1-(1-methylethyl)-ergoline-8 beta
      carboxylic acid, 2-hydroxyl-1-methyl propyl ester and maleate salt (LY53857)
      showed that the pressor effects of i.t. DOI were due to peripheral leakage and
      suggested that the depressor effects were due to a spinal site of action. The
      depressor effects of DOI were prevented by peripheral administration of
      phentolamine. Pretreatment with i.t. administration of 5-HT1C/2 antagonists
      (LY53857, ketanserin and mianserin) did not block the depressor or bradycardic
      effects of i.t. administration of DOI. Only LY53857 was effective in blocking the
      depressor effects of i.t. administration of alpha-methyl-5-HT.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1762082
TI  - Functional studies in the human submandibular duct cell line, HSG-PA, suggest a
      second salivary gland receptor subtype for nucleotides.
AB  - Extracellular nucleotides, acting through P2 purinoceptors, have been implicated
      in the regulation of ion transporting epithelia, including salivary gland acini.
      Multiple P2 purinoceptor subtypes have been suggested, including P2X, P2Y and P2U
      (or nucleotide) subtypes, as well as the P2Z subtype found in rat parotid acinar
      cells. We investigated responses to ATP, ATP analogs and UTP in transformed human
      submandibular gland duct cells (HSG-PA), in order to compare duct cell
      purinoreceptors with those in acinar cells. ATP, UTP and some ATP analogs
      increased, with different potencies, inositol phosphate accumulation, calcium
      mobilization and potassium efflux. Nucleotide-stimulated calcium mobilization
      occurred in the absence of, but was enhanced by, extracellular calcium, and
      maximal potassium efflux required extracellular calcium. UTP and ATP demonstrated
      equal potencies of about 1 microM and similar efficacies in eliciting these
      responses, and identical rank orders of potency for stimulating calcium
      mobilization and potassium efflux were obtained: UTP = ATP greater than ATP gamma
      S greater than ADP greater than ADP beta S, with alpha,beta-methylene-ATP and 2
      methylthio-ATP having little or no effect. Agents reported to block nucleotide
      effects in parotid acini were ineffective in HSG-PA cells, and experiments in
      Mg(++)- and Ca(++)-free medium did not indicate that a form of ATP other than
      MgATP was the active species at the HSG-PA purinoceptor. The extracellular
      nucleotide effects were not altered by pertussis toxin. These results indicate
      the presence of a P2U or nucleotide receptor subtype in HSG-PA submandibular duct
      cells distinguishable from the P2Z purinoceptor of rat parotid acinar cells,
      suggesting involvement of multiple nucleotide receptor subtypes in salivary gland
      regulation.

PMID- 1762083
TI  - Pharmacokinetics of 18F-labeled fluconazole in rabbits with candidal infections
      studied with positron emission tomography.
AB  - [4-18F]Fluconazole was used to measure the pharmacokinetics of fluconazole in
      normal and infected animals. The biodistribution of fluconazole was determined
      after administration of the 18F-tracer with/without a pharmacological dose of
      unlabeled drug by radioactivity measurements on excised tissues. In normal
      rabbits and rabbits with candidal infection of the thigh, tissue concentrations
      of drug were determined by serial positron emission tomographic imaging. In rats,
      coinjection of tracer quantities of [4-18F]fluconazole with a pharmacological
      dose of unlabeled drug resulted in a relatively uniform distribution of
      radioactivity in most organs, whereas, when the 18F-tracer was injected alone,
      spleen, muscle and heart accumulation was decreased and liver accumulation was
      increased. In rabbits, this effect was less pronounced. Early accumulation of [4
      18F]fluconazole was greater in infected muscle. The areas under the 2-hr uptake
      curves were 4.30 and 6.05 micrograms.hr.ml-1 for normal and infected tissue. A
      mathematical model was used to summarize the kinetics of fluconazole in normal
      and infected muscle. The model hypothesizes that fluconazole is compartmentalized
      in blood and tissue, with rate constants describing the transition between
      compartments. Direct measurement of the partition coefficient of fluconazole in
      muscle and predictions of the kinetic model were in close agreement, suggesting
      that fluconazole enters muscle via a passive transport mechanism. Transport rates
      of fluconazole, into (Kin) and out of tissue (kout), were increased in infected
      compared with normal muscle, possibly due to increased capillary permeability
      (Kin: 0.064 +/- 0.001 vs. 0.0270 +/- 0.0002, kout: 0.063 +/- 0.002 vs. 0.035 +/-
      0.001).

PMID- 1762084
TI  - Pharmacological characterization of serotonin-O-carboxymethyl-glycyl
      tyrosinamide, a new selective indolic ligand for 5-hydroxytryptamine (5-HT)1B and
      5-HT1D binding sites.
AB  - The affinity of a new serotonin (S) derivative, serotonin-O-carboxymethyl-glycyl
      tyrosinamide (S-CM-GTNH2), for the various 5-hydroxytryptamine (5-HT)1 receptor
      subtypes was tested using quantitative autoradiography on rat and guinea pig
      brain sections. In the rat, S-CM-GTNH2 is 57 and 24 times more potent at 5-HT1B
      sites (IC50 = 28 nM) than at 5-HT1A (IC50 = 1600 nM) and 5-HT1C sites (IC50 = 670
      nM), respectively. In the guinea pig, the affinity of S-CM-GTNH2 for 5-HT1D sites
      (IC50 = 67 nM) is 21 times higher than at 5-HT1A sites (IC50 = 1400 nM). S-CM
      GTNH2 shows a low affinity (less than 10 microM) for 5-HT2 and 5-HT3 binding
      sites. This new ligand is therefore highly specific for 5-HT1B and 5-HT1D binding
      sites and can be used to further characterize the involvement of these subtypes
      in physiological studies focusing particularly on behavioral effects.

PMID- 1762085
TI  - Rapid dissociation of platelet-rich fibrin clots in vitro by a combination of
      plasminogen activators and antiplatelet agents.
AB  - Thrombin promotes the formation of arterial thrombi by converting fibrinogen to
      fibrin and by causing platelets to aggregate. We have examined the combined
      effects of plasminogen activators and inhibitors of platelet aggregation on the
      lysis of platelet-rich fibrin clots formed by alpha-thrombin in citrated platelet
      rich plasma. The extent of platelet aggregation and clot formation were measured
      by recording light transmission in an aggregometer. Immediately after the
      formation of platelet-rich fibrin clots, addition of 2,000 U/ml streptokinase or
      50 micrograms/ml recombinant tissue-type plasminogen activator alone resulted in
      the degradation of polymerized fibrin and the release of trapped platelet
      aggregates without causing significant platelet deaggregation. Preincubation of
      the platelet-rich plasma with 20 microM indomethacin for 1 min before thrombin
      stimulation or simultaneous addition of prostaglandin E1 (10 microM) with the
      plasminogen activators after thrombin stimulation resulted in spontaneous
      platelet deaggregation. Because platelet aggregation is, in part, mediated by the
      binding of Arg-Gly-Asp-containing adhesive proteins to activated platelets, the
      effect of Arg-Gly-Asp peptides on platelet deaggregation was examined. By itself,
      Gly-Arg-Gly-Asp-Ser-Pro specifically caused dose- and time-dependent
      deaggregation of platelet aggregates formed by ADP or by thrombin in the presence
      of 1 mM Gly-Pro-Arg-Pro, but had no effect on the dissociation of thrombin
      induced platelet-rich fibrin clots. In combination with streptokinase or
      recombinant tissue-type plasminogen activator, Gly-Arg-Gly-Asp-Ser-Pro enhanced
      the rate of lysis of platelet-rich fibrin clots. The control Gly-Arg-Gly-Glu-Ser
      Pro peptide was completely ineffective.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762086
TI  - Ionic currents involved in vasodilating actions of E4080, a newly synthesized
      bradycardia-inducing agent, in dispersed smooth muscle cells of the rabbit portal
      vein.
AB  - The effects of E4080 [(E)-N-[3-[N'-(2-(3,5-dimethoxyphenyl)ethyl)-N'
      methyl)amino)propyl]-4- (4-(1H-imidazol-1-yl)phenyl)-3-butenamide dihydrochloride
      dihydrate] on ionic currents recorded from the rabbit portal vein were
      investigated by using the patch-clamp technique. A depolarization of the membrane
      produced an inward Ca current (ICa), a transient outward current (ITO), a
      sustained outward current (ISO) and an oscillatory outward current (IOO), whereas
      a hyperpolarization of the membrane produced a hyperpolarization-activated
      current (Ih). When ICa was evoked by a depolarizing pulse to 0 mV from the
      holding potential of -80 mV, 1 microM E4080 increased and higher concentrations
      (10 microM) inhibited ICa, whereas, at the holding potential of -60 mV, E4080
      (greater than 1 microM) consistently inhibited ICa, in a concentration-dependent
      manner. E4080 inhibited ITO, ISO (greater than or equal to 1 microM) and Ih
      (greater than or equal to 0.1 microM) concentration dependently. Inasmuch as 1
      microM E4080 did not inhibit ICa at the holding potential of -80 mV, the
      inhibition of ITO induced by 1 microM E4080 was not related to the inhibition of
      ICa. When a continuous depolarization (0 mV) was applied to the cell, E4080 (1
      microM) produced a maintained outward current (14.0 +/- 15.3 pA), which was
      inhibited by glibenclamide. I infinity was inhibited by E4080 (greater than or
      equal to 0.1 microM) and application of 1 microM glibenclamide partly restored I
      infinity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762087
TI  - Effects of calcitonin gene-related peptide on longitudinal muscle and myenteric
      plexus of guinea pig ileum.
AB  - Effects of rat calcitonin gene-related peptide (rCGRP) on the longitudinal muscle
      myenteric plexus (lm-mp) have been investigated in the present study. rCGRP was
      shown to have a biphasic effect on the nonstimulated lm-mp, i.e., a transient
      contraction followed by a longer lasting relaxation. This biphasic action was
      dose-dependent over the concentration range of 10(-10) to 10(-5) M. Tetrodotoxin
      (1 microM), atropine (1 microM), 2-chloroadenosine (1 microM) and clonidine (1
      microM) inhibited the stimulatory effect. Tetrodotoxin and clonidine also
      partially inhibited the relaxing effect of rCGRP. This biphasic action of rCGRP
      was also seen on the contraction of the lm-mp elicited by electrical field
      stimulation. rCGRP showed only a relaxing effect on the nonstimulated plexus-free
      longitudinal muscle. rCGRP (2.6 x 10(-10) to 2.6 x 10(-7) M) inhibited both the
      phasic and tonic contractions induced by histamine in a competitive way and
      showed a more potent effect on the tonic contraction than that on the phasic
      contraction. rCGRP at the same dose range also inhibited the tonic but not phasic
      contraction evoked by membrane depolarization with the maximal stimulation of KCl
      (30 mM). rCGRP inhibited KCl-, but not histamine-induced, extracellular calcium
      dependent contraction. The peptide did not affect the dose-response curve of
      oxotremorine. These results suggest that rCGRP may exert its stimulatory actions
      on the lm-mp via actions on the plexus nerves, whereas the depressant actions may
      be mediated via the nerves, as well as directly on the smooth muscle.

PMID- 1762088
TI  - Stereoselective disposition and metabolism of disopyramide in pediatric patients.
AB  - Pharmacokinetics of disopyramide (DP) enantiomers was studied in six pediatric
      patients, 5 to 12 years old, with arrhythmias after i.v. and p.o. administrations
      of racemic DP. The enantiomers of DP and its active metabolite, mono-N
      dealkyldisopyramide, in plasma and urine were determined using a chiral, high
      performance liquid chromatography. Plasma protein binding of DP was measured by
      ultrafiltration. Because the protein binding of DP was not only concentration
      dependent but also stereoselective (i.e., S-DP binds to protein more extensively
      than R-DP), unbound pharmacokinetic parameters were used for evaluating the
      kinetic behaviors of DP enantiomers. The pediatric age patients had the mean (+/-
      S.D.) systemic clearance of 15.0 +/- 3.8 and 12.7 +/- 3.9 ml/min/kg for unbound S
      and R-DP, respectively, which were not only stereoselectively different (P less
      than .05) but also at least about twice greater than the reported normal adult
      values. The mean postinfusion elimination half-life values for unbound S- and R
      DP (2.7 +/- 0.5 and 2.8 +/- 0.4 hr, respectively) in pediatric patients were
      shorter than those reported from normal adults (approximately equal to 4 to 5
      hr). The mean nonrenal (i.e., hepatic) clearance for unbound S- and R-DP (11.1 +/
      4.1 and 8.1 +/- 3.9 ml/min/kg, respectively) were also stereoselectively
      different (P less than .01) and accounted for approximately equal to 70% of the
      unbound systemic clearance of the respective enantiomers.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1762089
TI  - The new K+ channel opener Aprikalim (RP 52891) reduces experimental infarct size
      in dogs in the absence of hemodynamic changes.
AB  - The objective of the present study was to determine the effect of a novel K+
      channel opener, Aprikalim (RP 52891; [trans-(-)-N-methyl-2-(3-pyridyl)-2
      tetrahydrothio-pyran carbothiamide-1-oxide]), on myocardial infarct size in
      barbital-anesthetized dogs subjected to 90 min of left circumflex coronary artery
      occlusion followed by 5 hr of reperfusion. To determine if RP 52891 is mediating
      its effects by opening adenosine triphosphate regulated potassium channels
      (KATP), glibenclamide, a KATP channel antagonist was used. Dogs were pretreated
      with vehicle, a nonhypotensive dose of RP 52891 (10 micrograms/kg + 0.1
      microgram/kg/min i.v.), glibenclamide (1 mg/kg; i.v. bolus) or RP 52891 (10
      micrograms/kg and 0.1 microgram/kg/min i.v.) after pretreatment with
      glibenclamide (1 mg/kg i.v. bolus). At the end of reperfusion, myocardial infarct
      size was determined by triphenyltetrazolium staining. There were no significant
      differences in systemic hemodynamics, myocardial oxygen demand, collateral blood
      flow or ischemic bed size among groups with the exception of an increase in
      coronary blood flow to the ischemic area at 3 and 5 hr of reperfusion in both RP
      treated groups. However, myocardial infarct size, expressed as a percentage of
      the area at risk, was significantly (P less than .05) reduced (38%) by RP 52891
      and significantly increased (38%) by glibenclamide (vehicle, 39 +/- 4%; RP 52891,
      24 +/- 2%; and glibenclamide, 54 +/- 5%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762090
TI  - Developmental shift from local to central control of norepinephrine release in
      the cardiac-sympathetic axis: effects of cocaine and related drugs.
AB  - Developmental exposure to cocaine is associated with cardiovascular abnormalities
      as well as neurobehavioral disturbances. Because of the profound influence of
      cocaine on noradrenergic neurotransmission, we examined its acute effects on
      norepinephrine release from cardiac nerve terminals in the neonatal rat, as
      assessed by turnover measurements. Cocaine reduced norepinephrine turnover at all
      ages studied, but with an apparent transition in the mechanism of action related
      to the development of central control of sympathetic tone. At 1 day of age,
      before the establishment of functional connections between the central nervous
      system and sympathetic neurons, cocaine acted primarily through blockade of
      norepinephrine reuptake and consequent activation of alpha-2 adrenergic
      autoreceptors that inhibit transmitter release. Accordingly, its effects were
      shared by the uptake inhibitor, desmethylimipramine and the alpha-2 agonist,
      clonidine, but not by drugs whose actions depend upon sympathetic activity or
      high tonic release of transmitter (yohimbine, pargyline or chlorisondamine). By
      21 days, when neuronal activity is under dynamic control by the central nervous
      system, cocaine was still effective in shutting off norepinephrine release, but
      the effect was no longer dependent upon blockade of reuptake; desmethylimipramine
      did not reduce turnover at this age, but clonidine, pargyline and chlorisondamine
      did. Yohimbine evoked a profound increase in turnover by 21 days.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1762091
TI  - Human interleukin (IL) 1 alpha, murine IL-1 alpha and murine IL-1 beta are
      transported from blood to brain in the mouse by a shared saturable mechanism.
AB  - Interleukins (ILs) 1 alpha and 1 beta are important components of the neuroimmune
      axis. Recent work has shown that human 125I-IL-1 alpha can enter the brain from
      the blood by a saturable system, suggesting a mechanism that may directly link
      the immune and nervous systems. Here, it is shown that radioiodinated murine IL-1
      beta and especially murine IL-1 alpha are even more rapidly transported into the
      brain of the mouse than is radioiodinated human IL-1 alpha after i.v. injection.
      All three cytokines exhibited self-inhibition, thus demonstrating saturable
      transport. Also, they all cross-inhibited the transport of each other. This shows
      that there are not three separate transport systems, but that they either share
      transport systems with overlapping affinities or share a single system. It was
      calculated that 0.06% to 0.08% of the dose of human 125I-IL-1 alpha injected i.v.
      was present in the brain during the first 60 min. By contrast, no saturable
      component could be detected in the brain to blood passage of the three ILs. No
      disruption of the blood-brain barrier to radioactively labeled albumin was found
      with i.v. doses of up to 50 micrograms/kg of human IL-1 alpha. Additional studies
      on the blood to brain transport of human 125I-IL-1 alpha showed no modification
      by dexamethasone, morphine, indomethacin or alpha-melanocyte stimulating hormone.
      Studies with antibodies directed toward the binding or nonbinding sites of IL or
      its receptor on the murine T lymphocyte suggest similar, but not identical,
      structural requirements for transport and for receptor binding.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1762093
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. The Dosimetry System 1986 (DS86) and the Tentative Dosimetry System
      1965 (T65D): how do they compare, what is left to do?

PMID- 1762092
TI  - A temporal window for lateralization of interaural time difference by barn owls.
AB  - Lateralization of interaural time difference by barn owls (Tyto alba) was studied
      in a dichotic masking experiment. Sound bursts consisted of two parts: binaurally
      time-shifted noise, termed the probe, was inserted between masking noise. The
      owls indicated that they detected and lateralized the time-shift in the probe by
      a head turn in the direction predicted from sign of the time-shift. The general
      characteristics of head turns in response to this stimulus was similar to the
      head turns elicited by free-field stimulation or to head turns in response to
      presentation of the probe alone. The owls could easily lateralize stimuli
      containing long probes. The number of correct turns decreased as probe duration
      decreased, demonstrating that the masking noise interfered with the owls' ability
      to lateralize the probe. The minimal probe duration that the animals could
      lateralize ("minimal duration") became shorter as burst duration decreased.
      Minimal duration ranged from 1 ms to 15 ms for the two subjects and burst
      durations from 10 to 100 ms. These findings suggested that owls possess a
      temporal window. A fitting procedure proposed by Moore et al. (1988) was used to
      determine the shape of the temporal window. The fitting procedure showed that the
      shape of the owls' binaural temporal window could be described by the same
      algorithms as the human monaural temporal window. Thus, the temporal window is
      composed of a short time constant that determines the central part of the window,
      and a longer time constant that determines the shape at the skirts of the window.

PMID- 1762094
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors.

PMID- 1762095
TI  - Recalculation of data on 32P activity induced in sulfur in Hiroshima.
AB  - Historical data for 32P activity induced in sulfur by fast neutrons have been
      corrected for decay with a recent half-life value of 32P and recalculated with an
      experimentally determined efficiency ratio of the electroscope for beta rays from
      32P and natural uranium used as a standard. Most samples would have been pure
      enough so that no correction for the weight of sulfur has been made. The
      possibility of interference with 32P activity measurements due to induced
      activity of other elements in the samples could also be excluded. The revised
      data show little difference from the original ones except for one sample which
      contained much impurity. Uncertainty of the data was also discussed.

PMID- 1762096
TI  - Allowing for dose-estimation errors for the A-bomb survivor data.
AB  - Unless allowances are made, random errors in radiation dose estimates cause
      underestimation of linear risk estimates and distort the shape of dose-response
      curves. These errors also result in spurious associations between radiogenic
      endpoints, exaggerating possible variations in individual sensitivity to
      radiation. Statistical methods have been developed which reduce these biases,
      based on assumptions regarding the nature and magnitude of dose-estimation
      errors. Some understanding of the underlying statistical basis for these methods
      is necessary to both those interested in interpreting radiogenic effects and
      those interested in the dosimetry system. This paper discusses the basic
      statistical issues and their implications, presents some statistical methods to
      deal with the problem, and indicates the sensitivity of certain results to
      assumptions about the magnitude of the dose-estimation errors.

PMID- 1762097
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Theoretical background of the Dosimetry System 86 (D586).
AB  - DS86 is a calculation code system for the estimation of the radiation dose of
      atomic bomb survivors at Hiroshima and Nagasaki. The DS86 calculation process is
      as follows: 1. Compute free-field radiation environment: radiation transport
      calculation can be done for the free air field at Hiroshima and Nagasaki. 2.
      Compute shielded radiation environment: depending on each shielding situation,
      the shielding can be calculated by using either the Nine-Shielding Parameter or
      the Globe Shielding Data. 3. Compute radiation environment at the organ site:
      organ kerma and fluence spectra can be calculated using a transport calculation
      code depending on each survivor sex, age, orientation and posture.

PMID- 1762098
TI  - Recent uses of biological data for the evaluation of A-bomb radiation dosimetry.
AB  - Random errors in the DS86 radiation dose estimates used in the analysis of A-bomb
      survivor data are recognized to have an important impact upon estimates of the
      risk of late effects such as cancer. Little however is known for certain
      concerning the distribution of such random errors. This paper gives an overview
      of recent work at the Radiation Effects Research Foundation (RERF) using
      multivariate analysis of biological data, including acute effects of radiation
      exposure, late effects (eg leukemia mortality) and stable chromosome aberrations,
      for the purpose of evaluating the extent of random error in the estimation of
      individual doses using DS86. The emphasis here is on analyses of apparent
      association between biological endpoints, in light of a dosimetry error model
      framework proposed recently by Pierce et al. Analyses performed to date appear to
      be consistent with the view that lognormal random dosimetry errors with a
      standard deviation of 40% or greater of true dose may exist in DS86. Association
      between radiogenic outcomes in A-bomb survivors, after adjustment for DS86
      estimated dose level, has been detected for such widely varying pairs of outcomes
      as mutant T-cell frequencies and chromosome aberrations, epilation and leukemia
      mortality, and epilation and chromosome aberrations. The motivation for examining
      association between pairs of biological endpoints has usually been to determine
      the extent to which radiation sensitivity varies between individual survivors.
      Recognizing, however, that random error in dose estimates results in apparent
      association between biological outcomes is crucial to interpreting studies, such
      as these, which use data on multiple biological endpoints. To go one step
      further, in situations where there is a prior knowledge about the biological
      plausibility of such associations in outcome data the amount of association
      between radiogenic outcomes (remaining after adjustment for estimated dose), to
      the extent that they are greater than that assumed to be reasonable, is an
      important potential source of information concerning the magnitude of random
      errors in the DS86 dose estimates.

PMID- 1762099
TI  - Medical X-ray doses' contributions to the ionizing radiation exposures of atomic
      bomb survivors.
AB  - Doses from diagnostic radiological examinations were measured in order to
      evaluate the radiation risks of atomic-bomb survivors in Hiroshima and Nagasaki.
      Using a phantom human, doses to the active bone marrow, gonads, salivary glands,
      thyroid gland, lung, breast, stomach and colon were determined by type of
      examination and by examination site. The results of this dosimetry program will
      aid in estimating the diagnostic exposure doses received by each participant in
      the Adult Health Study of the Radiation Effects Research Foundation. The current
      results of these dosimetry studies also indicate that the effects of A-bomb
      exposure cannot be reliably assessed unless medical X-ray doses are carefully
      incorporated into these long-term evaluations.

PMID- 1762100
TI  - The LD50 associated with exposure to the atomic bombing of Hiroshima and
      Nagasaki.
AB  - Numerous attempts have been made to estimate the distance at which 50% of the
      individuals exposed to the A-bombing of Hiroshima and Nagasaki died, ostensibly
      from their exposure to ionizing radiation. It is difficult to convert most of
      these distance estimates to a dose-related LD50, since radiation shielding was
      ignored. The recent reassessment of the atomic bomb radiation dosimetry has
      provided an opportunity for the estimation of the bone marrow LD50. There is a
      surprising concordance in the various estimates that have been made given the
      different groups of survivors involved and the methods used to estimate the
      LD50/60.

PMID- 1762101
TI  - Atomic bomb and leukemia.
AB  - Characteristic features of leukemia among atomic bomb survivors were studied. The
      ratio of a single leukemia type to all leukemias was highest for CML in
      Hiroshima, and the occurrence of CML was thought to be most characteristic for
      atomic bomb radiation induced leukemia. In the distribution of AML subtypes of
      FAB classification, there was no M3 cases in 1Gy or more group, although several
      atypical AML cases of survivors were observed. Chromosome study was conducted
      using colony forming cells induced by hemopoietic stem cells of peripheral blood
      of proximal survivors. Same chromosome aberrations were observed in colony
      forming cells and peripheral blood of proximal survivors.

PMID- 1762102
TI  - Multiple myeloma among atomic bomb survivors.

PMID- 1762103
TI  - Cytogenetic and molecular changes in leukemia found among atomic bomb survivors.
AB  - Seventy five radiation-related leukemias (acute non-lymphocyte) in Hiroshima
      including 16 patients exposed to more than one Gray were cytogenetically
      examined. Statistical analysis of the data on the frequencies of chromosomal
      aberrations in survivors according to the bone marrow doses of DS86 estimation
      revealed that heavily exposed patients tended to have significantly higher
      aberration rates as compared with non-exposed patients. Furthermore, the
      chromosomal aberrations in the survivors were observed to be of a more complex
      nature and had characteristic findings of secondary leukemia. These observations
      therefore suggest that patients with a history of heavy exposure to atomic bomb
      radiation exhibit leukemic cells that originated from a stem cell which had been
      damaged by irradiation at the time of bombing and had been involved in the
      complex chromosome abnormalities. Molecular biological studies on transforming
      genes in acute and chronic leukemia and the bcr gene in chronic myelocytic
      leukemia have been performed in exposed and non-exposed groups. So far, no
      distinctive differences have been observed in the frequency and the sites of
      point mutations in N- and K-ras genes or in the rearrangement of the bcr gene,
      for a final conclusion of the specificity of radiation induced leukemia. Further
      retrospective studies require patient DNAs that developed in the early period of
      the atomic bomb exposure.

PMID- 1762104
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Thyroid cancer: reports up to date and a review.
AB  - Evidence to date from a number of studies, indicates that there is an increased
      incidence of thyroid cancer among A-bomb survivors, and that the incidence rises
      with increase of dose and is especially predominant in females exposed at younger
      ages. Although 45 years have elapsed since A-bomb exposure, there are still some
      questions about the development of thyroid cancer: 1) Is the incidence now
      decreasing? 2) What factors, other than radiation exposure, are involved? 3) What
      is the incidence of multiple cancer, including thyroid cancer? With these
      questions in mind, it is apparent that studies in this field must continue for
      some time to come.

PMID- 1762105
TI  - Parathyroid tumors in atomic bomb survivors in Hiroshima: a review.
AB  - Parathyroid tumors in A-bomb survivors in Hiroshima have been studied. Thirteen
      cases of parathyroid tumor were confirmed from 4,136 autopsy cases between 1961
      to 1977, and an elevated incidence of tumor with increase of dose (T65D) was
      demonstrated (P less than 0.01). A high proportion of 42.9%, 6 out of 14
      parathyroid tumors extirpated at Hiroshima University Hospital between 1956 and
      1988, were atomic bomb survivors exposed within 4.1 km from the hypocenter. From
      an epidemiological study using 23 parathyroid tumor cases detected in Hiroshima
      Prefecture between 1974 and 1987, an elevated incidence of parathyroid tumors
      with increase of dose (proximally exposed, other exposed and control nonexposed)
      was demonstrated (P less than 0.001).

PMID- 1762106
TI  - Thyroid cancer: epidemiological study of thyroid cancer in A-bomb survivors from
      extended life span study cohort in Hiroshima.
AB  - We analysed thyroid cancers which were diagnosed clinically or detected at
      autopsy during 22 years (1958 to 1979) in a sample of 75,493 study subjects
      exposed in Hiroshima belonging to the extended LSS sample of the Radiation
      Effects Research Foundation. One hundred and twenty-five cases of clinical
      thyroid cancer (15 in males and 110 in females) were confirmed, giving a crude
      incidence rate per 100,000 person-years of 2.7 for males, 12.4 for females and
      8.6 for both sexes combined. There was a significant increase of thyroid cancer
      with increase of atomic bomb radiation dose (thyroid tissue dose based on T65D)
      in females and in the sexes combined. This tendency was predominant in those
      exposed at less than 19 years of age. Compared to the control group, the relative
      risk in the greater than or equal to 0.50 Gy group was higher at 4.0 for males
      (not significant) and at 4.3 for females (p less than 0.01). Latent thyroid
      cancer was detected in 155 cases or 3.5% (2.5% for males and 4.5% for females) of
      the 4,425 cases that came to autopsy during the same period. Compared to the
      control group, the relative risk in the 50+ rad group was 1.7 for males (not
      significant), 2.0 for females (p less than 0.05) and 1.9 for both sexes combined
      (p less than 0.05). New data obtained from autopsy cases between 1950 and 1985
      have been added.

PMID- 1762107
TI  - Studies of radioactivity produced by the Hiroshima atomic bomb: 1. Neutron
      induced radioactivity measurements for dose evaluation.
AB  - This review summarizes measurements made of 152Eu and 60Co radioactivity induced
      by neutron radiation from the Hiroshima atomic bomb (A-bomb) with the goal of
      estimating the neutron dose released by the bomb. Prior to these measurements, A
      bomb-irradiated specimens such as rocks and pieces of concrete, which had not
      been shielded were collected. The specific radioactivity obtained (in bequerels
      per gram of Eu or Co) were compared with those calculated from DS86 neutrons.
      Findings of usefulness of 152Eu data within 700 m ground range are reported and
      systematic differences between measured activities and calculations are
      discussed. The 152Eu data were also useful for the discussion of circular
      asymmetry, and there was no asymmetry within the experimental errors. This review
      also covers the similar difference found in 32P data, which were measured
      immediately after the A-bomb, along with the other 152Eu and 60Co data. The need
      for more measurements of 152Eu activity in samples farther away from the
      hypocenter in order to verify the DS86 calculations is also discussed.

PMID- 1762108
TI  - Follow-up studies of breast cancer incidence among atomic bomb survivors.

PMID- 1762109
TI  - Mortality among atomic bomb survivors.
AB  - The Atomic Bomb Casualty Commission and its successor, the Radiation Effects
      Research Foundation, have conducted a long-term follow-up study of a cohort of
      120,000 atomic bomb survivors and non-exposed controls since 1950. The most
      recent findings regarding cancer mortality during the period 1950-85 in this
      cohort, based on the DS86 doses are as follows: 1) The dosimetry change does not
      alter the list of radiation-related cancers. Some city differences in dose
      response previously thought to be real are no longer significant with the DS86
      doses. Assuming a linear dose-response, and using estimated organ-absorbed doses,
      the risk coefficients derived from the two dosimetries are very similar. If
      larger RBE values are assumed, the disparity between the two dosimetries
      increases because the neutron dose is much greater in the T65 dosimetry. 2)
      Besides the well-known increase of leukemia, there also have been demonstrated
      increases in cancers of the lung, breast, esophagus, stomach, colon, ovary,
      urinary bladder, and of multiple myeloma, but no increase has yet been observed
      in mortality from cancer of the rectum, gallbladder, pancreas, prostate and
      uterus, and of malignant lymphoma. In general, radiation-induced solid cancer
      begins to appear after attaining the age at which the cancer is normally prone to
      develop (the so-called "cancer age"), and continues to increase proportionately
      with the increase in mortality in the control group as it ages. Sensitivity to
      radiation, in terms of cancer induction, is higher generally for persons who were
      young at the time of the bomb (ATB) than for those who were older ATB. Non-cancer
      mortality in the period 1950-78, based on the T65 doses, which is the most recent
      published report, did not show an increase with dose, but now, with the
      accumulation of seven more years of follow-up, there seems to be an excess in the
      very high dose range, particularly for the younger age ATB cohort. Further follow
      up is called for to confirm this suggestion.

PMID- 1762110
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Cancer risk among in utero-exposed survivors.
AB  - The Radiation Effects Research Foundation (RERF) continues to conduct a follow-up
      study initiated some years ago of cancer mortality and incidence among the
      survivors of the atomic bombing of Hiroshima and Nagasaki exposed in utero.
      Although only 18 incident cases of cancer were identified in the years 1950-1984
      (of which 5 cases were in the 0 dose group), cancer risk appears to increase
      significantly as maternal uterine dose increases. Only two cases of childhood
      cancer were observed among these individuals in the first 14 years of life; both
      had been exposed to greater than or equal to 0.30 Gy. All other cases developed
      cancer in adulthood, and the cancers they developed are, in the main, the ones
      known to be elevated in frequency among the postnatally exposed survivors. The
      estimated relative risk for cancer at 1 Gy (uterine dose) is 3.77. The results
      suggest that the in utero group may have a higher risk than that seen among
      exposed adults because the individuals exposed in utero have not reached the
      major cancer prone age. However, since the observed cases are too few to allow a
      site-specific review, further follow-up studies are required to determine if the
      observed increased cancer risk can definitely be attributed to A-bomb radiation,
      although there appears to be a significant dose-related cancer response.

PMID- 1762111
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Tumor registries and cancer incidence studies.
AB  - A tumor registry is essential in the systematic collection and analysis of tumor
      data in a defined population. Population-based tumor registries have been in
      operation for more than 30 years in Hiroshima and Nagasaki. While the tumor
      registry data have previously been used for many site-specific cancer studies in
      atomic bomb survivors, overall analysis of tumor registry based cancer incidence
      data among the atomic bomb survivors has not been undertaken for some time.
      However, a recent improvement in the tumor registries has made it possible to
      analyze most recent cancer incidence data among the Life Span Study population.
      Preliminary analysis under way indicates a potential power of the data. There are
      a few methodological problems associated with the use of the incidence data,
      especially relating to consistency of data and migration. Several measures taken
      to resolve such problems are discussed.

PMID- 1762112
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Hyperparathyroidism.
AB  - An epidemiological survey on hyperparathyroidism (HPT) among A-bomb survivors in
      Hiroshima has been conducted since August 1986. The results are summarized based
      on proceedings of meetings. The survey demonstrated that the prevalence rate of
      HPT increased with A-bomb radiation dose. Further analysis is now under way on
      the relationship between HPT prevalence and radiation dose, sex and age, the
      results of which will be published in the near future.

PMID- 1762114
TI  - Persistent chromosome aberrations in the somatic cells of A-bomb survivors,
      Hiroshima and Nagasaki.
AB  - Current status of knowledge on the radiation-induced chromosome aberrations
      persisting since their induction in 1945 to date in the somatic cells of A-bomb
      survivors in Hiroshima and Nagasaki is reviewed. Dose-response relationship for
      chromosome aberration frequencies observed with the use of the old A-bomb
      dosimetry system (T65D) is also demonstrable based on the new dosimetry system
      (DS86). Despite the fact that the remarkable decrease in the amount of neutron
      component relative to the total dose in Hiroshima, there still exist inter-city
      differences in aberration frequency per unit dose both for kerma and bone marrow
      dose; the dose-square term is smaller in Hiroshima than in Nagasaki. The
      differential contribution of neutron radiation may be responsible in some part
      for the observed difference between Hiroshima and Nagasaki, although proof still
      remains to be obtained. There is a wide variability of the frequency of cells
      with chromosome aberrations between survivors within a given dose range. Random
      errors in the dose estimates assigned to individual survivors seem responsible,
      to a large extent, for the observed overdispersions in aberration frequencies in
      both cities. New molecular biology-oriented techniques to differentially stain
      specific chromosomes using fluorescence in situ hybridization with chromosome
      specific composite DNA probes seem extremely promising for future rapid, accurate
      and extensive screening of reciprocal translocations observed predominantly in A
      bomb survivors. Such data may be utilized to establish a better biological
      dosimetry system, especially for those persons who are irradiated in vivo many
      years before cytogenetic examinations.

PMID- 1762113
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Brain damage among the prenatally exposed.
AB  - Significant effects on the developing brain of exposure to ionizing radiation are
      seen among those individuals exposed in the 8th through the 25th week after
      fertilization. These effects, particularly in the most sensitive period, 8-15
      weeks after fertilization, manifest themselves as an increased frequency of
      severe mental retardation (SMR), a diminution in IQ score and in school
      performance, and an increase in the occurrence of seizures. Of 30 SMR cases, 18
      (60%) had small heads. About 10% of the individuals with small head sizes
      observed among the in utero clinical sample were mentally retarded. When all of
      the cases of mental retardation are included in the analysis, a linear dose
      response model fits the data adequately and no evidence of a threshold emerges;
      however, if the two probable nonradiation-related cases of Down's syndrome are
      excluded from the 19 SMR cases exposed 8-15 weeks after fertilization, the
      evidence of a threshold is stronger. The 95% lower bound of the threshold based
      on the new dosimetry system appears to be in the range of 0.12-0.23 Gy. In the 16
      25 week period, the 95% lower bound of the threshold is 0.21 Gy both with and
      without inclusion of two probable nonradiation-related retarded cases. In a
      regression analysis of IQ scores and school performance data, a greater linearity
      is suggested with the new dosimetry (DS86) than with the old (T65DR), but the
      mean IQ score and the mean school performance of those exposed in utero to doses
      under 0.10 Gy are similar, and not statistically different from the means in the
      control group. The risk ratios for unprovoked seizures, following exposure during
      the 8th through the 15th week after fertilization, are 4.4 (90% confidence
      interval: 0.5-40.9) after 0.10-0.49 Gy and 24.9 (4.1-191.6) after 0.50 Gy or more
      when the mentally retarded are included and 4.4 (0.5-40.9) and 14.5 (0.4-199.6),
      respectively, when they are excluded.

PMID- 1762115
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Chromosome abnormality in early entrants.
AB  - A preliminary study was performed to estimate radiation dose in 10 individuals
      who had entered Hiroshima city one day after the explosion and worked around the
      hypocenter area for a week. The numbers of cells with chromosome aberrations
      differed in each subject, ranging from one to 18 (median: 11 abnormalities) in
      500 metaphases of lymphocytes cultured for 48 hours with Phytohemagglutinin. Five
      individuals had more than 1.6 percent stable type aberrations and were estimated
      to have been exposed to 6-13 rad. The other five individuals and the controls
      were estimated to be less than two rad.

PMID- 1762116
TI  - Somatic cell mutations in atomic bomb survivors.
AB  - Mutant frequencies in peripheral blood lymphocytes and erythrocytes have been
      measured for atomic bomb survivors having various DS86 doses. Among the four
      assay systems utilized so far, erythrocyte glycophorin A assay revealed a dose
      related increase of mutant frequency, similar to the results obtained with in
      vitro mutagenesis studies at HPRT locus using human diploid cells. Mutant T
      lymphocyte frequency of the HPRT locus detected as resistant to 6-thioguanine
      significantly increased with DS86 dose however the slope was very shallow
      compared with that of in vitro study. Mutation at T-cell receptor genes and the
      HLA-A gene did not show a significant increase in frequency with dose in cells of
      survivors studied.

PMID- 1762117
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Radiation cataract.
AB  - This report reviews the relationship of ionizing radiation to the occurrence of
      cataracts (posterior lenticular opacities) among the A-bomb survivors in
      Hiroshima and Nagasaki. The new DS86 doses are available for 1,983 (93.4%) of the
      2,124 A-bomb survivors analyzed in 1982. The DS86 kerma neutron component for
      Hiroshima is much smaller than its comparable T65DR component, but still 4.2 fold
      higher (0.38 Gy at 6 Gy) than that in Nagasaki (0.09 Gy at 6 Gy). Thus, if the
      eye is especially sensitive to neutrons, there may yet be some useful information
      on their effects, particularly in Hiroshima. Under the best fitting dose-response
      model, an L(gamma)-L(neutron) with two thresholds, both the gamma and neutron
      regression coefficients of the occurrence of cataracts on dose are positive and
      highly significant for the DS86 eye organ doses. The DS86 gamma coefficient is
      almost the same as that associated with the T65DR gamma dose, the ratio of the
      two coefficients being 1.1 (95% confidence limits: 0.5-2.3) for DS86 kerma in the
      individual dose data, and if the risks based on the DS86 eye organ dose and DS86
      kerma are compared, the ratio is 1.3 (0.6-2.8). However, the risk estimates
      associated with neutron exposure are 6.4 (2.2-19.2) fold higher for the DS86
      kerma than the T65DR kerma and 1.6 (0.5-2.3) fold higher for the DS86 eye organ
      dose than for the DS86 kerma.

PMID- 1762118
TI  - Mortality and cancer risk among the offspring (F1) of atomic bomb survivors.
AB  - The Atomic Bomb Casualty Commission (ABCC) and its successor Radiation Effect
      Research Foundation (RERF) has over the years conducted many studies to determine
      possible genetic effects of atomic bomb radiation among the offspring of atomic
      bomb survivors. Findings concerning mortality and cancer incidence of the
      offspring are summarized in this chapter.

PMID- 1762119
TI  - Overview of immunological studies on A-bomb survivors.
AB  - Among the peripheral blood lymphocytes, T-cells and B-cells significantly
      decreased in number with age. Radiation exposure resulted in further significant
      decrease of T-cell count (but not B cells) in the elderly. T-cell response to PHA
      and allo-antigens also decreased with dose in the elderly group. In contrast, NK
      cell number and function increased with age while a significant dose effect was
      not observed.

PMID- 1762120
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Aging.
AB  - The hypothesis that exposure to ionizing radiation accelerates the aging process
      has been actively investigated at ABCC-RERF since 1958, when longitudinal cohort
      studies of the Adult Health Study (AHS) and the Life Span Study (LSS) were
      initiated. In their 1975 overall review of aging studies related to the atomic
      bomb (A-bomb) survivors, Finch and Beebe concluded that while most studies had
      shown no correlation between aging and radiation exposure, they had not involved
      the large numbers of subjects required to provide strong evidence for or against
      the hypothesis. Extending LSS mortality data up to 1978 did not alter the earlier
      conclusion that any observed life-shortening was associated primarily with cancer
      induction rather than with any nonspecific cause. The results of aging studies
      conducted during the intervening 15 years using data from the same populations
      are reviewed in the present paper. Using clinical, epidemiological, and
      laboratory techniques, a broad spectrum of aging parameters have been studied,
      such as postmortem morphological changes, tests of functional capacity, physical
      tests and measurements, laboratory tests, tissue changes, and morbidity. With
      respect to the aging process, the overall results have not been consistent and
      are generally thought to show no relation to radiation exposure. Although some
      preliminary results suggest a possible radiation-induced increase in
      atherosclerotic diseases and acceleration of aging in the T cell-related immune
      system, further study is necessary to confirm these findings. In the future,
      applying the latest gerontological study techniques to data collected from
      subjects exposed 45 years ago to A-bomb radiation at relatively young ages will
      present a new body of data relevant to the study of late radiation effects.

PMID- 1762121
TI  - Studies of radioactivity produced by the Hiroshima atomic bomb: 2. Measurements
      of fallout radioactivity.
AB  - Three studies of fallout measurements were reviewed for the discussion of
      possible radioactivity intake from the Hiroshima atomic bomb. The first study
      discussed correlations between enriched 234U and 137Cs specific activities from
      the measurement of soil samples collected in the "black rain" area. The second
      study measured 137Cs activity on the rock and roof tile samples collected in the
      hypocenter area immediately after the explosion. Some of the rock and roof tile
      samples collected near the hypocenter had a small but detectable amount of 137Cs
      activity. However, it has been determined that 137Cs exposure, for example, was
      negligible compared with DS86 dose estimates, since these activity levels were
      low. The third study detected 90Sr activity in some of the specimens of human
      bones exhumed on Ninoshima Island. This study compared the difference in activity
      between the bone head and shaft, with higher activities obtained in the bone
      head. This fact suggests a short intake period for this activity, however, the
      levels of 90Sr contamination were too low to allow a discussion of the exposure
      risks.

PMID- 1762122
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Current summary of lymphocyte survival study.
AB  - A recently developed dose-survival assay in vitro using human G0 T-lymphocytes
      from peripheral blood was employed to assess possible interindividual variation
      of cellular radiosensitivity. Currently lymphocytes from a total of 99 atomic
      bomb survivors were tested and D10, the X-ray dose required to kill 90% of the
      cells, was calculated for each test. The mean +/- SD of D10 value was 3.35 +/-
      0.22 Gy for 61 survivors whose DS86 dose is below 0.004 Gy and for 38 survivors
      of DS86 dose above 1.5 Gy it was 3.31 +/- 0.26 Gy. So far, the results do not
      show any evidence in support of the hypothesis of a selective elimination of a
      radiosensitive subcohort among the survivors exposed to high doses.

PMID- 1762123
TI  - X-ray sensitivity of fibroblast cell strains derived from atomic bomb survivors
      with and without breast cancer.
AB  - Fibroblasts were established in vitro from skin biopsies obtained from 55 women
      and 1 man with or without breast cancer and with or without exposure to
      radiations from the atomic bomb (A-bomb) explosion in Hiroshima. The
      radiosensitivity of these cells was evaluated by clonogenic assays after exposure
      to X-rays. Dose-response curves were fitted to a multitarget model, S/S0 = A[1-(1
      e-D/D0)N]. There was no difference in the means or variances of radiosensitivity
      between exposed and nonexposed groups, or between groups with and without breast
      cancer.

PMID- 1762124
TI  - Interactive effects between radiation and other factors on cancer risk among A
      bomb survivors--an overview of RERF studies.
AB  - This paper reviews RERF cancer studies conducted to examine interactive effects
      between radiation and epidemiological risk factors, including smoking habits,
      occupation, dietary habits and OB/GYN history. Special emphasis is placed on a
      review of studies of interactive effects between cigarette smoking and radiation
      on lung cancer risk. Comments on these studies are made and proposals for future
      studies are presented.

PMID- 1762125
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Future research in epidemiology and statistics at RERF.

PMID- 1762126
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Biochemical genetics study.
AB  - After 40 years of studies on the children of atomic bomb survivors and a suitable
      control population in which no statistically significant genetic effects of A
      bomb radiation were observed, two new projects have been initiated in order to
      detect mutations in the DNA and RNA molecules. Permanent cell lines from
      peripheral B-lymphocytes from approximately 500 families composed of exposed
      parents and their children and approximately 500 control families are being
      established by Epstein-Barr virus transformation. Cells will be sources for DNA
      and RNA samples in the screening for mutations. After comparison of efficiencies
      of the scanning techniques, we selected the denaturing gradient gel
      electrophoresis (DGGE) of DNA fragments amplified by polymerase chain reaction
      (PCR) for our purpose. A small scale pilot study has started to solve problems
      and obtain a better efficiency in this approach. Current thinking about the most
      efficient procedures is presented.

PMID- 1762127
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Future studies of the prenatally exposed survivors.

PMID- 1762128
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Future perspective of radiobiological studies.

PMID- 1762129
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Summary and conclusions.

PMID- 1762130
TI  - Reassessment of gamma-ray doses in Hiroshima and Nagasaki.
AB  - Reassessment of gamma-ray doses from the atomic bombs in Hiroshima and Nagasaki
      has been carried out with the thermoluminescent measurements of bricks and
      decorative tiles which were collected from the buildings that remain as they were
      at the time of the explosions. The thermoluminescent measurements were performed
      using a dating technique generally used in archaeology. Annual background dose
      rates from natural radionuclides in the brick and tile samples and from
      environmental radiations around the samples were determined with commercially
      available thermoluminescent detectors. The resultant gamma-ray doses in Hiroshima
      and Nagasaki are given as a function of distance from the hypocenters and are
      compared with the DS86 (Dosimetry System 1986) and the T65D (Tentative 1965
      Dose).

PMID- 1762131
TI  - Thermoluminescence dosimetry of gamma rays using ceramic samples from Hiroshima
      and Nagasaki: a comparison with DS86 estimates.
AB  - This study reports gamma-ray doses measured using thermoluminescence (TL)
      dosimetry of atomic-bomb-exposed ceramic samples from Hiroshima and Nagasaki.
      Advances in the dosimetry of TL-sensitive minerals in the field of TL dating of
      archaeological and geological materials made it possible to measure a radiation
      dose of 10(-2) Gy. Ceramic samples such as tiles and bricks were collected from
      locations between 523 and 2,453 m from the hypocenter in Hiroshima and from
      between 731 and 1,565 m in Nagasaki. The gamma-ray dose estimates derived from
      these samples are compared with estimates from DS86. A significant discrepancy
      was noted between the doses measured for samples from Hiroshima and DS86 values.
      One possible cause of this discrepancy might be a secondary gamma-ray dose
      related to the neutron dose.

PMID- 1762132
TI  - A review of forty-five years study of Hiroshima and Nagasaki atomic bomb
      survivors. Residual radioactivity in neutron-exposed objects and residual alpha
      radioactivity in black rain areas.
AB  - The residual Eu-142 radioactivity due to the atomic bomb explosion in 1945 was
      first found in 1976 by in-situ high resolution gamma-ray spectrometry at
      Hiroshima. Since then, various studies on this nuclide have continued not only in
      Hiroshima but also in Nagasaki and they have contributed to the reevaluation of
      the neutron dose due to the A-bombing. By radiochemical separation methods and
      alpha-ray spectrometry, rather high levels of plutonium were found in the surface
      soil and in the bottom sediment of water reservoir which were collected at "Black
      rain area" in Nagasaki. The U-234/U-238 activity ratios for the uranium leached
      with 0.1 HNO3 from the surface of soil samples were found to be relatively higher
      for the samples which were collected at "Black rain area" in Hiroshima.

PMID- 1762133
TI  - Residual neutron-induced radionuclides in samples exposed to the nuclear
      explosion over Hiroshima: comparison of the measured values with calculated
      values.
AB  - Residual radionuclides induced by neutrons from the Hiroshima atomic bomb have
      been measured at Kanazawa University for 14 years. The results of 152Eu, 154Eu
      and 60Co are reviewed in this paper. Where appropriate, an attempt is made to
      provide our new data with the aim of reinterpreting our published data. From the
      comparison of the measured values with the calculated values by DS86 methodology,
      we may point out here: (1) that close agreement was found between measured and
      calculated values for the specific radioactivity of 152Eu in the samples exposed
      at ground ranges between 320 m and 720 m; (2) that the calculated/measured ratios
      for the specific radioactivity of 152Eu were, however, larger than unity in the
      vicinity of ground zero and smaller than unity at locations more than 1000 m
      apart from ground zero; (3) that, in the vicinity of ground zero, epithermal
      neutron fluence evaluated from a set of measured specific radioactivities of
      152Eu, 154Eu and 60Co showed a close agreement with the calculated result,
      whereas thermal neutron fluence evaluated in the same way was different from the
      calculated result; and (4) that the depth distribution of the specific
      radioactivity of 152Eu in a wall sample which was exposed at the location 320m
      from ground zero approximately agreed with the calculated result.

PMID- 1762135
TI  - A research agenda for dental public health.

PMID- 1762134
TI  - Determination of 60Co activity in steel samples in Hiroshima.
AB  - Specific activity of 60C in two steel samples taken at 687m S and 1295m NNW from
      the hypocenter was measured by gamma-ray spectrometry and neutron activation
      analysis. The results are consistent with previous data by Hashizume et al. for
      steel rings on the surface of roofs of buildings. content of nickel and copper in
      the samples was found to be too small to account for any significant 60Co
      production by fast neutron reactions.

PMID- 1762137
TI  - Research in prevention of oral diseases and conditions.

PMID- 1762136
TI  - Epidemiologic investigations.

PMID- 1762138
TI  - Research on oral health education and promotion and social epidemiology.

PMID- 1762139
TI  - Health services research in dental public health.

PMID- 1762140
TI  - Implementation of the research agenda.

PMID- 1762141
TI  - A research agenda for dental public health--rationale and development.

PMID- 1762142
TI  - Specific protein phosphorylation occurs in molluscan red blood cell ghosts in
      response to hypoosmotic stress.
AB  - The regulation of cellular volume upon exposure to hypoosmotic stress is
      accomplished by specific plasma membrane permeability changes that allow the
      efflux of certain intracellular solutes (osmolytes). The mechanism of this
      membrane permeability regulation is not understood; however, previous data
      implicate Ca2+ as an important component in the response. The regulation of
      protein phosphorylation is a pervasive aspect of cellular physiology that is
      often Ca2+ dependent. Therefore, we tested for osmotically induced protein
      phosphorylation as a possible mechanism by which Ca2+ may mediate osmotically
      dependent osmolyte efflux. We have found a rapid increase in 32Pi incorporation
      into two proteins in clam blood cell ghosts after exposure of the intact cells to
      a hypoosmotic medium. The osmotic component of the stress, not the ionic
      dilution, was the stimulus for the phosphorylations. The osmotically induced
      phosphorylation of both proteins was significantly inhibited when Ca2+ was
      omitted from the medium, or by the calmodulin antagonist, chlorpromazine. These
      results correlate temporally with cell volume recovery and osmolyte (specifically
      free amino acid) efflux. The two proteins that become phosphorylated in response
      to hypoosmotic stress may be involved in the regulation of plasma membrane
      permeability to organic solutes, and thus, contribute to hypoosmotic cell volume
      regulation.

PMID- 1762143
TI  - Generalized protein tertiary structure recognition using associative memory
      Hamiltonians.
AB  - In previous papers, a method of protein tertiary structure recognition was
      described based on the construction of an associative memory Hamiltonian, which
      encoded the amino acid sequence and the C alpha co-ordinates of a set of database
      proteins. Using molecular dynamics with simulated annealing, the ability of the
      Hamiltonian to successfully recall the structure of a protein in the memory
      database was successfully demonstrated, as long as the total number of database
      proteins did not exceed a characteristic value, called the capacity of the
      Hamiltonian, equal to 0.5N to 0.7N, where N is the number of amino acid residues
      in the protein to be recalled. In this paper, we describe the development of
      additional methods to increase the capacity of the Hamiltonian, including use of
      a more complete representation of the protein backbone and the incorporation of
      contextual information into the Hamiltonian through the use of secondary
      structure prediction. In addition, we further extend the ability of associative
      memory models to predict the tertiary structures of proteins not present in the
      protein data set, by making the Hamiltonian invariant with respect to biological
      symmetries that represent site mutations and insertions and deletions. The
      ability of the Hamiltonian to generalize from homologous proteins to an unknown
      protein in the presence of other unrelated proteins in the data set is
      demonstrated.

PMID- 1762144
TI  - Solution structure of the tissue-type plasminogen activator kringle 2 domain
      complexed to 6-aminohexanoic acid an antifibrinolytic drug.
AB  - The solution structure of a recombinant tissue-type plasminogen activator kringle
      2 domain, complexed with the antifibrinolytic drug 6-aminohexanoic acid (6-AHA)
      was determined via 1H nuclear magnetic resonance spectroscopy and dynamical
      simulated annealing calculations. The structure determination is based on 610
      intramolecular kringle 2 and 14 intermolecular kringle 2-6-AHA interproton
      distance restraints, as well as on 82 torsion angle restraints. Three sets of
      simulated annealing structures were computed from three different classes of
      starting structures: (1) random conformations devoid of disulfide bridges; (2)
      random conformations that contain correct disulfide bonds; and (3) a folded
      conformation modeled after the homologous prothrombin kringle 1 X-ray
      crystallographic structure. All three sets of structures are well defined, with
      averaged atomic root-mean-square deviations between individual structures and
      mean set structures of 0.77, 0.99 and 0.70 A for backbone atoms, and 1.36, 1.55
      and 1.41 A for all atoms, respectively. Kringle 2 is an oblate ellipsoid with
      overall dimensions of approximately 34 A x 30 A x 17 A. It exhibits a compact
      globular conformation characterized by a number of turns and loop elements as
      well as by one right-handed alpha-helix and five (1 extended and 4 rudimentary)
      antiparallel beta-sheets. The extended beta-sheet exhibits a right-handed twist.
      Close van der Waals' contacts between the Cys22-Cys63 and Cys51-Cys75 disulfide
      bridges and the central hydrophobic core composed of the Trp25, Leu46, His48a and
      Trp62 side-chains are among the distinguishing features of the kringle 2 fold.
      The binding site for 6-AHA appears as a rather exposed cleft with a negatively
      charged locus defined by the Asp55 and Asp57 side-chains, and with an aromatic
      pocket structured by the Tyr36, Trp62, His64 and Trp72 side-chains. The Trp62 and
      His64 rings line the back surface of the pocket, while the Tyr36 and Trp72 rings
      confine it from two sides. The Trp62 and Trp72 indole rings conform a V-shaped
      groove. The methyl groups of Val35 also contribute lipophilic character to the
      ligand-interacting surface. It is suggested that the positively charged side
      chains of Lys34 and, potentially, Arg69 may favor interactions with the
      carboxylate group of the ligand. The Trp25 and Tyr74 aromatic rings, although
      conserved elements of the binding site structure, seem not to undergo direct
      contacts with the ligand.

PMID- 1762145
TI  - Three-dimensional model for stellacyanin, a "blue" copper-protein.
AB  - A three-dimensional model of the "blue" copper-glycoprotein stellacyanin from
      Rhus vernicifera has been derived by computer graphics, energy minimization and
      molecular dynamics techniques. The initial atomic co-ordinates were obtained by
      making substitutions and insertions in the known structure of another blue copper
      protein, cucumber basic protein (CBP), which is 46% homologous with stellacyanin
      and has similar spectroscopic properties. An important difference between CBP and
      stellacyanin is that the latter lacks methionine, a residue that forms an
      exceptionally long bond to the copper atom in all blue copper-proteins of known
      structure. In the aligned amino acid sequences, stellacyanin has glutamine 97 at
      the position that corresponds to the copper-binding methionine 89 in CBP. The
      hypothesis that the copper atom in stellacyanin is co-ordinated by the side-chain
      functional groups of histidine 46, cysteine 87, histidine 92 and glutamine 97
      leads to a model that enables the spectroscopic properties, redox potential and
      electron-transfer kinetics of the protein to be rationalized. The present model
      for stellacyanin is more plausible than an antecedent model derived from the
      structure of plastocyanin. This demonstrates that the output from molecular
      modeling calculations is strongly dependent on the input, and that sequence
      homology with the target molecule is an important criterion for the selection of
      a starting model.

PMID- 1762146
TI  - High resolution structure of an oligomeric eye lens beta-crystallin. Loops,
      arches, linkers and interfaces in beta B2 dimer compared to a monomeric gamma
      crystallin.
AB  - beta-Crystallins are polydisperse, oligomeric structural proteins that have a
      major role in forming the high refractive index of the eye lens. Using single
      crystal X-ray crystallography with molecular replacement, the structure of beta
      B2 dimer has been solved at 2.1 A resolution. Each subunit comprises an N and C
      terminal domain that are very similar and each domain is formed from two similar
      "Greek key" motifs related by a local dyad. Sequence differences in the
      internally quadruplicated molecules, analysed in terms of their beta-sheets,
      hairpins and arches, give rise to structural differences in the motifs. Whereas
      the related family of gamma-crystallins are monomers, beta-crystallins are always
      oligomers. In the beta B2 subunit, the domains, each comprising two motifs, are
      separated by an extended linking peptide. A crystallographic 2-fold axis relates
      the two subunits of the dimer so that the N-terminal domain of one subunit of
      beta B2 and the C-terminal domain of the symmetry-related subunit are
      topologically equivalent to the two covalently connected domains of gamma B
      crystallin. The intersubunit domain interface is very similar to the intradomain
      interface of gamma B, although many sequence differences have resulted in an
      increase in polar interactions between domains in beta B2. Comparison of the
      structures of beta B2 and gamma B-crystallins shows that the two families differ
      largely in the conformation of their connecting peptides. A further extensive
      lattice contact indicates a tetramer with 222 symmetry. The ways in which
      insertions and extensions in the beta-crystallin effect oligomer interactions are
      described. The two kinds of crystallin are analysed for structural features that
      account for their different stabilities. These studies are a basis for
      understanding formation of higher aggregates in the lens.

PMID- 1762147
TI  - Hierarchy of globin complexes. The quaternary structure of the extracellular
      chlorocruorin of Eudistylia vancouverii.
AB  - The molecular dimensions of the extracellular, hexagonal bilayer chlorocruorin of
      the polychaete Eudistylia vancouverii, determined by scanning transmission
      electron microscopy (STEM) of negatively stained specimens, were diameter of 27.5
      nm and height of 18.5 nm. STEM mass measurements of unstained, freeze-dried
      specimens provided a molecular mass (Mm) of 3480 +/- 225 kDa. The chlorocruorin
      had no carbohydrate and its iron content was 0.251 +/- 0.021 wt%, corresponding
      to a minimum Mm of 22.4 kDa. Mass spectra and nuclear magnetic resonance spectra
      of the prosthetic group confirmed it to be protoheme IX with a formyl group at
      position 3. SDS/polyacrylamide gel electrophoresis, reversed-phase chromatography
      and N-terminal sequencing suggested that the chlorocruorin consists of at least
      three chains of approximately 30 kDa and five chains of approximately 16 kDa; the
      two types of subunits occur in the ratio 0.26:0.74(+/- 0.08). Complete
      dissociation of the chlorocruorin at neutral pH in the presence of urea or
      guanidine hydrochloride, followed by gel filtration, produced elution profiles
      consisting of three peaks, B, C and D. Fractions B and C consisted of the
      approximately 16 kDa chains and fraction D consisted of the approximately 30 kDa
      subunits. Mass measurements of particles in STEM images of unstained, freeze
      dried fractions B and C provided Mm of 208 +/- 23 kDa and 65 +/- 12 kDa,
      respectively, in agreement with 191 +/- 13 kDa and 67 +/- 5 kDa obtained by gel
      filtration. Particles with Mm = 221 +/- 21 kDa were also observed in STEM images
      of unstained, freeze-dried chlorocruorin. These results imply that the
      chlorocruorin structure, in addition to the approximately 30 kDa linker subunits
      that have 0.26 to 0.47 heme groups/chain, comprises approximately 65 kDa
      tetramers and approximately 200 kDa dodecamers (trimers of tetramers) of globin
      chains. The stoichiometry of the tetramer and linker subunits calculated from
      molar amino acid compositions was 34 +/- 4 and 43 +/- 9. The complete
      dissociation of the chlorocruorin was accompanied by a 50 to 75% loss of the 55
      +/- 14 Ca2+/mol protein, and was decreased to approximately 35% by the presence
      of 10 to 25 mM-Ca2+. Reassociation of dissociated chlorocruorin was maximal in
      the presence of 2.5 to 5 mM-Ca2+. The dodecamer and/or tetramer subunits in the
      absence or presence of Ca2+ exhibited very limited (less than 10%) reassociation
      into hexagonal bilayer structures, only in the presence of the linker
      subunit.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1762148
TI  - Poly[d(A.T)] and other synthetic polydeoxynucleotides containing oligoadenosine
      tracts form nucleosomes easily.
AB  - Synthetic double-stranded polydeoxynucleotides of the general form
      poly[d(AnT).d(ATn)], with n ranging from 3 to 11, have been synthesized. The
      conformation of the polymers was investigated by circular dichroism spectroscopy
      and the polymers were examined for their ability to form nucleosomes. Although
      spectra show that a circular dichroism band characteristic of poly[d(A.T)]
      appears in the polymer family for n greater than 7, we demonstrate that even
      polynucleotides with the longest tracts of contiguous adenosine bases (n = 11)
      are able to form nucleosomes when reconstituted using a histone exchange
      procedure. Thus resistance to nucleosome formation does not coincide with the
      appearance of features similar to that of poly[d(A.T)] over the bulk of the
      nucleosomal DNA. Furthermore, we show that an approximately 150 base-pair
      poly[d(A.T)] itself, long thought to be refractory to nucleosome formation, can
      assemble into such a protein-DNA complex when reconstituted by a low-salt
      exchange procedure. Competitive assays show that the homopolymer reconstitutes
      about as well as heterogeneous sequences DNA. Our work, therefore, suggests that
      highly adenosine-rich sequences in vivo apparently have a function that operates
      at a level other than that of nucleosome structure.

PMID- 1762149
TI  - ms2i6A deficiency enhances proofreading in translation.
AB  - The hypermodified base 2-methylthio-N6-isopentenyladenosine (ms2i6A) at position
      37 occurs frequently in tRNAs that read codons starting with uridine. Here we
      have studied how ms2i6A affects the accuracy of poly(U) translation in vitro.
      Deficiency leads to a higher rejection rate of tRNA4(Leu) by more aggressive
      proofreading on the wild-type ribosome, but with the initial selection step
      unchanged. Our data indicate that ms2i6A has no effect on codon-anticodon
      interactions on wild-type ribosomes as long as aminoacyl-tRNA is in ternary
      complex with EF-Tu and GTP. ms2i6A deficiency in the cognate poly(U) reader
      tRNA(Phe) leads to increased misreading when the near-cognate competitor
      tRNA4(Leu) is wild-type. ms2i6A deficiency in tRNA4(Leu) gives a decreased error
      level in competition with wild-type tRNA(Phe).

PMID- 1762150
TI  - Cysteine residue periodicity is a conserved structural feature of variable
      surface proteins from Paramecium tetraurelia.
AB  - The DNA sequences of the entire coding regions of the A and C type variable
      surface protein genes from Paramecium tetraurelia, stock 51 have been determined.
      The 8151 nucleotide open reading frame of the A gene contains several tandem
      repeats of 210 nucleotides within the central portion of the molecule as well as
      a periodic structure defined by cysteine residues. The 6699 nucleotide open
      reading frame of the C gene does not contain any identifiable tandem repeats or
      internal similarity but maintains a periodicity based on the cysteine residue
      spacing. The deduced amino acid sequences encoded by the two genes are most
      similar within the 600 amino-terminal and 600 carboxyl-terminal amino acid
      residues, the central portions show only limited sequence similarity. We conclude
      that internal repeats are not a conserved feature of variable surface proteins in
      Paramecium and discuss the possible importance of the regular pattern of cysteine
      residues.

PMID- 1762151
TI  - Evidence for horizontal gene transfer in Escherichia coli speciation.
AB  - After extracting more than 780 identified Escherichia coli genes from available
      data libraries, we investigated the codon usage of the corresponding coding
      sequences and extended the study of gene classes, thus obtained, to the nature
      and intensity of short nucleotide sequence selection, related to constraints
      operating at the nucleotide level. Using Factorial Correspondence Analysis we
      found that three classes ought to be included in order to match all data now
      available. The first two classes, as known, encompass genes expressed either
      continuously at a high level, or at a low level and/or rarely; the third class
      consists of genes corresponding to surface elements of the cell, genes coming
      from mobile elements as well as genes resulting in a high fidelity of DNA
      replication. This suggests that bacterial strains cultivated in the laboratory
      have been fixed by specific use of antimutator genes that are horizontally
      exchanged.

PMID- 1762152
TI  - Crystallization and preliminary X-ray analysis of the lactose-specific
      phosphocarrier protein IIAlac of the phosphoenolpyruvate: sugar
      phosphotransferase system from Staphylococcus aureus.
AB  - The IIA constituent of the lactose permease from Staphylococcus aureus has been
      crystallized in two different forms. Crystals of form I have been grown from
      polyethylene glycol 4000 with beta-octyl glucoside. They diffract to 3.0 A
      resolution and belong to space group C2 with unit cell dimensions a = 141.7 A, b
      = 130.7 A, c = 96.5 A and beta = 96.2 degrees. Form II crystals have been
      obtained from a solution containing polyethylene glycol 400, ammonium sulfate and
      manganese chloride. They diffract to at least 2.8 A resolution and belong to
      space group P2(1)2(1)2(1) with unit cell dimensions a = 89.9 A, b = 101.5 A and c
      = 90.9 A.

PMID- 1762153
TI  - Crystallization of diphtheria toxin.
AB  - Two new crystal forms (forms III and IV) have been grown of diphtheria toxin
      (DT), which kills susceptible cells by catalyzing the ADP-ribosylation of
      elongation factor 2, thereby stopping protein synthesis. Forms III and IV
      diffract to 2.3 A and 2.7 A resolution, respectively. Both forms belong to space
      group C2; the unit cell parameters for form III are a = 107.3 A, b = 91.7 A, c =
      66.3 A and beta = 94.7 degrees and those for form IV are a = 108.3 A, b = 92.3 A,
      c = 66.1 A and beta = 90.4 degrees. Both forms have one protein chain per
      asymmetric unit with the dimeric molecule on a twofold axis of symmetry. Form IV
      is exceptional among all crystal forms of DT in that it can be grown
      reproducibly. Thus the form IV crystals should yield a crystallographic structure
      giving insight into the catalytic, receptor-binding and membrane-insertion
      properties of DT.

PMID- 1762154
TI  - Crystals of the complex between human growth hormone and the extracellular domain
      of its receptor.
AB  - Single crystals suitable for high-resolution diffraction studies have been grown
      of the human growth hormone (hGH) complexed to the extracellular domain of its
      cloned receptor from the human liver (hGHbp), using the technique of repeat
      seeding. The crystals are in space group P2(1)2(1)2, with a = 145.8 A, b = 68.6
      A, c = 76.0 A, and diffract to at least 2.7 A resolution on a rotating anode X
      ray source. Analysis of the composition of these crystals showed the
      stoichiometry of the complex to be hGH: (hGHbp)2. This finding, coupled with
      biochemical data on the complex in solution, indicates that the biologically
      significant dimerization of the growth hormone receptor is mediated through a
      single hormone molecule. Structure determination of the complex is currently
      being completed.

PMID- 1762155
TI  - Crystallization of and preliminary X-ray data for the negative regulator (AmiC)
      of the amidase operon of Pseudomonas aeruginosa.
AB  - The negative regulator (AmiC) of the amidase operon of Pseudomonas aeruginosa has
      been purified from an over-expressing clone and crystalized. Crystals of
      diffraction quality were obtained from polyethylene glycol 4000 and ammonium
      sulphate. AmiC crystallizes in P4(2)2(1)2 (a = 104.4 A, c = 66.6 A) with one
      subunit in the asymmetric unit. Crystals diffract beyond 2.8 A.

PMID- 1762156
TI  - Crystallization and preliminary X-ray analysis of botulinum neurotoxin type A.
AB  - Botulinum neurotoxin serotype A was isolated from liquid culture of Clostridium
      botulinum. The pure Mr approximately 150,000 neurotoxin, composed of Mr
      approximately 50,000 light and Mr approximately 100,000 heavy chains, has been
      crystallized in three different crystal morphologies; all three have the same
      crystal form. The most suitable crystal form for X-ray analysis are bipyrimidal
      and crystallize in the hexagonal space group P3(1)21 (or P3(2)21) with one dimer
      per asymmetric unit. The unit cell dimensions are a = b = 170.5 A, c = 161.7 A.
      The crystals diffract to 3 A resolution.

PMID- 1762157
TI  - Analysis of the integration function of the streptomycete bacteriophage phi C31.
AB  - A 2.1 kb (1 kb = 10(3) base-pairs) segment of DNA from the streptomycete
      bacteriophage phi C31 was found to be sufficient to direct site-specific
      integration of plasmid vectors in Streptomyces ambofaciens and Streptomyces
      fradiae in the absence of any streptomycete origin of replication. Sequencing and
      analysis of phage, chromosomal and junction attachment sites of S. ambofaciens
      and S. fradiae revealed that recombination is conservative and that crossover
      takes place within three bases of homology between phage and host. Deletion
      analysis, sequencing and site-specific mutagenesis of the phi C31 DNA revealed a
      large open reading frame (ORF 613) whose expression was necessary for
      integration. This ORF begins near the point of crossover and reads away from the
      attachment site. A comparison of the predicted amino acid sequence of ORF 613
      with known recombinases did not reveal any significant similarities. A genetic
      analysis of the amino-terminal region of ORF 613 suggested that translation could
      initiate at any one of three possible start codons. Primer extension experiments
      showed that transcriptional initiation occurred at a T and a C only four and five
      bases, respectively, from the site of crossover. This analysis suggested that ORF
      613 would be separated from its promoter upon integration.

PMID- 1762158
TI  - Mutational specificity of the dnaE173 mutator associated with a defect in the
      catalytic subunit of DNA polymerase III of Escherichia coli.
AB  - We developed a system to examine forward mutations that occurred in the rpsL gene
      of Escherichia coli placed on a multicopy plasmid. Using this system we
      determined the mutational specificity for a dnaE173 mutator strain in which the
      editing function of DNA polymerase III is impeded. The frequency of rpsL-
      mutations increased 32,000-fold, due to the dnaE173 mutator, and 87 independent
      rpsL- mutations in the mutator strain were analyzed by DNA sequencing, together
      with 100 mutants recovered from dnaE+ strain, as the control. While half the
      number of mutations that occurred in the wild-type strain were caused by
      insertion elements, no such mutations were recovered from the mutator strain. A
      novel class of mutation, named "sequence substitution" was present in mutants
      raised in the dnaE173 strain; seven sequence substitutions induced in the mutator
      strain occurred at six sites, and all were located in quasipalindromic sequences,
      carrying the GTG or CAC sequence at one or both endpoints. While other types of
      mutation were found in both strains, single-base frameshifts were the most
      frequent events in the mutator strain. Thus, the mutator effect on this class of
      mutation was 175,000-fold. A total of 95% of the single-base frameshifts in the
      mutator strain were additions, most of which occurred at runs of A or C bases so
      as to increase the number of identical residues. Base substitutions, the
      frequency of which was enhanced 25,000-fold by the mutator effect, occurred
      primarily at several hotspots in the mutator strain, whereas those induced in the
      wild-type strain were more randomly distributed throughout the rpsL sequence. The
      dnaE173 mutator also increased the frequency of duplications 28,000-fold. Of the
      three duplications recovered from the mutator strain, one was a simple
      duplication, the region of which was flanked by direct repeats. The other
      duplications were complex, one half part of which was in the inverted orientation
      of a region containing two sets of inverted repeats. The same duplications were
      also recovered from the wild-type strain. The present data suggest that dnaE173
      is a novel class of mutator that sharply induces sequence-directed mutagenesis,
      yielding high frequencies of single base frameshifts, duplications with
      inversions, sequence substitutions and base substitutions at hotspots.

PMID- 1762159
TI  - 1-aminocyclopropane-1-carboxylate synthase in tomato is encoded by a multigene
      family whose transcription is induced during fruit and floral senescence.
AB  - The key regulatory enzyme in the biosynthetic pathway of the plant hormone
      ethylene is 1-aminocyclopropane-1-carboxylic acid (ACC) synthase (EC 4.1.1.14).
      It catalyzes the conversion of S-adenosylmethionine to ACC, the precursor of
      ethylene. We isolated complementary DNA sequences, ptACC2 and ptACC4, for two
      distinct and differentially regulated ACC synthase mRNAs expressed in ripe tomato
      fruit. The authenticity of the clones has been confirmed by expression
      experiments in E. coli. The predicted size of the encoded polypeptides (54,690
      and 53,519 Da) is similar to that of the primary in vitro translation products
      and to the proteins found in vivo. The sequence of the gene encoding one mRNA, LE
      ACC2, has been determined and its transcription initiation site defined. Four
      additional genes, LE-ACC1A, LE-ACC1B, LE-ACC3 and LE-ACC4, have also been
      identified and the sequence of their coding regions determined. The LE-ACC1A and
      LE-ACC1B genes are adjacent to each other and are convergently transcribed. Their
      encoded polypeptides are 96% identical; the identity of the other polypeptides to
      each other varies between 50 and 70%. The proteins predicted to be encoded by the
      ACC synthase genes so far cloned from tomato and zucchini contain 11 of the 12
      conserved amino acid residues found in various aminotransferases involved in the
      binding of the substrate and the cofactor pyridoxal-5'-phosphate. The data
      indicate that ACC synthase is encoded by a divergent multigene family in tomato
      that encodes proteins related to aminotransferases.

PMID- 1762160
TI  - Analysis of replicative intermediates produced during bacteriophage phi 29 DNA
      replication in vitro.
AB  - Replication of bacteriophage phi 29 DNA initiates at either end of its linear
      double-stranded DNA molecule and proceeds by a strand-displacement mechanism. In
      the present paper we have used an in vitro phi 29 DNA replication system to
      analyse by electron microscopy the replicative intermediates produced at
      different reaction times. Two types of replicative intermediates were observed:
      type I (full-length double-stranded phi 29 DNA molecules with one or more single
      stranded DNA branches) and type II (full-length phi 29 DNA molecules formed by a
      double-stranded DNA portion of variable length from one end plus a single
      stranded DNA portion spanning to the other end). Thus, the types of replicative
      intermediates produced in vivo were also formed in the in vitro phi 29 DNA
      replication system. Analysis of type I intermediates indicated that initiation of
      DNA replication occurs preferentially at both ends of the same DNA template, in a
      non-simultaneous manner. Type II intermediates appeared as early as two minutes
      after the reaction started, well before unit-length single-stranded phi 29 DNA
      molecules were synthesized. In addition, replication of recombinant phi 29 DNA
      templates lacking terminal protein at one end did not produce type II
      intermediates and led to an accumulation of full-length single-stranded phi 29
      DNA molecules. These two observations strongly suggest that type II intermediates
      appear when two growing DNA chains, running from opposite ends, merge.

PMID- 1762161
TI  - An axial binding site in the Tetrahymena precursor RNA.
AB  - Previous studies allow the construction of three distinct models of the binding
      of G and arginine within the active site of the Tetrahymena self-splicing
      preribosomal precursor RNA. These models (base triple, axial I and axial II) are
      now distinguished by measurements on the specificity of RNAs with nucleotide
      substitutions at positions spanning the site. Because the semi-conserved unpaired
      nucleotide 263 has no effect on substrate or inhibitor selection by the
      Tetrahymena RNA we conclude that the axial I model is improbable. In contrast,
      data with substituted RNAs and nucleoside analogs suggest that nucleotide 265
      makes a hydrogen bond with the substrate. Accordingly the active site appears
      axial because substrate contacts exist at more than one nucleotide on the 5' side
      of the P7 helix. The effects of this hydrogen bond are observable in cases where
      the donor or acceptor is on the RNA, whether nucleotide 265 is a purine or
      pyrimidine, or whether nucleotide 265 is mispaired, wobble paired or normally
      paired. This pattern is consistent with the axial II model. Molecular dynamics
      and energy minimization calculations lead to the same conclusions as these site
      directed substitutions; the base triple and axial I models are unstable
      dynamically. Under thermal agitation, the third model site (axial II) is
      transformed to a related, but more stable structure, axial III. The axial III
      active site is characterized by the extrusion of the conserved bulged base 263
      from the P7 helix, a semi-pocket for G base formed by stacking of nucleotide 262,
      and formation of all bonds to the G base originally proposed for both the base
      triple and axial II sites. Because of these hydrogen bonds the axial III site is
      also consistent with data on enzymatic specificity. The axial III model indicates
      an unforeseen capacity for pocket formation within the groove of an RNA helix,
      suggests that the site may be unusually flexible, and bears on a hypothesis
      concerning the origin of the genetic code.

PMID- 1762162
TI  - [Clinical evaluation of cefdinir 10% granules in children].
AB  - Cefdinir (CFDN, FK482) was evaluated in children with infections. CFDN was given
      at a daily dose of 6.4-19.8 mg/kg in 2 or 3 divided portions. CFDN was effective
      in 94% of 32 cases with respiratory tract, middle ear, urinary tract or skin
      structure infections. Side effects were loose stool and diarrhea (12.5%). In a
      pharmacokinetic study, 6.0 mg/kg of CFDN was given to each of the subjects before
      meal. Cmax was 0.81 +/- 0.38 microgram/ml, T 1/2 was 2.31 +/- 0.77 hours.
      Antibacterial activity against Staphylococcus aureus was the most excellent of
      oral cephem antibiotics tested. The data suggest that CFDN 10% granular
      preparation is safe and effective when used in children with infections caused by
      susceptible bacteria.

PMID- 1762163
TI  - [Clinical studies on 10% cefdinir granules in pediatric infections].
AB  - Ten% cefdinir (CFDN, FK482) granular preparation, a new oral cephalosporin
      preparation intended for children, was given to children with various infections.
      The results obtained are summarized as follows. 1. Ten% CFDN granules were
      administered to a total of 21 children with upper or lower respiratory tract
      infections, urinary tract infections or infectious impetigo at daily doses of 6.4
      18 mg/kg divided into 3 portions. Clinical efficacies were "excellent" in 13
      patients, "good" in 7 patients and "unknown" in 1 patient (viral infection),
      hence an efficacy of 100% was obtained. 2. Bacteria identified in various disease
      cases included 19 strains of 7 species, and the eradication rate was 100%. 3. No
      side effects were noted in any of the children. Laboratory test results showed an
      abnormality in 1 case with eosinophilia. These results suggest that 10% CFDN
      granules as well as 5% CFDN granules may be a very useful and safe drug for the
      treatment of pediatric infections.

PMID- 1762164
TI  - [A clinical study on cefdinir 10% granule in pediatrics].
AB  - Clinical evaluations of cefdinir (CFDN) 10% granule were carried out. The
      obtained results are summarized as follows. 1. Clinical responses to CFDN of 23
      patients with pediatric infections were excellent in 11 and good in 8. The
      overall efficacy rate was 82.6%. 2. Bacteriologically, the eradication rate for
      23 strains of bacteria identified to be pathogens was evaluated and was 82.6%. 3.
      Side effects observed were diarrhea in 2 of 25 patients. The incidence was 8.0%.
      Abnormal laboratory test results observed included 2 cases with elevation of GOT
      and 1 case with elevation of GPT. These results suggest that CFDN 10% granule, as
      well as 5% granule, may be a very useful and safe drug for the treatment of
      pediatric infections.

PMID- 1762165
TI  - [A clinical study on cefdinir in pediatric field].
AB  - Cefdinir (CFDN) was administered to pediatric patients with acute infectious
      disease. A summary of the results obtained is as follows. 1. Pharmacokinetic
      parameters were determined in a girl. In comparison to reported data in adults,
      Tmax was shorter, Cmax was slightly lower, and the plasma half life of CFDN was
      somewhat longer. 2. Clinical efficacy was studied in 11 children with acute
      tonsillitis (6 patients), scarlet fever (1 patient), acute pharyngitis (1
      patient), acute pneumonia (1 patient), acute otitis media (1 patient) and acute
      cervical lymphadenitis (1 patient). Responses to the treatment were excellent in
      7 (63.6%) and good in 2 (18.2%). 3. No adverse reactions were noted in this
      study.

PMID- 1762166
TI  - [Clinical studies of cefdinir in pediatric infections].
AB  - Five percent fine granule preparation of cefdinir (CFDN, FK482) was administered
      to 30 patients with acute febrile respiratory tract infections (RTI) at 4.9-21.1
      mg/kg/day divided into 3 portions. And 10% fine granule preparation of CFDN was
      also administered to 11 patients with acute febrile RTI and 1 patient with
      urinary tract infection at 10.0-20.0 mg/kg/day divided into 3 portions. Good
      clinical effects observed in 21 of 24 patients (87.5%) with acute pharyngitis, 12
      of 13 patients (92.3%) with acute tonsillitis, 2 of 4 patients (50.0%) with
      pneumonia and a patient with urinary tract infection. From these patients, 34
      causative organisms were isolated. Ten (83.3%) of 12 strains of Staphylococcus
      aureus, all 6 strains of Streptococcus pyogenes and 1 strain of Streptococcus
      pneumoniae, 6 (46.2%) of 13 strains of Haemophillus influenzae and 1 strain of
      Escherichia coli were eradicated from these patients. Among the patients with
      pneumonia, CFDN 20 mg/kg/day dose group showed better clinical responses and
      better bacteriological effects against H. influenzae among the patients given
      CFDN 20 mg/kg/day dose group than those given CFDN 5 mg/kg/day dose group. Side
      effects were noted in 2 cases, one case had soft stools and the other had
      diarrheas.

PMID- 1762167
TI  - [Clinical evaluation of cefdinir 5% fine granules in pediatrics].
AB  - Clinical evaluation in pediatrics on cefdinir (CFDN, FK482) (5% fine granules), a
      new oral cephem, was performed. 1. CFDN was administered to 112 pediatric
      patients with ages between 1 month to 13 years with various infections. Dose
      levels used were 3.0-8.9 mg/kg (mean 5.1 mg/kg) t.i.d. for 3-14 days (mean 6.7
      days). The studied patients included 2 patients with scarlet fever, 6 with acute
      pharyngitis, 6 with acute rhinopharyngitis, 52 with acute purulent tonsillitis, 8
      with acute bronchitis, 24 with acute pneumonia, 7 with acute urinary tract
      infections, 1 with acute vaginitis, and 6 with impetigo. Total doses ranged from
      0.6 to 4.05 g. One hundred eleven of the 112 patients were evaluated for clinical
      efficacy and all the patients were evaluated for safety. 2. Clinical effects were
      excellent in 51 cases, good in 57, and fair in 3 with an extremely high efficacy
      rate of 97.3%. Efficacy rates were 100% in scarlet fever, acute pharyngitis,
      acute purulent tonsillitis, acute bronchitis, acute vaginitis and impetigo, and
      83.3%, 95.7%, 85.7% in acute rhinopharyngitis, acute pneumonia, and acute urinary
      tract infections, respectively. Good clinical effects were observed regardless of
      diseases. 3. Causative organisms were identified in 79 cases, of which 71 were
      found to be monobacterial infections and 8 were found to be multi-bacterial
      infections. In mono-bacterial infections, clinical efficacies were 100% for those
      caused by Staphylococcus aureus/Streptococcus pyogenes/Streptococcus
      pneumoniae/beta-Streptococcus except those in A and B groups with an overall
      efficacy of 100% against Gram-positive cocci (GPC) and they were 89.5%, 100%,
      100% for those caused by Haemophilus influenzae, Haemophilus parainfluenzae, and
      Escherichia coli, respectively, with an overall efficacy of 90.3% in Gram
      negative rods (GNR). In multi-bacterial infections also, a clinical efficacy of
      100% was obtained. 4. Bacteriological effects were studied for 89 strains in the
      79 cases. The eradication rate for a few strains of S. pneumoniae was low, 25%,
      but it was 100% for S. aureus, with the same results for S. pyogenes, and beta
      Streptococcus. The eradication rate on GPC was high 94.1%. Among GNR, 66.7% of E.
      coli, 50.0% of H. influenzae, and 71.4% of H. parainfluenzae was eradicated. The
      overall eradication rate for GNR was 55.3%, lower than that for GPC. Microbial
      substitutions were observed in 13 cases, with Haemophilus sp. replacing other
      bacteria. 5. Diarrhea and soft stools were noted in 4 and 2 patients,
      respectively. The severity of these side effects, however, was slight and it was
      possible to continue the CFDN treatment.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1762168
TI  - [Pharmacokinetic, bacteriological and clinical evaluations of cefdinir 10% fine
      granules in pediatrics].
AB  - Pharmacokinetic, bacteriological, and clinical studies on cefdinir (CFDN, FK482)
      (10% fine granules), a new oral cephem, were performed in pediatrics. 1.
      Bioequivalencies of plasma concentrations and urinary excretions of CFDN 5% and
      10% fine granules were investigated on 3 pediatric patients with ages between 5
      to 13 years administered with a drug in fasting state at a dose level of 3 mg/kg
      using a cross over method. Average plasma concentrations in a group of patients
      administered with 5% fine granules peaked at 3 hours after administration with a
      level of 1.05 +/- 0.29 micrograms/ml (mean +/- S.E.) and decreased to 0.12 +/-
      0.05 micrograms/ml at 8 hours with a half-life of 1.48 +/- 0.09 hours. In the
      group administered with 10% fine granules, average plasma concentrations peaked
      at 2 hours after administration with a level of 1.32 +/- 0.12 micrograms/ml, and
      decreased to 0.20 +/- 0.11 microgram/ml at 8 hours with a half-life of 1.68 +/-
      0.28 hours. The first 8-hour urinary recovery rates of CFDN in the 5% and 10%
      fine granules groups averaged 19.64 +/- 5.69% and 23.37 +/- 2.36%, respectively.
      Both average and individual plasma concentrations and urinary recovery rates in
      the patients of the 10% fine granules group were somewhat higher than those of
      the 5% fine granules group, but no significant differences were observed between
      the 2 groups including areas under concentrations. 2. CFDN 10% fine granule
      preparation was administered to 33 pediatric patients with ages between 1 to 13
      years with various infections, and its clinical effects, bacteriological effects
      and safety were assessed. In 31 of the 33 patients (2 patients were excluded
      since they were with non-bacterial infections) clinical effects were excellent in
      all of 9 patients with scarlet fever (3), acute pharyngitis (3) or impetigo (3),
      excellent in 12 and good in 3 of 15 patients with acute purulent tonsillitis, and
      excellent in 4 and good in 3 of 7 patients with acute pneumonia. The overall
      efficacy rate was 100%. Bacteriological effects against causative organisms were
      evaluated. All the identified Staphylococcus aureus (4 strains) and Streptococcus
      agalactiae (1) were eradicated. Of 10 strains of Streptococcus pyogenes, 9
      strains were eradicated and the other one was reduced. Of 7 strains of
      Haemophilus influenzae 4 were eradicated, 1 persisted and the fate of the
      remaining 2 were unknown. The overall eradication rate was 90.0%. Microbial
      substitutions were observed in 5 patients. The new, replacing bacteria were all
      Haemophilus spp.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1762169
TI  - [Laboratory and clinical studies on cefdinir (10% fine granules) in pediatric
      field].
AB  - Clinical studies on 10% fine granules of cefdinir (CFDN), a new cephem
      antibiotic, were carried out in the field of pediatrics. The results obtained are
      summarized as follows. 1. Half-lives of CFDN in plasma in 3 children when
      administered on an empty stomach were 1.77 hours (3 mg/kg per os) and 1.47 hours
      (6 mg/kg per os), respectively. Eight hour urinary excretion rates of CFDN were
      21.5% (3 mg/kg per os) and 16.4% (6 mg/kg per os), respectively. 2. CFDN was
      administered to 11 children with various bacterial infections: 1 patient with
      scarlet fever, 1 with pharyngotonsillitis, 3 with acute bronchitis, 3 with
      pneumonia and 3 with urinary tract infections. The overall clinical efficacy rate
      was 90.9%. 3. Loose stool was noted in 1 patient. No abnormal laboratory test
      values were encountered.

PMID- 1762170
TI  - [Laboratory and clinical studies of cefdinir 5% and 10% fine granules in
      pediatric field].
AB  - We have carried out laboratory and clinical studies on cefdinir (CFDN) 5% and 10%
      fine granule preparations. The results are summarized as follows. CFDN 5% fine
      granule preparation was given via oral route to each of 2 children in the fasting
      state at a single dose of 3 mg/kg. After administration, the mean peak plasma
      level of CFDN was 0.76 micrograms/ml at 4 hours and the mean half-life was 1.77
      hours. The mean urinary excretion rate of CFDN was 31.5% in the first 12 hours
      after oral administration. CFDN 10% fine granule preparation and CFDN 100 mg
      capsule were given via oral route 3 children and to another child in the fasting
      state at single doses of 3 mg/kg and 2.63 mg/kg, respectively. After
      administration of 10% granules the mean peak plasma level of CFDN was 0.73
      micrograms/ml at 2 hours and the mean half-life was 1.62 hours. The peak serum
      level obtained after administration of CFDN 100 mg capsule was 0.91 micrograms/ml
      at 2 hours and the half-life was 1.08 hours. The mean urinary excretion rate
      obtained with CFDN 10% fine granules was 26.2% in the first 8 hours after oral
      administration and the urinary excretion rate obtained with CFDN 100 mg capsule
      was 19.7% in the first 12 hours after oral administration. Treatment with CFDN 5%
      fine granules was made for a total of 48 cases of pediatric bacterial infections
      including 21 cases of tonsillitis, 12 cases of scarlet fever, 3 cases of
      pharyngitis, 5 cases of impetigo, 1 case of subcutaneous abscess, 1 case of
      furuncle, 5 cases of UTI. Results obtained were excellent in 30 cases, good in 18
      cases. Treatment with CFDN 10% fine granules was made for a total of 16 cases of
      pediatric bacterial infections including 6 cases of tonsillitis, 3 cases of
      pneumonia, 4 cases of scarlet fever, 2 cases of impetigo, 1 case of UTI. Results
      obtained were excellent in 8 cases, good in 7 cases, poor in 1 case. No
      significant side effects due to the drugs were observed except 2 cases (1 case
      with 5% preparation and another with 10%) with eosinophilia, 3 cases (all with
      5%) with diarrhea and 1 case each of elevated GOT & GPT (with 5%) and elevated
      GOT, GPT & Al-P (with 10%).

PMID- 1762171
TI  - [Pharmacokinetic, bacteriological and clinical studies on cefdinir fine granules
      in the field of pediatrics].
AB  - The Pharmacokinetics and clinical effectiveness of cefdinir (CFDN, FK482) were
      examined in pediatric patients. The results are summarized as follows. 1. Plasma
      concentrations and urinary excretions of CFDN after administration of 5% fine
      granules were investigated on 4 children at a dose level of 6 mg/kg. Average
      plasma concentrations peaked at 4 hours after administration at 0.99
      micrograms/ml with a half-life of 2.12 hours. The first 24-hour urinary recovery
      rates of CFDN in 3 children averaged 22.0%. 2. CFDN was given to 24 children (11
      with pharyngitis, 3 with tonsillitis, 8 with scarlet fever, 1 with urinary tract
      infection and 1 with enteritis due to Salmonella); 15 were treated with 5% fine
      granules and 9 with 10% fine granules at daily doses of about 10 mg/kg in 2 to 3
      divided portions. Clinical effects were excellent in 16, good in 7 and not
      evaluable in 1, with an overall efficacy rate of 100%. 3. Identified causative
      organisms were 12 strains of Streptococcus pyogenes, 4 of Haemophilus influenzae,
      5 of Haemophilus parainfluenzae, 1 of Escherichia coli, and 1 of Salmonella.
      Bacteriological effects were rated as "eradicated" for 19 strains, "unchanged"
      for 4 with an eradication rate of 82.6%. 4. No side effects were observed. As for
      abnormal laboratory test results, a transient decrease of white blood cells was
      observed in 1 patient. 5. The CFDN fine granule preparations were preferably
      accepted by the children. 6. The fine granular preparations of CFDN, a new oral
      antibiotic, were useful for the treatment of bacterial infections in pediatrics.

PMID- 1762172
TI  - [Pharmacokinetic and clinical studies of cefdinir in the pediatric field.
      Pediatric Study Group of Cefdinir].
AB  - We studied pharmacokinetics and clinical effects of 5% and 10% fine granules of
      cefdinir (FK 482, CFDN), a new oral cephalosporin, in the pediatric field and the
      following results were obtained. 1. Pharmacokinetics (blood concentration and
      urinary excretion) Pharmacokinetics of CFDN in 163 children was investigated.
      Cmax and T 1/2 were 0.92 +/- 0.45 micrograms/ml and 1.95 +/- 1.06 hours,
      respectively, in the fasting state, and were 0.63 +/- 0.29 micrograms/ml and 2.26
      +/- 0.65 hours, respectively, in the non-fasting state, at a dose level of 3 mg
      (potency)/kg. At a dose level of 6 mg (potency)/kg, Cmax and T 1/2 were 1.29 +/-
      0.49 micrograms/ml and 2.11 +/- 1.85 hours, respectively, in the fasting state
      and were 1.28 +/- 0.48 micrograms/ml and 2.01 +/- 0.84 hours, respectively, in
      the non-fasting state. Data of Cmax and AUC showed that blood concentration of
      the drug depended on dose levels. Urinary recovery rates in the first 8 hours
      were 20.5 +/- 8.8% in the fasting state and 14.8 +/- 5.9% in the non-fasting at a
      dose level of 3 mg (potency)/kg and 16.5 +/- 6.7% and 17.8 +/- 2.4%,
      respectively, at 6 mg (potency)/kg. 2. Clinical effects Clinical effects of CFDN
      on various infections were studied in 612 children who were treated with 5% fine
      granules of CFDN (5% granule group) and in 208 with 10% fine granules of CFDN
      (10% granule group). CFDN granules were administered mainly at daily doses of 9.0
      18.0 mg (potency)/kg in 3 divided portions. Clinical efficacy rates in 428
      children of the 5% granule group and in 159 of the 10% granule group from whom
      causative bacteria were isolated, were 94.9% and 96.2%, respectively. The
      clinical efficacy rates for patients who were responsive to previous antibiotic
      therapy were 91.2% in the 5% granule group and 100% in the 10% granule group.
      Bacteriological eradication rate was 82.1% for 491 strains in the 5% granule
      group, and was 84.0% for 175 strains in the 10% granule group. The incidences of
      side effects were 3.9% (24/608) in the 5% fine granule group and 5.8% (12/206) in
      the 10% granule group. All of the side effects were slight gastrointestinal
      disorders, and no serious side effects were found. As for clinical laboratory
      test results, slight elevations of eosinophile, platelet or transaminase were
      observed. Based on the above results, it is considered that the appropriate dose
      levels of CFDN for pediatric infections ranged from 9.0 to 18.0 mg (potency)/kg a
      day, divided into 3 portions.

PMID- 1762173
TI  - [Biological and pharmacological properties of Clostridium perfringens alpha
      toxin].

PMID- 1762174
TI  - [Antibacterial and bactericidal activities of tea extracts and catechins against
      methicillin resistant Staphylococcus aureus].
AB  - We examined tea extract, (-) epigallocatechin gallate (EGCg) and theaflavin
      digallate (TF3) for their antibacterial and bactericidal activities against
      methicillin resistant Staphylococcus aureus (MRSA) and food poisoning strains of
      S. aureus. Twenty percent tea extract (50 microliters), EGCg (63 micrograms) and
      TF3 (125 micrograms) added to one ml of culture medium each inhibited the growth
      of all strains of MRSA and food poisoning S. aureus tested. Tea extract showed
      also a bactericidal activity against MRSA even at the same concentration of as in
      ordinarily brewed tea. EGCg at a concentration of 250 micrograms/ml showed a
      bactericidal activity against MRSA but not against food poisoning S. aureus, but
      at 500 micrograms/ml reduced markedly the viable number within 48h. These results
      suggest that tea and catechin can be used as prophylactic agents against MRSA
      infection.

PMID- 1762175
TI  - [Cross reactive antigens of Acholeplasma laidlawii and L-form of Staphylococcus
      aureus].
AB  - We demonstrated that the membrane of Acholeplasma laidlawii PG8 and L-form of
      Staphylococcus aureus, both of which induce cellular immunity in BALB/c mice,
      were antigenically related each other. Foodpad responses of the mice immunized
      with a mixture of either antigen and Freund's complete adjuvant showed clearly a
      cross reaction when challenged with the other antigen. Cross responses to
      incorporate 3H-thymidine to the spleen lymphocytes of the mice immunized with
      either antigen occurred in the presence of the other antigen. Furthermore, the
      purified T cells, but not B cells, of the spleen were activated in the presence
      of antigen-presenting cells. These antigens existing in the membrane fractions of
      both microorganisms were purified by Razin's method. Finally, these membrane
      components of A. laidlawii and L-form of S. aureus were subjected to gel
      electrophoresis and transferring to nitrocellulose membrane and used to stimulate
      the spleen lymphocytes of the mice immunized with A. laidlawii or of non
      immunized mice. The fractions representing molecular weights of approximately 45
      kD, 25 kD, and 13 kD of both microorganisms consistently stimulated the
      lymphocytes of the immunized mice but not those of non-immunized mice.

PMID- 1762176
TI  - [Clinical diagnosis and laboratory data].
AB  - Modern medicine can not be practiced without laboratory tests. Laboratory tests
      play a vital role from the initial stage of clinical examination. The Japanese
      Society of Clinical Pathology has formed a committee specifically dealing with
      the effective and economic use of lab tests without missing or duplicating the
      important tests. As is shown in table 1 in the main text "Essential Laboratory
      Tests" were initially agreed as those tests a patient should take when visiting a
      clinic regardless of the complaint. From an early stage, laboratory tests were
      done simultaneously with history-taking and physical examinations. Then the
      "Initial Impression" is obtained and "Organ-oriented 1st and 2nd screening tests"
      and confirmatory tests will be done to make the final diagnosis. To evaluate the
      validity of the "Essential Laboratory Tests", we performed the tests on 1026
      patients who visited our general medicine clinic for the first time. We compared
      the Initial Impression with or without Essential Laboratory Tests. Cases in which
      a diagnosis could not be made by history-taking and physical examination were
      decreased from 17.4% to 8.0% by performing the essential laboratory tests.
      Diagnoses made without the essential laboratory tests were found to be mistaken
      in 10.4% and the additional use of the tests was suggested to lead to a more
      accurate diagnosis. In 110 cases, diseases unrelated to the chief complaints,
      were discovered. Even for the respiratory tract infection, CRP and WBC count,
      which were included in the essential laboratory tests, were very informative.

PMID- 1762177
TI  - [Systematization of clinical laboratory--some problems caused from specimen
      transport through laboratory reports].
AB  - Through error and trials we have designed an ideal system for the clinical
      laboratory. Truly, it has been a very difficult task requiring our long-term
      experience working in the clinical laboratory. For example, if we purchase new
      examination equipment without any consideration or if we decide what type of
      equipment to introduce according to the common advice of the purchase committee
      of the hospital or the medical school, then we cannot design an ideal system of
      laboratory examinations and are forced to invest a large sum of money in vain.
      Moreover, the use of innumerable examination containers or test tubes which are
      disposable, can become a financial burden to the hospital. We have been trying to
      design a system of laboratory automation for more than ten years and have been
      successful in designing not only a specimen transport system using conveyer-belts
      but also various kinds of examination robotic systems. This report describes our
      own examples of designing a system of laboratory automation.

PMID- 1762178
TI  - [Computer-assisted laboratory diagnosis--principles and clinical application].
AB  - Methods of computer-assisted diagnosis based on laboratory data are divided into
      so called rule-base system in which the diagnostic knowledge of physicians is
      programmed and those using multivariate analysis and mathematical models such as
      fuzzy interference. In this report, the principles and the technique of matrix
      discrimination method, which belongs to the latter group, are described, and its
      usefulness in clinical diagnosis evaluated. By the present method, subjects
      (diseases) are separated from two or more groups of subjects (diseases) to be
      discriminated on the basis of laboratory data. The method, based on the linear
      discrimination analysis, is characterized by optimization of selection of
      subjects to be discriminated and selection of test items and inference by the use
      of a discrimination curve. When this method was applied to discrimination of
      healthy individuals and patients with various liver and biliary disorders (11
      diseases), all healthy individuals were discriminated from the patients. A mean
      of 97.0% of patients with hepatic parenchymal disorders were found in the top
      two, and 86.2% of those with space-occupying diseases in the top three, of the 12
      diseases from which the disease of each patient was to be estimated. This
      diagnostic ability of the matrix discrimination method far exceeded the
      physicians' expectations.

PMID- 1762179
TI  - [Laboratory interpretive reporting system. A prototypical approach for knowledge
      representation in acid-base and electrolyte disorders].
AB  - It is important to realize the problem-oriented diagnosis and the goal-oriented
      one to support general physicians as clinical decision makers under so many
      laboratory tests more than full with using practically. A prototypical model for
      computer-assisted interpretation of laboratory data was presented. To achieve
      both function of the problem-oriented inference and the goal-oriented one,
      knowledge base in this system was structured using the methods of semantic
      network and qualitative reasoning. Superficial knowledge level characterized by
      the intuitive reasoning from test results to diseases and deep knowledge level
      referring to the relations among the pathophysiologic states were stratified, and
      the heuristics based on the experiences at bed-side were incorporated in this
      knowledge representation. The pathophysiologic states were distilled from the
      textbooks and the articles, and were linked together by the relationships of
      cause and result, such as functional, constraint or conceptual relationship.
      Diagnostic knowledge on the computer was reconstructed by the causal network
      representing the pathological process as qualitative chaining between the
      pathophysiologic states, and was corrected and compiled by the clinical
      experiences and the experimental facts. Abnormal test data became a trigger of
      the start of inference, and presumptive pathophysiologic states and diagnoses
      were fired on the causal network. Consequently, the most important
      pathophysiologic states might become to be clear to understand the cause of
      changes of laboratory data.

PMID- 1762180
TI  - [Revolution of paradigm in clinical diagnosis--from the mechanization to the
      intelligent being].
AB  - The medical advancements, during the 20th century symbolize the industrialization
      of medical technologies, i.e., many clinical tests are carried out by the highly
      advanced automated machines. Also, the concept of intelligent processing of
      clinical diagnosis seems to have been established in the practice. However, it
      may be an illusion caused from the term artificial intelligence (AI) which
      attracts the attention of not only specialists of computer science but also
      clinicians. The essential nature of AI, especially of expert consultation systems
      is the same as the existing theories, such as Bayes' theorem, Boolean algebra,
      multivariate statistical analysis, and Fussy theorem, i.e., the evaluation of a
      weighted sum of multiple parameters. The weak point of these theories is the lack
      of time parameter. Therefore, the models using a time parameter including
      physiological simulation, dynamics model, Weibull model and Markov process are
      important to realize the revolution of clinical diagnosis from the standpoint of
      intelligent science and technology.

PMID- 1762181
TI  - [DNA diagnosis in endocrinological disease--pituitary disease].
AB  - Endocrine disorders have long been diagnosed by symptoms, before hormones were
      able to be measured by immunoassays. Recently, as molecular biological methods
      developed, DNA diagnosis has become available in many diseases including
      endocrine disorders. We present here DNA diagnosis in connection with anterior
      pituitary hormones. Our studies on thyrotropin (TSH) producing pituitary adenomas
      showed that TSH beta-subunit mRNAs of the adenomas were the same as those from
      normal pituitary tissues. Congenital isolated TSH deficiency is rare disease
      causing hypothyroidism including cretinism, severe mental and growth retardation.
      We have studied 3 families with consanguineous marriage and 2 families which were
      descendants of closed colonies. The molecular pathogenesis were elucidated in the
      cases of 3 Japanese families with consanguineous marriage. They had a same
      missense mutation in the 2nd exon of the TSH beta-subunit gene which made a
      restriction enzyme site, and could be analyzed either by genomic Southern blot
      analyses or by restriction enzyme digestion after amplification of genomic DNA by
      PCR. Congenital deficiency of growth hormone, prolactin, and TSH was first
      described in Snell dwarf mice. The gene encoding the nuclear factor Pit-1/GHF-1,
      which transactivates promoters of both growth hormone gene and prolactin gene,
      was shown to be the cause of Snell dwarf mice. A similar human case arose from a
      family with consanguineous marriage, and the relation with the pit-1/GHF-1 gene
      is now under study.

PMID- 1762182
TI  - [Molecular diagnosis of leukemia and lymphoma].
AB  - Diagnosis of leukemia and lymphoma has been made by morphological, cytochemical,
      and immunophenotypical methods. Recently molecular biological approaches have
      been introduced to clarify the cellular lineage of the tumor cells and to
      demonstrate the monoclonality. Southern blot analysis using immunoglobulin (Ig)
      and T cell receptor (TcR) genes revealed the presence of monoclonal components in
      some cases of angioimmunoblastic lymphadenopathy (AILD), in which demonstration
      of monoclonality was difficult by conventional methods. In preB-ALL, many cases
      had rearranged IgH and TcR genes simultaneously. These "dual genotype" cases were
      found to be of accidental involvement of TcR gene in the process of making
      effective IgH gene rearrangements by the precise analysis of rearranged IgH gene
      structures. The rearranged TcR gene which was detected in initial lymphoblastic
      lymphoma cells, was observed in relapsed blasts after lineage conversion to
      myeloid leukemia, which indicates the same clonal origin. Diagnosis and detection
      of minimal residual disease by the polymerase chain reaction (PCR) are now
      recognized as sensitive methods. PCR using oligonucleotides common to each VH and
      JH gene detects the rearranged IgH gene sensitively. PCR using primers located on
      the translocation boundary, such as bcr and abl in CML, is very useful in the
      diagnosis and pursuit of the disease course. PCR study also can be applied to the
      detection of alteration of some particular genes such as tumor suppressor genes.

PMID- 1762183
TI  - [DNA typing of HLA].
AB  - Recent advance of molecular biology and genetic engineering has made a profound
      influence on clinical and laboratory medicine. In this article we will review
      present aspects of DNA typing of HLA-class II alleles. The HLA system is
      characterized by its highly genetic polymorphisms. HLA -class I (A, B, C)
      molecule consists of alpha 1, alpha 2, alpha 3, and beta 2-microglobulin domain,
      and HLA-class II (DR, DQ, DP) molecule consists of alpha 1, alpha 2, beta 1, and
      beta 2 domain. Differences of amino acid sequences determining polymorphisms of
      HLA-class II molecule are located mainly on the beta 1 domain, while alpha 1
      chain of DQ molecule is also polymorphic. Polymerase chain reaction (PCR) has
      enabled us to make great progress in DNA typing of HLA, in place of RFLP
      (restriction fragment length polymorphisms) analysis. One of the most important
      and valuable advantages is to make us non-radioisotopic detection method
      available. There are several methods for the further analysis of products of PCR
      amplification; 1) dot-blot hybridization, 2) PCR-RFLP, 3) PCR-SSCP (single strand
      conformation polymorphism), 4) DGGE (denaturing gradient gel electrophoresis), 5)
      direct sequencing. As for dot-blot hybridization, there are also several methods
      for detecting hybridization; 1) radioactive detection with 32P - labelled probes,
      2) colorimetric reaction and 3) chemiluminescent assay. Newly developed
      chemiluminescent assay yields as high sensitivity just as radioactive probes. HLA
      D and -DP specificities have been typed cytologically by mixed lymphocyte culture
      (MLC) or primed lymphocyte test (PLT) method. Cytological typing will be replaced
      by PCR analysis in near future.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762184
TI  - [Theophylline pharmacokinetics in patients with liver diseases with reference to
      estimated hepatic blood flow].
AB  - Pharmacokinetics of theophylline were determined in patients with liver cirrhosis
      and idiopathic portal hypertension with reference to estimated hepatic blood flow
      assessed by indocyanine green (ICG). Decreased plasma clearance of theophylline
      was noted in patients with liver cirrhosis and the clearance was significantly
      lower in Child C group than in Child A, B groups (17.5 +/- 3.4 ml/Kg/hr vs 27.6
      +/- 8.7, p less than 0.05). Theophylline has been classified as a drug with a low
      hepatic extraction ratio and it has been believed that changes in hepatic blood
      flow have little effect on its clearance. The results of present study indicate
      that theophylline clearance is basically not related to ICG clearance but to
      theophylline extraction ratio, supporting the common belief. However, it is
      noteworthy that the clearance was related to decreased hepatic blood flow rather
      than extraction ratio in a cirrhotic patient with huge extrahepatic shunt,
      suggesting that hepatic clearance of this drug could be affected by hepatic blood
      flow under some circumstances.

PMID- 1762185
TI  - [Detection of immune complex by C1q solid phase enzyme immunoassay].
AB  - We have developed a new and improved method for detecting immune complexes (IC)
      by C1q solid-phase enzyme immunoassay (CSP-EIA). The sensitivity of this method
      was between 0.62 micrograms/ml and 1.25 micrograms/ml, and values in normal
      individuals were 1.8 micrograms/ml and less. The positive rate of IC of sera in
      which abnormal values were detected by autoimmune disease associated laboratory
      examinations was 50.0% in RA (2+), 20.4% in ANA (+), 60.0% in CH50 (less than
      10), 41.7% in LE latex (+). In sera of RA (2+), the higher the value of CRP
      detected by a semi-quantitative analysis was, the higher the frequency having
      abnormal high IC values was. The number of IC positive sera, in which enzyme
      linked immunoglobulins were detected, was 18 of 68 (positive rate 26.5%). The
      number of IC positive samples in asymptomatic carriers of sera, whose titer of
      anti-HTLV-I antibody was positive by gelatin particle agglutination assay (PA),
      was 14 of 67 (pos. rate 18.4%). All of these 14 samples were high positivity of
      anti-HTLV-I antibody (titer greater than or equal to 256 times). In urine of some
      patients with urogenital diseases, IC-like substances to show positive reaction
      by our CSP-EIA were detected. However, any positive reaction was not detected
      either by an anti-C1q- or an anti-C3d method. Studies are in progress to
      elucidate detailed characterization of the IC-like substances.

PMID- 1762186
TI  - [Difference of blood cell counts with reference blood cell counters in three
      different makers].
AB  - To determine the difference of CBC values in different blood cell counters, we
      have measured the values of CBC by using reference cell counters of three major
      makers; Coulter, Sysmex and Technicon. Thirty ml of whole blood was taken from 2
      healthy individuals and mixed with 45 mg of EDTA -2K. The blood samples were then
      sent to reference laboratory of each maker under identical conditions. The
      determination of cell counts was performed 4 hours after taking blood. Ten
      consecutive analysis were then carried out and the mean of 10 values was
      calculated. The apparent difference was displayed in leucocyte and platelet
      counts. In both of two samples, the highest values of either leucocyte or
      platelet count was obtained with Coulter instrument. And second high values were
      noted with Sysmex counter and the lowest values were observed by Technicon
      instrument. The extent of difference between each instrument was over 10% in case
      of platelet count and was 5 to 10% in leucocyte count. The difference of
      erythrocyte count, Hgb level, hematocrit value and MCV also existed, but the
      extent of difference was within 5% in all of these examinations. Since CV of each
      examination was sufficiently low level, this difference might be due to the
      difference in accuracy of reference cell counter of each maker. These results
      suggest that distinct differences of CBC count, particularly platelet and
      leucocyte count can be produced by the different procedures of calibration for
      reference counter in each maker of automated blood cell counter.

PMID- 1762187
TI  - [Analysis of CK-MB using immunoinhibition method].
AB  - The significance of creatine kinase (CK) in the diagnosis of acute myocardial
      infarction was evaluated. The serum level of CK-MB, a CK isozyme was determined
      by the immunoinhibition method. The CK-MB activity could be determined by the
      immunoinhibition method in a short time with an autoanalyzer, suggesting that the
      immunoinhibition technique is adequate as a method of emergency examination. The
      immunoinhibition method has the disadvantage of error induction because of
      contamination with CK-BB, CKm and macro-CK by this method. Thus, CK-MB activity
      should be determined in parallel with total CK activity. When a significant
      contribution from CK-BB is suspected, its presence should be confirmed by other
      methods. The present results suggest that the efficiency of coronary artery
      reperfusion therapy can be evaluated earlier by determination of CK-MB activity
      than by that of total CK activity.

PMID- 1762188
TI  - [Usefulness of CK-MM isoforms for early stage of acute myocardial infarction
      using electrophoretic technique].
AB  - MM isoform of CK (EC 2.7.3.2) was able to detect by high voltage electrophoresis.
      Sequential blood samples were collected from the patients with acute myocardial
      infarction and MM isoform (as MM3/MM1 ratio), CK activity and CK-MB activity were
      tested. Time of the maximum MM3/MM1 ratio from the onset was 9.4 hrs (average of
      16 cases) whereas 15.9 hrs on CK-MB activity and 17.3 hrs on CK activity were
      detected. In vitro time course of CK-MM isoform from myocardial and skeletal
      muscle extracts was tested. MM3 band was gradually converted into MM2 and then
      MM1 band, but MM3 isoform from myocardium was changed less than skeletal muscle.
      From these results, it is suggested that abnormal MM3/MM1 ratio on myocardial
      infarction continues relatively longer time than that on skeletal muscle disease.

PMID- 1762189
TI  - [Immunoinhibitory determination of CK-MM subbands by monoclonal antibody].
AB  - The measurement of CK-MM isoform by monoclonal antibody and its clinical
      application were summarized. The tissue type of CK-MM3 isoform was completely
      inhibited, MM2 isoform was about 57% and the serum type of CK-MM1 isoform was not
      inhibited by use of monoclonal antibody. This method enabled selective
      immunoinhibitory measurement of tissue type of CK-MM isoform. The heat lability
      and inhibition by EDTA suggested that it is a metal-depending enzyme. The
      analysis of MM isoform offers a promising alternate, non-invasive method to
      detect and follow up AMI and successful reperfusion. The MM3/MM1 ratio has been
      found to peak at about 2 to 6 hours, making it a quicker responding parameter to
      AMI than MM3 alone and significantly more responsive than the total CK or CK-MB.
      An MM3/MM1 ratio greater than 1.0 appears to be a practical cutoff point for
      detection of the pathological release of MM3 from tissue. Reperfusion therapy
      should be instituted within about 2 to 4 hours of AMI onset.

PMID- 1762190
TI  - [The determination of CK-MB protein mass].
AB  - It has been well known that the determination of CK-MB is a useful parameter for
      the diagnosis of acute myocardial infarction (AMI). Currently, several methods
      such as Electrophoresis, Ion-exchange chromatography, Immunoinhibition method and
      Protein mass determination are available. From a point of the diagnosis of AMI,
      the method should be satisfied with the requirements of high speed, ease to
      perform, high analytical specificity and high analytical sensitivity. However,
      there are no appropriate methods which can satisfy all of the requirement. In
      this paper, we have introduced the present situation concerning the determination
      of CK-MB in our hospital and discussed the results of study on the IMx method
      based on the determination of protein mass of CK-MB. We obtained good results in
      the fundamental study and found some advantages of protein mass determination.
      The first advantage was its high analytical specificity by use of monoclonal
      antibody. The second advantage was its high analytical sensitivity because of its
      low detection limit. The third advantage was the stability of sample because the
      antigenicity of CK-MB to the antibody of reagent is stable comparing with that of
      enzyme activity. From those advantages, the mass determination of CK-MB will be a
      useful method for the diagnosis of AMI in the near future.

PMID- 1762191
TI  - [Early diagnosis and early detection of successful reperfusion by latex
      agglutination turbidimetry of serum myoglobin in patients with acute myocardial
      infarction].
AB  - As latex agglutination turbidimetry of serum myoglobin (Mb) levels is simple,
      rapid and high sensitive method, it can be applied for early diagnosis and
      reperfusion therapy (PTCA, PTCR) in patients with acute myocardial infarction
      (AMI). The measurement of serum Mb levels is useful for early diagnosis of AMI,
      and we conclude that the measurement of serum Mb levels is useful and suitable
      for rapid judging on success or failure of reperfusion therapy use of the
      disappearance rate of it.

PMID- 1762192
TI  - [Biochemical diagnosis for acute myocardial infarction; myosin light chain].
AB  - Immunoassays for cardiac myosin light chains (LC) are important biochemical tests
      for diagnosis of acute myocardial infarction (AMI). LC appears in the serum 4-12
      hours after AMI. The most unique characteristic of the time-course of LC is that
      the elevation of LC in the serum lasts for 1-2 weeks, which allows the
      retrospective diagnosis of AMI when cardiac enzymes in the serum are decreased to
      the normal level. This long time-course is due to the continuous liberation of LC
      from the infarcted myocardium, which could be confirmed by the cardiac scintigram
      using anti-myosin heavy chain antibody. The serum LC level is also useful in
      predicting the extent of the cardiac wall damage since the peak LC level
      reflected well the ventricular ejection fraction or the presence of mechanical
      complications, such as the formation of ventricular aneurysm. Immunoassays for
      cardiac LC have recently been improved by the introduction of ELISA using two
      monoclonal anti-light chain antibodies. ELISA can be finished within 3 hours,
      which will help to make cardiac LC measurement one of the most important
      biochemical tests for diagnosis of acute myocardial infarction.

PMID- 1762193
TI  - [Evaluation of [troponin-T] as a new biochemical marker for acute myocardial
      infarction].
AB  - Troponin (Tn) and tropomyosin (Tm) are located in the thin actin-containing
      filaments. Tn, a complex of three subunits (Tn-C, Tn-I and Tn-T), plays an
      important role in muscle contraction via calcium metabolism. In the present
      study, we evaluated the usefulness of a serum Tn-T assay in patients with acute
      myocardial infarction. The method, based on the sandwich immunoassay, was
      developed for the determination of serum Tn-T. The analytical precision data were
      good enough for routine analysis (CVs of repeatability and day-to-day
      reproducibility were between 3.2 to 6.2%). The values obtained on 60 healthy
      adults were below 0.2 ng/ml. Physical activity (mountain climbing and golf)
      increased serum total CK and myoglobin, but did not increase Tn-T. In myocardial
      infarction, serum Tn-T was up to 20 times higher than the cut off value at
      admission, and had a large peak at around 14 hr and another small peak at 40 to
      55 hr after the onset. The ratio of Tn-T at around 14 and 32 hr (14/32) was an
      excellent marker for successful reperfusion. All cases of successful PTCA, had a
      ratio higher than 1.0.

PMID- 1762194
TI  - [Magnetoencephalographic studies on spike foci using a 37-channel biomagnetometer
      system].
AB  - We report the results of a clinical trial of Magnetoencephalography (MEG) on
      spike foci in patients with epilepsy, which was performed from December 1990 to
      June 1991 at The University of Tokyo Hospital. Fifty patients with focal
      epilepsy; 26 primary epilepsy, 24 secondary epilepsy (7 brain tumor, 4
      arteriovenous malformation, 4 encephalitis, 3 porencephaly, 2 arachnoid cyst, 1
      brain abscess, 1 hemimegaloencephaly, 1 Lance-Adams syndrome, 1 hygroma), and ten
      normal subjects were enrolled in this study. MEG data were recorded using a 37
      channel biomagnetometer system SMI-1001 (BTi Magnes, Biomagnetic Technologies,
      Inc., San Diego). A simultaneous 19-channel EEG recording with linked-ear
      reference was also obtained. The overall study was completed safely and none of
      the normal subjects showed abnormal paroxysmal MEG activity. Two patients showed
      interictal EEG spikes which would not have been noticed without first noting the
      presence of corresponding prominent MEG spikes. On the whole, the MEG signal
      seemed to have a wider frequency bandwidth than EEG. In most cases, the source
      localization predicted by MEG corresponded well with the EEG findings. The
      relative accuracy of MEG spike source localization was estimated to be within a
      cubic centimeter from the cases which showed tightly clustered localization of
      individual spikes. High-pass filtering reduced interference by superimposed slow
      wave activity, thereby improving the localization of spike sources. These results
      demonstrate that 37-channel biomagnetometer system could be a useful tool for
      analyzing epileptic spike sources.

PMID- 1762195
TI  - [A new method for immunological detection of fecal blood, using colloidal gold
      labeled with anti-human hemoglobin monoclonal antibody].
AB  - Application of colloidal gold agglutination to detection of fecal blood was done.
      Colloidal gold labeled with monoclonal antibody recognized human hemoglobin was
      agglutinated with hemoglobin and changed the color from red to gray. The color
      that diminished rapidly with an antigen was unchangeable from 30 min to 4 hr.
      Reaction was single step, and positive tests were easily distinguished from
      negative tests. Detectable hemoglobin concentration was 0.5 micrograms/ml.
      Comparison of colloidal gold agglutination with other methods, as low as latex
      agglutination and RPHA, showed good agreements in 1409 fecal samples. Colloidal
      gold agglutination method is superior in easiness of judgement and unnecessity of
      keeping time, and will be suitable for mass screening for colorectal cancer using
      96 well microplate.

PMID- 1762196
TI  - [Serum lipid and apolipoprotein levels in patients with chronic pancreatitis].
AB  - Serum lipid and apolipoprotein (apo A-I, A-II, A-IV, B, C-II, C-III, E and H)
      levels were determined in 26 patients with chronic pancreatitis without
      complications such as liver disease or diabetes mellitus. These patients were
      divided into two groups, CP-I (n = 16) and CP-II (n = 10), according to the
      clinical criteria for chronic pancreatitis. HDL-cholesterol and apo A-I levels in
      CP-I and CP-II groups significantly decreased compared to those in sex- and age
      matched healthy controls (p less than 0.05), whereas there were not significant
      differences in triglyceride and total cholesterol levels between these groups and
      controls. On the other hand, apo A-IV levels in CP-I and CP-II were 7.1 +/- 1.0
      mg/dl and 8.3 +/- 1.5 mg/dl, respectively and these values were significantly
      lower than 11.2 +/- 1.8 mg/dl in controls (p less than 0.001). In this study, the
      serum lipids apparently showed normal levels in patients with chronic
      pancreatitis who had no severe complication, and the markedly low apo A-IV levels
      in these patients were considered to be mainly due to the decrease of lipid
      absorption from the intestine.

PMID- 1762197
TI  - [Converse changes in serum levels of immunoglobulins (IgG, A and M) and
      complement components (C3, 4) during pregnancy].
AB  - Sequential changes in serum levels of the immunoglobulins IgG, A and M and of the
      complements C3 and C4 during pregnancy and the postpartum period were studied in
      8 healthy women. Serum IgG and A levels decreased gradually during pregnancy, but
      increased significantly during the first three months following delivery. Serum
      IgM level also decreased during pregnancy, reaching its minimum during the second
      trimester, but increased thereafter. In contrast, C3 and C4 levels increased
      significantly during pregnancy and reached their maximum levels during the last
      trimester. After delivery, levels of these two components decreased gradually for
      the next six months. The complement system may operate as a compensatory
      autoregulatory mechanism in the suppression of the humoral immune system during
      pregnancy.

PMID- 1762198
TI  - [Evaluation of serum myoglobin level in patients with muscular disorder and renal
      failure].
AB  - Since myoglobin is a low molecular weight proteins and most serum myoglobin is
      usually excreted into the urine, but serum myoglobin is elevated in patients with
      renal failure. This elevation hampers diagnosis of muscular damage in patients
      with renal failure. We studied the influence of renal function on serum myoglobin
      level and estimated corrected myoglobin levels. We first examined the correlation
      of serum myoglobin level with levels of serum creatinine and serum beta 2
      microglobulin in patients without muscular damage. Creatinine level was more
      highly correlated with serum myoglobin level than with beta 2 microglobulin
      level. Measured myoglobin level was corrected using the regression line obtained
      from the correlation between levels of myoglobin and creatinine, and the
      corrected myoglobin levels thus obtained were within a reasonable range. The
      influence of renal failure was compensated for by this correction. We then
      measured myoglobin level and creatine kinase activity in patients with various
      heart muscle or skeletal muscle diseases, with or without renal failure, and
      compared measured myoglobin levels with the corrected ones. In these patients,
      myoglobin level changed faster than such muscle enzymes as creatine kinase.
      Thereafter, we found that the stage and degree of muscular damage could be
      estimated from both corrected myoglobin level and creatine kinase activity, even
      in patients with renal failure. In conclusion, corrected serum myoglobin level
      might be a useful diagnostic marker of muscle damage even in patients with renal
      failure.

PMID- 1762199
TI  - [Effect of plasma on analysis of lymphocyte subsets].
AB  - We examined the effect of plasma on the analysis of lymphocyte subsets with a
      flow cytometer using whole blood cells. Removal of plasma from whole blood by
      washing them before labelling the lymphocytes with fluorescein-conjugated
      antibodies reduced the proportion of CD5+CD19+ cells and increased the
      proportions of CD16+ CD57- and CD16+ CD57+ cells, as compared with those measured
      without washing, but did not change the proportions of CD5+ CD19-, CD5- CD19+,
      CD4+ CD8-, CD4- CD8+ and CD16- CD57+ cells. Removal of plasma from whole blood
      also reduced the fluorescence intensity of CD4 and CD5 antigens and increased
      that of CD8, CD16, CD19 and CD57 antigens on each lymphocyte subsets.
      Characteristics of the changed lymphocyte subsets were to have a surface antigen
      with weak immunofluorescence on the flow cytometric analysis such as CD5 and
      CD16, and to have an unclear borderline between the positive and negative cells.
      Therefore, even slight changes in the fluorescence intensity of these antigens
      could change the proportion of CD5+ CD19+, CD16+ CD57- and CD16+ CD57+ cells.
      However, these changes were not observed, when using the washed blood cells as
      samples after readdition of plasma to them. These data suggest that removal of
      plasma from blood before labelling the lymphocytes with fluorescein-conjugated
      antibodies is necessary to make the sample condition equal for flow cytometric
      analysis of lymphocyte subsets.

PMID- 1762200
TI  - [von Willebrand factor multimer analysis using electroblotting and
      immunoperoxidase staining method].
AB  - Further modification of the previously reported peroxidase staining method for
      von Willebrand factor (vWF) multimer is described in this article. The alteration
      are as follows: affinity purified anti-human vWF rabbit IgG was replaced by
      commercial anti-human vWF rabbit IgG, and washing and reaction steps were
      shortened markedly. Despite these modification, the resolution of vWF multimers
      on the nitrocellulose membrane remains comparable to the autoradiography.
      However, unlike autoradiography, results produced by this method can be obtained
      in a day. The features of this method are especially useful in clinical
      laboratories where both time and equipments are limited.

PMID- 1762201
TI  - [Significance of determination of the blood antibody level in Chlamydia
      trachomatis infection of the uterine cervix].
AB  - Kits for measurement of C. trachomatis specific antibody are not commercially
      available, but of the significance of determination of the serum antibody level
      has not been clarified. In this study, we first determined the C. trachomatis
      antibody level in patients considered to be free of C. trachomatis infection.
      Then, we evaluated the relationship between the presence or absence of antigen
      with the antibody level in patients at our department who were available for
      antigen examination. Anti-C. trachomatis IgA and IgG antibodies were detected in
      all age groups with a peak frequency in the 20's expect that IgA antibody was
      absent in the umbilical blood (IgG antibody was detected also in the umbilical
      blood). Concerning the relationship between the presence or absence of C.
      trachomatis antigen and the serum antibody levels, both IgA and IgG antibodies
      were significantly different (chi 2 test, p less than 0.01) between the antigen
      positive group and the antigen-negative group. Because females infected by C.
      trachomatis were more often asymptomatic than infected males, and because antigen
      tests may produce false negative results, determination of the antibody level
      must be included in the clinical tests. Determination of the antibody level is
      considered to be valuable also in screening for mother-child infection and
      asymptomatic infection.

PMID- 1762203
TI  - Proceedings of the 24th annual meeting of the Japan Epilepsy Society and the
      Japanese Branch of the International League Against Epilepsy. November 16-17,
      1990, Okinawa.

PMID- 1762202
TI  - [Mixed type cryoglobulinemia with discrepancy of platelet counts measured with an
      automated cell counter and by manual counting method].
AB  - We experienced an abnormal blood sample which showed larger numbers of white
      blood cells and platelets counted by the electric resistance system and of
      platelets in mechanical counting by the flow system, than those in manual
      counting. Many precipitates were observed in this blood sample at room
      temperature or 4 degrees C, but were not observed at 37 degrees C. The
      precipitates were clarified to be caused by the mixed type (IgA, IgG and IgM)
      cryoglobulin by using an immunofluorescence method and an ouchterlony method.
      These data indicate that precipitation of cryoglobulin at room temperature induce
      falsely high value of platelet count in mechanical counting systems.

PMID- 1762205
TI  - The role of interhemispheric pathways in generalization of kindled seizures in
      cats and subhuman primates.
AB  - The role of interhemispheric pathways in generalization of partial seizures was
      evaluated in the kindling model of epilepsy. The generalized seizure kindled from
      the amygdala was asymmetrical in cats with callosal bisection, destruction of
      massa intermedia of the thalamus or bilateral ventral hippocampus. The
      generalized convulsion of amygdala kindled cats became asymmetrical or changed
      into partial seizures by callosal bisection. The fully-kindled amygdala seizure
      of a split-brain epileptic baboon and rhesus monkey was a hemiconvulsion or an
      asymmetrical generalized convulsion. The amygdala-kindled bisymmetrical
      generalized convulsion of the epileptic baboon was changed into a hemiconvulsion
      or an asymmetrical generalized convulsion. These results indicate that the corpus
      callosum plays an important, although not exclusive, role in bilateralization of
      epileptic activity, and its role becomes more important when the animal ascends
      the phylogenetic scale.

PMID- 1762204
TI  - Surgical treatment of epilepsy.

PMID- 1762206
TI  - Propagation of acute seizure activities observed by local cerebral glucose
      metabolism.
AB  - We studied the propagation of acute focal seizure activities in animals by means
      of the [14C]deoxyglucose method. Seizures were induced unilaterally by injecting
      penicillin in the neocortical area 4 and area 9 in the monkey, and by injecting
      kainic acid in the hippocampus of the rat and in the ventral posterolateral
      thalamic nucleus of the cat. The earliest and the most consistent propagation was
      the one to the target structures of the primary focus, mediated through the
      "preferential" projection pathways. At a more advanced stage, the propagation to
      the immediately adjoining brain regions occurred, followed by the secondary
      propagation to the target structures of the adjoining regions. Propagation to the
      contralateral homologous structure was not a major one at the early stage unless
      the structure of the primary focus had its own commissural connections.

PMID- 1762208
TI  - Epilepsy and driving licence in the Federal Republic of Germany and other
      European countries.

PMID- 1762207
TI  - Mechanism of electrographic seizure generation in the rat brain slice in low
      magnesium medium: modulatory effect of interictal bursting on seizure generation.
AB  - In order to understand the mechanisms underlying seizure generation, the present
      study investigated the functional and anatomical interaction between seizures and
      interictal bursts. Bathing rat brain slices of the hippocampus and entorhinal
      cortex in zero magnesium medium elicited electrographic seizures. In the later
      period, the electrographic seizures were eventually replaced by the interictal
      bursts. In this phase, lowering [K+]o and raising [Ca2+]o restored the tonic
      seizures by suppressing the interictal bursts. A multiple knife cut experiment
      revealed that the seizures arose in the entorhinal cortex and the interictal
      bursts originated in CA3. A selective knife cut across the subiculum showed that
      the interictal bursts, propagating from CA3 to the entorhinal cortex, disrupted
      and suppressed the electrographic seizures in standard Mg(2+)-free medium.

PMID- 1762209
TI  - Driving and epilepsy: a prospective questionnaire survey in Japan. Committee on
      Driver's Licenses, the Japan Epilepsy Society, Shizuoka.

PMID- 1762210
TI  - A study on driving status in 98 epileptic patients with driving licences.
AB  - As to the driving status in the period between January 1984 and December 1988, 98
      epileptic patients with driving licences were examined, paying regard to their
      clinical conditions. Sixty-one (62%) of the patients were seizure-free for the
      last five years or more in December 1988. Eighty-one (83%) were actually driving
      motor vehicles at the time of this study, and 27 (33%) of the 81 drivers still
      had fits during the past five years. Nine patients (9%) had caused traffic
      accidents, but no accident had occurred due to seizures. The type of the nine
      accidents was as follows: One case of a slight physical injury to the other
      person, four cases of the driver's own car damage without other material damage,
      and four of the accidents involving other cars.

PMID- 1762211
TI  - Epilepsy and driving: a survey of automobile accidents attributed to seizure.
AB  - From results of a survey of 72 epileptic car drivers who had a mean driving
      history of 8.6 years, 18 (25%) had experienced one or more automobile accidents
      ascribed to a seizure while driving, with the total number of accidents of the
      surveyed group amounting to 35. All the drivers were known to have partial
      epilepsy, 13 of them having temporal lobe epilepsy. The main characteristics of
      these 35 accidents were as follows: (1) Fifty-seven percent were caused by
      complex partial seizure without an aura in which consciousness was immediately
      impaired at onset, while about 10% were attributed to simple partial seizure in
      which the conscious state was not altered. No accident was caused by a first
      seizure; (2) Fifty-one percent occurred on an empty road with little pedestrian
      and/or vehicular traffic; (3) In about half the accidents, the driver's vehicle
      collided against an immovable object, and only 20% involved crashing into another
      car; (4) Most accidents caused damage to only the driver's car and/or mild
      physical injury; and (5) Fifty-four percent of the accidents were not reported to
      the police, and many that were reported were ascribed to driving while asleep, to
      careless driving or to similar behavior.

PMID- 1762212
TI  - Discussion on the 'problem of driving license for people with epilepsy'.
AB  - From the socio-medical points of view, the problem of a driving license for
      people with epilepsy was discussed. It was concluded that not only seizure but
      also the presence of side-effects of drugs and of personality change should be
      assessed to allow them the license. Finally, a medical guideline was proposed for
      the driving license for people with epilepsy.

PMID- 1762213
TI  - Classification of epilepsies, epileptic syndromes and related seizure disorders
      (1989): an outline and the use.

PMID- 1762214
TI  - Usefulness of the newly proposed International Classification of Epilepsies,
      Epileptic Syndromes, and Related Seizure Disorders (1989): a trial on adult
      patients in a neuropsychiatric clinic.
AB  - The utility of the "International Classification of Epilepsies, Epileptic
      Syndromes, and Related Seizure Disorders," proposed by ILAE in 1989, was
      investigated in a neuropsychiatric clinic with a patient population numbering
      300. Two hundred and three patients (67.7%) had localization-related epilepsies
      (LRE), including one idiopathic case. Sixty-six patients (22%) had generalized
      epilepsies, 50 idiopathic, 2 Lennox-Gastaut syndrome, and 14 symptomatic. Thirty
      one patients (10.3%) with generalized tonic-clonic seizures occurring only during
      sleep had the epilepsies undetermined whether they are focal or generalized. In
      the symptomatic LRE cases, 34 cases could not be classified, and 7 of the cases
      with frontal lobe epilepsies were difficult to subtype. Eleven of the symptomatic
      LRE cases had some independent seizures, multiple foci in surface EEGs and were
      intractable. These cases may be defined as "multifocal epilepsies."

PMID- 1762215
TI  - A new method for determination of motor cortex by electrical stimulation under
      general anesthesia: evaluation of its reliability.

PMID- 1762216
TI  - Multiple subpial transection (MST) for the control of seizures that originated in
      unresectable cortical foci.
AB  - Multiple subpial transection (MST) was applied to 12 cases with intractable
      epilepsy, the foci of which were located in unresectable essential areas. The
      result proved that MST is effective in controlling seizures, and no explicit
      neurological deficits have incurred postoperatively.

PMID- 1762217
TI  - Monotherapy for childhood epilepsies with zonisamide.
AB  - Zonisamide was tried on 44 children, 18 girls and 26 boys, from 8 months to 15
      years of age at the start of the trial. In 6 children the drug has been stopped
      because of side effects. The drug was introduced at a dose of 2-4 mg/kg/day and
      increased to 12 mg/kg/day unless a satisfactory response occurred at a lower
      dose. A 100% control of seizures was achieved in 5 of 5 cases of idiopathic
      generalized epilepsies, in 7 of 8 cases of symptomatic generalized epilepsies, in
      one of one case of idiopathic partial epilepsies, and in 17 of 24 cases of
      symptomatic partial epilepsies. The main side effect was drowsiness, especially
      during the introduction.

PMID- 1762218
TI  - 10-year follow-up study of epilepsy with psychosis.
AB  - Thirty-three cases of psychosis associated with epilepsy were followed in our
      clinic for 10 years. In 12 cases, the psychotic symptom appeared episodically and
      9 of them had more than one relapse and 7 of them more than 2 relapses. Only 3
      cases had no relapse. In 21 cases, the psychotic symptoms were continuous,
      lasting more than 2 years. In 8 of them, the symptoms were stable and remained
      unchanged but in 13 of them, the symptom showed exacerbation and partial
      remissions. In 11 cases, a decrease or discontinuation of antipsychotic drugs
      (mostly haloperidol) significantly provoked or aggravated the psychotic symptoms.

PMID- 1762219
TI  - Correlation of subclassification of temporal lobe epilepsies with performance
      rate of WAIS.

PMID- 1762220
TI  - Biochemical abnormalities in developing E1 mouse.
AB  - Complex biochemical abnormalities were found in the early developmental stage of
      the E1 mouse. First, the E1 mouse has abnormal levels of specific amino acid
      concentration within a week from birth. Second, an unusual expression of poly(A)+
      RNA from the one-day newborn liver of the E1 mouse was detected by use of Cot 100
      DNA as a probe. Third, sodium channels are increased in synaptosomes and at the
      mRNA expression level of the 3 or 4-week-old E1 mouse brains, compared with the
      ddY mouse. These results suggest that the biochemical abnormalities described in
      this study may affect greatly the epileptogenesis of E1 mouse.

PMID- 1762221
TI  - Cerebral metabolic changes induced by antiepileptic drugs: a sequential double
      label deoxyglucose study.

PMID- 1762222
TI  - Effect of adenosine agonist (propentofylline) on rat hippocampal seizures induced
      by microdialysis with potassium: analysis using compressed EEG power spectrum
      array.

PMID- 1762223
TI  - Roles of a subependymal nodule of tuberous sclerosis on pathophysiology of
      epilepsy.
AB  - Polysomnographies (PSG) were performed on two cases with tuberous sclerosis (TS),
      both having subependymal nodules on the medial wall of the caudate nucleus
      adjacent to the thalamostriatal sulci. Clinically one had suffered from infantile
      spasm and which later turned out to be complex partial seizure with a rotation
      toward the right. The other had developed tonic seizure on the right with a
      rotation toward the left in early childhood. Clinico-pharmacological studies
      revealed the existence of synaptic supersensitivity of the dopamine (DA) receptor
      in the left caudate and PSG confirmed the synaptic supersensitivity of the
      former, while in the latter case, it suggested a decrease in DA activity on the
      left. Subependymal nodules in the caudate nucleus could cause a reduction in the
      DA transmission and develops synaptic supersensitivity after suffering from TS.

PMID- 1762224
TI  - A case of localization-related epilepsies suspected of panic disorder.
AB  - Some localization-related epilepsies have autonomic symptoms as well as psychic
      symptoms. As these symptoms are similar to those of panic disorder, it is
      important to discriminate between the two disorders. In such cases, VTR
      polygraphic examination is necessary for the correct diagnosis.

PMID- 1762225
TI  - A video-EEG study of astatic seizures observed in patients with myoclonic astatic
      epilepsy of early childhood (Doose syndrome).

PMID- 1762226
TI  - Effects of intraamygdaloid injection of taurine and valyltaurine on amygdaloid
      kindled seizure in rats.
AB  - Antiepileptic effects of intracerebral injections of taurine and valyltaurine
      were examined in amygdaloid kindled rats. The effects were assessed whether the
      animals can evoke generalized seizures by a 10 microA higher stimulation
      intensity than triggering thresholds. In all fully-kindled animals that have
      received intraamygdaloid injection of 500 nmol taurine, the kindled seizure was
      completely abolished. Such a significant seizure suppression (p less than 0.05)
      was observed 12-24 h after the taurine injection. Valyltaurine (500 nmol) also
      suppressed the seizure in 60% of animals tested, but the effect was not
      statistically significant. The results indicate that taurine may effectively
      suppress epileptic seizures when it acts directly at the stimulation site
      amygdala.

PMID- 1762227
TI  - Effects of immobilization stress on hippocampal interictal discharges in
      hippocampal kindled rats.

PMID- 1762228
TI  - Afferent connections of the neurons in the Forel's field of H in cat.
AB  - An anatomico-physiological analysis was made to elucidate afferent connections of
      the neurons in the Forel's field of H (FFH) by horseradish peroxidase retrograde
      tracing technique and by evoked potential technique. 1) The FFH neurons receive
      fibers from the neocortex (layer V) and brainstem reticular formations. 2)
      Physiological projections from the mesencephalic reticular formation to the FFH
      as well as to the motor cortex were ipsilateral, but those from the pons and
      medulla oblongata were bilateral. 3) These data will suggest that the FFH neurons
      are in junction of the cortico-reticular connections and play an important role
      in the maintenance of an epileptic excitability of the neocortical system as
      suggested by Jinnai and Mukawa.

PMID- 1762229
TI  - Kainic acid microinjection into a unilateral occipital cortex or lateral
      geniculate body in unanesthetized cats: models of generalized epilepsy and photic
      epilepsy.

PMID- 1762230
TI  - Cerebral glucose metabolism in epilepsy patients associated with organic brain
      damage.

PMID- 1762231
TI  - Single photon emission computed tomography (SPECT) in patients with periodic
      lateralized epileptiform discharges (PLEDs).

PMID- 1762232
TI  - Reversal of MRI lesion with relapse and remission of partial motor seizures in
      epilepsia partialis continua.

PMID- 1762233
TI  - EEG findings in offspring of epileptic mothers.

PMID- 1762234
TI  - Severe myoclonic epilepsy in infancy: a long-term follow-up study.

PMID- 1762235
TI  - Clinical features and prognosis of complex partial seizures appearing in the
      first three years of life.

PMID- 1762236
TI  - An electroencephalographic study on withdrawal of antiepileptic drugs in children
      with epilepsy.

PMID- 1762237
TI  - Clinical course of epilepsy with continuous spike-waves during slow wave sleep.

PMID- 1762238
TI  - A morphological study on MRI in 100 patients with epilepsy.

PMID- 1762239
TI  - P300 in epileptic children: cognitive effects of antiepileptic drugs.

PMID- 1762240
TI  - A clinico-electroencephalographic study of intractable generalized epilepsy in
      childhood.

PMID- 1762241
TI  - Multicystic encephalomalacia in an adult case of Lennox-Gastaut syndrome: a case
      report.
AB  - It is well known that multicystic encephalomalacia results in a severe
      neurological deficit and psychomotor retardation. The authors reported the case
      of a 30-year-old man with Lennox-Gastaut syndrome who had multicystic
      encephalomalacia in CT and MRI but whose neurological deficit was not serious. It
      is possible that the forceps delivery caused MCE and that a vaccination against
      Japanese encephalitis at the age of 9 triggered the Lennox-Gastaut syndrome.

PMID- 1762242
TI  - Two cases with epilepsy who manifested manic-depressive symptoms under
      barbiturates treatment.

PMID- 1762243
TI  - Asymmetry of eye fixations in temporal lobe epileptics: analyzed by eye mark
      recorder.

PMID- 1762244
TI  - Epilepsy population and their care problems in sheltered day-service institutions
      for the mentally retarded in Tokyo District: a preliminary report.

PMID- 1762245
TI  - A case of age dependent epileptic encephalopathy with CT appearance and
      neuropathological findings.

PMID- 1762246
TI  - Myoclonic astatic epilepsy presenting eyelid myoclonic seizures induced by
      closing of eyes.
AB  - A male infant with myoclonic astatic epilepsy showed myoclonic seizures of the
      eyelids by closing of the eyes. There was no photosensitivity in EEG with flash
      stimulation and he could induce seizures even in total darkness. The latency
      between a lid closure and onset of seizure discharges on EEG was relatively long
      (0.3-0.5 second). Epileptic seizures in this patient may be induced via a
      brainstem reticular formation, and elevated Bell's position seems to be the
      necessary stimulus to produce seizures.

PMID- 1762247
TI  - Epilepsy associated with hemiplegia: 1. Seizure manifestations.
AB  - 1. The seizure manifestations of patients with hemiplegia were reminiscent of
      partial seizures. The motor manifestations were notably asymmetrical and
      impairment of consciousness was mild. Nevertheless, tonic seizures, identified by
      electroclinical correlation were found in 49 patients (88%) although they were
      predominantly unilateral or asymmetrical. 2. Unclassified seizures characterized
      by ictal automatisms, which mimic complex partial seizures was observed in 5
      patients (9%). 3. Late epileptic seizures of the HHE syndrome were regarded as
      psychomotor seizures by Gastaut et al. In the present study, however, complex
      partial seizures were found in only 3 at 28 patients with HHE syndrome (11%)
      whereas tonic seizures in 23 of these patients (82%). One possible reason for
      this discrepancy is bias in the selected patient population, because those with
      transient hemiplegia were not included, and infrequently occurring partial
      seizures might have been missed. Further study is therefore needed to determine
      whether the HHE syndrome is associated with complex partial seizures or
      predominantly unilateral tonic seizures.

PMID- 1762248
TI  - Multielemental analysis of hair in patients with epilepsy, with special reference
      to the clinical significance of hair in patients with hypocalcaemia.

PMID- 1762249
TI  - Studies on pharmacoepidemiology of antiepileptic adverse reactions (2).

PMID- 1762250
TI  - The effects of clonazepam on rolandic discharge of benign epilepsy of children
      with centro-temporal EEG foci.
AB  - 1) CZP had marked effects on RD. RD disappeared in 8 (73%) of 11 patients treated
      with CZP alone and 6 (43%) of 14 treated with CZP in combination with other
      drugs. Even when RD persisted, its amplitude and frequency decreased in some
      patients. 2) In the group treated with CZP in combination with other drugs, RD
      disappeared in all 5 patients with the persistent RD, of whom 2 had arachnoid
      cyst. Of the 6 patients with frequent seizures, 2 were subsequently diagnosed as
      having CPS and SPS, respectively. Patients who did not respond to CPZ included
      those in whom the diagnosis of BECCT should be reconfirmed, and electro-clinical
      response may be also useful for diagnosing RD. 3) In patients treated with CZP
      alone for a short-term treatment of BECCT, the drug administration could be
      discontinued only in one. A longer follow-up study is necessary to reach a
      conclusion in future.

PMID- 1762251
TI  - The long-term effectiveness of clonazepam therapy in the control of partial
      seizures in children difficult to control with carbamazepine monotherapy.

PMID- 1762252
TI  - Influence of concurrent administration of sodium valproate on the plasma
      concentrations of carbamazepine and its epoxide and diol metabolites.

PMID- 1762253
TI  - Teratogenicity of antiepileptic drugs: is the prevention possible?
AB  - To assess the relative contribution of antiepileptic drugs (AEDs) toward the
      occurrence of congenital malformation, two prospective studies (previous and
      present) were compared. In the present subjects of 145 cases, the total daily
      dose of AEDs (drug score) in each case was decreased as much as possible, and
      polypharmacy was changed to monopharmacy before conception where it was possible.
      The incidence of malformations significantly decreased from 13.5% to 6.2% (p =
      0.031) by the change in drug regimen. The drug score, number of AEDs, maternal
      age at delivery, seizure type, and etiology of epilepsy were statistically
      different between the two study groups. Even after the correction of the data by
      the last three factors, the difference in the incidence of malformation did not
      disappear, while it disappeared if data were corrected either by the drug score
      or number of AEDs. These results suggest that the possibility of prevention of
      AED related malformations is possible by an improvement in AED therapy.

PMID- 1762254
TI  - Clinico-electroencephalographical study on temporal lobe epilepsy.

PMID- 1762255
TI  - A case of epilepsy characterized by spike-wave stupor followed for long period.
AB  - A 34-year-old housewife with nonconvulsive status epilepticus was followed up for
      20 years since the initial fit. She maintained some contact with reality during
      the stupor and recalled the episode to some extent, while the EEG showed
      continuous spike-wave complexes. During the clinical course, the main type of
      seizures was spike-wave stupor, of which the maximum frequency was several times
      a week in the hospital and the duration was many minutes to several hours, and
      also secondarily generalized convulsive seizures occurred approximately once a
      month. The lasting control of spike-wave stupor was not achieved in spite of the
      various medications for the long follow-up period. The ictal EEGs of spike-wave
      stupor always showed the frontal origin. The meaning of the term "nonconvulsive
      status epilepticus" in this case was briefly discussed.

PMID- 1762256
TI  - Schoolchildren with epilepsy: epidemiological and longitudinal studies on
      questionnaire for teachers at intervals of 12 years.

PMID- 1762257
TI  - Social adjustment of epileptic patients with psychiatric symptoms.

PMID- 1762258
TI  - Dopamine and basal ganglia.

PMID- 1762259
TI  - Neuronal transplantation in parkinsonism.

PMID- 1762260
TI  - Central dopaminergic neurons: immunohistochemistry and in vivo monitoring of
      dopamine release correlated to behavior.

PMID- 1762261
TI  - [Acid phosphatase as tumor marker of prostatic cancer].
AB  - Prostatic cancer was the first malignancy in which tumor markers could be used to
      follow the response to therapy or progression of the prostate cancer. The use of
      these tumor markers has been of significant clinical value in diagnosis and
      follow-up of patients. Over the years, significant technical improvements have
      been made on the sensitivity and specificity of the assays for prostatic acid
      phosphatase.

PMID- 1762262
TI  - [The effects of gravity load on the canine kidney].
AB  - In Self-defense Force Hospitals we often treat pilots with renal stones who will
      be exposed to high gravity (G) load after the treatment. Because the regulation
      prohibits the flight of a pilot with urolithiasis, the stone must be removed
      completely by noninvasive procedure. Percutaneous nephrolithotomy, therefore, is
      one of the treatment of choice in such patients. The effect of G load on the
      kidney, in particular, on the renin-angiotensin-aldosterone (R-A-A) system and
      the safety of percutaneous nephrolithotomy in a pilot who is exposed to high G
      load have not been adequately investigated. In this study, I examined the effect
      of G load in canine kidney model. The effect of G load on R-A-A system: Twenty
      two adult mongrel dogs of a mean weight of 10.9 kg. maintained on a normal Na+
      intake were studied. To dogs in the sitting position, high G load was given. The
      exposure to G load consisted of maximum load of 8 G for 45 seconds with the onset
      ratio of 0.1 G/sec. for group 1, and 5 courses of maximum G load of 8 G for 10
      seconds with the onset ratio of 2.5 G/sec., followed by 1.5 G for 60 seconds for
      group 2. Plasma renin activity was unchanged in group 1, but it increased in
      group 2. Plasma aldosterone increased from 68.6 +/- 17.9 to 252.0 +/- 56.4 pg/ml
      (p less than 0.005) in group 1. and from 191.8 +/- 40.6 to 479.2 +/- 76.0 pg/ml
      (p less than 0.005) in group 2 after G load. Angiotensin II decreased from 129.0
      +/- 19.4 to 84.7 +/- 19.1 pg/ml (p less than 0.05) after G load in group 2. These
      data suggest that the increase in plasma aldosterone after G load in independent
      of the renin-angiotensin system. It is considered that the alteration of R-A-A
      system was caused by the change of blood flow distribution due to the effect of G
      load. The tolerance to G load on the kidney following subcutaneous nephrostomy:
      Unilateral subcutaneous nephrostomies were carried out under pentobarbital
      anesthesia in 15 adult female mongrel dogs. Each experimental dog was exposed to
      high G load 2 or 4 weeks after removal of the nephrostomy tube. Excretory
      urography, renal angiography and renal function tests were performed before and
      after G load. Excretory urograms demonstrated no remarkable changes at all after
      G load in all dogs. Renal angiograms revealed small renal infarction along the
      nephrostomy tract in almost all dogs.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1762263
TI  - [Correlation between the prostatic vessels and vertebral venous system of the
      dog].
AB  - We examined the correlation between the intrapelvic vessels, especially prostatic
      vessels, and the vertebral venous system in the male dog by radiography. Aorta
      abdominalis branches the right and left external iliac arteries at the 6th lumbar
      vertebra, and is divided into the right and left internal iliac arteries and
      arteria sacralis mediana at the 7th lumbar vertebra. Arteria urogenitalis arises
      from the internal iliac artery at the middle of articulatio iliosacralis, and is
      divided into arteria vesicalis caudalis cranially and arteria prostatica
      caudally. Arteria prostatica is divided in the prostatic capsule and distributed
      to the prostatic parenchyma in which arteries form the network. Vena prostatica
      is distributed to the prostatic parenchyma, forming the network and entered vena
      urogenitalis after joining vena vesicalis caudalis. Vena urogenitalis joins the
      internal iliac vein, and then the common iliac vein and vena cava posterior after
      joining the external iliac vein. The anastomosis between the intrapelvic vein and
      the vertebral venous system is formed by the vena intervertebralis. The vertebral
      venous system is anastomosis with the vena cava posterior, the common iliac vein,
      the internal iliac vein and vena pudenda interna.

PMID- 1762264
TI  - [An enzymatic determination of serum citrate with citrate lyase].
AB  - A method for the enzymatic determination of the serum citrate using citrate lyase
      is described. The optimum pH was equal to or higher than 8.6. Prior to the
      determination of the serum citrate, the samples were deproteinized with
      perchloric acid. After the precipitation of the proteins, potassium hydroxide was
      added under an ice-cooling condition in order to neutralize the solution. The
      recovery rates of the citrate added to serum ranged from 92% to 108%, and the
      coefficient of variation of triplicate assay was 4.2%. The mean serum value of 17
      healthy subjects was 1.57 mg/dl, with a range of 1.03-2.03 mg/dl. In seven
      healthy subjects, 3 g of sodium-potassium citrate was administered orally and the
      serum citrate was measured 0, 15, 30, 45, 60, and 120 min later. The serum
      citrate was significantly increased in the periods between 15 and 60 min.

PMID- 1762265
TI  - [Ureteral function at the ureterovesical junction. Action potentials of the
      canine intramural ureter during bladder filling or bladder contraction].
AB  - The relationship between bladder movements and the intramural ureter was studied
      in the dog by recording electromyograms of the intramural and extravesical
      ureters recorded during bladder filling and contraction. Bladder filling was
      achieved by instilling physiological saline at a rate of 10 ml/min to a volume of
      5 ml/kg, while bladder contraction was induced by electrical stimulation. For
      electromyography, an electrode was inserted transperitoneal into both the
      extravesical ureter and the intramural ureter after it had been separated from
      the extravesical ureter. A cystostomy for the instillation of water and another
      cystostomy for the measurement of intravesical pressure were also made in the
      bladder. During bladder filling at an intravesical pressure of about 10 cmH2O,
      the frequency of the action potentials in the intramural ureter showed no
      significant difference to those in the extravesical ureter. In addition, during
      bladder contraction at a greatly increased intravesical pressure of about 5 times
      the precontraction level, the frequency of the action potentials in the
      intramural ureter was not significant by different from those in the extravesical
      ureter, and also from its own precontraction value. The above findings suggest
      that action potentials in the intramural ureter are not affected by bladder
      movements such as filling or contraction, and that the ureter continues to
      actively transport urine to the bladder during such movements.

PMID- 1762266
TI  - [A clinical study of associated bladder cancer in patients with renal pelvic and
      ureteral cancer].
AB  - Retrospective study on the frequency of associated bladder cancer and the
      influence on the prognosis was carried out in 170 cases of renal pelvic and
      ureteral cancer. The number of cases of associated bladder cancer coexistent with
      renal pelvic and ureteral cancer was 31 (18.2%), and the number of subsequent
      cases 3 (19.4%). The frequency of occurrence of the primary tumor site was 27.2%
      in the renal pelvis, 45.6% in the ureter and 58.3% in both renal pelvis and
      ureter. Multiple tumors occurring in the renal pelvis and ureter occupy a high
      percentage. As for the degree of differentiation, many cases were subsequent to
      G1. As for the stage, a few cases with bladder cancer were subsequent to T4, but
      there was no definite tendency in the occurrence of bladder cancer. The prognosis
      of renal pelvic and ureteral cancer: the 10-year survival rate was 93.3% for G1,
      66.6% for G2 and 12.4% for G3. As can be seen, there was good correlation with
      the pathological gradings. It must be remembered, however, that 5-year survival
      rates in cases of associated bladder cancer of coexistent type, in cases of
      subsequent type and in cases without associated bladder cancer were 56.2%, 72.7%
      and 64.8%, respectively: there was no significant difference. Bladder cancer
      associated with renal pelvic and ureteral cancer makes the therapy troublesome,
      but no influence on the prognosis was observed. Therapy in conformity with the
      pathological grading and stage is regarded as particularly important in cases of
      associated bladder cancer.

PMID- 1762267
TI  - [Studies on renal damages after extracorporeal shock wave lithotripsy using Gd
      DTPA-enhanced dynamic MRI].
AB  - Renal damages after ESWL treatment were examined by Gd-DTPA enhanced dynamic MRI.
      Gd-DTPA was used as the contrast medium and fast magnetic resonance imaging with
      suspended respiration using the flip angle of 20 degrees and gradient echo
      technique at 0.5 Tesla was used for photographing. In normal kidneys, a low
      intensity band was observed with the passage of Gd-DTPA through the kidney from 1
      to 2 minutes after the injection. In patients who underwent ESWL treatment,
      however, the low intensity band which was observed before ESWL treatment became
      partly obscure after ESWL treatment. Furthermore, these find changes in the renal
      parenchyma could not be fully detected by usual MRI which does not use Gd-DTPA.
      Gd-DTPA enhanced dynamic MRI was considered to be effective for finding the
      limited dose of shock waves for ESWL treatment.

PMID- 1762268
TI  - [Lymphocytic subsets of tumor tissue, non tumorous kidney, and the peripheral
      blood in primary renal cell carcinoma].
AB  - Lymphocyte subsets were examined in renal cell carcinoma (TILs), adjacent non
      tumor renal tissue and peripheral blood (PBLs) by flow cytometry and
      histochemistry in eighteen patients with renal cell carcinoma. CD5-positive cells
      were predominant in the TILs in 14 patients. In the renal cell carcinoma tissue,
      CD8-positive cells were predominant over CD4-positive cells, resulting in a less
      than unity ratio of CD4/CF8-positive cells. The lymphocyte number was
      significantly in adjacent normal renal tissue than in renal cell carcinoma.
      However, lymphocyte subsets ratios were not significantly different between these
      two tissues. PBLs showed the same proportions (CD4/CD8 mean 1.9 +/- 0.8) as the
      previously published healthy controlled data. The proportions of CD8-positive
      cells were significantly increased (p less than 0.05) and those of CD4-positive
      cells were also significantly decreased (p less than 0.01) in the TILs. The
      infiltrating pattern of TILs in 17 patients was divided histochemically into
      cluster (N = 7), single (N = 4), and mixed types (N = 6). The cluster and mixed
      types were significantly more common in grade 1 tumors and the single type was
      more common in the grade 2 tumors (p less than 0.05). The pT3 tumors showed the
      single type of TIL infiltration pattern, but showed no significant difference. In
      the cluster pattern of TILs, CD8-positive cells were surrounded by CD4-positive
      cells. Non-tumorous kidneys showed no infiltration of lymphocytes, except in 2
      patients of pyelonephritis. These results suggest that cytotoxic T-cells stained
      as CD8 play an immunoreactive role against renal cell carcinoma.

PMID- 1762269
TI  - [Immunological study on renal cell carcinoma in dialysis patients with acquired
      cystic disease of kidneys].
AB  - The immunological study of the major histocompatibility complex (class I, class
      II and DR antigens), tumour infiltrating lymphocytes (TIL), regional lymph node
      lymphocytes (RLNL) and peripheral blood lymphocytes (PBL) was evaluated on the
      basis of immunohistochemical staining using monoclonal antibodies of each subset
      of lymphocytes in a series of 16 patients with renal cell carcinoma. Two renal
      cell carcinomas in dialysis patients with acquired cystic disease of the kidneys
      (ACDK) were also included in this study. With regard to the immunological
      environment, a comparative study between renal cell carcinoma accompanied with
      ACDK and 14 other renal cell carcinoma was carried out. The results are described
      below: 1) With regard to the expression of MHC antigens in tumour cells, the
      degrees of expression of MHC class I, class II and DR-antigen in case 1 were
      higher than that of the other 14 renal cell carcinomas. On the other hand, no
      expression of MHC was detected in case 2. 2) As to the subsets of TIL, the CD25
      (IL-2 receptor) was not expressed in all the renal cell carcinoma. As to the T
      cell receptor (TCR-alpha/beta chain), the degree of expression was the same in
      case 1 and the other 14 cases. On the other hand, no TCR was detected in the case
      2. As to the other subsets of TIL (CD3, CD4, CD8, CD16 and CD20), the rates of
      the infiltration were the same in case 1 and the other 14 cases, but those in
      case 2 were lesser than in all other 14 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762270
TI  - [Urethral indwelling catheter, intermittent self-catheterization and urinary
      infection].
AB  - Once a catheter has been passed into the bladder without contamination, there are
      several possible routes of subsequent infection during drainage period, such as:
      1. Entry of bacteria alongside the catheter in the urethra. 2. Introduced
      bacteria adhered easily to the indwelling catheter and drainage system and
      colonized. 3. The catheter tip is covered rapidly by various nutrient materials
      which becomes a good culture medium of stuck bacteria, which is a supply source
      of bacteria into the bladder urine. 4. Although the motile bacilli ascend very
      slowly through the stagnant tube and no bacteria ascend against a slowly moving
      column, rapid transport of organisms occurs in the swirling fluid caused by the
      passage of rising air bubbles. 5. Continuous urethral catheter drainage permits
      an average residual urine volume of 7.3 ml. 6. The catheter destroys the
      antibacterial defense mechanisms of the urinary bladder. The reasons why in many
      cases of intermittent self-catheterization (CID) urine becomes sterile despite
      non-sterile procedure, are as follows. In addition to that CIC has none of the
      disadvantages of the indwelling catheter, it improves the vesical defense
      mechanisms deteriorated by high pressure voiding. The number of bacteria
      reintroduced during catheterization is relatively small and they can be
      eradicated by usual scheduled catheterization within 4-5 hours without residual
      urine. CIC must be started before trabeculation or diverticuli are formed, in
      which bacteria remain. Actual determination of residual urine volume after
      catheterization will help to prescribe a rational program of CIC.

PMID- 1762271
TI  - [Gram-positive cocci in the urinary tract. Do they influence the postoperative
      course of transurethral prostatectomy?].
AB  - The influence of gram-positive cocci on the postoperative course of transurethral
      prostatectomy was analysed on 463 patients. The half of isolated cocci was
      Enterococcus, followed by S. epidermidis and S. aureus. The rates of
      postoperative urinary infection by gram-negative bacilli were nearly the same for
      patients with preoperative gram-positive cocci infection and those without any of
      bacteria (3/79 vs. 9/310). Patients who developed new infection with gram
      negative bacilli had fever, in contrast to patients with new gram-positive cocci
      infection. Gram-positive cocci prolonged the postoperative pyuria but not so long
      as gram-negative bacilli. All these findings suggest that infection caused by
      gram-positive cocci is not so severe as that caused by gram-negative bacilli.

PMID- 1762272
TI  - [Correlation of atypical hyperplasia and latent carcinoma of the prostate].
AB  - Atypical hyperplasia and latent carcinoma of the prostate from 310 prostates of
      all age obtained at autopsy were studied. Atypical hyperplasia was graded into 3
      groups based on the frequency of nucleoli and cell arrangement. The results were
      as follows: the origin of both atypical hyperplasia and latent carcinoma was
      considered to be in the peripheral zone. The frequency of atypical hyperplasia
      increased with age. Atypical hyperplasia was found in younger generation than
      latent carcinoma. Grade of atypical hyperplasia increased with age. Atypical
      hyperplasia was often coincident with latent carcinoma: 74% of atypical
      hyperplasia were associated with latent carcinoma. Atypical hyperplasia was
      significantly associated with multicentric latent carcinoma. All these findings
      supported the assumption that atypical hyperplasia was a premalignant lesion.
      Clinically, in a case in which atypical hyperplasia is found in biopsy, intense
      follow-up will be necessary. In particular, in cases of grade 3 atypical
      hyperplasia, further study for detection of probable coexistent carcinoma is
      recommended.

PMID- 1762273
TI  - [Pulsatile administration of LH-RH for hypogonadotropic hypogonadism].
AB  - A case of hypothalamic-pituitary failure is reported. A 28-year-old man who had
      been treated with testosterone for hypogonadism for two years was admitted to our
      hospital with the chief complaint of sexual problems. The serum level of
      gonadotropins was very low and hypophysial responses to luteinizing hormone
      releasing hormone (LH-RH) were good. Treatment was started with subcutaneous
      pulses of 10 micrograms LH-RH every 120 minutes using a portable infusion pump.
      Gradually, his potency improved and ejaculation returned. The serum concentration
      of FSH, LH and testosterone increased to the normal range of adult males and the
      testicular volume increased rapidly from 5 ml to 14 ml after 13 weeks of
      treatment. Sperms appeared in the ejaculated fluid after 25 weeks and, after
      following 16 weeks, the concentration of sperms increased up to 20 x 10(6)/ml.
      Prolonged pulsatile subcutaneous administration of a low-dose of LH-RH at a
      physiologic frequency was an effective therapy for pubertal induction and
      maturation in hypogonadotropic hypogonadism due to hypothalamic-pituitary
      failure.

PMID- 1762274
TI  - Self-nurturance: the nurse needs it also.

PMID- 1762275
TI  - Nursing directed health care with the homeless population.

PMID- 1762276
TI  - Rx for good relations with graduate nurses.

PMID- 1762278
TI  - Tips for self-nurturing: priorities, models and axioms.

PMID- 1762277
TI  - Simple tools for self-nurturance.

PMID- 1762279
TI  - [Left ventricular systolic function in young women with hyperkinetic syndrome-
      echocardiographic evaluation].
AB  - In twenty two young (mean age 31.6 years) normotensive women with hyperkinetic
      heart syndrome (HHS) we assessed echocardiographically left ventricular (LV)
      function indexes before and after 40 mg of oral propranolol. At baseline the HHS
      group differed from controls with respect to higher heart rate heart and
      diastolic blood pressure (BPs), lower systolic and systolic LV volumes, greater
      corrected mean circumferential fiber shortening, ejection fraction, cardiac index
      and contractility index (systolic blood pressure x body surface area/LV end
      systolic volume ratio). Propranolol normalized nearly all analyzed indexes except
      for BPs which remained increased compared to controls. In young women with HHS
      enhanced cardiac performance is expressed by higher cardiac index and speed of
      blood ejection from the left ventricle, is related to tachycardia and higher
      contractility but not to increased preload. Results post propranolol
      administration speak in favour of significant role of increased beta-adrenoceptor
      stimulation in HHS.

PMID- 1762280
TI  - [Acute myocardial infarction. Analysis of the activities of the ambulance "R"].
AB  - Frequency of emergency calls for ambulance help to patients with acute myocardial
      infarction (MI) as well as a number of infarct complications and the influence of
      immediate professional help on survival of prehospital phase of acute MI is
      reviewed. The diagnosis of acute MI was based on a typical history of chest pain
      and electrocardiographic findings. Acute MI was also diagnosed in all cases of
      sudden cardiac death. Out of 3674 calls for ambulance help, MI was diagnosed in
      379 patients what amounts for 10.1% of all interventions in life-threatening
      cases and for 61% of patients with acute MI in the analysed period of time.
      Complicated MI was observed in 61.7% of all patients, including 70.5% of men and
      49.3% of women. Arrhythmic complications occurred in 54.5% of patients.
      Ventricular ectopic activity was the most frequent arrhythmia and amounted to
      46.6%. The II0 or III0 atrioventricular block occurred in 4.5% of patients.
      Haemodynamic complications occurred in 12.3% of cases. Sudden cardiac death
      occurred in 23.6% of patients with acute MI, including 21.9% cases of ventricular
      fibrillation or flutter and 1.7% of asystole. 28.5% of those patients were
      successfully resuscitated. 61% of patients died in the prehospital phase of acute
      MI including 63.4% of males and 57.2% of females. Out of 61% of patients who died
      before admission to the hospital, 53% had died before ambulance team arrived and
      7.9 died being under the care of the ambulance team. 80% of patients who survived
      prehospital phase of acute MI were admitted to the hospital within 60 min after
      the call for the ambulance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762281
TI  - [First aid at the pre-hospital stage of treatment of acute myocardial
      infarction].

PMID- 1762282
TI  - [The mitral valve in mitral valve defect. Histological and clinical
      correlations].
AB  - The purpose of this study was to investigate the correlation between the
      histologic changes in the excised mitral valves and the clinical findings in
      patients with mitral stenosis (with or without regurgitation). The Study group
      consists of 26 men and 23 women ranged in age from 24 to 56 years. The mitral
      valves were removed in a uniform manner by one surgeon during mitral valve
      replacement. The controls were 13 mitral valves removed at necropsy from patients
      who died of extracardiac causes. Excised valves were fixed in 5% solution of
      formaline. The extent of calcification was determined by radiographs. Tissue from
      the center of the anterior and posterior leaflet were selected as the samples.
      The blocks were paraffin embedded and processed in the conventional manner. For
      histological examination 11.5 um thick sections were stained with haematoxylin
      and eosin, Alcian blue, Van Gieson and Von Koss stain. Then the sections were
      examined under light microscope. We estimated the degree of fibrotic
      disorganization of architecture, vascularization, acid mucopolysaccharide
      content, number of fibroblasts, and the presence of calcific deposits and
      lymphoid infiltrates. The control valves had normal architecture with thick
      "fibrosa". In all stenotic mitral valves we found complete or partial
      disorganization of architecture. The most common change was hyalinization present
      in 94% valves, vascularization in 84% and calcification present in 66% of valves.
      In 33% of stenotic valves were present infiltrations by lymphocytes. We found a
      significant correlation (p less than 0.05) between the presence of lymphoid
      infiltrates and the duration of disease prior to surgery.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1762284
TI  - [Surgical treatment of patients with Wolff-Parkinson-White syndrome].

PMID- 1762283
TI  - [Effects of verapamil and propranolol on the left-ventricular diastolic function
      in patients with primary arterial hypertension].
AB  - Mitral flow was assessed by Doppler echocardiography in patients with systemic
      hypertension. The study was carried out on 40 patients (27 men and 13 women) aged
      24-50 years, mean 43 years with essential hypertension stage II according to WHO
      classification. No patient had other heart disease or diabetes. All patients were
      randomly assigned to verapamil (20 patients) or propranolol (20 patients). The
      daily dose of verapamil was 60-120 mg, mean 80 mg and propranolol 120-180 mg,
      mean 140 mg. Pulsed Doppler studies in all patients were performed before the
      treatment and after 4-6 weeks of the treatment. Echocardiographic examination was
      performed with Hewlett-Packard 707020 A ultrasound system using 2.5 MHz
      transducer. Two dimensionally guided pulsed Doppler echocardiograms were recorded
      with sample volume positioned in the inflow area below the mitral annulus. The
      following Doppler parameters were measured: early diastolic flow velocity (EDF),
      late diastolic flow velocity (LDF) and their ratio (EDF/LDF) which represents the
      ratio of early and late diastolic flow velocity of left ventricular filling. The
      study has showed that before treatment the value of EDF, LDF and EDF/LDF ratio in
      both groups did not significantly differ. Heart rate and arterial pressure in
      patients with systemic hypertension after treatment with verapamil or propranolol
      were significant lower than before treatment. Treatment with verapamil caused
      significant increase of EDF from 61.2 to 78.2 cm/sek and increase EDF/LDF ratio
      from 1.02 to 1.30. While LDF values were not changed. In the group of patients
      treated with propranolol the values of EDF, LDF and ratio EDF/LDF were similar to
      those before treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762285
TI  - Racial differences in the incidence and progression of renal diseases.
AB  - There is an excess incidence of ESRD treatment among non-White North Americans
      that is not completely explained by the racial prevalences of the underlying
      diseases, including hypertension, which can potentially cause renal disease. The
      racial difference is particularly striking for presumed nephrosclerosis from
      hypertension and for nephropathy from Type II diabetes, but is not yet
      substantiated for ESRD attributed to polycystic kidney disease or Type I
      diabetes. The existing data are insufficient to support the notion that poorer
      blood pressure control alone is responsible for the racial differences in
      incident ESRD. Black race (and possibly Mexican or Native American heritage) may
      be a specific risk factor for ESRD, independent of hypertension and its
      treatment.

PMID- 1762286
TI  - Analysis of Na+-D-glucose cotransporter and other renal brush border proteins in
      human urine.
AB  - A sensitive quantitative radioimmunoassay is described by which different
      antigens in the urine can be assayed simultaneously. Urinary excretion of three
      proteins from proximal tubules was compared: 1) the Na+-D-glucose cotransporter
      from brush border membranes and subapical vesicles; 2) a kidney-specific
      hydrophobic M(r) 400,000 polypeptide from intermicrovillar invaginations and
      subapical vesicles; and 3) villin from microvilli cores. In the normal urine
      about 50% of the excreted Na+-D-glucose cotransporter and villin, and about 25%
      of the M(r) 400,000 polypeptide was associated with brush border membrane
      vesicles, whereas the remaining fractions of the three proteins formed small
      sedimentable aggregates which contained some cholesterol and fatty acids but no
      phospholipids. The normal urinary excretion of the Na+-D-glucose cotransporter
      was correlated with that of villin and the M(r) 400,000 polypeptide. The data
      show that membrane proteins from the proximal tubule are excreted by the shedding
      of different brush border membrane areas. They suggest that some microvilli are
      released in total, and that a large fraction of the brush border membrane
      proteins is excreted without being associated with a phospholipid bilayer. In an
      attempt to define protein excretion patterns during kidney malfunctions, the
      excretion of brush border membrane proteins was analyzed after one intravenous
      injection of the X-ray contrast medium, iopamidol. No change in villin excretion
      was observed, but a reversible increase in the excretion of brush border membrane
      proteins was found in patients without diabetes. With diabetes a more pronounced
      iopamidol effect on the excretion of brush border membrane proteins and a
      significant increase in the excretion of villin was observed.

PMID- 1762287
TI  - Distribution of tubulointerstitial nephritis antigen and evidence for multiple
      forms.
AB  - A monoclonal antibody (A8) to a basement membrane component (TIN antigen), which
      is associated with autoimmune tubulointerstitial nephritis, was developed and
      utilized to characterize tissue distribution and properties of TIN antigen by
      immunofluorescence microscopy and immunoblotting. Results were confirmed with
      polyclonal goat anti-rabbit and human autoantibodies. TIN antigen was found in
      basement membranes of kidney cortex, small intestines, skin, and cornea, but was
      not detected in the renal medulla. Within the kidney cortex proximal tubular
      basement membrane (TBM) showed the strongest staining. TIN antigen was also
      detected in Bowman's capsule, distal TBM, peritubular capillaries, and focally in
      the interstitium, but not in glomerular basement membrane or mesangial matrix.
      Immunoblotting of SDS-extracted human, rabbit, mouse, and Brown Norway rat TBM
      with A8 revealed predominantly a 58 kD TIN antigen; however, other reactive
      components were detected in minor quantities. Bovine TBM contained components of
      52 kD, 45 kD and 35 kD in varying concentrations. Immunoblotting of isolated
      rabbit TIN antigen revealed the major 58 kD component that was characterized
      previously, and minor components of 300 kD, 175 kD, 160 kD and 50 kD. TIN antigen
      was not detected in Lewis rat TBM by immunofluorescence or immunoblotting. These
      studies suggest the following: 1) TIN antigen may be synthesized as a high
      molecular weight glycoprotein that is processed to smaller forms; 2) it may be
      covalently associated with other basement membrane components; 3) the antibody
      reactive epitope may be present on multiple TBM components; and 4) high molecular
      weight forms may represent aggregates of TIN antigen.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1762288
TI  - Glomeruli synthesize nitrite in active Heymann nephritis; the source is
      infiltrating macrophages.
AB  - Glomeruli synthesize nitrite (NO2-) in experimental nephrotoxic nephritis, a
      model of glomerulonephritis where infiltrating macrophages are pathogenic. NO2-
      synthesis was studied in active Heymann nephritis (AHN), a model of membranous
      glomerulonephritis in which macrophages have not been implicated. Active Heymann
      nephritis (AHN) was induced with purified renal tubular epithelial antigen and
      adjuvants. Glomeruli isolated at seven to eight weeks after induction
      (proteinuria 183 +/- 28 mg/24 hr, N = 6; adjuvant controls, 1.2 +/- 0.8 mg/24 hr,
      N = 6) produced NO2- in culture spontaneously (7.1 +/- 1.4, adjuvant controls 2.1
      +/- 0.9 nmol/2000 g/48 hours; P = 0.021) and in increased amount following LPS
      stimulation (12.1 +/- 2.8, controls 4.2 +/- 1.6 nmol/2000 g/48 hours; P = 0.047).
      Synthesis was inhibited by L-NMMA, a competitive inhibitor of NO synthase.
      Enzymic digestion of glomeruli plus staining with mouse anti-rat macrophage
      monoclonal antibody ED1 showed macrophage infiltration (32 +/- 6, adjuvant
      controls 14 +/- 2 macrophages/glomerulus; P = 0.002). Whole body irradiation (XR)
      suppressed NO2- production (LPS stimulated: 1.0 +/- 0.4, N = 5; non-XR controls
      7.2 +/- 4.6 nmol/2000 g/48 hours; N = 5, P = 0.016) and macrophage infiltration
      (1.1 +/- 0.5; non-XR controls 30 +/- 12 macrophages/glomerulus; P = 0.008) but
      had no effect on proteinuria. Irradiation with renal shielding confirmed the
      close correlation between glomerular NO2- synthesis and glomerular macrophage
      numbers (rs = 0.837, P less than 0.001). These results show that macrophages
      infiltrate glomeruli in AHN; they are the source of NO2- in this model. Neither
      macrophages nor NO2- are the cause of proteinuria.

PMID- 1762289
TI  - Renal immunopathology in murine host-versus-graft disease.
AB  - BALB/c mice neonatally injected with 1 x 10(8) (A/J x BALB/c)F1 hybrid spleen
      cells develop polyclonal B cell activation and autoimmune features as a
      consequence of a host-versus-graft (HVG) reaction. In this study, we first
      analyzed the time-course development of the renal lesions in HVG mice. From week
      2 to week 6, linear deposits of IgG were observed by immunofluorescence along the
      glomerular capillary walls. From week 8 to week 12, the immunofluorescence
      pattern of IgG changed from linear to granular, and by immunoelectron microscopy,
      the IgG deposits were located on the epithelial side of the glomerular basement
      membrane (GBM). In addition, focal glomerulosclerosis complicated this membranous
      glomerulopathy in about 50% of the 12-week-old HVG mice and albuminuria was
      increased in most of them. Circulating antibodies to antigens of the GBM
      (laminin, type IV collagen) and of the renal tubular epithelial (RTE) cells
      (dipeptidyl peptidase IV, gp330) were already detected at week 2 and were still
      present at week 12. Immunoglobulins eluted from isolated glomeruli contained
      antibodies directed against type IV collagen, laminin, and to a lesser degree
      against gp330. F1 donor B cells were involved in the production of nephritogenic
      antibodies as indicated by (a) the presence of A/J allotypic determinants on
      serum anti-laminin antibodies and (b) the abrogation of the in vitro production
      of anti-GBM, anti-laminin and anti-RTE antibodies when spleen cells from HVG mice
      were depleted of F1 donor B cells. Finally, mixed lymphocyte culture experiments
      established that T cells from HVG mice stimulate normal B cells from F1 donor
      hybrids to produce anti-GBM, anti-laminin, anti-type IV collagen, anti-RTE, anti
      gp330 and anti-dipeptidyl peptidase IV antibodies. We conclude that mice
      neonatally injected with semi-allogeneic spleen cells develop a
      glomerulonephritis characterized by the transition from a linear to a granular IF
      pattern, and that the production of nephritogenic antibodies results from the
      activation of donor B cells by host helper T cells.

PMID- 1762290
TI  - Impaired in vivo antibody production in CRF rats: role of secondary
      hyperparathyroidism.
AB  - Antibody responses to antigens are impaired in humans and animals with chronic
      renal failure (CRF), and parathyroid hormone (PTH) inhibits Staphylococcus aureus
      Cowan I (SAC) or pokeweed mitogen (PWM)-induced antibody production by B cells
      from normal subjects. Since CRF is associated with secondary hyperparathyroidism
      and elevated blood levels of PTH, it is possible that impaired humoral immunity
      in CRF is due to chronic excess of PTH. To test this hypothesis we examined in
      vivo antibody production in response to sheep red blood cells (SRBC), BSA and
      influenza vaccine in normal rats, CRF rats and parathyroidectomized CRF rats
      maintained normocalcemic (CRF-PTX). The blood levels of PTH in CRF rats were
      elevated and significantly (P less than 0.01) higher than those in normal and CRF
      PTX rats. The latter groups of animals did not have elevated blood levels of PTH.
      The antibody response to all three antigens in CRF rats were significantly (P
      less than 0.01) and markedly lower than in normal or CRF-PTX rats. The antibody
      response to SRBC, the IgG anti-BSA and the IgG and IgM anti-influenza vaccine in
      CRF-PTX rats were not different from normal, while the IgM anti-BSA was lower
      than in normal rats but higher than in CRF rats. The data demonstrate that the
      state of secondary hyperparathyroidism of CRF plays a paramount role in the
      genesis of impaired humoral immunity in CRF.

PMID- 1762291
TI  - Subfractions in uremic plasma ultrafiltrate inhibit calcitriol metabolism.
AB  - Previous study from our laboratory has demonstrated that uremic plasma
      ultrafiltrate suppresses both the production rate (PR) and metabolic clearance
      rate (MCR) of calcitriol in normal rats. To characterize the the substances
      responsible for the suppression of the synthesis and degradation of calcitriol,
      we fractionated 20 ml uremic plasma ultrafiltrates into 13 fractions using high
      performance liquid chromatography (HPLC) and studied the effect of each fraction
      on calcitriol metabolism. We measured the MCR and PR of calcitriol in normal rats
      after they were infused for 20 hours with each fraction dissolved in 20 ml normal
      saline. Using a UV absorption and fluorescence emission technique, several known
      uremic compounds were identified as individual peaks corresponding to the
      fractions. We found that fractions 4, and 6 to 13 markedly reduced the MCR of
      calcitriol. The patterns of the MCR suppression by the HPLC fractions suggest
      that there were at least two groups of chemically distinguishable compounds.
      Infusion of a solution containing all 13 fractions of the uremic ultrafiltrate
      also inhibited the calcitriol synthesis. One of the 13 fractions (fraction 4,
      containing uric acid, xanthine, and hypoxanthine) was further fractionated into
      eight subfractions. Infusion of subfractions 4 to 7 markedly reduced both the PR
      and MCR of calcitriol. We conclude that uremic plasma ultrafiltrate contains
      factors that inhibit calcitriol synthesis and degradation. These substances have
      molecular weight less than 2,000 Daltons.

PMID- 1762292
TI  - Effects of methylprednisolone on glomerular and medullary mRNA levels for
      extracellular matrices in puromycin aminonucleoside nephrosis.
AB  - We examined the effects of methylprednisolone (MPSL) on type IV collagen, laminin
      and heparan sulfate proteoglycan (HSPG) mRNA levels in the renal glomeruli and
      medulla of puromycin aminonucleoside (PAN) nephrosis. mRNA levels encoding for
      type IV collagen and laminin increased markedly, whereas those for HSPG decreased
      significantly in glomeruli of PAN nephrosis. Administration of MPSL partially
      ameliorated the abnormal gene expression for basement membrane components.
      Furthermore, we showed that medullary mRNA levels for all these basement membrane
      components decreased with age in PAN nephrosis with or without MPSL treatment,
      suggesting that neither PAN nor MPSL has any effect on basement membrane
      component mRNA levels in the renal medulla. In contrast, mRNA levels for the
      interstitial collagens including alpha 1 (I) and alpha 1 (III) chains in
      glomeruli showed little change with or without MPSL treatment, whereas those in
      medulla increased significantly in PAN nephrosis when compared with the control.
      MPSL ameliorated the abnormal gene expression of alpha 1 (I) and alpha 1 (III)
      collagen in renal medulla. These results indicate that PAN affects both
      glomerular mRNA encoding for basement membrane components and medullary mRNA
      encoding for interstitial collagens, and that MPSL has marked effects on the
      amelioration of abnormal gene expression in both glomeruli and medulla of PAN
      nephrosis.

PMID- 1762293
TI  - Chronic tubulointerstitial changes induced by germanium dioxide in comparison
      with carboxyethylgermanium sesquioxide.
AB  - Chronic nephrotoxicity was investigated in rats orally administered germanium
      dioxide (GeO2) and carboxyethylgermanium sesquioxide (Ge-132) for 24 weeks.
      Increased BUN and serum phosphate as well as decreased creatinine clearance,
      weight loss, anemia and liver dysfunction were apparent at week 24 only in the
      GeO2 treated group. Vacuolar degeneration and granular depositions were observed
      by light microscope in the degenerated renal distal tubules in the rats of this
      group, with the semiquantitative scores of tubular degeneration being 95 +/- 9%
      in the GeO2 group, 3 +/- 1% in the Ge-132 group and 1 +/- 1% in the control
      group, respectively. Electron microscopy revealed electron-dense inclusions in
      the swollen mitochondrial matrix of the distal tubular epithelium in the GeO2
      group. Although systemic toxicities were reduced after GeO2 was discontinued at
      week 24, renal tubulointerstitial fibrosis became prominent even at week 40 (16
      weeks after discontinuation). A Ge.K alpha X-ray spectrum was clearly
      demonstrated in the mitochondrial matrix of the distal tubular epithelium in the
      GeO2 group with the help of electron probe X-ray microanalysis. On the other
      hand, neither toxic effects nor renal histological abnormalities were manifested
      in either the Ge-132 or the control group. The renal tissue content of germanium
      was high at weeks 24 and 40 in the GeO2 group. From these results, it is
      concluded that GeO2 causes characteristic nephropathy while Ge-132 does not. In
      addition, it appears that residual GeO2 remains for a considerably long time even
      after the cessation of GeO2 intake.

PMID- 1762294
TI  - Differentially regulated cell surface expression of leukocyte adhesion receptors
      on neutrophils.
AB  - To elucidate the molecular mechanisms accounting for hemodialysis-induced
      neutropenia, the regulation of plasma membrane expression of leukocyte adhesion
      glycoproteins was investigated by both flow cytometry and immunoprecipitation
      techniques. The members of the LFA family of integrins, Mac-1/Mo1 (CD11/CD18) and
      gp150/95 (CD11c/CD18), involved in adhesion of myeloid cells to endothelia and
      other substrates, were found to be overexpressed on the plasma membrane of
      neutrophils from patients undergoing hemodialysis with a Cuprophane dialyzer,
      whereas no change was observed in the expression of LFA-1 (CD11a/CD18). By
      contrast, dialysis with Cuprophane membranes, as well as in vitro treatment with
      different activating agents, induced a downregulation on the expression of both
      the Leu-8/LAM-1 antigen, the human neutrophil peripheral lymph node homing
      receptor, and the CD43 major sialoglycoprotein involved in leukocyte homotypic
      adhesion. Kinetics studies showed that these up- and downregulatory processes of
      antigen expression occur very rapidly, correlating with maximal neutropenia.
      Recovery of initial levels of expression of CD11b/CD18 and Leu-8/LAM-1 adhesion
      molecules was observed after one hour of hemodialysis. However, the basal
      expression of CD43 was not restored by that time. The coordinated upregulation of
      CD11b and CD11c and downregulation of LAM-1 and CD43 adhesion receptors provide
      molecular mechanisms for understanding leukoaggregation, adherence to endothelia,
      and extravasation of neutrophils ultimately leading to the hemodialysis-induced
      neutropenia.

PMID- 1762295
TI  - T-lymphocyte subsets in nephrotic syndrome.
AB  - T-lymphocyte subsets when measured in steroid responsive nephrotic syndrome
      (SRNS) have demonstrated significant variance from normal values. T-cell subsets
      were studied by using two-color flow cytometric analysis in 32 children (9.2 +/-
      5 years of age) with SRNS. The children were divided into four groups: a) SRNS in
      acute relapse, on prednisone; b) SRNS in acute relapse, off prednisone; c) SRNS
      in long-term remission, off prednisone (nephrotic controls); d) patients in
      remission on long-term prednisone therapy; and e) 15 age-matched normal controls.
      Children suffering an acute relapse of SRNS showed an increase in Leu2a+/DR+
      (CD8) activated lymphocytes (P less than 0.05), a decrease in Leu4a+ total T
      lymphocytes (P = 0.01) and a decrease in Leu3a+ (CD4) helper T-cells (P less than
      0.05) when compared to normal controls and nephrotic controls. Though some subset
      changes may represent a prednisone effect and the functional role of these
      lymphocytes in the disease process is unknown, this study provides additional
      evidence to support a role for abnormal T-cell subsets in the etiology of SRNS.

PMID- 1762296
TI  - Bone marrow changes following treatment of renal anemia with erythropoietin.
AB  - In 14 severely anemic patients with end-stage renal disease and chronic
      hemodialysis the effect of recombinant human erythropoietin (EPO) on hemopoiesis
      was investigated. Bone marrow biopsies were taken before and after four and 26
      months of treatment with EPO to evaluate quantitative and qualitative changes of
      histomorphology. EPO induced normalization of maturation and an increase in cell
      mass of the erythropoietic line in all patients. The number of megakaryocyte also
      increased significantly with EPO treatment (P less than 0.01). At the time of the
      third bone marrow biopsy (26 months) erythropoiesis was normal. Megakaryopoiesis
      remained unchanged compared to the second biopsy (4 months). No cytomorphologic
      abnormalities or other evidence for malignant disorder could be detected in any
      of the patients. Hematocrit increased from a mean of 19 to 31 percent at the
      second evaluation (P less than 0.001). Platelet count had risen by a mean of
      30,000 at four months (P less than 0.05) and slightly decreased at 26 months.
      These observations suggest great safety of long-term treatment with recombinant
      human erythropoietin, and demonstrate efficacy in correcting reduced and immature
      erythropoiesis in chronically hemodialyzed patients. EPO also stimulates human
      megakaryopoiesis.

PMID- 1762297
TI  - Urinary albumin, transferrin and iron excretion in diabetic patients.
AB  - The present study was undertaken to determine urinary and serum iron, transferrin
      and albumin levels in diabetic patients with varying amounts of proteinuria. A
      highly significant correlation was found between urinary albumin and transferrin
      excretion over a wide range of urinary albumin excretion (0.005 to 18 g/g
      creatinine) (r = 0.972). The urine/serum ratio of transferrin and albumin were
      identical, documenting a similar glomerular leak and tubule handling for these
      two proteins. In contrast to the above correlation between transferrin and
      albumin, there was no correlation between iron and either of these proteins until
      nephrotic range proteinuria had occurred, and even at that time the correlation
      was much weaker than that found between the proteins (r = 0.680). Urinary iron
      excretion increased early in the course of diabetic renal disease, being
      increased in 3 of 11 patients without proteinuria and in 8 of 10 patients with
      mild proteinuria. All patients with nephrotic range proteinuria had markedly
      increased urinary iron excretion (150 +/- 166 micrograms/g creatinine vs. 6.4 +/-
      0.7 micrograms/g creatinine in controls) and decreased serum iron levels (592 +/-
      189 micrograms/liter vs. 979 +/- 394 micrograms/liter in the control group). The
      iron/transferrin ratio in urine was consistently greater than the
      iron/transferrin ratio in plasma at all stages of proteinuria. In patients with
      both subnephrotic and nephrotic range proteinuria, approximately 35 to 40
      micrograms Fe/g creatinine was present in the urine with an excess of
      transferrin. In conclusion, urinary iron excretion is increased early in the
      course of diabetic renal disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762298
TI  - Prevention of hemodialysis subclavian vein catheter infections by topical
      povidone-iodine.
AB  - Subclavian catheter (SCC) related infections are a major cause of morbidity in
      hemodialysis patients, the vast majority due to staphylococci species. Povidone
      iodine (PI) has proven anti-staphylococcal activity. Therefore, a randomized
      controlled trial of topical PI ointment was undertaken to evaluate the impact of
      this prophylactic intervention on the incidence of SCC related infections in
      hemodialysis patients. The role of S. aureus nasal carrier state in the
      acquisition of infection was also evaluated. Patients requiring SCC for temporary
      hemodialysis access were randomized to receive the treatment (T; N = 63) or
      sterile gauze dressings alone (C; N = 66). Catheter duration ranged from 2 to 210
      days in both groups, with a mean of 38.6 days in T and 36.2 days in C (NS). Exit
      site (ES) infections were significantly less in T (5%) versus C (18%) (P less
      than 0.02); tip colonization (TC) was 17% in T versus 36% in C (P less than
      0.01), while the incidence of septicemia (S) was also significantly less in T
      (2%) versus C (17%; P less than 0.01). S. aureus nasal carriers were at a
      threefold higher risk of SCC related septicemia (0.009/day) than noncarriers
      (0.003/day; P less than 0.05). The beneficial effect of PI ointment was most
      evident in this high risk group of S. aureus carriers: ES = 0% T versus 24% C, TC
      = 12% T versus 42% C, S = 0% T versus 29% C, P less than 0.05. There were no
      adverse effects of the treatment. The routine application of topical PI ointment
      to temporary hemodialysis catheter exit sites is effective in reducing SCC
      related infections.

PMID- 1762299
TI  - Medical and social outcome in adolescents with end-stage renal failure.
AB  - Clinical information was collected on 118 adolescents who developed ESRF at age
      143 months or older and were treated between 1966 and 1986 at the Toronto
      Hospital for Sick Children. The cumulative survival rate in transplanted patients
      (N = 109) was 80.1% after 15 years. Survival rates after four years were 93.9% in
      transplanted and 46.9% in nontransplanted patients (P less than 0.001). No
      patient receiving dialysis alone (N = 9) was followed longer than four years.
      Nine patients received three transplants and had an 89% survival rate. Six of
      these had a functioning graft at end of the follow-up. The cumulative survival of
      the entire group was 76.4% at eighteen years. Forty-two (35.6%) patients had a
      height below the third percentile. Functional status obtained by a structure
      telephone interview with a member of the present treating nephrology service was
      good (G) or excellent (E) for 66.7% of all patients (73.5% of transplant patients
      (N = 68) and 45% of dialysis patients (N = 20). Hemodialysis patients functioned
      less well [25% G/E (N = 12)] than peritoneal dialysis patients [75% G/E (N = 8)].
      Most patients achieved an appropriate level of formal education although more
      slowly than normal adolescents. Only 11 patients were neither enrolled in an
      educational institution nor employed. We conclude that aggressive treatment for
      adolescents with ESRF is an appropriate application of health care resources.

PMID- 1762300
TI  - Regulation of renal ammoniagenesis in metabolic acidosis.

PMID- 1762301
TI  - Possible role of tumor necrosis factor and interleukin-1 in the development of
      diabetic nephropathy.
AB  - The possibility that tumor necrosis factor (TNF) and interleukin-1 (IL-1) could
      participate in the development of diabetic nephropathy was evaluated in
      streptozocin (STZ)-treated diabetic rats. Diabetic rats were divided into two
      groups: aminoguanidine treated group (25 mg/kg body wt, daily i.p. injection; DM
      AG group) and untreated group (DM group). Non-diabetic age-matched rats were also
      divided into two groups with the same manner and used as controls. After twelve
      weeks of treatment, glomerular basement membranes (GBM) were isolated from rats
      of each experimental group. When thioglycollate-elicited peritoneal macrophages
      (M phi) from normal rats were incubated with these GBM materials, GBM from DM
      group induced significantly greater levels of TNF and IL-1 production than did
      GBM from other three groups with at doses of 2.5 to 10 mg. The TNF and IL-1
      production by stimulation of GBM from the DM-AG group were similar to those from
      each control group. Aminoguanidine treatment significantly decreased the
      accumulation of advanced glycation end-products (AGEs) in GBM of diabetic rats.
      These findings suggest that AGE-proteins may be involved in the production of TNF
      and IL-1 from M phi. AGE-induced cytokines may be implicated in the development
      of diabetic nephropathy.

PMID- 1762302
TI  - Characterization of myosin heavy and light chains in cultured mesangial cells.
AB  - Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE)
      demonstrated that postconfluent mesangial cells in primary culture expressed
      three myosin heavy chains (MHCs), 204 kD, 200 kD and 196 kD, in a manner similar
      to that of smooth muscle cells. The MHCs of 204 kD and 200 kD in mesangial cells
      reacted positively with antibodies raised against bovine aorta smooth muscle
      myosin while the 196 kD MHC reacted positively with antibodies against platelet
      myosin. Moreover, the combined content of the MHCs in cultured mesangial cells
      was remarkably similar in amount to that in cultured aortic smooth muscle cells.
      After three passages, cultured mesangial cells expressed only the 196 kD MHC as
      has been reported for cultured smooth muscle cells. Two phosphorylated proteins
      were found in the immunoprecipitate after incubation of the cell extract with
      antibodies against platelet myosin: a MHC of approximately 200 kD and myosin
      light chain (MLC) of 20 kD. The level of MLC phosphorylation was quantitated by
      scanning densitometry of autoradiograms. Arginine vasopressin (AVP) at 100 nM
      induced MLC phosphorylation with a maximum effect at 10 minutes. AVP enhanced MLC
      phosphorylation in a dose dependent manner: maximum response was observed with
      100 nM and half maximum, at 3.5 nM. Similarly, angiotensin II (100 nM),
      endothelin-1 (10 nM) and the calcium ionophore, A23187 (1 microM), significantly
      enhanced MLC phosphorylation. Thus, although the expression of MHC was altered in
      quality after mesangial cells were placed in culture, the cells remained rich in
      myosin content and had an intact regulatory system for contraction which
      responded to a variety of vasoconstrictive agents.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1762303
TI  - Pathogenesis of interstitial fibrosis in chronic purine aminonucleoside
      nephrosis.
AB  - A cellular and molecular approach was used to gain new insight into the
      pathogenesis of interstitial fibrosis in chronic purine aminonucleoside nephrosis
      (PAN) nephrosis. Thirty experimental rats (PAN rats) were given 15 mg/100 g body
      wt of i.p. PAN at time 0, followed by 4.3 mg/100 g body wt i.p. on days 20, 27
      and 34; 25 control rats received i.p. saline at the same time intervals. All rats
      had a right unilateral nephrectomy within the first four days. Groups of control
      and PAN rats were killed at 21, 37, 52, 72 and 91 days. Renal sections were
      studied by immunofluorescence to quantitate interstitial macrophages, T
      lymphocytes and fibroblasts, and to characterize the deposition of the
      extracellular matrix (ECM) proteins (collagens I, III and IV, fibronectin and
      laminin) and the tissue inhibitor of the metalloproteinases (TIMP). Steady state
      concentrations of mRNA from the whole kidney for these ECM proteins, the
      metalloproteinases, TIMP, and transforming growth factor beta (TGF-beta 1) were
      quantitated by Northern blot analysis. Significant increases in the number of
      interstitial macrophages and T lymphocytes were found in the PAN rat groups
      compared to that in controls. All ECM proteins examined were quantitatively
      increased in the tubulo-interstitium of PAN rats. The pattern of distribution of
      some ECM proteins was also modified in experimental animals. TIMP was increased
      in the interstitium of PAN rats; at later times, TIMP was most prominent in
      sclerotic regions of the glomeruli and in tubular protein droplets. Northern blot
      analysis revealed increased steady-state mRNA levels for components of each of
      the ECM proteins, no change for the metalloproteinases--stromelysin or
      collagenase--and a marked increase for TIMP and TGF-beta 1 in PAN animals. The
      results of this study suggest that the diffuse interstitial fibrosis found in
      chronic PAN nephrosis results from both increased production of ECM proteins and
      decreased matrix degradation.

PMID- 1762304
TI  - Growth hormone prevents steroid-induced growth depression in health and uremia.
AB  - Treatment with supraphysiological doses of corticosteroids results in protein
      wasting and impairment of growth, whereas exogenous growth hormone (GH) causes
      anabolism and improvement of growth. We wanted to know whether the growth
      depressing effects of methylprednisolone (MP) are more expressed in an organism
      which is chronically diseased and whether these effects can be counterbalanced by
      concomitant treatment with recombinant human growth hormone (rhGH). MP in doses
      from 1 to 9 mg/kg/day caused a dose dependent reduction of length gain, weight
      gain and weight gain/food intake ratio in 140 g healthy female Sprague-Dawley
      rats. Food intake was not affected by MP. This points to a change in food
      metabolism as a mechanism for growth impairment. In addition, treatment with MP
      inhibited endogenous GH secretion, documented by serum GH concentration profiles
      over seven hours, decreased IGF-1 serum concentration and disturbed growth
      cartilage plate architecture. Concomitant treatment with 2.5 to 20 IU/rhGH/kg/day
      prevented the negative effects of MP on growth in a dose dependent manner and
      normalized growth plate architecture. In uremic rats in which food efficiency and
      growth was already reduced, 6 mg MP/kg/day further decreased length gain and
      prevented weight gain completely by bringing the weight gain/food conversion
      ratio to the nadir. All effects of MP including reduction of muscle mass could be
      prevented by concomitant treatment with 10 IU rhGH/kg/day. The effects of MP and
      rhGH on food efficiency and growth in uremic animals were numerically nearly
      identical to those in pair fed ad libitum fed controls, but this may be more
      relevant in the diseased organism in which basal growth is already suppressed.

PMID- 1762305
TI  - Deterioration of GFR in IgA nephropathy as measured by 51Cr-EDTA clearance.
AB  - In 191 patients with mesangial IgA nephropathy, GFR was determined as clearance
      of 51Cr-EDTA. 86 (45%) of them had subnormal renal function 7.3 +/- 4.6 years
      after renal biopsy. The change in GFR was followed in 153 patients with repeated
      determinations of 51Cr-EDTA clearance. 50.3% of the patients had a loss of more
      than 1.1 ml/min/year, which we regard as pathological. The markers of progressive
      disease were: male sex, high output of urinary protein, severe histological
      lesions and presence of hypertension. Even patients lacking these markers had a
      significantly increased incidence of progressive disease. Of 93 patients, with
      initially normal GFR, 32% will have a subnormal GFR within five years and 25%
      will develop end-stage renal failure within 20 years. In 38 patients with six or
      more determinations of 51Cr-EDTA clearance, the predictive value of the first
      four determinations was calculated. Of 26 with a decrease of more than 1.1
      ml/min/year, 13 (50%) developed subnormal GFR during follow-up, while 11 of 12
      (91.7%) with a decrease of less than 1.1 ml/min/year (P less than 0.05) remained
      normal. This shows that repeated determinations of GFR with an accurate method
      will predict the final outcome early in the disease. We also confirmed that
      single or repeated determinations of clearance of creatinine are of little value
      in separating a normal GFR from a slightly decreased one, but more reliable in
      detecting a markedly reduced GFR.

PMID- 1762306
TI  - Calcemic response to parathyroid hormone in renal failure: role of phosphorus and
      its effect on calcitriol.
AB  - The calcemic response to parathyroid hormone (PTH) is decreased in renal failure.
      The reduction of hyperphosphatemia improves the calcemic response to PTH in
      animals with advanced renal failure. However, since low calcitriol levels in
      renal failure may also contribute to the decreased calcemic response to PTH, the
      improved calcemic response observed during the reduction of serum phosphorus may
      be partially mediated by an increase in serum calcitriol levels. The present
      study evaluated the calcemic response to PTH in rats with moderate and advanced
      renal failure and how this response was modified by a high and a low phosphorus
      diet. In addition, the effect of a change in dietary phosphorus on calcitriol
      levels was also evaluated. A 48-hour continuous infusion of 1-34 rat PTH
      increased the serum calcium level to 18.2 +/- 0.4 mg/dl in normal rats, versus
      13.7 +/- 0.9 and 12.1 +/- 0.2 mg/dl in rats with moderate and advanced renal
      failure, respectively. During the PTH infusion, a high phosphorus diet increased
      the serum phosphorus and resulted in a reduced calcemic response to PTH at each
      level of renal function; respective serum calcium levels were 13.8 +/- 0.6 mg/dl
      in normals, 11.2 +/- 0.2 mg/dl in moderate renal failure and 9.6 +/- 0.5 mg/dl in
      advanced renal failure. In normal rats and in rats with moderate renal failure,
      dietary phosphorus restriction during the PTH infusion increased serum calcitriol
      levels. In rats with advanced renal failure, serum calcitriol levels were lower
      than in the other two groups and were not affected by changes in dietary
      phosphorus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762307
TI  - Calcemic response to parathyroid hormone in renal failure: role of calcitriol and
      the effect of parathyroidectomy.
AB  - Hyperparathyroidism due to renal failure begins in the early stages of renal
      insufficiency and is in part secondary to skeletal resistance to the calcemic
      action of parathyroid hormone (PTH). Factors which have been reported to reduce
      the calcemic response to PTH include: decreased calcitriol levels,
      hyperphosphatemia and down regulation of PTH receptors in bone. While
      hyperphosphatemia may directly decrease the calcemic response to PTH, it may also
      act indirectly by a suppression of calcitriol synthesis. In this study, the
      effect of calcitriol on the calcemic response to PTH was evaluated in normal rats
      and in rats with moderate and advanced renal failure. To determine the combined
      effect of calcitriol and phosphorus on the calcemic response to PTH, rats
      receiving calcitriol were fed either a high (1.0%) or low (0.2%) phosphorus diet
      during a 48-hour PTH infusion. In advanced renal failure, calcitriol
      administration increased the calcemic response to PTH independent of the dietary
      phosphorus intake. During ingestion of a low phosphorus diet, a 48 hour PTH
      infusion resulted in a serum calcium level of 13.7 +/- 0.5 and 12.1 +/- 0.2 mg/dl
      (P less than 0.02) with and without calcitriol administration, respectively. In
      normal rats and in rats with moderate renal failure, calcitriol administration
      improved the calcemic response only during a high phosphorus intake. After a 48
      hour PTH infusion in normal rats, the serum calcium levels with and without
      calcitriol were 16.1 +/- 0.9 and 14.8 +/- 0.6 mg/dl, P less than 0.01
      respectively; in rats with moderate renal failure, calcitriol administration
      increased serum calcium, 13.2 +/- 0.5 versus 11.2 +/- 0.4 mg/dl, P less than
      0.01.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762308
TI  - Complement activation retards resolution of acute ischemic renal failure in the
      rat.
AB  - We investigated the role of complement activation on the resolution of acute
      ischemic renal failure in the rat. Acute renal failure was induced by clamping of
      the renal arteries of Sprague-Dawley rats for 45 minutes (Day 0). On subsequent
      days, groups of rats with acute renal failure were exposed to daily zymosan
      infusion (an activator of the complement system), or to blood incubated with
      cuprophane (CUP) or polyacrylonitrile (PAN) dialysis membranes. We serially
      measured the change in BUN daily, glomerular filtration rate and 24-hour
      proteinuria on Day 3 and Day 5 following ischemia. On Day 6, the animals were
      sacrificed and their kidneys examined histologically. Zymosan and cuprophane
      exposed rats had a significant delay in the recovery of renal failure, reduced
      glomerular filtration rate, and histologically had more neutrophil infiltration
      than control or PAN exposed animals. To investigate the potential pathophysiology
      of these observations, we assessed the response of zymosan-exposed rats to
      infusion of deferoxamine (DFO), a potent inhibitor of hydroxyl radical formation
      (OH.). Infusion of DFO prior to zymosan significantly improved recovery of renal
      function. We also measured urinary thromboxane B2 levels in these groups of rats.
      While the groups of rats exposed to zymosan had the highest levels of thromboxane
      B2, these levels were not different between the groups exposed to zymosan alone,
      or to zymosan and DFO. These observations suggest a role for hydroxyl radicals in
      the prolongation of renal failure in this model. Taken together, these findings
      may have implications for the dialytic intervention in patients with acute renal
      failure.

PMID- 1762309
TI  - Electrophysiology of ammonia transport in renal straight proximal tubules.
AB  - To test for electrogenic transport of ammonium ions in straight proximal renal
      tubules, isolated perfused tubules have been exposed to peritubular ammonium ions
      during continuous recording of cell membrane potential. As a result, 20
      mmol/liter NH4+ leads to a rapid, reversible depolarization of the cell membrane
      by 9.0 +/- 0.3 mV (N = 86). This depolarization is not significantly affected by
      10 mmol/liter barium or 0.1 mmol/liter amiloride on both sides of the epithelium,
      but is significantly blunted by omission of extracellular bicarbonate and CO2
      (3.8 +/- 0.4 mV, N = 9), by 1 mmol/liter acetazolamide (4.3 +/- 0.3 mV, N = 11),
      by 1 mmol/liter peritubular amiloride (4.3 +/- 1.1 mV, N = 7), by 1 mmol/liter
      SITS (5.7 +/- 0.4 mV, N = 6), and by replacement of extracellular sodium with
      choline (4.7 +/- 0.5 mV, N = 8). In the presence of both amiloride (1 mmol/liter)
      and acetazolamide (1 mmol/liter) in the bath, the NH4+ induced depolarization is
      completely abolished. Furthermore, the combined omission of bicarbonate and
      addition of 10 mmol/liter barium eliminates the NH4+ induced depolarization.
      About 50% of the depolarization can be explained by enhanced electrogenic
      bicarbonate exit due to the intracellular alkalosis. The other 50% is explained
      by amiloride and barium sensitive electrogenic entry of NH4+ into the cell.

PMID- 1762310
TI  - Pregnancy in IgA nephropathy.
AB  - The impacts of IgA nephropathy and pregnancy on each other were evaluated in 118
      women who conceived 168 times between 1970 and 1988. Rates of spontaneous
      abortion, normal delivery, live birth and perinatal death were 9, 66, 87 and 4%,
      respectively. Infants born to women with glomerular filtration rates (GFR) lower
      than 70 ml/min prior to conception had a higher perinatal mortality rate (14% vs.
      3%, P less than 0.001). This was also true if pre-pregnancy blood pressures were
      consistently higher than 140/90 mm Hg (33% vs. 1%, P less than 0.001). These were
      the figures for the whole 18 year period, but stratification of the data revealed
      that most adverse results occurred in the 1970's, during which the perinatal
      death rate was 9%, while it was 0% in the 1980's. Eighty-five women were followed
      for three years or more. At final follow-up, the rates of decrease in GFR, and
      increases in blood pressure and proteinuria were 19, 11 and 7%, respectively. In
      most patients the natural history of IgA nephropathy was similar to that of women
      who had not experienced pregnancy, but there were five instances where gestation
      seemed to accelerate functional loss, with rapid development of end-stage or near
      end-stage renal failure. Most women with IgA nephropathy should anticipate few
      problems with pregnancy, if they are normotensive and their preconception GFR
      exceeds 70 ml/min. The gestation in such instances should have little influence
      on the natural history of their nephropathy.

PMID- 1762311
TI  - Effects of acetate dialysate on transforming growth factor beta 1, interleukin,
      and beta 2-microglobulin plasma levels.
AB  - To evaluate potential adverse effects of acetate use in hemodialysis (HD), we
      measured plasma interleukin (IL-1 alpha, IL-1 beta, IL-6), TNF alpha, TGF beta 1,
      and beta 2-microglobulin levels with ELISA assays in normal (N = 9), CRF (N = 6),
      CAPD (N = 7) and HD (N = 8) subjects and compared the effects of acetate (Ac) and
      acetate-free (Ac-free) dialysate. TGF beta 1 was the only cytokine consistently
      detected. Compared to normals (median 57, range 53 to 68 pg/ml, one undetected; N
      = 8), TGF beta 1 was higher in the CRF (75, 70 to 97 pg/ml, one undetected) and
      CAPD (75.5, 66 to 116 pg/ml, N = 6) groups (P less than 0.05), and was somewhat
      higher in the HD (68, 52 to 88 pg/ml) group (P less than 0.10). Acutely, TGF beta
      1 pre-HD (70, 63 to 88 pg/ml) increased above normals post AcHD [79.5, 65 to 140
      pg/ml uncorrected for ultrafiltration (UF)] and was higher after AcHD versus Ac
      free HD both uncorrected (79.5, 65 to 140 pg/ml vs. 70, 52 to 86 pg/ml) and
      corrected for UF (68, 51 to 115 pg/ml vs. 57, 43 to 69 pg/ml; P less than 0.05).
      beta 2-microglobulin was not different after AcHD (81.2 +/- 8.0 mg/ml) versus Ac
      free HD (72.5 +/- 6.9 mg/ml). Significantly lower serum inorganic phosphorus was
      also found four hours post-AcHD compared to four hours post-Ac-free HD (0.87 mmol
      +/- 0.10 SEM vs. 1.05 mmol +/- 0.07 SEM; P less than 0.05).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1762312
TI  - Increased sodium-lithium countertransport activity in red cells of IgA
      nephropathy patients.
AB  - The aim of this work was to analyze Na,Li countertransport activity in the
      erythrocytes from patients with IgA nephropathy, in relationship with their blood
      pressure status and lipid profile. Forty-nine patients (32 males, 17 females)
      with biopsy-proven IgA nephropathy and without significant impairment of renal
      function (serum creatinine less than or equal to 1.4 mg/dl) and 36 normal
      subjects (21 males, 15 females) were evaluated. Twenty-nine patients with IgA
      nephropathy were normotensive and 20 hypertensive (diastolic pressure greater
      than or equal to 95 mm Hg or treated by antihypertensive drugs). Na,Li
      countertransport was significantly higher in red cells from hypertensive than
      from normotensive patients (P = 0.002) and normal subjects (P = 0.0001), (values
      respectively 309 +/- 17; 241 +/- 12 and 211 +/- 11 mumol/liter RBC/hr);
      normotensive patients with IgA nephropathy did not differ from controls regarding
      the Na,Li countertransport rate. A multiple stepwise logistic regression analysis
      with blood pressure status as the dependent variable and Na,Li countertransport
      activity, age, serum creatinine, proteinuria, cholesterol, triglycerides, plasma
      potassium and time from onset as independent variables, indicated an independent
      significant association for Na,Li countertransport (P = 0.002) proteinuria (P =
      0.006), plasma potassium (P = 0.006) and age (P = 0.029). Other tested variables
      were not independently related to blood pressure status. Hyperlipidemic patients
      (plasma total cholesterol concentration greater than 200 mg/dl and/or plasma
      triglycerides greater than 172 mg/dl) had an erythrocyte Na,Li countertransport
      activity significantly higher than normolipidemic (P = 0.005) and controls (P =
      0.001) (values respectively 295 +/- 14; 226 +/- 12 and 211 +/- 11 mumol/liter
      RBC/hr).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762313
TI  - Adherence of neutrophils to hemodialysis membranes: role of complement receptors.
AB  - Complement activation occurs during hemodialysis using cellulosic dialysis
      membranes with the consequent deposition of C3 activation and degradation
      products on the membrane surface. To determine if these complement fragments are
      functionally active, we examined their capacity to mediate leukocyte adherence to
      cuprophan membranes. Immunoblotting of proteins eluted from plasma-treated
      cuprophan membranes confirmed the presence of both C3b and iC3b. Incubation of
      cuprophan membranes with heparinized whole blood resulted in adherence of
      leukocytes but not erythrocytes. Neutrophils were the primary cell type bound,
      with monocytes comprising less than 5% of the adherent cells. Studies using
      indium-labeled neutrophils demonstrated that the binding was plasma dependent and
      increased with time up to two hours. Neutrophil binding was inhibited by
      preincubation of the plasma-treated cuprophan membrane with anti-C3 or
      preincubation of neutrophils with an antibody directed against the alpha chain of
      complement receptor type 3 (CR3). These observations indicate that iC3b deposited
      on cuprophan membrane surface as a result of complement activation mediates
      neutrophil adherence via interaction with CR3. They also support the hypothesis
      that, in addition to the anaphylatoxins released into the fluid phase, complement
      activation products that remained membrane bound during hemodialysis also
      stimulate pathophysiological responses.

PMID- 1762314
TI  - Renal functional reserve: its significance in normal and salt depletion
      conditions.
AB  - The aim of this study was the evaluation, in healthy subjects, of the renal
      functional reserve (RFR), that is, the GFR increase induced by a combined
      infusion of amino acids (AA) and dopamine (D), in conditions of extracellular
      volume depletion caused by diuretic administration. In particular, this study was
      undertaken: a) to evaluate whether and to which extent, AA + D can reverse the
      functional GFR impairment induced by salt depletion, without volume restoration;
      b) to study whether any relationship may be found between the GFR in normal
      condition (the so-called "resting" GFR), and/or the renal functional reserve and
      the GFR impairment induced by salt depletion, in order to understand the role of
      both "resting" GFR and RFR in the degree of renal dysfunction induced by salt
      depletion. In control conditions the i.v. infusion of AA + D significantly
      increased RPF (+ 41% vs. baseline period) with a mean absolute increase of 211
      ml/min. A similar pattern was observed in GFR behavior (+31.5% with 34 ml/min of
      mean absolute increase). A significant inverse exponential relationship was
      observed between GFR before AA + D i.v. infusion ("resting" GFR) and renal
      functional reserve (P less than 0.05), suggesting that, in normal conditions,
      these inversely related parameters may widely vary according to the tone of the
      glomerular arterioles. Following salt depletion, we observed a variable degree of
      GFR impairment. Both GFR and RPF were significantly decreased (-25.9%, P less
      than 0.05 and -29%, P less than 0.05, respectively).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1762315
TI  - Measurement of SC5b-9 in urine in patients with the nephrotic syndrome.
AB  - In passive or active Heymann nephritis (HN) in the rat, the immune complexes that
      form in the glomerular subepithelial space result in complement activation and
      the urinary (U) excretion of S protein-membrane attack complex (SC5b-9, MAC).
      Because of the similarities between HN in rats and membranous nephropathy (MN) in
      humans, it has been suggested that measurement of SC5b-9 in urine (UMAC) could be
      useful in assessing the immunologic activity of MN in patients. The present study
      was undertaken in normal individuals and in patients with nephrotic syndrome to
      determine: 1) the conditions of urine collection and preservation needed for
      accurate measurement of UMAC for clinical purposes; and 2) whether UMAC levels
      are a sensitive and/or specific test for MN. In studies conducted on urine
      specimens from patients with increased UMAC levels, we found that UMAC in freshly
      voided urine was stable for at least three hours at 37 degrees C, with or without
      the addition of the enzyme inhibitors that were used to stabilize UMAC levels in
      the studies of HN in the rat. Urine pH, leukocytes and erythrocytes, over the
      ranges usually encountered, did not influence UMAC levels. However, freezing
      urine at -70 degrees C artifactually raised UMAC levels (1500 +/- 550 to 1800 +/-
      580 SE ng/ml, P less than 0.001 by paired t-test). Normal urine contained low
      UMAC levels: 80 +/- 3 ng/mg urinary creatinine (UCr). By contrast, patients with
      glomerulopathies tended to have elevated UMAC levels: 18 of 38 patients had
      levels that ranged from 200 to 20,000 ng/mg UCr.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762316
TI  - Anaphylactoid reactions in hemodialysis patients treated with the AN69 dialyzer.
AB  - During an 11 week period (May to July, 1990), we observed six anaphylactoid
      reactions (AR) in six different hemodialysis patients occurring at the onset of
      treatment with a new AN69 hollow-fiber dialyzer. Four patients required
      cardiopulmonary resuscitation and one of these expired. Four patients were also
      receiving an angiotensin converting enzyme (ACE) inhibitor while the other two
      were not on medication known to affect the renin-angiotensin system. Only
      patients treated with AN69 dialyzers were affected. A review of the literature
      indicated that out of 1087 patients reported, 72 patients were on the combination
      of an AN69 dialyzer and ACE inhibitor therapy and 41 (57%) demonstrated AR. Only
      two patients (0.4%; both from our series) treated with an AN69 dialyzer without
      ACE inhibitor therapy developed AR. AR did not occur in patients treated with a
      variety of other dialyzers during this 11 week period, with or without ACE
      inhibition. Possible causes for AR are discussed and include: (1.) blood-AN69
      membrane interaction leading to the production of bradykinin and other
      vasodilators, the breakdown of which may be delayed by the presence of ACE
      inhibitors; (2.) hypersensitivity to ethylene oxide; (3.) passage of bacterial
      products from dialysate to blood; (4.) changes in membrane manufacturing
      specifications. Recommendations are proposed for the prevention and treatment of
      AR.

PMID- 1762317
TI  - Factors predictive of post-transplant erythrocytosis.
AB  - Ninety-three patients with PTE (that is, hematocrit 51% or greater) were
      identified among 431 renal transplant recipients, an incidence of 21.6%. Thirty
      eight patients underwent blood volume measurements, and 22 of these had high red
      cell volume and therefore were considered to have true PTE. To analyze factors
      predictive of erythrocytosis, a control group with normal hematocrit was randomly
      selected from our renal transplant population and compared with the 93 patients
      with PTE, and with the 22 who had true PTE. Using step-wise logistic regression
      analysis, we identified three variables that were consistent predictors of PTE.
      In order of significance, the serum creatinine value at the onset of PTE appears
      to most strongly predict the occurrence of PTE (P less than 0.0001). As
      creatinine value increases, the probability of PTE decreases. Next was
      immunosuppression, where double immunosuppressive therapy was associated with a
      greater probability of PTE than triple therapy (P less than 0.0001). The overall
      incidence of PTE in patients on double therapy was 34%, while that for those on
      triple therapy 10.4%. Last was duration of dialysis for which increasing values
      correspond to increasing probability of PTE (P = 0.004). Comparison of the serum
      erythropoietin (EPO) levels for patients and controls yielded a nonsignificant
      result (P = 0.2507 and P = 0.383 for all patients with PTE and true PTE,
      respectively), and therefore EPO levels were inappropriately elevated for the
      level of hematocrit in the PTE group. Only the number of rejections and duration
      of follow-up (r = -0.3507) were significantly correlated with EPO (P less than
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762318
TI  - Simultaneous catheter replacement and removal in refractory peritoneal dialysis
      infections.
AB  - The present report describes more than nine years of experience with simultaneous
      removal and replacement of the chronic peritoneal dialysis (PD) catheter in
      treating refractory mechanical and infectious complications. Simultaneous
      catheter replacement and removal not only succeeded in 22 of 23 cases with non
      infectious mechanical complications, allowing uninterrupted PD in all but three,
      but also succeeded in 30 (83%) of 36 additional cases with persisting or
      recurring infection. Simultaneous procedures failed in six (17%) of 36 infectious
      cases, due to persistent infection in two cases and to procedure complications in
      four cases. The clinical characteristics of the 30 successful infectious cases
      were compared to the characteristics of both the six failures, as well as 29
      additional infectious cases in which the peritoneal catheter was removed but was
      not replaced because of a variety of serious complications (such as pancreatitis,
      abscess, sepsis, or fluid overload). At the time of simultaneous catheter
      replacement in successful cases, temporary control of active peritoneal
      inflammation was achieved more frequently (80% vs. 31%, P less than 0.001) with a
      shorter interval of antibiotic coverage (6.4 +/- 0.9 vs. 14.7 +/- 1.3 days, P
      less than 0.001). In addition, the successful cases were characterized by
      significantly more Staphylococcal infections (70% vs. 26%, P less than 0.001) and
      significantly fewer Pseudomonal or fungal infections (6% vs. 59%, P less than
      0.001), although successful cases included some non-Pseudomonal, non-enteric gram
      negative infections (23%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762319
TI  - Tumor necrosis factor (TNF alpha) binding protein: interference in immunoassays
      of TNF alpha.

PMID- 1762321
TI  - Polycystic kidney disease: clues to pathogenesis.

PMID- 1762320
TI  - Cimetidine improves the reliability of creatinine as a marker of glomerular
      filtration.
AB  - To investigate whether the administration of cimetidine can improve the
      reliability of creatinine as a marker of GFR, we compared the creatinine
      clearance (CCr) to the clearance of the true filtration markers 51Cr-EDTA (CEDTA)
      and inulin (CIn), after oral ingestion of cimetidine in 10 healthy men and 29
      patients with varying degrees of renal dysfunction. After administration of
      cimetidine for three to six days, serum creatinine level rose in all
      participants, while CEDTA and CIn remained stable in a subgroup of 14 subjects in
      whom they were measured before as well as after the administration of cimetidine.
      The mean (+/- SD) ratios of CCr to CEDTA (N = 39) and of CCr to CIn (N = 19)
      after ingestion of cimetidine were 1.02 +/- 0.13 and 1.01 +/- 0.13, respectively,
      and did not differ significantly from unity. This high degree of accuracy of the
      cimetidine-aided CCr was present over the entire range of renal function in the
      study population. Our results also indicated an improved precision of the
      cimetidine-aided measurement of CCr, resulting in a variability that did not
      differ significantly from that of the measurement of CEDTA or CIn. We conclude
      that after oral administration of cimetidine, the creatinine clearance can be
      used as a reliable measure of GFR within a broad range of renal function.

PMID- 1762322
TI  - Localization and polar distribution of several G-protein subunits along nephron
      segments.
AB  - Guanine nucleotide binding proteins (G-proteins) are heterotrimeric proteins
      involved in signal transduction in epithelia. In addition to possessing a
      polarized epithelium the nephron is composed of well defined segments, each with
      distinct receptors, transporters and other functions. Since different G-proteins
      interact with different receptors, a differential distribution of the various G
      protein subunits would be expected. To investigate this possibility, polyclonal
      antipeptide antibodies to several G-protein subunits were used to examine the
      distribution of these proteins in nephron segments and their localization to
      apical or basal membrane domains. Immunoblotting of cortical membrane vesicles
      demonstrated the presence of G-proteins in both the brush border and basolateral
      membrane. Staining with G alpha common and G alpha s antibodies demonstrated more
      of these G-protein subunits in the brush border than basolateral membrane. G
      protein beta subunits were also present in greater quantity in brush border
      membranes. Immunocytochemical analysis demonstrated good antigenic preservation
      and basically confirmed the results of immunoblotting of renal cortex. G-proteins
      were also found to be differentially distributed in the medulla, the amounts
      increasing with proximity to inner medulla. Only G alpha s and G beta subunits
      were demonstrated in glomeruli, but all subunits examined were detected in brush
      borders of proximal and apical membrane of distal tubules in cortex. In outer
      medulla G alpha s was detected in both basolateral and brush borders of some
      tubules and only brush borders of others, G alpha i2 and G beta were found in
      brush border and G alpha i3 was not detected in this area.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1762323
TI  - Partial lecithin:cholesterol acyltransferase (LCAT) deficiency in Balkan endemic
      nephropathy.
AB  - The role of lipid abnormalities has been also implicated in the progression of
      renal diseases. The search for lipid abnormalities in Balkan endemic nephropathy
      (BEN) has roused sporadic interest and has not been fully elucidated. This study
      was performed in 54 healthy subjects from the families affected with BEN (group
      A), 18 members from non-affected families living in the same location (group B),
      and 25 control subjects (group C). Lipid profiles and lecithin:cholesterol
      acyltransferase (LCAT) were determined in each subject. The most striking
      distinction between the groups was that of the LCAT activity, which was
      abnormally low in group A (39 +/- 2), significantly different (P less than
      0.0001) from that of the other groups. Thirty individuals from group A were those
      accounting for the low LCAT activity (A1). This group had a significantly lower
      total cholesterol and free cholesterol than all of the other subjects. The entire
      group A subjects had a significantly lower percentage of free cholesterol than
      the other two groups. There was no significant difference in HDL cholesterol
      between any of the groups, but group A1 had significantly higher HDL than group C
      (P less than 0.04). What emerges from our study is that a certain proportion of
      subjects from BEN families have a peculiar form of lipid abnormalities associated
      with an abnormal LCAT activity. At present we have no explanation for these
      findings. We believe that these changes may have an important role in the
      pathogenesis of BEN.

PMID- 1762324
TI  - Selenium deficiency and Balkan endemic nephropathy.
AB  - Data on selenium (Se) deficiency in Yugoslavia are summarized. These data include
      the selenium contents of stream sediments, rocks, soils, cereal crops grown in
      these soils, and human serum and scalp hair from several towns and regions.
      Analyses of human tissues in Yugoslavia show very low Se concentrations in both
      endemic and nonendemic areas. In some regions, including those with endemic
      villages, selenium contents of grains and human serum and hair are extremely low,
      approaching those in the low-selenium zone in China. According to the biological
      function of selenium, a very low intake of selenium may be a fundamental
      underlying condition that would predispose persons to attack by other agents in
      the development of Balkan endemic nephropathy.

PMID- 1762325
TI  - Early detection of tubular dysfunction.
AB  - The determination of low-molecular-weight proteins in urine as a tool for early
      detection of damage to the proximal tubules is briefly discussed. Beta 2
      microglobulin, retinol-binding protein and alpha 1-microglobulin are at present
      the most widely used markers for tubular dysfunction. The determination of beta 2
      microglobulin has earlier been the method of choice, but due to its instability
      at low pH there are certain disadvantages. Available data indicate that alpha 1
      microglobulin may replace beta 2-microglobulin for screening purposes. The low
      molecular-weight proteins are at present the best markers for early detection of
      tubular dysfunction; other constituents are not as well suited for this, even if
      the determination of urine enzymes has its supporters.

PMID- 1762326
TI  - Altered urinary beta 2-microglobulin excretion as an index of nephrotoxicity.
AB  - The experimental and clinical evidence indicate that beta 2-microglobulin (beta
      2m) is actively reabsorbed from the glomerular filtrate by receptors on the brush
      border located in the proximal third of the proximal tubule. Increased beta 2m
      excretion in the absence of increased filtered load of beta 2m is indicative of
      nephrotoxicity. The data presented show that urine beta 2m increases and
      creatinine concentrations decrease within four hours of administration of
      diatrizoate megalumine (DMG). In 9 of the 20 patients, the urinary excretion of
      beta 2m (U beta 2m) increased to clearly abnormal values. In 12 of the 20
      patients, the beta 2m excretion expressed as mg per g creatinine (Cr), increased
      from normal (less than 0.30) to an abnormal beta 2m excretion rate. The increased
      beta 2m excretion per g Cr occurring immediately after DMG administration lead us
      to conclude that this effect occurs when the nephrotoxic agent is present in the
      kidney. Based on these data we believe that the onset of abnormal urinary beta 2m
      excretion coincides with the presence of the causative agent. This criterion
      therefore, should prove to be useful in determining the time to conduct studies
      designed to search for the causative agent(s) in Balkan endemic nephropathy.

PMID- 1762327
TI  - Beta 2-microglobulin in patients with Balkan nephropathy and in healthy members
      of their families.
AB  - The aim of this study was to investigate serum levels, urinary excretion and in
      vitro peripheral blood mononuclear cell (PBMC) production of beta 2-microglobulin
      in patients with Balkan nephropathy and their families. Increased urinary beta 2
      microglobulin excretion was found in Balkan nephropathy, chronic pyelonephritis
      and glomerulonephritis patients, being highest in the first group. The serum
      level of beta 2-microglobulin in Balkan nephropathy patients correlated with
      residual kidney function. Synthesis of beta 2-microglobulin by PBMC, untreated or
      stimulated by PHA, was not increased in Balkan nephropathy patients or their
      healthy family members compared to the control group of healthy persons living
      outside of an endemic region. This study has shown that the increased serum beta
      2-microglobulin level in Balkan nephropathy patients is the consequence of the
      glomerular filtration rate (GFR) reduction. Urinary beta 2-microglobulin
      excretion was found increased not only in patients but in some healthy members of
      nephropathic families. beta 2-microglobulin therefore can serve as a marker of
      the early tubular damage in Balkan nephropathy. However, urinary beta 2
      microglobulin is not specific for Balkan nephropathy, lacking specificity
      required for screening purposes. The different patterns of serum and urinary beta
      2-microglobulin, and other urinary proteins, in patients with Balkan nephropathy
      from patients with chronic pyelonephritis and glomerulonephritis favor the
      opinion that Balkan nephropathy is a separate clinical entity.

PMID- 1762328
TI  - Beta 2-microglobulinuria as a predictor of death in a population exposed to
      Balkan endemic nephropathy.
AB  - During the year 1974, urinary beta 2-microglobulin (beta 2mu) was measured at
      monthly intervals using the first-morning urine sample of randomly selected
      individuals from the BEN affected village of Petka (416 persons) and from the
      nearby situated control village of Stubica (216 persons). Initial compliance was
      complete; over 90% of villagers had at least 10 tests performed. beta 2mu, as
      assessed by radial immunodiffusion (RID), was repeatedly (at least twice)
      positive in 12% and 1.4% of the populations of the endemic and control villages,
      respectively. Over the 15 years of follow-up (1974 to 1988), none from the
      control village developed BEN, while many medical records of the cohort exposed
      to BEN contained data suggestive of BEN. Death from/with BEN was used as a
      measure of outcome. Incidence density of 12 was 3.3 per 1000 person/years of
      observation (19/5723). A single positive beta 2mu test was a sensitive predictor
      of BEN death (sensitivity = 89.5%). Selecting two or more positive tests as the
      cut-off point, the specificity and positive predictive value were considerably
      increased. Using the sulfosalicylic acid test for detection of significant
      proteinuria, a similar level of validity indices was reached only by four
      testings.

PMID- 1762329
TI  - Beta 2-microglobulinuria in a population exposed to Balkan endemic nephropathy:
      inferences from repeated cross-sectional studies.
AB  - Baseline data from a study run in 1974, which comprised beta 2-microglobulinuria
      (beta 2mu) measurements at monthly intervals from 416 members in 112 households
      from the BEN affected village of Petka, were compared with the results of two
      subsequent, cross sectional studies. In June 1988, retesting involved 320
      available persons from the same households. Another collection of 284 urine
      specimens took place in October 1989. Prevalence of tubular proteinuria was the
      same in 1988 and 1989 as it was in 1974, indicating that the level of exposure to
      nephrotoxic agent did not change over time. Over 94% of the individuals who were
      always beta 2mu negative in 1974 remained negative in 1988. By contrast, over two
      thirds (68.7%) of those who were positive two or more times 14 years ago, tested
      positive upon re-examination in 1988. Particular interest arises from the data on
      those initially repeatedly positive persons in whom the overt disease did not
      occur over time; moreover, some appeared to be unaffected in 1988 and 1989
      according to our set of laboratory criteria. The results suggest occasional slow
      progression and even possible reversibility of tubular lesions in individuals
      living in the BEN affected environment.

PMID- 1762330
TI  - Beta 2-microglobulin studies in endemic Balkan nephropathy.
AB  - The diagnosis of BEN and its differentiation from other chronic interstitial
      nephropathies are difficult because of the insidious onset as well as nonspecific
      morphological changes in the kidney. Early diagnosis of this disease is by
      clinical and laboratory findings which have not been universally accepted. This
      study was designed to determine if the frequency of increased urinary beta 2
      microglobulin (U beta 2m) in village populations at risk to develop BEN was
      significantly higher than that seen in a control population. Individuals in the
      two population samples were classified in one of three categories: healthy,
      suspect or diseased. There were 23 individuals who met the criteria for the
      clinical diagnosis of BEN. Twenty (87%) of these had one or more positive tests
      for increased U beta 2m. The prevalence of kidney disease in the endemic village
      population sample was 13.4 times that for the control village population sample.
      The data show that the healthy individuals living in a village where BEN is
      endemic have 6.4 times greater chance of having tubular proteinuria than those
      living in a control area. The coincidence of the finding of U beta 2m in the
      urine of 87% of those sick with BEN and in 37 of the 342 (10.8%) people judged to
      be free of kidney disease suggests that a positive U beta 2m test is an early
      indicator of exposure to a nephrotoxic agent.

PMID- 1762331
TI  - Environmental renal disease: lead, cadmium and Balkan endemic nephropathy.
AB  - The similarity of lead and cadmium nephropathy to Balkan endemic nephropathy
      warrants careful reevaluation of the possibility that these nephrotoxic metals
      contribute to the production of the endemic renal disease. Low-level
      environmental exposure may result in a relationship between the concentration of
      the metals in tissue storage sites and biological fluids that differs from that
      encountered after occupational exposure. Urine and blood concentrations may
      therefore be inadequate measures of exposure. Lead is accumulated in the skeleton
      and cadmium in the liver and kidneys with biological half lives approximating a
      decade. Non-invasive in vivo x-ray fluorescence or neutron activation analysis
      can therefore be used to measure cumulative tissue stores. Multiple regression
      analysis of epidemiologic data could reveal the relative contribution of causal
      factors, including lead and cadmium, and help to distinguish Balkan endemic
      nephropathy from other renal diseases using rigorous diagnostic criteria. As long
      as Balkan endemic nephropathy remains a diagnosis of exclusion, the accuracy of
      the diagnosis of other renal disease determines the reliability of identification
      of the endemic disease.

PMID- 1762332
TI  - A fifteen year cohort based evaluation of beta 2-microglobulin as an early sign
      of Balkan endemic nephropathy.
AB  - The occurrence of elevated urinary beta 2-microglobulin (U beta 2m) has been
      established to be more common in village populations living in areas where BEN is
      endemic when compared to appropriate control population. In addition, beta 2
      microglobulinuria is associated with BEN. It has been demonstrated that there is
      an increase in the U beta 2m in apparently healthy populations located in high
      risk areas. It is 15 years since the first systematic investigations of U beta 2m
      in the villages of Brod Posavina were conducted. The purpose of this study was to
      determine the value of a positive test for tubular proteinuria as defined by
      increased U beta 2m, in identifying individuals at risk to develop BEN. In these
      studies we followed two cohorts for 15 years: one group consisted of individuals
      who were positive for tubular proteinuria by U beta 2m testing in 1974; the
      second group was an age and sex matched group from the same village who were
      never positive after 12 testings in 1974. The results show that a positive test
      for U beta 2m is associated with 9.9 times greater relative risk of developing
      BEN when compared to controls that had no positive U beta 2m tests.

PMID- 1762333
TI  - Relationship of anemia to Balkan endemic nephropathy.
AB  - Anemia has been reported to be an early sign of Balkan endemic nephropathy (BEN)
      occurring before the serum creatinine is elevated. This study was designed to
      determine if anemia occurred more frequently in an otherwise 'healthy' population
      living in an area where BEN is endemic when compared to a control population.
      Also, we wished to determine if any relationship existed between anemia and beta
      2-microglobulinuria (beta 2mu) in these populations. The prevalence of anemia in
      the control village population was 7%, compared to 21.4% of the at-risk village
      population. These data suggest that anemia is a part of the pathophysiologic
      picture of endemic nephropathy, and that anemia can be found in an early, non
      azotemic phase of the kidney disease.

PMID- 1762334
TI  - Anemia in Balkan endemic nephropathy.
AB  - The severity of anemia in patients at different stages of the evolution of two
      tubulointerstitial nephropathies, Balkan endemic nephropathy and chronic
      pyelonephritis, was compared to clarify the previous observations that anemia
      appears earlier and is more severe in Balkan endemic nephropathy than in other
      renal diseases. The role of erythropoietin insufficiency as the cause of anemia
      in endemic nephropathy was studied as well. The severity of anemia increased with
      the impairment of renal function in endemic nephropathy and was similar to anemia
      in chronic pyelonephritis. However, in patients with endemic nephropathy at the
      initial stage of renal insufficiency significantly lower red cell concentrations
      were found compared with control subjects from the endemic region. In contrast,
      patients with pyelonephritis did not have decreased red cell concentrations at
      the early phase of their renal failure, suggesting that earlier appearance of
      anemia is characteristic for endemic nephropathy. To confirm this finding a study
      involving larger number of patients would be necessary. The serum erythropoietin
      levels, inappropriately low for the degree of anemia in patients with renal
      failure, were unrelated to the type of tubulointerstitial nephropathy.

PMID- 1762335
TI  - Renal function, protein excretion and pathology of Balkan endemic nephropathy. I.
      Renal function.
AB  - Renal function studies were performed on 59 patients who had the clinical
      criteria for Balkan endemic nephropathy (BEN). They were divided into three
      groups according to DTPA clearance (DTPA). Group 1, 11 individuals, had a mean
      age of 41.6 years and DTPA greater than 100 ml/min. Group 2, 20 persons, had a
      mean age of 49 years and DTPA of 60 to 100 ml/min. Group 3 was made up of 28
      people with a DTPA less than 60 ml/min and an average age of 50.4 years. No
      distinguishing specific or characteristic symptoms of BEN were found in any of
      the three groups. Anemia was not found to be an early indicator when compared to
      other forms of progressive renal disease. Proteinuria was minimal and
      intermittent in all three groups. Maximum concentrating ability was significantly
      reduced only in the third group. These features do not allow the clinical
      differentiation of BEN from other chronic progress tubulointerstitial
      nephropathies. The geographic isolation and familial nature of the disease,
      associated with minimal proteinuria make BEN a unique entity. Kidney size by
      ultrasound was decreased in all three groups, suggesting that this may be another
      early and characteristic feature to BEN.

PMID- 1762336
TI  - Renal function, protein excretion, and pathology of Balkan endemic nephropathy.
      II. Protein excretion.
AB  - The urinary proteins of 40 patients with Balkan endemic nephropathy from the
      Tuzla region were examined using ultrathin-layer SDS pore-gradient polyacrylamide
      gel electrophoresis in combination with silver staining. The typical urinary
      protein spectrum contained immunoglobulin G, Tamm-Horsfall protein, transferrin,
      albumin, beta 2-microglobulin (beta 2m), immunoglobulin light chains, retinol
      binding protein, and alpha 1-microglobulin (alpha 1m). Densitometric measurements
      were used to derive glomerular tubular protein ratios (GTPR) and to characterize
      protein excretion patterns in the 28 patients who excreted more than 150 mg/liter
      of protein. Results showed that proteinuria of Balkan nephropathy is
      predominantly tubular, consisting of low-molecular-weight species. The most
      commonly identified proteins were alpha 1m, light chains, retinol binding
      protein, and beta 2m. The pattern of proteinuria based on GTPR did not correlate
      with the underlying histology or the degree of renal failure. These findings,
      using the ultrathin-layer SDS pore-gradient method of protein separation, more
      accurately demonstrates the low-molecular-weight proteinuria characteristic for
      the early stages of BEN.

PMID- 1762337
TI  - Renal function, protein excretion, and pathology of Balkan endemic nephropathy.
      III. Light and electron microscopic studies.
AB  - This study was performed to evaluate histomorphological features of BEN in 50
      kidney biopsies from patients who met the epidemiologic, clinical and laboratory
      criteria for BEN. This is the first such study reported in detail. The patients
      were divided into three groups based on the DTPA clearance values: group 1,
      greater than 99 ml/min, group 2, 51 to 99 ml/min, and group 3, 29 to 50 ml/min.
      All patients in all groups had an increase in proteinuria consisting of proteins
      less than 25,000 daltons. Multifocal interstitial sclerosis spreading from the
      superficial into the deep cortex was found in 49 (98%), tubular atrophy in 48
      (96%), and global glomerular sclerosis with microvascular hyalinosis/sclerosis of
      sclerotic and atrophic changes were significantly increased when compared to age
      related standards. An accelerated aging process may be assumed to occur in BEN.
      More peculiar additional findings with much lower incidence and extent included
      multifocal vascular and glomerular capillary changes resembling the chronic form
      of thrombotic microangiopathy group of diseases. These findings, together with
      the presence of arteriolar hyalinosis and tubulointerstitial sclerosis seen in
      patients with cyclosporine nephrotoxicity suggest that the mechanism of toxicity
      may be similar to BEN. We conclude that the histopathology is predominantly
      tubulointerstitial sclerosis without infiltrates. The combination of the
      histology, tubular proteinuria, geographic distribution, familial occurrence, and
      the remarkable association with papillary transitional cell carcinoma of the
      renal pelvis and ureters, qualifies BEN as a unique disease.

PMID- 1762338
TI  - Renal function, protein excretion, and pathology of Balkan endemic nephropathy.
      IV. Immunohistology.
AB  - Few controversial observations on the deposition of immunoglobulins (Igs) and
      complement components in kidney biopsies of Balkan endemic nephropathy (BEN)
      patients have been reported. In the present study, direct or indirect
      immunofluorescence testing of the deposition of IgA, IgG, IgM, C3, C1q, C4
      fibrin/fibrinogen, albumin, B2-microglobulin (beta 2m) and Tamm-Horsfall
      glycoprotein (THG) on frozen renal tissue sections was performed in 52 BEN
      patients. Glomerular findings were negative or mostly insignificant, with mild or
      moderate mesangial deposition of IgM in 16, IgA in 11, IgG in three, C3 in 15,
      C1q in two, C4 in one and fibrin/fibrinogen in two cases, respectively. The
      predominance of mesangial IgA deposits in five cases suggested IgA
      glomerulonephritis (GN) concomitant with BEN. Homogeneous lumpy or granular
      deposits in small extraglomerular vessels contained IgM in nine, C3 in 45, C1q in
      three, and C4 in one case. Focal linear or granular C3 was noted along the
      tubular basement membrane in eight cases. Resorptive droplets in tubular
      epithelial cells contained Igs and albumin, while complement, fibrin/fibrinogen
      and THG were found in tubular casts. There was no positive reaction with anti
      beta 2m and anti-THG antibodies. According to these results, humoral immune
      mechanisms would not appear to play a pathogenetic role in BEN. However,
      immunohistologic examinations are important in recognition of possible
      concomitant immune complex-mediated GN.

PMID- 1762339
TI  - Incidence of tumors of urinary organs in a focus of Balkan endemic nephropathy.
AB  - A prospective follow-up study which included a 25% sample of the population of
      Petka, a hyperendemic village located in the vicinity of Belgrade, was conducted
      over a 15 year period (1974 to 1988). The cohort consisted of 416 members who
      made up the denominator of 5,723 person-years of observation. Incidence of
      deaths, either from or with tumors of urinary organs, was taken as a measure of
      outcome. The diagnosis of tumor was based on pathohistological confirmation.
      Incidence density of urinary tract tumors was 1.75 per 1,000 person-years. Six
      individuals had upper urothelial tumors (incidence density = 1.40 per 1000 person
      years of observation). These tumors occurred in 32% of the cases who had Balkan
      endemic nephropathy.

PMID- 1762340
TI  - Balkan endemic nephropathy and papillary transitional cell tumors of the renal
      pelvis and ureters.
AB  - Papillary transitional cell tumors of the renal pelvis and ureters occur more
      frequently in the Balkan countries than in other areas in the world. The
      populations involved are the same as those who are at risk to develop Balkan
      endemic nephropathy (BEN). Seventy-seven patients were treated in the Urology
      Clinic for papillary cell tumors of the renal pelvis and ureters (UTT) from 1986
      to 1988. Forty-four of the patients were from areas where BEN is endemic. The at
      risk population is estimated to be less than 2% of the control population. Eleven
      of the 77 were on hemodialysis when UTT were detected, and all but one of those
      were from BEN areas. This finding emphasizes the need for continual monitoring of
      end-stage renal disease patients for evidence of these tumors. Comparing the
      frequency of the tumors from our study (1986 to 1988) with that of early studies
      indicates that the risk of developing the tumors remains very high in the BEN
      areas. We conclude that the causative agent(s) is still prevalent in the involved
      areas.

PMID- 1762341
TI  - Urinary tract tumors and Balkan nephropathy in the South Morava River basin.
AB  - The aim of this investigation was to study the frequency of urinary tract tumors
      (UTT) in settlements around the South Morava River and its tributaries where
      Balkan nephropathy is endemic. For this purpose 659 surgery and autopsy records
      of patients with UTT were reviewed. The records came from 25 counties and 1279
      settlements classified as endemic, hypoendemic and nonendemic. Upper tract
      urothelial, urinary bladder and kidney tumors were included in the evaluation. A
      highly significant geographic correlation between Balkan nephropathy and UTT
      localized in renal pelvis and ureter was noted in the South Morava River valley.
      These tumors were 57 and 61.8 times more frequent in endemic settlements than in
      control rural and city populations free of Balkan nephropathy. The frequency of
      urinary bladder tumors in endemic settlements was also increased compared with
      the nonendemic villages and large cities, up to 11.9 and 8.5 times, respectively.
      In endemic settlements, upper urinary tract tumors were five times and tumors of
      urinary bladder were seven times more frequent in families with Balkan
      nephropathy than in those without, and up to 224 times more frequent than in the
      city families. Familial clustering of UTT was also noted. The geographic
      correlation between Balkan nephropathy and UTT supports the speculation that
      these disorders share a common etiology.

PMID- 1762342
TI  - Survey of small molecule and ion binding to beta 2-microglobulin--possible
      relation to BEN.
AB  - Using a new method which permits rapid detection of ligand binding to cross
      linked protein films and crystals, we evaluated a spectrum of ligand binding to
      cross linked amorphous films of beta 2-microglobulin purified from urine of
      Balkan endemic nephropathy patients. Among more than 50 substances studied,
      including amino acids, fatty acids, sugars, nucleotides, nucleosides, and
      different inorganic ions, only polyvalent cations, such as Cu2+, Ca2+, Zn2+, Be2+
      and La3+, were found to strongly bind to human beta 2-microglobulin with
      dissociation constants in the range 10(-6) to 10(-4) M. These cations can release
      beta 2-microglobulin from HLA complexes leading to an increased beta 2
      microglobulin level in serum. These observations suggest a possible mechanism for
      the release of beta 2-microglobulin to make it available to exert toxic effects
      on the kidney as a potential pathogenesis of Balkan endemic nephropathy.

PMID- 1762343
TI  - Possible pathogenetic role of low-molecular-weight proteins in Balkan
      nephropathy.
AB  - Balkan endemic nephropathy (BEN) is a tubulointerstitial disease characterized by
      increased-low-molecular-weight protein (LMWP), most notably, beta 2-microglobulin
      (beta 2m) excretion in urine. We previously demonstrated that two species of
      LMWPs, immunoglobulin light chains (LC) and recombinant alpha interferon (rIF),
      are toxic at proximal tubule cell membrane level. Myeloma LCs and rIF inhibit Na
      dependent uptake of 14C-L-alanine and 14C-D-glucose by rat renal brush border
      membrane (BBM) vesicles at half-maximal inhibitory concentrations, IC50, ranging
      from 68 to 140 microM for LCs, and 5.4 to 18 nM for rIF. We further demonstrated
      that LCs bind to high-capacity, low-affinity sites on BBM with dissociation
      constants (Kd) ranging from 16 to 118 microM, a range similar to IC50s observed
      with the same LCs. Binding site occupancy is inversely related to alanine (r = 
      0.95, P less than 0.01), and glucose uptake (r = -0.96, P less than 0.01),
      implying that LC nephrotoxicity is determined by its binding to BBM. beta 2m
      shares behavioral and structural similarities with both LC and rIF. Preliminary
      studies in our laboratory showed that unlabeled LCs compete for the same binding
      sites on BBM with beta 2m. These observations confirm that all LMWP, including
      beta 2m, are potentially nephrotoxic. Thus, the characteristic beta 2
      microglobulinuria of BEN may be more than a consequence of tubular dysfunction,
      and may play a pathogenetic role.

PMID- 1762344
TI  - Relationship between weathered coal deposits and the etiology of Balkan endemic
      nephropathy.
AB  - Field studies in epidemiology and environmental geochemistry in areas in
      Yugoslavia containing villages with a high incidence of Balkan endemic
      nephropathy (BEN), indicate a possible relationship between the presence of low
      rank coal deposits and the etiology of BEN. Preliminary results from qualitative
      chemical analyses of drinking water from shallow farm wells indicate the presence
      of soluble polar aromatic and polynuclear aromatic hydrocarbons. These compounds
      may be derived from weathering of low-rank coals occurring in the vicinity of the
      endemic villages. All of the endemic villages are in alluvial valleys of
      tributaries to the Danube River. All except one of the clusters of endemic
      villages are located in the vicinity of known Pliocene age coals. Detailed
      sampling of the drinking waters and the nearby coals are being undertaken to
      identify a possible etiologic factor.

PMID- 1762346
TI  - Spontaneous and induced chromosome aberrations in Balkan endemic nephropathy.
AB  - The aim of the present study was to investigate the spontaneous aberrations and
      chromosome breakages induced by X-rays and folic acid deficiency. In patients
      with Balkan endemic nephropathy (BEN) a higher frequency of spontaneous
      aberrations and chromosome lesions in medium TC 199 and radiation induced
      breakages were found compared with the healthy individuals. In BEN patients the
      3q25 band was most frequently involved in the aberrations. These results support
      the idea that 3q25 may play a specific role and be a marker for BEN. Three of the
      additional five bands with increased frequencies of lesions in BEN patients
      contain oncogenes: 1q36-c src, 3p25-raf-1, and 6q23-myb. The frequent association
      of BEN and cancer can be explained by the chromosomal hypothesis of oncogenesis.

PMID- 1762345
TI  - Erythrocyte delta-aminolevulinate dehydratase measurements in Balkan endemic
      nephropathy.
AB  - Balkan endemic nephropathy (BEN) is a chronic progressive kidney disease leading
      to renal insufficiency. The possible etiological role of some toxic factors was
      considered in this study by investigating the activity of erythrocyte delta
      aminolevulinate dehydratase (ALA-D), an enzyme influenced by various
      environmental factors. We observed that ALA-D activity was markedly decreased in
      patients with BEN and in 32% of their healthy family members. Glutathione
      concentration was found normal in all the groups studied, however, it was
      possible to reactivate the enzyme in vitro by addition of exogenous glutathione.
      Percent activation was significantly higher in the groups with decreased ALA-D
      activity. Blood lead levels were within normal range. The results suggest a
      normal synthesis of ALA-D apoenzyme, and also the presence of some factors,
      environmental, metabolic, or genetic, which may affect the enzyme activity
      through binding to the reactive groups in the active center of this enzyme or by
      oxidation of the reactive groups. Additional studies are necessary to further
      elucidate the significance of decreased ALA-D activity in BEN and their healthy
      relatives.

PMID- 1762347
TI  - [The Nagel anomaloscope in the diagnosis of eye diseases].
AB  - The Nagel anomaloscope can be incorporated in the diagnosis of eye diseases.
      Three parameters are relevant: 1. The measure of the absolute matching range
      (scale units) 2. The preferred direction of the widened matching range (to red or
      to green) 3. The luminance matches with the yellow (decreasing matches indicating
      a pathologic scotopisation). - Six pathologic anomaloscope findings can be
      differentiated: 1. Pseudoprotanomaly (retinal diseases; type III acquired blue
      yellow defects) 2. Symmetrically widened absolute matching range (reduced hue
      discrimination without reference to its etiopathology) 3. Absolute matching range
      asymmetrically widened to red with scotopisation (retinal diseases; type III
      acquired blue-yellow defects or type I acquired red-green defects) or without
      scotopisation (retinal diseases or optic nerve diseases; type III acquired blue
      yellow defects) 4. Absolute matching range asymmetrically widened to green
      (mostly optic nerve diseases; type II acquired red-green defects) 5. Acceptance
      of both end matches ("0" up to "73") with scotopisation (retinal diseases) or
      without scotopisation (optic nerve diseases) 6. Achromatic matches (selective
      cone diseases, such as Stargardt's dystrophy or progressive cone dystrophy).
      Indications for anomaloscope examinations and clinical application of the method
      are discussed in ten cases. The utility of the Rayleigh-equation consists in
      diagnosing pathologic scotopisation (differential diagnosis between retinal
      diseases and optic nerve diseases) and in making a quantitative evaluation of the
      acquired color vision defect (follow-up examination).

PMID- 1762348
TI  - [Comprehensive study of the iris in transformed light in simple glaucoma].
AB  - Complex examination of the iris under light transformed by various methods -
      iridochromoscopy with iridochromophotography, transillumination in red light, and
      fluorescein angiography - was performed on 26 eyes of patients with simple
      glaucoma and 24 normal eyes of subjects aged between 42 and 76 years. All the
      methods employed revealed iris changes in 100% of the simple glaucoma cases. The
      differences found between the study group and the controls were significant (P =
      0.01). A highly positive correlation was found between the results of iris
      fluorescein angiography and iridochromoscopy with iridochromophotography (r =
      0.932; P = 0.0005), as well as between the results of iris fluorescein
      angiography and transillumination in red light (r = 0.921; P = 0.0005). Complex
      examination of the iris under transformed light showed the most typical changes
      in simple glaucoma to be exogenous pigmentation of the pupillary and ciliary
      regions, partial or complete destruction of the pupillary margin, and stromal
      atrophy affecting the pupil or the entire iris. Defects and thinning of the
      posterior iris pigment layer, iris vessel permeability disorders associated with
      hypoperfusion and microneovascularization in the lesser circle and the ciliary
      region were also found.

PMID- 1762349
TI  - [Determination of arteriovenous transit time of the choroid with indocyanine
      green].
AB  - We present a very sensitive, yet light-weight videosystem for infrared
      angiography with Indocyanine green. This system was used to quantify for the
      first time the choroidal arteriovenous passage time (chAVP) in eight healthy
      volunteers and eight patients with retinal detachment pre- and postoperatively.
      The mean normal value of the chAVP was measured to be 3,46 + 0,59 sec. Patients
      with retinal detachment could be divided into two groups. The chAVP did not
      change significantly (p = 0,298) from 3,37 + 0,55 sec. to 3,48 + 0,54 sec. in six
      patients (mean age 49,7 + 5,4 years), who had a simple scleral buckling
      procedure. In two further patients (63 and 70 years), who had been operated with
      an encircling band, a postoperative chAVP-delay of 0,72 and 1,48 sec. was
      detected. This verification of the clinically expected obstruction of choroidal
      venous outflow after encircling bands emphasizes the validity of the method.
      Nevertheless, since the procedure is time consuming and detects only marked
      disturbances, it must be taken as one basic step in the search for the
      quantification of the choroidal circulation.

PMID- 1762350
TI  - [Liquid perfluorocarbon in treatment of giant tears].
AB  - In 20 cases of giant tears with considerable proliferative changes, vitreoretinal
      silicone-oil-surgery was performed. With liquid perfluorocarbon, the involuted
      retina could easily be fixed during the operation in its former position without
      difficulties, before silicone oil as a permanent tamponade was used. The good
      results prove that more invasive manipulations, which were formerly necessary,
      become superfluous using this method.

PMID- 1762351
TI  - [Automatic perimetry of the central visual field in diseases of the macula].
AB  - We developed a program for testing the central 12 degrees of the visual field
      with a spatial resolution of 1.6 degrees that was easy to operate. The program
      was designed for the Octopus computer-perimeter and created by means of the
      SARGON-utility. Our way of examining differed slightly from the standard Octopus
      procedure. We tested 16 normal eyes and 13 eyes of patients with various diseases
      of the central retina. Our normal values of differential threshold sensitivities
      were about 1.8 dB below the normal values of the Octopus system. Sensitivity and
      specificity of the program were nearly identical irrespective of using our normal
      values or the Octopus normal values for the calculation of the above mentioned
      parameters. Sensitivity was 84.6%, specificity 87.5%. The ability of the program
      to correctly localize retinal defects was shown. The program was designed for
      follow-up of patients having undergone paramacular lasercoagulation.

PMID- 1762352
TI  - [Ciliary perfusion pressure in primary open angle glaucoma].
AB  - Oculo-oscillodynamography after Ulrich was performed in 103 patients suffering
      from primary open-angle-glaucoma. More than 67% of these eyes showed an increase
      of systolic ciliary perfusion pressure, 25% a normal one and only 7% a decreased
      systolic ciliary perfusion pressure.

PMID- 1762353
TI  - [Iris fluorescence angiography findings in oculo-oscillodynamography].
AB  - Supported by irisfluorescein angiography it should be examined if systolic
      ciliary pressure found by oculooscillodynamography is to be seen in every part of
      the uvea. Iris vessels were found to be perfused at 42 mm Hg (Median, Q1-Q3 = 38
      45 mm Hg) whereas oculooscillodynamography displayed systolic ciliary pressure to
      be 69 mm Hg (62-72 mm Hg). This different blood pressure in different districts
      of the uvea may be one explanation for the particular vulnerability of iris
      vessels e.g. in ischemic ophthalmopathy.

PMID- 1762354
TI  - [Monoclonal antibody HMB-45 in diagnosis of intra-ocular melanoma].
AB  - 69 eyes, which had to be enucleated because of an uveal melanoma, were
      investigated immunohistologically. HMB-45-antigen, which is supposed to be highly
      specific for melanocytic tumours, was found in 68 cases (sensitivity 99%) with a
      monoclonal antibody. S 100-antigen was positive in 63 cases (sensitivity 91%)
      using a polyclonal antibody. The addition of HMB-45-immunohistochemistry to
      routine histological diagnostic procedures is valuable, when a non-melanocytic
      uveal tumour cannot be ruled out or when the degree of melanoma-invasion has to
      be determined with greater accuracy. At the site of melanoma-invasion changes of
      cellular reactivity seem to occur, as 11 of the 69 studied tumours (16%) showed
      an increased HMB-45-expression in this area. HMB-45-antigen was detectable even
      in paraffin embedded material obtained from eyes enucleated 30 years ago.

PMID- 1762355
TI  - [The antiphlogistic effect of the ginkgolide BN 52 021 in the chemically burned
      rabbit eye].
AB  - BN 52 021, a specific antagonist of PAF receptors, was tested in the early-phase
      treatment of chemically burned eyes in 30 rabbits. The local application of BN 52
      021 eyedrops-1% (water-soluble preparation, 5 times daily, in comparison with the
      other eye as a control) led to a visible anti-inflammatory effect
      (microscopically and macroscopically) of the chemically burned anterior eye
      segment. There was only a moderate increase of the concentration of PGF2 alpha
      after the chemical burn. The use of specific PAF antagonists seems to have a real
      chance for treatment of inflammatory reactions of the anterior eye segment. A
      combination with other mediator antagonists should be tested in further
      experiments.

PMID- 1762356
TI  - [Silver nitrate burn after Crede's preventive treatment. A roentgen analytic and
      scanning electron microscopy study].
AB  - Following Crede's prophylaxis with silver-nitrate, the cornea of a newborn
      presented greyish-brown, lime-like plaques on the nasal part of the right eye. A
      paracentral ulcerating stromal opacification undermined these appositions, when
      the patient was admitted to the eye-clinic at Aachen. In the material taken in a
      lamellar keratectomy scanning electron microscopical examination was able to
      prove the existence of granules, previously described in light-microscopy. These
      granules measured 100 to 300 nm in diameter and were placed up to 110 microns
      deep into the corneal stroma of the specimen. An earlier chemical analysis of
      necrotic material showed no silver specific reaction. By means of EDX-Analysis
      these granules could be identified as silver-containing. This was once reassured
      by a newly developed modification of van-Kossa's-staining-method. The fact that
      the granular deposits contained mainly silver proves that the onset of a sodium
      chloride-irrigation did not promote an intended therapeutic silver-chloride
      precipitation and therefore had no effects on the silver-nitrate's penetration
      abilities. Injuries by silver-nitrate-solutions used for Crede's prophylaxis are
      seldom but still reported. The mechanism of injury in this case of a child, born
      by sectio remains unknown. Neither the use of an unusual silvernitrate solution,
      that was taken from a disposable ampoule (Mova-Nitrat) was reported, nor any
      corneal injury during sectio mentioned.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762357
TI  - [Choroid infarct in the posterior pole of the eye].
AB  - By means of a choroidal infarct located at the posterior pole current theories
      concerning the choroidal anatomy are demonstrated. The existence of watershed
      zones being adjacent in the macular area as postulated by S. S. Hayreh however
      cannot be confirmed.

PMID- 1762358
TI  - [Retinopathy as the first symptom of hairy cell leukemia].
AB  - Hairy cell leukemia is a seldom non-Hodgkin-lymphoma of the B-cells. The case of
      a 39 year old male with loss of vision as first sign of hairy cell leukemia is
      presented. The decrease of vision was caused by intraretinal bleeding into the
      macula. By means of ophthalmoscopy and angiography we found intraretinal
      bleedings, soft exudates, microaneurysms and capillary occlusions. The
      examination of blood cells showed leucocytosis (48.900/microliter), anemia
      (hemoglobin 8.7 g/l), thrombocytopenia (67.000/microliter) and hairy cells in
      peripheral blood and in bone marrow. Under treatment with alpha-Interferon visual
      acuity became normal and the fundus lesions decreased. This case points out that
      a retinopathy with bleedings and soft exudates can be caused by leukemia which
      should therefore be excluded by differential blood count.

PMID- 1762359
TI  - [Iridochromoscopy].
AB  - The author has developed methods for examination of the iris in the light of
      different spectral composition. The studies have revealed that employment of
      colored filters in biomicroscopy and photography of the iris helps detect the
      pathologic shifts undetectable by routine examination. Examinations in
      polychromatic and changing in succession monochromatic light help carry out a
      sort of spectral analysis of the clinical features of iridal diseases.

PMID- 1762360
TI  - [Prof. Witold Jan Orlowski 1918-1988].

PMID- 1762361
TI  - [Results of experimental studies of the possibility of using low temperature in
      the treatment of retinopathy of prematurity].
AB  - The purpose of the paper was to study whether the use of cryotherapy can cause
      decrease of angiogenic activity of the primary avascular retina in kittens with
      oxygen induced retinopathy. The studies showed that after cryotherapy comes to a
      considerable decrease of angiogenic activity of this part of the retina. It
      indicates that cryotherapy should arrest the development of more advanced stages
      of retinopathy of prematurity.

PMID- 1762362
TI  - [Comparative evaluation of blood flow velocity and pulsation curve in the
      posterior ciliary arteries supplying the choroid and the anterior part of the
      optic nerve].
AB  - The speed of the blood-flow and the indexes of pulsation in posterior ciliary
      arteries supplying the choroid and the anterior optic nerve segment were
      evaluated in 30 healthy persons (60 eyes) aged 20-60 years with intraocular
      pressure values of 15-20 mm Hg and in 60 persons with primary glaucoma (120 eyes)
      aged 22-76 years. The investigations were carried out by the method of Doppler
      focused pulsating ultrasonography, with an 8.0 MHz probe; the instrument used was
      the TC-2-64 produced by EME (Germany). It was established that the main speed of
      the blood-flow in the choroid vessels in healthy people is higher than in the
      arteries supplying the anterior segment of the optic nerve. These speeds are
      respectively: 15.13 +/- 4.3 cm/s and 12.03 +/- 3.0 cm/s. The difference is
      statistically significant. The index of pulsation in the posterior ciliary
      arteries of both vascular systems does not differ in a statistically significant
      way and amounts respectively: 0.68 +/- 0.13 and 0.71 +/- 0.11. In patients with
      glaucoma it comes much earlier to a decrease of the speed of the blood-flow and
      to an increase of the indexes of pulsation together with a raise of the IOP in
      the system of the choroidal posterior ciliary arteries than in the anterior
      segment of the visual system.

PMID- 1762363
TI  - [Value of the ERG in the "pattern" type (PERG) in the diagnosis of glaucoma].
AB  - The authors examined 14 persons (20 eyes) aged 51-77 years with open angle
      glaucoma and 3 persons (5 eyes) aged 37-59 years who were suspected for this
      condition. The control group consisted of 23 healthy persons (30 eyes) aged 14-40
      years. The PERG results were statistically worked up using the t-Student test.
      Full clinical examinations and PERG were performed by means of the UTAS E-1000
      system of LKC (USA) production according to modified by the authors method of May
      and coworkers. In the observed glaucoma group the authors revealed a
      statistically significant reduction of the interpeak values of the PERG in
      comparison with the control group; this points to a lesion of the ganglion cells
      in the course of this disease. The modified and adapted for the UTAS E-1000
      method of May and coworkers and the applied system of conductors ensured the
      optimal reception of the PERG signals i.e. the maximal amplitude with minimal
      disturbances.

PMID- 1762364
TI  - [Behavior of the x wave of the ERG in patients with macular degeneration].
AB  - A group of 133 persons (213 eyes) aged 6 to 80 years (mean 37 years) with macula
      degeneration were analysed. Basic ophthalmological examination and
      electroretinography were performed. The absent of the x-wave ERG is usually, but
      not always, connected with worse function of the macula. Pathological ERG and the
      absent of the x-wave ERG at the same time, suggest unsuccessful prognosis of the
      disease.

PMID- 1762365
TI  - [Pathological conditions of the vitreous body in children after eye injuries].
AB  - The material consists of 142 eyes in 138 children aged 2-17 years who sustained
      contusions and perforating injuries. Pathological changes of the vitreous have
      been observed in 75 p.c. of cases: haemorrhages, opacities, destructive and
      fibrous changes and even a total fibrosis of the vitreous with shortening of the
      anatomical axis of the eye. Vitrectomy was performed in 23 cases with extraction
      of the foreign body in 11. In eyes with a destruction of the vitreous and with
      vitreoretinal proliferation a laser photocoagulation of the retina or
      transscleral cryopexy was performed. It is considered that the prophylactical
      treatment is indicated in all eyes exhibiting structural changes in the vitreous.

PMID- 1762366
TI  - [Familial exudative vitreoretinopathy--vitreoretinopathia familiaris exsudative.
      I. Review of the literature].
AB  - Presented are the contemporary opinions of the etiopathogenesis, signs, the
      clinical course as well as the differentiation and therapy of the familial
      exudative vitreoretinopathy. Attention is called to the variety of the clinical
      picture of this disease and the importance of fluorescein angiography in
      diagnosis.

PMID- 1762367
TI  - [Familial exudative vitreoretinopathy--vitreoretinopathia familiaris exsudativa.
      II. Report of 4 cases].
AB  - The authors present four cases of familial exudative vitreoretinopathy observed
      in the course of the last years. Our cases appeared sporadically in families and
      showed a variable picture and clinical course. The accepted differential
      criterions and difficulties in differentiation are discussed.

PMID- 1762368
TI  - [Principles of qualifying retinal detachment for pneumoretinopexy].
AB  - The gases SF6 and C2F6 were used in 88 patients (88 eyes) with retinal detachment
      as endotamponade. Eighty eight patients constituted 3 groups in which the gas was
      used on the basis of following indications: 1) the eyes with retinal detachment
      from above and with holes between 9-12-3 or with a macular hole; 2) eyes with
      retinal detachment "without hole" or with a hole for evaluation for its size and
      localization, as an intervention preceding an extrascleral invagination; 3) eyes
      with retinal detachment from above in which after extrascleral indentation in
      spite of a good localization the retina did not reappose. On the basis of the
      presented material the authors emphasize the values of the pneumoretinopexy as a
      solitary procedure, a diagnostic procedure or completing an extrascleral
      indentation. The perils of this method are presented and the causes of failures
      discussed.

PMID- 1762369
TI  - [Silicone oil in the surgical treatment of retinal detachment--indications and
      clinical experience].
AB  - Silicone oil is being used with increased frequency for retinal tamponade during
      vitreous surgery for complicated retinal detachments. Though it is now possible
      to reattach most detached retinas, the visual outcome of the silicone oil
      procedure is often disappointing. This is due to the well known complications of
      silicone oil (i.e. cataract, glaucoma, corneal opacification), and the necessity
      to remove the silicone oil in a second surgical procedure with a certain risk of
      redetachment. Possible toxicity to retina and optic nerve has not yet get been
      completely evaluated. An alternative method is the use of expanding gases for
      internal retinal tamponade. Expanding gases are not as effective as silicone oil
      in advanced stages of proliferative vitreoretinopathy (PVR), but are afflicted
      with much less complications. We reviewed the charts of our patients, operated on
      for retinal detachment, to analyse the anatomical and functional results with
      silicone oil versus gas tamponade. Regarding the last 421 consecutive surgical
      procedures for retinal detachment (368 eyes), silicone oil has been used in 5%,
      expanding gases in 14%. The silicone oil procedure was restricted to the most
      advanced cases of PVR. The anatomic success rate with silicone was 72%, with gas
      tamponade 87%. Visual acuity of 0.05 and better achieved 19% of the eyes treated
      with silicone oil versus 61% of the eyes with gas tamponade. These results
      confirm the findings of other investigators: despite of the high anatomic success
      rate with silicone oil, the functional results are poor. Because many complicated
      cases of retinal detachment can also be treated successfully with gas tamponade,
      silicone oil should remain the last step in retinal detachment surgery.

PMID- 1762370
TI  - [Retinal detachment as a complication of lensectomy in post-traumatic cataract].
AB  - Presented were personal observations concerning 76 patients with traumatic
      cataract who underwent lensectomy. In 12 patients the retina detached in a
      various postoperative period. Causes and mechanisms of this complication were
      discussed.

PMID- 1762371
TI  - [Results of vitrectomy in children].
AB  - Presented are the results of vitrectomy in children operated in the
      Ophthalmological Department of Children Health Centre. The procedure was
      preformed in 110 eyes including 32 vitrectomies and 78 vitrectomies connected
      with lensectomy. Operated were eyes with chronical uveitis of various etiology,
      with posttraumatic changes, after vitreal haemorrhages in Eales' disease, in
      persistent vitreal artery cases. Improvement of the visual acuity was achieved in
      68 cases (61.8 p.c.), deterioration was observed in 28 (25.5 p.c.); the visual
      acuity did not change in 14 cases (12.7 p.c.). Retinal detachment was the most
      frequent complication--38 cases (34.5 p.c.); from this number 10 cases (9 p.c.)
      improved after a repeated operation.

PMID- 1762372
TI  - [Macular pucker after surgery for retinal detachment].
AB  - Twenty four patients with a preoperative macular detachment were subjected to a 6
      months observation. The evaluation of the macular function was carried out on the
      basis of following examinations: the visual acuity, central visual field,
      dazzling test, Amsler's test and Heidinger phenomenon. The morphology of the
      changes was evaluated ophthalmoscopically and biomicroscopically by means of
      Goldmann's lens and the slit-lamp. The macular pucker appeared in 25 p.c. of
      examined patients, in 16.7 p.c. of cases with non-translucent and in 8.7 p.c.
      with translucent membranes. In all cases of macular pucker after retinal
      detachment surgery the macular function remained severely handicapped.

PMID- 1762373
TI  - [Laser therapy of diabetic changes in the posterior pole of the eye. Early
      observations].
AB  - Presented are the results of treatment of diabetic changes at the posterior pole
      by argon laser. Among 26 eyes in which the "macular grid" technique was used an
      improvement or stabilization of vision was attained in 14 eyes, 12 remaining eyes
      showing deterioration. The anatomical condition improved or it was stabilized in
      24 eyes. Focused laser therapy after fluoresceine angiography was used in 15
      eyes; improvement or stabilization of the visual acuity was achieved in 12 eyes,
      deterioration was observed in 3 eyes. The anatomical condition improved or was
      stabilized in all the 15 eyes. The period of observation amounted 6 months.

PMID- 1762374
TI  - [Pathogenesis of retinal neovascularization].
AB  - Presented are the causes and actual opinions on the pathogenesis of retinal
      neovascularization. The ischaemic hypothesis of neovascularization is
      particularly discussed; it is commonly accepted to day as the most probable
      hypothesis.

PMID- 1762375
TI  - [Choroid ischemia syndrome].
AB  - Presented are the ischemic changes of the choroid on the basis of observation of
      patients treated in our Department in the course of the last years. In dependence
      on the advancement of the ischemic changes one can see 3 various types of signs
      at the fundus. It seems that the most proper name for these changes would be "the
      choroidal ischaemia syndrome". It is namely a complex of various fundus changes
      connected by a common pathogenesis but with various kind of causes.

PMID- 1762376
TI  - [A stereoscopic device for simultaneous imaging of the fundus oculi].
AB  - A stereoscopic countershaft worked out by the authors is cooperating with
      stereoophthalmoscope model 110. The element of the binocular with its original
      lenses used in the countershaft was supplemented with prisms which rectify the
      distance of the geometrical centres of the pictures on the frame of a 35 mm film.
      A vertical central screen prevents the half-pictures to overlap. The length of
      the optical path beyond the stereoophthalmoscope amounts 130 mm. Simultaneous
      stereograms of the eye fundus received by means of this construction are
      characterized by a transversal enlargement 1.3 X, 1.65X and 3.3X.

PMID- 1762377
TI  - [Medical expert systems and clinical needs].
AB  - The rapid expansion of computer-based systems for problem solving or decision
      making in medicine, the so-called medical expert systems, emphasize the need for
      reappraisal of their indication and value. Where specialist knowledge is
      required, in particular where medical decisions are susceptible to error these
      systems will probably serve as a valuable support. In the near future computer
      based systems should be able to aid the interpretation of findings of technical
      investigations and the control of treatment, especially where rapid reactions are
      necessary despite the need of complex analysis of investigated parameters. In the
      distant future complete support of diagnostic procedures from the history to
      final diagnosis is possible. It promises to be particularly attractive for the
      diagnosis of seldom diseases, for difficult differential diagnoses, and in the
      decision making in the case of expensive, risky or new diagnostic or therapeutic
      methods. The physician needs to be aware of certain dangers, ranging from
      misleading information up to abuse. Patient information depends often on
      subjective reports and error-prone observations. Although basing on problematic
      knowledge computer-born decisions may have an imperative effect on medical
      decision making. Also it must be born in mind that medical decisions should
      always combine the rational with a consideration of human motives.

PMID- 1762378
TI  - Insulin autoantibodies as determined by competitive radiobinding assay are
      positively correlated with impaired beta-cell function--the Ulm-Frankfurt
      Population Study.
AB  - Out of a random population of 4208 non-diabetic pupils without a family history
      of Type I diabetes 44 (1.05%) individuals had islet cell antibody (ICA) levels
      greater or equal to 5 Juvenile Diabetes Foundation (JDF) units. 39 of these ICA
      positives could be repeatedly tested for circulating insulin autoantibodies
      (CIAA) using a competitive radiobinding assay. The results were compared with the
      insulin responses in the intravenous glucose tolerance tests (IVGTT) and with HLA
      types. Six pupils were positive for CIAA. All of them had complement-fixing ICA,
      and 5 of them were HLA-DR4 positive. Three of the 6 showed a first-phase insulin
      response below the first percentile of normal controls. Our data indicate that in
      population-based studies CIAA can be considered as a high risk marker for
      impaired beta-cell function in non-diabetic ICA-positive individuals.

PMID- 1762379
TI  - Distribution of ischemic cerebrovascular events in cardiac embolism.
AB  - Distribution and number of ischemic cerebrovascular events were studied in 57
      patients who suffered from heart disorders with proven or highly probable source
      of cardiac embolism and compared to 39 patients with ulcerations of the
      craniocervical vessels. Patients with coexisting lesions were excluded from the
      present study. Out of the 57 patients with cardiac disorders, a single episode of
      cerebral embolism occurred in 33 patients. Of the 24 patients with recurrent
      ischemic episodes, different vascular territories were involved in only six
      cases. There was no evidence of a distinct distribution of vascular territories
      involved in cerebral embolism. The left middle cerebral artery was affected in
      42.9%, the right middle cerebral artery in 23.8%, the vertebrobasilar territory
      in 19%, and the ophthalmic arteries in 14.2%. Statistical analysis revealed no
      significant differences in lesion localization between the group with a cardiac
      source of embolism and the group with ulcerations of the craniocervical vessels.
      There was a high frequency of patients with recurrent cardiogenic emboli in the
      ophthalmic (6 of 9 patients) as well as in the vertebrobasilar (6 of 12 patients)
      circulation who experienced a delayed initiation of cardiac assessment. The
      possibility of cardiac embolism should be considered in any patient with cerebral
      ischemia, independently of the vascular territory affected.

PMID- 1762380
TI  - Arterial baroreflex sensitivity and blood pressure variabilities before and after
      carotid surgery.
AB  - Carotid surgery is frequently associated with postoperative blood pressure
      alterations. The role of baroreceptors with regard to these alterations was
      assessed in 50 patients by determining the pre- and postoperative mechanoreceptor
      sensitivity after Valsalva maneuver and intravenous injections of angiotensin and
      nitroglycerine as described by Smyth, Sleight and Pickering. In addition, blood
      pressure was monitored perioperatively and renin and aldosterone levels were
      measured. In patients with arterial hypertension a postoperative increase of
      receptor reactivity can be seen necessitating a reduction of antihypertensive
      therapy in more than 50% of cases. In normotensive patients no uniform response
      can be observed. A possible explanation for this effect might be the local
      increase of pressure in the operated vascular segment. The postoperative
      reintegration of receptor areas which had been adjusted to a reduced pressure
      level might induce a more sensitive response than can be seen for the remaining
      receptors, which usually are less responsive in hypertensive patients.

PMID- 1762381
TI  - [Increased prevalence of osteoporosis and arteriosclerosis in conventionally
      substituted anterior pituitary insufficiency: need for additional growth hormone
      substitution?].
AB  - In a retrospective study of 632 patients with pituitary disease we diagnosed
      pituitary insufficiency without hypersecretion of any pituitary hormone in 122
      patients. Patients were substituted with sex hormones (76%), hydrocortisone (74%)
      and/or L-thyroxine (77%). 76% had additional growth hormone deficiency, as shown
      by an increase of growth hormone of less than 5 ng/ml after i.v. administration
      of L-arginine. In 17% of all patients the diagnosis of osteoporosis was proven or
      suspected radiologically. 57% had low bone mass of lumbar spine
      (dualphotonabsorptiometry) and 73% had low bone mass of the proximal forearm
      (singlephotonabsorptiometry). BMD values of pituitary insufficient patients were
      in the same range as those of patients with established osteoporosis. More than
      half of all patients (53%) complained of tiredness, exhaustion and muscle
      weakness. 40% suffered from adipositas. 77% had hyperlipidemia (68%
      hypertriglyceridemia and 42% hypercholesterinemia), 18% had hypertension. 14% of
      the patients had arteriosclerotic events in their history (myocardial infarction
      or stroke). These figures are higher than incidences shown in the German PROCAM
      study. These data show an increased prevalence of osteoporosis and vascular
      diseases. This is in contrast to the general opinion, that patients with
      pituitary insufficiency are adequately treated by substitution with adrenal,
      thyroid and sex hormones. Whether other factors such as the additional growth
      hormone deficiency are responsible for these diseases has to be examined in
      prospective studies.

PMID- 1762382
TI  - A need to intensify drug surveillance in Germany.
AB  - Despite all its limitations, the spontaneous reporting system still forms the
      basis for drug safety assessments in the Federal Republic of Germany. Although
      there have been some promising attempts to standardise the methodology of
      detecting, analysing and evaluating adverse drug events (ADEs) in certain clinico
      pharmacological institutes and psychiatric departments, the approaches have not
      been integrated and are used only locally. The only exception is the Freiburg
      Documentation Centre for Severe Skin Diseases, which is attempting comprehensive,
      country-wide documentation of toxic epidermal necrolysis (Lyell's syndrome) and
      Stevens-Johnson syndrome. We show that surveillance of 40% of all hospital beds
      would allow the acquisition of reliable data even on rare and serious AEs which
      could then be extrapolated in a statistically meaningful way. The medical
      societies in Germany have traditionally taken a leading role in establishing
      standards for the preclinical and clinical investigation of new drug compounds.
      We suggest that they also make it their task to define the framework for an
      intensified adverse events monitoring system, since it is the patient who
      ultimately benefits from a quantification of drug therapy risks.

PMID- 1762383
TI  - Elevated high-density-lipoprotein cholesterol and normal triglycerides as markers
      of longevity.
AB  - Serum cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides
      of 85 year old home-living persons were compared to those of controls and of
      patients who had severe coronary artery disease (CAD) at an early age. Eighty
      five-year-olds had higher serum HDL cholesterol than controls and patients with
      CAD. Patients with severe CAD had higher serum total cholesterol and serum
      triglycerides and lower HDL-cholesterol than other groups. When 85-year-old
      persons were divided into quintiles according to serum HDL cholesterol, women
      with highest HDL cholesterol had lowest mortality, men with lowest HDL
      cholesterol had highest mortality. We conclude that elevated HDL cholesterol is
      correlating with longevity and low HDL cholesterol with CAD at an early age.

PMID- 1762384
TI  - [The spontaneous course of compensated autonomous thyroid gland adenomas].
AB  - The spontaneous course of 58 patients with compensated autonomous adenoma of the
      thyroid was followed. Scintigraphic appearance (compensated (CAA) or
      decompensated (DAA)) was documented and the serum levels of thyroxine (T4),
      triiodothyronine (T3) and thyroid-stimulating hormone after TSH-stimulating
      hormone were measured at the beginning of observation and 3.8 years (median)
      later. During follow-up period, 13 patients (22%) with CAA developed DAA. 9/13
      patients (15%) had overt hyperthyroidism with elevated T4 and/or T3 levels, 4/13
      patients (7%) had normal thyroid hormone levels. Life table analysis showed a
      risk for developing hyperthyroidism of 19% at five years. The size of all
      adenomata measured scintigraphically was increasing during follow-up, and there
      was no discrimination of CAA from DAA using this technique. Eight CAA patients
      received iodinated contrast medium but none develop DAA. In conclusion from these
      results as well as from the literature, there is no indication for surgery or
      radioiodine therapy of patients with a CAA, even if there are plans to administer
      iodinated contrast medium.

PMID- 1762385
TI  - Potassium substitution via the oral route: does its efficacy depend on the anion
      of the potassium salt?
AB  - In an open, randomized study, we investigated the effect of oral potassium
      chloride (KCl) and of potassium citrate/bicarbonate (K-cit/bic) in 42 patients
      with hypokalemia (less than or equal to 3.5 mmol/l). In both groups 80 mmol K+
      were administered daily. The parameters examined were serum potassium
      concentration, acid-base status, and urinary electrolyte excretion. Parameters
      were evaluated on days 0, 2, 4, and 6. With KCl, [K+] increased from 3.2 +/- 0.2
      (mean +/- SD) on day 0 to 3.8 +/- 0.4 mmol/l on day 2 (p less than 0.005) and 4.0
      +/- 0.5 mmol/l on day 4 (p less than 0.005). On day 6 [K+] was also 4.0 +/- 0.4
      mmol/l (p less than 0.005 vs day 0). With K-cit/bic, [K+] increased from 3.2 +/-
      0.2 to 3.7 +/- 0.4 on day 2, 3.9 +/- 0.5 on day 4, and 4.1 +/- 0.6 mmol/l on day
      6 (all p less than 0.005 vs day 0). The increase of [K+] was not different
      between the two groups. Blood pH on day 0 was in the normal range in both groups
      and did not change significantly during the study. There was a decrease of carbon
      dioxide partial pressure (pCO2) with KCl from 38.7 +/- 4.9 on day 0 to 36.4 +/-
      3.6 on day 2 (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762386
TI  - Glucose counterregulation in type 1 diabetic patients with decreased symptoms of
      hypoglycemia after insulin pump treatment.
AB  - We were interested in studying whether impaired hypoglycemic awareness after
      intensified insulin treatment with insulin pumps is associated with impaired
      glucose counterregulation. Glucose counterregulatory hormones were measured in 7
      type I diabetic patients with altered symptoms after 6 months of continuous
      subcutaneous insulin infusion (CSII) (group 1) and in 9 patients with unchanged
      symptoms of hypoglycemia under CSII (group 2). The groups did not differ in
      diabetic control, duration of diabetes, or prevalence of neuropathy.
      Counterregulatory hormone response to an insulin-induced episode of hypoglycemia
      was measured before (first test) and after 6 months (second test) of CSII.
      Glucose nadirs and glucose recovery were similar in both groups and both tests.
      The mean plasma glucagon values demonstrate a lack of glucagon response in both
      groups and both tests. Growth hormone and cortisol increased in both groups and
      both tests without any difference between the groups or first and second tests.
      Epinephrine response was similar in both tests of group 2 (first test: 50 +/- 5
      to 416 +/- 73; second test; 45 +/- 5 to 456 pg/ml), while in group 1 the response
      was not increased significantly in the second test [first test: 32 +/- 6 to 346
      +/- 63; second test: 44 +/- 7 to 575 +/- 91 pg/ml; areas under curve (AUC) 11,977
      and 16,345 pg x ml-1 x 90 min-1 (p = 0.36)].(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762387
TI  - Campylobacter fetus subspecies fetus infection.
AB  - During a six-year period five patients with Campylobacter fetus subspecies fetus
      infections were seen at the Mayo Clinic in Rochester, Minnesota. Bacteremia was
      observed in two patients, one presenting with aortic valve endocarditis and the
      other with abdominal atherosclerotic aortic aneurysm. C. fetus subsp. fetus was
      isolated from tibial tissue of a patient with osteomyelitis. Diarrhea was the
      main complaint of two further patients, and was also mentioned by the patient
      with the aortic aneurysm. Despite the use of incubation conditions and selective
      media geared to detect only Campylobacter jejuni, C. fetus subsp. fetus was
      isolated from stool specimens of the two patients with gastrointestinal symptoms.
      The fact that three of five C. fetus subsp. fetus infections observed in this
      study were associated with intestinal symptoms further supports the importance of
      the gastrointestinal tract in the pathogenesis of C. fetus subsp. fetus
      infections.

PMID- 1762388
TI  - Antithrombin III and early prognosis in polytraumatized patients: a pilot study.

PMID- 1762389
TI  - [The AIDS nursing concept of the German Federation of Nurses].

PMID- 1762390
TI  - [Safety for the care givers].

PMID- 1762391
TI  - [Alternative nursing possibilities for patients with AIDS].

PMID- 1762392
TI  - [Guidance of coworkers and team development].

PMID- 1762393
TI  - [Seeing one's coworkers holistically? Against the uncritical talk about
      "holistic"].

PMID- 1762394
TI  - [Characteristics of the various degrees in the quality of geriatric nursing-
      group living and group nursing].

PMID- 1762395
TI  - [An experiment: group nursing in partner and team work].

PMID- 1762396
TI  - [ICN (World Federation of Nurses): guidelines for national nursing societies. The
      development of standards for education and practice in nursing].

PMID- 1762397
TI  - [Relief for the nursing staff by ward secretaries].

PMID- 1762398
TI  - [Regulation of costs for supplying inhabitants of old age homes with incontinence
      aids].

PMID- 1762400
TI  - [The patient with artificial respiration in the intensive care unit].

PMID- 1762399
TI  - [Equal treatment of part time workers].

PMID- 1762401
TI  - [Scoring systems for the early detection of septic complications in intensive
      care patients].

PMID- 1762402
TI  - [Experiences with Seldinger's new central venous catheter].

PMID- 1762403
TI  - [Pain therapy with external and implanted pump systems near the spinal cord].

PMID- 1762404
TI  - [Postoperative PCA-pain therapy. Wellbeing comes first. Report of experiences
      from the Stuttgart Katharine's Hospital].

PMID- 1762405
TI  - [Realization of hospital hygiene in a large hospital with special regard to the
      intensive care unit].

PMID- 1762406
TI  - [A professional commission "Hygienic Safety of Medical Instruments" of the German
      Society for Hospital Hygiene has been founded].

PMID- 1762407
TI  - [Clinical experiences with use of the Draintec-system for closed rinse-suction
      drainage].

PMID- 1762408
TI  - [Neurologic intensive care units].

PMID- 1762409
TI  - [Environmental protection in the hospital].

PMID- 1762411
TI  - [Medical refuse and its disposal in gynecological practice].

PMID- 1762410
TI  - [Innovative environmental concept for hospitals].

PMID- 1762412
TI  - [Use and disposal of cytostatic agents].

PMID- 1762413
TI  - [Hospital hygienic legal problems for patient facilities].

PMID- 1762414
TI  - [Hygiene in the disposal of infectious refuse].

PMID- 1762415
TI  - [When do infusion systems have to be changed?].

PMID- 1762416
TI  - [The close relationship between man and his environment. Epidemics and infectious
      diseases].

PMID- 1762417
TI  - [The importance of correct care of dental prostheses in bed patients].

PMID- 1762418
TI  - [The effect of antibiotics on the intestinal flora].

PMID- 1762419
TI  - [Suicide and attempted suicide: incidence and possibilities of prevention].

PMID- 1762420
TI  - [Endoscopy--what hygienic measures are required?].

PMID- 1762421
TI  - [Cleaning of endoscopes: manual preparation and endoscope washing machine].

PMID- 1762422
TI  - [Ethical limits to our actions].

PMID- 1762423
TI  - [Development of stoma care].

PMID- 1762424
TI  - Individual responsibility.

PMID- 1762425
TI  - Smoking prevalence in South Carolina, 1985-1989.

PMID- 1762426
TI  - Cardiac surgery for patients maintained on chronic hemodialysis.
AB  - This study confirms and extends the available information about cardiac surgery
      in patients with chronic renal failure. With appropriate precautions, CABG and
      valve repair can be carried out in these patients without significant increase in
      operative mortality or morbidity as compared to patients with normal renal
      function. However, these patients remain susceptible to accelerated
      atherosclerosis in native vessels as well as bypass grafts and to complications
      (thromboembolism, infection) of prosthetic valves. Accordingly, while these
      patients are often significantly improved as a result of their cardiac surgery,
      long term outlook is guarded.

PMID- 1762427
TI  - Regionalized perinatal transport systems: association with changes in location of
      birth, neonatal transport, and survival of very low birth weight deliveries.
AB  - Changes in both the location of very low birth weight births and in the number of
      infants selected for transport were chosen for the evaluation of regionalized
      perinatal care and its effectiveness in the Lowcountry Perinatal catchment area.
      The four-year period reviewed was characterized by the initiation of a well
      defined regionalized perinatal transport program at the Medical University of
      South Carolina. In conjunction with this increased availability of transport,
      there was a statistically significant (p less than 0.02) increase in the number
      of VLBW neonates transported to MUSC after being delivered in community
      hospitals. This increase was accompanied by an increase in the proportion of
      infants referred for transport within the first hour of life. Among those
      neonates referred within the first four hours of life, survival was inversely
      proportional to the infant's age when the transport team arrived, suggesting that
      a rapid response by the neonatal transport team was associated with a
      significantly increased VLBW infant survival. Among all transported infants, in
      utero continues to be the most efficacious means of transport for VLBW infants
      and that delivery of VLBW infants at regional medical centers continues to result
      in the most optimal survival.

PMID- 1762428
TI  - Before starting resuscitation first know what you are getting into.

PMID- 1762429
TI  - Smoking cessation and prevention.

PMID- 1762430
TI  - Fracture prediction for the proximal femur using finite element models: Part I-
      Linear analysis.
AB  - Over 90 percent of the more than 250,000 hip fractures that occur annually in the
      United States are the result of falls from standing height. Despite this, the
      stresses associated with femoral fracture from a fall have not been investigated
      previously. Our objectives were to use three-dimensional finite element models of
      the proximal femur (with geometries and material properties based directly on
      quantitative computed tomography) to compare predicted stress distributions for
      one-legged stance and for a fall to the lateral greater trochanter. We also
      wished to test the correspondence between model predictions and in vitro strain
      gage data and failure loads for cadaveric femora subjected to these loading
      conditions. An additional goal was to use the model predictions to compare the
      sensitivity of several imaging sites in the proximal femur which are used for the
      in vivo prediction of hip fracture risk. In this first of two parts, linear
      finite element models of two unpaired human cadaveric femora were generated. In
      Part II, the models were extended to include nonlinear material properties for
      the cortical and trabecular bone. While there was poor correspondence between
      strain gage data and model predictions, there was excellent agreement between the
      in vitro failure data and the linear model, especially using a von Mises
      effective strain failure criterion. Both the onset of structural yielding (within
      22 and 4 percent) and the load at fracture (within 8 and 5 percent) were
      predicted accurately for the two femora tested. For the simulation of one-legged
      stance, the peak stresses occurred in the primary compressive trabeculae of the
      subcapital region.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762431
TI  - Fracture prediction for the proximal femur using finite element models: Part II-
      Nonlinear analysis.
AB  - In Part I we reported the results of linear finite element models of the proximal
      femur generated using geometric and constitutive data collected with quantitative
      computed tomography. These models demonstrated excellent agreement with in vitro
      studies when used to predict ultimate failure loads. In Part II, we report our
      extension of those finite element models to include nonlinear behavior of the
      trabecular and cortical bone. A highly nonlinear material law, originally
      designed for representing concrete, was used for trabecular bone, while a
      bilinear material law was used for cortical bone. We found excellent agreement
      between the model predictions and in vitro fracture data for both the onset of
      bone yielding and bone fracture. For bone yielding, the model predictions were
      within 2 percent for a load which simulated one-legged stance and 1 percent for a
      load which simulated a fall. For bone fracture, the model predictions were within
      1 percent and 17 percent, respectively. The models also demonstrated different
      fracture mechanisms for the two different loading configurations. For one-legged
      stance, failure within the primary compressive trabeculae at the subcapital
      region occurred first, leading to load transfer and, ultimately, failure of the
      surrounding cortical shell. However, for a fall, failure of the cortical and
      trabecular bone occurred simultaneously within the intertrochanteric region.
      These results support our previous findings that the strength of the subcapital
      region is primarily due to trabecular bone whereas the strength of the
      intertrochanteric region is primarily due to cortical bone.

PMID- 1762432
TI  - Prediction of femoral impact forces in falls on the hip.
AB  - A major determinant of the risk of hip fracture in a fall from standing height is
      the force applied to the femur at impact. This force is determined by the impact
      velocity of the hip and the effective mass, stiffness, and damping of the body at
      the moment of contact. We have developed a simple experiment (the pelvis release
      experiment) to measure the effective stiffness and damping of the body when a
      step change in force is applied to the lateral aspect of the hip. Results from
      pelvis release experiments with 14 human subjects suggest that both increased
      soft tissue thickness over the hip and impacting the ground in a relaxed state
      can decrease the effective stiffness of the body, and subsequently reduce peak
      impact forces. Comparison between our fall impact force predictions and in-vitro
      measures of femoral fracture strength suggest that any fall from standing height
      producing direct, lateral impact on the greater trochanter can fracture the
      elderly hip.

PMID- 1762433
TI  - An experimental method for measuring force on the spinal facet joint: description
      and application of the method.
AB  - A technique is described for measuring load magnitude and resultant load contact
      location in the facet joint in response to applied loads and moments, and the
      technique applied to the canine lumbar spine motion segment. Due to the
      cantilever beam geometry of the cranial articular process, facet joint loads
      result in surface strains on the lateral aspect of the cranial articular process.
      Strains were quantified by four strain gages cemented to the bony surface of the
      process. Strain measured at any one gage depended on the loading site on the
      articular surface of the caudal facet and on the magnitude of the facet load.
      Determination of facet loads during in vitro motion segment testing required
      calibration of the strains to known loads of various magnitudes applied to
      multiple sites on the caudal facet. The technique is described in detail,
      including placement of the strain gages. There is good repeatability of strains
      to applied facet loads and the strains appear independent of load distribution
      area. Error in the technique depends on the location of the applied facet loads,
      but is only significant in nonphysiologic locations. The technique was validated
      by two independent methods in axial torsion. Application of the technique to five
      in vitro canine L2-3 motion segments testing resulted in facet loads (in newtons,
      N) of 74+ / -23 N (mean + / -STD) in 2 newton-meter, Nm, extension, to unloaded
      in flexion. Lateral bending resulted in loads in the right facet of 40+ / -32 N
      for 1 Nm right lateral bending and 54+ / -29 N for 1 Nm left lateral bending. 4
      Nm Torsion with and without 100 N axial compression resulted in facet loads of
      92+ / -27 N and 69+ / -19 N, respectively. The technique is applicable to dynamic
      and in vivo studies.

PMID- 1762434
TI  - Nonlinear dynamic behavior of the human knee joint--Part I: Postmortem frequency
      domain analyses.
AB  - Characteristics results of postmortem experiments on five knee-joint specimens
      are reported. The experiments were performed to investigate the applicability of
      a local linearization technique that would make it possible to describe the
      dynamic behavior of the joint in terms of transfer functions. The results
      indicate that the stiffness of the bracing wires, attached to muscle tendons to
      create a static equilibrium position, can be accounted for when determining the
      stiffness of the joint. Besides the static equilibrium configuration, the
      magnitude of the dynamic load and the type of dynamic load applied to the joint
      can be shown to have their influence. As the influence of the dynamic load is
      significant, it has to be concluded that in essence the knee joint has to be
      regarded as a nonlinear system, making application of a Local Linearization
      Technique questionable. However, when the magnitude of the dynamic load is
      included as an additional measurement parameter, an indication can be obtained
      about the behavior of the joint and the degree of nonlinearity.

PMID- 1762435
TI  - Nonlinear dynamic behavior of the human knee joint--Part II: Time-domain
      analyses: effects of structural damage in postmortem experiments.
AB  - A description is given of the results obtained for step excitation for two human
      knee joint specimens using a time-domain analysis technique. As was expected from
      the results of a previous study, the magnitude of the dynamic load applied has a
      marked influence upon the stiffness and damping values for the two observed
      vibration modes. Deliberate damaging of selected joint elements also yields a
      well observable change in the dynamic behavior of the joint although these
      changes are difficult to interpret. Here the use of a nonlinear dynamic numerical
      model of the knee joint seems indispensable. An important observation is,
      however, that the experimental method discussed here enables to quantify the
      behavior of the joint and therefore may provide a valuable tool for validation of
      such a model.

PMID- 1762436
TI  - Application of the u-p finite element method to the study of articular cartilage.
AB  - The finite element method using the principle of virtual work was applied to the
      biphasic theory to establish a numerical routine for analyses of articular
      cartilage behavior. The matrix equations that resulted contained displacements of
      the solid matrix (mu) and true fluid pressure (p) as the unknown variables at the
      element nodes. Both small and large strain conditions were considered. The
      algorithms and computer code for the analysis of two-dimensional plane strain,
      plane stress, and axially symmetric cases were developed. The u-p finite element
      numerical procedure demonstrated excellent agreement with available closed-form
      and numerical solutions for the configurations of confined compression and
      unconfined compression under small strains, and for confined compression under
      large strains. The model was also used to examine the behavior of a repaired
      articular surface. The differences in material properties between the repair
      tissue and normal cartilage resulted in significant deformation gradients across
      the repair interface as well as increased fluid efflux from the tissue.

PMID- 1762437
TI  - Stiffness of canine stifle joint ligaments at relatively high rates of
      elongation.
AB  - A falling-weight impact tester was developed specifically to evaluate the tensile
      characteristics of animal joints at high elongation rates. The tensile force and
      elongation in the ligaments of the canine stifle joint were measured using a
      force transducer, a linear variable displacement transducer, and a digital
      storage oscilloscope. Stiffness and elongation rates were determined at 1 mm and
      at 2 mm elongation. The stiffness was calculated as the slope of the force
      elongation curve, and the elongation rate was calculated as the slope of the
      elongation-time curve. Results demonstrated that stiffness in the canine stifle
      joints was not affected by the rate of elongation in the 0.1 to 1.0 m/s range.

PMID- 1762438
TI  - Normal contact of elastic spheres with two elastic layers as a model of joint
      articulation.
AB  - An analytical model of two elastic spheres with two elastic layers in normal,
      frictionless contact is developed which simulates contact of articulating joints,
      and allows for the calculation of stresses and displacements in the layered
      region of contact. Using various layer/layer/substrate combinations, the effects
      of variations in layer and substrate properties are determined in relation to the
      occurrence of tensile and shear stresses as the source of crack initiation in
      joint cartilage and bone. Vertical cracking at the cartilage surface and
      horizontal splitting at the tidemark have been observed in joints with primary
      osteoarthritis. Deep vertical cracks in the calcified cartilage and underlying
      bone have been observed in blunt trauma experiments. The current model shows that
      cartilage stresses for a particular system are a function of the ratio of contact
      radius to total layer thickness (a/h). Surface tension, which is observed for a/h
      small, is alleviated as a/h is increased due to increased load, softening and/or
      thinning of the cartilage layer. Decreases in a/h due to cartilage stiffening
      lead to increased global compressive stresses and increased incidence of surface
      tension, consistent with impact-induced surface cracks. Cartilage stresses are
      not significantly affected by variations in stiffness of the underlying material.
      Tensile radial strains in the cartilage layer approach one-third of the normal
      compressive strains, and increase significantly with cartilage softening. For
      cases where the middle layer stiffness exceeds that of the underlying substrate,
      tensile stresses occur at the base of the middle layer, consistent with impact
      induced cracks in the zone of calcified cartilage and subchondral bone. The
      presence of the superficial tangential zone appears to have little effect on
      underlying cartilage stresses.

PMID- 1762439
TI  - Thermographic stress analysis in cortical bone.
AB  - Under adiabatic (or near adiabatic) conditions a volumetric change in an elastic
      material will produce a corresponding change in temperature. Based upon this
      principle, thermographic stress analysis (TSA) measures changes in surface heat
      flux (which are related to changes in surface temperature) and relates them to a
      coupled form of strains or stresses. To demonstrate the feasibility of using this
      technique for biomechanical applications, we thermographically measured heat flux
      from loaded specimens of cortical bone and correlated the results with strain
      gage data. Regular parallelepipeds were cut from the cortex of bovine femora and
      loaded sinusoidally at 20 Hz. At this rate of loading, mechanically induced
      changes in surface temperature could be sampled (via heat flux) prior to a
      measureable attenuation of the thermoelastic effect. Correlation coefficients
      demonstrated a significant linear relationship between TSA and measured and
      computed mechanical parameters (stress, strain, first strain invariant, and
      strain energy density). TSA therefore appears to be a promising technology for
      experimental stress analysis in cortical bone.

PMID- 1762440
TI  - Thermal property measurements on biological materials at subzero temperatures.
AB  - The self-heated thermistor technique was used to measure the thermal conductivity
      and thermal diffusivity of biomaterials at low temperatures. Thermal standards
      were selected to calibrate the system at temperatures from -10 degrees C to -70
      degrees C. The thermal probes were constructed with a convection barrier which
      eliminates convection inside liquid samples of low viscosity, without affecting
      the conductivity and diffusivity results. Using this technique, the thermal
      conductivity and diffusivity of two organ perfusates (HP5 and HP5 + 2M glycerol),
      one kidney phantom (a low ionic strength gel), as well as rabbit kidney cortex
      have been measured from -10 degrees C to -70 degrees C.

PMID- 1762441
TI  - Controlled freezing of nonideal solutions with application to cryosurgical
      processes.
AB  - Success of a cryosurgical procedure, i.e., maximal cell destruction, requires
      that the cooling rate be controlled during the freezing process. Standard
      cryosurgical devices are not usually designed to perform the required controlled
      process. In this study, a new cryosurgical device was developed which facilitates
      the achievement of a specified cooling rate during freezing by accurately
      controlling the probe temperature variation with time. The new device has been
      experimentally tested by applying it to an aqueous solution of mashed potatoes.
      The temperature field in the freezing medium, whose thermal properties are
      similar to those of biological tissue, was measured. The cryoprobe temperature
      was controlled according to a desired time varying profile which was assumed to
      maximize necrosis. The tracking accuracy and the stability of the closed loop
      control system were investigated. It was found that for most of the time the
      tracking accuracy was excellent and the error between the measured probe
      temperature and the desired set point is within +/- 0.4 degrees C. However,
      noticeable deviations from the set point occurred due to the supercooling
      phenomenon or due to the instability of the liquid nitrogen boiling regime in the
      cryoprobe. The experimental results were compared to those obtained by a finite
      elements program and very good agreement was obtained. The deviation between the
      two data sets seems to be mainly due to errors in positioning of the thermocouple
      junctions in the medium.

PMID- 1762442
TI  - Species dependence of the zero-stress state of aorta: pig versus rat.
AB  - The zero-stress state of an aorta can be characterized by the angle with which
      each segment of the vessel opens up when it is cut radially. The opening angle
      varies with the region of the aorta: significantly with respect to the axial
      location, less significantly with respect to polar angle of the radial cut. Both
      pig and rat aortas have large opening angles in the neighborhood of 130 deg in
      the aortic arch region. In the thoracic region, the species difference is
      evident. The opening angle of the pig aorta in the middle thoracic region is
      rather constant in the neighborhood of 60 deg. The opening angle of the rat aorta
      in the thoracic region varies considerably, decreasing to 10 deg at the lower end
      of the thoracic region. In the abdominal region the opening angle of the pig
      increases from 60 to about 80 deg, that of the rat increases from about 10 to 90
      deg. The potassium ion has effect on vascular smooth muscle, but has little
      effect on the opening angle. This suggests that the opening angle is not
      sensitive to smooth muscle contraction, similar to a previously known result that
      the opening angle is not affected by papaverine. The vessel wall thickness and
      vessel diameter were measured. It is shown that the ratio of the wall thickness
      to diameter of the pig is considerably larger than that of the rat throughout the
      aorta.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762443
TI  - The pressure-flow relation for plasma in whole organ skeletal muscle and its
      experimental verification.
AB  - The whole-organ pressure-flow relation in resting rat skeletal muscle is examined
      for the flow of plasma. Due to the small size of the blood vessels in this organ,
      inertia and convective forces in the blood are negligible and viscous forces
      dominate. Direct measurements in the past have shown that skeletal muscle blood
      vessels are distensible. Theoretical formulations based on these measurements
      lead to a third order polynomial model for the pressure-flow relation. The
      purpose of the current study is to examine this relation experimentally in an
      isolated muscle organ. A high precision feedback controlled pump is used to
      perfuse artificial plasma into the vasodilated rat gracilis muscle. The results
      indicate that the pressure-flow curve in this tissue is nonlinear in the low flow
      region and almost linear at physiological flow rates, following closely the third
      order polynomial function. Vessel fixation with glutaraldehyde causes the curves
      to become linear at all pressures, indicating that vessel distention is the
      primary mechanism causing the nonlinearity. Furthermore, the resistance of the
      post-fixed tissue is determined by the pressure at which the fixative is
      perfused. At fixation pressures below 10 mmHg, the resistance is three times
      higher than in vessels fixed at normal physiological pressures. Dextran (229,000
      Dalton) is used to obtain Newtonian perfusates at different viscosities. The
      pressure-flow relation is found to be linearly dependent on viscosity for all
      flow rates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762444
TI  - The effect of angle and flow rate upon hemodynamics in distal vascular graft
      anastomoses: an in vitro model study.
AB  - A steady flow, in vitro model of distal arterial bypass graft junctions was used
      to examine the effects of junction angle and flow rate on the local velocity
      field. Three test sections were fabricated from Plexiglas tubing having
      anastomotic junction angles of either 30, 45, or 60 deg. Flow visualization
      revealed velocity profiles skewed toward the outer wall with a flow split around
      a clear stagnation point along the outer wall. Laser Doppler anemometry [LDA]
      measurements confirmed a distinct stagnation point at the outer wall and both
      reverse and forward shear were detected immediately upstream and downstream,
      respectively, of this site. Axial velocities and shear rates along the outer wall
      were higher than along the inner wall and occurred in the junction angle order:
      45, 60, and 30 deg. This study clearly identified changes in wall shear which
      varied with the anastomotic angle and flow rate.

PMID- 1762445
TI  - Pulsatile non-Newtonian flow characteristics in a three-dimensional human carotid
      bifurcation model.
AB  - Numerical analysis of flow phenomena and wall shear stresses in the human carotid
      artery bifurcation has been carried out using a three-dimensional geometrical
      model. The primary aim of this study is the detailed discussion of non-Newtonian
      flow velocity and wall shear stress during the pulse cycle. A comparison of non
      Newtonian and Newtonian results is also presented. The applied non-Newtonian
      behavior of blood is based on measured dynamic viscosity. In the foreground of
      discussion are the flow characteristics in the carotid sinus. The investigation
      shows complex flow patterns especially in the carotid sinus where flow separation
      occurs at the outer wall throughout the systolic deceleration phase. The changing
      sign of the velocity near the outer sinus wall results in oscillating shear
      stress during the pulse cycle. At the outer wall of the sinus at maximum diameter
      level the shear stress ranges from -1.92 N/m2 to 1.22 N/m2 with a time-averaged
      value of 0.04 N/m2. At the inner wall of the sinus at maximum diameter level the
      shear stress range is from 1.16 N/m2 to 4.18 N/m2 with a mean of 1.97 N/m2. The
      comparison of non-Newtonian and Newtonian results indicates unchanged flow
      phenomena and rather minor differences in the basic flow characteristics.

PMID- 1762446
TI  - One-dimensional computer analysis of oscillatory flow in rigid tubes.
AB  - The dynamic characteristics of catheter-transducer systems using rigid tubes with
      compliance lumped in the transducer and oscillatory flow of fluid in rigid tubes
      were analyzed. A digital computer model based on one dimensional laminar
      oscillatory flow was developed and verified by exact solution of the Navier
      Stokes Equation. Experimental results indicated that the damping ratio and
      resistance is much higher at higher frequencies of oscillation than predicted by
      the one dimensional model. An empirical correction factor was developed and
      incorporated into the computer model to correct the model to the experimental
      data. Amplitude of oscillation was found to have no effect on damping ratio so it
      was concluded that the increased damping ratio and resistance at higher
      frequencies was not due to turbulence but to two dimensional flow effects. Graphs
      and equations were developed to calculate damping ratio and undamped natural
      frequency of a catheter-transducer system from system parameters. Graphs and
      equations were also developed to calculate resistance and inertance for
      oscillatory flow in rigid tubes from system parameters and frequency of
      oscillation.

PMID- 1762447
TI  - Sedimentation of a suspension in a centrifugal field.
AB  - To model centrifugal sedimentation of biological suspensions, the time history of
      sedimentation of particles in a centrifugal field was considered for two
      geometries: a tube and a cylindrical container. The Kynch theory for batch
      gravitational settling in Cartesian coordinates based on mass conservation was
      extended to include a centrifugal sedimentation force, cylindrical coordinates,
      and the Hawksley-Vand hindered settling model. The resulting quasi-linear partial
      differential equation was solved by the method of characteristics. The
      combination of radial dependence of the sedimentation force and cylindrical
      geometry in the centrifugal case results in several differences in the time
      position history diagram of the sedimentation process compared to the
      gravitational case. First, instead of a region of uniform concentration equal to
      the initial concentration, a region of concentration that is continuously
      decreasing with time results. Second, in the region of particle accumulation,
      curved constant concentration contours result instead of straight lines. Finally,
      a secondary shock that is dependent upon the initial concentration and the radius
      ratio of the rotating vessel appears in the centrifugal case. The time history of
      the concentration for a particle suspension with an initial concentration typical
      of blood is presented.

PMID- 1762448
TI  - Cardiac mechanics at the cellular level.
AB  - The active mechanical properties of heart muscle are load, length, and time
      dependent. The capability for investigating cardiac mechanisms at the cellular
      level may help to distinguish between those properties of the myocardium which
      arise from myocardial cells and those which arise from the tissue architecture
      and extracellular matrix of connective fibers. We present here, for the first
      time, a general approach for subjecting single heart cells to isometric,
      isotonic, afterloaded, or physiological loading sequences, while obtaining on
      line measures of cell force and length. This approach has been implemented and
      tested on freshly dissociated, adult frog ventricular myocytes. Examples are
      presented for each of the four loading sequences.

PMID- 1762449
TI  - Comparison of vascular perfusion in ischemia-sensitive and ischemia-resistant
      regions of gerbil brain by an automated laser cytometric device: a preliminary
      study.
AB  - Reduced blood supply in the hippocampus has been considered to be a factor
      contributory to this region's selective susceptibility to ischemia. To determine
      if there are differences in vascularization of vulnerable and resistant regions
      of the brain, a quantitative morphometric assessment of vascular filling was
      performed in the gerbil brain by using a relatively new and highly sensitive
      automated laser cytometric device, ACAS (Adherent Cell Analysis and Sorting).
      Evan's blue, an intravital vascular tracer, was injected intracardiac in 5
      Mongolian gerbils to identify perfused blood vessels in the cortex and CA1 region
      of hippocampus. Exactly 3 min later, the animal was decapitated, the brain
      removed and sections prepared for fluorescent quantitative morphometric analysis
      of blood vessels. The perfused vessels appeared as fluorescent structures due to
      the autofluorescent property of Evan's blue. Several fields in each of the two
      specified regions were studied and integrated numbers of blood vessels/mm2
      obtained for statistical comparisons. Control brains perfused with normal saline
      (vehicle for Evan's blue) were used to determine the background fluorescence. The
      number of perfused blood vessels of all sizes was found to be lower in the CA1
      sector of hippocampus than that in the cerebral cortex. The number of capillary
      size vessels was also lower in the CA1 region but the difference was not
      significant. Since it is the capillaries that are of prime importance in the
      diffusion system, and we found no significant regional difference in the density
      of capillary size vessels, it appears unlikely that the peculiarities of patterns
      of vascularization contribute significantly to vulnerability to ischemia.

PMID- 1762450
TI  - Threshold depolarization measurements in resting human motoneurones.
AB  - Threshold depolarization is defined as the amplitude of the depolarization that
      will just bring a neurone to its firing threshold. Here, a novel technique is
      described for the measurement of threshold depolarization in resting human
      motoneurones. The tibial nerve was stimulated at an intensity that was just
      sufficient for the resulting Ia afferent volley to activate a single motor unit
      in the soleus muscle. The same motor unit was then recruited by voluntary
      activation, and the amplitude of the EPSP elicited by this stimulus was
      determined by a manner described earlier. The value found for the threshold
      depolarization was around 5 mV for all 6 motoneurones that were successfully
      tested.

PMID- 1762451
TI  - Adrenal medullary "ribbon" grafts in non-human primates: transplant method.
AB  - A novel stereotaxic method permits the transplantation of autologous adrenal
      medullary tissue into the brain parenchyma in longtailed macaques. Long, narrow
      "ribbons" of intact medullary tissue are drawn into a 19 gauge needle by suction
      and deposited in the caudate, putamen or substantia nigra without collapsing
      their linear conformation. Methods of dissection, preparation of medullary
      ribbons, stereotaxic insertion, and chronic intracerebroventricular treatment are
      described in detail. The ribbon method consistently yields a large amount of
      viable adrenal tissue after the 4-8 week survival times tested. Although further
      development is necessary before this method can be applied in humans, the results
      suggest that autologous adrenal tissue may be viable when transplanted in human
      parkinsonian patients according to these methods.

PMID- 1762452
TI  - A simple computer-controlled analogue ramp generator for producing multiple ramp
      and-hold stimuli.
AB  - This report describes an inexpensive ramp generator which produces multiple ramp
      and-hold stimuli ("staircase-type" wave forms). The output voltage is analogue
      and is, therefore, free of stepping artifacts characteristic of digital function
      generators. When coupled with a standard power amplifier and mechanical vibrator,
      this system is particularly suitable for stimulation of mechanoreceptive sense
      organs. Connection to the serial port of an IBM personal computer, or the user
      port of a BBC computer allows complex ramp-and-hold sequences to be developed and
      repeated. The number, duration and sign of ramps, and the duration of intervening
      hold periods can be set using the computer. This system has been used
      successfully to characterise phasic and tonic neurones in the locust metathoracic
      femoral chordotonal organ (a leg position and movement detector).

PMID- 1762453
TI  - Kainic acid lesions of the superior olivary complex: a horseradish peroxidase
      study of surviving brain-stem projections.
AB  - Lesions of the superior olivary complex of the adult ferret were made by pressure
      injection of kainic acid (5 nM/microliters in Locke's solution) through a glass
      micropipette inserted into the lower brain-stem. Small injections of kainic acid
      (1.5 microliters) produced a localized loss of nerve cells in the superior
      olivary complex in the vicinity of the pipette tip without apparent damage to
      fibers of passage in the trapezoid body. The extent of neural damage was
      determined by the absence of cell bodies in Nissl-stained sections. Integrity of
      fibers in the trapezoid body and other decussating pathways of the auditory lower
      brain-stem was confirmed by retrograde transport of horseradish peroxidase (HRP)
      following large injections of the enzyme into the central nucleus of the inferior
      colliculus. Even animals with complete destruction of the superior olivary
      complex had a normal complement of HRP-labelled cells in all divisions of the
      cochlear nucleus (the dorsal, anteroventral and posteroventral nuclei)
      contralateral to the HRP injection. In cases with partial lesions, normal
      labelling was also seen in those parts of the superior olivary complex not
      directly destroyed by the kainic acid injection. There was no evidence of
      disruption of fibers of passage nor was there any indication of abnormal
      projections from the lower brain-stem to inferior colliculus even after prolonged
      survival times.

PMID- 1762454
TI  - The effects of number of trials per day, retention interval, gender and time of
      day on acquisition of a two-choice, win-stay water-escape working memory task in
      the rat.
AB  - A 2 x 2 x 2 factorial study was conducted to examine the effects of gender,
      trials/day (TPD), and retention interval (RI) on acquisition of a two-choice win
      stay water-escape task in 4-month-old Sprague-Dawley rats. Variations of this
      task have previously been shown to be sensitive to changes in working memory that
      occur with age (Means and Kennard, 1991) or to follow treatment with an
      anxiolytic (Bass et al., 1989) or with cognitive enhancers (Comer and Moore, in
      press) in males or to estrogen in ovariectomized females (O'Neal et al., 1990).
      Both training with 1 TPD and with a 5-min RI, time between an information "run"
      and a test "run", reduced errors during acquisition as compared to giving 3 TPD
      and a 1-min RI (P less than 0.05 in all cases). Males made fewer errors than did
      females (P less than 0.05). The three effects were additive: males trained with 1
      TPD and a 5-min RI performed best and females trained with 3 TPD and a 1-min RI
      performed worst. Also, rats given 1 TPD made fewer acquisition errors when
      trained 2 h before the lights were turned off than when trained during the middle
      of the light portion of the light/dark cycle (P less than 0.05). Finally, when
      given 3 TPD, the rats, especially the females, performed significantly worse on
      their third trial (P less than 0.05). It was concluded that two-choice win-stay
      water-escape is a very sensitive assay of working memory with much potential for
      neurobehavioral research.

PMID- 1762455
TI  - Methods for studying the conductance changes associated with synaptic activation
      of forebrain slices: the interpretation of field potentials using CSD profiles.
AB  - In this report the cortical slice preparation and an array electrode that
      instantaneously records laminar field potentials are used to evaluate issues
      related to the interpretation of cortical CSD profiles. The major issues are: (1)
      what cell types are responsible for producing the source/sink pairs seen in CSD
      profiles; (2) what neurotransmitters are responsible for producing the
      sinks/sources seen in the CSD profile and do the sinks/sources reflect activation
      of receptors that produce inward currents, outward currents, or both; (3) can
      active and passive currents be distinguished; (4) do action potentials contribute
      to the CSD profile; and (5) can synaptic population with different kinetics and
      onset latencies be distinguished? Methods for analyzing neuronal circuits and
      analyzing CSDs quantitatively are discussed.

PMID- 1762456
TI  - [Cerebral abscess in a general hospital. Analysis of 66 consecutive cases].
AB  - BACKGROUND: Analysis of the epidemiologic characteristics of cerebral abscesses
      and comparison with 2 therapeutic schedules. METHODS: The clinical history of 66
      patients with cerebral abscesses admitted over 14 years in the Neurosurgical Ward
      of the Virgen de la Arrixaca Hospital in Murcia were reviewed. Two therapeutic
      groups were designed of 33 and 31 patients respectively treated with classical or
      modern schedules and clinical efficacy was evaluated. RESULTS: Infections in the
      ORL area, craneoencephalic trauma, and brain surgery were the predisposing
      factors in 63% of the cases. The most frequent symptoms were migraine, fever, and
      alteration of consciousness in 75, 68 and 68% respectively. The most frequent
      locations were the temporal (36%), parietal (26%) and frontal lobes (23%).
      Microbiological studies were positive in 75% of the patients with the most
      frequent microorganisms being group A Streptococcus, Proteus mirabilis,
      Staphylococcus aureus and anaerobes. Mortality was 14%. Twenty-two percent of the
      patients had neurological sequelae. The rate of mortality was significantly
      associated to age greater than 40 years, fatal underlying disease, coma, initial
      clinical criteria and inadequate antibiotic treatment. The combination of
      cephotaxime-metronidazole was significantly associated to greater cure in
      comparison with the classical antibiotic combination although no significant
      differences were found in either the rate of mortality or relapse. CONCLUSIONS:
      The combination of cephotaxime-metronidazole may constitute an interesting
      advance in the treatment of these processes. The epidemiological data obtained
      confirm those of larger series.

PMID- 1762457
TI  - [Glycemic control and lipoprotein profile in type I diabetes mellitus].
AB  - BACKGROUND: To analyze the relation between the degree of glycemic control and
      the lipoprotein profile in type I diabetes mellitus. METHODS: Seventy-five
      diabetics were studied in whom the total glycohemoglobin (GHb), total
      triglycerides (TG), triglycerides of very low density lipoproteins (TG-VLDL),
      total cholesterol (TC), cholesterol of very low density lipoproteins (C-VLDL),
      cholesterol of high density lipoproteins (c-HDL), apolipoprotein AI (Apo AI) and
      apolipoprotein B (Apo B) were determined. Patients were classified according to
      their GHb: less than 9% (good glycemic control), 9-11% (moderate glycemic
      control) and greater than 11% (bad glycemic control). There was homogeneity in
      the 3 groups with regards to other variables which influenced the lipoprotein
      profile. RESULTS: The concentrations of TG, TG-VLDL, TC, C-VLDL and C-LDL were
      significantly higher in the groups of greater GHb while those of C-HDL, Apo I and
      Apo B were independent of the degree of glycemic control. The number of patients
      whose lipid profiles may be considered as atherogenic risk increases
      progressively in groups with greater GHb. CONCLUSIONS: In patients with type I
      diabetes mellitus, bad glycemic control is accompanied by decreases in TG, TC and
      C-LDL up to a magnitude which frequently reaches risk values for developing
      vascular disease. However, in these subjects, a less protector effect dependent
      on C-HDL is not to be expected since their concentrations are similar to those
      patients with good glycemic control.

PMID- 1762458
TI  - [Nutritional status in uremic patients treated with continuous ambulatory
      peritoneal dialysis. Relation with 1 year's evolution].
AB  - BACKGROUND: Signs of malnutrition have been detected in patients with chronic
      renal failure and a possible relation with complications of the disease has been
      speculated. The aim of the present study was to analyze the nutritional status of
      a group of patients with the aforementioned diagnosis on a substitutive treatment
      program with outpatient continuous peritoneal dialysis (CAPD) and its relation
      with complications over one year. METHODS: The nutritional status of 29 of these
      patients and 22 individuals with normal renal function (controls) with global
      parameters of body fat, muscular protein and visceral protein being evaluated.
      The study was repeated at 6 and 12 months after the initial evaluation. The
      incidence of mortality, need for hospital admission because of complication and
      episodes of clinical peritonitis were analyzed. RESULTS: More than 70% of the
      patients presented protein-caloric malnutrition to a greater or lesser degree.
      This percentage dit not modify throughout the study and was produced at the
      expense of visceral protein, additionally affecting the fat and muscular protein
      of the males. Mortality, need for admission and the number of cases of
      peritonitis were greater in those presenting the lowest fat parameters with these
      complications beings foreseen from determined fat values. CONCLUSIONS: These
      patients have malnutrition which is related with the complications in the course
      of substitutive therapy making surveillance and nutritional support necessary.

PMID- 1762459
TI  - [Carbohydrates and lipids: metabolically related].

PMID- 1762460
TI  - [Brain abscess].

PMID- 1762461
TI  - [Thalassemia minor with iron overload: genetic and clinical study of a family].
AB  - A patient with thalassemia minor (TM) is reported who ingested 80 g of
      alcohol/day and presented an important overload of iron with deposits and a
      hepatic iron ratio compatible with primary hemochromatosis. The results obtained
      from the study of histocompatibility antigens, clinical manifestations and family
      analysis discarded the possibility of two genetic diseases, beta-thalassemia and
      primary hemochromatosis, being concomitantly present in the same progeny.
      Thalassemia minor and alcoholic hepatopathy are considered as having acted
      together and being responsible for the iron overload. The relation between
      alcohol ingested, TM and iron deposits is discussed.

PMID- 1762462
TI  - [Treatment of pneumonia associated with mechanical ventilation].

PMID- 1762463
TI  - [Diagnosis of solid masses in native kidneys with acquired cystic renal disease].

PMID- 1762464
TI  - [Myopathy caused by fenofibrate].

PMID- 1762465
TI  - [Acute psychosis after the administration of a single doses of intravenous
      biperiden].

PMID- 1762466
TI  - [Rifampicin and doxycycline in the treatment of brucellosis].

PMID- 1762467
TI  - [Meningitis caused by Clostridium cadaveris].

PMID- 1762468
TI  - PC-based research-oriented clinical information system: a case study of Kuwait.
AB  - This paper describes the design and application of a clinical information system
      (CIS) in a tertiary care facility (Kuwait Center for Cancer Control) using low
      cost microcomputers (personal computers). The facility focuses on the collection
      and use of clinical information for prospective application in clinical trials,
      individual therapy and research. In order to meet this requirement the patient
      treatment and follow-up system (PTFS) was developed, based on recent database
      management technology. The exercise demonstrates that low-cost microcomputer
      systems can be used effectively in meeting the clinical management information
      and research needs of care facilities. It is anticipated that the application of
      the system will be replicated on other health care facilities.

PMID- 1762469
TI  - Incorporating user and dialogue models into the interface design of an
      intelligent patient monitor.
AB  - A user and dialogue modelling approach is proposed for the development of user
      interfaces for intelligent patient monitoring systems. Illustrative models and
      dialogues are developed and simple examples of user interfaces for a monitor
      system based upon these are presented. The user model and dialogue method is also
      used to evaluate some interface techniques from the literature.

PMID- 1762470
TI  - Interactive statistical analysis system for clinical investigators.
AB  - We have developed an interactive statistical analysis system (ISAS-Q) with which
      clinical investigators with little experience in computers and programming can
      easily perform statistical analyses. ISAS-Q can perform most of the frequently
      used statistical methods, including multivariate analysis, in an interactive
      mode. Furthermore, ISAS-Q has self-consistent and extensive help functions.

PMID- 1762471
TI  - A computer simulation model for cost-effectiveness analysis of cardiovascular
      disease prevention.
AB  - In this paper a computer simulation model for cost-effectiveness analysis of
      cardiovascular disease prevention is presented. Cost-effectiveness analysis makes
      it possible to compare the cost-effectiveness of different interventions in order
      to maximize the health effects for a given amount of resources. The computer
      simulation model was written in Turbo-Pascal to be used on an IBM-PC-compatible.
      The model was based on the 8-year logistic multivariate risk equations for CHD
      and stroke from the Framingham Heart Study, but the regression coefficients can
      easily be changed if local data exist. The main advantages with the model are
      that it is easy to use, transparent, and flexible. The model was mainly developed
      for scientific purposes, but should be useful also for educational purposes and
      clinical decision analysis. The modelling approach used should also be useful in
      many other medical areas.

PMID- 1762472
TI  - The effect of incomplete knowledge on the diagnoses of a computer consultant
      system.
AB  - The knowledge bases (KBs) of diagnostic decision support systems are often
      incomplete, and gaps in the KB could potentially lead systems to reach diagnoses
      that are implausible to physicians. To investigate this possibility we studied
      Iliad (Version 2.01), a computer consultant system that generates differential
      diagnosis across the domain of internal medicine. Data from the history, physical
      examination, and laboratory findings of 50 grand-rounds cases were entered into
      Iliad by a computer consultant aware of the diagnosis but blinded to its presence
      or absence in Iliad's KB. Two experienced internists were asked to diagnose these
      cases before and after seeing the results of the computer consultation, and to
      assess the plausibility of the computer's diagnoses. Twenty-eight of the 50 cases
      (56.0%) were diseases contained in Iliad's KB. After seeing Iliad's diagnoses for
      cases in the KB, physicians assigned to their correct diagnoses a higher mean
      ranked position (1.5 versus 2.0, p less than 0.008) and a higher mean probability
      (84.0% versus 77.6%, p less than 0.008) compared with their pre-Iliad values,
      whereas for cases not in the KB, mean position and probability for correct
      diagnoses did not change. Physician diagnostic accuracy did not change after
      consultation on cases included or not included in the KB. After adjusting for
      case difficulty, mean plausibility of Iliad's diagnoses was judged significantly
      higher (on a seven-point scale) for cases in the KB than for cases not in the KB
      (4.2 versus 3.2, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762473
TI  - Data security in medical information systems: technical aspects of a proposed
      legislation.
AB  - This paper analyses the results of a recent survey performed among medical
      establishment personnel in Greece, evaluates information security legislation
      existing in other countries and incorporates guidelines of international
      societies to propose principles governing a future legal framework. Furthermore,
      it presents a design methodology for designing secure information systems and
      provides an example of the use of this methodology in designing a database
      oriented secure medical information system with access rights incorporated.

PMID- 1762474
TI  - Current status of medicinal research in helminth diseases.

PMID- 1762475
TI  - Computer-assisted drug design. Part I. Conditions in the 1980s.

PMID- 1762476
TI  - [Chronology of civilian suffering in the war against Croatia].

PMID- 1762477
TI  - [The civilian massacre in Dalj on 1 August 1991].
AB  - On August the 1st, 1991, Yugoslav Federal Army and Serbian terrorists attacked
      the village of Dalj, near Osijek in Eastern Slavonia. The civilians took refuge
      in Osijek and Hungary, but many of them were captured by terrorists. Their fate
      is still unknown, and the number of missing persons is more than 300. The Federal
      Army denies the entry to the village and permitted only 25 cadavers to be taken
      to the Osijek Hospital. Two out of 25 were civilians: P. D., a baker of Albanian
      origin, and N. T., baker's assistant, a Croat. The decedent N. T. was killed from
      the back by rifle fire, while the decedent P. D. was first beaten and then
      executed by two close-range gunshots in the head.

PMID- 1762478
TI  - [Civilian massacre in Banija: Kraljevcani and Pecki, 14-16 March 1991].
AB  - On 14 and 16 August 1991, Serbian terrorists attacked two villages near Petrinja
      in the Banija region. The village of Kraljevcani was attacked on 14 August, when
      the terrorists killed five older villagers, 3 women and 2 men who stayed in the
      village to watch the livestock and the houses. The women were killed by automatic
      rifle fire and grenades, and the bodies of the two men were blown up by a hand
      rocket-launcher projectiles. On 16 August 1991, Serbian terrorists captured four
      villagers from Pecki, who came to the deserted village to feed the livestock left
      after the inhabitants fled from the terrorists. The forensic medical expertise
      revealed that they were first wounded by rifle fire, then tortured and finally
      executed by hand axes and bayonets.

PMID- 1762479
TI  - [Civilian massacre near Podravska Slatina, 3 September 1991].
AB  - Twenty one civilians, 5 women and 16 men, were found dead in their doorways and
      yards after Serbian terrorists attacked the village of Cetekovac on 3 September
      1991. The age of the decedents ranged from 18 to 91 years. The oldest victims
      were women (aged 63, 68, 72, 86 and 91). The wounds found on 19 decedents were
      characteristic of the long-range gunshot wounds, with projectiles fired mostly
      from the back or/and the side of the body. The autopsy of one decedent (J. B.)
      revealed that he died from two stabbing wounds and that those were the only
      wounds inflicted to the body. The body of the decedent (M. S.) was heavily
      carbonized so that the cause of the death or even whether he was alive when his
      body was set on fire could not be estimated.

PMID- 1762480
TI  - [Destruction of the General Hospital in Osijek by the Federal Army (13-17
      September 1991)].
AB  - The article provides documentation on destroyment of General Hospital of Osijek
      in the period from September 13th until September 17th 1991. By heavy artillery
      of the Federal army, primarily from garrison "M. Stanivukovic" the Hospital was
      shut 94 times and unnumbered times by bullets from light weapons. Most of the
      hospital Wards are destroyed and for a time being General Hospital Osijek works
      mostly in the shelters and other underground facilities. Intensity of the assault
      on the Hospital shows that, in spite of many humanitarian war regulations, it was
      a primary target for Federal army artillery.

PMID- 1762481
TI  - [War injuries in Sisak in 1991].
AB  - A review of 465 persons wounded during the war in Sisak, Croatia, is presented.
      The nature of injuries are listed as follows: 337 persons were wounded by fire
      arms, 120 by beating or falling, 4 by knife, 3 by low temperature and 1 person
      was injured by high temperature. Of 465 injured patients 7 were dead at the time
      of admission to the hospital and the other 6 died within one hour of arrival.
      Special surgical care was necessary for 17 persons and it was provided in Zagreb.
      Of particular interest was the treatment of the large skin defects caused by high
      velocity small missiles. The authors emphasize the importance of accurate and
      adequate stage-treatment which begins immediately on the battleline and proceeds
      in the ambulance and hospital.

PMID- 1762482
TI  - [War injuries in children].
AB  - The pathology of the wartime injuries in children, the ways of injuring, primary
      and secondary surgical treatment, and principles of war surgery applied in
      children age are analysed. Some typical patients admitted to the Clinical
      Hospital for Pediatric Surgery of the Institute for Mother and Child Health in
      Zagreb are presented.

PMID- 1762483
TI  - [War injuries of the thorax].
AB  - Chest injuries are very common in war circumstances. Chest injury is commonly
      associated with other injuries of intrathoracic organs and development of shock,
      which has to be treated immediately. Our patients with war chest injuries are
      presented, along with our approach to the treatment of these injuries. "The
      conservative treatment" is stressed, with particularly importance of proper chest
      drainage, as a corner stone of proper and successful therapy. Shock treatment and
      prevention of atelectasis does present an unavoidable procedure of this type of
      therapy.

PMID- 1762484
TI  - [War injuries of the blood vessels].
AB  - In this article the authors review their personal experience with shotgun
      injuries to the blood vessels. To date literature demonstrates a significant
      difference between the military injuries to the blood vessels versus the
      peacetime ones in the terms of healing. Injuries from high velocity missiles as
      well as blast injuries produce a massive damage of the tissue, muscles, bones,
      nerves and blood vessels. Therefore, such injuries demand a careful and
      appropriate primary surgical treatment and urgent revascularization within the
      ischemic tolerance of the tissue.

PMID- 1762485
TI  - [Injuries of the urogenital system].
AB  - War injuries of the urogenital system present serious injuries accompanied with
      significant morbidity and mortality as well as causing high degree of later
      disablement. The paper presents our experiences and basic directions in treating
      urogenital injuries especially those penetrating and inflicted by high velocity
      missiles. Thirteen patients with urogenital injuries have been operated on and
      that makes 4% of all war injuries treated at KBC-Rebro hospital. Among the total
      number of abdominal injuries those urological make a considerable share--as high
      as 21% and that could be the consequence of the triage. In all the patients
      except one, in whom either kidney, ureter or bladder has been injured there has
      also been an associated injury of another abdominal organ (mostly colon and small
      intestine, than liver and spleen). All the operating procedures have been
      performed together with the general surgery team. X-ray preoperative examinations
      have been carried out only in two patients while the general state of the rest of
      the patients has not allowed for such procedures which could delay surgery.
      Nephrectomy has been performed in only one out of these thirteen patients.
      Orchidectomy has been carried out in only one patient in whom extensive
      laceration of the testis has occurred, while in others preserving surgical
      treatment has been applied.

PMID- 1762486
TI  - [Infections in war injuries].
AB  - Between April and September 1991, 415 injured patients were treated at the
      University Hospital Rebro, Zagreb, 362 at the Department of Surgery and 53 at the
      Department of Neurosurgery. Infections developed in 15.7% of the injured patients
      (wound infections in 14.6% and sepsis or meningitis in 1.1% of the injured
      patients). 88.2% of wound infections as well as all sepsis and meningitis were
      hospital-acquired infections, while 7.95 of wound infections occurred within 48 h
      of injuring. The major pathogens, in 90% of cases, were the aerobic bacteria
      (Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter
      species) while 9% of infections were caused by mixed aerobic-anaerobic flora. One
      injured patient developed clinical features of gas gangrene. Neither
      streptococcal wound infections nor tetanus were present in this group of the
      injured patients.

PMID- 1762487
TI  - [Advantages of arthroscopy in a military setting].
AB  - The military setting does not leave room for the diagnostic evaluation of intra
      articular injuries and long-term postoperative rehabilitation. In this sense,
      diagnostic and surgical arthroscopy has an irreplaceable value. The authors
      present six patients, members of the Ministry of the Interior and the National
      Guard, with the knee injuries sustained under battle conditions who were treated
      successfully with diagnostic and surgical arthroscopy. With arthroscopic
      equipment, already owned by many orthopedic and trauma institutions in Croatia,
      arthroscopy (diagnostic and surgical) is safe and cost effective procedure, what
      is a further advantage of this method, both in peace- and in wartime.

PMID- 1762488
TI  - [War injuries of the extremities. Use of the CMC fixator].
AB  - The injuries of the extremities in the military setting, during hostilities, are
      classified to be the most frequent in general. Among them there are those caused
      by the missiles from rifles and automatic and semiautomatic weapons and those due
      to mine and shell fragments. The characteristics of modern array of weapons are
      missiles of high kinetic energy provoking extensive tissue injuries, often
      together with fractures of the long bones. When taking care of such fractures, in
      addition to surgical treatment of the wounds, the administration of medicine and
      prevention, the immobilization of the fragments is of fundamental significance.
      All modern armies in the world use external fixators for the immobilization of
      the fragments, those fixators being the most reliable and the most uncomplicated
      means of immobilization. The paper presents a new type of the external fixator to
      be used in war surgery. It is called the CMC fixator (Croatian Medical Corps).
      The fixator is made according to the original designs in the factory
      (Instrumentarija) at Zagreb. Following its biomechanic characteristics the
      fixator is classified into the group of unilateral or joining external fixators.
      It is designed for fixation of the long bone fractures in the war setting and
      disaster conditions. It may be used for two purposes: 1. for the transport
      immobilization to a medical facility where the problem is to be finally solved,
      2. as the means of an external immobilization until the final secondary bone
      healing. The fixator has only three elements and the universal kee. It is easily
      applied. The way how to apply this fixator is described in details. The first
      experiences in the field have given satisfactory results.

PMID- 1762489
TI  - [Transfusion therapy in the war setting].

PMID- 1762490
TI  - [Anesthesiology problems in the treatment of the wounded].

PMID- 1762491
TI  - [Intensive therapy of the wounded at the Department of Anesthesiology and
      Intensive Therapy in the Surgery Clinic in Rebro].

PMID- 1762492
TI  - [Chemical warfare agents].
AB  - In this article a chemical weapons are reviewed. Most important groups and some
      of the agents are presented as well as the mechanism of their action, symptoms
      and therapy.

PMID- 1762493
TI  - [Views on war injuries of the locomotor system].

PMID- 1762494
TI  - [Rules for extending first aid for wounded with and without bone fractures].

PMID- 1762495
TI  - [Drainage of the thorax].

PMID- 1762496
TI  - [First aid in maxillofacial injuries].

PMID- 1762497
TI  - [Psychiatric disorders in war and other catastrophic circumstances--
      posttraumatic stress disorder].
AB  - The paper presents mental disorders occurring in people as a consequence of
      facing extraordinary situations of mental stress which surpass common human
      experience and are very frequent in war circumstances. Since 1980 all similar
      conditions have been classified as a single entity called Post-Traumatic Stress
      Disorder (PTSD). The disorder may occur immediately after the traumatic
      experience (acute form), or several months and even years later (chronic, delayed
      form). The etiology and therapy of the PTSD is discussed.

PMID- 1762498
TI  - [Care of children during wartime].
AB  - Children represent the most vulnerable segment of the civilian population during
      wartime. Besides the direct effects of weapons and destructions during warfare,
      children are particularly prone to other forms of damage; extensive disruptions
      in the environment of the individual child are setting the stage for an increased
      appearance of infectious diseases, and long term limitations of adequate
      nutrition are causing various forms of malnutrition and of nutritional
      deficiencies. The consecutive decrease of general resistance against infectious
      diseases is an important dispositional factor in the pathogenesis of recurrent
      and chronic infections. Most severe, far reaching and often irreversible damages
      are those of mental health of children, sometimes lasting for the whole lifetime
      of the individual. Some of the most simple but effective preventive measures to
      alleviate the suffering of children during wartime, accessible to every health
      worker are briefly reviewed.

PMID- 1762499
TI  - [Health care of the aged in the war setting].

PMID- 1762500
TI  - [Stress erosions and ulcers].
AB  - The modern concept of the etiopathogenesis of stress erosions and ulcers is given
      in this paper. The importance of prophylaxis is emphasized due to the very
      complex problems of treating wounded in situation where medical institutions are
      being intentionally damaged and where delayed evacuation is a common occurrence.

PMID- 1762501
TI  - [Problems and recommendations for the care of refugees displaced by war in
      Croatia].
AB  - The present situation in Croatia and the principles of displaced person camp
      organization are described. Displaced person care has become the urgent problem
      imposed on the Croatian social service and health care system. The up to now work
      has revealed that their is a need for more precise categorization of displaced
      persons in order that a comprehensive registration system be developed. The
      number of registered displaced persons in Croatia up to 26 September 1991 is
      quoted. Based on problems noted in the organization of displaced person camps,
      elements of organization and known principles of health care system in Croatia, a
      new model of displaced person camp organization is proposed.

PMID- 1762502
TI  - [Work at the Department of Psychiatry and Psychology at the Medical Headquarters
      of the Republic of Croatia].
AB  - During the summer 1991, the Ward of Psychiatry and Psychology at the Medical
      Headquarters, Republic of Croatia has been established as a direct reaction to
      the cruel war in Croatia. The aim of the Ward is to prevent mental disorders
      among the individuals participating in the war and among the population of
      Croatia. Special attention is given to the threatened groups. These are: injured
      patients, displaced persons, children who have lost one or both of its parents,
      members of families of persons who have been killed or injured and the others.
      Treatment doctrines have been provided as well. Besides, a regional psychiatric
      service which has been formed in accordance with the characteristics of this war
      which is carried out without a known front, mobile psychiatric groups have also
      been established. They are made up of volunteers. Particular attention has been
      directed toward the education and publishing. The first Croatian war psychiatry
      entitled "Introduction into the War Psychiatry" is going to be published very
      soon. A program of the so-called veterans hospital has been worked out as well.

PMID- 1762503
TI  - [Drugs used in war conditions].

PMID- 1762504
TI  - [Possibilities of pharmaceutical production under war conditions].

PMID- 1762505
TI  - [Drugs for the physician's bag].

PMID- 1762506
TI  - [Management of pain in injured patients].

PMID- 1762507
TI  - [Topical treatment of war injuries].

PMID- 1762508
TI  - [Prevention of wound infection].

PMID- 1762509
TI  - [Prevention of wound infection in craniocerebral war injuries].

PMID- 1762510
TI  - [Yugoslavia: oppression of physicians in Kosovo].

PMID- 1762511
TI  - [Letter from Croatia].

PMID- 1762512
TI  - ApoA-I secretion by rabbit intestinal mucosa cell cultures.
AB  - Lipid and apolipoprotein (apo) A-I concentrations in different density fractions
      of New Zealand White (NZW) and Watanabe (WHHL) rabbit plasma were studied. Aside
      from the low plasma apoA-I and high density lipoprotein (HDL) cholesterol levels
      in WHHL rabbits, the distribution of apoA-I was also different between the two
      rabbits. ApoA-I was concentrated in both the HDL2 and HDL3 fractions of NZW
      rabbits but was found primarily in the HDL3 fraction of WHHL rabbits. ApoA-I
      secretion in these two rabbits was further studied in vitro by using intestinal
      and hepatocyte cell cultures. ApoA-I secretion was highest from cultures of the
      duodenum and the proximal end of the jejunum; whereas, cell cultures of the
      distal end of the small intestine secreted very little apoA-I into the medium.
      Intestinal cell cultures from WHHL rabbits secreted less, but significant amounts
      of, apoA-I compared to that of NZW rabbits. ApoA-I was most concentrated in the
      density range of 1.12-1.21 (HDL3) fraction in medium containing 10% fetal calf
      serum (FCS). Serum-free medium promoted apoA-I secretion by intestinal cell
      cultures that was mostly found in the d greater than 1.21 (lipoprotein-deficient)
      fraction. Hepatocytes isolated from the same rabbits by collagenase perfusion
      secreted little apoA-I, and it was found only in the d greater than 1.21
      fraction. The addition of oleic acid into the culture medium with 10% FCS
      decreased the secretion of total apoA-I and HDL by intestinal cell cultures and
      increased the secretion of very low density lipoprotein (VLDL) and intermediate
      density lipoproteins (IDL).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762513
TI  - Decrease in platelet reduced glutathione increases lipoxygenase activity and
      decreases vitamin E.
AB  - Unstimulated normal human blood platelets were treated with azodicarboxylic acid
      bis(dimethylamide) (diamide), a thiol-oxidizing agent. Oxygenated arachidonic
      acid (AA) metabolites, malondialdehyde (MDA), and tocopherols were then
      quantified by high-performance liquid chromatography (HPLC). Diamide treatment
      partially decreased the amount of reduced glutathione (GSH) content and induced a
      subsequent decrease in peroxidase activity. However, formation of 12-hydroxy
      eicosatetraenoic acid (12-HETE), the end-product of lipoxygenation of AA,
      increased. Formation of MDA, a marker of overall lipid peroxidation, was also
      enhanced. Furthermore, platelet alpha-tocopherol, but not gamma-tocopherol,
      significantly decreased. These results indicate that enhanced "basal"
      lipoxygenase activity, as a marker of specific AA oxygenation, may be linked to
      decreased platelet antioxidant status.

PMID- 1762514
TI  - Characterization of the coronary vascular responses to platelet-activating factor
      in the isolated perfused heart.
AB  - Platelet-activating factor (PAF) is a potent phospholipid mediator with diverse
      in vivo and in vitro coronary vascular effects. In the present study, the
      coronary vascular responses to bolus injections of PAF were compared in rat
      hearts perfused under constant flow and under constant pressure. Low levels of
      PAF (1 pmol) produced vasodilatation only, while higher PAF concentrations (100
      pmol) produced initial vasodilatation which was followed by a vasoconstriction
      under both experimental conditions. To determine species differences in PAF
      action, the effect of PAF was tested on perfused guinea pig hearts. Unlike in
      perfused rat hearts, only a dose-dependent vasoconstrictor response was observed
      in perfused guinea pig hearts following a bolus injection of 1 fmol to 10 pmol of
      PAF. The results from repeated injections of PAF indicated that depletion of
      vasoactive mediators induced by PAF or receptor desensitization may explain a
      failure of a second injection of PAF to initiate a vasoconstrictor response.
      After PAF injection, the coronary vascular response to leukotriene was not
      altered, indicating that the reduced vasoconstrictor effect of a second injection
      of PAF cannot be due to a reduced ability of the smooth muscle to constrict. The
      study demonstrates that similar coronary vascular responses to PAF are observed
      in perfused rat hearts under either constant flow rate or constant pressure and
      that some of the variable coronary vascular responses reported may be due to the
      difference between animal species.

PMID- 1762515
TI  - Modulation of polyunsaturated fatty acid content of triglycerides in rat pre
      adipocytes in culture.
AB  - Rat peri-renal and epididymal pre-adipocytes in culture undergoing triglyceride
      (TG) accumulation were incubated with oleic (18:1), linoleic (18:2), alpha
      linolenic (18:3 omega 3), arachidonic (20:4) and 4,7,10,13,16,19-docosahexaenoic
      (22:6 omega 3) acids in the presence of 0.8 microM insulin. The fatty acids were
      incorporated in cellular TG with relative enrichments over control from 1.4-fold
      for 18:1 to greater than 40-fold for 18:3 omega 3. Greater than 80% of fatty
      acids taken up were incorporated into cellular TG. The balance was distributed,
      in decreasing amounts, into phospholipids, unidentified intracellular
      constituents, and ketone bodies. The P/S ratio of cellular TG was at least an
      order of magnitude lower than that of the external milieu for both cell types and
      for all treatment groups, including controls. Doubling the concentration of
      treatment fatty acid increased its incorporation into cellular TG. However, it
      did not affect the accumulation of the other fatty acids in TG. Epididymal cells
      consistently acquire a higher proportion of treatment fatty acids in cell TG than
      peri-renal cells. Pre-adipocytes with polyunsaturated fatty acids (PUFA)-enriched
      TG is a potential model for the study of PUFA metabolism in these types of cells.

PMID- 1762516
TI  - Trans fatty acids. 4. Effects on fatty acid composition of colostrum and milk.
AB  - trans Isometric fatty acids of partially hydrogenated fish oil (PHFO) consist of
      trans 20:1 and trans 22:1 in addition to the trans isomers of 18:1, which are
      abundant in hydrogenated vegetable oils, such as in partially hydrogenated
      soybean oil (PHSBO). The effects of dietary trans fatty acids in PHFO and PHSBO
      on the fatty acid composition of milk were studied at 0 (colostrum) and 21 days
      postpartum in sows. The dietary fats were PHFO (28% trans), or PHSBO (36% trans)
      and lard. Sunflower seed oil (4%) was added to each diet. The fats were fed from
      three weeks of age throughout the lactation period of Experiment 1. In Experiment
      2 PHFO or "fully" hydrogenated fish oil (HFO) (19% trans), in comparison with
      coconut oil (CF) (0% trans), was fed with two levels of dietary linoleic acid, 1
      and 2.7%, from conception throughout the lactation period. Feeding trans
      containing fats led to secretion of trans fatty acids in the milk lipids. Levels
      of trans 18:1 and trans 20:1 in milk lipids, as percentages of total cis + trans
      18:1 and cis + trans 20:1, respectively, were about 60% of that of the dietary
      fats, with no significant differences between PHFO and PHSBO. The levels were
      similar for colostrum and milk. Feeding HFO gave relatively less trans 18:1 and
      trans 20:1 fatty acids in milk lipids than did PHFO and PHSBO. Only low levels of
      cis + trans 22:1 were found in milk lipids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762517
TI  - Dietary fat composition influences fatty acid composition of milk fat globule
      membrane in lactating cows.
AB  - Milk fat globule membranes are derived directly from the apical plasma membrane
      of mammary epithelial cells. To evaluate the effect of dietary fat on mammary
      membranes, we determined the fatty acid composition of the milk fat globule
      membrane in lactating dairy cows fed diets supplemented with fats of different
      fatty acid composition, or infused intravenously with soy oil emulsion. A
      preliminary survey, using an abbreviated preparation procedure (membranes
      isolated at 48,000 x g-max for 15 min), yielded about 45% of the total membrane
      fatty acids that could be recovered by centrifuging at the same speed for 120
      min, and showed that changes in fatty acid composition of membranes reflected
      dietary fatty acids to some extent. Dietary palmitic acid increased the content
      of 16:0 in the membranes. A high corn diet increased ruminal formation of t18:1,
      and its level increased to 12% of membrane fatty acids. Infusion of soy oil
      emulsion increased 18:2 membrane content, and decreased the levels of 18:1 and
      20:4. All treatments decreased the ratio of unsaturated/saturated fatty acids as
      compared to controls, whereas the ratio of polyunsaturated/saturated fatty acids
      was increased by feeding a high corn diet or by infusing soy oil. The ratio of
      18:2/c18:1 increased from 0.31 to 1.0 after infusing soy oil for 4 days. The
      fatty acids of membranes isolated upon 120-min centrifugation were slightly more
      saturated. The differences were not sufficiently large, however, to affect
      overall results significantly.

PMID- 1762518
TI  - Tocopherol contents of lipoproteins from frozen plasma separated by affinity
      chromatography.
AB  - We investigated whether freezing and storage of plasma altered alpha-tocopherol
      levels of whole plasma or the lipoprotein fractions derived from such plasma.
      Plasma from 24 men, at each of two collection periods, was frozen at -20 degrees
      C for six weeks, then high-density lipoproteins (HDL) were separated from low-
      plus very low-density lipoproteins (LDL-VLDL) by heparin affinity chromatography.
      Whole plasma and the lipoprotein fractions were analyzed for alpha-tocopherol
      content and compared to counterparts from fresh plasma. Freezing and storage did
      not reduce alpha-tocopherol levels of plasma or the lipoprotein fractions. alpha
      Tocopherol values from fresh and frozen plasma were highly correlated for both
      plasma (period 1, r = 0.94; period 2, r = 0.93) and the LDL-VLDL fractions
      (periods 1 and 2, r = 0.97). Percent distribution of alpha-tocopherol between the
      two lipoprotein fractions was comparable for lipoproteins derived from fresh and
      frozen plasma. Under the storage conditions used in this study, plasma can be
      frozen for at least six weeks prior to lipoprotein fractionation with no
      detectable detrimental effects on alpha-tocopherol content of either plasma or
      lipoproteins.

PMID- 1762519
TI  - Diet-induced type IV-like hyperlipidemia and increased body weight are associated
      with cholesterol gallstones in hamsters.
AB  - Male Syrian hamsters (60-70 g) were fed purified diets containing 5% fat
      (American Fat Blend) and 15% fiber with or without 0.3% cholesterol (0.86
      mg/kcal), for 12 weeks. Hamsters fed the cholesterol-supplemented challenge diet
      revealed a major increase in plasma triglyceride between 9 and 12 weeks, whereas
      plasma cholesterol (which reflected body weight dynamics) increased three-fold up
      to nine weeks and plateaued (342 +/- 22 vs. 122 +/- 5 mg/dL). The greatest
      increases in cholesterol occurred in the very low density lipoprotein (VLDL) and
      high density lipoprotein (HDL2) fractions. Gallstone incidence was similar (69%
      vs. 78%) for cholesterol-supplemented vs. control hamsters, but the type of
      stones differed. Of the cholesterol-supplemented hamsters with gallstones, 45%
      had cholesterol stones and 55% had pigment stones. Only pigment stones were seen
      in control hamsters. Hamsters with cholesterol stones were 25% heavier and
      transported most cholesterol in VLDL (33 +/- 5%), approximately double that in
      VLDL of cholesterol-supplemented hamsters with no stones (19 +/- 3%) or
      cholesterol-supplemented hamsters with pigment stones (21 +/- 3%). Hamsters with
      pigment stones or no stones (regardless of diet fed) transported the majority of
      their cholesterol in HDL2 (44%), whereas this figure was only 27% in hamsters
      that developed cholesterol stones. Thus pigment stones develop routinely in
      hamsters fed casein-based purified diets. Adding dietary cholesterol resulted in
      cholesterol gallstones only in those hamsters that gained the most weight and
      whose terminal VLDL/HDL cholesterol ratio exceeded 1.0, not unlike the
      lipoprotein profile of obese humans who develop cholesterol gallstones.

PMID- 1762520
TI  - Metabolism of meadowfoam oil fatty acids in mice.
AB  - Meadowfoam oil is unusual because over 95% of the fatty acids are 20- and 22
      carbon aliphatic acids with cis double bonds located principally at the 5- and/or
      13-position. Since little information is available on the metabolism of the 5c
      20:1 and 5c,13c-22:2 fatty acids, an exploratory study in mice was conducted to
      investigate the metabolism of purified samples of the free fatty acids isolated
      from meadowfoam oil, and to determine the effect of meadowfoam oil on weight gain
      and tissue lipid composition. Mice fed diets containing 5% by wt of the purified
      5c-20:1 or 5c,13c-22:2 for 6 days exhibited no apparent physiological problems.
      Total liver lipids from mice fed the purified fatty acid diets contained mean
      values of 2.0% 5c-20:1 and 2.1% 5c,13c-22:2; total heart lipids contained 1.7% 5c
      20:1 and 10.7% 5c,13c-22:2. Liver total phospholipids from mice fed a 5%
      meadowfoam oil diet for 19 wk contained 1.4% 5c-20:1 and 1.9% 5c,13c-22:2. There
      was no evidence of desaturation, elongation or retroconversion. Weight gain for
      mice fed the meadowfoam oil diet for 19 wk was similar to mice fed corn oil, and
      was higher than for mice fed hydrogenated cottonseed oil. Considering the high 5c
      20:1 and 5c,13c-22:2 content of the diets, the percentages of these fatty acids
      in mouse tissue lipids from both the short- and long-term studies were low.
      Weight gain was surprisingly good since the meadowfoam oil diet was essential
      fatty acid-deficient. Results of this initial investigation suggest that the 5c
      20:1 and 5c,13c-22:2 fatty acids were utilized primarily for energy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1762521
TI  - Prostaglandin synthesis and fatty acid composition of phospholipids and
      triglycerides in skeletal muscle of chicks fed combinations of flaxseed oil and
      animal tallow.
AB  - Chicks were fed isocaloric and isonitrogenous diets containing 6% (w/w) added fat
      consisting of various proportions of animal tallow and flaxseed oil (FSO). No
      differences among treatments were seen in growth rate, muscular deposition of
      protein and lipids nor in the muscle phospholipid (PL) and triglyceride (TG)
      contents. Prostaglandin (PG)E2 synthesis in isolated skeletal muscle was
      depressed significantly by feeding FSO or by treatment with naproxen (6-methoxy
      alpha-methyl-2-napthaleneacetic acid), an inhibitor of PG synthesis. The changes
      associated with diet may be related to differences in the fatty acid composition
      of muscle lipids. Levels of saturated fatty acids in muscle PL and TG were
      relatively insensitive to dietary treatments. Monounsaturated fatty acid levels
      were significantly lower in the FSO-fed groups. FSO diets caused significant
      depression in muscle PL 20:4 omega 6 and almost completely inhibited 22:5 omega 6
      incorporation. FSO diets decreased ratios of omega 6/omega 3 fatty acids and
      increased the unsaturation index of muscle PL. Muscles of chicks fed FSO showed
      increased levels of 18:3 omega 3, and of its derivatives 20:4 omega 3 and 22:5
      omega 3. These results suggest that FSO inhibits PG synthesis and modifies the
      fatty acids of PL and TG of chick muscle. These changes may have implications for
      PG-dependent and/or membrane-dependent processes in muscle metabolism.

PMID- 1762522
TI  - Distribution among tissues of intravenously administered sucrose octaoleate.
AB  - The distribution of [14C]oleate label in rat tissues in the 6 hr after
      intravenous administration of sucrose octa[14C]oleate (7.5 mg; SuO8) was compared
      with that observed after administration of [14C]triolein. The [14C]oleate label,
      whether injected as triolein emulsion, or as chylomicrons obtained from donor
      animals, rapidly cleared from the serum; only 10% or less remained in the serum
      15 min after injection. Labeled SuO8 disappeared less rapidly from the serum;
      about one-third of the dose was present after 15 min, and after 120 min 14%
      remained. In the liver, there was an initial greater accumulation of fatty acid
      label when an emulsion of either triolein or SuO8 was given rather than the
      chylomicrons. The octaester continued to accumulate in the liver throughout the 6
      hr of study, and 78% of the initial dose was present at that time. By contrast,
      although one-third of the triolein, as of SuO8, was found in the liver shortly
      after injection, levels subsequently decreased; at 6 hr, 12% of the label
      remained associated with that organ. A small portion, up to 8% of the acid label,
      whether administered as chylomicrons or as a triolein emulsion, was found in the
      epididymal fat pads. Smaller amounts, usually 1% or less, of the [14C]oleate
      label were found in fat pads following the injection of labeled SuO8. In a
      separate study, the levels of acid label in the liver and spleen were monitored
      for 21 days following the intravenous administration of [14C]SuO8. There was an
      initial accumulation of approximately half of the injected lipid label in the
      liver and one-quarter in the spleen. By day 21, the level in the liver had
      decreased to one-third of that administered, while the level in spleen remained
      at one-quarter.

PMID- 1762523
TI  - The excretion and characterization of intravenously administered olestra.
AB  - Although sucrose octaoleate that is consumed is neither digested or absorbed,
      following intravenous injection it is found mainly in the liver. Olestra is a
      mixture of the hexa-, hepta-, and octaesters of sucrose. To follow the metabolic
      fate of intravenously administered [14C]sucrose-labeled olestra, we measured its
      urinary elimination, and the rate of excretion of 14C in the feces, and
      characterized the 14C-labeled material that appeared in bile. The fecal excretion
      for days 4-14 after dosing was found to be first order with the half-life of the
      injected olestra being 5.0 +/- 0.5 days. The 14C recovered in the bile was
      soluble in chloroform. Two-dimensional thin-layer chromatography autoradiograms
      of the biliary lipid showed the pattern of the biliary 14C to be essentially the
      same as that of the dosed olestra. Biliary excretion and subsequent fecal
      egestion of essentially unhydrolyzed sucrose esters is the principal route for
      the removal of intravenously administered olestra. Only traces of 14C were found
      in the urine.

PMID- 1762524
TI  - Interaction between dietary proteins and lipids in the regulation of serum and
      liver lipids in the rabbit. Effect of fish protein.
AB  - Purified diets varying in dietary protein, namely casein (CA), soy protein (SP),
      fish protein (FP), and lipid origin (corn oil (CN), coconut oil (CO)) were fed to
      rabbits to evaluate the effects of protein and fat source, as well as protein
      lipid interactions, on serum total, lipoprotein and hepatic lipid levels. Dietary
      proteins and lipids exerted a separate effect on serum total cholesterol (C),
      very low-density lipoprotein cholesterol (VLDL-C), and low-density lipoprotein
      cholesterol to high density lipoprotein cholesterol (LDL-C/HDL-C) ratio. Hence,
      CA increased serum cholesterol compared to SP, while coconut oil enhanced serum
      and VLDL-C, and decreased LDL-C/HDL-C compared to corn oil. Dietary proteins
      interacted with dietary lipids to modulate HDL-C levels. Thus, FP maintained a
      high level of HDL-C regardless of lipid origin, compared to CA and SP whose HDL-C
      levels were decreased by corn oil, compared to coconut oil. A dietary protein
      lipid interaction was also observed in the regulation of liver cholesterol
      levels. Coconut oil, compared to corn oil, decreased liver cholesterol in rabbits
      fed FP, whereas hepatic cholesterol concentration was unaltered by dietary lipid
      source in CA- and SP-fed rabbits. These results demonstrate that dietary proteins
      act synergistically with dietary lipids to regulate cholesterol metabolism in the
      rabbit.

PMID- 1762525
TI  - The effects of tricaine methanesulfonate (MS-222) on plasma nonesterified fatty
      acids in rainbow trout, Oncorhynchus mykiss.
AB  - The effects of tricaine methanesulfonate (MS-222), a commonly used fish
      anesthetic, on plasma nonesterified fatty acid levels (NEFA) were examined in
      rainbow trout, Oncorhynchus mykiss. Total NEFA levels declined with increasing
      duration of exposure to MS-222. Most of the decline in total NEFA was due to
      decreases in saturated fatty acids (14:0, 16:0 and 18:0). The fatty acid
      displaying the most rapid response to exposure to MS-222 was 20:5n-3. The lower
      plasma NEFA levels in anesthetized fish may be explained by depressed lipolysis
      in the presence of the anesthetic.

PMID- 1762526
TI  - The nurse executive and AIDS.

PMID- 1762527
TI  - Lengthening light; decreasing dark--nursing at the winter solstice.

PMID- 1762528
TI  - Medicaid reimbursements to nurse practitioners: the current status in
      Massachusetts.

PMID- 1762529
TI  - Research commentary: testimony--Special Commission on Nursing Practice.

PMID- 1762530
TI  - [Physical and technical problems of radiotherapy of malignant neoformations].
AB  - Re-equipment of the radiotherapy clinics, the design of new facilities and
      methods of tele- and brachytherapy, the use of unconventional radiations, and
      computerization of the entire technological treatment process form the basis for
      raising the efficacy of radiotherapy and ensuring its quality. The clinics need a
      lot of high-qualified specialists: physicists, mathematicians, and x-ray
      technicians.

PMID- 1762531
TI  - [Medical radiation physics and informatics].

PMID- 1762532
TI  - [Detectors of ionizing radiation and image converters in medicine].
AB  - Radiation receivers used in medicine for image visualization and measuring the
      radiation characteristics are considered. The main attention is focussed on
      modern image converters for x-ray diagnosis and thermoluminescent detectors for
      dosimetry.

PMID- 1762533
TI  - [Concept of radiation safety in radiodiagnosis and therapy].

PMID- 1762534
TI  - [Physical-technical and medical aspects of therapeutic effects of electromagnetic
      irradiation].

PMID- 1762535
TI  - [Physical-technical problems of ultrasonic diagnosis].

PMID- 1762536
TI  - [Problems in the design of physiotherapeutic fiber-optics light sources].
AB  - The authors review tendencies in the application of fiber-optic laser coherent
      irradiation and monochromatized incoherent sources as phototherapy devices.
      Analyze the most important factors of the visible light impact on the biological
      tissues. Show that incoherent monochromatized light with a spectrum specially
      matched with the absorption spectrum of the biological molecules can produce a
      physiological effect comparable to that of laser radiation.

PMID- 1762537
TI  - [Development of a monitoring system for radiodiagnostic devices].
AB  - The authors review the possibilities of the application of the "man-machine"
      theory to the radiodiagnostic unit. Show implementation of the theory with
      special reference to the basic purpose of the unit RENA 50-6 MP equipped with the
      microprocessor system of monitoring.

PMID- 1762538
TI  - [Problems in operating computerized tomographs].

PMID- 1762539
TI  - [Foundation of the Association of Medical Physicists].
AB  - The paper is concerned with foundation of the Association of Medical Physicists
      under the Physical Society of the USSR. The Association is to unite the efforts
      of physicists, chemists, mathematicians and engineers working at the medical
      institutions and engaged in physical problems of medicine and in the design of
      appropriate instruments, devices, equipment and materials in industry, at the
      Institutes of the Academy of Sciences, and at higher educational establishments.
      The functions of medical physicists and their roles in consolidation of the
      relations between medicine and natural sciences and engineering are discussed.

PMID- 1762540
TI  - [The course on medical physics].
AB  - The definition of medical physics is given, the main directions of the course are
      described, and some practical examples are provided. Analysis is made of the
      status of the problem concerned with teaching medical physics.

PMID- 1762541
TI  - [A course on medical technology for future physicians].
AB  - It is suggested that senior-course medical students be trained in the use of the
      most popular medical devices and equipment intended for functional diagnosis and
      treatment and that a specialized course including lectures, methodological aids
      and specialized practice in medical equipment be organized.

PMID- 1762542
TI  - [Experience in the use of disposable packages for sterilization of medical
      items].
AB  - Disposable packages for medical items sterilization, manufactured by Vipack
      Medical (Finland) have been tested to demonstrate that it is strongly advisable
      that they may be employed at the treatment and prophylactic institutions of the
      USSR. The nomenclature of the packages holding promise for use has been
      delimited.

PMID- 1762543
TI  - [An improved model of portable illuminator OC-150-M1 for the equipment fitted
      with light guides].

PMID- 1762544
TI  - [Medical physics and conversion].

PMID- 1762545
TI  - [Approaches and problems in the development of radiodiagnostic equipment].
AB  - The authors analyze the current status of technical equipment of different
      sections of roentgenology. Note shortcomings in the units manufactured and in the
      equipment of the sections of radiodiagnosis. Make conclusions about the tasks the
      Association of Medical Physicists of this country face.

PMID- 1762546
TI  - Stress revisited. 2. Systemic effects of stress. Introduction.

PMID- 1762547
TI  - The major mechanisms of stress.

PMID- 1762548
TI  - The connection between steroid receptors and stress protein (hsp90).

PMID- 1762549
TI  - Stress in affective disorders.

PMID- 1762550
TI  - Genetic basis of increased sensitivity to environmental stress in hypertension.

PMID- 1762551
TI  - The effects of stress, emotion, and behavior on the heart.
AB  - The relationships between emotional status, neurohormonal control and the
      cardiovascular function are reviewed. In the first part of this paper, we
      reviewed (1) the pathways between brain and heart, physiology of the defense
      reaction and the role of the autonomic nervous system in the mediation of the
      effects of stress; (2) the cardiac manifestations of emotional stress, and (3)
      the role of stress and the influence of circadian variations in the occurrence
      and development of myocardial ischemia, myocardial infarction and sudden death.
      In the second part, we discussed the relationship between behavior, coronary
      heart disease and particularly the role of the so-called type A behavior and
      hostility. Finally, we emphasize the importance of life-style changes to improve
      the prognosis of coronary disease and to limit the progression and ultimately to
      cause a regression of atherosclerosis. Thus, it appears that a transdisciplinary
      approach associating cardiologists, neuroscientists and behavior scientists will
      help to devise more effective strategies for the prevention and early therapy of
      cardiovascular disease.

PMID- 1762552
TI  - Cellular and molecular changes in the heart during stress or exercise.

PMID- 1762553
TI  - Molecular design and modeling: concepts and applications. Part B. Antibodies and
      antigens, nucleic acids, polysaccharides, and drugs.

PMID- 1762554
TI  - Molecular modeling of antibody combining sites.
AB  - Each of the six CDRs of Gloop2 is shown with the modeled structure in. Overall,
      the results obtained using the combined algorithm are similar in accuracy to
      those achieved using the canonical method of Chothia et al. However, the
      canonical method is limited to those loops where the key residues identified by
      Chothia are present. With the number of antibody structures currently available,
      it is not possible to classify CDR-H3 into canonical ensembles. Additionally, a
      small percentage of examples in the remaining CDRs do not match the current
      canonical classifications and the protein engineer may well wish to mutate the
      key residues, precluding the use of Chothia's method for modeling the resulting
      conformation. Thus the best approach appears to be to use Chothia's method (at
      least to model the backbone conformation) when the loop to be modeled is
      represented in the database of canonical structures. Any other loops, either
      unrepresented among the known canonicals (including CDR-H3), or where mutations
      have been made to the key residues, may then be modeled by the combined algorithm
      presented here.

PMID- 1762555
TI  - X-ray crystallographic analysis of free and antigen-complexed Fab fragments to
      investigate structural basis of immune recognition.

PMID- 1762556
TI  - Use of two-dimensional 1H nuclear magnetic resonance to study high-affinity
      antibody-peptide interactions.

PMID- 1762557
TI  - Computer modeling of combining site structure of anti-hapten monoclonal
      antibodies.

PMID- 1762558
TI  - Nuclear magnetic resonance for studying peptide-antibody complexes by transferred
      nuclear Overhauser effect difference spectroscopy.

PMID- 1762559
TI  - Isotope-edited nuclear magnetic resonance studies of Fab-peptide complexes.

PMID- 1762560
TI  - Reductive methylation and carbon-13 nuclear magnetic resonance in structure
      function studies of Fc fragment and its subfragments.

PMID- 1762561
TI  - Modeling of antibody combining sites.

PMID- 1762562
TI  - Design and production of bispecific monoclonal antibodies by hybrid hybridomas
      for use in immunoassay.

PMID- 1762563
TI  - Catalytic antibodies.

PMID- 1762564
TI  - Antibody catalysis of concerted, carbon-carbon bond-forming reactions.

PMID- 1762565
TI  - Computer simulation of DNA supercoiling.
AB  - Major goals of this research are to comprehend and visualize the detailed three
      dimensional arrangements of supercoiled DNA. Attention has been focused in the
      initial stages on mathematical procedures to generate the spatial coordinates of
      the B-DNA double helix constrained to specific spatial pathways and on simple
      energy models of chain conformation. The new treatment of superhelical DNA in
      terms of parametric curves is an important first step in being able to generate
      and examine tertiary structure systematically. The location of every residue is
      implicitly determined by the equation of the closed curve, with the number of
      computational variables sharply reduced compared to the number required for
      explicit specification of all chain units. Furthermore, the constraints of ring
      closure in cyclic chains and/or the end-to-end limitations on constrained open
      chains are automatically satisfied by the formulations (cubic B-splines and
      finite Fourier series) chosen in this work. The predicted conformations of
      elastic DNA do not appear to be tied to either the form of chain representation
      or the computer simulation method. Significantly, two very different minimization
      and modeling approaches come to the same structural conclusions. The most stable
      configurations of the closed circular elastic DNA model are found to be
      interwound superhelices that are critically dependent on the specified linking
      number difference. The total elastic energy is proportional to the imposed
      linking number difference, and beyond the critical linking number difference
      separating the circular and figure-eight forms, the writhing number of the DNA
      superhelices is directly proportional to delta Lk. The measured proportionality
      constant between Wr and delta Lk, however, is somewhat greater than that deduced
      from experimental observations of plectonemically interwound DNA chains and an
      assumed structural model. Furthermore, at large delta Lk, the interwound
      structures appear to curve. The treatment of the DNA double helix as an ideal
      elastic rod is clearly incorrect. The chain cannot bend with the same ease in all
      directions. The degree of bending observed in atomic level models is also tied to
      the angular twist so that the presumed partitioning of bending and twisting
      components is in error. Furthermore, the local chain bending and twisting are
      base sequence dependent, with certain residues able to flex more symmetrically
      than others. The polyelectrolyte character of the DNA is additionally expected to
      govern the overall folding of the chain and to influence the local secondary
      structure. The next step in this work is to compare the properties of such "real"
      DNA with conventional elastic models.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1762566
TI  - Molecular modeling to study DNA intercalation by anti-tumor drugs.

PMID- 1762567
TI  - Molecular modeling in mutagenesis and carcinogenesis.

PMID- 1762568
TI  - Protein engineering of single-chain Fv analogs and fusion proteins.

PMID- 1762569
TI  - Transfer RNA with double identity for in vitro kinetic modeling of transfer RNA
      identity in vivo.

PMID- 1762570
TI  - Molecular modeling and electron diffraction of polysaccharides.

PMID- 1762571
TI  - Molecular design and modeling of protein-heparin interactions.
AB  - The methods and approaches taken to investigate heparin-apoE peptide interactions
      have involved a series of steps, including (1) identification of the heparin
      binding domains of apoE, (2) determination of the minimal amino acid sequence
      regions involved in heparin binding, heparin-induced conformational changes, and
      stability of apoE peptide structures in solution, (3) modeling of these peptide
      and oligosaccharide structures, and (4) examination of their behavior during
      molecular dynamics calculations to determine if the modeled complexes simulate
      the results of the solution study. The heparin-binding regions of apoE were
      determined by fragmentation of the protein and identification of the heparin
      binding fragments by ligand-blotting procedures using 125I-labeled heparin.
      Studies with synthetic peptide fragments of various lengths and dot-blot
      procedures with 125I-labeled heparin identified the minimal residues critical for
      heparin-binding and CD studies established the prominent secondary structures of
      these domains. These studies also showed that heparin binds to the apoE(211-243)
      and apoE(129-169) regions to induce and stabilize beta-strand and alpha-helical
      peptide conformations. Secondary structure algorithms were used to identify the
      specific residues with the highest probabilities of forming alpha-helix and beta
      strand structures. Based on the predictive algorithms, the apoE(211-234) and
      apoE(129-159) structures were built using the Insight program and their molecular
      interactions with various heparin oligosaccharide models were investigated by
      molecular dynamics. In agreement with the solution studies in the presence of
      salt, the molecular dynamics studies showed that the oligosaccharides stabilized
      the beta-strand and alpha-helical peptide configurations against simulated
      thermal denaturations. Further modeling studies are in progress to examine the
      mechanism of the heparin-induced increase in ordered structure of these peptides.

PMID- 1762572
TI  - Computer-assisted rational drug design.

PMID- 1762573
TI  - Pattern recognition methods in rational drug design.
AB  - Pattern recognition methods have much to offer the drug designer, particularly as
      the calculation and collation of data, both biological and physicochemical,
      becomes easier with the widespread use of computer databases, molecular modeling
      systems, and property prediction packages. Some of the techniques, however,
      suffer from difficulties in interpretation and the dangers of chance effects have
      received little attention. The wider use and understanding of these methods is
      expected to enhance their utility in drug design. Finally, it should be mentioned
      here that these methods are becoming applied increasingly in other areas of
      pharmaceutical research, e.g., the analysis of clinical data, and that new
      techniques for analysis continue to be developed and applied in this field.

PMID- 1762574
TI  - Pharmacophore for nicotinic agonists.

PMID- 1762575
TI  - Construction of single-chain Fv derivatives monoclonal antibodies and their
      production in Escherichia coli.

PMID- 1762577
TI  - On assessing the impact of medical information: does MEDLINE make a difference?

PMID- 1762576
TI  - Humanization of monoclonal antibodies.

PMID- 1762578
TI  - Probabilistic diagnosis using a reformulation of the INTERNIST-1/QMR knowledge
      base. I. The probabilistic model and inference algorithms.
AB  - In Part I of this two-part series, we report the design of a probabilistic
      reformulation of the Quick Medical Reference (QMR) diagnostic decision-support
      tool. We describe a two-level multiply connected belief-network representation of
      the QMR knowledge base of internal medicine. In the belief-network representation
      of the QMR knowledge base, we use probabilities derived from the QMR disease
      profiles, from QMR imports of findings, and from National Center for Health
      Statistics hospital-discharge statistics. We use a stochastic simulation
      algorithm for inference on the belief network. This algorithm computes estimates
      of the posterior marginal probabilities of diseases given a set of findings. In
      Part II of the series, we compare the performance of QMR to that of our
      probabilistic system on cases abstracted from continuing medical education
      materials from Scientific American Medicine. In addition, we analyze empirically
      several components of the probabilistic model and simulation algorithm.

PMID- 1762579
TI  - Probabilistic diagnosis using a reformulation of the INTERNIST-1/QMR knowledge
      base. II. Evaluation of diagnostic performance.
AB  - We have developed a probabilistic reformulation of the Quick Medical Reference
      (QMR) system. In Part I of this two-part series, we described a two-level,
      multiply connected belief-network representation of the QMR knowledge base and a
      simulation algorithm to perform probabilistic inference on the reformulated
      knowledge base. In Part II of this series, we report on an evaluation of the
      probabilistic QMR, in which we compare the performance of QMR to that of our
      probabilistic system on cases abstracted from continuing medical education
      materials from Scientific American Medicine. In addition, we analyze empirically
      several components of the probabilistic model and simulation algorithm.

PMID- 1762580
TI  - Validation, clinical trial, and evaluation of a radiology expert system.
AB  - The PHOENIX Radiology Consultant is a rule-based expert system which assists
      physicians in planning radiological work-up strategies. This article describes
      the methods used to create and validate the system's knowledge base. The
      feasibility and acceptability of PHOENIX were tested for two years in a clinical
      trial. During this period, the system was used 1,421 times, an average of 13.7
      times per week, primarily by medical students and nonradiologist physicians. Much
      of the system's use occurred at night and on weekends, when the radiology
      department was not fully staffed. Several physicians were enlisted to further
      evaluate the utility of the system. The results of their evaluation indicate that
      an expert system that helps physicians select diagnostic-imaging studies can
      serve as a useful and informative component of a radiology information system,
      and is particularly useful for medical students and physicians in training.

PMID- 1762581
TI  - A Medical Text Analysis System for German--syntax analysis.
AB  - Much information about patients is stored in free text. Hence, the computerized
      processing of medical language data has been a well-known goal of medical
      informatics resulting in different paradigms. In Gottingen, a Medical Text
      Analysis System for German (abbr. MediTAS) has been under development for some
      time, trying to combine and to extend these paradigms. This article concentrates
      on the automated syntax analysis of German medical utterances. The investigated
      text material consists of 8,790 distinct utterances extracted from the summary
      sections of about 18,400 cytopathological findings reports. The parsing is based
      upon a new approach called Left-Associative Grammar (LAG) developed by Hausser.
      By extending considerably the LAG approach, most of the grammatical constructions
      occurring in the text material could be covered.

PMID- 1762582
TI  - The design and management of national morbidity surveys.
AB  - This paper describes the three major morbidity surveys in general practice which
      have been conducted in England and Wales. In it, the evolution of the recording
      method is traced from the patient summary card of the first survey to the
      diagnostic index of the second and third surveys and finally, to the fully
      computerised recording programme to be used in the fourth survey due to start in
      September, 1991. Issues relating to the capture of social data, the use of
      diagnostic terms and the value of obtaining data over a 12 month period are
      discussed.

PMID- 1762583
TI  - WING--entering a new phase of electronic data processing at the Giessen
      University Hospital.
AB  - At the Giessen University Hospital electronic data processing systems have been
      in routine use since 1975. In the early years developments were focused on ADT
      functions (admission/discharge/transfer) and laboratory systems. In the next
      decade additional systems were introduced supporting various functional
      departments. In the mid-eighties the need to stop the ongoing trend towards more
      and more separated stand-alone systems was realized and it was decided to launch
      a strategic evaluation and planning process which sets the foundation for an
      integrated hospital information system (HIS). The evaluation of the HELP system
      for its portability into the German hospital environment was the first step in
      this process. Despite its recognized capabilities in integrating decision support
      and communication technologies, and its powerful HIS development tools, the large
      differences between American and German hospital organization, influencing all
      existing HELP applications, and the incompatibility of the HELP tools with modern
      software standards were two important factors forcing the investigation of
      alternative solutions. With the HELP experience in mind, a HIS concept for the
      Giessen University Hospital was developed. This new concept centers on the idea
      of a centralized relational patient database on a highly reliable database
      server, and clinical front-end applications which might be running on various
      other computer systems (mainframes, departmental UNIX satellites or PCs in a LAN)
      integrated into a comprehensive open HIS network. The first step towards this
      integrated approach was performed with the implementation of ADT and results
      reporting functions on care units.

PMID- 1762584
TI  - A versatile test for clustering and a proximity analysis of neurons.
AB  - A test for nonrandom patterns in populations of "cells" of binary attributes is
      formulated for applications in settings where it is impossible or impractical to
      completely specify the adjacency matrix, as in circumstances involving enormous
      numbers of cells and/or censored data. Applications are made to problems
      concerning spatial distributions of specially labeled cells in nervous system
      research.

PMID- 1762585
TI  - The octave approach to EEG analysis.
AB  - A "tonal" approach to EEG spectral analysis is presented which is compatible with
      the concept of physical octaves, thus providing a constant resolution of partial
      tones over the full frequency range inherent to human brain waves, rather than
      for equidistant frequency steps in the spectral domain. The specific advantages
      of the tonal approach, however, mainly pay off in the field of EEG sleep analysis
      where the interesting information is predominantly located in the lower octaves.
      In such cases the proposed method reveals a fine structure which displays regular
      maxima possessing typical properties of "overtones" within the three octaves 1-2
      Hz, 2-4 Hz and 4-8 Hz. Accordingly, spectral patterns derived from tonal spectral
      analyses are particularly suited to measure the fine gradations of mutual
      differences between individual EEG sleep patterns and will therefore allow a more
      efficient investigation of the genetically determined proportion of sleep EEGs.
      On the other hand, we also tested the efficiency of tonal spectral analyses on
      the basis of our 5-year follow-up data of 30 healthy volunteers. It turned out
      that 28 persons (93.3%) could be uniquely recognized after five years by means of
      their EEG spectral patterns. Hence, tonal spectral analysis proved to be a
      powerful tool also in cases where the main EEG information is typically located
      in the medium octave 8-16 Hz.

PMID- 1762586
TI  - Diagnostic consultations: a speech-act theoretical reconstruction for the design
      of consultation systems.
AB  - In this paper the theory of speech acts is applied for a structural
      reconstruction of medical diagnostic consultations. The reconstruction provides
      the conceptual model for a research prototype of a consultation tool which is
      expected to play a mediating role between the participants in the professional
      diagnostic discourse. Preliminary results of the design will be outlined.

PMID- 1762587
TI  - Important law change affects titling of nurses in advanced practice.

PMID- 1762588
TI  - [Grouping of beta-hemolytic streptococci isolated from clinical specimens and
      their sensitivity to penicillin G].
AB  - 260 beta hemolytic streptococci were isolated from clinical specimens sent to
      Microbiology Laboratory, Faculty of Medicine, Anadolu University between
      September 1988 - September 1989. They were grouped according to their sensitivity
      to bacitracin and trimethoprim/sulfamethoxazole (SXT) and also serologically. Of
      260 isolates, 83.8% were group A, 1.2% group B, 6.5% group C, 3.5% group D and 5%
      were group G. All of 121 group A isolates confirmed serologically were
      susceptible to bacitracin. Excluded 9 strains, all of them were resistant to SXT.
      Other groups were mostly resistant to bacitracin. While group C and G generally
      were susceptible to SXT, B and D were resistant. Streptococci were documented
      according to distribution of clinical specimens. From throat 191 group A, 16
      group C, 1 group D and 11 group G; from nose 7 group A; from pus 19 group A, 4
      group D and 1 group G; from vagina 1 group A, 3 group B, 2 group D and 1 group G;
      from urine 2 group D; from blood 1 group C were isolated. All isolates were
      tested for penicillin G sensitivity by Kirby-Bauer disc diffusion method. While
      one of three group B strains and four of eight group D strains were resistant to
      penicillin G, all the other isolates were susceptible to penicillin G.

PMID- 1762589
TI  - [Antibiotic sensitivity tests of methicillin-resistant staphylococci].
AB  - In this study, 231 Methicillin-Resistant Staphylococcus (MRS) and 76 Methicillin
      Susceptible Staphylococcus (MSS) strains were investigated. 23 antibiotics were
      tested by using Modified Kirby-Bauer Technique. The highest resistance ration in
      MRS strains were found for lincomycin, clindamycin and ampicillin with the ratios
      of 61.0%, 59.3%, and 56.2% respectively. And the lowest resistance ratios were
      measured for vancomycin, ciprofloxacin and ofloxacin 0.5%, 8.2%, 10.8%
      respectively. It was found that, resistance of MRS strains to 17 antibiotics were
      significantly higher than resistance of MSS strains, but not for sulbactam
      ampicillin, cefoperazone, ceftriaxone, vancomycin, ciprofloxacin, ofloxacin and
      netilmicin.

PMID- 1762590
TI  - [Penicillin resistance in gonococcal urethritis].
AB  - In this study, we researched the resistance of gonococci to penicillin among 30
      patients who had urethral discharge because of gonococcal urethritis, between
      1990 January and 1990 September at SSK Ankara Hospital. We established 26.6% of
      isolated 30 Neisseria gonorrhoeae species resistant to penicillin.

PMID- 1762591
TI  - [Neonatal sepsis].
AB  - We noticed coagulase positive staphylococcus is the most common pathogen in the
      neonatal sepsis in our neonatology unit. We followed 22 cases with neonatal
      sepsis. Blood cultures revealed coagulase staphylococcus in 9 cases, coagulase
      negative staphylococcus in 6 cases, Pseudomonas spp. in 5 cases, E. coli in 1
      case, Klebsiella spp. in 1 case. The most common symptom was apnea. CRP
      positivity was noted in 15 cases (68.2%) while increase in immature/total
      neutrophil ratio was observed in 12 cases (54.5%). However, we detected
      leukopenia in 2 cases (9.1%). Also, the birthweight of the cases died due to
      neonatal sepsis were below 2000 gr.

PMID- 1762592
TI  - [Female genital tract tuberculosis].
AB  - The frequency of female genital tract tuberculosis exhibits a parallelism that of
      pulmonary tuberculosis in the population. It is generally found in reproductive
      women, but also occurs in postmenopausal ones. Its frequency has declined since
      the introduction of specific treatment, but it is discovered incidentally during
      the course of an investigation for infertility. The most common location is in
      fallopian tubes. In the Department of Pathology from the Medical School of
      Cumhuriyet University 11 female genital tract tuberculosis have been described
      between the years of 1984 and 1990. In this study, age, symptoms, localizations
      and pathological findings of these cases have been reviewed.

PMID- 1762593
TI  - [HBsAg positivity in patients with prediagnosed viral hepatitis and hospital
      personnel].
AB  - HBsAg was determined in 172 sera from 106 persons with clinically pre-diagnosed
      viral hepatitis (Group I) and 66 hospital personnel (Group II). In the
      investigation, the passive haemagglutination test was used. Positive results were
      obtained in 29.2% of Group I and 7.6% of Group II. HBsAg positivity in two groups
      was found to be differ significantly.

PMID- 1762594
TI  - [The effect of some antibiotics on primary antibody response].
AB  - In this study, effect of four broad spectrum antibiotics (sodium cefoperazone,
      sulbactam-ampicillin, mezlocillin, rifamycin) on primary antibody response.
      Therefore, sheep red blood cells were injected into total 25 rabbits in control
      and experiment groups. Hemolysin levels were titrated in serum specimens prepared
      from blood specimens taken before the experiment and taken three weeks after the
      last antigen injection. It was found that statistically significant in all the
      experiment groups rather than control (p less than 0.05).

PMID- 1762595
TI  - [Stability of cefazolin sodium as eyedrops in various solutions].
AB  - Cephazolin sodium prepared with four different solutions (NaCl 0.9%, Protagent,
      Liquifilm and phosphate buffer) to be used as eye drops, was evaluated as to its
      physicochemical features at +4 degrees C, +37 degrees C and at room temperature
      and its activity in terms of minimal inhibition concentration. In conclusion,
      cephazolin sodium prepared with artificial tears at acidic pH can be kept for 3
      days at room temperature and at +4 degrees C without any loss of its activity.

PMID- 1762596
TI  - [Urogenital Chlamydia trachomatis infections].
AB  - Urogenital Chlamydia trachomatis infections are the most common sexually
      transmitted diseases which have shown a significant increase in the last few
      years. This organism presents a major health problem in many countries. It is
      recognized as the cause of both complicated and uncomplicated infections in men,
      women and infants passing through an infected birth canal. Tissue culture is
      accepted as the gold standard in the diagnosis of chlamydial infections. But,
      since this technique is expensive and cumbersome, antigen detection tests such as
      DFA and EIA are more widely used. Tetracyclines and erythromycins are the first
      choice antimicrobials in the treatment of chlamydial infections.

PMID- 1762597
TI  - [Colony-stimulating factors].
AB  - The colony-stimulating factors are glycoprotein hormones that regulate the
      proliferation and differentiation of hematopoietic progenitor cells and the
      function of mature blood cells. They are claimed to be used in the therapy of
      some hematologic disorders as well as infectious diseases in recent years.

PMID- 1762598
TI  - [The importance of the enzyme-linked immunosorbent assay (ELISA) for the
      serodiagnosis of tuberculosis].
AB  - The remainders of tuberculosis infection are still existing as a problem, as
      important and threatening as AIDS (acquired immune deficiency syndrome),
      especially in underdeveloped countries. The diagnosis of tuberculosis infection
      frequently creates problems which is related to clinical, radiological and
      bacteriological investigations and it requires a lot of time consumption. The
      ELISA procedure is a sensitive and reproducible technique and it doesn't require
      complex equipment. Recently, this technique provides hopeful results for the
      serodiagnosis of tuberculosis.

PMID- 1762599
TI  - [Why study pharmacy?].

PMID- 1762600
TI  - [Non-steroidal anti-inflammatory drugs--more than inhibitors of prostaglandin
      synthesis].

PMID- 1762601
TI  - [Treatment of endemic goiter, hypo- and hyperthyroidism].

PMID- 1762602
TI  - [Deglutition disorders. Definition, diagnosis and therapy].

PMID- 1762603
TI  - [The effects of licorice--not harmful to health?].

PMID- 1762604
TI  - Correlation of preS antigens and clinical status during chronic hepatitis B virus
      infection.
AB  - The serum kinetics of preS1 and preS2 antigens has been evaluated in 38 serial
      samples from eight patients with chronic active (CAH) or chronic persistent (CPH)
      hepatitis, followed for 2-7 years (mean 4.4 years) in whom liver biopsy was
      performed at intervals, and in 46 samples from ten asymptomatic HBsAg carriers
      followed for 4-5 years (mean 4.6 years). Four patterns of preS behaviour have
      been observed: (1) persistently positive preS1 and preS2; (2) disappearance of
      preS2; (3) disappearance of both preS1 and preS2; and (4) persistently negative
      preS1 and preS2. Pattern 4 has been observed exclusively among healthy carriers,
      while seven out of eight chronic patients exhibited either pattern 1 or 2. Among
      the chronic patients, preS2 disappearance was accompanied or followed by alanine
      aminotransferase (ALT) normalization. The correlation of preS antigens with
      conventional viral replication markers showed that 100% of hepatitis B virus
      (HBV)-DNA-positive and 86.6% of HBeAg-positive sera were preS1/preS2 positive,
      while 61% of HBV-DNA-negative and 64% of HBeAg-negative sera were preS1/preS2
      negative. Our data suggest that continuous monitoring of preS antigens in follow
      up sera will allow for an improved prognostic evaluation of chronic HBV
      infection.

PMID- 1762605
TI  - Prevalence of antibodies to recombinant hepatitis C virus protein C100-3 and of
      elevated transaminase levels in blood donors from Northern Germany.
AB  - Antibody to recombinant hepatitis C virus protein C100-3 (anti-C100-3) was
      assayed by a first generation enzyme-linked immunosorbent assay (ELISA; Ortho
      Diagnostics) in 116,700 blood donors who had not been tested before. Total
      prevalence of repeatably positive donors was 0.72% (n = 842). Prevalence
      increased significantly from 0.42% at 18-27 years of age to 1.26% at greater than
      or equal to 58 years. Donors with elevated serum transaminase levels were
      significantly more often anti-C100-3 positive, but in 98.7% of donors with
      current or 99.1% with previous transaminase elevations, anti-C100-3 was not
      found. Elevated transaminases were more often associated with positive anti-C100
      3 in females than in males. However, in the total donor population no significant
      differences of anti-C100-3 prevalence were found between the sexes. During follow
      up at three subsequent blood donations, 1.08% of donors were positive at least
      once, but only 0.48% were consistently positive. The cutoff of the Ortho ELISA
      was not in the minimum of the frequency distribution between positive and
      negative samples, but far within the range of the negative signals, i.e. the test
      is likely to produce a significant number of false-positive results. In retesting
      positive samples with two ELISAs from other producers only a 22% to 65% agreement
      was found. In a low prevalence group such as German blood donors, the first
      generation ELISAs for anti-C100-3 produced more false than specific positive
      results. Most donors with elevated alanine aminotransferase (ALT) are anti-C100-3
      negative.

PMID- 1762606
TI  - Effect of vasodilation and vasoconstriction on microvascular pressures in
      skeletal muscle.
AB  - The effect of topically applied papaverine (PAP) and norepinephrine (NE), on the
      microvascular pressure distribution was studied in the cremaster muscle of
      anesthetized rats. The cremaster muscle was exteriorized into a tissue bath
      containing Krebs bicarbonate buffer, and microvessel diameters and pressures were
      measured using a video caliper and the resistance servo-null method,
      respectively. Pressures were measured in the 1st through 4th branch order
      arterioles (1A to 4A) and 1st through 4th branch order venules (1V to 4V).
      Resistances were calculated across each segment from pressure gradients and 1A
      blood flow which was estimated from red cell velocities. PAP (10 microM) produced
      approximately a 15% decrease in arteriolar pressures with a concomitant increase
      in venular pressures of between 15 and 50%. In contrast, NE (0.1 microM)
      significantly increased arteriolar pressure by approximately 30% and decreased
      venular pressure by about 25%. Changes in systemic pressure during treatment with
      PAP and NE were small or insignificant and could not account for the observed
      changes in microvascular pressure. Significant dilation was observed in 3A, 4A,
      and 3V vessels after papaverine. In comparison, NE caused significant
      constriction in all vessel orders except 4V. PAP decreased resistance across all
      segments between 1A and 4V by 22-42% and increased venular resistance by almost
      400%. NE increased resistance in all microvascular segments with the largest
      changes occurring in 2A to 3A (+276%) and 4A to 4V (+277%) segments. These data
      demonstrate that PAP and NE induce significant and opposite changes in arteriolar
      and venular pressures. Such network alterations in microvascular pressure should
      be considered when evaluating microvascular reactivity and exchange in the
      presence of vasoactive agents.

PMID- 1762607
TI  - Ischemia-reperfusion induced gastric mucosal microcirculatory alterations in the
      rat.
AB  - The aim of this study was to determine the gastric microcirculatory alterations
      occurring during reperfusion after a period of ischemia and the possible role of
      oxyradicals in the microcirculatory disturbance. An in vivo microscopy technique
      was used to observe the superficial mucosal blood flow during reperfusion. After
      reperfusion, mucosal blood flow resumed quickly and then slowed with eventual
      cessation of flow. Thirty minutes of ischemia followed by reperfusion resulted in
      cessation of flow in 50 +/- 4% and 81 +/- 8%, of the capillaries in the
      microscopic field at 15 and 30 min, respectively, after reperfusion. During this
      mucosal microcirculatory change, numerous white thrombi were observed flowing in
      the mucosal microvessels. In rats pretreated with allopurinol to inhibit
      oxyradical formation, blood flow was maintained to a significant and markedly
      greater extent. Study of the submucosal microvasculature after reperfusion
      revealed a marked delay in transit of a fluorescein-albumin bolus from terminal
      submucosal arterioles through the mucosal microvasculature and back to submucosal
      collecting venules. Submucosal vascular diameter change could not explain the
      altered mucosal blood flow. These findings indicate that there is marked slowing
      and cessation (in many microvessels) of gastric mucosal blood flow during
      reperfusion after a period of ischemia, and that the obstruction to flow occurs
      in the mucosal microvessels. The results of the study with allopurinol suggest
      that oxygen-derived free radicals generated by xanthine oxidase may play a major
      role in the genesis of this gastric mucosal microcirculatory disturbance.

PMID- 1762608
TI  - Dynamic structure of blood flow in microvessels.
AB  - The present article summarizes the author's perennial research on the flow of red
      blood cells in microvessels, the major determinant of rheological properties of
      blood in the microcirculation. Two main patterns of blood flow structure in
      microvessels, in the smallest arteries and veins and in the capillaries are
      described. The red cell concentration (hematocrit) in the blood flowing in
      microvessels undergoes regular alterations with changes of blood flow rate and
      vessel diameter in the microvascular beds. Further, the red blood cell
      concentration and flow velocity gradients are found in the cross-section of
      microvessels that should considerably affect the blood rheological properties in
      the microcirculation. In addition, radial displacements and blood velocity
      fluctuations of red cells in the flow are discovered in the larger microvessels
      during ischemic decrease of blood flow rate. The main factor disturbing the
      normal blood flow structure, and hence the normal rheological properties of
      blood, is the intravascular aggregation of red blood cells, which is to be
      diagnosed and eliminated in patients with blood rheological disturbances.

PMID- 1762609
TI  - The effect of smoking and menopause on the small blood vessels.
AB  - The small blood vessels were examined in 31 premenopausal and 31 postmenopausal
      women. In each group there were 14 non-smokers and 17 smokers of age groups 35-45
      and 45-59. The women underwent full gynecological examination. Blood pressure was
      normal in each. The small blood vessels were examined by capillaroscopy of
      conjunctivae and nailfolds, by oscillometry of the radial artery, skin
      thermometry of the wrist and terminal phalanx, and by capillary fragility. When
      all abnormalities in non-smokers were compared with those in smokers in the
      menopausal groups, a significant difference was found, (Table 4), to the
      disadvantage of the smokers.

PMID- 1762610
TI  - Hepatic microvascular regulatory mechanisms. XI. Effects of serotonin on
      intralobular perfusion and volumetric flowrates at the inlet of periportal and
      outlet of centrivenous sinusoids.
AB  - A normotensive (1.0 microgram per 100 g b.w.) or hypotensive (10.0 micrograms per
      100 g b.w.) dose of serotonin (5-HT) was administered endoportally while changes
      in microcirculation at the inlet and outlet regions of hepatic lobules were
      measured on-line using quantitative in vivo microscopy. The number of sinusoids
      with decreased (cellular) flow also was counted to index intralobular perfusion
      in video recordings of microvasculature examined off-line. The normotensive and
      hypotensive doses of 5-HT elicited decreases in intralobular perfusion within
      periportal and centrivenous sinusoids. Hypoperfusion was accompanied by a
      transient decrease in volumetric flowrate (Q) at the outlet of centrivenous
      sinusoids in 40% of normotensive and in 100% of hypotensive rats. At the inlet of
      periportal sinusoids, Q was depressed in 75% of hypotensive and in 27% of
      normotensive rats. The remainder of these segments had either an increase or no
      change in Q at the inlet and outlet. These results suggested that during
      conditions of 5-HT induced (lobular) hypoperfusion: (a) Q at the inlet is
      maintained in 73% of normotensive rats by redistribution of intralobular blood
      flow, and decreased in all but 25% of hypotensive rats as a function of transient
      reductions in total hepatic (arterial) and/or portal (venous) blood flow(s), and
      (b) Q at the outlet is depressed in 40% of normotensive rats by apparent
      increases in flow redistribution and resistance to flow generated during
      sinusoidal constriction, whereas in all hypotensive rats this mechanism is
      aggravated by decreased total hepatic (arterial) and/or portal (venous)
      inflow(s). Therefore, although the initial time course for microvascular
      responses tended to be similar for normo- and hypo-tensive doses of 5-HT,
      quantitative differences in regional flow distribution and Q emphasize (a) the
      importance of intra- and extra-hepatic determinants in the regulation of blood
      flow within hepatic (unit) lobules, and (b) the presence of microvascular
      heterogeneity within these lobular units.

PMID- 1762611
TI  - Capillary recruitment and heterogeneity of perfused capillary distribution in dog
      myocardium.
AB  - To estimate functional diffusion distances, the distribution of perfused
      capillaries was calculated in dog myocardium. A fluorescent dye was injected via
      a femoral vein in 6 anesthetized, open-chest dogs, and passed once through the
      coronary circulation (23 +/- 3 s). In 6 animals the dye circulated 4-20 min. In 6
      animals the dye circulated for one pass following 2-3 min of asphyxia. The heart
      was then removed and frozen. Frozen sections from the left ventricule were cut,
      illuminated to excite the dye to fluoresce, and photographed. They were then
      stained by silver methenamine to mark all capillaries. The density of all
      capillaries was compared to that of capillaries containing fluorescent label. The
      distributions of capillaries were estimated by morphometry. In one pass of the
      normoxic coronary circulation, 66(+/- 4 SE)% of subepicardial and 60(+/- 4)% of
      subendocardial capillaries were detectably labeled. Their distribution approached
      a random pattern, and maximal distances to the nearest labeled capillary were
      lengthened by 50% compared to all capillaries. With multiple passes of the dye,
      or with asphyxia 76-79% of the capillaries were detectably labeled and their
      distribution approached the ordered pattern of the total capillary bed. We
      speculated that the unlabeled capillaries represented a spatially heterogeneous
      blood flow reserve.

PMID- 1762613
TI  - The quality of care.

PMID- 1762612
TI  - Understanding OSHA's bloodborne pathogen standard.

PMID- 1762614
TI  - Fusobacterium necrophorum sepsis in a six-year-old girl.

PMID- 1762615
TI  - The use of alternative therapies by HIV-positive patients attending the St. Louis
      AIDS Clinical Trials Unit.

PMID- 1762616
TI  - Centrifugal pump support for repair of thoracic aortic injury.
AB  - Spinal cord ischemia and the potential for paraplegia are always of concern
      during operations for repair of traumatic thoracic pseudoaneurysm. Patients who
      experience hypotension, loss of intercostal blood supply, or normothermic aortic
      cross clamp times greater than 30 minutes are more likely to become paraplegic.
      The preservation of renal perfusion is also a concern.

PMID- 1762617
TI  - New concepts in asthma.

PMID- 1762618
TI  - The differential diagnosis of asthma.
AB  - The clinical hallmarks of asthma are wheezing and reversibility. Any disease that
      impairs air flow through obstructed airways may cause wheezing. Patients with
      true asthma may give a history of allergy and past attacks of dyspnea and
      wheezing occurring when exposed to allergens, inhaled irritants, upper
      respiratory infection, cold and humid air, exercise, and emotional stress. When
      encountering a wheezing dyspneic patient who does not report such a history, it
      behooves the physician to entertain the possibility that the patient may have a
      disease other than asthma. Chronic bronchitis, pulmonary emphysema, cardiogenic
      pulmonary edema pulmonary emboli, aspiration of gastric contents, and upper
      airway obstruction are the common causes of nonasthmatic wheezing. In almost
      every instance a wide spectrum of easily obtainable data, particularly
      historical, are available to alert the physician that the patient's dyspnea and
      wheezing are not due to asthma. Laboratory data are also readily available to
      buttress the correct diagnosis.

PMID- 1762619
TI  - The role of mast cells in bronchial asthma: mechanisms and possible therapeutic
      implications.
AB  - The role of mast cells in human biology is important and complex. They probably
      play a dual role both in protecting the host and in causing disease symptoms. For
      example: mast-cell-mediated vasopermeability is an important manifestation of
      asthma, but it also provides access of antibody and other blood factors which are
      brought to the tissue and help in defense. Therefore, these cells, with their
      abundant mediators, may play an important role in both homeostasis and disease.

PMID- 1762620
TI  - Occupational airway diseases.

PMID- 1762621
TI  - The role of atopy in asthma.
AB  - Allergy plays an important role in chronic asthma. Aeroallergens, both indoor and
      outdoor, provide a constant source of bronchial inflammation that increases
      bronchial hyperreactivity. This increased reactivity lowers the threshold of
      response to nonspecific triggers of asthma flares such as viral infections,
      pollutants, and cold air. Asthma is a chronic inflammatory disease in much the
      same way that the rheumatic diseases are. In that respect, therapy should be
      directed at reducing inflammation, as it is in the rheumatic diseases. Along
      these lines, newer approaches to asthma therapy should emphasize steroids as
      first-line treatment. In this way, therapy is targeted against the underlying
      inflammation that causes the bronchial obstruction, rather than treating with
      bronchodilators such as theophylline and B agonists. The effect of such
      continuous antiinflammatory therapy is decreased airway hyperresponsiveness,
      which has obvious clinical benefit.

PMID- 1762622
TI  - Asthma in children and its management: an update.

PMID- 1762623
TI  - Pulmonary function testing in bronchial asthma: standard and emerging techniques.
AB  - Despite the myriad of tests available to characterize bronchial asthma, the
      simple forced expiratory spirogram remains the most straight-forward and reliable
      technique to diagnose the disorder and gauge its severity. When combined with
      bronchodilator and bronchial challenge testing, a wide range of clinical
      situations can be evaluated, even in the office setting. A well-performed forced
      expiratory spirogram remains the cornerstone of pulmonary function testing; the
      emergence of the additional analytic techniques described holds the promise of
      even greater utility in the future.

PMID- 1762624
TI  - Bone marrow failure disorders.

PMID- 1762625
TI  - Cloning and characterisation of an immunodominant major surface antigen of
      Echinococcus multilocularis.
AB  - A lambda gt11 cDNA expression library from mRNA of Echinococcus multilocularis
      protoscolices has been constructed in Escherichia coli Y1090. Immunoscreening
      with pooled sera obtained from patients suffering from E. multilocularis disease
      revealed 5 reactive clones. By partial DNA sequence comparison all clones proved
      to encode the same gene. The complete cDNA sequence of the clone pEM10 with the
      largest insert of 2.2 kb was determined and an open reading frame of 1.7 kb could
      be described. The derived amino acid sequence shares 42.6% identity with human
      microvillar cytovillin found in the membranes of placenta and carcinoma tissues.
      The coding region of the cDNA of pEM10 was amplified by polymerase chain reaction
      (PCR) and cloned in frame into expression vector pGEX-3X. Immunoblot analysis
      revealed the expression of a recombinant antigen of 65 kDa and a protein with the
      same molecular weight was also found in the lysate of E. multilocularis
      protoscolices. In contrast, the protein was absent from hydatid fluid or larvae
      of Echinococcus granulosus. By means of immunofluorescence studies this
      immunodominant antigen could be located in the germinal layer of brood capsules
      and in the tegument of E. multilocularis protoscolices. The fusion protein was
      purified and used for diagnostic purposes in immunoblot. The diagnostic value of
      this antigen is discussed.

PMID- 1762626
TI  - A repetitive DNA probe specific for a North American sylvatic genotype of
      Trichinella.
AB  - A partial genomic DNA library constructed in pUC 13 using DNA from a sylvatic
      isolate of Trichinella spiralis (T. spiralis T5) was differentially screened with
      radiolabeled homologous genomic DNA and with DNA from T. spiralis T1. One clone
      was identified and designated pUPB-3.7 which, by slot blot and Southern blot
      analyses, reacted specifically with T. spiralis T5 DNA and did not cross-react
      with DNA from any other T. spiralis genotype. The 482-bp repetitive sequence
      which is 70% rich in A and T residues, comprises at least 2.7% of the parasite
      genome and can detect as little as 0.4 ng of DNA. When used to assess the
      prevalence of T. spiralis T5 in Indiana wildlife, DNA from 19 of 20 independently
      obtained sylvatic isolates reacted positively with the pUPB-3.7 probe indicating
      that within this geographical locality, T. spiralis T5 is the predominating
      genotype in wild mammals.

PMID- 1762627
TI  - Phospholipids and protein kinase C in acetylcholine-dependent signal transduction
      in Ascaris suum.
AB  - Quantitatively, the major phospholipid in the muscle of the nematode Ascaris suum
      was found to be phosphatidylcholine (lecithin). Stimulation of Ascaris muscle
      with acetylcholine or the agonists carbachol and levamisole increased the level
      of phosphorylcholine, 1,2-diacylglycerides and phosphatidic acid. Increased
      levels of these compounds, together with the demonstration of phospholipase C
      activity, suggest that phospholipid hydrolysis may be associated with the ACh
      response of the muscle via second messenger pathways. In other tissues,
      diacylglycerides and phosphatidic acid have been reported to regulate protein
      kinase C activity. Protein kinase C activity also was demonstrated in the muscle
      of Ascaris. For optimal activity the kinase was dependent upon Ca2+, unsaturated
      1,2-diacylglyceride and phospholipid. All of the data are in accord with the
      possible involvement of a second messenger system being operative in the ACh
      stimulated contraction of Ascaris muscle.

PMID- 1762628
TI  - Characteristics of thymidine transport in Giardia intestinalis trophozoites.
AB  - The transport of thymidine by the protozoan parasite Giardia intestinalis was
      examined at 0 degrees C. This temperature prevented attachment of the cells to
      vessel walls, so that a rapid sampling technique could be used. Thymidine influx
      (distinguished from gross uptake) was readily measurable at 0 degrees C and was
      specific and saturable. The transporter appears to be a facilitative carrier,
      exhibiting a high affinity for thymidine (Km = 50 microM). Thymine and uracil
      were the most effective inhibitors (Ki = 30 microM and 45 microM, respectively),
      followed by thymidine, deoxyuridine and uridine (Ki = 64-96 microM). Cytosine,
      cytidine and deoxycytidine were not inhibitory, even at high concentrations. The
      data indicate that the oxygen at position 4 of the pyrimidine ring is essential
      for recognition by the transporter, whereas the 5-methyl group of thymine is
      unimportant. The furanose ring appears not to be recognized, since D-ribose was
      non-inhibitory and uridine and deoxyuridine were equally inhibitory but less so
      than uracil and thymine. This carrier probably mediates the transport of uracil,
      as well as uridine and thymidine, although influx of the base remains to be
      measured.

PMID- 1762629
TI  - Heterogeneity of the genes encoding the major surface glycoprotein of Leishmania
      donovani.
AB  - The major surface glycoprotein of Leishmania (GP63) is present on all known
      species of Leishmania and likely plays an integral role during the infection of
      macrophages in the mammalian host. To identify regions of GP63 which may be of
      functional significance, the nucleotide sequence of a gene encoding GP63 of
      Leishmania donovani was determined and compared to the sequences reported for
      GP63 genes of Leishmania major and Leishmania chagasi. The GP63 nucleotide and
      predicted protein sequence was highly conserved among the 3 species despite their
      diverse geographical distribution. L. donovani GP63 is encoded by a multigene
      family and the gene locus contains at least 7 tandemly repeated genes and at
      least 3 genes which are dispersed from the tandem array. In addition, polymerase
      chain reaction and Southern blot analyses demonstrated that there was size
      heterogeneity within the pro-peptide coding regions of the multiple GP63 genes of
      L. donovani and that such genes were expressed concurrently in the promastigote
      life stage.

PMID- 1762630
TI  - An 85-kilodalton surface antigen gene family of Trypanosoma cruzi encodes
      polypeptides homologous to bacterial neuraminidases.
AB  - We have determined the sequence of a cDNA (Tt34c1) encoding a Trypanosoma cruzi
      trypomastigote stage-specific 85-kDa surface glycoprotein (gp85). Within the
      peptide sequence of Tt34c1 are two 8-amino acid motifs, Ser-X-Asp-X-Gly-X-Thr
      Trp, that are characteristic of bacterial neuraminidases. Analysis of the Tt34c1
      sequence predicts the presence of an amino-terminal signal sequence and a
      hydrophobic carboxy-terminus that is probably replaced by a glycosyl
      phosphatidylinositol membrane anchor. Gp85 is encoded by an extensive multigene
      family that is distributed throughout the genome and can be divided into subsets
      on the basis of oligonucleotide hybridisation patterns. By sequencing products of
      polymerase chain reaction (PCR) amplification of the 5' end of trypomastigote
      gp85 mRNA we show that multiple copies of the gene family are transcribed
      simultaneously in a trypanosome population. Comparison of the sequence of the PCR
      clones and another gp85 cDNA showed a highly conserved region 5' of the first
      methionine extending 180 nt into the coding sequence. Insertions and point
      mutations were observable outside these homologous sequences demonstrating the
      variant nature of the gp85 mRNAs.

PMID- 1762631
TI  - High homology between variant surface glycoprotein gene expression sites of
      Trypanosoma brucei and Trypanosoma gambiense.
AB  - The AnTat 11.17 variant surface glycoprotein (VSG) is synthesized in both
      metacyclic and bloodstream forms of Trypanosoma gambiense. We have characterized
      the AnTat 11.17 gene, and analyzed its expression site (ES) in the bloodstream
      form by Southern and Northern blotting with probes from the Trypanosoma brucei
      AnTat 1.3A VSG ES, and by run-on transcription. The AnTat 11.17 ES is located at
      the end of a 700-kb chromosome. It appears to contain all the genes (ESAGs, for
      Expression Site-Associated Genes) present in the AnTat 1.3A VSG ES, with the
      possible exception of ESAG 1. Limited nucleotide sequence analysis of ESAG cDNAs
      from the AnTat 11.17 ES shows considerable conservation with ESAGs of T. brucei.
      The transcription promoter of the AnTat 11.17 VSG ES, localized by virtue of the
      specific accumulation of promoter-proximal transcripts which occurs following UV
      irradiation, was found to be at the same relative position to the first ESAG
      (ESAG 7) as in AnTat 1.3A.

PMID- 1762633
TI  - Economic costs, cost-effectiveness, financing, and community-based drug
      treatment.

PMID- 1762632
TI  - Sequence of the knob protein of Plasmodium falciparum recognized by a monoclonal
      antibody.

PMID- 1762634
TI  - Economic costs of drug abuse.

PMID- 1762635
TI  - Cost-effectiveness of drug abuse treatment for primary prevention of acquired
      immunodeficiency syndrome: epidemiologic considerations.
AB  - The prevention of AIDS has justified recent increases in drug abuse treatment
      expenditures. Three of the epidemiologic considerations involved in assessing the
      cost-effectiveness of drug treatment for primary prevention of AIDS among IV drug
      users were discussed. First, the considerable geographic variation in the
      prevalence of the virus that causes AIDS suggests that areas with relatively low
      infection levels may be more cost-effective targets when allocating limited drug
      abuse treatment resources. Expansions and modifications in the current national
      HIV-1 serologic surveillance system will be needed to make informed resource
      allocation decisions. Second, when comparing the cost-effectiveness of two
      alternative treatment modalities or programs, the number of new HIV-1 infections
      does not appear to be an appropriate outcome measure. Serologic testing should be
      supplemented with self-reported drug use behaviors, with or without drug testing.
      Finally, significant opportunity costs may be associated with employing drug
      abuse treatment as the principal approach to primary prevention of HIV-1
      infection among IVDUs, when alternative and complementary approaches are also
      effective. Specifically, treatment expansion is unlikely to be cost-effective
      when the demand for publicly funded treatment slots exceeds the number available
      and in communities where only a small minority of IVDUs are enrolled in
      treatment.

PMID- 1762636
TI  - Policy-relevant research on drug treatment.

PMID- 1762637
TI  - Community-based drug treatment reimbursement: progress and barriers.

PMID- 1762638
TI  - Financing treatment for substance abuse.

PMID- 1762639
TI  - Forecasting the cost of drug abuse treatment coverage in private health
      insurance.

PMID- 1762640
TI  - Health insurance coverage questions, public health surveys, and drug abuse.

PMID- 1762641
TI  - Economic cost of illicit drug studies: critique and research agenda.

PMID- 1762642
TI  - Economics and drugs: promises, problems, and prospects.

PMID- 1762643
TI  - Evaluating the cost-effectiveness of drug abuse treatment services.

PMID- 1762644
TI  - Cost-effectiveness of drug abuse treatment: relevant issues and alternative
      longitudinal modeling approaches.

PMID- 1762645
TI  - New perspectives on the benefit-cost and cost-effectiveness of drug abuse
      treatment.

PMID- 1762646
TI  - Planning and developing an academic curriculum in Israel.
AB  - The authors trace the development of academic curricula in nursing in Israel from
      the early 1960s to the present day. The foundation was laid with the first post
      basic programme in 1968, and the new basic nursing degree scheme was launched at
      Tel Aviv University in 1989. The initial success of this project has encouraged
      nursing schools to pursue means of upgrading their courses from diploma to degree
      level.

PMID- 1762647
TI  - Nurses' attitudes to elderly people: a survey of nursing homes and elderly care
      wards in an inner-London health district.
AB  - This paper is based on a survey of 104 nurses of varying grades and experience
      working with elderly people in nursing homes and hospitals in an inner-London
      health district. The aim was to establish the veracity of a hypothesis which
      stated that nursing home staff would express greater job satisfaction and
      perceive their environments more positively than hospital staff. Most nurses in
      all settings were satisfied with their work, although less than one-third
      reported their reason for applying for their current post as a preference for
      working with elderly people. The authors conclude that, although favourable views
      were recorded, the negativity and dissatisfaction expressed by the nurses is
      evidence of the low status and appeal of the specialty.

PMID- 1762648
TI  - Integrating research and practice.
AB  - The opinion that research is not a legitimate activity for nurses has support in
      and outside the profession. It has been argued that nursing is a simple art that
      is not enhanced by science, and that research hinders rather than facilitates the
      provision of quality nursing services. This paper will examine these arguments
      and relate them to current controversies in nursing theory, education, research
      and practice.

PMID- 1762649
TI  - Caring for dying patients in acute hospital wards: a review.
AB  - Evidence suggests that most people in Britain now die in hospital, or spend a
      period of their terminal illness there (1). People in the terminal stage of
      illness who are cared for in a hospice or at home are in the minority. Nurses
      working in busy acute hospital wards find that part of their role includes caring
      for dying patients. Given that the main responsibility of nurses working in the
      acute setting is to care for sick people receiving active treatment, it was
      decided to examine the experiences of these nurses when they were caring for
      terminally ill patients. The effects of the acute ward setting on the dying
      patient, relatives and friends will also be considered. A hospice has a
      specialist role in care of the dying. In contrast, a hospital emphasises cure
      (2). As it is inevitable that some hospitalised patients will die, nurses must be
      competent to care for them and patients must be confident of the care they will
      receive. This article will consider some of the problems of caring for the dying
      in the acute setting, as discussed in the literature, and will recommend
      improvements in practice.

PMID- 1762650
TI  - [Histological diagnosis of brain tumors: (18). Astrocytoma].

PMID- 1762651
TI  - [Anterior decompression surgery of aged patients with cervical myelopathy].
AB  - One hundred and thirty-nine patients with cervical myelopathy who underwent
      anterior decompression surgery were reviewed to determine the characteristics and
      surgical outcome in 26 elderly patients over the age of 65. The mean age of the
      aged group was 69.7 and that of the remaining 113 patients was 50.0. Extensive
      spur removal and interbody fusion with iliac bone graft were performed in all
      patients. Evaluation of clinical grades was based on the Japan Orthopedic
      Association Score (JOA score) on admission, at discharge and at the time of
      follow-up (mean 26.8 months). The improvement rate was calculated from
      Hirabayashi's formula at each point. Preoperatively, the mean duration of illness
      was longer and the mean JOA score was significantly lower in the aged group.
      Furthermore, low incidence of soft disc and multi-level lesions were
      characteristic for the aged. Final JOA score increased from 8.2 to 13.0 in the
      aged group, while that in the non-aged group increased from 10.5 to 14.8. These
      differences were statistically significant at each point. Excellent and good
      results which were designated as an improvement rate of 50% or more were obtained
      in 73.1% of the aged group, and in 79.6% of the non-aged group. Postoperative
      complications were slightly more frequent in the aged group, all of which,
      however, were dislocation of bone graft seen in 3 patients. As compared with the
      non-aged group, poorer surgical outcome in the aged group was attributed to
      preoperative poor clinical condition, long duration of preoperative symptoms, low
      incidence of soft disc herniation and multi-level lesions which were
      characteristic features for the aged patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762652
TI  - [Phosphenes elicited by subcortical stimulation in man].
AB  - Electrical stimulation of a point in the visual pathway can evoke a visual
      sensation which is called a phosphene. The phosphenes elicited by intracerebral
      stimulation were investigated in twenty-three subjects. One hundred and seven
      phosphenes were reported and all of them appeared in the visual field
      contralateral to the side of stimulation. The exception was a single case where a
      diffuse flashing sensation appeared in the whole visual field. Thirteen patients
      reported white phosphenes and nine patients reported coloured phosphenes. In the
      medial area (10-15 mm from the midline) of the occipital lobe, stimuli above the
      calcarine fissure resulted in phosphenes in the lower quadrant of the visual
      field. In the lateral area (16-32 mm from the midline), however, stimuli above
      the level of the calcarine fissure tended to produce phosphenes in the upper
      quadrant. These findings appear to conflict with traditional concept of the
      physiological anatomy of the visual pathway in man. The possible mechanism of
      this phenomenon produced by intracerebral stimulation is discussed in relation to
      the phosphenes produced by cortical stimulation.

PMID- 1762653
TI  - [Experimental study on brain reversibility following temporary regional cerebral
      ischemia; from the point of view of vessel behavior and histological changes].
AB  - Using a middle cerebral artery occlusion model in adult cats, we investigated the
      ischemic time threshold for inflicting damage on cerebral vessel behavior and
      brain tissue. With the transorbital approach, a middle cerebral artery (MCA) was
      exposed and temporarily obstructed by a Zen's clip. Animals were divided into ten
      groups (each group: N = 8) according to the ischemic time of 10, 20, 30 minutes,
      1, 2, 4, 6, 8, 12, 24 hours. Five hours after the recanalization, Evans' blue dye
      was injected intravenously and after further 30 minutes, the brain was fixed with
      transaortal perfusion for histological examinations. A cranial window was made
      above the ectosylvian gyrus which has poor anastomosis. The pial vessel behavior
      was observed through the cranial window and evaluated using an intravital
      microscope and a videoangiometer. Considering the correlation between functional
      change of vessel behavior and pathological change in the brain, the threshold
      time of ischemia inflicting irreversible damage was estimated. In the 30 minute
      ischemia group, deterioration of vessel behavior began to be observed as well as
      extravasation of Evans' blue dye. As the ischemic duration became longer,
      infarction and hemorrhage, which showed close correlation, increased. When the
      duration of ischemia was 6 hours, the infarcted area was significantly larger
      than that of the 4-hour ischemia group. Intracranial pressure (ICP) markedly
      increased as soon as recanalization took place. We think this phenomenon is due
      mainly to swelling. About three hours after recanalization, ICP further increased
      due to severe vasogenic edema in addition to the brain swelling.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1762654
TI  - [Immunohistochemical expression of alpha-1-antitrypsin in human gliomas].
AB  - The present paper describes the analysis of immunostaining patterns of four
      antibodies, alpha-1-antitrypsin (alpha-AT), glial fibrillary acid protein (GFAP),
      S-100 protein (S-100), and vimentin in 31 human gliomas. The gliomas were 10
      astrocytomas, 10 anaplastic astrocytomas, and 11 glioblastoma multiforme tumors.
      The immunoreactivity for vimentin and alpha-AT that is one of the main proteinase
      inhibitors changed in proportion to the degree of histological malignancy. As
      alpha-AT was localized mainly in the cytoplasm of tumor cells and partially in
      extracellular spaces, it was thought to have been derived from tumor cells.
      Preparations immunolabelled with anti-GFAP and anti-S-100 showed no increasing
      loss of immunoreactivity parallel with increasing malignancy.

PMID- 1762655
TI  - [Immunomodulatory effects of interferons on target human gliosarcoma cells in the
      tumor-specific CTL- and LAK-mediated cytolysis].
AB  - We compared the regulatory effects of interferon (IFN)-beta and IFN-gamma on the
      susceptibility of a human gliosarcoma line GI-1 to the attack of autologous
      cloned tumor-specific cytotoxic T-lymphocytes (CTL) and lymphokine-activated
      killer (LAK) cells. Preincubation of GI-1 cells with IFN-gamma caused augmented
      susceptibility to the cytotoxic attack of two autologous CTL clones, whereas IFN
      beta exhibited no such marked effect. On the other hand, preincubation with
      either IFN-beta or IFN-gamma made the GI-1 cells resistant to the attack of
      autologous LAK cells. Both IFNs augmented the surface expression of HLA class-I
      molecules on GI-1 cells. A monoclonal anti-HLA class-I antibody blocked the
      cytolysis by one CTL clone, but not by the other one. These results suggest that
      IFN-gamma exerts some different effect (s) from that of IFN-beta on the target GI
      1 cells in their susceptibility to the CTL-mediated cytolysis, and that
      recognition mechanisms of target cells by the CTL are different from those by LAK
      cells. This draws our attention to IFN administration in adoptive immunotherapy
      against brain tumors using CTLs and LAK cells.

PMID- 1762656
TI  - [Three cases of non-traumatic acute subdural hematoma].
AB  - The authors present three cases of non-traumatic acute subdural hematoma showing
      interesting clinical features and operative findings. Case 1: A-50-year-old male
      was admitted because of sudden headache and epileptic seizure. Computed
      tomographic (CT) scan showed a right thin subdural hematoma, but cerebral
      angiography demonstrated no pathological findings, that might cause acute
      subdural hematoma on the follow-up CT scans. The hematoma changed to a chronic
      one within only 15 days, which was proved by the operation. Case 2: A 52-year-old
      male was hospitalized because of loss of consciousness. CT scan revealed a right
      subdural hematoma without subarachnoid hemorrhage and cerebral angiography
      demonstrated a right middle cerebral artery aneurysm. The hematoma was surgically
      proved to be due to rupture of the aneurysm. Case 3: A 52-year-old male was
      admitted because of headache, vomiting and left motor weakness. CT scan showed a
      thick right subdural hematoma and right carotid angiography revealed two internal
      carotid artery aneurysms. It was surgically certified that the subdural hematoma
      was caused by a tear in a cortical artery attached to the dura, not by the
      rupture of the aneurysms. Clinical cause and pathogenesis of so-called "non
      traumatic" or "spontaneous" acute subdural hematomas were discussed, and the
      importance of emergency angiography for this condition is stressed.

PMID- 1762657
TI  - [Plasma cell tumor of the parieto-occipital bone; a case report].
AB  - Plasmacytoma originating in the cranial bone is a rare disease. A report is
      presented of a case of plasmacytoma originating in the parieto-occipital region.
      The patient was a 62-year-old male with palpation of a parieto-occipital mass as
      chief complaint. He showed no neurological deficit. Ig-G in the serum was 2240
      mg/dl, and M-protein (n-type) was demonstrated in the serum. Bence-Jones protein
      was negative and bone marrow was normal. Skull X-ray showed osteolytic change in
      the parieto-occipital region. CT scan and MRI demonstrated a markedly enhanced
      mass extending from the epidural to the subcutaneous space at the parieto
      occipital region. Common carotid angiography showed remarkable tumor stain
      flowing from the occipital artery, the superficial temporal artery, and the
      middle meningeal artery. Following embolization of the bilateral occipital
      artery, parieto-occipital horse shoe scalp incision was done. The tumor was
      elastic soft and bled easily around the margin of destroyed bone. Subtotal
      removal of the tumor was accomplished. The removed surgical specimen of the tumor
      was found to be plasmacytoma. The patient's postoperative course was favorable
      and no neurological deficit was found. Laboratory studies revealed a remarkable
      reduction of Ig-G in the serum to 1170 mg/dl. Six months after the operation, no
      signs of recurrence were seen on CT scan. Plasmacytoma originating in the cranial
      bone is so rare that only 18 cases have been reported to date. In these cases,
      laboratory studies have shown no evidence of anemia, Bence-Jones protein in
      urine, and abnormality of the bone marrow which are characteristic of multiple
      myeloma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762658
TI  - [A case of sellar germinoma which was misdiagnosed as pituitary adenoma].
AB  - The authors reported a rare case of sellar germinoma which was misdiagnosed as
      nonfunctioning pituitary adenoma. A 32-year-old woman was admitted to our
      hospital because of amenorrhea and disturbance of left visual acuity. She had
      become amenorrhagic after her second delivery two years before. Neurological
      examination revealed she was normal except for diminished left visual acuity (Rt.
      = 1.2, Lt. = 0.5). The general condition was good. Urine volume and its specific
      gravity were within normal range. Endocrinological examination showed
      hyperprolactinemia (PRL 72 ng/ml) accompanied with impairment of GH, TSH, LH and
      FSH's reserve. Basal levels and reserve of the blood cortisol were normal. AFP
      and hCG were within normal range. CT scan revealed a homogenously enhanced
      intrasellar tumor which had a suprasellar portion (vertical length: 15 mm). T1
      weighted MRI revealed low intensity tumor, and T2 weighted image revealed high
      intensity tumor. Sagittal MR image with gadolinium enhancement showed the
      pituitary gland anterior to the tumor. Transsphenoidal removal was performed. The
      histological diagnosis was pure germinoma. After the operation, the intracranial
      and spinal disseminations were disclosed. Complete neuraxis irradiation resulted
      in the complete remission of the tumor. Sellar germinoma without diabetes
      insipidus is considered to be very difficult to diagnose preoperatively. However,
      the authors proposed that anterior shift of the pituitary gland in sagittal MR
      image may be a clue to the diagnosis of sellar germinoma.

PMID- 1762659
TI  - [Cavernous angioma of falx cerebri; case report].
AB  - A first case of cavernous angioma of falx cerebri is reported. A 62-year-old
      woman who had a history of intermittent headache and dizziness was admitted to
      our hospital. On admission she had no neurological deficit, but CT scan showed a
      slightly high density tumor located beneath the falx cerebri. This was markedly
      and homogeneously enhanced by contrast medium. MRI showed a tumor with low
      intensity in T1-weighted image and high intensity speckled with low intensity in
      T2-weighted image. Angiogram revealed a faint tumor-stain fed by the bilateral
      pericallosal arteries at middle arterial to late venous phases. With the tumor
      attached to the lower edge, the falx was totally removed through a left front
      parietal craniotomy. Histologically the tumor was diagnosed as cavernous angioma
      and thought to have originated from the dura mater of the falx. A search in the
      literature revealed that only 7 cases of extracerebral cavernous angiomas
      excluding ones in the middle cranial fossa have been previously reported. Five of
      them were located at the tentorium cerebelli and two at the convexity. The MRI
      finding such as speckled mixed intensity may reflect the vascular lumens or their
      thromboses in the tumor. Angiographic finding such as faint tumor stain at middle
      arterial to late venous phases due to slow blood flow in the tumor are thought to
      be specific to intracranial cavernous angiomas. These findings are of particular
      importance in differentiating cavernous angiomas from meningiomas.

PMID- 1762660
TI  - [Total removal of hypothalamic glioma 15 years after irradiation of right optic
      glioma].
AB  - Hypothalamic glioma was found in a 17 year old male patient 15 years after
      irradiation of right optic glioma. It was totally removed by surgery. He was
      first admitted to Ryukyu University Hospital at the age of 1 year and 11 months,
      with right exophthalmos and visual disturbance. Diagnosis was anterior type of
      right optic glioma. This was treated by irradiation (47 Gy). Follow-up CT scans
      revealed no regrowth in intraorbital and intracranial regions. At the age of 17
      years, CT scan and MRI showed an enhanced mass in the hypothalamus above the
      suprasellar cistern. Total removal was performed by bifrontal interhemispheric
      trans-lamina terminalis approach. Histological diagnosis was pilocytic
      astrocytoma. Postoperatively, consciousness remained disturbed for 3 weeks
      because of infarction in the bilateral medial nucleus of the thalamus. Radical
      excision of hypothalamic glioma was reviewed in the literature. We concluded that
      such excision has a potentially good outcome, and should be attempted when
      circumstances indicate its feasibility.

PMID- 1762661
TI  - [A diffuse metastatic leptomeningeal carcinomatosis from gallbladder cancer; case
      report].
AB  - We encountered a 72-year-old woman with diffuse metastatic leptomeningeal
      carcinomatosis, who first suffered from occipital pain and died about a month
      after onset. On postmortem examination, gallbladder cancer (adenocarcinoma) was
      found to be the primary disease. We focused on its frequency and the metastatic
      route. On the metastatic route, we obtained the following results: tumor cells
      infiltrated only the cerebrospinal fluid, but not the areas surrounding the
      gallbladder cancer (spine or spinal cord) or into the brain parenchyma. A
      comparative study of the state of cerebrospinal fluid between the ventricle and
      the subarachnoid space disclosed that the cerebrospinal fluid pressure, cell
      count, and CEA and CA 19-9 levels increased more in the intraventricular
      cerebrospinal fluid, especially when the CEA level was higher than that in the
      serum. On histopathological examination, tumor emboli were seen in choroidal
      vessels in the ventricular wall, and tumor cells existed sparsely around
      choroidal secretory vessels. These results were thought to support the theory of
      hematogenous metastasis as Little et al proposed.

PMID- 1762663
TI  - Current bibliographies of neuropeptides prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 1762662
TI  - [An intradural arachnoid cyst of the craniovertebral junction; a case report].
AB  - An intradural arachnoid cyst of the craniovertebral junction possibly of
      traumatic origin is reported. A 59-year-old man was admitted to our hospital with
      a 10-month history of progressive gait disturbance. He had a history of head
      injury with a fracture of the occipital bone. Myelography revealed pooling of the
      contrast medium in the posterior fossa and on the dorsal sides of C1 and C2.
      Metrizamide-enhanced computed tomography also showed pooling at the same level.
      Magnetic resonance imaging indicated a large cystic lesion at the craniovertebral
      junction. Craniectomy of the posterior fossa and laminectomy of C1, C2 and C3
      were performed, and an intradural cyst with thickened dura and arachnoid was
      found. The cyst wall was opened to communicate with the subarachnoid space.
      Histological findings of the specimen showed that the arachnoid was thickened.
      There are over 130 reports of intradural arachnoid cyst of the spine, but those
      of traumatic origin are rare, and cysts located in the intracranial to spinal
      region are extremely rare.

PMID- 1762664
TI  - Modulation of the transient potassium current in rat hippocampal neurones by
      cholecystokinin.
AB  - Cholecystokinin (CCK) affects neuronal excitability in a variety of in vivo and
      in vitro preparations, apparently by modulating a resting potassium conductance.
      The data presented here show that CCK (applied as CCK8-S) also affects the
      transient potassium current in hippocampal neurones, by changing the voltage
      dependence of the inactivation and activation of the current. The way in which
      the voltage dependence is changed can lead to either an enhancement of the
      current or an attenuation, depending upon the voltage protocol used. This effect
      of CCK does not desensitise over a time period of minutes, and may therefore be
      important in controlling neuronal excitability in the CNS.

PMID- 1762665
TI  - Vasoactive intestinal peptide levels in the hypothalamus and anterior pituitary
      do not change in association with the pre-ovulatory prolactin surge in the rat.
AB  - We examined whether vasoactive intestinal peptide (VIP) is involved in the
      preovulatory prolactin (PRL) surge in the rat. Ovariectomized adult rats
      implanted sc with an estradiol capsule 2 days previously were decapitated at
      hourly intervals between 1100-1800 h. The plasma PRL and luteinizing hormone
      showed an evident surge at 1700 h and 1800 h, respectively. The anterior
      pituitary PRL content was significantly lower at and after 1600 h than at 1100 h.
      However, there was no significant change in the VIP content in the
      suprachiasmatic nucleus, paraventricular nucleus, median eminence or anterior
      pituitary throughout the entire period of observation. Since all of these regions
      are known to be involved in the VIP synthesis and/or release, the present results
      appear to cast some doubt on previous studies reporting a significant role for
      VIP in the generation of the pre-ovulatory PRL surge.

PMID- 1762666
TI  - Secretion of gastric acid inhibited by oxytocin injected into the hypothalamic
      paraventricular nucleus in the rat.
AB  - Gastric acid output was examined following oxytocin injection into the
      hypothalamic paraventricular nucleus (PVN) or into the vagus nucleus (X) of the
      medulla in rats with insulin-hypoglycemia. Gastric acid output was reduced
      following the injection of nanomolar quantities of oxytocin into these nuclei,
      and the response was dose-dependent. It was also noted that there was a
      synergistic action on the response by the peptide between PVN and X. The acid
      response was blocked by section of the vagus nerve at the subdiaphragmatic level
      or by prior administration of atropine sulfate. These observations suggest that
      oxytocin in the PVN is active in suppressing gastric acid secretion, and the
      vagal response is characteristic of activation of the PVN and X.

PMID- 1762667
TI  - Effect of ovariectomy and estrogen replacement on hypothalamic, pituitary and
      peripheral blood beta-endorphin levels in the rat.
AB  - This study was initiated to detect possible changes in beta-endorphin (beta-EP)
      levels of the hypothalamus, anterior pituitary gland, and peripheral blood of
      rats after ovariectomy and estrogen administration. Attempts were also made to
      determine the correlation between peripheral and central levels of beta-EP.
      Twenty-six Sprague-Dawley rats were decapitated. Nine had intact ovaries (Gr.
      INT), and 17 were ovariectomized 3 weeks before they were killed. Nine of the
      ovariectomized rats received estradiol benzoate (EB) (Gr. EB) and the other 8
      received peanut oil (Gr. OVX) prior to the decapitation. A beta-EP
      radioimmunoassay was used to analyze homogenates of the hypothalamus and anterior
      pituitary, and peripheral blood. In the hypothalamus, beta-EP levels were
      significantly lower in Gr. INT and Gr. EB than in Gr. OVX. In the pituitary gland
      and peripheral blood, beta-EP levels were significantly higher in Gr. INT than in
      Gr. OVX. Pituitary beta-EP levels did not vary between Gr. OVX and Gr. EB,
      although beta-EP levels in peripheral blood were significantly higher in Gr. EB
      than in Gr. OVX. No significant correlations were noted in beta-EP levels between
      the hypothalamus, pituitary gland, and peripheral blood in either Gr. INT, Gr.
      OVX, or Gr. EB. It appears that EB exerts different effects on beta-EP levels in
      the hypothalamus, anterior pituitary gland, and peripheral blood, and that beta
      EP levels in these regions may be independent of one another.

PMID- 1762668
TI  - Increased cerebrospinal fluid cyclo(His-Pro) content in schizophrenia.
AB  - Cyclo(His-Pro) (CHP) is a peptide endogenous to human brain and cerebrospinal
      fluid (CSF). In animal studies administration of exogenous CHP augments
      dopaminergic neurotransmission. To explore the role of this peptide in
      schizophrenia, a disease characterized by a hyperdopaminergic state, we have
      measured CSF CHP levels in control, never-medicated schizophrenics and medicated
      schizophrenics. Our data show a 53% increase in CSF levels of CHP in never
      medicated schizophrenics (p = 0.015), and a 25% increase in medicated
      schizophrenics when compared to controls. We speculate that CHP may contribute to
      the expression of hyperdopaminergic symptoms in schizophrenia.

PMID- 1762669
TI  - Indirect measures of memory in a duration-judgement task are normal in amnesic
      patients.
AB  - Nine amnesic patients of mixed aetiology were studied in a duration-judgement
      task that allowed three measures of memory to be obtained. On each trial of the
      task, subjects attempted to read a briefly flashed word and to estimate the
      duration of the flash. Both word identification and duration estimation differed
      as a function of prior study. Words that were previously studied were identified
      more often and were estimated to have been flashed for a longer duration than
      were words not previously studied. These priming effects were found in young
      subjects in Experiment 1 and in amnesic patients and age-matched control subjects
      in Experiment 2. Priming effects were normal in the amnesic patients, whereas
      these patients were severely impaired at recognizing the same words. Previous
      results have also shown that amnesic patients can perform normally on certain
      memory tests, including priming of word identification. These results show that
      priming of duration judgements can also be included in the category of indirect
      measures of memory that are spared in amnesia.

PMID- 1762670
TI  - Disentangling neglect and hemianopia.
AB  - In this paper we report findings which question the diagnosis of a hemianopia in
      B.Q., a 66-year-old lady who shows unilateral spatial neglect following a lesion
      to the right parietal lobe. The presence of a hemianopia has been indicated
      following two independent assessments of B.Q.'s visual fields. We examined B.Q.'s
      performance on a visuo-spatial task in which single or double stimuli were
      displayed left and right of a central fixation point. B.Q. failed to report left
      stimuli when the fixation point was continuously displayed (OVERLAP CONDITION).
      This performance is consistent with the suggestion of a left hemianopia as
      indicated by perimetric field testing. In a further condition the fixation point
      was extinguished prior to stimuli onset (GAP CONDITION). B.Q. consistently
      responded to left stimuli in the gap condition and also showed improved
      performance to right stimuli. Eye movements were recorded on a separate testing
      session, in which B.Q. showed a normal saccadic response to left targets in the
      gap condition, but not during the overlap condition. These results suggest that
      B.Q.'s failure to report left stimuli during field plotting is due to her
      neglecting left stimuli and not because she has a visual field defect. By using a
      testing procedure which reduces the severity of neglect B.Q. is able to respond
      to left stimuli. Reducing the severity of B.Q.'s neglect also abolishes the
      apparent hemianopia. Standard field plotting techniques which use a consistently
      displayed fixation point may not be appropriate for the testing of neglect
      patients' visual fields.

PMID- 1762671
TI  - Remission of somatoparaphrenic delusion through vestibular stimulation.
AB  - The effects of vestibular stimulation on somatoparaphrenic delusion were
      investigated in a patient suffering from a fronto-temporo-parietal infarction
      located in the right hemisphere. Transitory remission of the patient's delusional
      belief was consistently observed during unilateral vestibular activation obtained
      by means of cold-water irrigation of the left (contralesional) ear.

PMID- 1762672
TI  - Perceptual reference frames and visual field asymmetry for verbal processing.
AB  - Two experiments investigated the role of perceptual reference frames in producing
      visual field asymmetries for the recognition of consonant-vowel-consonant (CVC)
      nonsense syllables. In an upright stimulus display condition, both quantitative
      and qualitative visual field asymmetries replicated those obtained in earlier
      studies of CVC identification. When the stimulus displays were rotated 90 degrees
      clockwise or counterclockwise, there were no effects of presenting the CVC in
      relative LVF vs relative RVF stimulus locations. The contrast between results in
      the upright and rotated stimulus display conditions indicates that the LVF/RVF
      differences in the upright displays are attributable to the position of the CVC
      relative to the fovea, rather than relative to the perceptual reference frame.
      This finding is consistent with the interpretation that LVF/RVF differences in
      the upright condition are attributable to hemispheric differences in the
      processing of linguistic/phonetic information.

PMID- 1762673
TI  - Interhemispheric interaction in the split-brain.
AB  - An experiment is reported in which a split-brain patient (LB) was simultaneously
      presented with two words, one to the left and one to the right of fixation. He
      was instructed to categorize the right sided word (living vs non-living), and to
      ignore anything appearing to the left of fixation. LB's performance on this task
      closely resembled that of normal neurologically intact individuals. Manual
      response speed was slower when the unattended (left visual field) word belonged
      to the same category as the right visual field word. Implications of this finding
      for views of the split-brain syndrome are discussed.

PMID- 1762674
TI  - Unconscious perception of "extinguished" visual stimuli: reassessing the
      evidence.
AB  - When parietal-damaged patients fail to report a contralesional stimulus because
      of extinction, is this because the stimulus is not perceived, or because it is
      perceived but cannot reach conscious awareness? VOLPE et al. [10] reported an
      intriguing study that seemed to locate the problem at least partly in the
      transfer of information to conscious awareness. They showed patients with
      extinction pairs of stimuli, one in each hemifield. Although patients were
      predictably poor at reporting the identity of the contralesional stimulus, they
      were able to make accurate same/different judgements comparing the two stimuli.
      This was interpreted as evidence that both stimuli were perceived. In the present
      paper, we point out that the dissociation between identification and
      same/different matching could also be due to the possibility that less visual
      information about the contralesional stimulus is necessary to make a
      same/different judgement than to identify the stimulus, and that chance
      performance is considerably higher in the first than in the second type of task.
      In Experiment 1, we verified this by degrading one side of a stimulus display and
      "replicating" the dissociation with normal subjects. We also equated the amount
      of visual information needed for the two tasks by yoking the stimulus pairs on
      "different" trials of the same/different matching task with the choice pairs on a
      forced choice identification task. Under these conditions, the dissociation
      vanished. In Experiment 2, we administered these tasks to three parietal-damaged
      patients with extinction. When the original method was used, same/different
      matching was better than identification of the contralesional stimulus. With the
      forced choice identification method, the dissociation again vanished.

PMID- 1762675
TI  - Normal global-local analysis in patients with dorsolateral frontal lobe lesions.
AB  - The role of prefrontal cortex in the analysis of global and local levels of a
      visual stimulus was assessed by measuring reaction time to identify a target at
      one level or the other. Unlike patients with temporal-parietal lesions (STG),
      there were no global-local performance deficits in right or left prefrontal
      groups (RFL or LFL). Reallocation of attention to global and local levels was
      measured by examining changes in performance when the probability of a target
      appearing at one level or the other varied. While patients with lateral parietal
      lesions (IPL) have been shown to have deficits in these conditions, both RFL and
      LFL showed normal changes in performance. In sum, the performance of prefrontal
      groups differed from both IPL and STG groups but not from normal controls. These
      results strengthen previous arguments that posterior association cortex is
      crucial in responding to global and local levels of a pattern.

PMID- 1762676
TI  - Failure of object recognition due to a breakdown of figure-ground discrimination
      in a patient with normal acuity.
AB  - We report the case of a 71-year-old woman with partial cortical blindness
      attributable to cortical degeneration. Her visual acuity and colour perception
      were satisfactory but she was almost totally unable to recognize objects or
      people by sight. Investigations revealed a hitherto unreported dissociation
      between relatively well preserved shape discrimination and gravely impaired
      figure-ground discrimination. Thus, she was able to discriminate between a square
      and an oblong matched for total surface but she was unable to detect a simple
      shape against a pattern background. In a series of experiments it was shown that
      she could identify single printed capital letters of the alphabet relatively
      satisfactorily. She had no difficulty in identifying single, simple geometric
      shapes. By contrast, she was unable to discriminate configurations of two or
      three overlapping or concentric, simple, shapes. Strikingly she appeared to be
      "blind" to subjective contours and she was unable to perceive visual illusions
      normally. These deficits are interpreted to reflect a failure to achieve
      primitive organization of visual information rather than higher level perceptual
      impairments. The results are discussed in the context of physiological and
      computational models of early visual information processing.

PMID- 1762677
TI  - Differential effect of right and left hemispheric lesions on two memory tasks:
      free recall and frequency judgement.
AB  - We investigated the relationship between lateralized cerebral damage and two
      memory tasks; free recall and frequency judgement. Free recall is considered to
      be processed effortfully while frequency judgement is considered to be processed
      automatically (Hasher and Zacks). Nine right brain-damaged patients (RBD), nine
      left brain-damaged patients (LBD) and nine control subjects participated in this
      study. It was hypothesized that RBD would show an advantage over LBD on the free
      recall task, whereas LBD would show an advantage over RBD on the frequency
      judgement task. In accordance with our hypothesis, free-recall was more impaired
      in LBD than in RBD. In the frequency-judgement task, an effect of laterality of
      lesion was found in high (4-6) and low (0-1) frequencies, but not in the medium
      (2-3) frequencies. The anticipated LBD advantage was shown in judgement of the
      high frequencies, but unexpectedly RBD performed better than LBD in low
      frequencies. The results are discussed in terms of the relationship between
      effortful and automatic memory processes and cerebral lateralization.

PMID- 1762678
TI  - Extra-dimensional versus intra-dimensional set shifting performance following
      frontal lobe excisions, temporal lobe excisions or amygdalo-hippocampectomy in
      man.
AB  - Attentional "set" shifting was assessed in a group of 20 neurosurgical patients
      with localized excisions of the frontal lobes, a group of 20 patients with
      unilateral temporal lobe lesions and a group of 11 patients who had undergone
      amygdalo-hippocampus removal. These three patient groups were compared with
      groups of both young (age-matched) and elderly normal control volunteers on a
      computerized test of visual discrimination learning involving both an intra- and
      an extra-dimensional shift. The frontal lobe group were selectively impaired in
      their ability to shift response set to a previously irrelevant dimension but not
      to shift attention to new exemplars of a previously relevant dimension. A similar
      pattern was observed in the elderly group of normal control volunteers. By
      comparison, both the temporal lobe patients and the amygdalo-hippocampectomy
      patients were unimpaired in their ability to perform either shift, although both
      groups had significantly prolonged selection latencies at the extra-dimensional
      shift stage of the task. These data are compared to previous findings from
      patients with idiopathic Parkinson's disease and are discussed in terms of a
      specific attentional set shifting deficit following frontal lobe damage.

PMID- 1762679
TI  - Fatty acids modulate excitability in guinea-pig hippocampal slices.
AB  - A variety of fatty acids produced sustained changes in excitability in the guinea
      pig hippocampal slice. Although each fatty acid was unique, a general pattern was
      evident. During a 30-min exposure, the synaptic potential was minimally affected,
      although population spike amplitude showed significant increases. With wash,
      synaptic efficacy increased. The increase in the synaptic potential was
      significant with arachidonic acid (100 microM), oleic acid (100 microM), myristic
      acid (250 microM) and capric acid (250 microM). Also with wash, the coupling
      between the synaptic potential and the population spike was reduced significantly
      for most of the fatty acids tested: arachidonic acid (50 microM, 100 microM),
      linoleic acid (100 microM) oleic acid (100 microM), stearic acid (100 microM),
      myristic acid (250 microM) and capric acid (250 microM, 500 microM). The fatty
      acids may influence neuronal excitability, in part, through a direct membrane
      action. The observed synaptic enhancement is consistent with a role for a fatty
      acid in long-term potentiation. In addition, fatty acid exposure mimics the
      effects of X-radiation. We suggest that free radical-induced release of fatty
      acids contributes to electrophysiological damage in a number of pathological
      states.

PMID- 1762680
TI  - Autoradiographic localization of dopamine D1 and D2 receptors in rat nucleus
      accumbens: resistance to differential rearing conditions.
AB  - The radioligands [3H]SCH 23390 and [3H]spiroperidol were used to label dopamine
      D1 and D2 receptors, respectively, in rat brain slices. Striatal sections were
      incubated in one of various concentrations of radioligand in the presence or
      absence of (+)-butaclamol and the resulting labeling was determined by liquid
      scintillation spectrometry. Scatchard analyses of the data revealed KD values of
      1.18 nM for D1 receptors and 0.33 nM for D2 receptors. Tissue sections taken from
      the entire rostrocaudal extent of the nucleus accumbens, as well as other brain
      regions, were then processed for autoradiographic analysis of D1 and D2 receptors
      using a radioligand concentration equal to 1.5 X KD. After apposing the slices to
      3H-sensitive film, topographical differences among brain areas were analysed
      using a quantitative densitometry system which determined the absolute amount of
      ligand binding relative to calibrated optical density standards. The nucleus
      accumbens exhibited a rostral-to-caudal density gradient for both D1 and D2
      receptors. For D1 receptors, the density was similar across most of the nucleus
      accumbens, although the most caudal portion examined had a lower density than
      rostral portions. In contrast, the density of D2 receptors exhibited a more
      gradual gradient across the entire rostrocaudal extent of the nucleus accumbens.
      There was no significant rostrocaudal density gradient of either D1 or D2
      receptors in either the olfactory tubercle or caudate-putamen in the same tissue
      sections. A lateral-to-medial gradient of D2 receptors was also present in the
      nucleus accumbens. That is, while there was no difference in the density of D1
      receptors between the lateral core and medial shell subdivisions, the shell had a
      lower density of D2 receptors than did the core. The density of D1 and D2
      receptors in the mesolimbic and nigrostriatal systems was compared in groups of
      animals raised from 30 to 60 days of age in an impoverished condition, a group
      caged condition or an enriched condition. While the brain weight of enriched
      condition animals was higher than impoverished condition animals, there were no
      significant differences in the density of D1 or D2 receptors among the different
      groups. Apparently, the densities of D1 and D2 receptors in the brain are
      resistant to differential rearing conditions.

PMID- 1762681
TI  - Influence of N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced injury of
      dopaminergic nigrostriatal system on movement components of the instrumental
      reflex and motor thalamic neurons' reactions in the cat.
AB  - Peculiarities of excitation and inhibition in ventral lateral and ventral
      anterior thalamic neurons were studied in cats with movement disorders
      (bradykinesia and muscle rigidity) induced by injury of nigrostriatal
      dopaminergic neurons with neurotoxin N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine
      (5 mg/kg daily, intramuscularly for five days). As was shown in chronic
      experiments, mean discharge frequency of neurons related to initiation of upper
      limb movements increased. Excitation of these neurons coincided with movement
      initiation, flexion and extension becoming more prominent and prolonged as
      compared with normal animals. In parallel to those changes, bradykinesia
      developed. In acute experiments performed under ketalar anaesthesia and
      myorelaxine immobilization it was found that neurotoxin caused a decrease of the
      inhibition duration and effectiveness in relay and non-relay thalamic motor
      nuclei neurons. The inhibition deficiency was accompanied by a shortening of
      latencies of orthodromic responses evoked by red nucleus stimulation. Two days
      after the last neurotoxin injection, light microscope examination revealed that
      about 48% of neurons located in the pars compacta of substantia nigra were
      destroyed. Electron microscopic analysis showed hydropic changes in perykaria and
      dendrites in most neurons of the substantia nigra pars compacta that are typical
      of the light type of degeneration. Pathomorphological processes in the synaptic
      apparatus were also found. The content of dopamine in the caudate nucleus fell to
      30% as compared with intact animals. The suggestion is made that the deficiency
      of inhibition developed in motor thalamic neurons in response to nigrostriatal
      system destruction results from attenuation of dopamine-modulated direct
      GABAergic nigrothalamic influences and/or might be connected with increased
      inhibition of inhibitory interneurons of the same thalamic nuclei conditioned by
      pallidum disinhibition.

PMID- 1762682
TI  - Immunoelectron microscopic analysis of the synaptic connectivity of
      serotoninergic neurons grafted to the 5,7-dihydroxytryptamine-lesioned rat spinal
      cord.
AB  - The connections between the host and 5-hydroxytryptamine-containing neurons
      grafted to the spinal cord have been analysed using electron microscopic
      immunohistochemistry. Adult rats with 5,7-dihydroxytryptamine lesions of the
      brain and spinal cord received implants of embryonic medullary raphe neurons at
      three sites in the spinal cord. Eight to 10 months after grafting, the
      transplanted 5-hydroxytryptamine-positive neurons had formed extensive and
      complex contacts with spines, dendrites, perikarya and vesicle-containing
      structures in both the dorsal and ventral horns. Reinnervation of laminae IV-VI
      was less rich. In the graft itself, connections were also made between non
      immunoreactive varicosities and 5-hydroxytryptamine-containing dendrites, and
      somata, but the exact origin of the afferents was not determined. Outside the
      implant site, no obvious synaptic junctions onto grafted 5-hydroxytryptamine
      immunoreactive boutons were obvious, although labelled and unlabelled
      varicosities were often in close apposition. Synaptic junctions in the dorsal
      horn were predominantly symmetric, with the presynaptic varicosity containing
      mostly small agranular vesicles. By contrast, in the ventral horn most junctions
      were asymmetric, while the presynaptic element contained both small agranular and
      large dense-core vesicles. The results demonstrate that the types of synaptic
      contacts formed between the grafted 5-hydroxytryptamine neurons and the host
      spinal cord are remarkably similar to those found in intact spinal cord. In
      addition, the division of morphological differences that exists between 5
      hydroxytryptamine-containing boutons in the normal dorsal vs ventral horns is
      also apparent in the transplanted animals. Finally, there appear to be present
      several anatomical substrates for the regulation by the host of 5
      hydroxytryptamine output from the grafted neurons.

PMID- 1762683
TI  - A comparison of D1 receptor binding and mRNA in rat brain using receptor
      autoradiographic and in situ hybridization techniques.
AB  - D1, a subtype of the dopamine receptors, is widely distributed in the nervous
      system and has been shown to be positively coupled to adenylate cyclase. Using a
      combination of in vitro receptor autoradiographic and in situ hybridization
      techniques, the present study examines the co-distribution of D1 receptor binding
      sites and D1 receptor messenger RNA in adjacent rat brain sections. D1 receptor
      binding sites were labeled using the selective antagonist [3H]SCH23390 (4.6 nM)
      in the presence of 1 microM ketanserin, while the D1 receptor messenger RNA was
      visualized with a 35S-labeled riboprobe corresponding to a region between
      transmembrane domains III and VI of the rat D1 receptor (bp 383-843). Analysis of
      serial sections suggested a good agreement between D1 receptor binding and
      messenger RNA in several brain regions, including the paleocortex, caudate
      putamen, nucleus accumbens, amygdala and suprachiasmatic nucleus. Marked
      discrepancies between D1 receptor binding and messenger RNA were observed in
      other brain regions including the entopeduncular and subthalamic nuclei,
      substantia nigra (pars reticulata), hippocampus and cerebellum. While technical
      considerations may contribute to these results, much of the discordance between
      the distributions is likely due to the differential localization D1 receptor
      messenger RNA in cell bodies and receptor binding sites on fibers and may provide
      insights into receptor synthesis, transport and membrane insertion. In the basal
      ganglia, for instance, D1 receptors are synthesized in the striatum and are
      either transported to efferent projections in areas such as the substantia nigra,
      or remain localized in striatal cells bodies. Ibotenic acid lesions in the
      striatum are consistent with these conclusions and demonstrate a coordinate loss
      of D1 receptor binding and messenger RNA in the caudate-putamen that is
      accompanied by a degeneration of fibers projecting to substantia nigra and a loss
      of D1 binding in the pars reticulata. Neurons in the dentate gyrus and in the
      granular layer of the cerebellum, on the other hand, synthesize D1 receptors and
      transport them entirely to either their dendritic or axonal fields, respectively,
      in the molecular layer. This analysis provides a better understanding of
      dopaminergic receptor systems in the CNS and their anatomical organization.

PMID- 1762684
TI  - Chronic ascorbate potentiates the effects of chronic haloperidol on behavioral
      supersensitivity but not D2 dopamine receptor binding.
AB  - Ample behavioral evidence suggests that ascorbate parallels the action of
      haloperidol, a widely used neuroleptic. To determine the extent to which this
      parallel extends to chronic treatment, 21 days of exposure to ascorbate (100 or
      500 mg/kg) alone or combined with haloperidol (0.5 mg/kg) were assessed on
      stereotyped behavior and neostriatal D2 dopamine receptor binding in rats. Our
      results indicate that when challenged with the dopamine agonist, apomorphine (0.5
      mg/kg), animals chronically treated with haloperidol or high-dose ascorbate alone
      display a supersensitive sniffing response relative to controls, while animals
      chronically treated with the combination of haloperidol and high-dose ascorbate
      display a further potentiation of sniffing relative to the haloperidol groups. In
      addition, [3H]spiperone saturation studies showed, as expected, an up-regulation
      of striatal D2 dopamine receptors in rats treated with haloperidol as reflected
      by a change in receptor density (Bmax) but not affinity (KD). Ascorbate
      treatment, however, had no effect on D2 receptor density or the distribution of
      [3H]apomorphine in whole brain. Even though chronic treatment with the
      haloperidol-high-dose-ascorbate combination produced an up-regulation of striatal
      D2 dopamine receptors, this treatment did not cause a further up-regulation
      relative to haloperidol alone nor did it have any effect on [3H]apomorphine
      distribution. Taken together, these findings indicate that although chronic
      ascorbate produces behavioral supersensitivity to apomorphine through central
      mechanisms, they appear to differ from those induced by chronic haloperidol.

PMID- 1762685
TI  - Development of the endopiriform nucleus and the claustrum in the rat brain.
AB  - Long-survival [3H]thymidine autoradiography was used to quantitatively determine
      the time of origin of neurons in the endopiriform nucleus and the claustrum in
      rats killed on postnatal day 60 after their dams received two consecutive daily
      injections of [3H]thymidine on embryonic day E13 and E14, E14 and E15, ... E21
      and E22. The claustrum originates late, on E15 and E16, and has a strong gradient
      in the longitudinal direction, posterior (older) to anterior (younger). In
      contrast, the endopiriform nucleus originates early, on E14 and E15, and lacks a
      longitudinal gradient but has a strong one in the vertical direction, ventral
      (older) to dorsal (younger). Sequential-survival [3H]thymidine autoradiography
      was used to qualitatively determine the germinal sources and settling sites of
      endopiriform and claustral neurons in embryonic rats. The dams received a single
      injection of [3H]thymidine on either E14 (to heavily label older endopiriform
      neurons) or E16 (to heavily label younger claustral neurons) and were killed in
      sequential 24-h intervals. Neurons in the presumptive endopiriform nucleus settle
      within two to three days after their peak time of neurogenesis while those in the
      presumptive claustrum take approximately five days to settle after their peak. It
      is postulated that endopiriform neurons are generated in the palliostriatal
      ventricular angle, the neuroepithelium that forms a wedge between the primordia
      of the neocortex and the basal ganglia, and that claustral neurons are generated
      in the neocortical neuroepithelium. Divergent developmental patterns between the
      endopiriform nucleus and the claustrum support the anatomical evidence that these
      nuclei have different connections. Furthermore, neurogenetic gradients in the
      claustrum correlate with the pattern of anatomical connections between the
      claustrum and the neocortex.

PMID- 1762686
TI  - Expression of c-JUN, JUN B and JUN D proteins in rat nervous system following
      transection of vagus nerve and cervical sympathetic trunk.
AB  - Expression of c-JUN, JUN B and JUN D proteins was investigated in axotomized
      neurons following transection of the vagus nerve and the cervical sympathetic
      trunk in the rat. Vagotomy induced the expression of c-JUN and JUN D in the
      nodose ganglion, dorsal motor nucleus of the vagus nerve and nucleus ambiguus,
      whereas JUN B was not expressed in these areas, c-JUN and JUN D appeared after 10
      h in the nodose ganglion and after 24 h in the dorsal motor nucleus of the vagus
      nerve with a maximum of immunoreactivity after 48 h. The c-JUN protein remained
      expressed at an increased level up to 100 days, whereas the immunoreactivity of
      JUN D declined after five days. Crush of the vagus nerve initially evoked an
      intense expression of c-JUN and JUN D, but in the course of regeneration the
      expression of c-JUN and JUN D had returned to more basal levels after 100 days.
      Similar to vagotomy, application of colchicine and vinblastine on to the intact
      vagus nerve induced expression of c-JUN and JUN D. On the other hand, application
      of lidocaine prior to vagotomy did not prevent the expression of these proteins.
      Transection of the cervical sympathetic trunk induced expression of c-JUN and JUN
      D, but not of JUN B, in the preganglionic sympathetic neurons of thoracic spinal
      cord. In these neurons, expression of c-JUN was still enhanced after 60 days
      whereas JUN D had returned to basal level. One hour after vagotomy, c-JUN and JUN
      B were transynaptically expressed in the area of central termination of sensory
      vagal neurons and declined within 10 h to basal levels. JUN D showed a late onset
      of expression, it appeared after 5 h and persisted for 60 days in this area. We
      postulate that the expression of c-JUN and JUN D in axotomized neurons is induced
      by deprivation of a target-derived suppressor.

PMID- 1762687
TI  - Identification of a new non-neuronal cell type in rat olfactory epithelium.
AB  - We have examined adult and embryonic rat olfactory epithelia by
      immunohistochemical techniques using the monoclonal antibody 1A-6, which was
      raised against embryonic rat olfactory epithelia. A heretofore unidentified cell
      type, reactive with the monoclonal antibody 1A-6, was observed scattered within
      the epithelium. The 1A-6 reactivity of these cells is most intense on the
      microvilli projecting from the luminal cell surfaces. For several reasons, we
      believe these cells are not neurons but a distinct subpopulation of supporting
      cells or some other sort of non-neuronal cells. (1) They have no identifiable
      axonal process, are not reactive with an antibody against olfactory marker
      protein, and are not in juxtaposition with trigeminal axons. (2) They survive
      ablation of the olfactory bulb. (3) Their nuclei lie within the supporting cell
      layer, and they resemble supporting cells morphologically and in their
      [3H]thymidine birthdating and turnover characteristics. However, the 1A-6
      positive cells fail to react with the general supporting cell-specific monoclonal
      antibody SUS-1 [see Hempstead J. L. and Morgan J. I. (1983) Brain Res. 188, 289
      295] a finding which suggests that they are not typical supporting cells.
      Immunoreactivity to 1A-6 is developmentally regulated. Immunohistochemical
      preparations of almost all tissues we examined showed widespread reactivity in
      the embryo but a much more restricted pattern in the adult. In the olfactory
      epithelium of the fetus, the luminal surfaces of all cells, including supporting
      cells and olfactory receptor cells and cilia, are reactive, while in the adult
      only the non-neuronal cell subpopulation shows this reactivity. We also found
      that during the reconstitution of olfactory epithelium which occurs in response
      to olfactory bulbectomy-induced neuronal degeneration, fetal patterns of 1A-6
      reactivity are not re-expressed, i.e. the only 1A-6-positive cells are the non
      neuronal cells seen in unperturbed adult olfactory epithelium. Preliminary
      biochemical analyses of membrane fractions from E19 brain and from adult
      olfactory mucosa indicate that the 1A-6 reactivity is associated with two bands,
      having molecular weights of 42,000 and 46,000 on Western blots.

PMID- 1762688
TI  - A morphometric evaluation of the effects of trichloroethylene and
      dichloroacetylene on the rat mental nerve. Preliminary results.
AB  - Morphometric analysis was used to compare the effects of trichloroethylene (Tri)
      and dichloroacetylene (Dca) on the fibre parameters of the trigeminal nerve.
      Treated animals were clearly separated from controls according to a discriminant
      analysis. Furthermore, in the class of nerve fibres defined by a clustering
      analysis and corresponding to the largest fibres, myelin thickness was
      significantly decreased in the Dca group, but less so in the Tri group. In the
      group of the smallest fibres however, the myelin thickness was significantly
      increased by the treatments, but especially by Tri. Such a variability in the
      effects of Tri has already been demonstrated. Mechanisms for this are quite
      unclear although demyelination could be involved as already suggested. Our
      results thus show the ability of Tri and Dca to alter nerve parameters but
      probably with different modes of action depending on the size of the fibre.

PMID- 1762689
TI  - Arachidonic acid metabolism in cultured astrocytes: presence of 12-lipoxygenase
      activity in the intact cells.
AB  - In our previous study, it was revealed that the exogenous arachidonic acid is
      mainly metabolized by the lipoxygenase pathway in the cell-free homogenate of
      cultured astrocytes. This is apparently in contrast with other studies reporting
      production and release of the cyclooxygenase products (prostaglandins and
      thromboxanes) by cultured astrocytes. To help specify the reason for this
      discrepancy, the metabolism of endogenous arachidonic acid in the intact
      monolayer of cultured astrocytes was examined. When the astrocytes were
      stimulated with calcium ionophore A23187, a peak coeluted with authentic 12
      hydroxyeicosatetraenoic acid (12-HETE) on reverse-phase high-performance liquid
      chromatography (RP-HPLC) was observed. Formation of this peak was not affected by
      indomethacin, a speciic inhibitor for cyclooxygenase, but completely inhibited by
      BW755C, an inhibitor for both cyclooxygenase and lipooxygenases. Furthermore, the
      ultraviolet spectrum of the substance giving this peak agreed well with that of
      authentic 12-HETE. The amount of 12-HETE formed and released by the astrocytes
      was estimated to be 293.1 ng/mg protein/1 h. Taken together, these results
      suggest that the endogenous arachidonic acid is mainly metabolized by 12
      lipoxygenase in the intact monolayer of astrocytes.

PMID- 1762690
TI  - Rapid interaction of tetraethylammonium with delayed K+ channel in mammalian
      brain neuron.
AB  - In order to study the rapidity of interaction between tetraethylammonium (TEA)
      and the delayed K+ channel of the mammalian brain neuron, TEA was applied to
      isolated rat hippocampal pyramidal neurons in a time-controlled sequence with a
      voltage step using a concentration clamp technique. TEA at a concentration of 30
      mM, externally applied, started to decrease the delayed K+ current (IKD) without
      any detectable delay after the onset of the drug application. The inhibitory
      action of TEA reached a steady state within 10 ms while the full recovery from
      the inhibition required 20-30 ms after removing TEA from the external solution.
      Ba2+ at a concentration of 30 mM also reduced the IKD without any detectable
      delay. However, it took 40-60 s to reach the steady state of inhibition. Full
      recovery from the inhibition by Ba2+ was obtained around 60 s after removal of
      Ba2+ from the external solution. It is suggested that the interaction of TEA with
      the delayed K+ channel is much faster than that of Ba2+.

PMID- 1762691
TI  - Transient forebrain ischemia of three-minute duration consistently induces severe
      neuronal damage in field CA1 of the hippocampus in the normothermic gerbil.
AB  - We examined the effect of transient forebrain ischemia of 2-, 3-, 4- and 5-min
      duration on the development of delayed neuronal death in field CA1 of the
      hippocampus in the gerbil whose brain temperature was maintained at 37 degrees C.
      Transient ischemia of 3- and 4-min duration caused almost the same maximal damage
      in field CA1 as observed in the gerbils subjected to 5-min ischemia. A
      detrimental factor inducing delayed neuronal death in field CA1 may be already
      set up during the first 3 min after the onset of ischemia in the gerbil whose
      brain temperature is maintained at normothermic levels.

PMID- 1762692
TI  - Effect of bright light in the morning on diurnal variations of pineal indoles in
      NZBWF1 mice.
AB  - Exposure to bright light (2000 lx) for 2 h at the beginning of a 12 h light
      period (10 lx) resulted in about 1 h advances in the onset and termination of N
      acetylserotonin (NAc5HT) synthesis in the pineal gland of NZBWF1 strain mice
      compared with those in mice not exposed to bright light. These effects are in
      contrast with the effect of exposure to bright light throughout the light period,
      which delayed the onset of pineal NAc5HT synthesis in NZB mice. The possible
      relationship of these effects with the mechanism of action of phototherapy of
      human affective disorder is discussed.

PMID- 1762693
TI  - Production of an antiserum using a fusion protein produced by a cDNA for rat
      choline acetyltransferase.
AB  - A fusion protein produced by a cDNA for rat choline acetyltransferase (ChAT)
      inserted into a translation vector was used for immunization of rabbits. An
      antiserum was obtained that could recognize a single protein band in immunoblot
      analysis of a partially purified enzyme preparation of the rat brain. The
      antiserum revealed ChAT immunoreactivity in the motoneurons and terminal-like
      structures in the neuropil of the ventral horn in cryostat sections of the
      cervical spinal cord of the rat. This antiserum may be of particular use to study
      the development of the cholinergic neuron.

PMID- 1762694
TI  - Muscle inactivity reduces the content of parvalbumin in rat thymic myoid cells in
      vitro.
AB  - We investigated the influence of muscle inactivity by the addition of 1 microM
      tetrodotoxin in culture medium (complete abolishment of spontaneous firings);
      feeding with 50 mM KCl in the culture medium (inactivation of action potentials
      by depolarization) and the addition of 50 microM dantrolene sodium in culture
      medium (excitation-contraction uncoupling) on the content of parvalbumin in a
      cultured rat thymic myoid cell line (R615B2: M cells) using a highly sensitive
      enzyme immunoassay for rat parvalbumin. This is the first report of the content
      of parvalbumin in thymic myoid cells. Our studies clearly show that the content
      of parvalbumin is significantly decreased in paralyzed M cells compared with
      controls which had continuous muscle contractions. It is strongly suggested that
      muscle contractile activity plays an important role on the expression of
      parvalbumin in thymic myoid cells.

PMID- 1762695
TI  - Alteration in hypothalamic monoamine metabolism of freely moving diabetic rat.
AB  - Changes in hypothalamic monoamine metabolism were investigated in freely moving
      streptozotocin (STZ)-induced diabetic rats by using in vivo microdialysis
      technique. Six weeks later, the animals were implanted with microdialysis probe
      (molecular weight cut-off index: 12,000-14,000) into the ventromedial portion of
      the hypothalamus (VMH). The dialysate was collected and loaded onto HPLC to be
      assayed for norepinephrine (NE), dopamine (DA), serotonin (5-HT) and their
      metabolites (MHPG, DOPAC and 5-HIAA). The concentration of NE was decreased in
      the dialysate from the VMH of diabetic rats, whereas there was no significant
      change in MHPG level. The concentrations of 5-HT and 5-HIAA were reduced in
      diabetic rats. The DA concentration was obviously increased accompanied by the
      reduction of DOPAC level. The observed changes in hypothalamic monoamine
      metabolism, especially the reduced NE release, may play an important role in the
      induction of hyperphagia in freely moving STZ-induced diabetic rats.

PMID- 1762696
TI  - Spectrin breakdown products increase with age in telencephalon of mouse brain.
AB  - Calcium activated proteolysis of brain spectrin produces characteristic breakdown
      products (BDPs), the concentrations of which increase markedly in many instances
      of brain pathology. Results reported here indicate that levels of the BDPs rise
      with age (3-30 months) in the telencephalon but not in the hindbrain of Balb/c
      mice. These observations suggest that spectrin breakdown is a pathologic
      biochemical marker which increases with age in some but not all brain regions.

PMID- 1762697
TI  - Hoechst 33342 a suitable fluorescent marker for Schwann cells after
      transplantation in the mouse spinal cord.
AB  - Purified rat Schwann cells labeled with Hoechst 33342 were transplanted into a
      lysophosphatidyl choline induced myelin lesion of the adult shiverer mouse spinal
      cord. Remyelination by grafted Schwann cells within the lesion was evidenced by
      codetection of Hoechst labeled Schwann cells and P0 (peripheral myelin protein)
      immunolabeled myelin on serial cryostat sections and confirmed on adjacent sec
      ions by electron microscopy. These data show that the Hoechst-shiverer model is
      an excellent model which can be used in intraspinal transplantation of myelin
      forming cells to demonstrate the origin of the newly formed myelin. Using this
      model, we bring the unquestionable evidence that cultured Schwann cells are
      capable after transplantation to participate with host oligodendrocytes in repair
      of a myelin lesion of the central nervous system.

PMID- 1762698
TI  - Carbachol-phorbol ester interactions at muscarinic receptors modulating dopamine
      release from rabbit striatal slices.
AB  - Both 4-beta-12,13-dibutyrate phorbol-ester (PDBu) (EC50% = 82 +/- 12 nM) and
      carbachol (EC50% = 2.3 +/- 0.3.5 microM) enhanced dopamine (DA) release from
      rabbit striatal slices. No additivity was observed when slices were treated
      simultaneously with 0.1 microM PDBu and 10 microM carbachol. Pretreatment with
      PDBu (0.01-0.1 microM) abolished carbachol-induced facilitation of DA release.
      Pretreatment with carbachol (3-100 microM) antagonized the enhancement in DA
      release produced by PDBu. The effect of carbachol was blocked by atropine (0.1
      microM) and not by hexamethonium (10 microM). The effect of PDBu was not modified
      by the acetylcholine receptor (AChR) antagonists. If muscarinic (MAChR) MAChR
      were blocked by atropine (0.1 microM), pretreatment with carbachol failed to
      antagonize PDBu-induced facilitation of DA release. This is the first report to
      indicate that activation of M1-MAChR by an agonist prevents the effects of an
      active phorbol-ester. We suggest that activation of M1-MAChR enhances DA release
      possibly through activation of PKC.

PMID- 1762699
TI  - Effect of amygdaloid kindling on the high- and low-affinity [3H]TCP binding sites
      of the rat CNS.
AB  - The regulation of the binding sites of [3H]TCP, a non-competitive ligand of the N
      methyl-D-aspartate (NMDA) receptor, was studied on membranes prepared from
      different CNS regions of amygdaloid-kindled rats. The high-affinity binding sites
      (KdH = 4.2-7.4 nM), identified as the NMDA-gated ion channels, were not affected
      by kindling or by a daily injection of TCP (5 mg/kg before each electrical
      stimulation) which prevented kindling. These results suggest that the NMDA
      receptors participate to the establishment and not to the permanence of kindling.
      Kindling increases the number of low affinity [3H]TCP binding sites in the
      hippocampus (+21%, P less than 0.01) without change of the affinity (KdL = 340
      nM). In the striatum both KdL and BmaxL were increased (3.3-4.4 fold, P less than
      0.001) in animals pretreated with TCP before each electrical stimulation for 20
      days. These last results argue in favour of a function of the low-affinity
      [3H]TCP binding sites, the nature of which remains to be determined.

PMID- 1762700
TI  - Inhibitory action of acetylcholine, baclofen and GTP-gamma-S on calcium channels
      in adult rat sensory neurons.
AB  - High- and low-voltage activated calcium channel currents (HVA and LVA) were
      inhibited by acetylcholine (10-100 microM) and baclofen (10 microM) in adult rat
      sensory neurons. This modulatory effect was present on dihydropyridine
      (nifedipine 1 microM) and/or omega-conotoxin (3.2 microM, 2-5 h incubation)
      insensitive components and was insensitive to holding potentials (Vh -50 to -90
      mV). GTP-gamma-S (100 microM) prolonged calcium channel current activation in a
      time- and voltage-dependent manner. On the other hand, the current amplitude
      reduction induced by muscarinic and GABAB receptor activation, was not relieved
      by a 50-ms conditioning prepulse to +50 mV. This suggests the possibility of an
      alternative voltage-independent modulation mechanism.

PMID- 1762701
TI  - Battery burn.

PMID- 1762702
TI  - Fighting AIDS.

PMID- 1762703
TI  - What about Halcion?
AB  - Although Halcion has received a great deal of attention and scrutiny, Halcion and
      the other benzodiazepines have a place in the pharmacotherapy of anxiety, panic,
      and sleep disturbances. Obviously, any physician's prescribing practices are
      going to be influenced by a variety of factors, including the popular press, to
      some extent. However, by paying careful attention to prudent and appropriate
      prescribing practices, following indications and guidelines for safety, efficacy,
      and patient acceptance, and by prescribing Halcion with the same cautions one
      would prescribe any other short-acting benzodiazepine or other hypnotic, this
      medication can be safe, efficacious, and a useful adjunct to the treatment of
      insomnia. Side effects--even such rare ones as musical hallucinations--will
      occur, to a greater or lesser extent, as with any medication, but these can be
      managed by the prudent physician, taking into account the risk/benefit
      considerations of Halcion, or any benzodiazepine, as a physician would in
      prescribing any medication for any reason.

PMID- 1762704
TI  - A time for coming together.

PMID- 1762705
TI  - Advance directives for health care: clinical implications.
AB  - With the passage of new legislation concerning living wills, or advance
      directives for health care, the MSNJ Committee on Biomedical Ethics offers its
      resources to the physicians of the state including distribution of educational
      material and provision of sample advance directive forms.

PMID- 1762706
TI  - Oncogene probes in the diagnosis of malignant lymphoma.
AB  - The authors discuss the utility of oncogene probes to differentiate a case of
      follicular non-Hodgkin's lymphoma from follicular lymphoid hyperplasia. The case
      report concerns a 50-year-old white male; physical examination revealed
      generalized, marked lymphadenopathy.

PMID- 1762707
TI  - Musical hallucinations and triazolam use.
AB  - Musical hallucinations developed in a healthy 57-year-old man after using
      hypnotic triazolam (Halcion) for eight nights; the hallucinations continued for
      over one year. Although a causal relationship to triazolam cannot be proved, use
      of this drug has been associated with other bizarre alterations of memory.

PMID- 1762708
TI  - Ethical aspects of oncologic practice.
AB  - Oncologists must consider the ethical implications of all of their efforts. The
      patient's welfare and the likelihood of benefit from each therapeutic maneuver
      should be primary concerns. The author presents a set of general principles and
      guidelines for the care of cancer patients and others with incurable diseases.

PMID- 1762709
TI  - Colonic necrosis in the hemolytic uremic syndrome.
AB  - A previously healthy 14-year-old male survived extensive colon resection and
      ileostomy for acute colonic necrosis. The diagnosis of hemolytic uremic syndrome
      was made and intensive postoperative care was required. He made a complete
      recovery.

PMID- 1762710
TI  - The founding of the MSNJ Auxiliary.
AB  - The MSNJ Auxiliary was founded on June 7, 1927. Mrs. Miriam Lee Lippincott served
      as its first president and guided the Auxiliary in its early years. Mrs.
      Lippincott's medical contributions are outstanding. The MSNJ Auxiliary soon will
      celebrate 65 years of service to the medical community.

PMID- 1762711
TI  - A case for inservice education.

PMID- 1762712
TI  - Democracy at work.

PMID- 1762713
TI  - Nursing education: where do we go now?

PMID- 1762714
TI  - Hydration & ageing.

PMID- 1762715
TI  - Quenching thirst.

PMID- 1762716
TI  - Off her file!

PMID- 1762717
TI  - Proud of its involvement: Manawatu Polytechnic's role in the development of care
      giver courses.

PMID- 1762718
TI  - The right to speak out.

PMID- 1762719
TI  - Cup/disk ratio in branch retinal vein occlusion.
AB  - Recent reports have been attempted to evaluate, without obtaining a positive
      result, whether the reduction in size of the optic disc may influence the
      pathogenesis of central retinal vein occlusion. Cup/disc ratios in the fellow eye
      of 67 patients with branch retinal vein occlusion were compared with the ratios
      of 67 controls matched to cases for age, sex and refractive defect. There was no
      significant difference between cup/disc ratios of the two groups. These results
      suggest that the anatomical features of the optic disc are of no importance in
      the development of branch retinal vein occlusion.

PMID- 1762720
TI  - Ophthalmic complications in patients with paranasal sinus mucopyoceles.
AB  - We examined 45 (23 male and 22 female) Japanese patients with paranasal sinus
      mucopyoceles associated with ophthalmic complications. The patients ranged in age
      from 31 to 87 years. The patient distribution by the affected sinus was as
      follows: maxillary sinus alone, 17 patients; ethmoidal sinus alone, 9 patients;
      frontoethmoidal sinuses, 9 patients; frontal sinus alone, 7 patients, and other
      multiple sinuses, 3 patients. Thirty-nine mucoceles and 6 pyoceles were
      identified. Ophthalmic signs and symptoms included lid swelling, ocular pain,
      pseudoptosis, proptosis, displacement of the eyeball, epiphora, slight blurring
      of vision, severely decreased visual acuity, visual field abnormality, diplopia,
      disk edema, retinoichoroidal folds and increased intraocular pressure. Of the 45
      patients, 1 had a history of sinus trauma and 29 had a history of sinus surgery.

PMID- 1762721
TI  - Orbital tumor in an infant with acute monocytic leukemia associated with
      chromosome 5q-,t(9p-11q+),11p+.
AB  - We examined an 8-month-old infant with left proptosis, chemosis and orbital mass.
      A computed tomographic scan revealed a left orbital tumor. An anorectal nodule
      was also found. Results of the hematologic study showed poorly differentiated
      acute monocytic leukemia (M5 according to the French-American-British
      classification). Chromosomal analysis disclosed 46, XX,5q-,t(9p-;11q+),11p+. We
      believe that our patient represents a rare case of orbital tumor in acute
      monocytic leukemia associated with chromosomal abnormalities.

PMID- 1762722
TI  - Optic nerve hypoplasia associated with porencephalia in a girl and retinitis
      pigmentosa in her sister.
AB  - An 18-year-old women (case II-4) had decreased visual acuity, visual-field
      defects and small optic disks bilaterally that remained unchanged for a follow-up
      period of 9 years. The patient also had an abnormal cavity within the cerebral
      hemispheres. Her 29-year-old sister (case II-1) had night blindness, bone
      corpuscle pigmentation in mottled retinas and nonrecordable electroretinographic
      responses bilaterally. We believe that the occurrence of optic nerve hypoplasia
      associated with porencephalia in one patient and retinitis pigmentosa in her
      eldest sister may be rare.

PMID- 1762723
TI  - Effects of ionizing radiation on human conjunctival epithelial cells: a clinical
      and cytologic study.
AB  - In order to identify early and late modifications induced by ionizing radiation
      on the conjunctival surface, we studied 10 patients irradiated for paranasal
      sinus tumors. A clinical and morphological study of conjunctival epithelium
      (using an impression cytology technique) was performed; 5 patients were examined
      during and the others after treatment. Actinic conjunctivitis and keratitis,
      observed during treatment, reappeared within a few months after the end of
      radiotherapy. At a threshold dose of 25 Gy, chronic nuclear changes and cellular
      surface disorganization of the conjunctival epithelium were found--these
      progressed and persisted. Our data support the importance of careful monitoring
      of such irradiated patients and the benefit of planning a prospective clinical
      study to evaluate the effects of available drugs (all-trans retinoic acid) in the
      treatment of these lesions.

PMID- 1762724
TI  - Retinal early receptor potential in retinitis pigmentosa: correlations with
      visual field and fluorangiography estimates.
AB  - The flash induced electroretinogram (ERG) and early receptor potential (ERP) were
      recorded in a population of patients with definite diagnosis of retinitis
      pigmentosa in the context of a study protocol including a complete diagnostic
      screening. ERPs were evoked by full-field 20-joule stimuli (5 stimuli at 10 min
      of interval in dark adaptation); recording was by skin electrodes positioned at
      the inferior orbital margin; amplifiers were set at 10-10,000 Hz. The flash ERG
      was absent or markedly abnormal in all cases, even at an early stage of
      development of the retinitis, while ERPs (with a normal morphology, latency of
      the R1 component increased and a reduced amplitude compared to normal controls)
      could be identified unambiguously in all cases. The amplitude reduction was
      highly correlated with the severity of the disease as determined by kinetic
      perimetry and fluorangiography.

PMID- 1762725
TI  - Electrophysiological findings in peripheral uveitis.
AB  - Nine patients with peripheral uveitis were studied clinically and
      electrophysiologically. Electroretinographic findings varied widely from
      supernormal to nonrecordable responses, depending on the disease duration and
      severity. These results suggest that the pathology in peripheral uveitis is not
      necessarily limited to the inferior pars plana but can be diffuse and widespread.
      In the final stage of the disease, the fundus showed extensive pigmentation and
      narrow retinal arteries associated with a nonrecordable electroretinogram,
      similar to retinitis pigmentosa. Burned-out peripheral uveitis should be
      considered in the differential diagnosis of secondary pigmentary degeneration.

PMID- 1762726
TI  - Influence of amblyopia on high-pass resolution perimetry.
AB  - Seventeen subjects with amblyopia due to strabismus and anisometropia were
      examined using high-pass resolution perimetry. In addition to the standard
      technique, testing the 5-30 degrees visual field, an optional program testing the
      central 4 degrees visual field was used. Threshold elevation was confined to the
      central 4 degrees visual field and strongly correlated with visual acuity,
      expressed as minimum angle of resolution. Standard high-pass resolution perimetry
      did not reveal any significant abnormalities in the amblyopic subjects. In
      conclusion, the technique is useful for the diagnosis of ocular or neurologic
      disorders also in subjects with a high degree of amblyopia.

PMID- 1762727
TI  - [Current approaches to the development of a system of automated diagnosis of
      osteochondrodysplasias in children].
AB  - On the basis of studying of data on 1469 patients there is proposed a methodology
      of development of a system of automated diagnosis of osteo-chondrodysplasia in
      children. It is based on registration of the course peculiarities, variety of
      clinical and genetic forms, inter- and intragroup similarity and progredient
      course of diseases of the type. At the first stage there have been made a complex
      analysis of formalized clinico-roentgenologic signs of osteo-chondrodysplasia
      with the aid of "Rbase-5000" program package. Osteo-chondrodysplasia course
      regularities, revealed in this way, were used further on in the process of an
      expert system development for their automated diagnosis.

PMID- 1762728
TI  - [Pathogenesis of stenosing ligamentitis].
AB  - On the basis of complex examination of women with stenosing ligamentitis,
      including investigations of hormonal background in accordance with the clinical
      criteria, hormonal smears, radioimmunological assay of the initial vegetative
      tonicity, blood circulation by means of rheography, it has been concluded that
      the stenosing ligamentitis is the local expression of general dystrophy of the
      connective tissue due to hormonal shift, pathology of the vegetative nervous
      system and the circulatory system.

PMID- 1762729
TI  - [Comparative analysis of osteotomy methods in open setting of congenital hip
      dislocation in children].
AB  - There is given an analysis of the treatment of 89 children (99 joints) with
      congenital femur dislocation, which were subjected to corrective osteotomy at the
      open setting by three different methods. There are shown the advantages of
      oblique osteotomy, proposed by the authors. There have been developed and
      substantiated the indications for application of oblique and transversal
      osteotomy of the femur.

PMID- 1762730
TI  - [Treatment of bilateral dysplastic instability of the hip joints].
AB  - In the article are described the peculiarities of the treatment tactics and
      presented an integral assessment of treatment efficiency of 563 patients with
      bilateral dysplastic instability of the hip joints (bilateral dislocation,
      bilateral primary subluxation, dislocation of one and subluxation of the other
      joint), carried out in the hospital of the institute named after M. I. Sitenko in
      1955-1989. There is noted a necessity of achievement of anatomo-functional
      symmetry of the hip joints as a strategic aim of treatment and an expediency of
      application of "anticipation estimate" principle while planning the treatment
      measures for these patients.

PMID- 1762731
TI  - [Rehabilitative therapy after correction of congenital clubfoot in children].
AB  - There have been analysed 49 children with congenital club foot (79 feet). All
      patients before arrival were treated according to the common methods and 42
      children (64 articulations) were subjected to operative or apparatus-made
      correction of the club foot recurrence. In spite of the treatment obtained all
      children arrived with the residual signs of club foot. There are described the
      mechanisms of the club foot recurrence development, proposed a method of stage-by
      stage redressment, needle and manual therapy realization.

PMID- 1762732
TI  - [Characteristics of foot blood supply in rigidity of the great toe].
AB  - By means of angiography, made in 20 patients with rigidity of the first toes due
      to osteoarthrosis, there have been revealed chronic deficiency of blood
      circulation in the foot tissues, especially in its antero-internal section. Blood
      circulation deficiency is due either to the congenital anomaly of the foot
      vessels or to the consequences of their traumatic injuries. Blood supply
      deficiency results in degenerative-dystrophic changes of the first
      metatarsophalangeal articulations with development of their rigidity, aggravated
      by post-ischemic contracture of the foot muscles.

PMID- 1762733
TI  - [An echocardiographic study of the cardiovascular system in patients with
      kyphoscoliotic deformation of the spine in Marfan's syndrome].
AB  - In the work are presented the results of echocardiographic investigation of 19
      patients (aged 11-15) with kyphoscoliotic spine deformities at the Marfan's
      syndrome. The analysis of the obtained data has shown that the most common type
      of the cardiovascular system pathology in 78.9% of the examined children and
      adolescents was the II and III stage prolapse of the mitral valve. The changes of
      the heart cavity dimensions and the signs of the ventricle overloading have not
      been detected. Prolapse of the mitral valve cusps to the III stage was the most
      often accompanied by the root and aorta ascending section dilatation. The
      presence of the heart affection should be considered as one of the indications to
      carry out the corrective operations at the spine, allowing to reduce the heart
      overloading and decrease the probability and rate of progression of the cardiac
      disturbances, specific for this syndrome.

PMID- 1762734
TI  - [Effects of benzofurocaine, etaden and xanthinol nicotinate on reparative bone
      regeneration in animal experiments].
AB  - In the process of treatment of experimental close fractures of radius in rats by
      intramuscular administration of benzofurocaine (60 mg/kg), the regeneration
      processes of the bone tissue were activated to a greater degree than in case of
      administration of etadene (20 mg/kg) or xanthinol nicotinate (30 mg/kg). Under
      the influence of benzofurocaine, beginning on the 10-20-th day of the experiment,
      there have been noted the reorganization of young callus into the mature laminal
      bone. The preparations of comparison have demonstrated less expressed analogous
      action.

PMID- 1762735
TI  - [Possibilities of prognostication of complications in long bone fractures].

PMID- 1762736
TI  - [Some problems in the organization of medical aid in multiple and associated
      injuries].
AB  - On the local material are considered the cases of multiple and associated trauma
      according to the information of surgical department of the central regional
      hospital, bureau of forensic medical examination and traffic inspection. The
      results of the associated trauma treatment can be improved by means of timely
      first aid rendering at the place of an accident, short-term delivery of a patient
      to the hospital, extensive application of laparocentesis, operative intervention
      during the first hours of delivery to the hospital as well as by improvement of
      the ambulance and hospital work, further firm establishment of the sober mode of
      life and rigorous and centralized registration of patients with polytrauma.

PMID- 1762737
TI  - [Treatment of patients with ununited fractures and pseudarthrosis of crus bones
      using G. A. Ilizarov's method].

PMID- 1762738
TI  - [Rare forms of suppurative arthritis].

PMID- 1762739
TI  - [Talus distractor].

PMID- 1762740
TI  - [A device for performing of osteotomy and segmental resections of long bones].

PMID- 1762741
TI  - [A method of anterior spondylodesis].

PMID- 1762742
TI  - [Aplasia of the radius of the hand].
AB  - In the article is described the congenital pathology of the hand, characterized
      by the absence of one or several fingers with the corresponding metacarpal bones
      and bones of the wrist. There is given the clinical picture of 104 patients with
      the hand radius aplasia. There are singled out main forms of pathology, presented
      the data of the additional investigation methods (angiography, rheovasography,
      histologic structure of the affected hand tissues). There are presented the main
      principles of the hand radius aplasia treatment.

PMID- 1762743
TI  - [A device for external fixation using hollow rods].

PMID- 1762744
TI  - [A pivotal device for functional treatment of crus bone fractures].

PMID- 1762745
TI  - [Rubber hinges in prostheses].

PMID- 1762746
TI  - [Adaptive-compensatory changes in congenital disorders of the development of the
      locomotor system].

PMID- 1762747
TI  - [Conceptual model of the pathogenesis of instability of the shoulder joint].

PMID- 1762748
TI  - [Assessment of consolidation and temporary disability in fractures].

PMID- 1762749
TI  - [Index of surgical activity (for purposes of discussion)].

PMID- 1762750
TI  - [Life and activities of Fedor Rodionovich Bogdanov].

PMID- 1762751
TI  - [Liver diseases and changes in the locomotor system].

PMID- 1762752
TI  - [Several aspects of the surgical treatment of post-traumatic contractures and
      ankylosis of the elbow joint].
AB  - The authors have studied the results of treatment of 52 patients with inveterate
      damages of the elbow joint and different function disturbances as well as looked
      for the best variants of the operative treatment of contractures and ankylosis.
      They have analysed the results of treatment of 39 patients with inveterate and
      incorrectly consolidated elbow joint fractures and dislocation fractures in the
      period of 6 months--4 years after the operation. Excellent results were noted in
      9 patients, good in 13, satisfactory in 10 and unsatisfactory in 7 of them.
      Arthrolysis of the elbow joint in case of its inveterate damages is the method of
      choice. Arthroplasty is indicated in cast of fibro-osseous ankylosis, incorrectly
      consolidated fractures with the joint injury congruence disturbance, rheumatoid
      polyarthritis. The problem of control of cicatricial and commissural processes
      and development of heterotypic ossification is a very urgent one and requires
      special studying and working out of the control methods of these processes.

PMID- 1762753
TI  - [The significance of the dipyramidole echocardiography test in ischemic heart
      disease].
AB  - The diagnostic value of the dipyridamole echocardiography test was investigated
      in 46 patients who underwent coronary angiography due to suspected ischaemic
      heart disease. Twenty-two of 46 patients were found to have a narrowing of at
      least 70% one vessel. Twenty-four hour ECG monitoring was also performed on 19
      patients on the day of the dipyridamole test. The sensitivity and specificity of
      the two-dimensional echocardiography test (new wall motion abnormality) were
      72.7% and 62.5%. The ECG (V2-5-9) had a low sensitivity during the test (43.8%).
      Good agreement was found between the localization of the wall motion
      abnormalities and the site of anatomic narrowing in the ischaemic group. No
      significant ventricular arrhythmias were detected, and the sensitivity and
      specificity of ST-T changes were found to be 62.5% and 54.6% by means of Holter
      monitoring. The dipyridamole echocardiography test proved to be a suitable
      noninvasive method for the diagnosis of ischaemic heart disease and for the
      selection of patients for coronary angiography.

PMID- 1762754
TI  - [Primary hemostasis in mixed connective tissue disease].
AB  - Willebrand-factor antigen level and structure analysis, ristomycin-cofactor
      assay, beta-thromboglobulin and thromboxane metabolite estimations were performed
      in 22 patients with mixed connective tissue disease. High levels of Willebrand
      factor antigen and activity were detected in the presence of thrombocytopenia,
      previous thrombotic events, pulmonary vascular lesions and in the presence of
      circulating antiendothelial antibodies. Increased platelet activation was
      documented also in antibody positive cases and in thrombocytopenia. The
      alterations of endothelial and platelet functions may play important role in the
      development of vascular complications of mixed connective tissue disease.

PMID- 1762755
TI  - [Chromosome analysis in spontaneous abortion using direct preparation of
      chorionic villi].
AB  - Two hundred cases of spontaneous abortions were studied by analysing chromosomes
      directly from chorionic villi. Abnormal karyotypes were found in 52% of the
      investigated cases. Among the chromosome abnormalities the most frequent were the
      trisomies (56.7%) followed by polyploidy (23.1%), monosomy X (15.4%) and
      structural anomalies (4.8%). The rapid and relatively simple method is suitable
      for studying the causes of spontaneous abortions, and these information may be
      helpful also for genetic counselling.

PMID- 1762756
TI  - [Osteitis pubis].
AB  - Lytic degeneration of the pubic symphysis is a relatively rare entity. The
      present study is dedicated to the fact that the disease causes numerous
      diagnostic problems. Authors based on their three cases describe the clinical
      features and review the literature. It is stated that both from the aspect of the
      diagnosis and the result of the treatment, operative intervention is beneficial.
      In contraversion to numerous papers it is found that the described disease is
      often infectious and can be consequence of an infection of the urinary tract.

PMID- 1762757
TI  - [Idiopathic priapism in childhood].
AB  - The authors described the operation technique of the spongiocavernosum shunt in
      connection with a successfully operated patient. In their case the Quackels
      procedure was applied with minor modifications, since the conservative one wasn't
      successful. Their patient is perfectly healthy functionally too. The etiologic
      factors could not be clarified.

PMID- 1762758
TI  - [Position of the presidency of the Allied Association of Hungarian Medical
      Societies (MOTESZ) on the "Action Program"].

PMID- 1762759
TI  - [Search for human cancer genes].

PMID- 1762760
TI  - [Current concept of autism].
AB  - Childhood autism, the most characteristic subgroup of the broader PDD (pervasive
      developmental disorders) category, is the consequence of genetic or typically
      prenatal, organic factors causing cerebral damage. The resulting mental handicap
      lasts for a lifetime. It is characterized by a behavioural syndrome, that becomes
      recognizable between the 2.-3. year. The core of the syndrome is a deviant and/or
      retarded development of cognitive capacities and skills necessary for social
      relations, communication, fantasy and symbolic thinking. Almost all autistic
      people (95%) would not reach independence as adults, and most of them (75%) is
      mentally retarded as well. According to our calculations about 16,000 people are
      affected in Hungary, in a more or less serious degree, 2000 children among them.
      Their condition would require intensive, early and long lasting intervention:
      conditioning, training, education, and special social services. Today we do not
      possess the necessary organisational background, nor the professional training,
      and knowledge. For the early diagnosis, proper care and services the competence
      of child- and general psychiatrists, also of family doctors is indispensable. The
      author summarizes the most important available informations on the field first of
      all for those, who work in the general medical services.

PMID- 1762761
TI  - [The role of gastroesophageal reflux in the hemorrhaging of esophageal varices.
      Effect of endoscopic sclerotherapy].
AB  - From January 1st to December 31st 1987, 51 prospectively selected patients
      underwent 24-hour intraesophageal pH monitoring before, and 5 weeks after
      endoscopic paravariceal sclerotherapy (ESCL). Patients were divided into two
      groups: in group I. first pH monitoring was done 24 hours after acute variceal
      bleeding; in group II. one month after a previous bleeding episode.
      Gastroesophageal reflux (GER) was expressed by percentage of time below pH 4, and
      by average number of reflux episodes, lasting longer than 5 seconds, per hour. In
      group I. the time below pH 4 (10.3 +/- 2.05%) and the number of reflux episodes
      (24.4 +/- 4.2/h) were significantly higher, than those in group II. (2.57 +/-
      0.14%; 2.39 +/- 0.31/h). Pathologic GER parameters were significantly more
      frequent in group I. (50% and 73%), than in group II. (16.7% and 29.1%). ESCL
      significantly reduced GER in both groups of patients. In group I. GER remained
      pathologic at 12.5% and 20.8% of patients. In group II. time below pH 4 became
      normal at all of the patients, and only one of them has pathologic number of
      reflux episodes. Our data give evidence of GER having a possible causative role
      in initiating variceal bleeding. ESCL significantly reduces GER. This effect
      might contribute to long term results of ESCL.

PMID- 1762762
TI  - [Clinical usefulness of the dobutamine test in the diagnosis of coronary
      disease].
AB  - In the diagnostics of the coronary artery disease different exercise tests are
      well-known to be important. On the basis of the increasing number of publications
      of the eighties the authors examined the applicability of dobutamin stress test
      in 89 patients, whose anamnesis did not contain any justification of coronary
      artery disease. All patients were examined by coronarography. The authors
      compared the results of different tests with the results of coronarography. They
      found the sensitivity of dobutamin stress test significantly higher and its
      specificity--although not significantly--lower, than the dynamic treadmill tests,
      however the combination of the two methods resulted in very good sensitivity and
      acceptable specificity.

PMID- 1762763
TI  - [Rare cases of primary hyperparathyroidism].

PMID- 1762764
TI  - [Prinzmetal angina and syncope].
AB  - Authors report an unusual case of variant angina associated with unconsciousness.
      They were able to prove by coronary angiography the vasospasm of the circumflexus
      artery which was responsible for the morning attacks of the 35 year old patient
      with unconsciousness, ST segment elevation and high degree AV block.
      Unconsciousness was the first and earliest sign of the coronary vasospasm.

PMID- 1762766
TI  - [Current facts on the care of stomas].

PMID- 1762767
TI  - [Living with a stoma. Interview by Angelika Grimm].

PMID- 1762765
TI  - [Effect of antioxidants on the oxidative stress of red blood cells].
AB  - Antioxidant nomination covers a substance group of great variety, therefore, the
      determination of action mechanism of new antioxidants requires a complicated test
      system. The present work demonstrates this labour and time consuming procedure
      conducted on human red blood cells (RBCs) exposing them to "stress effect" with
      diluted hydrogen peroxide. It was studied how did these oxidative stress
      conditions affect the filtration parameters, lipid peroxidation, reduced
      glutathione content and superoxide dismutase activity of RBCs. It was attempted
      to reverse or influence the significant changes caused by "oxidative stress" with
      known antioxidants (vitamin E and uric acid).

PMID- 1762768
TI  - [Description of a profession: the stoma therapist].

PMID- 1762769
TI  - [Because the large size is dangerous].

PMID- 1762771
TI  - [The labyrinth].

PMID- 1762770
TI  - ["Woe be to those who publicly censure physicians"].

PMID- 1762772
TI  - The anatomy of the facial nerve.
AB  - The course of the facial nerve from its origin in the human brain-stem to the
      termination of its end fibers in the muscles of facial expression is reviewed in
      detail. The relation of the facial nerve to important adjacent structures is
      emphasized so that the aural surgeon is better prepared to explore in this
      intricate area.

PMID- 1762773
TI  - Management of facial nerve disorders.

PMID- 1762774
TI  - Surgical landmarks for the facial nerve.
AB  - A number of different approaches can be used to expose the facial nerve. The
      route taken will depend on the pathology and the portion of the nerve that
      requires exposure. When performing a parotidectomy approach to the extratemporal
      portion of the facial nerve, the tragal pointer is a key landmark, but other
      landmarks also should be used to identify the facial nerve safely. The lateral
      semicircular canal, the chorda tympani nerve, the digastric ridge, and the
      cochleariform process are some of the useful landmarks in the mastoid and middle
      ear. When performing a middle fossa approach, the superior semicircular canal,
      the greater petrosal nerve, and a window through the tegmen tympani into the
      attic are useful guideposts. The surgeon should use as many of the available
      landmarks as feasible to perform safe facial nerve surgery.

PMID- 1762775
TI  - Anatomic variations and anomalies involving the facial canal.
AB  - Congenital bony dehiscences in the facial canal result from incomplete closure
      during development and are observed in approximately 55% of temporal bones.
      Anomalies involving the facial canal frequently are encountered in malformations
      of the temporal bone. These anomalies include aberrations of the course of one or
      all of the segments of the canal; abnormal relation to the oval and round window;
      bifurcations and trifurcations of the nerve; and associations with dysplasia of
      the stapes, oval window, external ear canal, and auricle. Rarely, the facial
      nerve may be hypoplastic or totally absent. Two abnormal vessels occasionally may
      accompany the facial nerve in the Fallopian canal: a persistent stapedial artery
      and a persistent lateral capital vein.

PMID- 1762776
TI  - Testing facial nerve function.
AB  - A variety of facial nerve tests are now available. These tests can aid the
      clinician in discerning the site of lesion, estimating prognosis, assessing
      evidence of neoplastic or infectious involvement, and assisting in intraoperative
      facial monitoring.

PMID- 1762777
TI  - Facial nerve imaging.
AB  - A review of past, present, and potential future imaging of the facial nerve
      outlines the general technologic advances in radiology. The newer modalities
      provide more information than before; however, with more sophisticated
      technology, efficient use should be emphasized. A coordinated approach between
      the otolaryngologist and the radiologist is needed first to localize the most
      likely segment and then to perform a tailored radiographic study specifically for
      that segment. In this way, it is hoped that we can avoid unnecessary studies and
      achieve earlier diagnoses.

PMID- 1762778
TI  - Management of trauma of the facial nerve.
AB  - The general principles of management of trauma to the facial nerve from a variety
      of causes are presented and the indications for and timing of surgery are
      reviewed. Attention is given to management techniques unique to injuries of the
      extracranial, intratemporal, and intracranial divisions of the nerve.

PMID- 1762779
TI  - Differential diagnosis of facial nerve palsy.
AB  - The differential diagnosis of facial complex can be complex, but all efforts must
      be made to identify the cause so that appropriate treatment can be offered. This
      article presents a review of conditions associated with acute facial palsy and
      discusses the differential diagnosis of this condition. The focus is on the
      differentiation of other causes of acute facial palsy from the idiopathic, or
      Bell's type, which is a diagnosis of exclusion.

PMID- 1762780
TI  - Congenital and acquired facial nerve paralysis in children.
AB  - Facial nerve paralysis in children should be considered distinct from that which
      occurs in adults. The author submits a slightly different classification of
      facial nerve paralysis in children based on traditional thinking. Specifically,
      acquired facial nerve paralysis is thought to be influenced by both prenatal and
      postnatal factors. This segregated approach toward acquired paralysis should
      allow a clearer understanding of the pathophysiology of in utero factors.

PMID- 1762781
TI  - Management of the facial nerve in skull base surgery.
AB  - The facial nerve presents a significant obstacle to adequate surgical exposure of
      lesions involving the skull base. The evolution of various surgical approaches to
      the jugular foramen, petrous apex, and lateral facial approaches to the skull
      base aimed at preserving the seventh cranial nerve are reviewed. Methods and
      techniques in management of the intratemporal and extratemporal facial nerve are
      discussed.

PMID- 1762782
TI  - Medical management of idiopathic (Bell's) palsy.
AB  - Experience with treating more than 400 cases of Antoni's palsy, the findings of
      autoimmune reaction, and recent gadolinium-enhanced magnetic resonance imaging
      reports in "idiopathic" Bell's palsy verify the hypothesis that the disease
      results from a viral geniculate ganglionitis. The diagnosis no longer needs to be
      one of exclusion. We now are capable of establishing a positive diagnosis,
      permitting the clinician to initiate treatment with corticosteroids and acyclovir
      confidently. Facial nerve compression and electrotherapy are not advised. It is
      suggested that the term idiopathic Bell's palsy be replaced with Antoni's palsy
      as the first step in changing erroneous concepts of the past.

PMID- 1762783
TI  - Surgical decompression of idiopathic facial palsy.
AB  - There is no consensus on the cause of Bell's palsy, just as there is no proven
      medical therapy. Disregarding the numerous theoretic causes, preponderant
      anatomic, electrophysiologic, radiologic, clinical, and pathologic evidence
      supports entrapment at the medical foramen of the fallopian canal as a final
      common pathway resulting in facial nerve ischemia and degeneration. Middle
      cranial fossa decompression of the meatal foramen may benefit those patients most
      severely affected with Bell's palsy.

PMID- 1762784
TI  - Facial nerve grafting.
AB  - The techniques of facial nerve grafting have undergone several adjustments and
      refinements within the last 20 years. Those techniques that have stood the test
      of time are discussed, and new approaches to facial nerve grafting in the
      temporal bone are explored.

PMID- 1762785
TI  - Intraoperative facial nerve monitoring.
AB  - Facial nerve monitoring is one of the most exciting innovations in otologic
      surgery in the past decade. Intraoperative monitoring has been shown to reduce
      the probability of iatrogenic injury to the facial nerve during surgery. It saves
      surgical time and reduces the anxiety level of both patients and surgeons. There
      are several reasons to use facial nerve monitoring: The surgeon nerve knows when
      it will be needed in a particular case, the operating room personnel become
      familiar with the equipment, and the surgeon learns how to interpret the sounds
      produced by the monitor and how to correlate them with surgical manipulations
      around the facial nerve. Facial nerve monitoring has added another dimension of
      safety to otologic and neurotologic surgery and has reduced the incidence of
      facial weakness or paralysis in the authors' surgical practice.

PMID- 1762786
TI  - Rehabilitation of the paralyzed face.
AB  - Rehabilitation for facial paralysis is a highly individualized task that relies
      on a complex set of physical, physiologic, social, and emotional factors. A wide
      range of surgical techniques exist for establishing partial rehabilitation of
      facial expression and motion. The facial surgeon must analyze these factors and
      work with the patient in a realistic approach to the problem.

PMID- 1762787
TI  - Experimental nerve regeneration. A review.
AB  - The aim of peripheral nerve repair is to restore motor and sensory function,
      which requires more than just 10-0 sutures and a good microscope. The past decade
      has seen an explosion in the understanding of how nerves grow, and this
      information is being used to develop better treatments for nerve injuries. In the
      future, treatment will not be limited to the operating room, because
      postoperative adjuvant therapies will become increasingly more important in the
      management of nerve repairs. At the same time, advancement in manufacturing
      techniques, a better understanding of biomaterials, and the use of the laser will
      replace the time-honored techniques of surgical repair in many clinical settings.

PMID- 1762788
TI  - Cell and molecular anatomy of nicotinic acetylcholine receptor subunits and
      calcitonin gene-related peptide in the rat vestibular system.
AB  - In this report we demonstrate the pattern of calcitonin gene-related peptide
      (CGRP) mRNA and immunoreactivity in the central and peripheral vestibular system
      of the rat, using a CGRP cRNA probe and a polyclonal CGRP antiserum. We present
      evidence that somata in all regions of efferent vestibular neurons contain CGRP
      based on the correspondence between in situ hybridization (mRNA) and
      immunohistochemistry (mRNA translation product). CGRP immunohistochemistry
      (CGRPi) and in situ hybridization confirm that CGRPi axons and terminals present
      in the vestibular neuroepithelium are efferent in origin. Immunoelectron
      microscopy revealed an extensive innervation of the afferent vestibular pathway
      by CGRPi terminals that was not limited to the primary afferent chalice, as
      previously reported by Tanaka et al. (Brain Res 1989;504:31-5). An efferent
      neuromodulatory role of CGRP can be inferred from the distribution of terminals
      found on the primary afferent fibers, and type I and type II hair cells. In
      addition, we present evidence that nicotinic acetylcholine receptor (nAChR)
      subunit mRNA is expressed by primary afferent cell bodies. On the basis of these
      data, a hypothetical molecular mechanism of vestibular efferent modulation of the
      primary afferent pathway is proposed.

PMID- 1762789
TI  - The protective effects of tirilated mesylate (U74006F) on ischemic and
      reperfusion-induced cochlear damage.
AB  - We have recently demonstrated that allopurinol, a blocker of free oxygen radical
      (FOR) production, and superoxide dismutase (SOD), a scavenger of FOR, protect the
      cochlea from damage associated with ischemia/reperfusion. The purpose of this
      present study was to determine if tirilated mesylate (U74006F), a potent
      inhibitor of lipid peroxidation, can also protect the cochlea from
      ischemia/reperfusion. Eleven Wistar-Kyoto rats were randomly assigned to two
      groups: (1) a control group (6 animals) that was exposed to 15 minutes of
      cochlear ischemia by clamping the anterior-inferior cerebellar artery (AICA),
      followed by 15 minutes of reperfusion, and (2) a drug-treated group (5 animals)
      that received U74006F before ischemia/reperfusion. In the control group, the tone
      burst-evoked compound action potential (CAP) recorded from the round window (RW)
      was abolished and cochlear microphonic (CM) was reduced. In contrast, the U74006F
      treated animals showed post-reperfusion sensitivity in CAP, and less of a CM
      threshold shift. We interpret these results to indicate that U74006F lessens
      cochlear damage occurring as a result of ischemia/reperfusion and supports the
      hypothesis that FOR-induced lipid peroxidation may be partly responsible for the
      cochlear damage that occurs from ischemia.

PMID- 1762790
TI  - Hierarchical immunosuppression of regional lymph nodes in patients with head and
      neck squamous cell carcinoma.
AB  - Patients with head and neck squamous cell carcinomas (HNSCCs) manifest defects in
      cell-mediated immune function. Previous studies in this laboratory have
      demonstrated regional alterations in the immunocompetence of draining lymph nodes
      (LNs) in HNSCC patients. In this investigation, we studied functional activity of
      lymphocytes from lymph nodes in different locations in the radical neck
      dissections (RNDs) from patients undergoing operations for HNSCC. Lymphocytes
      from nodes close to the primary tumor ("near" lymph nodes or NLN) exhibited a
      significant decrease in interleukin-2 (IL-2)-activated cytotoxicity when compared
      to lymphocyts from distant nodes ("far" lymph nodes or FLN). In addition, co
      culture experiments suggested the existence of a soluble regulatory factor,
      produced by lymph nodes, that inhibited the development of lymphokine-activated
      killer (LAK) cells in vitro. Further experiments with conditioned supernatants
      from the lymph node cells confirmed the presence of this soluble inhibitory
      factor. The inhibitory effect is significantly greater in NLNs than in FLNS. This
      hierarchical phenomenon suggests a regional network of immunosuppression in HNSCC
      patients. It is likely that tumor- and lymph node-induced suppression plays a
      role in limiting the efficacy of current immunotherapy protocols in human beings.
      A greater understanding of mechanisms of local inhibition of immune function will
      aid in improving adoptive immunotherapy for treatment of cancers in human beings.

PMID- 1762791
TI  - Direct electrical stimulation of the cochlear nucleus: surface vs. penetrating
      stimulation.
AB  - Prosthetic stimulation of the cochlear nucleus (CN) has been used for
      rehabilitation of profoundly deaf patients who are not suitable candidates for
      cochlear implants. The goal of this article was to assess the relative
      effectiveness of surface vs. penetrating stimulation of the CN.
      Electrophysiologic and autoradiographic measures were used to study central
      auditory system activation elicited by direct stimulation of the CN. Eighteen
      pigmented guinea pigs, divided into three groups, underwent acute implantation of
      bipolar electrodes in the CN. One group was not stimulated and acted as a control
      (n = 7). Electrodes were placed on the surface of the CN in one test group (n =
      4) and within the CN in a second test group (n = 7). Thresholds for electrically
      evoked middle latency responses (EMLR) were determined and input/output (I/O)
      functions were obtained. The two test groups were then pulsed with [14C]-2
      Deoxyglucose (2-DG) intramuscularly and stimulated for 1 hour with biphasic;
      charge-balanced pulses having a total duration of 400 microseconds, a repetition
      rate of 100/sec, and an amplitude of 200 microA. After stimulation, animals were
      killed and brains were harvested and prepared for autoradiography using standard
      techniques. Threshold current for EMLRs in the surface-stimulated group had a
      mean of 67.5 +/- 23.9 microA (range, 40 to 100 microA). Thresholds for in-depth
      stimulated group had a mean of 11.4 +/- 3.5 microA (range, 10 to 20 microA). The
      saturation level of the I/O function for the surface-stimulated group had a mean
      of 287.5 +/- 41.5 microA (range, 250 to 350 microA). The saturation level for the
      in-depth stimulated group had a mean of 192.9 +/- 49.5 mciroA (range, 100 to 250
      microA). The dynamic range for the surface electrodes had a mean of 13.1 +/- 2.7
      dB (range, 9.9 to 15.9 dB), whereas the dynamic range for the penetrating
      electrodes had a mean of 24.5 +/- 2.6 dB (range, 20 to 28.0 dB). Autoradiographs
      generated by CNS tissue from stimulated animals demonstrated no significant
      difference in metabolic activity of the CN between surface and in-depth
      stimulated groups. However, there were highly significant differences in 2-DG
      uptake in the contralateral superior olivary complex, contralateral inferior
      colliculus, and ipsilateral and contralateral lateral lemniscus, with greater
      uptake in in-depth stimulated preparations. Electrophysiologic and
      autoradiographic data suggest that a penetrating CN prosthesis is capable of
      activating the auditory tract at a lower threshold, with a relatively wider
      dynamic range than a surface prosthesis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1762792
TI  - The cervical sympathetic nerves in surgery of the neck.
AB  - The otolaryngologist-head and neck surgeon is aware that the cervical sympathetic
      nerves lie behind the carotid artery and should be avoided during neck surgery.
      To render this sketchy dictum more tangible, relevant anatomy and physiology of
      the autonomic supply to the head and neck is reviewed, as are aspects of site-of
      lesion testing, with respect to Horner's syndrome. Examples of neck operations
      during which the cervical sympathetic chain--from the base of skull to the root
      of the neck--may be injured are illustrated.

PMID- 1762793
TI  - Dematiaceous fungal sinusitis.
AB  - Six cases of dematiaceous fungal sinusitis are reported, together with a review
      of 33 other cases collated from a review of the English literature. The sinusitis
      was more often unilateral vs. bilateral. A characteristic serpiginous hyperdense
      intrasinus opacification, as well as sinus expansion with bone erosion, was often
      seen on CT scan. MRI scan showed lucent sinus cavities on T1 and T2 weighting. A
      comparison of surgical treatment vs. surgery with systemic antifungal therapy
      revealed decreased recurrence and complication statistics in the combined therapy
      group. There was a trend toward increased recurrence/persistence and
      complications associated with invasive histologic findings and only surgical
      treatment, but not statistically significant. At the present time, we recommend
      comprehensive surgical treatment followed by systemic antifungal therapy, though
      clinical judgment and individualization should occur. Future studies are planned
      to further define the disease entity and its therapy.

PMID- 1762794
TI  - Mucosal changes induced by experimental pneumococcal otitis media are prevented
      by penicillin V.
AB  - Penicillin V (pcV) was administered to 50 rats, either before bacterial challenge
      (prevention group), or after bacterial challenge but before fulminant purulent
      acute otitis media (AOM) was established (early treatment group). Five animals
      from each group were killed on days 4, 8, and 12, and 2 and 6 months after
      challenge. Middle ear mucosa was sampled at six different sites and studied in
      the light microscope. Untreated pneumococcal AOM in the rat has been shown to
      cause persistent structural changes of the middle ear mucosa. Both in the early
      treatment group and in the prevention group, the structural changes were
      diminished, as compared with those of untreated infected controls. The persistent
      structural changes seen after 6 months in untreated controls were not seen in
      animals that had received pcV in conjunction with the AOM episode. Though the
      beneficial effect on the mucosal changes during the first 2 weeks was more
      pronounced when pcV was given prophylactically, its use as early treatment would
      seem to be almost as effective in preventing the persistence of mucosal changes.

PMID- 1762795
TI  - Study of phonation in the excised canine larynx.
AB  - Previous studies have demonstrated that the laryngeal muscles responsible for
      pitch variation and vocal efficiency are the cricothyroid muscles, affecting
      longitudinal tension of the vocal folds, and the thyroarytenoid muscles,
      controlling the lateral stiffness of the vocal folds. Longitudinal tension in the
      vocal fold is easily simulated in the excised canine larynx. The effect of the
      thyroarytenoid muscle, however, has not been adequately analyzed. To simulate the
      effect of the thyroarytenoid muscle, small balloons were placed in the
      paraglottic space at the level of the vocal folds in 10 excised canine larynges.
      These balloons (Fogarty catheters) could be inflated in increments to simulate
      the effect of the thyroarytenoid muscle contraction in altering the lateral
      stiffness of the vocal fold. During phonation subglottic pressure, vocal fold
      longitudinal tension and balloon size were systematically varied. The
      photoglottographic and electroglottographic signals, sound intensity, and airflow
      rate were measured. Multiple regression analysis showed that sound intensity was
      directly related to subglottic pressure (p less than 0.001) and inversely related
      to balloon size (p less than 0.001). Vocal efficiency was directly related to
      subglottic pressure (p less than 0.001). Frequency of vibration was directly
      related to balloon size (p less than 0.05), vocal fold tension (p less than
      0.001), and subglottic pressure (p less than 0.001). Open quotient was directly
      related to vocal fold tension (p less than 0.01) and inversely related to balloon
      size (p less than 0.001). Clinical implications of these results will be
      discussed.

PMID- 1762796
TI  - The endoscopic approach to the lateral accessory sphenoid sinus.
AB  - In summary, an interesting case of an accessory parasphenoid sinus mucocele in a
      10-year-old girl is reported. By choosing an endoscopic approach, hearing and
      balance were preserved, and an external sinus or neurosurgical procedure avoided.
      The surgery was done on an outpatient basis, with minimal postoperative
      discomfort and no complications. The mucocele was adequately drained and there
      has been no recurrence over the following 12 months.

PMID- 1762797
TI  - Increased intracranial pressure and blindness associated with obstructive sleep
      apnea.

PMID- 1762798
TI  - Diagnosis of septic sigmoid sinus thrombosis with magnetic resonance imaging.

PMID- 1762799
TI  - Acute suppurative thyroiditis with bilateral piriform sinus fistulae.
AB  - Although there are many possible routes of infection in AST, the clinician must
      be aware of a possible fistula between the piriform sinus and the perithyroidal
      space--especially in patients with recurrent episodes of AST. Diagnosis of this
      congenital tract requires a high index of suspicion and radiographic
      demonstration by a barium swallow or endoscopic visualization. Effective
      treatment of AST with intravenous antibiotics and appropriate surgical
      intervention have greatly reduced the mortality and secondary complications.
      Complete fistulectomy, however, is required for permanent cure.

PMID- 1762800
TI  - Home infusion therapy: device, therapy and staffing information.

PMID- 1762801
TI  - Learning to care for the self: an innovative educational model of the learning
      process.

PMID- 1762802
TI  - Nursing interest in research presentations.

PMID- 1762803
TI  - The B.S.N. requirement for certification: a positive step forward in nursing.

PMID- 1762804
TI  - Light up your practice with nursing research.

PMID- 1762805
TI  - Treatment outcome in a multidisciplinary cancer pain clinic.

PMID- 1762806
TI  - Comparison of intermittent bolus with continuous infusion of epidural morphine in
      the treatment of severe cancer pain.
AB  - Twenty-eight patients with severe pain due to cancer, who could no longer obtain
      acceptable pain relief from optimised doses of oral opioids, were entered into a
      study which compared pain relief, satisfaction with pain therapy and estimates of
      neuropsychological functioning during treatment with spinally administered (i.e.,
      epidural and intrathecal) morphine as either repeated bolus doses or as a
      continuous infusion. These measures of efficacy and side effects were repeated
      every 2 weeks until either the patient died (82% of patients), withdrew from the
      study or were no longer able to complete the tests due to deterioration of their
      condition. The mean (range) duration of treatment was 169 (6-537) days for those
      patients receiving continuous infusion and 140 (28-378) days for those patients
      receiving repeated bolus doses. There was no significant difference in visual
      analogue pain scores, pain relief scores and satisfaction scores between the
      bolus and infusion groups. Furthermore, low pain scores and high pain relief
      scores indicated that both treatment modalities provided effective pain control.
      Similarly, there was no significant difference between the two groups in the
      various tests used to assess depression or neuropsychological function (i.e.,
      memory, vigilance, attention and processing). There was a significantly greater
      degree of dose escalation in patients receiving continuous infusion compared to
      patients receiving repeated bolus doses. For 6 patients in the infusion group the
      catheter was sited in the intrathecal space, as the dose requirements by the
      epidural route exceeded the delivery capacity of the pump. For 4 patients in the
      bolus group the catheter was similarly sited, due to pain on injection and
      leakage/blockage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762807
TI  - The impact of a comprehensive evaluation in the management of cancer pain.
AB  - To evaluate the importance of a comprehensive evaluation in the management of
      patients with cancer pain, we surveyed 276 consecutive consultations (226
      retrospectively and 50 prospectively) performed by the pain consultant at
      Memorial Sloan-Kettering Cancer Center. For all consultations, the pain
      diagnosis, other medical and neurologic diagnoses, investigations and suggested
      therapeutic interventions were recorded. The pain consultation identified a
      previously undiagnosed etiology for the pain in 64% of patients in both surveys.
      Metastatic neoplasm was the most common lesion discovered. In addition, the
      prospective survey yielded new neurologic diagnoses in 36% of patients and an
      unsuspected infection in 4%. Eighteen percent of prospectively surveyed patients
      received radiotherapy, surgery or chemotherapy based on the findings of the pain
      consultant. These data confirm the importance of a comprehensive neuro-oncologic
      evaluation in the management of cancer pain. An understanding of oncology,
      neurology and medicine is critical to assess and treat these patients.

PMID- 1762808
TI  - Cephalic and extracephalic pressure pain thresholds in chronic tension-type
      headache.
AB  - Pressure pain thresholds were assessed with an algometer (Somedic Inc.), over the
      forehead, temple and suboccipital region as well as over the Achilles tendon. A
      group of 32 patients suffering from chronic tension-type headache was compared to
      20 healthy controls and to 10 migraineurs without aura. Although individual
      values were widely scattered, pressure pain thresholds were on average
      significantly lower in chronic tension-type headache, not only at pericranial
      sites but also over the Achilles tendon. Only 50% of these patients had one or
      more pericranial thresholds 1.5 S.D. below the mean of controls. After muscular
      biofeedback therapy, all pain thresholds were on average increased. Along with
      results obtained previously, the present data support the hypothesis that diffuse
      disruption of central pain-modulating systems, possibly due to a modified limbic
      input to the brain-stem, is pivotal in the pathophysiology of chronic tension
      type headache.

PMID- 1762809
TI  - Comparative effectiveness of different stimulation modes in relieving pain. Part
      I. A pilot study.
AB  - In this pilot study, to assess the optimal stimulation parameters, 3 different
      forms of transcutaneous electrical nerve stimulation were performed in 27
      patients. Conventional continuous stimulation with a constant frequency of 70 Hz,
      burst stimulation (90 msec trains of pulses with an internal frequency of 100 Hz
      repeated at 2 Hz, each train consisting of 10 pulses), and frequency-modulated
      stimulation (continuous pulses changed from 90 Hz to 55 Hz over 90 msec) were
      randomly delivered to the patients for half an hour in 3 separate sessions. The
      patients were blind to the modes of stimulation. This pilot study demonstrated
      that patients preferred modulated stimulation modes such as frequency modulation
      and burst rather than conventional constant mode.

PMID- 1762810
TI  - Comparative effectiveness of different stimulation modes in relieving pain. Part
      II. A double-blind controlled long-term clinical trial.
AB  - Part I of our earlier pilot study demonstrated that patients preferred modulated
      stimulation forms - frequency modulation and burst - rather than conventional
      continuous mode. To assess whether long-term therapeutic effects validate the
      immediate test results, this trial was performed in 14 patients with 21 pain
      conditions. Considering the results of the pilot study, the test stimulator was
      modified and 4 different forms of transcutaneous electrical nerve stimulation
      were randomly delivered to each patient who was blind to the modes of stimulation
      for 20 min. A second observer assessed the pain scores using visual analogue
      scales. The stimulation modes employed were: (1) conventional continuous
      stimulation (continuous pulses with a constant frequency of 70 Hz), (2) burst
      stimulation (80 msec long trains of pulses, each train consisting of 8 pulses,
      with an internal frequency of 90 Hz repeated 1.3 times a second), (3) high-rate
      frequency modulation, HRFM (continuous pulses changed from 90 Hz to 55 Hz over 90
      msec, 1.3 times a second), (4) low-rate frequency modulation, LRFM (continuous
      pulses changed from 60 Hz to 20 Hz over 90 msec, 1.3 times a second). After the
      test treatment of 4 sessions in the clinic, depending on the pain scores and
      duration of pain relief recorded, the most effective stimulation mode was
      determined for each patient and a portable stimulator preset appropriately for
      that mode was given to be used at home, under our supervision, for 3 months.
      Fourteen pain conditions out of 21 (66%) responded well to the therapy; the
      majority preferred was the HRFM and burst-type stimulation.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1762811
TI  - Postoperative pain treated by intravenous L-tryptophan: a double-blind study
      versus placebo in cholecystectomized patients.
AB  - The effectiveness of intravenous administration (i.v.) of L-tryptophan, which is
      the precursor of cerebral serotonin, was verified in the treatment of
      postoperative pain. The study was carried out on 45 female patients, aged between
      34 and 61 years, undergoing cholecystectomy who were randomly divided into three
      groups. Group 1 (age: 50.33 +/- 8.64 years) received 100 ml of 5% mannitol
      solution i.v.; group 2 (age: 49.80 +/- 11.11 years) 100 ml of a mannitol solution
      containing 7.5 mg/kg L-tryptophan; and group 3 (age: 53.46 +/- 9.60 years) 100 ml
      of a mannitol solution containing 15 mg/kg L-tryptophan. Vital capacity
      (preoperative VC) was measured before surgery. Anesthesia used was isoflurane.
      Narcotics or neuroleptics were not used. Pain was assessed before treatment (T-0
      min), at the end of administration (T-30) and at T-60, 120, 180, 240, 300 and 360
      min by the following variables: respiratory rate (RR), heart rate (HR), mean
      arterial pressure (MAP), Scott-Huskisson test (VAS), pain vital capacity (PVC),
      analgesic vital capacity (AVC), and respiratory restoration factor (RRF)
      calculated from Bromage's formula (RRF = (AVC - PVC/preoperative VC - PVC) X
      100). As regards variables RR, HR, MAP and VAS, differences between the values
      from T-30 to T-360 and the value at T-0 were calculated. Means and S.E.M. were
      calculated on the obtained values and on RRF values for each group. The
      significance of the differences between groups was calculated using Student's t
      test and Bonferroni's test. Results show a significant decrease of pain in groups
      2 and 3 treated with L-tryptophan, in comparison with group 1 (controls). No
      significant difference was observed between the treated groups, although more
      lasting pain relief was observed in group 3 in comparison with group 2.
      Intravenous L-tryptophan showed its effectiveness in the treatment of
      postoperative pain even when used alone. Its use may be considered for patients
      with renal failure, in order to strengthen pharmacological analgesia or to
      prevent postoperative pain by its intraoperative administration.

PMID- 1762812
TI  - Cerebral event-related responses induced by CO2 laser stimulation in subjects
      suffering from cervico-brachial syndrome.
AB  - The present study was undertaken to examine possible changes in subjective
      appraisal and central nervous system processing, indexed by pain-related cerebral
      evoked potentials (N290, P400), of incoming noxious information in 20 pain-free
      control volunteers and 18 subjects suffering from right-side cervico-brachial
      pain (CBS). Detection threshold and cerebral evoked potentials were recorded in
      response to noxious CO2 laser stimulation of the right and left hands. The
      results indicate that when compared to controls, CBS subjects exhibit an
      elevation in detection threshold intensity and a reduction in the amplitude of
      the P400 peak following laser stimulation of the pain affected side. There were
      also differences in the choice of qualitative descriptor for laser stimuli
      although not in the subjective rating of stimulus intensity. These changes were
      not apparent for responses on the unaffected limb. The severity of clinical pain
      was found to be related to the magnitude of reduction in P400 amplitude only on
      the pain affected side. Conversely, feelings of anxiety were associated with
      higher amplitude responses on both the right and left sides, suggesting a more
      generalized relationship between these factors. We interpret these findings to
      indicate an alteration in central nervous system processing and subjective
      appraisal of acute experimental pain in subjects with chronic CBS. Moreover,
      these alterations appear to be restricted to pain affected pathways and are more
      related to the severity of clinical pain than to general mood state.

PMID- 1762813
TI  - Psychosocial factors in chronic spinal cord injury pain.
AB  - Chronic pain is a problem among patients with spinal cord injuries, but the
      psychosocial factors associated with spinal cord injury (SCI) pain are not well
      understood. To understand SCI pain further, 54 patients (19 with quadriplegia and
      35 with paraplegia) completed the Beck Depression Inventory, State-Trait Anxiety
      Inventory, Profile of Mood States, Acceptance of Disability Scale and SCI
      Interference Scale. Forty-two patients stated they had SCI pain and completed the
      Multidimensional Pain Inventory and the Pain Experience Scale. Results revealed
      that anger and negative cognitions were associated with greater pain severity.
      Patients who reported pain in response to a general prompt experienced more
      severe pain than patients who reported pain only when directly questioned about
      the presence of pain, but these different reporting groups did not differ on
      emotional variables. Those who were less accepting of their disability reported
      greater pain severity. Additionally, patients who perceived a significant other
      expressing punishing responses (e.g., expressing anger at the patients or
      ignoring the patients) to their pain behaviors reported more severe pain. Level
      of lesion, completeness of injury, surgical fusion and/or instrumentation and
      veteran status were not associated with pain severity. Finally, pain was
      associated with emotional distress over and above the distress associated with
      the SCI itself. Overall, psychosocial factors, not physiological factors, were
      most closely associated with the experience of pain. Multidimensional aspects of
      pain are used to explain these findings and suggest that treatment should be
      directed at the emotional and cognitive sequelae of chronic SCI pain.

PMID- 1762814
TI  - Consensus and contention in the treatment of chronic nerve-damage pain.
AB  - A postal questionnaire survey was carried out to investigate beliefs in the
      efficacy of specific treatments held by consultants involved in the treatment of
      chronic nerve-damage pain. One hundred eighty-eight consultants experienced in
      the treatment of chronic pain were identified by local Pain Clinic consultants in
      5 centres. The specialties represented were neurology, neurosurgery, orthopaedic
      surgery, oncology/radiotherapy, plastic surgery and anaesthesia. Replies were
      received from 181 consultants (96%). Over one fifth of the consultants expressed
      no opinion about half of the treatments assessed. Widely divergent views were
      held by those who did give an opinion. Many clinicians assessed some treatments
      as 'poor' while other clinicians assessed the same treatments as 'excellent'
      (neurolytic nerve block, somatic nerve block, cordotomy and opioids). For some
      treatments divergence of opinion can be explained in part by differences between
      specialties. For other treatments marked diversity was seen within as well as
      between specialties. There is a clear need for education in the use of particular
      treatments, even amongst those clinicians who regularly see this type of patient.

PMID- 1762815
TI  - The validity of the General Health Questionnaire for first-stage screening for
      mental illness in pain clinic patients.
AB  - The validity of the 28-item version of the General Health Questionnaire (GHQ-28)
      was determined by comparison with the Clinical Interview Schedule (CIS) in 56
      pain clinic patients. Despite some limitations, the GHQ can be used effectively
      and cheaply as the first stage of an assessment to identify potential "cases" of
      mental disorder which must then be verified using a second-stage clinical
      interview such as the CIS. This process can result in a considerable reduction in
      the proportion of patients requiring a psychiatric interview and, therefore, in
      reduced service costs. Factors associated with lower validity coefficients
      include female sex, age above 60 years and pain with a duration of less than 2
      years.

PMID- 1762816
TI  - The expression of a deafferentation syndrome in the Sprague-Dawley rat: effects
      of frontoparietal cortical lesions.
AB  - Forelimb sensorimotor (SMI) cortical lesions in the rat have been found to
      suppress a deafferentation syndrome which follows C5-T2 ganglionectomy/avulsion
      whether the cortical lesions were made prior to, or several days after, the
      dorsal root lesions. None of the 6 rats with only frontoparietal lesions
      developed a deafferentation syndrome. These results may be influenced by the
      presence of a sensorimotor amalgam in the parietal cortex of the rat.

PMID- 1762817
TI  - Differentiating analgesic and non-analgesic drug activities on rat hot plate:
      effect of behavioral endpoint.
AB  - The contribution of behavioral endpoint to results obtained in the 55 degrees C
      rat hot plate procedure was assessed. Specifically, the use of a hind paw lick
      only endpoint was compared to that of a hind paw lick-or-jump endpoint. Effects
      of prototypical analgesic and non-analgesic compounds on response latency
      increases were determined under each condition. Whereas the effects of morphine,
      oxycodone and codeine were similar under each condition, effects of a number of
      non-analgesic agents differed markedly depending upon the endpoint used.
      Clozapine, chlorpromazine, thioridazine, atropine, scopolamine, benactyzine,
      yohimbine, idazoxan and cyproheptadine produced dose-dependent increases in
      response latency under the hind paw lick-only condition but did not increase
      latencies when the hind paw lick-or-jump endpoint was used. Haloperidol,
      sulpiride, benztropine, methyl atropine, phentolamine, prazosin, methiothepin,
      methysergide, diphenhydramine, pargyline and diazepam failed to increase response
      latencies under the hind paw lick-only condition. Moreover, whereas diazepam,
      chlorpromazine, pentobarbital, dantrolene and ethanol produced dose-dependent
      increases in the height required for successful aerial righting, increases in
      hind paw lick-or-jump latencies occurred only following near-anesthetic doses of
      pentobarbital and ethanol. These data indicate that the hind paw lick endpoint is
      susceptible to perturbation by extraneous pharmacologic activities. Drugs
      exerting muscarinic cholinergic and alpha 2-adrenergic antagonist effects are
      particularly able to disrupt this behavior. Disruption is not associated
      specifically with any other pharmacologic action, although other activities may
      interfere with the response. In contrast, the hind paw lick-or-jump endpoint
      fails to detect skeletal muscle relaxant activity and only detects gross motor
      impairment when near-anesthetic doses of drugs are used. The present data suggest
      that detection of non-analgesic drug activities by rat hot plate can be minimized
      by use of a hind paw lick-or-jump endpoint.

PMID- 1762818
TI  - Spinal co-administration of cholecystokinin antagonists with morphine prevents
      the development of opioid tolerance.
AB  - The effects of intrathecal (i.t.) co-administration of the cholecystokinin (CCK)
      antagonists lorglumide or proglumide with a "low" (1 microgram) and "high" (10
      micrograms) dose of i.t. morphine on the development of opioid tolerance were
      determined using the rat tail-flick assay. Although co-injection of 7 ng
      lorglumide or 20 ng proglumide (doses which have been demonstrated to acutely
      enhance 1 microgram morphine, i.t.) were without effect, co-administration of 70
      ng lorglumide or 64 ng proglumide with 1 microgram morphine for 6 days inhibited
      development of tolerance to this dose of opioid. Higher doses of CCK antagonists
      (1400 ng lorglumide and 1280 ng proglumide) were required to prevent the
      tolerance induced by 10 micrograms morphine. These findings provide further
      evidence that CCK mediates, at least partially, tolerance which develops to the
      analgesic effect of opioids and indicate the involvement of CCK pathways in the
      spinal cord. The results are also consistent with a mechanism in which the level
      of activation of compensatory, anti-opioid CCK circuitry is increased in
      proportion to the functional level of opioid pathways.

PMID- 1762819
TI  - The antinociception evoked by anterior pretectal nucleus stimulation is partially
      dependent upon ventrolateral medullary neurones.
AB  - Electrical stimulation (35 microA rms/15 s) of the anterior pretectal nucleus
      (APtN) inhibits the spinal reflex of the tail-flick (TF) to noxious heat in
      unanaesthetised rats. APtN stimulation also reduces the nociceptive response of
      spinal dorsal horn neurones in halothane-anaesthetised rats. This study
      determined if the antinociceptive effects of APtN stimulation depended on
      neurones in the ventral medulla. Bilateral electrolytic lesions of the
      ventrolateral medulla, but not the nucleus raphe magnus, reduced by 70% the
      antinociceptive effect of APtN stimulation in the TF test. In rats anaesthetised
      with halothane, electrical stimulation of the APtN (single square wave 0.1 msec
      pulses, 2-20 microA, 1 Hz) excited cells in the ventrolateral medulla. These data
      suggest a connection between both areas. This connection is further confirmed by
      neuroanatomical tract tracing studies in which the retrograde dye Fast Blue was
      injected into the ventrolateral medulla. Fluorescent cell bodies were found in
      the APtN. We therefore conclude that the ventrolateral medulla is part of a
      descending antinociceptive pathway from the APtN.

PMID- 1762820
TI  - Comment on 'Ischaemic spinal cord lesion following percutaneous radiofrequency
      spinal rhizotomy' by H.M. Koning, H.G. Koster and R.P.E. Niemeijer in Pain, 45
      (1991) 161-166.

PMID- 1762821
TI  - Ignorance of photobiology: a major pitfall in using lasers in medicine.

PMID- 1762822
TI  - Comments on 'The analgesic effects of caffeine in headache,' by D. Avery, D.
      Dunner, N. Ward and C. Whitney in Pain, 44 (1991) 151-155.

PMID- 1762823
TI  - Nail gun injury.
AB  - Traumatic penetrating wounds caused by compressed air or pneumatic tools initiate
      local tissue changes that are similar to gunshot wounds. Wounding caused by a
      pneumatic nail gun can range from mild tissue damage to severe life-threatening
      injury. This article presents a case review with appropriate nursing diagnoses.

PMID- 1762824
TI  - Limitsetting: dealing with difficult patients.
AB  - "Limitsetting" is an overall term for interventions that decrease problematic
      behavior. Orthopaedic units seem to have more than their share of patients with
      problematic behavior. Reasons for this include the pain, immobility, and body
      image changes as well as the fact that preinjury personality factors may include
      impulsive and angry dynamics. The limits set must match the behavior manifested.
      Dangerous behavior, the highest priority, demands an immediate, decisive
      strategy. Direct statements should be concrete and specific with positive,
      absolute directives of what must be done. Two case studies are included.

PMID- 1762825
TI  - The orthopaedic critical path.
AB  - Health care providers, purchasers, and insurers are struggling to manage the cost
      of health care while maintaining the quality of care. Alliant Health System has
      incorporated Total Quality Management (TQM) and the Critical Path Process
      throughout the corporation as a managed care strategy to deliver cost-effective
      quality care. Using the Critical Path Process has demonstrated a reduction in
      Length of Stay (LOS) and cost while maintaining quality. The success of this
      process depends upon an interdisciplinary and collaborative approach among health
      care providers in identifying practice patterns to assure appropriate and timely
      delivery of patient care.

PMID- 1762826
TI  - Children and pain: easing the hurt.
AB  - Relief of pain in children is a challenge to the pediatric health care provider.
      A clear understanding of the various developmental and cognitive levels will help
      the nurse better assess and manage children in pain. Age-appropriate assessment
      tools are currently available. A combination of a wide variety of treatment
      modalities, both pharmacologic and nonpharmacologic, can be used to effectively
      manage pain in children.

PMID- 1762827
TI  - Patient perceptions of pain and disability after joint arthroplasty.
AB  - Patients having elective total hip or knee arthroplasty are routinely assessed
      for flexibility, muscle strength, and gait both preoperatively and
      postoperatively, but there appears to be limited information available on
      patients' self-reported pain levels. This study used two self-report measures of
      health status and a pain scale to measure patients' perceptions of disability and
      pain immediately prior to surgery and at 6 weeks and 6 months after total hip or
      knee arthroplasty.

PMID- 1762828
TI  - Guidelines for master's degree in orthopaedic nursing.

PMID- 1762829
TI  - Femoral neck stress fracture.

PMID- 1762830
TI  - Specialty nurse organizations develop position statements.

PMID- 1762831
TI  - Initial assessment and management of a patient with a gunshot wound to the femur.
AB  - As the number of violent crimes rise, the likelihood increases that the nurse
      will be faced with patients presenting with gunshot injuries. These wounds pose a
      significant challenge to the nurse working in the acute care setting. Unlike
      other penetrating trauma, gunshot wounds produce a myriad of associated injuries
      related to the mechanism of injury. Nurses must be aware of the specific trauma
      associated with these wounds to assess and manage the victim in an organized and
      systematic fashion.

PMID- 1762832
TI  - [Cell polarity and protein transport in digestive epithelial cells].

PMID- 1762833
TI  - Purified recombinant CD4 inhibits HIV-1 infection of peripheral blood
      macrophages.
AB  - Purified recombinant soluble CD4 (rCD 4) is a new antiviral agent which has been
      shown to block HIV infection of lymphocytic and monocytic cell lines as well as
      peripheral blood mononuclear cells. The authors investigated here the ability of
      rCD4 to inhibit HIV-1 infection of peripheral blood macrophages. In this system,
      purified preparations of rCD4 provided, at concentrations above 10 micrograms/ml,
      a complete protection against a challenge with the monocytotropic strain HIV-1 Ba
      L. Also, anti-CD 4 monoclonal antibodies directed at the V1 domain of the CD 4
      molecule blocked infection of macrophages by HIV. Recombinant CD 4 is therefore a
      potent antiviral agent able to prevent HIV-1 infection of peripheral blood
      macrophages, and the CD 4 molecule is likely to be the main HIV receptor on these
      cells.

PMID- 1762834
TI  - [Cholecystitis and biliary infection].
AB  - Cytobacteriologic study of 150 gallbladder fluid samples obtained before
      cholecystectomy found no correlations between clinical manifestations, gross and
      histologic features of the gallbladder, and underlying biliary infection. The
      potential parts played in these discrepancies by bile, time to surgery, and use
      of antimicrobial agents are discussed.

PMID- 1762835
TI  - [Study of the bactericidal effect of cefpodoxime using an in vitro
      pharmacokinetic model].
AB  - Cefpodoxime is a new oral prodrug antibiotic. Following absorption from the
      proximal intestine, non-specific esterases hydrolyze this cleavable ester,
      releasing cefpodoxime, a new broad-spectrum third-generation cephalosporin with
      sustained plasma levels in humans. Cefpodoxime killing kinetics were studied
      using an in vitro model which simulates the pharmacokinetic profile obtained in
      healthy volunteers given a single oral dose of cefpodoxime proxetil providing
      100, 200 or 400 mg active cefpodoxime. Cefpodoxime exhibited strong antibacterial
      activity against tested strains of Escherichia coli, Streptococcus pneumoniae and
      Staphylococcus aureus. These results suggest that use of two daily doses of 100
      or 200 mg each are appropriate for the treatment of E. coli and S. pneumoniae
      infections in view of the pharmacokinetic properties of cefpodoxime. Less
      intensive therapy is probably adequate in uncomplicated community-acquired
      urinary tract infections. The bactericidal effect of cefpodoxime against S.
      aureus is prolonged due to a postantibiotic effect.

PMID- 1762836
TI  - [Evaluation of the prevalence of side effects of phenobarbital in patients in the
      Champagne-Ardenne region].
AB  - Side effects were compared in 454 patients under phenobarbital and in 133
      patients under other antiepileptic agents. Prevalence of adverse effects was 12%
      and 4% in these two groups, respectively. The fairly low prevalence of untoward
      reactions to phenobarbital in this study as compared with previously published
      reports is due to the methodology used. Despite unquestionable drawbacks,
      especially in patients above 50 years of age at first use, phenobarbital is a
      valuable therapeutic alternative in some cases.

PMID- 1762837
TI  - [Identification of a type 1 macrocreatine kinase].
AB  - A macrocreatine-kinase type 1 was identified by CK isoenzyme electrophoresis of a
      serum sample from a patient. Constituents of this enzyme complex were studied.
      The isoenzyme present in the macrocreatine-kinase was identified using
      immunoprecipitation with antibodies against the M subunit. Affinity
      chromatography then determined the type of the immunoglobulin bound to the CK
      isoenzyme. A protocol for studying macrocreatine-kinase type 1 compounds is
      proposed.

PMID- 1762838
TI  - [The blood-brain barrier: implications for chemotherapy in brain tumors].
AB  - The blood-brain barrier (BBB) is located between the blood and the extracellular
      space of the brain. This barrier is formed by the brain capillaries whose
      endothelial cells have tight intercellular junctions. Transcellular passage of
      drugs from the bloodstream to the brain occurs selectively, in a manner dependent
      on the ability of the molecules to penetrale through cell membranes. The blood
      brain barrier is one of the main factors of chemotherapy failure in central
      nervous system tumors. Penetration of a molecule from the bloodstream to the
      brain is dependent on the compound's liposolubility, expressed by the octanol
      water separation coefficient. Following intravenous administration, most drugs
      fail to achieve adequate levels in the central nervous system for a sufficiently
      long period of time. A variety of techniques have been used in an attempt to
      increase CNS penetration of drugs normally shut out by the blood-brain barrier:
      high-dose chemotherapy, intrathecal injections, intraarterial injections,
      induction of hyperosmolarity to make the blood-brain barrier permeable. The best
      results are obtained using liposoluble drugs with optimal octanol-water
      separation coefficients, such as fotemustine. This compound given as single drug
      therapy in brain metastases from malignant melanomas has yielded response rates
      of up to 28.2%.

PMID- 1762839
TI  - [Natural tyrosine-kinase inhibitors].
AB  - Changes in the degree of phosphorylation of protein tyrosine residues play a
      major role in the regulation of cell growth and differentiation. The biological
      mechanisms which control the activity of enzyme systems involved in these change
      (i.e. protein tyrosine-kinase [PTKs] and protein tyrosine-phosphatases) remain
      poorly understood. Similar to other regulation mechanisms, involving
      phosphorylation-dephosphorylation reactions, these enzyme systems can be
      regulated by naturally occurring effectors (with inhibitory or activating
      effects). This paper briefly reviews current knowledge on the few identified
      natural PTK inhibitors. The phosphoprotein PP 63 produced by rat hepatocytes
      inhibits insulin-receptors PTK in hepatoma cell cultures and abolishes insulin's
      mitogenic effect. PP 63 has a slight structural resemblance with Mullerian
      Inhibiting Substance, a molecule reported to inhibit epidermal growth factor
      (EGF) receptor PTK and to exhibit anti-mitogenic effects. Two other proteins,
      protein S-100 isolated from cattle brain and a thermostable factor found in human
      lymphoid tissues also have anti-PTK effects. Although in the current state of our
      knowledge, the physiologic role of these inhibitors is unclear, they may have
      potential value as anti-oncogenic agents as a result of their ability to decrease
      phosphorylation of protein tyrosine residues.

PMID- 1762840
TI  - [Chromium: physiologic role and implications in human pathology].
AB  - Reported values for total body stores of chromium vary between 0.4 mg and 6 mg.
      Chromium stores may be higher in neonates than in adults, relative to body size,
      whereas tissular chromium may be depleted in the elderly. The recommended daily
      allowance for chromium is 50 to 200 micrograms/day but actual needs are poorly
      known. Digestive absorption is better for organic chromium, which is part of the
      "glucose tolerance factor" (GTF), than for inorganic chromium. Furthermore,
      chromium (VI) is better absorbed than chromium (III). In the body, chromium (VI)
      is rapidly reduced to chromium (III) by a number of metabolic pathways. Absorbed
      chromium binds to proteins, mainly to transferrin which exhibits a high affinity
      for chromium (III). Most absorbed chromium is eliminated through the kidneys.
      Renal excretion occurs according to a two or more-compartment model. Current
      methods used to assay chromium, i.e., atomic absorption spectrometry using a
      graphite furnace or neutron activation, are sufficiently sensitive and specific
      to evaluate chromium levels in blood, urine or hair. However, none of these
      levels accurately reflects chromium body stores. Chromium is part of the GTF
      molecule. This factor has no effect per se but may facilitate binding of insulin
      to insulin receptors and amplify the effects of insulin on carbohydrate and lipid
      metabolism. Chromium deficiency may play a role in a development of some forms of
      adult diabetes mellitus and of arteriosclerosis. Partial chromium deficiencies
      seem to be common, especially in individuals with high intakes of refined foods.
      Acute chromium poisoning is usually due to an excess of chromium (VI) and is
      sometimes seen in the chromium industry.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1762841
TI  - [Malherbe's necrotizing epithelioma in a 6-year-old child].

PMID- 1762842
TI  - [A case of cutaneous-visceral mastocytosis in a 13-year-old boy].

PMID- 1762843
TI  - [A dysontogenetic cyst of the stomach in a child].

PMID- 1762844
TI  - [Eosinophilic granulomas of the bones of the skull in children].

PMID- 1762845
TI  - [Immunity in 6-year-old children born to women with a history of late pregnancy
      toxicosis].

PMID- 1762846
TI  - [Immunity in patients with the Macleod syndrome].

PMID- 1762847
TI  - [The dynamic lysozyme activity of the bronchial secretion in children in the
      acute period of pneumonia].

PMID- 1762848
TI  - [The clinico-genetic characteristics of children with local forms of primary
      tuberculosis].

PMID- 1762849
TI  - [Hemostasis and the blood lipid spectrum in children with a hereditary
      disposition for arterial hypertension and the autonomic vascular dystonia
      syndrome].
AB  - Overall 75 children aged 7-13 years with hereditary load as regards arterial
      hypertension were examined. Hemocoagulation, the content of total cholesterol and
      triglycerides in blood serum, and that of cholesterol in high density
      lipoproteins were estimated in children with and without vegetovascular dystonia.
      The changes in blood lipids of the atherogenic nature, activation of the
      processes of coagulation were coupled with vegetovascular dystonia and showed up
      maximally when combined with initial sympathicotonia, hypersympathicotonic
      reactivity, and with the hyperdiastolic variety of the clino-orthostatic test.
      The children with hereditary load as regards arterial hypertension and with
      vegetovascular dystonia should be attributed to the high risk group in order to
      carry out follow-up studies and a complex of treatment and health measures.

PMID- 1762850
TI  - [The characteristics of the personality interrelations of adolescents with
      different forms of secondary arterial hypertension].
AB  - Interpersonality relations and conflict situations were studied in patients who
      need psychological correction. In patients with symptomatic arterial
      hypertension, the degree of dissatisfaction was estimated according to the
      following three scales: educational ("Conflict Situations at School" including
      conflicts with friends); family and household ("Conflict Situations in the
      Family"); and "Internal Disputed Matters". The patients with symptomatic arterial
      hypertension of the nephrogenous and endocrine genesis may turn out more
      conflicting since they are trying to discover the cause of their life failures in
      their social surrounding rather than in their personal inability to cope with
      them because of the disease.

PMID- 1762851
TI  - [Clinico-laboratory criteria in the diagnosis of ARVI and respiratory allergoses
      in children].
AB  - Overall 219 ailing children aged 3 to 14 years were examined, using the disease
      history, clinical, morphological, immunological and cytochemical data. There were
      115 patients with allergoses and 104 patients suffering from acute respiratory
      viral infections (ARVI). A retrospective analysis has demonstrated that in 52.6%
      of the children, respiratory allergosis diagnosis was late (3-5 years since its
      onset). It has been established that hereditary allergic load, food and drug
      allergy, local eosinophilia of the nasal mucosa as well as a decrease of E-RFC, a
      rise of EAC-RFC levels, a lower T/B index, dysgammaglobulinemia marked by
      significant stable alterations in patients with respiratory allergoses and
      transitory, obscure changes associated with ARVI can serve differential
      diagnostic criteria.

PMID- 1762852
TI  - [Endocrine status changes in children with bronchial asthma].
AB  - A study was made of adrenocortical function by measuring blood plasma cortisol
      concentration and amount of glucocorticoid receptors in lymphocytes as well as
      thyroid function by measuring blood plasma triidothyronine and thyroxine
      concentration in 58 bronchial asthma children aged 1 to 14 years. The authors
      revealed alterations in the functional activity of the indicated endocrine glands
      depending on the intensity of bronchial patency disorders and the nature of the
      therapeutic measures carried out.

PMID- 1762853
TI  - [The vaccination of children with allergic diseases with reduced doses of
      adsorbed DT-m anatoxin].
AB  - During a remission and drug therapy, 71 children suffering from allergic diseases
      were vaccinated with DT-M toxoid containing different dose of diphtheria (1, 2.5,
      5 LF) and tetanus (1, 2.5, 5 EC) antigens. It has been shown that all the
      children responded to tetanus antigen by adequate serological tests, whereas as
      regards diphtheria toxoid, the patients immunized with the least dose of DT-M
      preparation (1 LF + + 1 EC antigens) produced specific antibodies later and at a
      lower level. During the postvaccinal period, they also manifested an increase of
      the content of IgE and exacerbation of the underlying disease in 17.8% of cases.
      The use of DT-M toxoid with 2.5 LF + EC antigens was shown to hold promise in
      vaccination of children suffering from allergic diseases.

PMID- 1762854
TI  - [A pharmacokinetic basis for schedules for administering amikacin to newborn
      infants].
AB  - The use of correlations between the pharmacokinetic parameters and the patient's
      factors is one of the most promising trends in the elaboration of the efficient
      regimens of dosage. To establish the analogous correlations in terms of
      specifying the causes of the widely known individual variability of serum
      aminoglycoside concentrations in 139 neonates given amikacin for suggested or
      documented infections, a study was made of the drug pharmacokinetics.

PMID- 1762855
TI  - [The serum and tissue concentrations of antibiotics used in pediatric
      pulmonology].
AB  - Measurements were made of the concentrations of different antibiotics in children
      with acute and chronic pneumonia. The data obtained do not only confirm the
      dependence of the peak concentration of the drug in blood serum and tissue fluid
      on the antibiotic single dose but also point to a direct relationship between the
      single dose and duration of a high drug concentration in the body. It has been
      established that parenteral drugs penetrate well the pleural cavity, making it
      inadvisable to administer antibiotics intrapleurally in the treatment of acute
      pneumonias complicated by exudative pleurisy. In chronic pneumonia, the maximal
      content of antibiotic in pulmonary tissue reaches 30% of its serum concentration
      2.5-3 hours after a single intramuscular drug injection. Study of the
      pharmacokinetics of antibiotics administered per os in the treatment of acute
      pneumonia attests to their rapid absorption from the gastrointestinal tract; as a
      rule, the peak concentrations were recorded 1 hour after the drug intake and
      exceeded many times the minimum inhibitory concentration for pneumococci isolated
      from the patients placed under observation.

PMID- 1762856
TI  - [The functional diagnosis of bronchial hyperreactivity and bronchial lability in
      children with bronchial asthma].
AB  - During a remission, bronchial asthma children were examined for bronchial
      hyperreactivity and bronchial lability by means of graded physical exercise
      tests, and pharmacological tests with bronchoconstrictors and bronchodilators. It
      has been established that normal lung function seen during aa remission does not
      mean the lack of bronchial hyperreactivity whereas incomplete recovery of
      bronchial patency during bronchial asthma remission is always attended by
      bronchial hyperreactivity in almost all the cases. In carrying out functional
      tests for bronchial hyperreactivity and bronchial lability, the recording of the
      velocity parameters of forced expiration making it possible to define patency of
      not only the central but also of the peripheral bronchi appeared very
      informative.

PMID- 1762857
TI  - [The functional diagnosis of irreversible changes in the bronchi in chronic
      pneumonia in children].
AB  - The recording of biopotentials of smooth muscle fibers of the bronchial wall in
      chronic pneumonia patients enables one to evaluate the degree of their impairment
      and to differentiate between reversible and irreversible lesions. Assay of the
      electromyobronchograms makes bronchological information more precise, allowing
      prediction of the further course of the inflammatory focus in the lungs.
      Functional diagnosis of the affected parts of the respiratory system is helpful
      in choosing an optimal treatment schedule, promoting improvement of the long-term
      results of both conservative and surgical treatment of patients with chronic
      respiratory pathology.

PMID- 1762858
TI  - [The status and outlook of immunoprophylaxis in the USSR].

PMID- 1762859
TI  - [The types of attitude to disease in functional disorders of the reproductive
      system at puberty].

PMID- 1762860
TI  - [Lipid peroxidation and antioxidant system functions in staphylococcal sepsis in
      nursing infants and the principles of pathogenetic therapy].

PMID- 1762861
TI  - [Neurological disorders and the problem of hip joint dysplasia in nursing
      infants].

PMID- 1762862
TI  - [The characteristics of the clinical manifestations and the prognosis of the
      outcome in suppurative meningitis in infants in the first 2 years of life].

PMID- 1762863
TI  - [Chronic granulomatous disease: the spectrum of the clinico-laboratory disorders
      and the therapeutic procedure].

PMID- 1762864
TI  - [The phytotherapy of children with thrombocytopenic purpura].

PMID- 1762865
TI  - [The treatment of a high fever in young children at the prehospital stage].

PMID- 1762866
TI  - [The treatment of children in a critical state with a combined course of
      bacterial intestinal and acute respiratory viral infections].

PMID- 1762867
TI  - [The characteristics of lipid metabolism in children with primary arterial
      hypertension].
AB  - Overall 183 children with arterial hypertension (AH) were examined. Of these, 122
      suffered from primary arterial hypertension (PAH). The lipid spectrum was defined
      in blood plasma of 95 children with PAH and in 30 normals. The same investigation
      was carried out in 109 parents of the children suffering from PAH. The lipid
      spectrum was established to be heterogeneous. 77.9% of the patients had
      dyslipidemia. A significant relationship was established between the stage of PAH
      and the nature of lipidemia as was a close interrelation between alterations in
      the lipid spectrum of blood plasma and hereditary load as regards essential
      hypertension.

PMID- 1762868
TI  - [The evolution and current characteristics of the clinical picture and treatment
      of brucellosis in children].

PMID- 1762869
TI  - [Medical ethics and deontology from the aspect of gynecology in children and
      adolescents].

PMID- 1762870
TI  - [The clinico-instrumental characteristics of gastroesophageal and duodenogastric
      refluxes in children].

PMID- 1762871
TI  - Virtually real.

PMID- 1762872
TI  - Induced motion: isolation and dissociation of egocentric and vection-entrained
      components.
AB  - Induced motion (IM) is illusory motion of a stationary test target opposite to
      the direction of the real motion of the inducing stimulus. We define egocentric
      IM as an apparent motion of the test target relative to the observer, and vection
      entrained IM as an apparent motion of a stationary object along with an apparent
      motion of the self (vection) induced by the same stimulus. These two forms of IM
      are often confounded, and tests for distinguishing between them have not been
      devised. We have devised such tests. Our test for egocentric IM relies on
      evidence that this form of IM is due mainly to a misregistration of eye movements
      when optokinetic nystagmus (OKN) is inhibited, and on evidence that OKN is evoked
      only by stimuli in the plane of convergence. Our test for vection-entrained IM
      relies on evidence that vection is evoked only by the more distant of two
      superimposed inducing stimuli. Thus we found egocentric IM to be induced without
      vection or vection-entrained IM when subjects converged on a foreground moving
      display with a stationary display in the background, and vection-entrained IM to
      be induced without egocentric IM when subjects converged on a stationary
      foreground display with a moving display in the background. The two types of IM
      were evoked in opposite directions at the same time when subjects converged on a
      foreground moving display while a background display moved in the opposite
      direction. The two forms of IM showed no signs of interaction, and we conclude
      that they rely on independent motion mechanisms that operate within distinct
      frames of reference. A control experiment suggested that the depth adjacency
      effect in IM is determined by the depth adjacency of the inducing stimulus to
      convergence, not just to the test target.

PMID- 1762873
TI  - Gender differences in apparent motion perception.
AB  - Distance disparity is a strong cue to element correspondence in apparent motion.
      Using a 2-AFC paradigm we have previously shown that shape similarity also plays
      a role. We now demonstrate a small gender difference in these effects: women are
      more sensitive to distance disparity, whereas men are more sensitive to
      differences in shape. Furthermore, in the competing presence of a shape cue,
      women's sensitivity to distance decreases while men's sensitivity is unaffected.
      These observations may be related to putative gender differences in the 'form'
      and 'motion-spatial relations' cortical pathways.

PMID- 1762874
TI  - Shape discrimination for motion-defined and contrast-defined form: squareness in
      special.
AB  - Shape discrimination was measured for: (i) two-dimensional rectangular targets
      that were perfectly camouflaged within a stationary pattern of random dots and
      rendered visible by relative motion of the dots, and (ii) similar dotted
      rectangles that were rendered visible by luminance contrast. Shape discrimination
      was disconfounded from size discrimination by requiring subjects to discriminate
      the aspect ratios of rectangles whose areas were altered independently of aspect
      ratio. When dot speed and contrast were both high, the aspect-ratio
      discrimination threshold was as acute for motion-defined (MD) rectangles as for
      contrast-defined (CD) rectangles and, at 2-3%, corresponded to a change of side
      length of about 24 s arc compared to a mean dot separation of 360 s arc.
      Discrimination of MD rectangles collapsed at low dot speeds and could not be
      measured at speeds less than about 0.03-0.08 deg s-1, but discrimination of CD
      rectangles was almost unaffected by dot speed. The aspect-ratio discrimination
      threshold was lowest for a square and progressively increased as the rectangle
      became more asymmetric. It is suggested that the visual system contains a
      mechanism that compares the separations of pairs of contours along different
      azimuths, and that, during visual development, this shape-discrimination
      processing of MD and CD targets is driven by the same environmental and
      behavioural pressures towards a common end point. The human equivalent of a
      pathway that includes the cortical area MT is thought to be important for shape
      discrimination of MD forms.

PMID- 1762875
TI  - On the salience of the inducer's displacement in induced rotary movement.
AB  - It has been reported that an annulus patterned with two equally-spaced radial
      lines elicits slower induced rotary movement than an annulus patterned with
      sixteen equally-spaced radial lines. This has been attributed to the quantity of
      inducing stimulation. However, the number of pattern elements also affects the
      time course of induced rotary movement: it can be intermittent with two-radii
      inducers, but persistent with sixteen-radii inducers. Displacement of a two-radii
      inducer may be more salient to the subject than displacement of a sixteen-radii
      inducer: from time to time the displacement of the former may come to dominate
      perception, suppressing induced movement. Hypotheses invoking quantity of
      stimulation and salience of inducer displacement were tested by way of inducers
      with different numbers and spacings of pattern elements. Subjects timed induced
      rotary movement (experiment 1) and a subsequent aftereffect (experiment 2). The
      results were consistent with both the quantity of stimulation (experiments 1 and
      2) and the salience of inducer displacement (experiment 2) having an effect. This
      suggests that at least two mechanisms may be involved in induced rotary movement.

PMID- 1762876
TI  - Serial search for targets defined by divergence or deformation of optic flow.
AB  - The optic flow field can be described in terms of the local differential
      measures, divergence, deformation, and rotation, which are informative about
      observer motion and the 3-D structure of the environment. Does an explicit
      representation of these measures exist in human visual processing in the form of
      a feature map? Triesman's criteria were used to investigate this; ie is there
      'pop-out' for a target defined as different in local divergence or deformation
      from surrounding elements, or is a serial search necessary? The stimulus arrays
      contained 3, 5, or 9 square or rectangular elements, which each underwent
      repeated cycles of expansion, contraction, or deformation. The time required to
      detect a target undergoing the opposite transformation increased steeply with the
      number of elements, implying very slow serial search. (The mean time was 210 ms
      per element for divergence targets and 542 ms per element for deformation). The
      process was clearly still serial when the density and number of elements was
      increased up to 48 in an array 2.16 deg x 2.16 deg. In contrast, a single line
      element undergoing the opposite direction of translation motion to the rest of
      the display did show pop-out. It is concluded that no parallel processes seem to
      exist which are sensitive to the spatial uniformity of divergence and of
      deformation of optic flow. These differential properties may be derived as
      conjunctions of signals from a primary process which extracts local velocity.
      This result contrasts with our findings for targets defined by stereo disparity
      gradient, which show parallel processing in analogous experiments.

PMID- 1762877
TI  - Pre-attentive detection of a target defined by stereoscopic slant.
AB  - Does the visual system represent stereoscopic depth purely as a map of local
      disparities, or does it explicitly represent local relationships of disparity,
      such as disparity gradients? Experiments are reported in which visual search for
      a target containing the same disparity range as other elements in the display,
      but differing in the relationship of the disparities (stereo slant), was used to
      determine whether the target showed 'pop-out' like a unitary feature, or the
      serial search characteristic of feature conjunctions. Each stereo pair of
      elements was selected randomly from a range of outline parallelograms leaning to
      the right or to the left, so that the target could not be identified using any
      monocular shape cue. Response times for detection of the target (present on 50%
      of the trials) were independent of the number of elements in the display. This
      result was confirmed by varying element size and spacing, and by using oblique
      crosses rather than parallelograms as stimuli. It is concluded that
      stereoscopically defined slant, or disparity gradient, can be processed and
      compared in parallel across the display, and acts in this respect as an explicit
      unitary visual property. This contrasts with findings in analogous experiments on
      movement, which show that targets defined by divergence or deformation of optic
      flow can only be identified by serial search.

PMID- 1762878
TI  - Training effects on dynamic visual acuity with free-head viewing.
AB  - Training effects on dynamic visual acuity (DVA) were determined over a range of
      target durations and target velocities under the viewing condition of free-head
      movement. Dynamic acuity levels were lower than static acuity levels, and
      training was found to be very effective in improving performance, particularly
      under the most difficult conditions in which performance was poorest. Improvement
      was also most evident among those observers who initially exhibited the poorest
      DVA scores. Preliminary comparisons between DVA scores of a nonselect sample of
      college students and those of a small group of college athletes indicated that
      the athletes were not very different from the nonselect group and would also
      benefit from training on the task.

PMID- 1762879
TI  - Comparison of contrast sensitivity functions across three orientations:
      implications for theory and testing.
AB  - The contrast sensitivity functions of a large group of observers (N = 71) were
      determined for three orientations of test gratings: vertical, oblique, and
      horizontal. Comparison of group means indicated that, consistent with previous
      findings for the 'oblique effect', sensitivity was poorer for the oblique
      orientation-but only for the mid-high spatial frequencies. Correlation analyses
      indicated that contrast sensitivity for a particular spatial frequency at a given
      orientation was highly correlated with contrast sensitivity for that same
      frequency at the other two orientations. Factor analysis of the intercorrelations
      revealed two strong factors, a low frequency factor, and a mid-high frequency
      factor. Results are discussed in terms of: (a) the implications for contrast
      sensitivity testing across orientations, (b) the basis for the oblique effect,
      and (c) a different type of evidence for a dichotomy among spatial-frequency
      channels that may reflect the distinction between X cells and Y cells or between
      the parvocellular and magnocellular systems.

PMID- 1762880
TI  - Origins of the proprioceptive function of vision: visual control of posture in
      one day old domestic chicks.
AB  - Recently hatched domestic chicks control their upright bipedal posture, at least
      in part, with respect to the flow of visual information at the retina, as do
      human infants when they first acquire control of the head, of sitting, and of
      standing. Some implications of the similarity of the proprioceptive function of
      vision in chicks and in humans for the origins and development of postural
      control are discussed.

PMID- 1762881
TI  - The spacing illusion: a spatial aperture problem?
AB  - A geometrical illusion in which the horizontal spacing between adjacent parallel
      lines in a row is underestimated when the lines are tilted away from vertical in
      a chevron configuration was investigated in two experiments. The perceived
      spacing was found to decrease as the tilt angle increased, consistent with the
      idea that separation judgements are influenced by the normal spacing between
      lines ie at right angles to the line orientation. It is proposed that this
      illusion reveals an analogue in spatial perception to the well-known aperture
      problem in motion perception. In establishing the separation of nearby or
      overlapping shapes in an image, the visual system cannot only rely upon the
      normal separation of contours belonging to each shape (as would be visible
      through small spatial apertures or receptive fields), since this varies with
      contour orientation. The system is therefore faced with a spatial aperture
      problem. The spacing illusion may arise because information usually available to
      solve the problem is absent in the illusion figure, or it may reflect a bias in
      favour of the orthogonal, which is adopted in the face of the ambiguity.

PMID- 1762882
TI  - Integration of form across saccadic eye movements.
AB  - To perceive a stable world, one must somehow be able to relate visual information
      from successive fixations. Little is known, however, about the nature of the
      integrative process. By using a task which requires the integration of spatial
      position information from different fixations, it is demonstrated that visual
      information from previous fixations is preserved in a world-centered
      representation which is precise enough to support judgements of geometric shape.
      It is also shown that successive views are aligned with respect to common visual
      features, indicating that visual stability may be normally accomplished by a
      visual matching strategy in combination with cancellation by an eye-position
      signal.

PMID- 1762883
TI  - Influence of physical and semantic information in a categorisation task of
      fragmented forms.
AB  - Two experiments were carried out to investigate the influence of structural and
      semantic information in the categorisation of visual forms. In experiment 1 the
      stimuli were pairs of 'well structured' or 'poorly structured' fragmented forms
      differing in structural properties including convexity, collinearity, and closure
      of the elements, and in their 'nameability'. The influence of structural and
      semantic information was tested by means of a task involving the presentation to
      both visual hemifields separately of stimuli having within-category physical
      similarity. For well structured forms, subjects were asked to judge if two
      sequentially presented forms belonged to the same semantic category. For poorly
      structured forms, subjects were required to decide if two stimuli belonged to the
      same previously learnt category of forms. For the two types of stimuli, one
      category was composed of physically similar items, and the other was composed of
      physically dissimilar items. The results show a marked advantage for the category
      composed of physically similar forms when the stimuli are well structured but no
      differences between the two categories when the stimuli are poorly structured.
      This suggests a facilitation in the computation of global shape information for
      forms having collinear and closed elements. The only effect of semantic
      information was a tendency towards a right visual field advantage for same
      category pairs of well structured forms. The pattern of results for well
      structured fragmented forms (experiment 1) and forms in which fragments had been
      joined in order to complete the contour (experiment 2) were similar, suggesting
      that structured incomplete forms can be processed in the same way as forms having
      a continuous contour. Hypotheses about the organisational processes of forms are
      proposed in the discussion.

PMID- 1762884
TI  - Thumb's rule tested: visual angle of thumb's width is about 2 deg.
AB  - Measures of the size of various hand parts and their viewing distance when held
      at arm's length were made on one hundred and eighteen undergraduate students. A
      simple rule of thumb can be confirmed: Visual angle of the width of the thumb
      held at arm's length is about 2 deg. The thumbnail subtends about 1.5 deg and the
      index fingernail about 1 deg in width, when both are held at arm's length. These
      figures are good approximations for males and females, although a significant,
      direct, linear relationship exists between hand-part size and the visual angle of
      the part at arm's length.

PMID- 1762885
TI  - Mandatory HIV testing of health care workers.

PMID- 1762886
TI  - Qualitative empirical nursing research.

PMID- 1762887
TI  - Continuing education--a professional mandate.

PMID- 1762888
TI  - Domestic violence 91-92: implications for nurses.

PMID- 1762889
TI  - [Scandinavian alcohol policy. Inconvenience or prevention?].
AB  - Both the occurrence of alcohol-related disorders and the effect of alcohol
      control policies on the level of alcohol consumption are well documented.
      Experience in the absence of restrictions has shown that price control, age
      limits, restricted availability, and other measures in fact have significant
      effects. As alignment with the European Community will probably limit the
      possibility of using price as an instrument of alcohol control, it will be
      important to preserve other methods of minimising alcohol consumption, and to
      promote public understanding and support of general alcohol control measures.

PMID- 1762890
TI  - [Scandinavian alcohol policy and future Europe].
AB  - Among the measures pertinent to Nordic alcohol policy neither age limits,
      information campaigns nor the issue of licences will be affected by a possible
      membership of EC. The Nordic countries stricter rules in this regard will be
      accepted. On the other hand it will probably be difficult to sustain the alcohol
      monopoly, the price policy, and the ban on advertisements. If the alcohol policy
      in the EC countries is imported to the Nordic area there is reason to believe
      that this will have dramatic consequences for the consumption of alcohol and
      alcohol-related problems in Finland, Iceland, Norway and Sweden.

PMID- 1762891
TI  - [NAD (Scandinavian Research Alcohol and Drugs)--important center for cross
      scientific contacts in the alcohol and drug field].

PMID- 1762892
TI  - [Danish alcohol policy].
AB  - The Danish alcohol policy is not as restrictive as in Sweden and Norway but based
      on information and taxes. The taxes on alcohol have now been reduced as a
      consequence of the establishment of the inner market in EEC. The expected higher
      consumption of alcohol will most likely increase the already high cost of health
      care and social welfare.

PMID- 1762893
TI  - [First-pass metabolism of alcohol and its clinical significance].
AB  - The metabolism of alcohol also proceeds in other parts of the body as well as the
      liver. Some part of the alcohol consumed by mouth is metabolized chiefly through
      the alcohol-dehydrogenase (ADH) activity in the gastric membrane before it is
      taken up into the bloodstream. This significant first pass-metabolism of alcohol,
      particularly on a full stomach, protects the organism against high concentrations
      of alcohol. The first pass-metabolism is lower in women than in men. It is low in
      alcoholics too, presumably because of alcohol-related damage to the gastric
      membrane. Several drugs in common use reduce the ADH activity in the gastric
      membrane, a point it may be well to remember when treating patients who use
      alcohol.

PMID- 1762894
TI  - [Finland's Medical Society's action program. Assistance for physicians with an
      alcohol problem].

PMID- 1762895
TI  - Women, youth and alcohol.

PMID- 1762896
TI  - [Munchausen syndrome. A rare condition requiring many resources].
AB  - This syndrome is an infrequent, but dramatic disorder. The patients do
      intentionally produce or feign physical symptoms in order to assume a patient
      role without any other obvious gain. It also characterized by multiple admissions
      to different wards and hospitals over years. The disorder differs from the
      somatoform disorders by the voluntary produced symptomatology. From a psychiatric
      angle of view the possible comorbidity with personality disorders is highlighted.
      Medicolegal aspects of the disorder is also discussed, particularly the
      legitimacy of accepting these persons' status as patients. References are made to
      the man who has given the name to the syndrome; an eighteen century German baron
      whose tall tales from his military service were used as illustrations to the
      syndrome nearly one and a half century later.

PMID- 1762897
TI  - [Rehabilitation of stroke patients. Possibilities, duration and effect].
AB  - A close relationship exists between the severity of a stroke and the functional
      level that can be obtained after rehabilitation. The goal of rehabilitation,
      therefore, should be based on the severity of the stroke. Remission mainly takes
      place (more than 80 per cent) within the first three months post stroke.
      Remission after six months is very rare. Age and side of hemiparesis do not seem
      to influence the effect of rehabilitation significantly. It is not elucidated
      whether the severity of the stroke influence the effect of rehabilitation. Most
      of the controlled and the randomized studies indicate that rehabilitation of
      stroke patients, especially in rehabilitation units, accelerate remission,
      reduces length of stay and gives rise to a lasting improvement of function.

PMID- 1762898
TI  - [Current therapeutic targeting possibilities in leukemia].
AB  - Investigations on the configuration of immunoglobulin (Ig) and T-cell receptor
      (TCR) genes have become more and more widespread. Through these methods it is
      possible to identify malignant clones, which by a transforming event have been
      blocked in further differentiation but continued to proliferate. Such clonal
      expansions can be verified by the Southern Blotting procedure as differences in
      molecular weight between normal and rearranged DNA fragments. In the lymphatic
      disorders it is possible to assign the malignant clone to B cell lineage by
      rearrangement in the immunoglobulin light chain gene, while heavy chain and T
      cell receptor genes do not show consistency in lineage restriction. In a study on
      AML patients with solitary expression of the T-cell marker CD7 we have identified
      a similarity in TCR beta and delta gene configurations, indicating a correlation
      between etiology and genetic pattern. Such observations can contribute to an
      elucidation of the malignant blood-diseases and by that a better choice in
      therapy.

PMID- 1762899
TI  - [Treatment with inhalation therapy or tablets?].

PMID- 1762900
TI  - Upstream box/TATA box order is the major determinant of the direction of
      transcription.
AB  - Mammalian gene promoters for transcription by RNA polymerase II are typically
      organized in the following order: upstream sequence motif(s)/TATA box/initiation
      site. Here we report studies in which the order, orientation and DNA sequences of
      these three elements are varied to determine how these affect polarity of
      transcription. We have constructed promoters with an 'octamer' upstream sequence
      ATTTGCAT (or its complement ATGCAAAT) in combination with several different TATA
      boxes and initiation (cap) sites, and tested these promoters in transfection
      experiments with cultured cells. TATA boxes derived from the adenovirus major
      late promoter (TATAAAA), immunoglobulin kappa light chain (TTATATA) and heavy
      chain (TAAATATA) promoter functioned equally well or even better when inverted.
      Only the beta-globin TATA box (CATAAAA) was poorly active when inverted. In
      addition, a symmetrical TATA box (TATATATA) derived from a casein gene was very
      active. Our results suggest that the asymmetry of most TATA boxes (consensus
      TATAAAA) is not a primary determinant of the polarity of transcription. We also
      found that the initiation (cap) site, which usually consists of an adenine
      embedded in a pyrimidine-rich region (PyPyCAPyPyPyPyPy), was permissive towards
      sequence alterations; even a randomly composed sequence worked well. However, an
      inverted, hence purine-rich, cap site reduced transcript levels to 1/7th, as did
      an oligo G sequence. Irrespective of the presence of a cap site, the
      configuration: 'TATA box/octamer' yielded a strong leftward, rather than
      rightward transcription. From this, we conclude that the polarity of
      transcription is primarily determined by the linear order of an upstream sequence
      relative to a TATA box, rather than by the individual orientations of either of
      these two elements.

PMID- 1762901
TI  - The role of two surface exposed loops in transcription activation by the
      Escherichia coli CRP and FNR proteins.
AB  - We have investigated a number of mutations that alter the ability of the E. coli
      transcription factors CRP and FNR to activate transcription. In CRP, some
      mutations at position 159 (H159L, H159I and delta 159) prevent transcription
      activation at a number of naturally-occurring and semi-synthetic CRP-dependent
      promoters. We suggest that some feature of the surface-exposed turn around
      residue 159 is recognised by RNA polymerase during transcription activation at
      these promoters. Mutations at position 52 increase CRP activity and reverse the
      effects of H159L and delta 159, most likely by creating a new contact with RNA
      polymerase. However this new contact only gives increased expression when the CRP
      binding site is located 41 1/2 base pairs upstream of the transcription start
      site and fails to reverse the effects of H159L and delta 159 at promoters where
      the CRP site is located further upstream. To explain our results we propose that
      the two surface-exposed turns around residues 52 and 159 contain elements that
      are potential RNA polymerase docking sites: in the CRP dimer these two active
      patches are located on adjacent faces of different subunits. FNR, a related
      transcription activator, contains amino acid sequences homologous to the CRP
      sequence around position 52. Mutations in this zone (from residues 81-88 in FNR)
      reduce expression from an FNR-dependent promoter without stopping FNR binding to
      its target. This defines a patch on FNR, which is homologous to the CRP surface
      exposed loop around position 52, which is involved in transcription activation,
      most likely by contacting RNA polymerase.

PMID- 1762902
TI  - Interaction of echinomycin with An.Tn. and (AT)n regions flanking its CG binding
      site.
AB  - We have prepared DNA fragments containing the sequences A15CGT15, T15CGA15 and
      T(AT)8CG(AT)15 cloned within the SmaI site of the pUC19 polylinker. These have
      been used as substrates in footprinting experiments with DNase I and
      diethylpyrocarbonate probing the effects of echinomycin, binding to the central
      CG, on the structure of the surrounding sequences. No clear DNase I footprints
      are seen with T15CGA15 though alterations in the nuclease susceptibility of
      surrounding regions suggest that the ligand is binding, albeit weakly at this
      site. All the other fragments show the expected footprints around the CG site.
      Regions of An and Tn are rendered much more reactive to DNase I and adenines on
      the 3'-side of the CG become hyperreactive to diethylpyrocarbonate. Regions of
      alternating AT show unusual changes in the presence of the ligand. At low
      concentrations (5 microM) cleavage of TpA is enhanced, whereas at higher
      concentrations a cleavage pattern with a four base pair repeat is evident. A
      similar pattern is seen with micrococcal nuclease. Modification by
      diethylpyrocarbonate is strongest at alternate adenines which are staggered in
      the 5'-direction across the two strands. We interpret these changes by suggesting
      secondary drug binding within regions of alternating AT, possibly to the
      dinucleotide ApT. DNase I footprinting experiments performed at 4 degrees C
      revealed neither enhancements nor footprints for flanking regions of
      homopolymeric A and T suggesting that the conformational changes are necessary
      consequence of drug binding.

PMID- 1762903
TI  - Echinomycin binding to alternating AT.
AB  - We have studied the binding of echinomycin to DNA fragments containing GC-rich
      regions flanked by blocks of alternating AT by DNase I footprinting and
      diethylpyrocarbonate modification. Regions of alternating AT flanking the
      sequences CCCG, CCGC, CGGC and GG show a four base pair DNase I cleavage pattern
      and reaction of alternate adenines with diethylpyrocarbonate. This pattern is
      strongest when the AT-block is immediately adjacent to the CpG ligand binding
      site. We explain these phenomena by suggesting that echinomycin binds to the
      dinucleotide step ApT in a cooperative fashion. The cooperative effects can be
      transmitted through the dinucleotide step GC but not CC or AA. No such repetitive
      patterns are seen with surrounding regions of (ATT).(AAT). Evidence is presented
      for secondary drug binding sites at CpC and TpG with weaker interaction at the
      CpG site within the hexanucleotide TTCGAA.

PMID- 1762904
TI  - DNA polymerase delta: gene sequences from Plasmodium falciparum indicate that
      this enzyme is more highly conserved than DNA polymerase alpha.
AB  - Genes encoding proteins homologous to the catalytic subunits of DNA polymerase
      alpha and delta have been cloned from the human malaria parasite Plasmodium
      falciparum. These are among the first cellular replicative DNA polymerase genes
      to be cloned and their sequences allow us to make new statements about the
      relative degrees of conservation of these two enzymes. The most important finding
      was that P. falciparum Pol delta showed considerable homology to the only other
      Pol delta enzyme for which published sequence is available, that of S.
      cerevisiae, displaying an overall amino acid identity of 45% and identity over a
      highly conserved central region of 59%. In contrast, the level of identity shown
      over the equivalent central region of Pol alpha between the P. falciparum and S.
      cerevisiae sequences is only 32%. The sequence data also allowed us to examine
      the degree of conservation in putative exonuclease domains of Pol delta. The Pol
      delta gene of P. falciparum maps to chromosome 10 and evidence is presented for
      the presence of different sized Pol delta mRNA's in the asexual and sexual
      erythrocytic stages of parasite development.

PMID- 1762905
TI  - Cloning and characterization of the rad4 gene of Schizosaccharomyces pombe; a
      gene showing short regions of sequence similarity to the human XRCC1 gene.
AB  - The rad4.116 mutant of the fission yeast Schizosaccharomyces pombe is temperature
      sensitive for growth, as well as being sensitive to the killing actions of both
      ultraviolet light and ionizing radiation. We have cloned the rad4 gene by
      complementation of the temperature sensitive phenotype of the rad4.116 mutant
      with a S. pombe gene bank. The rad4 gene fully complemented the UV sensitivity of
      the rad4.116 mutant. The gene is predicted to encode a protein of 579 amino acids
      with a basic tail, a possible zinc finger and a nuclear location signal. The
      amino terminal part of the predicted rad4 ORF contains two short regions of
      similarity to the C-terminal part of the human XRCC1 gene. Codon usage suggests
      that the gene is very poorly expressed, and this was confirmed by RNA studies.
      Gene disruption showed that the rad4 gene was essential for the mitotic growth of
      S. pombe.

PMID- 1762906
TI  - In the Escherichia coli lacZ gene the spacing between the translating ribosomes
      is insensitive to the efficiency of translation initiation.
AB  - We have constructed a series of 44 Escherichia coli strains in which the
      chromosomal region corresponding to the Ribosome Binding Site (RBS) of the lacZ
      gene, has been replaced by small DNA fragments harboring either RBSs from other
      genes, or artificial RBSs. The beta-galactosidase expression from these strains
      ranges from 1 to 130 per cent of that of the parental strain. Using this
      collection, we demonstrate here that strain-to-strain variations in expression
      are paralleled by nearly equivalent variations in lacZ mRNA content. We propose
      that, in this system, polarity and mRNA stability are tightly coupled to
      translation initiation, so that changes in RBS efficiency are detected mainly as
      changes in mRNA concentration rather than in the spacing between translating
      ribosomes. In addition, we show that the mRNA sequence immediately downstream
      from the initiator codon influences per se the lifetime of the lacZ mRNA. We
      discuss the mechanism of the interdependence between translation, transcription
      and degradation in this gene, and speculate about the general role of this
      interdependence in determining the expression of bacterial genes.

PMID- 1762907
TI  - Site-specific cleavage of natural mRNA sequences by newly designed hairpin
      catalytic RNAs.
AB  - The negative strand of tobacco ringspot virus satellite RNA is a self-cleaving
      RNA. Its catalytic domain and substrate domain have been identified, and the
      catalytic domain has been named hairpin catalytic RNA. Here we report the
      construction of a plasmid containing a modified hairpin catalytic RNA sequence
      that can be transcribed in vitro. Because this plasmid has two specific
      restriction enzyme recognition sites at both ends of the substrate binding site
      in the catalytic RNA sequence, it is possible to construct new plasmids by
      substituting different sequences in the substrate binding site. Using this
      plasmid, synthetic DNA, and in vitro transcription, we obtained three ribozymes
      designed to cleave Escherichia coli prolipoprotein signal peptidase (lsp) mRNA at
      specific sites. All three ribozymes cleaved the lsp mRNA sequence in vitro at the
      specific sites, and two of them cleaved it efficiently. Kinetic analyses showed
      that one had a higher kcat/Km value than that of the well-known hammerhead
      ribozyme. Problems associated with attaining the goal of expressing these
      ribozymes in vivo also are discussed.

PMID- 1762908
TI  - Apolipoprotein B mRNA sequences 3' of the editing site are necessary and
      sufficient for editing and editosome assembly.
AB  - Apolipoprotein B (apoB) mRNA is edited in rat liver and intestine through the
      direct conversion of cytidine to uridine at nucleotide 6666. Recently, we have
      proposed the 'Mooring Sequence' model, in which editing complexes (editosomes)
      assemble on specific apoB mRNA flanking sequences to direct this site-specific
      editing event. To test this model, apoB mRNA deletion and translocation mutants
      were constructed and analyzed. Specific sequences 3' of the editing site were
      absolutely required for editing, while specific sequences and bulk RNA 5' of the
      editing site were required for efficient editing. Translocation of apoB 3'
      flanking sequences induced editing of an upstream cytidine, demonstrating that 3'
      sequences are necessary and sufficient to direct editing in vitro. 3' flanking
      sequences were also shown to be necessary and sufficient for editosome complex
      assembly. These data provide strong support for a 'Mooring Sequence' model in
      which 3' apoB flanking sequences direct editosome assembly and subsequent editing
      in vitro, while 5' flanking sequences enhance these functions.

PMID- 1762909
TI  - cDNA cloning of the HMGI-C phosphoprotein, a nuclear protein associated with
      neoplastic and undifferentiated phenotypes.
AB  - The HMGI-C protein is a nuclear phosphoprotein expressed at high levels in
      transformed cells. The cDNA encoding the mouse protein has been isolated and the
      sequence of the encoded protein shows that it is related to the HMGY and I
      proteins, proteins which bind in the minor groove of DNA containing stretches of
      A and T. The HMGI-C protein has three short highly basic domains, an acidic C
      terminal domain, and potential CDC2/p34 and casein kinase II phosphorylation
      sites. Analysis of mRNA levels demonstrate that the HMGI-C gene is not expressed
      in a variety of mouse tissues but is expressed in Lewis lung carcinoma cells.

PMID- 1762910
TI  - Presence of regulatory sequences within intron 2 of the mouse thymidine kinase
      gene.
AB  - The intron 2 of the murine thymidine kinase (TK) gene was observed to contain two
      DNase hypersensitive site. In vitro footprinting experiments indicated specific
      binding sites for nuclear proteins which were characterized within the sequence
      of intron 2. Two GC boxes (binding sites for transcription factor SP1) and two
      new protein binding regions, one at the promoter proximal end of intron 2, the
      other one close to the border to exon 3 were found. Oligonucleotides were
      synthesized comprising the two new binding sites and were shown in gel mobility
      shift experiments to be capable of forming specific complexes with nuclear
      proteins. These proteins are present in growing as well as in quiescent cells
      suggesting that the sites described here do not contribute to growth regulation
      of TK expression. That they might play a role in upregulation of TK expression
      is, however, indicated by the results of CAT assays in which inclusion of
      downstream sequences of the TK gene containing parts or all of intron 2 were
      found to positively modulate the activity of the TK promoter.

PMID- 1762911
TI  - Probing of DNA structure with osmium tetroxide,2,2'-bipyridine. Adduct-specific
      antibodies.
AB  - Antibodies against DNA modified with a single-strand selective probe, OsO4 in
      complex with 2,2'-bipyridine (Os,bipy), were raised in rabbits. These antibodies
      were fractionated using affinity column chromatography and fractions S89-II and
      S89-III characterized as highly specific for DNA-Os,bipy adduct with no cross
      reactivity to at least 1000-fold excess of unmodified DNA, RNA and Os,bipy
      modified and unmodified proteins. Cross-reactivity to Os,bipy-modified RNA was
      very small. S89-II showed no cross-reactivity to DNA modified with OsO4 complexed
      with tetramethylethylenediamine or with bathophenanthroline disulphonic acid and
      to DNA oxidized with KMnO4. It cross-reacted, however, with DNA modified with
      OsO4,1,10-phenanthroline complex. The limit of detection of immunodot-blot
      analysis of extensively Os,bipy-modified DNA was below 0.5 pg. Small extent of
      Os,bipy-modification of supercoiled and linearized plasmids can be detected by
      DNA gel retardation and immunoblotting techniques. E. coli cells contain DNA
      regions in which bases are accessible to the single-strand selective probe.

PMID- 1762912
TI  - Requirement of protein factors and ATP for the disassembly of the spliceosome
      after mRNA splicing reaction.
AB  - Pre-mRNA splicing reaction occurs in a large ribonucleoprotein complex called the
      spliceosome. After the splicing reaction, the spliceosome is disassembled to
      release the splicing products including spliced mRNA. Here we show that protein
      factors in a HeLa nuclear extract or a DEAE-cellulose fraction as well as ATP are
      required to release the splicing products form the spliceosome in which the
      splicing reaction has already completed.

PMID- 1762913
TI  - Distribution of repetitive DNA sequences in eubacteria and application to
      fingerprinting of bacterial genomes.
AB  - Dispersed repetitive DNA sequences have been described recently in eubacteria. To
      assess the distribution and evolutionary conservation of two distinct prokaryotic
      repetitive elements, consensus oligonucleotides were used in polymerase chain
      reaction [PCR] amplification and slot blot hybridization experiments with genomic
      DNA from diverse eubacterial species. Oligonucleotides matching Repetitive
      Extragenic Palindromic [REP] elements and Enterobacterial Repetitive Intergenic
      Consensus [ERIC] sequences were synthesized and tested as opposing PCR primers in
      the amplification of eubacterial genomic DNA. REP and ERIC consensus
      oligonucleotides produced clearly resolvable bands by agarose gel electrophoresis
      following PCR amplification. These band patterns provided unambiguous DNA
      fingerprints of different eubacterial species and strains. Both REP and ERIC
      probes hybridized preferentially to genomic DNA from Gram-negative enteric
      bacteria and related species. Widespread distribution of these repetitive DNA
      elements in the genomes of various microorganisms should enable rapid
      identification of bacterial species and strains, and be useful for the analysis
      of prokaryotic genomes.

PMID- 1762914
TI  - Constitutive expression of the urokinase plasminogen activator gene in murine
      RAW264 macrophages involves distal and 5' non-coding sequences that are conserved
      between mouse and pig.
AB  - The 5' flanking regions of the mouse and pig urokinase plasminogen activator
      (uPA) genes were sequenced and sequence homology interrupted by repeat elements
      was found to extend to -4.6kb in pig and -6.6kb in mouse. A transient
      transfection procedure was devised for the murine macrophage cell line RAW264.
      Pig uPA promoter-CAT constructs were more active than mouse constructs in this
      assay. This contrast may involve sequence differences within 100 bp of the
      transcription start site. The selective deletion of distal regions of the
      promoter (greater than 2.6 kb upstream), and of a conserved element, 5'
      AGGAGGAAATGAGG-TCA-3' around -2 kb greatly reduced the activity of reporter
      constructs in RAW264 cells. Electrophoretic mobility shift assays using the
      latter sequence identified a single nuclear protein complex. This element has
      been referred to as PEA3/AP1-like, but the complex did not comigrate with either
      AP1 or known proteins that bind polypurines (including the macrophage-specific
      factor PU-1) and was not competed by AP1 or polypurine oligonucleotides. uPA
      promoters contain multiple AP1 and AP2-like DNA sequences, which were recognised
      by nuclear proteins expressed constitutively in RAW264 cells. They also contain
      multiple binding sites for NF kappa B but activated NF kappa B was not expressed
      in RAW264 cells. The conserved, transcribed 5' non-coding sequences were also
      required for maximal gene expression. Hence, the uPA promoter contains multiple
      weak cis-acting elements distributed over 7.0 kb 5' to the translation start
      site.

PMID- 1762915
TI  - An efficient, sequence-specific method for crosslinking complementary
      oligonucleotides using binuclear platinum complexes.
AB  - The binuclear PtII complexes [(trans-Pt(NH3)2Cl)2 (NH2(CH2)nNH2)]Cl2 (n = 4, 5 or
      6), crosslink oligodeoxynucleotide-5'-phosphorothioates rapidly, specifically and
      efficiently to complementary single-stranded oligodeoxynucleotide targets. In the
      case that we investigated in detail, the most abundant crosslink is formed to the
      G residue complementary to the 5'-terminal C residue of the phosphorothioate.
      Less efficient crosslinking occurs to many other residues of the target. The same
      PtII complexes also bring about crosslinking efficiently to the polypurine tract
      in triple-helical DNA.

PMID- 1762916
TI  - Purification and substrate specificity of a T4 phage intron-encoded endonuclease.
AB  - The T4 phage td intron-encoded endonuclease (I-Tev I) cleaves the intron-deleted
      td gene (td delta I) 23 nucleotides upstream of the intron insertion site on the
      noncoding strand and 25 nucleotides upstream of this site on the coding strand,
      to generate a 2-base hydroxyl overhang in the 3' end of each DNA strand. I-Tev I
      157, a truncated form in which slightly more than one third (88 residues) of the
      endonuclease is deleted, was purified to homogeneity and shown to possess
      endonuclease activity similar to that of I-TEV I, the full-length enzyme (245
      residues). The minimal length of the td delta I gene that was cleaved by I-Tev I
      and I-Tev I-157 has been determined to be exactly 39 basepairs, from -27
      (upstream in exon1) to +12 (downstream in exon2) relative to the intron insertion
      site. Similar to the full-length endonuclease, I-Tev I-157 cuts the intronless
      thymidylate synthase genes from such diverse organisms as Escherichia coli,
      Lactobacillus casei and the human. The position and nature of the in vitro
      endonucleolytic cut in these genes are homologous to those in td delta I. Point
      mutational analysis of the td delta I substrate based on the deduced consensus
      nucleotide sequence has revealed a very low degree of specificity on either side
      of the cleavage site, for both the full-length and truncated I-TEV I.

PMID- 1762917
TI  - Structural elements in the N-terminal half of transcription factor IIIA required
      for factor binding to the 5S RNA gene internal control region.
AB  - Zinc binding domains and the conserved Thr-Gly-Glu-Lys (TGEK) tetrapeptide in the
      N-terminal half of transcription factor IIIA (TFIIIA) were subjected to in vitro
      mutagenesis to biochemically assess their role in factor interaction with the 5S
      gene internal control region (ICR). TFIIIA containing a Leu in place of His33 in
      the Cys2His2 zinc binding site of finger I lost the ability to protect the entire
      5S RNA gene ICR (nucleotides +96 to +43) from DNase I digestion. Thus, mutation
      of one potential zinc ligand in the N-terminal finger inhibited specific DNA
      binding by the N-terminal as well as downstream fingers. Cooperativity apparently
      exists among TFIIIA zinc fingers in metal binding/finger folding and DNA binding.
      Substituting a Ser for Gly69 or a Glu for Lys 71 in the conserved TGEK
      tetrapeptide in finger II of TFIIIA resulted in the loss of DNA binding. A Gly
      dependent bend structure and a terminal positive charge in this tetrapeptide are
      important for TFIIIA interaction with DNA. Whereas TFIIIA with a Ser substituted
      for Cys20 in finger I (proposed zinc ligand) did not protect the ICR from DNase I
      digestion, TFIIIA containing a Ser substituted for Cys35 (not a proposed zinc
      ligand) retained the ability to bind the ICR. When Cys112 or Cys 164 (proposed
      zinc ligands in fingers IV and VI) were replaced by Ser, the DNase I footprint
      patterns afforded by the respective mutant proteins were similar, protection on
      the ICR from about nucleotides +96 up to +78. A similar pattern was obtained with
      a TFIIIA mutant in which fingers V, VI, VII, and a portion of VIII were deleted.
      Maintenance of zinc coordination spheres in necessary for DNA binding by
      downstream fingers. The six fingers comprising the N-terminal half of TFIIIA
      appear to act in two groups of three with binding of the second group dependent
      upon initial binding of the N-terminal group to the +90 to +80 region of the 5S
      gene ICR.

PMID- 1762918
TI  - Cloning and physical mapping of DNA sequences encompassing a region in N-myc
      amplicons of a human neuroblastoma cell line.
AB  - Cloning and physical mapping of DNA sequences encompassing N-myc amplicons of a
      human neuroblastoma cell line were done. A number of lambda phage clones within
      this region were isolated using the probes prepared by the phenol emulsion
      reassociation technique. Based on the restriction mapping, they were integrated
      into 8 contigs with sizes of 25-60 kb which, in total, encompassed a 330 kb
      region. Several amplicons, 100, 420, 480 and 520 kb in size as a Notl fragment,
      were identified using hexagonal field gel electrophoresis, and the contigs were
      assigned in these Notl fragments. The region encompassed by the contigs was
      equivalent to some 60-80% of the amplicons identified as a Notl fragment. In
      order to compare the amplified regions flanking the N-myc gene among the cell
      lines, the phage clones to cover the whole contigs were used for hybridization as
      a probe. The results showed that the portions of the whole contigs ranging 18-45%
      were also amplified in the cell lines examined. These results allowed us to
      identified the 'rearranged sites' which were rather evenly distributed, one at
      every 40 kb, through the contigs. These observations lead to the idea that an
      amplified DNA domain is constructed after the multiple rearrangements and then
      increases in number, finally resulting in the formation of subsets of amplicons
      with sequence homogeneity.

PMID- 1762919
TI  - A novel translation initiation region from Mycoplasma genitalium that functions
      in Escherichia coli.
AB  - The tuf gene of Mycoplasma genitalium uses a signal other than a Shine-Dalgarno
      sequence to promote translation initiation. We have inserted the translation
      initiation region of this gene in front of the Escherichia coli lacZ gene and
      shown that it is recognized by the translational machinery of E. coli; the signal
      operates in vivo at roughly the same efficiency as a synthetic Shine-Dalgarno
      sequence. The M. genitalium sequence was also used to replace the native
      translation initiation region of the cat gene. When assayed in E. coli, the M.
      genitalium sequence is equivalent to a Shine-Dalgarno sequence in stimulating
      translation of this mRNA also. Site-directed mutagenesis enabled us to identify
      some of the bases that comprise the functional sequence. We propose that the
      sequence UUAACAACAU functions as a ribosome binding site by annealing to
      nucleotides 1082-1093 of the E. coli 16S rRNA. The activity of this sequence is
      enhanced when it is present in the loop of a stem-and-loop structure. Additional
      sequences both upstream and downstream of the initiation codon are also involved,
      but their role has not been elucidated.

PMID- 1762920
TI  - Transcription factor binding and spacing constraints in the human beta-actin
      proximal promoter.
AB  - The human beta-actin promoter, including its 5' flanking region and 5'
      untranslated region, is ubiquitously active in mammalian cells in culture. In
      this report we investigated the transcriptional activity of, and the protein-DNA
      interactions that occur within, the proximal region of the human beta-actin
      promoter. Efficient beta-actin promoter activity in transfected human HeLa cells
      requires only 114bp of 5' flanking sequences. Two of the cis-actin regulatory
      elements within this region of the beta-actin promoter, the CCAAT box and
      proximal CCArGG box, are specific in vitro binding sites for the transcription
      factors, nuclear factor Y (NF-Y) and serum response factor (p67SRF),
      respectively. These two elements are required together to stimulate in vivo
      transcription from the homologous as well as a heterologous promoter. Finally, a
      particular spatial alignment between the CCAAT box and proximal CCArGG box is
      required for trans-activation in vivo. The above provides strong evidence for a
      functional interaction between NF-Y and p67SRF when bound to their respective
      binding sites in the beta-actin promoter.

PMID- 1762921
TI  - RNA editing makes mistakes in plant mitochondria: editing loses sense in
      transcripts of a rps19 pseudogene and in creating stop codons in coxI and rps3
      mRNAs of Oenothera.
AB  - An intact gene for the ribosomal protein S19 (rps19) is absent from Oenothera
      mitochondria. The conserved rps19 reading frame found in the mitochondrial genome
      is interrupted by a termination codon. This rps19 pseudogene is cotranscribed
      with the downstream rps3 gene and is edited on both sides of the translational
      stop. Editing, however, changes the amino acid sequence at positions that were
      well conserved before editing. Other strange editings create translational stops
      in open reading frames coding for functional proteins. In coxI and rps3 mRNAs CGA
      codons are edited to UGA stop codons only five and three codons, respectively,
      downstream to the initiation codon. These aberrant editings in essential open
      reading frames and in the rps19 pseudogene appear to have been shifted to these
      positions from other editing sites. These observations suggest a requirement for
      a continuous evolutionary constraint on the editing specificities in plant
      mitochondria.

PMID- 1762922
TI  - Rat elongation factor 1 alpha: sequence of cDNA from a highly metastatic fos
      transferred cell line.

PMID- 1762923
TI  - Complete nucleotide sequence of Friend murine leukemia virus, strain FB29.

PMID- 1762924
TI  - A conserved pseudoknot in telomerase RNA.

PMID- 1762925
TI  - The DNA polymerase gene from the hyperthermophilic marine archaebacterium,
      Pyrococcus furiosus, shows sequence homology with alpha-like DNA polymerases.

PMID- 1762926
TI  - Squashes of plant tissue as substrate for PCR.

PMID- 1762927
TI  - A U1 snRNA binding site improves the efficiency of in vitro pre-mRNA splicing.

PMID- 1762928
TI  - A simple method for sequencing the complementary strand of ssDNA from M13 clones.

PMID- 1762929
TI  - Binding of hairpin and dumbbell DNA to transcription factors.

PMID- 1762930
TI  - Sequencing self-ligated PCR products using 3' over-hangs generated by specific
      cleavage of dUTP by uracil-DNA glycosylase.

PMID- 1762931
TI  - Heat inactivation of DNA ligase prior to electroporation increases transformation
      efficiency.

PMID- 1762932
TI  - An STS in the human oct-1 gene located on chromosome 1.

PMID- 1762933
TI  - Dinucleotide repeat polymorphisms at the D16S164, D16S168 and D16S186 loci at
      16q21-q22.1.

PMID- 1762934
TI  - Dinucleotide repeat polymorphism in the human SRC gene on chromosome 20.

PMID- 1762935
TI  - Dinucleotide repeat polymorphism at the human tyrosinase gene.

PMID- 1762936
TI  - Dinucleotide repeat polymorphism at the FTHPI locus of chromosome 6.

PMID- 1762937
TI  - Dinucleotide repeat polymorphism at the D5S260 locus on chromosome 5q.

PMID- 1762938
TI  - Dinucleotide repeat polymorphism in D20S17 (CRI-L127).

PMID- 1762939
TI  - Properties of a highly polymorphic locus (D2S92) located in the telomeric region
      of chromosome 2.

PMID- 1762940
TI  - G/A polymorphism in an intron of the fibrillin gene FBNI.

PMID- 1762941
TI  - An Alu polymorphism intragenic to the TP53 gene.

PMID- 1762942
TI  - A microsatellite polymorphism at the D3S11 locus.

PMID- 1762943
TI  - Dinucleotide repeat polymorphism in the human angiotensinogen gene.

PMID- 1762944
TI  - Dinucleotide repeat polymorphism in the human coagulation factor XI gene, intron
      B (F11), detected using the polymerase chain reaction.

PMID- 1762945
TI  - Dinucleotide repeat polymorphism in the human alpha-cardiac actin gene, intron IV
      (ACTC), detected using the polymerase chain reaction.

PMID- 1762946
TI  - Tetranucleotide repeat polymorphism at the human beta-actin related pseudogene 2
      (ACTBP2) detected using the polymerase chain reaction.

PMID- 1762947
TI  - Dinucleotide repeat polymorphism at the D11S436 locus.

PMID- 1762948
TI  - A sequence polymorphism in the human peripherin/RDS gene.

PMID- 1762949
TI  - Polymorphism in the protein C gene detected by denaturing gradient gel
      electrophoresis.

PMID- 1762951
TI  - M1: principles of management. Part (i): Are you a manager?

PMID- 1762952
TI  - School nurses should be able to dispense lotion for head lice.

PMID- 1762953
TI  - Film test.

PMID- 1762950
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 1762954
TI  - Not waving ... but drowning.

PMID- 1762955
TI  - Patients' rights?

PMID- 1762956
TI  - The latest gag?

PMID- 1762957
TI  - Silent suffering.

PMID- 1762958
TI  - Elected to counsel.

PMID- 1762959
TI  - Stress--pressure point.

PMID- 1762960
TI  - Stress--something had to give.

PMID- 1762961
TI  - Management--taking stock.

PMID- 1762962
TI  - Education. Student-led maternity care.

PMID- 1762963
TI  - Moonstruck.

PMID- 1762965
TI  - Elderly people's view of nursing reforms.

PMID- 1762964
TI  - Support for staff in community units.

PMID- 1762966
TI  - Unfairly judged.

PMID- 1762967
TI  - Arts in action. Special effects.

PMID- 1762968
TI  - Systems of life. Reproductive system--Part 3.

PMID- 1762969
TI  - Child health--dental plates for oral feeding.

PMID- 1762970
TI  - Psychiatric help needed for people with HIV.

PMID- 1762971
TI  - Pain as a metaphor for illness. Part I: Impact of cancer pain on family
      caregivers.
AB  - While previous research has focused on patients' or professional caregivers'
      perspective of pain, this study describes cancer pain from the family caregivers'
      perspective. Chronic pain, which is associated with malignant disease, produces
      an intense burden on the patient as well as on the entire family. This
      qualitative study included 85 family caregivers of patients with cancer pain.
      Data were collected using an interview guide, and verbatim responses were
      analyzed for themes. The results identified four themes surrounding family
      descriptions of pain (anatomic descriptions, hidden pain, family fear and
      suffering, and overwhelming/unendurable pain) and three themes surrounding family
      experience of pain (helplessness, coping by denying feelings, and a wish for
      death). This study documents the important role that family members play in
      cancer treatment. If the number of patients receiving care in the home from
      family members continues to grow, this role will become even more important. Part
      I of this two-part paper focuses on the impact that cancer pain has on family
      caregivers and concludes that pain does have a tremendous impact on the family
      because it is perceived as a metaphor of progressive illness and death.

PMID- 1762972
TI  - Pain as a metaphor for illness. Part II: Family caregivers' management of pain.
AB  - Changes in the healthcare system have made the patient's home the primary site of
      cancer care. Family members, already burdened with the psychological impact of
      having a loved one with cancer, take on caregiving roles to meet the multiple and
      complex needs of the patient. Part I of this two-part article focused on family
      caregivers' descriptions of the patients' pain and the impact of this pain on
      caregivers. A model of the Caregiver Experience of Pain is provided along with
      implications for future inquiry and clinical practice. Themes identified in
      caregiver roles in medication administration included deciding what to give,
      deciding when to give, night duty, reminding/encouraging, keeping records, fear
      of addiction, and doing everything. Caregiver roles in nondrug interventions
      included positioning/mobility, massage, use of ointments/lotions, cold, heat,
      being there through touch, avoiding touch, and talk and other distractions.
      Caregiver perceptions of what doctors or nurses could do better included themes
      of being there, explain, be honest/listen, addiction concern, and giving
      medication. Caregiver questions included areas of future, understanding why,
      death, concern about medications, and fear about what to do at home. The study
      results offer important suggestions for oncology nurses in supporting family
      caregivers in the management of the patient in pain.

PMID- 1762973
TI  - The therapeutic use of music for cancer-related pain.
AB  - The purpose of this experimental crossover study was to evaluate to what extent
      the therapeutic use of music would decrease pain in patients with cancer who were
      receiving scheduled analgesics. Baseline data were collected for three days.
      Subjects then were assigned randomly to listen to their preference of seven types
      of relaxing music or a control (a 60-cycle hum) twice daily for three days. Then
      they crossed over into the alternate group for the next three days. Finally, each
      subject returned to a follow-up baseline period. Pain, the dependent variable,
      and mood, which was proposed as an intervening variable, were measured by visual
      analogue scales. The convenience sample included 15 outpatients with cancer, 12
      female and 3 male, ages 20 through 87. Results of the McGill Pain Questionnaire
      (MPQ), a reliable and valid multidimensional instrument administered upon entry
      into the study, indicated that the study sample was comparable to other samples
      of patients with cancer who were in pain. There was an inconsistent relation
      between pain and mood. The effect of the music on pain varied by individual; 75%
      had at least some response and 47% had a moderate or great response. Multivariate
      Analysis of Variance (MANOVA) indicated a statistically significant decrease in
      pain from using either the music or sound, but there was no effect on mood.
      Although the mean percentage of change in pain for music was twice that for
      sound, the results did not differ statistically. The findings support the use of
      music as an independent nursing intervention to relieve pain.

PMID- 1762974
TI  - Appraisal and caregiving burden in family members caring for patients receiving
      chemotherapy.
AB  - The purposes of this exploratory study of 49 family caregivers of patients
      receiving chemotherapy were to describe the time and difficulty associated with
      caregiving tasks, examine caregivers' appraisals of their situations, and to
      explore what variables are predictive of caregiver mood. Measures used in this
      study included the Caregiving Burden Scale, Appraisal of Caregiving Scale, Family
      Hardiness Index, and an abbreviated form of the Profile of Mood States. Multiple
      regression was used to examine predictive relationships. The 25 women and 24 men
      reported spending the most time giving emotional support and assisting with
      household tasks, errands, and transportation. Giving emotional support was the
      most time-consuming and difficult task; therefore, it received the highest burden
      score. Burden was predicted by level of patient dependency. Caregiving burden,
      family hardiness, and caregiver health predicted 50% of the variance in negative
      appraisal of caregiving. Negative appraisal and age of the caregiver explained
      49% of the variance in mood disturbance. Findings suggest that caregivers'
      appraisals of their situations may mediate the effects of illness and contextual
      factors on caregiver outcomes and that family hardiness is an important caregiver
      resource.

PMID- 1762975
TI  - A comparison of transparent adherent and dry sterile gauze dressings for long
      term central catheters in patients undergoing bone marrow transplant.
AB  - Patients undergoing bone marrow transplant (BMT) are at great risk of infection
      and sepsis. Long-term central catheters (LTCCs), required for IV therapy, can be
      a portal of entry for infectious agents. This randomized, prospective study
      compared two types of catheter dressings in 98 patients undergoing BMT: a dry
      sterile gauze dressing (DSGD) changed daily and a transparent adherent dressing
      (TAD) changed every four days. Study outcomes included incidence and severity of
      local and systemic complications, patient assessment of comfort, and calculation
      of nursing time. One case of catheter-related infection occurred during the
      study. No significant differences existed between the two dressings in the
      incidence of positive skin cultures or local complications with the exception of
      skin irritation. The TAD caused less skin irritation, was preferred by patients,
      cost less, and required less nursing time. The findings indicate that TADs
      provide a safe, comfortable, and cost-effective alternative to DSGDs for patients
      undergoing BMT and receiving antibiotic support during aplasia.

PMID- 1762976
TI  - Laughter therapy for patients with cancer.
AB  - Humor is an important part of life. Care should be taken to ensure that humor
      persists even during the bleakest times for patients, families, and medical
      personnel. Laughter eases the mind, defuses tension among people, and has
      positive physiologic effects on patients. Facilitated nursing intervention with
      humor helps to inject this important facet of life into difficult scenes. One
      successful approach to introducing humor into the hospital setting is a hall
      roving "Laugh Mobile." Its humorous novelties, books, and films help divert the
      attention of suffering patients to lighter thoughts.

PMID- 1762977
TI  - The practice of breast self-examination among older women.
AB  - Mammography, professional breast examination (PBE), and breast self-examination
      (BSE) are viewed as very important screening techniques for the early detection
      of breast cancer. Mammography and PBE are performed on a routine basis at
      healthcare facilities, while BSE can be performed in the privacy of the home. The
      self-care practice of monthly BSE is important for women of all ages. Older women
      often feel unsure about their ability to perform BSE properly, and many know very
      little about this self-care practice. The purpose of this research study was to
      explore the validity of teaching older women the practice of BSE using the method
      of return demonstration. The inclusion of actual practice opportunities with
      models into teaching sessions resulted in the older women feeling more confident
      about their ability to perform BSE.

PMID- 1762978
TI  - Teaching women about mammography through use of a brochure.
AB  - This paper describes the development and use of a brochure intended to educate
      women about the nature and benefits of mammography. This brochure, which is
      presented in its entirety, has several unique features. It addresses the myths
      associated with mammograms and includes a visual depiction of the difficult-to
      understand concept of relative difference with respect to size of breast lesions.

PMID- 1762979
TI  - 1991 Oncology Nursing Society Research Priorities Survey.
AB  - Documenting current research priorities is an ongoing process that is important
      to furthering the research agenda of oncology nursing. The purpose of this study
      was to update and partially replicate previous Oncology Nursing Society (ONS)
      research priorities surveys. Questionnaires were sent to a convenience sample of
      429 ONS members involved in research or in ONS leadership. The response rate was
      70% (N = 310). Respondents identified a combination of clinical problems,
      research issues, and cancer care economic factors among their top 10 research
      priorities. Quality of life and symptom management consistently were ranked as
      the highest priority items across all three methods used to rank-order the items.
      Respondents also provided suggestions for future ONS/Oncology Nursing Foundation
      small grants and for expansion of current ONS research activities. These findings
      provide direction for the focus of oncology nursing research by suggesting topics
      for research, by identifying areas that require additional research funding, by
      recommending new research activities for ONS, and by promoting research as the
      basis for oncology nursing practice.

PMID- 1762981
TI  - Assessing master's programs in oncology nursing.

PMID- 1762980
TI  - Performance of current procedural terminology codes by oncology nurses: a report
      to the ONS board of directors.
AB  - At the request of the ONS Board of Directors, a survey was conducted to determine
      the degree to which oncology nurses performed services listed in the Physicians
      Current Procedural Terminology manual--services for which physicians are
      reimbursed. Using a format modeled on a similar study of nurses in general, 100
      randomly selected ONS members were asked to describe the degree to which they
      performed a list of 90 coded procedures compiled by four oncology nurse experts.
      Response rate was 43%. Respondents, who were representative of the ONS membership
      on all demographic variables except education, performed an average of 32 of the
      procedures with very little, if any, direct physician supervision. Study results
      reflect trends found among nurses in general and raise important questions about
      patterns of reimbursement and healthcare delivery.

PMID- 1762982
TI  - Survey of graduate programs in cancer nursing.

PMID- 1762983
TI  - Patient information survey: meeting the psychosocial needs of the patient with
      cancer.

PMID- 1762984
TI  - Do not resuscitate: facilitating communication for patients with cancer followed
      in ambulatory care.

PMID- 1762985
TI  - Development of a self-contained chemotherapy delivery system.

PMID- 1762986
TI  - Helpful hints for patients who have undergone an ostomy.

PMID- 1762987
TI  - Nizoral and stomatitis cocktails may not mix.

PMID- 1762988
TI  - Central venous catheter pouch.

PMID- 1762989
TI  - Accumulation and release of adrenaline, and the modulation by adrenaline of
      noradrenaline release from rabbit blood vessels in vitro.
AB  - The accumulation of (-)-3H-adrenaline (3H-A) by rabbit isolated aorta was
      studied. In all experiments, monoamine oxidase and catechol-O-methyltransferase
      were inhibited by treatment with pargyline and 3',4'-dihydroxy-2-methyl
      propiophenone, respectively. The relationship between the accumulation of 3H
      derived from 3H-A and the duration of incubation was linear. The 3H-accumulation
      after 3 h incubation was 22.5 ml/g. In reserpine-treated tissue, the 3H
      accumulation levelled off after 30 min and was 8.5 ml/g after 3 h. The
      concentration of 3H-A or (-)-3H-noradrenaline (3H-NA) and the 3H-accumulation
      (ml/g) were inversely related. At 10(-8) M, the 1-hour accumulation of 3H derived
      from 3H-A and 3H-NA was 7.8 and 15.2 ml/g, respectively. With increasing
      concentrations the accumulation values approached each other. The accumulation of
      3H derived from 3H-A by reserpine-treated tissue also showed an inverse
      relationship with concentration. The accumulation of 3H derived from 3H-A was
      dependent on the bath temperature. Storage of tissue (0-5 days in salt solution
      without equilibration with 95% O2/5% CO2; 4 degrees C) did not affect the
      accumulation of 3H derived from 3H-A. Thereafter (7-14 days), the accumulation
      decreased. The inhibitory potency (IC50; -log M) of desipramine, cocaine,
      propranolol, isoprenaline, and normetanephrine on accumulation of 3H derived from
      3H-A was found to be 8.26; 6.50; 5.48; 4.88, and 4.02, respectively. The maximal
      degree of inhibition was almost the same for these drugs, while that of clonidine
      and corticosterone was 50 and 20%, respectively. In the presence of desipramine,
      either clonidine, corticosterone or isoprenaline reduces the accumulation of 3H
      derived from 3H-A. Ouabain and iodoacetic acid, but not sodium cyanide and 2,4
      dinitrophenol, reduced the accumulation of 3H derived from 3H-A. Anoxia (95%
      N2/5% CO2; 37 degrees C; 1-24 h) did not alter the accumulation of 3H derived
      from 3H-A. Glucose deprivation alone or combined with anoxia markedly reduced the
      3H-accumulation. The release of 3H-A from rabbit isolated aorta was studied. This
      release was compared with that of 3H-NA. The stimulation-evoked 3H-overflow from
      aorta preloaded with 3H-A decreased with repeated stimulation. In contrast,
      prestimulation enhanced subsequent stimulation-evoked 3H-overflows. For both 3H
      amines, the 3H-overflow increased concomitantly to the same degree with the
      number of pulses. The time course of 3H-overflows with either 3H-A or 3H-NA was
      compared.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1762990
TI  - [Methods for the prevention of psychologic developmental disorders within the
      scope of early childhood education--experiences in an American parent-child
      center].
AB  - Preventive methods for the work with children and parents are presented by the
      example of a mental health prevention center, where the early development of
      children is carefully attended on the basis of psychoanalysis and own movement
      studies. Besides a child-centered setting and multifarious ways of fostering the
      child's creative expression the emphasis is laid on methods helping to mediate
      between parents and child in everyday life, as well as methods supporting the
      child's ego to enable it to cope with future traumatic events.

PMID- 1762991
TI  - [Familial reality construction. On dealing with intrafamilial realization
      processes in psychodiagnostic and psychotherapeutic contexts].
AB  - Psychodynamic processes are connected to relationship-psychological and family
      dynamic phenomena in varied ways. Especially the processes of forming judgments
      and coming to realizations in the family influence the individual psychodynamics
      greatly. In these processes characteristics, purposes, roles and pathologies are
      ascribed to the individual family member. In this article these processes will be
      clearly shown with casuistic material. After this the author will clarify the
      theoretical relationship between the various levels of description which are the
      result of examining intrapsychic and family dynamic questions.

PMID- 1762992
TI  - [Documentation of child psychotherapy individual treatment--development of a
      protocol record].
AB  - A record schedule is presented which serves as a documentation of single
      treatments in child therapy containing: course of session, playing behaviour, and
      psychodynamics.

PMID- 1762993
TI  - [Individual help for children with developmental difficulties in child day care
      centers of Stuttgart].

PMID- 1762994
TI  - Stress revisited. 2. Systemic effects of stress.

PMID- 1762995
TI  - Recent advances in the assessment of lung function in infants.

PMID- 1762996
TI  - [13th annual meeting for Pediatric Pneumology. Dresden 21-23 March 1991].

PMID- 1762997
TI  - [Determination of respiratory system compliance from resonance frequency--animal
      experiment].
AB  - 10 anaesthetized and tracheotomized rabbits were used to test the possibility for
      calculation of total respiratory system compliance from resonance frequency (CR).
      Reference values were obtained by inflation method compliance (CI). A new
      servocontrolled infant ventilator was used with an integrated negative ventilator
      resistance mode for resistive unloading of combined resistances of lung,
      endotracheal tube and ventilator. This evoked oscillation at resonant frequency.
      By analogy with electrical circuit theory compliance was calculated as follows:
      CR = 1/(4 pi 2 x square root I.RF2). Pairs of CI and CR values were obtained from
      each animal during spontaneous breathing, after pancuronium relaxation and after
      surfactant depletion by lavage. There was found a significant linear correlation
      between CR and CI values (CR = 1.1 x CI-0.74; r = 0.97).

PMID- 1762998
TI  - [Dexamethasone in the treatment of bronchopulmonary dysplasia].
AB  - Dexamethasone has been reported to benefit premature infants with
      bronchopulmonary dysplasia. 13 ventilator-dependent premature infants (birth
      weight 780-1270 g) with chronic lung disease received dexamethasone 0.5 mg/kg/day
      with tapering doses over 3 weeks. Dexamethasone therapy was associated with a
      temporary increase in urine output and blood pressure. All infants showed a
      significant fall in oxygen requirement and an increase of total pulmonary
      compliance during the first week. The endotracheal tube was successfully removed
      in all infants with Northway stage I/II BPD within the first week of treatment
      and no infant relapsed. But in Northway stage III/IV, only 2/9 infants could be
      weaned from the ventilator during the first course of treatment and in the
      majority treatment led only to a temporary improvement of pulmonary status. In
      parallel to the improvement of lung function we found in 7 infants a decrease of
      the total cell counts, the ratio PMN/macrophages and albumin in relation to urea
      in the bronchial lavages with a secondary rise in cases of a clinical relapse.
      Free elastase and fibronectin/albumin ratio in the bronchial lavage did not
      correlate to the clinical course. Dexamethasone seems to have not only an effect
      on fluid balance but also on the alveolar capillary leakage and the PMN influx
      into the lung. This might explain the superior effect of dexamethasone in
      patients with Northway stage I/II BPD in comparison to infants with Northway
      stage III/IV.

PMID- 1762999
TI  - [Quantitative assessment of partial flow-volume curves in respiratory healthy and
      sick infants and young children].
AB  - In 83 patients of 1 to 24 months of age the flow quotients were calculated at 75,
      50 and 25% of the tidal volume. The subjects were classified into four groups,
      depending on their basic disease: 1. healthy patients in respect of respiration;
      2. patients with intrathoracic obstruction; 3. patients with extrathoracic
      obstruction and 4. patients suffering from a combined obstruction. It was found
      that in particular the quotient Fi25/Fe25 is suitable for differentiation between
      the studied groups.

PMID- 1763000
TI  - [Cold air provocation as a methods of differential diagnosis of bronchial asthma
      and chronic bronchitis].
AB  - To assess the usefulness of cold air hyperventilation challenge for the diagnosis
      of bronchial asthma (B. a.) and chronic bronchitis (c. B.) we studied 25 children
      with B. a. and 11 children with c. B. between 7 and 14 years. After baseline
      pulmonary function studies in a whole-body-plethysmograph and spirometry cold air
      challenge was done by 3 minutes hyperventilation of dry subfreezing (-15 degrees
      C) air in stepwise increasing doses of 20, 40 and 60% of maximum breathing
      capacity (MVV). Target size was specific airways resistance (sRaw). Its increase
      by 100% was considered a positive reaction. Thoracic gas volume (ITGV), airways
      resistance (Raw) and forced expiratory volume in one second (FEV1) were measured
      as well. The moment of maximum airway reaction and the time course of the
      recovery period were also studied. 18 children with B. a. and 1 patient with c.
      B. reacted significantly with sRaw. We neither found a reaction plateau nor a
      consistent moment of maximum reaction. Children with B. a. reacted especially
      with ITGV.

PMID- 1763001
TI  - [Bronchial hyperreactivity to physiological saline solution].
AB  - A case of a 10-year old boy suffering from asthma bronchiale following
      pleuropneumonia is reported. Paradoxically, bronchospasmolysis tests using
      physiological saline + salbutamol or ipratropium bromide impaired the lung
      function of this patient. Salt solutions inhaled in increasing doses until 1.4%
      generated severe bronchoconstriction, however, inhalation of DNCG + salbutamol
      normalized the lung function completely.

PMID- 1763002
TI  - [Treadmill ergometry with submaximal load in children and adolescents with
      mucoviscidosis (CF)].
AB  - Patients suffering from mucoviscidosis can improve their quality of life and can
      cope with greater physical load if they undergo intensive treatment. This can be
      objectively confirmed by measuring the lung function, by performing a blood gas
      analysis and by means of a self-rating mood scale. Load tests can be performed
      additionally, e.g. by a treadmill ergometer. Only two of 22 patients attained a
      level of 1 w/kg, in 21 patients the pulse rate increased partly long before the
      end of the test to more than 130 beats per minute. The rate at which the test was
      discontinued, was attained by all the patients. There was a significant volume
      increase after load. Blood gas pCO2 dropped significantly afterload, whereas pO2
      did not change.

PMID- 1763003
TI  - [A 13-year-old boy with a mild form of cystic fibrosis and heterozygote gene
      mutation for Delta F508].
AB  - We report a 13-year old boy with a chronic pseudomonas bronchitis who was first
      diagnosed as having cystic fibrosis at this age because of an elevated sweat
      chloride employing pilocarpine-iontophoresis. He is heterozygote for the gene
      mutation Delta F508. We point out the often moderate course of illness in
      compound heterozygotes.

PMID- 1763004
TI  - [Local immunization against P. aeruginosa with an outer-membrane-protein
      vaccine].
AB  - Averting initial colonization of the respiratory tract with P. aeruginosa would
      be of great benefit for patients with cystic fibrosis (CF). Our approach to this
      problem is mucosal immunization with a vaccine prepared from the OMP fraction of
      a PAO-1 strain of P. aeruginosa. Sprague-Dawley rats were given 5 intragastric
      doses of the vaccine on 5 consecutive days and an intranasal booster dose 21 days
      later. Immunized animals developed high titers of OMP-specific IgG antibodies in
      serum and a specific IgA response in bronchioalveolar and small intestinal lavage
      samples, all determined by ELISA. When challenged 7 days after the booster (day
      28) by intratracheal injection of live bacteria of a heterologous strain of P.
      aeruginosa the immunized rats showed enhanced bronchopulmonary bacterial
      clearance compared to nonimmunized controls, as indicated by bacterial counts
      from homogenized lung tissue taken 4 hrs after challenge. Thus, mucosal
      immunization with OMP vaccines might hinder initial colonisation of the lungs
      with P. aeruginosa.

PMID- 1763005
TI  - [Fibrosing alveolitis in a 7-year-old girl with autoimmune hemolytic anemia and
      autoimmune hepatitis].
AB  - A Coombs-positive haemolytic anaemia with proof of heat autoagglutinins and
      autoantibodies against cell nuclei was diagnosed in a girl, now 7 1/2 years of
      age, in the sixth month of her life as a sequel to jaundice. Shortly afterwards
      liver biopsy yielded a confirmed diagnosis of giant cell hepatitis. The signs of
      the disease receded under treatment with decortin and imurek. An attempt to
      discontinue the medication at 5 1/2 years of age resulted in a histologically
      confirmed recurrence of autoimmune hepatitis. When the patient was 5 years old,
      the x-ray revealed a mainly interstitial pneumonia; at 6 years of age,
      bronchiectases in the region of the left lower lobe were confirmed by
      bronchography. Resection of the lower lobe was performed after occurrence of
      atelectasis. Histopathological findings confirmed fibrotic alveolitis associated
      with giant cells. Based on the overall clinical course and the histological and
      immunological findings, autoimmune etiology of fibrotic alveolitis must be
      discussed. Progression of the disease could be avoided during the past 6 months
      by intensifying the immunosuppressive prednisolone therapy.

PMID- 1763006
TI  - [Plasma cell granuloma of the lung].
AB  - Isolated primary tumors of the lung are rarely seen in childhood and are benign
      in one third of the patients. Plasma cell granulomas represent the most common
      benign tumor of the lung in this age group. Histologically, the tumor is
      characterized by the various components of a chronic inflammation or granulation
      tissue. Frozen sections can pose difficulties in the differentiation between a
      malignant and benign process. In view of the case history of our patient we set
      out to demonstrate that a knowledge of the clinical picture and a correct
      interpretation of associated laboratory findings facilitate diagnosis. To our
      knowledge we describe for the first time the ultrastructural findings of so
      called "microtubule-reticular structures" giving further evidence of the
      inflammatory origin of this lesion.

PMID- 1763007
TI  - [Juvenile laryngeal papillomatosis--a case report].
AB  - Juvenile papillomatosis of the larynx is a disease of viral origin and is a rare
      cause of hoarseness and stridor in childhood. Although the tumours are basically
      benign, they may present problems in therapy due to their localisation and marked
      tendency to recur. According to the present state of knowledge, a combination of
      laser coagulation and alpha-interferon therapy is the treatment of choice. It can
      be applied on a long-term basis effectively and with few side effects due to
      individualised dosage determination. We report on a girl patient of 2 1/2 years
      of age with recurrent juvenile papillomatosis of the larynx. Long-term alpha
      interferon therapy was so far successful in preventing progress of the pattern of
      findings. Treatment is well tolerated after the most suitable dose has been found
      for a particular patient. No side effects were seen that would have compelled us
      to discontinue the treatment. We are planning to continue interferon therapy for
      at least 1 to 2 years with regular endoscopic control.

PMID- 1763008
TI  - [Congenital chylothorax].

PMID- 1763009
TI  - [Radiological diagnosis of congenital malformations of the tracheobronchial
      tree].
AB  - Diagnostic imaging in congenital abnormalities of the tracheo-bronchial tree
      needs new discussion. Common malformations are referred including diagnostic
      sequences.

PMID- 1763010
TI  - [Surgical indications in bronchopulmonary malformations in childhood].
AB  - Especially in childhood, the diagnosis of bronchopulmonary malformations should
      be carried out to such an extent as to enable an appraisal of the probable
      further development of symptoms. If increasing complications and secondary damage
      are impending, there should be no hesitation in having surgical treatment carried
      out by an experienced thorax surgeon even in early childhood, if possible before
      an absolutely life-threatening situation is present. Without exception, there
      were no complications in the postoperative courses, and the good development of
      symptom-free children with normalized lung function document the rational
      justification for thorax surgery in various bronchopulmonary malformations.

PMID- 1763011
TI  - [Diagnostic basic program in pneumological services: current conditions--a
      retrospective analysis. Work Group of administrative hospital physicians of
      pneumological services].

PMID- 1763012
TI  - Chemical implementation of neural networks and Turing machines.
AB  - We propose a reversible reaction mechanism with a single stationary state in
      which certain concentrations assume either high or low values dependent on the
      concentration of a catalyst. The properties of this mechanism are those of a
      McCulloch-Pitts neuron. We suggest a mechanism of interneuronal connections in
      which the stationary state of a chemical neuron is determined by the state of
      other neurons in a homogeneous chemical system and is thus a "hardware" chemical
      implementation of neural networks. Specific connections are determined for the
      construction of logic gates: AND, NOR, etc. Neural networks may be constructed in
      which the flow of time is continuous and computations are achieved by the
      attainment of a stationary state of the entire chemical reaction system, or in
      which the flow of time is discretized by an oscillatory reaction. In another
      article, we will give a chemical implementation of finite state machines and
      stack memories, with which in principle the construction of a universal Turing
      machine is possible.

PMID- 1763013
TI  - Infrared spectroscopy of exfoliated human cervical cells: evidence of extensive
      structural changes during carcinogenesis.
AB  - Infrared spectra were obtained from exfoliated cervical cells from 156 females,
      of whom 136 were normal, 12 had cervical cancer, and 8 had dysplasia. The spectra
      of the normal women, essentially identical, differed from those obtained from
      patients with either cancer or dysplasia. In malignant samples we noted (i)
      significant changes in the intensity of the glycogen bands at 1025 cm-1 and 1047
      cm-1, the bands at 1082 cm-1 and 1244 cm-1, the C--O stretching band at 1155 cm
      1, and the band at 1303 cm-1, (ii) significant shifts of the peaks normally
      appearing at 1082 cm-1, 1155 cm-1, and 1244 cm-1, and (iii) an additional band at
      970 cm-1. Further study of several of these bands, including the pressure
      dependence of their frequencies, revealed that in the malignant cervical tissue
      there were extensive changes in the degree of hydrogen bonding of phosphodiester
      groups of nucleic acids and C--OH groups of proteins, as well as changes in the
      degree of disorder of methylene chains of lipids. The IR spectra of samples with
      dysplasia demonstrated the same changes with cancer samples, except that the
      changes were of lesser magnitude and the phosphodiester peak normally appearing
      at 1082 cm-1 did not shift. These spectroscopic changes appear to progress in
      tandem with the morphological changes that lead normal cervical epithelium to
      cancer through the premalignant stage of dysplasia. The diagnostic potential of
      IR spectroscopy is discussed.

PMID- 1763014
TI  - Demographic predisposition to the evolution of eusociality: a hierarchy of
      models.
AB  - I present a hierarchy of models that illustrate, within the framework of
      inclusive fitness theory, how demographic factors can predispose a species to the
      evolution of eusociality. Delayed reproductive maturation lowers the inclusive
      fitness of a solitary foundress relative to that of a worker. Variation in age at
      reproductive maturity makes the worker strategy more profitable to some
      individuals than to others and thus predicts the coexistence of single-foundress
      and multiple-foundress nesting associations. Delayed reproductive maturation and
      variation in age at reproductive maturity also select for mixed reproductive
      strategies so that some individuals whose reproductive maturation is expected to
      be delayed can first act as workers and later switch over to the role of a queen
      or foundress. Assured fitness returns shows how identical mortality rates can
      have different consequences for workers and solitary nest foundresses because a
      solitary foundress will have to necessarily survive for the entire duration of
      development of her brood, whereas a worker can hope to get proportional fitness
      returns for short periods of work. In concert with assured fitness returns,
      delayed reproductive maturation and variation in age at reproductive maturity
      become more powerful in selecting for worker behavior, and mixed reproductive
      strategies become available to a wider range of individuals. These phenomena
      provide a consistently more powerful selective advantage for the worker strategy
      than do genetic asymmetries created by haplodiploidy.

PMID- 1763015
TI  - Ascorbic acid protects against endogenous oxidative DNA damage in human sperm.
AB  - Damage to the DNA of germ cells can lead to mutation, which may result in birth
      defects, genetic diseases, and cancer. The very high endogenous rate of oxidative
      DNA damage and the importance of dietary ascorbic acid (AA) in preventing this
      damage has prompted an examination of these factors in human sperm DNA. The
      oxidized nucleoside 8-hydroxy-2'-deoxyguanosine (8-oxo-7,8-dihydro-2'
      deoxyguanosine; oxo8dG), 1 of approximately 20 major products of oxidative damage
      to DNA, was measured in DNA isolated from human sperm provided by healthy
      subjects and compared to the seminal fluid AA levels. This relationship was
      studied in two groups. In a group of 24 free-living individuals 20-50 years old
      high levels of oxo8dG were correlated with low seminal plasma AA. The endogenous
      level of oxo8dG in this group was 13 fmol per microgram of DNA or approximately
      25,000 adducts per sperm cell. The second group of individuals was maintained on
      a controlled diet that varied only in AA content. When dietary AA was decreased
      from 250 to 5 mg/day, the seminal fluid AA decreased by half and the level of
      oxo8dG in sperm DNA increased 91%. Repletion of dietary AA for 28 days (from 5
      mg/day to 250 or 60 mg/day) caused a doubling in seminal fluid AA and reduced
      oxo8dG by 36%. These results indicate that dietary AA protects human sperm from
      endogenous oxidative DNA damage that could affect sperm quality and increase risk
      of genetic defects, particularly in populations with low AA such as smokers.

PMID- 1763016
TI  - Basic fibroblast growth factor released by single, isolated cells stimulates
      their migration in an autocrine manner.
AB  - Basic fibroblast growth factor (bFGF), a protein with angiogenic, mitogenic, and
      chemotactic properties, lacks a signal sequence and is not secreted via the
      classical secretory pathway. However, the growth factor is known to act
      extracellularly. Since no defined mechanism for bFGF release has been described,
      it has been suggested that this growth factor is released from dead or damaged
      cells. To test this hypothesis we characterized the effect of exogenously added
      bFGF and neutralizing antibody on the migration of single, isolated NIH 3T3 cells
      transfected with bFGF cDNA. Under these conditions the observed cell cannot be
      affected by bFGF derived from other cells. Cells were seeded onto colloidal gold
      coated coverslips at a density of one cell per coverslip. A cell migrating on
      this substrate produces a track free of refringent gold particles that is
      measured by an image analyzer. The results showed that cell motility directly
      correlated with the amount of bFGF released from the migrating cells. Affinity
      purified anti-bFGF antibody, but not irrelevant IgG, reduced the level of
      migration of the bFGF transfectants to that of the control cells transfected with
      the vector alone, showing that bFGF stimulates migration of the cell that
      releases it. Thus, bFGF is secreted by viable cells and mediates cell functions
      via a "true" autocrine mechanism.

PMID- 1763017
TI  - Identification and characterization of rat intestinal trefoil factor: tissue- and
      cell-specific member of the trefoil protein family.
AB  - The trefoil peptide family encompasses a group of small proteins that appear to
      assume a distinctive secondary structure that leads to intrinsic resistance to
      protease digestion. Induction of these peptides has been associated with response
      to injury in the gastrointestinal tract and related organs. Using an
      oligonucleotide derived from N-terminal amino acid sequencing of a transformed
      growth-inhibiting protein, a cDNA was cloned from rat intestinal villus
      epithelial cells that encodes a protein 81 amino acids in length with the
      characteristic trefoil peptide cysteine residue motif. Northern blot analysis
      demonstrates specific expression of a single transcript of 0.43 kilobase in small
      and large intestinal epithelium in rat and man. Indirect immunofluorescent
      staining with antiserum raised using a synthetic peptide based on the predicted C
      terminal sequence of this protein, designated intestinal trefoil factor,
      demonstrated that it is primarily expressed and secreted onto the intestinal
      surface by goblet cells, suggesting that it may be an important component of
      intrinsic mechanisms for defending mucosal integrity.

PMID- 1763018
TI  - Interleukin 2- and interleukin 5-induced changes in the binding of regulatory
      factors to the J-chain gene promoter.
AB  - In a primary immune response, B cells require signals from the T-cell lymphokines
      interleukins 2 and 5 (IL-2 and IL-5) to develop into IgM-secreting cells. One
      role of IL-2 and IL-5 is to activate transcription of the gene encoding the IgM
      joining component, the J chain. In this study the activation mechanism was
      investigated by using an inducible beta-lymphoma cell line to examine J-chain RNA
      expression and factor binding to the J-chain promoter. The analyses revealed that
      both IL-2 and IL-5 trigger a decrease in the binding of two promoter-specific
      nuclear proteins that precedes the appearance of J-chain RNA. In combination the
      two lymphokines effected nearly additive changes in factor binding and J-chain
      RNA abundance. Both effects were reversed upon withdrawal of the lymphokine
      stimulus and both were inhibited in the presence of the T-cell lymphokine IL-4.
      These findings indicate that the IL-2 and IL-5 signal pathways converge to
      deliver a common signal that regulates the repressor activities of two lymphokine
      responsive promoter elements.

PMID- 1763019
TI  - The structure of the antigen-binding groove of major histocompatibility complex
      class I molecules determines specific selection of self-peptides.
AB  - We have examined the effect of diversity in the antigen-binding groove of the Kb,
      Db, Kbm1, and Kbm8 major histocompatibility complex (MHC) class I molecules on
      the set of self-peptides they present on the cell surface, by using a procedure
      we recently developed in our laboratory to isolate endogenously processed
      peptides bound to MHC class I molecules. We found that such naturally processed
      peptides are 7-10 amino acids long. A major motif of tyrosine and phenylalanine
      residues at positions three and five was found for peptides binding to Kb. The
      availability of Kb mutant molecules Kbm1 and Kbm8, each with localized clustered
      changes in the antigen-binding cleft, allowed us to probe the effect of such
      small alterations on peptide selection. We found that such changes in different
      regions in the antigen-binding groove exert an absolute effect by changing
      subsets of self-peptides bound to these MHC molecules. In the Kbm1 mutant, the
      binding of the characteristic major set of Kb-associated peptides with tyrosine
      at position three or both positions three and five is abrogated, although this
      MHC molecule still binds peptides with tyrosine at position seven; the latter
      peptides also bind to Kb. Kbm8 shares the major Tyr-3, Tyr-5 peptide set that
      binds to Kb but does not bind the peptides with tyrosine at position seven. Thus
      differences in binding selectivity in Kbm1 and Kbm8 appear to be the major
      determinant for the observed alterations in in vivo immune responses.

PMID- 1763020
TI  - Magnetic field tomography of coherent thalamocortical 40-Hz oscillations in
      humans.
AB  - This paper introduces the use of magnetic field tomography (MFT), a noninvasive
      technique based on distributed source analysis of magnetoencephalography data,
      which makes possible the three-dimensional reconstruction of dynamic brain
      activity in humans. MFT has a temporal resolution better than 1 msec and a
      spatial accuracy of 2-5 mm at the cortical level, which deteriorates to 1-3 cm at
      depths of 6 cm or more. MFT is used here to visualize the origin of a
      spatiotemporally organized pattern of coherent 40-Hz electrical activity. This
      coherence, initially observed during auditory input, was proposed to be generated
      by recurrent corticothalamic oscillation. In support of this hypothesis, we
      illustrate well-defined 40-Hz coherence between cortical-subcortical sites with a
      time shift that is consistent with thalamocortical conduction times. Studies on
      Alzheimer patients indicate that, while a similar activity pattern is present,
      the cortical component is reduced in these subjects.

PMID- 1763021
TI  - Sustained activation of protein kinase C is essential to HL-60 cell
      differentiation to macrophage.
AB  - Although a single dose of phorbol 12-myristate 13-acetate (PMA) allowed HL-60
      cells to differentiate to macrophages, a single dose of membrane-permeant
      diacylglycerol (DAG), 1,2-dioctanoylglycerol (1,2-DiC8), was normally
      insufficient to differentiate these cells. These cells metabolized 1,2-DiC8 very
      rapidly, and 1,2-DiC8 available to protein kinase C (PKC) activation was removed
      from the incubation medium at a rate proportional to cell density. However,
      increasing the duration of exposure of HL-60 cells to this DAG either by its
      repeated addition or by decreasing the cell density greatly enhanced their
      differentiation to macrophages as measured by CD11b expression. During this
      differentiation induced by DAG, neither measurable translocation nor depletion
      (down-regulation) of PKC was observed. When the cells were exposed to PMA, on the
      other hand, some PKC subspecies were instantaneously translocated to membranes
      and subsequently disappeared very quickly, whereas the alpha-subspecies was
      decreased to the level of approximately 60% of the resting cell, but thereafter
      its activity was maintained at a nearly constant level in membranes. After
      approximately 4 hr, the PKC subspecies, once depleted, reappeared gradually in
      the membrane fraction. The results suggest that sustained activation of PKC is
      essential to differentiation of HL-60 cells to macrophages, and depletion of the
      enzyme is not needed. Perhaps translocation of PKC represents an extreme state of
      the active form of the enzyme, which may result from PMA action, and the alpha
      subspecies presumably plays a key role in HL-60 cell differentiation.

PMID- 1763022
TI  - Bag model for DNA migration during pulsed-field electrophoresis.
AB  - A model for pulsed-field electrophoresis was developed by picturing large DNA as
      a deformable "bag" that (i) moves with limiting mobility in a continuous electric
      field, (ii) adopts an orientation aligned with the field direction, and (iii)
      reorients after a change in field direction in a size-dependent manner. The model
      correctly predicted the resolution of large DNA in a pulsed field including the
      surprising phenomena of mobility inversion, lateral band spreading, and improved
      resolution for obtuse angles. A simple parametrization agreed with observations
      of two completely different aspects of DNA behavior: bulk mobility as measured
      during gel electrophoresis and molecular reorientation as measured by linear
      dichroism. The model also provides quantitative guidelines for setting
      experimental parameters in pulsed-field electrophoresis experiments.

PMID- 1763023
TI  - A strategy for finding classes of minima on a hypersurface: implications for
      approaches to the protein folding problem.
AB  - Locating the native structure of a given protein is a task made difficult by the
      complexity of the potential energy hypersurface and by the huge number of local
      minima it contains. We have explored a strategy (the "antlion" method) for
      hypersurface modification that suppresses all minima but that of the native
      structure. Transferrable penalty functions with general applicability for
      modifying a hypersurface to retain the desired minimum are identified, and two
      blocked oligopeptides (alanine dipeptide and tetrapeptide) are used for specific
      numerical illustration of the dramatic simplification that ensues. In addition,
      an intermediary role for neural networks to manage some aspects of the antlion
      strategy applied to large polypeptides and proteins is introduced.

PMID- 1763024
TI  - Uncoupling thermotolerance from the induction of heat shock proteins.
AB  - Exposure of cells to elevated temperatures causes a rapid increase in the
      synthesis of heat shock proteins (hsps) and induces thermotolerance, the
      increased ability of cells to survive exposure to lethal temperatures; however,
      the connection between hsp induction and the acquisition of thermotolerance is
      unclear. hsp induction in the yeast Saccharomyces cerevisiae is mediated by the
      activation of heat-shock transcription factor, and recently we have described a
      mutation, hsf1-m3, in heat-shock transcription factor that prevents the factor's
      activation. We now demonstrate that this mutation results in a general block in
      heat-shock induction but does not affect the acquisition of thermotolerance. Our
      results indicate that high-level induction of the major hsps is not required for
      cells to acquire thermotolerance.

PMID- 1763025
TI  - Xenotransplantation of canine, bovine, and porcine islets in diabetic rats
      without immunosuppression.
AB  - Permselective acrylic membranes were employed to prevent immune rejection of
      discordant islet xenografts isolated from various large animals. Canine, porcine,
      and bovine islets were seeded into tubular diffusion chambers and transplanted
      into the peritoneum of 27 nonimmunosuppressed streptozotocin-induced diabetic
      Lewis rats. Six recipients received islet grafts from bovine calves, 7 received
      grafts from pigs, and 14 received grafts from dogs. Four of the latter were
      removed at 1 month. In the control group of 10 diabetic rats, 4 received
      nonencapsulated canine islets, 3 received nonencapsulated bovine islets, and 3
      received nonencapsulated porcine islets. Recipients of encapsulated islets
      promptly dropped from a pretransplantation plasma glucose level of 487 +/- 36
      (mean +/- SEM) to 84 +/- 2 (canine), 81 +/- 4 (bovine), and 81 +/- 3 mg/dl
      (porcine) during the first week. All of the animals sustained these levels for at
      least 1 month. One rat spontaneously reverted to diabetes at 54 days
      posttransplantation; 4 other rats became hyperglycemic (glucose, greater than 600
      mg/dl) after membrane removal on day 30. The remaining 22 rats maintained fasting
      euglycemia for greater than 10 weeks. In contrast, rats that received
      nonencapsulated islets became hyperglycemic in less than 7 days. Intravenous
      glucose tolerance test K values (decline in glucose levels, %/min) at 1 month for
      the canine and bovine encapsulated islet transplant group were 3.5 +/- 0.3 and
      3.3 +/- 0.1 compared with 3.3 +/- 0.1 (P = 0.63) and 0.91 +/- 0.1 (P less than
      0.0001) for normal (n = 4) and diabetic (n = 4) control groups. Morphologic
      studies of long-term functioning grafts (30-130 days) revealed well-preserved
      alpha, beta, and delta cells, with varying degrees of granulation. These results
      demonstrate that immune isolation of islet tissue using permselective artificial
      membranes can protect discordant islet xenografts from immune rejection in the
      absence of any immunosuppressive drugs.

PMID- 1763026
TI  - Folding of group I introns from bacteriophage T4 involves internalization of the
      catalytic core.
AB  - Fe(II)-EDTA, a solvent-based cleavage reagent that distinguishes between the
      inside and outside surfaces of a folded RNA molecule, has revealed some of the
      higher-order folding of the group IB intron from Tetrahymena thermophila pre
      rRNA. This reagent has now been used to analyze the bacteriophage T4 sunY and td
      introns, both of which are members of the group IA subclass. Significant portions
      of the phylogenetically conserved secondary structure are protected from Fe(II)
      EDTA cleavage. However, the P4 secondary structure element, which is
      substantially protected in the Tetrahymena intron, is available for cleavage in
      the two T4 introns. We conclude that a family of catalytic RNAs (ribozymes) that
      possess similar secondary structures and have similar activities fold into
      similar but nonidentical tertiary structures that nevertheless serve to
      internalize portions of the catalytic center. Furthermore, comparison of cleavage
      patterns of the sunY and td intron RNAs indicates that conserved nucleotides
      outside as well as within the catalytic core participate in the tertiary
      structure.

PMID- 1763027
TI  - The C-terminal region of the Vibrio fischeri LuxR protein contains an inducer
      independent lux gene activating domain.
AB  - The Vibrio fischeri luminescence genes are activated by an autoinducer and the
      250-amino acid residue LuxR protein. To develop a general view of LuxR structure
      and function, a set of luxR 5'-deletion mutations was generated. Ten luxR mutant
      plasmids encoding active LuxR proteins with deletions ranging from residues 2-5
      (delta 2-5) to residues 2-182 (delta 2-182) were studied. The degree of
      transcriptional activation of luminescence genes by the truncated LuxR proteins
      ranged from 0.01% to greater than 200% of the wild-type level. LuxR proteins with
      small deletions (up to delta 2-20) were active and remained autoinducer
      dependent, LuxR proteins with deletions between residues 2-58 and 2-138 showed
      low activity and were not affected by autoinducer, and LuxR proteins with large
      deletions such as the delta 2-162 protein were highly active and autoinducer
      independent. However, proteins with deletions equal to or greater than delta 2-20
      were unable to autoregulate luxR. Our data indicate there is a C-terminal LuxR
      domain capable of functioning as a transcriptional activator. We suggest that an
      N-terminal region of LuxR starting between residues 20 and 58 and extending to
      the region of residues 138-162 masks the activator function of the C-terminal
      domain. Residues prior to position 20 are needed for autoregulatory function.
      Experiments showing that wild-type luxR is dominant over luxR genes coding the
      delta 2-58 through delta 2-138 proteins indicate the N-terminal arm masks lux DNA
      binding.

PMID- 1763028
TI  - Antibody redesign by chain shuffling from random combinatorial immunoglobulin
      libraries.
AB  - A number of experiments on the shuffling of heavy and light chains from
      antibodies of defined specificity for the transition-state analogue hapten
      nitrophenyl phosphonamidate are described. The experiments report on the
      promiscuity of heavy and light chains in binding antigen and the feasibility of
      antibody redesign by this shuffling process. The concepts of incestuous and
      extraclonal promiscuous association are described. Shuffling opens the
      possibility of generating panels of antibodies with related specificity but of
      distinct idiotypic composition that may have significance in the use of human
      monoclonal antibodies in therapy.

PMID- 1763029
TI  - Calorie restriction suppresses subgenomic mink cytopathic focus-forming murine
      leukemia virus transcription and frequency of genomic expression while impairing
      lymphoma formation.
AB  - Calorie restriction suppresses mammary proviral mRNA expression and protooncogene
      activation in breast tumor-prone C3H/Ou mice while inhibiting tumor formation. To
      determine whether the beneficial effects of chronic energy-intake restriction
      (CEIR) can be extended to an organ site of retrovirus-induced tumorigenesis where
      the dynamics of growth and sexual maturity are not paramount as they are in
      breast tissue, calorie restriction of 40% was imposed on thymic lymphoma-prone
      AKR mice when 4 weeks old. Recombination between various murine leukemia virus
      (MuLV) mRNAs, resulting in the generation of an 8.4-kilobase genomic-length
      transcript with mink cytopathic focus-forming (MCF) characteristics, is
      considered the proximal retroviral event in AKR lymphomagenesis. Thymic
      expression of subgenomic MCF MuLV mRNA was uniformly suppressed among 6- and 8
      week-old CEIR mice (P less than 0.02). This suppression of MuLV transcription
      preceded a 25% reduction in the appearance of genomic-length MCF transcripts
      among CEIR mice and a 28% reduction in cumulative lymphoma mortality. The latency
      to median tumor incidence was extended greater than 3 months by calorie
      restriction, and median lifespan was extended approximately 50%. Survival curves
      for the full-fed and CEIR dietary cohorts were found to be significantly
      different (P less than 0.0001), with full-fed mice experiencing a 3 times greater
      risk of lymphoma mortality. These findings extend the known range of pathologic
      states influenced by CEIR in inbred mice and show that retroviral mechanisms
      involved in generation of lymphoid malignancy can be significantly impaired by
      calorie restriction.

PMID- 1763030
TI  - Attenuation of focal cerebral ischemic injury in transgenic mice overexpressing
      CuZn superoxide dismutase.
AB  - Oxygen-derived free radicals have been implicated in the pathogenesis of
      vasogenic edema and infarction caused by ischemia and reperfusion injury. In
      earlier studies, exogenously supplied liposome-entrapped CuZn superoxide
      dismutase (CuZn-SOD) ameliorated ischemic brain edema and infarction in rats
      following focal cerebral ischemia. To ascertain directly the role of SOD in the
      protection against superoxide radical-induced injury, we measured infarct size
      and water content 24 hr following focal cerebral ischemia in nontransgenic mice
      and in transgenic mice bearing the human SOD1 gene. These transgenic mice have
      3.1-fold higher cellular CuZn-SOD activity in the brain than do their
      nontransgenic littermates. We also measured antioxidant levels (reduced
      glutathione and reduced ascorbate) of contralateral cortex, infarct cortex,
      surrounding cortex, and striatum. Infarct size and brain edema were significantly
      decreased in transgenic mice compared with nontransgenic mice. Reduced
      glutathione and reduced ascorbate levels decreased in the ischemic hemisphere,
      but levels in surrounding cortex and striatum were significantly higher in
      transgenic mice than in nontransgenic mice. These results indicate that increased
      endogenous SOD activity in brain reduces the level of ischemic damage and support
      the concept that superoxide radicals play an important role in the pathogenesis
      of infarction and edema following focal cerebral ischemia.

PMID- 1763031
TI  - Low-resolution genome map of the malaria mosquito Anopheles gambiae.
AB  - We have microdissected divisions of the Anopheles gambiae polytene chromosomes,
      digested the DNAs with a restriction enzyme, and PCR-amplified the DNA fragments
      to generate a set of pooled probes, each corresponding to approximately 2% of the
      mosquito genome. These divisional probes were shown to have high complexity.
      Except for those derived from near the centromeres, they hybridize specifically
      with their chromosomal sites of origin. Thus, they can be used to map cloned DNAs
      by a dot blot procedure, which is much more convenient than in situ hybridization
      to polytene chromosomes. We discuss additional potential uses of these probes,
      such as easier isolation of molecular markers and genes, including those that
      cross-hybridize with clones available from other insects. It is expected that the
      probes will substantially accelerate molecular genetic analysis of this most
      important malaria vector.

PMID- 1763033
TI  - Mechanism of the initial charge separation in bacterial photosynthetic reaction
      centers.
AB  - The initial electron transfer in reaction centers from Rhodobacter sphaeroides
      R26 was studied by a subpicosecond transient pump-probe technique. The measured
      kinetics at various wavelengths were analyzed and compared with several
      mechanisms for electron transfer. An unambiguous determination of the initial
      electron transfer mechanism in reaction centers cannot be made by studying the
      anion absorption region (640-690 nm), due to the spectral congestion in this
      region. However, correlations between the stimulated emission decay of the
      excited state of the special pair, P*, at 926 nm and bleaching of the
      bacteriopheophytin Qx absorption at 545 nm suggest that the electron transfer at
      283 K is dominated by a two-step sequential mechanism, whereas one-step
      superexchange and the two-step sequential mechanism have about equal
      contributions at 22 K.

PMID- 1763032
TI  - Reconstitution of tracheal grafts with a genetically modified epithelium.
AB  - A rational approach to the development of gene therapies for cystic fibrosis
      requires a better understanding of the cellular targets for gene transfer in the
      airway epithelium. We have used recombinant retroviruses to study the dynamics
      and lineage relationships of a regenerating rat tracheal epithelium. Primary
      cultures of tracheal epithelial cells were exposed to lacZ-transducing
      retroviruses and subsequently seeded into denuded trachea that were implanted
      into BALB/c (nu/nu) mice. The grafts developed a fully differentiated mucociliary
      epithelium containing large clones of lacZ-expressing cells with virtually all
      cell types represented within each clone. These data are most consistent with
      gene transfer into a putative progenitor cell that is capable of extensive self
      renewal and pleuripotent development. Vector-specific variation in transgene
      expression was noted in the various cell types.

PMID- 1763034
TI  - Rapid-flow resonance Raman spectroscopy of bacterial photosynthetic reaction
      centers.
AB  - Rapid-flow resonance Raman vibrational spectra of bacterial photosynthetic
      reaction centers from the R-26 mutant of Rhodobacter sphaeroides have been
      obtained by using excitation wavelengths (810-910 nm) resonant with the lowest
      energy, photochemically active electronic absorption. The technique of shifted
      excitation Raman difference spectroscopy is used to identify genuine Raman
      scattering bands in the presence of a large fluorescence background. The
      comparison of spectra obtained from untreated reaction centers and from reaction
      centers treated with the oxidant K3Fe(CN)6 demonstrates that resonance
      enhancement is obtained from the special pair. Relatively strong Raman scattering
      is observed for special pair vibrations with frequencies of 36, 94, 127, 202,
      730, and 898 cm-1; other modes are observed at 71, 337, and 685 cm-1. Qualitative
      Raman excitation profiles are reported for some of the strong modes, and
      resonance enhancement is observed to occur throughout the near-IR absorption band
      of the special pair. These Raman data determine which vibrations are coupled to
      the optical absorption in the special pair and, thus, probe the nuclear motion
      that occurs after electronic excitation. Implications for the interpretation of
      previous hole-burning experiments and for the excited-state dynamics and
      photochemistry of reaction centers are discussed.

PMID- 1763035
TI  - The 29-kDa proteins phosphorylated in thrombin-activated human platelets are
      forms of the estrogen receptor-related 27-kDa heat shock protein.
AB  - Thrombin plays a critical role in platelet activation, hemostasis, and
      thrombosis. Cellular activation by thrombin leads to the phosphorylation of
      multiple proteins, most of which are unidentified. We have characterized several
      29-kDa proteins that are rapidly phosphorylated following exposure of intact
      human platelets to thrombin. A murine monoclonal antibody raised to an
      unidentified estrogen receptor-related 29-kDa protein selectively recognized
      these proteins as well as a more basic, unphosphorylated 27-kDa protein. Cellular
      activation by thrombin led to a marked shift in the proportion of protein from
      the 27-kDa unphosphorylated form to the 29-kDa phosphoprotein species. Using this
      antibody, we isolated and sequenced a human cDNA clone encoding a protein that
      was identical to the mammalian 27-kDa heat shock protein (HSP27), a protein of
      uncertain function that is known to be phosphorylated to several forms and to be
      transcriptionally induced by estrogen. The 29-kDa proteins were confirmed to be
      phosphorylated forms of HSP27 by immunoprecipitation studies. Thus, the "estrogen
      receptor-related protein" is HSP27, and the three major 29-kDa proteins
      phosphorylated in thrombin-activated platelets are forms of HSP27. These data
      suggest a role for HSP27 in the signal transduction events of platelet
      activation.

PMID- 1763036
TI  - Dose-dependent differences in the profile of mutations induced by an ultimate
      carcinogen from benzo[a]pyrene.
AB  - Mutations in the coding region of the hypoxanthine (guanine)
      phosphoribosyltransferase (HPRT) gene of Chinese hamster V-79 cells were examined
      after exposure of the cells to a high cytotoxic dose (0.48 microM; 35% survival)
      and a low noncytotoxic dose (0.04 microM; 100% survival) of the ultimate
      carcinogen (+)-7R,8S-dihydroxy-9S,10R-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene
      [(+)-BPDE]. Independent 8-azaguanine-resistant colonies were isolated and cDNAs
      were prepared by reverse transcription. The coding region of the cDNA of the HPRT
      gene was amplified by the polymerase chain reaction and sequenced. An examination
      of the DNA base sequence changes induced by different doses of (+)-BPDE
      demonstrated that the high dose of (+)-BPDE caused base substitution mutations
      almost exclusively at G.C base pairs whereas the low dose of (+)-BPDE caused
      mutations at both G.C and A.T base pairs. Thus, use of a low dose of (+)-BPDE
      allowed the detection of mutations (at A.T base pairs) that were not readily
      observed with a high dose of (+)-BPDE. The data also suggest that the low dose of
      (+)-BPDE may have caused a different profile of base substitutions at G.C base
      pairs and exon deletions than the high dose. The results indicate dose-dependent
      differences in the profile of mutations for an ultimate carcinogen.

PMID- 1763037
TI  - Point mutation in the cytoplasmic domain of the neutrophil p22-phox cytochrome b
      subunit is associated with a nonfunctional NADPH oxidase and chronic
      granulomatous disease.
AB  - Chronic granulomatous disease (CGD) is a congenital disorder in which phagocytes
      cannot generate superoxide (O2-) and other microbial oxidants due to mutations in
      any one of four components of the O2(-)-generating complex, NADPH oxidase. We
      report here a female CGD patient in whom a missense mutation in one of these
      components, the p22-phox subunit of the neutrophil membrane cytochrome b [where
      phox indicates phagocyte oxidase (used to designate protein components of the
      phagocyte NADPH oxidase)] results in a nonfunctional oxidase and failure of
      neutrophils to produce O2- in response to phorbol 12-myristrate 13-acetate.
      Cytochrome b in the patient's neutrophils was normal in appearance and abundance
      as determined by visible spectroscopy and by immunoblots of the gp91 and p22
      subunits. However, the neutrophil plasma membranes were devoid of activity in the
      cell-free oxidase activation system, whereas the cytosol functioned normally. We
      postulated that the patient was homozygous for a mutation in p22 that results in
      the synthesis of normal levels of a nonfunctional cytochrome b. A single-base
      substitution (C----A) was found in the patient's mononuclear cell p22-phox cDNA
      that predicts a nonconservative Pro----Gln substitution at residue 156. The same
      mutation was also identified in all clones sequenced from patient genomic DNA,
      demonstrating homozygosity for the mutant allele. An antipeptide antibody against
      p22 residues 153-164 was found to bind only to permeabilized neutrophils,
      indicating that the mutation occurs in a cytoplasmic domain. These studies
      establish that this domain of p22-phox is cytoplasmic and that mutations in this
      region can have profound effects on cytochrome b function.

PMID- 1763038
TI  - Evolution of human immunodeficiency virus type 1 nucleotide sequence diversity
      among close contacts.
AB  - The degree of change in the nucleotide sequence of human immunodeficiency virus
      type 1 (HIV-1) that occurs when it is transmitted sexually from one individual to
      another or vertically from mother to child is unknown. Previous studies have
      shown that most cultured HIV-1 isolates from the same individuals differed in the
      entire envelope gene nucleotide sequence by up to 2%, although most isolates from
      unrelated individuals differed by 6-22%. To examine diversity among HIV-1
      isolates from close contacts, we determined the nucleotide sequences of viruses
      from a family with a known epidemiologic profile, in which a woman transmitted
      HIV-1 heterosexually to her partner and vertically to her daughter. Direct DNA
      sequence analysis of primary HIV-1 isolates amplified by PCR was used to
      distinguish the major and minor viral sequences, termed quasispecies, to rapidly
      determine the predominant sequences and their phylogenetic relationships. The
      nucleotide sequence diversity of a major portion of the HIV-1 envelope gene was
      3.7% between isolates from the woman and her heterosexual partner and 8.5%
      between isolates from this woman and her daughter, who had been infected for a
      longer period than the partner. The configuration of the phylogenetic tree
      demonstrated that the daughter's predominant isolate evolved from a progenitor of
      her mother's current strain. This study provides evidence of a continuous
      spectrum of sequence diversity between any two isolates ranging from those
      derived from the same person to those from close contacts and, ultimately, those
      from unrelated individuals. These data and methods can be applied to
      epidemiologic investigations of possible HIV-1 transmission between health care
      workers and their patients.

PMID- 1763039
TI  - A damage-responsive DNA binding protein regulates transcription of the yeast DNA
      repair gene PHR1.
AB  - The PHR1 gene of Saccharomyces cerevisiae encodes the DNA repair enzyme
      photolyase. Transcription of PHR1 increases in response to treatment of cells
      with 254-nm radiation and chemical agents that damage DNA. We report here the
      identification of a damage-responsive DNA binding protein, termed photolyase
      regulatory protein (PRP), and its cognate binding site, termed the PHR1 upstream
      repression sequence, that together regulate induction of PHR1 transcription after
      DNA damage. PRP activity, monitored by electrophoretic-mobility-shift assay, was
      detected in cells during normal growth but disappeared within 30 min after
      irradiation. Copper-phenanthroline footprinting of PRP-DNA complexes revealed
      that PRP protects a 39-base-pair region of PHR1 5' flanking sequence beginning 40
      base pairs upstream from the coding sequence. A prominent feature of the foot
      printed region is a 22-base-pair palindrome. Deletion of the PHR1 upstream
      repression sequence increased the basal level expression of PHR1 in vivo and
      decreased induction after exposure of cells to UV radiation or methyl
      methanesulfonate, whereas insertion of the PRP binding site between the CYC1
      upstream activation sequence and "TATA" sequence reduced basal level expression
      and conferred damage responsiveness upon a reporter gene. Thus these observations
      establish that PRP is a damage-responsive repressor of PHR1 transcription.

PMID- 1763040
TI  - Sex chromosome evolution: platypus gene mapping suggests that part of the human X
      chromosome was originally autosomal.
AB  - To investigate the evolution of the mammalian sex chromosomes, we have compared
      the gene content of the X chromosomes in the mammalian groups most distantly
      related to man (marsupials and monotremes). Previous work established that genes
      on the long arm of the human X chromosome are conserved on the X chromosomes in
      all mammals, revealing that this region was part of an ancient mammalian X
      chromosome. However, we now report that several genes located on the short arm of
      the human X chromosome are absent from the platypus X chromosome, as well as from
      the marsupial X chromosome. Because monotremes and marsupials diverged
      independently from eutherian mammals, this finding implies that the whole human X
      short arm region is a relatively recent addition to the X chromosome in eutherian
      mammals.

PMID- 1763041
TI  - Locating protein-coding regions in human DNA sequences by a multiple sensor
      neural network approach.
AB  - Genes in higher eukaryotes may span tens or hundreds of kilobases with the
      protein-coding regions accounting for only a few percent of the total sequence.
      Identifying genes within large regions of uncharacterized DNA is a difficult
      undertaking and is currently the focus of many research efforts. We describe a
      reliable computational approach for locating protein-coding portions of genes in
      anonymous DNA sequence. Using a concept suggested by robotic environmental
      sensing, our method combines a set of sensor algorithms and a neural network to
      localize the coding regions. Several algorithms that report local characteristics
      of the DNA sequence, and therefore act as sensors, are also described. In its
      current configuration the "coding recognition module" identifies 90% of coding
      exons of length 100 bases or greater with less than one false positive coding
      exon indicated per five coding exons indicated. This is a significantly lower
      false positive rate than any method of which we are aware. This module
      demonstrates a method with general applicability to sequence-pattern recognition
      problems and is available for current research efforts.

PMID- 1763042
TI  - Domain exchange: characterization of a chimeric lipase of hepatic lipase and
      lipoprotein lipase.
AB  - Hepatic lipase and lipoprotein lipase hydrolyze fatty acids from triacylglycerols
      and are critical in the metabolism of circulating lipoproteins. The two lipases
      are similar in size and amino acid sequence but are distinguished by functional
      differences in substrate preference and cofactor requirement. Presumably, these
      distinctions result from structural differences in functional domains. To begin
      localization of these domains, a chimeric lipase was constructed composed of the
      N-terminal 329 residues of rat hepatic lipase linked to the C-terminal 136
      residues of human lipoprotein lipase. The chimera hydrolyzed both monodisperse
      short-chain (esterase) and emulsified long-chain (lipase) triacylglycerol
      substrates with catalytic and kinetic properties closely resembling those of
      native hepatic lipase. However, monoclonal antibodies to lipoprotein lipase
      inhibited the lipase activity, but not the esterase function, of the chimera.
      Therefore, the chimeric molecule is a functional lipase and contains elements and
      characteristics from both parental enzymes. It is proposed that the N-terminal
      domain, containing the active center from hepatic lipase, governs the catalytic
      character of the chimera, and the C-terminal domain is essential for hydrolysis
      of long-chain substrates.

PMID- 1763043
TI  - Methylation changes in the apolipoprotein AI gene during embryonic development of
      the mouse.
AB  - We report here a detailed study of developmental changes in the methylation
      status of specific sites in a single-copy tissue-specific gene, from the germ
      cell through the early embryo to adult tissues. Two sites at the 5' end of the
      mouse apolipoprotein AI gene were unmethylated in the ovulated unfertilized
      oocytes and methylated in the sperm. In contrast, a third site, located upstream
      of the gene, was methylated and a CpG island within the gene was unmethylated in
      both oocyte and sperm. The methylated sites, regardless of maternal or paternal
      origin, underwent demethylation in the early embryo (8-16 cells) and stayed
      unmethylated through the late blastocyst stage. During gastrulation, non-CpG
      island sites underwent methylation, followed by gradual demethylation at specific
      sites in tissues parallel to expression of the gene (liver and intestine). The
      formation of the mature tissue-specific methylation pattern of the apolipoprotein
      AI gene, therefore, involves the following three major events: (i) erasure of the
      germ-cell methylation pattern (at the 8- to 16-cell stage), (ii) formation of a
      new methylation pattern by de novo methylation of non-CpG island sites (during
      gastrulation), and (iii) tissue-specific demethylation associated with the onset
      of expression of the gene.

PMID- 1763044
TI  - CD4-binding regions of human immunodeficiency virus envelope glycoprotein gp120
      defined by proteolytic digestion.
AB  - The gp120 envelope glycoprotein of human immunodeficiency virus type 1 binds the
      cell surface protein CD4 with high affinity. Here we report the use of
      proteolysis to define regions of gp120 involved in CD4 binding. Cleavage of gp120
      with Staphylococcus aureus V8 protease at residue 269 or with trypsin at residue
      432 destroys CD4 binding. These same sites are protected from proteolytic
      cleavage by bound CD4. Cleavages at 64, 144, 166, 172, and 315 do not affect
      binding and are not protected by bound CD4, indicating that these regions are not
      critical for binding CD4. All proteolytic fragments found in coprecipitates with
      CD4 were covalently associated via disulfides and comprised complete gp120
      molecules. Previous conclusions by Nygren et al. [Nygren, A., Bergman, T.,
      Matthews, T., Jornvall, H. & Wigzell, H. (1988) Proc. Natl. Acad. Sci. USA 85,
      6543-6546] that both large and small (95-kDa and 25-kDa) V8 proteolytic fragments
      bind CD4, independently, are not distinguished by their experiments from the
      result found here that the small fragment immunoprecipitates with CD4 while
      disulfide-linked to the larger fragment.

PMID- 1763045
TI  - Positioning of a peptide in the cleft of HLA-A2 by complementing amino acid
      changes.
AB  - Several mutant HLA-A2 molecules have been constructed and expressed in the mutant
      human B-cell line C1R, which lacks HLA-A and HLA-B antigens, and examined for
      presentation of a previously defined peptide epitope derived from the influenza
      matrix protein to appropriate human cytotoxic T-lymphocyte lines. When leucine
      residue 66 in this matrix peptide containing residues 57-68 (matrix peptide 57
      68) was replaced by arginine, the resulting matrix peptide 57-68 R66 was not
      presented to HLA-A2, but the mutation Y116D (tyrosine to aspartic acid at residue
      116) in the floor of the peptide binding cleft near its right end dramatically
      restored peptide presentation. A similar result was obtained by substitution of
      ornithine for leucine at residue 66. These data provide strong support for a
      model in which the peptide is orientated with its amino terminus at the left end
      of the cleft of HLA-A2 and its carboxyl terminus at the right.

PMID- 1763046
TI  - Ectopic dendrites occur only on cortical pyramidal cells containing elevated GM2
      ganglioside in alpha-mannosidosis.
AB  - In a variety of neuronal storage diseases, cortical pyramidal cells elaborate
      ectopic dendrites at the axon hillock. A feature common to all the diseases
      characterized by ectopic dendrites is an elevated level of GM2 ganglioside in
      cerebral cortex. In cats with one such disease, alpha-mannosidosis, the number of
      pyramidal cells bearing ectopic dendrites is small; the present study shows that
      GM2 ganglioside is stored only in those pyramidal neurons exhibiting ectopic
      dendrites. Using a Golgi-electron microscopy method with periodic acid-Schiff
      (PAS) staining, we first established that pyramidal cells bearing ectopic
      dendrites contained PAS+ membranous inclusions, consistent with storage of
      glycolipids. In contrast, those with smooth axon hillocks accumulated PAS-
      floccular inclusions, consistent with storage of oligosaccharides. Next,
      application of a monoclonal antibody against GM2 ganglioside revealed that
      subsets of both pyramidal and intrinsic neurons contained GM2-like
      immunoreactivity. Every GM2+ cell contained PAS+ membranous inclusions,
      indicating that pyramidal cells bearing ectopic dendrites stored GM2 ganglioside.
      In cats with alpha-mannosidosis induced by swainsonine, some pyramidal neurons
      showed GM2-like immunoreactivity after 4 weeks of treatment, whereas ectopic
      dendrites only became evident after 7 weeks of treatment. Thus, GM2 ganglioside
      accumulated in pyramidal neurons before ectopic dendrites emerged from the axon
      hillock. We propose that the reinitiation of dendrite growth on mature pyramidal
      cells is brought about by accumulated GM2 ganglioside.

PMID- 1763047
TI  - Blast crisis in a murine model of chronic myelogenous leukemia.
AB  - The P210bcr/abl protein is produced in cells from patients with Philadelphia
      chromosome-positive chronic myelogenous leukemia (CML). Retroviral transfer of
      the gene encoding P210bcr/abl into murine bone marrow induces a granulocytic
      leukemia that models the chronic phase of human CML. We have transferred the
      leukemic clone to syngeneic animals, albeit with surprising inefficiency, and
      have observed CML and clonally related acute leukemias of lymphoid or myeloid
      phenotype in some transplant recipients. These data show that murine CML can
      result from retroviral transfer of the bcr/abl gene into pluripotent
      hematopoietic stem cells, that infected clones repopulate poorly after adoptive
      transfer, and that these clones can give rise to acute leukemia, reflecting
      evolution to a phase resembling blast crisis in the human disease.

PMID- 1763048
TI  - Song-selective auditory circuits in the vocal control system of the zebra finch.
AB  - Birdsong is a learned behavior controlled by a distinct set of brain nuclei. The
      song nuclei known as area X, the medial nucleus of the dorsolateral thalamus
      (DLM), and the lateral magnocellular nucleus of the anterior neostriatum (L-MAN)
      form a pathway that plays an important but unknown role in song learning. One
      function served by this circuit might be auditory feedback, which is critical to
      normal song development. We used single unit recordings to demonstrate that all
      three of these nuclei contain auditory neurons in adult male zebra finches
      (Taeniopygia guttata). These neurons are song selective: they respond more
      robustly to the bird's own song than to songs of conspecific individuals, and
      they are sensitive to the temporal structure of song. Auditory neurons so highly
      specialized for song within a pathway required for song learning may play a role
      in the auditory feedback essential in song development. Recordings in the robust
      nucleus of the archistriatum (RA), the nucleus to which L-MAN projects, showed
      that RA also contains highly song-selective neurons. RA receives a direct
      projection from the caudal nucleus of the ventral hyperstriatum (HVc) as well as
      from L-MAN. We investigated the contributions of these two inputs to auditory
      responses of RA neurons by selectively inactivating one or both inputs. Our
      results suggest that there is a song-selective pathway directly from HVc to RA in
      addition to the circuit via L-MAN. Thus the songbird brain contains multiple
      auditory pathways specialized for song, and these circuits may vary in their
      functional importance at different stages of learning.

PMID- 1763049
TI  - Cloning and expression of a cDNA encoding the alpha subunit of rat p21ras protein
      farnesyltransferase.
AB  - The complete amino acid sequence of the alpha subunit of heterodimeric p21ras
      protein farnesyltransferase from rat has been deduced from the sequence of a
      cloned cDNA. The cDNA encodes a 377-amino acid protein that migrates on
      NaDodSO4/polyacrylamide gels identically to the alpha subunit purified from rat
      brain. When introduced into mammalian cells by transfection, the cDNA for the
      alpha subunit produced no immunodetectable protein or farnesyltransferase
      activity unless the cells were simultaneously transfected with a cDNA encoding
      beta subunit. In light of previous evidence that alpha subunit forms a
      heterodimer with at least two different beta subunits, current data suggest a
      mechanism for coordinating amounts of alpha and beta subunits. If an alpha
      subunit were stable only as a complex with a beta subunit, the number of alpha
      subunits would be automatically maintained at a level just sufficient to balance
      all beta subunits, thereby avoiding the potentially toxic overaccumulation of
      free alpha subunits.

PMID- 1763050
TI  - RAM2, an essential gene of yeast, and RAM1 encode the two polypeptide components
      of the farnesyltransferase that prenylates a-factor and Ras proteins.
AB  - In the yeast Saccharomyces cerevisiae, mutations in either of two unlinked genes,
      RAM1 or RAM2, abolish the farnesyltransferase activity responsible for
      prenylation of Ras proteins and the a-factor mating pheromone. Here we report
      that the function of RAM1 and RAM2 genes is required for the membrane
      localization of Ras proteins and a-factor. The RAM2 gene was sequenced and can
      encode a 38-kDa protein. We examined the functional interaction of RAM2 and RAM1
      by expressing the genes in Escherichia coli. Extracts derived from an E. coli
      strain that coexpressed RAM1 and RAM2 efficiently farnesylated a-factor peptide
      and Ras protein substrates. In contrast, extracts derived from E. coli strains
      that expressed either RAM gene alone were devoid of activity; however, when the
      latter extracts were mixed, protein farnesyltransferase activity was
      reconstituted. These results indicate that the yeast farnesyl-protein transferase
      is comprised of Ram1 and Ram2 polypeptides. Although Ram1 is a component of the
      enzyme, disruption of the RAM1 gene in yeast was not lethal, indicating that the
      Ram1-Ram2 farnesyltransferase is not essential for viability. In contrast,
      disruption of RAM2 was lethal, suggesting that Ram2 has an essential function in
      addition to its role with Ram1 in protein farnesylation.

PMID- 1763051
TI  - Mutants of Escherichia coli initiator tRNA that suppress amber codons in
      Saccharomyces cerevisiae and are aminoacylated with tyrosine by yeast extracts.
AB  - We recently described mutants of Escherichia coli initiator tRNA that suppress
      amber termination codons (UAG) in E. coli. These mutants have changes in the
      anticodon sequence (CAU----CUA) that allow them to read the amber codon and
      changes in the acceptor stem that allow them to bind to the ribosomal aminoacyl
      (A) site. We show here that a subset of these mutants suppress amber codons in
      Saccharomyces cerevisiae and that they are aminoacylated with tyrosine by yeast
      extracts. Analysis of a number of mutants as substrates for yeast tyrosyl-tRNA
      synthetase has led to identification of the C1.G72 base pair and the
      discriminator base A73, conserved in all eukaryotic cytoplasmic and
      archaebacterial tyrosine tRNAs, as being important for recognition. Our results
      suggest that the C1.G72 base pair and the discriminator base, in addition to the
      anticodon nucleotides previously identified [Bare, L.A. & Uhlenbeck, O.C. (1986)
      Biochemistry 25, 5825-5830] as important in yeast tyrosyl-tRNA synthetase
      recognition, may comprise the critical identity determinants in yeast tyrosine
      tRNA.

PMID- 1763052
TI  - Premature termination of transcription from the P1 promoter of the mouse c-myc
      gene.
AB  - Modulation of transcriptional elongation within the c-myc gene is thought to play
      a major role in determining levels of c-myc mRNA in both normal and tumor cells.
      A discrete site of blockage to transcriptional elongation has previously been
      localized at the 3' end of exon 1 of the mouse and human c-myc genes. We here
      identify an additional site of transcriptional attenuation that is located
      between the P1 and P2 promoters of the c-myc gene and that mediates premature
      termination of transcripts initiating from the P1 promoter. A 95-nucleotide DNA
      fragment derived from this region prematurely terminated transcription when
      placed downstream from the promoter of the H-2Kbm1 gene and assayed by expression
      in Xenopus oocytes. We also show that the previously identified attenuation
      signal in exon 1 of the mouse c-myc gene can mediate premature termination of P1
      initiated transcripts. Premature termination of P1-initiated transcripts
      presumably increases transcription from the downstream P2 promoter; aberrant
      regulation of this termination may explain the increased use of the P1 promoter
      that is characteristic of certain tumors in which myc is overexpressed.

PMID- 1763053
TI  - Association of ubiquitin-activating enzyme with HeLa cell chromosomes during
      mitosis.
AB  - Ubiquitin-activating enzyme (E1) is the first enzyme in the pathway leading to
      formation of ubiquitin-protein conjugates. Antibodies raised against E1 were
      affinity purified and used for immunostaining HeLa cells. Condensed chromosomes
      in mitotic cells were found to be strongly immunoreactive. Chromosomes from
      metaphase-arrested HeLa cells were isolated and chromosome-associated proteins
      were analyzed by Western blotting. E1 was detected in fractions containing
      isolated chromosomes. These results suggest that E1 is associated with condensed
      chromosomes during mitosis.

PMID- 1763054
TI  - Terminal region recognition factor 1, a DNA-binding protein recognizing the
      inverted terminal repeats of the pGKl linear DNA plasmids.
AB  - The yeast linear DNA plasmids pGKl1 and pGKl2 contain inverted terminal repeats
      (ITRs) and terminal proteins covalently bound to the 5' termini of each plasmid.
      The presence of these features suggests a protein-primed mechanism of DNA
      replication, similar to that exemplified by mammalian adenovirus and phi 29 phage
      of Bacillus subtilis. In this paper, we report the identification of an activity
      in cytoplasmic extracts of yeast harboring the pGKl plasmids that recognizes the
      termini of both pGKl1 and pGKl2. We call this activity TRF1, for terminal region
      recognition factor 1. Deletion analyses and DNase I protection experiments
      demonstrate that the activity recognizes base pairs 107-183 within the ITR of
      pGKl1, and base pairs 126-179 within the ITR of pGKl2. The presence of T-tracts
      within these two regions, but otherwise dissimilar nucleotide sequences, suggests
      that TRF1 recognizes a common structural feature within the ITRs of the two
      plasmids. TRF1 has been partially purified from yeast cytoplasmic extracts and
      Southwestern analysis indicates that the apparent molecular mass of the protein
      is 16 kDa. By expressing three open reading frames from pGKl2 in Escherichia
      coli, we found that open reading frame 10 (ORF10) of pGKl2 encodes TRF1. The
      sequence of the ORF10 gene product indicates that TRF1 is a highly basic protein
      of small molecular mass. Comparison of TRF1 with other DNA-binding proteins known
      to recognize the terminal regions of linear DNAs, such as NFI and NFIII involved
      in adenovirus DNA replication, and phi 29 p6, involved in phi 29 DNA replication,
      indicates that TRF1 has a different mode of binding.

PMID- 1763055
TI  - A test of Fisher's theory of dominance.
AB  - One of the first patterns noticed by geneticists was that mutations are almost
      always recessive to their wild-type alleles. Several explanations of this
      striking pattern have been offered. The two most influential are Fisher's theory-
      which argues that dominance results from natural selection against recurring
      deleterious mutations--and Wright's theory--which argues that dominance results
      from the physiology of gene action. The debate over which of these theories is
      correct represents one of the most protracted controversies in the history of
      evolutionary biology. Here I test Fisher's theory by assessing the dominance of
      mutations in an organism that is typically haploid, the alga Chlamydomonas
      reinhardtii. The results show that mutations are recessive just as often among
      haploid as among diploid species. This result falsifies Fisher's theory of
      dominance and provides strong support for the alternative physiological theory.

PMID- 1763056
TI  - TAL2, a helix-loop-helix gene activated by the (7;9)(q34;q32) translocation in
      human T-cell leukemia.
AB  - Tumor-specific alteration of the TAL1 gene occurs in almost 25% of patients with
      T-cell acute lymphoblastic leukemia (T-ALL). We now report the identification of
      TAL2, a distinct gene that was isolated on the basis of its sequence homology
      with TAL1. The TAL2 gene is located 33 kilobase pairs from the chromosome 9
      breakpoint of t(7;9)(q34;q32), a recurring translocation specifically associated
      with T-ALL. As a consequence of t(7;9)(q34;q32), TAL2 is juxtaposed with
      sequences from the T-cell receptor beta-chain gene on chromosome 7. TAL2
      sequences are actively transcribed in SUP-T3, a T-ALL cell line that harbors the
      t(7;9)(q34;q32). The TAL2 gene product includes a helix-loop-helix protein
      dimerization and DNA binding domain that is especially homologous to those
      encoded by the TAL1 and LYL1 protooncogenes. Hence, TAL2, TAL1, and LYL1
      constitute a discrete subgroup of helix-loop-helix proteins, each of which can
      potentially contribute to the development of T-ALL.

PMID- 1763057
TI  - Neural networks as a tool for utilizing laboratory information: comparison with
      linear discriminant analysis and with classification and regression trees.
AB  - Successful applications of neural network architecture have been described in
      various fields of science and technology. We have applied one such technique,
      error back-propagation, to a medical classification problem stemming from
      clinical chemistry, and we have compared the performance of two different neural
      networks with results obtained by conventional linear discriminant analysis or by
      the technique of classification and regression trees. The results obtained by the
      various models were tested for robustness by jackknife validation ("leave n out"
      method). Compared with the two other techniques, neural networks show a unique
      ability to detect features hidden in the input data which are not explicitly
      formulated as input. Thus, neural network techniques appear promising in the
      field of clinical chemistry, and their application, particularly in situations
      with complex data structures, should be investigated with more emphasis.

PMID- 1763058
TI  - Differential distribution of AT1 and AT2 angiotensin II receptor subtypes in the
      rat brain during development.
AB  - Angiotensin II (AII) receptor subtypes were analyzed in the brains of adult and 2
      week-old rats by in vitro autoradiography with 125I-labeled [Sar1,Ile8]AII and
      competition studies with three AII antagonists: the nonpeptide antagonist, DuP
      753, which is specific for AT1 receptors that mediate the calcium-inositol
      phospholipid signaling actions of AII; and nonpeptide (PD 123177) and peptide
      (CGP 42112A) antagonists that are selective for AT2 receptors of yet unknown
      function. In the adult rat brain, DuP 753 inhibited radioligand binding to the
      circumventricular organs and paraventricular nucleus but not to the lateral
      septum, subthalamic nucleus, and inferior olive. However, binding of 125I-labeled
      [Sar1,Ile8]AII in the latter regions was inhibited by the AT2 receptor
      antagonists PD 123177 and CGP 42112A. These areas showed similar displacement by
      the AT2 receptor subtype-specific antagonists in 2-week-old rats. In addition,
      radioligand binding at multiple sites of transient expression of AII receptors in
      2-week-old rats, including several thalamic nuclei, the nuclei of the 3rd and
      12th cranial nerves, geniculate bodies, cerebellum, and cingulate cortex, was
      displaced by the AT2 antagonists but not by DuP 753. These studies have
      demonstrated the presence of two AII receptor subtypes in the brain, one (AT1) in
      areas related to regulation of blood pressure, water intake, and pituitary
      hormone secretion, and one (AT2) whose function is not yet defined. The abundance
      and location of brain AT2 receptors in young animals, and the age-related changes
      in relative expression of the receptor subtypes, suggest that AII exerts specific
      actions according to the developmental stage of the central nervous system.

PMID- 1763059
TI  - Interaction of the human T-cell lymphotrophic virus type I (HTLV-I)
      transcriptional activator Tax with cellular factors that bind specifically to the
      21-base-pair repeats in the HTLV-I enhancer.
AB  - The human T-cell lymphotrophic virus type I (HTLV-I) Tax protein activates
      transcription from three 21-base-pair (bp) repeat sequences in the viral
      enhancer. Using gel electrophoretic mobility-shift assays, we now show that Tax
      interacts directly with the nuclear proteins, Tax activation factors (TAFs), that
      bind the 21-bp repeats. This interaction is demonstrated by decreased
      electrophoretic mobilities of the TAFs-21-bp-repeats complexes upon supply of Tax
      exogenously. Formation of the TAFs-21-bp-repeats and Tax-TAFs-21-bp-repeats
      complexes correlates with in vivo transactivation by Tax. Furthermore,
      interaction of Tax with TAFs enhances their binding to the 21-bp repeats. These
      data indicate that trans-activation by Tax is most likely mediated by interaction
      of Tax with TAFs.

PMID- 1763060
TI  - Sterically stabilized liposomes: improvements in pharmacokinetics and antitumor
      therapeutic efficacy.
AB  - The results obtained in this study establish that liposome formulations
      incorporating a synthetic polyethylene glycol-derivatized phospholipid have a
      pronounced effect on liposome tissue distribution and can produce a large
      increase in the pharmacological efficacy of encapsulated antitumor drugs. This
      effect is substantially greater than that observed previously with conventional
      liposomes and is associated with a more than 5-fold prolongation of liposome
      circulation time in blood, a marked decrease in uptake by tissues such as liver
      and spleen, and a corresponding increased accumulation in implanted tumors. These
      and other properties described here have expanded considerably the prospects of
      liposomes as an effective carrier system for a variety of pharmacologically
      active macromolecules.

PMID- 1763061
TI  - Intracellular replication is essential for the virulence of Salmonella
      typhimurium.
AB  - Salmonella typhimurium is a facultative intracellular parasite, capable of
      penetrating, surviving, and multiplying within diverse eukaryotic cell types,
      including epithelial and phagocytic cells. We have been studying intracellular
      replication of S. typhimurium and found that it is essential in the pathogenesis
      of this bacterium. A total of 45,000 independent mini-Mu MudJ transposon mutants
      in S. typhimurium SL1344 were screened in Madin-Darby canine kidney (MDCK)
      epithelial cells with a beta-lactam, cefotaxime, to enrich for mutants defective
      for intracellular replication. Ten different auxotrophic (purine, pyrimidine,
      purine/methionine, and valine/isoleucine) and three prototrophic replication
      defective mutants (Rep-) were identified. All Rep- mutants showed no differences
      in aerobic and anaerobic growth patterns, motility, serum sensitivity, mouse
      macrophage survival, iron uptake, and phosphate requirements. All Rep- mutants
      were unable to multiply inside MDCK, HeLa, and Caco-2 epithelial cells. When
      required nutrients for various auxotrophs were supplemented, auxotrophs then
      replicated inside MDCK cells. Although the parental strain multiplies in large
      vacuoles inside MDCK cells that distort the host cells, MDCK cells infected with
      the Rep- mutants appeared relatively normal and few bacteria were seen inside
      vacuoles. The purine auxotrophs and the three prototrophic Rep- mutants were
      highly attenuated in mice, and oral and intraperitoneal LD50 levels were 3 to 4
      orders of magnitude higher than the wild type level. The three prototrophs were
      invasive and persisted in the murine organs such as livers and spleens for at
      least 3 weeks. Therefore, these prototrophic genes are needed for intracellular
      replication and are essential to the virulence of S. typhimurium.

PMID- 1763062
TI  - Age-dependent decrease in the affinity of muscarinic M1 receptors in neocortex of
      rhesus monkeys.
AB  - In vitro autoradiography on tissue sections and receptor assay in cortical
      membrane homogenates revealed that pirenzepine high-affinity muscarinic sites
      (M1) decrease in affinity in the prefrontal cortex and in other cortical areas of
      aged rhesus monkey (Macaca mulatta). Carbachol competition experiments detected
      only a single, low-affinity class of sites in old monkeys, while two classes of
      sites (low and high affinity) were observed in young adults. The change in
      affinity in the aged monkeys is not accompanied by a decrease in the density of
      these sites and, further, the age-related decline in the affinity of the M1 site
      is reversible. In the presence of Mg2+, the M1 muscarinic receptors in the aged
      monkeys were capable of forming carbachol high-affinity sites. These results
      provide evidence for age-dependent functional changes in receptor activity in
      cerebral cortex and indicate that these receptors maintain a degree of plasticity
      that could be a strategic target for research aimed at treatment of memory
      disorders in aged humans.

PMID- 1763063
TI  - The E-cadherin promoter: functional analysis of a G.C-rich region and an
      epithelial cell-specific palindromic regulatory element.
AB  - The cell-cell adhesion molecule E-cadherin is specifically expressed in epithelia
      and is involved in the maintenance of the epithelial phenotype. Expression of E
      cadherin is downregulated in many poorly differentiated carcinomas, which leads
      to higher motility and invasiveness of the cells. To examine the mechanisms that
      regulate tissue-specific expression, we have characterized the promoter of the E
      cadherin gene. We found that an upstream fragment (positions -178 to +92)
      mediates strong expression of a chloramphenicol acetyltransferase reporter gene
      in epithelial cells (i.e., 60% of the level obtained with simian virus 40
      promoter/enhancer constructs), whereas in nonepithelial cells this promoter was
      either inactive or much less active. By DNase I footprinting and gel retardation
      analysis as well as through functional dissection of the regulatory sequences, we
      identified two regions that contribute to tissue-specific activity of the
      promoter: (i) a G-C-rich region between -25 and -58 that generates basic
      epithelial promoter activity, most likely in combination with an "initiator"
      element present at the single transcription start site of the gene, and (ii) a
      palindromic sequence between -75 and -86 (named E-pal) that potentiates the
      activity of the proximal E-cadherin promoter and confers epithelial cell-specific
      activity on a simian virus 40 promoter. The E-pal sequence is homologous to cis
      regulatory elements active in keratin gene promoters and competes with these
      elements for nuclear factor binding. Interestingly, the activity of the E
      cadherin promoter was reduced in dedifferentiated breast carcinoma cells,
      indicating that the identified elements are subject to negative regulation during
      tumor progression.

PMID- 1763064
TI  - Phosphorylation state of the GLUT4 isoform of the glucose transporter in
      subfractions of the rat adipose cell: effects of insulin, adenosine, and
      isoproterenol.
AB  - The acute effects of insulin, adenosine, and isoproterenol on the activity,
      subcellular distribution, and phosphorylation state of the GLUT4 glucose
      transporter isoform were investigated in rat adipocytes under conditions
      carefully controlled to monitor changes in cAMP-dependent protein kinase (A
      kinase) activity. In contrast to GLUT1, which has not been shown to be
      phosphorylated even when cells are exposed to any of the above agents, GLUT4 was
      partially phosphorylated (0.1-0.2 mol/mol) when the activity of the A-kinase was
      suppressed, and remained unchanged in response to insulin. Isoproterenol elicited
      a 64% inhibition of insulin-stimulated glucose transport activity in the absence,
      but not the presence, of adenosine receptor agonists. However, in either the
      presence or the absence of agonists, A-kinase was activated as assessed by
      examining the phosphorylation of the major adipocyte A-kinase substrate,
      perilipin. Similarly, under either condition, phosphorylation of GLUT4 was
      enhanced 1.4-fold in the intracellular membranes, but no significant change was
      observed in the plasma membrane. In the absence of adenosine receptor agonists,
      isoproterenol exerted a small (14%) but significant inhibition of the insulin
      induced translocation of GLUT4 but had no effect on the translocation of GLUT1.
      Thus, changes in the phosphorylation state and/or subcellular distribution of
      GLUT4 cannot account for the inhibition of insulin-stimulated glucose activity
      induced by isoproterenol.

PMID- 1763065
TI  - Human interferon gamma potently induces the synthesis of a 55-kDa protein (gamma
      2) highly homologous to rabbit peptide chain release factor and bovine
      tryptophanyl-tRNA synthetase.
AB  - An interferon gamma (IFN-gamma)-inducible protein, gamma 2, was identified by two
      dimensional gel electrophoresis of transformed human amnion (AMA) cell proteins.
      cDNA clones coding for this protein have been isolated and characterized as
      encoding a polypeptide with a predicted molecular weight of 53,165 and a pI of
      6.16. Both values are in good agreement with those observed in two-dimensional
      gel electrophoresis. The gamma 2 protein is found to be highly induced by IFN
      gamma, whereas no induction was seen after addition of IFN-alpha to AMA cells. A
      gamma 2-specific 2.7-kilobase mRNA was likewise seen to accumulate selectively in
      response to IFN-gamma in these cells. Comparison of the predicted amino acid
      sequence of gamma 2 to proteins in GenBank data bases revealed that gamma 2 is
      highly homologous to rabbit peptide chain release factor [Lee, C. C., Craigen, W.
      J., Muzny, D. M., Harlow, E. & Caskey, C. T. (1990) Proc. Natl. Acad. Sci. USA
      87, 3508-3512] and bovine tryptophanyl-tRNA synthetase [M. Garret, V. Trezeguet,
      B. Pajot, J. C. Gandar, M. Merle, M. Guegiev, J. P. Benedetto, C. Sarger, J.
      Alteriot, J. La Bouessec, J. Labouesse, and J. Bonnet (1990), GenBank accession
      no. X52113]. Amino acid sequence similarities of 94% and 97%, respectively, are
      found, which in general would indicate that gamma 2 represents the human
      equivalent to either of these two mammalian genes. Based on these sequence
      similarities, the current data raise the possibility that tryptophanyl-tRNA
      charging and peptide chain release are carried out by the same enzyme. The gamma
      2 protein is shown to possess tryptophan-dependent aminoacyl-tRNA synthetase
      activity and thus constitutes an enzymatic activity involved in the biological
      activity of IFN-gamma.

PMID- 1763066
TI  - Amantadine selection of a mutant influenza virus containing an acid-stable
      hemagglutinin glycoprotein: evidence for virus-specific regulation of the pH of
      glycoprotein transport vesicles.
AB  - Mutants of influenza Rostock virus (H7N1 subtype) were selected for resistance to
      amantadine hydrochloride at concentrations of the antiviral drug known to affect
      the function of the virus M2 transmembrane protein. Sequence analysis revealed
      that three mutants had no changes in M2 but contained a lysine to isoleucine
      substitution in the hemagglutinin (HA) membrane glycoprotein at position 58 of
      HA2. The mutant viruses were found to fuse membranes at a pH value 0.7 lower than
      wild type and to exhibit changes in the conformation of their HAs specifically at
      the lower pH. The homologous lysine to isoleucine substitution was introduced by
      site-specific mutagenesis into the HA of X-31 influenza virus (H3 subtype), which
      was expressed by using vaccinia virus recombinants. The expressed HA also
      mediated membrane fusion and changed in conformation at a pH value 0.7 lower than
      wild type. These results indicate that increased acid stability of the HA
      obviates the consequences of the inhibition of M2 function by amantadine and
      provide further evidence for the role of M2 in regulating the pH of vesicles
      involved in glycoprotein transport to the cell surface.

PMID- 1763067
TI  - Application of crystallographic and modeling methods in the design of purine
      nucleoside phosphorylase inhibitors.
AB  - Competitive inhibitors of the salvage pathway enzyme purine-nucleoside
      phosphorylase (purine-nucleoside:orthophosphate ribosyltransferase, EC 2.4.2.1)
      have been designed by using the three-dimensional structure of the enzyme as
      determined by x-ray crystallography. The process was an iterative one that
      utilized interactive computer graphics, Monte Carlo-based conformational
      searching, energy minimization, and x-ray crystallography. The proposed compounds
      were synthesized and tested by an in vitro assay. Among the compounds designed
      and synthesized are the most potent competitive inhibitors of purine nucleoside
      phosphorylase thus far reported.

PMID- 1763068
TI  - Genes for two calcium-dependent cell adhesion molecules have similar structures
      and are arranged in tandem in the chicken genome.
AB  - Genomic sequences immediately upstream of the translational start site for the
      chicken liver cell adhesion molecule (L-CAM) gene contain a second closely
      related gene, which, because of its location, we have designated the K-CAM gene.
      Less than 700 base pairs separate the presumed poly(A) site in the K-CAM gene
      from the translation initiation site for L-CAM. The sizes of exons 4-15 of the K
      CAM gene are almost identical to those in the L-CAM gene and the exon/intron
      junctions occur at exactly equivalent positions in both genes. Exon 16, which
      includes the 3' untranslated region, is much shorter in the K-CAM gene and intron
      sizes and sequences are not generally conserved between the two genes. Probes
      from the K-CAM gene hybridized to a 3-kilobase mRNA that was present at high
      levels in embryonic skin, at lower levels in kidney, heart, and gizzard, and at
      still lower levels in brain and liver, as determined by Northern blotting. The
      sequence of the predicted gene product was nearly identical to that of the
      chicken B-cadherin cDNA, although the distribution of the K-CAM gene transcript
      differed from that reported for the cadherin. The proximity and identical overall
      structure of the K-CAM and L-CAM genes strongly suggest that they arose by gene
      duplication and raise the possibility that genes for other calcium-dependent CAMs
      may be located in clusters. Moreover, the tandem arrangement of the genes may
      have important implications for the regulation of their expression.

PMID- 1763069
TI  - Aminoguanidine treatment inhibits the development of experimental diabetic
      retinopathy.
AB  - Retinal capillary closure induced by hyperglycemia is the principal
      pathophysiologic abnormality underlying diabetic retinopathy, but the mechanisms
      by which this induction occurs are not clear. Treatment of diabetic rats for 26
      weeks with aminoguanidine, an inhibitor of advanced glycosylation product
      formation, prevented a 2.6-fold accumulation of these products at branching sites
      of precapillary arterioles where abnormal periodic acid/Schiff reagent-positive
      deposits also occurred. Aminoguanidine treatment completely prevented abnormal
      endothelial cell proliferation and significantly diminished pericyte dropout.
      After 75 weeks, untreated diabetic animals developed an 18.6-fold increase in the
      number of acellular capillaries and formed capillary microaneurysms,
      characteristic pathologic features of background diabetic retinopathy. In
      contrast, aminoguanidine-treated diabetic animals had only a 3.6-fold increase in
      acellular capillaries and no microaneurysms. These findings indicate that
      advanced glycosylation product accumulation contributes to the development of
      diabetic retinopathy and suggest that aminoguanidine may have future therapeutic
      use in this disorder.

PMID- 1763070
TI  - High-resolution optical imaging of functional brain architecture in the awake
      monkey.
AB  - Optical imaging of the functional architecture of cortex, based on intrinsic
      signals, is a useful tool for the study of the development, organization, and
      function of the living mammalian brain. This relatively noninvasive technique is
      based on small activity-dependent changes of the optical properties of cortex.
      Thus far, functional imaging has been performed only on anesthetized animals.
      Here we establish that this technique is also suitable for exploring the brain of
      awake behaving primates. We designed a chronic sealed chamber and mounted it on
      the skull of a cynomolgus monkey (Macaca fascicularis) over the primary visual
      cortex to permit imaging through a transparent glass window. Restriction of head
      position alone was sufficient to eliminate movement noise in awake monkey imaging
      experiments. High-resolution imaging of the ocular dominance columns and the
      cytochrome oxidase blobs was achieved simply by taking pictures of the exposed
      cortex when the awake monkey was viewing video movies alternatively with each
      eye. Furthermore, the functional maps could be obtained without synchronization
      of the data acquisition to the animal's respiration and the electrocardiogram.
      The wavelength dependency and time course of the intrinsic signal were similar in
      anesthetized and awake monkeys, indicating that the signal sources were the same.
      We therefore conclude that optical imaging is well suited for exploring
      functional organization related to higher cognitive brain functions of the
      primate as well as providing a diagnostic tool for delineating functional
      cortical borders and assessing proper functions of human patients during
      neurosurgery.

PMID- 1763072
TI  - Synaptic background activity influences spatiotemporal integration in single
      pyramidal cells.
AB  - The standard one-dimensional Rall cable model assumes that the electrotonic
      structure of neurons does not change in response to synaptic input. This model is
      used in a great number of both theoretical and anatomical-physiological structure
      function studies. In particular, the membrane time constant, tau m, the somatic
      input resistance, Rin, and the electrotonic length are used to characterize
      single cells. However, these studies do not take into account that neurons are
      embedded in a network of spontaneously active cells. Synapses from these cells
      will contribute significantly to the membrane conductance, especially if recent
      evidence of very high specific membrane resistance, Rm = 100 k omega.cm2, is
      taken into account. We numerically simulated the electrical behavior of an
      anatomically reconstructed layer V cortical pyramidal cell receiving input from
      4000 excitatory and 1000 inhibitory cells firing spontaneously at 0-7 Hz. We
      found that, over this range of synaptic background activity, tau m and Rin change
      by a factor of 10 (80-7 msec, 110-14 M omega) and the electrotonic length of the
      cell changes by a factor of 3. We show that this significantly changes the
      response of the cell to temporal desynchronized versus temporal synchronized
      synaptic input distributed throughout the neuron. Thus, the global activity of
      the network can control how individual cells perform spatial and temporal
      integration.

PMID- 1763071
TI  - Receptor class desensitization of leukocyte chemoattractant receptors.
AB  - To better define their regulation, formylpeptide and C5a chemoattractant receptor
      cDNAs were transiently expressed with high efficiency (approximately 35-54%) in
      human kidney cells. As in neutrophils, both receptors were active in elevating
      intracellular calcium (ED50 approximately 0.5-1 nM). Agonist-specific
      desensitization for calcium elevation was observed for both chemoattractant
      receptors at doses of approximately 1 nM. Heterologous desensitization of
      formylpeptide, C5a, and alpha 1-adrenergic receptors required high doses of
      phorbol ester (100 nM phorbol 12-myristate 13-acetate). To further study the
      phenomenon of desensitization, formylpeptide and C5a receptor cDNAs were
      cotransfected resulting in approximately 80% of receptor-positive cells
      expressing both receptors. These cells also possessed endogenous alpha 1
      adrenergic receptors. Interestingly, chemoattractant receptors were cross
      desensitized by pretreatment with low doses of either C5a or
      formylmethionylleucylphenylalanine (10 nM) but not by the alpha 1-adrenergic
      agonist norepinephrine (up to 10 microM). Neither chemoattractant desensitized
      alpha 1-adrenergic receptors. This phenomenon was reproduced in human
      neutrophils. These data suggest a previously uncharacterized mechanism of
      receptor regulation, which is intermediate between homologous and heterologous
      desensitization. Class desensitization of chemoattractant receptors is less
      selective than homologous desensitization but is far more efficient and specific
      than heterologous desensitization. Receptor class desensitization may affect
      functional classes of receptors via modification of either the receptor or the
      shared guanine nucleotide-binding regulatory protein.

PMID- 1763073
TI  - Escherichia coli mfd mutant deficient in "mutation frequency decline" lacks
      strand-specific repair: in vitro complementation with purified coupling factor.
AB  - Mutation frequency decline (MFD) is the rapid decrease in the frequency of
      certain induced nonsense suppressor mutations occurring when protein synthesis is
      transiently inhibited immediately after irradiation. MFD is abolished by
      mutations in the uvrA, -B, or -C genes, which prevent excision repair, or by a
      mfd mutation, which reduces the rate of excision but does not affect survival.
      Using an in vitro repair synthesis assay we found that although wild-type cells
      repair the transcribed (template) strand preferentially, mfd- cells are incapable
      of strand-specific repair. The deficiency in strand-selective repair of mfd- cell
      extract was corrected by adding highly purified "transcription-repair coupling
      factor" to the reaction mixture. We conclude that mfd is, most likely, the gene
      encoding the transcription-repair coupling factor.

PMID- 1763076
TI  - Who pays for PREPP?
AB  - Although it is now known that PREPP is to be implemented, there is still much
      uncertainty as to how it will be funded. Will nurses receive funding for their
      continuing education needs from health trusts, be expected to self-fund or seek
      sponsorship from drug companies?

PMID- 1763075
TI  - Inward-rectifying K+ channels in guard cells provide a mechanism for low-affinity
      K+ uptake.
AB  - The molecular mechanisms by which higher plant cells take up K+ across the plasma
      membrane (plasmalemma) remain unknown. Physiological transport studies in a large
      number of higher plant cell types, including guard cells, have suggested that at
      least two distinct types of K(+)-uptake mechanisms exist, permitting low-affinity
      and high-affinity K+ accumulation, respectively. Recent patch clamp studies have
      revealed the presence of inward-conducting (inward-rectifying) K+ channels in the
      plasma membrane of higher plant cells. Research on guard cells has suggested that
      these K+ channels provide a major pathway for proton pump-driven K+ uptake during
      stomatal opening. In the present study the contribution of inward-rectifying K+
      channels to higher plant cell K+ uptake was investigated by examining kinetic
      properties of guard cell K+ channels in Vicia faba in response to changes in the
      extracellular K+ concentration. Increasing the extracellular K+ concentration in
      the range from 0.3 mM to 11.25 mM led to enhancement of inward K+ currents and
      changes in current-voltage characteristics of K+ channels. The increase in K+
      conductance as a function of the extracellular K+ concentration revealed a K(+)
      equilibrium dissociation constant (Km) of approximately 3.5 mM, which suggests
      that inward-rectifying K+ channels can function as a molecular mechanism for low
      affinity K+ uptake. Lowering the extracellular K+ concentration in the range from
      11 mM to 1 mM induced negative shifts in the activation potential of K+ channels,
      such that these channels function as a K+ sensor, permitting only K+ uptake. At
      low extracellular K+ concentrations of 0.3 mM K+, inward-rectifying K+ channels
      induce hyperpolarization. Results from the present study suggest that inward
      rectifying K+ channels constitute an essential molecular mechanism for plant
      nutrition and growth control by providing a K(+)-sensing and voltage-dependent
      pathway for low-affinity K+ uptake into higher plant cells and additionally by
      contributing to plasma membrane potential regulation.

PMID- 1763074
TI  - Association of DQw7 (DQB1*0301) with ocular cicatricial pemphigoid.
AB  - Ocular cicatricial pemphigoid (OCP) is an autoimmune blistering disease that
      affects the conjunctiva and multiple mucous membranes. Class I and II and
      complement genetic markers of the major histocompatibility complex were studied
      in 20 Caucasian OCP patients and members of their families. Frequencies of
      individual alleles and common fixed or extended haplotypes in the patients were
      compared with those in normal family control haplotypes and with overall normal
      Caucasian haplotypes. The most striking increase compared with overall controls
      was noted in HLA-DQw3 (P = 0.006), unassociated with any extended haplotype. All
      but 1 of the 20 patients carried DQw3 in linkage with HLA-DR4 (increased
      significantly with P = 0.042 compared with overall normal genotype controls) or
      DR5. The DQw3, on analysis by restriction fragment length polymorphism in genomic
      DNA, was, in every instance, DQw7 (3.1, DQB1*0301). The frequency of DQB1*0301 in
      patient haplotypes compared with overall normal DR4 and DR5 DQw3-bearing
      haplotypes was statistically significantly increased (P less than 0.003, relative
      risk = 9.6). The distribution of homozygotes and heterozygotes for DQB1*0301
      among the patients was consistent with dominant but not recessive inheritance of
      DQB1*0301 or a gene, probably a class II allele, in linkage disequilibrium with
      it as the major histocompatibility complex susceptibility gene for OCP.

PMID- 1763077
TI  - Prevention is better than coma. Patient education on diabetic coma.
AB  - It is well recognised that people with diabetes may have comas at times. A coma
      is not, however, inevitable, and patient education can enable people with
      diabetes to recognise situations which may cause them to have a coma, and take
      preventive action.

PMID- 1763078
TI  - Diabetes: how to avoid a coma.

PMID- 1763079
TI  - Euthanasia: the way to a peaceful end?
AB  - Euthanasia is an emotive subject, and one in which the line between what is legal
      and illegal is often blurred. Nurses need to tackle the issue personally and
      professionally to ensure they deliver care that is in their patients' interests.

PMID- 1763080
TI  - A fighting chance to breathe. Repair of congenital diaphragmatic hernia.
AB  - Diaphragmatic hernia is a congenital lung defect which has high mortality rates.
      It can be corrected by surgery if the lungs are not too severely affected, and
      requires excellent postoperative nursing care.

PMID- 1763081
TI  - Clinical support in a homely setting. Hostel wards for long-term psychiatric
      care.
AB  - Closure of long-stay psychiatric hospitals has posed problems providing for some
      people with chronic problems. Hostel wards provide homely settings where they can
      receive intensive therapy to increase their independence.

PMID- 1763082
TI  - A therapeutic aid in cancer care. Uses of radioisotopes in diagnosis and
      treatment.

PMID- 1763083
TI  - Where there's life ... Intensive care for patients with AIDS and HIV.
AB  - The most common cause of Aids-related death is respiratory failure. Although the
      mortality rates are high, drug therapy can lead to successful outcomes. By
      keeping up-to-date with current developments, nurses working in ICUs can help
      adapt practice to suit individual needs and requirements.

PMID- 1763084
TI  - Can grief be turned into growth? Staff grief in palliative care.
AB  - Palliative care nurses can experience profound feelings of grief and helplessness
      when a patient dies. Staff support can help them work through their feelings of
      grief and use them as growing experiences.

PMID- 1763085
TI  - Safety first: the key consideration. Management of clinical waste.
AB  - Strict protocols are required for the storage and disposal of waste. If staff are
      alerted to the correct procedures, and protective clothing and equipment is
      provided, potentially dangerous accidents can be prevented.

PMID- 1763086
TI  - Incidence and aetiology of leg ulcers.

PMID- 1763087
TI  - A coordinated programme will identify needs. Practice nurses' role in screening
      elderly people.
AB  - The new GP contract requires that practices implement a screening programme for
      people aged over 75. With training, practice nurses can provide this screening,
      playing an important role in a coordinated primary healthcare service.

PMID- 1763088
TI  - He's wearing his glasses again.

PMID- 1763089
TI  - Dihydropyridine-induced release of catecholamines in cardiac tissue.
AB  - The symmetrically substituted dihydropyridine-dicarboxylate 3 exerts only weak
      calcium antagonistic activity on smooth muscles compared with the standard
      nifedipine. On electrically stimulated, left guinea pig-atria and particularly on
      electrically stimulated papillary muscles marked positive inotropic effects are
      registered. They can be attributed to release of catecholamines from
      intracellular stores.

PMID- 1763090
TI  - The influence of some anthracene and diphenylmethane derivatives on water and
      electrolyte movement in rat colon.
AB  - The secretagogue activity of 30 different anthracene and diphenylmethane
      derivatives was investigated by determining their influence on water, sodium and
      potassium absorption in the gastrointestinal tract of the rat by direct
      administration into the rat colon. To obtain an effect two phenolic groups are
      necessary. However the distance between these groups seems to be a major factor
      for secretagogue activity. In the case of the anthranoids an intact anthraquinone
      or anthrone structure is a prerequisite.

PMID- 1763091
TI  - Availability and activity of preservatives in emulsified systems.
AB  - Availability and activity of methyl-p-hydroxybenzoate, phenoxyethanol and
      chlorocresol in emulsions were studied by equilibrium dialysis and
      microbiological methods. Equation proposed by Bean and coworkers for calculating
      the availability of free preservatives in the aqueous phase of simple emulsion
      was also found to be applicable to modern emulsions composed of more than one oil
      and surfactant. The antimicrobial activity varied with the type of preservative
      and microorganism. Among the four test organisms, Pseudomonas aeruginosa and
      Staphylococcus aureus were more resistant to the various preservatives than
      Candida albicans and Aspergillus niger. The concentration of free preservative in
      the aqueous phase of the emulsion required to reduce the microbial population to
      the level specified in BP was found to be less than the concentration needed in
      distilled water indicating that the antimicrobial activity of the preservatives
      in emulsions is not entirely dependent on the concentration of their free form in
      the aqueous phase of emulsions.

PMID- 1763092
TI  - [The bioavailability of paracetamol II. The effect of porosity and mechanical
      properties of the dosage form on solubility].
AB  - The authors attempt to explain differences observed in dissolution rate of twelve
      different brands of paracetamol (nine tablets and three capsules) in terms of
      pore structure and tensile strength; the pore structure of both tablets and
      capsules is investigated by mercury porosimetry. Brands (tablets) which liberate
      paracetamol rapidly are characterized by a higher porosity value. Higher mean
      pore diameter signifies less t50 and higher porosity. An increase in tensile
      strength results in an increase in t50 and a decrease in porosity. Porosity alone
      cannot dictate the dissolution behaviour of capsules.

PMID- 1763093
TI  - [Medicinal Lamiaceae with antioxidant properties, a potential source of
      rosmarinic acid].
AB  - Hydroalcholic extracts from four native medicinal Lamiaceae, Lycopus europaeus
      L., Melissa officinalis L., Origanum vulgare L. and Prunella vulgaris L. have
      shown significant antioxidative activities, by free radical scavenger effect on
      DPPH, compared with those of Rosmarinus officinalis L. and Salvia officinalis L.
      extracts. The antioxidative activity was partly in relation to the rosmarinic
      acid content. The major hydroxycinnamic compound, quantitatively determinated by
      HPLC, was present in large amount. The content in Prunella vulgaris L. spikes
      average 6.1%, based on dry weight.

PMID- 1763094
TI  - Chemical properties-dissolution relationship. IV. Behaviour in solution of the
      diclofenac/N-(2-hydroxyethyl) pyrrolidine salt (DHEP).
AB  - The behaviour in solution of the salt formed between diclofenac and N-(2
      hydroxyethyl) pyrrolidine (DHEP) was examined. This salt is more soluble and
      dissolves more rapidly than sodium diclofenac and tends to give rise to
      supersaturated solutions, that only slowly evolve to equilibrium. Above 35 mM of
      DHEP, the solutions show unexpected solubilization ability towards sparingly
      soluble materials. The faster plasma level found, when DHEP is administered per
      os, can be associated to this weak detergency. These properties make DHEP a
      suitable pharmaceutical form to prepare extemporary solutions for short term
      analgesic therapy.

PMID- 1763095
TI  - Diffusion of naproxen in presence of beta-cyclodextrin across a silicone rubber
      membrane.
AB  - The diffusion of Naproxen through a silicone rubber membrane has been studied for
      four different release systems: solution and suspension both of Naproxen and
      Naproxen beta-cyclodextrin coprecipitates. Differences in transport between the
      two forms indicate the existence of an interaction between the acid and beta
      cyclodextrin in solution. Independence of the transport on pH in the case of the
      coprecipitate indicates rapid liberation of Naproxen from the complex prior to
      entering the membrane. Increase in the cumulative amount diffused for the
      suspension of Naproxen with increasing pH was interpreted as due to an increase
      in its solubility with increasing pH.

PMID- 1763096
TI  - Hypothermia and feeding induced simultaneously in rats by perfusion of
      neuropeptide Y in preoptic area.
AB  - Changes in the body temperature (Tbo) of the unrestrained rat as well as the
      hyperphagic-like ingestion of food were simultaneously determined during the
      sustained elevation of neuropeptide Y1-36 (NPY) within the anterior hypothalamic
      preoptic area (AH/POA). A single guide tube was implanted stereotaxically in each
      rat for repeated perfusions by means of push-pull cannulae of either the CSF
      solvent vehicle or NPY. Following postoperative recovery, each site in the AH/POA
      was perfused for 6.0 min at a rate of 20 microliters/min over four successive
      intervals at a concentration of 100 ng/1.0 microliters or 250 ng/1.0 microliters,
      with an interval of 6.0 min intervening between perfusions. During repeated
      perfusions of NPY in the fully sated and normothermic rat, concentration
      dependent eating, or a hypothermia or both responses occurred simultaneously.
      Mean cumulative intakes of food over 3.0 h were 12.1 +/- 1.4 and 21.5 +/- 2.7 g
      following the 100 and 250 ng concentrations of NPY, respectively. The mean
      maximal declines in Tbo were -0.92 +/- 0.21 and -1.1 +/- 0.28 degrees C,
      respectively after the lower and higher concentrations of the peptide. Push-pull
      perfusions of artificial CSF control vehicle at homologous anatomical sites in
      the AH/POA were without effect on feeding or the Tbo of the rats. These results
      demonstrate that repeated and sustained elevation of NPY in the AH/POA can cause
      a perturbation of the neuronal mechanisms underlying the normal "set-point" for
      body temperature as well as satiety.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1763097
TI  - Self-administration of the high-affinity cocaine analog 2 beta-carbomethoxy-3
      beta-(4-fluorophenyl)tropane.
AB  - Self-administration of the high-affinity cocaine analog 2 beta-carbomethoxy-3
      beta-(4-fluorophenyl)tropane (CFT) and cocaine were compared in squirrel monkeys
      responding under a second-order schedule of IV drug injection. Both CFT and
      cocaine maintained self-administration in all subjects. As the dose of either
      drug was increased, the rate of responding first increased and then decreased.
      Although the two drugs had qualitatively similar effects, CFT was approximately
      six times more potent than cocaine. This potency relation corresponds closely
      with the potency relations reported for CFT and cocaine in studies of dopamine
      uptake inhibition and binding at cocaine recognition sites. The results are
      consistent with the view that the reinforcing effects of cocaine-like drugs are
      mediated at cocaine recognition sites associated with the dopamine uptake system,
      and suggest that radioligand probes based on CFT may be suitable markers for
      these sites.

PMID- 1763098
TI  - Failure to detect increases in brain dopamine metabolism in rats sham feeding
      sucrose and corn oil.
AB  - In a recent study we found that when rats sham fed 6% sucrose, 10% sucrose, and
      100% corn oil, the rank order of inhibitory potency for D-1 and D-2 receptor
      antagonists was 6% sucrose greater than 10% sucrose greater than 100% corn oil.
      In a complementary study, sham-feeding rats preferred 100% corn oil greater than
      10% sucrose greater than 6% sucrose as measured by two-bottle preference tests.
      The preferences are evidence for the rank order of reward value of these
      solutions. In the present study we tested the hypothesis that the relative
      antagonist potencies were due to differential release of DA, dependent on the
      reward value of the sham-fed solution. Dopamine metabolism, estimated by the
      ratio of dihydroxphenylacetic acid (DOPAC) to DA, was measured in forebrain-DA
      terminal fields during sham feeding of 100% corn oil, 6% sucrose, and 10%
      sucrose. The results did not support our hypothesis: no increase in DA metabolism
      was observed after the sham feeding of any solution.

PMID- 1763099
TI  - Hypotensive effects of sarthran in normotensive and spontaneously hypertensive
      rat strains.
AB  - The specific angiotensin receptor antagonist [Sar1, Thr8]AII (sarthran) was
      intracerebroventricularly (ICV) infused in anesthetized spontaneously
      hypertensive rats (SHR) and Wistar-Kyoto (WKY) normotensive controls. The results
      extend earlier findings by determining that: 1) the hypotensive effect of ICV
      infused sarthran could be enhanced in anesthetized as compared with alert
      animals; 2) SHRs revealed a greater hypotensive response as compared with WKY
      rats; and 3) no sarthran-induced agonistic effects were observed in contrast with
      previous results using alert SHRs. These findings support the use of sarthran as
      a potent angiotensin receptor antagonist to investigate the role of the brain
      angiotensin system in the control of normal and dysfunctional blood pressure.

PMID- 1763100
TI  - Effects of ketamine and 1-glutamic acid diethyl ester on concept learning in
      rats.
AB  - The effects of ketamine, an NMDA receptor antagonist, and 1-glutamic acid diethyl
      ester (LGDE), a non-NMDA glutamate antagonist, were evaluated in the acquisition
      of concept learning in a water maze. In concept learning, the rats must locate an
      invisible platform whose location changes from day to day. In spatial learning
      (Morris task), the rats must locate an invisible (or visible) platform whose
      location does not change. Ketamine increased quadrant entries at 5, 10 and 20
      mg/kg, and latencies at 10 and 20 mg/kg on the final two days of training on the
      concept task. At 5 mg/kg ketamine disrupted concept learning but not spatial
      learning or visuo-motor coordination as assessed by invisible and visible
      platform conditions of the Morris maze. Progressively higher doses of ketamine
      affected first the invisible condition and then the visible platform condition.
      On the other hand, LGDE did not affect the Morris task at any dose. However,
      there was no decrease in latencies over days in concept learning at the two
      highest doses (240 and 360 mg/kg) of LGDE. Thus LGDE appeared to slow down
      decision time in the concept task but not the spatial task in the absence of an
      effect on quadrant entries in any version. These results indicate that NMDA
      receptors are involved in spatial and concept learning. Non-NMDA receptors appear
      to be involved only in concept learning.

PMID- 1763101
TI  - Effects of THA on passive avoidance retention performance of intact, nucleus
      basalis, frontal cortex and nucleus basalis + frontal cortex-lesioned rats.
AB  - Unilateral quisqualic acid lesions of the nucleus basalis magnocellularis (NBM)
      produced marked choline acetyltransferase depletion (-67% ipsilateral to lesion)
      and impaired passive avoidance (PA) retention at 24 hours. Pretraining injections
      of tacrine (THA: 1, 3 and 5 mg/kg), an anticholinesterase, failed to facilitate
      PA retention in intact rats. However, the retention performance of NBM-lesioned
      rats was improved by pretraining administration of THA at 3 mg/kg but not at
      either 1 or 5 mg/kg. Frontal cortex lesioning did not impair PA retention, and
      THA at 3 mg/kg had no effect on the PA retention of frontal cortex-lesioned rats.
      THA at 3 mg/kg failed to improve retention performance of NBM + frontal cortex
      lesioned rats. After 10 days of chronic treatment with THA, NBM lesion-induced PA
      retention deficits were partially restored at both 3- and 5-mg/kg doses. The
      results suggest that 1) the insult to cholinergic neurons in the NBM may be
      involved in the PA memory consolidation deficit induced by nonselective
      quisqualic acid lesioning; 2) the beneficial effects of THA on NBM lesion-induced
      PA retention deficit occur in a narrow dose range; 3) the alleviating effects of
      THA on NBM lesion-induced PA memory deficits are blocked by frontal cortex
      lesions; and 4) the dose-response window for THA-induced PA retention performance
      improvement is broadened by repeated treatment.

PMID- 1763102
TI  - Role of histaminergic mechanisms in the regulation of some stress responses in
      rats.
AB  - The involvement of histaminergic mechanisms in the regulation of some stress
      responses was studied in rats. The brain neuronal histamine (HA) depletor, alpha
      fluoromethyl histidine (alpha-FMH), at doses (50 or 100 mg/kg) which markedly
      lower brain HA, significantly attenuated the gastric ulcer formation and the
      elevation in plasma corticosterone in response to cold restraint stress (CRS).
      alpha-FMH also appreciably reduced gastric mucosal HA content. The H1-antagonist,
      pheniramine (25 mg/kg), attenuated both the gastric mucosal and endocrine
      response to CRS, while the effects of the H2-antagonist, cimetidine (200 mg/kg),
      were on the plasma corticosterone levels. These results are discussed in light of
      complex HA-ergic mechanisms in the maintenance of physiological homeostasis
      during stress.

PMID- 1763103
TI  - On the development of behavioral tolerance to organophosphates. IV: EEGand visual
      evoked responses.
AB  - Several earlier studies showed that, in contrast with DFP, repeated injections
      with soman did not lead to behavioral tolerance in rats. The reason for the
      difference between the effects of these two organophosphate cholinesterase
      inhibitors was not clear and a neurophysiological approach was undertaken. Four
      experiments (A, B, C and D) were carried out, each consisting of three groups of
      rats, SC injected with saline, DFP (600 micrograms/kg) or soman (60
      micrograms/kg) respectively. In Experiment B and D the rats were trained to
      criterion in a two-way shuttlebox. Thereafter, the animals of Experiment B were
      fitted with suitable electrodes and two days later their EEGs and visual evoked
      responses (VERs) were recorded, 1 and 24 h after a single dose of the above
      mentioned compounds. In Experiment D the trained animals were subsequently
      injected 3 times per week for 4 weeks with the same doses and their performance
      was tested 5 days per week, 1 and 24 h after injection. After those 4 weeks, when
      the DFP-treated animals had developed behavioral tolerance, electrodes were
      fitted and EEGs and VERs were recorded after two days, again 1 and 24 h after
      injection, as in Experiment B. The difference with Experiments A and C was that
      these animals were not trained. Otherwise, treatment schedules and recording
      procedures of Experiment A were identical to those of Experiments B and of
      Experiment C to those of Experiment D. In all cases the EEGs and VERs were
      recorded from animals slowly walking in a rotating hollow transparent wheel. The
      results show a similar pattern in all four experiments.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1763104
TI  - Discriminated taste aversion with chlordiazepoxide.
AB  - Discriminative stimulus effects have been studied extensively with the two
      response, food-reinforced operant procedure and more recently also with
      discriminated taste aversion (DTA) procedures. DTA procedures have the advantage
      of a more rapid discrimination training. However, the test phase, i.e., drug
      substitution, of the DTA procedure is more time consuming (1 test per 4 days)
      than the test phase of the two-response procedure (2 tests per 5 days). The
      present study investigated whether a DTA procedure with 2 tests per 5 days could
      be implemented. In addition, the specificity of the DTA procedure was
      investigated. Rats were trained to discriminate chlordiazepoxide (CDP, 20 mg/kg,
      IP) from vehicle using a discriminated taste aversion procedure. Selective
      suppression of saccharin consumption after CDP injections was maximal after seven
      CDP-LiCl pairings. In subsequent substitution tests, with 2 tests per 5 days, CDP
      mimicking effects were found only for another benzodiazepine, diazepam, and for a
      barbiturate, pentobarbital. The results indicate that rats can be rapidly trained
      to discriminate CDP from vehicle in the discriminated taste aversion procedure
      and that the CDP-cue so produced has the same specificity as in a two-response,
      food-reinforced operant procedure. However, the DTA procedure has a number of
      drawbacks that make its advantage over the two-response procedure questionable.

PMID- 1763105
TI  - The behavioral effects of heptyl physostigmine, a new cholinesterase inhibitor,
      in tests of long-term and working memory in rodents.
AB  - We assessed the effects of heptyl physostigmine, a new cholinesterase inhibitor,
      in a mouse tail-flick (TF) test, a mouse and rat passive avoidance test, a rat
      conditioned suppression-of-drinking (CSD) test, a rat Random Interval (RI)
      response rate test and a rat delayed matching-to-position (DMTP) test. In the TF
      test, a dose of 8.0 mg/kg of heptyl induced a significant antinociceptive effect
      that was in excess of 75% of the maximum possible effect 300 minutes after
      administration. In the mouse passive avoidance test, a dose of 3.0 mg/kg of
      heptyl fully reversed, and a dose of 1.0 mg/kg partially reversed, a scopolamine
      induced (0.2 mg/kg) deficit. In the rat passive avoidance test, a dose of 8.0
      mg/kg fully reversed a scopolamine-induced (0.2 mg/kg) deficit, while a dose of
      4.0 mg/kg of heptyl was without effect. In the same experiment, a dose of 0.6
      mg/kg of physostigmine partially reversed the scopolamine-induced deficit. In the
      CSD test, a dose of 8.0 mg/kg of heptyl fully reversed, and doses of 1.0 and 4.0
      mg/kg of heptyl partially reversed, the deficit induced by scopolamine (0.4
      mg/kg). In the RI response rate test, doses of 8.0 mg/kg and 0.6 mg/kg of
      physostigmine fully suppressed lever pressing for food rewards. Doses of 4.0
      mg/kg of heptyl and below had no effect on lever-pressing rates. In the working
      memory test (DMTP), 4.0 mg/kg heptyl partially reversed the scopolamine-induced
      deficit (0.2 mg/kg) in the number of correct choices made, but did not affect the
      scopolamine-induced deficit in the number of trials completed.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1763106
TI  - Individual differences in behavioral measures: correlations with nucleus
      accumbens dopamine measured by microdialysis.
AB  - Rats were placed in one of two novel test environments for behavioral
      observation. In one, exploratory behavior (assessed by hole pokes) and locomotion
      were assessed during a 10-min test session. In the other, the chewing of varied
      objects on the cage floor was rated over a 20-min session. Within 2-18 days,
      animals were anesthetized and microdialysis probes were implanted into the
      nucleus accumbens for measurement of basal and d-amphetamine-stimulated levels of
      dopamine (DA). These measures were then correlated with the individual behavioral
      rating collected earlier from the drug-free animals. We found a significant
      correlation between duration of exploratory behavior and amphetamine-induced DA
      release. Locomotor activity did not correlated with either basal or amphetamine
      stimulated DA release. Duration of chewing episodes correlated with basal levels
      of DA, as well as with amphetamine-induced DA release. Our studies indicate that
      differences in the dopaminergic responsivity of the nucleus accumbens (or other
      circuitry influencing nucleus accumbens DA function) may contribute to individual
      differences in certain behaviors displayed by the animals when placed in a novel
      environment.

PMID- 1763107
TI  - The effects of postnatal caffeine exposure on growth, activity and learning in
      rats.
AB  - Caffeine is both ingested by pregnant women in their third trimesters and
      administered therapeutically to premature infants to stimulate respiration. This
      experiment attempted to delineate any persistent effects of low dose caffeine
      exposure during the first week of life in rats, since this time period provides
      an animal model equivalent to the human third trimester or premature infant
      exposure. Rat pups who had received either 1 or 9 mg/kg of caffeine during the
      first week of life grew more slowly, were hypoactive at two weeks of age, and
      were impaired on an operant spatial learning task as adults. Adding visual cues
      to the operant task did not improve their performance. The timing of the
      appearance of developmental landmarks, adult body weight and adult brain weight,
      however, were not affected by postnatal caffeine exposure. The persistent
      behavioral deficits noted after postnatal caffeine exposure were all opposite in
      direction to the acute effects of caffeine, and similar to the effects of
      adenosine. Thus the behavioral deficits reported here may reflect an upregulation
      of developing adenosine receptors that persists into adulthood subsequent to
      early chronic postnatal caffeine exposure.

PMID- 1763108
TI  - Subjective and brain-evoked responses to electrical pain stimulation: effects of
      cigarette smoking and warning condition.
AB  - Infrahuman studies employing behavioral indices of pain reactivity have supported
      a central antinociceptive action of nicotine which appears to be selective and
      dependent on the class of pain elicited. Human investigations employing
      subjectively based ratings and judgments of pain intensity have been less
      conclusive regarding the painfulness of stimuli following nicotine/smoking
      administration. As the more objective brain-evoked potential (EP) measure has
      been shown to reflect pain intensity and to be sensitive to a variety of
      analgesics, this study attempted to examine, together with subjective responses,
      the effects of cigarette smoking on EPs to pain stimuli administered under
      varying warning conditions. Twelve male and twelve female smokers served as
      experimental subjects. In smoking and nonsmoking sessions, subjective intensity
      ratings (SR) and vertex EPs were assessed in response to electrical skin stimuli
      presented at a level 20% above pain threshold. Stimulation was either nonwarned
      or warned with warning conditions involving single or repeated presentations of
      electrical current at constant or increasing intensities 12 seconds prior to pain
      stimulation. SRs and peak-to-peak N1-P2 EP amplitudes were measured for each
      smoking session and warning condition. A significant condition effect was
      observed for SRs with increasing prepain warning stimulation resulting in the
      greatest pain ratings. Although smoking did not directly alter SRs or EPs to
      pain, smoking exposure, as measured by carbon monoxide, was found to be
      differentially correlated with EP alterations in male and female smokers
      depending on the warning condition.

PMID- 1763109
TI  - Effects of pimozide on the hedonic properties of sucrose: analysis by the taste
      reactivity test.
AB  - The ability of the neuroleptic agent, pimozide, to modify sucrose palatability
      was assessed using three 10-min taste reactivity test sessions. Pimozide was
      found to suppress the ingestive response of tongue protrusions, but enhance the
      mildly ingestive/neutral response of mouth movements elicited by an intraoral
      infusion of sucrose solution. Since the pattern of taste reactivity responding
      shifted from highly ingestive to mildly ingestive/neutral, our results suggest
      that pimozide pretreatment reduces the palatability of sucrose solution. The
      temporal pattern of the modification of these taste reactivity responses was
      predicted by the Anhedonia Hypothesis.

PMID- 1763110
TI  - Effects of systemic and intra-amygdaloid diazepam on long-term habituation of
      acoustic startle in rats.
AB  - Two experiments were conducted to examine the effects of the anxiolytic drug,
      diazepam, on long-term habituation of the acoustic startle response. The
      experiments were based upon the hypothesis that manipulations that reduce fear
      should enhance long-term response decrements by reducing a fear-like
      sensitization process. In Experiment 1 rats given intraperitoneal injections of
      0.5, 1.2, or 2.5 mg/kg showed larger decrements of startle amplitude than vehicle
      injected controls both over trials within sessions and over days. In Experiment 2
      rats injected with 35 micrograms of diazepam bilaterally into the amygdala showed
      larger decrements of startle amplitudes over days than vehicle-injected controls.
      No within-session startle effects were detected in Experiment 2. Freezing
      behavior was measured in Experiment 2 as an index of fear, and the amygdala
      injections of diazepam retarded the development of fear in the startle chamber.
      This index of fear was not possible in Experiment 1 because of the sedating
      effects of systemic diazepam. We conclude that diazepam, acting at least in part
      through the amygdala, attenuates the fear-like sensitization process associated
      with the acoustic startle stimulus. By attenuating sensitization diazepam
      produces larger than normal reductions in startle amplitudes over trials and days
      without significantly affecting initial responsiveness.

PMID- 1763111
TI  - Learning factor in rapid tolerance to ethanol-induced motor impairment.
AB  - Exposure of male Wistar rats to a single moderate dose (1.7 g/kg, IP) of ethanol
      (EtOH), followed by intensive intoxicated practice on the moving belt apparatus
      (a total of 12 min during the first hour after EtOH injection), results in
      functional tolerance to the motor-impairing effects of a second dose given either
      8 or 24 h later. In the absence of intoxicated practice, or after a considerably
      reduced opportunity for it (a total of 4 min during the first hour after EtOH
      injection), the same dose of EtOH fails to produce tolerance. Thus, not only the
      opportunity to practice, but also its extent and possibly its quality are
      important determinants in the rapid development of intersessional tolerance. In
      contrast to its rapidity of development, no significant loss of this tolerance is
      evident three weeks after the tolerance acquisition sessions.

PMID- 1763112
TI  - Sex differences in locomotor activity after acute and chronic cocaine
      administration.
AB  - Adult, intact and gonadectomized male and female Wistar rats (n = 9) were exposed
      to an automated open field to assess the behavioral effects of acute cocaine
      administration (saline, 1.0 and 10.0 mg/kg subcutaneous). The subjects were
      exposed to the open field for 10 min, removed to be injected and returned to the
      open field for another 30 min. Three saline and two drug sessions were run in
      counterbalanced order. Locomotor activity in intact and castrated male rats and
      ovariectomized female rats decreased following injection, irrespective of the
      dose of cocaine. The locomotor activity of intact female rats was higher than
      that of any other group of subjects. It decreased during the session after saline
      and 1.0 mg/kg cocaine, but increased towards the end of the 30 min session after
      10.0 mg/kg. Rearing measures paralleled the observations on locomotor activity.
      To determine the effects of chronic, home-cage, cocaine administration, five of
      the subjects in each group were injected with 10.0 mg/kg cocaine for 9
      consecutive days. The remaining four subjects received saline injections. On day
      10, all subjects were re-exposed to the open-field for 10 min, removed, injected
      with 10.0 mg/kg cocaine and returned to the open field for another 30 min.
      Chronic home cage cocaine administration produced an increase in cocaine's
      effects on locomotor activity and rearing in intact female rats only. However,
      behavioral sensitization was also observed in intact female rats who had been
      treated with saline for 9 consecutive days, suggesting that behavioral
      sensitization to cocaine in intact female rats may develop very rapidly and
      independent of environmental context.

PMID- 1763113
TI  - Effect of a single dose of an acetylcholinesterase inhibitor on oxotremorine- and
      nicotine-induced hypothermia in mice.
AB  - Downregulation of cholinergic receptors is a consequence of subchronic exposure
      to an organophosphate anticholinesterase. The purpose of this investigation was
      to determine if there was a downregulation of the cholinergic receptors in mice
      following administration of a single dose of soman (pinacolyl
      methylphosphonofluoridate) or physostigmine. The change in the temporal response
      (mean minimum temperature and area under the curve) of core temperature following
      administration of either a muscarinic or nicotinic agonist such as oxotremorine
      (156 micrograms/kg, IP) or nicotine hydrogen tartrate (15 mg/kg, SC) was used as
      an indicator of downregulation of muscarinic or nicotinic receptors,
      respectively. Twenty-four h following soman (100 micrograms/kg, SC)
      administration, there was a significant decrease (p less than 0.05) in
      oxotremorine- but not nicotine-induced hypothermia. The significant differences
      in the mean minimum temperature and AUC were still present 4 days after exposure
      to the soman. Neither lower doses of the organophosphate anticholinesterase,
      soman (50 and 70 micrograms/kg), nor the carbamate anticholinesterase,
      physostigmine (500 micrograms/kg), produced a significant change in either
      oxotremorine- or nicotine-induced hypothermia. The results of this study suggest
      that receptor downregulation observed after subchronic administration of soman is
      also evident following administration of a single, sublethal dose of an
      organophosphate anticholinesterase, soman, but not after administration of a
      carbamate anticholinesterase, physostigmine. The in vivo assessment of the
      muscarinic receptor using oxotremorine hypothermia may be a sensitive indicator
      of the functionality of the drug-receptor coupling and indicate a physiological
      consequence of receptor downregulation.

PMID- 1763114
TI  - The effects of scopolamine and cues to forget on pigeons' memory for time.
AB  - Pigeons were trained with a 0-s delayed symbolic matching-to-sample procedure to
      indicate whether a houselight sample stimulus was short (2 s) or long (8 s) by
      pecking a red or a green comparison stimulus. In Experiment 1, the pigeons
      received injections of scopolamine hydrobromide (0.015 mg/kg), or saline, and the
      delay interval was manipulated (0, 1, 3, and 9 s). Memory for time was
      significantly poorer following scopolamine injections than following saline
      injections. A significant choose-short bias was observed under scopolamine at
      delays as brief as 3 s, but not under saline. In Experiment 2, a brief postsample
      cue (a vertical or horizontal line) signaled whether the comparison stimuli would
      be presented or omitted on each trial. During training, comparison stimuli were
      always presented following the remember (R) cue, but never following the forget
      (F) cue. During testing, memory for time was significantly poorer on F-cue trials
      than on R-cue trials. A significant choose-short bias was observed on F-cue
      trials at the 5- and 10-s delays, but not on R-cue trials. The results suggest
      that anticholinergic blockade accelerates the rate at which memory for temporal
      events is foreshortened in working memory. This effect is similar to that
      produced by an explicit cue to forget the temporal sample.

PMID- 1763115
TI  - Dynamic properties of respiratory timing following cocaine administration.
AB  - We assessed the timing and amplitude characteristics of diaphragmatic muscle
      activity following administration of intravenous cocaine HCl (10 mg/kg) to awake,
      unrestrained cats. Cocaine produced a pronounced tachypnea which was interrupted
      by deep inspiratory efforts coincident with tonic-clonic movements over the first
      10 min following cocaine administration. Following that period, diaphragmatic
      cycle rates slowly increased for up to 1 h and were interrupted occasionally by
      longer inspiratory efforts which were not associated with other overt motor
      activities. As respiratory rate increased, breath-to-breath variability
      decreased, and the incidence of deep inspiratory efforts decreased. As total
      cycle time decreased, the ratio of inspiratory time to expiratory time remained
      the same between precocaine and early, intermediate and late intoxication
      periods. The amplitude of diaphragmatic EMG activity increased with the extreme
      tachypnea. A number of neural mechanisms may mediate the changes in diaphragmatic
      muscle activity, including hyperthermia and alteration of rostral brain
      influences on brainstem timing mechanisms.

PMID- 1763116
TI  - Comparison of the effects of repeated oral versus subcutaneous fenfluramine
      administration on rat brain monoamine neurons: pharmacokinetic and dose-response
      data.
AB  - The importance of the route of drug administration (oral vs. subcutaneous) on the
      neurochemical effects and pharmacokinetics of repeated d,1-fenfluramine
      administration in rats (1-24 mg/kg b.i.d., i.e., 2-48 mg/kg/day for 4 days) was
      examined. Overall, comparable dose-dependent alterations in brain monoamine
      markers were observed following repeated oral (PO) and subcutaneous (SC)
      administration of fenfluramine. Doses of 1 and 2 mg/kg fenfluramine were without
      significant effects on the density of 3H-paroxetine-labeled serotonin (5-HT)
      uptake sites. Higher doses of fenfluramine (4, 12 and 24 mg/kg) produced dose
      dependent decreases in 5-HT, 5-hydroxyindoleacetic acid and 5-HT uptake sites
      with maximal decreases (80-90%) occurring at the 12 mg/kg dose. Fenfluramine
      administration produced dose-dependent and biphasic effects on brain dopamine
      markers with increases in homovanillic acid (HVA) observed at 2 hours, whereas
      decreases in the levels of dopamine, HVA and dihydroxyphenylacetic acid were
      evident at 18 hours posttreatment. Norepinephrine levels were only decreased at
      the highest dose of fenfluramine. Significantly higher levels of brain
      fenfluramine were observed following SC than following PO administration of the
      drug. On the other hand, comparable levels of its active metabolite
      norfenfluramine were present in the brain following the two routes of
      fenfluramine administration. These data suggest the importance of norfenfluramine
      levels in the brain in determining the high-dose neurotoxic effects of
      fenfluramine on brain 5-HT neurons in rats.

PMID- 1763117
TI  - Nasal pungency, odor, and eye irritation thresholds for homologous acetates.
AB  - We measured detection thresholds for nasal pungency (in anosmics), odor (in
      normosmics) and eye irritation employing a homologous series of acetates: methyl
      through octyl acetate, decyl and dodecyl acetate. All anosmics reliably detected
      the series up to heptyl acetate. Only the anosmics without smell since birth
      (congenital) reliably detected octyl acetate, and only one congenital anosmic
      detected decyl and dodecyl acetate. Anosmics who lost smell from head trauma
      proved to be selectively less sensitive. As expected, odor thresholds lay well
      below pungency thresholds. Eye irritation thresholds for selected acetates came
      close to nasal pungency thresholds. All three types of thresholds decreased
      logarithmically with carbon chain length, as previously seen with homologous
      alcohols and as seen in narcotic and toxic phenomena. Results imply that nasal
      pungency for these stimuli rests upon a physical, rather than chemical,
      interaction with susceptible mucosal structures. When expressed as thermodynamic
      activity, nasal pungency thresholds remain remarkably constant within and across
      the homologous series of acetates and alcohols.

PMID- 1763118
TI  - Visual recognition memory in squirrel monkeys: effects of serotonin antagonists
      on baseline and hypoxia-induced performance deficits.
AB  - Cognitive deficits resulting from neuropathological brain changes such as
      Alzheimer's Disease or normal aging are most likely due to alterations in
      multiple neurotransmitter systems. While the majority of preclinical studies have
      focused on the effects of acetylcholine (ACh), it has been shown that activation
      of the serotonergic (5-HT) pathways in the central nervous system interferes with
      passive avoidance retention in rats. In contrast, decreased 5-HT activity has
      been shown to improve learning and memory in rats using similar procedures. In
      the present experiment, 5-HT antagonists were evaluated for their effects on
      performance in a delayed match to sample task (DMTS) in two groups of squirrel
      monkeys: one in which the baseline level of performance was low (less than 65%
      correct, N = 5; group 1) and another in which DMTS performance was high (greater
      than 80% correct, N = 3; group 2) but impaired by exposure to hypoxia. Initial
      parametric tests exposing group 2 to various levels of oxygen deprivation were
      conducted to determine optimal conditions for performance deficits. Each monkey
      in both normoxia (group 1) and hypoxia (group 2) served as his own control and
      received an individualized range of doses for each test compound. For both
      groups, ketanserin and mianserin, the 5-HT2-selective antagonists, produced dose
      dependent increases in DMTS performance at 0.3-1.5 mg/kg PO and 0.05-1.5 mg/kg
      PO, respectively. Pirenperone, another 5-HT2-selective antagonist, was active in
      improving performance in group 1 at 0.001 to 0.2 mg/kg PO but was not effective
      against hypoxia-induced performance deficits.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1763119
TI  - Naftidrofuryl oxalate, nootropic effects on the scopolamine- and the basal
      forebrain lesion-induced amnesia in rats.
AB  - We studied the effects of naftidrofuryl oxalate on scopolamine- and basal
      forebrain (BF) lesion-induced amnesia using passive avoidance and multiple T-maze
      tasks, in comparison with Ca-hopantenate and physostigmine in rats. In the
      passive avoidance task, one-week treatment with naftidrofuryl oxalate (12.5 and
      25 mg/kg, IP) ameliorated BF lesion-induced amnesia. The multiple T-maze task was
      done with two training sessions per day for five continuous days. We measured the
      number of errors made from start box to goal box. Naftidrofuryl oxalate (12.5
      mg/kg, IP, b.i.d.) and physostigmine (0.1 mg/kg, IP, b.i.d.) attenuated
      scopolamine- and BF lesion-induced amnesia. However, treatment with naftidrofuryl
      oxalate for one week failed to inhibit the decrease of the choline
      acetyltransferase induced by the BF lesion. Ca-hopantenate did not show
      attenuation of amnesia induced by the scopolamine or BF lesion. These results
      suggest that naftidrofuryl oxalate enhances the storage of spatial information,
      and that the nootropic effects of naftidrofuryl oxalate may be produced by an
      indirect activation of the cholinergic system through serotonergic neuronal
      systems.

PMID- 1763120
TI  - [Phenytoin and phenytoin derivatives for local administration].
AB  - A well known side effect of the long-term therapy with phenytoin is gum
      hyperplasia. 1-Acyl compounds and esters of the p-hydroxymetabolite with
      aliphatic and aromatic carboxylic acids were synthesized as potential prodrugs
      for therapeutic use if the neoformation of connective tissue is intended. The
      compounds were characterized by there physico-chemical constants and the
      absorption was proofed by a buccal test.

PMID- 1763121
TI  - [Pharmaceutical technology texts and criteria for evaluation of their
      intelligibility].
AB  - This article gives a report on the criteria of the intelligibility of texts and
      on the possibility of their evaluation. With the help of these criteria it
      becomes possible to describe different levels in the pharmaceutical
      communication. Their conscious construction may promote the understanding of
      texts.

PMID- 1763122
TI  - [Defined cyclic doses (DCD)--a proposal for the application of the DDD method to
      the antineoplastic group].
AB  - The establishment and implementation of defined daily doses (DDD) has provided a
      useful tool to compare drug consumption studies on regional as well as
      international level. One of the limitations of the concept so far is the fact
      that according to the definition of the DDD there are no DDDs for certain groups
      of drugs like antineoplastic drugs. In order to close that methodological gap we
      suggest a special technical unit of measurement with regard to the therapeutical
      routine of application of antineoplastic drugs: the defined cycle dosis (DCD).
      That the DCD can be applied to comparing the consumption of antineoplastic drugs
      in principle is shown by means of statistical data covering the years from 1983
      to 1988 in East Germany.

PMID- 1763123
TI  - [Synthesis and antiphlogistic activity of amino- and nitro-substituted DL
      phenylamino acid octylester hydrochlorides].

PMID- 1763124
TI  - [The effect of drugs on the in vitro detection of glucose in urine with the
      Benedict test].

PMID- 1763125
TI  - Determination of pentazocine in human plasma by high performance liquid
      chromatography.

PMID- 1763126
TI  - Determination of captopril by two simple spectrophotometric methods using
      oxidative coupling reaction.

PMID- 1763127
TI  - [The use of isolated and cultivated lymphocytes of rats for the study of
      biotransformation of drugs].

PMID- 1763128
TI  - Pharmacokinetic investigations with dexamethasone megadoses in rats.

PMID- 1763129
TI  - Comparison of the effect of stobadine on lipid peroxidation of liver, heart,
      kidney and brain homogenate.

PMID- 1763130
TI  - Effect of kampo medicines on lipid peroxidation of phosphatidylcholine liposomes.

PMID- 1763131
TI  - [The effect of (+) and (-)-propranolol in high doses on selected heart
      circulatory parameters in the rat].

PMID- 1763132
TI  - Cytotoxic activity of sesquiterpene lactones, isolated from Ambrosia maritima.

PMID- 1763133
TI  - [The biochemical basis of pharmaceutical chemistry. 11(1). Stereochemical aspects
      of active drug substances].

PMID- 1763134
TI  - Biological and NMR markers for cancer.
AB  - The search for a universal tumor marker continues. Present markers range from
      tumor products (polyamines, glycoproteins, peptides, hormones or carbohydrate
      linked markers) to reaction products produced by the host tissues during tumor
      invasion. Techniques used to identify them include the classical methods of
      histology and cytochemistry as well as the more recent radioimmunoassay and
      metabolic probes. The in vivo techniques of increasing use for patient monitoring
      are MRS (magnetic resonance spectroscopy) and MRI (magnetic resonance imaging).
      The efficiency of some markers and statistical methods used in analyzing data are
      discussed, as are the ethical problems surrounding the use of new testing
      methods. Recent developments in MRI and MRS, marker elucidation, and evidence for
      a new autocrine differentiation-inhibiting factor (ADIF) are reviewed. Future
      needs and approaches focus on greater utilization of indicators of the
      preneoplastic state and of risk to cancer, as well as more careful attention to
      statistical analysis.

PMID- 1763135
TI  - The drug interaction potential of ranitidine: an update.
AB  - Ranitidine is a H2-receptor antagonist widely used in the treatment of a variety
      of gastrointestinal disorders. Since cimetidine--the predecessor drug of
      ranitidine--interacts with a variety of other agents and moreover ranitidine is
      often administered in combination with other drugs the interaction potential of
      ranitidine has been subject to extensive investigations. This review updates the
      information available from 1988 to present. Pharmacokinetic interactions of
      ranitidine with other drugs may occur at the site of absorption, metabolism and
      renal excretion. Most of the interactions reported at each of the three levels
      are minor and of low clinical significance. In view of some uncontrolled
      anecdotal reports, one cannot completely rule out the possibility that ranitidine
      might have some limited interaction potential in special patient populations
      under certain clinical conditions. However, it must be emphasized that numerous
      controlled studies have proven that ranitidine can be safely coadministered with
      other drugs.

PMID- 1763136
TI  - The potential use of catalytic RNAs in therapy of HIV infection and other
      diseases.
AB  - This article describes the applications (both real and potential) of a new
      antiviral strategy, based on the use of antisense, catalytic RNAs (ribozymes) as
      therapeutic agents. An understanding of both antisense inhibition of gene
      expression and RNA autocleavage reactions are essential to the use of this
      technology. In addition, for the successful application of this technology in
      clinical settings, an interdisciplinary approach involving clinicians, molecular
      and cellular biologists, will be necessary. The following treatise will highlight
      several salient features of ribozyme technology, emphasizing its application as
      an antiviral as well as discuss some problems and potential solutions pertinent
      to the clinical application of this technology.

PMID- 1763137
TI  - Regulatory functions of calmodulin.
AB  - Calmodulin is a Ca2+ binding protein present in all eukaryotic cells that serves
      as the primary intracellular receptor for Ca2+. This 148 amino acid protein is
      involved in activation of more than 20 enzymes which mediate a wide variety of
      physiological processes. Many of these enzymes are inhibited in an intramolecular
      manner and the Ca(2+)-calmodulin complex relieves this inhibition. Calmodulin is
      essential for life as disruption of the gene in genetically tractable organisms
      is lethal. This protein plays important regulatory roles in cell proliferation
      and is required at multiple points in the cell cycle. The mechanism of enzyme
      activation by calmodulin and its importance in cell growth regulation are
      reviewed.

PMID- 1763138
TI  - Fact sheet on mental health.

PMID- 1763139
TI  - Of helping relationships: a concept paper.
AB  - As professionals engaged in the practice of nursing, our involvement with people
      in different situations provides us many opportunities to be of significant help
      to them. People are often motivated to enhance themselves. It is the aim of this
      paper to present a concept in helping relationships that may assist nurses
      towards a positive direction in helping other people, whether sick or well to
      improve themselves, to achieve growth, realize their potentials and/or limit
      their disabilities.

PMID- 1763140
TI  - The current status of psychiatric/mental health nursing--and some future
      challenges. International Council of Nurses.

PMID- 1763141
TI  - Brigadier General Elvegia R. Mendoza: first woman (nurse) general of the armed
      forces of the Philippines.

PMID- 1763142
TI  - Importance of pharmacologic control in PET studies: effects of thiothixene and
      haloperidol on cerebral glucose utilization in chronic schizophrenia.
AB  - This study compares the effects of two neuroleptic drugs with different
      pharmacologic characteristics (thiothixene and haloperidol) on cerebral glucose
      utilization in chronic schizophrenic inpatients. Positron emission tomographic
      (PET) scans were obtained from all subjects in a neuroleptic-free condition and
      again after 4-6 weeks of neuroleptic treatment. Eight subjects were treated with
      thiothixene and 12 with haloperidol. Thiothixene and haloperidol had different
      metabolic effects. For example, all thiothixene-treated subjects showed increased
      whole brain glucose utilization; all but one haloperidol-treated subject showed
      decreased utilization. Different patterns of relative prefrontal and striatal
      metabolism were also observed. These results highlight the importance of
      controlling for the effects of neuroleptic treatment and indicate the difficulty
      of interpreting data from studies with complex or poorly defined drug regimens.

PMID- 1763143
TI  - Apomorphine effects on brain metabolism in neuroleptic-naive schizophrenic
      patients.
AB  - Since neuroleptic treatment produces a significant increase in striatal
      metabolism relative to cortical metabolism, we wished to determine whether the
      dopamine agonist apomorphine (APO) might have the opposite effect, and whether it
      would discriminate schizophrenic patients from healthy controls. Eleven
      neuroleptic-naive schizophrenic patients (diagnosed according to DSM-III) and
      eight normal subjects were compared with respect to cerebral accumulation of 18F
      fluorodeoxyglucose measured by positron emission tomography following APO, 0.75
      mg/70 kg (weight adjusted), or saline. Relative striatal glucose metabolism
      decreased significantly after APO in schizophrenic patients but not in control
      subjects. Post hoc analysis of data in 12 other regions revealed that relative
      superior temporal metabolism decreased very slightly, but significantly, in
      schizophrenic patients but not in control subjects after APO, and that the
      posterior frontal region increased in control subjects but not in the patient
      group.

PMID- 1763144
TI  - A magnetic resonance imaging study of putamen nuclei in major depression.
AB  - The basal ganglia are recognized as putative mediators of certain cognitive and
      behavioral symptoms of major depression. Moreover, patients with basal ganglia
      lesions have repeatedly exhibited significant affective symptomatology, including
      apathy, depressive mood, and psychosis. Using high resolution, axial T2
      intermediate magnetic resonance images, and a systematic sampling stereologic
      method, we assessed putamen nuclei volumes in 41 patients with major depression
      (DSM-III) and 44 healthy volunteer controls of similar age. Depressed patients
      had significantly smaller putamen nuclei compared with controls. Age was
      negatively correlated with putamen size in both groups. These results are the
      first demonstration of diminished putamen volumes in depression and further
      support a role for basal ganglia structures in the etiopathogenesis of
      depression.

PMID- 1763145
TI  - The psychoanalytic theories of Melanie Klein and Donald Winnicott and their
      interaction in the British Society of Psychoanalysis.

PMID- 1763146
TI  - Gender stereotyping in supervisory styles.

PMID- 1763147
TI  - On Aphasia at 100: the neuropsychodynamic legacy of Sigmund Freud.

PMID- 1763148
TI  - The working alliance: current concepts and controversies.

PMID- 1763149
TI  - The addiction to negativity.
AB  - In this paper, we have described a type of resistance that has attracted
      increasing psychoanalytic attention in recent years. Patients exposed to intense
      negativity during early life may develop an addiction to negative experience as
      adolescents and adults, and this may constitute a central organizing feature of
      their personality. In almost all patients, however, some moments of negativity
      may be observed. We have traced the developmental origins of an attachment to
      negativity, drawing especially on psychoanalytic investigations of preoedipal
      pathology. Manifestations and derivatives of early negativity include anhedonia,
      attachment to physical pain, fear of success, masochism, deprivation of self and
      others, and negative voyeurism. In discussing the dynamic functions of
      negativity, we place particular emphasis on two motives: the patient's desires
      for revenge against early objects that have been a source of deprivation and
      frustration; and the defensive function of negativity in helping to express as
      well as ward off dangerous wishes to merge with the object. Deviant forms of
      autoerotism are likely to be used by these patients to deal with the reactivation
      of early experiences of neglect and rejection. When negativity is used as a
      defense or method of relating to others it can lead to a severe disruption of the
      psychotherapeutic relationship. We have reviewed suggestions for the management
      of extreme negativity in treatment. Resolution of the therapist's
      countertransference reactions, especially induced feelings of frustration, rage,
      and helplessness, is crucial. Emphasis also has been placed on the patient's
      desires for revenge against self and object, and the manner in which these may be
      understood and eventually resolved. Only when patient and therapist begin to
      investigate the adaptive functions of extreme negativity can this pathological
      symptom be resolved and the patient's awareness of self and sense of autonomy be
      enhanced.

PMID- 1763150
TI  - Pornography and the primal scene: a report on the voyage to Brobdingnag.

PMID- 1763151
TI  - Retrospective treatment of incest victims: suggested analytic attitudes.
AB  - This paper includes a brief consideration of literature relevant to childhood
      sexual abuse detection and prevalence. That literature indicates that such
      detection may be difficult and that the occurrence of childhood sexual abuse is
      widespread. These findings, as well as a consideration of literature relevant to
      trauma, stress, and the identification of survivors of sexual abuse, suggest an
      analytic attitude of receptivity to the hypothesis of the event of sexual abuse
      as well as the fantasy of sexual abuse. A second analytic attitude suggested
      concerns diagnosis. Childhood trauma is implicated in the development of BPD, as
      the majority of borderline patients have experienced the trauma of child abuse.
      Further, trauma can lead to dissociation as a defense against stress, and
      multiple personality disorder is an extreme example of dissociation. The analytic
      attitude suggested here is that the diagnosis of BPD or MPD may be a necessary
      but not a sufficient explanation when the symptomatology is a defensive reaction
      to the traumatic event of childhood sexual abuse. Lastly, it is suggested that
      the abuse may need to be central to the treatment in analytic work with sexually
      abused victims. This is suggested in light of the importance of recovery and
      integration of traumatic memories with their associated affects.

PMID- 1763152
TI  - Imagination and the unconscious: a critique of the neo-romantic program.

PMID- 1763153
TI  - Freud's quotation from Virgil.

PMID- 1763154
TI  - Between hermeneutics and science. An essay on the epistemology of psychoanalysis.

PMID- 1763155
TI  - A measure of linear influence between patient and therapist.
AB  - This paper describes the application of the cross-correlation function (CCF) to
      four quantified dimensions of the therapeutic consultation dialogue: newness of
      themes, degree of narration, and positive and negative thematic tone of images. A
      10-min. window was used to study lag relationships in both directions of effect-
      from therapist to patient and the reverse. This measure of linear influence was
      applied to six psychotherapeutic consultation sessions carried out by different
      well known psychoanalysts with two women patients. Analysis showed a range of
      significant CCF effects that totaled from zero to 1360 sec. depending on the
      consultation. The implications of these and other findings are discussed in the
      context of viewing the present study as part of a program of investigations into
      the nonexperimental nature--the underlying laws, structures, and transactions--of
      therapeutic and everyday emotional dialogues.

PMID- 1763156
TI  - Relationships between steps taken in selecting a nursing home and consumers'
      satisfaction.
AB  - Analysis of data related to selection of a nursing home by 411 families of
      nursing home residents led to the conclusion that steps selected and taken by
      consumers in the selection of a home were associated with their subsequent
      satisfaction with the home. Satisfaction was greater (a) for families in
      agreement about the home selected and (b) for families who investigated all homes
      in an area before selecting one. Less satisfied were families (a) who were forced
      to make an immediate decision about placement following illness of a patient, (b)
      who felt they lacked sufficient time to investigate homes, and (c) who chose the
      first home with space available.

PMID- 1763157
TI  - National measures of extraversion and neuroticism and suicide and homicide rates.

PMID- 1763158
TI  - Religion as a cultural phenomenon, and national mortality rates from heart
      disease.
AB  - An hypothesis is developed which proposes that mortality rates from heart disease
      are a function of a nation's dominant religious tradition, with predominantly
      Catholic countries having lower rates than the more Protestant countries. The
      hypothesis was tested on data from 24 economically developed Western countries. A
      significant inverse relationship of -0.588 was found between the proportion of
      Catholics in the 24 nations and mortality rates from heart disease, which
      supports the hypothesis.

PMID- 1763159
TI  - Psychology of the scientist: LXIV Work-related attitudes of U.S. scientists.
AB  - It is logical to think that doing important, meaningful work contributes to job
      satisfaction. In contrast to all other professional workers, however, evidence
      from nationwide surveys shows that scientists are more likely to prefer
      important, meaningful work but are less satisfied in their jobs. This suggests
      that various factors in the work environment of U.S. scientists somehow may
      prevent them from achieving the satisfaction they desire in their jobs. This
      paper speculates about the nature of some of these factors.

PMID- 1763160
TI  - MMPI experimental scale correlates of the MAACL--R with male alcoholics.
AB  - Concurrent and discriminative validity of the MAACL--R scales were studied by
      means of correlations with selected MMPI experimental scales (AR, DR, HOS, Poor
      Morale, and ES) for a sample of 88 male VA alcoholics. Concurrent validity of
      Anxiety, Depression, Hostility and PASS, and discriminative validity of the
      Anxiety scale were confirmed.

PMID- 1763161
TI  - Parental identification of rapists and pedophiles.
AB  - It is well documented that sex offenders experience a higher incidence of sexual
      abuse and are more likely to have been reared in dysfunctional families than are
      individuals in most comparison groups. It is unclear, however, whether growing up
      in an abusive or dysfunctional family affects the extent to which the potential
      sex offender would subsequently identify with his parents. Sixteen rapists, 18
      pedophiles, 9 general offenders, and 11 college students completed the Parental
      Identification Scale to assess their parental identification. It was predicted
      that the rapists and pedophiles would identify less with their parents than would
      college students or general offenders. Analysis indicated a strong and
      significant correlation between group membership and parental identification.
      Rapists and pedophiles identified less with their mothers and fathers than did
      members of corresponding control groups.

PMID- 1763162
TI  - Fakability of two different role-play methodologies for assessing assertion.
AB  - The fakability of two methodologically different role-play tests of assertion was
      examined, 30 undergraduates low in assertiveness were tested and retested on the
      Behavioral Assertiveness Test--Revised and the Idiographic Role-play Test. Half
      of the testees were instructed to fake assertion during the second testing.
      Analysis indicated that both tests were fakable; however, testees reported more
      difficulty faking the latter test than the former. The detection of faking may be
      possible, particularly on role-play tests employing an idiographic methodology.

PMID- 1763163
TI  - Influences of situation-specific mastery beliefs and satisfaction with social
      support on appraisal of stress.
AB  - Previous research on the effects of mastery beliefs on appraisal of stress
      usually employed generalized measures such as locus of control and produced mixed
      findings, depending, in part, on whether the encounters experienced were within
      the domains of control assessed. The present study examined the effects of
      situation-specific mastery and satisfaction with social support on the appraisal
      of a situation's stressfulness by 147 male college students. Mastery was
      positively correlated with the appraisal of desirability of the situation and
      accounted for 36.9% of the variance. Greater satisfaction with social support was
      related to more positive appraisals by subjects with high mastery but with more
      negative appraisals by subjects with low mastery. Mastery and satisfaction with
      support also interacted to moderate the effects of the number of stressors
      experienced on total stress. For subjects who faced many stressors, those with
      low mastery experienced high stress regardless of their satisfaction with
      support, whereas those with high mastery experienced high stress if their
      satisfaction with support was low, but moderately low stress if satisfaction with
      support was high.

PMID- 1763164
TI  - Historical reliability: a key to differentiating populations among patients
      presenting signs of multiple personality disorder.
AB  - The clinical value of inconsistencies in the historical data of patients
      presenting with signs of multiple personality disorder was assessed. Three major
      inconsistencies in historical data were identified in 23 patients who were
      admitted to a Dissociative Disorders Program with a diagnosis of Multiple
      Personality Disorder. This group showed psychological disturbance that was quite
      different from 23 patients with a similar discharge diagnosis but who did not
      exhibit inconsistencies in history. The former group reported less psychological
      disturbance and fewer dissociative experiences. Patients who are less credible by
      virtue of inconsistencies in their historical reports may belong to a different
      diagnostic group. The findings point to the need to chart history carefully in
      authenticating genuine cases.

PMID- 1763165
TI  - Bulimics' perceptions of emotional responding during binge-purge episodes.
AB  - The concept of changes in emotional arousal during the binge-purge cycle plays a
      principal role in bulimia theory. Female bulimic patients (n = 29)
      retrospectively rated the intensity of several emotions during their binge-purge
      cycle. When collapsed into positive versus negative emotion categories, both
      categories showed significant changes in emotions over the course of the binge
      purge episode. Negative emotion increased after a binge and decreased during the
      purge. Positive emotion decreased after binging and increased during and after
      purging.

PMID- 1763166
TI  - Psychology of computer use: XXIV. Computer-related stress among technical college
      students.
AB  - Hudiburg's Computer Technology Hassles Scale, along with a measure of global
      stress and a scale on attitudes toward computers, were administered to 186
      students in a two-year technical college. Hudiburg's work with the hassles scale
      as a measure of "technostress" was affirmed. Moderate, but statistically
      significant, correlations among the three scales are reported. No relationship
      between the hassles scale and achievement as measured by GPA was detected.

PMID- 1763167
TI  - The Basic HIV Disease Knowledge Questionnaire: a Rasch-scaled instrument to
      measure essential HIV knowledge.
AB  - The need for improvement in HIV disease-related psychometric questionnaires is
      noted. In response to this need a Rasch-scaled measure to ascertain basic HIV
      disease knowledge was developed and calibrated on 1092 subjects. Four studies
      conducted with the measure suggest adequate test-retest reliability. Three
      validity studies also conducted with this questionnaire suggest that the measure
      is sensitive to knowledge obtained from HIV-related training and education.
      Potential uses and limitations of this new questionnaire are discussed.

PMID- 1763168
TI  - Symptom-positively and -negatively worded items in two popular self-report
      inventories of anxiety and depression.
AB  - Substantially higher mean scores on symptom-negatively versus symptom-positively
      worded items have consistently been reported in the literature for the balanced
      State-Trait Anxiety Inventory. In this study we aimed to replicate and extend
      these findings to Dutch trait versions of the inventory and Zung's similarly
      balanced Self-rating Depression Scale. Analysis indicated significantly higher
      mean subscale scores for symptom-negative as opposed to symptom-positive items of
      both measures, across sexes and age groups as well as across different levels of
      distress in nonclinical (n = 863), subclinical (n = 450), and clinical subject
      samples (n = 96). Sex and age differences were mainly confirmed to symptom
      positive subscales. Scale intercorrelations were lowest between symptom
      positively and symptom-negatively worded scales both within and across measures.
      Factor analyzing the combined measures identified a symptom-negative and a
      symptom-positive factor, tentatively labeled "absence of positive affect" and
      "presence of negative affect." Several explanations of the findings among which
      item-intensity specificity, the response style of social desirability, and the
      trait model of positive and negative affectivity are discussed.

PMID- 1763169
TI  - Differences between men and women on stress producers and coping strategies.
AB  - Differences in stress producers and coping strategies for 158 men and 243 women
      were investigated. Analyses of participants' responses to a survey on stress
      showed significant differences between men and women on eight stress producers
      and on five coping strategies.

PMID- 1763170
TI  - Liking for chocolate, depression, and suicidal preoccupation.

PMID- 1763171
TI  - Accidental and unspecified deaths among prisoners as disguised suicides.
AB  - Analysis of 1987 data from the US Department of Justice for prisoners under the
      jurisdiction of state and federal correctional authorities indicated that suicide
      rates were not negatively correlated with accidental or unspecified death rates.
      These findings do not provide evidence of disguised suicides among prisoners.
      Possible explanations for high rates of unspecified death among prisoners are
      presented.

PMID- 1763172
TI  - Task-achievement, obsessive-compulsive, type A traits, and job satisfaction of
      professionals in public practice accounting.
AB  - This paper contains a description of the results of a two-year study of task
      achievement, obsessive-compulsive, Type A traits, and job satisfaction within
      randomly selected groups of 499 public practice accountants in Ontario, Canada.
      The results supported the notion that this profession attracts and conditions
      personalities with task-oriented, order-driven, Type A characteristics. With the
      exception of those who were advanced partners, the majority of public practice
      accountants were only moderately job-satisfied and were reportedly not committed
      to staying in their present jobs until retirement.

PMID- 1763173
TI  - On threat of shock as an elicitor of anxiety: a methodological note.
AB  - The effects of anxiety on the eyeblink component of the human startle response
      were measured in 32 college students. The manipulation of threat of shock was not
      successful in eliciting anxiety, suggesting that, while threat of shock can
      increase anxiety, this increase is not inevitable, illustrating the importance of
      a manipulation check of the effectiveness of the threat.

PMID- 1763174
TI  - Correlations between self-handicapping and self-defeating personality.
AB  - In this study scores on Strube's self-handicapping scale were correlated with
      scores on Schill's self-defeating personality scale. Berglas believes there are
      subtypes of self-defeating personality and that his concept of self-handicapping
      should be correlated with the three criteria which represent a self-protective
      component of self-defeating personality. Some support for Berglas' proposition
      was found, particularly for men. However, correlations with other components of
      self-defeating personality suggest the criteria thought to be self-protective may
      need to be reconsidered.

PMID- 1763175
TI  - Behavioral science in medical education: a 1987-1991 bibliography.
AB  - Holmes, et al. in 1988 compiled 61 studies in an updated bibliography of
      behavioral science in undergraduate and graduate medical education. Since then,
      64 additional studies of behavioral science in medical education have been
      published and abstracted in Index Medicus and Psychological Abstracts, the
      sources for the bibliography.

PMID- 1763176
TI  - Finnish and American university students compared on a verbal aggression
      construct.
AB  - 232 Finnish and 145 American university students showed no significant
      differences on Infante and Wigley's measure of verbal aggressiveness. In keeping
      with general stereotypes, the men of both cultures (88 Finns, 86 Americans) were
      more verbally aggressive than were the women (144 Finns, 59 Americans).

PMID- 1763177
TI  - Role of craving for carbohydrates upon completion of a protein-sparing fast.
AB  - Pretreatment measures of craving for carbohydrates were related to higher dropout
      rates during the first month of a protein-sparing fast. 97 patients in a
      medically supervised weight-loss program, who were at least 50 pounds overweight,
      completed the Beck Depression Inventory, the Eating Inventory, and a
      questionnaire about their food habits before beginning a supplemented fast. While
      self-reported cravers of carbohydrates were significantly more likely to drop out
      during the first month of treatment than noncravers, this result does not appear
      to be related to differences in depression, disinhibition, or cognitive
      restraint.

PMID- 1763178
TI  - Personal Orientation Inventory correlated with physical health.
AB  - Predicting 92 subjects' physical health status from their scores on the Personal
      Orientation Inventory using regression analysis showed that those who obtained
      high self-regard scores and high self-actualizing value scores also reported
      better physical health. Those subjects who reported poorer physical health also
      scored high on the synergy scale.

PMID- 1763179
TI  - Nurses sue hospital for fraud re job security.

PMID- 1763180
TI  - Physicians retract opinion: nurses not negligent. Case in point: Galloway v.
      Baton Rouge General Hosp. (583 So. 2d 1169--LA (1991)).

PMID- 1763181
TI  - Pharmacological properties of the natural polyamines and their depletion by
      biosynthesis inhibitors as a therapeutic approach.

PMID- 1763182
TI  - Potassium channel openers: airway pharmacology and clinical possibilities in
      asthma.

PMID- 1763183
TI  - Antifungal chemotherapy--are we winning?

PMID- 1763184
TI  - The hopanoids, bacterial triterpenoids, and the biosynthesis of isoprenic units
      in prokaryotes.

PMID- 1763185
TI  - Isosterism and bioisosterism in drug design.

PMID- 1763186
TI  - Leukotriene antagonists and inhibitors of leukotriene biosynthesis as potential
      therapeutic agents.

PMID- 1763187
TI  - Bacterial resistance to antibiotics: the role of biofilms.
AB  - Bacteria adhere to natural and synthetic, medically important surfaces within an
      extracellular polymer generically termed the glycocalyx. This quasi-structure is
      a biofilm. The enhanced antibiotic resistance of biofilm bacteria, relative to
      floating (planktonic) bacteria, encourages the establishment of chronic bacterial
      infections. Resistance mechanisms include the hinderance of antibiotic diffusion
      by the glycocalyx, the physiology of the bacteria and the environment conditions
      of the niche in which the biofilm resides.

PMID- 1763188
TI  - Cholinergic systems in mammalian brain and spinal cord.

PMID- 1763189
TI  - Neurite growth from, and neuronal survival within, cultured explants of the
      nervous system: a critical review of morphometric and stereological methods, and
      suggestions for the future.

PMID- 1763190
TI  - 5-HT1A receptor responsivity in anxiety disorders and depression.
AB  - 1. Azapirones, selective partial agonists at the 5-HT1A receptor subtype, induce
      hypothermia and corticotropin (ACTH)/cortisol release as specific functional
      correlates of central 5-HT1A receptor activation. 2. Compared to controls,
      hypothermic and ACTH/cortisol responses to the azapirone ipsapirone are
      attenuated in patients with unipolar depression and panic disorder but not in
      patients with obsessive-compulsive disorder. The impaired thermic and
      neuroendocrine responses are associated with increased basal cortisol secretion
      in depressed patients but not in patients with panic disorder. 3. Chronic
      treatment with the selective 5-HT reuptake inhibitor fluoxetine decreases 5-HT1A
      receptor-mediated responses in patients with obsessive-compulsive disorder, while
      long-term treatment with the tricyclic antidepressant amitriptyline further
      decreases hypothermia following ipsapirone but has no effect on ACTH/cortisol
      release. 4. Alteration of the 5-HT1A receptor and/or its signal transduction
      pathways may play a role in the pathophysiology and treatment of anxiety
      disorders and depression.

PMID- 1763191
TI  - Animal study on the role of serotonin in depression.
AB  - 1. In our series of experiments the role of serotonin in human depression was
      studied by using animal models of depression. 2. The results of these studies
      support the hypothesis that some types of human depression may be primarily due
      to an excessive transmission of serotonin at the synapse.

PMID- 1763192
TI  - Is a single tricyclic antidepressant trial an active treatment for psychotic
      depression?
AB  - 1. A retrospective chart review of 256 consecutively admitted depressed
      inpatients assessed their treatment response to optimal somatic therapy. 2. There
      were no differences in treatment response between patients with Major Depressive
      Episode (MD) and Major Depression with Psychosis (MD-P). 3. In addition, twenty
      six studies were reviewed to clarify the role of tricyclic antidepressants (TCA)
      in the treatment of MD-P. The authors conclude from this literature review that
      TCA's should not be considered an active treatment for MD-P patients.

PMID- 1763193
TI  - Pharmacokinetics of peptide T in patients with acquired immunodeficiency syndrome
      (AIDS).
AB  - 1. The pharmacokinetics of Dala1-peptide T-NH2 (peptide T) was determined during
      phase I clinical trials in patients with acquired immunodeficiency disease (AIDS)
      and AIDS related complex (ARC). Drug levels were determined by specific RIA, and
      in some cases with HPLC analysis, after intravenous (i.v.) or intranasal (i.n.),
      via metered sprayer, administration. 2. The plasma kinetics appeared to be bi
      phasic with a first compartment half-life of 30 to 60 minutes and a second plasma
      clearance rate of 4 to 6 hours, observed for both routes of administration.
      Peptide T, in one individual was confirmed to be present at 6 hrs in plasma,
      determined after HPLC isolation followed by specific RIA. 3. Bioavailability,
      determined for a 2 mg test dose in six individuals was 9.3 +/- 6.9 nmol/L. Peak
      plasma levels of 41 +/- 30 nmol/L after 10 mg i.n., 2.8 +/- 5.9 nmol/L after 2 mg
      i.n., and 0.13 +/- 0.07 nmol/L after 0.4 mg i.n. were observed. In two
      individuals tested, peptide T was detected in CSF at levels 20% of the
      corresponding plasma level 90 and 145 minutes post i.v. administration. Peptide T
      was not detected in urine. I.N. administration was well tolerated for times up to
      21 months.

PMID- 1763194
TI  - Hypnotic action of flunitrazepam is reversed by proglumide in rats.
AB  - 1. Caerulein, an analogue of cholecystokinin (CCK-8), like CCK-8, has been shown
      to produce hypnotic effects similar to those of benzodiazepine (flunitrazepam).
      2. Proglumide antagonizes the action of CCK-8 and of its analogue. 3. The aim of
      the present study was to demonstrate whether proglumide would affect the potent
      hypnotic action of flunitrazepam in rats. 4. The association of proglumide with
      flunitrazepam suppress the increase of total sleep time and slow wave sleep seen
      after flunitrazepam alone. Proglumide alone has no effect on sleep stages. The
      authors report here for the first time that the hypnotic action of flunitrazepam
      is antagonized by proglumide in rat.

PMID- 1763195
TI  - The effects of conditioning with amphetamine on the thermic effects of
      amphetamine and pentobarbital.
AB  - 1. Rats were injected with amphetamine (1.5 mg/kg) in the presence of a
      distinctive set of environmental stimuli (CS1) and saline in the presence of a
      different set of environmental stimuli (CS2) on different days for a total of 10
      amphetamine and 20 saline injections. 2. The hyperthermic effect of amphetamine
      first increased but then declined to levels seen during the very first drug
      administration. 3. Following the conditioning phase, half the rats were injected
      with amphetamine in CS1 and half in CS2. Although there was little thermic effect
      of amphetamine injected in CS1, there was pronounced hyperthermia following
      amphetamine in CS2. 4. Next, pentobarbital (30 mg/kg) was administered to half
      the rats in CS1 and half in CS2. The hypothermic effect of pentobarbital was
      attenuated in CS2.

PMID- 1763196
TI  - Emerging pharmacology of nerve growth factor.
AB  - 1. Partial transection of the septo-hippocampal pathway decreased measures of
      presynaptic cholinergic function in the rat hippocampal formation. 2. Chronic
      intraventricular treatment with recombinant human nerve growth factor attenuated
      lesioned-induced deficits in cholinergic function. Following nerve growth factor
      treatment measures of choline acetyltransferase activity, acetylcholine synthesis
      and release were significantly increased compared to cytochrome c-treated
      lesioned animals. 3. Single injections of nerve growth factor were ineffective in
      altering lesioned-induced deficits in cholinergic function. 4. Chronic nerve
      growth factor treatment was ineffective in increasing presynaptic cholinergic
      function if administered 3 or more weeks following fimbrial transections. 5. The
      nerve growth factor-induced increases of presynaptic cholinergic function
      persisted for 3 weeks following the cessation of chronic 3 week nerve growth
      factor treatment.

PMID- 1763197
TI  - Antagonism of physostigmine induced hypothermia and neuroendocrine changes
      following exposure to different environmental temperatures.
AB  - 1. The magnitude of physostigmine-induced hypothermia increased with decreasing
      environmental temperature. 2. The hypothermic response was accompanied by
      significant changes in plasma levels of corticosterone, glucose and fatty acids.
      3. Central cholinergic mediation appears to be a significant component of
      physostigmine-induced hypothermia and neuroendocrine changes at moderate
      temperature. 4. At lower ambient temperatures cholinergic blockers produced less
      antagonism of physostigmine-induced effects. 5. The decreased effectiveness of
      cholinergic blockers at low environmental temperatures and the increased plasma
      fatty acid levels under almost all conditions studied may be of importance in
      considering long term therapy with cholinergic agonists.

PMID- 1763198
TI  - Alpha-methyltryptophan as a therapeutic agent.
AB  - 1. Alpha-methyltryptophan, on administration to experimental animals gives rise
      to cerebral alpha-methylserotonin, which substitutes for serotonin in certain
      behavioral and functional tests. 2. Such results are consistent with the
      similarity of the properties of the two indoleamines with respect to storage,
      uptake and release, as well as with the 5HT2-receptor agonist activity of alpha
      methylserotonin. 3. It is proposed that alpha-methyltryptophan be regarded as a
      candidate drug for the provision of alpha-methylserotonin as a substitute for
      serotonin in disorders where the latter amine is thought to be deficient.

PMID- 1763199
TI  - Evolution of enzymatic regulation of prostaglandin action: novel connections to
      regulation of human sex and adrenal function, antibiotic synthesis and nitrogen
      fixation.
AB  - The recent determination of the amino acid sequences of enzymes that metabolize
      prostaglandins and steroids has revealed interesting connections between some of
      these enzymes. Human placental 15-hydroxyprostaglandin dehydrogenase, which
      catalyzes the oxidation of the C15 alcohol on prostaglandins E2 and F2 alpha, is
      homologous to 11 beta-hydroxysteroid, 17 beta-hydroxysteroid, and 3 alpha, 20
      beta-hydroxysteroid dehydrogenases. That is, these four enzymes are derived from
      a common ancestor. Moreover, enzymes important in synthesis of antibiotics and
      proteins synthesized by soil bacteria that form nitrogen-fixing nodules in
      alfalfa and soybeans are homologous to 15-hydroxyprostaglandin dehydrogenase.
      These homologies provide important insights into the origins of intercellular
      communication that is mediated by prostaglandins, steroids, and fatty acids.

PMID- 1763200
TI  - The differences in 12-hydroxyeicosatetraenoic acid and thromboxane B2 release
      from guinea pig platelets.
AB  - Anti-12(S)-hydroxyeicosatetraenoic acid (12-HETE)-antibody and anti-thromboxane
      B2 (TXB2)-antibody were generated and applied to the radioimmunoassay. The
      detection limit for 12-HETE was 16 pg. The cross-reactivities of anti-12-HETE
      antibody were 4.6% for 15-HETE, 0.18% for 5-HETE and below 0.15% for leukotrienes
      and prostaglandins (PGs). 12-HETE and TXB2 released from guinea pig platelets
      were measured by radioimmunoassay. Platelet activating factor (PAF) at 10(-9) M
      induced the aggregation of platelets, the releases of immunoreactive-12-HETE (1.8
      +/- 1.2 ng/10(8) platelets, mean +/- S.D.) and immunoreactive-TXB2 (18.5 +/- 17.3
      ng/10(8) platelets). Collagen at 1 microgram/ml also evoked platelet aggregation,
      the releases of immunoreactive-12-HETE (2.7 +/- 1.1 ng/10(8) platelets) and
      immunoreactive-TXB2 (11.8 +/- 4.6 ng/10(8) platelets). By the stimulation with
      these compounds, TXB2 was produced in a greater amount than 12-HETE from guinea
      pig platelets. Although 10(-7) M and 10(-6) M U46619, a TXA2 mimetic, caused
      platelet aggregation, arachidonic acid metabolites were not released. These data
      suggest the presence of different mechanisms of platelet activation depending on
      each stimulus.

PMID- 1763201
TI  - Cicaprost inhibits metastases of animal tumors.
AB  - Since an involvement of platelet aggregation in the metastatic process has been
      found, platelet activation inhibitors were investigated for their potential to
      reduce tumor metastases. Recent in-vitro and in-vivo investigations showed an
      antimetastatic effect of prostacyclin (PGI2) and stable prostacyclin analogues.
      This study concentrates on the effect of the stable prostacyclin analogue
      Cicaprost (Schering AG) on tumor metastases in two metastasizing tumors of
      rodents. C57BL/6 mice bearing s.c.-implanted M5076 reticulum sarcoma were treated
      with Cicaprost in doses of 0.1-1.0 mg/kg throughout the experiment. Cicaprost in
      all doses tested reduced the number of liver metastases in a statistically
      significant manner. The 1.0 mg/kg dose, which decreases the median number of
      liver metastases to more than 93% compared to the control, was most effective.
      Cicaprost in the 0.5 mg/kg dose reduced the number of liver metastases in mice
      bearing i.v.-implanted M5076 reticulum sarcoma. In Cop-Fisher rats bearing s.c.
      implanted spontaneously metastasizing R3327 MAT Lu prostate carcinoma, Cicaprost
      in a dose of 1.0 mg/kg p.o. daily strongly reduced the number of lung metastases.
      These results indicate that Cicaprost is a potent inhibitor of tumor metastases
      in different tumor models in rodents.

PMID- 1763202
TI  - Pharmacological effects of oral E6123, a novel PAF antagonist, on biological
      changes induced by PAF inhalation in guinea pigs.
AB  - The effects of a newly synthesized PAF antagonist E6123, (S)-(+)-6-(2
      chlorophenyl)-3-cyclopropanecarbonyl-8,11-dimethyl-2, 3,4,5- tetrahydro-8H
      pyrido[4',3':4,5]thieno[3,2-f][1,2,4]triazolo [4,3-a][1,4]diazepine, on in vivo
      inhaled PAF-induced pulmonary changes were investigated. E6123 inhibited PAF
      inhalation-induced bronchoconstriction in guinea pigs with an ED50 value (p.o.)
      of 1.3 micrograms/kg which was lower than those of other PAF-antagonists such as
      WEB2347 (ED50 = 26 micrograms/kg) and Y-24180 (ED50 = 12 micrograms/kg). E6123
      significantly inhibited PAF inhalation-induced eosinophil infiltration into the
      bronchiole and trachea, and bronchial hyperreactivity in guinea pigs after oral
      administration at 1 and 10 micrograms/kg, respectively. E6123 inhibited the PAF
      induced increase in intracellular free calcium ion concentration ([Ca2+]i) in
      guinea pig eosinophils with an IC50 value of 14 nM. The present results suggest
      that E6123 may be beneficial for the treatment of asthma, in which PAF is assumed
      to be involved.

PMID- 1763203
TI  - Interference in the radioimmunoassay of gastric prostaglandins by cimetidine, a
      histamine H2 blocker.
AB  - The present study was undertaken to assess whether cimetidine alters the levels
      of endogenous prostaglandin (PG) E2 and 6-keto-PGF1 alpha in the rat stomach.
      When cimetidine was mixed in vitro with a suspension of dextran-coated charcoal,
      to which [3H]-PGE2 had been adsorbed, levels of free [3H]-PGE2 were increased by
      cimetidine at concentrations above 1.0 mM, because of preferable adsorption of
      this blocker to the charcoal. Dextran-coated charcoal is used for the separation
      of antibody-bound [3H]-PGs from the free labelled compounds in the
      radioimmunoassay of PGs. Addition of cimetidine to standard solutions of PGE2
      shifted the PGE2 calibration curve upward. Thus, when PGs in cimetidine
      containing samples were quantitated by reference to the normal calibration curve,
      the assessed levels of PG were lower than the actual levels. Removal of
      cimetidine from the assay samples was successfully achieved by use of SEP-PAK C18
      columns. Rats were injected intraperitoneally with 100 mg/kg of cimetidine only
      once or with 20 mg/kg twice daily for 7 days. Using this cleaning method, we
      found that both the basal levels of PGE2 and 6-keto-PGF1 alpha and those levels
      increased by intragastric administration of 1.0 M NaCl solution did not differ
      between rats treated with cimetidine and those treated with vehicle. It can be,
      therefore, concluded that cimetidine does not affect the gastric PG production.

PMID- 1763204
TI  - Safety report.

PMID- 1763206
TI  - Remote area nursing: the silent reality.

PMID- 1763205
TI  - Unionism-professionalism: a false dichotomy.

PMID- 1763207
TI  - The Australian-American Nurses' Exchange: a unique experience in the celebration
      of nursing.

PMID- 1763208
TI  - [Correlation of plasma lipids and microproteinuria in diabetes mellitus].
AB  - Microproteinuria is an early sign of clinical diabetic nephropathy, and it also
      has the power to predict cardiovascular mortality in both types of diabetes. In
      order to investigate this last aspect, we have analyzed serum lipids in diabetes
      type I and II (128 male patients) with or without microproteinuria [determined
      using MICRAL/TEST (Boerhinguer M)]. The results revealed the following:
      hypertriglycerinemia and a low HDL-Cholesterol level in insulin dependent
      diabetes mellitus together with hypercholesterolemia in non insulin dependent
      diabetes mellitus. It seems that both microproteinuria as well as
      hyperlipidemiain diabetes mellitus reflect a generalizes vascular lesion.

PMID- 1763209
TI  - [Idiopathic inflammatory myopathy. Analysis of 31 patients].
AB  - A series of 31 patients suffering idiopathic inflammatory myopathy (IIM); we
      describe the extramuscular manifestations, specially pulmonary, the association
      to neoplasia, the histopathological characteristics, and their response to
      treatment. Fourty three percent of IIM patients presented a pulmonary
      involvement, 9% presented an associated neoplasia. The histopathological study
      allowed us to clearly differentiate dermatomyositis and polymyositis within IIM.
      65% of patients initially responded to glucocorticoids and the most usefull
      therapeutic alternatives were azatioprine and cyclosporin-A.

PMID- 1763210
TI  - [Complications of liver transplant in intensive care. Experience in 130 cases].
AB  - Liver transplant is the first therapeutic choice in most of the advanced liver
      diseases. Nevertheless, its performance originates a number of complications
      derived from: a) conservation techniques of the organ (in our study a prolonged
      time of hot ischemia was significantly associated with); b) surgery (all patients
      who required massive blood transfusions developed metabolic alkalosis); c) the
      graft itself (all the F 1. degrees were significantly infected), and d)
      extrahepatic causes (cyclosporin was responsible for high blood pressure and
      nephrotoxicity which appeared as oliguria with good response to furosemide, as
      well as hyperglycemia). Some other relevant results in our series were: right
      pleural effusion and thrombopenia which appeared with a high incidence.
      Infections were usually originated the staphylococcus which grows in half of the
      cultures. We also want to highlight the short mean stay and the low mortality
      incidence in the ICU.

PMID- 1763211
TI  - [Sneddon syndrome: diagnostic value of antiphospholipid antibodies].
AB  - The association of livedo reticularis and cerebrovascular lesions is known as
      Sneddon's syndrome. It affects young adults and is more common in females.
      Repeated strokes lead these patients to residual deficits. Recently, Sneddon's
      syndrome has been described in a subset of patients with systemic lupus
      erythematous and primary antiphospholipid syndrome. We report two cases, one of
      them with antiphospholipid antibodies. Antiphospholipid antibodies do not seem to
      explain the events of Sneddon's Syndrome. Perhaps, different pathogenic
      mechanisms play role in the clinical expression of this syndrome.

PMID- 1763212
TI  - [Pericardial tamponade as a complication of T-cell cutaneous lymphoma].
AB  - Mycosis fungoides is a T cell lymphoma characterized by the initial skin
      involvement. Organ infiltration generally occurs many years after the cutaneous
      presentation. The organ disease is accompanied of peripheral blood involvement
      (more than 20% lymphocytes have atypical convolute nucleus and there are palpable
      adenopathies. Pericardic involvement is a rare complication as the initial
      manifestation of the visceral disease, in patients with mycosis fungoides of long
      evolution. We present a patient suffering mycosis fungoide who presented a
      pericardic tamponade. The visceral disease in our patient was not accompanied by
      blood anomalies or palpable adenopathies.

PMID- 1763213
TI  - [Splenic abscess: clinico-microbiologic study of 15 cases].
AB  - We have reviewed 15 cases of splenic abscesses diagnosed using a
      histopathological and microbiological study. Mean age was 48 years (range 18-78).
      Eight of them were male and 7 female. Eighty per cent of them had predisposing
      diseases, amongst which the most frequent were endocarditis and bacteriemia of
      other origin (26.6% in both cases). All patients presented fever and in 7 of them
      (47%) splenomegaly was appreciated. The most frequently isolated germs were
      gramnegative bacteria (33%), anaerobics (20%), and with a similar incidence
      grampositive bacteria, tuberculosis and fungii; in only one case cultures were
      sterile. Seven patients had multiple splenic abscesses and 8 patients single
      abscesses. Thorax x-ray showed alterations in more than half of the patients
      (53%). Abdominal echography was the diagnostic method in 67% of the patients and
      TAC in all the cases in which it was performed. Eight patients underwent
      splenectomy and one was surgically drained being the mortality rate of this group
      of 22%. Overall mortality was 33% and was related to the presence of multiple
      splenic abscesses (5/7, 71.4%), positive hemocultures (6/6, 100%), extrasplenic
      abscesses (7/8, 87.5%), and endocarditis (4/4, 100%), fungii infections (2/2,
      100%), and late diagnosis (6/6, 100%).

PMID- 1763214
TI  - [What do general practitioners think about risk factors in arteriosclerosis?].
AB  - At present the management of atherosclerosis is still based on the control of
      risk factors. The role of the general practitioner is very important in this
      setting and, therefore, we thought it would be useful to know the opinion on the
      subject of these physicians in our area. In order to find that out, we have
      polled by mail 286 physicians and have received an answer from 111. The largest
      number (91%) considered that the most frequent cause of death were cardiovascular
      diseases. In relation to coronary heart disease, hypercholesterolemia was
      considered to be the most important risk factor (65%), followed by arterial
      hypertension (14%). On the other hand arterial hypertension was considered to be
      the most important risk factor for cerebrovascular disease. There was agreement
      on low animal fat diet as the initial step in the management of the patient with
      hypercholesterolemia. Among the fats, olive oil is recommended more than other
      vegetable oils (64%). Fish was considered as an appropriate for these patients
      than blue fish, still persist. Seventy two per cent prescribe dietary treatment
      when total serum cholesterol levels are above 221 mg/dl. Eighty three per cent
      prescribe drug treatment when serum cholesterol levels are above 251 mg/dl.
      Fibrates are still the drugs mostly used with a low level of use of resins in our
      area.

PMID- 1763215
TI  - [New perspectives in the knowledge of endothelial mediators: their repercussion
      in clinical medicine. Fernandez-Cruz Lecture].

PMID- 1763216
TI  - [Superior vena cava syndrome: radiologic study].

PMID- 1763217
TI  - [Eosinophilia and giardia lamblia intestinal parasitism].

PMID- 1763218
TI  - [Malignant melanoma of the lung. Apropos of a case].

PMID- 1763219
TI  - [Subarachnoid hemorrhage as a manifestation of idiopathic thrombocytopenic
      purpura].

PMID- 1763220
TI  - [Paralysis of the hypoglossal nerve secondary to venous catheterization].

PMID- 1763221
TI  - [Disseminated candidiasis with pulmonary involvement].

PMID- 1763222
TI  - [Primary Sjogren syndrome and IgA deficiency].

PMID- 1763223
TI  - [Respiratory cryptosporidiosis: apropos of a new case].

PMID- 1763224
TI  - [Subacute thyroiditis: an entity to be considered in the context of fever of
      unknown origin].

PMID- 1763225
TI  - [Cervical actinomycosis in a carrier of human immunodeficiency virus].

PMID- 1763226
TI  - [Hepatic epithelioid angiomatosis in the absence of HIV infection].

PMID- 1763227
TI  - [Brain protection in heart surgery].
AB  - We investigated the effect of CDP-choline on brain protection during extra
      corporeal circulation (ECC) in patients submitted to open-heart surgery. We
      studied forty patients, using neurological, neuropsychological, neuroradiological
      (CT scan), and CBF evaluations. All the patients were evaluated two weeks before
      (T1), two weeks (T2), one month (T3) and six months after surgery (T4). Patients
      were randomly divided into two groups: subjects of the first group were treated
      with 2000 mg/die e.v. from two weeks before surgery to ten days after surgery,
      and then with 1000 mg/die i.m., 15 days per month, for the following 6 months
      (Group A), while subjects of the second group were treated with 100 mg/die, from
      two weeks before surgery to six months after surgery (Group B). After surgery,
      neither neurological symptoms nor morphostructural lesions were observed in the
      two groups. However, in the Group A, 75% (15 out of 20) of the patients evidenced
      reduced performances on neuropsychological tests at T2, compared to T1. At T4
      only 66% (10 out of 15) of the impaired patients showed a persistence of the
      deficit. In the Group B 70% (14 out of 20) of the patients displayed reduced
      performances at T2. At T4, almost all of the patients, namely 86% (12 out of 14),
      showed a persistence of neuropsychological deficits. CBF data showed
      hypoperfusion areas in 9 patients in Group A (1.7 +/- 4.15 mean areas per
      patient), and in 10 patients in Group B (3.33 +/- 1.3 mean areas per patient), at
      T2. In 2.2+ off

PMID- 1763228
TI  - [Prevalence of liver damage in alcoholics and drug addicts].
AB  - The behaviour of drug addicts and alcoholics leads to the cooperation of risk
      factors concerning the development of chronic hepatitis, liver cirrhosis and
      hepatocarcinoma. The authors evaluate the prevalence of infections from B, C and
      Delta virus among a group of 40 intravenous drug users and 40 alcoholics affering
      to a territorial centre for drug dependence located in Valtellina (Italy). The
      prevalence of at least one serum marker of virus B, C or Delta hepatitis results
      to be 85% among drug addicts and 17% among alcoholics. The prevalence of Anti-HCV
      in alcoholics results to be much lower than found in former works. For what
      concerns the hepatitis B virus, 68% of the drug addicts and 10% of the alcoholics
      had at least one positive serum marker. The hepatitis B seronegative patients
      underwent vaccination with a recombinant-DNA vaccine. Those affected by chronic C
      hepatitis have been treated with alpha-recombinant interferon. All of the
      patients underwent health education, psychotherapy and drug-addiction therapy for
      a period of 8 months. These strategies in prevention and therapy aim to the
      reduction over the years of the incidence of chronic hepatitis liver cirrhosis
      and hepatocarcinoma among intravenous drug users and alcoholics.

PMID- 1763229
TI  - Purine nucleotide content of lymphocytes from healthy subjects and asymptomatic
      HIV-1 seropositive patients.
AB  - The purine nucleotide content of lymphocytes of normal subjects and asymptomatic
      HIV-1 seropositive patients was analyzed by HPLC. An increase in IMP and a
      decrease in ADP, GDP, ATP and GPT were observed in the HIV-infected patients with
      respect to healthy subjects. The changes may depend on different factors and
      indicate that the virus influences purine nucleotide metabolism of the cell. The
      finding sheds light on the metabolic situation of the infected cell, and could be
      applied to monitoring the disease.

PMID- 1763230
TI  - [Association of chronic obstructive bronchitis and upper digestive pathology. A
      clinical study].
AB  - The association of chronic obstructive pulmonary disease (COPD) with esophageal
      gastric and duodenal disease is very common. In our experience 21.8% of patients
      with COPD were affected by peptic ulcer and 50.9% by inflammatory disease of
      upper digestive tract. This association appears independent from smoking and
      alcohol abuse. Dyspepsia and corticosteroid therapy were associated with
      endoscopic lesions (dyspepsia was present in 75.6% of patients with abnormal
      endoscopy vs 42.8% without endoscopic lesions, p less than 0.01 and
      corticosteroid therapy in 43.9% vs 0, p less than 0.001). On the contrary therapy
      with theophylline and beta 2-adrenoceptor-agonists is not associated with
      digestive disease. Spirometric parameters and blood gas analysis were not
      different among patients with and without endoscopic lesions. We suggest
      endoscopy of upper digestive tract in patients affected by COPD with dyspepsia
      and/or corticosteroid therapy.

PMID- 1763231
TI  - Pathologic sideroblastosis in myelodysplastic syndromes and acute nonlymphocytic
      leukemia.
AB  - To assess the incidence and the eventual prognostic relevance of pathologic
      sideroblastosis in myelodysplastic syndromes and acute nonlymphocytic leukemia, 5
      acquired idiopathic sideroblastic anemias, 2 refractory anemias, 9 refractory
      anemias with excess of blasts, 10 acute nonlymphocytic leukemias were studied
      with regard to sideroblast type (ring or ferritin) and percentage. Pathologic
      sideroblastosis was commonly found in each subgroup, in some patients it appeared
      later in the course of the disease while in other reversed. In a successfully
      treated leukemic patient, pathologic sideroblastosis in otherwise normal bone
      marrow after therapeutic hypoplasia suggested clonal remission. Although the
      patient number was small, pathologic sideroblastosis seems to correlate with poor
      treatment response in leukemic patients. We conclude that systematic looking for
      pathologic sideroblastosis may have some biologic and clinical implications in
      myelodysplasia and acute leukemia.

PMID- 1763232
TI  - [Spontaneous remission of visceral metastases of hypernephroma after nephrectomy.
      Description of a case and review of pathogenetic hypotheses].
AB  - We describe an absolutely spontaneous regression of visceral metastases from a
      renal carcinoma, following nephrectomy, in a 46 years old patient, who is at
      present in a complete uninterrupted remission for 39 months. After a literature
      review we point out the rarity of this event and emphasize its absolute
      spontaneity. Moreover, we suggest some considerations about the possible
      pathogenetic mechanisms of this unexpectedly positive outcome. Between these,
      because of the strongly positive psychologic attitude of the patient, the psycho
      neuro-immunologic one is suggestive.

PMID- 1763233
TI  - [Extraskeletal diffusion of multiple myeloma. A clinico-pathological description
      of 4 cases].
AB  - The authors describe 4 cases of multiple myeloma that developed one or more
      extraskeletal localizations. They have evaluated the relation between the onset
      of the extraskeletal localizations and the following myeloma characteristics:
      tumor burden, clinical phase, chemotherapy response, prognostic significance. All
      the patients showed these localizations in a plateau phase of myeloma. None of
      the patients had fever, pancytopenia and in no one the performance status
      worsened. All patients obtained at least a partial reduction of the localization
      and only the patient with the retro-orbital localization, got worse and died for
      myeloma. The other three patients are alive and do not show any sign of
      progression.

PMID- 1763234
TI  - [Use of high-dose intravenous immunoglobulins in the therapy of connectivitis:
      preliminary experience in 5 cases].
AB  - The Authors report their favourable experience concerning the treatment of five
      cases of connective tissue diseases with high-dose intravenous immunoglobulins:
      three cases of systemic lupus erythematosus with nephritis, hematological
      involvement and fever; one case of antiphospholipid antibody-associated
      pregnancy; and one case of juvenile dermatomyositis. Disease manifestations had
      proved refractory to previous conventional and sometimes aggressive therapies in
      all the patients. The results obtained are discussed on the basis of more recent
      data from the literature. Further investigation in the treatment of connective
      tissue diseases with intravenous immunoglobulins is suggested. However, this
      therapy should be employed only in carefully selected patients.

PMID- 1763235
TI  - [Anamnesis: a diagnostic passe-partout].
AB  - There is universal consensus that the anamnesis is a fundamental and
      irreplaceable phase both for the formulation of the diagnosis and for
      establishing the correct physician-patient relation. In a high percentage of
      cases the diagnostic hypothesis formulated during the history-taking is
      successively confirmed. The analysis of the structure of the anamnesis has
      demonstrated to realize a cognitive approach of phenomenological type. This kind
      of approach fits with the structure of illness because of its dynamic aspect.
      That is the reason why it represents an indispensable diagnostic key.

PMID- 1763236
TI  - [History of immunologic deficiency].
AB  - The description of agammaglobulinemia by O. Bruton in 1952 and later clinical
      studies by R. Good preceeded by sporadic clinical observations on deficits in the
      immune function associated with hyponutrition, nephrosis and tumors or with
      inborn errors of metabolism have all made their contribution to the emerging of
      the concept of immunological deficiency diseases. The clinical-pathogenetic
      description of immunological deficiency diseases has played a fundamental role in
      the understanding of the anatomo-functional bases of the immune system and
      research work on the phylogenetic and ontogenetic evolution of the immune
      response. Various methodologies, from the idea of experimentum naturae to
      molecular pathology, combine to define and direct this research, the result of an
      ongoing interaction between the hospital and the laboratory. This leads to a
      necessary theoretical-practical synthesis and contributes to the consolidation of
      an immunologically-directed medicine.

PMID- 1763237
TI  - [Physiopathological aspects of secondary hyperuricemia].
AB  - Secondary hyperuricaemia expresses a heterogeneous group of clinical conditions
      generally classified according to the pathogenetic criteria. Hyperuricaemia can
      depend on an increased production, reduced renal excretion or on the combination
      of both. Myelo and lymphoproliferative diseases are clinically prevalent among
      the conditions accompanying this overproduction. The most frequent causes of
      reduced uric acid excretion are chronic renal failure and diuretic treatment. In
      recent years, several conditions of hyperuricaemia with mixed pathogenesis have
      revealed a common mechanism connected to the ATP cellular depletion.

PMID- 1763238
TI  - Guidelines for the evaluation of chemicals for carcinogenicity. Committee on
      Carcinogenicity of Chemicals in Food, Consumer Products and the Environment.
AB  - Chapter 1 gives some background information on general issues in chemical
      carcinogenesis. It briefly discusses mechanisms by which genotoxic and
      nongenotoxic substances may be involved in the development of cancer. The role of
      oncogenes and tumour-suppressor genes in molecular carcinogenesis is also
      described. The contribution from epidemiological studies to the overall
      assessment is dealt with in Chapter 2. The relative merits and limitations of
      different types of epidemiological investigations are discussed. Chapter 3
      considers the major classes of chemical carcinogens with regard to the different
      mechanisms by which they exert their carcinogenic effects. The role of metabolism
      is considered. Chapter 4 covers the use of short-term predictive tests for
      screening for carcinogenic potential of chemicals (mutagenicity tests and cell
      transformation assays). Reference is made to the strategy for mutagenicity
      testing given in the Committee on Mutagenicity's 'Guidelines for the Testing of
      Chemicals for Mutagenicity', which is also relevant to predictive short-term
      testing for carcinogenicity. The main points to be considered in designing a
      carcinogenicity bioassay are covered in Chapter 5, and some of the problems which
      might be encountered during the performance of such a study are discussed.
      Special problems associated with the carcinogenicity testing of certain classes
      of substances are reviewed. The interpretation of the results of carcinogenicity
      studies is covered in Chapter 6. Statistical methodology is not dealt with in
      detail, but reference is made to more specialized guidelines. Advice is given on
      the problems of interpreting the biological significance of results. A number of
      factors which can influence the interpretation of the results of a study
      (confounding factors) are examined. Mechanisms of carcinogenicity are discussed
      in the context of interpreting the relevance to humans of a carcinogenic response
      in animals. Assessment of the hazards and risks from exposure to chemical
      carcinogens is discussed in Chapter 7. It explains the COC's differential
      handling of carcinogens, depending on whether or not a threshold level of
      exposure can be set for the chemical's carcinogenicity. It is proposed here and
      in earlier Chapters that threshold levels of exposure (below which there is no
      carcinogenic hazard) can reasonably be set for many non-genotoxic carcinogens if
      their modes of action are understood but not for genotoxic carcinogens (which are
      assumed to present a finite carcinogenic risk at any level of exposure). Methods
      of quantitative risk assessment of exposures to non-threshold (presumed
      genotoxic) carcinogens are briefly presented, and the COC's reasons for not using
      such methods are set out.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1763239
TI  - A nursing model for chronic illness management based upon the Trajectory
      Framework.
AB  - The trajectory framework developed by Strauss and associates provides a
      conceptual basis for developing a nursing model that gives direction for
      practice, teaching, and research in the area of chronic illness. This paper
      presents an overview of the trajectory framework and shows how it can be used to
      generate such a nursing model.

PMID- 1763240
TI  - The trajectory of cancer recovery.
AB  - In response to the Corbin and Strauss illness trajectory framework, this paper
      offers a recovery model as a more relevant trajectory for cancer as a specific
      chronic disease and as a general framework for clinical science. As counterpoint,
      the course of recovery is considered as a separate but influential continuum vis
      a-vis the course of illness. The text presents an overview of the nature and
      meaning of cancer as a chronic disease, an operational definition of the recovery
      model, and a comparison and contrast of the illness and recovery trajectory
      frameworks in terms of their philosophic nature, therapeutic approach and
      research and educational and health policy-making emphases with regard to the
      cancer experience. When fully grounded in recovery science, the recovery
      trajectory model is predicted to be the more therapeutically effective clinical
      approach for professionals who care for patients diagnosed with cancer and their
      families.

PMID- 1763241
TI  - Using the Trajectory Framework: reconceptualizing cardiac illness.
AB  - Cardiac disease is known to be the leading cause of premature morbidity and
      mortality in the United States. Nursing management of cardiac illnesses, as such,
      is a primary concern for most practicing nurses. Dramatic changes in cardiac
      patient populations and associated technology available for treatment indicate a
      need to reconceptualize the nature of cardiac illness and to consider alternative
      approaches to guide the care of these patients. Traditional care, to a large
      degree, has focused upon acute illness, consequently limiting needed attention to
      the increasing group of patients suffering chronic illness and disability. In the
      present paper, the major changes in the cardiac patient population and in
      utilization of available technology are presented. The application of the Corbin
      and Strauss trajectory framework as an appropriate and useful framework for
      conceptualizing cardiac illness and care is then discussed. Five characteristics
      of the framework which render the model particularly well suited to address
      cardiac care are identified and discussed. These characteristics are: 1)
      comprehensiveness of care, 2) patient-centered care, 3) gender issues in care, 4)
      family-focused care, 5) technology and cardiac care.

PMID- 1763242
TI  - Applying the chronic illness Trajectory Model to HIV/AIDS.
AB  - The Corbin and Strauss chronic illness trajectory model is particularly helpful
      in explaining the different phases of HIV (Human Immunodeficiency Virus) disease,
      since this infectious process is characterized by both phases and subphases. The
      model is not particularly helpful in identifying when the illness trajectory
      begins, since the model starts with the onset of symptoms, and HIV disease is
      characterized by a long, symptomless phase. The importance of politics and
      economics is also underestimated when applying this model to HIV disease. While
      this model presupposes the existence of support systems as being significant
      others, HIV disease is unique in that whole family systems may be eliminated by
      this infectious process, i.e., the typical pattern of HIV disease in the 1990s is
      that of a father dying from AIDS, a mother sick with HIV disease, one or more
      siblings infected, and one or more siblings coping with tremendous losses at a
      very young age.

PMID- 1763243
TI  - Chronic mental illness: the timeless trajectory.
AB  - Mental illness encompasses many dimensions. While the etiology of most major
      disorders remains unclear, their devastating effects are readily apparent. The
      substantive and practical value of the trajectory model of chronic illness is
      examined in relation to the characteristics of major mental disorders. Two
      clinical vignettes illustrating the timeless trajectory of chronic mental illness
      are analyzed with reference to the model's components. The potential utility of
      this model for revitalizing research and practice in psychiatric-mental health
      nursing is discussed.

PMID- 1763244
TI  - Use of the Trajectory Model of nursing in multiple sclerosis.
AB  - Multiple sclerosis (MS) is a chronic, demyelinating disorder that is
      unpredictable in its overall course, in the type of symptoms that will
      predominate, and in its eventual outcome. It has been used as a model in
      research, education, and practice to examine the course of chronic illness,
      patient and family responses, coping and adjustment to chronic illness, and
      specific concepts and variables of interest to researchers. MS is used in this
      paper to evaluate for nursing practice the utility of the Corbin and Strauss
      trajectory model of nursing. The assumptions and major concepts of the trajectory
      framework are discussed, use of the model in multiple sclerosis is demonstrated,
      and the strengths and limitations of the framework as a nursing model are
      identified.

PMID- 1763245
TI  - Shaping the course of a marathon: using the Trajectory Framework for diabetes
      mellitus.
AB  - Persons with either insulin-dependent or non-insulin-dependent diabetes mellitus
      live with a chronic illness that can have both acute and long-term complications.
      The therapeutic regimen for glycemic control in diabetes is often complex and is
      lifelong; it requires special knowledge and skills for both patients and health
      care providers. In this article, the Corbin and Strauss trajectory framework for
      chronic illness management is clinically applied to the planning of patient care
      in two case studies of persons with diabetes. The benefits of using the
      trajectory framework as a model for care in diabetes include: introduction of the
      concepts of "locating" the patient on the trajectory and assessing the trajectory
      projection for both patient and provider, and a more realistic evaluation of
      incremental change in chronic illness. Two possible barriers to clinical
      application of the framework for diabetes management are: difficulty in
      translating the framework for clinical use, and some terminology in the framework
      that does not seem to describe reimbursable care. The trajectory framework
      provides a necessary shift in focus to quality of life issues in diabetes
      management over the lifespan.

PMID- 1763246
TI  - Factors associated with injury proneness.

PMID- 1763247
TI  - Can blood pressure be measured during exercise? A review.

PMID- 1763248
TI  - The induction and decay of heat acclimatisation in trained athletes.
AB  - Heat acclimatisation/acclimation involves a complex of adaptations which includes
      decreased heart rate, rectal temperature, perceived exertion as well as increased
      plasma volume and sweat rate. These adaptations serve to reduce physiological
      strain, improve an athlete's ability to exercise in a hot environment, and reduce
      the incidence of some forms of heat illness. Few differences exist in the ability
      of men and women to acclimatise to heat. Typically, older runners do not perform
      in the heat as well as younger runners, but physical training can negate
      differences between these groups. Hormonal adaptations (e.g. aldosterone,
      vasopressin) during heat acclimatisation encourage fluid-electrolyte retention
      and cardiovascular stability. Athletes with high maximal aerobic power (VO2max)
      acclimatise to heat faster (and lose adaptations slower when they are inactive in
      a cool environment) than athletes with low VO2max values. Physical training in a
      cool environment improves physiological responses to exercise at high ambient
      temperatures. In attempting to optimise heat acclimatisation, athletes should
      maintain fluid-electrolyte balance, exercise at intensities greater than 50%
      VO2max for 10 to 14 days, and avoid factors (e.g. sleep loss, infectious disease)
      which are known to reduce heat tolerance. Once acclimatisation has been achieved,
      inactivity results in a decay of favourable adaptations, after only a few days or
      weeks.

PMID- 1763250
TI  - Biomechanical factors associated with injury during landing in jump sports.
AB  - Many sport and movement activities contain a jumping component which necessitates
      landing. Several injury surveys across a variety of jump sports have identified
      the lower extremities and specifically the knee joint as being a primary injury
      site. Factors which might contribute to the frequency and severity of such
      injuries include stresses to which the body is subjected during performance
      (forces and torques), body position at landing, performance execution and landing
      surface. Most of the initial landing studies were primarily descriptive in nature
      with many of the more recent efforts being directed toward identifying the
      specific performance factors that could account for the observed system stresses.
      Continued investigations into landing are necessary to more thoroughly understand
      the force attenuation mechanisms and critical performance variables associated
      with lower extremity injuries.

PMID- 1763249
TI  - Protein intake and athletic performance.
AB  - For most of the current century, exercise/nutritional scientists have generally
      accepted the belief that exercise has little effect on protein/amino acid
      requirements. However, during the same time period many athletes (especially
      strength athletes) have routinely consumed diets high in protein. In recent
      years, the results of a number of investigations involving both strength and
      endurance athletes indicate that, in fact, exercise does increase protein/amino
      acid need. For endurance athletes, regular exercise may increase protein need by
      50 to 100%. For strength athletes, the data are less clear; however, protein
      intakes in excess of sedentary needs may enhance muscle development. Despite
      these observations increased protein intake may not improve athletic performance
      because many athletes routinely consume 150 to 200% of sedentary protein
      requirements. Assuming total energy intake is sufficient to cover the high
      expenditures caused by daily training, a diet containing 12 to 15% of its energy
      from protein should be adequate for both types of athletes.

PMID- 1763251
TI  - Rehabilitation concerns following anterior cruciate ligament reconstruction.
AB  - Rehabilitation following anterior cruciate ligament reconstruction is a subject
      of controversy in the orthopaedic and rehabilitation literature. With an
      increasing number of these operations currently being performed and with the
      advent of arthroscopically assisted ACL reconstruction over the past several
      years, particular rehabilitation needs and problems have been identified in
      association with these patients. Various authors have stressed one or a
      combination of a few basic themes which outline the basic rehabilitation concerns
      following ACL reconstruction. The most fundamental concern is the need to
      initiate motion very soon after surgery. Prolonged postoperative immobilisation
      is known to cause serious complications after ACL reconstruction which can be
      avoided by early motion. Positions or activities which may apply excessive stress
      to a newly reconstructed ACL must also be considered. The amount of protection
      required by the graft will vary depending upon the type of graft used and the
      quality of fixation obtained intraoperatively. Most authors agree that
      nonweightbearing, active resistive quadriceps exercises should be avoided for an
      extended period, while closed chain exercises may be initiated much earlier.
      Strength recovery is obviously important for the quadriceps postoperatively, but
      maximal strength returns of all of the muscles about the knee must be pursued.
      Hamstring strength is of particular concern as this may provide an active support
      to the reconstructed ACL. Sensory loss in the knee after ACL disruption should
      also be addressed during rehabilitation, prior to a patient's return to full
      athletic activity. Progressive neuromuscular re-education exercises which rely on
      sensory input from intact pericapsular structures are encouraged. A final concern
      is the role of bracing after ACL reconstruction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1763252
TI  - Laser-evoked cerebral potentials in the assessment of cutaneous pain sensitivity
      in normal subjects and patients.
AB  - Heat stimuli, applied to the skin by non-contact radiation pulses emitted by a
      CO2-laser, activate simultaneously both A-delta (mean conduction velocity 14 m/s)
      and C-fibres (0.8 m/s), which terminate in the most superficial skin layers.
      Correspondingly, brief heat stimuli elicit two pain sensations with mean reaction
      times of about 500 ms and 1400 ms. Similarly, two evoked potential waveforms were
      observed in the electroencephalogram: the late components N240/P370 and the
      ultralate components N1050/P1250. The shape of the two components was
      reproducible in independent samples of healthy volunteers. In patients with
      dissociated sensory loss, the laser evoked cerebral potentials are affected,
      depending on the kind of disturbed nerve and tracts. This is shown in patients
      with syringomyelia, encephalomyelitis disseminata, myelitis, Brown-Sequard
      syndrome, Wallenberg syndrome. In cases with hereditary motor and sensory
      neuropathy type I or with neurosyphilis, ultralate potentials are observed as
      correlates of delayed pain perception in the affected body areas. The laser
      evoked cerebral potentials reflected the clinical disorder of pain sensitivity in
      most cases, whereas somatosensory evoked potentials in response to conventional
      nerve stimuli failed in objectifying the diagnosis. As such, evoked cerebral
      potentials in response to laser heat stimuli applied to the hairy skin can be
      used for an overall examination of the functional integrity of peripheral small
      fibres, anterolateral tracts and thalamocortical projections.

PMID- 1763253
TI  - [Genetics of neurofibromatosis: recent progress and prospects].
AB  - Two forms of neurofibromatosis are currently described. Von Reckinghausen
      Neurofibromatosis (NF 1) is the classic and common form, recently localised to
      chromosome 17. Neurofibromatosis type 2 (NF 2) or bilateral acoustic
      Neurofibromatosis, formerly the "central form" of von Reckinghausen disease, is
      characterized by multiple brain tumors, most often bilateral acoustic neuromas.
      The NF 2 mutation lies on the long arm of chromosome 22. The two forms predispose
      to benign or malignant familial tumors, derived from neural crest germ lines,
      such as Schwann cells. Rapid progress in the understanding of mechanisms
      underlying neurological tumor formation is expected in these inherited diseases.
      Molecular biology will allow the precise identification of genes responsible for
      the neurofibromatose syndromes. Practical applications, such as screening of
      individuals at risk for the disease will soon be available. Medical follow-up and
      genetic counselling should improve as a result of these advances.

PMID- 1763254
TI  - [Spontaneous intracerebral hemorrhages in young patients. Study of 33 cases].
AB  - We report 33 cases of intracerebral hemorrhage (ICH) in patients aged from to
      9/44 years (male: 20, female: 13, mean age: 32.5 years). ICH was due to vascular
      malformations in 39 p. 100 of cases, to arterial hypertension in 30% and to
      various causes in 18% no cause could be found in 13% of the cases. ICH was lobar
      in 64%, deep in 33% and infratentorial in 3% of the cases. The diagnosis was
      assessed by arteriography in 9 patients. The vascular malformations were arterial
      angiomas, saccular aneurysms and cavernous angiomas. Death rate was 24%. There
      was a fast ICH handicap in 40% of cases. Only 36% of the patients were not
      disabled.

PMID- 1763255
TI  - [Prolonged traumatic coma caused by diffuse axonal lesions].
AB  - A 22-year old male patient was admitted for deep coma probably of traumatic
      origin. There was neither fracture of the skull nor expansive intracranial
      lesion. The patient survived for 6 years and 8 months without any change in
      consciousness. Post-mortem neuropathological examination showed lesions which
      predominated in the white matter and had features that were compatible with
      diffuse axonal injury. The mechanism responsible for these lesions seems to be
      stretching and shearing of axones at the moment of impact. The exceptionally long
      duration of survival probably accounts for the severity of the lesions observed.

PMID- 1763256
TI  - [Sensory neuropathy and subacute dysautonomia. Clinical and pathological study].
AB  - We report a case of severe subacute autonomic and sensory neuropathy in a 52 year
      old man. Cerebrospinal fluid protein was 275 mg/dl. Electrophysiological data
      were consistent with an axonal sensory neuropathy. Nerve biopsy showed a severe
      decrease in myelinated fibers, and a less severe loss of unmyelinated fibers. No
      cause was found and recovery was almost complete over 4 years, with minimal
      persistent dysautonomia. This case and 4 similar reported cases are compared with
      pure dysautonomia and with sensorimotor dysautonomic neuropathy. The site of
      damage is discussed and it is suggested that these cases are axonal forms of
      inflammatory polyneuropathy.

PMID- 1763257
TI  - [Left pseudothalamic cortical syndrome and pain asymbolia].
AB  - We report a case of left pseudothalamic cortical syndrome associated with
      asymbolia for pain in a right-handed male patient. The responsible lesion,
      detected at both CT and MRI, was infarction of the superficial territory of the
      middle cerebral artery, restricted to the posterior insula, the superior aspect
      of T1, the parietal operculum and the supramarginal gyrus. The ascending parietal
      gyrus and the thalamus were spared. This case, together with data from the
      literature, suggest that the somatosensory area II was responsible for the
      pseudothalamic syndrome. This interpretation is concordant with the hypothesis
      that S II plays the principal role in passive somatosensory discrimination,
      whereas S I plays the principal role in active discrimination implying stimulus
      exploration. The location of lesions that were responsible for asymbolia for pain
      is discussed. This case and those reported by Berthier et al. (1988), provide
      arguments in favour of Geschwind's hypothesis which attributes asymbolia for pain
      to sensory-limbic disconnection due to damage of the insula.

PMID- 1763258
TI  - [Ataxic hemiparesis and simultaneous supra- and subtentorial hematomas].
AB  - In a chronically hypertensive woman with a rapidly developing right ataxic
      hemiparesis syndrome, computed tomography and magnetic resonance imaging (MRI)
      revealed two small unrelated hemorrhages: one in the posterior limb of the left
      internal capsule, the other in the right cerebellar hemisphere. In this patient,
      the ataxic hemiparesis syndrome might have resulted either from the association
      of the two lesions or from the capsular hemorrhage alone. The rarity of
      simultaneous hypertensive hematomas and the value of MRI in the diagnosis are
      underlined.

PMID- 1763259
TI  - [Opsoclonus associated with multisystemic sarcoidosis].
AB  - A 32 year old patient with unexplained cough developed an opsoclonus-ataxic
      myoclonic syndrome. Chest X-ray film were normal at this onset but became
      pathologic, and the diagnosis of multisystemic sarcoidosis was made. The
      possibility of sarcoidosis being the cause of the opsoclonus is discussed.

PMID- 1763260
TI  - [Nuclear oculomotor nerve syndrome and ocular tilt reaction caused by
      mesencephalic hematoma].
AB  - A 78-year-old man had a midbrain hemorrhage, documented by CT scan and MRI,
      resulting in a mild cerebellar syndrome predominant on the left upper limb,
      lateropulsion, and a complex ocular motor syndrome. The latter was associated
      with right nuclear oculomotor nerve palsy, gaze paresis to the left for voluntary
      saccades, and a tonic ocular tilt reaction. Pathophysiological mechanisms are
      discussed.

PMID- 1763261
TI  - [Axonal polyneuropathy in Chagas disease].
AB  - We report the case of a 44-year-old woman presenting with chronic symmetrical,
      sensitive polyneuropathy on the lower limbs in the course of Chagas' disease. The
      electrophysiological findings were in keeping with axonal degeneration. The
      histological data displayed axonal degeneration with perivascular inflammatory
      mononuclear cells in the epineurium, with some neutrophils and eosinophils.
      Mononuclear cells surrounding endoneurial vessels were observed. Laboratory data
      did not suggest neither a mixed connective tissue disease nor a collagen vascular
      disorder. Hematological disease, malignancies, drug-or medicine-induced
      neuropathy were ruled out. The polyneuropathy in this case was probably related
      to Trypanosoma cruzi infection on account of the presence of high levels of anti
      T. cruzi antibodies, and an immune mechanism might play a role in the vasculitic
      process.

PMID- 1763262
TI  - [Acute corticosteroid myopathy in patient with asthma].
AB  - A patient, treated by mechanical ventilation with pancuronium or atracurium and
      with intravenously administered corticosteroid for status asthmaticus, presented
      with rhabdomyolysis (severe amyotrophy and marked of creatine kinase activity)
      and acute flacid and areflexic quadriplegia, involving the proximal and distal
      muscles but sparing the cephalic musculature. After review of the investigations
      (biochemistry, electromyogram, muscle biopsy), the diagnostic of acute
      corticosteroid myopathy following status asthmaticus was suggested, and a
      pancuronium neuromuscular complication or a critically ill polyneuropathy
      excluded. The non-inflammatory rhabdomyolysis concerned all the fiber types.
      Predominantly distal weakness resolved six months after the insult, in spite of
      the laboratory recurrence of the rhabdomyolysis at the time of a new status
      asthmaticus briefly treated with corticosteroid.

PMID- 1763263
TI  - [The corpus luteum and progesterone secretion].
AB  - The pulsatility of LH secretion has been known only since 1970. The pulsatility
      of progesterone secretion has now also been shown. The frequency and amplitude of
      these pulses vary during the three phases of the luteal period. The first or
      early luteal (EL) phase lasts four days starting from the peak of LH. There is no
      pulsatility of progesterone during EL. The frequency of LH pulsatility is 103 +/-
      8 minutes. The second or mid luteal (ML) phases, from +6 to +9 days after the
      peak of LH, is characterised by pulses of LH and of progesterone, most often in
      positive crossover correlation and with 7 to 14 pulses per 24 hours. The
      frequency of LH pulsatility is 166 +/- 33 minutes according to Filicori. The
      amplitude of LH secretion is 4 to 40 ng/ml. The third or late luteal (LL) phase,
      occurring at +11 days before the menstrual period, has the same characteristics
      in terms of quality but shows variations in frequency and amplitude towards a
      decrease. Thus the amplitude of progesterone secretion is 2.8 to 9 ng/ml
      (Veldhuis). In the opinion of clinicians, the corpus luteum is independent up to
      LH+ 5 days. The injection of hCG during this time is ineffective. A single
      progesterone level is sufficient if the result is 10 ng/ml or more. The problem
      remains complex concerning results below 10 ng/ml. The solution suggested for the
      present is that described by Olive: during ML and/or LL, three samples in the
      morning at hourly intervals and two endometrial biopsies during two consecutive
      cycles.

PMID- 1763264
TI  - [The value of endometrial biopsy in the assessment of the corpus luteum].

PMID- 1763265
TI  - [The role of umbilical Doppler in the monitoring of pregnancy].
AB  - Doppler recordings from the umbilical cord in utero explores the placental
      reserves and fetal well being. Compliance with the technical conditions of
      performance ensures reliability of the determination. This examination predicts
      the state of the child at birth, particularly in cases of delayed intra-uterine
      growth, maternal hypertension or gestosis, and in cases of twin pregnancies. The
      change is maximum when the umbilical diastolic flow disappears. In the absence of
      any pathological context, a congenital or chromosomal abnormality should be
      considered and the fetal karyotype should be determined. Follow-up is carried out
      during hospitalization, and the decision on whether to extract the fetus is based
      on cerebral Doppler recordings and a detailed analysis of the fetal heartbeat.

PMID- 1763266
TI  - [The role and limits of Doppler studies of the uterine arteries].
AB  - Doppler study of the uterine arteries investigates the utero-placental vascular
      bed. It can be used to identify a population at risk of vascular complications,
      in particular retroplacental hematoma. This type of study is indicated when there
      is a history of a vascular problem during pregnancy, as well as following the
      onset during pregnancy of hypertension, pre-eclampsia, delayed intrauterine
      growth or thrombocytopenia. The measurement technique avoids neighbouring
      vessels. An abdominal or vaginal approach may be used. The quality of the signal
      recorded and compliance with practical technical aspects enable long term
      prediction of the course of the pregnancy and the organisation of appropriate
      obstetric monitoring.

PMID- 1763267
TI  - [Utero-placental circulation].

PMID- 1763268
TI  - [Distribution of the concentrations of angiotensin II (A II), A II receptors,
      hPL, prolactin, and steroids in human fetal membranes].
AB  - By analyzing human trophoblastic tissues at the full term of pregnancy, this
      study shows the highest levels of angiotensin-II (729 +/- 111 and 602 +/- 105
      pg/g of tissue), angiotensin-II receptors (295 +/- 30 and 250 +/- 32 fmol/mg
      proteins), human placental lactogen (973 +/- 154 and 680 +/- 28 micrograms/g) and
      progesterone (1,501 +/- 193 and 1,070 +/- 151 ng/g) in chorionic villi and in
      placental basal plate respectively. Tissue values of angiotensin-II, hPL and
      Progesterone were 4 times superior to those obtained in amniotic fluid and in
      umbilical and maternal blood. Estradiol values in chorionic villi were similar to
      those in placental basal plate, in chorionic plate and in chorion, but
      significantly higher (p less than 0,001) than in amnion, amniotic fluid and in
      umbilical and maternal blood. The concentrations of prolactin in chorion were 3
      times superior than those found in amnion, in placental tissue, in amniotic fluid
      and in umbilical and maternal blood. A positive correlation was observed between
      Angiotensin-II and its receptors and also with hPL, P4/hPL ratio and E2/P4 ratio.
      Thus, angiotensin-II could play an important role in the physiology of pregnancy,
      due to its vasopressive action and due to its interactions with other peptides
      and chorio-placental steroids.

PMID- 1763269
TI  - [Von Recklinghausen's disease and pregnancy].
AB  - On the basis of six cases and a review of the literature, the authors identify
      the special features associated with the combination of von Recklinghausen's
      disease and pregnancy. Fertility is unaffected and pregnancy possible. Careful
      monitoring is required because of severe complications. In certain probably minor
      forms of the disease, the outcome of pregnancy is favourable with no
      complications.

PMID- 1763270
TI  - [Multiple pregnancies. Neonatal morbidity and mortality].
AB  - The increase in the number of multiple pregnancies and the high incidence of
      prematurity in this type of pregnancy justifies a pediatric evaluation. A
      retrospective study (1985-1989) compared the perinatal and neonatal
      characteristics of children resulting from 14 multifetal (at least 3 fetuses)
      pregnancies, with a gestational age of less than 34 weeks, with 27 children
      resulting from monofetal pregnancies of the same duration. Neonatal morbidity and
      mortality appeared to be similar in both groups. Thus at this very early time of
      onset of labour (mean gestational age of 30 weeks), fetal multiplicity expressed
      itself neither by any particular neonatal pathology nor by malnutrition.

PMID- 1763271
TI  - [Classic complication of uterine revision after a late abortion: uterine
      synechia. Current review based on two cases].
AB  - The authors use two personal cases to review the etiological circumstances,
      pathology and clinical and paraclinical manifestations, stressing in particular
      the current value of diagnostic and therapeutic hysteroscopy. Advice is given
      concerning prevention and treatment.

PMID- 1763272
TI  - [Uterine rupture due to unrecognized uterine scarring].
AB  - Uterine rupture affecting the pregnant uterus has become rare. It occurs
      essentially in the presence of scarring. The cases reported here described
      rupture following evacuation curettage which had caused an unrecognized uterine
      perforation. While such perforations often have no serious consequences, this
      explaining the usual abstention from treatment, it is nevertheless important that
      acute complications (intestinal or vascular trauma) or long term (uterine rupture
      of pregnant uterus) should not pass unrecognized.

PMID- 1763273
TI  - [A twin pregnancy in a bicornuate uterus].
AB  - A case of twin pregnancy in bicornuate uterus with a fetus in each horn is
      presented. During the second trimester, the rudimentary horn ruptured. This horn
      was extirpated and two non viable fetus were delivered by cesarean section. Later
      on, the patient had another pregnancy in the unicornuate uterus. She was
      delivered at 36th week of pregnancy by cesarean section. The baby was in good
      condition.

PMID- 1763274
TI  - The varied uses of gallstones.

PMID- 1763275
TI  - The language of epidemiology (VI): prevalence.

PMID- 1763276
TI  - The natural and unnatural history of gallstones.

PMID- 1763277
TI  - Assisted reproductive technics for the treatment of male factor infertility.
AB  - Several treatment choices remain for the couple with male factor infertility due
      to idiopathic male infertility or in couples in which specific therapy has
      failed. Empiric medical therapy continues as a viable option; however, the
      physician and patient must understand that the success rates with any of the
      pharmacological therapies remain suboptimal. In addition, this therapy should
      only be used for patients with idiopathic male infertility. It is not indicated
      for other classes of infertile males. Another option is that of IVF and related
      technologies. These technics continue to improve and we can expect more specific
      technics to be developed to optimize fertilization and pregnancy rates in those
      couples with male factor infertility. At the present time, the pregnancy rates
      achieved with this technology in male factor couples are less than those in non
      male factor patients. In addition, all of these technics entail considerable
      expense, often not covered by insurance. The third alternative for the patient
      with idiopathic male infertility is that of therapeutic insemination with the
      husband's sperm. Recent studies combining ovarian hyperstimulation with IUI
      suggest a clear advantage of this technic over other insemination approaches. As
      this treatment is significantly less expensive and time-consuming than the prior
      therapies, it should be considered when choosing therapy. Additional choices the
      couple with male factor infertility should consider are adoption and therapeutic
      donor insemination. It is only after careful consideration of all the available
      options that an appropriate decision can be made. This will vary, depending on
      the particular clinical characteristics of the couple as well as their social and
      financial situation.

PMID- 1763278
TI  - Hospitalizations for biliary tract disease, 1990.

PMID- 1763279
TI  - Doctors, drug companies and gifts.
AB  - This paper by Chren and Landefeld was originally presented at the Miriam Hospital
      on March 21, 1991, as the 1991 Lichtman Oration, an annual meeting devoted to
      ethical problems in medicine honoring Herbert C. Lichtman, MD, former physician
      in-chief at the hospital. Because of the importance of this paper, and its
      controversial character, the Journal has asked a number of practicing physicians
      and other concerned persons to offer their opinions on this paper. These
      commentaries will then be published in a subsequent issue of the Journal, along
      with reactions by our readers.

PMID- 1763280
TI  - Light and transmission-electron microscopy study of enamel organ cells in
      germectomized human third mandibular molars.
AB  - Using nine serially sectioned germectomized mandibular third molars it was
      possible to examine light microscopical (LM) and transmission-electron
      microscopical (TEM) features of maturing human enamel organ cells. The degree of
      enamel mineralization was estimated by quantitative imbibition studies in
      polarized light. It was possible to distinguish between three progressive stages
      of enamel mineralization. The most advanced stage was characterized by external
      enamel porosity. In the least advanced stages the enamel porosity appeared more
      extensive beneath a less porous surface layer. Ruffle- and smooth-ended
      ameloblasts were identified corresponding to the maturing enamel. Smooth-ended
      ameloblasts were the most frequently observed. However, no preferences for one of
      the two cell types could be observed in relation to the different stages of
      enamel mineralization. The maturing human enamel organ cells broadly revealed the
      same characteristics with respect to morphology features, intracellular
      organization, and junctional complexes as described in the maturation zone of the
      rat incisor enamel organ. Our findings therefore add to the view that the basic
      pattern of amelogenesis is identical in human and rat incisor enamel.

PMID- 1763281
TI  - Experimental erosion of dentin.
AB  - Experimental erosion in human dentin was investigated with scanning electron
      microscopy. Erosion was caused by solutions containing either 0.030 mekV/g malic
      acid (pH 3.4), 0.034 mekV/g phosphoric acid (pH 2.6), or 0.038 mekV/g citric acid
      (pH 2.8). Test specimens prepared from the coronal parts of erupted third molars
      were immersed in the solutions from 30 s to 60 min. When compared with controls,
      exposure of dentin tubules was observed in all the specimens already after 30 s
      immersion, irrespective of the acid used. Mineral loss was seen to progress at
      the interface between peritubular and intertubular dentin in specimens immersed
      for 60 s in the acidic solutions. Longer times of immersion resulted in hollowing
      of the tubular openings by complete destruction of the peritubular dentin.
      Surface roughness and porosities were seen also at the intertubular areas.
      Although based on a simplified study model, our results may explain why so many
      patients with erosions suffer from painful sensitivity of their teeth: the acids
      causing erosion can expose inner dentin structures to outer stimuli by
      significant enlargement of the dentinal tubules.

PMID- 1763282
TI  - Irradiation of human dental tissues with CO2-, Nd:YAG-, and CO2-Nd:YAG
      combination laser.
AB  - Extracted third molars were used to study the effect of Nd:YAG laser irradiation
      combined with CO2 laser beam on dental hard tissues. The specimens were studied
      with SEM after lasing and the size of the impact areas and beam penetration into
      enamel and dentin were planimetrically analyzed. High-energy CO2 laser (e.g. 10 s
      irradiation with 10 W output energy) penetrated all enamel and dentin. The
      simultaneous addition of Nd:YAG irradiation to the CO2 beam was found to increase
      the effect of CO2 laser, while Nd:YAG irradiation alone, used with equivalent
      energy densities, did not cause any effect on enamel surface. Thus, Nd:YAG laser
      was found to potentiate statistically significantly the effect of CO2
      irradiation, but the morphologic alterations on dental hard tissues, such as
      crater formation at the beam focus site, appeared to be due to CO2 irradiation
      alone.

PMID- 1763283
TI  - Concepts of health and disease and caries prediction: a literature review.
AB  - Biomedical determinants of dental caries have been more extensively investigated
      than psychosocial factors and their impact on caries prevalence and incidence
      seems to be greater. However, a majority of these investigations relate to
      children and adolescents. An implementation of social and psychologic variables
      may be more relevant regarding dental caries in adults. In addition, a
      multidisciplinary approach might improve our understanding of dental caries as a
      multifactorial disease and bridge the gap between a biomedical concept and a more
      holistic approach to dental health.

PMID- 1763284
TI  - Effect of whole saliva on the rheologic behavior of extracellular water-soluble
      glucan produced by Streptococcus mutans.
AB  - The viscosity of mixtures of Streptococcus mutans water-soluble glucan and
      stimulated whole saliva or buffer was measured at pH 5, 6, 7, and 8. The
      viscosity was measured as a function of shear rate in the range 15 s-1-230 s-1.
      Though the centrifuged saliva had a viscosity close to that of water it increased
      the viscosity of the glucan up to 65% at pH 6 and 55% at pH 7 and at a shear rate
      of 20 s-1, indicating an interaction between saliva components and glucan that
      could be an important part of the cohesive forces of plaque matrix. The
      interaction between saliva and glucan was less pronounced at pH 5 and 8, which
      indicates a charge-dependent interaction. The viscosity increase at pH 6 and 7
      was higher at low than at high shear rates, suggesting a higher contribution to
      plaque stability when weak as opposed to high mechanical forces are exerted on
      the plaque.

PMID- 1763285
TI  - Oral implantation in man of Streptococcus mutans in relation to salivary IgA
      activity.
AB  - Oral implantations of and salivary IgA activity against a freshly isolated
      Streptococcus mutans strain and a repeatedly subcultured variant strain were
      studied in 20 subjects. The variant strain was eliminated at a higher rate than
      the parent strain. Both strains were eliminated at a lower rate in subjects with
      high oral levels of indigenous mutans streptococci than in subjects with low
      levels of these microorganisms. Subjects with high respectively low IgA activity
      against the parent strain also had high respectively low IgA activity against the
      variant strain (P less than 0.01). The correlation between IgA activity and
      clearance rate of implanted bacteria was not statistically significant. However,
      following both implantations, median values of IgA activity were consistently
      higher in subjects who had eliminated the implanted strain than in subjects who
      had not.

PMID- 1763286
TI  - Interactions between and within Streptococcus mutans and Streptococcus sobrinus
      isolated from humans harboring both species.
AB  - The prevalence of Streptococcus mutans and Streptococcus sobrinus was examined in
      plaque samples from small discrete areas of the buccal tooth surfaces of seven
      subjects. Strains of S. mutans and S. sobrinus were isolated and tested for
      bacteriocin-mediated interactions between and within the two species, using the
      stab inoculation technique. S. mutans and S. sobrinus did not colonize each tooth
      surface uniformly and, in plaque from small discrete sites, S. mutans and S.
      sobrinus were either undetected or present in different interspecies proportions.
      Within the same subject, there were no bacteriocin-mediated interactions between
      strains of the same mutans species and no difference in bacteriocin activity was
      found between the strains of S. mutans and S. sobrinus from different sites. When
      bacteriocin interactions were tested between isolated strains from all seven
      subjects a somewhat higher inhibition ability was found for producer strains
      isolated from plaque compared with those isolated from saliva. S. mutans appeared
      to be more bacteriocinogenic than S. sobrinus. Replacing the glucose in the
      medium with sucrose enhanced the bacteriocin activity of S. mutans towards other
      S. mutans strains but reduced the inhibitory interaction towards strains of S.
      sobrinus.

PMID- 1763287
TI  - Effect of repeated sampling and prestimulation on saliva buffer capacity and flow
      rate values in children.
AB  - Great variations reported in the frequency distribution of buffer capacity values
      may partly be due to methodological differences in saliva sampling. In this study
      we wanted to see to what extent these variations are due to repetition and
      prestimulation. 9-yr-old schoolchildren (n: 41, 23 girls and 18 boys), who had
      never had saliva samples taken before, participated in the present study. The
      repetition tests were carried out between 9 and 11 a.m. on three subsequent days.
      The effect of prestimulation was tested 4 days later with the same subjects. The
      buffer capacity of the samples was determined electrometrically immediately after
      sampling using the commercial Dentobuff-test. The intraindividual analysis
      revealed a significant increase in flow rate but not in buffer capacity along
      with repetition of the sampling. The analysis further showed that the buffer
      capacity of children accustomed to saliva sampling increased significantly
      through prestimulation of 1 min. The use of prestimulation resulted in
      substantial changes also in the frequency distribution of the buffer capacity
      values. Our results emphasize the importance of proper sampling conditions in
      saliva collection when screening children for high caries risk.

PMID- 1763288
TI  - Conceptions of dental amalgam and oral health aspects during pregnancy in Finnish
      women.
AB  - All 277 pregnant women (mean age 28.4 yr, SD 4.6) living at the Lohja municipal
      health center area in Southern Finland participated in a survey during the first
      6 months in 1990. The women's own opinions of the effect of pregnancy on their
      oral health were questioned during their first trimester of gestation. A special
      emphasis was put on the attitudes of dental restorative materials. The results
      showed that 57% of the subjects would have accepted the use of any restorative
      material during pregnancy while 43% were against one or more materials. 77 (65%)
      were opposing dental amalgam. 129 women (47%) were of the opinion that pregnancy
      as such is detrimental to their dental health. This opinion was significantly
      more frequent among women who were pregnant for third or more times than those
      having their first gestation. 70 (26%) thought dental treatment to have an effect
      on their gestation. Also 70 subjects (26%) thought that dental treatment may
      affect normal development of the fetus. The results showed that in spite of the
      long tradition in maternity counseling in Finland, the conceptions among pregnant
      women are often erroneous from the dental point of view.

PMID- 1763289
TI  - Fracture toughness measurements of some dental core ceramics: a methodologic
      study.
AB  - Fracture toughness is regarded as an important property of dental ceramics. The
      most widely used methods for fracture toughness (KIc) determination are based on
      assessment of cracks created by hardness indentations. Different formulas have
      been developed for KIc calculations and all these methods and formulas include
      empirical factors based on pure ceramics, i.e. non-composite ceramics. These
      factors may, however, vary for a specified method for materials with different
      and complex structure. An important question is whether the various proposed
      methods and formulas lead to approximately the same numerical KIc values or at
      least to the same ranking of materials. The aim of this work was to compare two
      indentation methods and various formulas for calculation of KIc values when used
      on four commercial composite dental ceramics. The two applied methods and the
      different formulas showed substantial differences in the obtained values for one
      and the same material and a different ranking of various materials. It is unknown
      which method gives the most correct KIc values for these ceramic materials.

PMID- 1763290
TI  - In vitro antibacterial effect of chlorhexidine added to glass-ionomer cements.
AB  - The aims of the present study were to investigate the antibacterial properties of
      glass-ionomer cements containing different concentrations of chlorhexidine and
      the possible release of chlorhexidine from the compound. Chlorhexidine gluconate
      or diacetate was mixed with glass-ionomer cements and tested in vitro against
      strains of Lactobacillus casei and mutans streptococci. A spectrophotometric test
      was used to monitor the release of chlorhexidine from the mixture. In a broth
      culture test, the higher the concentrations of chlorhexidine in the mixture, the
      longer the time of antibacterial effect on Streptococcus mutans and the greater
      the tendency of the material to deteriorate. Agar diffusion tests revealed
      bacterial inhibition in a dose-response manner. The tested bacterial strains were
      similarly inhibited and the antibacterial properties decreased with time. A minor
      portion of added chlorhexidine was released from the cement. The deterioration of
      the cements indicates that the material could be useful as a varnish-like
      chlorhexidine carrier.

PMID- 1763291
TI  - The eosinophil in inflammatory bowel disease.

PMID- 1763292
TI  - Budesonide enema in distal ulcerative colitis. A randomized dose-response trial
      with prednisolone enema as positive control. The Danish Budesonide Study Group.
AB  - The effect of budesonide, 1, 2, and 4 mg/100 ml in daily enemas, on active distal
      ulcerative colitis was compared with that of prednisolone disodium phosphate
      enemas, 25 mg/100 ml, in a multicentre, randomized, group-comparative trial. A
      total of 146 patients with active disease were treated for 2 weeks. Data from 139
      were valid for statistical analyses. Bowel habits, proctoscopy findings, and
      histologic pictures were evaluated, and plasma cortisol was determined for
      measurement of influence on the hypothalamic-pituitary-adrenal axis. Clinical
      symptoms and proctoscopy findings improved within all treatment groups. The
      improvement of these effect variables tended to be less after treatment with the
      lowest dose of budesonide, 1 mg/100 ml, than after the other treatments. Plasma
      cortisol did not change in any of the budesonide groups, whereas a mean reduction
      of 30% (P = 0.07) was observed after prednisolone. It can be concluded that
      budesonide enemas of 2 mg/100 ml constitute an attractive alternative to
      prednisolone enemas for topical treatment of distal ulcerative colitis.

PMID- 1763293
TI  - Inhibition of gastrin release induced by fundic distension. Evidence of a
      defective inhibition in duodenal ulcer patients.
AB  - The serum gastrin response to an infusion of gastrin-releasing peptide (GRP),
      with or without simultaneous fundic distension, was studied in healthy volunteers
      and in patients with duodenal ulcer disease before and after a complete proximal
      gastric vagotomy (PGV). We also studied the effect of fundic distension alone on
      gastrin release and intraluminal gastric pressure in healthy volunteers and in
      patients after PGV. We observed an increased intraluminal pressure in patients
      after PGV compared with healthy subjects. During fundic distension with 600 ml of
      air no significant increase in gastrin values was observed in healthy subjects or
      in duodenal ulcer patients. In healthy subjects fundic distension significantly
      inhibited the gastrin response to the higher dose of GRP. This inhibitory effect
      exerted by fundic distension was counteracted by cholinergic blockade. In
      contrast, fundic distension did not alter the gastrin response to GRP in duodenal
      ulcer patients, suggesting a defective inhibitory mechanism in duodenal ulcer
      patients. After PGV, GRP infusion resulted in an enhanced gastrin response, and
      fundic distension seemed to facilitate the gastrin-stimulatory effect of GRP.
      This supports the concept of a vagally dependent inhibitory oxyntopyloric
      mechanism and that fundic distension can elicit both inhibitory and stimulatory
      secretory mechanisms.

PMID- 1763294
TI  - Mucosal surface area of a reversed intestinal segment in rats.
AB  - Only scarce knowledge exists of morphologic changes after antiperistaltic
      reversal of the small intestine. Previous animal models using a reversed segment
      of the small intestine after massive intestinal resection have been mostly
      concerned with assessing absorption. A rat model was therefore developed for the
      purpose of studying mucosal surface area in the small intestine after reversal of
      an intestinal segment. A reversal of 10 cm, representing a length of about 10%,
      was found suitable for the investigation. Marked dilatation of the reversed
      segment occurred. A pronounced increase in mucosal surface area caused by mucosal
      hyperplasia was observed. The mucosal surface area in an anastomosed, but not
      reversed, segment also increased markedly compared with a group undergoing no
      operation, although less than in the reversed segment. We conclude that a
      reversed intestinal segment will increase mucosal surface area in an optimal
      length used for this purpose. This increase is possibly caused by prolonged
      exposure to intestinal chyme.

PMID- 1763295
TI  - Incidence and prevalence of ulcerative colitis in Copenhagen county from 1962 to
      1987.
AB  - The incidence of ulcerative colitis was estimated during the period 1962 to 1987
      in the county of Copenhagen. Within this area of approximately 550,000
      inhabitants, 1161 patients were diagnosed. The mean annual incidence for the
      period was 8.1 per 10(5) inhabitants. There were significant increases in
      incidence in the early 1970s and in the early 1980s, both of which were followed
      by significant decreases. A bimodal age distribution was found in men, with
      incidence peaks in young adult life and late in life. In women a peak incidence
      was found in the young adult age group. The interval from onset of symptoms to
      diagnosis in terms of years remained unchanged over the period, with a median of
      1 year (range, 0-37 years). The extent of disease at diagnosis was total colon in
      18% of the patients, a substantial part of the colon in 36%, and distal colon in
      44%--with no changes during the study period. The distribution of different
      localizations did not differ among age groups except for a tendency towards more
      extensive disease in young patients, below 20 years of age. The disease activity
      in the 1st year was fulminant in 9.1% of the cases, moderate to high in 70.7%,
      and low in 20.2%, with a tendency towards higher activity in patients diagnosed
      late in the study period. The prevalence of ulcerative colitis increased steadily
      during the study period, reaching a value at the end of the study (31 December
      1987) of 161 per 10(5) inhabitants.

PMID- 1763296
TI  - Scintigraphic determination of gastrointestinal transit times. A comparison with
      breath hydrogen and radiologic methods.
AB  - A scintigraphic method for determination of gastrointestinal transit times was
      compared with the breath hydrogen test and a multiple-bolus, single-radiograph
      technique. A close temporal association was found between the caecal appearance
      of radioactivity and the onset of breath hydrogen excretion in eight healthy
      subjects. Neither mean small-intestinal nor mean orocaecal transit times of the
      radiolabelled marker were correlated with the magnitude of hydrogen peak,
      hydrogen peak time, or the area under hydrogen curve. No correlation was noted
      between whole-gut transit time of the radiolabelled marker and mean whole-gut
      transit time calculated from a 6-day administration of the radiopaque marker in
      16 healthy subjects. The stool weight was inversely correlated with the mean
      colonic (r = -0.46, p = 0.009) and the mean whole-gut (r = -0.45, p = 0.011)
      transit times of the radiolabelled marker. In conclusion, inadequate delineation
      of the caecal region seems to be an unimportant drawback of the scintigraphic
      measurements, whereas day-to-day variation in gastrointestinal transit rates may
      influence the reliability of the assessments. Probably, quantitative transit data
      cannot be obtained from the breath hydrogen concentration profiles.

PMID- 1763297
TI  - Effect of biliary tract procedures on duodenogastric reflux and the gastric
      mucosa.
AB  - The effect of alterations in the biliary tract on the gastric milieu was
      evaluated in gallstone disease and after cholecystectomy or biliary fenestration
      and compared with a control group. Endoscopic bile reflux was often found in
      gallstone patients (67%) and almost always after cholecystectomy (89%). Gastric
      bile acid concentrations were greater in the gallstone patients than in the
      control patients, were higher still after cholecystectomy, and were highest after
      biliary fenestration. The pH of the gastric fluid was more alkaline in the
      cholecystectomized groups. Lysolecithin concentrations were generally low and did
      not differ between the groups, nor was there any difference in scintigraphic
      reflux between the groups. Endoscopic erythematous gastritis correlated with the
      grade of bile reflux and was a common finding after biliary tract procedures.
      There were no consistent histologic findings associated with duodenogastric
      reflux. Helicobacter pylori colonization rates were similar in the various
      patient groups and were not affected by the reflux grade.

PMID- 1763298
TI  - Gallbladder sensitivity to cholecystokinin in coeliac disease. Correlation of
      gallbladder contraction with plasma cholecystokinin-like immunoreactivity during
      infusion of cerulein.
AB  - The present study was undertaken to determine whether alterations in the
      gallbladder sensitivity to cholecystokinin (CCK), apart from a reduced endogenous
      CCK secretion, contribute to the abnormally decreased postprandial gallbladder
      contraction in patients with coeliac disease. Gallbladder emptying, measured by
      cholescintigraphy, and plasma CCK levels, measured by radioimmunoassay, were
      studied during infusion of graded doses of the CCK analog cerulein in six coeliac
      patients with subtotal villous atrophy, six coeliac patients on a gluten-free
      diet with normal villous architecture, and nine control subjects. Both in the
      patients and in the controls infusion of stepwise increasing doses of cerulein,
      in the range of 1-16 ng.kg-1.h-1, induced dose-related changes in plasma CCK-like
      immunoreactivity (CCK-LI) (r = 0.99; p less than 0.001) and gallbladder emptying
      (r greater than 0.97; p less than 0.01-p less than 0.001). Plasma CCK-LI and
      gallbladder responses were not significantly different among untreated coeliac
      patients, treated coeliac patients, and controls. Gallbladder sensitivity to
      cerulein in untreated and treated coeliac patients was not significantly
      different from that in controls. It is concluded that the abnormally decreased
      gallbladder contraction in coeliac patients is the result of a reduced endogenous
      CCK secretion and not of a lack of end-organ responsiveness to CCK.

PMID- 1763299
TI  - Risk of recurrence and reoperation after resection for ileocolic Crohn's disease.
AB  - To evaluate possible risk factors for recurrence after primary resection of
      ileocolic Crohn's disease, the clinical course of 48 consecutive patients
      operated on over a 27-year period were reviewed. Median follow-up was 10 years
      (range, 3-27 years). The probability of not having a recurrence and the
      probability of not undergoing a second resection were 0.476 (+/- 0.191, 95%
      confidence limits) and 0.701 (+/- 0.180), respectively, after 10 years. None of
      the possible risk factors examined--sex, age at the primary resection, length of
      preoperative history, length of bowel involvement, failure of preoperative
      medical treatment, and residual microscopic disease at resections lines-
      significantly influenced the risk of recurrent disease (P greater than 0.05, log
      rank test); however, there was a trend towards a higher risk of recurrence for
      the patients who had received medical treatment preoperatively. In the present
      study it was not possible to identify any factors that influenced the risk of
      recurrence.

PMID- 1763300
TI  - [Thrombocyte-vascular wall interaction and coronary heart disease].
AB  - The interaction of platelets with the vessel wall plays an important
      pathophysiological role in coronary artery disease. While in healthy blood
      vessels platelets remain inactivated and do not adhere or aggregate, an augmented
      interaction occurs in coronary artery disease. Due to their strategic anatomical
      position between the circulating blood and the media of the vascular wall,
      endothelial cells play an important regulatory role. Indeed, after endothelial
      denudation, massive platelet adhesion and aggregation at the vessel wall occurs.
      Platelet-derived substances lead to vasoconstriction and in the long run also to
      proliferative changes of the vascular wall. Besides other substances, endothelial
      cells release vasoactive mediators such as endothelium-derived nitric oxide (NO),
      prostacyclin and endothelin. In healthy human arteries, aggregating platelets
      cause endothelium-dependent relaxations in spite of the liberation of serotonin
      and thromboxane A2 and through the luminally released NO also induce a feedback
      inhibition of the platelets. In contrast, in arteries without endothelium, a
      marked vasoconstriction (due to thromboxane A2 and serotonin) is noted.
      Endothelin may also play a role in platelet-vessel wall interaction, since
      thrombin and transforming growth factor beta (a platelet-derived product)
      stimulate the production of this potent vasoconstrictor. Oxidized low-density
      lipoproteins inhibit the relase of NO and thereby activate the platelet-vessel
      wall interaction. In atherosclerosis even more pronounced dysfunctions of the
      endothelium occur, which lead to vasoconstriction, ischemia and thrombus
      formation in patients with coronary artery disease.

PMID- 1763301
TI  - [Drug therapy prevention of coronary sclerosis].
AB  - Primary preventive drug treatment of coronary artery disease (CAD) has gained
      importance in recent years as more efficient lipid lowering drugs and substances
      with new mechanisms become available, e.g. calcium entry blockers and
      antioxidants. For lipid lowering drugs, the exact mechanism of action is still
      not clear; the results of quantitated coronary angiography (QCA) revealing a
      small but significant increase in luminal size in stenotic areas can be explained
      both by stabilization of endothelial function (increased EDRF production)--as
      demonstrated in animal studies--leading to a decrease in basal tone, and by a
      decrease in plaque volume (so far not evidenced by QCA in man). Calcium entry
      blockers and antioxidants inhibit the formation of new atherosclerotic lesions,
      mainly by improving cholesterol excretion from vascular smooth muscle cells and
      macrophages into the extracellular space, and by suppression of proliferation and
      differentiation of vascular smooth muscle cells. The ensuing reduction of cardiac
      events is not yet proven for calcium entry blockers and also needs further
      confirmation for lipid lowering drugs; the difficulty of studies looking for
      clinical endpoints (myocardial infarction on sudden coronary death, unstable
      angina) lies in the very slow anatomical progression of CAD as demonstrated by
      QCA, demanding large numbers of patients and long intervals to demonstrate
      statistical significance.

PMID- 1763302
TI  - [Aortoiliac occlusive disease: yesterday and today].
AB  - The surgical management of aortoiliac atherosclerotic occlusive disease includes
      endarterectomy and prosthetic by-pass in either the anatomical or extraanatomical
      position. Aortoiliac endarterectomy is only indicated in localized disease which
      spares the external iliac artery and does not exhibit aneurysmal changes.
      Prosthetic by-pass is easier to perform, but carries graft-related risks
      including anastomotic pseudoaneurysms in 5 to 10% of cases at 10 years.
      Extraanatomical shunts are performed when there are general or abdominal
      contraindications to an anatomical by-pass. Simultaneous revascularisation of the
      aortic visceral branches mainly involves the renal, inferior mesenteric and
      hypogastric arteries. Correction of celiac and superior mesenteric artery
      stenosis is less frequently indicated. The appropriate approach and surgical
      technique depend on the artery and the lesion involved. Suprarenal implantation
      of aortoiliac by-passes is performed at the celiac, descending aortic and
      ascending aortic levels. Indications include suprarenal coarctation of the aorta,
      reoperation following ligature of the juxtarenal aorta, and some cases of
      extensive thoracoabdominal atherosclerosis. The surgical management of aortoiliac
      occlusive disease in 353 patients treated in our clinic between 1976 and 1986 is
      reported. Mean follow-up exceeded 5 years. Operative mortality for endarterectomy
      (15 patients) was nil, and was 3.9% for by-pass graft. Early complication rate
      was 6.5% and late complication rate 23.2%. Half of the late complications were
      due to progression of the atherosclerotic process. Pseudoaneurysms at the aortic
      (3.1%) and femoral (9.9%) levels occurred between the fifth and tenth years.
      Prosthesis infection occurred shortly after operation in 3 patients and much
      later in 2 patients.

PMID- 1763303
TI  - Conservative mitral valve surgery: has the progress changed the indications?
AB  - Cardiac valve replacement still means replacement of one disease by another.
      Thromboembolic complications in the case of mechanical valves, as well as
      restenosing and calcification of bioprostheses, are major causes of further
      morbidity and mortality. Hence valve reconstruction, where indicated, represents
      an attractive alternative. In the late 1960s mitral valve reconstruction received
      new impetus from Carpentier through a number of techniques based on a
      multifactorial concept of mitral valve pathology. Although initially other
      surgery groups showed little enthusiasm for this approach, more recently a marked
      trend towards valve-preserving surgery has been observable. The experience of
      Carpentier and others, including our own, has provided better medium and long
      term results with mitral reconstruction compared to valve replacement, in regard
      to all indices of valve function except the reoperation rate, which is higher
      after valve reconstruction. It can also be shown that the results of
      reconstruction of rheumatically damaged valves are less good than in non
      rheumatic valve diseases and in particular myxomatous mitral valves. On the other
      hand, rheumatic populations are as a rule young and show poor compliance in
      taking medication, especially anticoagulants, which is why in these cases valve
      replacement is even less attractive. Although valve reconstruction is subject to
      a marked learning curve, it is possible to take advantage of others' experience.
      Several new surgical techniques have been developed and others are being adapted
      to new needs. Together these two factors have helped to make valve reconstruction
      a more reliable and reproducible method. The improved results have changed the
      indication for valve replacement, in that nowadays an attempt is made to
      reconstruct the valve before left ventricular hemodynamics are irreversibly
      damaged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1763304
TI  - [Hemodynamics of various heart valve prostheses].
AB  - Modern tilting disc and bileaflet prostheses, and bio-prostheses, perform
      similarly regarding pressure gradients, discharge coefficient and performance
      index; however, only bio-prostheses increase their opening area with increasing
      flow. Ball valve prostheses of the Starr-Edwards type perform less satisfactorily
      with higher pressure gradients and lower performance indices, which may result in
      less favorable long-term follow-up. Bio-prostheses show degenerative changes with
      increasing age which, over a period of 7-10 years, can lead to clinically
      relevant stenoses necessitating reoperation.

PMID- 1763305
TI  - [Mechanical circulatory support today].
AB  - Invasive mechanical circulatory support is the approach of choice in patients
      with acute myocardial failure resistant to conventional therapy. Today survival
      rates between 24% for postcardiotomy cardiac failure and 40% for bridge to heart
      transplantation can be achieved. However, a broad armamentarium of devices for
      mechanical circulatory support is necessary to provide optimum assistance for the
      failing heart in the various clinical situations. The available devices and their
      potential indications and limitations are reviewed.

PMID- 1763306
TI  - Surgery for supraventricular tachyarrhythmias.
AB  - Since the first successful surgical intervention for Wolff-Parkinson-White
      syndrome by W. C. Sealy, a surgical electrophysiological intervention has been
      developed for every single supraventricular arrhythmia. The surgical rationale is
      based on the site of the mechanism of the arrhythmia and associated pathology
      which characterizes the "arrhythmogenic substrate". Wolff-Parkinson-White
      syndrome is a congenital heart disease characterized by an accessory
      atrioventricular connection distinct from the AV node-His bundle system. It is
      associated with AV reentrant tachycardia and/or atrial fibrillation with fast
      ventricular responses via the accessory pathway. The current surgical management
      is ablation of the accessory pathway using either an endocardial dissection or
      epicardial approach. Surgical ablation is associated with high efficacy and low
      morbidity. Epicardial dissection of the accessory pathway on the beating heart
      has helped to localize variant accessory pathways associated with Coumel's
      tachycardia or Mahaim's fiber electrophysiological entity. AV nodal reentrant
      tachycardia can be cured using direct AV nodal dissection (or perinodal
      cryoablation). Atrial flutter can be interrupted by cryoablation of the
      arrhythmogenic substrate located in the coronary sinus orifice of the region
      modifying atrial inputs. Chronotropic atrial function abolished by chronic or
      paroxysmal idiopathic atrial fibrillation can be restored using the corridor
      operation (sinus node-AV node insulation). Surgery is an alternative in patients
      with resistant atrial tachycardias. Currently surgery is indicated only after
      other non-invasive EP interventions have been either attempted or rejected.

PMID- 1763307
TI  - [AIDS--a dangerous pandemic].

PMID- 1763308
TI  - [Fluoride excretion in schoolchildren with differing systemic fluoride care].
AB  - The aim of the present study was to collect data on urinary fluoride output in 8
      16-year old students exposed to either drinking water fluoridation (DWF), or
      domestic salt fluoridation (DSF). Spot urine samples were collected in the canton
      of Basel-Stadt (DWF, n = 123), in the canton of Berne (DSF, n = 264), in the
      county of Davos (DSF, n = 241), and in the city of Winterthur (DSF, n = 40).
      Furthermore, fluoride concentrations were determined in plasma samples drawn from
      33 students from Winterthur. The urinary fluoride concentrations were higher in
      Basel and Davos (0.62 +/- 0.35 mg/l; 0.61 +/- 0.42 mg/l) than in Berne and
      Winterthur (0.46 +/- 0.42 mg/l; 0.50 +/- 0.31 mg/l). A relatively high natural
      fluoride content (0.3 mg/l) in the drinking water explained the difference in
      urine fluoride concentration between students from Davos and the two other
      regions with domestic salt fluoridation (Berne, Winterthur). The average fluoride
      concentration in plasma was 12.7 +/- 3.8 ng/ml. We concluded that, in general,
      the supply with fluoride consumed with fluoridated domestic salt is close to the
      level obtained with drinking water fluoridation. However, in areas with very low
      systemic fluoride supplementation through the drinking water this level might not
      be reached with salt as the only source of systemic fluoride. Also, the data
      confirmed the safety of domestic salt fluoridation.

PMID- 1763309
TI  - [The Perioplaner/Periopolisher. The loss of substance on the root surface and the
      initial clinical experiences].
AB  - A new system for the removal of supragingival and subgingival plaque and calculus
      was studied. The system involves two motor driven handpieces. One handpiece works
      with curettes and hoes (Perioplaner) and the other works with diamond-layered
      instruments (Periopolisher). In the first part of this study the loss of root
      substance was measured as a consequence of treatment by these motor-driven
      instruments. These results were compared with those using classical hand curettes
      and rotating diamonds (Perio-Set). In the literature there is still debate over
      whether it is necessary to remove not only plaque and calculus but also cementum
      which may contain endotoxin or may even be infected. Whatever opinion one may
      have, it must be known how much root substance is lost by using a particular
      scaling instrument. This study has shown that the use of the Perioplaner and
      Periopolisher results in about the same loss of root substance as the use of hand
      instruments. In the second part of this study, first clinical experiences with
      these instruments are reported.

PMID- 1763310
TI  - Long-term stability of treatment results in cleft lip and palate patients.
AB  - The stability of the orthodontic and prosthetic results of the treatment of 18
      individuals with isolated cleft of the palate, 18 subjects with a complete
      unilateral and 8 with a complete bilateral cleft was evaluated in an eight-year
      follow-up period. The subjects were examined at the age of 19 years, after
      completed orthodontic and surgical treatment, and again at the age of 27 years.
      After the first examination the majority of the individuals with a complete cleft
      had at the age of 20 to 21 years been treated with a fixed bridge which was only
      minimally extended. The width of the upper dental arch at the second bicuspid
      decreased slightly in the subjects with an isolated cleft of the palate and in
      those with a bilateral cleft. In the subjects with a unilateral cleft there was a
      slight decrease of the upper dental arch widths at both bicuspids and at the
      first molar. In the subjects with complete clefts the slight decrease in upper
      dental arch widths was accompanied by a slight increase of the number of
      posterior teeth in cross-bite. The total number of teeth in cross-bite was small,
      however. On the whole, the upper dental arch was relatively stable during the
      follow-up period. This was found in the group with bilateral clefts,
      reconstructed with 5-8 unit bridges, as well as in the subjects with a unilateral
      cleft who had received no or only minimally extended reconstructions and in the
      group with an isolated cleft of the palate (no bridge).

PMID- 1763311
TI  - [The symptomatic therapy of cervical hard-substance defects with dentin-adhesive
      composite systems].
AB  - For covering of hypersensitive, morphologically disturbed and non-esthetic
      cervical (wedge-shaped) defects of hard dental tissues, dentine adhesive
      composite systems are suitable for a careful and less invasive preparation.
      Presumption is a smooth and at probing hard-touched defect surface. A clinical 2
      year study (15 patients with 143 cervical lesions) using 5 different dentine
      adhesive composite systems resulted in superiority of the hybrid composite P-30
      in view of low filling losses (after 1 year: 1 of 28 fillings after 2 years: 2 of
      27 fillings), the acceptable bond zone morphology (after 1 and 2 years clinical
      intact bond zones), and a constant volume behaviour (after 1 and 2 years no
      clinical changes of volume). The micromorphological evaluation correlated in a
      lot of cases with the clinical findings after 2 years. It has to be expected that
      improved dentine adhesive composite systems together with changed setting
      mechanisms of dentine adhesives will be able to eliminate filling losses in the
      treated indication.

PMID- 1763312
TI  - [The Turbocid. An apparatus for the cleaning, disinfection and lubrication of
      handpieces, anglepieces and turbines].

PMID- 1763313
TI  - [The uses of the EVA system (II). The different potential uses of the vibration
      grinding principle in dental practice].

PMID- 1763314
TI  - [The prevention of AIDS: possibilities and limits].

PMID- 1763315
TI  - ["We are putting the accent on continuing education". Interview by Kurt Venner].

PMID- 1763316
TI  - The Human Genome Project and patents.

PMID- 1763317
TI  - Respect for vitamin C.

PMID- 1763318
TI  - New AIDS drug poised to move into development.

PMID- 1763319
TI  - Soviet science: a struggle for survival.

PMID- 1763320
TI  - Breast cancer: stalemate in the war on cancer.

PMID- 1763321
TI  - Fight erupts over DNA fingerprinting.

PMID- 1763322
TI  - HIV risk higher for first-born twins.

PMID- 1763323
TI  - The utility of DNA typing in forensic work.

PMID- 1763324
TI  - Linkage of faulty major histocompatibility complex class I to autoimmune
      diabetes.
AB  - Pancreatic islet cells are the targets of an autoimmune response in type I
      diabetes. In the nonobese diabetic (NOD) mouse model of autoimmune diabetes,
      expression of major histocompatibility complex (MHC) class I proteins was
      inversely correlated with diabetes; in this mouse a mutation in the MHC class II
      linked gene for the putative MHC class I peptide transporter was also present.
      Mice deficient in MHC class I expression because they do not produce beta 2
      microglobulin also developed late onset autoimmune diabetes. In cells from humans
      with type I diabetes expression of MHC class I was decreased; subsets of
      prediabetics categorized as most likely to become hyperglycemic also had low MHC
      class I. T cell responses to self antigens are faulty in diabetics. In sets of
      genetically identical twins that are discordant for diabetes, the defect appeared
      to reside with the antigen presenting cell. Thus, a lack of surface MHC class I
      protein is associated with autoimmune diabetes; the concomitant defect in antigen
      presentation may impair the development of self tolerance, which could result in
      autoimmune disease.

PMID- 1763325
TI  - Characterization of a cofactor that regulates dimerization of a mammalian
      homeodomain protein.
AB  - Dimerization among transcription factors has become a recurrent theme in the
      regulation of eukaryotic gene expression. Hepatocyte nuclear factor-1 alpha (HNF
      1 alpha) is a homeodomain-containing protein that functions as a dimer. A
      dimerization cofactor of HNF-1 alpha (DCoH) was identified that displayed a
      restricted tissue distribution and did not bind to DNA, but, rather, selectively
      stabilized HNF-1 alpha dimers. The formation of a stable tetrameric DCoH-HNF-1
      alpha complex, which required the dimerization domain of HNF-1 alpha, did not
      change the DNA binding characteristics of HNF-1 alpha, but enhanced its
      transcriptional activity. However, DCoH did not confer transcriptional activation
      to the GAL4 DNA binding domain. These results indicate that DCoH regulates
      formation of transcriptionally active tetrameric complexes and may contribute to
      the developmental specificity of the complex.

PMID- 1763326
TI  - A fungal gene for antibiotic resistance on a dispensable ("B") chromosome.
AB  - A family of cytochrome P-450 (Pda) genes in the pathogenic fungus Nectria
      haematococca is responsible for the detoxification of the phytoalexin pisatin, an
      antimicrobial compound produced by garden pea (Pisum sativum L.). The Pda6 gene
      was mapped by electrophoretic karyotype analysis to a small meiotically unstable
      chromosome that is dispensable for normal growth. Such traits are typical of B
      chromosomes. The strains of Nectria studied here have no sequences that are
      homologous to the Pda family other than Pda6 and therefore demonstrate that
      unique, functional genes can be found on B chromosomes. Unstable B chromosomes
      may be one mechanism for generating pathogenic variation in fungi.

PMID- 1763327
TI  - Identification and characterization of zinc binding sites in protein kinase C.
AB  - Metal ion coordination in the regulatory domain of protein kinase C (PKC) is
      suggested by the conservation of six cysteines and two histidines in two
      homologous regions found therein. By monitoring x-ray fluorescence from a
      purified sample of rat PKC beta I overexpressed in insect cells, direct evidence
      has been obtained that PKC beta I tightly binds four zinc ions (Zn2+) per
      molecule. Extended x-ray absorption fine structure (EXAFS) data are best fit by
      an average Zn2+ coordination of one nitrogen and three sulfur atoms. Of the
      plausible Zn2+ coordination models, only those featuring nonbridged Zn2+ sites
      accommodate the EXAFS data and all of the conserved potential ligands.

PMID- 1763328
TI  - Maintenance of normoglycemia in diabetic mice by subcutaneous xenografts of
      encapsulated islets.
AB  - The goal of islet transplantation in human diabetes is to maintain the islet
      grafts in the recipients without the use of immunosuppression. One approach is to
      encapsulate the donor islets in permselective membranes. Hollow fibers fabricated
      from an acrylic copolymer were used to encapsulate small numbers of rat islets
      that were immobilized in an alginate hydrogel for transplantation in diabetic
      mice. The fibers were biocompatible, prevented rejection, and maintained
      normoglycemia when transplanted intraperitoneally; hyperglycemia returned when
      the fibers were removed at 60 days. Normoglycemia was also maintained by
      subcutaneous implants that had an appropriately constructed outer surface on the
      fibers.

PMID- 1763329
TI  - Low affinity interaction of peptide-MHC complexes with T cell receptors.
AB  - The interaction of antigen-specific T cell receptors (TCRs) with their ligands,
      peptides bound to molecules of the major histocompatibility complex (MHC), is
      central to most immune responses, yet little is known about its chemical
      characteristics. The binding to T cells of a labeled monoclonal antibody to the
      TCR was inhibited by soluble class II MHC heterodimers complexed to different
      peptides. Inhibition was both peptide- and TCR-specific and of low affinity, with
      a KD = 4 x 10(-5) to 6 x 10(-5) M, orders of magnitude weaker than comparable
      antibody-antigen interactions. This finding is consistent with the scanning
      nature of T cell recognition and suggests that antigen-independent adhesion
      precedes TCR engagement.

PMID- 1763330
TI  - Inhibition of Rap1A binding to cytochrome b558 of NADPH oxidase by
      phosphorylation of Rap1A.
AB  - Rap1A is a low molecular weight guanosine triphosphate (GTP)-binding protein in
      human neutrophil membranes whose cellular function is unknown. Rap1A was found to
      form stoichiometric complexes with the cytochrome b558 component of the phagocyte
      nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system. The
      (guanosine-5'-O-(3-thiotriphosphate) (GTP-gamma-S)-bound form of Rap1A bound more
      tightly to cytochrome b558 than did the guanosine diphosphate-bound form. No
      complex formation was observed between cytochrome b558 and H-Ras-GTP-gamma-S or
      Rap1A-GTP-gamma-S that had been heat-inactivated, nor between Rap1A-GTP-gamma-S
      and hydrophobic proteins serving as controls. Complex formation between Rap1A-GTP
      gamma-S and cytochrome b558 was inhibited by phosphorylation of Rap1A with cyclic
      adenosine monophosphate (cAMP)-dependent protein kinase. These observations
      suggest that Rap1A may participate in the structure or regulation of the NADPH
      oxidase system and that this function of the Rap1A protein may be altered by
      phosphorylation.

PMID- 1763331
TI  - Inhibition of HIV replication in acute and chronic infections in vitro by a Tat
      antagonist.
AB  - The human immunodeficiency virus-1 (HIV-1) trans-activator Tat is an attractive
      target for the development of antiviral drugs because inhibition of Tat would
      arrest the virus at an early stage. The drug Ro 5-3335 [7-chloro-5-(2-pyrryl)-3H
      1,4-benzodiazepine-2(H)-one], inhibited gene expression by HIV-1 at the level of
      transcriptional trans-activation by Tat. The compound did not inhibit the basal
      activity of the promoter. Both Tat and its target sequence TAR were required for
      the observed inhibitory activity. Ro 5-3335 reduced the amount of cell-associated
      viral RNA and antigen in acutely, as well as in chronically infected cells in
      vitro (median inhibition concentration 0.1 to 1 micromolar). Effective inhibition
      of viral replication was also observed 24 hours after cells were transfected with
      infectious recombinant HIV-1 DNA. The compound was active against both HIV-1 and
      HIV-2 and against 3'-azido-3'-deoxythymidine (AZT)-resistant clinical isolates.

PMID- 1763332
TI  - House of Delegates reaffirms voluntary, confidential testing for HIV.

PMID- 1763333
TI  - Disordered energy and protein metabolism in liver disease.
AB  - Although progress has been made, more information is needed on the role of
      nutritional therapy in liver disease. Because considerable heterogeneity exists
      among patients regarding both nutritional needs and the pathophysiology of
      malnutrition, their nutritional status must be monitored to permit careful
      selection and individualization of therapy. It is important to remember that the
      factors controlling nutritional status and overall survival in cirrhosis are
      multifactorial and the pathophysiologic mechanisms influencing outcome remained
      to be further defined. Consequently, it seems unlikely that any single therapy
      will be effective alone. In this regard, it should be emphasized that nutritional
      management should not be aimed solely at restoring normal metabolic homeostasis
      but should maximize anabolic regenerative processes in addition and minimize
      abnormal liver function so as to promote the effectiveness of other
      interventional therapies in patients with chronic liver disease.

PMID- 1763334
TI  - Nutritional therapies in liver disease.

PMID- 1763335
TI  - Role of nutrition in hepatic encephalopathy.

PMID- 1763336
TI  - Impact of malnutrition and its therapy on liver transplantation.
AB  - The consequences of malnutrition and impact of nutritional support on the liver
      transplant patient have not been adequately addressed in clinical research
      studies. As we have gained experience in assessing patients for transplantation
      surgery, the risks of malnutrition have been realized. Part of the success of
      liver transplantation today is related to improved timing of surgery, patient
      selection, and perioperative management. Malnutrition is one of the adverse risk
      factors that is potentially reversible and therefore specialized nutritional
      support techniques should be able to improve postsurgical outcome. However, the
      performance and interpretation of nutritional research has been impeded by
      difficulties in separating the effects of liver dysfunction from disturbances
      secondary to nutritional deficiencies; for example, hypoproteinemia would be a
      consequence of both. Through the use of multivariate prognostic formulas and
      development of better nutritional indices for patients with liver disease, it
      should be possible to identify those patients who will receive the greatest
      benefit from preoperative and perioperative nutritional support. Furthermore, the
      kinds of nutritional supplementation having the greatest impact could then be
      determined.

PMID- 1763337
TI  - Nutrition, hormones, metabolism, and liver regeneration.

PMID- 1763338
TI  - Trace metals in liver disease.

PMID- 1763339
TI  - Interaction between alcohol and nutrition in the pathogenesis of alcoholic liver
      disease.

PMID- 1763340
TI  - The pain of parturition.

PMID- 1763341
TI  - Options for labor analgesia: techniques of epidural and spinal analgesia.
AB  - The results of the clinical research evaluating techniques of labor analgesia
      suggest that drug combinations hold much promise for providing excellent
      analgesia for labor, while minimizing the adverse effects associated with each
      technique. With the various combinations of drugs and techniques available, the
      anesthesiologist is better able to customize the control of pain for each
      parturient.

PMID- 1763342
TI  - Does epidural anesthesia affect the course of labor and delivery?
AB  - The progress of labor ideally leads to a normal, spontaneous, vaginal delivery.
      Many factors--maternal, fetal, obstetrical and anesthetic--may collectively
      contribute to delaying or precluding an ideal outcome. Adverse outcomes of labor
      and delivery must be clearly defined in terms of maternal, fetal, or neonatal
      morbidity or mortality, and should be distinguished from abnormal data (such as
      fetal heart rate, duration of labor, and incidence of low forceps deliveries)
      that are only indirectly related to outcome. Epidural anesthesia is not a
      singular phenomenon. Variations and subtle nuances in the administration of
      epidural anesthesia create a vast array of potential anesthetic regimens. To
      discover the anesthetic methods that provide excellent analgesia with no adverse
      effects on the course of labor is an ideal goal that has not yet been achieved.
      To approach this goal, the answers to several questions are needed. Are study
      patient groups adequately matched for risk factors? Are obstetrical practices
      well-defined with respect to elective versus indicated use of instrumental or
      cesarean delivery methods? Do the risks of instrumental delivery outweigh the
      benefit of perineal analgesia associated with epidural anesthesia? Is it possible
      to provide optimal analgesia throughout stage two labor without tending to
      increase the risk of instrumental delivery? Can delayed pushing during stage two
      labor increase the probability of spontaneous vaginal delivery with continuous
      epidural anesthesia? Well-controlled clinical trials and refinements in both
      anesthetic and obstetric techniques are necessary to resolve such issues so that
      every parturient (and fetus) may undergo a safe and painless delivery.

PMID- 1763343
TI  - Alternatives to epidural analgesia.

PMID- 1763344
TI  - General anesthesia and maternal mortality.

PMID- 1763345
TI  - Anesthetic concerns in the patient with preeclampsia.
AB  - Preeclampsia is a disease of unknown etiology and a major contributor to maternal
      and neonatal morbidity and mortality. With severe preeclampsia, numerous factors
      including intravascular volume depletion and susceptibility of developing
      pulmonary edema complicate anesthetic management. Invasive monitors such as CVP
      or PA pressure measurements are often required for guiding fluid management. When
      possible, lumbar epidural blockade is the preferred method for providing
      analgesia and anesthesia. Under all circumstances, a collegial and collaborative
      approach between obstetrician and anesthesiologist facilitates optimum patient
      care.

PMID- 1763346
TI  - Anesthesia for procedures involving the fetus.

PMID- 1763347
TI  - Principles of analgesia in the neonate.

PMID- 1763348
TI  - [Study of the right heart and external respiratory functions in patients with
      liver cirrhosis by Doppler echocardiography].
AB  - The paper presents clinical and instrumental evidence on 47 patients with hepatic
      cirrhosis. The revealed ventilatory disorders and worse bronchial permeability
      closely correlated with the degree of pulmonary hypertension which in its turn
      depended on portal hypertension degree. Pulmonary hypertension decreased with a
      decline in the activity of the pathological process in the liver due to
      treatment. External respiration insufficiency observed in hepatic cirrhosis
      contributes to the onset of arterial hypoxemia and hypoxic impairment of the
      liver activating in it a pathological process. It is recommended that such
      patients should receive a combined treatment incorporating oxygen therapy,
      calcium antagonists, antioxidants.

PMID- 1763349
TI  - [Various neurohumoral aspects of hemodynamic changes in patients with
      hypertension after correction of electrolyte disorders].
AB  - Changes in activity of sympathetic-adrenal and + renin-angiotensin-aldosterone
      systems (SAS and RAAS), hemodynamics and electrolyte metabolism when correcting
      sodium balance in consideration of their "salt sensitivity" were studied in 83
      hypertension stage I and II patients. In moderate restriction of sodium chloride
      response of the patients was not uniform. "Salt--sensitive" subjects responded
      positively with improvement of central and peripheral hemodynamics, electrolyte
      balance in enhanced activity of SAS and RAAS. In salt nonresponders and in
      paradoxical sensitivity SAS and RAAS show activation, most distinct in
      paradoxical sensitivity, and worse central and peripheral hemodynamics,
      electrolyte imbalance.

PMID- 1763350
TI  - [Analysis of the profiles of functional psychomotor asymmetry and mental stress
      in patients with cardiovascular diseases].
AB  - The profile of functional sensomotor asymmetry (FSMA) was evaluated by a series
      of tests and inversion of emotional reflection. Altogether 70 healthy subjects
      and 114 cardiovascular diseases patients were examined. Among the patients there
      were 36 subjects with acute myocardial infarction, 28 with coronary heart
      disease, 26 with borderline hypertension and 24 with neurocirculatory dystonia
      (NCD). The highest emotional tension was recognized in myocardial infarction and
      coronary heart disease. NCD patients exhibit the left FSMA profile more
      frequently than healthy subjects.

PMID- 1763351
TI  - [Status of phosphorus-calcium metabolism and secretion of calcium- regulating
      hormones in diabetic nephropathy].
AB  - The studies performed by the authors led them to the conclusion that diabetic
      nephropathy aggravates derangement of phosphoric--calcium metabolism in patients
      with diabetes mellitus. Secondary hyperparathyroidism, as a result of negative
      calcium balance in decompensated diabetes mellitus and renal dysfunction,
      contributes to development of marked alterations of the osteoarticular system.

PMID- 1763352
TI  - [Indications for using a new magnetotherapeutic method in arterial hypertension].

PMID- 1763353
TI  - [Biosorption with extracorporeal use of heterologous spleen in the complex
      treatment od suppurative-septic diseases].
AB  - The search for new methods in the control of purulent infection is highly topical
      nowadays. For this purpose a complex of intensive therapy is suggested involving
      hemosorption via the patient's blood perfusion through porcine heterospleen. By
      literature and experimental data this technique is not inferior in efficacy to
      the use of the donor spleen. The spleen is removed conventionally, in
      modification of the authors. The results of the hemosorption analysed on 82
      procedures performed in 1989-1990 justify employment of the above hemosorption in
      view of its efficacy, availability, simplicity.

PMID- 1763354
TI  - [Glutathione levels and the activity of the enzymes of glutathione metabolism in
      erythrocytes of patients with acute cholecystitis].
AB  - It is shown that in acute cholecystitis patients versus chronic cholecystitis
      ones and donors, the total glutathione in blood is lower while the activity of
      glutathione metabolism enzymes in red blood cells inhibited. Enzymological
      findings correlate with clinical symptoms of intoxication. Surgery aggravates
      disturbed activity of the enzymes. Conventional conservative therapy is not
      effective in normalizing the enzymes activity either. A good therapeutic response
      can be achieved by a directed transport of antibiotics in autologous blood ghosts
      which promotes recovery of normal activity of glutathione metabolism enzymes,
      routine glutathione level, early stabilization of hepatocytic membranes
      beneficial for surgical patients.

PMID- 1763355
TI  - [Metabolic disorders in peritonitis: hemodynamic or cellular disorders?].
AB  - Systemic and hepatic hemodynamics, gas exchange, acid-base balance in blood from
      the artery, portal, hepatic and peripheral veins were examined in 113 patients
      with diffuse peritonitis varying etiologically. In view of adequate tissue
      perfusion and oxygen transport revealed it is suggested that causes of metabolic
      derangement arising in peritonitis and responsible for multiple organ
      insufficiency should be searched into at the level of intracellular metabolism.

PMID- 1763356
TI  - [Combined treatment of cancer of the stomach using a specific immunotherapy].
AB  - Autoinoculation is suggested as an adjuvant means to augment the effect of
      surgery in gastric cancer which may prevent the development of recurrences and
      metastases. Surgery alone is not a curative method and 5-year survival in gastric
      cancer stage III ranges from 9.2 to 28%. The data have been obtained on
      comparative survival in a control group and a group of inoculated patients. The
      greatest effect was achieved in patients with poorly differentiated
      adenocarcinoma. Further investigation of the two groups adjusted for the
      patients' age, kind of surgery and morphological structure of the tumor will help
      to work out precise criteria for inoculation.

PMID- 1763357
TI  - [Predicting the probable passage of common bile duct calculi in patients with
      mechanical jaundice].
AB  - The authors propose a mathematical method of predictingthe passage of common bile
      duct calculi. An original mathematical formula derived by a computer allows a 98%
      accuracy of the prognosis. The estimations were based on the principal parameters
      influencingthe choledochal calculi movement defined with the help of the
      regression analysis. Such prediction simplifies the choice of therapeutic policy
      in mechanical jaundice due to choledocholithiasis.

PMID- 1763358
TI  - [Pathogenesis of diffuse toxic goiter].

PMID- 1763359
TI  - [Organizational aspects of the prevention of strokes].

PMID- 1763360
TI  - [Importance of bacteriological control of surgicenters for establishing anti
      epidemic measures in emergency situations].

PMID- 1763361
TI  - [Clinico-statistical aspects of newly detected destructive tuberculosis in the
      Eastern Siberia].

PMID- 1763362
TI  - [Comparative evaluation of the effectiveness of antiseptics currently used in
      surgery].

PMID- 1763363
TI  - [Experience with using UV-irradiated blood in the treatment of acute pneumonia].

PMID- 1763364
TI  - [Evaluation of the degree of trauma in biliary tract surgery using a laser method
      in relation to the status of the plasma protease inhibitor system].

PMID- 1763365
TI  - [Evaluation of the status of various indicators of body resistance in smokers].

PMID- 1763366
TI  - [Prevention of suppuration of postoperative wounds in emergency abdominal laser
      surgery].

PMID- 1763367
TI  - [Causes of mortality in acute pancreatitis and the ways of its reduction].

PMID- 1763368
TI  - [Clinico-immunological and biomicroscopic parallels in neuro- rheumatism].

PMID- 1763369
TI  - [Does splenectomy affect the immediate results of surgical treatment of
      esophageal cancer?].

PMID- 1763370
TI  - [Clinical aspects of using cytological methods in oncological practice].

PMID- 1763371
TI  - [Characteristics of the clinical course of malignant extra-organic tumors of the
      head and neck].

PMID- 1763372
TI  - [Current methods of diagnosis and evaluation of dissemination of carotid
      chemodectoma].

PMID- 1763373
TI  - [Tuberculosis of the breast detected in an oncological clinic].

PMID- 1763374
TI  - [Microflora of the gastrointestinal tract in children with intestinal
      infections].

PMID- 1763375
TI  - [Age-related characteristics of bacterial meningoencephalitis (clinico
      morphological studies)].

PMID- 1763376
TI  - [A case of successful treatment of a patient with breast cancer using rotational
      electromagnetic field].

PMID- 1763377
TI  - [Thrombohemorrhagic syndrome after aorto-femoral shunt].

PMID- 1763378
TI  - [Treatment of pseudarthroses and ununited fractures of the scaphoid bone of the
      hand by using bone transplant on vascular pedicle].

PMID- 1763379
TI  - [Effect of ethacizine on the heart conduction system and the indicators of
      central hemodynamics].
AB  - A trial of the antiarrhythmic drug ethacizine made in the Soviet Union which is
      an analogue of ethmozine was performed in 38 patients suffering from coronary
      heart disease. Automatism, conduction and excitation of the myocardium,
      hemodynamics and the antiarrhythmic effect were studied using
      electrophysiological methods, echo-cardiography and Holter monitoring. Ethacizine
      was found effective in arrhythmia. It reduces conduction in small changes of
      hemodynamics and myocardial contractility.

PMID- 1763380
TI  - [Late outcomes of hepatitis A].

PMID- 1763381
TI  - [Differential diagnosis of atypical forms of tuberculous spondylitis and tumors
      of the cervical segment of the spine].

PMID- 1763382
TI  - [Treatment of myopathies with ribonucleotides].

PMID- 1763383
TI  - Mammalian sex chromosomes. III. Activity of pseudoautosomal steroid sulfatase
      enzyme during spermatogenesis in Mus musculus.
AB  - Parallel to the inactivation of the X chromosome in somatic cells of female, the
      male X in mammals is rendered inactive during spermatogenesis. Pseudoautosomal
      genes, those present on the X-Y meiotically pairable region of male, escape
      inactivation in female soma. It is suggested, but not demonstrated, that they may
      also be refractory to the inactivation signal in male germ cells. We have assayed
      activity of the enzyme steroid sulfatase, product of a pseudoautosomal gene, in
      testicular cells of the mouse and shown its presence in premeiotic, meiotic
      (pachytene), and postmeiotic (spermatid) cell types. It appears that, as in
      females, pseudoautosomal genes may escape inactivation in male germ cells also.

PMID- 1763384
TI  - Beta 1-4-galactosyltransferase gene expression is regulated during entry into the
      cell cycle and during the cell cycle.
AB  - Mammalian glycosyltransferases have been implicated in a wide variety of
      functions besides N-linked glycosylation, including developmental processes. For
      this reason, we studied the effects of cell cycle and entry into the cell cycle
      on beta 1-4-galactosyltransferase gene expression. In this study we report that
      beta 1-4-galactosyltransferase (GalTase) gene expression is, indeed, regulated
      during the normal cell cycle, peaking during late G1-, S, and early G2 phase of
      the cell cycle. In addition, GalTase gene expression is regulated in a manner
      that resembles other "early response" genes such as jun and fos upon reentry into
      the cell cycle from quiescence. Finally, we show that the GalTase gene is
      differentially expressed during murine embryogenesis and in terminally
      differentiated adult tissues. It is most abundant in testis, followed by skeletal
      muscle and spleen. The reasons for this pattern of differential expression in
      adult tissues are unknown. These studies should provide important new information
      regarding GalTase gene expression, its regulation, and its potential link to
      other developmental functions.

PMID- 1763385
TI  - The use of irradiation and fusion gene transfer (IFGT) hybrids to isolate DNA
      clones from human chromosome region 9q33-q34.
AB  - We have generated somatic cell hybrids containing fragments of human chromosome
      arm 9q by an irradiation and fusion technique. No selection for human material
      was imposed, but of 23 clones analyzed most contained human DNA sequences and
      many contained multiple fragments of the human chromosome arm. A hybrid that
      appears to contain only two small fragments of human DNA from the regions of q33
      and q34 has been used as a source from which to clone probes specific to those
      areas of the chromosome.

PMID- 1763386
TI  - Somatic cell hybridization of Roberts syndrome and normal lymphoblasts resulting
      in correction of both the cytogenetic and mutagen hypersensitivity cellular
      phenotypes.
AB  - Roberts syndrome (RS) is a rare recessive condition of limb deformities, growth
      retardation, and developmental delay. Cultured cells from approximately half of
      RS patients exhibit a "puffing" of the constitutive heterochromatin and a
      hypersensitivity to mitomycin C (MMC). Patients exhibiting these cellular
      phenomena are designated RS+. Somatic cell hybridization with normal cells has
      been shown to correct the heterochromatin abnormality in RS+ cells. To determine
      if the MMC hypersensitivity could also be corrected by hybridization to normal
      cells, we fused two different RS+ lymphoblastoid cell lines (LCLs) to a ouabain
      resistant, HAT-sensitive, normal LCL. Cytogenetic analyses of hybrid cell lines
      (HCLs) revealed complete correction of the heterochromatin abnormality. MMC cell
      killing assays revealed correction of the mutagen hypersensitivity as well. Five
      of the six HCLs tested exhibited D10 values (the dose at which 10% of the cells
      survive) that were not significantly lower than that of the normal parent but
      that were 6- to 18-fold greater than those of the RS+ parents. Correction of both
      of these cellular phenotypes in RS+ cells by fusion with normal cells supports
      the hypothesis that both of these phenomena are caused by a common defect in the
      Roberts syndrome gene (RBS).

PMID- 1763387
TI  - Kinds and locations of mutations arising spontaneously in the coding region of
      the HPRT gene of finite-life-span diploid human fibroblasts.
AB  - Spontaneous thioguanine-resistant mutants were derived from populations of finite
      life-span, diploid human fibroblasts by means of a fluctuation analysis. cDNA was
      prepared from mutant HPRT mRNA and amplified by the polymerase chain reaction,
      and the sequence of the product was analyzed. Exon deletions, which very likely
      arose from mutations in the intron splice site consensus sequences, were found in
      10 of the 37 mutants examined (27% of the total). Among the 28 mutations in the
      coding sequence, base pair substitutions predominated (89%). With the exception
      of one base pair involved in a tandem mutation, all base pair substitutions
      resulted in alterations in the predicted amino acid sequence of the protein. In
      addition there were three frameshift mutations, consisting of the deletion of one
      or two base pairs. Although mutations occurred throughout the coding sequence,
      50% (14/28) were found in the 5' portion of exon 3.

PMID- 1763388
TI  - Localization of the gene encoding the alpha 2 subunit of the human VLA-2 receptor
      to chromosome 5q23-31.
AB  - The alpha 2 subunit of the VLA-2 receptor (CD49B) was mapped to human chromosome
      5 by several independent approaches. First, the expression of the alpha 2 subunit
      at the protein level was investigated in a panel of human-mouse hybrid cell
      lines. Cell surface expression was detected by indirect immunofluorescence with
      monoclonal anti-alpha 2 antibody 12F1. Intracellular alpha 2 antigen was detected
      by immunostaining of whole cell extracts or of immunoprecipitated 12F1 antigen
      with the monoclonal antibodies 3H8 and 5C5. Second, the presence of human genomic
      alpha 2 sequences in the panel of human-mouse hybrids was detected by PCR, using
      primers derived from the published alpha 2 cDNA sequence. The specificity of the
      amplification product was shown by direct sequencing. The results of the PCR
      study were confirmed by amplifying a CD14 gene fragment, known to map to
      chromosome 5. Finally, in situ hybridization with a 3H-labeled 1040-bp cDNA
      probe, also obtained by PCR, confirmed and refined the localization of CD49B on
      chromosome 5 at q23-31.

PMID- 1763389
TI  - High-efficiency stable gene transfection using chloroquine-treated Chinese
      hamster ovary cells.
AB  - We describe a highly efficient stable gene transfection procedure for Chinese
      hamster ovary (CHO) cells using a modification of the calcium phosphate-DNA
      coprecipitation method. We have found that treatment of CHO cells with
      chloroquine increases the efficiency of gene transfer by up to 20-fold (from
      approx. 0.01% to approx. 0.2%) when transfection is done using the pSV2-neo
      plasmid. The optimized transfection procedure requires that CHO cells to be
      incubated with calcium phosphate-DNA coprecipitate and chloroquine (100 microM)
      for a total of 16 h. By using high-molecular-weight human genomic DNA as a DNA
      source for transfection, we show that this procedure is equally efficient for
      stably transferring a much larger gene, such as the 49-kb human hypoxanthine
      phosphoribosyltransferase gene.

PMID- 1763390
TI  - Enhancing peri-operative pain control.

PMID- 1763391
TI  - Aortobifemoral bypass for the critically ischaemic limb--is it worth while?
AB  - Little is written of the place of aortobifemoral bypass as a limb or below-knee
      level amputation stump salvage procedure in patients presenting with critical
      ischaemia with threat of limb loss. Over a 4-year period 151 patients referred to
      the Vascular Service of the University of Natal Hospitals with aorto-iliac
      occlusive disease and a threatened limb were studied. All were submitted to
      aortobifemoral bypass. Patients were divided into two subgroups: group 1 patients
      presented with rest pain or focal necrosis and were submitted to aortobifemoral
      bypass with concomitant digital or transmetatarsal amputation; and group 2
      patients were submitted to a guillotine-type below-knee amputation in view of
      ascending infection or extended necrosis that made below-knee amputation
      impracticable. The objective was to obtain healing of the stump at the below-knee
      level. Early results within 1 month of operation were as follows: 5 patients
      (3.3%) died of myocardial infarction. There was no graft sepsis, and groin wound
      sepsis occurred in 7 (4.5%). Of the group 1 patients 8 required major amputation
      (8.2%). Three patients in group 2 required proximal above-knee revision (14.3%).
      The overall limb or stump salvage rate within 1 month of surgery was 89.4%. It
      was possible to follow up 105 patients in group 1 and 18 in group 2 for between 2
      years and 5 years. In group 1, 2.9% required major proximal amputation and 3.8% a
      subsequent femoral-to-distal bypass. In group 2 none required subsequent major
      proximal amputation. Overall in those available for long-term follow-up 97%
      retained the use of a salvaged limb or stump.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1763392
TI  - Evaluation of a new hydrocolloid occlusive dressing for central catheters used in
      total parenteral nutrition.
AB  - Catheter-related sepsis still remains one of the most frequent and serious
      complication of total parenteral nutrition. Strategies for preventing
      contamination of central venous lines have focused on decreasing the number of
      micro-organisms around the exit site and inhibiting their entry into the catheter
      wound. This prospective study compares a new occlusive hydrocolloid dressing
      (Visiband; Convatec Squibb) with that of a polyurethane film dressing for
      nutritional catheters. Dressings were changed either on day 3 or day 5 after
      application. Swab smears of the catheter exit site at each dressing change were
      stained by Gram's method before inoculation onto a blood agar plate, a chocolate
      agar plate and a MacConkey agar plate. Significantly less colonisation occurred
      under the former dressing at day 3 and day 5 dressing changes. In addition, the
      polyurethane film dressing was associated with a significant increase in skin
      colonisation (P = 0.04) and the number of positive Gram-stain microbes if left
      unchanged for 5 days (P = 0.0018). Staphylococcus aureus catheter-related sepsis
      occurred in 1 patient on day 18 in the polyurethane film dressing group. In
      addition, Candida albicans colonisation was confined to patients with the
      polyurethane film dressing. While the type of dressing applied to the catheter
      exit site may influence the incidence of catheter colonisation and infection, it
      must be emphasised that strict adherence to aseptic technique during catheter
      insertion and manipulation of the dressing is vital in the prevention of catheter
      related sepsis during total parenteral nutrition.

PMID- 1763393
TI  - The Breast Clinic at Ga-Rankuwa Hospital/MEDUNSA.
AB  - The Breast Clinic at Ga-Rankuwa Hospital/MEDUNSA serves a large population of
      black South Africans. The patients present at a young age and commonly with very
      advanced disease. Problems in follow-up are more complex in this group because of
      difficulties with finance, transport and communication. The very large number of
      cases lost to follow-up and regular supervision after completion of treatment
      militates against collecting data for accurate reporting of results. An account
      is given of our experience in dealing with 532 cases of breast carcinoma seen
      over a period of 6 years.

PMID- 1763394
TI  - Foreign bodies in the gastro-intestinal tract.
AB  - Between 1971 and 1990, 70 patients with foreign bodies in the gastro-intestinal
      tract were admitted to our service. There were 35 children and 35 adults. Foreign
      bodies were found in the pharynx and the oesophagus in 22 patients, with 1
      perforation; and in the stomach and intestines in 27, with 14 perforations.
      Fifteen foreign bodies were swallowed and defecated, 6 were inserted into the
      rectum. Coins were found in 8 patients, toys in 3, pins and needles in 6, chicken
      bones and fish bones in 15, and toothpicks, shaving blades, cutlery, dentures,
      plastic bag containing cocaine, parts of a foam rubber mattress and other items
      in the remainder. Foreign bodies retained in the oesophagus must be removed
      promptly lest obstruction and perforation occur. Many foreign bodies that have
      passed the oesophagus progress uneventfully to defaecation. Others become
      retained and should be removed. If retained in the stomach, endoscopic removal
      may be attempted before resorting to a laparotomy. Perforation is an urgent
      indication for operation. Those patients inclined to swallow foreign bodies
      intentionally and those who insert items into the rectum should undergo
      psychiatric evaluation.

PMID- 1763395
TI  - Trauma of the ureter.
AB  - Thirty-three ureteric injuries were treated over a 2-year period. The majority of
      patients presented late. The most common modes of repair were either
      ureteroneocystostomy or transuretero-ureterostomy. Complications were few and of
      little significance.

PMID- 1763396
TI  - An unusual thyroid cyst. A case report.
AB  - A solitary hydatid cyst in a 69-year-old woman presented as a cold area on
      thyroid scan. Clinically, it forms part of the differential diagnosis of
      neoplastic thyroid lesions. Surgery is effective for this uncommon thyroid cyst.

PMID- 1763397
TI  - Acute parapharyngeal space infections. A report of 12 cases.
AB  - Parapharyngeal space infections are a serious condition with a significant
      morbidity and mortality. Twelve cases seen between 1987 and 1990 are described.
      From the clinical findings it was clear that the tonsils appeared to be the most
      common source of infection and not other aetiological factors, such as dental and
      salivary gland pathology. Computed tomography was excellent in delineating the
      mass, but if this is not available ultrasonography appears to be of benefit.
      Intravenous antibiotics and the appropriate surgical intervention, when
      indicated, is the treatment of choice. An excellent clinical response was
      experienced; however, in 25% of patients recovery was complicated by aspiration
      pneumonia.

PMID- 1763398
TI  - Anal canal adenocarcinoma. A report of 4 cases.
AB  - Although rare, adenocarcinoma of the anal canal may be more common than
      previously thought in populations with a high incidence of peri-anal sepsis. Four
      such cases are presented and published reports reviewed. To avoid unnecessary
      delays in diagnosis, the clinician must adopt a high index of suspicion when
      dealing with chronic peri-anal disease. More regular follow-up examinations and
      biopsies of suspicious lesions are necessary. Since the origin and histological
      appearance of these tumours are often not clear cut, both clinician and
      pathologist must work closely together when correlating their findings. Until
      recently, the vast majority of cases have been managed surgically, and a
      concerted effort needs to be made to evaluate the role of chemoradiotherapy and
      preoperative radiotherapy as therapeutic modalities.

PMID- 1763399
TI  - Hemodynamic monitoring and pulse oximetry during percutaneous gastrostomy and
      jejunostomy: necessity or nuisance?
AB  - Hemoglobin desaturation and arrhythmias have been reported during diagnostic
      gastroscopy and colonoscopy. During endoscopic placement of percutaneous
      gastrostomy tubes (PEG), the gastroscope is inserted twice and the stomach is
      markedly distended, thus increasing the potential risk of complications. Also,
      the procedure is frequently performed in patients exhibiting underlying systemic
      disease or little respiratory reserve. Patients undergoing PEG or percutaneous
      endoscopic jejunostomy (PEJ) were studied prospectively. Blood pressure, pulse,
      pulse oximetry, and lead II ECG tracings were obtained. Measurements were made
      before sedation, after sedation, at gastroscope insertion, at gastrostomy
      placement, at gastroscope reinsertion, and at 5 min after the procedure. In all,
      50 patients (mean age, 56.8 years; 16 women, 26 men) underwent PEG only (39
      cases) or PEG/PEJ (11 cases). The endoscopy suite was the site for the procedure
      in 38 cases and the intensive care unit was used in 12 cases. The mean time
      required for PEG and PEG/PEJ was 14.7 +/- 1.1 and 18.9 +/- 2 min, respectively.
      Blood pressure remained stable throughout the procedure. Sinus tachycardia was
      observed in 72% of patients. Arterial oxygen saturation decreased after the
      administration of intravenous sedation but remained constant during the
      procedure. We reached the following conclusions: (1) desaturation occurs during
      sedation, (2) saturation remains constant during PEG/PEJ, (3) the mean blood
      pressure remains constant during PEG/PEJ, and (4) PEG/PEJ are safe procedures and
      monitoring should be individualized.

PMID- 1763400
TI  - Long-term efficacy of endoscopic papillo-sphincterotomy for common bile duct
      stones and benign papillary stenosis.
AB  - Since its introduction in 1974, endoscopic sphincterotomy (EST) for common bile
      duct stones and benign papillary stenosis has become a well-established
      therapeutic procedure; however, at present, its long-term efficacy in comparison
      with that of biliary tract surgery remains a matter of debate. The long-term
      results observed during our follow-up (4 +/- 2 years) were satisfactory,
      revealing the disappearance of or an improvement in symptoms in 85.6% of subjects
      who had undergone EST. Recurrent stones were documented in 10.2% of patients; EST
      related stenosis occurred in 3.8% of cases, approximately 3 times more frequently
      in papillary stenosis than in choledocholithiasis, likely due to the presence of
      a more extended incision in cases with common duct stones. A gallbladder in situ
      did not seem to be an additional risk factor after EST. As documented in other
      recent follow-up studies, the long-term efficacy of EST seems to be confirmed and
      comparable with that of biliary surgery.

PMID- 1763401
TI  - An appraisal of small and diminutive colonic polyps.
AB  - A retrospective review of all colonoscopic polypectomies performed in a busy
      surgical endoscopy unit over a 6-month period was undertaken. All patients were
      included who presented with colonic polyps measuring less than 1 cm in diameter
      for which sufficient specimens were available for histopathologic examination. In
      all, 262 were polyps removed from 206 patients; of these, 158 (60%) were
      neoplastic. There was a statistically significant predilection for polyps in the
      right colon to be neoplastic. Worrisome histologic patterns (severe dysplasia,
      carcinoma in situ, or invasive carcinoma) were seen in 18 specimens (6.5%). In
      two patients, polypoid carcinoma could be identified; in one case it involved a
      lesion measuring 0.2 cm in diameter. Since these lesions exhibit no distinctive
      gross features, only their endoscopic removal and histologic study can ensure
      proper diagnosis and treatment.

PMID- 1763402
TI  - Diagnosis of neuronal colonic dysplasia in primary chronic constipation and
      sigmoid diverticulosis endoscopic biopsy and enzyme-histochemical examination.
AB  - Neuronal colonic dysplasia is a separate clinical entity belonging to the group
      of congenital defects of intestinal innervation. Its enzyme-histochemical
      diagnosis is possible by endoscopic biopsy examination of the rectosigmoid.
      Enzyme-histochemically, it is characterized by dysplasia of the submucous plexus
      secondary to developmental defects. The principal clinical feature is weak
      propulsive motility. A clinical study was carried out to investigate the role of
      neuronal colonic dysplasia in the aetiology and pathogenesis of primary chronic
      constipation and diverticulosis of the sigmoid colon in adults.

PMID- 1763403
TI  - Real-time sonography of the mediastinum in adults: a study in 100 healthy
      volunteers.
AB  - Real-time sonography has proved to be a valuable tool in the evaluation of the
      mediastinum in children. In the literature there is a paucity of information on
      ultrasound examination of the mediastinum in adults. Using a 3.5-MHz sector
      scanner, we evaluated a new method for the examination of mediastinal organs in
      adults, which is practicable in routine as well as emergency diagnosis. The
      endpoints of this study were the visibility of mediastinal organs and the
      discomfort of the patient. In 100 healthy volunteers aged 20-40 years, the normal
      anatomy of the anterior and middle mediastinum was investigated. Neither the
      height nor the weight of the volunteers limited the examination. We found that
      this method causes no discomfort to the subject. Via the supra-, infra- and left
      parasternal approaches, anatomical structures of the mediastinum are visible in a
      high percentage of cases. To date, this method has proved its practicability in
      more than 250 patients suffering from blunt thoracic trauma, primary and
      metastatic tumours, and infections of the mediastinum.

PMID- 1763404
TI  - The role of fast neutrons in radiooncology--a critical appraisal.
AB  - The contribution of fast neutrons to local tumour control has been investigated
      worldwide since the mid-60's in more than 20 institutions. The high expectations
      anticipated from the promising results of experimental studies could not be
      adequately realized in the clinic. The late normal tissue damage was unacceptable
      due to poor depth dose characteristics and further technical limitations of the
      first generation low-energy machines. Even with sophisticated therapy planning
      systems and high-energy cyclotrons as well as comparable late normal tissue
      damage as witnessed after photons, only a few tumour entities have responded
      superiorly to fast neutrons. These particularly include macroscopic tumours of
      the salivary glands, prostate and, potentially, soft and osseous tissues. The
      role of fast neutrons for head and neck cancer has not yet been definitely
      proved. For bladder-, cervical- and rectal carcinomas, non-small cell lung-,
      pancreatic- and breast cancers as well as malignant gliomas, no therapeutic
      benefit as compared with photons was observed in the case of macroscopic residual
      or inoperable recurrent tumours.

PMID- 1763406
TI  - A prospective randomized study concerning to the point A dose in high-dose rate
      intracavitary radiation therapy for carcinoma of the uterine cervix.
AB  - From January 1983 through December 1987, a total of 138 patients with previously
      untreated carcinoma of the uterine cervix were entered into the prospective
      randomized study concerning the two different schedules of point A dose of remote
      afterloading high-dose rate intracavitary therapy (RALS) and external irradiation
      dose at the Center for Adult Diseases, Osaka. Group A consisted of 71 patients
      who were treated with fraction size of point A dose of 7.5 Gy and group B
      included 67 patients treated with fraction size of 6 Gy. According to the staging
      system of UICC (1978), 33 patients were classified into stage I, 50 patients
      stage II, 45 patients stage III, and ten patients stage IV. Three-year survival
      rates by stage and RALS schedule were in group A 80% and in group B 100% in stage
      I, 57% and 68% in stage II, 62% and 60% in stage III and 2/8 and 0/2 in stage IV.
      Survival curves showed no statistically significant difference in each stage.
      Late rectal and bladder complications requiring treatment (Kottmeier's grade 2 or
      more) after RALS developed 1.5% (2/138, group A none, group B two) and 1.5%
      (2/138, group A one, group B one), respectively. This result suggests that this
      trial is acceptable on survival as well as complication rates.

PMID- 1763405
TI  - [Simultaneous radiotherapy and chemotherapy with cisplatin and 5-fluorouracil in
      advanced head and neck tumors].
AB  - Between 1.1. 1987 and 31.12. 1988 47 patients with locally advanced head- and
      neck tumours (UICC-stage II: one patient, stage III: 16 patients, stage IV: 30
      patients) were treated with simultaneous radio-chemotherapy. Localisations were
      hypopharynx (23 = 49%), oropharynx (16 = 34%) and other sites (8 = 17%).
      Radiation therapy consisted of 60 Gy (primary region, N+) or 50 Gy (N0) in daily
      fractions of 2 Gy each over six weeks. During week 1 and 5 of radiotherapy two
      courses of chemotherapy with 5-FU (600 mg/m2/day, i.v. continuous infusion for
      five days) and cis-platin (25 mg/m2/day i.v. bolus for five days) were
      administered. 43/47 patients (91%) responded to therapy. 34/47 (72%) patients
      achieved a complete remission, 9/47 (19%) a partial remission, and 4/47 (9%) no
      change. With a minimum follow-up of 26 months 17/47 patients (36%) are alive and
      NED, 4/47 (9%) are alive with tumour. 18 patients (38%) died of cancer, eight
      patients (17%) died of second tumours, intercurrent diseases and of unknown
      reasons. Actuarial four-year survival is 45% (stage III: 56%, stage IV: 42%),
      four-year NED survival is 35% (stage III: 68%, stage IV: 18%). There were no loco
      regional recurrences after additional surgical treatment of the primary and the
      neck following complete remission. In contrast after RCT alone and complete
      remission local recurrences in 6/21 patients (29%) and regional recurrences in
      5/24 patients (21%) occurred. We conclude that simultaneous RCT is a new very
      effective treatment modality of locally advanced head and neck tumours producing
      superior loco-regional control compared to conventional management.

PMID- 1763407
TI  - Biological isoeffect distributions: consideration of the influence of dose per
      fraction and overall treatment time. A possible tool in future treatment
      planning.
AB  - The biological isoeffect distributions are calculated on the basis of the
      physical isodose distributions. They consider parameters of biological relevance
      such as the dose per fraction and the overall treatment time. A clinical example
      is presented to illustrate the method. The technique presented in this paper only
      requires minimal modifications in the conventional computer programs for
      treatment planning and can be updated very easily. The calculation of biological
      isoeffect distributions is a simple technique to facilitate the transfer of new
      radiobiological and clinical findings on alpha/beta ratios, tolerance doses and
      repopulation kinetics, into treatment planning. However, before they can be
      introduced into clinical practice, more reliable radiobiological data on normal
      tissues and tumours are required.

PMID- 1763408
TI  - [Effects of lonidamine alone or in combination with radiotherapy on survival and
      metabolism in human and rodent cell lines].
AB  - In vitro investigations on the combined effect of radiation and Lonidamine in one
      human (LXI) and two rodent cell lines (3T3, V79) showed not a clear
      radiosensitizing effect. Especially no inhibiting influence on the repair of
      potentially lethal damage of V79 cells was found. Incubation at lower pH values
      (6.7 to 6.9) caused no increasing effects. Lonidamine induced damage on the
      mitochondrial dehydrogenase-system was quantitatively measured with a modified
      MTT-assay.

PMID- 1763409
TI  - [Effects of aphidicolin on cell recovery and repair of DNA damage in irradiated
      human fibroblasts].
AB  - The effect of aphidicolin, a specific inhibitor of DNA polymerases alpha and
      delta, on recovery and repair of X-irradiated human fibroblasts was investigated.
      Aphidicolin concentrations from 0.5 to 5 micrograms/ml reduce DNA synthesis in
      exponentially growing cells after short incubation periods (1 h), longer
      incubation times (24 h) enhance this effect. Colony forming ability of
      unirradiated fibroblasts, treated in confluent growth state with aphidicolin, was
      not reduced. After incubation with aphidicolin contact-inhibited fibroblasts show
      reduced PLD recovery. For the short preincubation time (1 microgram/ml) the
      effect depends on aphidicolin concentration, for the long preincubation period
      the effect is independent of concentration. DNA double-strand break induction and
      rejoining was investigated after combined action of aphidicolin and X-rays using
      the neutral filter elution technique. The yield of initial DNA double-strand
      breaks was not affected by aphidicolin. After a 90-min recovery time, however,
      DNA double-strand break rejoining was markedly reduced. This effect was dependent
      on concentration for the short incubation time (1 h) but not for the long
      preincubation (24 h).

PMID- 1763410
TI  - Acute effects of T-2 toxin on radioactive iron incorporation into circulating
      erythrocytes in mice.
AB  - The 24-h and 72-h incorporation of 59Fe into circulating erythrocytes in mice
      were strongly inhibited by a single subcutaneous dose of T-2 toxin given 1 h
      before the radioisotope. The system is extremely sensitive, since a significant
      effect was detected with T-2 toxin doses as low as 0.30 mg/kg, which is about one
      tenth of the LD50 in the BALB/c strain used for the present study. In the treated
      animals no initial changes were observed in the blood 59Fe levels or in the rate
      of radioisotope clearance from plasma, indicating that the toxin does not
      interfere with iron absorption or transport. It is concluded that the inhibition
      observed reflects the damage produced by this toxin on reticulocytes and/or
      erythroblasts, and therefore this method could be of value as a very sensitive
      means of studying the risk of erythropoietic injury produced by dietary exposure
      to trichothecene mycotoxins.

PMID- 1763411
TI  - Effect of antioxidants on vanadate-induced toxicity towards isolated perfused rat
      livers.
AB  - The effect of trolox C, a water soluble vitamin E analogue, propyl gallate and
      ascorbate on vanadate hepatotoxicity was investigated in vitro. In isolated
      perfused livers from fasted rats, sodium orthovanadate (2 mmol/l) led to toxic
      responses including reduction of oxygen consumption, release of cytosolic
      (glutamate-pyruvate-transaminase (GPT) and lactate dehydrogenase (LDH)) and
      mitochondrial (glutamate-dehydrogenase (GLDH)) enzymes, intracellular
      accumulation of calcium, a marked depletion of glutathione (GSH) and an enhanced
      formation and release of thiobarbituric acid- (TBA) reactive material. Trolox C
      and propyl gallate inhibited the release of GPT and LDH partially and that of
      GLDH totally, but had no influence on vanadate-induced calcium accumulation or on
      the reduction of oxygen consumption. Both agents suppressed vanadate-induced
      lipid peroxidation (LPO) and partially prevented GSH depletion. Ascorbate failed
      to provide any protection probably due to the interference of its pro-oxidant
      potential with its antioxidant activity. The protection, mainly of mitochondria,
      afforded by those agents which also inhibited LPO substantiates our previous
      findings that the pro-oxidant activity of vanadate is mainly responsible for its
      direct hepatotoxic actions [2]. Besides, reduction of organ perfusion rate due to
      vasoconstriction also contributes to vanadate toxicity, but oxidative stress is
      not involved in this indirect toxic activity.

PMID- 1763412
TI  - Renal accumulation and urinary excretion of cisplatin in diabetic rats.
AB  - Previous work has demonstrated that cisplatin nephrotoxicity was attenuated in
      streptozotocin (STZ)-induced diabetic rats. The following studies investigated
      the hypothesis that renal cisplatin accumulation was reduced in diabetic rats.
      Male Fischer 344 (F344) rats were injected with 32 mg/kg STZ (i.p.) or citrate
      buffer. Renal platinum (Pt) accumulation was quantitated 0-96 h after the
      administration of 5 mg/kg cisplatin (i.p.) to normoglycemic and diabetic rats
      (greater than or equal to 4/group). Total renal Pt accumulation was decreased (P
      less than 0.05) in the diabetic rats, when compared to the normoglycemic group, 6
      48 h after cisplatin injection. Further studies were also conducted to examine if
      urinary cisplatin excretion was enhanced in diabetic relative to normoglycemic
      groups. Urinary Pt excretion was quantitated 0-96 h following cisplatin (5 mg/kg,
      i.p.) administration. Pt excretion was increased in the diabetic group relative
      to the normoglycemics when comparisons were made on the basis of Pt excreted per
      hour or cumulative Pt excretion. Differences were also detected in urinary Pt
      concentration. The diabetic group had a lower urinary concentration of the metal
      12-96 h after cisplatin injection. These findings suggest that the reduction in
      nephrotoxicity in diabetic rats may be at least partially due to decreased renal
      accumulation as well as altered renal excretion.

PMID- 1763413
TI  - Role of lipid peroxidation on renal dysfunction associated with glutathione
      depletion. Effects of vitamin E.
AB  - This study was designed to investigate the role of lipid peroxidation in the
      pathogenesis of renal dysfunction in glutathione (GSH)-depleted rats. Renal
      function parameters and acid-base status were analyzed in diethylmaleate (DEM)
      treated rats previously injected with vitamin E (Vit.E). Vit.E was effective in
      inhibiting the elevation in renal lipid peroxidation found in GSH-depleted rats.
      Vit.E also ameliorated the renal response to the metabolic acidosis without
      modification in lactate production induced by DEM administration. The increase in
      sodium and water urine excretion and the diminution of the urine to plasma
      osmolalities ratio were not reversed in these animals. These results lead us to
      conclude that lipid peroxidation is associated with distal acidification
      impairment observed with GSH-depletion, but it is not related to the sodium
      reabsorption alteration in the ascending loop of Henle.

PMID- 1763414
TI  - Effects of ozone on cellular ATP levels in rat and mouse alveolar macrophages.
AB  - Hydrogen peroxide (H2O2) is thought to be a major intermediate in the toxicity of
      ozone. In a previous study we demonstrated that ATP depletion may play an
      important role in the H2O2-induced inhibition of the phagocytic functions of
      alveolar macrophages. Ozone exposure can adversely affect the phagocytic
      capacities of alveolar macrophages. In the present study we investigated whether
      a decrease in the cellular ATP concentration may underly the effects of ozone on
      alveolar macrophages. Neither following single (6 and 12 h) exposure nor repeated
      (12 h/day for 3 and 7 days) exposures of mice or rats to 0.4 ppm ozone, were
      decreased levels of ATP found in the alveolar macrophages. In contrast, repeated
      exposures of mice for 7 days to ozone led to a significant increase (1.5-fold) in
      the ATP content of the alveolar macrophages. In vitro ozone exposure of rat and
      mouse alveolar macrophages also did not lead to a decrease in the cellular ATP
      concentration. These results showed that ATP depletion does not play a role in
      the toxicity mechanism of ozone for alveolar macrophages.

PMID- 1763415
TI  - Effects of aflatoxin B1 on myelopoiesis in vitro.
AB  - The short-term cultures of mouse myeloid progenitor cells for granulocytes and
      monocytes, granulocyte-monocyte colony-forming units (CFU-GM) (CFU-GM assay) and
      mouse long-term bone marrow culture (LTBMC) were used to investigate the
      hemopoietic suppression caused by aflatoxin B1 (AFB1). A dose-related suppression
      of granulopoiesis in short-term bone marrow cultures was seen when the cultures
      were treated with 10, 5, 1, 0.5 and 0.1 micrograms of AFB1/ml. Two selected doses
      of AFB1 (5 and 0.5 micrograms/ml) considered to be highly and slightly
      suppressive in CFU-GM assay exerted a strong suppression of myelopoiesis in LTBMC
      when applied long-term. Short-term (2 h) exposure of LTBMC to 5 micrograms of
      AFB1/ml caused a small damage to the myelopoiesis detected in the non-adherent
      layer. Short-term exposure to 0.5 micrograms AFB1/ml was without any effect on
      myelopoiesis in LTBMC. The production of colony-stimulating activity (CSA) by an
      adherent layer of LTBMC was decreased on the second and fifth day after the short
      term exposure to both doses of AFB1 and comparable with non-treated culture on
      the seventh day after the exposure. Presented results indicate that both short
      term culture of CFU-GM and LTBMC can be used in the definition and the prediction
      of host toxicity of AFB1 to hemopoiesis. However, comparing these two in vitro
      systems, the LTBMC appears to be more sensitive and discriminatory in an
      evaluation of hemopoietic toxicity.

PMID- 1763416
TI  - 1,1-Dichloroethylene hepatotoxicity: hypothyroidism decreases metabolism and
      covalent binding but not injury in the rat.
AB  - Our objective was to determine if the previously reported protective effect of
      hypothyroidism against 1,1-dichloroethylene hepatotoxicity was associated with a
      change in distribution and covalent binding. Sprague-Dawley male rats were made
      hypothyroid (HypoT) by surgical thyroidectomy 2 weeks prior to studies and
      compared to euthyroid (EuT) rats. Hypothyroidism decreased body weights and liver
      to body weight ratios while mitochondrial non-protein sulfhydryl groups and
      cytosolic alcohol dehydrogenase activities were increased by 50%. Rats received a
      single oral dose of 100 mg [14C]1,1-dichloroethylene (DCE)/kg in mineral oil and
      were killed at 2, 4, 12 or 24 h; controls received mineral oil only. More rapid
      liver injury, as measured by serum alanine aminotransferase activity and
      histology, was present at 2 and 4 h after DCE in HypoT than EuT rats, but a
      similar magnitude of injury was evident at 12 and 24 h. DCE decreased liver non
      protein sulfhydryl groups to a comparable extent in HypoT and EuT rats. Cytosolic
      glutathione S-transferase and alcohol dehydrogenase activities were decreased
      only in HypoT rats after DCE. HypoT rats excreted approximately 30% less total
      [14C]DCE-derived label in urine and their livers, kidneys and lungs consistently
      contained slightly less covalently bound [14C]DCE-derived label. In contrast,
      between 1 and 4 h after DCE, greater amounts of acid-soluble and acid
      precipitable [14C]DCE-derived label were recovered in red blood cells of HypoT
      rats. Our results indicate that hypothyroidism did not protect against oral DCE
      hepatotoxicity but was associated with a more rapid injury at early times.
      Concurrently, hypothyroidism was found to change the fate of [14C]DCE with higher
      amounts of 14C-label recovered at early times in red blood cells while less 14C
      label was excreted in urine and bound to liver.

PMID- 1763417
TI  - Effects of trichloroethylene on hepatic and splenic lymphocytotoxic activities in
      rodents.
AB  - The effects of trichloroethylene (TRI), a widely used industrial solvent, on
      various immunological and toxicological parameters have been examined in Sprague
      Dawley rats and B6C3F1 mice. Rats were administered TRI in vivo at 0.05, 0.5 and
      5.0 mmol/kg per day intraperitoneally (i.p.) for 3 days. Mice were similarly
      treated with TRI at 10.0 mmol/kg. The highest TRI dose resulted in decreased
      splenocyte count and relative spleen weights, in rats and mice respectively and
      inhibition of hepatic natural killer cell (NK), natural cytotoxic cell (NC) and
      NPK cell (a newly described immune cell killing) activities in both rats and
      mice. High dose TRI in vitro resulted in minor decreases (less than 10%) in
      splenocyte viability, inhibition of LPS-stimulated mitogenesis in rat cells and
      marked inhibitions of NK and NC activities in all groups of effector cells. At
      the lowest in vitro dose mouse hepatic NK activity was still inhibited. Overall
      the data show that TRI is able to inhibit the activity of lymphocytotoxic cells
      which are involved in the immune surveillance of cancerous cells. This inhibition
      is particularly evident in the liver after in vivo administration and both liver
      and spleen cells after in vitro exposure. This suggests the possibility that
      compromised immune function may play a role in the carcinogenic responses in
      experimental animals on exposure to TRI.

PMID- 1763419
TI  - [Limitless].

PMID- 1763418
TI  - Cardiotoxicity and cytotoxicity of the anthracycline analog 4'-deoxy-4'-iodo
      doxorubicin.
AB  - The cardiotoxicity and cytotoxicity of the novel doxorubicin (DXR) derivative 4'
      deoxy-4'-iodo-DXR were evaluated and compared to DXR. A single dose of DXR 10
      mg/kg i.v. in anesthetized rats induced a significant widening of S alpha T
      segment of the electrocardiogram, an increase in both mean arterial blood
      pressure and heart rate and a fall in systemic arterial dP/dtmax, while 4'-deoxy
      4'-iodo-DXR 4 mg/kg i.v. induced a significant widening of S alpha T segment and
      an increase in mean arterial blood pressure. A chronic cardiomyopathy was induced
      over a 6-week period by three injections of DXR 3 mg/kg per week i.v. and was
      characterized by a progressive enlargement of S alpha T segment, a flattening of
      T wave, the occurrence of arrhythmias and histological alterations of myocardium.
      The contractile responses to adrenaline of isolated hearts from DXR-treated
      animals were significantly reduced compared to controls. 4'-Deoxy-4'-iodo-DXR
      (1.2 mg/kg per week three times) induced minor ECG alterations and sporadic
      episodes of arrhythmias. The contractile responses of isolated hearts were not
      significantly different from those of controls and microscopic examination of
      hearts revealed only minor changes. Cytotoxicity in vitro was evaluated by the
      colony formation assay; based on IC50, 4'-deoxy-4'-iodo-DXR was up to six times
      more cytotoxic than DXR on four human cancer cell lines. These results suggest
      that 4'-deoxy-4'-iodo-DXR is significantly less cardiotoxic and more cytotoxic
      than DXR.

PMID- 1763420
TI  - [Nursing home admission; a study among elderly applicants].
AB  - This article describes the care needs, social network, housing conditions,
      utilization of care and diagnoses of 157 elderly applicants to nursing homes in
      Maastricht. The study was conducted during the period of February 1987 to July
      1988. Possible differences in these characteristics in relation to the goal of
      the admission (rehabilitation versus continuous support) and in relation to prior
      living arrangements (home versus hospital) were investigated. In addition, the
      question to what extent substitution of care is possible is discussed. Within the
      group of nursing home applicants, a fairly clear distinction could be made
      between a number of subgroups, although care needs, social network (with the
      exception of the number of visits paid), and demographic characteristics showed
      no differences in relation to admission goals and prior living arrangements. The
      distinction was based particularly on the nature of the disorders
      (psychogeriatric versus somatic and chronic versus more or less acute), which was
      reflected not only in the main diagnosis itself, but also in differences in
      housing conditions, numbers of visits paid to others, and utilization of care
      prior to admission. Under the proposed policies for substitution, about a quarter
      of the applicants would be eligible for substitution. However, the major care
      needs, and the levels of formal and informal care prior to admission, as well as
      the shortage of alternative services, would seem to indicate that the actual
      possibilities for substitution are more limited.

PMID- 1763421
TI  - [Falling and getting up in a psychogeriatric nursing home. 2-year Incident
      Reports Resident Care].
AB  - In 1988 and 1989 2880 incidents were reported in the psychogeriatric nursing home
      Stadzicht in Rotterdam. The incidents consist mainly of patient-falls (40%) or
      patients being found on the floor (29%). A patient falls approximately 2 times a
      year and is found on the floor approximately 1.5 times a year. Male patients ran
      a greater risk of falling than female patients. The incidents occur especially
      during the daytime in the living room or the hall. In 41 (2%) incidents the
      consequences for the patient are serious, including 28 hipfractures. Intrinsic
      factors (such as gender) are more important risk factors for falling than
      extrinsic factors (environment or the use of physical restraints). Several risks
      are therefore inevitable. The extrinsic factors are most suitable for prevention
      in the short run. Furthermore, it is necessary to asses patients on admission in
      terms of proneness to falls.

PMID- 1763422
TI  - [Faces get names--cognitive training for psychogeriatric patients for remembering
      names and faces].
AB  - By systematic training, 14 psychogeriatric patients (aged 70 to 95 years and
      admitted to day care because of dementia) were taught the first names of 8
      members of staff of the day care center. Treatment duration was one month, twice
      weekly. The therapist introduced the names by a step-by-step approach, beginning
      with two name-face combinations, and adding one new name (and photograph of that
      person's face) every next training session. Treatment consisted of a combination
      of several cognitive strategies: organisation and directed attention, rehearsal,
      first letter cueing and vanishing cue techniques, and paired-associate learning
      based on rhymes, pictures and visual imagery. Patients were assigned at random to
      a treatment and a control group (waiting list condition). Patients in the control
      group received their training after the waiting period of one month. Using this
      pretest-posttest-control-group design, we were able to objectively evaluate
      treatment effects. Treatment caused a significant enhancement of knowledge of
      staff members names. Gains achieved using this program persisted over at least
      one month, as could be demonstrated by a follow-up evaluation.

PMID- 1763423
TI  - [Validity of a new psychogeriatric behavior observation scale for application in
      nursing homes and homes for the aged].
AB  - In this article we report a study on the validity and discriminating power of the
      behaviour rating scale OPG - 'Observation Psycho Geriatrics'. The OPG was
      designed to measure the need of care and the remaining capacities of people with
      a mild dementia syndrome. To establish the external validity in nursing homes,
      the OPG was compared with the BOP (Dutch version of the Stockton Geriatric Rating
      Scale) for 74 residents and in homes for the aged with the BPS, a rating scale
      for mental and social problems (66 residents). Both scales show a substantial
      relationship with the OPG and confirm its validity. Assumptions concerning OPG
      scales were given for six different levels of residential care (829 residents).
      The 7 distinguished OPG-scales show differences in mean scores, which are in
      general plausible in the light of these assumptions. The mean scores for
      residents in homes for the aged who receive special treatment are best comparable
      with those of average nursing home residents.

PMID- 1763424
TI  - His and hers recombinational hotspots.

PMID- 1763425
TI  - Vertebrate development: an emerging synthesis.

PMID- 1763426
TI  - From linked marker to gene.
AB  - An area of increasing importance in human genetics research is the strategy of
      'reverse genetics' or 'positional cloning', whereby a gene associated with a
      genetic disease is isolated on the basis of its approximate chromosomal position.
      This article and the accompanying centrepage diagram describe the main features
      of this strategy and outline the techniques involved; they are designed to be
      used for teaching purposes and as a general reference for those from other fields
      of genetics research.

PMID- 1763427
TI  - Genetically identified protein kinases in yeast. II: DNA metabolism and meiosis.
AB  - Genetic analysis of protein kinases in Saccharomyces cerevisiae has revealed
      protein phosphorylation as a key regulatory mechanism both in the mitotic cell
      cycle and in meiosis. This article reviews genetically identified protein kinases
      that are associated with DNA metabolism and the meiotic pathway.

PMID- 1763428
TI  - Molecular analysis of male gametogenesis in plants.
AB  - Reproduction in plants rivals the complexity of the process in animals. Recently,
      several genes that are expressed at specific stages during male gametogenesis
      have been cloned. These anther-specific genes are providing tools with which to
      study the cis- and trans-acting factors that regulate gene expression during
      pollen formation. Sequence analysis of the coding regions of some of these
      abundantly expressed anther genes is providing unexpected insights into the cell
      cell interactions occurring during gamete formation and fertilization.

PMID- 1763429
TI  - 5-HT advances on four fronts.

PMID- 1763430
TI  - Nuclear magnetic resonance and differential scanning calorimetry as tools for
      studying drug-membrane interactions.

PMID- 1763431
TI  - Chaos and illusion.
AB  - Pharmacology is the study of the interaction of drugs with living organisms,
      especially humans. The body is a very complicated system, which suggests that the
      'effect' induced by a drug is not a single entity but a change in several
      variables at the same time, all of which are interrelated in a nonlinear fashion.
      Research on nonlinear systems in other fields of science--commonly known as chaos
      theory--may therefore be of use in understanding pharmacology, as explained here
      by J. M. van Rossum and J. E. G. M. de Bie. They argue that in the study of drug
      effects, several variables should be measured simultaneously. Many
      pharmacologists prefer to construct an illusion of reality, studying just one of
      the essential variables and averaging data in a population of subjects, thus
      losing the opportunity to understand what a drug really does to a patient.

PMID- 1763432
TI  - Amyloid deposition as the central event in the aetiology of Alzheimer's disease.
AB  - While there may be many causes of Alzheimer's disease (AD), the same pathological
      sequence of events, described here by John Hardy and David Allsop, is likely to
      occur in all cases. The recent discovery of a pathogenic mutation in the beta
      amyloid precursor protein (APP) gene on chromosome 21 suggests that APP
      Mismetabolism and beta-amyloid deposition are the primary events in the disease
      process. The occurrence of AD in Down syndrome is consistent with this
      hypothesis. The pathological cascade for the disease process is most likely to
      be: beta-amyloid deposition----tau phosphorylation and tangle formation---
      neuronal death. The development of a biochemical understanding of this
      pathological cascade will facilitate rational design of drugs to intervene in
      this process.

PMID- 1763433
TI  - Epidemiological observations on helminth infections of calves in southern Ghana.
AB  - This paper describes helminth infections in three groups of calves of different
      ages grazing naturally infested pastures from March 1987 to May 1988. Calves in
      which the faecal egg output was followed from birth showed Toxocara vitulorum
      eggs as early as two days after birth and maximum patency occurred after two
      months. The fall in Toxocara egg output coincided with a rise in that of the
      strongylates; Haemonchus spp., Trichostrongylus spp. and Oesophagostumum spp. The
      influence of rainfall in dictating strongylate nematode infection was clear with
      high egg output during high rainfall and low egg counts when the rainfall was
      lower. There was an indication that calves carry the infection from the end of
      the minor rainy season in November to the beginning of the next rains in March
      and then contribute to pasture contamination. However, calves born in December
      may remain uninfected until the onset of the rains.

PMID- 1763434
TI  - Porcine trypanosomosis in Nigeria: infections in local and exotic pigs in the
      Nsukka area of Anambra State.
AB  - A twelve-month survey in three Local Government Areas (LGA) in Nsukka zone,
      Anambra State, Nigeria revealed that out of 150 local and exotic breeds of pig
      examined, 46 (30.7%) were infected with trypanosomes. Both single and mixed
      infections of Trypanosoma brucei and T. congolense were observed. However, T.
      brucei was the predominant trypanosome encountered. The husbandry system in
      practice was the most significant factor influencing the prevalence of
      trypanosomes in the pigs. In addition significantly higher prevalences were
      recorded during the rainy seasons. Clinical trypanosomosis was encountered in
      only eight of the 46 positive cases seen, with anaemia, loss of weight and
      anoestrus being the most important effects associated with these infections. The
      pathogenic and economic significance of these findings are discussed.

PMID- 1763435
TI  - Economic value of urea-treated straw fed to lactating buffaloes during the dry
      season in Nepal.
AB  - An experiment was conducted to study the effects of feeding urea-treated rice
      straw to lactating buffaloes in the Koshi Hills. Six pairs of similar buffaloes
      on farms were selected. All were given a conventional diet based on rice straw
      for four weeks, then one of each pair was given 15 to 20 kg/day of urea-treated
      rice straw for a period of four weeks while the control group received untreated
      rice straw. In the final four week period all animals were given the conventional
      diet. Feeding straw treated with 4% urea increased the voluntary intake of straw
      by 25% and increased milk yield by 1.6 litres/day compared with buffaloes fed the
      conventional diet containing untreated straw. Milk production remained elevated
      after the four-week treatment period had finished. The results show that buffalo
      cows fed urea-treated straw achieved better weight gain, and milk yield increased
      significantly (P less than 0.01) compared with the control animals. During the
      treatment period the net benefit was 4.0 (i.e. US$1.16) Nepalese currency rupees
      (NCRs) per day and the incremental rate of return was 46 per cent. Moreover, in
      the four weeks following the treatment period the net benefit was 10.0 NCRs (i.e.
      US$0.40) per day. Ensiling rice straw with 4% urea can be recommended as a safe,
      economical and suitable method for improving the nutritional value of rice straw
      on small farms in Nepal thus increasing milk production and liveweight of
      lactating buffaloes. The practice of feeding urea-treated straw is economic for
      farmers during the dry season from January to April.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1763436
TI  - Bordetella bronchiseptica from aborted equine foetus.

PMID- 1763437
TI  - Prevalence of bovine campylobacteriosis in indigenous cattle of three states in
      Nigeria.
AB  - A survey of bovine campylobacteriosis in breeding bulls and cows was carried out
      in the states of Kaduna, Kano and Borno. Six hundred and eighty nine cattle
      composed of 585 and 104 breeding bulls and cows respectively were sampled.
      Campylobacter fetus subsp. venerealis was isolated from 12 bulls while
      Campylobacter fetus subsp. fetus was isolated from three of them. Campylobacter
      fetus subsp. fetus was isolated from four cows while Campylobacter fetus subsp.
      veneralis was isolated from one cow. The overall prevalence of campylobacteriosis
      in the three states was 2.9% (20/689). The result of the study identifies
      Campylobacter fetus subsp. venerealis as the agent of enzootic infertility in
      Nigeria and suggests that it may be a significant problem.

PMID- 1763438
TI  - Communal farmers and tick control--a field study in Zimbabwe.
AB  - Intensive dipping of cattle to control ticks and tick-borne diseases precludes
      development of endemic stability to the latter. Alternative control strategies
      have been recommended which reduce the frequency of dipping and permit the
      expression of tick resistance and endemic stability. However, such strategies
      imply acceptance by cattle owners of higher tick burdens. In this study the views
      of a group of communal farmers to tick control are described and the impact of
      these views upon adoption of other strategies is discussed.

PMID- 1763439
TI  - Distribution of Boophilus species ticks in Swaziland.
AB  - Recent outbreaks of bovine babesiosis caused by Babesia bovis in Swaziland had
      indicated the presence of the vector tick Boophilus microplus in the country
      although it had never before been directly identified. Engorged female Boophilus
      ticks were collected from cattle at diptanks in the course of a tick resistance
      survey and used to map the distribution of the two different species of
      Boophilus. B. decoloratus was found to be widespread throughout the country. B.
      microplus was identified for the first time in Swaziland and was found to have a
      patchy distribution. The implications of these findings are discussed.

PMID- 1763440
TI  - Copper deficiency in ruminants in the Rift Valley of East Africa.
AB  - Enzootic ataxia of newborn domestic ruminants and particularly of small ruminants
      is a widespread disease often observed in East Africa. It is characterised by
      very low blood copper levels and sometimes by histological lesions characteristic
      of a severe copper deficiency. This disease observed and described by various
      authors in Kenya, Ethiopia and Djibouti seems to be closely associated with the
      pedogeological area of the Rift Valley. Climatic conditions and geo-morphological
      characteristics of this area, particularly the molybdenum and sulphur excess in
      this volcanic region, seem to account for the marked clinical signs of this
      mineral deficiency.

PMID- 1763441
TI  - Analyses of baseline survey data on rinderpest in Bahr el Ghazal Province, with
      proposal of an improved vaccination strategy against rinderpest for southern
      Sudan.
AB  - Results from analyses of baseline surveillance data on rinderpest are used for
      proposing an improved vaccination strategy against rinderpest in southern Sudan.
      Sera from 4,074 (47%) of the total sample of 8,565 cattle collected in a series
      of cross-sectional surveys in 400 cattle camps in the Bahr el Ghazal Province of
      southern Sudan were tested for rinderpest antibodies using the standard virus
      neutralisation test (VNT) technique: 77.4% were positive while 22.6% gave
      negative results. The data were cross-classified according to five variables:
      herd management, breed, age, sex and geographic region (grazing location). The
      percentage antibody-positivity level (taken as an approximation of past
      experience with rinderpest antigen and the corresponding prevalence ratio
      estimates of relative risk) for each variable are discussed within the context of
      the known characteristics of immunity to rinderpest in endemic areas and the
      husbandry practices of the cattle owners in the study area. Results suggest that
      rinderpest "hot-spots" of transmission and/or low level of herd immunity should
      be mapped out for concentrated efforts to vaccinate calves and young adults so
      that the high level of antibody-positivity observed in this study can be
      maintained and transmission permanently interrupted.

PMID- 1763442
TI  - [Use of fluorescence methods in glaucoma].

PMID- 1763443
TI  - [Postradiation secondary glaucoma and prevention measures].
AB  - The authors have examined the possibility of preventing the development of
      secondary glaucoma after eye irradiation with a narrow medicinal proton beam.
      Twenty-eight patients with cilio-choroidal melanoma were involved in the study, 7
      male and 21 female ones, aged 48.4 on an average. The authors' findings evidence
      that postradiation changes in the anterior segment of the eye, resulting from
      radiation iridocyclitis, are mainly responsible for the development of secondary
      glaucoma. Preliminary laser-effected formation of iridal coloboma is conducive to
      a normal flow in the anterior chamber at the expense of an additional pupil
      functioning and thus helps reduce the possibility of secondary glaucoma
      development by 1.6 times (or by 38.5%).

PMID- 1763444
TI  - [Intraoperative diagnosis in removal of foreign bodies from the eye].
AB  - The efficacy of intraoperative application of a complex of diagnostic clinical
      and instrumental methods, including gonioscopy, biomicroscopy, ophthalmoscopy,
      electron location, transillumination, ultrasonic location, and acoustic scanning,
      has been demonstrated in surgeries for removal of foreign bodies from the eyes of
      548 patients. Clinical variants of the fragment site and the aggravating factors
      were defined, as were the informative value of each of the afore-said methods for
      each of these clinical variants.

PMID- 1763445
TI  - [Late results of cosmetic prosthesis in patients with anophthalmia syndrome].

PMID- 1763446
TI  - [Possibilities of reflexotherapy in the treatment of post-traumatic eye
      complications].
AB  - Reflex therapy was used in the treatment of 448 patients with various post
      traumatic conditions of the eye and its appendages. Both routine methods and the
      methods developed by the author were employed. Good results were achieved in the
      majority of cases. For the first time visual function was improved in the
      patients with optic nerve atrophy.

PMID- 1763447
TI  - [Use of quantum hemotherapy in multimodal treatment of uveitis].
AB  - The results of recurrent uveitis treatment in two groups of patients are
      analyzed. Group I patients were administered drug therapy, in Group 2 it was
      combined with auto-transfusion of UV-irradiated blood. Autotransfusion had a good
      effect on the general status of the patients, on the clinical course of the
      disease, and on some hemogram and immunity parameters. This permits a conclusion
      on the usefulness of adding quantum hemotherapy to the therapeutic complex for
      patients with uveitis.

PMID- 1763449
TI  - [Radial asymmetric keratotomy in mild-degree myopia].
AB  - The suggested method for surgical correction of weak myopia involves two mutually
      perpendicular incision on the cornea in the major meridians. These two incisions
      result in but a slight alteration of the tissues, and a stable refraction effect
      of about 1.5 diopters is achieved at once; vision acuity improves to make 0.9
      1.0.

PMID- 1763448
TI  - [Copper metabolism in scleral tissue and possibilities of its correction in
      myopia].
AB  - Copper measurements in scleral tissue of 14 cadaveric emmetropic eyes and in 10
      eyes with myopia of various degrees have shown a significant reduction of these
      levels in the equatorial and posterior segments of myopic sclera and abnormal
      distribution of copper in the tissue, this indicating disordered metabolism of
      this trace element. A method for drug correction of the detected disorder has
      been experimentally tried, consisting in administration under the Tenon's capsule
      of a copper coordination compound on a foam composition base, used for sclera
      fortifying injections in progressive myopia. This resulted in elevation of
      scleral copper concentration, activization of collagen biosynthesis processes,
      and improvement of scleral tissue elasticity.

PMID- 1763450
TI  - [Iridoangiography using indocyanine green in severely pigmented iris in clinical
      conditions].
AB  - The authors presented the results of iridoangiography. In the course of the
      studies it was established that infrared light is tolerated easier than the blue
      one in fluorescent iridoangiography. This technique is of interest for the study
      of microcirculation in the vessels of the iris of the eye in inflammatory and
      dystrophic processes.

PMID- 1763451
TI  - [Indocyanine green fluorescence iridoangiography in pigmented iris].
AB  - Indocyanine green (ICG) fluorescent iridoangiography was used to diagnose
      pigmented tumors of the iris. Ten patients with pigmented tumors of the iris were
      examined using a modified photo-slit lamp with infrared narrow-strip optic
      filters. Fluorescein fluorescent iridoangiography was found ineffective. ICG
      fluorescent iridoangiograms have shown the vascular net and helped define the
      time parameters. Signs characteristic of the studied condition were defined. ICG
      fluorescent iridoangiography, biomicroscopy, and clinical data helped specify the
      diagnosis, this permitting the choice of the correct treatment strategy.

PMID- 1763452
TI  - [Use of distant thermography in uveitis in children].
AB  - Forty-four children aged 6 months to 14 years, suffering from endogenous uveitis
      of various sites were examined at different phases of the diseases by a scanning
      type apparatus, AGA-780M-thermographer (Sweden). The results permit a conclusion
      that long-distance thermography may be effectively used to assess the ocular
      status even in small restless children. Uveitis active phase was found associated
      with a hyperthermal reaction in all the examined sites. Hyperthermia was found
      related to uveitis localization. The authors suggest that thermoasymmetry
      parameters and the corneolimbic gradient be used as additional objective criteria
      for the assessment of uveitis activity and dissemination in children.

PMID- 1763453
TI  - [A new method of drug administration into the posterior section of the sub
      Tenon's space].
AB  - A new method for instillation and deposition of drugs in the sub-Tenon's space
      has been developed, that permits the maintenance of a high concentration of the
      drug directly in contact with the posterior segment sclera and membranes of the
      optic nerve anterior segment. It consists in the following: a collagen hemostatic
      sponge, connected to a silicone tube, is implanted into the sub-Tenon's space;
      the drugs are administered via this tube. Analysis of the results of 115
      surgeries has demonstrated considerable advantages of this method over the
      traditional methods of drug instillation.

PMID- 1763454
TI  - [Planning of ophthalmologic research in the 11th 5-year period according to the
      branch fund of research activities].

PMID- 1763455
TI  - [Use of T-activin and thymalin in the treatment of ophthalmic herpes].
AB  - Therapeutic efficacies of thymalin and T-activin were assessed in 80 patients
      with ophthalmic herpes. Thymic hormone preparations are recommended for the
      treatment of a protracted condition. To monitor the course of immunomodulating
      therapy, the neutrophil injury index and measurements of secretory IgA in the
      lacrimal fluid may be used, besides the routine tests.

PMID- 1763456
TI  - [Ocular drug films: problems and perspectives].
AB  - Fifteen such films created at two Moscow Institutes were allowed for use after
      clinical trials by the Pharmacologic Committee of the USSR Ministry of Health.
      Two principal advantages of ocular medicinal films as against ocular drops and
      ointments are prolonged action of the drugs and accurate dosage of the drug.
      Application of films may replace subconjunctival instillations in a number of
      cases. The film completely dissolves in the conjunctival sac, thus providing the
      daily dose of the drug. Therefore the film may be applied once a day and only in
      grave cases twice. A packed film retains its activity and sterility for 12-14
      months. Unfortunately commercial films do not always meet the medicinal
      requirements. Noteworthy that individual intolerance of some film brands varies
      within 0.1 to 8.03%, and that there are certain contraindications against the use
      of these films. Ocular medicinal films is an intensive care dosage form that may
      be manipulated only by specially trained personnel. Of course the films cannot
      absolutely replace other forms of drug administration. Further research is
      necessary, aimed at improvement of the tolerance of films, creation of films for
      children, and commercial manufacture of the drugs that were found the most
      effective and were best of all tolerated, as well at training of personnel.

PMID- 1763457
TI  - [A device to determine sensitivity to glare].

PMID- 1763458
TI  - [Effects of laser fragmentation of the lens mass on ocular tissues in
      experimental animals].
AB  - Side effects of laser on the posterior corneal epithelium and the retina during
      intracapsular YAG laser fragmentation of transparent lens fibers in various modes
      of laser operation were experimentally studied. The pulse power varied from 3 to
      7.7 mJ, number of pulses from 55 to 160, length of exposure 10(-8) sec, diameter
      of the spot in the focus 30 microns. Animal eyes were enucleated on days 3-6
      after the procedure. Posterior corneal epithelium was examined in the Hitachi
      scanning electron microscope, the retina in a light microscope. The findings
      evidence that injury to the posterior corneal epithelium in intracapsular YAG
      laser fragmentation of the lens depends mostly on the number of pulses and not on
      the exposure energy. A safe number of coagulates should not surpass 100, this
      being quite sufficient for fragmentation of the lens fibers at exposure power of
      5-6 mJ. Such operation mode is safe for the retina as well, this recommending it
      for clinical use.

PMID- 1763459
TI  - [Ocular morbidity in Palestine].
AB  - Examinations of 1427 subjects (2848 eyes) on the Western Bank of the Jordan and
      in the Ghaza sector have revealed a high incidence of ophthalmic diseases,
      particularly of conjunctivitis, cataracts (nuclear among other ones), corneal
      opacities, pigmented retinal dystrophies, diabetic retinopathies, congenital
      conditions. Blindness resulted mostly from corneal opacities, most often
      developing after trachoma, and from congenital diseases of the eyes. Marriages
      between relatives appear to play an essential role in the development of
      congenital diseases of the eyes, as well as of pigmented abiotrophy of the
      retina.

PMID- 1763460
TI  - [A case of correction of weak vision by means of a system involving a dispersing
      intraocular lens].

PMID- 1763461
TI  - [Use of magnifiers in poor eyesight (literature review)].

PMID- 1763462
TI  - [Modification of sinusotomy].
AB  - Sinusotomy modification, developed by the authors, consists in combination of
      traditional subscleral surgery with posterior cyclo-retraction and the formation
      of an uveal pouch. This technique was used in the treatment of 28 patients (28
      eyes) with primary open-angle glaucoma. Immediate hypotensive effect was achieved
      in all the patients (in one case surgery was paralleled by pilocarpine
      instillations). Twenty-four patients were examined in late periods (up to 1 year)
      after surgery. Ophthalmic tone normalization was achieved in 91.7% of cases (in
      83.3% of cases no drug instillations were used). Vision acuity and visual field
      were unchanged or improved in 87.5 and 95.8% of cases, respectively. No grave
      complications were recorded.

PMID- 1763464
TI  - Change and challenges for the SVS.

PMID- 1763463
TI  - [Dosed drainage in the surgical treatment of post-traumatic glaucoma in
      children].
AB  - The authors have developed an operation involving artificial drainage system
      implantation to children with secondary posttraumatic glaucoma. The drainage
      system represents a silicon cylinder 2 mm long with an external diameter of 2 mm
      and internal diameter of 1.5 mm. A thin membrane attached to the internal walls
      of the cylinder along 1/3 of the diameter, free otherwise, is situated in the
      middle of the cylinder. There are small openings, directed to opposite sides, in
      the terminal sections of this membrane. Such surgery was carried out in 18 eyes
      of 18 children aged 5 to 14 with secondary posttraumatic glaucoma. The patients
      were discharged from hospital on days 7-10 after surgery with ophthalmic tone of
      17 to 21 mm Hg. A follow-up of up to 1.5 years has shown that the ocular pressure
      was normal (17-22 mm Hg) in 13 eyes, slightly higher in 4 (23-26 mm Hg), and high
      (35 mm Hg) in 1. Repeated surgery of this patient with revision of the
      intervention site has revealed that the distal end of the drainage tube was
      closed with solid connective tissue. This complication was due to a technological
      error in the course of operation.

PMID- 1763465
TI  - Tuberculosis and badgers.

PMID- 1763466
TI  - Epidemiology of Salmonella typhimurium infection in calves: persistence of
      salmonellae on calf units.
AB  - Salmonella typhimurium DT204C infection is the commonest cause of salmonellosis
      in calves. On five calf rearing farms a distinct strain, as indicated by plasmid
      profile analysis, was found to have persisted on the premises for periods ranging
      from four months to two years, the average being 14 months. The persistence of
      salmonellae in the environment appears to be an important factor in the
      epidemiology of calf salmonellosis and clearly indicates the inadequacy of many
      cleaning and disinfection routines.

PMID- 1763467
TI  - A radiographic method for measuring the effect of exogenous hormone therapy on
      uterine involution in ewes.
AB  - Twenty-six pluriparous Suffolk ewes were used to monitor the effects of four
      hormone treatments on the rate of uterine involution, which was assessed by means
      of radio-opaque markers and radiography. The close correlation between
      measurements of the genital tract in live sheep and after slaughter indicated
      that this method of monitoring uterine involution was acceptably accurate.
      Uterine involution was complete by about 29 days after lambing. None of the
      hormone treatments with progesterone, oestradiol-17 beta, prostaglandin F2 alpha
      or an oxytocin analogue, administered shortly after lambing, had any effects on
      the rate of uterine involution. There was no correlation between the duration of
      increased plasma concentrations of 13.14 dihydro-15-keto-prostaglandin F2 (PGFM)
      and the rate of uterine involution.

PMID- 1763468
TI  - Preliminary observations on reproduction in a female sheep-goat chimaera.
AB  - Four oestrous cycles of a female sheep-goat chimaera were monitored by using a
      vasectomised ram. The mean (+/- se) length of the cycle was 18.5 +/- 0.64 days
      with a range from 17 to 20 days. The chimaera was superovulated twice, bred to
      fertile rams, and the embryos recovered by laparotomy 13 or five days after
      oestrus, so that karyotype analysis could reveal the genotype of the oocyte.
      After the first superovulation one ovine day-13 embryo was collected; two
      fragments of another embryo (or embryos) were also collected, but readable
      chromosome spreads were not obtained from these embryos or from the two four-cell
      embryos that were collected five days after the second superovulation. Two
      surgical embryo transfers to the chimaera resulted in pregnancies. The first
      transfer involved an eight-cell ovine embryo and two caprine morulae and ended in
      the abortion of an ovine fetus between days 110 and 130. The second pregnancy
      occurred after the transfer of two ovine and two caprine morulae. A healthy lamb
      was born on day 147 of pregnancy. Both placentae had small numbers of cotyledons.
      A histological evaluation of the cotyledons revealed an abnormal placentome
      structure in the first pregnancy but not in the second.

PMID- 1763469
TI  - An electrocardiographic survey of cardiac rhythm in Irish wolfhounds.

PMID- 1763470
TI  - Morbillivirus infection in Mediterranean striped dolphins (Stenella
      coeruleoalba).

PMID- 1763471
TI  - Continued susceptibility of Ostertagia ostertagi infective larvae to morantel
      tartrate.

PMID- 1763472
TI  - Embryo transfer: putting welfare first.

PMID- 1763473
TI  - Bordetella bronchiseptica in a closed cat colony.

PMID- 1763474
TI  - Anthelmintic resistance.

PMID- 1763475
TI  - Integrated strategy to control East Coast fever.

PMID- 1763476
TI  - Atypical M avium induced tubercular lesions in pigs.

PMID- 1763477
TI  - Medetomidine in horses.

PMID- 1763478
TI  - Trypanosomiasis in different breeds of cattle from Benin.
AB  - Blood of different breeds of cattle, namely Lagune from the Atlantic province,
      Borgou and Borgou x Zebu from the Borgou province, and Somba and Zebu from the
      Atacora province of Benin, were examined for trypanosome infection. Thick and
      thin blood smears for trypanosomes, the card agglutination test (CATT), indirect
      immunofluorescent antibody test (IFAT) and trypanolytic test for antibodies to
      trypanosomes were used. Trypanosomes were detected in 19.3% (range 9.8-31.4%) of
      animals by examination of blood smears; antibodies to trypanosomes were found in
      89.8% (range 88.4-100%) of samples by IFAT, 50.6% (range 34-87.5%) by CATT and
      3.4% (range 1.1-7.1%) by trypanolytic test. Trypanosoma vivax and Trypanosoma
      congolense were the main species in Benin with a low number of Trypanosoma
      brucei. Zebu had lower infection rates than trypanotolerant breeds of Benin. The
      infection rates of various trypanotolerant breeds were not significantly
      different.

PMID- 1763479
TI  - Identification of sylvatic Trichinella (T3) in foxes from France.
AB  - Thirty-three foxes (Vulpes vulpes) from a sample of 1912 collected in France were
      found to be infected with Trichinella spp. Four isolates were obtained for
      genetic identification. Isoenzymatic and biological analysis of these isolates
      revealed the presence of two distinct genetic types of Trichinella, Trichinella
      spiralis s.str. (T1) and Trichinella sp. (T3) (Trichinella nelsoni according to
      Soviet authors) in the fox population. The reproductive capacity index of these
      isolates in Wistar rats was high for T. spiralis and low for T3. This is the
      first report of T3 type from wild animals in France. The epidemiological
      implications are discussed.

PMID- 1763480
TI  - Experimental Trichinella spiralis infection in sheep.
AB  - During susceptibility studies of non-specific hosts, three merino sheep were
      infected with 3000, 5000 or 7000 Trichinella spiralis larvae by gavage. Clinical,
      physiological and serological parameters were assessed during the experiment. On
      the 152nd day p.i., animals were necropsied and, using artificial digestion
      methods, numbers of Trichinella larvae in muscle tissues were determined. The
      most infected parts were masseters with 3122 larvae g-1 muscle, 5526 larvae g-1
      muscle and 4058 larvae g-1 muscle and diaphragms with 2778 larvae g-1 muscle,
      2725 larvae g-1 muscle and 2320 larvae g-1 muscle, for the 3000, 5000 and 7000
      infection levels, respectively. A positive correlation between infective rate and
      circulating antibodies was observed using ELISA and latex agglutination (LA) test
      methods. Trichinella larvae from sheep applied by gavage to ICR mice developed to
      the muscle stage. No significant changes were found in the clinical and
      physiological parameters of infected animals. Our results confirm the high
      susceptibility of merino sheep to T. spiralis infection.

PMID- 1763481
TI  - Evaluation of a beef-based chewable formulation of pyrantel pamoate against
      induced and natural infections of hookworms and ascarids in dogs.
AB  - Pyrantel pamoate, formulated in a beef-based chewable tablet, was evaluated for
      efficacy in dogs against induced and natural infections of Toxocara canis,
      Toxascaris leonina, Ancylostoma caninum and Uncinaria stenocephala. Dose
      titration trials were conducted in Canada, the UK and Germany in dogs treated
      with pyrantel (as pamoate salt) at 0, 2.5, 5 or 10 mg kg-1 body weight. These
      studies showed that a dose rate of 2.5 mg kg-1, the efficacy of pyrantel against
      adult T. canis, T. leonina, U. stenocephala and A. caninum was 76.1, 85.6, 100
      and 87.9%, respectively. Efficacy at 5 mg kg-1 against the same parasites was
      94.2, 92.0, 93.5 and 93.8%, respectively, and at 10 mg kg-1 efficacy was 91.2,
      97.6, 98.7 and 91.3%, respectively. No adverse effects due to treatment were seen
      in any of these trials.

PMID- 1763482
TI  - Antigen-specific lymphocyte proliferative responses in vaccinated and Hypoderma
      lineatum-infested calves.
AB  - Cattle infested with the common cattle grub, Hypoderma lineatum (Villers) develop
      specific humoral antibodies and a cellular immune reaction, defined by delayed
      type hypersensitivity, to purified H. lineatum proteins. This investigation was
      designed to study the antigen-specific bovine lymphocyte response to hypodermin A
      (HyA), a serine protease of larval first-instar H. lineatum. Calves were
      vaccinated with either native or denatured HyA, and challenge-infested with H.
      lineatum. The kinetic development of a cellular immune response to HyA was
      monitored during vaccination and infestation. The HyA-specific responses were
      highly variable and weak during vaccination and infestation. Although HyA
      specific lymphocyte blastogenic responses were observed, no correlation was noted
      between the magnitude of antigen-specific, peripheral lymphocyte proliferation
      and larval mortality. In striking contrast to responses observed during
      infestation, intense HyA-specific lymphocyte responses were observed with 3
      calves 6 months after recovery from infestation. In addition, those responses
      were further heightened by a 250 micrograms booster injection of pure HyA.

PMID- 1763483
TI  - Survey of Eimeria spp. oocysts in feces from Louisiana State University ewes.
AB  - The prevalence and identification of Eimeria spp. in the Louisiana State
      University ewe flock were determined from 109 fecal samples. Unsporulated oocysts
      were recovered from 94 of the samples and 1208 oocysts representing ten species
      of Eimeria were identified: E. ahsata, E. crandallis, E. Faurei, E. granulosa, E.
      intricata, E. ovina, E. ovinoidalis, E. pallida, E. parava and E. punctata.
      Eimeria ovinoidalis, which is probably the most pathogenic, was the species
      common to the most number of samples (59.6%); however, E. granulosa, which is non
      pathogenic, was the most numerous species (23.7% of the total identified). The
      prevalence and identification of oocysts from ewes may be useful to evaluate
      infection potential when considering control programs, especially for lambs.

PMID- 1763484
TI  - Prevalence of Sarcocystis in domestic pigs in India.
AB  - Muscle samples from 890 slaughtered pigs were examined for the presence of
      sarcocysts. A high prevalence rate of 67.98% was observed. Two types of
      microsarcocysts were recorded. The sarcocyst wall of one type had redial
      striations and the other possessed hair-like villar protrusions. The species were
      identified as Sarcocystis miescheriana and Sarcocystis suihominis; there was a
      slightly higher incidence of the latter species (47.11%) than of the former
      (43.14%). S. suihominis has been identified for the first time from pigs in
      India.

PMID- 1763485
TI  - Effect of temperature on transtadial transmission of Theileria annulata in
      Hyalomma anatolicum anatolicum ticks.
AB  - The effect of temperature on the transtadial transmission of Theileria annulata
      in Hyalomma anatolicum anatolicum was studied. Variation in temperature (4-40
      degrees C) had a significant effect on moulting rate of the ticks and
      transmission of theilerial parasites from nymphs to resultant adults. The
      temperatures above 40 degrees C and below 12 degrees C prevented moulting.
      Maximum infection levels were obtained in salivary glands of adult ticks when the
      infected engorged nymphs were incubated at 24-28 degrees C. The infection rate in
      salivary glands was assessed using a methyl green pyronin technique.

PMID- 1763486
TI  - Treatment of stephanofilariosis ('earsore') with ivermectin.
AB  - Thirty-four adult male buffaloes with clinical signs of 'earsore' were used to
      determine the efficacy of ivermectin against Stephanofilaria zaheeri. On the
      basis of parasite counts in skin scrapings, ivermectin was effective as a
      microfilaricide. Adult parasite counts were reduced, but removal of adults was
      incomplete. Clinical improvement was recorded in more than half of the treated
      buffaloes, but constant reinfection meant that meaningful interpretations were
      not possible.

PMID- 1763487
TI  - Spiculopteragia spiculoptera, S. asymmetrica and Ostertagia leptospicularis from
      Cervus elaphus in La Pampa, Argentina.
AB  - The nematode species Spiculopteragia spiculoptera, Spiculopteragia asymmetrica
      and Ostertagia leptospicularis were recovered from the abomasum of wild red deer,
      Cervus elaphus, in the forest area of the semi-arid Pampeana Region of La Pampa
      (Argentina) for the first time. Oesophagostomum venulosum and Dictyocaulus spp.
      were also found.

PMID- 1763488
TI  - Coccidia of the llama, Lama glama, in Colorado and Wyoming.
AB  - Fecal samples were collected from 144 llamas, Lama glama, on four premises in
      northern Colorado and southern Wyoming. Feces were examined for the presence of
      coccidial oocysts; Eimeria alpacae was found in 55.6%, Eimeria lamae in 67.3% and
      Eimeria macusaniensis in 1.4% of the samples. An adult female llama was found to
      be infected with Eimeria macusaniensis at necropsy. This is the first report of
      these species of coccidia in the llama.

PMID- 1763489
TI  - Gastro-intestinal parasitism of cattle in native pasture grazing system in
      Guadeloupe (French West Indies).
AB  - Gastro-intestinal parasitism of creole cows and calves, Limousin x creole cross
      calves and Brahman x creole cross calves was recorded during seasons of calving
      in a native grazing system in Guadeloupe, a wet tropical area. Calvings were
      pooled during the dry season for two herds and during the rainy season for two
      other herds. For each calving season, calves of one herd were drenched monthly
      with anthelmintic. A marked periparturient rise in egg excretion was observed in
      cows. Coccidial infection was always present in calves, but no clinical signs
      were observed. The main parasites during the first 2 months of life were
      Strongyloides papillosus and Toxocara vitulorum. Then, Haemonchus placei,
      Trichostrongylus spp. and Cooperia spp. were the dominant species encountered.
      Brahman cross calves were the most heavily infested animals. There was no clear
      relationship between third stage larvae (L3) population size on pasture and worm
      burdens in calves, except during the second month of life. Despite medium levels
      of infestation, parasitism inhibited the growth of creole calves: -10.5 kg of
      bodyweight at weaning (-59 g day-1 of daily bodyweight gain from birth to
      weaning). The pathological effects of subclinical parasitism were confirmed by a
      lower packed cell volume and albuminaemia in parasitized calves than in treated
      calves.

PMID- 1763490
TI  - Survival of snails and characteristic lesions of Fasciola hepatica infection in
      four European species of Lymnaea.
AB  - The survival of snails and characteristic organ lesions were investigated in four
      different age categories (new-born, 1 and 2 mm shell height, adults) and in four
      species of Lymnaea (L. glabra, L. palustris, L. peregra ovata, L. truncatula)
      infected by Fasciola hepatica. Mortalities were higher in infected groups on Days
      30 and 45 post-infection (+42% and +45%, respectively) than in controls. Lesions
      depended on the species and age of the Lymnaea. Epithelial necrosis of the kidney
      was recorded in L. glabra, L. palustris and L. p. ovata, whereas intralamellar
      deposits were found in the same organ of L. truncatula. All categories of L.
      truncatula had evolutive infections (snails with living parthenitae); the young
      snails of other species became infected, but the adults did not, as estimated at
      Day 45 post-infection. The lesions were related to the intensity of evolutive
      infections: necrosis of the digestive gland was found in moderate to low
      infections and, conversely, gonadal atrophy with epithelial necrosis was found in
      highly infected snails.

PMID- 1763491
TI  - Efficacy of albendazole, levamisole and fenbendazole against gastrointestinal
      nematodes of cattle, with emphasis on inhibited early fourth stage Ostertagia
      ostertagi larvae.
AB  - An experiment was conducted to compare the anthelmintic efficacy of albendazole
      (ABZ), levamisole (LEV) and fenbendazole (FBZ) against inhibited early fourth
      stage larvae (EL4) of Ostertagia ostertagi during April in Louisiana. Forty cross
      bred beef heifers (average weight 165 kg) were acquired during winter and grazed
      on pastures contaminated with O. ostertagi and other nematodes until early April.
      The cattle were weighed and randomly allotted into four groups of ten animals on
      6 April and treatments were administered on 7 April. Experimental groupings were:
      Group 1, non-treated controls; Group 2, ABZ by oral drench at 10 mg kg-1; Group
      3, LEV by topical, pour-on administration to back midline at 10 mg kg-1; Group 4,
      FBZ by oral drench at 10 mg kg-1. Equal numbers of cattle from each group were
      slaughtered daily between 10 and 13 days after treatment. Mean numbers of O.
      ostertagi developmental stages present in untreated controls were: adults,
      13,714; developing L4 (DL4), 6487; inhibited EL4, 21,719. The mean percentage of
      inhibited EL4 was 51.8. Smaller numbers of Haemonchus placei, Trichostrongylus
      axei and Cooperia spp. were recovered uniformly in control cattle. Percentage
      reduction values for the three compounds against O. ostertagi adults, DL4 and
      EL4, respectively, were: ABZ, 99.0, 95.3, 84.9; LEV, 1.0, 21.8, 32.1; FBZ, 99.2,
      97.2, 97.5. Differences between ABZ and LEV EL4 counts were not significant, but
      in all other cases worm counts in ABZ and FBZ-treated cattle were significantly
      lower (P less than or equal to 0.05) than in LEV-treated and control cattle. Both
      ABZ and FBZ were 98-100% effective against Haemonchus adults and L4, T. axei
      adults, and Cooperia spp. adults and L4. LEV was 100% effective against
      Haemonchus adults and L4, 85.6% against T. axei, and 94.6% and 89.59% effective
      against Cooperia spp. adults and L4, respectively.

PMID- 1763492
TI  - Efficacy of levamisole against Ostertagia ostertagi in Louisiana cattle during
      maturation of inhibited larvae (September) and during minimal inhibition
      (December/January).
AB  - Levamisole (LEV) was tested in four experiments to compare efficacy values
      against Ostertagia ostertagi when larval maturation was occurring (September),
      following inhibition and also when populations were expected to be largely adult
      (winter). A primary objective was to determine the importance of developing
      fourth-stage larvae (DL4) and inhibited, early fourth-stage larvae (EL4) in
      replacing adult worms lost through treatment and the effect of this on reduced
      efficacy against adult worms. Young crossbred beef calves ranging in weight from
      150 to 230 kg were used in the first (September 1981), second (September 1983)
      and third experiments (January 1987). Jersey calves of 110 kg average weight were
      used in the fourth experiment (December 1988). Calves were randomized to groups
      according to weight and group sizes ranged from three to five calves. All
      parasite infections were naturally acquired, but a mixture of nematode third
      stage larvae (L3) (22,500 per calf), including 20% Ostertagia ostertagi, was
      inoculated into Jersey calves of Experiment 4 following a 2 week exposure to
      natural infection. All LEV treatments were by subcutaneous injection at dosages
      of 6 and 8 mg kg-1. Treatment with ivermectin was used only in Experiment 3 as an
      efficacy reference. All calves were killed at 8-10 days after treatment. The
      efficacy of LEV against all developmental stages of Ostertagia ostertagi was
      consistently low in all experiments and a dose-dependent response was not
      evident. Large numbers of all Ostertagia ostertagi developmental stages were
      present in non-treated calves in both September experiments. Percent reduction of
      adults, DL4 and EL4 at the 6 mg kg-1 and 8 mg kg-1 dosages, respectively, were
      adults, 51.7 and 23.6 (1981), 8.7 and 51.3 (1983); DL4 40.3 and 13.2 (1981), 37.9
      and 33.1 (1983); EL4, 19.6 and 0 (1981), 59.6 and 42.9 (1983). Smaller numbers of
      Ostertagia ostertagi were present in winter experiments and adult worms greatly
      outnumbered larval stages. Percent reductions of adults, DL4 and EL4,
      respectively, were (1987) LEV 6 mg kg-1, 40.2, 0 and 0; ivermectin 200 micrograms
      kg-1, 98.7, 97.7 and 100.0; (1988) LEV 6 mg kg-1, 62.4, 100.0 and 100.0; LEV 8 mg
      kg-1, 49.1 65.0 and 74.1. Too few larval stages were present in the latter
      experiment for valid efficacy values.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1763493
TI  - Effects of time of day, season and stratum on Haemonchus contortus and Haemonchus
      placei third-stage larvae on irrigated pasture.
AB  - The effect of time of day, season and stratum of herbage and soil on the
      availability of Haemonchus contortus and Haemonchus placei third-stage larvae
      (L3) on pasture was assessed. Feces from infected calves and lambs were placed on
      pasture plots and samples of upper herbage, lower herbage, mat and soil were
      collected at five intervals per day throughout the daylight hours on 18 sample
      days over 12 months. Using recovery rate factors derived from a preliminary
      investigation on the efficacy of larval recovery from each stratum, the data on
      larval recoveries were analyzed for the effect of season, time and stratum, and
      their interactions. Significant (P less than 0.05) differences were found for
      season, stratum and the season-with-stratum interaction for both parasites. No
      significant differences were detected for larval counts at different times of the
      day. Larval recoveries of H. contortus were larger throughout the study than
      those of H. placei. Most H. contortus L3 were recovered in the summer and autumn,
      and H. placei in the spring and summer. For both parasites, the recoveries of
      larvae from the upper and lower herbage were larger than those from the mat and
      soil. The implications of these findings are discussed in terms of control
      strategies.

PMID- 1763494
TI  - Interaction of parasitism and nutrition and their effects on production and
      clinical parameters in goats.
AB  - Weaned wether goats (n = 144) approximately 6 months of age were placed in a 2 x
      3 factorial design experiment for 5 months to test the main effects and
      interaction of two levels of nutrition (growth + maintenance, NUT1; twice growth
      + maintenance, NUT2) and three levels of Haemonchus contortus burden (0, 500 and
      2000 larvae administered every 2 weeks: W0, W500 W2000, respectively) on weight,
      feed intake, level of infection and packed cell volume (PCV). The rationale for
      the experimental design was based on the lack of information concerning the
      interaction between nutritional status and worm burden. Results indicated
      significant effects of worm burden levels on PCV, faecal egg contents (eggs per
      gram of feces (EPG)), actual worm numbers, feed intake and efficiency of feed
      utilization. Nutrition x worm burden interactions were also significant for PCV
      and EPG. However, the differences detected for PCV and actual worm numbers did
      not translate into large or consistent differences in body weight. Goats on NUT2,
      after an initial period, showed little difference in body weight, irrespective of
      worm burden. Within the NUT1 level, W0 kids weighed more than W500 or W2000 kids
      throughout the study. Although not statistically significant, this constitutes a
      trend towards an interaction between nutrition and worm burden. In both nutrition
      levels, there were no body weight differences between W500 and W2000 until the
      last 14 days. Feed intake was depressed in the first 3 months of the experiment
      for infected animals, but was subsequently followed by a compensatory reaction.
      Lower establishment rates, based on actual worm counts, were observed for the
      higher infection level, but in both infection levels establishment rates tended
      to decrease with time. Nutrition was found to be more important to counteract the
      consequences of a parasitic infection than to counteract the establishment of
      that same infection.

PMID- 1763495
TI  - Quantitation of soluble HLA class II molecules by an enzyme-linked immunosorbent
      assay.
AB  - In order to quantify soluble HLA-DR,DQ,DP molecules (sHLA-RQP) an enzyme-linked
      immunosorbent assay was developed utilizing two monoclonal antibodies specific
      for HLA-DR,DP (Tu35) and HLA-DQ (Tu22) gene products, respectively. Highly
      purified HLA class II molecules isolated from a lymphoblastoid cell line were
      used for calculation of exact sHLA-RQP protein values. Circadian variations of
      sHLA-RQP plasma levels were studied in 7 healthy probands showing no significant
      deviations; measurements in 4 probands at intervals between 4 and 6 weeks
      revealed that sHLA-RQP levels remain relatively stable. The population analysis
      of 209 unrelated, HLA-typed healthy donors resulted in an average protein
      concentration of 1.53 +/- 2.44 micrograms/ml plasma for sHLA-RQP. Four out of 209
      probands (= 1.9%) had no detectable sHLA-RQP. Significant associations of high or
      low sHLA-RQP levels to particular HLA-DR or -DQ specificities were not observed.
      However, plasma derived from HLA-DR9 positive had the highest and from HLA-DR8
      positive donors the lowest mean sHLA-RQP values. By comparing HLA identical with
      two-haplotype-different siblings we found no evidence that sHLA-RQP plasma levels
      are under genetic control of the HLA complex or closely linked genes.
      Furthermore, soluble HLA class I plasma concentrations in 100 probands analyzed
      showed no correlation to those of sHLA-RQP.

PMID- 1763496
TI  - Platelet antibody binding and spontaneous aggregation in 21 lupus anticoagulant
      patients.
AB  - In order to ascertain the role of the antiphospholipid antibody in the
      pathogenesis of thrombotic disorders, a study of 21 lupus anticoagulant-positive
      patients was done by a number of serologic and functional platelet tests. In
      immunofluorescent studies, we found that 80% showed a mitochondrial pattern on
      HEp cells and all patients gave an ubiquitously intense staining of donor
      platelets. By a microscopic spontaneous aggregation test, all lupus anticoagulant
      positive patients showed accelerated platelet aggregation which was calcium
      independent. The results show that the plasma of lupus anticoagulant-positive
      patients contains a platelet-binding antibody and causes spontaneous
      agglutination of platelets. These properties may play a role in the
      thrombogenesis common to the antiphospholipid syndrome.

PMID- 1763497
TI  - Serology and genetics of the red blood cell factor Rh34.
AB  - Rh34 antibodies were found to have a unique, previously only partly
      characterised, specificity within the Rh system. No evidence was seen that they
      were mixtures of hrB and Hr-like antibodies, or that hrB antibodies existed
      independently in the natural state. The term anti-hrB applied to Rh34 antibodies
      after they had been partially absorbed with R2R2 red cells. Four haplotypes not
      expressing Rh34 antigen were identified in the present study. The prefix * has
      been used to indicate them in this text. They were *r's (*dCces), *Ro (*Dce),
      *Rou (*D(uce)) and *R(od) (category III *Dce). Red cells with partially deleted
      or Rh(null) phenotypes were therefore not the sole red cells compatible with anti
      Rh34. R2R2 red cells, which are known to carry weak Rh34 antigen, were
      incompatible. Twenty-two family and mother-child studies established that the Rh:
      34 haplotypes were inherited as normal Mendelian dominant characters. Anti-Rh34
      was capable of recognising RH 34 dosage and of excluding some men who had been
      wrongly accused in disputed paternity tests.

PMID- 1763498
TI  - Autologous blood transfusion.

PMID- 1763499
TI  - Isolated anti-HBc and hepatitis B virus occult infection.

PMID- 1763500
TI  - Concomitant exposure of Tn and Th cryptantigens on the red cells of a patient
      with myelodysplasia.

PMID- 1763501
TI  - Can anti-HBc testing decrease the residual risk of transfusion-related HIV
      transmission?

PMID- 1763502
TI  - Autologous transfusion--too far, too soon?

PMID- 1763503
TI  - Effect of EDTA on platelet count and other platelet parameters in blood and blood
      components collected with CPDA-1.
AB  - We have shown in this study that addition of dried K2EDTA (1.5 mg/ml) to blood
      samples anticoagulated with CPDA-1 increases significantly the platelet count and
      mean platelet volume (MPV) of whole blood, red cell concentrate (RCC) and
      platelet concentrate (PC), but not of platelet-rich plasma (PRP) or of platelet
      poor plasma (PPP). Transmission and scanning electron microscopy illustrated that
      platelet aggregates which are present in some components are dispersed on mixing
      of the sample with EDTA and that this is accompanied by a change in platelet
      morphology. Determination of the platelet distribution width (PDW) indicated that
      the platelet populations in whole blood and RCC seem to be more uniform in size
      than the populations in PRP, PPP and PC. The determination of MPV and PDW changes
      after addition of EDTA may provide a new approach to quality control of PC.

PMID- 1763504
TI  - The influence of cryopreservation on activity and surface markers of lymphokine
      activated killer cells.
AB  - Ficoll-separated and monocyte-depleted mononuclear cells isolated from normal
      leukapheresis products were cryopreserved. These cells were incubated with or
      without 1,000 U/ml of recombinant interleukin-2 (rIL-2) for 4 days, and their
      lymphokine-activated killer (LAK) and natural killer (NK) activities were
      measured. IL-2 activation induced a significant increase in the expression of the
      CD25 antigen. There was no change in CD2, CD3, CD4, CD8, CD16, CD56 and CD57 cell
      marker expression. Cryopreservation did not induce any change in the membrane
      antigen expression and in the lymphocyte subsets. The NK activity was well
      preserved and the decrease of LAK activity of IL-2-activated cells after
      cryopreservation was not significant. In contrast, cells activated before
      cryopreservation had a significantly lower cytotoxic activity and the number of
      cells expressing the IL-2 receptor was also significantly reduced. However, the
      decrease of CD56 expression was not significant. CD25 expression seemed to be
      proportional to the LAK activity of the cells. This study demonstrated that
      cryopreserved lymphocytes, after 4 days of culture with rIL-2, could be as active
      and could express the CD25 and CD56 cell surface markers in the same manner as
      fresh LAK cells.

PMID- 1763505
TI  - Intravenous drug abuse causes Rh immunization.
AB  - Intravenous drug abuse causes many health problems. From March 1989 to January
      1990 of 27 Rh-negative women (28 pregnancies) referred to our centre, 4 women (5
      pregnancies) were Rh immunized due to the sharing of needles and blood with their
      Rh-positive partners. Severe hydrops was present in 4 of their 5 fetuses when
      they were first seen at 17-35 weeks of gestation. Only the fetus first seen at 35
      weeks survived. That infant was moribund at birth and now has evidence of
      leukomalacia and porencephaly. The fifth fetus, not hydropic, required two
      intravascular fetal transfusions in order to survive. A fifth woman, immunized in
      a similar manner, had a spontaneous abortion. These fetuses represent some of the
      earliest and severest examples of hydrops fetalis ever seen at our centre. The
      severity of their fetal hemolytic disease is probably due to the fact that their
      mothers' exposure to Rh(D) antigen by blood sharing was continuous and ongoing.
      Because of their aberrant behaviour, these women have suffered irreversible
      reproductive damage.

PMID- 1763506
TI  - [Effect of structured ambulatory training of patients with chronic respiratory
      tract diseases on the efficiency of long-term care].
AB  - In spite of the availability and widespread use of a number of effective
      medications, the frequency of severe attacks of asthma bronchiale including those
      with fatal outcome has not decreased. One possible reason for this is the delay
      in therapeutic intervention of up to 30 minutes resulting either from transport
      time to a hospital or from the response time of mobile ambulance services.
      Treatment delays are also frequent co-factors for decreased well-being in non
      emergency cases. Prompt initiation of countermeasures, regardless of time or
      place, can only be guaranteed when the patient himself is capable of carrying
      them out with the same expertise as his attending physician. Toward this end, a
      model patient-training program was investigated. The didactic goal of the
      training was to make the patient an expert in his chronic disease. The medical
      goal of the training was to improve the quality of a complex long-term therapy
      and with it, the patient's well-being and quality of life. The content of the
      training corresponded largely to that contained in a lecture series for medical
      students or physicians on the same subject. Style and choice of words (avoidance
      or explanation of medical terminology) was of course adapted to the lay-status of
      the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1763507
TI  - [Clinical epidemiologic data of malignant melanoma based on 1,368 patients of the
      Graz University Dermatology Clinic (1970-1989)].
AB  - Epidemiological and histological data of 1368 patients with invasive malignant
      melanoma treated at the Department of Dermatology between 1970 and 1989 were
      analysed retrospectively. Frequency of melanoma increased from 103 cases between
      1970 and 1974 to 593 between 1985 and 1989. The male/female ratio was 1/1.5 and
      did not change during the study period. Mean age of patients at the time of
      primary operation was 56.1 years and was approximately the same for males and
      females (males 55.8, females 56.3 years). The predominant site was the trunk in
      males (58.7 per cent) and the lower leg in females (41.6 per cent). There was a
      relative increase of melanomas of the back in males and the lower leg in females
      at the expense of melanomas of the face. The Breslow index was significantly
      higher in males than in females. In patients older than 69 years, the proportion
      of thick melanomas was above average. During the study period, the frequency of
      thick melanomas (greater than 1.5 mm) showed an encouraging decrease in both
      sexes. In 1989, 50 per cent of all melanomas were thinner than 1.01 mm. This can
      be interpreted as a successful outcome of efforts in preventive medicine.

PMID- 1763508
TI  - [Nicotine--drug addiction--AIDS. Drug use habits of Vienna addicts].
AB  - In Austria it is illegal to sell tobacco to young adolescents. A diverse sample
      of 358 narcotic addicts was investigated at the Psychiatric University Clinic of
      Vienna. Data were obtained from on site confidential interviews and a HIV-test
      was conducted. The individual drug use history was recorded and, interestingly,
      tobacco addiction was the first stage in starting a drug career. Furthermore, a
      strong correlation was observed between onset of heroin use and HIV-1 infection.
      It is concluded that in Austria not only the availability nicotine and alcohol to
      young adolescents should be prohibited, but also their use should be punishable.
      Easy access to nicotine as in public restaurants or from automatic distributors,
      has to be withdrawn. Tobacco advertisements may drive vulnerable young
      adolescents to early nicotine abuse and this may be followed by addition to other
      drugs and diseases causing death, including AIDS. Socioeconomic data, as well as
      the methadone data are presented. 180 out of the 358 patients were on methadone
      maintenance. Methadone treatment offers a first step toward social rehabilitation
      for drug addicts who have been living as criminals on the fringe of society.
      Physicians have a clear responsibility to lead the effort on all fronts against
      tobacco, especially in view of the HIV epidemic.

PMID- 1763509
TI  - Familial defective apolipoprotein B-100: molecular basis, prevalence and clinical
      features.
AB  - Familial defective apo B-100 is an autosomal dominant trait which causes moderate
      to severe elevation of LDL-cholesterol in the plasma and may predispose the
      coronary heart disease. The primary defect is a single amino acid change (Arg3500
      to Gln), which disrupts the normal binding of LDL to the LDL-receptor. The
      mutation occurs at an estimated frequency of 1/600 in the normal population and
      is, therefore one of the most common known single-gene defects causing an
      inherited abnormality.

PMID- 1763510
TI  - [Recurrent epicondylitis after Wilhelm's operation and its treatment].
AB  - Three patients among 107 operated on before 1985 according to Wilhelm's procedure
      for epicondylitis humero radialis showed no therapeutic response due to
      insufficient discission of the extensor carpi radialis brevis. We successfully
      used Garden's procedure at reoperation, with lengthening of the extensor carpi
      radialis brevis at the distal part of the forearm. As a direct result of our
      experience with these cases of recurrent epicondylitis we now consider a
      combination of the Garden and Wilhelm procedures the method of choice in treating
      patients suffering from the primary ligamentum anulare syndrome with shortened
      musculus extensor carpi radialis brevis. Two patients primarily treated according
      to the combined procedure have shown a successful result on follow-up over 60 and
      55 months, respectively.

PMID- 1763511
TI  - Therapeutic approaches to Lambert-Eaton myasthenic syndrome in the intra
      individual comparison.
AB  - A patient with Lambert-Eaton myasthenic syndrome was clinically treated several
      times over a period of 9 months. During at least 3 weeks each time, the patient
      received prednisone, then underwent 9 plasmaphereses, and was given guanidine
      hydrochloride (HCl) and 3,4-diaminopyridine (3,4-DAP). The muscle-power scoring,
      muscle function tests and the electrophysiological parameters showed a
      superiority of 3,4-DAP over the other pharmacological therapies. Good results
      were also obtained with plasmapheresis. Corticoid medication proved to be less
      effective. No improvement was seen with guanidine-HCl. For comparative judgement,
      two months after beginning the last therapy, the patient and the attending
      physician were questioned with regard to subjective therapeutic success. The
      answers largely match the objective results. Both favour 3,4-DAP. In contrast to
      the patient's opinion, the physician sees a distinct effect of plasmapheresis.
      All in all, the administration of 3,4-DAP may be seen as an effective and
      acceptable therapy in Lambert-Eaton myasthenic syndrome.

PMID- 1763512
TI  - [15-year-factor analysis of multiple sclerosis].
AB  - The authors have conducted a longitudinal survey for a period of 14 years with
      171 patients suffering from multiple sclerosis. In each case, therapeutic and
      diagnostic procedures were in accordance with the latest development. In almost
      half of the cases with a duration of illness up to 20 years the degree of
      impairment can be regarded as minimal, which can be used as an argument in favour
      of conscientious and continuous rehabilitative measures, including psychotherapy
      (this in opposition to a "rehabilitative pessimism"). Two thirds of the patients
      have been in employment with full working capacity during the first ten years of
      their illness. The consequences for social medicine and social policy are self
      evident and imperative. In accordance with earlier studies, motor pareses are
      predominant among the first symptoms of multiple sclerosis, whereas disorders of
      cranial nerves, of urinary excretion and of cerebral function appear later in the
      course of the disease. Factor analysis did not yield any clues with respect to
      the predictability of the development of illness. Psychoreactive depression is
      relatively common in the earlier stages, later we can find somatogenic (psycho
      organic) depressions, which respond relatively poor to treatment. Among the
      diagnostic tool, analysis of the critical flicker fusion frequency (CFFF) has
      proved to be very sensitive, by far not as cumbersome as visually evoked
      potentials and at least as reliable as the later. Therapeutic strategies should
      include: early treatment of any acute attack, consequent long-term care with
      modern nursing methods and rational concomitant medication, prophylaxis against
      infection. Multiple sclerosis represents itself as a problem of long-term
      rehabilitation, thus emphasizing the necessity of increased commitment to
      rehabilitation within a general framework of health care, which should include:
      a) better representation of rehabilitation as a discipline at the universities.
      b) systematic concomitant research in rehabilitation, c) legal and administrative
      adaptations, d) the development of a general "rehabilitation mentality" (as we
      have come to call it), which means involvement with the patient and his
      environment throughout his entire life-span.

PMID- 1763513
TI  - [Alzheimer dementia. A clinical long-term study with quantitative
      neuropathology].
AB  - Alzheimer's disease causes about 80% of dementias in old age. The pathological
      hallmarks of Alzheimer's disease are senile plaques (SP) and neurofibrillary
      tangles (NFT), which to a lesser degree can also be found in the brains of
      mentally intact elderly. The question whether SP or NFT or any other process are
      primarily correlated to severity of dementia can only be answered in prospective
      longitudinal clinical and neuropsychological studies with quantitative
      neuropathological investigation. We report the correlations between mini-mental
      state scores and lesion counts in 3 isocortical and 3 hippocampal areas in a
      consecutive series of 19 Alzheimer's patients studied prospectively in the Vienna
      Longitudinal Study on Dementia. Lesion counts increased at very late stages of
      dementia and were rather low in mild to moderate severity of dementia. Mildly
      demented patients with very slow progression of dementia also had rather high
      lesion counts. Neurofibrillary changes in NFT and neuritic plaques were
      correlated with severity of dementia, but diffuse plaques, i.e. SP without
      neuritic degeneration, were not at all correlated with severity of dementia. We
      speculate that NFT and SP do not represent the primary process which leads to
      dementia.

PMID- 1763514
TI  - [The confused and the demented patient as a problem in neuro-rehabilitation. Old
      age rehabilitation].
AB  - Organic psychosyndromes may be classified 1) by the state of vigilance (agitated
      or reduced), 2) by the progress in time (episodic versus progressive), 3) by the
      presence or absence of brain-local or vegetative accompanying phenomena, 4) by
      etiology. The most frequent forms are: multi-infarct-dementia and primary
      degenerative dementia of Alzheimer's type. We must be aware that this didactic
      differential diagnosis in reality mostly shows overlapping criteria. Either more
      to the one side or more to the other. Etiological therapy (as well "vasoactive"
      as "nootropic") should in most cases be combined with therapy of underlying
      internistic (cardiac for example) and accompanying (infection for example)
      symptoms. Depression as a special frequent dimension needs special attention.
      Furthermore there are complex therapeutic possibilities in the social,
      recreative, psychologic, rehabilitative, psychotherapeutic etc. field. Relatives
      need to be treated concommitantly. Only thus scientific as well as human
      implications for rehabilitation can meet.

PMID- 1763515
TI  - [The horse as an aid in therapy].
AB  - Physiotherapy on the back of the moved horse has two important dimensions: 1) The
      somatotropic effect regards mainly spasticity, ataxia, the vertebral column, the
      basis of the pelvis and the skin. 2) A general psychotherapeutic and
      psychohygienic effect is created by joy, change and new impetus in rehabilitation
      and by the emotional contact with the "comrade animal". Or unit was the first to
      introduce hippotherapy with adults in Austria. There is specially good experience
      with the spastic atactic component in multiple sclerosis. However other diagnosis
      as well showed good profit, such as stroke, etc. Some good effects in cephalaea
      patients indicate transition to riding as a medical pedagogic instrument with
      further transitions to psychosomatic patients. We want to proceed in this
      direction. Well organized hippotherapy is cheaper than the hydrotherapy (being
      current almost everywhere. Therefore opposition against the valuable hippotherapy
      by reasons of economics should be ruled out. Today's medicine goes farther and
      farther away from natural possibilities (slogan: "overtechnologized"). We see in
      hippotherapy an important counterweight in the sense of a valuable methodology
      towards holistic therapy especially in rehabilitation.

PMID- 1763516
TI  - Verofylline pharmacokinetics in dietary-induced obese rats: role of fat mass and
      protein binding in determining volume of distribution.
AB  - 1. Verofylline, a lipophilic polysubstituted methylxanthine, was utilized to
      examine how severely altered body composition in obesity affects drug
      disposition; the role of fat-free mass, fat mass and protein binding in
      determining the volume of distribution (Vss) was investigated. Obesity was
      induced by feeding Sprague-Dawley rats for 8 months with a calorie-dense diet;
      the obese rats showed increases of 50% in total body mass and 150% in body fat.
      2. Both the absolute Vss and the clearance (Cl) in the obese rats increased 2
      fold over control. Since Cl and Vss increased similarly, the half-life of
      verofylline in obese rats did not change. 3. The increase of Cl in obese rats can
      be accounted for by metabolic function related to fat-free mass and decreased
      serum binding. Similarly, an increase in fraction unbound and in total body mass
      accounted for the increase in Vss. 4. Based on in vitro measurements of muscle
      and fat tissue uptake of verofylline, and the assumed body space (from tritium
      dilution method), the predicted values for Vss closely approximated those of
      observed values. The semi-physiological model proposed here appears adequate to
      relate changes of body composition and serum protein binding in obesity to Vss.

PMID- 1763517
TI  - Investigations on the biotransformation of mebendazole using an isolated perfused
      rat gut system.
AB  - 1. The intestinal metabolism of the benzimidazole, mebendazole (MEB), has been
      investigated using isolated perfused jejunal segments of rats. Significant
      absorption and intestinal metabolism of the substance was observed. 2. The
      metabolites, the reduced alpha-hydroxy-analogue, its glucuronide, and the
      decarbamoylated 2-amino-analogue, were transported into the resorbate collected
      at the serosal side or were resecreted into the gut lumen. 3. The intestinal
      decarbamoylation of mebendazole increased up to 20-fold after pretreatment with 3
      methylcholanthrene (MC), and complete re-secretion of this metabolite into the
      gut lumen led to a total loss of the absorption of mebendazole and metabolites
      across the gut wall. 4. The results indicate the ability of the gut to metabolize
      mebendazole by phase I and II reactions. 5. An almost complete loss of
      bioavailability after induction of the gut enzyme system by MC was observed.

PMID- 1763518
TI  - Quinine is a more potent inhibitor than quinidine in rat of the oxidative
      metabolic routes of methoxyphenamine which involve debrisoquine 4-hydroxylase.
AB  - 1. Lewis rats (n = 7 or 8) were dosed with methoxyphenamine with and without
      prior administration of various doses of either quinine or its diastereomer
      quinidine. Methoxyphenamine and its N-desmethyl, O-desmethyl and aromatic 5
      hydroxy metabolites were quantified in 0-24 h urine. 2. The oxidative routes of
      methoxyphenamine metabolism which had been previously shown to involve the
      debrisoquine/sparteine isoenzyme, namely O-demethylation and 5-hydroxylation,
      were both significantly inhibited by quinine. The inhibition was selective in
      that N-demethylation which does not involve this isoenzyme was not affected by
      quinine. 3. Quinidine which had been previously shown at a relatively high dose
      (80 mg/kg) to affect the three metabolic routes of methoxyphenamine in a similar
      fashion was ineffective in this regard at a 25 mg/kg dose. Quinine more
      effectively inhibited the O-demethylation and 5-hydroxylation of methoxyphenamine
      than did quinidine, and its inhibition was marked at the lowest dose examined,
      12.5 mg/kg. 4. As quinidine is a more potent inhibitor than quinine of
      debrisoquine 4-hydroxylase in man, the rat should be used only with full
      realization of its limitations when investigating substrates metabolized by this
      isoenzyme.

PMID- 1763519
TI  - The metabolites of chlorpromazine N-oxide in rat bile.
AB  - 1. The metabolism of chlorpromazine N-oxide was studied in female rats after a 20
      mg/kg single i.p. dose. 2. Metabolites identified in urine and faeces were
      chlorpromazine, 7-hydroxychlorpromazine, chlorpromazine sulphoxide, N
      desmethylchlorpromazine and N-desmethylchlorpromazine sulphoxide. As these same
      five metabolites were previously shown to be present after oral administration
      this indicates that reduction of chlorpromazine N-oxide occurs not only in the
      gastrointestinal tract but also at other sites. 3. The metabolism of
      chlorpromazine N-oxide was studied following its administration by either i.p.,
      i.v. or oral routes to female rats in which the bile duct was cannulated. 4.
      There were no qualitative differences between the three routes of administration
      with respect to the metabolites identified. With the exception of the absence of
      N-desmethylchlorpromazine and N-desmethylchlorpromazine sulphoxide, all
      metabolites previously identified in urine and faeces were also present in bile.
      5. Additionally there were three compounds present in rat bile which were not
      identified in urine or faeces. These were chlorpromazine N-oxide, chlorpromazine
      N,S-dioxide and 7-hydroxychlorpromazine O-glucuronide. This is the first
      unequivocal evidence for the identification of intact 7-hydroxychlorpromazine O
      glucuronide in any species. 6. The inability to detect chlorpromazine N-oxide and
      chlorpromazine N,S-dioxide in the faeces of rats is likely to be due to the
      reduction of the N-oxide group on the passage of these biliary metabolites down
      the intestinal tract.

PMID- 1763520
TI  - Inhibition and induction of drug metabolism by psoralens: alterations in duration
      of sleep induced by hexobarbital and in clearance of caffeine and hexobarbital in
      mice.
AB  - 1. Hexobarbital (100 mg/kg i.p.) sleeping times in male CD-1 mice pretreated (-1
      h) with a single i.p. injection of 150 mumol/kg of psoralen or coumarin analogues
      were increased, most markedly (6-fold) by linear, methoxy-substituted psoralens.
      2. Hexobarbital sleeping times of mice which received three daily injections (231
      mumol/kg; 50 mg/kg) of 8-methoxypsoralen (8-MOP) were 44% of controls (corn oil).
      3. The whole-body half-life of caffeine (1 mg) in mice was 10.2, 1.2, and 0.37 h
      following 8-MOP (50 mg/kg per day) x 1, vehicle, and 8-MOP x 3 respectively. 4.
      The whole-body concentrations of hexobarbital (100 mg/kg dose) in mice 30 min
      after dosing were 14.3 +/- 0.9, 8.4 +/- 0.3, and 5.2 +/- 0.5 micrograms/ml (1
      mouse = 150 ml) following 8-MOP (50 mg/kg per day) x 1, vehicle, and 8-MOP x 3
      respectively. 5. It is concluded that, administered acutely, psoralen analogues
      inhibit hexobarbital metabolism in mice; and 8-MOP administered acutely inhibits
      the metabolism of caffeine and hexobarbital, but administered repeatedly
      increases their metabolism.

PMID- 1763521
TI  - The metabolism and excretion of prochloraz, an imidazole-based fungicide, in the
      rat.
AB  - 1. Following oral administration of prochloraz (1-[N-propyl-N-2-(2,4,6
      trichlorophenoxy)ethylcarbamoyl]imidazole) at 100 mg/kg body weight to rats, the
      compound underwent extensive metabolism, the primary route appearing to be
      opening of the imidazole ring followed by hydrolysis of the alkyl chain. The
      major metabolites were 2,4,6-trichlorophenoxyacetic acid and 2-(2,4,6
      trichlorophenoxy)ethanol, which is present mainly as a glucuronide conjugate.
      Ring hydroxylation occurred to produce several minor metabolites. No unchanged
      prochloraz was excreted in the urine. 2. Tissue residues 96 h after dosing were
      generally less than 1 mg prochloraz equivalents/kg tissue. The highest residues
      were found in the liver (2.8-5.1 mg prochloraz equivalents/kg tissue) and kidney
      (1.5-2.1 mg prochloraz equivalents/kg tissue), the principal organs of metabolism
      and excretion. Residues in female rats were generally slightly higher than those
      found in males. 3. The metabolites were quantitatively excreted within 96 h, with
      greater than 50% of the dosed radioactivity being found in the 0-24 h excreta.
      Urinary excretion accounted for 65% dose in male and 41% in female rats,
      respectively.

PMID- 1763522
TI  - Species- and sex-related differences in the plasma clearance and metabolite
      formation of antipyrine. A comparative study in four animal species: cattle,
      goat, rat and rabbit.
AB  - 1. The plasma disposition of antipyrine, and its urinary metabolite pattern, were
      studied in both sexes of four animal species: rat, dwarf goat, rabbit and cattle.
      2. No sex differences in plasma elimination of antipyrine were found in rabbit
      and goat; however, in rat and cattle the effect of sex was marked. As expected,
      male rat showed a higher plasma clearance value than female. In contrast bulls
      showed a significantly lower clearance value than cows. 3. Metabolite patterns
      varied widely from one species to another. The major urinary metabolite in rabbit
      and the two ruminant species was 4-hydroxy-antipyrine (OHA), whereas in rat 3
      hydroxymethylantipyrine (HMA) was quantitatively the most important metabolite.
      4. HMA was excreted in the 24 h urine in larger amounts by male rats than by
      females. Metabolism of antipyrine to HMA was also sexually different in the dwarf
      goat, but in this species females were more active than males. The effect of sex
      on the metabolite pattern in cattle was marked. 5. It is concluded that in
      ruminants there may be xenobiotic metabolic pathways which are under hormonal
      control, just as there are in rats and mice. If hormones influence drug
      metabolism in food-producing animals, residue levels of xenobiotics or their
      metabolites in food from animal origin may differ with the sex of the animal, or
      may be altered after treatment with anabolic hormones.

PMID- 1763523
TI  - Identification of novel phencyclidine metabolites formed in vitro by rabbit
      microsomal metabolism.
AB  - 1. Phencyclidine (PCP) was incubated with rabbit liver and brain microsomal
      fractions, and the structures of metabolites formed by oxidation determined by
      g.l.c.-mass spectrometry. 2. The formation of several known mono- and di
      hydroxylated metabolites, as well as two new metabolites, was seen in the liver
      preparations. 3. Hydroxylated PCP metabolites were also formed after incubation
      of PCP with brain microsomes, indicating that PCP biotransformation may occur in
      the brain itself.

PMID- 1763524
TI  - Thebaine O-demethylation to oripavine: genetic differences between two rat
      strains.
AB  - 1. Codeine O-demethylation to morphine is mediated by cytochrome P450 IID1 (rat),
      or P450 IID6 (man), and exhibits genetic polymorphism. Thebaine is a precursor in
      the formation of endogenous morphine and codeine in man, being O-demethylated to
      oripavine. 2. The objective of the present study was to ascertain whether the O
      demethylation of thebaine to oripavine was mediated by cytochrome P450 IID1 in
      rat liver microsomes. 3. Thebaine O-demethylation showed strain differences in
      female Sprague-Dawley (SD) and female Dark-Agouti (DA) rats, which serve as a
      model for the human debrisoquine/sparteine metabolism phenotypes. 4. The total
      intrinsic clearance of thebaine to oripavine was high (19.7 ml/h per mg protein)
      in SD rats, indicating that oripavine is a major metabolite of thebaine. A 3-fold
      lower intrinsic clearance was observed in DA rats (6.7 ml/h per mg protein). 5.
      Thebaine O-demethylation was inhibited by quinine and known substrates of
      cytochrome P450 IID1/P450 IID6, supporting the major involvement of cytochrome
      P450 IID1 in oripavine formation in rats.

PMID- 1763525
TI  - Comparative pharmacokinetics and bioavailability of oxolinic acid and
      oxytetracycline in rainbow trout (Oncorhynchus mykiss).
AB  - 1. The pharmacokinetics and bioavailability of oxolinic acid and oxytetracycline
      were studied in rainbow trout at a water temperature of 16 degrees C after
      intravascular (10 and 20 mg/kg, respectively) and oral (75 mg/kg) dosing. 2. The
      pharmacokinetics were best described by a two-compartment open model giving
      distribution half-lives of 0.31 h and 1.53 h, and elimination half-lives of 69.7
      h and 60.3 h for oxolinic acid and oxytetracycline, respectively. The respective
      volumes of distribution (Vdarea) were 1.94 l/kg and 1.34 l/kg. 3. The apparent
      oral bioavailability for oxolinic acid and oxytetracycline was 13.6% and 5.6%. 4.
      The plasma protein binding was 27% for oxolinic acid and 55% for oxytetracycline.
      5. Both drugs were well tolerated, the acute oral toxicities (LD50) exceeding
      4000 mg/kg.

PMID- 1763526
TI  - Identification of a hydroxy metabolite of diflunisal in rat and human urine.
AB  - 1. A new metabolite of diflunisal, a hydroxy derivative, has been identified in
      rat and human urine following administration of diflunisal. 2. This hydroxy
      metabolite of diflunisal is excreted in urine of both species as a polar
      conjugate, most likely a sulphate. 3. Attempts to isolate the polar conjugate in
      pure form were unsuccessful due to its rapid hydrolysis in the presence of acid,
      and organic solvents such as diethyl ether. Its breakdown product, however, was
      more stable and was isolated and purified by semi-preparative h.p.l.c.
      Unequivocal identification as 3-hydroxy-diflunisal (i.e. hydroxylation in
      position 3 of the salicylic acid ring) was accomplished by means of FAB-mass
      spectrometry and n.m.r. spectroscopy. 4. The contribution of this oxidative
      metabolic pathway to the overall elimination scheme of diflunisal is more
      important in rat than in man. Gunn rats excrete more of the hydroxy diflunisal
      conjugate in urine (20-30% of a 50 mg/kg i.v. dose of diflunisal) than Wistar
      rats. In healthy humans, hydroxylation of diflunisal contributes only to a small
      extent to the overall biotransformation of diflunisal.

PMID- 1763527
TI  - Absence of phenolic glucuronidation and enhanced hydroxylation of diflunisal in
      the homozygous Gunn rat.
AB  - 1. The disposition of diflunisal (DF) was investigated in bile-exteriorized and
      intact homozygous Gunn rats given 10 and 50 mg/kg doses i.v. and in Wistar rats
      given 10 mg/kg doses i.v. 2. In Gunn rats, DF sulphate, DF acyl glucuronide, and
      a hitherto unidentified metabolite of DF, a conjugate of 3-hydroxy-DF, were
      identified as the major metabolites, accounting for approximately 37%, 16% and
      11% respectively of 10 mg/kg doses and 35%, 24% and 15% respectively of 50 mg/kg
      doses in bile-exteriorized animals. There was no evidence for formation of DF
      phenolic glucuronide. 3. Total plasma clearance of DF and formation clearances of
      DF to DF sulphate and 3-hydroxy-DF were little affected by increase of dose from
      10 to 50 mg DF/kg, whereas formation clearance of DF to DF acyl glucuronide was
      increased, but not significantly. 4. In Gunn rats with undisturbed bile flow into
      the gut, recoveries of DF sulphate and total 3-hydroxy-DF in urine increased to
      approximately 48% and 25% dose respectively at the expense of DF acyl glucuronide
      through enterohepatic recirculation. 5. In bile-exteriorized Wistar rats, DF
      phenolic glucuronide, DF acyl glucuronide, DF sulphate and 3-hydroxy-DF accounted
      for 16%, 27%, 14% and 2%, respectively, of 10 mg/kg doses. In intact Wistar rats,
      urinary recoveries of the metabolites were 15%, 13%, 23% and 5%, respectively. 6.
      Thus in comparison to Wistar rats, phenolic glucuronidation of DF was absent or
      negligible in homozygous Gunn rats, acyl glucuronidation was significantly
      decreased, sulphation was unchanged, and the 3-hydroxylation of DF was
      significantly enhanced.

PMID- 1763528
TI  - Toxicity of colistin in cystic fibrosis patients.
AB  - Pulmonary exacerbations of cystic fibrosis associated with strains of Pseudomonas
      aeruginosa that are resistant to multiple antibiotics are becoming increasingly
      common. The search for treatment alternatives continues and may include the
      reexamination of older antibiotics. Colistin sulfate is a polypeptide antibiotic
      with good activity against P. aeruginosa. Although its use was largely
      discontinued in the early 1970s because of reports of frequent renal and
      neurologic toxicity, intravenous colistin is often prescribed at our institution
      for patients with P. aeruginosa resistant to multiple-drug therapy. We
      prospectively monitored 19 patients during 21 courses of colistin therapy to
      identify the character and incidence of this agent's toxicity. Only one case of
      renal toxicity occurred. Six cases of neurotoxicity occurred, which were
      characterized by perioral paresthesia, ataxia, or both. The rate of intolerable
      renal adverse effects secondary to colistin therapy was appreciably lower among
      these patients than that reported previously for other patients. It appears that
      intravenous colistin can be considered for cystic fibrosis patients with strains
      of P. aeruginosa that are resistant to more commonly used antibiotics.

PMID- 1763529
TI  - Pentamidine-associated nephrotoxicity and hyperkalemia in patients with AIDS.
AB  - The incidences of pentamidine-associated nephrotoxicity and hyperkalemia were
      determined from a retrospective review of records in AIDS patients using standard
      definitions for both toxicities. There were 37 patients, mean age 35.6 +/- 7.7
      years and mean initial creatinine clearance (Clcr) 96 mL/min (1.6 mL/s). The mean
      pentamidine dose was 255 +/- 60 mg/d (3.87 +/- 0.33 mg/kg/d). The mean total dose
      was 2900 +/- 1600 mg given over 11.6 +/- 5.9 days (range 3-21 d). In 28 patients
      who were nephrotoxic (8 mild, 6 moderate, 14 severe), 27 episodes were possibly
      or probably pentamidine-associated. Total dose and days to nephrotoxicity onset
      were 1570 +/- 710 mg and 6.4 +/- 2.8 days (range 2-15 d), respectively. Nine
      patients became hyperkalemic (one required countermeasures) and all cases were
      pentamidine-associated. Total dose and days to hyperkalemia onset were 2510 +/-
      1460 mg and 9.2 +/- 4.9 days (range 3-16 d), respectively. Mean baseline
      potassium increased and Clcr decreased significantly during therapy (from 4.2 to
      4.9 mEq/L and from 96 to 70 mL/min, respectively). No correlation between
      nephrotoxicity or hyperkalemia and initial renal function was found, but
      significant correlations were found between the total pentamidine dose or
      duration and the percent of renal function remaining. AIDS patients have a high
      incidence of pentamidine-associated nephrotoxicity (up to 73 percent) and
      hyperkalemia (24 percent) with a trend to earlier onset of the former.

PMID- 1763530
TI  - Amantadine neurotoxicity in a pediatric patient with renal insufficiency.
AB  - Amantadine hydrochloride, a dopamine agonist with antiviral and antiparkinsonism
      properties, is used for the prevention and treatment of influenza A respiratory
      infections in high-risk populations. The occurrence of amantadine-induced
      hallucinations and tremors is described in a young, renal transplant patient with
      declining renal function. Following discontinuation of amantadine, plasma
      amantadine concentrations were correlated with central nervous system toxicity.
      In view of the usage of amantadine in renal transplant recipients and the
      elderly, clinicians must be alert to the possibility of amantadine-induced
      neurotoxicity in patients with changing renal function.

PMID- 1763531
TI  - Hypotension and bradycardia possibly associated with intraocular injection of
      acetylcholine.
AB  - Topically applied drugs are an important part of the pharmacologic management of
      cataract extraction and lens implant surgery. Acetylcholine facilitates this
      procedure via its miotic effect on the ciliary body of the eye. Systemic effects
      can occur with topically administered ophthalmic medications. Acetylcholine has
      been implicated in several cases of systemic cholinergic effects, such as
      hypotension, bradycardia, and bronchospasm, following intraocular administration.
      The patients we present experienced profound hypotension and bradycardia
      occurring up to 45 minutes after intraocular injection of acetylcholine. Both
      patients were over 90 years of age and had a history of first-degree
      atrioventricular block. As cataract surgery and lens implantation become more
      prevalent in the older ambulatory segment of the geriatric population, healthcare
      professionals should be aware that these patients may be more sensitive to the
      pharmacologic effects of medication used during surgery. Monitoring for adverse
      effects must be performed intraoperatively and several hours postoperatively.
      Additionally, patients with known conduction abnormalities prior to surgery
      should be monitored closely and proper emergency equipment and personnel should
      be available. Pharmacists who investigate adverse drug reactions should consider
      ophthalmic medications as potential causes for unexplained or suspected adverse
      drug reactions.

PMID- 1763532
TI  - Ofloxacin during the second trimester of pregnancy.
AB  - Ofloxacin can cause retarded ossification and arthropathy in young animals, but
      there is no published information about its teratogenicity in humans. A 36-year
      old woman was treated with ofloxacin 200 mg bid for 6 days during the 19th week
      of gestation. Ultrasound follow-up of the measurements and structure of the fetal
      long bones revealed no abnormalities. The neonate's physical examination and X
      rays of the chest and long bones were normal. Although no teratogenic or toxic
      effects were observed in this patient, the use of ofloxacin in human pregnancy
      should only be a clinical consideration until sufficient evidence regarding its
      safety in the human fetus has been published.

PMID- 1763533
TI  - Naproxen-induced recurrent aseptic meningitis.
AB  - Aseptic meningitis has been linked to treatment with several nonsteroidal
      antiinflammatory drugs (e.g., ibuprofen, tolmetin, sulindac), particularly in
      patients with disturbed immunity. Naproxen, however, has only once been reported
      to cause meningitis. We report a case of recurrent aseptic meningitis related to
      prolonged naproxen usage in a 38-year-old woman with longstanding, minimally
      symptomatic systemic lupus erythematosus (SLE). Two years after starting
      naproxen, she experienced three separate episodes of meningitis within a period
      of 10 months; each episode was preceded by resumption of naproxen administration
      or an increase in drug dosage. There was no clinical or serologic evidence for
      the flare-ups of her SLE. Discontinuation of naproxen was followed by prompt
      recovery once the relationship of the drug to her symptoms was realized. Off the
      drug, the patient has remained free of meningeal symptoms for more than 18
      months. Nonsteroidal antiinflammatory agents should be considered as possible
      causal agents in evaluating meningitis of obscure etiology.

PMID- 1763534
TI  - Calcitonin in migraine.

PMID- 1763535
TI  - Talc in the treatment of malignant pleural effusion.

PMID- 1763536
TI  - Warfarin and the international normalized ratio: reducing interlaboratory
      effects.
AB  - In North America, the dose of warfarin has been unintentionally increased during
      the past two decades because of failure to recognize the effect on the
      anticoagulation test of less sensitive tissue thromboplastins. Although there
      still is some controversy, the suggested dose of warfarin has now been adjusted
      downward to reduce the risk of bleeding. These revised dosing recommendations
      incorporate the international normalized ratio (INR), which takes into account
      the source of thromboplastin. However, there is considerable variability in the
      sensitivities of thromboplastin from manufacturer to manufacturer and lot to lot.
      Therefore, prothrombin times (PTs) are not comparable from laboratory to
      laboratory without knowing the sensitivity of the thromboplastin. Unless
      laboratories adopt a standardized tissue thromboplastin, the PT should be
      reported as an INR.

PMID- 1763537
TI  - Felodipine: a new dihydropyridine calcium-channel antagonist.
AB  - Felodipine, a dihydropyridine calcium-channel antagonist, significantly reduces
      systolic and diastolic blood pressure (BP) in patients with hypertension and has
      been associated with beneficial hemodynamic effects in patients with chronic
      stable angina pectoris or congestive heart failure (CHF). In hypertensive
      patients, felodipine does not appear to significantly affect glomerular
      filtration rate, creatinine clearance, glucose tolerance, or plasma lipoprotein
      concentrations. Studies comparing felodipine with other agents as monotherapy in
      mild to moderate hypertension have demonstrated felodipine to be at least as
      efficacious as hydrochlorothiazide (HCTZ) and HCTZ plus amiloride hydrochloride
      in combination. Comparisons of felodipine with other agents as adjuncts to beta
      blocker or diuretic therapy have shown felodipine to be at least as effective as
      HCTZ, propranolol hydrochloride, prazosin hydrochloride, and nifedipine.
      Evaluations of patients with chronic stable angina are limited, and additional
      studies are needed before felodipine can be recommended for the routine
      management of angina pectoris. Similarly, additional studies are essential to
      delineate the role of felodipine, if any, in the management of CHF. In the
      management of hypertension, felodipine 5-40 mg/d significantly reduces systolic
      and diastolic BP. Although some patients may be controlled throughout the entire
      dosing interval when felodipine is administered bid, many patients will require
      more frequent dosing to obtain adequate BP control. Adverse effects associated
      with felodipine are similar to those of other dihydropyridine calcium-channel
      antagonists and include peripheral edema, headache, dizziness, flushing, and
      fatigue. A potentially clinically important drug interaction was observed when
      felodipine was administered concomitantly with theophylline aminopropanol;
      significant decreases in theophylline concentrations were noted. In summary,
      felodipine appears to be safe and effective for the management of hypertension
      when used alone or in combination with other antihypertensive agents. The
      efficacy of felodipine in the management of chronic stable angina pectoris and
      CHF requires further investigation.

PMID- 1763538
TI  - Treatment of attention deficit hyperactivity disorder: a critical review.
AB  - This review evaluates the treatment of attention deficit hyperactivity disorder.
      Current evidence supports the belief that stimulants are the most effective and
      least toxic of the drugs used in the treatment of hyperactivity. Tricyclic
      antidepressants (TCAs), however, are preferable in subpopulations with
      concomitant anxiety or depressive disorders. Studies comparing stimulants with
      TCAs are evaluated and studies that have examined other antidepressants are
      summarized. In addition, TCAs and stimulants are compared according to adverse
      effect profiles, pharmacokinetic properties, and subgroup responses. Based on
      these data and the recently reported sudden deaths in children receiving
      desipramine, treatment recommendations are made.

PMID- 1763539
TI  - The effect of renal failure on hepatic drug clearance.
AB  - It is known that loss of renal function decreases the hepatic clearance of some
      drugs, but the mechanisms by which this occurs are unclear. Knowledge of which
      drugs display reduced hepatic metabolism may be important for appropriate dosing
      of these drugs in uremic patients. Although no firm conclusions can be made
      regarding common pharmacokinetic and metabolic characteristics of drugs that
      display decreased hepatic metabolism in renal failure, certain observations
      deserve consideration. It appears that drugs metabolized by oxidation,
      conjugation, or both may be predisposed to decreased hepatic clearance in renal
      failure. Drugs that undergo oxidation by the P-450IID6 isozyme may be more likely
      to exhibit inhibition whereas those metabolized by the P-450IIIA4 isozyme may be
      spared. Future studies designed to clarify the mechanisms of decreased hepatic
      clearance in renal failure should take into account the multiplicity of P-450
      enzymes for drugs that are oxidatively metabolized. The phenomenon of reduced
      hepatic drug clearance in uremia should be considered when evaluating the
      influence of renal failure on drug disposition.

PMID- 1763540
TI  - Charge and reimbursement analysis for intensive care unit patients in a large
      tertiary teaching hospital.
AB  - Hospital charge and reimbursement data were analyzed for 115 patients admitted to
      the surgical intensive care and burn-trauma units at Brigham and Women's Hospital
      over a two-month study period. A skewed distribution of hospital charges resulted
      in mean and median charges of $43,068 and $29,081, respectively. Major
      differences were observed in total charges among major diagnostic groups. The
      median charge was highest in orthopedic trauma and neurosurgery patients. The
      median charge across major diagnostic groups correlated with the length of stay
      in the unit and in the hospital, and the number of drugs used. The median percent
      reimbursement from private providers, Medicaid, Medicare, and health maintenance
      organizations was 93, 55, 40, and 30 percent, respectively, and 55 percent
      overall. Reimbursement was high from private providers regardless of major
      diagnostic group. Medicare reimbursement through the diagnostic reference group
      system was considerably higher in cardiothoracic patients (77 percent) than in
      other major diagnostic groups. The discrepancy between charge and Medicare
      reimbursement in these patients was consistent with that reported for intensive
      care units in other hospitals, thereby underscoring the need for cost containment
      and more realistic reimbursement methods.

PMID- 1763541
TI  - The safety, efficacy, and tolerability of cefuroxime axetil suspension in infants
      and children receiving previous intravenous antibiotic therapy.
AB  - The tolerability, safety, and efficacy of cefuroxime axetil suspension was
      studied in 36 children (aged 3 mo to 12 y) who had been hospitalized for
      respiratory tract or soft-tissue infections. After receiving parenteral
      antibiotics for a mean of 3.7 days, children were discharged home to receive
      cefuroxime axetil suspension at doses of 10, 15, or 20 mg/kg every 8 or 12 hours
      for a mean of 8.2 days. One child was lost to follow-up. Three of 35 evaluated
      patients were withdrawn from therapy because of adverse events, one of which was
      a drug-related hypersensitivity reaction. Of the 32 children who completed
      therapy, 9 developed mild reactions including oral thrush, diarrhea, or diaper
      dermatitis; none were withdrawn from therapy. Complete clinical cure occurred in
      28 children (80 percent); 4 (11.4 percent) were clinically improved but still
      required an additional antibiotic within one week of completing therapy with
      cefuroxime axetil suspension. This favorable tolerability and safety of
      cefuroxime axetil suspension warrants further efficacy trials in pediatric
      patients.

PMID- 1763542
TI  - Quinolone-cation interactions: a review.
AB  - The quinolone class of antibiotics is enjoying a recent resurgence in interest
      and use due to the development of improved compounds. Norfloxacin, ciprofloxacin,
      and, most recently, ofloxacin have been marketed. Enoxacin and other agents are
      in various stages of investigation. These newer compounds are often used for
      indications not successfully treated by the original quinolones, or in some
      cases, not optimally treated with any previously available oral antibiotic. A
      potential problem with the increasing use of quinolone-type antibiotics for
      systemic illness is the chelation and inactivation of these compounds by several
      cations. One outcome of these potential interactions is a possible reduction in
      bioavailability and effectiveness of quinolone compounds. A review of the
      literature on quinolone-cation interactions, in vivo and in vitro significance,
      and recommendations to avoid potential problems are provided.

PMID- 1763543
TI  - Tryptophan toxicity: a pharmacoepidemiologic review of eosinophilia-myalgia
      syndrome.
AB  - Tryptophan, an essential amino acid commercially available as a dietary
      supplement, has been implicated in the development of a new and potentially fatal
      clinical entity: eosinophilia-myalgia syndrome (EMS). EMS reached epidemic
      proportions in the US in late 1989 and early 1990, with 1536 cases and 27 deaths
      reported as of August 1990. Features of the syndrome include intense,
      debilitating myalgias and marked peripheral eosinophilia. Vasculitis, neuropathy,
      and pulmonary involvement also may be observed but are not pathognomonic. Death
      typically ensues from ascending polyneuropathy with resulting paralysis and
      respiratory arrest. Treatment involves discontinuation of tryptophan ingestion.
      Administration of prednisone may not always alleviate or reverse the symptoms.
      Recovery is generally slow. The etiology of EMS has been traced to a contaminant
      in the bulk manufacturing process of tryptophan by a single Japanese company.
      Efforts are currently underway to confirm the structure of the contaminant by
      laboratory synthesis and to define its biologic and toxic effects using an animal
      model for EMS.